V.\fc^v Metropolitan Borough of Paddington REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1951 A. B. STEWART, M.D., D.P.H. CONTENTS PAGE PAGE Aged and Infirm Persons 11 Ice-cream—see " Food " Bakehouses 14 Infectious Disease Births 5 Bacteriological Examinations 8 Borough: Notifications 8 Area 4 Visiting 8 Houses in 4 Legal Proceedings 14 Population 4 London County Council (General Powers) Act 15 Rateable value 4 Marriages 5 Burials 11 Mass Radiography 17 Canal Boats 14 Medicinal Baths 11 Chest Clinic 10 Milk—see " Food " Clean Food Campaign 18 Mortuary 11 Common Lodging Houses 14 National Assistance Acts 11 Cremations. 11 Outworkers 13 Deaths: Pharmacy and Poisons Act 14 Classification 6, 7 Pigeons .12 Infantile 5 Population 4 Maternal 5 Rag Flock Act 15 Rates 5 Rateable Value 4 Sex-age Distribution 6, 7 Rent (Restrictions) Acts 14 Statistics Summary 5 Rodent Control 14 Tuberculosis 10 Sampling 15 Disinfecting Station 11 Sanitary Work :— Disinfection 11 Complaints 13 Drainage Reconstruction Plans 14 Notices. 13 Factories 12 Visits 13 Food Work carried out 13 Bacteriological Examinations 16 Shops Acts 17 Food Poisoning 16 Slaughtermen 15 Food Premises 17 Smoke nuisance 12 Labelling 16 Staff . Marking 16 Stillbirths 5 Milk Licences 17 Tuberculosis:— Samples 15 Chest Clinic 10 Unsound Food 16 Deaths 10 Fumigation 11 Notifications 9 Holiday Home 18 Numbers and Rates 10 Housing : Sex-age Distribution 9 Accommodation 19 Ward Distribution 10 Basements 18 Venereal Disease 11 Closed Premises 18 Verminous Persons 11 Compulsory Repairs 19 Verminous Premises 11 Overcrowding 19 Vital Statistics 4 Unfit Houses 18 Water Supply 11 Except where otherwise indicated, the figures in brackets throughout this Report are the figures for 1960, and are shown for comparison. 3 His Worship the Mayor, Aldermen and Councillors of the Metropolitan Borough of Paddington. Mr. Mayor, Ladies and Gentlemen, I have pleasure in submitting my annual report for the year 1951. The vital statistics for the year show a slight rise in the birth rate and the death rate in infants remains at a very low level. There has been a distinct rise in the death rate, but it is not possible to attribute this rise to any particular disease. It will be noted that in the abridged list of causes of death the miscellaneous group, classified as "Other Diseases," has increased from 135 to 152. The total number of deaths from tuberculosis has increased slightly, but the number of new cases is reduced. The reader will notice an increase in the number of notifications of puerperal pyrexia. This increase is due to the new method of notification. Previously, cases which occurred in hospital had the notification transferred to the place of residence of the patient. The new regulations have the effect of making the notifications of hospital cases refer to the borough in which the hospital is situated; having two large hospitals with maternity departments, this borough has had a considerable increase in the number of cases of puerperal pyrexia. This does not mean that there has been any general increase in the number of cases, and in future it will be possible to obtain this information only by reference to the figures published for the country as a whole. The number of notified cases of food poisoning or suspected food poisoning shows a substantial increase, but it should be noticed that notification of this disease includes not only food poisoning but suspected food poisoning, and to a considerable degree the large number of notifications is due to the keenness and care of the practitioners in the borough. The great majority of the cases on investigation have been found to be digestive upsets of varying kinds and not due to infection. The body of the report contains details of one fatal case which occurred during the year. Although every effort was made to trace the source, this remained a matter for conjecture. The volume of complaints dealt with by the District Sanitary Inspectors shows a reduction, and it has been possible to undertake more detailed work in the dwelling houses inspected, and as a result of follow-up letters, subsequent to notices being served, it has been possible to effect more repairs without recourse to legal proceedings. Housing accommodation in the borough remains a source of anxiety to the Public Health Department. Since 1945 the greatest possible attention has been paid to this problem in the borough, and the past, present, and future building programmes indicate that the Council has taken all possible steps, within its powers, to improve the housing position. From the Public Health point of view, however, having regard to what has been achieved and what is proposed and practicable for the future, and having consideration for the deterioration taking place in much of the property in the borough, it does not seem that houses are being built fast enough to replace obsolete houses. The position is aggravated by the present high cost of repairs in relation to controlled rents, and the work which this Council can carry out under the Housing Act to render properties reasonably fit will be liable to greater restriction in the future by reason of the work being considered uneconomical. This is a problem which affects many other Authorities, in some cases perhaps more acutely than in Paddington. The solution to the problem is not one for the Public Health Department alone, but is intimately connected with finance. The only possible solution to the problem would appear to be a complete reorientation of our views as to what constitutes a reasonable financial outlay in the repair of existing properties. The London County Council (General Powers) Act, which is mentioned elsewhere in this report, gives some help in this direction, but to tackle this problem effectively the Council would require substantial financial backing and wider powers if full use is to be made of existing buildings. During the year steps were taken towards providing better facilities in the Council's mortuary, and it is anticipated that work will commence shortly. My thanks are due, not only to all members of the Public Health staff, but to the other Chief Officers and to many members of the Council staff in other departments for their support and co-operation during the year. 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 4 PUBLIC HEALTH OFFICERS (on December 31st, 1951).— Medical Officer of Health:— A. B. Stewart, M.D., D.P.H. Clerical Staff:— S. W. Ruffey (Chief Clerk) A. J. O. Sheppard 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 E. Craddock T. New A. W. Haskey Miss D. Smeaton (Medical Officer's Secretary) Mrs. L. Walters Miss P. Goldenberg Public Analyst:— C. H. Wordsworth, B.Sc., F.R.I.C. Sanitary Inspectors:— C. G. Heron (Senior Sanitary Inspector) V. L. Ronchetti E. B. Wilde F. J. Pallet (Chief Food Inspector) E. Marshall A. C. Harrison (Food Inspector) G. Duncan W. H. G. Atkins J. Mains G. A. Fraser V. A. Vickers C. Chesterman D. B. Hooper B. W. James R. Fowler D. B. Mills L. H. Whanslaw Miss E. Z. Amor Health Visitor:— Miss K. Brennand Mortuary Superintendent:— C. C. Lewis Rodent Officer:— W. A. Dunkley Assistant Mortuary Superintendent E. F. Crabb Holiday Home:— Mrs. G. Hoskings (Manageress) and three whole-time and one part-time Domestic Staff. In addition there are eleven Disinfecting, Fumigation and Rodent operatives and two Groundsmen. VITAL STATISTICS—1951. Area of Borough : 1,356 acres including 20 acres of waterways. Population : The Registrar-General's estimate of the population at the middle of the year was 125,400 (130,600). Inhabited houses : 23,319 (22,819) at the end of the year according to the Rate Books. Rateable value : £1,773,718 (£1,772,008). The product of a penny rate is £7,104 (£6,996). Rate in the £ levied : 19s. Od. (18s. 6d.). 5 Males Females Total Live Births. Legitimate 987 (945) 889 (941) 1,876 (1,886) Illegitimate 142 (146) 137 (124) 279 (270 Total 1.129 (1,091) 1,026 (1,065) 2,155 (2,156) Stillbirths. Legitimate 22 (19) 18 (16) 40 (35) Illegitimate 7 (2) 5 (4) 12 (6) Total 29 (21) 23 (20) 52 (41) Deaths. Under one year of age:— Legitimate 32 (30) 13 (20) 45 (50) Illegitimate 7 (9) 9 (3) 16 (12) Total 39 (39) 22 (23) 61 under lour weeks of age:— Legitimate 21 (15) 7 (15) 28 (30) Illegitimate 5 (7) 7 (3) 12 (10) Total 26 (22) 14 (18) 40 (40) Maternal _ (-) 3 (-) 3 (—) All ages 755 (704) 764 (693) 1,519 (1,397) Rates:— Live birth rate per 1,000 estimated population 17.19 (16.51) Stillbirth rate per 1,000 (live and still) births 23.56 (18.66) Infant deaths under one year of age— All infants per 1,000 live births 28 (29) Legitimate infants per 1,000 legitimate live births 24 (27) Illegitimate infants per 1,000 illegitimate live births 57 (44) Infant deaths under four weeks of age All infants per 1,000 live births 19 (19) Legitimate infants per 1,000 legitimate live births 15 (16) Illegitimate infants per 1,000 illegitimate live births 43 (37) Maternal death rate per 1,000 (live and still) births 1.36 (-) Death rate (all ages) per 1,000 estimated population . 12.11 (10.70) County of London Birthrate .. 17.8(17.8) Death rate 13.1 (11.8) England and Wales Birth rate .. 15.5 (15.8) Death rate . 12.5 (11.6) 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 7 3.97 68 0.68 1946 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 1 1.24 81 0.63 1949 130,640 2243 17.17 1489 11.39 58 36 3 0.87 85 0.65 1950 130,600 2156 16.51 1397 10.70 58 29 2 0.00 55 0.42 1951 125,400 2155 17.18 1519 12 11 61 28 8 1.36 58 0.40 * Corrected figures after allowing for inward and outward transfers MARRIAGES.—The number of marriages solemnised in the Borough during the year was 1,635 (1,608). DEATHS.—In the following table 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. For comparison, a similar table relating to the year 1950 is given. 6 Deaths, 1951.—Abridged List of Causes of Death, and Sex-Age Distribution. Cause of Death All Ages Deaths at Ages 0— 1— 5- 15— 25— 45— 65— 75— M. F. Total M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Pulmonary tuberculosis 31 24 55 1 1 — 1 3 8 10 14 5 9 2 — 1 Other tuberculous diseases 2 1 3 — — 1 — — — — — — 1 — — — — 1 — Syphilitic diseases 7 5 12 — — — — — — — — — — 3 3 3 2 1 — Diphtheria — — — — — — — — — — — — — — — — — — — Whooping cough 2 — 2 1 — 1 — — — — — — — — — — — — — Meningococcal infections — — — — — — — — — — — — — — — — — — — Acute poliomyelitis — — — — — — — — — — — — — — — — — — — Measles — — — — — — — — — — — — — — — — — — — Other infective and parasitic diseases 1 2 3 — — — — 1 — — — — — — 1 — 1 Malignant neoplasm of the stomach 21 16 37 — — — — — — — — 3 — 12 5 3 6 3 5 Malignant neoplasm of the lung and bronchus 41 8 49 — — — — — — — — 2 — 26 4 8 2 5 2 Malignant neoplasm of the breast — 34 34 — — — — — — — — 1 — 4 — 18 — 6 — 6 Malignant neoplasm of the uterus _ 10 10 — — — — — — — — — — — — — 5 — 3 Other malignant and lymphatic neoplasms 70 64 134 1 — 1 — — — — — 4 7 32 11 18 23 14 23 Leukaemia and aleukaemia 5 3 8 — — — — — — — — 2 1 1 1 2 — — 1 Diabetes 3 6 9 — — — — — — — — — — 2 1 1 3 — 2 Vascular lesions of nervous system 44 106 150 — — — — — — — — 2 10 17 13 32 21 55 Coronary disease, angina 119 62 181 — — — — — — — — 5 2 49 13 42 27 23 20 Hypertension with heart disease 33 31 64 — — — — — — — — — 8 4 17 8 8 19 Other heart diseases 68 104 172 — — 1 — — — — 1 3 2 13 11 14 17 37 73 Other circulatory diseases 23 33 56 — — — — — — — — 2 — 5 3 8 10 8 20 Influenza 10 15 25 1 2 3 2 7 5 5 Pneumonia 34 39 73 2 4 1 1 1 2 5 10 12 18 17 Bronchitis 67 47 114 — 1 — — — — — 1 6 o 17 8 23 13 21 22 Other diseases of the respiratory system 13 7 20 — — — — 1 — — — — — 6 1 2 3 4 3 Ulcer of stomach and duodenum 15 5 20 — — — — — — — — 2 1 5 1 6 1 2 Gastritis, enteritis and diarrhoea 2 2 4 1 — — — — — — — 1 1 1 — Nephritis and nephrosis 10 8 18 — — — — — — — — 1 1 7 1 1 2 1 4 Hyperplasia of the prostate 12 — 12 — — — — — — — — — — — — 6 — 6 — Pregnancy, childbirth and abortion 3 3 — — — — — — — 1 — — — — — — — — Congenital malformations 7 12 19 3 4 1 1 — 1 — — 1 1 2 4 — — — 1 Other diseases 74 78 152 27 10 1 I — — — — 3 3 18 12 9 18 16 34 Motor vehicle accidents 7 4 11 — — — — — — 2 — I— — 2 2 — 1 3 1 Other accidents 16 25 41 3 2 1 — 2 — 3 2 3 4 2 3 1 4 1 10 Suicide 17 8 25 — — — — — — — — 5 — 10 6 — 1 2 1 Homicide and operations of war 1 2 3 — — — — — — — — 1 — — 1 — — — 1 All Causes (Totals) 755 764 1,519 39 22 8 3 4 2 5 8 52 45 248 146 198 207 201 331 7 Deaths, 1950.—Abridged List of Causes of Death, and Sex-Age Distribution. Cause of Death All Ages Deaths at Ages 0— 1— 5— 15— 25— 45— 65— 75— M. F. Total M. F. M. F. M. F. M. F M. F. M. F. M. F. M. F Pulmonary tuberculosis 35 18 53 1 — — — — 3 1 5 7 16 8 8 2 2 — Other tuberculous diseases — — 2 — — 1 — — — — — — — — — — — — — Syphilitic diseases 8 6 14 — — — — — — — — 1 4 4 2 2 1 — Diphtheria — — — — — — — — — — — — — — — — — — — Whooping cough — — — — — — — — — — — — — — — — — — — Meningococcal infections — — — — — — — — — — — — — — — — — — — Acute poliomyelitis 1 — 1 — — — — — — — — — — — — — — — — Measles — — — — — — — — — — — — — — — — — — — Other infective and parasitic diseases 2 2 4 1 — — — — — — 1 — 1 — — 1 — Malignant neoplasm of the stomach 24 15 39 — — — — — — — — 1 2 10 4 9 4 4 5 Malignant neoplasm of the lung and bronchus 36 12 48 — — — — — — — — 3 1 18 6 13 3 2 2 Malignant neoplasm of the breast — 32 32 — — — — — — — — — 3 — 12 — / — 10 Malignant neoplasm of the uterus 11 11 — — — — — — 1 — 5 — 2 — 3 Other malignant and lymphatic neoplasms 71 66 137 — — — — — — — 1 6 6 23 22 22 21 20 16 Leukaemia and aleukaemia 4 — 4 — — — — — — — — — 1 1 — — — — — Diabetes 3 4 7 — — — — — — — — — 1 1 1 2 1 — 1 Vascular lesions of nervous 49 88 137 — — — — — — — — — 2 10 18 17 28 22 40 Coronary disease, angina 102 66 168 — — — — — — — — 2 1 46 10 29 24 25 31 Hypertension with heart disease Other heart diseases 35 72 32 118 67 190 — — — — — — 1 — 6 — 10 8 18 20 37 84 Other circulatory diseases 22 36 58 — — — — — — — — 1 — 5 7 5 10 11 19 Influenza 1 3 4 — — 1 — — — — — — — — — — — — — Pneumonia 35 28 63 3 1 4 1 — — — — 1 — 7 — 11 0 9 19 Bronchitis 54 26 80 1 1 — 1 — — — — 1 — 17 7 18 3 17 14 Other diseases of the respiratory 6 3 9 — — — — — — — — 1 — 2 1 2 — 1 2 Ulcer of stomach and duodenum 12 8 20 — — — — — — — — 1 — 3 4 5 2 3 2 Gastritis, enteritis and diarrhoea 9 4 13 7 2 — — — — — — — — 1 1 — — 1 1 Nephritis and nephrosis 4 11 15 — — — — — — — — — 1 3 1 — 6 1 z Hyperplasia of the prostate 9 — 9 — — — — — — — — — — — — — — — — Pregnancy, childbirth and abortion — — — — — — — — — — — — — — — Congenital malformations 6 8 14 2 2 1 1 — — 1 — — — 1 3 — — — — Other diseases 59 76 135 22 16 2 2 — — — — 3 6 14 20 12 18 6 14 Motor vehicle accidents 5 6 11 — — — 1 1 — — — — — 1 1 — 1 1 3 Other accidents 17 7 24 3 1 — — 2 — 2 — 3 2 4 1 — 6 3 Suicide 19 7 26 — — — — — — 1 — 8 — 5 6 6 1 2 — Homicide and operations of war 2 — 2 — — — — — — — — 1 — — — 1 — — — All Causes (Totals) 704 693 1,397 39 23 10 6 3 1 8 2 47 42 212 161 197 169 188 289 8 INFECTIOUS DISEASE.— Notifications.—Following is a table showing the numbers of cases of infectious disease notified in each year from 1946 to 1951. Commencing with 1948 the actual number of cases after allowing for corrections of diagnoses is shown in brackets. Disease 1946 1947 1948 1949 1950 1951 Acute encephalitis (infective) — — (-) — (—) 1 (1) — (Acute encephalitis (post infectious) — — — (-) — (-) — — 1 (1) Acute pneumonia (influenzal) 20 18 8 (8) 25 (24) 11 (11) 33 (33) Acute pneumonia (primary) 100 67 59 (59) 62 (62) 41 (41) 57 (57) § Acute poliomyelitis (paralytic) — — — (-) — (—) 7 (?) 2 (1) § Acute poliomyelitis (non-paralytic) 2 21 6 (5) 35 (32) 6 (6) 3 (2) Diphtheria 37 20 10 (3) 13 (7) 4 (-) 2 (1) Dysentery 34 8 13 (11) 14 (10) 22 (22) 110 (1(19) Erysipelas 23 27 29 (27) 13 (12) 18 (18) 10 (10) Food poisoning or suspected food poisoning 11 17 16 (16) 24 (23) 41 (38) 69 (69) Infective enteritis 143 128 68 (57) 64 (58) 37 (36) 25 (24) Malaria 9 2 3 (3) 2 (2) 1 (1) 1 (1) Measles 690 960 1,027 (1,023) 568 567) 944 (940) 1,512 1,511) †Meningococcal infection. — — — (-) — (-) 3 (2) 3 (3) Ophthalmia neonatorum 5 4 9 (9) 8 (8) 1 (1) 4 (4) Paratyphoid fever — 1 2 (2) 1 (1) 2 (2) — (-) *Puerperal fever 10 3 1 (1) — (—) — (-) — (-) Puerperal pyrexia 24 16 20 (20) 18 (18) 9 (9) 4J (41) Scabies 726 344 196 (196) 84 (83) 51 (51) 35 (35) Scarlet fever 228 129 147 (134) 127 123) 165 (157) 84 (79) Smallpox — — — (-) 2 (2) — (—) — (-) Typhoid or enteric fever — 2 — (—) 3 (-) 1 (1) — (—) Whooping cough 155 227 254 (250) 131 130) 254 (253) 294 (292) * Ceased to be notifiable on 30.7.48. †Notifiable from 1.1.50. § Not divided between paralytic and non-paralytic before 1950. Bacteriological Examinations.—The number of examinations made in connection with infectious disease was 531 (239) including 41 (33) examinations for tuberculosis. 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. In addition to the visits listed they made 726 (1,477) unclassified calls. Disease Visits Disease Visits Acute encephalitis — (—) Meningococcal infections 15 (3) Chickenpox 403 (191) Pneumonia. 80 (55) Diphtheria 12 (16) Poliomyelitis 22 (51) Dysentery 206 (33) Scabies and lice 347 (686) Erysipelas 17 (16) Scarlet fever 118 (246) Malaria 1 (1) Typhoid fevers 5 (17) Measles 1,660 (1,288) Whooping cough 351 (272) 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. Visits to cases of infectious disease paid by the male Sanitary Inspectors numbered 193 (85) all of which were to smallpox contacts referred to us by Port Authorities or under the Aircraft Regulations. 9 TUBERCULOSIS. Notifications.—Two hundred and thirty three (246) new cases of pulmonary tuberculosis and 32 (23) of non-pulmonary tuberculosis were notified. The number of cases on the Notification Register at the end of the year was 1,211 against 1,213 at the end of 1950. 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 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 128,100 306 23 329 2.6 1949 130,640 305 28 333 2.5 1950 130,600 246 23 269 2.1 1951 125,400 233 82 265 2 .1 Seventy (33) 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 6(6) 3(3) l(-) l (-) Death Returns from Registrar-General -(5) 1(2) -(-) l(-) Posthumous notifications 2(2) 1(-) -(-) -(-) Transfers from other areas (excluding transferable deaths) 29(11) 19(4) 3( ) 3(—) Totals 37(24) 24(9) 4(-) 5(—) The following table shows the age distribution of the 265 (269) new cases:— 0— 1— 2— 5— 10— 15— 20— 25- 35— 45— 55— 65— 75— Total All Ages Pulmonary-Male 1 (-) 1 (2) 4 (1) 4 (5) 1 (3) 5 (8) 12 (12) 40 (38) 29 (29) 11 (21) 14 (10) 10 (5) 1 (1) 133 (135) Pulmonary-Female -(-) 2 (1) 5 (6) 3 (-) 4 (—) 5 (7) 18 (32) 35 (34) 15 (21) 8 (4) 4 (3) 1 (3) - (1) 100 (111) Non-Pulmonary-Male - (1) - (1) 4 (1) 4 (-) —(1) 2 (-) 2 (2) 3 (1) —(-) 3 (-) -(-) — (—) -(-) 18 (7) Non-Pulmonary-Female 1 (-) - (-) 2 (1) 1 (-) 1 (1) 3 (-) 1 (4) 3 (4) 1 (2) 1 (2) " (1) -(-) - (1) 14 (16) Total 2 (1) 3 (4) 15 (8) 12 (5) 6 (5) 15 (15) 33 (50) 81 (77) 45 (52) 23 (27) 18 (14) 11 (8) 1 (3) 265 (269) 10 The ward distribution of the cases notified during 1951 is as follows:— Ward Pulmonary Non-Pulmonary Total Males Females Males Females Queens Park 10 (10) 6 (4) — (1) (3) 16 (18) Harrow Road 27 (21) 15 (20) 4 (1) 3 (1) 49 (43) Maida Vale 16 (23) 16 (19) 5 (1) — (4) 37 (47) Westbourne 25 (29) 23 (20) 2 (1) 3 (3) 53 (53) Church 10 (8) 6 (12) 3 (2) 3 (2) 22 (24) Town 1 (2) 4 (8) - (-) - (—) 5 (10) Lancaster Gate, West 18 (18) 11 (9) 2 (-) 1 (1) 32 (28) Lancaster Gate, East 10 (11) 8 (13) - (— 2 (1) 20 (25) Hyde Park 16 (13) 11 (6) 2 (1) 2 (1) 31 (21) Borough 133 (135) 100 (111) 18 (7) 14 (16) 265 (269) Deaths.—The numbers of deaths from tuberculosis, and the death rates for each year from 1939 are set out in the following table:— Year Number 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 1950 53 2 55 0.41 0.42 1951 55 3 58 0.44 0.46 Work carried out at the Chest Clinic.—The following particulars relating to Paddington patients have been supplied by the Chest Clinic:— Patients examined for the first time (excluding contacts) 1,918 (1,622) Number of the above found to be tuberculous 305 (248) Contacts examined 769 (442) Contacts found to be tuberculous 11 (11) Attendances at Chest Clinic 9,448 (7,571) Visits by Chest Physicians 347 (561) Visits by Nurses 2,266 (2,477) 11 VENEREAL DISEASES.—The Borough Council continued to give publicity to the dangers of these diseases, and to the facilities for treatment. A contribution was made to the funds of The National Society for the Prevention of Venereal Diseases. There is a Special Clinic at St. Mary's Hospital. NATIONAL ASSISTANCE ACT, 1948. Section 47—Removal to suitable premises of persons in need of care and attention.—No (one) Orders for compulsory removals were applied for during the year. Two hundred and forty one (340) visits, however, were made by the lady inspectors in connection with aged persons. It is sometimes possible to alleviate the conditions found by calling on the social services such as home helps and the National Assistance Board, or by drawing the attention of relatives to the circumstances. Whenever a wish to enter an Institution is expressed the Admissions Officer of the London County Council is asked to pay a visit with a view to arranging this. The National Assistance (Amendment) Act, 1951, came into force on the 1st September, 1951. This Act simplifies the procedure for the compulsory removal of persons in need of care and attention as defined in Section 47 of the 1948 Act, but limits the period of detention to three weeks instead of three months as in the main Act. Section 50—Burial or cremation of the dead.—During the year 39 (35) burials were arranged. MORTUARY.—The rather makeshift arrangements made for viewing the bodies and for the interviewing of relatives by the Mortuary Superintendent and Coroner's Officer following the destruction of the Coroner's Court by enemy action have, from time to time, been a source of embarrassment to the visitors and officers alike. As will be readily realised, strict privacy is essential in conducting interviews with bereaved relatives and other interested persons and to achieve this it has often been necessary to ask callers to wait outside irrespective of the climatic conditions. Certain difficulties have prevented an improvement being effected but it is hoped that more satisfactory accommodation will be provided in the very near future which will overcome the inconvenience which is often suffered by members of the public who have to attend at the mortuary. Details of the work at the mortuary are given below:— Bodies received at mortuary 356 (345) Inquests held 108 (94) Coroner's certificates issued 239 (243) Post mortem examinations made 309 (294) Bodies received to await burial 9 (8) WATER SUPPLY.—No (one) water supply certificates under Section 95 of the Public Health (London) Act, 1936, were issued. The water supply was cut off by the Water Board in seven (eight) cases on account of wastage or non-payment of rates and the Council notified in accordance with Section 98 of the Public Health (London) Act, 1936. Appropriate action was taken by the Department for the reinstatement of supplies. Eight (one) complaints about the quality of the water supply were received. No action was found necessary in four cases, three complaints were remedied when the water cisterns were cleansed and one supply was referred to the Metropolitan Water Board for further investigation. The sediment complained of in this last case proved to be a small amount of rust disturbed by a reversal in direction of the normal flow in the mains. A further flushing of the mains was at once carried out by the Water Board and there was no further trouble. FUMIGATION SERVICE AND CLEANSING OF VERMINOUS ROOMS.—During the year 19 (160) rooms were fumigated and 1,193 (1,414) sprayed for vermin by the Council at the request of owners or occupiers. It was found necessary to serve onlv one (6) notice under Section 123 of the Public Health (London) Act. 1936. DISINFECTING STATION AND MEDICINAL BATHS.— Disinfection carried out :— Weight of goods passed through the steam disinfector 121/2 tons (21 tons) Number of rooms disinfected after infectious disease . . 305 (375) Number of library books disinfected . . 581 (608) Scabies:— . . . . Number of adults treated . . 143 (147) Number of children treated . . 17 (20) Number of treatments given . . 262 (316) Vermin:— Heads Bodies Number of adults treated 126 (138) 189 (161) Number of children treated 66 (33) - (4) Number of treatments given 197 (179) 200 (177) School children receive treatment at the London County Council Cleansing Station and where necessary this Department is requested to investigate contacts or home conditions. 12 SMOKE NUISANCE.—This important subject has for some years attracted much research and investigation and whilst it is recognised that the pollution of the atmosphere by smoke is unhealthy and undesirable the difficulties of achieving anything like immunity from this nuisance in Paddington, such as the types of buildings, the fuel situation, the excessive costs of conversion to other means of heating, and many other problems too numerous to mention, mean that only a minimum amount of success can at present be hoped for in this direction. It will be realised that insistence on the installation of approved fuel burning appliances in new buildings, such as those recommended by the National Smoke Abatement Society, is to be commended, and the Public Health Committee have drawn the attention of the Housing (Special Delegations) and Building Licensing Committee to this aspect with a view to that Committee considering the advisability of urging all appropriate applicants for licences to instal approved fuel burning appliances where required by means of a leaflet issued by the National Smoke Abatement Society. Five (one) complaints regarding smoke nuisance were received during the year. An informal approach to the owners concerned resulted in four nuisances being abated while one was still being dealt with at the end of the year. Thirty-five (4) observations were made by the Inspectors. PIGEONS.—Four (one) complaints were received relating to two areas. Section 121 of the Public Health (London) Act, 1936, authorises the Council to destroy or cause to be destroyed any ownerless pigeons which are causing a nuisance. Two persons have been authorised to destroy pigeons in the Borough. Anyone complaining of a nuisance from pigeons is referred to these pigeon catchers who do their work without cost to the Council. Advice about measures which can be taken to prevent the birds settling or nesting on the buildings is given by the Inspectors concerned. 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 94 (115) 36 (65) 3 (7) - (-) (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 487 (498) 249 (245) 13 (33) -(-) (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 13 (8) 9 (—) - (-) -(-) TOTAL 594 (621) 294 (310) 16 (40) -(-) Particulars of Defects Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness (S.l) 3 (1) 3 (1) - (—) 3 (1) -(-) Overcrowding (S.2) 1 (—) 1 (-) - (—) -(—) -(-) Unreasonable temperature (S.3) - (—) -(—) " (—) -(-) -(-) Inadequate ventilation (S.4) 1 (1) - (1) -(—) -(-) -(-) Ineffective drainage of floors (S.6) - (1) - (1) - (—) - (—) -(-) Sanitary Conveniences (S.7) (a) Insufficient 3 (4) 2 (4) - (—) 3 (4) -(-) (b) Unsuitable or defective 27 (41) 22 (37) - (—) 5 (7) -(-) (c) Not separate for sexes 5 (-) 4 (-) - (—) 3 (-) -(-) Other offences against the Act (not including offences relating to Outwork) 7 (10) 2 (7) 5 (1) - (—) -(-) TOTAL 47 (58) 34 (51) 5 (1) 14 (12) -(-) 13 OUTWORKERS. Section 110 Section 111 No. of outworkers 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 104 (163) -(-) - (—) - (—) - (—) - (—) The 104 (163) Outworkers visited were engaged in the following occupations:— Wearing apparel 56 (92) Paper bags 36 (50) Christmas crackers 2 (-) Buttons, carding of 1 (2) Household linen - (2) Toys, stuffed 3 (4) Furniture and upholstery - (2) Lampshades 5 (6) Artificial flowers - (4) Metalwork 1 (1) No cases of infectious disease were reported from outworkers' premises, and the 461 (176) visits 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, inspections and notices served:— Complaints received 4,141 (4,732) Inspections and reinspections of dwelling houses 34,585 (36,682) Inspections of basements 384 (445) Inspections for purposes of the Housing Acts 194 (115) Visits in connection with re-housing applications 1,541 (1,707) Visits in connection with infectious disease 193 (85) Written Intimation Notices served 1,794 (2,717) Statutory Notices served 832 (1,199) Bye-law Notices served 372 (647) Work Carried Out. Defects remedied :— New dustbins provided 213 (387) Roofs repaired 996 (1,079) Gutters and rainwater pipes renewed or repaired 278 (344) Dampness remedied 1,163 (1,448) Rooms, staircases and passages cleansed 1,833 (2,838) Yard paving repaired 31 (64) Water-closets repaired or renewed 449 (466) Wall and ceiling plaster renewed 1,448 (1,978) Flooring repaired 322 (479) Accumulations of rubbish removed 140 (150) Sundry repairs 1,172 (1,465) Staircase lighting provided 22 (26) Windows repaired 913 (1,099) Drainaee:— Entire re-drainage carried out 31 (18) Partial re-drainage carried out 225 (153) Drains tested or examined 510 (538) Drains repaired 189 (206) Drains cleared 280 (276) Drainage conversion work carried out 97 (60) Soil and waste pipes repaired or renewed 171 (181) New sinks provided 290 (270) New baths or lavatory basins provided 665 (473) Water supply:— New supplies provided 57 (71) Supplies reinstated 27 (31) Cisterns cleansed 15 (28) Cisterns renewed 62 (47) 14 LEGAL PROCEEDINGS.— Number of cases referred for legal action 147 (258) Number of summonses heard 49 (153) Fines imposed £65 0s. Od. (£177 0s. 6d.) Costs awarded in cases heard £79 15s. Od. (£128 0s. 6d) Abatement and/or Prohibition Orders made 25 (41) Number of cases adjourned sine die 3 (8) Number of summonses withdrawn on payment of costs 56 (67) Amount of costs received on withdrawn summonses £114 10s. Od. (£108 3s. Od.) RENT AND MORTGAGE INTEREST (RESTRICTIONS) ACTS.—Applications for disrepair certificates numbered 12 (15), all (13) of which were granted. One (two) clearance certificate was applied for and one (one) was issued. DRAINAGE RECONSTRUCTION PLANS.—During the year 229 (231) plans were submitted for drainage work in existing buildings. In one case legal proceedings were taken for the non-deposit of plans and £3 3s. Od. costs were awarded, the plans being submitted by the time the case was heard. COMMON LODGING HOUSES.—A Lady Sanitary Inspector made two (18) visits to Cecil House and visits were paid by a Male Sanitary Inspector to examine the boilers and fire escape arrangements. PHARMACY AND POISONS ACT, 1933.—At the end of the year the Register contained the names of 110 (109) persons entitled to sell the poisons scheduled in Part II of the Poisons List. CANAL BOATS.—The Canal Boats Inspector visited Paddington Basin on 48 (85) occasions during the year and made 31 (53) inspections of canal boats. One notice, to make a cabin weatherproof, was served and complied with and some other defects remedied following a letter to the owner. Nine (7) children of school age were found to be living on boats coming into the basin. No deaths were registered in Paddington and no cases of infectious disease reported from among the canal boat population. BAKEHOUSES.—The number of bakehouses in the Borough remains the same as last year—eighteen " level " and eight " basement." These bakehouses are inspected constantly to ensure the maintenance of a high standard of hygiene. During the year 193 (257) visits were paid. RODENT CONTROL.—The following table gives details of the work carried out during the year under the Prevention of Damage by Pests Act, 1949. Dwelling Houses All other Property Total Total number of properties in district 23,319 3,331 26,650 Number of properties inspected as a result of— (a) notifications 354 103 457 (b) otherwise 176 50 226 Number of properties found to be infested by rats— Major infestation — 1 1 Minor infestation 185 71 256 Number of properties found to be seriously infested by mice 120 32 152 Number of infested properties treated by rodent operatives 304 104 408 It was necessary to serve only one notice under the Act, for proofing. This was complied with so that no default action or legal proceedings were required. Five "block" control schemes were carried out and the sewers in the Borough received two treatments, in January and June. In 1945 the charges for work done by the Council were fixed at 5s. Od. per treatment for private premises and a minimum of 10s. Od. per treatment for business premises, subject to the discretion of the Medical Officer of Health to exempt premises where such a course was considered desirable. With a view to bringing these charges more into line with the cost involved it was decided that from November, 1951, the charge for business premises should be 5s. 6d. per man-hour. It had also been found that infestation in private residences arose in a large number of cases from defective drains and other external causes which could not, except in rare instances, in any way be attributed to the fault of the occupier of the premises. It was also decided therefore that from the same date private residences should be treated free of charge except where the co-operation of the occupier could not be obtained and it became necessary to serve notices on him. 15 RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951.—The Act came into force on the 1st November, 1951. Premises where any filling material specified in the Act is used, such as in upholstery and the stuffing of toys, must be registered with the local authority. Rag flock intended for filling may only be supplied for use to registered premises. Premises where rag flock is manufactured or stored must be licensed. At the end of the year five premises had been registered where filling material was being used. There are no premises in the Borough at present where rag flock is manufactured or stored. The statutory fee for the registration of premises is £1. SLAUGHTER OF ANIMALS ACT, 1933.—One licence to act as a slaughterman was applied for and granted during the year. LONDON COUNTY COUNCIL (GENERAL POWERS) ACT, 1951.—Section 8 of this Act enables a charge to be made against the premises when work is done by the Council under the Public Health (London) Act, 1936. This section was used in one case during: the vear when an owner failed to coitidIv with a Nuisance Notice. FOOD SUPERVISION. Sampling.—Six hundred (600) samples were submitted to the Public Analyst, 30 (15) being formal samples (all milk) and 570 (585) informal. All the samples were reported on as genuine. Number Examined Number Adulterated Number Examined Number Adulterated Formal Informal Formal Informal Formal Informal Formal Informal Ale 3 Luncheon meat, canned 10 Arrowroot — 1 — — Lysol — 1 — — Aspirin — 2 — — Margarine — 10 — — Bacon — 6 — — Marmalade — 2 — — Baking powder — 1 — — Mayonnaise — 1 — — Biscuits — 1 — — Meat, goat — 1 — — Black pudding — 2 — — Meat paste — 1 — — Blancmange powder — 1 — — Meat pie — 4 — — Borax — 1 — — Milk 30 247 — — Brawn, canned — 2 — Milk powder 2 — — Bread — 6 — — Milkreem — 1 — — Butter — 13 — — Mineral waters — 6 — — Camphorated oil — 1 — — Molasses, canned — 1 — — Castor oil — 1 — — Morfat — 1 — — Cheese — 10 — — Mustard — 1 — — Chocolate spread — 1 — — Noodles — 2 — — Coconut, desiccated — 1 — — Oil, frying — 1 — — Coffee — 1 — — Olive oil — 2 — — Coffee essence — 1 — — Paprika — 1 — — Cooking fat — 9 — — Pastries — 1 — — Cordial — 2 — — Pepper — 9 — — Cough mixture — 5 — — Pepper compound — 2 — — Cream — 3 — — Pickled cabbage — 1 — — Cream powder — 1 — — Pickles — 3 — — Custard powder — 2 — — Potatoes — 1 — — Dessert powder — 1 — — Quinasps — 1 — — Epsom Salts — 2 — — Ravioli, canned — 1 — — Faggots — 1 — — Rennet essence — 1 — — Fish, canned — 17 — — Rose hip syrup — 1 — — Fish, paste — 4 — — Saccharin tablets. — 1 — — Flavouring — 1 — — Salted almonds — 1 — — Friars Balsam — 1 — — Sauce — 2 — — Fruit, bottled — 1 — — Sausage meat — 1 — — Fruit, canned — 13 — — Sausages — 1 — — Fruit, dried — 1 — — Sausages, canned — 3 — — Fruit, glace — 1 — — Sausages, smoked — 5 — — Fruit juice — 1 — — Semolina — 1 — — Fruit pie — 1 — — Soup, canned — 5 — — Glycerine — 1 — — Soup, powder — 5 — — Ham, canned — 1 — — Spaghetti — 1 — — Haslet — 1 — — Spice — 2 — — Hearts, canned 1 — — Stabiliser — 1 — — Herbs, dried 3 — — Stout — 3 — — Honey 3 — — Suet — 1 — — Honey cakes — 1 — — Sugar — 10 — — Icecream — 30 — — Sunchoc — 1 — Ice lollies 8 — Tea — 8 Iodine — 2 — — Thymol — 1 — — Jam 4 — — Tonic — 1 — — Jelly crystals — 1 — — Turmeric — 1 — — Lard — 1 — — Vegetables, canned — 9 — — Lemon juice — 1 — — Vermicelli — 1 — — Liver, potted — 1 — — Vinegar — 3 — — Liver pills 1 — — Vitacream — 1 — — Liver sausage — 2 — Zinc ointment — 1 — — 16 Unsound food.—Approximately 16 (10) tons of diseased or unsound food were surrendered for destruction. After carefully considering all the facts in each of the following cases of food offered or exposed for sale being unfit for human consumption, the Public Health Committee instructed that cautionary letters be sent to the firms concerned:— 1.—Wasp found in a jar of jam. 3.—Meat pie unfit for consumption. 2.—Cut loaf found to be mouldy. 4.—Nail in a tin of fruit pudding. Bacteriological examination of milk and food.—Bacteriological examinations were made of 170 (102) samples of milk all of which complied with the tests prescribed in the Milk Regulations. Nineteen (11) of these samples were from milk supplied to hospitals and 129 (72) from milk supplied to schools in the Borough. Samples of ice-cream, 45 (42) in number, examined for bacterial content as prescribed in the Ice-Cream (Heat Treatment) Regulations gave the following results :— Grade 1 14 (8) Grade 3 14 (10) Grade 2 8 (16) Grade 4 9 (8) Eight (2) ice lollies were examined. Samples of cream horns and tinned crab meat were submitted for examination in connection with food poisoning investigations. No pathogenic organisms were found in either sample. Food poisoning.—The following table gives a summary of the corrected cases of food poisoning or suspected food poisoning notified during the year. 1. Number of corrected cases 69 2. Outbreaks due to identified agents Total outbreaks 1 Total cases 3 3. Outbreaks due to:— Chemical poisons Nil Staphylococci 1 Salmonella organisms Nil Other bacteria C1. botulinum Nil Nil 4. Outbreaks of undiscovered cause:— Total outbreaks Nil Total cases Nil 5. Single cases:— Agents identified 5 Unknown cause 61 Total 66 There was a fatal case of food poisoning during the year. A twelve-year-old boy was taken ill and diagnosed as a case of acute appendicitis. An operation was performed but he made an incomplete recovery and developed, after the operation, definite signs of food poisoning. The organism causing this was identified as salmonella typhimurium. In spite of active treatment with sulphonamides and antibiotics the boy died. It is known that this organism is carried by mice as well as other animals, and it was thought that, as there was some mice infestation at the boy's home, the disease may have been carried by mice. One mouse was caught while rodent extermination work was being carried out and found to be not suffering from typhimurium infection. We were unable to trace any food which might have carried the disease. The home was clean and the food properly stored and prepared. The coroner certified death as due to natural causes. Agricultural Produce (Grading and Marking) Act, 1928.—Sections 3 and 4 of this Act are now again fully operative. These sections deal with the marking of preserved eggs and the cold or chemical storage of eggs. No action was necessary during the year regarding preserved eggs and there are no premises within the Borough registered for the storage of eggs. Merchandise Marks Act, 1926.—The Orders made under this Act were suspended during the war. This suspension was not continued beyond the 24th May, 1951, except in the case of butter and poultry. The suspension of the Order relating to poultry ended on the 31st December, 1951, and that relating to butter is due to end on the 24th May, 1952. After this latter date, therefore, all the Orders relating to foodstuffs should again be fully operative. No legal action was necessary during the year regarding the Orders then in force. Labelling of Food Order, 1950.—A complaint was received from a trade association regarding the labels on some bottles of claret being sold in the Borough. Upon investigation the complaint was seen to be well founded but the unsold bottles were at once properly labelled. As there had been no intent to deceive the public no further action, other than a formal warning, was considered necessary. 17 Food premises and undertakings.—Following are details of the food premises and undertakings in the Borough at the end of the year:— Food " Shops ":— Bakers 27 (34) Provision stores 110(101) Cake shops 16 (14) Domestic stores 16 (16) Butchers 60 (60) Corn chandlers 2 (2) Horsemeat shops (human consumption) 2 (3) Greengrocers 79 (79) Confectioners 110 (109) General shops 46 (46) Chemists 48 (48) Public Houses 98 (98) Fishmongers 24 (24) Cider Houses 2 (2) Fried fish shops 22 (22) Off Licences 54 (54) Grocers 43 (43) Cafes, restaurants, etc... 142 (139) Note.—There are 115 (103) shops registered for the sale of milk and 170 (160) premises registered for the sale of ice-cream. Food Factories:— There are 11 (11) food factories in the Borough including 3 (3) ice-cream factories. Street Traders:— Coffee stalls 11 (11) Greengrocers' rounds 18 (18) Greengrocers' stalls 33 (33) Ice-cream stalls 2 (2) Animal Food Dealers:— There are two cats' meat shops and one cats' meat stall in the Borough as last year. Catering Establishments:— The following establishments hold catering licences from the Ministry of Food. Private hotels 164 (155) Staff canteens .. 55 (59) Industrial canteens 17 (24) Institutions .. 16 (17) Public Houses 83 (90) Note.—There are an unknown number of residential establishments (probably several hundreds) which Drovide meals to residents on their books, but which do not hold catering licences. Milk Licences.—Licences in force at the end of the year are given in the table below. Dealers' Principal Licences Dealers' Supplementary Licences To sell— " Pasteurised " milk 65 (59) 20 (16) " Sterilised " milk 101 (100) 20 (17) " Tuberculin Tested " milk 75 (52) 20 (16) Dealers' supplementary licences enable holders to sell milk in the Borough from premises outside the Borough on condition that they hold principal licences from the authorities concerned. The Milk (Special Designations) (Specified Areas) Order came into operation on the 1st October, 1951. All milk sold by retail in the Borough, amongst other specified areas, must now be designated milk. This is another step in the long journey to safeguard the public from milk borne infections begun by the Milk (Special Designations) Regulations in 1923. SHOPS ACTS.—The Shops Acts Inspectors made 1,500 (1,591) visits. No notices were served, all contraventions being dealt with informally. MASS RADIOGRAPHY.—The North-West Metropolitan Regional Hospital Board installed an X-ray Unit at the Welfare Centre at 283a, Harrow Road from the 8th to the 27th February and below is a summary of the work done. The figures in brackets relate to the work of the Unit in 1949, when it last operated in the Borough. The figures have been supplied by the Liaison Officer of the Unit. 18 Males Females Total Miniature X-Rays taken 2,327 (3,159) 2,087 (2,332) 4,414 (5,491) Recalled for large films 63 (87) 54 (55) 117 (142) Analysis of large films:— No further action 35 (52) 33 (27) 68 (79) Referred to Chest Clinics 16 (14) 11 (20) 27 (34) To return to Unit for recheck at later date 9 (17) 8 (6) 17 (23) Failed to attend for large film 3 (4) 2 (2) 5 (6) CLEAN FOOD CAMPAIGN.—Continuous efforts were made, mainly through the Food Inspectors, to improve the standards of public eating places and food shops. In detail the improvements are small—a hot water supply provided here, the tiling of a room there—but they represent a steady rise in the mechanics of cleanliness. By drawing the attention of managers and individual staff to malpractices whenever found, and by constantly emphasising the necessity for scrupulous cleanliness where food is concerned, the attitude of the men and women behind the counters has been improved in many instances. This work cannot be shewn by statistics, however, and is often not given its full value. Many cases of food poisoning are still found to be caused by food kept at home under unhygienic conditions. The majority of the people thus affected would have been untouched by local leaflets, films or lectures on the dangers of food poisoning. This lends weight to the personal and individual approach. To be fully successful campaigns such as the Clean Food Campaign must be nation-wide and have the weight of the press and cinema behind them. It cannot be too strongly stressed that the success of any "Clean Food" campaign depends a great deal on the insistence by the shopping public on hygienic handling of food by the shop assistants; and by the housewife herself using every care in the storage of food and the preparation of meals in the home. So many elementary precautions such as seeing that everyone washes the hands after using the water-closet, covering any sores on the hands when preparing food and keeping all food covered from flies, if practised consistently, would go a long way to preventing any risk of possible infection. Briefly, constant vigilance is necessary, and expert advice on this important subject is always obtainable from the Council's Food Inspectors. BEXHILL HOLIDAY HOME.—The popularity of the Home continued to increase ; only about half of those who applied were able to go because of lack of accommodation. Vacancies were allocated on the basis of previous visits and as everyone wanted to go in the summer, June, July and August were filled with people who had never been to " Kincardine " before. The year was uneventful except for the death, from natural causes, of one visitor. Some structural alterations and additions to the house were necessary to comply with the local fire escape regulations and the work was in progress at the end of the year. Rising food prices increased the catering difficulties. The popular theory that old people are naturally small eaters has proved incorrect. That the stay at the Home is a "real holiday," as symbolised by the early morning cup of tea in bed, is still frequently expressed by appreciative guests. During January, February and March (when guests go for a fortnight) 91 people were accommodated. From April to October 475 visitors had a week at the Home. HOUSING. Houses unfit for human habitation:— No. of basement rooms dealt with by closing orders 234 (190) No. of upper parts of mews premises dealt with by closing orders 1 (-) No. of houses dealt with by demolition orders or in respect of which undertakings were accepted 16 (8) Thirty-three (38) persons were displaced as a result of the Council's operations, eighteen (14) being rehoused by the Paddington Borough Council and four (3) by the London County Council. Four (6) secured accommodation through their own efforts and seven (15) are awaiting suitable Council vacancies. 19 Closing orders were determined or undertakings cancelled on seven (5) basements and the upper parts of three (6) mews premises. One (3) house was wholly made fit following action under Section 11 of the Housing Act, 1936. Seven (—) other basements were made fit without recourse to formal proceedings. Compulsory Repairs. Thirty-eight (12) Notices under Section 9 of the Housing Act, 1936, were served during the year. Seven (1) Notices were complied with, and works were in progress at fifteen (5) other premises. In one (2) further case works are being undertaken by the Council in default, and at fifteen (4) other premises the works have not yet commenced. Nine notices served prior to 1951 have also been complied with during the year, and in two (1) other cases the work was carried out by the Council in default. At several other premises the required repairs were carried out by the owners without service of Notice. Housing Act, 1936—Overcrowding. (a) (1) Number of dwellings overcrowded at the end of the year 548 (633) (2) Number of families dwelling therein 554 (661) (3) Number of persons dwelling therein 2,084 (Units) (2.4671/2) (b) Number of new cases of overcrowding reported during the year 184 (421) (c) (1) Number of cases of overcrowding relieved during the year 269 (315) (2) Number of persons concerned in such cases 9951/2 (Units) (1,122) The number of overcrowded dwellings on the Register of Overcrowding at the end of 1951 (548) shows a decrease of 85 on the figure for 1950 (633). Some 118 of these were basement dwellings. It is also interesting to note that the number of new cases reported in 1951 (184) showed a marked decrease on the number of new cases reported in 1950 (421). Of the cases of overcrowding relieved during the year, 14 (39) were provided with accommodation by the Borough Council, 135 (86) secured accommodation privately, 35 (31) were relieved by a natural reduction in the size of the family or on obtaining additional accommodation, and 85 (156) were rehoused by the London County Council. 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. Slum Clearance Survey. Under the draft programme of slum clearance in London prepared by the London County Council, no property in the Borough was scheduled for demolition in 1951. Use of War-Damaged site. Following representations by this Council, the London County Council has decided to acquire the war-damaged properties, Nos. 2-8, Paignton Street, for the extension of St. Paul's School playground. All four properties have been the subject of demolition order proceedings. In two cases demolition orders were made, but on being informed that the District Surveyor was undertaking repair works to make the other two buildings reasonably safe, the demolition order proceedings were withdrawn. Rehousing Inquiries. Some 700 communications were received during the year from the Borough Director of Housing, the County Divisional Medical Officer, the County Director of Housing and Valuer, and from other authorities requesting information on the housing conditions of persons applying for re-housing on grounds of overcrowding, insanitary conditions, and ill-health. Such information enables the inquirer to assess the degree of priority to be given to the applicants concerned. In each case a visit was made by the Sanitary Inspector and a report furnished. Housing Accommodation : Preferential Treatment. Five (5) families recommended for preferential consideration in the allocation of accommodation on medical grounds were rehoused by the Borough Council, and four (19) by the London County Council. New Accommodation. During the year 6 flats at John Aird Court and 12 flats at Lancefield Court were completed, and families selected from the Council's waiting list were rehoused therein. Fumigation. Associated Fumigators, Ltd., under an agreement with the Council, removed and treated the furniture and effects of 44 families with hydrogen cyanide gas during the year. The cost of the work was £269. On the 1st April the charge for this work was increased from £8 10s. Od. to £9 18s. Od. per van per day, and as from the same date the charge made by the Council to persons whose furniture and effects are dealt with under this agreement was increased from £2 to £5. In 1950, 153 families were removed at a cost of £680. VAIL & Co., Ltd.. Printers to the Council, 170, Farringdon Road, E C. I