PAD 57 Ac . 4349 Metropolitan Borough of paddington Ret. B REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1957 H. LESLIE OLDERSHAW, M.D. (London), B.S., D.P.H. CONTENTS Page Aged and infirm persons 20 Atmospheric pollution 14 Bakehouses 23 Burials and cremations 19 Common Lodging houses 20 Deaths 9 Disinfection and disinfestation 14 Drainage reconstruction 20 Factories 16 Food supervision 22 Hairdressers and barbers 23 Holiday Home 21 Home safety 22 Housing 25 Housing Repairs and Rents Act 24 Infectious disease 11 Legal proceedings 18 Marriages 7 Medicinal baths 13 Mortuary 19 National Assistance Acts 21 Outworkers 18 Pet Animals Act 19 Pharmacy and Poisons Acts 20 Pigeons 19 Protective helmets 24 Public Health Inspectors—Summary of work 13 Rag Flock Act 20 Rent Act, 1957 24 Rodent control 19 Shops Acts 19 Slum clearance 27 Smoke control areas 15 Staff 5 Vital statistics 6 Water-closet byelaws 24 Water supply 20 Except where otherwise indicated, the figures in brackets throughout this Report are the figures for 1956, and are shown for comparison. 3 To The Mayor, Aldermen and Councillors of the Metropolitan Borough of Paddington Mr. Mayor, Ladies and Gentlemen, I have the honour to present to you the Annual Report of the Medical Officer of Health for the year 1957. Infectious Disease During the year 1,204 cases of measles were notified in the Borough as compared with 340 the previous year. This follows the usual expectation in so far as there is invariably an increased incidence of measles every other year, so that it would be more appropriate to compare the 1957 figure with that of 1955, namely 1,596. I am happy to report that fortunately there were only eight cases of poliomyelitis reported throughout the whole of the year. Otherwise the incidence of infectious disease remains at a low level, closely following that of the preceding years. Causes of Death Coronary disease was again responsible for most deaths. There were no less than 204 deaths recorded from this disease, only seven of which were under 45 years of age. Cancer of the lung was responsible for 68 deaths, of which 57 were in males. During the year there were 47 deaths arising from accidents and 43 from suicide. There was one adult death from poliomyelitis. Smoke Control Area During the year considerable attention was given to the preliminary work connected with the preparation of a smokeless zone to be operated in the southern part of the Borough. Reports in respect of this were submitted to the Public Health Committee, and subsequent to the appointment of the Clean Air Inspector in September, considerable progress was made. Care of the Aged, and Home Safety These important Public Health matters are dealt with at some length in the body of the report. Holiday Home During the year no less than 598 guests were accommodated at the Council's Holiday Home at Bexhill. I make special reference to this because ever since the Council opened this Home in 1949 it has been regarded with admiration by many other local authorities, and indeed many have since followed the example set them by the Paddington Council nine years ago. Slum Clearance Programme Considerable headway was made during the year in the slum clearance programme initiated in co-operation with the London County Council. During the year Inquiries had been held on those areas which it was agreed should be undertaken by the London County Council, namely Edensor Gardens, North Wharf Road and Clarendon Crescent. All the detail work and all the necessary preliminary steps had been taken by the Borough Council in respect of the Braithwaite Place and Adpar Street Areas, on which a Ministry of Health Inquiry will be held next year. 4 Co-operation with London County Council Divisional Health Area No. 2 It is appreciated that the health services of the Borough Council deal generally with matters of environmental health, whilst those appertaining to personal health are administered by the London County Council. In order that the public may receive full benefit it is essential that there should be continuous close co-operation between these two aspects of the domiciliary health services in the Borough. I am pleased to record that this has been obtained by the cordial relationship of medical officers, health visitors, public health inspectors, domestic help organiser and clerical officers working in the Borough. In addition, of course, the Borough Council has three representatives on the London County Council Divisional Health Committee No. 2. Staff Unfortunately, in common with many other authorities, the public health inspectorate is below establishment, which necessarily has its consequential repercussion on the work of the department. During the year two male student public health inspectors were appointed, and arrangements were in hand to appoint a third female student public health inspector. This is a new departure, and will ensure recruitment to the inspectorate when these officers qualify in about two years' time. The Area Inspectors are assisting in the training of these students, and opportunity is afforded them to attend courses of instruction at the Polytechnics. At the time of writing this report it is with great regret that I record the death of the Chief Food Inspector. Mr. F. J. Pallet had served the Paddington Borough Council since May, 1927, loyally and well, and his sudden and tragic death, coming as it did in the course of his duties, has produced an irrevocable loss. Mr. Pallet will be grievously missed not only by his colleagues in all departments of the Town Hall, but by the public with whom he came into contact. I would like to express my gratitude for the help and co-operation I have received from the Public Health Committee, the Chief Officers of the Council, and especially to all the staff of the Public Health Department. I have the honour to be Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, Medical Officer of Health. 5 PUBLIC HEALTH COMMITTEE (at 31st December, 1957) Aid. Miss C. P. Rabagliati, M.B.E. (Chairman) Clr. J. J. L. de Segrais, F.R.I.B.A. Clr. Mrs. I. L. Bolton Clr. A. A. Dumont Clr. Mrs. I. M. B. Gordon Clr. W. Dow Clr. Mrs. M. S. Hornby Clr. G. J. O'Connell Clr. A. F. Waley, B.A. COUNCIL MEMBERS SERVING ON OTHER COMMITTEES (at 31st December, 1957)—- London County Council Divisional Health Committee No. 2:— Aid. Miss C. P. Rabagliati, M.B.E. Clr. Mrs. E. G. Lane Clr. W. Dow Paddington (Group 21) Hospital Management Committee:— Aid. Miss C. P. Rabagliati, M.B.E. Aid. F. Lawrence Aid. W. E. Harriss Paddington and St. Marylebone District Nursing Association:— Aid. Miss C. P. Rabagliati, M.B.E. Paddington Tuberculosis Care Committee:— Aid. Miss C. P. Rabagliati, M.B.E. Clr. W. Dow Clr. Mrs. I. L. Bolton Clr. Major J. Collins, J.P. Clr. F. H. Harris PUBLIC HEALTH OFFICERS (at 31st December, 1957).— Medical Officer of Health:— H. Leslie Oldershaw, M.D. (London), B.S., D.P.H. Deputy Medical Officer of Health:— Hilary Stella Mary Hadaway, M.B., B.S., D.P.H. Public Analyst:— C. H. Wordsworth, B.S., F.R.I.C. Administrative Staff.— S. W. Ruffey (Chief Clerk) H. J. Parker S. W. Wordingham A. G. L. E. Houghton E. J. Cleaver D. J. Myers L. Allchin H. C. P. Eagle A. E. Blake R. A. Cummins C. Webdale Miss D. L. Smeaton Mrs. F. M. Bean Area Public Health Inspectors:— W. H. G. Atkins (1) V. L. Ronchetti (1) (2) G. S. Adams (1) (2) (3) E. B. Wilde (1) (2) (3) 6 District Public Health Inspectors:— C. Chesterman (1) (2) R. Fowler (1) (2) C. G. Heron (1) (2) E. Marshall (1) (2) R. E. Williams (1) (2) V. A. Vickers (1) J. Forbes (1) There is one female Public Health Inspector:— Miss E. Z. Amor, S.R.N., S.C.M., H.V. (1) (2) and one Visitor:— Mrs. E. L. Falloon, S.R.N. There are two student Public Health Inspectors. Food Inspectors'.— F. J. Pallet (Chief Food Inspector and Sampling Officer) (1) (2) A. C. Harrison (1) (2) Mortuary.— Superintendent: C. C. Lewis Assistant Superintendent: E. F. Crabb Manageress, Holiday Home :— Mrs. G. Hoskings Rodent Officer'.— W. A. Dunkley There are three whole-time and one part-time domestic staff at the Holiday Home. Ten Disinfection, Fumigation and Rodent Operatives and one Groundsman are employed in the Public Health Department. (1) Public Health Inspector's certificate of the Royal Society for the Promotion of Health or Royal Sanitary Association (Scotland). (2) Meat and Other Food Inspector's certificate. (3) Smoke Inspector's certificate. VITAL STATISTICS Area of Borough (including 20 acres of waterways) 1,356 acres Rateable value £2,442,139 (£2,654,898) Product of a penny rate (net) £9,543 (£10,700) Population (Registrar General's mid-year home population) 120,500(121,200) Number of dwellings (according to the Rate Books) 31,417 (31,444) Deaths from all causes 1,205 (1,262) Number of maternal deaths 4 (1) 7 Borough birth rate (live births per 1,000 population) 18.76 (18.77) Borough death rate (deaths per 1,000 population) 10.00(10.41) Comparability factors—Births 0.79 Deaths 1.08 England and Wales—Birth rate 16.1 Death rate 11.5 Total I Legitimate Illegitimate! Live births Males Females 1,147(1,168) 980 (983) 167 (185) 1,114(1,107) 921 (938) 193 (169) Still births Males Females 26 (15) 17 (17) 22 (11) 4 (4) 12 (15) 5 (2) Deaths of infants under Males one year of age Females 30 (33) 25 (29) 5 (4) 24 (22) 15 (19) 9 (3) Deaths of infants under Males four weeks of age .. Females 24 (25) 20 (23) 4 (2) 20 (18) 14 (15) 6 (3) The number of marriages solemnised in the Borough during the year was 1,592 (1,820). 8 Summary of Vital Statistics Year Reg. General's Estimate of Population Live Births Deaths Deaths under One Year Deaths under Four Weeks Still Births Number\ * Rate † Number * Rate † Number * Rate § Number * Rate § Number * Rate ‡ 1901 143,976 3359 23.29 2163 15.00 455 135 146 43 No recojrd 1911 142,541 2977 20.88 1885 13.22 388 129 104 35 1921 145,600 2859 19.63 1758 12.06 265 92 104 36 80 27 1931 140,300 2075 14.79 1831 13.05 182 87 67 32 82 38 1938 137,400 1888 13.74 1557 11.33 125 66 43 23 74 38 1939 135.300 1812 13.39 1608 12.74 106 60 49 27 53 28 1940 97,860 1556 15.90 1766 18.04 88 59 43 28 57 35 1941 77,640 1217 15.67 1418 18.26 64 60 36 30 44 35 1942 83,640 1397 16.70 1268 15.16 78 56 47 34 47 33 1943 90,580 1569 17.32 1390 15.32 107 68 41 26 40 25 1944 93,030 1639 17.62 1388 14.92 100 61 38 23 49 29 1945 99,790 1712 17.16 1367 13.69 104 61 68 40 49 28 1946 117,670 2386 20.28 1525 12.96 113 47 76 32 59 24 1947 127,450 2520 19.77 1567 12.29 109 43 58 23 57 22 1948 128,100 2353 18.37 1381 10.78 85 36 43 18 50 21 1949 130,640 2243 17.17 1489 11.39 58 26 42 19 47 21 1950 130,600 2156 16.51 1397 10.70 62 29 40 19 41 19 1951 125,400 2155 17.19 1519 12.11 61 28 40 19 52 24 1952 124,800 2078 16.65 1450 11.62 56 27 38 18 46 22 1953 123,800 2107 17.02 1563 12.63 50 24 36 17 36 1*7 1954 123,100 2147 17.44 1190 9.67 37 17 31 14 38 17 1955 121,500 2119 17.44 1306 10.75 52 25 34 16 42 19 1956 121,200 2275 18.77 1262 10.41 55 24 43 19 32 14 1957 120,500 2261 18.76 1205 10.00 54 24 44 19 43 19 † Per 1,000 population. § Per 1,000 live births. * Corrected figures after allowing for inward and outward transfers. ‡ Per 1,000 (live and still) births. 9 DEATHS In the following table the deaths are classified according to the Abridged List of the International Manual of Causes of Death. Causes of Death Sex All Ages 0 — 1 — 5— 15— 25— 45— 65— 75— ALL Causes M 603 30 3 2 7 57 196 145 168 F. 602 24 4 1 6 38 134 122 273 Tuberculosis, respiratory M. 7 — — — — — 3 1 3 F. 4 — — — — — 3 1 — Tuberculosis, other forms M. — — — — — — — — — F. 1 — — — — — — — 1 Syphilitic diseases M. 2 — — — — — — 2 — F. 3 — — — — — 2 — 1 Diphtheria M. — — — — — — — — — F. — — — — — — — — — Whooping Cough M — — — — — — — — — F. — — — — — — — — — Meningococcal infections M. — — — — — — — — — F. — — — — — — — — — Acute Poliomyelitis M. 1 — — — — 1 — — — F. — — — — — — — — — Measles M. — — — — — — — — — F. 1 — 1 — — — — — — Other infective and parasitic diseases M. 3 1 — — — 1 1 — — F. 1 — — — — — 1 — — Cancer of stomach M. 20 — — — — 1 6 8 5 F. 13 — — — — — 3 1 9 Cancer of lung, bronchus M. 57 — — — — 1 36 13 7 F. 11 — — — — — 7 3 1 Cancer of breast M. — — — — — — — — — F. 22 — — — — 3 12 4 3 Cancer of uterus M. — — — — — — — — — F. 16 — — — 1 4 8 2 1 Cancer of other sites M. 56 — — — — 3 19 13 21 F. 57 — — — — 2 22 15 18 Leukaemia, aleukaemia M. 4 — — — — 1 1 — 2 F. 3 — 1 — 1 — — — 1 Diabetes M. 1 — — — — 1 — — — F. 3 — — — — — — 2 1 Vascular lesions of nervous system M 45 — — — — 1 13 11 20 F. 78 — — — — 6 17 13 42 Coronary disease, angina M 118 — — — — 7 43 40 28 F. 86 — — — — — 14 30 42 Hypertension with heart disease M. 8 — — — — — 2 2 4 F. 17 — — — — — 2 3 12 10 Deaths—(contd.) Causes of Death Sex All Ages 0— 1 — 5— 15— 25— 45— 65— 75— Other heart diseases .. M. 43 — — — — 5 11 6 21 F. 68 — — — — 4 6 8 50 Other circulatory diseases M 24 — — — — 1 8 8 7 F. 26 — — — — 2 6 18 Influenza M. 6 — — — — 2 3 1 F. 5 — — — 1 1 — 3 — Pneumonia VI. 31 3 — — — 3 4 8 13 F. 27 3 — — — 2 4 2 16 Bronchitis iM. 43 — — — — — 12 13 18 F. 26 — — — — — 4 4 18 Other diseases of the respiratory system M. 4 — — — — 1 2 — 1 F. 1 — — — — — — — 1 Ulcer of stomach and duodenum M. 7 — — — — — 3 2 2 F. 8 — — — — — 1 3 4 Gastritis, enteritis and diarrhoea M. 3 2 1 — — — — — — F. 9 — — — — — 1 3 5 Nephritis and nephrosis M. 3 — — 1 — — — 1 1 F. 4 — — — — — 1 1 2 Hyperplasia of the prostate M. 8 — — — — — 1 3 4 F. — — — — — — — — — Pregnancy, childbirth and abortion M. — — — — — — — — — F. 4 — — — — 4 — — — Congenital malformations M. 10 6 2 — — 2 — — — F. 5 3 1 — — — — 1 — Other diseases M. 44 18 — — — 4 10 8 4 F. 65 17 — 1 1 2 16 12 16 Motor vehicle accidents M. 11 — v 1 3 3 3 1 F. 7 — — — — 1 2 2 2 Other accidents M 17 — — — 1 2 7 3 4 F. 12 — 1 — 1 — 1 — 9 Suicide M. 26 2 12 8 2 2 F. 17 — — — — 9 5 3 — Homicide and operations of war .. M. 1 — — — 1 — — — — F. 2 1 — — 1 — — — — 11 INFECTIOUS DISEASE Bacteriological examinations.—The number of examinations made in connection with infectious disease was 253 (351) most of which were in respect of food poisoning and dysentery cases. Visiting.—Puerperal pyrexia, Tuberculosis, Ophthalmia Neonatorum and Infective Enteritis cases are visited by the London County Council's Health Visitors. Smallpox cases enquiries are made by the male Public Health Inspectors and food poisoning investigations by the Food Inspectors. Cases of other diseases and associated enquiries are made by the Borough Council's women Visitors who made 2,005 (1,189) calls in connection with this work. International certificates.—During the year 1,961 (1,718) certificates of inoculation or vaccination were submitted for the authentication of the signature of the medical practitioner concerned. These certificates are required by passengers proceeding abroad from this country and the purpose of the authentication is to provide proof that the signature of the person issuing the certificate is that of a registered medical practitioner. Poliomyelitis.—The Divisional Medical Officer of Health of the London County Council has furnished me with the following information in respect of inoculations of children against poliomyelitis carried out by the London County Council in Paddington:—at the clinics—2,131; by general practitioners—283; a total of 2,424 children inoculated during the year covered by this Report. Notifications.—Following is a table showing the numbers of cases of infectious disease notified. The number of cases after allowing for corrections of diagnosis is shown in brackets. 12 Disease 1953 1954 1955 1956 1957 Acute encephalitis(infective) — (—) — (—) 1 (1) — (—) (—) Acute encephalitis (post infectious) — (—) 2 (2) — (—) 1 (1) — (—) Acute pneumonia (influenzal) 43 (43) 7 (7) 12 (12) 12 (12) 23 (23) Acute pneumonia (primary) 55 (55) 22 (22) 39 (39) 31 (31) 32 (32) Acute poliomyelitis (paralytie) 5 (5) 6 (5) 14 (12) 6 (3) 3 (2) Acute poliomyelitis (non-paralytic) 3 (3) 3 (2) 14 (14) 6 (6) 5 (2) Diphtheria 2 (—) 1 (—) — (—) — (—) — (—) Dysentery 106 (105) 45 (45) 31 (29) 86 (86) 33 (33) Erysipelas 13 (13) 6 (6) 14 (14) 5 (5) 7 (7) Food poisoning or suspected food poisoning 107 (107) 90 (89) 69 (69) 52 (51) 55 (55) Infective enteritis 33 (31) 17 (17) 68 (68) 18 (18) 11 (11) Infective enteritis 2 W1/ (2) 1 (1) — (—) 2 (2) — (—) Malaria 8*8 r8S4\ 55 (55) 1.596 (1.596) 340 (339) 1.204 1,203) Measles 5 (4) 2 (1) 11 (10) 7 (7) 3 (2) Ophthalmia neonatorum 1 (1) 6 (6) 6 (6) 3 (3) 5 (5) Paratypoid fever (—) 2 (2) 1 (1) — (—) — (—) Puerperal pyrexia 104 (104) 70 (70) 137 (137) 186 (186) 202 (202) Scabies 34 (34) 42 (42) 35 (35) 30 (30) Scarlet fever JO 71 l JO J (71) 47 w~/ (47) 41 (39) 25 (25) 51 (51) Smallpox (—) (—) (—) — (—) — (—) Typoid or enteric fever 1 (—) (—) 3 (3) 2 (2) — (—) Whooping cough 322 (322) 203 (203) 120 (119) 102 (102) 93 (93) Tuberculosis (pulmonary) (non-pulinonary) 1953 1954 1955 1956 1957 247 195 177 220 191 19 17 18 22 18 13 PUBLIC HEALTH INSPECTORS' WORK.—Following is a summary of the work of the male Public Health Inspectors, excluding work in connection with factories. Dwelling houses inspected:— Premises inspected as a result of complaints 3,471 (4,207) Premises inspected in house to house visits 5 (4) Premises inspected for action under the ing Act (Sec. 9) 29 (8) Premises inspected in connection with cates of Disrepair 130 (36) Premises inspected for improvement grants 8 (47) Premises inspected in connection with making of Closing Orders 446 (355) Premises inspected other than those noted above 682 (635) Notices served:— Intimation notices under the Public Health (London) Act, 1936 804 (1,321) Statutory notices under the Public Health (London) Act, 1936 182 (495) Notices under the London County Council or Paddington Borough Council bye-laws 158 (318) Notices under the London County Council (General Powers) Act, 1954 56 (49) Notices under the London County Council (General Powers) Act, 1955 3 (2) Visits made in connection with'.— Aged persons 30 (61) Bakehouses 144 (169) Basement occupation checks 330 (987) Canal boats — (10) Clean Air Act 43 (-) Dwelling houses 20,044(22,413) Fireguards Act 18 (10) Hairdressers' establishments 119 (128) Infectious disease 53 (18) Miscellaneous calls 143 (180) Outworkers 4 (-) Overcrowding 167 (323) Rodent control 162 (260) Pet Animals Act 30 (6) Rag and bone stores 19 (-) Rag Flock Act 5 (7) Rehousing applications 149 (321) Smoke observations 62 (47) Town Planning 80 (119) Vermin investigations 524 (452) MEDICINAL BATHS AND DISINFECTING STATION.—The tables below give a summary of the work done at the Medicinal Baths and by the Disinfecting and Fumigation Operatives. 14 Disinfestation:— Rooms treated for vermin 850 (770) Articles disinfested 1,342 (2,441) Disinfection:— Rooms disinfected after infectious disease 144 (162) Library books disinfected 527 (367) Articles of clothing, etc., disinfected 718 (863) Scabies:— Number of adults treated 46 (59) Number of children treated 6 (13) Number of treatments given 99 (147) Vermin:— Heads Bodies Number of adults treated 34 (42) 29 (51) Number of children treated 10(15) - (6) The medicinal baths staff also deal with the laundry and home bathing of old people which is reported under " Aged and Infirm Persons." Disinfestation.—As a result of a review of charges for disinfestation services which had been in existence from 1944 the following charges per visit were fixed for all types of disinfestation treatment in respect of (a) business premises, including hotels, boarding houses and similar types of premises, and (b) private dwellings, as from 30th June, 1957. (a) (1) 15s. for first room plus 10s. for each additional room treated at the same time; (2) 15s. for each substantial article of furniture required to be removed for treatment— such charges to be payable in advance. (b) That no charge be made for any type of disinfestation in respect of private domestic premises. ATMOSPHERIC POLLUTION.—The results obtained from the recording apparatus at the Welfare Centre, 283a, Harrow Road, during 1957 are given below:— Month Rainfall in mms. Insoluble deposits in tons per square mile Soluble deposits in tons per square mile S.03 in mgs. per day per 100 square cms. January 38 (87) 14.83 (13.38) 10.71 (13.32) 4.46 (5.25) February 77 (4) 11.98(12.48) 9.80 (6.11) 3.44 (5.01) March 28 (26) 18.59(11.77) 7.62 (8.55) 3.27 (4.10) April 4 (27) 10.24(12.96) 3.89(10.68) 3.19(2.69) May 26 (4) 11.03 (9.53) 7.48 (3.26) 2.45 (1.59) June 13 (52) 16.31 (8.66) 7.04 (5.27) 1.63 (1.40) July 84 (78) 11.68 (8.79) 11.74 (6.61) 1.77(1.26) August 40 (111) 6.78 (8.46) 6.58 (12.71) 1.73 (1.47) September 62 (74) 10.94(10.68) 6.27(14.26) 1.77 (2.12) October 49 (32) 13.15 (9.09) 7.48 (10.64) 3.76 (2.92) November 61 (9) 11.24(10.44) 10.96 (6.81) 3.95 (4.43) December 45 (67) 13.82 (13.69) 13.86(12.86) 5.23 (4.30) 15 Clean Air Act, 1956.—In my last Annual Report I commented generally on the provisions of this Act as it affected the Council. It will be remembered that the Minister of Housing and Local Government fixed the appointed day for the operation of the Act, with certain exceptions, for the 31st December, 1956. Since that date, pursuant to Section 3, fifteen notifications of furnace installations have been received, three of which were gas fired for which no approval was necessary, and three oil fired for which no approval was applied for. Of the remaining nine applications submitted for approval four of the installations were approved. Details about the remaining five were still being awaited at the end of the year. In order that approvals to installations under Section 3 of the Act should not be delayed the Council at the Committee's request delegated the Council's powers and duties under this Section to the Committee on the 30th May. This will ensure that works of installation can be proceeded with expeditiously, which is so essential where plans for conversions, comprising new heating arrangements, are involved. Smoke Control Area.—In the early part of the year the question of the adoption of a common policy for the establishment of Smoke Control Areas was being considered by the Metropolitan Boroughs' Standing Joint Committee with the ultimate object that the whole of the County of London should be a smokeless zone in the course of time. In accordance with that Committee's recommendations boroughs with common boundaries with the City of London, which had already been declared a smokeless zone (under a private Act) were asked to confer as soon as possible and to produce a co-ordinated scheme and the remaining Councils asked to review conditions and where considered desirable should seek to establish smoke control areas without departing from the principle of establishing without delay smoke control areas for the inner zones of the County. It was left to the constituent Councils to initiate and carry out co-ordinated programmes on this basis, and to keep the Standing Joint Committee advised. A preliminary report on the initial steps that were being taken by me to deal eventually with the southern part of the borough as a first stage, were approved in principle by the Committee and reported to the Council in May. With the appointment in September of Mr. G. S. Adams as Area Public Health and Clean Air Inspector I am hopeful of being in a position to submit the result of a preliminary survey of an area in the southern part of the Borough to the Committee early next year which will enable the Council to place before the Minister the required information preparatory to making an Order classifying the area as a Smoke Control Area. 16 FACTORIES.—Following are tables showing the work carried out during the year in connection with the factories in the Borough. 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 78 (87) 57 (65) — (—) — (—) (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 493 (484) 427 (391) 18 (13) — (1) (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 30 (12) 10 (8) — (—) — (—) Total 601 (583) 494 (464) 18 (13) — (1) 17 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) 13 (6) 12 (4) - (-) - (-) — ( -) Overcrowding (S.2) - (-) - (-) - (-) — (—) - (-) Unreasonable temperature (S.3) (1) - (1) - (-) - (1) — (—) Inadequate ventilation (S.4) 1 (2) 1 (2) - (-) — (—) — (—) Ineffective drainage of floors (S.6) — (-) - (-) - (-) — (—) - (—) Sanitary Conveniences (S.7) (a) Insufficient 1 (1) — (—) - (1) — (-) — (—) (b) Unsuitable or defective 40 (34) 21 (28) - (-) 1 (1) — (—) (c) Not separate for sexes - (1) - (1) - (-) — (1) — (—) Other offences against the Act (not including offences relating to Outwork) 2 (3) 1 (2) - (-) — (—) — (1) Total 57 (48) 35 (38) (1) 1 (3) (1) 18 OUTWORKERS.—The 58 (60) outworkers on the current register were engaged in the following occupations:— Wearing apparel making 28 (44) Stuffed toy making 6 (5) Upholstery work 2 (2) Lampshade making 3 (3) Artificial flower making 1 (2) Household linen making 2 (—) Paper bag making 12 (1) Basket making 2 (—) Feather sorting 2 (3) The female Public Health Inspector made 186 (301) visits to the premises concerned. All the premises were found to be suitable. LEGAL PROCEEDINGS Offence Result of Hearing Fine Costs 28, Walterton Road— (1) Defective waste pipe to sink £1 Is. Od. Order to abate in 21 days. (2) Nuisance—damp walls 10s. Od. £1 Is. Od. 20, Marylands Road— (1) Nuisance—General defects £1 Is. Od. Order to abate in 21 days. (2) Failing to provide three dustbins £1 0s. Od. £1 Is. Od. 103, Cirencester Street— Nuisance—Defective glazing £2 2s. Od. Order to abate in 14 days. 16, Barnsdale Road— Nuisance—General defects £2 2s. Od. Order to abate in 21 days. 103, Cirencester Street— Non-compliance with Justices' Order to abate Absolute £2 2.s Od. discharge 16, Barnsdale Road— Non-compliance with Justices' Order to abate £12 7s. 6d. £2 2.s Od. 20, Marylands Road— Non-compliance with Justices' Order to abate £50 0s. Od. £2 2.s Od. 67, Chepstow Road— Nuisance—roof not watertight, etc. Order to abate in 28 days. 51, Fording ley Road— Failing to provide two dustbins £1 0s. Od. £2 2s. Od. 16, Gotdney Road— Nuisance—General defects Order to abate in 28 days. 52, Warwick Avenue— Permitting 3 rooms to be overcrowded £6 0s. Od. £2 2s. Od. 1, Westbourne Park Crescent— Using basement rooms in contravention of Closing Orders £5 0s. Od. £1 Is. Od. 1, Westbourne Park Crescent— Permitting basement rooms to be used as above Dismissed. 19 In addition to the above, 21 (36) summonses were withdrawn and 22 (54) guineas costs received in connection therewith. SHOPS ACT.—The Shops Acts Inspectors made 1,838 (1,856) inspections during the year. No statutory action was necessary, any contraventions found being dealt with informally. PET ANIMALS ACT.—Six (6) premises were licenced under this Act during the year. Routine inspections are made to ensure that the conditions attaching to the licences are being maintained. BURIALS.—During the year 51 (44) burials and 7 (2) cremations were arranged under the National Assistance Act, 1948. MORTUARY.—The number of bodies received at the mortuary was 216 (258) and 199 (237) post mortem examinations were made there. The decrease is due to the practice of holding post mortem examinations at hospitals in cases where patients have died in hospital. RODENT CONTROL.—The following table gives details of the work carried out under the Prevention of Damage by Pests Act, 1949, and at the request of the Ministry of Agriculture, Fisheries and Food, relates to the year ended 31st March, 1958. Dwelling Houses All other property Total Total number of lies in district Number of properties inspected as a result of— 31,417(31,444) 7,765 (7,803) 39,182(39,247) (a) Notifications 412 (516) 87 (100) 499 (616) (b) Otherwise 115 (164) 5 (29) 120 (193) Number of properties found to be infested by rats— (a) Major infestation — (2) — (-) — (2) (b) Minor infestation 223 (207) 30 (38) 253 (245) Number of properties found to be infested by mice 230 (249) 54 (58) 284 (307) Number of infested properties treated by Council 452 (451) 84 (95) 536 (546) Tt was not found necessary to serve any notices. Two " block control " schemes were carried out. It was decided to carry out the twice-yearly sewer treatments in April and October. PIGEONS.—Four complaints about pigeons were received. Advice was given by the Public Health Inspectors or the complainant was referred to the pigeon catcher authorised to operate in the Borough. No nuisance occurred in the Borough from starlings. 20 RAG FLOCK ACT.—Four (4) premises where filling material was being used were on the register at the end of the year. There are no premises in the Borough where rag flock is manufactured or stored. One (2) sample was taken, which was satisfactory. PHARMACY AND POISONS ACTS.—At the end of the year the register contained the names of 111 (111) persons entitled to sell the poisons scheduled in Part II of the Poisons List. DRAINAGE RECONSTRUCTION PLANS.—During the year 166 (189) plans were deposited for drainage work in existing buildings. Prosecutions in connection with drainage work are reported under "Legal Proceedings." COMMON LODGING HOUSES.—There is one common lodging house in the Borough which provides fifty-nine beds for women. WATER SUPPLY.—All drinking water in the Borough is supplied from the Metropolitan Water Board's mains and has been satisfactory. One (2) water supply certificate was issued under the Public Health (London) Act, 1936. CARE OF THE AGED General.—This national problem continues to be reflected locally in Paddington and there has been a heavy demand for the assistance of the Council's officers during the past year. As the immensity of this problem becomes apparent it is obvious that an increasing proportion of the national resources will have to be devoted towards the alleviation of distress among the aged. The problem is to some extent aggravated by the advance of medical science which continues to prolong the expectation of life. The problem presents a challenge to local authorities which must be taken up with increased determination to help old people lead a happy life. The request for help received is in respect of old people who may be broadly grouped into three categories. (a) Those who, at a comparatively early age, require help because of some chronic ailment, e.g., arthritis, heart trouble, etc., and who need assistance with housework, shopping, etc. (b) Those who up to an advanced age are able to look after themselves but then become senile, and, owing to modern medical attention, survive for some considerable time—it has been called medical survival. This section needs similar attention as at (a). (c) A large group who are fit and capable of looking after themselves but who are lonely, and feel they have no place in society. Broadly speaking groups (a) and (b) are helped by the Council's services in co-operation with the London County Council, the District Nursing Association, W.V.S., etc.; and group (c) by the Paddington Old People's Welfare Committee and other voluntary organisations. 21 Some idea of the problem may be gathered from the fact that today one person in nine is over 65 years of age, compared with one in twenty-one at the beginning of the century. By 1975 this proportion will have risen to one in seven. In London alone there are at present 470,000 people of pensionable age—50,000 of these are over 80 and in Greater London out of a population of 8,251,000 the number of people aged 65 and over is 944,000. Institutional treatment for old people is provided as follows: (a) Hospital: Where ill and requiring medical attention, after which they may be discharged home. (b) Chronic Sick Wards: Not necessarily suffering from a specific ailment, but not well enough or mobile enough to be admitted to a Home. (c) Old Persons' Welfare Home: For old people in reasonable health. All the above are in great demand and are at present inadequate to meet the demand. Further, the pro rata cost is very high. It is now generally accepted that the best place for old people is in their own homes, and that the pattern and underlying principle of the services for the aged should be based on this. Only when they can no longer get proper care and attention in their own homes should they go to a Welfare Home, Chronic Sick Ward, or Hospital. The Council's efforts in this direction are through the provision of:— (i) Home Bathing (ii) Laundry Service (iii) Home Visiting (iv) Holiday Home (v) Liaison with other authorities and organisations, e.g., the London County Council, District Nursing Association, general practitioners, Paddington Old People's Welfare Committee, Women's Voluntary Services and National Assistance Board (vi) Disinfestation Service and Medicinal Baths. At the end of the year there were 145 (168) names on the register of old people. The female visitors made 1,211 (1,257) visits, and the male inspectors 30 (61) visits during the year. National Assistance Acts.—It was not found necessary to apply to the Court for a compulsory removal order during the year. Holiday Home.—During the year 968 (937) applications for holidays were received and 598 (613) guests were accommodated. Two hundred and ninety-two applicants refused the holiday offered (mainly on account of illness or because the dates allocated were too early or too late). In the remaining 78 cases no allocation was made due to death, removal from the Borough, unfitness or to single rooms or specific dates not being available. These figures are exclusive of the Christmas period when 51 people applied for a holiday. Sixteen were selected by the Holiday Home Sub-Committee for a week's holiday. 22 As the Council will remember, this holiday home was opened in 1948 and the charges therefor were fixed at that time as follows:— 21s. per week; or for those with Supplementary Old Age Pensions 15s. per week, inclusive of transport to and from the Home. The net cost of the Home has increased each year from £3,164 in 1949/1950 to £5,152 in 1956/1957, and the Committee after considering the many aspects of this valuable and popular service for elderly residents considered that it would be reasonable to increase the charges, without involving hardship, to 30s. per week inclusive of transport to all visitors, as from the 1st July, 1957. No adverse effect has been noticed in the number of applicants, in fact the cheapness of such an excellent amenity was often a subject of comment among visitors. Home Bathing and Laundry Service.—Six hundred and one (442) baths were given at home during the year and the number of cases being dealt with at the end of the year by the laundry service was ten (9). Twenty-nine (25) people received help from the laundry service during the year. HOME SAFETY.—This important subject was referred to the Public Health Committee in July. It is a matter in which close liaison exists between this Council and the London County Council through the medium of its Divisional Health organisation at 313/319, Harrow Road. In addition to the home visits paid by the London County Council officers as well as our own, considerable publicity in the form of posters and press has taken place. Further, small booklets for the use of the aged which incorporate hints on home safety have been circulated widely to the elderly through the medium of the Post Office, the Women's Voluntary Services, the libraries, etc., to whom I extend my grateful thanks. FOOD SUPERVISION Unsound food.—Approximately 5¾ (8½) tons of diseased or unsound food were surrendered for destruction. Diseased meat is incinerated, and other condemned food disposed of through the normal refuse channels. Bacteriological examinations.—The samples of milk submitted, 102 (95) were all satisfactory. Samples of ice cream examined under the Ice Cream (Heat Treatment) Regulations were graded as follows:— Grade 1—5: Grade 3—5 Grade 2—8: Grade 4—7 Registrations.—The following registrations were in force at the end of the year under the Milk and Dairies Regulations or the Food and Drugs Acts:— Distributors of milk 129 (127) Dairies 1 (1) Ice cream premises 204 (199) Food premises 71 (72) Licences.—Licences to sell designated milk in force at the end of the year are given below:— 23 Dealers' principal licences— Dealers' supplementary licences— Pasteurised 113 (108) Pasteurised 26 (24) Sterilised 125 (122) Sterilised 29 (27) Tuberculin tested 90 (85) Tuberculin tested 25 (23) Inspections.—During the year the two Food Inspectors paid 1,053 (1,040) visits to restaurants and cafes and 4,833 (4,634) visits to other food shops. Food premises.—Following are details of the food premises in the Borough at the end of the year:— Food shops:— Bakers 19 (19) Provision stores 124 (124) Cake shops 19 (20) Horsemeat shops - (1) Butchers 60 (62) Domestic stores 21 (20) Confectioners 144 (148) Corn chandlers 3 (2) Chemists 44 (46) Greengrocers 83 (85) Fishmongers 20 (22) Public houses 105 (106) Fried fish shops 11 (11) Cider houses 2 (2) Grocers 43 (44) Off licences 57 (57) General shops 31 (36) Restaurants, cafes 137 (136) Food factories.—There are 12 (10) food factories in the Borough including 2 (2) ice cream factories. Street traders.—Coffee stalls 6 (6); fruit and vegetable stalls 24 (25); ice cream stalls 2 (2). Sampling.—During the year 600 (600) samples were submitted to the Public Analyst for examination. No legal proceedings were found necessary, warning letters being sent to the firms concerned in four cases where samples were "adulterated" or incorrectly labelled. Food poisoning.—During the year there were no "outbreaks" and of the 55 notified cases 44 were of unknown origin. The agents in the remaining cases were— Salmonella typhimurium 8 Salmonella bredeney 1 Bacillus coli 2 BAKEHOUSES.—At the end of the year there were 17 (18) "Level" and 2 (2) "underground" bakehouses in operation. HAIRDRESSERS AND BARBERS.—There are 86 (83) hairdressers and barbers establishments in the Borough registered with the Council under the London County Council (General Powers) Act, 1954. Periodical inspections are carried out by the Public Health Inspectors. FREE HAND WASHING FACILITIES IN COUNCIL PUBLIC CONVENIENCES.—This service was inaugurated in August, 1950. Soap and paper towels are provided free on request and notices to this effect are exhibited in all of the Council's public conveniences. 24 WATER CLOSETS.—The London County Council Bye-law No. 7, stipulating the number of water-closets to be provided and maintained by the owner of any occupied building, which laid down a standard of one water-closet for every twelve inmates of any building has been repealed, and in its place a common standard has been adopted of one water-closet for each household where practicable; and where premises are let in lodgings, at least one water-closet for every eight persons or one water-closet for every four rooms whichever standard is the higher. PROTECTIVE HELMETS.—Under the Road Traffic Act, 1956— Section 42—and the Motor Cyclists (Protective Helmets) Regulations, 1947, the Council are required to arrange for the testing of protective helmets for motor cyclists. This duty has been assigned to the Public Health Committee and will be carried out by the Chief Food Inspector, Mr. F. J. Pallet. The necessary arrangements for the actual testing of these helmets have been made with the British Standards Institution at £2 10s. Od. each. HOUSING REPAIRS AND RENTS ACT, 1954, AND RENT ACT, 1957.—The Rent Act, 1957, came into force on the 6th July, 1957, and repealed (inter alia) those provisions of the Housing Repairs and Rents Act, 1954, relating to the issue of Certificates of Disrepair. The following tables give details of the applications made under the two Acts. The information relating to the Housing Repairs and Rents Act is for the period 1st April to 5th July and that relating to the Rent Act for the period 6th July to 31st December. The figures in brackets in the first table relate to the year ending 31st March, 1957. Housing Repairs and Rents Act, 1954 Dwelling houses which have been the subject of a notice under Part 11 of the Housing Repairs and Rents Act, 1954 Dwelling houses which have been the subject of a notice under the Rent and Mortgage Interest (Restrictions) Act, 1920 No. of applications for certificates — (11) — (2) No. granted - (6) - (2) No. refused - (5) -(-) No. of applications for revocations of certificates 3(10) — (4) No. granted 2 (8) — (1) No. refused 1 (2) - (3) Rent Act, 1957 Applications for certificates of disrepair— No. of applications for certificates 93 No. of decisions not to issue certificates 12 No. of decisions to issue certificates— (a) in respect of some but not all defects 62 (b) in respect of all defects 16 25 No of undertakings given by landlords under paragraph 5 of the First Schedule 31 No. of undertakings refused by Council under proviso to paragraph 5 of the First Schedule Nil No. of certificates issued 39 No. of applications awaiting report 3 Applications for cancellation of certificates— Applications by landlords for cancellation of certificates 4 Objections by tenants to cancellation of certificates 3 Decisions by Council to cancel in spite of tenants' objections Nil Certificates cancelled by Council 1 HOUSING Housing Act, 1957—Overcrowding (a) (1) Number of dwellings overcrowded at the end of the year 237 (277) (2) Number of families dwelling therein 244 (293) (3) Number of persons dwelling therein 1,040½(1,192) (Units) (b) Number of new cases of overcrowding reported during the year 35 (73) (c) (1) Number of cases of overcrowding relieved during the year 75 (93) (2) Number of persons concerned in such cases 321½ (368) (Units) (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 The number of overcrowded dwellings on the Register of Overcrowding at the end of 1957 (237) shows a decrease of 40 on the figure for 1956 (277); 86 of these were basement dwellings. Of the cases of overcrowding relieved during the year 4 (2) were provided with accommodation by the Borough Council, 19 (7) were rehoused by the London County Council, 30 (54) secured accommodation privately, 19 (26) were relieved by a natural reduction in the size of the family or on obtaining additional accommodation, and 3 (4) families were rehoused under the Industrial Selection Scheme for New Towns. 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. Section 80 of the Housing Act, 1957, gives a local authority power, where they are satisfied that exceptional circumstances exist which make it expedient to do so, to allow the temporary use of a house by persons in excess of the permitted number. During the year, the Council issued 9 (8) licences under this section of the Act. 26 During the year, a total of 769 (291) families from Paddington were rehoused on London County Council Estates or provided with accommodation in New Towns under the Industrial Selection Scheme. Housing Act, 1949—Improvements and Conversions. Two (twenty-seven) applications for grants in respect of proposed improvement or conversion of properties were referred to the Department for examination and report. The preparation of these reports involves consultation between the Public Health Inspectors and other technical officers of the Council, as well as interviews on the premises with the architects and owners concerned. Town Planning. One hundred and eighty-seven (229) applications to the London County Council under the Town and Country Planning Act, 1947, for the conversion and alteration of premises, change of user and continuation of consent were referred to the Council for examination and comment. As a result of the Council's observations, permission was refused for certain basement rooms to be used for human habitation where the rooms did not conform to the statutes and regulations in force in the Borough. Land Charges Act, 1925. Under the above-mentioned Act it is incumbent on the local authority to keep a register of local land charges. Houses included in clearance, improvement and redevelopment areas must be registered, as well as houses subject to repair notices under Part II of the Housing Act, 1957, and houses on which closing or demolition orders have been made. Some 1,530 (1,305) enquiries were referred to the Public Health Department during the year asking for details of notices outstanding and orders in operation under the Housing Act. At the same time particulars were called for of sanitary or other notices outstanding on the properties concerned. Housing Enquiries. Some 80 (200) communications were received during the year from the Borough Director of Housing, the County Divisional Medical Officer, the County Director of Housing and from other authorities, requesting information on the housing conditions of persons applying for rehousing on grounds of overcrowding, insanitary conditions and ill-health. Such information enables the enquirer to assess the degree of priority to be given to the applicants concerned. In each case a visit was made by the Public Health Inspector and a report furnished. New Accommodation. During the year eight flats were completed at Arnold House, Edbrooke Road. The following is a list of Council-owned new accommodation:— Pre-war No. of flats Post-war No. of flats Brindley House 8 Flemming Court 48 Dudley House 50 Queen's Park Court 96 Artesian House 8 John Aird Court 228 27 Post-war No. of flats No. of flats Lancefield Court 24 Worcester House 22 Philip Court 26 Exeter House 80 Crompton House 36 Taunton House 22 Gilbert Sheldon House 40 Winchester House 80 Portnall House 10 Newbury House 22 Leamington House 12 Reading House 80 Caernarvon House 80 Lynton House 22 Clovelly House 22 Brecon House 22 Bridgewater House 22 Marlow House 80 Tenby House 22 Sutherland Court 24 Arnold House 8 Housing Accommodation : Preferential Treatment. During the year 167 (274) medical certificates were referred to me by the Borough Director of Housing for "pointing." This arrangement enables the necessary degree of preference to be given to each certificate as well as bringing to notice sanitary defects which might otherwise have escaped detection and in respect of which no previous complaint had been received. Slum Clearance Programme. During the year the following London County Council Compulsory Purchase Orders were confirmed by the Minister of Housing and Local Government on the dates shown— L.C.C. (Edensor Gardens, Paddington) Order, 1956-— 20th June, 1957. L.C.C. (North Wharf Road, Paddington) Order, 1956— 11th September, 1957. L.C.C. (Clarendon Crescent, Paddington) Order, 1956— 5th November, 1957. On the 9th December, 1957, the London County Council made the London County Council (Brindley Road, Paddington) Compulsory Purchase Order, 1957. On the 4th July, 1957, the Paddington Borough Council declared an area, to be known as the Braithwaite Place and Adpar Street Area, a clearance area. The area consists of 8-11 (consec.) Adpar Street, 32-38 (even) and 7-25 and 29-35 (odd) Hall Place, 1-9 (consec.) Hall Place West, 2-13 (consec.) Braithwaite Place and 168-174 (even) Church Street. The area is approximately 1.316 acres in extent and the properties comprise 45 dwelling houses and two shops with residential upper parts (one shop being derelict). At the end of the year the Council were preparing a compulsory purchase order to be known as the Paddington Borough Council (Braithwaite Place and Adpar Street) Compulsory Purchase Order, 1958, which was to be made early in 1958. The order included the lands in the clearance area and about 0.693 acres of adjoining lands to be acquired. In addition the Council already own some 0.362 acres in the area. It is anticipated that about 210 families will be 28 displaced from the clearance area and adjoining lands and the London County Council have agreed to accept responsibility for the rehousing of 50 per cent. of these. Fumigation. Associated Fumigators, Limited, under an agreement with the Council, removed and treated the furniture and effects of one (49) family with hydrogen cyanide gas during the year. The cost of the work was £11 15s. Up to the 1st June, 1956, the charge for this work was £12 10s. per van per day in cases where two removals were effected in one van. With effect from the 1st July, 1957, this charge was increased to £12 15s. per van per day and if one family only was removed the charge became £11 15s. The charge made by the Council to the tenant remains at £6 5s. Houses Unfit for Human Habitation. No. of basement rooms dealt with by closing orders 362 (270) No. of upper rooms closed 22 (-) No. of mews premises closed 7 (-) No. of houses dealt with by closing orders (Local Government (Miscellaneous Provisions) Act, 1953) (4) No. of houses dealt with by demolition orders or in respect of which undertakings were accepted - (-) Ninety-three (12) persons were displaced as a result of the Council's operations. Closing Orders were determined or undertakings cancelled on 57 (28) basement rooms, 3 (—) upper rooms and 7 (—) mews premises; and 46 (43) other basement rooms and 2 (2) mews premises were made fit without recourse to formal proceedings. DELEGATION OF POWERS.—As will be generally recognised, implementation of public health functions is often a matter of urgency and to be effective cannot wait for confirmation of the Council at its monthly meetings. The Public Health Committee, therefore, requested the General Purposes, Legal and Parliamentary Committee to recommend the Council to delegate certain powers and duties to the Committee, thus ensuring the minimum of delay in carrying out their duties under the Public Health, Housing and other Acts. The Council, on the 28th February, 1957, adopted recommendations which will now enable the Public Health Committee to exercise their duties as expeditiously as the law permits, which will not only be an advantage to the public but will assist materially the efforts of myself and my officers in the performance and administration of the public health functions of the Council.