Metropolitan Borough of Paddington REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1963 H. LESLIE OLDERSHAW, M.D. (London), B.S., D.P.H. ERRATA: Page 1 Public Analyst's Report: Page 32 to read 33 Welfare Officer's Report: Page 34 to read 35 Page 9 Deaths under 4 weeks All causes - Male : 26 to read 24 Deaths 1 - A11 causes - Male : 5 to read 7 Diabetes Male : Delete 1 case under 4 wks. Add 1 case under 45 - Page 10 Other accidents Under 4 weeks : Delete Male 2 " 1 - : Add Male 2 Page 13 Tuberculosis : Amend 1962 to 1963 Page 25 Installation of furmoes : Amend 1962 to 1963 Page 26 Holiday Home : Illness amend 76 to 70 Page 27 Housing Act 1,957 - Overcrowding Amend 1953 to 1963 Index : Aged persons -Holiday Home Amend 25 to 26 Factories Amend 38 to 39 Holiday Home Amend 25 to 26 Invalid Meals Service Amend 36 to 26 P.H.Is. Summary of work Amend 15 to 18 CONTENTS Page Public Health Committee 4 Council's Representatives on other Committees 4 Staff 4 Summary of Statistics 6 Infectious and Other Diseases 11 Sanitary Circumstances 17 Food—Inspection and Supervision 20 Housing 27 Public Analyst's Report 32 Welfare Officer's Report 34 Index 40 Except where otherwise indicated, the figures in brackets throughout this Report are the figures for 1962, 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 1963. In order to avoid repetition of what is already contained in the body of the Report, 1 would like, nevertheless, to draw the particular attention of the Council to certain items, viz:— (1) A restricted Typhoid Fever outbreak (page 12). (2) A Mass X-Ray investigation undertaken by Dr. Brett in your Borough (page 13). (3) Immunisation in Paddington against certain infectious diseases during 1963 (page 14). (4) Implementation of the Housing Act, 1961 (page 28). I would like to express my gratitude for the help and co-operation I have received from the Chairman and Members of the Public Health Committee, the Chief Officers of the Council, and in particular to all the staff of the Public Health Department. I have the honour to be Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, H. LESLIE OLDERSHAW, Medical Officer of Health. July, 1964. Public Health Department, 14-15, Park Place Villas, London, W.2. Tel. No.: Paddington 1251. 4 PUBLIC HEALTH COMMITTEE (at 31st December 1963), Clr. Miss M. M. Bacon Clr. Mrs. I. L. Bolton, J.P. Clr. Mrs. N. Bulmer Clr. P. J. Crawford, M.A. Clr. Mrs. M. E. Nuttall Clr. R. S. Price Aid. Miss C. P. Rabagliati, M.B.E. Clr. Mrs. J. Silverman (Vice-Chairman) Clr. B. K. Vincent, F.C.A. (Chairman) COUNCIL REPRESENTATIVES OF OTHER COMMITTEES (at 31st December, 1963) London County Council Divisional Health Committee:— Clr. W. Dow Aid. Mrs. E. G. Lane Aid. Miss C. P. Rabagliati, M.B.E. Paddington Group (No. 21) Hospital Management Committee:— Mrs. D. Barrett Aid. W. E. Harriss Paddington and St. Marylebone District Nursing Association:— Aid. Miss C. P. Rabagliati, M.B.E. Paddington Tuberculosis Care Committee:— Clr. Mrs. 1. L. Bolton, J.P. Clr. Mrs. G. E. Haywood Clr. Mrs. M. E. Nuttall Clr. R. S. Price Aid. Miss C. P. Rabagliati, M.B.E. Clr. Mrs. J. Silverman PUBLIC HEALTH OFFICERS (at 31st December, 1963) 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:— J. H. E. Marshall, M.A., F.R.I.C. Administrative Staff:— H. J. Parker {Chief Clerk) S. W. Wordingham A. G. L. E. Houghton E. J. Cleaver D. J. Myers W. J. Mouls G. L. Quant R. Verrall D. S. Wright H. C. P. Eagle E. Crabb Miss D. L. Smeaton Mrs. F. M. Bean 5 Chief Public Health Inspector:— E. W. Pike (1) (2) Area Public Health Inspectors:— W. H. G. Atkins (I) V. L. Ronclietti (I) (2) E. B. Wilde (1) (2) (3) Area Public Health Inspector and Clean Air Inspector:— G. S. Adams (1) (2) (3) District Public Health Inspectors:— C. Chesterman (1) (2) R. Fowler (1) (2) V. A. Vickers (I) P. B. Blowes (1) J. C. Buckner (1) R. K. Young (1) (2) L. Rawlings (1) Chief Food Inspector and Sampling Officer:— A. C. Harrison (1) (2) Welfare Officer:— Miss I. O. D. Harrison, S.S.D., M.I.W.O. Visitors (Infectious Disease and Old People):— Mrs. A. J. Short (4) Mrs. N. R. McCredie (4) Holiday Home Manageress:— Mrs. M. E. Reeve Rodent Officer:— W. A. Dunkley Clean Air Technical Assistant:— E. F. Bonnar Clean Air General Assistants:— C. Lewis A. V. Du(field There are two male Student Public Health Inspectors undergoing training. Three Rodent Operatives, three Medicinal Baths Attendants, I four Disinfection and Disinfestation Operatives, and one Drain Testing Assistant are employed in the Public Health Department. A cook, waitress, one full time and one part-time domestic are employed at the Holiday Home. (1) Public Health Inspector's Certificate. (2) Meat and Other Foods Certificate. (3) Smoke Inspector's Certificate. (4) State Registered Nurse. 6 VITAL STATISTICS Area of Borough (including 20 acres of waterways) 1,356 acres Rateable Value £9,027,848 Product of a penny rate (net) £37,200 Population (Registrar General's midyear home population) 113,960 (113,600) Number of dwellings (according to the Rate Books) 32,070 (31,613) Live Births Number 2,637 (2,670) Rate per 1,000 population 23.14 (23.50) Illegitimate Live Births per cent, of total live births 24 (25) Still Births Number 33 (43) Rate per 1,000 total live and stillbirths 12 (16) Total Live and Still Births 2,670 (2,713) Infant Deaths (deaths under one year) 47 (70) Infant Mortality Rates Total infant deaths per 1,000 total live births 19 (26) Legitimate infant deaths per 1,000 legitimate live births 17 (25) Illegitimate infant deaths per 1,000 illegitimate live births 22(31) Neo-natal Mortality Rate (deaths under four weeks per 1,000 total live births) 14 (21) Early Neo-natal Mortality Rate (deaths under one week per 1,000 total live births) 12(18) Perinatal Mortality Rate (still births and deaths under one week combined per 1,000 total live and still births) 24 (34) Maternal Mortality (including abortion) Number of deaths 2(3) Rate per 1,000 total live and still births 0.75 (1.1) Deaths from all causes 1,296 (1,248) Borough death rate (deaths per 1,000 population) 11.37 (10.99) Comparability factors—Births 0.73(0.81) Deaths 1.20(1.00) England and Wales—Birthrate 18.2(18.0) Death rate 12.2 (11.9) Marriages 1,312(1,410) 7 VITAL STATISTICS—(cont.) Live and Still Births and Infant Deaths Legitimate Illegitimate Total Live births— Males 961 (1,058) 338 (331) 1,299 (1,389) Females 1,030 (941) 308 (340) 1,338 (1,281) Total 1,991 (1,999) 646 (671) 2,637 (2,670) Still births— Males 16 (20) 4 (7) 20 (27) Females 10 (10) 3 (6) 13 (16) Total 26 (30) 7 (13) 33 (43) Deaths of infants under one year of age— Males 23 (24) 9 (14) 32 (38) Females 10 (25) 5 (7) 15 (32) Total 33 (49) 14 (21) 47 (70) Deaths of infants under four weeks of age— Males 15 (21) 9 (11) 24 (32) Females 8 (19) 4 (6) 12 (25) Total 23 (40) 13 (17) 36 (57) Deaths of infants under one week of age— Males 14 (20) 6 (9) 20 (29) Females 7 (14) 4 (6) 11 (20) Total 21 (34) 10 (15) 31 (49) 8 VITAL STATISTICS {cont.) 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 record 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 17 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 1958 115,700 2334 20.17 1335 11.54 51 22 45 19 51 21 1959 113,400 2288 20.18 1227 10.82 51 22 40 17 44 19 1960 113,350 2480 21.88 1192 10.52 64 26 46 19 48 19 1961 113,980 2491 21.85 1250 10.97 55 22 41 16 49 19 1962 113,600 2670 23.50 1248 10.99 70 26 57 21 43 16 1963 113,960 2637 23.14 1296 11.37 47 19 36 14 33 12 † Per 1,000 population. * Corrected figures after allowing for inward and outward transfers. § Per 1,000 live births. ‡ 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 Under 4 weeks 4 wks. and under 1 yr. 1— 5— 15— 25— 35— 45— 55— 65— 75 & over All Causes M. 649 26 8 5 2 5 8 24 73 159 166 173 F. 647 12 3 2 1 5 8 23 46 80 148 319 Tuberculosis, respiratory M. 7 — — — — — — 2 — 2 2 1 F 4 — — 1 — — — 1 1 — — 1 Tuberculosis, other forms M. — — — — — — — — — — — — F. — — — — — — — — — — — — Syphilitic diseases M. 2 — — — — — — — — 2 — — F. — — — — — — — — — — — — Diphtheria M. — — — — — — — — — — — — F. — — — — — — — — — — — — Whooping Cough M. — — — — — — — — — — — — F. — — — — — — — — — — — — Meningococcal infections M. 1 — 1 — — — — — — — — — F. — — — — — — — — — — — — Acute Poliomyelitis M. — — — — — — — — — — — — F. — — — — — — — — — — — — Measles M. — — — — — — — — — — — — F. — — — — — — — — — — — — Other infective and parasitic diseases M. 3 — — — — — — — — 2 — 1 F. — — — — — — — — — — — — Malignant neoplasm of stomach M. 11 — — — — — 1 — 2 1 6 1 F. 16 — — — — — — 1 4 3 3 5 Malignant neoplasm of lung, bronchus M. 62 — — — — — 1 — 7 27 20 7 F. 25 — — — — — — — 4 7 8 6 Malignant neoplasm of breast M — — — — — — — — — — — — F. 24 — — — — — — 1 7 7 2 7 Malignant neoplasm of uterus M. — — — — — — — — — — — — F. 13 — — — — — 2 2 1 3 3 2 Other malignant and lymphatic neoplasms M. 56 — — — — — — 1 14 8 14 19 F. 61 — — — 1 — 1 — 8 13 18 20 Leukaemia, aleukaemia M. 6 — — — — — — — 2 — 3 1 F. 6 — — — — 1 — — — — 2 3 Diabetes M. 1 1 — — — — — — — — — — F. 7 — — — — — 1 1 — 1 1 3 Vascular lesions of nervous system M. 43 — — — — — — 1 3 10 13 16 F. 83 — — — — — — 1 2 8 18 54 Coronary disease, angina M. 171 — — — — — — 3 22 53 50 43 F. 95 — — — — — — — 2 6 31 56 Hypertension with heart disease M. 4 — — — — — — — — 2 1 1 F. 11 — — — — — — — — — 2 9 10 Deaths—(contd.) Causes of Death Sex All Ages Under 4 weeks 4wks. and under 1 yr. 1— 5— 15— 25— 35— 45— 55— 65— 75 & over Other heart diseases M. 27 — — — — — 1 — 2 5 9 10 F. 55 — — — — 1 — 1 5 6 8 34 Other circulatory diseases M. 23 — — — — — — 1 2 4 7 9 F. 40 — — — — — — — — 4 9 27 Influenza M. 3 — — — — — — — — 1 1 1 F. 2 — — — — — — — — — — 2 Pneumonia M. 33 — 2 — 1 — — — — 2 7 21 F. 45 2 1 — — — — 1 — 2 8 31 Bronchitis M. 56 — 1 — — — — 2 3 13 14 23 F. 37 — — — — 1 — — 1 5 11 19 Other diseases of the respiratory system M. 6 — — — — — — 1 1 — 2 2 F. 10 — — — — — — — — 2 3 5 Ulcer of stomach and duodenum M. 9 — — 1 — — — 1 1 1 2 3 F. 6 — — — — — — — — — 3 3 Gastritis, enteritis and diarrhœa M. 3 — 1 — — — — — — 1 1 — F. 2 — — — — — — — — — 1 1 Nephritis and nephrosis M. 4 — — — — — — — 2 1 1 — F. 3 — — — — — — — 1 — 1 1 Hyperplasia of the prostate M. 7 — — — — — — — — — 3 4 F. — — — — — — — — — — — — Pregnancy, childbirth and abortion M. — — — — — — — — — — — — F. 2 — — — — — — 2 — — — — Congenital malformations M. 7 5 1 — — — — 1 — — — — F. 3 — — 1 — — — — — — 1 1 Other diseases M 51 19 — 2 — — — 2 6 11 5 6 F. 54 10 2 — — — 1 3 2 8 13 15 Motor vehicle accidents M. 10 — — 2 1 3 2 — — — 2 — F. — — — — — — — — — — — — Other accidents M 15 2 2 — — — 1 5 — 4 — 1 F. 29 — — — — 1 — 4 6 3 2 13 Suicide M. 28 — — — — 2 2 4 5 9 3 3 F. 14 — — — — 1 3 5 2 2 — 1 Homicide and operations of war M. — — — — — — — — — — — — F. — — — — — — — — — — — — ] 1 INFECTIOUS DISEASE Notifications.—Following is a table showing the number of cases of infectious disease notified. The number of cases after allowing for corrections of diagnosis is shown in brackets. Disease 1959 1960 1961 1962 1963 Acute encephalitis (infective) — (—) — (—) — (—) — (—) — (—) Acute encephalitis (post infectious) — (—) — (—) — (—) — (—) — (—) Acute pneumonia (influenzal) 23 (23) 4 (4) 14 (14) 1 (1) 3 (3) Acute pneumonia (primary) 14 (14) 19 (19) 16 (16) 11 (11) 12 (12) Acute poliomyelitis (paralytic) 7 (3) 6 (5) 2 (2) 1 (1) — (—) Acute poliomyelitis (non-paralytic) 2 (1) 3 (2) 1 (1) 1 (1) — (—) Diphtheria 1 (—) — (—) 1 (1) — (—) — (—) Dysentery 25 (25) 34 (34) 39 (39) 32 (32) 18 (18) Erysipelas 2 (2) 3 (3) 3 (3) 1 (—) 3 (3) Food poisoning or suspected food poisoning 88 (87) 77 (77) 67 (67) 102 (102) 47 (47) Infective enteritis 13 (13) 7 (7) 13 (13) 1 (1) 7 (7) Malaria 1 (1) — (—) — (—) — (—) 1 (1) Measles 388 (388) 809 (809) 838 (838) 343 (343) 662 (662) Meningococcal infection 1 (1) — (—) — (—) 1 (1) 4 (4) Ophthalmia neonatorum 1 (1) 2 (2) 3 (2) 1 (1) 3 (3) Paratyphoid fever — (—) — (—) — (—) 1 (1) — (—) Puerperal pyrexia 139 (139) 138 (138) 137 (137) 150 (150) 142 (142) Scabies 22 (22) 35 (35) 24 (24) 18 (18) 46 (46) Scarlet fever 37 (37) 27 (27) 25 (25) 9 (9) 29 (29) Smallpox — (—) — (—) — (—) — (—) — (—) Tuberculosis (respiratory) 149 (149) 137 (137) 148 (148) 144 (144) 135 (135) Tuberculosis (C.N.S. or Meninges) 1 (—) — (—) — (—) — (—) 1 (1) Tuberculosis (other forms) 15 (15) 14 (14) 14 (14) 20 (20) 12 (12) Typhoid or enteric fever 2 (2) 3 (3) 3 (3) 3 (3) 6 (6) Whooping cough 49 (49) 117 (117) 29 (29) 15 (15) 76 (76) 12 Typhoid Fever Outbreak, 1963.—During the latter part of the year there was a minor outbreak of typhoid fever in the borough which, fortunately, was confined to one house. The four persons infected (2 adult females and 2 children) were Wcit Indians who had been living in this country for approximately one year. All cases were-treated in hospital, three being diagnosed as clinical cases and the other was a "carrier" and was presumed to be the source of the outbreak. Investigations by officers of my department involved tracing numerous contacts, arranging the disinfection of the household concerned and obtaining bacteriological specimens from the other occupants thereof. Specimens were also obtained from 35 contacts at a day nursery situated in the borough. A toy factory in the borough where the "carrier" had worked, was also disinfected and some 200 soft toys manufactured there were disinfected at the Council's Disinfecting Station. In addition, bacteriological specimens were obtained from 23 of the factory employees. The other adult case was employed at a large food factory located outside the borough. The company medical officer of the firm arranged for the disinfection of part of the factory premises and also for the collection and examination of bacteriological specimens from employee contacts. All the cases made a satisfactory recovery and were discharged from hospital before the end of the year and then placed under the surveillance of my department. 13 Tuberculosis.— The ward distribution of the cases of tuberculosis notified during 1963 is as follows: Ward Pulmonary Non-Pulmonary Total Males Females Males Females Queen's Park 5 3 — — 8 Harrow Road North 17 10 — — 27 Harrow Road South 7 2 — 1 10 Maida Vale North 4 1 — — 5 Maida Vale South 6 3 — 4 13 Town 4 — — — 4 Readings 4 11 — — 15 Church 2 1 — — 3 Westbourne 13 4 2 1 20 Lancaster Gate West 14 8 — 3 25 Lancaster Gate East 9 2 1 — 12 Hyde Park 3 2 1 — 6 Borough 88 47 4 9 148 There were 11 deaths from respiratory tuberculosis and NIL from other forms of tuberculosis during the year. Visiting.—The investigation of cases of food poisoning are made by the Food Inspector; and the London County Council Health Visitors visit cases of puerperal pyrexia, ophthalmia neonatorum, infective enteritis and tuberculosis. The two Borough Council Visitors investigate all other cases of infectious disease (in addition to their work in connection with elderly people which is reported under "Care of the Aged") and during the year they made 829 (535) visits in the course of these investigations. Bacteriological examinations.—The number of examinations made in connection with infectious disease was 329 (265). International certificates.—During the year 2,648 (3,359) certificates of inoculation or vaccination were submitted by persons travelling abroad for the authentication of the signature of the medical practitioner concerned. This authentication is required under the World Health Organisation agreement. MASS X-RAY Dr. G. Z. Brett, the Physician-in-charge of the Mass X-Ray Unit, has reported that during 1963 the number of people X-rayed in the Borough was 6,780. Fifteen cases of active pulmonary tuberculosis and six observation cases of pulmonary tuberculosis were found. In addition, two cases of lung cancer and one of secondary deposits in the lung were found. This department gave Dr. Brett appropriate assistance to conduct his survey. 14 IMMUNISATION The following immunisations were given in Paddington during 1963:— Diphtheria Immunisation Primary courses Reinforcing doses By London County Council and General Practitioners 1,740 1,705 whooping cough immunisation Primary courses Reinforcing doses By London County Council and General Practitioners 1,462 463 Poliomyelitis immunisation Primary courses Reinforcing doses By London County Council and General Practitioners 2,124 705 LONDON COUNTY COUNCIL SERVICES.—The following Clinics and Day Nurseries in the Borough are provided by the London County Council :— Maternity and child welfare centres— Dibdin House, Maida Vale, W.9 Hallfield, Pickering House, Hallfield Estate, W.2 Harrow Road, 283a, Harrow Road, W.9 Queen's Park, 66, Lancefield Street, W.10 St. David's Hall, St. Mary's Terrace, W.2 School treatment centre— Paddington School Treatment Centre, 12 Maida Avenue, W.2. Chest Clinic— Paddington & Kensington Chest Clinic, 14-18 Newton Road, W.2. The London County Council is responsible for the prevention, care and after care of tuberculosis ca?es while the Regional Hospital Board is responsible for diagnosis and treatment. Day Nurseries— Katharine Bruce, Queen's Park Court, llbert Street, W. 10. Marylands, Marylands Road. W.9. St. Jude's, 88 Bravington Road, W.9. St. Stephen's, 38-46 Westbourne Park Road, W.2. The Home Help Service and the Mental Health Service are administered from the Divisional Health Office of the London County Council at 313-319 Harrow Road, W.9. 15 CONTRIBUTIONS TO ORGANISATIONS.—Among the Organisations to which the Council make grants the following are closely associated with the work of the Public Health Department:— Organisation Grant £ s. d. Family Welfare Association 200 0 0 Paddington Old People's Welfare Committee 2,200 0 0 W.V.S. (for meals-on-wheels service) 370 0 0 Salvation Army (for meals-on-wheels service) 50 0 0 Kensington and Paddington Family Service Unit 200 0 0 Royal Society for the Prevention of Accidents 25 4 0 Central Council for Health Education 16 0 0 Noise Abatement Society 5 5 0 British Standards Institute 10 10 0 HEALTH EDUCATION During the year the question of publicity directed towards education in health matters received regular attention. Each month posters on a number of subjects were displayed on the Council's notice boards and leaflets made available in the Council's offices visited by the general public. Among other matters receiving attention in this way were Food Hygiene ; Accidents in the Home ; Smoking and Lung Cancer. LEGAL PROCEEDINGS Offence Result of Hearing Fine Costs 16, Moorhouse Road— Nuisance—defective main roof £3 £1 1s. Order to Abate in 14 days Insect in loaf £10 £3 3s. St. John's Buildings— Nuisance—general defects £2 £1 1s. Order to Abate in 2 months 45, Palace Court— Nuisance—dampness of ceilings £5 — Order to Abate in 28 days Artificiallightingofcommonstaircase £2 £1 1s. 452, Harrow Road— Nuisance—general defects £3 £1 1s. Order to Abate in 28 days 190, Shir land Road— 1. Nuisance—defective ceiling plaster in basement back room £5 0s. £1 1s. Order to Abate in 14 days 2. Nuisance—defective ceiling plaster in basement front room Order to Abate in 14 days 16 Legal Proceedings—(contd.) Offence Result of Hearing Fine Costs 245, Shirland Road— Nuisance— general defccts - £1 1s. Order to Abate in 21 days Flat 6, 43, Warrington Crescent— Nuisance—general detects £5 0s. £2 2s. 9, Chippenham Road - Artificial lighting of common staircase £2 0s. £2 0s. 6d. 25, Fermoy Road— Defective waste pipes £1 £1 1s. 508, Harrow Road — Mouldy chicken puff pie £2 £3 3s. 69, Chepstow Road— Contravention of Closing Orders— Basement back room £5 £1 1s. Basement front room £5 Basement back addition room £5 — 58, Chippenham Road— Continued non-compliance with Order to Abate £25 £2 10s. 72, Sutherland Avenue— Nuisance—general defects £5 £1 1s. Order to Abate in 28 days 56, Amberley Road— Nuisance—general defects £5 £1 1s. Order to Abate in 7 days Artificial lighting £5 £1 1s. 99, Shirland Road— Nuisance—general defects £2 £1 1s. Order to Abate in 1 month 5, Westbourne Gardens— Contravention of Closing Orders— Basement back room £30 £1 1s. Basement front room £30 — Basement back addition room £30 — 197, Harrow Road— Insufficient dust bins £2 10s. 6d. 15, Fermoy Road— Insufficient dustbins £2 £3 5s. 6d. Dirty Milk Bottle £2 — 12, Torquay Street— Nuisance—general defects £5 £1 1s. Order to Abate in 28 days 98, Elgin Avenue— Nuisance—general defects £5 £4 Order to Abate in 28 days 17 Legal Proceedings—(contd.) Offence Result of Hearing Fire Costs 1, Coomassie Road— Building at rear— Nuisance -defective sashcords — £1 1s 32, Bravingtost Road— Order to Abate in 14 days Non-compliance with Justices Order to Abate £5 £1 1s. 82, Shirland Road— Nuisance—general defects £2 £1 1s. Order to Abate in 21 days 4, Modena Street— Nuisance—defective ceiling £4 £1 1s. Order to Abate in 7 days 193, Harrow Road— Defective basement water-closet £4 £1 1s. 197, Harrow Road— Nuisance—general defects £4 £1 1s. Order to Abate in 28 days In addition to the above, thirty su n.nonses were withdrawn as the work was done before a hearing was reached. PUBLIC HEALTH INSPECTORS' WORK.—Following is a summary of the work of the Public Health Inspectors. Further details of their work in connection with Factories and Outworkers is given in the Annex to the Report. Dwelling houses inspected:— Premises inspected as a result of complaints 3,101 (2,798) Premises inspected in house to house visits 163 (27) Premises inspected for action under the Housing Acts 777 (52) Premises inspected in connection with Certificates of Disrepair 11 (6) Premises inspected in connection with improvement grants 173 (145) Premises inspected in connection with making of Closing Orders 360 (309) Premises inspected other than those noted above 788 (435) Notices served:— Intimation notices under the Public Health (London) Act, 1936 605 (440) Statutory notices under the Public Health (London) Act, 1936 307 (273) Notices under the London County Council or Paddington Borough Council bye-laws 199 (145) Notices under the London County Council (General Powers) Act, 1954 52 (46) Notices under the London County Council (General Powers) Act, 1955 32 (20) Notices under the Clean Air Act, 1956 110 (35) Notices under the Noise Abatement Act, 1960 1 (—) 18 Visits made in co/uiection with:— Aged persons 26 (28) Bakehouses 48 (61) Basements (checking occupation) 201 (83) Canal and House Boats — (—) Caravans — (1) Clean Air Act 1,312 (1,643) Dwelling houses 16,363 (14,428) Factories 298 (72) Fireguards Act 1 (5) Hairdressers' establishments 52 (95) Infectious disease 85 (150) Miscellaneous calls 93 (190) Outworkers 54 (119) Overcrowding 129 (248) Pet Animals Act 8 (14) Rag and bone stores — (—) Rag Flock Act 5 (—) Rehousing applications 88 (49) Restaurants and Cafes 229 (629) Rodent control 217 (296) Shops 1,031 (963) Smoke (observations made) 66 (117) Town Planning 211 (266) Vermin investigations 580 (359) The infectious disease visits are made in connection with contacts of cases of smallpox or suspected smallpox. NOISE NUISANCES During the year 49 complaints of noise were received from the public. Some of these, however, did not come within the scope of either the Noise Abatement Act, 1960, or the Good Rule and Government By-Laws made by the Council. One notice was served during the year under the Noise Abatement Act, 1960, the other contraventions being abated after informal representations were made from this Department. MEDICINAL BATHS AND DISINFECTING STATION.—The figures below give a summary ,of the work done at the Medicinal Baths and by the Disinfecting and Disinfesting Operatives. Disinfestation:— Rooms treated for vermin 856 (619) Articles disinfested 1,407 (834) Disinfection:— Rooms disinfected after infectious disease 72 (47) Library books disinfected 375 (292) Articles of clothing, etc., disinfected 560 (363) Scabies:— Number of adults treated 58 (24) Number of children treated 19 (28) Number of treatments given 138 (96) 19 Vermin:— Number of adults treated (heads) 22 (15) (bodies) 62 (35) Number of children treated (heads) 16 (21) (bodies) — (5) The Medicinal Baths are in a self-contained annex to the Kensal Road Swimming Baths, which are at the junction of Kensal Road and Wedlake Street. Access to the Baths is via Kensal Road or, often more conveniently, from the Harrow Road by means of the footbridge over the Grand Union Canal opposite Second Avenue. In addition to the facilities for the treatment of scabies and delousing there is an American type steam disinfecting apparatus, and an Electrolux rotary washing machine for the incontinent laundry service. The staff of the medicinal baths and disinfecting service also deal with the laundry and home bathing, further details of which will be found under " Care of the Aged PHARMACY AND POISONS ACT.—The Pharmacy and Poisons Act, 1933, requires the Council to keep a list of persons entitled to sell poisons in Part II of the Poisons List. Such persons are required to apply each year to have their names retained on the list. At the end of 1963 the register contained the names of 68 (69) persons. HAIRDRESSERS AND BARBERS.—Section 18 of the London County Council (General Powers) Act, 1954, requires the registration of hairdressing and barbers' establishments, and bye-laws made in accordance with Section 18 (4) of the Act are for the purpose of securing generally :— (a) the cleanliness of the premises; (h) the cleanliness of any instruments, materials, equipment, etc.; and (c) the cleanliness of persons employed in such premises. There are 98 (98) registered establishments in the Borough. PET ANIMALS ACT, 1951.—This Act requires the Council to licence all pet shops. The provisions of this Act ensure that :— (a) The accommodation where ajiimals are kept is generally satisfactory, proper and clean. (b) That the animals are properly provided for. (c) That the animals are not sold at too early an age. (d) That reasonable precautions are taken to prevent the spread in animals of infectious disease. (e) That appropriate steps can be taken in case of fire or other emergency. Four (5) applications for licences were made and granted during 1963, and one pet shop ceased business. Eight visits were made to Pet Shops during the year. RAG FLOCK ACT.—Three (3) premises where filling material is 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. 20 PROTECTIVE HELMETS.—During the year shops selling protective helmets were visited and samples of the stocks were inspected to ensure that the helmets had been certified by the British Standards Institute as required by the Motor Cycles (Protective Helmets) Regulations, 1957. No infringement of the Regulations was found. ANI MAL BOARDING ESTABLISHMENTS ACT, 1963.—This Act becomes operative on 1st January, 1964, and provides for a system of licensing and inspection by local authorities of any establishment at which a business of providing accommodation for cats or dogs is carried on. At the end of the year no application had been received for such a licence. BURIALS.—During the year 4S (49) burials and 2 (4) cremations were arranged under the National Assistance Act, 1948. DRAINAGE RECONSTRUCTION PLANS.—During the year 222 (233) plans were deposited for drainage work in existing buildings. MORTUARY.—Bodies from Paddington are now taken to the St. Pancras Borough Council mortuary when private arrangements are not made. During the year 318 (284) bodies were taken there and 316 (283) post mortem examinations were carried out. BAKEHOUSES.—At the end of the year there were 10 (11) level bakehouses in operation. COMMON LODGING HOUSES.—There are no Common Lodging Houses in the Borough. PIGEONS.—Six complaints about pigeons were received during the year and were dealt v/ith by advice from the Public Health Inspectors, or by i formal action if their congregation was caused by someone feeding them. PUBLIC SWIMMING BATHS.—Water for the two swimming baths in the Borough is supplied from the Metropolitan Water Board's mains. Apart from routine tests by the Baths' staff, 14 samples were taken for bacteriological and chemical analysis by the Public Analyst during the summer months. FOOD SUPERVISION Unsound foods.—Approximately 6 (6) tons of diseased or unsound food was seized or surrendered for destruction. Diseased meat is incinerated, and other condemned food disposed of through the normal refuse channels. Registrations.—The following registrations were in force at the end of the year under t e Milk and Dairies Regulation.; or the Food and Drugs Act. Distributors of milk (142) (144) Dairies (—)(—) Ice-cream premises (203) (211) Food premises (47) (54) Food shop's.—Following are the details of thi food shops in the Borough at the end of the year:— Bakers and cake shops 25 (31) Butchers 53 (53) Confectioners 125 (129) Chemists 36 (39) 21 Fishmongers 14 (14) Fried fish shops 13 (13) Grocers 28 (29) General shops 22 (23) Provision stores 120 (118) Domestic stores 15 (15) Corn chandlers 2 (3) Greengrocers and fruiterers 68 (72) Public Houses 91 (96) Cider Houses 1 (1) Off licences 52 (53) Restaurants and cafes 129(131) During the year 2,476 (2,390) visits were paid to food shops by the Food Inspectors. Canteens.—There are approximately 30 canteens of various sizes in the Borough. Wholesale food stores.—There are 16 (18) wholesale food stores in the Borough. Food factories.—There are 7 (9) food factories in the Borough including 1 (2) ice cream factory. Sampling.—During the year 500 (500) samples were submitted to the Public Analyst for examination. Prosecutions in respect of samples are reported under "Legal Proceedings." The report of the Public Analyst will be found as an appendix. Bacteriological examinations.—Twenty-four ice cream samples were graded as follows:— Grade1 19 Grade2 5 Grade3 — Grade4 — Twenty-four (24) samples of milk were examined and all conformed to the standards required by the Milk Regulations. Street Traders.—The Council have licenced 7 (7) coffee stalls, 21 (21) fruit and vegetable stalls and 2 (2) ice-cream stalls. Milk Licences.—The following Dealers' (Pre-packed Milk) Licences were in force at the end of the year:— Tuberculin Tested 124 (105) Pasteurised137 (130) Sterilised 130 (124) These licences are valid until the 31st December, 1965. Milk Vending Machines are now licensed under the Milk (Special Designation) Regulations, 1960, and seventeen machines were licensed, also until the 31st December, 1965. Food Poisoning.—The Food Inspector made 51 (156) visits in connection with enquiries into cases of food poisoning or suspected food poisoning. SEWAGE.—The Minister of Health has requested that this Report should indicate whether the arrangements for sewerage and sewage disposal in the district are reasonably adequate. I have consulted the Borough Engineer & Surveyor and he informs me that the County Council sewers crossing the Borough do become surcharged on occasions, and under these conditions are unable to 22 accept the discharge from the Borough Council sewers. This problem, of course, also affects other Boroughs and the County Council are supplied with full details to assist them in dealing with the problem. The disposal of sewage is a matter for which the London County Council are responsible. The sewage from Paddington goes to the Northern Outfall Works at Beckton. At these works the sewage is treated and separated into effluent sufficiently pure to be discharged into the Thames, and sludge which is disposed of at sea. RODENT CONTROL.—The following table gives details of the work carried out under the Prevention of Damage by Pests Act, 1949, during the year:— Dwelling Houses All other property Total Number of properties in district 32,070 (31,613) 5,863 (7,224) 37,933 (38,837) Number of properties inspected as a result of— (a) Notification 443 (389) 85 (102) 528 (491) (b) Survey 118 (125) 3 (2) 121 (127) (c) Otherwise - (2) - (1) - (3) Total inspections and re-inspections 2,899 (2,713) 594 (805) 3,493 (3,518) Number of properties found to be infested by— (a) Rats— Major infestation — (—) — (— ) — (— ) Minor infestation 165 (136) 31 (34) 196 (170) (b) Mice— Major infestation — (—) — (— ) — (— ) Minor infestation 248 (233) 51 (66) 299 (299) Number of infested properties treated by the Council 413 (369) 81 (98) 494 (467) Total treatments and re-treatments 462 (406) 90 (108) 552 (514) It was not found necessary to serve any notices under the Act. The sewers in the Borough were treated twice during the year. WATER SUPPLY.—All drinking water in the Borough is supplied from the Metropolitan Water Board's mains and the Director of Water Examination (E. Windle Taylor, M.A., M.D., D.P.H.) has kindly supplied the following report and figures. The water is derived from the River Thames, stored in the Board's reservoirs in the Thames Valley and filtered and chlorinated at the Board's works at Hampton and Ashford Common. The water supplied to the Borough during 1963 was satisfactory, both in quality and quantity. There were no new sources of supply instituted by the Metropolitan Water Board during the year, nor 23 any new important extensions of trunk mains. The general scheme of supply was the same as during 1962 but 957 yards of service main were laid in Paddington during 1963. SOURCE OF SUPPLY Hampton Ashford Chemical Examination Common Number of samples 52 52 Ammonia nitrogen 0.165 0.22 Albuminoid nitrogen 0.076 0.083 Nitrate nitrogen 3.9 3.9 Chlorides as Chlorine 32 32 Oxygen absorbed from permanganate (four hours at 27°C.) 1.22 1.26 Turbidity units 0.3 0.2 Colour—Burgess's Tintometer 11 11 Hardness (total) 276 284 Hardness (non-carbonate) 68 66 pH value 7.8 7.9 Phosphate as PO4 1.3 1.3 Silicate as SiO 2 12 12 Sulphate as SO4 60 60 Fluoride as F 0.25 0.25 Magnesium as Mg 5 5 Surface active material as Manoxol 0.08 0.08 Electrical conductivity (micromhos) 560 560 The above figures are given as milligrammes per litre unless otherwise stated. Bacteriological Results (after treatment) Number of samples 1.091 768 Agar plate count per ml. (20—24 hours at 37°C.) 10.6 13.6 Coliform count—per cent. samples negative in 100 ml 100.0 99.87 E. coli count—per cent. samples negative in 100 ml. 99.87 99.87 CLEAN AIR ACT, 1956 There were no major "smog" incidents in the year. This is due no doubt to the absence of appropriate weather conditions, although the continued decline in the amount of smoke emitted may well have played an important part, particularly at critical periods. The decline is due principally to the continued introduction of Smoke Control areas assisted by the control of new furnaces, the improvement of existing industrial and commercial heating arrangements and the reduction in coal-fired locomotives operating from Paddington Station. The sulphur dioxide concentration is unchanged. The Clean Air Act does not offer controls for emissions of this gas, although indirectly it does make a contribution. In Smoke Control areas the replacement of coal fires by modern appliances burning smokeless fuel efficiently means a smaller fuel consumption, which reduces the SO2 in direct proportion, and if the coal fires are replaced by electric or gas fires, which emit no SO2, or fires burning light oils, which emit only minute amounts, the reduction is even greater. Similarly, improved heating arrangements in commercial and industrial 24 premises reducc fuel demand and therefore SO2 production. This reduction is, however, offset by higher consumption necessitated by the demand for increased heating facilities and by the replacement of low or no sulphur fuels by fuels of comparatively high sulphur content. It is unfortunate that the increased momentum, which had been hoped for, by the appointment of a Technical Officer, has not been fully attained. This is due partly to the absence of the officer owing to illness for a long period, continuing into 1964, and also to the resignation of one survey assistant. Although the post was filled fairly quickly, delay was caused by the necessary essential training of the replacement. Smoke control areas.—The Council's revised programme envisages that the whole Borough will be a smokeless zone by 1968. The present position is as follows:— Hyde Park No. i Order. Confirmed by the Minister of Housing and Local Government and in operation from the 31st October, 1959. Lancaster Gate East Order. Confirmed by the Minister of Housing and Local Government and in operation from the 1st November, 1960. Lancaster Gate West Order. Confirmed by the Minister of Housing and Local Government and in operation from the 1st August, 1962. Westbourne No. I Order. Confirmed by the Minister of Housing and Local Government and in operation from the 1st November, 1963. IVestbourne No. 2 Order. Confirmed by the Minister of Housing and Local Government with an operation date of 1st July. 1964. Harrow Road North Order. Preliminary survey is beingcarried out. Hyde Park No. 2 & Reading Orders. The surveys for both these areas have been completed. Smoke Control Orders will be made when the extensive redevelopment schemes in these areas have reached an appropriate stage. Measurement of atmospheric pollution.—The results obtained from the recording apparatus at the Welfare Centre, 283a, Harrow Road, during 1963 are given below. Month Rainfall in mms. Insoluble deposits in tons per square mile Soluble deposits in tons per square mile S.O in mgs. per day per 100 square cms. January 19 (88) 7.72 (14.12) 4.86 (10.40) 5.00 (3.87) February 8 (9) 12.04 (6.81) 7.04 (8.22) 5.34 (2.70) March 65 (41) 22.88 (12.30) 6.98 (13.90) 3.25 (3.63) April 49 (40) 15.14 (11.88) 1.88 (4.87) 2.38 (2.68) May 42 (42) 13.02 (12.69) 4.09 (5.47) 1.27 (1.76) June 83 (8) 10.78 (9.56) 1.91 (5.77) 1.06 (1.36) July 36 (74) 7.82 (9.09) 4.13 (0.94) 1.23 (1.19) August 68 (38) 8.32 (8.28) 7.72 (3.59) 0.94 (1.30) September 91 (142) 9.62 (7.08) 21.80 (12.08) 1.81 (1.18) October — (37) (6.48) — (3.42) 1.81 (2.73) November 113 (37) 9.82 (6.91) 2.88 (7.95) 3.01 (3.80) December 17 (46) 18.26 (6.81) 7.01 (12.68) 3.88 (4.55) *Combined figure for September/October. 25 The following results were obtained during 1963 from the recording apparatus at the Public Health Department offices at 15, Park Place Villas:— Month Smoke Microgrammes per cu.m. SO2 Microgrammes per cu.m. Average value Highest value Lowest value Average value Highest value Lowest value January 199 (164) 704 (545) 0 (49) 357 (222) 1,149 (549) 158 (127) February 247 (155) 428 (414) 6 (60) 446 (198) 909 (431) 197 (112) March 85 (157) 188 (319) 9 (49) 182(299) 369 (910) 105 (112) April 104 (88) 264 (319) 28 (40) 230 (160) 556 (273) 103 (68) May 47 (52) 107 (120) 27 (28) 98 (113) 101 (237) 68 (60) June 32 (28) 86 (48) 13 (14) 77 (83) 244 (178) 37 (29) July 31 (38) 81 (74) 14 (11) 81 (84) 291 (175) 43 (43) August 38 (23) 77 (49) 10 (10) 87 (79) 232 (138) 35 (46) September 60 (46) 157 (102) 23 (16) 132 (88) 546 (263) 51 (44) October 78 (106) 132 (298) 35 (35) 143 (241) 430 (612) 74 (90) November 138 (196) 660 (499) 27 (79) 204 (260) 616 (689) 51 (96) December 206 (402) 453 (142) 71 (75) 301 (521) 620 (257) 160 (113) Installation of furnaces.—It is obligatory under Section 3 of the Clean Air Act that a person who proposes to instal a furnace with a capacity of 55,000 or more B.T.U's. an hour must notify the local authority; he may also make application for prior approval of the plant. The following figures for 1962 are submitted:— No. of notifications under Sec. 3 (3) of intention to instal a furnace 13 (10) No. of applications under Sec. 3 (2) for prior approval of the proposols 1 ( 1 ) No. of applications under Sec. 3 (2) approved by the Council .. 1 (1) The Clean Air Inspector is responsible for the routine inspection of all large sized boiler plants, and investigations and advice to operatives following complaints of smoke emissions. CARE OF THE AGED General.—At the end of the year there were 630 (559) names on the register of old people who are visited regularly. In addition 35 (22) other elderly people were visited but not put on the register as regular visiting was unnecessary. The two Visitors made 3,221 (3,283) visits and the Public Health Inspectors 26 (28) visits to old people during the year. Home bathing.—Sixty-six (69) persons were given 1,337 (1,811) baths at home during the year. Laundering of Linen.—The number of cases being dealt with at the end of the year by the laundry service was 24 (25). Sixty (52) people received help from the service during the year. National Assistance Acts.—It was not found necessary to apply to the Court for the compulsory removal to hospital of any person during the year. 26 Holiday Home.—The following guests were accommodated at "Kincardine". Guests stay for a fortnight during January, February, March and November and for a week during the remainder of the year. No. of applications received 885 No. of Guests accommodated 555 Applicants refusing holiday offered:— Date offered unacceptable 49 Private reasons 51 Illness 76 Death of applicant, friend or relative 25 Removed from borough subsequent to offer 10 Private holiday taken 4 Obtained employment 6 Applicants not offered a holiday:— Removed from borough 5 Died 20 Single rooms not available 30 Special date not available 21 Priority not reached 39 Of the 555 guests accommodated, 150 were having their first holiday at the Home. At Christmas a further sixteen guests were selected from sixty-seven applicants and spent at a week at the Home. In addition to the services provided by the Paddington Borough Council for the elderly, a number of voluntary organisations provide the following services which enable the elderly person to remain at home:— Meals.—In Paddington the provision of hot meals at the home of the elderly devolves mainly on the Women's Voluntary Services, who deliver meals twice a week to any one person, the service being restricted to the housebound only. The Salvation Army also supply meals twice a week at their Goodwill Centre. The Invalid Meals Service, organised by the London County Council, has, of course, a wider scope than meals for the elderly and is used for appropriate cases. Chiropody.—In Paddington this service is provided both by the Paddington Old People's Welfare Committee and by the London County Council. The Paddington Old People's Welfare Committee scheme provides for the following :— (a) Some 1,500 treatments per year at the surgery of a local chiropodist. (b) The equivalent of two sessions per week at a clinic at Leonora House. (c) Some 750 treatments at the homes of the housebound. The London County Council hold a foot clinic at the Welfare Centre, 283a Harrow Road, on seven occasions each week. These clinics are not exclusively for the elderly. Recreational Centres.—A. number of clubs for the elderly are organised by the Women's Voluntary Services, the Salvation Army 27 and the Paddington Old People's Welfare Committee. Three of the clubs provide meals, one each by the aforementioned organisations. VISITING OLD PEOPLE The Council having considered the need for co-ordinating the social visiting of old people undertaken by various official and voluntary organisations in the Borough, have arranged after consultation with the British Red Cross Society and other organisations for the voluntary social visiting of old people to be co-ordinated in the Borough by the Paddington Division of the British Red Cross Society. For this purpose the Council have agreed to make a grant in aid to cover the remuneration of a full-time organiser to be employed by the British Red Cross Society, plus the cost of telephone and office equipment. The project commenced on the 1st January, 1964. HOUSING (FINANCIAL PROVISIONS) ACT, 1958 AND HOUSE PURCHASE AND HOUSING ACT, 1959 When applications are made to the Council for either discretionary or standard Improvement Grants the Public Health Department is asked to comment on the scheme submitted. If a grant is made, any works carried out have to be to the satisfaction of this department so far as public health matters are involved, e.g. drainage, underground rooms. During 1963 the department's comments were invited upon 78 (39) applications, but not all of these were proceeded with. The department is also asked to supply information regarding the property (the existence of closing orders; permitted numbers, etc.) before the Council considers applications for loans for house purchase, and 108 (101) such cases were dealt with during the year. HOUSING Housing Act, 1957—Overcrowding (a) (1) Number of dwellings overcrowded at the end of the year 136 (120) (2) Number of families dwelling therein 137 (123) (3) Number of persons dwelling therein 594£ (556) . (Units) (b) Number of new cases of overcrowding ported during the year 58 (32) (c) (1) Number of cases of overcrowding lieved during the year 42 (64) (2) Number of persons concerned in such cases 169½ (274) (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 Nil The number of overcrowded dwellings on the Register of Overcrowding at the end of 1953 was 136 (120). There were 39 (44) basement dwellings on the Register. Of the cases of overcrowding relieved during the year 3 (17) were rehoused by the London County 23 Council, 9(15) were provided with accommodation by the Borough Council, 24 (26) secured accommodation privately and 6 (6) were relieved by a natural reduction in the size of the family or on obtaining additional accommodation. The practice of sending warning letters to owners against perimitting the premises to become again overcrowded has been continued in all known cases where overcrowding 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 one (—) licence und:r this section. During the year a total of 147 (201) Paddington families were rehoused by the London County Council and 135 (194) by the Borough Council. Housing Accommodation—Preferential Treatment During the year 241 (303) medical certificate were referred to me by the Borough Director of Housing for "pointing." Points are awarded for certified ill-health, and if the applicant's health is affected by his living conditions the Public Health Department investigates these conditions and in many instances is able to get them remedied. Houses Unfit for Human Habitation No. of basement rooms dealt with by closing orders 59 (60) No. of upper rooms closed 3 (5) No. of mews premises closed 20 (5) No. of houses dealt with by closing orders in lieu of demolition orders — (1) No. of houses dealt with by demolition orders or in respect of which undertakings were accepted — (—) Fifty-two (25) persons were displaced as a result of the Council's operations. Closing Orders were determined or undertakings cancelled on 72 (95) basement rooms. Fifty (58) other rooms were made fit without recourse to formal proceedings. New Accommodation During the year the Council completed eight (82) new flats at Westbury House. HOUSING ACT, 1961 The house to house survey in the Portnall Road Area, referred to in my previous report, was continued at the commencement of 1963. The attention of the owners of the properties was drawn to any deficiencies and advice was given on some of the problems involving controlled lettings, and where the occupiers were elderly persons with long-standing tenancies. Many of these were not particularly enthusiastic and in some cases feared the possibility of repercussions of the Council's insistence on the provision of additional amenities. Publicity as to the availability of Standard and Discretionary Improvement Grants was also given but the response was disappointing. 29 For the first seven months of the year the one Public Health Inspector, seconded for specialist Housing Act duties, continued to work on these lines. Our experience up to this time confirmed the possibilities expressed in my last year's report, viz.:— (i) The problems of over-occupation coupled with insecure tenancies would have to be approached with discretion. The service of statutory notices insisting on the provision of a standard of amenities adequate for the house as occupied at the time of inspection would, in our opinion, inspire evictions. (ii) The difficulty faced represented an intensely human problem inseparable from the availability of alternative housing accommodation, and where the Council could not re-house families evicted without prejudicing those already on the long waiting list. In the middle of the year the Borough received more than its share of publicity in the national and local press, consequent upon questions raised in Parliament and throughout the remainder of the year many discussions took place between Borough Councillors and senior officers of both the Borough and the London County Council. In particular, a meeting took place in August between the Minister of Housing and Local Government and his senior advisers and representatives of the Borough Council and officers. At this meeting the Borough Council's difficulties in implementing Part II of the 1961 Act were stated, including our Public Health staff deficiencies. Advice was given by the Minister's staff on the standard "Code of Practice" adopted by the Council for amenitiee in relation to Section 15 notices and to making limits under Section 19. In the same month the Council instructed that a special " houseto-house " statistical survey should be carried out in St. Stephen's Gardens, a road associated with " Rachmanism " and one which had for some years presented difficulties to the Public Health Inspectors. The survey carried out by the staff of this Department, assisted by other officers, gave the Council considerable statistical information as to the lettings of the 120 houses and persons occupying those lettings but did not indicate that conditions were in the state that appeared to be the impression of many, due mainly to the publicity that attended the bad properties. A detailed house to house inspection by the Public Health Inspector of all houses in multiple occupation in St. Stephen's Gardens was then commenced and a further Inspector was temporarily seconded from District work to give assistance. It was decided as a matter of Council policy to deal with all the houses in St. Stephen's Gardens that qualified, using the powers given in Section 12/14 (Management Order procedure) and Section 19 (the application of limits to prevent future over-occupation, made in relation to those amenities that were existing). It was also decided that those houses so far inspected in Portnall Road should be dealt 30 with in like manner, and at a special Public Health Committee called in September, action was taken in respect of 40 houses and a further 3 in Beethoven Street. The publication of the Housing Bill, containing many very important amendments and extensions to the powers of the 1961 Act, coincided with the decision of the Council to strengthen considerably the Housing Section of the Public Health Department, and appoint four senior Inspectors for specialist duties under the Housing Acts. The Chief Public Health Inspector and myself gave considerable thought to the best method of using the new Inspectors with the object of utilising their experience to the full and making the most effective practical impact on the housing situation. It was decided that four Housing teams should be formed, each consisting of an Inspector, a technical assistant and additional assistance as far as practicable from one of the student public health inspectors. Each team would operate independently in a selected area in the Borough and additional clerical staff would be provided to cope with extra reports and records produced. This recommendation received the approval of the Council and the progress of the scheme will be a subject for my 1964 Report. Another very important recommendation accepted by the Council was in relation to the fixing of limits under Section 19. The Housing Act, 1957, already stipulates a legal maximum (termed the permitted number) for the occupation of separate dwellings based on the size and number of rooms. Section 19 of the Housing Act, 1961, empowers the Local Authority to fix as a limit for the house (or parts thereof) what in their opinion is the highest number of individuals who should live in the house (or part) in its existing condition, having regard to the facilities listed in Section 15. Such limit must be for the purpose of preventing the occurrence of, or remedying, a state of affairs calling for the service of a Notice, or a further Notice, under Section 15. Thus, all directions given under this Section must be related directly to the facilities available, i.e., natural and artificial lighting; ventilation; water supply; personal washing facilities; drainage and sanitary conveniences; facilities for the storage, preparation and cooking of food and for the disposal of waste water; and installations for space heating or for the use of space heating appliances. These two controls of necessity overlap, although being completely separate in themselves. It is necessary in any parts of a house where full facilities are provided, that the Section 19 limit be made to coincide with the legal maximum. This is of considerable importance in the case of small rooms for single occupation, and for family limits for multiple-room lettings. The Paddington Borough Council adopted standards for Section 15 in November, 1962, and these have been used from that date in all discussions with owners concerning conversion or improvement of houses. Had they been used without amendment for the purpose of calculating limits under Section 19, the effect would have been that a very large proportion of houses would have qualified for zero limits throughout on the grounds of the absence of food stores, baths and/or hot water. 31 The matter was raised during the discussion, to which I have already referred, with the Minister of Housing and Local Government, who thought that, although our high standard was to be applauded, there was some doubt as to whether it was enforceable. Bearing in mind that the limits may be varied subsequently, " notwithstanding the existence of any previous direction .. . laying down a higher maximum," amended standards were agreed upon, which are as follows:— 1. Natural and artificial light—to be reasonably adequate for occupation, i.e., not capable of closure, etc. Any room which could be subject to a Closing Order to be given " zero " limit. 2. Ventilation—as for natural and artificial light above. 3. Water supply—to be readily available to each letting and on same floor as letting. 4. Personal washing facilities—family units to have some facility within letting. Baths—one fixed bath or shower to 10 persons irrespective of age. The absence of hot water and/or bathroom will not automatically give " zero " limit, but will call for limit of 1 per room (over 70 sq. ft.). 5. Drainage and sanitary conveniences—minimum standard to be one water-closet to eight persons. 6. Storage, preparation and cooking of food—separate cooking facility for each family unit required. 7. Space heating—to be disregarded in relation to limits. Since the manner of letting is always within the control of the owner and may be varied frequently, it has been found necessary to calculate the limits in five ways in order to provide a reasonably effective control of the occupation :— 1. For each separate room in the house. 2. For each multiple room letting as existing—on the basis of occupation by separate individuals. 3. For each multiple room letting as existing—on the basis of occupation by a family unit. 4. Overall limits for shared water-closets or bathrooms—where applicable. . 5. Overall limit for the house as a whole. RENT ACT, 1957.—Below is a table showing details of the applications during 1963 for certificates of disrepair under this Act together with the action taken thereon. Applications for certificates of disrepair— No. of applications for certificates 7 (1) No. of decisions not to issue certificates 1 (—) No. of decisions to issue certificates— (a) in respect of some but not all defects 6 (—) (b) in respect of all defects — (1) No. of undertakings given by landlords under paragraph 5 of the First Schedule 1 (—) No. of undertakings refused by Council under proviso to paragraph 5 of the First Schedule — (—) 32 No. of certificates issued 2(1) No. of applications awaiting report at end of year 3 (—) Applications for cancellation of certificates— Applications by landlords for cancellation of certificates 3 (2) Objections by tenants to cancellation of certificates — (—) Decisions by Council to cancel in spite of tenants' objections — (—) Certificates cancelled by Council 3 (2) No. of applications awaiting report at end of year — (—) TOWN PLANNING.—Three hundred and eighty-eight (352) applications under the Town and Country Planning Acts for the conversion and alteration of premises, change of use or continuation of consent were referred to the Department for examination and comment. LAND CHARGES.—Some 2,217 (1,764) enquiries on matters in connection with the registered statutory charges under the Land Charges Act, 1952 were dealt with by the Department during the year. 33 APPENDIX Report of the Public Analyst (J. H. E. Marshall, M.A., F.R.I.C.) for the year ended 31st December, 1963. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Paddington. Your Worship, Ladies and Gentlemen, The number of samples submitted for examination during the year was 500. Of these, 486 were obtained under the provisions of the Food and Drugs Act, 1955, and 14 were complaint samples. There were irregularities in 14 of the samples obtained under the Food and Drugs Act and these, with the 14 complaint samples, were the subjects of special reports. Six of the samples were chemically unsatisfactory in that three contained excessive traces of copper (a metal which is toxic if present in large quantities). These three articles had probably been prepared in copper vessels. Two medicines did not have the requisite composition. The last unsatisfactory sample was that of mincemeat which was only very slightly deficient in soluble solids. This latter indicates how closely a manufacturer tries to get to the statutory standards with his article. It is natural to conclude that such a manufacturer is more concerned with an exact application of the standard than marketing an excellent product at a fair price. A further six samples were inaccurately labelled. The complaint samples were quite varied in character:—A sample of fish that caused illness because it was not properly cookcd, though the complainant blamed the quality of the fish; two milk bottles were dirty; a hot meat pie was stale; lemon curd was of old stock; a wedding cake was mouldy and a bottle of lemonade had been capped with a stopper which had a residue of disinfectant on it. Complaints which were not justified were:—Potatoes alleged to be bitter; bread containing a "foreign object; cake with an alleged splinter of glass; "contaminated" corned beef and a sample of butter. Lastly, a sample of Camembert cheese' was submitted for adjudication on the question of ripeness which is, of course, always a matter of personal preference. New legislation during the year included Bread and Flour Regulations which prescribed permitted ingredients for bread and imposed requirements as to labelling and also restrictions on such things as claims for slimming. Soft Drinks Regulations impose standards of composition and requirements as to labelling. The Poisons Rules contained many detailed amendments. A matter which is at present very much in the mind of the public is the control of drugs in respect of their safety and purity, and the accuracy of their compounding. The number of drugs available to the public has increased enormously since the introduction of the National Health Service, and there is little or no control of their quality by independent authority. Whilst it may be 34 held that drugs are at present covered by the Food and Drugs Act, new legislation unifying all the various aspccts of drug control would be welcome. Your Analyst looks forward to examining the extra samples of drugs which the provisions of the new legislation could make obligatory. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, J. H. E. Marshall, Public Analyst. 35 Report of the Welfare Officer (Miss I. O. D. Harrison, S.S.D.) In my Report for 1962, I referred to the explosive increase in the numbers of Commonwealth Immigrants who were arriving in the Borough in an attempt to forestall any barriers they felt might result from the pending Commonwealth Immigrants Act (July, 1962). During the last year the restrictions of the Act have naturally been reflected in the numbers of people from the Commonwealth arriving in Paddington because, as we know, the figures were immediately drastically reduced. The Home Office figures in respect of movement in and out of the United Kingdom by Commonwealth citizens (subject to control under Part 1 of the Act) show that for the last six months of the year 1963, the total net inflow was 33,980. During this period the highest net inflow recorded was from India and Pakistan, total 22,800. Other figures showed net inflow from Nigeria total 2,459, Jamaica total 1,793, British Guiana total 1,195, Barbados 733. (All figures including men, women and children). In the case of Jamaica there was an actual net outflow of men, and, in fact, it should be particularly remarked that for all the Caribbean territories the low net inflow was the result of fairly substantial outflow. In the Borough of Paddington the largest group of Commonwealth Immigrants comprises people from West Indian Territories. Although we have a number of people from the countries of Africa, they, nevertheless, form a much smaller group. People from Pakistan and India are to date an extremely small minority. I have quoted the above figures because from them 1 think it is reasonable to assume that the immigrant population in Paddington over the last year would have remained fairly static—although, of course, we must take it for granted that there may have been minor fluctuations owing to such things as change of residence. There are, of course, no statistics available to indicate the situation in respect of Irish immigrants. The severe winter of 1962/63 created new problems and aggravated many of the existing ones. Particularly affected was employment because outdoor and buildings trades were drastically hit. Numbers of people were put out of employment at this time and the unemployment figures at local exchanges showed this. As the local population comprises large numbers of working-class newcomers, a preponderance of people attending the labour exchanges were immigrants. This situation gave me particular cause for anxiety, quite apart from the actual problems created by unemployment. First, because unemployment engenders fear and panic, and it is therefore at such times that latent prejudice can more easily erupt, particularly if obvious newcomers are seen in employment, while natives of this country are without it. Secondly, because prejudiced people will seize on anything which tends to justify their points of view, and the sight of newcomers attending the labour exchanges was quickly taken by many of them as being confirmation of their contention that immigrants come here to draw "dole" or live on National Assistance. As we know, working-class immigrants come with the specific intention of obtaining work and are subjected to the same rules in relation to National Insurance and National Assistance as the rest 36 of the population; therefore they do not draw "dole" unless they have paid sufficient contributions. Naturally, all groups include a certain number of work-shy or undesirable characters, but I know of very few Commonwealth newcomers who would choose unemployment. They are far more ambitious. Indeed, it is ambition that brings them to England. Another problem which was made even more acute by the bad winter was that of the method of heating, and sometimes cooking, in the large multi-occupied houses. I refer to the ubiquitous oil heater. This is the only form of heat possible in this type of house for people with slender resources and although many of these heaters are structurally safe, the potential fire danger remains high, particularly in houses that are draughty and where there are several children in crowded rooms. This type of fire, started in one room, could mean that the whole house is gutted. I spent a great deal of time visiting houses of this description for the purpose of advising tenants of the dangers that exist and ensuring they took all reasonable precautions to prevent a tragedy. This situation creates particular problems for the mother with sick children. As a newcomer she may not have immediate friends or members of her family who can assist, and consequently, when obliged to go out, has no alternative but to leave the fire burning, at great risk, or to turn it out, leaving the children in the cold. As was inevitable, problems concerned with accommodation and housing featured very extensively in my work. It was during this period that matters came rather to a head as a result of publicity given to the Rachman exposure. Apart from the many genuine cases of hardship with which I was dealing, I also attracted numerous problems and enquiries from individuals and groups, all of whom were quite convinced that Rachman must be their landlord, and that, as a result of the exposure, I should be able to do something to help them. This situation put a nearly impossible load on my shoulders, because investigations which in my particular work are most time-consuming, nevertheless had to be carried out, and frequently resulted in showing that the situation was one in which the Council was powerless to intervene or assist. As we know, the publicity at this time resulted in the Government deciding to set up a Committee of Enquiry into the size of the problem and what steps might be taken to overcome difficulties that exist. The practical difficulty in pursuing the enquiries necessary, however, remains the same, i.e. the fear of unprotected tenants that complaints will result in eviction. As a Welfare Officer I sometimes find myself in an extraordinarily difficult position. In confidence, I have verified information where regulations are breached but, at the same time, I am implored by my client to prevent any action being taken, because they know this will result in eviction, therefore inflicting even more hardship on their families. We should be deluding ourselves if we thought that the only type of exploitation was the dramatic type symbolised by the Rachman publicity or that any group had the monopoly of unscrupulous people. We still have unsatisfactory landlords. We still have unsatisfactory estate agents, and we must appreciate that there are also unsatisfactory tenants. 37 I continue to be perturbed by the unsatisfactory landlord occupiers, who treat their unprotected tenants shamefully, and persecute their bitterly resented controlled tenants, while at the same time avoiding grounds for legal action. In certain cases this is caused by sheer avarice, but in other cases this arises from financial over-commitment or unwise house purchase. The whole field is bedevilled by some highly unsatisfactory estate agents who appear to be able to establish themselves in districts like this. I am personally perplexed by the fact that there appears to be no difficulty or formal requirements in the way of unscrupulous unqualified people setting up in such a business. A great difficulty in my work is getting clients to accept the fact that as a Welfare Officer I am advisory only, and have no powers, other than those of persuasion. I can only help people to live with the situation that exists. It is worthy of note that we have many employers who care sufficiently about their workers who are newcomers to get in touch with me personally to enlist my aid in assisting such employees who have personal problems complicated by different backgrounds. These approaches have the added advantage of providing an opportunity for me to advise and inform on these differences, thus promoting deeper understanding. Unfortunately I have had complaints from people who feel they have been the victim of discrimination from other employers. What is more troubling is when the complaints emanate from young people, some of whom have been here long enough to receive sufficient education to have passed recognised examinations. Making all due allowances for rumour, disappointments, undue sensitivity, inadequate adaptability and inadequate qualifications and abilities, etc., I seek ways and means for best dealing with cases where some prejudice may exist. When I have investigated specific complaints I have approached the employer concerned, but it is always impossible to pinpoint reasons for rejection. The nearest one gets to this is to be told that it is " the people on the floor who would object In an earlier report I drew attention to the fact that there were newcomer men who were not accepting the marital or even extramarital responsibilities for their womenfolk and children, which we normally accept in this country, and that in fact' they would have been expected to accept in their country of birth. I have had an increasing number of mothers coming to me with problems created by deserting fathers, or fathers who refuse properly to maintain and support them or the children. I am still surprised by the loyalty and attitude of many of these women who, despite extreme hardship and unhappiness, are still reluctant to take court action where this is possible. It is, of course, always encouraging to notice that more unions are being legalised by marriage, but the problem that arises out of this is when the situation is complicated by children of earlier unions. I have had a number of cases where the wife has brought over children of earlier unions which her husband resents and is not willing to support, and often completely rejects. An added complication can be the attitude of such children, who are older and who, quickly assimilating patterns of behaviour of school friends in this country, are not then prepared to accept the man of the house as 38 having parental authority over them, or any authority which may be recognised in the country of birth. Naturally, serious emotional disorders can result in this type of situation, and as well as grappling with the normal problems of growing up, such children experience additional problems of adaptation and conflict of authority. The rise in the numbers of illegitimate births in the Borough, as reported in the Report of 1962, gave rise to many sharp criticisms of newcomers, and reference was frequently made to " unwanted " babies. In view of the different behaviour patterns, which mean that for some immigrants marriage and raising children are still not synonymous, it cannot be denied that many children are born to them out of wedlock. This does not mean, however, that all such children are unwanted, on the other hand, many such mothers struggle valiantly to fulfil the role of a caring mother without the support of the father. I am happy to report that certain anti-social problems, such as noisy social gatherings and illegal parties appear to be easing. The easing of these problems has been directly due to the co-operation and active support received from members of the local police force. Normally when referring to the police one thinks of their role in relation to prosecution, and it is because of this that I would wish particularly to draw attention to the diplomatic and preventive work they have so skilfully performed among people who were creating these problems. The problems of newcomers, of their acceptance and adaptation, are not confined to our Borough and consequently understanding of such problems cannot best be found working in a narrow field. In an attempt to improve my knowledge, understanding and efficiency I have, of course, needed to keep abreast of current situations, familiarise myself with the varied backgrounds of newcomers, meet other people and organisations with experience in this field and to attend discussion groups, discussions and conferences for this purpose. Naturally, many of these activities encroach on my week-ends and evenings, but the Council have also been kind enough to grant me leave of absence to attend some of these functions. For this I am extremely grateful. In conclusion, I would again extend my grateful thanks to Dr. Oldershaw and his Staff for the help and courtesy which is always readily available, and to the Officers of the London County Council with whom I am frequently in touch. I should also like to pay tribute to the Staff of the Citizens' Advice Bureau for their help and co-operation, and also to thank the Staff at our Town Hall, whose advice and help I value. 39 The Ministry of Health has requested that the following figures regarding factories and outworkers should be annexed to the Annual Report. Annual Report of the Medical Officer of Health in respect of the year 1963 for the Metropolitan Borough of Paddington in the County of London Prescribed Particulars on the Administration of the Factories Act, 1961 Part I of the Act 1. Inspections for purposes of provisions as to health (including inspections made by Public Health Inspectors). Premises (1) Number on Register (2) Number of Inspections (3) Written notices (4) Occupiers prosecuted (5) (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 514 115 1 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority. 49 1 - - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 99 - - - Total 662 116 1 - 2. Cases in which defects were found. Particulars (1) Number of cases in which defects were found Number of cases in which prosecutions were instituted (6) Found (2) Remedied (3) Referred To H.M. Inspector (4) By H.M. Inspector (5) Want of cleanliness (S.l) 13 4 — — — Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) 1 — 1 — — Inadequate ventilation (S.4) 1 1 — — — Ineffective drainage of floors (S.6) — — — — — Sanitary Conveniences (S.7) (a) Insufficient — — — — — (b) Unsuitable or defective 10 — — 2 — (c) Not separate for sexes — — — — — Other offences against the Act (not including offences relating to Outwork) 1 — — — — Total 26 5 1 2 — 40 Part VIII of the Act Outwork (Sections 133 and 134) Nature of Work (1) Section 133 Section 134 No. of outworkers in August list required by Section 133 (l)(c) (2) No. of cases of default in sending lists to the Council (3) No. of prosecutions for failure to supply lists (4) No. of instances of work in unwhole some premises (5) Notices served (6) Prosecutions (7) Wearing apparel Making, etc. 33 — — — — — Cleaning and washing — — — — — — Household linen — — — — — — Lace, lace curtains and nets — — — — — — Curtains and furniture hangings — — — — — — Furniture and upholstery — — — — — — Electro-plate — — — — — — File making — — — — — — Brass and brass articles — — — — — — Fur pulling — — — — — — Iron and steel cables and chains — — — — — — Iron and steel anchors and grapnels — — — — — — Cart gear — — — — — — Locks, latches and keys — — — — — — Umbrellas, etc. — — — — — — Artificial flowers — — — — — — Nets, other than wire nets — — — — — — Tents — — — — — — Sacks — — — — — — Racquet and tennis balls — — — — — — Paper bags — — — — — — The making of boxes or other receptacles or parts thereof made wholly or partially of paper — — — — — — Brush making — — — — — — Pea picking — — — — — — Feather sorting — — — — — — Carding, etc., of buttons, etc. — — — — — — Stuffed toys 1 — — — — — Basket making — — — — — — Chocolates and sweetmeats — — — — — — Cosaques, Christmas stockings, etc — — — — — — Textile weaving — — — — — — Lampshades 2 — — — — — Total 36 — — — — — INDEX Aged persons Wholesale premises 21 Bathing 25 Food poisoning 11,21 Holiday Home 25 Health education 15 Laundry 25 Hairdressers 19 Meals 26 Holiday Home 25 Register of 25 Home Bathing of Old Compulsory removal 25 Persons 25 Chiropody 26 Home Helps 14 Analyst 33 Housing (Financial Provisions) Animal Boarding Establishments 20 Act 1958 27 Atmospheric pollution * House Purchase and Housing Furnaces 25 Act 1959 27 Measurement of 24, 25 Housing Smoke Control Areas 24 Closing Orders 28 Bacteriological examinations 13,21 Medical certificates28 Bakehouses 20 New accommodation 28 Barbers 19 Overcrowding27 Bathing old persons 25 Housing Act 1961 28,29 Births 7 Icecream 21 Comparability factor 6 Immunisation 14 Illegitimate 6,7 Improvement grants 27 Live 6,7 Incontinent Laundry Service 25 Rates 6 Infant Deaths 6, 7 Still 6, 7 Infectious Disease 11 Borough Bacteriological Area 6 examinations 13 Dwellings 6 Diphtheria11, 14 Penny Rate 6 Food poisoning 11,21 Population 6 Notifications 11 British Standards Institute 15 Poliomyelitis 11,14 Burials 20 Scabies 11, 18 Care of the Aged 25 Smallpox 11 Central Council for Tuberculosis 13 Health Education 15 Typhoid fever 11,12 Chest Clinic 14 Verminous persons 19 Clean Air Act 1956 23,24,25 Whooping cough11,14 Closing Orders 28 International certificates 13 Committees 4 Invalid Meals Service 36 Common Lodging Houses 20 Land charges 32 Compulsory removals 25 Legal proceedings 15,16,17 Contributions to London County Council Organisations 15 Services 14 Cremation 20 Marriages 6 Day Nurseries 14 Mass X-ray 13 Deaths Maternal Deaths 6 Causes 9,10 Maternal and Child Welfare 14 Comparability factor .. 6 Mealson-Wheels 26 Infant 6,7 Medicinal Baths 18,19 Maternal 6 Milk 21 Rates 6 Mortuary 20 Disinfection and Mortuary 20 disinfestation 18,19 Noise Abatement 8 Drainage 20 Notices 17, 18 Factories 38 Nurseries 14 Family Service Unit 15 Old Peoples'Welfare Food Committee15 Canteens 21 Old People 25, 26 Factories 21 Outworkers 39 Ice cream 21 Pet Animals Act 19 Milk 21 Pharmacy & Poisons Acts 19 Registration 20 Pigeons 20 Restaurants 20 Pigeons 20 Samples 21 Poisons 19 Shops 20 Population 6 Stalls 21 Poliomyelitis 11, 14 Unsound 20 Protective helmets 20 INDEX (Continued) Public Analyst Statistics 6 Report 33 Street traders 21 Samples 21 Swimming Baths 20 Public Health Inspectors Town Planning 32 Staff 5 Travel—International Summary of work 17,15 certificates 13 Public Swimming Baths „ 20 Tuberculosis Rag Flock Act 19 Deaths9,13 Rent Acts 31 Notifications 11,13 Restaurants 20 Typhoid Fever Rodent control 22 Underground rooms 28 Ro.S.P.A. 15 Vaccination 13 Ko.S.P.A 15 Verminous persons 18 Salvation Army 15,26 Visiting old people 27 Samples 21 Vital statistics 6 Scabies 11,18 Births 7 School Teatment Centre 14 Deaths 9,10 Sewers and sewage 21 Summary 8 Shops 20 Water supply 22,23 Smallpox 11 Welfare Officer's report 35 Smoke control 24 Whooping cough 11,14 Staff 4,5 Women's Voluntary Service 26