Ac 4413(1) BOROUGH OF RICHMOND (SURREY) ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH 1963 BOROUGH OF RICHMOND (SURREY) ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH 1963 J. H. BROAD & Co. Ltd., Printers, 8, King Street, Richmond, Surrey 3 STAFF OF THE PUBLIC HEALTH DEPARTMENT. Medical Officer of Health : ERIC PEREIRA, M.B., B.S., D.P.H. Deputy Medical Officer of Health : C. J. RADWAY, M.A., B.M., B.Ch., D.P.H. (Resigned : 24.6.63). ELZA H. TODD, M.B., Ch.B., D.P.H. (Commenced: 15.7.63). Chief Public Health Inspector : EDWARD S. HERBERT, M.A.P.H.I. Senior Additional Public Health Inspector : HENRY DOUGLAS WILLIAMS, M.A.P.H.I. Additional Public Health Inspectors : JOHN WILLIAM REAVLEY, M.A.P.H.I., A.R.S.H. ROGER WALTER SHEPPARD, M.A.P.H.I., A.R.S.H. Technical Assistant : WILLIAM J. HAUTING. Chief Clerk : MRS. FLORENCE G. SMITH. Clerks : MISS EILEEN M. LANE. MISS MARGARET M. DENNEHY. MISS DORIS RIDGWAY, (Temporary Clerk,) Commenced: 18.11.63. Rodent Officer : THOMAS R. SMITH. Rodent Operator : RONALD EVANS. Disinfector and Driver : ALBERT CLEGG, 4 Public Health Department, Municipal Offices, Parkshot, Richmond. August, 1964 To the Mayor, Aldermen and Councillors of The Borough of Richmond (Surrey). Mr. Mayor, Ladies and Gentlemen, I have the honour to present the Annual Report of the Medical Officer of Health for the year 1963, upon the Sanitary Circumstances, Sanitary Administration, and Vital Statistics of the Borough. Bound copies of the Report dating back to 1874 exist in the Health Department and provide an interesting and valuable record of work done throughout that period. It is a matter of sincere regret that this is the last report to be presented to the existing Authority. I am indebted to Mr. E. S. Herbert, Chief Public Health Inspector, for his report on the Sanitary Circumstances of the area, and to Mrs. F. G. Smith for compiling the tables of Vital Statistics. As usual, I have received complete co-operation from my colleagues in all other departments and I wish to express my thanks to the Chairman and Members of the Health Committee for their support at all times, and to every member of the staff of the Public Health Department for their loyalty, hard work, and co-operation. I am, Ladies and Gentlemen, Your obedient Servant, ERIC PEREIRA, Medical Officer of Health. 5 BOROUGH OF RICHMOND (SURREY). PREFACE. SECTION A. — SUMMARY OF STATISTICS AND SOCIAL CONDITIONS. Staff. In March 1963 Mrs. F. G. Smith, Chief Clerk, fell and sustained a serious injury to her leg which incapacitated her for just over a year. The clerical work was efficiently carried out by Miss Lane and Miss Dennehy, and it was not until November that it became essential to obtain the additional services of Miss Ridgway, in a temporary capacity. Population. The Registrar General's estimate of the population was 40,630. This may be compared with his estimate of 40,680 for the previous year and the Census 1961 figure of 41,002. Births. During the year 656 births were recorded (323 males and 333 females) compared with 640 in 1962. There were 40 premature live births and of these 34 survived. Deaths. The total number of deaths occuring amongst residents was 660 (315 males, and 345 females) compared with 607 in 1962. The death rate when corrected to allow for the high proportion of elderly residents is 12.02 per thousand population which compares favourably with other towns in the country. The Infant Mortality, Neo-natal Mortality and Still Birth rates, are at a very low level; and although the number of illegitimate births rose to 65 there was not a single death. There were 7 infant deaths, and of these, one died of pneumonia, four of prematurity, and two of congenital abnormality. 6 SECTION B. — GENERAL PROVISION OF HEALTH SERVICES IN THE AREA. These are mainly provided by the Surrey County Council, the South West Metropolitan Regional Hospital Board, and the Executive Council for the County. In order to make the report complete these are briefly described below. (a) Services Provided by the Surrey County Council. These are organized on a Divisional basis, the Northern Division comprising the Boroughs of Richmond and Barnes. The Medical Officer of Health for Richmond is also the Divisional Medical Officer and this arrangement assists co-ordination of the personal health services and environmental health. Administrative, Infant Welfare, and School Medical functions are carried out from the following Centres : — Divisional Health Offices and Welfare Centre, Kings Road, Richmond. Welfare Centre, Windham Road, Richmond. Welfare Centre, Back Lane, Ham. Health Visitors are employed and, according to the District in which they work they are based at one or other of the above centres. District Nurses and Midwives are provided and they work under the direct supervision of the general practitioners. Moral Welfare or the care of unmarried mothers and illegitimate children is undertaken by an officer based at the Divisional Health Office. A Home Help Service provides for domestic help in the home in cases of home confinement or illness. The service is under the management of the Home Help Supervisor who is based at the Divisional Health Office. An Ambulance Service is provided from the station in Kings Road, Richmond which operates under the control station in Maiden The service is supported by the ambulance of the local division of the St. John Ambulance Brigade. A Day Nursery for the care of children up to the age of five years is located in Parkshot, Richmond. 7 (b) Services Provided by the Regional Hospital Board. Hospitals. The Royal Hospital and Kingston Hospital provide general treatment both for in-patients and out-patients. In addition, hospitals in London and Middlesex are frequently used by Richmond residents Patients suffering from infectious diseases are admitted to the South Middlesex Hospital, Mogden Lane, except in the few instances when no beds are available. In these cases, patients are admitted to Tolworth Isolation Hospital or to a hospital in the London area. Psychiatric Services. The Medical Staff of Banstead Hospital hold Out-patient Clinics on Tuesday and Friday afternoons at the Royal Hospital for patients living in Richmond and Barnes. Laboratory Facilities. The laboratory of the Royal Hospital is available for the examination of specimens sent in by general practitioners. The Ministry of Health, Public Health Laboratory, Epsom, is available for the examination of samples of milk, ice-cream, and water and of any pathological specimens. In addition, the staff is always available to assist the Medical Officer of Health in field investigations in the case of epidemics or outbreaks of food poisoning. The Central Public Health Laboratory, Colindale, N.W.9, is available for advice, special immunising agents and special investigations. The Counties Public Health Laboratories, Victoria Street, S.W.1 are used for the examination of water samples and for advice in the control of purity of the water supply. Mortuary. This is provided and maintained by Richmond Borough Council on a site close to the Petty Sessions Court. It is well equipped with two post-mortem examination tables. All such examinations required within the boroughs of Richmond and Barnes are carried out here and Barnes Borough Council make an annual payment for this service. 8 Nursing Homes. The following private Nursing Home is registered by the Surrey County Council: — Tyneham House Nursing Home, 108, Church Road. (c) Services Provided by the Surrey Executive Council. Under Part IV of the National Health Service Act, 1946, the Surrey Executive Council has the responsibility of providing General Medical and Dental Services, Pharmaceutical Services, and Supplementary Ophthalmic Services. More than twenty doctors living within the Borough have undertaken to provide General Medical Services. Many of these have also undertaken to provide Maternity Medical Services. A list of doctors taking part is available at the Main Post Office, Public Library and Public Health Department. The offices of the Council are situated at 187, Ewell Road, Surbiton. Care of the Aged and the Chronic Sick. The local scheme for the care of the aged and the chronic sick is largely unchanged. The general Health Visitors continue to supervise those who are frail or in need of assistance while the geriatric Health Visitor supervises those who are on the Waiting List for admission to hospital. Other than in times of epidemic the waiting period for admission to a hospital is not unduly long, and a desperate case is invariably admitted without delay. The Home Helps and District Nurses continue to play an important part in the care of elderly patients in their homes and the voluntary services do most valuable work by such services as "Meals on Wheels, Old Peoples' Clubs, etc. The Richmond Club for the House Bound, was established at the Congregational Church Hall, Raleigh Road, by a group of volunteers whose work and enthusiasm cannot be too highly praised. Under this Scheme housebound people of all ages are transported twice weekly to the Club where they are made welcome and cared for throughout the day. Services provided include physiotherapy, occupational therapy, chiropody, and hair-dressing. In addition, they get companionship and entertainment which would otherwise completely elude them. The work of maintaining this regular and quite complex service 9 is very considerable, and it is a great credit to the Chairman, and the whole group that such enthusiasm can be maintained on a voluntary basis. Transport is a major problem but this is soon to be eased by the purchase of a specially adapted Mini-bus which will be able to carry those who are confined to wheel chairs. There is no doubt that enthusiasm for the service is maintained by the rewarding nature of the work. Those who attend almost invariably improve markedly in general health and, in some cases begin to over' come their infirmities. This is undoubtedly a service which has come to stay, and which should be developed. The Richmond Old Peoples' Centre was opened in Meadows Hall in November. The hall has been specially built for the purpose and must provide one of the best centres of its kind in the country. It is excellently equipped and provides good food, entertainment and companionship for a rapidly increasing number of members. Various services have been provided and others are being developed. Situated close to the new headquarters of the Richmond Council for Social Services, it has established itself as a most important centre for the care of the elderly, and there is no doubt that there will be important developments here. Chiropody. The Surrey County Council has established a most effective chiropody service throughout the Boroughs of Richmond and Barnes. Under this Scheme any person who is of pensionable age or substantially and permanently physically handicapped can obtain treatment at a Chiropodist's Surgery for a payment of three shillings or free in case of need. Surgeries are fairly conveniently situated and there are facilities for domicilliary visits. At the present time over 800 elderly persons are obtaining treatment under this scheme, in addition to those who are attending special sessions provided by voluntary bodies. The Scheme is quite costly, but by helping to keep elderly people mobile and in good health, it will undoubtedly tend to reduce the need for institutional accommodation. NATIONAL ASSISTANCE ACT, 1948 —SECTION 47. In many cases old people create their own difficulties by refusing to leave their homes when they can only properly be cared for in hospital or other suitable accommodation, 10 A satisfactory solution is generally arrived at without resort to compulsion. Under the National Assistance Act, 1948 and the Amendment Act, 1951 the Medical Officer of Health can apply to the Court or to a Magistrate for a compulsory Removal Order which has the effect of placing and detaining the patient in hospital or home. In March my attention was drawn to the case of an old woman who was living alone in one room and was neglecting herself. Both she and her accommodation were becoming filthy and, at times, she wandered about the district, lost herself, and had to be returned home by the police. On three occasions she had agreed to enter a Home but each time the car arrived for her, she refused to go. She was clearly in need of care and attention and in these circumstances, application was made to a Magistrate for a Removal Order. The Order was granted and the old person was removed to Kingsmead the same day. Laundry Service. A laundry service for incontinent patients is provided which considerably reduces the burden on relatives and makes it possible for them to nurse at home a patient who would otherwise have to be admitted to hospital. The service is confined exclusively to incontinent patients and articles laundered are limited to sheets and draw sheets. This Service is provided twice weekly throughout the year. Soiled sheets are collected on Tuesdays and Fridays and at the same time an appropriate number of laundered sheets is delivered to the house. A charge of sixpence per sheet is made which is covered by a supplementary allowance for those in receipt of National Assistance. The charge has not been known to cause hardship. The service continues to be of great benefit to those who use it, and similar arrangements are now being made in other parts of Surrey. During the year ending 31st December, 1963, 2,043 sheets were issued and laundered. Public Conveniences. These are provided in the borough as follows : — Twickenham Road Men and Women. Kew Bridge do. Terrace Gardens da. 11 Buccleuch Gardens do. Petersham do. George Street Men only. Sheen Road Women only. The above all provide toilets, wash-hand basins, electric hand driers and incinerators. The washing facilities are entirely free, and are being used more and more by members of the public — especially women. Hot and cold water, soap and a suitable number of most efficient electric driers are provided. Because of the activities of vandals it is not practical to leave the washing facilities available to the public when an attendant is not present. This is unfortunate, but the difficulty has been overcome to a great extent by a careful programme of times when an attendant is present based on the known demand. A disadvantage of the system is that it is no longer possible to have the "wash-and-brush-up" for which a charge was formerly made, but it appears that the demand for the service has decreased steadily in recent years. From the aspect of public health the provision of entirely free hand washing facilities is of much greater importance. In addition to the above there is a convenience for women at Richmond Bridge which has only one wash-hand basin, no hot water, and no incinerator. The reason for this is lack of an adequate supply of electricity. All deficiences are to be remedied in the next financial year. There is also a convenience for men in Lower Mortlake Road which has been constructed in an old Air Raid Shelter. It is cleaned daily but is otherwise un-attended and leaves much to be desired. It appears mainly to be used by lorry drivers who could quite conveniently use the accommodation provided in the Twickenham Road. It is a matter for consideration whether this convenience should be closed down or whether it should be replaced by a new construction. Close to the Town Hall Gardens a riverside convenience is under construction which will give full facilities for men and women and will be attended daily throughout the year. There is need for a convenience at Ham Common and when this has been provided the service to the public will compare very favourably with that of any other borough. With regard to the completely free handwashing service this could be a pattern for the remainder of the new Borough. 12 SECTION F. — PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. (Civilians only). NOTIFIABLE DISEASES. The table in Section F sets out the number of cases of infectious diseases notified during 1963. Measles. The expected epidemic of Measles occurred during the early part of the year and a total of 473 cases were notified by general practitioners. Of these, 10 were severe enough to require admission to hospital, but all made good recoveries. Dysentery. In the Autumn of 1962 there were outbreaks of a mild form of dysentery due to Shigella sonnei at two primary schools. These outbreaks threw a great deal of work on the Public Health Inspectors and were only controlled after a prolonged period. The 73 cases notified by General Practitioners in 1963 all originated from the outbreaks which commenced in the previous year. There is no doubt that the spread of this disease in schools is greatly influenced by the possibility or otherwise of a strict hand-washing routine by pupils after using the toilet and before taking a meal. It happens that the toilet facilities at the two affected schools were of modern construction, but limited accommodation, and an ungenerous supply of towels made such a routine extremely difficult to enforce. Any future school building should provide for this on a generous scale and the older schools with toilets entirely divorced from washing facilities should be replaced on high priority. Food Poisoning. Only three cases were notified. These were isolated cases caused by different organisms and quite unrelated to one another. It was not possible to discover the source of the infection in any case and no secondary cases occurred. Typhoid Fever. Three unrelated cases of typhoid fever were notified during the year. One case was that of a woman resident of Teddington who was 13 admitted to the Royal Hospital where the diagnosis was made. She had recently returned from a holiday in Italy where she was, presumably, infected. Another case was that of a child who had travelled by air from Bombay and had taken up residence with her family in a local hotel. There was no doubt that the infection had been contracted abroad, but there was some danger of secondary cases occurring amongst several very close contacts. The third case was a young man who returned from holiday in Zermatt. He was taken ill the following day and was treated at home for twelve days before the probable diagnosis was made and he was admitted to hospital. None of these patients gave rise to secondary cases and all made good recoveries. IMMUNIZATION. The Schemes for immunizing children against diphtheria, whooping cough, tetanus, and poliomyelitis continued as in previous years, and the response from parents was very good indeed. Reference to Section F will show how these schemes are progressing. Smallpox. The Minister of Health advised that the safest time for primary vaccination was in the second year of life rather than in the early months. The adoption of this policy reduced the number of vaccinations carried out during the year, but it is hoped that the response will be satisfactory when children are called to the clinics at the appropriate age. Poliomyelitis. Only the oral vaccine is now in use. It is well received by the infants and children and no serious re-actions to it have been observed. The usual protective course consists of three doses at monthly intervals; children entering school are given a fourth dose as an extra precaution. I am pleased to report that no case of poliomyelitis occurred in the Borough during the year. Tetanus. It has become routine now for all infants to be protected by a "Triple" Antigen which gives protection against Diphtheria, 14 Whooping Cough and Tetanus. In addition, parents of older children are readily accepting immunization against tetanus. The chief advantage is that if an immunized child suffers an injury that could lead to tetanus infection, it is sufficient to give a booster dose of tetanus antigen instead of anti-tetanic serum which, at times, causes dangerous reactions. Tuberculosis. As in previous years all children aged 13 years were offered B.C.G. vaccination. The object is to provide artificial immunity to the disease during the adolescent period when children are susceptible and can be seriously affected. During 1963 a total of 430 boys and girls were inoculated with B.C.G. Mass Radiography Service. The Regional Hospital Board sets up a Mobile X-Ray Unit at the Bus Station behind the Odeon Cinema on every Thursday from 5.30 to 6.30 p.m. The Unit is primarily for the conveniece of the local general practitioners who can refer their patients without any prior appointment, and who receive a written report within two or three days of the examination. The service is much appreciated by the doctors, and is also a convenience to the patients who are saved both travelling and waiting time. Prospective employees of the Council who are unable to provide proof of recent chest X-Ray are referred, and the reports are of considerable assistance in enabling a decision to be made as to whether or not they are suitable for inclusion in the Superannuation or Sick Pay Schemes. The Unit is also available for use by the general public. 15 THE REPORT OF THE CHIEF PUBLIC HEALTH INSPECTOR, Mr. E. S. HERBERT, IS CONTAINED IN THE FOLLOWING SECTIONS C, D and E. SECTION C —SANITARY CIRCUMSTANCES OF THE AREA. 1. Water Supply. The drinking water supply in Richmond is served partly from local wells and partly from the Metropolitan Water Board, and the origin, purity and treatment of these supplies has been fully reported in the past. Water from the five local wells is pumped to the low level reservoir at Petersham Pumping Station, and thence to the high level reservoir in Richmond Park; from here it is distributed by gravity to a proportion of the residents and, in particular, to those living in and around Richmond Hill. Formerly the water was treated only by chlorination, but during 1962 apparatus was installed to enable treatment by "superchlorination and dechlorination" to be carried out. The advantage of this process is that a dose of chlorine large enough to deal with any possible contamination can be added to the water at its entry to the Petersham Reservoir and, after a suitable contact period excess chlorine is destroyed by the addition of an appropriate amount of sulphur dioxide. This procedure gives an even greater measure of safety, and in addition, by preventing fluctuations in the level of residual chlorine reduces to a minimum the chances of the water tasting unpleasant. Frequent sampling ensures that the purity of the water supply is maintained, and throughout the year the sample results have shown a high standard of bacteriological and chemical fitness. The drinking water supplies in the district are not plumb-solvent and every dwelling house in the Borough has a piped supply of water fit for human consumption. The determination of radioactivity in the well water supplies of the Borough was first carricd out in 1959 when samples from each of the five wells proved to be satisfactory. The examination has been repeated annually at times of flooding and further samples were taken in past year which continued to show entirely satisfactory results, 16 A river water supply is piped to Kew Gardens, allotments and to many domestic gardens; the water is chlorinated as a precautionary measure but it is not fit for drinking. Table 17 gives information on the consumption of water in the Borough and on the samples taken. 2. Swimming Pools. There is only one public swimming pool in the Borough which is the public baths establishment owned by the Council. The pool is 100 feet by 32 feet with a capacity of 96,000 gallons, the water supply being from local wells and the Metropolitan Water Board. The water is filtered by Candy pressure filters, giving a turnover of approximately six hours, and sterilization is achieved by chlorine gas treatment. Daily recordings are made of available and residual chlorine in the water, the pH value, and the shallow and deep-end temperatures. In addition, bacteriological samples of the water are taken each month, and all during the year, have proved satisfactory. 3. Sewerage and Sewage Disposal. The Borough is sewered on a partially separate system, with the drainage from roads discharging directly into the river through surface water sewers. The soil sewers drain to the purification works of the Richmond Main Sewerage Board, which receives sewage from the Boroughs of Richmond and Barnes. During the early summer complaints were received from residents in Kew about the obnoxious smell emanating from the Sewage Works due to defects which had developed in the sludge primary digestion tanks. The complaints coincided with the commencement of contract work to build a new primary digestion tank, and to reconstruct the faulty roofs of the existing tanks; the contract, in addition, provided for extensive ancillary works including a new boilerhouse. The work will take at least twelve months to complete and the Board have implemented a number of measures to minimise nuisance to nearby residents, including the use of chemical deodorants. However, a breakdown in the purification plant at a sewage works inevitably creates a most serious problem, and in this instance while the building works are in progress the Board has still to receive and deal with some 7 million gallons of sewage each day, and in order that a good effluent is discharged into the River Thames, the sludge must be separated and dried. 17 4. Public Health Inspections. The wide range of public health inspections is shown in Table 18 and routine visits to food premises and for food sampling were main tained throughout the year. The number of infectious disease enquiries was considerably reduced because there was no widespread incidence of Sonne dysentery. Table 19 shows that many improvements are effected by informal action and without the need to resort to statutory procedures. Nearly all formal notices served under the Public Health and Housing Acts arose because of delay in carrying out works of repair. The number of complaints (Table 20) increased by 78 on the figure for the previous year. There were more complaints about housing defects, rodent infestations and the nuisance from smoke or fumes; the complaints about noise remained surprisingly small, and the excessively cold winter in 1962-63 accounted for the comparatively high number of complaints about water supplies being cut off when service pipes were frozen. Every effort is made to ensure that each complaint is investigated within twenty-four hours of its receipt. Legal proceedings were instituted by the Council to enforce property repairs in the following cases : (1) the owner of a dwelling house was fined £1 (with five guineas' costs) for failing to comply with a statutory notice to provide a larder, and a nuisance order was made in respect of other defects in the house (with a further five guineas' costs); (2) an owner was fined £3 (with five guineas' costs) for failing to give information as to the ownership of premises to enable statutory notices to be correctly addressed; (3) a nuisance order was granted against the owner of a rented house in respect of items of disrepair; (4) an owner of a dwelling house was fined £1 (with two guineas' costs) for failing to carry out drainage works within the time specified on the statutory notice, and a nuisance order was made (and three guineas' costs granted) in respect of other matters of disrepair. 5. Disinfection and Disinfestation. There has been no increase in the treatment of premises after case: of infectious disease or of bed-bug infestation. The fumigation of clothing before being sent abroad is carried out to assist members of 18 the public to satisfy Post Office regulations, and a small charge is made for the treatment. A summary of the work done is contained in Table 21. 6. Atmospheric Pollution. (a) The fourth Smoke Control Order came into operation on 1st October, 1963, and the Council made the No. 5 Smoke Control Order during the year which comes into operation on 1st October, 1964. The progress made in the Clean Air programme is summarised below: — Area. Dwelling. Other Premises. No. 1 Order 85 acres 338 3 No. 2 Order 1,910 acres 1,517 83 No. 3 Order 382 acres 1,877 112 No. 4 Order 122 acres 1,068 485 No. 5 Order 126 acres 2,280 24 The work of approving proposed works of firegrate adaptations and of examining grant applications has proceeded smoothly and the Clean Air Officer has endeavoured to give householders full information and advice on every enquiry made to the department. The Council have given sympathetic consideration to many cases of financial hardship and, where need has been shown, a 100% grant has been made instead of the normal 70% grant. (b) Complaints of Smoke Emission. The number of complaints received has remained low and they have referred to bonfires in gardens and on building sites rather than to industrial chimneys. The few complaints made of smoke emission from factory chimneys were properly investigated and the advice given generally resulted in the desired improvement. No legal proceedings were taken in the year for any contravention of the Clean Air Act. 7. Diseases of Animals Act, 1950. Suspected swine fever at a Petersham farm was notified in February, 1963 and an Infected Place Notice was served upon the occupiers as required by the Swine Fever Order. The outbreak was later confirmed by officers of the Ministry of Agriculture, Fisheries and Food and all necessary precautions were taken to control the outbreak. The restrictions imposed were removed in the following month. Routine visits were continued to the Ham piggery during the year to insure that all waste foods for animal feeding are sterilized by heat treatment. 19 8. Petroleum Spirit Storage. Forty-eight premises are licensed to store petrol and petroleum mixtures and total storage amounted to 92,450 gallons. During the year petrol storage was discontinued at one premises and petrol mixtures storage at one premises. New licences were granted for the storage of petroleum mixtures at two premises. The conditions of licence require storage tanks to be tested in the 20th, 25 th and 30th year after installation and thereafter in every second year, and 12 tanks were tested and all but one were found to be satisfactory. The defective tank was filled with concrete slurry, and two other old tanks at the garage were removed and replaced by two new larger tanks. At another garage a storage tank was reported to be giving irregular readings on the dipstick and a nitrogen pressure test applied to the tank showed no evidence of leakage. 9. Caravan Sites. The Caravan Sites and Control of Development Act, 1960 came into operation during the year. The Act gives local authorities effective powers for controlling sites so that they may be properly equipped and conducted and permitted only in acceptable places. There is, in the Borough, only one licensed site which accommodates three caravans. 10. Shops Act, 1950. A number of enquiries are dealt with each year about general closing hours and Sunday trading and the advice given is usually acted upon with confidence. The co-operation of shopkeepers in dealing with the complexities of the Act has not been lacking, and no legal proceedings were taken during the year for contravention of this Act. 20 SECTION D. —HOUSING. 1. Unfit Houses. The Clearance Order made in respect of Nos. 4-10 (consecutive) Wellington Place in 1962 became the subject of a public enquiry in July 1963, and the Minister confirmed the Order in September, 1963. The properties Nos. 1-28 (consecutive) Wilton Avenue were represented as a Clearance Area during the year and a Compulsory Purchase Order was made by the Council. Fifteen dwellings were reported as being unfit for human habitation and not capable of repair at reasonable expense, namely: Basement, 94, Kew Road. 2, 3, 5, 6, 7, 8 and 10, Waterloo Place. 21, St. John's Road. 52, Sheen Park. 2, Lonsdale Mews. Basement, 68, Kew Green. 3a, Vine Cottages, Petersham Road. Basement, 25, Queen's Road. Basement, 30, The Green. By the end of the year Closing Orders had been made in respect of 6, Waterloo Place, 21, St. John's Road, Basement, 68, Kew Green and Basement, 94, Kew Road. Closing Orders were cancelled in respect of two dwellings which had been made fit for human habitation, namely, 310, Kew Road (Order dated 13th December, 1961) and Basement, 15, Onslow Road (Order dated 7th May, 1936). A further survey of the Borough was made during the year and the Council received a report on the estimated number of unfit houses which have still to be inspected and represented for action. 2. Houses in Multiple Occupation. The implementation of the Housing Act, 1961 made further progress during the year when the Council approved a guide setting out standards of amenities for houses in multiple occupation. The standards provide for each living-room, bedroom and kitchen having adequate natural lighting and ventilation; each letting is required to have a sink and water supply, cooking facilities and a ventilated larder provided within the letting; baths and W.C's. are required on a scale of at least one fitting for eight occupiers. 21 The new standards are being drawn to the attention of owners whenever houses in multiple occupation are visited. 3. Council Houses. Number of dwellings owned by the Local Authority as at 31st December, 1963 : Number of houses 1,364 Number of flats 643 Total 2,007 Total number of houses erected post-war, 31st December, 1963. Temporary bungalows 179 Permanent Houses 498 Permanent Flats 468 966 1,145 Since 1956 a total of 111 prefabricated bungalows have been demolished and one taken over for use as a dental clinic by the Surrey County Council 112 Total 1,033 Housing Waiting List. Total number of families on Waiting List as at 31st Dec., 1963 372 Applications from Aged Persons as at 31st Dec., 1963 239 Total number of families rehoused in 1963 11 Miscellaneous allocations 9 —20 Conversion of Shop. During the year 80, Manor Grove, a shop with living accommoda- tion above owned by the Council, was converted into two one bedroomed flats. Current Building Programme. The redevelopment of the Ham Close site (192 dwellings) is now in progress and the first flats and maisonettes are expected to be ready for occupation at the beginning of March, 1964. Among the first will be the three-bedroomed flats and bed-sitting room flatlets. These are designed to provide adjoining but separate accommodation for a family and an elderly parent or relative. Thereafter there will be a continuous flow of flats ready for occupation until the completion of the contract. 22 SECTION E. — INSPECTION AND SUPERVISION OF FOOD. 1. Unsound Food Complaints. Twenty-one complaints alleging that food had been sold to the dissatisfaction of the customer were received during the year. The investigations which followed showed that about one-third of complaints referred to mould growths or souring due to the failure of the food trader to turn over stock in a proper manner. There is growing evidence of the advantage to the retailer if a system of visual-aid coding is adopted for deliveries of prepacked perishable goods; the retailer can then easily determine the date of delivery and is in no doubt as to the day when the "shelf-life" of the article has expired, so that such foods can be withdrawn from sale and destroyed. One of the complaints resulted in legal proceedings being taken against the retailer for selling mouldy sausage rolls and a fine of £10 with five guineas' costs was imposed. 2. Food Premises. There has been an improving standard of hygiene in food shops in the Borough over a number of years, and in many premises now the proprietor is choosing to reconstruct and re-equip food rooms rather than patch and repair them as was the practice in the immediate post-war years. Table 29 shows the broad headings under which food premises were improved in the past year. In general, excellent co-operation has been maintained with proprietors of food businesses, and in only two cases were legal proceedings necessary where premises failed to conform to the standards laid down in the Food Hygiene (General) Regulations, 1960. In one case fines totalling £155 with 16 guineas' costs were imposed against a baker and in the second case a fine of £24 with £16 costs was imposed against a restaurant proprietor. 3. Food Sampling. One hundred and twenty-six samples were procured during the year of which 15 were shown to be irregular. The Public Anaylst (D. D. Moir, Esq., M.Sc., F.R.I.C.) has at all times given most helpful advice and his continued interest has contributed in great measure to the usefulness of this branch of public health work. As in past years most of the irregular samples failed to satisfy the Labelling of Food Order either in the description of the product or in 23 the list of ingredients, but in all cases it proved possible to reach agreement with the manufacturers or importers to remedy the irregularity revealed by sampling. 4. Ice-Cream. There is only one ice-cream manufacturer in the Borough; the process involves the heat-treatment of the product to a temperature of not less than 160°F for 10 minutes, and not the high-temperatureshort-time method (175°F for 15 seconds), which is also permitted by the Ice-Cream (Heat Treatment) Regulations. One hundred and twenty premises are registered for the sale and storage of ice-cream, and during the year 99 samples were submitted to the Public Health Laboratory for examination, of which 80 were satisfactory (Grades I and II) and 19 were unsatisfactory (Grades III and IV). Unsatisfactory samples received thorough investigation, and in both instances there was evidence that the low grading was due to a failure to keep sterile the water in which the server was kept. The proprietors, in each case, were advised on the use of sterilising agents and subsequent samples proved satisfactory. 5. Other Foods. Twenty-six other samples were examined bacteriologically; these samples included meat products, ice cream server waters, frozen egg, flavouring essence, artificial cream and spaghetti sauce mix. Eight samples of ice-cream server water proved to be unsatisfactory and after suitable advice had been given the results showed a very satisfactory standard. 6. Milk — Licensing and Sampling. Under the provisions of the Food and Drugs Act, 1955, and Regulations made thereunder, Dairy Farms have become the direct responsibility of the Ministry of Agriculture and Fisheries; the premises on which milk is pasteurised or sterilised are licensed by the Food and Drugs Authority and in all other cases, Dairies or Dealers in Designated milk come under the complete control of the Local Authority in respect of licensing, inspection and control. There is one dairy farm within the Borough under the control of the Ministry. Details of sampling are included in Table 30. BOROUGH OF RICHMOND (SURREY ) APPENDIX TO THE ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH 1963 25 TABLE 1. STATISTICAL SUMMARY — 1963. SECTION A. — SUMMARY OF STATISTICS AND SOCIAL CONDITIONS. Area in acres 4,234 Population (Census 1961) 41,002 Population (Estimated 1963) 40,630 Number of inhabited houses (estimated) at 1.4.63 12,500 Rateable value at 1.4.63 £2,550,291 Sum represented by a Penny Rate, 1963/64 £10,147 BIRTHS. Birth Rate per 1,000 of estimated resident population 16.3 (Corrected) 15.9 Total number of births (live and still) 661 Analysis:— M F Total Live Births Legitimate 297 294 591 Illegitimate 26 39 65 Still Births Legitimate 3 2 5 Illegitimate - - - Still Birth Rate per 1,000 total births 7.6 Environment of Births :— Proportion taking place in Institutions (317) 71.4 Proportion taking place in dwelling houses (127) 28.6 DEATHS. Total number of deaths from all causes 660 Death rate per thousand estimated resident population 16.2 (Corrected) 12.02 The principal causes of deaths : — Malignant Neoplasms 123 Heart disease 205 Vascular lesions of Nervous System 105 341 Other circulatory diseases 31 Pneumonia 42 Bronchitis 35 |79 Other respiratory diseases 2 Malignant Neoplasms were responsible for 123 deaths or 18.6% of total deaths. 26 Diseases of the Heart and Circulation caused 341 deaths or 51.7% of total deaths. Diseases of the Respiratory System caused 79 deaths or 11.9% of total deaths. TABLE 2. — ANALYSIS OF DEATHS RELATING TO RICHMOND FOR THE YEAR 1963. Causes of Deaths. Male. Female. Total. Tuberculosis, other - 1 1 Syphilitic Disease 1 - 1 Malignant neoplasm, stomach 9 8 17 Malignant neoplasm, lung bronchus 27 1 28 Malignant neoplasm, breast l 16 17 Malignant neoplasm, uterus - 3 3 Other malignant and lymphatic neoplasms 35 23 58 Leukaemia, Aleukaemia 1 3 4 Diabetes 1 2 3 Vascular lesions of nervous system 36 69 105 Coronary disease, angina 63 66 129 Hypertension with heart disease 1 4 5 Other heart disease 30 41 71 Other circulatory diseases 17 14 31 Influenza 10 13 23 Pneumonia 17 25 42 Bronchitis 24 11 35 Other diseases of respiratory system 2 — 2 Ulcer of stomach and duodenum 2 2 4 Nephritis and nephrosis 2 3 5 Hyperplasia of prostate 3 - 3 Congenital malformations 1 1 2 Other defined and ill defined diseases 21 26 47 Motor vehicle accidents 3 2 5 All other accidents 3 7 10 Suicide 5 4 9 315 345 660 TABLE 3. MATERNAL MORTALITY — 1963. The provisional numbers of deaths and death rates per 1,000 total live and still births are : — England and Wales. Number Rate Maternal causes, excluding abortion 195 0.22 Due to abortion 49 0.06 Total maternal mortality 244 0.28 27 Richmond. Maternal causes, excluding abortion Nil Due to abortion Nil Total maternal mortality Nil TABLE 4. INFANT MORTALITY. (Deaths under one year of Age). Infant Mortality Rate for all infants per 1,000 live births 10.7 Rate for legitimate infants per 1,000 legitimate live births 10.2 Rate for illegitimate infants per 1,000 illegitimate live births 15.4 Total number of infant deaths in the Borough 7 Analysis: — M F Total Legitimate 2 4 6 Illegitimate ... ,.. _ 1 1 Environment of Infant Deaths:— Number occurring in the Borough 3 Number occurring outside the Borough 4 Number occurring in Institutions 4 Cause of Death Under 1 week 1-2 weeks 2-3 weeks 3-4 weeks over 4 weeks Total 1. Pneumonia — — — — 1 1 2. Prematurity 4 — — — — 4 3. Congenital Abnormality — — — — 2 2 4 1 - - 3 7 Neo-natal Mortality Rate : (Deaths under 4 weeks per 1,000 total live births) 6.09 Early Neo-natal Mortality Rate : (Deaths under 1 week per 1,000 total live births) 6.09 Perinatal Mortality Rate : (Stillbirths and deaths under 1 week combined per 1,000 total live and stillbirths) ,,, ,,, 13.5 28 TABLE 5. ILLEGITIMATE BIRTHS. 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 No. of illegitimate births 33 31 40 30 40 36 46 45 54 65 No. of illegitimate deaths under 1 year 2 0 3 1 0 1 1 2 0 1 Illegitimate death rate 60 0 75 33 0 27 21 44 0 15 TABLE 6. COMPARATIVE STATISTICS — 1963. Rate per 1,000 Population LIVE BIRTHS Rate per 1,000 (Total Live & Still) STILLBIRTHS Rate per 1,000 Population DEATHS (All Ages) Rate per 1,000 Related Live Births DEATHS (Under One Vpar) Neonatal Mortality (Under 4 weeks) (Live Births). England & Wales 18.2 17.2 12.2 21.1 14.2 Richmond 15.9 ( Corrected) 7.6 12.02 ( Corrected) 10.7 6.09 29 TABLE 7. BOROUGH OF RICHMOND (SURREY). WEIGHT AT BIRTH PREMATURE LIVE BIRTHS — 1963 PREMATURE STILLBIRTHS BORN IN HOSPITAL. BORN AT HOME OR IN A NURSING HOME. Nursed entirely at Home or in a Nursing Home. Transferred to Hospital on or before 28th day. TOTAL BIRTHS DIED TOTAL BIRTHS DIED TOTAL BIRTHS DIED BORN Within 24 Hours of Birth In 1 and under 7 days. In 7 and under 28 days. Within 24 Hours of Birth In 1 and under 7 days. In 7 and under 28 days. Within 24 Hours of Birth In 1 and under 7 days. In 7 and under 28 days. In Hospital. At Home or in a Nursing Home. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) 1. 2lb. 3os. or less 3 3 _ — — — — _ _ _ _ _ 2. Over 2lb. 3oz. up to and including 3lb. 4oz. 3 2 - - - - - - - - - - 1 - 3. Over 3lb. 4oz. up to and ineluding 4lb. 6oz. 6 _ 1 _ _ - - - 1 - 4. Over 4lb. 6oz. up to and including 4lb. 15oz. 8 _ _ - - - - - 1 - 5. Over 4'lb. 15os. up to and including 51b. 8oz. 16 - - - 4 - - - - - - - - - 6. TOTAL 36 5 1 — 4 - - - - - - - 3 — 30 SECTION F. — PREVALENCE OF, AND CONTROL OVER. INFECTIOUS AND OTHER DISEASES. (Civilians only). TABLE 8. NOTIFIABLE INFECTIOUS DISEASES. Diseases. Total Cases Notified. Cases admitted to Hospital. Total Deaths. Pueperal Pyrexia 1 Erysipelas 6 2 — Scarlet Fever 8 4 — Pneumonia 8 2 — Measles 473 10 — Whooping Cough 21 3 — Food Poisoning 3 - — Dysentery 73 - — Typhoid 3 - - 596 21 Nil TABLE 9. FOOD POISONING. Total number of outbreaks Nil Number of cases notified 3 Number of deaths Nil TABLE 10. DIPHTHERIA IMMUNISATION. Number of children immunised for the first time during the year 1963 : — (a) Pre-school children (under 5 years) 521 (b) Between 5 and 15 years 14 535 Number of children given re-inforcing doses during 1963 811 Total number of children immunised during last five years: — (a) Under 5 years 2,764 (b) Between 5 and 15 years 3,329 Si TABLE 11. VACCINATION AGAINST SMALLPOX 1963. 1. Analysis of Vaccinations of Children at Welfare Centres and Private Doctors' Surgeries : Children. Primary Vaccination 92 Re-vaccination 31 Total 123 TABLE 12. IMMUNIZATION AGAINST TETANUS. During the year 770 children were given courses of inoculations against Tetanus at the parents' request. In addition 582 children were given a re-inforcing dose to maintain their immunity. TETANUS IMMUNIZATION. AGE at date of final injection 0—4 years 5—14 year Total Number of children who have completed a primary course of three injections whether single or combined during the year ended 31st December, 1963 523 247 770 Number of children who received a reinforcing dose 407 175 582 TABLE 13. WHOOPING COUGH IMMUNIZATION. Number of children who have completed a primary course of 3 injections during the year ended 31st December, 1963 514 32 TABLE 14. POLIOMYELITIS VACCINATION. Northern Division — Richmond and Barnes. PRIMARY COURSE. Age Group — Born in Number of Persons who completed a Primary Course of Treatment in 1963. 1963. 120 1962. 630 1961. 146 1943-60. 123 1933-42. 60 Others. 10 Total 1,089 In addition 1,022 re-inforcing doses were given during the year. TUBERCULOSIS. Vaccination Against Tuberculosis. During 1963 a total of 430 boys and girls were inoculated with B.C.G. in the Northern Division (Richmond and Barnes). NOTIFICATIONS : Respiratory Tuberculosis. Twenty-eight cases of respiratory tuberculosis were notified during the year, viz : — 15 males and 13 females. The corresponding figure for 1962 was 33. Non-Respiratory Tuberculosis. Two new cases of non-respiratory tuberculosis were notified during the year and there were no deaths from this cause. Three cases were notified in 1962. TABLE 15. TUBERCULOSIS REGISTER. After all additions and deletions had been taken into account the number of cases of tuberculosis remaining upon the Register at the close of the year was as under:- Pulmonary NonPulmonary Males 101 2 Females 47 11 148 13 Corresponding figures for 1962 163 12 33 TABLE 16. ANALYSIS OF CASES AND DEATHS FOR 1963. Age Periods New Cases Deaths Respiratory NonRespiratory Respiratory NonRespiratory M F M F M F M F 0— 4 - - - - - - - 5—14 - 2 15—24 1 5 - - - - - - 25—44 4 1 1 — 1 45—64 5 4 - - - - - - 65 and upwards 5 1 — 1 — — — — Totals... 15 13 — 2 — — — 1 Under the Public Health (Prevention of Tuberculosis) Regulations, 1925, powers are given to prohibit any person suffering from respiratory tuberculosis from entering upon employment involving the handling of milk. Under the Public Health Act, 1936, (Section 172), powers are given to cause the removal and detention of any tubercular patient where proper precautions are not being taken and the circumstances are such as could constitute a danger to others. MASS RADIOGRAPHY SERVICE. General Practitioners' Service. Men 'Women Total Number of patients referred 367 325 692 Cases of Pulmonary Tuberculosis 6 1 7 Cases of Lung Cancer 5 2 7 Public Mass Radiography Service 1142 847 1989 Cases of Pulmonary Tuberculosis 1 1 2 Cases of Lung Cancer 2 Nil 2 Employees of Richmond Borough Council referred by Medical Officer of Health—31. 34 SECTION C—SANITARY CIRCUMSTANCES. TABLE 17. WATER SUPPLY. (a) The following figures show the daily average consumption of water in the district: — 1962 1963 All Richmond Wells 740,907 galls. 737,074 galls. Metropolitan Water Board 1,169,183 galls. 1,093,505 galls. Raw River Water 257,011 galls. 261,276 galls. (b) During the year the following samples were taken for examina tion: — (i) Richmond Water Supply: Untreated water 453 samples. Treated water 179 For chemical analysis 23 (ii) Metropolitan Water Board Supply : Bacteriological examination 1,121 Chemical examination 52 (iii) Raw River Water 52 (c) Swimming Water samples 28 TABLE 18. PUBLIC HEALTH INSPECTIONS. Houses inspected 288 Revisits to houses and other premises 1,038 Houses visited for Certificates of Disrepair 8 Visits paid in connection with : — Permitted number for dwellings 3 Vermin 106 Enquiries into Infectious Diseases and Disinfection 490 Routine inspections in connection with : — Factories (mechanical) 65 Factories (non-mechanical) 4 Outworkers 7 Bakehouses 53 Butchers' Shops 121 Confectioners (Flour) 17 Confectioners (Sugar) 25 Dairies and Milk Shops 7 Fishmongers and Poulterers 13 Fried Fish Shops 17 35 Greengrocers and Fruiterers 84 Grocers 178 Ice-cream premises 41 Public Houses 34 Restaurants and Tea Shops 230 Food and Drugs Act Sampling 16 Milk Sampling (Designated Milk) 62 Ice-cream Sampling 70 Unsound Food 41 Caravans 2 Clean Air Act— Inspection and Observations 355 Diseases of Animals Act 9 Drainage 934 Interviews 508 Heating Appliances (Fireguard) Act 20 Massage Establishments — Merchandise Marks Act 4 Noise Abatement 4 Pet Animals Act, 1951 4 Petroleum Act, 1928 173 Piggeries 2 Rag Flock Act 9 Rats and Mice (Visits to Properties) 4,129 Rats and Mice (Visits re sewer treatments) 480 Schools — Elementary and Secondary 3 Shops Act, 1950 129 Theatres and Cinemas 1 Water Supply 321 Miscellaneous Visits 1,958 12,063 36 (b) under the Public Health Act, 1961 — (i) Section 32 (food cupboards) 3 (ii) Section 17 (drainage) 1 (c) under the Housing Act, 1957 — Section 9 (disrepair) 1 (d) under the Housing Act, 1961 — (i) Section 12 (Management Order) 2 (ii) Section 15 (essential amenities) 4 (e) under the Clean Air Act, 1956 — Section 12 (firegrate adaptations) 48 TABLE 20. COMPLAINTS. The complaints received have been classified as follows: — Disrepair of premises : — Dampness 17 Drainage 123 General defects 126 Nuisance from refuse 10 Nuisance from smoke or fumes 65 Nuisance from insects, animals, ctc 17 Rodent infestations 223 Unsound food 21 Miscellaneous nuisances 15 Noise nuisance 5 Pigeons 8 Water Supply 19 649 TABLE 21. DISINFECTION AND DISINFESTATION. A summary of the treatment of premises, bedding, clothing and other articles is given below:- Houses. Rooms. Bedding, etc. Infectious Fevers 5 6 6 Tuberculosis 1 1 1 Vermin 12 44 132 Other Diseases - - 149 Costs recovered throughout the year: £15 8s. 8d, 37 TABLE 22. FACTORY INSPECTIONS. 1. Inspections. Premises. Nlumber on Register. Inspections. Written Notices. Prosecutions Factories (non-power) 121 4 Nil Nil Factories (power) 144 49 6 Nil Building Sites and Institutions 16 16 Nil Nil 2. Defects. Particulars. Found. Remedied. Referred by H.M. Inspector Want of Cleanliness Nil Nil Nil Sanitary Conveniences. (a) Unsuitable 2 2 Nil (b) Insufficient 2 2 Nil Miscellaneous 4 4 Nil 3. Outworkers. Nature of Work Number of Outworkers. dumber of Unwholesome Premises. Wearing apparel (making 28 Nil Brass and brass articles 2 Nil Lampshades 1 Nil Artificial flowers 10 Nil Brushes 2 Nil Legal Proceedings — no prosecutions were taken in 1963. TABLE 23. RODENT CONTROL. The rodent control staff have continued to do much useful work in eradicating rats and mice from premises. Number of complaints received 217 Number of infestations found 199 Number of infestations cleared 190 The treatment of foul sewers was carried out in May and November using the anti-coagulent, Warfarin, and baiting was concentrated in specific areas known to be persistently infested with rats, 38 May. November. Manholes test-baited 43 Nil Manholes above found infested Nil Nil Manholes Warfarin-baited 47 54 Manholes infested 19 12 Number of visits 264 216 SECTION D — HOUSING. TABLE 24. Housing Statistics for 1963. 1. Number of dwellings owned by the Local Authority :— Number of houses 1,364 Number of Flats 643 Total 2,007 2. Unfit Houses. (a) Dwelling houses inspected 288 (b) Total number of visits made 1,337 (c) Clearance Areas represented to Council 1 (d) Dwellings included in (c) above 28 (e) Compulsory Purchase Orders made by Council 1 Nil (f) Dwellings demolished after Clearance Orders made (g) Dwellings represented for Demolition or Closing Orders 15 (h) Undertakings received that dwellings be not used for human habitation Nil (i) Closing Orders made (a) in respect of whole of building 1 (b) in respect of part of building 3 (j) Dwellings demolished in pursuance of Demolition Order Nil (k) Undertakings received to repair dwellings Nil (l) Closing Orders determined on a building being made fit 2 (m) Undertakings cancelled on part of a building being made fit Nil (n) Dwellings in respect of which formal notices were served requiring defects to be remedied 18 (o) Dwellings in which defects were remedied after service of formal notices 20 39 (p) Dwellings in respect of which informal notices were served requiring defects to be remedied 287 (q) Dwellings in which defects were remedie'd after service of informal notices 255 TABLE 25. RENT ACT, 1957. The Rent Act, 1957, came into operation on the 6th July, 1957, and repealed the Housing Repairs and Rent Act, 1954. The 1957 Act permits the rents of controlled houses to be in creased within specified limits, and lays down a procedure to enable the tenant and landlord to reach agreement on works of repair which should be carried out to the property. Should agreement not be possible, the tenant may apply to the local authority for a Certificate of Disrepair which, if granted, stops the rent increase. The landlord has the opportunity, however, of giving an undertaking to carry out the repairs within 6 months, and if such an undertaking is accepted by the local authority, the rent increase continues to be payable. The following tables show the action taken since the Act came into force: — PART 1. — Applications for Certificates of Disrepair. 1961 1962 1963 Number of applications 119 2 2 Number of decisions not to issue certificates 5 Nil Nil Number of decisions to issue certificates : — (a) in respect of some but not all defects 80 2 2 (b) in respect of all defects 34 Nil Nil Number of undertakings given by landlords 82 2 2 Number of undertakings refused by Local Authority 1 Nil Nil Number of certificates issued 33 Nil Nil PART 2. — Applications for Cancellation of Certificates. Applications by landlords to Local Authority 1961 1962 1963 for cancellation of certificates 16 Nil 1 Objections by tenants to cancellation of certificates 5 Nil 1 Decisions by Local Authority to cancel in spite of tenants' objection 3 Nil 1 Certificates cancelled by Local Authority 14 Nil 1 40 SECTION E.—INSPECTION AND SUPERVISION OF FOOD. TABLE 26. INSPECTION OF FOOD. The following foodstuffs, found to be unfit for human consumption, were voluntarily surrendered and destroyed. cwts. qrs. lbs. ozs. Fresh Foods (all classes) 2 1 13 9 Tinned Meats, vegetables 5 1 3 10½ Tinned Fruits 3 1 10 2½ Animal Foods 1 22 8 10 5 21 14 TABLE 27. FOOD SAMPLING. The following table shows the results of examinations made of samples procured during the year. Articles. Number Analysed Number Irregular Formal Informal Total Formal Informal Total Cereals and Cakes ... - 17 17 - 1 1 Cream and Cream Products - 8 8 _ _ - Drinks _ 4 - 2 2 Fish _ 1 1 _ 1 1 Fruit and Vegetables 2 12 14 - 1 1 Health Foods - 3 3 - 2 2 Jams and Marmalade — 2 - _ _ - Jelly - 1 1 - _ - Meat and Meat Products 2 41 43 _ 6 6 Medicinal Preparations — 3 3 _ - - Milk and Milk Products 2 13 15 — - - Pickles and Sauces — 3 3 _ 1 1 Sweets _ 5 - _ 1 1 Syrup — 1 - - - Totals 6 114 120 — 15 15 The irregular samples are referred to below : Sample 3: Pork Sausages. „ 4 : Beef Chipolatas. „ 5 : Pork Chipolatas. „ 6: Beef Sausages. „ 14: Pork Sausages. „ 92 : Pork Sausages. 41 In each case the sample contained an added preservative which was not disclosed on the label or by notice clearly exhibited in the shop. Representations were made to the retailers who immediately arranged to exhibit the necessary preservative notice. Sample 31 : Batter and Pancake Mixture : the label stated one ingedient to be "egg" instead of "dried egg" and no mention was made of the need to add milk in preparing the mixture; the manufacturers agreed to print a new label to amend these points. Sample 59 : Lemon Juice : the label failed to disclose the presence of a preservative and the manufacturers undertook to amend the labelling to show the presence of the preservatives. Sample 65 : Fresh Frozen Sliced Apple : the product contained a preservative and the description "fresh" was not justified; the importers deleted the word from the label. Sample 76 : Slippery Elm Food : descriptive literature referred to the product as a "complete food", but when prepared with water it contained no animal protein and lacked essential vitamins; the booklet was reprinted so as to eliminate any misleading statement. Sample 78 : Wheat Germ Oil Capsules : literature about the product made a misleading claim that it was rich in certain vitamins; the booklet was reprinted so as to avoid any misleading claim about the product. Sample 83 : Ice-Pops : the product contained a preservative not disclosed on the label and the manufacturers agreed to amend correctly the label. Sample 86 : Sea Food Dressing : the label showed certain ingredients by generic instead of specific names and the label was reprinted to show the ingredients correctly described. Sample 92 : Pork Sausages : the sample contained a preservative which was not disclosed by label or notice; the retailer subsequently provided and exhibited a preservative notice, 42 Sample 114: Quickset Cake Covering: the ingredients were not shown and the manufacturers agreed to reprint the wrappers so as to include a declaration of the ingredients. Sample 120 : Seasparkles : the labelling did not show that the product consisted of fish portions in batter and bread crumbs, and the producers ordered new cartons with correct descriptive labelling. TABLE 28. CLASSIFICATION OF FOOD PREMISES. No. of Premises. No. of Visits Bakehouses 6 53 Butchers (including 23 premises registered for manufacture of preserved food) 28 121 Confectioners (flour) 14 17 Confectioners (sugar) 48 25 Dairies (registered under Milk and Dairies Regulations) 3 7 Fishmongers 12 30 Greengrocers 35 84 Grocers (including 4 premises registered for manufacture of preserved food) 58 178 Ice-cream premises (manufacture) 2 41 Ice-cream premises (sale and storage) 127 Licensed premises 83 34 Restaurants, cafes, etc. 80 230 496 820 43 TABLE 29. IMPROVEMENTS IN FOOD PREMISES. As the result of inspections made the following improvements were carried out: — 1. Food rooms reconstructed 17 premises 2. Food rooms repaired, cleansed or redecorated 194 3. Food storage improved 9 4. Food preparation equipment improved 84 5. Ventilation and lighting improved 26 6. Staff washing facilities improved 38 7. Staff clothing accommodation provided 17 8. First aid boxes provided 12 9. Constant hot water supply installed 27 10. New sinks provided 9 11. Existing sanitary accommodation improved 3 12. Drainage improved, repaired or altered 38 13. Refuse accumulations removed 7 14. Refuse receptacles provided 7 15. Other improvements or repairs carried out 164 44 TABLE 30. MILK LICENSING. The following licences have been granted by the Council authorising dealers to store and sell Designated milks: — Pasteurised Milk 30 Tuberculin Tested Milk 21 Sterilised Milk 24 All premises are inspected before licences are granted, and principal licences are verified with the appropriate local authorities before licences are issued. No licences were refused. Under the regulations the Local Authority continued to take samples from dealers and during the year under review the following were taken: — Pasteurised Milk 44 samples Number found unsatisfactory Nil Tuberculin Tested (Pasteurised) Milk 23 „ Number found unsatisfactory Nil Sterilised Milk 10 „ Number found unsatisfactory Nil Raw Milk examined biologically for the presence of Tubercle bacilli 5 „ Number found unsatisfactory Nil The District Medical Officer of Health retains the power to take appropriate action to prevent the spread of disease by infected milk.