AC.4353. STMARY 64 BOROUGH OF ST. MARYLEBONE REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1959 J. H. BRISCOE-SMITH, M.B., Ch.B., D.P.H. CONTENTS page Members of the Public Health Committee 1 Staff of the Public Health Department 1 Section A—Statistics and Social Conditions 2 Section B—General Provision of Health Services 4 Section C—Sanitary Circumstances 9 Section D—Housing 15 Section E—Inspection and Supervision of Food 17 Section F—Infectious and other Diseases—Prevalence and Control 24 Appendix of Statistical Tables and Supplementary Information 29 Index 44 WELbeck 7766 Public Health Department, Town Hall, St. Marylebone, W.1. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of St. Marylebone. Mr. Mayor, Ladies and Gentlemen, I have the honour to present to you my Annual Report on the health of the Borough for the year 1959. An examination of the vital statistics recorded on page 2 reveals, on the whole, little change from last year, although it is pleasing to note that there were only 11 infant deaths as compared with 26 in 1958. There were no serious outbreaks of infectious disease among the residents of the Borough and the total of notifications received was lower by 26 than in the previous year. The largest contribution to this reduction was a fall in the number of cases of pneumonia from 21 in 1958 to 6 in 1959 and there was also a fall in the number of cases of food poisoning from 18 in 1958 to 10 in 1959. This last figure cannot be regarded as a true representation of the amount of food poisoning contracted in St. Marylebone, however, since comparatively few of those who eat in catering establishments and attend functions in the Borough live locally, a fact which is well illustrated by two of three outbreaks reported in detail on pages 24-26. Further progress towards smokeless air has been made during the year. A second smoke control area comprising Lords Ward came into operation on 1st October, 1959, and a third order for Hamilton Terrace Ward has been confirmed by the Minister. When this order becomes operative on 1st October, 1960, the whole of the Borough north of St. John's Wood Road and Prince Albert Road will be a continuous smoke control area. Smoke and other products of combustion are not, however, the only sources of air pollution. Fine dust which easily becomes airborne can also be a serious source of nuisance and even disease. On page 14 the Director of Cleansing reports the introduction of a footway cleansing machine, designed to combat this nuisance. Operating broadly on the principle of the domestic vacuum cleaner, it collects not only the ordinary street refuse but also the very fine dust which in the past it has been impossible to remove. Another development which can confidently be expected in the near future is the introduction of dustless loading of domestic refuse. Although dustless loading of refuse has been in use for some time in certain countries abroad, the idea of the suction street cleaning vehicle can be said to have originated in the Council's own Cleansing Department. Both are to come into regular service shortly and, together with the measures being taken to control smoke, should contribute materially to health and comfort. Public conveniences as a rule receive scant attention in the reports of Medical Officers of Health and yet their efficient supervision and maintenance is extremely important. Vandalism breeds vandalism and the fact that there is comparatively little malicious damage in the conveniences in St. Marylebone is, I am sure, due to the efforts of the staff to ensure a high standard of cleanliness and the proper maintenance of the various fitments. Two developments in this service, of which full details are given on page 13, are of interest. The opening of a new convenience in Paddington Street provided an opportunity to introduce a new type of tap serving the wash-hand basins which has given rise to favourable comment by members of the public. This delivers a spray of water the temperature of which can be controlled by the user. Although the hands are washed under the running spray and no stopper is provided in the basin, there is a considerable saving in both water and electricity used to heat it. Another experiment which is proving to have been worth while is the provision in Oxford Circus women's convenience of a small room suitably equipped, so that a mother may "change" or feed her baby in reasonable comfort and privacy, and where any woman who is feeling unwell may rest. At the same time a changing room with facilities for washing, shaving and shoe cleaning was provided in the men's convenience and is being used with increasing frequency. The use of the women's rest room is free but a charge of one shilling is made for the use of the changing room. Under the heading "Rodent Control" on page 11 details are given of a new method of baiting in sewers which has been introduced for a trial period and appears to be successful. Previously the sewers were treated at intervals, the bait being laid, in manholes, on the benching of the sewers or on plates laid across the sewers and, at side entrances, on the floor at the bottom of the shaft. In all cases it was necessary for men to enter the sewer with all the attendant precautions, while in the case of manholes in the road there was the added complication of heavy traffic. Since side entrances are approached from the pavement, it was decided that control should be attempted by maintaining a constant supply of poisoned bait at these points and also to devise a method whereby it could be laid and inspected from the surface. The method finally adopted was to suspend the bait, enclosed in polythene bags, by wires secured at the top of the shaft. The bags keep the bait in good condition for a considerable time and do not appear to deter the rats from taking it. Whereas previously it was often difficult to distinguish a true "take" from scattering of the bait caused by flooding, dripping water, or accidental disturbance by sewermen, it is now easy to see when a bag has been gnawed by a rat. The true measure of the success or otherwise of the system will depend on the analysis of results obtained over several years, but in the meantime reports of sewermen appear to indicate that the rat population in the sewers is decreasing. The almost universal use for domestic washing and cleaning of foaming detergents has given rise to a new type of problem in connection with the drainage of blocks of flats. When these products are used without proper discrimination the action of the water descending from the upper floors causes a build-up of foam in the lower part of the drainage system. This forces its way out through the sanitary fittings in the ground floor flats giving rise to considerable nuisance. Occasionally it has been possible to discover one tenant who is the offender. In these cases a visit by the Public Health Inspector, to explain the proper use of detergents and the needless extravagance of using them in excess of the amounts recommended by the makers, has usually been successful. More often, however, no one tenant is at fault. In these circumstances, a fair measure of success has been attained by seeking the cooperation of the owners who have been asked to circularise their tenants using as a basis a suitable draft letter prepared in the department. During the year the assistance of the Public Health Department was sought by three hospitals to disinfect wards following outbreaks among the patients of infection due to resistant staphylococci. This type of infection continues to be a major problem in all hospitals but, at last, with the recent introduction of the new penicillins, a solution appears to be in sight. Hospitals for human patients are not the only ones with problems and we were pleased to give our help when we were asked by the London Zoo to advise on modifications to the ventilating system in the sanitarium there to minimise cross infection among the animals under treatment and in quarantine. There were increases in the work of the department in 1959 as compared with the previous year particularly staff medical examinations, drainage schemes, and land charge enquiries and town planning applications referred to the department. No special hazards due to radioactivity have so far been encountered in the Borough but it was thought advisable to have at least some of the Public Health Inspectors trained in this subject and, as a first measure, Mr. Bignell, the Senior Public Health Inspector and Mr. Pearson, Smoke Inspector, attended a suitable course of lectures. The training scheme for Student Public Health Inspectors is beginning to bear fruit and Mr. Bithrey, one of the two under instruction in the department, qualified during the year and was appointed to fill a vacancy on the staff. It is with regret that I have to record the death on the 4th March, 1959, of Mr. Bryan, who was Bath Attendant at the Welfare Centre. Mr. Bryan, who died following a short illness, had always carried out his duties in an exemplary manner and he will be much missed by many of the old people who regularly visit the Centre. As always, I have received the willing co-operation of every officer of the Council from whom I have sought help during the year. I would, however, like to say a special word of thanks to the Borough Librarian for providing space in the window of St. John's Wood Branch Library, and in the vestibule of the Central Library at the Town Hall, for the display of health education material and for his help in the distribution of book marks and pamphlets on various health topics. I would also like to thank my medical colleagues in general practice and in hospitals for their many kindnesses and to express my appreciation of the assistance I have received from the officers and members of the voluntary bodies whose work supplements that of the Public Health Department. To the staff of the Department, my thanks are due for their conscientiousness, loyalty and friendship, and for a year's work well done. Finally, to His Worship the Mayor, to Alderman C. D. Dennis-Smith and to his successor as Chairman of the Public Health Committee, Councillor Miss F. E. Wilson, and to the members of the Committee, may I express my gratitude for your support and consideration during the year. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, J. H. BRISCOE-SMITH, Medical Officer of Health. 1 PUBLIC HEALTH COMMITTEE 1959 HIS WORSHIP THE MAYOR: *Councillor A. D. H. Plummer, T.D., J.P., F.A.I. †Councillor Lt.-Co1. H. C. S. Thomson, O.B.E., J.P., A.C.A. ALDERMEN: C. D. Denis-Smith (Chairman until May) *Miss L. F. Nettlefold, M.A., LL.B., L.C.C. Capt. R. G. Whitney, M.B.E., J.P. COUNCILLORS: R. H. S. Allen *H. Levitt Dr. H. K. Ashworth, T.D. The Rev. W. M. Long †J. C. C. Blofeld †Mrs. J. P. G. Nuttall †Mrs. R M. Challis †s/Ldr. S. Stanley *H. C. Garrard †F. H. J. Wileman Dr. L. Jacobs *W. R. Willcocks *L. M. Laurance Miss F. E. Wilson (Chairman from June) * until May † from June STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health and Medical Referee for Cremation: J. H. Briscoe-Smith, M B., Ch.B., M.R.C.S.(Eng.), L.R.C.P.(Lond.), D.P.H. Occasional Deputy Medical Officer of Health and Deputy Medical Referee for Cremation: C. J. C. Britton, M.D., D.P.H. Public Analyst (Part-time): T. McLachlan, D.C.M., A.C.G.F.C., F.R.I.C., M.I.Biol., 4, Hanway Place, W.1 Bacteriologist (Part-time): C. J. C. Britton, M.D., D.P.H., 35, Harley Street, W.l Administrative and Clerical Assistants: H. G. E. Brown (Chief Assistant) D. H. Drewell P. C. Bedward S. P. Fleming F. W. Dines J. H. Manning (until October) F. V. Terry D. J. W. Rigg (from October) Miss C. A. Cruickshank Miss M. L. Shaul Public Health Inspectors: V. A. Btgnell (a, b, c) (Senior Inspector) Food Hygiene and Sampling: Rodent Control: L. Newland (a, b) J. A. Cummins (a, b) Drainage: Care of Old People and Rehousing: J. R. Baily (a, b) Miss M. M. Sharp, M.B.E. (a, d, e, f) J. E. Broadhead (a) District: Smoke Control: D. B. Hooper (a) L. Pearson (a, b, c) P. W Jolly (a, b) Restaurants: S. W. Wright (a, b) Mrs. M. I. Tipi.ady (a, b, d, f) E. W. J. Miller (a, b) *Miss B. Wilson (a, b, d, e, f) A. J. Bithrey (a) (from August) Outdoor Superintendent and Mortuary Keeper: R. G. Turner Streets Nuisance Inspector: D. Telford Student Public Health Inspectors: fR- C. Morton, A. J. Bithrey (until August) Messenger/Handyman: W. G. Sharwood Rodent Operatives 4 Disinfectors 3 Public Conveniences Staff 36 Cleansing Station Attendants 3 Van Driver I (a) Public Health Inspector's Certificate (b) Meat and Other Foods Inspector's Certificate (c) Smoke Inspector's Certificate (d) Health Visitor's Certificate (e) Central Midwives' Board Certificate (f) State Registered Nurse's Certificate * Also Infectious Diseases. † Appointed as student inspectors under a scheme of paid pupilage adopted by the Borough Council on the 19th January, 1956. 2 SECTION A.—STATISTICS AND SOCIAL CONDITIONS GENERAL STATISTICS Area of Borough, etc.: (a) excluding area covered by water, 1,427.8 acres; (b) including area covered by water, 1,473 acres; (c) roads—approximately 57 miles of public highway. There is a variation of approximately 100 ft. in the elevation of the Borough from north to south, the highest point being at the junction of Finchley Road and Boundary Road, 173 ft. above Mean Sea Level at Newlyn, and the lowest at the junction of Oxford Street and James Street, 70 ft. above Mean Sea Level at Newlyn. The sub-soil consists generally of clay with various pockets of gravel, hoggin and sand. Rateable value of the Borough: £5,976,481. Sum represented by a penny rate: £23,657. Residential units (separate assessments): 24,560. Population: 1951 census—Males: 31,649, Females: 44,172. Total: 75,821. Foreign-born residents: 1951 census—8,872 (approximately 12 per cent. of total population). Registrar General's estimate of the home population (which includes members of the armed forces stationed in the area and is used in calculating various rates in this report): mid-1959—70,430. Registrar General's estimate of the child population: mid-1959—under 1 year: 720; 1-4 years inclusive: 2,480; 5-14 years inclusive: 5,000. Total child population: 8,200 (approximately 12 per cent. of total population). It is estimated that approximately 68 per cent. of the Boroughs' population are aged between 15 and 65 years, and approximately 20 per cent. are over 65 years of age. Expectation of Life (Born in 1959): Girls—73.53 years; Boys—67.85 years. Marriages. The following table shows the number of marriages in St. Marylebone each year since the 1st January, 1949:— Year No. of Marriages Year No. of Marriages 1949 1,461 1954 1,262 1950 1,439 1955 1,298 1951 1,415 1956 1,257 1952 1,358 1957 1,250 1953 1,290 1958 1,227 1959 1,205 The 1959 figure is 22 below that for 1958 and 120 below the average (1,325) for the previous ten years. EXTRACTS FROM VITAL STATISTICS Total M. F. Live Births—Legitimate 616 310 306 Live birth-rate per 1,000 population 9.68 Illegitimate 66 31 35 (Standardized) 7.55 Stillbirths—Legitimate 4 1 3 Stillbirth rate per 1,000 live and Illegitimate 6 5 1 stillbirths 14.45 Total live and stillbirths 692 345 347 Infant Deaths—Legitimate 11 3 8 Illegitimate - - - Total Legitimate Illegitimate Infant mortality rate per 1,000 live births 14.67 17.85 Nil Neo natal mortality rate per 1,000 live births 10.26 11.36 Nil Illegitimate live births per cent. of total live births .. .. 9.66 Maternal deaths (including abortions) .. .. Nil Total M. F. Deaths (all ages) 1,141 554 587 Death rate per 1,000 population 16.20 (Standardized) 11.34 Area comparability factors. Births, 0.78; ; Deaths, 0.70 3 Deaths. The total number of deaths (1,141) shown in Table 1, page 30, is inclusive of persons who though normally resident in the Borough died elsewhere in England and Wales, but exclusive of persons who, though they died in St. Marylebone were ordinarily resident in other parts of England and Wales. Deaths of persons ordinarily resident outside the borders of England and Wales are included in the St. Marylebone figures if they occur in the Borough, as also are those of members of H.M. Forces who were stationed in the area. Deaths in 1959 were 30 less than in 1958. The principal causes were diseases of the heart and circulatory system, which accounted for 37 per cent. of the total deaths; malignant diseases 19 per cent.; and respiratory diseases, including tuberculosis, 13 per cent. Deaths from lung cancer compared with the previous year rose from 58 to 63. Seventy-five per cent. of the deaths registered were of persons aged over 65 and twenty per cent. were aged between 45 and 65 years. Infant Mortality. Eleven infants died under one year of age (all legitimate) as compared with twenty-six last year (23 legitimate, 3 illegitimate), giving a death rate of 14.67 per 1,000 live births, as against 33.42 per 1,000 last year. Details showing causes of death according to age group and sex are given in Table 2, page 30. Although the number of deaths under one year of age was the lowest on record, the figure for the previous year (26) was the highest since 1954, when it was 27. Fluctuations of this kind are almost inevitable where comparatively small groups of population are involved and only by comparison of the average figures over several years can a true picture be gained. The average infant mortality rates in St. Marylebone for the five-year periods 1950-1954 and 1955-1959 were respectively 23.78 and 21.85 per 1,000 live births. Maternal Mortality. No maternal death was reported during the year. Accidental Deaths. During the year, 24 residents died from accidents of all kinds. This was six less than last year. Motor vehicle accidents accounted for six deaths as compared with twelve in 1958. National figures show that children under five years and elderly people account for 80 per cent. of accidental deaths. Year after year far more deaths result from accidents in the home than from road accidents and every effort must be made to make householders realise the urgent need to take all possible precautions and, by avoiding carelessness, reduce this appalling toll of life and unnecessary suffering. Again, local road accident figures show an increase on the previous year (887), there having been 978 such accidents in the Borough, resulting in 11 (7) deaths, 131 (109) serious injuries and 1,045 (959) slight injuries. The figures in brackets relate to 1958 and a summary of the accidents in 1959 is given in Table 4, page 32. Weather. The following summary of the weather during 1959, and Table 3, page 31, are based upon information supplied by the Meterological Office:— January.—About twice the average amount of sunshine; mean temperature about 3.5 degrees below normal. Rainfall about average. Sleet or snow on 4 days. Foggy all day on 14th, 28th, 29th and 30th. February.—Sunshine about average. Cold at first becoming very mild later; five days with frost. Rainfall only about 5 per cent. of average. Foggy all day 17th, 18th and 19th. March.—Sunshine about average. Rainfall a little above average. April.—Sunshine slightly below average. Mean temperatures 2 to 3 degrees above average. Rainfall about 15 per cent. above average. May.—Sunshine about 20 per cent. above average. Mean temperature one to two degrees above average. Rainfall 30 to 50 per cent. of average and most of it fell on the night of 21st/22nd in thunderstorms. June.—Sunshine about 20 per cent. above average. Mean temperature about two degrees above average. Rainfall very variable between 30 and 90 per cent. of average due to thunderstorms. 4 July.—Sunshine about 50 per cent. above average. Mean temperature two to three degrees above average. Rainfall about 50 to 60 per cent. of average. August.—Sunshine about 30 per cent. above average. Mean temperature just over three degrees above average. Rainfall very variable between 40 and 100 per cent. due to local thunderstorms. Heavy thunderstorms on 21st and 22nd. September.—Sunshine about 60 per cent. above average. Mean temperature about 4 degrees above average. Rainfall exceptionally low between 1 and 7 per cent. only and most of this fell on 21st. The driest September on record. October.—Sunshine about 70 per cent. above average. Sunniest October on record at Kew. Mean temperature between 4 and 5 degrees above average. Rainfall about 80 per cent. of average. Gust of 58 miles per hour on Air Ministry Roof on 18th. November.—Sunshine variable from about average to 40 per cent. above average. Mean temperature 1 to 2 degrees above average. Foggy all day on the 12th. Rainfall near average. December.—Sunshine 80 to 90 per cent. of average. Mean temperature 3 to 4 degrees above average. Month remarkably free from air frost. Rainfall about 50 per cent. above average. More rain fell in December at Kew than in the 5 months, February, May, June, August and September combined. Public Holiday Weather. Easter (March 27-30th) Good Friday mainly cloudy with slight rain or drizzle; temperatures little above average. Saturday mainly sunny. Sunday cloudy with rain in afternoon and evening. Monday mainly dry with sunny intervals. Whitsun (May 16th-18th) Saturday sunny all day and rather warm; Sunday mainly cloudy but cold. Monday cloudy early but sunny periods developed during afternoon though it was rather cold. August (lst-3rd August) The holiday started cloudy and rather cool with rain setting during Saturday evening. Sunday dry with sunny periods and average temperatures. It rained on Sunday night but cleared early in the morning and the remainder of Monday dry but mostly cloudy with average temperatures. Christmas (24th-26th December) Christmas eve started with a little rain but soon became fine with sunny periods and average temperatures. Christmas day cloudy and rain commenced early afternoon ; it stopped by evening but isolated squally showers through the night. Mild. Thunderstorms broke out in small hours of Boxing day ; this is only the second time this century that thunder has been reported at Kew over Christmas. The day was showery and windy but mild. SECTION B.—GENERAL PROVISION OF HEALTH SERVICES Representation upon Other Bodies. The Council were represented upon the under-mentioned statutory and voluntary bodies as indicated:— Body Representatives London County Council Health Committee. Alderman Capt. R. G. Whitney, M.B.E., J.P. London County Council Divisional Health Com-mittee (Division 2). Councillor Dr. Elizabeth Jacobs. Councillor S/Ldr. S. Stanley (until July). St. Marylebone Tuberculosis Care Committee. Councillor Mrs. R. M. Challis (from July). Councillor L. M. Laurance. The Medical Officer of Health. Paddington Hospital Group House Committee, No. 1. Councillor H. C. Garrard (until April). Paddington Hospital Group House Committee, No. 2. Councillor Dr. L. Jacobs (from April). Paddington Hospital Group House Committee, No. 5. Councillor Mrs. S. Rivington. National Society for Clean Air The Chairman of the Public Health Committee. The Medical Officer of Health. Paddington and St. Marylebone District Nursing Councillor Mrs. S. Rivington. Association—Executive Committee. 5 Body Representatives St. Marylebone Youth Centre Committee—Management Committee. Councillor Mrs. S. Rivington. Councillor Miss O. M. Stone. St. Marylebone Clean Food Association—Executive Committee. Councillor H. C. Garrard (until July). Councillor Mrs. J. P. G. Nuttall (from July). Councillor Miss F. E. Wilson. Department of Scientific and Industrial Research— The Chairman of the Public Health Committee. Standing Conference of Co-operating Bodies The Medical Officer of Health. dealing with Atmospheric Pollution. Samaritan and Western Ophthalmic Hospitals Councillor L. M. Laurance (from April). Joint House Committee. Conferences. The Council were officially represented at the under-mentioned conferences dealing with matters within the purview of the Public Health Department:— Conference Royal Society of Health—Harrogate, 27th April to 1st May. Association of Public Health Inspectors—Margate, 15th to 18th September. National Society for Clean Air—London, 20th to 23rd October. Conference on The Elderly in the Community— London, 22nd January. Conference of the Central Consultative Committee on the Welfare of Old People—London, 10th April. Cremation Society Conference—Llandudno, 1st to 3rd September. Delegates Alderman Capt. R. G. Whitney, M.B.E., J.P. The Medical Officer of Health. Mr. V. A. Bignell, Senior Public Health Inspector. Councillor Dr. H. K. Ashworth, T.D. The Medical Officer of Health. Alderman Miss L. F. Nettlefold, M.A., LL.B., L.C.C. Miss M. M. Sharp, M.B.E., Public Health Inspector. Councillor Miss F. E. Wilson. Miss M. M. Sharp, M.B.E., Public Health Inspector. The Medical Officer of Health. Financial Contributions to Voluntary Organisations. Payments to the funds of voluntary bodies were, on the recommendation of the Public Health Committee, made by the Council during 1959, as follows:— Organisation £ s. d. Statutory Authority Central Council for Health Education 11 11 0 Public Health (London), Act, 1936, section 298. Family Welfare Association (Area 2) 100 0 0 Local Government Act, 1948, section 136. St. Marylebone Youth Committee 75 0 0 do. National Society for Clean Air 7 7 0 Public Health (London) Act, 1936, section 298. St. Marylebone Old People's Welfare Association— "Meals on Wheels" Service, Foot Clinic, etc. 1,075 0 0 National Assistance Act, 1948, section 31. Assisted Holidays Scheme 250 0 0 do. "Inner Wheel" Old People's Club—Rent of Hall 30 0 0 do. Women's Voluntary Services 40 0 0 do. Care of Old People. The women public health inspectors visited 679 old people during the year. Although included in this figure were 77 married couples, most of these old people lived alone and some required constant observation. The St. Marylebone Old People's Welfare Association, acting voluntarily and in close co-operation with the department, continued to give invaluable service to the elderly. Some of the more important activities are mentioned in the extract from their Annual Report reproduced below. The London County Council's domestic help service and Department for the Handicapped, together with the District Nurses, likewise were of great assistance. 6 Special Laundry Service.—Under the scheme started in 1950 for laundering bed linen and clothing of acutely ill and incontinent or very dirty and verminous old people, sixty-five cases were dealt with. Fifty-two of these were new and each was the subject of a certificate given by the Medical Officer of Health under the provisions of section 122 of the Public Health (London) Act, 1936. The work is done by the Council's staff at the Public Health Department laundry at 217, Lisson Grove, N.W.8. Bathing.—Under the provisions of section 43 of the London County Council (General Powers) Act, 1953, sanitary authorities are empowered to make arrangements for bathing old people at their own request or with their consent. During the year, a total of 493 baths were given, 341 to women and 152 to men, under the scheme started in 1954 for bathing old persons at the Lisson Grove Centre. A trained nurse is employed part-time, under the general direction of a woman public health inspector, to supervise the bathing and accompany the old people on the journeys between their homes and the Centre. St. Marylebone Old People's Welfare Association. The Executive Committee of the Association (Chairman—Mrs. L. Fewster; Hon. Secretary—Mrs. K. M. Cowan, Room 103, Town Hall, St. Marylebone, W.l) has kindly provided the following information, which has been extracted from the Association's Annual Report, on work carried out during 1959:— "The end of the year was saddened by the death in hospital after a short illness of Miss M. K. C. Macintosh, Vice-President, who, as Hon. Secretary of the Association from its beginning until early in 1958, largely inspired the creation and development of its work, and gave devoted service to old people's welfare, not only in this Borough but in the wider spheres of this work. Donations and Gifts.—The kindly idea of the regular distribution of a parcel of groceries to needy old people led to the organisation by Mrs. Pomeroy of a small committee which twice distributed such packages from 'The Friends of the Aged in St. Marylebone' to one hundred people whose names were suggested by the Association. Warm appreciation is expressed for this generosity. It is impossible to list all the kindly donors whose support has given so much encouragement to the work. One donation specially appreciated was £5 from someone in the country who wished to express gratitude for the help given her elderly aunt by everyone concerned at the Town Hall. Harvest Festival and Christmas gifts were distributed by several Churches and Schools. The Association was happy to suggest names and to see the great pleasure brought by these presents, especially when taken into the homes of old people by the children. Although the main offices of the Central Office of Information are no longer in the Borough, their staff kindly remembered the old people at Christmas. Meals-on-Wheels.—This service was initiated in St. Marylebone by the W.V.S., greatly encouraged by the Mayor of that time, Councillor A. T. Coucher. Since 1947, by which time it had outgrown the early distribution by private cars, the responsibility has been undertaken by the Association, the meals being distributed by W.V.S. workers. A direct grant comes from the Borough Council and a contribution for each meal is made by the London County Council, this being paid through the Borough. At first meals went out twice a week; in January, 1948, the service was extended to four days, in December, 1949, to five. From November, 1954, the dinners have been prepared in the canteen of Messrs. Spencer, Turner and Boldero, Ltd. (Factory Restaurants, Ltd.). The Welfare Department of the London County Council agreed to contribute to voluntary organisations arranging for the provision of meals to old people, at the rate of 8d. per meal, in respect of meals obtained at a cost not exceeding 1s. 6d. each, sold to people at 10d. This contribution was increased to 10d. a meal from September, 1956. In spite of rising costs a most satisfactory standard of meals has been maintained. One part of the Borough is served two days weekly, the other part two days, the fifth day being reserved for more urgent cases, but it has not been possible to serve any person daily. The Committee has given considerable attention to the distribution of hot meals, re-examining the method and looking into the possibility of improvements or alternatives. The Public Health Department was very helpful in making tests as to heat conservation. Further consideration, however, would be needed before any changes could be undertaken. 6,101 meals were delivered during 1959, the service continuing to be a great benefit to many old people, sometimes only in temporary difficulties. ' I feel I can now manage my meals, at any 7 rate for the time being, wrote one old lady, 'so shall not need the kindly, useful and much appreciated service. I tender my sincere thanks for the help the service has been and to the kind ladies who have so cheerfully mounted this staircase to reach me.' 'Frood' Christmas dinners were kindly donated by the Mayor, to be distributed by W.V.S. members on Christmas Eve to all receiving ' Meals-on-Wheels.' The van has been efficiently serviced and garaged by the Council, which also provides the driver. The Association is much indebted to all concerned in the team work of this useful service. Luncheon Club.—This valuable service had another successful year in Church Army premises at 134, Seymour Place. The W.V.S. helpers under the leadership of Mrs. Lush make it a very cheerful centre, where pensioners can get a good hot mid-day meal for l0d. 6,096 meals were served and once again a special Christmas dinner was given by the helpers. Chiropody Clinics.—The Association has been fortunate in retaining the services of the same three chiropodists and is also indebted to Miss Cotsford, B.R.C.S. member, who has continued to act as voluntary appointments clerk at the Town Hall Clinic, where 2,339 treatments were given. This Clinic opened in June, 1951, held by courtesy of the L.C.C. in their rooms, which have been rent-free since 1955. Mrs. E. Baird, Chiropodist, has worked there since the beginning, joined by Miss Curran in 1952 and by Miss Lerner in 1955. At least one patient has attended regularly since the opening day. The L.C.C. Lisson Grove Health Centre has again provided Chiropody for old ladies whenever possible. Twelve such treatments on an average have been given monthly. This helpful addition to the service dates from November, 1957. It had long been the wish of the Association to extend old people's chiropody to the eastern part of the Borough. At last this hope was realised with the opening of Clinic 2 in premises most generously made available by All Souls' Church at their Club-house in Cleveland Street. Miss Lerner undertook the professional care for a weekly session on Mondays and 286 treatments were given between March and December. Clerical help was at first provided by B.R.C.S. and W.V.S., later a pensioner carried on the appointment work. The equipment for the new Clinic was provided from Association funds, assisted by gifts from the Chairman, and the Association also met all the running costs. All patients paid a fee of 1s. 6d. for each treatment. Home Chiropody.—619 treatments were given, at the same charge as previously, 2s. a time. This was a slight increase in the number of new patients and the waiting list was reduced at the end of the year to 7. Regularity of visiting has made it possible to lengthen the interval between visits, the average time now being 9 weeks. Mrs. E. Baird started work from the beginning of the service in January, 1951, being joined in 1952 by Miss Curran. At least three old ladies have been receiving the benefit of this service since it was inaugurated. Parking difficulties in W.l added complications and we are specially grateful to our chiropodists and the Red Cross driver, Mrs. Simmonds, for surmounting this problem and for maintaining such an efficient service. Miss Lewis devotes much time and trouble to plotting the rounds so that the time of the chiropodists is utilised to the best advantage. Holidays.—The glorious summer of 1959 made Brighton particularly enjoyable for the 62 elderly folk who were helped to have a week there in May. Each contributed £1 17s. 6d. The remainder of the cost of £4 14s. fid. for board, lodging, transport and entertainment was met by the Association from the Borough grant. Miss Sharp again accompanied each party and saw them happily settled; much kindness was shown by the landladies of the guest-houses. Again the Soroptimist Club of Mayfair 'adopted' an old lady, paying her expenses and giving kindly personal thought to her happiness. In addition, 28 elderly people were helped with individual holiday arrangements, at different times and places, including the Church Army short stay home at Woking and the British Red Cross Society's Edith Priday Home. The Association was pleased to be able to contribute £25 to the Fourth Feathers Club and £10 to the Barrow Hill Club, for their own holiday schemes, 8 Home Visiting.—The friendly, unofficial visiting of lonely old people, which was the first work undertaken by the Association, continues to be of real value, though the effectiveness of such a service is sometimes difficult to assess. 'Thank you for asking Miss E. to come to see me,' wrote one old lady. 'She is quite young, only 21, and she is such a joy. She comes up bright and smiling every Thursday evening after she leaves the school where she teaches and we have a cup of tea together, she always says she enjoys that cup of tea.' Another wrote: 'Mrs. N. is a very nice person, she helps to cheer one up.' Five new 'friendly visitors' joined in this service, but several others were obliged to discontinue on leaving the neighbourhood. No two people are alike, so many different types of visitors can be of use. There are at present too few men visitors to call on. The monthly meeting with Miss Sharp and the Secretary provides not only opportunities for learning about conditions met during visiting, but about many kindnesses shown to old folk by Churches and other groups. For example, the Samaritan League connected with the City Temple, provided a wireless set for one of the old people, a T.V. licence as well as gifts of money at Christmas for about a dozen. It is a great advantage to have six churches represented on the visitors' committee. The Church of All Souls, represented by Mr. J. A. Johnson, has the largest number of members engaged in visiting. Clubs.—The 'Good Companions,' meeting in All Souls' Club-house, was a welcome addition to the Borough's clubs for the elderly. Later in the year Mrs. Willey, the W.V.S. Centre Organiser, was asked to start a W.V.S. club in Luxborough Lodge, an innovation which was an unqualified success. There are other clubs in the Lodge such as a club for the blind. An L.C.C. lip-reading class was reported and the excellent work of the Red Cross has continued. Christmas parties and summer outings were as usual most popular and all the older established clubs had a successful and happy year, most of them filled to capacity. Relief.—As usual most items of help were small in terms of money but represented timely and useful assistance not available from other sources. Wireless licences were provided in three cases, repairs were paid in others, a gas ring was fixed to add to the comfort of two elderly sisters, a taxi helped with a removal, assistance was given in such items as insurance arrears, the cost of spectacles, a newspaper bill and tailor's alterations for a man's suit before its new owner went away for a holiday. Home decoration was an innovation made possible through the kindness of students connected with Hinde Street Methodist Church, who between June and November gave spare time to decorate rooms for eight pensioners. The Association provided paint and other equipment and paid expenses of a chimney sweep and cups of tea for the workers. This service was immensely appreciated, specially in the case of an old lady who returned from a spell in hospital to find her home transformed, with clean walls and new linoleum on the floor. In several cases the National Assistance Board was able to refund the cost of materials. Fuel.—Miss Sharp was quick to the rescue in any emergency due to fuel shortage; a bag of coal from the Association's store could thus prevent much discomfort. 17 such deliveries were made. Coal tickets given by a kind friend were also distributed. Wireless.—At the end of the year 29 sets obtained from the 'Wireless for the Bedridden' Society were being used and enjoyed under Miss Sharp's supervision. The Society generously provided the licence with most of the seven new sets lent during 1959 and renewed others. Other sets privately given or lent, have also given joy. Library.—The delivery of books to the housebound, instituted by the Public Libraries Committee in 1957, has been carried out regularly by library staff, mainly to cases recommended by the Home Help service. Twenty-four old people are now receiving this service and over 3,000 books were delivered to them during 1959. Fireguards.—Applications to the L.C.C. were made in only two new cases. Entertainments.—Once again the highlight among entertainments was the wonderful Christmas party and cabaret show given by Mrs. Lew Grade at the Seymour Hall, for eight hundred old people. Everyone felt it was 'better than ever,' an occasion to be remembered, and went away with a large bag of good things for Christmas. The Association allocated the invitations, making special efforts to include a larger number of individuals outside the Clubs, and is grateful to Club leaders and other friends who helped so efficiently on the day. Two Christmas trees went on to give pleasure at Luxborough Lodge and Newstead. The Distillers' Drama League again gave tickets for an evening performance." 9 Diseased or Infirm Persons—Compulsory Removal. Section 47 of the National Assistance Act, 1948, as amended by the National Assistance (Amendment) Act, 1951, empowers the Council to apply to the Courts for Orders for the removal to a hospital or institution, for the purposes of securing the necessary care and attention, of persons who— (a) are suffering from grave chronic disease or, being aged, infirm or physically incapacitated, are living in insanitary conditions, and, (b) are unable to devote to themselves, and are not receiving from other persons, proper care and attention. It is seldom necessary to follow this procedure, except in distressing cases which sometimes occur of old persons who, although no longer able to look after themselves and living in conditions which make it impossible for them to be nursed at home, refuse to enter a home or hospital voluntarily. During 1959 there was one such case, particulars of which are given in Table 5, page 32. Public Swimming Baths. The Seymour Hall, opened in April, 1937, covers an area of 37,000 square feet. The building is electrically heated and contains two indoor swimming pools, private baths, squash rackets court, changing and club rooms. Swimming and private bath facilities are available daily throughout the year. The large pool, which is converted from October to April inclusive for use as a public hall, has a water area of 132 feet by 42 feet with depths from 3 feet to 12 feet, and the smaller pool a water area of 100 feet by 30 feet with depths from 2 feet 9 inches to 6 feet 6 inches. The pools are provided with independent purification plants which are cross-connected to purify water in either pool if necessary. These plants have a capacity of 65,000 and 23,800 gallons per hour respectively. This enables the contents of the pools, 228,000 and 83,600 gallons, to be circulated and purified within 31 hours. Continuous filtration is applied so that all the pool water does not have to be changed. Water from the pool is used to wash the filter beds and "make up" water is taken from the mains of the Metropolitan Water Board. Chemical treatment is by alumina and soda, and the water is sterilized by chlorine gas with modern "breakpoint chlorination" equipment. Residual recorders provide a continuous visual and graph record of chlorine residual, and periodic re-agent tests are also taken. Samples from both pools are regularly sent to the Council's Bacteriologist and the results have been satisfactory. Staff Medical Examinations. The Medical Officer of Health is medical adviser to the Council for staff purposes. During 1959, one hundred and sixty-two examinations of the Council's employees and new entrants to the superannuation scheme were carried out. New Legislation. A list of the new Acts, Regulations and Orders, relating to the work of the Department, is given in Table 6, page 32. SECTION C.—SANITARY CIRCUMSTANCES Sanitary Inspection. The Borough is divided into five areas each of which is dealt with by a district public health inspector. Inspection of dwelling-houses is dealt with in Table 7, page 33. Excluding rat and mouse infestations, 1,181 complaints were received and details of the 888 various nuisances detected and remedied are shown in Table 8, page 33. Notices.—Intimation notices numbered 263, and 74 of these were followed by the service of a statutory notice to secure abatement of nuisances. In addition, ten notices were served under Byelaws made under the Metropolis Management or Public Health Acts. Legal Proceedings. Details of legal proceedings under the provisions of the Public Health (London) Act, 1936, are given in Table 10, page 34. Noise. Fifty-seven complaints of noise were received and these involved forty-three alleged nuisances. Extensive engineering works and operations on demolition and building sites, involving the use of 10 pile-drivers, mechanical excavators and other heavy equipment, continued to be undertaken in the Borough, and most of the complaints were of noise coming from these, particularly late at night and during week-ends. The remaining complaints concerned a wide variety of supposed causes, including radio and speech amplifiers, loading and handling of milk bottle crates, noise from factories and workshops, an electrical transformer and generator, a refrigerator, tenants' parties, clubs, socials, operatic rehearsals and road works. The complaints were not always justified but where, upon investigation, nuisances were found to exist these were nearly all abated or reduced after informal action by the public health inspectors or the streets nuisance inspector. In some cases the Department was unable to take direct action and the facts giving rise to the complaints were referred to other authorities possessing the necessary powers to deal with them. Checks were kept on mobile ice-cream vendors for possible nuisance from mechanical chimes or other "musical attractions." Pigeons. For the purpose of abating or mitigating nuisance, annoyance or damage caused by pigeons, Section 121 of the Public Health (London) Act, 1936, empowers the Council to arrange for the seizure or destruction of these birds in excess of such numbers as the Council consider reasonable. Accordingly, a pigeon catcher is authorised to operate under the direction of the Medical Officer of Health, at places in the Borough where nuisance is being caused. During 1959 eleven complaints of this type of nuisance were investigated but it was only found necessary to refer five cases to the pigeon catcher. Water. Although at a small number of blocks of flats and offices water for domestic purposes is obtained from private wells, the chief source of a constant supply throughout the Borough is from the mains of the Metropolitan Water Board whose Director of Water Examination has kindly provided the following information:— "The water supplied by the Board to the borough of St. Marylebone is derived from the River Thames. The water is purified in the Board's reservoirs at Littleton, Staines and Walton and filtered and chlorinated at the Board's Works at Barn Elms, Ashford Common, Kempton Park and Hampton. The water has been of satisfactory hygienic quality throughout 1959. Samples are collected at every stage of purification at least five days a week." The average results of analyses of the water leaving the works concerned are set out in Tables 12 and 13, pages 34 and 35. Further examinations of the private well waters from the twelve borings still in use (eight in full operation and four for emergency purposes only), were made by the Council's Bacteriologist. These indicated that since the last survey, made in 1947 at the request of the Ministry of Health, there has been no appreciable change. The reports for 1959 were generally satisfactory, and no pathogenic contamination was found. It is the practice of the Department to keep the wells supplying water for drinking purposes under observation and sample their waters every six months. Fifteen certificates relating to the provision of a proper and sufficient supply of water in dwelling houses were issued under the provisions of Section 95 (2) of the Public Health (London) Act, 1936. Drainage—Alterations and New Buildings. Of the 273 drainage plans approved during the year, 59 were in respect of new buildings. Upon request, the Borough Engineer examined 29 sewer connections and 12 of them were found to be defective and had to be renewed. The two drainage inspectors made 3,335 visits and no circumstances were found which necessitated legal proceedings. Combined Drainage. Eight orders under seal were issued in respect of combined drainage operations. Town Planning. Observations were made on 115 plans submitted to the Council under the Town and Country Planning Act, 1947, and referred to the Department 11 Rodent Control. There were 272 notifications of rat infestation at premises in the Borough, a reduction of 71 on the previous year's figure of 343. This follows the trend of a steady annual decline since the Council's rodent control service was started in 1949, when the total was 840. Only four cases of infestation by black rats were recorded. One particularly large pocket of this type of infestation was satisfactorily treated by a pest control firm in the early part of the year and there have been no further reports of rats from this source. Notifications of mice totalled 264, 23 less than during the previous year, and again during recent years there has been a gradual decline. Block surveys as a method of rodent control were continued throughout the year, 37 blocks involving 1,091 premises being dealt with. Infestations discovered in this way were of a minor character and few in number. This can be taken as an indication that occupiers of the premises concerned are responding well to their statutory responsibilities to notify the local authority of the presence of rodents. The incidence of rats in the borough sewers during 1957 and 1958 gave cause for concern, and it was decided that firmer measures of control should be undertaken in this direction. In co-operation with the Borough Engineer, research work was started to discover the most satisfactory method to employ and this was continued throughout 1959. The Ministry of Agriculture, Fisheries and Food were consulted from time to time about the matter and they have shown special interest in the particular line of research which has been followed. In St. Marylebone the sewers are entered at many points from "side entrances" which give access from the pavements. It was felt that there would be obvious advantages if control could be established from these points, especially if bait could be laid and "takes" recorded from the surface. This would avoid the necessity of lifting manhole covers in busy streets and the time-consuming business of men going down into sewers to lay bait and record "takes," so leading to a financial saving. Thus the same expenditure will now enable baiting to be carried out at shorter intervals. With those objects in mind a covered baiting-tray was developed for lowering into side entrances and subsequently polythene bags were substituted for the trays. These were filled with bait and suspended by wires. This latter technique does not appear in any way to deter the rats from taking bait and has therefore been generally adopted. It is not only easy to apply but also makes the assessment of "takes" a very simple matter. In addition, since the polythene bag keeps the bait in reasonable condition for a considerable time, it is always available to the rats at the selected points. Another advantage of the method is that "takes" can be recorded with an accuracy not possible with any method of sewer baiting previously tried. Statistics of rodent control are shown in Table 14, page 35. Disinfestation. The insecticide used to rid dwelling houses of bugs is Kerosene with 5 per cent. D.D.T. and 0.1 per cent. pyrethrins applied as a spray either by hand or under pressure from a motor compressor, according to the circumstances. This treatment is also given for flea and similar infestations which occur from time to time. During the year, 231 rooms were disinfested, including four requisitioned premises. Furniture, more particularly that of people removing to fresh accommodation, is dealt with by hydrocyanic acid gas in specially constructed vans. The Council continued to have this work done by a contractor and during 1959 the furniture of 14 families, of whom 13 were being rehoused, was treated by this method. In addition 456 verminous articles of bedding were disinfested by steam. A small steam disinfector situated in the cleansing of persons section of Welfare Centre No. 2 is used for the treatment of all articles up to the size of a single mattress. Arrangements with the Council of the Royal Borough of Kensington for articles above this size to be steam treated in their plant at Shepherd's Bush have worked most satisfactorily. Verminous Persons. The Council's Cleansing Station in Lisson Grove dealt with 600 verminous persons: adults 552 (men 522, women 30); children 48 (boys 7, girls 41). Shelter. It was not necessary during the year to make use of the shelter accommodation provided at No. 217, Lisson Grove, under Section 195 (4) of the Public Health (London) Act, 1936, for families temporarily dispossessed of their homes. The room set aside for this purpose was, however, utilised for other public health work. Air Pollution. The co-operation of the owners and occupiers of premises within the Borough to prevent unnecessary pollution of the air is worthy of comment. Residents of St. John's Wood Terrace Ward continued 12 their support of the first Smoke Control Order and from 1st October, when the second Order came into operation, there was almost total compliance by the occupiers of premises in Lord's Ward. On 2nd July, 1959, the Council made a third Smoke Control Order in respect of Hamilton Terrace Ward. Subsequently the Order was confirmed by the Minister of Housing and Local Government and it will become operative on 1st October, 1960. Cavendish Square Ward was surveyed for the Council to consider making a fourth Order during 1960. Complaints totalled 186, an increase of 28 over the figure for 1958. Timed observations of dark smoke were made on 150 occasions and verbal or written warnings were given when the emissions were excessive. Notifications of intention to instal new furnaces, as required by Section 3 of the Clean Air Act, 1956, were received in respect of 30 proposals, and twelve applications for the Council's approval of the plans and specifications were received. Atmospheric pollution was continuously measured at four sites within the Borough and the information obtained was sent regularly to the Department of Scientific and Industrial Research. The statistics are shown in Tables 15, 16 and 17, pages 35 and 36. Offices. Attention has been drawn in previous Annual Reports to the unsatisfactory state of legislation affecting working conditions in offices and reference was made to the recommendations of the Gowers Committee concerning the health, welfare and safety of non-industrial workers. There are some 3,300 office buildings in the borough and whilst there is no evidence of low standards in these buildings, the absence of adequate legislation makes it difficult to ensure satisfactory conditions for all those engaged in this class of occupation. It has long been doubtful whether routine inspection of offices, as distinct from enquiries based upon specific complaints, could legally be made under the Public Health (London) Act, 1936, and it is hoped that the Gowers Committee recommendations will soon become the subject of legislation. Shops. In accordance with the provisions of the London County Council (General Powers) Act, 1958, the duties of the London County Council under section 38 of the Shops Act, 1950, relating to lighting, washing facilities and facilities for taking meals, were, with specific exceptions, transferred to the Metropolitan Borough Councils on the 1st January, 1959. There are 2,487 shops in the borough, including 1,099 food premises, to which regular visits were made and in respect of which six notices were served. Factories. There were 1,974 factories on the register at the end of the year, 41 more than last year. A report on the administration by the Department of matters under Parts I and VIII of the Factories Acts, 1937-1959, is given in Tables 18 and 19, page 37. Outworkers. Sixty employers submitted lists in respect of a total of 553 outworkers (161 contractors and 392 workpeople). Of these, thirty-nine contractors and thirty-two workpeople operated in the Borough. The nature of the different classes of work and the numbers of outworkers engaged is indicated in Table 20, page 37. Fireguards. Inspections under the provision of the Heating Appliances (Fireguards) Act, 1952, numbered seventy-two. Of the comparatively few heaters that were found not to comply with the requirements, the majority were second-hand and the main fault was inadequate guards. Twenty-four notices were served and in each case the vendors withdrew appliances from sale or fitted new guards and sought approval before again displaying for sale. No legal proceedings were necessary. It is to be noted, however, that auctioneers can still legally sell heating appliances which do not comply with the Regulations unless they do so as agents for someone whose normal business is the selling of heating appliances. This loophole in the Act leads to administrative difficulties and in some degree defeats the aim of legislation designed to safeguard the users of these appliances from accidents. 13 Hairdressers and Barbers. The Council's Byelaws regulating these establishments came into operation on 18th December, 1955. There are in the Borough 119 registered hairdressers and barbers and 142 inspections were made. One notice was served but otherwise conditions generally were found to be satisfactory. Pet Shops. The Pet Animals Act, 1951, provides for a system of inspection and annual licensing of pet shops by local authorities, a fee of 10s. being payable for each licence, thirteen of which were issued during the year. A few of the licensees keep puppies and other mammals for sale but mostly they deal in cage birds, goldfish and tropical fish. The premises concerned were kept under observation by the public health inspectors who made 27 visits and inspected weekly the stalls licensed to sell pets in the street markets. Conditions under which the livestock was kept were reported as satisfactory. Poisons. At the end of the year the names of sixty-seven traders were on the Council's list of persons entitled to sell poisons included in Part II of the Poisons List (Pharmacy and Poisons Acts, 1933-1941) the number of premises concerned being seventy-eight. Details of the premises concerned are given in Table 21, page 38. Protective Helmets. The Motor Cycles (Protective Helmets) Regulations, 1957, makes it an offence for any person to sell or hire or offer to sell or hire any helmet as a helmet affording protection to motor cyclists, in the event of an accident, which is neither of a type prescribed nor of a type authorised under Regulations made by the Minister of Transport and Civil Aviation as being a helmet recommended as affording such protection. These Regulations prescribe the types of helmet which may be sold or hired to motor cyclists. Five premises in the Borough where these helmets are sold were kept under observation but no sub-standard helmets were found. Public Conveniences. There are in the borough 10 conveniences and three urinals for men and six conveniences for women. Supervision is exercised by the Public Health Department and no special problems arose during the year other than minor difficulties due to staff shortages. Because of these and in order to maintain the service it was sometimes necessary to leave some of the conveniences temporarily unattended but no vandalism occurred. During the year a new chalet type convenience for men and women was opened in Paddington Street at the north-east corner of the old burial ground. The cost of construction was borne by a company developing a site adjoining the urinal which for many years existed at the north-west corner of the burial ground. The new convenience replaces the old urinal, which has been demolished, and provides for men three water closets (one free), three wash-hand basins and six urinals; and for women three water closets (one free) and two wash-hand basins. The wash-hand basins in this convenience are fitted with a new type of tap with a hot and cold mixing valve which delivers the water at suitable temperature in the form of a spray. No basin stoppers are provided and it has been found that the spray delivery of warm water is not only acceptable to the public but is also effecting economy on water consumption and electricity. At Oxford Circus the convenience has been adapted so as to provide a rest room for women and a changing room for men. No charge is made for the use of the ladies' rest room which has been partitioned off from the toilet room so as to provide privacy. The tiled floor has been covered with lino and a rug provided, and there is a formica-topped table, a chair, extra washing facilities in the form of a wash-hand basin and a deep butler's sink. Linen towels and toilet soap are also provided. The rest room is intended primarily for the use of the travelling public, in particular mothers who may have to attend to the needs of their babies, or any woman who may feel unwell. The men's changing room, for which a charge of 1s. is made, is similar in construction to the rest room except that no deep sink is provided. It does, however, have facilities for shaving with an electric shaver operated by inserting a sixpence. Shoe cleaning materials, linen towels and toilet soap are provided. Now established in its eleventh year at all public conveniences where wash-basins are provided, the free washing scheme with paper towels and liquid soap is still increasing in popularity with the general public. 14 Public Cleansing and Salvage. The Director of Public Cleansing has kindly provided the following information:— "The materials dealt with during 1959 were: house and trade refuse, 34,229 tons; street sweepings and gully slop, 2,242 tons; salvaged materials, 2,137 tons. A sum of £11,113 was obtained from the sale of salvaged materials. In addition, £1,777 was received for the removal of trade refuse and cleansing petrol interceptors, etc. A minimum twice-weekly refuse collection was maintained, and approximately one quarter of all premises in the Borough received a thrice-weekly clearance. A daily collection was made from premises where this service is necessary, such as hospitals, restaurants, hotels and blocks of flats. All street gullies were mechanically cleansed at least six times during the year and all streets swept at least once daily. To deal with the removal of portable containers from the increasing number of blocks of flats and offices being erected in the Borough, two further diesel-powered refuse collection vehicles were purchased and put into service; six of these vehicles are now in operation. A further diesel-powered mechanical sweeper was purchased and put into service during the year. Following introduction of the Litter Act, 1958, consideration has been given to litter problems in the Borough. Litter bins have been attached to an increasing number of lamp and bus stop posts, etc., and additional bins are being provided which will bring the total number to approximately 400. Neater and more secure methods of fixing litter bins to lamp columns and bus stop posts have been devised. With the aim of further mechanisation of the street cleansing service, experimental work has been carried out in St. Marylebone, in collaboration with the manufacturers, to produce a pedestrian-controlled suction footway cleaning machine. Numerous prototypes were built to the requirements of the Department and a successful model was evolved; two of these machines are on order for the Department. This project attracted attention in the local and national press." Rag Flock and Other Filling Materials. The Rag Flock and Other Filling Materials Act, 1951, is intended to ensure that the fillings for upholstered and other stuffed articles shall be clean and wholesome. Standards of cleanliness are laid down in Regulations made under the Act, which also provides for licensing of premises where the filhngs are manufactured or stored, and registration by the local authority of all business premises where these materials are used. No premises in St. Marylebone are licensed for manufacture or storage but eleven premises, mainly those of upholsterers and manufacturers of cushions and pillows, are registered. Thirteen samples of hair and other filling materials taken during the year complied with the statutory requirements. Burial or Cremation of the Dead. Under section 50 of the National Assistance Act, 1948, it is the responsibility of the Council to arrange for the burial or cremation of the body of any person who has died or been found dead in the Borough where no other suitable arrangements for disposal have been or are being made. Eleven burials and five cremations were arranged during the year. Mortuary. Six bodies were received into the Public Mortuary in Chiltern Street. Transportation of Bodies Abroad. In certain cases where bodies are transported overseas, the Medical Officer of Health of the district in which death has taken place is asked, where applicable, to furnish a certificate to the effect that the deceased did not die from any infectious or contagious disease and that no recent epidemic of dangerous infectious disease has occurred in the district. During the year two certificates were issued in respect of bodies being transported to Persia and Iraq. Cremation. The Medical Officer of Health is Medical Referee for the Council's crematorium, which is situated at the St. Marylebone Cemetery, East Finchley. During the year, 2,050 certificates authorising cremation were issued and since December, 1937, when the crematorium was opened, 19,249 cremations have taken place. As a means of disposing of the dead, cremation is increasing in public regard and 15 in this country almost half as many cremations take place as earth burials. Approximately half a million people die in Great Britain each year and to bury those who are not cremated requires annually an average of 400 acres of land. In addition, the maintenance of cemeteries is said to cost the ratepayers a total of nearly two million pounds a year. Crematoria on the other hand are for the most part financially self-supporting. Dog Nuisance. The Council's bye-law dealing with this nuisance provides that:— "No person being in charge of a dog in any street or public place and having the dog on a lead shall allow or permit such dog to deposit its excrement upon the public footway." Although it has been shown that dogs can carry and excrete germs capable of producing illness in man, cases of human disease can seldom be positively related to infection from this source. However, there are many obvious objections to fouling of the footway by dog excreta and not least amongst them is the attraction to flies and blowflies with the consequent hazards to health. During the year, contraventions reported by the Streets Nuisance Inspector and the Police resulted in eleven summonses. In eight of these convictions were secured and penalties imposed. In two cases the summonses were not served and another was adjourned "sine die "—the defendant having left England. Street Photographers. A local bye-law, made by the Council under section 146 of the London Government Act, 1924, came into operation on the 1st August, 1952, prohibiting the importuning by a street photographer of any person, in certain prescribed streets or public places, for the purpose of taking or selling any photograph. An offender against the bye-law is liable on summary conviction to a fine not exceeding £5. As the administration and enforcement of most other "good rule and government" bye-laws have been referred to the Public Health Committee, a similar course was followed in regard to this bye-law, more particularly as the officers of the Department, including the Streets Nuisance Inspector, are continually about the streets. During 1959 the Council took out eleven summonses and, apart from two which were not served, obtained convictions in each case. Fines and costs amounting to £24 15s. 6d. were imposed. SECTION D.—HOUSING Permanent Estates. The Town Clerk has kindly supplied the following information regarding housing ac provided by the Council up to 31st December, 1959:— Pre-war Estates No. of Dwellings Crawford Place Dwellings 52 Fisherton Street 130 Post-war Estates Barrow Hill 172 Church Street 140 Winchilsea House 23 Townshend 222 Abbey Road/Boundary Road 54 Hamilton Terrace 52 Queen's Terrace/Pembroke Terrace.. 38 35/55, Boundary Road 48 Wellington Road 121 147/149, Gloucester Place 10 1/7, Aquila Street 6 Abercorn Place 34 22-30, Balcombe Street 14 17-19, Balcombe Street 4 Townshend Road 8 147-165, Lisson Grove 12 57-73, Boundary Road 36 Aquila Street Extension 23 Violet Hill House 22 1,221 16 At the close of the year the following additional sites were in course of redevelopment for housing purposes:— Church Street Extension (76 flats, with shops below) Foundation works in progress. Completion expected in April, 1961. 40/47, Chapel Street (20 flats with offices below) Completion expected early in 1960. Newcourt Street (48 flats) Flats expected to be completed early in 1960. 9/25, Cochrane Street (32 flats) Completion expected in July, 1961. Further Development Linked with Slum Clearance. Broadley Street/Penfold Street (32 flats) Development of site to density approaching 200 persons per acre refused by planning authority. Appeal lodged with Ministry of Housing and Local Government. Ashbridge Street (East)—(12 flats) 4 properties purchased by voluntary negotiations. Decision on Compulsory Purchase Order awaited for remainder from Ministry of Housing and Local Government. Freshwater Place (16 flats) 7 properties purchased by voluntary negotiations—terms agreed for remainder to be purchased early in 1960. Mulready Street (118 or 174 flats—dependent on density) 12 properties purchased by voluntary negotiations. Decision awaited from Minister of Housing and Local Government on Compulsory Purchase for remainder. Clipstone Street (305 flats) Proposals for the redevelopment of the area bounded by Carburton Street, Cleveland Street, Clipstone Street and Gt. Titchfield Street under consideration. Requisitioned Premises. Satisfactory progress was made towards the release of requisitioned premises by the 31st March, 1960. Two Compulsory Purchase Orders were made and confirmed by the Minister of Housing and Local Government to enable the purchase of requisitioned premises where terms could not be settled by voluntary negotiation. The number of dwelling units held under requisition at the end of the year was 199. Housing Acts, 1949/58. (a) Loans.—The Council continued to make loans to enable approved applicants to acquire their own houses. The total sum advanced during the year was £12,260. (b) Improvement Grants.—Grants totalling £2,413 were approved during the year for private owners to convert and improve existing houses. Factory-Made Bungalows. A further seven factory-made bungalows were vacated and removed during the year, leaving 17 families still occupying this type of accommodation. Housing of Old People. (a) 51/54, Beaumont Street.—The Council have agreed to take a building lease of Nos. 51/54, Beaumont Street with a view to the development of the site for the accommodation of old people. (b) St. Marylebone Almshouses, St. John's Wood Terrace.—The Council agreed to make a grant of a sum not exceeding £30,000 under the Housing Act, 1957, towards the cost of rebuilding the St. Marylebone Almshouses. (c) The Ladies' Home for Gentlewomen, 41, Abbey Road, N.W.8.—A grant of approximately £11,000 was agreed by the Council under the Housing Act, 1957, for the modernisation of this Home. (d) Dorset Chambers, Chagford Street, TV.W.l.—An improvement grant of approximately £5,508 was approved under the Housing Acts to the Individual Housing (W.V.S.), Ltd., to assist the conversion of Dorset Chambers into 16 self-contained flats with modern conveniences, for elderly people. 17 Dwelling-Houses. Statistics regarding the inspection of dwelling-houses under the Public Health or Housing Acts, defects remedied and action taken under statutory powers are contained in Table 7, page 33. Certificates of Disrepair. Applications for the issue or cancellation of certificates under the provisions of the Rent Act, 1957, were dealt with by the Town Clerk and referred to the Medical Officer of Health for investigation. A public health inspector visited each of the premises concerned and on his report the Medical Officer of Health was able to recommend appropriate action. Statistics relating to these matters are shown in Table 9, page 33. Rehousing Medical Certificates—Closing Orders. The Medical Officer of Health receives requests from the Borough Council's Housing Director for reports and advice on the housing conditions and the health of persons applying for rehousing. Seventy-seven confidential medical certificates referred to the Medical Officer of Health were considered in conj unction with reports from the public health inspectors on environmental circumstances and, where justified, additional points were recommended. Closing orders were made on 14 rooms and where the occupiers could not be given alternative accommodation immediately, they received additional points increasing their degree of priority for rehousing. Until they can be provided with other accommodation the operation of the closing orders remains in abeyance. Land Charges Act, 1925. The Town Clerk referred to the Department 1,808 enquiries relating to details of any outstanding notices, orders or other restrictions on the properties concerned. This was an increase of almost 300 on the previous year's figure, and 500 more than in 1957. Immigrants. The south-east portion of the Borough is contiguous with Soho and, as might be expected, contains a cosmopolitan population. Immigrants from Cyprus and European countries predominate. During the year, 16,400 West Indians, 3,000 Indians and 900 Pakistanis are reported to have arrived in England but, so far, very few of these people appear to have settled in St. Marylebone. Common Lodging Houses. There are two common lodging houses in the Borough. One is run by the Salvation Army, at No. 2, Burne Street and premises in Lisson Street, to accommodate 391 men. The other, conducted by the Church Army, at Portman House, No. 10, Daventry Street, is registered for 85 women. At the quarterly fire inspections it was found that the fire-fighting equipment provided and the precautions taken were satisfactory in both lodging houses. SECTION E.—INSPECTION AND SUPERVISION OF FOOD Food and Drugs Analysis. The Public Analyst (Mr. Thomas McLachlan, D.C.M., A.C.G.F.C., F.R.I.C., M.I.Biol.) has submitted the following report on the year's work:— "During the year, 414 samples of food and drugs were examined. Of these, 18 were taken formally and 396 informally. The number adulterated or incorrect in some other manner was 57 and the incidence of adulteration may be classified as follows:— Number of samples examined Number of samples adulterated Milk 78 1 Other foods 321 54 Drugs 15 2 18 A sample of hot milk contained only 1.59 per cent. of milk fat and 6.01 per cent. of solids not fat. It therefore contained not less than 28 per cent. of added water, and, after allowing for the addition of water, was not less than 26 per cent. deficient in fat. The freezing point—0.347 degrees C. indicated the presence of 33 per cent. of added water. Two dirty milk bottles were examined. In one case the dirt on the bottom consisted of dried cement, but judging by the cleanliness of the interior sides of the bottle it had probably been through the cleansing process. The other bottle contained a layer of dirt on the interior base consisting mainly of organic matter with some green algae. It had probably been lying about dirty for some time, and although it had been through the washing machine the process was insufficient to remove the dirt. Three samples of butter called for comment. One was discoloured due to moulds, a grey black growth on the surface being due to a Fusarium type and a red one to an unidentified mould, possibly Oidium. Another sample, received as a complaint, was genuine butter, but was almost white in colour. It possessed a rancid flavour and gave a positive reaction for rancidity by the Kreis test. The peroxide value was 23.8. The third sample contained not less than 16.16 per cent. of water, which is 1 per cent. above the legal limit. Owing to the high price of butter there is a general tendency at present to make its water content as great as possible. It was thought that the packer's attention should be drawn to the matter. A roll sold as "buttered" was found to be spread with margarine, and a sliced white loaf contained 7 pieces of brown matter derived from a small piece of wholemeal bread which had been broken up during the moulding. A sample of Demi Pont-L 'Eveque Fermier cheese was dried and unsatisfactory for edible purposes. It contained only 36.1 per cent. of moisture, whereas the moisture content should range from 45 to 50 per cent. The fat was 47.8 per cent. calculated on the dry matter, and the label claimed "45 per cent. matiere grasse." It was therefore incorrectly labelled. The salt, 1.21 per cent., was low, as this cheese generally contains about 2 per cent. of salt. Several samples of Austrian cheese were labelled only in German which, when translated, still conveyed little to the English mind. It was, therefore, decided to ask the manufacturers what they were supposed to be and whilst the discussions were continuing the samples themselves decomposed so badly that they had to be discarded. It was later learned from Somerset County Council that they were in fact all made with a margarine cheese base. The filling of some Cheese Sandwich and Cheese Filled Biscuits consisted of 30 per cent. cheese, and the remainder was essentially margarine. The Standards Committee of the Association of Public Analysts has decided that this is satisfactory, but your analyst is not in agreement with his colleagues in this matter. Your analyst's view is that since these fillings are essentially margarine they should be correctly described and that the present anomalous position of margarine cheese and margarine cheese products should be cleared up. Some "Slim Wheat Biscuits "possessed a slightly rancid flavour and it was found that the fat gave a strong reaction for rancidity. A sample labelled "The Original Macaroon Biscuit Mix "was found to consist of 62 per cent. of sugar and 25 per cent. of groundnuts with minor constituents. Macaroons must consist essentially of ground almonds, sugar and egg. A sample of Grape and Blackcurrant Juice was stated to contain the pure juices only, but contained artificial flavouring. A complaint sample of prepared coffee infusion was examined, and found to contain 1 per cent. of salt. Although this is excessive it is doubtful whether it had been added maliciously. Some chocolates were submitted because they were thought to be mouldy, but the trouble was due to a coating of "sugar bloom." A "Cherry Crush Sandwich" contained only 1.25 per cent. of cherries and the order of declaration of ingredients was incorrect. As dates were the principal constituent it should have been labelled "Date Crush" rather than "Cherry Crush." Another vegetarian food described as "Almond Date Cubes" gave no disclosure of ingredients as required by the Labelling of Food Order. Since it contained 86.4 per cent. of dates and only 13.6 per cent. of almonds, a more correct description would be "Date Almond Cubes." A sample of Marmalade and a follow-up sample of the same product contained only 64.2 per cent. and 66 per cent. of soluble solids respectively. The Food Standards Preserves Order requires 68.5 per cent., for preserves not packed in sealed containers. 19 A complaint regarding a sample of Coffee Jap Pastry was referred to in last year's report and subsequently the Coffee Glace Compound used in the cake was submitted for examination. This was satisfactory and it would appear that insufficient essence had been used in the cake. Two Pork Pies and a Steak and Kidney Pie showed mould growth and were considered unfit for sale. A canned Casserole Steak contained three large pieces of gristle amounting to 17 per cent. by weight of the pack and a considerable number of small pieces of gristle and was, therefore, reported as inferior. A product labelled "Pork Kidneys in Natural Juice" contained about 90 per cent. of kidney and was very satisfactory as a canned meat, but it contained 10 per cent. of added water, which is not natural juice, so that the description was incorrect. Two samples of Luncheon Meat were sold as Chopped Pork, and were, therefore, reported as adulterated. Four other samples of Luncheon Meat were examined for the presence of Milk Powder, but its presence could not be proved. A complaint sample of portions of chicken for frying, and an unopened packet used for comparison, consisted of the back of the chicken cut up, whereas the illustration on the label showed a leg, a wing, and a breast. The illustration was considered to be misleading. A worm found in a portion of Frozen Chicken Liver was identified as a portion of a round worm (Ascandia galli) commonly found in the intestine of a variety of birds. Apples reported to have caused food poisoning were examined, but nothing could be found which might cause such symptoms. The lead was less than 1 part per million, the copper 0.3 parts per million and the arsenic less than 0.1 part per million. Two samples, one sold as Swedish Salad, and the other as Prawn Balchow, contained added benzoic acid preservative. It is doubtful whether these come under the heading of Pickles and Sauces permitted to contain benzoic acid as a preservative, but it was thought that the distinction was so academic that, provided they were labelled correctly and complied with the requirements of the Preservative Regulations, and also bore a label stating that they contained preservative, no exception should be taken. In the case of the Prawn Balchow, however, the quantity of benzoic acid, 320 parts per million, was excessive as the maximum permitted quantity for a pickle or sauce is 250 parts per million. A can of molasses was fermenting badly when opened, showing that the concentration of the sugar was insufficient. Two samples of Norwegian dressed crab were not of the quality expected. They were sterile, but were a very dark muddy grey colour, in small pieces, and much bone was present. They had an unpleasant flavour but the appearance may have helped to create the impression of an unpleasant taste. A canned cream of chicken soup contained 3 per cent. of fat and was reported as 14 per cent. deficient in fat. Two soup mixes were considered to be incorrectly labelled as your Analyst believes that these products should be described as "appetizer soup powders" rather than soup mix powders. Some chipped potatoes had a rancid flavour and, although the free fatty acids in the oil were only 0.3 per cent. as oleic acid, the oil gave a strongly positive reaction to the Kreis test for rancidity. A number of people were ill after eating some steak and kidney pies, and an enamel bowl used in their preparation was therefore submitted for examination. No antimony or other poisonous material could be detected. Three cans of peas stated to be the subject of complaint were examined. They were reported as inferior because they were over-ripe; insufficient care had been exercised in picking out defective peas and pieces of pod, and the processing was unsatisfactory. A box of prunes contained a considerable amount of faecal matter from some form of larva, and also an appreciable quantity of actual webbing from larvae which had pupated, but there was only one pupa left in the box. The so-called sugar on the prunes consisted essentially of yeast, probably encouraged by the excrement of the larvae. Some mushroom sauce stated to be prepared with white French wine and other constituents contained only 0.984 per cent. of alcohol calculated as proof spirit. Unfortunately, owing to claims by manufacturers that they boil off most of the alcohol during manufacture it is very difficult to check up on the quantity initially used. A sample of rheumatism herbs contained part of the body of a dead beetle, while an extract of herbs sold for making herb beer was stated to yield a non-intoxicating beverage. In view of the fact that the beer was to be made from a solution containing 15 per cent. sugar, the resultant alcoholic strength could be as high as 7.5 per cent. of alcohol by weight or 16 per cent. proof. Such a liquor is highly intoxicating. 20 The blue colour used for some coloured popping corns was found to be a colour not permitted in this country. Seeds sold as Mustard Seed consisted entirely of white mustard seed, and when sold as a spice must be labelled as "White Mustard Seed." A sample of ground aniseed placed in a cardboard container had lost most of its aroma. It also contained 150 parts per million of lead, whereas the limit for lead in a spice is 10 parts per million. The description "Bean Gressel" for a sample of "Summer Savory" was considered to be meaningless in England. The correct name should have been used. The illustration on a package of horseradish indicated that it was full strength, but the sample examined in this laboratory appeared to have lost its strength through oxidation and was reported as inferior. A sample of ground rice contained a large number of black specks, consisting of vegetable matter, and was reported as inferior. A sample of German gelatine was coloured with amaranth which was not disclosed on the label, either in German or in English. New Food Legislation. Four Food Regulations, one draft Regulation and three Food Standards Committee Reports have been issued during the year. The Arsenic in Food Regulations, 1959.—The Royal Commission on Arsenic Poisoning met in 1901-1903, issued a First Report in 1901 and a Final Report in 1903. The full reports with evidence occupied 780 foolscap pages, but as no real standards were laid down for foods generally, it was necessary to rely on recommendations, which have been amended slightly from time to time, leaving the position unsatisfactory. The present Regulations prescribe a standard maximum arsenic content, expressed as arsenic, of 1 part per million in foods generally, with modifications down to 0.1 part per million for soft drinks and up to 5.0 parts per million for spices, colourings and certain other substances used in small quantity. Draft Regulations for Lead in Food.—During the year the Ministers responsible issued this draft which has not yet been implemented. The proposal is that approximately twice as much lead as arsenic should be permitted in foods and is, on the whole, very reasonable, though your analyst cannot see why cider should be permitted to contain 1 part per million of lead, whilst perry may only contain 0.2 parts per million. Someone appears to have tripped up, but this is a point to which the perry manufacturers should attend if they wish it to be altered. The Condensed Milk Regulations, 1959, consolidate and amend the Public Health (Condensed Milk) Regulations, 1923 to 1953, and now provide for the sale of half cream sweetened or unsweetened condensed milk with the proviso that it shall be labelled to the effect that it should not be used for babies except under medical advice. The regulations further lay down revised methods for the labelling of any type of condensed milk in order to make clear whether the food is prepared from full cream, half cream, or machine skimmed milk, whether it is sweetened or unsweetened, and what are the equivalent pints contained in each tin. The Food Standards (Ice-Cream) Order, 1959, prohibits the use of artificial sweeteners in ice-cream and, having done so, rescinds the requirement for a minimum quantity of sugar. The fat and milk solids-not-fat contents of ice-cream remain as before, though if all the fat is derived from milk such ice-cream may be described as Dairy Ice-Cream, Dairy Cream Ice, or Cream Ice. Provision is now made for Milk Ices, which contain not less than 2½ per cent. of milk fat and not less than 7 per cent. of milk solids other than fat. Parev (kosher) ice remains as before. Whilst this regulation makes no provision regarding the labelling of ice-cream made with fat other than milk fat the Labelling of Food (Amendment) Regulations, 1959, prohibits the use of any illustration suggestive of butter, cream or milk, or anything connected with the dairy, unless all the fat, other than that present in egg or a flavouring substance, in the ice-cream is derived from milk, though it is permissible to state that the ice-cream contains skimmed milk solids. Any ice-cream made with fat other than milk fat must be labelled to the effect that it "Contains non-milk fat." Since standards are no longer made under the Emergency Regulations, in order to allow for the modification in labelling of ice-cream, the wording of the principal Order has been changed slightly. The Ice-Cream (Heat Treatment, etc.) Regulations, 1959, now permit a sterilisation process, other than pasteurisation, to be employed and, provided that the whole process is kept sterile, the conditions affecting cooling have been relaxed. The Methylene Blue Test is maintained for the bacteriological control of the quality of ice-cream. 21 Fluorine in Food.—The original Fluorine in Food Order, 1947, was brought into operation on account of the difficulty of obtaining suitable qualities of phosphates for baking powders. Now that conditions are normal the Minister has decided to allow a maximum quantity of 3 parts per million of fluorine in self-raising and similar flours, 15 parts per million in phosphate-containing baking powders, and 30 parts per million of the acidic phosphate content of any other food. This amendment will require more care in analytical control, but it is to be welcomed. Preservatives in Food.—Without doubt the most important report or statutory instrument issued by the Ministry during the year was that on Preservatives in Food. The report itself is controversial and it is better merely to summarise the conclusions. Sulphur dioxide will remain the chief preservative permitted and it is suggested that this may be used in wines, beer, cider and perry, soft drinks, fruit juices, vinegar, dried fruit, fruit and fruit pulp, crystallised, glace, candied and syruped fruit, raw peeled potatoes or dehydrated potatoes, other dehydrated vegetables, sausages and butchers' minced meat, prepared starches and sugar syrups derived therefrom, as well as other sugar, jams, gelatine and pectin, pickles and sauces and dry root ginger. Benzoic acid could be used as an alternative or with sulphur dioxide in soft drinks and fruit juice products. Either benzoic acid or a para-hydroxybenzoic acid ester could be used in unfermented grape juice used for sacramental purposes, liquid rennet, liquid coffee extract, flavouring syrups and drinking chocolate concentrates. It is further suggested that propionic acid, sorbic acid, nisin, diphenyl, or ortho-phenylphenol should be used in very special circumstances. Report on Soft Drinks.—The Food Standards Committee issued this report early in the year, but it has not yet been implemented by a Regulation. The Committee recommend that soft drinks should be sweetened entirely by sugar and that artificial sweeteners, such as saccharin, should be prohibited. They also recommend that manufacturers should be obliged to state the quantity of fruit juice present in drinks reputed to contain it, and finally they recommend that no soft drink contains sufficient carbohydrate to justify any claims relating to energy value. Other minor suggestions are put forward, but the three mentioned above are those which are likely to be discussed before its implementation. Report on the Composition of Milk Bread.—In October the Food Standards Committee issued a report in which they stated that the Committee were divided on what should be contained in milk bread and by what description a loaf containing separated milk solids should be known. The majority view of the Committee was that bread containing not less than 4.2 per cent. of milk solids not fat should be sold as milk bread. The Committee generally were of the opinion that the presence of milk fat does not greatly affect the nutritive value of bread, so that the consumer is not prejudiced by the use of separated milk powder. Thomas McLachlan, Public Analyst." Food—Adulterated or Unsatisfactory Samples. The majority of the unsatisfactory samples referred to in the Analyst's report were in respect of technical faults in labelling or description and after consultation with the manufacturers concerned the labels were revised or corrected in all cases. The remainder included minor contraventions, which were dealt with informally, and five instances where legal proceedings were instituted, details of which are given in Table 11, page 34. Unsound Food. Approximately nine tons of food was certified as being unsound and unfit for human consumption and voluntarily surrendered for destruction. In addition some ten tons of unsound food was destroyed at the request of a large firm of wholesalers in the borough, without certification, bringing the total to approximately nineteen tons. This is a marked reduction on the quantities of unsound food surrendered during recent years. It is partly accounted for by the fact that one of the large wholesale firms in the borough have transferred a section of their storage arrangements to another district and also by the fact that recently retailers have tended to carry smaller stocks. Group buying by associations of retailers has also had the effect of securing a quicker turn-over of stock. A further contributing factor to the improvement which has taken place is the adoption of better techniques for food storage and in particular the increasing use of cold storage for canned products. A large part of the food condemned during the past year did, however, consist of canned goods including imported meat and meat products, and the Public Analyst considers that more efficient processing might still further reduce the number of failures. No very large consignments which called for special action were involved and when destruction on the premises was impracticable or the unsound food was unfit for animal feeding, it was sent in bulk to a central refuse depot at Westminster. 22 Milk. There are 81 registered premises from which milk is sold and 15 milk roundsmen operate in the Borough from shops or depots elsewhere. During the year, 260 applications under the Milk (Special Designation) (Raw Milk) Regulations, 1949-1954, and the Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949-1953 were received. Details are given in Table 22, page 38. The average composition of the 77 genuine samples of milk analysed was : total solids 12.40 per cent. ; fat 3.70 per cent. ; solids not fat 8.69 per cent. ; as compared with the legal minima, namely, 11.50 per cent. ; 3.00 per cent. ; and 8.50 per cent. respectively. Twelve samples of milk taken at the premises of two authorised wholesale firms operating heat treatment plants were submitted to the tests prescribed for the various designations; all were reported to be satisfactory. Other samples of milk examined by the Council's Bacteriologist numbered 60 and all were found to comply with the requisite standards. Ice-Cream. Five premises are registered for the manufacture of ice-cream and 228 for sale and storage. Details of the classes of premises are given in Table 23, page 38. Seventeen samples of ice-cream were examined by the Council's Bacteriologist, with the following results : Grade 1—14 ; Grade II—3 ; seventeen samples submitted for chemical analysis were also reported to be satisfactory. Preserved Food. There are 101 premises registered for the preparation or manufacture of sausages or potted, pressed, pickled or preserved food intended for sale ; regular inspections were made and informal action was taken to remedy unsatisfactory conditions found from time to time. Details of the classes of premises registered are given in Table 23, page 38. Catering Establishments. There are in the Borough 1,077 premises of this type, details of which appear in Table 24, page 39. During the year, 2,237 inspections were made and 43 informal notices served. Whilst some proprietors and staff of these establishments show a growing realisation of the need for good hygiene, there were, unfortunately, many instances of failure to maintain satisfactory standards within a short period of such standards having been achieved by some special effort. Constant supervision by the Public Health Inspectors is therefore necessary. Wholesale and Retail Food Premises. There are 621 of these premises, excluding catering establishments, details of which appear in Table 24, page 39. During the year, 2,130 inspections were made and 62 informal notices served. Food Stalls. During the year food was sold from 92 licensed stalls in street markets in the Borough and regular inspections were made for compliance with the requirements relating to stalls in the Food Hygiene Regulations and the London County Council Byelaws for the Protection of Food. Hygiene in Food Premises—New Materials. One of the special difficulties of the occupiers of the older food premises is keeping them clean, for the daily woman cleaner has deserted them in this west-end area for the more rewarding work of dusting around the new blocks of offices and smart showrooms. For this reason alone it is more than ever important that all surfaces in food premises should be easy to clean. Unfortunately with the ever-growing variety of materials claiming to meet these needs and thus to improve hygiene, it is not surprising that the availability of so many alternatives may lead to bewilderment, and good intentions sometimes end in disappointing results. As examples, failure is frequently due to the choice of a type of wall board which, although having an impervious surface, proves less durable than others ; to fixing wall boarding to battens spaced too far apart; or to the use of adhesives which are unsuitable because their effective life is short. 23 As many of these products lend themselves so easily to the present " do-it-yourself " trend, the employment of trained craftsmen is too often dispensed with. The full degree of improvement that could have followed is sometimes not achieved as " bellying " and resilient surfaces result and joints open between the sheets and at horizontal junctions with skirtings and dado rails. When ranges of metal adjustable shelving are installed merely by the use of a screwdriver, as a result of the inexpert work a space is often left beneath the lowest shelf which resists access for cleaning and very early in their life show more than a tendency to lean to one side or the other. These and other shortcomings would be avoided by the adoption of the manufacturers' advice and frequently this is more readily available to even the small trader than is appreciated. Firms marketing materials and equipment are unstinting in guidance, and group-buying organisations to which many small food establishments belong sometimes offer the full-time services of a surveyor well-acquainted with the problems likely to be met. But when all has been done to provide the best possible premises and equipment the well-being of the customers and their families remains at the mercy of the food handler. Well-trained staff with a sense of responsibility can do much to minimise shortcomings in premises. Conversely, food handlers with a lack of understanding of the reasons underlying food hygiene can bring to nought all the expense and planning of the finest shop or restaurant. Basement Bakehouses. Under the provisions of section 54 of the Factories Act, 1937, a local authority is required to examine, every fifth year, all basement bakehouses for which a certificate of suitability has been issued. The last special survey for this purpose was made in 1958 when only three basement bakehouses remained in the Borough. At that time one certificate of suitability was renewed, after certain work had been done, and the proprietors of the other two establishments were given notice of the Council's intention not to issue further certificates of suitability in respect of their premises. Routine inspections of the one remaining underground bakehouse, as well as of those above ground, continued to be made periodically throughout the year. Fifty years ago there were 75 basement bakehouses in St. Marylebone and until just before the last war there were still 49. Among the reasons for their gradual disappearance is the fact that no new ones have been permitted to be established since 1904, and with the passage of time costly structural repairs have become necessary to maintain a satisfactory standard of hygiene in those which existed and continued to operate. Rather than face this, occupiers have preferred to discontinue baking and obtain supplies of bread and cakes from bakeries elsewhere. In certain other instances, owing to the growth of the amount of business done and the physical impossibility of extending the underground bakeries, the proprietors have dispensed with them in favour of new bakehouses above ground. Horseflesh. There are now no shops in the Borough selling horseflesh for human consumption. Slaughter of Animals. There are in the Borough no slaughterhouses where animals are killed for human consumption but in the grounds of the Zoological Society of London, who are licensed by the Council for the slaughter of animals for feeding purposes, there is a knacker's yard, shortly to be replaced by a new building which during the year has been under construction. Thirteen inspections were made. St. Marylebone Clean Food Association. The Executive Committee of the Association (Chairman : Mr. D. W. Moeran, Hon. Secretary : Mr. P. Phillips, Hon. Treasurer : Mr. W. Bragg) have kindly provided the following information which is extracted from their report for the year 1959/60:— " Membership of the Association. During the year under review, eleven businesses have changed hands, and nine have closed down. The total membership is now 140. Resignation of Chairman. It is with much regret that we have learned that our Chairman, Mr. D. W. Moeran, is unable to accept nomination for re-election, as he is no longer in business in the district. Mr. Moeran has been a tower of strength to the Association since its inception in 1950, first as the Hon. Secretary of the Working Committee which formulated the Articles of Association, including the Code of 24 Practice, and then for the next three years in the combined office of Hon. Secretary and Treasurer. From 1953 to 1957 he was the Hon. Treasurer and he has been our Chairman since that date. He has always shown great interest in the work of the Association and has been most punctilious in his attendance at our Meetings. We are sorry indeed to lose this keen member and wish him well in the future. The Past Year. We are happy to record that no infringements of the Code of Practice by members have been reported by the public. The Annual General Meeting in May was again very poorly attended and this was very disappointing to those Officers of the Association who had made all the necessary arrangements." SECTION F.—INFECTIOUS AND OTHER DISEASES—PREVALENCE AND CONTROL There was again a decrease in the number of cases of infectious disease reported in the Borough, 430 notifications being received as against 456 in the previous year. Of the total, measles accounted for 250 cases, the figure for 1958 being 246, and the expected bi-annual increase in the incidence of this disease did not become apparent. There were no serious outbreaks of any of the notifiable diseases and incidence of these, though generally slightly lower, remained remarkably similar to that of the previous year. For the eleventh successive year there was no diphtheria and despite the hot and dry summer there was only one case of poliomyelitis. Table 25, page 39, gives details of notifications and the age groups concerned. Tuberculosis. Table 25, page 39, gives information regarding primary notifications of pulmonary and non-pulmonary tuberculosis received during the year. Table 26, page 39, shows the age and sex distribution of new cases and of deaths from all forms of the disease, and Table 27, page 40, sets out the number of cases on the Tuberculosis Register at the beginning and end of the year with details of the adjustments made in respect of new cases, transfers, deaths inwards and outwards and removals due to cases cured and deceased. Enquiries into housing and sanitary conditions involved 162 visits by one of the women public health inspectors to all new cases and those moving into the Borough from other areas. Mass Miniature Radiography. The Unit continued to work in the borough from time to time, mainly by way of closed surveys, but public sessions were also held. The results of this work are shown in Table 28, page 40. In November the Unit started a new scheme for two sessions, one in the afternoon and one in the evening, to be held weekly at a static site in the borough for the radiographical examination of individual members of the public and for patients sent by general practitioners. This service has made a satisfactory start and the general practitioners are gradually making increased use of it. Food Poisoning. Ten cases of food poisoning were notified during the year. Seven of these were single sporadic cases in which the agents responsible were not discovered. The other three notifications were in respect of persons living in St. Marylebone who were suffering from food poisoning associated with separate minor outbreaks. In one of these a woman aged 69 years was removed to hospital with a diagnosis of acute dysentry. She was also said to be dehydrated and in a state of collapse. The following day the hospital reported a diagnosis of food poisoning and that meat was suspected. Unfortunately she died five days later the cause of death being given as " acute gastro-enteritis due to salmonella Newport (food poisoning) " and the Coroner recorded a verdict of " accidental death." Investigations failed to trace the source of infection but some of the people living in the same house on other floors were found to have been suffering from diarrhoea. Stools of all these residents were examined and three were found to yield the same organism namely, salmonella (Newport), one being a child who showed no symptoms. All responded to treatment. In another of these minor outbreaks of food poisoning the causal organism was identified as salmonella typhi murium but in the third the agent responsible was not discovered. 25 In a district such as St. Marylebone with its large number of restaurants, staff canteens and other places where people eat away from home, as well as hotels accommodating numerous visitors from home and abroad and persons in transit, there are inevitably during the course of the year reports of suspected food poisoning. These all require investigation even though for one reason or another the cases may not be notifiable to this Authority. In addition, enquiries have frequently to be made regarding food handlers who are contacts of this disease or other intestinal disturbances. Among the more interesting investigations which took place during 1959 were the following. Outbreak of Food Poisoning following a Private Party. Following a luncheon party given on Saturday, 27th June, seven of the eleven guests plus the cook were reported to have been taken ill with symptoms of food poisoning late on the same evening and during the following day. Another guest was taken ill late on Monday the 29th. Amongst the foods suspected were chicken livers with chopped onions mixed with egg and chicken fat served as hors d'oeuvre, cold roast chicken, cold tongue, sauerkraut and potato salad with mayonnaise, meringue tart and fresh cream. Conditions in the home were excellent, with a modern kitchen equipped and designed on hygienic lines. All perishable food had been stored in a refrigerator and the cook had no history of previous illness, symptoms of diarrhoea or evidence of skin or other infection. Portions of the chicken, potato salad, mayonnaise and cream were left over from the meal and these were examined bacteriologically but yielded nothing of significance but the stools of some of the patients produced salmonella typhi murium phage type 2C. During the course of investigations the source of the various foods was traced, including the frozen egg white used in the mixing of the meringue which was of Dutch origin, and the chickens which had come via a wholesaler in the East End of London. The mode of preparation of the chicken livers gave rise to suspicion that there was a possibility of salmonellae in the centre of the liver having escaped destruction by insufficient cooking and in the absence of more positive evidence this seemed to be a possible source of infection. Outbreak of Suspected Food Poisoning at Business Premises. Following a telephone call to this office on the 25th September, by the manager of a business house in the Borough who reported that several members of his staff were ill with symptoms of food poisoning, it was found that at least 22 people had been taken ill during the late evening of Thursday, 24th September and the early hours of the following day with symptoms of abdominal pain and attacks of diarrhoea. The meal suspected was the mid-day lunch served to 300 members of the staff and although only 22 reported sick it is believed that many more had slight symptoms. The food eaten common to all those taken ill was steak and kidney pie served with gravy and vegetables and it was noted that only members of the first party for lunch at twelve noon were affected. Bacteriological examination of the available foods left over from the suspected meal failed to reveal any organism which could definitely be said to be responsible for the outbreak. Furthermore no food poisoning organisms were found in stools from either the patients or the kitchen staff. However, it was discovered that the steak and kidney pie had been made the previous evening and left to cool overnight in the kitchen and re-heated the next day and this is thought to be the probable source of infection. This item had been consumed at both the first and second sittings. Although there is no reliable explanation of why only members of the first party should have become ill, it is interesting to note that the pie served at the second sitting had been re-heating for nearly an hour longer than that served at the first and this may have had some effect. Outbreak of Food Poisoning following Staff Party. On the afternoon of the 26th November, information was received that following a large staff party held in the Borough on the 24th November, many of the guests had become ill with symptoms suggestive of food poisoning. Some 800 employees and their friends coming mostly from outer London and the home counties, had attended the party. The extent of the outbreak was somewhat obscured and investigations complicated by the fact that no list of guests existed and the firm in question had a large number of branches in many different local authorities' areas. Although no one living or working in St. Marylebone was reported as ill, as the party had been held in this Borough responsibility for the co-ordination of investigations was undertaken and full scale enquiries made from here. The Medical Officer of Health of each district in which there was a branch of the firm was immediately contacted by telephone, followed on the 27th by a letter and questionnaire setting out full details of the menu and requesting information as to the exact items of food consumed by those who had attended and details as to the time of onset, symptoms, etc., of any who had been ill. At the same time, enquiries 26 elicited the fact that the food for the party had been prepared in three places, namely (1) on the premises where the party was held, where some chickens had been cooked and sandwiches prepared, (2) a bakery in another district where vol-au-vent of chicken and pineapple had been prepared and (3) a second bakery outside St. Marylebone where sausage rolls and pastries, etc., had been made. Investigations were made at each of these premises but unfortunately, other than a few items from bulk supply, all of which were satisfactory, none of the suspected food remained for bacteriological examination. In the absence of direct evidence from food left over, indication of the source of infection had to be sought from statistics obtained from an analysis of the replies to the questionnaire. Sixty-eight such replies were received and these gave information regarding 199 persons who were ill and 77 who showed no symptoms of illness. Of the former, 101 (50 per cent.) were reported to have the organism salmonella typhi-murium in their stools and the Enteric Reference Library at Colindale typed organisms recovered from between 40 and 50 of these patients. In every case they were found to be the same, namely phage type 2C. Of the various items on the menu consumed by the guests of whom there were records with the exception of chicken and pineapple vol-au-vent, statistical evidence points to no item as suspect. Of the 199 people who were ill, however, 169 (85 per cent.) stated that they remember eating the vol-au-vent, whereas of 77 who were not ill only 6 (8 per cent.) stated that they had eaten this particular item. It was found that the chickens used in the vol-au-vent had come from East Anglia and those for the sandwiches from Berkshire. Since it is known that salmonella typhi murium infection is not uncommon among chickens enquiries were made of the veterinary authorities in both of these districts. Although it was not possible to establish with certainty the identity of the actual farms from which the birds had come it was reported from East Anglia that organisms of the particular phage type associated with this outbreak of food poisoning, namely phage type 2C, had been found in six out of nine recent " isolations " in that area. This phage type was stated not to have been met with in Berkshire. Stools from the food handlers at the premises where the party was held and the bakery where the vol-au-vent were prepared on examination produced no pathogenic organisms of any kind and the Medical Officer of Health of the district in which the second bakery was situated stated that no member of the staff connected with food handling had been ill. Impetigo. No cases of impetigo were referred to the Cleansing Station for treatment during the year. Scabies. The Council's Cleansing Station in Lisson Grove dealt with 42 cases of scabies : adults 41 (men 18, women 23) ; children 1 (boy). Venereal Diseases. Continued assistance was given to the propaganda campaign for drawing public attention to the dangers of these conditions and to the adequate facilities which exist for those in need of treatment. Disinfection. During the year 81 rooms and 633 articles of bedding (mattresses, blankets, sheets, bolsters, pillows, etc.), and 397 books, were disinfected. The Department continued to be asked by residents in the Borough to certify that worn clothing intended for despatch to foreign countries was free from infection. Disinfection was carried out only when clothing had actually been in contact with infectious disease but, during the year, 156 certificates, relating to a total of 1,868 articles, were issued to indicate that no infectious disease had been reported for at least one month at the premises from which the clothing was purported to have come. Exclusion from Work of Contacts of Infectious Disease. Both by Regulations made under the National Insurance Act, 1946, and the Public Health Disease Regulations, 1953, persons may be excluded from work and qualify for National Health sickness benefit if, in the opinion of the Medical Officer of Health, they are contacts or carriers of disease and it is necessary to exclude them from work in order to prevent the spread of infection. These regulations apply particularly to food handlers in shops and to cooks, kitchen hands and others employed in cafes, canteens and restaurants. During the year five certificates were issued. 27 International Certificates of Vaccination. Travellers to most countries abroad have to produce evidence of recent vaccination against certain prescribed diseases. For this purpose an international certificate of vaccination is used in respect of smallpox, cholera and yellow fever. Methods of protection previously known as " inoculation " are now described internationally as vaccination. Under the terms of Ministry of Health circulars Nos. 60/48 and 20/52 the Medical Officer of Health is required to authenticate the signatures on certificates issued by doctors practising within his district. During the year, signatures on 4,603 of these certificates were authenticated. Bacteriological Examinations. Table 29, page 40, shows the number of specimens examined for the purposes of diagnosis and also indicates the organisms in relation to which the examinations were made. 29 APPENDIX OF STATISTICAL TABLES AND SUPPLEMENTARY INFORMATION 30 TABLE 1.—Deaths—According to Age-Group and Sex. Code No. CAUSE OF DEATH Net Deaths at the Sub-joined Ages of Residents (Male and Female) whether occurring within or without the Borough All Ages Under 1 and 5 and 15 and 45 and 65 and 1 year under 5 under 15 under 45 under 65 upwards M. F. M. F. M. F. M. F. M. F. M. F. M. F. 1 Tuberculosis, respiratory 7 3 — — — — — — — 1 2 1 5 1 2 Tuberculosis, other 1 — — — — — — — — 1 — — — 3 Syphilitic disease — 1 — — — — — — — — — — — 1 4 Diphtheria — — — — — — — — — — — — — — 5 Whooping cough — — — — — — — — — — — — — 6 Meningococcal infections — — — — — — — — — — — — — — 7 Acute poliomyelitis — — — — — — — — — — — — — — 8 Measles — — — — — — — — — — — — — 9 Other infective and parasitic diseases 2 1 — — — — — — — — 2 — — 1 10 Malignant neoplasm, stomach 11 8 — — — — — — — — 6 1 5 7 11 Malignant neoplasm, lung, bronchus 50 13 — — — — — — 2 — 24 6 24 7 12 Malignant neoplasm, breast — 20 — — — — — — — — — 11 — 9 13 Malignant neoplasm, uterus — 5 — — — — — — — — — 3 — 2 14 Other malignant and lymphatic plasms 51 51 — — — — — — 5 1 15 21 31 29 15 Leukaemia, aleukaemia 2 6 — — — — — 1 1 3 — 1 1 1 16 Diabetes 2 5 — — — — — — — — 2 1 — 4 17 Vascular lesions of nervous system 66 88 — — — — — — 1 1 16 8 49 79 18 Coronary disease, angina 100 64 — — — — — — — — 33 7 65 57 19 Hypertension with heart disease 18 39 — — — — — — 1 — 2 — 15 39 20 Other heart disease 65 88 — — — — — — — — 2 5 61 83 21 Other circulatory disease 23 32 — — — — — — 1 2 4 2 18 28 22 Influenza 13 18 — — — — — — — — — 1 13 17 23 Pneumonia 24 29 1 3 — — — — 1 3 6 16 23 24 Bronchitis 50 29 — — — — — — 1 — 9 3 40 26 25 Other diseases of respiratory system 4 3 — — 1 — — — — 1 1 2 2 26 Ulcer of stomach and duodenum 10 3 5 — 5 3 27 Gastritis, enteritis and diarrhoea 1 4 — — — — — — — — — 2 1 2 28 Nephritis and nephrosis 1 3 — — — — — — — 1 — 1 1 1 29 Hyperplasia of prostate 2 — — — — — — — — — — — 2 — 30 Pregnancy, childbirth, abortion — — — — — — — — — — — — — — 31 Congenital malformations 1 3 — 1 — — 1 — — 1 — 1 — — 32 Other defined and ill-defined diseases 23 53 2 4 — — 1 — 2 3 8 15 10 31 33 Motor vehicle accidents 4 2 — — — — — — 2 1 — — 2 1 34 All other accidents 6 12 — — — — — — 2 2 2 1 2 9 35 Suicide 17 4 — — — — — — 6 3 4 — 7 1 36 Homicide and operations of war — — — — — — — — — — — — — — Totals 554 587 3 8 i — 2 1 29 22 144 92 375 464 1,141 11 1 3 51 236 839 TABLE 2.—Infant Mortality—According to Age-Group and Sex. CAUSE OF DEATH Under 1 week 1 and under 2 weeks 2 and under 4 weeks 1 and under 3 months 3 and under 6 months 6 and under 9 months 9 and under 12 months Total m. f. m. f. m. f. m. f. m. F. m. f. m. f. m. f. Atelectasis 1 — — — — — — — — — — — — 1 — Premature Birth 1 4 — — — — — — — — — — — — 1 4 Broncho-Pneumonia 1 — — 2 — — — 1 — — — — — — 1 3 Congenital Heart Defect — — — 1 — — — — — — — — — — — 1 Totals 3 4 — 3 — — — 1 — — — — — — 3 8 31 TABLE 3.—Weather Statistics. Station : Regent's Park. Height of rain-gauge above mean sea level : 129 feet. 1959 Air Temperature in Degrees Fahrenheit Rainfall Weather Number of Days Sunshine Means of Mean of A and B Highest and Lowest Most in a day Rain Snow or Sleet Thunder heard Fog (9h. G.M.T.) Air Frost Ground Frost Gale, force 8 or more Total Daily Mean Per cent. of Average* A Max. B Min. Highest Max. Date Lowest Min. Date Total Amt. Date °f. °f. °f. °F. °F. in. in. hrs. hrs. % Jan 41.8 31.6 36.7 54 22 25 12, 17 2.39 .57 20 11 1 1 5 21 23 — 41.9 1.35 142 Feb 45.7 35.6 40.7 65 28 31 5, 20 .08 .08 21 1 — — 3 5 15 — 49.9 1.78 111 Mar 53.7 41.4 47.5 63 2 36 16, 19 1.59 .35 3 9 — — 1 — 9 — 100.2 3.23 109 April 58.4 44.3 51.3 69 13 37 29 2.13 .37 14 15 — — — — — — 137.3 4.58 104 May 65.8 47.1 56.5 80 11, 12 38 4 .99 .47 21 4 — — — — — — 224.3 7.24 120 June 71.9 53.1 62.5 82 24 44 13 1.49 .44 24 9 — — — — — — 229.3 7.64 112 July 76.7 57.0 66.9 92 5 49 14 1.34 .45 28 7 — — — — — — 284 5 9.18 148 Aug. 75.9 57.5 66.7 87 20 48 30, 31 2.34 1.02 21 9 — — — — — — 225.5 7.27 128 Sept. 73.0 53.0 63.0 84 11 43 28 .04 .04 21 1 — — — — — — 209.4 6.98 167 Oct. 64.1 48.9 56.5 80 3 36 30 1.95 .75 26 11 — — — — 1 — 148.9 4.80 179 Nov. 52.1 40.4 46.3 60 2, 20 28 12, 13 2.52 .59 17 15 — — — 5 9 — 56.0 1.87 136 Dec. 48.9 39.5 44.2 55 20 32 13 3.24 .36 25 23 — — — — — — 30.2 0.97 113 * Average for years 1921-1950. 32 Table 4.—Summary of Road Accidents. Number of Accidents Fatal Injuries— Serious Slight January 72 — 8 73 February 44 — 5 44 March 72 1 13 69 April 89 1 15 99 May 83 1 10 94 June 104 1 10 111 July 82 — 12 81 August 75 — 7 86 September 88 — 11 98 October 81 3 15 88 November 77 1 11 83 December 111 3 14 119 Totals 978 11 131 1,045 TABLE 5.—Diseased or Infirm Persons removed to Hospital, etc., under Court Orders. Person Age Removed to Remarks Mrs. E. C. 74 Hospital Emergency Order for 3 weeks. Died in Hospital eight days after admission. TABLE 6.—New Legislation. Legislation Operative Date Factories Act, 1959 Various House Purchase and Housing Act, 1959 14.6.1959 Housing (Underground Rooms) Act, 1959 14.6.1959 London County Council (General Powers) Act, 1959 29.7.1959 Factories Act, 1959 (Commencement No. 1) Order, 1959 Various Slaughterhouse Reports (Appointed Day) Order, 1959 1.2.1959 Slaughter of Animals (Prevention of Cruelty) Amendment Order, 1959 5.9.1959 Smoke Control Areas (Exempted Fireplaces) Order, 1959 17.7.1959 St. Marylebone (No. 3 : Ward 1) Smoke Control Order, 1959 1.10.1960 Arsenic in Food Regulations, 1959 10.8.1959 Condensed Milk Regulations, 1959 26.6.1959 Fluorine in Food Regulations, 1959 14.3.1960 Food Standards (Ice-Cream) Regulations, 1959 27.4.1959 Ice-Cream (Heat Treatment, etc.) Regulations, 1959 27.4.1959 Milk and Dairies (General) Regulations, 1959 8.3.1959 Meat (Staining and Sterilization) (Revocation) Regulations, 1959 26.3.1959 Meat (Staining and Sterilization) Regulations, 1959 1.4.1959 Labelling of Food (Amendment) Regulations, 1959 27.4.1959 Public Health Officers Regulations, 1959 15.6.1959 Slaughterhouse (Hygiene) (Amendment) Regulations, 1959 5.9.1959 Slaughterhouse Licences (Forms and Records) Regulations, 1959 1.1.1960 33 TABLE 7.—Dwelling-Houses : Summary of Inspections, Conditions Found and Action Taken. Inspection under Public Health or Housing Acts :— (1) (a) Inspected for housing defects 1,022 (6) Inspections made for the purpose ... 4,268 (2) Found to be in a state so dangerous or injurious to health as to be unfit for human habitation 87 (3) Found not to be in all respects reasonably fit for human habitation 426 Defects remedied without service of formal Notices :— Defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 341 Action under Statutory Powers :— (a) Proceedings under Public Health Acts :— (1) Dwelling-houses in respect of which notices were served requiring defects to be remedied 299 (2) Dwelling-houses in which, after service of formal notices, defects were remedied :— (a) By owners 82 (6) By Local Authority in default of owners 3 (6) Proceedings under the Housing Act, 1957 :— (1) Rooms in respect of which Closing Orders were made :— Underground rooms 5 Other rooms 9 (2) Closing Orders determined, the tenement or room having been made fit 6 (3) Rooms affected by (2) above 10 (4) Closing Orders varied — (5) Undertakings accepted in respect of underground rooms 1 TABLE 8.—Nuisances Remedied. Nuisance Abated or Defect Remedied Number Houses damp, dirty or dilapidated 167 Doors, windows, floors, ceilings, sash cords, grates and flues, etc., defective 220 Drain, water-closet and waste pipe stoppages 55 Drains, water-closets and waste pipes defective 95 Yard, area and wash-house defects 11 Roofs, gutters and rainwater pipes defective 159 Insufficient water supplies 11 Water cisterns dirty or defective 12 Ashpits, dustbins, etc., defective 40 Rubbish accumulations 58 Animal nuisances 11 Miscellaneous 49 Total 888 TABLE 9.—RENT ACT, 1957. Applications for Certificates of Disrepair 19 Notices served on landlords of Proposal to issue Certificate of Disrepair 12 Undertakings received from landlords 6 Certificates of Disrepair issued 2 Applications for Certificates as to Remedying of Defects 14 Certificates as to Remedying of Defects issued 14 Applications for cancellation of Certificates of Disrepair 4 Certificates of Disrepair cancelled 3 (one by County Court) 34 TABLE 10.—Legal Proceedings : Public Health (London) Act, 1936. Non-compliance with Nuisance Notice regarding Result Fine Costs £ £ s. d. 8, Aybrook Street 28 day abatement order 1 1 16 6 29, Cramer Street Guilty—work done 1 10 6 136, New Cavendish Street Dismissed, premises concerned having become vacant - - 2, Blandford Place 28 day abatement order - 10 6 7, Aybrook Street Guilty—work done 3 10 6 8, Aybrook Street Guilty—work done 3 10 6 2, Garbutt Place Guilty—work done 3 10 6 TABLE 11.—Legal Proceedings : Food and Food Hygiene. Date of Hearing Offence Result 6.3.59 Dirty milk bottle (The Milk & Dairies Regulations, 1949) Fined £10. 6.3.59 Dirty milk bottle (The Milk & Dairies Regulations, 1949) Fined £10 with 3 gns. costs. 6.3.59 Smoking in a food room, etc. (Food Hygiene Regulations, 1955-1957) Fined £5 with 10s. 6d. costs. 10.7.59 Selling unfit food—mouldy pork pie (Food & Drugs Act, 1955, section 8) Fined £20 with 5 gns. costs. 4.9.59 Dirty milk bottle (The Milk & Dairies (General) Regulations, 1959) Fined £25 with 3 gns. costs. 4.9.59 Selling unfit food—mouldy pork pie (Food & Drugs Act, 1955, section 8) Case dismissed—witness reluctant to attend court and give evidence. TABLE 12.—Chemical Examination of Water supplied to St. Marylebone— Average Results. Milligrammes per Litre (unless otherwise stated) Source of Supply Barn Elms Ashford Common Kempton Park Hampton No. of samples 43 52 52 52 Ammonia Nitrogen 0.023 0.050 0.025 0.022 Albuminoid Nitrogen 0.072 0.084 0.072 0.075 Nitrate 3.4 3.4 3.4 3.8 Chlorides as C1. 27 28 27 28 Oxygen abs. from Permanganate 4 hrs. at 27° C. 0.92 1.08 1.00 1.08 Turbidity in terms of Silica 0.3 0.6 0.3 0.4 Colour m.m. brown 2 ft. Tube Burg ss's Tintometer 9 10 8 10 Hardness (total) 244 252 262 250 Hardness (non-carbonate) 52 54 56 56 pH. Value 7.8 7.9 7.8 7.7 Phosphate as PO4 0.95 0.90 0.95 0.95 Silicate as SiO2 9 10 10 9 Sulphate as SO4 54 54 54 54 Flouride as F. 0.2 0.2 0.2 0.2 Magnesium as Mg 4.0 4.0 4.0 4.0 Electrical Conductivity (gemmhos) 525 525 525 525 35 TABLE 13.—Bacteriological Examination of Water supplied to St. Marylebone— Average Results. Source of supply Number of samples After Treatment Agar plate count per ml. Coliform count E. coli count 20-24 hours at 37 °C. 3 days at 22 °C. Per cent. samples negative in 100 ml. Per cent. samples negative in 100 ml. Barn Elms 516 5.3 — 99.03 100.0 Ashford Common 257 18.0 — 100.0 100.0 Kempton Park 515 15.5 — 99.8 100.0 Hampton 976 6.7 — 100.0 100.0 TABLE 14.—Rodent Control. Complaints received 536 Dwellings 342 Business premises 184 Rats 272 Mice 264 Blocks surveyed 37 Premises involved 1,091 Premises disinfested 519 Black rats 4 Brown rats 243 Mice 272 Treatments carried out 1,745 TABLE 15.—Air Pollution. Readings from Deposit Gauges and Other Apparatus for Measuring Air Pollution Site Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. ' ' ... Insoluble Matter—Tons per sq. mile (collected in deposit gauges) N.L. 15.43 5.94 18.17 13.76 6.51 14.51 7.97 9.12 4.17 12.38 15.28 21.58 T.H. 17.78 23.64 24.88 12.89 6.65 5.65 6.91 8.15 1.96 16.12 9.77 9.84 Soluble Matter—Tons -ber sa. mile (collected in deposit gauees). N.L. 8.87 3.94 7.23 6.85 4.16 5.09 3.89 3.85 1.78 7.42 9.77 9.13 T.H. 10.43 3.08 10.83 7.32 5.75 6.87 5.36 7.71 2.29 11.36 10.05 12.29 Sulphur Trioxide—Milligrams -ber day collected (tier 100 sq. cm. of lead peroxide) N.L. 5.27 4 36 2.38 1.98 0.99 0.92 0.85 0.92 0.90 2.12 3.82 4.12 T.H. 8.24 7.66 5.06 3.80 2.60 2.40 1.81 2.32 2.80 4.68 7.00 5.54 E.R. 7.38 6.56 4.19 3.37 2.40 1.58 1.47 1.98 2.96 4.37 5.27 3.93 Smoke—Milligrams -ber 100 cubic metres of air average per day (Volumetric method) T.H. 47 29 21 14 11 9 6 T 5 16 39 24 G.P. 53 36 29 17 — 7 5 T* 7 12 44 28 Sulphur Dioxide—Parts per 100 million parts of air average per day ( Volumetric method) T.H. 24 24 13 12 7 6 4 5 4 11 18 12 G.P. 21 21 21 9 - 5 5 4 5 7 15 10 * T Less than 0.05 milligrams of smoke per 100 cubic metres of air. 36 TABLE 16.—Air Pollution. Annual Daily Average of Mean Concentration of Smoke and Sulphur Dioxide. Site 1959 1958 1957 1956 1955J Smoke mg./100m3 SO2 p.p. 100m. Smoke mg./100m3 SO2 p.p. 100m. Smoke mg./100m3 SO2 p.p. 100m. Smoke mg./100m3 SO2 p.p. 100m. Smoke mg./100m3 SO2 p.p. 100m. t.h. 17 12 20 10 23 9 34 11 39 9 G.P. 19 10 20 8 24 8 32 9 51 7 TABLE 17.—Air Pollution. Annual Monthly Average of Deposited Matter and Sulphur Trioxide. Site 1959 1958 1957 1956 1955‡ Tons per sq. mile Mg. per 100 sq. cm. Pb02 Tons per sq. mile Mg. per 100 sq. cm. Pb02 Tons per sq. mile Mg. per 100 sq. cm. Pb02 Tons per sq. mile Mg. per 100 sq. cm. Pb02 Tons per sq. mile Mg. per 100 sq. cm. Pb02 T.H. 19.80 4.49 20.87 4.16 17.7 3.9 19.22 3.9 19.02 4.03 N.l. 18.06 2.38 22.28 2.78 20.8 2.6 17.24 2.4 17.56 2.47 D.S. — — 21.9† — 17.3 — 18.9 — 19.3 — E.R. — 3.79 — 3.13 — 3.4 — 3.5 — 3.7 Notes to Tables 15, 16 and 17 Sites : NX. Nuffield Lodge E.R. Edgware Road T.H. Town Hall G.P. Greville Place D.S. Devonshire Street (maintained by the D.S.I.R. until the end of 1958.) † The figures given for 1955 are based upon the average for six months—July to December inclusive—as recording apparatus was not used before that date, † Average for three months only. 37 TABLE 18.—Factories : Inspections for Purposes of Provisions as to Health. Premises Registered Inspections Written notices Occupiers prosecuted Factories without mechanical power 197 229 5 — Factories with mechanical power 1,324 837 33 — Other premises* (excluding outworkers' premises) 453 500 — — Totals 1,974 1,566 38 — * Electrical stations, institutions, sites of building operations and works of engineering construction. TABLE 19.—Factories : Defects Found. Particulars Defects Found Remedied Referred In respect of To H.M. Inspector of Factories By H.M. Inspector of Factories which prosecutions were instituted Want of cleanliness 13 7 — 3 — Overcrowding — — — — — Unreasonable temperature — — — — — Inadequate ventilation — — — — — Ineffective drainage of floors — — — — — Sanitary conveniences:- (a) insufficient 1 2 — 1 (b) unsuitable or defective 42 43 — 10 — (c) not separate for sexes 1 — — 1 — Other offences (excluding offences relating to outwork) 5 5 23 — — Totals 62 57 23 15 — TABLE 20.—Summary of Outwork. Description of Work Outworkers Employed Wearing apparel 541 Textile weaving 7 Curtains and furniture hangings 2 Furniture and upholstery 2 Umbrellas 1 553 38 TABLE 21.—Pharmacy and Poisons Acts, 1852-1941 : Summary of Sellers of Part II Poisons. Type of Business Total Licensed Grocery and provision stores 32 Hardware and domestic stores 16 General stores 15 Hairdressers 6 Builders' merchants 3 Drugstores 2 Pest control contractor 1 Dental sundriesman 1 Photographic dealer 1 Veterinary sundriesman 1 78 TABLE 22.—Milk (Special Designation) Regulations : Summary of Licences Issued. Type of Licence, and Designation Number Issued Pasteuriser's 1 Steriliser's 2 Dealer's : Tuberculin tested 55 Pasteurised 77 Sterilised 66 Supplementary Tuberculin tested 18 Pasteurised 20 Sterilised 21 TABLE 23.—Summary of Premises Registered for Preserving Food or for the Manufacture, Storage or Sale of Ice-Cream. Type of Business Preserving Food Ice Cream Butchers 63 1 Tobacconists, confectioners/newsagents — 88 Grocers and provision merchants 32 49 Fishmongers 5 1 General stores — 9 Milk shops — 20 Greengrocers and fruiterers — 20 Public houses — 4 Ice-cream factories — 5 Miscellaneous 1 36 101 233 39 TABLE 24.—Summary of Food Premises. Type of Business Totals Restaurants, cafes and snack bars 310 Canteens and clubs 203 Grocers and provision merchants 190 Butchers 63 Greengrocers and fruiterers 62 Fishmongers 14 Bakers 38 Confectioners 125 Wine merchants (off licence) 37 Public houses and other licensed premises 163 Hotels and boarding houses 345 Coffee stalls and kiosks 5 Schools and nurseries 51 Stalls, street trading 92 1,698 TABLE 25.—Notifiable Diseases and Notifications. * Notifiable Disease Cases notified in whole Borough Cases removed to hospital Cases isolated at home At all ages At ages—years —1 1- 2— 3— 4— 5— 10— 15— 20— 35—45—65— Poliomyelitis Paralytic 1 — — — — — 1 — — — — — — 1 — Ophthalmia Neonatorum 1 1 — — — — — — — — — 1 — Erysipelas 3 — — — — — — — — 2 — 1 — 1 2 Scarlet fever 19 3 2 2 1 7 3 1 — — — — 2 17 Puerperal pyrexia 19 — — — — — — — 1 15 3 — — 17 2 Pneumonia 6 — — — — — — — — — — 4 2 — 6 Dysentery 46 — 2 — — — 2 — 1 1 — 4 36 20 26 Measles 250 5 16 30 25 35 110 12 3 6 1 1 — — 250 Whooping cough 5 2 1 — 1 — 1 — — — — — — 1 4 Scabies 8 — — — — — 1 — 2 5 — — — — 8 Tuberculosis— Pulmonary 58 — — — 1 1 — 2 1 15 9 20 9 24 34 N on-pulmonary 1 — — — — — — — — 1 — — — 1 — Food poisoning 10 — — — — — — — — 4 — 4 2 2 8 Meningococcal infection 1 1 — — — — — — — — — — — 1 — Acute Encephalitis 2 — — 1 — — — — — 1 — — — 2 — (Infective) Totals 430 9 22 33 29 37 128 17 9 50 13 34 49 73 357 * There were no cases in the Borough of the following diseases which are also notifiable : Smallpox, diphtheria, membranous croup, cholera, typhus fever, relapsing fever, continued fever, plague, leprosy, hydrophobia, glanders, farcy, anthrax, malaria, induced malaria, paratyphoid fever, typhoid fever. TABLE 26.—Tuberculosis : New Cases and Deaths. At ages— years *NEW CASES deaths Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary M. F. M. F. M. F. M. F. 0—1 — — — — — — — — 1—5 3 — — — — — — — 5—15 1 1 — — — — — — 15—25 3 8 — — — — — — 25—35 10 17 — 1 — — — — 35—45 10 6 — 1 — 1 — — 45—55 14 11 — — — — — — 55—65 12 4 — — 2 1 1 — 65 and upwards 8 2 — — 5 1 — — Totals 61 49 — 2 - 3 1 — * Including all primary notifications and also any other new cases of tuberculosis which came to the knowledge of the Medical Officer of Health during the year. 40 TABLE 27.—Tuberculosis : Summary of Register. Pulmonary N on-Pulmonary M. F. Total M. F. Total Total (a) Number of cases of tuberculosis on the Register at the beginning of the year 535 391 926 35 51 86 1,012 (6) Number of cases notified to the Medical Officer of Health under the Regulations for the first time during the year 34 24 58 — 1 1 59 (c) Number of cases removed from the Register during a preceding year which have been restored to the Register during the year 7 2 9 — — — 9 (d) Number of cases added to the Register during the year which have been brought to the notice of the Medical Officer of Health otherwise than by notification under the Regulations 27 25 52 — 1 1 53 (e) Number of cases removed from the Register during the year 50 28 78 — 2 2 80 (f) Number of cases remaining on the Register at the end of the year 553 414 967 35 51 86 1,053 TABLE 28.—Mass Radiography Statistics. No. X-rayed Active P.T. Discovered Rate per 1,000 Referred to Chest Clinic for Observation Lung Cancer Discovered Organised Groups M. F. M. F. M. F. M. F M. F. 8,165 9,999 19 18 2.3 1.8 25 7 5 — General Public ... 785 755 3 — 3.8 — — — — — Total 8,950 10,754 22 18 2.4 1.7 25 7 5 — TABLE 29.—Summary of Work of the Bacteriological Laboratory. Nature of Specimen and Examination Positive Negative Total Throat and nasal swabs for— B. diphtheriae — 36 36 Haemolytic streptococci 7 24 31 Vincent's organisms 4 7 11 Swabs for B. Coli — 4 4 Sputum for- Tubercle bacilli 1 13 14 Faeces for— Parasites, typhoid, paratyphoid, dysentery and food poisoning organisms 5 200 205 Foods for— Food poisoning organisms 4 50 54 Swabs for— Food poisoning organisms 3 7 10 Totals 24 341 365 41 SERVICES AVAILABLE FOR OLD PEOPLE NATIONAL. National Assistance Board, 177, Tottenham Court Road, W.I. (Tel.: MUS. 7002).—This Office assists old age pensioners whose income is insufficient for their needs, by financial grants and special grants for clothing, blankets, etc. Letters to be addressed to the Manager. On Saturdays urgent cases are dealt with at 1, Tavistock Square, W.C.I. (Tel.: EUS. 8052). National Health Service.—All old people should be on a list of a doctor. This part of the service is controlled by the London Executive Council, Insurance House, Insurance Street, W.C.I. (Tel.: TER. 7833). A complete list of doctors can be seen at any Post Office, or advice can be obtained from the Public Health Department at the Town Hall. National Insurance : Local Offices— For Postal Area, W.I. For Postal Area, N.W.I. For Postal Areas, W.2 and N.W.H. Colquhoun House, 30, Euston Square, N.W.I. 5, Praed Street, W.2. Broadwick Street, W.l. Tel. : EUS. 6451. Tel. : PAD. 3411. Tel. : REG. 7010. LONDON COUNTY COUNCIL. Homes.—Luxborough Lodge, 1, Luxborough Street, W.I. (Tel.: WEL. 5619).—Apply to Admission Officer, 5, Princes Row, S.W.I. (Tel.: VIC. 0162).—9.15 a.m. to 5.15 p.m. Monday to Friday. Saturdays 9.15 a.m. to 12.15 p.m After office hours urgent cases can be referred direct to Luxborough Lodge. The L.C.C. also have a number of small homes for old people in the London Area. Apply through Admission Officer as above. Welfare of the Blind.—This is the responsibility of the L.C.C. Apply to The "Welfare of the Blind" Department, 5, Princes Row, S.W.I. (Tel.: VIC. 0162, Ext. 22). Recuperative Holidays and Loan of Sich-Room Equipment, 313-319, Harrow Road, W.9. (Tel.: CUN. 4815). Mental Illness.—Dealt with at County Hall, Westminster Bridge Road, S.E.I. This service is available for urgent cases at all times. Apply to Duly Authorised Officer. (Tel.: WA T. 5000, Ext. 273); where possible this should be done through the patient's doctor. Home Helps Service, Room 91, Town Hall, St. Marylebone, W.I. (Tel.: WEL. 7766, Ext. 30).—The organiser can send domestic helps to old people who by reason of age or infirmity can no longer manage all their own domestic work. Department for Handicapped, 5, Princes Row, S.W.I. (Tel.: VIC. 0162)—Assistance and advice for the handicapped. Fireguards.—These appliances can be provided and fixed free of charge in necessitous cases. Apply to the Secretary, St. Marylebone Old People's Welfare Association. (See below.) ST. MARYLEBONE BOROUGH COUNCIL. Public Health Department, Town Hall, St. Marylebone, W.l. (Tel. : WEL. 7766, Ext. 105).—Miss Sharp, M.B.E., Public Health Inspector, deals with any public health matters among old people which are brought to her notice. A special laundry service for incontinent old people is run by the Council, and arrangements can be made for bathing old people, at their own request, at the Lisson Grove Centre. Similarly, arrangements can be made to cleanse verminous persons at the cleansing station at Lisson Grove or, if they are enfeebled, in their own homes. Under various statutory powers the Council may :— (i) Apply to the courts for orders for the removal to suitable premises of persons who are suffering from grave chronic diseases or, being aged, infirm or physically incapable, are living in insanitary conditions and are unable to devote to themselves, AND are not receiving from others, proper care and attention ; (ii) Arrange for the burial of the body of anyone who has died or been found dead in the borough where no other suitable funeral arrangements are being made. Public Baths, Seymour Place, W.I.—Monday to Friday up to 4.30 p.m. Old age pensioners pay Id. (soap and towels extra). Library Booh Service.—This is operated by the Borough Council Library and delivery of books is made to the infirm or housebound each Tuesday. Arrangements must be made with the Borough Librarian at the Town Hall. (Tel.: WEL. 7766). Holidays.—The Borough Council's grant towards the cost of holidays for old age pensioners is administered by the Old People's Welfare Association. Fuel.—Old people without coal owing to delayed delivery should be reported to Miss Sharp, who can arrange delivery of 281bs. of coal to tide over until the coalman calls. VOLUNTARY SOCIETIES. St. Marylebone Old People's Welfare Association, Room 103, Town Hall, St. Marylebone, W.I. (Tel.: WEL. 7766, Ext. 97).—Tuesdays and Thursdays 10.30 a.m. to 12.30 p.m., 2.30 p.m. to 5 p.m. Mrs. K. M. Cowan, Secretary. Visiting.—The Old People's Welfare Association has a panel of voluntary visitors, men and women, who pay regular friendly visits to old people. Four of these visitors are liaison officers between the Association and groups of lay visitors attached to churches. This is in addition to the visiting done by the Clergy and Church workers of all denominations. Meals on Wheels. (Dinners).—This service is financed by the Old People's Welfare Association (aided by a grant from the Borough Council and L.C.C.), and operated by the W.V.S. Hot dinners can be taken to the home, price l0d. for two courses. It is at present restricted to the ill or infirm. Apply either to the old People's Welfare Association or to the W.V.S. 42 W. VS. Luncheon Club, 134, Seymour Place, W.I. (Tel.: PAD. 5597).—Old age pensioners can obtain dinners for 10d. from Monday to Friday. Notice to attend must be given to W.V.S. beforehand. Home Nursing.—Paddington and St. Marylebone District Nursing Association, 117, Sutherland Avenue, W.9. (Tel.: CUN. 1462). Chiropody.—A clinic is run by the Old Peoples' Welfare Association and the British Red Cross Society in Room 115, Town Hall, St. Marylebone, W.I, every Tuesday 10 a.m. to 12.30 p.m. and 2.15 p.m. to 5.15 p.m. A charge of up to 3s. 0d. is made. Treatment is by appointment which must be arranged on Tuesdays in Room 115. London County Council Foot Clinic, 217, Lisson Grove, N.W.8. Treatment by appointment, Monday 10 a.m. to 12.30 p.m., charge as above. A Home Chiropody Service is also run by the Association on five days in each month. Bookings to be made with the Secretary, Old People's Welfare Association. A charge of up to 3s. 0d. is made. Clubs.—There are three W.V.S. "Darby and Joan" Clubs and one recreation room:— 7, Wyndham Place, W.I, on Wednesdays and Thursdays, 2.30 to 4.30 p.m. 60, Paddington Street, W.l, on Tuesdays, 2.30 to 4.30 p.m. Recreation Room.—104, St. John's Wood Terrace, N.W.8, on Mondays and Wednesdays, 2.15 to 4 p.m. Other "Darby and Joan" Clubs are:— The Liberal Jewish Women's Club, St. John's Wood Road, N.W.8 (for old people of all denominations) on Wednesdays, 2.30 to 4 p.m. The "Inner Wheel" Club on Fridays, 2.30 to 4.30 p.m. in Christ Church Hall, Shroton Street, N.W.I. The Fourth Feathers Club, 28, Mulready Street, Church Street, N.W.8, on Thursdays, 2.30 to 4.30 p.m. The Barrow Hill Club, De Walden Rooms, Charlbert Street, N.W.8, alternate Thursdays, 2.30 to 4.30 p.m. The Evergreen Club, Salvation Army Hall, Bell Street, N.W.I, Thursdays, 2.30 to 4 p.m. The Good Companions Club, Greenwell Street, W.l, on Mondays, 2.30 to 4.30 p.m. The women's organisations of churches in the Borough have large numbers of old age pensioners among their members. Women's Voluntary Services, 104, St. John's Wood Terrace, N.W.8. (Tel.: PRI. 1051). Citizens' Advice Bureau, 60, Paddington Street, W.l. (Tel.: WEL. 8614 and WEL. 8708). The "Wireless for the Bedridden" Society, 55a, Welbech Street, W.I. (Tel.: WEL. 0949).—Wireless sets can be installed and maintained on loan to bedridden or housebound persons. Applications must be backed by some person or agency who has investigated the applicant's financial position, and who can also keep in touch with them. Family Welfare Association, 8, Kensington Park Road, W. 11. (Tel.: PAR. 6683). Sailors', Soldiers' and Airmens' Families Association (S.S.A.F.A.), Room 103, Town Hall, St. Marylebone, W.l. (Tel.: WEL. 7766, Ext. 97).—Wednesdays and Fridays, 10 a.m. to 12.30 p.m. Salvation Army Headquarters, 236, Portman Buildings, Lisson Grove, N.W.I. (Tel.: PAD. 8553). Church Army, 55, Bryanston Street, W.l (Tel.: PAD. 9211). British Red Cross Society, 106, Crawford Street, W.l. (Tel.: WEL. 3416). National Association for the Paralysed, 1, York Street, W.l. (Tel.: WEL. 8373). National Association for Mental Health, 39, Queen Anne Street, W.l. (Tel.: WEL. 1272). HOMES. St. Marylebone Almshouses, St. John's Wood Terrace, .N.W.8. (Tel.: PRI. 0696).—For St. Marylebone residents of either sex, aged 65 or over and still able-bodied. Applications to the Secretary. Christian Union Almshouses, 21, Crawford Place, W.l. (Tel.: PAD. 7579).—This is a Church of England charity. Applications to the Secretary. Church Army Home for Men, 187, Marylebone Road, N.W.I. (Tel.: PAD. 6649).—This Home has some beds for old men. Apply Secretary. Church Army Lodging House for Women, 10, Daventry Street, N. W.I. (Tel.: PAD. 4855).—Elderly able-bodied women, still at work, can be admitted although the hostel is not specially for the aged. The Ladies' Home, 41, Abbey Road, N.W.8. (Tel.: MAI. 6831).—For elderly ladies in reduced circumstances. "Newstead", 17-19, Greville Place, N.W.6. (Tel.: MAI. 5711).—Maintained by the St. Marylebone old People's Homes, Ltd., for the aged of either sex in need of care and attention. Old People's Homes Committee, 296, Vauxhall Bridge Road, S.W.I. (Tel.: VIC. 9977). Details of old people's homes in London and provinces. CINEMAS. The following local cinemas admit old age pensioners for 9d. on weekdays (excluding Saturdays) up to 3 p.m.:— The Gaumont, Edgware Road. The Odeon, Edgware Road. The Regal, Harrow Road. 43 SUMMARY OF HOSPITALS AND CLINICS SERVING THE BOROUGH Ambulance Service : Removals, Emergency Bed Service (to all hospitals in Greater London) HOP 7181 Hospitals : Florence Nightingale Hospital, 19, Lisson Grove, N.W.I PAD 2341 Hospital for Nervous Diseases, 4, Maida Vale, W.9 CUN 5172 Hospital of St. John and St. Elizabeth, 60, Grove End Road, N.W.8 CUN 5126 King Edward VII Hospital, Beaumont Street, W.I . HUN 4411 Marlborough Day Hospital, 38, Marlborough Place, N.W.8 MAI 8605 National Dental Hospital, Gt. Portland Street, W.I. LAN 5361 National Heart Hospital, Westmoreland Street, W.I. HUN 0824 Paddington General Hospital, Harrow Road, W.9 CUN 4884 Paddington Green Children's Hospital, Paddington Green, W.2 PAD 1081 Royal National Orthopaedic Hospital, 234, Gt. Portland Street, W.I EUS 5070 St. Charles Hospital, Ladbroke Grove, W.10 LAD 2281 St. Marylebone Hospital for Psychiatry and Child Guidance, 48, Cosway Street, N.W.I. PAD 8854 St. Mary's Hospital, Praed Street, W.2 AMB 1280 Samaritan Hospital, Marylebone Road, N.W.I. PAD 6011 The Middlesex Hospital, Mortimer Street, W.I. MUS 8333 Western Ophthalmic Hospital, Marylebone Road, N.W.I. PAD 1871 Clinics : Arthur Stanley Institute for Rheumatic Diseases and Allied Conditions, Peto Place, N.W.I LAN 6778 Charterhouse Rheumatism Clinic, 56-60, Weymouth Street, W.I. WEL 1264 Chest Clinic, Town Hall, Marylebone Road, W.I. WEL 7766 Temperance Clinic (Church of England), 14, Gloucester Place, W.I. WEL 5222 The Tavistock Clinic (Psychiatric), 2, Beaumont Street, W.I. WEL 5415 Vaccination (Smallpox) Clinic, The Middlesex Hospital, W.I MUS 8333 Vaccination (Smallpox) Clinic, Town Hall, Marylebone Road, W.I. WEL 7766 The Maternity and Child Welfare services for the Borough are administered by the London County Council, Division 2, 313-319, Harrow Road. W.9 CUN 4815 MEDICAL AND NURSING, ETC. INSTITUTIONS IN THE BOROUGH British Institute of Radiology, 32, Welbeck Street, W.1 WEL 6237 Fellowship of Postgraduate Medicine, 60, Portland Place, W.1 LAN 4266 General Medical Council, 44, Hallam Street, W.I. LAN 2727 General Nursing Council for England and Wales, 23, Portland Place, W.1 LAN 8334 Institute of Cardiology, 35, Wimpole Street, W.I. WEL 1896 Institute of Medical Laboratory Technology, 74, New Cavendish Street, W.1 LAN 2752 Institute of Orthopaedics, 234, Gt. Portland Street, W.l EUS 5070 Medical Society of London, 11, Chandos Street, W.l LAN 1043 Royal College of Midwives, 15, Mansfield Street, W.l LAN 6523 Royal College of Nursing, la, Henrietta Place, W.l LAN 2646 Royal College of Obstetricians and Gynaecologists, 27, Sussex Place, Regent's Park, N.W.1 AMB 5425 Royal Institute of Public Health and Hygiene, 28, Portland Place, W.l LAN 2731 Royal Medico-Psychological Association, 11, Chandos Street, W.l LAN 1495 Royal Society of Medicine, 1, Wimpole Street, W.l LAN 2070 Royal Society of Tropical Medicine and Hygiene, 26, Portland Place, W.1 LAN 2127 44 INDEX Page Page Accidental Deaths 3,32 Food Stalls 22 Accidents 3,32 Food, Unsound 21 Adulterated Food Samples 17,21 Fouling of Footways by Dogs 15 Aged Persons 5,6,9,16,41 Aged Persons—Services available 41 General Statistics 2 Air Pollution 1,35,36 Ambulance Service 43 Hairdressers and Barbers13 Analysis of Food and Drugs17 Heating Appliances (Fireguards) 12 Analyst, Public 1 Horseflesh 23 Analyst, Public, Report 17 Hospitals 43 Housing 15 Bacteriological Examinations 22,27,40 Housing, Certificates of Disrepair 17,33 Bacteriological Examination of Milk and Ice Cream 22 Housing, Closing Orders 17,33 Bacteriologist 1 Housing, Factory-made Bungalows 16 Bakehouses, Basement 23 Housing, Improvements, Conversions and 16 Barbers 13 Housing, Inspection and Action taken 17,33 Baths, Cleansing of Persons 11 Housing of Old People 16 Baths for Old People 6 Housing, Permanent Estates 15 Baths, Swimming 9 Housing, Re-housing, Medical Certificates 17 Bodies, Transportation Abroad 14 Housing, Requisitioned premises 16 Books, Library 8,26 Housing, Slum Clearance 16 Bugs 11 Hydrogen Cyanide Disinfestation 11 Burial or Cremation of the Dead 14 Hygiene—Food Premises 22 Cancer 3 IceCream 22,38 Care of Old People 5,6,9,16,41 Immigrants 17 Catering Establishments 22,39 Impetigo 26 Causes of, and Ages at. Death 3,30 Improvement and Conversions, Housing16 Census Population 2 Infant Mortality3,30 Certificates of Disrepair 17,33 Infectious Diseases, Exclusion from Work of Contacts 26 Clean Air 11,35,36 Infectious Diseases, Notification 24,39,40 Cleansing, Public 14 Infectious Diseases, Prevalence and Control 24 Cleansing Station 11,26 Infectious Diseases, Statistics 39,40 Cleansing of Verminous Persons 11 Inspection, Sanitary 9,33 Clearance, Slum 16 Inspection of Food 21 Clinics 43 Institutions, Medical and Nursing, etc 43 Closing Orders 17,33 Intimation Notices 9 Combined Drainage 10 Committee, Public Health 1 Land Charges Enquiries 17 Common Lodging Houses 17 Laundry Service for Old People, etc. 6 Compulsory Removal 9,32 Legal Proceedings 9,34 Conditions, Social 2 Legislation, New 9,20,32 Conferences 5 Conveniences, Public 13 Marriages 2 Cremation 14 Mass Miniature Radiography 24,40 Maternal Mortality 2,3,30 Dairies, Milkshops 22,38 Measles 24,39 Deaths 2,3,30 Medical Examinations, Staff 9 Deaths, Infant Mortality 2,3,30 Medical and Nursing, etc., Institutions 43 Deaths, Maternal Mortality 2,3,30 Medical Referee, Cremation 1,14 Deaths, Vital Statistics 2 Mice 11,35 Diseased or Infirm Persons, Removal 9, 32 Milk 17,22,38 Diseases, Notifiable 24,39,40 Milk, Bacteriological Examination 22 Disinfection 26 Milk (Special Designations) Regulations 22,38 Disinfestation 11 Milk. Pasteurised 22,38 Disrepair Certificates 17 Milk, Sellers 22,38 Dog Nuisance 15 Milk, Sterilised 22,38 Drainage 10 Milk, Tuberculin Tested 22,38 Drainage, Combined 10 Mortality, Infant 2, 3, 30 Drugs, Analysis 17 Mortality, Maternal 2,3,30 Dwelling-Houses 17,33 Mortuary 14 Exclusion from Work 26 New Legislation 9, 20,32 Noise 9 Factories 12,37 Notices, Intimation and Statutory 9 Factory-made Bungalows 16 Notification of Infectious Diseases 24,39,40 Financial Contributions to Voluntary Organisations 5 Nuisances 9,10,15,33 Fireguards 12 Flock, Rag and Other Filling Materials 14 Offices 12 Food, Adulterated, etc. 17,21 Old People 5,6,9,16,41 Food Analysis 17 Old People, Services Available 41 Food Inspection 21 Outworkers 12,37 Food Poisoning 24 Food Premises 22, 39 Pasteurised Milk 22,38 Food, Preserved, etc. 22, 38 Pet Shops 13 45 Page Page Pharmacy and Poisons Acts 13,38 Smoke Control 11,35,36 Photographers, Street 15 Social conditions 2 Pigeons 10 Staff 1 Poisoning, Food 24 Staff Medical Examinations 9 Poisons 13,38 Stalls, Food 22 Poliomyelitis 24,39 Statistics: General 2 Population 2 Infectious Disease 24,26,39,40 Preserved, etc., food 22,38 Tuberculosis 39,40 Private wells 10 Vital 2 Protective helmets 13 Statutory Notices 9 Public Analyst 1 Sterilised Milk 22,38 Public Analyst's Report 17 Stillbirths 2 Public Cleansing 14 Street Cleansing 14 Public Conveniences 13 Street Photographers 15 Public Health Committee 1 Swimming Baths 9 Public Health Department Staff 1 Public Health Inspectors 1 Town Planning 10 Public Swimming Baths 9 Transportation of Bodies Abroad 14 Pulmonary Tuberculosis 24,39,40 Tuberculin Tested Milk 22,38 Tuberculosis: General 24,39,40 Radiography, Mass Miniature 24,40 New Cases and Deaths 24,39 Rag Flock and Other Filling Materials 14 Notifications 24,39 Rateable Value 2 Registe 40 Rats 11,35 Referee, Medical (Cremation) 1, 14 Underground Bakehouses 23 Refuse Collection and Disposal 14 Underground Rooms 33 Removal, Compulsory 9, 32 Unsound Food 21 Rent Act 17,33 Representation upon other Bodies 4 Vaccination, International Certificates 27 Requisitioned Premises (Housing) 16 Venereal Diseases 26 Restaurants 22, 39 Vermin 11 Rodent Control 11,35 Verminous Persons, Cleansing 11 Vital Statistics 2 St. Marylebone Clean Food Association 23 St. Marylebone Old People's Welfare Association 5,6,41 Water 10.34,35 Sanitary Circumstances 9 Weather 3, 31 Sanitary Inspection 9, 33 Wells, Private 10 Scabies 26 Shelter 11 X-ray Examination 24,40 Shops 12 Slaughter of Animals 23 Zoological Society of I,ondon 23 Slum Clearance 16 Vaii. & Co. Ltd, Leeke Street, King's Cross, W.C.I.