4353 achl STMARY 65 BOROUGH OF ST. MARYLEBONE REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1960 HASTINGS E. A. CARSON, M.D., D.P.H., S.M.(Harv.) 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 11 Section D—Housing 17 Section E—Inspection and Supervision of Food 19 Section F—Infectious and other Diseases—Prevalence and Control 25 Appendix of Statistical Tables and Supplementary Information 29 Index 46 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 this Annual Report on the health of the Borough during 1960, having succeeded Dr. Briscoe-Smith as Medical Officer of Health towards the end of August of that year. At the request of the Minister of Health the report retains its usual form and also contains full details of the water supply, sewerage and public swimming baths in the Borough. Public health throughout the year was generally good, there being comparatively little infectious disease. No epidemic of any note occurred. Measles, which accounted for 145 of the 326 notifications of infectious disease, is chiefly responsible for the periodic fluctuation in the annual figures for notifiable infectious diseases. The current predominance of this disease in the yearly returns may well disappear if the vaccine at present under trial in the United States proves to be effective. The absence of smallpox in St. Marylebone for some three decades and of diphtheria for the past dozen years coupled with the recent decline in the incidence of acute poliomyelitis—only one case being notified in 1960— bears striking testimony to the efficacy of active immunisation in providing specific protection against these serious infections. In spite of the great advances made in this century in the control of communicable disease there can be no grounds for complacency. A vigilant watch has to be maintained and this is well illustrated by the action described on page 25 which followed the discovery of a case of smallpox in an adjoining Borough. The resident population continued to decline slowly—the preliminary report on the 1961 Census revealing a decrease of almost one-tenth during the previous ten years—although the very low birth rate did increase from 7.55 to 8.30 (standardized) per thousand population and stillbirths fell from 14.45 to 8.10 per thousand total births. The standardized death rate rose slightly from 11.34 to 11.58 per thousand population and infant mortality appreciably from 14.67 to 26.99 per thousand live births ; the latter increase reflects the small population group involved in which a small variation in the number of deaths causes a sharp fluctuation in the mortality rate. In fact the 20 infant deaths in 1960 represented an increase of 9 on the previous year, when the total was the lowest ever recorded in St. Marylebone, and of this number no fewer than 18 occurred in the first month of life when the influence of pre-natal factors, of which our knowledge is as yet far from complete, is particularly felt; much research is taking place in this field. Among adults the,main causes of death were diseases of the cardio-vascular and respiratory systems and various forms of cancer. These reflect the increased expectation of life which has stemmed from a steadily improving standard of living ; a healthier environment in the form of better sanitation, housing, working conditions, food and water ; the control of the major communicable diseases; and last but not least the great advances which have been made in medicine, surgery and anaesthesia. Today the prospect of attaining the Biblical span has indeed become a reality for the new-born babe. In St. Marylebone approximately one-fifth of the residents are of retirement age and, with the proportion of old people growing from year to year, the Department is becoming more and more concerned with the welfare of the elderly. In this field it works in close co-operation with hospitals, family doctors, the personal health and welfare services of the London County Council, and in particular with the St. Marylebone Old People's Welfare Association, an extract from whose annual report appears on page 6. I should also like to draw attention to the summary of services available for old people on page 43 of the appendix to this Report. One aspect of this sphere of activity which is receiving increasing attention is the prevention of accidents in the home and much informal personal advice on safety measures is given by the field staff. Of course, awareness of potential danger in the home needs to be constantly fostered in all age-groups and, in this connection, it is regrettable that a loop-hole in the provisions of the Heating Appliances (Fireguards) Act, whereby auctioneers (when acting on behalf of a client whose normal business is not the sale of heating appliances) can legally sell such appliances even though they do not comply with the Regulations, is also to be found in the new Oil Burners (Standards) Act. In view of the undoubted association between chronic bronchitis and lung cancer and atmospheric pollution, it is especially pleasing to record the steady progress, reported on page 13, which has been made in the Clean Air Campaign in the Borough. A further substantial contribution to the cleanliness of St. Marylebone is being made by the introduction of the " dustless litterless " system of refuse collection ; details of this exciting innovation have been kindly supplied by the Director of Public Cleansing and are to be found on page 15. This system has the additional merit of reducing the noise hitherto inherent in older methods of refuse collection, the special bins being fitted with a rubber rim at the base and a plastic ring inside the lid. The problem of personal discomfort caused by noise has come very much to the fore of late and this Department receives many complaints from people living or working in the Borough. As my predecessor pointed out in his admirable review of the subject in his Annual Report for 1958 it is possible to reduce the amount of noise emanating from certain sources, for example the drills used in building operations. Since then the Noise Abatement Act has come into force, and the publicity which it has very naturally received appears to have led members of the public to believe that a local authority is now able to stop any kind of noise to which they may personally object. This concept is wholly misleading. The fact is that individual variation in reaction to noise is so great that a concerted complaint is the exception rather than the rule. A certain amount of noise may be inseparable from a particular activity and at the present time it is purely a matter of opinion as to when this may constitute a nuisance from a legal standpoint. In these circumstances the findings of the Wilson Committee, set up by the Ministry of Science to review the whole complex subject of noise, are awaited with especial interest. The first sixty years of the twentieth century have witnessed a truly remarkable transformation in the public health. Entering the seventh decade of this dramatic century it is true to say of this country that an increasingly major obstacle to good health is the failure of the individual to take advantage of knowledge readily available and to use it for the benefit of himself, his family, and the community at large. Thus health education assumes ever greater importance and for this reason the appointment of the Cohen Committee to review the whole subject as mentioned on page 10 is particularly welcome. Clean personal habits are a fundamental goal in this field ; yet a recent census of the use of facilities provided in the Oxford Circus Public Conveniences, where free washing amenities have been provided since 1948, showed that only a quarter of the users washed their hands ! By similar neglect of elementary hygiene a food handler can, and all too frequently does, make a mockery of the most up-to-date premises and equipment. In truth, personal responsibility in matters of health cannot be abrogated. There is no truer saying than that " Public Health is People." The contribution of the individual is as vital to communal health as it is to prosperity. Everyone has a part to play. It is in this spirit of team-work that I wish to express my profound gratitude to His Worship the Mayor, to the Chairman, Councillor Mrs. F. E. Glenny, and members of the Public Health Committee, and to members of the Council, generally, for their kindness and encouragement during my first few months in office. To my colleagues in other Departments of the Council I offer my sincere thanks for their unfailing help and co-operation. Lastly I am very conscious of the debt which I owe to the staff of the Public Health Department for their loyal and invaluable support at all times. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, HASTINGS E. A. CARSON, Medical Officer of Health. 2 1 PUBLIC HEALTH COMMITTEE 1960 HIS WORSHIP THE MAYOR : Councillor Lt.-Col. H. C. S. Thomson, O.B.E., J.P., A.C.A. †Councillor Gregory Matveieff, J.P. ALDERMEN: C. D. Denis-Smith Capt. R. G. Whitney, M.B.E., J.p. COUNCILLORS : R. H. S. Allen Dr. H. K. Ashworth, T.D. (Vice-Chairman) J. C. C. Blofeld Mrs. R. M. Challis Mrs. F. E. Glenny (Chairman) * until May. Dr. L. Jacobs The Rev. W. M. Long Mrs. J. P. G. Nuttall Mrs. H. Shire E. H. J. Wileman, LL.B., F.C.C.S. † 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. {until June) Hastings E. A. Carson, M.D., D.P.H., S.M.(Harv.) (from August) 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.l 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 D. J. W. Rigg F. V. Terry (until April) Miss M. L. Shaul Miss C. A. Cruickshank (until February) Mrs. P. Woods (from May) J. Bradley (from February) R. J. Crozier (from October) Public Health Inspectors : V. A. Bignell (a, b, c) (Senior Inspector) Food Hygiene and Sampling : Rodent Control : L. Newland (a, b) J. A. Cummins (a, b) A. C. Bruton (a, b) (from August) Care of Old People and Rehousing : Drainage : Miss M. M. Sharp, M.B.E. (a, d, e, f) J. R. Baily (a, b) District : J. E. Broadhead (a) D. B. Hooper (a) Smoke Control : P. W. Jolly (a, b) L. Pearson (a, b, c) S. W. Wright (a, b) Restaurants : E. W. J. Miller (a, b) Mrs. M. I. Tiplady (a, b, d, f) A. J. Bithrey (a, b) *Miss B. Wilson (a, b, d, e, f) Outdoor Superintendent and Mortuary Keeper : R. G. Turner Street Nuisance Inspector : D. Telford Messenger/Handyman : W. G. Sharwood Rodent Operatives 5 Disinfectors 4 Public Conveniences Staff 39 Cleansing Station Attendants 3 Van Driver 1 (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 (/) State Registered Nurse's Certificate * Also Infectious Diseases. 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, 1,472 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 : £6,507,851. Sum represented by a penny rate : £25,994. Residential units (separate assessments) : 24,623. Population : 1961 census (Preliminary Report)—Males 29,360 ; females 39,474. Total : 68,834. 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-1960—69,640. Registrar General's estimate of the child population : mid-1960—under 1 year : 670 ; 1—4 years inclusive : 2,330 ; 5—14 years inclusive : 5,100. Total child population : 8,100 (approximately 12 per cent.of total population). It is estimated that approximately 68 per cent. of the Borough's population are aged between 15 and 65 years, and approximately 20 per cent. are over 65 years of age. Expectation of life at one year : Girls—74 years ; Boys—69 years. EXTRACTS FROM VITAL STATISTICS Total M. F. Live Births—Legitimate 653 338 315 Live birth-rate per 1,000 population 10.64 Illegitimate 88 43 45 (Standardized) 8.30 Stillbirths—Legitimate 6 6 - Stillbirth rate per 1,000 live and stillbirths 8.10 Illegitimate — — - Total live and stillbirths 747 387 360 Infant Deaths—Legitimate 17 13 4 Illegitimate 3 2 1 Total Legitimate Illegitimate Infant mortality rate per 1,000 live births 26.99 26.03 33.41 Neo-natal mortality rate per 1,000 live births 24.29 22.97 33.41 Illegitimate live births per cent. of total live births 11.88 Maternal deaths (including abortions) Nil Total M. F. Deaths (all ages) 1,090 528 562 Death rate per 1,000 population 15.65 (Standardized) 11.58 Area comparability factors. Births, 0.78 ; Deaths, 0.74. Marriages The number of marriages in St. Marylebone during 1960 was 1,219, which is 14 more than for 1959 but 81 below the average (1,300) for the previous ten years. Deaths. The total number of deaths 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 occurred in the Borough, as also are those of members of H.M. Forces who were stationed in the area, 3 Deaths registered in 1960 numbered 1,090 (15.65 per 1,000) compared with 1,141 (16.20 per 1,000) in 1959. The rate of 15.65 when standardised by the comparability factor gives a figure of 11.58 ; the standardised rates for the County of London and for England and Wales were 11.4 and 11.5 respectively. The principal causes of death were diseases of the heart and circulatory system, which accounted for 38 per cent. of the total; malignant diseases, 21 per cent. ; and respiratory diseases, including tuberculosis, 11 per cent. Deaths from lung cancer, compared with the previous year, fell from 63 to 48. Seventy-two per cent. of the deaths registered were of persons aged 65 and over, whilst twentytwo per cent. were between 45 and 65 years. Accidental Deaths. During the year, 24 residents died from accidents of all kinds; this was the same total as last year. Motor vehicle accidents accounted for eight deaths as compared with six in 1959. Home and Road Accidents. The London Ambulance Service reports that 186 home accident cases requiring removal to hospital occurred in the Borough during the year. More deaths are stated to result from accidents in the home than from road accidents. Every effort should be made to make people realise this and they must be urged to take the simple and practical precautions in their homes which, together with the avoidance of carelessness, would reduce so heavy a toll of life and unnecessary suffering. Again, local road accident figures show an increase on the previous year (978), there having been 1,054 such accidents in the Borough, resulting in 10 (11) deaths, 149 (131) serious injuries and 1,174 (1,045) slight injuries. The figures in brackets relate to 1959 and a summary of the accidents in 1960 is given in Table 4, page 32. Births. The total of live births registered during the year was 741 (381 males : 360 females) giving a live birth rate of 10.64 per 1,000 of population, equivalent to a standardised rate of 8.30 compared with 18.0 for the County of London and 17.1 for England and Wales. Illegitimate live births numbered 88 (43 males : 45 females), representing 11.88 per cent. of the total live births. Still-births totalled 6, representing a rate of 8.10 per 1,000 total births. Infant Mortality. Deaths of infants under one year totalled 20 (17 legitimate: 3 illegitimate) giving a rate of 26.99 per 1,000 live births as compared with 14.67 in 1959. The rate for England and Wales is 21.7 per 1,000. Details showing causes of death according to age group and sex are given in Table 2, page 30. Of the 20 infant deaths 18 were under four weeks old, giving a neo-natal mortality rate of 24.29 per 1,000 live births as compared with 10.26 in 1959. The neo-natal mortality rate for England and Wales is 15.56. Although the figures for 1960 are higher than for the previous year the latter were the lowest on record. Maternal Mortality. No maternal death was reported during the year. Population. The Census 1961 Preliminary Report gives the total population as 68,834 (males : 29,360 ; females : 39,474) while the 1951 Census showed a total of 75,821 (males : 31,649 ; females : 44,172). During the period 1951-1961 the population has decreased by 6,987 (males : 2,289 ; females : 4,698), a percentage decrease of 9.2 compared with one of 4.6 in the County of London, and an increase of 5.3 in England and Wales. Of the twenty-eight Metropolitan Boroughs, 24 showed population decreases ranging from 1.0 to 19.4 per cent. and four showed increases ranging from 1.6 to 6.4 per cent. Weather. The following summary of the weather during 1960, and Table 3, page 31, are based upon information supplied by the Meteorological Office:— 4 January.—Sunshine about 140 per cent. average. Mean temperature about average. Rainfall about 75 per cent. average. Sleet or snow on 8 days. February.—Sunshine 30 per cent. above average. Mean Temperature average. Rainfall nearly 150 per cent. average in parts of London. Sleet or snow on 4 days. March.—Sunshine only 65 per cent. of the average. Mean temperature about 1 degree above average. Rainfall about 110 per cent. of average. April.—Sunshine 115 per cent. average. Mean temperature about 1 degree above average. Rainfall only about 30 per cent. average. May.—Sunshine about 90 per cent. Mean temperature between 2 and 3 degrees above average. Rainfall about average. June.—Sunshine about 115 per cent. Mean temperature about 2 degrees above average. Rainfall about 80 per cent. average. July.—Sunshine about 80 per cent. Mean temperature about 2.5 degrees below average. Rainfall about 140 per cent. average. August.—Sunshine about 90 per cent. average. Mean temperature about 2 degrees below average ; maximum 77 degrees at Regent's Park on 23rd. Rainfall about 150 per cent. average. September.—Sunshine about average. Mean temperature about 1 degree below average. Rainfall variable but well above average. October.—Sunshine about average. Mean temperature a little above average. Rainfall about 240 per cent, average. November.—Sunshine about 150 per cent. average. Mean temperature about 2.5 degrees above average. Rainfall about 150 per cent. average. December.—Sunshine a little above average. Mean temperature and rainfall about average. Public Holiday Weather. Easter (April 15-18th) Good Friday and Easter Saturday were rather cool with showers in the afternoon but Sunday and Monday were mainly fine with a good deal of sunshine and near average temperatures. Whitsun (June 4-6th) Whit-Saturday was sunny and very warm ; at Kew the maximum of 80 degrees equalled the highest temperature on a Whit-Saturday this century—the previous occasion was 1933. Next day was even warmer with a maximum of 83 degrees but some rain fell in the evening. Whit-Monday was cloudy all day with slight rain at times; temperatures dropped considerably and barely touched 70 degrees. August (July 30-August 1st) Bank Saturday was cloudy and rather cool with slight rain in places but Sunday was fine Holiday and sunny with average temperatures. Monday was cloudy with showers at times and a thunderstorm broke out in the afternoon ; it was rather cool, too, with afternoon temperatures in the middle sixties. Christmas (December 24-26th) Christmas Eve was cloudy all day with a little drizzle in the morning but temperatures were a little above average. Christmas Day was cloudy at first but the sun broke through in the afternoon and it was mild. The wind freshened in the early hours on Boxing Day accompanied by heavy and squally rain which finally cleared by about midday ; there were sunny periods in the afternoon and temperatures were a little above normal. 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:— 5 Body London County Council Health Committee. London County Council Divisional Health Committee (Division 2). St. Marylebone Tuberculosis Care Committee. Paddington Hospital Group House Committee, No. 2. Paddington Hospital Group House Committee, No. 5. National Society for Clean Air. Paddington and St. Marylebone District Nursing Association—Executive Committee. St. Marylebone Youth Committee—Management Committee. St. Marylebone Clean Food Association—Executive Committee. Department of Scientific and Industrial Research— Standing Conference of Co-operating Bodies dealing with Atmospheric Pollution. Representatives Alderman Capt. R. G. Whitney, M.B.E., J.P. (until July). Councillor Dr. Elizabeth Jacobs. Councillor Mrs. R. M. Challis. Councillor Mrs. R. M. Challis. Councillor Mrs. F. E. Glenny. The Medical Officer of Health. Councillor Dr. L. Jacobs. Councillor Mrs. S. Rivington (until March). Councillor Mrs. J. P. G. Nuttall (from April). The Chairman of the Public Health Committee. The Medical Officer of Health. Councillor Mrs. S. Rivington. The Medical Officer of Health. Councillor Mrs. S. Rivington. Councillor Mrs. J. P. G. Nuttall. Councillor Mrs. F. E. Glenny. The Chairman of the Public Health Committee. The Medical Officer of Health. 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—Torquay 25th-29th April. Association of Public Health Inspectors—Scarborough, 20th-23rd September. National Society for Clean Air—Harrogate, 5th7th October. National Old People's Welfare Council's Conference —Blackpool, 31st March-2nd April. Conference of the Central Consultative Committee on the Welfare of Old People—London, 17th June. Cremation Society Conference—Great Yarmouth, 28th-30th June. Delegates Councillor Dr. H. K. Ashworth, T.D. The Medical Officer of Health. Mr. L. Pearson, Public Health Inspector. Councillor Dr. H. K. Ashworth, T.D. The Medical Officer of Health. Miss M. M. Sharp, M.B.E., Public Health Inspector. Councillor Mrs. F. E. Glenny. Miss M. M. Sharp, M.B.E., Public Health Inspector. The Medical Officer of Health. Mr. H. G. Willes, Town Clerk's Department. 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 1960, as follows :— Organisation £ s. d. tory 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 350 0 0 do. " Inner Wheel" Old People's Club—Rent of Hall 30 0 0 do. Women's Voluntary Services 40 0 0 do. 6 Care of Old People. The number of old persons registered in the department is as follows :— Bachelors or widowers 161 Single women 313 Widows 664 Married persons living together 252 1,390 The majority of them (1,138) live alone and some require constant observation. During the year, 737 people, including 83 married couples, were visited by the two women public health inspectors, who made a total of 3,490 visits. Special Laundry Service.—The department continued the service, begun in 1950, for laundering bed linen and clothing of acutely ill and incontinent or very dirty and verminous old people. During the year, 49 cases were dealt with, some over long periods, others for a short while only. Thirty-nine of these were new cases 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 staff of the department's 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 553 baths were given, 365 to women and 188 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. 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, British Red Cross Society, W.V.S., and other voluntary societies, likewise were of great assistance. Services available for old people are summarised on pages 43 and 44. St. Marylebone Old People's Welfare Association. The Executive Committee of the Association (Chairman—Mrs. L. H. 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 1960 :— " Grants.—This was a year of important changes. From 1st April the Association started receiving a grant from the London County Council, to cover the chiropody services. This amounted to £760 during the next nine months. Instead of charging the patients 1s. 6d. for each treatment in the Clinics and 2s. at home, it was now the rule to charge 3s. in both services, subject to certain conditions. No charge was made to any patient receiving supplementary pension from the National Assistance Board. As a result of this change about half the patients now paid no fee ; by the end of the year the L.C.C. had decided that no charge was to be made for chiropody for pensioners and arrangements were made for another change at the beginning of 1961. These services had been pioneered by the Association in 1951. Although the Borough Council's general grant to the Association did not specifically cover chiropody the effect of its generous financial support was that the Association was able to maintain these valuable services on a sound basis for some nine years, prior to the L.C.C. taking over the financial responsibility. The fees for Chiropodists were adjusted in accordance with the practice in clinics run by the Statutory Authorities, and domiciliary treatments were now paid on a basis of sessions rather than cases. The general Borough grant starting April, 1959, was at the rate of £1,075, that for holidays £250. From 1st April, 1960, the general grant was raised to £1,275 and for holidays to £350. Owing, however, to the L.C.C. now taking over responsibility for chiropody the Association's applications to the Borough Council were accordingly reduced. 7 King George VI Social Service Scheme.—The Association was allowed the use of a committee room at the Town Hall for four evenings in the spring of 1960 for a course on old people's welfare arranged under the auspices of this Scheme. We were grateful to Miss E. M. Andrews, Tutor for the Scheme, who most ably steered this instructive and helpful course and secured some fine speakers. Nearly 30 students attended, mainly people engaged in visiting old people. Miss Blaylock of the Fourth Feathers Club attended a specialised course under the Scheme. Publicity.—Local newspapers have continued to give useful publicity during the year, as a result of which several old people hitherto unknown to the office have become acquainted with us. The form for the leaflets to be distributed to new pensioners by the Ministry of Pensions and National Insurance in order to let them know the availability of local services, was finally agreed by all Old People's Welfare Associations in London and the leaflets were expected to go into distribution early in 1961. The last Report referred to the unwillingness of the Public Relations Department of the General Post Office to allow the name and address of the Association to be added to the list of organisations displayed in local post offices. It is satisfactory to report that as the result of representations this situation was rectified during 1960. ' Meals-on-Wheels.'—This service has been grant-aided as before, not only by the London County Council, their contribution for each meal being made through the Borough Council and therefore not appearing in the Association's accounts, but also by the Borough grant direct to the Association. In November the cost of the meal was increased from 1s. 8d. to 1s. 10d., a penny extra on each meal being granted by the L.C.C. and an additional penny being charged to each old person. The improvement in the variety of the meals has made the change a beneficial one. It had been increasingly felt that the system of delivery of meals was no longer completely satisfactory and, after prolonged consideration of ways and means and of schemes elsewhere, the Executive decided in November to purchase from the General Electric Company two electrically heated food containers and to adapt the existing van for their use, the cost to be defrayed by the Borough Council. The W.V.S. helpers distributed 6,747 meals, an increase on the previous year's figure (6,101). Thanks to wonderful team work this service is quite invaluable for people who could not possibly prepare a hot meal for themselves. The van is garaged and serviced by the Borough Council and the very helpful driver is a Council employee. Luncheon Club.—This service also shows an increase in meals supplied, 6,431 against 6,096 the previous year. The Club has continued to meet in most convenient premises kindly lent at a modest rental by the Church Army. At a time of high prices these meals are more than ever proving a great benefit and we should like to express our warmest thanks to Mrs. Lush and all W.V.S. helpers for the devoted and efficient working of these two important services. Chiropody.—To our great regret Mrs. E. Baird, who had worked with the chiropody services since they.started in Marylebone, resigned to work nearer home. At her final session Mrs. Baird was presented by Mrs. Fewster with a travelling clock as a token of the Association's appreciation of her work. Miss Curran and Miss Lerner, both of whom have also rendered most valuable service as chiropodists, the former since 1952 the latter since 1953, were now joined by Miss I. Meares. Miss Curran and Miss Meares carried on the domiciliary work, Miss Lerner the useful weekly session of Clinic 2, all three working on Tuesdays at the Town Hall where Clinic 1 continues to benefit by the loan of L.C.C. rooms for its work. For some time it had been an advantage to be able to send a few old ladies for treatment to the L.C.C. Welfare Centre in Lisson Grove, and during the year under review a fairly large number of patients were transferred there, consequently waiting lists have been kept low. 2,383 treatments were given, a slight increase. Throughout the year Miss Cotsford (B.R.C.S.) has continued her regular and most essential work as honorary appointments clerk, and we are also indebted to Miss Hoogendoorn for doing similar work at Clinic 2, where the hospitality of All Souls' Club-house, Greenwell Street, W.l, enabled us to look after eight or nine patients each Monday morning. 8 Home Chiropody.—617 treatments were given, 54 new patients being added to our lists. There was usually a small waiting list, newcomers occasionally having to wait several months for an appointment. For the less infirm there is certain interchange between attendance at Clinics and treatment at home, as some can get to the Clinics in summer only. Thanks are due to Miss M. Lewis for managing the appointments for this service, an exacting task complicated by our wish to give the individual care and treatment at varying intervals and to use the services of the Chiropodists with the least possible waste of time, though without the help of any transport. The Association is grateful to the Chiropodists who add much personal interest and kindness to their professional care of the old people. Holidays.—The Association was happy to make holiday arrangements for a greater number of people than in previous years. The group holidays in the ' all-in ' scheme arranged through Hotel Bookings & Information, Ltd., at Brighton were again most successful. 93 elderly people enjoyed a comfortable week at Brighton, each contributing £1 17s. 6d., to cover board, transport and entertainments. The remainder of the cost totalling £4 18s. 6d. a head was met from the higher grant from the Borough Council. Gratitude is expressed to the Soroptimist Club of Mayfair which once again ' adopted ' an elderly lady for her holiday, a particularly happy idea. The Fourth Feathers Club and the Barrow Hill Club were both helped with their own holiday schemes, the former with a grant of £34, the latter with £10. Apart from cases referred to other organisations, individual arrangements were made for eleven people for whom the group holiday was for some reason unsuitable. Some of these cases were sent for a fortnight to the Church Army short stay home at Woking, others to appropriate seaside places; one was assisted with fares to visit friends. By the kindness of the Caravan Service, Ltd., Thayer Street, W.l, an elderly couple from Marylebone enjoyed the free use of a caravan at Folkestone for a week, a second week's holiday being added by the generosity of the Mayor of that town. Social Visiting.—Miss Sharp and Mrs. Cowan have continued to look after the monthly meetings of the Visitors Committee. In addition to taking a helpful interest in the problems of those old people, mostly housebound, who are regularly visited, the Visitors are often able to report special needs that can be met through different channels and difficult problems can be discussed in Committee. Six Churches as well as other bodies are represented on the Committee and efforts were made to keep in touch with all organised groups and others engaged in visiting in order to supplement where necessary. Relief.—Through the public-spirited energy of students connected with Hinde Street Methodist Church, home decoration of old people's rooms has continued. This spare-time service was extremely useful in five homes and the young people themselves were obviously much enjoyed. The Association supplied equipment and materials and in some instances the National Assistance Board was able to refund the cost of materials. Gifts of a number of coal tickets were distributed by Miss Sharp and a bag of coal from the Association's small store several times prevented an uncomfortable emergency. Other items of relief included payment for several wireless licences, lowering of meters or changing the position of gas taps, small loans or gifts in a crisis, cleaning of clothes before a holiday, useful articles such as keys and buckets, transport to visit relatives in hospital, repairs for wireless sets, tailor's alterations, repair of windows, chimney sweeping. Clubs.—Regular reports about Club activities, given to the Executive, reflected another successful year. While it is pleasant to hear of much enjoyment given by summer outings and Christmas parties, it is probably the regular gathering with its companionship and good cheer which makes the greatest difference to an elderly person living alone but reasonably fit and active. The Fourth Feathers Club works closely with the Youth Club of the same name. Among the kindnesses of youth to age were a gramophone and records for the use of the elderly members, presented after a special fund-raising dance. The possibility of starting a workshop for the elderly has again been discussed in the Executive and enquiries, so far unavailing, made about possible premises. An all-day centre for the elderly, with special provision for infirm or handicapped old persons, either too frail for membership of an ordinary club or needing special transport might well be considered in Marylebone, not only for the benefit of the elderly folk themselves but for the occasional relief of those relatives constantly looking after them, 9 Library Service to Housebound Readers.—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 2,500 books were delivered to them during 1960. Radio.—Nine new applications were approved by the ‘Wireless for the Bedridden’ Society, and at the end of the year there were 28 people enjoying sets lent by this Society, which generously gave the licences in several cases, and provides an immense amount of pleasure for home-bound people. Fireguards.—Applications to the L.C.C. for the loan of fireguards were made in four new cases. Entertainments.—The wonderful party for eight hundred elderly Marylebone residents given by Mrs. Lew Grade at Christmastime in the Seymour Hall was once again a great event, eagerly anticipated and enthusiastically remembered. Mrs. Grade's thoughtfulness about detail, her friendly personality, the first-class cabaret and the gifts made it a memorable gathering and the Association felt privileged to be able to assist with the distribution of invitations and the supply of helpers. The majority of guests were club members, but at least two hundred and sixty, who belong to no club, were included. The Women's Institute at Wye, Kent, once again kindly invited a party of Marylebone people for an August outing, and the visit was a most happy one, in spite of bad weather. We were glad to distribute one hundred and ninety tickets for a play by the St. Marylebone Literary Institute, which was much enjoyed ; others for commercial television shows also gave much pleasure." 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. Fortunately there were none of these during 1960. Public Baths and Laundry. 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, public laundry, squash racket court, changing and club rooms. Swimming, private bath, and laundry facilities are available daily throughout the year. The large swimming 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 3½ 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. Automatic recorders provide a continuous check on residual chlorine 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. Both pools have spacious dressing rooms which are provided with foot-baths and showers. Diving stages and spring-boards offer every facility for the advanced swimmer and diver, and refreshments are obtainable in the upper balconies. 10 Private bath facilites consist of 24 baths each for men and women. Attendances during the year totalled 79,626 as compared with 81,417 in the previous year. The decline in attendance is thought to be largely due to the Council's rehousing schemes which have provided hitherto regular users with their own facilities. The baths are available every day and charges are Monday to Wednesday: adults 6d., children 3d. ; Thursday to Sunday : l0d. Old age pensioners, unemployed or blind persons can obtain baths from Monday to Friday at a cost of 1d. Foam baths are being introduced in both the men's and women's sections. They can be had in private and for this reason are often preferred to Turkish Baths, which are communal. Public laundry facilities consist of a machine laundry, comprising eight fully automatically controlled washing machines, three water-extractors and 24 drying racks, and a hand laundry provided with 16 composite units for washing, boiling and ironing, 3 water-extractors and 16 drying racks. The installation of automatically controlled washing machines has encouraged greater use of the machine laundry and it is in some measure due to this that attendances at the hand laundry have declined. Further modifications to the controlling apparatus have achieved improvements in the quality of laundrywork and a saving in time. It has been noted that the number of young married women using these facilities has greatly increased. Staff Medical Examinations. The Medical Officer of Health is medical adviser to the Council for staff purposes. During 1960, one hundred and twenty-seven examinations of the Council's employees and new entrants to the superannuation scheme were carried out. Health Education. The importance of this subject is becoming increasingly recognised and in a public health department its practice falls into two main categories, namely, dissemination of information by word of mouth, and education by the use of posters, pamphlets, book marks and other media for conveying the written word. The first is undoubtedly the more effective and consequently in their day-to-day contacts with the public the inspectors and other members of the staff take every opportunity to impart information on health matters. In addition, provision is made for lectures and talks to be given to selected groups, such as food handlers on the subject of food hygiene, and the department also uses a film strip projector in this connection. The Council has for many years made a financial contribution to the Central Council for Health Education. Posters, pamphlets, book marks and other printed matter on health subjects, and more particularly on those matters which directly concern the functions of the department, are regularly purchased from this source and from ROSPA House and other bodies, and displayed or distributed as widely as possible where it is considered they will bring the most satisfactory results. In this work the Libraries Committee and the Public Library staff have been most helpful and co-operative. A pamphlet board is sited in the entrance to the Central Library permanently, except for short periods when this vestibule is required for a special exhibition, and a window at the St. John's Wood Branch Library is at the disposal of the Public Health Department for publicity purposes. Book marks and pamphlets are also regularly distributed from the Library counters. Very limited space is available for posters but displays are maintained at all times at the Public Health Offices, from which pamphlets are also distributed, and publicity is given to certain subjects at the public conveniences. The department again co-operated with the London County Council in the annual Home Safety Campaign Week and with the Ministry of Health for Mental Health Week. A special display was also arranged drawing attention to the connection between smoking and lung cancer, and continued assistance was given to the campaign for drawing public attention to the dangers of venereal diseases and to the adequate facilities which exist for those in need of treatment. As each of the Council's Smoke Control Orders comes into operation the opportunity is taken for intensive publicity in the area concerned. Apart from the statutory action necessary, attempt is made through the local press, local display and by individual contact with each household in the area to ensure that requirements of the Clean Air Act are both understood and appreciated. A Joint Committee of the English and Scottish Health Services Councils has been appointed under the Chairmanship of Lord Cohen of Birkenhead to consider fresh fields for health education and to assess past results and suggest what methods are likely to be most effective in future. The report of the Committee on this important subject will be received with great interest. New Legislation. A list of the new Acts, Regulations, Orders and Byelaws, relating to the work of the Department, is given in Table 5, page 32. 11 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 summarised in Table 6, page 33. Excluding rat and mouse infestations, 1,179 complaints were received and details of the 1,017 various nuisances detected and remedied are shown in Table 7, page 33. Notices.—Intimation notices numbered 255, and 37 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 9, page 34. Noise. The Noise Abatement Act, 1960, which came into operation during November, provides that a noise or vibration which is a nuisance is a statutory nuisance and thus one which can be dealt with in a magistrate's court. The Act does not, however, recognise any form of nuisance which did not exist before. Forty-five complaints of noise were received and these involved thirty-nine alleged nuisances. Extensive engineering works and operations on demolition and building sites, involving the use of 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, a refrigerator, noisy neighbours, clubs, road works, telephone and fire alarm bells, garages, traffic and a lift. 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. Pigeons. For the purpose of abating or alleviating 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 1960 twelve complaints of this type of nuisance were investigated but it was only found necessary to refer eight cases to the pigeon catcher. Water. Although at two blocks of flats and two office buildings water 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 your Borough is derived from the River Thames. The water is purified in the Board's reservoirs at Staines, Littleton 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 excellent hygienic quality throughout 1960." I he average results of chemical and bacteriological analyses of the water leaving the works concerned are set out in Tables 11 and 12, pages 34 and 35. The number of dwelling houses supplied from public water mains is 24,356, with an estimated population of 69,137. No stand-pipes are in use and the remaining dwelling-houses, namely two blocks of flats comprising 267 residences, obtain water from the private wells referred to above. There was a complaint from a block of flats about water obtained from a private well. Samples from the flat concerned were examined bacteriologically and chemically and found to be wholesome and satisfactory. It is the practice of the department to keep these wells under observation and sample their waters every six months. The Council's Bacteriologist's reports for 1960 were satisfactory. 12 During 1960, the Metropolitan Water Board notified the department of seven instances where water had been cut off from premises ; one due to waste of water and the other six for non-payment of rates. The supply was restored without service of a notice in these latter cases but in the other it was necessary to serve notice on the owner of the premises before repairs were carried out to enable the water to be reinstated. Four 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 262 drainage plans approved during the year, 38 were in respect of new buildings. Upon request, the Borough Engineer examined 17 sewer connections and 9 of them were found to be defective and had to be renewed. The two drainage inspectors made 3,354 visits and no circumstances were found which necessitated legal proceedings. Combined Drainage. Seven orders under seal were issued in respect of combined drainage operations. Sewerage. The Borough Council's sewers are controlled and maintained by the Borough Engineer and discharge into the London County Council's main drainage system. The disposal of sewage is the responsibility of the London County Council and there are no disposal plants in the Borough. Although sewerage in the Borough is generally satisfactory, exceptionally heavy rainfall has from time to time caused the King's Scholars' Pond sewer to become surcharged, with consequent flooding of the basements of some business premises at a point immediately north of Oxford Street where a sharp change of direction occurs. During the year the County Council diverted this sewer through Wellington Place and St. John's Wood High Street and whilst the work was in progress complaints were received of stench from the open sewer. At the request of this department the Contractors provided some temporary shielding which reduced nuisance. The road level ventilators introduced on this new sewer line have caused renewed local complaint and the emanations are undoubtedly from the County Council middle level sewer which has long been a source of nuisance. As far back as 1955 discussions were held with the County Council regarding the provision of adequate high-level ventilation but so far no material progress has been made. Town Planning. Observations were made on 151 plans submitted to the Council under the Town and Country Planning Act, 1947, and referred to the Department. Rodent Control. There were 211 notifications of rats at premises in the Borough, a reduction of 61 on the previous year's figure. Notifications of mice however showed an increase of 96 over last year's figure of 264. Statistics of the monthly notifications indicate a higher average from June till October. There is no specific reason for this other than perhaps the influence of a wet summer and autumn. Block surveys have been continued and the system has been altered to give greater coverage, which involved 1,757 premises with the discovery of 23 un-notified infestations, as compared with 1,091 premises and 12 infestations last year. Sewer treatment began in May, when all suitable manholes and side-entrances were baited. A follow-up treatment, consisting of re-laying baits at side entrances only, was carried out about every six weeks. " Takes " were consistently recorded at these points, showing that colonies and individual migrant rats were being poisoned more or less continuously, resulting in the residual number of rats in the sewers being kept at a low level. The use of the polythene bag system, introduced last year, was continued and proved a satisfactory method of depositing bait. Statistics of rodent control are shown on Table 13, page 35. 13 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, 188 rooms were disinfested. 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 1960 the furniture of 18 families, of whom 16 were being rehoused, was treated by this method. In addition 278 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 continued to work most satisfactorily. Verminous Persons. The Council's Cleansing Station in Lisson Grove dealt with 652 verminous persons : adults 497 (men, 466 ; women, 31) ; children, 155 (boys, 42 ; girls, 113). The increase would appear to be due to the closing down of a treatment centre in an adjoining borough. 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. During the three years before the 31st December, 1956, the date on which certain provisions of the Clean Air Act, 1956, first came into force, the average annual number of complaints about smoke was 47, the highest figure being 55 in 1955. Sharp increases during the period 1957 to 1959 resulted in an annual average for those years of 155, the number of complaints reaching a maximum of 186 in 1959. Complaints during 1960 totalled 144, eleven less than the recent annual average and forty-two less than in the previous year. It is hoped that this first reduction in the number of complaints received annually since the Clean Air Act, 1956, began to operate is an indication that the efforts made to control the pollution of the atmosphere are meeting with success. Members of all sections of the community were co-operative and when infringements of the law were detected or conditions likely to lead to infringements were found, those responsible were generally willing to do everything possible to abate or prevent nuisance. During 1,283 casual observations it was necessary to time dark smoke emission on 53 occasions. There were 12 offences under Section 1 of the Clean Air Act relating to dark smoke, 8 emissions of smoke from chimneys in Smoke Control Areas contravening Section 11 were observed and there were 28 instances of nuisance by smoke, other than smoke from chimneys constituting an offence under Section 16. Abatement of the nuisance or attention to the plant, if not being given already, was secured in most cases forthwith. Offenders were cautioned but in no case did the circumstances justify legal proceedings. With the coming into operation on the 1st October, 1960, of the Council's third Smoke Control Order, affecting Ward No. 1 (Hamilton Terrace), the whole of that part of the Borough north-east of St. John's Wood Road and Prince Albert Road is within the boundaries of Smoke Control Areas. During the year a fourth Smoke Control Order in respect of Ward No. 10 (Cavendish Square) was submitted for approval to the Minister of Housing and Local Government and the survey of a fifth Area, Ward No. 8 (Portman Square) was commenced. Notifications of intention to instal new furnaces, as required by Section 3 of the Clean Air Act, were received in respect of 40 proposals and 10 applications for the Council's approval of the plans and specifications were received. The degree of atmospheric pollution was measured continuously at four sites within the Borough and statistical information was supplied regularly to the Department of Scientific and Industrial Research. The statistics are detailed in Tables 14, 15 and 16, pages 35 and 36. 14 Offices. There are some 3,364 office buildings in the Borough. The Offices Act, 1960, is due to come into operation on the 1st January, 1962, and further legislation is also anticipated. As an exploratory measure, seventy-two offices were inspected during the year. One defect commonly found was lack of through ventilation. This appears to be due to the practice of letting office accommodation in terms of space. The occupier moves in and erects partitions, from floor to ceiling, to form individual offices within the space. The partitioning prevents air movement and results in the formation of pockets of humid vitiated air with excess humidity which is most certainly not in the interests of either the well-being or the efficiency of the occupants. Shops. There are 2,472 shops in the Borough to which regular visits were made and in respect of which six notices were served. Ventilation is often a problem in shops and it is felt that shop-fitters should pay more attention to adequate free air movement when designing shop fronts and interiors. Conversely, complaints have been received of too much ventilation via open doors which during the winter leads to unreasonably low temperatures. Some shopkeepers apparently insist that an open door invites custom and their doors are kept open even during the coldest weather. The Shops Act requires that a " reasonable temperature " shall be maintained but, unlike the Factories Acts, does not give any standard. It therefore becomes a matter of hard bargaining with the shopkeeper to reach agreement on how best a reasonable temperature can be maintained despite an open door. The usual solution is to provide heaters where staff can warm themselves at intervals between serving customers. Factories. There were 1,918 factories on the register at the end of the year, 56 less 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 17 and 18, page 37. Outworkers. Sixty-eight employers submitted lists in respect of a total of 704 outworkers (169 contractors and 535 workpeople). Of these, thirty-six contractors and seventeen workpeople operated in the Borough. The nature of the different classes of work and the numbers of outworkers engaged is indicated in Table 19, page 37. Fireguards. Regular inspections were made under the provision of the Heating Appliances (Fireguards) Act, 1952, and in nineteen instances heaters were found which failed to comply with the requirements. The main fault was inadequate guards 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 again to be noted that auctioneers can still legally sell heating appliances which do not comply with the Regulations provided that they act on behalf of private individuals and not 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. Hairdressers and Barbers. The Council's Byelaws regulating these establishments came into operation on 18th December, 1955. There are in the Borough 146 registered hairdressers and barbers ; 148 inspections were made and 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, eleven 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 18 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. 15 Poisons. At the end of the year the names of sixty-three 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-four. Details are given in Table 20, 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 type 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. The Department controls 10 public conveniences and three urinals for men and seven conveniences for women. No special problems arose during the year, although staff shortages due to lack of suitable employees sometimes made it necessary to leave one or other of the less busy conveniences temporarily unattended ; no vandalism occurred. The rest room for women and changing room for men provided at Oxford Circus conveniences last year have been well used and fill an obvious need. The free washing scheme with paper towels and liquid soap, now established in its twelfth year, has become widely accepted by the public as a standard provision and other local authorities are gradually following the pattern set in this Borough. Public Cleansing and Salvage. The Director of Public Cleansing has kindly provided the following information :— “The materials dealt with during 1960 were : house and trade refuse, 36,291 tons ; street sweepings and gully sludge, 2,614 tons ; salvaged materials, 2,186 tons. A sum of £11,396 was obtained from the sale of salvaged materials. In addition, £2,142 was received for removing trade refuse and for 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 four times during the year and all streets swept at least once daily. Arrangements are being made for a pilot scheme of dustless refuse collection to be introduced into a part of the St. John's Wood Area, and two dustless loading vehicles and 1,500 dustbins have been ordered for this purpose. With the dustless system, refuse will be taken direct to the special vehicles in covered bins, which are mechanically emptied into the vehicles, thus preventing the escape of dust or litter. To reduce noise the new bins are fitted with a rubber ring at the base and a plastic ring inside the lid. If this scheme is successful, it is hoped to extend it to other areas in the Borough. Delivery was received of a 10 ton tractor and 30 cu. yd. bulk loading semi-trailer, which is capable of conversion to 40 cu. yd. capacity when suitable loading facilities have been provided at the Department's depot. This vehicle is being used to transport to the disposal plant at Westminster refuse brought to the Council's Central Depot in small capacity collection vehicles, thus eliminating frequent and uneconomic journeys by the latter. In emergencies the bulk loader will also be used to take refuse to tips outside the London area when the normal channel for disposal is not available. Delivery was also received of two pedestrian-controlled vacuum-operated footway cleaning machines, and these have proved successful, particularly in the residential areas of the Borough. An anti-litter campaign was organised during Whitsun week, to coincide with similar campaigns held by other local authorities throughout the country. A prominent feature of the campaign was a specially prepared publicity vehicle which was sent off from the Town Hall by His Worship the Mayor. 16 In July, His Worship the Mayor opened a new office and stores building at the Department's Central Depot, 23, North Wharf Road, W.2, and the whole of the Department's activities are now administered from this building." Refuse Storage Accommodation. Section 24 of the London County Council (General Powers) Act, 1959, required inter alia, that from the 1st April, 1960, new buildings or buildings substantially altered or adapted shall be provided with refuse storage accommodation approved by the Borough Council. The Department is concerned that suitable and sufficient accommodation shall be provided and the Director of Public Cleansing that the refuse shall be easily accessible for collection. Five schemes were approved during the year after consultation with the Director of Public Cleansing. 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 fillings 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 filling materials, including hair, fibre, rag flock, felt and wadding, were taken during the year and found to comply 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. Twelve burials and one cremation were arranged during the year. 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 five certificates were issued in respect of bodies being transported to Pakistan, Italy and Egypt. 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, 1,840 certificates authorising cremation were issued and since December, 1937, when the crematorium was opened, 21,089 cremations have taken place. Dog Nuisance. From 31st May, 1960, the Council's byelaw, made in 1928, dealing with this nuisance was repealed and replaced by a new byelaw which came into operation on 1st June, 1960, and is reproduced in substance on page 41. In many streets in the Borough permanent notices are attached to lampposts warning of the offence committed in allowing dogs to foul the footway. During the year, contraventions reported by the Streets Nuisance Inspector resulted in fourteen summonses of which two were not served. Twelve convictions were secured and penalties and costs amounting to £25 10s. 6d. were imposed. 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 17 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 1960 the Council took out seven summonses. Three were not served but convictions were obtained in respect of each of the other four cases, fines and costs amounting to £18 4s. Od. being imposed. SECTION D.—HOUSING Permanent Estates. The Town Clerk has kindly supplied the following information regarding housing accommodation provided by the Council up to 31st December, 1960 :— 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 40-47, Chapel Street 20 Newcourt Street 48 Church Street Extension (Part) 16 1,305 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) 16 Dwellings and “supermarket” in three storey block completed. Remaining 60 flats and 2 shops in 16 storey block due for completion early in 1961. 9/25, Cochrane Street (32 flats) Work has reached roof-construction stage. Further Development Linked with Slum Clearance. Broadley Street/Penfold Street (30 flats) Following the dismissal of the Council's appeal to the Minister against the planning authority's refusal of consent to an increase in the permitted density, a revised scheme for the erection of 30 flats has been adopted. Ashbridge Street (East)—(16 flats) Four properties on this site were purchased by voluntary negotiation and a Compulsory Purchase Order made on the remainder, Sketch plans for the scheme have been prepared. 18 Freshwater Place (16 flats) Planning consent has been received in respect of this site and tenders will be invited shortly. Mulready Street (171 flats) Draft proposals for the development of this site have been approved and planning consent is awaited. Clipstone Street (305 flats) Proposals for the redevelopment of the area bounded by Carburton Street, Cleveland Street, Clipstone Street and Great Titchfield Street, have been approved in principle. The London County Council's observations are awaited. Requisitioned Premises. Completion of the Council's de-requisitioning programme was effected by the 31st March, 1960. Of the 907 premises originally requisitioned the Council have acquired a freehold interest in 136 and a leasehold interest in 166. Housing (Financial Provisions) Acts, 1958 and 1959. (a) Loans.—The Council made loans during the year totalling £26,960 to enable applicants to acquire premises for owner-occupation. (b) Improvement Grants.—Discretionary and Standard Grants totalling £3,038 were made during the year to private owners to convert and improve existing premises. In addition a grant not exceeding £2,000 was approved to enable the Octavia Hill Housing Trust to improve 5 unfit houses in Cato Street. Factory-Made Bungalows. The Council received notice to vacate the Marlborough Hill site and themselves decided to determine their tenancy of the Marlborough Place site. It is expected that the 17 bungalows on these sites will be vacated early in 1961. These are the remaining bungalows provided under the Housing (Temporary Accommodation) Act, 1944. Housing of Old People. (a) 51/54, Beaumont Street.—The Council have prepared a scheme for the development of this site by the erection of 29 flats for old people. (b) The Ladies' Home for Gentlewomen: 41, Abbey Road, N.W.8.—The modernisation of these premises, towards which the Council agreed to make a grant of approximately £11,000, nears completion. (c) Dorset Chambers, Chagford Street, N.W.1.—The conversion of these premises into 16 selfcontained flats for elderly people, by Individual Housing (W.V.S.), Ltd., has now been completed. An improvement grant of approximately £6,000 was made by the Council towards the cost of the work. 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 6, 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 8, 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. One hundred and four confidential medical certificates referred to the Medical Officer of Health were considered in conjunction with reports from the public health inspectors on environmental circumstances and, where justified, additional points were recommended. 19 Closing Orders were made on 4 rooms and an undertaking received regarding 2 rooms. Where the occupiers could not be given alternative accommodation immediately, they received additional points increasing their degree of priority for rehousing and until they can be provided with other accommodation the operation of the closing orders remains in abeyance. Closing orders on 19 rooms were determined and orders on 5 rooms were varied. Land Charges Act, 1925. The Town Clerk referred to the Department 1,788 enquiries relating to details of any outstanding notices, orders or other restrictions on the properties concerned. Immigrants. The south-eastern corner of the Borough is contiguous with Soho and, as might be expected, contains a cosmopolitan population in which immigrants from Cyprus and European countries predominate. During the year, 49,700 West Indians, 6,000 Indians and 2,500 Pakistanis are reported to have arrived in England but very few of them appear to have become resident in St. Marylebone. Common Lodging Houses. There are two common lodging houses in the Borough. One accommodating 391 men is run by the Salvation Army, at No. 2, Burne Street and premises in Lisson Street. The other, conducted by the Church Army, at Portman House, No. 10, Daventry Street, is registered for 85 women. Regular inspections were made and at the quarterly fire inspections it was found that the firefighting equipment provided and the precautions taken were satisfactory in both lodging houses. Houses in Multiple Occupation: Artificial Lighting of Common Staircases. Byelaws were made by the London County Council in 1938 under Section 6 of the Housing Act, 1936, for securing the provision of adequate means for lighting common staircases of houses in multiple occupation. The enactment under which the Byelaws were made was repealed by the Housing Repairs and Rents Act, 1954. The power to make such Byelaws having been restored, and conferred upon Metropolitan Borough Councils under Section 63 of the London County Council (General Powers). Act, 1956, Draft Byelaws prepared by the Metropolitan Boroughs' Standing Joint Committee, and approved in principle by the Ministry of Housing and Local Government, were adopted by the Borough Council and came into effect on 15th November, 1960. The substance of the new Byelaws is set out on page 42. 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, 420 samples of food and drugs were examined. Of these, 5 were taken formally and 415 informally. The number adulterated or incorrect in some other manner was 72 and the incidence of adulteration may be classified as follows :— Number of samples examined, Number of samples adulterated,, etc. Milk 44 1 Other foods 370 69 Drugs 6 2 A bottle of milk was submitted and, when filled, it was seen that an area 4½ ins. x 1½ ins. was covered with minute black particles, but when the bottle was emptied these particles were barely visible although they were still adherent to the glass. The milk was satisfactory showing that the bottle had passed through the cleansing machine. A bottle of cream contained some general dirt, but the cream appeared to be satisfactory and had not commenced to go bad, indicating that this bottle also must have been through the cleansing process without the dirt being removed. 20 Some ‘real table cream dessert topping,’ packed in an aerosol pressure container with nitrous oxide gas, was claimed to keep, but was found to decompose once the cream was expressed into the nozzle and freed from the nitrous oxide. As the cream keeps inside the container under pressure of the nitrous oxide, the latter acts as a preservative and in the opinion of your analyst contravenes the Preservatives Regulations. Two samples of butter contained 16.4 and 16.15 per cent. of water respectively which is in excess of the 16 per cent. legal limit (Food Standards (Butter and Margarine) Regulations, 1955). Three samples of processed cheese were deficient in fat calculated on the dry matter ; they contained respectively 41.5 per cent., 30.7 per cent. and 35 per cent. of fat instead of 48 per cent. Two of these samples were labelled only in German. They were, moreover, margarine cheeses and should have been sold as such. A Bavarian blue cheese contained 46.1 per cent. of fat on the dry matter instead of 50 per cent., and the German label stating ‘50 per cent. Fett i.T. Kase 50 per cent.’ was not only misleading but incorrect. A sample of wheatmeal flour contained only 0.0165 per cent. of calcium carbonate which is half the quantity demanded by the Flour (Composition) Regulations, 1956. The label of a whole-meal baby food failed to comply with the Labelling of Food Order, as it was claimed to possess all the vitamins required but no quantities were given. It was in fact doubtful whether it contained all the vitamins required in spite of the fact that it had been ‘Bio-dynamically grown.’ In general, cereals are deficient in vitamin D, and oats, owing to their high content of phytic acid, require more vitamin D in order to enable calcium to be properly metabolised. Three samples of Tanganyika rice were examined. The first sample was dirty, containing small pellets of rice grain tissues mixed with insect hairs, dirt, vegetable tissue and small insect parts. Two further samples were submitted, before and after fumigation and cleaning. Before cleaning the sample contained 18 live weevils, 6 foreign seeds and 20 pellets consisting of clay and mixed vegetable matter. After cleaning approximately 12 pellets of shrivelled up rice and pieces of clay, and 2 pellets of insect parts, dirt and vegetable tissue remained in the rice. A sample of cornflakes was submitted with the complaint that it contained a black tarry foreign body attached to a cornflake, but this was found to be only a burnt cornflake. Five samples of bread contained foreign matter. One contained gear oil, another general dirt, the third a piece of grape stalk, the fourth a sultana and a currant, and the fifth sample a nail. Some cheese and celery biscuits were stated to have made two ladies ill, and examination showed they contained 30 per cent. of fat with Reichert value of 10.9, indicating that 60 per cent. of the fat was margarine type fat. The biscuits were, moreover, overcooked and nauseating to taste. Some fruit wholemeal biscuits contained only 1.44 per cent. of fruit and this was considered insufficient to justify their description as fruit biscuits. A coffee cake mix contained no coffee and the ingredients did not disclose any coffee, so that the label was misleading. It was an American product and, when sold in England, should be labelled in such a manner as to make its composition clear. A custard tart contained some black matter in the filling. This consisted of insect parts, plant tissue and general dirt, and had possibly become contaminated by falling dirt in the factory. A veal cutlet consisted of minced meat with 7 per cent. starch filler, whereas a veal cutlet should consist of one piece of meat and be a cutlet. Another veal cutlet submitted was contaminated with eggs of the house fly. Some canned ham was submitted with the complaint that it had an objectionable flavour. On opening the can the odour was not objectionable, the colour was good, but the meat was rather watery. The bacteriological count was low and no antibiotics could be detected, so that it was impossible to see any reason for the complaint of an objectionable odour. Two further cans of cooked shoulder ham were examined. The meat was discoloured and the bacteriological counts were high. Spoilage was probably due to inadequate processing. Some braised beef hearts in rich sauce contained only 46 per cent. total meat, which was considered insufficient since it has been agreed by the Association of Public Analysts and British Food Manufacturers that braised meat must contain not less than 95 per cent. of meat and braised meat in gravy not less than 75 per cent. of meat. Some beef sausages contained 47 per cent. total meat but as this is not much below 50 per cent., the quantity of meat usually expected for a beef sausage, they were reported as inferior. Other 21 sausages had been stored in galvanised iron buckets and contained respectively : zinc 100 p.p.m., iron 25 p.p.m. ; zinc 150 p.p.m., iron 40 p.p.m. ; and zinc 100 p.p.m., iron 25 p.p.m. It was interesting to note that the zinc appeared to pass through the skins of the sausages into the interior meat whereas the iron remained on the skins. Some Scotch eggs contained only 50 per cent. of sausage meat and it was considered that the layer of crumbs and frying oil were too thick. A mock salmon cutlet was essentially a superior coloured white fish cake and was not a cutlet. The label of ' Herring Fillets in Paprika Sauce ' was considered to have a misleading illustration, as paprikas were prominently illustrated but were present only in very small quantity. A product labelled ‘Bar-B-Qu Smoke’ for the flavouring of meat or fish consisted of an aqueous extract of wood tar oil, but there was no disclosure of ingredients. It contained 0.43 per cent. of phenols calculated as resorcinol. A canned consomme beef soup contained only 2.7 per cent. of protein, which did not comply with the requirements of the revoked Canned Meat and Canned Soup (Control and Maximum Prices) Order, 1941. When diluted according to the directions it made a very inferior product. Some Kosher condensed chicken soup with matzo balls contained only 10.94 per cent. of total solid matter with 1.87 per cent. of protein, and when diluted as directed with an equal volume of water the total solids would be reduced to 5.5 per cent. and the protein to 0.9 per cent. The label of a lobster bisque with cognac was considered misleading as the product contained less than 1 per cent. of cognac. Some chocolate novelties were of very poor quality, but were probably sold at a low price. A walnut delight was stated to have been prepared from seedless raisins, dates, walnuts, and honey, but at least half the so-called walnuts were cashew nuts, so that it should have been labelled ' walnut and cashew nut delight,' with cashew nuts included amongst the ingredients. The green colour used for a sample of coloured sugar crystals was a colour permitted in the United States but not in this country and the blue dye used for some cake decoration balls was also a colour not permitted in this country. A sample of marmalade contained 60.8 per cent. only of soluble solids, calculated as sucrose. The marmalade was packed in a hermetically sealed container and must contain not less than 65 per cent. of soluble solids. In spite of considerable correspondence no satisfactory description has yet been suggested by the manufacturers. A Greek product labelled ‘Quince Gelly’ neither complied with the requirements of the Food Standards (Preserves) Order nor was it labelled with a list of its ingredients. A pineapple flavourd curd and a banana flavoured curd were received, but by implication such curds cannot be sold since the Food Standards (Preserves) Order requires all fruit curds to contain lemon or orange oil. Some prunes were reported as inferior because a maggot and insect faeces were present in the 5 ozs. received, and most of the prunes were more or less covered with a bloom consisting of yeast colonies. Muscatel cluster raisins contained 12 raisins attacked by insects, some debris of raisin tissue and insect faeces, probably from maggots, and insect webbing was also present. The sample was reported as inferior. A mineral water possessed a paraffin odour. When submitted for examination the bottle contained less than l/5th of a fluid ounce of liquid so that it appeared that some 98-99 per cent. of the contents had been consumed before the taint was noticed. The stopper and washer of the bottle were the probable origin of contamination. Some raspberry syrup contained sulphur dioxide which was not declared, though the label purported to make a declaration of ingredients. If any ingredients are declared they must all be listed except water. A dried coffee extract was labelled ‘Pure Coffee in Powder Form—100 per cent. Pure Coffee,’ whereas it was a sample of dried coffee extract and should have been described as ' coffee extract in powder form—100 per cent. pure ' without the final coffee. A seed tea consisted of four mixed spices, caraway, anise, fennel, and coriander and was very satisfactory as such, but these ingredients were not disclosed as required by the Labelling of Food Order. A sample of roasted chick peas was salted, but the presence of the salt was not disclosed. Some broad beans contained 32 per cent. of worm eaten beans and three pupa cases, whilst another sample contained 8.5 per cent. of worm eaten beans. A sample of brown beans contained 7 dead beetles and continental lentils contained 0.28 per cent. of stones. 22 Some parsley and thyme stuffing contained 2.9 per cent. of fat, of which 40 per cent, had been decomposed by the enzymes of the herbs to free fatty acids. Fourteen samples of 'chili' or 'chilli' sauce were examined and were mostly satisfactory as sauce, though one contained 800 parts per million of benzoic acid, the maximum quantity permitted being 250 parts per million. Some of these samples were either tomato ketchup or tomato sauce. One manufacturer claimed that the word' chili' referred to the country, others pointed out that these descriptions are acceptable in America. There may be some sympathy with American manufacturers wishing to market their products in this country under their American descriptions, but this does not justify British manufacturers doing the same thing. A sample of pickled red cabbage contained sugar and saccharin, the presence of which was not disclosed on the label and a lime pickle contained 11.9 per cent. of salt without disclosure. A curry sauce was also incorrectly labelled. Two samples of solution of acetic acid contained excessive quantities of acetic acid, but one can accept the fact that such an excess would not have been added intentionally on account of cost. The tin container of a sample of soya bean oil leaked rather badly and as soya bean oil oxidises fairly readily, not only would the purchaser obtain short measure, but the product would rapidly become rancid. Food Legislation The year brought little change in food legislation, although the Food Standards Committee issued two long reports, of which mention will be made later. The Food Hygiene (General) Regulations, 1960, consolidated and amended the previous regulations. One amendment extends the regulations to cover the cleaning of food utensils and equipment, but it is remarkable that no regulations have yet been made to cover the material of which food handling utensils and equipment are made. Over many years attention has been drawn to the risk involved in using articles such as enamelware coated with antimony enamels and toasting prongs coated with lead, but it is still necessary to show that the food stored in or treated with this equipment has been contaminated before any action can be taken. The Milk (Special Designation) Regulations, 1960, prescribe modifications of the existing Methylene blue test, provide a fresh Phosphatase test for pasteurised milk, and also provide a new test, the Clot-on-Boiling Test for tuberculin tested milk. The Skimmed Milk with Non-Milk Fat Regulations, 1960, cover fresh ground in food law in as much as they provide for the sale of milk, condensed milk, and dried milk, from which the original milk fat has been removed and replaced by other fats or oils. Fats and oils used for this exchange are generally of vegetable origin and are intended primarily for persons suffering from coronary disease, and the reconstituted milk products are not to be used for babies. The Regulations are unfortunate in that they 'do not apply to any food intended at the time of sale for export from the United Kingdom,' because certain foreign governments accept foods, which comply with the requirements of the British Food and Drugs Act to be admitted into their countries and accept the certificates either of any public analyst or of certain recognised public analysts to this effect. Any Regulations should, therefore, be so worded that they apply only to countries where there are no restrictions. Another unfortunate provision in these regulations is that the labelling requirements do not apply to sales to catering or manufacturing businesses or to sales for immediate consumption. One would have thought that the casual consumer or ' eaterout ' is as much entitled to know what he is consuming as the purchaser buying a pre-packed food for use in the home. The Arsenic in Food (Amendment) Regulations, 1960, increase the amount of arsenic in brewers' yeast to be used in manufacture from 2.0 to 5.0 parts per million when calculated on the dry matter, but make no other alteration to the existing regulations. The Report of the Departmental Committee on ' Milk Composition in the United Kingdom ' occupies some 86 pages and makes 23 main recommendations, which may be summarised as follows :— (a) Milk should continue to be sold as it comes from the cow except for separated and other - grades, which must be clearly labelled ; (b) Efforts should be made to improve the quality of milk both with regard to fat and solids- not-fat, though the committee is more concerned about the solids-not-fat than the fat content; 23 (c) The presumptive minimum standards should in five or ten years' time become minimum legal standards for sale to the consumer ; (d) The Hortvet Freezing test should be made legal subject to certain provisos ; (e) Differential payment schemes should be introduced according to the quality of the milk ; (f) Better provision should be made for the testing both of bulk and of individual cow milks. The Food Standards Committee Report on Bread and Flour occupies 19 pages and includes 24 general recommendations regarding flour and 10 regarding bread, but it also contains 51 pages of Appendices. The main provisions are that all flour required to be fortified at present should continue to be fortified for the present and that no change should be made in the quantities prescribed, that all sampling should be made at mills or docks, and that only certain bleaching and improving agents should be permitted. It is recommended that there should be a statutory list of ingredients permitted to be used in bread, that descriptions of ' protein,' ' milk ' and ' Slimming ' breads should be controlled, and that exaggerated claims for enrichment or energy-producing qualities of bread should be prohibited. Thomas McLachlan, Public Analyst." Food—Adulterated or Unsatisfactory Samples. Twenty-seven of the seventy-two unsatisfactory samples referred to in the Analyst's report concerned technical faults in labelling or description and, after consultation with the manufacturers, at the end of the year only one case was outstanding where the label had not been revised or corrected. The other samples reported upon adversely consisted of minor contraventions and these were dealt with informally. Unsound Food. Approximately twelve tons of food were voluntarily surrendered for destruction and certified as being unsound and unfit for human consumption. Details are given in Table 24, page 39. This is 3 tons more than was surrendered last year and the increase is accounted for by the fact that a sausage manufacturing firm have temporarily taken wholesale and storage premises in the Borough. No other large consignments calling 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. Milk. There are 89 registered premises from which milk is sold and 14 milk roundsmen operate in the Borough from shops or depots elsewhere. The Milk (Special Designation) Regulations, 1960, came into operation during the year and consolidate and amend the previous regulations relating to raw milk and pasteurised and sterilized milk. So far as the department is concerned, the principal changes are that instead of separate licences a dealer's (pre-packed milk) licence is introduced to permit the sale of all three kinds of designated milk; the period for which licences are granted is extended from one year to five years ; dealer's licences will permit sales outside as well as inside the licensing authority's area and supplementary licences will no longer be necessary for this purpose. With regard to milk sampling, a licensee is no longer required to allow samples of milk to be taken free of charge, conditions of the methylene blue test are modified, and a different phosphatase test is prescribed for pasteurised milk. During the year, 298 applications for licences were received and details are given in Table 21, page 38. The average percentage composition of the 44 genuine samples of milk analysed was : total solids 12.2, fat 3.09, solids not fat 8.73, the legal minima being, 11.50, 3.00, and 8.50 respectively. Fourteen samples of milk taken at the premises of two wholesale firms operating heat treatment plants were submitted to the tests prescribed for the various designations and all were reported to be satisfactory. The Council's Bacteriologist examined 50 other samples of milk and all were found to comply with the requisite standards. Ice-Cream. Three premises are registered for the manufacture of ice-cream and 193 for sale and storage. Details of the classes of premises are given in Table 22, page 38. Twelve samples of ice-cream were examined by the Council's Bacteriologist, with the following results: Grade I—9; Grade II—3; twelve samples submitted for chemical analysis were also reported to be satisfactory. 24 Preserved Food. Fifty-nine premises are 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 22, page 38. Catering Establishments. There are in the borough 1,121 premises of this type, details of which appear in Table 23, page 39. During the year 2,093 inspections were made and 48 informal notices served. Many proprietors now realise the advantages of mechanisation, particularly where staff difficulties exist. Washing-up used to be regarded by staff and proprietors alike as an unimportant task, poorly paid and degrading, so that there has always been a shortage of suitable staff for this work. However, the importance of washing-up has now been realised and machines have not only done much to overcome the staff problem but have resulted in cleaner crockery, cutlery and kitchen utensils. Formerly the " washerup " had not been legally defined as a food handler but this omission was rectified in the Food Hygiene (General) Regulations, 1960. Caterers who still do their washing-up by hand have also realised that crockery, etc., is not really clean unless it is sterilized. The special properties of detergent-sterilizers are now appreciated and these are being increasingly used with obvious advantage. Regular inspection and the co-operation of the caterers has brought about generally cleaner conditions in the storage, preparation and serving of food. Sanitary Conveniences—Provision at Inns, Refreshment Houses, etc. Under Section 25 of the London County Council (General Powers) Act, 1959, a Borough Council may require the owner or occupier of any Inn, Refreshment House or place of public entertainment (not coming within certain exempted classes of premises listed below), to provide and maintain in a suitable position a reasonable number of sanitary conveniences for use of persons frequenting the premises. If necessary the Borough Council may, by agreement, execute at the expense of the owner or occupier such works as are necessary and recover the costs in the manner laid down in the London County Council (General Powers) Act, 1951. The classes of premises which are exempted are as follows:— (a) those in respect of which a licence is in force under the Disorderly Houses Act, 1751, or the Cinematograph Acts, 1909 and 1952; (b) premises licensed for the consumption of intoxicating liquor on the premises; (c) premises licensed for the public performance of stage plays; (d) premises forming part of railway stations. It was not necessary for any notices to be served under this Section during 1960. Wholesale and Retail Food Premises. Excluding catering establishments there are 592 of these premises, details of which appear in Table 23, page 39. During the year, 2,243 inspections were made and 122 informal notices served. One of the main faults found is the incorrect storage of food. Stock-rooms are often overcrowded, or food is placed directly on the floor, thus preventing effective cleaning and exposing food to the risk of contamination. In most cases the provision of suitable duckboards would improve matters but there are instances where the storeroom is too small for the amount of stock which has to be carried. Another result of overcrowded storerooms is that stock is drawn upon out of rotation and this leads to the sale of food which is stale or otherwise out of condition. Thorough and efficient cleaning is still difficult to achieve and lack of staff has resulted in the employment of part-time cleaners who only concern themselves with cleaning away the easily visible dirt and ignore the surfaces above and below fixtures. Several complaints were received regarding dirty milk bottles but in some cases the complainants were unwilling to give evidence in court. Despite the precautions instituted by the dairy companies at their bottling plants there is a regular incidence of this type of complaint. Although offences are proved in court and fines imposed and there is unwelcome publicity, nothing effective seems to be done to remedy matters. However, the use of non-returnable cartons is increasing and their general adoption as milk containers would do away with the need for bottle-washing, with its attendant risks of bottles which should be rejected emerging from the process undetected. At present the cost puts them at a disadvantage with the bottle but improvements in manufacture and in the speed of filling should help matters. 25 Complaints are often received of unprotected bread and of crates of milk left on the forecourts of premises, usually in the early hours of the morning, attracting the attention of dogs and cats, etc. Early morning inspections have confirmed the existence of these unsatisfactory conditions and the attention of the suppliers has been drawn to the Food Hygiene Regulations which prohibit the placing of unprotected food lower than eighteen inches from the ground or otherwise exposing it to the risk of contamination. Similar conditions occur in the street markets. Compliance with the Borough Council's Street Trading Byelaws can sometimes lead to difficulty in meeting the requirements of the Food Hygiene Regulations in as much as the former provide for stock to be kept underneath the stalls where, because of the limited space, foodstuffs are placed on or within eighteen inches of the ground and thus contravene the Regulations. Several street traders were found to be selling imported apples and tomatoes which were either not labelled as such or described as "English." In each case the trader was warned of the offence and his attention drawn to the relevant Orders made under the Merchandise Marks Act. More shops have installed deep-freeze cabinets which, if correctly used and maintained, are an asset. Unfortunately, should they break down the whole contents often have to be destroyed. It is still evident that, in general, employees need to be impressed with the importance of hygiene and what is good and what is bad practice. Every opportunity is taken by inspectors to draw attention to this bat managements frequently complain that staff are not interested. During the year, Codes of Practices in respect of the hygiene of handling, storing and transporting in the meat and fish trades were published and although they have no statutory force, the Codes are intended to make a helpful and practical contribution. Copies were sent to all butchers and fishmongers in the Borough and it is hoped that the recommendations made, which have been agreed by the appropriate trade associations, will be implemented. The Food Hygiene (General) Regulations, 1960, came into operation during the year and these consolidate and amend the 1955-1957 Regulations. Among the changes are the extension of th : definition of " the handling of food " to include the cleaning of food utensils and equipment, whilst the person carrying on the food business is now principally responsible for securing compliance with the Regulations, a manager or foreman being also required to take all reasonable steps to secure compliance by the food handlers under his control. Food Stalls. During the year food was sold from 91 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. Horseflesh. There are no shops in the Borough selling horseflesh for human consumption. Slaughter of Animals. There are no slaughterhouses in the Borough but in the grounds of the Zoological Society of London for many years there has been a knacker's yard, licensed by the Council, where animals are slaughtered for feeding purposes. This yard has now been replaced by a new building which was completed during the year. Twelve inspections were made and conditions found to be satisfactory. 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, 326 notifications being received as against 430 in the previous year. Of the total, measles accounted for 145, the figure for 1959 being 250. 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. There was only one case of poliomyelitis (non-paralytic) and for the twelfth successive year there was no diphtheria. Table 25, page 39, gives details of notifications and the age groups concerned. Smallpox Contacts. On 6th October, 1960, information was received from the Medical Officer of Health of Westminster that, on that same day, a Dutch businessman who had arrived in this country on 3rd October by air 26 from Singapore had visited the out-patients' department of a hospital where he had been diagnosed as suffering from modified smallpox. Some twelve contacts were stated to have proceeded to addresses in this Borough. The necessary enquiries were made immediately and vaccination of all primary contacts was carried out, for the most part at a special clinic set up at Westminster. Vaccination was also offered to all known secondary contacts. The primary contacts were kept under daily surveillance and fortunately no other cases of the disease developed. Anthrax. On 2nd May, the Middlesex Hospital reported that an out-patient appeared to be suffering from Anthrax. The diagnosis was subsequently confirmed, and the Medical Officer of Health of Wood Green, where the patient lived, was informed. Later it was established that the patient was employed at an address in this borough and investigations there showed that as the secretary of a staff horticultural society he handled bonemeal for use as fertilizer. Examination of samples of the bonemeal revealed that certain bags which had come originally from Pakistan were infected with Anthrax. The whole of remaining stock was collected and destroyed and advice was given as to precautionary measures to be taken by members of the horticultural society who had already received allocations of the bonemeal. No further cases developed. Tuberculosis. Table 25, page 39, gives information regarding primary notifications of pulmonary and non-pulmonary tuberculosis received during the year. Table 26, page 40, 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 150 visits by one of the women public health inspectors to all new cases and those moving into the Borough from other areas. Food Poisoning. Ten cases of food poisoning were notified during the year. Seven of these were single unrelated incidents, whilst the other three involved members of one family. Of the former, the agents identified as causing illness were, in one case salmonella infantis, in two salmonella typhi murium and in a fourth an unspecified toxin. The causes of the other three single cases were not traced. The family outbreak involved a father and two children, one whom first became ill and was removed to hospital where salmonella typhi murium was isolated as the responsible organism. Routine testing showed the presence of the same organism in the stools of the father and the other child, though they were both quite symptomless. The source of the infection was not discovered. 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 38 cases of scabies : adults 23 (men 12, women 11); children 15 (boys 6, girls 9). Disinfection. During the year, 65 rooms, 948 articles of bedding (mattresses, blankets, sheets, bolsters, pillows, etc.) and 214 books, were disinfected. The department continued to be asked by residents to certify that clothing intended for despatch to foreign countries, mainly in central and eastern Europe, was free from infection. Disinfection was carried out only when the articles concerned had actually been in contact with infectious disease. 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, 178 certificates relating to a total of 2,485 articles, were issued. 27 Exclusion from Work of Contacts or Carriers of Infectious Diseases. If with a view to preventing the spread of a notifiable infectious disease, or certain other diseases as provided in Section 26 of the London County Council (General Powers) Act, 1959, a Medical Officer of Health for a borough requests in writing a person to discontinue his employment, the Borough Council are empowered by the Act, if they think fit, to compensate such person for any loss occasioned by his compliance with the request. Similarly, 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 they are contacts or carriers. These provisions apply particularly to food handlers in shops, to cooks, kitchen hands and others employed in cafes, canteens and restaurants and to persons in charge of young children. During the year three certificates were issued in this connection. 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 5,420 of these certificates were authenticated. Bacteriological Examinations. Table 28, 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 year † 1 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upwards M. F. M. F. M. F. M. F. M. F. M. F. M. F. 1 tuberculosis, respiratory 4 1 - - - - - - - - 1 1 3 - 2 Tuberculosis, other 2 1 — - - - — - 1 - 1 1 - - 3 Syphilitic disease 2 3 - - - - - - - - - - 2 3 4 Diphtheria - - - - - - - - - - - - - - 5 Whooping cough - - - - - - - - - - - - - - 6 Meningococcal infections - - - - - - - - - - - - - - 7 Acute poliomyelitis — — — — — — — - — - - - - - 8 Measles — — — — — — — — — - — — — - 9 Other infective and parasitic diseases - - - - - - - - - - - - - - 10 Malignant neoplasm, stomach 15 12 - - - - - - 1 1 3 1 11 10 11 Malignant neoplasm, lung, bronchus 40 8 - - - - - - - - 23 5 17 3 12 Malignant neoplasm, breast — 28 - — — — — — — 2 — 12 — 14 13 Malignant neoplasm, uterus 1 9 - — — — — — 1 1 — 4 — 4 14 Other malignant and lymphatic neoplasms 55 65 1 - - - 1 - - 2 23 19 30 44 15 Leukaemia, aleukaemia 3 1 — — — — — — 1 - 1 - 1 1 16 Diabetes 6 3 - - - - - - - - 2 1 4 2 17 Vascular lesions of nervous system 62 92 - - - - - - - - 7 9 55 83 18 Coronary disease, angina 110 67 - - - - - - 3 1 43 12 64 54 19 Hypertension with heart disease 14 32 - - - - - - - - 2 1 12 31 20 Other heart disease 52 87 - - - - - - 2 2 5 3 45 82 21 Other circulatory disease 20 29 - - - - - - - 1 3 3 17 25 22 Influenza — — — — — — — — - — - — - - 23 Pneumonia 19 27 1 — — — — — 1 - 4 3 13 24 24 Bronchitis 36 25 — — — — — — 1 — 5 2 30 23 25 Other diseases of respiratory system 8 4 - - - - - - - - 3 2 5 2 26 Ulcer of stomach and duodenum 4 3 - - - - - - - - - 1 4 2 27 Gastritis, enteritis and diarrhoea 2 3 — — 1 — — .— — — — 1 1 2 28 Nephritis and nephrosis 1 — — — — — — - —- — — — 1 — 29 Hyperplasia of prostate 5 - - - - - - - - - - — 5 — 30 Pregnancy, childbirth, abortion - - - - - - - - - - - - - - 31 Congenital malformations 5 3 1 1 2 — 1 — — — — 2 1 — 32 Other defined and ill-defined diseases 36 40 12 4 — — — — — 9 3 15 33 33 Motor vehicle accidents 6 2 — — — 1 1 — 1 — 2 - 2 1 34 All other accidents 8 9 — — - — 2 1 — 1 5 2 1 5 35 Suicide 12 8 — — - — — — 4 3 7 3 1 2 36 Homicide and operations of war - - - - - - - - - - - - - - Totals 528 562 15 5 3 1 5 1 16 14 149 91 340 450 1,090 20 4 6 30 240 790 † There were no deaths in the age group 1 and under 5. 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 4 2 - - - - - - - - - - - - 4 2 Premature Birth 5 1 - - - - - - - - - - - - 5 1 Broncho-Pneumonia — — — — — — — 1 1 — — — — — 1 1 Congenital Heart Defect - - - - 1 - - - - - - - - - 1 - Haemolytic disease 1 - - - - - - - - - - - - - 1 - Multiple congenital abnormalities - - - 1 - - - - - - - - - - - 1 Respiratory failure 2 - - - - - - - - - - - - - 2 — Retroperitoneal sarcoma - - - - 1 - - - - - - - - - 1 — Totals 12 3 — 1 2 — — 1 1 — — — — — 15 5 31 TABLE 3.—Weather Statistics. Station : Regent's Park. Height of rain-gauge above mean sea level: 129 feet. 1960 Air Temperature in Degrees Fahrenheit Rainfall Weather Number of Days Sunshine Means of Mean of A and B Highest and Lowest Total 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 Amt. Date °F. °F. °F. °F. °F. in. in. hrs. hrs. % Jan. 44.7 36.3 40.5 55 4 25 14 1.81 .60 23 19 - - 3 11 14 - 40.5 1.31 138 Feb. 46.4 36 6 41.5 63 29 27 18 2.28 .31 12 14 - - 2 5 12 - 74.3 2.56 160 Mar. 50.1 40 4 45.3 60 15 34 7, 20 1.92 .53 28 11 - - — — 7 - 59.7 1.93 65 April 57.9 42.1 50 0 66 20 34 17, 27 .49 .21 7 4 - - — — 7 - 152.2 5.07 115 May 65.8 49.5 57.7 75 7, 8 42 2,3 1.65 .84 19 7 - - - - - - 168.5 5.44 90 June 71.4 54.4 62.9 83 5 46 30 1.64 .33 14 10 - - - - - - 232.9 7.76 114 July 68.5 54.8 61.7 74 28 45 1 3.59 .95 19 16 - - - - - - 143.8 4.64 75 Aug. 69.0 54.4 61.7 77 23 47 13, 19 2.86 .88 11 12 - - - - - - 154.1 4.97 87 Sept. 65.5 51.4 58.5 77 11 45 25 4.89 1.50 1 11 - - - - - - 126.2 4.20 100 Oct. 58.2 47.6 52.9 69 2 34 13 5.66 .88 26 24 - - 2 — 2 - 75.l 2.42 90 Nov. 52.8 42.6 47.7 63 1 33 7, 28 13, 14 4.21 .75 21 24 - - - - 7 - 61.9 2.06 150 Dec. 44.8 37.3 41.1 55 3 32 29 2.32 .73 3 12 - - 2 3 14 - 41.6 1.34 156 * Average for years 1921-1950. 32 Table 4.—Summary of Road Accidents. Month Number of Accidents Fatal Injuries— Serious Slight January 80 1 15 87 February 79 1 6 88 March 85 1 14 98 April 82 1 11 92 May 78 2 14 78 June 96 — 16 101 July 108 — 9 134 August 91 — 19 98 September 91 1 17 102 October 103 — 9 111 November 84 2 14 84 December 77 1 5 101 Totals 1,054 10 149 1,174 TABLE 5.—New Legislation. Legislation Operative Date London County Council (General Powers) Act, 1960 29.7.1960 Caravan Sites and Control of Development Act, 1960 29.8.1960 Clean Rivers (Estuaries and Tidal Waters) Act, 1960 29.9.1960 Noise Abatement Act, 1960 27.11.1960 Oil Burners (Standards) Act, 1960 1.1.1961 Betting and Gaming Act, 1960 1.5.1961 Offices Act, 1960 1.1.1962 Public Health Laboratory Services Act, 1960 To be appointed Radioactive Substances Act, 1960 Civil Defence (Disease) Regulations, 1960 1.4.1960 Poison List Order, 1960 19.4.1960 Poisons Rules, 1960 19.4.1960 Slaughter of Animals (Prevention of Cruelty) Regulations (Appointed Day No. 1) Order, 1960 1.7.1960 Slaughterhouses (Hygiene) Regulations (Appointed Day No. 1) Order, 1960 1.7.1960 Authorised Officers (Meat Inspection) Regulations, 1960 12.8.1960 Caravan Sites (Licence Applications) Order, 1960 29.8.1960 Food Hygiene (General) Regulations, 1960 1.10.1960 Milk (Special Designation) Regulations, 1960 1.10.1960 Slaughter of Animals (Prevention of Cruelty) Regulations (Appointed Day No. 2) Order, 1960 1.10.1960 Slaughterhouses (Hygiene) Regulations (Appointed Day No. 2) Order, 1960 1.10.1960 Food Hygiene (Docks, Carriers, &c.) Regulations, 1960 1.11.1960 Meat (Staining and Sterilising) Regulations, 1960 1.11.1960 Public Health (Infectious Disease) (Amendment) Regulations, 1960 1.12.1960 Arsenic in Food (Amendment) Regulations, 1960 14.12.1960 Factories (Cleanliness of Walls and Ceilings) Order, 1960 1.1.1961 Slaughterhouses (Hygiene) Regulations (Appointed Day No. 3) Order, 1960 1.1.1961 Skimmed Milk with Non-Milk Fat Regulations, 1960 19.9.1961 Byelaws made by Borough Council: Fouling of Footways by Dogs 1.6.1960 Artificial Lighting of Staircases 15.11.1960 33 TABLE 6.—Dwelling-Houses : Summary of Inspections, Conditions Found and Action Taken. Inspection under Public Health or Housing Acts:— (1) (a) Inspected for housing defects 1,000 (b) Inspections made for the purpose 3,739 (2) Found to be in a state so dangerous or injurious to health as to be unfit for human habitation 18 (3) Found not to be in all respects reasonably fit for human habitation 386 Defects remedied without service of formal Notices:— Defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 328 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 255 (2) Dwelling-houses in which, after service of formal notices, defects were remedied:— (a) By owners 58 (b) By Local Authority in default of owners 2 (b) Proceedings under the Housing Act, 1957:— (1) Rooms in respect of which Closing Orders were made:— Underground rooms 4 Other rooms - (2) Closing Orders determined, the tenement or room having been made fit 9 (3) Rooms affected by (2) above 19 (4) Closing Orders varied 5 (5) Undertakings accepted in respect of underground rooms 2 TABLE 7.—Nuisances Remedied. Nuisance Abated or Defect Remedied Number Houses damp, dirty or dilapidated 156 Doors, windows, floors, ceilings, sash cords, grates and flues, etc., defective 319 Drain, water-closet and waste pipe stoppages 56 Drains, water-closets and waste pipes defective 108 Yard, area and wash-house defects 20 Roofs, gutters and rainwater pipes defective 180 Insufficient water supplies 14 Water cisterns dirty or defective 17 Ashpits, dustbins, etc., defective 35 Rubbish accumulations 63 Animal nuisances 11 Miscellaneous 38 Total 1,017 TABLE 8.—RENT ACT, 1957. Applications for Certificates of Disrepair 4 Notices served on landlords of Proposal to issue Certificate of Disrepair 3 Undertakings received from landlords — Certificates of Disrepair issued 3 Applications for Certificates as to Remedying of Defects — Certificates as to Remedying of Defects issued — Applications for cancellation of Certificates of Disrepair — Certificates of Disrepair cancelled — 34 TABLE 9.—Legal Proceedings: Public Health (London) Act, 1936. Non-compliance with Nuisance Notice regarding Result Fine Costs £ £ s. d. 92, Gloucester Place Guilty 2 1 1 0 3 months abatement order - 5 5 0 TABLE 10.—Legal Proceedings: Food Hygiene. Date of Hearing Offence Result 12.2.60 Smoking whilst handling open food (Food Hygiene Regulations. 1955-57) Fined £5 with £2 costs TABLE 11.—Chemical Examination of Water supplied to St. Marylebone— Average Results. Milligrammes per Litre (unless otherwise stated) Supply derived from River Thames No. of samples 363 Ammonia Nitrogen 0.030 Albuminoid Nitrogen 0.081 Nitrate 4.0 Chlorides as Cl. 28 Oxygen abs. from Permanganate 4 hrs. at 27° c. 1.24 Turbidity units 0.4 Colour m.m. brown 2ft. Tube Burgess's Tintometer 13 Hardness (total) 260 Hardness (non-carbonate) 66 pH. Value 7.8 Phosphate as PO4 0.95 Silicate as SiO2 9 Sulphate as SO4 58 Flouride as F. 0.25 Magnesium as Mg. 4 Surface active material as manoxol 0.12 Electrical Conductivity (gemmhos) 525 35 TABLE 12.—Bacteriological Examination of Water supplied to St. Marylebone— Average Results. Supply derived from River Thames After Treatment Agar plate count per ml. Coliform count E. coli count Number of samples 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. 3,652 11.4 — 99.15 100.0 TABLE 13.—Rodent Control. Complaints received 571 Dwellings 399 Business premises 172 Rats 211 Mice 360 Blocks surveyed 48 Premises involved 1,757 Premises disinfested 570 Black rats 2 Brown rats 175 Mice 393 Treatments carried out 2,037 TABLE 14.—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 tier sq. mile (collected in deposit gauges) N.l. 12.28 14.45 10.03 11.92 8.53 10.54 16.81 12.19 9.15 7.23 17.96 20.07 t.h. 9.24 10.01 11.85 7.87 9.19 8.08 7.58 8.72 8.50 11.78 7.67 5.06 Soluble Matter—Tons per sq. mile (collected in deposit gauges). N.l. 7.06 8.97 6.45 7.03 5.33 5.04 9.08 7.86 7.73 11.55 8.05 7.43 t.h. 5.40 8.83 10.84 8.49 7.78 7.21 8.95 15.25 18.50 19.62 7.52 3.21 Sulphur Trioxide—Milligrams per day collected (per 100 sq. cm. of lead peroxide) N.l. 3.67 3.57 2.09 1.22 1.38 1.15 1.05 0.88 1.09 1.78 3.59 3.49 t.h. 6 24 5.53 5.52 3.02 3.11 2.42 1.76 1.94 2.93 4.68 5.04 5.58 E.R. 5.07 4.59 5.59 2.58 2.69 1.77 1.04 1.16 2.42 i 3.57 4.26 4.72 Smoke—Milligrams per 100 cubic metres of air average per day (Volumetric method) t.h. 23 26 22 — 6 4 4 4 9 11 26 29 G.P. 30 30 18 4 5 4 2 - — 12 33 44 Suplhur Dioxide-Parts per 100 million parts of air average per day (Volumetric method) t.h. 15 15 14 8 4 3 5 8 11 11 15 G.P. 13 11 9 4 5 4 2 - - 7 7 8 36 TABLE 15.—Air Pollution. Annual Daily Average of Mean Concentration of Smoke and Sulphur Dioxide. Site 1960 1959 1958 1957 1956 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.. 15 10 17 12 20 10 23 9 34 11 G.P. 18 7 19 10 20 8 24 8 32 9 TABLE 16.—Air Pollution. Annual Monthly Average of Deposited Matter and Sulphur Trioxide. Site 1960 1959 1958 1957 1956 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. 18.92 3.98 19.80 4.49 20.87 4.16 17.7 3.9 19.22 3.9 N.L. 20.22 2.08 18.06 2.38 22.28 2.78 20.8 2.6 17.24 2.4 D.S. — — — — 21.9† — 17.3 — 18.9 — E.R. - 3.28 — 3.79 - 3.13 — 3.4 - 3.5 Notes to Tables 14, 15 and 16 Sites: N.L. 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.) † Average for three months only. 37 TABLE 17.—Factories: Inspections for Purposes of Provisions as to Health. Premises Registered Inspections Written notices Occupiers prosecuted 186 202 11 - Factories with mechanical power 1,297 901 43 — Other premises* (excluding outworkers' premises) 435 511 — — Totals 1,918 1,614 54 — * Electrical stations, institutions, sites of building operations and works of engineering construction. TABLE 18.—Factories: Defects Found. Particulars Defects Found Remedied Referred In respect of which prosecutions were instituted To H.M. Inspector of Factories By H.M. Inspector of Factories Want of cleanliness 24 17 2 5 - Overcrowding — — — 2 — Unreasonable temperature — — — — — Inadequate ventilation — — — 2 — Ineffective drainage of floors — — — — — Sanitary conveniences :— (a) insufficient 1 1 — 1 — (b) unsuitable or defective 47 40 — 6 — (c) not separate for sexes 1 1 — 2 — Other offences (excluding offences relating to outwork) 34 32 4 7 — Totals 107 91 6 25 — TABLE 19.—Summary of Outwork. Description of Work Outworkers Employed Wearing apparel 695 Textile weaving 5 Curtains and furniture hangings 2 Furniture and upholstery 1 Household linen 1 704 38 TABLE 20.—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 15 General stores 15 Hairdressers 6 Builders' merchants 3 Drug stores 1 Dental sundriesman 1 Photographic dealer 1 74 TABLE 21.—Milk (Special Designations) Regulations: Summary of Licences Issued. Type of Licence, and Designation Number Issued Pasteuriser's 2 Steriliser's 2 Dealer's: Tuberculin tested 69 Pasteurised 90 Sterilised 75 Supplementary: Tuberculin tested 16 Pasteurised 19 Sterilised 20 TABLE 22.—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 31 1 Tobacconists, confectioners/newsagents — 86 Grocers and provision merchants 19 34 Fishmongers 2 3 General stores 5 12 Milk shops — 17 Greengrocers and fruiterers — 21 Public houses — 2 Ice-cream factories — 3 Miscellaneous 2 17 59 196 39 TABLE 23.—Summary of Food Premises. Type of Business Totals Hotels and boarding houses 335 Restaurants, cafes and snack bars 307 Grocers and provision merchants 180 Canteens and clubs 170 Public houses and other licensed premises 161 Confectioners 125 Refreshment houses 93 Stalls, street trading 91 Greengrocers and fruiterers 58 Butchers 55 Schools and nurseries 50 Bakers 30 Wine merchants (off-licence) 30 Fishmongers 13 Milk depots 7 Coffee stalls and kiosks 5 Ice-cream manufacturers 3 1,713 TABLE 24.—Unsound Food Voluntarily Surrendered. Description Tons Cwts. Qtrs. Lbs. Meat and offal 1 8 1 1 Sausages, brawn, etc 3 3 2 3 Canned meat 3 10 1 14 Bacon and ham — 9 — 3 Poultry and game — 1 3 22 Canned food (other than meat) 2 17 3 15 Fish — 4 1 2 Fruit and Vegetables — 3 — 27 Miscellaneous — 5 1 21 Totals 12 3 3 24 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— Non-Paralytic 1 — — — 1 - — — - — - - - 1 - Erysipelas 2 — — — — - — — - — - 2 - 1 1 Scarlet fever 15 — - - — 3 9 2 - 1 - - - - 15 Puerperal pyrexia 14 — — — — — — — - 12 2 - - 14 - Pneumonia 7 — - - - - 1 1 - 1 - 1 3 1 6 Dysentery 19 1 4 2 1 1 5 — - 5 — - - 6 13 Measles 145 5 21 15 31 23 48 — - 1 — — 1 6 139 Whooping cough 53 7 2 6 6 6 25 1 - — — - - 3 50 Scabies 3 - - - - - - - 1 1 - 1 - - 3 Tuberculosis— Pulmonary 55 — 1 1 — 1 1 — 1 18 11 18 3 27 28 Non-pulmonary 3 — — — — — — — 1 2 — — — 3 — Food poisoning 8 — — — 1 — 1 — - 2 2 2 - 4 4 Acute Encephalitis (Infective) 1 — — — — - - — - 1 — — — 1 - Totals 326 13 28 24 40 34 90 4 3 44 15 24 7 67 259 * 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, ophthalmia neonatorum, meningococcal infection. 40 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 2 — — — — — — — 15—25 6 3 - 1 — — — — 25—35 15 12 2 - - - - - 35—45 10 9 - - - - - - 45—55 12 2 1 — 1 — 1 — 55—65 9 2 - — 1 - — — 65 and upwards 5 4 - - 7 — — — Totals 62 32 3 1 9 2 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. † The figures shown are in respect of deaths from all causes of registered tuberculous patients and do not necessarily correspond with the numbers given in other tables as due to tuberculosis. TABLE 27.—Tuberculosis: Summary of Register. Pulmonary Non-Pulmonary M. F. Total M. F. Total Total (a) Number of cases of tuberculosis on the Register at the beginning of the year 553 414 967 35 51 86 1,053 (b) Number of cases notified to the Medical Officer of Health under the Regulations for the first time during the year 38 19 57* 2 1 3 60* (c) Number of cases removed from the Register during a preceding year which have been restored to the Register during the year 3 2 5 - - - 5 (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 24 13 37 1 - 1 38 (e) Number of cases removed from the Register during the year 49 29 78 2 2 4 82 (f) Number of cases remaining on the Register at the end of the year 569 419 988 36 50 86 1,074 * Includes 2 notifications after death. TABLE 28.—Summary of Work of the Bacteriological Laboratory. Nature of Specimen and Examination Positive Negative Total Throat and nasal swabs for— B. diphtheriae — 30 30 Haemolytic streptococci 10 35 45 Vincent's organisms 1 7 8 Sputum for— Tubercle bacilli — 11 11 Faeces for— Parasites, typhoid, paratyphoid, dysentery and food poisoning organisms 6 196 202 Foods for— Food poisoning organisms — 11 11 Swabs for— Food poisoning organisms 2 17 19 Totals 19 307 326 41 NUISANCE FROM DOGS Byelaw for the Good Rule and Government of the Metropolitan Borough of St. Marylebone and for the prevention and suppression of nuisances therein, made by the Council of the Metropolitan Borough of St. Marylebone in pursuance of Section 146 of the London Government Act 1939. 1.—No person being in charge of a dog shall allow the dog to foul the footway of any street or public place by depositing its excrement thereon. Provided that a person shall not be liable to be convicted of an offence against this byelaw if he satisfies the Court that the fouling of the footway by the dog was not due to culpable neglect or default on his part. 2.—For the purposes of this byelaw the owner of the dog shall be deemed to be in charge thereof unless the Court is satisfied that at the time when the dog fouled the footway it had been placed in or taken into the charge of some other person. 3.—Any person offending against this byelaw shall be liable on summary conviction to a fine not exceeding Five Pounds. 4.—The byelaw as to dog nuisances made by the St. Marylebone Borough Council on the 16th day of February, 1928, is hereby repealed. 42 BYE-LAWS AS TO ARTIFICIAL LIGHTING OF COMMON STAIRCASES IN TENEMENT HOUSES AND FLATS BYE-LAWS made by the Mayor, Aldermen and Councillors of the Metropolitan Borough of St. Marylebone under Section 63 of the London County Council (General Powers) Act, 1956, for the adequate artificial lighting of any common staircase in tenement houses and flats. 1.—In these byelaws, unless the context otherwise requires—"flat" means a separate and self-contained set of premises constructed for use for the purposes of a dwelling and forming part of a building from some other part of which it is divided horizontally; "block of flats" means a building which contains two or more flats and which consists of three or more storeys; "family" includes a single person living alone or a group of persons living together as a single household; " tenement house" means a house which is not a block of flats and which is let in lodgings or is occupied by members of more than one family; "owner" means in relation to a flat or block of flats the person for the time being entitled to receive the rack rent for his own benefit or as agent or trustee for another person or the person who would be so entitled if the dwellings were let at rack rents; "occupier" means in relation to a tenement house the person for the time being having control of the lettings of the separate tenements comprised in the tenement house; "common staircase" means any staircase the use of which is common to the members of two or more families and includes any landing used in connection therewith. 2.—These byelaws apply to common staircases in tenement houses and blocks of flats. Provided that in the case of common staircases in tenement houses such byelaws shall not apply until after service by the Borough Council on the occupier thereof of a notice in writing requiring such occupier to provide and maintain adequate artificial lighting of common staircases therein. 3.—The occupier of every tenement house to which these byelaws apply and the owner of every block of flats shall provide and maintain adequate means for the artificial lighting of all common staircases within every such tenement house or block of flats and such artificial lighting shall be by means of either gas or electricity. 4.—The occupier of every tenement house to which these byelaws apply and the owner of every block of flats shall provide adequate artificial lighting for all common staircases— (a) from half an hour before sunset until 1 a.m. (b) for one hour before sunrise during the months of October, November, December, January, February and March ; and (c) at other times as and when necessary if adequate means of natural lighting are not provided. 5.—Electric lighting controlled by a suitable system of retracting switches or other similar device shall be deemed to comply with the preceding byelaw. 6.—Any system of artificial lighting provided in pursuance of the requirements of these byelaws shall be efficiently maintained in good working order by the occupier of every tenement house to which these byelaws apply or by the owner of every block of flats and shall be reasonably protected against interference by unauthorised persons. 7.—Every person who shall offend against any of these byelaws shall be liable on summary conviction to a fine not exceeding five pounds, and in the case of a continuing offence to a further fine not exceeding forty shillings for each day during which the offence continues after conviction. 43 SERVICES AVAILABLE FOR OLD PEOPLE NATIONAL. National Assistance Board, 177, Tottenham Court Road, W. 1. (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. 1. For Postal Area, N.W. 1. For Postal Areas, W.2 and N.W.S.. 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, I, Luxborough Street, W.l. (Tel.: WEL. 5619).—Apply to Admission Officer, 10, Warwick 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, 10, Warwick Row, S.W.I. (Tel. : VIC. 0162, Ext. 22). Recuperative Holidays and Loan of Sick-Room Equipment, 313-319, Harrow Road, W.9. (Tel.: CUN. 4815). Mental Illness.—Apply to Local Office, 313-319, Harrow Road, W.9. (Tel.: CUN. 4815) through the patient's doctor, Monday to Friday 9.15 a.m. to 5.15 p.m. Emergency calls during the night and at weekends, apply to the County Hall, Westminster Bridge Road, S.E.I. (Tel. : WAT. 5000, Ext. 7005). Home Helps Service, Room 91, Town Hall, St. Marylebone, W.l. (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, 10, Warwick 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). Chiropody.—A clinic is run by the L.C.C. at Health Centre 2,217, Lisson Grove, N.W.8, on Mondays 9.30 a.m. to 12.30 p.m., 1.30 p.m. to 4.30 p.m. and Tuesdays 1.30 p.m. to 4.30 p.m. Treatment is by appointment which must be made at the above address. No charge to pensioners. See also under " Voluntary Societies." 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 Book 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 who are not in smoke control areas finding themselves without coal owing to delayed delivery should be notified to Miss Sharp, who can arrange delivery of 28 lbs. 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.l. (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. Five 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 11d. 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. 44 W.V.S. Luncheon Club, 134, Seymour Place, IV. 1. (Tel.: PAD. 5597).—Old age pensioners can obtain dinners for lid. 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.l, every Tuesday 10 a.m. to 12.30 p.m. and 2.15 p.m. to 5.15 p.m. No charge. Treatment is by appointment which must be arranged on Tuesdays in Room 115. Another clinic is run by the Old People's Welfare Association at All Soul's Church Hall, Greenwell Street, W.l, on Mondays 10 a.m. to 1 p.m. No charge. Applications for appointments to be made to the clinic on Monday mornings or by letter. 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. No charge. Clubs.—There are three W.V.S. "Darby and Joan" Clubs:— 7, Wyndham Place, W.l, 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. Other Clubs are:—- The St. John's Wood "Darby and Joan" Club, 28, St. John's Wood Road, N.W.8, 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, 3 to 5 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, 20, Wimpole Street, W. 1. (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 need, and who can also keep in touch with them. Family Welfare Association, 8, Kensington Park Road, W.I1. (Tel.: PAR. 6683). Sailors', Soldiers' and Airmen's 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. 1. (Tel.: PAD. 8553). Church Army, 55, Bryanston Street, IF. 1 (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). The Horder Centres for Arthritics, 17, Rugby Mansions, Bishop King's Road, W. 14. (Tel.: FUL. 0593). 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, 1ST, 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, 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 on weekdays (excluding Saturdays) as follows:— The Odeon, Edgware Road, until 4 p.m., charge 9d. The Regal, Harrow Road, until 4 p.m., charge 9d. The Classic, Baker Street, until 3 p.m., charge 2s. 45 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.l HUN 4411 Marlborough Day Hospital, 38, Marlborough Place, N.W.8 MAI 8605 National Dental Hospital, Gt. Portland Street, W.l LAN 5361 National Heart Hospital, Westmoreland Street, W. 1 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.l 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.l 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.l WEL 1264 Chest Clinic, Town Hall, Marylebone Road, W.l WEL 7766 Temperance Clinic (Church of England), 14, Gloucester Place, W.lWEL 5222 The Tavistock Clinic (Psychiatric), 2, Beaumont Street, W.l WEL 5415 Vaccination (Smallpox) Clinic, The Middlesex Hospital, W.l MUS 8333 Vaccination (Smallpox) Clinic, Town Hall, Marylebone Road, W.l 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.l WEL 6237 Fellowship of Postgraduate Medicine, 60, Portland Place, W.l LAN 4266 General Medical Council, 44, Hallam Street, W.l LAN 2727 General Nursing Council for England and Wales, 23, Portland Place, W.l LAN 8334 Institute of Cardiology, 35, Wimpole Street, W.l WEL 1896 Institute of Medical Laboratory Technology, 74, New Cavendish Street, W.l 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.I AMB 5425 Royal Institute of Public Health and Hygiene, 28, Portland Place, W.l LAN 2731 Royal Medico-Psychological Association, 11, Chandos Street, W.1 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 46 INDEX Page Accidental Deaths 3,30 Accidents—Home and Road 3, 32 Adulterated Food Samples19,23 Aged Persons 6,43 Aged Persons—Services available 43 Air Pollution 13,35,36 Ambulance Service 45 Analysis of Food and Drugs 19 Analyst, Public 1, 19 Analyst, Public, Report 19 Anthrax 26 Bacteriological Examinations 27,40 Bacteriological Examination of Milk and Ice Cream 23 Bacteriologist 1 Barbers 14 Baths: Cleansing of Persons 13 for Old People 6 Swimming 9 Public 9 Births 3 Bodies, Transportation Abroad 16 Books, Library 9,26 Bugs 13 Burial or Cremation of the Dead 16 Byelaws : Lighting of Staircases 42 Fouling of Footways 41 Cancer 3 Care of Old People 6 Catering Establishments 24 Causes of, and Ages at. Death 30 Census Population 2,3 Certificates of Disrepair 18 Clean Air 13,35,36 Cleansing, Public 15 Cleansing Station 13 Cleansing of Verminous Persons 13 Clearance, Slum 17 Clinics 45 Closing Orders 18 Combined Drainage 12 Committee, Public Health 1 Common Lodging Houses 19 Compulsory Removal 9 Conditions, Social 2 Conferences 5 Conveniences, Public 15 Cremation 16 Dairies: Milkshops 23 Deaths: General 2,30 Accidental 3 Infant Mortality 2 Maternal Mortality 2 Vital Statistics 2 Diseased or Infirm Persons, Removal 9 Diseases, Notifiable 25, 39 Disinfection 26 Disinfestation 13 Disrepair Certificates 18 Dog Nuisance 16,41 Drainage 12 Drainage, Combined 12 Drugs, Analysis 19 Dwelling-Houses 18,33 Exclusion from Work 27 Factories 14,37 Factory-made Bungalows 18 Financial Contributions to Voluntary Organisations 5 Fireguards 14 Flock, Rag and Other Filling Materials 16 Foam Baths 9 Food: Adulterated, etc 19,23 Analysis 19 Page Food: Inspection 23 Legislation 22 Poisoning 26 Premises 24,39 Preserved, etc. 24,38 Stalls 25 Unsound 23 Fouling of Footways by Dogs 16,41 General Statistics 2 Hairdressers and Barbers 14 Health Education 10 Heating Appliances (Fireguards) 14 Home Accidents 3 Horseflesh 25 Hospitals 45 Housing: Certificates of Disrepair 18 Closing Orders 18 Factory-made Bungalows 18 Improvements, Conversions and 18 Inspection and Action taken 33 of Old People 18 Permanent Estates 17 Re-housing, Medical Certificates 18 Requisitioned Premises 18 Slum Clearance 17 Hydrogen Cyanide Disinfestation 13 Hygiene—Food Premises 24 IceCream 23,38 Immigrants 19 Impetigo 26 Improvement and Conversions, Housing 18 Infant Mortality 2,3,30 Infectious Diseases : Exclusion from Work of Contacts 27 Notification 25, 39 Prevalence and Control 25 Statistics 39 Inspection, Sanitary 11 Institutions, Medical and Nursing, etc 45 International Certificates of Vaccination 27 Intimation Notes 11 Knacker's Yard 25 Land Charges Enquiries 19 Laundry : Public 9 Service for Old People, etc. 6,9 Legal Proceedings 11,34 Legislation, New 10,19,22,32 Lighting of Staircases 19,42 Lung Cancer 3 Marriages 2 Maternal Mortality 3 Measles 25 Medical Examinations, Staff 10 Medical and Nursing, etc., Institutions 45 Medical Referee, Cremation 1, 16 Merchandise Marks Act 25 Mice 12, 35 Milk: Bacteriological Examination 23 (Special Designations) Regulations 23,38 Sellers 23 Mortality: Infant 3 Maternal 3 New Legislation 10,22,32 Noise 11 Notices, Intimation and Statutory 11 Notification of Infectious Diseases 25,39 Nuisances 11,33 Offices 14 47 Page Old People : St. Marylebone Welfare Association 6 Services Available 43 Care of 6 Outworkers 14,37 Pet Shops 14 Pharmacy and Poisons Acts 15,38 Photographers, Street 16 Pigeons 11 Poisoning, Food 26 Poisons 15,38 Poliomyelitis 25 Population 2, 3 Private wells 11 Protective Helmets 15 Public Analyst 1,19 Public Analyst's Report 19 Public Baths 9 Public Cleansing 15 Public Conveniences 15 Public Health Committee 1 Public Health Department Staff 1 Public Health Inspectors 1 Public Laundry 9 Public Swimming Baths 9 Pulmonary Tuberculosis 26,39,40 Rag Flock and Other Filling Materials 16 Rateable Value 2 Rats 12,35 Referee, Medical (Cremation) 1,16 Refreshment Houses 24 Refuse Collection and Disposal, Storage 15,16 Removal, Compulsory 9 Rent Act 18,33 Representation upon other Bodies 4 Requisitioned Premises (Housing) 18 Restaurants 24 Road Accidents 3, 32 Rodent Control 12,35 St. Marylebone Old People's Welfare Association 6 Sanitary Circumstances 11 Page Sanitary Inspection 11 Scabies 26 Sewerage 12 Shelter 13 Shops 14 Slaughter of Animals 25 Slum Clearance 17 Smallpox contacts 25 Smoke Control 13,35,36 Social Conditions 1 Staff : of Department 1 Medical Examinations 10 Stalls, Food 25 Statistics : General 2 Infectious Disease 39 Tuberculosis 39,40 Vital 2 Statutory Notices 11 Stillbirths 2 Street Cleansing 15 Street Photographers 16 Swimming Baths 9 Town Planning 12 Transportation of Bodies Abroad 16 Tuberculosis : General 26 New Cases and Deaths 26,40 Notifications 26,39 Register 26,40 Underground Rooms 19 Unsound Food 23,39 Vaccination, International Certificates 27 Venereal Diseases 10 Vermin Verminous Persons, Cleansing 13 Vital Statistics 2 Water 11,34,35 Weather 3,31 Wells, Private 11 Zoological Society of London 25 Vail & Co. Ltd., Leeke Street, King's Cross, W.C.I.