Ac 433 Ackd: 6.11.62. STMARY 66 BOROUGH OF ST. MARYLEBONE REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1961 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 18 Section E—Inspection and Supervision of Food 20 Section F—Infectious and other Diseases—Prevalence and Control 28 Appendix of Statistical Tables and Supplementary Information 31 Index 46 WELbeck 7766 Public Health Department, Town Hall, St. Marylebone, W.l. 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 1961. At the request of the Minister of Health the report retains its usual form and gives full details of the water supply, sewerage and public swimming baths in the Borough. Public health throughout the year was generally satisfactory, the incidence of infectious disease remaining at a low level. The customary biennial upsurge in the number of cases of measles comprised the only epidemic of note and this was almost wholly responsible for an appreciable rise in the total of notifications received—467 compared with 259 in 1960. A welcome feature was the marked fall in whooping cough notifications, only 12 being recorded as against 53 in the previous year. Once again the Borough remained free from smallpox and diphtheria, and for the first time since 1958 no case of poliomyelitis was reported. This happy record can only be maintained if full advantage is taken of the vaccines which offer specific protection against these formidable foes of mankind ; neglect to do so may exact a heavy toll in terms of death and disability. Quite unnecessary tragedy can so easily be averted by a little forethought. The year witnessed a further slight decrease in the estimated size of the resident population and a modest increase in general mortality (the standardized death rate rising from 11.58 to 12.14 per thousand population), partly offset by a continued slow improvement in the birth rate which rose from 8.30 to 8.85 (standardized). The infant mortality rate dropped fractionally from 26.99 to 26.39 per thousand live births, the number of infant deaths (20) being the same as last year; threequarters of these occurred within the first month of life. The still-birth rate increased noticeably from 8.10 to 19.40 per thousand total births but such a marked fluctuation is to be expected in view of the small numbers involved. One maternal death occurred in 1961, only the second to take place in St. Marylebone during the past eight years. It is always sad to record such an untimely event but its comparative rarity to-day bears witness to the high standard of maternity service which has been achieved in this country. The public health movement has just cause to be proud of its part in this achievement. The main causes of death amongst adults were diseases of the cardio-vascular system which accounted for nearly one-third of the total; malignant disease, responsible for roughly one death in five ; and respiratory diseases, to which were attributable just under one-eighth of all deaths. Approximately three out of every four deaths in the Borough occurred over the age of 65. In highly developed countries the correspondingly greater expectation of life has the natural corollary that an increasing proportion of public health practice is devoted to the welfare of the aged. This is certainly true of St. Marylebone. In this sphere the Department continues to work closely with numerous voluntary and statutory bodies and in particular with the St. Marylebone Old People's Welfare Association, an extract from whose annual report appears on pages 6 to 9; of especial interest is the account of the small inquiry undertaken by the Association into the housing needs of elderly residents in the Borough. Quite rightly this subject is receiving more and more attention and details of the current activities of the Council in this important field are given on page 19. In drawing attention to the summary of services available for old people on page 42 of the appendix to this Report, I welcome the opportunity to pay a sincere tribute to the many organisations which do so much to warm the winter of life. Another increasingly important aspect of public health practice in an ageing population is the prevention of accidents in the home for these take by far their heaviest toll amongst the elderly. On page 10 will be found a review of the size and nature of the problem and of the work of the Department in this field. Here I wish to emphasize the major contribution which well designed houses make to the cause of home safety. This is an excellent example of the interdependence of health and welfare. All too frequently in built up areas has the benefit of good housing been placed in jeopardy by the blight of atmospheric pollution. For this reason it is gratifying to report the satisfactory progress made in implementing the Clean Air Act. A fourth smoke control area, embracing the Cavendish Square Ward, came into operation on the 1st of October and at the end of the year the Minister of Housing and Local Government confirmed the fifth smoke control order (covering the Portman Square Ward) to be made by the Council. It is anticipated that the entire Borough will be virtually smokeless by the autumn of 1965. One major blot on the horizon remains, namely the antiquated electricity generating stations in the Church Street Ward. The station in Aberdeen Place, which has tall chimneys and operates only very occasionally, does not present so serious a problem as that at Lodge Road which, having low chimneys and being in operation throughout the year, causes considerable pollution in the form of grit and dust much to the annoyance and discomfort of local residents. If these veteran power stations are to operate indefinitely, then the installation of the most modern grit and dust arresting plant becomes an absolute necessity in order to reduce atmospheric pollution from this source to a minimum. The information about refuse collection and street cleansing ou page 16, kindly supplied by the Director of Public Cleansing, illustrates the manifold contribution which this important service makes to the public health. It plays a full part in the Clean Air Campaign in employing dustless methods of collection ; it endeavours to eliminate unnecessary noise—another problem which increasingly engages the attention of the public health department—and it promotes the cause of food hygiene and of rodent control by the frequent removal of refuse from catering establishments. Health education is an essential ingredient of public health practice. To be fully effective it needs to be fostered constantly and this is well brought out in the section of the report dealing with the inspection and supervision of food. The regular visits paid to food premises play an important role in ensuring a high standard of cleanliness, so essential if the hazards of contamination are to be avoided. Much has been achieved in this field. The high national incidence of food poisoning—over 6,000 incidents were notified in 1960—shows all too clearly how much remains to be done. As a means of disseminating in an attractive manner, on the widest possible front, knowledge about the basic facts of clean food handling and indeed of all health matters, the value of television cannot be over-estimated. Woefully little use has been made of this powerful new weapon in the armoury of health education. May this omission be remedied in the near rather than the distant future. In conclusion I wish to express my very real gratitude to His Worship the Mayor, to the Chairman, Councillor Mrs. F. E. Glennv, and members of the Public Health Committee, and to members of the Council, generally, for their continued help and encouragement. To my colleagues in other Departments of the Council I extend my sincere thanks for their ever ready assistance so willingly given. Finally I am indeed grateful to the Staff of the Public Health Department for their valuable, cheerful and loyal support. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, HASTINGS E.A. CARSON, Medical Officer of Health. 1 PUBLIC HEALTH COMMITTEE 1961 HIS WORSHIP THE MAYOR : *Councillor Gregory Matveieff, J.P. † Alderman Peter Pettit, D.S.O., T.D., J.P. ALDERMEN: C. D. Denis-Smith Capt. R. G. Whitney, M.B.E., J.P. (until July) COUNCILLORS : R.H.S. Allen The Rev. W.M. Long Dr. H.K. Ashworth, T.D. Mrs. J.P.G. Nuttall (Vice-Chairman) E.R. Seaden, B.Sc. (Eng.), A.M.I.E.E., J.C.C. Blofeld Assoc.I.Mech.E. (from October) Mrs. R.M. Challis Mrs. H. Shire Mrs. F.E. Glenny (Chairman) E.J.H. Wileman, LL.B., F.C.C.S. Dr. L. Jacobs * until May. f from June. STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health and Medical Referee for Cremation : Hastings E. A. Carson, M.D., D.P.H., S.M.(Harv.) 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., E.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 J. Bradley Miss M.L. Shaul R.J. Crozier Mrs. P. Woods Public Health Inspectors : V. A. Bignell (a, b, c) (Senior Inspector) Food Hygiene and Sampling : Drainage : L. Newland (a, b) J. R. Baily (a, b) A.C. Bruton (a, b) J. E. Broadhead (a) Catering Premises—Hygiene : Smoke Control : Mrs. M.I. Tiplady (a, b, d, f) L. Pearson (a, b, c) *Miss B. Wilson (a, b, d, e, f) Care of Old People : Rodent Control : Miss M. M. Sharp, M.B.E. (a, d, e, f) J.A. Cummins (a, b) (until October) District Inspectors : D.B. Hooper (a) A.J. Bithrey (a, b) (until October) P. W. Jolly (a, b) (until February) D. A. Hitchcock (a) (from November) S. W. Wright (a, b) K. G. Mahers (a, b) (from December) E. W. J. Miller (a, b) (until September) fStudent Public Health Inspector : C. A. Chase (from July) (a) Public Health Inspector's Certificate (b) Meat and Other Foods Inspector's Certificate. (c) Smoke Inspector's Certificate (d) Health Visitor's Certificate. (e) Central Midwives' Board Certificate. (f) State Registered Nurse's Certificate. * Also Infectious Diseases. f Appointed under a scheme of paid pupilage adopted by the Borough Council on 19th January, 1956. Outdoor Superintendent and Mortuary Keeper : R. G. Turner Streets 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 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 : £6,810,350. Sum represented by a penny rate : £27,349. Residential units (separate assessments) : 24,721. 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-1961—67,690. Registrar General's estimate of the child population: mid-1961—under 1 year: 730; 1—4 years inclusive: 2,270; 5—14 years inclusive: 5,000. Total child population: 8,000 (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 667 332 335 Live birth-rate per 1,000 population 11.20 Illegitimate 91 48 43 (Standardized) 8.85 Stillbirths—Legitimate 12 8 4 Stillbirth rate per 1,000 live and Illegitimate 3 2 1/ stillbirths 19.40 Total live and stillbirths 773 390 383 Infant Deaths—Legitimate 18 9 9 Illegitimate 2 1 1 Total Legitimate Illegitimate Infant mortality rate per 1,000 live births 26.39 26.99 21.98 Neo-natal mortality rate per 1,000 live births 19.79 19.49 21.98 Illegitimate live births per cent, of total live births 12.00 Maternal deaths (including abortions) 1 Total M. F. Deaths (all ages) 1,111 563 548 Death rate per 1,000 population 16.41 (Standardized) 12.14 Area comparability factors. Births, 0.79 ; Deaths, 0.74. Marriages. The number of marriages in St. Marylebone during 1961 was 1,314, which is 95 more than for 1960 and 36 above the average (1,278) for the previous ten years. > Deaths. The total number of deaths shown in Table 1, page 32, includes persons who though normally resident in the Borough died elsewhere in England and Wales, but excludes 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 1961 numbered 1,111 (16.41 per 1,000) compared with 1,090 (15.65 per 1,000) in 1960. The rate of 16.41 when standardized by the comparability factor gives a figure of 12.14 ; the standardised rates for the County of London and for England and Wales were 11.9 and 12.0 respectively. The principal causes of death continued to be diseases of the heart and circulatory system, which accounted for 31 per cent. of the total; malignant diseases, 21 per cent.; and respiratory diseases, including tuberculosis, 12 per cent. Deaths from lung cancer, compared with the previous year, rose from 48 to 53. Nine deaths were attributed to influenza. Seventy-two per cent. of the deaths registered were of persons aged 65 and over, whilst 22 per cent. were between 45 and 65 years. Accidental Deaths. During the year, 16 residents died from accidents of all kinds, eight less than last year. Motor vehicle accidents accounted for four deaths as compared with eight in 1960. Road Accidents. The St. Marylebone Road Safety Committee, which was set up in 1946 to advise the Council as to the activities which should be undertaken locally in an effort to secure a reduction in the number of accidents occurring on the roads, consists of members of the Council and representatives of outside organisations with interests in this field of local government activity. In April, 1961, a Road Safety Officer was appointed. His duties include acting as a liaison between the Council and local organisations with whom he must have a close personal contact. This is of inestimable value in ensuring that the road safety message is fully brought home to those to whom particular propaganda is directed. Three matters, however, required his immediate attention : (i) active participation in the National Proficiency Scheme for Child Cyclists which is particularly commended by the Minister of Transport; (ii) the arrangement of visits to RoSPA House, to which the Borough Council contributes £360 per annum, by school children, youth clubs and other local organisations ; (iii) regular visits to Old People's Clubs. Local road accident figures show a slight decrease on the previous year (1,053), there having been 1,027 such accidents in the Borough, resulting in 3 (10) deaths, 156 (149) serious injuries and 1,127 (1,174) slight injuries. The figures in brackets relate to 1960 and a summary of the accidents in 1961 is given in Table 4, page 34. Births. The total of live births registered during the year was 758 (380 males: 378 females) giving a live birth rate of 11.20 per 1,000 of population, equivalent to a standardized rate of 8.85, the comparable figure for the County of London being 18.9 and for England and Wales 17.4. Illegitimate live births numbered 91 (48 males: 43 females), representing 12.00 per cent. of the total live births, compared with 12.7 per cent for the County of London. Still-births totalled 15, representing a rate of 19.40 per 1,000 total births compared with 18.0 for the County of London. Infant Mortality. Deaths of infants under one year totalled 20 (18 legitimate: 2 illegitimate), giving a rate of 26.39 per 1,000 live births as compared with 26.99 in 1960. The rate for England and Wales is 21.6 per 1,000, and 21.5 for the County of London. Details showing causes of death according to age group and sex are given in Table 2, page 32. Of the 20 infant deaths 15 were under four weeks old, giving a neo-natal mortality rate of 19.79 per 1,000 live births as compared with 24.29 in 1960. The neo-natal mortality rate for England and Wales is 15.5, and 16.0 for the County of London. Maternal Mortality. One maternal death was reported during the year. This was of a married woman aged 34 years who died in hospital, the cause of death being given as congestive cardiac failure. Weather. The following summary of the weather during 1961, and Table 3, page 33, is based upon information supplied by the Meteorological Office:— 4 January.—Mean temperature above average. Rainfall 115 per cent. of average. Sleet or snow fell on 4 days. Sunshine 153 per cent. of average. February.—Mean temperature about 3.2°F. above average. At Kew the mean temperature was 46.9°F.—the mildest February since records began in 1871. Rainfall 140 per cent. of average. No sleet or snow reported. Sunshine 125 per cent. of average. March.—Mean temperature about 4°F. above average. A maximum of 73°F. on the Air Ministry Roof on March 16th equalled the 1948 high temperature record for March. Rainfall only 5 per cent. of average. Sunshine about 150 per cent. of average and on the Air Ministry Roof it was the sunniest March since at least 1929 when sunshine records began. April.—Mean temperatures about 3°F. above average. No air frost reported. Rainfall 111 per cent. of average. Sunshine 68 per cent. of average. May.—Mean temperature about average. No air frost. Rainfall about 50 per cent. of average. Sunshine about 112 per cent. of average. June.—Mean temperature about 1°F. above average. Rainfall about 80 per cent. of average. Sunshine 113 per cent. of average. July.—Mean temperature about 1°F. below average. A temperature of 92°F. on the Air Ministry Roof equalled the high record of July 3rd, 1947. Rainfall about 50 per cent. of average. Sunshine about average. August.—Mean temperature about average. Rainfall about 120 per cent. of average. Sunshine about 90 per cent. of average. September.—Mean temperature between 2° and 3°F. above average. Rainfall 117 per cent. of average. Sunshine 93 per cent. of average. October.—Mean temperature about 2°F. above average. Rainfall 86 per cent. of average. Sunshine 130 per cent. of average. November.—Mean temperature a little above average. Five days with frost. Rainfall 90 per cent. of average. Sunshine 150 per cent. of average. The 4th was a very sunny day with 8.6 hours at Hampstead and 8.5 hours at Kew; these totals arc the highest for a November day since records began in 1910 and 1871 respectively. December.—Mean temperature about 2°F. below average. Rainfall about 175 per cent. of average. About 3 inches of level snow fell on the 31st, the heaviest fall since the winter of 1947. Sunshine about 130 per cent. average. SECTION B.—GENERAL PROVISION OF HEALTH SERVICES Representation upon Other Bodies. The Council were represented upon the under-mentioned statutory and voluntary bodies as indicated:— Body 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. 3. National Society for Clean Air. St. Marylebone Clean Food Association—Executive Committee. Department of Scientific and Industrial Research— Standing Conference of Co-operating Bodies dealing with Atmospheric Pollution. Representatives Councillor Dr. H.K. Ashworth. Councillor Mrs. R.M. Challis. Councillor Dr. E. Jacobs. Councillor Mrs. F.E. Glenny. Councillor Dr. L. Jacobs. Councillor Mrs. F.E. Glenny. Councillor Mrs. F.E. Glenny. The Medical Officer of Health. Councillor Mrs. F.E. Glenny Councillor Mrs. J.P.G. Nuttall. The Chairman of the Public Health Committee. The Medical Officer of Health. 5 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—Blackpool 24th-28th April. Association of Public Health Inspectors— Bournemouth 19th-22nd September. National Society for Clean Air—Brighton 4th-6th October. Conference of the Central Consultative Committee on the Welfare of Old People—London County Hall 14th July. Delegates Alderman Captain R.G. Whitney. The Medical Officer of Health. Mr. V.A. Bignell, Senior Public Health Inspector. Councillor Dr. H.K. Ashworth. The Medical Officer of Health. Councillor Mrs. F.E. Glenny. Miss M. M. Sharp, M.B.E., Public Health Inspector. 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 1961, as follows:— Organisation £ s. d. Statutory Authority Central Council for Health Education 12 14 0 Public Health (London) Act, 1936, section 298. Family Welfare Association (Area 2) 75 0 0 Local Government Act, 1948, section 136. St. Marylebone Youth Committee 125 0 0 do. National Society for Clean Air 8 8 0 Public Health (London) Act, 1936, section 298. St. Marylebone Old People's Welfare Association— National Assistance Act, 1948, " Meals on Wheels " Service, etc. 820 0 0 section 31. Assisted Holidays Scheme 450 0 0 do. " Inner Wheel " Old People's Club—Rent of Hall 30 0 0 do. Women's Voluntary Services 40 0 0 do. Health Education. The importance of this subject is becoming increasingly recognised. In the Public Health Department its practice falls mainly into two channels, namely: the spreading of information by informal personal contact, and education by means of posters, pamphlets, bookmarks and other visual media. The first is undoubtedly the more effective and a great deal remains to be done in this field. The presence of so many different agencies involved in health education emphasises the need for close co-operation between them in order to avoid duplication of their work and to make the best use of available resources. It is amongst school children that basic principles can be taught most easily and profitably, and the subject should be included in the school curriculum. Next there are youth clubs, boy scouts, girl guides and other groups of young people for whom film lectures are suitable and valuable. Amongst workers, food handlers form a special group. Despite difficulties, particularly affecting the smaller firms, in releasing staff during normal hours, courses of instruction in food hygiene are essential and have the greatest chance of success when they form a part of recognised training and are held during the employer's time. Every encouragement should also be given to the various adult clubs and institutions, particularly those for old people, to use lecture services made available to them by the Council. Health Departments can make a valuable contribution in this respect as they have a wealth of knowledge and experience to draw upon. Prevention is not only better than cure but it is also cheaper. Prevention lies to a great extent in right thinking and there is a real need for health education activities to be expanded and the services available to the public made more widely known. Care of Old People. The number of old persons registered in the Department is as follows:— Bachelors or widowers 151 Single women or widows 977 Married persons living together 260 1,388 6 The majority of them (1,128) live alone and some require constant observation. During the year 2,956 visits were made to 813 old people of whom 117 were married couples. In addition 48 visits were made by the two women public health inspectors to seven infirm persons. 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, 55 cases were dealt with, some over long periods, others for a short while only. Forty-two 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 597 baths were given, 424 to women and 173 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 42 and 43. 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 1961:— "Grants.—In response to the Association's suggestion that a larger number of St. Marylebone pensioners should have a seaside holiday, the Borough Council grant for this purpose was raised to £450. In spite of this rise, supplemented by donations, expenditure on holidays exceeded income by almost £80 and owing to this fact and because an increase of 5s. a head weekly in charges at Brighton had already been announced for 1962, the Committee decided in the autumn to request the Council to make the grant up to £600 for the 1962 season. Their grant for the meals services and other purposes in 1961-2 was £820. L.C.C. grants continued for chiropody (paid to the Association) and as subsidy on meals (paid through the Borough Council). Borough Council grants refund each quarter's expenditure while L.C.C. grants are made in advance of expenditure. The Association's financial year does not coincide with that of the two authorities. Legacy and Donations.—A legacy of £170.12s. 2d. from the estate of the late Miss Gladys Robson, received in March, together with very welcome donations made it unnecessary for the time being to draw on the funds invested in Building Societies. General.—High affiliation fees were paid to the National Old People's Welfare Council and the London Council of Social Service, and a donation was again sent to the Old People's Homes Department of the Family Welfare Association. The general increase in expenditure to a certain extent reflects rises in costs, but is also mainly due to increased benefits for old people. King George VI Social Service Scheme.—A second course under the auspices of this scheme was held at the Town Hall on four Monday evenings in March. The Medical Officer of Health presided at the opening meeting, Councillor Desmond Plummer on the closing evening. The other Chairmen were Miss D. Fox, M.B.E., former Regional Welfare Officer of the Ministry of Health and the Rev. Donal Browne of St. Mary's Church. The Association's thanks are due to them, to the Scheme itself, to Mrs. Rachel Chinn, who proved a most agreeable and helpful Tutor, to the Borough Council for making the accommodation available, and to some authoritative speakers, including Miss M. Bucke, Secretary of the National Old People's Welfare Council, who all contributed to an exceedingly interesting and helpful course. The majority of those attending, some thirty in number, are engaged in visiting. 7 Publicity.—The leaflets distributed to new pensioners by the Ministry of Pensions and National Insurance, to make known the whereabouts of local services for the old, started going out early in 1961 in all Boroughs. Very few new pensioners in Marylebone sent the attached cards asking for information or a call, but it is hoped that others may have kept the cards for future reference. The Association printed small leaflets giving an outline of all the services and Clubs, and these have proved very useful. Before Christmas the Chairman sent a letter to three local papers to suggest that anyone wishing to give Christmas presents to elderly people living in St. Marylebone might send them to the Association for distribution to suitable homes. The Borough Council kindly agreed to place a name plate for the Association outside the entrance used for the office, and that the Association's name should be entered in the telephone directory against the Town Hall's number. Housing and Other Services.—In March a welcome joint circular from the Ministry of Housing and Local Government and the Ministry of Health referred to provisions for the well-being of old people, urging local authorities to co-operate as closely as possible with voluntary organisations concerned with the varying needs of old people. A preliminary consultation was consequently held in May between representatives of the Borough Council Housing (Development) Sub-Committee and representatives of the Association, who laid special emphasis on the need in St. Marylebone for more housing, especially flatlets, for the elderly. This led to an informal survey being undertaken by the Association to examine the extent of the problem. Information was collected from responsible persons concerning 130 old people known to be in urgent need of housing accommodation. The cases were classified in four categories, whether in accommodation unsuitable for reasons of infirmity, or for financial reasons, those with bad housing conditions, and fourthly, cases of eviction, expiration of lease, loss of home due to the cessation of employment such as caretaking. This fourth category was the largest. The analysis did not take into consideration people at present unsatisfactorily housed who would, however, not wish to move, nor others who had been obliged to leave the district but still wished to live here. The Association's representatives, while considering housing needs had priority, hoped for further consultation to discuss possibilities of expanding the work for old people in other channels. 'Meals on Wheels' —This service has been grant-aided as in previous years. The Borough also contributed £125 towards the cost of the new electrically heated food containers whose introduction has meant an increase in the number of meals distributed and a vast improvement in the temperature of the dishes reaching the old people. A total of 7,003 meals, 256 more than in the previous year, were taken round by the W.V.S. helpers, whose steady work under the direction of Mrs. Lush ensures that this beneficial service works smoothly and happily. The van, garaged and serviced by the Borough Council, has been driven by two helpful Council employees. With only one van it is not possible to provide any person with hot meals more than twice a week, or three times in the more urgent cases. Although these meals are a very great blessing to many old folk who cannot themselves prepare an adequate hot meal, there is a strong case for delivery five times a week as an early objective in St. Marylebone, particularly as there is no service of invalid meals in the Borough. The Luncheon Club.—This cheerful place has been greatly improved in appearance by fresh paint without and within. The Association gladly met the expense of the internal decoration and part of the external painting. A total of 5,806 meals were served and as usual the helpers provided a special Christmas dinner. The Association is deeply grateful to Mrs. Lush and all W.V.S. helpers for their wonderful work in both these services, and to the Church Army who let these most convenient premises at 134, Seymour Place, for a nominal sum. The meals have been cooked in the canteen of Messrs. Spencer, Turner and Boldero for several years past. Chiropody.—This was the first complete year with no charge being made for treatment of old people. The London County Council grant covered all expenses of the Clinics at the Town Hall and at All Souls' Club-house, Greenwell Street, also for the Home Chiropody service. Miss Cotsford (B.R.C.S.), honorary appointments clerk with Clinic 1 since its beginning, contributed greatly to the smooth running of appointments, as did Miss Hoogendoorn at Clinic 2. Miss Curran, Miss Lerner and Miss Meares have carried on their efficient and kindly professional care of the old people. A total of 2,282 treatments were given at Clinic 1 and 376 at Clinic 2. The Clinic at the Lisson Grove L.C.C. Health Centre increased the number of their sessions for old people. Home Chiropody.—645 treatments were given, an increase of 28 over the previous year. Thirty-two new patients were taken on, but the waiting list lengthened from 7 at the beginning of the year to 22 at the end. With the present service there seemed no likelihood of reducing this effectively 8 and the Medical Officer of Health of the London County Council was told of the Association's anxiety about the number of patients waiting for treatment. It was learnt that a complete review of the chiropody services would be undertaken shortly. With the home treatments the interval between visits is fixed as far as possible according to the individual needs of the patients, and works out an average of 2¼ months. Holidays.—Thanks to donations and a higher grant from the Borough Council, the Association was glad to provide the benefit of holidays for a larger number of old people, including some who had been away the previous year. Under the usual " all-in " scheme 124 people enjoyed a week at Brighton and in spite of a rise in charges they were still asked to contribute only £1. 17s. 6d. towards a week's board, lodging, transport and entertainments. The remainder of the total expense of £4. 18s. 6d. a head weekly was met by the Association. The smooth running of this service owes a great deal to Miss Sharp who accompanied each party to see them settled in, and to the kindliness of the landladies who made the old people so comfortable. Arrangements were also made for 21 people who needed a different type of holiday. Four of these had a fortnight in the care of the Church Army at the short stay Sunset Home at Woking, one who went to a B.R.C.S. Home had transport paid for by the Association, six went to Cliftonville landladies known to us, each for a fortnight. In other cases the Association contributed to holidays spent with friends or relatives and in two cases gave financial help through hospital authorities. In about a dozen other cases arrangements for holidays broke down for various reasons, an indication of the difficulty of planning for infirm people. The Committee allocated £10 to the Barrow Hill Club toward the cost of their holiday scheme and £34 to the Fourth Feathers Club for similar purposes. Members of other Clubs applied to the office for holidays, though the St. John's Wood Club very helpfully collected their members' contributions. Social Visiting.—Four new individual members were welcomed, also a new representative from St. Mark's Church, Marylebone Road, and a representative for the first time from St. James' Church, Spanish Place. Seven local churches now co-operate in the Committee, which generally meets monthly, with Miss Sharp and Mrs. Cowan. Every endeavour is made to fill gaps and solve the problems which are reported. Welcome offers of help were received from a group of students residing at Nutford House and from the Trefoil Guild of the Girl Guides' Association. Clubs.—Regular reports to the Executive showed a successful year for all clubs. Each club has parties and presents at Christmas time, outings in the summer and best of all a regular weekly gathering, the experienced club leaders ensuring a friendly atmosphere and many different interests. Information important for old people, such as news of the National Fire Prevention Week, was spread among members and some clubs gave special attention to road safety questions. There is no need for old people to feel lonely or forgotten if they belong to a Darby and Joan Club. If they fall ill at home or are sent to hospital there is soon a club visitor on the spot. Relief.—Students connected with Hinde Street Methodist Church have again done admirable jobs of decoration. More than a dozen homes were given attention in varying degree. The need for this particular service is growing although unfortunately the costs of materials and labour continue to increase. Perhaps only someone who has been confined to the house with nothing to look at but dirty ceilings and dingy walls can really appreciate what it means to have such a scene transformed and brightened. The visits of cheerful young people are often part of the enjoyment. The National Assistance Board refunded to the Association the cost of materials in about half the cases dealt with. The accounts show that more was spent on relief in the past year. As usual most items were small, but they represented urgent needs which could not be met from official sources. For example radio licences, buckets, help with a telephone bill, electricity bills, a coat altered, another cleaned, a lamp repaired, taxis from Christmas party, keys, ferrules for sticks, transport, electric work, linoleum and linoleum laying. Some work was again undertaken to lower meters as a matter of safety, and the Association is grateful for the co-operation of the North Thames Gas Board and the London Electricity Board. Coal was provided in a few emergencies, and Miss Sharp was helped in this respect by several gifts. The Association is grateful also to numerous friends who gave useful items of clothing and bedding tor distribution where they were most needed. 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 the library staff, mainly to cases recommended by the Home Help Service. Twenty-two old people are now receiving books at home and 2,904 were delivered to them during 1961. 9 Radio.—Ten new applications were approved for sets on loan by the 'Wireless for the Bedridden' Society, who in needy cases generously provided licences also on request. There were at the end of the year 29 sets under the supervision of the Association, also other sets sponsored by other bodies. This Society clearly gives a vast amount of enjoyment and encouragement to homebound people and the Association greatly appreciates its fine work. Entertainments.—The highlight among entertainments was once again a splendid party given by Mrs. Lew Grade at the Seymour Hall for 800 old people of St. Marylebone to all clubs, homes, institutions and almshouses. Invitations were allocated and some 300 old people belonging to no club were included. The Association was very glad to help with a party which brought delight to so many and expresses the warmest possible thanks to Mr. and Mrs. Grade for another really memorable occasion. Fifty old people enjoyed a Christmas party at the Y.M.C.A. in Great Russell Street. It is not possible to list similar entertainments arranged by the clubs. The Women's Institute at Wye, near Ashford, again invited a party of St. Marylebone people for an August outing. This proved a very happy day for a coach load of old people who were not otherwise having any holiday. The Student Theatre Group of the St. Marylebone Literary Institute gave 40 tickets for the use of old people at an entertainment. Christmas Gifts.—The Association was glad to submit names of needy people for money gifts from the St. Martin-in-the-Fields Christmas Appeal of 1960. Warm thanks are expressed to many generous friends and firms who co-operated with the Association in giving parcels and hospitality to old people at Christmas, and also harvest festival gifts." 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 was not necessary to follow this procedure during 1961 but unfortunately distressing cases do 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. 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 facilities consist of 24 baths each for men and women Attendances during the year totalled 76,659 as compared with 79,626 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: 10d. Old age pensioners, unemployed or blind persons can obtain baths from Monday to Friday at a cost of 1d. Foam baths have been 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 lor 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. Medical Examinations. Staff.—The Medical Officer of Health is medical adviser to the Council for staff purposes. During 1961, one hundred and thirty-one examinations of the Council's employees and new entrants to the superannuation scheme were carried out. Parking Meter Exemptions.—The Council are empowered in certain circumstances to give exemption from parking meter charges to a person who is severely disabled. During the year, sixty-five applications were referred to the Medical Officer of Health for observations and, if necessary, medical examination. Home Safety. The Home Safety Act received the Royal Assent on the 18th May, 1961. It enables certain local authorities (including Metropolitan Boroughs) to promote safety in the home by publishing or making other arrangements for giving information or advice on the subject and to make contributions to voluntary organisations whose activities consist of, or include, the promotion of safety in the home. The Act repealed Section 82 of the London County Council (General Powers) Act, 1957, which contained comparable powers to be exercised by each Metropolitan Borough Council within its own area. The need to arouse public awareness to the serious problem presented by home accidents is imperative. It does not appear to be generally realised that in England and Wales more people die annually as a result of home accidents than are killed on the roads. The provisional figures for the year 1961, which are 6,648 and 6,237 respectively, again exemplify the position. In addition there is a yearly average of some 75,000 hospital in-patients who have suffered accidents at home. Ignorance and carelessness appear to be the major causal factors and at a Conference held by The Royal Society for the Prevention of Accidents it was suggested that the continued existence of such a state of affairs indicates an unhealthy complacency. Within the County of London estimates based upon a London County Council survey indicate that annually at least 25,000 home accident victims go to hospital and of these about 1,650 receive in-patient treatment averaging 21 days each, which in total represents the occupation of 94 hospital beds for a full year. During 1961 the London Ambulance Service removed to hospital 121 home accident cases from addresses in St. Marylebone. The number who reached hospital by other means or who were treated by doctors at home or at the surgery is unknown but it seems clear that a large proportion were children under 5 or persons over 65 years of age, the latter group accounting for about one-third of the total number. The most common causes ot injury are falls (60 per cent.—chiefly among old folk), poisoning (17 per cent.—three in every four caused by domestic gas), burns and scalds (10 per cent.), and suffocation and choking (8 per cent.—about three in every four concerning children under 5 years of age). In the field of prevention the Department's activities take the form of general publicity and the giving of advice and information by (1) informal personal contact, (2) the use of posters, leaflets, and other printed matter, (3) co-operation with the London County Council in their annual Home Safety Weeks, particularly by arranging window and other displays and distributing leaflets. In addition arrangements are being made shortly to commence a series of talks illustrated by films and 11 film strips on the subject of home safety to old people's clubs. In view of the high accident potential of old people, and bearing in mind that one in five of the Borough's population is over 65, this group demands special attention. Whilst making their day-to-day visits members of the inspectorate are watchful for possible accident hazards in the home and advise accordingly. For example, they sometimes find in homes of the elderly or handicapped, or where there are young children, that fireguards are not provided and in such cases the householder is helped to obtain a fireguard at a nominal cost or even free of charge. Similarly, where gas or electric meters are found to be dangerously sited or inaccessibly high, particularly in the homes of old people, arrangements are made with the gas or electricity undertaking to have them placed in safer positions. So far as general information is concerned, leaflets and posters are displayed in conjunction with health education material in the Department and use is made of the Central Public Library for presenting leaflets and bookmarks, and of the St. John's Wood Branch Library for a window display and the distribution of printed material. During the "National Fire Prevention Week" some 2,500 copies of the "Fire Prevention Code for the Home" were sent to Borough Council housing tenants and to as many old people as possible with an accompanying letter offering help in any matter of home safety. With regard to mothers and young children, the London County Council as a part of their wider scheme give formal and informal talks on home safety through their infant welfare sessions and take similar opportunities at mothercraft classes, mothers' clubs and discussion groups. The subject is also dealt with in the schools and by Health Visitors when going into individual homes. 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 34. 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 34. Excluding rat and mouse infestations, 1,151 complaints were received and details of 730 various nuisances remedied are shown in Table 7, page 35. Notices.—Intimation Notices served under the Public Health (London) Act, 1936, numbered 219, and 34 of these were followed by the service of Statutory Notices to secure abatement of nuisances. In addition thirteen other formal notices were served, as follows: eight in respect of blocked drains, three requiring the provision of sufficient dustbins and two for the provision of artificial lighting on common staircases—as required by the Borough Council's Byelaws. For offences under London County Council Byelaws eleven notices were served, seven being in respect of water-closets, two for drainage defects and two requiring proper maintenance of dustbins. Legal Proceedings. No legal proceedings under the provisions of the Public Health (London) Act, 1936, were necessary. Noise. Sixty-five complaints of noise were received and these concerned forty-three alleged nuisances. Most of the complaints were of noise coming from engineering works and operations on demolition and building sites, involving the use of pneumatic and electric hammers, pile-drivers, mechanical excavators and other heavy equipment, particularly late at night and during weekends. The various contractors against whom complaint was made genuinely appreciated the problem and offered willing co-operation in seeking and applying noise reduction methods, even though loss of efficiency or time was caused. The remainder concerned a wide variety of supposed causes, including radio and speech amplifiers, noise from factories and workshops, noisy neighbours, clubs, road works, garages, dogs, ice cream vans, ventilating and pumping systems, a public house, a cigarette vending machine, night baking, a hooter and a diesel locomotive maintenance depot. The complaints were not always well founded but where justified they were followed up and the offending noise abated or reduced to a reasonable level. In certain instances where the Council had no legal powers, informal action by the Public Health Inspectors or the Streets Nuisance Inspector resulted in improved conditions. 12 Pigeons. Section 121 of the Public Health (London) Act, 1936, empowers the Council to arrange for the seizure or destruction of pigeons in excess of such numbers as the Council consider reasonable. Pigeons cause nuisance through fouling, defacement and damage. Where they congregate in flocks their droppings, apart from being unsightly, produce stench and fly nuisance, and many walls and roofs of houses where these birds nest are similarly fouled. The remains of food fed to them by the public attracts rats, mice and flies and it is known that pigeons can be vectors of diseases affecting mankind. Additionally, incessant cooing during nesting gives rise to noise nuisance. Public opinion, however, is sharply divided upon the question of destroying these birds. Whilst some people regard them as an intolerable nuisance others look upon them as pets and by putting down food regularly cause them to congregate. Such people object most strongly to any attempt to reduce the number of these birds. It is also found that some people who otherwise have no particular interest in pigeons resent the operations of the pigeon catcher, whose methods are approved by the Royal Society for the Prevention of Cruelty to Animals, and sometimes do all they can to interfere with his work however discreetly he may try to go about it. One lady who was asked not to attract pigeons by putting down food took the line that although she did not particularly like them, whilst they existed she was going to do her best to see that they were properly fed. During the year, seven complaints were received and upon investigation it was found necessary to refer four of these 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 to your Borough by the Board has been satisfactory both in hygienic quality and quantity during 1961. The water is derived from the River Thames, purified in the Board's reservoirs at Staines, Littleton and Walton and filtered and chlorinated in the Board's works at Hampton, Ashford Common and Barn Elms. The average results of the chemical and bacteriological quality of the water are set out in Tables 8 and 9, page 35. There were no sources of supply instituted by the Board during the year nor any important extensions of trunk mains, but 146 yards of service main was laid in the Borough during the year." In the event of a complaint of contaminated public mains water the Metropolitan Water Board is informed, investigations are made and, if necessary, samples are taken for examination. Complaints are few and normally refer to unusual taste—which is often due to temporary super-chlorination following works on the mains. In various properties in the Borough drinking water is derived from private storage tanks supplied with water from the public mains. A Borough Council Byelaw requires these tanks to protect water adequately from the risk of contamination and to be cleaned at least twice a year. A complaint about the supply from a storage tank referred to "slimy water", but bacteriological and chemical examinations showed that the water was satisfactory. The occupier of a house, the sole occupant, complained that the drinking water contained foreign matter. On investigation the water was found to be satisfactory, but work had been carried out to the water main in the locality and it is possible that this was an isolated case where the water was temporarily affected. The number of dwellings supplied from public water mains is 24,491, with an estimated population of 67,214. No stand-pipes are in use and the remaining dwellings, namely two blocks of flats comprising 230 units with some 476 residents, obtain water from private wells. 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 1961 indicated the water to be satisfactory. The Metropolitan Water Board sent four notifications of premises where the water supply had been cut off, in three cases for non-payment of rates and in the other for wastage of water caused by a defective service pipe. At the first three premises the supply was restored quickly when the rates were paid, the other house was vacated and remained unoccupied. It was not necessary for any notices to be served. 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. 13 Drainage—Alterations and New Buildings. Of the 291 drainage plans approved during the year, 36 were in respect of new buildings. Upon request, the Borough Engineer examined 18 sewer connections and seven of them were found to be defective and had to be renewed. The drainage inspectors made 3,416 visits and no circumstances were found which necessitated legal proceedings. Combined Drainage. Eleven 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 main drainage system of the London County Council, who are responsible for the disposal of sewage. There are no disposal plants in the Borough. No progress has been made with the County Council regarding the provision of adequate high-level ventilation referred to in last year's report. However, local nuisances have been abated by the simple and short-term expedient of screening the road level covers and relying upon wider dispersal of gases through branch sewer ventilators. Town Planning. Observations were made by the Department on 241 plans submitted to the Council under the Town and Country Planning Act, 1947. Rodent Control. There were 184 notifications of rats at premises in the Borough, a reduction of 27 on the previous year's figure. Notifications of mice, however, showed an increase of 62 over last year's figure of 360. Although many theories have been put forward for the continuing increase of mice in many parts of the country the specific cause has not so far been ascertained. Block surveys have been continued and the system has been further altered to provide improved coverage, which involved 6,346 premises in 105 blocks; twenty-three unnotified infestations were discovered as compared with twenty-three located in 1,757 premises last year. Sewers have been treated by the polythene bag system the bait being applied at side entrances only. Baiting was carried out at approximately eight week intervals and "takes" were consistent at all points. The residual number of rats in the sewers is being kept to an absolute minimum. Statistics of rodent control are shown in Table 10, page 36. 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, 248 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 1961 the furniture of 30 families, of whom 24 were being rehoused, was treated by this method. In addition 508 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 Department's Cleansing of Persons Baths in Lisson Grove dealt with 618 verminous persons : adults 477 (men, 435 ; women, 42) ; children, 141 (boys, 29 ; girls, 112). 14 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. Although there was a large reduction in the number of complaints, 108 during 1961 as compared with 144 in 1960, the number of smoke offences detected increased from 48 to 63. Arising out of 1,373 casual observations, dark smoke emissions were timed on 52 occasions. There were 18 offences under Section 1 of the Clean Air Act, 1956, relating to dark smoke, 11 contraventions of Section 11 in respect of smoke discharged from chimneys in smoke control areas and 34 instances of smoke causing nuisance to the inhabitants of the neighbourhood contrary to Section 16. The infringements were dealt with by cautions and in one case the offenders were specially warned by the Town Clerk after the circumstances had been considered by the Public Health Committee. Thirty-two notifications of intention to instal new furnaces as required by Section 3 of the Clean Air Act were received, and application for the Council's approval of plans and specifications, which is not obligatory, was sought in respect of three proposals. At the beginning of the year a fourth smoke control Order affecting premises in Ward No. 10 (Cavendish Square) was confirmed by the Minister subject to a modification whereby fireplaces, other than fireplaces fired by pulverised fuels, equipped with mechanical stokers are exempted from the operation of Section 11 of the Clean Air Act, 1956 provided that they are so installed, maintained and operated as to minimise the emission of smoke and that no fuel is used other than that for which the fireplace was designed. The Order came into operation on the 1st October, 1961. Applications for grants were few from owners and occupiers of dwellings in the area but the terms of the Order appear to have been well supported. The Council made a fifth Order in respect of Ward No. 8 (Portman Square) and at the request of the Minister of Housing and Local Government a clause in the Order exempted fireplaces equipped with mechanical stokers and authorised the use of kindling sticks and paper in fireplaces in buildings without a gas supply. The Order was confirmed by the Minister at the close of the year and will come into operation on 1st October, 1962. A survey of Ward No. 7 (Bryanston Square) was commenced in preparation for a sixth smoke control area. By 31st December, 18,641 premises in 629 acres of the Borough were covered by Smoke Control Orders made and confirmed. At four sites measurement of atmospheric pollution was continued and statistical information was supplied regularly to the Department of Scientific and Industrial Research. The statistics are shown in Tables Nos. 11, 12 and 13 on pages 36 and 37. Offices. There are some 3,474 office buildings in the Borough but there is at present no record of the number of individual offices. The Offices Act, 1960, comes into operation on the 1st January, 1962. Regulations for securing the health, safety and welfare of employees have not yet been made but it is anticipated that this long awaited legislation will be placed before Parliament in the near future. Shops. There are 2,488 shops in the Borough to which regular visits were made. Factories. There were 1,781 factories on the register at the end of the year, 137 less than last year. A report on the administration by the Department of matters under Parts I and VIII of the Factories Act, 1961, is given in Tables 14 and 15, page 38. 15 Outworkers. Fifty-eight employers submitted lists in respect of a total of 597 outworkers (217 contractors and 380 workpeople). Of these, twenty-three contractors and twenty-seven workpeople operated in the Borough. The nature of the different classes of work and the numbers of outworkers engaged is indicated in Table 16, page 38. Fireguards. The Heating Appliances (Fireguards) Act, 1952, was repealed by the Consumer Protection Act, 1961, which came into operation during August. The Heating Appliances (Fireguards) Regulations, 1953, however, were re-enacted without amendment. In previous reports mention has been made of the fact 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. It is regretted that auctioneers still enjoy this same exemption under the Consumer Protection Act, 1961. Regular inspection was made of appliances exposed for sale but only two heaters were found which failed to comply with the statutory requirements. The fault was inadequate guards and the vendors withdrew the appliances from sale. No legal proceedings were necessary. Hairdressers and Barbers. The Council's Byelaws regulating these establishments came into operation on 18th December, 1955. There are in the Borough 150 registered hairdressers and barbers ; regular 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, ten 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 28 visits and inspected weekly the stalls licensed to sell pets in the street markets. Conditions under which the livestock was kept were reported as satisfactory. Poisons. At the end of the year the names of sixty-four 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-five. Details are given in Table 17, page 39. Protective Helmets. The Motor Cycles (Protective Helmets) Regulations, 1957, make 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. At the request of the Public Health Committee a review was made of the Council's public conveniences with special regard to the adequacy or otherwise of existing accommodation. At present there are ten conveniences and three urinals for men and seven conveniences for women. In some of the more busy parts of the Borough the existing facilities appear to be inadequate; particularly does this apply to Edgware Road and Oxford Street. However, there are proposals to reconstruct the convenience provided by Paddington Borough Council at the junction of Harrow Road and Edgware Road, and re-siting of the Oxford Circus convenience when the underground station is reconstructed is also under consideration. These improvements should do much to provide more adequate accommodation in their respective vicinities and, similarly, a proposal to reconstruct the Marylebone Road 16 convenience in connection with a road widening scheme should be of benefit. There will, however, still be a serious lack of accommodation for women in the Maida Vale/St. John's Wood Road area and between Oxford Circus and Marble Arch. The possibility is being examined of reconstructing the St. John's Wood Road and Barrett Street conveniences to provide women's sections. Furthermore, the Salisbury Street convenience is considered inadequate to deal with the demand on market days and advantage should be taken of any opportunity that might arise to consider its replacement in connection with redevelopments in the Church Street area. For some years the normal opening time of conveniences has been 7.40 a.m. In order to ascertain whether the use between 7.40 a.m. and 8 a.m. justified opening at this time or whether 8 a.m. could be adopted with a consequent financial saving, a census was taken. It was found that reasonable use was made of the conveniences between 7.40 a.m. and 8 a.m. and variation of the opening time was not desirable. 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. Public Cleansing and Salvage. The Director of Public Cleansing has kindly provided the following information:— "The refuse and salvage collected during 1961 were : house and trade refuse, 35,611 tons; street sweepings and gully sludge, 2,443 tons; salvaged materials, 2,178 tons. A sum of £16,295 was obtained from the sale of salvaged materials. In addition, £2,279 was received for removing trade refuse and for cleansing petrol interceptors, etc. Although a five day working week was introduced for the refuse collection staff, a minimum twiceweekly service was maintained, and approximately one quarter of all premises in the Borough received a thrice-weekly clearance. A daily collection was continued where necessary, such as at hospitals, restaurants, hotels and blocks of flats. All street gullies were mechanically cleansed approximately four times during the year and all streets swept at least once daily. The pilot scheme of dustless refuse collection began in April in a part of the St. John's Wood area. The new system proved most satisfactory and appreciative comments were made by residents. Research has been carried out with a view to decreasing the weight of the present all-metal bins used for dustless collection by the use of lighter materials, and experiments are continuing. Arrangements were made to deal with the unsatisfactory conditions for refuse storage at the remaining buildings in the Borough where fixed ashpits were still in use, resulting in unhygienic working conditions for the refuse collectors. With the co-operation of the property owners, structural alterations are being made where necessary and ' Paladin ' type storage containers installed. At the beginning of the year, a wastepaper baling plant was put into operation in a new temporary building at the Department's Central Depot. It has resulted in more efficient handling of the large tonnages of wastepaper collected and a considerable increase in the revenue obtained from the sale of this material to the mills. During the year, delivery was received of one new gully emptier to replace an old machine,' and of twelve aluminium street orderly tracks to replace a similar number of old steel type tracks." Refuse Storage Accommodation. Section 24 of the London County Council (General Powers) Act, 1959, requires 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. Nine 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 17 thirteen premises, mainly those of upholsterers and manufacturers of cushions and pillows, are registered. Four samples of hair and three of fibre were taken during the year and found to comply with the statutory requirements. The Rag Flock and Other Filling Materials Regulations, 1961, came into operation on the 1st August and supersede the Regulations of 1951 and 1954. Used wood wool is now prescribed as filling material to which the Act applies. 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. Nine burials and four cremations 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 had occurred in the district. During the year two certificates were issued in respect of bodies being transported to Iraq. Cremation. The Medical Officer of Health is Medical Referee for the Council's Crematorium, which is situated at the St. Marylebone Cemetery, East Finchley. During the year 1,961 certificates authorising cremation were issued and since December, 1937, when the crematorium was opened, 23,050 cremations have taken place. The annual number of cremations continues to increase and in 1961 this was 36.45 per cent. of that of the total deaths in England and Wales, representing 2 per cent. more than in 1960. Dog Nuisance. The Council's new byelaw dealing with this nuisance came into operation on 31st May, 1960. It provides that:—"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." Contraventions reported by the Streets Nuisance Inspector during the year resulted in the issue of seven summonses, two of which could not be served. Five convictions were secured with penalties and costs amounting to £8. 1s. 0d. Street Photographers. A local byelaw, 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 byelaw is liable on summary conviction to a fine not exceeding £5. As the administration and enforcement of most other " good rule and government " byelaws have been referred to the Public Health Committee, a similar course was followed in regard to this byelaw, more particularly as the officers of the Department, including the Streets Nuisance Inspector, are continually about the streets. During 1961 the Council took out one summons resulting in conviction and a fine of £3. 0s. 0d. with one guinea costs. 18 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, 1961:— No. of Pre-war Estates 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 Place34 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 76 9-25, Cochrane Street 32 1,397 Further Development Linked with Slum Clearance. Progress in further developments during the year was disappointing. Delays were caused by the need for lengthy discussions with the Planning Authority on the relaxation of density restrictions and final plans had to await the decision of the Ministry of Housing and Local Government on the Council's representations. In respect of the Broadley Street/Penfold Street Scheme, a public inquiry was held on the question of density. The original plan for the Freshwater Place site proved to be too costly and a revised plan was eventually adopted. The position at the end of the year was :—- Broadley Street/Penfold Street (30 flats) Scheme approved. Site preparation works were commenced in December. Ashbridge Street (East)—(10 flats) Plans for the scheme have been approved and tenders obtained for the erection of the flats. The formal consent of the Minister of Housing and Local Government is awaited. Freshwater Place/Homer Row (9 maisonettes) Site clearance work is almost complete and tenders for the erection of buildings will be invited shortly. Malready Street (171 flats) Draft proposals for the development of this site have been approved. The possibility of extending the scheme by the inclusion of the adjoining Broadley/Salisbury/Ashmill/Penfold Street Site is being discussed with the London County Council, 19 Clipstone Street (305 flats) Proposals for the redevelopment of the area bounded by Carburton Street, Cleveland Street, Clipstone Street and Great Titchfield Street are still under discussion with the Planning Authority. Housing (Financial Provisions) Acts, 1958 and 1959. (a) Loans.—The Council made loans during the year totalling £23,945 to enable applicants to acquire premises for owner-occupation. (b) Improvement Grants.—Discretionary and Standard Grants totalling £1,913 were approved during the year to enable private owners to convert and improve existing premises. Housing of Old People. (a) 51/54, Beaumont Street.—The development of this site by the erection of 29 flats for old people was commenced. (b) The Ladies' Home for Gentlewomen: 41, Abbey Road, N.W.8.—The modernisation of these premises was completed with the aid of a grant from the Council of £15,000. (c) St. Marylebone Almshouses.—Works of modernisation and improvement are in progress with the aid of a Council grant of £40,000. (d) Newstead, St. Marylebone Old People s Homes.—An application for a grant for the improvement of the Home was under consideration at the end of the year. Old People's Consultative Committee. A consultative committee was set up composed of members of the Housing Committee, the Public Health Committee and representatives of the St. Marylebone Old People's Welfare Association to meet from time to time to review the provision of housing accommodation made in the Borough for old people and to advise the Housing Committee where and how they consider such accommodation needs to be supplemented. Slum Clearance Programme—1961-65. A joint programme for further progress in the clearance of slums by 1965 was agreed with the London County Council and adopted for action. The following summary shows the proposals:— 1. The total problem (i) Estimated number of unfit houses 373 (ii) Period required for securing demolition 3 years. 2. Action already taken No. of houses closed or demolished since January, 1956 180 (113 by London County Council and 67 by Borough Council). 3. Further Proposals No. of houses to be demolished in clearance areas 373 (86 by London County Council and 287 by Borough Council). 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 34. 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 18, page 39. 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 ninety-one confidential medical certificates referred to the Medical Officer of Health were considered in conjunction with reports from the public health inspectorson environmental circumstances and, where justified, additional points were recommended. 20 Closing Orders were made on three rooms and an undertaking received regarding one room. 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 16 rooms were determined and orders on two rooms were varied. Land Charges Act, 1925. The Town Clerk referred to the Department 1,747 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, 66,300 West Indians, 23,700 Indians and 25,100 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 particular attention given to fire precautions, the numbers of lodgers accommodated, the possible presence of any verminous persons or articles, catering arrangements, sanitary and washing facilities and to general conformity with Bye-law requirements. Both lodging houses were found to be well managed and kept in a satisfactory condition. 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, 389 samples of food and drugs were examined. Of these 8 were taken formally and 381 informally. The number adulterated or incorrect in some other manner was 64 and the incidence of adulteration may be classified as follows:— Number of Samples examined Number of samples samples etc. Milk 29 1 Other foods 352 63 Drugs 8 — A sample of milk contained 7.75 per cent. of solids not fat, indicating the presence of not less than 8.8 per cent. of added water as judged by the Sale of Milk Regulations. The freezing point -0.489°C. indicated the presence of 6.9 per cent. of added water. Several dirty milk bottles were submitted for examination. One, full of milk, contained a film of dirt on the upper part of the bottle which had evidently been exposed for some considerable time before being collected and the dirt had not been removed by the bottle washing machine. The milk itself was fresh and contained no dirt showing that the bottle had been through the washing machine and was sterile. Another bottle possessed an unpleasant smell and there was a slight yellowish coloration at the bottom of the bottle, but no paraffin as suggested in the complaint was detected. A third bottle contained a sediment of tobacco ash. The dregs of the milk in the bottle were not sour and it would appear that the dust had gained access after the cap had been removed from the bottle. The dirt in a fourth bottle appeared to consist of decomposed milk which had not been removed during the bottle washing process. 21 A sample of butter contained 16.2 per cent. of water. Before the last war butter and margarine seldom contained more than about 14 per cent. of water, now they seldom contain less than 15.5 per cent. and, as a result, the legal maximum tends to be exceeded periodically. A cheese was labelled 'Farmhouse Soft Cheese' and packed as though it were a superior product, whereas in fact it was a skimmed milk cheese and should have been so described. Two other samples of cream cheese contained respectively 53.2 per cent. and 50.6 per cent. of fat calculated on the dry basis, whereas the fat content of a cream cheese should not fall below 65 per cent. calculated on the dry matter. A cheese preparation labelled 'Exultation of Flowers Elizabethan Cheese' was supposed to possess wonderful properties. The Exultation of Flowers was apparently used in order to manure the soil on which grows the grass, which feeds the cows, which provide the milk which forms the cheese, which makes the man glow healthy. If Exultation of Flowers were radio-active one might conceive of such a possibility, but not otherwise. A complaint was received concerning some frozen fillet steak. This consisted of three pieces of steak of which the largest was tainted and inedible although the two smaller pieces were quite edible. A sample purchased for comparison was not fresh, but at the same time one could not complain about it. A sample of minced steak contained approximately 250 parts per million of sulphur dioxide. It is illegal to add preservatives to minced meat. Some sausage meat contained 270 parts per million of sulphur dioxide without declaration. This failure to disclose the addition of preservatives in sausages is often due to suppliers of salt-spice-preservative mixtures not making it clear to sausage manufacturers that sausages containing this mixture are preserved sausages and must be sold as such. Some beef steak with gravy was reported as inferior because it contained only 67 per cent. of meat. Your analyst considered that it must contain not less than 80 per cent. of meat, but as the agreement between the Food Manufacturers Federation and Local Authorities had only recently been reached it was not reported as adulterated. A can of luncheon meat appeared to be blown but the contents were sterile. The tin was in a satisfactory condition and the blown appearance was due to the can having been overfilled with ice cold meat. A sample labelled 'chopped ham' contained 66 per cent. of total meat and was obviously a form of pork meat loaf and not chopped ham at all. A game pie in wine sauce was deficient in meat. The total meat on the whole pie was 14 per cent. Four samples of steak and kidney pie were mouldy and unfit for sale. A sample of baked beans with baconburgers in tomato sauce contained only 52 per cent. of meat in the baconburgers. Even assuming that the baconburgers absorb an appreciable amount of water from the beans and tomato sauce, the meat content should not be as low as 52 per cent. A baconburger is similar to a hamburger and should contain 80 per cent. of meat. A sample of egg ravioli contained only 5.8 per cent. of meat even calculating the protein of the egg as meat. It was considered that ravioli should contain at least 10 and preferably 15 per cent. of meat. Some hot dogs in gravy contained only 48 per cent. of total meat in the sausages. The order of ingredients listed 'pork' as the principal constituent with 'beef' in smaller quantity and it was therefore considered that the meat content should be not less than that of a pork sausage, i.e. 65 per cent. The sample was accordingly reported as inferior. A sample of pork sausages and one of pork sausage meat were discoloured due to bacterial spoilage and were unfit for sale. Two samples of beef sausages were mouldy and unfit for sale. These sausages had been unsatisfactorily stored. The illustration on a label of tunny fish with vegetables was considered to be misleading. It showed tomatoes, cucumber, carrots, peas, and potatoes whereas the vegetables in the can consisted of carrots, celery, cucumber, and cauliflower with a very little tomato. The varieties of vegetables present were not stated on the label. Some herrings in dill sauce were reported as inferior. The code markings on the top of the tin had been cut too severely with the result that the tin plate was cut right through so that the can leaked badly. The contents were, however, still sterile. Some bottled herrings were also incorrectly labelled as they were stated to contain 'REAL LEMON JUICE' in letters four times the size of other listed ingredients, although lemon juice was really the ingredient in smallest quantity. In your analyst's experience the words such as ' in wine 22 in wine sauce', 'with lemon juice', etc., are continually used in a sense which is out of all proportion either to their flavour or other value. Samples of caviar style salmon roe and hors d'oeuvres in jelly, received as complaints, were on the contrary quite fit for consumption. An egg and tomato sandwich possessed a strong cheesey odour and taste, but no cheese as such was detected in the sandwich. The odour and taste were probably caused by the use of a knife, heavily contaminated with a cheese of the Gorgonzola type, being employed in spreading the fat in the sandwich, or in slicing the egg. A slice of white bread, submitted wrth a large number of other pieces of bread, contained a piece of mouse dirt. Some biscuits, described as 'Butter Sandwich Biscuit Wafers,' contained 2.6 per cent, of fat on the whole biscuit, and the butter fat was less than 1.3 per cent. It was questioned whether they should be described as flour confectionery or as sugar confectionery. If sold as sugar confectionery they must contain at least 4 per cent, of butter fat, but if the sellers wished to claim that they were flour confectionery they contained insufficient fat to warrant the description Butter Sandwich Biscuit Wafers. Several samples of fruit biscuits were examined and the percentage of fruit found ranged from 1.44 per cent, to 51 per cent. Fruit biscuits containing less than 8 per cent, of fruit were reported as inferior. The pastry of some blackcurrant tarts had an objectionable soapy flavour, but the extracted fat and the extracted pastry on drying possessed quite a pleasant flavour. The free fatty acids were not excessive, and the flavour might have been due to the slight acidity of the fat used in the pastry reacting with an alkaline baking powder. Such an occurrence could not have been foreseen by the baker although the consequences were most unpleasant. Some Ryvita biscuits were submitted with the allegation that they contained a piece of plastic material but no further plastic could be found in the biscuits. Your analyst was of the opinion that the piece of plastic submitted had not been cooked in the biscuits, and thought it more likely that it had been in some butter or other substance which was adherent to the biscuit when it entered the mouth. A complaint was received about foreign matter in a Christmas pudding. This consisted of a piece of shale and was probably a contaminant of one of the fruits, no doubt the currants or sultanas, used in making the pudding. A sarnph of lemon juice possessed a dirty brown colour and contained a precipitate. No microbiological growth had taken place but the Vitamin C had been destroyed and it was thought that the juice must be old stock. Some salad herbs contained a snail shell, and more woody stalk fibre than should have been present. If the herbs were to be sprinkled on the salad half an hour before consumption, as directed, there would still be the sharp stalks present, which would be very unpleasant for anybody wearing dentures. Thay were reported as inferior. The flower of a portion of cooked cauliflower had a bluish tinge, but the amount of colour was so minute that it was impossible to isolate it, and it was thought that as cauliflowers belong to the brassica family the formation of the colour might be due to throwback. Although a lemon curd was vacuum packed it possessed an unpleasant odour and taste due to the oxidation of the lemon oil. The extracted fat gave a positive Kreis reaction for rarcidity and contained 1.93 per cent, of free fatty acids calculated as oleic acid. A sample of marzipan was stated to be prepared from 60 per cent. of sugar and 40 per cent. of almonds, whereas it contained 51.5 per cent. of sugar, 37 per cent. of almonds, and 11.5 per cent. of water and was therefore 14 per cent. deficient in sugar and 7.5 per cent, deficient in ground almonds. A sample of canned sweet corn was received with the complaint that it had caused sickness. The lead was less than 2, and the arsenic less than 4 parts per million and the condition of the lacquer was extremely good, so that no cause for sickness could be found. A complaint regarding the taste of a syphon of soda water was found to be justified. The soda water was badly contaminated with smoke and whilst the quantities of various smoke constituents were too small to be identified and determined they made the water objectionable and unfit for drinking purposes. Another complaint was received regarding a bottle of whisky. It appeared that the contents had been emptied out and the bottle refilled with water, but the bottle was in fact a sales dummy, which had been filled with water, and should not have been sold. 23 A further complaint was received about the quality of some chocolate cherry flavoured liqueurs as the chocolate coatings were broken and dried out. Your analyst agreed with the complaint, but his chief objection was that the so-called liqueur contained practically no alcohol and therefore the chocolates should not have been labelled 'Chocolate Cherry Flavoured Liqueurs 'but' Cherry Imitation Liqueur Chocolates'. The distributors were relucant to use the word 'Imitation' and iinally agreed to amend their label to ' Cherry Liqueur Flavoured Chocolates '. Some chocolate coins contained 10 parts per million of lead, whereas chocolate comes under the heading of other foods which are permitted to contain 2 parts per million only. The Lead in Food Regulations are a trifle inconsistent inasmuch as cocoa butler may contain 5 parts per million of lead on the fat free dry basis, whereas chocolate, including the fat and sugar, is restricted to 2 parts per million. A filling prepared from ground poppy seeds was mouldy and infested with mites. The declaration of ingredients was also incorrect. Water was included as an ingredient, although it need not be, but any ingredient for the presence of which a claim is made must be placed in its correct order of magnitude. A nut filling was similarly incorrectly labelled, but the product appeared to be satisfactory in itself. Two flakey pastry apple pies were found to be covered on the interior with a heavy mould growth of Penicillium glaucum, and were unfit for consumption. They were at least ten and probably more days old. A chocolate eclair was badly moulded throughout. If the eclair had been kept refrigerated this mould growth might have taken two to three weeks to develop, but under favourable conditions the growth could have occurred within five days. The labels of two samples of prune juice which were considered to be misleading apparently complied with the U.S.A. requirements. The liquids contained only 19.2 per cent, and 19.3 per cent, respectively of total solid matter and were labelled ' Prune Juice. A water extract of dried prunes '. If the label claimed that the products were ' A watery extract of dried prunes ' the matter would be entirely different, but under the Pharmacy and Medicines Act a water extract would mean that the prunes had been extracted with water and concentrated. Three artificial flavouring essences were incorrectly labelled as extracts. According to the Labelling of Food Order these may be described as ' flavouring ' or ' flavouring essences ' but not extracts. An essence is obtained by distillation whereas an extract is a preparation made by alcoholic or other solution of the active principles of a substance in concentrated form. The manufacturers of a low calorie salad dressing endeavoured to contract out of the Food Standards Order by using the title ' Salad Dressing '. The wording of the Order, however, is quite definite that it includes ' salad cream, mayonnaise and other salad dressing '. The label bore no declaration of ingredients, and if manufacturers of a product wish to contract out of a Standards Order they must declare the ingredients used in manufacture and make it clear that the product does not comply with the particular Order concerned. The manufacturers agreed to comply with the Labelling of Food Regulations. The predominating flavour of some ' Enchiladas ' (filled pancakes) with chili sauce was that of thyme, but there was no declaration of the presence of thyme or other herbs. It was considered that the word ' Chili' was also used incorrectly since the quantity of paprika was smaller than the quantity of tomato puree, whereas tomato puree is approximately six times concentrated tomato juice and the Enchiladas had no appreciable flavour of chili at all. Some Tortillas appeared to be thin flat cakes made of ground maize. According to the recipes on the label they were intended to be used in a similar manner to Italian macaroni pastes. The ingredients were not stated on the label, whereas only wheat flour products are exempt from such a declaration. A rice pudding with preserved fruits was incorrectly labelled. Some ' vanilla granules ' which were present were described as consisting of ' amylaceous matters, sugar, and agar-agar ' without reference to the artificial colouring or flavouring. The so-called fruits were of three colours. They all appeared to be of the same vegetable matter, but with different colourings, and it was impossible to identify the vegetable matter. A food thickener appeared to be a dried, powdered, aqueous extract of carrageen moss and in accordance with the Labelling of Food Order must be labelled as such. 24 The label of a health food did not disclose the ingredients in order of magnitude. The label showed ' Honey' in larger letters than the other constituents, whereas it appeared to be present only as the third constituent in order of quantity. A product labelled sour salt appeared to consist of pure citric acid. In accordance with the Labelling of Food Order a product must be labelled with its common or usual name. Other labels to which objection was taken included a vegetable oil which was labelled entirely in French ; a ' waffle Nadziewane ' which consisted of thin slices of cheese, but bore only a foreign label; and a processed cheese with ham which was labelled only in German. In accordance with the Labelling of Food Regulations ingredients must be disclosed. Food Legislation. The year brought little change in food legislation, although proposals were made for such changes. The Lead in Food Regulations, 1961, brought into force the proposals made by the Food Standards Committee in 1959. The maximum quantity of lead permitted in a ready-to-drink non-alcoholic beverage is 0.2 parts per million and for other foods 2.0 parts per million with the exception of certain foods. These are divided into two classes, those for which a larger amount of lead will be permitted for a limited time only and those which contain larger quantities of lead naturally and can never be kept at the low limit proposed for ordinary foods. Such foods include apples, pears, concentrated fruit juices and tomato puree or paste, fish and canned fish, raw sugars, including liquid or solid glucose, cocoa powder, tea, yeast and yeast products, dried onions, herbs, ground spices, flavourings, and pectin. The quantity permitted in these foods is based on the amounts likely to be present from natural causes. The Labelling of Food (Amendment) Regulations, 1961, exempts wines prepared from preserved or concentrated grape juice from declaring the fruit juice from which they have been prepared, even though they have not been obtained from the fermentation of the freshly expressed juice. The Ministers of Agriculture, Fisheries and Food, and of Health, the Home Secretary and the Secretary of State for Scotland have asked the Food Standards Committee to undertake a review of the existing labelling of food provisions of the Labelling of Food Order and other food regulations relating to labelling and the Food Standards Committee have asked for the views of any interested parties. The Food Standards Committee issued a supplementary Report on Preservatives in Food together with Proposals for new Regulations. The problem of preservatives, food additives, and similar substances is becoming so complex that one cannot but sympathise with any committee advising a government at the present time. In the opinion of your analyst, moreover, the time has now arrived when no country of importance can afford to make laws governing such additions without considering carefully the existing and possible legislation of other countries of similar development. Your analyst will be the opening speaker next September at an International Symposium called to explore the matter of food regulations. In the meantime one can only consider legislation as it affects this country and agree that the Committee have made a brave attempt to cope with the position as it is. It is unfortunate that many substances, such as salt, glycerin, propylene glycol, acetic acid, and others, should not be defined as preservatives when they are the most efficient and commonest preservatives in use. When advising the Government on legislation the Committee have also to consider the possibility of its implementation and one can only state that many experts are in grave doubt about the implementation of food legislation now and in the future. It is suggested that sulphur dioxide and benzoic acid shall continue as permitted preservatives for certain foods and it is interesting to note that it is suggested that sulphur dioxide shall be recognised as a preservative in unfermented grape juice to be used for sacramental purposes, provided that not more than 70 parts per million are employed, while ordinary fruit juices to be used for other purposes may contain up to 350 parts per million. As an alternative 2,000 parts per million of benzoic acid, or methyl- or propyl-p. hydroxybenzoate may be employed. The existing regulations have caused immense difficulties owing to an uncertainty, which was never intended. Methyl- or propyl-p. hydroxybenzoate will be permitted also in liquid coffee or tea extracts, drinking chocolate concentrate, pickles and sauces, tomato pulp, or liquid rennet. Here it is noted that liquid tea extract is given official notice for the first time in proposed British legislation and that permission will be given to use a preservative in a drinking chocolate concentrate, but there is no mention of chocolate syrups used on a very large scale for pouring over ice creams, puddings, etc. By definition these last are not flavouring syrups because they are not to be diluted with milk or water to make a drink with a distinctive flavour nor can they be described as flavouring emulsions. It is proposed that bread shall be permitted to contain up to 3,000 parts per million, i.e. 0.3 per cent, of propionic acid and that flour confectionery shall be permitted 1,000 parts per million of either propionic acid or sorbic acid. 25 Sorbic acid and nisin are to be permitted in cheese and nisin is also to be permitted in canned foods. Benzoic acid or sorbic acid are to be permitted in solutions of permitted food colours or in silicone anti-foam emulsions. It will be difficult for an analyst to say whether a trace of sorbic acid in a food has been introduced by reason of the inclusion of a small amount of a silicone anti-foaming agent. Sodium nitrate and nitrite are accepted as preservatives in cured meats and in Gouda and Edam type cheese. Ortho-phenylphenol may be employed as a preservative on apples, pears, pineapples, peaches, melons, and citrus fruit, but no such permission is extended to apricots, or to fruit such as Avocardo pears, which belong to the laurel family and are quite distinct from ordinary pears. Citrus fruits may also contain diphenyl. The food pattern of civilised countries is changing so rapidly at the present time that one wonders for how long such legislation can be effective. In support of the earlier note on the necessity for international collaboration in food legislation it may be mentioned that during the year W.H.O. issued a press report to the effect that boric acid may be added to caviar for all countries except Germany and the United States. Great Britain has forbidden its use since 1925. At the same time it may be mentioned that F.A.O. is now bringing out a series of monographs dealing with the legal position of food additives in various countries, each monograph being written by an acknowledged expert of the country concerned. The monograph on food additives in Great Britain was the second to be issued in the series. Proposals have been issued by the Food Standards Committee for Soft Drinks Regulations. Your analyst is greatly concerned that at the present time manufacturers of soft drinks can add vitamins or other ingredients to make them resemble official nutritional products and describe them by the official titles so long as letters such as B.P., or B.P.C. are not used. Blackcurrant syrups fall into this category but, so far, the Ministry has refused to take any action, though now that even broadcasting has drawn attention to the matter the situation may be changed. Similarly certain drinks need not comply with the requirements of the Regulations for sugar content if there is a clear and conspicuous description in writing indicating to the purchaser that the drink has been prepared for consumption by persons suffering from diabetes. Products have been creeping on to the market recently which claim the protection of this proviso, but which are intended for slimming purposes and are not expected to be used primaiily by diabetics. Even the names of the products suggest that they are intended for slimming. Another provision which your analyst would like to see introduced is one to prevent claims such as ' made from such and such fruit' for a product, which complies with the requirement of the order to the extent that it contains 2 lbs. of potable fruit and 4.5 lbs. of sugar in 10 gallons, i.e. 100 lbs. of final drink, over 93 per cent, of the drink being therefore added water. Following the issue towards the end of 1960 of the ' Food Standards Committee Report on Bread and Flour ' proposals for regulations were issued during 1961. Probably the most interesting point in these proposed regulations at the present time, in view of the interest taken in slimming, is that it shall be an offence to make any sort of claim, whether by inference or otherwise, that a bread, rusk, biscuit, or cereal food may be used as a slimming aid unless there is a clear statement indicating that it may only be so used if it forms part of a diet in which the total intake of calories is controlled. The Food Standards Committee were also asked to review the use of solvents and flavouring agents used in foods. Apart from water the number of solvents employed is confined to a small number of chemical liquids, but the number of chemicals employed for flavouring is very large. Proposals were also made for regulations to control the use of emulsifiers and stabilisers in food. One of the difficulties of British law is that if the use of a substance is generally recognised as suitable and safe for a particular purpose it ceases to be such a substance by legal definition, and these proposed regulations are no exception to this rule. Thus under the Labelling of Food Order sodium citrate, sodium tartrate, and sodium phosphates may be described generically as ' emulsifying salts ', but under the proposed regulations they are not to be considered as ' emulsifiers ' or ' stabilisers '. It is hardly surprising that exporters from other countries complain that it is difficult to understand British law. Thomas McLachlan, Public Analyst." Food—Adulterated or Unsatisfactory Samples. Twenty of the sixty-four unsatisfactory samples referred to in the Analyst's report concerned technical faults in labelling or description. After consultation with the manufacturers or importers the labels were revised or corrected. The other samples adversely reported upon were dealt with informally and no legal proceedings were necessary. 26 Unsound Food. Approximately 25 tons of food were voluntarily surrendered for destruction and certified as being unsound and unfit for human consumption. Details are given in Table 19, page 39. This is twice the amount surrendered last year and the increase is attributable to one consignment of several tons of imported cheese which was found to be mouldy, the surrender by a chain-store of their entire stock of coconut marshmallows containing unsterilized coconut, and to 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 of the unsound food on the premises was impracticable, or the material was unfit for animal feeding, it was sent in bulk to a central refuse disposal depot at Westminster. Merchandise Marks. During the year, seven instances were found of traders offering imported apples or tomatoes for sale as " English " or without indicating the country of origin. Six offenders were street traders and the other a shopkeeper. In each case a letter was sent indicating the requirements of the Orders and warning that legal proceedings would be instituted for any future offence. Milk. There are 92 registered premises from which milk is sold and 17 milk roundsmen operate in the Borough from shops or depots elsewhere. During the year, 100 applications for licences were received under The Milk (Special Designation) Regulations, 1960, for the five year period ending 31st December, 1965. The average percentage composition of the 28 genuine samples of milk analysed was : total solids 12.44, fat 3.73, solids not fat 8.70, the legal minima being, 11.50, 3.00, and 8.50 respectively. Twelve 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 27 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 202 for its sale and storage. Details of the classes of premises are given in Table 20, page 39. Twenty-one samples of ice-cream were examined by the Council's Bacteriologist, with the following results: Grade I—10; Grade II—5; Grade III—5; Grade IV—I. Chemical analysis of all these samples proved to be satisfactory. Grades I and II are considered to indicate that the samples are satisfactory but Grades III and IV call for further investigation. In the cases of the samples under review which were graded III and IV they had all come from catering premises where ice-cream was served from bulk containers which were intermittently opened and exposed to the air over periods of up to three days. In addition it was discovered that the washing-up of the equipment used for serving this ice-cream was not satisfactory. When these conditions were remedied subsequent samples were reported to be Grade I. Preserved Food. Sixty 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 20, page 39. Inns, Refreshment Houses, etc.—Provision of Sanitary Conveniences. There are 94 refreshment houses licensed by the London County Council in the Borough. 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. 27 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 1961. Catering Establishments. Most caterers strive to maintain a good standard of hygiene both in relation to staff and premises. St. Marylebone being a West End Borough, a large number of home and overseas visitors use the restaurants and if the absence of complaint to the Department is any criterion the premises in general are well-run. One of the greatest problems facing proprietors is lack of suitable staff. During the busy season part-time workers are engaged who in the main are inexperienced and, unless closely supervised, their lack of appreciation of rudimentary hygiene can cause great concern. In some instances the problem is so acute that, rather than accept this hazard, proprietors have closed parts of their premises so that they can continue with their regular staff only. A hitherto unusual occurrence is that because of the labour position some establishments close down completely for a holiday period during the summer months to enable their permanent employees to have a complete rest. Details of the various types of catering premises are given in Table 21, page 40. A total of 1,647 inspections was made, and although many defects were found the great majority were remedied with the willing co-operation of the caterers ; the service of only 38 informal notices was necessary. Wholesale and Retail Food Premises. Excluding catering establishments there are 575 of these premises, details of which appear in Table 21, page 40. During the year, 2.284 inspections were made and although many defects were found the majority were remedied voluntarily by the proprietors, and the service of only 77 informal notices was necessary. It may be too much to expect the achievement and the continued maintenance at all times of a completely satisfactory standard of hygiene in all food premises. There is still a great deal of work needed before the stage is reached when personal hygiene and the cleanliness of food premises advance beyond any possible risk to health, and cleanliness becomes an end in itself. In the meantime the most effective spurs to progress are frequent inspection and action under the Food Hygiene Regulations. Codes of Practice, Clean Food Guilds, and trade associations, as well as publicity and education, can and do play a useful part in improving standards but the presence of the Inspector within the premises, carrying out a thorough examination, is of the greatest value. Codes of practice and recommendations of trade associations are followed by the more progressive and conscientious businesses but for those showing laxity and indifference enforcement of the law provides the only answer. It is a pleasure to pay tribute to the outstanding achievements in the practice of hygiene of certain stores with headquarters in the Borough, which set a fine example throughout the country, and also, within the sphere of education, to the excellent courses in food hygiene held by the Royal Institute of Public Health and Hygiene at the Portland Place headquarters and at their many other centres. In one instance it was necessary to institute legal proceedings under the Food Hygiene (General) Regulations, 1960. Details are given in Table 22, page 40. Codes of Practice—Poultry. During the year a Code of Practice entitled " Poultry Dressing and Packing " was issued jointly by the Minister of Health and the Minister of Agriculture, Fisheries and Food. As with previous Codes, copies were sent to those engaged in the poultry trade with the request that the contents should be brought to the attention of all those concerned. Licensing Act, 1961. From the 1st November new types of licences to sell alcoholic drinks were introduced for restaurants, private hotels and guest houses, etc., and the procedure for granting of Justices' licences was revised. In each case the application is referred to the Public Health Department and this imposes much additional work on the staff. Objection can be raised to the granting or renewal of a licence if the premises are found to be unsuitable or inconvenient for the proposed use having regard to their character and condition. 28 Food Stalls. During the year food was sold from 87 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. Ten inspections were made and conditions found to be satisfactory. SECTION F.—INFECTIOUS AND OTHER DISEASES-PREVALENCE AND CONTROL There was an increase in the number of cases of infectious disease reported in the Borough, 467 notifications being received against 25!) the previous year. Of the total, measles accounted for 422, the figures for 1960 and 1959 being 145 and 250 respectively. Cases of whooping cough reported showed a decrease, 12 being notified this year as against 53 in 1960. There were no cases of poliomyelitis and again no diphtheria. Table 23. page 40, gives details of notifications and the age groups concerned. Smallpox Contacts. On arriving in London on the 4th April, the motor vessel " Strathnaver " reported that a member of the crew had been landed at Suez on the 25th March suffering from modified smallpox, a diagnosis which was confirmed by the Egyptian authorities. Nine contacts from the ship proceeded to addresses in St. Marylebone and five of these subsequently moved to other districts. All were followed-up, those who remained in the Borough being kept under daily surveillance until the end of the quarantine period on 10th April. No further cases developed. Tuberculosis. Table 25, page 41, gives information regarding primary notifications of pulmonary and non-pulmonary tuberculosis received during the year. Table 24, page 41, shows the age and sex distribution of new cases and of deaths from all forms of the disease, and Table 25, page 41, 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 130 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 notifications were received during the year but two relating to members of one family were withdrawn as the organism concerned, salmonella typhi-murium, was on that occasion thought not to have been food-borne. Of the remaining eight, two were probably connected with outbreaks at holiday camps, the organisms responsible being salmonella Newport and salmonella typhi-murium respectively; three isolated cases were respectively stated to be due to salmonella enteritidis, salmonella group ' B ', and staphylococcal toxin. In the other three cases no agent was identified. 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 65 cases of scabies : adults 46 (men 20, women 26) ; children 19 (boys 9, girls 10). 29 Disinfection. During the year, 59 rooms, 607 articles of bedding (mattresses, blankets, sheets, bolsters, pillows, etc.) and 562 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, 196 certificates relating to a total of 2,266 articles, were issued. Exclusion from Work of Contacts or Carriers of Infectious Diseases. 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, if 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, 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 (Infectious 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 one certificate was 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 4,520 of these certificates were authenticated. In addition, twenty-two certificates were issued, upon request, to the effect that no cases of smallpox had been reported in the district during the preceding two weeks. Applicants for these certificates are usually travelling to America and do not wish to submit to vaccination but the American immigration authorities reserve the right to place such persons under surveillance despite the production of this certificate. Bacteriological Examinations. Table 26, page 41, shows the number of specimens examined for the purposes of diagnosis and also indicates the organisms in relation to which the examinations were made. 30 31 APPENDIX OF STATISTICAL TABLES AND SUPPLEMENTARY INFORMATION 32 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 5 5 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. M. F. 1 Tuberculosis, respiratory 6 2 - - - - - - - - 1 - 2 2 3 - 2 Tuberculosis, other — 1 - - - - - - - - - - - 1 - - 3 Syphilitic disease 3 2 - - - - - - - - - - - - 3 2 4 Diphtheria - - - - - - - - - - - - - - - - 5 Whooping cough - - - - - - - - - - - - - - - - 6 Meningococcal infections - - - - - - - - - - - - - - - - 7 Acute poliomyelitis - - - - - - - - - - - - - - - - 8 Measles - - - - - - - - - - - - - - - - 9 Other infective and parasitic diseases — 3 - - - - - - - - - - - 2 — 1 10 Malignant neoplasm, stomach 10 10 - - - - - - - - 1 — 2 3 7 7 11 Malignant neoplasm, lung, bronchus 42 11 - - — — — — — — — 1 22 4 20 6 12 Malignant neoplasm, breast — 21 - — - - - - - - - 2 — 7 — 12 13 Malignant neoplasm, uterus — 7 - - - - - - - - - 2 - 4 - 1 14 Other malignant and lymphatic neoplasms 68 46 - - - - 1 1 1 - 5 2 26 12 35 31 15 Leukaemia, aleukaemia 5 2 - - - - - - - - - 1 4 1 1 — 16 Diabetes — 7 - - - - - - - - - - - 4 — 3 17 Vascular lesions of nervous system 54 93 - - - - - - 1 - - 3 8 10 45 80 18 Coronary disease, angina 44 66 - - - - - - — — 1 1 43 10 70 55 19 Hypertension with heart disease 22 20 - - - - - - - - - - 4 2 18 18 20 Other heart disease 70 90 - - - - - - - - - 4 5 3 65 83 21 Other circulatory disease 24 37 - - - - - - - - - - 6 5 18 32 22 Influenza 6 3 - - - - - - - - - - 2 2 4 1 23 Pneumonia 16 29 2 - - - - - — — 1 — 6 3 7 26 24 Bronchitis 45 25 — 1 — — — — — — — — 11 1 34 23 25 Other diseases of respiratory system 5 2 - - - - - - - - - - 3 — 2 2 26 Ulcer of stomach and duodenum 10 6 - - - 1 - - - - - - 3 — 7 5 27 Gastritis, enteritis and diarrhœa 1 5 - - - - - - - - - - 1 - - 5 28 Nephritis and nephrosis 3 3 — — — — 1 — — — — — 1 2 1 1 29 Hyperplasia of prostate 7 - - — - - - - - - - - 2 - 5 - 30 Pregnancy, childbirth, abortion — 1 - - - - - - - - - 1 - - - - 31 Congenital malformations 4 5 2 3 — — — — 1 — — — 1 2 - — 32 Other defined and ill-defined diseases 29 37 6 6 — — — — — - 2 — 8 3 13 28 33 Motor vehicle accidents 1 3 - - - - - - — 1 — 1 1 1 — — 34 All other accidents 9 3 - - - - - - 1 - 1 — 4 1 3 2 35 Suicide 9 7 - - - - - - 1 - 5 2 3 5 — — 36 Homicide and operations of war — 1 - - - - - - - - - - - - - 1 Totals 563 548 10 10 — 1 2 1 5 1 17 20 168 90 361 425 1,111 20 1 3 6 37 258 816 TABLE 2.—Infant Mortality—According to Age-Group and Sex. CAUSE OF DEATH Under 1 week 1 and under 2 weeks 2 and under 4 weeks 1 and under 3 months 3 and under 6 months 6 and under 9 months 9 and under 12 months Total M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Atelectasis 1 1 - - - - - - - - - - - - 1 1 Premature Birth 1 2 - - - - - - - - - - - - 1 2 Bronchitis - - - 1 - - - - 1 - - - - - 1 1 Congenital Abnormalities 2 2 - - - - 1 - - - - 1 - - 3 3 Renal Failure - - - - 1 - - - - - - - - - 1 - Asphyxia 1 - - - - - - - - - - - - - 1 - Pneumonia - 1 - - - - 1 - 1 - - - - - 2 1 Anoxia - 1 - - - - - - - - - - - - - 1 Subarachnoid Haemorrhage — 1 - - - - - - - - - - - - - 1 Totals 5 8 — 1 1 — 2 — 2 - — 1 — — 10 10 13 1 1 2 2 1 — 20 33 TABLE 3.—Weather Statistics. Station: Regent s Park. Height of rain-gauge above mean sea level:129 feet. 1961 Air Temperature Rainfall Weather Number of Days Bright 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 °C. °C. °C. °C. °C. in. in. hrs. hrs. % Jan. 7.1 2.2 4.3 11.7 29 1.7 12, 26 2.44 .47 29 14 - - - 5 20 - 37.9 1.22 128 Feb. 10.7 5.6 8.2 17.8 14 2.2 3 2.08 .65 27 13 - - - - 2 - 56.4 2.01 126 Mar. 14.2 4.3 9.3 22.2 15,16 0.5 20 .03 .02 18 2 - - 1 1 18 - 146.7 4.73 159 April 15.2 9.6 11.4 18.9 6 4.4 4 2.11 .45 3 19 - - - - 2 - 85.5 2.85 65 May 17.2 7.8 12.5 24.4 13 2.8 27, 28 1.04 .49 4 7 - - - - 6 - 209.7 6.76 112 June 21.9 11.3 16.6 30.0 30 7.8 3 1.42 1.12 12 4 - - - - - - 231.7 7.72 113 July 22.0 12.7 17.3 33.9 1 7.8 30 1.86 .56 15 11 - - - - - - 186.8 6.03 97 Aug. 21.5 13.0 17.3 31.1 29 9.4 7 2.58 .71 10 15 - - - - - - 158 2 5.10 90 Sept. 21.1 12.7 16.9 27.8 2 8.3 8.9 2.36 .62 13 13 - - - - - - 120.8 4.03 96 Oct. 15.7 8.6 12.1 21.1 10 1.7 30 2.59 .45 24 15 - - 2 - 3 - 110.1 3.55 132 Nov. 9.7 4.1 6.9 16.7 1 0.9 10, 24 26, 27, 28 2.76 1.26 10 13 — — - 5 13 — 48.5 1.62 118 Dec. 6.8 1.3 4.1 14.4 10, 11, 12 0.61 28 4.06 .80 31 13 2 - 2 16 21 - 49.9 1.61 187 *Average for years 1921-1950. 34 Table 4.—Summary of Road Accidents. Month Number of Accidents Fatal Injuries Serious Slight January 84 - 11 91 February 69 1 13 79 March 88 1 7 92 April 78 — 19 82 May 81 — 14 83 June 82 - 16 93 July 93 — 10 107 August 92 — 17 104 September 91 — 11 99 October 86 — 17 86 November 94 1 11 98 December 89 — 10 113 Totals 1,027 3 156 1,127 TABLE 5.—New Legislation. Legislation Operative Date Public Health (Aircraft) (Amendment) Regulations, 1961 17.1.1961 Public Health (Ships) (Amendment) Regulations, 1961 17.1.1961 Authorised Officers (Meat Inspection) Regulations, 1961 10.3.1961 Labelling of Food (Amendment) Regulations, 1961 20.3.1961 Anthrax (Disinfection Fee) Amendment Rules, 1961 1.4.1961 Home Safety Act, 1961 18.5.1961 Motor Cycles (Protective Helmets) (Amendment) Regulations, 1961 1.8.1961 Rag Flock and Other Filling Materials Regulations, 1961 1.8.1961 London County Council (General Powers) Act, 1961 3.8.1961 Rivers (Prevention of Pollution) Act, 1961 27.9.1961 Public Health Act, 1961 3.10.1961 Licensing Act, 1961 1.11.1961 1.3.1962 Housing Act, 1961 24.11.1961 Rent Restrictions (Amendment) Regulations, 1961 24.11.1961 Factories Act, 1961 1.4.1962 Lead in Food Regulations, 1961 16.4.1962 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 1,298 (b) Inspections made for the purpose 2,923 (2) Found to be in a state so dangerous or injurious to health as to be unfit for human habitation 1 (3) Found not to be in all respects reasonably fit for human habitation 280 Defects remedied without service of formal Notices :— Defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 218 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 219 (2) Dwelling-houses in which, after service of formal notices, defects were remedied :— (a) By owners 70 (b) By Local Authority in default of owners — (b)Proceedings under tne Housing Act, 1957 :— (1) Rooms in respect of which Closing Orders were made :— Underground rooms 3 Other rooms — (2) Closing Orders determined, the tenement or room having been made fit 8 (3) Rooms affected by (2) above 16 (4) Closing Orders varied 1 (5) Undertakings accepted in respect of underground rooms 1 35 TABLE 7.—Nuisances Remedied. Nuisance Abated or Defect Remedied Number Houses damp, dirty or dilapidated 146 Doors, windows, floors, ceilings, sash cords, grates and flues, etc., defective 195 Drain, water-closet and waste pipe stoppages 61 Drains, water-closets and waste pipes defective 61 Yard, area and wash-house defects 15 Roofs, gutters and rainwater pipes defective 125 Insufficient water supplies 10 Water cisterns dirty or defective 10 Ashpits, dustbins, etc., defective 40 Rubbish accumulations 35 Animal nuisances 5 Miscellaneous 27 Total 730 TABLE 8.—Chemical Examination of Water supplied to St. Marylebone— Average Results. Milligrammes per Litre (unless otherwise stated) Source of Supply:— Hampton Ashford Common Barn Elms No. of samples 52 52 52 Ammonia Nitrogen 0.045 0.055 0.034 Albuminoid Nitrogen 0.080 0.084 0.082 Nitrate 4.1 3.9 3.9 Chlorides as CI. 26 26 26 Oxygen abs. from Permanganate 4 hrs. at 27º C. 1.06 1.14 1.14 Turbidity units 0.2 0.2 0.4 Colour m.m. brown 2 ft. Tube Rurgess's Tintometer 13 13 13 Hardness (total) 268 278 276 Hardness (non-carbonate) 52 52 52 pH. Value 7.9 8.0 8.0 Phosphate as P04 0.95 0.95 0.90 Silicate as Si02 9 9 9 Sulphate as S04 50 50 50 Natural Fluoride as F 0.2 0.2 0.2 Magnesium as Mg. 6 6 6 Surface active material as manoxol 0.11 0.11 0.11 Electrical Conductivity (micromhos) 525 550 550 TABLE 9.—Bacteriological Examination of Water supplied to St. Marylebone— Average Results after Treatment. Source of supply Number of samples Agar plate count per ml. Coliform count E. coli count 20-24 hours at 37°C. 3 days at 22°C. Per cent, samples negative in 100 ml. Per cent, samples negative in 100 ml. Hampton 1,066 11.7 99.91 100.0 Ashford Common 765 24.1 — 99.87 100.0 Barn Elms 510 19.7 — 100.0 100.0 36 TABLE 10.—Rodent Control. Complaints: Complaints of rats received 184 Complaints of mice received 422 Total premises involved 606 Block Treatment : Blocks of premises surveyed 95 Separate premises involved 6,386 Infestations : Premises rid of brown rats 176 Premises rid of black rats — Premises rid of mice 434 Total premises disinfested by Council's staff 619 Total visits to such premises 3,287 Notices : Intimation notices served 62 Statutory notices served — TABLE 11.—Air Pollution. Readings from Deposit Gauges and Other Apparatus for Measuring Air Pollution Site Jan. Feb. Mar. Apr. May June July Aug. Sept Oct. Nov. Dec. Insoluble Matter—Tons per sq. mile (collected in deposit gauges) N.l. 29.62 25.19 7.18 9.26 10.38 8.93 7.43 8.48 9.31 17.82 13.33 21.11 t.h. 14.24 12.74 5.51 11.15 5.94 7.03 6.18 8.08 8.75 9.05 8.09 10.81 Soluble Matter—-Tons per sq. mile (collected in deposit gauges). N.l. 6.71 5.80 2.45 5.80 3.23 5.31 4.10 7.06 5.10 4.22 6.56 8.44 t.h. 5.98 6.64 2.76 6.61 4.77 10.32 4.12 5.92 6.81 7.93 7.86 9.49 Sulphur Trioxide—Milligrams per day collected (per 100 sq. cm. of lead peroxide) N.l. 2.75 4.37 3.46 1.93 1.25 0.85 0.86 0.95 1.55 2.23 3.02 3.74 t.h. 4.41 5.54 5.09 4.05 2.33 2.01 1.76 1.99 2.81 4.46 5.54 6.52 e.r. 4.40 5.63 4.12 3.33 1.97 1.50 1.30 1.50 2.44 3.18 5.57 5.81 Smoke—Microgrammes per cubic metre (Volumetric method) t.h. 200 200 150 67 47 46 51 42 63 94 200 288 G.P. 370 270 190 80 49 28 36 27 50 84 218 320 Sulphur Dioxide—Microgrammes per cubic metre (Volumetric method) t.h. 372 372 429 313 168 155 78 83 141 121 152 134 G.P. 200 172 257 154 110 85 81 46 96 149 292 284 37 TABLE 12.—Air Pollution. Annual Daily Average of Mean Concentration of Smoke and Sulphur Dioxide. Site 1961 1960 1959 1958 1957 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. 12 7 15 10 17 12 20 10 23 9 g.p. 14 6 18 7 19 10 20 8 24 8 TABLE 13.—Air Pollution. Annual Monthly Average of Deposited Matter and Sulphur Trioxide. Site 1961 1960 1959 1958 1957 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. 15.61 3.87 18.92 3.98 19.80 4.49 20.87 4.16 17.7 3.9 n.l. 19.40 2.25 20.22 2.08 18.06 2.38 22.28 2.78 20.8 2.6 D.S. - — — — — — 21.9† — 17.3 — E.R. — 3.40 - 3.28 — 3.79 - 3.13 - 3.4 Notes to Tables 11,12 and 13 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. 38 TABLE 14.—Factories : Inspections for Purposes of Provisions as to Health. Premises Registered Inspections Written notices Occupiers prosecuted Factories without mechanical power 231 110 4 - Factories with mechanical power 1,090 778 24 — Other premises* (excluding outworkers' premises) 460 523 - — Totals 1,781 1,411 28 — *Electrical stations, institutions, sites of building operations and works of engineering construction. TABLE 15.—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 19 15 2 1 - Overcrowding — — — — — Unreasonable temperature — — — — — Inadequate ventilation 2 2 — — — Ineffective drainage of floors — — — — — Sanitary conveniences:— (a) insufficient — — — — — (b) unsuitable or defective 29 28 — 15 — (c) not separate for sexes — — — 1 — Other offences (excluding offences relating to outwork) 3 3 2 1 — Totals 53 48 4 18 — TABLE 16.—Summary of Outwork. Description of Work Outworkers Employed Wearing apparel 576 Textile weaving 9 Curtains and furniture hangings 8 Furniture and upholstery 3 Household linen 1 597 39 TABLE 17.—Pharmacy and Poisons Acts, 1852-1941 : Summary of Sellers of Part II Poisons. Type of Business Total Licensed Grocery and provision stores 33 Hardware and domestic stores 14 General stores 16 Hairdressers 7 Builders' merchants 2 Drug stores 1 Dental sundriesman 1 Photographic dealer 1 75 TABLE 18.—RENT ACT, 1957. Applications for Certificates of Disrepair 4 Notices served on landlords of Proposal to issue Certificate of Disrepair 5 Undertakings received from landlords — Certificates of Disrepair issued 6 Applications for Certificates as to Remedying of Defects — Certificates as to Remedying of Defects issued — Applications for cancellation of Certificates of Disrepair 3 Certificates of Disrepair cancelled 2 TABLE 19.—Unsound Food Voluntarily Surrendered. Description Tons Cwts. Qtrs. Lbs. Meat and offal - 13 3 5 Sausages, brawn, etc. 10 2 — 17 Canned meat 1 18 3 19 Bacon and ham 1 - 3 1 Poultry and game — 17 1 6 Canned food (other than meat) 1 6 2 12 Fish - 7 2 7 Fruit and Vegetables 1 13 — 11 Miscellaneous 7 — 2 26 Totals 25 0 3 20 TABLE 20.—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 29 - Tobacconists, confectioners/newsagents — 89 Grocers and provision merchants 23 46 Fishmongers 6 3 General stores 1 9 Milk shops — 15 Greengrocers and fruiterers — 20 Public houses — 2 Ice-cream factories — 3 Miscellaneous 1 18 60 205 40 TABLE 21.—Summary of Food Premises. Type of Business Totals Hotels and boarding houses 332 Restaurants, cafes and snack bars 305 Grocers and provision merchants 174 Canteens and clubs 184 Public houses and wine bars 165 Confectioners 119 Refreshment houses 94 Stalls, street trading 87 Greengrocers and fruiterers 61 Butchers 52 Schools and nurseries 49 Bakers 30 Wine merchants (off-licence) 29 Fishmongers 13 Milk depots 7 Coffee stalls and kiosks 5 Ice-cream manufacturers 3 1,709 TABLE 22.—Legal Proceedings : Food Hygiene. Date of Hearing Offence Result 30.5.61 Smoking whilst handling open food (Food Hygiene (General) Regulations, 1960) Fined £10 with 2 gns. costs. TABLE 23.—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— Erysipelas 5 - - - - - - - - - - 3 2 2 3 Scarlet fever 13 — — — — 3 9 1 - - - - - — 13 Puerperal pyrexia 4 — — — — — — — 1 3 — - — 4 — Pneumonia 3 - - - - - - - - 1 1 - 1 2 1 Dysentery 9 — 1 1 1 1 1 — — 2 1 - 1 6 3 Measles 422 17 44 74 47 58 158 8 6 8 2 - — 17 405 Whooping cough 12 2 2 1 1 1 4 1 - - - - - 2 10 Scabies 11 - - - - - 1 1 3 4 2 - — 11 — Tuberculosis— Pulmonary 40 - - - - - 3 — 1 11 5 16 4 17 23 Non-pulmonary 2 — — — — — — — — 1 — 1 — — 2 Food poisoning 8 - - 1 1 - 1 - - 4 - - 1 1 7 Totals 529 19 47 77 50 63 177 11 11 34 11 20 9 62 467 *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, poliomyelitis or acute encephalitis. 41 TABLE 24.—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 - — — — - — — — 5—15 2 2 — — - — — — 15—25 2 6 1 — - — — — 25—35 12 9 — 1 1 - - - 35—45 9 5 - - 1 - — — 45—55 9 — — 1 1 — — — 55—65 9 7 — 1 2 2 1 — 65 and upwards 6 2 — — 5 — — — Totals 49 31 1 3 10 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. TABLE 25.—Tuberculosis : Summary of Register. Pulmonary Non-Pulmonary Total M. F. Total M. F. Total (a) Number of cases of tuberculosis on the Register at the beginning of the year 569 419 988 36 50 86 1,074 (b) Number of cases notified to the Medical Officer of Health under the Regulations for the first time during the year 20 21* 41 1 1 2 43 (c) Number of cases removed from the Register during a preceding year which have been restored to the Register during the year 3 1 4 - - - 4 (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 29 10 39 - 2 2 41 (e) Number of cases removed from the Register during the year 82 53 135 4 3 7 142 (f) Number of cases remaining on the Register at the end of the year 539 398 937 33 50 83 1,020 *Includes one notification after death. TABLE 26.—Summary of Work of the Bacteriological Laboratory. Nature of Specimen and Examination Positive Negative Total Throat and nasal swabs for— B. diphtheriae — 74 74 Haemolytic streptococci — 53 53 Vincent's organisms 1 2 3 Sputum for— Tubercle bacilli - 7 7 Faeces for— Parasites, typhoid, paratyphoid, dysentery and food poisoning organisms 6 115 121 Foods for— Food poisoning organisms 2 14 16 Swabs for— Food poisoning organisms — 1 1 Totals 9 266 275 42 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, IV.2 and N.W.8. Colquhoun House, 30, Euston Square, N.W.1. 5, Praed Street, W.2. Broadwick Street, W.L Tel. : EUS. 6451. Tel. : PAD. 3411. Tel. : REG. 7010. LONDON COUNTY COUNCIL. Homes.—Luxborough Lodge, 1, Luxborough Street, W.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.—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.l. (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., Tuesdays 1.30 p.m. to 4.30 p.m. and Fridays 9 a.m. to 12 noon. 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. and Miss B. Wilson, Public Health Inspectors, deal with any public health matters among old people which are brought to their 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.l.—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. Eight 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. 43 Meals on Wheels. (Dinners).—This service for the housebound 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 lid. for two courses. Apply either to the Old People's Welfare Association or to the W.V.S. W.V.S. Luncheon Club, 134, Seymour Place, W.l. (Tel.: PAD. 5597).—Old age pensioners can obtain dinners for lid. from Monday to Friday. Notice to attend must be given to the 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 Souls' 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. Monday to Friday, 10 a.m. to 5 p.m. (Tel.: WEL. 8614 and WEL. 8708). The "Wireless for the Bedridden" Society, 20, Wimpole Street, W.l. (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.ll. (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, 236, Portman Buildings, Lisson Grove, N. W. 1. (Tel.: PAD. 8553). Church Army, 55, Bryanston Street, W.l (Tel.: PAD. 9211). British Red Cross Society, 106, Crawford Street, W.l. (Tel.: WEL. 3416). National Association for Mental Health, 39, Queen Anne Street, W.l. (Tel.: WEL. 1272). The Horder Centres for Artliritics, 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, 187, Marylebone Road, N. W.l. (Tel.: PAD. 6649).—-This Home has some beds for old men. Apply Secretary. Church Army Lodging House for Women, 84, Bell Street, N.W.I. (Tel.: PAD. 0447).—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 6d, 44 SUMMARY OF HOSPITALS AND CLINICS SERVING THE BOROUGH Ambulance Service : Emergency Bed Service (to all hospitals in Greater London) HOP 7181 Normal Removals ( do. ) WAT 3311 Hospitals : Florence Nightingale Hospital, 19, Lisson Grove, N.W.1 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.l 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.l0 LAD 2281 St. Marylebone Hospital for Psychiatry and Child Guidance, 48, Cosway Street, N.W.1 PAD 8854 St. Mary's Hospital, Praed Street, W.2 AMB 1280 Samaritan Hospital, Marylebone Road, N.W.1 PAD 6011 The Middlesex Hospital, Mortimer Street, W.l MUS 8333 Western Ophthalmic Hospital, Marylebone Road, N.W.1 PAD 1871 Clinics : Arthur Stanley Institute for Rheumatic Diseases and Allied Conditions, Peto Place, N.W.1 LAN 6778 Carter Foundation (Temperance Clinic), 34, Seymour Street, W.l. AMB 6689 Charterhouse Rheumatism Clinic, 56-60, Weymouth Street, W.l WEL 1264 Chest Clinic. Town Hall, Marylebone Road, W.l WEL 7766 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 6867 General Medical Council, 44, Hallam Street, W. 1 LAN 2727 General Nursing Council for England and Wales, 23, Portland Place, W.l LAN 8334 Institute of Cardiology, 35, Wimpole Street, W.l HUN 3043 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, II, Chandos Street, W.1 LAN 1043 Royal College of Midwives, 15, Mansfield Street, W.l LAN 6523 Royal College of Nursing, la, Henrietta Place, W.l LAN 2646 Royal College of Obstetricians and Gynaecologists, 27, Sussex Place, Regent's Park, N.W.1 AMB 5425 Royal Institute of Public Health and Hygiene, 28, Portland Place, W.l LAN 2731 Royal Medico-Psychological Association, 11, Chandos Street, W.l LAN 1495 Royal Society of Medicine, 1, Wimpole Street, W.l LAN 2070 Royal Society of Tropical Medicine and Hygiene, 26, Portland Place, W.l LAN 2127 45 46 INDEX Page Accidental Deaths 3,34 Accidents : Home 10 Road 3, 34 Adulterated Food Samples 20, 25 Aged Persons 5,6,9,19 Aged Persons—-Services available 42,43 Air Pollution 14,36,37 Ambulance Service 44 Analysis of Food and Drugs 20 Analyst, Public 1,20 Analyst, Public, Report 20 Bacteriological Examinations 29,41 Bacteriological Examination of Milk and Ice Cream 26 Bacteriologist 1 Barbers 15 Baths : Cleansing of Persons 13 for Old People 6 Public 9 Swimming 9 Births 2, 3 Bodies, Transportation Abroad 17 Books, Library 8, 29 Bugs 13 Burial or Cremation of the Dead 17 Cancer 3, 32 Care of Old People 6, 6, 9, 19, 42, 43 Catering Establishments 27,40 Causes of, and Ages at, Death 32 Census Population 2 Certificates of Disrepair 19,39 Clean Air 14,36, 37 Cleansing, Public 16 Cleansing Station 6, 13,28 Cleansing of Verminous Persons 13 Clearance, Slum 18, 19 Clinics 44 Closing Orders 19 Codes of Practice—Food 27 Combined Drainage 13 Committee, Public Health 1 Common Lodging Houses 20 Compulsory Removal 9 Conditions, Social 2 Conferences 5 Consumer Protection 15 Conveniences, Public 15 Cremation 17 Deaths : Accidental 3, 32, 34 General 2,32 Infant Mortality 2,3,32 Maternal Mortality 2,3 Vital Statistics 2 Diseased or Infirm Persons, Removal 9 Diseases, Notifiable 28,40 Disinfection 29 Disinfestation 13 Disrepair Certificates 19, 39 Dog Nuisance 17 Drainage 13 Drugs, Analysis 20 Dwelling-Houses19,34 Exclusion from Work 29 Factories 14,38 Financial Contributions to Voluntary Organisations 5 Fireguards 15 Food : Adulterated, etc 20, 25 Analysis 20 Codes of Practice 27 Inspection 20 Legal proceedings 27,40 Legislation 24,34 Page Food: Poisoning 28 Premises 26,27,39,40 Preserved, etc. 26,39 Stalls28, 40 Unsound 26,39 Fouling of Footways by Dogs 17 General Statistics 2 Hairdressers and Barbers 15 Health Education 5 Heating Appliances (Fireguards) 15 Home Accidents 10 Horseflesh 28 Hospitals 44 Housing: Certificates of Disrepair 19 Closing Orders 19,34 Improvements and Conversions 19 Inspection and Action taken 34 Of Old People 19 Old People's Consultative Committee 19 Permanent Estates 18 Re-housing, Medical Certificates 19 Slum Clearance 18, 19 Hydrogen Cyanide Disinfestation 13 Hygiene—-Food Premises 26,27 IceCream 26,39 Immigrants 20 Impetigo 28 Improvement and Conversions, Housing 19 Infant Mortality 2,3,32 Infectious Dieases : Exclusion from Work of Contacts 29 Notification 28,40 Prevalence and Control 28 Statistics 40,41 Inns, Refreshment Houses, etc. 26 Inspection, Sanitary 11,34,35 Institutions, Medical and Nursing, etc 44 International Certificates of Vaccination 29 Intimation Notices 11, 34 Knacker's Yard 28 Land Charges Enquiries 20 Laundry : Public 9 Service for Old People, etc.6 Legal Proceedings 11,27,40 Legislation, New 11,24,34 Library books 8,29 Licensed Premises 27 Lung Cancer 3 Marriages 2 Maternal Mortality 2, 3 Measles 28,40 Medical Examinations : Staff 10 Parking Meter Exemptions 10 Medical and Nursing, etc., Institutions 44 Medical Referee, Cremation 1,17 Merchandise Marks Act 26 Mice 13,26 Milk : Bacteriological Examination 26 Sellers 26 (Special Designations) Regulations 26 Mortality : Infant 2,3, 32 Maternal 2,3 New Legislation 11,24,34 Noise 11 Notices, Intimation and Statutory 11,34 Notification of Infectious Diseases 28,40,41 Nuisances 11,17,35 47 Page Offices 14 Old People : Care of 5 Housing—Consultative Committee 19 St. Marylebone Welfare Association 6 Services Available 42,43 Outworkers15,38 Parking Meter Exemptions—Medical Examination 10 Pet Shops 15 Pharmacy and Poisons Acts 15, 39 Photographers, Street 17 Pigeons 12 Poisoning, Food 28 Poisons 15,39 Poliomyelitis 28 Population 2 Preserved Food 26,39 Protective Helmets 15 Public Analyst 1, 20 Public Analyst's Report 20 Public Baths 9 Public Cleansing 16 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 28,40,41 Rag Flock and Other Filling Materials 16 Rateable Value 2 Rats 13, 36 Referee, Medical (Cremation) 1, 17 Refreshment Houses 26 Refuse Collection and Disposal, Storage 16 Removal, Compulsory 9 Rent Act 19, 39 Representation upon other Bodies 4 Restaurants 27,40 Road Accidents 3,34 Rodent Control 13,36 Page St. Marylebone Old People's Welfare Association 6, 42, 43 Sanitary Circumstances 11 Sanitary Inspection 11 Scabies 28 Sewerage 13 Shelter 14 Shops 14 Slaughter of Animals 28 Slum Clearance 18,19 Smallpox Contacts 28 Smoke Control 14,36,37 Social Conditions 2 Staff : of Department 1 Medical Examinations 10 Stalls, Food 28,40 Statistics: General and Vital 2 Tables 32 to 41 Statutory Notices 11 Stillbirths 2 Street Cleansing 16 Street Photographers 17 Swimming Baths 9 Town Planning 13 Transportation of Bodies Abroad 17 Tuberculosis : General 28 New Cases and Deaths .28, 41 Notifications 28,40,41 Register 28,41 Unsound Food 26, 39 Vaccination, International Certificates 29 Vermin 13 Verminous Persons, Cleansing 13 Vital Statistics 2 Water 12,35 Weather 3,33 Wells, Private 12 Zoological Society of London 28 Vail & Co. Ltd., Leeke Street, King's Cross, W.C.I.