AC 4353 STMARY 67 BOROUGH OF ST. MARYLEBONE REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1962 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 10 Section D—Housing 17 Section E—Inspection and Supervision of Food 20 Section F—Infectious and other Diseases—Prevalence and Control 26 Appendix of Statistical Tables and Supplementary Information 28 Index 42 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 my Annual Report on the health of the Borough during 1962. 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. Throughout the year the public health continued to be satisfactory. The standardized birth and general death rates remained virtually the same as in 1961 while infant mortality fell from 26.39 to 22.22 per thousand live births; the stillbirth rate of 11.63 per thousand total births was appreciably lower (19.40 last year) and happily there were no maternal deaths. Furthermore, the incidence of infectious disease was the lowest on record, only 277 notifications being received. Measles accounted for 107 of these (compared with 422 in the previous year) and dysentery for 81—of the latter cases 70 occurred in two residential homes emphasising how difficult it is to prevent the spread of this fortunately mild infection in such closely knit communities. Only two cases of whooping cough and one of poliomyelitis were notified in 1962 and the long sequence of years free from diphtheria and smallpox continued. No case of smallpox has occurred in St. Marylebone for more than thirty years but this record was gravely threatened in the early part of the year following the arrival just across the border in the neighbouring borough of St. Pancras, at the very end of 1961, of a Pakistani already ill with the disease. This was the first of five separate importations of variola major from Karachi leading in all to the occurrence of 62 cases, with 24 deaths, in England and Wales. Thus the beginning of 1962 found the Department intensely engaged in following up smallpox contacts, making arrangements for vaccination, and authenticating many thousands of International Certificates as described on page 26. Mercifully, no secondary cases developed in St. Marylebone. In a world growing smaller year by year there is less and less room for complacency. The main causes of death amongst adults continued to be diseases of the cardiovascular and respiratory systems and various forms of cancer. This toll is unnecessarily heavy—a fact underlined in the report of the Royal College of Physicians on "Smoking and Health" which was published in March, 1962. The association between cigarette smoking and lung cancer and bronchitis is convincingly demonstrated in this authoritative survey which also suggests that the habit may contribute to the development of coronary heart disease as well as aggravating and perpetuating ulcers of the stomach and duodenum. Here at least is one sphere where the value of abstention is beyond dispute and in which the exercise of personal responsibility is inescapable. Where there is a will there is a way ! However, much encouragement will be needed to persuade the tobacco lover to give up smoking cigarettes for it is far from easy to abandon a pleasure of long standing. "Better not to acquire the habit in the first place" must be the theme where the young are concerned. There can be no doubt that the self-inflicted wounds of personal pollution through cigarette smoking are aggravated by the impersonal contamination of the atmosphere emanating from domestic and industrial chimneys. Hence it is good to report that the smoke control programme for the Borough proceeds according to plan. The smoke control area covering the Portman Square Ward came into operation on the 1st of October and by the end of the year the sixth order (affecting the Bryanston Square Ward) to be made by the Council had received confirmation from the Minister pf Housing and Local Government. If further justification of smoke control measures were needed it was provided early in December when thick fog enveloped London for a period of four days. In similarly unfavourable weather conditions, while the sulphur dioxide concentrations closely resembled those experienced in the great smog of 1952, the smoke readings were down by over a third thanks to the Clean Air Act of 1956. Making full allowance for the greater public awareness of the hazards of smog—scarves and handkerchiefs being more widely used as protective filters and the chesty tending to remain indoors—it seems highly probable, to say the least, that the reduction in smoke pollution contributed to the substantially smaller number of deaths directly attributable to the smog (340 in London in contrast to some 2,000 ten years previously). Although smoke particles constitute the greatest menace to health, efforts to remove other pollutants are always welcome. In this respect it was heartening to learn near the end of the year of the proposed conversion to oil firing of the boilers in use at Lodge Road Power Station, with the concomitant prospect of relief from grit and dust pollution. It is also pleasing to note, in the information kindly supplied by the Director of Public Cleansing on page 15, that an extension of the dustless refuse collection system, so successful in the St. John's Wood area, is contemplated. (ii) Harmful as atmospheric pollution is to health, in terms of baneful effect it cannot compare with bad housing conditions. Hence the priority rightly given to slum clearance. In recent years, however, there has been a growing appreciation of the major public health problem posed by the multiple occupation of houses originally designed for single families. The squalid Living conditions associated with overcrowding, lack of basic amenities, and poor management are clearly inimical to health, and the Housing Act of 1961 gives local authorities new powers to deal with such deplorable circumstances. The number of houses in multiple occupation in St. Marylebone exceeds four figures and, as mentioned on page 19, a detailed survey of these commenced towards the end of the year. In this context it is gratifying to record that much modernisation of privately owned property, including renovation of blocks of tenement buildings, is taking place in the Borough with the active encouragement of the Council. Nonetheless it remains true that only the building of many more new homes can remove the misery and heartache experienced by so many families in the Metropolis today. One new housing scheme of especial interest is the Beaumont Street project being undertaken by the Council. This block of 29 flats specifically designed for old people will be of great value to the infirm elderly who need the friendly help of a resident warden. Once again comfort and companionship for many of the senior citizens of the Borough have been provided by the St. Marylebone Old People's Welfare Association which works in close harmony with the Health Department. An extract from the annual report of this sterling organization appears on pages 6 to 9. The passage of an Amending Act to the National Assistance Act will enable the Council to give more direct help in the provision of meals and recreational facilities for the aged. The full report of the 1961 census indicated a night population in St. Marylebone of 69,045 (of whom 10,823 were aged 65 years or more) compared with 78,521 a decade previously. This downward trend in population has been present for many years. At the beginning of the century the inhabitants of the Borough numbered more than 141,000 and a hundred years ago the population was 161,860. Dr. Robert Dundas Thomson, who was Medical Officer of Health at that time, refers in his Annual Report for 1862 to the terrible plight of the people caused by overcrowding and to the resultant disease and death. He observes that "our new buildings are diminishing and our population is increasing. It must therefore become denser, and as this overcrowding proceeds a limit must be reached at which fever is the powerful check, but it is an awful one, since the poison thus produced in the human system by vitiated air and excretions is capable of extending its baneful influence to others and in a most fatal manner." Happily the appalling conditions which then prevailed and which stirred him so deeply have largely vanished, and the St. Marylebone of today is a very different place. Thanks to the work of pioneers in public health such as Dr. Thomson and to more recent advances in medicine and hygiene coupled with improved social conditions, the decline in population in St. Marylebone has been due primarily not to disease but to the transformation of the Borough from a predominantly residential district to one in which commercial premises feature prominently. A century ago universal elementary education had yet to be introduced and the national standard of hteracy was understandably low. Today reading, writing and arithmetic are taught to all but we are still largely untutored in the field of human relationships. If as much attention were paid to fostering a sense of personal responsibility, respect and concern for others, and the self-discipline reflected in voluntary restraint as the three formal 'R's' of education receive, then the seemingly intractable problems of race, religion and behaviour might be resolved to the lasting benefit of humanity. In truth the inculcation of the three social' R's ' provides the best guarantee of attaining that state of positive health which betokens something more than the mere absence of disease. True health and true education are indivisible. In conclusion it is a pleasure to express my gratitude to His Worship the Mayor, Councillor Mrs. F. E. Glenny and Councillor Dr. H. K. Ashworth, the Chairmen who have been in office during the year, the members of the Public Health Committee and to members of the Council generally for their continuing help and encouragement. To my colleagues in other Departments of the Council I extend my sincere thanks for the assistance they have so willingly given me. Finally I am more than grateful to the Staff of the Public Health Department for their unfailing cheerfulness and loyal support. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, HASTINGS E. A. CARSON, Medical Officer of Health. (iii) 1 PUBLIC HEALTH COMMITTEE 1962 HIS WORSHIP THE MAYOR : *Alderman Peter Pettit, D.S.O., T.D., J.P. †Councillor G. J. Brown, O.B.E., J.P., M.I.Mech.E. ALDERMAN: C. D. Denis-Smith COUNCILLORS : R. H. S. Allen (†Vice-Chairman) The Rev. w. M. Long Dr. H. K. Ashworth, T.D. (†Chairman) Mrs. J. P. G. Nuttall †Miss P. D. Blackstone E. R. Seaden, B.Sc. (Eng.), A.M.I.e.E., Mrs. R. M. Challis Assoc.I.Mech.E. †K. F. Dibben, B.Com., A.C.A. Mrs. H. Shire Mrs. F. E. Glenny (*Chairman) *F. J. H. Wileman, LL.B., F.C.C.S. Dr. L. Jacobs * until May. †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., F.R.I.C., M.I.Biol., 4, Hanway Place, W.l Bacteriologist (Part-time) : C. J. C. Britton, M.D., D.P.H., 35, Harley Street, W.l Administrative and Clerical Assistants : H. G. E. Brown (Chief Assistant) D. H. Drewell P. C. Bedward S. P. Fleming F. W. Dines D. J. W. Rigg J. Bradley Miss M. L. Shaul R. J. Crozier (until March) Mrs. P. Woods (until October) R. F. Penfold (from September) Mrs. J. Chambers (from November) 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) Catering Premises—Hygiene : J. E. Broadhead (a) Mrs. M. I. Tiplady (a, b, d, f) Smoke Control : "Miss B. Wilson (a, b, d, e, f) L. Pearson (a, b, c) Rodent Control : Care of Old People : A. C. Bruton (a, b) Miss M. M. Sharp, M.B.E. (a, d, e, f) District Inspectors : D. B. Hooper (a) D. Hitchcock (a, b) S. W. Wright (a, b) K. G. Mahers (a, b) †Student Public Health Inspectors : C. A. Chase R. J. Crozier (from April) (a) Public Health Inspector's Certificate (b) Meat and Other Foods Inspector's Certificate. (c) Smoke Inspector's Certificate (d) Health Visitor's Certificate. (e) Central Midwives' Board Certificate. (f) State Registered Nurse's Certificate. * Also Infectious Diseases. †Appointed 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 I Handy man : 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 : £7,114,638. Sum represented by a penny rate : £29,003. Residential units (separate assessments): 24,919. Population : 1961 census—Males 29,366; females 39,679. Total: 69,045. Foreign-born residents: 1961 census—12,225 (approximately 17 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-1962—68,070. Registrar General's estimate of the child population : mid-1962—under 1 year : 750 ; 1—4 years inclusive : 2,050 ; 5—14 years inclusive : 5,000. Total child population : 7,800 (approximately 12 per cent, of total population). 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 671 322 349 Live birth-rate per 1,000 population 11.24 Illegitimate 94 50 44 (Standardized) 8.88 Stillbirths—Legitimate 8 1 7 Stillbirth rate per 1,000 live and Illegitimate 1 1 stillbirths 11.63 Total live and stillbirths 774 374 400 Infant Deaths—Legitimate 12 6 6 Illegitimate 5 3 2 Legitimate Illegitimate Total Infant mortality rate per 1,000 live births 17.88 53.19 22.22 Neo-mortality rate (deaths under four weeks per 1,000 total live births) 15.69 Early neo-natal mortality rate (deaths under one week per 1,000 total live births) 14.38 Peri-natal mortality rate (stillbirths and deaths under one week combined per 1,000 total live and stillbirths) 25.84 Illegitimate live births per cent. of total live births 12.28 Maternal deaths (including abortions) Nil Total M. F. Deaths (all ages) 1,135 583 552 Death rate per 1,000 population 16.67 (Standardized) 12.17 Area comparability factors: Births: 0.79 ; Deaths, 0.73. Marriages. The number of marriages in St. Marylebone during 1962 was 1,220, which is 94 fewer than for 1961 and 48 below the average (1,268) for the previous ten years. Deaths. The total number of deaths shown in Table 1, page 29, 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 1962 numbered 1,135 (16.67 per 1,000) compared with 1,111 (16.41 per 1,000) in 1961. The rate of 16.67 when standardized by the comparability factor gives a figure of 12.17; the rates for the County of London and for England and Wales were 11.7 and 11.9 respectively. The principal causes of death continued to be diseases of the heart and circulatory system, which accounted for 40 per cent. of the total; malignant diseases 18 per cent. ; and respiratory diseases, including tuberculosis, 14 per cent. Deaths from lung cancer, compared with the previous year, fell from 53 to 42. Four deaths were attributed to influenza. Seventy per cent, of the deaths registered were of persons aged 65 and over, whilst 23 per cent, were between 45 and 65 years. Accidental Deaths. During the year, 26 residents died from accidents of all kinds, ten more than last year. Motor vehicle accidents accounted for six deaths as compared with four in 1961. Road Accidents. The St. Marylebone Road Safety Committee, which was set up in 1946 to advise the Council as to the activities whic'i should be undertak e 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, the Council appointed a Road Safety Officer whose duties include acting as a liaison between the Council and local organisations. The close personal contacts which have been established are valuable in ensuring that the road safety message is fully brought home to those to whom particular propaganda is directed. Three matters which receive special attention are (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 by school children, youth clubs and other local organisations to RoSPA House, to which the Borough Council contributes £360 per annum ; (iii) regular visits to Old People's Clubs. The number of local road accidents, reported as 956, was less than in the previous year (1,027) but unhappily there were 6 deaths as against 3 in 1961. There were 136 (156) serious injuries and 1,092 (1,127) slight injuries. The figures in brackets relate to 1961, and a summary of the 1962 accidents is given in Table 4, page 31. Births. The total of live births registered during the year was 765 (372 males ; 393 females) giving a live birth rate of 11.24 per 1,000 of population, equivalent to a standardized rate of 8.88, the comparable figure for the County of London being 17.6 and for England and Wales 18.0. Illegitimate live births numbered 94 (50 males: 44 females), representing 12.28 per cent, of the total live births, compared with 14.1 per cent, for the County of London. Stillbirths totalled 9, representing a rate of 11.63 per 1,000 total births compared with 16.6 for the County of London and 18.1 for England and Wales. Infant Mortality. Deaths of infants under one year totalled 17 (12 legitimate: 5 illegitimate), giving a rate of 22.22 per 1,000 live births, as compared with 26.39 in 1961. The rate for England and Wales is 21.6 per 1,000 and 21.0 for the County of London. Details showing causes of death according to age group and sex are given in Table 2, page 29. Of the 17 infant deaths 12 were under four weeks old, giving a neo-natal mortality rate of 15.69 per 1,000 live births as compared with 19.79 in 1961. The neo-natal mortality rate for England and Wales was 15.1, and for the County of London 15.2. Tha early neo-natal mortality rate (deaths under one week per 1,000 total live births) was 14.38 (England and Wales 13.4 ; County of London 13.0) and the peri-natal mortality rate (stillbirths and deaths under one week combined per 1,000 total live and stillbirths) was 25.84 (England and Wales 30.8 ; County of London 29.8). Maternal Mortality. No maternal deaths were reported during the year. Weather. The following summary of the weather during 1962, and Table 3, page 30, is based upon information supplied by the Meteorological Office :— 4 January.—Wet but very sunny. Mean temperatures a little above average. Minimum of —16.1°C. (3.0°F.) at Northolt Airport on the 1st ; a temperature lower than this has not been recorded in the London Area since 1867 when it fell to —17°C. (1°F.) at Kew. Rainfall 143 per cent, of the average at Camden Square. Sleet or snow fell on 3 days. Sunshine 196 per cent, of average at Regent's Park. February.— Very dry ; sunny. Mean temperature a little above average. 12 days with frost at Hampstead. Rainfall 26 per cent, of average at Camden Square. Sleet or snow fell on 5 days at Kew. Sunshine 134 per cent, of the average at Regent's Park. March.—Exceptionally cold. Mean temperature 2.9°C. (5.2°F.) below average at Kew. Minimum of -6.1°C. (21.0°F.) at Hampstead on the 6th. 22 days with frost at Hampstead. Rainfall about average. Sleet or snow fell on 10 days at Hampstead. Sunshine a little above average in central London. April.—Rather cold. Mean temperature 0.8°C. (1.4°F.) below average at Camden Square. Rainfall about average. Snow or sleet fell on one day at Kensington Palace. Sunshine 95 per cent, of the average in central London. May.—Cool and dull; rather dry. Mean temperature 2.1°C. (3.8°F.) below average at Camden Square. Rainfall 83 per cent, at Camden Square. Sunshine about 75 per cent, in central London. June.— Very sunny and dry. Mean temperature 1.3°C. (2.3°F.) below average at Camden Square Rainfall was over 19 per cent, of the average at Camden Square. Sunshine was 131 per cent, of the average at Kingsway. July.—Dull, cool and wet.—Mean temperature 2.0°C. (3.6°F.) below average at Kensington Palace. Rainfall 141 per cent, at Camden Square. Sunshine was 61 per cent, of the average at Regent's Park. August.—Cool; rather dry.—Mean temperature 1.7°C. (3.1°F.) below average at Kensington Palace. Rainfall 79 per cent, of average at Camden Square. Sunshine was 94 per cent, of average in central London. September.—Cool and wet. Mean temperature 1.5°C. (2.7°F.) below average at Kensington Palace. Rainfall 175 per cent, of average at Camden Square. Sunshine 113 per cent, of average at Regent's Park. October.—Dry and very sunny. Mean temperature 0.5°C. (0.9°F.) above average at Kensington Palace. Rainfall 76 per cent, of the average at Camden Square. Sunshine 135 per cent, average at Regent's Park. November.—Dry and dull. Mean temperature 0.5°C. (0.9CF.) below average at Camden Square. Rainfall 68 per cent, at Kensington Palace. Sunshine 77 per cent, of the average at Regent's Park. December.—Cold and sunny. Mean temperature 2.2°C. (4.0°F.) below average at Kew. Rainfall 104 per cent, of the average at Kew. Snowy at end of month. Sunshine 170 per cent, of the average at Kew. Foggy from evening of the 3rd to the evening of the 7th December. SECTION B.—GENERAL PROVISION OF HEALTH SERVICES Representation upon Other Bodies. The Council were represented upon the under-mentioned statutory and voluntary bodies as indicated : Body Representatives London County Council Divisional Health Com- Councillor Mrs. R. M. Challis. mittee (Division 2). Councillor Dr. E. Jacobs. St. Marylebone Tuberculosis Care Committee. Councillor Mrs. F. E. Glenny. Paddington Hospital Group House Committee No. 2. Councillor Dr. L. Jacobs. Paddington Hospital Group House Committee No. 3. Councillor Mrs. F. E. Glenny. National Society for Clean Air. *Councillor Mrs. F. E. Glenny. †Dr. H. K. Ashworth. The Medical Officer of Health. St. Marylebone Clean Food Association—Executive Councillor Mrs. F. E. Glenny Committee. Councillor Mrs. J. P. G. Nuttall. Department of Scientific and Industrial Research— The Chairman of the Public Health Com- Standing Conference of Co-operating Bodies mittee. dealing with Atmospheric Pollution. The Medical Officer of Health. Mr. L. Pearson, Public Health Inspector, *Until May. †From June, 5 Conferences. The Council were officially represented at the under-mentioned conferences dealing with matters within the purview of the Public Health Department:— Conference Delegates Royal Society of Health—Scarborough 9th-13th Councillor Mrs. F. E. Glenny. April. The Medical Officer of Health. Association of Public Health Inspectors—Southport Mr. J. R. Baily, Public Health Inspector. llth-14th September. National Society for Clean Air—Harrogate 9th-12th Councillor Dr. H. K. Ashworth. October. Mr. L. Pearson, Public Health Inspector. Conference of the Central Consultative Committee Councillor Mrs. J. P. Nuttall. on the Welfare of Old People—London, County Miss M. M. Sharp, M.B.E., Public Health Hall 25th June. Inspector. National Old People's Welfare Council's Conference Miss M. M. Sharp, M.B.E., Public Health —29th-31st March. Inspector. Royal Society for the Prevention of Accidents, Home Councillor Mrs. J. P. Nuttall. Safety Conference—Central Hall, Westminster The Medical Officer of Health. 4th-5th October. Mr. P. C. Bedward. Royal Institute of Public Health and Hygiene, Councillor Mrs. R. M. Challis. —Eastbourne 10th-12th October. The Medical Officer of Health. Financial Contributions to Voluntary Organisations. Payments to the funds of voluntary bodies were, on the recommendation of the Public Health Committee, made by the Council during 1962, 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 175 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 600 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. In the Public Health Department the practice of this important subject falls mainly into two channels, namely : the spreading of information by personal contact, and education by means of posters, pamphlets, bookmarks and other visual media. The first is undoubtedly the more effective and with this in mind the public health inspectors take advantage of opportunities which arise in the course of their day-to-day visits. For displaying posters and distributing pamphlets and bookmarks, full use is made of available sites and the facilities afforded in the public libraries. So far as possible a different theme is used each month, regard being had to topicality ; for example, " bronchitis " with the onset of winter. Observation leads one to believe that of the many thousands of pamphlets distributed in this way the vast majority are taken by individual members of the public with discrimination and because their interest in the subject has been aroused. A good deal remains to be done in the field of food hygiene education and efforts are again being made to interest some of the larger food firms in the Borough in accepting courses of food hygiene for their staffs. Care of Old People. The number of old persons of whom the Department have particulars is as follows :— Bachelors or widowers 175 Single women or widows 1,168 Married persons living together 302 1,645 6 The majority of them (1,343) live alone and some require constant observation. During the year 3,058 visits were made to 850 old people of whom 125 were married couples. In addition 50 visits were made by the two women public health inspectors to six infirm persons other than old age pensioners. Special Laundry Service.—The Department continued to operate 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, 51 cases were dealt with, some over long periods, others for a short while only. Forty 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 570 baths were given, 402 to women and 168 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 in a Public Health Department vehicle 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 39 and 40. 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 1962 :— " Grants.—Owing to rising costs for all seaside accommodation and a larger number of people being assisted to have holidays the special grant from the Borough Council of £450 had not covered the 1961 expenditure. The Association therefore requested a grant of £600 for holidays for the 1962 season. This was generously agreed by the Council. The L.C.C. Welfare Department announced that from 2nd July the Council's contribution towards old people's meals would be Is. Id., instead of lid. for meals costing up to 2s. 2d. The cost of each meal would now be 2s. instead of Is. lOd. and the Association Executive decided that the amount contributed by old people should remain at lid. The outcome was a pleasing improvement in the variety of the meals, which were provided as hitherto from the canteen of Messrs. Spencer, Turner and Boldero in Lisson Grove. The grant for meals was paid as before through the Borough Council. L.C.C. grants continued for chiropody (paid to the Association). Following an award of the Industrial Court, agreement had been reached by the L.C.C. to pay chiropodists from 1st April at the rate of 12s. 6d. per patient for domiciliary treatments. The Association Executive agreed that an application for increased grant to meet these higher fees should accordingly be made to the L.C.C. General.—In March £200 was withdrawn from the Portman Building Society for relief and general work, apart from the grant-aided services. Donations.—Warm thanks are expressed for donations totalling £164. It would indeed be difficult to carry on our work were it not for the generosity of friends who help with gifts in money and in kind. In order to expand our work in future we should warmly welcome a wider circle of interest. Old People's Consultative Committee.—The last Report referred to the preliminary consultation between representatives of the Borough Council and of the Association, which led to an informal survey undertaken by the Association on the extent of housing hardship among the elderly in the Borough. Consultations continued in what was now called the Old People's Consultative Committee, which should prove to be an increasingly useful body. The functions of the Committee are informal, solely advisory and without any commitment on the part of the Council. As representatives of the Association, Miss Lumby, the Secretary and Mr. fi. Hamer were joined by Mr. J. A. Johnson when the Committee met again in April. The meeting discussed a memorandum from the 7 Association, starting with the informal survey of 1961, showing the number of people known to the Association as urgently in need of accommodation to be about 135. The Chairman of the meeting indicated that as these figures were not comprehensive they could not be put before the Council. It was clear, however, that if a more complete picture of the urgent need for further housing for the elderly was needed, the Association itself was not in a position to undertake a large scale professional survey. Possibilities of an independent body being asked to undertake a comprehensive survey of the housing needs of old people in St. Marylebone were examined in various quarters but no definite action was taken by the Association. In several ways the consultations proved helpful. They led to comparison between the Housing Department and the Association of lists of old people requiring accommodation, and this led to communications from the Housing Director to a number of old people previously unknown to his Department. Helpful information regarding developments in Council housing for the elderly was given, as were full figures of the Council's financial support, already given or allocated, for other welfare of the elderly, apart from grants to the Association. A second meeting was held in November, when the Association's objective of acquiring premises for a day centre was one of the points discussed. ' Meals on Wheels '.—7,727 meals were taken to old people in their own homes, 724 more than in the previous year. The electrically heated food containers continued to ensure that meals were really hot when delivered. The Austin van which the Association had purchased in 1954 was beginning to show signs of wear and tear and it was therefore an immense benefit to the work that, as an extremely generous gift from Mr. and Mrs. Lew Grade, it was replaced by a new Austin van which started its work in August. The containers were of course transferred. In the autumn the Association suggested to the Council that a second van would enable the service to be extended to provide, where necessary, hot meals five times weekly instead of the maximum up to now of three times. Before the end of the year it was gratifying to learn that the Public Health Committee had agreed in principle to recommend the Council to finance the purchase of a second van and plans ahead were made for additional helpers from the B.R.C.S. W.V.S. workers have delivered the meals since the service started, under the leadership of Mrs. E. Lush whose devoted and efficient work for both meals services has been beyond all praise. The workers who take round meals become real friends of the recipients and are able to give news of them or call for other help in an emergency. With New Year wishes to the W.V.S. one lady wrote ' Appreciative thanks for the pleasant efficient way with which the meals are delivered in the attractive foil containers. The Christmas fare deserves special mention, the dinner was delicious and the lucky bag wonderful, full of acceptable surprises, all gratefully received.' The festive extras at this season are planned and provided by W.V.S. Luncheon Club.—5,587 meals were served. A slight decrease in attendance was due to the early onset of the unusually severe winter weather. Chiropody.—Another excellent year's work can be reported. 2,397 treatments were given at the Town Hall Foot Clinic (an increase of more than 100) and 388 at Clinic 2, at All Souls' Clubhouse, Greenwell Street, premises generously made available by the church of All Souls'. The smooth working of the services is largely due to the experienced and kindly work of Miss Curran and Miss Lerner, chiropodists with the Association for many years. Miss Meares resigned in the summer and in her stead we welcomed Miss O. Reeves in Clinic 1 and for home chiropody. Miss Cotsford and Miss Hoogendoorn, appointments clerks, continued their most essential work. The L.C.C. Health Centre 2 at Lisson Grove undertook 1,158 treatments for elderly people in 1962, so that the total of elderly people having their feet cared for increased. All treatment is free of charge. Home Chiropody.—637 treatments were given, 38 new patients being accepted. The waiting list of 22 at the beginning of the year was reduced to 16 at the end, though it was sometimes unfortunately necessary to keep a new applicant waiting for some months before the first appointment could be made. Holidays.—124 people took part in the ' all-in ' group holiday, arranged early in the season at Brighton as in previous years. In addition 12 others were helped to have a similar holiday of one week, also at Brighton under the auspices of Rutland Tours Ltd., during October. These had the best weather of the season, but everyone appeared to have real benefit from the seaside holiday. ' Everything has been done for our comfort and I have enjoyed every minute ' is a typical note of 8 appreciation. 32 had never been on a holiday with the Association before, and about that number belonged to no clubs. Two ladies had a fortnight's holiday in the care of the Church Army Short-stay home at Woking, and eight other people who did not fit into a group holiday were assisted with individual plans, some being helped with a grant towards the fare to visit relatives. The Association again made a contribution to the Barrow Hill Club's holiday scheme. Social Visiting.—Ten meetings were held for the Visitors' Committee, which is looked after by Miss Sharp and Mrs. Cowan. Although some of the Visitors can seldom attend, the meetings do give a valuable opportunity to hear reports, keep in touch and discuss problems which have arisen in the course of visiting. Much useful information from the Visitors is helpful to the Health Inspectors, Miss M. Sharp and Miss B. Wilson, in their professional work among the elderly. The Association is exceedingly fortunate in its excellent relations with Miss Sharp and Miss Wilson, as indeed with the Public Health Department whose co-operation and support continue to be of immense encouragement. Innumerable kindnesses are shown by Visitors who are often able to establish genuine friendship and not only recognise signs where professional help should be called, but do many little services for housebound folk. All Souls' Church Visitors provided a rota of nursing care, night and day, for an elderly lady waiting to go into hospital. In another such case one of the Visitors stayed up all night. Several new Visitors have been welcomed ; care is taken in their guidance and in matching the Visitor to the person to be visited. Nine churches now co-operate in this service. Clubs.—Club reports to the Executive told of another year of beneficial and steady work. The regular meetings, the big event of the week for so many, are highlighted at Christmastime by special festivities and in the summer by outings. More talks and advice on Home Safety—sometimes with a film—were given by the Public Health Department. There are still nine Clubs, and also the one operated by W.V.S. in Luxborough Lodge. As yet we have no club open all day or offering special facilities for the really infirm. Relief.—The decoration of old people's rooms has been usefully extended. Two main groups have been active, one from the Methodist Students' Society of London University, another, nondenominational, organised by Miss Pilkington. In addition to the great benefit of having their rooms made bright and clean, the old people enjoy the presence of cheerful young workers and are often visited by them afterwards. Some sixteen homes were re-decorated, in some cases one room only, others larger. The workers will tackle anything. It may be simple enough when the occupant and her things can be moved into another room while the painting is going on, but if she has to remain sitting in the middle whilst enthusiastic young people paint and hang wallpaper and lay linoleum among all the furniture it certainly tests everyone's good humour and powers of organisation. In several instances the National Assistance Board refunded the money spent on paint, wallpaper, etc., and the Association is grateful for the Board's prompt and sympathetic co-operation. As in previous years most other sums spent on relief were modest but they met pressing needs outside the scope of the statutory authorities. Transport for a lady to visit her husband in hospital during his last weeks is one example of help given : help or guidance about a worrying bill can bring relief of mind, while an extra door key to enable helpers to enter a home is a simple but important contribution: ferrules for walking sticks and small items of household equipment are provided frequently. The Gas and Electricity Boards have again been helpful in arranging the lowering of meters for the greater safety of elderly people and also in advising in the case of difficulties with bills. Report from Borough Librarian on Library Service to Housebound Readers. The delivery of books to the housebound, instituted by the Public Libraries Committee in 1957, has been carried out regularly by library staff, mainly to cases recommended by the Home Help Service. Twenty-five readers are now receiving this service and 3,352 books were delivered to them in 1962. In a letter of appreciation, one reader wrote ' It means so much to us housebound people—and I should be very unhappy and lonely without books—my deafness prevents me using the radio. Miss-, a very pleasant lady, brings me a much better selection of books than I ever chose for myself when I was able to walk out.' During the past year, too, St. Marylebone Public Library received a bequest of £20 from a deceased reader on the ' housebound ' list, ' as an expression of the value of the library and its Circus Road branch has been to me and my deep appreciation of the courtesy and kindness of its staff '. 9 Radio.—10 sets on loan were issued on the Association's application to the ' Wireless for the Bedridden ' Society. The Society generously supplied licences in a number of instances and altogether brings immense pleasure to the people befriended. At the end of the year 32 sets remained under the supervision of the Association, also other sets in St. Marylebone were sponsored by other bodies. A Christmas Appeal on television by the Society included pictures of St. Marylebone people who had the benefit of the Society's radio sets on loan. The Public Health Department made it possible for suitable photographs to be taken and each person concerned received a copy. Fireguards.—During 1962 only two applications were made to the L.C.C. for the loan of fireguards ; one of these was referred to the Welfare of the Blind. Entertainments.-—Mrs. Lew Grade once again gave elderly residents in the Borough a wonderful party at the Seymour Hall in December, when 800 thoroughly enjoyed tea, a delightful show with community singing, presents to take home. Invitations were allocated to a proportion of people in all clubs, almshouses, Homes, and also to a large number who are not members of any clubs, including some very infirm people. Mrs. Grade's thoughtfulness in every detail once again made it an occasion to remember, while all did their best to make things run smoothly—stewards, firstaiders, policewomen, car drivers and Council staff. Sixty-five people enjoyed a Christmas party at the Y.M.C.A. in Great Russell Street. The Student Theatre Group of the St. Marylebone Literary Institute again presented welcome tickets. Other people were included in hospitality by the Philanthropic Lodge. A group from the Buyers' Department of Selfridges also gave a party. Christmas.—This is always a busy time when Miss Sharp and Miss Wilson work on innumerable lists, trying to ensure that the gifts which are sent from private individuals, local churches, schools and firms, are fairly and suitably distributed. The list of kindly donors of parcels and people who gave invitations for Christmas meals is too long to give here, but the Association's warm gratitude is expressed to each one of them for bringing so much pleasure and comfort into the homes of old people at this season. A number of donors have continued to keep in touch by friendly visiting." Diseased or Infirm Persons—Compulsory Removal. Section 47 of the National Assistance Act, 1948, as amended by the National Assistance (Amendment) Act, 1951, empowers the Council to apply to the Courts for Orders for the removal to a hospital or institution, for the purposes of securing the necessary care and attention, of persons who— (a) are suffering from grave chronic disease or, being aged, infirm or physically incapacitated, are living in insanitary conditions, and, (b) are unable to devote to themselves, and are not receiving from other persons, proper care and attention. It is seldom necessary to follow this procedure, but distressing cases sometimes occur of old persons who, although no longer able to look after themselves and living in conditions which make it impossible for them to be nursed at home, refuse to enter a home or hospital voluntarily. During 1962 there was one such case, particulars of which are given in Table 21, page 36. 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 3| 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. 10 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. The numbers of school children receiving swimming instruction has been maintained and a greater interest in Life Saving Instruction is apparent by the numbers of school children obtaining awards for personal survival issued by the Royal Life Saving Society and the Amateur Swimming Association. Private bath facilities consist of 24 baths each for men and women. Attendances during the year totalled 68,796 as compared with 76,659 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 7d., children 3d. ; Thursday to Sunday : lid. Old age pensioners, unemployed or blind persons can obtain baths from Monday to Friday at a cost of Id. 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. The Public laundry facilities consist of a machine laundry, comprising 8 fully automatically controlled washing machines, 3 water-extractors and 24 drying racks, and a hand laundry provided with 8 composite units for washing, boiling and ironing, 2 water-extractors and 10 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. Two Rotary Ironing Machines have recently been installed and it is now possible to take home a 15 lb. load of domestic washing completely dried and ironed in lj hours. The number of young married women using the laundry has increased and many expressions of appreciation of the Ironing Machines have been received. Medical Examinations. Staff.—The Medical Officer of Health is medical adviser to the Council for staff purposes. During 1962, one hundred and fifty-two 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, forty-nine applications were referred to the Medical Officer of Health for observations and, if necessary, medical examination. Home Safety. The provisional statistics for 1962 indicate that some 8,750 people died in Great Britain as a result of an accident at home. Although this figure is 2,000 more than were killed on the roads, public awareness does not seem to have been aroused to the serious problem of home accidents. The Department tries to give as much publicity as possible to this subject and during the year talks illustrated with films or film-strips were given at several old people's clubs and a home safety handbook was issued to all tenants of Borough Council properties. In addition, regular displays of posters and pamphlets were arranged in support of the national "Training for Home Safety Campaign ", organised by RoSPA, which commenced in October. New Legislation. A list of the new Acts, Regulations and Orders, relating to the work of the Department, is given in Table 26, page 38. 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 5, page 31. Excluding rat and mouse infestations, 1,089 complaints were received and details of 1,094 various nuisances remedied are shown in Table 6, page 32. Notices.—Intimation Notices served under the Public Health (London) Act, 1936, numbered 267, and 57 of these were followed by the service of Statutory Notices to secure abatement of nuisances, In addition seventeen other formal notices were served, as follows: eight in respect of blocked drains. 11 one for the reinstatement of water supply, and eight for the provision of artificial lighting on common staircases—as required by the Borough Council's Byelaws. For offences under London County Council Byelaws twenty-nine notices were served, sixteen being in respect of water-closets, eleven 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-three complaints of noise were received and these concerned forty-five 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 and in many instances restricted hours of working were adopted. The remainder concerned a wide variety of supposed causes, including radio and speech amplifiers, noise from factories and workshops, night baking, road works, garages, dogs, a cockerel, loading and unloading of vans, slamming of car doors, ventilating systems, noisy neighbours, clubs and social functions. 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. 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, and for this purpose an authorised pigeon catcher is employed. 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 walls and roofs of houses where these birds nest are similarly fouled. Almost invariably feeding by members of the public is the cause of pigeons congregating and the remains of food fed to them 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. During the year, nine complaints were received in respect of twenty-seven premises but upon investigation it was found necessary to refer only one case 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 1962. The water is all River Thames-derived filtered water. There were no new sources of supply instituted by the Board during the year, nor any new improved extensions of trunk mains. The general scheme of supply was the same but 685 yards of service main were laid in the Borough during the year." The average results of the chemical and bacteriological quality of the water are set out in Tables 7 and 8, page 32. 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. Only one such complaint was received during 1962 and upon investigation it was found not to be justified. 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. The number of dwellings supplied from public water mains is 24,689, with an estimated population of 67,574. No stand-pipes are in use and the remaining dwellings, namely, two blocks of flats comprising 230 units with some 496 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 1962 indicated the water to be satisfactory. 12 The Metropolitan Water Board sent seven notifications of premises where the water supply had been cut off, in six cases for non-payment of rates and in the other for wastage of water caused by a defective service pipe. At all these premises the supply was restored quickly when the rates were paid or the defect remedied. It was not necessary for any notices to be served. During the last few days of the year severely cold weather set in which was later to give rise to much dislocation of water supplies due to freezing. Ten certificates relating to the provision of a proper and sufficient supply of water in dwelling houses were issued under the provisions of Section 95 (2) of the Public Health (London) Act, 1936. Drainage—Alterations and New Buildings. Of the 287 drainage plans approved during the year, 40 were in respect of new buildings. Upon request, the Borough Engineer examined 22 sewer connections and 13 of them were found to be defective and had to be renewed. The drainage inspectors made 3,461 visits and no circumstances were found which necessitated legal proceedings. Combined Drainage. Five 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. During the year discussions with the County Council's Main Drainage Department officers were held in connection with the re-siting of the King's Scholars' Pond Sewer, and the associated re-connection of branch sewers serving premises in Finchley Road, St. John's Wood Park, Wellington Road and Acacia Road. The trunk sewer will eventually join up with the deviated line at Wellington Place/Cochrane Street. There are no disposal plants in the Borough. Town Planning. Observations were made by the Department on 208 plans submitted to the Council under the Town and Country Planning Act, 1947. Rodent Control. There were 159 notifications of rats at premises in the Borough, 25 less than in the previous year, and reports of mice declined from 422 to 366. It having become evident that block surveys no longer j ustified the time and labour involved, this routine procedure was discontinued after 30th April, up to which time 2,258 premises in 37 blocks had been dealt with during 1962. Sewers are treated by the polythene bag system at approximately eight week intervals, the bait being applied at side entrances only. "Takes" at most points varied little from time to time but secondary baiting was carried out wherever they were consistently "good By these means the residual number of rats in the sewers is kept to a minimum. Statistics of rodent control are shown in Table 9, page 33. Disinlestation. The insecticide used to rid dwelling houses of bugs is kerosene with 5 per cent. D.D.T. and 0.1 p-ir 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, 236 rooms were disinfested. Furniture, more particularly that of people removing to fresh accommodation, is dealt with Dy hydrocyanic acid gas in specially constructed vans. The Council continued to have this work done by a contractor and during 1962 the furniture of 6 families, of whom 4 were being rehoused, was treated by this method. In addition 347 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. 13 Verminous Persons. The Department's Cleansing of Persons Baths in Lisson Grove dealt with 478 verminous persons : adults 304 (men, 268 ; women, 36) ; children, 174 (boys, 21 ; girls, 153). 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. A lower number of complaints, 84 compared with 108 in 1961 and 144 in 1960, was accompanied by a reduction in the total number of smoke offences detected, 43 against 63 in 1961 and 48 in 1960. Dark smoke was timed on 76 occasions but in six cases only did the emissions contravene Section 1 of the Clean Air Act, 1956 by exceeding the limits prescribed in the Dark Smoke (Permitted Periods) Regulations, 1958. Contraventions of Section 11 of the Clean Air Act in respect of smoke discharged from the chimneys of buildings situated in Smoke Control Areas were observed on 10 occasions and there were 27 infringements of Section 16 arising out of smoke causing nuisance to the inhabitants of the neighbourhood. Notification of the intention to instal new furnaces as required by Section 3 of the Clean Air Act was given in 26 cases. A fifth Smoke Control Order covering the premises in Ward 8 (Portman Square) came into operation on the 1st October, 1962. A sixth Order in respect of Bryanston Square Ward which will become operative on the 1st October, 1963 was made by the Council and confirmed by the Minister of Housing and Local Government. A survey of Ward No. 6 (Dorset Square) and Ward No. 9 (Park Crescent) was commenced in preparation for a seventh Smoke Control Order. At the end of the year Smoke Control Orders in respect of 23,503 premises in 743 acres of the Borough had been made and confirmed by the Minister. Atmospheric pollution was measured at four sites and the statistics are shown in Tables Nos. 10 and 11, page 33 In consequence of changes in the methods of assessing and reporting pollution, comparative figures for previous years have been omitted. Smoke filter stains are assessed by the use of a reflectometer and the concentrations of smoke and sulphur dioxide are calculated by a computer at Warren Spring Laboratory. The average concentrations over periods of four or five complete weeks are reported by the Laboratory in microgrammes per cubic meter. During the first week in December, " smog " conditions prevailed over a period of five days. On the 1st August, 1962 the use of obsolescent lead dioxide instruments and the use of deposit gauges, the results from which are no longer required by the Department of Scientific and Industrial Research, was discontinued preparatory to the establishment of additional sites at which the concentrations of smoke and sulphur dioxide will be measured by means of volumetric instruments. Offices. There are some 3,511 office buildings in the Borough but there is at present no record of the number of individual offices. The Offices Act, 1960, came into operation on the 1st January, 1962. Regulations for securing the health, safety and welfare of employees have not yet been made but preliminary inspections of 88 offices were made during the year. Shops. There are 2,482 shops in the Borough which, in addition to regular visits to food shops, necessitated 280 special inspections. Factories. There were 1,623 factories on the register at the end of the year, 158 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 12 and 13, page 34. 14 Outworkers. Fifty-six employers submitted lists in respect of a total of 517 outworkers (168 contractors and 349 workpeople). Of these, fifteen contractors and twenty workpeople operated in the Borough. The nature of the different classes of work and the numbers of outworkers engaged is indicated in Table 14, page 34. Fireguards. The Consumer Protection Act, 1961, superseded the Heating Appliances (Fireguards) Act, 1962, but the Heating Appliances (Fireguards) Regulations, 1953, 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. The Council raised the matter with the Metropolitan Boroughs' Standing Joint Committee who made representations to the Home Office seeking to amend the legislation by including the sale of heating appliances by public auction. The Secretary of State, however, did not consider the introduction of amending legislation on this subject justifiable. Regular inspection was made of appliances exposed for sale by retailers but no heaters were found which failed to comply with the statutory requirements. Hairdressers and Barbers. The Council's Byelaws regulating these establishments came into operation on 18th December, 1955. There are in the Borough 157 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 pat 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 12 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 fifty-nine 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-three. Details are given in Table 15, page 35. 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. There are in the Borough ten conveniences and three urinals for men and seven conveniences for women, a full list of which appears under Table 16, page 35. The hours of opening are from 7.40 a.m. until 10.0 p.m. except at Oxford Circus where the conveniences are normally open until 11.0 p.m. and until midnight during the Christmas shopping season, when large numbers of people come to see the Oxford Street and Regent Street illuminations at night. All conveniences have attendants, other than at Violet Hill public gardens and the three urinals which are cleansed by a " flusher " who visits them at least twice daily. The attendants work on a two-shift system and an extra man and woman are employed on the morning shift at Oxford Circus 15 so that if necessary they can be called upon for emergency duty elsewhere. No special problems arose during the year and although staff shortages sometimes occurred during the holiday period, or because of sickness, there has been an improvement in the general situation because there have been more suitable applicants for this kind of work than in recent years. Consequently it has seldom been necessary to leave conveniences unattended. Although there has been a certain amount of minor vandalism, this has occurred in toilets which are unattended and appears mainly to have been caused by children. Public Cleansing and Salvage. The Director of Public Cleansing has kindly provided the following information :— " The refuse and salvage collected during 1962 were : house and trade refuse, 35,401 tons ; street sweepings and gully sludge, 2,524 tons; salvaged materials, 2,121 tons. The sum of £14,864 was received from the sale of salvaged materials. In addition, £2,306 was received for the removal of trade and extra refuse and the cleansing of petrol interceptors, etc. Apart from a period of several weeks at the end of the year, when the refuse collection employees were ' working to rule ' and heavy snowfalls occurred, a minimum twice weekly refuse collection service was maintained and approximately one quarter of all premises in the Borough received a thrice weekly clearance. A daily collection was made at premises where this is necessary, such as hospitals, restaurants, hotels and blocks of flats. All street gullies were mechanically cleansed approximately 4 times during the year and all streets swept at least once daily. Following the successful introduction of dustless refuse collection in a part of the St. John's Wood area, arrangements are being made to extend the system to other parts of the Borough. Five new refuse compression vehicles were ordered and these are easily adaptable to dustless loading when required by the fitting of the special shutter equipment. Co-operation between the Department and bin and plastics manufacturers has resulted in the production of a satisfactory lightweight bin for use with the dustless vehicles, for which the Council have approved the name ' St. Marylebone Model Bin'. It was originally considered that the dustless system would be suitable only for residential districts, but the advent of this new lightweight bin to replace the all-metal bin, will allow the system to be extended to shopping and business districts as well. During the year, delivery was received of a further 12 aluminium street orderly trucks, to replace a similar number of old steel type trucks. The new trucks are much lighter and easier to handle. A two-wheeled trailer was also purchased for trial use with the new refuse compression vehicles, which have limited salvage accommodation. This trailer has facilitated and improved the yield of salvage material and further machines of this type are being purchased For the first time, the regular cleaning of the bulk refuse storage containers in use at all the Council's housing estates was undertaken by this Department. A hydraulic tail lift was fitted to one of the Council's vehicles, to enable the containers to be lifted and transported to the Department's depot for cleaning and return to site." 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. Twelve 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 fourteen premises, mainly those of upholsterers and manufacturers of cushions and pillows, are registered. Eight samples of hair, three of fibre and one of rag flock 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. 16 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. Eight burials and five 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 four certificates were issued in respect of bodies being transported abroad, two to Italy, one to Poland and one 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 1,954 certificates authorising cremation were issued and since December, 1937, when the crematorium was opened, 25,004 cremations have taken place. 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 ten summonses, one of which could not be served. Nine convictions were secured with penalties and costs amounting to £18 5s. Od. 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 0s. Od. 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 1962 the Council applied for six summonses of which only four could be served. These all resulted in conviction and a fine of £5 with 10s. 6d. costs was imposed in each of three cases, and a fine of £3 with one guinea costs in the other. 17 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, 1962 :— Pre-war Estates No. of Dwellings Crawford Place Dwellings 52 Fisherton Street 130 Post-war Estates Barrow Hill 172 Church Street 140 Winchilsea House 23 Townshend 222 Abbey Road/Boundary Road 54 Hamilton Terrace 52 Queen's Terrace/Pembroke Terrace 38 35/55, Boundary Road 48 Wellington Road 121 147/149, Gloucester Place 10 1/7, Aquila Street 6 Abercorn Place 34 22-30, Balcombe Street 14 17-19, Balcombe Street 4 Townshend Road 8 147-165, Lisson Grove 12 57-73, Boundary Road 36 Aquila Street Extension 23 Violet Hill House 22 40-47, Chapel Street 20 Newcourt Street 48 Church Street Extension 76 9-25, Cochrane Street 32 1,397 Further Development Linked with Slum Clearance. The position at the end of the year was :— Broadley StreetjPenfold Street (30 flats) Good progress has been made on this scheme and work has reached the plastering stage. Ashbridge Street (East) (10 flats) Demolition has been completed and progress has been made up to ground floor level. Freshwater PlacejHomer Row (9 maisonettes) Work has been commenced on the foundations. Mulready Street (182 dwellings) Clearance of the site has commenced and sketch plans for the development are under consideration. Clipstone Street (246 flats) Sketch proposals for the redevelopment of the area bounded by Carburton Street, Cleveland Street, Clipstone Street and Great Titchfield Street for housing with a limited amount of commercial use have been submitted to the Planning Authority. Housing (Financial Provisions) Acts, 1958 and 1959. (a) Loans.—The Council made three loans during the year totalling £9,200 to enable applicants to acquire premises for owner-occupation. (b) Improvement Grants.—11 Discretionary and 49 Standard Grants totalling £10,554 were approved during the year to enable private owners to convert and improve existing premises. 18 Housing of Old People. (a) 51/54, Beaumont Street.—The block of 29 flats for old people being erected on this site has now reached roof level. (b) St. Marylebone Almshouses.—Works of modernisation and improvement are in progress with the aid of a Council grant of £40,000. (c) Newstead, St. Marylebone Old People's Homes.—The Council have agreed to make a grant of £14,000 and an interest-free loan of £3,000 towards the improvement of the Home. Old People's Consultative Committee. The Consultative Committee, composed of members of the Housing Committee, the Public Health Committee and representatives of the St. Marylebone Old People's Welfare Association, met twice during the year 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. 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 5, page 31. Certificates of Disrepair. No applications for the issue or cancellation of certificates under the provisions of the Rent Act, 1957, were received during the year. 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 forty-five confidential medical certificates referred to the Medical Officer of Health were considered in conjunction with reports from the public health inspectors on environmental circumstances, and, where justified, additional points were recommended. There were no Closing Orders but a statutory undertaking in respect of one underground room was accepted and one demolition order covering six rooms was made. Closing orders on 20 underground rooms were determined, orders on two rooms were varied, and one statutory undertaking was cancelled. Land Charges Act, 1925. The Town Clerk referred to the Department 1,730 enquiries relating to details of any outstanding notices, orders or other restrictions on the properties concerned. Immigrants. In previous reports mention has been made of the fact that the south-eastern comer of the Borough, which is contiguous with Soho,fcontains a cosmopolitan population in which immigrants from Cyprus and European countries predominate. Very few immigrants from the West Indies, India or Pakistan appear to have settled 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. 19 Housing Act, 1961—Houses in Multiple Occupation. Part II of this Act which came into operation on the 24th November, 1961, contains powers enabling Local Authorities to secure a proper standard of management of houses in multiple occupation. The standard is prescribed by regulations made by the Minister in Statutory Instrument No. 668 of 1962 which came into effect on 22nd May, 1962, and is amplified in Circular 16/62. The new powers fall into four main groups :— (i) An entirely new power to apply a Code of Management to individual houses in which proper standards of management have not been observed. (ii) Stronger powers to require the provision of additional facilities and amenities essential to decent living conditions, and the provision of adequate means of escape from fire. (iii) A new power for Local Authorities to carry out works themselves in default and recover the cost. (iv) A power, also new, to make a direction limiting the number of persons who may live in a house, or part of a house, which is in multiple occupation. The Minister emphasised that these powers are designed to deal primarily with the worst type of multi-occupied house manifestly in need of repair where nothing less than strong action will be likely to achieve results. At the same time the Minister placed reliance on Local Authorities to make quite clear to the people concerned what it is that the regulations require to ensure the satisfactory management of these houses and to give them ample opportunity to put matters right before resorting to the new penalty provisions. On the 25th October, 1962, the Council delegated their powers and duties under Part II of the Housing Act, 1961, to the Housing Committee. A preliminary survey made by the Public Health Department had indicated that approximately 1,229 premises in St. Marylebone would probably fall into the category under review and by the end of the year 100 premises had been inspected in detail to ascertain the type of deficiency to be anticipated. To meet the necessity for the Council to indicate their requirements in respect of facilities to be provided in houses in multiple occupation a Code of Practice was drawn up in the Department and adopted by the Council. It follows closely a draft Code circulated to constituent authorities by the Metropolitan Boroughs' Standing Joint Committee and is intended to serve as a guide on the basis of which the Council can seek the cooperation of the landlord concerned in the improvement of his property with a view to avoiding as far as may be possible the necessity for compulsion. Section 16 of the Act deeds with means of escape in case of fire and this aspect is being dealt with in conjunction with the Borough Engineer's Department and in liaison with the London County Council. By the end of the year, however, regulations regarding means of escape from fire had not been issued and as it was felt that each house in multiple occupation should be dealt with as a whole and not piecemeal the absence of these standards has in some measure halted progress. A fuller account of the action now being taken under Part II of this Act will be made in the Annual Report, 1963. 20 SECTION E.—INSPECTION AND SUPERVISION OF FOOD Food and Drug 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, 402 samples of food and drugs were examined. Three of these were taken formally and 399 informally, though several of the latter were received as the result of complaints from members of the public. The number adulterated or incorrect in some other manner was 63, and the incidence of adulteration may be classified as follows:— Number of samples examined. Number of samples adulterated, etc. Milk 18 1 Other Foods 379 62 Drugs 5 — A carton of milk contained extraneous dirt and was reported as adulterated, although the milk was satisfactory. A milk bottle showed dirty marks on the interior, when filled with milk, due to mould growth, but when the bottle was emptied and dried these marks were almost invisible, and it was not surprising that it had passed the inspection point during washing and filling. One of the results of progress and speed is that empty bottles are now generally fed into bottle washing machines by de-craters so that they miss any initial inspection for dirt while they are still wet. When dirt is wet it possesses a much darker colour than when it is dry. Another dirty bottle submitted as a complaint was badly scratched on the exterior of the bottle although the interior was perfectly clean. A cream sold as 'Whipping Cream' contained only 38 per cent. fat, whereas the Food Standard (Cream) Order requires a thick cream to contain 48 per cent. of milk fat. A powder for making Ice Cream was satisfactory but the declaration of ingredients included 'stabiliser' ; whereas the name of the stabiliser must be given. Four differently flavoured Ice Lolly Syrups listed alginate and saccharin as ingredients instead of sodium alginate and soluble saccharin or sodium saccharin. A sugar described as 'Slimmers Sugar ' consisted of sugar with 1 per cent. saccharin. As it was also recommended for making puddings and cakes this description was considered to be misleading, because a consumer eats a pudding to satisfaction or repletion and does not reduce the quantity because of the presence of saccharin. Some chocolate coated biscuits were stated to produce nausea. The taste was very rich and the fat was found to consist of a mixture of cocoa butter and palm kernel oil. Another chocolate biscuit was considered to have a misleading label as the description ' Milk Chocolate Cream Sandwich' did not suggest a biscuit. Two chocolate coins contained respectively 4 and 5 parts per million of lead, and a chocolate novelty contained 3.5 parts per million; chocolate is permitted to contain only 2 parts per million of lead. A complaint was received of the presence of black material in a chocolate crunch. This was due to carbonised matter, probably burnt sugar, from a pan which had been improperly cleaned. Another complaint was made regarding a bottle of a soft drink. It possessed a slight taint due to the plastic cap with a rubber insert having been contaminated with disinfectant, due to some member of the public having used an empty bottle for this purpose. It is impossible both to prevent people acting in this manner and to remove all traces of disinfectant from such stoppers. Bottlers should, therefore, take more care with returned stoppers to see whether they should be discarded or cleaned, and rubber inserts should always be washed separately from the stoppers. An orange nectar stated to have been prepared from orange, water and sugar, contained not less than 50 per cent. of added water so that the order of ingredients should have been declared as water, orange and sugar. A product claimed to be pure cabbage juice appeared to contain about 36 per cent. only of juice with added water. The manufacturers stated that it was pure unadulterated juice with nothing added after it has been washed, but not dried. It is suggested that 10 per cent, of added water would be a generous allowance after washing. The labelling of a tomato juice and a carrot juice was incorrect. They contained a proper definition in German but bore stick-on labels with the words 'Tomato' or 'Carrot' in English. 21 They appeared to have been genuine carrot or tomato juice, but the cork sealing the carrot juice bottle was mouldy on the surface showing that the juice was far from sterile. A product labelled as ' peach butter ' was packed in a sealed container, and only contained 60 per cent. sugar. If it had been called jam it must have contained not less than 65 per cent. soluble solids and it was probably for this reason that it was described as ' Butter '. Although the term ' peach butter ' may be accepted in the United States it is not known on this side of the Atlantic. The produce tasted more like plum jam than peach jam, and the ingredients were not declared in the correct order. A preserve made from brown sugar and fresh oranges was labelled ' Integrity It contained only 63 per cent. soluble solids, as sucrose, and as it was in a sealed container it must contain not less than 65 per cent. soluble solids. Although rich in oranges its keeping qualities would be impaired by the deficiency in sugar. A fruit conserve also contained only 61.4 per cent. soluble solids and a red currant jelly only 62.5 per cent. instead of not less than 65 per cent. There is a tendency at the present time to avoid the legal implications of the Preserves Regulations, which control the soluble solid content of jams, and, while some of these products are satisfactory in many respects, many of them lack the keeping qualities of jam. A cake frosting mix was incorrectly labelled as the ingredients declared included ' shortening' instead of ' edible fat'. A product described as 'Minced Beef' in large letters and 'with onion and gravy' in small letters contained only 46 per cent. of meat. Minced Beef with Gravy must contain not less than 75 per cent. of meat and with onion the meat content should be approximately 60 per cent. The manufacturers suggested that the addition of the onion made the dish into a complete meal, but the flavouring of a stew with onion does not convert it into a composite meal. According to the Food Standards Committee Report a composite meal should consist of meat and vegetables with gravy and not merely flavoured meat. A can of lambs tongues contained only 73 per cent. of meat and two further cans contained 76 per cent. and 84 per cent. total meat respectively, whereas in the report of Canned Meat Products the Food Standards Committee of the Ministry of Agriculture, Fisheries and Food suggested a minimum of 95 per cent. meat. Two samples of minced ham and chicken in jelly contained only 67.1 per cent. and 66 per cent. of total meat, whereas the agreement between the Association of Public Analysts and the manufacturers is that the meat content should be not less than 70 per cent. A pork brawn lacked the appearance of brawn and contained only 72.5 per cent. of meat instead of 85 per cent. A product sold as 'chopped ham' was really a luncheon meat and contained 79 per cent. total meat, whereas chopped ham must contain not less than 95 per cent. A further can of this product contained only 84 per cent. of meat and the manufacturers stated that the low meat content was due to a mishap and that they would increase their effective control on this line. Another chopped ham resembled a pork luncheon sausage and contained only 81 per cent. of total meat and, in this case, the manufacturers offered to call the product 'chopped ham loaf' which would be satisfactory. Some beef steak with gravy consisted of beef minced much too fine for beefsteak with gravy, and also contained 22 per cent. of loose fat. Not more than 8 per cent., or at the most 10 per cent. of loose fat is expected in preparations of this type. A kosher condensed clear chicken soup contained 0.94 per cent. of protein. The Meat Products, Canned Soup and Canned Meat (Control and Maximum Prices) Order, 1946, required meat soup to contain 2½ per cent. of protein and this product was, therefore, 60 per cent. deficient in protein. Four different varieties of soup mix all had their declaration of ingedients in the incorrect order. The free fatty acids of the fat in two stuffng mixtures was excessive, being respectively 6.4 and 4.0 per cent. A portion of back fat possessed an unpleasant flavour but could have been used for cooking purposes. It contained 5 per cent. of undeclared salt and should have been sold by some description such as ' salted lard ' or ' salted pork fat' and not as back fat. The metal cap of a jar of prawns in aspic was badly corroded and rusty and the product was, therefore, reported as inferior. A product called ' Java Crackers ' consisted chiefly of starch with shrimp and spices for flavouring, but there was no disclosure of the ingredients as required by the Labelling of Food Order. Another submitted as cod roe was unlabelled and probably consisted of herring roe. As a prepacked product, not prepacked on the premises it must be labelled in accordance with the requirements of the Labelling of Food Order. A Canadian product described as a 'Salad French Dressing' was neither a salad cream nor a French dressing as expected in this country, although its sale is permitted in Canada as a French dressing. The label of a soft ripened cheese was also considered misleading. It was stated to contain 72 per cent. of fat on the dry matter, but in fact contained only 65 per cent., and the statement in English 22 was hardly legible. Some camembert and brie cheeses contravened the Labelling of Food Order, as they appeared to have been sold under a proprietary name which was not a registered trade mark. Another camembert cheese contained only 41.5 per cent. of water and 18.2 per cent. of fat indicating that it had been made from a partially defatted milk, and it bore no label on the carton as required by the Labelling of Food Order. A cheese sold as 'Pemento Cheese' should have been described either as ' pimento ' or ' sweet pepper cheese 'Pimento' is the official name for allspice and is the fruit of Pimenta officinalis, which is quite different from the sweet peppers. A cheese dressing contained 661 parts per million of benzoic acid and was, therefore, reported as adulterated. Some instant coffee contained only 2.67 per cent. of caffeine, whereas a dry coffee extract should contain 4 per cent. A Christmas pudding contained only 15.8 per cent. of fruit, instead of 30 per cent. at least. Most Christmas puddings contain nearer 50 than 30 per cent. of fruit. The pudding was, moreover, a stodgy heavy mass. An assorted vegetable macaroni, stated to contain fresh egg was artificially coloured to create the impression that vegetables were present, but any added vegetable and egg could only have been present in small quantities. The declaration of ingredients was in the wrong order and, therefore, contravened the Labelling of Food Order. Another sample called chocolate macaroni shells contained only 3.21 per cent. of fat on the dry matter and should have been described as ' Chocolate Flavoured They contained 6.83 per cent. of sugar sucrose, very little egg and mostly semolina, and the order of declaration 'chocolate, sugar, fresh eggs, and semolina ' was completely contrary to the labelling of food requirements. The interior lacquer of a can of rhubarb had separated from the tin and iron plate causing considerable corrosion and resulting in the presence of 309 parts per million of tin in the rhubarb. The Ministry of Food limit is 250 parts per million of tin, but in your analyst's opinion any quantity of tin over 125 parts per million makes a food objectionable for consumption. Some prunes submitted for analysis were very old stock; some were split and appeared to be bird pecked. On cooking they were satisfactory and would be considered suitable for a fairly cheap product; they were, therefore, reported as inferior. A sample of split broad beans contained beetles and other dirt, one of split peas contained grit, stones, and four mouldy peas, and some split chick peas contained grit, stones, and snail shells. All these samples came from the same packer. Some rice was reported as inferior because it also contained small pieces of stone, leguminous seeds and one mite. Food Legislation. During the year the most important item of food legislation was the introduction of the Preservatives in Food Regulations, 1962, together with its subsidiary The Milk and Dairies (Preservatives) Regulations. The Preservatives Regulations follow the lines foreshadowed in the Report of which a precis was given last year so that there is little object in repeating the information. The number of preservatives permitted in foods has been increased to twelve, but in no case are more than three defined preservatives permitted to be used for any specified food. A recommendation by the Food Standards Committee that nisin should be permitted as a preservative for cheese has not been adopted in spite of a common belief that it may now be used. The chief item of interest, which had not been foreseen, was that no provision has been made for an expiry date for the sale of pickles and sauces containing benzoic acid as a preservative, so that, theoretically, the sale of thousands of bottles and jars of such products became illegal overnight and have remained so. The Emulsifiers and Stabilisers in Food Regulations, 1962, together with the Milk and Dairies (Emulsifiers and Stabilisers) Regulations, 1962, follow very nearly the lines suggested in the Report of the Food Standards Committee in 1961. The main difference is that definitions have been introduced in these regulations, which will fail to satisfy everyone. Thus an emulsifier is described as a substance which is capable of aiding the formation of a uniform dispersion of two or more immiscible substances and, in the opinion of your analyst, this is a natural definition which is long overdue, but many authorities believe that an emulsion must be a suspension of one liquid in another. Similarly, mixtures have been on the market for many years now called by the simple name glyceryl monostearate. Henceforth these mixtures of indefinite composition become partial glycerol esters, which in fact they are, although they often contain free stearic acid. On the other hand, the term interesterification, not mentioned in the Draft Regulations, has now been employed to mean the 23 polymerisation which takes place when castor oil is heated, whereas the word is known internationally among chemists to mean a re-arrangement of fatty acid groups within a fat, which is quite a different thing. The Pre-Packed Food (Weights and Measures: Marking) (Amendment) Regulations, 1962, the Food and Drugs (Legal Proceedings) Regulations, 1962, and the Milk and Dairies (Legal Proceedings) Regulations, 1962, enable Local Authorities, when taking proceedings for infringements of certain orders, to take direct action against persons, other than the vendor, if thought to be responsible, thus making action under all food and drugs regulations similar to other infringements of the Act. It will be noted that the Minister has introduced the custom of bringing in statutory regulations for foods generally, and for milk separately. This is at times unfortunate as it implies, for example, that substances declared not to be preservatives, emulsifiers, or stabilisers within the meaning of the regulations may be added to milk. It remains to be seen how the Courts will interpret these Regulations, if called upon to do so. Certain manufacturers have always resented the idea of Food Standards Orders on the grounds that they restrict initiative and the Ministry has shown a tendency to reduce the number of such orders to a minimum, so long as the public are adequately protected. With this end in view the Food Standards (Table Jellies) (Amendment and Revocation) Regulations, 1962, revoke the existing standards for table jellies and table jelly crystals, but require manufacturers to label them in accordance with the provisions of the Labelling of Food Order. During the year the Food Standards Committee of the Ministry issued four Reports dealing with:— (1) Canned Meat, (2) Hard, Soft and Cream Cheeses, (3) Dried Milk, and (4) Mineral Oil in Food. The Report on Canned Meat endeavours to make all canned meat products fall into one of ten different categories for meat content and thus to prevent manufacturers lowering the recognised meat content of a product by giving it a slightly different name. The proposed groups are:— Canned meat 95 per cent., Canned minced meat 90 per cent., Canned meat with jelly 80 per cent., Canned meat with gravy 75 per cent., Canned meat with sauce 65 per cent., Canned meat with cereal 80 per cent., Meat loaf 65 per cent., Meat loaf with stuffing 50 per cent., Canned meat with vegetables 35 per cent., Canned meat with pastry 45 per cent., Canned meat puddings 35 per cent., Canned meat pieces 25 per cent., Canned sausage 50 per cent., Canned pork sausage 65 per cent. Any other canned meat product 35 per cent. In general this is a very satisfactory grouping, though it would be difficult to bring products such as canned raviolis containing meat into the category of canned meat with pastry. Similarly one already finds certain manufacturers flavouring stews with onion and claiming, therefore, that the product falls within the definition of canned meat with vegetables, which is not the intention of the report. Probably the most contentious proposal in the report is that of the proposed limit of 30 per cent. for fat in canned pork products, other than bacon, sausages, and chops, which should be allowed to contain 50 per cent. Danish manufacturers suggested that pork luncheon meats and similar products should be allowed to contain 50 per cent, of their meat content as fat. Your analyst has examined many hundreds of samples of pork luncheon meat and finds that an average fat content is 38 per cent., a figure with which Danish manufacturers inform him they would be content. Another report, which is to be welcomed, is that on the composition of Hard, Soft, and Cream Cheeses. One of the difficulties concerned with standards for cheese is that of reconciling the water and fat contents. This has been very successfully dealt with in the report by suggesting that the maximum moisture content of most hard cheese should be 40 per cent., but that 42 per cent. should be allowed in Derby, Leicester, or Blue Stilton, 44 per cent. in Cheshire, Gloucester, or Double Gloucester, 46 per cent. in Caerphilly, Wensleydale or White Stilton, and 48 per cent. in Lancashire cheese. After allowing for this moisture the milk fat on the dry matter should be not less than 48 per cent. It is further proposed that cheeses of foreign origin should conform to the standards for the named cheese laid down in the country of origin of the particular variety. The standards proposed for cream cheese are 45 per cent. of milk fat and for double cream cheese, 65 per cent. The standard suggested for soft cheese is a minimum of 20 per cent. milk fat and 60 per cent. water. Other proposals are put forward for medium fat soft cheese, skimmed milk soft cheese, full fat curd cheese, and medium fat curd cheese. Most of the proposals are excellent, but one would have liked to see some mention made of the so-called 'cottage cheese' of which a considerable amount is sold, but presumably this would have to be described either as 'medium fat curd cheese' or 'skimmed milk soft cheese It is not proposed to relate the fat content of cheeses to the dry matter except in the case of hard cheese. 24 The report on Dried milk is intended largely to bring our present regulations into line with the proposals of F. A.O. and is, therefore, to be welcomed, even if one is not entirely in agreement, because it will make for a general simplification of international trade. It is suggested that dried milk should contain not less than 26 per cent. of milk fat and not more than 5 per cent. of moisture, and that partly dried skimmed milk powder should contain not less than 1.5 per cent. of milk fat nor more than 5 per cent. of moisture with the proviso that when sold in containers of 10 lbs. or less, the fat content should be declared and the product labelled as at present to the effect that it is not to be used for babies except on medical advice. Dried machine-skimmed milk would have to be labelled as unfit for babies. It is suggested in the report on the use of Mineral oil in Food that generally no alteration should be made to existing regulations, but that the sealing of eggs and of the rind of whole pressed cheeses should be permitted and, what is more important, that any paraffin wax or paraffin oil used for food purposes should be at least of B.P. quality. It would be useful if this last provision could be extended to apply to packing materials in which fruit is packed, since apples are frequently contaminated with paraffin due, possibly, to the use of paraffin on packing material round the fruit, though it is impossible to state definitely whether or not the apples have been polished with paraffin. Although the Hygiene Regulations already cover the sale of milk, milk drinks, and similar beverages from automatic machines, it may not be out of place to mention that special legislation may eventually be needed for their more effective control. Members of your analyst's staff have, on more than one occasion, bought chocolate milk drinks from automatic machines and have found them to be mouldy on opening. Thomas McLachlan, Public Analyst." Food—Adulterated or Unsatisfactory Samples. Twenty-seven of the sixty-three 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. Of the other samples adversely reported upon, two necessitated legal proceedings, details of which are given in Table 20, page 36. The remainder were dealt with informally. Unsound Food. Approximately 8 tons of food were voluntarily surrendered for destruction and certified as being unsound and unfit for human consumption. Details are given in Table 17, page 35. No 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, one shopkeeper was found to be selling Dutch tomatoes as "English"; he was warned of the offence. A letter was sent to all greengrocers and fruiterers in the Borough indicating the requirements of the Orders applying in particular to imported apples and tomatoes. Milk. There are 72 registered premises from which milk is sold and 17 milk roundsmen operate in the Borough from shops or depots elsewhere. A total of 86 licences are extant under The Milk (Special Designation) Regulations, 1960, for the five year period ending 31st December, 1965. The average percentage composition of the 20 genuine samples of milk analysed was: total solids 12.25, fat 3.50, solids not fat 8.75, the legal minima being, 11.50, 3.00, and 8.50 respectively. The Council's Bacteriologist examined 25 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 217 for its sale and storage. Details of the classes of premises are given in Table 18, page 36. Six samples of ice-cream were examined by the Council's Bacteriologist, with the following results : Grade I—4 ; Grade II—2. Chemical analysis of these samples proved to be satisfactory. 25 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 18, page 36. Inns, Refreshment Houses, etc.—Provision of Sanitary Conveniences. Section 25 of the London County Council (General Powers) Act, 1959, provided that a borough council could require the owner or occupier of any "refreshment house or place of public entertainment " to provide and maintain sanitary conveniences for the use of persons frequenting the premises. Difficulty arose concerning the definition of a "refreshment house" and it was held that this term only applied to refreshment houses licensed by the London County Council to remain open between the hours of 10 p.m. and 5 a.m. In order to clarify the position a clause was promoted in the London County Council (General Powers) Act, 1962, that "refreshment house" means any building in which food or drink is sold to and consumed by the public, and this definition became operative from October, 1962. It would not have been practicable to visit all catering premises in the Borough for the sole purpose of deciding which of them should be required to provide sanitary accommodation, and the policy is to look at this aspect during routine visits. However, when plans are submitted in respect of alterations or re-building of such premises the opportunity is taken of securing the provision of adequate accommodation, and similarly when land charge enquiries are received regarding catering premises attention is drawn to the Council's powers in this respect. Food and Catering Premises. There are 1,557 of these premises in the Borough, details of which are given in Table 19, page 36. During the year, 3,201 inspections were made and although many defects were found the majority of these were remedied with the willing co-operation of the proprietors, and the service of only 84 informal notices was necessary. Most proprietors strive to maintain good standards but there is still a great deal of work to be done before a completely satisfactory standard is achieved. The most effective aids to progress are undoubtedly the regular visit of the Public Health Inspector and education by personal contact with food handlers. It has to be realised that however willing and co-operative proprietors might be they are to a large extent dependent upon the staffs whose attitudes and limitations often cause serious concern. Thus one of the greatest problems lies in recruiting suitable staff in an industry which in general lacks any organised training schemes. Against this background the presence of the Inspector within the premises, carrying out a thorough examination, does impress upon the food handler that hygiene is a statutory requirement and not merely a whim of a fussy employer. With the increasing publicity given to food hygiene the public are becoming more aware of its importance and frequently bring incidents of poor hygiene to the attention of the Department. Apart from the value of attention being drawn to such occurrences, the hand of the Inspector is strengthened when it can be pointed out to a proprietor that not only are his standards technically low but that they have been seen to be low by the lay public. Licensing Act, 1961. From the 1st November, 1961, 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. Applications are referred to the Public Health Department and 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. By the end of the year under review licences of this type had been issued to 76 clubs, 30 restaurants, 4 residential hotels with restaurants open to the public and 54 residential hotels. Food Stalls. During the year food was sold from 86 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. 26 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. Twelve inspections were made and conditions found to be satisfactory. SECTION F.—INFECTIOUS AND OTHER DISEASES—PREVALENCE AND CONTROL There was a decrease in the number of cases of infectious diseases reported in the Borough, 277 notifications being received against 529 the previous year. This was mainly accounted for by a drop in the incidence of measles, 107 cases being notified against 422 in 1961. Only 2 cases of whooping cough were reported, against 12 in 1961 and 53 in 1960, but dysentery cases increased from 9 to 81, 70 of which were confined to two residential homes. There was one notification of acute poliomyelitis (paralytic) and 2 of acute encephalitis (post infectious) of which none had been reported in 1961. Table 22, page 37, gives details of notifications and the age groups concerned. Smallpox Contacts. (a) A Pakistani arrived at London Airport on 25th December, 1961 and proceeded by taxi to an address in St. Pancras. He developed a focal rash on 27th December and was seen in the early hours of the following morning at the University College Hospital where a diagnosis of smallpox was made. The patient was removed to Dartford Isolation Hospital where he subsequently died on 8th January, 1962. Four contacts on the same flight were traced to addresses in this Borough. All were visited and two who had not recently been vaccinated were re-vaccinated. Two of these passengers left the district almost immediately but the other two were kept under surveillance until the end of the quarantine period. No secondary cases developed. The publicity attending this and several other importations of a similar kind in other parts of the country at this time resulted in a very large number of requests from the general public for vaccination. Special vaccination clinics were organised by the London County Council. Soon after the commencement of the outbreak the Ministry, in order to conserve the supply of lymph and to ensure proper control, channelled all supplies through the Public Health Laboratory Service and requested doctors to apply either direct to the Laboratory at Colindale or to their local health departments. During this period 7,479 doses of lymph were distributed by the Department to doctors practising in the Borough. (6) The s.s. "Oronsay" arrived in the Thames on the 15th August, 1962, and on the same day an Asian boy, aged 3 years, was removed from the ship and admitted to hospital suffering from suspected modified smallpox. The boy had embarked with his family at Bombay on the 30th July and was taken ill on the 9th August. Subsequently his brother, aged 8, and sister, aged 4, were reported to be suffering from a similar modified form of the disease. Ninety-six other passengers were stated to have gone to addresses in this Borough. Appropriate enquiries were made and surveillance maintained of contacts found to be staying in the Borough. No secondary cases occurred. Tuberculosis. Table 22, page 37, gives information regarding primary notifications of pulmonary and non-pulmonary tuberculosis received during the year. Table 23, page 38, shows the age and sex distribution of new cases and of deaths from all forms of the disease, and Table 24, page 38, 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 116 visits by one of the women public health inspectors to all new cases and those moving into the Borough from other areas. Food Poisoning. Sixteen notifications were received during the year but ten were withdrawn as the salmonella organisms responsible were not thought to have been food-borne. Of the remaining six cases, one, in which no organism was identified, was connected with a large outbreak in Westminster, and the others were single cases. Salmonella typhimurium was the organism found to be responsible for two of these but in the other three no agent was identified. 27 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 66 cases of scabies : adults 40 (men 32, women 8); children 26 (boys 11, girls 15). Disinfection. During the year, 54 rooms, 894 articles of bedding (mattresses, blankets, sheets, bolsters, pillows, etc.) and 413 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, 129 certificates relating to a total of 2,348 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 three certificates were issued in this connection. International Certificates of Vaccination. Travellers to most countries abroad have to produce evidence of recent vaccination against certain prescribed diseases. For this purpose an International Certificate of Vaccination is used in respect of smallpox, cholera and yellow fever. Methods of protection previously known as " inoculation " are now described internationally as vaccination. Under the terms of Ministry of Health circulars Nos. 60/48 and 20/52 the Medical Officer of Health is required to authenticate the signatures on certificates issued by doctors practising within his district During the year, signatures on 23,717 of these certificates were authenticated. This was more than five times the number dealt with in 1961, the increase being mainly due to the large number of vaccinations which were performed because of the smallpox incidents referred to on page 25. In addition, nine 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 25, page 38, shows the number of specimens examined for the purposes of diagnosis and also indicates the organisms in relation to which the examinations were made. 28 APPENDIX OF STATISTICAL TABLES AND SUPPLEMENTARY INFORMATION 29 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 4 3 - - - - - - - - 1 - 2 2 1 1 2 Tuberculosis, other — 2 - - - - - - - - - 1 - 1 - - 3 Syphilitic disease 1 - - - - - - - - - - - 1 - - - 4 Diphtheria - - - - - - - - - - - - - - - - 5 Whooping cough - - - - - - - - - - - - - - - - 6 Meningococcal infections - - - - - - - - - - - - - - - - 7 Acute poliomyelitis - - - - - - - - - - - - - - - - 8 Measles - - - - - - - - - - - - - - - - 9 Other infective and parasitic diseases - - - - - - - - - - - - - - - - 10 Malignant neoplasm, stomach 7 4 - - - - - - - - 1 1 4 — 2 3 11 Malignant neoplasm, lung, bronchus 38 4 - - - - - - - - 3 — 15 2 20 2 12 Malignant neoplasm, breast — 28 — — — — — — — — — 1 — 12 — 15 13 Malignant neoplasm, uterus — 12 — — — — — — — — — 2 — 5 — 5 14 Other malignant and lymphatic plasms 54 50 - - - - - - - 1 3 1 24 20 27 28 15 Leukaemia, aleukaemia 6 2 - - - - - - - - - - 2 1 4 1 16 Diabetes 2 5 - - - - - - - - - - - - 2 5 17 Vascular lesions of nervous system 78 85 — — 1 — — — — — 1 — 13 7 63 78 18 Coronary disease, angina 133 98 - - - - - - - - 3 — 43 20 87 78 19 Hypertension with heart disease 13 14 - - - - - - - - - - 1 — 12 14 20 Other heart disease 58 79 - - - - - - - 1 — 1 7 5 51 72 21 Other circulatory disease 24 33 - - - - - - - - - - 7 2 17 31 22 Influenza 2 2 - - - - - - - - - - 1 — 1 2 23 Pneumonia 25 22 - - - - - - - - - - 5 1 20 21 24 Bronchitis 54 32 1 - - - - - - - - - 11 3 42 29 25 Other diseases of respiratory system 7 3 - - - - - - 1 - - - 2 — 4 3 26 Ulcer of stomach and duodenum 3 3 - - - - - - - - - - 3 1 — 2 27 Gastritis, enteritis and diarrhoea 3 3 1 - - - - - - - - - - - 2 3 28 Nephritis and nephrosis 3 1 - - - - - - - - - - 2 — 1 1 29 Hyperplasia of prostate 3 - - - - - - - - - - - - - 3 — 30 Pregnancy, childbirth, abortion - - - - - - - - - - - - - - - - 31 Congenital malformations 5 6 1 3 1 — 1 — — — 1 1 — — 1 2 32 Other defined and ill-defined diseases 33 39 6 4 — — — 1 2 2 1 — 8 11 16 21 33 Motor vehicle accidents 3 3 - - - - - - 1 1 - — 2 1 - 1 34 All other accidents 11 9 - 1 - - - 1 3 1 3 1 4 2 1 3 35 Suicide 13 8 - - - - - - 2 — 4 2 7 4 — 2 36 Homicide and operations of war — 2 - - - - - - - - - 1 - - - 1 Totals 583 552 9 8 2 — 1 2 9 6 21 12 164 100 377 424 1,185 17 2 3 15 33 264 801 TABLE 2.—Infant Mortality—According to Age-Group and Sex. cause OF death Under 1 week 1 and under 2 weeks 2 and under 4 weeks 1 and under 3 months 3 and under 6 months 6 and under 9 months 9 and under 12 months Total M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Atelectasis 1 - - - - - - - - - - - - 1 - Premature Birth 2 3 - - - - - - - - - - - - 2 3 Bronchitis — — - — — - — - — - - - 1 - 1 - Congenital Abnormalities. — 2 - — — 1 1 - - - - — — — 1 3 Subdural Hæmatoma — — - — — — — 1 — - — — — — - 1 Asphyxia neonatorum 1 - - - - - - - - - - - - - 1 - Gastritis, Enteritis — — - — — — — — 1 - — — — — 1 - Anoxia — — - — — — - - 1 - — - - - 1 - Subarachnoid Haemorrhage — 1 - - - - - - - - - - - - - 1 Unascertainable 1 - - - - - - - - - - - - - 1 — Totals 5 6 — — — 1 1 1 2 — — — 1 — 9 8 11 — 1 2 2 — 1 17 30 TABLE 3.—Weather Statistics. Station : Regent's Park. Height of rain-gauge above mean sea level: 129 feet. 1962 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 8.1 2.3 5.2 12.2 24, 26 -7.2 1 3.36 .75 21 18 - - 0 8 19 - 57.6 1.86 196 Feb 7.7 2.0 4.8 12.8 12 -3.3 26 51 .25 12 8 - - 0 10 18 — 60.2 2.15 134 Mar 7.3 0.1 3.7 14.4 29 -5.0 6 1.61 .68 28 9 - - 0 16 24 - 98.2 3.17 107 April 12.7 5.3 9.0 21.7 26 1.1 14 1.79 ,34 4 12 - - 0 0 10 - 125.8 4.19 95 May 15.4 7.4 11.4 18.9 4.8 1.1 1,2 1.59 .55 4 14 - - 0 0 7 - 138.7 4.47 74 June 20.2 9.7 14.9 26.1 9 1.1 1 .31 .15 28 3 - - 0 0 4 — 259.0 8.63 127 July 20.4 12.2 16.3 24.4 2,20 7.8 7 3.41 1.46 28 11 - - 0 0 0 - 120.5 3.89 61 Aug. 20.3 12.0 16.1 23.9 1,19 7.8 9 1.91 .94 6 8 - - 0 0 0 — 166.2 5.36 94 Sept. 18.1 10.1 14.1 25.0 2 4.4 18 3.73 1.26 6 13 - - 0 0 0 — 141.2 4.71 113 Oct. 15.8 8.1 11.9 20.6 8, 18 0.0 27 1.89 .77 25 5 - - 3 1 4 — 112.4 3.63 135 Nov. 9.2 4.2 6.7 15.0 2 -2.8 20 1.83 .32 1 15 - - 6 6 11 - 31.4 1.05 77 Dec 5.1 0.3 2.4 12.8 15 -5.6 26 2.61 .50 29 10 - - 10 17 24 - 63.4 2.05 238 31 Table 4.—Summary of Road Accidents. Month Number of Accidents Fatal Injuries— Serious Slight January 73 1 15 75 February 74 1 12 79 March 95 - 10 120 April 60 — 9 62 May 83 1 10 104 June 73 — 10 83 July 86 — 11 98 August 88 1 9 113 September 93 — 18 113 October 82 — 10 81 November 79 1 14 90 December 70 1 8 74 Totals 956 6 136 1,092 TABLE 5.—Dwelling-Houses : Summary of Inspections, Conditions Found and Action Taken. Inspection under Public Health or Housing Acts:— (1) (a) Inspected for housing defects 1,364 (b) Inspections made for the purpose ... 3,966 (2) Found to be in a state so dangerous or injurious to health as to be unfit for human habitation - (3) Found not to be in all respects reasonably fit for human habitation 409 Defects remedied without service of formal Notices:— Defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 348 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 267 (2) Dwelling-houses in which, after service of formal notices, defects were remedied:— (a) By owners 61 (6) By Local Authority in default of owners — (b) Proceedings under the Housing Act, 1957 :— (1) Rooms in respect of which Closing or Demolition Orders were made:— Underground rooms — Other rooms (1 house) 6 (2) Closing Orders determined, the tenement or room having been made fit 10 (3) Rooms affected by (2) above 20 (4) Closing Orders varied 1 (5) Undertakings accepted in respect of underground rooms 1 32 TABLE 6.—Nuisances Remedied. Nuisance Abated or Defect Remedied Number Houses damp, dirty or dilapidated 164 Doors, windows, floors, ceilings, sash cords, grates and flues, etc., defective 350 Drain, water-closet and waste pipe stoppages 109 Drains, water-closets and waste pipes defective 80 Insufficient or unsuitable w.C. accommodation 11 Yard, area and wash-house defects 28 Roofs, gutters and rainwater pipes defective 144 Insufficient water supplies 23 Water cisterns dirty or defective 5 Ashpits, dustbins, etc., defective 44 Rubbish accumulations 49 Animal nuisances 4 Miscellaneous 83 Total 1,094 TABLE 7.—Chemical Examination of Water supplied to St. Marylebone— Average Results. Milligrammes per Litre (unless otherwise stated) Analysis data Source of Supply Hampton Ashford Common No. of samples 52 52 Ammonia Nitrogen 0.040 0.046 Albuminoid Nitrogen 0.078 0.081 Nitrate 4.0 4.0 Chlorides as C1. 31 31 Oxygen abs. from Permanganate 4 hrs. at 27° C. 1.12 1.14 Turbidity units 0.3 0.2 Colour m.m. brown 2 ft. Tube Burgess's Tintometer 12 12 Hardness (total) 264 276 Hardness (non-carbonate) 58 58 pH. Value 7.8 7.9 Phosphate as PO4 1.2 1.3 Silicate as SiO2 9 10 Sulphate as SO4 61 61 Natural Fluoride as F 0.25 0.25 Magnesium as Mg. 6 6 Surface active material as manoxol 0.12 0.12 Electrical Conductivity (micromhos) 550 560 TABLE 8.—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 1.121 11.9 - 99.91 100.0 Ashford Common 767 20.1 - 100.0 100.0 33 TABLE 9.—Rodent Control. Complaints: Complaints of rats received 159 Complaints of mice received 366 Total premises involved 525 Block Treatment : Blocks of premises surveyed 37 Separate premises involved 2,258 Infestations: Premises rid of brown rats 139 Premises rid of black rats - Premises rid of mice 341 Total premises disinfested by Council's staff 480 Total visits to such premises 7,701 Notices: Intimation notices served 35 Statutory notices served 4 TABLE 10.—Air Pollution. Period Average Concentrations of Smoke and Sulphur Dioxide Smoke—Microgrammes per cubic metre (Smoke Filter) Site Weeks 1-5 6-9 10-13 14-17 18-22 23-26 27-30 31-35 36-39 40-44 45-48 49-52 T.H. 158 138 146 76 51 37 44 38 49 128 167 347 G.P. 165 * — 42 31 24 26 24 46 — 192 374 Sulphur Dioxide—Microgrammes per cubic metre (Volumetric method) Site Weeks 1-5 6-9 10-13 14-17 18-22 23-26 27-30 31-35 36-39 40-44 45-48 49-52 T.H. 102 117 142 129 94 102 83 130 70 161 209 744 G.P. 128 * — 71 59 63 146 74 55 — 220 554 * Insufficient results. T.H. Station No. 6, Town Hall. — No results received. G.P. Station No. 7, Greville Place. TABLE 11.—Air Pollution. Deposited Matter and Concentration of Sulphur Trioxide For the Period January to July. (The use of these instruments was discontinued on 1st August, 1962) Site Jan. Feb. Mar. April May June July Insoluble Matter—Tons per sq. mile (collected in deposit gauges) N.L 36.37 12.42 13.61 13.61 13.39 8.31 9.55 T.H. 12.65 6.40 11.16 8.91 8.49 5.13 6.70 Soluble Matter—Tons per sq. mile (collected in deposit gauges) N.L 11.63 3.87 16.18 6.18 4.78 30.12 3.92 T.H. 10.38 5.56 6.71 6.81 5.48 3.15 6.99 Sulphur Trioxide—Milligrams per day collected (per 100 sq. cm. of lead peroxide) N.L. 4.06 2.96 2.67 2.01 1.36 0.71 0.74 T.H. 5.99 4.86 4.28 3.18 2.12 1.81 1.94 E.R. 4.39 3.33 3.62 2.61 1.40 1.38 1.38 N.L. Station No. 4 Nuffield Lodge T.H. Station No. 6 Town Hall E.R. Station No. 5 Edgware Road. 34 TABLE 12.—Factories : Inspections for Purposes of Provisions as to Health. Premises Registered Inspections Written notices Occupiers prosecuted Factories without mechanical power 220 72 3 - Factories with mechanical power 938 745 21 - Other premises* (excluding outworkers' premises) 465 528 — — Totals 1,623 1,345 24 — * Electrical stations, institutions, sites of building operations and works of engineering construction. TABLE 13.—Factories : Defects. 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 5 10 3 - - Overcrowding — — — — — Unreasonable temperature — — — — — Inadequate ventilation — — — — — Ineffective drainage of floors — — — — — Sanitary conveniences:— 1 (a) insufficient 1 — — — (b) unsuitable or defective 23 23 — 6 — (c) not separate for sexes — — — — — Other offences (excluding offences relating to outwork) 16 18 6 — — Totals 44 62 9 6 — TABLE 14.—Summary of Outwork. Description of Work Outworkers Employed Wearing apparel 498 Textile weaving 8 Curtains and furniture hangings 8 Furniture and upholstery 2 Household linen 1 517 35 TABLE 15.—Pharmacy and Poisons Acts, 1852-1941 : Summary of Sellers of Part II Poisons. Type of Business Total Licensed Grocery and provision stores 32 Hardware and domestic stores 14 General stores 16 Hairdressers 6 Builders' merchants 2 Drug stores 1 Dental sundriesman 1 Photographic dealer 1 73 TABLE 16.—Public Conveniences. Convenience Urinals W.C's. Free W.C's. Wash basins (free) Additional Information Underground : Oxford Circus (Men) 26 11 1 7 Changing Room (1s.), 1 Lavatory basin. Electric razor (6d.) Oxford Circus (Women) - 8 1 4 Rest Room (free), 1 Lavatory basin and sink. Foley Street (Men) 8 3 1 3 — Gt. Portland Street (Men) 6 4 1 3 - Gt. Portland Street (Women) — 4 1 3 - Marylebone Road (Men) 12 7 1 8 — Marylebone Road (Women) — 3 1 5 — St. John's Wood Road (Men) 6 3 1 3 — Barrett Street (Men) 11 3 1 3 — Above ground : Paddington Street (Men) 6 2 1 3 — Paddington Street (Women) — 2 1 2 — Salisbury Street (Men) 6 3 1 3 — Salisbury Street (Women) — 4 2 2 — Wellington Place (Men) 6 1 1 1 — Wellington Place (Women) — 2 1 1 — Violet Hill (Men) 2 1 1 1 Unattended. Violet Hill (Women) - 1 1 1 do. Lisson Grove—Urinal 4 — - — Open Day and Night. *Red House Public House, Park Road—Urinal 4 - - - - *† Exeter Arms Public House, Ashmill Street Urinal 4 — — — Open 9 a.m. to 11 p.m. * Cleansed by the Borough Council but maintained by brewers. † Due to be closed to public, brewers incorporating space for toilet accommodation inside the premises. TABLE 17.—Unsound Food Voluntarily Surrendered. Description Tons Cwts. Qtrs. Lbs. Meat and offal - 8 2 3 Sausages, brawn, etc 2 14 1 6 Canned meat 1 1 - 16 Bacon and ham - 9 1 18 Canned food (other than meat) 1 10 1 21 Fish - 7 3 2 Fruit and Vegetables 1 — — 4 Miscellaneous — 16 1 21 Total 8 8 - 7 36 TABLE 18.—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 30 1 Tobacconists, confectioners/newsagents — 93 Grocers and provision merchants 21 66 Fishmongers 6 3 General stores 1 14 Greengrocers and fruiterers — 20 Public houses — 5 Ice-cream factories — 3 Miscellaneous 2 15 60 220 TABLE 19.—Summary of Food Pr emises. Type of Business Totals Hotels and boarding houses 328 Restaurants, cafes and snack bars 300 Grocers and provision merchants 168 Canteens and clubs 159 Public houses and wine bars 164 Confectioners 105 Stalls, street trading 82 Greengrocers and fruiterers 60 Butchers 52 Schools and nurseries 52 Bakers 30 Wine merchants (off-licence) 30 Fishmongers 14 Milk depots 5 Coffee stalls and kiosks 5 Ice-cream manufacturers 3 1,557 TABLE 20.—Legal Proceedings : Food and Drugs Act. Date of Hearing Offence Result 29.3.62 Selling food not of the substance demanded—meat pie containing mould. (Food and Drugs Act, 1955—section 2) Fined £10 with 3 gns. costs. 29.3.62 Selling food not of the substance demanded—cheese sandwich containing drawing-pin. (Food and Drugs Act, 1955—section 2) Fined £10 with 3 gns. costs. TABLE 21.—Diseased or Infirm Persons removed to Hospital, etc., under Court Orders. Person Age Removed to Remarks Miss M. C. 79 Hospital Emergency order for 3 weeks. Remained in hospital voluntarily at end of period. 37 TABLE 22.—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— 65— Acute Encephalitis (Post-Infecious) 2 - 1 - - - 1 - - - - - - 2 - Scarlet fever 9 — — — 1 — 6 — 1 1 — — — 1 8 Puerperal pyrexia 8 - - - - - - - 1 6 1 — — — — Pneumonia 3 — — — — — — 1 — — 1 1 — 3 — Dysentery 81 — 12 9 13 9 17 1 2 15 1 1 1 69 12 Measles 107 5 19 16 17 12 28 3 4 3 — — — 52 55 Whooping cough 2 — — — — — 1 1 — — — — — — 2 Scabies 6 — — — — — 1 — — 4 1 — — 1 5 Tuberculosis— Pulmonary 42 - - - - 1 - - - 15 6 15 5 21 21 Non-pulmonary 10 — — — — — 1 — — 6 2 — 1 8 2 Food poisoning 6 1 — — — 1 — — — 1 1 1 1 — 6 Acute Poliomyelitis (Paralytic) 1 - - - - - - - - - - 1 — 1 — Totals 277 6 32 25 31 23 55 6 8 51 13 19 8 166 111 *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, erysipelas. TABLE 23.—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 - 1 - - - — — — 5—15 - 1 1 - - - — — 15—25 1 5 1 - - — — — 25—35 13 6 1 5 1 — — 1 35—45 8 4 1 1 - — — — 45—55 10 2 - - 2 - — - 55—65 6 3 - - - 2 - 1 65 and upwards 6 2 — 1 1 1 — — Totals 44 24 4 7 4 3 — 2 *Including all primary notifications and also any other new cases of tuberculosa which came to the knowledge of the Medical Officer of Health during the year. 38 TABLE 24.—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 639 398 937 33 50 83 1,020 (b) Number of cases notified to the Medical Officer of Health under the Regulations for the first time during the year 25 17 42 4 6 10 52 (c) Number of cases removed from the Register during a preceding year which have been restored to the Register during the year 4 - 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 19 7 26 - 1 1 27 (e) Number of cases removed from the Register during the year 90 75 165 9 12 21 186 (f) Number of cases remaining on the Register at the end of the year 497 347 844 28 45 73 917 TABLE 25.—Summary of Work of the Bacteriological Laboratory. Nature of Specimen and Examination Positive Negative Total Throat and nasal swabs for— B. diphtheriae — 1 1 Haemolytic streptococci 2 29 31 Vincent's organisms — 1 1 Sputum for— Tubercle bacilli — 9 9 Faeces for— Parasites, typhoid, paratyphoid, dysentery and food poisoning organisms 2 172 174 Foods for— Food poisoning organisms — 13 13 Totals 4 225 229 TABLE 26.—New Legislation. Legislation Operative Date Milk and Dairies (Emulsifiers and Stabilisers) Regulations, 1962 11.4.62 Housing (Management of Houses in Multiple Occupation) Regulations, 1962 22.5.62 Housing (Prescribed Forms) (Amendment) Regulations, 1962 24.5.62 National Assistance Act, 1948 (Amendment) Act, 1962 24.5.62 Oil Heaters Regulations, 1962 1.6.62 Milk and Dairies (Legal Proceedings) Regulations, 1962 27.6.62 Food and Drugs (Legal Proceedings) Regulations, 1962 27.6.62 Motor Cycles (Protective Helmets) (Amendment) Regulations, 1962 30.6.62 Food Standards (Table Jellies) (Amendment and Revocation) Regulations 1962 12.7.62 Emulsifiers and Stabilisers in Food Regulations, 1962 16.7.62 Milk and Dairies (Preservatives) Regulations, 1962 26.7.62 Preservatives in Food Regulations, 1962 26.7.62 London County Council (General Powers) Act, 1962 1.8.62 Local Government Records Act, 1962 1.10.62 Landlord and Tenant Act, 1962 1.11.62 Factories : The Slaughterhouses Order, 1962 7.11.62 The Slaughterhouses (No. 1) Regulations, 1962 7.11.62 The Slaughterhouses (No. 2) Regulations, 1962 7.11.62 Abstract of Factories Act Order, 1962 7.12.62 Discharge of Radioactive Waste (Extension of Temporary Control) Order, 1962 7.12.62 Poisons List Order, 1962 31.12.62 Poisons Rules, 1962 31.12.62 Food Hygiene (General) Regulations, 1962 1.1.63 Town and Country Planning Act, 1962 1.4.63 39 SERVICES AVAILABLE FOR OLD PEOPLE NATIONAL. National Assistance Board, 177, Tottenham Court Road, W.l. (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.l. Colquhoun House, Broadwick Street, W.l. Tel. : REG. 7010. For Postal Area, N.W.I 30, Euston Square, N.W.I. Tel. : EUS. 6451. For Postal Areas, W.2 and N.W.8. 5, Praed Street, W.2. Tel. : PAD. 3411. LONDON COUNTY COUNCIL. Homes.—Luxborough Lodge, 1, Luxborough Street, W.l. (Tel.: WEL. 0966).—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.1. (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.1. (Tel. : WAT. 5000, Ext. 7005). Home Helps Service, Room 91, Town Hall, St. Marylebone, W.1. (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.1. (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 S ecretary, 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.1.—Monday to Friday up to 4.30 p.m. Old age pensioners pay 1d. (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 or smokeless fuel 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. 40 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 11d. 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 People's 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:— St. Mary's Church Hall, Crawford Street, 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.$ (Tel.: PRI. 1051). Citizens' Advice Bureau, 60, Paddington Street, W.1. 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 and television 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. 11. (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, Af.W.l. (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 Arthritics, 17, Rugby Mansions, Bishop King's Road, W. 14. (Tel. : FUL. 0593). The Chest and Heart Association, Tavistock House North, Tavistock Square, W.C.I. (Tel.: EUS. 3102). 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 Lodging House for Women, 84, Bell Street, N.W. 1. (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.1. (Tel.: VIC. 9977). Details of old people's homes in London and provinces. CINEMAS. The following local cinemas admit old age pensioners on weakdays (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. 41 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.10 LAD 2281 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. 1 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.l LAN 2727 General Nursing Council for England and Wales, 23, Portland Place, W.l LAN 8334 Institute of Cardiology, 35, Wimpole Street, W.l 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, 11, Chandos Street, W.l LAN 1043 Royal College of Midwives, 15, Mansfield Street, W.l LAN 6523 Royal College of Nursing, la, Henrietta Place, W.l LAN 2646 Royal College of Obstetricians and Gynaecologists, 27, Sussex Place, Regent's Park, N.W.1 AMB 5425 Royal Institute of Public Health and Hygiene, 28, Portland Place, W.l LAN 2731 Royal Medico-Psychological Association, 11, Chandos Street, W.l LAN 1495 Royal Society of Medicine, 1, Wimpole Street, W.l LAN 2070 Royal Society of Tropical Medicine and Hygiene, 26, Portland Place, W.l LAN 2127 42 INDEX Page Accidental Deaths 3, 29 Accidents : Home 10 Road 3, 31 Adulterated Food Samples 20, 24 Aged Persons 5, 6, 39 Aged Persons—Services available 39 Air Pollution 13,33 Ambulance Service 41 Analysis of Food and Drugs 20 Analyst, Public 1, 20 Analyst, Public, Report 20 Bacteriological Examinations 9, 27, 38 Bacteriological Examination of Milk and Ice Cream 24 Bacteriologist 1 Barbers 14 Baths : Cleansing of Persons 13 For Old People 6 Public 9 Swimming 9 Births 2, 3 Bodies, Transportation Abroad 16 Books, Library 8, 27 Bugs 12 Burial or Cremation of the Dead 16 Cancer 3 Care of Old People 5 Catering Establishments 25 Causes of, and Ages at. Death 29 Census Population 2 Certificates of Disrepair 18 Clean Air 13, 33 Cleansing, Public 15 Cleansing Station 13 Cleansing of Verminous Persons 13 Clearance, Slum 17 Clinics 41 Closing Orders 18, 31 Combined Drainage 12 Committee, Public Health 1 Common Lodging Houses 18 Compulsory Removal 9 Conditions, Social 2 Conferences 5 Consumer Protection 14 Conveniences, Public 14, 35 Cremation 16 Deaths : Accidental 3, 31 General 2, 29 Infant Mortality 2, 3, 29 Maternal Mortality 2,3 Vital Statistics 2 Diseased or Infirm Persons, Removal 9, 36 Diseases, Notifiable 26, 37 Disinfection 27 Disinfestation 12 Disrepair Certificates 18 Dog Nuisance 16 Drainage 12 Drugs, Analysis 20 Dwelling-Houses 18, 31 Exclusion from Work 27 Factories 13, 34 Financial Contributions to Voluntary Organisations 5 Fireguards 14 Food : Adulterated, etc 20,24 Analysis 20 Inspection 24 Legal proceedings 24, 36 Legislation 22, 38 Poisoning 26 Premises 25, 36 Page Food : Preserved, etc. 25, 36 Stalls 25 Unsound 24, 35 Fouling of Footways by Dogs 16 General Statistics 2 Hairdressers and Barbers 14 Health Education 5 Heating Appliances (Fireguards) 14 Home Accidents 10 Horseflesh 25 Hospitals 41 Houses in Multiple Occupation 19 Housing : Certificates of Disrepair 18 Closing Orders 18,31 Improvements and Conversions 17 Inspection and Action taken 31 Of Old People 18 Old People's Consultative Committee 18 Permanent Estates 17 Re-housing, Medical Certificates 18 Slum Clearance 17 Hydrogen Cyanide Disinfestation 12 Hygiene—Food Premises 25 Ice Cream 24,36 Immigrants 18 Impetigo 27 Improvement and Conversions, Housing 17 Infant Mortality 2, 3, 29 Infectious Diseases : Exclusion from Work of Contacts 27 Notification 26, 37 Prevalence and Control 26 Statistics 26 Inns, Refreshment Houses, etc. 25 Inspection, Sanitary 10, 32 Institutions, Medical and Nursing, etc 41 International Certificates of Vaccination 27 Intimation Notices 10 Knacker's Yard 26 Land Charges Enquiries 18 Laundry : Public 9 Service for Old People, etc. 6 Legal Proceedings 11, 24 Legislation, New 10, 22, 38 Library books 8 Licensed Premises 25 Lung Cancer 3 Marriages 2 Maternal Mortality 2, 3 Measles 26 Medical Examinations : Staff 10 Parking Meter Exemptions 10 Medical and Nursing, etc., Institutions 41 Medical Referee, Cremation 1,16 Merchandise Marks Act 24 Mice 12, 33 Milk : Bacteriological Examination 24 Sellers 24 (Special Designations) Regulations 24 Mortality : Infant 2, 3; 29 Maternal 2, 3 Multiple Occupation, Houses in 19 New Legislation 10, 22, 38 Noise 11 Notices, Intimation and Statutory 10 Notification of Infectious Diseases 26, 37 Nuisances 10,32 43 Page Offices 13 Old People : Care of 5 Housing—Consultative Committee 6,18 St. Marylebone Welfare Association 6, 39 Services Available 39 Outworkers 14,34 Parking Meter Exemptions—Medical Examination 10 Pet Shops 14 Pharmacy and Poisons Acts 14,35 Photographers, Street 16 Pigeons 11 Poisoning, Food 26 Poisons 14 Poliomyelitis 26 Population 2 Preserved Food 25, 36 Protective Helmets 14 Public Analyst 1 Public Analyst's Report 20 Public Baths 9 Public Cleansing 15 Public Conveniences 14,35 Public Health Committee 1 Public Health Department Staff 1 Public Health Inspectors 1 Public Laundry 9 Public Swimming Baths 9 Pulmonary Tuberculosis 26, 37, 38 Rag Flock and Other Filling Materials 15 Rateable Value 2 Rats 12, 33 Referee, Medical (Cremation) I Refreshment Houses 25 Refuse Collection and Disposal, Storage 15 Removal, Compulsory 9 Rent Act 18 Representation upon other Bodies 4 Restaurants 25 Road Accidents 3,31 Rodent Control 12, 33 Page St. Marylebone Old People's Welfare Association 6, 39 Sanitary Circumstances 10 Sanitary Inspection 10 Scabies 27 Sewerage 12 Shelter 13 Shops 13 Slaughter of Animals 26 Slum Clearance 17 Smallpox Contacts 26 Smoke Control 13,33 Social Conditions 2 Staff : of Department 1 Medical Examinations 10 Stalls, Food 25 Statistics : General and Vital 2 Tables 29 Statutory Notices 10 Stillbirths 2, 3 Street Cleansing 15 Street Photographers 16 Swimming Baths 9 Town Planning 12 Transportation of Bodies Abroad 16 Tuberculosis : General 26 New Cases and Deaths 26,37 Notifications 26, 37 Register 26, 38 Unsound Food 24, 35 Vaccination, International Certificates 27 Vermin 12 Verminous Persons, Cleansing 13 Vital Statistics 2 Water 11,32 Weather 3,4,30 Wells, Private 11 Zoological Society of London 26 Vail & Co. Ltd., Leeke Street, King's Cross, W.C.i.