AC 4353 STMARY 69 BOROUGH OF ST. MARYLEBONE REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1964 HASTINGS E. A. CARSON, M.D., D.P.H., S.M.(Harv). CONTENTS 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 12 Section D—Housing 19 Section E—Inspection and Supervision of Food 21 Section F—Infectious and other Diseases—Prevalence and Control 26 Appendix of Statistical Tables and Supplementary Information 29 Index 43 (i) 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 1964. At the request of the Minister of Health the report retains its usual form and gives full details of the water supply, sewerage and common lodging houses in the Borough. Public health throughout the year was generally good. The number of cases of infectious disease notified reached a record low level, 140 of the 233 notifications received being accounted for by measles. If the clinical trials of measles vaccines which commenced early in the year under the auspices of the Medical Research Council fulfil expectations, then this common and frequently tiresome childhood ailment will soon cease to dominate the annual returns of notifiable diseases. Once again the Borough remained free from smallpox, diphtheria and poliomyelitis. Only one case of typhoid fever—almost certainly contracted on holiday abroad—was notified but the need to remain on constant guard was dramatically illustrated by the epidemic which assailed Aberdeen during the summer of 1964; fortunately no secondary cases developed amongst the contacts kept under surveillance in St. Marylebone. The size of the resident population remained virtually stationary with both the standardized birth and general death rates showing a decrease compared with the previous year. Not unexpectedly, in view of the small numbers involved, the stillbirth, perinatal, neonatal and infant mortality rates all rose appreciably; in such circumstances even quite marked fluctuations in these rates can be regarded with equanimity. Happily there were no maternal deaths in 1964. Of the 17 infant deaths recorded all but one occurred within four weeks of birth—a period when the influence of prenatal factors, of which much remains to be learned, is particularly felt. The leading causes of death amongst adults continued to be diseases of the heart and circulatory system, the various forms of cancer, and respiratory diseases in that order. Seven out of every ten deaths registered during the year were of persons over the age of 65. Details of the activities of the Public Health Department on behalf of the elderly, and of the St. Marylebone Old People's Welfare Association will be found on pages 6-10 of this report. The official opening by His Worship the Mayor on the 27th of November of the St. Marylebone Centre for the Elderly was a memorable moment in the history of the Association. This attractive day centre, conveniently situated near the Town Hall, will be the focal point for voluntary services for the aged in the Borough; in addition to serving as the administrative headquarters of the Old People's Welfare Association it provides facilities for social recreation, a foot clinic, a luncheon club, and a base for the distribution of meals to the housebound. In the first full year of operation with two vans the "Mealson-Wheels" service, manned by the stalwart members of the Women's Voluntary Service and the British Red Cross Society under the able supervision of the indefatigable Mrs. Lush, delivered no fewer than 15,538 hot mid-day meals. A splendid record. Another happy feature was the appointment in June of Mr. Gosby as deputy to Mrs. Cowan who has rendered such sterling service as Secretary of the Old People's Welfare Association—the Department is greatly in her debt for wise counsel and cheerful assistance unstintingly given. The Borough Council also derived great satisfaction from the opening in July by Miss Lucy Nettlefold, a former alderman and a tireless worker for the aged in St. Marylebone, of the first purposebuilt block of flats it had erected for old people. Mackintosh House (named in memory of the distinguished predecessor of Mrs. Cowan) contains 28 flatlets, each linked by an alarm system with the flat of the resident warden who keeps a friendly eye on the inhabitants. A large communal sitting room and a small secluded terrace and garden are added attractions. This type of accommodation meets a very real need whereby, in the presence of infirmity, independence is maintained and help is immediately at hand. Hence the enthusiasm which greeted the completion of this project. Atmospheric Pollution was another field in which notable progress was made. At the beginning of October the smoke control area embracing the Dorset Square and Park Crescent Wards came into operation, and on the last day of the year the Minister of Housing and Local Government confirmed without modification the final smoke control order (covering the old Church Street and Bell Street Wards) to be made by the Council. This eighth order, coming into force next October, completes the smoke control programme of the Council as planned—an achievement which reflects the greatest credit on all concerned with the programme since its inception eight years ago. Thus the whole of (ii) St. Marylebone will be within a smoke control area from the autumn of 1965. The conversion of the boilers at Lodge Road power station to oil firing and the impending closure of the antiquated generating plant at Aberdeen Place together represent a major industrial contribution to the local clean air scene. Nationally, it is indeed instructive to note that the amount of smoke emitted by industry has been reduced by more than two-thirds since the passage of the Clean Air Act whereas domestic chimney smoke has declined by less than one-fifth during the same period! Indicative of the progress which is being made, albeit too slowly from a public health standpoint, in the industrial and domestic spheres of atmospheric pollution is the growing public clamour for clean air on the roads of Britain. Diesel smoke and petrol exhaust products are under increasing attack and rightly so. Over the next decade much progress can confidently be predicted in dealing with these sources of pollution. A full description appears on pages 15 and 16 of the initial impact in St. Marylebone of the main provisions of the Offices, Shops and Railway Premises Act which became effective at the beginning of August. The office worker is now entitled to that legal concern for health, safety and welfare which has long been enjoyed on the factory floor. Truly a great step forward. As always it is a pleasure to record the contribution which the public cleansing service makes towards a cleaner healthier environment. The dustless system of refuse collection now covers the whole of the St. John's Wood area; details of this extension and of other advances are contained in the information kindly supplied by the Director of Public Cleansing on page 17 of the report. In April personal hygiene in public places received further encouragement from the decision of the Council to abolish the small charge made for the use of water closets at public conveniences, thus providing a completely free service. Personal hygiene in public and in private is one of the fundamental goals of health education. This important aspect of public health work received a timely boost from the Report of the Cohen Committee with its emphasis on unifying effort, intensifying training, defining targets and evaluating progress; a note on the main recommendations of the Committee appears on page 6. How urgently a more intensive approach to health education is needed can be judged from the current failure to convince the public that good teeth matter— the real reason for the successful opposition to fluoridation of water as a means of preserving dental health. Once popular concern is aroused a very different climate prevails! Thus the education of the food handler gained additional impetus from the typhoid epidemic in Aberdeen with more than four hundred cases of enteric fever being notified. An outbreak of this magnitude is always instructive. In this instance a forceful reminder of the ease with which infection, once introduced, can be conveyed from one article of food to another; of the hazard involved in keeping cold cooked meats on display at room temperature; and of the limitations of scrupulous personal cleanliness in the face of food contaminated during the process of manufacture. Perhaps the most important lesson to be learned from the major typhoid epidemics occurring in successive years at Zermatt and Aberdeen is the need to abandon insular attitudes. In 1963 the outbreak at a Swiss tourist resort emphasised the contracting size of the world in terms of ease of travel from one country to another. This year the necessity for a global outlook in matters of health was reinforced by the outbreak at a Scottish tourist resort attributable to the cooling of cans of sterilised corned beef in unchlorinated river water thousands of miles away. Today world health is the concern of us all. As St. Marylebone merges with its neighbours to form the new City of Westminster a broad note seems a peculiarly appropriate one on which to conclude this last annual report on the health of what the first holder of my office, Dr. Robert Dundas Thomson, referred to one hundred and eight years ago as "perhaps, the most important district in England"! It only remains for me to thank His Worship the Mayor, the Chairman, Councillor Dr. H. K. Ashworth, and members of the Public Health Committee, and the members of the Council generally for their continued help and encouragement. To my colleagues in other Departments of the Council I extend my sincere thanks for all the assistance they have so willingly given me. Finally, I am very mindful of the debt of gratitude which I owe to the Staff of the Public Health Department for their loyal and cheerful support at all times. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, HASTINGS E. A. CARSON, Medical Officer of Health. (iii) 1 PUBLIC HEALTH COMMITTEE 1964 HIS WORSHIP THE MAYOR: *Councillor Leonard Pearl., J.P. ††Councillor F. D. N. Simon, J.P. ALDERMAN: C. D. Denis-Smith COUNCILLORS: R. H. S. Allen, (Vice Chairman) Dr. H. K. Ashworth, T.D. (Chairman) Miss P. D. Blackstone †Mrs. E. M. Brown Mrs. R. M. Challis K. F. Dibben, B.Com., A.C.A. Mrs. F. E. Glenny * until May. Dr. L. Jacobs Mrs. P. Merriton ††L. Pearl E. R. Seaden, B.Sc. (Eng.), A.M.I.E.E., Assoc. I.Mech.E. Mrs. H. Shire † from February. †† from May. 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. Deewell S. P. Fleming D. J. W. Rigg Miss M. L. Shaul Mrs. J. Chambers (until July) Miss T. Jakes (from July) P. C. Bedward F. W. Dines J. Bradley R. F. Penfold M. Harris (from May) Miss B. McLean (from July) Public Health Inspectors : V. A. Bignell (a, b, c) (Chief Inspector) Food Inspection and Hygiene: L. Newland (a, b) J. R. Pritchard (a, b, c) Care of Old People: Miss M. M. Sharp, M.B.E. (a, d, e, f) *Miss B. Wilson (a, b, d, e, f) Drainage: J. R. Baily (a, b) J. E. Broadhead (a) Smoke Control: L. Pearson (a, b, c) District Inspectors: D. B. Hooper (a) S. W. Wright (a, b) C. A. Chase (a, b) D. Hitchcock (a, b) (until June) K. G. Mahers (a, b, c) t Student Public Health Inspectors: R. J. Crozier Miss C. Hussey (from September) (а) Public Health Inspector's Certificate. (b) Diploma for Inspectors of Meat and Other Foods. (c) Diploma for Smoke Inspectors. (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 Handyman: W. G. Sharwood Rodent Operatives 3 Disinfectors 3 Public Conveniences Staff 39 Cleansing Station Attendants 3 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: £24,157,041. Sum represented by a penny rate: £93,802. Residential units (separate assessments): 25,117. Population—1961 Census:— Age Groups M. F. Total Percentage of Population Under 15 3,825 3,738 7,563 11 15 and under 65 21,817 28,842 50,659 73 Over 65 3,724 7,099 10,823 16 Totals 29,366 39,679 69,045 100 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-1964—67,250. Registrar General's estimate of the child population: mid-1964—under 1 year: 760; 1—4 years inclusive: 1,840 ; 5—14 years inclusive: 4,200. Total child population: 6,800 (approximately 10 per cent. of total population). Expectation of life at one year: Boys—68.8 years; Girls—74.4 years. EXTRACTS FROM VITAL STATISTICS Total M. F. Live Births—Legitimate 641 316 325 Live birth-rate per 1,000 population 10.93 Illegitimate 94 47 47 (Standardized) 8.31 Stillbirths—Legitimate 10 10 — Stillbirth rate per 1,000 live and Illegitimate — — — stillbirths 13.42 Total live and stillbirths 745 373 372 Infant Deaths—Legitimate 13 8 5 Illegitimate 4 1 3 Infant mortality rate per 1,000 live births 23.13 Legitimate infant death rate per 1,000 legitimate live births 20.28 Illegitimate infant death rate per 1,000 illegitimate live births 42.49 Neo-mortality rate (deaths under four weeks per 1,000 total live births) 21.77 Early neo-natal mortality rate (deaths under one week per 1,000 total live births) 21.77 Peri-natal mortality rate (stillbirths and deaths under one week combined per 1,000 total live and stillbirths) 35.37 Illegitimate live births per cent. of total live births 12.79 Maternal deaths (including abortions) Nil Total M. F. Deaths (all ages) 889 449 440 Death rate per 1,000 population 13.22 (Standardized) 9.78 Area comparability factors: Births: 0.76; Deaths: 0.74. Marriages. The number of marriages in St. Marylebone during 1964 was 1,192, which is 54 less than for 1963 and 57 below the average (1,249) for the previous ten years. 3 Deaths. The total number of deaths shown in Table 1, page 30, 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. Deaths registered in 1964 numbered 889 (13.22 per 1,000) compared with 1,114 (16.55 per 1,000) in 1963. The rate of 13.22 when standardized by the comparability factor gives a figure of 9.78; the rates for the County of London and for England and Wales were 11.0 and 11.3 respectively. The principal causes of death continued to be diseases of the heart and circulatory system, which accounted for 39 per cent. of the total; malignant diseases 21 per cent.; and respiratory diseases, including tuberculosis, 11 per cent. Deaths from lung cancer, compared with the previous year, fell from 53 to 49. Two deaths were attributed to influenza. Seventy per cent. of the deaths registered were of persons aged 65 and over, whilst 25 per cent. were between 45 and 64 years. Accidental Deaths. During the year, 22 residents died from accidents of all kinds, two less than last year. Motor vehicle accidents accounted for two deaths as compared with seven in 1963. Road Accidents. The St. Marylebone Road Safety Committee, which was set up in 1946 to advise the Council as to the activities which should be undertaken locally in an effort to secure a reduction in the number of accidents occurring on the roads, consists of members of the Council and representatives of outside organisations with interests in this field of local government activity. In April 1961, 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 it is particularly directed. Three matters which receive special attention are: (i) training and testing child cyclists under the National Cycling Proficiency Scheme sponsored by the Ministry of Transport; (ii) arranging visits by school children, youth clubs and other local organisations to RoSPA House, to which the Borough Council contributes £594 per annum; (iii) lecturing at old people's clubs, Youth Clubs and similar organisations. There were 990 (949) local road accidents involving personal injury which resulted in 3 (3) deaths, 136 (133) serious injuries and 1,138 (1,021) slight injuries—the figures in brackets relate to 1963. A summary of the accidents is given in Table 4, page 32. Births. The total of live births registered during the year was 735 (363 males; 372 females), giving a live birth rate of 10.93 per 1,000 of population, equivalent to a standardized rate of 8.31, the comparable figure for the County of London being 19.9 and for England and Wales 18.5. Illegitimate live births numbered 94 (47 males; 47 females), representing 12.79 per cent. of the total live births, compared with 14.3 per cent. for the County of London. Stillbirths totalled 10, representing a rate of 13.42 per 1,000 total births, compared with 15 for the County of London and 16 for England and Wales. Infant Mortality. Deaths of infants under one year totalled 17 (13 legitimate; 4 illegitimate), giving a rate of 23.13 per 1,000 live births, as compared with 18.04 in 1963. The rate for England and Wales is 19.9 per 1,000 and 21.3 for the County of London. Details showing causes of death according to age group and sex are given in Table 2, page 30. Of the 17 infant deaths, 16 were under four weeks old, giving a neo-natal mortality rate of 21.77 per 1,000 live births, as compared with 15.46 in 1963. The neo-natal mortality rate for England and Wales was 13.8, and for the County of London 14.9. The early neo-natal mortality rate (deaths under one week per 1,000 total live births) was 21.77 (England and Wales 12.0; County of London 13.4) and the peri-natal mortality rate (stillbirths and deaths under one week combined per 1,000 total live and stillbirths) was 35.37 (England and Wales 28.2; County of London 28.1). Maternal Mortality. No maternal deaths were reported during the year. 4 Weather. The following summary of the weather during 1964 and Table 3, page 31, is based upon information supplied by the Meteorological Office:— January.—Very dry. Mean temperature just below average but about 5°C. (9°F.) higher than January 1963. Three days snow lying in Regent's Park. No thunder or gales. Average sunshine in central London. February.—Continuing Dry. Mean temperature just above average and about 5°C. (9°F.) higher than February 1963. No thunder or gales. Sunshine near average but dullest February and winter for 5 years. March.—Cold, dull, turning wet. Mean temperature 2.2°C. (4.0°F.) below normal at Camden Square. Rain 249% of average at London Airport. Eight days with snow or sleet at Kew but only 1 with snow lying. Sunshine 62 % of average at Kew where it was dullest and wettest March since 1947. April.—Dull and showery. Mean temperature near average, but 2nd and 3rd were coldest April days at Kew for 35 years. Wettest April at Kew since 1931. Gale force gusts in Kingsway 6 days. One morning fog in Regent's Park. May.—Very warm; warmest May for over a century. Wettest spring at Kew since 1878 following an exceptionally dry winter. June.—Rather cool, dull and thundery. Maximum temperature at Kew on 21st was lowest for that date since 1886. No frost. Rain 254% of average at Greenwich. Sunshine 81% of average in Regent's Park. July.—Dry; becoming warm. Temperature on roof of London Weather Centre exceeded 27°C. (81°F.) on 3 days. Sunshine 110% of average in Kingsway. August.—Dry. Mean temperature near average. Rain 61 % of average at Kensington Palace where there were 2 days with thunder. Sunshine 125% of average in the city. Warmest and sunniest August and summer at Kew since 1959. September.—Dry, warm and sunny. Mean temperature 1.0°C. (1.8°F.) above average at London Airport. No thunder. Gusts to gale force on 2 days in Kingsway where sunshine was 161 % of average. Sunniest September at Kew since 1911. October.—Dry but rather cold. Coldest October at Kew for 25 years. Rain 65% of average at Kensington Palace. Fog on 10 days at Northolt. Gale force gusts on 2 days in Kingsway where sunshine was 148 % of average. November.—Dry and rather mild. Mean temperature 1°C. (1.8°F.) above average at Hampstead. Driest autumn at Kew since 1947 (driest on record) and no similar early November dry spell in at least the last 50 years. No thunder; 10 days with fog at Northolt, persisting all day on 10th and 30th and, in other parts of London area, on 1st. Sunshine near average; second sunniest autumn on record at Kew. December.—Another dry month. Mean temperature 0.6°C. (1°F.) below average at Kew. Rain 59 % of average at London Airport. Much of London area had a light sprinkling of snow overnight 24th-25th. No thunder. Four days with fog in central London. Sunshine 105% of average at London Airport. Sunniest Boxing Day on record at Kew. SECTION B.—GENERAL PROVISION OF HEALTH SERVICES Representation upon Other Bodies. The Council were represented upon the under-mentioned statutory and voluntary bodies as indicated:— Body London County Council Divisional Health Committee (Division 2) St. Marylebone Tuberculosis Care Committee Paddington Hospital Group House Committee No. 2 Paddington Hospital Group House Committee No. 3 National Society for Clean Air * Until March. Representatives Alderman Dr. E. Jacobs. Councillor Mrs. F. E. Glenny. Councillor Mrs. F. E. Glenny. *Councillor Dr. L. Jacobs. *Councillor Mrs. F. E. Glenny. Councillor Dr. H. K. Ashworth, T.D. The Medical Officer of Health. 5 Department of Scientific and Industrial Research— Standing Conference of Co-operating Bodies dealing with Atmospheric Pollution London and Home Counties Clean Air Advisory Council Area 10 Home Safety Committee of RoSPA No. 2 Area Committee of the Family Welfare Association Councillor Dr. H. K. Ashworth, T.D. The Medical Officer of Health. Mr. L. Pearson, Public Health Inspector. Councillor R. H. S. Allen. The Medical Officer of Health. Councillor Mrs. H. Shire. Councillor Miss E. C. Adams. Conferences. The Council were officially represented at the under-mentioned conferences dealing with matters within the purview of the Public Health Department:— Conference Central Council for Health Education, Annual Conference—Westminster, 30th January Paddington Council of Social Service Conference— Westminster, 18th February London Council of Social Service Standing Conference on Old People's Welfare—London, 5th March and 17th November Area 10 Committee RoSPA, Home Safety Conference—Wembley, 4th April National Old People's Welfare Council's National Conference—Torquay, 16th to 18th April Royal Society of Health—Eastbourne, 27th April to 1st May Association of Public Health Inspectors—Portsmouth, 15th to 18th September Royal Institute of Public Health and Hygiene— Folkestone, 7th to 9th October National Society for Clean Air—Harrogate, 20th to 23rd October Conference of the Central Consultative Committee on the Welfare of Old People—London 23rd October Royal Society for the Prevention of Accidents, National Home Safety Conference—London, 27th to 28th October Delegates The Medical Officer of Health. Councillor Dr. H. K. Ashworth, T.D. Councillor Mrs. F. E. Glenny. The Medical Officer of Health. Mr. C. S. Marshall. Councillor Mrs. F. E. Glenny. The Medical Officer of Health. Councillor Mrs. H. Shire. Mr. P. C. Bedward. Councillor Miss P. M. Blackstone. Miss M. M. Sharp, M.B.E., Public Health Inspector. Councillor Mrs. F. E. Glenny. The Medical Officer of Health. Mr. L. Newland, Public Health Inspector. Councillor Mrs. F. E. Glenny. The Medical Officer of Health. Councillor Dr. H. K. Ashworth, T.D. Mr. L. Pearson, Public Health Inspector. Councillor Mrs. F. E. Glenny. Miss M. M. Sharp, M.B.E., Public Health Inspector. Councillor Mrs. H. Shire. Mr. P. C. Bedward 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 1964, as follows:— Organisation ₤ s. d. Statutory Authority Central Council for Health Education 14 0 0 Public Health (London) Act, 1936, section 298. Family Welfare Association (Area 2) 175 0 0 Local Government Act, 1948, section 136. St. Marylebone Youth Committee 75 0 0 do. St. John's Wood Adventure Playground 200 0 0 do. Islington Family Planning Centre 44 0 0 do. The Samaritans 80 0 0 do. National Society for Clean Air 10 10 0 Public Health (London) Act, 1936, section 298. St. Marylebone Old People's Welfare Association— " Meals on Wheels " Service, etc. 514 0 0 National Assistance Act, 1948, section 31. Assisted Holidays Scheme 600 0 0 do. " Inner Wheel " Old People's Club—Rent of Hall 30 0 0 do. York Street Day Centre 2,585 0 0 do. Women's Voluntary Services 10 0 0 do. 6 Health Education. A Joint Committee of the Central and Scottish Health Services Councils (known as the Cohen Committee) was appointed in December, 1959, to consider Health Education. The Committee held twenty-five meetings and received written and oral evidence from selected individuals and organisations and, by advertisement, invited evidence from interested individuals or organisations. The Committee submitted its Report in December, 1963, and this was subsequently published by the Ministry of Health during 1964. Forty-three specific recommendations were made, the most notable being: "the Government should establish a strong Central Board in England and Wales which would promote a climate of opinion generally favourable to health education, develop ' blanket' programmes of education on selected priority subjects, securing support from all possible national sources, commercial and voluntary as well as medical, and assist local authorities and other agencies in the conduct of programmes locally. It would foster the training of specialist Health Educators; promote the training in health education of doctors, nurses, teachers and dentists; and evaluate the results achieved by health education ". Another recommendation was that local authorities should appoint Health Educators to draw up and carry out local health education programmes which would take account of national developments, local conditions, and the support which could be obtained locally from professional and community leaders, churches and voluntary organisations. Such an officer would work under the Medical Officer of Health. With the impending amalgamation of St. Marylebone with Paddington and the City of Westminster it is not opportune to recommend any course of action in respect of the policy of the present Department, but it is to be hoped that the Cohen Committee's recommendations will be implemented in the New City of Westminster. With the population now almost completely literate and showing a growing interest in matters of health it is time to consider the prospects of administering less medicine by providing more teaching in prevention, early diagnosis and the rules for obtaining and maintaining a good state of health. During the year local health education was again furthered by the use of posters, pamphlets and bookmarks, special emphasis being given to the subjects of smoking and health, venereal diseases and food hygiene. The outbreak of typhoid in Aberdeen gave forceful evidence of the need for more positive food hygiene education, and received much publicity, particularly in the national press. Advantage was taken of the opportunity thus provided to circulate to all catering premises in the Borough food hygiene picture sets, issued by the Ministry of Health, and the public health inspectors when visiting food premises gave special emphasis to advice on methods of preventing the contamination of food. It is regrettable that the majority of employees in the food industry still receive little or no training in food hygiene. Such training would not only lead to the better protection of the public health but could also provide a strong sales factor and bring about economies by preventing spoilage of food and enhancing the useful life of plant and machinery. Care of Old People. The number of old persons of whom the Department have particulars is as follows:— Bachelors or widowers 141 Single women or widows 1,413 Married persons living together 268 1,822 The majority of them (1,554) live alone and some require constant observation. During the year two women public health inspectors made 4,481 visits to old people and 530 other visits in this respect. Special Laundry Service.—The Department continued to operate the service, begun in 1950, for laundering bed linen and clothing of incontinent or very dirty and verminous old people. During the year, 68 cases were dealt with, some over long periods, others for a short while only. Forty-seven 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 528 baths were given, 458 to women and 70 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 7 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 continued to be of great assistance. Services available for old people are summarised on pages 40 and 41. St. Marylebone Old People's Welfare Association. The Executive Committee of the Association (Chairman—Councillor G. J. Brown, O.B.E., M.I.Mech.E.; Hon. Secretary—Mrs. K. M. Cowan) has kindly provided the following information, which has been extracted from the Association's Annual Report, on work carried out during 1964:— " St. Marylebone Centre for the Elderly. Owing to complications in the negotiations which were begun early in 1963, there were delays before the Association could obtain possession of part of the basement at York Street Chambers, and unforeseen expenses were found necessary. Meanwhile prices rose. It was impossible for the work of conversion to start until the requisite licence had been seen and the lease signed by the Trustees on behalf of the Association. This was signed in July, when instructions could be given by the architects for the builders to start work. It was on the 10th November that the headquarters of the Association eventually moved from the Town Hall, where since it was set up, a part-time office had been provided by the Council. The new premises were now complete except for some additional fire precaution requirements and part of the external entrance, a ramp which was delayed, owing to industrial difficulties, beyond the end of the year. The official opening took place on the 27th November, when the Mayor of St. Marylebone, Councillor Derek Simon, accompanied by the Mayoress, declared the premises open in the presence of the Town Clerk and of other Borough Council officials, with representatives of the bodies co-operating in the work of the Association, and colleagues from Westminster and Paddington. A blessing on the work of the Centre was asked by the Rev. V. L. Tucker-Harvey, M.A., Rector of St. Mary's Church, Bryanston Square. The skilful and imaginative modernisation and the pleasant decoration and furnishing were much admired. Warm thanks are expressed to Mr. R. M. McCarthy, A.R.I.B.A. (Messrs. Fewster & Partners), responsible for the conversion. Tea for the guests at the opening was arranged by Mrs. Dalby; as a member of the sub-committee dealing with the premises she is congratulated on her selection of curtain materials. The Luncheon Club and Foot Clinic 1 started work at the Centre on the 1st December. After the decision had been taken to negotiate for the premises, it was learnt that the London Electricity Board required one of the rooms for its own purposes, and space is unfortunately more restricted than at first expected. The foot clinic can provide for not more than two chiropodists working at the same time. Its equipment, however, is now up to modern standards and the Clinic is open two days a week at present. The Rotary Club of St. Marylebone generously provided the two patients' chairs. Other gifts to the Centre included most valuable things from Luxborough Lodge, tables, three armchairs, T.V., Piano, kitchen dresser and hot-plate, bookcase; Mr. Louis Lebus gave two desks, Mrs. Wells a radio, Mr. D. H. Drewell a clock, Mr. Stonebridge the Radio Times regularly, and in his capacity of Borough Librarian he is warmly thanked for making available a small collection of books. Money contributions are also gratefully acknowledged from Mrs. H. J. Hawkings, Miss Lucy Nettlefold and Mr. and Mrs. Lush. Finance.—For the year beginning 1st April, 1964, the Borough Council agreed to grant £600 for holidays, not more than £500 for expenses in respect of meals on wheels (items of insurance and licences for two vans and foil containers for meals) £125 for administrative expenses: further, the running expenses of the new Centre estimated at £3,100, including an estimated sum as proportion of rates, and rent of £500. As regards the capital grant approved to cover the conversion and equipment of the premises, the Council agreed to a sum of £4,000. In June, however, on the Chairman's application for a supplementary grant to cover unforeseen expenditure in the conversion, an application supported by the relevant committees, the Council agreed to reimburse an additional sum of £1,250. A No. 2 account was opened to handle the capital expenditure on the premises. This expenditure was by no means complete by the end of the year, and accounts for the Centre are not fully shown. The grant for chiropody services was continued by the London County Council, to end in March 1965, when it was expected the new City of Westminster Council would undertake financial responsibility. £250 was withdrawn from the Portman Building Society in February for welfare needs and expenses not met by grant. For the first time an Hon. Treasurer was appointed, the A.G.M. electing Councillor A. F. Lockwood, J.P., to this office. Previously the Hon. Secretary had acted as Hon. Treasurer. 8 In preparation for the long-needed full time office when the new Centre should be ready for use, Mr. W. M. C. Gosby was appointed Deputy Secretary, and took up his duties on the 1st June. Donations.—These were most gratefully received from the following: West London Synagogue Charitable Fund £30; Mrs. Findlay for dog licences for elderly people £5; Women's Mirror Fuel Fund £10; Mrs. Brighten £25; Mr. and Mrs. Hawkings £25; Miss Bryant £1 2s. 6d.; Councillor and Mrs. Desmond Plummer £10; St. Marylebone Parish Church (Extra Parochial Giving) £20; Miss E. V. Savage £1 Is. Od.; Abbey National Staff Association Darts Club £2; Hon. Mrs. North £5; Miss G. Tassinari £2 10s. Od.; Artizans & General Properties Co. Ltd. £10 10s. Od.; Anon. £5; some boys of St. Marylebone Grammar School £10 15s. Od.; S. J. Jones £1; Mrs. G. M. McNair £2; Mrs. L. Fewster for Christmas parcels £10; St. John's Wood Darby and Joan Club for holidays £10; Balance of Old People's Day at Lord's £25 17s. 11d. During the last weeks of the year the Association had an unprecedented experience when £6,000 was donated through a firm of solicitors from an anonymous fund. This amount was placed on deposit at the Bank. Gifts.—Much appreciated Harvest gifts to old people were given by several schools and churches. Gratitude is expressed also for Christmas parcels sent to the Association for distribution. They were somewhat fewer than the previous year; the Association added £10 worth of groceries, and with other help it was possible to send parcels where they were most needed. The Grant-Aided Services. 'Meals on Wheels'.—1964 was the first full year with two vans working, and the number of meals served showed a valuable increase in this most important welfare service. 15,538 hot midday meals were taken into the homes of elderly infirm people (4,608 more than in 1963). B.R.C.S. helpers continued to supplement the work of W.V.S. The vans were driven by Borough employees from the Cleansing Department, where the vans were garaged and serviced. Luncheon Club.—In spite of two removals, the Club carried on with the minimum of interruption. The premises in Seymour Place, so long provided at a nominal rent by the Church Army, were needed for other purposes before the new Centre was ready to receive the Luncheon Club. Owing to the kindness of the London County Council, through Mr. P. Linton, Warden of Luxborough Lodge, it was arranged for the two meals services to operate from Luxborough Lodge temporarily, a period eventually stretched to six months. Very sincere gratitude is expressed to everyone who helped smooth out the difficulties of the year, above all to Mrs. E. Lush, whose untiring devotion to the organisation of both services has been beyond all praise, and to all the W.V.S. and B.R.C.S. helpers. 5,142 midday meals were served, and again a special Christmas dinner was kindly provided by W.V.S. The removal to the Centre led to an increase in attendance at the Club. Foot Clinics.—Clinic 1 can report another successful year. Miss Curran, Miss Lerner and Miss Reeves gave 2,412 treatments. Miss Cotsford (B.R.C.S.) continued her helpful service as Appointments Clerk. The big event of the year was the removal from the Town Hall, where the L.C.C. had provided house-room since the service was started. This move required an adjustment in the time-table of the Chiropodists, whose helpful co-operation was much appreciated. Clinic 2 continued to hold one session weekly at All Souls' Church Club-house through the generous hospitality of the Church. Miss Lerner, the Chiropodist in charge, was again helped by Mr. Vincent with the appointments. 342 treatments were given, 7 new patients being taken on. The Lisson Grove (L.C.C.) Clinic gave 1,609 treatments and, apart from regular patients, helped 33 who attended sporadically. Home Chiropody.—This service was slightly expanded, 53 more visits being made—the total 763. Twenty-two were on the waiting list at the end of the year. Before treatment can start for a new patient delays are unfortunately unavoidable, but we were glad to take on 47 new patients. Holidays.—Once again the main group holidays were arranged at Brighton, through Rutland Tours Ltd. 105 elderly people were helped to enjoy a week's holiday in April/May, 11 others in the autumn, both parties having favourable weather, and, on the whole, reporting very appreciatively on the facilities provided. The contribution asked was still only £1 17s. 6d. a head, to include board, transport, drives and an entertainment. The charge paid by the Association was £6 16s. 6d. Twenty-two of the participants were helped in this way for the first time. ' Thank-you ' letters and calls afterwards were as appreciative if not all as eloquent as the following: ' Our hosts were very capable and considerate; our accommodation was very comfortable. Our meals were very pleasant and varied, promptly and cheerfully served and quite suitable and ample for a mixed party of old people ... To thank you for your very diligent and capable planning towards ensuring that we old folks get a healthy break after Winter, to tide us over another year.' 9 A further 16 people were helped in various ways, some having a fortnight's care at the Church Army short-stay Home at Woking, others visiting friends or relations. The Association contributed £40 to the Fourth Feathers Club holiday scheme transport. Visiting.—For a number of years the professional visiting of elderly people in their homes has been carried out by Miss Sharp, more recently by Miss B. Wilson also. This has been a most fortunate arrangement for the Association, as the close and friendly co-operation of these two Public Health Inspectors has ensured a valuable exchange of information. Social Visiting.—The Visitors' Committee held 8 meetings with Miss Sharp, Mrs. Cowan, and latterly Mr. Gosby. In this field as in all services, Miss Sharp has given freely of her advice and help from an exceptionally wide experience. All Souls' Church, still operating the largest group of Visitors, was represented first by the Rev. O. M. Thomson, later by Dr. D. E. Ford. Councillor J. G. Brown, Chairman, attended a meeting in order to get to know the Visitors and their work. Mr. J. Bedward of the Public Health Department attended another, to discuss home safety matters with the Committee. Dr. Ford drew attention to the problem of accidental hypothermia in elderly people. The meetings were devoted as usual to the dissemination of information likely to be of use to the Visitors, and to discussion of some of the problems they met. Owing to several Visitors having left the neighbourhood, the Association would welcome the help of a few recruits (men as well as women) who could spare a little time for this most essential service. ' Can there be any question ' to quote from the National Corporation for the Care of Old People—17th Annual Report—' but that the individual approach to those who are both old and lonely is bound to produce a far greater feeling of support and security than can be given by all the official services put together ? ' Decorating.—Decoration was undertaken in twenty-nine homes of elderly people by groups of volunteers connected with Hinde Street Methodist Church and from St. John's Wood Church Voluntary Service Group. Expenditure by the Association was £121 6s. 2d., but the National Assistance Board refunded £45 15s. 7d.; in a number of cases pensioners themselves were glad to help with the cost of materials, contributing £39 18s. 1d.: the net expenditure was thus £35 12s. 6d., of which part would probably be recovered. Miss Sharp and Miss Wilson again gave much thought to deciding priority for the jobs, and to organising the offers of voluntary help. ' I am delighted with my room since it was decorated. How can I thank the students enough for all the work they put into doing it for me '. This was a typical note of appreciation and as usual the old folk enjoyed the cheerful company of the young people, who often followed up their kindnesses in other ways. Relief.—The B.R.C.S. are always co-operative and provided a gas heater and an electric heater, when their attention was drawn to cases of great need. They also helped with transport for many purposes. Through special donations considerable help was given towards heating appliances and bills. Smaller items of help varied from cleaning an eiderdown to lowering gas meters and providing keys and ferrules for sticks. Additional groceries were provided for a number of Christmas parcels. Through the kindness of Mrs. Fewster and Mrs. Hawkings it has been possible to continue providing a T.V. set on hire for an elderly homebound man. Clubs.—No major development or change is reported, but news of the Clubs comes regularly to the Executive. All have special events in summer and in winter and do steady work of real benefit to their members. Members sick in hospital are not forgotten. A great many more people, who seem too shy or for some other reason do not wish to join a Club, would obviously be better for the companionship and the stimulus of a regular outing to look forward to. The St. John's Wood Darby & Joan Club makes use of special transport to bring infirm members to the meeting. Library Service to Housebound and partially-sighted readers.—The book delivery service to housebound readers instituted in 1957 has been carried out regularly by the Libraries Department, mainly to cases recommended by the Home Help services. Forty-one readers (all except one of whom are elderly) are at present receiving this service and 5,981 books have been delivered to them in 1964. The fortnightly visits and the service received are much appreciated by the readers. Progress has been made in the provision of books specially printed in larger type for partially-sighted readers. These are being published by the Ulverscroft Press (F. A. Thorpe, Leicester). Copies are available at the Central Public Library and Branch Libraries and also for housebound readers, if required. Radio 6- Television.—Twelve new applicants received radio sets on loan from the ' Wireless for the Bedridden ' Society. In addition 30 enjoy sets provided in previous years: 8 other sets were returned to the Society. There is an increase of 4 in the number of sets under the supervision of the Association: Other sets were sponsored by different bodies. Twenty television sets (3 of which were provided in 1964) supplied by the anonymous benefactors through the Central Consultative Committee give very real pleasure, enhanced by the provision of licences. The help here again of Miss Sharp and Miss Wilson has been invaluable. Two sets were returned. 10 Laundry Services.—The Association was glad to help publicise details of concessions available to old people using the Public Baths. Entertainments.—Mrs. Lew Grade was responsible once again for the big party of the year, so much looked forward to, so thoroughly enjoyed. 800 elderly people were invited to Seymour Hall in December for a wonderful occasion, with tea, fine Christmas parcels and an entertainment. The Association was happy to allocate the invitations and made the stewarding arrangements. The Y.M.C.A. gave another most enjoyable Christmas party, as did the 11th St. Marylebone Scout Group. The Rotary Club and Philanthropic Lodge provided their customary outings in summer and parties in winter for their own lists of elderly people. St. Marylebone Literary Institute Student Theatre Group kindly presented tickets for some theatrical performances. Accommodation designed or converted for the needs of the elderly remains disappointingly inadequate. One very cheering event, however, was the opening in July by the Borough Council of Macintosh House, Beaumont Street, which comprises 28 flatlets specially built for old and infirm people, with accommodation for a resident warden. Miss Lucy Nettlefold, now resident overseas but gratefully remembered for her work for the O.P.W.A., performed the opening ceremony. The Association appreciates the Council's choice of a name for this House, commemorating the work of the late Miss Mary Macintosh, a founder member of the Association and long its Hon. Secretary. This is the last full year's report of the present Association. At the A.G.M., when it will be presented, a resolution will propose the dissolution of the Association and its integration in the new City of Westminster Old People's Welfare Association: it will be re-constituted as the St. Marylebone District Committee of the new Association. This change of course comes to pass as part of the re-organisation of local government in London." 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. Unfortunately, during 1964 there were two such cases, particulars of which are given in Table 23, page 38. 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 number of swimmers using the pools during 1964 was 202,295, and spectators numbered 17,063. Organised Swimming Instruction—Schools.—The number of school children receiving swimming instruction increased to 32,773 from 31,979 last year. Public Laundry.—The Laundry facilities are now completely " Self-Service ", comprising 8 fully automatic washing machines, 2 spin dryers and 4 tumbler dryers and hand laundry with 4 units, spin and tumbler dryer. By means of time and temperature controllers the tumbler dryers will dry all types of materials, including woollens. The rotary ironing machines have proved most popular and 15 lbs. of domestic washing can be washed, dried and ironed in 1¼ hours. This all-electric installation has resulted in an increased number of young married women using the laundry and numerous expressions of appreciation have been received. Modern lighting and replacement of existing washing machines have been completed and the gaily coloured tiled floor recently laid makes the weekly visit to the Laundry an attractive occasion. Old Age Pensioners—Reduced Laundry Charges.—These facilities, introduced in September 1964, have been greatly appreciated and 1,110 Old Age Pensioners have attended. 11 Foam Baths.—Installation of foam baths is nearing completion and a booking system will be introduced. Medical Examinations. Staff.—The Medical Officer of Health is medical adviser to the Council for staff purposes. During 1964 one hundred and five examinations of Council employees and new entrants to the superannuation scheme were carried out. Parking Meter Exemptions.—The Council is empowered in certain circumstances to give exemption from parking meter charges to a person who is severely disabled. During the year, thirty-eight applications were referred to the Medical Officer of Health for observations and, if necessary, medical examination. Home Safety. The provisional figures for 1964 indicate that 8,600 people died in Great Britain as a result of accidents at home. Yet again these fatalities exceeded in total the number killed on the roads, but the publicity given to this subject is so insignificant that few members of the public are aware of the great seriousness of the problems presented by home accidents. Four-fifths of the victims are children of under 5 years of age and persons over 65 years of age. With the present division of responsibility the local health authority are better able to give advice and help in respect of the under five's and the local authority similarly in respect of the over 65's. One group thought to be at special risk is the housebound elderly. Through the good offices of the St. Marylebone Old People's Welfare Association the assistance of the voluntary visitors was obtained in discovering what specific risks existed in the homes of the people they visit. Their reports showed the presence of various possible hazards, and the two women public health inspectors attended to these matters. Although some of the cases could only be dealt with informally, where the hazard constituted a " nuisance " within the meaning of the Public Health (London) Act official action was taken. In view of the increasing number of outbreaks of fire in domestic premises, the Department gave special publicity to this subject. A " Fire Prevention Code for the Home ", prepared by RoSPA, was sent to five thousand residents, including all the Borough Council tenants, and this subject was the theme of exhibitions staged by the Department at bazaars held by both the local Conservative and Labour Parties. As in previous years, pamphlets and bookmarks were distributed through the public libraries and posters were displayed at all possible sites. In addition, publicity was given to the Children's Nightdresses Regulations, details of which are given below. The Children's Nightdresses Regulations, 1964. It has been estimated that accidental ignition of clothing accounts for approximately 300 deaths and 1,000 injuries annually, and a significant proportion of the victims are young children whose nightwear has caught fire. As a result of the increased public awareness of the fire hazards from such clothing, the Secretary of State made the Children's Nightdresses Regulations, 1964, under powers conferred upon him by Section 1 of the Consumer Protection Act, 1961. The Regulations, which came into force on 1st October, 1964, (i) require all nightdresses coming within their scope to be made of a fabric (including trimmings and thread) which conforms to the low flammability requirements of British Standard 3121:1959; (ii) require nightdresses made from fabrics which have been chemically treated to make them flame resistant to have a durable label stitched to the nightdress, warning against washing it with soap or soap powder and against boiling or bleaching it; (iii) apply to all children's nightdresses sold or offered for sale after the 1st October irrespective of the date of manufacture; and (iv) confer on London boroughs (Metropolitan Boroughs until 31st March, 1965) power of inspection, testing and enforcement. The Regulations will not apply to any nightdresses sold by or on behalf of a person not acting in the course of a business or to those sold or held for export. The main provisions of the Regulations were brought to the notice, by letter, of every known retailer of children's nightdresses in the Borough. Personal Health Services. The local health authority is responsible for either providing these services or arranging for them to be provided by some other organisation. In the Administrative County of London this matter is the responsibility of the London County Council, and the services provided include maternity and child welfare, vaccination and immunisation, health visiting, domestic help, day nurseries, midwifery, ambulance and mental health. 12 The services available for the Borough are adequate and the majority of them are administered from the Divisional Health Office, 313, Harrow Road, W.9. New Legislation. A list of the new Acts, Regulations and Orders, relating to the work of the Department, is given in Table 27, page 39. 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 32. Excluding rat and mouse infestations, 1,246 complaints were received and details of 1,071 various nuisances remedied are shown in Table 6, page 33. Notices.—Intimation Notices served under the Public Health (London) Act, 1936, numbered 394 and 107 of these were followed by the service of Statutory Notices to secure abatement of nuisances. In addition, seven other formal notices were served for the provision of artificial lighting on common staircases—as required by the Borough Council's Byelaw. For offences under London County Council Byelaws, forty-five notices were served, eighteen being in respect of water-closets, nineteen for drainage defects, and eight requiring proper maintenance of dustbins. Legal Proceedings. The institution of legal proceedings under the provisions of the Public Health (London) Act, 1936 and of the L.C.C. Drainage Byelaws was necessary in two cases, both in respect of 39, Homer Street. A fine of £5 with five guineas costs was imposed in each instance. Noise. Seventy-nine complaints of noise were received and these concerned 53 alleged nuisances anc necessitated 440 visits by the public health inspectors. A substantial proportion of the complaint; were of noise coming from building sites, demolitions, and engineering works and operations, whicl may be summarised as follows:— Pneumatic and other drills 8 Concrete Mixer 1 Compressors 1 Generator 1 General works 4 A reduction in amenities, sometimes over a long period, is inevitable for people living or working near works of this type, particularly where rebuilding or demolitions are in a congested area, but providing contractors are fully aware of the annoyance that can be caused to people nearby and make a positive effort to reduce noisy operations, inconvenience can be kept to a minimum. It has been noticeable that pneumatic drills, one of the main sources of noise, are now muffled more frequently, but the problem of compressors, cranes, hoists and pile-drivers has not yet been generally solved. The remainder of the supposed causes were as follows, namely:— Ventilation and air-conditioning plant 5 Workshops 5 Garage 3 Neighbours 3 Slamming of car doors, cars starting up at night, coaches 3 Dogs 2 Refrigeration plant 2 Loading and unloading of vans 2 Club and Restaurant 2 Boiler house installation 1 Lift gates 1 Bakery 1 Launderette 1 Diesel Depot 1 Band practice 1 Street musicians 1 Radio and Record player 2 Recording company 1 Church Bells 1 13 All of these complaints were investigated, observations sometimes having to be kept during the late evening or early morning, and where necessary action was taken to abate or minimise the noise. Complaints were not always justified and some of those that could be substantiated related to conditions which could not be held to constitute a "nuisance". In many cases the public health inspectors were able to give advice to the persons responsible for causing or permitting noise so that they could take steps to prevent further grounds for complaint. This applied whether or not the Council had legal powers to take action and in most cases the person against whom complaint had been made was only too anxious to help, for sometimes an approach by the inspector was the first intimation received that any inconvenience was being caused. In this connection noise from a ventilating or air-conditioning plant might only affect a neighbour or the nearest tenants and could be overcome by an adjustment or overhaul of the equipment. In some cases where the Council could take no effective action complainants had to be advised to take private action, and where noise arose from the slamming of car doors late at night and the 'revving' of engines of cars parked near clubs, restaurants, etc., the police were asked to assist in finding a remedy. Complaints were received about noise at night from the maintenance sheds of the British Railways Diesel Depot attached to Marylebone Station, but as the Council has no power to take action against a statutory undertaker all that could be done was to ask the Depot Superintendent to ensure that noise was kept to a minimum consistent with the safety of the maintenance workers and the efficiency of the diesel engines. One statutory notice was served in respect of noise nuisance from a restaurant late at night. The proprietors had agreed to co-operate, but as their efforts to provide a remedy were being extended over a long period, with the nuisance continuing, formal action had to be taken. This had the desired effect and as structural alterations were carried out quickly and the nuisance abated, legal proceedings were unnecessary. 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, whilst the remains of food fed to them attract rats, mice and flies. It is known that pigeons can be vectors of diseases affecting mankind, and their incessant cooing during nesting gives rise to noise nuisance. During the year, eight complaints were received. These involved forty-five visits by the public health inspectors but after investigation it was found necessary to refer only one case to the pigeon catcher. Water. Apart from two blocks of flats and two office buildings where water is obtained from private wells, a constant water supply throughout the Borough is derived 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 1964. The supply is River Thames-derived filtered water from two main filtration works, namely Ashford Common and Hampton. There were no new sources of supply instituted by the Board during the year, nor any important extension of trunk mains. The general scheme of supply was the same but 1,359 yards of service main were laid in the Borough during the year." The analytical results of the chemical and bacteriological examination of the water are set out in Tables 7 and 8, page 33. The Metropolitan Water Board notified five instances where water supply had been cut off at premises for failure to pay rates. At three houses the supply was restored quickly when payment had been made. In the other two cases the premises concerned were unoccupied for some time but the supply was reinstated as soon as the outstanding rates had been paid on re-occupation. Three complaints were received about the quality of water. Investigation by the public health inspectors failed to find any cause for complaint and in two instances subsequent chemical and bacteriological examination confirmed that the water was satisfactory. The number of dwellings supplied from public water mains is 24,897, with an estimated population of 66,818. No stand-pipes are in use and the remaining dwellings, namely two blocks of flats occupied 14 by some 432 residents, obtain water from private wells. The water in these wells is sampled by the Department every six months and the Council's Bacteriologist's reports for 1964 were satisfactory. 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. During the year it was necessary to require the cleaning of twenty-five tanks. Upon request, six 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. During the year, 243 drainage plans were approved, of which 33 were in respect of new buildings, and the public health inspectors made 3,796 visits. No circumstances were found which required legal proceedings. The Borough Engineer was requested to examine 10 sewer connections and five were found to be defective and had to be renewed. The re-drainage scheme begun in 1963 at the premises of the Zoological Society of London, Regent's Park, which involves laying a 24-inch diameter main drain under Regent's Canal to the London County Council Middle Level Sewer, is now well advanced and the principal drainage lines have been installed. When completed the scheme will extend throughout the Zoological Gardens. Combined Drainage. Five Orders under Seal were made 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. The re-laying of the London County Council King's Scholars' Pond Sewer from Swiss Cottage to Wellington Place is now well advanced. 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. The Borough Engineer referred to the Department for observation 211 plans submitted to the Council under the Town and Country Planning Act, 1947. Rodent Control. There were 201 notifications of rats at premises in the Borough, 4 less than in the previous year, and reports of mice increased from 314 to 387. 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 34. Disinfestation. The insecticide used to rid dwelling houses of bugs is composed of kerosene with 5 per cent. D.D.T. and 0.1 per cent. pyrethrins, applied as a spray either by hand or under pressure from a motor compressor according to the circumstances. This treatment is also given for flea and similar infestations which occur from time to time. During the year, 351 rooms were disinfested and in this connection the Public Health Inspectors made 245 visits to the 155 premises involved. Furniture, more particularly that of people removing to fresh accommodation, is dealt with by hydrocyanic acid gas in specially constructed vans. The Council continued to have this work done by a contractor and during 1964 the furniture of one family, who were being rehoused, was treated by this method. In addition 383 verminous articles of bedding were disinfested by steam. A small steam disinfector situated in the cleansing of persons section of Welfare Centre No. 2 is used for the treatment of all articles up to the size of a single mattress. Arrangements with the Council of the Royal Borough of Kensington for articles above this size to be steam treated in their plant at Shepherd's Bush have continued to work most satisfactorily. Verminous Persons. The Department's Cleansing of Persons Baths in Lisson Grove dealt with 449 verminous persons: adults 238 (men 202, women 36); children 261 (boys 72, girls 189). 15 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. Complaints about smoke were received on 53 occasions and the number of contraventions of the Clean Air Act, 1956, detected was 42. Dark smoke was timed on 61 occasions and in 24 cases the emissions exceeded the limits prescribed in the Dark Smoke (Permitted Periods) Regulations, 1958, thus infringing Section 1 of the Clean Air Act. Smoke from the chimneys of buildings in Smoke Control Areas contravening Section 11 of the Act was observed 7 times and smoke nuisances within the meaning of Section 16 were found on 11 occasions. The offences were dealt with by means of verbal cautions, letters and statutory notices and it was not necessary to institute legal proceedings in any case. Notifications of the intention to install new furnaces given under Section 3 of the Clean Air Act totalled 26. In 5 cases the Council's approval for the purposes of Section 3 of the relative plans and specifications was sought and given. On 1st October, 1964, the St. Marylebone (No. 7: Wards 6 and 9) Smoke Control Order, 1963, became operative. A Smoke Control Order in respect of Church Street Ward including the former Bell Street Ward was made by the Council on 18th June, 1964. The Order was confirmed without modification by the Minister of Housing and Local Government on 31st December, 1964. This eighth Order, which will come into operation on the 1st October, 1965, completes the Council's Smoke Control programme as planned. After that date the emission of smoke caused by the use of fuels, including bituminous coal, other than authorised fuels from the chimneys of buildings will be prohibited throughout the Borough except for smoke from chimneys serving heating installations in respect of which legal exemption has been given. Approximately 34,832 units of occupation are affected including 671 industrial establishments, 6,531 commercial premises, 26,321 dwellings and 1,309 premises occupied for professional and miscellaneous purposes. Co-operation with the Department of Scientific and Industrial Research was continued throughout the year and for the purpose of the National Survey of Air Pollution instruments were maintained at the Town Hall, Greville Place, Penfold Street and Oxford Street. The concentrations of smoke and sulphur dioxide measured by the instruments are recorded in Monthly Summaries and Annual Tables of Observations compiled at Warren Spring Laboratory, Stevenage, Herts, and published by the Department of Scientific and Industrial Research. Offices and Shops. Although the Offices, Shops and Railway Premises Act was published in July, 1963, the main provisions did not come into operation until the 1st August, 1964. The intention of the Act is to secure the health, safety and welfare of persons employed to work in office, shop and certain railway premises, and amends for this purpose certain sections of the Factories Act, 1961. Enforcement of the Act is divided between local authorities, H.M. Factory Inspector and local fire authorities, and although initial demarcation difficulties were experienced these have in the main been resolved. To eliminate visits to the same premises by both the factory inspector and the public health inspector, H.M. Inspector of Factories is responsible for offices and shops forming part of factory premises. However, there remains a possibility of duplication as the situation now arises where the public health inspector visits factories to enforce the Sanitary Accommodation Regulations, 1938, and if there is an office or shop within the factory the Factory Inspector can visit the same accommodation for the purposes of the Offices and Shops legislation. In St. Marylebone where almost one-third of the total hereditaments come within the scope of the Act enforcement becomes a major task. The Act requires the employer at all existing and proposed premises to register with the appropriate authority. Although in an analysis of rateable value provided by Inland Revenue, 7,688 premises are shown of the classification coming within the scope of the Act, to date only 3,337 registrations have been made. Towards the end of the year a system was adopted of block surveys to discover premises for which registration has not been sought. During the year, 1,752 premises were surveyed and, as was to be expected, some instances were found where conditions were below standard and the service of 58 informal notices was necessary. Occupiers must be given a reasonable period in which to convert their premises to the standard visualized 16 by this legislation but occupiers are responsible for complying with the requirements of the Act without prior notice from the local authority. Occupiers are required to notify the enforcing authority of certain specified types of accident should they occur to persons working in their premises. This is to enable enforcing authorities to detect breaches of the Act and to advise occupiers on measures to prevent the recurrence of similar accidents. Notification will also provide statistical information which will assist the Minister of Labour to assess the need for preventive measures. During the year, notification was received of forty-eight accidents. One of these involved a fatality, but subsequent investigation showed that no hazard existed at the site of the incident and that the accident was due to the victim's medical condition. Post-mortem examination revealed that the deceased suffered from heart disease, and the Coroner was satisfied that death was due to natural causes. Twenty-five of the accidents were due to slipping or falling. In two instances, investigation of the incidents revealed the existence of hazards, and the occupiers are co-operating in adopting the suggested remedies. The Act empowers enforcing authorities, if they are satisfied that compliance is "not reasonably practicable ",to grant exemption from the requirements relating to room space, temperature, sanitary accommodation and running water, and, in certain circumstances, exemption can also be granted from the requirements relating to first aid provisions. During the year, 16 applications for exemption were received. Of these, 10 were in respect of first aid provisions and with one exception were granted. The remainder concerned various shops adjoining underground railway premises and the applications were found to be unnecessary as the premises did, in fact, comply with the statutory requirements. Section 60 of the Act requires the local authority to make a report to the Minister on their proceedings under the Act. The form of report has been prescribed by Order and appears in Table No. 10 on page 34. Factories. There were 1,354 factories on the register at the end of the year, 240 less than last year. A report on the administration by the Department of matters under Parts I and VII of the Factories Act, 1961, is given in Tables 12 and 13, page 35. Outworkers. Fifty-one employers submitted lists in respect of a total of 416 outworkers (162 contractors and 254 workpeople). Of these, fourteen contractors and fifteen 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 35. Heating Appliances—Fireguards. The Consumer Protection Act, 1961, superseded the Heating Appliances (Fireguards) Act, 1952, but the Heating Appliances (Fireguards) Regulations, 1953, were re-enacted without amendment. Regular inspection was made of appliances exposed for sale by retailers, and no new or secondhand 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 162 registered hairdressers and barbers; regular inspections were made and conditions generally were found to be satisfactory. Pet Animals. The Pet Animals Act, 1951, provides for a system of inspection and annual licensing of pet shops by local authorities, a fee of 10s. being payable for each licence, nine 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 public health inspectors made fifteen visits to the premises concerned and inspected the stalls licensed to sell pets in the street markets. Conditions under which the livestock was kept were found to be satisfactory. The Animal Boarding Establishment Act, 1963, came into operation on the 1st January, 1964, and requires animal boarding establishments to be licensed by the Council on payment of a fee. At present there are no such establishments in the Borough. Poisons. At the end of the year the names of fifty 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 fifty-nine. Details are given in Table 15, page 36. 17 Protective Helmets. The Motor Cycles (Protective Helmets) Regulations, 1963, came into operation on the 18th November, 1963. These Regulations amend and consolidate previous legislation and prescribe the type of helmet which may be sold or hired to motor-cyclists. The sale or hire of a helmet not conforming with the Standard constitutes an offence under the Road Traffic Act, 1960. No sub-standard helmets were found at the five premises concerned in the Borough. 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 in Table 16, page 36. 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. Other than at Violet Hill public gardens and the two urinals which are cleansed by a "flusher" who visits them at least twice daily, all conveniences have attendants. They work on a two-cycle shift system and an extra man and woman are employed on the morning shift at Oxford Circus so that if necessary they can be called upon for emergency duty elsewhere. The usual supervision was exercised over the conveniences and urinals, and the free washing scheme with paper towels and liquid soap, now well-established over the last 16 years, continued to be widely appreciated. The penny charge for the use of water-closets was abolished from the 1st April, 1964, thus providing a completely " free " service. Staff problems again caused concern, with shortages occurring during staff sickness and holiday periods, necessitating some of the smaller conveniences being left unattended for short periods. Fortunately, incidents of vandalism were few but minor damage to fittings, etc., occurred at the unattended Violet Hill Gardens convenience. Public Cleansing and Salvage. The Director of Public Cleansing has kindly provided the following information:— " The refuse and salvage collected during 1964 were: house and trade refuse, 36,101 tons; street sweepings, market refuse and gully sludge, 2,254 tons; salvaged materials, 2,287 tons. An income of £15,813 was obtained from the sale of salvaged materials. In addition, £2,101 was received for the removal of trade and extra refuse and the cleansing of petrol interceptors, etc. A minimum twice weekly refuse collection was maintained throughout the year, and about a quarter of all premises in the Borough received a thrice weekly clearance. A more frequent collection was made at premises where this is necessary, such as hospitals, restaurants, hotels and blocks of flats. In a section of the eastern part of the Borough where an evening and night collection service was introduced last year, refuse was collected five times per week. The dustless refuse collection service has been further extended, and the whole of the St. John's Wood area is now covered by the lightweight dustless bin system, together with part of the area between Marylebone Road and St. John's Wood Road. The latter area will be fully covered when a further 6,000 bins on order are available. In conjunction with Paddington and Westminster, the methods of refuse storage and collection at large blocks of flats, and other premises with a high output of refuse, were reviewed. Owing to the rapid increase in the number of such premises in all three areas, the amount of refuse collected from buildings of this type forms a high proportion of the total quantity collected, and alternative methods were investigated to replace the present methods of Paladin container storage and trailer exchange, which are not the most suitable or economical systems for future development. It was therefore decided that the three Councils should jointly purchase and install large capacity containers at suitable premises in their boroughs. A 'Dumpster' unit, comprising a special vehicle and sufficient 8 cu. yd. containers for a week's work, was purchased and put into service in October. Containers were installed at four premises in St. Marylebone, and the system is working satisfactorily. During the year, an additional 'Paladin' type container vehicle was purchased to augment the existing fleet. This was necessary owing to the considerable increase in the number of Paladin refuse containers installed at premises in the Borough, caused by new property development and an increasing volume of refuse. For the collection of street market and trade refuse, a new side loading vehicle was purchased, to replace an old vehicle of similar type." Refuse Storage Accommodation. Section 24 of the London County Council (General Powers) Act, 1959, requires, inter alia, that new buildings, or buildings substantially altered or adapted, shall be provided with refuse storage accommodation approved by the Borough Council. The Department is concerned to ensure that suitable 18 and sufficient accommodation shall be provided, and the Director of Public Cleansing that the refuse shall be easily accessible for collection. During the year, twelve schemes were approved after consultation with the Director of Public Cleansing. At Portman Buildings, Crawford Buildings, Ossington Buildings and Wharncliffe Gardens the replacement of fixed ashpits with bins was completed during the year, and replacement is almost complete at Wendover Court. Radioactive Substances Act, 1960. This Act came into operation on the 1st December, 1963, and introduced a system of registration by the Minister of Housing and Local Government of premises at which radioactive substances and apparatus are kept or used, and requires the Minister (unless questions of national security are involved) to send copies of registration certificates to local authorities in whose area the premises are situated. The Act also prohibits the accumulation or disposal of radioactive waste except with the authority of the Minister and he is required to consult with appropriate local authorities and public bodies before granting any such authority which is likely to result in a need for special precautions to be taken by them. Copies of all authorisation certificates must be sent to the local authorities whose areas will be affected. Three premises are registered in the Borough for the keeping and use of radioactive material and three premises authorised for the accumulation and disposal of these materials. Additional national arrangements for dealing with incidents involving radioactive substances came into force on the 15th March, 1964. These are intended to cover incidents such as damage to containers occurring on premises where expert assistance is not immediately available or accidents to vehicles carrying radioactive substances, and should ensure that expert advice can be obtained quickly in radiological emergencies. Responsibility for initiating action rests with the police. The special arrangements include all action for dealing with casualties, for decontamination, and for disposal of radioactive waste. There might be some public alarm if an incident receives publicity, and the Medical Officer of Health should be able to give information or reassurance after consultation with the expert officer in charge of the arrangements. 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. 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. Four burials and four cremations were arranged during the year. Transportation of Bodies Abroad. In certain cases where bodies are transported overseas, the Medical Officer of Health of the district in which death has taken place is asked, where applicable, to furnish a certificate to the effect that the deceased did not die from any infectious or contagious disease and that no recent epidemic of dangerous infectious disease had occurred in the district. During the year seven certificates were issued in respect of bodies being transported abroad, four to Italy, one to Cyprus, one to France and one to Saudi Arabia. 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, 1,785 certificates authorising cremation were issued and since December, 1937, when the crematorium was opened, 28,881 cremations have taken place. Dog Nuisance. The Council's revised 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." 19 Contraventions reported by the Streets Nuisance Inspector during the year resulted in the issue of thirteen summonses, four of which could not be served and one case was not proceeded with. Eight convictions were secured with penalties and costs amounting to £21 6s. 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 Os. 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 1964 the Council applied for two summonses which resulted in each case in conviction and a fine of £1 0s. 0d. with ten shillings and sixpence costs. 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, 1964:— 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 Broadley/Penfold Street 30 Ashbridge Street 10 Freshwater Place/Homer Row 9 Beaumont Street, Macintosh House—for old people 29 1,475 Further Development linked with Slum Clearance. The position at the end of the year was:— Church Street Site No. 3 (Mulready Street) (175 dwellings) A tender for Stage 1 (139 dwellings and a Branch Library) has been accepted and work on the site commenced towards the end of the year. 20 Church Street Site No. 4 (196 dwellings) Sketch plans and estimates for this site are under consideration. Clipstone Street Area (246 flats) Some properties have been acquired and negotiations for the acquisition of the remainder of the site are proceeding. A Compulsory Purchase Order resolution has been passed by the Council. Preservation of Lower Rented Accommodation. The purchase of the freehold interest in Wharncliffe Gardens, a block of 539 flats, commenced in 1963 in pursuance of the Council's policy of acquiring lower-rented properties in danger of losing their rental character, was completed during the year. The properties which have been purchased in pursuance of this policy, and now managed by the Council, comprise nearly 900 dwellings and are as follows:— Aubrey Mansions 15 Scott Ellis Estate* Scott Ellis Gardens 344 Wharncliffe Gardens 539 * Bronwen Court, also purchased as part of this estate, is a higher-rented block of 64 flats. Discussions have taken place with the tenants' association with a view to the tenants forming a housing association to acquire a long lease from the Council. Housing (Financial Provisions) Acts, 1958-59. (а) Loans.—The Council approved the making of 6 loans during the year totalling £27,500 to enable applicants to acquire premises for owner/occupation. (b) Improvement Grants.—Discretionary and Standard Grants totalling £7,885 1s. 5d., in respect of 32 dwellings, were approved during the year to convert and improve existing premises. Old People's Consultative Committee. This Committee was formed in 1961 and comprises members of the Housing Committee, Public Health Committee and representatives of the St. Marylebone Old People's Welfare Association. They meet from time to time to review the provision in the Borough of housing accommodation for old people and to advise the Housing Committee accordingly. For the last two years they have been concerned with the development of the Day Centre for the Elderly which has now been completed and came into use during the year. A full report on this Centre appears under the heading " St. Marylebone Old People's Welfare Association " on page 7. 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 32. Certificates of Disrepair. Two applications for the cancellation of certificates under the provisions of the Rent Act, 1957, were received during the year, and one was cancelled. Housing Act, 1961—Houses in Multiple Occupation. The system started in 1962 was continued whereby full information upon this aspect of housing legislation was made available to owners of the type of property concerned. Upon initial inspection indicating that a house within the category had deficiencies under the Code of Practice, a copy of the Code, together with other pertinent information on overcrowding, etc., was sent to the owner or managing agent with an invitation to discuss the premises under consideration. This has brought good response, resulting in much useful informal work being done and many voluntary improvements being made. Where, after a reasonable lapse of time, the invitation had not been accepted, the premises were re-visited to ascertain that conditions remained as previously noted, and full particulars of all deficiencies were recorded so that a schedule of specific requirements could be prepared and sent to the person responsible. Inspections are made by the Borough Engineer's staff in respect of the provision of means of escape in case of fire, and schedules of works in respect of both amenities and means of escape are despatched concurrently. The greatest number of amenity deficiencies occur in respect of baths, availability of hot water, and proper food storage facilities. Means of escape from fire are frequently found to be sub-standard, and the remedy could in many cases be the most costly part of the total work required. 21 Land Charges Act, 1925. The Town Clerk referred to the Department 1,912 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 corner of the Borough, which is contiguous with Soho, contains 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. 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 fifty-five confidential medical certificates were considered in conjunction with reports from the public health inspectors on environmental circumstances and, where justified, additional points were recommended. Three Closing Orders were made in respect of eight underground rooms, and one Order on three other rooms. Closing Orders on twelve underground rooms were determined, and Orders on six rooms were varied. Common Lodging Houses. There are two common lodging houses in the Borough. One accommodating 391 men is kept by the Salvation Army, at No. 2, Burne Street and premises in Lisson Street. The other, conducted by the Church Army, at Elgood House, No. 84, Bell 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. The Church Army lodging house is well-managed and has amenities which are above those usually found at such premises. It had been hoped that the building occupied by the Salvation Army would have been demolished during the year, but it has been given a temporary reprieve and will probably remain until the middle of 1965. There has been no improvement in conditions and none is envisaged. Although 391 lodgers are permitted at these premises only 197 are actually accommodated, and this number will not be exceeded except by an urgent appeal from the National Assistance Board. The lodgers rent accommodation on a weekly basis and, at present, about 6 per cent. are old age pensioners. As a rule residents are barred from all rooms from 9 a.m. to noon, and from 2 to 4 p.m., but exceptions are made for any who are ailing. 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 1964, 245 samples of food and drugs were examined. Of these 1 was taken formally and 244 informally. The number adulterated or about which some comment was made was 54 or 22 per cent. The incidence of these criticisms may be classified as follows:— Number of samples examined Number of samples adulterated, etc. Milk 12 - Other Foods 232 54 Drugs 1 - Numerous complaints were received during the year regarding articles of food, which had been purchased, and these were largely responsible for the high percentage of samples found to be unsatisfactory. Two milk bottles were submitted because of the presence of foreign matter. One contained pieces of general dirt and mould spores. The other a deposit of dried milk which had become mouldy, but which had not been properly washed in the bottle washing machine although the mould mycelium had been attacked by hot alkali. Some cream contained 27.5 per cent. of fat and 10.5 per cent. of 22 solids-not-fat, this quantity of solids-not-fat being excessive for a cream as normally separated from milk. A 'cream cheese ' had only 4.5 per cent. of fat, and 23 per cent. of total solid matter and was, therefore, obviously a 'curd cheese' and not a ' cream cheese '. A sample of butter contained 18.77 per cent. of water whereas the maximum permitted quantity is 16 per cent. A product submitted as 'ice cream 'was in fact an 'ice lolly', and contained no fat of any description. Some unsalted ice cream margarine was badly stained due to the presence of cladosporium mould, while other moulds such as aspergillus and penicillium were also present. This was the result of improper storage making the margarine unfit for consumption. A steak and kidney pie was deficient in meat and contained only 20 per cent. of meat, whereas it must contain not less than 25 per cent. A can of corned beef contained 550 p.p.m. of tin and 290 p.p.m. of iron, probably resulting from contamination with cooling water entering a defective scoring line, whilst another can of corned beef and a follow-up sample both possessed an unpleasant odour, due to contamination of the can seams at the ends of the cans. The tin coating of the iron plate was too thin and the machine tooling was also defective. Some Pork Brawn contained a piece of hide with long coarse black bristle adherent to it, showing that the pig had been improperly singed and scraped and that the head had been improperly prepared before making the brawn. The contents of two cans of Whole Roast Duck were decomposed and contained numerous gram positive, spore-bearing, filamentous bacteria. A canned Pork Loin was also unfit for consumption as it was not sterile and contained rod shaped bacteria and viable gram-positive cocci. Some meat pies were mouldy on the upper surfaces of the meat and, even allowing for the hot weather at the time, it was probable that they had been made for over a week and exposed to atmospheric conditions before sale. Some canned spam was contaminated with fly eggs, the contamination probably having occurred after removal of the product from the can. One very small larva, probably of a house fly or similar species was found on the outside of the transparent wrapper of some sausages but no other larvae could be detected in the sausages. From the odour it was probable that they had been manufactured for well over a week, or if kept in a refrigerator, for a fortnight, so that it was impossible to state where the contamination had occurred. A canned Turkey soup contained 9.45 per cent. of total solid matter and 0.90 per cent. of protein, whereas the manufacturers claimed 1.25 per cent. of protein. Some crystals found in a can of salmon were crystals of magnesium ammonium phosphate (Struvite). This is commonly found in canned salmon, canned lobster, and similar products, but for these crystals to have become so large the salmon must have been canned for an unduly long time. Six cans of ' ravioli in tomato sauce ' were all blown, but examination proved them to be sterile and the blowing was due to hydrogen swelling. The tin, calculated on the contents of 2 cans, was 117 and 82 parts per million respectively and in your analyst's opinion this should never be more than 100 parts per million, although the Ministry has recommended that a limit of up to 250 parts per million should be permitted. Two samples of bread contained foreign matter, one loaf containing carbonised bread from a baking tin, and the other (a sliced white loaf) brown bread folded in after fermentation. The frequent complaints received about bread indicate carelessness in bakeries. Some forcemeat contained 4.46 per cent. of fat of which 13.5 per cent. consisted of free fatty acids. This is caused by the enzyme present in the spices and herbs used in forcemeat and may be overcome by the use of very dry rusk or other cereal filler. A breakfast food claimed slimming properties, which were not justified, and also a high Vitamin C content without disclosure of the quantity. The ingredients were also disclosed in an incorrect order of magnitude. The manufacturers agreed to amend the label. A stick of rock, stated to have caused sickness, possessed an unpleasant flavour and contained five parts per million of arsenic, whereas the permitted limit is 1 part per million, otherwise no reason could be found for the actual sickness. Some glace pineapple cubes in both an opened and an unopened box were mouldy and this was due to improper preparation. The purple colour in a walnut melba sauce was found to be due to iron reacting with the tannins of the walnut. Three tins contained respectively 18, 16 and 12 parts per million of iron. The cans were lacquered inside, but a strip of unlacquered tinplate had been soldered at the top and where this had rusted, iron was dissolved into the sauce. Complaint was received regarding the presence of fat in Demerara sugar and this amounted to 0.95 per cent. The manufacturers stated that fat was not present at any stage of manufacture, or at the factory, and as contamination was unlikely to have been at the premises where the sugar was sold, it was difficult to say where it could have taken place. Some lemonade was stated to have an unpleasant taste and possessed a very strong odour of petrol. Whilst the stopper was dirty, the contamination appeared to be inside the bottle rather than on the stopper. It was thought possible that the contamination originated with the dirty stopper and that the lemon oil flavouring had attracted the petrol odour away from the stopper. Numerous insect pupae and minute green particles of partially digested plant tissue found in a can of peaches were probably due to an insect, 23 either already in the can or on one of the peaches before the can was sealed, having laid its eggs and left some excrement behind. Two cans of beans and some dried beans from which the canned product was made were also thought to have caused sickness. The beans looked unappetising, when canned, and contained cyanogenetic glucoside yielding from 7 to 11 parts per million of HCN in different cans. The Code of Federal Regulations of the U.S.A. permits 25 parts per million of prussic acid, calculated on dried beans and dried peas, and 100 parts per million calculated on wheat and barley. If the quantities found in the complaint beans had caused sickness those concerned must have been hypersensitive. The sale of these canned beans cannot be stopped, but they should have been better prepared before canning. Some canned pineapple slices possessed an unpleasant and, in one can, a definitely revolting flavour. This was probably due to the pineapple not being as fresh as it should have been before canning, though the product as sold was sterile. Some mixed nuts and fruit sold in a decorated plastic case contained about 70 live maggot larvae together with the resulting webbing and faecal matter. No residue of any fly or bluebottle as such was detected, indicating that the case must have been left exposed for a female to deposit her eggs and disappear. In view of the fact that the hatching time would have varied with the temperature at which the fruit and nuts were kept, it was difficult to say where the contamination had taken place, but it was noted that there was an infestation in the shop from which the product was purchased. A beetle, probably a 'bloody nosed beetle' stated to have been found in a blackcurrant and apple pie was submitted wrapped in a separate piece of paper with some starchy matter adherent to it, but it was impossible to state definitely whether the beetle was cooked in the pie or had gained access to it later. Some complaint brussels sprouts and a control sample were both badly contaminated with a large number of green and black aphids. This infestation may have been due to the warm dry summer, but the trouble was extremely common during the autumn of 1964. Several products were incorrectly labelled. A vegetable concentrate labelled as 'seaweed with various elements and pure vegetable fat' appeared to be a modified form of hydrolysed protein. If the manufacturers wished to claim that it was anything other than this they must list the constituents and place them in the correct order of magnitude. The disclosure of ingredients was incorrect on a sample of instant fruit and cereal coffee substitute. It claimed cereals and roots, but the type of cereals employed was not described, nor were the names of the roots given. It has now been suggested by the Food Standards Committee on the labelling of food that the word 'instant' for products of this type should be made illegal. The ingredients were not declared in the correct order of magnitude on some herb salt as, although it contained 88 per cent, of salt, this was listed as a minor constituent only. The ingredients were also listed in the wrong order on a packet of mixed peel, and on a can of soupe de poisson, whilst a can of cannelloni mengere was not labelled with its ingredients in accordance with the requirements of the Labelling of Food Order. A product labelled as ' Scotch Whisky Flavoured Marmalade' was flavoured with an artificial whisky essence and the description was considered to be misleading. A similar product was made up for comparison but a tremendous amount of genuine whisky had to be added to marmalade before the flavour was affected and then the resulting product was quite different from that of the sample in question. The labelling of a ' low fat yogurt with real fruit' was considered misleading. An illustration on the cap showed hazelnuts and the carton was coloured to indicate the presence of fruit. Hazelnuts are not fruit as generally understood. A ' blackberry and apple pie filling ' contained starch, the presence of which was declared only in very small print. It is not usual for housewives to add starch to pie fillings and a better description for this product would have been ' Prepared Blackberry and Apple Pie Filling '. Some cider vinegar had been badly acetified and contained 2.16 per cent, v/v alcohol and 2.9 per cent, v/v acetic acid. On the basis of 4 per cent, acetic acid in vinegar this sample was 27.5 per cent, deficient in acetic acid, but unless the sellers had special permission from the Customs and Excise Authorities it should not have been sold in unlicensed premises. A complaint about the action of some substance sold as citric acid resulted in an analysis which proved it to be cream of tartar. Legislation issued or proposed during 1964. Whereas the year 1963 was comparatively quiet as regards food legislation, the year 1964 was busy, not because of the number of Statutory Instruments issued, but on account of fresh legislation, which is being initiated. The following items are of interest:— Food Additives and Contaminants Committee.—The Minister of Agriculture, Fisheries and Food decided to make the above Committee a committee in its own right on account of the importance that this aspect of food has assumed. He asked the Committee, among other things, to examine the leaching out of poisonous substances into foods from any wrapping materials that might be employed. Urgent attention, however, is needed about the presence of lead and other toxic substances in children's toys and paints, which children are likely to suck or chew. It is believed that lead and 24 mercury are causing more ill-health among children than was formerly recognised. The Committee have also been asked to examine the whole subject of food preservatives. Colouring Matter in Food Regulations.—The Colouring Matter in Food Regulations, 1957, were considered and the Food Standards Committee issued a report making recommendations for amendments to these regulations. The Ministry is now adopting the policy of keeping Statutory Instruments constantly under review and amending them, if necessary, fairly frequently. It is now suggested that six of the existing food colours should be withdrawn from the list, that titanium dioxide should be permitted only for the surface colouring of food, that the colouring of citrus fruit should be forbidden, and that specifications of purity should be introduced. On the other hand it it suggested that another black colour should be provisionally added to the permitted list and that two named carotenoids should be permitted. It is noted that no organic blue colour will now be permitted in food if the recommendations are adopted and it is a remarkable thing that no natural food appears to be coloured blue. Probably the most important proposed piece of legislation is the suggestion that the control of foods should be separated from that of drugs and that the whole of drug legislation should be brought under one main umbrella. The present proposals would, however, retain many of the existing anomalies of control, and doubtless more consideration will be given to this in the near future. During the year The Food Standards Committee issued a Report on Food Labelling and, although the recommendations included some 72 provisions, there is little doubt that many of the proposals will have to be modified. The Meat (Treatment) Regulations, 1964, prohibit the addition of ascorbic acid, erythorbic acid, nicotinic acid, nicotinamide, and any of their salts or derivatives to raw and unprocessed meat intended for human consumption. Unfortunately the definition of the word ' processed ' does not clarify exactly whether products such as sausages and salamis would be considered as processed or not. Proposals were issued for canned meat products and also for meat pies. Doubtless many of these proposals are being contested behind the scenes, but it will be a great advantage if the drafts can come into force without too much amendment. The Dried Milk Regulations, 1964, will come into operation on the 11th March, 1965. The chief modifications introduced are the maximum and minimum percentages of milk fat required for grades of milk powder other than full cream powder, and regulations for the labelling of such products. There is also a proposal to amend the present Skimmed Milk with Non-Fat Regulations, 1960. During the year the Ministry issued a provisional method for the testing of milk for the presence of antibiotics. It is very seldom, however, that the presence of antibiotics can be proved in bulk milk. Fresh Mineral Hydrocarbons in Food Regulations were issued during the year. Besides increasing the amount of paraffin hydrocarbons permitted in or on foods, they also lay down specifications for the quality of such hydrocarbons. The difficulty of enforcing regulations regarding the quality of liquid paraffin employed in other countries for coating citrus or dried prunes, currants, sultanas or raisins to be sold in Great Britain will be appreciated. The Soft Drinks Regulations, 1963, which should have come into force in 1964, were revoked and replaced by the Soft Drinks Regulations, 1964, which will come into operation on the 2nd June, 1965. These Regulations will permit the use of cyclamates for sweetening soft drinks and presumably, therefore, Regulations will be introduced to permit the use of these compounds in other foods, such as diabetic jams. These Regulations also require the disclosure of the presence of artificial sweeteners in soft drinks and prescribe standards for semi-sweet and low calorie soft drinks. Thomas McLachlan, Public Analyst." Food—Adulterated or Unsatisfactory Samples. Eleven of the fifty-four unsatisfactory samples referred to in the Analyst's report concerned technical faults in labelling or description. After consultation with the manufacturers or importers the labels were revised or corrected. The remainder of the samples adversely reported upon were dealt with informally. A complaint was received that a portion of savoury meat pie purchased at a public house in the Borough was found to contain a piece of adhesive first-aid dressing. Legal proceedings were instituted under section 2 of the Food and Drugs Act, 1955, and resulted in a fine of £10 with two guineas costs. Unsound Food. Approximately seven 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 36. No large consignments calling for special action were involved and when destruction of the unsound food on 25 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. Canned Meats—Typhoid Fever—Aberdeen. During the year an outbreak of typhoid fever occurred in Aberdeen and was associated with cold cooked meat obtained from a local store. Consequently the Ministry of Health issued several circulars to all Medical Officers of Health in England and Wales (i) advising the withdrawal of 6 lb. tins of corned beef originating from specific packing stations in the Argentine and Uruguay, supplemented later by information of particular code numbers; (ii) advising that all food handling establishments should be made aware of the desirability of bacteriological investigation of any employees who had recently been in Aberdeen; (iii) advising that canned tongue from " suspect " packing stations had been imported into this country; (iv) reporting that routine sampling of corned beef in Edinburgh had resulted in the isolation of organisms likely to cause food poisoning from a can of " Andes " Brand corned beef coming from a particular packing station in the Argentine; and (v) advising that brands other than " Andes " had been imported from the packing station referred to in (iv) above. It was imperative that all food and catering establishments should be made aware of the situation as soon as possible and be requested to check their stocks and staff immediately. Accordingly, on the same day as information was received from the Ministry the proprietors of these premises were informed by letter. This entailed sending five consecutive circulars to the known 800 probable users of canned meat, and completing the despatch took precedence over all else. In addition the public health inspectors visited all large firms in the Borough which might operate staff canteens which could carry stocks of canned meats. As a result of this action requests were received from many food traders and caterers for their stocks to be examined, and the public health inspectors traced and withdrew from use forty-eight tins of the " suspect " canned meats. Fourteen food handlers who had visited Aberdeen during the period of the outbreak were also traced and excluded from actual food handling whilst bacteriological investigation was carried out. In every instance a negative report was received and no secondary cases occurred in St. Marylebone. As is usual during these episodes, a large number of enquiries was received from the general public regarding the use of canned meats. The co-operation extended by the traders concerned was a significant factor in the early and successful completion of this urgent investigation . Merchandise Marks. During the year, two stallholders were found to be selling imported tomatoes as " English "; they were warned of the offence. Milk. There are 99 premises registered for the sale of milk and 17 milk roundsmen operate in the Borough from shops or depots elsewhere. A total of 105 Dealer's "Pre-packed Milk" licences are extant under The Milk (Special Designation) Regulations, 1960/3, for the five-year period to 31st December, 1965. This form of single licence allows the use of the special designations " pasteurised ", " sterilized " and " untreated The designation " untreated " replaced the designation " tuberculin tested " from the 1st October, 1964. The composition of the twelve samples of milk analysed was found to be satisfactory. Of the 19 samples of milk examined by the Council's Bacteriologist, two failed to satisfy the phosphatase test. The matter was taken up with the suppliers concerned and subsequent samples were found to be satisfactory. Ice Cream. Two premises are registered for the manufacture of ice cream and 190 for its sale and storage. Details of the classes of premises are given in Table 18, page 37. Five samples of ice cream were examined by the Council's Bacteriologist, with the following results: Grade I—1; Grade II—3; Grade III—1. Samples reported as Grade III are considered as "borderline " and the supplier is warned of the need to exercise greater care in methods of manufacture, storage and sale and advised as may be necessary. Preserved Food. Fifty-nine premises are registered for the preparation or manufacture of sausages or potted, pressed, pickled or preserved food intended for sale; regular inspections were made and informal action was taken to remedy unsatisfactory conditions found from time to time. Details of the classes of premises registered are given in Table 18, page 37. 26 Inns, Refreshment Houses, etc.—Provision of Sanitary Conveniences. Section 25 of the London County Council (General Powers) Act, 1959, enables a borough council to 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. Section 25 of the London County Council (General Powers) Act, 1962, defined " refreshment house " as any building in which food or drink is sold to and consumed by the public. There are 931 premises within this category in the Borough and, at present, it would not be practicable to visit for the sole purpose of deciding which of them should be required to provide sanitary accommodation. The policy is to deal with this aspect during routine visits. In addition, opportunity is taken to secure the provision when the premises are altered or rebuilt and to draw attention to the Council's powers on any land charge enquiries regarding catering premises. During the year the proprietors of one restaurant were required to provide sanitary accommodation. Food and Catering Premises. There are 1,551 of these premises in the Borough, details of which are given in Table 19, page 37, and during the year 2,121 visits were made. In addition to the large number of defects dealt with informally, the service of 138 notices was found necessary. The majority related to dirty conditions arising from the lack of simple domestic cleaning of floors and equipment and the attitude that walls can be ignored until the need for redecoration arises. Much remains to be done in the field of food hygiene before a completely satisfactory standard is reached beyond any possible risk to health. Licensing Act, 1961. Applications for registration certificates in respect of club premises are made to the Magistrate's Court and the Council have the right to make objections on the grounds set out in Section 27 (2) of the Act within 28 days from the date of application. Forty-one applications were referred to the Department and a public health inspector visited the premises to report on their suitability in regard to the requirements of public health and food hygiene legislation. Food Stalls. During the year food was sold from 84 licensed stalls in street markets in the Borough and regular inspections were made for compliance with the requirements relating to stalls in the Food Hygiene Regulations and the London County Council Byelaws for the Protection of Food. Horseflesh. There are no shops in the Borough selling horseflesh for human consumption. Slaughter of Animals. There are no slaughterhouses in the Borough but in the grounds of the Zoological Society of London for many years there has been a knacker's yard, licensed by the Council, where animals are slaughtered for feeding purposes. 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, 233 notifications being received against 428 the previous year. Of the total, measles accounted for 140, the figures for 1963 and 1962 being 311 and 107 respectively. There were decreases also in puerperal pyrexia with 4 cases against 22 in 1963, dysentery 4 cases against 11 the previous year, and whooping cough 4 against 11 cases. One case of typhoid was reported but there was again no poliomyelitis or diphtheria. Table 20, page 37, gives details of notifications and the age groups concerned. Tuberculosis. Table 20, page 37, gives information regarding primary notifications of pulmonary and non-pulmonary tuberculosis received during the year. Table 21, page 38, shows the age and sex distribution of new cases and of deaths from all forms of the disease, and Table 22, 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. 27 Enquiries into housing and sanitary conditions involved 98 visits by one of the women public health inspectors to all new cases and those moving into the Borough from other areas. Typhoid Fever. (a) The case of typhoid fever notified during the year under review occurred in a man of 25 who ia thought to have contracted the disease whilst on holiday abroad. No other cases developed. (b) Aberdeen Outbreak.—Seventeen contacts of cases or visitors to the City of Aberdeen during the severe outbreak of typhoid fever in late May and June were found to be residing or working in the Borough. All were kept under surveillance during the incubation period. Food Poisoning. During the year, fifteen notifications were received and four of these concerned instances where more than one member of the same family was involved. The remaining eleven notifications were all of single cases. Particulars of these food poisoning outbreaks and of the causative agents, where identified, are given in Table 24, page 38 and Table 25, page 39. 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 55 cases of scabies: adults 29 (men 16, women 13); children 26 (boys 9, girls 17). Disinfection. During the year, 29 rooms, 785 articles of bedding (mattresses, blankets, sheets, bolsters, pillows, etc.) and 400 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, 64 certificates, relating to a total of 875 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 two 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 6,576 of these certificates were authenticated. In addition seventeen certificates were issued, upon request, to the effect that no cases of smallpox had been reported in the district during the preceding three months. 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. The Public Health (Aircraft) (Amendment) Regulations, 1963, and The Public Health (Ships) (Amendment) Regulations, 1963, which came into force on 1st August, 1963, were made as a result 28 of recommendations by the Public Health Committee of the Council of Europe. They are intended to increase the safeguards against the importation of smallpox into the " excepted areas " and as a result, national health administrations should normally require from travellers from locally infected areas and " endemic areas " a valid International Certificate of Vaccination. The " endemic areas " are now defined as consisting of Africa, Asia and the Americas (excluding Canada and the United States of America). During 1964 one hundred and four travellers from such areas who had arrived in the Borough without valid International Certificates of Vaccination were seen and kept under surveillance. Bacteriological Examinations. Table 26, page 39, shows the number of specimens examined for the purposes of diagnosis and also indicates the organisms in relation to which the examinations were made. 29 APPENDIX OF STATISTICAL TABLES AND SUPPLEMENTARY INFORMATION 30 TABLE 1.—Deaths—According to Age-Group and Sex. Code No. CAUSE OF DEATH Net Deaths at the Sub-joined Ages of Residents (Male and Female) whether occurring within or without the Borough All Ages Under 1 year 1 and under 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 - - - - - - - - - - - 2 - 2 - 2 Tuberculosis, other - - - - - - - - - - - - - - - - 3 Syphilitic disease 1 - - - - - - - - - - - - - 1 - 4 Diphtheria - - - - - - - - - - - - - - - - 5 Whooping cough - - - - - - - - - - - - - - - - 6 Meningococcal infections - - - - - - - - - - - - - - - - 7 Acute poliomyelitis - - - - - - - - - - - - - - - - 8 Measles - - - - - - - - - - - - - - - - 9 Other infective and parasitic diseases 2 - - - - - - - 1 - - - 1 - - - 10 Malignant neoplasm, stomach 8 7 - - - - - - - - - - 2 1 6 6 11 Malignant neoplasm, lung, bronchus 41 8 - - - - - - - - - - 21 3 20 5 12 Malignant neoplasm, breast - 24 - - - - - - - - - 1 - 11 - 12 13 Malignant neoplasm, uterus - 8 - - - - - - - - - - - 5 - 3 14 Other malignant and lymphatic neoplasms 52 40 - - - - 2 1 2 - 1 1 19 17 28 21 15 Leukaemia, aleukaemia 2 3 - - - - - - - - - 2 1 1 1 - 16 Diabetes 2 2 - - - - - - - - - - - - 2 2 17 Vascular lesions of nervous svstem 46 81 - - - - - - - - - 2 13 10 33 69 18 Coronary disease, angina 103 80 - - - - - - - - 5 - 46 10 52 70 19 Hypertension with heart disease 7 13 - - - - - - - - - - 2 1 5 12 20 Other heart disease 48 52 - - - - - - - - - 1 6 3 42 48 21 Other circulatory disease 17 24 - - - - - - 1 - - - 1 1 15 23 23 Pneumonia 18 22 1 - - - - - - - - - 6 2 11 20 24 Bronchitis 29 15 - - - - - - - - - 1 3 3 26 11 25 Other diseases of respiratory system 4 2 - - - - - - - - 1 - - 1 3 1 26 Ulcer of stomach and duodenum 7 1 - - - - - - - - - - 1 - 6 1 27 Gastritis, enteritis and diarrhoea - 2 - - - - - - - - - - - - - 2 28 Nephritis and nephrosis — 1 - - - - - - - - - - - - - 1 29 Hyperplasia of prostate 3 - - - — — — - - - - - - 3 - 30 Pregnancy, childbirth, abortion - - - - - - - - - - - - - - - - 31 Congenital malformations 3 2 2 - 1 1 - - - 1 - - - - - - 32 Other defined and ill-defined diseases 30 32 6 7 - - - - 1 2 4 1 8 7 11 15 33 Motor vehicle accidents 2 - - - - - - - 1 - - - 1 - - - 34 All other accidents 11 9 - 1 - - - - 1 - 3 - 2 2 5 6 35 Suicide 9 10 - - - - - - 1 - 3 4 3 6 2 - 36 Homicide and operations of war - - - - - - - - - - - - - - - - Totals 449 440 9 8 1 1 2 1 8 3 17 13 138 84 274 330 889 17 2 3 11 30 222 604 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 Totai. m. f. m. f. m. f. m. f. m. f. m. f. m. f. m. F. Atelectasis 1 3 - - - - - - - - - - - - 1 3 Premature Birth 1 3 - - - - - - - - - - - - 1 3 Broncho-Pneumonia - - - - - - - - - - - - 1 - 1 - Congenital Abnormality 2 - - - - - - - - - - - - - 2 - Asphyxia Neonatorum - 1 - - - - - - - - - - - - - 1 Anoxia - - - - - - - - - - - - - - 1 - Cerebral Haemorrhage 1 - - - - - - - - - - - - - 1 - Respiratory Failure 1 - - - - - - - - - - - - - 1 - Unascertainable 1 1 - - - - - - - - - - - - 1 1 Totals 8 8 - - - - - - - - - - 1 - 9 8 16 - - - - - 1 17 31 TABLE 3.—Weather Statistics. Station : Regent's Park. Height of rain-gauge above mean sea level : 129 feet. 1964 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 5.8 0.5 3.1 11.7 31 -4.4 14 .70 .25 27 9 3 - 11 9 22 — 23.0 0.74 72 Feb 8.0 9 8 5 4 13 3 1 27 3 9 6, 7 .92 .23 28 11 1 - 5 7 12 — 49.7 1.71 96 Mar 7 7 - - 14.4 13 - - 301 .92 14 10 — - — — 10 — 62.0 2.00 66 April 12 8 5 9 9 3 21.1 27 -1.1 6 3.28 .70 16 15 — - 1 1 5 — 111.3 3.71 77 May 19.3 10.1 14.7 25.6 12 5.0 15 2.82 .85 31 14 — - 4 — — — 195.8 6.32 106 June 19.4 11.3 15.3 25.0 10, 27 5.0 20 4.23 .87 1 15 - - - - - - 163.0 5.43 81 July 22.7 13.7 18.2 27.8 17 9.5 10 1.66 .50 21 10 - - - - - - 194.0 6.26 104 Aug. 22.1 12.8 17.5 30.0 26 6.7 20 1.51 .58 18 14 - - - - - - 218.5 7.05 1.25 Sept. 21.0 10.7 15.9 26.1 4 5.0 21 .53 .19 14 6 - - 1 - - - 202.8 6.76 154 Oct. 13 8 5.9 9.9 21.7 5 0.0 13 1.39 .33 7 13 - - - - - - 123.1 3.97 144 Nov. 11.3 6.1 8.7 15.0 18 -2.8 30 1.63 .44 13 12 — - 5 1 8 — 43.1 1.44 99 Dec. 7.2 1.7 4.5 14.5 8 -5.5 29 1.45 .37 12 17 1 1 10 21 - 39.1 1.26 147 * Average for years 1931-1960. 32 TABLE 4.—Summary of Road Accidents Involving Personal Injury. Month Number of Accidents Casualties Fatal Serious Slight Total January 77 - 5 91 96 February 64 — 8 76 84 March 65 — 7 83 90 April 74 — 10 76 86 May 73 — 5 83 88 June 89 — 16 113 129 July 88 1 7 106 114 August 80 1 17 77 95 September 88 — 16 111 127 October 102 — 12 129 141 November 88 — 14 92 106 December 102 1 19 101 121 Total 990 3 136 1,138 1,277 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 1,134 (b) Inspections made for the purpose 4,809 (2) Found to be in a state so dangerous or injurious to health as to be unfit for human habitation 3 (3) Found not to be in all respects reasonably fit for human habitation 527 Defects remedied without service of formal Notices:— Defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 414 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 394 (2) Dwelling-houses in which, after service of formal notices, defects were remedied:— (a) By owners 114 (b) 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 8 Other rooms 3 (2) Closing Orders determined, the tenement or room having been made fit 7 (3) Rooms affected by (2) above 12 (4) Closing Orders varied 6 (5) Undertakings accepted in respect of underground rooms — 33 TABLE 6.—Nuisances Remedied. Nuisance Abated or Defect Remedied Number Houses damp, dirty or dilapidated 189 Doors, windows, floors, ceilings, sash cords, grates and flues, etc., defective 293 Drain, water-closet and waste pipe stoppages 88 Drains, water-closets and waste pipes defective 78 Insufficient or unsuitable W.C. accommodation 23 Yard, area and wash-house defects 21 Roofs, gutters and rainwater pipes defective 146 Insufficient water supplies 21 Water cisterns dirty or defective 25 Ashpits, dustbins, etc., defective 78 Rubbish accumulations 70 Animal nuisances 6 Miscellaneous 33 Total 1,071 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 53 53 Ammoniacal Nitrogen 0.041 0.066 Albuminoid Nitrogen 0.075 0.088 Nitrate Nitrogen 5.0 4.4 Chlorides as Cl. 34 33 Oxygen abs. from KMn04 4 hrs. at 27°C. 1.06 1.16 Turbidity units 0.1 0.2 Colour (Burgess) scale 11 11 Hardness (total) 268 272 Hardness (non-carbonate) 64 64 pH. Value 7.6 7.7 Phosphate as PO4 1.4 1.3 Silicate as SiO2 9 7 Sulphate as SO4 60 62 Natural Fluoride as F 0.25 0.25 Magnesium as Mg. 5 5 Surface active material as manoxol OT 0.09 0.09 Electrical Conductivity (micro-ohms) 560 550 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 1,109 13.4 - 100.0 100.0 Ashford Common 773 16.3 - 99.87 100.0 34 TABLE 9.—Rodent Control. Complaints: Complaints of rats received 201 Complaints of mice received 387 Total premises involved 588 Infestations treated by Council's staff: Premises rid of brown rats 173 Premises rid of black rats - Premises rid of mice 417 Total premises disinfested 590 Total visits to such premises 7,094 Notices: Intimation notices served 3 Statutory notices served 2 TABLE 10.—Offices, Shops and Railway Premises—Registration and General Inspections*. Class of Premises Number of Premises Registered During the Year Number of Registered Premises at End of Year Number of Registered Premises Receiving a General Inspection During the Year† Offices 2,116 2,093 1,641 Retail Shops 734 728 93 Wholesale Shops, Warehouses 254 249 5 Catering Establishments Open to Public, Canteens 232 228 13 Fuel Storage Depots 1 1 — Totals 3,337 3,299 1,752 * Period Covered, 1st May to 31st December, 1964. † Includes Inspections by Survey Assistants. Number of visits of all kinds made by Public Health Inspectors to Registered Premises 479 TABLE 11.—Analysis of Recorded Particulars of Persons Employed in Registered Premises by Workplace. Class of Workplace No. of Persons Employed Offices 54,864 Retail Shops 13,542 Wholesale Departments, and Warehouses 4,169 Catering Establishments Open to the Public 4,480 Canteens 1,514 Fuel Storage Depots 9 Males Females Totals 38,142 40,436 78,578 35 TABLE 12.—Factories: Inspections for Purposes of Provisions as to Health. Premises Registered Inspections Written notices Occupiers prosecuted Factories without mechanical power 190 62 5 - Factories with mechanical power 977 703 13 — Other premises* (excluding outworkers premises) 187 521 - — Totals 1,354 1,286 18 — * 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 - - - - - Overcrowding — — — — — Unreasonable temperature — — — — — Inadequate ventilation — — — — — Ineffective drainage of floors — — — — — Sanitary conveniences:— (a) insufficient — — — — — (b) unsuitable or defective 13 16 — 11 — (c) not separate for sexes — — — — — Other offences (excluding offences relating to outwork) 17 21 8 — — Totals 30 37 8 11 — TABLE 14.—Summary of Outwork. Description of Work Outworkers Employed Wearing apparel 403 Textile weaving 9 Curtains and furniture hangings 4 416 36 TABLE 15.—Pharmacy and Poisons Acts, 1852-1941: Summary of Sellers of Part II Poisons. Type of Business Total Licensed General stores 18 Grocery and provision stores 17 Hardware and domestic stores 13 Hairdressers 5 Builders' merchants 4 Dental sundriesman 1 Photographic dealer 1 59 TABLE 16.—Public Conveniences. Convenience Urinals W.C's (free) Wash basins (free) Additional Information Underground: Oxford Circus (Men) 26 12 7 Changing Room (1s.), 1 Lavatory basin, Electric razor (6d.) Oxford Circus (Women) - 9 4 Rest Room (free), 1 Lavatory basin and sink. Foley Street (Men) 8 4 3 — Gt. Portland Street (Men) 6 5 3 — Gt. Portland Street (Women) — 5 3 — Marylebone Road (Men) 12 8 8 — Marylebone Road (Women) — 4 5 — St. John's Wood Road (Men) 6 4 3 — Barrett Street (Men) 11 4 3 — Above ground: Paddington Street (Men) 6 3 3 — Paddington Street (Women) — 3 2 — Salisbury Street (Men) 6 4 3 — Salisbury Street (Women) — 6 2 — Wellington Place (Men) 6 2 1 — Wellington Place (Women) — 3 1 — Violet Hill (Men) 2 2 1 Unattended. Violet Hill (Women) — 2 1 do. Lisson Grove—Urinal 4 — — Open Day and Night. *Red House Public House, Park Road—Urinal 4 — — — * Cleansed by the Borough Council but maintained by brewers. TABLE 17.—Unsound Food Voluntarily Surrendered. Description Tons Cwts. Qtrs. Lbs. Meat and offal - 7 - 24 Sausages, brawn, etc. — 1 1 10 Canned meat — 15 3 — Bacon and ham — 3 - 20 Canned food (other than meat) 2 13 — 26 Fish — 3 — 13 Fruit and Vegetables 1 11 — 26 Miscellaneous 1 8 1 24 Total 7 0 2 3 37 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 33 - Tobacconists, confectioners/newsagents — 95 Grocers and provision merchants 21 60 Fishmongers 5 3 General stores — 11 Greengrocers and fruiterers — 19 Ice-cream factories — 2 Miscellaneous — 2 59 192 TABLE 19.—Summary of Food Premises. Type of Business Totals Hotels and boarding houses 320 Restaurants, cafes and snack bars 307 Grocers and provision merchants 166 Canteens and clubs 169 Public houses and wine bars 135 Confectioners 104 Stalls, street trading 86 Greengrocers and fruiterers 56 Schools and nurseries 52 Butchers 43 Wine merchants (off-licence) 32 Bakers 27 Chemists 20 Fishmongers 12 Coffee stalls and kiosks 10 Milk depots 5 Ice-cream manufacturers 2 1,551 TABLE 20.—Notifiable Diseases and Notifications. * Notifiable Disease Cases notified in whole Borough Cases removed to hospital Cases isolated at home At all ages At ages—years -1 1- 2— 3— 4— 5— 10— 15— 20— 35— 45- 65— Scarlet fever 9 - 1 - 3 2 2 1 - - - - - 1 8 Puerperal pyrexia 4 - - - - - - - - 4 - - - 4 — Pneumonia 1 - - - - - - - - - 1 - - 1 — Dysentery 4 1 — — - - 1 - - 1 - 1 - - 4 Measles 140 4 13 17 22 23 49 4 5 3 — — — — 140 Erysiphelas 3 — — — — — — — — — — 3 — 2 1 Ophthalmia neonatorum 2 2 - - - - - - - - - - - 1 1 Whooping cough 4 1 — — 1 — 1 1 — — — — — — 4 Scabies 8 - - - - - - - 2 4 1 1 — — 8 Tuberculosis: Pulmonary 35 — — — — 1 — 1 2 8 5 14 4 18 17 Non-pulmonary 7 — — — 1 — — — 1 1 2 2 — 5 2 Food poisoning 15 1 - - - - - 1 2 3 7 1 2 13 Typhoid fever 1 - - - - - - - - 1 - - - 1 — Totals 233 8 15 17 27 26 53 7 11 24 12 28 5 35 198 * There were no cases in the Borough of the following diseases which are also notifiable: smallpox, diphtheria, membranous croup, cholera, typhus fever, relapsing fever, plague, leprosy, hydrophobia, glanders, farcy, anthrax, malaria, induced malaria, paratyphoid fever, meningcoccal infection, acute encephalitis, acute poliomyelitis. 38 TABLE 21.—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 - 2 - 1 - - - - 5—15 1 1 - - - - - - 15—25 2 5 - 1 - - - - 25—35 10 8 - 1 - - - - 35—45 10 3 1 1 - - - - 45—55 5 5 1 - - - - - 55—65 5 3 1 - 1 - - - 65 and upwards 6 — — — 5 - - - Totals 39 27 3 4 6 — — — * Including all primary notifications and also any other new cases of tuberculosis which came to the knowledge of the Medical Officer of Health during the year. TABLE 22.—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 446 308 754 13 29 42 796 (b) Number of cases notified to the Medical Officer of Health under the Regulations for the first time during the year 22 13 35 1 6 7 42 (c) Number of cases removed from the Register during a preceding year which have been restored to the Register during the year 2 6 8 1 - 1 9 (d) Number of cases added to the Register during the year which have been brought to the notice of the Medical Officer of Health otherwise than by notification under the Regulations 15 12 27 - 1 1 28 (e) Number of cases removed from the Register during the year 80 49 129 6 5 11 140 (f) Number of cases remaining on the Register at the end of the year 405 290 695 9 31 40 735 TABLE 23.—Diseased or Infirm Persons Removed to Hospital, etc., Under Court Orders. Persons Age Removed to Remarks Miss M. R. 84 Hospital Emergency order for 3 weeks. Remained in hospital voluntarily at end of period. Miss M. L. 91 Hospital Emergency order for 3 weeks. Remained in hospital voluntarily at end of period. TABLE 24.—Food Poisoning—Family and Other Outbreaks. Causative Agent Family Outbreaks Other Outbreaks Total number of cases Number Number of cases Number Number of cases Notified Otherwise ascertained Notified Otherwise ascertained Salmonella-type: Enteritidis 1 1 1 - - - 2 Causative Agent not identified 3 3 4 — — — 7 Totals 4 4 5 — — — 9 39 TABLE 25.—Food Poisoning—Single Cases. Causative Agent Number of cases Notified Otherwise ascertained Total Salmonella—type: Typhimurium 2 — 2 Bareilly 1 — 1 Tennessee 1 — 1 Oranienburg 1 — 1 Causative agent not identified 6 — 6 Totals 11 — 11 TABLE 26.—Summary of Work of the Bacteriological Laboratory. Nature of Specimen and Examination Positive Negative Total Throat and nasal swabs for— B. diphtheriae — 5 5 Haemolytic streptococci 4 25 29 Vincent's organisms — - - Sputum for— Tubercle bacilli — 25 25 Faeces for— Parasites, typhoid, paratyphoid, dysentery and food poisoning organisms 7 213 220 Urine for— Typhoid — 7 7 Foods for— Food poisoning organisms 6 31 37 Swabs for— Food poisoning organisms 1 11 12 Totals 18 317 335 TABLE 27.—New Legislation. Legislation Operative Date Meat (Treatment) Regulations, 1964 23.1.64 Poisons (Fluoracetamide and Fluoracetamilide) Rules, 1964 7.2.64 Poisons Rules, 1964 8.5.64 Poisons List Order, 1964 8.6.64 Soft Drink Regulations, 1964 2.6.64 2.6.65 Housing Act, 1964 16.7.64 16.8.64 Offices, Shops and Railway Premises Act, 1963 (Exemption No. 1) Order, 1964 1.8.64 Prescribed Dangerous Machines Order, 1964 1.8.64 Offices, Shops and Railway Premises Act, 1963, (Modification of Section 29) Regulations, 1964 1.8.64 Offices, Shops and Railway Premises Act, 1963, Annual Reports Order, 1964 13.8.64 Mineral Hydrocarbons in Food Regulations, 1964 15.8.64 London Authorities (Health and Welfare Services) Order, 1964 25.9.64 Rent Restrictions (Amendment) Regulations, 1964 28.9.64 The Children's Nightdresses Regulations, 1964 1.10.64 Poisons List (No. 2) Order, 1964 1.10.64 Offices and Shops in Factories (First Aid) Regulations, 1964 1.12.64 Offices, Shops and Railway Premises Act, 1963 (Commencement No. 2) Order, 1964 1.12.64 1.9.65 Offices, Shops and Railway Premises First Aid Order, 1964 1.12.64 1.9.65 The Dried Milk Regulations, 1964 11.3.65 Riding Establishments Act, 1964 1.4.65 Shops and Offices, Washing Facilities Regulations, 1964 1.1.66 Shops and Offices, Sanitary Conveniences Regulations, 1964 1.1.66 40 SERVICES AVAILABLE FOR OLD PEOPLE NATIONAL. National Assistance Board, 177, Tottenham Court Road, W.1. (Tel.: MUS. 7002).—This Office assists old age pensioners whose income is insufficient for their needs, by financial grants and special grants for clothing, blankets, etc. Letters to be addressed to the Manager. On Saturdays urgent cases are dealt with at 1, Tavistock Square, W.C. 1. (Tel.: EUS. 8052). National Health Service.—All old people should be on a list of a doctor. This part of the service is controlled by the London Executive Council, Insurance House, Insurance Street, W.C.I. (Tel.: TER. 7833). A complete list of doctors can be seen at any Post Office, or advice can be obtained from the Public Health Department at the Town Hall. National Insurance: Local Offices— For Postal Area, W.1. Colquhoun House, Broadwick Street, W.1. Tel.:REG. 7010 For Postal Area, N.W.1. 30, Euston Square, N.W.I Tel.: EUS 6451. For Postal Areas, W.2 and N.W.S 5, Praed Street, W.2. Tel.: PAD. 3411. LOCAL AUTHORITY. Homes.—Apply to Admission Officer, 10, Warwick Row, S.W.1. (Tel.: VIC. 0162). Welfare of the Blind.—Apply to the "Welfare of the Blind" Department, 10, Warwick Row, S.W.1. (Tel.: VIC. 0162). Recuperative Holidays and Loan of Sick-Room Equipment.—Apply to Health Department, Westminster City Hall, Victoria Street, S.W.1. (Tel.: TAT. 8070). Mental Illness.—Apply to Health Department at City Hall, where there is a twenty-four hour service. Home Helps Service, Room 91, Town Hall St. Marylebone, W.1. (Tel.: WEL. 7766).—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 Secretary, Old People's Welfare Association. (See below). Chiropody.—A clinic is run at the Health Centre, 217, Lisson Grove, N.W.8 (Tel.: PAD. 8244) on Tuesdays and Wednesdays 9.30 a.m to 12.30 p.m., 1.30 p.m. to 4.30 p.m.; Thursdays 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." Health Department, Town Hall, St. Marylebone, W.1. (Tel.: WEL. 7766).—Public Health Inspectors deal with any public health matters among old people which are brought to their notice. Special Laundry.—A special laundry service for incontinent old people is run by the City Council. Bathing.—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 Id. (soap and towels extra). Library Book Service.—This is operated by the City Council Library and delivery of books is made to the infirm or housebound each Tuesday. Arrangements must be made with the City Librarian at the Town Hall. (Tel.: WEL. 7766). Holidays.—The Council's grant towards the cost of holidays for old age pensioners is administered by the Old People's Welfare Association. Fuel.—Old people without coal or smokeless fuel owing to delayed delivery should be notified to the Old People's Welfare Association (Tel.: WEL. 7766, Ext. 39 or AMB. 3873), who can arrange delivery of 28 lbs. of coal or smokeless fuel to tide over until the coalman calls. VOLUNTARY SOCIETIES. City of Westminster Old People's Welfare Association (St. Marylebone Branch), 20, Enford Street, York Street, W.1 (Tel.: AMB. 3873), 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. Old People's Welfare Officers, Town Hall, St. Marylebone, W.1 (Tel.: WEL. 7766). Meals on Wheels. (Dinners).—This service for the housebound is financed by the Old People's Welfare Association (aided by a grant from the City Council), and operated by the W.V.S. and British Red Cross Society. Hot dinners can be taken to the home, price 1s. Od. for two courses. Apply either to the Old People's Welfare Association or to the W.V.S. 41 W.V.S. Luncheon Club, 20, Enford Street, York Street, W.1. (Tel.: AMB. 3873).—Old age pensioners can obtain dinners for 1s. Od. from Monday to Friday. Notice to attend must be given to the W.V.S. beforehand. Home Nursing.—City of Westminster 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 at 20, Enford Street, York Street, W.1 on Tuesdays and Wednesdays 10 a.m. to 12.30 p.m. and 2.15 p.m. to 5.15 p.m. and on Thursdays and Fridays 10 a.m. to 12.30 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.1, 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. Bookings to be made with the Secretary, Old People's Welfare Association. No charge. Clubs.—There are three W.V.S. Clubs for the Elderly:— St. Mary's Church Hall, Crawford Street, W.1, on Wednesdays and Thursdays, 2.30 to 4.30 p.m. 60, Paddington Street, W.1, 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.1. 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.1, Thursdays, 2.30 to 4 p.m. The Good Companions Club, Greenwell Street, W.1, on Mondays, 3 to 5 p.m. The Day Centre, 20, Enford Street, York Street, W.1, on Mondays and Wednesdays 2.30 to 4.30 p.m. The women's organisations of churches in the Borough have large numbers of old age pensioners among their members. Women's Voluntary Services, Town Hall, St. Marylebone, W.1. (Tel. WEL.: 7766). Tuesday to Friday 10 a.m. to 3.30 p.m. Citizens' Advice Bureau, Town Hall, St. Marylebone, W.1 (Tel.: WEL. 7766). Monday to Friday, 10 a.m. to 5 p.m. The "Wirelessfor the Bedridden" Society, 20, Wimpole Street, W.1. (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.1l. (Tel.: PAR. 6683). Sailors', Soldiers' and Airmen's Families Association (S.S A.F.A.), Room 103, Town Hall, St. Marylebone, W.1 (Tel.: WEL. 7766). Wednesdays and Fridays, 10 a.m. to 12.30 p.m. Church Army, 185, Marylebone Road, N.W.1. (Tel.: AMB. 3211). British Red Cross Society, 106, Crawford Street, W.1. (Tel.: WEL. 3416). National Association for Mental Health, 39, Queen Anne Street, W.1. (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.1. (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.1. (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.9,. (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 weekdays (excluding Saturdays) as follows:— The Odeon, Edgware Road, until 4 p.m., charge 9d. The Regal, Harrow Road, until 4 p.m., charge 9d. The Classic, Baker Street, until 3 p.m., charge 2s. 6d. 42 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.l MUS 8333 Western Ophthalmic Hospital, Marylebone Road, N.W.1 PAD 1871 Clinics : Arthur Stanley Institute for Rheumatic Diseases and Allied Conditions, Peto Place, N.W.1 LAN 6778 Carter Foundation (Temperance Clinic), 34, Seymour Street, W.l. AMB 6689 Charterhouse Rheumatism Clinic, 56-60, Weymouth Street, W.l WEL 1264 Chest Clinic, Town Hall, Marylebone Road, W.l WEL 7766 The Tavistock Clinic (Psychiatric), 2, Beaumont Street, W. 1 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 Health Department, Westminster City Hall, Victoria Street, S.W.1 TAT 8070 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. 1 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 43 INDEX Page Accidental Deaths 3, 30 Accidents : Home 11 Road 3, 30, 32 Adulterated Food Samples21,24 Aged Persons 6, 7, 40 Aged Persons—Services available 40 Air Pollution 15 Ambulance Service 42 Analysis of Food and Drugs 21 Analyst, Public 1. 21 Analyst, Public, Report 21 Bacteriological Examinations 28, 33, 39 Bacteriological Examination of Milk and Ice Cream 25 Bacteriologist 1 Barbers 16 Baths : Cleansing of Persons 14 For Old People 6 Public 10 Swimming 10 Births 3 Bodies, Transportation Abroad 18 Books, Library 9, 27 Bugs 14 Burial or Cremation of the Dead 18 Cancer 3,30 Care of Old People 6, 7 Catering Establishments 26 Causes of, and Ages at, Death 30 Census Population 2 Certificates of Disrepair 20 Clean Air 15 Cleansing, Public 17 Cleansing Station 14 Cleansing of Verminous Persons 14 Clearance, Slum 19 Clinics 42 Closing Orders 21, 32 Combined Drainage 14 Committee, Public Health 1 Common Lodging Houses 21 Compulsory Removal 10 Conditions, Social 2 Conferences 5 Consumer Protection 16 Conveniences, Public 17, 36 Cremation 18 Deaths : Accidental 3, 30, 32 General 2, 3, 30 Infant Mortality 2, 3, 30 Maternal Mortality 2, 3, 30 Vital Statistics 2 Diseased or Infirm Persons, Removal 10 Diseases, Notifiable 26, 27, 37 Disinfection 27 Disinfestation 14 Disrepair Certificates 20 Dog Nuisance 18 Drainage 14 Drugs, Analysis 21 Dwelling-Houses 20, 32 Exclusion from Work 27 Factories 16, 35 Financial Contributions to Voluntary Organisations 5 Fireguards 16 Food : Adulterated, etc. 21, 24 Analysis 21 Inspection 21 Legislation 23, 39 Poisoning 27, 38, 39 Premises 26, 37 Page Food: Preserved, etc. 25, 37 Stalls 26 Unsound 24, 36 Fouling of Footways by Dogs 18 General Statistics 2 Hairdressers and Barbers 16 Health Education 6 Health Services, personal 11 Heating Appliances (Fireguards) 16 Home Accidents 11 Horseflesh 26 Hospitals 42 Houses in Multiple Occupation 20 Housing : Certificates of Disrepair 20 Closing Orders 21, 32 Improvements and Conversions 20 Inspection and Action taken 32 Of Old People 20 Old People's Consultative Committee 20 Permanent Estates 19 Re-housing, Medical Certificates 21 Slum Clearance 19 Hydrogen Cyanide Disinfestation 14 Hygiene—Food Premises 26 Ice Cream 25, 37 Immigrants 21 Impetigo 27 Improvement and Conversions, Housing 20 Infant Mortality 2, 3, 30 Infectious Diseases: Exclusion from Work of Contacts 27 Notification 26, 37 Prevalence and Control 26 Statistics 37, 38 Inns, Refreshment Houses, etc. 26 Inspection, Sanitary 32 Institutions, Medical and Nursing, etc. 42 International Certificates of Vaccination 27 Intimation Notices 12 Knacker's Yard 26 Land Charges Enquiries 21 Laundry : Public 10 Service for Old People, etc. 6, 10 Legal Proceedings 12 Legislation, New 12, 33, 39 Library Books 9, 40 Licensed Premises 26 Lung Cancer 3, 30 Marriages 2 Maternal Mortality 2, 3, 30 Measles 2, 26 Medical Examinations: Staff 11 Parking Meter Exemptions 11 Medical and Nursing, etc.. Institutions 42 Medical Referee, Cremation1,18 Merchandise Marks Act 25 Mice 14, 34 Milk: Analysis and Bacteriological Examination 21, 25 Sellers 25 (Special Designations) Regulations 25 Mortality: Infant 2, 3, 30 Maternal 2, 3, 30 Multiple Occupation, Houses in 20 New Legislation 12, 23, 39 Noise 12 Notices, Intimation and Statutory 12 Notification of Infectious Diseases 26, 37 Nuisances 12 44 Page Offices 15 Old People: Care of 6, 7, 40 Housing—Consultative Committee 20 St. Marylebone Welfare Association 7, 40 Services Available 40 Outworkers 16, 35 Parking Meter Exemptions—-Medical Examination 11 Personal Health Services 11 Pet Animals 16 Pharmacy and Poisons Acts 16 Photographers, Street 19 Pigeons 13 Poisoning, Food 27, 28, 39 Poisons 16 Poliomyelitis 26 Population 2 Preserved Food 25, 37 Protective Helmets 17 Public Analyst 1, 21 Public Analyst's Report 21 Public Baths 10 Public Cleansing 17 Public Conveniences 17, 36 Public Health Committee 1 Public Health Department Staff 1 Public Health Inspectors 1 Public Laundry 10 Public Swimming Baths 10 Pulmonary Tuberculosis 26, 37, 38 Radioactive Substances 18 Rag Flock and Other Filling Materials 18 Rateable Value 2 Rats 14, 34 Referee, Medical (Cremation) X, 18 Refreshment Houses 26 Refuse Collection and Disposal, Storage 17 Removal, Compulsory 10 Rent Act 20 Representation upon other Bodies 4 Restaurants 26, 37 Road Accidents 3, 30, 32 Rodent Control 14, 34 Page St. Marylebone Old People's Welfare Association 7, 40 Sanitary Circumstances 12 Sanitary Inspection 12 Scabies 27 Sewerage 14 Shelter 15 Shops 15 Slaughter of Animals 26 Slum Clearance 19 Smallpox Contacts 28 Smoke Control 15 Social Conditions 2 Staff : of Department 1 Medical Examinations 11 Stalls, Food 26 Statistics : General and Vital 2 Tables 30 Statutory Notices 12 Stillbirths 2, 3 Street Cleansing 17 Street Photographers 19 Swimming Baths 10 Town Planning 14 Transportation of Bodies Abroad 18 Tuberculosis : General 26 New Cases and Deaths 26, 38 Notifications 26, 37 Register 27, 38 Typhoid Fever 27 Unsound Food 24, 36 Vaccination, International Certificates 27 Vermin 14 Verminous Persons, Cleansing 14 Vital Statistics 2 Water 13, 33 Weather 4, 31 Wells, Private 13 Zoological Society of London 26 Vail & Co. Ltd., Leeke Street, King's Cross, W.C.1.