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Early Commissioners of Sewers were solely concerned with land drainage and the prevention of flooding, not with the removal of sewage in the modern sense. In 1531 an Act of Sewers was passed which set out in great detail the duties and powers of Commissioners and governed their work until the 19th century. Gradually a permanent pattern emerged in the London area of seven commissions, five north and two south of the Thames, with, after the Great Fire, a separate commission for the City of London. The London commissioners had more extensive powers than those in other parts of the country; they had control over all watercourses and ditches within two miles of the City of London as well as newly constructed drains and sewers. After 1800 the London commissioners also obtained powers to control the formation of new sewers and house drains.
The first reference to a commission of sewers for Westminster which has been found occurs in 1596. During the 17th century the areas named in the several commissions varied considerably, but they always extended beyond the bounds of Westminster. The first extant Letters Patent, that for 1691, includes within the jurisdiction of the commissioners Hampton, Teddington, Isleworth, Hanwell, Ealing, as well as Hammersmith, Kensington and Chelsea. It was not until 1807 that the area was defined by statute; it then included all parishes within what is now the County of London west of the City and north of the Thames as far as Stamford Brook, with part of Willesden. The same statute gave the Commissioners power to control the construction of new sewers.