AC4386 Public Health BAT 46 Metropolitan Borough of Battersea REPORT on THE HEALTH of the Metropolitan Borough of Battersea, FOR THE YEAR 1947 BY G. MACDONALD, M.A., M.B., D.P.H., medical officer of health. Metropolitan Borough of Battersea REPORT on the HEALTH of the Metropolitan Borough of Battersea, FOR THE YEAR 1947 by G. MACDONALD, M.A., M.B., D.P.H., medical officer of health. 2 Health Maternity and Child welfare Committee. As constituted 9th November, 1946. Chairman : Councillor Miss E. A. Coles. His Worship the Mayor (Councillor T. J. Hines, j.p.) Councillor Mrs. E. A. Cooper', j.p. „ Mrs. C. M. Davis. „ Dr. H. L. Gulati, j.p. Alderman A. P. Holden. „ Mrs. H. E. Hughes. Councillor A. J. Knott. „ Mrs. O. Leete. „ Mrs. N. E. Roberts. „ Mrs. E. Stone. „ Mrs. D. L. Varran. Mrs. A. R. Wye. As constituted 9th November, 1947. Chairman : Councillor Miss E. A. Coi.es, j.p. His Worship the Mayor (Councillor F. Humphrey, j.p.) Councillor Mrs. E. A. Cooper, j.p. „ Mrs. C. M. Davis. „ Dr. H. L. Gulati, j.p. Alderman A. P. Holden. „ Mrs. H. E. Hughes. Councillor A. H. Humphrey. „ A. J. Knott. „ Mrs. N. E. Roberts. „ Mrs. E. Stone. „ Mrs. D. L. Varran. „ Mrs. A. R. Wye. Tuberculosis Care Committee Councillor Mrs. E. A. Cooper, j.p. {Chairman). „ Mrs. C. M. Davis. „ Dr. H. L. Gulati, j.p. „ Mrs. H. N. Halsey. Alderman A. P. Holden. „ Mrs. H. E. Hughes. Councillor Mrs. A. R. Wye. Miss L. Agelasto, representing Local Social Welfare Committee. Councillor G. F. Meecham, representing Local Social Welfare Committee. Mr. H. B. Robinson, representing London Insurance Committee. Mrs. A. H. Monk, representing Family Welfare Association. Mrs. F. Young. Consultative Members: Dr. C. N. Atlee, London County Council Divisional School Medical Officer. Miss A. M. Gray, London County Council District Organiser. Miss M. de Fonblanque, Invalid Children's Aid Association. Dr. F. H. Whitehead, War Pensions Committee. Miss A. M. Stanford, South London District Nursing Association. Miss M. Kennedy Bell, British Red Cross Society. Miss M. S. Coltart, Almoner of Bromp.ton Hospital. Miss B. Spencer, „ „ St. George's Hospital. Miss A. B. Reed, „ „ St. Thomas's Hospital. Miss E. W. White, „ „ Victoria Hospital. 3 Staff of public Health Department (At 31st December, 1947.) Deputy M.O.H. and Tuberculosis Officer Assistant Medical Officers (Maternity and Child Welfare) Medical Officer, Southlands AnteNatal Cinic Medical Officer, Post-Natal Clinic Medical Officer, Nine Elms Centre Assistant Medical Officer Tuberculosis, part time, temporary Public Analyst J. G. S. McQueen, m.d., d.p.h. (Miss) M. L. Hamilton, m.b., ch.b., d.p.h. E. L. Tee, m.r.c.s., l.r.c.p., d.p.h. (Miss) Alice Bloomfield, m.d., f.r.c.s., f.c.o.g. (Mrs.) M. A. Radford, m.b., b.s., d.p.h. (Miss) E. M. Saxton, m.d. A. L. Meikle, m.b., ch.b. J. E. Woodhead, b.sc., f.i.c., ph.c. Chief Sanitary Inspector F. H. Chuter (a c) Sanitary Inspectors : District. 1. W. E. Selway (b c). 2. G. Weeks (b c). 3. S. W. Simpson-Scott (b c). 4. P. D. O'Grady (b c). 5. J. R. Glover (b c). 6. R. J. McCarthy (o c). 7. A. Webb (b c). 8. J. R. Holloway (a c). 9. T. W. Glf.W (6). 10. P. Ianson (b c). Other. (Food) J. A. H. Brownlow (b c). (Factories, I. R. Lewis (b c). etc.) Miss J. Round (a d). Rodent Officer—F. G. Daniels. Superintendent Health Visitor (Miss) B. L. Kaye (a d f) Health Visitors : (Miss) F. B. Goodall (a d f g). „ A. Bannerman (d f). „ V. Ventris (e f g). „ H. A. Blackburn (b e f g h). „ B. E. Prager (e f g h). „ I. M. J. Sweeney (e f g). „ E. L. Flemons (e f g). „ I. B. Abbott (e / g). „ K. I. Brown (e f g). „ W. M. Llewellyn (e f g). „ E. GilroY (e f g). „ M. F. Weller (e f g). „ D. Pipe (e f g). „ M. Heaton (e f g). Administrative and Clerical Staff— Principal Administrative Assistant H. C. Godfrey (a) W. Halstead. . R. Graham. P. Brocking. (Miss) M. A. Weller. (Miss) K. M. Hone. (Mrs.) V. M. Bentley. F. H. White. E. B. Moreton. J. W. M. Meston. One temporary clerk. One Office youth. (For notes see next page.) 4 Staff (Continued). Home Help Organiser Miss E. Fonceca (f). Tuberculosis Dispensary— Tuberculosis Nurses—(Miss) M. Schotborch (e g h), (Miss) B. O'Connor (g), (Miss) C. Thompson (f g). Secretary and Clerk—(Miss) L. Wadham (a d). Clerks—(Miss) C. Turner. (Mrs.) M. E. Werrett. Disinfecting Station—Superintendent—T. J. Farrow. Mortuary—Superintendent—W. Newman. Nurseries—Matrons—Battersea Park Nursery—(Miss) G. E. Elliott (f g). Clapham Common Nursery—(Mrs.) E. A. Burns (g). Nightingale Lane Nursery—(Miss) E. Edwards (f g). Sisters Avenue Nursery—(Mrs.) S. Norris (f g). (a) Sanitary Inspectors' certificate of the Sanitary Inspectors' Examination Board- (b) Sanitary Inspectors' certificate of the Royal Sanitary Institute and Sanitary Inspectors' Examination Joint Board. (c) Meat and other Foods certificate, Royal Sanitary Institute, or Sanitary Inspectors' Examination Board. (d) Health Visitors' certificate, Board of Education. (e) „ „ „ Royal Sanitary Institute. (f) State certified midwife. (g) State registered nurse. (h) Tuberculosis certificate. 5 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Battersea. Mayor, Ladies and Gentlemen, I present herewith my report upon the Health and Sanitary conditions of the Borough during the year 1947. In accordance with the Instructions of the Ministry of Health, te report is an abridged one and is mainly a statistical review, but there are one or two matters, particularly that relating to maternity and child welfare on pages 13/17; the review of the Tuberculosis dispensary service on page 29; and the report on the survey of wells in the Borough set out on pages 48/55 to which I would draw special attention. I wish to thank the Mayor and Members of the Borough Council, and more particularly the Chairman and Members of the Public Health, Maternity and Child Welfare Committee, for the continued encouragement and assistance that I have received from them during the year. I gratefully acknowledge, also, the help I have received from the Chief Officers of the Council and the loyal service so readily rendered by the whole staff of the Public Health Department. I have the honour to be, Mr. Mayor, ladies and gentlemen, Your obedient servant, (Signed) G. MACDONALD, Medical Officer of Health. Principal Figures for 1947. Area of Borough, excluding tidal water (acres) 2,163 Population (Registrar-General's mid-year estimate) 114,960 Structurally separate occupied dwellings 26,986 Rateable value—£1,108,586. Sum produced by 1d. rate £4,554 Births (live, 2,663, still, 74) 2,737 Live birth rate 23.16 deaths—1,446. Death rate 12.58 Maternal deaths—2. Maternal death rate 0.73 Infant deaths—84. Infant mortality rate 31.54 6 Vital Statistics. The Registrar-General's estimate of the 1947 mid-year population of Battersea was 114,960, as compared with 108,610 in 1946. The population of Battersea at the census taken in April, 1931, was 159,552, and the Registrar-General's estimate for 1947 therefore indicates a decrease of 44,592 (or 28 per cent.) since the census, but an increase of 6,350 during 1946/7. The Registrar-General's estimate of the mid-year population of the Borough (114,960) has been adopted for the purpose of the statistics contained in this report. BIRTHS. The number of live births registered in the Borough during 194/ was 2,905 (1,460 male, 1445 female). Of this number 1,137 were transferred out, the permanent residence of the parents being outside the Borough, and 895 registered outside the Borough, were transferred in, giving on balance a total of 2,663 births (1,296 male, 1,367 female, an excess of 71 females) relating to Battersea residents, and a live birth rate of 23.16 per 1,000 of the population. This is a decrease ot 0.28 on that of 1946. Of the Battersea births (live and still) which occurred within the Borough, 1,143 were "domiciliary births." Illegitimate births numbered 174 or 6.5 per cent. of the live births. The number of births occurring in each quarter of the year is shown in the table on page 12. The live birth rate for the County of London was 22.7 per 1,000 of the population, and for England and Wales the rate was 20.5. Still-Births. The registration of still-births is made compulsory by the Births and Deaths Registration Act, 1926. During 1947 there were 102 still-births registered in Battersea, of which 45 were of Battersea parents. 29 still-births occurring outside the Borough were registered as belonging to Battersea, making 74 in all, representing a still-birth rate of 27.04 per 1,000 births (live and still) registered. Of the 74 still-births 4 (5.4 per cent.) were registered as illegitimate. The number of Battersea still-births registered, and the still-birth rates, from 1938 to 1947, were as under:— No. Rate No. Rate 1938 56 25.8 1944 40 24.0 1939 40 19.6 1945 38 23.3 1940 47 25.5 1946 59 22.7 1941 42 31.5 1947 74 27.0 1942 43 26.7 Mean 1938-47 47 24.8 1943 36 21.6 7 Notification of Births. During 1947 the number of notifications of live births received belonging to the Borough was 2,561. The corrected number of Battersea births registered during the year was 2,663. The proportion of notified to registered births was, therefore, 96.2 per cent. Notifications of 834 live births of Battersea children occurring outside the Borough were received from the districts in which the births occurred, these cases being included in the total of 2,561 above. Sixty-five still-births were notified under the provisions of the Public Health (London) Act, 1936, during the year, including 20 cases occurring outside the Borough, the number notified being 87.8 per cent. of the total Battersea still-births registered. The homes from which births are notified are visited and revisited by the Council's official health visitors or the health visitors of the voluntary organisation included in the Council's Maternity and Child Welfare scheme. MARRIAGES. The marriages registered in Battersea during 1947 numbered 1,085. The marriage rate (i.e., the number of persons married per 1,000 of the population) was 18.9. Year. Marriages. Marriage-Rate. 1942 963 22.4 1943 810 18.4 1944 730 17.1 1945 1,082 23.9 1946 1,043 19.2 Mean, 1942-46 926 20.2 1947 1,085 18.9 DEATHS. The number of deaths registered in the Borough during 1947 was 1,993. Of these 1,160 were deaths of non-residents and were trans- ferred to the districts in which the persons ordinarily resided. There were on the other hand, 613 deaths of Battersea residents registered outside the Borough. The total (corrected) number of deaths belonging to the Borough was 1,446 (males 731, females 715). This gives a recorded death rate of 12.58 compared with 12.8 for London, and 12.0 for England and Wales. 8 The following table shows the age and sex distribution of the total deaths (corrected) in Battersea during 1947:— Under 1 year. 1— 5— 15— 45— 65 + Total. M 48 12 2 62 204 403 731 F 36 6 5 62 132 474 715 Totals 84 18 7 124 336 877 1,446 % of Total 5.8 1.2 0.5 8.6 23.2 60.7 100 It is well known that in almost all districts the average age at death tends to increase. The position of Battersea in this respect is illustrated by the following figures:— Average Age at Death, 1938-1947. Mean, 1938/1942 60.2 1943 61.4 1944 59.9 1945 62.4 1946 61.4 1947 62.6 Mean, 1943/1947 61.5 During 1947 the deaths of 877 residents of Battersea aged 65 years and upwards were registered. The distribution of these deaths, which constituted 60.7 per cent. of the deaths at all ages, is set out in the following table Sub-District. 65 and under 75. 75 and under 85. 85 and upwards. Total over 65. Total M. F. M. F. M. F. M. F. North Battersea 82 64 55 75 10 22 147 161 308 South Battersea 151 110 77 148 28 55 256 313 569 Borough 233 174 132 223 38 77 403 474 877 The number of infant deaths in each quarter of the year is shown in the table on page 12. The natural increase of population (that is, excess of births over deaths) was 1,217 in 1947 as compared with 1,077 in 1946. The causes of the 1,446 deaths occurring in 1947, classified in various age groups, are shown in the following tables. 9 Causes of Death at different Periods of Life in Battersea during 1947. The following table is supplied by the Registrar-General:— Causes of Death. Sex. All Ages. 0— 1— 5— 15— 45— 65— All Causes m. 731 48 12 2 62 204 403 F. 715 36 6 5 62 132 474 1. Typhoid and paratyphoid fevers m — — — — — — — F. — — — — — — — 2. Cerebro-spinal fever m. 2 — 2 — — — — F. 1 — 1 — — — — 3. Scarlet fever m. — — — — — — — F. — — — — — — — 4. Whooping cough m. 2 — 2 — — — — F. — — — — — — — 5. Diphtheria m. — — — — — — — F. — — — — — — — 6. Tuberculosis of respiratory system m 36 — — — 17 17 2 F. 23 — — — 18 3 2 7. Other forms of tuberculosis m. 7 1 1 1 3 1 — F. 4 — 1 — 3 — — 8. Syphilitic diseases m. 6 — — — 1 3 2 F. 7 — — — — 2 5 9. Influenza M 4 — — — —_ 1 3 F. 5 — 1 — — 1 3 10. Measles M. — — — — — — — F. — — — — — — — 11. Ac. polio-myelitis and polio-encephalitis M — — — — — — — F. 1 — 1 — — — — 12. Ac. infective encephalitis M. — — — — — — — F. 2 — — — — 2 — 13. Cancer of buccal cavity and oesophagus (M.) uterus (F.) M. 16 — — — — 2 14 F. 12 — — — 1 5 6 14. Cancer of stomach and duodenum M. 21 — — — 3 5 13 F. 10 — — — 1 1 8 15. Cancer of breast m — — — — — — — F. 32 — — — . 3 15 14 16. Cancer of other sites M. 94 — — — 7 39 48 F. 67 — — — 5 19 43 17. Diabetes m 1 — — — — — 1 F. 6 — — — 1 1 4 18. Intra-cranial vascular lesions M 57 — — — — 9 48 F. 63 — — — 1 11 51 19. Heart disease M. 192 — — — 9 45 138 F. 204 — — — 4 28 172 10 Causes of Death, 1947—(contd.). Causes of Death. Sex. All Ages. 0— 1— 5— 15— 45— 65— 20. Other diseases of circulatory system M. 21 — — — — 7 14 F. 46 — — 1 1 4 40 21. Bronchitis M. 73 4 2 — 1 23 43 F. 57 5 — — 3 12 37 22. Pneumonia M. 49 7 2 — 3 11 26 F. 41 3 — — 6 9 23 23. Other respiratory diseases M. 8 — — — 2 4 2 F. 2 — — — — — 2 24. Ulcer of stomach or duodenum M. 11 — — — — 8 3 F. 8 — — — — 1 7 25. Diarrhoea (under 2 years) M 4 4 — — — — — F. 6 6 — — — — — 26. Appendicitis M 1 — — — — 1 — F. 2 — 1 — 1 — — 27. Other digestive diseases M. 12 — — — — 2 10 F. 15 1 — — 1 3 10 28. Nephritis M. 14 — — — 1 7 6 F. 14 — — 1 1 3 9 29. Puerperal and postabortive sepsis F. 1 — — — 1 — — 30. Other maternal causes f. 1 — — — 1 — — 31. Premature birth m. 9 9 — — — — — F. 5 5 — — — — — 32. Congenital malformations, birth injuries, infantile diseases M 16 13 1 — 1 — 1 F. 15 10 — 1 2 2 — 33. Suicide M. 4 — — — — 3 1 F. 3 — — — 1 — 2 34. Road traffic accidents M. 6 — 1 1 — 2 2 F. 2 — — 1 — — 1 35. Other violent causes M. 20 6 — — 7 2 5 F. 15 3 — — — — 12 36. All other causes M, 45 4 1 — 7 12 21 F. 45 3 1 1 7 10 23 Infant Mortality. During 1947 the deaths of 84 infants under 1 year of age were registered as belonging to Battersea. The total number of live births registered during the year was 2,663, giving an infant mortality rate of 31.54 per 1,000 live births, as compared with 42.42 in 1946, 40.8 in 1945, and 49.82 in 1944. The infant mortality rates in the County, of London and in England and Wales during 1947 were 37 and 41 respectively. 11 The following table sets out the causes of death in detail. Infant Mortality, 1947. Nett Deaths from stated causes at various ages under 1 year. Causes of death age periods. Under 24 hours. 1-7 days. Weeks. Total under 4 weeks. Months. Total deaths under 1 year. Percentage of Total. 1-2 2-3 3-4 1-3 3-6 6-9 9-12 Tuberculosis (Non-pulmonary) M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. 1 1 — 1.19 Bronchitis 1 3 2 2 1 4 5 10.71 Pneumonia 1 1 2 2 2 3 1 7 3 11.91 Diarrhoea 4 3 1 1 1 4 6 11.91 Digestive diseases 1 1 1.19 Premature birth 5 3 2 1 2 1 9 5 9 5 16.67 Congenital ation, birth injury, infantile diseases 4 1 5 7 1 1 11 8 1 2 1 13 10 27.38 Violent causes 1 1 1 1 1 1 3 1 1 6 3 10.71 Other causes 1 1 2 1 2 1 1 4 3 8.33 Totals 10 2 10 9 4 2 1 1 25 14 6 6 6 11 9 3 2 2 48 36 100.00 12 19 6 1 I 39 12 17 12 4 84 — Percentage of Total 14.3 22.6 7.1 1.2 1.2 46.4 14.3 20.2 14.3 4.8 — M. 57.1 F. 42.9 There were 39 deaths of infants during the first four weeks of life (or 46.4 per cent. of the total infant deaths) as compared with 56 deaths lor 51.8 per cent.) in 1946 and a percentage for the quinquennium 1942-1946 of 49.8. Table showing Deaths of Infants under 1 day, under 1 week and under 4 weeks from 1942 to 1947. Year Under 24 hours 1 to 7 days 1 to 4 weeks Total under 4 weeks Percentage deaths under 4 weeks of total infant deaths 1942 14 15 7 36 42.9 1943 17 14 15 46 52.3 1944 12 12 9 33 40.7 1945 21 13 6 40 61.5 1946 20 20 16 56 51.8 Mean 17 15 10 42 49.8 1947 12 19 8 39 46.4 12 The number of deaths and infant deaths registered in each quarte of the year is set out in the following table, in which, for convenience the corresponding figures for births have also been inserted. Quarter. Births (live). Infant Deaths (under 1 year). All Deaths. No. Per cent. of Total. No. Per cent. of Total. No. Percent of Total. 1 742 27.8 36 42.9 555 38.4 2 737 27.7 20 23.8 321 22.2 3 596 22.4 6 7.1 230 15.9 4 588 22.1 22 26.2 340 23.5 Total 2,663 100.0 84 100.0 1,446 100.0 Deaths of Illegitimate Infants. The death rate amongst illegitimate children during 1947 was 45.98 per 1,000 births, as compared with 87.91 in 1946, 37.04 in 1945, 74.83 in 1944, and 94.02 in 1943. The corresponding death rate of legitimate children in 1947 was 30.53, the ratio of mortality rate of illegitimate infants to that of legitimate being 150 to 100. Maternal Mortality. During 1947, there were 2 deaths of women from diseases or accidents of child-birth which is equivalent to a fatality rate of 0.73 per 1,000 births (live and still), as compared with 4 deaths and a fatality rate of 1.54 in 1946. The rate for England and Wales in 1947 was 1.17. Comparative Statistics of Births, Mortality, etc. (Compiled from Registrar-General's Returns.) Year Population Live Birth Rate Death Rate Maternal Death Rate Infant Mortality Rate 1938 141,700 14.9 11.8 2.76 53.4 1939 B 139,200 14.4 12.8 2.03 61.7 D 131,600 1940 108,380 16.6 18.4 1.77 41.3 1941 82,100 15.7 18.3 1.88 63.4 1942 85,940 18.3 14.9 1.24 53.5 1943 89,160 18.3 15.8 0.0 53.9 1944 85,380 19.0 17.7 1.22 49.8 1945 90,420 17.6 13.8 1.23 40.8 1946 108,610 23.4 13.5 1.54 42.4 1947 114,960 23.2 12.6 0.73 31.5 B—Population as estimated for purpose of Birth rate. D— „ „ „ Death rate. 13 Maternity and Child Welfare. As 1947 will be the last full year in which the Council will be the authority for Maternity and Child Welfare it is not inopportune to give a brief resume of the development of this important branch of the Public Health Service. It can, I think, be said that the first steps towards the provision of a Maternity and Child Welfare Service for the Borough were inaugurated in 1901, when an enquiry was made by the Health Committee into the causes of the high rate of the infantile mortality prevailing in the Borough in common with the rest of the country. In their opinion this heavy mortality was in great part due to improper feeding and they felt that by providing a supply of pure milk modified by special treatment to render it more assimilable, much of this wastage of human life might be prevented. As a consequence they decided to establish an Infants' Milk Depot, which was opened in June, 1902. This Milk Depot was the first of its kind to be established in London and one of the first in England. The milk, which was supplied under stringent conditions, was obtained from a herd of tuberculin-tested cows on a farm, which was from time to time inspected by the Medical Officer of Health, and after being modified, bottled and sterilized, was distributed to the applicants, all of whom were unable to breast feed their infants. On two afternoons a week the depot was opened for the weighing of the children, who were being fed on this specially prepared milk, and mothers were expected to take their children there weekly. The homes of the infants fed on the milk were visited by a woman sanitary inspector, who endeavoured to secure that the instructions given were properly carried out. During the first years of its existence the cost of running the Milk Depot was surcharged annually by the District Auditor, as there was no legal authority for maintaining such an establishment. The surcharge charge was, however, remitted by the President of the Local Government Board. The reputation attained by the Milk Depot was such that, at the request of the promoters, a stall showing its activities was established at the Ideal Homes Exhibition at Olympia in 1911. . During the war years 1914/18 difficulties were encountered in maintaining the high standard of the milk supplied, and in 1915 dried milk was to a certain extent used as a substitute, and in the following years it was decided to close down the Milk Depot and use dried milk exclusively. Under the Maternity and Child, Welfare Act, 1918, authority was given to supply free, or at reduced cost or at cost price, fresh or dried milk to expectant and nursing mothers and children under 5 years of age-a provision which was put to full use by the Council. In 1925 it was decided by the Council that milk supplied under their Maternity and Child Welfare scheme should be Grade A, and this continued, with the exception of a period of about 2½ years, until the scheme was brought to an end in 1940 by the introduction of the National Scheme inaugurated by the Ministry of Food. 14 Even though the distribution of milk, both fresh and dried, is now dealt with by the Ministry of Food, expectant and nursing mothers and children can still be supplied with dried milk at the Welfare Centre and, in addition, Cod Liver Oil and fruit juices. When the Milk Depot was established mothers were encouraged to bring their children at regular intervals for weighing. No centre for examination and advice was available until 1908 when a voluntary society held a session on alternate Thursday afternoons at the Latchmere Baths, where a room was placed at their disposal free of charge) by the Council. This Society was formed with the object of visiting the T.B. patients, lying-in cases and babies attending hospital and the Council agreed to the Medical Officer of Health rendering such assistance as he considered necessary. The weighing rooms used in connection with the supply of sterilized milk were not exclusively used by children in receipt of such milk and with a trained woman sanitary inspector in attendance advice was given, and any serious deviation from the normal progress of the child was reported to the Medical Officer of Health. In January, 1915, the Council, following the receipt of a memorandum on the subject from the Local Government Board decided to formulate a comprehensive scheme for Maternity and Child Welfare, and as a commencement to establish a Welfare Centre, with the regular attendance thereat of a Medical Officer. It was, however not until February, 1917, that the Centre was opened at Latchmere Baths. In December, 1917, an additional Centre was established at Lurline Gardens, the Medical Consultant attending on alternate weeks. This was transferred to Battersea Tabernacle in May, 1919. In December, 1919, a room at Plough Road Baths was put at the disposal of the Maternity and Child Welfare Committee for use as a Centre, which in the first instance was run by the Battersea School for Mothers to whom an annual grant was made in respect of both this Centre and the one maintained by them at Mundella Road. During 1919 arrangements were made for massage to be provided, where necessary at the Centres. As an ancillary to the Council's scheme in 1920 a grant was made to the Women's League of Service, a voluntary organisation, in connection with the provision of dinners to mothers and children under the Maternity and Child Welfare Scheme. These grants were continued until 1937, when the scope of the work was extended and a specified payment was made from a block grant received from the Government. In July, 1920, the Centre at Plough Road was taken over from the Battersea School for mothers and administered direct by the Council. In the same month the first dental clinic, consisting of one session weekly, was inaugurated by agreement with the British Dental Hospital and in each of the years 1923, 1925, 1926, and 1930, was extended by an additional weekly session. The dental clinics were transferred to Southlands, but owing to damage due to enemy action these were discontinued in 1940 and arrangements made with the London County Council for patients to be dealt with in one of their general hospitals. 15 In April, 1922, the Centre at Battersea Tabernacle was transferred to All Saints Church Hall and in the following year an additional Centre was opened at Chatham Hall. Owing to the increase in the Maternity and Child Welfare and other activities, it was proposed in 1924 to erect a health centre on vacant land in Latchmere Road. The proposals were approved and, in fact, the building had actually been commenced, when a suitable building, Southlands, came on to the market and this was purchased and adapted by the Council as the main Maternity and Child Welfare Centre of the Borough and the Latchmere Baths Centre, Women's League of Service, Dental Clinic, and the Tuberculosis Dispensary were transferred thereto. Adiphtheria immunisation clinic was established at Southlands in 1927, with one session weekly, increased to two in 1930. At the same time the Council instituted a Sunlight Clinic for the treatment of expectant and nursing mothers and children under five years of age, and also for patients suffering from tuberculosis. To enable the Battersea School for mothers to continue to function at Mundella Road Centre the Council in 1927 purchased the freehold of the property and for financial reasons the Council took over this Centre in April, 1935, which continued to function there until 1940, When, owing to its destruction by enemy action, it was transferred to St. George's Hall, and subsequently, in 1947, to Nine Elms Baths. In 1928 an additional Centre to serve the needs of the residents of Bolingbroke Ward was proposed and, after negotiation, a Centre was opened at Gideon Road School in 1930. In the same year an additional session weekly was held at Plough Road Centre. Ante-natal clinics were first established in 1921 at the Borough Maternity Home, and at this clinic there was a special (V.D.) session. Additional clinics were established in 1922 at All Saints' Hall, Plough Road Baths and at Latchmere Baths (subsequently transferred to Southlands), and in 1926 the number of sessions weekly at the Battersea Maternity Hospital was increased to two. The closing of the Battersea Maternity Hospital in 1939 caused the transfer of one session to Southlands. Owing to war conditions, the total number of sessions was reduced from 4 to 3 in November, 1940, but in 1943, by the opening of an ante-natal clinic at Gideon Road, this reduction was made good, and in 1946 an additional ante-natal clinic was commenced at Chatham Road Centre. As in the case of ante-natal clinics, the Maternity Home first housed the post-natal clinic, which was established in 1927. On the closing of the home a gynaecological clinic was provided in February, 1939, at Southlands. This, too, was discontinued in 1940 owing to war conditions, but was re-established at Gideon Road in 1944. 16 In order to meet the needs of the children between the ages of 1 and 5, toddlers' clinics were opened, firstly at Southlands in 1936 and, as a result of the experience thus gained, at each of the other Centres early in 1938. Owing to war conditions these special clinics for toddlers were discontinued until 1947, when they were re-established at all but one Centre during alternate weeks. Mothercraft classes have been held at most of the Centres weekly since 1935. Battersea Maternity Home. In 1920 the Council acquired two large mansions, " Elmhurst" and " Westwood Towers," fronting on to Wandsworth Common, and adapted them to serve as a lying-in hospital. Thirty beds were thus made available for the reception of maternity cases and, in additionfacilities were provided for the training of pupil midwives. The number of cases admitted each vear was:— 1921 200 1930 516 (Opened in Feb.) 1922 371 1931 555 1923 419 1932 552 1924 400 1933 543 1925 560 1934 493 1926 625 1935 489 1927 634 1936 418 1928 653 1937 477 1929 605 1938 468 Owing to the unsound structural condition of the premises and the extreme difficulty of securing adequate staff the Council reluctantly decided to close the Hospital in 1938. In conjunction with the Maternity Home, a District Midwifery service was instituted in 1921. This service continued to function until 1938 by which time the provision of an adequate domiciliary service of midwives by the London County Council—the authority for such provision under the Midwives Act—had become well established. Staff. To cope with the various extensions of the service it has, of course, been necessary to increase the staff. In 1897 the first female Sanitary Inspector was appointed, and she held office until 1899. The vacancy was not then filled. Her duties do not appear to have included health visiting. In 1902 a woman Inspector was appointed to deal with factories and she also carried out health visiting duties. In 1904 a second Inspector was appointed. It was not until the passing of the L.C.C. (General Powers) Act, 1908, that power was given to appoint Health Visitors as such, whose duties included the giving of advice as to the proper nurture, care and management of young children, and in 1909, following the passing of the Notification of Births Act, an, additional Visitor was appointed. The female visiting staff remained at 3 until 1916, when an additional Health Visitor was appointed. 17 In 1919, after the passing of the Maternity and Child Welfare Act, the number was increased to 7, and has grown progressively with the extension of the services provided, to 8 (1923); 9 (1924); 10 (1930); 12 (1934); 14 (1937); and 15 (1946). The Medical Staff especially appointed for Maternity and Child Welfare work, apart from the Resident Medical Officer at the Borough Maternity Home, has also increased in order to cope with the nature and scope of the services rendered. In 1919 a part-time Medical Officer was appointed, but in 1921 an additional full-time Medical Officer was employed for Maternity and Child Welfare Services. Additional part-time Medical Officers (on a sessional basis) were appointed from time to time and the present medical staff for Maternity and Child Welfare Services consists of:— 2 full-time Medical Officers. 3 part-time „ „ (1 Session weekly each). A close study of the figures set out in the table on page 12, showing the comparative statistics of births, infant and maternal deaths, etc., will, I think, convince everyone of the value of the services provided for the benefit of the inhabitants of the Borough. Maternity and Child Welfare Districts and Centres. For administrative purposes, the Borough is divided into fourteen districts, for each of which a health visitor is responsible. There were, at the end of the year, seven Maternity and Child Welfare centres (municipal, 6; voluntary, 1). The situation and times of opening of the centres, municipal and voluntary, and the work carried out thereat, are set out in the tables on pages 19/20. At each of the municipal centres a clinic is held twice weekly, with a Medical Officer in attendance, as shewn in the table on page 19. Each centre is under the supervision of a trained Health Visitor and voluntary helpers assist in the work. The voluntary centre is conducted on similar lines to those of the municipal centres. Mothercraft Classes. Instruction in mothercraft is given weekly at 5 centres, the average attendance during 1947 being respectively:— Gideon Road 15.2 Southlands 12.8 Nine Elms 13.9 Women's League of Service (Southlands) 13.8 Plough Road 14.7 In total there were 279 meetings with a total attendance of 3,920, giving an average 14.1 attendances per session. 18 Voluntary Centres. Women's League of Service.—The Battersea centre of this League (formerly held at 111 Bridge Road West) was established in 1911, and was transferred to Southlands in 1928. The district served by the League is a populous one adjoining the Thames, and situate between Battersea Bridge Road and Battersea High Street. A qualified Health Visitor (Miss F. Pethybridge) undertakes the usual duties of a health visitor within the district. The centre is carried on as an integral part of the Council's Maternity and Child Welfare scheme, and the Council make an annual grant of £574 10s. Od. towards the expenses. An important feature of the work of the League is the provision of dinners for nursing and expectant mothers and children at a minimum charge or free. Although provided mainly for residents in the League's district, mothers and children from other parts of the Borough are, in suitable cases, sent to the dining rooms and supplied with dinners. 4,603 women and 3,930 children were supplied with dinners on the 217 days on which the centre was open for this purpose. 19 Maternity and Child Welfare Centres (at 31st December, 1947). Name and situation of Centre (Italics indicate voluntary centre) Type of Clinic, etc. Ante-Natal Post-Natal Infant Welfare Toddlers Diphtheria Immunisation Mothercraft All Saints' Parish Hall, Prince of Wales Drive Tuesday, 9.30 a.m. — Tuesday and Thursday, 2 p.m. Thursday,* 9.30 a.m. — — Chatham Hall, Chatham Road Friday, 9.30 a.m. — Tuesday and Friday, 2 p.m. Wednesday,* 9.30 a.m. — — Gideon Road (disused L.C.C. School), Gideon Road Monday, 9.30 a.m. Tuesday, 9.30 a.m. Wednesday and Friday, 2 p.m. Thursday,* 9.30 a.m. — Monday (a), 2 p.m. Nine Elms Baths, Cringle Street — — Tuesday and Thursday (a), 2 p.m. — — Monday (a), 2 p.m. Plough Road Baths, Plough Road Thursday, 9.30 a.m. — Monday and Thursday, 2 p.m. Wednesday,* 9.30 a.m. — Wednesday (a), 2 p.m. Southlands, Shuttleworth Road Wednesday, 9.30 a.m. — Monday and Wednesday, 2 p.m. Monday,* 9.30 a.m. Tuesday, 9.30 a.m. Thursday, 2 p.m. Friday (a), 2 p m. Women's League of Service, Southlands, Shuttleworth Road Tuesday,* 10 a.m. — Tuesday, 2 p.m. — — Mondays (a), 2 p.m. Thursdays (a), 2 p.m. (lectures') * Fortnightly. A Medical Officer attends at all sessions except those marked (a). 20 Summarised Statistics Relating to Infant Welfare Centres, 1947. Municipal. Voluntary Grand Total All Saints' Chatham Road Gideon Road Nine Elms Plough Road Southlands Total Women's League of Service Municipal and Voluntary Sessions held 103 102 102 103 99 102 611 52 663 Weights recorded 4,655 6,421 7,116 2,409 3,313 4,203 28,117 2,261 30,378 Advice only given 572 473 746 299 371 328 2,789 43 2,832 Total attendances 5,227 6,894 7,862 2,708 3,684 4,531 30,906 2,304 33,210 Average per session 50-7 67.6 77.1 26.3 37.1 44.4 50.6 44.3 50.1 First attendances 404 493 468 186 347 339 2,237 166 2,403 Children attended 640 766 734 306 493 522 3,461 270 3,731 Doctor's attendances 78 85 82 52 74 61 432 52 484 „ interviews 1,418 1,832 1,568 696 1,137 1,145 7,796 1,306 9,102 „ average per attendance 18.2 21.6 19.1 13.4 15.3 18.8 18.0 25.9 18.8 Referred to Hospital 123 89 92 46 51 86 487 10 497 (Summary of the work carried out at other centres will be found as under Ante-natal Clinic, page 22; Post-natal Clinic, page 22; Anti-diphtheria Clinic, page 27; Mothercraft classes, page 17; Toddlers' Clinic, page 23.) 21 Health Visitors. The personnel of the health Visiting Staff, which consists of 1 Superintendent Health Visitor and 14 Health Visitors, is set out on Page 3. Facilities are granted by the Council to students of recognised training bodies for practical instruction and training as health visitors and women sanitary inspectors. During the year five students from the Hygiene Department, Battersea Polytechnic, received a course of training under the Council's Maternity and Child Welfare scheme, and, on completion of their training, certificates as to their work were supplied to the Polytechnic authorities. The home visiting carried out during 1947 by the Council's health visitors and those of the voluntary organisations included in the Borough Maternity and Child Welfare scheme is summarised in the following table:- Visits. Council. Vol. Total. Expectant mothers 4,253 385 4,638 Notified births 11,685 969 12,654 Still-births 45 1 46 Children aged 1-5 years 6,405 761 7,166 Infant deaths 83 6 89 Notifiable infectious disease 2,788 193 2,981 Non-notifiable disease 322 14 336 Prevention of diphtheria 66 4 70 Foster mothers and children 217 — 217 Other 760 253 1,013 Totals 26,624 2,586 29,210 Hospital Provision. The Council have made provision for the needs of children requiring special hospital treatment by arrangement with the Victoria Hospital for Children, Chelsea, and the St. Thomas's Babies' Hostel, The Council make an annual grant to these Hospitals in respect of the facilities afforded. Women and children are referred where necessary from the ante-natal and child welfare centres to appropriate institutions, children being usually sent to one of the above-named hospitals. The Council's health visiting staff also visit and report on the home conditions of Battersea women and children receiving treatment in the obstetric, gynaecological and other departments of the various hospitals. 942 cases were referred to hospitals, etc., from the various centres. Dental Clinic. Following the destruction of the Dental Clinic by enemy action, arrangements were made with the London County Council for dental treatment to be carried out at St. James' Hospital, this service commencing in March, 1941. During the year 265 mothers and 102 children were referred to the Clinic, and of these 94 Mothers and 68 children had attended. 22 Ante-Natal Clinics. The subjoined table shows in summary the number of attendances, etc., during 1947, at the municipal ante-natal clinics. Clinics held at All Saints' Chatham Hall Gideon Road Plough Road Southlands Total Sessions 52 51 53 51 53 260 Attendances 708 585 671 640 629 3,233 Attendances average 13.6 11.5 12.7 12.6 11.9 12.4 New cases 276 166 182 207 165 996 Total patients 320 213 242 253 210 1,238 Interviews by doctor 679 565 622 570 569 3,005 Average per session seen by doctor 131 11.1 11.7 11.2 10.7 11.6 Referred to Hospital 34 48 28 30 23 163 In addition 26 sessions were held at the Women's League of Service, the attendances being 335. Of the 109 patients who attended 95 were new and 10 were referred to hospital. Southwark Diocesan Homes. Instead of the usual grant of £150 being paid direct to the Southwark Diocesan Association the Council made an agreed contribution of £109 to a Central Fund out of which the Metropolitan Boroughs' Standing Joint Committee made annual grants to the various Moral Welfare Associations in London. During the year 16 Battersea mothers were admitted to the homes maintained' by the Southwark Diocesan Association and stayed an aggregate of 1,282 days. Post-Natal Clinic. The Post Natal Clinic is held weekly at Gideon Road Infant Welfare Centre. During the year 51 sessions were held and the total number of attendances was 415. The number of patients seen was 272 of whom 264 were new cases. Twenty-nine patients were referred to hospital and 28 who were found to require, on medical grounds, advice on birth control were referred by agreement to the North Kensington Women's Welfare Centre. Premature Infants. In accordance with Circular 20/44 of the Ministry of Health, arrangements were made for information as to the weight of infants to be given on the birth notification when such weight was less than 5½ lbs. 23 Suitable equipment was also purchased so that it could be loaned out if required. In addition, arrangements were made for the services of a paediatrician to be available at the request of general practitioners in such cases as was considered necessary. His services were not called upon during 1947. The following table sets out a record of the number of premature infants who were notified during 1947:— Born No. of premature babies At Home In Hospital Total Notified 28 60 88 Nursed entirely at home 22 — 22 Died during first 24 hours 2 11 13 Survived at the end of one month 23 31 54 Toddlers' Clinic. Toddlers' Clinics are held fortnightly at five of the Infant Welfare Centres. No. of Sessions held 108 „ Attendances 1,049 Referred to Hospital, etc. 153 ,, Dental Clinic 62 Invalid Children's Aid Association. The Battersea Branch of this Association has since 1929 been granted, rent free, the use of a room at Southlands as an office. The Council also make an annual grant, which was increased during the year to £100. Child Life Protection. The statutory provisions relating to infant life protection, so far as London is concerned, are now embodied in the Public Health ( London) Act, 1936. Foster mothers and the children in their care were visited throughout the year by the health visiting staff, who have been appointed by the Council as Infant Life Protection visitors. The number of visits paid by them in 1947 to foster mothers and children Was 217. At the end of 1947 there were 25 Battersea foster-mothers known to the Council, 17 of whom had nurse children in their care to the number of 20. Nurseries. There are in the Borough six Day Nurseries. Four of them are Maintained by the Council and two privately. The expenses of those Maintained by the Council rank for a grant from the Ministry of Health £500 whilst to one of the private nurseries—St. Margaret's—a grant of is made under the block grant scheme of the Ministry of Health, and to the other—Battersea Central Mission—a grant of 1s. per head per attendance is made by the Council, the amount so expended being recoverable from the Ministry. 24 The following table shows the attendances at the Nurseries during the year : — Nursery Places Total Attendances 0—2 2—5 Total Municipal Battersea Park 50 2,585 8,191 10,776 Clapham Common 50 3,770 8,790 12,560 Nightingale Lane 50 2,932 9,107 12,039 Sisters Avenue 40 2,552 7,542 10,094 Total, Municipal 190 11,839 33,630 45,469 Voluntary St. Margaret's 27 1,996 3,495 5,491 Battersea Central Mission 50 - 11,024 11,024 Grand Total 267 13,835 48,149 61,984 Home Helps. Facilities have for many years been provided by the Council in suitable cases for assistance in the home during the mother's lying-in period or in the case of temporary illness of an expectant or nursing mother. This service has been extended so that domestic help can be given in cases of old age, infirmity or illness where considered necessary. In view of the difficulties in securing sufficient help to meet the demand and to ensure adequate supervision the Council appointed a Home Help Organiser, who took up duties in March, 1947. The Home and Domestic Helps who are engaged on a part-time and casual basis are paid at rates laid down by the Joint Industrial Council and the patients are assessed to pay a proportion of the cost in accordance with their means. During the year Home Helps were engaged on 98 cases, the net cost to the Council amounting to £566 8s. 5d. So far as the Domestic Helps are concerned 79 cases were attended, the cost for which amounted to £2,414 18s. 7d., and the contributions from the patients amounted to £279 5s. 7d. The net cost of this service is the subject of reimbursement by the Ministry of Health. St. Thomas's Babies' Hostel. Since 1926 cases have been sent from the Borough Maternity and Child Welfare clinics to this Hostel for the encouragement of breast feeding. The result of this work during 1947 is as follows :— Test Feeds. Number of cases, 81. Number of attendances, 147. In-Patient Treatment. Battersea cases received — 9 mothers and 16 babies. 25 Period of stay. 9 mothers, 238 days, and 16 babies, 855 days; average, mothers 27 days, babies 52 days. A contribution of £400 is made by the Council annually in respect of the work carried out by the Hostel for Battersea mothers. National Dried Milk and Vitamins. Throughout the year, National dried milk, fruit juice and cod liver oil, supplied by the Ministry of Food, have been distributed to children and expectant mothers through the Public Health Department and the Welfare and Ante-natal Clinics. The totals issued through these sources during the year were : National Dried Milk, 21,014 packets; Fruit Juice, 29,439 bottles; Cod Liver Oil, 7,096 bottles, and 1,332 packets of capsules. Nursing Facilities. The Council have made arrangements with the South London District Nursing Association, of 109 Clapham Common North Side, for the nursing of mothers and children under the powers contained in part XII of the Public Health (London) Act, 1936, and also of Patients suffering from certain infectious illnesses. A payment of £300 per annum is made to the Association in respect of their services. ^ The total number of attendances made by the nurses of the District ursing Association in connection with cases of infectious disease Was; ^ Nursing Service, 1947. Name of Disease Age. Total Under 5 years Over 5 years Cases Visits Cases . Visits Cases Visits Fye afflictions 98 1,133 98 1,133 Ophthalmia neonatorum, etc. 4 19 4 19 Ears 39 412 39 412 Measles, etc. 3 19 3 19 Diarrhœa and vomiting 1 2 1 2 Tuberculosis . 3 25 3 25 Impetigo 1 4 1 4 Bronchitis 5 29 5 29 Pemphigus neonatorum 1 2 1 2 Puerperal pyrexia 3 31 3 31 Pneumonia 2 42 27 346 29 388 Influenza 72 112 72 112 her diseases 405 2,593 14 90 419 2,683 Totals 559 4,255 119 604 678 4,859 26 Infectious Diseases. The following table shows the number of cases notified during 1947, and for the purposes of comparison, the average number of cases notified annually in the five years, 1942—46 :— Notified 1947 Average 1942/6 Diphtheria 18 50 Erysipelas 31 45 Scarlet Fever 118 203 Enteric Fever 1 1 Puerperal Fever 6 3 Puerperal Pyrexia 13 10 Meningococcal Meningitis. 5 10 Ophthalmia Neonatorum 12 17 Polio-myelitis, etc. 23 1 Encephalitis Lethargica — — Malaria 2 5 Dysentery 1 14 Pneumonia (Acute Influenzal) 23 27 (Acute Primary) 132 123 Whooping Cough 639 383 Measles 583 1,023 Tuberculosis (all forms) 162 209 Scabies 219 667* Total 1,988 2,791 *Scabies became notifiable on 1st August, 1943; equivalent annual rate. In the aggregate there was a considerable drop in the number of cases of infectious disease notified in 1947 as compared with those of 1946. Of those diseases which showed an increase, reference must be made to Acute Anterior Polio-myelitis.. There was an outbreak of this disease throughout England, the largest that this country has ever experienced. So far as Battersea is concerned the outbreak was not so severe as in some other parts of London. Thirty-five cases were notified, but of these 12 were subsequently cancelled. In addition to these, 12 cases were removed to hospital as suspects but afterwards found not to be suffering from this disease. There was one fatality from Polio-myelitis in the Borough. Whooping Cough is another disease which showed a sharp rise. Acute Primary Pneumonia, which had shown a gradual decline from 1943, again rose during 1947. 27 Notifications of Scarlet Fever, Meningococcal Meningitis, Measles and Scabies showed a very definite decrease. In addition, Diphtheria further declined so that the case rate for this disease has dropped much lower than ever before to 0-16 per 1,000 population, which again Indicates the value of the work carried out at the Diphtheria Immunisation Clinic. An analysis of the cases notified will be found on page 28. Diphtheria Immunisation. Diphtheria immunisation was continued at Southlands and, in edition, immunisation was also carried out at Nine Elms Welfare Centre, where 53 first and 43 second injections were given. The increase in the proportion of children known to have been immunised has been slow and shows that much work still remains to be done before mass-immunity of the population is assured. The estimated figures are as follows :— Age Group. Immunised. Population. 0— 5 3,245 10,130 5—15 7,898 14,330 In the following table the year's work of the Diphtheria Immunisation Clinic is set out in summarised form Sessions held 103 Patients attending (new, 1,688) 2,103 Attendances 5,023 „ (average per Session) 48.7 Patients who completed course of immunisation:— (a) At Clinic 1,197 (b) Elsewhere 365 1,562 Post-Schick Tests 1,258 Readings— Negative 1,215* Positive 31 No Reading (1947) 20 1.266 * Includes 8 from 1946 tests. Arrangements are in force for private practitioners to immunise children who were unable to attend the clinic, and 7 children were immunised in this way during the year, and 1 child received a supplementary inoculation. The Schick test is offered to all children who have been immunised whether at the Council's clinic or elsewhere. It was found that 97.5 pen cent, of the children tested after inoculation were Schick negative. A very stringent standard was maintained in reading the test and most of those found to be Schick positive showed by the mildness of the reaction that they had attained a considerable degree of protection against diphtheria. 28 Analysis of Cases of Infectious Disease notified during the Year. 1947, and Deaths from such Diseases. Notifiable Disease. Cases Notified in Battersea, at Ages (Years). Deaths 0— 1— 2— 3— 4— 5— 10— 15— 25— 45— 65 & over Total Small-pox — - - - - - - - - - Diphtheria 1 - 1 2 1 6 3 —. 4 — 18 __ Erysipelas — - — — — .— — —• 15 8 8 31 - Scarlet fever 1 1 8 11 4 57 20 10 5 1 — 118 - Enteric (typhoid) fever 1 — — — — — — —• — — 1 - Continued fever — . — — — — — — — —. — —. - Puerperal fever — — — — — — 4 2 — — 6 - Puerperal pyrexia — — — — — - 7 6 — — 13 - Meningococcal meningitis 1 1 2 1 — — — — — — — 5 3 Ophthalmia neonatorum 12 — — — — — — | — — — 12 - Polio-myelitis, etc 2 3 5 1 1 6 2 1 2 — — 23 1 Polio-encephalitis — ■ — — — — — — — 1 — — — — Encephalitis lethargica — — — — — — — — — — — — - Malaria - - - - - - - - 2 — —• 2 - Dysentery — — — — — — — — 1 — — 1 - Acute primary pneumonia 9 8 6 — 6 17 4 3 26 30 23 132 - Acute influenzal pneumonia 1 — 1 — 5 — — 5 6 5 23 - Whooping cough 86 113 85 84 72 185 11 1 1 1 — 639 2 Measles 47 85 91 77 69 186 14 5 9 — . — 583 - Scabies S 5 6 5 5 12 17 57 75 24 8 219. - Tuberculosis - Pulmonary 1 2 1 2 — 6 8 41 55 19 5 140 59 Non-pulmonary 1 1 1 2 — 6 5 5 1 — — 22 11 Totals 168 219 207 185 158 486 84 134 ; 209 89 49 1,988 166 29 TUBERCULOSIS. The Tuberculosis Dispensary, which was founded by a voluntary .Society in 1911, was, in the first instance, situated in a private house in Battersea Bridge Road. The Staff originally consisted of a Tuberculosis Officer, Nurse, Dispenser, Secretary and Resident Caretakers. In 1917 an additional Appointment of Health Visitor and Assistant Secretary (joint appointment) was made, but in the subsequent year, on the resignation of the Secretary, her place was filled by the Health Visitor/Assistant Secretary. An additional nurse was appointed in 1919, half of whose time was allocated to duties at Spring well House Open-air School. The staff was subsequently increased by an additional clerk in 1920 a third nurse in 1921, a second clerk in 1926, and a part-time Medical Officer in 1930. The Dispensary passed into the control of the Council in 1921 and was transferred to more suitable premises at Southlands in 1928. In 1940 the Dispensary was destroyed by enemy action and thereafter its work was conducted in what was previously used as a Solarium. The value of the work carried out at the Dispensary can be gauged by the comparative tables which follow. During the year 1947 there were 162 cases of Tuberculosis (all forms) notified in Battersea as compared with 228 in 1946, 199 in 1945, 184 in 1944 and 233 in 1943. In addition, 52 cases were reported or otherwise came to the knowedge of the Medical Officer of Health, making a total of 214 cases for the year. The case rate per 100,000 population was .186.2. Tuberculosis Dispensary. The staff engaged on Tuberculosis work at the Dispensary will be found on pages 3 and 4. Deaths from Tuberculosis. During 1947 deaths from Tuberculosis registered as belonging to the Borough of Battersea numbered 70, of which 59 (i.e., 84.3 per cent.) were due to pulmonary tuberculosis, 11 (i.e., 15.7 per cent.) of other forms of the disease. 30 The death rate per 100,000 of the population during the 47 years ended 1947 in quinquennial averages and in 1946 and 1947 are given in the following table :— Years Pulmonary NonPulmonary Total 1901-1905 138.1 50.9 189.0 1906-1910 126.8 45.9 172.7 1911-1915 124.2 338 158.0 1916-1920 134.8 30.0 164.8 1921-1925 92.6 23.0 115.6 1926-1930 91.1 14.2 105.3 1931-1935 81.8 14.4 96.2 1936-1940 76.1 9.2 85.3 1941-1945 91.8 11.0 102.8 Average (45 years) 106.2 25.8 132.0 1946 76.48 8.3 84.7 1947 51.3 9.6 60.9 Patients and Attendances. In 1947 the number of new patients, contacts and transfer cases added to the Dispensary Register was 905, as compared with 942 in 1946. Of these 694 were discharged as being non-tuberculous; 44 were still under observation at the end of the year, and 167 were found to be suffering from Tuberculosis. Five cases kept under observation during previous years were also found to be suffering from the disease, making a total of 172 new definite cases. Particulars of the 172 positive cases are given on pages 31/32. Old patients to the number of 728 also attended during the year, and the total number of attendances at the Dispensary in 194.7 was 7,735 (of which 6,830 were of old patients), as compared with 7,531 in 1946. Visits to the homes of dispensary patients were made by the Tuberculosis Officers in 249 instances, and 3,572 visits were made by the Dispensary nursing staff, including 418 to patients not on the Dispensary register. The number of deaths of Dispensary patients was 53 as compared with 65 in 1946. Thirty-six of the patients were discharged as " recovered " during the year, and 53 patients removed to other districts or ceased to attend. New Patients. The five following tables contain particulars of the 172 new cases found to be suffering from tuberculosis. In the first table the Pulmonary cases are grouped under two headings : — (1) Group T.B. minus. In those cases Tubercle bacilli have never been found in the sputum. 31 (2) Group T.B. plus. In those cases Tubercle bacilli have been found in the sputum at some time. Group T.B. plus is sub-divided under three headings : — Group I.—Early cases. Group II.—Intermediate cases. Group III.—Advanced cases. A.—Pulmonary Tuberculosis—Age Groups. Years. 0-5 6-10 11-15 16-25 26-35 36-45 46-55 56-65 over 65 Total Group T.B. minus 8 5 5 34 30 5 6 2 — 95 Group T.B. plus Group I 1 — — 3 2 1 — — — 7 Group II — — — 9 20 6 2 2 — 39 Group III — — 3 5 2 — 2 1 13 Total 9 5 5 49 57 14 8 6 1 154 B.—Non-Pulmonary Tuberculosis—Age Groups. Years. 0-5 6-10 11-15 16-25 26-35 36-45 46-55 56-65 over 65 Total Bones and joints 1 1 1 1 2 — - — - 6 Abdominal - - - 1 - - - - - 1 Peripheral glands 1 5 3 1 - - - - - 10 Skin &other organs - - - - 1 - - - 1 Total 2 6 4 3 3 — — -— — 18 C.—Mode of Onset in Pulmonary Cases. Mode of Onset Number of Cases Percentage Cough 34 22.08 Influenza 4 2.60 Pleurisy 11 7.14 Pleurisy with effusion 1 0.65 Haemoptysis 21 13.63 Other modes 83 53.90 Totals 154 100.00 32 D.—Occupations in the 149 cases of Pulmonary Tuberculosis. Occupation No. of Patients Occupation No. of Patients Actor 1 Licensee 1 Bus Conductor 1 Needle worker 1 Carpenter 1 No occupation 2 Cinema Attendants 2 Painters 4 Clerks, various 19 Porters 4 Domestic Workers 4 School Children 23 Draughtsmen 2 Schoolmaster 1 Drivers, Carmen, etc. 4 Sewerman 1 Engineers, various 16 Shop Assistants 2 Factory Workers, various 9 Store-keeper 1 Student 1 Gardener 1 Traveller 1 Housewives 38 Waiters and Waitresses 3 Infants 8 Labourers, various 11 Ex-service 9 Laboratory Assistant 1 E.—Family History of Tuberculosis in Pulmonary and Non-Pulmonary Cases. Near Relative Remote Relative No Family History Pulmonary 36 8 110 Non-Pulmonary 2 — 16 Totals 38 8 126 Of the 172 cases, therefore, a history of Tuberculosis in a near relative was elicited in 22.09 per cent, and in a remote relative in 4.65 per cent. In all 26.74 per cent, gave a family history of Tuberculosis. Contacts. All contacts are asked to attend the Dispensary for examinationHome contacts of infectious cases are encouraged to attend the Dispensary every six months. Institutional Treatment. The London County Council are the authority for the provision of institutional treatment for Tuberculosis in London, and such treatment is supplied free of charge. The number of patients who received institutional treatment under the scheme of the London County Council was 172, and the average length of stay was 239 days. The average period of waiting before admission was 38 days. Of these patients, 123 were discharged during the year, leaving 49 under treatment at the end of the year. Definite improvement as a result of institutional treatment was shown in 96 cases. Twenty patients discharged themselves while undergoing institutional treatment., 33 X-ray Examinations. Since October, 1936, the Council has made use (at scale charges) X-ray apparatus at St. John's Hospital for the examination of tuberculous patients, and during 1947 the Tuberculosis Officer carried out 1,916 X -ray examinations and screenings at that hospital. Artificial Pneumo-thorax Treatment. During 1947 the Tuberculosis Officer carried out at St. John's Hospital artificial Pneumothorax treatment and A. P. P. refills. The number of patients treated was 144 and the number of refills given 2,666. In addition, 2 refills were given to another patient at Brompton Hospital, for which the Council accepted liability. Examinations and Reports. . Bacteriological examinations made during the year numbered 623, the Specimens in 114 cases coming from medical practitioners. The number of positive results was 122, or 19.6 per cent. Reports to public bodies numbered 2,526. Consultations with medical practitioners at the homes of patients and reports made on patients sent to the Dispensary totalled 653. There were 22 patients referred to hospitals, other than for X-ray examination. Extra Nourishment. Extra nourishment was provided during the financial year ended 31st March, 1948, for 16 necessitous dispensary patients at a cost of approximately £90. Handicraft Class. .The Handicraft Class was held on 49 occasions during the year with an average attendance of six. Care Committee. Set out as an Appendix to this Report is an Annual Report and Financial Statement of the Care Committee. CANCER. During 1947 the number of deaths of Battersea residents from Cancer was 252 (males 131, females 121) as compared with 224 in 1946, 214 in 1945, 216 in 1944 and and 227 in 1943. The death rate the disease per 1,000 of the population was 2.19. The deaths from cancer constitute 17.4 per cent, of the total Battersea deaths during the year. The following gives the comparative average death rates from Cancer in Battersea for quinquennial periods since 1896: — 1896-1900 0.52 1926-1930 1.51 1901-1905 0.88 1931-1935 1.75 1906-1910 0.95 1936-1940 1.99 1911-1915 1.11 1941-1945 2.44 1916-1920 1.28 1946 2.06 1921-1925 1.33 1947 2.19 34 The following- table shows the localisation of the disease in the case of the 252 deaths recorded in 1947. Localisation No. of Deaths Percentage of Total Male Female Total Buccal cavity, (Esophagus (M), Uterus (F) 16 12 28 11.1 Stomach and Duodenum 21 10 31 12.3 Breast — 32 32 12.7 All other sites 94 67 161 63.9 Total 131 121 252 100.0 DIABETES. For some years past, with the sanction of the Ministry of Health, the Council has borne the cost of insulin required by certain necessitous patients who were receiving treatment for diabetes at London hospitals. During 1947 insulin was supplied to 21 such cases. Seven deaths from this disease were registered in Battersea in 1947. BACTERIOLOGICAL EXAMINATIONS. The bacteriological examination of clinical material (with the exception of specimens of sputum, which are dealt with at the Tuberculosis Dispensary, vide page 33) is carried out by the Clinical Research Association, of Watergate House, Strand. During 1947 the number of bacteriological examinations of specimens sent in by medical practitioners practising in Battersea was 464 (exclusive of the specimens dealt with at the tuberculosis dispensary). The following table gives particulars of the bacteriological examinations carried out during the year :— Suspected disease Positive Results Negative Results Total Diphtheria 15 447 462 Other — 2 2 Total 15 449 464 The cost of these examinations is borne by the Council, and in 1947 amounted to £70 9s. l1d. 35 Sanitary Circumstances. The following table sets out in summarised form the details of the main work of the Department in relation to sanitation :— Summary of Main Operations for the Year 1947. Sanitary Operations. Inspections— Drainage plans received 74 New houses 119 Frontage drains constructed or reconstructed 15 House-to-house — Houses let in separate tenements - New houses—certificates issued re water supply 119 Houses—following complaints 8,506 Houses supplied with water and fittings repaired ... 178 Houses—following infectious disease 737 Gipsy vans — Additional water supplies to tenement houses 3 common Lodging Houses 37 Water closets provided, supplied with water, or supply disconnected from drinking water cisterns 79 Public urinals and chalets 78 Re-inspections 23,881 Other visits . 6,320 Water closets and urinals cleansed and repaired 920 Notices served— Intimations 4,900 Drinking water cisterns cleansed and repaired 105 Statutory (Sec. 197 and 200) 154 Rain-water and waste pipes disconnected or repaired 361 Statutory (Fifth „ Schedule) 2,722 Summonses issued 159 Soil pipes and drains ventilated 78 Magisterial Orders obtained 52 Defective roofs and gutters repaired 1,445 Drains laid to new houses 119 Dustbins provided 273 Drains relaid (wholly or partly) .40 Yards paved or repaired 158 Premises disinfected 1,067 Drains cleansed and rePaired 486 Persons cleansed (including 3,924 children) 5,165 Drains tested (smoke) 142 Articles disinfected 10,910 do- do. (water) 842 Rat repression— do- found defective 72 premises inspected 2,430 Protection of Food Supply. Nspections— Inspections—contd. Butchers' and other food shops 1,091 Dairies and milk shops 125 Ice cream premises 132 Slaughterhouses 46 Restaurant kitchens 114 Fish shops 99 Samples taken 1,221 Food storage premises 17 Summonses isued 2 36 Summary of Main Operations for the year 1947—contd. Factories, Workshops and Shops. Inspections— Inspections—contd. Shops 7 Outworkers 374 do. (Pharmacy Act) 1 Smoke observations 152 Intimation notices served 38 Factories 309 Workshops 37 Summonses issued - Legal Proceedings. Legal proceedings were taken by the Council during 1947 in respect of 159 contraventions of various Acts, by-laws, etc., administered by the Health Department, and for the recovery of expenses incurred by them in default of owners in two instances. A summary is set out below. Summary of Legal Proceedings. Acts and Regulations under which proceedings taken Cases Fines Costs £ s. d. £ s. d. Public Health (London) Act, and by-laws made thereunder 159 81 0 0 49 6 6 Food and Drugs Act, 1938 2 2 0 0 5 5 0 Total 161 83 0 0 54 11 6 Common Lodging Houses. There are now only two common lodging houses in Battersea, of which particulars are as under :— Premises Males— Lodgers authorised Inspections Notices Prosecutions Served Complied with 75 Falcon Road Females— 21 26 — — — 67 Winstanley Road 50 11 — — — Total 71 37 — — — Systematic inspection of these houses is carried out by the Council's Inspectors and, generally speaking, they are found to be in a sanitary condition, and conducted in accordance with the requirements of the by-laws. Applications for the renewal for one year of the existing licences were granted by the Committee in June. There are no seamen's lodging houses in the Borough. 37 Public Lavatory Accommodation. Six public conveniences for both sexes are provided by the Council in various parts of the Borough, two being underground. In addition to the usual lavatory accommodation (at least one free Water-closet being provided for each sex) facilities for washing are also provided. In addition, two public urinals are maintained. Sanitary Conveniences attached to Licensed Premises. By arrangement with the owners, urinals attached to seven licensed premises have been made available to the general public. Drainage Work. The by-laws made by the London County Council under the Metropolis Management Acts with regard to drainage, and also those under the Public Health (London) Act relating to water-closets, etc., are enforced by the Council. During the year new drains were constructed to 119 new buildings, and the drains of 40 old buildings were partially or entirely reconstructed, under the supervision of the Officers of the Department. During 1947, 3 claims made by the owners that the Council were liable for the reconstruction of the common portion of the drainage systems of their premises were dealt with. In 2 cases liability, wholly or in part, was admitted by the Council. The total expenditure incurred in these 2 cases amounted to £159. In the other case liability was not admitted. Seventy-four plans of proposed drainage work were deposited during 1947, as compared with 78 in 1946. During the year 1947, drains were tested by smoke on 142 occasions. The water test was applied on 842 occasions, this being Mainly applied to drains in course of construction or reconstruction. Water Supply. During 1947 certificates of water supply in respect of 119 houses or tenements were issued in accordance with Section 95 (2) of the public Health (London) Act, 1936. Underground Water Supplies. In accordance with the request of the Ministry of Health contained in their Circular letter 91222/1/46/C, dated 13th August, 1947, a survey of all deep wells known to exist in the Borough has been made, and the report which was submitted to and approved by Council on 28th January, 1948, is set out in the Appendix (see pages 48/55). 38 Personal Cleansing Station. During the year 1947 there were 4,179 children and 986 adults cleansed and treated at the station. Of the 4,179 children attending) 1,224 were suffering from scabies or itch, a contagious parasitic skin affection. The remainder were verminous.. Of these children 3,924 attended from the public elementary schools in the Borough by arrangement with the London County Council, who have entered into a contract with the Borough Council for the use of their Personal Cleansing Station. The cleansing and treatment of the school children is carried out under the supervision of officers of the London County Council while the disinfestation of the clothing and (if necessary) of the homes is carried out concurrently by the Borough Council's sanitary staff. Head Lice.—It has been the practice for many years to refer to the Personal Cleansing Station all cases of head lice discovered by the staff during home visiting, at the Welfare Centres, or at Da)' Nurseries. The following table shows the numbers of persons cleansed and treated at the Personal .Cleansing Station and the expenditure incurred since 1906, the year in which the cleansing of verminous persons was begun : — Number of Baths, &c. Year Adults Children *Expenditure * Amount Contributed Verminous and Scabies Verminous and Scabies £ £ 1906-1915 10,443 6,430 1,037 303 1916-1925 3,269 39,117 5,007 3,155 1926-1935 2,404 39,293 8,521 4,045 1936 265 4,524 723 403 1937 389 4,256 729 403 1938 432 3,808 820 402 1939 534 2,820 795 402 1940 778 3,497 866 404 1941 2,558 5,456 1,026 435 1942 3,083 6,656 1,059 440 1943 2,017 5,223 1,149 422 1944 1,798 3,931 1,100 441 1945 1,885 3,277 1,179 454 1946 1,822 4,229 1,352 443 1947 986 4,179 1,402 424 Total 32,663 136,696 26,765 12,576 * Financial year ending 31st March. Other columns, calendar year. Rats and Mice (Destruction) Act, 1919. This Act imposes on local authorities and occupiers of premises responsibilities in connection with rat repression. 39 The work carried out during 1947 under the Council's Rat Repression scheme is summarised as follows :— Premises visited 2,625 Value of contracts £190 0 0 poison baits used Dead rats found 1,728 Cash for poison bait, etc. £7 9 6 1,173 Contracts made or renewed 18 Drains were tested or examined at 164 premises in connection with this Work, and in 87 cases defects of more or less serious character were found. The presence of rats in houses is usually regarded as Prima facie evidence of drain defects. The work of the Rodent Officer therefore is carried on in close co-operation with that of the district Sanitary Inspectors. During the year two treatments of the sewers under the control of the Council were carried out in accordance with the directions of the Ministry of Food, Infestation Division. 1,565 manholes were baited. Poison bait takes were very good and several hundreds of rats were destroyed. Coroner's Court and Mortuary. Details as to the number of inquests held at the Coroner's Court, and bodies received into the Mortuary during 1947 are set out in lowing table . Battersea Mortuary, 1948. Details of Bodies received Usual place of residence Total Battersea Wandsworth Elsewhere Residence unknown Post-mortem only 121 254 67 4 446 Post-mortem and inquest 42 108 100 7 257 Total post-mortems 163 362 167 11 703 Inquest only — 1 4 — 5 Total inquests 42 109 104 7 262 Sanitary and other reasons 5 1 — 2 8 Total bodies received 168 364 171 13 716 verdicts at inquests held Natural causes 7 15 37 1 60 Accident and misadventure 23 61 55 2 141 Open verdict 8 7 5 4 24 Suicide 4 26 7 — 37 Homicide — - — — — Total 42 109 104 7 262 40 PROTECTION OF FOOD SUPPLY. Slaughter Houses and Knackers' Yards. The duty of licensing knackers and slaughterers of cattle and horses, and the premises used by them, was transferred to the Metropolitan Borough Councils in 1933. At the beginning of this century there were nine premises licensed as slaughterhouses, and the only one now remaining is at No. 345 Battersea Park Road at which only a few animals are slaughtered from time to time. There are no knackers' yards in the Borough. Food and Drugs Act, 1938. The analysis of samples of food and drugs procured under the provisions of the above-mentioned Act, or informally (i.e., without following in detail the procedure prescribed by the Act) is carried out by the Public Analyst for the Borough, at his laboratory at 325 Kennington Road, S.E.1 1. The bacteriological examination of samples (mainly milk) is carried out by the Clinical Research Association, Ltd., at Watergate House, Strand, W.C. The total number of food samples taken under the Act during 1947 was 595, of which 3 or 0.5 per cent, were certified by the Public Analyst to be adulterated. In addition to the foregoing, 605 informal samples were procured, of which 10 or 1.7 per cent, were reported against. The total number of samples certified by the Public Analyst to be adulterated, or not to comply with the requirements of the various Orders or Regulations, was 13, as follows Gelatine.—One formal sample, excess of 80 parts per million of zinc; 2 informal samples, excess of 14 and 6 parts per million respectively of lead, and 1 informal sample, excess of 60 parts per million of zinc. Iodine, Solution of.—Informal samples, 14 per cent, and 20 per cent, respectively deficient in iodine. Fruit Preserving Tablets.—One formal and 1 informal sample, 16 per cent, and 17 per cent, respectively deficient in sulphur dioxide. Malt Vinegar.—One formal sample, 7 per cent, deficient in acetic acid. Condensed Milk.—One informal sample, 7 per cent, deficient in butter fat. Baking Powder.—One informal sample, 16 per cent, deficient in carbon dioxide. Sage.—Excessive insoluble ash (7-5 per cent.). 41 The percentage of samples reported by the Public Analyst to be Iterated during the quinquennia 1921 to 1945 and yearly from 1946, is given in the following table: — Year Formal samples (per cent.) Informal samples (per cent.) Mean 1921—1925 6.4 7.4 „ 1926—1930 3.3 2.4 „ 1931—1935 1.8 2.1 „ 1936—1940 0.9 0.9 „ 1941_1945 1.4 1.1 1946 1.5 1.2 1947 0.5 1.7 The following tables give details of the articles of which samples ei"e obtained for the purpose of analysis. PUBLIC ANALYST'S REPORTS, 1947. TABLE I. Main Statement. Nature of Sample Examined Adulterated Formal Informal Total Formal Informal Total Butter 33 - 33 0 - 0 Cocoa — 10 10 — 0 0 Coffee 13 7 20 0 0 0 Confectionery 8 - 8 0 — 0 Flour, Self-raising 8 — 8 0 — 0 Jam and Marmalade 6 — 6 0 — 0 Lard 1 — 1 0 — 0 Margarine 19 — 19 0 — 0 Meat Products:— Minced Meat 3 - 3 0 — ' 0 Sausages and Sausage Meat 24 12 36 0 0 0 Milk 415 — 415 0 — 0 Milk, Condensed 10 10 20 0 1 1 Vinegar, Malt 14 ' 14 1 0 1 Vinegar, Non-Brewed 7 4 11 0 0 0 Spirits, Whisky 2 — 2 0 — 0 Other Articles 32 409 441 2 7 9 Drugs — 153 153 — 2 2 Total 595 605 1,200 3 10 13 42 Other Articles. Examined Adulterated Nature of Sample Formal Informal Total Formal Informal Total Arrowroot - 1 1 0 0 Baking Mixture - 15 15 - 0 0 Baking Powder - 10 10 - 1 1 Cereal Preparations 2 11 13 0 0 0 Chocolate Preparations - 5 5 1 1 Cocoa Preparations - 2 2 — 0 0 Coffee and Chicory Essence - 6 6 - 0 0 Cooking Fat 8 - 8 0 — 0 Curry Powder — 4 4 — 0 0 Fish, Canned — 1 1 — 0 0 Fish Paste — 57 57 — 0 0 Flavouring Essences — 16 16 — 0 0 Fruit, Dried 6 6 0 — 0 Gelatine 4 11 15 1 3 4 Golden Raising Powder - 2 2 - 0 0 Gravy Preparations — 18 18 — 0 0 Ground Ginger — 9 9 — 0 0 Herbs and Stuffing — 14 14 — ■ 1 1 Jelly 1 — 1 0 — 0 Junket Preparations — 3 3 — 0 0 Lemonade Crystals — 9 9 — 0 0 Lime-juice Substitute 1 1 2 0 0 0 Meat Extract — 9 9 — 0 0 Meat Paste 1 46 47 0 0 0 Meat Pies 6 — 6 0 — 0 Mustard Preparations — 12 12 — 0 0 Oatmeal 1 11 12 0 0 0 Pea Flour — 1 1 — 0 0 Pepper — 14 14 — 0 0 Pickles and Sauces — 41 41 — 0 0 Powder, Blancmange — 1 1 — 0 0 Powder, Custard — 1 1 — 0 0 Pudding Mixtures — 12 12 — ' 0 0 Soup, Canned — 12 12 — 0 0 Soup Powder — 10 10 — 0 0 Spices and Condiments - 30 30 - 0 0 Table Dessert — 1 1 — 0 0 Tablets, Fruit Preserving 1 5 6 1 1 2 Tablets, Saccharin — 7 7 — 0 0 Tomato Savoury 1 — I 0 — 0 Vita-Cup — 1 1 0 0 Total 32 409 441 2 7 6 43 Drugs. Nature of Sample Examined Adulterated Formal Informal Total Formal Informal Total Camphorated Oil - 11 11 - 0 0 Castor Oil — 13 13 — 0 0 Cream of Tartar - 8 8 — 0 0 Effervescent Preparation - 1 1 - 0 0 Epsom Salts — 8 8 — 0 0 Glauber's Salts ' — 2 2 — 0 0 Iodine, Solution of — 6 6 — 2 2 Ointment, Boracic — 10 10 — 0 0 Ointment, Sulphur — 10 10 — 0 0 Ointment, Zinc — 4 4 — 0 0 Paraffin, Liquid — '8 8 — 0 0 Seidlitz Powder — 7 7 — 0 0 Soda, Bicarbonate of — 15 . 15 —. 0 0 Syrup of Figs — 8 8 — 0 0 Tablets, various - 42 42 - 0 0 Total — 153 153 - 2 2 Milk. Of the 415 samples of milk, all of which were formal samples, none were reported as adulterated. . In the 5 years 1942-46, and in 1947, the percentage of adulterated (formal) samples of milk was as under :— Year Samples taken Adulterated No. Percentage 1942 608 3 0.5 1943 576 5 0.9 1944 462 5 1.1 1945 459 2 0.4 1946 430 0 0.0 Mean 507 3 0.6 1947 415 0 0.0 44 The average composition of the 415 samples of milk reported as genuine, proved to be as under :— Total milk solids 12.28 per cent. Milk fat 3.56 „ Non-fatty solids 8.72 „ Milk (Special Designations) Order. The number of licences valid during 1947 was as follows :— Full. Supplemental. " Tuberculin Tested " milk 21 8 Accredited milk — — Pasteurised milk 27 9 48 17 One licence to pasteurise milk was granted and is included in the above figures. In so far as graded milk is concerned 24 of the premises in respect of which full licences were valid during the year were used for the purveyance of both " Tuberculin Tested" and "Pasteurised " milk. Of the remainder 5 were used for "Tuberculin Tested" milk only and 12 for Pasteurised " milk (one for pasteurising). Heat Treated Milk. Samples of heat treated milk are taken at regular intervals for submission to the Public Analyst for phosphatase and methylene blue tests, and during the year samples as under were taken with the results set out:- Phosphatase Satisfactory Failed Methylene Blue Satisfactory Failed Pasteurised 12 - 11 1 Heat Treated 44 2 46 Sterilised 23 _ 23 Ice Cream. The number of premises registered for the manufacture, storage and/or sale of ice cream at the end of the year was 48, 15 having been added and 1 removed. Regulations were issued during the year by the Minister of Health specifying conditions under which ice cream should be manufactured, stored and sold. A copy of the regulations was sent to all occupiers of premises included in the register as well as t0 proprietors of restaurants. Food Shops, etc. 126 premises were on the register for the sale of preserved foods and 50 as fish shops. Street stalls from which food was sold number 93.. These establishments have been subject to systematic inspections- 45 Factories and Homework. Factories and Workshops. The following is a list of the factories on the register at the e«d of 1947 :— Trade Number on Register. Where Mechanical Power IS used Where Mechanical Power is NOT used Baker 38 2 Boot Repairer 20 3 Builder 3 8 Carpenter 4 1 Chocolate Maker 5. 1 Coach Builder 1 2 Cycle Repairer 4 1 Engineer (General) 35 1 Engineer (Motor) 18 13 Farrier — 2 firewood Cutter 6 1 Florist - 2 Food Manufacturer 8 3 Mason 5 1 Printer 12 — Bag Sorter —. 9 Sign Writer — — Laundry 9 1 Wearing Apparel 15 15 Other Trades 78 34 Total 261 100 Twenty-two new factories where mechanical power is used were added to the register, dealing with the following trades:— Baker 2 Painter 1 Cycle Maker 3 Tailor 1 Engineer 4 Other Trades 10 Laundry 1 Nineteen were closed, the total number of factories being '"creased to 261. Five new factories where mechanical power is not used were added to the register, dealing with the following trades : — Engineer 1 Rap- Sorter 1 Food Manufacturer 1 Other Trades 2 Nine were closed, the total number of factories being decreased to 100. 46 Outworkers. During 1947, 71 lists of outworkers were received, viz., 45 from Battersea employers, containing 108 names, and 26 from the Medical Officers of Health of other districts, containing 93 names. After eliminating outworkers not residing in Battersea (of whon 65 names were forwarded to the Medical Officers of the districts concerned) and duplicated entries, there remained the names and addresses of 91 Battersea outworkers. The total number of registered outworkers in the Borough is 13l, of whom 10 are " contractors," i.e., employers of labour for the purpose of the home-work received by them, and many of the premises are workshops within the meaning of the term as used in the Factory and Workshop Act. There were 374 inspections of outworkers' premises, most of which were made by the female inspector. Bakehouses. There were 41 bakehouses in Battersea at the end of 1947, at one of which no person other than the proprietor was employed. Of this total 38 use power and are therefore technically factories. Ten of the 41 are underground bakehouses. Additions to and removals from the list during 1947 were :— New bakehouses Factories—2 Premises closed Factories—1 (1 underground). Housing. New Working Class Dwellings. At the end of the year work was nearing completion on some of the dwellings on the Sheepcote Lane Extension Site, and work was hand on the Honeywell Road Site and in the Hibbert Street Clearance Area. In addition, 118 prefabricated bungalows and one flat were completed during the year on various sites throughout the Borough. Clearance Areas. Hibbert Street (Nos. 1 and 2) Areas.—The Orders in connection with these areas were confirmed in 1938, but progress was held up during the war years. A number of the families residing within this area have been re-housed during the year, and the premises closed. In one part building work was in hand at the end of the year. Demolition and Closing Orders. During the year one house was represented with a view to a Demolition Order being made under Section 11 of the Housing Act, 1936. The owner has given an undertaking to carry out the repairs necessary to make this house fit for habitation, however, and this undertaking was accepted subject to the works being carried out by the 15th May, 1948. 47 Representation was also made with a view to obtaining a Closing Order under Section 12 of the Act in respect of the first and second one house. Further action has been suspended, however, as the owner has voluntarily undertaken to demolish the first and second floor down to the level of the shop premises, and to complete the work within six months. Increase of Rent, etc., Acts. Eleven applications were received from tenants for the certificate the Sanitary Authority under the above-mentioned Acts, and ten certificates were granted. In the eleventh case a certificate was not granted, as all the defects to the premises were considered to be due to war damage. Eight applications from owners for the report of the Sanitary Authority were received, and were granted in each case. Statistics for the Year ended 31st December, 1947. Number of new houses or tenements (including prefabricated dwellings) erected during the year 119 Number of dwelling-houses inspected for housing defects 6,291 (26,562 inspections) Number of dwelling-houses found not to be in all respects reasonably fit for human habitation— (i) Dealt with under Housing Act 2 (ii) Dealt with under Public Health (London) Act 3,579 Number of defective dwelling-houses rendered fit by informal action Nil Number of dwelling-houses in respect of which Statutory Housing Act notices were served requiring repairs Nil Number of dwelling-houses in respect of which Public Health Act notices were served requiring defects to be remedied 3,579 (4,468 intimation notices) Number of dwelling-houses in which defects were remedied after service of formal notices— (i) By owners 3,613 (4,594 intimation notices complied with) (ii) By Local Authority in default of owners 7 Nurnber of dwelling-houses in respect of which Demolition Orders were made Nil Number of dwelling-houses in respect of which an undertaking was accepted under sub-section 3 of section 11 1 Number of dwelling-houses demolished in pursuance of Demolition Orders Nil Number of separate tenements or underground rooms in respect of which Closing Orders were made Nil 48 Appendix. REPORT OF THE MEDICAL OFFICER OF HEALTH ON UNDERGROUND WATER SUPPLIES. In accordance with the request of the Ministry of Health contained in their Circular letter 91222/1/46/C, dated 13th August, 1947, a survey of all deep wells known to exist in the Borough has been made, and I submit herewith my report on them. The total number of well borings is 29, situated at 18 different premises. Particulars are set out in the attached list. For the sake clarity and convenience, they can be classified, and I am dealing with them, under the following headings — (1) Borings in actual use 17 (2) Borings disused, but still open 4 (3) Borings permanently sealed 4 (4) Others 4 29 (1) Borings in Actual Use. Particulars of the premises at which these wells are situated, and important data relative to the borings, are given in the attached list; together with the reports of the Public Analyst on samples of the water taken ,for bacteriological examination and chemical analysis. The reports show that, in general, the water was, at the time the various samples were taken, of a high degree of purity, so high, in fact, that no sample was reported as being unfit for drinking. It is, however, very unwise to place too much reliance upon a single sample, for it is a well-known fact that a well which normally yields water of satis' factory purity may, for various reasons, become so polluted, often in a very short space of time, as to render it dangerous to use the water for human consumption, at least without suitable treatment. It wil be noted that there are 5 wells (4 at the Latchmere Baths and 1 at the Co-operative Wholesale Society's Milk Processing Depot at Silverthorne Road), the water from which is used for drinking. In the case of the Baths, the water is chlorinated before use as a safety measure, and samples for bacteriological examination are taken at fortnightly intervals, with results which have so far been consistently satisfactoryIn the case of the Milk Processing Depot, the water is-used untreated, but the Society have it regularly examined, and copy of their Analys't report is sent to me at quarterly intervals under arrangements made between them and the Council in 1938. Here again, the reports have always been satisfactory. In two further cases, namely, Mark Mayhew, Ltd., and Meux's Brewery, Ltd., the water is used in the processing of wheat and beer respectively. Regarding Meux's, the Analyst reports that tidal water is gaining access to the well, and that the pollution has not been completely removed by natural filtration of this water in its passage through the ground. Although the contamination slight, he recommends that this well be kept under observation. It Will be noted that ingress of tidal water is reported in several wells, after ' it is, I believe, becoming increasingly common over London. This 49 water originates from the lower reaches of the Thames, where river and sea water intermix. It penetrates into the water-bearing strata which in areas are at or close to the surface, and thence reaches the main water reservoir in the chalk under Central London. It is, of course, initially highly polluted, but under .normal conditions the pollution is removed by natural filtration as the water passes through the ground. Occasionally, however, perfect filtration is not achieved, as is evidently happening at Meux's. Although I think it practically certain that any pathogenic organisms would be destroyed in the processing, there is a potential danger which cannot, in my view, be entirely ignored. I consider that further samples should be taken from this well. In the other case (Mark Mayhew) the water is reported free of pollution. Although water from all but the 5 wells already referred to is ostensibly used for drinking, I think it right to mention that, in the course of the visits made by the Council's Inspectors to the various premises to take samples and gather data for this report, it came to light that it is in fact sometimes drunk by employees (in some instances in face of warnings by the factory owners), especially in hot weather when it is much cooler than tap water. I would also refer to the figures, given in the list, of rest-levels and yields. The rest-level, I should explain, is the level to which the water in the boring returns when pumping is suspended for an appreciable time, and is therefore an indication of the rate at which water pumped out is replaced by percolation of fresh supplies from the adjacent strata. I have, of course, had to rely for these figures on information supplied by the well owners, and I have grave doubts about much of it, as most of the firms displayed an ignorance of the figures, especially of the rest-level. All some of them seemed to know was that water came up when the pumps were operated. The general impression gained, however, was that there is a progressive fall going on in the general water level and in the yield. This is in accord with facts already well known. A typical case is provided by the Latchmere Baths, where the four borings formerly provided a supply ample for all requirements. The yield has now fallen to such an extent that pumping on two bores is scarcely worth while, and the others are quite inadequate to meet demands, with the result that their supply has had to supplemented by increasingly large quantities drawn from the mains of the Metropolitan Water Board. It will be noted that in a number of cases there are no arrangements made by the well owners for the regular examination of the purity of the water. I shall be referring in more detail to this later in my report. (2) Borings Disused, but still Open. There are three wells coming within this category, viz.:— Pure Water Co., Ltd., 274/276 Queenstown Road, S.W.8. One boring. The following information has been obtained from Messrs. Clayton Bros., Mineral Water Manufacturers, of East Hill, S.W.18, of which firm the Pure Water Co. is a subsidiary. The well was sunk in 1897, and from then until 1938 the water was in constant use for the manufacture of Table waters. It was submitted to regular chemical and bacteriological examinations, and proved of consistently good quality. In 1938, however, the yield began to 50 fall off. The boring was then deepened by 50 feet, but this made little difference. About the end of 1940 or beginning of 1941, samples began to show the presence of coliform organisms, indicating organic pollution, and use of the water was thereupon discontinued. The cause of the pollution was suspected to be fracture of the upper part of the well lining tube, resulting from bombing in the vicinity. In 1943, and again early in 1944, further works were carried out, but no material improvement resulted. Towards the end of 1944, an entirely new lining, 240 feet deep and 7 inches in diameter, was put down inside the old lining, which was 8½ inches in diameter, at a further cost of £667 18s. 0d. The account for this work, carried out by Messrs. LeGrand, Sutcliff & Gell, Ltd., was produced. Further samples were then taken and submitted to several different Analysts. The results were conflicting, some samples being reported satisfactory and others to contain coliform organisms, some of faecal type, in 100 c.c., 10 c.c. and 1 c.c. In view of the uncertainty of the position, the firm ultimately decided to abandon the use of the well, and state they will have the boring sealed as soon as opportunity offers. It was not possible to obtain a sample of the water, as the pump is out of order. This case is of special interest, as being of the type to which particular reference is made in the Ministry's letter. 140 Battersea Park Road, .S.1L.11. Two borings. The well here was, it is understood, used by the previous occupiers, Messrs. Spiers & Pond, Ltd., for their business of launderers. They left the premises in January, 1942, and since then the well has not, so far as can be ascertained, been used. The present occupiers, Messrs. Dalanium, Ltd., a firm of engineers, state that they do not propose to use it, but have made no arrangements to have it sealed. No sample of the water could be obtained, as the pumps were out of order. Battersea Borough Council Public Baths, Battersea Park Road, S.W.8. One boring. One of the two borings here is in use and has already been mentioned under Category 1. The Baths Superintendent informs me that the other has been out of use since September, 1943. Prior to that date, the yield had been falling off, and on examination it was found that the borehole (originally 440 feet deep) had silted up to the extent of 84 feet. Efforts by Messrs. LeGrand, Sutcliff & Gefl, Ltd., to clear the silt failed, and it was therefore decided to abandon the boring. Instructions have now been given for it to be sealed. I would draw special attention to the existence of the above three disused borings. They represent a particularly serious danger, as in the event of their becoming polluted, the pollution is likely to remain undiscovered until, perhaps, it contaminates some other well. (3) Borings Sealed. There are 3 premises within this category, as under:— Garton, Sons & Co., Ltd., Southampton Place, York Road, S.W.11. Two borings. Price's Patent Candle Co., Ltd., Belmont Works, York Road, S.W. 11. One boring. Meux's Brewery, Ltd., 27 Nine Elms Lane, S. W.8. One boring. 51 In all these cases the firms state that the borings were abandoned and sealed many years ago. The reasons for the abandonments could not be ascertained. Assuming the statements to be correct, the wells in this category call for no comment. (4) Other Wells. In the Catalogue of London Wells, published by the Geological Survey of the Department of Scientific and Industrial Research, there are references to four further borings, as under:— Formerly Orlando Jones & Co., York Road, S.W.ll. Two borings. From enquiries made, it appears that this firm's premises were situated on the Riverside between Steelworks Road and Chatfield Road. They went out of business about 45 years ago, and their premises were subsequently taken over by, and now form part of the works of Messrs. A.D. Dawnay, Ltd., Structural Engineers, of Steelworks Road, S.W.ll. Ah, traces of the wells appear, however, to have been lost, and their exact location cannot be identified. It is not known whether they were ever sealed. Formerly Beaufoy's "Pays Bus" Works; Hanbury Road, S.W.11. Two borings. There is no factory now existing in or near Hanbury Road, and all trace of the location of these borings appears to have been lost. It is not known whether they were ever sealed. In the complete absence of information regarding the above wells, it is, course, impossible for me to make any comment on them. to ^av'ng reported in detail on the various wells, it remains for me summarise and to put forward, for the consideration of the Council, trtain observations and recommendations. To consider first, as being of more immediate concern, the 7 wells seel either for drinking purposes or in connection with the manufacture ! human food and drink, the position in regard to 6 of them is, at c moment, satisfactory. I have already commented on the seventh n. .UX s Brewery). I would, however, again emphasise the point I J eViously made in regard to the possibility of pollution gaining access f° wells which normally give good quality waters. This may arise not . 'y from the development of some fault in the well itself, but also ^.0tri polluted water from some other well—perhaps some considerable ^'stance away—or from imperfectly filtered tidal water, reaching the ater-bearing strata and thence being drawn into the good well. Pollu^°n may be gradual in its onset, but may equally well be rapid, with e result that, unless frequent examinations are made of the water, th °Vtbreak some water-borne disease may be the first intimation b ^ ^ bas occurre(I- While regular bacteriological examinations are e'ng made of the 5 wells used for drinking, they are not in the two Sed for the manufacture of food and drink, nor in the remaining wells *ed for other purposes, or disused. Furthermore, even regular rlr^Pfing can do no more than reveal that pollution is already occurring, l( 1 f it had reached a serious degree the affected well would have to 'e dosed until the cause of the trouble could be located and remedied, Undertaking which is likely to prove both length}' and expensive, 52 especially if it arises from another well not subject to regular examination. This brings into consideration all the other wells (except, of course, those permanently sealed) and raises the question of the desirability of regular examination of all of them, on the principle that " prevention is better than cure." I have always felt such examinations to be desirable, but as they necessarily involve some amount ot trouble and expense, and cases of noticeable pollution have hitherto been rare, it would have been difficult to justify them. I think, however, that the position has now materially altered, and the Ministry's letter indicates that they, too, are concerned about it, especially in regard to disused wells. I am led to that conclusion by three main facts—the increasing age of the borings—implying correspondingly increasing risk of failure of the lining tubes through deterioration; the possibility of latent damage by enemy action; and the progressive lowering of the water level in the chalk, consequent upon intensive pumping, whereby the risk of drawing in polluted water has increased. Bacteriological examination is of more importance than chemical analysis, as it provides much more definite evidence of the condition of the water. As to the frequency with which examinations should be made, it is somewhat difficult to advise. In view of the rapidity with which pollution may arise, it would, in theory, be almost impossible to have them too often, but, as already stated, they involve trouble and expense (particularly in a well not regularly used, where, in order to obtain a proper sample, the water would have to be pumped to waste for several hours to remove any superficial contamination of the pumping apparatus due to it standing idle). As a compromise, I do not think that intervals of two months for bacteriological examination, and twelve months for chemical analysis, would be unreasonable. On the subject of legal powers to deal with polluted wells, the Ministry, in their letter, call attention to powers now available to the Council under Section 21 of the Water Act, 1945, whereby any act or neglect causing or likely to cause pollution of any spring, well, or adit, the water from which is used or likely to be used for human consumP' tion or domestic purposes, or for manufacturing food or drink for human consumption, is made a punishable offence. These powers do not seem to differ materially from those previously provided, and still existing, under Section 102 of the Public Health (London) Act, 1936Moreover, Section 103 of the latter Act enables the Courts, on an application by the Council, to close such a well if it is polluted, a power which is not contained in the 1945 Act. Neither of the Acts, however, appears to give any power to take action in regard to a well not used for the purposes stated above, however polluted it may be known to be, except possibly in the very unlikely existence of positive proof that it lS polluting another well that was so used. The Minister has power, under Section 6 of the 1945 Act, to make Regulations requiring records to be kept, and returns submitted, of the quantity and quality of water abstracted from wells, and such other matter as he may prescribeHe has, in fact, recently made Regulations, but they relate to such physical data as quantities of water abstracted, rest levels and pumping levels, and do not require examinations of the quality of the water unless specifically asked for. In an explanatory memorandum issued with the Regulations, it is stated that such examinations will not, in general, be required more often than once in five years. The Regulations are enforceable by the Minister and not by the Council. 53 In conclusion, I would put forward, for the consideration of the Council, the following recommendations:— (a) That the occupier of every premises in which there is a well sunk into the chalk, whether that well is in use or disused (unless in the latter case the boring has been effectively and permanently sealed), and for whatever purposes the water may be used, should be required, at his own expense, to submit samples of the water to a competent and independent person, for bacteriological examination at intervals of two months, and for chemical analysis at intervals of twelve months. Where there are two or more borings, whether or not interconnected for pumping purposes, each should be regarded as a separate well and separate samples submitted in respect of each boring. (b) That the occupier, on receipt of the reports on the examination and analysis, should be required forthwith to transmit copies to the Medical Officer of Health for the district. (c) That the Medical Officer of Health, if he is satisfied, from the reports, that the water is polluted to a degree dangerous to health, in whatever manner that danger may be apprehended, should be empowered to give notice to the occupier requiring him immediately to discontinue use of the water (if it is being used) either entirely or for such purposes as may be specified, and to take all requisite steps to ascertain and remove the cause of the pollution, or alternatively to have the well permanently and effectively sealed. (d) That where the occupier has taken steps to remove the cause of the pollution in consequence of a notice served on him under (c) above, he should have the right to apply to the Medical Officer of Health for the revocation of the notice. Power should be given to the latter, before complying with the request, to require the occupier to furnish such further reports on the quality as he may consider reasonably necessary, and also to make the revocation conditional upon the occupier restricting use of the water to such purposes as may be specified. (e) That right of appeal should be provided to the occupier against any action taken by the Medical Officer of Health under (c) or (d) above. (f) That the Medical Officer of Health should be required to report to his Local Authority and to the Minister of Health, all actions taken by him under the above powers. It is, of course, appreciated that to provide some of the powers suggested in these recommendations would involve additional G. Macdonald, Medical Officer of Health. Public Health Dept., Electric House, 204 Lavender Hill, S.W.11. January, 1948. 54 55 Premises BATTERSEA BOROUGH COUNCIL ELECTRICITY STATION, Lombard Road, S.W.11. BATTERSEA BOROUGH COUNCIL PUBLIC BATHS, Latchmere Road, S.W.ll— Bore No. 1 Bore No. 2 Bore No. 3 Estate Well MARK MAYHEW, LTD., 112 Battersea Church Road, S.W.ll. MORGAN CRUCIBLE CO., LTD., Battersea Church Road, S.W.ll. MEUX'S BREWERY CO., LTD., Nine Elms Lane, S.W.8. Ditto. GAS LIGHT & COKE CO.. LTD., 109 Nine Elms Lane, S.W.8— Bore No. 1 Bore No. 2 Bore No. 3 T. & W. FARMILOE, LTD., 88 Nine Elms Lane, S.W.8. RATTERSEA BOROUGH COUNCIL PUBLIC BATHS, Battersea Park Road, S.W.8. Ditto. SOUTHERN RAILWAY, Stewarts Lane, Loco. Depot, Silverthorne Road, S.W.8. SOUTHERN RAILWAY, Nine Elms Loco. Depot, S.W.8. LONDON & PROVINCIAL STEAM LAUNDRY CO., LTD., 154 Battersea Park Road, S.W.ll. CO-OPERATIVE WHOLESALE SOC., LTD., Milk Processing Depot, Silverthorne Road, S.W.8. PURE WATER CO., LTD., 274/276 Queenstown Road, S.W.8. 140 Battersea Park Road, S.W.ll. (2 .borings) GARTON, SONS & CO., LTD., Southampton Place, York Road, S.W.ll. (2 borings) PRICE'S PATENT CANDLE CO., LTD., Belmont Works, York Road. S.W.ll. Formerly ORLANDO JONES & CO., York Road, S.W.ll. (2 borings) Formerly BEAUFOY'S "PAYS BAS," WORKS, Hanbury Road, S.W.ll. (2 borings) Geological Survey Catalogue No. L 16 L 17 and L 18 L 19 L 20 M 20 M 19 M 21 M 22 M 23 M 23 M 24 M 25 M 28 M 30 M 26 M 27 L 14 L 15 L 13 M 29 Water used for Boiler feed Public baths and washhouses, also domestic supply to Latchmere Housing Estate Wheat washing and general factory purposes (not drinking water) Processing Brewing Disused and sealed See Processing Processing Public baths and washhouses Disused. See heading 2 Locomotive washing and boiler feed Locomotive washing and boiler feed Boiler feed General dairy purposes, also drinking water Disused, but bore still open. Disused, but bore still open. Disused and sealed. See Disused and sealed. See No information available No information available Rest-level of water (O.D. Liverpool) Between —205 and —235 —280 —272 —243 —314 Not known —310 —131 heading 3 in —125 —140 —140 —240 —121 in the report Not supplied Not supplied —138 (in 1937) Not supplied See heading See heading heading 3 in heading 3 in See heading 4 See heading 4 Routine Tests by Well Owners. (???) Chemical (???)Occasionally (???)None (???)None (???)None (???)None (???)None (???)Occasionally (???)Irregularly (???)Daily (???)Occasionally (???)Quarterly (???)Monthly (???) (???) (???) (???) (???) (???) Bacteriological None Fortnightly sample from storage tank into which all wells deliver None None Irregularly Irregularly Irregularly None None None None Monthly Sample taken by Council 11/11/47 20/10/47 20/10/47 20/10/47 20/10/47 5/11/47 5/11/47 1/11/47 19/11/47 12/11/47 11/11/47 28/10/47 29/10/47 18/11/47 18/11/47 29/10/47 28/10/47 Analyst's Report Satisfactory. Slight contamination owing to bore being out of use. Satisfactory. Satisfactory. As for bore No. 1. Satisfactory. Satisfactory. Contains tidal water. Slight contamination probably due to imperfect filtration of river waterShould be kept under observation. Satisfactory, but tidal water gain ing access to wells. Satisfactory, but tidal water gain ing access to well. Satisfactory, but tidal water gain ing access to well. Satisfactory. Satisfactory, but tidal water gain ing access to well. Satisfactory. Satisfactory. Remarks. — Bore little used owing to low yield. — — As for bore No. 1. Quarterly bacteriological reports submitted by well owners to Council. 56 ANNUAL REPORT OF THE TUBERCULOSIS CARE COMMITTEE. For the Year ended 31st December, 1947. The Care Committee held eleven meetings during 1947 and the following cases were referred to suitable agencies for assistance :— Social Welfare Committee 30 British Legion 6 Family Welfare Association 8 Other Agencies 13 Battersea Borough Council— Extra Nourishment 33 Dentures 1 Beds and Bedding 7 In addition the Care Committee has its own Voluntary Fund from which loans and grants was made to 29 necessitous cases not eligible or suitable for help from other sources. The Care Committee received a grant of 150 articles of new clothing from Queen Mary's London Needlework Guild. These were distributed to necessitous cases attending the Dispensary or being sent away for institutional treatment. The necessary clothing coupons have, of course, to be collected for these articles (474). The Committee have granted 16 applications for the loan of invalid requisites during the year. The Care Committee Secretary visits the Tuberculosis Wards of St. John's Hospital (the local L.C.C. General Hospital) each week with a view to keeping in touch with the patients there and attending to their needs and the needs of their families during the patient's absence. The Chairman of the Committee visits these patients at Christmas time to distribute a small sum of money to each Battersea patient in the Wards, and visits are paid at varying intervals by other members of the Committee. From their Voluntary Fund the Committee have, during the year, made immediate advances of money on loan to patients, or their dependants, pending payment under the Tuberculosis Allowance Scheme. Advances of this kind have been made in 71 cases and the total sum advanced amounted to £96 8s. 6d. The whole of this amount was recovered when the allowances were received. By advancing these amounts, the Committee are able to prevent hardship and difficulty arising pending the official payment. The Committee have to report with great regret the death of Mrs. Bowler on January 21st, 1947. She had been a member of the Tuberculosis Care Committee for many years and Chairman of the Committee since 1944. The Committee would also like to thank The National Deposit Friendly Society and the London Co-operative Society and other subscribers who continued their help throughout the year, and the Family Welfare Association, British Red Cross Society, British Legion and other Societies for their help and support in dealing with cases. 57 The distribution of gift foods from the Dominions to the tuberculosis patients and their families was continued throughout 1947, and has been of very great assistance to the many deserving cases being dealt with at the Dispensary. Handicraft Class. The Handicraft Class was held at the Dispensary on 49 occasions and there was an average attendance of six patients. This Class continues to meet a need of men and women patients awaiting sanatorium treatment, or returning from sanatorium, who are temporarily unfit tor work, also for patients who are unlikely to be able to return to Work again. It provides them with something to occupy their minds and distracts their attention from their condition. A teacher is provided by the London County Council and the students are taught all branches of leather work, needlework and embroidery, making of fireside stools, rug-making or, in fact, any branch of handicraft that they feel inclined to take up. Although the students are constantly changing—some returning to work, others proceeding to institutional treatment, etc.— a very high standard of work has been maintained. The Tuberculosis Care Committee is responsible for this class, the expenses for which are met from the Care Committee Fund, which is derived from voluntary sources. The Borough Council provides the necessary accommodation, lighting and heating. An audited statement of receipts and payments of this Fund is included in this report. Battersea Tuberculosis Care Committee and Handicraft Fund. Statement of Receipts and Payments for Year ended 31st December, 1947. Receipts. Payments. £ s. d. £ s. d. Balance at Jan. 1st, 1947 80 15 2 Materials purchased for Handicraft Class 61 0 1 Granada Theatres, Ltd. 51 5 8 Patients' Contributions 6 7 6 Comforts for Invalids ant help in kind for patients in hospital 15 13 7 Other Contributions:— Co-op. Wholesale Society, Ltd. Loans advanced 8 3 10 2 2 0 Payments to patients for work 5 15 8 National Deposit Friendly Society 5 5 0 Grants to necessitous cases Maintenance allowances advanced 78 3 5 Mrs. Henstock 1 0 0 E. Young 10 0 96 8 6 1 9 1 Goods sold from Handicraft Class 64 6 5 Postages 2 0 Balances at Dec. 31st, 1947: Loans repaid 4 12 6 Cash at Bank £24 9 1 Maintenance allowances repaid 95 1 0 Cash in hands of Hon. Sec. 20 0 0 44 9 1 £311 5 3 £311 5 3 (Signed) H. W. Coleman, Hon Treasurer. June 30th, 1948. (Signed) E. A. Cooper, Chairman. July 2nd, 1948. ■