AC4386 BAT 47 Metropolitan Borough of Battersea. REPORT on the HEALTH of the Metropolitan Borough of Battersea, FOR THE YEAR 1948 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 1948 \ 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, 1947. Chairman : Councillor Miss E. A. Coles, 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. As constituted 9th November, 1948. Chairman : Councillor Miss E. A. Coles, 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. Councillor R. C. Hudson. Alderman Mrs. H. E. Hughes. Councillor 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. 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. Mr. 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 Brompton 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. † Deputy M.O.H. and Tuberculosis Officer J. G. S. McQueen, m.d., d.p.h. *Assistant Medical Officers (Maternity and Child Welfare) (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. *Medical Officer, Southlands AnteNatal Clinic (Miss) Alice Bloomfield, m.d., f.r.c.s., f.c.o.g, *Medical Officer, Post-Natal Clinic (Mrs.) M. A. Radford, m.b., b.s., d.p.h. * Medical Officer, Nine Elms Centre † Assistant Medical Officer (Tuberculosis, part time, temporary) (Miss) E. M. Saxton, m.d. (Mrs.) M. K. McAllen, m.d.. m.r.c.s., l.r.c.p. Public Analyst J. E. Woodhead, b.sc., f.i.c., ph.c. Chief Sanitary Inspector F. H. Chutfr (a c). Sanitary Inspectors : District. 1. W. E. Selway (b c). 2. G. W. P. Weeks (b c). S. W. Simpson-Scott (b c). 4- P. D. O'Grady (b c). J. R. Glover (b c). 6- R. J. McCarthy (a c). A. Webb (b c). 8. J. R. Hoi.loway (a c). 9. P. Ianson (b c). 10. J. J. K. Helmer (b c) (appointed 1/4/1948). 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). (Miss) 1. B. Abbott (e f g). „ k. I. Brown (e f g). „ W. M. Llewellyn (e f g). „ E. Gilroy (e f g). „ M. F. Wellf.r (e f g) „ D. Pipe (e f g). „ M. Heaton (e f g). *Principal Administrative Assistant H. C. Godfrey (a). Administrative and Clerical Staff : 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. K. A. Pye. Home Help Organiser Miss E. Fonceca (f) (For notes see next page.) 4 Staff (Continued). Tuberculosis Dispensary— *Tuberculosis Nurses—(Miss) M. Schotborgh (eg 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. Wf.rrett. 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. (r) Meat and other Foods certificate, Royal Sanitary Institute, or Sanitary Inspectors' Examination Board. (d) Health Visitors' certificate, Board of Education. (e) „ „ „ Royal Sanitary Institute. (/) State certified midwife. (g) State registered nurse. (h) Tuberculosis certificate. * These Officers were transferred to the London County Council on the 5th July, 1948, consequence of the operation of the National Health Service, † These Officers were transferred to the Hospitals Board on the 5th July, 1948, in consequence of the operation of the National Health Service. INDEX TO SECTIONS. page Preface 5 Staff of the Public Health Department 3 Principal Figures for 1948 6 Vital Statistics 7 Maternity and Child Welfare 14 Infectious Diseases 22 Tuberculosis 24 Cancer 27 Bacteriological Examinations 28 Sanitary Circumstances 29 Protection of Food Supply : (a) Inspection of Food Premises 37 (b) Sampling of Food and Drugs 41 Housing 47 Factories and Homework 51 Miscellaneous Matters 54 5 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Battersea. Mr. Mayor, Ladies and Gentlemen, I present herewith my report upon the Health and Sanitary conditions of the Borough during the year 1948. On July 5th, 1948, under the National Health Service Act, certain services, which for many years were administered by the Borough Council, were transferred to the London County Council and the Regional Hospital Board. As a result of this, a number of officers were transferred to the authorities concerned. Many of these had rendered valuable service to the Council for many years. I have no doubt that the experience which they gained in the Council's service will be of the greatest value to the new Authorities under whom they now work and that they will give to them the loyal and devoted service which they have given to your Council in the past. During the year there was an increase in the number of cases of infectious diseases as compared with the previous year, mainly as a result of the increase in the cases of measles. There were five cases of Poliomyelitis as compared with 23 in 1947 and the number of notifications of Scabies was markedly reduced. A clinic for immunisation against Whooping Cough was opened at Southlands during the year and many parents availed themselves of the opportunity to have their children immunised. There were no deaths from Diphtheria during the year. The housing situation in the Borough is one of considerable difficulty and much of the work of the Sanitary Inspectors is concerned with the investigation of complaints received in the Department. The time taken to secure the abatement of nuisances is, for various reasons, generally more prolonged than it was in pre-war years and entails many more visits to premises by the Inspectors. Overcrowding is still Prevalent in the Borough, although a large number of overcrowded families were rehoused during the year. I wish to thank the Mayor and Members of the Borough Council, and more particularly the Chairman and Members of the Health, Maternity and Child Welfare Committee for the continued encouragement and assistance 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 always 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. 6 Principal Figures for 1948. Area of Borough, excluding tidal water (acres) 2,163 Population (Registrar-General's mid-year estimate) 116,500 Structurally separate occupied dwellings 26,843 Rateable value—£969,273. Sum produced by Id. rate £3,991 Births (live, 2,248; still, 46) 2,294 Live birth rate 19.30 Deaths—1,314. Death rate 11.28 Maternal deaths—3. Maternal death rate 1.00 Infant deaths—71. Infant mortality rate 31.58 7 Vital Statistics. The Registrar-General's estimate of the 1948 mid-year population of Battersea was 116,500 as compared with 114,960 in 1947. The population of Battersea at the census taken in April, 1931, was 159,552, and the Registrar-General's estimate for 1948, therefore, indicates a decrease of 43,052 (or 27 per cent.) since the census, but an increase of 1,540 during 1947/8. The Registrar-General's estimate of the mid-year population of the Borough (116,500) has been adopted for the purpose of the statistics contained in this Report. BIRTHS. The number of live births registered in the Borough during 1948 was 2,527 (1,271 male, 1,256 female). Of this number 1,112 were transferred out, the permanent residence of the parents being outside the Borough, and 833 registered outside the Borough were transferred in, giving on balance a total of 2,248 births (1,104 male, 1,144 female, an excess of 40 females) relating to Battersea residents, and a live birth rate of 19.30 per 1,000 of the population. This is a decrease of 3.86 on that of 1947. Of the Battersea births (live and still) which occurred within the Borough, 909 were " domiciliary births." Illegitimate births numbered 158, or 7.0 per cent. of the live births. The number of births occurring in each quarter of the year is shown in the table on page 13. The live birth rate for the County of London was 20.1 per 1,000 of the population, and for England and Wales the rate was 17.9. Still-Births. The registration of still-births is made compulsory by the Births and Deaths Registration Act, 1926. During 1948 there were 58 still-births registered in Battersea, of which 22 were of Battersea parents. 24 still-births occurring outside the Borough were registered as belonging to Battersea, making 46 in all, representing a still-birth rate of 20.05 per 1,000 births (live and still) registered. Of the 46 still-births 3 (6.5 per cent.) were registered as iilegitimate. The number of Battersea still-births registered, and the still-birth rates from 1939 to 1948 were as under : — No. Rate No. Rate 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 1948 46 20.1 1943 36 21.6 Mean 1944 40 24.0 1939-48 46 24.2 8 Notification of Births. During 1948 the number of notifications of live births received belonging to the Borough was 2,195. The corrected number of Battersea births registered during the year was 2,248. The proportion of notified to registered births was, therefore, 97.6 per cent. Forty-five still-births were notified under the provisions of the Public Health (London) Act, 1936, during the year, the number notified being 97.8 per cent. of the total Battersea still-births registered. The homes from which births are notified are visited and revisited by the Health Visitors. MARRIAGES. The marriages registered in Battersea during 1948 numbered 988. The marriage rate (i.e., the number of persons married per 1,000 of the population) was 17.0. Year. Marriages. Marriage-Rate. 1943 810 18.4 1944 730 17.1 1945 1,082 23.9 1946 1,043 19.2 1947 1,085 18.9 Mean, 1943-47 950 19.5 1948 988 17.0 DEATHS. The number of deaths registered in the Borough during 1948 was 1,840. Of these 1,039 were deaths of non-residents and were transferred to the districts in which the persons ordinarily resided. There were, on the other hand, 513 deaths of Battersea residents registered outside the Borough. The total (corrected) number of deaths belonging to the Borough was 1,314 (males 697, females 617). This gives a recorded death rate of 11.28, compared with 11.6 for London, and 10.8 for England and Wales, and a decrease of 1.30 on 1947. The following table shows the age and sex distribution of the total deaths (corrected) in Battersea during 1948 : — Under 1 year 1— 5— 15— 45— 65 + Total. M 43 6 4 59 196 389 697 F 28 7 4 48 113 417 617 Totals 71 13 8 107 309 806 1,314 % of Total 5.4 1.0 0.6 8.1 23.5 61.4 100 9 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. Mean, 1939/1943 60.7 1944 59.9 1945 62.4 1946 61.4 1947 62.6 1948 63.3 Mean, 1944/1948 61.9 During 1948 the deaths of 806 residents of Battersea aged 65 years and upwards were registered. The distribution of these deaths, which constituted 61-4 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 84 65 60 71 12 I 24 156 160 316 South Battersea 127 85 89 134 17 38 233 257 490 Borough 211 150 149 205 29 62 389 417 806 The number of infant deaths in each quarter of the year is shown in the table on page 13. The natural increase of population (that is, excess of births over deaths) was 934 in 1948 as compared with 1,217 in 1947. The causes of the 1,314 deaths occurring in 1948 classified in various age groups, are shown in the following tables. 10 Causes of Death at different Periods, of Life in Battersea during 1948. The following table is supplied by the Registrar-General :— Causes of Death. Sex. All Ages. 0— 1— 5— 15— 45— 65— All Causes M. 697 43 6 4 59 196 389 F. 617 28 7 4 48 113 417 1. Typhoid and para. typhoid fevers M. - - - - - - - F. - - - - - - - 2. Cerebro-spinal fever M. - - - - - - F. 2 1 — — 1 — — 3. Scarlet fever M - - - - - - - F. 1 — 1 — — — — 4. Whooping cough M. 2 2 F. - - - - - - - 5. Diphtheria M. - - - - - - - F. - - - - - - - 6. Tuberculosis of respiratory system M. 47 — — 1 12 23 11 F. 22 — 1 — 17 3 1 7. Other forms of tuberculosis M. 6 2 2 1 1 - F. 2 — 1 — 1 — —. 8. Syphilitic diseases M. 4 — — — .1 1 2 F. 2 - - - - - 2 9. Influenza M. 1 - - - 1 _ F. 1 - - - - - 1 10. Measles M. - — .— F. 1 — 1 — — — — 11. Ac. polio-myelitis and polio-encephalitis M. 1 1 -* F. - - - - - - - 12. Ac. infective encephalitis M. - - - - - - - F. 1 — — — — 1 — 13. Cancer of bu ccal cavity and oesophagus (M.) uterus (F.) M 7 - - - 1 1 5 F. 7 — — — - 3 4 14. Cancer of stomach and duodenum M. 22 1 9 12 F. 17 — — — — 6 11 15. Cancer of breast M. 1 - - - - - 1 F. 23 — — — 2 10 11 16. Cancer of other sites M 96 - 1 6 35 54 F. 59 — — — 4 17 38 17. Diabetes M. 1 - - - - - 1 F. 10 — — — — 4 6 18. Intra-eranial vascular lesions M. 50 - - 1 11 38 F. 58 — — — 1 9 48 19. Heart disease M. 202 - - - 10 47 145 F. 195 — —- — 4 27 164 11 Causes of Death, 1948—(contd.). Causes of Death. Sex All Ages. 0— 1— 5- 15— 45— 65— 20. Other diseases of circulatory system M. 17 - - - _ 5 12 F. 25 — — — 1 2 22 21. Bronchitis M. 62 3 1 - 2 19 37 F. 38 1 — — 1 9 27 22. Pneumonia. M. 46 11 - - 1 16 18 F. 29 6 1 — 3 3 16 23. Other respiratory diseases M. 11 - _ - 4 7 F. 3 — — — 1 — 2 24. Ulcer of stomach or duodenum M. 13 - - -_ 3 5 5 F. 6 — — —. 1 2 3 25. Diarrhoea (under 2 years) M. 4 4 - - - _ F. 2 2 — — — — — 26. Appendicitis M - - - - - - F. 2 — — 1 — 1 — 27. Other digestive diseases M. 11 2 - - 2 1 6 F. 16 — 1 1 1 4 9 28. Nephritis M 6 - - - - - 6 F. 21 — — 1 3 — 17 29. Puerperal and postabortive sepsis F. 1 — 1 — — 30. Other maternal causes F. 2 — — 2 — — 3l. Premature birth M. 11 11 - - - - F. 5 5 — — — — — 32. Congenital malformations, birth injuries, infantile diseases M. 9 7 - - 2 - - F. 10 9 — — — 1 — 33. Suicide M. 6 - - - 1 2 3 F. 4 — — — 2 1 1 34- Road traffic accidents M. 6 - 2 1 3 — F. 2 — — — — 1 1 Other violent causes M. 15 - 1 - 8 3 3 F. 16 2 - — 1 1 12 3®- All other causes M. 40 1 1 - 5 10 23 F. 34 2 1 1 1 8 21 Infant Mortality. During 1948 the deaths of 71 infants under 1 year of age were registered as belonging to Battersea. The-total number of live births registered during the year was 2,248, giving an infant mortality rate of 31.58 per 1,000 live births as compared with 31.54 in 1947 and 42.42 in 1946. The infant mortality rates in the County of London and in England and Wales during 1948 were 31 and 34 respectively. 12 The following table sets out the causes of death in detail. Infant Mortality, 1948. 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. tage of Total 1-2 2-3 3-4 1-3 3-6 6-9 9-12 M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. 1.4 Cerebro Spinal Fever Whooping Cough 2 2 2.8 Tuberculosis (Non-pulmonary) 2 2 2.8 Bronchitis 3 1 3 1 5.6 Pneumonia 1 2 1 2 2 5 1 2 3 1 1 11 6 24.0 Diarrhoea 1 3 1 1 4 2 8.4 Digestive diseases 2 2 2.8 Premature birth 6 2 3 2 1 1 10 5 1 11 5 22.6 Congenital malformation, birth inj ury, infantile diseases 2 3 2 3 1 5 6 2 1 2 7 9 22.6 Violent causes 1 1 1 2 2.8 Other causes 1 1 2 1 1 2 4.2 Totals 8 6 5 7 4 2 1 17 16 12 2 9 5 4 4 1 1 43 28 100.0 14 12 6 1 33 14 14 8 2 71 Percentage of Total 19.7 16.9 8.4 1.4 46.4 19.7 19.7 11.4 2.8 100.0 M.60.6 F.39.4 There were 33 deaths of infants during the first four weeks of life (or 46.4 per cent. of the total infant deaths) as compared with 39 deaths (or 46-4 per cent.) in 1947 and a percentage for the quinquennium 1943-1947 of 50.5. Table showing Deaths of Infants under 1 day, under 1 week aNP under 4 weeks from 1943 to 1948. 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 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 1947 12 19 8 39 46.4 Mean 16 16 11 43 50.5 1948 14 12 7 33 46.4 13 The number of deaths and infant deaths registered in each quartet 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. Percent. of Total. No. Per cent. of Total. No. Per cent of Total. 1 559 24.9 30 42.3 351 26.7 2 518 23.0 15 21.1 271 20.6 3 567 25.2 9 12.7 304 23.2 4 604 26.9 17 23.9 388 29.5 Total 2,248 . 100.0 71 100.0 1,314 100.0 Deaths of Illegitimate Infants. The death rate amongst illegitimate children during 1948 was 44.30 per 1,000 births, as compared with 45.98 in 1947, 87.91 in 1946, 37.04 in 1945, and 74.83 in 1944. The corresponding death rate of legitimate children in 1948 was 30.62, the ratio of mortality rate of illegitimate infants to that of legitimate being 144 to 100. Maternal Mortality. During 1948, there were 3 deaths of women from diseases or accidents of child-birth, which is equivalent to a fatality rate of 1.00 per 1,000 births (live and still), as compared with 2 deaths and a fatality rate of 0.73 in 1947. The rate for England and Wales in 1948 was 1.02. Camparative Statistics of Births, Motality, etc. (Compiled from Registrar-General's Returns.) Year Population Live Birth Rate Death Rate Maternal Death Rate Infant Mortality Rate 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 1948 116,500 19.3 11.3 1.00 31.6 B—Population as estimated for purpose of Birth rate. D— „ „ „ Death rate. 14 Maternity and Child Welfare. The following is a brief resume of the work and statistics during the period 1st January to 4th July, 1948, after which date control passed to the London County Council. Maternity and Child Welfare Districts and Centres. For administrative purposes, the Borough was divided into fourteen districts, for each of which a Health Visitor was responsible. There were, at the 4th July, 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 page 15. At each of the municipal centres a clinic was held twice weekly, with a Medical Officer in attendance, as shewn in the table on page 15. Each centre was under the supervision of a trained Health Visiitor, and voluntary helpers assisted in the work. The voluntary centre was conducted on similar lines to those of the municipal centres. Mothercraft Classes. Instruction in mothercraft was given weekly at 5 centres, the average attendance being respectively :— Gideon Road 13.2 Nine Elms 11.4 Plough Road 20.5 Southlands 18.4 Women's League of Service (Southlands) 14.0 In total there were 143 meetings with a total attendance of 2,209. giving an average 15.4 attendances per session. 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 Strteet. A qualified Health Visitor (Miss F. Pethybridge) undertook the usual duties of a Health Visitor within the district. The Centre was carried on as an integral part of the Council's Maternity and Child Welfare scheme, and the Council made a grant of £143 12s. 6d. towards the expenses. An important feature of the work of the League was 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 were, in suitable cases, sent to the dining rooms and supplied with dinners. 3,037 women and 2,956 children were supplied with dinners on the 123 days on which the Centre was open for this purpose. 15 Maternity and Child Welfare Centres (at 4th July, 1948). Name and situation of Centre (Italics indicate voluntary centre) Type of Clinic, etc. Ante-Natal Post-Natal Infant Welfare. Toddlers Whooping Cough and 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, Shuttle-worth 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, 9.30 a.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). 16 Summarised Statistics Relating to Infant Welfare Centres, January 1st to July 4th, 1948. Municipal Voluntary Grand Total All Saints' Chatham Hall Gideon Road Nine Elms Plough Road Southlands Total Women's League of Service Municipal and Voluntary Sessions held 53 52 52 53 51 50 311 32 343 Weights recorded 2,286 3,403 3,693 1,077 2,238 2,187 14,884 1,378 16,262 Advice only given 269 262 386 171 199 138 1,425 16 1,441 Total attendances 2,555 3,665 4,079 1,248 2,437 2.325 16,309 1,394 17,703 Average per session 48.2 70.3 784 23.5 47.8 46.5 52.1 43.6 51.6 First attendances 190 214 194 80 178 139 995 103 1,098 Children attended 456 579 547 227 372 347 2,528 250 2,778 Doctor's attendances 51 49 49 26 49 49 273 26 299 „ interviews 863 1,079 965 323 773 765 4,768 659 5,427 „ average per attendance 16.9 22.0 19.7 124 15.8 15.6 17.5 25.3 18.2 Referred to Hospital 43 46 43 20 21 30 203 9 212 (Summary of the work carried out at other centres will be found as under:— Ante-natal Clinic, page 18; Post-natal Clinic, page 18; Anti-diphtheria Clinic, page 24; Mothercraft classes, page 14; Toddlers' Clinic, page 20.) 17 Health Visitors. The personnel of the Health Visiting Staff, which consisted of Superintendent Health Visitor and 14 Health Visitors, is set out on Page 3. Facilities were granted by the Council to students of recognised training bodies for practical instruction and training as health visitors and women sanitary inspectors. Four 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 by the Council's Health Visitors and those of the voluntary organisation included in the Borough Maternity and Child Welfare scheme is summarised in the following table:- Visits Council. Vol. Total. Expectant mothers 1,983 148 2,131 Notified births 5,882 463 6,345 Still-births 34 4 38 Children aged 1-5 years 3,809 431 4,240 Infant deaths 38 2 40 Notifiable infectious diseases 2,276 178 2,454 Non-notifiable diseases 103 18 121 Prevention of diphtheria 37 7 44 Foster mothers and children 141 — 141 Other 395 152 547 Totals 14,698 1,403 16,101 Hospital Provision. The Council 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 made a grant to these Hospitals in respect of the facilities afforded. Women and children were 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 visited and reported on the home conditions of Battersea women and children receiving treatment in the obstetric, gynaecological and other departments of the various hospitals. 392 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. 113 mothers and 55 children were referred to the Clinic, and of these 30 mothers and 37 children had attended. 18 Ante-Natal Clinics. The subjoined table shows in summary the number of attendances, etc., at the municipal ante-natal clinics. Clinics held at All Saints' Chatham Hall Gideon Road Plough Road Southlands Total Sessions 25 26 24 27 26 128 Attendances 270 235 313 309 278 1,405 Attendances average 10.8 9.0 13.0 114 10.7 11.0 New cases 85 65 94 116 73 433 Total patients 120 99 122 148 113 602 Interviews by doctor 260 231 299 297 251 1,338 Average per session seen by doctor 104 8.9 12.5 11.0 9.7 10.5 Referred to Hospital 2 19 9 11 8 49 In addition, 13 sessions were held at the Women's League of Service, the attendances being 159. Of the 76 patients who attended. 44 were new and 7 were referred to hospital. Post-Natal Clinic. The Post-Natal Clinic was held at Gideon Road Infant Welfare Centre. Twenty-six sessions were held and the total number of attendances was 202. The number of patients seen was 127 of whom 113 were new cases. Ten patients were referred to hospital and 17, 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. 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 were considered necessary. His services were not called upon. The following table sets out a record of the number of premature infants who were notified during the period under review :— No. of permature babies Born At Home In Hospital Total Notified 13 35 48 Nursed entirely at home 12 — 12 Died during first 24 hours 2 5 7 Survived at the end of one month 10 22 32 19 Nurseries. There were in the Borough six Day Nurseries. Four of them were maintained by the Council and two privately. The expenses of those maintained by the Council ranked for a grant from the Ministry of Health, whilst to one of the private nurseries—St. Margaret's—a grant was 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 was made by the Council, the amount so expended being recoverable from the Ministry. The following table shows the attendances at the Nurseries. Nursery Places Total Attendances 0—2 2—5 Total Municipal Battersea Park 50 1,490 4,338 5,828 Clapham Common 50 1,656 4,855 6,511 Nightingale Lane 50 1,440 4,815 6,255 Sisters Avenue 40 1,554 3,945 5,499 Total, Municipal 190 6,140 .17,953 24,093 V oluntary St. Margaret's 27 140 647 787 Battersea Central Mission 50 5,760 5,760 Grand Total 267 6,280 24,360 30,640 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 case of temporary illness of an expectant or nursing mothre. this service was extended so that domestic help could be given in cases of old age, infirmity or illness where considered sary. 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 were engaged on a part-time and casual basis were paid down by the down by the Joint Industrial Council and the patients assessed to pay a proportion of the cost in accordance with their means. Home Help were engaged on 68 cases, the nett cost to the Council amounting to £269 18s. 1d. So far as the Domestic Helps are concerned, 217 cases were attended, the cost for which amounted to £1,173 7s. 4d., and the contributions from the patients amounted to £98 14s. 4d. The nett cost of service is the subject of reimbursement by the Ministry of Health. 20 Toddlers' Clinics. Toddlers' Clinics were held fortnightly at five of the Infant Welfare Centres. No. of Sessions held 63 „ Attendances 766 Referred to Hospitals, etc 61 „ Dental Clinic 35 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 made a grant of £25. 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 by the health visiting staff, who were appointed by the Council as Infant Life Protection visitors. The number of visits paid by them to foster mothers and children was 141. At the 4th July, 1948, there were 18 Battersea foster-mothers known to the Council, all of whom had nurse children in their care to the number of 25. 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 was as follows :— Test Feeds. Number of cases, 57. Number of attendances, 82. In-Patient Treatment. Battersea cases received— 5 mothers and 8 babies. Period of stay. 5 mothers, 201 days, and 8 babies, 321 days; averagemothers, 40 days; babies, 40 days. A contribution of £100 was made by the Council in respect ot the work carried out by the Hostel for Battersea mothers. National Dried Milk and Vitamins. 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 were: National Dried Milk, 9,125 packets; Fruit Juice, 11,527 bottles; Cod Liver Oil, 3,276 bottles, and 781 packets of capsules. 21 Nursing Facilities. The Council had 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 £48 15s. Od. was made to the Association in respect of their services. The total number of attendances made by the nurses of the District Nursing Association in connection with cases of infectious disease was: — Nursing Service. Name of Disease Age. Total Under 5 years Over 5 years Cases Visits Cases Visits Cases Visits Eye afflictions 49 486 — — 49 486 Ophthalmia neonatorum, etc. 1 10 — — 1 10 Ears 39 532 — — 39 532 Measles, etc. — — 1 3 1 3 Diarrhœa and vomiting 1 3 — — 1 3 Tuberculosis — — 2 197 2 197 Bronchitis 1 9 — 1 9 Puerperal pyrexia 1 6 1 6 Pneumonia — — 4 52 4 52 Influenza — — 5 6 5 6 Other diseases 133 1,105 1 6 134 1,111 Totals 224 2,145 14 270 238 2,415 22 Infectious Diseases. The following table shows the number of cases notified during 1948 and, for the purposes of comparison, the average number of cases notified annually in the five years, 1943-47 :— Notified 1948 Average 1943/7 Diphtheria 17 40 Erysipelas 31 40 Scarlet Fever 227 201 Enteric Fever 2 1 Puerperal Fever 3 3† Puerperal Pyrexia 10 10 Meningococcal Meningitis 6 8 Ophthalmia Neonatorum 13 15 Polio-myelitis, etc. 5 6 Encephalitis Lethargica — Malaria — 5 Dysentery 10 13 Pneumonia (Acute Influenzal) 12 30 (Acute Primary) 137 118 Whooping Cough 588 405 Measles 1,470 859 Tuberculosis (all forms) 213 201 Scabies 94 578* Total 2,838 2,533 * Scabies became notifiable on 1st August, 1943; equivalent annual rate. † Puerperal Fever became notifiable as Puerperal Pyrexia as from 1st September, 1948. In the aggregate, there was a considerable increase in the number of cases of infectious disease notified in 1948 as compared with those of 1947, caused mainly by a periodic outbreak of Measles. Notified cases of Measles rose from 583 in 1947 to 1,470 in 1948. Scarlet Fever also showed an increase. Notifications of Scabies decreased considerably, there being 94 notifications in 1948 as against 219 in 1947. Polio-myelitis decreased from 23 cases in 1947 to 5 cases in 1948. One death was recorded as due to this disease. 23 Analysis of Cases of Infectious Disease notified during the Year 1948, and Deaths from such Diseases Notifiable Disease. Cases Notified in Battersea, at Ages (Yeaus). Deaths 0— 1— 2— 3— 4— 5— 10— 15— 25— 45— 65 & over Total Small-pox — — — — Diphtheria i — 1 — 2 4 4 4 — — 1 17 — Erysipelas — 1 — — 1 — 1 1 8 14 5 31 1 Scarlet fever 3 10 10 23 21 104 36 13 6 1 227 1 Enteric (typhoid) fever — — — — — — 1 1 — 2 Continued fever — — — — — — — — *Puerperal fever — — — — — — — 1 2 — — 3 1 Puerperal pyrexia — — — — — — — 7 3 — — 10 — Meningococcal meningitis 3 — — — — 1 — 1 1 — — 6 2 Ophthalmia neonatorum 13 — — — — — — — — 13 Polio-myelitis, etc 1 — — — — — 1 1 2 — 5 1 Polio-encephalitis — — — — — — — — — — Encephalitis lethargica — — — — — — — — 1 Malaria — — — — — — — _ — — — Dysentery — — 3 1 1 2 — 1 2 — — 10 Acute primary pneumonia 14 14 8 3 8 13 2 11 18 24 22 137 75 Acute influenzal pneumonia 3 2 1 — 2 — 1 2 1 12 — Whooping cough 60 99 87 78 78 172 8 2 3 1 588 2 Measles 81 236 200 224 174 515 28 4 7 1 1,470 1 Scabies — 3 3 3 1 11 7 27 28 9 2 94 — Tuberculosis — — — — — — — — — — — — Pulmonary 3 1 2 1 6 7 3 56 71 34 6 190 69 Non-pulmonary 2 1 1 — 1 4 3 4 5 1 1 23 8 Totals 184 367 316 333 293 835 94 134 159 86 37 2,838 162 * Puerperal Fever became notifiable as Puerperal Pyrexia as .from 1st September, 1948. 24 Diphtheria Immunisation. Diphtheria immunisation was continued until the 4th July, 1948, at Southlands and, in addition, immunisation was also carried out at Nine Elms Welfare Centre, where 62 first and 47 second injections were given. In the following table the work of the Diphtheria Immunisation Clinic is set out in summarised form :— Sessions held 53 Patients attending (new, 994) 1,538 Attendances 3,163 ,, Average per Session 59.7 Patients who completed course of immunisation :— (a) At Clinic 815 (b) Plsewhere 41 856 Post-Schick Tests 714 Readings— Negative 680* Positive 3 No Reading (during period) 8 Reading after July 4th (all Negative) 30 * Includes 7 from 1947 tests. 721 Arrangements were in force tor private practitioners to immunise children who were unable to attend the clinic, and 9 children were immunised in this way. The Schick test was offered to all children who had been immunised whether at the Council's clinic or elsewhere. It was found that 99.6 per 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. There were no Battersea deaths from diphtheria during 1948. Immunisation against Whooping Cough was commenced on the 25th May, 1948, at Southlands, and held in conjunction with the Diphtheria Immunisation Clinic. There were 158 attendances at 6 sessions. 140 children attended, 18 of whom received second injections. No children completed a course of immunisation before the 4th July, 1948, when the clinic was taken over by the London County Council. TUBERCULOSIS. During the year 1948 there were 213 cases of Tuberculosis (all forms) notified in Battersea as compared with 162 in 1947, 228 in 1946, 199 in 1945, 184 in 1944 and 233 in 1943. In addition, 39 cases were reported or otherwise came to the knowledge of the Medical Officer of Health, making a total of 252 cases for the year. The case rate per 100,000 population was 216.3. The following tables give details in age groups of the 252 cases. 25 Age Periods Formal Notifications Number of Primary Notifications of new cases of tuberculosis 0— 1— 2— 5— 10— 15— 20— 25— 35— 45- 55— 65— 75— Total (all ages) Respiratory,Males 3 — 7 2 3 11 10 21 15 16 15 5 108 Respiratory,Females — 1 2 5 — 8 1 27 26 9 1 2 — 1 82 Non-Respiratory,Males 2 1 1 3 1 1 1 1 — — — 12 Non-Respiratory,Females — — 1 1 2 1 1 2 1 ] — 1 — 11 New cases Tuberculosis coming to the knowledge of the Medical Officer of Health otherwise than by formal notification. Source of Information Number of cases in age Groups 0- 1- 2- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- Total Death Returns from Local Registrars R. M - - - - - - - - - 1 1 2 — 4 (A) F - - - - - - - - - - - - - - (B) N.R. M - — 1 — — — — — - - - - - 1 (C) Death Returns from trar General (Transferable Deaths) R. M - - - - - - - - - - - - - - (d) M - - - - - - — — — 1 1 — - 2 (A) F - 1 — — — — — — 1 — — — — 2 (B) N.R. M - — — — — — — — — 1 1 — — 2 (C) F — - - - - - - - - - - - - (D) Posthumous Notifications R. M — - — — — — — - - - - - - -(a) F — — — — — — — - - - - - - - (B) N.R. M 1 — — — — — — - - - - - - 1 (C) F - - - - - - - 1 - - - - - 1 (D) "Transfers" from Other Areas (excluding transferable deaths) R. m - - — — — — 4 3 1 — - — - 8 (A) F — — — — — 2 7 2 4 — 1 — — 16 (B) N.R. M — — — — - - - - 1 - - - - 1 (C) F - - - - - - 1 - - - - - - 1 (D) Other Sources R M — — — — — - - - - - - - - - (A) F — — — — — - - - - - - - - - (B) N.R. M — — — — — - - - - - - - - - (C) F - - - - - - - - - - - - - (D) R.-Respiratory. Totals (A) 14 N.R.-Non-Respiratory. " (B) 18 " (C) 5 " (D) 2 Total number of Informal Notifications 39 26 Tuberculosis, 1948. Cases added to and removed from Notification Register. PULMONARY NON-PULMONARY GRAND TOTAL Males Females Total Males Females Total Males Females Total Already on Register, 31/12/47 424 424 848 61 103 164 485 527 1,012 Primary notifications 108 82 190 12 11 23 120 93 213 Notified after death — — 1 1 2 1 1 2 Unnotified deaths 6 2 8 3 — 3 9 2 11 Restored 4 2 6 — 2 2 4 4 8 Removals into Borough 8 16 24 1 1 2 9 17 26 TOTAL ADDITIONS 126 102 228 17 15 32 143 117 260 Deaths 47 24 71 2 — 2 49 24 73 Notified after death — — — 1 1 2 1 1 2 Unnotified deaths 6 2 8 3 — 3 9 2 11 Removals from Borough 22 35 57 5 6 11 27 41 68 Recovered 11 18 29 4 7 11 15 25 40 Diagnosis not confirmed 4 — 4 — 2 2 4 2 6 TOTAL DELETIONS 90 79 169 15 16 31 105 95 200 Net increase 36 23 59 2 — 1 38 22 60 Net -decrease — — — — 1 — — — On Register at 31/12/48 460 447 907 63 102 165 , 523 549' 1,072 27 Deaths from Tuberculosis. During 1948 deaths from Tuberculosis registered as belonging to the orough of Battersea numbered 77, of which 69 (i.e., 89.6 per cent.) eie due to pulmonary tuberculosis, 8 (i.e., 10.,4 per cent.) to other rorms of the disease. The death rate per 100,000 of the population during the 48 years ended 1948 in quinquennial averages and in 1946, 1947 and 1948 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 33.8 158.0 1916-1920 134.8 30.0 164.8 1921-1925 92.6 23.0 115.6 1926-1930 91.1 14.2 1053 1931-1935 81.8 14.4 96.2 1936-1940 76.1 9.2 85.3 1941-1945 91.8 11.0 10.8 Average (45 years) 106.2 25.8 132.0 1946 76.5 8.3 84.7 1947 51.3 9-6 60.9 1948 59.2 6-9 66.1 Extra Nourishment. Extra nourishment was provided during the period ended 4th July, 1948, for 9 necessitous dispensary patients at a cost of £24 8s. lOd. CANCER. During 1948 the number of deaths of Battersea residents from Cancer was 232 (males 126, females 106) as compared with 252 in 1947, 224 in 1946, 214 in 1945, and 216 in 1944. The death rate from the disease per 1,000 of the population was 1.99. The deaths from cancer constitute 17.7 of the total Battersea deaths during the The following gives the comparative average death rates from Cancer in Battersea for quinquennial periods since 1901:— 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 1926-1930 1.51 1948 1.99 28 The following table shows the localisation of the disease in the case of the 232 deaths recorded in 1948. Localisation No. of Deaths Percentage of Total Male Female Total Buccal cavity, Œsophagus (M), Uterus (F) 7 7 14 6.0 Stomach and Duodenum 22 17 39 16.8 Breast 1 23 24 10.3 All other sites 96 59 155 66.9 Total 126 106 232 100.0 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. Insulin was supplied to 18 such cases. Eleven deaths were attributed to this disease. BACTERIOLOGICAL EXAMINATIONS. The bacteriological examination of clinical material (with the exception of specimens of sputum, which are dealt with at the Tuberculosis Dispensary) is carried out by the Clinical Research Association, of Watergate House, Strand. During 1948 the number of bacteriological examinations of specimens sent in by medical practitioners practising in Battersea was 383 (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 11 347 358 Other — 25 25 Total 11 372 383 The cost of these examinations is borne by the Council, and in 1948 amounted to £74 19s. 4d. 29 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 1948. Sanitary Operations. Inspections— Frontage drains constructed or reconstructed 23 New houses 182 House-to-house — Houses let in separate tenements — New houses — certificates issued re water supply 182 Houses—following complaints 6,429 Houses supplied with water and fittings repaired 139 Houses—following infectious disease 466 Gipsy vans 17 Additional water supplies to tenement houses 16 Common Lodging Houses 30 Public urinals and chalets 100 Water closets provided, supplied with water, or supply disconnected from drinking water cisterns 36 Re-inspections 27,934 Other visits 3,411 Notices served— Water closets and urinals cleansed and repaired 871 Intimations 4,164 Statutory (Sec. 197 and 200) 208 Drinking water cisterns cleansed and repaired 143 Statutory (Fifth Schedule) 2,519 Rain-water and waste pipes disconnected or repaired 394 Summonses issued 304 Magisterial Orders obtained 100 Soil pipes and drains ventilated 65 Drains laid to new houses 182 Defective roofs and gutters repaired 1,619 Dustbins provided 260 Drains relaid (wholly or partly) 53 Yards paved or repaired 299 Premises disinfected 1,039 rains cleansed and repaired 341 Persons cleansed (including 3,266 children) 3,763 Drains tested (smoke) 114 Articles disinfected 12,970 Found defective 58 Rat repression- Drains tested (water) 676 Premises inspected 363 Drainage plans received 112 Inspections 3,122 Protection of Food Supply. Inspections— Inspections—contd. Butchers' and other food shops 1,364 Dairies and milk shops. 344 Slaughterhouses 53 Ice cream premises 233 Fish shops 273 Restaurant kitchens 356 Food storage premises 97 Samples taken 1,200 Summonses issued 17 30 Factories, Workshops and Shops. Inspections— Inspections—-contd. Shops 29 Outworkers 1,234 do. (Pharmacy Act) 14 Smoke observations 140 Intimation notices served 62 Factories 1,661 Summonses issued 3 Legal Proceedings. During the year, legal proceedings were taken by the Council in 326 cases, for the enforcement of various Acts, by-laws, regulations, etc., administered by the Health Department. A summary is set out below, and further details will be found in the sections dealing with the respective matters. Public Health (London) Act, 1936 304 Food and Drugs Act, 1938 16 Milk and Dairies Order, 1926 1 London County Council By-laws re Pag and Bone Dealers 3 Housing Act, 1936 1 National Assistance Act, 1948 (Removal of Aged and Infirm Persons) 1 326 Fines totalling £43 were imposed in connection with these proceedings, and £203 6s. 6d. costs were awarded to the Council. Public Health (London) Act, 1936. The provisions of this Act in regard to Nuisances continued to afford practically the only means whereby the remedy of insanitary conditions found in dwelling houses could be secured. During the year, 4,164 Intimation, and 2,519 Statutory (Nuisance) Notices were served. The high proportion of Statutory to Intimation Notices gives some indication of the difficulty in securing compliance with the latter. Furthermore, legal proceedings to enforce compliance with Statutory Notices had to be taken in no less than 296 cases. Of these, 100 resulted in Nuisance Orders being made by the Court. The remaining 196 summonses were either adjourned or withdrawn, as the work required to comply with the Notices was either in hand, or had been completed, before the hearing. In no case were the proceedings unsuccessful. In 33 cases action to enforce compliance with Nuisance Orders had to be taken. In 26 of these, the Council carried out the work in default of the persons on whom the Orders were made. In those cases, the Council were entitled to recover the cost of the works from those persons, and accounts were accordingly rendered to them. Most of these accounts had been settled by the end of the year, but in one instance proceedings for the recovery of the cost had to be taken. An Order for payment was secured. In the remaining 7 cases, the Council elected to take proceedings for non-compliance with the Nuisance Orders. Fines totalling £25 were imposed, and the work was eventually done by the owners. 31 Common Lodging Houses. There were at the beginning of the year only two common lodging houses in Battersea, of which particulars are as under:— Premises Lodgers authorised Inspections Notices Prosecutions Served Complied with Males— 75 Falcon Road 21 9 — — — Females— 67 Winstanley Road 50 21 — — — Total 71 30 — — — 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. The common lodging house at 75 Falcon Road was closed in May. The annual licence in respect of 67 Winstanley Road was renewed in June. There are no Seamen's lodging houses in the Borough. Public Lavatory Accommodation. Five public conveniences for both sexes and one for females only 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. Three public urinals are also maintained. In addition, the urinals attached to seven licensed premises are, by arrangement with the owners, available to the general public. In one of these cases, three months' notice to terminate the arrangement was given by the owners in December, as they wished to make alterations involving the abolition of the urinal. 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 182 new buildings, and the drains of 53 old buildings were partially or entirely reconstruced under the supervision of the Officers of the Department. 112 plans of proposed drainage work were deposited in 1948, as compared with 74 in 1947. During the year drains were tested by smoke on 114 occasions, and 58 were found defective. The water test was applied on 676 occasions, this being mainly to drains in course of construction. The frontage drains of 23 premises were constructed or structed. 32 Combined Drainage. During the year six claims were made by owners of houses drained by combined operations that the common portions of those drainage systems were "sewers" within the meaning of the Public Health (London) Act, 1936, and that the Council were consequently responsible for their maintenance. In the following five cases the Council admitted the liability and carried out the necessary works to the "sewers" at the cost shown :— £ s. d. 22/24 Ascalon Street 42 10 0 34/36 Glycena Road 225 6 3 108/114 Northcote Road 260 14 1 135/137 St. James' Drive 34 0 8 153, &c., Usk Road 132 10 4 £695 1 4 In the remaining case, liability was repudiated, and the work was subsequently carried out by the owner at his own expense. In all the five cases mentioned above, the drainage systems were, in every sense but the legal one, private drains, and but for the definitions of the terms "drains" and "sewer" in the Act they would have been the responsibility of the owners. Smoke Nuisances. During the year a number of complaints were made, alleging nuisances from smoke, dust, grit, etc., emitted from premises occupied by various industrial and public utility undertakings in the Borough. All such complaints were carefully investigated. By far the most persistent and serious emissions were found to be taking place from the premises of two public utility undertakings. There is no doubt whatever but that these emissions were very extensive, and apart from the danger to health, they seriously affected the amenities of considerable areas around them. In both cases the emissions were brought to the notice of the Authorities operating the undertakings, and their representatives subsequently discussed the matters with myself and other Officers of the Health Department. The representatives laid great emphasis on the frequency with which fuel of unsuitable type and/or poor quality was supplied to them, and upon the difficulty and delay in securing the replacement of obsolete or worn-out plant. While there undoubtedly was a certain element of truth in these suggestions, I was by no means satisfied that the Authorities were employing the best practicable means to minimise the emissions. Accordingly, meetings were arranged at the premises, at which all aspects of the operation of the plants were investigated. As a result, the Authorities agreed to put into effect various measures. Some of these measures involve the replacement of old plant, and the installation of new, and it will therefore necessarily be some considerable time before they become effective. In the meantime, assurances were given that all possible steps to reduce emissions to the absolute minimum would be taken. 33 The remainder of the complaints related to small emissions from isolated factories, etc. They also were investigated, and remedial measures suggested. In these cases, also, unsatisfactory fuel supplies were blamed for much of the trouble. The total number of observations made was 140. Effluvium Nuisances. A number of complaints alleging nuisances from effluvia emitted from business and industrial premises were received. In only one case was any justification found for the complaint. This case was reported to the Health Committee, and on their direction a notice requiring the abatement of the nuisance was served. The time allowed for compliance with this notice had not expired by the end of the year. Offensive Trades. There are three premises in the Borough at which scheduled offensive trades are carried on. All these businesses have been established for many years and are satisfactorily conducted. Water Supply. During the year certificates under Section 95 (2) of the Public Health (London) Act, 1936, were issued in respect of 182 new or re-rected dwelling houses or tenements. In 16 houses additional water supplies on upper floors were provided, in compliance with notices served under Section 95 (5) of the Act. Twenty notices of waste of water from defective fittings, etc., observed during routine inspections of various premises, were sent to the Metropolitan Water Board. Over 360 tenements on the Council's Housing Estate at Sheepcote Lane are supplied, in part, with water drawn from deep artesian wells at the Latchmere Baths, supplemented by supplies from the mains of the Metropolitan Water Board. The water from the wells is chlorinated, as a safety measure, before passing into supply. Prior to the war, samples for bacteriological examination were taken at fortnightly intervals. During the war, this practice was discontinued, as the Metropolitan Water Board earmarked the wells for use as an emergency supply should their normal supplies be seriously interrupted by enemy action, and themselves took periodical samples. At the end of 1947, the practice was resumed. Twenty-six samples were taken during the year, and the Public Analyst's reports on them showed that the water maintained a high degree of purity. Rag and Bone Dealers. Premises occupied by rag and bone dealers in the Borough are subjected inspection. During the year 80 inspections were made. Various small irregularities found to exist were brought to the notice occupiers of the premises and were remedied without recourse to formal action. 34 Three cases of offences against that part of the by-laws relating to rag and bone dealers, which prohibits the giving of toys in exchange for rags, were reported by the Police. By direction of the Health Committee, legal proceedings were taken in all these cases. One summons was dismissed under the Probation of Offenders Act, 1907In each of the other two cases, a fine of £1 was imposed, and in one of them £1 costs were awarded to the Council. Verminous Premises. The number of premises found to be infested by vermin (principally bed-bugs) was markedly less than in previous years. This reduction can be ascribed in part to improved standards of cleanliness, and in part to the advent of the insecticides known as "D.D.T." and "Gammexane," the use of which is now standard practice. They possess the property, not shown by the older types of insecticide, of imparting to surfaces on which they are sprayed or dusted a lethal action against insects, which remains active for some months if undisturbed. During the year, 270 verminous premises, including 44 flats or houses on the Council's Estates, were treated. Van Dwellings. There are four sites in the Borough on which van dwellings have regularly been placed for many years. The number of vans on the sites varies from time to time. All the sites are subject to regular inspection and are in general reasonably well kept. Dangerous Structures. Seventy-eight cases in which structures or parts thereof had been noted, in the course of inspections for various purposes, as appearing to be unsafe, were referred to the District Surveyor of the London County Council for his attention. Rats and Mice (Destruction) Act, 1919. The provisions of this Act, which give power to require steps to be taken to eradicate infestations of rats and mice, and to prevent infestations, are administered by the Council. The work is carried out by the Rodent Officer, assisted by three Rodent Operatives (one additional Operative having been appointed during the year). All infestations coming to light, whether by. way of complaint or otherwise, are systematically investigated, and the necessary steps taken to deal with them. In some cases the occupier of the affected premises (who is the person primarily responsible under the Act), is called upon to take those steps, and in others the work is carried out by the Rodent Control Staff. In the latter event, the cost is recoverable from the occupier. Except in the case of business premises, where the cost is recovered in full, the charges made are usually nominal. At the same time, steps are taken to ascertain, and to secure the remedy of, the cause of the infestation. This is frequently found to be defective drainage or other defects in the building, for which the owner is responsible, and he is called upon to remedy the defects. The work of the Rodent Control Staff is, therefore, carried on in close co-operation with the Sanitary Inspectors. 35 During the year the Staff made 3,122 visits to 363 different The sewers under control of the Council were treated on two occasions to destory rats. The method adopted was that recommended by the Ministry Agriculture and Fisheries, namely, to lay prebait (unpoisoned) on two successive days, and to follow on the third day with poisoned bait. The Ministry of Agriculture and Fisheries, under the terms of their Circular N.S. No. 11 pay a grant of 50 per cent, towards the cost of the service in so far as this is not recovered by the Council from occupiers of premises. In regard to business premises, I should mention that for many years past there have existed arrangements between the Council and the occupiers of a numbers of business premises, mostly large factories, whereby, in consideration of their paying a fixed annual sum, the Council have carried out all the necessary treatments. For that purpose, routine visits were paid to the premises. This system worked exceedingly well, for it ensured continuity of treatment and saved much time and trouble in rendering periodical accounts. The Ministry, however, took exception to it, for reasons not understood. With considerable reluctance, therefore, these arrangements were allowed to lapse, and accounts are now rendered quarterly. Vacant Sites, Static Water Tanks, etc. Many complaints were received during the year of nuisances alleged to be caused by the caused by the dumping of rubbish on vacant sites and in derelict buildings and disused static water tanks, and by the accumulation of stagnant water in the last named. In many cases the deposits were merely builders' rubbish and other material which, though unsinghtly, could not be a danger to health, and no action could therefore be taken. In some cases, however, vegetable refuse, dead animals, old bedding and other material of a putrescible nature was found. The whole question of such nuisances was considered by the Metropolitan Boroughs' Standing Joint Committee, by whom representantions, seeking some solution of the problem, were made to the appropriate Government Departments. It does not appear that anything tangible resulted from these representations. The view was, however, expressed that in the cases of cleared sites and derelict buildings, and of water tanks where the sites had been derequisitioned, the owner of the building or site is responsible, under the Public Health (London) Act, 1936, for the abatement of any statutory nuisance. The ment of this responsibility is by no means a simple matter. In one case, however, of a tank which was in a particularly bad state, a notice was served on the owners, who eventually had the tank removed. The Council set aside a sum of £100 to be expended in removing any deposit which was causing a serious nuisance. Four cases were dealt with in this way. On the 23rd June, 1948, the Council made a by-law under which it was made an offence for anyone to deposit rubbish on any land abutting the highway so as injuriously to affect the amenities of the neighbourhood. No case was dealt with under this by-law during the year. 36 Burial of Deceased Persons. Under Section 50 of the National Assistance Act, 1948, which came into operation on the 5th July, 1948, the duty of arranging for the burial or cremation of the body of any person dying or being found dead in the Borough, for the disposal of whose body no other suitable arrangements have been made, was transferred to the Council. They are given power to recover from the estate of the deceased, or from any person who, under the Act, was liable to maintain the deceased immediately prior to his death, their expenses incurred in carrying out the duty, in so far as these expenses are not covered by any grant made under Section 22 (5) of the National Insurance Act, 1946. Between the 5th July and the end of the year, 38 cases were dealt with. The majority were of persons dying in the local hospitals, as the following table shows:— Died in St. James's Hospital 20 „ „ St. John's Hospital 13 „ at home 4 Found drowned in river 1 38 Only 10 of these persons were residents of Battersea. The burials were carried out by a local undertaker under contract with the Council, and not more than one coach is provided for relatives who wish to attend the funeral. The Health Department make arrangements with the undertaker, and collect all available information regarding any estate left by the deceased and the existence of any liable relatives. This information is passed to the Borough Treasurer so that he may take any steps necessary to recover the cost. The total cost incurred in dealing with the 38 cases was £237 12s. 7d., of which £68 9s. 4d. had been recovered by the end of the year. Aged and Infirm Persons. Section 47 of the National Assistance Act, 1948, which came into operation on the 5th July, 1948, repealed, and re-enacted, with certain modifications, Section 224 of the Public Health (London) Act, 1936, which had previously provided power to apply to the Court for an Order for the removal to a suitable hospital or other place of any person who is aged or infirm or suffering from some grave chronic disease, and is living under insanitary conditions. The principal modifications are:— (1) There is now no need to obtain a second medical report. (2) The application for the Order has to be made to the Court by the Council, and not, as formerly, by the Medical Officer of Health. (3) Seven days' notice (in lieu of three days as previously) has to be given to the person concerned and to the hospital, etc., authorities. One such case was dealt with during the year. 37 A number of other cases of persons, mostly of advancing years, alleged to be living under unsatisfactory conditions, were reported. In none of these was there justification for certifying that an application for an Order for removal be made. In some cases, however, it was found possible to arrange voluntary admission to hospital, and other cases were under observation at the end of the year. The question of the care and maintenance of old persons, cially those living alone, is one which clearly calls for urgent and thorough consideration. PROTECTION OF FOOD SUPPLY. (A)—INSPECTION OF FOOD PREMISES. Regular and systematic inspection of all premises where food for human consumption is prepared, stored, or sold is carried out as a routine measure. In general, they have been found to be conducted in a satisfactory manner, such irregularities as were found being mainly of a minor nature remedy of which was secured without difficulty. In the following two cases, however, recourse had to be had to legal proceedings:- (a) A factory where jelly crystals, soup powders, tomato sauce and similar commodities were being prepared and packed, The undermentioned contraventions of Section 13 (1) of the Food and Drugs Act, 1938, were found to exist:- (i) A sanitary convenience communicated directly with the part of the building where the food was being handled. (ii) A sufficient supply of hot water and clean towels was not provided for the use of the employees. (iii) Proper precautions to protect the food from contamination were not being taken, as the premises generally were in a dirty and untidy state, and materials such as scouring powder, soap powder, etc., were being manufactured and packed in close proximity to the foodstuffs. After repeated warnings had failed to secure the remedy of these conditions, legal proceedings were taken against the firm occupying the factory, and against their principal director for permitting the offences. The cases came before the Court on the 20th May and were adjourned to the 25th June, and then further adjourned to the 20th August, to enable alterations to be carried out to the factory. By the last-named date the first two contraventions had been remedied, and the summonses in respect of them were not separately dealt with. On the summonses for the third offence, the and the director 40s., and £10 10s. 0d. costs were awarded to the Council. The firm, through their Counsel, gave an undertaking that, pending sub-division of the building to separate the food and non-food processes, the latter would be discontinued. The position was under observation at the end of the year. 38 (b) A mobile canteen, operated by a man and his wife, serving meals to men engaged on building sites in adjacent areas. It was found that the food sold from this canteen was being prepared and stored in one room in a house in Battersea, in which room the two persons lived and slept. Legal proceedings were taken against both the persons, and were dismissed under the Probation of Offenders Act, 1907, on payment of 4s. costs. In connection with this case, it was ascertained that a licence to operate the canteen had been issued by the London Divisional Food Office, apparently without any enquiry as to the conditions under which the food would be prepared. This matter was reported to the Council, who decided to refer it to the Metropolitan Boroughs' Standing Joint Committee with a view to representations being made to ensure that no licence of this nature should in future be issued without prior consultation with the Local Authority, on the subject of compliance with statutory requirements. Slaughterhouses. There is only one licensed slaughterhouse in the Borough. It is used only occasionally, for the slaughter of calves. Fifty-three visits were made to it during the year, and 22 calves were examined, all of which were passed as fit for human consumption. Butchers' Shops. There are 71 butchers' shops in the Borough, and in addition a number of shops where cooked meats are sold. All these shops are systematically inspected, 1,364 visits having been made during the year. In general, the shops are well conducted, and no formal action was found necessary. Public Health (Meat) Regulations, 1924. No contravention of these Regulations was reported during the year. Dairies and Milkshops. The following table gives the dairies and milkshops registered in the Borough, and the changes during 1948 : (a) Dairies, where loose milk is sold, and both the premises and the occuoier are registered :— Retail Wholesale Total On register at 1st January 53 7 60 Added during year — — — 53 7 60 Removed during year:— (i) Premises closed — — — (ii) Transferred to (b) below I — 1 On register at 31st December 52 7 59 39 (b) Milkshops, where milk is sold only in sealed containers, and only the occupier is registered:- On register at 1st January 23 Added during year, by transfer from (a) above 1 24 Removed during year - On register at 31st December 24 A total of 344 visits were made to these shops during the year. Generally they are very well conducted. In 17 cases, however, it was found necessary to draw the occupier's attention to minor contraventions of the statutory requirements. These were rectified without recourse to formal action. Legal proceedings were taken under the Milk and Dairies Order, 1926, in respect of the use of a dirty bottle for the delivery of milk. The defendant company was fined £5, and £5 5s. 0d. costs awarded to the council. Milk (Special Designations) Orders. The designations authorised by these Orders are "Accredited," "tuberculin Tested, and "Pasteurised." Metropolitan Borough Councils are the authorities, within their respective areas, for the issue of licences authorising the use of these designations. The number of licences issued during 1948 was as follows:- Full Supplementary Accredited — — Tuberculin Tested 28 9 Pasteurised 24 10 52 19 One licence to pasteurise milk was granted, and is included in the above figures. Ice Cream Premises. The number of premises registered for the manufacture, storage, and/or sale of ice cream at the end of the year was 63, 16 having been added and 1 removed during the course of the year. All these premises are regularly inspected. 233 visits were made and 5 notices served. Particular attention is paid to premises where manufacturer takes place, and not only are the premises, plant, and methods of operation scrutinised, but samples of the product are taken for examination by the methods suggested by the Ministry of Health, The premises generally are found to be well conducted. In particular, much new and up-to-date plant has been installed to comply with the requirements of the Ice Cream (Heat Treatment, &c.) Regulations, 1947. Further reference to sampling of ice cream will be found on page 46 40 Fish Shops. Shops in which fish, either cooked or uncooked, is sold, or where the curing or smoking of fish is carried on, are regularly inspected. There were 53 such shops in the Borough in 1948. 273 inspections were made, and 11 notices were served, mostly for minor matters which were remedied without difficulty. Restaurant Kitchens. The number of restaurants and cafes (including fixed and mobile stalls) on the register is 146. 356 inspections were made, and 8 notices served for various defects. It has become increasingly obvious that the conditions under which much of the food is prepared in restaurants leave much to be desired, and there is a growing recognition of the amount of illness caused by the consumption of contaminated food. The Food and Drugs Act, 1938, lays down certain standards and requirements to be observed in places where food is prepared, stored and sold, but its provisions are necessarily in general terms, and it is evident that the average person engaged in the handling of food has very little idea of the principles underlying the production of clean food. Accordingly, towards the end of the year, a survey of all restaurants, etc., in the Borough was commenced, with a view to ascertaining the conditions existing, and advising on ways and means of improving them. The question of formulating a Code of Standards was also being considered. Street Stalls. All street stalls from which food for human consumption is sold are regularly inspected and, where the food sold is stored in the Borough, the storage places are also inspected. It was not found necessary to take any formal action during the year. Unsound Food. The following table gives particulars of the unsound foodstuffs which, under the provisions of the Public Health (London) Act, 1936, Section 180 (8), were voluntarily surrendered to the Council. Most of these foodstuffs were ultimately used for the manufacture of animal feeding stuffs. Fish (preserved) 3,648 tins „ (fresh) 156 boxes, 1 bag, 205 lbs. Meat and sausages (preserved) 2,385 tins „ „ (fresh) 1,435 lbs. Poultry 1,035 lbs. Vegetables (preserved) 1,333 tins ,, (fresh) 20 boats, 12 boxes, 5 cwts. 18 lbs. Fruit and fruit juices (preserved) 957 tins and iars „ „ (fresh) 130 lbs., 1 box, 5 casks Coconuts 4,200 Milk 14,206 tins Eggs (shell) 1,599 „ (dried) 7 tins Fats 48 tins, 10 ozs. Suet 6½ lbs. 41 Cheese 78 tins, 34 lbs. Bread and biscuits 377 lbs. Cakes 75 Crumpets 660 Flour and cereals 592 tins and packets, 420 lbs. Tea ½ lb. Sugar 16½ lbs. Jams, syrups and preserves 710 tins and jars Pickles and sauces 249 tins, jars and bottles Paste (meat and fish) 313 tins and jars Patent foods and beverages 96 tins Sweets 142½ lbs. Raking powder 1 tin Legal proceedings were taken in respect of a bun which had been sold from a local baker's shop and found to contain a cigarette end. The defendant was fined £5, and £5 5s. 0d. were awarded to the Council. Food Poisoning. During the year five cases of food poisoning were notified. All were isolated cases and of a minor nature, and call for no special comment. PROTECTION OF FOOD SUPPLY. (B)—SAMPLING OF FOOD AND DRUGS. The analysis of samples of food and drugs, procured under the provisions of the Food and Drugs Act, 1938, or informally (i.e.; without following the procedure prescribed by the Act), and the examination of samples of heat-treated millk and of ice-cream by the prescribed tests, is carried out by the public Analyst for the Borough at his laboratory at 325 Kennington Road, London, S.E.I 1. The total number of formal samples taken under the Act during 1948 was 596, of which 4, or 0.7 per cent., were certified to be adulterated. In addition, 604 informal samples were procured, of which 2, or 0.3 per cent., were reported against. The percentage of samples reported by the public Analyst to be adulterated 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 1.1 1947 0.5 1.7 1948 0.7 0.3 42 The following tables give details of the articles of which samples were obtained for the purpose of analysis. TABLE I. Main Statement. Nature of Sample Examined Adulterated Formal Informal Total Formal Informal Total Bread — 3 3 — — — Butter 28 — 28 — — — Cocoa — 11 11 — — — Coffee 7 3 10 —- — — Confectionery 2 1 3 — — — Flour, Self-Raising 13 2 15 — — — Jam and Marmalade 9 2 11 — — — Margarine 1 — 1 — — — Milk 402 — 402 — — — Milk, Condensed 2 2 4 — — — Mince 1 — 1 1 — 1 Sausages and Sausage Meat 22 6 28 — — — Suet, Shredded 3 — 3 — — — Tea 3 — 3 — — — Vinegar:— Malt 22 4 26 — — — Non-Brewed 7 1 8 1 — 1 Spirit 1 — 1 — — — Other Articles 72 433 505 1 1 2 Drugs 1 136 137 1 1 2 Totals 596 604 1,200 4 2 6 43 Other Articles. Nature of Sample Examined Adulterated Formal Informal Total Formal Informal Total Apple Pulp 1 — 1 — — — Arrowroot — 1 1 — — — Baking Powder — 3 3 — — — Beverages 16 6 22 — — — Bun & Cake Mixture 1 28 29 — — — Cereal Preparations 4 7 11 — — — Chewing Gum — 1 1 — — — Coffee and Chicory Essences 1 8 9 — — — Cooking Compound 1 — 1 — — — Cooking Fat 15 — 15 — — — Custard Powder — 12 12 — — — Fish Paste — 45 45 — — — Flavouring Essence — 17 17 — — — Fru-Bar — 1 1 — — — Fruit, Dried 5 — 5 — — — Gelatine — 16 16 — — — Golden Raising Powder — 4 4 — — — Gravy Preparations — 21 21 — — — Jelly 1 — 1 — — — Lemon Crystals — 10 10 — — — Meat Preparations- Black Pudding 3 — 3 — — — Meat Extract — 1 1 — — — „ Paste — 44 44 — — — „ Pie 5 — 5 — — — Meat and Vegetable Cubes — 2 2 — — — Mustard Preparations — 11 11 — — — Oils, Edible— Olive Oil 1 — 1 — — — Tea Seed Oil 1 — 1 — — — Pastries, Jam Tarts 2 — 2 — — — Pea Flour — 1 1 — — — Pickles and Sauces 13 45 58 1 1 2 Pudding Mixture — 21 21 — — — Rissoles 1 — 1 — — — Soup, Canned — 21 21 — — — „ Packet — 16 16 — — — Soya Flour 1 2 3 — — — Spices & Condiments — 71 71 — — — Tablets— Fruit Preserving — 3 3 — — — Malted — 2 2 — — — Saccharin — 11 11 — — — Table Dessert — 1 1 — — — Vegetable Extract — 1 1 — — — Total 72 433 505 1 1 2 44 Drugs. Nature of Sample Examined Adulterated Formal Informal Total Formal Informal Total Camphorated Oil — 7 7 — — Castor Oil — 11 11 — — — Cough Mixture — 2 2 — — — Cream of Tartar — 6 6 — — — Epsom Salts — 5 5 — — — Glauber's Salts — 9 9 — — — Iodine, Solution of — 8 8 — — — Ointment, Boracic — 4 4 — — — Ointment, Sulphur — 7 7 — — — Ointment, Zinc — 6 6 — — — Paraffin, Liquid — 2 2 — — — Seidlitz Powder — 11 11 — — — Soda, Bicarbonate of — 13 13 — — — Syrup of Figs — 2 2 — — — Tablets, Aspirin 1 22 23 1 1 2 Tablets, various — 21 21 — — — Totals 1 136 137 1 1 2 Milk. Of the 402 samples of milk, all of which were formal samples, none were reported as adulterated. In the 5 years 1943-47, and in 1948, the percentage of adulterated (formal) samples of milk was as under:— Year Samples taken Adulterated No. Percentage 1943 576 5 0.9 1944 462 5 1.1 1945 459 2 0.4 1946 430 0 0.0 1947 415 0 0.0 Mean 468.4 2.4 0.5 1948 402 0 0.0 - 45 The average composition of the 402 samples of milk reported as genuine, proved to be as under: — Total milk solids 12.38 per cent. Milk fat 3.55 Non-fatty solids 8.83 The Analyst reports that the content of milk fat in these 402 samples ranged as follows:— 4 per cent, and over 26 samples or 6.5 per cent. Between 3.9 and 4.0 per cent. 15 „ „ 3.7 „ „ „ 3.8 „ 3.9 „ 27 „ „ 6.7 „ „ „ 3.7 „ 3.8 „ 40 „ „ 9.9 „ „ „ 3.6 „ 3.7 „ 65 „ „ 16.1 „ „ „ 3.5 „ 3.6 „ 48 „ „ 11.9 „ „ „ 3.4 „ 3.5 „ 71 „ „ 17.7 „ „ „ 3.3 „ 3-4 „ 75 „ „ 18.7 „ „ „ 3.2 „ 3.3 „ 24 „ „ 6.0 „ „ „ 3.1 „ 3.2 „ 8 „ „ 2.0 „ „ „ 3.0 „ 3.1 „ 3 „ „ 0.8 „ „ 402 100.0 The following action was taken in regard to the 4 formal samples certified as adulterated:— (1) Salad Cream. Containing 600 parts per million of benzoic acid as a preservative, contrary to the Public Health (Preservatives in Food) Regulations. This product appeared, from the label, to have been imported from Holland. In the course of enquiries, it was learned that the presence of the preservative had already been brought to the notice of the Ministry of Food, and that steps were being taken to stop the importation of any further supplies. The Health Committee thereupon decided to take no action. The whole of the stock remaining in the hands of the retailer from whom the sample was obtained was returned to the wholesaler. (2) "Mince." This substance appeared to have been sold as a substitute for mincemeat, which it closely resembled. There is a standard for mincemeat set up by the Food Standards (Preserves) Order, 1944, to which the "mince" did not conform. The Council's Solicitor, however, advised that a prosecution was unlikely to be successful, particularly as no "points" had been given up. In view of this, and that the manufacturer had ceased business, the Health Committee decided to take no action. The facts of the case were, however, communicated to the Ministry of Food. (3) Non-brewed Vinegar. Certified to contain only 1.56 per cent. of acetic acid, instead of the usually accepted minimum of 4 per cent. Summonses were issued, but before they came before the Court it was learned that adverse decisions on 46 similar cases had been given by several Magistrates' Courts. In one of these, the Local Authority had appealed against the decision, which was that as there was no prescribed standard for non-brewed vinegar, no offence had been committed. The Divisional Court allowed this appeal, pointing out that if there were no such standard the Court had to fix one on the evidence before it, and in this particular case there was overwhelming evidence in favour of a minimum acetic acid content of 4 per cent. The Health Committee then further considered the matter, and in view of the lapse of time since the summonses had been issued, and the previous good record of the retailer, decided to withdraw the proceedings, but to send a cautionary letter. (4) Aspirin Tablets. Containing 4.3 grains of acetylsalicylic acid per tablet, as against 5 grains declared on the label and required, within certain tolerances, by the British Pharmacopoeia. Proceedings were taken against the manufacturers in respect of the deficiency, and for giving a false warranty to the retailer. On the first count a fine of £2 was imposed, and £3 3s. Od. costs awarded to the Council. The second summons was dismissed under the Probation of Offenders Act. 1907. The two informal samples were of "mince" and aspirin tablets, and it was in consequence of adverse reports on them that the formal samples of these articles, referred to above, were taken. 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 Methylene Blue Satisfactory Failed Satisfactory Failed Pasteurised 10 — 10 — Heat Treated 49 — 48 1 Sterilised 24 — 24 — Monthly returns of the samples taken, and of the results of the examinations, are sent to the Milk Division of the Ministry of Food, and they are at once notified of any adverse report. Milk supplied to Schools and Hospitals. Samples of milk in course of delivery to Schools and Hospitals in the Borough are regularly taken, both for chemical analysis and for submission to the "Phosphatase" and "Methylene Blue" tests. These samples are included in the general totals given on pages 42 and 45. The results of the analyses and examinations are communicated to the London County Council or to the appropriate Hospital Area Board. Ice Cream. Seventy-one samples of ice cream were taken during the year, each sample being submitted to the presumptive test for coliform organisms in 3 tubes at 1/10 ml. dilution, and to the methylene blue test, in 47 ance with the technique suggested by the Ministry of Health. The following is a summary of the results Coliform Test. Methylene Blue Test. Positive in 3 tubes 32 Provisional Grade 1 17 „ „2 „ 3 „ „2 12 „ „1 tube 4 „ „ 3 10 Negative 32 „ „ 4 32 71 71 These results indicate a state of affairs which is far from satisfac- tory, especially in view of the fact that all ice cream is, by virtue of the Ice Cream (Heat Treatment, &.) Regulations, 1947, now required to be subjected to a prescribed method of heat treatment, unless it is made by the "complete cold mix" process from materials already subjected to heat treatment. Where samples of ice cream made at premises in the Borough recieved unsatisfactory reports, the premises, plant, and methods of operation were examined, and, where possible, improvements were suggested. It is worthy of comment that some of the poor samples were of ice cream made by reputable manufacturers, operating the most up-todate plant, and usually wrapping the product at the place of manufacture. It is difficult to explain why this should be so. Doubts have, however, been expressed as to whether the coliform and methylene blue tests really give true picture of the bacteriological condition of ice cream, and it is understood that the Ministry of Food is now working on new tests. Housing. Provision of New Accommodation. Sheepcote Lane Area. Redevelopment by the Council of the first section of this area,which was the subject of a Clearance Order made prior to the war completed during the year, a total of 34 houses and flats being provided. Work of an extension of the original area was in hand at the end of the year. Hibbert Street Area. redevelopment of this area, comprising Hibbert Street, Linda Street, and parts of Wynter Street, Maysoule Road, Hope Street, and York Road, is being carried out by the London County Council. By the end of the year, 3 blocks, containing 105 flats,had been completed. Honeywell Road/Broomwood Road. This site resulted from the demolition, by enemy action of 25 houses, and was subsequently acquired by the Council. Redevelopment was completed during the year, 30 flats being provided. 19/20 Bolingbroke Grove. This site was formerly that of the Council's Maternity Hospital, which was closed in 1938. During the war, the buildings were used as a Civil Defence Depot, and afterwards as offices for the War Damage Repair Organisation and for other purposes. During the year the buildings were demolished and the erection of new flats commenced. 48 Other Permanent Housing Sites. Consideration was given during the year by this Council, and by the London County Council, to the acquisition of a number of sites, with a view to their redevelopment as housing sites. Prefabricated Bungalows. Early in the year the Council's programme for the provision of these bungalows was completed by the erection of 9 further bungalows. The total number provided since the war is 463. Private Enter prise. During the year 4 houses, which had been demolished by enemy action, were rebuilt by the owners, and the rebuilding of two more commenced. Summary of New Accommodation Provided. By Battersea Borough Council (Permanent) 64 (Temporary) 9 — 73 By London County Council 105 By Private Enterprise 4 182 Conversion of Existing Houses. During the year the Council converted into flats 12 houses held under requisition. 28 family units were made available in this way. Repair of Unfit Houses. The question of the maintenance of existing housing accommodation is one of grave concern. Virtually all houses, with the exception of those which have had major works of repair following damage by. enemy action, have had very little maintenance work done to them for the past ten years. Furthermore, many of them have, by reason of the general shortage of housing accommodation, been occupied by more families than would normally have been the case, and have suffered an amount of extra wear and tear. Very many houses, being of considerable age, and not too well constructed, simply will not stand up to continued neglect, and it is no exaggeration to say that quite an appreciable number have already reached a stage of disrepair at which it is problematical whether they can, without virtual reconstruction, be rendered fit for habitation. Very many more are fast approaching that stage. It is abundantly clear that, at the present rate of progress in the provision of new accommodation, a lengthy period will elapse before the general shortage of houses is overtaken, to say nothing of the replacement of those which have come to the end of their useful life. The maintenance of existing houses is, therefore, a matter of paramount importance. This question of maintenance is complicated by the large increase in the cost of building work, coupled with the pegging practically all rents at pre-war levels. These two factors have led to a situation in which the owner of the average house is often unable to overtake arrears of maintenance, and to keep it fit for habitation, without incurring an expenditure out of all proportion to the income from the house. Unless a remedy is found, there will inevitably be a serious and progressive decline in the general standard of housing accommodation. 49 Prior to the War, the Council operated, with considerable success, their powers under Section 9 of the Housing Act, 1936, relating to the repair of unfit houses. During and after the war, these operations, through force of circumstances, were brought to a standstill. Towards the end of 1948, consideration was given to the question of resuming use of these powers. It was decided to do so on a limited scale, and that every effort should be made to secure the repair of the houses by informal action, without recourse to the service of formal notices. In this connection, particular thought was given to the question or "reasonable cost." Prior to the war, the Council had decided, as a general rule, that if the cost of repairing the house exceeded 50 per cent. of its value when repaired, this should be regarded as unreasonable. The rise in building costs over the last ten years, however, and the necessity for preserving as many houses as possible, have obviously rendered this figure obsolete. This matter was under consideration at the end of the year, with a view to formulating a new basis. Acting on these new arrangements, informal notices were served in respect of 23 houses. All these notices were served in the last two months of the year, and work had been commenced in only 5 cases. Closing Orders. One Closing Order under Section 12 of the Housing Act, 1936, was made during the year, in respect of a basement room. A survey of all parts of houses in respect of which Closing Orders had been made by the Council in past years was undertaken, for the Purpose of ascertaining whether these Orders were being observed. In 4 cases it was found that contraventions were taking place. In 3 of these cases, the illegal occupation ceased immediately the existence of the Order was brought to the notice of the occupier, and no action Was taken beyond the sending of a cautionary letter. In the remaining case, the Housing Committee ordered proceedings to be taken, but the summons was not due for hearing till after the end of the year. Demolition Orders. Undertakings given during 1947, under Section 11of the Housing Act, 1936, by the owners of two houses, were complied with during 1948. One undertaking was to demolish the dwelling portion of a combined shop and dwelling-house, and the other was to carry out a Works necessary to render a house fit for habitation. Houses Let in Lodgings. No special action was taken in respect of such houses. Overcrowding. 712 cases of overcrowding were discovered during the year, 642 in consequence of applications for housing accommodation made either this Council or to the London County Council. In some of these cases it appeared that the circumstances were such as to give rise to an offence against the relevant provisions of the Housing Act, but in view of the difficult housing situation it was considered inadvisable to take any legal action. 326 overcrowded families were rehoused during the year, 305 by this Council and 21 by the London County Council. 50 Housing Accommodation Applications. All applications made to the Council are normally dealt with by the Housing Manager, who refers to me those cases in which the application is based wholly or partly on medical grounds. He also refers to me certain cases in which some special feature (e.g., fitness of basement rooms, etc.) is involved. During the year 464 cases were so referred, and the following recommendations were made on them:— Rehousing essential 106 „ advisable 124 No recommendation 234 Eighty-nine families, in respect of which "essential" recommendations had been given in 1947 and 1948 were rehoused in 1948. The London County Council also refer cases in which there appears to be overcrowding, for the submission, in appropriate cases, of an "orange form.'' Overcrowding was found to exist in 70 instances. The London County Council also notify cases in which the application alleges sanitary defects. The houses are inspected and action to secure the remedy of any defects found is taken. Increase of Rent, &c., Acts. Six certificates that houses or parts thereof were not in a reasonable state of repair were issued to tenants. Four reports that houses or parts thereof were in a reasonable state of repair were issued to landlords. Statistics for the Year ended 31st December, 1948. Number of new dwellings (including prefabricated bungalows), erected or re-erected 182 Number of houses demolished:— In pursuance of clearance orders 27 In pursuance of demolition orders — In pursuance of undertakings to demolish 1 28 Number of dwelling houses inspected for housing defects (under Public Health and Housing Acts) 6,974 Number of inspections made for that purpose 34,908 Number of houses at which defects found:— Dealt with under Housing Act (informally) 23 Dealt with under Public Health (London), Act 3,331 3,354 Number of houses where defects remedied:- As result of action under Housing Act 1 As result of action under P.H. Act 3,500* 3,501 Number of houses in respect of which demolition orders were made Nil Number of underground rooms in respect of which closing orders were made 1 Number of closing orders determined Nil * Representing 4,506 notices complied with. In 26 of these cases the Council carried out the work in default of the owner. 51 Factories and Homework. Factories Act, 1937. Metropolitan Borough Councils are responsible for the enforcement of the provisions of this Act in regard to:— (i) Sanitary conveniences—Section 7—In all factories. (ii) Cleanliness Overcrowding, Temperature, Ventilation, and Drainage of Floors—Sections 1, 2, 3, 4 and 6—In all factories where mechanical power is not used. (iii) Certificates of Suitability for Basement Bakehouses—Section 54—In all basement bakehouses. (iv) Water Supply (where derived from a source other than the public mains)—Section 53—In all factories. The following table gives the number of factories on the register at the end of the year, with the number of inspections, defects found, and action taken. 1. inspections for purposes of provisions as to health. Premises Number on Register Number of Inspections Written notices Occupiers prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 113 602 15 — (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 301 1,102 31 — (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 2 5 — — total 416 1,709 46 — 52 2.—Cases in which DEFECTS were found. Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness (S.1) 10 10 — 5 — Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) — — — — — Inadequate ventilation (S.4) 4 4 — — — Ineffective drainage of floors (S.6) 1 1 — — — Sanitary Conveniences (S.7) (a) Insufficient 14 14 — 1 — (b) Unsuitable or defective 24 24 — 10 — (c) Not separate for sexes 1 1 — 1 — Other offences against the Act (not including offences relating to Outwork) — — — — — TOTAL 54 54 — 17 — The table on page 53 shows the factories in the Borough, classified according to the trades carried on. 53 Factories Classified according to Trades. Trade Mechanical Factories Non-Mechanical Factories At 1 Jan. Added Closed At 31 Dec. At 1 Jan. Added Closed At 31 Dec. Baker 38 — — 38 2 1 - 3 Boot Repairer 20 — — 20 3 ] - 3 Builder 3 2 — 5 8 - - 3 Carpenter & Joiner 4 5 — 9 1 - - 8 Chocolate Maker 5 — — 5 1 1 - 2 Coach Builder 1 2 — 3 2 - - 1 cycle Repair 4 — — 4 1 - - 2 Engineer (General) 35 8 — 43 1 1 1 1 Engineer (Motor) 18 3 — 21 13 - 1 1 Farrier — — — — 2 — — 16 Firewood Cutter 6 — — 6 1 3 - 2 1 Florist — — — — 2 - - 1 2 Food Manufacturer 8 1 — 9 2 - - 2 Mason 5 1 — 6 1 - - 2 2 Printer 12 3 — 15 — - - 1 Rag sorter — — — — 9 - - - Sign Writer — 2 — 2 — 2 - 11 Steam Laundary 9 — — 9 — 2 - - 2 Wearing Apparel 16 — — 16 16 - - - Other Trades 77 15 2 90 38 - - 16 39 Total 261 42 2 301 103 6 16 5 6 113 Outworkers. During the year, 52 lists of outworkers were received, 24 from Battersea employers, containing 246 names, and 28 from other authorities containing 118 names. Some of these lists included outworkers no residing in Battersea. These were forwarded to the appropriate authorities. After eliminating them, and duplicate entries, theie remained 222 names and addresses of Battersea outworkers. The total number of registered outworkers' premises in the Borough at the end of the year was 231 (including 4 contractors), 163 premises having been added, and 24 removed, during the year. The total num ei of inspections made was 1,234, most of them by the female Inspectoi. The premises were found to be generally satisfactory, and it was no found necessary to serve any notices or take any other action. Two cases of infectious disease occurred at outworkers premises, and the usual precautions to prevent spread of infection were taken. The following table gives details of the outworkers' premises:— Trade Number on Register Persons employed Premises Workrooms Wearing Apparel 106 107 120 Curtains, etc. 3 3 3 Artificial Flowers 5 5 5 Boxes, etc 6 6 6 Lampshades 111 112 125 231 233 259 54 Bakehouses. There were 41 bakehouses on the register at the end of the yearAll of these are classed as factories, and 38 of them use mechanical power. Fifty-six inspections were made and 16 notices served for defects of various kinds, all of which were complied with. Nine of the bakehouses are " basement bakehouses " within the meaning of the Factories Act, 1937, and the quinquennial inspection of such bakehouses, for the purpose of deciding whether or not the " Certificate of Suitability " should continue in operation, fell due to be made in the year commencing 1st July, 1948. One of these bakehouses was inspected, and on consideration of the report on its condition the Council decided to give notice to the occupier that the certificate would cease to operate as from a period of three months from the date of the notice. The notice was served on the 15th December. The occupier has right of appeal against it to a Court of summary jurisdiction, this right to be exercised within 21 days of the date of service. He had not exercised it by the end of the year. Miscellaneous Matters. Student Sanitary Inspectors. During the year practical training was given to 3 student sanitary inspectors, under the Government's Special Scheme for the training of Sanitary Inspectors. Each of these students attended in the Public Health Department for a period of 8 weeks, and spent similar periods with each of two other local authorities. In addition, practical training was given to two members of the Clerical Staff of the Health Department who are studying for the Qualifying Certificate, at such times as they could be spared from their normal duties. Conferences. The Council were officially represented at the undermentioned Conferences dealing with matters within the purview of the Public Health Denartment. Conference. Family Relations Group—" Education for Family Life." London. 5th and 6th January. Royal Sanitary Institute. Harrogate. 24th to 28th May. Sanitary Inspectors' Association. Blackpool. 7th to 11th June. National Association for Maternity and Child Welfare and Prevention of Infant Mortality. London. 23rd to 25th June. Delegates. Cllrs. Mrs. N. E. Roberts and Mrs. A. R. Wye. Cllr. Miss E. A. Coles, j.p., and the Medical Officer of Health. Cllr. Mrs. E. A. Cooper, j.P., and the Chief Sanitary Inspector. Cllr. Mrs. E. A. Cooper, J.p., and the Assistant Medical Officer of Health (M. & C.W.). 55 National Smoke Abatement Socy. Cheltenham. 29th September to 1st October. Public Health and Municipal' Engineering Annual Congress and Exhibition. London. 15th to 20th November. National Old People's Welfare Committee — " Care of Old People." London. 26th and 27th November. Ald. A. P. Holden and the Medical Officer of Health. Ald. A. P. Holden and Cllr. Mrs. A. R. Wye. Cllr. A. H. Humphrey and Mrs. E. Stone. 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 1948 are set out in the following table :— Battersea Mortuary, 1948. Details of Bodies received Usual place of residence Total Batter- sea Wandsworth Elsewhere Residence unknown Post-mortem only. 111 251 95 5 462 Post-mortem and inquest 42 137 107 7 293 Total post-mortems 153 388 202 12 755 Inquest only — — 3 2 5 Total inquests 42 137 110 9 298 Sanitary and other reasons — — — 2 2 Total bodies received 153 388 205 16 762 VERDICTS AT INQUESTS HELD Natural causes 11 32 46 4 93 Accident and misadventure 23 67 54 2 146 Open verdict — 2 2 2 6 Suicide 7 36 7 1 51 Homicide 1 — 1 — 2 Total 42 137 110 9 298 The Wandsworth Borough Council again made a grant of £250 towards the cost of maintaining the Mortuary. 56 Personal Cleansing Station. During the year 1948 there were 3,266 children and 497 adults cleansed and treated at the station. Of the 3,266 children attending, 713 were suffering from scabies or itch, a contagious parasitic skin affection. The remainder were verminous. Of these children 3,116 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 Day 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 betrun :— 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 1948 497 3,266 1,808 408 Total 33,160 139,962 28,573 12,984 * Financial year ending 31st March. Other columns, calendar year.