AC 4386 P II BAT 51 Alertopoitan Borough of Battersea. REPORT ON THE HEALTH OF THE Metropolitan Borough of Battersea, FOR THE YEAR 1952 BY J. TUDOR LEWIS, M.D., D.P.H. MEDICAL OFFICER OF HEALTH. BATTERSEA BOROUGH COUNCIL With the compliments of the Medical Officer of Health Electric House, 204 Lavender Hill, Battersea, S.W.11. Metropolitan Borough of Battersea. REPORT ON THE HEALTH OF THE Metropolitan Borough of Battersea, FOR THE YEAR 1952 BY J. TUDOR LEWIS, M.D., D.P.H. MEDICAL OFFICER OF HEALTH, Dealtb Committee. As constituted 21st May, 1951. Chairman : Alderman Miss E. A. Coles, j.p. The Worshipful The Mayor As constituted 21st May, 1952. Chairman: Councillor Mrs. E. A. Cooper, j.p. The Worshipful the Mayor (Cllr. Douglas A. G. Prichard, J.P., L.C.C.) Councillor C. J. Bennett. (Alderman Miss E. A. Coles, j.p.) Councillor C. J. Bennett. „ Mrs. E. A. Cooper, j.p. „ Miss N. F. Clark- Lawrence. „ Mrs. C. M. Davis. „ Miss B.L. Hayr. „ Mrs. C.M.Davis. Alderman A. P. Holden. Councillor A. J. Knott. „ L.W.Goodwin. „ *A.C. Marshall. „ Miss B.L. Hayr. „ Miss G. A. Morgan. Alderman A.P.Holden. Alderman A.A.Rignall. Councillor Mrs. N.E.Roberts Councillor C.E.Lang. „ Miss G. A. Morgan. Alderman A. A. Rignall. Councillor Mrs. N. E. Roberts. „ Dr.I.N.Samuel. * This Member subsequently resigned. iuviiiuvi 1 V.OigllVV.1. Cllr. Miss N. F. Clark-Lawrence was appointed to fill the vacancy. „ Dr.I.N.Samuel. Staff of public health Department. Medical Officer of Health J. Tudor Lewis, m.d., d.p.h. Deputy Medical Officer of Health A. Garland, m.d., m.r.c.p., d.p.h. Chief Sanitary Inspector F. H. Chuter (a c). Deputy Chief Sanitary Inspector J. R. Holloway (a c). Sanitary Inspectors: District. 1. W. E. Selway (b c). 2. G. W. P. Weeks (b c). 3. A. Webb (b c). 4. P. D. O'Grady (b c). S. J. R. Glover (b c). Other. CFood) J. A. H. Brownlow (b c). (Factories, I. R. Lewis (b c). etc.) Miss J. Round (a d). Rodent Officer: F.G.Daniels. Administrative and Clerical Staff: W. Halstead. P. Brocking. E. B. Moreton. K. A. Pye. Disinfecting Station— Superintendent—T.J.Farrow. Mortuary —Superintendent—W. Newman. 6. R.J. McCarthy (a c). 7. R.C.Decent (b). 8. J. R. Holloway (o c). 9. P. Ianson (b c). 10. J.J.K.Helmer (b c) I (Catering Establishments) Miss A. L. Jones (6 c). (Miss) E. Town. (Miss) P. J. Blow. S. Whitbread. W. A. G. Griffiths (temporary, appointed 8th Sept.) Public Analyst j. E Woodhead, B.sc, f.r.i.c, ph.c. Deputy Public Analyst (Vacant) (a) Sanitary Inspectors certificate of the Sanitary Inspectors' Examination Board. (b) Sanitary Inspectors' certificate of the Royal Sanitary Institute and Sanitary Inspectors' Examination Joint Board. (c) Meat and other Foods certificate, Royal Sanitary Institute, or Sanitary Inspectors' Examination Board. (d) Health Visitors' certificate, Board of Education. 3 INDEX TO SECTIONS. page Preface 4 Health Committee 2 Staff of the Public Health Department 2 Principal Figures for 1952 7 Vital Statistics 8 Infectious Diseases 14 Tuberculosis 17 Cancer 20 bacteriological Examinations 20 Sanitary Circumstances 22 Protection of Food Supply:— (a) Inspection of Food Premises 33 (b) Sampling of Food and Drugs 38 housing 44 factories and Homework 47 Miscellaneous Matters 50 4 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Battersea. Mr. Mayor, Ladies and Gentlemen. I beg herewith to present to you the Annual Report on the health and sanitary conditions of the Borough for the year 1952. Many matters touching the health of the people of Battersea are dealt with fully in the Report and here all I need do is to indicate generally some of the more interesting or important details. The population showed a slight decline over the previous year. The birth rate continued the decline which has been noted since the termination of the war, while the death rate also was slightly less than the previous year although a little above that for 1950. There was quite a remarkable drop in the infant mortality rate from 27 to 17 infant deaths per thousand live births. This is the lowest infant mortality rate ever recorded in Battersea, and I think it reflects every credit on the many agencies at work in the Borough concerned with the health and welfare of infants. Even greater efforts will be required to reduce the rate still further and this emphasises the need for an ever increasing effort in the realms of child health. Unfortunately, the still-birth rate was rather above that of the previous year although below that for 1950. There were three deaths from causes relating to child-birth. Infectious diseases did not provide us with any serious problems. The total number of notifications was considerably less than in the previous year, due in the main to a drop in the number of notifications of measles and whooping cough. Fourteen confirmed cases of Poliomyelitis occurred, but of these fortunately six were of the nonparalytic type. I am very sorry to have to report that the only case of Diphtheria which occurred in the Borough was a fatal case. The child had not been immunised against Diphtheria. The lesson to be learnt from this unfortunate case is that we cannot and must not relax our efforts to maintain the high proportion of children immunised against what still remains a dread disease. The Department continued to give special attention to the prevention of food poisoning and the supervision of catering establishments, and a good deal of work was again put in at the Festival Gardens, regular visits being made by Food Inspectors and periodic visits by your Medical Officers. Every facility and courtesy was received from the Festival Gardens Authorities and the caterers themselves. One of the more urgent problems in public health and sociology is the welfare of old people. We have tried to pay particular attention to this very important matter over and above our statutory obligations and you will find in the body of the Report a short summary of what we are trying to do in the way of assisting and co-ordinating the many voluntary bodies in the Borough which themselves are doing such excellent work in this sphere. 1952 was the first complete year in which the new and somewhat novel arrangements for health administration in Battersea were in operation. I refer, of course, to the arrangements by which the Medical Officer of Health of Battersea is also Medical Officer of Health of the adjoining Metropolitan Borough of Wandsworth and Divisional Medical 5 Officer for the London County Council Health Division 9, while the Deputy Medical Officer of Health of Battersea is also Assistant Divisional Medical Officer for Health Division 9. I do not wish to make more than a brief reference to this important subject in this Report since at the time of writing the arrangements have been operating for only about eighteen months. It is, however, proper that members of the Council should have a short interim statement on a method of public health administration which I know has aroused a good deal of interest and comment. One of the major problems in the administration of the health services is to effect the closest liaison between the various branches of the health and medical services. The main branches are the public health and preventive medical services, the responsibility of various types of local authorities; the hospital and specialist services, the responsibility of the Regional Hospital Boards, Boards of Governors and the Hospital Management Committees; and the general medical or general Practitioner services, the responsibility of the Local Executive Councils. Everyone is agreed on the need for the closest integration of the work of these three statutory bodies and of the officers of all grades who serve under them. The problem, however, is even more marked where there is a dual responsibility within the local authority health services, and Probably is most acute within the County of London. Many of the Metropolitan Boroughs (Battersea is an example) which are responsible only for the environmental health services are larger than many of the important provincial County Boroughs which are all-purpose authorities, whereas the London County Council (the largest public health authority in the country) is responsible for the personal health services and is also the education and the welfare authority. It is, I think, a testimony to the efficiency and skill of the officers engaged in the local public health service in London that, under the circumstances, the standard of public health practice and administration in both spheres is so high. Nevertheless, it must be obvious that this dual responsibility is a very serious weakness in the administration, and there is everything to be said for effecting an integration and blending of the two sections of the preventive health services. There are a number of ways, no doubt of varying degrees of practicability, by which this Ca n be attempted, and one way is the method which has been adopted in this area, where the Medical Officer of Health for the adjacent Boroughs and the Divisional Medical Officer is ultimately responsible to t he Committees concerned for the administration of the two sections of the public health services, and it should be possible, at least m theory, for the two branches of the public health and preventive medical services to be very closely combined and co-ordinated. I am happy to be able to state that up to the time of writing, no difficulty whatsoever has been experienced. I have not met a my unduly serious administrative problems and lam unaware that a ny commitment or responsibility has gone undischarged. Apart from the feasibility and practicability of the arrangements as a purely administrative problem, there are many other advantages. For instance, the area and population concerned is such that it forms a convenient a nd economic unit for the purpose of planning the public health services a nd this means that over a reasonably sized area unified methods of sanitary administration and the practice of preventive medicine can be applied. This in itself tends to eliminate problems which might arise if there were three separate departments with three separate heads, and local difficulties can be more easily ironed out with resulting benefit to all sections of the work. Of the advantages, however, perhaps the most obvious are those which concern those aspects of the work which are partly the responsibility of the Metropolitan Borough of Battersea and partly of the London County Council. In the control of infectious diseases, for example, particularly outbreaks in schools and day nurseries, the Borough Council has the main responsibility as the authority charged with the prevention of infectious diseases, but the London County Council is also concerned in that the infectious disease occurred in one of their institutions. By having one person responsible for both, there is only one guiding hand and both authorities' officers can be employed as may be necessary in conjunction or separately to the best effect. We have had examples during the year where the arrangements have been found most effective. Another example is in the care of old people, where the statutory responsibilty for the removal of an old person to hospital rests on the Borough Council, whereas much of the other responsibility in relation to their health and welfare rests on the London County Council. Here again with one person in charge, it has been possible to effect the very closest liaison with, I think, material benefit to the old person concerned. Again in the matter of housing, both authorities are concerned, particularly in recommendations on medical or health grounds, and undoubtedly this work is much facilitated under the present arrangements. These are but a few examples of how the two separate services can be closely integrated under the present system. An efficient public health and preventive medical service is essentially a team service, and probably the team spirit i£ more vital in the system operating in Battersea than in any other system. Undoubtedly the greatest single factor in making for success in this form of administration is an abundance of good-will and a determination by all persons at both committee and officer level, to make the system work through a community of effort. It is most gratifying to be able to report that I have experienced nothing but the greatest keenness by everybody to ensure the success of this venture I should like to record the great help and encouragement I have personally received from the members of the Battersea Borough Council, especially the members of the Battersea Health Committee and, in particular, from the two Health Committee Chairmen under whom I have served, namely Alderman Miss E.A.Coles, j.p., and Councillor Mrs. E.A.Cooper, j.p. I should like to say how much I have appreciated and valued the great deal of help, encouragement, and kindly advice which has always been forthcoming at member level. In like measure, the Chief Officers and the Senior Officers of Battersea have done everything to make my first year in the Borough a happy and successful one, and if I mention Mr. R.G.Berry, o.b.e., the Town Clerk, separately. it is because inevitably I have been most closely in touch with himThen the officers and staff of the Health Department in all sections and all grades have rendered me yeoman service and every member has played his or her part in the work as a whole. I should like particularly to mention my deputy, Dr. Anderson Garland, who has been untiring in giving me every support and I am most grateful to him for the loyal and efficient way in which he has done so and for ensuring that our contacts with other departments and outside bodies related to our work have been close and harmonious. The Chief Sanitary Inspector, Mr.F.H.Chuter, has been most assiduous in his efforts to make available to me his extensive experience of sanitary work in general, and of problems connected with the Borough in particular, and I am most appreciative of the great help he has given me. To everyone concerned, therefore, I would like to express my warmest thanks and appreciation for making my first year's work in Battersea as much a pleasure as it has been a privilege. Eighteen months is not a very long time and I have been deliberately cautious in making this interim statement. My feeling at the moment is that certainly the foundations of a permanent success have been laid and if the very happy spirit of team-work, which has so far permeated the whole of our efforts at all levels, can be continued, I see no reason why this method of public health administration should not in this area prove to be highly successful. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, J. TUDOR LEWIS, Medical Officer of Health. May, 1953. Principal Figures for 1952. Area of Borough, excluding tidal water (acres) 2,163 Home population (1951 Census—Provisional) 117,130 Home population (Registrar-General's Mid-Year Estimate) 116,400 Structurally separate occupied dwellings 27,391 births (live, 1,765; still, 42) 1,807 Live birth rate 15.16 Deaths—1,387. Death rate 11.92 Maternal deaths—3. Maternal death rate 1.66 Infant deaths—31. Infant mortality rate 17.56 Vital Statistics. The Registrar-General's estimate of the mid-year home population of Battersea was 116,400 as compared with 117,000 in 1951, a decrease of 600. The estimated mid-year home population figure of 116,400 has been adopted for the purpose of the statistics contained in this Report. BIRTHS. The number of live births registered in the Borough during 1952 was 1,484 (767 male, 717 female). Of this number 691 were transferred out, the permanent residence of the parents being outside the Borough, and 972 registered outside the Borough were transferred in, giving on balance a total of 1,765 births (896 male, 869 female, an excess of 27 males) relating to Battersea residents, and a live birth rate of 15.16 per 1,000 population. This is a decrease of 0.96 on that of 1951. Of the Battersea births (793 live and 20 still) which occurred within the Borough, 468 were "domiciliary births." Illegitimate births numbered 97 or 5.5 per cent, of the live births. The live birth rate was 17.6 for the County of London, and 15.3 for England and Wales. Still-Births. The registration of still-births is made compulsory by the Births and Deaths Registration Act, 1926. During 1952 there were 43 still-births registered in Battersea, of which 20 were of Battersea parents. 22 still-births occurring outside the Borough were registered as belonging to Battersea, making 42 in all, representing a still-birth rate of 23.24 per 1,000 births (live and still) registered. Of the 42 still-births 1 (2.4 per cent.) was registered as illegitimate. The number of Battersea still-births registered, and the still-birth rates from 1942 to 1952 were as under:— No. Rate No. Rate 1942 43 26.7 1948 46 20.1 1943 36 21.6 1949 43 20.8 1944 40 24.0 1950 53 27.2 1945 38 23.3 1951 37 19.2 1946 59 22.7 Mean 1947 74 27.0 1942-51 47 23.3 1952 42 23.2 MARRIAGES. The marriages registered in Battersea during 1952 numbered 884. The marriages rate (i.e. the number of persons married per 1,000 of the population) was 15.2. Year. Marriages. Marriage Rate. 18.9 1947 1,085 988 17.0 1948 1949 1,031 17.2 1950 16.1 949 929 1951 15.9 Mean 1947-51 996 17.0 884 1952 15.2 DEATHS. The number of deaths registered in the Borough during 1952 was 1.985. Of these, 1,080 were deaths of non-residents and were transferred to the districts in which the persons ordinarily resided. There were, On the other hand, 482 deaths of Battersea residents registered outside the Borough. The total (corrected) number of deaths belonging to the Borough was 1,387 (males, 718; females, 669). This gives a recorded death rate of 11.92 compared with 12.6 for London, and 11.3 for England and Wales. The following table shows the age and sex distribution of the total deaths (corrected) in Battersea during 1952: — rn Under 1 year. 1- 5- 15- 25- 45- 65- 75+ Total 218 M. 21 9 9 3 33 190 718 235 10 116 1 4 6 35 669 F. 184 13 313 10 9 68 Totals 306 1,387 31 402 548 % of Total 0.7 0.9 0.6 4.9 22.1 29.0 39.6 2.2 100.0 Of the 1,387 Battersea deaths, 757 (or 54.6 per cent.) occurred in h opitals, etc. 10 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, 1940/1944 60.9 1945 62.4 1946 61.4 1947 62.6 1948 63.3 1949 65.3 Mean, 1945/1949 63.0 1950 65.5 1951 66.7 1952 67.7 The deaths of 950 residents of Battersea aged 65 years and upwards were registered during 1952. These 950 deaths constituted 68.6 per cent, of the total deaths at all ages. The natural increase of population (that is, excess of births over deaths) was 378 in 1952 as compared with 430 in 1951. The causes of the 1,387 deaths in 1952 classified in various age groups, are shown in the following tables. 11 Causes of Death at Different Periods of Life in Battersea during 1952 The following table is supplied by the Registrar-General:— Sex. All Ages. 0- 1- 5- 15— 25— 45— 65— 75- Causes of Death. 3 6 9 1 33 35 190 116 M. 718 669 9 4 235 313 All Causes 21 10 218 184 F. M. F. 24 10 - - - - 2 4 4 1 1.Tuberculosis, respiratory - 15 4 3 1 - - - - - M. F. - - - - - - - - 2.Tuberculosis, other forms 2 1 1 - - - 1 1 2 1 3. Syphilitic disease M. F. M. F. 4 2 - - - - - - - - - - 1 - 1 1 4. Diphtheria 1 - - - - - 1 - - - - - - - - - - - - - M. F. - - - - - - - - 5. Whooping cough - - - - - - - - M. F. - 1 - - - - 6. Meningococcal infections - 1 - - - - - - - - - - M. F. - - - - - - - - - - 7. Ac. polio-myelitis and polio-encephalitis - - - - - - - - - - - - - - - 8. Measles M. F. - - - - - - - - - - M. F. - - - - - 9. Other infective and parasitic diseases 2 - 1 - 1 - - - - - - - - - 8 10 7 5 10. Cancer of stomach M. F. 21 22 - - - - - - 6 5 - - - 2 43 9 - - 2 1 3 3 11.Cancer of lung, bronchus M. F. - - - - 27 3 11 2 - - - - - - - 1 - 1 - - - - - - - - - 21 - - - - - - 10 12. Cancer of breast M. F. - 2 - 3 - 6 - 1 13. Cancer of uterus M. F. - - - - - - 1 - 6 - 1 - 10 - 1 57 56 17 23 14. Cancer of other sites 1 - - - 3 3 M. F. - - 18 17 18 12 1 - - - 15.Leukæmia, aleukæmia M. F. 3 1 - - - - 1 - 1 - - - M. F. - 4 16. Diabetes 3 8 - - - - 1 2 2 2 - - - - 14 14 17.Vascular lesions of nervous system 60 94 - - - - - - 1 4 12 31 33 45 M. F. 100 73 - - 31 10 30 32 M. F. - 1 39 30 18. Coronary disease, angina - - - - 19.Hypertension with heart disease 20 13 - - - - - - 6 7 M. F. - - 2 1 12 5 12 Causes of Death, 1952—(contd.). 25— 65- 21 28 13 8 1 - 10 5 75— Causes of Death. Sex. All Ages. 0- 1- 5— 15— 45 — M. F. - - 99 133 - - - - 61 90 20. Other heart disease - - 5 3 12 12 - - - - - - 21. Other circulatory disease M. F. 36 30 - - 1 - 9 6 13 16 2 2 - - - - - - - 1 1 - 22. Influenza - 1 M. F. - - 4 2 2 - 1 - 23. Pneumonia M. F. 32 32 - - 2 1 5 5 8 19 - 1 1 - 24. Bronchitis M. F. 2 - - 1 - - 20 5 26 30 88 55 - - 40 18 - - - - 25. Other diseases of respiratory system M. F. 7 5 1 - 2 1 4 - 1 - 1 1 1 - - - - 1 8 9 2 1 3 2 4 - - - 3 2 - 2 - - - - 26. Ulcer of stomach and duodenum M. F. - - - - 9 2 18 6 - - 3 4 2 - M. F. - - 1 - 27. Gastritis, enteritis and diarrhæa 2 1 - - - - - - - 1 - - - - 28. Nephritis and nephrosis M. F. - 1 - 1 - 2 1 3 5 8 2 - 1 - 10 - 29. Hyperplasia of prostate M. F. - - - - - - 5 - 4 - - - - - - 1 - - - - 30. Pregnancy, childbirth, abortion M. F. - 3 - - - - - 2 - - - - - - 31. Congenital malformations M. F. 3 4 2 2 1 - - 1 - - - - 47 48 12 5 M. F. 1 1 32. Other defined and illdefined diseases 2 1 3 4 12 15 7 13 2 - 8 6 1 - 33. Motor vehicle accidents M. F. 1 - 1 1 1 2 1 2 - - 1 - 13 13 - - M. F. - - 1 - 3 8 34. All other accidents - - 6 - - 3 - - 1 - 35. Suicide M. F. 2 1 8 1 - - - - 1 - - - - - 36. Homicide and operations of war - - - - - - - 1 M. F. - - - 1 - - Infant Mortality. During 1952 the deaths of 31 infants under 1 year of age were registered as belonging to Battersea. The total number of live births registered during the year was 1,765 giving an infant mortality rate of 17.56 per 1,000 live births as compared with 27.57 in 1951 and 26.86 in 1950. The infant mortality rates in the County of London and in England and Wales during 1952 were 23.8 and 27.6, respectively. 13 The following table sets out the causes of death in detail. Infant Mortality, 1952 Nett Deaths from stated causes at various ages under 1 year. CAUSES OF DEATH Under 24 hours. AGE PERIODS 1-7 days. Weeks. Total under 4 weeks Months. Total deaths under 1 year. 1-2 2-3 3-4 1-3 3-6 6-9 9-12 M. L F. _ r 3 r □ M. _ F. J L M. F. M. F. M. 1 F. 4 M. 1 F. 1 M. 4 F. 2 M. 1 F. 1 M. F. M. 1 F. M. 1 F. 1 ■ 1 1 1 Bronchitis : " 2 J 4 J. 1 « I 1 Gastritis, enteritis and diarrhœa 5 1 L 1 Congenitat malformations 1 2 1 ■ i 1 2 r r 2 2 - I 1 2 I. 8 2 4 3 4 1 4 8 2 3 J 1 Other defined and ill-detined diseases: Prematurity Other causes 4 1 3 1 Motor vehicle accidents r 1 1 5 3 7 1 2 1 21 10 1 a 3 3 1 2 2 Totals 13 4 31 8 17 6 3 2 8 1 3 Percentage of total 54.8 19.4 9.7 6.4 25.8 25.8 3.2 9.7 100.0 There were 17 deaths of infants during the first four weeks of life (or 54.8 per cent. of the total infant deaths) as compared with 32 deaths (or 61.5 per cent.) in 1951 and a percentage for the quinquennium 1947-1951 of 57.1. Table showing Deaths of Infants under 1 day, under 1 week and under 4 weeks from 1947 to 1952. Under 24 hours 1 to 7 days 1 to 4 weeks Total under 4 weeks Percentage deaths under 4 weeks of total infant deaths Year 1947 19 8 39 46.4 12 1948 7 33 46.4 14 12 1949 33 64.7 13 13 7 1950 5 14 15 34 66.7 1951 8 21 3 32 61.5 Mean 12 16 6 57.1 34 19 52 8 8 1 17 54.8 Pneumonia 14 Deaths of Illegitimate Infants. The death rate amongst illegitimate children during 1952 was 41.23 per 1,000 illegitimate live births, as compared with 42.73 in 1951, 40.40 in 1950, 22.73 in 1949 and 44.30 in 1948. The corresponding death rate of legitimate children in 1952 was 16.19 the ratio of mortality rate of illegitimate infants to that of legitimate being 255 to 100. The corresponding figure for 1951 was 161 to 100. Maternal Mortality. During 1952 there were three deaths of women from diseases or accidents of child-birth, which is equivalent to a fatality rate of 1.66 per 1,000 births (live and still). There were no such deaths during 1951. The rate for England and Wales in 1952 was 0.72. Comparative Statistics of Births, Mortality, etc. (Compiled from Registrar-General's Returns.) Live Birth Rate Death Rate Maternal Death Rate Infant Mortality Rate Year Population 0.0 53.9 89,160 18.3 15.8 1943 1.22 49.8 1944 85,380 19.0 17.7 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 1.00 31.6 11.3 1949 117,510 17.2 0.97 12.1 25.2 1950 26.9 117,700 16.1 11.2 1.02 16.1 1951 117,000 12.4 0.00 27.6 1952 116,400 15.2 11.9 1.66 17.6 Infectious Diseases. There was a decrease in the number of notifications received during 1952, there being 1,661 during the year as compared with 3,476 in 1951, a decrease of 1,815. This, in the main part, was due to a drop in the number of notifications of measles and whooping cough. There were 1,657 measles and 199 whooping cough notifications less in 1952 than in the previous year 1951. Seventeen cases of polio-myelitis were notified, but in three of these cases the diagnosis was not confirmed, leaving 14 confirmed cases (8 paralytic and 6 non-paralytic) all but one occurring in children under 15 years of age. A further 9 suspected cases were removed to hospital where it was found that the patients were not suffering from this disease. There were 23 confirmed cases in 1947, 5 in 1948, 28 in 1949, 7 in 1950 and 2 in 1951. During the year there was only one case of diphtheria in the Borough, occurring in a child who had never been immunised. This case unfortunately proved fatal, the patient dying before he could be removed to hospital. 15 Diphtheria and Whooping Cough Immunisation, Smallpox Vaccination. Diphtheria and Whooping Cough immunisation and vaccination against Smallpox were carried out throughout the year under the control of the London County Council. The following table shows the number (corrected) of cases notified during 1952 and, for the purpose of comparison, the average number of cases notified annually in the five years, 1947 —1951: — Diphtheria Notified 1952 Average 1947/51 8 1 12 28 Erysipelas 122 175 Scarlet Fever 1 Enteric (Typhoid) Fever - 40 Puerperal Pyrexia 19 Meningococcal Infections 4 2 6 Ophthalmia Neonatorum - - Acute Encephalitis - 13 Polio-Myelitis & Polio-encephalitis 14 Malaria - - 10 Dysentery 8 Pneumonia 105 96 (Acute Primary) 8 13 (Acute Influenzal) 82 5 Scabies 5 6 Food Poisoning 426 141 Whooping Cough 1,007 1,230 Measles Tuberculosis (all forms) 176 188 1,661 Totals 2,290 Analysis of Cases (After Correction of Diagnosis) of Infectious Disease Notified during the Year 1952. Notifiable Disease. Cases Notified in Battersea,6 at Ages (Years). 0— 1— 5— 10- 25— 35— 45— 65 & over 3— 15— Total - - - - - - Small Pox - - - - - 1 Diphtheria - - - 1 - - - - - - 1 - - 4 - 4 Erysipelas - 1 2 12 - 2 6 29 2 Scarlet fever - 75 8 - - 122 - - - Enteric (typhoid) fever - - - - - - - - - - - - - - - - - - - - Continued fever - - 6 - Puerperal pyrexia - 19 15 40 - - 1 - - - Meningococcal infections 1 - - - - - 2 - - - - - - Ophthalmia neonatorum - - - - - - - - 8 Polio-myelitis:- 2 - - Paralytic 2 4 - - - 1 - - - - Non-paralytic 2 1 2 - 6 - Acute Encephalitis:— - - - - - Infective - - - - - - - - - - - Post-infectious - - - - - 2 - - - - - Malaria - - 1 - - - 10 - 1 - - - 1 Dysentery 1 3 1 - 5 Acute primary pneumonia 8 7 12 9 20 105 10 1 - 11 22 3 Acute influenzal pneumonia 1 1 1 2 8 - - - - - 1 - 2 Scabies - 1 1 1 5 - 1 - 2 - - Food poisoning 2 - 6 - 51 - 1 - 1 - 11 29 Whooping cough 44 32 - 7 1 - 141 - 27 - 9 212 260 456 4 3 39 1,007 Measles Tuberculosis:— .. 4 2 11 35 5 1 171 53 Pulmonary 22 4 - - - - Non-pulmonary 1 1 - 3 4 3 17 Totals 38 282 336 77 94 56 77 30 54 617 1,661 17 TUBERCULOSIS. During the year 1952 there were 188 cases of Tuberculosis (all forms) notified in Battersea as compared with 162 in 1951, 149 in 1950, 194 in 1949, 213 in 1948 and 162 in 1947. In addition 61 cases were reported or otherwise came to the knowledge of the Medical Officer of Health, making a total of 249 cases for the year. The case rate per 100,000 population was 213.9. The tables on page 19 give details in age groups of the 249 cases. Deaths from Tuberculosis. During 1952 deaths from Tuberculosis registered as belonging to the Borough of Battersea numbered 37, of which 34 (i.e., 92 per cent.) were due to pulmonary tuberculosis, 3 (i.e., 8 per cent.) to other forms of the disease. The death rate per 100,000 of the population during the 50 years ended 1950 in quinquennial averages and the years 1951 and 1952 are given in the following table: — Years Pulmonary Non- Pulmonary Total 1901-1905 138.1 50.9 189.0 1906-1910 45.9 126.8 172.7 33.8 158.0 1911-1915 124.2 134.8 30.0 1916-1920 164.8 1921-1925 92.6 23.0 115.6 91.1 105.3 1926-1930 14.2 1931-1935 81.8 14.4 96.2 85.3 1936-1940 9.2 76.1 1941-1945 91.8 11.0 102.8 6.1 53.1 59.2 1946-1950 101.0 23.9 Average (50 years) 124.9 42.7 1951 39.3 3.4 2.6 1952 29.2 31.8 The death rate per 100,000 population was 24 for England and Wales, and 31 for the County of London. 18 - 195 56 1,190 GRAND TOTAL Total 1,134 188 - 251 - 5 2 56 42 - 5 94 48 6 - Females 570 78 - 2 2 30 - 112 12 - 2 55 28 5 - 102 10 - 580 Males 564 110 - 3 - 26 - 139 30 - 3 39 20 1 - 93 46 - 610 Cases Added to and Removed from Notification Register. NON-PULMONARY Total 129 17 - 1 - 5 - 23 2 - 1 8 10 4 - 25 - 2 127 Females 87 12 - 15 1 18 84 - - - 3 - - 6 7 4 - - 3 Tuberculosis, 1952. - 1 - 2 - - 1 2 3 - - 1 - 7 43 Males 42 5 8 1 PULMONARY Total 1,005 171 - 4 2 51 - 228 40 - 4 86 38 2 - 170 58 - 1,063 Females 483 66 - 2 2 27 - 97 11 - 2 49 21 1 - 84 13 496 - Males 522 105 - 2 - 24 - 131 29 - 2 37 17 1 - 86 45 - 567 Already on Register, 31/12/51 Primary notifications Notified after death Unnotified deaths Restored Removals into Borough From other sections TOTAL ADDITIONS Deaths Notified after death Unnotified deaths Removals from Borough Recovered Diagnosis not confirmed To other sections TOTAL DELETIONS Net increase Net decrease On Register at 31/12/52 19 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) Age Periods - 2 Respiratory, Males 12 7 - 10 7 31 11 18 3 2 105 2 22 - 66 Respiratory, Females 1 4 11 11 - - 1 - 7 6 3 - Non-Respiratory, Males - 1 - 1 - 5 - - - - - 3 - - Non-Respiratory, Fem. - - 2 4 - - 12 - 2 - 3 - 1 New Cases of Tuberculosis coming to the knowledge of the Medical Officer of Health otherwise than by formal notification. Source of Information. I II 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. - - - - - - - - - - - - - -(A) F - - - - - - - - - - 1 - - 1 (B) N.R. M — — 1 - - - - - - - - - - 1 (C) F - - - - - - - - - - - - - -(D) Death Returns from Registrar-General (Transferable Deaths) R. M - - - - - - - - - - 2 - - 2 (A) F - - - - - - - - - - - 1 - 1 (B) N.R. M - - - - - - - - - - - - - - (C) F - - - - - - - - - - - - - - (D) Posthumous Notifications R. M. - - - - - - - - - - - - - - (A) F - - - - - - - - - - - - - - (B) N.R. M - - - - - - - - - - - - - - (C) F - - - - - - - - - - - - - - (D) "Transfers" from Others Areas (excluding transferable deaths) Other Sources R. M F N.R. M F R . M F N.R. M F R-Respi ra tory N.R-Non-Respnatory. - - - - - - 6 9 3 4 2 - - 24 (A) - - - - - 3 11 11 2 - - - - 27 (B) - - 1 1 - - - - - - - - - 2 (C) - - - - - 1 1 - 1 - - - - 3 (D) - - - - - - - - - - - - - - (A) - - - - - - - - - - - - - - (B) - - - - - - - - - - - - - - (C) - - - - - - - - - - - - - - (D) 26 (A) Totals 29 (B) „ 3 (C) „ 3 (D) „ 61 Total number of Informal Notifications 20 MASS X-RAY. A Mass X-Ray unit of the South-West Metropolitan Regional Hospital Board was stationed at the Town Hall (Lower Hall) during the period 4th June to 3rd July, 1952, and 5,057 persons (2,200 men and 2,857 women) were examined. The results of the examinations showed that 12 men and 8 women had radiologically significant lesions, probably tuberculous, requiring investigation, and were referred to chest clinics through their general practitioners. In addition 9 men and 2 women were to be followed up with an occasional film through the X-Ray service. 6 men and 1 woman had chest lesions, probably not tuberculous, of sufficient seriousness to merit investigation at a chest hospital. The unit also visited several individual large firms in the Borough during the course of the year. CANCER. During 1952 the number of deaths of Battersea residents from Cancer was 239 (males, 121; females, 118) as compared with 252 in 1951, 237 in 1950, 269 in 1949 and 232 in 1948. The death rate from the disease per 1,000 of the population was 2.05. The deaths from Cancer constitute 17.2 per cent, of the total Battersea deaths during the year. The following gives the comparative average death rates from Cancer in Battersea for quinquennial periods since 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 1946-1950 2.11 1921-1925 1.33 2.15 1951 1926-1930 1.51 2.05 1952 Details in age groups and the localisation of this disease will be found on page 11. BACTERIOLOGICAL EXAMINATIONS. Until the 31st August, 1952, the bacteriological examination of clinical material (with the exception of sputum, which is still dealt with at the Chest Clinic) was carried out by the Clinical Research Association. Watergate House, Strand, W.C. As from 1st September, however, arrangements were made for the examination of all clinical material, except sputum, from Battersea patients to be undertaken by the Public Health Laboratory Service. 134 Denmark Hill, S.E.5. 21 The following table gives particulars of the bacteriological examinations carried out by the Clinical Research Association from 1st January to 31st August, 1952:— Suspected Disease Positive Results Negative Results Total Diphtheria 1 44 45 3 Other - 3 Total 1 47 48 The cost, borne by the Council, of the 48 examinations made by the Clinical Research Association was £12 19s. 0d. The following table gives particulars of the examinations carried but by the Public Health Laboratory Service between 1st September a nd the end of the year. No charge is made to the Council for these examinations:— Positive Results Negative Results Total Suspected Disease Diphtheria - 13 13 Venereal Disease 1 1 - Dysentery, etc. 5 22 27 Total 5 36 41 22 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 1952. Sanitary Operations. Inspections— New houses 21 House-to-house Houses let in separate tenements — Houses —following complaints 4,231 Houses —following infectious disease 1,890 Gipsy vans 9 Common Lodging Houses — Public urinals and chalets 74 Re-inspections 22,042 Other visits 2,648 Notices served — Intimations 2,357 Statutory (Sec. 197 and 200) 233 Statutory (Fifth Schedule) 1,233 Summonses issued - 137 Magisterial Orders obtained 41 Drains laid to new houses 21 Drains relaid (wholly or partly) 17 Drains cleansed and repaired 229 Drains tested (smoke) 166 Found defective 50 Drains tested (water) 1,262 Drainage plans received 104 Frontage drains constructed or reconstructed 15 New houses —certificates issued re water supply 21 Houses supplied with water and fittings repaired 55 Additional water supplies to tenement houses 12 Water closets provided, supplied with water, or supply disconnected from drinking water cisterns Water closets and urinals cleansed and repaired 494 Drinking water cisterns cleansed and repaired 122 Rain-water and waste pipes disconnected or repaired 232 Soil pipes and drains ventilated 28 Defective roofs and gutters repaired 1,097 Dustbins provided 15 Yards paved or repaired 160 Premises disinfected 910 Persons cleansed (including 1,994 children) 2,170 Articles disinfected 20,956 Rat repression— Premises infested 248 Inspections 3,422 Protection of Food Supply Inspections— Butchers' and other food shops 1,038 Fish shops 423 Food storage premises 247 Dairies and milk shops 301 Inspections—contd. Ice cream premises 576 Restaurant kitchens 1,006 Samples taken 500 Summonses issued 2 Factories, Workshops and Shops Inspections— Shops 128 Inspections—contd. Outworkers 1,085 do. (Pharmacy Act) 25 Rag flock 7 Smoke observations 206 Intimation notices served 56 Pet shops 17 Statutory notices served - Summonses issued 2 Factories 2,325 23 Legal Proceedings. During the year, legal proceedings were taken by the Council in 145 cases, for the enforcement of various Acts, by-laws, regulations, e tc, 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 142 Food and Drugs Act, 1938 2 By-laws re fouling of footpaths by dogs 1 145 Fines totalling £15 10s. 0d. were imposed in connection with these proceedings, and £61 8s. 0d. costs were awarded to the Council. Public Health (London) Act, 1936. The provisions of this Act in regard to Nuisances continued to afford the main means whereby the remedy of insanitary conditions found in dwelling houses could be secured. During the year, 2,357 Intimation, and 1,233 Statutory (Nuisance) Notices were served. The high proportion of Statutory to Intimation Notices shows the continuing difficulty, referred to in previous reports, of securing the remedy of these conditions. Furthermore, legal proceedings to enforce compliance with Statutory Notices had to be taken in no less than 137 cases. Of these, 41 resulted in Nuisance Orders being made by the Court. One of these Orders was a Closing Order in respect of a tenement house deficient in water supply. Further details of this case are given under the heading of " Water Supply," on page 26. The remaining 96 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 23 cases action to enforce compliance with Nuisance Orders had to be taken, and 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 Recounts were accordingly rendered to them. In 3 instances proceedings for the recovery of the cost had to be taken. Judgments for the a mounts claimed were obtained in each case. Dustbins. Under Section 105 of the Public Health (London) Act, 1936, if a ny house is found to be without a proper dustbin, the Council may serve notice on the owner or occupier requiring provisions to be made, The same Section, as amended by the London County Council (General Powers) Act, 1951, provides that any person aggrieved may appeal to a court of summary jurisdiction. Similar provisions are contained in the Public Health Act, 1936, which applies to England and Wales outside the administrative County of London. 24 In the last few years, a number of such appeals have been made, some of them being subsequently taken to the Divisional Court. As a result, the principle has been established that, in deciding whether notice should be served on the owner or on the occupier, the local authority must consider all the circumstances of the individual case. It had previously been the practice of the Council, save in very exceptional circumstances, to regard the provision of dustbin accommodation as a matter for the owner, and accordingly to serve notice on him. In view, however, of the situation created by the various appeals referred to above, the Health Committee decided in 1949 that in future the circumstances of each case (e.g., net rent of house, number of tenants, existence of any tenancy agreement, financial circumstances of the occupier, etc.) should be submitted to them for their decision as to whether the notice is to be served on the owner or occupier. It should, however, be made clear that whatever the Committee may decide, the person served with a notice still has his right of appeal to the court. During the year, 4 such cases were considered by the Committee. In 3 of them it was decided to serve the notice on the owner, and in the remaining 1 on the occupier. In no case was an appeal lodged. Common Lodging Houses. There are no Common Lodging Houses or 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 nine licensed premises are, by arrangement with the owners, available to the general public. The Council provide, in the interests of public health, free washing facilities at each of the public conveniences in the Borough. 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, 1936, relating to water-closets, etc., are enforced by the Council. During the year new drains were constructed to 21 new buildings, and the drains of 17 old buildings were partially or entirely reconstructed under the supervision of the Officers of the Health Department. 104 plans of proposed drainage work were deposited in 1952, as compared with 79 in 1951. During the year drains were tested by smoke on 166 occasions and 50 were found defective. The water test was applied on 1,262 occasions, this being mainly to drains in course of construction. 25 The frontage drains of 15 premises were constructed or reconstructed. In 3 cases, the Council carried out drainage works in default of compliance by the owners with the requirements of notices served under the Public Health (London) Act, 1936, the cost being recoverable from the respective owners. No legal proceed0ings for offences against the Drainage By-laws w ere taken. Under the provisions of the London County Council (General Powers) Act, 1951, which came into operation on the 1st August, 1951, appeals against acts and decisions of sanitary authorities in regard to drainage and water closets, which formerly had to be made to the London County Council, now have to be made to a court of summary jurisdiction. No such appeal was made during the year. Combined Drainage. Claims were made by the owners of two blocks of houses drained by combined operations that the combined portions of the drainage systems were " sewers " repairable by the Council. In both cases the claim was admitted and the necessary repairs to the combined drains w ere carried out by the Council. Smoke Nuisances. During the year a small 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. The most serious and persistent source of dust and grit emissions has again been a large gas works. This has been referred to in previous Annual Reports and is due principally to the operation of plant of an obsolete type, replacement of which does not seem likely to take place for a number of years. Apart from this instance, the complaints related to emissions from Va rious industrial plants. On investigation, they were found to be due to some transient cause such as the use of unsuitable fuel, or temporary breakdown of some part of the plant. In one case intimation notice was served, on which the nuisance was abated, and no further action was found necessary. The total number of observations made was 206. Effluvium Nuisances. A small number of complaints alleging nuisance from effluvia e mitted from various industrial and business premises were received. In one case, a fried fish shop which was not provided with proper means to carry off the fumes arising from the frying ranges, legal Proceedings had to be taken. The summons was, however, adjourned sin e die on the proprietor's undertaking to abate the nuisance, and no further action was found necessary. The remaining cases were all of a minor nature and were successfully dealt with by informal action. Offensive Trades. There are two premises in the Borough at which scheduled offensive trades are carried on. These businesses have been established for many years and are satisfactorily conducted. 26 Water Supply. During the year certificates under Section 95 (2) of the Public Health (London) Act, 1936, were issued in respect of 21 new or re-erected dwelling houses or tenements. In 12 houses an additional water supply on an upper floor was provided, in compliance with notices served under Section 95 (5) of the Act. One of these cases is worthy of comment. The facts were that the house in question, a three-storey non-basement type, had been let by the owner to one tenant, who had in turn sub-let the top floor to his married son and family. This top floor had at one time had a separate water supply, but for some reason which could not be definitely ascertained the supply pipe and tap had been removed some years ago, leaving the only water supply on the ground floor. A notice was accordingly served on the owner requiring provision of a separate water supply on the top floor. The owner disputed the notice on the grounds that the house was not a " tenement house " within the meaning of the Section, as all the occupants were members of one family, that the Section applied only to houses let in separate tenements by the owner, and that the additional supply was not reasonably necessary. The learned Magistrate, after hearing evidence and legal arguments, decided against the owner on all these points, but held that, as the house was, by the terms of Sub-Sections 1 and 5 of Section 95, prima facie, unfit for human habitation, he had no alternative but to make a closing order, in view of the wording of paragraph 8 of the Fifth Schedule to the Act, and he accordingly made that order. The Health Committee, concerned lest the owner should enforce the order and evict both tenant and sub-tenant (as he clearly intended to do) decided to negotiate with him. The result was that the Council agreed to instal the water supply and to make a contribution towards the owner's legal costs in defending the case. These arrangements were duly carried out and the closing order rescinded. Forty-one notices of waste of water from defective fittings, etc., observed during routine inspections of various premises, were sent to the Metropolitan Water Board. At the public baths in Latchmere Road there are deep wells which supply water, not only to the Baths Establishments, but also, for all domestic purposes, to over 360 tenements on the Council's Latchmere Estate. Formerly, supplies were adequate for all these purposes, but of recent years the yield from the wells has fallen, so that supplies from the mains of the Metropolitan Water Board had to be drawn upon to an increasing extent. During 1950, the existing air-lift pumps on two of the borings were replaced by electrically operated submersible pumps of modern design, with the result that the yield from these borings is now sufficient for normal requirements. The water is chlorinated as a safety measure, before passing into supply. A sample of the chlorinated water is taken every fortnight, and in addition, every three months a sample is taken from the rising main of each borehole (i.e., before chlorination). These samples are submitted, for bacteriological examination, to the Public Analyst, whose reports show that the water consistently maintains a high degree of purity. 27 Rag and Bone Dealers. Premises occupied by rag and bone dealers in the Borough are subjected to regular inspection. During the year 130 inspections were made. Various small irregularities found to exist were brought to the notice of the occupiers of the premises and were remedied without recourse to formal action. Fouling of Footpaths by Dogs. One offence against the Council's By-law relating to this matter Was reported by the police. Legal proceedings were taken against the offender, who was fined 10s. and ordered to pay 10s. costs. Verminous Premises. During the year 257 premises which were found to be infested with vermin (principally bed-bugs) were disinfested. The usual method of treatment is by a D.D.T./pyrethrum spray. 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. 106 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. Prevention of Damage by Pests Act, 1949. This Act, which came into operation on the 31st March, 1950, repealed, and re-enacted, with many alterations and additions, the Rats and Mice (Destruction) Act, 1919. It gives power generally to the Council to require steps to be taken to eradicate infestations of rats and mice, and to prevent infestations. These duties are carried out by the Rodent Officer, assisted by three Rodent Operatives. All infestations coming to light, whether by way of complaint or otherwise, are systematically investigated, and the appropriate action taken. Where the cause of the trouble is obviously defective drains or other defects in the building, the owner is called upon to effect the Necessary repairs. This aspect of the work involves close co-operation between the Rodent Control Staff and the Sanitary Inspectors. In other cases, the occupier is called on to set traps, lay baits or take other action as the circumstances may require. The setting of traps and laying of baits is, on request, carried out by the Rodent Control Staff, charges being made for this service. These charges are usually nominal e xcept in the case of business premises, where the cost is charged in full. The sewers under the control of the Council are treated twice yearly, in accordance with the suggestion of the Ministry of Agriculture and fisheries (Infestation Control Division). Their recommended method of treatment, namely, the laying of prebait (unpoisoned) on two days, followed on the third day by poisoned bait, is followed. 28 The Ministry make a grant of 50 per cent, towards the cost of the service, in so far as this is not recovered from the owners or occupiers of premises. The following table shows the prevalence of rats and mice in the Borough for the year:— Property Infested by Rats Seriously infested by Mice Minor Major - 3 Council's properties 2 - Dwelling houses 154 62 1 46 32 Business premises 96 1 203 The total number of visits made to the above premises, and to others which were found not to be infested, was 3,422. Poison baits were laid or traps set on 1,943 occasions. Shops Act, 1950. One exemption certificate was issued under Section 38 of this Act, in respect of a shop where restricted space precluded the provision of a sanitary convenience on the premises. This was in substitution for a certificate issued during 1951 in respect of the same shop, the change being made necessary by an alteration in the circumstances. Vacant Sites, Static Water Tanks, etc. Nuisances caused by the dumping of rubbish and the accumulation of rainwater in disused static water tanks, and the dumping of rubbish on cleared sites, showed a considerable diminution over those arising in previous years, although in a number of cases the Council had to clear these deposits. The diminution was no doubt largely due to the removal of a number of tanks and the use of the sites for rebuilding or other purposes. Towards the end of the year, arrangements were made whereby the Council were empowered to clear static water tanks and obtain refund of the cost from the London County Council. These arrangements should obviate the difficulties, frequently experienced in the past, of compelling the owners of the sites to clear them. Burial of Deceased Persons. Under Section 50 of the National Assistance Act, 1948, the Council are responsible for the burial or cremation of the body of any person dying, or being found dead, in the Borough, and have power to recover from the estate of the deceased person, 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 the National Insurance Act, 1946. 29 During the year, 7 cases were dealt with, as per the following table:— Died in St. James's Hospital 1 „ at home 5 Body found at Albert Bridge 1 7 The decrease, as compared with previous years, is largely due to the fact that most of the persons dying in hospitals were buried by the hospital authorities. The burials arranged by the Council are carried out by a local undertaker under contract, and not more than one coach is provided for followers. The Health Department make the arrangements and collect all available information regarding any estate left by the deceased, Particulars of his National Insurance, and the existence of any "liable" relatives. This information is passed to the Borough Treasurer so that he may take steps to recover the cost. The total cost incurred in dealing with the 7 cases was £75 of which £30 had been recovered by the end of the year. Aged and Infirm Persons. Under Section 47 of the National Assistance Act, 1948, the Council are empowered to apply to a Court of Summary Jurisdiction for an Order for the removal to a hospital or other suitable place of any person who is aged or infirm or suffering from some grave chronic disease, and is living under insanitary conditions. This power is exercisable on the certificate of the Medical Officer of Health. The Order remains Operative for a period of three months, but the Court may, on application by the Council, extend it for such further periods, not exceeding three Months each, as are considered necessary. The procedure under Section 47, as outlined above, was amended by the National Assistance (Amendment) Act, 1951, which came into operation on the 1st September, 1951, for the purpose of enabling very u rgent cases to be dealt with more expeditiously. This new Act provides that the Court, or a single Justice of the Peace, may, on the certificates of the Medical Officer of Health and another registered medical practitioner, make an Order without formal notice of the application having been given to the person concerned or to the hospital authority, subject, in the case of the latter, to evidence being produced of their willingness to admit the person. The length of time a person may be detained under such an Order is limited to three weeks, instead of three months, and any application for an extension of this period must be made in accordance with the procedure laid down in Section 47. An application under the new Act may be made by the Medical Officer of Health without special authority from the Health Committee in each individual case provided a general authority to act is given. Such general authority was in fact given by the Council at their meeting on the 3rd October, 1951. 30 It was not found necessary to put the above powers into operation during the year. A number of cases of persons, mostly of advanced age, alleged to be living under unsatisfactory conditions, were reported and investigated. In some of these it was found possible to arrange voluntary admission to a hospital or other suitable place, and some cases were still under observation at the end of the year. Care of Old People. In an ageing population every endeavour must be made to ensure that old people receive adequate care. Members of the staff of the Health Department are well aware of this special need. The Sanitary Inspectors visit old people and render every assistance within their power. In cases of neglect, the Inspectors rely upon the use of gentle persuasion, sympathy and tact rather than the strict enforcement of statutory obligations. Addresses are noted, with particular reference to old people who live alone and who are unfortunate in having no relatives. Visits are repeated whenever the necessity arises. Problems of extreme difficulty are often set by old persons who have reached a state of physical and mental deterioration. They neglect themselves and their homes; their condition is indeed pitiable. Loneliness breeds degeneration. A great deal can be achieved by visiting old people in order to prevent the onset of adverse changes. Good neighbours are always helpful, but a campaign is needed to secure lists of volunteers who will take responsibility for visiting old people in their vicinity. In this connection, tribute must be paid to the work of the Battersea Old People's Welfare Committee, the South London District Nursing Association, the British Red Cross Society, the Women's Voluntary Service and the Family Welfare Association. Close liaison is maintained between the Health Department and these Associations. Old People's Clubs are extremely active in Battersea and their members carry out excellent work by helping one another. The meals-on-wheels service is under the management of the Battersea Old People's Welfare Committee, and the Council makes an annual grant towards the cost of this service. Application to the Committee on behalf of an old person requiring a meal invariably evokes an immediate response. Invaluable domiciliary services are rendered by the Health Visitors and Home Helps of the London County Council. In addition, the London County Council is responsible for welfare homes, and the Admitting Officers show the utmost consideration in effecting the admission of old people. As for the care of the aged sick, discussions are continually held between the medical staff of the Health Department, general practitioners, and the Medical Superintendent and Geriatric Specialist of St. John's Hospital, St. John's Hill, S.W.11. Thanks are due to the Battersea and Putney Group Hospital Management Committee for reserving beds for the treatment of old people, but there is always a waiting list owing to the heavy demand for beds. Much remains to be accomplished despite the gratifying results which have already emerged from the system of co-ordination between the Health Department, the London County Council, the Battersea and Putney Group Hospital Management Committee and the various voluntary associations. For example, suitable housing is at once the most pressing requirement and the most difficult to secure. 31 Rag Flock and other Filling Materials Act, 1951. This Act, which came into force on the Ist November, 1951, and is enforceable by the Council, repealed the Rag Flock Acts, 1911 and 1928, and Section 136 of the Public Health (London) Act, 1936, which d ealt with the sale of rag flock. It enacts new provisions relating not only to rag flock, but also to a number of other filling materials, e.g., kapok, feathers, down, straw, hair, unwoven cotton and woollen substances, etc., specified in it. The Minister of Local Government and Planning, and the Home Secretary, acting jointly, have power to extend this list. The principal provisions of the Act are as follows: — Registration: Premises in which rag flock or other filling materials are used in upholstering, or the stuffing or lining of bedding, toys, baby carriages, and any other articles prescribed by regulations, must, with certain exceptions, be registered with the Council. Licensing: Premises used for the manufacture or storage of rag flock (but not other filling materials) must be licensed by the Council. Entry, Inspection and Sampling: An authorised officer of the Council has right of entry at all reasonable times to registered or licensed Premises, or premises which he has grounds for believing should be registered or licensed. He may inspect any articles, and take samples of any filling materials. The Medical Officer of Health, and Sanitary Inspectors, are deemed to be authorised officers. The Minister subsequently made the Rag Flock and Other Filling Materials Regulations, 1951, prescribing standards of cleanliness for each kind of filling material, the methods of testing samples, the nature of the tests to be applied, the names and addresses of Analysts, the form of certificate of analysis, and the fees payable. There are no premises in the Borough dealing with rag flock, There are, however, five premises at which other filling materials are Used in such circumstances as to require them to be registered. Registration of these premises has been duly effected. Seven visits were made to registered premises during the year, but no contravention of the Act was discovered. Three informal samples of filling materials were taken and submitted to the Analyst. Two were certified to be in conformity with the Regulations, while the third showed a slight excess of "trash." This was notified to the Medical Officer of Health for the district from which the consignment originated. Pet Animals Act, 1951. This Act came into operation on the 1st April, 1952, and is enforceable by the Council, who authorised the Medical Officer of Health, the Deputy Medical Officer of Health, and the Sanitary In spectors to act on their behalf. The object of the Act is to regulate the sale of pet animals, with Particular reference to their welfare while kept for sale in pet shops. A pet shop may not be kept except under the authority of a licence granted in accordance with the provisions of the Act. The keeping of a pet shop is defined as the carrying on at premises of any nature including a private dwelling and a stall or barrow in a market) of a 32 business of selling animals as pets or keeping them with a view to sale. "Animal" is defined as " any species of vertebrate." Licences are renewable annually, and a fee of 10s. may be charged for them. In considering an application for a licence, the Council must have regard to the need for securing:— (a) that animals will at all times be kept in accommodation suitable as regards size, temperature, lighting, ventilation and cleanliness; (b) that animals will be adequately supplied with suitable food and drink, and (so far as necessary) visited at suitable intervals; (c) that mammals will not be sold at too early an age; (d) that all reasonable precautions will be taken to prevent spread of infectious disease among animals; (e) that appropriate steps will be taken in case of fire or other emergency. These matters are without prejudice to the Council's discretion to withhold a licence on other grounds. It is also required that the licence shall specify such conditions as the Council consider necessary to secure all or any of the objects set out above. In this connection the Council adopted a standard set of conditions prepared by the Metropolitan Boroughs' Standing Joint Committee. A person aggrieved by the refusal of a licence, or by any condition subject to which it is proposed to be granted, has a right of appeal to a Court of Summary Jurisdiction. Fourteen applications for licences were received. In considering arrangements for the inspection of the premises, it was deemed inadvisable, having regard to the matters to be considered when deciding whether to grant or refuse them, and in the subsequent administration of the Act, for expert advice to be available. An approach on this matter was therefore made to the Royal Society for the Prevention of Cruelty to Animals, who very kindly agreed to their local officer accompanying the Sanitary Inspector on his initial visit to the premises, and also being available for consultation and advice at any future time. All the premises were, however, found to be suitable, and the licences were duly granted, subject to the standard conditions referred to above. A total of 17 visits were made during the year. Heating Appliances (Fireguards) Act, 1952. This Act received Royal assent on the 1st August, 1952, but does not come into force until a date to be appointed by the Secretary of State. It will be enforceable by the Council, who have authorised the Medical Officer of Health, the Deputy Medical Officer of Health, and the Sanitary Inspectors to act on their behalf. The Act prohibits, subject to certain minor exceptions, the sale or exposure for sale, or the letting or offer for letting under a hirepurchase agreement or on hire, of any appliance required by regulations to be made under the Act to be fitted with a guard, if either the guard is not fitted or it does not comply with the standard prescribed for it by the regulations. The date of operation had not been fixed, nor had regulations been made, by the end of the year, and no action could therefore be taken. 33 Use of Slipper Baths by Old Age Pensioners. On the 30th January, 1952, the Council, on a recommendation of the Health Committee (with which the Baths and Wash-Houses Committee w ere in agreement) decided to make available to old age pensioners free u se of the slipper baths at their Baths Establishments (with use of towel) on production of their pension books. During the first twelve months this arrangement was in operation, it was taken advantage of by 6,224 persons —2,560 men and 3,664 women. Public Swimming Baths. The Council maintain four public swimming pools —three at Latchmere Baths and one at Nine Elms Baths. Samples of the water from these pools are taken weekly for bacteriological examination. The results show that the water has consistently maintained a high degree of purity. Protection of Food Supply. (A)—INSPECTION OF FOOD PREMISES. Regular inspection of all premises where food for human consumption is prepared, stored, or sold has always been carried out as a routine measure In the Annual Report for 1951, reference was made to the fact than an additional Sanitary Inspector had been appointed in November, 1950, to supplement the existing inspectors engaged on this particular work, and that during 1951 she had undertaken a complete survey of all catering establishments, canteens, etc., these being the type of food premises most in need of constant supervision. This survey was completed early in 1952, and there is no doubt that the Ve ry material improvement in the general standard of food preparation and handling in the Borough, which resulted from it, more than justified the additional appointment. Since the completion of the survey, the Inspector's time has been devoted principally to re-visits, particularly to those establishments which had, on the initial inspection, been found much below a satisfactory standard, or whose proprietors had shown re calcitrance in making any suggested improvements, with the object of ensuring that the ground gained was not lost. It appears increasingly ev ident that regular supervision of this nature, with emphasis rather on advice and education than on formal enforcement of statutory r equirements, is far more likely to produce good results than any other method. There, will, of course, always be cases where it does not s ucceed, and in these the law must be invoked. Experience has, however, shown that they are very few and far between. By-laws for the Protection of Food. These By-laws, made by the London County Council under Section 15 of the Food and Drugs Act, 1938, came into operation on the 3 r d November, 1952. They are designed to secure the observance of sanitary and cleanly conditions and practices in connection with the handling, wrapping and delivery of food sold or intended for sale for 34 human consumption, and in connection with the sale or exposure for sale in the open air of food intended for human consumption. They are, of course, in addition to and not in substitution for, other statutory requirements on the same subjects (e.g., Section 13 of the Food and Drugs Act, 1938). A copy of the By-laws was sent to each food trader in the Borough, and they will all subsequently be visited at a later date by one of the Sanitary Inspectors; who, in addition to ascertaining whether the Bylaws are being complied with, will offer advice to the trader on any aspect of them on which he may be in doubt. Talks to School Children. By arrangement with the London County Council as Education Authority, two of the Sanitary Inspectors visited a number of local schools at various times during the year and gave talks to the pupils on hygiene in the kitchen, and on clean milk production. Arrangements were also made for parties of pupils to visit food factories and milk processing depots. These talks and visits were greatly appreciated and are undoubtedly of considerable educational value. Festival Pleasure Gardens, Battersea Park. In the Annual Report for 1951, an account was given of the catering arrangements in these Gardens and of the control exercised over them by the Council's Officers. The Gardens were again open to the public for the period of about six months during 1952. The attendance was considerably below that of 1951, but the catering arrangements were maintained on practically the same scale. The close supervision described in the 1951 Report was therefore continued, with even more satisfactory results, the standards of hygiene attained being in every way satisfactory. Once again, it is gratifying to record that no case of serious illness was traced to any food consumed in the Gardens, nor was any complaint of any substance made about the catering arrangements. Slaughterhouses. There is only one licensed slaughterhouse in the Borough. Its use ceased about the middle of 1950 and has not been resumed. Butchers' Shops. There are 75 butchers' shops in the Borough, and in addition a number of shops where cooked meats are sold. All these shops are systematically inspected, 1,038 visits having been made during the year. In general, the shops are well conducted, and no formal action was found necessary. Four shops where horseflesh is sold for human food are included in the above figure. About the middle of the year it was found that the conditions under which horseflesh intended for human food was being transported and delivered to shops in the Borough left much to be desired On 35 enquiries being made, it transpired that the horseflesh was being transported by road from slaughterhouses in a northern city. The journey took two days, and on arrival in London the lorries were frequently parked in a depot for the night, delivering their loads to the shops on the following day. To make matters worse, the lorries themselves were quite unsuitable for the purpose. They were constructed largely of wood with many joints, leading to absorption of blood and juices and rendering cleansing very difficult. The only covering of the meat took the form of tarpaulins, frequently torn and contaminated with oil and grease. To deal satisfactorily with these very undesirable conditions presented some difficulty. The Public Health (Meat) Regulations, 1924, could not be invoked as the definition of "meat" in them does not include horseflesh, and the by-laws for the protection of food had not a t the time come into operation. The matter was, however, taken up with the Medical Officer of Health for the city in question, and it is satisfactory to record that as a result of his representations to the lorry owners, conditions speedily improved, the lorries being reconditioned a nd lined with metal to facilitate cleansing, and clean coverings being placed over the meat. Public Health (Meat) Regulations, 1924. No offence against the 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 1952: — (a) Dairies where loose milk is sold, and both the premises and the occupier are registered:— Retail Wholesale Total On register at 1st January 40 7 47 No alteration took place in the register during the year. (b) Milkshops, where milk is sold only in sealed containers, and only the occupier is registered as a distributor:— On register at Ist January 94 Added during year, by new registrations 7 101 Removed during year 8 On register at 31st December 93 (c) "Out-of-Borough" registrations (i.e., persons selling milk in Battersea from premises in other boroughs):— On register at 1st January 28 New registrations 1 On register 31st December 29 A total of 301 visits were made to these shops during the year. Generally they are very well conducted. In no case was any contravention of the Statutory requirements found. 36 Milk and Dairies Regulations, 1949. Enforcement of these Regulations, which relate to premises where milk is stored, processed, or sold, is dealt with in the preceding paragraph. It was not found necessary to take any action under Regulation 20, which gives power to the Medical Officer of Health to stop the supply of milk suspected of conveying infectious disease. Milk (Special Designations). Under the two sets of Milk (Special Designations) Regulations issued in 1949, four designations are prescribed, namely, Accredited, Tuberculin Tested, Pasteurised, and Sterilised. Accredited Milk may not be heat-treated. Tuberculin Tested milk may be pasteurised or sterilised, provided it is so described. Pasteurised milk must be so treated by either the "Holder" or "High Temperature Short Time" processes, and must comply with the " phosphatase " and " Methylene blue " tests. Sterilised milk must be filtered or clarified, homogenised, and heated to and maintained at a temperature of not less than 212° F. for such time as will ensure that it complies with the " turbidity " test. All persons who pasteurise or sterilise, or deal in special designation milk, are required to hold licences, which (except in the case of producers of raw milk) are issued by Food and Drugs Authorities. The Milk (Special Designations) (Specified Areas) Order, 1951, which came into force on the 1st October, 1951, requires that all milk sold by retail (other than in catering establishments as part of a meal or refreshment) in the areas specified must be sold under one or other of the special designations. Among such areas is the whole of the County of London. The number of licences issued by the Council during 1952 was as follows: — Full Supplementary Accredited - - Tuberculin Tested 49 21 Pasteurised 86 22 Sterilised 121 24 256 67 One licence to pasteurise, and one to sterilise milk were issued, and are included in the above figures. Details of examination of samples of pasteurised and sterilised milk are given on page 43. 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 233, 64 having been added and 7 removed during the course of the year. One application for registration was refused on the ground of unsuitability of the premises. The applicant did not exercise his right of appeal to the Court. 37 All these premises are regularly inspected, 576 visits being made. Particular attention is paid to premises where manufacture takes place, and not only are the premises, plant, and methods of operation scrutin ised, but samples of the products are taken for examination by the Methods suggested by the Ministry of Health. The premises generally a re found to be well conducted. Further details in regard to sampling of ice-cream will be found on page 43. 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 50 such shops in the Borough in 1952. 365 inspections were made, and 2 notices were served, for minor matters which were remedied without difficulty. 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 were voluntarily surrendered to the Council. Most of these foodstuffs were ultimately used for the manufacture of animal feeding stuffs. Fish (preserved) 171 tins, 6 boxes Fish (wet) 54 boxes Meat and meat products (preserved) 1 ton 4 cwts. 1 st. 7 lbs., 1,500 tins Meat (fresh) 1 ton, 2 cwts. 6½ lbs. Poultry and game 9 cw t s . 9 lbs Vegetables (preserved) 1,123 tins Fruit (preserved) 2,002 tins 3 cwts. 3 st. 7 lbs., Fruit (fresh) 2 qtrs. 1 st. 1¾ lbs., 17 boxes Milk (tinned) 709 tins Eggs (shell) 1,382 2 qtrs. 7 lbs. Cheese 3 cw ts. 1 qtr. 5 lbs., 22 packets Cakes and biscuits 1 cwt. 3 qtrs. Hour and cereals 5 cwts. 2qtrs. 5½ lbs. Jams, syrups and preserves 235 tins and jars Pickles and sauces 338 j ars an d bottles Paste (meat and fish) 7 tins Patent foods and beverages 17 tins Sweets and chocolate 4 lbs. Puddings 3 tins Soups and gravy preparations 154 tins Cordials and fruit juices 22 bottles and tins Tea 7 lbs. 38 Eight cases of the presence of foreign matter in food came to light during the year. All were reported to the Health Committee, on whose instructions legal proceedings were taken in two cases. Convictions were secured in both cases, fines totalling £15 being imposed and £12 12s. Od. costs awarded to the Council. The remaining six cases were dealt with by cautionary letters. Food Poisoning. During the year six cases of food poisoning were notified. All were isolated cases and of a minor nature, and call for no special comment. (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 milk and of ice-cream by the prescribed tests, are carried out by the Public Analyst for the Borough (J. E. Woodhead, Esq., B.SC, F.R.I.C, PH.c.) at his laboratory at 325 Kennington Road, London, S.E.11. Prior to 1952 it had been the custom, for many years, to take 1,200 samples for chemical analysis, plus an unspecified number of milk and ice-cream for prescribed tests. The Public Analyst was paid a fee of 12s. 6d. per chemical sample, and a fee for prescribed tests varying with the nature of the particular test. In December, 1951, however, the Joint Negotiating Committee for Public Analysts, which had been set up to consider the question of fees to public analysts, recommended that, as from Ist January, 1952, the fees payable for chemical analyses should be £1 1s. 0d. in the case of milk, and 355. for other articles, with a proviso that samples involving specially difficult or complicated analysis should be the subject of special local arrangements in each case. The Council decided to implement the recommendations and the opportunity was taken of reviewing the sampling practice in the light of modern ideas and conditions. It was decided in future to take about 500 samples per year for chemical analysis, for a trial period. The fees for prescribed tests on milk and ice-cream were not affected by the recommendation of the negotiating committee. The total number of formal samples taken under the Act during 1952 was 306, of which 5, or 1.6 per cent, were certified to be adulterated. In addition, 194 informal samples were procured, of which 5, or 2.6 pet cent., were reported against. The percentage of samples reported by the Public Analyst to be adulterated during the quinquennia 1921 to 1950 and in 1951 and 1952 is given in the following table: — Formal samples (per cent.) Informal samples (per cent.) Year Mean 1921—1925 6.4 7.4 „ 1926—1930 3.3 2.4 „ 1931—1935 1.8 2.1 0.9 0.9 „ 1936—1940 „ 1941—1945 1.4 1.1 „ 1946—1950 1.0 1.1 1951 1.1 1.9 1952 1.6 2.6 39 Milk. 101 samples of milk were taken during the year, of which 100 w ere formal samples, and one sample taken informally. Of the 101 samples, 16 were designated as "Channel Islands" or "South Devon" milk, for which a higher minimum percentage (viz. 4 per cent.) of milk fat content is provided for under arrangements made between the producers and the Ministry of Food. The average composition of these 16 samples of milk reported as genuine proved to be as under: — Total milk solids 13.65 per cent. Milk fat 4.49 „ Non-fatty solids 9.16 „ Of the remaining 85 samples, all were reported as genuine, the average composition of these samples being as under: — Total milk solids 12.52 per cent. Milk fat 3.74 „ Non-fatty solids 8.78 „ The Analyst reports that the content of milk fat in these 85 samples r anged as follows:— 4 per cent. and over 10 samples or 11.8 per cent. Between 3.9 and 4.0 per cent. 10 „ „ 11.8 3.8 „ 3.9 „ 12 „ „ 14.1 3.7 „ 3.8 „ 22 „ „ 25.9 3.6 „ 3.7 „ 10 „ „ 11.8 3.5 „ 3.6 „ 12 „ „ 14.1 3.4 „ 3.5 7 „ „ 8.1 3.3 „ 3.4 „ 1 sample „ 1.2 3.2 „ 3.3 „ 1 „ „ 1.2 3.1 „ 3.2 „ -„ „ - „ „ 3.0 „ 3.1 „ - „ „ - 85 100.0 The milk fat content of the 16 samples of " Channel Island " or "South Devon" milk ranges as under:— Between 4.7 and 4.8 per cent. 4 samples „ 4.6 „ 4.7 „ 3 „ ” 4.5 „ 4.6 ” 3 „ ” 4.4 „ 4.5 ” 2 „ „ 4.3 „ 4.4 „ - ” 4.2 „ 4.3 „ 3 „ 4.1 „ 4.2 „ 1 sample 16 40 The following tables give details of the articles of which samples were obtained for the purpose of analysis. Nature of Sample Examined Adulterated Formal Informal Total Formal Informal Total Almonds, Ground - - 1 1 - - - - Apricots in Syrup 1 1 - - Baking Powder 1 1 - - - - - 2 - 2 - 2 Black-Currant Juice - - - 3 Bread 2 - 3 Butter - 9 9 - - 13 Cake and Pudding Mixture 1 1 - 7 20 Cereal Preparations 7 5 12 - - - - - Cheese Spread 1 1 - - - Cocoa 6 6 - - - - — Coconut Desiccated 2 2 - - 1 4 - - Coffee 3 - Coffee and Chicory Essence 6 - - 1 5 1 - - Confectionery, Flour 20 1 21 1 Confectionery, Sugar - 1 6 6 - - - - - Cooking Fat 1 - - 1 Corn Flour 1 - 1 - - - - - - - Cream, Synthetic 1 - 5 - Custard Powder 1 6 4 - - - Fish Cakes 1 3 - Fish Paste - - 4 11 11 - - - - - - Flavourings 7 7 - - Flour, Self-Raising 2 6 - 3 - - Gelatine 2 5 - Golden Raising Powder - - - 2 - 2 Gravy Preparations 7 7 - - - - - - 3 - 3 Herbs - - - Honey - - 2 2 - 1 - 1 - Ice-Cream 1 1 10 - Jam and Marmalade 10 - - Jelly Crystals - 1 - 1 - - - Jelly Squares 1 1 - - - 3 - Jelly, Table 10 13 - - - - - Junket Preparations 3 - - 3 3 - Lard - - 3 - - Lemonade Crystals 1 - - - 2 1 - - Lemonade Powder 2 - Lime Juice Cordial - - 1 1 - - 4 Carried forward 103 84 1 5 187 41 Nature of Sample Examined Adulterated Formal Informal Total Formal Informal Total 103 84 5 Brought forward 187 1 4 - Meat Preparations:- 3 - - 3 - Black Pudding Luncheon Meat, Canned 1 - 1 1 1 - - - Meat Paste - 6 14 14 - - Meat Pies 6 - - - - - Sausages, Beef 4 4 - - - - 2 2 Sausages, Breakfast - - - - 2 1 3 1 - Sausages, Liver - - 2 - Sausages, Luncheon - 11 1 2 Sausages, Pork 11 - - - - Sausage Meat 2 2 - - - - Sausage Rolls 2 2 - 1 - - Meringue Powder 1 101 - — 100 - 1 - - Milk - - - - - 1 Milk, Condensed 1 - 2 - 6 Mincemeat 2 - - - - - Mineral Waters - 6 1 - Mustard Compound 1 - 2 - 7 - - 2 7 Non-Brewed Condiment - - - Olive Oil 7 - 7 - - 2 - Pea Flour 2 - - - - 1 - 1 Pears in Syrup - 3 Pepper Flavoured Compound - - 3 - - - Pudding, Marmalade, Canned 1 1 - - - - - Rennet Essence 2 2 - - - - Saccharin Tablets 2 2 - - - - Salad Cream 2 - 2 - - - 1 1 - Sandwich Spread - - - - 8 3 11 Sauces 9 9 - - - Soup, Canned - 3 3 - Soup, Packet - - - - - - 5 5 - Spices 9 - - - 1 9 - Squashes Stuffing 1 - - - 2 - - - - 2 Suet - - 3 Sultanas 3 - - - 2 2 Tea - - - - - 18 18 Vinegar - - - - - 2 Wines, British 2 - - 1 - - - Yoghourt 1 - 6 - 52 Drugs (see following table) 58 - - 5 Totals 306 500 5 10 194 42 Drugs. Nature of Sample Examined Adulterated Formal Informal Total Formal Informal Total Glycerine - - - 1 1 - Glycerine, Honey and Lemon - - - 1 1 - 4 - Iodine, Tincture of - 4 - - - Oil, Camphorated - 3 3 - - - - Oil, Castor 3 7 3 - - - - - Ointment, Sulphur 7 - 7 - 7 Ointment, Zinc - - - - - 3 Salts, Epsom 2 5 - 3 Salts, Glauber 1 4 6 - - - - Seidlitz Powders 6 - - - - - Soda, Bicarbonate of 3 3 - - Tablets:— I o 8 - - - - Aspirin 8 - - 2 Soda-Mint 2 - - 4 Sulphur 4 - - - - 6 - - - Totals 52 58 In the five years 1947-51 and in 1952 the percentage of adulterated samples of milk was as under: — Year Samples taken Adulterated No. Percentage 1947 415 0 0.0 402 0 1948 0.0 10 2.4 1949 421 462 0 0.0 1950 1 1951 428 0.2 Mean 426 2 0.5 1952 101 0 0.0 43 Adulterated Samples. The following action was taken in regard to the 5 formal samples certified as adulterated:— No. 84 & 85. Pork sausages 1 per cent, deficient in meat content in each case —Cautionary letters. No. 100. Ice Cream per cent, deficient in sugar Cautionary letter. No. 200. Non-brewed Condiment 16 per cent, deficient in acetic acid —Cautionary letter. No. 268. Non-brewed Condiment 9 per cent, deficient in acetic acid—Cautionary letter. Heat Treated Milk. Samples of pasteurised and sterilised milk are taken at regular intervals for submission to the Public Analyst for the prescribed tests, a nd during the year samples as under were taken with the results set put:- Phosphatase Methylene Blue Satisfactory Failed Satisfactory Failed Pasteurised 28 - 28 - Turbidity Satisfactory Failed Sterilised 24 - Monthly returns of the samples taken, and of the results of the laminations, are sent to the Milk Division of the Ministry of Food, a nd they are at once notified of any adverse report. Ice-Cream. Twenty samples of ice cream were taken during the year, each sa mple being submitted to the presumptive test for coliform organisms in 3 tubes at 1/10 ml. dilution, and to the methylene blue test, in with the technique suggested by the Ministry of Health. The following is a summary of the results: — Coliform Test. Methylene Blue Test. Negative 12 Provisional Grade 1 7 Positive in 1 tube 1 „ 2 ... 7 „ 2 tubes 1 „ 3 ... 5 „ 3 tubes 6 „ 4 ... 1 20 20 Where samples of ice cream made at premises in the Borough re ceive unsatisfactory reports, the premises, plant, and methods of oPeration are examined, and, where possible, improvements are su ggested. Milk supplied to Schools and Hospitals. Samples of milk in course of delivery to Schools and Hospitals the Borough are regularly taken, both for chemical analysis and fo r submission to the prescribed tests for such milk. These samples are included in the general totals given on pages 39, 41 and 43. The results of the analyses and tests, are communicated to the London County Council or to the appropriate Hospital Management Committee. 44 Housing. Provision of New Accommodation. During the year 1952, the rebuilding of a block of 20 flats, and one house, destroyed by enemy action during the war, was completed. The following new houses and flats were under construction at the end of the year:— By Battersea Borough Council:— Rollo Street 143 flats Gowrie Road/Rush Hill Road 12 „ Devereux Road 4 „ Stormont Road, 98/100 2 „ Silverthorne Road/Froude Street 6 „ Battersea Park Road, 203/217 18 „ Battersea Park Road, 208/218 6 „ Cambridge Road, 24/28 6 „ Meath Street, 2/8 9 „ Balfern Street/Stanmer Street 8 „ Lavender Sweep/Parma Crescent 13 houses St. James's Drive, 20/22 8 „ Battersea Rise Cemetery Lodge 1 house Total flats and houses 236 By the London County Council:— Patmore Street 383 flats Usk Road/Petergate 66 Schoolkeeper's house, Bradmede School 1 house Schoolkeeper's house, John Milton School 1 „ Schoolkeeper's house, Linda Street School 1 „ Total houses and flats 452 A number of other sites were under consideration at the end of the year, with a view to their being utilised for housing purposes. Action taken under Section 9, Housing Act, 1936. Repairs to two houses were completed—one by the owner after service of an informal notice; and one by the owner after service of formal notice in 1951. Closing Orders. Four Closing Orders under Section 12 of the Housing Act, 1936. were made during the year, all in respect of basement rooms. One Closing Order under the Public Health (London) Act, 1936 was also made in respect of a house which was deficient in water supply but was later rescinded, the necessary additional supply having been provided. Details of this case are given under the heading " Water Supply " on page 26. 45 Demolition Orders. It was not found necessary to make any Order under Section 11 of the Housing Act, 1936. Houses Let in Lodgings. No special action was taken in respect of such houses. Overcrowding. 43 cases of overcrowding were discovered during the year, 29 in consequence of applications for housing accommodation made to this Council, and 14 to the London County Council. 25 overcrowded families were rehoused during the year, 12 by this Council and 13 by the London County Council. 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. These cases include applications for transfer from Council tenants and licensees of requisitioned premises. He also refers certain cases in which some special feature is involved (e.g., fitness of basement rooms). Under the Council's " Points Scheme," points are allocated by the housing Manager for statutory overcrowding, bedroom deficiency, lack of a separate home, etc., and he refers to me cases of ill-health (for additional points up to a maximum of 15 for pulmonary tuberculosis and 10 for other conditions can be allocated), and unsuitable accommodation (for which the maximum additional points is 10). Each case is placed in a group according to the number of bedrooms required by the family. Applications with the highest number of Points in each group are submitted to the Housing Committee for in structions. Cases where the applicant or a member of his household suffering from pulmonary tuberculosis and is infectious, and where the accommodation is considered to be inadequate, are submitted to the Committee irrespective of the total number of points allocated. The points scheme does not apply to applications for transfers from Council or requisitioned property, which are still dealt with under the Previous system, " essential " and " advisable " recommendations being made on medical grounds. During 1952, a total of 660 cases were dealt with under the arrangements set out in the three preceding paragraphs. The maximum number of Points on medical grounds other than pulmonary tuberculosis were located to 10 applications. In 10 cases the maximum points were given for pulmonary tuberculosis, 6 of these being referred to the Housing Committee for special consideration as the accommodation was inadequate. In 10 cases of transfer applications, rehousing was recommended as essential on medical grounds. 46 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 14 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. One certificate that a house was not in a reasonable state of repair was issued to the tenant. One report that a house was in a reasonable state of repair was issued to the landlord. Statistics for the Year ended 31st December, 1952. Number of new dwellings erected or re-erected 21 Number of houses demolished: — In pursuance of clearance orders Nil In pursuance of demolition orders Nil In pursuance of undertakings to demolish Nil Number of dwelling houses inspected for housing defects (under Public Health and Housing Acts) 4,111 Number of inspections made for that purpose 30,832 Number of houses at which defects found:— Dealt with under Housing Act (informally) Nil Dealt with under Housing Act (formally) Nil Dealt with under Public Health (London) Act 1,886 1,886 Number of houses where defects remedied:— As result of action under Housing Act 2 As result of action under P.H. Act 1,975* — 1,977 Number of houses in respect of which demolition orders were made Nil Number of houses in respect of which undertakings under Section 11(3) were accepted Nil Number of underground rooms in respect of which closing orders were made 4 Number of closing orders determined Nil * Representing 2,362 notices complied with. In 23 of these cases the Council carried out the work in default of the owner. 47 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—ln all factories. (ii) Cleanliness, Overcrowding, Temperature, Ventilation, and Drainage of Floors—Sections 1, 2, 3, 4 and 6—ln all factories where mechanical power is not used. (iii) Certificates of Suitability for Basement Bakehouses —Sec- tion 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, an d action taken. 1-INSPECTIONS for purposes of provisions as to health. Number of Number on Register Premises Inspections Written notices Occupiers prosecuted 109 1,164 7 - (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 303 1,755 18 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 15 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 28 - - 427 2,947 25 Total 48 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) - 9 - 1 9 Overcrowding (S.2) - - - - - - - - Unreasonable temperature (S.3) - - - Inadequate ventilation (S.4) - - - - Ineffective drainage of floors (S.6) - - - - - 7 - Sanitary Conveniences (S.7) (a) Insufficient - 7 2 17 - 6 - (b) Unsuitable or defective 17 (c) Not separate for sexes - - 2 2 1 - Other offences against the Act (not including offences relating to Outwork) - 1 - - 1 TOTAL 35 35 - 10 49 The following table shows the factories in the Borough, classified According to the trades carried on. Factories Classified according to Trades Mechanical Factories Non-Mechanical Factories Trade At 1 Jan. At 31 Dec At 1 Jan. At 31 Dec. 28 40 41 9 - - 55 10 9 18 42 10 54 316 Building and Allied Clothing and Allied Engineering and Heavy Industry Electrical and Allied Florist 26 21 19 42 18 18 40 - - 11 - 1 2 2 Food and Allied 55 5 5 Furniture and Allied Metal Worker 10 3 3 8 - - Printer and Allied 20 3 3 Road Vehicle Repairer St eam Laundry Others 42 15 15 10 - - 54 41 43 Total 318 108 109 Outworkers. During the year, 56 lists of outworkers were received, 27 from Battersea employers, containing 17 names, and 29 from other authorities containing 154 names. Some of these lists included outworkers not residing in Battersea. These were forwarded to the appropriate authorities. After eliminating them, and duplicate entries, there remained 177 names and addresses of Battersea outworkers. The total number of registered outworkers' premises in the Borough at the end of the year was 433 (including 6 contractors), 52 premises having been added, and 87 removed, during the year. The total number of inspections made was 1,071, most of them by the female Inspector. the premises were found to be generally satisfactory, and it was not found necessary to serve any notices or take any other action. 20 cases of infectious diseases occurred at outworkers' premises, and the usual precautions to prevent spread of infection were taken. 50 The following table gives details of the outworkers' premises:— Number on Register Trade Premises Workrooms Persons employed Wearing Apparel 252 261 308 Curtains, etc. 2 2 2 Artificial Flowers 4 4 4 Paper Bags 1 1 1 Boxes, etc. 9 9 9 Christmas Stockings 1 1 1 Lampshades 164 164 169 433 442 494 Bakehouses. There were 37 bakehouses on the register at the end of the year. All of these are classed as factories, and 34 of them use mechanical power. 78 inspections were made and 12 notices served. Five of the bakehouses were " basement bakehouses " within the meaning of Section 54 of the Factories Act, 1937. Miscellaneous Matters. Conferences. The Council were officially represented at the undermentioned Conferences dealing with matters within the purview of the Public Health Department. Conference. Royal Sanitary Institute. Margate —22nd to 25th April. Central Consultative Committee on the Welfare of Old People. London —19th June. Sanitary Inspectors' Association. Brighton—9th and 12th September. National Smoke Abatement Society. Portsmouth—24th to 26th September. Delegates. The Mayor and the Deputy Medical Officer of Health. Cllr. Mrs. E. A. Cooper, J.P." and Cllr. Miss G. A. Morgan. Cllr. Mrs. E. A. Cooper, J.P-and the Chief Sanitary Inspector. Aid. A. P. Holden and Mr. I. R. Lewis, Factory and Workshops Inspector. Personal Cleansing Station. During the year 1952 there were 1,994 children and 176 adults cleansed and treated at the Station. Of the 1,994 children attending 234 were suffering from scabies or itch, a contagious parasitic skin affection. The remainder were verminous. Of these children 1,894 attended from the public elementary schools in the Borough by arrangement with the London County Council, who have entered into a contract with the Battersea 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. 51 The homes of all cases of scabies that come to the knowledge of the Medical Officer of Health are visited by the Council's Sanitary inspectors. The following table shows the numbers of persons cleansed and at the Personal Cleansing Station and the expenditure incurred since 1906, the year in which the cleansing of verminous persons was begun:— Number of Baths, &c. Year Adults Children Expenditure *Amount Contributed Verminous and Scabies Verminous and Scabies £ 1906-1915 £ 10,443 6,430 1,037 303 1916-1925 39,117 3,155 3,269 5,007 1926-1935 2,404 39,293 4,045 8,521 1936 265 4,524 403 723 403 1937 4,256 389 729 432 1938 3,808 402 820 534 402 1939 2,820 795 778 404 3,497 1940 866 435 1941 2,558 5,456 1,026 440 1942 3,083 6,656 1,059 1943 2,017 5,223 422 1,149 441 1944 1,798 3,931 1,100 454 1945 3,277 1,885 1,179 443 1946 1,822 4,229 1,352 1,402 1,808 1,534 1,750 1,992 1,956 1947 424 986 4,179 408 1948 3,266 497 286 2,773 411 1949 1950 226 2,238 410 406 1951 1952 200 1,858 1,994 535 176 * Financial year ending 31st March. Other columns, calendar year. . The contract with the London County Council, referred to above, Originally provided for the payment by them of 2s. per verminous case and Is. per scabies case treated, with a minimum payment of £400 per annum. In consequence of negotiations, however, the scale of payments was increased, with effect from Ist January, 1952, to 3s. 6d. for each case treated, whether scabies or vermin, with a minimum payment of £500 per annum. The Council, at their meeting on the 23rd May, 1951, decided, on th e recommendation of the Health Committee to accede, until further order, to a request of the Divisional Medical Officer, No. 9 Division, London County Council, for the use of the Station for the treatment of a small number of children suffering from minor ailments, without cha rg e . 52 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 1952, are set out in the following table: — Battersea Mortuary, 1952. Details of Bodies received Post-mortem only Post-mortem and inquest Total post-mortems Inquest only Total inquests Sanitary and other reasons - Total bodies received VERDICTS AT INQUESTS HELD Natural causes Accident and misadventure Open verdict Suicide Homicide Alcoholism Self-Neglect Total Usual place of residence Total Battersea Wandsworth Elsewhere Residence unknown 561 170 69 316 6 39 30 4 78 151 209 99 394 1 79 - 712 10 1 - - - 4 39 152 30 - 2 2 99 12 715 209 395 2 - 1 5 2 1 88 20 25 42 3 2 10 4 1 7 44 8 29 - 2 1 1 - - 3 - - 1 - 1 - - 1 - 39 79 30 4 152 In addition to the above, four inquests were held on non-resident s and in each case the body was absent, not having been brought in to the Mortuary. The Wandsworth Borough Council again made a grant of £250 towards the cost of maintaining the Mortuary. The London County Council pay a rent for the use of the Coroner's Court. For a number of years this had been £275 per annum, but after considerable negotiations they agreed to increase it to £450 per annum as from 1st April, 1950. Subsequently, in August, 1951, the London County Council gave notice to terminate their tenancy of th e Court on 31st March, 1952. This notice was, however, later withdraw and use of the Court continued throughout the year 1952.