AC 4366 pc Ack Car. 20.10.55 BAT 53 Metropolitan Borough of Battersea. REPORT on the HEALTH of the Metropolitan Borough of Battersea FOR THE YEAR 1954 by J. TUDOR LEWIS, M.D., D.P.H. MEDICAL OFFICER OF HEALTH. Battersea Borough Council Wiith the Compliments of the Medical Officer of Health Public Health Departments, Electrio House, 204 Lavender Hill, Rattesson, I.W..11 Metropolitan Borough of Battersea. REPORT on the HEALTH of the Metropolitan Borough of Battersea FOR THE YEAR 1954 by J. TUDOR LEWIS, M.D., D.P.H. MEDICAL OFFICER OF HEALTH. 2 health, Baths and Wash=houses Commitee. As constituted 20th May, 1953. Chairman: Alderman Miss E. A. Coles, j.p. The Worshipful the Mayor (Councillor H. F. Harrison, j.p.) Councillor Miss N. F. Clark- Lawrence. „ Mrs. E. A. Cooper, j.p. Mrs. C. M. Davis. Alderman J. H. Dunning. Councillor F. J. J. Harper. „ C. E. Lang. Mrs. P. G. Mitchell. „ Mrs. J. O. Parry-Williams. Alderman S. E. Paul. Councillor Mrs. E. Reynolds. G. Whitehead. As constituted 24th May, 1954. Chairman: Alderman Miss E. A. Coles, j.p. The Worshipful the Mayor (Councillor S. F. C. Sporle, j.p.) Councillor Miss N. F. Clark- Lawrence. „ Mrs. E. A. Cooper, j.p. „ Mrs. C. M. Davis. „ F. J. J. Harper. C. E. Lang. „ Mrs. P. G. Mitchell. „ Mrs. D. L. L. Newman. Alderman S. E. Paul. Councillor Mrs. E. Reynolds. „ T. J. A. Rose. G. Whitehead. Staff of public "Ibealtb 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). (Superannuated Is/ December.) Deputy Chief Sanitary Inspector and Acting Chief Sanitary Inspector as from 1st December J. R. Hollow ay (a c). Acting Deputy Chief Sanitary Inspector as from 1 st December A. Webb (b c). Sanitary Inspectors: District. 1. W. E. Selway (b c). 2. G. W. P. Weeks (b c e). 3. A. Webb (b c). 4. P. D. O'Grady (b c). (Resigned in September.) A. W. E. Porter (b c). (Appointed in December.) 5. J. R. Glover (b c). 6. R. J. McCarthy (a c). 7. L. Burrows (b c). (Appointed in February.) 8. J. R. Holloway (a c). 9. P. Ianson (b c). 10. J. J. K. Helmer (b c). Other. (Food) J. A. H. Brownlow (b c). (Factories, I. R. Lewis (b c). etc.) Miss J. Round (a d). (Catering Establishments) Miss A. L. Jones (b c). Rodent Officer: F. G. Daniels. Administrative and Clerical Staff: P. Brocking. E. B. Moreton. (Miss) E. Town. (Miss) P. J. Blow (Resigned in December.) S. J. P. Whitbread. R. M. Nicol (Appointed in March.) W. A. G. Griffiths (temporary). (In H.M. Forces since May.) H. P. Reed (temporary) (Appointed in June ) (Mrs.) V. J. Dawson (temporary). (Appointed in December.) Disinfecting Station—Superintendent—J. Mandry. Mortuary—Superintendent—W. Newman. Public Analyst J. E. Woodhead, b.sc., f.r.i.c., PH.C. Deputy Public Analyst D. G. Forbes, b.sc., f.r.i.c. (Appointed in October.) (a) Sanitary Inspectors' certificate of the Sanitary Inspectors' Examination Board. (b) Sanitary Inspectors' certificate of the Royal Sanitary Institute and Sanitary Inspectors' Examination Joint Board. (c) Meat and other Foods certificate, Royal Sanitary Institute, or Sanitary Inspectors' Examination Board- (d) Health Visitors' certificate, Board of Education. (e) Smoke Inspectors' Certificate of the Royal Sanitary Institute. 3 INDEX TO SECTIONS. PAGE Preface 4 Health baths and Wash=houses Committee 2 Staff of the Public Health Department 2 Principal Figures for 1954 8 Vital Statistics 9 Infectious and Other Diseases 16 Sanitary Circumstances 22 Protection of Fnnrl Sunnlv:— (a) Inspection of Food Premises 30 (b) Samnlino nf PnoH and Drues 34 Housing 41 Factories and Homework 45 Miscellaneous Matters 49 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 1954; the third year for which I have had the privilege of being responsible for the health services in this area. As in previous reports, most aspects of our work are covered, and in this introduction, I refer mainly to one or two of the more interesting features of the work as they appeared during the year. In my last report, I drew attention to the slight reduction in the population of the Borough. In 1954, this decrease continued by 500 to 114,300. In the previous year, the reduction in the population amounted to 1,600 so that the curve of decrease is now less steep than previously. The birth rate was 15.21, a slight reduction over the previous year, while the death rate was 10.07, which was over 2 points lower than in 1953. This figure is 1 point lower than the death rate for England and Wales. The infant mortality rate was very slightly up, compared with the previous year—18.99 as against 18.56. The total number of infant deaths (that is the number of infants who died before reaching one year of age), remained the same, the slightly increased rate being due to the smaller number of live births on which the infant mortality rate is calculated. This was substantially lower than that for England and Wales during 1954, which was 25.5, and also lower than the rate of 20.7 for the County of London. In studying these infant deaths more closely, one or two factors emerge which, while quite in line with the generally accepted facts about infant deaths, nevertheless are not without some interest. Of the 33 infant deaths, 25 or 75.8 per cent, occurred within the first four weeks of life, and 15 or 45.5 per cent, occurred within the first twenty-four hours of life. It is well recognised that deaths within the first four weeks of life and especially in the first twenty-four hours are most likely due to factors operating before birth on the expectant mother and child. It is clear, therefore, from the above figures that those deleterious and harmful influences which are likely to have an adverse effect on the child's life and well-being during the first year of life are now of less importance than those influences which affect the expectant mother and unborn child. This is borne out by a study of the causes of infant deaths. The conditions which are most likely to cause death within the first twenty-four hours of life and, less markedly, within the first four weeks of life, are congenital malformations and certain ill-defined diseases such as prematurity. It is seen that of the 25 babies who died within the first four weeks of life, the cause of death of 16 was prematurity, 4 congenital malformations (probably incompatible with prolonged life), and 4 other causes mainly obstetrical in character. It is clear from these facts that a further reduction in the infant mortality rate is to be brought about by an attack on those adverse factors which affect the expectant mother and her unborn child. Unfortunately, what these factors are, and how they act, are much less clearly defined and understood than are the influences acting on the infant during its first year of life, which in the main are associated with 5 environmental and social conditions. To determine what are the adverse mfluences acting during pregnancy, which are likely to give rise to Prematurity, and, more important, how they can be overcome, is a complex problem involving the complicated interplay of genetic, ostetric, and environmental and social factors, and probably others even less clearly understood. The fact that adverse environmental and social factors affecting tne child over the first year of life are now less likely to cause infant deaths should not be regarded with complacency. None the less, it does mean that the focus of attention in infant welfare work is changing, and is being given a slightly different emphasis. For instance, taking the first year of life as a whole, we now think less in terms of infant deaths than of infant health and welfare, the maintenance of real health, rather than only the prevention of deaths. Taking a still larger view, we are beginning to consider how infant welfare work can help to influence certain diseases of adult life, which are known to be a serious drag on a civilized community, and a serious cause of ill-health. For instance, there is reason to think that mental ill-health in later life might be associated with instability and emotional reactions in young children, and a small start is now being made to ascertain how and in what ways, amd by what methods, work in the infant welfare service might possibly reduce the degree of mental ill-health in later years. The number of cases of infectious disease was less than in the pevious year, owing to the diminished incidence of measles and whooping cough. There were also fewer notifications of scarlet fever, primary fid influenzal pneumonia, and also of pulmonary tuberculosis. Five cases of poliomyelitis were notified; in one case the diagnosis was not confirmed, so that we had four confirmed cases, of which three were non-paralytic, and one had some paralysis. There was one death from poliomyelitis. Once again, I am glad to report that there were no comfirmed cases of diptheria. I referred last year to the question of housing as a social and public health problem, and the importance of good and adequate living conditions as a basic need for the family in the same way as are good food, pure and wholesome, and fresh air. During the year, the Housing Repairs and Rents Act, 1954, became law, and its working imposed additional responsibilities on the Health Department, particularly as to that part of the Act dealing with the issue of Certificates of Disrepair. In spite of the fact that these Sections of the Act allowed some scope for differences in interpretation, no real difficulty was experienced and the work under the Act proceeded quite smoothly, As anticipated, after a period of inertia, there was a flood of applications by tenants, which, however, gradually tailed off. I should like to take the opportunity of expressing my appreciation of the work of the Sanitary Inspectors on most of the responsibility for carrying out the inspections and making reports fell. I am pleased to say that they met their responsibilities very adequately. The other important part of the Housing Repairs and Rents Act was that dealing with slum clearance, and at the end of the year, measures had been taken to complete the returns necessary under the Act. In terms of legally unfit properties, it may be that Battersea has no problems of a magnitude comparable with those of some of the large industrial areas in the North and 6 lands. But while the number of houses which are statutorily unfit for human habitation may be comparatively small in Battersea, the number of houses which are sub-standard in terms of modern ideas is large. Another aspect is that in some quite circumscribed areas, properties in various categories are intermixed. Thus, we may have some houses which are undoubtedly unfit for human habitation, and some which are reasonably satisfactory, while others, although not actually statutorily unfit, are sub-standard in terms of modern ideas. The type of substandard house I have in mind is the house which was originally intended for one family, but which is now occupied by two or possibly three families. Such houses do not possess those modern amenities which are now generally accepted as necessary for a happy family life. One of the problems to which it will be necessary to turn our attention in the not distant future is how to provide housing accommodation for each family unit, which is in accord with modern ideas. In other words, to effect a transformation of old and sub-standard property into family housing units, which comply with modern standards. A great deal is being done in Battersea, both by the Borough Council, and the London County Council, to provide homes for the people, and there are large new areas being developed in the Borough. So far as estates developed by the Borough Council are concerned, the new tenants are already Battersea residents. In the case of London County Council estates, however, a high proportion of the tenants come from areas outside Battersea. When the areas now under development are, in the course of time, completed, a tremendous advance will have been made in the housing of the people of the Borough. I made some mention in my report for 1952 of arrangements in this area whereby the duties of the Medical Officer of Health for Battersea, Medical Officer of Health for Wandsworth, and Divisional Medical Officer, London County Council, Health Division No. 9, are combined in a single appointment. I ventured the opinion, writing at that time on the basis of some eighteen months experience of the work, that the idea was basically sound, and offered many advantages over forms of administration where there were functional divisions between the environmental health services and the personal health services. Now, two years later, after some three and a half years experience of the work, I am confirmed in my opinion that this form of aministration is highly satisfactory and satisfying. From the point of view both of the services, and of those responsible for operating them, there is a tremendous advantage in abolishing lines of demarcation between the personal and environmental health services which from the functional or working point of view are largely artificial. Over the past three and a half years, no difficulties have been encountered, and a very important contributory factor has been the ready help and cooperation which has been forthcoming from everyone connected with the work. Over and above the statutory or generally accepted duties of a Medical Officer of Health are two ancillary functions, which ought & be undertaken whenever opportunity presents, since apart from their intrinsic worth, they are valuable and stimulating adjuncts to the routin work of the Medical Officer of Health and the Health Department. I refer to the academic teaching of public health and to the conduct of research into problems of public health work and preventive medicine. 7 I should like to say a word about some of the work we are doing in this area. First, to deal with the question of teaching. We have been fortunate in forming an arrangement with London School of Hygiene and Tropical Medicine, whereby a number of lectures on Public health administration is given, and thereafter, students of the School, who are medical men and women studying for the University of London Post Graduate Diploma in Health, come to our Departments to study methods of public health administration in this country. During the Spring and Summer terms, for one session per week, we receive about twelve students from the School. Dealing as we do with both the environmental and personal health services, we are able to give to the students what we hope is a wide, all-embracing and at the same time well balanced exposition of public health work in this country. Over the past three years, some seventy students from many parts of the World and Commonwealth have passed through our Departments. We hope they will carry back with them to the many countries whence they came, useful ideas of what we have been able to show them. Turning to the problem of research, there are many questions in Public health and preventive medicine which need investigation. One of them is to decide whether three injections of a combined diphtheria/ whooping cough preventative is as effective in the prevention of diphtheria and whooping cough as injections against the two diseases given separately. The advantages of the " combined " method is that the child has to have only three injections instead of five. Research of this kind is an expensive and prolonged procedure, and unless special staff and facilities are available, it is rarely that a reliable answer can be provided. We are fortunate in being able to participate, in an investigation of this kind, in conjunction with the staff of the Medical Research Council. A special team of nursing and clerical staff is available to us; the giving of the injections being the responsibility of the personal health services. The investigation is helped considerably by the participation of the Borough Health Department, since we are able to utilise such services as transport for taking specimens quickly to the laboratory, and the ready access of certain records is also very useful, My senior medical colleagues and I supervise the work of the team in the field, while at the same time, we work in close conjunction with the medical staff of the Medical Research Council and the local general practitioners,and we hope that in the course of a year or two we can give an answer to this very important question. I would not wish to end this introduction to my Report for 1954 without saying something about Mr. F. H. Chuter, recently Chief Sanitary Inspector for Battersea, who retired in November. Mr. Chuter, whose father, incidentally, was Food Inspector in Battersea for many years, Joined the Battersea Health Department in 1926 as a Sanitary Inspector. In 1935 he became Senior Sanitary Inspector, and was designated Chief Sanitary Inspector in 1946. In 1948 were added the duties of Principal Administrative Assistant. He had many years of service with the Council, during which time he gave loyal and most efficient service to the Health Department. His resignation, on the ground of ill-health, was regretted by everybody. My own personal dept to Mr, Chuter is a considerable one, for when I took up my appointment he placed his knowledge of public health work in general, and his knowledge of Battersea, in particular, at my disposal, and I was 8 very grateful for his help. Mr. Chuter's retirement was undoubtedly a loss to the Council and the public health service. He left with an abundance of good will from everybody, and best wishes for a long and happy retirement. Once again, it is a great pleasure to acknowledge the kindness and help which I have received from all persons concerned in the work of the Department. Again I especially thank the Chairman of the Health, Baths and Wash-houses Committee, Alderman Miss E. A. Coles, J.P., for her support and ever ready assistance, and the various Committees, particularly, of course, the Health, Baths and Wash-houses Committee, and the Housing Committee, with whose work I am concerned, for their continued confidence. The Chief Officers of the Council, and not least, Mr. R. G. Berry, O.B.E., the Town Clerk, have been most helpful to me, and, as in the previous years, the officers and staff of the Health Department in all sections have given me loyal and efficient service. I would like again to thank my colleague, Dr. Garland, for the excellent way in which he carries out his duties, and for the capable way in which he assists me. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, J. TUDOR LEWIS, Medical Officer of Health- July, 1955. Principal Figures for 1954. Area of Borough, excluding tidal water (acres) 2,163 Home population (1951 Census) 117,140 Home population (Registrar-General's Mid-Year Estimate) 114,300 Structurally separate occupied dwellings 27,862 Births (live, 1,738; still, 50) 1,788 Live Birth rate 15.21 Deaths—1,151. Death rate 10.07 Maternal Deaths—1. Maternal death rate 0.56 Infant deaths—33. Infant mortality rate 18.99 9 Vital Statistics. POPULATION. The Registrar-General's estimate of the mid-year home population of Battersea was 114,300 as compared with 114,800 in 1953, a decrease of 500. The estimated population at the Census taken in April 1951 was 117,140; the 1954 figure of 114,300, when compared with this, shows a decrease of 2,840 (or 2.4 per cent.). The estimated mid-year home population figure of 114,300 has been adopted for the purpose of the statistics contained in this Report. BIRTHS. The number of live births registered in the Borough during 1954 was 1,048 (554 male, 494 female). Of this number 406 were transferred out, the permanent residence of the parents being outside the Borough, and 1,096 registered outside the Borough were transferred in, giving on balance a total of 1,738 births (927 male, 811 female, an excess of 116 males) relating to Battersea residents, and a live birth rate of 15.21 per 1,000 population. This is a decrease of 0.28 on that of 1953. Of the Battersea births (642 live and 12 still) which occurred within the Borough, 471 were "domiciliary births." Illegitimate births numbered 94 or 5.4 per cent, of the live births. The live birth rate for England and Wales was 15.2. Still-Births. The registration of still-births is made compulsory by the Births and Deaths Registration Act, 1926. During 1954 there were 29 still-births registered in Battersea, of which 12 were of Battersea parents. Thirty-eight still-births occurring outside the Borough were registered as belonging to Battersea, making 50 in all, representing a still-birth rate of 27.96 per 1,000 births (live and still) registered. Of the 50 still-births 3 (6.0 per cent.) were registered as illegitimates. The number of Battersea still-births registered, and the still-birth rates from 1943 to 1954, were as under:— No. Rate No. Rate 1943 36 21.6 1950 53 27.2 1944 40 24.0 1951 37 19.2 1945 38 23.3 1952 42 23.2 1946 59 22.7 Mean 1947 74 27.0 1943-52 47 22.9 1948 46 20.1 1953 38 20.9 1949 43 20.8 1954 50 28.0 10 MARRIAGES. The marriages registered in Battersea during 1954 numberd 912. The marriage rate (i.e., the number of persons married per 1,000 of the population) was 16.0. Year. Marriages. Marriage Rate. 1949 1,031 17.2 1950 949 16.1 1951 929 15.9 1952 884 15.2 1953 876 15.3 Mean 1949/53 934 15.9 1954 912 16.0 The marriage rate for England and Wales was 15.4. DEATHS. The number of deaths registered in the Borough during 1954 was 1,885. Of these, 1,076 were deaths of non-residents and were transferred to the districts in which the persons ordinarily resided. There were. on the other hand, 342 deaths of Battersea residents registered outside the Borough. The total (corrected) number of deaths belonging to the Borough was 1,151 (606 males, 545 females). This gives a recorded death rate of 10.07 compared with 11.3 for England and Wales. The following table shows the age and sex distribution of the total deaths (corrected) in Battersea during 1954:— Under 1 year 1— 5— 15— 25— 45— 65— 75 + Total M. 18 4 5 2 32 166 184 195 606 F. 15 2 2 4 23 100 140 259 545 Totals . 33 6 7 6 55 266 324 454 1,151 % of Total 2.9 0.5 0.6 0.5 4.8 23.1 28.1 39.5 100.0 Of the 1,151 Battersea deaths, 639 (or 55.5 per cent.) occurred hospitals, etc. 11 The average age at death is shown in the following table:— Average Age at Death. 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 1953 68.9 1954 67.2 Mean, 1950/1954 67.4 The average age at death for 1954 (67.2) shows a decrease on the corresponding figure for 1953. This is due to the fact that in 1953 the Registrar-General decreed that all deaths, with the exception of those from tuberculosis, that occurred in St. John's Hospital, a hospital for the aged sick, were assignable to Battersea, irrespective of the home address of the patient prior to admission. In 1954, however, this was rescinded, and only Battersea residents who died during the year in that hospital were recorded as Battersea who died during the year in that hospital were recorded as Battersea deaths. As from the 1st January, 1953, the deaths of Battersea residents, in hospital for the chornic sick, insitutions, etc., situated without the Borough were assigned to the area where the death occurred. The deaths of 778 residents of Battersea aged 65 years and upwards were registered during 1954. These 778 deaths constituted 67.6 per cent, of the total deaths at all ages. The natural increase of population (that is, excess of births over deaths) was 587 in 1954 as compared with 304 in 1953. The causes of the 1,151 deaths in 1954 classified in various age groups, are shown in the following table. 12 Causes of Death at Different Periods of Life in Battersea during 1954 The following table is compiled from figures supplied by the Registrar-General:— Causes of Death. Sex. All Ages. 0— 1— 5— 15—;25— 45— 65— 75— All Causes M. 606 18 4 5 2 32 166 184 195 f. 545 15 2 2 4 23 100 140 259 1. Tuberculosis respiratory M 11 — — — — — 8 3 f. 9 — — 1 1 2 2 3 — 2. Tuberculosis other forms M. 2 — 1 — 1 1 — f. 2 — — — — — 2 — — 3. Syphilitic disease M. 3 — — — — — 1 2 — f. 6 — — — — — 1 2 3 4. Diphtheria M. — — — — — — — — — f. — — — — — — — — — 5. Whooping cough M. — — — — — — — — — f. 1 — — — — — — — 1 6. Meningococcal infections M. — — — — — — — — ----- f. — — — — — — — — — 7. Ac. polio-myelitis and polio-encephalitis M. — — — — — — — — —- f. 1 — 1 — — — — — _ 8. Measles M — — — — — — — — — f. — — — — — — — — — 9. Other infective and parasitic diseases M. 1 — — — — — 1 — — f. 1 — — — — — — 1 — 10. Cancer of stomach M. 13 — — — — 6 6 1 f. 12 — — — — — 5 3 4 11. Cancer of lung, bronchus M. 53 — — — — 4 25 22 2 f. 9 — — — — — 4 2 3 12. Cancer of breast M. — — — — — — — — — f. 22 — — — — 1 9 7 5 13. Cancer of uterus M. — — — — — — — — f. 6 — — — — 3 2 1 — 14. Cancer of other sites M. 49 — 1 1 3 13 16 15 f. 50 — — — — 4 13 17 16 15. Leukæmia, aleultæmia M. 7 — — 2 1 1 2 1 --- f. 2 — — — — — 2 — — 16. Diabetes M. 1 — — — — — — — 1 f. 3 — — — — — — 2 — 17. Vascular lesions of nervous system M. 63 — — — — 1 16 22 24 f. 80 — — — 1 1 11 22 45 18. Coronary disease, angina M. 111 — — — — 5 41 36 29 f. 50 — — — — — 13 17 20 19. H ypertension with heart disease M. 13 — — — — 1 1 6 5 f. 13 — — — — — 1 6 6 13 Causes of Death, 1954—(contd.). Causes of Death. Sex. All Ages. 0— 1— 5— 15— 25—45— 65— 75— 20.Other heart disease M 75 — — — — 4 10 18 43 f. 107 — — — — 2 8 18 79 21.Other circulatory disease M. f. 25 30 — — — — — — — — — 6 1 3 10 10 9 16 22.Influenza M. 1 — — — — — 1 — — f. 1 — — — — — — — 1 23.Pneumonia M. 20 — — — — 1 5 5 9 K 25 1 — — — — — 8 16 24.Bronchitis M. 47 1 — 1 12 10 23 f. 19 — — — — 1 2 3 13 25. Other diseases of respiratory system M. 3 — — 1 — 2 — f. 3 — — — — — — 2 1 26. Ulcer of stomach and duodenum M. 15 — — — — — 3 8 4 f. 6 — — — — — 2 1 3 27. Gastritis, enteritis and diarrhœa M. 5 2 1 1 1 _ f. 4 2 — — — 1 — — 1 1 28. Nephritis and nephrosis M. 3 — — — — — 1 1 f. 4 — — — 1 2 — — 1 29. Hyperplasia of prostate M. 10 — — — — — — 1 9 f. — — — — — — — — — 30. Pregnancy, childbirth, abortion M. — — — — — — — — — f. 1 — — — — 1 — — — 31.Congenital malformations M. 6 4 1 — — — _ 1 f. 3 1 1 — — — 1 — — 32.Other defined and illdefined diseases M. 35 11 _ 3 4 9 8 f. 58 11 — 1 — 3 15 10 18 33.Motor vehicle accidents M. 6 1 1 1 1 2 f. 4 — — — — — 2 2 — 34.All other accidents M. 16 — — 1 — 3 5 1 6 K 9 — — — 1 — — 2 6 35. Suicide M. 12 3 2 3 4 f. 4 — — — — 1 2 1 — 36.Homicide and operations of war M. — — — — — — — — — f. — — — — — — — — — Infant Mortality. During 1954 the deaths of 33 infants under 1 year of age were registered as belonging to Battersea. The total number of live births resistered during the year was 1,738 giving an infant mortality rate of 18.99 per 1,000 live births as compared with 18.56 in 1953 and 17.56 in 1952. The infant mortality rate in England and Wales during 1954 was 25.5. 14 The following table sets out the causes of death in detail. Infant Mortality, 1954. Nett Deaths from stated causes at various ages under 1 year. CAUSES OF DEATH AGE PERIODS Under 24 hours. 1-7 days. Weeks. Total under 4 weeks. Months. Total deaths under 1 year age of Total 1-2 2-3 3-4 1-3 3-6 6-9 9-12 M F. M F M. F. M F M F. M F M F. M. F. M F M F M. F. Pneumonia 1 1 Bronchitis 1 1 3.0 Gastritis, enteritis and diarrhœa 1 1 1 1 1 2 2 3.0 Congenital malformations 2 1 1 3 1 1 4 1 15.2 Other defined and ill-defined diseases: 48.5 Prematurity 7 3 2 2 1 1 11 5 11 5 18.2 Other causes 3 1 4 1 1 6 100.0 Totals 9 6 3 3 1 1 1 1 15 10 2 3 1 1 1 18 16 15 6 1 1 2 25 5 1 1 1 33 M. 54.5 F.45.5 Percentage of total 45.5 18.2 3.0 3.0 6.1 75.8 15.5 3.0 3.0 3.0 100.0 There were 25 deaths of infants during the first four weeks of life (or 75.8 per cent, of the total infant deaths) as compared with 18 deaths (or 54.5 per cent.) in 1953 and a percentage for the quinquennium 19491953 of 60.4. Table showing Deaths of Infants under 1 day, under 1 week and under 4 weeks from 1948 to 1954. Year Under 24 hours 1 to 7 days 1 to 4 weeks Total under 4 weeks Percentage deaths under 4 weeks of total infant deaths 1949 13 13 7 33 64.7 1950 14 15 5 34 66.7 1951 8 21 3 32 61.5 1952 8 8 1 17 54.8 1953 7 8 3 18 54.5 Mean 10 13 4 27 60.4 1954 15 6 4 25 75.8 15 Deaths of Illegitimate Infants was The death rate amongst illegitimate children during 1954 42.55 per 1,000 illegitimate live births, as compared with 70.71 in 1953, 41.23 in 1952, 42.73 in 1951, and 40.40 in 1950. The corresponding death rate of legitimate children in 1954 was 17.64, the ratio of mortality rate of illegitimate infants to that of legitimate being 241 to 100. The corressponding figure for 1953 was 456 to 100. Maternal Mortality. During 1954 there was one death from "diseases or accidents of child-birth," which is equivalent to a fatality rate of 0.56 per 1,000 births (live and still). There was one such death during 1953. The rate for England and Wales in 1954 was 0.69. Comparative Statistics of Births, Mortality, etc. (Compiled from Registrar-General's Returns.) Year Population Live Birth Rate Death Rate Maternal Death Rate Infant Mortality Rate 1945 90,420 17.6 13.8 1.23 40.8 1946 108,610 23.4 13.5 1.54 42.4 1947 114,960 23.2 12.6 0.73 31.5 1948 116,500 19.3 11.3 1.00 31.6 1949 117,510 17.2 12.1 0.97 25.2 1950 117,700 16.1 11.2 1.02 26.9 1951 117,000 16.1 12.4 0.00 27.6 1952 116,400 15.2 11.9 1.66 17.6 1953 114,800 15.5 12.8 0.55 18.6 1954 114,300 15.2 10.1 0.56 19.0 16 Infectious and Other Diseases. There was a large decrease in the number of notifications received during 1954. Notifications received numbered 648, as compared with 1,612 in 1953, a decrease of 964, and an average of 1982 for the preceding 5 years (1949/53). The decrease was due mainly to a drop in the number of measles and whooping cough notifications, the incidence of measles and whooping cough declining from 762 and 410 in 1953, to 192 and 116 in 1954, respectively. There were fewer notifications of scarlet fever, acute primary and acute influenzal pneumonia, also pulmonary tuberculosis, but there was a slight increase in food poisoning notifications, there being 14 in the year under review compared with 4 in 1953, There were no cases of diphtheria. Five cases of polio-myelitis were notified, but in one of these cases the diagnosis was not confirmed, leaving 4 confirmed cases (1 paralytic and 3 non-paralytic). In addition to the above, there was one fatal un-notified case, occurring in a child aged 2 years, who died within a few hours of being admitted to hospital. It was only after extensive pathological investigation that it was established that polio-myelitis was the cause of this death. The following table shows the number (corrected) of cases notified during 1954 and, for the purpose of comparison, the average number of cases notified annually in the five years, 1949—1953:— Notified Average 1954 1949/53 Diphtheria — 2 Erysipelas 13 22 Scarlet fever 69 148 Paratyphoid fever 1 1 Continued fever — — Puerperal pyrexia 21 27 Meningococcal infection 2 3 Ophthalmia neonatorum 1 2 Acute Encephalitis 1 1 Polio-myelitis & Polio-encephalitis 4 13 Malaria 1 Dysentery 23 13 Pneumonia (Acute primary) 36 75 (Acute influenzal) 2 11 Scabies 12 22 Food poisoning 14 6 Whooping cough 116 291 Measles 192 1,173 Tuberculosis (all forms) 140 172 Total 648 1,982 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. 17 Analysis of Cases (after Correction of Diagnosis) of Infectious Disease Notified during the Year 1954. Notifiable Disease. Cases Notified in Battersea, at Ages (Years). 0— 1— 3— 5— 10— 15— 25— 35— 45— 65 & over Total Small pox — — — — — — — — — — — Diphtheria — — — — — — — — — — — Erysipelas — — — 1 1 — 1 1 2 5 3 13 Scarlet fever — 4 15 44 3 — — — — 69 Paratyphoid fever — — — — 1 — — — — — 1 Continued fever — — — — — 11 — — — — 21 Puerperal pyrexia — — — — — 7 3 — — Meningococcal infection 1 — — — 1 — — — — — 2 Ophthalmia neonatorum 1 — — — — — — — — — 1 Polio-myelitis:— Paralytic — — — — — — 1 1 — — 1 Non-paralytic — — — 2 — — — — — 3 Acute Encephalitis: — Infective — — — 1 — — — — — — 1 Post-infectious — — — — — — — — — Malaria — — — — — 1 — — — — 1 Dysentery 1 4 2 6 3 2 4 1 — — 23 Acute primary pneumonia 4 3 — 4 — 2 4 3 7 9 36 Acute influenzal pneumonia — — 1 — — 1 1 — — — 2 Scabies 1 — 2 2 3 2 1 — — 12 Food poisoning 1 4 4 1 — — — 1 — 3 14 Whooping cough 17 25 36 37 1 — — — — 116 Measles 14 40 37 96 2 — 1 1 — 1 192 Tuberculosis:— Pulmonary — 5 2 7 7 26 29 17 28 7 128 N on-pulmonary — — — 3 — 2 1 3 3 — 12 Totals 40 85 97 204 23 49 51 33 43 23 648 18 TUBERCULOSIS. During the year 1954 there were 140 cases of tuberculosis (all forms) notified in Battersea as compared with 165 in 1953, 188 in 1952, 162 in 1951, 149 in 1950 and 194 in 1949. In addition 81 cases were reported or otherwise came to the knowledge of the Medical Officer of Health, making a total of 221 cases for the year. The case rate per 100,000 population was 193.4. The tables on page 20 give details in age groups of the 221 cases. Deaths from Tuberculosis. During 1954 deaths from tuberculosis registered as belonging to the Borough of Battersea numbered 24, of which 20 (i.e., 83.3 per cent.) were due to pulmonary tuberculosis, 4 (i.e., 16.7 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, 1952, 1953 and 1954 are given in the following table:— Years Pulmonary NonPulmonary Total 1901-1905 138.1 50.9 189.0 1906-1910 126.8 45.9 172.7 1911-1915 124.2 33.8 158.0 1916-1920 134.8 30.0 164.8 1921-1925 92.6 23.0 115.6 1926-1930 91.1 14.2 105.3 1931-1935 81.8 14.4 96.2 1936-1940 76.1 9.2 85.3 1941-1945 91.8 11.0 102.8 1946-1950 53.1 6.1 59.2 Average (50 years) 101.0 23.9 124.9 1951 39.3 3.4 42.7 1952 29.2 2.6 31.8 1953 12.2 4.4 16.6 1954 17.5 3.5 21.0 The death rate per 100,000 population was 17.9 for England and Wales. 19 Tuberculosis, 1954. Cases Added to and Removed from Notification Register. PULMONARY NON-PULMONARY GRAND TOTAL Males Females Total Males Females Total Males Females Total Already on Register, 31/12/53 621 508 1,129 39 80 119 660 588 1,248 Primary notifications 66 62 128 4 8 12 70 70 140 Notified after death 1 4 5 — — — 1 4 5 Unnotified deaths — — — 1 1 2 1 1 2 Restored 1 — 1 — — — 1 — 1 Removals into Borough 32 38 70 2 2 4 34 40 74 From other sections — 1 1 — — — — 1 1 TOTAL ADDITIONS 100 105 205 7 11 18 107 116 223 Deaths 14 7 21 1 1 15 7 22 Notified after death — 3 3 — — — — 3 3 Unnotified deaths 1 1 2 1 1 2 2 2 4 Removals from Borough 58 43 101 5 3 8 63 46 109 Recovered 10 15 25 4 12 16 14 27 41 Diagnosis not confirmed 4 2 6 — 1 1 4 3 7 To other sections — — — — 1 1 — 1 1 TOTAL DELETIONS 87 71 158 11 18 29 98 89 187 Net increase 13 34 47 — — 9 27 36 Net decrease — — — 4 7 11 — — — On Register at 31/12/54 634 542 1,176 35 73 108 669 615 1,284 20 Formal Notifications, 1954. Age Periods Number of Primary Notifications of new cases of tuberculosis 0— 1— 2— 5— 10— 15— 20— 25— 35— 45— 55— 65— 75— Total (all ages) Respiratory, Males — — 2 3 3 6 4 14 8 13 9 3 1 66 Respiratory, Females — 2 3 4 4 8 8 15 9 5 1 3 — 62 Non-Respiratory,Males — — — 1 — — — 1 1 1 — — — 4 Non-Respiratory, Fem. — — — 2 — 2 — — 2 — 2 — — 8 New cases of Tuberculosis coming to the knowledge of the Medical Officer of otherwise than by formal notification. Source of Information Number of cases in age Groups 0— 1— 2— 5— 10— 15— 20— 25— 35— 45— 55— 65— 75— Total Death Returns from Local Registrars r. M — — — — — — — — — — — 1 — 1 (A) F — — — — — — — — — — 1 — — 1 (B) N.R. M — — — — — — — — — — — — — — (C) F — — — — — — — — — — 1 — — — (D) Death Returns from Registrar-General (Transferable Deaths) R. M — — — — — — — — — — — — — — (A) F — — — — — — — — — — — — — — (B) N.R. M — — — — — — — — — 1 — — — 1 (C) F — — — — — — — — — — — — — — (D) Posthumous Notifications R. M — — — — — — — — — — — — — — (A) F — — — 1 — — — — 1 — — 1 — 3 (B) N.R. M — — — — — — — — — — — — — — (C) F — — — — — — — — — — — — — — (D) "Transfers" from Other Areas (excluding transferable deaths) R. M — — 2 1 — — 6 14 7 2 — — — 32 (A) F — — — — — 2 8 16 9 2 1 — — 38 (B) N.R. M — — — — 1 — — 1 — — — — — 2 (C) F — — — 1 — — — 1 — — — — 2 (D) Other Sources R. M — — — — — — — — — — — — — — (A) F — — — — — — — — — — — — — — (B) N.R. M — — — — — — — — — — — — — — (C) F — — — — — — — — — — — — — — (D) R.—Respiratory. Totals (A) 33 N.R —Non-Respiratory. „ (B) 42 „ (C) 3 (D) 3 81 Total number of Informal Notifications 21 BACTERIOLOGICAL EXAMINATIONS. The bacteriological examination of clinical material (with the exception of sputum which is dealt with at the Chest Clinic) and foodstuffs suspected as being the cause of food poisoning was carried out by the Public Health Laboratory Service, County Hall, Westminster Bridge, S.E.1. No charge is made to the Council for these examinations. During the year 343 examinations were made as follows:— Description Disease Number of Specimens or Food Samples Positive Results Faeces Dysentery or Food Poisoning 272 80 do Paratyphoid Fever 6 Nil do Thread Worm 1 Nil Throat Swabs Diphtheria 47 Nil Nasal Swabs Whooping Cough 2 Nil Foodstuffs Food Poisoning 15 Nil INTERNATIONAL CERTIFICATES OF VACCINATION and INOCULATION. At the request of the Ministry of Health arrangements are made for the authentication, by the Medical Officer of Health, of certificates of vaccination and inoculation issued by medical practitioners in the Borough in respect of persons going abroad. During 1954, 237 certificates were authenticated. CANCER. During 1954 the number of deaths of Battersea residents from Cancer was 214 (males, 115; females, 99) as compared with 242 in the 1952, 252 in 1951, and 237 in 1950. The death rate from the disease per 1,000 of the population was 1.87. The deaths from cancer contitute 18.6 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 1936-1940 1.99 1906-1910 0.95 1941-1945 2.44 1911-1915 1.11 1946-1950 2.11 1916-1920 1.28 1951 2.15 1921-1925 1.33 1952 2.05 1926-1930 1.51 1953 2.11 1931-1935 1.75 1954 1.87 Details in age groups and the localisation of this disease will be found on page 12. 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 1954. Sanitary Operations. Inspections— New houses—certificates issued re water supply New houses 358 358 House-to-house — Houses supplied with water and fittings repaired Houses let in separate tenements 25 75 Houses—following complaints 3,922 Additional water supplies to tenement houses — Houses—following infectious disease 736 Water closets provided, supplied with water, or supply disconnected from drinking water cisterns Gipsy vans — Public urinals and chalets 62 5 Re-inspections 18,787 Water closets and urinals cleansed and repaired Other visits 2,545 364 Notices served— Drinking water cisterns cleansed and repaired Intimations 2,022 113 Statutory (Sec. 197 and 200) 152 Rain-water and waste pipes disconnected or repaired Statutory (Fifth Schedule) 995 165 Soil pipes and drains ventilated Summonses issued 106 70 Magisterial Orders obtained 48 Defective roofs and gutters repaired 860 Drains laid to new houses 358 Dustbins provided 44 Drains relaid (wholly or partly) 15 Yards paved or repaired Premises disinfected 56 818 Drains cleansed and repaired 194 Personal Cleansing Treatments— Drains tested (smoke) 104 To adults 214 Found defective 35 To children 2,383 Drains tested (water) 1,496 Articles disinfected 6,142 Drainage plans received 141 Rodent Control— Frontage drains constructed or reconstructed 27 Premises infested 347 Inspections 5,600 Protection of Food Supply. Inspections— Butchers' and other food shops 1,877 Inspections—contd. Ice cream premises 253 Fish shops 318 Restaurant kitchens 689 elc\ Food storage premises 217 Samples taken 560 Dairies and milk shops 312 Summonses issued 1 Factories, Workshops and Shops. Inspections— Inspecti ons—contd. Shops 57 Outworkers 1,160 do. (Pharmacy Act) 21 Smoke observations 207 Rag flock 14 Intimation notices served 24 Pet shops 24 Statutory notices served 2 Factories 2,005 Summonses issued Nil 23 Legal Proceedings. During the year, legal proceedings were taken by the Council in 107 cases, for the enforcement of various Acts, by-laws, regulations, etc., administered by the Health Department. A summary is set out elow, and further details will be found in the sections dealing with e respective matters at the pages stated. Cases Page No. Pubic Health (London) Act, 1936 104 23 Food and Drugs Act, 1938 1 34 London County Council by-laws as to Drainage 1 24 National Assistance Acts 1 49 107 Fines totalling £21 0s. 0d. were imposed in connection with these Proceedings, and £45 3s. 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, 2,022 Intimation, and 995 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, it was found necessary to refer 192 cases to the Council's Solicitor with instructions to Statutory by legal proceedings if necessary, to enforce compliance with Sattutory Notices. In 90 of these cases a warning letter from the Solicitor had the desired effect. In the remaining 102 cases, however, summonses had to be issued. As a result, Nuisance Orders were made by the Court in 48 instances. The remaining 54 summonses were ultimately withdrawn, the Notices having been complied with subsequent to the issue of the summonses. In 37 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 accounts were accordingly rendered to them. Two summonses for failure to comply with Nuisance Orders made in 1953 in respect of one house, were heard in 1954. Fines of £3 were inposed in each case, and total costs of £4 4s. Od. were awarded, The owener did not carry out the necessary repairs, and at the end of the year actions was being taken to obtain a Closing Order under the Housing Act, 1936, and the Local Government (Miscellaneous Provisions) Act, 1953. Dustbins. The London County Council (General Powers) Act, 1954, came into operation on 5th luly. Section 12 of the Act repeals and re-enacts, with a number of modifications, Section 105 of the Public Health (London)Act, 1936, which provision of dustbins for dwelling houses could previously be required. The most important modification is that the notice is now required to be served on the owner and not on the owner or occupier as previously. This simplifies procedure insofar that the Health, Baths and Wash-houses Committee do not now have to decide upon whom the notice should be served. 24 The notice must specify the number, size, material and construction of the dustbins to be supplied. The Section gives to the owner the right of appeal to the Court on the ground that the dustbin ought to be provided by the occupier. He must, however, serve a copy of his notice of appeal on the occupier and on the Council. The latter must then send a copy of the original notice to the tenant, together with a statement of certain provisions of Section 286 of the Public Health (London) Act, 1936, which define the powers of the Court on hearing appeals. Prior to the alteration in procedure, 25 cases were considered by the Committee, and in each case it was decided to serve the notice on the owner. 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 is provided for each sex. Facilities for washing are also provided. Three public urinals are maintained, and 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 362 new buildingsand the drains of 15 old buildings were partially or entirely reconstructed under the supervision of the Officers of the Health Department- 141 plans of proposed drainage work were deposited in 1954, 3s compared with 123 in 1953. During the year drains were tested by smoke on 104 occasions and 35 were found defective. The water test was applied on 1,496 occasions, this being mainly to drains in course of construction. The frontage drains of 27 premises were constructed or reconstructed- One summons was issued against a builder under the Drainage By-laws for failing to deposit plans of drainage work carried out, but the plans were deposited before the hearing of the summons, which was then withdrawn. The drainage of multi-storey blocks of flats in connection with the internal lay-out of soil and waste pipes has normally been governed by practice laid down in the Drainage By-laws. With a view to reducing costs, experiments have been going °n for a number of years with the "single pipe" system, which in effect is the normal system of plumbing with some or all of the trap ventilating pipes omitted. The experiments have shown that, with careful attention to certain principles of design, the system is quite satisfactory, at least 25 for blocks of up to five storeys. For higher blocks, the system is still somewhat in the experimental stage, and ventilation to the water-closet connections are advised. These systems are in the process of installation in blocks of flats °n the Anerley Street site. Combined Drainage. Claims were made by the owners of two houses, the drainage system of which had been found to be defective following an infestation of rats, that the combined portion of the system was a "sewer" repairable by the Council. The claim was admitted, and the work to the common Portion of the drain was carried out by the Council. Smoke Nuisances. During the year 17 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 total number of observations made was 207. Five notices were served (three intimation and two statutory) and were complied with. Effluvium Nuisances. A small number of complaints alleging nuisance from effluvia emitted from various industrial and business premises were received. They 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. Water Supply. During the year certificates under Section 95 (2) of the Public Heath (London) Act, 1936, were issued in respect of 358 new or re-erected dwelling houses or tenements. Thirty-nine notices of waste of water from defective fittings, etc., observed during routine inspections of various premises, were sent to the Metropolitan Water Board. The deep wells at the Latchmere Road Public Baths, which originally supplied the Baths establishment and the houses of the Council's Latchmere Estate, have been out of operation due to the necessity for an overhaul of the pumps and the replacement of the storage tank. The necessary work is in hand, and in the meantime the Metropolitan Water Board is maintaining a supply. Rag and Bone Dealers. Premises occupied by rag and bone dealers in the Borough are subjected to regular inspection. During the year 127 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 a Police Officer, and was dealt with by a cautionary letter. 26 Verminous Premises. During the year 212 premises which were found to be infested with vermin (principally bed-bugs) were disinfected. 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. One hundred and ten 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 gives power generally to the Council to require steps to be taken to eradicate infestations of rats and mice and where possible to prevent infestations occurring. 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 except 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. 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 Major Minor Council's properties - 4 3 Dwelling houses - 159 43 Business premises - 184 77 - 347 123 The total number of visits made to the above premises, and to others which were found not to be infested, was 5,600. 27 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, is still proving a problem, but the number of complaints is gradually diminishing due to the sites being used for rebuilding and other purposes. Arrangements are in operation whereby the Council are empowered to clear static water tanks and to obtain refund of the cost from the London County Council. Rag Flock and Other Filling Materials Act, 1951. 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 Inspectors, any filling materials. The Medical Officer of Health, and Sanitary Inspector, 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 filing 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, six premises at which other filling materials are used in such circumstances as to require them to be registered. Resistration of these premises has been duly effected. Fourteen 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. All were certified to be in conformity with the Regulations. Pet Animals Act, 1951. This Act came into operation on the 1st April, 1952, and is enforceable by Council, who authorised the Medical Officer of Health, the Deputy Medical Officer of Health, and the Sanitary Inspectors 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 grantedd in accordance with the provisions of the Act. The keeping 28 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 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. Licences were issued in respect of 12 shops, and 24 visits were made during the year. 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 and where the applicant was able to secure suitable alternative accommodation within reasonable distance. Amongst other very numerous inspections of shop premises undertaken during the year, thirty-five were visited for the specific purposes of the Act, mainly as the result of complaints made. These were principally concerned with allegations of failure to maintain a reasonable temperature, and were all dealt with in a satisfactory manner at the time of inspection. In one other case a notice was issued to remedy offences against the Act, and these were subsequently rectified in a satisfactory manner. Heating Appliances (Fireguards) Act, 1952. This Act received Royal assent on the 1st August, 1952, but did not come into operation until the 23rd March, 1953, the date fixed by Order of the Secretary of State. It is 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. 29 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 Regulations, known as the Heating Appliances (Fireguards) Regulations, 1953, were made by the Secretary of State and came into operation on the 1st October, 1953, except in regard to appliances manufactured in Great Britain before that date. For the latter, the operative date was 1st October, 1954. The Regulations prescribe that every heating appliance of a type which is so designed that it is suitable for use in a dwellin house or other residential premises shall be fitted with a guard which shall be robustly made and securely attached to the appliance, and shall satisfy certain tests which are set cut in a Schedule to the Regulations. These tests comprise a loading test of rigidity, the use of probes of specified shapes and dimensions to check the mes of the guard, and the placing of flannelette on the guard while the fire is alight, the requirement being that the flannelette must not smoulder or ignite within a period of ten seconds. It is estimated that there about 60 shops and other premises in the Borough at wich heating appliances are sold or let on hire. These are visited from time to time and tests of appliances made. A careful watch is also maintained on such fittings exhibited for sale. It has been found, however, that almost without exception appliances on sale carry the seal certifying their compliance with the British Standard Specification. Upon these there is, of course, the double assurande of their being subject to inspection at the place of manufacture. Use of Slipper Baths by Old Age Pensioners. On the 30th January, 1952, the Council decided to make available to old age pensioners free use of the slipper baths at their Baths Establishment (with use of a towel) on production of their pension books. This facilitv has now been extended to blind persons. During the year 1954 this arrangement was taken advantage of at the respective Baths Establishments as follows:- Males Females Latchmere 2,514 3,124 Nine Elms 1,035 315 Plough Road 1,235 1,645 Total 4,784 5,084 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 maintaind a high degree of purity. 30 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, for it is evident that constant inspection and supervision is the only really satisfactory way of securing and maintaining satisfactory hygienic conditions in such premises. Abundant evidence of this is provided by the immense improvement in the conditions at catering establishments which, in the past three years, have had special attention paid to them. In all these inspections, emphasis is on advice and education rather than upon formal enforcement of statutory provisions, the latter being invoked only when peaceful persuasion fails to achieve the desired improvement. For many years it had been the practice in Battersea to allocate the responsibility for the inspection of all food premises to specialist inspectors. The increasing recognition of the importance to public health of those premises, and the increase in legislation affecting them, however, has made it evident that an increase in the volume of inspection had become a matter of urgent necessity. The Council, therefore, decided that as from 1st November, 1953, the District Sanitary Inspectors should be given responsibilities in this field, and accordingly they are now undertaking the routine inspection of certain food premises in their various districts. 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 3rd 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 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 were all subsequently visited by one of the Sanitary Inspectors, who, in addition to ascertaining whether the By-laws were being complied with, offered advice to the trader on any aspect of them on which he was in doubt. During the year one case occurred of an offence against the By-laws. This concerned the serving of customers with fish wrapped in newspaper without any other covering, so that the newspaper came into direct contact with the fish. The matter was dealt with by a cautionary letter. 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 31 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 depôts. These talks and visits were greatly appreciated and are undoubtedly of considerable educational value. Festival Pleasure Gardens, Battersea Park. A close control is exercised by the Council's Officers over the catering arangements in these Gardens, and it can be recorded that no case of serious illness was traced to any food purchased there, nor was any complaint 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 72 butchers' shops in the Borough, and in addition a numberof shop where cooked meats are sold. All these shops are systematically inspected, 1,056 visits having been made during the year. In general, the shops are well conducted, and no formal action was found necessary. Four shop where horseflesh is sold for human food are included in the above figure. Dairies and Milkshops. The following table gives the dairies and milkshops registered in the Borough and the changes during 1954:- (a) Dairies where both the premises and the occupier are registerd:- Retail Wholesale Total On register at 1st January 37 7 44 Transferred to (b) below 2 - 2 Closed during year 1 - 1 On register at 31st December 34 7 4l (b) Milkshops, where only the occupier is registered as a distributor:- On register at 1st January 99 Added during year, by new registrations 3 Transferred from (a) above 2 On register at 31st December 104 (c) "Out-of-Borough" registrations (i.e., persons selling milk in Battersea from premises in other boroughs):- On register at 1st January 30 Removed during year 1 On register at 31st December 29 A total of 312 visit were made to these shop during the year. Generally they are very well conducted. In no case was any contravention of the Statutory requirements found. 32 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 were prescribed—Accredited, Tuberculin Tested, Pasteurised and Sterilised. The following deferred provisions of these Regulations came into operation on the 1st October, 1954:- The designation "Accredited " ceased to be used. Tuberculin Tested milk must be supplied in a properly closed container. If the container is a bottle, the cap must bear the address of the premises at which the bottle was filled and the words "Tuberculin Tested Milk." Any other type of container must be closed with a tightly fitting cover and suitably sealed and labelled. Pasteurised milk must be delivered in containers closed at the dairy where they were filled, with a cap or cover over-lapping the lip of the container and labelled "Pasteurised Milk." 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. 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. The whole of the County of London is included in such areas. The number of licences issued by the Council for 1954 was as follows:- Full Supplementary Tuberculin Tested 53 22 Pasteurised 90 23 Sterilised 131 24 274 69 One licence to sterilise milk was issued, and is included in the above figures. Details of examination of samples of pasteurised and sterilised milk are given on page 40. 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 264, 35 having been added and 9 removed during the course of the year. These premises are regularly inspected, 253 visits being made, Particular attention is paid to premises where manufacture takes place, and not only are the premises, plant, and methods of operation 33 ised, but samples of the products are taken for examination by the Methods suggested by the Ministry of Health. The premises generally are found to be well conducted. Further details in regard to sampling of ice-cream will be found on page 40. Fish Shops. Shops in which fish, either cooked or uncooked, is sold, or where the curing or smoking of fish is carried on, are regularly inspected. There were 47 such shops in the Borough in 1954. 318 inspections were made. It was not found necessary to serve any notices in respect of these shops during the year. Street Stalls. All street stalls from which food for human consumption is sold are regularly inspected and, where the food sold is stored in the Borough, the storage places are also inspected. It was not found necessary to take any formal action during the year. Unsound Food. The following table gives particulars of the unsound foodstuffs which, under the provisions of the Public Health (London) Act, 1936, Section 180 (8), were voluntarily surrendered to the Council. Most of these foodstuffs were ultimately used for the manufacture of animal feeding stuffs. Fish (preserved) 2st., 192 tins Fish (wet) 5 cwts., 3 qtrs., 3½ lbs., 3 boxes Meat and meat products (preserved) 12 cwts., 2 qtrs., 1 St., 5 lbs., 1,187 tins Meat (fresh) 1 ton, 5 cwts., 3 qtrs., 9½lbs. Offal 11 cwts. Poultry 18 chickens Vegetables (preserved) 1,680 tins Fruit (preserved) 3 qtrs., 1 lb., 1,502 tins, 31 jars, 12 pkts. Milk (tinned) 690 tins Cream (tinned) 32 tins Eggs (shell) 2,940 eggs Eggs (frozen) 16 lbs. Cheese 1 cwt., 1qtr., l st., 12 lbs. Cakes and bisuits 3 qtrs. Floor and cereals 16 lbs. Jams, syrups and preserves 314 tins, 26 jars Pickles and Sauces 8 tins, 4 jars, 319 bottles Pudding and Cake Mixture 4½lbs., 1 tin, 24 pkts., 3 Xmas Pudding. Soups 55 tins Cordials and fruit juices 18 tins, 2 barrels 34 Two cases of the presence of foreign matter in food were reported during the year. Legal proceedings were taken in one case of a piece of cinder in cake, and a fine of £15 was imposed, and £5 5s. Od. costs awarded to the Council. The other case was dealt with by a cautionary letter. An unusual case arose during the year, when a butcher asked my advice on the condition of a forequarter of beef which had been hung in his cold room for a week. The forequarter was suspended by the ordinary type of tinned iron hook from a metal rail. Across the top of the rail was lying a rubber covered cable leading to an electric lighting point. On examining the meat, he noticed that it was discoloured where the hook had passed through it. The protective tinning on the hook had been completely eaten away, and the iron rusted. I submitted specimens of the meat and the hook to the Public Analyst, who reported that the dark stain on the meat was due to sulphide of iron produced by sulphur compounds in the meat acting on iron oxide. He suggested that these conditions were probably due to a leakage of electricity in the refrigerator. An examination of the cable showed surface cracking, and the Analyst's conclusion that electrolysis played some part in affecting the meat was undoubtedly correct. Food Poisoning. (Outbreak of Salmonella typhimurium infection.) During the months of November and December, 12 cases of children with symptoms resembling a mild form of dysentery were reported to the Health Department. The ages of the children ranged from 11 months to 8 years, and for the most part the cases were reported from one area of the Borough. On investigation it was found that the symptoms were due to infection by the micro-organism, Salmonella typhimurium. Examination of contacts revealed 6 carriers of the micro-organism. Immediate precautions were adopted as soon as the first case was discovered, but despite extensive investigations no evidence was detected of bacterial contamination of the food and water supplies. As a result of treatment, either in hospital or at home, the patients or their contacts soon became free from infection. In this context excellent co-operation was secured with the respective family doctors, a feature which contributed in no small measure to the control of the outbreak. There were in addition a few isolated cases that 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), is 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.l1. The Public Analyst had also carried out the examination of samples of heat-treated milk and of ice cream by the prescribed tests since the inception of those tests, but as from 21st September, 1953. this particular work was transferred to the Public Health Laboratory Service. As the latter Service make no charge for this work, the 35 arrangement enabled an increase to be made in the number of samples for chemical, etc., analysis submitted to the Public Analyst while keeping within the sum provided in the Annual Estimates. The total number of formal samples taken under the Act during 1954 was 322, of which 7, or 2.2 per cent., were certified to be adulterated. In addition, 238 informal samples were procured, of which 4, or 1.7 per cent., were reported against. The percentages of samples reported by the Public Analyst to be adulterated during the quinquennia 1921 to 1950 and in 1951, 1952, 1953 and 1954 are given in the following table:- Year Formal samples (per cent.) mal samples (per cent.) Mean 1921-1925 6.4 7.4 „ 1926-1930 3.3 2.4 „ 1931-1935 1.8 2.1 „ 1936-1940 0.9 0.9 „ 1941-1945 1.4 1.1 „ 1946-1950 1.0 1.1 1951 1.1 1.9 1952 1.6 2.6 1953 2.6 2.8 1954 2.2 1.7 Milk. One hundred formal samples of milk were taken during the year. Of the 100 samples, 21 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. All of these samples were reported to be in conformity with this standard, their average composition being:- Milk fat 4.38 per cent. Non-fatty solids 9.12 „ Total milk solids 3.50 „ The milk fat content of the 21 samples of "Channel Island" or "South Devon" milk ranged as under:- Between 4.6 and 4.7 per cent. 4 samples „ 4.5 „ 4.6 „ 2 „ „ 4.4 „ 4.5 „ 5 „ „ 4.3 „ 4.4 „ 5 „ „ 4.2 „ 4.3 „ 4 „ „ 4.1 „ 4.2 „ 1 sample 21 36 Seventy-three samples of ordinary milk were reported as genuine and their average composition was as follows:- Milk fat 3.67 per cent. Non-fatty solids 8.78 „ Total milk solids 12.45 „ Their content of milk fat ranged as follows:- 4 per cent, and over 2 samples or 2.7 per cent. Between 3.9 and 4.0 per cent. 2 „ „ 2.7 „ „ 3.8 „ 3.9 „ 9 „ „ 12.3 „ „ 3.7 „ 3.8 „ 11 „ „ 15.1 „ „ 3.6 „ 3.7 „ 10 „ „ 13.7 „ „ 3.5 „ 3.6 „ 9 „ „ 12.3 „ „ 3.4 „ 3.5 „ 14 „ „ 19.3 „ „ 3.3 „ 3.4 „ 9 „ „ 12.3 „ „ 3.2 „ 3.3 „ 6 ,, „ 8.2 „ „ 3.1 „ 3.2 „ 1 sample „ 1.4 „ „ 3.0 „ 3.1„ - „ - „ - „ 73 100.0 The remaining 6 samples (of ordinary milk) were reported to be deficient in milk fat to the extent of between 4 per cent, and 20 per cent. Further information concerning these samples is given on page 39. In the five years 1949-53 and in 1954 the percentage of adulterated samples of milk was as under:- Year Samples taken Adulterated No. Percentage 1949 421 10 2.4 1950 462 0 0.0 1951 428 1 0.2 1952 101 0 0.0 1953 100 1 1.0 Mean 302 2 0.7 1954 100 6* 6.0 * For particulars of these adulterated samples see page 39. 37 The following tables give details of the articles of food of which sample were obtained for the purpose of analysis. Nature of Sample Examined Adulterated Formal Informal Total Formal Informal Total Baking Powder - 1 1 - - - Blancmange Powder - 2 2 — - - Bread - 1 1 - 1 1 Butter 29 - 29 - - - Cake and Pudding Mixture 1 16 17 - - - Cereal Preparations 2 10 12 - - - Cheese - 2 2 - - - Cider Vinegar 1 - 1 - - - Chocolate Spread - 1 1 - - - Cocoa 1 3 4 - - - Coconut, Desiccated 1 — 1 - - - Coconut, Sweetened — 1 1 - - - Coffee 1 1 2 - - - Coffee and Chicory Essence 8 2 10 - - - Confectionery Flour 7 1 8 - - - Confectionery Sugar 6 3 9 - - - Custard Powder — 4 4 - - - Dressed Crab - 1 1 - - - Fish Paste - 15 15 - - - Flavourings - 6 6 - - - Food, Self-Raising 17 — 17 - - - Food-Colour - 1 1 - - - Fruit, dried 9 - 9 - - - Fruit, tinned 1 - 1 - - - Fruit Preserving Tablets - 1 1 - - - Gelatine - 6 6 - - - Ginger, ground 3 3 - 1 1 Glucose - 3 3 - - - Golden Raising Powder - 3 3 - - - Gravy Preparations 1 6 7 - - - Honey - 2 2 - - - Ice Cream 4 - 4 - - - Jam 5 - 5 - - - Jelly 11 3 14 - - - Jelly Crystals 1 - 1 - - - Lard and Preparations - 2 2 - - - Lard and other Fats 12 2 14 1 - 1 Carried forward 118 102 220 1 2 3 38 Nature of Sample Examined Adulterated Formal Informal Total Formal Informal Total Brought forward 118 102 220 1 2 3 Lemonade Crystals - 2 2 - - - Lemon Curd - 2 2 - - - Margarine 3 - 3 - - - Meat-hook with meat - 1 1 - - - Meat Preparations:— Black Pudding 1 - 1 - - - Faggots 1 — 1 — — — Meat Extract — 1 1 — — — Meat Paste — 16 16 — — — Meat Pies 5 1 6 — 1 1 Sausages 14 — 14 — — — Sausage, Beef 5 — 5 — — — Sausage, Breakfast 2 — 2 — — — Sausage, Liver 2 3 5 — — — Sausage, Luncheon — 3 3 — — — Sausage, Meat — 1 1 — — — Sausage, Pork 11 — 11 — —- — Milk 100 — 100 6 — 6 Mustard — 3 3 - — — Non-brewed Condiment 5 — 5 - — — Olive Oil 1 1 2 - - — Pea Flour — 4 4 — - — Peel, Mixed 3 — 3 - - — Pepper-flavoured Compound - 1 1 - - - Pepper — 5 5 — — — Pickles — 1 1 — — Rose Hip Syrup 1 — 1 — — — Saccharin Tablets - 1 1 - — Sandwich Spread — 1 1 — — — Sauces 6 3 9 — - — Soft Drinks 4 1 5 - - - Soups, canned 1 3 4 - - - Soups, powder — 4 4 - — — Special Ration Type C — 1 1 - — — Spices and Condiments — 16 16 - - - Stuffing — 6 6 - - - Suet 1 1 2 - - - Teaseed Oil 1 - 1 - - - Vinegar 24 1 25 - - - Wine, British 4 - 4 - - - Yeast Extract — 2 2 - — - Totals 313 187 500 7 3 10 39 Drugs. The following table gives details of the drugs of which samples were obtained for the purpose of analysis:- Nature of Sample Examined Adulterated Formal Informal Total Formal Informal Total Glycerine 4 1 5 - - - Honey and Lemon 1 — 1 - - - Iodine, Tincture of — 4 4 - - - Linctus 1 2 3 - - - Oil, Camphorated - 4 4 - - - Oil, Castor - 7 7 - - - Oil, Cod-Liver 1 — 1 - - - Ointment, Boric — 1 1 - - - Ointment, Sulphur — 3 3 - - - Ointment, Zinc — 2 2 - — — Paraffin, Liquid 1 1 2 - - - Salts, Epsom - 4 4 - - - Salts, Glauber - 1 1 - - - Seidlitz Powder - 4 4 - - - Soda, Bicarbonate of — 6 6 - - - Syrup of Figs 1 - 1 - - - Tablets:- Aspirin - 6 6 - - - Milk of Magnesia - 2 2 - - - Soda Mint - 1 1 - - - Sulphur - 2 2 - 1 1 Totals 9 51 60 - 1 1 Adulterated Samples. The following action was taken in regard to the 7 formal samples certified as adulterated:- No. 162. Lard 1.80 per cent. excess of water and an acid value of 4.3 per cent.—Cautionary letter. The remaining 6 samples formed part of 8 samples of Milk taken in curse of delivery at Claphan Junction Station at the request of the Medical Officer of Health, Wandsworth, and copies of the Public Analyst's reports on the samples were forwarded to him. Bacteriological Examination of Food. In addition to samples taken for chemical examination, 5 samples of cream, cream in confectionery, jellied veal and pork pies were submitted for bacteriological examination. These were all reported to be satisfactory. 40 Heat Treated Milk. Samples of pasteurised and sterilised milk are taken at regular intervals for submission to the Public Health Laboratory Service for the prescribed tests, and during the year samples as under were taken with the results set out:— Phosphatase Satisfactory Failed Methylene Blue Satisfactory Failed Pasteurised 45 — 45 — Turbidity Satisfactory Failed Sterilised 37 — Monthly returns of the samples taken, and of the results of the examinations, are sent to the Milk Division of the Ministry of Food, and they are at once notified of any adverse report. Ice-Cream. Fifty-nine samples of ice-cream were taken during the year, each sample being submitted to the methylene blue test. The samples were, as a result of the test, placed in the following grades:- Provisional Grade 1 35 „ „ 2 17 „ „ 3 3 „ „ 4 4 59 Where samples of ice-cream made at premises in the Borough receive unsatisfactory reports, the premises, plant, and methods of operation are examined, and, where possible, improvements are suggested. Milk supplied in Schools and Hospitals. Samples of milk in course of delivery to Schools and Hospitals in the Borough are regularly taken, both for chemical analysis and for submission to the prescribed tests for such milk. The samples are included in the general totals given on pages 36, 38 and 40. The results of the analyses and tests are communicated to the London County Council or to the appropriate Hospital Management Committee. 41 Housing. Provision of New Accommodation. During the year 1954 construction of the following 358 new houses and flats was completed:— By Battersea Borough Council:— 154, 154a, 156, 156a Lavender Hill 4 flats 116, 116a, 118, 118a Lavender Hill 4 „ 1/64 Rawson Court 64 „ 1/15 (odd) Salcott Road 8 „ 9/38 (Cons.) St. James's Close 30 houses 110 By London County Council:— Stroudley House Patmore Street Estate 42 flats Martley House 3 flats and 14 maisonettes Hookham Court 31 flats Crampton House 52 „ Mansell House 12 „ Kirtley House 52 „ Mills House 15 „ Dungeness House Usk Road Estate 20 „ 241 By Private Enterprise:— 69, 71 Beaufoy Road 2 houses 40 Taybridge Road 1 house 34 Culvert Road 1 „ Flats 1 & 2, 14/28 (even) York Road 2 flats 100 Kyrle Road 1 house 7 Total 358 Housing Repairs and Rents Act, 1954. The above Act was passed on the 30th July, 1954, and came into operation on the 30th August. The Act is in two main parts: Part I, which deals with slum clearance, deferred demolition and improvements, etc. Part II, which deals with increases of rent ("repairs increases") and other matters related to controlled dwellings. The inspection of houses for the purpose of slum clearance and preparation for representation is in hand, and during the year one area, relating to 19 houses, was represented. 42 Part II of the Act, which deals with the increase of rents of controlled dwellings under certain conditions, was responsible for a considerable amount of work to the Department. The following table shows the position as from the date of operation of the Act to the end of the year:— Applications for Certificates of Disrepair received 154 Applications for Certificates of Disrepair withdrawn 11 Certificates of Disrepair issued 120 Certificates of Disrepair refused 2 Applications for revocation of Certificates received 12 Revocations of Certificates issued 11 Revocations of Certificates refused Nil One certificate under the Increase of Rent and Mortgage Interest (Restrictions) Act, 1920, was issued during the year. Closing Orders. Seven Closing Orders under Section 12 of the Housing Act, 1936, were made during the year, in respect of basement rooms, and six Closing Orders in respect of dwelling houses under Section 11 of the Act as amended by Section 10 of the Local Government (Miscellaneous Provisions) Act, 1953. Demolition Orders. It was not found necessary to make any Demolition Orders under Section 11 of the Housing Act, 1936. Houses Let in Lodgings. Sections 11 and 12 of the Housing Repairs and Rents Act, 1954, repeal the power which Local Authorities had of making by-laws to cover houses let in lodgings, and in its place power is given to serve a notice on the person having control of the house requiring certain work to be done and to limit the number of persons occupying the house. New problems have arisen in this connection by the fact that latterly there has been an influx from abroad of people seeking work and consequently accommodation. Cases have been referred to the Housing Committee, and Section 11 notices were served upon the owner of two premises. Prior to the Act coming into operation, 26 houses let in lodgings were inspected and action taken where necessary. Overcrowding. Eighteen cases of overcrowding were discovered during the year. Twenty-two overcrowded families were rehoused during the year, 14 by this Council and 8 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 43 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 which 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 instructions. Cases where the applicant or a member of his household is 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 1954 a total of 667 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 allocated to 8 applications, and 6 cases were referred to the Housing Committee for special consideration on these grounds. In 21 cases the maximum points were given for pulmonary tuberculosis, 11 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. The London County Council also refer cases in which there appear to be overcrowding, for the submission, in appropriate cases, of an "orange"form. Overcrowding was found to exist in 2 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. j Statistics for the Year ended 31st December, 1954. 'nspeCfj0|1 ()f Dweii;ngS Houses. a> Dwellings inspected for housing defects (under Public Health and Housing Acts) ... ... ... ... 3,874 Number of inspections made for that purpose ... 23,387 Dwellings (included above) inspected under the Hous- ln8 Consolidated Regulations, 1925 and 1932 ... Nil Number of inspections made for that purpose ... Nil (f) ^We"'n®s f°und to be unfit for human habitation ... 25 Dwellings found not to be in all respects reasonably "I for human habitation (not included under (e) above) 1.618 44 II. Remedy of Defects without service of formal Notices. Dwellings rendered fit in consequence of informal action by the Council 825 III. Action under Statutory Powers. Housing Act, 1936: 1. Action under Sections 9, 10 and 16. (a) Dwellings in respect of which notices were served requiring repairs Nil (b) Dwellings which were rendered fit by owners after service of formal notices Nil (c) Dwellings which were rendered fit by Council in default of owners Nil 2. Action under Sections 11 and 13. (a) Houses in respect of which demolition orders were made Nil (b) Houses demolished as a result of demolition orders Nil (c) Houses in respect of which undertakings were accepted from owner to render premises fit for habitation Nil 3. Action under Section 11, as amended by Section 10 of the Local Government (Miscellaneous Provisions) Act, 1953. Houses in respect of which closing orders were made 6 4. Action under Section 12. (a) Parts of houses in respect of which closing orders made (other than underground rooms) Nil (b) Underground rooms in respect of which closing orders made 7 (c) Closing orders determined Nil 5. Action under Section 25. Number of areas represented to Council for clearance (comprising 19 houses) 1 Public Health (London) Act, 1936: (a) Number of dwellings in respect of which notices were served requiring repairs 796 (b) Number of houses where defects remedied after service of formal Notices:— (i) by owners 738 (ii) by Council in default of owners 34 Housing Repairs and Rents Act, 1954: Action under Section 11. Number of dwellings in respect of which notices were served requiring certain works to be executed to render the premises suitable for the number of persons and households in occupation 2 45 Factories and Homework. Factories Act, 1937. Metropolitan Borough Councils are responsible for the enforcement of the provisions of this Act in regard to:— (i) Sanitary conveniences—Section 7—In all factories. (ii) Cleanliness, Overcrowding, Temperature, Ventilation, and Drainage of Floors—Sections 1, 2, 3, 4 and 6—In all factories where mechanical power is not used. (iii) Certificates of Suitability for Basement Bakehouses—Section 54—In all basement bakehouses. (iv) Water Supply (where derived from a source other than the public mains)—Section 53—In all factories. The following table gives the number of factories on the register at the end of the year, with the number of inspections, defects found, and action taken. I.-INSPECTIONS for purposes of provisions as to health. Premises Number on Register Number of Inspections Written notices Occupiers prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 119 771 4 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 359 1,191 4 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) 26 43 - - TOTAL 504 2,005 8 - 46 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.l.) 4 4 _ Overcrowding (S.2) - - - - - Unreasonable temperature (S.3) _ - Inadequate ventilation (S.4) - - - - - Ineffective drainage of floors (S.6) - - - - - Sanitary Conveniences (S.7) (a) Insufficient 2 2 - - - (b) Unsuitable or defective 3 3 - - (c) Not separate for sexes - - - - - Other offences against the Act (not including offences relating to Out-work) - - - - - TOTAL 9 9 - - - 47 The following table shows the factories in the Borough, classified according to the trades carried on. Factories Classified according to Trades. Trade Mechanical Factories Non-Mechanical Factories At 1 Jan. At 31 Dec. At 1 Jan. At 31 Dec. Building and Allied 25 27 20 21 Clothing and Allied 43 45 18 17 Engineering and Heavy Industry 46 48 1 2 Electrical and Allied 11 12 1 1 Florist - - 2 2 Food and Allied 53 51 4 4 Furniture and Allied 12 13 4 4 Metal Worker 9 10 — — Printer and Allied 23 24 2 2 Road Vehicle Repairer 42 41 17 19 Steam Laundry 10 10 — — Transport (Road & Rail) 20 — Other 57 56 45 49 Total 331 357 114 121 Outworkers. During the year 68 lists of outworkers were received, 29 from Battersea employers, containing 256 names, and 39 from other authorities containing 131 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 194 names and addresses of Battersea outworkers. The total number of registered outworkers' premises in the Borough at the end of the year was 375 (including 7 contractors), 77 premises having been added, and 130 removed, during the year. The total number of inspections made was 1,160, most of them by the female Inspector. The premises were found to be generally satisfactory, and it was not necessary to serve any notices or take any other action. Two cases of infectious diseases occurred at outworkers' premises, and the usual precautions to prevent spread of infection were taken. 48 The following table gives details of the outworkers' premises: — Trade Number on Register Premises Workrooms Persons employed Wearing Apparel 265 272 319 Linen 1 1 1 Curtains, etc. 1 1 1 Artificial Flower 2 2 2 Paper Bags 8 8 8 Boxes, etc 7 7 7 Stuffed Toys 2 2 2 Lampshades 88 88 93 Christmas Stockings, etc. 1 1 1 375 382 434 Bakehouses. There were 32 bakehouses on the register at the end of the year. All of these are classed as factories, and 29 of them use mechanical power. 89 inspections were made and 3 notices served. Five of the bakehouses were "basement bakehouses" within the meaning of Section 54 of the Factories Act, 1937. 49 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, Scarborough—27th to 30th April. Central Consultative Committee on the Welfare of Old People, London—25th June. Sanitary Inspectors' Association, Southport—7th to 10th September. National Smoke Abatement Society, Scarborough—22nd to 24th September. Delegates. Aid. Miss E. A. Coles, J.P., and the Deputy Medical Officer of Health. Cllrs. Mrs. P. G. Mitchell and Mrs. D. L. L. Newman. Cllrs. Mrs. E. A. Cooper, J.P., and Mr. F. H. Chuter, Chief Sanitary Inspector. Cllr. Mrs. C. M. Davis, and Mr. I. R. Lewis, Sanitary Inspector. 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 operative 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 urgent 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 has been given the Council to the Medical Officer of Health and his Deputy. It was found necessary to use these emergency powers in one case during the year. This case was a man of 85 years of age, who was suffering from grave chronic disease, was unable to give himself proper care and attention and was not receiving care from any other persons. He clearly needed removal to hospital in the interests of his own health and safety. All efforts to persuade him to enter hospital voluntarily were 50 unsuccessful, and application therefore had to be made to the Court for an Order for his compulsory removal. This Order was granted. It was not necessary to apply for a further order for the patient's retention, as the hospital authorities stated that his condition precluded any possibility of his early discharge. Many other 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 the Aged. Throughout the year the staff of the Health Department have continued to take an active interest in the welfare of the aged. Successful results have been achieved, not only by direct action but also by working in close co-ordination with voluntary and statutory organisations. Much attention has been paid to the encouragement and implementation of domiciliary care. On the other hand, priorities for institutional care have been assessed when the necessity for admission to either a hospital or welfare home has become all too obvious; it is a pleasure to record that these priorities have invariably met with sympathetic consideration on the part of the medical and welfare officers in charge of the institutions concerned. With regard to voluntary associations for the welfare of the aged, special reference must be made to the old people's clubs, which continue to serve as important centres for maintaining immediate contact with individual members. Officers of the Health Department acknowledge with gratitude the help afforded by club secretaries as soon as the need arises. In this respect, during the year under review, there has been considerable activity in securing chiropody facilities for club members. Old folk are constantly enjoined not to neglect their feet, and it is emphasised that no old person should be forced to stay indoors for lack of a chiropody service. 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. During the year, 10 cases were dealt with. 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 10 cases was £83 approximately. £36 was recovered by the end of the financial year at the 31st March, 1955. 51 Personal Cleansing Station. During the year 1954, 229 treatments were given to persons suffering from, or contacts of, scabies. 79 of these treatments were given to adults, 116 to school children, and 34 to other children under school age. In addition to the above, 135 adults and 2,349 children, found to be verminous, were cleansed. Of the 2,349 children cleansed, 2,260 attended from local schools 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. 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 number of treatments 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, Etc. Year Adults Children *Expenditure *Amount Contributed Verminous and Scabies Verminous and Scabies £ £ 1906-1915 10,443 6,430 1,037 303 1916-1925 3,269 39,117 5,007 3,155 1926-1935 2,404 39,293 8,521 4,045 1936-1945 13,739 43,448 9,446 4,206 1946 1,822 4,229 1,352 443 1947 986 4,179 1,402 424 1948 497 3,266 1,808 408 1949 286 2,773 1,534 411 1950 226 2,238 1,750 410 1951 200 1.858 1,992 406 1952 176 1,994 1,956 535 1953 144 1,943 1,932 508 1954 214 2,383 1,966 512 *Financial year ending 31st March. Other columns, calendar year. The contract with the London County Council, referred to above, Provides for the payment by them of 3s. 6d. for each treatment given. whether for vermin or for scabies, with a minimum payment of £500 per annum. 52 The Council have two flats attached to the Personal Cleansing Station for the temporary use in emergency of people or a family displaced, usually following fumigating procedure. The Council have agreed that these shelters may be used for Wandsworth residents at an annual fee of £25 for the right to use the shelters and a weekly charge of £1 10s. 0d. per shelter for every case sent there. 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 1954, are set out in the following table: — Battersea Mortuary, 1954. Details of Bodies received Usual place of residence Total{/###] Batter- sea Wandsworth Elsewhere Residence unknown Post-mortem only 172 368 134 8 682 Post-mortem and inquest 34 82 33 5 154 Total post-mortems 206 450 167 13 836 Inquest only — — — — - Total inquests 34 82 33 5 154 Sanitary and other reasons — — — — — Total bodies received 206 450 167 13 836 VERDICTS AT INQUESTS HELD Natural causes 1 1 2 2 6 Accident and misadventure 20 40 25 3 88 Open verdict 1 3 3 — 7 Suicide 12 36 3 — 51 Alcoholism — 2 — — 2 Total 34 82 33 5 154 The Wandsworth Borough Council again made a grant of £250 towards the cost of maintaining the Mortuary. The London County Council pay a rent of £450 for the use of the Coroner's Court.