BER 58 Borough of Bermondsey REPORT ON THE SANITARY CONDITION OF THE BOROUGH OF BERMONDSEY For the Year 1945 BY D. M. CONNAN, M.D., D.P.H., Medical Officer of Health BER 58 Borough of Bermondsey REPORT ON THE SANITARY CONDITION OF THE BOROUGH OF BERMONDSEY For the Year 1945 BY D. M. CONNAN, M.D., D.P.H., Medical Officer of Health TABLE OF CONTENTS PUBLIC HEALTH DEPARTMENT— PAGE Public Health Committee 4 Maternity and Child Welfare Committee 4 Staff 5 VITAL STATISTICS— Area 8 Population 8 Births 8 Deaths 9 Marriages 9 Infantile Mortality Rates 10 Deaths from Tuberculosis 10 Vital Statistics of District 11 Causes of Death 12 Infantile Mortality, Causes of Deaths 14 INFECTIOUS DISEASES— Diseases Notifiable 15 Diphtheria Prevention 15 Disinfection 16 Cleansing Station 16 Bacteriological Laboratory 17 Food Poisoning 17 Insulin for Diabetic Patients 17 Vaccination 18 Nursing 18 Cases Notified in 1945 19 Cases Notified for last ten years 20 TUBERCULOSIS— New Cases and Deaths 21 Period between Notifications and Deaths 21 Nursing, Extra Nourishment and Shelters 22 Tuberculosis Allowances 22 Work of the Tuberculosis Dispensary 23 Summary of Notifications 24 Cases on the Register 25 LIGHT TREATMENT, ELECTRO-THERAPY AND MASSAGE— Work done in the Solarium 26 MATERNITY AND CHILD WELFARE — PAGE Fairby Grange Convalescent Home 27 Premature Children, Illegitimate Children, Home Helps 27 Work of the Health Visitors 28 Attendances at Centres 29 Extracts from Vital Statistics,1945 30 DENTAL TREATMENT— Particulars of Children Treated 31 Particulars of Treatment and Work for 1945 32 CONSULTATION AND OTHER CLINICS— X-ray Department 33 Post-Natal and Special Clinics for Women 34 Heart Clinic 34 Ophthalmic Clinic 34 Foot Clinic 34 PROPAGANDA 35 SANITARY ADMINISTRATION— Housing 36 Housing Act, 1936 —Overcrowding 36 Eradication of Bed Bugs 36 Inspections and Proceedings 36 Work of the District Inspectors 39 Factories and Workshops —Homework 40 Factories and Workshops—lnspections 41 Bakehouses 42 House, Trade and Market Refuse 42 Offensive Trades 42 Mortuary 42 Street Markets 43 Drainage Work 43 Work of Factories and Shops Inspector 43 FOOD CONTROL— Imported Food Regulations —Samples taken 44 Unsound Food —Shops and Stalls 46 Milk Premises 47 Milk Licences 47 Milk Sampling 47 Ice Cream 48 Pharmacy and Poisons Act, 1933 49 Food and Drugs—Samples Taken 50 Unsound Food —Wharves, etc. 52 Work of the Wharves and Food Inspectors 53 HEALTH SERVICES 54 PUBLIC HEALTH DEPARTMENT PUBLIC HEALTH COMMITTEE, 1945. Chairman Councillor E.J. GIBSON 1944-5, 1945-6 Vice-Chairman Alderman S. R. WEIGHTMAN 1944-5, 1945-6 Alderman Mrs. L. M. Brown. Councillor A. V. Kidd. Councillor H. A. Beal. Mrs. „ Mrs. E.Koerting „ Mrs. E. V. Coyle. „ Miss E. R. M. Laker. „ Mrs. M. Cushing. „ C. J. Lee. „ Mrs. M. Donoghue. „ Mrs. A. E. Martin. „ A. M. Downing. „ A. E. Martin. „ Mrs. D. Downing. „ F. W. McLeod. W. L. Ellis. „ F. A. Melvin. „ G. A. Freestone. „ Mrs. F. A. Powell. „ Miss E. F. Greenwood. „ E. Snowdon, „ G. W. Griffin. J.P., L.C.C. „ P. G. Henley. „ Mrs. J. V. Snowdon. „ Mrs. F. Humphreys. „ J. P. Sullivan. „ G. Jacques. „ A. E. Winch. Ex-officio. Councillor G. LOVELAND, J.P., Mayor of Bermondsey, 1944-5 (part) Mrs. F. M. LOVELAND, J.P., Mayor of Bermondsey, 1945 (part) Councillor Mrs. L. JONES, M.B.E., J.P., Mayor of Bermondsey, 1945-6 MATERNITY AND CHILD WELFARE COMMITTEE, 1945. Chairman Alderman Mrs. L. JONES, M.B.E., 1944-5. Chairman Councillor Mrs. E. V. COYLE, 1945-6. Vice-Chairman Councillor Mrs. J. V. Snowdon, 1944-5. Vice-Chairman Councillor Mrs. D. Downing, 1945-6. Alderman Mrs. L. M. Brown Councillor Mrs. F. Humphreys. „ Mrs. F. M. Loveland. „ Mrs. M. F. Lowery. Councillor Mrs. M. Cushing. „ Mrs. C. Martin. „ Mrs. F. E. Flint. „ Mrs. F. J. Melvin. „ E. J. Gibson. „ Mrs. K. Potter. „ Mrs. L. A. Glasson. „ Mrs. E. R. P. Walters „ Mrs. A. M. Hatcher. Co-opted Members. Mrs. D. Freestone. Mrs. R. L. Stocking. Mrs. A. P. Henley. Mrs. D. Topley. Mrs. L. M. Kidd. Mrs. F. Whitnall. Mrs. K. E. Smith. Ex-officio. Councillor G. LOVELAND, J.P., Mayor of Bermondsey, 1944-5 (part) Mrs. F. M. LOVELAND, J.P., Mayor of Bermondsey, 1945 (part) Councillor Mrs. L. JONES, M.B.E., J.P., Mayor of Bermondsey, 1945-6 STAFF: MEDICAL OFFICER OF HEALTH. D. M. Connan, M.D., B.S.(Lond.), M.R.C.S., L.R.C.P., D.P.H. SANITARY INSPECTORS : J. G. Frankson, Senior Inspector. G. F. J. Toll, Wharves and Food Inspector. H. E. Butcher, Wharves and Food Inspector. W. C. Tapsfield, Wharves and Food Inspector. F. L. Richardson, Drainage and Markets Inspector. H. J. Bailey, Food and Drugs Inspector. W. A. Campbell, Factories and Shops Inspector. District Inspectors. F. J. Carpenter. W. A. Pilson. A. W. Hancock. W. F. Smith. L. T. Knott. Flora Mercer (resigned July, 1945). S. R. Weightman J. L. Springett (commenced Jan., 1946). (Commenced June, 1945). TUBERCULOSIS DISPENSARY. Deputy Medical Officer of Health and Clinical Tuberculosis Officer— C. H. C. Toussaint, M.R.C.S., L.R.C.P., D.P.H. Assistant Medical Officer and Assistant Tuberculosis Officer — *H. T. Levi, M.B., Ch.B. Tuberculosis Nurse —Celia Clapson. LADY ALMONER. Florence Child. Assistant—Mary Benford. LIGHT TREATMENT CENTRE. Medical Officer in Charge—Florence L. Telfer, M.D., D.M.R.E. Orthopædic Surgeon—G. O. Tippett, M.B., B.S.(Lond.), F.R.C.S.(Eng.) Nurse in Charge—Mrs. Dorothy Cottier. Solarium Nurses—Estelle Jagôt, Muriel Coleby, Mrs. Joyce Turner, Helen Failes and Margaret Verrier. Masseuse —Mrs. Zoe Smith. MATERNITY AND CHILD WELFARE. Assistant Medical Officers for Maternity and Child Welfare— Florence L. Telfer, M.D., D.M.R.E. Margaret S. Gillatt, M.B., Ch.B. Health Visitors. Barbara Anderson. Edith Crundwell. Elizabeth Lawrence. Sarah Bowles. Olive Oram. Lucy Brown. Phyllis Cunningham (commenced July, 1945). Kathleen Parry. Mrs. Phyllis Carson (resigned Jan., 1945). Mrs. Gwendolen Hook (commenced Feb., 1945). Gwendolen Riches. Edith Riley. Kathleen Cranmer. Florence Robson. Mrs. Avis Knott (resigned April, 1945). Isabel White. FAIRBY GRANGE CONVALESCENT HOME. Matron—Anne O'Meara. Sister—Gladys Coleby. At present serving in H.M. Forces. POST-NATAL AND SPECIAL CLINICS FOB WOMEN. Consultant Gynæcologist—Gladys Dodds, M.D., D.P.H., M.R.C.O.G., F.R.C.S. (Eng.). OPHTHALMIC CLINIC. Consultant Ophthalmic Surgeon —Victoria E. Brander, M.B., Ch.B., D.P.H., D.O.M.S. EAR, NOSE AND THROAT CLINIC. Consultant Surgeon—S. C. Suggit, M.B., B.S.(Lond.), F.R.C.S.(Eng.). X-RAY SECTION. Radiologist—Florence L. Telfer, M.D., D.M.R.E. Radiographers —C. F. Lumley, Mrs. Janet Mason (Part-time resigned July, 1945) and Jessie Jack (commenced. January, 1945). DENTAL DEPARTMENT. Municipal Dental Surgeon—Grantley Smith, L.M.S.S.A., H.D.D., R.C.S. (Edin.), L.D.S., R.C.S. (Eng.). Assistant Dental Surgeon—W. H. Shapland, L.D.S., R.C.S. (Eng.). Dental Nurses —Mrs. Daisy Hodgson and Winifred Lander. Prosthetic Assistants—G. W. Clarke, W. B. Monger and T. H. Baggott. FOOT CLINIC. Chiropodists—Ethel Cook, Mrs. Florence Rock, Mary Bradley, and E. F. Part. PUBLIC ANALYST. A. Prideaux Davson, A.R.C.Sc, F.R.I.C, F.C.S. PROPAGANDA AND ADMINISTRATIVE OFFICER. H. W. Bush, F.1.P.A., M.R.I.P.H.H. (died, June, 1945). C. W. Whye (commenced October, 1945). CLERICAL STAFF. F. W. Smith, Chief Clerk. *F. Cornwell, General Clerk. *F. R. Parker, General Clerk. *H. D. White, General Clerk. J. A. Blake, General Clerk. *F. H. Mummery, General Clerk. J. F. M. Brooker, General Clerk. *Nellie Simms, General Clerk. C. H. Harris, General Clerk. *A. E. Gambrell, General Clerk. *J. W. J. Saward, General Clerk. *J. T. Bryant, Junior Clerk. Alice Jones, General Clerk. DISINFECTING AND CLEANSING STATION. A. Manning, Supervisor. PUBLIC HEALTH DEPARTMENT, MUNICIPAL OFFICES, SPA ROAD, S.E.16. At present serving in H.M. Forces. Borough of Bermondsey. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH. To the Mayor, Aldermen and Councillors of the Borough of Bermondsey. Madam, Ladies and Gentlemen, I have the honour to submit my Annual Report for the year 1945. The report takes the form of a statistical summary, and presents no special features requiring comment. I have to thank the Chairmen and Members of both Committees for their kindness and support during the year. I am, Madam, Ladies and Gentlemen, Your obedient Servant, D. M. CONNAN. 1.-VITAL STATISTICS. AREA. The area of the borough (exclusive of area covered by water) is 1,336 acres. POPULATION. Census Estimate of Registrar-General 1921 1931 to 30th June, 1944 to 30th June, 1945 119,452 111,542 44,800 47,040 BIRTHS. The total number of births belonging to the borough registered during 1945 was 848, consisting of 427 males and 421 females. The number for 1944 was 846. The birth-rate for 1945 was 18.0 per thousand persons living, compared with 18.9 for 1944. DEATHS. The total number of deaths belonging to the borough registered during 1945 was 686, consisting of 374 males and 312 females. The number for 1944 was 809. The death-rate for 1945 was 14.6 per thousand persons living, compared with 18.1 for 1944. MARRIAGES. The total number of marriages in the borough in 1945 was 737, being 367 above the number for 1944, and 132 below the average for the last 10 years. The figures have been supplied by the Superintendent Registrar. Year No. Rate 1,027 1935 20.00 1936 970 19.32 1,090 1937 22.07 1938 941 19.32 1,258 1939 26.35 1940 1,186 33.13 1941 725 32.79 1942 666 29.97 1943 458 20.16 1944 370 16.52 Average for years 1935 —1944 23.96 869 31.34 1945 737 INFANTILE MORTALITY. Year Whole Borough London Rate per 1,000 Births No. of Deaths Rate per 1,000 Births No. of Deaths 3,229 103 69 58 1935 92 3,691 66 1936 60 1937 84 3,309 60 59 45 1938 65 3,130 57 1939 45 37 2,409 47 1940 40 35 2,062 48 32 61 1941 1,543 57 38 47 2,035 50 1942 1943 49 53 2,284 51 1944 66 2,250 51 56 Average for years 1935 - 1944 60 53 2,594 54 2,011 44 1945 44 52 TUBERCULOSIS OF THE RESPIRATORY SYSTEM. In the following Table will be found particulars of deaths from Tuberculosis of the Respiratory System since the year 1935. Sub-District Bermondsey Rotherhithe St. Olave Whole Borough London Year No. No. No. No. Rate No. Rate 1935 70 23 5 98 0.95 2847 0.68 1936 51 22 6 79 0.79 2848 0.69 1937 63 22 2 87 0.89 2888 0.71 1938 42 23 1 66 0.68 2590 0.64 1938.. 1939.. 21 65 0.72 2650 0.70 38 6 1940 43 21 4 68 0.95 2687 087 1941 34 17 1 52 1.18 2552 1.10 1942 34 13 1 48 0.93 2164 0.90 1943 30 15 4 49 1.08 2204 0.88 1944 30 16 1 47 1.05 2073 0.84 Averages for years 1935-1944 19 3 66 0.92 2550 43 0.80 1945 28 15 2 45 0.96 2033 0.78 VITAL STATISTICS OF WHOLE DISTRICT DURING 1945 AND PREVIOUS YEARS. Year 1 Population estimated to Middle of each Year 2 Births Total Deaths registered in the District Total Deaths in Public Institutions in the District 9 Deaths of NonResidents registered in Public Institutions, etc., in the District 10 Deaths of Residents registered in Public Institutions etc. beyond the District 11 Net Deaths at all Ages belonging to the District No. 3 Rate 4 Under 1 Year of Age At all Ages No. 12 Rate 13 No. 5 Rate per 1,000 Births registered 6 No. 7 Rate 8 1935 102,700 1,487 14.5 99 67 1,142 11.1 756 255 314 1,201 11.7 1936 100,400 1,545 15.4 76 49 1,136 11.3 723 175 328 1,289 12.8 1937 98,790 1,421 14.4 61 43 1,148 11.6 741 245 309 1,212 12.3 1938 97,420 1,439 14.8 60 42 1,002 10.3 488 201 271 1,072 11.0 *95,500 1939 1,275 13.4 40 31 968 10.7 445 201 243 1,010 11.2 ‡90,210 1940 71,590 1,232 17.2 35 28 1,483 20.7 829 304 373 1,551 21.7 1941 44,220 756 17.1 23 44 874 19.8 569 259 432 1,047 23.7 1942 44,440 814 18.3 36 44 673 15.1 520 285 285 673 15.1 31 34 713 15.7 517 228 276 761 16.7 1943 45,440 925 20.6 1944 44,800 846 18 .9 28 33 722 16.1 453 209 296 809 18.1 Averages for years 1935-1944 74,530 1,174 16.5 49 42 986 14.2 604 236 313 1,063 15.4 47,040 848 18.0 13 15 582 12.4 357 147 251 686 14.6 1945 *For calculation of Birth Rate. ‡For calculation of Death Rate. CAUSES OF, AND AGES AT, DEATHS DURING THE YEAR 1945. Deaths at the subjoined ages of "Residents" whether occurring in or beyond the District. Causes of Death All Ages Under 1 1 and under 2 2 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upwards All / Certified Causes \Uncertified 686 44 4 9 11 15 58 168 377 - - - - - - - - - Typhoid and Paratyphoid Fever - - - - - - - - - Cerebro-spinal Fever 1 1 - - - - - - - Scarlet Fever - - - - - - - - - Whooping Cough - - - - - - - - - Diphtheria - 1 1 - - 2 - - - 45 - 8 Tuberculosis of Respiratory System - 1 - 22 10 4 1 Tuberculosis—other forms 4 - 2 - - - 1 - Syphilitic Disease 5 - - - - 3 2 - - 1 - 1 Influenza 3 - - - 1 - Measles - - - - - - - - - Acute Poliomyelitis and Polioencephalitis - - - - - - - - - Acute Infectious Encephalitis - - - - - - - - - Cancer of Buccal Cavity and Œsophagus (Males only) - - - 1 10 11 - - - - - Cancer of Uterus 4 - - - - - 4 - Cancer of Stomach and Duodenum 21 - - - 1 5 15 - Cancer of Breast 4 - - - 1 3 - - - - - - 1 23 Cancer of all other sites 60 - 3 33 - Diabetes 5 - - - - - 2 3 Intra-cranial Vascular Lesions CAUSES OF, AND AGES AT, DEATHS DURING THE YEAR 1947,—continued. Causes of Death Deaths at the subjoined ages of "Residents" whether occurring in or beyond the district. All Ages Under 1 1 and under 2 2 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upwards Heart Disease 171 - - - - 2 3 38 128 Other Diseases of the Circulatory System 47 - - - - - - 15 32 Bronchitis 43 2 - 1 - - 1 10 29 Pneumonia 42 5 1 - - 3 11 22 - Other Respiratory Diseases 3 - 1 - - - 2 - - Ulceration of the Stomach or Duodenum 10 - - - - - 2 6 2 Diarrhœa (under 2 years of age) 12 12 - - - - - - - Appendicitis 5 - - - 1 - 2 1 1 Other Digestive Diseases 11 - 1 - - 1 1 1 4 Nephritis 16 - - - 1 - 4 6 5 Puerperal and Post-abortive Sepsis 1 - - - - - 1 - - Other Maternal Causes 2 - - - - 1 1 - - Premature Births 5 5 - - - - - - - Congenital Malformations, Birth Injury, Infantile Diseases 14 - - - 1 - - 15 - Suicide 3 - - - - - - 3 - Road Traffic Accidents 6 - - 1 1 1 - 1 2 Other Violent Causes - 1 1 1 5 1 5 3 14 All Other Causes 42 1 - 1 2 - 7 8 23 INFANTILE MORTALITY. Deaths from Stated Causes at Various Ages under One Year of Age, 1945. Cause of Death Total under 1 year Under 1 week 1 — 2 weeks 2 — 3 weeks 3 — 4 weeks Total under 1 month 1 — 3 months 3 — 6 months 6 — 9 months 9 — 12 months - - - - - - - - - Measles - Scarlet Fever - - - - - - - - - - Whooping Cough - - - - - - - - - - Diphtheria - - - - - - - - - - Influenza - - - - - 1 - - - 1 Cerebro-spinal Meningitis - - - - - 1 - - 1 - Tuberculous Meningitis - - - - - - 1 - 1 - Other Forms of Meningitis - - - - - - - - - - Tuberculosis of Respiratory System - - - - - - - - - - Other Tuberculous Diseases - - - - - - - - - - Syphilis - - - - - - - - - - Bronchitis - - - - - - 2 - 2 - Pneumonia (all forms) - - - - - 1 2 2 5 - Other Respiratory Diseases - - - - - - - - - - Diarrhœa and Enteritis - - - - 12 - 3 5 1 3 Congenital Debility and Malformation, Premature Birth 6 - - - 6 2 - - - 8 Injury at Birth 2 - 1 - 3 - - - - 3 Other Causes 7 2 1 - 10 1 - - - 11 II.—INFECTIOUS DISEASES. The following diseases are notifiable:— Anthrax Acute Polioencephalitis Acute Poliomyelitis Acute Primary Pneumonia Acute Influenzal Pneumonia Cholera Cerebro-Spinal Meningitis Continued Fever Diphtheria Dysentery Enteric Fever and Typhoid Encephalitis Lethargica Fever Erysipelas Glanders Hydrophobia in Man Malaria Measles Membranous Croup Ophthalmia Neonatorum Plague Puerperal Pyrexia Puerperal Fever Scarlet Fever and Scarlatina Relapsing Fever *Scabies Small-pox Typhus Tuberculosis—all forms Whooping Cough * A notification is not required where to the knowledge of the medical practitioner, a case of scabies has occurred in the house and has been notified within the four weeks immediately preceding the date on which he first became aware of the disease in the case he is attending. DIPHTHERIA PREVENTION. The appended table shows the attendances at the Schick Clinics during the year. Clinic No. of Sessions No. of New Patients Total Attendances 566 1,765 Public Health Centre, Grange Road 119 373 L.C.C. Schools 22 219 Totals 2,138 785 141 DISINFECTION. The figures showing the work done in the disinfecting station are set out below. Beds 580 Pillows 2,365 Blankets 4,645 Pillows (cases) 789 Quilts 445 Bolsters 247 „ (cases) 57 Sheets 923 Books 85 Miscellaneous 2,016 Cushions 94 Verminous Clothing 1,398 Overlays 2,332 Number of rooms disinfected 491 Number of air raid shelters disinfected 12 Number of mattresses and other articles destroyed 181 Furniture, Floorcloth, etc., destroyed 7 Loads CLEANSING STATION. Verminous persons cleansed Adult Females 90 Adult Males 137 Children 2,820 Persons treated for Scabies: — Number treated Number of baths given Adult Females 334 1,025 Adult Males 197 603 Children, Females (School Age) 313 1,738 Children, Males ( „ „ ) 236 1,474 Children, Females (Under School Age) 53 160 Children, Males ( „ „ „) 57 191 BACTERIOLOGICAL LABORATORY. The work done in the Laboratory during the year is set out in the appended table. Examined for Total Examinations Results of Examination Positive Negative 1944 1945 1944 1945 1944 1945 Diphtheria (specimens taken by Medical Officer of Health 146 - 144 109 2 109 Ditto (taken by general practitioners) 10 278 327 270 317 8 424 436 10 Diphtheria (total specimens taken) 414 426 10 Phthisis 425 397 352 316 73 81 Various 35 13 35 13 - - Total specimens taken 884 846 83 91 801 755 FOOD POISONING. Four cases of Food Poisoning were notified to me during the year under The Public Health (London) Act, 1936, Section 182. There was one death. The onset of illness in this case was very sudden and the patient died within about twenty-four hours. Post-mortem appearances were consistent with the diagnosis of food poisoning. Bacteriological evidence suggested that death was due to infection by Streptococcus Hæmolyticus. At the inquest a verdict of death from misadventure was returned. INSULIN FOR DIABETIC PATIENTS. Thirty patients have been supplied during the year as compared with twenty-nine patients in 1944. (The Public Health (London) Act, 1936, Section 227.) VACCINATION. 339 births were notified to the Vaccination Officer by the local Registrars during 1944. The number of children successfully vaccinated was 67, and the number in respect of whom statutory declarations of conscientious objection were received was 96. The percentage of children vaccinated to births notified was 19.76. NURSING. The following table shows the number of patients nursed under the Council's Scheme by The St. Olave's (Bermondsey and Rotherhithe) District Nursing Association:— Disease Cases Visits Pneumonia 37 481 Broncho-pneumonia 3 44 Bronchitis 16 141 Influenza 27 265 Measles 89 834 3 Whooping Cough 1 Tuberculosis: — (a) Respiratory System 49 2,065 (b) Other Forms 2 65 Puerperal Pyrexia - - - - Puerperal Fever Pregnancy and Labour 64 787 Diseases of the Digestive System 115 15 Infantile Diarrhoea (under 2 years) 1 5 Discharging Ears 2 20 Discharging Eyes 19 289 Post-operative cases: — (a) Tonsils & Adenoids - - (b) Other cases - - Other diseases 771 46 Totals 371 5,885 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1945. NOTIFIABLE DISEASE NUMBER OF CASES NOTIFIED BERMONDSEY ROTHERHITHE ST. OLAVE Total Cases removed to Hospital At all Ages At Ages — Year 1 2 3 4 5 6 Total 1 2 3 Total St. John St. Olave St.Thomas Total 0 to 1 1 to 5 5 to 10 10 to 15 1 5 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 & upwards Diphtheria (including Membranous Croup) 31 - 7 10 2 2 3 5 1 1 - - 2 - 5 6 1 1 15 7 5 4 16 - - - - 30 Erysipelas 14 - - 2 1 1 - 3 2 2 1 2 - 2 3 1 1 1 8 3 2 - 5 1 - 1 2 - Scarlet Fever 28 95 3 41 18 2 1 - 1 - 1 - 12 4 17 7 8 8 56 14 14 8 36 1 2 - 3 61 Enteric Fever 2 - - - - - - 1 1 - - - - - - 1 - - 1 - - 1 1 - - - - 2 Malaria 1 - - - - - 1 - - - - - - - - 1 - 1 - - - - - - - - - - Malaria (Induced) 1 - - - - - - - 1 - - - - - - - - - - - - - - 1 - - 1 - Ophthalmia Neonatorum 4 4 - - - - - - - - - - - - - - - - - 3 - 1 4 - - - - 3 Dysentery 32 1 11 10 - - 1 4 3 - 1 1 2 5 4 - 2 2 15 2 12 3 17 - - - - 13 Acute Polio-Myelitis 2 - 2 - - - - - - - - - - 1 1 - - 2 - - - - - - - - 2 - Puerperal Fever 2 - - - - - 1 1 - - - - - - - - - - - 1 - - 1 1 - - 1 2 Puerperal Pyrexia 7 - - - - - 2 4 1 - - - 1 2 1 - - 2 6 - - - - 1 - - 1 1 Pneumonia (Acute Primary and Acute Influenzal) 66 9 16 10 2 4 2 1 6 2 8 6 8 12 11 7 5 1 44 7 9 4 20 - 1 - 2 - Whooping Cough 42 7 28 7 - - - - - - - 4 6 7 3 4 1 25 2 9 2 13 11 3 - 4 5 - Measles 544 32 328 169 12 3 - - - - 59 34 97 107 62 16 375 56 60 34 150 11 8 - 19 62 - - Scabies 366 3 29 61 43 43 47 47 38 16 23 16 47 37 70 47 35 10 246 32 36 32 100 6 14 - 20 - Tuberculosis — Respiratory System 126 1 - 4 4 21 30 22 12 14 7 16 19 7 12 7 74 21 15 8 44 3 5 - 8 - 13 11 Other forms of Tuberculosis 14 1 1 6 3 2 - - 1 - - - - - 2 2 1 2 1 8 3 2 - 5 - 1 - 1 61 450 320 85 76 89 89 66 36 45 32 151 123 231 188 132 50 875 151 165 97 413 27 34 - 61 183 1349 Totals CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEARS 1936 - 1945. Notifiable Disease. 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 Small Pox - - - - - - - - - - Diphtheria (including Membranous Croup) 207 167 187 135 56 89 72 74 30 31 Erysipelas 39 28 35 43 48 39 17 14 57 21 266 Scarlet Fever 167 200 112 243 75 128 197 108 95 Cerebro-Spinal Meningitis 4 10 3 8 29 18 2 7 7 - Acute Polio-Myelitis and Acute Polio-Encephalitis - 1 7 3 - 2 1 2 1 - 6 10 5 2 - 1 7 3 4 1 Ophthalmia Neonatorum Anthrax - 1 1 1 - 1 - - - - 15 - 2 1 2 3 2 Enteric Fever 5 2 - 1 2 3 Puerperal Fever 1 - 1 - - 2 6 Puerperal Pyrexia 9 13 10 9 11 3 - 10 6 7 Encephalitis Lethargica 2 - - - - - - - - - 43 Dysentery 26 2 6 11 7 15 23 32 1 Malaria - - 2 1 1 1 - - - - Malaria (Induced) - 2 - - 1 1 - - - - Pneumonia (Acute Primary and Acute Influenzal) 112 99 66 170 112 125 121 104 55 99 Whooping Cough 103 275 101 383 25 274 93 208 224 42 85 889 39 229 381 600 345 544 Measles 7 345 283 Scabies - - - - - - - 489 366 Tuberculosis — Respiratory System 106 100 147 94 142 112 97 109 111 126 34 Other forms of Tuberculosis 31 18 20 6 9 19 14 18 14 966 1,145 1,730 973 855 1,120 1,120 1,482 1,411 Totals 1,349 III.-TUBERCULOSIS. In Table I are set out particulars of new cases and deaths during the year, and Table II shows the period elapsing between notification and death. TABLE I. TUBERCULOSIS, 1945—NEW CASES AND DEATHS. NEW CASES DEATHS AGE PERIODS Nonpulmonary Pulmonary Nonpulmonary Pulmonary F. M. - F. F. M. F. M. - M. - - - 1 0 1 1 1 - - 2 1 1 1 - - - 5 5 3 1 1 - - - 3 2 2 - 10 2 - - - 14 - 10 2 - 15 - - - 2 20 - 2 4 20 16 - - 16 6 15 1 - 5 1 25 - 5 - - 6 35 12 - - 14 5 4 6 4 3 - - 45 1 - - 1 - 55 10 - - - - 7 - - 65 and upwards - - - - 7 28 17 2 2 90 63 10 TABLE II. TUBERCULOSIS, 1945—PERIOD BETWEEN NOTIFICATION AND DEATH. Period Between Notification and Death Respiratory System Other Forms Males Females Percentage of Total Deaths Males Females 1 Total Percentage of Total Deaths Total 2 50.00 3 1 1 4 8.89 Not notified I 4 5 1 25.00 0-1 month 1 11.11 - 1 5 - 1-3 months 4 1 11.11 - - - 2 2 4.45 - 3-6 months - - - - 2 - 6-12 months 1 1 4.45 - - - 4 5 11.11 - - - - 1-2 years 1 8 4 12 26.66 - - 2-5 years - - 2 1 - 1 25.00 Over 5 years 8 10 22.22 100.00 Totals 2 2 4 28 17 45 100.00 NURSING, EXTRA NOURISHMENT AND SHELTERS. District Nurses visit many patients suffering from Tuberculosis and being treated at home; 2,130 visits were paid by the nurses in 1945. A limited provision is made for the supply of extra nourishment to tuberculous persons, and this usually takes the form of extra milk; 110 patients received help in this way during the year. The scheme for the provision of shelters has been continued, and 2 shelters are at present in use. TUBERCULOSIS ALLOWANCES MADE UNDER MINISTRY OF HEALTH MEMO. 226/T. Particulars of applications for allowances dealt with under this scheme during the year are as follows:— Number of applications considered 679 Number of new cases during the year 83 Number of applicants who have received allowances during the year 532 Renewal applications and cases of changed circumstances reviewed 145 Applicants found to be ineligible 2 RETURN SHOWING THE WORK OF THE DISPENSARY DURING THE YEAR 1945. Diagnosis Pulmonary Non-Pulmonary Total Grand Total Adults Children Adults Children Children Adults M. F. M. F. M. F. M. F. M. F. M. F. A.—New Cases examined during the year (excluding contacts): — 1 2 62 53 44 2 9 5 5 49 8 4 123 (a) Definitely tuberculous 3 (b) Diagnosis not completed - - - - - - - 8 1 1 14 - 4 - - - - - - 130 92 6 244 (c) Non-tuberculous - - 16 B. — Contacts examined during the year:— -I I . Il . I I 3 (a) Definitely tuberculous 2 - 2 - - 1 2 3 3 8 - - (b) Diagnosis not completed - - - - - - - 2 6 1 3 12 - (c) Non-tuberculous - - - - 21 40 131 - - - - 42 28 C.— Cases written off the Dispensary Register as:— _ I 1 3 2 10 1 (a) Recovered 7 3 2 2 5 4 20 - (b) Non-tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous) - - - - - - - 151 132 58 34 375 (23) - D.—Number of Cases, on Dispensary Register on December 31st: — I I I Il I 611 257 18 23 16 17 249 280 47 232 31 17 35 (a) Definitely tuberculous (6) Diagnosis not completed - - - - - - - - 6 14 2 4 26 1. Number of cases on Dispensary Register on January 1st 546 7. Number of visits by Tuberculosis Officers to homes (including personal consultations) 513 2. Number of cases transferred from other areas and cases returned after discharge under Head 3 in previous years 17 8. Number of visits by Nurses or Health Visitors to homes for Dispensary purposes *972 3. Number of cases transferred to other areas, cases not desiring further assistance under the scheme, and cases "lost sight of" 26 9. Number of:— (a) Specimens of sputum, etc., examined 341 (b) X-ray examinations made in connection with Dispensary work 2,057 4. Cases written off during the year as Dead (all causes) 45 5. Number of attendances at the Dispensary (including Contacts) 2,090 10. Number of " Recovered " cases restored to Dispensary Register, and included in A (a) and A (b) above Nil 6. Number of consultations with medical practitioners:— 11. Number of " T.B. plus" cases on Dispensary Register on December 31st 197 (a) Personal 81 (6) Other 364 12. Number of Artificial Pneumothorax Refills 908 * In addition to these visits 148 visits were made by the Lady Almoner. 1 1 1 - - - - 1 - - 4 5 - Non-Pulmonary Males „ Females 1 - 5 2 - 2 - - - 10 10 - - New cases of Tuberculosis coming to the knowledge of the Medical Officer of Health during the above-mentioned period, otherwise than by formal notification: — Age Periods 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards Total - Pulmonary Males - 1 4 7 4 3 - - 20 - 1 - - - 2 2 2 1 - - - 7 „ Females - - - 1 - - 1 - - - - 3 1 Non-Pulmonary Males - - „ Females - - - - - - - - - - Returns rendered under the PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930. 1st QUARTER, 1945. I Respiratory System Other Forms M. F. M. F. Number of Cases on Register at commencement of Quarter 313 274 65 65 7 Number of Cases notified during Quarter 17 17 - 2 - Inward Transfers, Un-notified Deaths, etc. - - 2 Number of Cases removed from the Register 12 12 5 Number of Cases remaining on the Register at end of Quarter 70 279 320 60 2nd QUARTER, 1945. r Respiratory System Other Forms M. F. M. F. Number of Cases on Register at commencement of Quarter 320 279 60 70 Number of Cases notified during Quarter 18 12 1 2 Inward Transfers, Un-notified Deaths, etc. 7 7 1 - Number of Cases removed from the Register 15 3 1 - Number of Cases remaining on the Register at end of Quarter 330 295 61 72 3rd QUARTER, 1945. Respiratory System Other Forms M. F. M. F. 320 61 72 Number of Cases on Register at commencement of Quarter 295 15 2 Number of Cases notified during Quarter 21 1 Inward Transfers, Un-notified Deaths, etc. 3 2 1 - 7 Number of Cases removed from the Register 11 1 3 Number of Cases remaining on the Register at end of Quarter 63 305 343 70 4th QUARTER, 1945. Respiratory System Other Forms M. F. F. M. Number of Cases on Register at commencement of Quarter 343 305 63 70 Number of Cases notified during Quarter 14 12 1 - Inward Transfers, Un-notified Deaths, etc. 2 4 1 - Number of Cases removed from the Register 67 50 19 18 Number of Cases remaining on the Register at end of Quarter 292 46 52 271 IV:—LIGHT TREATMENT, ELECTRO-THERAPY AND MASSAGE. The following table shows the work done in the Solarium during 1945:— Total Number of Attendances 13,025 Number of Medical Examinations 1,504 Number of New Cases 560 Number of Discharges 458 Referred for X-Ray 66 Treatments:— Massage 4,191 Physical Exercises 1,909 Diathermy 1,982 Medical Electricity 4,569 Radiant Heat 5,415 Local Ultra Violet Light 1,798 General Ultra Violet Light 5,669 Special Treatments 353 Total Number of Treatments 25,886 V.-MATERNITY AND CHILD WELFARE. FAIRBY GRANGE CONVALESCENT HOME. The total number of patients received into the home during the year, including mothers, babies and toddlers, was 289. Number of women admitted 144 Number of babies admitted 69 Number of toddlers admitted 76 PREMATURE CHILDREN —ILLEGITIMATE CHILDREN— HOME HELPS—CHILD LIFE PROTECTION. There were twenty-nine premature births during the year including one set of twins ; eight of these children died. Five of them died within twenty-four hours of birth and could probably not have been saved by any means. Of the remaining three children, one was born at twenty-eight weeks pregnancy and had only the slenderest chance of survival, one died at eight weeks of gastro-enteritis being only 3 lb. 10 ozs. at birth, and the third one died at five months of meningitis. The total number of illegitimate children under five now known to be living in the Borough is 137. During the year we have employed four full-time and sixteen part-time Home Helps in giving assistance to fifty patients. HEALTH VISITORS. The following table shows the work done by the Municipal and Voluntary Centres and Health Visitors during 1945: — District Birth Notified Visits to Infants and Children Visits to Expectant Mothers Visits to Cases of Infectious Diseas Unclassified or Special Visits Attendances at Centres & Clinics Health Talks Puerperal Pyrexia and Fever Ophthalmia Neonatorum Measles Whooping Cough Tuberculosis Post-Infectious Disease First Visits Re-visits Primary Visits Revisits Under 1 year 1-5 years Miss Anderson 73 91 595 784 98 192 3 - 77 2 - 206 186 - 1 *Miss Bowles - - - - - - - - - - - - - 215 - Miss Brown - - - - - - - - - - - 20 262 - - Mrs. Carson 4 2 44 23 1 5 - - 4 - - - 8 8 - Miss Cranmer 73 73 473 513 53 89 - - 39 2 - - 40 142 - Miss Cunningham 35 35 169 340 41 135 - - 13 1 - - 24 77 - 21 643 Mrs. Hook 33 1044 3 93 - 1 69 7 1 - 57 135 - 85 463 783 60 104 - 43 587 178 - Miss Oram 78 1 - - - Miss Parry 94 97 746 862 94 345 - 3 59 - 4 - 95 156 - Miss Riches 14 93 374 811 34 141 - - 46 5 - 1 188 120 - Miss Riley 97 84 548 470 84 127 1 - 51 7 - - 163 113 - Miss Robson 49 57 652 983 35 114 - - 33 4 2 81 188 - - Miss White 66 71 636 1048 71 211 - 29 76 249 107 - - 1 — Salomon's Centre 29 42 186 718 211 366 - - - 15 - 6 298 - - Totals 633 763 5529 8379 785 1922 4 4 478 30 8 77 1724 2185 - * Miss Bowles has been employed for much of her time in the X-Ray Department. Miss Lawrence is Matron of Kintore Way Nursery and Miss Crundwell is Matron of Tenda Road Nursery. ATTENDANCES AT MATERNITY AND CHILD WELFARE CENTRES. The following table shows attendances at Maternity and Child Welfare Centres during 1945:— Children's Consultations Ante-natal Clinic Sewing Class Gynaecological Clinic No. of Sessions New Cases Total Attendances No. seen by Doctor No. of Sessions New Cases PostNatal Cases Total Attendances No. of Sessions No. of Attendances No. of Sessions New Cases Total Attendances Name of Centre Under 1 year 1-5 years Under 1 year 1-5 years Public Health Centre, Grange Road 306 33 1,987 3,376 112 35 2,251 - 43 123 417 147 4,615 387 - Community Centre 52 70 25 709 377 637 - - - - - - - - - Bermondsey Gospel Mission 47 68 10 1,057 586 868 - - - - - - - - - Stephen-the-Yeoman Mission 56 15 2,036 508 1,145 103 323 109 1,966 - - - - 203 - Central Hall 97 102 8 1,538 541 843 - - - - 41 337 - - - Salomon's Centre 98 52 10 587 626 543 200 339 43 1,723 - - - - - Totals 801 101 10,542 4,625 7,412 415 1,049 187 5,940 337 43 123 417 EXTRACTS FROM VITAL STATISTICS, 1945. Births. Registered— Total Males Females Live Births Illeg Legitimate Illegitimate 778 70 394 33 384 37 Total Males Females Stillbirths 21 12 9 Rate per 1,000 total (live and still) births 24 Notified within 36 hours of birth— (1) Live Births, 561. (2) Stillbirths, 15. (3) Total, 576. Total Males Females Deaths 686 374 312 Maternal Deaths. Deaths from puerperal causes: — Deaths. Rate per 1,000 total (live and still) births Puerperal Sepsis 1 1.15 Other puerperal causes 2 2.30 Total 3 3.45 Heath Rate of Infanta under 1 year of age. All Infants per 1,000 live births 52 Legitimate infants per 1,000 legitimate live births 53 Illegitimate infants per 1,000 illegitimate live births 43 Health Visitors. Visits paid by Health Visitors during the year : — To Expectant Mothers (1) First Visits, 785. (2) Total Visits, 2,707 To Infants under 1 (1) First Visits, 763. (2) Total Visits, 6,292 To Children, 1 - 5 Total Visits, 8,379 Convalescent Homes for Children under 5. Number of Beds, 16. Number of Children under 5 received during the year 145 Day Nurseries. Number of day nurseries 5. Deaths from Cancer (all ages) 100 Deaths from Measles (all ages) Nil Deaths from Whooping Cough (all ages) Nil Deaths from Diarrhoea (under 2 years of age) 12 (31) VI.—DENTAL TREATMENT. The attached tables summarise the work which has been done at the two dental centres during the year. TREATMENT OF CHILDREN DURING 1945. CENTRE Age Group Number Examined Number Treated Number of Extractions Anaesthetics Number of Fillings Number of Scalings Number of Attendances for Orthodontics Local General PUBLIC HEALTH CENTRE, GRANGE ROAD. Under 5 years 132 104 209 - 60 - - - 311 732 123 221 140 6 - Over 5 years 346 Totals 478 415 941 123 281 140 6 - 98, ROTHERHITHE NEW ROAD. Under 5 years 51 75 185 1 54 - - - Over 5 years 214 311 603 29 172 77 2 - 265 386 788 30 226 77 2 - Totals Totals both Centres 743 801 1729 153 507 217 8 - (32) DENTAL TREATMENT CARRIED OUT DURING 1945. CENTRE Type of Case Number of Patients Examined Number of Patients Treated Number of Extractions Anæsthetics Number of Fillings Number of Scalings Number of Dentures Fitted Number of Repairs to Dentures Number of Attendances Local General PUBLIC HEALTH CENTRE, GRANGE ROAD Maternity Cases 761 729 2210 289 311 139 78 247 117 2113 Women 754 746 1683 375 216 206 38 196 45 1914 Men 1025 1003 1605 606 105 132 63 197 80 1847 Tuberculosis Cases 16 11 19 7 2 12 2 5 1 39 Children (Table I.) 478 415 941 123 281 140 6 1 - 884 646 Totals 3034 1400 915 629 187 243 2904 6458 6797 98, ROTHERHITHE NEW ROAD Maternity Cases 311 492 1365 129 231 62 73 140 32 1282 Women 256 497 823 147 144 96 40 103 50 1110 Men 201 646 1154 356 99 39 30 110 74 1165 Tuberculosis Cases 1 1 1 1 - - - - - 1 Children (Table I.) 265 386 788 30 226 77 2 - - 580 Totals 1034 2022 4131 663 700 274 145 353 156 4138 Totals both Centres 4068 4926 10589 2063 1615 903 332 999 399 10935 VII.-CONSULTATION AND OTHER CLINICS. X-RAY DEPARTMENT. The following table shows the work done in this Department during 1945: — Total number of Attendances - 5,478 Number of Individual Cases 5,174 Number of New Cases 3,896 Number of Screenings 1692 Analysis of Films : — Bones 275 Gastro-intestinal Tract 189 Chests 4,586 Other Examinations 116 Air Training Corps 9 POST-NATAL AND SPECIAL CLINICS FOR WOMEN. The total number of attendances during the year, in which 43 sessions were held, was 417. There were 123 new cases, the majority of whom were suffering from menopausal or menstruation disorders; 26 were investigated for sterility; 8 were found to be pregnant; no cases of carcinoma were found. Suitable cases were treated at the Clinic, others being referred to their own doctors or to hospitals. HEART CLINIC. Patients, at this Clinic, come by appointment, and are sent by their own doctors for investigation. During the year 44 sessions were held ; the total number of attendances was 193 ; the number of new patients was 76, of which number 29 were found to be suffering from cardiac disease. OPHTHALMIC CLINIC. The number of sessions held during the year was 87. There were 507 new patients and the total number of attendances was 943. FOOT CLINIC. Attendances during the year are shown in the following table:— Clinic Men Women Total 4,568 6,102 Bermondsey 1,534 1,390 3,811 Rotherhithe 5,201 Totals 8,379 11,303 2,924 VIII.-PROPAGANDA. The following is a list of lectures, demonstrations and cinema film shows given during the year : — Youth Organisations 46 attended by 3,220 Schools — — — — 46 ~ 5,860 Other Adult Organisations — 53 „ 2,930 145 12,010 IX.-SANITARY ADMINISTRATION HOUSING. During the year 1945 no areas were represented or declared by the Council. No permanent dwellings were erected, but during 1945 temporary accommodation in the form of 54 Uni-Seco Hutments (2 year) have been completed and are occupied. The erection of Emergency Factory-made Houses (10 year) is now proceeding and it is intended to provide 243 of these which will be controlled by this Council, and a further 94 to be under the supervision of the London County Council in this Borough. Up to December 31st, 1945, 69 had been completed and taken over by this Council of which 60 were in occupation on that date. HOUSING ACT, 1936—OVERCROWDING. No detailed survey has been made during the year with regard to overcrowding, but the outstanding applications for accommodation in the Borough numbered 3,404 and these were made up as follows: — Homeless by enemy action 519 families. No separate accommodation (chiefly young married couples) 1,288 „ Overcrowded 144 „ Applications on Medical Grounds 49 „ General list (no special grounds) 1,104 „ ERADICATION OF BED BUGS The following table shows the fumigations carried out during 1945 :— Infested Disinfested Council houses or flats 57 57 Other houses or flats 186 186 INSPECTIONS, PROCEEDINGS, ETC. Hereunder will be found particulars of Inspections, Proceedings, etc., for the year 1945 :— Inspection of Dwelling-Houses during the Year :— (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 5,870 (b) Number of Inspections made for the purpose 17,547 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 114 (b) Number of Inspections made for the purpose 114 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (4) Number of dwelling-houses (exclusive of those referred to under the preceding subhead) found not to be in all respects reasonably fit for human habitation Nil Remedy of Defects during the Year without Service of Formal Notices : — Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 1,581 Action under Statutory Powers during the Year : — (A) Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936 :— (1) Number of dwelling-houses in respect of which notices were served requiring repairs Nil (2) Number of dwelling-houses which were rendered fit after service of formal notices : — (a) By owners Nil (b) By Local Authority in default of owners Nil (B) Proceedings under Public Health Acts : — (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 2,101 (2) Number of dwelling-houses in which defects were remedied after service of formal notices : — (a) By owners 520 (b) By Local Authority in default of owners Nil (C) Proceedings under Sections 11 and 13 of the Housing Act, 1936 :— (1) Number of dwelling-houses in respect of which Demolition Orders were made Nil (2) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil (D) Proceedings under Section 12 of the Housing Act, 1936 :— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made Nil (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit Nil REGISTERED PREMISES— Premises Number on Register at end of 1945 Number of Inspections Number of Prosecutions - 3 41 Common Lodging Houses 2 - 10 Seamen's Lodging Houses 104 Milkshops 285 - 353 695 - Houses let in lodgings 74 Ice Cream Premises 90 - 13 48 - Offensive Trades (including Poultry Slaughter-houses) SMOKE NUISANCES— Number of observations 14 Number of notices Nil Number of complaints Nil Number of summonses Nil WATER SUPPLY TO TENEMENT HOUSES— Premises supplied Nil Prosecutions Nil SALE OF FOOD Number of premises used other than ice-cream premises, milk-shops and cowsheds 335 Number of inspections 510 RAG FLOCK ACT, 1911, and PUBLIC HEALTH (LONDON) ACT, 1936 :— There are three premises in the District where rag flock is used and three inspections were made during the year. WORK OF DISTRICT INSPECTORS, 1945. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 TOTALS House-to-House Special Inspections Complaints Infectious Diseases Factories & Workshops Specially Inspected Offensive Trades Outworkers' Bi-Annual Inspection Underground Conveniences Drains Tested Other Calls and Visits Chimney Watched Bakehouses Common and Seamen's Lodging Houses Butchers Fishmongers, Friers and Curers Food Stores Fruiterers and Greengrocers Ice Cream Markets Restaurants and Eating Houses Destruction of Food Various Visits Ints. District No 1 1704 629 172 - - 15 - 22 2554 - 29 49 31 8 62 1 7 1 35 26 - 5345 501 113 1274 127 - - 6 1 19 4353 - 14 1 1 4 67 18 3 31 20 2 7080 1026 226 - 958 1075 234 3 - 16 - 18 1112 - 1 13 4 49 7 3 6 19 - 3543 540 1 7 17 844 992 122 - - - - 15 1741 - 7 - 5 1 12 1 1 12 30 - 3783 434 - - - 1004 1070 61 - - - - 33 1917 - 3 - 6 2 23 - 1 - 11 22 - 4153 361 5536 5040 716 3 37 1 107 11677 60 51 56 19 213 27 25 8 95 117 23904 2062 2 114 - - FACTORIES AND OTHER PREMISES. HOMEWORK, Outworkers' Lists, Section 110 Outwork in Unwholesome Premises, Section 111 NATURE OF WORK (1) Lists received from Employers Outworkers resident in Bermondsey received from other Districts Notices served on Occupiers as to keeping or sending lists (8) Prosecutions Instances (11) Notices served (12) Prosecutions (13) Lists (2) Outworkers Failing to keep lists (9) Failing to send lists (10) Resident in Bermondsey Resident in other Districts (5) Contractors (3) Workmen (4) Contractors (6) Workmen (7) Wearing Apparel — I - I 3 7 15 (1) Making, etc. 1 15 - - - - - - - (2) Cleansing and washing - - - - - - - - - - - - Fur pulling - - - - - - - - - - - - Umbrellas, etc. - - - - - - - - - - - - Cotton Bags 2 - 14 4 - - - - - - - - - - - 7 - - - - Paper, etc., Boxes, Paper Bags - - - - Brush making - - - 3 - - - - - - - - Combs, etc. - - - - - - - - - - - - Upholsterers - - - - - - - - - - - - Cycle Engineers - - - - - - - - - - - - Coathangers - - - - - - - - - - - - Carding of buttons, etc. - - - - - - - - - - - - Onion Peeling - - - - - - - - - - - - Games and Toys - - - - - - - - - - - - Fancy Goods 1 - 4 3 1 9 - - - - - - Sack Manufacture 1 - 2 - - - - - - - - Total 7 1 27 22 1 34 - - - - - - FACTORIES AND OTHER PREMISES. INSPECTION. Premises Number of Inspections Written Notices Occupiers Prosecuted Factories with mechanical power Factorieswithout mechanical power Other Premises under the Act (including works of building and engineering construction but not including outworkers' premises) 4,020 63 - 1,125 5 - 196 14 1 5,341 1 Total 82 DEFECTS FOUND. Particulars Number of defects in respect of which Prosecutions were instituted Number of Defects Found Remedied Referred to H.M. Inspector 13 Want of Cleanliness (S.1.) 13 - - Overcrowding (S.2.) - - - - - Unreasonable Temperature (S.3.) - - - - Inadequate Ventilation (S.4.) Ineffective Drainage of Floors 1 1 - - - (S.6.) - - Sanitary Conveniences (S.7.) — Insufficient 6 - - 6 46 Unsuitable or Defective 46 - - - Not separate for Sexes - - - 31 31 - 1 Other Offences (Not including offences relating to Home Work or offences under the Sections mentioned in the Schedule dule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921, and re-enacted in the Third Schedule to the Factories Act, 1937.) - 97 97 1 Total BAKEHOUSES. In Use Not in Use Underground Above ground Above ground Underground 2 3 26 3 27 of these are Factory Bakehouses HOUSE, TRADE AND MARKET REFUSE. The following table shows the amount of house, trade and market refuse disposed of during 1945 :— Disposal Loads tons qrs. cwts. House Refuse to Barge 7,845 10,505 - 12 House Refuse Shot at Ordnance Wharf 17 28 11 - 1,584 13 Trade Refuse to Barge 1,960 - 584 16 Street Markets Refuse to Barge 688 - 12,703 12 - Totals 10,510 OFFENSIVE TRADES. The offensive trades on the Register are as follows :— Fellmongers 3 Fatmelters — 1 Glue and size makers 3 Dresser of Fur Skins 6 MORTUARY. The Public Health (London) Act, 1936, Section 234, requires the Borough Council to provide a proper place for the reception of dead bodies before interment. The London County Council acts as agent for the Borough Council in this matter and receives into the mortuary at St. Olave's Hospital those bodies for which it is the duty of the Borough Council to provide. A fee of one guinea per body is paid by the Borough Council for this service. Number of infectious bodies removed ...... ...... ...... ...... Nil Total number of bodies removed ...... ...... ...... ...... 11 STREET MARKETS. The market scheme continues to work smoothly and satisfactorily. Number of Licences in operation — — 228 Income £836 19s. 0d. There were no prosecutions during the year. DRAINAGE WORK. Particulars of work carried out by the Drainage Inspector during 1945 :— Drais Tested 512 Visits to Shelters (Civil Defence) 178 Other Visits - 1395 WORK OF THE FACTORIES AND SHOPS INSPECTOR. Shops. Visits 130 Notices served under Shops Act, 1934 1 Notices served under Public Health (London) Act, 1936 13 Factories (with mechanical power). Visits 393 Notices under Factory Act, 1937 - 16 Notices under Public Health (London) Act, 1936 36 Factories (without mechanical power). Visits 39 Notices under Factory Act, 1937 3 Notices under Public Health (London) Act, 1936 1 Workplaces. Visits 103 Notices served 14 Prosecutions 1 Visits to Offensive Trade premises 39 Chimneys watched 21 Visits to Underground Conveniences 314 Other calls and visits 270 X.-FOOD CONTROL. PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1937. FOOD AND DRUGS ACT, 1938. Thirty samples were taken during the year by the Senior Inspector and Wharves Inspectors. No.of Samples Action Article Examined Purpose of Examination Result For preservative Released Beef Powder 1 Satisfactory. Creatinine 0.89% ; Sulphur phur Dioxide, nil „ „ „ Beef Stock Satisfactory. Creatinine 1.0% ; Sulphur phur Dioxide, nil 1 To ascertain composition Disposed of for animal feeding Cocoa Powder 1 Very inferior quality Fat 2-84%. Consisted largely, if not entirely, of shell Released 1 „ „ Satisfactory. Cocoa Fat 2l.5%. No insects, sects, foreign starches, or excess of shell „ „ Coconut, desiccated „ „ Satisfactory. Oil 63.16%. Refractive Index at 40º C. (Zeiss) 35.0, Zinc 15 parts per million; Copper, 2 parts per million „ 1 Released with warning to owner For metallic contamination Curry Powder 2 Unsatisfactory. Lead, 22 and 9 parts per million „ „ Released Satisfactory. Arsenic as arsenious oxide 0.6 parts per million; Copper, practically nil; Lead, 4.0 parts per million; Zinc, 20.0 parts per million; Ash, 2% Gelatine, Sheet 1 No.of Samples Article Examined Purpose of Examination Result Action Gelatine For Metallic contamination Satisfactory. Arsenic as arsenious oxide, 1.6 parts per million; Copper, less than 5.0 parts per million; Zinc, 40.0 parts per million No action 1 Gelatine, Ground „ „ Satisfactory. Arsenic as arsenious oxide, 0.5 parts per million; Copper, nil; Zinc, 80.0 parts per million Released 1 „ „ Satisfactory. Arsenic as arsenious oxide, 1.6 parts per million; Zinc, nil; Copper, 5.0 parts per million Gelatine, Powdered 1 „ Gelatine Satisfactory. Arsenic as arsenious oxide, 0.4 parts per million; Copper, nil; Zinc, nil No action 1 „ „ Gelatine, Powdered Unfit for food. Arsenic senic, as arsenious oxide 0.8 parts per million; Copper, 25.0 parts per million; Lead, 2.0 parts per million; Zinc, 60.0 parts per million; Ash, 3.7% 1 „ „ Released for industrial purposes Unfit for food. Arsenic as arsenious oxide, 0.6 parts per million; Copper, 6.0 parts per million; Lead, 3.0 parts per million; Zinc, 45.0 parts per million; Ash, 3.4% „ „ „ „ 1 „ „ Gooseberry Pulp Satisfactory. Sulphur Dioxide, 700 parts per million 1 For preservative Released To ascertain cause of wet stain Hessian ex Mutton Carcase Moisture due to brine 1 Meat trimmed. Sound portion released Satisfactory. Sulphur Dioxide, 330 parts per million Lemon Juice For preservative 1 Released No.of Samples Result Action Purpose of Examination Article Examined 1 For preservative Satisfactory. Creatinine, 2.28% ; Sulphur Dioxide, nil Meat Essence Released „ „ 1 Satisfactory. Creatinine, 3.63% ; Sulphur Dioxide, nil Meat Extract „ 1 „ „ Satisfactory. Sulphur Dioxide, 685 parts per million Orange Juice „ To ascertain composition 1 Party Loaf, Tinned Satisfactory No action Copper, 3.3 parts per million For metallic contamination Pease Pudding, Canned 1 „ „ Contained no ground rice; consisted of potato starch with trace of salt and vanilla flavouring To ascertain composition Rice, Ground 1 Disposed of for animal feeding Lead, 6 parts per million Sardines in Oil 1 For metallic contamination Released 1 Lead, 4 parts per million Sardines in Tomato „ „ " 1 Satisfactory. Sulphur Dioxide, 950 parts per million For perservative „ Strawberry Pulp 1 , „ Satisfactory. Fruit— Sulphur Dioxide, 925 parts per million Liquid — Sulphur Dioxide, 940 parts per million Strawberry Pulp „ 1 To ascertain cause of mould Unfit for human consumption. Acidity, 15.6% expressed as oleic acid Suet, Flaked Released for industrial purposes 1 To ascertain if suitable for edible purposes Satisfactory Tallow, Edible Released „ 1 „ „ „ „ „ UNSOUND FOOD. The general inspection of food in shops and on stalls forms part of the duty of the District Sanitary Inspectors. Food, in the quantities stated, came under the notice of the Inspectors during the year, and being found unfit for human consumption was destroyed or disposed of for animal feeding purposes. Description of Food Weight tons cwts. qrs. lbs. Fish — 6 2 10 Dairy Produce .. .. •• — I — 1 15 Dried Fruit .. .. .. • • — 4 1 14 Meat — 9 2 22 Various .. .. .. .. 1 10 1 — Total 2 11 1 5 MILK PREMISES. MILK AND DAIRIES (AMENDMENT) ACT, 1922. FOOD AND DRUGS ACT, 1938. Seven milk sellers were registered under the above Acts during 1945, and 38 were removed from the Register. There were 104 milk sellers on the Register at the end of the year. MILK (SPECIAL DESIGNATIONS) ORDER, 1936. During the year under report the following licences were granted: — Dealers' Licences. To sell Tuberculin Tested Milk 17 To sell Pasteurised Milk 24 Supplementary Licences. To sell Pasteurised Milk 9 To sell Tuberculin Tested Milk 6 All premises used for the sale of milk are regularly inspected to ensure that the standard of cleanliness laid down is maintained. MILK SAMPLING. Samples of milk, both for bacteriological and chemical examination, are taken from milksellers, and special arrangements are made for the sampling of the milk supplied to all schools in the borough. The total number of samples submitted for analysis during 1945 was 436, of which number 19 were taken from schools. For Chemical (i.e., Fat and non-Fatty Solids) Examination. Liquid Milk, undesignated 232 Sterilized Milk 124 Pasteurised Milk (informal) 7 Condensed Milk (informal) 19 Tuberculin Tested (informal) 3 385 For Bacteriological Examination. Pasteurised Milk (from schools) 19 Pasteurised Milk (other than from schools) 10 For tubercle bacilli 6 For brucella abortus 3 Tuberculin Tested 4 Tuberculin Tested (Pasteurised) 10 Heat Treated 12 Dysentery 6 70 ICE CREAM. Seventy-eight samples of ice cream have been examined, with the following results: — 1. Bacterial Count. Up to 500 per 1 c.c 1 Over 500 to 1,000 per c.c 1 Over 1,000 to 5,000 per 1 c.c 2 Over 5,000 to 10,000 per 1 c.c. - Over 10,000 to 50,000 per 1 c.c. 8 Over 50,000 to 100,000 per 1 c.c. 5 Over 100,000 to 200,000 per 1 c.c. 4 Over 200,000 to 400,000 per 1 c.c. 5 Over 400,000 to 600,000 per 1 c.c. 3 Over 600,000 to 1,000,000 per 1 c.c. 1 1 Over 1,000,000 per 1 c.c. 1 31 2.Presence of B. Coli B. Coli present in 1 c.c., 1 10th c.c. and 1 100th c.c. 19 B. Coli present in 1 c.c. and 1 10th c.c. 4 B. Coli present in 1 c.c. 2 B. Coli absent in 1 c.c., 1 10th c.c., and 1 100 th c.c. 6 31 (48) 3. Chemical Analysis. Acidity as Lactic Acid Protein (NX 6.25) Fat Ash Dextrin Water Sugar Starch 73.96 2.50 0.15 0.11 17.25 5.48 0.55 - 75.73 2.06 1.20 0.57 15.53 - 0.67 4.24 72.63 2.52 2.75 0.27 13.45 7.84 0.54 - 78.37 2.75 3.20 0.59 9.65 4.73 0.71 - 71.16 3.33 1.80 0.91 8.78 13.04 0.98 - 80.44 5.15 0.25 0.60 10.57 2.15 0.84 - 77.28 3.61 0.33 0.25 10.30 7.60 0.63 - 67.70 3.96 3.35 0.14 17.40 6.75 0.70 - 75.40 2.98 1.00 0.14 11.25 8.7 0.56 - 69.20 3.19 2.38 0.15 13.98 10.52 0.58 - 65.97 9.93 8.19 0.70 14.33 0.88 - - - 62.21 4.38 11.48 0.81 15.81 0.73 4.58 67.19 4.06 5.20 0.74 10.64 - 0.75 11.42 63.75 3.19 5.00 0.59 16.49 10.33 0.65 - 5.28 - 77.81 1.49 0.56 5.36 0.76 8.74 Figures given are percentages. PHARMACY AND POISONS ACT, 1933. Forty-three premises were entered on the Council's list for the year under report. As a result of samples being purchased, it was found that three contraventions of the Act occurred, poisons being sold wrongly by unlisted vendors. Warnings were given in all cases. FOOD AND DRUGS. During the year 1,241 samples were submitted by the Food and Drugs Inspector. In twenty-four cases the analysis disclosed an infringement of the law. Date purchased Sample Infringement Remarks No. 17 16.1.45 3.70% coarse Grit Warning Mixed Herbs Formal sample 6.2.45 satisfactory Lemonade (Informal) 29.1.45 47 16.6% deficient in Citric Acid ; 58.8% deficient in sugar 13.2.45 Dripping Warning 105 Free Fatty Acid, 3.5% Pork Fat 149 20.2.45 Warning Free Fatty Acid, 6.0% 28.2.45 Milk (Informal) Warning. Further samples taken and found to be satisfactory 182 3.3% deficient in Milk Fat 5.3.45 Orangeade Warning letter sent and ex-planation received from Manufacturers. Third sample taken proved to be satisfactory 217 10.7% deficient in Citric Acid; 4.2% deficient in sugar 27.3.45 301 Orangeade 10.7% deficient in Citric Acid; 4.9% deficient in sugar 246 13.3.45 Warning Shredded Suet 4.1% deficient in Fat 253 14.3.45 Dried Parsley 25 parts per million of Arsenic Warning Milk 21.3.45 286 1.4% deficient in Non-fatty Solids Warning. Subsequent samples satisfactory Warning 28.3.45 305 Orange Squash 6.25% deficient in Citric Acid 13.4.45 337 Shredded Suet 4.2% deficient in Fat Warning Warning. Subsequent samples satisfactory 356 18.4.45 Milk 1.0% deficient in Non-fatty Solids 402 30.4.45 Sterilized Milk 1.3% deficient in Fat Warning. Subsequent samples satisfactory Pearl Barley Retailer surrendered remainder of parcel (4 1bs.) which was old stock. Warning 469 16.5.45 Infested with Mites Date purchased Sample Infringement Remarks Remainder of parcel satisfactorily cleansed. Warning 26.7.45 Slightly infested with living mites Pearl Barley 19.9.45 34.0% deficient in Acetic Acid Vinegar Baking Powder Prosecution. Fined 40s. with £3 3s. costs 38.7% deficient in available Carbon Dioxide 24.9.45 Warning letter as it was purchased by the retailer before the Order came into force 39.4% deficient in Total Solids ; 27.2% deficient in Protein 27.9.45 Oxtail Soup (Informal) Resampled 6.11.45 Oxtail Soup 40.25% deficient in Total Solids ; 56.8% deficient in Protein Manufacturer's explanation accepted Vinegar 28.9.45 9.25% deficient in Acetic Acid Prosecution. Fined 20s. with £2 2s. costs 3.0% deficient in Acetic Acid 22.10.45 Vinegar Warning 23.10.45 Total Solids ; 8.09% ; Protein, 1.60% Celery Soup According to the Canned Meat and Canned Soup (Control and Maximum Prices) Order, 1941, the total solids should be 10% and the Protein 1 %. Warning letter sent to manufacturers Baking Powder 29.10.45 42.5% deficient in available Carbon Dioxide Warning letter as it was purchased chased by the retailer before the Order came into force. Remainder of stock—5 packets—surrendered PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1937. Quantity Unsound Released for disposal under other Sanitary Authorities Articles Disposed of for purposes other than human food Destroyed Weight Weight Weight lbs. Tons cwts. Tons cwts. Tons cwts. qrs. lbs. qrs. qrs. lbs. Canned Goods 21 14 9 2 5 13 1 6 95 11 - 6 - Cereals 116 5 2 5 - - - - - - - Dairy Produce 6 2 1 620 16 19 - - - - - - 16 Evaporated Milk 63 14 3 13 29 10 3 1 5 2 15 Flour and Cornflour - 675 6 3 26 - - - - - - - 7 13 25 Fruit, Dried 8 12 3 1 - 1 - - - - - Fruit, Fresh 24 12 - - - - - - - - - Meat 1 16 2 21 2 18 4 - - - - Peas and Beans - 630 7 2 14 9 17 24 - - - - - Vegetables - 6 2 - - - - - - - - 22 86 10 16 7 9 1 49 18 15 Various - - Total 1678 5 2 18 82 12 - 11 718 14 2 20 WORK OF THE WHARF AND FOOD INSPECTORS, 1945. 1 2 3 4 5 6 7 8 9 10 11 12 Food Factories Food Stores Food Wharves and Depots Ice Cream Premises Milksellers Pharmacy and Poisons Condemnation of Food Nuisances Found Intimations Served Food Control Various Number of Samples taken for Analysis Chemical Bacteriological Food and Drugs Imported Food Regulations Milk (Special Designation) Order Heat Treated Milk (Regulation 55G) Milk for Tubercle Bacilli Milk for Bacillus Abortus Ice Cream Milk for Dysentery Jam Butter and Margarine Other - - 386 409 1208 - - - 278 6 4 - 265 - 9 - - - - - - 19 4 103 683 1453 - - - 213 5 5 - 184 - 13 - - - - - - 331 26 3 346 1148 - - - 312 1 1 - 116 - 7 - - - - - - 6 - - - 32 31 285 50 15 - 416 161 1241 - 43 12 3 34 6 - - 7 820 1438 3841 31 285 50 818 12 10 416 726 1241 29 43 12 6 3 34 XII.-HEALTH SERVICES. MATERNITY AND CHILD WELFARE CENTRES. Public Health Centre, Grange Road. Monday 2.0 p.m.-4.0 p.m. Wednesday 10.0 a.m.-12 noon. Thursday 2.0 p.m.-4.0 p.m. Ante-natal Clinics:— Tuesday 2.0 p.m.-4.0 p.m. Thursday 10.0 a.m.-12 noon. Bermondsey Gospel Mission, 1-3, Jamaica Road. Monday 2.0 p.m.-4.0 p.m. Ante-natal Clinic : — Wednesday 10.0 a.m.-12 noon. Stephen-the-Yeoman Mission, franbourne Place. Wednesday 10.0 a.m.-12 noon. Friday 2.0 p.m.-4.0 p.m. Ante-natal Clinics:— Monday 2.0 p.m.-4.0 p.m. Wednesday 2.0 p.m-4.0 p.m. Community Centre, Redriff Estate. Thursday 2.0 p.m.-4.0 p.m. Central Hall, Bermondsey Street. Thursday 2.0 p.m.-4.0 p.m. Salomon's Centre, Newcomen Street. Monday 2.0 p.m.-4.0 p.m. . Thursday 2.0 p.m.-4.0 p.m. Ante-natal Clinics:— Monday 8.30 a.m.-12 noon. Wednesday 8.30 a.m.-12 noon. Thursday 8.30 a.m. -12 noon. Friday 8.30 a.m. -12 noon GYNÆECOLOGICAL CLINIC. Public Health Centre, Grange Road. Wednesday 2.0 p.m-4.0 p.m. OBSTETRIC CONSULTANT. Miss Gladys Dodds, F.R.C.S., 15, Devonshire Place, W.1. (Telephone: Welbeck 5868.) Application should be made direct to the Consultant. PUERPERAL FEVER—CONS ULTANT. Miss Gladys Dodds, F.R.C.S., as above. Application should be made direct to the Consultant. HEART CLINIC, Public Health Centre, Grange Road. Patients are seen by appointment only. Appointments are made at the Public Health Centre. X-RAY CLINIC, Public Health Centre, Grange Road. Patients are seen by appointment only at the request of their own medical attendant. Evening sessions are held for patients who are at work. EVE CLINIC, Public Health Centre, Grange Road. Patients are seen by appointment only. An evening session is held for patients who are at work. Appointments are made at the Public Health Centre. EAR, NOSE AND THROAT CLINIC, Public Health Centre, Grange Road. Patients are seen by appointment only. Appointments are made at the Public Health Centre. FOOT CLINICS. Public Health Centre, Grange Road. Monday to Thursday (inclusive) 9.0 a.m. 1.0 p.m. 2.0 p.m. 5.0 p.m. 5.30 p.m. -7.30 p.m. Friday 9.0 a.m.-1.0 p.m. 2.0 p.m.-5.0 p.m. Saturday 9.0 a.m.-1 2 noon. 98, Rotherhithe New Road. Monday to Thursday (inclusive) 9.0 a.m.-1.0 p.m. 2.0 p.m.-5.0 p.m. 5.30 p.m.-7.30 p.m. Friday 9.0 a.m.-1.0 p.m. 2.0 p.m.-5.0 p.m. Saturday 9.0 a.m.-12 noon. DIPHTHERIA IMMUNISATION CLINIC, Public Health Centre, Grange Road. Monday 9.30 a.m. DIPHTHERIA "CONTACTS" CLINIC, Municipal Offices, Spa Road. Monday and Thursday 9.30 a.m. DIPHTHERIA "CARRIER" CLINIC, Guy's Hospital. Thursday 9.30 a.m. —12 noon and 1.30 p.m. —4.0 p.m. FAIRBY GRANGE CONVALESCENT HOME, Hartley, near Longfield, Kent. For expectant and nursing mothers and mothers with children under five years of age. Application forms and full particulars can be obtained at any of the Maternity and Child Welfare Centres. DAY NURSERIES. Whitstable Street, Marine Street, Fulford Street, Tenda Road. Application for admission to be made to the Medical Officer of Health, Public Health Centre, Grange Road. DENTAL TREATMENT CENTRES. Public Health Centre, Grange Road. Monday and Wednesday 10.0 a.m. 12.30 p.m. 2.0 p.m.—4.30 p.m. 5.30 p.m.—7.0 p.m. Tuesday 10 .0 a.m.—12.30 p.m. Thursday and Friday 10.0 a.m. 12.30 p.m 2.0 p.m.— 4.30 p.m 98, Rotherhithe New Road. Monday, Tuesday and Friday 10.0 a.m. 12.30 p.m 2.0 p.m.—4.30 p.m. Wednesday 10.0 a.m. 12.30 p.m 2.0 p.m. —4.30 p.m. 5.30 p.m. — 7.0 p.m. Thursday 2.0 p.m. 4.30 p.m. TUBERCULOSIS CLINIC, Public Health Centre, Grange Road. Patients are seen by appointment only. An evening session is held for patients who are at work. Appointments are made at the Public Health Centre. SOLARIUM, Public Health Centre, Grange Road. Patients are seen by appointment at the request of their own medical attendant. (Light treatment, electrical treatment and massage). Evening sessions are held for patients who are at work. VENEREAL DISEASE CLINIC, Guy's Hospital. Women Monday to Friday (inclusive), 12 noon—6.0 p.m. Saturday, 10.0 a.m.—4.0 p.m. Men Monday to Friday (inclusive), 9.30 a.m. —12.30 p.m. and 5.0 p.m.—7.0 p.m. Saturdays, 9.30 a.m.—12.30 p.m. and 5.0 p.m.—6.0 p.m. PUBLIC VACCINATOR. Dr. W. B. Pemberton, 50, Grange Road. NURSING ASSOCIATION. St. Olave's (Bermondsey and Rotherhithe) District Nursing Association, 13, Cherry Garden Street. INVALID CHILDREN'S AID ASSOCIATION (Bermondsey Branch), 7, Storks Road. Office Hours Monday to Friday (inclusive), 9.0 a.m.—6.0 p.m. Saturday, 9.0 a.m.—12.30 p.m. AMBULANCE FACILITIES. The following facilities are afforded by the London Ambulance Service of the London County Council. Ambulances are provided free of cost except where otherwise stated. Infectious Cases. Telephone—Waterloo 3311. At any hour of the day or night. Patients will not be removed to hospital unless a medical certificate stating definitely the nature of the disease is handed to the ambulance nurse. Infectious cases are conveyed to hospitals other than the L.C.C. hospitals for infectious diseases at a minimum fee of 12/6. Non-Infectious Cases. Telephone —Waterloo 3311. At any hour of the day or night. Minimum fee, 12/6. Free Ambulances to London Voluntary Hospitals.—These are provided for the removal of patients resident in the County of London to Voluntary Hospitals in the County, except for patients for admission to " pay " wards, in which cases the charges set out above will operate. Applications for free ambulances will only be accepted from Voluntary Hospitals in the County of London or the Emergency Bed Service, so that medical practitioners should make arrangements for the patient's admission with the voluntary hospital concerned or with the Emergency Bed Service (Clerkenwell 6571; City 2162). Accident Cases. Dial 999 and ask telephone operator for " Ambulance." At any hour of the day or night. Serious Illness. Telephone—Waterloo 6000, Reliance 3622, Central 6301, or Regent 4000. At any hour of the day or night. Ambulances are provided for persons suffering from illnesses in their homes if a medical practitioner certifies that the case is one of life or death, and that arrangements have been made for the reception of the patient in a hospital. Maternity Cases. Telephone—Waterloo 6000, Reliance 3622, Central 6301, or Regent 4000. Urgent Cases At any hour of the day or night on application by a doctor or certified midwife, provided that either a doctor or midwife accompanies the case and that arrangements for the reception of of the patient in a hospital have been made. Non-urgent Cases At any hour of the day or night —provided that admission to a maternity bed has been previously arranged and a card (issued by the London County Council to hospitals, maternity homes, etc.) for such admission obtained. This card must be handed to the ambulance attendant at the time of removal. The husband or a female friend must accompany the patient.