METROPOLITAN BOROUGH OF BERMONDSEY ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1956 D. M. CONNAN, M.D., D.P.H., Medical Officer of Health CW Ga c4378 METROPOLITAN BOROUGH OF BERMONDSEY ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1956 D. M. CONNAN, M.D., D.P.H., Medical Officer of Health TABLE OF CONTENTS PUBLIC HEALTH DEPARTMENT— PAGE Public Health Committee 4 Staff 4 VITAL STATISTICS— Area 13 Population 13 Births 13 Deaths 14 Marriages 14 Infantile Mortality Rates 15 Deaths from Tuberculosis 15 Vital Statistics of District 15 Causes 17 Infantile Mortality, Causes of Deaths 19 Extracts from Vital Statistics, 1956 20 INFECTIOUS DISEASES— Diseases Notifiable 21 Food Poisoning 21 Cases Notified in 1955 22 Cases Notified for last ten years 23 TUBERCULOSIS— New Cases and Deaths 24 Notification Register 24 25Summary of Notifications SANITARY—Circumstances of the Borough Housing 26 Housing Act, 1936 —Overcrowding 26 Eradication of Bed Bugs 26 Inspections and Proceedings 26 Registered Premises 28 Smoke Nuisances 8 Water Supply to Tenement Houses 29 Sale of Food 29 Rag, Flock and other Filling Materials Act, 1951 29 9 Hairdressers and Barbers 29 Housing Repairs and Rents Act, 1954 29 Work of the District Inspectors 30 Factories and Workshops —Homework 31 Factories and Workshops—Inspections 32 Defects Found 32 Bakehouses 33 House, Trade and Market Refuse 33 Offensive Trades 33 Pet Animals Act, 1951 Catering Establishments Work of Factories and Shops Inspector Rodent Control 35 FOOD CONTROL- Imported Food Regulations —Samples taken Section 14, Food and Drugs Act and Dairies 39 Disposal of Unsound Food 39 Food Premises and Types of Business 39 Unsound Food—Shops and Stalls 40 Pharmacy and Poisons 40 Milk Premises 40 Milk Licences 4 Milk Sampling 41 Ice Cream 42 Food and Drugs —Samples Taken 43 Sampling of Egg Products 45 Unsound Food —Wharves, etc 48 Work of the Wharves and Food Inspectors 50 MISCELLANEOUS SERVICES— Old People's Welfare 51 Clubs 51 Outings to Women's Institutes 51 Holidays 51 Meals Service 52 Outings 52 Workrooms for the Elderly 55 Investigations of Atmospheric Pollution 46 International Certificates of Vaccination and Inoculation 57 Food Hygiene Regulations, 1955 57 Street and Open Markets 58 National Assistance Act Section 47 58 National Assistance Act, Section 50 58 Public Health Act, Section 122 59 PUBLIC HEALTH DEPARTMENT MUNICIPAL OFFICES, SPA ROAD, S.E.16 PUBLIC HEALTH COMMITTEE (As at 31st December, 1956) Chairman Councillor W. H. WARDELL Vice- Chairman Councillor Mrs. E. V. COYLE, L.P. Alderman A. M. Downing Councillor Mrs. M. A. Henley „ A. V. Kidd „ Jos. Mahoney Councillor J. A. Clark „ Mrs. A. E. Martin „ W. L. Ellis „ W. E. Nicklin „ F. W. Florance ,, Miss M. A. Roll „ L. H. George „ Miss M. Shaw „ T. Hendy „ W. Stockman Ex-officio. Councillor Mrs. I. B. Thomas, J.P., Mayor of Bermondsey. STAFF: MEDICAL OFFICER OF HEALTH D. M. Connan, M.D., B.S., (Lond.), M.R.C.S., L.R.C.P., D.P.H. ADMINISTRATIVE OFFICER J. W. J. Saward, A.F.C., M.R.I.P.H.H. PUBLIC ANALYST A. Prideaux Davson, A.R.C.Sc., F.R.I.C., F.C.S. (Retired September, 1956). D. G. Allen, B.Sc., F.R.I.C. (with effect from 30th September, 1956). PUBLIC HEALTH INSPECTORS F. L. Richardson, Chief Public Health Inspector and Factories Inspector. W. A. Campbell, Wharves Inspector and Deputy Chief Public Health Inspector. H. E. Butcher, Wharves and Food Inspector. W. C. Tapsfield, Wharves and Food Inspector. A. W. Hancock, Food and Drugs Inspector. W. A. Pilson, Drainage Inspector. L. T. Knott, District Inspector. W. F. Smith, District Inspector. S. R. Weightman, D.P.A.(Lond.), District Inspector. C. H. Whitelock, District Inspector. CLERICAL STAFF H. D. White (Senior Clerk). A. E. Gambrell. E. T. Hodgkins. G. A. Blake. G. A. Hunt. A. J. Kiddell. E. M. Watkins. M. W. Bridgman (H.M. Forces with effect from 12th March, 1956). Miss S. Denham. WELFARE ASSISTANT Mrs. M. V. Reynolds, M.W.I. STREET AND OPEN MARKETS Market Collectors and Supervisors—J. A. Hart, C. E. Featherstone DISINFECTING AND CLEANSING STATION. A. Manning, Supervisor (Retired April, 1956). R. Towll, Supervisor (with effect from June, 1956). INVESTIGATOR, RODENT CONTROL H. E. Staples Borough of Bermondsey. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH. To the Mayor, Alderman and Councillors of the Borough of Bermondsey. Madam, Ladies and Gentlemen, I beg to present my Annual Report for the year 1956 and, as this will be the last report for which I shall be responsible, it provides a suitable opportunity for commenting on the changes which seem to me to have taken place in the sanitary condition of the Borough during my time as Medical Officer. I came to Bermondsey in March, 1920, as Assistant Medical Officer in the Tuberculosis Dispensary, so that my acquaintance with conditions in the Borough extends over about one third of a century. I was appointed as Medical Officer of Health in the Autumn of 1928, having acted in that capacity for about six months previously owing to the absence through sickness of my predecessor. I was fortunate in having so kindly and experienced a man as Dr. King Brown to succeed as I was also in having so nice an apprenticeship, so to speak, before assuming full responsibility as Medical Officer of Health. From the very first, owing to Dr. King Brown's kindly interest in my career, I was encouraged to take a really active part in the whole work of the department. Thus, I was employed far beyond the limits of work in the Tuberculosis Dispensary and, in the year 1920, I was engaged in the inspection of houses in the Hickman's Folly area under the guidance of Dr. King Brown ; this area is now covered by the Dickens Estate of the London County Council. As in many other districts throughout the country, the most striking changes which have taken place in connection with sanitary conditions in this Borough are those which concern the housing of the inhabitants. For instance, most of the property in the Hickman's Folly area comprised small two-storied cottages not only deficient both as to water supply and Hickman's Folly Before 1930 Tay Buildings, Decima Street, 1933 W.C. accommodation but damp and dark, and with bad internal arrangements and many other defects which combined together to render them totally unfit for human habitation. Thus it was that, when the 1914-1918 war was over, the problem of housing the people engaged the earnest attention of the Council at once. It was at this time also that changes in the political complexion of the Council gave added impetus to the movement for improving housing conditions. The major part of the work, so far as housing was concerned, had fallen upon the Chief Sanitary Inspector who, at first, was given the additional title of Housing Manager; he was, however, subsequently designated Housing Director and put in charge of a Housing Department separated from the Public Health Department. Since that time, almost a hundred insanitary areas have been dealt with, most of them being small areas, of course, but all of them requiring each house to be individually inspected by the Medical Officer of Health and the District Sanitary Inspector, the necessary schedules to be prepared and, usually, the holding of a public enquiry by a Ministry Inspector. The representation of these areas remained, and still remains, a function of the Medical Officer of Health while the provision of new housing accommodation and the management thereof is allotted to the Housing Department. So far as building in this Borough is concerned, the new accommodation has, for obvious reasons, almost all been provided in flats; one experiment was made, however, chiefly under the impetus given by Dr. A. Salter, M.P., providing for the erection of cottages at the Garden Estate in Salisbury Street. Although I suppose most folk would prefer a house and a garden to a flat in which to bring up a family, considerations of space and population in this Borough render that alternative impossible. So it has come about here, as in other parts, that the physical appearance of the whole area has changed. Many problems have been encountered by the two departments but they have been solved during the years by good will and understanding. Standards have changed and have very much improved. It is only necessary to compare the block of flats known as Vine Lane Buildings, erected in 1884 by the London Labourers Dwelling Society Ltd., with, say, the Neckinger Estate or Pynfolds to note the tremendous improvement in design and amenity which has been achieved under the Housing Department. Included among the many problems still to be solved, however, is the dampness in some flats which is often attributed to condensation, perhaps not altogether reasonably. I think also that more attention should be given to management of property where the adequate maintenance is largely a question of personal care. It is for this reason that I have always insisted on the necessity of " house to house " inspection by the District Sanitary Inspectors who really are the only protection which the tenant has against a bad landlord, whether it be a private owner or a public authority. One other irritating difficulty which I have encountered in this Borough is the very confusing method of naming and of numbering flats. Following on the subject of housing, I cannot help remarking on the considerable increase in the number of playgrounds for children, and the praise due for this helpful provision must be shared between the Borough and the London County Councils. At this point also, the change in the Borough, as far as offensive trades is concerned, must be noted. I have always been sorry that the opportunity of using the Rotherhithe Street area for offensive trades was not exploited. This street was, at one time, the longest street in London and a number of "nuisance" trades was centred there. It was, and still is to a large extent, separated from the rest of the Borough, running as it does between the river on one side and the Surrey Commercial Docks on the other and, as the area is mainly an industrial one, the transfer of" nuisance " trades from other parts of Bermondsey would have been for the good of the whole Borough. It is certainly not a popular area with tenants now. Other changes, as distinct from those such as statistical changes obvious only to the expert, will be noted by the public in connection with street markets and public conveniences, which are controlled by the Public Health Department, dusting and cleansing of streets, controlled by the Works Department, and the provision of trees in the streets by the Gardens Department. I suppose the most noticeable change which has taken place in my time here has been the fall in the incidence of infectious diseases. I remember that, in 1922, there were eleven hundred cases of diphtheria; last year there were none. A similar, though not perhaps so striking a fall, has been observed in the incidence of many other infectious diseases in this, and other, districts. We are extremely grateful for this trend and, although we are able to suggest many factors which have obviously played a part in producing this result, it is not possible to attribute the fall to any one predominant factor. The same trend is observable in tuberculosis and, combined with the administrative changes which have taken place in the health schemes of the whole country, it seems to me that the time may have come to abolish the Dispensary Scheme as devised by Sir Robert Philip and to transfer consultant clinics to the hospitals where, in my opinion, that work now properly belongs, leaving the investigation of home conditions and the provision of accommodation to the local health authority. Another subject which almost immediately received attention in 1920 was maternity and child welfare. As was the case with tuberculosis, the first efforts to deal in a systematic way with this problem was made by voluntary effort. The voluntary Tuberculosis Dispensary was first opened in 1911, and I believe there were Health Visitors employed by voluntary bodies as far back as 1911 but, of course, real impulse and direction were given to the movement by the Maternity and Child Welfare Act of 1920. Much good work was done in the Borough under this act until 1948 when, by the passage of the National Health Service Act, responsibility was transferred to the London County Council. While the former act was in force the Borough Council established a Maternity Hostel at 110 Grange Road but it was eventually closed because it was found to be unnecessary and excessively costly. As the result of a gift from Dr. Salter M.P., the Borough also established a convalescent home for women and children at Fairby Grange at Fawkham, in Kent. This was a lovely place and used to be exceedingly popular in the summer months but, after a number of years, it also had to be closed on somewhat obscure legal grounds. Two municipal dental clinics, established under the same act, did magnificent work for many years until they were transferred under the National Health Service Act 1948, one clinic going to the Regional Dental Board, and the other to the London County Council. As a direct result of a lecture given at Guy's Hospital by Dr. Rollier of Leysin, our Council were very impressed by the results he had obtained in the treatment with natural sunlight of cases of surgical tuberculosis, and it was decided to send a number of patients to Leysin for treatment. The results were very encouraging but this arrangement was suspended when war broke out in 1939 and it came to an end when responsibility for the treatment of tuberculosis was transferred under the National Health Service Act 1948. Simultaneously with the decision to send patients to Leysin, the Council also decided to set up a Light Treatment Centre for cases of surgical tuberculosis and for the treatment of under-weight and ill-nourished children. This scheme was begun in 1924 in the premises of the Tuberculosis Dispensary at 108 Grange Road and the council were so pleased with the results that, after prolonged consideration, it was decided to replace the old buildings at 108/10 Grange Road by a properly designed building which was to include a physiotherapy department, a "foot" clinic, an infant welfare department, dental clinics and an X-ray department. After the usual number of changes and modifications, the new building, designated the Public Health Centre, was finally opened in 1937. It flourished exceedingly and became very popular with the public. The X-ray department actually carried out a larger number of examinations per annum than the local general hospital — I believe it still does—and the quality of the films taken reached a very high standard indeed. That part of the clinic which seemed to appeal most to the public, however, was the section devoted to physiotherapy. This included provision for all forms of electrical treatment, diathermy, ultra-violet light and radiant heat treatment together with massage and a great variety of exercises. I think the reason for this somewhat unexpected popularity may be found in the following three facts : (i) the whole of the Borough, except for two tiny areas, lies below High Water Mark and, therefore, most of the houses were inveterately damp and, consequently, rheumatism in its many forms seemed to be very prevalent, (ii) the majority of the inhabitants of the Borough work with their muscles and they often received very great relief from one or other of the forms of physical treatment available and were able to get back to work quickly, (iii) there was a popular demand for this form of treatment at the time, and there was no other place in the vicinity at which such treatment could be obtained so speedily and conveniently. Whatever the reason, there is no question about the popularity of the Clinic nor of the dismay at the change which took place in 1948. The building still functions in a sort of a way, though the heart has gone out of it. The Medical Officer of Health was still retained as Honorary Medical Superintendent but shorn of all control and, instead of one authority, there were three or four, all of which had some say in the management of the centre, with much resultant confusion and lack of co-ordination. In fact, the confusion is such that, even eight years after the passing of the act, the financial details of the transfer have not yet been completed and, as yet, there is no single authority directing the management of the building and the operation of the services. The disappointment amongst the members of the Borough Council has, naturally, been intense not so much, perhaps, at the transfer of functions from their control as at the slow demise of a living organism which they themselves had originated and which they saw slowly dying before their eyes simply through lack of knowledge and lack of interest on the part of the " powers that be " This result of the National Health Service Act, disastrous so far as this Borough is concerned, seems to have been due to two factors : (1) insufficient consideration while the act was in the bill stage, probably due to the desire of the government of the day to get the bill on the statute book at once, and (2) lack of understanding of local circumstances. Anyway, whatever the explanation may be, it is rather a sad ending to a very great and devoted effort by the Borough Council and one which was worthy of far more considerate treatment than it has had. Another indirect result of Dr. Rollier's lecture on tuberculosis was the setting up of a Propaganda Section in the Public Health Department. The Council decided to do this in 1924 and to concentrate, in the first instance, on trying to secure for the Borough a supply of tubercle free milk. In this objective they were remarkably sucessfull and almost every milk seller eventually had a licence to sell tuberculin tested milk. Naturally, this project developed and we were soon dealing with almost all aspects of public health. Lectures and talks were given to all sorts of audiences, both great and small. They were all illustrated and a good deal of interest was created ; quite often there was some amusement with hecklers, especially when we operated in the open air. We made our own slides and films because, at that time (1924), films on health subjects were not obtainable. We also had the permission of the London County Council to go into the schools when asked to do so. In all, a great deal of good work was done, but it came to an end with the outbreak of war. During the war, the population of the Borough dropped to less than fifty thousand and a very large amount of property, both residential and industrial, was destroyed or badly damaged, and it seems to be quite clear that, in the future, this Borough will never be more than a very small one. At the beginning of the century there were about three hundred local authorities in the London area, each with its own governing functions. These were reduced to about thirty by the Metropolis Management Act. By this act, a revolution in the Public Health Centre, Grange Road, 1936. The Original Grange Road Welfare Centre and T.B. Clinic, 1934. Nos. I08-IIO Grange Road local government of London was achieved, and the time appears to have arrived for a similar act for the better local government of the capital. It is an immense problem, full of difficulties, and one to which much thought has been given by many of the best minds; it is, in all probability, insoluble. Like many other folk working in local government, I think it would be well if the service were totally divorced from politics. lam aware that this is not possible until some radical change takes place in human nature, but I have spent much time in considering the problem as it affects this Borough in the public health side of its sunctions, and it seems to me that the time has arrived for it to be approached from a somewhat different angle. Local government has two prevalent habits of mind which are very convenient from the point of view of the official but not so satisfactory from the point of view of the governed —I mean secrecy and anonymity. So far as secrecy is concerned, I remember receiving documents marked " Confidential" from a high authority when the subject of the confidential documents was on the agenda for the Public Health Committee at which I was supposed, as Medical Officer of Health, to attend and to advise. As to what I mean by anonymity, I remember an occasion when a diphtheria swab taken in a school on a Friday afternoon was found to be positive on the following morning when neither the name nor the whereabouts of the doctor who took the swab could be discovered. I think there are two or three principles which should always be in the mind of a medical officer: firstly, he should always remember that he is the servant of the public; secondly, if he has a job to do he should do it at once; and thirdly, he should examine complaints personally. Far too much time is spent on office work and at committees and too Little time is given to personal investigation of the conditions of the district. This suggestion that a medical officer should be well acquainted, personally, with his district and, incidentally, with his staff, is not by any means universally observed and, in itself, provides a clear indication of the size of units which ought to be contemplated ; for one man certainly could not deal properly with a population of more than two hundred thousand or so and have much personal knowledge of these people and their problems. The present policy seems to be to combine the areas of two small boroughs to make one district for the purpose of public health administration and, if action of this kind is taken for Bermondsey, it will almost certainly mean some arrangement with the adjacent borough of Southwark. Some such combination will, undoubtedly, come to pass in the future and it is to be hoped that it will not be merely the combination of two departments but that there will be the actual amalgamation of boroughs, giving to the new borough a high degree of independence of action so as to preserve, so far as possible, local interest in local government and to avoid, if possible, the ponderously slow reactions of a very large authority. There have been few changes in the functions and work of the Council so far as food control is concerned. The Food and Drugs Act has been operated in this last year on the same lines as it was in 1920 though, of course, the statistics are different. So far as imported food is concerned, there have been no special changes during my time as Medical Officer of Health though many interesting problems have arisen from time to time. When I was a student, I was strongly advised by my teachers to have nothing to do with services such as the asylum and public health services; indeed, I did not choose the public health service as a career but I came into it, somewhat by accident. As a patient in hospital myself not so long ago, I heard two young doctors discussing careers and saying that public health provided the laziest avenue in the whole of medicine, and the dullest. Certainly it is true that a job is what you make it, and I have never found time to be really lazy. As for the criticism that it is a dull career that is not by any means true here. I have been very happy with my colleagues, not only in the Public Health Department but in other departments, and though I have never had anything to do with local politics I have also been very fortunate in the committees it has been my duty to attend and, especially, in the chairmen of the Public Health and Maternity & Child Welfare Committees, with whom it has been really a pleasure to work. On the other hand, to show that life has not been dull in Bermondsey in my time, it is only fair to say that I have twice been present at a committee when it was moved by a member that I be dismissed, I have been offered a quite substantial money bribe by an importer of food, I have four times been threatened with violence (once with a nasty looking weapon), and once I was actually attacked. I have made many real friends, however, and have come to the end of my term of office with many happy memories and one regret only— that the time has come to go ! I am, Madam, Ladies and Gentlemen, Your obedient Servant, D. M. CONNAN. VITAL STATISTICS. AREA The area of the borough (exclusive of area covered by water) is 1,336 acres. POPULATION Census Estimate of Registrar-General 1931 1951 to 30th June, 1955 to 30th June, 1956 111,542 60,640 57,580 56,200 BIRTHS The total number of births belonging to the borough registered during 1956 was 913 consisting of 475 males and 438 females. The number for 1955 was 931. The birth-rate for 1956 was 16·24 per thousand persons living, compared with 16·17 for 1955. DEATHS The total number of deaths belonging to the borough registered during 1956 was 569, consisting of 315 males and 254 females. The number for 1955 was 578. The death-rate for 1956 was 10·1 per thousand persons living, compared with 10.04 for 1955. MARRIAGES The total number of marriages in the borough in 1956 was 468, being 33 below the number for 1955, and 101 below the average for the last 10 years. The figures have been supplied by the Superintendent Registrar. No. Rate Year 1946 665 23·62 684 23.17 1947 595 19·70 1948 1949 609 20·15 545 18·23 1950 582 19·28 1951 516 17·26 1952 520 17·52 1953 16·21 475 1954 17·40 1955 501 569 19·25 Average for years 1946-1955 1956 468 16·6 INFANTILE MORTALITY Whole Borough London Year Rate per 1,000 Births No. of Deaths Rate per 1,000 Births No. of Deaths 1946 53 2,527 39 38 1947 50 33 2,454 34 1948 1,869 20 16 31 1,517 1949 29 27 33 1,372 1950 23 20 26 1951 25 1,333 25 27 1952 20 20 1,189 23 27 1,216 1953 27 24 1954 23 24 1,047 21 1955 21 23 1,157 23 Average for years 1946-1955 26 27 1,568 30 1956 18 1,106 21·3 16 TUBERCULOSIS Of THE RESPIRATORY SYSTEM In the following Table will be found particulars of deaths from Tuberculosis of the Respiratory System since the year 1946. Year Whole Borough London No. Rate No. Rate 1946 32 0·57 0·78 2,033 1947 52 0·88 1,940 0.62 0·74 2,044 1948 45 0·62 1949 41 0·68 1,900 0·57 1950 23 0·38 1,585 0·47 1951 21 0·35 1,225 0.36 1952 20 0·35 0·34 1,154 1953 14 0·24 933 0·28 1954 0·24 596 0·18 14 1955 0·14 517 0·16 8 Averages for years 1946-1955 27 0·45 1,392 423 0.43 1956 10 0·13 0·18 VITAL STATISTICS OF WHOLE DISTRICT DURING 1956 AND PREVIOUS YEARS. Deaths of Non- Residents registered in the District 10 Deaths of Residents regisstered beyond the District 11 Net Deaths at all Ages belonging to the District Total Deaths registered in the District Total Deaths in Hospitals in the District 9 Year 1 Population estimated to Middle of each Year 2 Births Rate 4 No. 3 Under 1 Year of Age At all Ages No. 12 Rate 13 No. 5 Rate per 1,000 Births registered 6 No. 7 Rate 8 424 191 242 779 13·8 1,353 24·0 18 13 728 12·9 1946 56,320 777 13·2 766 13·0 421 198 209 59,040 1,531 25·9 22 14 1947 710 11·8 11·0 332 166 200 1,218 20·2 16 13 676 1948 60,410 12·0 11·0 108 170 726 1,140 18·9 16 14 664 301 1949 60,440 181 175 12·1 10 731 12·2 413 725 1950 59,810 1,146 19·2 9 743 12·3 11·9 417 180 200 1951 60,380 17·6 10 9 723 1,062 738 12·9 510 183 12·5 16·7 5 771 216 1952 59,780 998 5 9·9 28 28 664 11·2 445 214 135 585 59,350 970 16·3 1953 112 579 9·9 24 673 11·5 206 1954 58,590 986 16·8 23 455 452 202 137 578 10·0 57,580 16·2 21 23 643 10·9 1955 931 Averages for years 1946-1955 11·8 417 186 176 694 11·7 1,133 17 59,170 19·2 15 704 913 16·2 18 16·16 10.9 167 126 569 407 10·0 CAUSES OF, AND AGES AT, DEATHS DURING THE YEAR 1956. Deaths at the subjoined ages of "Residents" whether occurring in or beyond the District All Ages 0-4 5-14 15-24 Causes of Death 25-44 45-64 Tuberculosis, respiratory - - 2 1 5 10 Tuberculosis, other - - - - - - 1 Syphilitic disease 1 - - - - Diphtheria - - - - - - - - - - - - Whooping Cough Meningococcal infections - - - - - - Acute poliomyelitis 1 - 1 - - - Measles - - - - - - Other infective and parasitic diseases - - - - - - Malignant neoplasm, stomach 18 - - - - 4 Malignant neoplasm, lung, bronchus - - 2 16 27 - Malignant neoplasm, breast 5 - - - - 1 Malignant neoplasm, uterus 5 - - 2 - - Other malignant and lymphatic neoplasms 60 - - - 1 24 Leukæmia, aleukæmia 2 - - - 2 - Diabetes 4 - - - - - Vascular lesions of nervous system 44 - - - - 7 Coronary disease,angina 73 CAUSES OF, AND AGES AT, DEATHS DURING THE YEAR 1956—continued. Causes of Death Deaths at the subjoined ages of "Residents" whether occurring in or beyond the District All Ages 0-4 5-14 15-24 25-44 45-64 65-74 75 & over - - - - Hypertension with heart disease 13 - 4 9 Other heart disease 62 - 5 - - 13 17 27 Other circulatory disease 49 - - 1 11 32 - 5 Influenza - - - - - - - - Pneumonia 40 2 - - - 6 9 23 Bronchitis 58 1 - - 1 15 20 21 Other diseases of respiratory system 5 - - - 3 - - 2 Ulcer of stomach and duodenum 10 - - - - 2 4 4 Gastritis, enteritis and diarrhoea 2 1 1 - - - - - Nephritis and nephrosis 5 - - - - 2 - 3 Hyperplasia of prostate 2 - - - 2 - - - Pregnancy, childbirth, abortion - - - - - - - - Congenital malformations 5 2 - - 1 2 - - Other defined and ill-defined diseases 51 14 - - 2 10 14 11 Motor vehicle accidents 3 1 - - 1 1 - - All other accidents 6 1 - - 1 3 1 - Suicide 8 - - 1 5 2 - - Homicide and operations of war - - - - - - - - 3 2 17 190 204 Total Certified Deaths 569 20 133 INFANTILE MORTALITY. Deaths from Stated Causes at Various Ages under One Year of Age, 1956. Cause of Death Under 1 week 1-2 weeks 2-3 weeks 3-4 weeks Total under 1 month 1-3 months 3-6 months - - - - - - - Measles Scarlet Fever and Streptococcal Sore Throat - - - - - - - Whooping Cough - - - - - - - Diphtheria - - - - - - - Influenza - - - - - - - Meningococcal Infections - - - - - - - Tuberculous Meningitis - - - - - - - - - - - - - Non-Meningococcal Infections - Tuberculosis of Respiratory System - - - - - - - - ther Tuberculous Diseases - - - - - - - - - - - - - Syphilis and its Sequelæ Bronchitis - - - - - - - Pneumonia - - - - 2 1 - Other Respiratory Diseases - - - - - - - Gastro Enteritis and Colitis - - - - - - - Congenital Malformations 1 - - - 1 1 - Birth Injuries, Post-Natal Asphyxia and Atelectasis - - - 1 10 9 - Infections of the Newborn - - - - - - - Other Diseases peculiar to Early Infancy and Immaturity Unqualified 1 - - - 1 - - Other Causes 2 - - 2 - - - Totals 13 14 1 3 EXTRACTS FROM VITAL STATISTICS, 1956 Births. Registered— Total Males Females Live Births Legitimate Illegitimate 876 37 453 22 423 15 Total Males Females Stillbirths Legitimate Illegitimate 20 - 13 - 7 - Rate per 1,000 total (live and still) births 21.4 Notified within 36 hours of birth— (1) Live Births, 892 (2) Stillbirths, 35 (3) Total, 927 Total Males Females Deaths 569 315 254 Muternal Deaths. Deaths. Rate per 1,000 total (live and still) births Deaths from complications of pregnancy, childbirth and the puerperium NIL NIL Death Rate of Infants under 1 year of age. All Infants per 1,000 live births 18-22 Legitimate infants per 1,000 legitimate live births 17.56 Illegitimate infants per 1,000 illegitimate live births NIL Day Nurseries. Number of day nurseries 4. Deaths from Malignant Neoplasms (all ages) 115 INFECTIOUS DISEASES. NOTIFICATION Of INFECTIOUS DISEASES Every medical practitioner attending on, or called in to visit a patient, shall, as soon as he becomes aware that the patient is suffering from a notifiable infectious disease, send to the Medical Officer of Health of the district in which the disease occurs a certificate stating the name and address of the patient and the disease from which the patient is suffering. Books of certificates are available free of charge from this Department. The following diseases are notifiable: — Acute Encephalitis Malaria Acute Influenzal Pneumonia Measles Acute Primary Pneumonia Membranous Croup Acute Poliomyelitis Meningococcal Infection Anthrax Cholera Ophthalmia Neonatorum Plague Continued Fever Puerperal Pyrexia Diphtheria Relapsing Fever Dysentery *Scabies Enteric Fever (includes Typhoid and Paratyphoid) Scarlatina or Scarlet Fever Erysipelas Small-pox Food Poisoning Tuberculosis Glanders Typhus Fever Hydrophobia in Man Whooping Cough Leprosy (to be notified to Chief Medical Officer, Ministry of Health) *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. FOOD POISONING Nineteen cases of food poisoning were notified to me during the year under The Food and Drugs Act, 1955, Section 26. CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1950. Neckinger Central Tunnel Dockyard Park Raymouth South Thorburn Willow Walk South West Abbey Leather Market Total Total Cases removed to Hospital NUMBER OF CASES NOTIFIED Saints NOTIFIABLE DISEASE At all Ages At Ages—Year 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 & upwards 4 - - - - - - - - 2 - 2 1 - - 1 1 - - - 1 - - 4 - 2 Erysipelas 82 Scarlet Fever 82 - 26 41 13 1 - - 1 - - 2 4 2 9 4 4 5 5 2 9 11 13 12 4 - Dysentery 7 14 7 12 8 1 6 9 23 39 6 6 12 1 8 5 14 8 27 164 14 164 9 34 50 13 9 Acute Polio-Myelitis and Acute Polio-Encephalitis - - 2 - - - - - - - - - - - - 1 1 - - - - - - - 2 2 2 Puerperal Pyrexia 1 - - - - - 1 - - - - - - - - 1 - - - - - - - 1 - - - 2 19 1 Food Poisoning 19 - 1 5 2 1 1 3 3 1 1 1 - - 8 1 1 - - 2 - 5 - - Pneumonia (Acute Primary and Acute Influenzal) 30 1 5 2 - 2 - 1 3 - - 4 9 2 1 1 1 4 2 5 1 30 - - 5 6 5 Whooping Cough 43 12 26 2 - - - - - - - 1 7 11 4 2 4 3 1 1 1 2 3 3 43 3 3 Measles 149 8 83 54 2 1 - 1 - - - 4 3 23 15 44 6 4 4 - - 22 5 19 149 4 - Scabies 4 - 2 1 1 - - - - - - 2 - - - - - - - - - - 1 1 4 - - Tuberculosis- Respiratory System 60 - 2 2 4 5 13 11 5 8 8 9 5 3 8 7 3 2 1 3 2 2 3 60 - 2 12 Other forms of Tuberculosis 6 - - - - 1 2 2 - 1 - - - 2 2 1 - - - - 1 - - - 6 - - Totals 17 25 28 76 88 69 25 27 15 15 53 38 564 564 21 165 183 35 18 14 35 29 23 24 28 77 30 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEARS 1947-1956. Notifiable Disease. 1947 1948 1949 1950 1951 1952 1953 Small Pox 1 - - - - - - Diphtheria (including Membranous Croup) 34 65 2 2 37 3 Erysipelas 12 13 7 9 9 8 Scarlet Fever 152 199 85 72 82 87 Meningococcal Infection 3 1 - 1 6 2 Acute Polio-Myelitis and Acute Polio-Encephalitis 27 7 4 3 2 1 Ophthalmia Neonatorum 2 5 3 - 1 2 Anthrax 1 1 - - - - Enteric Fever 1 - - - 1 - Puerperal Pyrexia 4 5 5 4 18 19 1 Puerperal Fever 4 - - - - - Food Poisoning - - - - - - Dysentery 4 2 1 4 131 7 Paratyphoid Fevers - - - - - - Malaria 1 1 - - - - - Pneumonia (Acute Primary and Acute Influenzal) 52 43 57 16 28 25 40 Whooping Cough 297 237 40 267 75 124 40 Measles 334 899 771 367 1197 716 514 Scabies 81 42 7 2 6 4 - Tuberculosis — Respiratory System 100 120 105 89 59 72 105 Other forms of Tuberculosis 16 27 12 10 9 8 10 TUBERCULOSIS. In Table I are set out particulars of new cases and deaths during the year, and Table II shows the state of the Notification Register. TABLE I TUBERCULOSIS, 1956—NEW CASES AND DEATHS DEATHS AGE PERIODS NEW CASES Pulmonary Non- Pulmonary Pulmonary Non- Pulmonary M. F. M. F. M. F. M. F. 0 - - - - - - - - - - - - - - - - - - - - - - - - 1 - - - - 2 - - 2 - - - - - 2 - - 5 - - - - 1 - 2 - - - - 10 - 5 - - - 15 - 2 2 - - - - 20 9 4 1 - - - 1 25 7 1 5 - - - 35 2 4 1 - 45 - 1 - - 7 2 - 3 2 55 - - - 5 2 65 2 - - - - 1 - - 75 and upwards I 2 - - 3 37 25 2 4 7 - TABLE II TUBERCULOSIS, 1956—NOTIFICATION REGISTER Respiratory System Other Forms Males Females Males Females 41 325 256 39 2 Number of Cases on Register at commencement of Year Number of Cases Notified during Year 37 23 Inward Transfers, Un-notified Deaths, etc., during Year 16 - 8 8 Number of Cases Removed from the Register during Year 40 4 - 2 30 Number of Cases Remaining on the Register at end of Year 338 35 257 41 - Summary of Tuberculosis Notification during the period from the 1st January, 1956, to the 31st December, 1956. Formal Notifications Number of Primary Notifications of New Cases of Tuberculosis Age Periods 0 to 1 1 to 2 2 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 to 75 75 and upwards Total (all ages) Pulmonary, Males - - - 2 - 2 7 - 9 4 7 5 1 37 - - 2 - 2 5 2 4 4 1 - 2 23 „ Females 1 - - - - - - - - 1 - - 2 Non-Pulmonary Males 1 - „ Females - - - - - - 1 1 2 - - - - 4 New cases of Tuberculosis coming to the knowledge of the Medical Officer of Health during the above-mentioned period, otherwise has by formal notification : — Age Periods 0 to 1 1 to 2 2 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 to 75 75 and upwards Total Pulmonary, Males - - - - - - - - - - - - - - - - - - - 1 - - - 2 „ Females 1 - - - - - - - - - - - - - Non-Pulmonary Males - - - - - - - - - - - - - - „ Females - - - - SANITARY CIRCUMSTANCES OF THE BOROUGH HOUSING During the year the Slippers Place Area, comprising 159 dwelling houses and 1 shop with dwelling over, was represented. The Borough Council completed 219 flats, 263 were in course of erection at the end of the year and plans for 905 flats were prepared or in course of preparation. 438 families from the waiting list, clearance areas, etc., have been rehoused and 260 transfer and exchanges were arranged. This has resulted in 698 families being provided with better accommodation by the Borough Council. 655 families were rehoused by the London County Council, 51 having been specially recommended by the Borough Council. 27 families were accommodated in new towns. 17 E.F.M. Bungalows were demolished during the year. HOUSING ACT, 1936—OVERCROWDING The following new cases of overcrowding have been encountered during the year:— In private dwellings 11 In Bermondsey Borough Council dwellings - In London County Council dwellings 1 Total 12 Total number of cases of overcrowding at present on the Register 464 ERADICATION OF BED BUGS The following table shows the fumigations carried out during 1956:— Disinfested Council houses or flats 30 Other houses or flats 73 INSPECTIONS, PROCEEDINGS, ETC. Hereunder will be found particulars of Inspections, Proceedings, etc., for the year 1956:— Inspection of Dwelling-Houses during the Year:— (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 3,278 (b) Number of Inspections made for the purpose 19,166 (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 1,240 (b) Number of Inspections made for the purpose 1,867 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 8 (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 157 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 778 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 1,942 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners 545 (b) By Local Authority in default of owners 3 (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 1 (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 13 (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 (E) Proceedings under the Local Government (Miscellaneous Provisions) Act, 1953: — (1) Number of dwelling houses in respect of which Closing Orders were made under Section 10 (1) 8 (2) Number of dwelling houses in respect of which undertakings were received not to use for human habitation Nil Prosecutions Under the Public Health (London) Act, 1936:- (1) Number of prosecutions 17 (2) Fines imposed - (3) Costs awarded £59 17 0 REGISTERED PREMISES— Number on Register at end of 1956 Number of Inspections Number of Prosecutions Premises 72 - 2 Common Lodging Houses Seamen's Lodging Houses Milkshops Ice Cream Premises Offensive Trades (including Poultry Slaughter-houses) - 138 120 - - - - 204 48 11 8 - SMOKE NUISANCES— Number of observations 24 Number of notices 6 Number of complaints - Number of summonses - 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 606 Number of inspections 2,007 RAG, FLOCK AM) OTHER FILLING MATERIALS ACT, 1951:- Number of premises registered 3 DRAINAGE WORK Particulars of work carried out by the Drainage Inspector during 1956:— Drains Tested 889 Visits to Conveniences and Urinals 498 Other Visits 1,502 Total visits 2,889 HAIRDRESSERS AM) BARBERS All premises are inspected regularly to ensure that the requirements of the Byelaws are carried out and during the year 130 such inspections were made. HOUSING REPAIRS AND RENTS ACT, 1954. 26 applications for Certificates of Disrepair and 16 applications for revocation of Certificates of Disrepair have been granted during the year. WORK OF DISTRICT INSPECTORS, 1956 Mr. Knott Mr. Whitelock Mr. Weightman Mr. Smith TOTALS 652 444 382 389 1867 1 House-to-House 278 2 Special Inspections 822 499 1077 2676 571 2525 634 606 714 3 Complaints 152 158 160 4 Infectious Diseases 122 592 45 42 31 5 123 5 Rats 38 24 19 126 6 Outworkers' Inspection 45 39 48 214 7 Drains Tested 55 72 4041 8 Other Calls and Visits 2574 2256 2386 11257 9 2 9 Chimneys watched 12 29 52 40 10 Bakehouses 4 15 3 43 64 21 107 35 18 11 Common and Seamen's Lodging 72 - 29 - 374 12 Butchers 115 80 115 28 13 Fishmongers, Friers and Curers 32 109 28 139 14 Food Stores 600 188 166 44 140 33 28 15 Fruiterers and Greengrocers 70 - 19 10 16 Pet Animals 41 70 236 17 Markets 34 68 64 - 32 18 Restaurants and Eating Houses 19 Destruction of Food 3 28 20 57 4524 406 1 76 10 15 31 20 Hairdressers 35 130 10 28 6893 659 4610 374 5284 503 21311 1942 21 Totals Visits intimation Notices FACTORIES AND OTHER PREMISES HOMEWORK NATURE OF WORK Section 110 Section 111 Number of out-workers in August list required by Section 110 (1) (c) Number of cases of default in sending lists to the Council Number of prosecutions for failure to supply lists Number of instances of work in unwholesome premises Notices served Prosecutions - Wearing Apparel— Making 27 27 - - - - - - - - Cotton Bags 12 - Sacks - - - - - - 1 - - - Paper Bags - - 6 - - - - The making of Boxes or other Receptacles or parts thereof made wholly or partially of paper - - - - Brush making - - - - - - - Publishers 6 Lampshades 1 - - - - - - Carding of Buttons, etc. - - - - - 1 - - - Christmas Crackers - - - Fancy Goods 2 - - - - 55 Total - - - - - (31) FACTORIES AND OTHER PREMISES INSPECTION Number on Register Number of Premises Inspections Written Notices Occupiers Prosecuted (i) Factories in which Sections 1,2,3,4 and 6 are to be enforced by Local Authorities 219 121 2 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 409 632 - - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers premises) Total 62 237 - - 690 990 2 - DEFECTS FOUND Particulars Number of Cases in which Defects were found Number of defects in respect of which Prosecutions were instituted Found Remedied Referred to H.M. Inspector Referred by H.M. Inspector Want of Cleanliness (S.1.) - - - - Overcrowding (S.2.) - - - - - - - - Unreasonable Temperature (S.3.) - - - - - Inadequate (S.4.) - - - Ineffective Drainage of Floors (S.6.) - - - - - - - - Sanitary Conveniences (5.7.)— Insufficient - - - 2 2 - - - - - - - Unsuitable or Defective Not separate for Sexes Other Offences - - - - - (Not including offences relating to Home Work) Total 2 - - - 2 BAKEHOUSES In Use Not in Use Underground Above ground Above ground Underground 1 25 - - 26 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 1956:— Disposal Loads tons cwts. qrs. House Refuse to Barge 10,420 17,656 7 - 4,307 19 - Trade Refuse to Barge 7,682 774 443 17 - Street and Open Markets Refuse to Barge 15,501 25,783 3 3 Totals OFFENSIVE TRADES The offensive trades on the Register are as follows:— Fellmongers 3 Dresser of Fur Skins 4 Glue and size makers 1 PET ANIMALS ACT, 1951 During the year 7 licences to keep a pet shop were granted. Three of these were in respect of stalls in market places. Inspections are made to ensure that the terms of the licence are complied with. CATERING ESTABLISHMENTS Inspections 251 Notices served 95 Re-visits 461 WORK OF THE FACTORIES AND SHOPS INSPECTOR Shops. Visits - Notices served under Shops Act - Notices served under Public Health (London) Act, 1936 - Factories (with mechanical power). Visits 167 Notices under Factories Act, 1937 - Notices under Public Health (London) Act, 1936 - Factories (without mechanical power). Visits 13 Notices under Factories Act, 1937 2 Notices under Public Health (London) Act, 1936 - Workplaces. Visits 90 Notices under Public Health (London) Act, 1936 - Visits to Offensive Trade premises 11 Smoke observations 22 Other calls and visits 438 (35) RODENT CONTROL Prevention of Damage by Pests Act, 1949. Type of Property Local Authority Dwelling Houses All other (including Business and Industrial) I. Total number of properties in Local Authority's District 15,014 2,294 33 11. Number of properties inspected by the Local Authority during 1956 as a result of (a) of notification or (b) otherwise. 324 (a) 7 139 (b) 13 - 560 111. Number of properties (under II) found to be infested by rats. Major- — 23 Minor 11 223 264 IV. Number of properties (under II) found to be seriously infested by mice 133 3 101 V. Number of infested properties (under 111 and IV) treated by the Local Authority 334 324 14 VI. Number of Notices served under Section 4:— - - 1. Treatment - 2. Structural Works (i.e. Proofing) - - - - Total - - VII. Number of cases in which default action was taken by Local Authority following issue of Notice under Section 4 - - - VIII. Legal Proceedings - - - IX. Number of " block " control schemes carried out FOOD CONTROL. Public Analyst The Public Analyst, Mr. A. P. Davson, retired on 30th September, 1956, after nearly 30 years' service with the Council. He was succeeded by Mr. D. G. Allen, who had been Deputy Public Analyst since 1949. Mr. Davson was appointed Public Analyst in January, 1927 and took over two rooms in the old Tuberculosis Dispensary at 108 Grange Road. When the new Public Health Centre was built in 1936 a fully equipped laboratory was incorporated for the use of the Public Analyst. Control of the Public Health Centre was, alas, lost to the Council with the passing of the National Health Service Act in 1948 and Mr. Allen has had to make arrangements for his accommodation with the Ministry of Health. PUBLIC HEALTH (IMPORTED FOOD) REGULATION, 1937/48. FOOD AND DRUGS ACT, 1955. Sixty-five samples were taken during the year by the Wharves Inspectors. Result Action Article Examined No. of Samples Purpose of Examination Blackcurrant Pulp 1 For presence of preservatives Satisfactory Released „ „ Bubble Gum 1 To ascertain composition „ „ „ 5 Butter To ascertain condition „ „ „ Carrots, Dried For presence of preservatives 1 „ „ „ Cream, Tinned To ascertain condition 2 „ „ „ Cucumbers, Canned For presence of preservatives Released with warning regarding labelling 11 Cucumbers, Canned Benzoic Acid 650 parts per million „ „ Consignment reexported 1 „ „ „ „ Benzoic Acid 610 parts per million Consignment detained 1 Article Examined No. of Samples Purpose of Examination Result Action 1 For presence of preservatives Consignment detained Cucumbers, Canned „ „ Benzoic Acid 770 parts per million 1 „ „ „ „ Benzoic Acid 680 parts per million Benzoic Acid not detected 1 Released Cucumbers, Pickled „ „ 2 For metallic contamination „ „ „ Curry Mixture, Malayan Satisfactory 1 To ascertain nature of white powder on dates Dates,Diced Powder proved to to be Cornflour 1 „ For presence of preservatives Egg Albumen, Dried Satisfactory To ascertain composition 1 „ Egg Product, Synthetic „ „ 1 For presence of preservatives „ Egg Albumen, Liquid „ „ 10 „ Gherkins „ „ „ „ 1 Jam, Raspberry (Hungarian) To ascertain composition „ „ „ 1 „ Margarine „ „ „ „ „ Meat Balls, Cocktail 1 To ascertain composition and verify weight „ „ 1 To ascertain condition „ Milk, Evaporated „ „ 1 For metallic contamination and to ascertain condition „ Mussels in Brine „ „ „ 1 For presence of preservatives Mustard, „ „ „ „ 2 „ „ Orange Juice „ 1 For metallic contamination „ Peaches, Canned „ „ 1 To ascertain condition „ Peppers, Red (Spanish) „ „ 1 Pork in Natural Juice „ „ „ „ „ Article Examined No. of Samples Purpose of Examination Result Potato, Dried 1 For presence of preservatives Satisfactory Rice, Flaked In contact with leaking cylinders of propane gas No propane gas detected 1 Ravioli 1 To ascertain composition Satisfactory 1 To ascertain composition „ „ Sausages, Frankfurter Sausages, Cocktail To ascertain composition and to verify weight 3 „ „ Soup Mix For presence of preservatives „ „ 2 Soy To ascertain composition „ „ 1 Tapioca, Flaked No propane gas detected In contact with leaking cylinders of propane gas 1 Tomato Puree in Tube Satisfactory For presence of preservatives 1 SECTION 14, FOOd & DRUGS ACT AND DAIRIES Inspections Ice Cream Premises 204 98 Preserved Food, etc. 93 311 Dairies 4 24 DISPOSAL OF UNSOUND FOOD Condemned food suitable for animal feeding is disposed of for this purpose under supervision. Condemned food for destruction is collected by Council's van and barged with household refuse. FOOD PREMISES AND TYPES OF BUSINESS Restaurants, cafes and snack bars 141 Factory Canteens 83 Groceries and Provisions 133 Butchers 55 Greengrocers and Fruiterers 78 Fishmongers 32 Bakers 32 Confectioners 80 Public Houses 152 Food Factories 178 Wholesale Food Stores 112 Food Wharves and Depots 53 UNSOUND FOOD The general inspection of food in shops and on stalls forms part of the duty of the District Public Health 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 purposes other than human food. Weight tons cwts. qrs. lbs. Description of Food Meat - 4 1 20 3 - 6 5 21 Meat, Canned 3 Fruit, Canned - - 1 - 30 Vegetables, Canned - - - - - Tomatoes, Canned - - 1 18 12 9 21 Milk, Canned 2 Fish - - - Various - 1 - 12 3 Total PHARMACY AND POISONS ACT, 1933 AND PHARMACY AND MEDICINES ACT, 1941 Sixty premises were entered on the Council's list for the year under report. MILK PREMISES FOOD AND DRUGS ACT, 1955 MILK AND DAIRIES REGULATIONS, 1949 11 milk sellers were registered under the above Acts during 1956, and 7 were removed from the Register. There were 138 milk sellers on the Register at the end of the year. ICE CREAM 87 samples of ice cream have been examined, with the following results: — 1. Bacterial Count. Up to 500 per 1 c.c. 39 Over 500 to 1,000 per c.c. 11 Over 1,000 to 5,000 per 1 c.c. 20 Over 5,000 to 10,000 per 1 c.c. 5 Over 10,000 to 50,000 per 1 c.c. 10 Over 50,000 to 100,000 per 1 c.c. 1 Over 100,030 to 200,000 per 1 c.c. - Over 200,000 to 400,000 per 1 c.c. 1 Over 400,000 to 600,000 per 1 c.c. - Over 600,000 to 1,000,000 per 1 c.c. - Over 1,000,000 per 1 c.c. - 87 2. Presence of B. Coli. B. Coli present in 1 c.c. and 1 10th c.c. and 1 100 th c.c - B. Coli present in 1 c.c. and 1 10th c.c. - B. Coli present in 1 c.c - B. Coli absent in 1 c.c., 1 10th c.c. and 1 100 th c.c 87 87 3. Methylene Blue Grading. Grade 1 51 2 24 3 4 4 7 Not graded 1 87 4. CHEMICAL ANALYSIS. Fourteen samples of ice cream were submitted for chemical analysis under the Food Standards (Ice cream)order, 1951. All samples were satisfactory. FOOD AND DRUGS. During the year 846 samples were submitted by the Food and Drugs Inspector. In 25 cases the analysis disclosed an infringement of the law. Date purchased Sample Infringement Remarks 10.1.56 Pearl Barley Infested with mites Letter to Manufacturer. Remainder of stock destroyed 12.1.56 Meat content 42% instead of not less than 65% Pork Sausages Prosecution Fine £4 Costs £3 3s. Dripping Contained 2.4% of free fatty acid instead of not more than 1.5% Letter to Manufacturer 12.1.56 Contained 2.2% w/v Hydrogen Peroxide instead of not less than 2.5% Letter to Manufacturer 16.2.56 Hydrogen Peroxide Luncheon Sausage Letter to Manufacturer 22.2.56 Contained 130 parts per million of Sulphur Dioxide in contravention of the Public Health (Preservatives &c., in Food) Regulations Letter to Manufacturer 1.3.56 Pork Sausages Meat content 57% instead of not less than 65% 8.3.56 Prescription 50% deficient in Ammonium Chloride Letter to Dispenser 21.3.56 Self-raising Flour Letter to Manufacturer Available Carbon Dioxide 0.26% instead of not less than 0.4% 9.4.56 Channel Island Pasteurised Milk Letter to Supplier Milk fat 3.81% instead of not less than 4.0% 8.5.56 Pasteurised Milk Contained 34% of added water Contained wood splinter Meat content 51% instead of not less than 65% Contained only 14.5% of meat Not possible to establish liability 28.5.56 Strawberry Jam Letter to Manufacturer 13.6.56 Pork Sausages Letter to Manufacfacturer 29.6.56 Sausage Rolls Letter to Manufacturer Date purchased Sample Infringement Remarks 29.6.56 Beef Pies Contained only 17.1% of meat Letter to Manufacturer 2.7.56 Pork Sausages Contained 52.7% of fat meat Letter to Manufacturer 4.7.56 Pork Sausages Meat content 51% instead of not less than 65% Letter to Manufacturer Not genuine Cider Vinegar Letter to Retailer Unable to trace manufacturer 23.7.56 Cider Vinegar 26.7.56 Lemonade Powder Contained dirt Manufacturer not known. Remainder of stock destroyed Milk Gums Contained 1.5% of milk solids instead of 10% Letter to Manufacturer 31.8.56 4.9.56 Pik-nik Drink Incorrectly labelled Letter to Manufacturer 13.9.56 Pearl Barley Contained live grain beetle Remainder of stock withdrawn 18.9.56 Beef Sausages Sold as Pork Sausages Prosecution Dismissed 16.10.56 Cherry Jam Fruit content 27% instead of 40% Letter to Manufacturer Butter-fat 0.4% instead of 4.0% Letter to Manufacturer 12.11.56 Buttered Caramel Popcorn 20.11.56 Dripping Contained 2.57% of free fatty acid instead of not more than 1.5% Letter to Manufacturer SAMPLING OF EGG PRODUCTS Sampling of egg products was continued and extended during 1956. Whereas, during 1955, sampling had been confined to Chinese Egg Albumen it was decided early in 1956 to examine all egg products entering the borough for possible contamination. Co-operation was readily given by the importers who were responsible for quite a large proportion of the samples taken, thus facilitating the work of the Council's Inspectors. As the result of examination the amount of egg found to be contaminated totalled nearly 120 tons and this was eventually released either for heat treatment or for re-export only. In May, 1956 information was received of an outbreak of Paratyphoid Fever which had occurred in the Dagenham area. The suspeçted source of infection was artificial cream thought to be contaminated by Chinese Frozen Albumen which had been used in a bakery in the district. Upon investigation it was found that 22 tins of the suspected consignment of albumen were still lying in a cold store in Bermondsey. Each of these tins was sampled and 4 were found to be contaminated with Salmonella organisms, two of these being identified as Salmonella typhi-murium. The contaminated tins were destroyed. A further outbreak of Paratyphoid occurred at Bexley, Kent, in June. This time the suspected source of infection was Chinese Frozen Whole Egg. A total of 141 tins remaining from this particular consignment was discovered in Bermondsey and each of the tins was sampled. The bacteriological report showed 25 positives, including 7 Salmonella typhi-murium. The whole of this stock, together with 168 tins transferred from Southwark, was released to the order of the Ministry of Agriculture, Fisheries and Food for pasteurisation in Northern Ireland. Number of Samples found to be Contaminated Quantity Imported Number of Samples Taken Quantity of Contaminated Egg Country of Origin Type of Egg L. C. Q. L. T. C. Q. T. China Frozen Whole Egg 2794 18 222 18 - - 52 3 - - Frozen Albumen 2244 13 394 4 24 2 - - - - Frozen Yolk 46 17 15 - - - - - - - Glycerinated Yolk 5 16 2 - - - - - - - Dried Whole Egg 489 2 457 44 2 Dried Albumen - - - - - 98 4 91 20 16 - - - - - 120 4 Dried Yolk 62 16 5 3 - - - - Argentine Frozen Albumen 123 10 - - 68 - - - - - Dried Whole Egg 68 8 40 7 9 14 - - - - Australia Frozen Whole Egg 550 6 153 - - - - - - - Frozen Albumen 3 4 15 - - - - - - - Brazil Frozen Whole Egg 9 17 - 4 - - - - - - Denmark Frozen Whole Egg 1 2 - - - - - - - - Frozen Albumen 16 10 - - - - - - - - Dried Whole Egg 8 2 1 - - - - - - - Dried Albumen 39 11 7 4 1 - - - - - France Frozen Albumen 21 9 - - - - - - - - Frozen Yolk 29 7 15 - - - - - - - Germany Frozen Albumen 5 - 10 - - - - - - - Holland Frozen Albumen 13 15 30 - - - - - - - Dried Whole Egg 1 1 20 2 - 1 2 24 - - Dried Albumen 18 23 2 4 - - - - - - New Zealand Frozen Whole Egg 2 37 10 4 13 9 - - - - Frozen Egg Pulp 145 36 - - - - - - - - Poland Dried Whole Egg 6 15 5 - - - - - - - South Africa Frozen Whole Egg 45 20 - - - - - - - - Sweden Dried Albumen 3 22 2 4 - - - - - - 3 20 1798 119 11 - 24 Totals 6835 11 110 FOOD AND DRUGS ACT, 1955 Legal proceedings taken as result of complaints made by members of the public. Date Offence Result 8.-5.56 Selling loaf of bread containing piece of string. Fine £2 0s. 0d. Costs £5 5s. 0d. 23.-5.56 Selling cream bun containing cigarette ash. Absolute discharge. Costs £5 5s. 0d. 13.-7.56 Selling loaf of bread containing -piece of string. Fine £2 0s. 0d. Costs £3 3s. 0d. 18. 7.56 Selling coconut cakes unfit for human consumption. Fine £2 0s. 0d. Costs £3 3s. 0d. 22. 8.56 Selling sausage rolls unfit for human consumption. Fine £2 0s. 0d. Costs £2 2s. 0d. 23. 8.56 Selling pork pie unfit for human consumption. Absolute discharge. Costs £2 2s. 0d. 6.10.56 Selling loaf of bread containing foreign matter. Fine £3 0s. 0d. Costs £3 3s. 0d. 19 warning letters were sent to manufacturers in respect of other articles of food complained of by members of the public. (48) PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 193T/48. Disposed of for purposes other than human food Removed for sorting under Sanitary Authority Destroyed Re-exported Weight Weight Weight Weight T. C. Q. L. T. C. Q. L. T. C. Q. L. T. C. Q. L. Bacon 2 4 2 17 4 3 11 2 - - - - - - - - Beans 45 15 1 22 1 1 3 10 - - - - - - - - Butter 1 1 7 156 7 2 - - - - - - - - - - Cake - - - - - 2 - - - - - - - - - - Casings 1 16 - - - - - - - - - - - - - - Cereals 10 24 3 10 3 2 - - - - - - - - - - Cheese 1 7 8 19 4 1 22 4 - 2 26 - - - - - Clover 1 1 12 - - - - - - - - - - - - - Cocoa Beans 4 2 24 2 7 3 14 1 21 - - - - - - - Cocoa Butter 10 11 - - - - - - - - - - - - - - Coconut 4 7 2 16 1 14 3 17 2 14 4 - - - - - Coffee Beans 1 1 9 - - - - - - - - - - - - - Confectionery 5 3 18 - - - - - - - - - - - - - Egg, Albumen 3 16 63 - - - - 16 3 20 51 19 2 16 - - Egg, Dried 1 19 1 4 13 16 - - - - - - - - - - Egg, Frozen 4 18 1 19 6 1 27 17 - - - - - - - - Egg Yolk - - - - - - - 5 - - - - - - - - Fish, Canned 11 1 23 - - - - - - - - - - - - - Flour 100 - - - - - - - - - - - - - - - Fondant - 3 2 - - - - - - - - - - - - - Fruit | 58 7 2 - - 24 - - - - - - - - - - Fruit, Canned 1 17 1 16 20 10 2 24 - - - - - - - - Fruit, Dried 2 6 3 4 - 17 2 24 8 7 16 - - - - - Fruit, Juice & Pulp 6 15 3 24 23 15 2 - - - - - - - - - Gherkins 4 7 - 1 4 1 - - - - - - - - - Ginger - - 3 3 3 1 10 2 6 - - - - - - - - Honey 3 18 - - - - - - - - - - - - - - Lard 7 2 3 1 11 3 - - - - - - - - - - Margarine - - - - - - 3 - - - - - - - - - Meat 13 3 19 1 5 3 - 6 6 - - - - - - - Meat, Canned 23 59 16 - 1-5 8 7 1 21 2 16 4 12 2 - - Milk, Canned 1 1 17 - - - - - - - - - - - - - Milk Powder 3 16 - - - - - - - - - - - - - - Molasses 6 2 - - - - - - - - - - - - - - Nuts 11 3 8 3 11 3 4 1 1 - - - - - - - 1 1 8 - 1 - - Offals 6 6 - - - - - - - Onions - - - 17 5 - - - - - - - - - - - Peas 3 15 19 - - - - - - - - - - - - - Pepper 2 5 - - - - - - - - - - - - - - 66 4 405 6 Potatoes - - - - - - - - - - - - Poultry, Canned 1 3 9 - - - - - - - - - - - - Preserves - 1 1 19 - - - - - - - - - - - - - Rice 3 2 23 - - - - - - - - - - - - - 4 - - Sage Leaves 17 - - - - - - - - - - - - Sausages, Canned 3 15 7 - - - - - - - - - - - - - (49) PUBLIC HEALTH IMPORTED FOOD REGULATIONS, I93T/48—continued. Disposed of for purposes other than human food Removed for sorting under Sanitary Authority Re-exported Destroyed Weight Weight Weight Weight T. C. Q. L. T. C. Q. L. T. C. Q. L. T. C. Q. Soups, Canned 11 1 - - - - - - - - - - - - - 1 15 Tapioca 17 2 22 1 2 24 - - - - - - - Tea 2 16 3 - - - - - - - - - - - - Tomatoes, Canned 18 13 2 23 - - - - - - - - - - - Tomato Juice 1 12 1 - - - - - - - - - - - - Tomato Ketchup 4 10 - - - - - - - - - - - - - Tomato Paste 1 19 14 - - - - - - - - - - - - 5 12 Tomato Pulp - - - - - - - - - - - - - Tomato Puree 31 4 3 18 14 15 - - - - - - - - - Various - - 50 8 - - - - - - - - - - - 2 2 3 6 Vegetables - - - - - - - - - - - Vegetables, Canned 4 11 2 12 - - - - - - - - - - - - - Wheat 7 6 3 - - - - - - - - - - 720 4 2 16 348 8 5 127 17 1 Total 265 19 2 19 - (50) WORK OF THE WHARVES AND FOOD INSPECTORS, 1956 Mr. Tapsfield Mr. Campbell Mr. Hancock Mr. Butchur Totals 2144 1500 869 4513 Food Wharves and Depots - Food Factories 158 167 126 451 - 210 107 1044 Food Stores 454 273 Condemnation of Food 357 687 555 48 2047 VISITS 120 120 Milksellers - - - 48 48 Ice Cream Premises - - - Pharmacy and Poisons 9 9 - - - 712 712 Catering Establishments - - - 135 54 26 323 538 Various Consignments of Imported Food Detained 62 63 49 174 - Certificates issued for Unsound Food 1708 770 488 373 77 2 95 97 Intimations Served - - Chemical 846 846 Food and Drugs - - - Number of samples taken for analysis 34 65 Imported Food Regulations 14 17 - Egg Products 319 367 640 3 1329 Canned Meats 16 4 12 Bacteriological - - Milk (Special Designation) Regulations 218 218 - - - Milk for T.B. 4 4 - - - Milk for Brucella Abortus 2 2 - - - Ice Cream 87 87 - - - MISCELLANEOUS SERVICES OLD PEOPLE'S WELFARE The staff of the Department have continued to undertake responsibility for the administrative and secretarial work of the Council for the Welfare of Old People. CLUBS: The activities of the eight clubs have continued throughout the year and classes have been arranged for handicraft and singing. Where conditions were suitable, film shows were provided by the Borough Council. Each club has held a Christmas Party and Club Leaders have arranged outings to the seaside and to pantomimes, ice shows and circuses. The work undertaken by the Club Leaders and their helpers is of great importance and plays a large part in the relief of loneliness in the aged. OUTINGS TO WOMEN'S INSTITUTES: During the summer of 1956 eighteen visits were paid to various Women's Institutes in and around the Home Counties and once again it is necessary to thank these Institutes for their hospitality and generosity. Some invitations were received from Institutes which had not been visited before and it is a pleasure to extend the activities in this field. Some of the clubs have in turn entertained parties from Women's Institutes. HOLIDAYS: Arrangements were made for 126 people to spend holidays at Margate, Ramsgate and Herne Bay. MEALS SERVICE: This service is operated by the Department under the existing arrangements with the Council for the Welfare of Old People who meet all the operating costs. The meals are delivered each day from Monday to Friday, and the total number of meals delivered during the year was 17,925, an increase of 1,795 over the previous year. As in previous years a special Christmas Dinner was provided for each person on the meals list. This dinner, consisting of traditional Christmas fare, is specially pre-cooked and packed so that it is simple to prepare for consumption. Each person was also given six new laid eggs by a donor who wished to remain anonymous. OUTINGS: As in 1955, afternoon coach outings were arranged for the homebound old folk who rarely have the opportunity of getting out. Three coach parties were taken for a ride around the countryside and tea was provided en route. Members of the Council for the Welfare of Old People were in charge of the parties and the District Nursing Association arranged for a nurse to accompany each party. WORKROOMS FOR THE ELDERLY: The Council are firmly of the opinion that the employment of elderly people within the limits of their reduced working capacity, under good conditions, is of great value in preserving health of body and mind, and that old people find happiness and deep satisfaction in the assurance that they are part of, and are wanted by, the community. It helps them to pass the time, to find comfort and cheer in the company of their fellows, and the money earned allows of the purchase of a few extra amenities. Moreover, it helps, admittedly in a small way, the economic life of the country by providing a further source of labour. Acting as agents for the Council for the Welfare of Old People, the Borough Council have instituted a scheme providing for the employment of suitable persons for two hours per day (from Monday to Friday) on simple tasks, and workrooms for this purpose were opened in April 1956 with a complement of five workers, four of whom have continued to be regular attenders. Approximately twenty old people, whose average age is 75, have been employed for varying lengths of time and it has become apparent that certain of them have been eager to attend the workrooms merely to enjoy the companionship they find there, monetary reward for the work they do being of secondary importance. It is safe to say that the workrooms have given these elderly persons a fresh interest in life and that it would have been necessary to arrange for certain of them to be admitted to homes for the elderly had they been unable to take advantage of the facilities which have been afforded. The Council have been fortunate in securing the ready co-operation of a number of local industrialists who have gone to some trouble to supply the material for the following types of work : Folding of cardboard pockets and files. Assembling nose clips for underwater apparatus. Cutting of braid for men's braces. Stringing of price tickets. Folding of trade circulars and putting into envelopes. A party was held for the employees at Christmas, the cost of which was met from the sale of articles they had made outside working hours and, amongst other gifts, each was presented with either a silk scarf or tie by a local manufacturer for whom a considerable amount of work is carried out. During the year over 1,000 visits were made to old persons in the Borough whose need for help or advice had been drawn to the Department's attention by voluntary and other organisations, hospital almoners, medical practitioners, or neighbours. A number of cases was also brought to light during the course of house-to-house inspections by District Public Health Inspectors. The immediate need of patients was assessed and, in cases of need, contact on their behalf was made with the National Assistance Board or, where an old person was prepared to have the assistance of a " home help the necessary arrangements were made with the London County Council. The recreational facilities offered by Old People's Clubs were drawn to the attention of the people visited and, subject to their suitability and their willingness to attend, the names of various persons were noted with a view to their ultimate employment in the Workshops for the Elderly. It has been found that, in many cases, distress is caused, not by financial need, but by the feeling that nobody is interested in an aged or homebound person's problems which are often accentuated by a sense of acute loneliness. Although many of these persons are well cared for by relatives it is felt, nevertheless, that they should be visited as regularly as possible if only to encourage relatives to maintain their efforts. Because of their medical condition, however, many patients are unlikely to benefit from any material help we are in a position to provide or obtain, but regular visits help to assure them that they are not forgotten. On the other hand, it is also necessary to make repeated visits to old persons living in a state of self-neglect which is quite often attributable to the fact that none of their relatives, near or otherwise, is prepared to take much interest in their welfare. Arrangements are made for the regular bathing of such persons in the Disinfecting Station and, where necessary, this is carried out in their own homes. The cases reported below are fairly representative of those which have been encountered during the year. Mr. and Mrs. A, aged 84 years and 79 years respectively, were visited following a request received from their doctor and it was found that the woman was totally blind and was suffering from bronchitis ; she was also extremely dirty. No night clothes were found and the old lady was clad only in a coat; she was, therefore, supplied with night dresses and was later removed to hospital. The couple's clothing ing and bedding were infested with lice and bugs and, after some difficulty, the man was persuaded to attend the Disinfecting Station to be bathed and fitted with clean clothes. The infested bedding was destroyed and, pending fumigation of the two basement rooms the couple occupied and the completion of work required by a sanitary notice, Mr. A was temporarily accommodated at Ladywell Lodge. Clean bedding was provided and after the couple's return to their home the services of a '' home help " were obtained. In this particular case there is no financial need to warrant such neglect as, apart from his retirement pension, Mr. A is in receipt of a good pension from his former employers. Mrs. B., a widow aged 79 years, is a cripple. She fell on the fire and sustained severe facial burns. When she was visited at the request of a hospital almoner, it was found that there were only old coats on the bed. The patient's room was sparsely furnished and contained a quantity of old clothes in need of cleansing. The laundry was collected, daily meals were provided and arrangements were made for the attendance of a '' home help." Mr. and Mrs. C., aged 79 years and 66 years respectively, lived in a two-room flat which was infested with bed bugs; the cat, moreover, was permitted to eat from the table. The woman was paralysed and bed-ridden, and her husband was unemployed in consequence of a street accident he had sustained some time before the visit. Dirty laundry was cleansed, and, after some persuasion, the man consented to the attendance of a " home help Mrs. C. died shortly after her removal to hospital. During the year, 25 persons agreed voluntarily to enter London County Council institutions because they were unable to devote to themselves proper care and attention. Before their removal all these patients were bathed and, where necessary, provided with clean clothing. Only in exceptional cases, where persons will not respond to offers of assistance, is it necessary to make application to a magistrate for a committal order. Many sick room requisites such as rubber sheets, bed pans, urinals, commodes, back-rests, walking sticks, etc., have been supplied during the year by the Council from its own resources, or by voluntary and statutory organisations, and 14 homebound persons were provided with wireless sets by the Wireless for the Bedridden Society on recommendation by this Department. INVESTIGATION OF ATMOSPHERIC POLLUTION During the year the Council has continued the study of atmospheric pollution in co-operation with the Department of Scientific and Industrial Research. The tables given below show the concentration of smoke and sulphur-dioxide, as recorded at the Municipal Offices, and the amount of deposited matter recorded by the deposit gauges at Brunei Road, Rotherhithe, and the Public Health Centre, Grange Road. Concentration of Smoke and Sulphur-Dioxide Sulphur dioxide Expressed in parts per million Smoke Expressed in mgs. per cubic metre Month Monthly Average Highest Daily Average Monthly Average Highest Daily Average Jan. .646 3.560 .256 1.227 Feb. .332 1.284 .177 .489 March .188 .412 .142 .321 April .201 .661 .126 .246 May June July .096 .186 .076 .170 .124 .183 .054 .138 .116 .183 .043 .111 August .117 .189 .050 .130 Sept. .111 .220 .067 .188 October .317 .700 .107 .225 Nov. Dec. .329 .889 .142 .316 .627 2.890 .251 1.028 Matter deposited in tons per square mile Month Grange Road Brunel Road Rainfall ins. Matter deposited in tons per sq. ml. Rainfall ins. Matter deposited in tons per sq. ml. Jan. 3.02 20.19 2.85 23.23 15.55 Feb. 27.80 0.22 0.16 March 35.82 34.60 0.82 0.86 0.92 25.27 29.77 April 0.99 14.24 17.14 May 0.23 0.34 16.68 June 18.54 2.19 2.56 19.62 20.15 July 2.28 3.19 August 16.76 20.75 2.62 3.85 Sept. 20.79 2.05 25.00 1.88 October 1.23 19.15 20.37 1.23 0.33 2.32 16.40 Nov. 22.88 0.38 Dec. 28.43 2.37 21.40 INTERNATIONAL CERTIFICATES OF VACCINATION AND INOCULATION At the request of the Ministry of Health and in order to comply with the International Sanitary Regulations 89 certificates were dealt with during the year. FOOD HYGIENE REGULATIONS, 1955 Most of the provisions of these Regulations came into force on 1st January, 1956, and the remainder on 1st July, 1956. In order to gain the co-operation of the food and catering industries in the Borough, all were invited to attend a meeting held in February, 1956, at which the provisions of the Regulations were discussed in detail and the opportunity given to raise questions. In addition, all food premises were visited by the Public Health Inspectors and advice given on the requirements of the Regulations. During the year written intimation of requirements under the Regulations was given in respect of 196 premises. STREET AND OPEN MARKETS Bermondsey Square ('New Caledonian'). Number of licences in operation 232 Income for 1956 £3,999 3 0 Twelve additional pitches were created during the year to cope with the continuing demand. At the end of 1956 there were 205 traders licensed of whom 170 were dealers in antiques and similar commodities. Street Markets. Total Income for 1956- £2,831 13 £2,831 13 3 Number of licences in operation: — Albion Street 6 Bermondsey Street 48 Railway Approach 15 Southwark Park Road 43 Tower Bridge Road 31 Trident Street 2 Various 16 Total 161 There were no prosecutions for unlicensed trading during 1956. NATIONAL ASSISTANCE ACT, 1948. NATIONAL ASSISTANCE (Amendment) ACT, 1951. SECTION 47. The Council has authority under this section of the Act to apply to a Court for an Order for the removal to hospital, or other institution, of an aged, infirm or physically incapacitated person whose living conditions are insanitary and who is "unable to devote to himself, and is not receiving from other persons, proper care and attention." On certification by the Medical Officer of Health and a general practitioner, the National Assistance (Amendment) Act 1951 also empowers a magistrate to order the emergency removal of such persons to an institution for periods not exceeding three weeks. In no case during the year was it necessary to make use of the Council's powers under the Act; 3 patients considered to be in need of mental treatment, however, were referred to the duly authorised officer appointed by the London County Council and 15 persons wer e persuaded, in their own interests, to enter institutions voluntarily. Two old persons were also temporarily accommodated in institutions whilst their homes were cleansed and fumigated. SECTION 50. Under the provisions of Section 50 of the Act it is the Borough Council's duty to arrange for the burial or cremation of a person dying in the Borough where it is impossible to trace relatives or friends who would be prepared to make funeral arrangements. In such cases the costs incurred by the Council, inclusive of administrative expenses, may be reimbursed from the estate of the deceased. During 1956, the bodies of 2 female and 4 male persons were removed to the mortuary after having been recovered from the River Thames which bounds the Borough on its north side, and all these were identified by relatives. In one case the deceased's brother requested the Council to arrange for burial subject to his meeting all expenses incurred and in one further case the Council considered it necessary to write off the cost of removing the body to the mortuary in order to avoid possible hardship to the deceased person's widow who was reported by the Coroner's Officer to be in somewhat straitened circumstances. The cases to which reference is made below were also dealt with under the provisions of Section 50. 1. Following a request for assistance by a home-help the Council arranged for the funeral of Mr. J. W. D. whose wife, aged 74, was in a very poor state of health and it was impossible for her to make the necessary arrangements. Subsequently, Mrs. D. authorised the Council to dispose of the household effects and she agreed voluntarily to enter a London County Council institution. Funeral expenses were met from the estate. 2. At the request of the Coroner's Officer, arrangements were made for the interment of Mr. J. K. who died in a common lodging house in the Borough on 1st May, 1956, the sum of only 11½d. being found on his person. Expenses incurred by the Council were, however, partly reimbursed by a death grant from the Ministry of Pensions & National Insurance. 3. Mr. J. H. died in a common lodging house in the Borough on 8th June, 1956 and, no relatives having been traced, the Council undertook the funeral arrangements. Expenses, less the sum of 19/7 ½ d. in cash found on the deceased's person, were borne by the Council. 4. Mr. H. J. S. died at his home on 27th August, 1956 and, there being no known relatives, arrangements for the funeral were made by the Council. The deceased's effects, including a quantity of furniture in good condition, were taken into store and, by agreement with the Treasury Solicitor who administered the estate, were subsequently purchased by the Mayor from her Contingency Fund for distribution to old people. Funeral expenses incurred by the Council were met from the estate. 5. As no relatives could be traced the Council arranged for the burial of Mr. S. T. J. who died on 21st October, 1956, in a furnished room he occupied. The only property of the deceased was a quantity of old and dirty clothing which was destroyed. The Council's expenses were fully met by a death grant from the Ministry of Pensions & National Insurance. 6. Mr. F. E. died in a common lodging house on 28th October, 1956 and no relatives were traced. It was ascertained that his employers were prepared to meet the funeral expenses but they did not wish to be concerned in any way with the disposal of the estate and, in these circumstances, the Council undertook to arrange for the funeral. The estate, which has not yet been wound up, is being administered by the Treasury Solicitor. PUBLIC HEALTH (LONDON) ACT, 1936, SECTION 122 Under the provisions of this Act, the Council have authority to remove and cleanse personal effects where it is considered by the Medical Officer of Health that the condition of such articles is likely to cause the spread of infectious disease. During 1956, visits were made to the homes of 28 old people who were senile, seriously ill or incontinent. In each case quantities of soiled bedding and personal clothing were found and it was considered essential to have these effects cleansed in the Disinfecting Station. In most cases it has been necessary for the articles in question to be collected at regular intervals for cleansing and return to the owners.