AC 4376 LIBRARY Metropolitan Borough of Camberwell REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1950 HOWELL W. BARNES, B.A., M.B., B.Ch., D.P.H. Printed by MERRITT & HATCHER LTD. London, S.E.10 Dated. 26/9 Borough of Camberwell. Public Health Department, Town Hall, Camberwell, S.E.5. With the Compliments of the Medical Officer of Health. Public Health Department, Town Hall, Camberwell, S.E.5. August, 1951. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Camberwell. Your Worship, Ladies and Gentlemen, I submit herewith my report on the Health of the Borough in 1950, which has been prepared on the lines requested by the Ministry of Health in Circular 112/50, dated the 6th December, 1950. The Registrar-General's estimate of the population at the middle of the year is 590 more than the estimate for mid-1949. The birth rate of 16·2 shows a further decline from the figure for 1949. The general death rate of 11·3 per 1,000 of the population shows a decrease of six points on the previous year. The infantile mortality rate of 27 per 1,000 live births is not as low as in 1949. There has been no serious epidemic of infectious disease, notifications of which numbered 2,618. Of these, measles was responsible for 1,441, whooping cough 706 and scarlet fever 206. Fortunately, these types of diseases are mild in character. The tuberculosis problem remains with us although there was a considerable fall in the number of primary notifications and deaths from this cause, which amounted to 325 and 64 respectively. It is generally agreed that notifications are not always an accurate reflection of the incidence of tuberculosis, and that mortality figures are regarded as the most valuable criterion of the trend of this disease. A report of the British Medical Association Group Committee issued during the year under review submits various proposals but it is doubtful whether it contains a solution to this scourge. The existing arrangements for the prevention of tuberculosis cannot be regarded as an improvement on the service provided by the Local Sanitary Authority previous to the operation of the National Health Service Act of 1946. There is urgent need for a complete revision of our tuberculosis administration from the point of view of placing both the curative and preventive aspects under the control of one authority. It must not be forgotten that a person suffering from tuberculosis is not merely a case of infectious disease. His way of life and that of his family is affected for many years if not for a lifetime. Overcrowding exists everywhere and there seems not much hope of improvement in the near future. When the figures of the recent Census are available it will be possible to assess the amount of overcrowding prevailing at the present time. In 1949, 378 cases of overcrowding came to the notice of the Health Department and in 1950, 336 families were found to be living in overcrowded dwellings. In conclusion, may I again express my appreciation of the loyalty and able assistance afforded to me by the Staff of the Public Health Department during the year and my thanks to the Members of the Council for their support and consideration. I am, Mr. Mayor, Aldermen and Councillors, H. W. BARNES, Medical Officer of Health. Staff of the Public Health Department at the end of 1950. Medical Officer of Health: H. W. Barnes, B.A., M.B., B.Ch., M.R.C.S., L.R.C.P., D.P.H. Deputy Medical Officer of Health. Vacant. Public Analyst. D. F. H. Button, A.R.C.S., F.R.I.C. Food Inspector and Senior Sanitary Inspector. R. F. Nash. a Sanitary Inspectors. Dist. No. Dist. No. 1. A. G. O'Gilvie. b 7. W. C. Scales. b 2. J. H. Prosser. b 8. H. Attwater. a 3. R. C. Charlton. b 9. M. L. Malins. a 4. D. V. Watkins. a 10. H. M. Hough. a 5. J. A. Harris. b 11. A. C. Charlton. b 6. L. A. Biggs. b 12. F. Maughan. a 13. L. W. Burrell. a Housing Inspector. H. W. Leonard. a Sampling Officer —Food and Drugs Act, etc. H. R. Weaver. a Chief Clerk. S. A. Cranfield. Senior Clerk. A. J. Carly. Clerks. N. Westley. Mrs. J. Oke. A. M. Rowlatt. Miss M. Laws. (Temp.) D. Danter. One vacancy. Mrs. M. Findlay. Rodent Control Staff. Rodent Officer W. H. G. Saunders, b Rodent Investigator Mrs. M. J. Kenny Rodent Operators C. Green (Working Foreman), A. P. Abrahams, P. Collins, G. Glazebrook, R. Humphreys, J. Carver. Bait Preparer Mrs. A. Grice. Disinfecting and Cleansing Station. Superintendent Disinfector A. Franklin. Disinfector Apparatus Attendant B. Russell. Disinfectors R. T. J. Hodgson, A. Thomas, E. Manning, A. E. Kenny. Motor Driver H. King. Cleansing Station Attendants. Mrs. D. O. Farmer. Mrs. E. E. Doe. (a) Certificate Sanitary Inspectors Examination Board and Meat and other Foods Certificate. (b) Certificate Sanitary Inspectors Examination Board. Summary of Statistics for the year 1950. Area of the Borough 4,480 acres Greatest length 4¾ miles „ breadth 2½ miles „ height above Ordnance Datum (Sydenham Hill) 365 feet Total area of Public Parks and Open Spaces 234-64 acres Population (estimated mid-1950) 178,900 „ (Census 1931) 251,294 Number of inhabitated houses (end of 1950) 40,156 Rateable value (April 1950) £1,552,856 Sum represented by a penny rate (estimated) £6,270 Number of live births 2,905 Birth rate 16.2 Number of deaths 2,029 Death rate 11.3 Infantile Mortality:— Deaths under 1 year 78 Infant deaths per 1,000 live births 27 Maternal Mortality : — Deaths of women from diseases or accidents associated with childbirth 2 Maternal death rate per 1,000 total births 0.6 Deaths from phthisis 57 Phthisis death rate 0.3 Deaths from all forms of Tuberculosis 64 Tuberculosis death rate 0.3 5 GENERAL INFORMATION AND STATISTICS. The Borough of Camberwell, which covers approximately seven square miles, is roughly pear-shaped. The sub-soil consists mainly of clay with a few small scattered areas of gravel. The southern portion of the borough is residential and is well provided with parks and open spaces; such amenities however, are sadly lacking in the northern area which is mainly industrial. Summary of vital statistics for the year 1950, with comparative figures for the previous four years. 1950 1949 1948 1947 1946 Population 178,900 178,310 178,200 175,060 164,380 3,396 No. of Live Births 2,905 3,185 4,278 3,848 No. of Still Births 70 64 66 70 87 No. of Legitimate Births 2,778 3,087 3,295 4,120 3,686 No. of Illegitimate Births 197 162 167 228 249 Birth rate (per 1,000 population) 16·2 17·8 19·0 24·4 23·4 No. of Deaths 2,029 2,135 2,032 2,336 2,218 Death rate (per 1,000 population) 11.3 11.9 11.4 13.3 13.5 Deaths of infants under 1 year 77 105 167 78 148 Infant death rate per 1,000 live births 27 24 31 39 38 Deaths of legitimate infants 70 70 101 163 134 Deaths of illegitimate infants 8 7 4 4 14 Death rate of legitimate infants per 1,000 legitimate live births 26 23 31 40 37 Death rate of illegitimate infants per 1,000 illegitimate live births 41 44 24 18 58 Deaths of women from diseases or accidents associated with childbirth 2 4 4 5 5 Maternal death rate per 1,000 total births 0·6 1·2 1·1 1·1 1·2 Deaths from pulmonary tuberculosis 79 119 89 57 101 Death rate from pulmonary tuberculosis 0·5 0·6 0·5 0·3 0·4 Deaths from all forms of tuberculosis 64 94 117 135 99 Death rate from all forms of tuberculosis Births. The number of live births allocated to Camberwell after adjustment for inward and outward transfers was 2,905, comprising 1,450 males and 1,455 females. One hundred and ninety-four of these births were illegitimate. Still births numbered 70, representing 2.3 per cent, of the total births, an increase of 0.4 per cent, on the previous year. The following table compares the birth rates in England and Wales, London and Camberwell for the past five years:— 1949 1948 1947 1946 1950 England and Wales 15·8 16·7 17·9 20·5 19·1 17·8 18·5 20·1 22·7 21·5 London 19·0 24·4 Camberwell 16·2 17·8 23·4 Deaths. The following table indicates the deaths registered during the year, adjusted for inward and outward transfers, and shows the classified causes of death in age groups:— Causes of death. Sex. All Ages. 0- 1- 5- 25- 45- 65- 15- 75- All causes M. 1,077 51 6 7 12 49 315 319 318 F. 952 27 6 2 6 46 180 254 431 Tuberculosis, respiratory M. 47 - 1 - 2 7 28 8 1 F. 10 - - - 1 7 1 1 - Tuberculosis, other M. 4 - - - - 2 - 1 1 F. 3 - 1 1 - 1 - - - Syphilitic disease M. 8 - - - - - 6 2 - F. 2 - - - - - 1 1 - Diphtheria M. 2 1 1 - - - - - - F. - - - - - - - - - Whooping Cough M. 2 2 - - - - - - - F. - - - - - - - - - Meningococcal infections M. - - - - - - - 1 - F. 1 - - - - - 1 - - Acute poliomyelitis M. 1 - 1 - - - - - - F. 2 - 1 - 1 - - - - M. - - - - - - - - Measles - F. - - - - - - - - - Other infective and parasitic diseases M. 1 1 - - - - - - - F. 2 - 1 - - - 1 - - Malignant neoplasm, stomach M. 31 - - - 2 11 10 8 - F. 25 - - - 2 5 10 8 - Malignant neoplasm, lung, bronchus M. 62 - - - - 5 36 15 6 F. 11 - - - - 2 4 2 3 M. 1 - - - - - 1 - Malignant neoplasm, breast - F. 31 - - - - 5 15 7 4 DEATHS—continued. All Ages. Causes of Death. Sex. 0- 1- 5- 15- 25- 45- 65- 75- Malignant neoplasm, uterus F. 15 - - - - - 10 4 1 Other malignant and lymphatic neoplasms 47 M. 107 2 1 3 33 21 - - 20 F. 80 3 31 26 - - - - Leukaemia, aleukemia M. 5 2 1 1 - - - 1 - F. 5 1 1 2 1 - - - - - 2 Diabetes M. 4 2 - - - - - F. 12 3 3 6 - - - - - Vascular lesions of nervous system M. 83 1 22 26 34 - - - - 1 F. 103 1 14 54 34 - - - Coronary disease, angina 130 M. 4 54 47 25 - - - - F. 71 1 29 - - - - 14 27 Hypertension with heart disease M. 35 9 14 12 - - - - - F. 47 8 14 25 - - - - - Other heart disease M. 176 2 18 52 104 - - - - 157 F. 245 10 19 59 - - - - Other circulatory disease M. 30 1 5 11 13 - - - - F. 2 31 4 9 16 - - - - Influenza M. 5 3 2 - - - - - - F. 9 1 1 2 - - - - 5 Pneumonia M. 35 5 1 8 13 8 - - - F. 20 40 4 1 6 9 - - - Bronchitis M. 103 3 1 19 38 38 - - 4 F. 67 1 1 13 15 37 - - - Other diseases of respiratory system M. 16 4 5 6 1 - - - - F. 1 5 1 3 - - - - - Ulcer of stomach and duodenum M. 24 3 10 8 3 - - - - F. 4 1 1 2 - - - - - Gastritis, enteritis and diarrhoea M. 4 1 1 2 - - - - - F. 2 1 1 - - - - - - Nephritis and nephrosis M. 11 1 3 5 2 - - - - 9 1 1 3 4 F. - - - - Hyperplasia of prostate M. 18 1 9 8 - - - - - Pregnancy, childbirth, abortion F. 2 2 - - - - - - - Congenital malformations M. 15 12 2 1 - - - - - F. 9 3 5 1 - - - - - Other defined and ill-defined diseases M. 86 27 2 1 3 4 19 13 17 28 F. 81 15 4 18 16 - 1 - Motor vehicle accidents M. 4 1 1 1 1 - - - - F. 3 1 1 1 - - - - - All other accidents M. 16 1 1 3 1 4 - - 6 F. 19 2 1 8 8 - - - - Suicide M. 11 2 4 2 3 - - - - F. 5 1 1 3 - - - - - Homicide and operations of war M. - - - - - - - - - F. 1 1 - - - - - - - It will be seen that the chief causes of death during 1950 were:— Diseases of the heart and circulatory system 765 Malignant disease 363 Bronchitis, pneumonia and other respiratory diseases (excluding phthisis) 280 The death rates for England and Wales, London and Camberwell during the past five years are as follows:— 1950 1949 1948 1947 1946 England and Wales 11·6 11·7 10·8 12·0 11·5 London 11·8 12·2 11·6 12·8 12·7 11·3 11·9 11·4 13·3 Camberwell 13·5 Infantile Mortality. There were 78 deaths in 1950 of Camberwell children under one year of age, 55 of which were neo-natal deaths (i.e. death occurring before reaching the age of one month). Although the infantile mortality rate of 27 was slightly higher than that for the previous year, it must be remembered that the figure of 24 infant deaths per 1,000 live births which was recorded that year, was the lowest ever reached in Camberwell. The infant death rates in England and Wales, London and Camberwell for the past five years were:— 1950 1949 1948 1947 1946 England and Wales London 29 34 41 43 32 26 29 31 37 41 Camberwell 27 24 31 39 38 Maternal Mortality. There were only two maternal deaths during 1950 giving a maternal mortality rate of 0.6 per 1,000 total births, this is the lowest figure ever recorded in Camberwell. Cancer Deaths. The following table gives the deaths from malignant disease during the past five years :— 1950 1949 1948 1947 1946 363 372 370 390 364 Hope for the prevention or successful treatment of this dread disease depends on research. Persistence in research will ultimately lead to success and every assistance should be given in that direction. SANITARY CIRCUMSTANCES OF THE AREA. Water Supply. The domestic water supply for every dwelling house in the Borough is provided from the mains of the Metropolitan Water Board. The water from the seven wells in operation in the Borough is used only for industrial purposes. Water Certificates. During the year, Water Certificates were issued under the provisions of the Public Health (London) Act, 1936, in respect of 559 new dwellings. Drainage and Sewerage. The length of sewers reconstructed during 1950 amounted to 315 yards. Twenty-seven brick road gullies were replaced by pot gullies, and 5 defective pot gullies were renewed. One hundred and sixty-two drainage plans for new and existing buildings were submitted for examination and approval. Public Cleansing. The following particulars have been kindly furnished by the Borough Engineer and Surveyor, who is responsible for the operation of this service. Amount of house refuse (including salvage and kitchen waste) collected during the year 43,449 tons. Method of disposal Rmoved by barges from Honduras Wharf, Bankside, to a controlled tip. Frequency of collection Weekly from dwelling houses and twice weekly from blocks of flats and tenements. Smoke Abatement. Complaints of alleged nuisances caused by the emission of smoke, etc., numbered 30, and 58 observations were kept by the district sanitary inspectors. In the early part of the year, following complaints of the emission of smoke and grit from the Gas Works in Old Kent Road, an investigation was carried out by the Deputy Chief Inspector, Alkali, etc. Works Regulation Act, Ministry of Health, who visited the Gas Works accompanied by two of the Council's sanitary inspectors and two representatives of the South Eastern Gas Board. A communication was subsequently received from the Ministry's Inspector stating that complaint is likely to occur with more or less justification so long as the retort houses continue in operation, as the method of carbonisation is such that some emission of grit, etc. is inevitable. In this connection the amount of coal carbonised at these works is likely progressively to fall as new plant becomes available at the East Greenwich Works. The handling of coal by grab also contributed to the nuisance, especially with unfavourable winds and dry coal. Measures were taken, however, to reduce such wind-whipping but elimination was considered to be impracticable. The South Eastern Gas Board were asked to do all that is practicable to keep emissions to a minimum. Bombed Sites and Static Water Tanks. Complaints were received from time to time of nuisances arising from the deposit of organic refuse on bombed sites and in static water tanks. In the case of the former, the Borough Engineer and Surveyor arranged for the removal of the offensive matter. Static water tanks, however, presented difficulties as they frequently contained stagnant water. When requested by the Public Health Department, the London Fire Brigade arranged for the water to be pumped out. This often left a quantity of foul smelling sludge and the only way to deal with the matter was to have the tanks entirely cleaned out. The Public Health Committee approved this course of action where necessary. Nuisance from Mosquitoes in the vicinity of the Heme Hill Track. A number of complaints were received from residents in the area of the Herne Hill Track of a nuisance caused by the presence of mosquitoes. The district sanitary inspector made investigations and secured a live specimen of the fly alleged to be causing the trouble, which was identified at the British Museum as a mosquito of the culex molestus species. A general survey of the area was therefore made for underground water where these pests might be breeding. Samples of larvae and flies were subsequently taken from the ditch and cesspit on the site of the Heme Hill Track and a Notice was served on the lessees under the provisions of Section 83 of the Public Health (London) Act, 1936, in relation to the ditch and drains on the property. The open ditch was piped in and no further complaints have been received. Piggery. A Piggery situated in Oakhurst Grove formed the subject of complaints from local residents of offensive smells and the presence of flies. The district sanitary inspector kept a close observation on this piggery and as a result of his action, improvements were carried out by the proprietors to secure the abatement of any nuisances existing. Under existing legislation it would have been difficult to prevent pig keeping on this site but fortunately, the piggery was voluntarily closed soon after Christmas 1950. Swimming Bath Waters. During 1950, 28 samples of water were taken from the Dulwich and Camberwell Public Baths for bacteriological examination and 33 for chemical analysis. A request from the governors of the Mary Datchelor Girls' School was submitted to the Public Health Committee who authorised this Council's Officers to take samples from the school swimming bath during the summer term. Three samples were taken for both bacteriological examination and chemical analysis. Apart from minor adjustments to ensure a satisfactory pH value and free chlorine content, all the waters examined were found to be satisfactory. Rag Flock —Public Health (London) Act, 1936 —Section 136 and Regulations made thereunder. During the year 5 samples of different types of rag flock were taken and submitted to the Public Analyst for examination. All the samples were reported to be satisfactory. Summary of Sanitary Work Carried Out During the Year 1950.s Inspections. Nuisance inspections 7,496 Offensive trades 5 Smoke observations 58 Drainage, new and existing 4,981 Overcrowding 1,817 Factories and workplaces 615 Outworkers' premises 240 Rag and bone dealers 9 Infectious and other diseases 945 Verminous premises and persons 147 Aged and infirm persons 62 Common lodging houses 39 Conveniences, public and private 168 Rent (Restrictions) Act 73 Shops Act 667 Voluntary work 901 Inspections not defined 812 Re-inspections 22,427 Total inspections 41,462 Works supervised. Tests applied to drains (existing premises) 885 Drains found defective 198 Drains totally reconstructed 68 Drains repaired or partially reconstructed 413 Tests applied to drains (new buildings) 2,599 Drains constructed 981 Buildings converted into flats 11 Buildings converted into business premises 2 Additional water supply provided 12 Description of Sanitary Improvements ordered during the Year. Cleanse and repair walls and ceilings 2,493 Repair roofs, gutterings, etc. 2,035 Abate dampness 1,768 Abate overcrowding 1 Repair stoves, fireplaces and coppers 792 Repair windows, sashlines, sills, etc. 1,015 Repair flooring, stairs, doors, etc. 1,019 Provide sufficient light and ventilation 65 Provide dustbin 89 Remove offensive matter 25 Provide or repair yard paving 140 Provide or render accessible water supply 57 Repair water pipes and fittings 170 Clear premises of vermin 20 Cleanse or repair water closets and flushing apparatus 543 Repair or clear defective or obstructed drains 238 Repair soil pipes, waste pipes, sinks, etc. 322 Abate nuisances caused by animals improperly kept 5 Miscellaneous 211 Total repairs and improvements ordered 11,008 SUMMARY OF NOTICES SERVED, 1950. Intimations, Public Health (London) Act, Byelaws, etc. 4,541 Statutory Notices, Public Health (London) Act, Byelaws, etc. 2,425 Public Health (London) Act, 1936, (Part II) 30 Section 4, Housing Act, 1936 109 The following table indicates the extent of the Inspectors' work during the past five years. 1950 1949 1948 1947 1946 No. of complaints received 7,187 8,024 8,823 8,672 7,489 No. of visits by Inspectors 41,304 45,344 39,687 35,612 25,618 Intimation Notices served 4,541 5,326 6,274 5,044 5,088 No. of Statutory Notices served 2,425 2,585 2,687 1,807 1,811 No. of Police Court proceedings 171 248 177 85 74 Offensive Trades. The following premises in the Borough are registered for the conduct of offensive trades :— Skin dressers 4 Soap boilers 1 The district sanitary inspectors kept these premises under observation but no infringements of the Bye laws were discovered. Rag and Bone Dealers. There are only 8 premises in the Borough occupied by Rag and Bone Dealers and it did not become necessary to take any formal action in respect of the conduct of these businesses. Shops Act, 1950. This Act came into operation on the 1st October, 1950, and repealed the Shops Act, 1934, but those provisions of the 1934 Act which were enforceable by this Authority have been re-enacted in the later Act. No applications were received for exemption certificates to be granted in accordance with the provisions of Section 38 (6) of the Act. Pharmacy and Poisons Act, 1933. Under this Act, any person who sells poisons listed in Part II of the Act is required to be registered by the local sanitary authority. During 1950, 12 applications were received for entry in the Council's register of Sellers of Part II Poisons and 172 for the renewal of registrations. No contravention of the Act was reported by the Council's officers. Factories Acts, 1937 and 1948. The following tables showing the work carried out under the provisions of the above Acts have been prepared in accordance with the form prescribed for submission to the Ministry of Labour and National Service : — I.—INSPECTIONS, 1950. Premises. Number on Register. Number of Inspections. Written Notices. Occupiers prosecuted. Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 556 126 Nil 3 Factories not included above in which Section 7 is enforced by the Local Authority 444 15 915 Nil Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) - - 6 - Totals 1,477 570 18 Nil 2—CASES IN WHICH DEFECTS WERE FOUND, 1950. Particulars. No. of cases in which defects were found. Number of cases in which prosecutions were instituted. Found. Remedied. Referred To H.M. Inspector. By H.M. Inspector. 1 Want of cleanliness 3 4 - - Overcrowding - - - - - Unreasonable temperature Inadequate ventilation - - - - - - - - - - Ineffective drainage of floors 1 3 - - - Sanitary conveniences— 12 5 3 (a) insufficient - - 7 (b) unsuitable or defective 1 7 - - (c) not separate for sexes - - - - - Other offences against the Act (not including offences relating to outwork) 4 4 - - - Total - 27 23 5 - Outworkers. Section 110 of the Factories Act, 1937, requires employers of home workers to forward to the local authority in February and August each year a list of the names and addresses of all such workers employed by them during the preceding six months. Section 111 empowers the local authority to prohibit by notice the giving out of work to be done in a place dangerous to the health of the persons employed there, e.g. insanitary premises, or premises in which dangerous infectious disease is present. The following table indicates the number of outworkers in employment in Camberwell at the end of the year classified by trades: — Outworkers 1950. Artificial flowers 3 Needlework 8 Novelties 14 Baby linen 1 Belts 5 Overalls 32 Blouses 7 Paper bags 6 Brushes 2 Shoulder pads 19 Cardboard Boxes 27 Surgical shoes 1 Card lacing 27 Stationery 9 Coathangers 1 Tailoring 18 Diaries 1 Ties 7 Embroidery 5 Uniform caps 2 Hats 2 Wearing apparel 281 Hosiers 3 Miscellaneous 29 Lampshades 8 523 Linens 5 15 GENERAL PROVISION OF HEALTH SERVICES IN THE AREA Welfare Services provided for Aged Persons. In January of the year under review, the Medical Officer of Health submitted to the Public Health Committee of the Council a report on the Supply of Hot Midday Meals to Old People. The Committee decided to ask the Voluntary Associations concerned to take steps to extend this service for which financial assistance was already being granted by the Council. Towards the end of the year, the Camberwell Old People's Welfare Association submitted to the Council their proposals for re-organising the Association involving the appointment of a full-time Organising Secretary and the establishment of a Central Office to serve as a registry for old people and a co-ordinating centre for the direction and allocation of the work. A statement of the estimated expenditure for the first full year was also submitted and the Council authorised payment of a grant to the Association amounting to £1,200 to cover the net expenses for one year, exclusive of the cost of operating three foot clinics. The Sanitary Inspectors made 62 visits of inspection to aged persons' premises and took steps to secure the abatement of any sanitary nuisances found. It is essential for those concerned with aged persons to see that the necessary procedure is followed to provide them with the services of a doctor under the National Health Service Act as the responsibility for securing the admission into hospital of an aged sick person who is willing to be so removed falls upon the general medical practitioner who is the National Health Service doctor in charge of the patient. The Medical Officer of Health of a local Sanitary Authority has no statutory power to enable him to secure the admission of an old person into hospital UNLESS the person concerned is unwilling to go into an institution or hospital and, IN ADDITION, is suffering from a grave chronic disease or being aged, infirm or physically incapacitated is living in insanitary conditions and is unable to devote to himself or herself, and is not receiving from other persons, proper care and attention. In such circumstances, Section 47 of the National Assistance Act, 1948, enables a local sanitary authority to apply to a Court of Summary Jurisdiction for an Order to remove the person to a hospital or institution. It did not become necessary during the year to resort to these statutory powers to secure the compulsory removal of any old person to an institution. Disinfecting and Cleansing Station. The following is the record of work carried out at the Council's Disinfecting and Cleansing Station during the year :— CLEANSING STATION ATTENDANCES (VERMIN) Male. Female. Total. Adults 35 4 39 1,378 1,707 Children 329 Total 364 1,382 1,746 CLEANSING STATION ATTENDANCES (SCABIES). Male. Female. Total. Adults 35 51 86 Children 97 160 257 343 Total 148 195 Disinfection. The following is a summary of the work carried out by the Disinfecting Staff during 1950 : — Notified Infectious Diseases. Other Diseases. Miscellaneous. Vermin. Total. All Cases. 1,108 10 2,276 Rooms disinfected 1,079 79 Lots of bedding disinfected 38 60 96 1,525 1,719 Total visits 1,609 91 1,404 970 4,074 Number of articles disinfected by steam 1,842 Number of articles disinfected by formalin 919 Number of books disinfected 508 Number of towels washed 4,856 Number of gowns washed 1,075 Number of mattress covers washed 179 Number of overalls washed 235 Number of covering sheets washed 477 Beds and mattresses destroyed 253 Miscellaneous goods destroyed 405 Weight of Tons. Cwts. Qtrs. Lbs. Unsound food dealt with 29 9 1 16 Hospital dressings destroyed 18 4 0 0 Furniture, etc., destroyed 12 8 3 0 Dead animals destroyed 19 3 0 - 48 Hospital bedding disinfected 3 0 0 17 Prevention of Damage by Pests. The Prevention of Damage by Pests Act, 1949, which came into operation on 31st March, 1950, supersedes the Eats and Mice (Destruction) Act, 1919. It lays a duty upon every local authority to take such steps as may be necessary to secure so far as practicable that their district is kept free from rats and mice. It also requires that the occupier of any land shall give notice in writing forthwith to the local authority if it comes to his knowledge that rats or mice are living on or resorting to the land in substantial numbers. Section 4 of the Act empowers the local authority to serve notice on the owner or occupier of the land requiring him to take reasonable steps for the destruction of rats or mice on the land or otherwise keeping the land free from rats or mice. Such notice may specify the form of treatment to be applied, and may require the execution of any structural repairs. It did not become necessary to serve any notices under this Section of the Act during the year. The Ministry of Agriculture and Fisheries approved the continuation by the Council of a free rodent control service for occupiers of private dwelling houses. The following is a summary of the work carried out by the Rodent Control Staff during 1950 :— No. of complaints received 1,546 No. of inspections 3,533 No. of operators' calls 17,554 No. of private premises treated 1,573 No. of business premises treated 176 No. of pre-baits laid 38,644 No. of poison baits laid 22,194 In addition, 584 tests were applied to the drains of infested premises and positive results were obtained in 120 instances. Vertical block control treatment of the Council's sewers was carried out throughout the year and the half-yearly maintenance treatment in June and November. Tenants of premises infested with mice were supplied with poison baits totalling 5,724. Maternity and Child Welfare. The personal health services are the responsibility of the London County Council. The Divisional Medical Officer is assisted in the day-to-day administration of these services by the Borough Medical Officer of Health with the permission of the Local Sanitary Authority. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES An increase in the number of notifications was recorded during the year for whooping cough, measles and acute primary pneumonia, while the only fall of any size was scarlet fever. The mortality from notified infectious diseases was almost negligible—six, of which measles was responsible for two deaths, diphtheria two deaths and whooping cough and poliomyelitis one death each. Diphtheria. During the year there were 8 cases of diphtheria confirmed Two of these had been immunised —a boy of 8½ years who was immunised at the age of 2½ years and a boy of 13 years who was immunised when 6 years of age. Neither of these children had received a reinforcing injection. Both cases made a successful recovery. There were two deaths from this disease, one child aged 2 years, who had not been immunised and another child aged 9 years of whom there was no record of immunisation. In spite of the efforts to emphasise the value of immunisation to all parents, there yet remains a percentage whose neglect to avail themselves of this proved prophylactic gives rise to much anxiety and sometimes loss of life. Paratyphoid Fever. Of the three cases notified, one was found not to be suffering from the disease. The source of infection of the other two cases was not discovered. Puerperal Pyrexia. Of the 24 cases of this disease notified, twenty were treated in hospital. There were no deaths from this cause. INFECTIOUS DISEASES, 1950. SUMMARY OF NOTIFICATIONS RECEIVED AND DEATHS FROM THESE CAUSES AMONG NOTIFIED CASES Found not to be suffering from the Disease. Disease. No. of Notifications. Age Distribution of Notifications. Treated in Hospital. Deaths of Notified Cases. Under 1. 10 to 15. 15 to 20. 20 to 35. 35 to 45. 45 to 65. 5 to 10. 1 to 2. 2 to 3. 3 to 4. 4 to 5. 206 46 5 - - 2 17 20 31 104 19 4 7 1 1 Scarlet Fever Whooping Cough 706 62 5 1 66 81 107 120 95 223 12 2 - - - Poliomyelitis & Polio-encephalitis 26 26 8 1 1 3 2 5 5 4 3 1 2 - - Measles 5 1,441 41 3 2 57 152 204 270 205 538 3 6 1 - 2 1 1 Diphtheria 20 20 12 2 1 4 7 3 1 - - - Pneumonia Acute Influenzal - 1 1 1 4 - - - - - - - - - - Acute Primary 77 23 5 3 1 3 9 6 3 15 8 11 - - - Dysentery 17 11 4 1 1 3 2 2 6 1 - - - - - Paratyphoid Fever 1 - 2 3 3 - - - - - - - - - - 4 12 Erysipelas 33 6 1 9 - - - - - - - - - Meningococcal Infection 6 6 4 1 2 3 - - - - - - - - - Puerperal Pyrexia 20 2 16 6 24 - - - - - - - - - - 3 6 Ophthalmia Neonatorum 6 - - - - - - - - - - - - Scabies 46 3 4 3 2 8 3 5 8 6 5 - - - - 3 Malaria 1 1 1 - - - - - - - - - - - 343 36 35 2,618 267 43 6 135 244 420 340 53 22 67 Totals 898 Acute Poliomyelitis, Acute Polio-encephalitis and Meningococcal Infection. The Public Health (Cerebro-Spinal Fever and Acute Poliomyelitis) Regulations, 1912, and the Public Health (Acute Encephalitis Lethargica and Acute Polio-Encephalitis) Regulations, 1918, as extended by the Public Health (Acute Encephalitis Lethargica and Acute Polio-Encephalitis) Regulations, 1919, were revoked as from the 1st January, 1950, by the Public Health (Acute Poliomyelitis, Acute Encephalitis and Meningococcal Infection) Regulations, 1949. Every Medical Practitioner practising within the Borough received a copy of these regulations, which are designed to introduce nomenclature consistent with the international standard classification of disease and slightly extend the scope of clinical conditions notifiable under the head of acute encephalitis. They also require notifications of Acute Poliomyelitis to indicate whether the disease is paralytic or non-paralytic. Poliomyelitis is caused by one of a group of viruses and infection is mainly spread from person to person. Susceptibility to infection is general. The following table gives a summary of the confirmed cases of these diseases :— Acute Poliomyelitis, Paralytic Acute Poliomyelitis, Non-paralytic Acute Polio-encephalitis Meningococcal Infection M. F. M. F. M. F. M. F. January - 1 - - - - - - February - - - - - - - - March - - - - - - - - April - - - - - - - - May - - - - - - - - June 1 - - - - - - - July 1 1 1 - - - - - August 2 2 2 - - - - - September 4 1 - - - - - - October 2 1 - - - - - - November - - - - - - - - December 1 - - - - - - - Total 9 2 3 - 1 1 4 - Smallpox. At the beginning of the year a small outbreak of this disease occurred at a South coast town and information was received that a number of Camberwell residents were possible contacts. In July a case of smallpox occurred on a ship which docked at Tilbury and a list was received from the Port Health Authority of persons who travelled on this ship who were proceeding to addresses in this Borough. All of these persons were visited daily by the Sanitary Inspectors until all danger of the disease developing had passed, and where necessary, arrangements were made for vaccination or re-vaccination. Fortunately, no case of smallpox occurred in Camberwell during the year. Dysentery. There were 17 notifications of dysentery received during the year, 13 of which were subsequently confirmed. The majority of them were due to infections from Bact. Sonnei. The infectivity of this organism is very great. There is reason to believe that many cases are not notified. Clinically the disease was mild in type and there were no deaths. The fact that a case is mild in type should not obviate the necessity for notification, in view of its danger to the community. Food Poisoning. Food poisoning is due either to an infection or a toxin. In the infection type of food poisoning the individual has ingested living organisms, usually of the salmonella or dysentery group. The toxin type is usually due to staphylococcus pyogenes. The foods commonly associated with food poisoning are those in which bacterial multiplication can take place. The following return of food poisoning notifications for 1950 is reproduced in the form required by the Ministry of Health: — ANNUAL RETURN OF FOOD POISONING NOTIFICATIONS (Corrected) 1. Local Authority—CAMBERWELL. Year : 1950. 2. FOOD POISONING NOTIFICATIONS (Corrected) RETURNED TO R.G 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter TOTAL 1 35 10 56 10 3. OUTBREAKS DUE TO IDENTIFIED AGENTS. Total outbreaks — Nil. Total cases — Nil. Outbreaks Due to :— (a) Chemical poisons Nil. (b) Salmonella organisms Nil. (c) Staphylococci (including toxin) Nil. (d) Cl. botulinum Nil. (e) Other bacteria Nil. 4. OUTBREAKS OF UNDISCOVERED CAUSE. Total cases approx. — 76*. Total outbreaks — 4. 5. SINGLE CASES. Agent identified — Nil. Unknown cause — 56. Total — 56. * Only 18 of these cases were notified. Three of the outbreaks referred to in item 4 occurred at schools in the Borough following the consumption of midday meals prepared by the London County Council School Meals Service. The other outbreak occurred at a Hostel for Crippled Women, the suspected cause being a meat pie prepared in the Hostel kitchen. Reduction of food poisoning depends on the raising of hygienic standards in all persons intimately associated with food. Considerable attention continues to be given to the Clean Food Campaign. In this connection the Central Office of Information arranged for the following films to be shown at Dulwich Baths on the 7th December, 1950 : — " Town Rats." " The Good Housewife in the Kitchen." " Another case of Poisoning." "A Fly about the House." The programme lasted approximately one hour and was shown three times during the day. There was no charge for admission. The Medical Officer of Health addressed a communication to the proprietor of every food premises in the Borough requesting that all persons engaged in the food trade should be encouraged to attend. It is to be regretted that the attendances were poor, and one is compelled to conclude that this is due to lack of interest. Scabies. There was a considerable reduction in the number of notifications of scabies during 1950—46 as compared with 84 in the previous year. Every case was visited by the District Sanitary Inspector who endeavoured to arrange for all members of the family to attend at the Cleansing Station for treatment. The record of such attendances is shown in the table appearing on page 17. TUBERCULOSIS. There was a marked decline in the incidence and mortality of this disease in 1950. Primary notifications of pulmonary tuberculosis numbered 289, and non-pulmonary 36, as compared with 430 and 48 respectively in 1949. There were 57 deaths from respiratory tuberculosis as against 79 during the previous year and the total deaths from all forms of this disease was 64 in 1950 and 94 in 1949. Eight deaths from tuberculosis occurred in persons who had not previously been notified. The following table shows the sex and age distribution of all new cases and deaths from tuberculosis during 1950 : — New Cases.* Deaths.† Age Periods. Pulmonary. Non-Pulmonary. Pulmonary. Non-Pulmonary. Male. Female. Male. Female. Male. Female. Male. Female. - - 0-1 yr. 1 3 1 - - - 7 1- 5 yrs. 11 12 5 1 - - 1 - 5-15 „ 14 14 3 4 - 1 - 2 1 15-25 „ 45 53 2 5 1 - 52 50 1 6 3 5 1 1 25-35 „ 35-45 „ 2 18 21 1 3 4 - - 45-55 „ 28 9 2 13 - - - - 1 55-65 „ 34 4 2 15 - - 14 1 - 9 2 65 and over - 1 1 - 167 47 4 Totals 217 15 28 3 10 * Including primary formal notifications and cases which came to the knowledge of the Medical Officer of Health from other sources. † After correction for inward and outward transfers. Particulars of notifications and deaths, together with the estimated population during the past five years are set out below :— Year. Estimated Population. No. of Primary notifications. Notification Rate per 1,000 Population. No. of Deaths. Death Rate per 1,000 Population. 164,380 336 99 0·6 1946 2·0 2·0 135 0·7 1947 175,060 356 1948 178,200 391 2·2 117 0·6 2·7 94 0·5 1949 178,310 478 178,900 325 1·8 64 0·3 1950 The following table indicates the number of cases on the Tuberculosis Register at the end of 1949 and 1950 :— I No. of Cases on the Register at 31st December, 1949. 1950. Male. Female. Total. Male. Female. Total. 1,002 1,806 1,828 Pulmonary 804 992 836 95 126 221 94 127 221 Non-Pulmonary 930 1,086 963 2,049 Total 1,097 2,027 Mass Miniature Radiography. The Mass Miniature Radiography Unit administered by the South East Metropolitan Regional Hospital Board returned to Camberwell during the year and was established at premises in Rye Lane, Peckham, from 31st August to 4th October. The Public Health Department again co-operated in publicising this free and confidential service which is available to any person who desires to take advantage of the facilities it offers for an X-ray examination of the chest. The Unit was operated on an appointment basis and evening sessions were held for persons who were unable to attend during the day. Dr. F. D. Beddard, the Medical Director of the Unit, has kindly provided the following particulars in respect of the work carried out in Camberwell during 1950. No. of Persons Examined No. Probably Tuberculous Percentage Probably Tuberculous 49 1·17 Males 4,195 Females 4,478 34 0·76 83 0·96 Total 8,673 In addition, 5 women and 12 men were referred to their private medical practitioners for other abnormalities found. Annual Report of the Camberwell Tuberculosis Care Committee for the year 1950. This is the first Annual Report of the Camberwell Tuberculosis Care Committee since the administration of the care and after-care of tuberculous persons was transferred to the London County Council by the National Health Service Act, 1946. This transfer took place on 5th July, 1948. After review by the Committee of its membership the following Bodies were invited and accepted representation on the Committee: — British Bed Cross Society, Miss K. Karslake. Ministry of National Assistance, Mr. C. Evans. Ministry of National Insurance, The Manager. The Ranyard Nurses, Miss S. Burkin. We regret to record the death of Mr. Alfred Collins, an immediate past member, who has served the Committee for many years. The Committee continued its functions during the year. These included financial and other assistance to patients, the raising of funds by voluntary subscriptions through the Christmas Seal Sale, the reference to other Bodies and organisations and generally to see that patients' needs were met where circumstances necessitated action. Most of the cases which the Committee considered were referred to it by the medical staff and health visitors of the Chest Clinic, who, in their daily contact with patients at the clinic or their homes, know where need exists, and to whom patients readily air their troubles and anxieties both before and after treatment away from home. The work carried out by the Committee during the year 1950 is given in detail below. It is by the generous response to the Christmas Seal Sale, mainly on the part of the citizens of Camberwell, that the Committee is able to continue its work of assistance to those who are in need. It is interesting to record that Camberwell collected the highest amount of money throughout the Metropolitan Boroughs in the Christmas Seal Sale for the year ended 31st March, 1950. We are indebted to the London County Council to the extent of £30 from the Sunday cinematograph entertainments which was received during the year. The Handicraft class continued to meet each Friday during the year between 2 and 4 p.m. During the first six months there was a Roll of sixteen students with an average attendance of twelve; during the second six months there was a Roll of eleven students with an average attendance of eight. Of the students who left the class, three became fit for work and the other two moved from the Borough. The work learnt and carried out by the class included leather work, glove making, cane work, seagrass stool making, lampshade making, embroidery and needlework. The following is a list of the type of assistance given and the number of patients assisted by the Committee during the year:— Assistance given. Number. Clothing 55 Pocket money while in hospital 15 Wireless: repair, rental and licences 6 Fares of relatives to distant sanatoria 79 Taxi fare 6 Holiday for patients 6 Board and lodging to relative 2 Household removals 4 Loan of bedside comforts 94 Loan of beds 40 Supply of bedding where L.C.C. are unable to assist 63 Loan of jigsaw puzzles 275 Re-housing advance rent 1 Children "sitter" during hospital visit 2 Hire purchase payments 5 Payment of house insurance 1 All the above were assisted from the voluntary fund. The National Assistance Board is able to give financial assistance in some cases. In certain circumstances they can also give additional monies to purchase clothing, bedding, pay fares and hire purchase payments. After investigation the Secretary referred 172 patients to the Board for assistance. During the year close co-operation with the voluntary organisations in the Borough was maintained: The British Red Cross Society, Family Welfare Association, Legal Advice Bureau, Nursing Associations, Invalid Childrens' Aid Association, Soldiers, Sailors and Air Force Families Association and the Women's Voluntary Services. We thank them for their assistance. We also thank the official Bodies who have always readily given advice. We record our thanks to our honorary officers: Mrs. Cecilia Greenwell, the Organiser to the Christmas Seal Sale and Mr. H. Smith, Borough Treasurer to the Committee. J. LEONARD, Secretary. A. F. CROSSMAN, Chairman. NON-NOTIFIABLE DISEASES. Lymphocytic Choriomeningitis. Only one case of this disease came to the notice of the Public Health Department. This was in the person of a woman who was removed to hospital in February stated to be suffering from poliomyelitis. The diagnosis was subsequently amended to lymphocytic choriomeningitis and at the request of the Central Public Health Laboratory, investigations were made at the patient's home address for mice infestation. There was no evidence of such vermin in the rooms occupied by the patient, but two mice trapped in the flat below were forwarded to the above Laboratory and it is understood that a virus with the characteristics of lymphocytic choriomeningitis virus was isolated from the brains of these mice. Influenza. This disease did not give rise to any anxiety during the year. The deaths numbered only 14, of which 9 were of persons over 65 years of age. HOUSING Satisfactory progress was made with the Council's Housing Schemes. Two-hundred and fifteen new dwellings were completed during the year and 395 were in the course of erection at the 31st December. The total number of tenancies under the control of this Authority at the end of the year was 7,145 made up as follows : — Requisitioned properties 5,626 Prefabricated bungalows 519 Permanent housing 1,000 Five-hundred and forty-seven families were rehoused by this Council during the year and 6,767 applications were outstanding at the end of December. Slum Clearance. At the request of the London County Council a preliminary survey was undertaken early in the year and a list of potential Clearance Areas was prepared and submitted to that Authority for consideration together with a map of the Borough on which such areas were indicated. Owing to the outbreak of the war in 1939, action was postponed in respect of eight Clearance Areas which had already been declared. As the result of further action by this Council, however, the buildings in three of these areas had been demolished by the end of the year under review, and endeavours were being made to rehouse the only remaining tenant in another of these areas. Individual Unfit Houses capable of being rendered fit at reasonable expense. Twenty-two houses were represented during the year as unfit for human habitation but capable of being rendered so fit at a reasonable expense. Informal action was taken for the repair of 10 houses and 14 formal notices were served under the provisions of the Housing Acts, 1936/1949. Twenty-five houses were rendered fit, 10 by informal action, 9 by owners following formal notice and 6 by the Council in default of the owners. Individual Unfit Houses not capable of being rendered fit at reasonable expense. During the year, 7 representations were made in respect of houses which were not capable of being rendered fit at reasonable expense. Demolition Orders were made in respect of 8 houses and 8 undertakings by owners to render houses fit for habitation were accepted. Five houses were rendered fit by owners following undertakings to repair. Seven houses were demolished as a result of action taken in accordance with the provisions of the Housing Acts, including one which was dealt with by the Council in default of the owner. Parts of buildings used as dwellings not capable of being rendered fit at reasonable expense. Five parts of buildings were represented as unfit for human habitation and not capable at reasonable expense of being rendered so fit. Five Closing Orders were made by the Council and in 2 instances undertakings were accepted from the owners not to use the parts of premises concerned for human habitation. Underground Rooms. Representations were made to the Council in respect of 32 underground rooms involving 21 houses. The Council made Closing Orders in respect of 26 rooms. Overcrowding. Three-hundred and thirty-six cases of overcrowding came to the notice of the Public Health Department during the year. Three-hundred and thirty-two certificates of overcrowding were forwarded to the Director of Housing and Valuer, London County Council, following a visit of enquiry by the Sanitary Inspector. This Council's Housing Department was also notified of the circumstances of each overcrowded family. Two-hundred and fifty overcrowded families were provided with suitable housing accommodation during the year, 181 by the London County Council and 69 by this Authority. In one instance the owner/occupier of a house had sub-let the rooms in such a manner as to cause overcrowding of his own family and two other families in the premises. This matter was brought to the notice of the Public Health Committee who instructed that a cautionary letter should be sent to the person responsible. At the end of the year one overcrowded family had removed from the premises and the owner/occupier had abated the overcrowded conditions of his own family; he had, however, re-let one room to another family consisting of man, wife and a child aged 7 years, thus creating a fresh case of overcrowding. Rehousing Applications. Where medical certificates are submitted by applicants for alternative housing accommodation, such cases are referred to the Medical Officer of Health for his opinion as to whether additional points should be awarded on medical grounds. The Medical Officer of Health dealt with 743 cases of this kind which were referred to him by the Housing Department during the year. Rent and Mortgage Interest (Restrictions) Act. Following the receipt of applications from tenants of dwelling houses, 69 certificates of disrepair were issued under this Act during 1950. Common Lodging House. The only Common Lodging House situated in the Borough is licensed for the accommodation of 224 male persons. Thirtynine visits of inspection were made to this establishment during the year but no conditions were found necessitating any statutory action by the Council. Housing Acts, 1936-1949. Record of Work carried out during the year by the Council's Housing Inspector. I Inspections Re-Inspections Total Clearance areas Individual unfit houses— 136 28 164 64 395 331 Section 9 196 20 216 Section 11 Underground rooms and parts of Premises Section 12 449 355 94 Miscellaneous 197 197 - 910 1,421 511 Total 31 Housing Statistics, 1950. 1. Inspection of Dwelling Houses during the Year:— (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 8,007 (6) Number of inspections made for the purpose 31,252 (c) Number of dwelling-houses found not to be in all respects reasonably fit for human habitation 6,013 2. Remedy of defects during the year without service of Formal Notices:— Number of dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers —Public Health (London) Act 527 3. Action under Statutory Powers during the year:— (a) Proceedings under Public Health (London) Act:- (1) Number of dwelling-houses in respect of which statutory notices were served requiring defects to be remedied 2,425 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners 4,276 (b) By local Authority in default of owners Nil (b) Proceedings under Sections 9 and 10 of the Housing Act, 1936:— (1) Number of dwelling-houses in respect of which notices were served requiring repairs:— Informal Notices 10 Formal Notices 14 (2) Number of dwelling-houses which were rendered fit after service of: — Informal Notices 10 Formal Notices 15 (a) By owners 9 (b) By Local Authority in default of owners 6 (c) Proceedings under Section 11 of the Housing Act, 1936:- Number of dwelling-houses not capable of repair at reasonable expense:- (a) In respect of which demolition orders were made 8 (a) In respect of which undertakings to render house fit for human habitation were accepted 8 (c) Number of houses demolished 7 (d) Number of houses made fit 5 (d) Proceedings under Section 12 of the Housing Act, 1936:— (1) Number of separate tenements and/or underground rooms: — (a) in respect of which Closing Orders were made 31 (b) in respect of which undertakings not to use for habitation were accepted 2 (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 Section 25 of the Housing Act, 1936 :— Houses demolished 9 INSPECTION AND SUPERVISION OF FOOD AND FOOD PREMISES. Provision of a Safe Milk Supply. The Milk Marketing Board is responsible for the supply of milk in the Borough. The bulk of the milk supplied is pasteurised, but for part of the year under review raw milk continued to be sold to families living in the vicinity of the cowhouse which is licensed for 53 cows. It was the practice for the Sampling Officer to obtain samples of raw milk from the cows in this cowshed and submit them for biological testing for the detection of tubercle bacilli. During 1950, 49 samples were taken for this purpose, and one was found to contain tubercle bacilli. A Notice was therefore served on the proprietor of the cowhouse under the provisions of the Pood and Drugs Act, 1938, and the Milk and Dairies Regulations, 1949, prohibiting the sale of raw milk for human consumption from the premises in question until such milk had been heat treated. This Notice was served on the 23rd September, 1950, and was not withdrawn until the 10th November, when the proprietor decided to arrange for all milk from his cows to be heat treated and to sell only heat treated milk at his premises. The following table shows the number of premises on the Dairies and Milkshops Register at the end of the year:— Dairies and Milkshops Register. Dairies 29 Distributors of Milk in the Borough 160 Distributors of Milk dealing from premises outside the Borough 12 Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949. There is no pasteurising or sterilising establishment situated in the Borough of Camberwell. The number of licences issued during the year in respect of the sale of designated milk were as follows : — Type of Licence. Sterilised. Pasteurised. Tuberculin Tested. Dealers 159 119 68 23 21 21 Supplementary Total 182 140 89 Special Designated Milk. The following is a summary of the results of various tests carried out during the year on samples of special designated milk :— Methylene Blue Test. Phosphatase Test. Turbidity Test. Designation. Satisfactory. Unsatisfactory. Satisfactory. Unsatisfactory. Satisfactory. Unsatisfactory. Pasteurised 96 - - 94 3 - Tuberculin tested pasteurised - - 12 13 - - - 22 Sterilised - - - - Undesignated 2 1 - - - - Supply of Milk to Schools and Hospitals. During the year, 36 samples were taken from hospitals and 34 from schools in the Borough and submitted to the Phosphatase Test. All were satisfactory. In addition, 35 samples were taken from hospitals and 34 from schools for bacteriological examination. One hospital sample failed to comply with the Methylene Blue Test. FOOD AND DRUGS ADULTERATION. Four hundred and seventeen formal samples and 598 informal samples were obtained by the Sampling Officer and submitted to the Public Analyst under the provisions of the Food and Drugs Act, 1938. The following table summarises the results of the examinations made :— Number examined. Number adulterated, etc. Percentage of adulteration. Formal. Informal. Total. Formal. Informal. Total. Formal. Informal. 417 598 1,015 4 12 16 0.96 2.0 The percentage of samples reported by the Public Analyst to be adulterated during the past five years was:— Year. Formal samples, (per cent.) Informal samples, (per cent.) 1946 2·19 1·97 1947 2·60 1·85 1948 3·2 2·95 1949 0·4 2·74 1950 0·96 2·0 Details of the samples both formal and informal found to be adulterated during 1950, together with particulars of the action taken and results of legal proceedings, will be found on the following pages. 37 36 Serial No. Article. Whether Formal or Informal. Observations. Result of Proceedings or other Action taken. Nature of Adulteration or Irregularity. Complaint justified Cautionary letter sent by Public Health Committee. 61 Milk Formal Transfer of milk from one receptacle to another on public footway. - 123 Hot milk Summons :—£7 fine, £7 costs. Formal 16 per cent, extraneous water. Small amount of weed seeds present Due to careless handling by retailer's staff. Manager of retailer's shop interviewed and steps taken to obviate recurrence. Coarse oatmeal Informal 127 Coarse oatmeal Informal Small amount of stones and weed seeds present. 154 - Reported to Public Health Committee; no action taken. Informal Contained a deposit consisting of mould growth. 345 Milk bottle - Summons £5 fine, £3 3s. costs. Formal 41 per cent, under proof. 351 Gin - Summons :—£2 10s. fine, £3 3s. costs. Contained rodent droppings. Wholewheat porridge meal. Formal 391 Remainder of stock returned to wholesaler. - Strong odour of sulphuretted hydrogen and objectionable taste. Red cherries in syrup Informal 400 - Cautionary letter sent by Public Health Committee. Formal 1 per cent. added water. 414 Milk - Cautionary letter sent by Public Health Committee. Incorrectly labelled. Do. Artificial vinegar Informal 449 "Non-brewed" Informal 450 - Remainder of stock surrendered and destroyed. Informal 24 parts of lead per million. Curry powder 457 - Remainder of stock surrendered and destroyed. Canned strained vegetables. Informal Can blown. 481 - Cautionary letter sent by Public Health Committee. Incorrectly labelled. Sherry type wine Informal 487 38 39 Whether Formal or Informal. Article. Nature of Adulteration or Irregularity. Observations. Result of Proceedings or other Action taken. - Pork sausages Informal 30 per cent, deficient in meat. Formal sample taken (following quarter 1951) and Summons issued. Potted meat Informal 10 per cent. cereal filler. Government import Matter referred to Ministry of Food. - Pepper Informal 1 per cent, maize starch. Formal sample taken (following quarter 1951) and Summons issued. - One-pint bottle pasteurised milk Complaint sample Bottle contained dead mouse. Summons :—£10 10s. fine, £5 5s. costs. Sausage mouldy and unfit for food. - Summons :—£10 fine, £5 5s. costs. Sausage roll Complaint sample - Contained cigarette end. Summons :—£7 fine, £3 3s. costs. Loaf of bread Complaint sample - Contained tail of mouse. Summons :—£3 fine, £3 3s. costs. Loaf of bread Complaint sample - Jar contained a piece of metal. Proceedings authorised but subsequently withdrawn, Cautionary letter sent by Public Health Committee. Sweet pickle Complaint sample Contained a piece of copper wire. - Cautionary letter sent by Public Health Committee. Loaf of bread Complaint sample - Cautionary letter sent by Public Health Committee. Mincemeat Complaint sample Jar contained a piece of wire. MEAT AND OTHER FOODS. Registration of Food Premises. Section 14 of the Pood and Drugs Act, 1938, requires that all premises used for the sale, manufacture or storage of ice cream, or the preparation or manufacture of sausages or potted, pressed, pickled or preserved food intended for sale shall be registered by the local authority. The premises so registered in Camberwell at the end of the year were as follows : — Sale, manufacture or storage of ice cream 387 Manufacture of sausages 142 Preparation or manufacture of:— Potted, pressed, pickled or preserved meat 218 Potted, pickled or preserved fish 92 Potted, pickled or preserved other foods 31 Supervision of Food Premises. All premises in the Borough where food is manufactured stored or sold are periodically visited by the district sanitary inspectors to ensure that a satisfactory standard of hygiene is observed. The record of such inspections carried out during the year under review is summarised in the following table: — Type of Premises. No. of Inspections. Bakehouses 137 Bakers and Confectioners 127 Butchers 182 Cooked and Preserved Meat 22 Dairies and Milkshops 213 Fishmongers and Shell Fish Vendors 79 Fish Fryers 183 Fish Curers 259 Food Factories 24 Ice Cream 642 Public Houses 84 Restaurants and Eating Houses 486 Slauehterhouses 24 Street Markets 1,535 Street Traders Food Stores 9 Other Food Premises 3,455 Total 7,461 Food Inspection. It is one of the duties of the Pood Inspector to examine any food suspected to be unsound, and if in his opinion it is unfit for human consumption, the food is surrendered and a condemnation certificate issued. Two thousand, four hundred and forty-two such certificates were issued during the year. The following table gives particulars of the unsound food condemned during 1950 : — Description. Weight. Total Weight. Tons cwt. qrs. lbs. Tons cwt. qrs. lbs. Meat. Meat pies 0 9 1 19 Corned beef 0 4 2 14¾ Corned mutton 0 0 0 12 Butcher's meat 0 7 2 3½ Pigs' carcases 0 6 0 8 Sausage meat 0 1 3 0 Sausages 0 0 2 16 Bacon 0 1 1 10¾ Ham 0 0 2 12 Rabbits 0 0 0 4 Offal 0 4 3 13 1 17 0 1 Poultry Chickens (frosted) 0 14 1 18 Chickens feet (frosted) 0 2 0 16 0 16 2 6 Fish. Shrimps (frosted) 0 15 2 5¾ Skate 0 13 0 20 Rock Salmon 0 4 1 21 Plaice 0 2 1 14 Haddocks 0 1 2 12 Haddocks (filleted) 0 0 1 21 Kippers 0 0 3 0 Cod 0 0 2 0 Cod (fillets) 0 0 1 0 Herrings 0 0 1 21 1 19 2 2¾ Fruit. Prunes 0 15 1 15 Greengages (frosted) 0 10 2 24 Plums (frosted) 0 3 3 12 Coconut (desiccated) 0 2 0 26 Currants 0 0 1 6 Pineapples (dried) 0 0 0 23 Figs 0 0 0 8 Apples 0 1 3 0 1 14 2 2 Tinned Foods. Meat 0 18 0 23¼ Vegetables 1 9 1 21¾ Fruit 5 15 3 4½ Milk (evap. and cond.) 1 4 2 10¼ Fish 1 16 2 2 Jam (assorted) 0 2 2 1¾ Marmalade 0 0 2 27¼ 11 7 3 6¾ Miscellaneous. Confectionery, Rice, Salads, Tomato ketchup, Sauces, Sandwich spread, Preserved fruits (assorted), Vegetables, Pickles (assorted), Lard, Eggs, Cheeses (various), Cooking paste, Gravy cubes, Salts, Soups and Custard Powders (assorted), Ice Cream Mixture, etc. 11 13 3 25½ Grand Total 29 9 1 16 Slaughterhouses. Only one of the three licensed slaughterhouses in the Borough was used during the year. The following table giving particulars of the animals slaughtered is set out in the form laid down by the Ministry of Health in Circular 2/50. Carcases Inspected and Condemned. Cows. Cattle, excluding Cows. Sheep and Lambs. Calves. Pigs. Nil Nil Nil Number killed 29 Nil - - - Number inspected 29 - 3 All diseases except Tuberculosis. Whole carcases condemned - - - - Carcases of which some part or organ was condemned Nil. - - - - Percentage of the number inspected affected with disease other than tuberculosis - - - - 10·3 - Tuberculosis only. Whole carcases condemned 3 - - - Carcases of which some part or organ was condemned - 1 - - - Percentage of the number inspected affected with tuberculosis - - - - 13·8 Public Health (Meat) Regulations. During the year a number of complaints were received of the conditions under which meat is transported by road and handled in the Borough. At present the transport of meat and edible offal for sale for human consumption, except for the relatively small number of pig carcases sold direct by selfsuppliers to pork butchers and the small quantities of meat products imported by private individuals under licence, is under the general direction of the Ministry of Food. The transport of meat by road which includes all deliveries to retail butchers' shops and to meat manufacturers' premises is undertaken, with few exceptions, by the Meat Transport Organisation Ltd. under agreement with the Minister of Food. Observations kept by the Sanitary Inspectors did not reveal any irregularity which could be dealt with under the provisions of Part VI of the Public Health (Meat) Regulations, 1924 to 1928. Many of the vehicles used for the transport of meat are out of date. They are, however, gradually being replaced by vehicles which have been specially constructed for the transport of meat. Merchandise Marks Act, 1926. It was not found necessary to take action against any trader in the Borough for failure to comply with the provisions of the Orders in Council made under the above Act which require all imported food sold or exposed for sale to be clearly marked with the country of origin. Ice Cream. At the 31st December, 1950, there were 387 premises in the Borough registered for the sale of ice cream. The Food Inspector obtained 62 samples of this commodity for examination by the Methylene Blue Test with the following results :— Grade. No. of Samples. I 25 I 22 III 10 IV 5 In addition, 27 samples of ice cream were submitted for chemical analysis, none of which was found to have a fat content under 2½ per cent. Bakehouses. The number of bakehouses in the Borough at the end of the year was 79, of which 12 were underground bakehouses. These premises were kept under observation by the district sanitary inspectors and where necessary, steps were taken to secure the elimination of any unsatisfactory conditions. Restaurants and Eating Houses. The register of eating houses contained the addresses of 304 premises at the end of the year. The District Office of the Ministry of Food forwards information to this Department of all premises in respect of which catering licences are issued. In cases where the premises have not previously been used as a cafe or eating house, the sanitary inspector visits the property and a report is forwarded to the Ministry as to its suitability for the establishment of a business of this nature. All restaurants and eating houses in the Borough are inspected periodically by the district sanitary inspectors in order to ensure that a high standard of hygiene and cleanliness is maintained. Street Traders. Street trading licences were issued by the Council to 94 persons engaged in the sale of foodstuffs from barrows and stalls in the streets and market places. These traders were kept under constant supervision, and the premises used by them for storage purposes were regularly inspected. INDEX PAGE Aged Persons 16 Bakehouses 43 Births 6 Bombed Sites 11 Cancer 9 Cleansing Station 17 Common Lodging House 31 Deaths 6-9 Cancer 9 Chief Causes 8 Infantile Mortality 8 Maternal Mortality 8 Table of Causes and Ages 6-7 Diphtheria 19 Disinfecting and Cleansing Station 17 Drainage and Sewerage 10 Dysentery 22 Eating Houses and Restaurants 43 Factories Acts 14-15 Inspection tables 14-15 Outworkers 15. Food and Food Premises 33-44 Adulteration 35 ,, Table 36-39 Bakehouses 43 Ice Cream 43 Inspections 40 Merchandise Marks Act 43 Milk 33-34 Public Health (Meat) Regulations 42 Registration of Food Premises 40 Restaurants and Eating Houses 43 Slaughterhouses 42 INDEX —continued. PAGE Food and Food Premises —continued. Street Traders 44 Supervision of Food Premises 40 Unsound Food Condemned, table 41 Food Poisoning 22-23 General Information and Statistics 5 Health Services, General Provision 16-18 Housing 29-32 Applications for rehousing 31 Common Lodging House 31 Individual Unfit Houses, etc. 29-30 New Accommodation 29 Overcrowding 30 Rent and Mortgage Interest (Restrictions) Act 31 Slum Clearance 29 Statistics 32 Underground Rooms 30 Work of Housing Inspector, table 31 Ice Cream 43 Infantile Mortality 8 Infectious Diseases 19-28 Non-Notifiable diseases 27-28 Table of Notifications 20 Tuberculosis 24-27 Influenza 28 Lymphocytic Choriomeningitis 27 Mass Miniature Radiography 25 Maternal Mortality 8 Maternity and Child Welfare 18 Meat and Other Foods 40-44 Meningococcal Infection 21 Merchandise Marks Act 43 Milk 33-34 Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations 1949 33 Safe Milk Supply 33 Special Designated Milk —tests 34 Supply of Milk to Schools and Hospitals 34 Mosquitoes 11 offensive Trades 13 Outworkers 15 INDEX —continued. PAGE Overcrowding 30 Paratyphoid Fever 19 Pharmacy and Poisons Act 14 Piggery 12 Poliomyelitis and Polio-encephalitis 21 Prevention of Damage by Pests Act 18 Public Cleansing 10 Public Health (Meat) Regulations 42 Puerperal Pyrexia 19 Rag and Bone Dealers 14 Rag Flock 12 Rent and Mortgage Interest (Restrictions) Act 31 Restaurants and Eating Houses 43 Rodent Control 18 Sanitary Circumstances of the Area 10-15 Sanitary Inspection, Tables 12-13 Inspections 12 Notices Served 13 Works Supervised, etc. 13 Scabies 23 Sewerage and Drainage 10 Shops Act 14 Skin Dressers 13 Slaughterhouses 42 Slum Clearance 29 Smallpox 21 Smoke Abatement 10 Soap Boilers 13 Staff of the Public Health Department 3 Static Water Tanks 11 Statistics, Summary 4 „ Vital 5 Street Traders 44 Swimming Bath Water 12 Tuberculosis 24-27 Care Committee Annual Report 25-27 Mass Miniature Radiography 25 Notifications, table 24 Underground Rooms 30 Water Certificates 10 Water Supply 10