library Lon 69 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE CITY OF LONDON for the year 1943. 1. STAFF. Date of Apointment. MEDICAL OFFICER OF HEALTH. White, Charles Francis, O.B.E., M.D., Ch.B., D.P.K., D.T.M. CLERICAL STAFF. Dec.1937 Lowe., George. Principal Assistant & Vaccination Officer. Nov.1902 Gray, Charles M. Deputy Principal Assistant Mar.1911 Blunt, Harold F. 2nd Class Assistant May.1924 (on Active Service) Stout, James Erl. ) Jul.1930 Ehreaagold, Arthur W.) Nov.1923 Stevens, F .W . ) 3rd Class Assistants Nov.1937 (on Active Service)) Peters, E.J. ) Nov.1935 (on Active Service)) Wilson, J.C. ) Jan.l936 (on Active Service)) Clements. K.N.F. ) Unclassified Assistants Nov.1936 (on Active Service)) Furney, Miss M.L. ) May.1939 (temporary) ) SANITARY INSPECTORS. cGrath, William Richard.) Mar.1922 Earrington, George Edwin.) Dec .1925 illett, David Ernest. Apr.1926 Leale, William G.C. Jul.1928 Euorpe, Robert C. Senior Inspectors Mar .1930 Febber, G.A.(Rat Officer)) Jul.1932 Fudson, Leslie A. ) Apr .1934 Hdhous, F.J. Apr .1935 Followay, A.B., O.B.E.) May.1937 (on Active Service) ) Lox,C .R. ) Junior Inspectors Oct.1938 (on Active Service) ) Ecott,A.E.R. ) Oct.1938 (on Active Service) ) MEAT INSPECTION STAFF. Erace, LB.A, M.R.C.V.S. Veterinary Officer and Chief Meat Inspector Jun.1934 Waston,William S. First Senior Inspector of Meat. Dec.1910 EHLtterCharles. ) May.1908 Funsburry Samuel B. Sep.1911 ellish, Cyril E. ) Senior Inspectors Jan.1912 Hompson,Frank E. ) Jul.1924 Cann,S.W ) May. 1927 (on Active Service) ) Peyton, H.R.) Junior Inspectors Set.1932 (on Active Servicc) ) W.R. ) Jul.1930 (on Active Service) ) srnhardt;D.R.) May.1931 (on Active Service) ) Probationary Meat eymour, K.D. Inspectors Jul.1935 (on Active Service) ) WOMAN SANITARY INSPECTOR. BLkinson, Miss Annie M. Jul.1909 1 A. TUBERCULOSIS SISTER & HEALTH VISITOR. Bakehouses, Miss S.A. Jun.1931 TUBERCULOSIS NURSE & ASST. HEALTH VISITOR. bbon, Miss E.N.(temporary) Mar ,1943 KEEPER OF THE MORTUARY. eggles, T. Dec .1918 DISINFECTOR. Conneli, R.J. MESSENGERS Apr .1903 tts, Charles .(Head Messenger) (on Active Service) Apr ,1926 erney, T .E. (temporary) Dec .1926 LABOURERS. stings, T. (General Duties at Mortuary) Jun.1920 Kon. John H. Mar .1936 pence, F.h. May.1936 (on Active Service) icate, G. (General Duties at Smithfield Market) Oct.1906 rong, S.R. Mar .1914 eris W.F. Mar .1925 evost, A.C Feb.1926 on Active Service) en, Ernest V . Jan. 1928 Rational Fire Service) trence, Charles J. Feb.1928 aham, Mrs,. (Bath Attendant and Cleaner) Jun.1927 2. of the Right Honourable, The Lord Mayor, Aldermen & Commoners of the Corporation of London. Public Health Department, Guildhall, E.C.2. July, 1944. Lord Hay or & Gentlemen. I have the honour to submit a report on the work of my Apartment for the year 1943 . On the instructions of the Minister of Health, this report is again presented in an abridged form and briefly summarises the Activities of the Department, the normal work of which has been rewricted by war circumstances. Particular attention has been given to the rat problem and Also to the supervision of food supplies. Statistical Information. pea. 661 acres (including the Temple and Tidal Water and foreshore). Population. Registrar General's estimate for 1943 - 4,860 Annual Rateable Value. As at October, 1943 - £6,175,791. Annual Sum received from Penny General Pate. Estimated £23,500. Births:- Total. M. F. Legitimate 20 11 9 ) Birth Rate per 1,000 estimated Live Births ) resident population 1943 - 4.94 Illegitimate 4 1 3 ) tillbirths 0 0 0 Rate per 1,000 total (live and still) births - 0.00 Deaths. Deaths under 1 year 1 0 1 Death Rate per 1,000 estimated Deaths (all ages) 40 26 66 average population - 13.6 Deaths from puerperal causes (Headings 29 & 30 of the Registrar General's Short List):- Deaths . Rate per 1,000 total (live and still) births. 0.29 Puerperal sepsis nil. - 0.30 Other puerperal causes nil. - Total nil. - Birth Rate of Infants under one year of age:- All Infants per 1,000 live births 42 Legitimate Infants per 1,000 legitimate live births 0 Illegitimate Infants per 1,000 illegitimate live births 250 Deaths. from Cancer (all ages) 18 " " Measles (all ages) 0 " " Whooping Cough (all ages) 0 " "Diarrhoea (under 2 years of age) 0 Vaccination. Of the 118 births notified to the Vaccination Officer during 42, 33 had been successfully vaccinated by the end of 1943. 11 had died before the age for vaccination and 1 was insusceptible Vaccination was postponed in no case, and 54 had removed into her districts. 1 case was pending. There were 18 cases of conscientious objection. The Public Vaccinator performed 1 revaccination 3. On during the year, and in addition to the successful vaccinations referred to above, 0 adult persons were vaccinated for the first time. MAERNITY CHILD WELFARE. No. of City .Births notified (including stillbirths) 22 Visits by Health Visitors. Under one year 476 Over one year and under 5 years 538 Ante Natal 85 Ophthalmia 0 Still Births 0 Home Helps 0 Infant Life Protection 4 Scabies 0 613 lbs. of Dried Milk were supplied to children under 1 year; also 112 lbs. farex and 366 bottles radiostoleum to mothers and children. Liquid Milk, Cod Liver Oil and Fruit Juices were distributed through the Child Welfare Centre, to mothers and children on behalf of is Food Office. INFANT WELFARE CENTRE. 3 No. of Sessions (including sessions for Diphtheria Immunisation and Schick Testing) 101 Attenaances Under one year 476 ) Over 1 year and under 5 years 538 ) 1,053 Mothers 39 ) Dentures provided 0 Home Helps provided 0 No. of children, under 5 years, immunised against Diphtheria 29 ) No.of children, over 5 years and under 15, immunised against ) 52 Diphtheria 23 ) No. of injections 104 No. of Post Schick Tests & Readings 63 INFECTIOUS DISEASE. Notifications received:- These consisted of the following Total cases notified. Cases admitted to Hospital. Erysipelas 1 1 Measles 29 3 Scarlet Fever 7 7 Tuberculosis 12 7 Lobar Pneumonia 1 1 Diphtheria 1 1 PROVISION OF HEALTH SERVICES. Tuberculosis Dispensary. No. of Sessions Held 201 No. of Patients attending Residents 199 ) Non-Residents789 )988 No. of New Patients 204 No. of Patients admitted to Sanatoria, Hospices, etc 81 No. of Artificial Pneumothorax Refills given 232 No. of Visits made to Homes 118 No. of Contacts kept under observation 14 Milk was supplied to two patients during the year. 4. Genreal Diseases. Sessions held daily except Sunday M. F. . No. of Attendances 11,563 5,238 16,801 New Patients 491 190 681 Ecteriological Examinations. The following specimens were examined during the year. Specimen. Disease Suspected. Result. Positive. ive. Sputum Tuberculosis 0 3 Throat Swabbing Diphtheria 1 7 Diphtheria Anti-Toxin. Quantity provided to private practitioners Nil. MEAT INSECTION. Count of meat delivered at Smithfield Market:- 34,436 tons Count of meat seized by Meat Inspectors at Smithfield Market:- 24 tons.5 cwts.l qrs.2 lbs. Count of meat seized by Meat Inspectors at Cold Stores. Leadenhall Mkt. & City Shops:- 13 tons.3 cwts.0 qrs.6 lbs. No. of Prosecutions instituted Nil. No. of Demonstrations and Instructions in Meat Inspection:- Nil. No.of Naval Officers receiving instruction in Feat Inspection:- Nil. PUBLIC HEALTH (MEAT) REGULATIONS, 1924. The improvement in carriage of meat noted in past reports has been maintained, although of course the quantities carried are very Such less. PREMISES WHERE FOOD IS PREPARED AMD OFFERED FOR SALE. All these premises are subject to regular inspection. Inspections have been made and without exception all criticisms have received immediate attention. ITINERANT FOOD VENDORS. Constant irspections of barrows and of itinerant food vendors have been maintained and no difficulty has been experienced in connection with this class of trade. FOOD INSPECTION. The food delivered at riverside wharves and at other premises in the City has consisted of the customary varieties, and has been the Subject of constant inspection. 117 tons 15 cwts. 1 qr. 21 lbs. were condemned as unfit for human consumption. 117 tons 1 cwt. 1 qr. 17 lbs of this Food was utilised for stock-feeding, fertilizing or manufactbring purposes. The remainder, consisting of 14 cwts.O qrs .4 lbs. was destroyed either by the Cleansing Department of the City Corporation, sing useless for stock feeding purposes, or else on the sites on which it as condemned, the individual quantities being so small as not to warrant the use of petrol in transport. 5- FOOD AND DRUGS ACTS. 553 samples have been submitted to the Public Analyst for examination. 22 of these were formal samples and 531 were informal samples. 24 samples were reported against. The percentage of adulterated samples was 4.34. Legal proceedings were necessary in 5 cases. 4 applications were received for registration as dairymen or purveyors of milk, all of which were granted. 4 supplementary licenses were issued under the Milk (Special Designations) Orders 1936 & 1938. SANITARY CIRCUMSTANCES. 1 The general sanitary supervision has been maintained and in this connection 2,462 inspections have been made. As a consequence of these inspections it was necessary to serve 3 Statutory Orders and 14 Intimation Notices. No legal proceedings were necessary. Tenement Houses were inspected and the only common lodging house in the City was kept under regular supervision. HOUSING. The total number of dwelling houses inspected for housing lefects was 92. 25 were found not to be in all respects reasonably fit for human habitation; 23 of these were rendered fit, in 16 cases as a result of informal action by the inspectors, and in 7 cases subsequent to the service of notices requesting the defects to he remedied. One case of overcrowding in the City was reported, but was remedied as a result of informal action by the Inspector. FACTORY ACT, 1937. Factory premises have been under such supervision as has been possible having regard to their needs. There are 4 above-ground bakehouses and 4 underground bakehouses . The provisions of the Act relating to outworkers have been carried out as heretofore. No case of infectious disease was. reported in connection with outworkers' premises in the City. SHOPS ACT, 1934. 37 shops and warehouses have been inspected and where necessary re-inspected. Any-defects have been remedied without recourse to legal proceedings. PHARFlACY AND POISONS ACT, 1933. 67 firms were registered under this Act, 61 of Which were re-registrations . FERTILIZERS AND FEEDING STUFFS ACT, 1926. The provisions of the above Act were carried out without re-course to legal proceedings or especial difficulty. 6. MERCHANDISE MARKS ACT, 1908. Agricultural Produce (Grading & Marking) Act, 1928 - 1931. No difficulty was experienced during the year in regard to the ministration of the above Act. CREMATIONS. 647 cremations were carried out at the City of London Crematorium Ilford. CITY MORTUARY. bodies received 46 Inquest on bodies 26 " " fires 0 DISINFECTION AND CLEANSING OF VERMINOUS PERSONS. Export of Clothing. No. of articles disinfected 330 Fess received £15. General Disinfection. Infectious Diseases, etc. Articles of clothing and bedding disinfected 10,138 Horse-hair (cases) 18 Articles of Bedding & Clothing destroyed 636 Cleansing of persons. No. of Scabeous Persons bathed 39 No. of verminous persons bathed 264 No. of scabeous and verminous articles disinfected 3,132 Cleansing of School Children. No. of children cleansed 3,026 No. of articles disinfected 1,378 Restruction of Pigeons. igeons destroyed - by staff 0 bv one private individual duly authorised by the Corporation 1,381 RAT REPRESSION. In time of War when the feeding of the people of this country becomes a serious national problem, special efforts must be made to reduce to a minimum the destruction of foodstuffs by rats. It is appropriate, therefore, that the Ministry of Food should have taken statutory powers to require the occupiers of land or remises and the owners of food or other commodities, to take more Active measures of rat repression than they have done under the its & Mice (Destruction) Act, 1919, and to direct Local Authorities to report as to the degree of rat infestation in their districts; to immededy such infestation in certain cases, and in others to enforce trections of the Minister given to occupiers of premises. Under the Infestation Order, 1943, a report has been made to the Ministry of Food on the degree of infestation throughout the City. Your Rodent Officer knows from his long experience in the City What premises .are seriously and constantly infested, and the factors Which have mitigated against the success of attempts to remedy the conditions. these factors include the common difficulties associated with the storage of foodstuffs and other rat-attractive materials, and the preparation of food and the disposal of waste in restaurants, cafes, etc"., particularly when the premises provide abundant rat harbourage, as is often the case; together with unskilled rat catching and an absence of co-ordination of effort by the several, sometimes many, occupiers of individual blocks of buildings. The Rats & Mice (Destruction) Act, 1919, provides that if an occupier fails to take all reasonable and practicable steps to destroy the rats in infested premises, the Local Authority may enter, carry out the work themselves and recover the cost from the occupier. The Minstry of Food have encouraged Local Authorities to place themselves in a position to put is section of the Act into effect, and have undertaken to re-imburse the net cost of the aditional staff and equipment necessary to enable them to do so. the Corporation promptly acted on this suggestion, and in January 1943 appointed two part-time Assistant Officers and trained them in rat repression. This experiment was so successful that in November 1943 six whole-time Assistant Rodent Officers were appointed. These men work on the lines recommended after carefully controlled experiments, by the technical experts: attached to the Directorate of Infestation Control of the Ministry of Food arid the results obtained have been very satisfactory. The duties of these Assistant Rodent Officers are to examine premises to ascertain whether they are infested by rats, and if so, to what degree, to ascertain what measures of rat repression are being taken by the occupier and whether they are effective. If he occupier is taking no measures or they are unskilled and Eneffective, he is interviewed and usually agrees to the Corporation Staff carrying out the necessary measures at his expense. In some Cases a member of the occupier's staff 'is instructed in the measures Which should be adopted to deal with any re-infestation, If the occupier is taking effective measures against rats the premises are simply kept under observation, for which of course no charge is made. Renewed efforts are being made to secure co-ordination and synchronisation of all the rat repression measures throughout blocks of buildings in defined areas. he advice and help of the Corporation's staff has been welcomed, but the destruction of rats and the prevention of re-infestation remain the responsibility of the occupiers of premises and will not be taken over by the Corporation. I have the honour to be, Gentlemen, Your obedient Servant, CHAS. F. WHITE. Medical Officer of Health, City of London.