AC4375 DEPT 33 METROPOLITAN BOROUGH OF DEPTFORD. ANNUAL REPORT on the HEALTH OF THE BOROUGH during 19 4 8 by FREDERICK LEONARD KEITH, M.D., D.P.H., L.D.S. Medical Officer of Health. . v . To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Deptford. Mr. Mayor, Ladies and Gentlemen, I have the honour to present the Annual Report on the Health of the Borough of Deptford in 1948. Following the request of the Minister of Health the Report is produced in the abridged form which has been the case since the outbreak of war in 1959. During the year, on the 5th July, the National Health Service Act came into operation. This measure, amongst others such as the National Insurance Act and the National Assistance Act, brought about great changes in the social welfare services of the country. To name a few:- the Deptford Borough Council's Maternity and Child Welfare service was transferred to the London County Council, but arrangements were made whereby the Borough Medical Officer carried out the day to day supervision. The Vaccination Act became redundant upon the coming into operation of the National Health Service Act, and in consequence there are no Public Vaccinators as heretofore but Veccination Clinics are arranged by the London County Council. Diphtheria and Whooping Cough Immunisation is now carried out by London County Council staff instead of staff provided by the Deptford Borough Council although it is personally carried out by the same medical officers as before. The Tuberculosis Dispensary service was transferred to the Regional Hospital Board, Dr. N.M. Donnelly continuing as Chest Physician until his retirement in September. Amongst other staff personnel to be transferred were the Health Visitors, many of whom had given spendid service with the Borough Council over a period of years and it is satisfactory to note that these experienced officers are still retained in this Borough. Although the Maternity and Child Welfare and Tuberculosis Services have been transferred to other Authorities it must not be forgotten that the main duty of the Department, i.e., environmental public health, in its widest connotation, remains the responsibility of the Borough Council. The duties of the Sanitary Inspectors were carried on under conditions of great difficulty although with the relaxation of controls regarding building licencing, it was possible to maintain an improvement in the lapse of time between the service of Notices and the completion thereof. My thanks are duo to the Staff, both permanent and temporary, for the able and enthusiastic manner in which they have discharged their duties. I have the honour to be, Your obedient Servant, F.L. KEITH. Medical Officer of Health. (1) STAFF. MEDICAL OFFICER OF HEALTH. F.L. KEITH, M.D., Ch.B., D.P.H., L.D.S. © DEPUTY MEDICAL OFFICER OF HEALTH AND TUBERCULOSIS OFFICER. N.M. DONNELLY, M.B., B.Ch., B.A.O., D.P.H. MATERNITY AND CHILD WELFARE OFFICERS. (1.1.48-4.7.48). E.R.EMSLIE, M.D., M.B., Ch.B., D.P.H., (Resigned March 1948). (PART-TIME). G.E. KEITH, F.R.C.S., M.R.C.O.G. L. RAFTERY, M.R.C.S., L.R.C.P., M.S.A., M.R.C.O.G., J. RAFTERY, F.R.C.S., F. ALLPORT, M.R.C.S., L.R.C.P., D.Obst.R.C.O.G., K. STUART HARRIS, M.R.C.S., L.R.C.P. D.H. TOMES, M.R.C.S., L.R.C.P., e. frankel, m.d., M.B., B.S. GYNAECOLOGICAL CLINIC. L. HEMMANT. M.A., M.R.C.S., L.R.C.P., BACTERIOLOGIST. G.L. ROBINSON, M.D. Dreadnought Hospital. PUBLIC ANALYST. H.AMPHLETT WILLAMS, Ph.D., A.C.G.F.C., F.R.I.C. DENTAL SURGEON. W. HARTLEY JENNINGS, .D.S., (ENG.). ASSISTANT ADMINISTRATIVE OFFICER. C.A. CHAPMAN. (ii) SENIOR CLERK. G. A. LANGLEY. Clerks:- L.C. SOUTHGATE, L. THORPE, J. THORPE, and MISS T.F.K. HALLIWELL, (Appointed November 1948). Medical Officer of Health's Secretary and Shorthand-Typist:- MRs. K.N. COLEMAN. Temporary Clerks:- *MISS D. POETT, *MRS. E. MEADE. SANITARY INSPECTORS. G.B. allen (i) H.E. GREEN (i) T.R.W. MASON (ii) W.F. MAYO (ii) F. A. SAUNDERS (iii) J.E. WARING (i) A.C. WEBSTER (iv) G.F. WILTON (i) FOOD INSPECTOR. R.W. ALLEN, (i) (i) Cert. R.S.I. Joint Board, Cert. R.S.I. Meat and Other Foods. (ii) Cert. S.I.E.B. (London). (iii) Cert. R.S.I. Joint Board. (iv) Cert. S.I.E.B. (Lond.) Cert.R.S.I., Meat and other Foods. GENERAL ASSISTANT. E. H. EVANS. *MISS E.T. STOWELL, *MISS K.O. LOUGHLIN. *MISS B.M. HULL. (appointed 19.4.48) MISS b. MAURICE. (resigned 11.1.48). DENTAL NURSE. *MRS. M. NOLAN. HEALTH VISITORS. *MISS M. LITTLE. *MRS. M. PARRY. (resigned 3.4.48) *MISS GLEESON. (appointed 1.4.48). *MISS E. CLOKE. . MISS G. THOMAS. (resigned 23.5.48) *MISS E.M. FRANKLIN. *MISS KEARNEY. (appointed 1.4.48) clinic reCEptionist. *MRS. E.M. HIGGETT. DISPENSER. *miss G.F. greig XMISS A.M. ROY. TUBERCULOSIS HEALTH VISITORS. *MISS E.M. COLES. (2) STAFF. (Continued). TUBERCULOSIS CARE COMITTEE SECRETARY. *mrs. D.K. chatterton. dispensary clerk. © miss i. smith. chiropodists (full tiMe). *miss b. forder. *MISS M. saunders. plus part-time staff. MORTUARY KEEPER. a.t. capStick. rodENT cONTROL STAFF. E. J. summers. R.c. gibbs. DISINFECTING STATION (TEMPORARILY AT:- SOUTH EASTERN HOSPITAL). Chief Disinfoctior:- F. PEACHE. Disinfectors:- C.GOOD AND J. WALD0N. Driver:- J.LLOYD. *Transferred to London County Council on 5.7.48. ©Transferrer to Regional Hospital Board on 5.7.48. (3) VITAL STATISTICS. The tables following give the important vital statistics for 1948, together with comparative figures for the previous year:- Area of the Borough 1,564 acres, 1947. 1948. Estimated Civilian population 73,380 75,670 Comparative figures for London. Comparative figures for London. Birth rate (per 1,000 living) 25.4 22.7 20.6 20.1 Stillbirths -do- 0.33 0.49 0.62 0.49 Death rate -do- 13.0 12.8 11.6 11.6 Infantile Mortality rate (deaths under 1 year per 1,000 live births). s 33 37 22 31 1947. 1948. Live births registered (adjusted for inward and outward transfers). Legitimate 1767 1482. Illegitimate 98 80 1865 1562 Still Births registered, Legitimate 22 46 Illegitimate 2 1 24 47 Infant Deaths (under 1 year) Legitimate 56 32 Illegitimate 6 2 62 34 Total deaths (adjusted for Inward and Outward Transfers) 955 878 (4) INFECTIOUS DISEASES 1948. Typhoid fever - cases - deaths. Cerebro-spinal fever 1 " - " Scarlet Fever 112 " - " Whooping cough 149 " - " Diphtheria 6 " 1 death. Erysipelas 11 " - deaths. Smellpox - " - " Measles 816 " — " Pneumonia (Acute primary and Acute influenzal 58 " 34* " Puerperal sepsis 12 " - " Scabies 60 " - " Dysentery 2 " - " Diarrhoea and Enteritis (under 2 years) 30 " - " Ophthalmia Noonatorum 3 " - " Malaria - " - " Acute Poliomyelitis 3 " - " Acute Polio-Encephalitis - " - " *This figure relates to deaths from all forms of pneumonic:- FOOD POISONING. 10 cases of Food Poisoning were notified during the year. DISINFECTION AND DISINFESTATION. The work of disinfection and disinfestation has continued to be carried out at the temporary Disinfecting Station and Bathing Centre at the South Eastern Hospital, the Council's establishments having been destroyed by enemy action in July, 1944. Premises disinfected (infectious disease) 249 Total articles disinfected in Steam disinfector 21,487 Premises disinfected (requests) 27 Books disinfected 251 Premises disinfected (verminous conditions) 437 Articles destroyed at owners' request 149 BATHING CENTRE. No. of School children who received baths (other than for Scabies 1,267 Adults who received baths (other than for Scabies) 379 No. of Sohool children who received baths for the treatment of Scabies 144 Scabies baths to adults. 57 MORTOARY & CORONERS COURT. Bodies received 451 Inquests held The Coroner's Court was not used for inquests during the year by reason of damage sustained by enemy action. The County Council subsequently decided to dispense with this Court, utilising the existing accomodation in adjoining Boroughs. (5) SANITARY INSPECTION. The following tables illustrate the work carried out by the Sanitary Inspectors during the year under review:- Total Number of Inspections 9,179 Total Number of Re-Inspections, calls etc 29,988 Complaints 3,190 Infectious Diseases 160 Notices from Builders 496 Referred from T.C. Dispensary 7 Factories (Power) 151 Factories (Non-Power) 19 Food Premises 1,553 Butchers' Premises 281 Ice Cream Premises 230 Milk Promises 160 Bakehouses 99 Fish Shops 149 Offensive Trades 2 Outworkers 94 Common Lodging Houses 6 Shops Act Inspections 392 Housing Inspections 728 Poisons Act Inspections 17 Miscellaneous 1,445 Public Health (London) Act, 1936. Intimation Notices served 2,934 Statutory Notices served 1,160 Section 40 Notices served 21 Notices completed during year 2,735 SUMMARY OF IMPROVEMENTS EFFECTED UNDER THE SUPERVISION OF THE SANITARY INSPECTORS. No. of rooms cleansed 3,025 Premises. Roofs repaired 1,057 Rainwater pipes and gutters repaired 596 Dampness abated 658 Yards and Forecourts repaired 134 Water fittings renewed and repaired 124 Sinks and waste pipes renewed or repaired 293 Drains entirely reconstructed 39 Drains partially reconstructed 124 Drains unchoked or cleansed 181 Soil and vent pipes renewed or repaired 71 Gullies provided, unchoked etc 50 Manhole chambers and fresh air inlets provided or renewed 59 Repairs to W.C.'s 814 Repairs to Windows etc 537 Repairs to Stoves, Coppers, Flues etc 624 Repairs to Stairs, doors, etc 268 Repairs to flooring 393 Ventilation and Lighting improved 73 Offensive accumulations removed 26 Dustbins provided 110 Miscellaneous 128 (6) FOOD INSPECTIONS. VISITOR TO PREMISES Potted Pickled Preserved etc premises 62 Fish Shops 65 Ice Cream 175 Dairies 63 Stalls, Shops(Labelling etc.) 682 Grocers 458 Cafes 25 Pharmacy and Poisons 16 Butchers 208 Bakehouses 50 Miscellaneous 387 2,191 LEGAL PROCEEDINGS Public Health (London) Act, 1936. Date. Nature of Offence. Fine. Costs. Remarks. 15.1.48 Non-compliance with Statutory Notice105, Pomeroy Street. - £2.2.0. Order to execute work in 28 days. -do- Non-compliance etc.,107a, Pomeroy Street - £2.2.0. Order to execute work in 28 days. -do- Non-compliance etc.,3, Lovelinch Street. - £3.3.0. Order to execute work in 21 days. 24.3.48 Non-compliance etc.,34, Kerry Road. - £3.3.0. Order to execute work in 28 days. 3.5.48 Non-compliance etc.,141, St. Asaph Road. - - Order to execute work in 28 days. 27.9.48 Non-compliance etc.,63, Lausanne Road. — - Work completed prior to hearing Summons withdrawn. -do- Non-compliance etc.,118, Drakefell Road. - £10.10.0. Order to execute work in 28 days. 1.11.48 Non-compliance etc.,18, Erlam Road. - - Summons dismissed £4.4.0. costs against Council. -do- Non-compliance etc.,20, Erlam Road. - — Summons dismissed £4.4.0. costs against Council. FOOD AND DRUGS. Notices served under Section 13, Food & Drugs Act 5 Milk. Others. Total. Samples taken 164 334 498 Number adulterated or otherwise infringing the Act by reason of improper labelling or other irregularity 4 25 29 Instances in which legal proceedings were instituted (Informal action taken in all other cases) - 1 1 (7) FOOD & DRUGS. (Continued). All drugs where prepacked, were considered under the Pharmacy and Medicines. Act and one case was referred to the Pharmaceutical Society. Legal proceedings were instituted as a result of information to the effect that a certain butcher was using horseflesh for making sausages. The defendants were subsequently fined for offences under the Food and Drugs Act. In view of the other legislation on the subject, the Council's witnesses acted also for the Deptford Food. Control Committee and the defendants were sentenced to imprisonment (varied on appeal to increased fines) and substantial fines and costs. Bacteriological Examinations. Dates 2, Mincement 1, Sultanas 1, Condensed Milk 1. Desiccated Coconut 1, Bread Baits 1. Use of Bacteriological Rodent Poison on Food Premises. Some poisoned baits issued by a firm specialising in disinfestation to a baker for use in his bakehouse and shop were submitted for bacteriological examination. The bread was found to be infected by an organism called Salmonella enteridis Darysz. The Pathologist reported that "it has occasionally been isolated from infections in man." The use of such poisons on food premises is not desirable especially, as in this case, where no precautions are advised by the contractors. FOOD EXAMINED AND FOUND UNFIT FOR FOOD. Bacon-37lbs. Biscuits-71lbs. Bread-160lbs. Bovril-2bottles. Butter-2½lbs. Cheese-68lbs. Cake Mixtures-113lbs. Cooking Fat-lbs. Cereals-93pkts and 187lbs. Dried Eggs-11tins. Dried Fruit-15,956lbs. Coconut (Desiccated) 2cwt. 3qrs. 12½lbs. Coconuts-59. Eggs-75. Fish-326½stone. Fishpaste-23tins or jars. Fruit-2,462lbs. Gravy powder-52pkts. Flour-24lbs. Jam-190 jars or tins. Meat-743½lbs. Macaroni-18cwt. Margarine-¼lb. Pickles or sauces-113jars. Sweets-133½lbs. Sausages and Sausage Meat-109lbs. Tinned Fish-357tins. Tinned Fruit-18,393tins. Tinned Meat-355tins. Tinned Puddings-6tins. Tinned Soup-234tins. Tinned Vegetables-651tins. Tinned Milk-801tins. Vegetables 23 tons 19cwts 2qrs 13lbs. Sugar-16lbs. Tea-2¾lbs. Nuts-3tons 6cwts 3qrs 15½lbs. (8) FOOD EXAMINED at royal naval victoria yard. Dried Fruit-8,323lbs. Flour-7,605lbs. Haricot Beans-4,397lbs. Marrowfat Peas-3,160lbs. Split Peas-2,719lbs. Biscuits-18,060lbs. FOOD SAMPLED. X Ammoniated Tincture or Quinine. 3 Liver Sausage 1 Aspirin Tablets. 3 Lime Juice. 1 Apple Juice. 1 Lemon Barley Water. 1 Anchovies. 1 Mustard. 2 Bacon. 12 Margarine. 14 Basilican Ointment. 1 Mixed Herbs. 1 Beer. 4 Malt Vinegar. 4 Butter. 14 Meat Pie. 3 Borax and Honey. 1 Maté. 1 Biscuits. 3 Marmalade. 2 Bournvita. 1 Mint. 2 Browning. 1 Macaroni. 3 Bread. 6 Meat. 1 Breakfast Sausage. 1 Mixed Spice. 5 Barley Crystols. 1 Milton. 1 Breakfast Oats. 1 Non-brewed Vinegar. 2 Coffee extract powder. 2 Nutmeg. 1 Coffee essence. 3 Oatmeal. 1 Cheese. 14 Olive Oil. 3 Cloves. 1 Orangeade, 1 Colouring. 1 Potato Crisps. 1 Cooking Fat. 14 Potato Powder. 1 X Cooking Fat Substitute. 7 Peas. 4 Cocoa. 8 X Peppermints. 3 Custard Powder. 1 Pilchards. 2 Cornflakes. 1 Peam Barley. 1 Curry Powder. 4 Pepper. 6 X Chlorodyno. 1 Parsley. 1 Carraway Seeds. 2 Pickles. 1 X Cakes. 9 Rennet. 1 X Camphorated Oil. 5 Sulphur Ointment. 4 Castor Oil. 1 Semolina. 1 Cloves. 1 X Sugar. 14 Dates. 1 Salmon. 1 Date Pudding. 1 Sage. 4 Eucalyptus Oil. 3 Sage & Onion Stuffing. . 3 Fruit (tinned). 2 Soup powder. 2 X Fish Paste. 8 Sausag Rolls. 2 Fish Cakes. 1 Sardines. 3 Frying Oil. 2 X Sausages. 11 Fruit Wine. 1 Soup. 11 Flour. 3 X Sauce. 12 Ground Ginger. 1 Spaghetti in Tomato Sauce. 1 Grapefruit Juice. 2 Glace Cherries. 1 X Sweetening Tablets. 5 Glycerine & Rosewater. 1 Salt. 2 Galatine. 1 Salami. 1 Gin. 1 X Sal Volatile. 4 Honeycomb. 1 Scotch Broth. 1 X Jam. 4 Salad Dressing. 1 Jelly. 1 Tomato Juice. 1 Liquorice. 1 Thyme. 1 Lemonade. 1 Tea. 14 Lemonade Crystals. 1 Treacle Pudding. 1 Liquid Paraffin. 3 Vegetable Sausage. 1 Wheat flakes. 1 Zine & Castor Oil Cream. 3 X Milk 164 X Items which involved further action. (9) Designated Milks. Phosphatase and Methylene Blue Tests 21 samples. School Milks. 21 Milks were submitted for chemical examination. ICE CREAM. The hygienic conditions under which Ice Cream is made and the methods of manufacture have continued to improve. Poor results have on several occasions been traced to the "ageing" before freezing of an insufficiently cooled mix. Several of the most modern dairy-type mix coolers were found not to cool the mixes sufficiently. During the year 47 samples of ice cream were subjected to the Methylene Blue test with the following results:- Grade 1 20 Grade 2 6 Grade 3 5 Grade 4 18 These samples were also tested for the presence of B.Coli with the following results:- B.Coli absent in 1c.c. 19 B.Coli present in 1 c.c. 8 B.Coli present in 0.1 c.c. 1 B.Coli present in 0.01 c.c. 19 RODENT CONTROL. The Block System of Rodent Control terminated in December 1947 and during the year under review investigations and operations were carried on by a Supervisor and an Operator. Total No. of Investigations 1,174 Total No. of Positives 470 Total No. of Operations 670 Total No. of Business Premises 57 (10) THE FACTORIES ACT, 1937. In conformity with Section 128, the following is an epitomised statement of the administration of this Act:- Inspections. Inspections. Number of Written Notices. Occupiers Prosecuted. Factories to which Section 7 applies 170 26 - The types of premises inspected were as follows:- Bakehouses. Chemical Works, Cinemas, etc., Dressmakers, etc., Engineering, general " motoring. Food preparation. Glass bottle makers. Laundries, Cleaners, etc. Paint and Varnish Works. Printers. Stables, etc., Sawmills. Timber Stores. Tar Refiners. Tailors. Woodwork, Joiners, etc. Woodchoppers, etc. Whitening Manufacturers. Offensive Trades. Miscellaneous. Defects Found. Number of Defects. Found. Remedied. Referred to H.M. Inspector. Sanitary Accommodation (Insufficient 2 2 (Unsuitable or (defective 24 24 mm (Not separate (for sexes - - - 26 26 - Outworkers. No. on Register 47. No. of visits paid by Sanitary Inspectors 94. In no case were insanitary conditions found calling for formal action under the Factory or the Public Health Act. (11) TUBERCULOSIS. Cases notified for the first time Pulmonary 94 Non-Pulmonary 17 New cases coming to knowledge otherwise than by notification Pulmonary 8 Non-Pulmonary 1 DISPENSARY. Cases on Dispensary Register at 31.12.48 Definite 502 Observation 87 Consultations between Practitioners and Chest Physician 425 Visits of Chest Physician to homes 36 Visits of T.B. Health Visitors to homes:- Dispensary Cases 3,498 Other cases 960 Number of Contacts examined 155 Total attendances of patients and contacts at Dispensary 2,465 X-Ray examinations made in connection with Dispensary cases 901 Total Specimens of sputum examined at Dispensary 751 TUBERCULOSIS CARE COMMITTEE. Cases recommended for institutional treatment reffered to Care Committee 91 Visits by Secretary 680 Interviews 902 Cases dealt with by Care Committee 445 Sums raised by Christmas Seals (1948) £198.12.5. Expenses £6.1.3. plus £9.12.5. being 5% proceeds to NAPT. The Handicraft Class has continued to meet regularly, the students producing a variety of articles, especially in leather and felt work. maternity and child welfare. 1.1.48 - 4.7.48. Infant Welfare Centres: Total number of attendances 6,719. Centres held at:- Central Clinic; St. Georges Hall; Hales Street and Gosterwood Street. Ante-Natal Centres: Total number of attendances 3,007. Centres held at: Centra] Clinic; St. Georges Hall and Clyde Street. Post-Natal Centres: Total number of attendances 226. Centres hold at:- Central Clinic and Clyde Street. CHILD LIFE PROTECTION. Persons receiving children for reward (registered Foster Mothers 9 Total number of children involved 10 Total visits of Health Visitors 22. (12) CARE OF ILLEGITIMATE CHILDREN. The work outlined in the Ministry of Health Circular 2866 is undertaken by the Health Visiting Staff. GYNAECOLOGICAL CLINIC. Total Number of attendances 209. DAY NURSERIES. Two nurseries function at South Eastern Hospital and Evelyn Street respectively. CARE OF PREMATURE INFANTS. During the period 1st January-4th July, 1948, the births of 38 premature infants were notified, of these 11 were nursed entirely at home. Provision has been made in accordance with Ministry of Health Circular 20/44 for the special services which may be required in this connection, such as the supply of cots and clothing, hot waterbottles, expressed milk, and, when required, the provision of a home help. NATIONAL, ASSISTANCE ACT. Burial of the Dead. Under Section 50 of the above Act it is the duty of the Council to arrange for the burial or cremation of any person who dies or is found dead within the Borough, and where no private arrangements are made for the disposal of the remains. This Section came into being on the 5th July 1948, and one person was buried under the provisions of this Act. Removal of aged and infirm persons to Institutions. The power of the Council to remove aged, infirm or physically incapacitated persons living in insanitary conditions and needing care and attention was previously vested in the Public Health (London) Act. From 5th July this power was revoked and re-enacted under Section 47 of the National Assistance Act. During 1948, it was not found necessary to take any action to remove any such person. HOUSING. During the year 9 houses were represented as unfit for human habitation. Number of families found to be living in overerowded conditions 165 Number of overerowded families who have obtained alternative accommodation 30 Number of houses erected and completed by the Borough Council for working classes during the year 48 Number of flats erected and completed etc 103 (13) HOUSING. (Continued). Council's Permanent Housing Programme. Position at 31.12.48. 1st Stage. KNOYLE STREET SITE-All houses now occupied. ARICA ROAD SITE-All flats now occupied. MILTON COURT ROAD SITE-48 houses completed, 10 houses in an advanced state of construction. CLYDE STREET SITE-Sycamore House (40 flats) occupied. Larch House-(15 flats occupied, remainder under construction. Beech House-in an advanced state of construction. 2nd Stage. SHARDELOES ROAD SITE (31flats) ROKEBY ROAD SITE (17flats) ERLANGER ROAD SITE)(30flats) (East) IDONIA STREET SITE-(60flats) Tenders submitted to London County Council for approval. BREAKSPEARS ROAD SITE-Town Planning and Housing approval received from London County Council. 3rd Stage. EDWARD STREET SITE.-Compulsory Purchase Order approved. NEW CROSS ROAD SITE.—Compulsory Purchase Order made by London County Council. ERLANGER ROAD SITE.-Lay-out plans, sections and (West) elevations submitted to London County Council for approval. (14)