AC 4375 LIBRARY Dept 35 Metropolitan Borough of Deptford ANNUPAL REPORT OF THE MEDICAL OFFICER OF HEALTH for the year 1950 REGINALD DUNCAN DEWAR B.Sc., M.B., Ch.B., D.P.H. PUBLIC HEALTH COMMITTEE His Worship the Mayor (Councillor F. Rolf, J.P.) Chairman: Councillor W. Taylor, J.P. Alderman Mrs. G.E. Green Councillor A. F. Bennington Miss D. Burley (Vice-chairman) G. T. Blackmore A. E. Cox Mrs. F. K. Dolby R. C. Evans R. W. Hutson Mrs. A. M. Ott E. C. Sherwood Public Health Department, Deptford Town Hall, S.E.14. June, 1951. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Deptford. Mr. Mayor, Ladies and Gentlemen, I have the honour to submit my Annual Report on the health and sanitary circumstances of the Borough during 1950. During the year the Public Health Department was transferred to its present quarters at 286, New Cross Road adjoining the Town Hall. Before the war, the Public Health Department was housed in the Town Hall occupying rooms on the ground floor and in the basement. When the basement was required as a Control Centre, other temporary accommodation was provided in the Town Hall and shortly after the outbreak of war the Sanitary Inspectors were transferred to the Goldsmiths' College in Lewisham Way. Following damage by enemy action at Goldsmiths' College, the staff of the Public Health Department was transferred to the Central Clinic in Amersham Road in January 1941, and it remained there until the beginning of 1950. The Central Clinic was built by the Deptford Borough Council and was opened on 11th July, 1936. It consists of an administrative block with quarters for the caretaker fronting on to Amersham Road with the Clinic block set back beyond a courtyard at the rear. Although the buildings had not been used exclusively for the personal health services it was, in accordance with the spirit rather than the letter of the National Health Service Act, 1946, transferred as a whole to the London County Council on 5th July, 1948. Similarly the Health Centre in Harton Street, mainly used for the treatment of tuberculosis, was transferred to the control of the Regional Hospital Board. It was anticipated that the Public Health Department would be transferred from the Central Clinic as soon as alternative accommodation became available and the requirement of the other services hastened the process. It was required to install an X-ray department in the Harton Street centre and this necessitated the transfer of the Foot Clinic to the Amersham Road buildings with the consequent transfer of the Public Health Department staff. It was decided to use 286, New Cross Road for the Public Health Department, providing a reasonable amount of accommodation by the rebuilding of the first floor, the building having been reduced to a single storey during the war as a result of enemy action. Pending the completion of this adaptation the staff moved into temporary quarters in the Town Hall which proved to be extremely inconvenient and it was with some relief that the final transfer was made in July 1950. As the whole chain of transfers was the immediate result of the provision of the X-ray equipment at the Harton Street Clinic it would be fitting to record that this equipment was only obtained by the unceasing efforts of Councillor E. C. Sherwood who for many years as a member of the Borough Council and a member of the London County Council, and more recently as a member of the Regional Hospital Board, has done so much to improve the public health and hospital services. I am indebted to the Council and particularly to the Members of the Public Health Committee for their help and encouragement, to the Officers of the Council for their ready help and co-operation. My thanks are also due to my own staff for their loyal assistance. Some of their work is tabulated in the report which follows ; the high standards of the clerical work has maintained and enhanced the reputation of the Borough Council, but the sympathy and understanding which all the members of the staff, and particularly the Sanitary Inspectors, have shown in dealing with the problems and difficulties of the public, must remain largely unrecorded. I remain, Your obedient Servant, R. Duncan Dewar, Medical Officer of Health. STAFF Medical Officer of Health R. Duncan Dewar, B.SC., M.B., ch.B., D.P.H. Assistant Administrative Officer G. A. Langley Senior Clerk R. H. Shrive Clerks L. Thorpe, J. Thorpe, Mrs. D. Tieman Medical Officer of Health's Secretary and Shorthand Typist: Mrs. K. N. Coleman Sanitary Inspectors G. B. Allen (i) F. A. Saunders (iii) H. E. Green (i) J. E. Waring (i) W. F. Mayo (ii) A. C. Webster (iv) G. J. H. Roscow (iii) G. F. Wilton (i) Food Inspector R. W. Allen (i) (i) Certificate R.S.I. Joint Award. Certificate R.S.I. Meat and Other Foods (ii) Certificate S.I.E.B. (London) (iii) Certificate R.S.I. Joint Award (iv) Certificate S.I.E.B. (London). Certificate R.S.I. Meat and Other Foods Mortuary Keeper A. T. Capstick Rodent Control Staff 1 Supervisor 1 Operator Disinfecting and Bathing Station Staff Chief Disinfector Driver 2 Disinfectors 2 Female Attendants Section "A" VITAL STATISTICS 6 VITAL STATISTICS The following are the principal vital statistics for 1950 together with comparative figures for London and for the previous year. The proportions of old or young people vary in different areas and the Registrar General gives Area Comparability factors which take these variations into account. The factor for births is 0.97 and for deaths 0.99 and the birth rate and death rate should be multiplied by the appropriate factor when making comparison with rates in other towns. The figure for population is now the estimated mid-year home population which includes members of the armed forces stationed in the area. The estimated increase in the population is 210, whereas the number of births exceed the number of deaths by 355. The birth rate continues to show a decline from the peak in 1947. The pattern is similar to that which occurred after the first World War but the decline appears to be rather more rapid than that which occurred during the 1920'S. The table setting out the causes of deaths will be found in the Appendix Table I. The deaths are classified under the 36 headings based on the Abbreviated List of the International Statistical Classification of Diseases, Injuries and Causes of Death, 1948. This differs in some respects from the classification in previous years and the figures are consequently not always readily comparable. Area of Borough 1,564 acres Estimated mid-year home population 76,580 1950 1949 London Deptford London Deptford Birth rate (per 1,000 living) 18.8 18.5 16.4 17.8 Still births (ditto) 0.30 0.36 0.34 0.37 11.8 Death rate (ditto) 11.8 12.1 12.2 Infantile mortality rate (deaths under 1 year per 1,000 live births) 29.4 26.3 29 29 Legitimate 1950 1949 Live births registered (adjusted for inward and outward transfers) 1,206 1,372 Illegitimate 50 61 1,256 1,433 Total 21 25 Still births registered Legitimate Illegitimate 2 1 23 26 Total 33 Infant deaths (under 1 year) Legitimate Illegitimate 38 4 4 37 42 Total 901 925 Total deaths (adjusted for inward and outward transfers) Section “B” INFECTIOUS DISEASES INFECTIOUS DISEASES The control of infectious diseases has always been one of the major duties of a Public Health Department, but in the opinion of the public its importance seems to have diminished in recent years. Deaths and calamities are always interesting but the absence of these happenings through prevention, creates no enthusiasm whatever in the public mind. Unusual happenings are naturally given prominence in the press and this can be misleading. During 1947 nearly 8,000 cases of poliomyelitis were notified and there were 700 deaths. The epidemic was reported upon in the press almost daily for some months. During the same year there were 92,000 cases of whooping cough with 900 deaths, but as this was not “news” it did not provoke any reports in the popular papers. In spite of this, I am devoting more space to the diseases which did not occur in large numbers than to those which caused many cases. It is not unusual to confine the matter in this section of the Report to the notifiable infectious diseases although the department is concerned with all the infectious diseases, whether notifiable or not, and with diseases which are preventable although they are not “infectious” in the usual sense of the term. The reason is, of course, that unless the disease is notifiable it is extremely difficult to obtain accurate information as to the number of cases occurring in the area. Of the notifiable diseases, an increased number of cases of measles, whooping cough and poliomyelitis were notified as compared with 1949, but the number of cases of the other diseases declined. There were no cases of smallpox, typhus, or typhoid fever notified. Smallpox is not now endemic in this country and all outbreaks originate from abroad. Vaccination provides considerable protection even after long periods and it is much to be regretted that the proportion of children being vaccinated has dropped sharply since vaccination ceased to be compulsory. It is not widely appreciated that vaccination in infancy is much less painful and much less liable to unpleasant effects or complications than vaccination when carried out for the first time in adult life, nor is it fully appreciated that re-vaccination when carried out at intervals of a few years, does not even cause any inconvenience. The prevention of outbreaks of smallpox depends largely on the recognition of cases or of contacts arriving in the country and the infrequency of outbreaks is due to the efficiency of the Port Health Authorities. Notifications are received of the names and addresses of persons coming into the Borough who may have been in contact with smallpox, and they are kept under observation for the necessary period. As members of the Public Health Department are likely to come in contact with any case which occurs, efforts are made to ensure that all the staff are always fully protected. Typhoid Fever or Enteric Fever is now comparatively rare, and the decrease in the number of cases is probably mainly due to the provision of a pure piped water supply, the proper disposal of sewage and the 9 pasteurisation of milk. Some outbreaks in other parts of the Country have been caused by contaminated ice-cream, and the continued control of the purity of this and other foods, is still of major importance in the prevention of the spread of typhoid fever. During 1950 one notification of Diphtheria was confirmed. The patient recovered and investigation did not reveal the source of the infection. For the ten years before the war, the average yearly numbers were 285 cases and 8 deaths. This improvement is due almost entirely to the immunisation of young children of whom upwards of 70% are immunised in this area. One danger of immunisation must be kept in mind; this is that an immunised and protected child may carry the infecting organism in the throat or nose, and although the child itself suffers no ill effect, it can infect and cause illness in other children; in other words, the child may become a carrier. When only 50% of the children are immunised, the number of carriers increases and the remaining 50% who are not protected are consequently more likely to be exposed to infection and the number of cases of diphtheria may be as many or even more than if none were immunised. It is when the proportion of children immunised exceeds 60% that the real benefits of immunisation become apparent. In this connection mention should be made of the undue publicity given to the association between immunisation and poliomyelitis. It is now known that during an epidemic of poliomyelitis, only a proportion of the cases show any paralysis and a far larger number show no paralysis at all. If during the incubation period a muscle is injured, then the group of muscles in that area may become paralysed. In infancy the commonest injury which is recorded is an injection for immunisation. In Deptford during 1950 approximately 4,000 separate injections were given throughout the year and paralysis of the arm where the injection was given was found in 3 cases only, and in other parts of the country proportion is probably of a similar order. Some of these cases would have shown some paralysis in any case and although it has been established that there is some connection between the giving of injections and the onset of paralysis, there is no doubt, that the dangers have been greatly exaggerated. Investigation is at present proceeding concerning the extent to which these paralyses recover. In the past the most effective vaccines for immunisation against diphtheria had to be injected deeply into the muscle because they tended to cause pain if they were injected close under the skin. With newer preparations this disadvantage has been overcome and it is therefore likely that the danger of paralysis due to immunisation during a poliomyelitis epidemic will be avoided in the future. It has been advocated that immunisation should be suspended during the poliomyelitis “season.” In my opinion, this advice is not sound unless there is a severe poliomyelitis epidemic in the district and unless one can be assured that immunisation will be carried out when the epidemic is over. The danger of a diphtheria epidemic following a fall in the proportion of children 10 immunised is likely to be far greater than the danger of paralysis following injection. As was indicated earlier in this section, a calamity such as paralysis following an injection is news, but the absence of seven or eight deaths from diphtheria is not news because "it never happened." It is right that the information should be made known, but the method of presentation and the interpretations placed on the known facts have in some cases been unfortunate and have caused unnecessary alarm and unnecessary harm to the immunisation service. The notifications of Scarlet Fever were approximately half those of the previous year. The character of this disease has changed very considerably. At the beginning of the century the fever hospitals were provided primarily for the isolation and treatment of scarlet fever which was a deadly disease. Nowdays, scarlet fever is a mild complaint with a case mortality below that of any of the other notifiable infectious diseases, the general appearance of a case has changed considerably and it not infrequently happens that cases are not diagnosed until the patients are almost recovered. Treatment with the sulphonamides and penicillin is very effective and complications which 50 years ago were both common and dangerous are now very rare. Uncomplicated cases are now not normally accepted into hospital unless the home circumstances make it necessary. Twelve cases of Poliomyelitis were notified and the diagnosis was confirmed in nine cases. Of these eight showed some paralysis and one had no paralysis. This would appear to indicate that a number of cases without paralysis were not diagnosed and it may be that the symptoms were so slight in some patients that medical advice was not sought. No deaths occurred in any of these cases but one case in addition to the above, occurred when the patient was away on holiday, and in this case the patient died. The notification of the disease was made in the area in which the patient was staying but the death was transferred to the home area for record purposes. The disease was most prevalent in Deptford during July and August, five out of the nine cases being notified between 14th July and 18th August. This was approximately the period of greatest incidence throughout the country. One case of Encephalitis (Infectious) was notified during the year. There were 885 cases of Measles notified during 1950. Approximately three-quarters of these occurred during the last quarter of the year, and half the cases occurred in children between 2 and 5 years of age. Two infants who were suffering from whooping cough and who had in addition been exposed to measles infection were given prophylactic injections with satisfactory results, and several cases were given similar treatment by their own medical attendants. As the prophylactic material is in short supply and is expensive and as the more usual complications generally respond to 11 ordinary therapeutic measures, artificial immunisation is not recommended except in special cases. There were no deaths from measles. Whooping Cough was notified in 279 cases, and there were three deaths from this disease. Two of the deaths occurred amongst the 21 cases notified in children under 1 year, and the other death amongst the 29 cases in children between 1 and 2 years of age. There were no deaths amongst the other 229 cases occurring in persons over two years of age. It has been recognised for many years that whooping cough is a dangerous disease in infants and immunisation has been advocated for some time. The results of investigations are not as conclusive as could be wished, but it is probably true to say that whilst a proportion of cases are prevented, and in a further proportion the attack is modified, the whooping cough vaccine which is available at present is not effective to any degree approaching that of the diphtheria vaccine for the prevention of diphtheria. A further disadvantage is that three injections are required, they must be intra muscular injections and they are of greater bulk than the anti-diphtheria injections. Having regard to the above, immunisation against whooping cough was discontinued at the Clinics for a time whilst poliomyelitis was occurring in Deptford. No outbreak of Food Poisoning occurred during 1950 but 27 individual cases were notified all but one occurring in the second half of the year. In many of these cases the notification was received so late that the patients had recovered, the suspected food was not available for examination, and even the causative organism could not be identified. In only one case was the infecting organism definitely identified, the organism implicated being Salmonella typhi-murium, but in this case it was not possible to discover the food which was involved. In fourteen of the cases the foods which, from the history given seemed most likely to have been involved, were, cooked meats in various forms 7, ice cream 2, shell-fish 2, duck eggs 2 and dates 1. The sample of dates showed contamination with B. welchii but in the cases of the other suspected foods either specimens were not available or no pathogenic organisms were discovered. In the remaining cases, it was not possible to identify any particular food either from the history given or from examination of such specimens as were available. It is disappointing that the investigations should show such little result but this cannot be avoided where notification is late, and also in individual home cases where it is not unusual for the whole of the food to be consumed or disposed of before any symptoms arise. 12 1950 Infectious Diseases. Corrected Notifications. over 65 years 0-1 years 1-2 years 2-5 years 5-15 years 15-25 years 25-45 years 45-65 years Total Deaths F M F M F M F M F M F M F M M F Diphtheria 1 1 Scarlet Fever 1 7 7 11 11 17 32 1 1 2 90 2 Puerperal Pyrexia 2 4 Erysipelas 2 1 6 1 1 11 Acute Poliomyelitis and Polio Encephalitis 1 1 2 1 3 1 10 1 1 4 L Dysentery 1 2 1 5 44 51* Acute Pneumonia 1 2 2 2 2 1 4 2 1 5 5 6 4 2 Measles 21 12 44 41 206 236 167 157 1 885 Whooping Cough 12 9 16 13 57 67 41 58 5 1 279 3 2 Scabies 1 1 1 2 1 8 2 8 Zymotic Enteritis 5 1 1 Malaria 1 Food Poisoning 1 4 2 2 3 1 5 3 3 3 27 TOTALS 41 26 71 64 281 321 229 257 9 12 14 15 9 13 3 7 1372 No cases of smallpox, ophthalmia neonatorium, anthrax, typhoid fever, or cerebro-spinal meningitis. Includes deaths from all forms of pneumonia. Tuberculosis remains the notifiable disease which causes the greatest number of deaths and one of the most important of all diseases in this country from an economic point of view. In many cases it is a chronic disease and even if it does not kill it may cause a very prolonged absence from work and more or less permanent disability. Moreover it commonly attacks young adults when they have just started to be an economic asset to the community. The deaths due to respiratory tuberculosis in Deptford in 1950 were 19 males and 7 females as compared with 35 and 5 respectively during the previous year. The large excess of males is largely due to the presence of Carrington House, a common lodging house for men with upwards of 800 beds, situated within the Borough. Of the 19 male deaths, 10 were of persons residing at this lodging house. Of the deaths from respiratory tuberculosis 15 of the 19 male deaths and all the female deaths were in persons between the ages of 15 and 65 years, whereas of the deaths from all causes, only about 31% were within this age group. 13 Tuberculosis Register Pulmonary Non-Pulmonary M F Total F Total M Cases notified for the first time 135 106 241 8 9 17 Posthumous notifications 4 2 6 - 1 1 New cases in Borough coming to knowledge otherwise than by notification - 18 21 39 2 2 Cases on Tuberculosis Register at 31.12.50 502 65 368 870 44 109 The number of new cases notified was 258 compared with 208 in 1949 and an average of 100 during the previous four years. This does not necessarily mean that the actual number of new cases is increasing. The increase might be due to a better discovery of new cases or to an alteration in the standard of notification. The diagnosis of tuberculosis is a clinical diagnosis, it is assisted by X-ray examination, bacteriological examination of the sputum and various other tests, and cases may be roughly classified as possible, probable or certain. The stage at which a case should be notified depends largely on the physician who must take into account the fact that a certain stigma rests on, and certain disabilities in regard to work, attach to persons labelled as tuberculous; and also that persons so labelled received some financial advantages and some of them are more ready to accept and continue a course of treatment. The better discovery of persons suffering from tuberculosis is in part due to the better facilities provided at clinics, the operation of mass radiography units, the publication of the success of the newer treatments (as something new is frequently considered to be better than something old) and an energetic programme of contact examination. All these factors have been in operation in this Borough. Immunisation with B.C.G. has been introduced into this country so recently that it cannot yet have had any appreciable effect in reducing the number of new cases. The South East London Mass Radiography Unit visited Deptford during the middle of 1950 and the figures for attendances were — Total Examined Referred for large films Referred to General Practitioners Probably T.B. Probably Non T.B. Cardio Vascular 4,032 47 2 Men 170 5 3,294 177 37 2 1 Women 14 Of the total examined 1,348 men and 2,210 women were private residents, the remainder being from various works or organisations in the district. Dr. F. D. Beddard the Medical Director of the Unit when supplying the figures stated: “There is no very striking figure in these results and they seem to follow the usual pattern in other Boroughs. The figures given under the column “ Probably Tuberculosis ” are, of course, based on the X-ray findings alone and a proportion of these turn out on follow up to be inactive lesions. The more important figure is only obtainable after many months when follow up has revealed the true active cases.” Towards the end of 1950 there was a suggestion that the Tuberculosis Regulations of 1930 should be replaced by new regulations which would maintain the necessity for notification, but would otherwise largely remove the powers and duties of the local authorities concerning tuberculosis. It must be admitted that the powers given to local authorities under the existing regulations have not been used to any great extent by many authorities; that the responsibility for treatment now rests on the Regional Hospital Boards and that the Local Health Authorities have powers under the National Health Service Act, 1946, to take steps to prevent the spread of tuberculosis. On the other hand, few people would deny that the hospitals are far more concerned with treatment and a rapid turnover than with prevention and with the reduction in the numbers of both patients and beds, that the importance of environment in the spread of tuberculosis is as great if not greater than in any other disease and that local sanitary authorities can deal with environmental work both more cheaply and more expeditiously than those local health authorities which are county councils. There can be no doubt that the prevention of tuberculosis is of far more importance than the cure of this disease but that from sentimental or mock-humanitarian reasons this principle is not generally carried into practice. There is a tendency to be very proud of curing or helping to cure an actual case of tuberculosis, but a disinclination to accept any personal blame for any new case that occurs. There is also no doubt that the activities of a local authority are strictly limited by the auditor's interpretation of the legislation. Should local sanitary authorities be denied the power to spend any necessary sum for the special purpose of preventing the spread of tuberculosis, the result is likely to be financially wasteful and medically deplorable. The following figures concerning the Deptford Chest Clinic have been kindly supplied by the Chest Physician, Dr. J. P. V. Rigby:— Cases on Chest Clinic Register at 31.12.50 :— Definite 809 Observation 48 Consultation between Practitioners and chest physician 1,081 15 Visits of Chest Physician to homes 663 Visits of T.B. Health Visitors to homes 2,244 Number of Contacts examined: Seen for First time 496 Reattenders 142 Total attendances of Patients and Contest at Chest Clinic 6,557 X-ray examinations made in connection with Chest Clinic Cases 4,056 Total specimens of sputum examined 1,361 TUBERCULOSIS CARE COMMITTEE The Deptford Tuberculosis Care Committee has been a very active body for many years, and it maintained its work throughout 1950. The following is a very short summary of the work done. It gives but a small idea of the amount of kindly advice and help which has been given to the tuberculous patients in the Borough. Cases recommended for institutional treatment referred to Care Committee 138 Interviews by Secretary 1,417 Cases assisted by Care Committee 66 Sums raised by Christmas Seal Sale (1950) £182 3s. 6d. Expenses £6 14s. 11d. plus £9 2s. 2d. being 5% proceeds to NAPT. Since this report was written the Medical Research Council have published some results of their investigation into the prevention of Whooping Cough by vaccination, and these results are very favourable. It is also of interest to note that three injections each were given to 7,558 children and that in no case did poliomyelitis develop within two months of inoculation. Section “C” SANITARY CIRCUMSTANCES ETC., AND FACTORIES ACT 18 SANITARY CIRCUMSTANCES The Borough of Deptford is roughly rectangular in shape, its greatest length being approximately 2½ miles and the width 1½ miles. It is bordered, roughly, on the north by Bermondsey, on the south by Lewisham and on the west and east by Camberwell and Greenwich respectively. It has a frontage on to the River Thames of about half a mile. The area of the Borough is 1,564 acres of which the railways and canals occupy 242 acres. The principal open spaces are Deptford Park, which covers 22 acres and Telegraph Hill Recreation Ground covering 45½ acres. Other open spaces occupy a total of approximately 16 acres. The Borough is divided into two nearly equal parts by New Cross Road and Queen's Road. The portion to the north is flat and contains the major proportion of the 2,694 industrial, commercial and business premises. The portion to the south is more hilly, rising to 160 feet above sea level at Telegraph Hill and it is predominantly residential in character. Nevertheless the northern half of the borough houses slightly more than half the residents, the houses being in general smaller and more crowded than those in the southern part of the Borough. The extent of crowding on an area basis is however less than before the war, as it was in the northern half that the majority of houses which were totally destroyed by enemy action had been situated. The number of occupants per house has diminished since 1938 when there were 18,572 houses for a population of 95,460 as compared with the present 16,123 houses for 76,580 persons. This gives an average of 514 persons per 100 houses in 1938, and 475 persons in 1950. The majority of the work of the Sanitary Inspectors has been concerned with sanitary defects in houses. Details of inspections and sanitary improvements effected will be found in the Appendix Tables II and III, but a summary of the work is shown below with comparative figures for some previous years:— 1938 1946 1949 1950 9,505 8,609 7,423 7,764 Total primary inspections 19,968 23,840 27,031 Total re-inspections 25,295 2,694 1,758 2,675 Total intimation notices served 2,406 702 824 1,043 Total statutory notices served 935 Total premises on which works were completed 2,574 2,585 1,695 2,657 11,425 9,120 9,950 3,937 Total improvements effected during the year 19 Difficulties and delays still, unfortunately, persist. It is necessary, where sanitary defects are the result of war damage for the owner to obtain agreement with the War Damage Commission before the work is commenced and although the Commission has been extremely co-operative in giving urgent attention to those cases where a sanitary notice has been served, a certain amount of delay is unavoidable. The amount to which building licences can be issued is limited and in some cases the delay in the issue of a licence has been considerable. Prices have continued to rise and the cost of repairs has increased disproportionately to the increase in rent on the basis of the pre-war figures. In some instances the owners have been unable to order the repairs because they have had insufficient resources to meet the cost. In general defects were dealt with under the provisions of the Public Health (London) Act, 1936 and the Housing Act, 1936, Section 9 was only used in one instance. Smoke Abatement The problem of nuisance from the emission of smoke, grit, etc., is one requiring constant attention. In some instances the industrial process is one where the emission of smoke cannot be avoided, in some difficulty arises from the poor quality of the fuel used and in others from the inability through shortages of material, or labour, or in obtaining the necessary licences, to carry out the modifications to the plant which would prevent the emission of undue quantities of smoke. The regular visits for inspection and observation and the advice given have produced some improvement but some nuisance does exist from time to time particularly where high blocks of flats have been built in proximity to the industrial installations. Offensive Trades In two premises in the Borough occupations are carried on which come within the definition of offensive trades. These have been regularly inspected and the work in general is well conducted. No notices were necessary in this connection. Rodent Control One Rodent Supervisor and one Operator were employed throughout the year and the following tables summarised the work carried out: — PREVALENCE OF RATS AND MICE (i) (ii) (iii) (iv) Number of properties in Local Authority's Area in which infestation was (v) (vi) (vii) Analysis of Column (iv) Number infested by Rats Type of Property Total Notified by Occupier Otherwise discovered Recorded Total of (ii) & (iii) Mice only Minor Major 3 2 Local Authority's 26 - 3 1 - - 332 43 Dwelling House 16,123 235 40 375 - 18 Business Premises 2,694 18 - 17 1 - - Agricultural - - - - 1 349 46 43 Total 18,843 253 396 20 MEASURES OF CONTROL BY LOCAL AUTHORITY Number of treatments carried out* Type of Property No. of properties inspected No. of inspections made By arrangement with occupier Under Section 5 (1) Mice only Mice only Rats† Rats Local Authority's 3 9 2 2 - - Dwelling House 375 689 388 40 - - Business Premises 18 83 22 1 - - Agricultural - - - - - - Total 396 781 412 43 - - *Excluding treatments included under block treatments. Included under this heading are properties infested with both rats and mice. A high proportion of business premises in the borough have their own contracts with private service companies for the control and destruction of rats and mice. This largely accounts for the smallness of the figures relating to business premises. Disinfection and Cleansing The use of the disinfector at the South-Eastern Fever Hospital (now renamed the New Cross General Hospital) was continued as a temporary measure throughout the year, the Bathing Station also occupying part of the hospital premises. Neither of these are entirely satisfactory. It is also anticipated that the Regional Hospital Board will require the premises to be vacated in the near future. It is hoped that the construction of the proposed new station will be commenced during 1951. The following is a summary of the work of disinfection, disinfestation and cleansing:— Premises disinfected (infectious disease) 276 Premises disinfected (requests) 29 Premises disinfected (verminous condition) 533 Premises disinfected (removals) 10 Total number of articles disinfected 73,130 Books disinfected 274 Number of articles destroyed at owner's request 356 In addition to the normal disinfection a considerable amount of work was done for firms engaged in exporting second-hand clothing and rags mainly to certain parts of Africa where the clothing is not allowed to be imported unless previously disinfected. The majority of the garments were men's jackets (20,000) trousers (10,000) and women's coats and dresses (5,000). The total dealt with during 1950 was 49,459 garments and 2 tons of rags. 21 Bathing Centre Number of school children who received baths (other than for scabies) 1,099 Number of school children who received baths for the treatment of scabies 24 Adults who received baths (other than for scabies) 423 Scabies baths for adults 46 Water Supply The water supply for domestic purposes for the whole of the Borough is obtained from the mains of the Metropolitan Water Board. Routine bacteriological examination is not normally carried out by the Council but the Water Board have supplied information on the bacteriological purity when requested. The water supply has been fully satisfactory throughout the year. Certificates in accordance with Section 95 of the Public Health (London) Act, 1936, that dwelling houses had a proper and efficient water supply were issued in respect of 185 new premises comprising 23 houses and 162 flats. THE FACTORIES ACT, 1937 The following is an epitomised statement of the administration of the Act. The inspections, visits, etc., are carried out by the District Sanitary Inspectors. Inspections Number of Number on Register Notices Written Occupiers Prosecuted Inspections 41 65 1 - (1) Factories in which Sections 1, 2,3,4 and 6 are to be enforced by Local Authorities (2) Factories not included in (1) in which Section 7 is enforced by the Local Authority 300 281 32 - Defects Found Remedied Referred Found To H.M. Inspector By H.M. Inspector Sanitary Conveniences: - Unsuitable or Defective 33 33 6 22 The types of premises inspected were as follows: — Bakehouses. Chemical works. Cinemas. Dressmakers, etc. Engineering, general. Engineering, motoring. Foundries. Food preparation. Glass bottle makers. Laundries, cleaners. Marine stores. Printers. Stables, etc. Sawmills. Timber stores. Tar refiners. Tailors. Woodwork joiners, etc. Woodchoppers. Whitening manufacturers. Offensive trades. Miscellaneous. Paint and varnish works. The number of inspections made to home workers premises was 121. The types of work carried on by outworkers in this Borough were as follows:— Wearing apparel, umbrellas, artificial flowers, paper bags, string bags and lampshades. Section “ D ” FOOD AND DRUGS AND REPORT OF THE PUBLIC ANALYST 24 FOOD AND DRUGS A full-time Food Inspector is employed in the supervision of Food and Food Premises. Food Samples are sent for chemical analysis to the Public Analyst, and for bacteriological examination to The Public Health Laboratory Service at Park Hospital. Details of the work of the Food Inspector will be found in the Appendix Tables V, VI and VII and details from the Public Analyst's Report are included at the end of this section. Royal Victoria Yard Considerable quantities of food no longer considered fit for prolonged storage by the Admiralty, are examined in order to assess their fitness for sale to the general public. Ice-Cream Conditions under which ice-cream is made and distributed in the Borough have continued to improve. 168 premises are registered for the manufacture, storage or sale of Ice Cream. One fault which was found to contribute to the number of lower graded bacteriological samples was the practice in which a manufacturer raised the temperature unnecessarily high “ just to make sure ” and then found his cooling plant incapable of lowering the temperature quickly enough to the required level. 85 Samples were taken for bacteriological examination. Grade I 36 Grade II 27 Grade III 15 Grade IV 6 Too Coloured For examination 1 85 Labelling of Food Orders, 1946/50 All pre-packed samples of food submitted under the Food and Drugs Act were considered also under the Labelling of Food Orders, 1946 and 1950. In 74 instances separate examinations were made under these Orders and several slight infringements were dealt with by correspondence. Pharmacy and Medicines Act, 1941 All pre-packed drugs submitted under the Food and Drugs Act were also considered under the Pharmacy and Medicines Act, 1941. In 5 instances separate reports were made. Food Standards 48 samples were specially examined under the various Food Standard Orders. They were all found to comply with the prescribed standard. Public Health (Preservatives etc. in Food) Regulations Wherever desirable Food and Drugs Act samples were examined for the 25 presence of prohibited preservatives and colouring matters and for excessive amounts of the permitted preservatives. No action was found necessary under the Regulations. Mineral Oil in Food Order 1949 Sixteen samples were taken under the Order—no contraventions were found. Public Health (Condensed Milk) Regulations Sixteen samples were submitted. Two slight labelling infringements were dealt with by correspondence. Vitamins Three samples were submitted in order to verify the presence of Vitamins claimed by the labels. In each case the claim was substantiated. Artificial Cream Act, 1929 “Imitation” Cream is made in this Borough but it is not covered by the definition of “ Artificial Cream ” in the above-mentioned Act. This material is, however, such a good medium for the growth of bacteria that the processing and distribution is subject to frequent inspection and sampling. Pharmacy and Poisons Act, 1933 Fifty-three visits were made and one sample was submitted for analysis. Letters were sent on several occasions pointing out the need for the vendor's name and address to be written upon each package. School Milks Three samples were sent for chemical examination and nineteen were sent for bacteriological examination. Eleven samples were also sent from Day Nurseries. Milk (Special Designations) Act Forty-one samples were submitted. In two instances failure to comply was taken up with the wholesale dairies concerned and follow-up samples were found to be in order. Foreign Bodies in Milk Bottles Several complaints of glass in milk bottles and of dirty milk bottles were received. Mainly there was insufficient evidence to substantiate legal proceedings, but the complaints were taken up with the dairies concerned. In one case a conviction was obtained in respect of a dirty milk bottle. Foreign Bodies in Food Several instances were found of foreign bodies in food. In the main, insufficient evidence was available to ensure successful prosecution and the makers of the food in question were warned. In one case a summons was dismissed upon payment of costs by the defendant. 26 The following is an extract from the report of the Public Analyst, Dr. H. Amphlett Williams, Ph.D. (Lond.), A.C.G.F.C., F.R.I.C., for the year 1950. “During the year, 529 samples were submitted for analysis under the Food and Drugs Act, 1938. These samples were also examined wherever applicable under the Defence (Sale of Food) Regulations, 1943, the Food Standards Orders, 1944-50, and the Labelling of Food Orders, 1946-50. “ Of the total number, 86 were taken formally, in accordance with the procedure prescribed under the Food and Drugs Act, the remaining 443 being undivided, or informal samples. “ Adulteration or irregularities were found in 28 instances; and the following Table summarises the proportions of milk samples and other samples of food and drugs recorded as unsatisfactory during the year, with the corresponding figures for the three previous years: Number Submitted Number “ Adulterated ” Percentage “ Adulterated ” Milk samples Other samples Total 137 260 397 164 353 517 128 401 529 87 442 529 8 5.8 1947 16 6.2 24 6.0 Milk samples Other samples Total 4 2.4 1948 28 7.9 32 6.2 Milk samples Other samples Total 0 0 1949 16 4.0 16 3.0 Milk samples Other samples Total 2 2.3 1950 26 5.9 28 5.3 “ The figures show a slight fall in the average quality of the milk as compared with previous years, and a marked fall in both fat and solidsnot-fat contents during the months of February, March and April. The averages are shown in the following Table. Southern England Deptford Year 1946 Pre-War Average Feb.-April 1950 Whole Year 1950 Year 1949 Year 1948 Year 1947 3.56 8.73 12.29 3.75 8.89 12.64 Fat Solids-not-fat Total solids 3.32 3.32 11.87 3.44 8.70 12.14 3.47 8.74 12.21 3.45 8.72 12.17 3.51 8.68 12.19 “ Of the 26 samples other than milk reported adversely, 7 may be classed as' deteriorated' ; these included mouldy Pickles and Vinegar, tainted 27 Condensed Milk, and rancid Pudding Mixture and Pastry. 3 samples (Canned Brisling and Canned Cherries) were found to be contaminated by metallic substances, due to corrosion of the containers, and three others (Cake, Cheese Cake and Paraffin) were contaminated by dirty impurities, including rodent excrement in the sample of Cake. 4 articles did not correspond to their description; soft, processed cheese (11% butter fat, 68% water, 191 Calories) being described as Cream Cheese, which would contain 70% butter fat, 25% water and 680 Calories; a mixture of soya flour, sugar and oil was sold as ' Almond Powder'; Cream of Tartar as 'Tartaric Acid' ; and a confection made from sugar and synthetic gum, as ' Meringues.' The sale of imitation meringues was commented upon in my Report for 1949, in connection with a previous sample of similar composition. Deficiencies of essential constituents were found in 4 samples, viz. of meat in Sausages, sugar in Table Jelly Tablets, and of saccharin in Saccharin Tablets. Excesses were found in 2 samples, viz. of bicarbonate of soda in ' Honeycomb ' and of calcium in Table Salt. In the 3 remaining samples (Preserved Sausages and Condensed Milks), labelling requirements had not been observed. “ No further instances of mineral oils in cakes or other foods were detected during 19.50, due no doubt to the passing of the Mineral Oil in Food Order in 1949, which prohibited their use. “ In addition to the analyses under the Food and Drugs Act, the results of which have been summarised above, 133 samples were examined under other Acts, Orders and Regulations. Particulars of these samples are furnished below: — Number of Samples Number Failing to Comply Relevant Act or Order Article Nature of Irregularity Defence (Sale of Food) Regulations 1943 Dessert Gelatine No. 135 Incorrect description. 1 1 4 0 Food Standards (Mustard) (No.2) Orders, 1944-48 Mustard Food Standards (Liquid Coffee Essences) Order 1945 Coffee and Chicory Extract 9 0 Food Standards (Self-raising Flour) Order 1946 Self-raising Flour 2 0 Food Standards (Preserves) Orders, 1944-50 Marmanlade Jam Mincemeat 5 0 8 0 2 0 28 Number of Samples Number Failing to Comply Article Nature of Irregularity Relevant Act or Order Food Standards (Salad Cream and Mayonnaise) Order, 1945 Salad Cream 1 0 3 0 Food Standards (Curry Powder) Order, 1949 Curry Powder 5 0 Food Standards (Shredded Suet) Order, 1944 Shredded Suet Food Standards (Tomato Ketchup) Order, 1949 Tomato Ketchup 5 0 Food Standards (Baking Powder & Golden Raising Powder) Order, 1944 Baking Powder Golden Raising Powder 7 0 1 0 11 No declaration of ingredients. Soup, Canned (No. 21) 1 Labelling of Food Order, 1946 & 1950 6 3 Incomplete declaration of ingredients. Declaration of ingredients not in accordance with the Order. Soup, Powder (44, 60 & 211) Pepper Flavoured Compound (No. 67) 1 1 4 1 Incomplete declaration of ingredients. Incomplete declaration of ingredients. Incomplete declaration of ingredients. Table Salt (No. 129) Beef Cubes (No. 312) 1 1 Gravylets (No. 315) 1 1 Various other pre-packed foods 50 0 Total 74 8 29 Article Number of Samples Number Failing to Comply Relevant Act or Order Nature of Irregularity Pharmacy and Medicines Act, Act, 1941 “Truth League Tablets” (83) 1 1 Did not contain the ingredients claimed on the label. “Fynnon Salt” (No. 158) “Quant's Witch Hazel” (No. 192) “Woodward's Gripe Water” (No. 369) “Nurse Harvey's Mixture” (372) 0 1 1 0 1 0 1 0 1 0 Pharmacy and Poisons Act, 1933 Paint Remover “Other samples not falling within the categories mentioned above were as under: — 2 Waters for metallic contamination. 4 Swimming Bath Waters for complete analysis. “The total number of samples of all kinds analysed during the year was 541.” The Analyst also commented unfavourably on the reduced number of samples of milk and the practice of obtaining formal samples, mainly on Sundays. Samples for examination by the Methylene Blue Test, the Phosphatase test and the Turbidity test are submitted to the Public Health Laboratory at the Park Hospital. The taking of formal samples of milk on Sundays is considerably simpler from an administrative point of view and the results of examinations do not indicate in any way that the Sunday samples are not fully representative. Section “E” HOUSING 32 HOUSING At the end of 1950 the Council had a total of 652 permanent houses and flats, a total of 586 temporary houses of various types, and controlled a further 1,450 properties under requisition. The grand total of these properties represents about 17% of all the dwellings in the Borough. During the year 138 permanent flats were completed for the Council. Since the end of the Second World War there have been over 12,000 applications for housing in Deptford, 900 being made during 1950. At the end of the year there were 3,500 “live” applications on the waiting list. It is not easy to obtain a realistic picture of the housing need. An application refers of course to a family and the figures imply that well over 15% of the whole population is in need of re-housing. In addition a large number of single persons and married couples without children have made no application because they realise that they have no reasonable chance of obtaining the tenancy of a council controlled house. It is not known how many people have applied to the private house agents but the number must be very large and many names are probably on the Council list and several private lists. It is known that throughout the country the number of families has increased by 2 million since the war and that only 1£ million houses have been built in the same period but from general observation it seems that the tragic shortage of houses is not quite so acute as it appeared some years ago in spite of the very large number in real need in this area. During 1950 the cost of building maintained an upward trend with the consequent necessity for higher rents. It would seem that, in the future, Council houses will only be available for persons within the moderate or higher income groups and that the lower paid section of the community will have to fall back on the older sub-standard properties in private ownership. Although 1950 was another year of austerity with its accompanying shortages and controls it was found somewhat less difficult to ensure that sanitary defects were remedied. Property owners, as a whole, have been co-operative in maintaining reasonable housing standards, the exceptions being perhaps more noticeable because of the comparatively small number. The improvements effected during 1950 were more numerous than in any other post-war year but still somewhat below the pre-war figures. During the year 9,950 improvements were made to 2,657 houses as compared with 11,425 improvements to 2,585 houses in 1938. In general owners are less willing to spend money on internal decorations, because of the marked increase in labour costs and in recent cases the Magistrates have excluded decorative work from Nuisance Orders, leaving only structural repairs. In the maintenance of existing houses the following is a summary of the work done during 1950. 33 Public Health (London) Act, 1936 Total number of houses inspected for housing defects 3,644 Number of Statutory Notices served 935 Number of houses repaired or nuisances remedied 2,657 Housing Act, 1936 Number of houses represented to the Council 22 Number of Demolition Orders made by the Council, following representation — Number of houses repaired by owners 2 Number of houses, the subject of Closing Orders 20 Number of Closing Orders determined — Overcrowding Number of individual dwellings overcrowded at the end of year 187 Number of families found to be living in overcrowded conditions during year 125 Number of families who have obtained alternative accommodation with London County Council during year 58 Underground Rooms Number occupied, but unfit — Number closed — There are many underground rooms throughout the Borough and a fairly high proportion of them, although used as dwellings, do not conform in all respects with the statutory requirements and cannot without major structural alterations be made to do so. Closure is not, however, practicable in present circumstances and owners have been co-operative in making these rooms reasonably fit. Increase of Rent and Mortgage Interest (Restrictions) Acts Certificates of Disrepair were granted in 8 cases during the year. Section “F” PERSONAL HEALTH SERVICES 36 PERSONAL HEALTH SERVICES The London County Council, as the Local Health Authority, became responsible for the health services set out in Part 111 of the National Health Service Act on 5th July, 1948. These services are now commonly referred to as the“personal” health services as distinct from the environmental health services for which the Metropolitan Boroughs continue to be responsible. For the purposes of administering the personal health services the Metropolitan Boroughs have been grouped in nine divisions. Deptford is included in Division 6, together with the Boroughs of Greenwich and Woolwich. The administration of the services is in the hands of the Divisional Medical Officer, Dr. F. R. Waldron, who is assisted in the day-to-day work by the Medical Officers of Health of the three Boroughs. Such a system has certain inherent defects but co-operation between the staffs of the County Council and the Borough Council has been very good indeed and the very happy and smooth working of the services in Deptford is very largely due to the efforts of Dr. Waldron. The services which are provided at the various clinics are as follows:— Health Centre, Amersham Road, S.E.14. Infant Welfare, Toddlers, Ante-Natal and Post-Natal clinics. Ante-natal exercise clinic. Vaccination and Immunisation. Artificial sunlight. Sewing class. Foot clinic. Rheumatism and Nutrition clinics. St. George's Hall, Shardeloes Road, S.E.4. Infant Welfare and Ante-natal clinics. St. Luke's Hall, Gosterwood Street, S.E.8. Infant Welfare clinic. Princess Louise Institute, Hales Street, S.E.8. Infant Welfare Clinic. St. John's Nurses, Watson Street, S.E.8. Ante-natal clinic. School Treatment Centre, Reginald Square. Dental clinic. Ophthalmic. Special Aural and Minor Ailment clinics. The County Council also maintain two Day Nurseries. The nursery in Evelyn Street is a special prefabricated building with 60 places under normal conditions. A structural defect has caused a portion of the nursery to be put temporarily out of use. The other nursery is housed in the buildings of the New Cross General Hospital in Avonley Road, and it provides places for 72 children. In both nurseries children are accepted from a few weeks old up to 5 years of age. The Health Centre at Amersham Road is also used as the Divisional Sub-Office for the administration of the personal health services in the Deptford area, including the offices for the Health Visitors and the Organiser and staff dealing with the Domestic Help Service. The headquarters of the Divisional Medical Officer are at St. Paul's House, Deptford High Street. Section “G” MISCELLANEOUS 38 MISCELLANEOUS Canal Boats Act The section of the Grand Surrey Canal passing through the Borough was kept under observation by the District Inspector but no canal boats were found of a type requiring inspection. Common Lodging Houses There is only one Common Lodging House in the Borough. This is Carrington House which is maintained by the London County Council. This building was erected in 1903 and it contains 814 separate cubicles, for use by men only. In addition to the usual facilities for washing and bathing, there is a reading room and a smoking room. The dining room is provided with a large stove on which the men can cook their own meals, and in addition, there is a canteen which provides excellent meals at a low price. A sick bay is provided on the ground floor for cases awaiting admission to hospital. No nursing of any sort is provided but sick persons are not so isolated as they would be in cubicles on an upper floor, and serious or dangerous illness is less likely to be overlooked. In addition to the casual users a large number of men live there either permanently or for long periods. Several men have lived there for nearly 30 years, and a number who have married children residing in the Borough, merely sleep at the lodging house and have their meals and spend the day at the houses of their children. The standard of accommodation is high and it compares favourably with many of the rooms occupied by singly elderly men throughout the district. Laboratory Service The bacteriological laboratory at the Park Hospital is run in association with the Public Health Laboratory Service. It provides a full bacteriological service for all public health requirements and the examinations are carried out without charge to the local authority. It has the additional advantages that the laboratory can carry out the very large number of bacteriological examinations which might be required during an epidemic, and that help can be provided to assist in the field work necessary in tracing the source of infection. The laboratory facilities at the Devonport Laboratory, Seamen's Hospital, continue to be available for the examination of swabs and other specimens sent by general practitioners. A week-end service is provided here and it is rather more convenient for the general practitioner to call for a consultation with the pathologist—a matter of some importance with the increasing complexity of bacteriological examinations. 39 Mortuary and Coroner's Court Before the war both the Boroughs of Deptford and Greenwich maintained their own mortuaries and coroner's courts. By arrangement, and following war damage, the coroner's court at Deptford and the mortuary at Greenwich have been closed. The mortuary at Watson Street, Deptford, serves both the Boroughs as does the coroner's court at Greenwich. The number of bodies received at the mortuary is, as a result of this arrangement, approximately doubled. The number of bodies received during 1950 was 626. National Assistance Act, 1948 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. Four persons were buried under the provisions of this Act during 1950. Removal of Aged and Infirm Persons to Institutions Section 47 of this Act provides for securing the necessary care and attention for the aged and chronic sick by means of an order of the Court. The main difficulty in securing the necessary care is in obtaining a vacancy in a suitable institution. The hospital provides accommodation for the chronic sick but there is a waiting list and admission may be delayed for weeks or in some few cases, months. The turn-over of beds is naturally very much slower than with acute cases and vacancies are consequently comparatively infrequent. The hospitals require to be assured that the patient is in need of a hospital bed, either on the grounds that medical treatment is required which cannot be given at home, or that the patient is bedridden and requires nursing care as a result. The London County Council provides accommodation for persons who are unable properly to care for themselves but who are not in need of nursing care, and who can get up and wash and dress themselves. There is at present a lack of provision for those persons who by reason of age or chronic ill-health require a certain amount of nursing care, who may be unable to wash and dress themselves or to walk without difficulty, but who are not bedridden. They are too well for the hospital and too ill for the County Council's Homes. In spite of the difficulties, both the Hospitals and the County Council have been very helpful in dealing with the many difficult and distressing cases. Action under Section 47 of the National Assistance Act was contemplated in several cases during 1950 but it was not found necessary to take action to remove any person. 40 Services for Old People The Council was concerned at the lack of suitable housing accommodation for old people in the Borough and plans were prepared for the erection of a number of dwellings designed to meet the special needs of the aged. The lowest tender which was received for erecting the premises was, however, so high that even with the usual subsidies and an additional contribution from the rates, the rents would have been beyond the means of these persons for whom the dwellings were intended. The Council were consequently obliged to abandon the project and this was done with considerable regret. The extent of the housing need of the old people in Deptford is largely unknown and exact figures will not be available without a detailed survey. It is known, however, that a very large number of old persons live by themselves, commonly in one room, with a minimum of facilities. A survey of one of the worst streets in Deptford showed that the 52 houses, all of three storeys, were occupied by 161 families of which 87 " families " consisted of one person only, the great majority of these being persons over 65 years of age. In none of these houses is there an indoor lavatory and there is no piped water supply into any room although in some cases a tap is provided on the staircase landing. On the other hand there are numbers of old people in other parts of the Borough who occupy houses which are far too large for their needs. They are usually unwilling to move because they are fond of the houses in which they have lived for many years, they do not like any upheaval such as a removal, and removal would, in many cases, involve loss of contact with their neighbours and old friends. The voluntary services in the district provide some assistance and recreation for old people. The W.V.S. have organised five Darby and Joan Clubs in various parts of the Borough so that one or more is within reasonable reach of persons living in any part of the district. In addition, the Albany Institute Old People's Club, although situated just beyond the Borough boundary, is patronised mainly by Deptford people. A Meals-on-Wheels service operates in the Borough. This supplies meals to aged and infirm people in their homes twice a week, to three of the Darby and Joan Clubs once a week, and to the Albany Institute daily from Monday to Friday. The meals are obtained from the London County Council's meals service and supplied to the old people at a charge of Bd. each. The vehicle was supplied and fitted by the Borough Council, which also provides the driver and maintains the vehicle. The remainder of the work is done by members of the W.V.S. The average numbers receiving one or more meals per week are 32 persons in their own homes and 250 persons at the clubs. Amongst other facilities provided by voluntary bodies, outings for old people are organised by the Deptford Rotary Club and the Inner Wheel, a yearly banquet for old-age pensioners is provided by the 1st New Cross 41 Group of Boy Scouts who also do many " odd jobs " for the old people throughout the year, and many of the religious bodies, and especially the Salvation Army, do excellent work in visiting old people in their own homes. Shops Act, 1934 In the course of their routine inspection the Sanitary Inspectors paid attention to the ventilation and temperature of shops and the provision of washing accommodation and sanitary conveniences. Slaughter Houses Two slaughter houses are licensed in this Borough but were not in use during the year. Baths and Wash-Houses The Council maintains three swimming baths at Laurie Grove adjoining the Town Hall. A plant giving continuous filtration and sterilisation maintains the purity of the water at all times. The plant is capable of filtering the whole of the water in the baths within four hours and the system of “ break-point” chlorination ensures the purity and safety of the water even during periods of maximum use. Two of the swimming baths are open all the year, but the large bath is closed from October until April, during which time a sprung floor is put in place and the building is used as a hall. At the end of 1950 it was not possible to use the hall because the worn condition of the floor necessitated the supply of a complete new floor. At the same time alterations were made to improve the dressing accommodation for females and to improve the lavatory and pre-cleansing facilities for both sexes. In addition to the swimming baths there are 60 slipper baths for public use at Laurie Grove. At the Evelyn Baths, Clyde Street, there are 60 slipper baths and facilities for Russian Vapour Baths and Foam Baths, and in addition a public wash-house is provided. At the baths at Ilderton Road 18 slipper baths are provided. APPENDIX 44 TABLE I Causes of Death at Different Periods of Life During 1950 in the Metropolitan Borough of Deptford Causes of Death Sex All Ages 0-1 years 1-5 years 15-45 years 5-15 years 65 years & over 283 290 4 - 45-65 years 139 78 M F 473 428 19 18 - 5 - 2 32 35 All Causes - - M F 19 7 - - - - 4 7 1. Tuberculosis, Respiratory 11 - - - - - - 1 - - - - 2. Tuberculosis, Other M F 1 2 - 1 M F - - 3 2 - - - - 1 2 - 2 - 3. Syphilitic Disease - - - - - - 4. Diphtheria M F - - - - - - - - - - - M F 1 1 - - 5. Whooping Cough 1 2 - 1 - - - - M F - - - — 6. Meningococcal infections - - - - - - - - - - 7. Acute Poliomyelitis 1 - - - - - 1 - - - M F - - - - - - - - - - M F - - - - - - - - 8. Measles M F - - - - - 1 - 1 9. Other Infective and Parasitic Diseases - 2 - - - - - - 7 8 10. Malignant Neoplasm, Stomach 16 10 - - - 1 9 1 M F - - - - - - 13 4 M F 31 6 - - 1 - 17 2 11. Malignant Neoplasm, Lung, Bronchus - 1 - 14 - 21 - - - 6 12. Malignant Neoplasm, Breast M F - - - - 13. Malignant Neoplasm, Uterus - - - 2 - 3 - 3 M F - 8 - - - - 4 5 24 23 14. Other Malignant and Lymphatic Neoplasms 35 39 - - - 1 7 10 M F - - - - - - 1 3 2 1 5 4 2 - 15. Leukaemia, aleukaemia M F - - 2 1 16. Diabetes M F 4 3 - - - - - - 2 2 - - 5 7 17. Vascular Lesions of Nervous System 30 52 - - 25 43 M F - - - - - 2 18. Coronary disease, Angina 59 34 22 7 35 26 M F - - - - 2 1 - - 17 10 1 - 4 2 12 8 19. Hypertension with Heart Disease - - M M - - - - 43 83 20. Other Heart Disease M F 55 92 - - - - - - 2 2 10 7 4 1 27 12 21. Other Circulatory Disease M F — - 1 - 32 13 - - - - 3 1 22. Influenza M F - 1 — - - - 3 4 - 1 - 1 - - 1 3 16 12 23. Pneumonia M F 29 22 3 3 - 1 9 3 45 Table I (Continued) Causes of Death Sex 0-1 years 1-5 years 5-15 years 15-45 years 45-65 years All Ages 65 years & over 24. Bronchitis M F 49 24 9 1 1 1 - - - - - - 39 22 7 4 - - 2 1 4 2 25. Other Diseases of Respiratory System M F - 1 - - 1 - 26. Ulcer of Stomach and Duodenum 6 1 3 1 M F 10 3 - - - - 1 1 - - 2 - 27. Gastritis, Enteritis and Diarrhoea 3 1 - 1 - - - - 1 - M F - - 28. Nephritis and Nephrosis M F M F 4 4 - - 1 1 3 2 2 - - - - - - 1 29. Hyperplasia of Prostate - - 7 - 9 - - - - - - - - 2 30. Pregnancy, Childbirth, Abortion M F - - - - - - - - - 2 - - 31. Congenital Malformations M F 2 5 2 4 — - - 1 - - - - - — 32. Other Defined and Ill-defined Diseases M F 28 37 9 7 3 4 7 7 9 19 - - - - M F — — 2 - 1 - 33. Motor Vehicle Accidents 3 1 - - - - - 1 34. All Other Accidents 10 12 2 - 1 1 M F 3 - - - - - 4 11 35. Suicide M F - - - - 2 1 4 - 1 1 7 2 - - 36. Homicide and operations of War M F - - - - - - - - - - - - - - 46 TABLE II Summary of Sanitary Work Carried Out During the Year 1950 Districts 1 2 3 4 5 6 7 8 Total 449 406 528 248 354 332 417 491 3,225 Primary Inspections Complaints Infectious Disease 52 31 80 75 40 49 45 47 419 55 49 Notice of Builder 57 38 63 57 66 39 424 Ref. T.B. Disp. 2 - 2 1 1 - 1 7 - Factory (Power) 17 21 67 39 30 15 23 69 281 2 - 10 17 12 3 4 17 65 Factory (Non-Power) Food Premises 11 32 37 71 37 9 33 70 300 Butcher's Premises 3 - 2 21 22 2 14 5 69 Ice Cream Premises 27 9 16 27 28 6 20 12 1 45 6 10 1 13 4 Milk Premises 6 10 12 62 6 1 6 10 1 34 Bakehouses 4 - 6 17 2 16 21 9 4 76 Fish Premises 7 - - 3 - Offensive Trades - - - - - 3 8 16 14 Outworkers 1 8 29 22 23 121 Comm. Lodg. Houses - - 5 - - - - - 5 6 36 Shops Act Insps. 26 26 3 1 3 8 109 Special Housing 70 76 133 127 91 74 62 112 745 141 91 156 233 304 140 186 82 1,333 Miscellaneous Total 757 824 918 990 7,423 1,006 1,265 922 741 Re-Inspections, Calls, etc. 3,985 25,295 4,295 1,250 3,676 2,086 3,278 3,615 3,110 Notices Served—Public Health (London) Act, 1936 Intimation Statutory Section 40 368 78 - 324 134 — 508 253 - 130 43 - 392 134 2 2,406 935 4 261 57 - 171 92 - 252 144 2 Premises in Respect of Which Notices were Completed 260 525 489 416 324 159 178 306 2,657 Premises in Respect of Which Notices were Outstanding at the End of the Year 119 719 135 103 180 32 69 54 27 47 TABLE III Description of Sanitary Improvements Effected During the Year Districts 3 4 5 8 1 2 6 262 7 Total Rooms cleansed 308 485 969 369 566 131 508 3,598 Roofs repaired 108 239 91 196 48 54 141 1,001 124 86 Gutters and Rainwater Pipes renewed or repaired 144 42 34 45 505 77 50 27 Dampness abated 79 62 74 87 37 72 624 121 92 45 18 8 Yards and Forecourts, etc., repaired or repaved 9 17 145 4 5 39 12 Water Fittings renewed or repaired 10 12 9 92 14 12 4 19 Sink Waste Pipes renewed or repaired 40 29 27 243 17 45 37 23 25 2 5 6 8 20 47 Drains entirely reconstructed 1 8 12 4 46 8 Drains partially reconstructed 14 16 16 28 41 19 162 21 38 Drains unchoked 35 18 236 18 33 26 8 Soil and Ventilating Pipes renewed and repaired 9 12 16 11 81 8 5 12 Gullies provided, unchoked, etc. 7 8 8 4 12 24 10 5 78 Manholes, Chambers, Fresh Air Inlets provided or repaired 9 8 5 28 18 13 5 7 93 Premises in which repairs were effected to W.C.s 64 56 62 90 49 565 65 101 78 105 Repairs effected to Windows, etc. 52 89 12 654 43 110 186 57 Repairs to Stoves, Coppers, Flues, etc. 49 53 88 19 557 30 72 198 48 Repairs to Stairs, Doors, etc. 59 98 15 15 53 20 45 342 37 39 105 46 62 Repairs to Floors 34 60 27 49 422 23 6 Ventilation and Lighting improved 8 10 8 88 - 21 12 Offensive accumulations removed 1 6 1 3 1 1 4 3 20 Dustbins supplied or renewed 10 11 5 8 19 80 14 4 9 Miscellaneous improvements effected 26 26 9 31 41 99 2,438 47 18 297 Total 948 536 726 1,299 1,085 1,387 1,510 9,929 Reference to Districts No. 1 Mr. Mayo No. 5 Mr. Green No. 2 Mr. Webster No. 6 Mr. G. B. Allen No. 3 Mr. Saunders No. 7 Mr. Wilton No. 4 Mr. Waring No. 8 Mr. Roscow 48 TABLE IV Legal Proceedings Public Health (London) Act, 1936 Premises and Nature of Offence Date of Hearing Fine Costs Remarks £7 0 0 6th Feb. 65, Musgrove Road. Non-compliance with Magistrates' Order. £3 5 0 £38 0 0 £5 5 0 13th Mar. do. 17th July 117, St. Asaph Road. Non-compliance with Statutory Notice. - £3 3 0 Order for work to be completed in 28 days. - £2 2 0 do. 11th Sept. 29a, Tressillian Road. Non-compliance with Statutory Notice. - £5 5 0 do. 2nd Oct. 36, Lewisham Way. Non-compliance with Statutory Notice. - £6 6 0 Work completed prior to hearing. 67, Bousfield Road. Non-compliance with Statutory Notice. 16th Oct. - £5 5 0 Order for work to be completed in 21 days. 30th Oct. 33, St. Norbert Road. Non-compliance with Statutory Notice. £51 0 0 £10 10 0 20th Nov. 117, St. Asaph Road. Non-compliance with Magistrates' Order. Food and Drugs Act, 1936 Date of Hearing Nature of Offence Fine Costs Remarks .1 £5 5 0 27th Mar. £5 0 0 Dirty milk bottle. Absolute discharge on payment of Costs. 24th April Offence against Section 3. £2 2 0 - 24th April do. - £3 3 0 do. London County Council Bye-Laws (Rag and Bone Dealers) Date of Hearing Fine Costs Nature of Offence Remarks 16th Oct. Exchange Toys for Rags. £2 0 0 £1 0 0 49 TABLE V Samples of Food Submitted for Analysis Food Number Examined Number Adulterated Formal Informal Total Formal Informal Total Ale and Stout - 4 4 - - - Almonds, Ground 2 - 2 - - Almond Powder, Sweetened 1 - - 1 - 1 1 Antiseptic Solution (" Milton ") 1 1 - - 1 - - Arrowroot 1 - - - - Aspirin Tablets 5 5 - - - - Bacon 6 6 - - - - Baking Powder 8 8 - - - - Barley, Pearl 2 - 2 - - - Biscuits 6 - 6 - - Blackcurrant Syrup 1 - - 1 - - Blancmange Powder 3 - - 3 - - Brawn 2 - - 2 - - Breadcrumbs 1 - - 1 - - Butter - - 6 6 - - - Cakes, Pastries, etc. 19 19 - 3 3 - Cake and Pudding Mixtures 3 3 - 1 1 - Cake Decorations 3 3 - - Calamine Lotion - - 2 2 - - - - Cheese 17 17 - - 1 - Cherries, Glace 2 - 2 - - - Chocolate, Drinking 2 - - 2 - - Christmas, Puddings 3 - - 3 - Cider 1 - - 1 - - Cocoa - - 9 9 - - Coconut, Desiccated - - 4 4 - - Coffee and Chicory - - 3 3 - - Coffee - 3 3 - Coffee and Coffee and Chicory Extracts - - - - - 10 10 - - Coconut in Syrup 1 1 Confectionery Sugar - - - - 2 2 - - - - Cooking Fat 4 4 - - - - Cream Powder, Artificial 1 1 - - - - Curry Powder 3 3 - - - Custard Powder 2 - - 2 - - - Dessert Powder 1 - 1 - - Drinks, Soft - - 2 2 - - Fish - - 2 2 - - Fish, Canned - 4 4 - 1 1 - Fish Paste 4 4 - - - - Flour, Plain 2 2 - - - - Flour, Self-raising 2 2 - - - - Fruit, Canned 3 3 - 2 2 - Gelatine 3 3 - - - - Gelatine, Dessert 3 3 - 1 - 1 Glucose with Vit. D 1 1 - - - - Gravy Preparations (Betox, Bisto, Bovril, Beef and Veg. Cubes, Gravylets, Marmite, Oxo) - 7 - - 7 Herbs, Dried - - 9 9 - - Honey 2 - - 2 - Honeycomb Toffee 1 - - - 1 - 1 Ice Cream 1 3 3 - lodine, Tincture of - - - 3 3 - lodine, Decolourised, solution of - - 1 1 - - - - Jam 10 10 - - - - Jelly, Table 10 10 - - - - Lard 1 1 - - - - Lemonade, Crystals 2 - - 2 - - Macaroni 2 2 - - - - Margarine - 6 6 - - Marmalade - 3 3 - - Meat Products - - 18 - 18 - - Meat Pie - - 3 3 - Meat Paste - - - - 1 - Milk - - 84 3 87 2 Milk, Condensed 17 - 2 17 - 5 5 Milk Whipping Compound - 1 1 - - - - Meringues 2 2 Mincemeat - - 1 1 2 2 Mustard - - - - 4 4 - - - - Oatmeal 3 3 - - - - 50 Table V (Continued) Food Number examined Number Adulterated Formal Informal Total Informal Total Formal Oats, Breakfast - - - 3 1 4 1 2 4 6 - 10 1 3 1 5 1 4 9 9 3 - - - 1 18 6 1 1 7 5 5 6 - 1 5 - 15 3 2 2 1 1 443 3 - Olive Oil - 1 - - - Paraffin, Medicinal - 4 - 1 1 Paraffin, Soft (Vaseline) - 1 - - - Pastry Mix - 2 - - - Peel, Candied - 4 - - - 6 - - Pepper - - - Pepper Compound 1 - - - 10 - 1 1 Pickles - - - 1 Potato Crisps - - - Proprietary Foods (Bournvita, Ovaltine, Vitacup) 3 - - - - Puddings, Christmas - 1 1 - - Saccharin Tablets - 5 1 - 1 1 Salad Cream - 1 - - - Sal Volatile - 1 - - 1 Salt - 4 1 - Sauce 9 - - - - Sausages 1 10 1 2 3 Seidlitz Powders 3 - - - - - 1 Senna Pods - - - Sherry - - 1 - - - 1 - Soda, Bi-carbonate of - - Soup - 1 - - - Soup, Canned - 18 Soup, Powder - 7 - - - - - Spaghetti in Meat Sauce - 1 - - - Spaghetti in Tomato Sauce - 1 - - - - Spices - 7 - - Stuffing Mixture - 5 I 5 - - - - - Suet, Shredded - - - 6 Sugar - - - - 1 - Sulphur Ointment - - Tartaric Acid 1 1 - 1 - - 5 Tea - - - Turpentine, Oil of 1 - - - 15 - - Vegetables, Canned - - - 1 Vinegar (Malt) - 3 1 - Wines, Alcoholic - 2 - - - Wintergreen Ointment - 2 - - - Yeast Tablets - 1 - - - Zinc and Castor Oil Ointment - 1 - - - 86 529 3 25 28 Totals 51 TABLE VI Food and Drugs FOOD INSPECTORS' VISITS Markets 120 Cafes, Restaurants, etc. 36 Fish Shops 27 Slaughterhouses (not in use) 2 Butchers 156 Milk Premises 146 Ice cream premises 273 Calls, stalls, etc. 830 Grocers 365 Bakers 36 Pressed Meat Premises 47 Pharmacy and Poisons 53 Miscellaneous 313 FOOD CONDEMNED AND DESTROYED Tinned Meat 332 tins Tinned Hams 2 tins Tinned Fish 6,482 tins Tinned Vegetables 589 tins Tinned Fruit 732 t i ns Tinned Milk 4,950 tins Tinned Puddings 4 tins Tinned Soup 168 tins Fish 150 stone Meat 1,882 lbs. Butter 4¼ lb. Cheese 92 lb. Margarine 1½ lb. Pickles 1,335 jars Sauces 473 bottles Jam 693 jars or tins Sweets 12 lb. Tea ¼ lb. Meat or Fish Paste 267 tins or jars Frozen Egg 80 lb. Cereals 606 lb. Onions 3,718 crates Onions 3,284 half bags Cauliflower 14 cwt. Fruit 537 lb. Cherries 48 boxes Eggs 800 52 TABLE VI (Continued) FOOD CONDEMNED AND DESTROYED (Continued) 30 lb. Flour 916 lb. Nuts 1 tin Peanut Butter 1 bottle Vinegar Split Peas 15 lb. Lemonade Powder 42 lb. 40 lb. Crystallised Ginger Marshmallow Jelly 1 cwt. 1½ lb. Biscuits Crystallised Cherries 5 lb. FOOD FOUND UNFIT FOR HUMAN CONSUMPTION BUT APPARENTLY FIT FOR ANIMAL FEEDING 393 lb. Dried Fruit 2,600 lb. Biscuits 8,371 lb. Cereals Tinned Fish 13 tins Tinned Jam Tinned Vegetables 53 tins 9 tins 61 tins Tinned Milk 136 tins Tinned Fruit Tinned Fish Paste 18 tins Chocolate 190 lb. 603 lb. Sugar 24 lb. Lard 43 lb. Mustard 100 lb. Pie Fillings Baking Powder 19 lb. Salt 50 lb. 3,595 lb. Nuts FOOD FOUND UNFIT FOR NORMAL SALE BUT SUITABLE FOR MANUFACTURING PURPOSES 1,739 lb. Sugar 14 lb. Tinned Fruit 1,826 tins Tinned Fish 115 tins Tinned Milk 759 lb. Chocolate 154 lb. Margarine 330 bottles Beef Extract 149 lb. Dried Fruit 53 Number Food Type of Sample Nature of Irregularity Action Taken 11 Ministry of Food approved label. The sample consisted of a table jelly tablet, but was not of the composition required by the Food Standards (Table Jellies) Order, 1949, being deficient in sugar. Informal. Dessert, Gelatine, Strawberry Flavour. 135 Accepted surrender of rest of consignment. Contained Tin. 2.8 grains per pound. Informal. Brisling, Canned. 91 This was taken as a result of having been asked to condemn it. The owner was warned that it could not be sold with its present label but that it was not unfit for food. The powder contained no almonds but consisted of a mixture of sugar, soya flour and oil. Informal. Sweetened Almond Powder. 154 Legal proceedings taken. Contained meat, 39%. Formal. Pork Sausages. 9 Legal proceedings taken. Contained meat, 38%. Informal. Pork Sausages. 5 Whole consignment destroyed. Unsound. Informal. Sweet Pickles. 65 Whole consignment destroyed. Consisted of Condensed Milk of inferior quality. Informal. Condensed Machineskimmed Milk, sweetened. 71 No legal action taken. Further samples satisfactory. Contained:— Fat 3.40% Solids not fat 8.41% corresponding to the presence of one per cent, added water. Formal. Milk. 7F. No legal action taken. Further samples satisfactory. Contained:— Fats 3.30% Solids not fat 8.34% corresponding to the presence of one per cent, added water. Formal. Milk. H.6 No action taken. Contained Bicarbonate of Soda, 9%. Informal. Honeycomb Toffee. 35 Letter sent to Ministry of Food. No further action taken. Contained Water 67.7% Fat 11.2% corresponding to 34.7% fat calculated on the dry substance; indicating that the cheese was made from partially skimmed milk. Informal. Demi-sel Pasteurised Cream Cheese. 34 Whole consignment destroyed. The fat in the sample was rancid and contained 34% of free fatty acids Informal Sweetened Steam Pudding Mixture. Action taken in respect of Food and Drug Irregularities TABLE VII 54 TABLE VII (Continued) Type of Sample Nature of Irregularity Number Food Action Taken 163 Meringues. Informal. Ministry of Food did not advise prosecution. Consisted of Imitation Meringues made with synthetic gum (Methyl cellulose) instead of white of egg or albumen. 130 Condensed Full Cream Milk, Sweetened. Informal. Genuine Full Cream Condensed Milk, Sweetened, incorrectly labelled. Wrote to Ministry of Food who took the matter up. Contained calcium carbonate 0.35%. Wrote to manufacturer, whose chemist had an interview with the Public Analyst. 129 Table Salt. Informal. 416 Cheese Cakes. Informal. Contained dirty extraneous matter, 1 grain. Informed baker. Cake. Informal. Contained a piece of foreign matter weighing 0.7 grain. (Probably rodent excrement.) Matter taken up with Baker and Local Authority in whose area it was made. 428 Contained dissolved Iron, 390 parts per million. 379 Cherries in Syrup, Canned. Informal. Whole consignment destroyed. Condensed Full Cream Milk, Sweetened. Informal. Genuine Condensed Full Cream Milk, Sweetened, incorrectly labelled. Wrote to Ministry of Food. 413 350 Tartaric Acid. Informal. Consisted of Potassium Acid Tartrate (Cream of Tartar). Wrote to Chemist. Pastry (Eccles Cake). Informal. The fat obtained from filling of the pastry contained 5 per cent. free fatty acids. Wrote to baker —interviewed manager of company. 257 Wholesaler withdrew stocks and took matter up with importers. 232 Red Cherries in Syrup Canned. Informal. Contained dissolved iron, 510 parts per million. Informal. Deteriorated condensed milk. Wholesaler withdrew remainder. H.13 Condensed Machineskiimmed Milk, Sweetened. Deteriorated condensed milk. Rest of consignment destroyed. 279 Condensed Machineskimmed Milk, Sweetened. Informal. Insufficient evidence of purchase to warrant action. B.19 Liquid Paraffin. Informal. Contained dirty extraneous matter, 1.5 per cent. 55 TABLE VII (Continued) Type of Sample Number Food Action Taken Nature of Irregularity 228 Standard Saccharin Tablets. Informal. Contained saccharin, 0.17 grain per tablet. Further supply satisfactory. 268 Beef Sausages. Informal. Contained sulphur dioxide, 220 parts per million. Preservative declared on display label. 256 Malt Vinegar. Informal. Deteriorated Malt Vinegar. Retailers' stock inspected. No further bad vinegar was found. INDEX A PAGE Aged and Infirm Persons - 39 Area and Population 6 Artificial Cream Act, 1929 25 B Baths 41 Bathing Station 21 Births 6 Births, Illegitimate 6 Burial of the Dead 39 C Canal Boats Acts 38 Cleansing Station 21 Committee, Public Health ii Common Lodging Houses 38 Condensed Milk Regulations 25 D Deaths 44 Death Rate 6 Disinfection & Disinfestation 20 F Factories Act 21 Food and Drugs 24 Food Poisoning 8 Food Sampling 49 Food Standards 24 Food Unsound 51 Foreign Bodies in Food 25 H Housing 32 Housing Act, 1936 33 I Ice Cream 24 Illegitimate Births 6 Increase of Rent and Mortgage Interest (Restrictions) Act - 33 Infant Mortality 6 Infectious Diseases 8 Infectious Diseases' Notifications 12 Introduction to Report 1 L Labelling of Food Order 24 Laboratory Service 38 Legal Proceedings 48 M PAGE Mass Radiography 13 Maternity and Child Welfare 36 Milk (Special Designations) Act 25 Mineral Oil in Food Order, 1949 25 Mortuary 38 N National Assistance Act, 1948 39 Notification of Births 6 o Offensive Trades 19 Old People, Services for 40 Overcrowding 33 P Personal Health Services 36 Pharmacy and Medicines Act, 1941 24 Pharmacy and Poisons Act, 1933 25 Population 6 Preservatives in Food Regulations 24 Public Analyst's Report 25 Public Health (London) Act, 1936 33 R Rodent Control 19 Royal Victoria Yard 24 S Sanitary Circumstances 18 Sanitary Inspection 46 School Milks 25 Shops Act, 1934 41 Slaughter Houses 41 Smoke Abatement 19 Staff, List of 3 Swimming Baths 41 T Treatment Centres and Clinics 36 Tuberculosis 12 „ Report of Chest Physician 14 Register 13 U Underground Rooms 32 V Vital Statistics 6 w Water Supply 21