DEPT43 Ac 4375 METROPOLITIAN BOROUGH OF DEPTFORD. ANNUAL REPORT of THE MSDICAL OFFICER OF HEALTH, FOR THE YEAR 1958. by J. KERR BROWN, B.Sc., M.B., Ch.B., D.P.H. PUBLIC HEALTH COMMETTEE The Worshipful the Mayor (Councillor A,J. Blackman, J.P.) Chairman: Councillor R,S. Marriott, J.P. Councillor S.H. Banks. „ A.A, Carroll. Alderman Mrs. M.J. Chrisp. Councillor A.E. Cox. „ J.P. Hall. „ Mrs. D. Nason. „ Mrs. A.M. Ott, „ F. Pain. „ F.A. Smith. „ W. Taylor, J.P. Telephones:- TIDeway 1288 „ 1360 Public Health Department, Deptford Town Hall, S.E.14. June, 1959. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Deptford. Mr. Mayor, Ladies and Gentlemen, I have much pleasure in presenting the Annual Report on the health and environmental circumstances of Deptford for 1958. In general the health of the Borough continued to be satisfactory although the infantile mortality rate has risen drastically from 12.3 P er 1,000 live births, which was an all time low figure for Deptford, to 28.5. However, as I mentioned in last year's report no definite conclusions can be drawn from the analysis of figures for one year, the trend has to be observed for a period, perhaps not less than five years. The death rate is down and the birth rate at 16.47 is substantially higher than last year. In analysing the causes of death, once again cancer of the lung and other malignant conditions are high on the list and coronary artery disease and circulatory affections continue to rise. On the other hand deaths from bronchitis are down probably due to the absence of any serious influenza outbreak during the winter; and although we had periods of prolonged fog, pneumonia also showed a slight reduction. In regard to infectious diseases the Borough was free from serious outbreak of communicable disease; there was no Poliomyelitis, Smallpox, or Diphtheria notified to the Health Department, but Dysentery became troublesome during the spring and early summer. This necessitated much labour in arranging for examination of clinical specimens both from cases and carriers and organising appropriate treatment with family doctors. It is pleasing to note a reduction in the cases of Pulmonary Tuberculosis and a slight decrease in deaths from this disease. These figures are a further indication of the changing pattern of this disease in modern society. This is occasioned by the general environmental improvements, the vigilance of chest physicians and medical practitioners, and the effectiveness of the new drugs now available, togaher with the use selectively and in random surveys of the Mass Miniature Radiography Units, a report of whose work is included in the body of the report, I am also grateful to Dr. Rigby for his contribution which is most welcome and as always very stimulating. I am interested to note his remarks on the relationship between a dust laden atmosphere and disorders of the lung, but I would be loathe to say that Deptford is any smokier or dustier than any other comparable industrial area; indeed an analysis of our figures for the last three years indicates a progressive decrease of smoke in the atmosphere, although sulphur dioxide appears to remain at about the same level. The reduction of smoke is undoubtedly due to the greater use of smokeless fuels in the area and the conversion of many industrial concerns from coal to oil consumption. Already the Clean Air Act is making contribution to the general improvement of our atmosphere and a reference is made in the body of the report to the making of a Smoke Control Area in one part of the Borough. It is hoped that this will be followed by other more extensive areas in the future. Welfare of old people continues to exercise much of our attention. There are approximately 10,000 people in Deptford over the age of 65, and the Council are taking steps to appoint an officer whose primary duty will be dealing with problems connecting with the aged, together with liaison with all the voluntary agencies concerned with the subject. The Bathing Station is providing a valuable laundry service for the aged and incontinent, and a bathing service is also available. It is hoped that increasingly close ties between the hospitals, the family doctors, the voluntary workers and the /Health -1- Health Department will ensure that all the activities of the multifarious bodies providing care and welfare for old people can be co-ordinated and overlapping and duplication of effort avoided. I am pleased to pay tribute to the help and advice, and support which I have received from the Chairman and Vice Chairman of the Health Committee during the year and as always I wish to record my high appreciation of the loyalty and application duty of the staff in the Department. I remain, Your obedient Servant, JOHN KERR BROWN, Medical Officer of Health. -2- STAFF. Medical Officer of Health. J, Kerr Brown, B.Sc., M.B., Ch.B., D.P,H. Public Analyst (part time) H. Amphlett Williams, Ph.D. (Lond.), A.C.G.F.C., F.R.I.C. Assistant Administrative Officer, G.A. Langley. Senior Clerk. R. H. Shrive. Clerks, L. Thorpe, D.F.C., J. Thorpe, Mrs. K.N. Coleman, A. Stanton. Chief Public Health Inspector, A.C. Webster (ii). Public Health Inspectors, H.E. Green (i) J.A.G. White, (i) G.F. Wilton (i) * J.E. Waring, (i) T.F. Hinde, (i) *Commenced 6.2.58. Resigned 3.5.58. Food Inspector, R.W. Allen, (i). Certificate R.S.I. Joint Award. Certificate R.S.I. Meat & Other Foods. Certificate S.I.E.B. (London). Certificate R.S.I. Meat & Other Foods. Mortuary Keeper, A.T. Capstick. Rodent Control Staff, Supervisor: E.J. Summers. 2 Operators. Disinfecting and Bathing Station Staff, Superintendent Disinfector, 1 Driver/Disinfector. 1 Disinfector, 2 Female Attendants. -3- SECTION "A". VITAL STATISTICS. -4- VITAL STATISTICS. The following are the principal statistics for 1958, set out in the manner required by Ministry of Health Circular 22/58 dated 9th December, 1958. The proportions of old or young vary in different areas and the Registrar General gives Area Comparability factors which take these variations into account. The factor for births is 0.96 and for deaths 1.00 and the birth rate and death rate should be multiplied by the appropriate factor when making comparisons with rates in other towns. The figure for population is the estimated mid-year home population. The estimated decrease in the population is 750, whereas the number of births exceed the number of deaths by 318. The table setting out the causes of deaths will be found in the Appendix Table I. The deaths are classified under 36 headings based on the Abbreviated List of the International Statistical Classification of Diseases, Injuries and Causes of Death, 1948. Area of Borough ... ... ... ... ... ... 1,564 acres. Estimated mid-year home population ... ... 70,220. Live 1 Births - Legitimate ... ... 1078 ) 1,157 Illegitimate. ... 79 ) ' Live Birth Rate per 1,000 living population. 16.47 Still Births - Legitimate ... ... 17 ) 21 Illegitimate. ... 4 ) Still Birth Rate per 1,000 (live and still births.).. 17.82 Total Live and Still Births. ... ... ... 1,178 Infant Deaths - Legitimate.. ... 29 ) 33 Illegitimate ... 4 ) Infant Mortality Rate per 1,000 live births - total ... 28.52 Infant Mortality Rate per 1,000 live births - legitimate ... ... ... 26.90 Infant Mortality Rate per 1,000 live births - illegitimate. ... ... 50.63 Neo-natal Mortality Rate per 1,000 live births (first four weeks). ... ... ... 20,74 Illegitimate live births per cent of total live births.. ... ... ... ... ... 6.82% Maternal Deaths (including abortion) ... ... 1 Maternal mortality rate per 1,000 live and still births. ... ... ... 0.84 Total deaths.. ... ... ... ... ... ... 839 Death Rate (per 1,000 living) ... ... ... 11.9 -5- SECTION "B". IN FECTIOUS DISEASES. -6- INFECTIOUS DISEASES. General. The total number of notifiable infectious diseases showed a decrease of 602, but this is largely accounted for by the drop in Measles as only 122 cases were notified as against 819 in 1957. Sonne Dysentery was again troublesome during the year, and entailed many visits by Public Health Inspectors, and examinations of several hundred specimens of faeces by the Public Health Laboratory Service. There was no significant alteration in the numbers of other Infectious Diseases as compared with the previous year. INFECTIOUS DISEASES. CORRECTED NOTIFICATIONS. 0-1 years 1-2 years 2-5 years 5-15 years 15-25 years 25-45 years 45-65 years Over 65 years Total M F M F M F M F M F M F M F M F Scarlet Fever. 24 1 1 9 6 17 1 59 Erysipelas. 2 3 6 1 12 19 3 15 30 5 Dysentery. 3 7 10 5 5 6 1 7 116 Acute * Pneumonia. 10 8 1 2 3 1 4 3 2 7 7 14 6 4 72 3 Measles. 6 32 4 9 26 23 17 1 1 122 Whooping Cough. 12 9 1 1 4 15 4 11 57 Scabies. 2 2 4 Zymotic Enteritis. 1 1 Food Poisoning. 3 1 1 Ophthalmia Neonatorum 1 1 Puerperal Pyrexia. 1 1 14 6 20 63 49 97 79 10 7 18 17 18 22 6 5 448 Totals. 17 No cases of anthrax, cerebro-spinal meningitis, diphtheria, meningococcal infection, poliomyelitis, smallpox, or typhoid fever were notified during the year. * Includes all forms of pneumonia. TUBERCULOSIS. All new cases in the Borough, whether or not they are transferred from other areas, are visited by the Public Health Inspectors in order to ascertain the housing conditions and to see if any improvements can, or should, be effected. There was a decrease of 43 in the number of cases of Pulmonary Tuberculosis notified for the first time (33 male and 10 female) and the number of deaths due to respiratory tuberculosis in Deptford in 1958 was again down as compared with the previous year, i.e., 8 males and 2 females as compared with 10 and 2 respectively. Of the deaths from respiratory tuberculosis 4 of the male deaths and both female deaths were of persons between the ages of 15 and 65 years, whereas of the deaths from all causes, only about 28% were within this age group. -7- . 1 ... ... ... ... ... ... ... ... ... ... ... ... ... TUBERCULOSIS. (continued). TUBERCULOSIS REGISTER, Pulmonary. Non-Pulmonary. M. F. Total. M. F. Total. Cases notified for the first time. 64 36 100 4 5 9 Posthumous notifications 3 3 1 - 1 - New cases in Borough coming to knowledge otherwise than by primary notification 20 19 1 1 2 39 I am indebted to the Chest Physician, Dr. J.P.V. Rigby, for the following report concerning the Chest Clinic at Harton Street, which is of great interest:- Cases on Chest Clinic Register at 31.12.58:- Definite ... ... ... ... ... ... 1,121 Observation ... ... ... ... ... 44 Number of new contacts examined. ... ... ... 376 Total attendance at the Chest Clinic. ... ... 7,352 Total attendance at the Refill Clinic ... ... 25 TUBERCULOSIS CARE COMMITTEE. Interviews by Secretary ... ... ... ... ... 984 Cases assisted by Care Committee ... ... ... 70 Sums raised by Christmas Seal Sale, 1958.. ... £118.18.0. "You will notice that the attendance figures are slightly higher than .1957 which was 7,278. You will note that there are also a few attendances at the Refill Clinics. The figures are greatly reduced in the last few years and are likely to remain at zero in the years to come. Air collapse measures in the treatment of pulmonary tuberculosis have now been superseded by a combination of the anti-tuberculous drugs, mainly Streptomycin,PAS and Izoniazid, combined in some cases with major chest surgery which nowadays mainly aims at removal of the area of lung disease by resection. This is rather a different matter to an operation previously extensively used called thoracoplasty, where.the chest wall was collapsed inwards and the tuberculous lung allowed to heal by relaxation This procedure is still done at times, but less frequently nowadays when the tuberculous lesions in the lungs can be more safely operated on without risk of spread if the anti-tuberculous drugs are given at the same time. In such cases the drugs act as a sort of "umbrella", preventing the spread of tuberculous disease after the operation. This was, in fact, why resections were impossible before the era of anti-tuberculous drugs. With regard to chest diseases in general, the last winter was a severe one and the Chest Clinic services were at times strained to cope with the flow of car for investigation and'treatment of bronchitis, pneumonia, bronchiectasis, new growth of the lungs and other disorders. I feel that the dust laden atmosphere of Deptford exaggerates the tendency to lung diseases in these parts, especially when combined with dampness and exhaust fumes from vehicles and machinery. The addition of a personal factor of tobacco smoking, particularly cigarettes, see render the lungs more liable to the diseases I have mentioned, particularly in excess of 15 to 20 cigarettes daily. -8- TUBERCULOSIS. (continued). The writer was very fortunate indeed to be able to visit the British West Indies earlier this year and to observe, amongst other things, the hospital system and in particular the anti-tuberculosis campaign in action. One very noticeable factor was that owing to the warm though admittedly moist tropical climate, there was far less bronchitis and emphysema, but another factor is undoubtedly that there are no domestic chimneys and hardly any industrial atmospheric pollution." MASS MINIATURE RADIOGRAPHY. The Director of the Mass Miniature Radiography Unit has supplied me with figures on the results of the visits of this Unit to Deptford in 1958. These figures include public surveys and visits to factories, Carrington House, and Goldsmiths' College. General analysis. Men. Women. Total. (a) Total X-rayed 1,744 1,251 2,995 (b) Total previously mass X-rayed within five years.... 965 656 1,621 (c) Total recalled for large film 89 48 137 (d) Number normal on large film. 31 25 56 (e) Number abnormal on large film 56 22 78 (f) Not yet attended for large film 2 1 3 Analysis of abnormal large films. Cases considered tuberculous and referred for further investigation - (a) No further action required - - - (b) Occasional supervision 6 - 6 (c) Requiring close supervision or treatment 14 2 16 (d) Still under investigation - - - (e) Refused further investigation 1 - 1 Previously known tuberculous cases 7 1 8 Non-tubcrculous cases. (a) Investigated 9 4 13 (b) Still under investigation - - - Cardio vascular lesions 1 2 3 Abnormalities requiring no action 18 13 31 -9- SECTION "C". SANITARY CIRCUMSTANCES ETC. AND FACTORIES ACT. -10- SANITARY INSPECTION. General. The total number of primary inspections increased from 5,907 in 195? to 6,185. The number of complaints increased from 1,283 to a total of 151. This is the first year for some time that complaints have increased and this may be one of the effects of the Rent Act. Now that many people have to pay more rent, they may feel that a higher standard of housing is required. Defects found were dealt with under the Public Health (London) Act, the London County Council (General Powers) Acts and the London County Council Bye-laws. RODENT CONTROL. One Rodent Supervisor and two operators were employed throughout the year under the general direction of the Chief Public Health Inspector, and the following tables summarise the work carried out:- PREVENTION OF DAMAGE BY PESTS ACT, 1949. Report for the year ended 31.12.58. TYPE OF PROPERTY. Non-Agricultural. I. Number of properties in T ocal Authority's District II. Number of Properties inspected as a result of:- (a) Notification. I I 307 25 332 (b) Survey under the Act. (c) Otherwise (e.g., when visited primarily for some other purpose). 11. Total inspections carried out including re-inspegtions. IV. Number of properties inspected (in Sect,II) which were found to be infested by:- (a) Rats. (MaJor. (Minor. (h) Mice .(Major, (Minor. V. Number of infested properties (In Sect.IV) treated by the L.A. VI. Total treatments carried out including re-treatments. i L • ' • (1) Local Authority. 28 2 5 (2) Dwelling Houses (inc: Council Houses) 17,650 521 1,540 464 123 587 751 -11- (3) All other (inc: business) 2,530 119 162 12 10 22 25 (4) Total of Cols (1) (2) & (3) 20,208 642 1,707 476 133 609 776 /continued RODENT CONTROL. (continued). TYPE OF PROPERTY. Non-Agricultural. (4) Total of cols.(1) (2) & (3) V (1) Local Authority. (2) Dwelling Houses (inc: Council . Houses.) (3) All other (including business.) VII. Number of notices served under Section 4 of the Act:- I I (a) Treatment. I (b) Structural Work (i.e. proofing). ■ VIII. Number of cases in which default action was taken following the issue of a notice under Sect. 4. of the Act, NIL. IX. Legal Proceedings X. Number of "BlocK" control schemes carried out. Total No. of Drains Tested 87. Found defective 36. Total number of visits made by Operators - 3,518. Total number of inspections by Public Health Inspectors - 348 Total number of re-inspections by Public Health Inspectors - 470. 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 figure relating to business premises. DISINFECTION AND CLEANSING. The following is a summary of the work of disinfection, disinfestation and cleansing:- Premises disinfected (infectious disease) 51 Premises disinfected (requests) 36 Premises disinfected (verminous condition) 158 Total number of rooms disinfected 447 Total number of articles disinfected 12,195 Books disinfected 62 Number of articles destroyed at owner's request 361 In addition there was a small amount of disinfection undertaken on behalf of the Admiralty in respect of stores of bedding at the Royal Victoria Yard, Grove Street, Deptford, and £21.14.6d, was received from the Admiralty in respect of this service. BATHING STATION. Number of school ehildren who received baths (other them for scabies) ... ... ... 1,045 Number of school children who received baths for the treatment of scabies and impetigo ... ... ... ... 44 Adults who received baths (other than for scabies):- Male ... ... ... ... ... ... ... 219 Female.. ... ... ... ... ... ... 47 -12- BATHING STATION, (continued). Scabies baths for adults:- Male... ... ... ... ... ... ... ... ... ... 35 Female. ... ... ... ... ... ... ... ... ... 27 LAUNDRY. The laundry service is for aged infirm people in the Borough, who are incontinent and who have difficulty in obtaining someone to wash and cleanse their bedclothes and personal underclothing, etc. The equipment consists of a Washing Machine, Hydro Extractor, and Ironing Machine, and the work is carried out by the Bathing Station and Disinfecting Staff. Number of patients... ... ... ... 58 Number of collections and deliveries 882 Number of articles cleansed ... ... 9253 WATER SUPPLY. The water supply for domestic purposes for the whole of the Borough in 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 238 new premises. 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 Public Health Inspectors, INSPECTIONS. Number of Number on Register. Inspections. Occupiers Prosecuted. Notices Written. (1) Factories in which Sections 1, 2, 3, 4, and 6 are to be enforced by Local Authorities 48 48 (2) Factories not included in. (1) in which Section 7 is. enforced by the Local Authority 228 330 DEFECTE FOUND. Sanitary Conveniences: Found. Remedied. Referred To H.M. Inspector. By H.M. Inspector. Unsuitable or Defective - - - - -13- - - - - THE FACTORIES ACT, 1937. (continued). The types of premises inspected were as follows:- Bakehouses. Paint and varnish works. Printers, Chemical Works. Cinemas, Stables, etc. Sawmills. Dressmakers, etc. Engineering, general. Timber stores. Tar refiners. Engineering, motoring. Foundries. Tailors. Food preparation. Woodwork joiners, etc. Woodchoppers. Glass bottle makers. Laundries, cleaners. Marine stores. Whitening manufacturers. Miscellaneous. The number of inspections "made to home workers premises was 99. The types of works carried on by the l64 outworkers in this Borough were as follows Wearing apparel (120), paper bags (1), boxes (9), button cards (5), shuttlecocks (1), electrical components (1), druggists' sundries (1), cardboard tubes (5), lampshades (6), leather goods (2), jewellery (4), wire embroidery (1), umbrellas (1), uniform caps (4), firework cases (1), artificial flowers (1), and coat hangers (1). CLEAN AIR ACT. 1956. It was not necessary to undertake legal proceedings or any action other than informal during the year. The Council has approved a proposal to make a small Smoke Control Area in the S.W. corner of the Borough, and abutting on the Boroughs of Camberwell and Lewisham. The area is approximately acres and consists of 678 houses, 78 flats, 8 shops and one school. The confirmation of the Minister of Housing and Local Government will be sought in 1959. A station for measuring atmospheric pollution is set up in the Public Health Department building, and results and details are.sent to the Fuel Research Station at Greenwich. Attached is a summary of readings during the year. Smoke Concentration MG/M3 Sulphur dioxide Concentration per 100 x 10 Average Value. Highest Value. Lowest Value. Average Value. Highest Value. Months. Days. 42.1 121.6 8.4 11.6 8.1 42.5 January, February. March. 31 28 29.3 70.5 4.1 16.3 29.36 31 36.0 132.35 13.15 9.7 33.7 76.0 6.2 7.4 14.6 April. May. 25 27 14.1 70.5 2.3 3.5 15.8 15.8 5.8 June. July. 30 37.2 3.1 9.0 31 17.7 53.5 1.95 3.6 9.3 18.5 August. 23 57.1 3.6 3.4 14.0 18.4 37.2 1.8 8.7 September. October. 23 2.9 31 33.4 76.0 3.7 3.0 11.7 43.3 November. December. 30 51.5 172.5 17.2 11.2 26 56.0 132.5 9.2 16.3 41.0 FOOD AND DRUGS. -15- FOOD AND PRUGS. 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 County Hall, 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. 178.EVELYN STREET. Details will be found in Appendix VI, ICE CREAM. Twenty-four samples were taken for bacteriological examination. Grade I... ... ... ... ... ... 17 Grade II. ... ... ... ... ... 3 Grade III. ... ... ... ... ... 2 Grade IV.. ... ... ... ... ... 2 PUBLIC HEALTH (PRESERVATIVES ETC. IN FOOD) REGULATIONS. Wherever desirable, Food and Drugs Act samples were examined for the presence! of prohibited preservatives and colouring matters, and for excessive amounts of the permitted preservatives. No infringements were found. SCHOOL MILKS. Fifteen samples were sent for chemical examination and twelve were sent for bacteriological examination. MILK (SPECIAL DESIGNATIONS) ACT. Twenty-two samples were submitted. MILK AND DAIRIES REGULATIONS. 1949-53. Dealers Licences issued: Tuberculin Tested Milk... 23 Pasteurised Milk... ... 69 Sterilised Milk ... ... 96 Supplementary Licences issued: Tuberculin Tested Milk... 15 Pasteurised Milk... ... 15 Sterilised Milk ... ... 18 SLAUGHTERHOUSES. There are two Slaughterhouses licensed in the Borough. Only one is regularly used and the following tables etc., give details of work carried out in the slaughterhouses and the food condemned by the Food Inspection -16- ANIMALS SLAUGHTERED. Slaughterhouse. Sheep. Pigs. Calves. Bovines. Total. 13a, Deptford High Street. 491 794 192 111 - 180, Brockley Road. - - - - - 192 111 491 Totals. 794 - CARCASES AND OFFAL INSPECTED AND CONDEMNED IN WHOLE OR IN PART. Cattle (excluding Cows.) Cows. Calves. Horses. Sheep & Lambs. Pigs. Number killed 491 111 192 - - - Number inspected 111 491 192 - - - All diseases except Tuberculosis & Cysticerci: Whole carcases condemned - - - - - - Carcases of which some part or organ was condemned. 16 15 10 - - - Percentage of the number inspected affected with disease other than tuberculosis and cysticerci 14.4% 3.0% 5.2% - - - Tuberculosis only: Whole carcases condemned - - - - - - Carcases of which some part or organ was condemned. 1 - - - - - Percentage of the number inspected affected with tuberculosis. - - - - 0.9% - Cysticercosis: Carcases of which some part or organ was condemned. - - - - - - LEBANESE APPLES. Early in the year many consignments of Lebanese Apples "stopped" by the Port of London, were allowed to be sent to a Fruit Depot in this Borough "to be treated to the satisfaction of this Council" prior to release. These apples had been sprayed with lead arsenate insecticide which had penetrated the skins and accumulated in both ends of the apples. It was soon found that dry-cleaning, ordinary washing, or even vigorous scrubbing failed to reduce materially the amount of contamination. Eventually the Public Analyst suggested a method involving immersion in 1% Hydrochloric Acid, together with a "wetting agent" and after controlled experiments the bulk of the apples were rendered safe in this way. -17- /continued. LEBANESE APPLES. (continued). Complications arose from the fact that the maximum limits for lead and arsenic in-food were only "recommended" figures, generally, but not necessarily acceptable in any legal proceedings. Fortunately it was found possible to render these apples safe. -18- SECTION "E". HOUSING. -19- HOUSING. At the end of 1958 the Council had a total of 753 permanent houses, maisonettes and flats, a total of 26? temporary houses of various types, and controlled a further 401 properties under requisition. The requisitioned properties housed 597 units of tenancy. During the year, flats were completed for the Council. Also, improvements were carried out in 932 houses, rather more than last year, and outstanding works at the end of the year totalled 172. Apart from the flats completed by the Council, 137 flats and maisonettes were completed by the London County Council, and 27 houses were completed by private builders. In the maintenance of existing property the following is a summary of the work done in 1958:— PUBLIC HEALTH (LONDON) ACT. 1936. Total number of houses inspected for housing defects... ... ... ... 1,673 Number of Statutory Notices served. ... ... ... ... 333 Number of houses repaired or nuisances remedied... ... 932 OVERCROWDING. Number of individual dwellings overcrowded at the end of the year... ... ... ... ... 53 Number of families found to be living in overcrowded conditions during the year ... ... ... 2 Number of families who have obtained alternative accommodation during the year ... ... - 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. RENT ACT, 1957. During the year applications under the Act were received and dealt with as follows:- Applications by tenants for Certificates of Disrepair... ... ... ... 174 (Granted 165. Refused or withdrawn 9) Applications by tenants for Certificates as to remedying of defects ... 40 (Granted 37. Refused 3). Applications by landlords for Certificates as to remedying of defects.. 38 (Granted 33. Refused 5). Applications by landlords for Revocation of Certificates of Disrepair,. 37 (Granted 36» Refused 1). -20- SECTION "F". PERSONAL HEALTH SERVICES. 21 PERSONAL HEALTH SERVICES. (LONDON COUNTY COUNCIL). The headquarters of the Divisional Medical Officer (Dr. F.R. Waldron) are at St, Paul's House, Deptford High Street, S,E,8, and the services which are provided by the London County Council at the various clinics are as follows:- HEALTH CENTRE, AMERSHAM ROAD, S.E.14. Infant Welfare, Toddlers, and Ante-Natal Clinics. Vaccination and Immunisation. Foot Clinic. Mothercraft Class. Day Nursery. Artificial Sunlight, Simple Massage and Exercises Clinic. Domestic Help Service. 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' HOME, WATSON STREET, S.E.8. Ante-Natal Clinic. SCHOOL TREATMENT CENTRE, REGINALD SQUARE. Dental Clinic. Vision Clinic. Speech Therapy. Ear, Nose and Throat Clinic. Orthoptic Clinic. Audiology Clinic. WELFARE FOODS SERVICE. National Welfare Food items are available for issue at the Health Centre, Amersham Road; Princess Louise Institute Clinic and St. Luke's Hall Clinic at certain times. These items are also available at St. Paul's House, Deptford High Street, S.E.8, and the Women's Voluntary Services, 302, New Cross Road, S.E. 22 SECTION "G". MISCELLANEOUS: 23 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 sickbay 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. The standard of accommodation is high and it compares favourably with many of the rooms occupied by single elderly men throughout the district. LABORATORY SERVICE. Food samples are normally sent to the Medical Research Laboratory at County Hall, but clinical items, e.g., faeces specimens, continue to be sent to the Park Hospital Laboratories. The facilities at the Devonport Laboratory, Seamen's Hospital, Greenwich, are occasionally used by general practitioners for the examination of swabs and other specimens. MORTUARY. The mortuary at Watson Street, Deptford, serves parts of Greenwich and Woolwich, in addition to Deptford. The number of bodies received at the mortuary is, as a result of this arrangement, greatly increased. The total number of bodies received during 1958 was 501, of which 232 were received from Greenwich, and 182 from Woolwich, A fee of £1. 1. Od. per body is paid by the Greenwich and Woolwich Borough Councils in respect of these admissions. 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 1958. 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. /continued. 24 REMOVAL OF AGED AND INFIRM PERSONS TO INSTITUTIONS. (continued). Several cases were removed either to hospital or County Council homes for the aged after persuasion, but it was not necessary to invoke Section 47 during the year. SERVICES FOR OLD PEOPLE. 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. I give details regarding our "Meals on Wheels" service which is carried out in co-operation with the Women's Voluntary Services Organisation. Meals are provided to about 190 old people each week. The meals are obtained from the United Girls Schools for Social Services at a cost of 1s. 8d, per meal, for which the individuals pay 10d. and the London County Council pay a subsidy of 10d. per meal. The Council pay the United Girls Schools monthly for the cost of the meals, 10,310 meals were provided during the year. The Deptford Borough Council provide a vehicle (which was presented by a local firm) and a driver, to deliver about bo meals twice a week to housebound old folk and the remainder of the meals to "Darby and Joan" Clubs. The W.V.S. provide the helpers for delivery of meals. SHOPS ACT, 1950. In the course of their routine inspection the Public Health Inspectors paid attention to the ventilation and temperature of shops and the provision of washing accommodation and sanitary convenience. 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. 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. PET ANIMALS ACT, 1951. Seven applications for licences were received, and all were approved by the Council and granted. 25 MEDICAL EXAMINATIONS. During the year 53 examinations were carried out to ascertain if people appointed to the Council's Permanent Staff were fit for admission to the Superannuation Scheme. Fifty-one examinations of sick employees were also made during the year and reports submitted thereon. CONFERENCES. The Council was-represented at Conferences during the year as follows:- Royal Society for Promotion of Health-Eastbourne. The Chairman of the Public Health Committee (Councillor R.S. Marriott, J.P.) and the Medical Officer of Health. National Society for Clean Air-Llandudno. Councillor Mrs. A.M. Ott and Mr. A.C. Webster, Chief Public Health Inspector. Sanitary Inspectors' Association-Blackpool. Councillor Mrs, D. Nason and Mr. H.E.Green, Public Health Inspector. REGISTRATION OF HAIRDRESSERS PREMISES. Fifty-two premises are registered under Section 18(1) of the London County Council (General Powers) Act, 1954. Occasional inspections are made to ensure that the bye-laws are observed. 26 TABLE .I. CAUSES OF DEATH AT DIFFERENT PERIODS OF LIFE DURING 1958 IN THE METROPOLITAN BOROUGH OF DEPTFORD. AGE. 0-1 years. All Ages. 1—5 years. 45-65 years. 65-75 years. 5-15 years. 15-25 years. 25-45 years. Sex. 8 M 1 1 1 2 2 - - F 2 2 - - - - - - M - - - - - - - - F 1 1 - - - - - - M 1 1 - - - - - - F - - - - - - - - M - - - - - - - - F - - - - - - - - M - - - - - - - - F - - - - - - - - M - - - - - - - - - F - - - - - - - - M - - - - - - - F - - - - - - - - - M - - - - - - - F - - - - - - - - M - - - - - - - - - F - - - - - - - - M 15 7 7 - - - - 1 F 10 1 2 - - - - - M 35 16 11 - - - - 6 1 2 F - - - - M - - - - - - - - - 3 5 5 F 15 - - - M - - - - - - - - - F 2 - - - - - - M 31 2 14 2 - - - - 3 7 F 33 - 12 - - - - 1 M 1 - - - - - F - - - - - - - M - - - - - - - - F - - - - - - - - - 10 14 M 36 - - - 16 F 58 1 9 - - - - - - - 427 Causes of Death. 75 years & above Sex. All Ages. 0-1 years. 1-5 years. 5-15 years. 15-25 years. 25-45 years. 45-65 years. 65-75 years. 18. Coronary Disease, Angina. M 87 - - - - 2 35 27 2 F 46 - - - - - 6 14 2 19. Hypertension with heart disease. - M 10 - - 4 2 - - F 13 - - - - - - 4 - 20. Other heart disease. 47 - M - - - 3 19 2 1 F - 74 - - 1 6 11 5 - 21. Other circulatory disease. 19 M - 4 9 ir - - - - F 14 - 1 1 - - - - 2 22. Influenza. - - - M - - - - - F 3 - - 1 - - - - 23. Pneumonia. M - 1 32 4 1 - - 7 9 F - 1 - - 3 1 26 1 4 24. Bronchitis 1 M 50 2 - - 15 - - 15 F - 30 1 3 9 1 - - - 25. Other diseases of respiratory system. M - - 2 1 - 4 - - 2 F - - 1 1 - - - 26, Ulcer of stomach & duodenum. - - - 6 11 M 3 6 - - F 1 - - - - 1 i - - 27. Gastritis, enteritis & diarrhoea. 1 M 1 - - - - - - - - F r - - - - - - - - - - - 28. Nephritis & neophrosis. M - - - 1 1 oti - - - - 1 - F 1 - - - 29. Hyperplasia of prostate. M - 3 - - - 2 F - - - - - - - - - M - 30. Pregnancy, childbirth or abortion. - - - - - - fci - F 1 - - - 1 - - - - - L M 2 - - 31. Congenital malformation. - 1 - 3 - 1 1 - k F 2 - - - 32. Other defined & ill-defined diseases. M - 2 4 33 I 10 1 3 6 6 F 34 12 4 E - - - - 2 i 33. Motor vehicle accidents. 1 1 10 - M - 2 - r F - - - 1 2 4 - - - 1 2 34. All other accidents. M 10 - 1 1 5 1 F - - 4 - - - - 35. Suicide. - - 2. 1 - M 3 - - F - 1 2 1 5 - - - 36, Homicide & operations of wa r. M - - - - - - - - F - - - - - - - - 1 5 132 451 18 3 6 11 140 Total deaths, All causes. M 15 1 2 14 59 88 2 F 388 - -28- TABLE II. SUMMARY OF SANITARY WORK CARRIED OUT DURING THE YEAR 1958. r DISTRICTS. 1 2 3 4 5 6 7 TOTAL. Primary Inspections. Complaint. 199 172 154 276 200 203 230 1434 Infectious Disease 67 5 23 7 7 11 139 19 42 55 26 Notice from Builder 61 137 56 32 409 Rodent Control 44 29 15 19 207 30 44 26 Factories (Power) 10 38 8 89 23 7 228 53 (Non-power) 4 10 12 2 48 2 1 3 5 Food Premises 18 14 54 157 88 171 530 28 6 25 72 Butchers Premises 6 17 16 2 - 4 1 14 18 19 92 Ice Cream Premises 33 3 Milk Premises 8 14 25 36 25 8 1 3 129 Bakehouses - 3 2 4 11 - 2 - 10 1 13 Fish Premises - - 1 1 - - Common Lodging Houses - - - 16 - 16 - Outworkers 14 16 7 42 - 9 99 11 Shops Act Inspections 11 68 130 71 32 523 60 151 Rent Act Inspections 47 41 52 33 35 37 43 288 3 3 1 3 8 5 36 Pharmacy & Poisons Act Inspections 13 - 2 6 Pet Animals Act Inspections 2 - 2 - - Smoke Observations - 3 - - 4 - 4 11 5 Hairdressers & Barbers Premises. - 1 3 5 10 5 1 39 Miscellaneous 895 93 2 02 231 188 130 116 1855 Total 1385 573 712 1269 839 858 549 6185 Re-Inspections, Calls, etc., 1261 2086 1125 2792 3023 1924 1369 13580 Notices Served-Public Health (London) Act, 1936. Intimation 96 107 93 149 149 169 192 955 Statutory 27 13 17 79 75 58 64 333 London County Council (General Powers) Act. 1954 Section 12 8 1 4 37 1 8 12 3 Premises in respect of which Notices were completed 128 87 61 148 134 163 211 932 Preemises in respect of which Notices were outstanding at the end of the year. 23 25 19 28 32 28 17 172 29 TABLE 111 Description of Sanitary Improvements Effected during the year. Districts. 4 6 1 2 3 5 7 Total. I Rooms cleansed. 28 43 49 37 58 143 383 I fc 25 75 78 38 24 66 Roofs repaired. 27 59 367 Gutters and rainwater pipes renewed or repaired. 20 13 34 24 33 11 39 59 220 86 Dampness abated 25 22 16 50 32 66 297 10. Yards and Forecourts, etc., repaired or repaved. 4 8 6 4 24 54 1 7 24 11 18 26 10. Water fittings renewed or repaired. 9 23 11 122 Sink Waste Pipes renewed or repaired. 18 8 11 56 13 11 7 124 51. Drains entirely reconstructed. 4 1 2 3 2 1 13 Drains partially reconstructed or repaired 11 14 42 4 4 15 21 111 12 Drains unchoked. 19 23 11 27 30 13 15 138 Soil and Ventilating Pipes renewed or repaired 9 2 6 2 2 12 2 35 9 Gullies provided, unchoked, etc. 6 4 6 43 I 5 13 2 7 9 Manholes, Chambers, Fresh Air Inlets, provided or repaired 11 4 4 19 7 6 3 54 Premises in which repairs were effected to W.C's 31 23 21 81 35 15 17 223 9 Repairs effected to Windows etc. 18 21 16 33 33 36 68 225 Repairs to Stoves, Coppers, Flues, etc. 7 12 4 16 28 88 30 10 11 Repairs to Stairs, Doors etc 8 6 8 26 24 86 3 11 Repairs to Floors 8 18 6 16 10 21 21 100 121 Ventilation and Lighting Improved 2 1 1 1 1 3 1 9 Offensive accumulations removed. 5 6 4 7 6 7 3 38 121 6 Dustbins supplied or renewed 3 3 14 47 11 3 7 26 14 34 166 21 Miscellaneous improvements effected. 22 10 10 50 347 584 364 461 680 2943 Total. 295 212 2 - 30 TABLE IV. LEGAL PROCEEDINGS. PUBLIC HEALTH (LONDON) ACT. 1936. Remarks. Premises and Nature of Offence. Fine. Costs. 6, Florence Cottages. Non-compliance with Magistrate' s Order. - £20. 0. 0. £5. 5. 0. 12, St. Donatt's Road, Non-compliance with-Statutory- Notice. - - £3. 3. 0. Order for work to be completed in 21 days. - - - 29, Heston Street, Non-compliance with Statutory Notice. - £3. 3. 0. Work completed prior to hearing. £40. - 6, Florence Cottages, Non-compliance with Magistrate's Order. 0. 0. £5. 5. 0. - - 39, Tressillian Road, Non-compliance with Statutory Notice. £3. 3. 0. Order for work to be completed in 14 days. - - - 14, Upcot Street, Non-compliance with Statutory Notice. £3. 3. 0. Order for work to be completed in 14 days. - - - - 16, Upcot Street, Non-compliance with Statutory Notice. £3. 3. 0. Order for work to be completed in 14 days. - - £3. 34, Brocklehurst Street, Non-compliance with Statutory Notice. 3. 0. Order for work to be completed in 28 days. - £10. 0. - 0. £3. 3. 0. 12, St. Donatt's Road, Non-compliance with Magistrate's Order. - - - £3. 0. 10, Upcot Street, Non-compliance with Statutory Notice. 3. Order for work to be completed in 7 days. - - - 12, Upcot Street, Non-compliance with Statutory Notice. - - Work completed prior to hearing. - - - 2. 19, Upcot Street, Non-compliance with Statutory Notice. £2. 0. Order for work to be completed in 7 days. - - - £5. 76, 82, 86, and 88, Speedwell Street, Non-compliance with Statutory Notices. 0. 5. Work completed prior to hearing. - TABLE IV. (Continued). LONDON COUNTY COUNCIL (GENERAL POWERS) ACT. 1954 Date of Hearing. Premises. Fine. Costs. Remarks. 12.5.58. Upcot Street. - £3. 3. 0. Dustbin supplied prior to hearing. LONDON COUNTY COUNCIL DRAINAGE BYE-LAWS. Date of Hearing. Premises and Nature of Offence. Fine. Costs. Remarks. £2. 0. 0. £3. 3. 0. 6,.Florence Cottages. - 13.1.58. 31.3.58. 6, Florence Cottages. £2. 0. 0. £2.2. 0. -