ERI 30 BOROUGH OF ERITH ANNUAL REPORT OF THE Medical Officer of Health FOR THE YEAR ENDED 1950 BY JOHN LANDON M.R.C.S., L.R.C.P., D.P.H. BOROUGH OF ERITH ANNUAL REPORT OF THE Medical Officer of Health FOR THE YEAR ENDED 1950 BY JOHN LANDON M.R.C.S., L.R.C.P., D.P.H. Printed by Freame, Manning & Co., Ltd. Lewisham, S.E.13 Arrangement of Report. Section Page A Statistics and Social Conditions of the Area 1. Physical Situation and Amenities 8 2. Comparative Rainfall 8 3. Unemployment Figures and Comments 9 4. Statistics 9 (a) General 9 (b) Births, Birth Rate, Still Births, Still Birth Rates 10 (c) Deaths, Death Rate, Maternal Mortality Rate 10 (d) Infant Mortality 11 (e) Summary of Vital Statistics for year 1950 12 (f) Vital Statistics of whole District during 1950 and previous years 13 (g) Table Showing Summary of Causes of Death during 1950 14 (h) Comparison of Maternal Mortality Rate 15 (i) Infant Mortality—Causes of death and table of comparison 15 B Prevalence of and Control over Infectious and other Diseases 1. Notifications 17 (a) Age Distribution 18 (b) Ward Distribution 19 2. Tuberculosis 20 (a) New cases notified during 1950 20 (b) Deaths 21 (c) Quarterly statements for year 1950 20 (d) Mass Radiography 22 3. Diphtheria Immunisation 23 4. Scabies 24 5. Smallpox 24 C General Provision of Health Services for the Area 1. General Hospital Facilities 26 2. Infectious Disease Hospitals 26 3. Tuberculosis Treatment and Hospital Accommodation 26 4. Venereal Diseases 26 5. Ambulance Service 26 6. School Clinics 26 7. Maternity and Child Welfare Centres 27 i Section Page 8. Maternity Home 27 9. Private Nursing Homes 27 10. Day Nurseries 27 11. Laboratory Facilities 27 12. Mortuary 28 13. Disinfection Services 28 14. Old Peoples' Welfare 28 15. National Assistance Act 1948, (Burials) tion 50 31 D Sanitary Circumstances of the Area 1. Refuse Collection and Disposal 32 (a) Costs 32 (b) Details of Refuse Collection Vehicles and Staff 32 (c) Details of Tonnage 33 2. Trade Refuse 33 3. Salvage 33 4. Public Conveniences 33 5. Sanitary Inspection of the Area 34 (a) Visits by Sanitary Inspectors 34 (b) Premises visited and results of such visits 34 (c) Summary of Nuisances and defects remedied during the year 34 (d) Closet accommodation and cesspools 35 (e) Smoke Abatement 35 (f) Swimming Baths and Pools 35 (g) Camping Sites 36 (h) Hop Pickers 36 (i) Rag Flock Act 36 (j) Eradication of Bed Bugs 36 (k) Mosquito Control 37 (l) Rodent Control 37 (m) Pest Control 37 (n) Offensive Trades 37 6. Factories 38 (i) Inspections 38 (ii) Defects Found 38 7. Shops Acts 38 (a) Shops Acts, 1950 38 (b) Shops (Sunday Trading Restriction) Act, 1936 39 8. Offices 39 9. Effluvia from River Thames 39 10. Atmospheric Pollution 40 ii Section Page 11. Housing 41 (a) Inspection of Dwelling Houses during the year 41 (b) Remedy of Defects during the year 41 12. Rent and Mortgage Interest (Restrictions) Act, 1939 43 13. Legal Proceedings 43 E Water Supply—Milk and Food and Drugs 1. Water Supply 44 2. (a) Dairies and milk stores 44 (b) Bacteriological examination of Milk 44 (c) Biological testing of Milk 45 (d) Designated Milk 45 (e) Ice Cream 45 3. Food and Drugs Act 1938, Sections 3 and 68, Routine Sampling 46 4. Meat and Food Inspection 47 5. Slaughter of Animals Act, 1933 48 6. Food Hygiene—Food Traders' Guild 48 F General 1. Members of Committee 2 2. Staff of Public Health Department 3 3. Introductory remarks of Medical Officer of Health 4 4. National Assistance Act 1948, Sec. 47 48 5. Legislation in force 49 iii 2 F (1) BOROUGH OF ERITH Mayor:—Councillor J. N. Powrie, J.P., C.C. (1949-1950) Mayor:—Councillor E. J. Clarke, J.P. (1950-1951) Deputy Mayor:—Alderman F. T. Ellis, J.P. (1949-1950) Deputy Mayor:—Councillor J. N. Powrie, J.P., C.C. (1950-51) Health Committee Chairman:—Alderman Mrs. L. F. Christian, J.P. Members of Committee May 1949—May 1950 May 1950—May 1951 Aldermen Mrs. E. M. Ewens C. F. Morling C. F. Morling Councillors W. F. Alford F. W. E. Gilder E. Handy Mrs. H. A. Jerome T. G. Tuffee W. F. Alford F. W. E. Gilder E. Handy Mrs. H. E. Jerome E. Taylor T. G. Tuffee Ex-Officio-Members Ex-Officio Members Aldermen F. T. Ellis, J.P. G. W. H. Luck T. C. Pannell, M.P. G. W. H. Luck Councillors J. N. Powrie, J.P., C.C. E. J. Clarke, J.P. J. N. Powrie, J.P., C.C. 3 F (2) PUBLIC HEALTH DEPARTMENT STAFF Medical Officer of Health John Landon, M.R.C.S., L.R.C.P., D.P.H. (Acts also as Medical Officer of Health for the Borough of Bexley and the Urban District of Crayford). Senior Sanitary Inspector L. E. King, M.R.San.I., Cert.S.I.E.B., I.S.A.A.(Dip), Meat Inspectors Certificate. Sanitary Inspectors J. Hacker, M.R.San.I., Cert.S.I.E.B., Meat Inspectors Certificate. A. J. Gould, Cert.S.I.E.B. (Resigned 15.4.1950) N. E. Broom. Cert.S.I.E.B. (Appointed 10.7.1950) P. R. Hickson, Cert.S.I.E.B. (Appointed 8.7.1950) Pupil Sanitary Inspector P. R. Hickson (Qualified 8.7.1950) Chief Clerk J. M. Roberts Clerks Shorthand-typist:— Mrs. E. A. Shaw (Resigned 29.4.1950) Miss B. A. Fackrell (Appointed 25.5.1950) E. A. Howard General Clerk:— Junior Clerks:— L. G. Whitman (Transferred to Treasurers Department 15.4.50) M. J. Butler (Returned from Forces 17.4.50) Resigned 8.7.50) J. W. Tiptaft (Appointed 21.8.1950) 4 To the Mayor, Aldermen and Councillors of the Borough of Erith Mr. Mayor, Ladies and Gentlemen, I have the honour to present my annual report for the year 1950. In trying to assess the health of the Borough during the year under review we are beset by many difficulties. On the one hand the vital statistics which are available to us and which are dealt with in detail below, afford a useful guide in regard to the major causes of death at the various ages from infancy to old age and much information is, also, available of the incidence of infectious diseases many of which, such as diphtheria and scarlet fever, have diminished in importance as a result of improved environmental conditions and advances in preventive medicine. What we lack, at present, is reliable statistical evidence in regard to morbidity i.e. ill-health of the kind which results in the filling of hospitals, out-patients' departments and doctors' surgeries and which result, not necessarily in death, but in lowered resistance, anxiety states, reduced efficiency, absenteeism and an inability to enjoy life to the fullest extent. The survey of sickness now regularly carried out by the Registrar-General on representative population samples in England and Wales gives a good indication of national trends but has no specific application to the area with which we are concerned, and we must rely, therefore, on the evidence which comes to us in the course of our daily work and contacts with the general public, doctors, health visitors, sanitary inspectors and the voluntary organisations which operate in the Borough. It is necessary, occasionally, to make this distinction if only to avoid an excess of optimism which might well be justified by a study of the vital statistics of the Borough by themselves, which are satisfactory. The birth rate for 1950 was 14.96 per thousand compared with 17.00 in 1949; for the first time the Registrar General has supplied a comparability factor (0.95) to enable a comparison to be made with other parts of the country. The adjusted rate was 14.21. The birth rate for England and Wales for 1950 was 15.8 so that the birth rate for Erith during the year under review was below that for the country as a whole. 5 The death rate for 1950 was 10.2 per thousand as compared with 9.95 during 1949 and the death rate adjusted for comparison with other areas was 11.0 compared with 10.75 in 1949. The death rate for England and Wales for 1950 was 11.6 so that the rate for the Borough was lower than that for the country as a whole. The infant mortality rate, that most sensitive index of environmental conditions, parental care and welfare services, at 20 per thousand relative live births was the lowest ever recorded in the Borough and compared well with 23.9 per thousand in 1949 and with 29.8 per thousand which was the rate for the country as a whole for the year 1950. As the infant mortality rate for the Borough in 1930 was 65.6 per thousand, there has been a reduction of two thirds in the infant mortality rate in 20 years, and this despite the war years and the many adverse factors which resulted from it. We are now reaping the reward of 40 years of preventive health services which has brought about a revolution in the care of the infant. It should be remembered, however, that the considerable fall in the birth rate during the past 60 years has also had much to do with this result. Although there were no deaths from infantile diarrhoea, there were 7 deaths from pneumonia, so that there is still much room for improvement and it is evident that a rate even below 20 per thousand is still possible although 20 years ago this would have appeared to be a Utopian dream. During 1950 no mother died as a result of childbirth in the Borough, giving a maternal rate of nil per thousand compared with 0.86 per thousand for the country as a whole. In 1928 there were 5.84 deaths per thousand total births. This great improvement is a reflection of advances in obstetric services and of the application of sulphonamide drugs of penicillin and other antibiotics to the practice of midwifery. During the year 1950, no case of diphtheria was notified in the Borough and, as in 1949, there were no deaths from any notifiable infectious disease, with the exception of tuberculosis which remains one of the gravest medico-social problems confronting the health services. Housing assistance was given during the year by the Council in a number of cases of tuberculosis which had been referred to them by the Medical Officer of Health. The needs of old people received considerable attention during the year and attention is drawn to the report on page 28 which deals with the setting up, in the Borough, of an Old People's Welfare Committee to provide "good neighbour" 6 services for old people. This Committee has been very active during the year and much has been done to alleviate the sense of loneliness from which the old people frequently suffer. The problem of old people living alone is a grave one at the present time. Many of them wish, above all else, to remain in their own homes and should be encouraged to do so whenever possible, but there may come a time when illness or accident may supervene necessitating immediate removal to hospital. Much good work is done, unobtrusively, by neighbours in looking after old people living near them and, but for their help in many cases, the plight of the latter would, indeed, be grim. The work done by them and by the voluntary organisations is worthy of the highest praise. In regard to the Clean Food Campaign, the Food Traders' Guild which was formed for the area of Erith, Bexley and Crayford continued its operations during 1950. Codes of Practice were approved for a number of food trades and this part of the work is now reaching completion. A Clean Food exhibition was planned in the latter part of the year and was successfully held in May, 1951. It is hoped, in the near future, to invite applications from food traders for membership of the food traders' guild and the real work of improving standards of food preparation, handling and sale will then begin. This campaign is a long term effort in health education which will entail a good deal of hard work on the part of the Sanitary Inspectors and other members of the Health Department. It is hoped, hoewver, that this work, while unspectacular and slow moving, will result, in due course, in an appreciable raising of standards of food hygiene in the Borough. Effluvia from the river Thames continued to be a cause of discomfort and exasperation to the people of the Borough during the year, although the nuisance was not so pronounced as during the previous year. The remedy, however, does not lie with the Borough Council, who have given this matter considerable attention, but with the London County Council, whose £5,000,000 scheme to improve the sewage effluents from their Barking and Crossness outfalls has been approved by the Ministry of Health and is now in the early stages of implementation. There appears to be no method of bringing this nuisance to an early end and the remedy is, unfortunately, a long term one. The housing problem, of course, constitutes the main obstacle to full health in the Borough as in the rest of the country, although much has been done during the year to improve the position. The Health Department has to deal with 7 many housing letters during the year from people whose living conditions are very bad, and a sympathetic ear and a kindly, word is often all that is possible in view of the points system of priorities which is in operation. However, many cases were referred to the Housing Committee with success, especially where they involved tuberculous families in which overcrowding existed, and where the infection of young children was an important factor. The development of the Riversite Gardens by the Council, in providing opportunities for relaxation in the open air, is an important addition to the facilities of the Borough and should be a source of enjoyment and happiness to many people from over a wide area. In conclusion I wish to thank the Council for their support and encouragement during the year. My thanks are also due to the Senior Sanitary Inspector, the Chief Clerk, and all members of the Health Department for much good work which was carried out during the year. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, JOHN LANDON, Medical Officer of Health. 8 SECTION A:—STATISTICS AND SOCIAL CONDITIONS OF THE AREA Annual Report 1950 A (1) Physical Situation and Amenities Erith is situated in the north west corner of Kent, and bounded on the North-East by the River Thames, to which it has a frontage of about 4 miles; on the West by the Metropolitan Borough of Woolwich and the Borough of Bexley, and on the South by the Borough of Bexley and the Urban District of Crayford. The residential parts of the Borough consist of areas in Abbey Wood, Belvedere, Northumberland Heath and the southern portion of the Town, all of which are well wooded and excellently situated. The main arterial road connects the Town with London, 10 miles distant, good rail transport facilities being provided by British Railways. The chief industries are light and heavy engineering; edible oil refining; chemical works; coal shipping and lighterage, and production of building materials, i.e., stoneware, plastic boards, asbestos, etc. A (2) Comparative Rainfall 1950 Inches 1949 Inches January 1.00 1.19 February 3.43 1.18 March 0.69 0.62 April 2.16 1.44 May 1.40 1.90 June 1.43 0.98 July 3.23 0.41 August 1.29 0.82 September 2 50 0.82 October 0.30 6.86 November 4.80 2.88 December 1.52 1.43 Total 23.75 Total 20.53 9 A (3) Unemployment Figures and Comments With the co-operation of the Manager of Erith Employment Exchange, to whom I am indebted for the necessary information, it is once again possible to give definite figures with regard to the state of unemployment in the district, as shown in the following table. Erith and District Unemployment Figures 1939—1950 Month and year Males Females Total 18 and over Under 18 18 and over Under 18 December, 1939 373 31 299 48 751 December, 1940 75 3 255 37 370 December, 1941 39 17 44 17 117 December, 1942 38 1 39 5 83 December, 1943 27 1 6 5 39 December, 1944 31 — 6 3 40 December, 1945 91 1 133 1 226 December, 1946 177 12 58 13 260 December, 1947 131 4 94 5 234 December, 1948 208 7 129 2 346 December, 1949 111 8 153 3 275 December, 1950 114 3 122 1 240 The unemployment figures for Erith and District remained at a low level throughout 1950, and towards the end of the year even shewed a slight reduction. This satisfactory position was due to the continued maintenance of a high level of employment in the area. A (4) STATISTICS A (4)a General Area (1) Including River:—4,607 acres. Area (11) Excluding River:—3,859 acres Population figure supplied by Registrar General:— Estimated mid-year Home Population—46,850 Density of population i.e. No. of persons per acre (Based on (11) above):—14.1 No. of inhabited houses at 31st December, 1950:— (Excluding houses with shops and houses with Public Houses assessed as single heraditaments) 12,314 Rateable value at 31st December, 1950:—£344,726 Sum produced by a penny rate, 1950:— (Estimated product for 1950/51) £1,400. 10 EXTRACTS FROM VITAL STATISTICS FOR YEAR 1950. A(4)b Births Male Female Total Live Births Legitimate 369 315 684 Illegitimate 13 4 17 382 319 701 Live Birth rate per 1,000 Home Population (Registrar General's Figure):—14.96 Birth rate corrected for comparison with other areas:— 14.21 Comparability factor supplied by Registrar General :— 0.95. Live birth rate, England and Wales:—15.8 Corresponding rate for the Borough of Erith for year 1949 17.00 Male Female Total Still Births Legitimate 9 6 15 Illegitimate — — — 9 6 15 Still Birth rate per 1,000 total births:—20.95 Still Birth rate per 1,000 Home population:—.32 Still Birth rate per 1,000 Home population, England and Wales:—0.37 A (4)c Deaths Male 269 Female 209 Total:—478 Death rate per 1,000 Home population:—10.2 Death rate corrected for comparison with other areas:— 11.0. (Comparability Factor supplied by Registrar General):— 1.07. Corresponding rate for 1949:—9.95. Death rate per 1,000 Home population, England and Wales (1950) 11.6 Number of women dying in, or in consequence of, childbirth :—Nil. Maternal Mortality Rate per 1,000 total births:—Nil. Comparative figure for England and Wales:—0.86 11 A (4)d Infant Mortality Deaths of infants under 1 year of age:— Male Female Total Legitimate 9 4 13 Illegitimate 1 — 1 10 4 14 Death rate of infants under 1 year of age per 1,000 live births:—20 Death rate of infants under 1 year of age per 1,000 live births, England and Wales:—29.8 Deaths of infants under 4 weeks of age:— Male Female Total Legitimate 5 2 7 Illegitimate 1 — 1 6 2 8 Death rate of infants under 4 weeks of age per 1,000 live births 11.41 Total number of deaths from:— 1949 1950 Measles (All ages) — 1 Whooping Cough — — 12 A (4)e Summary of Vital Statistics for the Year 1950 England and Wales 126 County Boro's & Great towns including London 148 smaller towns (Resident population 25,00050,000 at 1931 census) London Administrative County Borough of Erith Births Rates per 1,000 Home Population Live births 15.8 17.6 16.7 17.8 14.21 Still births 0.37 0.45 0.38 0.36 0.32 Deaths:— All causes 11.6 12.3 11.6 11.8 11.0 Typhoid and Para-Typhoid 0.00 0.00 0.00 0.00 0.00 Whooping Cough 0.01 0.01 0.01 0.01 0.00 Diphtheria 0.00 0.00 0.00 0.00 0.00 Tuberculosis 0.36 0.42 0.33 0.39 0.38 Influenza 0.10 0.09 0.10 0.09 0.10 Smallpox 0.00 0.00 0.00 0.00 0.00 Acute Poliomyelitis (including encephalitis) 0.02 0.02 0.02 0.01 0.00 Pneumonia 0.46 0.49 0.45 0.48 0.51 Deaths:— Rates per 1,000 Live Births All causes under 1 year of age 29.8(a) 33.8 29.4 26.3 20.0 Notifications:— (Corrected) Rates per 1,000 Home Population. Typhoid Fever 0.00 0.00 0.00 0.01 0.00 Para-Typhoid Fever 0.01 0.01 0.01 0.01 0.00 Meningococcal Infection 0.03 0.03 0.02 0.03 0.00 Scarlet Fever 1.50 1.56 1.61 1.23 1.25 Whooping Cough 3.60 3.97 3.15 3.21 2.66 Diphtheria 0.02 0.03 0.02 0.03 0.00 Erysipelas 0.17 0.19 0.16 0.17 0.04 Smallpox 0.00 0.00 0.00 0.00 0.00 Measles 8.39 8.76 8.36 6.57 5.57 Pneumonia 0.70 0.77 0.61 0.50 0.75 Acute Poliomyelitis (including Polioencephalitis) Paralytic 0.13 0.12 0.11 0.08 0.13 Non-Paralytic 0.05 0.05 0.06 0.05 0.02 Food Poisoning 0.17 0.16 0.14 0.25 0.00 Notifications:— Rates per 1,000 Total (Live & Still) Births. (corrected) Puerperal Fever and Pyrexia 5.81 7.43 4.33 6.03 0.00 (a) Per 1,000 Related Live Births. 13 Year Population Figure according to Registrar General No. of Live Births according to Registrar General Live Birth Rate per 1,000 population No. of Deaths according to Registrar General Death rate per 1,000 Population No. of Deaths of infants under 1 year of age Infant Mortality Rate per 1,000 live births A (4)f Vital Statistics of Whole District during 1950 and previous years 1938 39,800 634 15.87 390 9.8 34 53.62 1939 41,870 721 17.22 452 10.98 31 44.28 1940 40,210 721 17.8 486 12.08 24 37.17 1941 36,520 606 16.8 473 17.00 23 37.95 1942 37,340 734 19.6 415 11.1 26 45.4 1943 37,890 822 21.6 439 11 .58 35 42.57 1944 36,780 895 24.3 463 12.5 44 49.16 1945 38,270 732 19.13 451 11.78 29 39.61 1946 42,900 958 22.3 446 10.4 31 32.3 1947 44,350 1,006 22.6 493 11.1 34 33.7 1948 46,250 877 18.96 458 9.9 20 22.8 1949 46,730 (Civilian) 46,770 (Total) 46,850 (Home Population) 795 17.00* 465 9.95* (Corrected) 10.75 19 23.9 1950 701 14.96 (Corrected) 14.21 478 10.2 (Corrected) 11 0 14 20.0 *Per 1,000 Home Population. 14 A (4)g Table showing Summary of Causes of Death during the year ended 31st December, 1950 Cause of Death Males Females Total 1 Tuberculosis, Respiratory 11 4 15 2 Tuberculosis, Other forms 1 2 3 3 S>philitic diseases — 1 1 4 Diphtheria — — — 5 Whooping Cough — — — 6 Meningococcal Infections — — — 7 Acute Poliomyelitis — — — 8 Measles — 1 1 9 Other infective and parasitic diseases 1 1 2 10 Malignant neoplasm, stomach 9 5 14 11 Malignant neoplasm, lung, bronchus 14 2 16 12 Malignant neoplasm, breast — 11 11 13 Malignant neoplasm, uterus — 3 3 14 Other forms malignant neoplasm and lymphatic neoplasms 26 20 46 15 Leukaemia, Aleukaemia 2 — 2 16 Diabetes 3 1 4 17 Vascular lesions of nervous system 22 30 52 18 Coronary disease, angina 29 8 37 19 Hypertension with heart disease 9 7 16 20 Other heart diseases 54 54 108 21 Other circulatory diseases 7 6 13 22 Influenza 3 2 5 23 Pneumonia 13 11 24 24 Bronchitis 15 12 27 25 Other diseases of respiratory system 5 1 6 26 Ulcer of stomach and duodenum 2 — 2 27 Gastritis, enteritis and diarrhoea 1 — 1 28 Nephritis and Nephrosis 1 2 3 29 Hyperplasia of prostate 3 — 3 30 Pregnancy, Childbirth and abortion — — — 31 Congenital Malformations 1 — 1 32 Other defined and ill-defined diseases 21 19 40 33 Motor vehicle accidents 1 — 1 34 All other accidents 9 5 14 35 Suicide 6 1 7 36 Homicide and operations of war — — — Total all causes 269 209 478 15 A (4)h Comparison of Maternal Mortality Rate Yearly Maternal Mortality rates are given Year Maternal Deaths Live Births Still Births Maternal Mortality Rate per 1,000 total Births 1921 3 735 11 4.0 1922 3 644 22 4.5 1923 1 623 14 1.57 1924 1 558 13 1.75 1925 — 602 9 — 1926 3 546 9 5.4 1927 1 532 — 1.88 1928 3 513 — 5.84 1929 1 547 11 1.82 1930 2 488 17 3.96 1931 — 492 7 — 1932 2 475 13 4.2 1933 1 492 10 2.03 1934 1 481 17 1.96 1935 2 525 19 3.67 1936 1 510 18 1.96 1937 1 605 20 1.52 1938 3 634 22 4.57 1939 3 721 24 4.28 1940 1 721 24 1.38 1941 1 606 23 1.65 1942 2 734 28 2.6 1943 3 822 21 3.65 1944 2 895 18 2.2 1945 — 732 17 — 1946 — 958 23 — 1947 1 1,006 27 0.9 1948 2 877 12 2.25 1949 1 795 13 1.24 1950 — 701 15 — A (4) i. Infant Mortality 14 infants died before reaching one year of age giving an infant mortality rate of 20 per 1,000 live births. The comparable figure for the whole of the country is 29.8. Of the 14 children who died, 8 died before reaching the age of one month, giving a neo-natal mortality rate of 11.41 per 1,000 live births. 9 died in hospital and the remaining 5 in their own homes. Coroner's Postmortem examinations, without inquests, were carried out in three cases. Analysis of the causes of death and of the age at death reveals the following figures. 16 Causes of death as certified under 1 day 1 day 2 days 3 days 4 days 5 days 6 days 7-14 days 14-21 days 21-28 days 28 days-2 months 2 months 3 months 4 months 5 months 6 months 7 months 8 months 9 monihs 10 months 11-12 months Total deaths under 1 year Pneumonia 1 2 1 1 5 Broncho Pneumonia Toxaemia 1 1 Broncho Pneumonia Pink Disease 1 1 Prematurity 2 2 Cardiac Failure Aslhenia Prematurity 1 1 Inanition Premature Birth 1 1 Intracranial Haemorrhage Prematurity 1 1 Atelectasis Anoxaemia 1 1 Toxaemia Pul. Abscesses Atelectasis 1 1 Totals 3 1 1 1 1 1 2 1 1 1 1 14 17 Below is given a table showing the Infant Mortality rates at five yearly intervals 1920-1945 and for the years 1946, 1947, 1948, 1949 and 1950. Year Erith England and Wales 1920 60 -5 83 1925 56 -48 75 1930 65 -6 60 1935 40 -00 39 1940 37-17 55 1945 39 -61 46 1946 32-3 43 1947 33 -7 41 1948 22-8 34 1949 23 -9 32 1950 20 -0 29-8 SECTION B.—PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES B (1) Notifications. Disease Total No. of cases notified Cases admitted to infectious disease hospital Total No. of Deaths among notified cases Scarlet Fever 59 38 Whooping Cough Acute Poliomyelitis 125 2 — Non-Paralytic 1 1 — Paralytic 6 5 — Measles 261 — — Acute Pneumonia 35 13 1 Dysentery Acute Encephalitis 2 2 — Post Infectious 1 1 1 Erysipelas Ophthalmia 2 - - Neonatorum 3 1 - Total 495 63 2 Three cases notified as Scarlet Fever were subsequently rediagnosed on admission to hospital, 1 as sulpha rash, 1 as tonsilitis, and 1 as toxic erythema. One case admitted to hospital as a queried Diphtheria was finally diagnosed as tonsilitis. Two cases thought to be food poisoning proved on subsequent investigation not to be so. Diagnosis was not confirmed in two cases admitted to hospital as query meningococcal infection. 81 B (l)a Age Distribution The following table shows the age distribution of cases of Infectious Disease notified during the year Age Groups Disease under 1 year 1-2 3-4 5-9 10-14 15-24 25-44 45-64 65 & over Age not known Totals M F M F M F M F M F M F M F M F M F M F Scarlet Fever _ — 2 1 10 4 15 24 2 - 1 - - - - - - - - - 59 Whooping Cough Acute Poliomyelitis 3 6 14 29 17 15 19 20 - - - - - 1 - - - - 1 - 125 Non-Paralytic - - - - - - - - - - 1 - - - - - - - - - 1 Paralytic — — 2 1 — — 1 — — - — 1 1 — — — — — — - 6 Measles 4 4 30 20 44 37 58 59 — 2 — 1 — 1 — 1 — — — - 261 Acute Pneumonia 1 1 3 — 1 1 2 3 1 1 1 - 6 1 9 2 — 2 — - 35 Dysentery Acute Encephalitis - - - - - - 1 - - - - - - 1 - - - - - - 2 Post Infectious - - - - - - - - - - - 1 - - - - - - - - 1 Erysipelas Ophthalmia - - - - - - - - - - - - - - 1 - 1 - - - 2 Neonatorum 2 1 - - - - - - - - - - - - - - - - - - 3 Totals 10 12 51 51 72 57 96 106 3 3 3 3 7 4 10 3 1 2 1 - 495 61 B (l)b WARD DISTRIBUTION Number of cases of Infectious Disease notified in each ward in the Borough. Disease Ward Total Town Old Church Belvedere North Heath Abbey Wood Bostall Scarlet Fever 12 8 4 18 3 14 59 Whooping Cough 25 22 17 30 10 21 125 Acute Poliomyelitis 3 — — 1 2 1 7 Measles 35 47 44 68 24 43 261 Acute Pneumonia 3 15 2 7 2 6 35 Dysentery — — — — 2 — 2 Erysipelas — 1 — 1 — — 2 Ophthalmia Neonatorum 1 1 — 1 — — 3 Acute Encephalitis, Post Infectious - — 1 - — — 1 Totals 79 94 68 126 43 85 495 20 B (2) Tuberculosis B (2)a New Cases notified for the first time during 1950 Age Respiratory Non-Respiratory Total M F M F 0— 1 — - — 1 1— 1 4 - — 5 5— 3 3 - — 6 10— — 1 - — 1 15— 9 9 1 1 20 20— 5 5 1 — 11 25— 6 6 12 35— 10 6 - 1 17 45— 13 4 - — 17 55— 4 2 - — 6 65 & over 2 3 - 1 6 Totals 54 43 2 3 102 In addition to the above cases, two females suffering from Respiratory Tuberculosis were transferred into the district from other areas. B (2)b Deaths According to the figures supplied by the RegistrarGeneral, the following is the number of deaths from Tuberculosis during the year. Tuberculosis of Respiratory system Other forms of Tuberculosis All forms of Tuberculosis Male Female Total Male Female Total Male Female Total 11 4 15 1 2 3 12 6 18 21 B (2)c Quarterly Statements for the Year 1950 Tuberculosis 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter M F Total M F Total M F Total M F Total Respiratory Tuberculosis Number on register at commencement of Quarter 206 150 356 208 152 360 215 160 375 234 172 406 New notifications during Quarter Cases removed, which have been 6 5 11 11 9 20 21 15 36 12 13 25 restored Cases added other than by formal - - - - - - - - - - - - notification Cases removed from register — — - 1 2 3 1 1 2 2 - 2 during Quarter Cases remaining on register at end 4 3 7 5 3 8 3 4 7 6 6 12 of Quarter 208 152 360 215 160 375 234 172 406 242 179 421 Non-Respiratory Tuberculosis Number on register at ment of Quarter 38 40 78 37 41 78 37 40 77 38 41 79 New notifications during Quarter Cases removed, which have been — 1 1 - - - 1 1 2 1 •—— 1 restored Cases added other than by formal - - - - - - - - - - - - notification Cases removed from register - - - - - - - - - - 1 1 during Quarter Cases remaining on register at end 1 - 1 - 1 1 - - —— —— 2 2 of Quarter Total of Respiratory and NonRespiratory Cases on Register 37 41 78 37 40 77 38 41 79 39 40 79 at end of Quarter 245 193 438 252 200 452 272 213 485 281 219 500 Respiratory: Non-Respiratory: Total Number of cases left on the register at end of 1950 is as follows :—242 males 179 females 39 males 40 females 500 22 B (2)d Mass Radiography During the year a Mass Radiography Survey of the general public in Erith was carried out by the South East London Mass Radiography Unit. The following is the report received from the Lewisham Group Hospital Management Committee. Analysis of Results of Survey carried out at Civil Defence Association Headquarters, Council Offices, Erith, from 12th April, 1950 to 20th April, 1950. Part I—Stages of Procedure. Men Women Total (a) Total Radiographed (b) Total passed on 1,030 1,033 2,063 iature Film 947 968 1,915 (c) Total recalled for Large Film 49 39 88 (d) Total classified abnormal on Miniature Film 34 26 60 (e) Total classified abnor mal on Large Film 28 33 61 (f) Total abnormal 62 59 121 Part II—Analysis of Abnormals (Large Films). No. Men Women Total % of(a) No. % of (a) No, % of(a) 1. Non-tuberculous— Cardiac Disease 1 .1 8 .8 9 .4 Other abnormalities 11 1.07 6 .6 17 .8 2. Previously diagnosed Tuberculosis 1 .1 - - 1 .05 3. Tuberculous Lesions requiring no action 10 1.0 13 1.3 23 1.1 4. Newly discovered probably significant tuberculous lesions 5 .5 6 .6 11 .5 Comments Group (d) consists of minor congenial abnormalities, calcified lesion, etc., and is only of statistical importance. Men. Of the 49 men recalled for large films, 13 were found to be normal, 3 are still under investigation, and 5 did not re-attend. Women. Of the 39 women recalled for large films, 6 were found to be normal. 23 B (3) Diphtheria Immunisation This service is administered by the Kent County Council. The latest figures supplied by the County Medical Officer of Health show the position at December 31st, 1950, and are given below. It is interesting to note that no case of Diphtheria occurred in an immunised child. Table A:—Number of children resident in the Borough of Erith who were given immunising injections during 1950 Date of Birth Number Immunised Primary Inoculations Number given Reinforcing Inoculations Date of Birth Number Immunised Primary Inoculations Number given Reinforcing Inoculations 1950 Under 1 year of age 51 — 19451941 5-9 years of age 18 208 1949 1 year of age 388 — 19401936 10-14 years of age - 6 1948 2 years of age 49 — 1947 3 years of age 16 — 1946 4 years of age 15 15 Total 519* 15* 18* 214* *Apportioned amongst these figures are 16 children who received the immunising injections in 1949 no intimation being received until 1950. 24 Table B:—Number of children resident in the Borough of Erith under the age of 15 years on 31st December 1950, who had completed a course of Immunisation at any time since 1st January, 1936 1 - 4 years 5-14 years Year of Birth Number considered to be immunised Year of Birth Number considered to be immunised 1950 51 1945 823 1949 469 1944 745 1948 558 1943 708 1947 761 1942 694 1946 1,049 1941 633 1940 604 1939 604 1938 362 1937 528 1936 600 Total 2,888 Total 6,301 Percentage of child population 0-4 years of age considered to be immunised at 31.12.1950 65% Percentage of child population 5-14years of ageconsidered to be immunised at 31.12.1950 91% B(4) Scabies Although the Scabies Order, 1941, was revoked on the 1st January 1948, the Department continues to treat cases and contacts as soon as it becomes aware of them. During the year no cases were dealt with. B(5) Smallpox Glasgow Outbreak. This resulted from a case of smallpox on board R.M.S. " Chitral " which docked at Tilbury on the 5th March, 1950. No cases or contacts were reported in this area. S.S. " Strathnaver " During the year owing to the dispersal of the passengers and crew from S.S. " Strathnaver " from which a case of smallpox was removed, a member of the crew was notified as having proceeded to the Borough of Erith. The necessary action was taken for the daily supervision of this contact and no case of smallpox developed in the Borough. 25 Brighton Outbreak. It transpired that over the Christmas holidays, persons from Erith had visited the Bevendean Hospital, where the smallpox cases were temporarily isolated, either as visitors or in connection with the County Ambulance Service, and therefore came into contact, however remotely, with smallpox infection. The names and addresses of all these persons were ascertained, and vaccination of all concerned was carried out. They were all kept under constant supervision of the Health Department. In addition all medical practitioners were circularised. The measure of control was satisfactory and no case of smallpox occurred in the Borough as a result of the outbreak. Vaccination Age at 31st December 1950 Under 1 year 1-4 years 5-14 years 15 or over Total Number vaccinated 142 133 21 19 315 Number re-vaccinated — 2 4 44 50 26 SECTION C.—GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA C (1) General Hospital Facilities Erith and District Hospital. This hospital is administered by the Regional Hospital Board. In addition, the services of the large General and Specialist Hospitals in London are readily accessible to residents in this area. C (2) Infectious Disease Cases— Hospital Accommodation. Brook Hospital. * Bow Arrow Hospital. Any other Infectious Disease Hospital controlled by the South East Metropolitan Regional Hospital Board. * After 9th July, 1950, Bow Arrow Hospital ceased to admit ordinary infectious cases, the hospital being used for Tuberculosis cases. After this date ordinary infectious cases were admitted to the River Hospitals, Joyce Green. C (3) Tuberculosis Treatment and Hospital Accommodation The South East Metropolitan Regional Hospital Board is responsible for sanatorium treatment and hospital accommodation. A dispensary is held weekly at 65, Bexley Road, Erith, by a whole-time Chest Physician. C (4) Venereal Diseases Venereal Disease Clinics for this area are provided and administered by the South East Metropolitan Regional Hospital Board. C (5) Ambulance Service This is provided by the Kent County Council, an ambulance being obtained through Mr. P. E. Light, District Officer, Kent County Council, 148, West Street, Erith, telephone Erith 4747/8 or the Ambulance Station, Council Offices, Erith, telephone Erith 3603. C (6) School Clinics Hainault, Lesney Park Road. Minor Ailments, Refraction, Dental. Bedonwell Hill, Minor Ailments, Dental, Orthopaedic.* Lessness Abbey. Minor Ailments. Erith and District Hospital. Ear, Nose and Throat. *These clinics are administered by the Health Committee of the County Council, or the Regional Hospital Board. 27 C (7) Maternity and Child Welfare Centres Hainault, Lesnev Park Road. Ante-Natal Sessions:— Mondays 9 a.m.—12 noon. Child Welfare Sessions:— Mondays 1.45 p.m.—4 p.m. Thursdays 1.45 p.m.—4 p.m. Belvedere Public Hall. Child Welfare Sessions:— Tuesdays 1.45 p.m.—4 p.m. Thursday 1.45 p.m.—4 p.m. Lessness Abbey. Ante-Natal Sessions:— Wednesdays 9 a.m.—12 noon. Fridays 9 a.m.—12 noon. Child Welfare Sessions:— Wednesdays 1.45 p.m.—4 p.m. Fridays 1.45 p.m.—4 p.m. Bedonwell Schools. Ante-Natal Sessions:— Thursdays 9 a.m.—12 noon. Saturdays 9 a.m.—12 noon. Child Welfare Sessions:— Tuesday 1.45 p.m.—4 p.m. Wednesdays 1.45 p.m.—4 p.m. Fridays 1.45 p.m.—4 p.m. C (8) Maternity Home Hainault, Lesney Park Road. The administration of this Home is carried out by the Woolwich Group Hospital Management Committee. C (9) Private Nursing Homes The Eaves, 64, Picardy Road, Belvedere. Ormonde House, 68, Picardy Road, Belvedere. These are registered by the Erith Borough Council for the Ground floors only. C (10) Day Nurseries These are administered by the Kent County Council and are located at Riversite and Franks Park. C (11) Laboratory Facilities Examination of pathological specimens and other laboratory work for the district are undertaken by the Public Health Laboratories, County Hall, Maidstone. 28 C(12) Mortuary The Borough Mortuary is situated at the rear of Erith Parish Church in West Street, and consists of a reception room and a viewing room. There is accommodation for four bodies. During the year 1950, 13 bodies were received therein. Post mortem examinations were carried out in 12 cases. Discussions are afoot for the provision of an up-to-date mortuary to serve the Boroughs of Bexley and Erith and the Urban District of Crayford, and it is hoped that definite proposals will result from these discussions, with the possible provision of the mortuary in 1951. C(13) Disinfection and Disinfestation of Bedding, Clothing, etc. A joint arrangement is in existence with the Bexley Borough Council for the disinfection and disinfestation of bedding, clothing, etc. There is, also, a cleansing station for dealing with verminous persons. In the case of notifiable infectious disease, the service is carried out free of charge. It is also available to those persons who wish to make use of the facilities and in these cases a charge is made towards the cost of the work. C(14) Welfare of Old People In January 1950, the Ministry of Health issued a Circular requesting Local Authorities to consider suggestions for developing better collaboration between them and local voluntary organisations in promoting the welfare of old people. In the Circular the Ministry pointed out the great value to old people of mobile services, social and recreational clubs, and the need of services of the more personal kind which were not covered by existing statutory provisions and which could best be provided by voluntary workers actuated by a spirit of good neighbourliness. Such services include the regular visiting of old people in their homes, helping them with their shopping, obtaining magazines and books from local libraries, letter writing, mending and generally in solving minor domestic difficulties. Home visiting of this kind has been shown to be of particular value, for it can mitigate the sense of isolation and loneliness often experienced by old people, and it can draw attention also to those who need the benefit of other voluntary services, possibly the doctor or the Public Health Service. As a result of this Circular the Erith Borough Council, through His Worship The Mayor, called a public meeting of 29 Townspeople whom it was thought might be interested in the setting up of a Welfare Committee. At this meeting the problem of Old People's Welfare was fully discussed and the purpose of the Ministry of Health Circular outlined. Resulting from this, an Executive Committee with power to co-opt was set up. This Committee met on five occasions during the year. At these meetings a variety of matters appertaining to the welfare of elderly people was considered, but in the main the Committee has been concerned with the visiting of old people in their own homes and the provision of " Good Neighbours Services." In this connection a panel of visitors was formed, the members being drawn from the Committee and voluntary organisations in the town. It is clear that the visits, in the majority of cases, are very much appreciated by the old people. Reports are submitted regularly which indicate that a wide variety of assistance is being given to mitigate the acute sense of loneliness from which they suffer. Domestic help is supplied by the Kent County Council and the help given is of great assistance to the old folk, who speak very highly of the service. Whilst, usually, a visit only is necessary, there are some cases which are extremely difficult and illustrate the plight of many of the old people, and a great deal of work is necessary on the part of the Public Health Department in conjunction with the District Officer of the Kent County Council, the voluntary organisations, and the visitors concerned, between whom there is close co-operation. To illustrate this I set out below details of some of the cases dealt with since the Committee came into being. Case No. 1 This was the case of an elderly woman, eighty-four years of age, owner/occupier of a bungalow, living alone. A visit was paid to the house by the Medical Officer of Health and Senior Sanitary Inspector when it was found that the old lady was in a very dirty condition and in need of attention. The house was very neglected and the bedding in a verminous state. With the co-operation of the Commandant of the British Red Cross Detachment, the old lady was cleaned up, fresh clothing and bed clothes supplied by the Red Cross Society, and a new mattress and bolster provided by the District Officer of the Kent County Council. The house was cleaned by Red Cross personnel and the dirty bedding and clothing collected and destroyed by the Health Department. To achieve 30 this a great deal of work and persuasion was necessary. The Domestic Help Organiser was contacted and a domestic help was provided daily. In addition the next door neighbour, who was extremely helpful, undertook to do the old lady's shopping and to call in every day. The Red Cross Commandant also visited weekly. The old lady's physical condition, however, deteriorated and the neighbour referred to above, not hearing her moving around, and finding the doors secured, gained access with the aid of the Police. On further visitation, the old lady was found to be in a very weak state, and as she had no doctor attending her, the neighbour, on the advice of the Health Department, called in her own medical practitioner to give medical attention, and every effort was made to get the old lady into hospital, fortunately with success. Case No. 2 This case, an old lady aged eighty-nine years, was living alone. She had indicated her willingness to go into institutional accommodation and efforts were being made by the District Officer to get her admitted. Unfortunately before anything could be done she fell ill with acute bronchitis and was confined to bed. She was visited regularly by one of the visitors and her step-daughter came to live with her temporarily. At the request of the visitors arrangements were made through the District Officer for the old lady to be provided with a bed rest and a rubber ring. Her doctor was also calling in frequently. The old lady subsequently died and at the request of the stepdaughter all the bedding etc., which had been used, was removed by the Health Department and destroyed. Case No. 3 This was the case of an old lady aged eighty-one years living alone, which came to the notice of the Health Department just before Christmas. According to the report of the visitor, she was confined to bed and had to fend for herself relying for food on what could be left near at hand by the Domestic Help who was going in daily. The Senior Sanitary Inspector visited the house and made the necessary arrangements to see that the old lady was not left alone over Christmas. A doctor was also in attendance and he was, fortunately, successful in getting her admitted to hospital so that the arrangements made by the Senior Sanitary Inspector were not necessary. 31 Such cases present constant difficulty to the Health Department and I feel that some form of emergency team might be useful for dealing with them. Such a team should be on call whenever necessary and the basis of the organisation might be the paid domestic help service, the Health Department, and the voluntary organisations. Obviously the formation of any scheme of this kind is fraught with difficulties, and it is doubtful whether the County Council would approve of any proposals at this juncture owing to the expense involved, but I feel that nothing can be lost by approaching them on the matter. C(15) National Assistance Act 1948 Section 50 Public Burials During the year 1950 Public Burial was carried out by the Council under Section 50 of the National Assistance Act 1948 in two cases, details of which are given below. Case No. 1 The person concerned, a woman aged eighty-three years, lived entirely alone, had no living relatives, and did not qualify for a grant under the National Insurance Act 1946 in that she was a person who was born before the year 1888. Case No. 2 This case, a man aged seventy-seven years, was found dead in bed at his lodgings and was reported by the Coroner's Officer. On enquiring it was found that the man had been receiving public assistance, was without means, had no known relatives, and did not qualify for a grant under the National Insurance Act, 1946, in that he was a person born before the year 1883. In both cases the necessary steps were taken to recover whatever possible towards the cost of the burial. 32 SECTION D.—SANITARY CIRCUMSTANCES OF THE AREA I am indebted to the Borough Engineer and Surveyor for the following information relating to refuse collection and disposal. D (1) Refuse Collection and Disposal The method of storage is by means of sanitary dustbins, and some 14,500 are emptied weekly. The dustbins are provided and maintained by the owners of the properties concerned, the Council securing this by a local act—the Erith Improvement Act, 1920. Disposal is effected by barging under contract, and these arrangements are still working very satisfactorily. D (l)a Costs £ s. d. Cost per ton of collecting refuse 10 3 Cost per ton of disposing of refuse 13 7 Net cost per 1,000 population per annum 322 10 3 The following tables show:— 1. Details of the refuse collection vehicles and staff. 2. Details of the tonnage dealt with during the year. D (l)b Table 1 Vehicle Capacity 1 Dennis lorry 12 cubic yards 5 S. & D. Freighters 7 „ „ 1 S. & D. Freighter 12 „ „ 1 Scammell Lorry 5 „ „ 1 Fordson lorry 12 „ „ 1 Austin 10 Utility van They are operated by:— 1 Foreman 10 Driver Loaders 6 Loaders 1 Salvage sorter 33 D (l)c Table 2 Month Tonnage Tons Cwts. January, 1950 971 6 February, „ 879 18 March, „ 901 3 April „ 762 11 May, „ 767 8 June, „ 581 7 July, „ 523 16 August, „ 530 9 September „ 580 16 October, „ 682 15 November, „ 823 7 December, „ 768 0 Total 8,772 16 D (2) Trade Refuse Trade Refuse is collected from the shops by arrangement with the shopkeepers, an agreed charge being made. The growth of this section of the refuse services continues, and in 1950 the amount reached approximately 270½ loads, producing a revenue of £304 9s. Od. D (3) Salvage Tonnage collected Bottles Income T. 946 C. 8 o. 1 lbs. 17 Gross 21 Dozen 2¼ £ 4,034 s. 18 d. 0½ (D4) Public Conveniences Public Conveniences under the control of the department are as under:— Site Hours of opening Walnut Tree Road, Male and Female *Riversite 6.30 a.m.—Midnight Male and Female 6.30 a.m.—Midnight Station Road, Belvedere Male and Female 24 hrs.—Day and Night West Street, Male 24 hrs.—Day and Night Heron Hill, Male 24 hrs.—Day and Night Woolwich Road, Female 6.30 a.m.—11 p.m. *These conveniences were closed from 5th May, 1950. 34 D (5) Sanitary Inspection of the Area D (5)a Visits by Sanitary Inspectors The total number of visits of all kinds was 9,121 Notices served 890 : Formal 53 : Informal 837. Number of dwellings and other premises disinfected 176 Complaints received and investigated 1,725 D(5)b Premises Visited and Results of Such Visits Premises No. in district No. of visits No. of defects found No. of defects remedied Bakehouses 11 31 5 5 Dairies 5 27 4 4 Butchers' shops 33 159 11 11 Fish friers 14 44 6 6 Slaughter houses 4 — — — Factories 166 93 28 28 Outworkers 98 98 — — Food Factories 4 21 1 1 Many requests were received from owners and occupiers in respect of clearing drains, eradication of vermin, destructions of ants and wasps nests, etc. In each case the necessary service was provided with much beneficial result to the applicant. D (5)c Summary of Nuisances and defects remedied during the year Other than those enumerated in the above tabulations :— Drains repaired 88 Drains cleared 23 New W.C. pans 25 New W.C.'s provided 5 Cisterns repaired 41 New sinks 18 Roofs made watertight 146 Damp walls remedied 142 Houses cleansed 25 Floors repaired 62 Eaves, gutters, etc.repaired 174 Cooking stoves renewed, etc. 23 Plasters renewed 296 Windows made to open 158 Dustbins provided 64 Accumulations removed 21 Yard pavings repaired 26 Coppers repaired 6 Repointing walls 57 Water supply provided 2 Demolition Orders made 0 Miscellaneous 113 35 The charges made in connection with the above service amounted to £35. 14s. Od. During the summer months an appropriate aerosol spray has been successfully employed for quick knock-down and kill of flies and other flying insects. In this particular regard, Council restaurants and factory canteens have been kept free from flies, etc. D(5)d Closet Accommodation and Cesspools The whole of the closet accommodation both in the older parts of the town and the recently developed areas is on the main drainage system, there being only 24 known cesspools existing. Cesspools are emptied once a month free of charge under Council resolution of 10th March, 1942, and sewage contents of cesspools are discharged by Council plant into the nearest sewer. The cesspools requiring the service of the Corporation are scattered throughout the district, and in the majority of cases, necessitate the covering of considerable distances both for pumping out and conveying to the point of discharge. During the year, cesspools were emptied on 9 occasions. Two cesspools were abandoned and drains connected to main sewer. D(5)e Smoke Abatement Emission of smoke and grit at 3 factory premises necessitated action being taken which resulted in the following improvements :— (a) Foundry. Spark catcher installed. Change of flux from chalk to dense limestone. (b) Factory. Change to higher grade fuel. (c) Factory Survey by Ministry of Fuel and Power. Four mechanical stokers and elevator installed. D(5)f Swimming Baths and Pools (1) The Council's open air bath is situated in Stonewood Road and comprises one pool of some 55,000 gallons capacity which is now exclusively used by the Kent Education Committee during normal school hours, and local youth clubs during evenings and on Saturday mornings. Water in the pool is heated to a temperature of 72 degrees Fahrenheit by low pressure steam heating and is sterilised by the chlorine process. 36 There is a slipper establishment with accommodation for 16 males and 4 females. Adjacent to the public bath is a mechanical laundry which launders on behalf of various undertakings which include the Corporation's catering department, works department, and County health and education departments. During the year 138,443 articles were dealt with. Attendances at Public Baths for 1950. Swimming pool. Slipper Baths Schools: During term 11,319 16,208 bathers Schools : During holidays 3,652 Youth Clubs 8,164 23,135 (2) A children's paddling pool of some 60,000 gallons capacity is situated within the Belvedere recreation ground. This pool is regularly emptied and cleansed, and during the summer months is methodically dosed with chloros. D(5)g Camping Sites There are no summer camping sites within the Borough. There are however, 4 sites which have been occupied by vans for a number of years. One licence under Section 269 Public Health Act 1936 was granted. D(5)h Hop pickers There are no hop fields within the district. D(5)i Rag Flock Act No premises exist in the Borough in which rag flock is manufactured or sold. D(5)j Eradication of Bed Bugs During the year dwelling houses found to be infested with vermin and subsequently disinfested were as follows:— Privately owned houses 25 Corporation houses 9 Disinfestation of both privately owned and Corporation houses is carried out by an operative under the supervision of Sanitary Inspectors, presence of the vermin being revealed either on complaint, or when inspections are being carried out. With a view to keeping good control, occupiers are encouraged 37 to report infestations, when every assistance is given to cope with the menace. For an appropriate charge, the operative carries out the necessary destruction. Close co-operation exists between the Housing Department and the Sanitary Inspectors, in which case successful disinfestation is promptly carried out, and in the case of transfers it is sometimes necessary for the tenant to surrender certain household effects for destruction. D(5)k Mosquito Control During the year, no obvious mosquito was found to exist, nevertheless the usual appropriate precautionary measures were taken which included spraying many of the water-courses within the Borough. The 290 pig food salvage bins in the streets received attention. D(5)I Rodent Control Two operatives continue to be employed on rodent destruction in accordance with the terms of Circular N.S.19. As in previous years, Corporation sewers were effectively treated for sewer rat during the months of March and September when a total of 338 manholes were baited. Rats were found to be active in the sea wall at Jenning Tree Point when the department carried out successful clearance on behalf of the Kent Rivers Board which Authority met the costs incurred. D(5)m Pest Control Ants, wasps, beetles, silverfish, crickets, etc. are well known to be the cause of much distress amongst occupiers, and to alleviate such condition, a disinfestation service is available. The charge incurred includes the cost of materials used plus apportionment charge on operative's time devoted to the service. A suspected Colorado beetle submitted for identification proved to be amphimallus (summer chafer). D(5)n Offensive trades In addition to the ordinary statutory trades which are specified in Section 107 Public Health Act 1936, fish frying was declared to be an offensive trade on 17th March 1939 and byelaws were made accordingly. Within the Borough, there are no offensive trades other than those of fish frying, and of these premises, there are 14. 38 D (6) Factories (1) Inspections for the purpose of provisions as to health are detailed below :— Premises Number of Inspections Written Notices Occupiers Prosecuted 164 Factories on Register 91 11 — 2 Other premises under the Act (including building works and engineering construction but not including out - workers' premises) X 2 - — 166 Total 93 11 — (2) Defects found Particulars Number of defects Number of defects in respect of which prosecutions were instituted Found Remedied Referred to H.M. Inspector Washing facilities 5 5 — — Want of cleanliness 4 4 — — Overcrowding — — — — Unreasonable temperature - - - - Inadequate ventilation 1 1 — — Ineffective drainage of floors - - - - Sanitary Conveniences : Insufficient 3 3 — — Unsuitable or defective 9 9 — — Not separate for sexes 1 1 — — Absence of Abstract 1 1 — — Other offences 4 4 — - Total 28 28 - — D(7)a Shops Act 1950 This Act came into operation on 1st October, 1950, and generally consolidates the previous multifarious legislation with regard to hours of closing, health and comfort, Sunday trading, etc. With regard to statutory hours of closing it was 39 necessary to issue 5 warnings to shop-keepers respecting closing of shops at the prescribed hour. Infringements of health and comfort provisions were located in the following instances, and the necessary improvements were subsequently effected :— Heating provided 1 Shops cleansed 2 New floors laid 2 Plasters renewed 2 D(7)b Shops (Sunday Trading Restriction) Act 1936 Two offences under the above Act were prosecuted under Section 1, the defendants being fined 40/- and 20/- respectively. D(8) Sanitary Accommodation at Offices At two offices attached to factory buildings it was found necessary to implement provisions of Section 46 Public Health Act 1936, in consequence of which 3 additional conveniences were erected. D(9) River Thames—Effluvia Though not so pronounced as in 1949, when obnoxious odours from the River Thames persisted during the whole of the summer, objectionable smells arising from the same source gave cause for many complaints at various times during the year. For the first time an exceptionally rank odour was evident in the river area in mid-November fog, when shopkeepers in the High Street deemed it necessary to keep doors closed. To convince the public under conditions such as these that the remedy lies not with local administration, is extremely irksome, and it is to be hoped that the necessary major works at the Metropolitan sewer outfalls will not be long delayed. In describing the work of the Water Pollution Research Laboratory, "Water Pollution Research 1949 "announces that the survey of the Thames Estuary to examine the causes of silting is being carried out on behalf of the Port of London Authority. For this purpose the Port of London Authority have equipped a laboratory at Tilbury and have supplied a surveying launch. The work so far reported has consisted mainly of a study of the condition of the estuary water, and of an examination of samples of bottom deposits taken from Teddington to the sea. Cooperating in the survey are the L.C.C. who have placed at the disposal of the laboratory very complete records of surveys of the tidal reaches which they made have regularly for many years. 40 From Richmond to Woolwich, the bed of the river, particularly near the centre, is said to be of comparatively hard material, but seaward from Barking, there are large areas of fine black mud, with patches of fine or medium sand sometimes mixed with mud. One of the objects of the survey is to attempt to correlate the nature of the bottom deposits with the movements and character of the water above them. Reference in the Report to large areas of fine black mud seaward of Barking is highly significant, and it can be confirmed locally that such expanses of mud are increasing in acreage. Furthermore, it is known that this mud emits much potent sulphuretted hydrogen gas. D(10) Atmospheric Pollution Dust emission—Thameside area With a view to ascertaining whether the local plasterboard (gypsum processing) factory was contributive to the serious atmospheric pollution by cement dust in North West Kent, and which was duly investigated by a County committee appointed for that purpose, an intensive local survey was conducted in June, when petrie dishes were disposed over a wide area in the Borough. Chemical analysis of the dish contents proved as follows :— Report of analysis. No of dish Site Days Exposed Weight of deposit Milligrammes Equivalent to tons: square mile per month Calcium per cent. 1. Brook St. 3 9.0 30 17.5 2. Ightham Rd. 4½ 23.6 52 10.4 3. Hoddesdon Rd. 4 7.4 18 11.8 4. Gertrude Rd. 4 12.7 32 7.9 5. Crabtree M’way 1½ 7.9 45 12.0 6. Dryden Rd. 1½ 5.4 31 15.7 7. Alford Rd. 2 7.1 35 14.1 8. Lower Rd. 2 11.4 57 17.1 9. Lower Rd. 2 9.5 47 15.3 10. Battle Rd. 2 8.7 43 17.8 11. Lower Rd. 1½ 8.2 47 13.4 12. Walnut Tree Rd. 5½ 9.0 16 11.4 Percentage of sulphate on 12 combined deposits is 6.4% sulphate: equivalent 9.1% gypsum. The deposits show no evidence of the presence of gypsum, the characteristic ingredient of plaster board 41 Similar tests carried out by County Investigation Committee during 1949 in the cement producing area of Kent revealed calcium content to be 23.7 per cent, of the total solids (or 34} tons of calcium per square mile per month)., whilst the highest individual reading for total deposits in the whole series of tests was recorded at 146 tons per square mile per month. In comparison, the highest reading for total deposits during the local survey in Erith showed 57 tons per square mile per month, the lowest reading being 16 tons per square mile per month. Industrial dust is visibly evident in the Borough when east and north-east winds are prevalent, and widespread deposits have been observed on foliage and roofs at times coinciding with and after fog dispersal. D(ll) Housing D(ll)a Inspection of Dwelling Houses during the year. 1. (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 1,347 (b) Number of inspections made for the purpose 1,510 2. (a) Number of houses (included under sub-head (1) above) which were recorded and inspected under the Consolidated Housing Regulations, 1925 and 1932 1 (b) Number of inspections made for the purpose 4 3. Number of houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 0 4. Number of houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 891 D(ll)b Remedy of defects during the year without service of Formal Notices Number of defective dwelling houses rendered fit in consequence of informal action by the local authority 693 Action under Statutory Powers during the year. (a) Proceedings under Section 9 and 10 Housing Act, 1936 (1) No. of houses in respect of which Notices were served requiring repairs 0 42 (2) No. of houses which were rendered fit after service of formal notices (a) By owner 0 (b) By Local Authority 0 (b) Proceedings under the Public Health Act. (1) No. of houses (dwelling) in which Notice was served requiring defects to be remedied 53 (2) No. of dwelling houses in which defects were remedied after service of formal Notices (a) By owner 52 (b) By Local Authority 1 (c) Proceedings under Sections 11 and 13 of the Housing Act, 1936. (1) No. of dwelling houses in respect of which demolition orders were made 0 (2) No. of houses demolished in pursuance of demolition orders 18 (d) Proceedings under Section 12 of the Housing Act, 1936 (1) No. of separate tenements or underground rooms in respect of which closing orders were made 1 (2) No. of separate tenements or underground rooms in respect of which closing orders were determined, the tenement or room having been made fit 0 The closing order referred to was in respect of 38 High Street. The houses demolished were :— 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 and 13, Victoria Cottages. 1, 2, 3, 4, 5, Amelia Cottages, Crayford Road. The acute problem of housing continues to give considerable anxiety, and I am indebted to the Borough Surveyor and Housing Assistant for the following information on the subject: Number of permanent houses constructed in 1950 :— By the Council 65 By private enterprise 40 105 Total number of permanent Council houses in Borough 1,032 Total number of prefabricated temporary houses in Borough 250 43 Total number of requisitioned premises in Borough 211 Number of premises requisitioned in 1950 5 Number of premises de-requisitioned in 1950 8 D(12) The Rent and Mortgage Interest (Restriction) Act, 1939 The provisions regarding extortionate rents etc. are administered by the Senior Sanitary Inspector, and during the year 1950, 130 applicants sought advice and assistance. The maximum rent of houses brought under control by this Act is the rent payable at 2nd September 1939, subject to certain permitted increases. Houses let for the first time after the aforementioned date come within the orbit of the Landlord and Tenant (Rent Control) Act 1949, which Act provides for application to be made to the Rent Tribunal for the assessing of a reasonable rent. This Act also provides an umbrella for control of tenants who share living accommodation. Appended below is a summary of improvements effected under the Rents Restrictions Act:— (a) Rent reduced from 20/3 to 19/- per week. (b) Rent reduced from 25/- to 11/8 per week and £69.6.8d extortionate rent returned to tenant. (c) Rent reduced from £1. 10. 6d. to £1. 3. 7d. per week. (d) Several references were recommmended to the Rents Tribunal under the Furnished Houses (Rent Control) Act 1946, and the Landlord and Tenant (Rent Control) Act 1949, with satisfactory results. D(13) Legal Proceedings Statute Offence Penalty (1) Shops (Sunday Tra- Selling groceries on £2 0 0 ding Restriction) Act Sunday. 1936 (2) „ „ £10 0 (3) Children & Young Neglect of children Parents Persons Act 1933— Action by N.S.P.C.C. sentenced Section 1. Evidence given by to two Senior Sanitary In- months' spector. ment. (4) Public Health Act Three Nuisance Orders 1936—Section 94 granted by Magistrates Court. 44 SECTION E—WATER SUPPLY—MILK AND FOOD AND DRUGS, ETC. E(l) Water Supply The water supply in the district is supplied by the Metropolitan Water Board, and, though possessing a considerable degree of hardness, is palatable and of good quality. The supply is led direct into the premises served, no standpipes being known to exist. Two monthly samples have been regularly obtained and submitted to the Kent County Council's Laboratory for examination, with satisfactory results. Detailed report on a sample submitted for chemical examination is as follows:— Parts per million. Total solid residue (Dried at 180 C) 318 Chlorine 25 Free Ammonia (as Nitrogen) None Albuminoid Ammonia (as Nitrogen) None Nitrogen as Nitrates 6.0 Nitrogen as Nitrites None Oxygen absorbed ¼ hr. at 26.7 C 0.03 „ „ 4 hrs. at 26.7 C 0.07 Toxic metals None detected pH.6.8. The water is of satisfactory organic quality and on the above chemical analysis should be fit for drinking. (Signed) H. E. Monk, Public Analyst for the County of Kent E(2)a Dairies and milk stores The current Register of dairies and milk stores records the following registration figures:— No. of registered distributors 8 No. of dairies 5 Regular inspections have been made throughout the year with a view to maintaining the high standard of cleanliness. E(2)b Bacteriological Examination of Milk The following examples of designated milk retailed within the Borough were obtained and forwarded to the County 45 Laboratory for examination:— Pasteurised 36 Tuberculin tested (Past.) 7 Sterilised 9 Total 52 All were reported upon satisfactorily, such milk satisfying the phosphatase, methylene blue and turbidity tests. E(2)c Biological Testing of Milk Two samples of pasteurised milk were submitted to the County Laboratory for biological examination. No evidence of Tuberculosis was found to exist. E(2)d Designated Milk The following table indicates the number of licences issued by the Local Authority in 1950 under (1) Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations 1949 and (2) Milk (Special Designation) (Raw Milk) Regulations 1949 viz.:— Dealers Pasteurised 7 Sterilised 12 Tuberculin tested 2 Tuberculin tested (pasteurised) 1 Supplementary Pasteurised 6 Sterilised 7 Tuberculin tested 5 Total 40 E(2)e Ice-Cream During the year 18 samples of ice-cream were procured and submitted to the bacteriologist, examination resulting as follows:— Grade 1 8 2 1 3 7 4 2 18 46 E (3) Food and Drugs Act, 1938, Sections 3 and 68 The following samples were procured during the year and submitted to the Public Analyst for analysis. Nature of Sample Adulterated Genuine No. of Samples Breakfast spread — 1 1 Meat paste — 5 5 Fish paste — 3 3 Soup powder — 2 2 Desiccated soup — 1 1 Oxtail soup — 2 2 Gravy salt — 1 1 Gravy powder — 3 3 Bisto — 1 1 Gravy lets — 1 1 Meat extract — 1 1 Oxo cubes — 1 1 Cake mixture — 6 6 Pastry mixture — 1 1 Pudding mixture — 2 2 Raising powder — 3 3 Bicarbonate of soda — 1 1 Baking powder — 1 1 Peas — 1 1 Peas pudding — 1 1 Pea flour — 4 4 Milk — 41 41 Ice Cream — 11 11 Pickling spice — 1 1 Mixed spice — 1 1 Cinnamon — 1 1 Pepper — 1 1 Mustard — 2 2 Corn flour — 1 1 Arrowroot — 1 1 Cream of tartar — 1 1 Mixed herbs — 1 1 Mint — 1 1 Thyme — 1 1 Custard powder — 3 3 Blanc mange powder — 2 2 Table delight — 2 2 Junket — 1 1 Dessert powder — 3 3 Dessert crystals — 1 1 Baby food — 1 1 Orange Squash — 2 2 Drinking chocolate — 2* 2 Coffee — 1 1 Coffee cubes - 1 1 Coffee and chicory — 2 2 Teaseed oil — 1 1 Suet — 1 1 Quaker oats — 1 1 Macaroni — 1 1 Tomato Ketchup — 1 1 47 Salad cream — 2 2 Horse radish cream — 1 1 Saccharines - 1 1 Dates — 1* 1 Nutty cream bar — 1 1 Jam — 1 1 Mixed cut peel — 1 1 Potato crisps — 2 2 Table jelly — 2 2 Flavouring essence — 2 2 Daisy Powder — 1 1 Eucalyptus oil — 1 1 Castor oil — 1 1 Headache tablets — 6 6 Rennies — 1 1 — 156 156 *The sample of Dates was from a private source and was found to be heavily infested with mites. The samples of Drinking Chocolate were found to contain wheat flour, the presence of which was not declared on the label. Action against the manufacturers under the Labelling of Food Order 1946, is pending. The milk samples averaged a content of 3.63% fat, and 8.79% solids not fat. The ice-cream samples averaged a content of 9.68% fat, and 32.2% solids not fat. E(4) Meat and Food Inspection (a) Considerable time and attention has been devoted to the inspection of meat and other foods in shops and stores, and the following were confiscated as being unfit for human consumption:— Meat 2,665½ lbs. Meat 279 tins Fish 805 lbs. Fish 167 tins Vegetables 71 lbs. Vegetables 224 tins Fruit 142¾ lbs. Fruit 539 tins Preserves 52 lbs. Preserves 133 tins Milk 320 tins Dried Milk 112 lbs. Cereals 74 lbs. Sugar 15 lbs. Cheese 4 lbs. Rabbits 86 Approximate total weight:—2 tons. 15 cwt. 0 qrs. 21 ¼ lb. 48 (b) Various consignments of food rejected at the Bermondsey wharfs were released for manufacturing purposes at Erith. All such foodstuffs were inspected during the course of such manufacturing process. (c) During the greater part of the year, the district was free of itinerant tea service waggons etc. One such contrivance was installed on a site adjacent to a busy thoroughfare, where the disposal of trade wastes was found to be impossible. Joint action with the Town Planning department effected the vacating of the said site. (d) It was found that a purveyor of horseflesh labelled "Animal food" was occupying a stall in the High Street, as a result of which the requirements of Section 38, Food and Drugs Act 1938 were implemented; the sale of this commodity was subsequently discontinued. E(5) Slaughter of Animals Act 1933 The above Act makes the use of mechanically operated instruments a statutory obligation. By resolution of the Council dated 23rd May 1938, the provisions of Section 1 of the Act apply to sheep which are slaughtered in the district. E(6) Food Hygiene Food Traders' Guild The first Executive Committee meeting of the Food Traders' Guild for the Boroughs of Erith and Bexley and the Urban District of Crayford was held on 25th May when draft Constitution was submitted and approved. At the same meeting it was resolved that codes of practice should be formulated by the appropriate officers of the local authorities concerned, and that the said codes should be approved by the Executive Committee. During the year, the Executive committee has met regularly, and much progress has been made. At the end of the year, codes of practice had been formulated and approved in regard to fishfriers, bakers and confectioners, butchers, etc. F(4) National Assistance Act 1948. Sec. 47 The persons covered by the above section are those mentioned in sub-section 1 as follows:— (a) Persons who:— Are suffering from grave chronic disease or, being aged, infirm or physically incapacitated, are living in insanitary conditions, and 49 (b) Are unable to devote to themselves, and are not receiving from other persons, proper care and attention. Considerable time and attention has been devoted to the above Statute with a view to alleviation of distressing home circumstances which have been found to exist. It is gratifying to report that considerable improvements have been effected, and service has been much appreciated by those in need. F(5) Legislation in Force—Byelaws Tents, vans and sheds 28th Feb. 1928 Houses let in lodgings 27th Jan. 1930 Slaughterhouses 29th Feb. 1932 Libraries and Museums 15th June 1934 Nursing Homes 20th July 1934 Pleasure grounds 4th Feb. 1936 Dogs fouling footpaths 22nd Feb. 1939 Fish Frying 9th May 1939 Building bye-laws 10th Aug. 1939 House refuse 17th Oct. 1939 Erith Cemetery 25th Oct. 1939 Public Baths 26th Oct. 1939 Prevention of Nuisances 23rd Apr. 1940 Good rule and government 1st Jan. 1941 Offensive trades 9th May 1939 Deposit of litter 9th Jan. 1950 Clean food 19th July 1950 c - •• ,