AC 4373 Metropolitan Borough of Greenwich GRE 47 REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1949 Metropolitan Borough of Greenwich REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1949 Printed by Freanie, Manning & Co., Ltd. Lewisham, S.E. 13 CONTENTS Page Public Health Committee 3 Introductory 6 Section A.—General and Vital Statistics 10 „ B.—General Provisions of Health Services in the Area 20 „ C.—Sanitary Circumstances of the Area 27 „ D.—Housing 43 „ E.—Inspection and Supervision of Food 51 „ F.—Prevalence of, and Control Over, Infectious Diseases 64 Appendix—Statistical Tables 3 PUBLIC HEALTH COMMITTEE as at 31/12/49. The Mayor: Councillor G. Bkuce, J.P., and 13 Members. Councillor Mrs. A. D. A. Kennedy (Chairman) Councillor H. W. Gorman (Vice-Chairman) Aldermen: Mrs. C. Berry, Mrs. F. Carter, Miss. M. Golloqly and A. E. Rutter Councillors: A. C. Chrisp W. O. Littler Mrs. J. Golloqly D. P. Lynch Mrs. L. Hilldrith Miss K. E. H. Ross Dr. W. Smith Powers and Duties of the Public Health Committee: 1.—The Committee shall consist of 13 members of the Council. 2.—There shall stand referred to the Committee all matters relating to the powers and duties of the Council under Acts of Parliament, bye-laws and regulations dealing with the public health and the sanitary condition of the Borough; the administration of the Food and Drugs Act, 1938 and any regulations dealing with the preparation, storage and sale of Food and Drugs; the powers and duties of the Council under enactment relating to milk and dairies. 3.—Without prejudice to the generality of the provisions of the preceding paragraph, the powers and duties of the Council to serve and receive Notices, take proceedings and empower officers to make complaints and take proceedings on the Council's behalf, and otherwise to enforce the provisions of the Public Health (London) Act, 1936, other than those specified in Part I of the First Schedule to such Acts, the functions of the Council under Section 14 of the Food and Drugs Act, 1938 (registration of premises used in connection with manufacture or sale of ice-cream, preserved food, etc.) the Food and Drugs (Milk and Diaries) Act, 1944 and the Milk 4 (Special Designations) Act, 1949, and all Regulations made or to be made under such last mentioned statutes and under the Slaughter of Animals Act, 1933 (licensing of slaughtermen) and also the functions of the Council under the Bye-law dealing with the deposit of rubbish on vacant sites in the Borough, shall be delegated to the Committee. 4.—All plans for the drainage and re-drainage of buildings in the Borough shall be considered by the Committee, and all works of drainage and re-drainage of buildings shall be carried out under their jurisdiction. 5.—The Committee shall have the control of any Mortuary and of any disinfecting apparatus and plant provided and maintained by the Council, as well as public sanitary conveniences and conveniences maintained by the Council. 6.—The Committee shall have the control of all public drinking fountains other than those provided in any open space or other property belonging to the Council and coming within the jurisdiction of any other Committee. 7.—The powers and duties of the Council in connection with the repair, closure or demolition of individual insanitary dwellings and the duty of the Council to issue certificates under Section 5 (1) of the Rent and Mortgage Interest Restrictions Act, 1923 and Section 12 of the Rent and Mortgage Interest Restrictions (Amendment) Act, 1933 and the issue of reports under Section 5(2) of the former Act, shall stand referred to the Committee. 5 STAFF. as at 31/12/49. Medical Officer of Health: John Kerr Brown, B.Sc., M.B., Ch.B., D.P.H. Public Analyst: H. A. Williams, Ph.D., A.C.G.F.C., F.R.I.C. (Part-time) District Sanitary Inspectors: ac W. H. Collins (Senior) abc S. A. Radford. ab G. W. Heath. abd J. Ashmore. ab J. E. Millway. ae Miss E. Arnold. a J. G. Lyons. a H. L. Davies Food Inspectors: ab H. L. Bennett. (Senior) ab J. Collier. Scabies Clinic Nurse: Mrs. C. Cullen, S.R.N. CLERICAL STAFF. L. A. Westacott (Chief Clerk) A. H. Wilcox. C. W. Spore. J. F. Vickers. K. Allum F. B. Osborn. (away on National Service) Mrs. V. I. Starr. Mrs. H. J. Readdy. A. H. Hammond (Temporary) Miss R. P. Williams (Temporary) W. A. Pearce (Conveniences Superintendent) DISINFECTING STAFF. G. Hook (Foreman) T. Smith (Motor Driver). A. Nash. A. Moore. W. Clements. H. C. W. scarff. RODENT CONTROL, FLY DISINFESTATION, ETC. C. Weymouth — Investigator and a Team of eight men a Certificated Sanitary Inspector. b „ Meat and Other Foods, eto. c „ Smoke Inspector. d „ Housing Officer e „ Health Visitor. 6 Public Health Department, Town Hall, S.E.10 June, 1950 To the Mayor, Aldermen and Councillors, Metropolitan Borough of Greenwich. Ladies and Gentlemen, It is my pleasure to present this, my first Annual Report on the state of the health of the Metropolitan Borough of Greenwich for 1949. Dr. Waldron, my predecessor in this office, acted in a parttime capacity until June 6th, when I took up my appointment. I extend to him my thanks and good wishes. The population continues to increase and is approaching prewar level. The birth rate shows a slight decrease and the death rate a slight increase from last year, but both compare favourably with the National rates. The Infantile Mortality rate of 24 per 1,000 live births is the lowest ever recorded in the history of the Borough and is most gratifying. Generally speaking, Infectious Diseases still decline. Scarlet fever, however, increased slightly from 73 notifications in 1948 to 128 this year, but the disease was mild in character. Whooping Cough has declined from 385 to 194. How much this decline is due to immunisation is as yet difficult to assess, but it is pleasing to note that Diphtheria is now practically non-existent in Greenwich—there were only two cases last year as opposed to 9 in 1948. Pulmonary Tuberculosis has increased from 109 to 117 and it is interesting to note that a high proportion of cases are notified from the Kidbrooke area where the L.C.C. are giving high priority to the rehousing of tuberculous families. This raises the question of the wisdom of housing healthy families in close proximity to tuberculous cases, especially where there are young children, and to my mind the practice is not without some danger. This year saw a sharp rise throughout the country in the incidence of Infantile Paralysis. Fortunately, in Greenwich we had only 4 confirmed cases. In 1948 we had 5 and in 1947, which was an epidemic year, there were 16. 7 Towards the end of the year it was decided to make use of the Public Health Laboratory Services in connection with the bacteriological examination and grading of milks, ice-cream, water and other specimens of a public health nature; but Seamen's Hospital Laboratory continues to serve the requirements of General Practitioners. These new arrangements aie working smoothly. Under Section 31 of the National Assistance Act, 1948, preparations have been made for the Borough Council to make a contribution of £200 per annum to the British Red Cross Society towards the cost of supplying hot midday meals to old people who, by reason of infirmity or illness, would benefit from a regular midday meal. The meals are collected by the Red Cross van from the Londoners' Meals Service and are subsidised by the London County Council to the extent of 4d. per meal and are delivered to the homes of the old people at a cost to them of 8d. Although there is no provision in the Act, I hope that in the future the Red Cross may be able to extend their activities to include bedridden invalids of all ages, e.g., tuberculous patients. Whether this would be a function of the Local Health Authority or the Borough Council would have to be agreed. While on the subject of old people, it should be remembered that they, as an age group, have been least well provided for under the new Health Act. The Sanitary Inspectors, and particularly the Lady Sanitary Inspector, are constantly bringing to my notice old people living in insanitary conditions, suffering from infirmity or illness, with no relative willing or able to help them. Institutions are full and there are long waiting lists for beds at St. Alfege's Hospital. Nevertheless, we supply to the Superintendent of that hospital reports on the domestic circumstances of the old people on the waiting list and every effort is made to find a bed for those whose home conditions and circumstances are most pitiable. I consider the association between St. Alfege's Hospital and this Department to be most useful and I appreciate the reliance which Dr. Young, the Physician Superintendent, places on our reports. Powers under Section 47 of the National Assistance Act, 1948, have, fortunately, not been required. This section deals with the compulsory removal from their homes of aged and infirm persons unable to care for themselves by reason of grave chronic illness or other cause, and living in insanitary conditions. It is our experience that most old people are only too willing to be removed to a place where they can be nursed and cared for. Work associated with the old people, of course, is intimately 8 bound up with the Home Help Service, the Social Welfare Department of the L.C.C., the British Red Cross, the W.V.S., the Old People's Welfare Association and the Old Age Pensioners' Association, and the Lady Sanitary Inspector is in frequent contact with such organisations. It would appear, from the reports of the Chief Medical Officer of the Ministry of Health, that outbreaks of food poisoning are increasing. The outbreaks reported to the Ministry since the War are as follows:— 1945 422 1946 598 1947 765 1948 964 Great publicity has been given to the need for greater care in handling and preparing food; this is all the more important because of the increased numbers of the population who now use restaurants and canteens. There can be little doubt that this factor is largely contributory to the present high figures of notified food poisoning. This being so, it behoves all Health Departments to ensure that the highest possible standards of hygiene are practised in food establishments in their areas, and this should apply not only to catering establishments—although they are perhaps of primary importance— but to all premises where food is stored, handled, prepared or distributed. Local Authorities have certain well-defined powers under Sections 13 and 14 of the Food and Drugs Act, but these legal standards are not sufficiently exhaustive. A more personal approach is desirable with a view to encouraging a standard of hygiene which is practised voluntarily and at the same time goes much further than enforcible legal standards. With this in view, we in Greenwich are contemplating the inauguration of a Guild of Hygiene which will embrace not only the food and drink trades but such people as hairdressers and laundry workers. We are prepared to draw up codes of practice with which each member of the Guild will be required to comply. Already we have been promised the active support of progressive traders and business people in sufficient numbers to warrant the launching of a Guild in the early New Year. The success or failure of such a Guild rests with the traders themselves and with the general public, who receive as high or as low a standard of hygiene as they are prepared to accept. It is not our intention to launch on a meteoric campaign. We hope for steady progress and continuous addition to our members. 9 There are many obstacles in the way, not the least of which is in stimulating the interest and enthusiasm of those engaged in the more menial tasks in large kitchens. This is a difficult problem. Perhaps enlightened supervision may be the answer and it is in this regard that an active Guild of Hygiene can play an important role in advocating codes of practice appropriate to the trade, organising lectures and film shows and generally educating the food traders on hygiene matters. From what I have said it should not be assumed that standards in Greenwich are lower than in other areas: Greenwich compares very favourably with boroughs of a similar character and the fact that last year we had only 6 notified cases of food poisoning puts the position in correct perspective; but we must also take into account the fact that cases of severe diarrhoeas and gastro-intestinal upsets do occur in large numbers and are not notified ; but, of course, this problem must not be measured solely in terms of the statistical yardstick. Nevertheless, many premises leave a great deal to be desired and barely meet minimum legal requirements and it is the owners of such premises that we are anxious to encourage. If progress means anything at all we should spare no efforts to raise the general level in the Borough to that of the best. We have goodly hopes of eventual success. I have performed the day-to-day administration of the Personal Health Services in Greenwich for the Divisional Medical Officer. It would be ungracious of me in this report to make comment on any administrative arrangements which have been made by another Authority, but, personally, I welcome the opportunity of playing some part in the running of the Personal Health Services and I gladly acknowledge the consideration which has been shown to me by Dr. Waldron, the Divisional Medical Officer. I am also grateful to him for supplying statistics concerned with the personal health services in the area. I wish to thank the Chairman and the Vice-Chairman of the Public Health Committee for their support and confidence and I am glad to acknowledge the help and co-operation I have received from the Town Clerk and other Chief Officers. Finally, I must record my appreciation of the loyalty and good service given by each member of the Health Department. I have the honour to be, Your obedient Servant, J. Kerb Brown, Medical Officer of Health 10 SECTION A STATISTICS AND SOCIAL CONDITIONS OP THE AREA General Statistics Elevation.—Varies from below high-water mark up to 249 feet above sea level. Area of the Borough and Districts— East Greenwich 1,300 acres West Greenwich 453 „ St. Nicholas, Deptford 115 „ Charlton & Kidbrooke 1,990 „ 3,858 acres Population— At Census, 1931 100,924 Estimated, 1949 (Civilian) 87,680 Density of Population 23 persons per acre Number of Inhabited Dwellings—end 1949 (according to Rate Books) 21,687 Structurally separate dwellings at Census, 1931 18,114 Number of Uninhabited Dwellings— At Census, 1931 250 At end 1949 49 Number of Families or Separate Occupiers— At Census, 1931 25,144 Rateable Value,1949 £772,627 Sum Represented by a Id. Rate, 1949 £3,125 11 PUBLIC OPEN SPACES. Borough Council— Charlton House and Gardens 9.25 acres R.N. College Cemetery 5.86 „ St. Alfege Recreation and Church Grounds 2.3 „ St. Nicholas Recreation Grounds 1.25 „ Hughes Fields Recreation Grounds .74 „ Batley Park .97 „ Bellot Memorial Gardens .19 „ Other Open Spaces 5.25 „ Approximately 26.00 acres H.M.Office of Works— Greenwich Park 185 acres L.C.C.— Blackheath (part of) 73 acres Maryon Park 46.70 „ Charlton Park 45.75 „ Charlton Lido 23 Sayes Court Recreation Grounds 143 „ Mileage of Streets 88 (approx) SOCIAL CONDITIONS. The Metropolitan Borough of Greenwich comprises three districts, viz., Greenwich, Charlton and Kidbrooke, and St. Nicholas, Deptford, all of which are now united into one civil Parish. The sub-soil of the greater portion of the Borough consists of gravel and sand, the exception being in the Kidbrooke area which is mostly clay. The altitude varies from a few feet below high-water mark on the marshes, up to 249 feet above sea-level on the Shooter's Hill Road by the Borough boundary. The Borough is well catered for in the way of parks and open spaces, the largest being the famous Greenwich Park, with its historical surroundings, covering an area of 185 acres. Blackheath forms a Southern boundary, 73 acres of which are within the Borough. There are also the excellent Recreation Grounds serving the Charlton Area, viz., Maryon Park and Charlton Park. More recently has been added the L.C.C. Play Centre and Lido with its wellequipped swimming bath. 12 The part situated near the River Thames is, generally speaking, an industrial area and is more densely populated than the upper parts of the Borough. Considerable alteration has taken place during the post-war years by the demolition of 'bombed' property and the utilising of site3 for the erection of modern houses and blocks of flats. Little now remains to be added to the Brooke and Evelyn estates for the London County Council Housing Scheme to be completed in the Kidbrooke area. This district, which pre-war had always been described as the rural area of the Borough, is almost entirely built over. The majority of the industries and sources of employment in the Borough are to be found in close proximity to the River Thames which forms the Borough boundary on the north side. Chief among these are large Cable and Engineering Works, Ship Repairing Works, Gasworks, Soap and Candle Works, L.T.E. Generating Station and Tramway Car Repair Depot, The British Electricity Authority's Works, Glass Bottle Works, Rope Works, Ship Propelling Works, Merryweather's Works (Fire Engines), Cement and Stone Works, Asbestos Works, Cold Meat Storage, Pressed Tool Works, Constructional Engineering Works, Galvanising and Sheet Metal Works, Brewery, Flour Mills, Aero Parts, Wireless and Vehicle Parts and Tin Box Manufacturing Works. The numbers employed at 11 of the larger factories range between 500 and 5,000 each, whilst 17 smaller works each employ between 100 and 400. Population.—The Registrar-General has estimated the civilian population for Greenwich at 1949 to be 87,680, and it is upon these figures the statistics in this report have been based. This shows that the population has increased by 3,270 since last year, and by no less than 23,880 since 1945. * EXTRACTS FROM VITAL STATISTICS OF THE YEAR. Live Births Total M. F. Legitimate 1,483 761 722 Birth Rate 17.76 Illegitimate 69 36 33 1,552 797 755 Still Births Legitimate 24 15 9 Rate per 1,000 total Births 15.22 Illegitimate — — — Deaths 944 523 421 Death Rate (Crude) 10.80 (Adjusted) 11.44 13  Rate per 1000 total births. Deaths from Puerperal Causes:— Puerperal Sepsis 1 0.63 Other Puerperal Causes — — Total 1 0.63 Death Rate of Infants under one year of age:— All Infants per 1,000 live births 24 Legitimate Infants per 1,000 legitimate live births 23 Illegitimate Infants per 1,000 illegitimate live births 29 Deaths from Tuberculosis (All forms) 46 „ ,, Pulmonary Tuberculosis 41 Death Rate from Tuberculosis (All forms) per 1,000 0.53 ,, ,, „ Pulmonary Tuberculosis „ „ 0.47 Deaths from Cancer (all ages) 172 „ „ Measles (all ages).. — „ „ Whooping Cough (all ages) 1 ,, Diarrhoea (under 2 years of age) 1 * These figures, which are supplied by the Kegistrar-lieneral, may ditter slightly from those shown in other parts of the Report. MARRIAGES. Mr. F. H. Searle, the Superintendent Registrar of the Greenwich Registration District, has kindly furnished me with particulars relating to the number of marriages solemnised or registered in the Boroush of Greenwich. The following table shows these particulars giving the number of marriages in the Borough for each year since 1938 :— Year Churches of England Chapels and Roman Catholic Churches SuperintendentRegistrar's Office Total Approximate Population Greenwich Charlton and Kidbrooke St. Nicholas 1938 309 185 31 101 268 894 95,770 1939 395 218 31 128 397 1,169 94,790 1940 451 243 33 126 345 1,198 74,280 1941 277 174 7† 91 241 790 57,070 1942 257 192 3 79 198 729 60,530 1943 209 166 2 73 171 621 62,870 1944 211 136 — 74 171 592 61,800 1945 228 211 2 87 233 761 63,800 1946 258 196 1 86 235 776 76,840 1947 192 160 13 93 318 776 82,230 1948 202 152 8 104 345 811 84,410 1949 184 129 10 90 272 685 87,680 †Parish Church destroyed by enemy action. 14 METEOROLOGICAL OBSERVATIONS I am indebted to the Astronomer Royal, Sir Harold Spencer Jones, F.R.S., for the following meteorological data for the year ended December, 1949. The mean temperature for the year was 52.4° which is 2.7° higher than the average for 100 years 1841-1940 and the highest on record. This brings the total of consecutive years warmer than average to seven. The highest temperature in the shade was 89.3°, registered in a Stevenson screen ,onJune27th. Temperatures exceeding 80° were recorded on 29 days including 84.0° on Easter Saturday, April 16th. This is the highest temperature ever recorded at Greenwich in any April since records began. September was the second warmest on record, the mean temperature of 63.7° being exceeded only in 1865. There were 38 days on which the thermometer gave readings below freezing point. The lowest temperature was 19.8° which occurred on February 4th. The mean daily horizontal movement of the air was 245 miles. The greatest daily movement was 710 miles (April 4th) ; the greatest hourly movement was 41 miles (February 9th), and the greatest wind pressure 33.0 lbs. to the square foot, also on Febiuary 9th. The duration of bright sunshine was 1597.8 hours—the sunniest year since 1929. The sunniest day was July 3rd when 15.2 hours, representing 92% of the possible total, were registered. Theie were 55 entirely sunless days, only 5 of which occurred during the six months April to September. The total rainfall was 18.65 inches, 5.68 inches below a 1C0 years average. Only 9.92 inches of rain had been recorded by the end of September, whilst 5.02 inches fell in October. The greatest daily rainfall was 1.27 inches on October 26th. There were seven periods of ten or more consecutive days on which no measurable rain fell; the longest of these being one of 19 days, June 15th to July 3rd. No. in Short List. Causes of Death Sex Deaths at subjoined Ages of "Rosidents," whether occurring within or without the District. All Ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 45. 45 and under 65. 65 and over. All Causes M 523 111 8 2 38 139 317 F 421 17 2 1 34 73 294 1. Typhoid and Paratyphoid Fevers M ... ... ... ... ... ... ... F ... ... ... ... ... ... ... 2. Cerebro-spinal Fever M ... ... ... ... ... ... ... F ... ... ... ... ... ... ... 3. Scarlet Fever M ... ... ... ... ... ... ... F ... ... ... ... ... ... ... 4. Whooping Cough M ... ... ... ... ... ... ... F 1 1 ... ... ... ... ... 5. Diphtheria M ... ... ... ... ... ... ... F ... ... ... ... ... ... ... 6. Tuberoulopis of Respiratory System M 27 ... 1 ... 12 10 4 F 14 ... ... ... 12 2 ... 7. Other forms of Tuberculosis M 3 ... ... ... 1 2 ... F 2 ... 2 ... ... ... ... 8. Syphilitic Disease M 4 ... ... ... ... 3 1 F 6 ... ... ... ... 1 5 9. Influenza M 4 ... ... ... ... 2 2 F 5 ... ... ... ... ... 5 10. Measles M ... ... ... ... ... ... ... F ... ... ... ... ... ... ... 11. Ac: Poliomyelitis and Polioencephalitis M ... ... ... ... ... ... ... F ... ... ... ... ... ... ... 12. Ac: Infectious Encephalitis M ... ... ... ... ... ... ... F ... ... ... ... ... ... ... 13. Cancer of Bucc. Cav. and Oesoph. Uterus M 13 ... ... ... ... 1 12 F 6 ... ... ... ... 4 2 14. Cancer of Stomach and Duodenum M 18 ... ... ... ... 6 12 F 19 ... ... ... 3 4 12 15. Cancer of Breast M ... ... ... ... ... ... ... F 15 ... ... ... 1 6 8 16. Cancer of all other sites M 70 ... 2 1 7 28 32 F 31 ... ... ... ... 10 21 17. Diabetes M ... ... ... ... ... ... ... F 4 ... ... ... ... 1 3 18. Intra-cranial Vascular Lesions M 42 ... ... ... ... 13 29 F 56 ... ... ... ... 14 42 19 Heart Disease M 140 ... ... ... 4 31 105 F 110 ... ... 1 2 15 92 20. Other diseases of Circulatory System M 39 ... ... ... ... 5 31 F 25 ... ... ... 2 4 19 21. Bronchitis M 42 ... ... ... ... 14 28 F 28 ... ... ... 1 3 24 22. Pneumonia M 31 3 3 ... ... 6 19 F 18 3 ... ... ... ... 15 23. Other Respiratory Diseases M 11 ... ... ... ... 6 5 F 10 ... ... ... 3 2 5 24. Ulcer of Stomach or Duodenum M 8 ... ... ... 1 3 4 F ... ... ... ... ... ... ... 25. Diarrhoea (under 2 years) M 1 1 ... ... ... ... ... F ... ... ... ... ... ... ... 26. Appendicitis M 3 ... ... ... 1 1 1 F 1 ... ... ... l ... ... 27. Other Digestive Diseases M 6 I 5 F 14 ... ... ... 3 2 9 28. Nephritis M 6 ... ... ... 1 2 3 F 2 ... ... ... ... ... 2 29. Puerperal and Post-abortive Sepsis F 1 ... ... ... 1 ... ... 30. Other Maternal Causes F ... ... ... ... ... ... ... 31. Premature Birth M 4 4 ... ... ... ... ... F 4 4 ... ... ... ... ... 32. Congenital Malformations, Birth Injury, etc. M 11 10 1 ... ... ... ... F 8 8 ... ... ... ... ... 33. Suicide M 9 ... ... ... 1 2 6 F 3 ... ... ... ... 2 1 34. Road Traffic Accidents M 4 ... 1 1 1 ... 1 F 1 ... ... ... ... ... 1 35. Other Violent Causes M 11 1 ... ... 6 1 3 F 11 1 ... ... 2 ... 8 36. All Other Causes M 16 ... ... ... 3 2 11 F 26 ... ... ... 3 3 20 No. in Short List. Causes of Death Sex Deaths at subjoined Ages of "Residents," whether occurring within or without the District. All Ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 45. 45 and under 65. 66 and over. All Causes M 523 19 8 2 38 139 317 F 421 17 2 1 34 73 294 1. Typhoid and Paratyphoid Fevers M ... ... ... ... ... ... ... F ... ... ... ... ... ... ... 2. Cerebro-spinal Fever M ... ... ... ... ... ... ... F ... ... ... ... ... ... ... 3. Scarlet Fever M ... ... ... ... ... ... ... F ... ... ... ... ... ... ... 4. Whooping Cough M ... ... ... ... ... ... ... F 1 1 ... ... ... ... ... 5. Diphtheria M ... ... ... ... ... ... ... F ... ... ... ... ... ... ... 6. Tuberculosis of Respiratory System M 27 ... 1 ... 12 10 4 F 14 ... ... ... 12 2 ... 7. Other forms of Tuberculosis M 3 ... ... ... 1 2 ... F 2 ... 2 ... ... ... ... 8. Syphilitic Disease M 4 ... ... ... ... 3 1 F 6 ... ... ... ... 1 5 9. Influenza M 4 ... ... ... ... 2 2 F 5 ... ... ... ... ... 5 10. Measles M ... ... ... ... ... ... ... F ... ... ... ... ... ... ... 11. Ac : Poliomyelitis and Polioencephalitis M ... ... ... ... ... ... ... F ... ... ... ... ... ... ... 12. Ac : Infectious Encephalitis M ... ... ... ... ... ... ... F ... ... ... ... ... ... ... 13. Cancer of Bucc. Cav. and Oesoph. Uterus M 13 ... ... ... ... 1 12 F 6 ... ... ... ... 4 2 14. Cancer of Stomach and Duodenum M 18 ... ... ... ... 6 12 F 19 ... ... ... 3 4 12 15. Cancer of Breast M ... ... ... ... ... ... ... F 15 ... ... ... 1 6 8 16 Cancer of all other sites M 70 ... 2 1 7 28 32 F 31 ... ... ... ... 10 21 17. Diabetes M ... ... ... ... ... ... ... F 4 ... ... ... ... 1 3 18. Intra-cranial Vascular Lesions M 42 ... ... ... ... 13 29 F 56 ... ... ... ... 14 42 19 Heart Disease M 140 ... ... ... 4 31 105 F 110 ... ... 1 2 15 92 20. Other diseases of Circulatory System M 39 ... ... ... ... 5 34 F 25 ... ... ... 2 4 19 21. Bronchitis M 42 ... ... ... ... 14 28 F 28 ... ... ... 1 3 24 22. Pneumonia M 31 3 3 ... ... 6 19 F 18 3 ... ... ... ... 15 23. Other Respiratory Diseases M 11 ... ... ... ... 6 5 F 10 ... ... ... 3 2 5 24. Ulcer of Stomach or Duodenum M 8 ... ... ... 1 3 4 F ... ... ... ... ... ... ... 26. Diarrhoea (under 2 years) M 1 1 ... ... ... ... ... F ... ... ... ... ... ... ... 26. Appendicitis M 3 ... ... ... 1 1 1 F 1 ... ... ... 1 ... ... 27. Other Digestive Diseases M 6 ... ... ... ... I 5 F 14 ... ... ... 3 2 9 28. Nephritis M 6 ... ... ... 1 2 3 F 2 ... ... ... ... ... 2 29. Puerperal and Post-abortive Sepsis F 1 ... ... ... 1 ... ... 30. Other Maternal Causes F ... ... ... ... ... ... ... 31. Premature Birth M 4 4 ... ... ... ... ... F 4 4 ... ... ... ... ... 32. Congenital Malformations, Birth Injury, etc. M 11 10 1 ... ... ... ... F 8 8 ... ... ... ... ... 33. Suicide M 9 ... ... ... 1 2 6 F 3 ... ... ... ... 2 1 34. Road Traffic Accidents M 4 ... 1 I 1 ... 1 F 1 ... ... ... ... ... 1 35. Other Violent Causes M 11 1 ... ... 6 1 3 F 11 1 ... ... 2 ... 8 36. All Other Causes M 16 ... ... ... 3 2 11 F 26 ... ... ... 3 3 20 15 BIRTHS The total number of births registered in the Borough during the year was 1,630. Of this number, 951 occurred in St. Alfege's Hospital, 122 in various nursing homes and 557 in private dwellings. In 706 cases the parents resided in areas outside the Borough and the births were consequently transferred to the appropriate districts, leaving a figure of 924. To this must be added 628 births belonging to the Borough which took place in Institutions outside the Borough, thus making a final figure for Greenwich of 1,552, a decrease of 113 from that of the previous year. Of this total 797 were males and 755 females. The Birth Rate for the year, calculated on the figure of 1,552 births, is 17.76 per thousand of the population, 2.03 lower than that for 1948. The average for the previous ten years is 18.89. The Rates for the County of London and for England and Wales are 18.5 and 16.7 respectively, showing relative decreases of 1.6 and 1.2 from the figures for 1948. Illegitimate Births numbered 69, representing 4.4 per cent. of the total live births. The number of Still Births legistered was 24, which is equivalent to a rate of 15.22 per 1,000 total births, a decrease of 6.48 from that of the previous year. DEATHS The net number of deaths registered during 1949 was 944, of which 523 were males and 421 females, as compared with 859 for last year. This gives a crude Death Rate for the Borough of 10.80 per thousand of the population and although this is an increase of 0.59 over that of the previous year it is still 2.51 less than the average for the last ten years viz., 13.31. The crude Death Rate figure is slightly increased to 11.44 when the comparability factor, furnished by the Registrar-General for adjusting Local Deaths, is taken into account. The Comparability Factor for Greenwich is 1.06 and this figure may be regarded as the population handicap to be applied, which, when multiplied by the Crude Death Rate for the year, modifies the latter so as to make it comparable with the country as a whole or with any other similarly adjusted area. The adjusted Death Rate is in effect a' corrected ' Death Rate. The Death Rates for the County of London and for England and Wales are 12.2 and 11.7 respectively, indicating relative increases of 0.6 and 0.9 over those of the previous year. The inset table showing causes of deaths at all ages has been supplied by the Registrar-General and is included in accordance with requests contained in the Ministry of Health Circular No. 1728. 16 DEATHS IN INSTITUTIONS. The following table shows the number of deaths of Greenwich residents in Public Institutions during the last seven years :— Year Total Deaths of Greenwich Residents Total Deaths of Greenwich Residents in Public Institutions. 1943 888 609 1944 978 616 1945 813 521 1946 874 585 1947 952 561 1948 862 441 1949 942 484 Average 901 545 AGE MORTALITY. The age mortality and the distribution of the deaths between the different quarters of the year are shown by the following table:— Deaths 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Total Under 1 year of age 8 8 15 5 36 Between 1 and 2 years 3 1 1 1 6 Between 2 and 5 years — — 2 2 4 Between 5 and 15 years 1 1 i — 3 Between 15 and 25 years 5 6 3 4 18 Between 25 and 45 years 14 8 14 18 54 Between 45 and 65 years 70 40 48 53 211 65 years and upwards 212 121 124 153 610 Totals 313 185 208 236 942 INFANTILE MORTALITY The Infantile Mortality Rate, measured by the deaths of children under 1 year of age to the number of live births registered, was 24 per thousand live births as compared with 26 for the previous year. For the County of London the Rate was 29 and for England and Wales 32 per 1,000 related live births. This is the lowest Infantile Mortality Rate ever recorded in the Borough and compares very favourably with the previous 10 years average of 39. 17 The total number of deaths during the year was 36 as compared with 44 for the previous year. The death causes of the 36 were:— Prematurity 12 Congenital Malformations 9 Pneumonia 6 Atelectasis 3 Injury at Birth 2 Gastro-enteritis 1 Whooping Cough 1 Other causes 2 Of the above, 19 were male and 17 female. Thirteen died in St. Alfege's Hospital, 19 in other Hospitals and 4 at home. Infants dying before attaining the age of one month numbered 26, equivalent to 72.2 per cent, of the total Infantile deaths ; of this number, 22 died in the first week. As usual, the principal causes were Prematurity and Congenital Malformations. A table showing the causes of deaths and ages is included in the Appendix of the Report. The following Table shows the comparative Infantile Mortality Rates for the quinquennial periods since 1931, together with the Rate for the years 1946, 1947, 1948 and 1949:— District Average for five years 1931-1935 Average for five years 1936-1940 Average for five years 1941-1945 Year 1946 Year 1947 Year 1948 Year 1949 Greenwich 75 50 40 34 26 26 24 London 63 56 60 41 37 31 29 England & Wales 62 55 50 43 41 34 32 REMARKS ON VARIOUS DEATH CAUSES Classification of Deaths.—It should be borne in mind that the statistical data compiled locally relating to cause of death may not agree entirely with the figures furnished to Local Authorities. Classification of the cause of death is taken from one or more causes as stated on the medical certificate in accordance with the Rules generally adopted throughout England and Wales. The Registrar-General is able in cases where it is deemed desirable, to obtain fuller information from the certifying practitioner. 18 This enables his Department to modify the original classification— hence the possibilities of discrepancies in some cases between the figures prepared locally and those referred by the Registrar-General. Common Infectious Diseases.—The class known as Common Infectious Diseases, comprising Measles, Scarlet Fever, Diphtheria, Whooping Cough and Diarrhoea is credited with causing the total of 2 deaths, equalling a Death Rate of .02 per thousand. Small Pox.—There were no deaths from Small Pox, this being the 47th year since a death occurred from this cause. Measles.—There were no deaths arising from this cause during the year—a similar return to that of the previous year. No deaths were recorded for the years 1943, 1944 and 1945, but one was registered for each of the years 1946 and 1947. Scarlet Fever.—There were no deaths arising from this cause, the position being similar to that of 1948. None occurred in 1942 and 1943, one death in 1944, none in 1945, one in 1946 and none in 1947. Whooping Cough.—This disease was given as the cause of one death, with a Death Rate of 0.01 per thousand. There was one each for the years 1943 and 1944, none in 1945, two in 1946 and one each in 1947 and 1948. Diphtheria.—For the third successive year there were no deaths attributable to this cause during 1949. Three were recorded for 1942, three in 1943, seven in 1944, one each in 1945 and 1946. Enteric Fever.—No deaths have been recorded from this disease since 1941. Diarrhoea and Zymotic Enteritis.—One death was stated to be due to this cause, equalling a Death Rate of 0.01 per thousand. Last year there were 3 deaths, 4 occurred in 1947, 4 in 1946, 13 in 1945, 9 in 1944, 7 in 1943 and none in 1942. Tuberculosis.—This class included 46 deaths giving a rate of 0.53. These figures compare with 64, 60, 50, 53, 75, 69 and 62, the totals for the years 1942, 1943, 1944, 1945, 1946, 1947 and 1948 respectively, and the respective Rates of 1.05, 0.94, 0.81, 0.82, 0.97, 0.82 and 0.73. Tuberculo3is of the Respiratory System is, as usual, credited with the major portion of these deaths, there being 41 attributed to the cause, or a Rate of 0.47 per thousand as compared with 0.67 for the previous year. 19 The deaths were allocated to : 11 in East Greenwich, 10 in West Greenwich, 2 in St. Nicholas, Deptford, and 18 in Charlton and Kidbrooke. The remaining forms of Tuberculosis were responsible for 5 deaths. Cancer.—This disease was responsible for a total of 170 deaths with a Death Rate of 1.94 per thousand—an increase of 0.14 over that of the previous year. The number of deaths for the previous 5 years ware 130,127 ,137,142 and 152. The distribution of the deaths was as follows :—60 in East Greenwich, 35 in We3t Greenwich, 13 in St. Nicholas, Deptford, and 62 in Charlton and Kidbrooke. The sites of the affected parts were:- Cancer of Buccal cavity and oesophagus (males only) 13 Cancer of Uterus 6 Cancer of Stomach and Duodenum 35 Cancer of Breast 15 Cancer of all other sites 101 170 Intra-Cranial Lesions of Vascular Origin .-This class which includes deaths arising from Cerebral Haemorrhage, Thrombosis, Hemiplegia, etc., was responsible for a total of 95 deaths. Of this number 23 died between the ages of 45-65 years and 72 from 65 years and upwards. Diseases of the Circulatory System.—Heart Disease.— As usual the deaths from this cause occupied the principal place in the classification of diseases. There were 250 deaths under this class as compared with 223 for the previous year. Eighty-eight were allocated to East Greenwich, 48 to West Greenwich, 11 to St. Nicholas, Deptford, and 103 to Charlton and Kidbrooke. Diseases of the Respiratory System.—There were altogether 121 deaths from these causes. Bronchitis was responsible for 55, and Pneumonia (all forms) 66. Of the total deaths 82 were of persons aged 65 and over. The distribution of the deaths was, 56 in East Greenwich, 24 in West Greenwich, 5 in St. Nicholas, Deptford, and 36 Charlton and Kidbrooke. Deaths From Violence.—These numbered 42, including 12 from Suicide and 5 due to Road Traffic Accidents. 20 SECTION B General Provision of Health Services for the Area Since July 1948 the Personal Health Services available to residents of the Borough have been under the control of the London County Council and Dr. Waldron, the Divisional Medical Officer, has kindly supplied me with the following information and statistics relating to Health Visitors' Records, attendances at Infant Welfare Centres, Prophylaxis figures etc., for 1949. " The services transferred to the London County Council from the Greenwich Borough Council under the National Health Service Act, 1946, were maintained during 1949. Attendances at the various sessions were on a level corresponding with those of 1948. So far as Maternity and Child Welfare is concerned, an advantageous development was the integration of the ante-natal and midwife sessions at the Welfare Centres. Arrangements were made whereby midwives sessions in the main were held at the same time as the doctor's session, thus enabling patients to be referred to the doctor when necessary without delay. There was considerable development of the Home Help service. The number of cases attended on 5th July, 1948 (68), rose to 228 on 31st December, 1949, whilst the number of part-time home helps rose from 18 to 107. The continued popularity of the chiropody service was evident by the demand for treatment. An improvement in the service was effected by a re-arrangement of the sessions at Chevening Road Centre and by the transfer of sessions from Charlton Lane Centre to the nearby Fairfield House Centre, thereby ensuring availability of treatment in those areas throughout the week. A link-up with the school medical service was provided by the reference of school children to the foot clinics for the treatment of verruca paedis. By this method, early and effective treatment is ensured. On 31st December, 1949, registration had been effected under the provisions of the Nurseries and Child Minders Regulation Act, 1948, of one child minder with a capacity for the care of three children. Under the Council's voluntary registration scheme for persons undertaking the care of not more than two children, there were 6 child minders who were minding 6 children." Health Visitors' Records, Attendances at Infant Welfare Sessions, Prophylaxis figures, etc. Health Visitors' Visits Qtr. ended Expectant Mothers Premature Babies Still-Births Infants (under 1 year) Total Visits Infants 1-5 years Infantile Diseases Miscellaneous Total 1st visit Revisit 1st visit Revisit 1st visit Revisit 1st visit Revisit 2nd April 227 83 19 79 4 430 972 1,773 537 445 4,569 2nd July 131 88 18 58 7 13 437 895 1,937 508 527 4,619 1st October 130 74 20 19 5 4 317 821 1,563 100 466 3,519 31st December 166 87 10 37 9 1 349 1,057 1,934 20 613 4,283 Totals 654 332 67 193 25 18 1,533 3,745 7,207 1,165 2,051 16,990 Attendances at Infant Welfare Clinics Quarter ended Sessions Attendances 0-1 year 1-2 years 2-5 years 1st Total 1st Total 1st Total 2nd Apr. 208 400 5,410 45 1,642 57 1,450 2nd July 199 395 5,854 29 1,614 45 1,565 1st October 204 352 6,294 18 1,573 44 1,529 31st December 201 292 5,399 23 1,415 36 1,399 Totals 812 1,439 22,957 115 6,244 182 5,943 22 Attendances at Ante-Natal Clinics Sessions Attendances First Total Quarter ended M.O. Midwife Ante-Natal Post-Natal Ante-Natal Post-Natal M.O. Midwife M.O. Midwife M.O. Midwife M.O. Midwife 2nd April 148 117 465 {No } record {kept } 82 1,825 1,359 95 - 2nd July 134 106 399 96 - 1,733 1,177 122 - 1st October 136 105 395 61 — 1,502 938 79 — 31st December 129 107 330 55 — 1,468 905 75 — Totals 547 435 1,589 — 294 — 6,528 4.379 371 — Attendances at Dental Centres Quarter ended Sessions Nursing and Expectant Mothers Children under 5 years First Treatment Total Attendances First Treatment Total Attendances 2nd April 46 37 120 42 95 2nd July 41 41 102 52 131 1st October 35 32 103 43 114 31st December 45 51 204 57 153 Totals 167 161 529 194 493 23 Attendances at Artificial Sunlight Centres Quarter ended Sessions Attendances First Total 2nd April 212 311 4,978 2nd July 256 193 4,141 1st October 265 149 2,442 31st December 220 204 2,774 Totals 953 857 14,335 Chiropody Clinics Quarter ended Sessions Attendances First Total 2nd April 336 364 4,328 2nd July 309 46(> 4,168 1st October 320 252 2,861 31st December 325 201 3,815 Totals 1,290 1,283 15,172 Prophylaxis Number of completed cases during the year :— Type At Prophylaxis Sessions (including work at Devonport Laboratory). By General Practitioners Total Vaccination 335 73 408 Diphtheria 487 58 545 Whooping Cough 416 — 416 Whooping Cough and Diphtheria combined 890 7 897 24 TREATMENT CENTRES AND CLINICS Particulars relating to the local Health Services throughout the Borough are given below :— INFANT WELFARE CLINICS DAY A.M. P.M. Bardsley Lane, S.E.10. Thursday 1.30 Charlton Lane, S.E.7. Tuesday 9.30 Thursday 1.30 Chevening Road, S.E.10 Tuesday 9.30 Wednesday 9.30 Thursday 9.30 Friday 1.30 Creek Road, S.E.8. Monday 9.30 Friday 1.30 Fairfield House, S.E.7. Monday 9.30 Wednesday 1.30 Thursday 9.30 Ridgebrook Road, S.E.3. Tuesday 9.30 (Toddlers) 1.30 Shooters Hill Road, S.E.3. Monday 1.30 Tuesday 1.30 Wednesday 9.30 Thursday 1.30 ANTE & POST NATAL CLINICS Note : (a) Doctor in attendance (b) Midwife in attendance Charlton Lane, S.E.7. Friday 1.30 (ab) Chevening Road, S.E.10 Monday 1.30 (ab) Tuesday 1.30 (ab) Creek Road, S.E.8. Tuesday 1.30 (ab) Wednesday (1st and 3rd) 1.30 (ab) Thursday 9.30 (a) 1.30 (ab) Fairfield House, S.E.7. Tuesday 1.30 (b) Wednesday 9.30 (a) Thursday 1.30 (ab) Ridgebrook Road, S.E.3. Thursday 9.30 (a) 1.30 (b) Shooters Hill Road, S.E.3. Tuesday 9.30 (a) Friday 9.30 (a) 1.30 (b) 25 ARTIFICIAL SUNLIGHT TREATMENT DAY A.M. P.M. Charlton Lane, S.E.7. Tuesday 1.30 Friday 9.30 Chevening Road, S.E.10 Tuesday 9.30 Wednesday 9.30 1.30 Thursday 9.30 Friday 9.30 1.30 Creek Road, S.E.8. Monday 1.30 Tuesday 9.30 Wednesday 9.30 Friday 9.30 Fairfield House, S.E.7. Monday 9.30 1.30 Wednesday 9.30 1.30 Shooters Hill Road, S.E.3. Tuesday 9.30 1.30 Thursday 9.30 1.30 Friday 1.30 IMMUNISATION AND VACCINATION CLINICS Chevening Road, S.E.10 Friday 9.30 Fairfield House, S.E.7. Monday 1.30 Shooters Hill Road, S.E.3. Wednesday 1.30 DENTAL CLINICS Shooters' Hill Road, S.E.3. Monday 9.30 1.30 Wednesday 9.30 1.30 FOOT CLINICS (2/per treatment—by appointment only) Chevening Road, S.E.10 Monday 10 1 Tuesday 10 1 Wednesday 10 1 2 8 Thursday 2 8 Friday 10 1 2 5 Saturday 9 12 Fairfield House, S.E.7. Monday 2 5 Tuesday 2 8 Wednesday 2 5 Thursday 2 8 Friday 10 1 2 5 Ridgebrook Road, S.E.3. Wednesday 10 1 Shooters Hill Road, S.E.3. Monday 2 8 Tuesday 10 1 2 5 Wednesday 10 1 2 5 Thursday 2 8 Friday 10 1 2 5 St. Alfege's Hospital S.E.10. (Diabetic Patients) Friday 2 5 26 CHEST CLINICS (By appointment only). DAY A.M. P.M. Maze Hill, S.E.10 Monday 2 Tuesday 10 2 Thursday 10 5 6.30 (workers only) T.B. Handicraft Centre Tuesday 2.30 4.30 Friday 10.30 12.30 SCABIES & CLEANSING CLINICS Tunnel Avenue Daily (Saturdays excepted) 9 12 (School Children) 2 . 4 (Adults and Children under school age WOMEN'S SPECIAL CLINIC (Family Planning Association) Charlton Lane, S.E.7. Wednesday 2 DAY NURSERY Application for entry to :—Divisional Medical Officer, London County Council, St. Paul's House, Deptford High Street, S.E.8. HOME HELP SERVICE Applications for this service to be addressed to :—Divisional Medical Officer London County Council, Greenwich Sub-Office, 105, Shooters Hill Road, S.E.3 DISINFECTING STATION Applications to :—Medical Officer of Health, Public Health Department, Town Hall, S.E.10. NURSING ASSOCIATIONS. Queens District Nursing Association for Blackheath & Charlton, 78, Elliscombe Road, S.E.7. Ranyard Mission, Ranyard House, 11, Taviton Street, W.C.I. Nursing Sisters of St. John the Divine, Watson Street, S.E.8. REGISTRATION OF BIRTHS, DEATHS AND MARRIAGES {9 a.m. to 12 noon Town Hall, S.E.10. Mon Fn { 2 p.m. to 4.30 p.m. Fri. 5 p.m. to 7 p.m. Sat. 9 a.m. to 11 a.m. 27 SECTION C Sanitary circumstances of the Area The tables on pages 40 and 42 summarise, as far as possible, the sanitary work of the Department; from these it will be seen that a total of 20,786 houses and premises have been inspected or re-inspected during the year; 1,632 intimation notices and 350 statutory notices were served. Once more the number of registered complaints, viz., 2,205, was greatly in excess of the pre-war average of 700, again serving to emphasise the difficulties which face the Sanitary Inspector in his task of maintaining a proper standard of housing in his district. Routine complaints mainly arise from the continued deterioration of old property despite the application of the nuisance sections of the Public Health Act. The rate of provision of new dwellings is not such as to allow of Housing Act procedure to any appreciable extent in the case of sub-standard accommodation. A good deal of effort is, therefore, spent on obtaining repairs to worn out property which, in other circumstances, would be scheduled for demolition. Factories Act, 1937. Under this Act the principal functions are administered by the Ministry of Labour and National Service through H.M. Factory Inspectors. The Sanitary Authority is charged with the duty of enforcing the legislation as to sanitary accommodation in all factories in its area, and in those factories where mechanical power is not used the following :— Cleanliness. Ventilation. Overcrowding. Drainage of floors. All factories must have an adequate supply of drinking water from a public main or some other source approved in writing by the Council. During the year, 432 inspections were made by the Council's Inspectors in relation to the 359 registered factories. The latter figure includes 68 premises where mechanical power is not used. Defects were found in 37 instances, all of which were remedied. Outworkers.—Premises where homework is carried on were visited on 85 occasions by the Woman Inspector. In no instance was it necessary to take action because of infectious disease. 28 FACTORIES ACT 1937 Inspections for purposes of provisions as to health. Premises Number on Register Number of Inspections Written notices Occupiers prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 68 54 3 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 279 345 4 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers'premises) 12 33 Total 359 432 7 - Cases in which defects were found. Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness (8. 1.) 14 14 — __ Overcrowding (8.2) — — — — — Unreasonable temperature (8.3) _ Inadequate ventilation (8.4) 1 1 — — — Ineffective drainage of floors (8.6) - _ - Sanitary Conveniences (8.7) (a) insufficient 10 10 3 - (6) Unsuitable or defective 10 10 — 3 — (c) Not separate for sexes 2 2 — — — Other offences against the Act (not including offences relating to Outwork) — — — __ Total 37 37 - 6 - 29 Outwork—(Sections 110 and 111) Nature of Work Section 110 Section 111 No. of out-workers in August list required by Sect. 110(1) (c) No. of cases of default in sending list to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwholesome premises Notices served Prosecutions Wearing apparel Making, etc. 62 — — — — — Racquet and tennis balls 1 - - - - - Paper bags 3 — — — — — The making of boxes or other receptacles or parts thereof made wholly or partially of paper 4 - - - - - Carding, etc., of buttons, etc. 1 __ - Cosaques, Christmas crackers. Christmas stockings, etc. 1 - - - - - Lampshades 3 — — — — Total 75 — — — — — Grit Emission.—It is believed that coal-fired electricity generating stations are a major source of atmospheric pollution especially in regard to the emission of grit. The local Generating Station at Greenwich has been a source of annoyance in this respect to the inhabitants for many years. In 1938, as a result of legal action taken by the Greenwich Borough Council, 16 new boilers were fitted with special grit arresters which effected some improvement, but since the end of the war conditions have deteriorated, partly due to the poor quality of the coal which is now being burned. This problem of grit emission was repeatedly before the Public Health Committee during the year and a Sub-Committee was formed in an attempt to find a solution to the problem. The Sub-Committee have made preliminary investigations and are seeking a comprehensive technical report from a fuel combustion expert. It is to be hoped that next year will see some alleviation from this serious 30 nuisance. Smoke observations were carried out on 120 occasions, but in no instance was it necessary to serve a notice. Smells From the River.—About the middle of August numerous complaints were received by the Health Department regarding offensive smells noticed in the Borough. These smells were variously described as' sulphury,'' suffocating ' and ' sickly,' and it was alleged that polished brasswork and copper was becoming quickly tarnished. The smells were not confined to Greenwich but were common to most riverside Boroughs, as far up as Fulham and Chelsea, and had been reported in many areas on the lower reaches of the Thames. Observation by this Department indicated that the trouble was due to the reduced flow of water in the River during the abnormally dry and warm spell of weather with, firstly, a greater concentration of organic matter in the River and, secondly, a greater exposure to the atmosphere of the riverside mud, causing excessive putrefaction and the production of sulphuretted hydrogen. This explanation was confirmed when conditions improved as the temperature dropped and the level of the River rose with increasing rainfall. Nuisances Arising From Bomb Damaged Buildings and E.W.S. Sites.—The condition of bombed sites and E.W.S. tanks in the Borough continues to exercise the attention of this Department Towards the end of the year the Council adopted a Bye-Law under Section 146 of the London Government Act, 1939, prohibiting the depositing of rubbish on unfenced ground and bombed sites, specified in a Schedule prepared by the Health Department. Copies of the Bye-law are exhibited on the sites and there has been some improvement but total clearance and fencing is the only solution. The E.W.S. tanks are used as dumping grounds and organic matter and water accumulates in considerable quantities. In many cases the owners of the ground on which the E.W.S. tanks are situated cannot be traced and the matter is further complicated by the fact that the Government are not encouraging the demolition of the tanks. However, if obnoxious matter is present or a Public Health nuisance exists, Notices can be served on the owners of the ground if they are known but it is doubtful if a Court would uphold a prosecution in the event of non-compliance. This whole problem bristles with difficulties and the time has surely come when some National policy should be formulated. Defective DwELLiNGS.-REPAiRS.-With regard to houses found not to be in a reasonable state of repair, the following procedure, classified under three headings, is generally adopted :— 31 (1) Complaints from or on behalf of the occupier.—The District Sanitary Inspector makes inspection and an intimation is sent to the owner specifying the defects and nature of nuisance found. Where necessary, the circumstances are reported to the Public Health Committee for authority to serve a Statutory Notice to enforce abatement of the nuisance. The premises are re-inspected by the Sanitary Inspector and, if work required is not executed within a reasonable period, Statutory Notice is served. In cases of noncompliance the Town Clerk is instructed to institute proceedings. (2) Sanitary defects due to depreciation of property.—Depreciation of property usually occurs as a result of the owner's inability to carry out repairs during the war period. A Notice is served on the owner by the Sanitary Inspector, and where expenditure exceeds £100 it is necessary for a licence to be obtained before the work is allowed to proceed. (3) Housing defects.—These are cases where the conditions are such that they cannot be remedied under the procedure of the Public Health (London) Act, 1936, and are dealt with under the Housing Act, 1936, as being houses unfit for human habitation. Representations are made to the Public Health Committee to consider as to whether such houses can be repaired at a reasonable cost having regard to the value of the premises, or whether Closing and Demolition Orders should be made. Disinfestation Scheme—Anti-Fly and Anti-Mosquito Measures.—The Anti-fly and Anti-mosquito Scheme instituted in 1947 was continued during the summer period of the year under review with very satisfactory results. At the inception of the scheme it was realised that the main factors to be controlled included house refuse, static water sites, ponds, ditches, cafes and food shops etc., and in general, the problems during 1949 remained the same. As previously, the methods of control included spraying with D.D.T., the dusting of ' Gammexane ' powder and in certain instances the use of ' Malariol.' Again with the Borough Engineer's co-operation the dustmen were instructed to treat dustbins with ' Gammexane ' powder after emptying and the dust vans themselves were sprayed with D.D.T. in kerosene at the Council's Depots. Prior to 1948 the collection of refuse-laden barges off the foreshore at Blackwall Point had usually been a source of annoyance but now this nuisance has been almost entirely eliminated by the subjection of the refuse to treatment before barging by the Authorities using this method of disposal. 32 In previous years numerous complaints had been received from the various blocks of flats in the Borough concerning fly maggots in the dust-shoots and in order to combat this nuisance a system was introduced in 1948 of regular treatment of these shoots as soon as practicable after dust collection. The system effected a marked improvement and during 1949 this improvement was sustained to such good effect that no complaints were received. Routine visits were made to static water tanks, and mosquito and fly breeding was effectively controlled by D.D.T. spraying or ' Gammexane ' dusting and the ' Malariol' sawdust bomb in cases which were not readily accessible. Various canteens, food shops, cafes and fish-shops received attention during the year and, despite the difficult problems accompanying work on these types of premises, very good results were obtained. The disinfestation staff are to be commended on the method and rapidity with which they countered any potential source of fly or mosquito breeding during their journeys throughout the Borough. The table given below is a brief schedule of the work carried out during the period under review. No. OF TREATMENTS Refuse Heaps Considerable Stables 17 Ponds, Streams, etc. 2 Standings for Pig Bins 4 Private Houses 20 Shops 4 E.W.S. Dams 110 Clinics 1 Bombed Sites 127 Council Flats (Dust Shoots) 533 Factory Canteens & Offices 6 Piggeries 4 Shoots 17 Scavenging and Refuse Disposal.—The collection of refuse in the Borough is under the control of the Borough Engineer who has kindly supplied me with the following information :— During 1949 the amount of house refuse and street sweepings amounted to approximately 16,747 tons and 1,380 tons respectively, totalling 18,127 tons, most of which was tipped into barges alongside the Council's Tunnel Avenue Depot and from thence conveyed to controlled tips in the Thames Estuary. The increase in the tonnage collected was mainly accounted for by the housing development in the Kidbrooke area of the Borough. In March the Council resolved to purchase, at a cost estimated at £9,028, four of the modern 33 type "Paragon" refuse collecting vehicles, and it is anticipated that delivery of these will be made during the Spring of 1950. The continuation of the collection of salvage was carried out in an intensive manner, and these efforts produced the following results.— Total Salvage Collected 2,632 tons (Two main items were:— Paper 782 tons Kitchen Waste 1,557 tons) Income (including Government Grants) £11,627 The question of the continuation of the collection of salvage was considered in the light of the Government's revocation of the Salvage of Waste Materials Orders, and it was decided on economic grounds that as from the end of the year 1949 the present arrangements for the collection and disposal of salvage, with the exception of kitchen waste and trade refuse, be discontinued. Rent and Mortage Interest (Restrictions) Acts, 1920/39— Under the provisions of these Acts landlords are permitted to make certain increases of rent, and tenants whose houses are not in all respects reasonably fit for human habitation may apply to the Sanitary Authority for a certificate to this effect enabling them to suspend payment of the increased rent until the necessary works shall have been completed to the satisfaction of the Sanitary Authority. During the year 11 applications were received and 11 certificates were duly granted. Landlords may also apply to the Sanitary Authority for a report that the necessary works had been executed to the satisfaction of the Council. One application was received and a report duly granted. Public Baths and Washhouses.—The Public Baths and Washhouses situated in Trafalgar Road, Greenwich, contain three large swimming pools (one is out of order owing to enemy action), 74 ladies' and gents' slipper baths, vapour and medicated baths, and Public Laundry. The second class swimming bath is open to bathers all the year round, the first class swimming bath is floored over during the winter months (October to April) and the hall used for social functions of all kinds. The water in the swimming baths is continuously filtered, aerated and chlorinated, the whole of the bath water being Passed through the pressure filters once every three and a quarter hours. Chemical tests are taken twice daily, and bacteriological tests taken periodically. 34 I am indebted to Mr. K. L. Embley, Superintendent Engineer, for the following statistics:— Attendances.—For the year ended 31st December, 1949:— Slipper Baths 97,480 Swimming Baths (a) 129,905 Vapour and Medicated Baths 9,717 Public Laundry 10,008 Total 247,110 (a) includes 34,648 School-children Houses Let in Lodgings.—The L.C.C. Bye-laws made under Section 6 of the Housing Act, 1936, define a house let in lodgings as one which is occupied, or is of a type suitable for occupation, by persons of the working classes and let in lodgings or occupied by members of more than one family. These dwellings are subject to registration and must comply with certain requirements as to sanitation, cleanliness, etc. The number of houses on the Register at the end of the year was 3; these have been visited by the Woman Inspector on 59 occasions. Pig Bin Nuisance.—The nuisance of foul smells and flies arising from pig bins has largely been overcome during the year. The Borough Engineer's introduction of hard standings and permanent fixtures for the bins, coupled with the vigilance of our disinfestation squad appear to have eliminated the main cause of complaint, i.e: the overturning of the bins with the resultant distribution of the contents over the footway. Rodent Control.—The Council's Rodent Scheme as approved by the Ministry of Agriculture and Fisheries, has continued and during the year 2,107 investigations were made and infestation found to exist in 574 dwelling houses, 15 shops, 20 factories and 8 bombed sites : 398 premises were covered under block treatment schemes. In addition to baiting and poisoning methods every effort was made to discover the source of infestation and it was frequently found necessary to take up floorings, yard pavings and excavate further to trace rat runs. These steps were also taken when infestation persisted after a series of treatments. In 93 instances infestation was found to be due to defective drainage and much work and persistent effort was necessary to accomplish results. Bombed sites and dumps providing suitable harbourage have been test-baited and where necessary treatments have been carried out. The number of infestations at these sites has diminished 35 during the year due to the persistent efforts in t he past and the regular inspection of these areas for signs of evidence of re-infestation. The average number of complaints received in a month was 52 compared with 62 last year. In only three cases during the year has there been failure to discover the source of infestation. These cases are, of course, receiving regular attention. Four major infestations have been dealt with and in three of these the premises were found to be infested by both black and brown rats. Details are as follows:— (1) Badcock's Wharf, Banning Street.-Owing to the nature of the merchandise stored, viz: barley, wheat and sugar, and to the frequent movement of these goods, it was found difficult to effect a clearance. Despite evidence of serious infestation normal poison baits were ineffective and it was decided, with the consent of the Ministry, to use "ANTU." Results were most satisfactory but periodical treatment of the property is being continued. (2) South Eastern Gas Board.—Complaint of rat infestation in the Works Canteen revealed serious infestation outside. Ratproofing in the Canteen was effected and the usual methods of baiting and poisoning showed good results. The job of dealing with the rest of the premises involved much investigation over a large area. Black and brown rats were found in large numbers. Final results obtained were most satisfactory. (3) Robinson's Mills, Deptford Bridge.—At the request of the owners, rodent control work at these premises was commenced in December, 1949. Initial investigation revealed a major infestation by black and brown rats both inside and outside the premises. Extensive baiting was carried out along the river banks and jetties. In addition, owing to the large quantities of animal feeding stuffs in the premises, it was decided to use batteries of traps. These methods are proving successful and are being continued. Over 100 rats have been trapped. (4) Unit Construction Company.—This Company is engaged in the erection of a large housing estate in the Kidbrooke area and temporary hutments were erected for use as store-rooms and messrooms. The Management notified us of the probable date of demolition of these huts and treatments were carried out. So far only four complaints have been received from this area and it would seem that possible infestation has been prevented by the close co-operation of the Company with this Department. I would like to thank the Rodent Control personnel for the excellent work performed during the year. 36 Baiting of Sewers.—The Borough Engineer has kindly supplied me with the undermentioned information of the treatments carried out in the Council's sewers in connection with the scheme:— Details Date of Treatment 6th to 22nd Dec., 1949 7th to 23rd June, 1949 1. No. of Manholes in foul and connected systems 1,157 1,157 2. Bait base and poison used Sausage rusk and zinc phosphide 3. No. of Manholes baited 1.054 976 4. No. of Manholes showing prebait takes 573 495 5. No. of Manholes showing complete prebait take (on one or both days) 346 215 6. Schemes of baiting used (e.g.; consecutive days or 1st, 3rd and 5th days) Consecutive days Consecutive days 7. No. of Manholes test-baited in conjunction with this treatment and not included in No. 3 above — 28 Remarks: Test-baiting did not warrant any 'treatment'. All manholes in system have either been 'treated' or 'test-baited' (15%) (or 15% of 181difference between items No. 1 & No. 3) It may be mentioned that the neighbouring Boroughs of Woolwich and Lewisham took action at the same time as Greenwich. Disinfestation of Verminous premises.-The disinfestation of verminous premises has been conducted on similar lines to those of the previous year, a residual vermicide spray containing 5% D.D.T. being successfully employed in the treatment of furniture, floors and wall surfaces. In the course of their duties during the year, the Sanitary Inspectors dealt with 246 cases of verminous and dirty rooms compared with the figure of 151 for 1948. In addition, the Disinfestation Staff sprayed 938 rooms and contents whilst in 29 cases bedding, etc., was removed to the Council's Disinfecting Station for steam disinfection. Pharmacy and Poisons Act, 1933.—This Act came into force on 1st May, 1936, and has for its object closer control of the sale of poisons and poisonous substances. Under it the Medical Officer of Health and the Sanitary Inspectors are appointed to carry out the provisions referred to in Part II of the Poisons List. These chiefly 37 relate to the Sale of Poisons used for domestic, horticultural and sanitary purposes. Daring the year 6 applications to sell poisons under Part II were received and granted and 66 applied for retention in the Council's list. Shops Act, 1934.—Under the provisions of this Act 168 visits were made and in no case was it necessary to serve a notice. No applications were received under Section 10 for Certificates of Exemption with regard to the provision of sanitary convenience accommodation. Drainage and Sewerage.—One hundred and ten plans of drainage and other sanitary works relating to existing and new buildings were examined and approved. Water Supply.—The whole of the Borough is supplied with water by the Metropolitan Water Board which is a Statutory undertaking, and the responsibility for its purity rests with that Authority. There are 21,687 dwellings with direct connection to the Board's mains. No complaints were received during the year as to taste or possible contamination caused by insects or silt. During the year 517 water supply certificates were granted under Section 95 of the Public Health (London) Act, 1936. Water fittings have been amended in 177 cases, and extra water supply to tenement houses in 3 cases. Underground Water Supplies (Wells).—In the year 1947 the Ministry of Health requested a survey of underground water supplies in the Borough, and in my report for that year, I appended a table giving particulars of all wells known and a map showing the positions of the borings. Of the 40 wells listed, only 2 are used for the supply of drinking water, and these are properly supervised, regular testing being carried on throughout the year. No deterioration has been detected in either of these wells for many years. Of the remainder, 13 are used for commercial purposes and 25 are disused. Public Sanitary Conveniences, etc.—The Public Sanitary Conveniences of the Borough, nine in number, are situated in the main arteries of traffic. Repairs to Charlton House Convenience, which was closed in January 1945 owing to war damage, were completed early in the year and the convenience was re-opened on 6th April. A site has now been purchased for the erection, as and when circumstances permit, of a new convenience in the Woolwich Road, near Anchor and Hope Lane. Priority is being given to the 38 ment of the Blackwall Lane Convenience which, owing to its dilapidated condition, has been condemned as unfit and unsuitable for renovation. The site for the replacement has not yet been determined but is expected to be in close proximity to the present convenience. Particulars of Public Sanitary Conveniences in the Borough Convenience MEN WOMEN / W.C.'s Lavatory basins Urinal stalls W.C.'s Lavatory basins Batley Park (Blackheath) 6 2 12 4 2 7a.m. to 11p.m. Blackheath Hill (foot of) 3 — 10 4 — Blackwall Lane (East Greenwich) 5 2 16 4 2 Blackwall Tunnel 3 — 6 5 — Charlton House 2 — 4 2 — Creek Road (St. Nicholas, Deptford) 4 2 10 4 2 Greenwich South Street (near Town Hall) 4 1 10 4 2 King William Walk (near Greenwich Park) 4 2 9 7 2 Shooters Hill Road (junc. Well Hall Rd.) 3 1 6 3 1 Totals 34 10 83 37 11 NOTE:—Women's Conveniences are without an Attendant between 7 a.m. and 9 a.m. On Sundays, Conveniences open at 10.30 a.m. (with the exception of Batley Park (Men) which opens at 9 a.m.), and close at 10.30 p.m. The following are the Drinking Fountains and Horse Troughs in the Borough which are cleansed daily by the attendants attached to the Department:— Drinking Fountains Armada Street, Deptford. Blackheath (Andrew Gibb Memorial) (Damaged by enemy action) Blackheath (Greenwich Park). 39 Drinking Fountains (continued) Blackheath Hill, West Greenwich. Blackwall Lane, East Greenwich. (Damaged by enemy action) Charlton Church Lane. Westcombe Hill, Blackheath. Horse Troughs Charlton Church Lane. Creek Road, Deptford. Invicta Road, Blackheath. Tunnel Avenue, East Greenwich. In addition to the above-mentioned Drinking Fountains and Horse Troughs one Council urinal and four others attached to Public Houses are cleansed daily by two attendants, responsibility for the repairs of the Public House urinals remaining with the Brewers concerned. Burial or Cremation of the Dead.—Under Section 50 of the National Assistance Act, 1948, the Council is required to arrange for the burial or cremation of any person who has died or been found dead in the Borough if in such cases it appears to the Council that no suitable funeral arrangements have been or are being made. The Council is empowered, if it so desires, to recover expenses for the burial or cremation from the estate of the deceased person or from any person who, for the purposes of this Act, was liable to maintain the deceased person immediately prior to his death. During 1949 arrangements were made, under the above Act, for the burial of 24 bodies (18 males and 6 females) at a cost to the Council of £87 4s. 1d. Exhumations.—Notice was received from the Home Office of two exhumations at the Council's Cemeteries. In each case the Sanitary Inspector for the District was present to see that the usual precautions were observed. Aged, Infirm and Physically Incapacitated Persons.— Cases of infirm persons who are unable to maintain a reasonable standard of cleanliness owing to senility or ill-health are usually brought to the notice of the Department either through complaints by neighbours or through the secretaries of old peoples' associations and other organisations. Other cases are brought to light in the course of the Woman Sanitary Inspector's visits to almshouses, etc. 40 Daring the year 281 cases were visited on 936 occasions by the Woman Sanitary Inspector. Experience has shown that these visits serve a very useful purpose, especially in the case of those individuals who for various reasons have ceased to take an interest in their own welfare. The Domestic Home Help scheme is proving of inestimable value in this connection and although the scheme is now administered by the London County Council, the expansion of the service noted prior to July 5th, 1948, has continued. Since the transfer of functions, close liaison between the two authorities has been pursued thus ensuring that the advantages of the scheme are available to the old and infirm in the Borough. As provided for under Section 31 of the National Assistance Act, 1948, a scheme for the supply of hot mid-day meals to the old and infirm of the Borough has been formulated and will be introduced in 1950. The introduction of such a service will undoubtedly serve to alleviate one of the many hardships peculiar to elderly folk, a section of the community who were the least well provided for under the new National Health Act. It was not found necessary during the year for your Medical Officer to make any application under section 47 of the National Assistance Act, 1948, for compulsory removal. Summary of Work Performed by the Sanitary Inspectors during the Year 1949 Inspections— Houses inspected (House-to-House) 133 ,, „ (Complaints, nuisances) 2,408 „ „ (Infectious Disease) 221 „ ,, (Overcrowding) 559 Re-inspections, calls made, etc. 14,146 Inspections of Factories 432 ,, „ Shops 106 „ ,, Stables and yards 46 „ „ Urinals 118 ,, ,, Miscellaneous 970 „ ,, Houses let in Lodgings 59 „ ,, Outworkers premises 85 Inspection of Premises (Pharmacy and Poisons Act, 1933) 9 Investigations (Rats and Mice) 712 On notice from Builder 782 20,786 41 Drains— Drains tested—by smoke 330 „ ,, —by water 314 Opened, cleansed and repaired 351 Reconstructions and additions 196 Inspection chambers constructed 130 New covers to manholes 125 Soil and vent shafts repaired or renewed 111 Traps (gully) 211 Drains sealed off, etc. 52 Yards and forecourts drained 89 Waterclosets and Urinals— Closets erected 72 W.C.s repaired 264 Sanitary conveniences or improvements effected to Factories, Workshops and Workplaces 37 Pans or traps furnished 382 Urinals cleansed or repaired 31 Dustbins— Provided 230 Pavings— Yards and Forecourts 158 General Water Supply— Water Fittings amended 177 Extra water supply to tenement houses 3 Water supply certificates granted (Sect. 95) 517 Other Improvements— Houses generally repaired 135 Rooms cleansed and repaired 2,823 Rooms and staircases lighted and ventilated 33 Verminous rooms cleansed 246 Roofs, gutters and rainwater pipes repaired 991 Dampness abated 771 Sinks, baths and lavatory basins 296 Sink, lavatory and bath waste pipes trapped or amended 253 Stoves and fireplaces 345 Washing coppers repaired or provided 52 Floors repaired 436 Provision for storage of food 15 Miscellaneous repairs 889 Other Nuisances Abated— Illegal use of Underground rooms discontinued 7 Overcrowding abated 121 Animals kept in unfit places discontinued or removed 3 Dung receptacles provided — Accumulation of manure and other obnoxious matter removed 33 Rat infestation abated 188 Smoke Nuisances— Observations 120 Statutory Notices served (Sects. 147 and 148) — Notices, Ac.— Intimations served under Public Health (London) Act, 1936 1,632 Statutory Notices served 350 Houses rendered fit by informal action 206 42 Legal Proceedings Premises Offence Result of Proceedings 60, Charlton Church Lane Non-compliance with Statutory Notice Adjourned Sine Die 86, Charlton Lane do. do. 87, Creek Road do. Case adjourned for one month 89, Creek Road do. do. 103, Creek Road, do. Order made for compliance within 14 days 107, Creek Road do. do. 276, Creek Road do. Adjourned Sine Die. 18C, Eversley Road. do. Order made for compliance within 28 days 21, Glenluce Road, (Ground Floor Flat) do. Adjourned Sine Die. 21, Glenluce Road, (Top Floor Flat) do. do. 7, Park Drive do. Order made for compliance in 3 months 3/- Costs. 43 SECTION D Housing General.—At 31st December, 1949, the inhabited dwellings in the Borough numbered 21,687 and the uninhabited 49. In considering these figures the following points should be borne in mind:— (a) Many of these properties are dilapidated and outworn and in more normal times would undoubtedly have been dealt with under the Housing Act. (b) Of the remainder, a fair proportion are deteriorating mainly due to the neglect occasioned by the high cost of repairs in relation to the controlled rents coupled with the continued shortage of certain building materials allocated for maintenance and repairs. (c) Much of the older property does not lend itself satisfactorily to conversion into the type of accommodation in demand at the present time and until there is a significant increase in the provision of new dwellings it is essential that the existing housing standards should, at the very least, be held at the present level and not allowed to fall. It is not surprising, therefore, to find that an undue proportion of the Sanitary Inspectors' time is absorbed in routine complaints with accompanying re-visits instead of in preventive functions which would follow from house to house inspection of their districts. Rehousing.— (a) Borough Council.—During the year the number of applicants rehoused by the Housing Department amounted to 129 of which 23 were in respect of overcrowded cases and 7 in respect of closures made under the Housing Act. As the number of new dwellings becoming available during the year was somewhat limited the majority of these families were rehoused in requisitioned properties and casual voids occurring on the Council's estates. At the end of the year, in addition to 109 occupied hutments, a total of 1,083 properties, giving 1,903 units of accommodation, were requisitioned by the Council in order to provide for persons rendered homeless as a result of enemy action or who were otherwise inadequately housed. (b) London County Council.—Over the same period, the L.C.C. provided alternative accommodation for 469 families in the Borough, of which 98 were in respect of overcrowded cases. 44 Overcrowding.—The number of complaints received during the year was 519. These cases were investigated by the Sanitary Inspectors concerned and in 168 instances families were found to be overcrowded according to the standards laid down by the Housing Act, 1936. As a direct result of rehousing by the Council's Housing Department and the L.C.C., 121 cases of overcrowding were abated during the year under review. New Housing Accommodation.—The following table lists the new dwellings erected in the Borough during the year:— G.B.C. L.C.C. Private Total Permanent Houses — 380 2 382 Permanent Houses (rebuilt) — 3 12 15 Flats 60 59 1 120 60 442 15 517 Excluding the families accommodated in requisitioned property, the total number of dwellings provided since the termination of the war is now 2,578. Council Housing.—Additional to the 8 three-bedroom type houses being erected on the Woolacoombe Road site there were 393 flats in the course of construction at the end of the year. Many of these are expected to be occupied before the end of 1950 and the following table gives an indication of the type of dwellings to be made available in the various areas:— Type Springfields Tuskar Street Coldbath Street TOTAL 1 Bedroom Type 5 21 — 26 2 „ „ 71 3 47 121 3 „ „ 137 12 75 224 4 „ „ 16 — 6 22 Totals 229 36 128 393 The problem of future housing development has been constantly before the Council and in this respect, whilst not finally settled, the following additions and extensions have been envisaged:— Site Dwellings Victoria Way (North) 72 Cherry Orchard 320 Blackheath Hill 22 Greenwich High Road 18 Ashburnham Place 12 Elliscombe Road 12 Invicta Road 18 45 Procedure under Housing Act, 1936.—The following representations were made under various sections of Part II of the above Act during 1949:— Section 9—(Houses unfit for human habitation but capable at reasonable expense of being rendered so fit). 173, Brookmill Road, S.E.8. (Council undertook work owing to owner's default) Section 11—(Houses unfit for human habitation and not capable at reasonable expense of being rendered so fit). 29, Herringham Road, S.E.7. 105, The Stowage, S.E.8. 108, The Stowage, S.E.8. 38, Point Hill, S.E.10 5, Sigismund Street, S.E.10 61, Lenthorp Road, S.E.10 Section 12—(Parts of buildings unfit for human habitation, i.e., rooms being more than 3ft. below surface of adjoining ground and not complying with Local Authority's Regulations). 50, Crooms Hill, S.E.10 1, Egerton Drive, S.E.10 1a, Shooters Hill Road, S.E.3. 37b, Shooters Hill Road, S.E.3. 37c, Shooters Hill Road, S.E.3. 57a, Shooters Hill Road, S.E.3. 75, Shooters Hill Road, S.E.3. 137a, Shooters Hill Road, S.E.3. 139a, Shooters Hill Road, S.E.3. 141, Shooters Hill Road, S.E.3. 38, Lansdowne Lane, S.E.7. 105, Lansdowne Lane, S.E.7. 328a, Tunnel Avenue, S.E.10. 17, Wellington Gardens, S.E.7 50, Lassell Street, S.E.10 115, Old Dover Road, S.E.3. Action was also taken in respect of 106, Old Woolwich Road, S.E.10. This property was originally included in a Clearance Order made under Part III, Section 26, of the Housing Act, 1936, and confirmed by the Ministry just prior to the outbreak of war. It was recommended that the premises be closed forthwith. The 'Points' Scheme.—On 1st January, 1949, the new 'Points' Scheme, which had been approved by the Council in September, 1948, came into effect and through the courtesy of Mr. 46 Dore, the Housing Manager, the following extracts are quoted from his survey on the 'lettings progress' during the year. "A report on the work of revising the Housing Register was submitted to the Committee on the 21st January, 1949. On the new Register at the beginning of the year, there were shown 3,155 housing applicants. A number of late re-registrations continued to be received however, until towards the end of February, and a more realistic figure for the size of the Register as at the 1st January would be in the neighbourhood of 3,250. The year has afforded ample opportunity of testing the practical working of the Scheme, and the following observations are submitted:— Experience in Working the Scheme.—On the whole, the Points Scheme has proved to be a satisfactory and equitable system of classifying needs. Nevertheless, it will be appreciated that no Points Scheme has yet been devised which could, of course, take into account every possible factor arising out of the housing hardship, and, therefore, anomalies are bound to arise. It can, however, be confidently stated that the present Scheme is operating very fairly indeed to the overwhelming majority of applicants, and it is interesting to note that the Scheme operated by this Council follows very closely the recommendations of the Housing Management SubCommittee of the Central Housing Advisory Committee, whose Report was issued by the Ministry of Health during the year. The main point of difference is in respect of the "residential qualification" which the Report recommended should be a balancing factor, whereas in your Scheme "basic" points are awarded for this particular qualification. There can be no doubt that the policy of giving maximum publicity to the working of the Scheme has fully justified itself and although it cannot be said that the amount of correspondence and the number of callers have reduced during the year, it is possible to discuss an applicant's housing prospects much more satisfactorily when the basis of the working of the Scheme is made fully known. In April it became apparent to the Committee that a number of newly registered applications were attracting high points and there was the difficulty that, because of this, an applicant might be rehoused in a matter of a few weeks or months after registration, whilst many hundreds of others had been waiting for years. To prevent this the Committee resolved that, except in special circumstances, no application should be considered until it has been registered for at least twelve months. One important aspect in which the Points Scheme has not proved effective is in the matter of assessing the needs of elderly persons. Their problems are so different from other applicants that 47 it is extremely doubtful whether any Points Scheme could fairly deal with them. The numbers of elderly persons registered, however, has never exceeded 200 so that it is possible to consider these cases individually on their merits quite apart from the Scheme. Table 'A' in the Appendix to this Report gives the numbers of applicants in the various points ranges as at 31st December, 1949. It will be noted that the total number on the register at that date was 3,880. Lettings.—For the greater part of 1949 no new properties were becoming available, and it was not until November that the first block of flats at Mascalls Court were ready for allocation. The only lettings, therefore, that could be effected apart from this were in respect of casual voids and a total of 129 families were rehoused from the waiting list during the year. Of these 107 were accommodated in requisitioned properties and 22 Council owned permanent dwellings and E.F.M. bungalows. By far the heaviest demand for accommodation came from those families whose minimum requirements were two bedrooms, whilst the greatest proportion of accommodation on the Council's estates contained three bedrooms. Consideration of this led to reconsideration of the earlier policy of allocation whereby a family comprising husband and wife and two children of the same sex were allocated two bedroomed accommodation, and in February it was decided that families with two children, even though they be of the same sex, should be considered for three bedroomed accommodation so as to ease the demand on the limited supply of two bedroomed units. Reference to Table 'B' in the Appendix will show that of the lettings effected to applicants under Category 2, only 4% went to those in Category 2 (a) (i.e. active tuberculosis patients), whereas the Points Scheme provides for an allocation of 20% to such applicants. This is partly due to the fact that only approximately 0.5% of the registered housing applicants came within this category and partly to the fact that so few of the vacancies have been really suitable for these families. After consultation with the Medical Officer of Health, I do not propose to advise the Committee that any alteration should, however, be made at the present time in the percentage of allocations of Category 2 lettings. It will be noted that lettings under Category 2(c) (that is, transfer to enable release of requisitioned properties to owners), has been kept exactly to the prescribed percentage (i.e. 10%). In September an important decision was made relating to the letting of properties on the Council's permanent estates as distinct from temporary bungalows and requisitioned properties. The 48 Council resolved that all applicants approved for accommodation should be interviewed by the Housing Committee before they were granted tenancies of Council houses and flats, and this policy was operated during the last three months of the year. Transfers.—In the early part of the year, a postal survey of all requisitioned accommodation was carried out with a view to bringing up-to-date information regarding the occupation of requisitioned properties. The first results of the survey were reported to the appropriate Committee in July 1949. They showed that according to the information returned by the licensees there were 442 units of accommodation where there were insufficient bedrooms for the families, and 66 householders who had more than one room in excess of their requirements. On receiving this report consideration was given to the question of a definite policy whereby licensees in requisitioned property could be accommodated in permanent dwellings. It was decided that, in the first place, all casual voids on the Council's permanent estates should be reserved for these transfer cases. Where new properties became available, it was left that the Housing Committee should decide on the proportions to be allocated to new applicants and to transfer cases in the light of circumstances prevailing when such accommodation became available. For example, their decision in respect of the 74 Mascalls Court Flats which became available toward the end of the year was that 37 should go to transfer cases and 37 to registered applicants. The effect of this decision means that, in the majority of cases, housing applicants are accommodated in requisitioned units of accommodation in the first instance. Thereafter they are transferred to permanent accommodation. In considering such transfers, of course, the Committee take into account the records of the licensees concerned in deciding whether they would make satisfactory tenants. It was further decided that 60% of the allocations available to transfer cases should go to families where there is bedroom deficiency other than statutory overcrowding, those cases longest in occupation of requisitioned property to be considered first, and the remaining 40% to go to those cases approved on special grounds such as medical reasons, under-occupation, statutory overcrowding, occupation of temporary hutments, etc. It is too early yet to be able to say how this decision will work out in practice, but there is no reason to believe that it will be other than satisfactory. During the year a total of 127 transfers were effected, 77 of the families moving to requisitioned properties and 50 into permanent dwellings or E.F.M. bungalows. 49 Mutual Exchanges.—During the year efforts have been directed to effecting as many moves as possible by way of mutual exchange. A Mutual Exchange Register has been set up in the Housing Department for the convenience of tenants and licensees who wish to exchange accommodation with others, and this has proved effective in putting a number of families in touch with each other. The majority of mutual exchanges have, however, been the result of individual contact between families concerned, sometimes by way of advertisement. All such applications have been sympathetically considered by the Housing Committee, and the vast majority of them have been approved. A total of 47 such exchanges were effected during the year, which means of course, that double this number of families were satisfactorily housed by this means. Every opportunity is taken to bring to the notice of tenants and licencees requiring other accommodation the facilities offered through the Mutual Exchange Register, and the number of applications for these exchanges has shown a gratifying increase during the year. In dealing with these applications, the Committee have not restricted themselves to exchanges between their own tenants. In a great number of cases they have been effected with the ready co-operation of the London County Council Housing Department. Others have been arranged by co-operation with other Local Authorities, most of them in London but a few others in the provinces. It has also been possible to effect exchanges with private tenants through the co-operation of their landlords." 50 Appendix to Housing Report TABLE 'A' ANALYSIS OF HOUSING REGISTER as at 31.12.49 Points Group Minimum Accommodation Required Total EP/A0 EP/A1 A0 A1 A2 A3 B3 B4 35½— — — — 4 — 3 2 — 9 30½—35 — — — 6 18 8 1 — 33 25½—30 — 1 1 36 100 16 5 — 159 20½—25 3 1 1 61 210 43 7 2 328 15½—20 11 5 8 199 384 90 17 2 716 10½—15 33 24 4 296 426 158 31 5 977 5½—10 37 34 14 199 411 153 20 8 876 0—5 19 10 16 175 294 112 20 2 648 Approved by Committee 4 7 2 19 40 30 1 2 105 Category I — 1 — 1 9 7 1 1 20 Category IIA — — — 3 4 1 1 — 9 Total 107 83 46 999 1,896 621 106 22 3,880 TABLE 'B' CATEGORY II LETTINGS EFFECTED DURING YEAR Lettings During Year Percentage Notes Category IIA 7 4 Category IIB 133* 86 *This figure includes 18 Lettings by nomination to L.C.C. Category IIC 15 10 These are all transfer cases The 18 Category IIB nominations to the L.C.C. and the 15 Category IIC transfers are not included in the figure of 129 lettings mentioned in the report. This figure is made up as follows:— Category I Lettings 7 Category IIA „ 7 Category IIB „ 115 129 51 SECTION E Inspection of Food and Supervision of Food Premises. Food Inspection.—In reviewing the work carried out under this section, it should be recorded that due to certain alterations in legislation, 1949 was a year of interest and great endeavour in ensuring that the high standard of hygiene already attained by food handlers in the Borough was not only maintained, but in many instances, improved. Good results were observed from the display of 'Clean Food Campaign' notices in the kitchens of catering establishments and invaluable work was performed by the Food Inspectors in affording the tradesmen personal advice based on long experience. Under Section 13 of the Food and Drugs Act, 1938, authority is given for the enforcement of certain standards of cleanliness at premises where food is handled or stored and the actual conduct of food handlers is the subject of constant attention. In one instance only was gross uncleanliness observed and in this case the offender, the proprietor of a fried fish shop, was seen to foul a chip basket in use in his gutting shed. Prosecution followed and fines totalling £40 with £10 costs were imposed for this offence, an appeal to the London Quarter Sessions being dismissed and the judgment upheld. The groundwork has been prepared for the formation of a Guild of Hygiene during the year 1950 and it can be anticipated that a large number of Greenwich traders will apply for, and be granted, membership, in accordance with an agreed constitution. Milk.—This commodity has been the cause of much legislation during the year. The Food and Drugs (Milk and Dairies) Act, 1944, amends the provisions of the Food and Drugs Act, 1938, relating to the Milk and Dairies Regulations and other matters connected therewith and, in association with the Milk (Special Designations) Act, 1949, which revokes Regulation 55G of Defence (General) Regulations 1939, caused a number of new Regulations to be introduced, details of which are given below. These Acts came into operation on 1st October, 1949. The Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949, and the Milk (Special Designation) (Raw Milk) Regulations, 1949, re-enact with amendments the Milk (Special Designations) Regulations, 1936/48. All purveyors of Pasteurised, Sterilised, Tuberculin-Tested and Accredited Milk are required to be licensed by the Local Authority for the use of such designations and all Pasteurisers and Sterilisers must be licensed by the Local Food 52 and Drugs Authority, which for this area is the Greenwich Borough Council. A licence is now required under the first of the above Regulations for the sale of 'Sterilised' milk and, in addition to the Phosphatase and Methylene Blue tests for Pasteurised milk made necessary by these Regulations, a 'Turbidity' test for Sterilised milk has been instituted, the latter test indicating the standard of efficiency of the sterilising process. The method of taking samples and the carrying out of the prescribed tests are elucidated in the Schedules to the above Regulations. Payment of fees for licences is now discontinued. The Milk and Dairies Regulations, 1949, re-enact the Milk and Dairies Regulations, 1926/43, with amendments, the main alteration being that all producers and their premises (now to be known as Dairy Farmers and Dairy Farms respectively) are to be licensed by, and come under the jurisdiction of, the Ministry of Agriculture and Fisheries. As required by the Regulations, all milksellers with premises either within or outside the Borough and who trade in Greenwich were registered by the Council as 'Distributors' of milk and any premises where milk is handled or sold other than in the properly closed and unopened vessels in which it is delivered were registered as Dairies. Such foregoing requirements do not apply in the event of the milk being consumed on the premises. In the Regulations minor changes have been made relating to buildings, the cleansing of vessels and utensils and the distribution of milk and its protection against contamination and infection. Milk Supply.—This is under the direction of the Milk Marketing Board, the supplies,'in the main, coming from the Home Counties with the addition of a small quantity of highly-fatted milk from Devon and the Channel Islands. Heat treatment is general and the quality has proved to be most satisfactory. Milk and Dairies Regulations, 1949.—These Regulations, which came into force at the latter end of the year, supersede the Milk and Dairies (Amendment) Act, 1922, and the Milk and Dairies Regulations, 1926/43. Under the Regulations the Food Inspectors made 180 visits and, as a result of their inspections, the following defects were remedied by informal action:— Dairies cleansed and limewashed 1 Shop cleansed and painted 1 Provision of hot and cold water 2 At the time of the inception of the new Regulations, i.e. 1st October, 1949, the previous register of Dairies and Milkshops was 53 abolished and registers of Distributors and Dairies introduced. Fifty-eight applications for Registration as Distributor were received and approved in respect of premises within the Borough and 21 for Distributors with premises outside. It was found that, in respect of Dairies, there were very few premises where milk is handled other than in properly closed containers as delivered and at the end of the year only 6 premises had been entered into the appropriate register. The Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949, and the Milk (Special Designation) (Raw Milk) Regulations, 1949.—The Milk (Special Designations) Regulations, 1936/46, concerning the issue of Licences for the sale of milks known as Tuberculin-Tested, Accredited and Pasteurised were superseded bv the above Regulations from 1st October. At the beginning of the year and under the old Regulations the following licences had been granted:— Principal Licences Distribution of Tuberculin Tested Milk 13 „ „ Pasteurised Milk 22 Supplementary Licenses „ „ Pasteurised Milk 10 „ ,, Pasteurised Milk 10 These licences remained valid for the whole of 1949 but under the new Regulations the following additions were effected:— Principal Licences Distribution of Tuberculin Tested Milk 1 ,, „ Pasteurised Milk 1 „ ,, Sterilised Milk 53 Supplementary Licences Distribution of Tuberculin Tested Milk 6 „ ,, Pasteurised Milk 7 ,, „ Sterilised Milk 15 Supplementary Licences are granted in cases where licensed premises are situated outside the District and the Vendor desires to sell within the Borough. Heat Treated Milk (Prescribed Tests) Order, 1944.—This Order indicated the technique to be adopted in respect of the Methylene Blue and Phosphatase Tests with regard to Pasteurised Milk and, prior to the 1st October, 72 samples were taken under the Order, 7 of which failed the Methylene Blue Test. Particulars of the unsatisfactory samples were forwarded to the Area Milk Officer of the Ministry of Food. 54 Under the new Special Designations Regulations which became operative from 1st October, 1949, 12 Sterilised Milk samples were submitted to the Turbidity Test all of which proved satisfactory. Analytical Examinations of Milk.—Ninety-nine samples were submitted to the Public Analyst, 43 of which were formal and 56 informal. Three were reported as being unsatisfactory but as in each case an acceptable reason for failing to reach the required standard was furnished, the Vendors were warned against a recurrence of non-genuine reports in relation to future samples. The arrangements were continued whereby results of samples taken for analytical and heat treatment examinations from L.C.C. Schools and Nurseries, are furnished quarterly to that Authority. The results of samples taken from Hospitals in the Borough for similar purposes were reported to the appropriate Authorities. Preserved Food Premises.—In accordance with the provisions of the Food and Drugs Act, 1938, Section 14, all premises with the exception of clubs, hotels or restaurants used :— (a) for the sale or manufacture for the purpose of sale of ice-cream or other similar commodity, or storage of ice-cream or other similar commodity intended for sale ; or (b) for the preparation or manufacture of sausages or potted, pressed, pickled, or preserved meat, fish or other food intended for sale ; are required to be registered by the owner or occupier with the Sanitary Authority. Preserved Meat, Fish, etc. Premises.—Four applications for registration were received and approved under this section of the Act and at the end of the year, after adjustment, 103 premises were registered with this Authority. Two hundred and thirty-nine visits were made to these premises, insanitary conditions being detected and remedied in 5 instances. Ice Cream Premises.—Thirty-two premises were registered during the year and at the end of 1949 the total number of registrations in compliance with this section of the Act was 165. The Food Inspectors made 300 visits to registered premises and improvements were effected in 15 instances. Manufacture and Sale of Ice Cream.—The Ice Cream (Heat Treatment, etc.) Regulations, 1947, and the Amendment Regulations, 1948.—The amount of Ice-cream consumed in the Borough has considerably increased during the year and the need for strict supervision of hygiene practised by the manufacturer and vendor 55 has grown in proportion. The above Regulations were introduced to secure the elimination of pathogenic organisms by a heat-treatment process similar to that used in the pasteurisation of milk and, generally speaking, this has been accomplished. Ice Cream Sampling.—At the latter end of 1949 the Public Health Committee decided to take advantage of the Public Health Laboratory Service as provided for under the new National Health Act and in accordance with these arrangements ice-cream samples were subjected to a Methylene Blue Reductase Test and graded accordingly. Prior to this, bacteriological examinations were carried out at the Pathological Laboratory attached to the Seamen's Hospital and here the ice-cream samples were subjected to four tests, viz : 2 plate counts (at room and blood temperatures), a test for B.Coli and a Methylene Blue Reductase Test. Bacteriological examinations were carried out in respect of 137 samples, 17 of which proved to be unsatisfactory by reason of (a) the presence of B. Coli in less than I c.c.; or (b) the high bacterial count; or (c) the sample being graded 3 or 4 in accordance with the Ministry's Provisional Grading Scheme based on the results of the Methylene Blue Reductase Test. The number of unsatisfactory samples shows an appreciable and noteworthy decrease and it should be recorded that a large percentage of these were manufactured outside the Borough and under conditions over which we have no direct control. In such cases the Medical Officers of Health of the areas concerned were furnished with full details of the examinations for any action they considered necessary. Twenty-seven samples of ice-cream were taken during the year for quantitative analysis and full reference is made to this activity under the heading of Food and Drugs Act, 1938. Food Rejected.—The amount of food rejected is shown in the following summary:— Shops, Stalls, etc.— Meat— Beef 860 lbs Beef trimmings 222 „ Mutton and Lamb 324½ „ Lamb trimmings 43½ „ Bacon and trimmings 72½ „ Cooked Meat 192½ „ Meat (Canned) 1,186 „ Sausage 40 „ 2,940½ lbs. 56 Other Foods— Fish 2,771 lbs Provisions, various 1,165½ „ „ „ (canned) 251 „ Sugar 1,158 „ Custard powder, cereals, etc. 350 „ Dried Milk 112 „ Cheese and trimmings 821¼ „ Dried Fruit 81 Condensed Milk 69 „ Butter and Margarine 64½ „ Sweets 15½ „ Eggs 6 6,125¾ lbs. Total Food Rejected 9,066¼ lbs. Public Health (Meat) Regulations, 1924/48.—These regulations provide for the supervision of slaughterhouses, butchers' shops, stalls, and the protection of meat against contamination by dirt and flies, etc., in transport and handling. Butchers' shops and stalls are under the constant supervision of the Inspectors and proceedings are only instituted after disregard of the Officer's warning. In no case was it found necessary to caution Vendors during the year. To improve the standard of hygiene, structural and other defects were remedied in 31 instances mainly as a result of informal action. Slaughterhouses.—Two premises in the Borough originally licensed as slaughterhouses have not been used as such since the introduction of the Livestock (Restriction of Slaughtering) Order, 1940. In both instances the premises are no longer to be used as slaughterhouses and the issue of the appropriate licences has therefore been discontinued. Public Health (Imported Food) Regulations 1937 and 1948 —The Metropolitan Borough of Greenwich with a river frontage of five miles, with more than 30 wharves and two of London's largest and most modern cold stores receives a considerable percentage of London's imported meat stored on behalf of the Ministry of Food. In addition considerable quantities of fresh fruit, tinned foods and miscellaneous provisions are dealt with. Visits to wharves and cold stores are made by the Food Inspectors and imported food generally is carefully supervised. Imported Food Rejected.—The following unsound or diseased imported foods were surrendered, the meat being passed for non-edible and refining purposes, and other unsound food, with the exception of fruit pulp and juice, being processed for stock feeding. 57 The following foods were rejected at the wharves:— Meat— Lamb trimmings 3 lbs. Salted Pigs' Ears and Chitterlings 978 „ Whalemeat 2,045 „ Whalemoat trimmings 1,291 „ 4,317 lbs. Other Foods— Condensed Milk 2,640 „ Fruit Pulp 22,226 „ Fruit Juice 3,072 „ 27,938 lbs. Total Imported Food Rejected 32.255 lbs. Caseous Lymphadenitis.—During the year, the sum total of all carcases examined for this condition and the results of such examinations are given in the following table:— Landed Examined Rejected Weight Mutton Carcases 75,065 2,983 9 slight lesions 3 lbs. Bags of Mutton 5,064 69 — — Merchandise Marks Act, 1926.—Under the powers conferred by this Act, Orders in Council have been made prohibiting the sale or exposure for sale, of imported foodstuffs unless bearing an indication of the country of origin. One hundred and eighty-five inspections were made to secure compliance with the various Orders but on no occasion was it found necessary to take action against Vendors. Blackheath Fair.—Blackheath once again provided accommodation for a large Fair at Easter, Whitsun and the August Bank Holiday and thousands of people from this and adjacent Boroughs availed themselves of the opportunity of making a visit to this source of entertainment. Constant supervision of the food stalls was necessary to ensure that a safe standard of cleanliness was maintained among the vendors of such light refreshments as shellfish, stewed eels, ice-cream, minerals, etc., and to this end a Food Inspector was always in attendance. The observance of hygiene on these occasions was assisted by the provision of a clean water supply and adequate sanitary accommodation by the London County Council Parks Department. Street Traders.—There were 64 Street Traders engaged in selling articles of food in the Borough and who were licensed in accordance with the provisions of the London County Council 58 (General Powers) Act, 1947. The premises where such articles of food were stored, were kept under regular supervision by the Food Inspectors. Supervision of Premises Including Factories Where Food is Prepared.—Flour-millers, brewers, mineral water, pharmaceutical sundries, ice-cream, whalemeat packing and fruit-canning factories were among the premises visited on 5,179 occasions to ensure that a satisfactory state of hygiene was maintained by all food traders in the Borough. It was found necessary to serve notices to cleanse and limewash or otherwise improve premises, on 10 occasions only—improvements being effected mainly on verbal instructions. The considerable decrease in the number of notices served is the direct result of the persistence and vigilance of the Food Inspectors who have during the past few years raised the standard of food traders' premises to the present high level. Food Premises No of Visits No. of Improvements effected. Caterers' and Restaurants 722 93 Butchers' Shops 441 31 Dairies and Milkshops 180 4 Wharves and Factories 169 1 Bakehouses 155 19 Ice Cream Shops etc 300 15 Fried Fish Shops 185 10 Other Fish Shops 97 6 Cooked Meats & Preserved Foods 239 5 Brewery 1 — Fairs 27 — Miscellaneous Visits & Interviews 376 30 Re Rat Infestation 45 — Sampling Visits 662 — Visits Re Food & Drugs Act 123 — Re Merchandise Marks Act & Markets 185 — Re Shops Act 62 — Other Visits 880 — Food Poisoning Investigations 6 — Complaints Investigated 124 — Totals 5,186 214 59 Basement Bakehouses.—As the result of an examination made under Section 54 of the Factories Act, 1937, notice was given at the commencement of the year that the Certificate of Suitability issued in respect of the basement bakehouse at 29, Blackheath Road, S.E.10., would cease to have effect after the expiration of a period of 3 years from the date of the said notice. After this time the premises will no longer be used as a bakehouse. These premises form part of a clearance area and as a result, the repairs made necessary by war damage with its consequent dilapidations, were not sanctioned. Notice that the premises would be closed at the expiration of a period of 3 years was, therefore, served on the assurance that satisfactory alternative accommodation would be provided in the re-planning of the area. The basement bakehouses in use in the Borough, including the above premises, now number 6. Catering Establishments.—Of the large number of food trades represented in the Borough the Catering Establishment plays a major part in the harmonious operation of the business and industrial life of Greenwich. Hotels, cafes, restaurants and public houses provide refreshments not only to the inhabitants of the Borough but to numerous visitors who come by road, rail and river to spend leisure hours at the National Maritime Museum, the famous Greenwich Park and other places of historical interest. The Food Inspectors ensure that a high standard of cleanliness is maintained at these establishments by regular and frequent visits, the total number of inspections during the year amounting to 722. As a result of visits made to public houses certain reconstructional works have been effected. Brewers have, in all cases, provided a direct supply of hot water to the bars for proper and efficient washing of glasses. In increasing numbers the publicans are supplying sandwiches, buttered rolls, etc., at the counter for sale with liquid refreshment and in these instances they have been advised as to the most hygienic methods of handling the foods. The following table indicates the type of improvements secured in local catering establishments:— 60 Type of Improvement Effected Total No. Cleansed and painted 51 Ceilings repaired 2 Walls repaired 2 Floors „ 2 W.C.'s „ or provided 4 Natural Lighting improved 2 New Sinks fitted 30 Hot and/or Cold water installed 28 Dustbins and Swill Bins provided 2 Food Stores provided 2 Staff rest-rooms provided 2 Refrigerators repaired or installed 3 Waste Pipes fitted or amended 8 Premises partly reconstructed 3 Miscellaneous improvements 17 Total 158 Food and Drugs Act, 1938.—During the year 481 samples were taken and submitted to the Public Analyst for analysis under the provisions of the above Act and of these, 58 were formal and 423* informal. Twenty samples (4 formal and 16 informal) were reported upon as being non-genuine, the resultant adulteration figure of 4.1 % of the total samples examined was 1.3% less than that of the previous year. As in past years, Milk was the main commodity sampled and of the 99 samples sent for examination (43 formal and 56 informal) only 3 proved to be non-genuine. As satisfactory explanations were furnished in each instance no proceedings were instituted in respect of any of the adulterated samples but the Vendors were warned that future adverse reports of analyses to which their careless handling had contributed would result in more stringent action on the part of the Council. For some time now ice-cream manufacturers have been taking advantage of the Ministry of Food's scheme of extra allocation of fat and sugar for the preparation of ice-cream and, in view of this fact, *This figure includes two samples of whalemeat taken 'on request' and not in the normal course of Food and Drugs sampling. These samples were taken after 3 weeks' application of ozone to ammoniacontaminated whalemeat. This treatment effected a considerable reduction of the amount of ammonia present and the whalemeat was released for consumption. These samples have not been included in the adulteration percentage figures. 61 the Ministry requested that copies of quantitative analysis reports of ice-cream samples taken in the Borough should be forwarded. Although no legal standard has yet been adopted, the Ministry considered that samples of ice-cream taken from manufacturers availing themselves of the above scheme should contain a minimum of 2½% fat. Twenty-seven samples were examined during the year and all exceeded this requirement, the percentage in ordinary ice-cream ranging from 3.4% to 10.1% and in chocolate-coated from 16.6% to 22.8%. Public Health (Dried Milk) Regulations, 1923 and 1927.— No samples were taken under these Regulations during the year. Public Health (Condensed Milk) Regulations, 1923-1927. Three samples were taken under these Regulations and all proved to be genuine. NOTIFICATION OF FOOD POISONING Under the provisions of Section 17 of the Food and Drugs Act, 1938, every registered medical practitioner attending on any person shall, if he suspects or becomes aware that any person is suffering from food poisoning, forthwith notify such case to the Medical Officer of Health. Six cases were notified during the year, as compared with 5 for the year 1948. Each case was investigated thoroughly in order to ascertain the source of infection but in no instance was direct connection with any specific food established. A complete recovery was made by all patients. 62 Administrative Action Taken in Regard to Samples Reported to be NOT GENUINE. Sample No. Article Nature of adulteration or irregularity Action taken T. 3 Beef Sausage Was deficient in meat to the extent of 8% by weight Final warning letter T. 4 Tomato paste (canned) Excessive copper content Warning letters to Wholesaler and Importers T. 9 Whalemeat (after three weeks application of ozone) Contained 0.17 % ammonia This food, on being held at Cold Storage Warehouse was found to be contaminated by ammonia T. 10 Whalemeat (after three weeks application of ozone) Contained 0.18% ammonia Ozone was applied for three weeks and, on request 'test' samples were taken. Only small ammonia content remained and the food was released for consumption T. 95 'Frutella' Dessert Infested with mites Stock destroyed. T. 96 'Thirst Quenchers' Not in accordance with the Labelling of Food Order, 1946, in that the presence of 4% Calcium Carbonate was not noted on label Manufacture discontinued T. 108 Cod, Liver and Roe paste (canned) Contained cereal filler, calculated as dry starch—2.4%. Not noted on label Warning letter to Wholesaler T. 147 Sweet Fat Unsatisfactory quality, being stale and unpalatable owing to oxidative rancidity Existing stock withdrawn T. 226 Seidlitz Powder Contravened Pharmacy and Medicines Act, 1941 in that no statement of ingredients appeared on the label Manufacture discontinued T. 227 Lemon Crystals Contravened Labelling of Food Order, 1946 in that no statement of ingredients appeared on label and the claim as to ascorbic acid not expressed in manner prescribed Satisfactory explanation received from Wholes alers 63 Sample No. Article Nature of adulteration or irregularity Action taken T. 275 Chutney Contained Sulphur Dioxide to the extent of 300 parts per million by weight Satisfactory explanation received from Manufacturer T. 307 Mushrooms (preserved) The sample contained 90% salt and 10% dried mushroom. It had a fetid, revolting smell Stock destroyed T. 320 Breakfast Sausage Contained Soya meal, a prohibited ingredient, of a quantity not less than 5% Reported to the Enforcement Branch, Ministry of Food T. 332 Luncheon Sausage Contained Soya meal, a prohibited ingredient, of a quantity not less than 5% Reported to the Enforcement Branch, Ministry of Food T. 364 Pastry Mix The sample was rancid, the fat in it containing 5.9% of free and saponified fatty solids Stock withdrawn from sale T. 397 Friars Balsam Pastilles Quantity of Friars' Balsam contained in pastilles considered by Public Analyst as too small to justify description Full consideration given to report. Decided that no further action necessary T. 401 Pastry Mix The sample was rancid. The fat contained 6.8% of free fatty acids Stock withdrawn from sale T. 416 Dessert Powder Contained potato starch the presence of which was not included in the statement of ingredients on the label Explanation, by importer, that small quantity of potato starch detected used as conveyer for colouring and flavouring material, accepted. 812 Beef Sausage Contained only 45% meat by weight Referred to Ministry of Food. Further action not warranted 815 Milk Deficient in solids not fat-equivalent to 1% added water Warning letter Explanation accepted 819 Milk Deficient in solids not fat-equivalent to 1% added water Warning letter. Explanation accepted 825 Milk Deficient in solids not fat-equivalent to 1% added water Warning letter. Further sample proved genuine 64 SECTION F Prevalence of, and control over, infectious and other Diseases The total number of infectious diseases notified under Section 192 of the Public Health (London) Act, 1936, and associated Orders and Regulations was 1,247. Under the Public Health (Tuberculosis) Regulations, 1930, there were 127 notifications, giving a consolidated total of 1,375 infectious diseases notified during the year. In 40 of these cases the diagnoses were not confirmed, thus giving a corrected figure of 1,335. There have been no outbreaks giving cause for alarm and, as indicated in the following table, this total is slightly less than the average for the last five years:— Year No. of corrected notifications 1945 1,216 1946 1,691 1947 1,013 1948 1,671 1949 1,335 Average 1,385 Particulars of age groups and districts affected are shown in the tables at the end of the Report. Smallpox.—There were no cases notified during the year but a number of contacts were reported arriving in the Borough from abroad and these were kept under observation for the requisite period. Public Health (Smallpox Prevention) Regulations, 1917.—It was not necessary for your Medical Officer of Health to take any action during the year. Measles.—There were 791 notifications received of which two were not confirmed. The corrected total of 789 compares with 928 for the previous year and 278 for 1947. The distribution of the cases was as follows :—East Greenwich 332, West Greenwich 199 ; St. Nicholas, Deptford, 24 ; Charlton and Kidbrooke 234. Twenty-seven cases occurred in children under one year of age, 460 between 1 and 5 years, and 281 between the ages of 5 and 15. The outbreak began in February, reached its peak in early June, finally subsiding towards the end of July. Forty-one cases were removed to hospital, two of which were subsequently re-diagnosed as forms of Dermatitis. There were no fatalities. 65 Whooping Cough.—The figure of 194 notified cases compares favourably with the total of 385 for the previous year. Of the 194 cases notified, 71 occurred in East Greenwich ; 31 in West Greenwich 12 in St. Nicholas, Deptford ; and 80 in Charlton and Kidbrooke. Twelve cases were under one year of age ; 122 between 1 and 5 years ; and 60 between the ages of 5 and 15. Thirteen cases were removed to hospital. There were no fatalities among the notified cases. The death of a child of 4 months in the Brook Hospital was later attributed to this cause although no notification had been received in respect of this case. Diphtheria.—Out of 9 cases notified, 7 were subsequently re-diagnosed giving a final total of 2 which is the lowest figure ever recorded. There were no fatalities arising from this disease. Antitoxin.—In accordance with the Antitoxin Order, 1910, a supply of Antitoxin is provided by the Council for the use of General Practitioners in emergency cases. One request was dealt with during the year. Bacteriological Examinations.—Three hundred and fifteen swabs from suspected cases of Diphtheria were forwarded by Medical Practitioners for bacteriological examination. Of this number only 1 proved to be positive in character, being dealt with accordingly. Acute Primary Pneumonia and Acute Influenzal Pneumonia.—There were 30 cases attributed to these causes as compared with 32 for the previous year and 72 during 1947. Eight occurred in East Greenwich ; 9 in West Greenwich ; 5 in St. Nicholas, Deptford; and 8 in Charlton and Kidbrooke. There was one death ascribed to Acute Influenzal Pneumonia. Seven cases were removed to hospital. Typhoid Fever.—In the first instance 2 cases were notified, one of which was not confirmed. Subsequently, a notified case of Zymotic Enteritis was re-diagnosed as Typhoid Fever, thus giving a final figure of 2 attributable to this cause. Both cases received hospital treatment which resulted in complete recovery. Despite investigation, no contact with other cases or other source of infection could be established in the first of these two cases, but in respect of the second, the patient was an ex-passenger of the liner S.S. " Mooltan " which arrived from Australia in the middle of December. Several members of the crew were diagnosed as suffering from the disease. Thorough investigation was carried out, including the taking of 20 specimen faeces, all of which proved negative. 66 Scarlet Fever.—After deducting 14 unconfirmed cases there remained a total of 128 notifications received during the year compared with 78 in the previous year and 151 in 1947. The distribution was 54 in East Greenwich ; 20 in West Greenwich ; 7 in St. Nicholas, Deptford ; and 47 in Charlton and Kidbrooke. Of the 128 confirmed cases, 44 received hospital treatment, although a further 14 admitted to hospital as Scarlet Fever cases were re-diagnosed and discharged. No deaths resulted from this disease. Erysipelas.—Compared with 22 for the previous year, 20 cases were notified during 1949 and of these 11 were removed to hospital. There were no fatalities. Zymotic Enteritis or Epidemic Diarrhoea (Children under 5 years of age).—Originally 26 cases were notified but this figure was modified and 18 were eventually recorded as confirmed compared with 23 for the previous year. Of these cases 11 were under 1 year and 7 were between 1 and 5 years. There were no fatalities arising from this disease among the notified cases but the death of a child of 3 months in the Brook Hospital was attributed to this cause although no notification was received in respect of this case. Dysentery.—Two cases, both originally notified as GastroEnteritis and later re-diagnosed, occurred during the year, compared with 5 and 4 respectively in the years 1948 and 1947. Scabies.—This disease continues to be notifiable under the County of London (Scabies) Regulations, 1943, and during the year 14 cases were so notified. This figure shows a marked decrease from that of the previous year, viz : 46, and it is very satisfactory to note the remarkable decline from 405 in 1944 to the present figure of 14. The use of the Centre at St. Alfege's Hospital was discontinued in the latter half of the year under review and from November onwards treatment of all cases has been carried out at the Tunnel Avenue Centre. Puerperal Pyrexia.—There were 6 cases attributed to this disease but 2 were not confirmed, giving a final total of 4 compared with 11 for 1948 and 8 for 1947. All but one case received treatment in hospital. There were no deaths. Ophthalmia Neonatorum.—One notification of non-venereal type was received during the year. The case, which occurred in Charlton, was treated at home and kept under observation by the Health Visitor until full recovery. 67 Cerebro-Spinal Meningitis.—Although 5 notifications were received during the year, every case was subsequently re-diagnosed. Four cases occurred in 1948 and 7 in 1947. Acute Anterior Poliomyelitis.—Four confirmed cases occurred during the year as compared with 5 in the previous year and 16 in 1947. There were no deaths. Continued Fever.—One notification was received in respect of this disease but was not confirmed. Tuberculosis.—During the year 127 cases of Tuberculosis were notified in the Borough, 3 more than in 1948. Of this number 117 were of the pulmonary type, ordinarily known as consumption, and 10 were non-pulmonary, i.e., tuberculosis of parts of the body other than the lungs. The following table gives the distribution:— Pulmonary NonPulmonary Total East Greenwich 31 2 33 West Greenwich 30 6 36 St. Nicholas, Deptford 6 — 6 Charlton and Kidbrooke 50 2 52 Totals 117 10 127 Disinfection was offered and carried out in 88 cases, including 171 rooms and 1,174 articles of bedding, etc. The number of notified Tuberculosis cases remaining on the Register at 31st December, 1949, was as follows:- PULMONARY NON-PULMONARY Men Women Children Total Men Women Children Total M F M F 408 298 44 52 802 15 24 15 8 62 68 Verminous Conditions.—The procedure adopted to combat infestation by lice and general verminous conditions is essentially the same. In addition to the notified cases of Scabies, all suspected cases are followed up and the homes visited by the Woman Sanitary Inspector, assisted by a qualified Nurse who gives advice and instruction concerning treatment. School-children were dealt with at the Council's Cleansing Station at Tunnel Avenue and adults, together with children under 5 years of age, were treated at the Bathing Centre attached to St. Alfege's Hospital up to October in the year under review. From November cases of all ages have received treatment at the Tunnel Avenue Cleansing Station. The following return summarises the work carried out during the year:— Attendances Vermin Scabies Adults 3 201 Children under school age 8 116 School children 837 137 No. of home visits by Nurse 317 No. of home re-visits by Nurse 951 Disinfection.—The disinfection of rooms is effected by the formaldehyde spray. This is carried out on removal of the infectious case or termination of the illness and, on request, for conditions other than notifiable. In cases of request a charge is made according to the circumstances of the case. Bedding and wearing apparel may be removed to the Disinfecting Station, Tunnel Avenue, where they can be submitted to steam disinfection. Books may be treated with formalin. The following return shows in detail the work carried out during the year:— Rooms and Articles Disinfected, Year ended December, 1949 Diseases, etc. Premises Entered Rooms Beds Mattresses Bolsters Pillows Sheets Blankets Eiderdowns Cushions Quilts Odd Articles Wearing Apparel Rugs and Mats Covers Total No. of Articles Disinfected Scarlet Fever 121 180 55 108 70 250 242 337 53 26 71 342 407 17 80 2,058 Diphtheria 12 19 6 11 8 22 28 30 3 4 8 21 37 9 5 192 Tuberculosis 88 171 28 58 40 156 114 191 32 28 27 246 218 6 30 1,174 Cancer 26 41 12 17 18 67 50 58 10 16 12 62 36 2 14 374 Cerebro-Spinal Fever 10 12 4 8 6 23 21 28 3 1 4 21 44 — 7 170 Puerperal Fever — — — — — — — — — — — — — — — — Typhoid Fever 3 4 1 4 1 5 6 11 — 1 2 2 14 8 1 56 Polio-Myelitis 9 17 5 9 7 21 18 22 3 3 5 17 27 1 6 144 Erysipelas — — — — — — — — — — — — — — — — Whooping Cough 1 2 1 2 — 3 4 4 — — 1 — — 1 2 18 Measles 8 18 — 16 1 20 13 36 — — 2 17 18 — 1 124 Scabies 3 4 — 7 2 7 28 18 1 — 7 153 8 — 2 233 Other Diseases 61 75 19 88 20 133 36 374* 7 15 12 69 3,401† — 10 4,184 Verminous Premises 29 — 16 47 24 77 54 112 12 15 28 62 91 2 26 566 Day time Nurseries — — — — — — — — — — — — — — — — Totat. 371 543 147 375 197 784 614 1,221 124 109 179 1,012 4,301 46 184 9,293 Articles destroyed — — 19 32 6 31 11 17 3 5 — 103 23 — 5 255 Notes:— * 200 disinfected on behalf of a firm for exportation. † 3,356 ,, ,, ,, ,, ,, ,, ,, ,, 70 TUBERCULOSIS REPORT 1949 I am indebted to Dr. C. W. L. Jeanes, Chest Physician, for the following report on Tuberculosis in the Borough:— " During the year 272 new cases of tuberculosis of all types were notified, including 131 cases transferred from other districts. Notifications and deaths since 1938 are shown in the following tables:— Year. Pulmonary Tuberculosis. Non-Pulmonary Tuberculosis. Deaths. 1938 153 38 53 1939 93 14 60 1940 125 17 73 1941 138 32 74 1942 164 18 64 1943 117 26 60 1944 113 16 47 1945 149 16 53 1946 173 18 56 1947 171 13 67 1948 112 17 62 1949 117 10 53 Of the 127 cases notified primarily, 121 came under the care of the Dispensary, and were made up as follows :— Pulmonary Tuberculosis Non-Pulmonary Adults Children Adults Children 93 19 8 1 Only 43 of the 93 new adult cases had positive sputum on diagnosis. In most cases this meant that the disease was not infectious on diagnosis. Against this, however, must be recorded the fact that the waiting time for admission to Hospital and Sanatorium is now often as long as 1 year. During this time, unfortunately, the early case may well become advanced before admission to Hospital, with the possible risk of infecting others in the same family. To counteract this, a scheme of domiciliary treatment has been worked out by the Chest Physician. In suitable cases collapse therapy is started in the patient's home, and where indicated the new tuberculostatic drugs—Streptomycin, Para-amino-salicylic acid and Thioparamizone—are administered. In 1949, 21 Pneumoperitoneums and 7 Artificial Pneumothoraces were successfully induced at home. In most of these cases the patients' disease was rendered quiescent by the treatment before 71 Sanatorium vacancies were offered, with the consequent saving of hospital beds. The problem of the chronic sputum-positive case remains as great as ever. There are 85 such cases attending the Clinic for supervision. In a number of cases there are in the homes of these patients child contacts who require very careful supervision. B.C.G. vaccination will be available in the near future which will provide an additional safeguard for children thus exposed to infection. These schemes have provided much additional work at the Clinic with consequent increase in the duties of the nursing and medical staff. For example, the number of patients attending for pneumothorax refills has increased from 15 per week in 1946 to 65 per week in 1949. X-rays are essential for the early diagnosis. In 1945, 625 Xrays were taken. By 1949 this number had been increased in the year to 3,646. At present the Clinic has no X-ray apparatus of its own, which is a very regrettable fact. Without such apparatus being freely available in a chest clinic the control of Tuberculosis must be deficient, and the treatment given to patients, especially those undergoing collapse therapy, must be very unsatisfactory, if not often dangerous. Deaths.—Among patients attending the Dispensary there were 48 deaths. Pulmonary Tuberculosis. Non-Pulmonary Tuberculosis. Adults Male 27 — Female 18 — Children 2 1 Total 47 1 There were also 4 deaths from Pulmonary Tuberculosis, and 1 from Non-Pulmonary Tuberculosis among non-clinic patients, making the total deaths in the Borough 53. 72 Tuberculosis Dispensary.— No. of New Cases examined 1,262 No. of Cases of Tuberculosis notified 122 No. of X-rays reported on by Chest Physician 3,646 No. of Artificial Pneumothorax Refills 3,215 No. of patients' attendances 4,474 No. of Nurses' visits 3,046 No. of Medical Consultations in Patients' homes 468 An efficient medical service for tuberculosis demands a comprehensive social welfare service within its structure. At the Chest Clinic every patient is seen by the Almoner to ensure that as far as possible he can co-operate with the treatment recommended by the Chest Physician and that there is no domestic, financial or personal difficulty which may constitute a hindrance to recovery. Not only at the commencement, but all during the course of a long illness, problems are dealt with which cannot be recorded in figures because of their intangible nature but are, nevertheless, a most important part of general welfare. Some of the patients need financial help when unexpected or urgent needs arise and the Care Committee's fund is available to help. During 1949,£315 was spenton individual needs,s summer outing for softie of the patients and postal orders to patients in hospital at Christmas-time." INDEX Page A Acute Anterior Poliomyelitis 67 Adoptive Acts, By-laws and Local Regulations 3, 4 Age Mortality 16 Aged, Infirm and Physically Incapacitated Persons 39 Ante-Natal Clinics 24 Ante-Natal Clinics, Attendances 22 Anti-Fly and Anti-Mosquito Measures 31, 32 Area of Borough 10 Articles and Rooms Disinfected 69 Articles Destroyed 69 Artificial Pneumothorax 70, 72 Artificial Sunlight Centres, attendances 23 Artificial Sunlight Treatment 25 B Bacteriological Examinations 55, 65 Baiting of Sewers 36 Basement Bakehouses 59 Baths and Wash-houses 33, 34 B.C.G. Vaccine 71 Births 15 Birth Registrations 15 Blackheath Fair 57 Bomb-damaged Buildings, Nuisances arising from 30 Bronchitis 19 Burial or Cremation of the Dead 39 C Cancer 19 Care Committee, Tuberculosis 72 Caseous Lymphadenitis 57 Catering Establishments 59 Cerebro-Spinal Meningitis 67 Chest Clinic 27, 70-72 Chiropody Clinics 25 Chiropody Clinics, Attendances 23 Circulatory System—Diseases of 19 Classification of Deaths 17 Cleansing of Children 68 Cleansing and Scabies Clinic 26 Page Clinics and Centres 21-26 Common Infectious Diseases 18 Complaints 27, 40 Continued Fever 67 Council Rehousing 43 Cremation or Burial of the Dead 39 D Day Nursery 26 Deaths 15 Death Registrations 15 Death Causes, Remarks 17-19 Deaths from Violence 19 Deaths in Institutions 16 Death, Tables showing Causes of and Ages at Appendix Deaths, Tables showing Causes of and Ages under 1 Appendix Defective Dwellings—Repairs 30, 31 Density of Population 10 Dental Clinics 25 Dental Centre Attendances 22 Diarrhoea and Zymotic Enteritis 18, 66 Diphtheria 18, 65 Diphtheria Prophylaxis Cases 23 Diphtheria Immunisation Clinics 5 Diseases of Circulatory System 19 Diseases of Respiratory System 9 Disinfecting Station 26 Disinfection 68, 69 Disinfestation of Verminous Premises 36 Disinfestation Scheme 31, 32 Domestic Helps 20 Drainage, New and Alterations to 37 Drinking Fountains 38, 39 Duties and Powers of the Public Health Committee 3, 4 Dysentery 66 E Elevation of Borough 10 Enteric Fever 18, 65 Erysipelas 66 INDEX (continued) Page E.W.S. Sites, Nuisances arising from 30 Exhumations 39 Extracts from Vital Statistics 12, 13 F Factories Act, 1937 27-29 Family Planning Association, Sessions 26 Food—Inspection of 51-61 Food Poisoning, Notification of 61 Food—Premises for Preparation of 54, 58 Food Rejected 55, 56, 57 Food & Drugs—Non-genuine Samples 62, 63 Food & Drugs Act, 1938, Samples taken under 60 Foot Clinics 25 Foot Clinics, Attendances 23 G General Statistics 10-13 Grit Emission and Smoke Abatement 29 H Habitation Certificates (Water Supply) 37 Health Centres 20-26 Health Visitors, Visits, etc 21 Heart Disease 19 Heat Treated Milk (Prescribed Tests) Order, 1944 53 Home Helps 20 Home Helps Service, Applications for 26 Horse Troughs 39 Houses Let in Lodgings 34 Housing 43-50 Housing, "Points Scheme" Progress 45-50 Housing Act, 1936 45 Housing Accommodation 43, 44 Housing Homeless Persons 43 I Ice-Cream — Bacteriological examinations 55 Ice-Cream, Chemical Analysis of 60, 61 Ice-Cream (Heat Treatment) Regulations, 1947 54,55 Page Ice-cream Premises 54 Immunisation and Vaccination Clinics 25 Immunisation and Vaccination Clinics, Attendances 23 Imported Food Rejected 56, 57 Infantile Mortality 13, 16, 17 Infant Welfare Centres 24 Infant Welfare Clinics, Attendances 21 Infectious Diseases 18, 64-69 Inhabited Houses 10 Institution Deaths 16 Intra-Cranial Lesions 19 Introductory Review 6-9 L Laboratory Work 55, 65 Legal Proceedings 42, 51 M Marriages 13 Maternal Mortality 13 Maternity and Child Welfare 20-26 Maze Hill Clinic (Tuberculosis) 26 Measles 18, 64 Meat Regulations 56 Meat Surrendered 55, 57 Merchandise Marks Act, 1926 57 Meteorological Observations 14 Milk, Analysis of 54, 60 Milk and Dairies Regulations 51-54 Milk & Dairies Regulations, 1949 52 Milk—Heat Treated 53 Milk (Special Designations) Act, 1949 51 Milk (Special Designations) (Pasteurised & Sterilised Milk) Regulations, 1949 51, 53 Milk (Special Designations) (Raw Milk) Regulations, 1949 51, 53 Milk (Special Designations) Regulations, 1936/46 53 Milk Supply 52 N Notices, etc 27, 41 Notifications of Infectious Diseases 64-68 & Appendix INDEX (continued) Page Notifications of Food Poisoning 61 Nurseries and Child Minders Regulation Act, 1948 20 Nursing Associations 26 O Ophthalmia Neonatorum 66 Outworkers 27, 29 Overcrowding 44 P Persons Cleansed 68 Pharmacy & Poisons Act, 1933 36, 37 Pig Bins, Nuisances arising from 34 P.H. (Condensed Milk) Regulations 61 P.H. (Dried Milk) Regulations 61 P.H. (Imported Food) Regulations 56 P.H. (Meat) Regulations 56 P.H. (Smallpox Prevention) Regulations 64 Pneumonia 19, 65 Poliomyelitis 67 Population 10, 12 Post-Natal Attendances 22 Powers & Duties of the Public Health Committee 3, 4 Preserved Food Premises 54 Proceedings under Housing Act, 1936 45 Prophylaxis Cases 23 Prophylaxis Clinics 25 Public Health Committee 3 Public Health Laboratory Service 55 Public Open Spaces 11 Public Sanitary Conveniences 37-39 Puerperal Pyrexia 66 R Rateable Value 10 Rates, Births and Deaths, etc 12, 13 Rat Repression 34-36 Refuse Disposal 32, 33 Registered Births 15 Registered Deaths 15 Registrar—Office Hours 26 Registration of Preserved Food Premises 54 Rehousing 43 Page Remarks on Various Death Causes 17-19 Rent & Mortgage Interest (Restrictions) Acts 33 Requisitioned Accommodation 43 Respiratory System, Diseases of 19 River Smells 30 Rodent Control 34-36 S Sanitary Conveniences 37-39 Sanitary Work—Summaries, etc. 40, 41 Scabies 66 Scabies & Cleansing Clinics 26 Scarlet Fever 18, 66 Scavenging and Refuse Disposal 32, 33 Sewers—Baiting of 36 Shops Act, 1934 37 Slaughterhouses 56 Smallpox 18, 64 Smells from River 30 Smoke Abatement and Grit Emission 29 Social Conditions of the Area 11-12 Staff of Public Health Department 5 Statistical Tables Appendix Street Traders 57,58 Supplies of Underground Water (Wells) 37 T Treatment Centres and Clinics 24-26 Tuberculosis 18, 67, 70-72 Tuberculosis Care Committee 72 Tuberculosis Handicraft Centre Sessions 26 Tuberculosis Officer's Report 70-72 Typhoid Fever 18, 65 U Underground Water Supplies (Wells) 37 Uninhabited Houses 10 Unsound Food 55-57 V Vaccination Cases 23 Vaccination and Immunisation Clinics 25 INDEX (continued) Page Various Death Causes, Remarks on 17-19 Verminous Conditions 68 Verminous Premises 36, 69 Violent Deaths 19 Vital Statistics 10-19 & Appendix W Water—Underground Supplies (Wells) 37 Water Supply 37 Water Supply Certificates 37 Wells 37 Page Whooping Cough 18, 65 Whooping Cough Prophylaxis Cases 23 Whooping Cough Prophylaxis Clinics 25 Women's Special Clinic 26 X X-Ray Examinations 72 Z Zymotic Diseases 18, 66 INFANTILE MORTALITY DURING THE YEAR 1949 Deaths from stated Causes in Weeks and Months under 1 Year of Age. Cause of Death. Under 1 week. 1—2 Weeks. 2—3 Weeks. 3—4 Weeks. Total under 1 Month. 1—3 Months. 3—6 Months. 6—9 Months. 9—12 Months. Total Deaths under One Y«ar. Small-Pox ... ... ... ... ... ... ... ... ... ... Chicken-Pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... 1 ... ... 1 Diphtheria—Croup ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... Pulmonary Tuberculosis ... ... ... ... ... ... ... ... ... ... Tubercular Meningitis ... ... ... ... ... ... ... ... ... ... Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... ... Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... ... ... Convulsions ... ... ... ... ... ... ... ... ... ... Diseases of Trachea ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... ... ... ... ... ... Pneumonia (all forms) 1 ... ... 1 2 ... 2 ... 2 6 Diarrhoea (all forms) ... ... ... ... ... ... ... ... ... ... Gastro-Enteritis ... ... ... ... ... ... 1 ... ... 1 Injury at Birth 2 ... ... ... 2 ... ... ... ... 2 Atelectasis 3 ... ... ... 3 ... ... ... ... 3 Congenital Malformation 4 2 1 ... 7 ... 1 1 ... 9 Premature Birth 12 ... ... ... 12 ... ... ... ... 12 Atrophy, Debility and Marasmus ... ... ... ... ... ... ... ... ... ... Suffocation, Overlay ... ... ... ... ... ... ... ... ... ... „ Otherwise ... ... ... ... ... ... 1 ... ... 1 Other Causes ... ... ... ... ... ... ... 1 ... 1 Totals 22 2 1 1 26 ... 6 2 2 36 Male 19 Female 17 CASES OF INFECTIOUS DISEASE notified during the Year ended 31st December, 1949. Notifiable Disease Cases Notified in Whole District Total Cases Notified in each Locality No. of Cases removed to Hospital from each Locality Age & Sex Group At all Ages 0 to 1 1 to 3 3 to 5 6 to 10 10 to 15 15 to 25 25 to 45 45 to 65 65 and over Greenwich East Greenwich West St. Nicholas Charlton and Kidbrooke Greenwich East Greenwich West St. Nicholas Charlton and Kidbrooke Total m f m f m f M f m f m f m f m f m f m f Small-Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 1 1 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 1 ... ... ... 1 ... ... 1 Dysentery 2 ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 1 ... ... 1 2 Erysipelas 8 12 ... ... 1 ... ... ... ... ... 2 ... ... ... 2 4 1 6 2 2 12 2 ... 6 7 ... ... 4 11 Acute Polio-Mylelitis 2 2 ... 1 1 ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 3 ... ... 1 2 3 Scarlet Fever 65 63 ... ... 13 6 11 13 31 38 6 5 3 1 1 ... ... ... ... ... 54 20 7 47 24 7 1 12 44 Enteric Fever 1 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 1 ... ... 1 1 ... ... 2 Scabies 5 9 ... ... ... ... ... ... 1 3 1 1 ... 1 2 3 1 1 ... ... 9 2 1 2 ... ... ... ... ... Puerperal Pyrexia ... 4 ... ... ... ... ... ... ... ... ... ... ... l ... 3 ... ... ... ... ... 1 1 2 ... 1 ... 2 3 Cerebro Spinal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Malaria ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 427 362 12 15 134 109 129 98 143 131 2 5 6 3 1 1 ... ... ... ... 332 199 24 234 8 3 2 26 39 Whooping Cough 113 81 5 7 41 21 29 31 38 21 ... 1 ... ... ... ... ... ... ... ... 71 31 12 80 3 4 2 4 13 Diarrhoea 7 11 5 6 2 4 1 ... ... ... ... ... ... ... ... ... ... ... ... 7 4 3 4 6 2 3 4 15 Ophthalmia Neonatorum ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... Pneumonia, Acute Primary or Acute Influenzal 15 15 1 1 ... 2 ... 1 2 ... ... ... 2 2 2 3 6 5 2 1 8 9 5 8 2 ... 2 3 7 Tuberculosis, Pulmonary 71 46 1 2 2 3 1 1 1 3 1 3 15 13 25 16 18 5 7 ... 31 30 6 50 10 7 1 17 35 „ Non Pulmonary 3 7 ... ... ... ... ... 1 ... ... ... ... 1 2 1 2 1 2 ... ... 2 6 ... 2 2 4 ... 1 7 Totals 720 615 26 33 196 145 171 146 216 197 12 15 27 23 34 34 27 19 11 3 530 306 60 439 64 30 12 76 182 NOTE:—The above Table refers to "Corrected Notifications" only, i.e. all cases in which diagnosis was not confirmed have been ignored, CAUSES OF, AND AGES AT, DEATH, during the year ended 31st December, 1949. No. in Short List Causes of Death. Deaths at Subjoined ages of "Residents" whether occurring within or without the District Deaths at all Ages of "Residents" belonging to Localities, whether occurring In or beyond the District Deaths of "Residents" in Public Institutions Total Deaths whether of "Residents" or "NonResidents" in Public Institutions in the District All Ages Under 1 1 and under 2 2 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upwards Greenwich East Greenwich West St. Nicholas, Deptford Charlton and Kidbrooke St. Alfece's Hospital Seamen's Hospital Miller Hospital Herbert M ilitary Hospital Brook Hospital Other Institutions Outside Institutions 1 Typhoid and Paratyphoid Fevers ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2 Cerebro-Spinal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 Whooping Cough 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 5 Diphtheria ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 6 Tuberculosis of Respiratory System 41 ... 1 ... ... 6 19 12 3 12 10 2 18 11 1 ... ... ... ... 6 59 7 Other Forms of Tuberculosis 5 ... 2 ... ... 1 ... 2 ... 2 3 ... ... ... 1 ... ... ... ... 4 4 8 Syphilitic Disease 10 ... ... ... ... ... ... 3 7 3 3 ... 4 2 ... ... ... ... ... 1 8 9 Influenza 9 ... ... ... ... ... ... 3 6 4 2 ... 3 1 1 ... ... ... ... 1 5 10 Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 11 Acute Poliomyelitis and Polioencephalitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 12 Acute Infectious Encephalitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 13m Cancer of buccal cavity and oesophagus (males only) 13 ... ... ... ... ... ... 1 12 5 5 1 2 3 ... ... ... ... ... 8 6 13f Cancer of Uterus 6 ... ... ... ... ... ... 4 2 1 2 l 2 3 ... ... ... ... ... ... 6 14 Cancer of Stomach and Duodenum 35 ... ... ... 1 ... 3 10 21 10 7 1 17 8 1 1 ... ... ... 4 30 15 Cancer of Breast 15 ... ... ... ... ... 1 6 8 4 1 3 7 4 ... 1 ... ... 1 1 8 16 Cancer of all other sites 101 ... ... 2 ... ... 6 3 8 55 40 20 7 34 32 3 2 ... ... 1 20 127 17 Diabetes 3 ... ... ... ... ... ... 1 2 1 ... 1 1 1 ... ... ... ... ... 1 4 18 Intra-cranial Vascular Lesions 95 ... 23 72 31 22 2 40 28 . 3 12 85 19 Heart Disease 250 ... ... ... 1 1 5 41 202 88 48 11 102 3 1 2 1 ... 3 2 35 164 20 Other Diseases of the Circulatory System 57 ... ... ... ... ... 1 9 47 32 7 1 17 34 1 3 ... 1 10 98 21 Bronchitis 55 ... ... ... ... ... 15 40 23 14 2 16 4 1 2 ... ... 4 42 22 Pneumonia 66 ... 2 1 ... ... ... 15 42 33 10 3 20 37 ... 1 ... 2 ... 8 122 23 Other Respiratory Diseases 21 ... ... ... ... 1 1 10 9 6 3 ... 12 5 2 1 ... ... ... 2 19 24 Ulceration of the Stomach or Duodenum 13 ... ... ... ... ... 1 4 8 3 8 ... 2 4 1 1 ... ... ... 3 17 25 Diarrhoea (under 2 years of age) 1 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... 8 26 Appendicitis 4 ... ... ... ... 2 ... 1 1 3 ... ... 1 1 1 1 ... ... ... 1 53 27 Other Digestive Diseases 21 ... ... ... ... ... 3 2 16 10 4 2 5 13 1 2 ... ... ... 2 15 28 Nephritis 8 ... ... ... ... 2 ... 1 5 3 1 ... 4 2 1 ... ... ... ... 1 ... 29 Puerperal and Post-abortive Sepsis 1 ... ... ... ... ... 1 ... ... 1 ... ... ... 1 ... ... ... ... ... ... 1 30 Other Maternal Causes ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 31 Premature Birth 8 8 ... ... ... ... ... ... ... 4 1 ... 3 4 ... ... ... ... ... 4 15 32 Congenital Malformations, Birth Injury, Infantile Disease 19 18 1 ... ... ... ... ... ... 3 6 3 7 6 ... 1 ... ... ... 9 18 33 Suicide 12 ... ... ... ... ... 1 4 7 5 3 ... 4 4 ... 1 ... ... ... ... 11 34 Road Traffic Accidents 5 ... ... 1 1 ... 1 ... 2 1 ... 1 3 2 ... 1 ... ... ... 2 10 35 Other Violent Causes 25 2 ... ... ... 3 7 2 11 8 10 ... 7 10 ... 3 ... ... 1 8 33 36 All Other Causes 42 ... ... ... ... 2 4 4 32 19 8 ... 15 16 1 2 ... 1 ... 10 54 Totals 942 36 6 4 3 18 54 211 610 354 199 41 348 267 18 27 ... 9 6 157 1,036 Note.—All "Transferable Deaths" of residents, i,e., persons resident in the Borough who died outside it have been included. The transferable deaths of non-residents, i.e., of persons resident elsewhere in England and Wales, and who died in the Borough in like manner have been excluded.