Ac 4383 1 City Emara Dis 513 2 Sibrary REPORT ON THE HEALTH OF THE Borough of Lambeth DURING THE YEAR 1956 68626 BOROUGH OF LAMBETH PUBLIC HEALTH COMMITTEE (appointed by the Council on the 23rd May, 1956) *** The Worshipful the Mayor of Lambeth (Mrs. Councillor J. E. M. Wood, J.P.) (ex-offido) Aldermen; A.E. COTTON (Chairman.) C.S. JORDAN W. LAVERICK * Councillors: Mrs, D.R. COLLS S. A, DAVEY W. DRISOOLL Miss B. W. HIGH J. E. JANES Miss K.L. JENNER G.F.S. LIGHT Mrs. M. MAROCK (Vice-Chairman) T, ROBINSON *** 3 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Lambeth Your Worship, Ladies and Gentlemen, I have the honour to present to you the annual report on the health of the Borough of Lambeth for the year 1956. This year marked the centenary of the appointment of the first Medical Officer of Health to the Parish of Lambeth, which was practically identical in its boundaries with the present borough. He was Dr William Odling who was appointed to the office on the 1st February, 1856, just over 100 years prior to my taking up the duties of Medical Officer of Health on 23rd May,1956. Another appointment, made on 8th February, 1856, about which I must confess to some personal curiosity, was that of John Summers as the first Inspector of Nuisances, a forerunner of the present day Public Health Inspector. In 1857, the first annual report of the Medical Officer of Health on his work and that of his two Inspectors was recorded on two pages of the 27 page Annual Report of the proceedings of the Vestry of Lambeth A reproduction of this report appears on pages 56 and 57. A centenary is usually a time for looking back, reviewing the changes that have taken place and noting what achievements there have been in the hundred years which have passed. The processes of public health normally operate at a much slower rate than those of curative medicine so that from year to year there appears to be little or no change A century of public health as depicted in the annual reports of successive Medical Officers of Health of the Parish and later the Borough of Lambeth shows a remarkable story of achievement, so much so that it is difficult to know what particular aspect to pick out for comment. Perhaps the most striking change is adecline in deaths from infectious disease, and most of the credit for this can go to those public health pioneers who introduced measures to control the spread of the disease and improve the environment of the people. It is true that in latter years the discovery of sulphonamide drugs and the antibiotics have contributed to the decreased mortality from these diseases but most of the improvement in this field had taken place before these drugs were known In successive reports of Medical Officers in the latter part of the nineteenth century one reads that 20 to 25% of the mortality was due to acute infectious diseases. This year there were 16 deaths from these diseases out of a total of 2,389 deaths. 4 On the other hand however there are some diseases which have shown an increase, notably poliomyelitis and food poisoning amongst the infectious diseases, and cancer, coronary heart disease and peptic ulcer amongst the non-infectious. Whilst on the subject of infectious disease it is interesting to read the reports of the Medical Officer of Health on smallpox epidemics which occurred in 1871 and 1876 in the former there were 937 deaths and in the latter 371 deaths from this disease in the parish. All of these however were not from Lambeth but included persons from other districts who died in Stockwell Hospital. The last recorded case of smallpox in the borough was in 1934 but the rapidity of modern travel is such that a person could get from any part of the world to any other well within the incubation period of the disease. It therefore is essential that the vaccinial state of the population should be kept at a high level which is. unfortunately, not the case. Infant mortality which is regarded as a reliable index of the health of a community has shown a remarkable fall over the years. In 1876,the year in which it was first recorded.it was 150 per 1,000 live births. Even in 1906 it was still 121 whereas in 1956 it was only 21.2. Until the end of the 19th century the reports of the Medical Officer of Health were confined to vital statistics, epidemic diseases and the improvement of environmental conditions. In 1899, however a bacteriological laboratory was set up for the examination of specimens submitted by general practitioners. In 1901 a female sanitary insoector was appointed to be followed in 1906 by a female health visitor. A milk depot was established in 1904 despite a veto on a similar scheme in the previous year by the Local Government Board, and with the knowledge that the District Auditor would probably disallow the project and surcharge to the Council. Prom this small beginning the Lambeth Maternity and Child Welfare Scheme grew and had atone time the equivalent of fifteen welfare centres, a maternity hospital and later nine nurseries. Upon the coming into force of the National Health Service Act on the 5th July, 1948, these services were handed over with administrative staff to the London county Council and many felt that the work of the public health departments of sanitary authorities would be curtailed as a result. At first this may have been so but the increasing interest of local authorities in the welfare of the aged, and new legislation on clean food and clean air have resulted in an expansion of the work of the department. During the year the Council decided to apnoint an officer to the staff of the department to help with the work among the aged 5 with a view to preventing their deterioration socially to the point where steps would have to be taken for their removal to hospital or a home. The officer appointed, who is a state registered nurse took up her duties on 7th August and a report of her work is to be found in the body of the report. The office of the Lambeth Old People's Welfare Association moved during the year to the Town Hall and is now adjoining the Public Health Department. Thisleads to quicker andbetter contact between the department and the Association. Both clean food and clean air have been the subject of legislation during the year. On January 1st, the Pood and Drugs Act, 1955 and some of the POod Hygiene Regulations 1955, came into force. The remainder of the Regulations - dealing mainly with structural matters were operative from July 1st- The Clean Air Act received Royal Assent on5th July, andcertain sections, notably those dealing with smoke control areas and installation of new furnaces became operative as from the 31st December. On 2nd August, 1956, the Sanitary Inspectors (Change of Designation) Act, 1956 became operative. Under this the Inspectors will henceforth be known as Public Health Inspectors At the end of the year the inspectorial staff was still two below the establishment of nineteen. There were also vacancies on the clerical staff. These shortages of necessity meant more work for the existing staff and I would like to express my thanks to all the staff for the way in which they have cheerfully carried out the extra duti es, I am pleased to express my gratitude to the Chief Officers of the Council for their help and consideration and to thank the Public Health Committee and other members of the Council for their assistance and understanding during my first year of office as your Medical Officer of Health, I am, Mr. Mayor, Ladies and Gentlemen, Your obedient servant. J. Semmur. Medical ofticer of Health July, 1957 7 STAFF of the PUBLIC HEALTH DEPARTMENT DURING the YEAR ENDING 31st DECEMBER, 1956. Medical Officer of Health P. SUMMERS, M, B , B, S.. M. R, C, S,, L. R, C. P. . D. P. H. from 23rd May, 1956 W. STOTT, M. B. , B. S., D. P. H. , Acting from 23rd September, 1955 to 22nd May, 1956 Deputy Medical Officer (Part-time) B.J.L. MOSS, M.B. ,B. S. ,D.P.H. Public Analyst (Part-time) J.E. WOODHEAD, B. Sc. ,p. R. I. C., Ph. C. Chief Administrative Assistant H.P. WRIGHT Clerical Staff Miss L. E. Baker, A. W. Bayley, Mrs. G. Hopkins, N.A. Jupp, E. F. Mannerson, Mrs. M. Rogers, E. Walker, Mrs. K. Williams Public Health Inspectors (a) District Inspectors J. BOWERS Cert. S. I. E. B. (Meat and other foods and smoke) S.G. STARLING (Meat and other foods) D.J. HUGGINS (Meat and other foods) * J. SMIIH (Meat and other foods) R. A. NEWTON (Meat and other foods) R. G. CUTLER E. E. MORGAN (Meat and other foods) H. P. BRYAN J. B. SAINSBURY A.E. WHITE (Meat and other foods) *retired 31st August, 1956 8 Public Health Inspectors - continued (b) Pood Inspectors S. BRADLEY Cert. S.I.E.B. (Meat and other foods) C.W. IDLE (Meat and other foods) (c) Housing Inspectors S. G. PORD (Meat and other foods) P.J. HEFFIELD (Meat and other foods) (d) Rodent Officer S.P. HEAL (Meat and other foods) (e) Women Inspectors Miss L.E. AUGER Cert. S.I.E.B., S.C.M., H.V. Cert. Miss A.P. CROMBIE (f) Public Health Visitor Miss M. McNAIR S.R. N., S. C. M. (commenced 7th August, 1956) Disinfecting Station Wanless Road, Loughborough Junction, S. E.5. Superintendent: L. BRANN General Assistants R.C. AYLING W. DEAMER (Assistant Rodent Officer) L. WHISTON (Rodent Operative) *** 9 GENERAL STATISTICS Area of Borough- 4,087. 5 statute acres Divided into 4 Registration sub-districts 3 Parliamentary constituencies and 21 wards. Population - Registrar General's estimate for mid-year 1956-223,900 Rateable value of District at 1st April 1956 £3,898,091 Sum represented by Penny Rate at 1st April 1956 £16,000 Live Births 3,915 *Birth rate (per 1,000 population) 15,74 Still Births 81 Deaths 2,389 *Death rate 11.10 Maternal Mortality 0.25 Infantile Mortality 21.20 *as adjusted by the following comparability factors: Births 0.90 Deaths 1,04 (Detailed vital statistics will be found in statistical summary on page 45 ) 11 1- CONTROL OF DISEASE The following diseases are compulsorily notifiable in Lambeth: Anthrax Paratyphoid Cholera Plague Continued Fever Pneumonia, acute influenzal Diphtheria Pneumonia, acute primary Dysentery polio-Encephalitis, acute Encephalitis Lethargica, Polio-My elitis, acute acute Puerperal Pyrexia Enteric Fever Relapsing Fever Erysipelas Scabies Food poisoning Scarlatina Glanders Scarlet Fever Hydrophobia Smallpox Malaria Tuberculosis, all forms Measles Typhoid Fever Membranous Croup Typhus Fever Ophthalmia Neonatorum Whooping Cough The total number of infectious diseases notified during the year was 1,951, a decrease of 2,995 on those for 1955. In the early partof that year, however, there was an epidemic of measles which accounted for some 3,798 notifications out of 4,910. This year again measles showed thehighest incidence, in this instance it being due to cases in the latter part of the year and marked the commencement of an epidemic. Tuberculosis. The number of cases on the tuberculosis register on 31st December, 1956 was 3,533, an increase of 17 on the previous year. On the other hand the number of new cases of tuberculosis notified during the year was 55 less than in 1955, being 198 (180 pulmonary, 18 non-pulmonary) compared with 253 (232 pulmonary, 21 non-pulmonary). 12 CHANGES IN THE TUBERCULOSIS REGISTER DURING 1956 [###Details Pulmonary Non-Pulmonary Total Mai e Female Male Female Number on Register 1st January, 1956 1772 1446 128 170 3516 New cases notified during 1956 106 74 8 10 198 Transfers in 38 43 nil nil 81 1916 1563 136 180 3795 CASES REMOVED FROM REGISTER Deaths 19 4 1 - 24 Transfers out 107 104 5 8 224 Recovered 5 4 - 1 10 Diagnosis not confirmed 2 1 - 1 4 133 113 6 10 262 Number on Register 31st December, 1956 1783 1450 130 170 3533 The table and Graph below demonstrate the trends in the notification and death rates of tuberculosis in the Borough over the past ten years. NOTIFICATIONS AND DEATHS PER 1,000 OF POPULATION IN LAST 10 YEARS 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 Notifications 1.68 1.63 2.01 1.87 1.86 1.55 1.52 1.63 1.13 .88 Deaths .68 .60 .68 .43 .45 .28 .23 .18 .16 .11 13 It will be seen that up to and including 1954 the notification rate wasmore or less stationary whereas the death rate steadily fell. In 1956 the notification rate was just over one-half of that for 1S47. whereas the death rate had fallen to less than one-sixth. The falling death rate undoubtedly reflects the success of modern methods of treating the disease. The maintenance of the level of notifications in the earlier years may mean one of two things, either the incidence of the disease has remained oonstant or the disease has decreased in incidence but notification has been more complete. Over the past two years, however, there have been signs of a decline in notifications and whilst it would be unwise to base conclusions on two years' figures, it may foreshadow the elimination of the disease as a major cause of death and invalidism. 14 Respiratory Tuberculosis and Lung Cancer. In thelast fewannual reports it has been customary to compare the deaths from these two diseases in tabular form for a number of preceding years. The accompanying graph presents this information in pictorial form for the past ten years. Comparison of deaths from Respiratory Tuberculosis and Cancer of Lung and Bronchus. 15 Diphtheria. There was one case of diphtheria in an unimmunised girl aged four years. Fortunately she made an uninterrupted recovery and no secondary case occurred. It might well have been a different story and the need for immunisation of the susceptible population is still as great as ever. Many parents who have never seen or heard of a case of diphtheria fail to appreciate the value of immunisation, but those persons who have seen the victims of diphtheria both during the course of the disease and the often protracted convalescence need no persuading as to its worth. Scarlet Fever. 156 cases of this disease were notified, and there were no deaths. Nowadays it is a mild disease and very many of the cases are nursed at home, but in 1870, for example, it was responsible for 479 deaths in the Parish of Lambeth. That year happened to be a rather exceptional one, but the annual deaths from this disease about that time were almost always in three figures. Whooping Cough. There were 345 notifications of this disease and one death of a female infant of six months Whooping Oough is particularly dangerous in children under one year, and such fatalities as do occur arepractically confined to this age group. It may, however, be serious in the older infants as it can give rise to much chronic ill-health. Measles. As indicated in the introduction to this section of the report measles was the most prevalent infectious disease in the year. Thiswasdue to the commencement of the expected epidemic in the latter part of the year. During the year 571 cases were notified, but no deaths from this disease were recorded. Poliomyelitis. Poliomyelitis is a disease which has been occuring with increasing frequency in the past few years. It is probably one of theprices that has to be paid forprogress and the establishment of better standards of living. The paralytic stageof the disease 16 is practically unknown in the under-developed countries of the world and the inhabitants of those countries show a high level of protective antibodies in their blood. This state of affairs almost certainly arises from repeated sub-clinical infections in infancy which confer a life-long immunity on the individual. In those countries with a higher standard of living infants and children are not exposed to these repeated infections with the result that when poliomyelitis is introduced into a community they have no protection. To give the necessary protection the campaign for inoculation against poliomyelitis was launched during the year. The immunisation is effected by injecting a preparation of the killed virus into the child so as to provoke the production of antibodies. At present nobody knows how long the immunity will last. The campaign got off to a rather slow start owing to technical difficulties in production and the imposition of rigid safety precautions to see that no live virus is present in the inoculum. During the year there were 15 notifications of poliomyelitis of which 9 were paralytic. One boy of five died. Food poisoning In all, 60 notificationsof food poisoning were received during the year. 9 were notified in the first quarter, 31 in the second, 11 in thethird, and 9 in the fourth. There were 47 single cases in 12 of whom the cause was found to be an organism of the salmonella group. In the remaining 35 cases, the organism was unidentified. There was one outbreak in an institution involving 13 individuals, and was thought to have been caused by some mince. Unfortunately a sample of the mince was not available by the time symptoms occurred, but the recovery of an organism, CI. welchii,from the stools of some of the patients suggested that this was the bacterial agent responsible. Dysentery. This disease has become more prevalent in recent years, and is almost always due to an organism known as Shigella sonne. It is not usually serious except in infants and old persons. During theyear 303 cases were notified, more than two-thirds of them in the first half of the year, when it was particularly prevalent in day nurseries. The co-operation of the Public Health Staff of the London County Council was enlisted, and eventually the outbreak was brought under control, although the source was not definitely traced. 17 Typhoid. One case of typhoid fever was notified during the year. It occurred in a male aged47 who was employed by theborough council as a sewerman. The course of the disease was uneventful, and no signs of infection were found in other members of the family, nor were any other cases reported- Scabies. There were 93 cases of scabies notified compared with 30 in 1955. tancer. There were 2,389 deaths in the borough from all causes, and of these 481, or just over 20%, were due to cancer. Of the 1,233 male deaths, 266 were due to cancer, and 215 of the l,156 female deaths were attributable to the same cause. The incidence of cancer has been gradually rising over many years. Fifty years ago in Lambeth there were 294 deaths from cancer in a population of nearly 316,000 a death rate of 0.94 per 1,000. In 1956 there were 481 deaths from cancer in a population of 223,900 a death rate of 2.15 per 1,000. Undoubtedly someof this increase isdue to improved diagnosis and an ageing population. Nevertheless there would appearto have been a real increase in the incidence of cancer over the past fifty years, and it is likely that this is associated with the changing environment and habits of individuals over that period. Diseases of the Heart and Circulation. The diseases responsible for the greatest proportion of deaths are thoseofthe heart and circulation, lb some extent one would expect this in an ageing population but one disturbing feature is the toll which coronary thrombosis takes of those in the 4564 age group. Mortality figures do not show the whole picture as deaths may be preceded by prolonged invalidian and someof those deaths recorded in the older age groups may well have been victims of the disease at a much earlier age. Coronary disease is one of the so-called 'stress diseases' which have increased over the past ten or twenty years. It appears to be associated more with mental and psychological stress than with physical. 18 In all, diseases of the heart and circulation, including vascular disease of the nervous system were responsible for 1,096 deaths or nearly 46% of the total. 19 This part of the report deals with the work carried out by the Food Inspectors under the Pood and Drugs Act, 1955, the Public Health (Meat Regulations) 1924 and the Milk (Special Designation) Regulations. 1949 and 1950 and the Ice Cream (Heat Treatment etc.) Regulations, 1947- Sampling of Food and Drugs (a) FDR CHEMICAL ANALYSIS. Number procured formally 200 Number procured informally 1,300 Of the 200 formal samples 174 were of milk, 2 of which were adultered. of the remaining 26 other samples, three were found to be adulterated. (b) FOR BACTERIOLOGICAL AND OTHER EXAMINATIONS The following shows thenumber and types of samples submitted for bacteriological and other examinations - Ice Cream and Ice Cream Mix 297 Ice Cream Lolly 32 Ice Lolly 12 * Black Pudding 2 Chinese Egg Albumen 1 Egg Albumen 60% Syrup 1 Egg Albumen 1 Chinese Egg 2 * Meat and Vegetable Hotpot 1 Orange and Lemon Slices 1 * Tomato Juice 1 Luncheon Meat (canned) 3 * Corned Beef 3 Sausage Meat 1 Pork Pie 3 Milk (canned) 5 366 * These articles were suspected of having caused food poisoning. 20 Milk Type of Test Samples No. procured No, passing test No. failing to pass test Methylene Blue 165 162 nil Phosphatase 164 161 nil Three of these samples were void - Atmospheric Shade temperature was over 65% F. Inspection of Food (i) AT STOPS, STORES AND FACTORIES; Large quantities of food of all varieties were inspected and as a result the following weight of food was surrendered as unfit for human consumption and unsound food certificates were issued : 18 tons 11 cwts, 1 qr, 23 lbs. (ii) TOE METHOD OF DISPOSAL OF CONDEMNED POOD- All condemned animal products are sent to firms specialising in the making of glues and other like commodities. Such vegetable waste as is suitable is converted into pig food under the Council's Scheme, (iii) COMPLAINTS 94 complaints about food were received 60 of which were justified and a list of these is set out below 1, Mincemeat tart containing metal 2. Prying oil containing foreign matter 3. Bread containing foreign matter 4. Ham (canned) unfit 5. Luncheon neat (canned) unfi t 6. Butter containing metal 7. Bread containing wood 8. Bread containing foreign matter 9. Bread containing wood 10. Pork pie mouldy condition 11. Bread containing wood 12. Bread containing tobacco ash 13. Sugar containing beetle 14. Bread containing insect 15. Cake unpleasant taste 16. Bread containing dirt and maggot 17. Butter unfit 18. Potatoes (old) mis-rep resented as new 19. Milk dirty bottle 21 20. Peaches (canned) containing foreign matter 21. Bread roll containing foreign matter 22. Milk dirty bottle 23. Bread dirty condition 24- Peanuts (roasted) rancid * 25. Bread containing cigarette stub 26. Sweets containing maggot 27. Bread containing maggot 28. Bottled beer containing sediment 29. Cheese containing part of insect 30. Meat containing caseous material 31. Bread mouldy condition 32. Butter containing nail 33. Sausage roll mouldy condition 34. Bread containing wood 35. Rice (unpolished) contaminated * 36. Orange drink dirty bottle 37. Ham unfit 38. Pepper deterioration due to improper storage 39. Sweets containing maggot 40. Chocolate containing maggot 41. Tea containing cigarette stub 42. Sweets containing insect 43. Chocolate containing maggot 44. Sponge cake wasp in filling 45. Corned beef mouldy condition 46. Lemonade unpleasant flavour 47. Bread containing metal 48. Chicken unfit 49. Bread containing nail 50. Tea containing caterpillar 51. Lemonade unpleasant flavour 52. Swiss Roll dirty condition 53. Bread containing metal 54. Fish roes unfit 55. Fish containing hook 56. Bread containing bristle 57. Meat tainted 58. Bread mouldy condition 59. Turkey unfit 60. Bread dirty condition * Legal proceedings were instituted in the under-mentioned cases with the result shown - 25. Bread containing cigarette stub Pined £5. £2.2,0, costs 36. Orange drink bottle dirty Fined £7. The following case was taken on behalf of Greenwich Borough Council - Milk Bottle dirty Pined £5. £2.2.0.costs 22 Ice Cream Samples (Methylene Blue Test) Year No. of samples Grade I Grade II Grade III Grade IV 1956 297 186 88 19 4 1955 236 171 42 20 3 1954 155 120 30 5 - 1953 149 123 20 6 - 1952 179 148 25 5 1 1951 196 76 15 4 1 Food Premises. (i) The number of food premises by type of business in the area is as follows - Greengrocers and fruiterers 172 Pish shops wet, dry and fried 94 Bakers 99 Butchers 163 Restaurants 240 (ii) The number of premises registered under section 16 Pood and Drugs Act, 1955 and Milk and Dairies Regulations 1949. Ice Cream 527 Sausages and potted processed etc. meat 297 Registered Milk distributors 263 (iii) Number of inspections of food premises 1. 586 In one instance action was taken through the courts to secure compliance with the Food Hygiene Regulations. The company concerned was engaged in the manufacture of cakes and pastry and, despite verbal and written requests for an improvement in the standards prevailing, the firm took no action. Therefore in November summonses were taken out against the company and when thecase washeard in January 1957 pleas of guilty were entered on 11 counts for contravention of the Food Hygiene Regulations. General. The Food and Drugs Act, 1955 and the Food Hygiene Regulations 1955, both came into operation on the 1st January, 1956- 23 The new Act has introduced a number of changes in administration. Most of these are minor changes designed to bring the law dealing with the adulteration of food and standards of hygiene in food handling into line with present day requirements- The Pood Hygiene Regulations have brought about a major change in the standards of cleanliness necessary in the sale, storage display and preparation of food- They not only impose standards of hygiene for food premises but they also require that persons handling food shall maintain standards of personal cleanliness. An outstanding example is the prohibition on the use of tobacco by persons handling food. This new legislation has entailed detailed inspections being made of food shops, food factories and other places and the work is being done by the existing staff of inspectors. It is not possible at this stage to say when it will be completed but good progress is being made. 24 III - SANITARY CIRCUMSTANCES OF THE AREA Water Supply. I am indebted to Dr. E. Windle Taylor, Director of Water Examination, Metropolitan Water Board, for the following report on the water supplied to the Borough "The supply to the Lambeth area has been satisfactory both in quantity and quality during the year 1956- Hie water is all River Thames-derived It is stored intheBoard's reservoirs at Staines Laleham and Walton and treated in the Board's works at Hampton, Surbiton and Walton- The method of purification is by storage, filtration and terminal chiorination and contact tanks are in operation at Hampton and Walton to ensure efficient disinfection of the water. Plans are progressing for the construction of a contact tank at the Surbiton worts. Samples are collected on five days in every week, and more frequently if required, from each stage of the purification process and in the distribution system. Tests include physical, chemical and micro biological examination of the water. All new and repaired mains are chlorinated before being restored to service and samples of water from them are tested bacteriologically to ensure that its quality is up to that normally supplied. The water supplied to the Borough of Lambeth is not piumbo-solvent" There are in addition a few deep wells in Lambeth which supply water forpurposes other than human consumption whilst in a few cases the water is used for drinking on the premises and for the manufacture of beverages. In the latter case periodic chamical and bacteriological examination is made to ensure that there is no danger to health, SECTION 95 PUBLIC HEALTH (LONDON) ACT 1936 In 1956, 1,345 applications were received for certificates of the provision of a proper and sufficient supply of water. 674 of these were in respect of borough council property. 25 Drainage and Sewerage System The sewers within the borough are operated on what is known as the combined system, that is, both the surface water and sewage are discharged into the same set of pipes which are designed to take many times the dry weather flow. In the event of flow above the capacity of the sewers, arrangements are made so that excess storm water is diverted into the River Thames; which sometimes involves pumping. The local sewers, which arenearly 150 miles in length, are under the control of the borough council, whilst the main sewers are the responsibility of the London County Council. These main sewers, as far as the south side of the river is concerned, eventually discharge their contents at the southern outfall works at Crossness some 13 miles below London Bridge. Here the sewage undergoes treatment before the effluent is discharged into the river- Drainage plans, Ail plans are registered with the Borough Engineer but the Public Health Inspectors are responsible for seeing that the work is carried out in accordance with the drainage by-laws, 46 plans of new buildings and 54 plans of alteration to existing drains were deposited. In addition combined drainage was carried out in 16 cases- There were no cases of relaying defective comhined drains for which no order had been made by the Council and no plans could be found and which therefore were deemed to be sewers repairable by the Council Atmospheric Pollution. The year 1956 saw the Clean Air Act placed on the statute book and certain sections of the Act. notably those dealing with Smoke Control Areas, came into force on the 31st December, 1956. Other provisions of the Act dealing with emission of dark smoke, grit and dirt from industrial furnaces are not yet operative. There are ten recording stations for atmospheric pollution in the borough of which three are under the control of the borough council. These are volumetric smoke and sulphur dioxide recording machines at the Town Hall and the Tate Library, South Lambeth Road and a deposit gauge and lead peroxide candle for measuring sulphur dioxide at the Brixton Hill M. W. B reservoir. The remainder are controlled by the London County Council and with one exception are in or within a short distance of County Hall- These comprise one deposit gauge two lead peroxide candles and four volumetric smoke and sulphur dioxide recorders. 26 All the records of pollution by both smoke and sulphur dioxide at all the stations with volumetric instruments show the sane seasonal trend. From a peak figure in January the average daily pollution falls steadily until May when it is about a fifth to a quarter of the January figure. It then remains stationary until September when it commences to rise until in December the figure is approaching that of January. This isundoubtedly due in large measure to the fact that the domestic grate is not., generally speaking, in use during the summer months, but I feel that atmospheric conditions may also play a part by more adequate dispersion of those pollutants that are emitted. Repair, Maintenance and Sanitary Conditions of Houses HOUSING ACT. 1936. PART II Section 9. Nil. Section 10. Nil. Section ll and Section ll as amended by Section 10 Local Government (Miscellaneous Provisions) Act, 1953 Representations (Demolition Orders) made during the year 5 Demolition Orders Made (7) Undertakings accepted (–) 7 Demolition Orders not made before 3lst December 3 Demolition Orders complied with 12 Demolition Orders not yet complied with 2 Premises surveyed but not yet represented nil Premises surveyed but no action found necessary 6 Section 12. Representations made during the year 18 (a) Underground rooms 34 (b) Parts of buildings 9 rooms Formal Action. Closing Orders made (80), Undertakings accepted (4) 84 Closing Orders not yet made 4 Closing Orders determined (1), complied with (50) 51 Closing Orders or undertakings not yet complied with 45 Premises made fit after representation nil Premises vacated or closed after representation nil Premises surveyed but not yet represented 1 27 Informal Action, Premises made fit after informal action 5 (a) Underground rooms 12 (b) Parts of buildings nil Premises closed or vacated after informal action nil Premises where works are still outstanding after informal action nil HOUSING ACT 1936 PART III SECTION 25 CLEARANCE AREAS No clearance are as have been represented during the year 1956. Preliminary surveys have, however been made of potential areas involving the inspection of 62 individual premises. Waterworks Place, Brixton Hill (Nos 2–7 cons,) Order confirmed July 1955, Remaining tenants have been rehoused. The 6 houses in the Clearance Area have been demolished and order complied with, Premises surveyed but no action found necessary 12 Total visits (revisits 1,051) 1894 MINISTRY OF HEALTH TABLE1- Inspection of dwelling houses during the year. (1) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts). 6721 (b) Number of inspections made for the purpose. 18885 (2) (a) Number of dwelling houses (included under sub head (1) above) which were inspected and recorded under the Housing Consolidated Regulations- 64 (b) Number of inspections made for the purpose. 181 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 5 (4) Number of dwelling houses (exclusive of those referred to under the preceding sub head) found not to be in all respects reasonably fit for human habitation. 18 28 2. Remedy of defects during the year without service of formal notices. Number of defective dwelling- houses rendered fit in consequence of informal action by the Local Authority or their Officers 1882 3, Action under statutory powers during the year. (A) Proceedings under Sections 9 10 and 16 of the Housing Act 1936- (i) Number of dwelling-houses in respect of which notices were served requiring repairs nil (ii)Number of dwelling-houses which were rendered fit after service of formal notices (a) By owners nil (b) By Local Authority in default of owners nil (B) Proceedings under Public Health Acts. (i) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 1272 (ii)Number of dwelling houses in which defects were remedied after service of formal notices - (a) By owners 1411 (b) By Local Authority in default of owners 182 (C) Proceedings under Section 11 and 13 of the Housing Act 1936 and Section 11 as amended by Section 10 Local Government (Miscellaneous Provisions) Act 1953- (i) Number of dwelling-houses in respect of which Demolition Orders were made 7 (ii)Number of dwelling-houses demolished in pursuance of Demolition Orders 5 (D) Proceedings under Section 12 of the Housing Act, 1936 (i) Number of separate tenements or underground rooms in respect of which Closing Orders were made 80 (ii)Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit 1 29 HOUSING ACT, 1949 SECTION 4- Advances for increasing housing accommodation. Formal applications received and inspections made with position at the end of 1956 Josephine Avenue 13 Thurlow Hill 42 Loan not granted HOUSING ACT 1949 SECTION 20 AND HOUSING REPAIRS AND RENTS ACT, 1954 SECTION 16 IMPROVEMENT GRANTS Preliminary Inspections. Bartley Road 154 Broxholm Road 65 Burton Road 33 Carson Road 52 Clive Road 27 Clive Road 83–91 (cons.) - 9 premises Eider Road 14 Gipsy Road 199 Woodland Road 48 Poplar Walk Road 102 Rommany Road 57 Thornlaw Road 84 Total 20 premises The Council decided to suspend the making of Grants for 12 months from March 1956- Applicants were advised to apply to the London County Council, HOUSING AND RELATED ACTS: (REHOUSING SECTIONS) INSPECTIONS ARISING FROM REHOUSING. 331 premises were inspected as a result of notifications received from the Directors of Housing of the Lambeth Borough Council and the London County Council of the rehousing or transfer of families to new or other properties In one instance only was it necessary to take action to prevent the premises being re-occupied. This was done informally and the premises were later made fit 30 REHOUSING AND OVERCROWDING, 1948 cases have been investigated with the following results: London County Council Cases Overcrowding 47 Illness 247 Insanitary conditions 601 Lambeth Borough Council Health (Medical Certificates) 477 Insanitary conditions 220 Inquiries from other Authorities 33 During this period the London County Council have rehoused 94 During this period the Lambeth Borough Council have rehoused 229 HOUSING REPAIRS AND RENTS ACT 1954. Certificates of disrepair issued 50 Certificates of disrepair refused 6 Applications withdrawn 3 Revocation certificates issued 66 Revocation certificates refused 37 The cost of repairs particularly to old property remains a serious problem both for owners and for the Council who themselves carry out the necessary work when a Court Order is ignored, collecting rents to recoup themselves and registering a charge upon the property. Under the London County Council (General Powers) Act 1955. the Council may in cases of urgency in lieu of obtaining a Court Order serve a notice on the owner or occupier of defective premises setting out the defects and stating that it intends to remedy them itself. If the owner does not within seven days serve a counter-notice stating that he intends to execute the works and does not within a reasonable time thereafter commence and diligently proceed with the works the Council may after the expiration of nine days from the service of the notice execute the works and recover the expense reasonably incurred in doing so from the person upon whom the notice was served. At the end of the year there were 130 cases outstanding from which some £7,614 was owing while in 35 others the estimated cost of warks approved but not completed was £2,624. 31 Dangerous Structures, Information was forwarded to the District Surveyor on 95 occasions during the year of the presence of structures which were considered to be dangerous to life or limb. Rodent Control During the year 1956, 909 complaints have been investigated, Of these 668 were found to be brown (common) rats, no black (ship) rats 168 mice and 73 were found to be not justified, 926 baitings were carried out and in 139 cases defective or disused drains were found to be the cause of infestations and were dealt with by the Borough Engineer and the Public Health Inspectors, No major infestations have come to light during the year. In no case has the infestation been of a serious character. Inspections 1,177 Revisits 1 252 Notices served 34 Sewer treatment with poison was carried out by the Borough Engineer's department during the year in conjunction with the Rodent Officer and his staff. Disinfection and Disinfestation 2817 rooms and 17 507 articles of bedding and clothing were dealt with during the year among them being the rooms and articles used by the 510 cases of various forms of infectious disease taken tohospital; 186 certificates of disinfection were issued and 185 library books dealt with from the 4 408 premises visited during the year, 206 houses were treated for bed bugs and in them 607 separate rooms were sprayed with Vermacine a preparation of 5 per cent. D. D. T. withPyrethrum as a 'Knockout'. It was necessary to treat 39 houses a second time, There weremany complaints during the year of insect infesta tions. The usual offenders were wood boring beetles psocids, ants, cockroaches drug store beetles, carpet beetles clothes moths, weevils, clover mites and silver fish. Clover mite infestation on new housing estates has been difficult to eradicate although some measure of control has been achieved. It would seem that the mite is imported in the turves which are used when the spaces around the blocks are laid out. Close oontact hasbeen maintained with the Ministry of Agriculture Fisheries and Food in the campaign against these pests. 32 Registrations. MILK Under the Milk and Dairies Regulations, 1949, 36 distributors of milk were registered- Under the Milk (Special Designation) (Raw Milk) Regulations, 1949, and the Milk (Special Designation), (Pasteurised and Sterilised Milk) Regulations, 1949, there were 263 licenses with 24 supplementary licenses and two Pasteurisers licenses. PHARMACY AND POISONS ACT 1933. The number of persons entered or retained on the list under the Pharmacy and Poisons Act, 1933 (Section 21) Part II was 175. RAG FLOCK AND OTHER FILLING MATERIALS ACT 1951. Under the provisions of this Act no premises were registered during the year. PET ANIMALS ACT, 1951. Under the provisions of this Act, which came into force on the 1st January 1952, no pet animals may be sold except from registered premises. The condition in which animals, including birds, fish, reptiles, etc., must be kept if registration is granted ensure that they enjoy a reasonably comfortable existence while on the premises and has greatly improved safety from fire, and other calamities, 22 premises have been registered and are under supervision, SLAUGHTER OF ANIMALS ACT 1933. Licensing of Slaughtermen. No application was made for the issue of a licence under the provisions of this Act. LONDON COUNTY COUNCIL (GENERAL POWERS) ACT 1954Hairdressers and Barbers, On the 6th July 1955. the Council made by-laws as to hairdressers and barbers under this Act and fixed the appointed day for their operation to be the 1st January 1956. Sub section 1 of Section 18 of the Act requires that as from the appointed day no person shall carry on the business of a hairdresser or barber on any premises in the borough unlessheand those premises 33 are registered by the Borough Council. During the year 26 registrations were made making a total of 166 premises and 181 persons on the register. Offensive Trades Establishment Orders have been granted to two companies who carry on the offensive trades respectively of (a) fellmonger and (b) fatboiler. (a) Messrs- Gaston Morreil, Ferndale Road. (b) Messrs. Lepard Wandsworth Road, These two orders are renewable annually. Street Markets Markets are held in The Cut, Lower Marsh Lambeth Walk and Wilcox Road in the inner wards and in Popes Road. Electric Avenue and Brixton Station Road. All these are inspected regularly. HOME OFFICE TABLE Factories, and other premises 1. INSPECTIONS FOR PURPOSES OF PROVISIONS AS TO HEALTH (including inspections made by Public Health Inspectors), Premises (1) Number on Register (2) Number of Inspections. (3) Written Notices (4) Occupiers prosecuted (5) FACTORIES" With mechanical power 641 202 9 Without mechanical power 164 65 3 OTHER PREMISES under the Act (including works of building and engineering construction but not including outworkers premises) 51 58 1 Total 856 325 13 34 2. Defects Pound Particulars Number of defects Referred by H. M. inspector No. of defects in respect of which prosecutions were instituted. Found Remedied Referred to H. M. Inspector (1) (2) (3) (4) (5) (6) Want of cleanliness (&1) 12 12 2 Overcrowding (S. 2) Unreasonable Temperature (S. 3) Inadequate Ventilation (S. 4) Ineffective drainage of floors (S. 6) 1 1 Sanitary Conveniences (S. 7) Insufficient 2 1 2 Unsuitable or defective J 5 5 Not separate for sexes 1 1 Other offences (Not including offences relating to Home Work or offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921 and re-enacted in the Third Schedule to the Factories Act, 1937. ) 5 5 1 Total 26 25 1 4 35 OUTWORK NATURE OF WORK No, on Register Notices served Prosecutions (1) (2) (3) (4) Wearing Apparel Making, etc. Cleaning and washing 282 Household linen 1 Lace; lace curtains and nets Curtains and furniture hangings Furniture and upholstery Electro-pi ate File making Fur pulling Cables and chains Anchors and grapnels Cart gear Locks, latches and keys Umbrellas, etc. 1 Artificial flowers 1 Nets other than wire nets Tents Sacks Racquet and tennis balls Paper bags 3 Paper, etc. boxes 23 Brush making Pea picking Feather sorting Carding, etc. of buttons, etc. 11 Stuffed toys Basket making Chocolates and sweetmeats Cosagues, Christmas crackers Christmas stockings, etc. 2 Textile weaving Lampshades 55 Total 379 36 Summary. Public Health Inspectors. Total number of inspections 8,322 Total number of reinspections 14,089 Total number of intimation notices served 2,213 Total number of statutory notices served 1,260 Women Public Health Inspectors. Total number of visits and inspections (factories workplaces infectious disease, etc,) 1,341 Total number of intimation notices served 143 Total number of statutory notices served 1 Total number of revisits 720 Restaurants in which defects were found Visits to Old and Infirm persons living in 123 insanitary conditions 84 37 IV - GENERAL Health Services provided by other authorities HOSPITALS Lambeth iswithin the catchment areas of two hospital groups, the Lambeth and Camberwell groups, these in turn being administered by two different Regional Hospital Boards, the South West Metropolitan and South East Metropolitan respectively. Further the areas served by the two hospital groups extend beyond the borough boundaries the Lambeth group has premises outside the borough whilst the Camberwell group has none within it, In addition to hospitals within the normal hospital framework of the National Health Service there are two teaching hospitals in the borough King's College Hospital and St. Thomas's Hospital, each with its own board of governors. The following is a list of hospitals within the borough - Lambeth Hospitals Group (S. W. Regional Hospital Board) Lambeth Hospital - Brook Drive, S, E, 11. South Western Hospital - Landor Road , S W.9. Annie McCall Maternity Hospital Jeffreys Road. S.W. 4. King's Cbllege Hospital Group. King's College Hospital - Denmark Hill.. S. E-5. Belgrave Hospital for Children - Clapham Road, S.W.9. St. Thomas' s Hospital Group. St, Thomas' s Hospital - Westminster Bridge, S. E. 1. St. Thomas's Babies Hostel - Black Prince Road S-E-ll. General Lying-in-Hospital - York Road S.E.1. Royal Waterloo Hospital - Waterloo Road, S.E.1. Personal Health Services: It is the duty of the local health authority; i.e. the London County Council, to either provide these services or arrange for their provision by some other organisation. The county council does in fact administer the Maternity and Child Welfare services, the vaccination and immunisation, health visiting and domestic help services from the Divisional Health Offices, 128, Brook Drive, S.E. 11. 38 Vaccination and immunisation is also done by general practitioners. The midwifery, ambulance and mental health services are administered direct from the Public Health Department, County Hall, S.E.l. and home nursing is carried out on behalf of the county council by voluntary organisations, The voluntary nursing associations working in the borough are as follows - Brixton District Nursing Association, Camberwell District Nursing Association, Norwood and District Nursing Association. Ranyard Nurses. Roman Catholic Nurses' Institute- South London District Nursing Association. Southward Newington and Walworth District Nursing Association. Public Health Laboratory service The Public Health Laboratory service provides a comprehensive service for the examination of specimens submitted by local authorities and general practitioners, The local laboratory is situated at County Hall and is under the direction of Dr. A. J. H, Tomlinson. Care of the Aged, The care of the aged is a matter which is constantly engaging the attention of the department. Unfortunately it is not always possible for your officers to intervene directly in the welfare of theold people unless there is a nuisance or danger to health. Nevertheless close contact is maintained with the officers of the Lambeth Old People's Welfare Association and through them it is often possible to assist. Similarly, officers of the Public Health department are frequently able to help the Old People's Welfare Association in dealing with cases. The factors which bring about the unhappy plight of many of these old people are varied. They are often alone in the viorld and have to make do on a small fixed income such as the old age pension and some are reluctant to apply for National Assistance. The result is that they live in one room, usually in a basement or at the top of the house and get insufficient to eat. It often appears at first sight that some of those who have 39 children are neglected by them. This may betrue in some instances but on the other hand investigation may shew that there is some real obstacle such as the housing circumstances of these children which will not permit them to give shelter to their parents. A further factor which is often overlooked is the independence of the old person himself who will carry on long after he should have had help, and who is reluctant to do anything which in the slightest way suggests a whittling away of that independence. There is almost an element of tragedy when one comes across an old person who steadfastly refuses to accept the services which are available in the mistaken idea that he will lose something of his independence by so doing. It is usually this type of case which becomes the subject of court action under Section 47 of the National Assistance Act, 1948- The sad thing about this procedure is that so often the person concerned dies soon after he or she has been removed, as if the will to live has been lost, Consequently, one is reluctant to take action, but if conditions are such as to constitute a serious nuisance or danger to the individual or other persons then action is taken but only if persuasion fails. NATIONAL ASSISTANCE ACT 1948 SECTION 47. NATIONAL ASSISTANCE (AMENDMENT) ACT 1951. This Act enables an authority on the certificate of the Medical Officer of Health, to apply to the Court for an order to remove a person in need of care and attention to a home or hospital for a period of up to three months Before granting the order the Court must be satisfied that certain conditions laid down in the Act are met As action under this Act may be protracted, an amending Act was introduced in 1951 which enables the Medical Officer of Health under delegated powers to apply to the Court himself in an emergency, but in this instance a second medical certificate is required and the maximum period of detention is three weeks. During theyear sevenpersons were removed under the provisions of these Acts. LAUNDRY FOR INCONTINENT AGED. One of the problems which faces those looking after bedridden aged persons in their homes is the cleansing of soiled linen and clothing. Facilities for doing this in the home are usually lacking and commercial laundries are naturally reluctant to handle thematerial without prior cleansing- The local authority has power under Section 122 of the Public Health (London) Act, 1936 tocleanse filthy and unwholesome articles, but the problem 40 still remains - where can it be done or who will do it? Some boroughs have solved the problem by coming to an agreement with a neighbouring borough which has the appropriate facilities, or by arrangement with a local hospital laundiy. Neither of these courses was possible in Lambeth although Southwark is installing machinery in its cleansing station for this purpose and it may be possible to come to an arrangement with that authority when the installation is complete. A temporary solution was, however, possible through the generosity of a local laundry proprietor who offered to run a pilot scheme free of charge for a period of three months. For administrative reasons it was not possible to do personal and individual laundry, so the laundry proprietor provided a stock of draw sheets sheets and pillowcases, sufficient for six cases, which became the property of the Lambeth Old People's Welfare Association. Instances of persons needing this service are referred to the Public Health department generally by the di strict nurses. The service was started on 5th December and although at first confined to the area of one District Nursing Association, six patients were being catered for and there were two on the waiting list at the end of the year. It has been a boon to both the patients and those attending them and has been greatly appreciated by them HOLIDAYS FOR TOE ELDERLY. The scheme to send old age pensioners to the seaside for a week' s holiday for £1 was continued again during the year under review To be eligible to participate in the scheme a person had to be an old age pensioner who had lived in the borough for at least three years and not to have had a holiday in the same period. During four weeks in May and early June some 237 old persons availed themselves of the holiday and in a similar period in September and early October 219 went away. The 456 persons consisted of 65 married couples, 245 individual females and 81 males. The holidays were arranged at Brighton, and the old folk were taken by coach from the Town Hall to the hotels at Brighton where the accommodation had been reserved for them. A stop was made at Crawley for light refreshments. At the end of their week's stay they were collected from the hotels and brought back to the Town Hall where the next party was already assembling. During the week cinema and theatre shows and afternoon coach trips were arranged. The old people were very grateful 41 for theholiday and the entertainment provided for them and many appreciative comments have been made both verbally and in letters to the Public Health department WORKROOMS FOR THE ELDERLY- In July, this project was started at 58 Lansdowne Way and some forty oldpeople are employed for two hours per day, either morning or afternoon, for five days per week for which they are paid 10s- per week. They are engaged on simpl e employment, such as button carding, plastic sorting and light assembly work. The old folk are not pressed but encouraged to give of their best- The scheme is an attempt to relieve some of the monotony and boredom of old age and let them feei that they can still do useful work, and in this respect It nas succeeded as the changes which have taken place in some of the workers have been truly remarkable, From being depressed and careless about their personal appearance they have become cheerful and bright and once again taken an interest in themselves. In the latter months of the year it was decided to provide hot rneals for those who wanted than through the Meals on Wheels service. This has been much appreciated by the workers and during the winter months as many as 25 meals were delivered on four days per week, VISITING BY THE PUBLIC HEALTH VISITOR When it became apparent that more time would have to be spent in the follow up of cases of old folk referred to the Public Health department by various outside agencies, the Council agreed to the appointment of a woman injector for this purpose. Prior to this the temporary Deputy Medical Officer of Health had devoted much of his time to this wrk. The officer appointed took up her duties early in August and she is primarily engaged in the follow up of those cases which appear to be in danger of social breakdown. Her work does not cut across that of the Lambeth Old People's Welfare Association but is complementary to it- At the time of her appointment records of some 53 old people were held in this department, and by the end of the year 146 new names had he® added to the register and 452 visits made, The following table gives an analysis of the new cases by age and sex. 42 Age Group Male Female Total 65-69 5 9 14 70-74 6 13 19 75-79 17 17 34 80-84 9 38 47 85-89 7 19 26 90-94 3 3 6 95-100 - - - Totals 47 99 146 It will be seen that the bulk of the cases are over 75, and the majority of them are women. This is almost certainly a reflection of the preponderance of women in these age groups as a whole. The visitor is able, by periodic visiting - the frequency in any particular case depending on the conditions prevailing - to enlist the help of the various statutory and voluntary agencies which may assist in preventing further deterioration. I am certain that by this supervision the lot of many old people in the borough has been eased and the appointment has been worth while. It would be appropriate at this point to mention the valuable help given by the Domestic Help Service to the old folk. This is a London County Council service which is administered from two centres in the borough and the organisers in charge have co-operated wholeheartedly in efforts to help the elderly and this now forms the greater part of their work. No amount of goodwill however on the part of the organisers would be of any avail without the support of those who do the work in the homes. On going round the district one repeatedly meets these ladies working cheerfully in the homes of the old folk, sometimes in the most trying conditions. Not only that but many will keep a friendly eye on them at weekends and at holiday times when they would otherwise be lonely, LAMBETH OLD PEOPLE' S WELFARE ASSOCIATION. This report on the care of the aged would be incomplete without reference to the activities of the Lambeth Old People's Welfare Association which acts as the co-ordinating body in the borough for services devoted to the welfare of the aged. It receives financial assistance from the Council and acts as its agent in those welfare activities which the Council is unable to do directly, 43 The following details of the work of the Association have been obtained from its latest report and relate to the year ending 3lst March, 1957. Meals-on-Wheels. This service has been operated in the north end of the borough by the Association and during the year the number of meals delivered was almost doubled - 15,436 as against 8,033. The southern end of the borough is covered by the Women's Voluntary Service, who delivered 13,850 meals as against 9,490 last year. Not only does the Meals-on-Wheels Service provide meals for the old folk, but it provides a means of keeping in constant touch with them so that early changes in their condition are noted. Chiropody This much appreciated service has further expanded and there are now five clinics working, in all, 17 sessions. A domiciliary service has also been started and comprises three sessions per week. The number receiving treatment in their homes is 98 and the total number of persons to benefit from the service during the year is over 1,400. Old People's Clubs. There are now 27 Clubs operating in the borough including an all-day luncheon club at St. Anne's Catholic Settlement in Kennington. King George VI Memorial Club This Club is designed to cater for infirm old people who would normally be denied the benefits of a club by reason of their handicap. Its catchment area is the Boroughs of Lambeth and Camberwell. At the time of writing the club is not functioning on its permanent site, but a pilot scheme has been running for some weeks at Havil Hall, Camberwell. The old people are collected by ambulance and brought to the club where they are given a hot lunch, a light tea and entertainment before being taken home. National Assistance Act, 1948, Section 50 - Burials During the year under review 30 funerals were arranged by the Council (16 males and 14 females) at a cost of £224, 19. 1d. 44 The actual amount paid to the Council's Funeral Contractors was £364. 4. 6d but the sum of £139. 5. 5d, was recovered by way of grants, insurance policies, money found and also by sale of secondhand furniture etc. 45 V - STATISTICAL SUMMARY The classification of deaths is in accordance with the International List of Diseases Injuries and Causes of Death as revised under the World Health Organisation: 1955 1956 Area of district (in acres) 4,087.5 Population mid year (Registrar General's estimate etc.) 224,200 223,900 Rateable value at 1st April £2,249,788 £3,898,091 Sum represented by 1d. rate (Revaluation 1st April, 1956) £9,100 £16,000 Births Registered live births (a) Legitimate 3,308 3,523 (b) Illegitimate 289 392 (c) Total Live Births 3,597 3,915 *Birth rate (corrected) per 1,000 estimated population 14.12 15.74 Still Births (a) Legitimate 87 67 (b) Illegitimate 6 14 Total 93 81 Still birth rate for 1,000 Total (Live and still) births 25.20 20.27 Deaths 2,385 2,389 *Death rate per 1,000 estimated population 10.74 11.10 46  1955 1956 Maternal deaths 4 1 Maternal death rate per 1,000 (live and still) births 1.08 0.25 Deaths of infants under l year of age (a) Legitimate 64 72 (b) Illegitimate 10 11 Total 74 83 Infantile death rate per 1,000 live births 20.57 21.20 Neo natal (under 4 weeks) deaths 56 68 Neo-natal death rate per 1,000 live births 15.57 17.37 Marriages. 1,949 2,088 Marriage rate per 1,000 population 8.69 9.33 * as adjusted by comparability factor 47 TUBERCULOSIS SUMMARY OF CASES NOTIFIED DURING THE YEAR 1956. PARLIAMENTARY CONSTITUENCY RESPIRATORY NON-RESPIRATORY NEW CASES ADMITTED TO HOSPITAL DISCHARGED FROM HOSPITAL OR DIED INWARD TRANSFERS ETC. NEW CASES ADMITTED TO HOSPITAL DISCHARGED FROM HOSPITAL OR DIED INWARD TRANSFERS ETC. VAUXHALL 50 84 88 17 8 3 2 - BRIXTON 62 64 77 36 7 3 3 - NORWOOD 68 37 46 28 3 2 1 - TOTALS 180 185 211 81 18 8 6 - 48 INFECTIOUS AND OTHER NOTIFIABLE DISEASES DURING THE YEAR 1956 (CORRECTED FIGURES) Age Groups Scarlet Fever Whooping Cough Acute Poliomyelitis Measles Diphtheria Dysentery Meningococcal Infection Puerperal Pyrexia Totals Paralytic Non-para lytic M F M F M F M F M F M F M F M F F Under l year - - 24 21 19 13 6 5 88 1 year 1 3 23 19 2 37 28 14 16 2 145 2 years 6 2 26 28 1 1 42 46 11 15 178 3 years 4 3 22 14 1 37 44 13 8 146 4 years 7 10 23 18 1 32 33 1 11 10 146 5-9 years 40 43 61 56 2 1 122 99 44 41 509 10-14 years 15 12 3 4 3 1 2 5 8 11 64 15-24 years 5 3 1 1 1 8 6 16 1 44 86 25 and over 1 1 1 1 1 3 24 44 41 117 Total 79 77 183 162 6 3 5 1 296 276 1 137 166 2 1 85 1479 49 Age Groups Pneumonia Small Pox Acute Encephalitis Typhoid Fever Erysipelas Food Poisoning Oph. Neon. Scabies Totals Infective Post Infective M F M F M F M F M F M F M F M F M F Under 5 years 8 4 4 4 4 4 7 5 40 5 - 14 3 3 1 1 2 3 3 8 24 15 - 44 17 24 1 4 10 13 16 20 105 45 - 64 27 19 1 4 7 8 5 71 65 and over 9 10 1 3 6 5 34 Totals 64 60 1 1 6 15 30 30 4 4 26 33 274 50 51 CAUSES OF AND AGES AT DEATH (CORRECTED) DURING 1956 CAUSES OF DEATH AGES (both sexes) TOTALS Under 1 year. 1 and under 5 years. 5 and under 15 years. 15 and under 25 years. 25 and under 45 years. 45 and under 65 years. 65 and under 75 years. 75 and upwards Male Female 1, Tuberculosis, Respiratory M 5 3 6 4 18 4 F 1 1 1 1 2- Tuberculosis, other M F 3, Syphilitic disease M 3 3 6 1 F 1 4- Diphtheria M F 5, Whooping Cough M 1 F 1 6. Meningococcal, infection M 1 1 F 7, Acute Poliomyelitis M 1 1 F 8. Measles M F 9, Other infective and parasitic diseases M 2 2 2 F 1 1 10- Malignant Neoplasm, Stomach M 6 15 6 7 34 24 F 6 6 12 11. Malignant Neoplasm, Lung Bronchus M 5 60 30 10 105 19 F 9 3 7 12. Malignant Neoplasm, Breast M 36 F 2 18 7 9 13, Malignant Neoplasm, uterus F 1 11 7 3 22 14. Other malignant and lymphatic neoplasm M 1 10 38 42 30 121 113 F 1 9 36 33 34 15, Leukaemia, aleukaemia M 1 1 2 1 1 6 1 F 1 16. Diabetes M 2 1 1 4 11 F 1 4 6 17. Vascular lesions of nervous system M 1 5 20 36 41 103 179 F 4 27 50 98 18- Coronary Disease, angina M 7 58 85 57 207 112 F 13 36 63 19. Hypertension with heart disease M 2 9 18 29 F 6 16 29 51 20. Other heart diseases M 2 2 20 24 66 114 F 1 4 22 36 109 172 52 53 CAUSES OF AND AGES AT DEATH (CORRECTED) DURING 1956 CAUSES OF DEATH AGES (both sexes) TOTALS Under l year. 1 and under 5 years. 5 and under 15 years. 15 and under 25 years. 25 and under 45 years. 45 and under 65 years. 65 and under 75 years. 75 and upward Male Female 21. Other circulatory diseases M 3 13 24 27 67 62 F 2 3 18 39 22. Influenza M 2 2 4 4 F 1 1 1 1 23. Pneumonia M 6 1 1 10 24 41 83 85 F 7 1 2 5 13 57 24. Bronchitis M 2 1 28 29 44 104 84 F 1 1 5 26 51 25. Other diseases of respiratory system M 4 2 5 11 15 F 1 3 6 5 26. Ulcer of stomach and duodenum M 2 5 4 7 18 9 F 3 1 5 27. Gastritis, enteritis and diarrhoea M 3 1 3 7 7 F 1 2 1 3 28. Nephritis and nephrosis M 3 3 3 4 13 7 F 1 1 3 2 29. Hyperplasia of prostate M 1 7 4 12 F 30. Pregnancy, childbirth, abortion F 1 1 31. Congenital malformation M 9 1 2 3 15 5 F 2 1 1 1 32. Other defined and illdefined diseases M 28 2 8 20 20 19 97 102 F 21 2 2 1 7 24 13 32 33. Motor Vehicle accidents M 2 3 2 1 3 11 5 F 2 2 1 34. All other accidents M 1 2 4 8 2 2 19 15 F 1 2 2 3 7 35. Suicide M 1 1 9 7 2 20 7 F 2 4 1 36. Homicide and operations of war M 1 1 F Total 1233 1156 Grand Total 2389 All ages under 1 year 1-4 5-14 15 - 24 25 - 44 45 - 64 65 - 74 75 and over 2,389 100% 3.52 0.29 0.54 0.29 4.65 4.52 27.38 40.81 54 STATISTICS OF LAMBETH FOR THE LAST TEN YEARS Year Population Deaths Death Rate Births Birth Rate Infantile Deaths Infantile Death Rate 1947 223,670 2,917 13.04 5,166 23.10 169 32 1948 226,600 2,508 11.07 4,311 19.0 2 118 27 1949 229,400 2,736 *12.04 4,108 17.91 119 29 1950 231,000 2,725 *11.91 3, 875 *15.60 111 28.6 1951 229,100 2,947 *12.86 3,829 *15.40 96 25.07 1952 230,200 2,824 *12.27 3,626 *14.49 92 25.37 1953 229,000 2,408 *10.62 3,649 *15.93 93 25.49 1954 226,200 2,298 *10.26 3,684 *14.33 86 23.34 1955 224,200 2,385 *10.74 3,597 *14.12 74 20.57 1956 223,900 2,389 *11.10 3,915 *15.74 83 21.2 * as adjusted by comparability factor. 55 APPENDIX A MEDICAL OFFICERS OF HEALTH TO THE VESTRY AND BOROUGH OF LAMBETH IN THE 100 YEARS FROM 1ST FEBRUARY, 1856. William ODLING M. B. , M. R. C. P. , 1856-1862 F. R. S. George PUCKLE, M. D. 1863-1871 M J. MacCORMACK, M. B. 1871-1876 Archer FARR 1876-1881 Firth GROVES, M. R. C. S. , L. R. C. P. , 1881-1883 L. S. A. H. Walter VERDON, M. D. , F. R. C. S. 1883-1894 Joseph PRIESTLY, M. D. 1895-1927 A. G. G. THOMPSON, M. A., M D. , D. P. H. 1927-1955 * W. STOTT, M. B., B. S., Acting from September D. P. H. 1955 * Medical Officer of Health, Southwark. SANITARY IMPROVEMENTS. On the 3rd day of April, l856, the Medical Officer of Health made his First Report to the General Purposes Committee. By the 27th day of March, 1857, there had been brought under the consideration of the Committee, by the Medical Officer and two Inspectors, 1629 cases of nuisance. With regard to the nature of the above-mentioned nuisances, 846 cases referred to the unwholesome condition of 1964 dwelling-houses, forming nearly one-tenth part of the total number of inhabited houses that existed in the Parish at the period of the last census in 1851. In all these cases improvements to a greater or less extent have been effected. These improvements have related principally to the state of the Drainage, to the Water supply, to the condition of cleanliness, dryness, and repair, and to the means for enclosing domestic refuse. There have been 22 cases of nuisance, arising from offensive trades. The investigation of these cases, and the frequent supervision of the premises to which they refer, have occupied much of the time of the Medical Officer. The remaining 761 miscellaneous cases pertain to a variety of subjects; such, for instance, as offensive ditches and drains, foul urinals, piggeries, cow-sheds and slaughter-houses, accumulations of filth and refuse. The following Tabular Statement shows the operations of the Vestry, with reference to Nuisances, &c.— Return shewing the number and nature of Nuisances complained of in the Parish of Lambeth, and the steps taken to remove or abate the same, with the Results, from 9th of February, 1856, to the 25th March, 1857. Description of Nuisances. No. of cases of each class included in Complaint. No. of cases in winch Notices served to abate Nuisances. No. of cases of each class in which the causes of Nuisance were abated on Notice. No. of cases for each class in which Summonses were taken out. No. of cases of each class in which Magistrates' Orders for abatement were made. REMARKS. Foul Privies 1186 758 802 384 329 In consequence of an objection by the Magistrates to make Orders for necessary Constructive Works, the process of Summonses for such purpose was discontinued in 1856 In all subsequent eases, in which Constructive Defective drains 1392 758 1004 358 294 Overcharged Cesspools 63 63 45 18 15 Filthy Dwellings 1261 758 997 264 240 Want of Ashpits 637 637 423 214 163 Dust and Garbage 858 Verbal 858 ... ... Dung and other filthy Accumulations 79 79 77 2 2 Offensive Gullies 79 Verbal 79 ... ... Filthy Highways 22 Verbal 22 .. ... Offensive Urinals 18 18 14 4 2 Offensive Smells 61 19 60 1 ... Offensive SlaughterHouses 4 4 2 2 2 Works were requisite for effecting Sanitary improvements, the Vestry has issued its Orders for carrying the same into execution. Swine, &c. 283 173 209 74 74 Obstructions of High ways 58 2 53 5 2 Total 6001 3269 4675 1326 1123 Number of Slaughter Houses Visited and Licensed, 110. 58 INDEX Atmospheric Pollution 25 Birth rate 9 Burials 44 Care of the Aged 38 National Assistance Act 1948, Section 47 39 Holidays for the Elderly 40 Workrooms for the Elderly 41 Visiting by Public Health Visitor 41 Lambeth Old People's Welfare Association 42 Meals-on-Wheels Service 43 Chiropody 43 Old People's Clubs 43 King George VI Memorial Club 43 Control of Disease 11 Tuberculosis 11 Respiratory Tuberculosis and Lung Cancer 14 Diphtheria 15 Scarlet Fever 15 Whooping Cough 15 Measles 15 Poliomyelitis 15 Pood poisoning 16 Dysentery 16 Typhoid 17 Scabies 17 Cancer 17 Diseases of Heart and Circulation 17 Dangerous Structures 31 Deaths. Causes of and Ages 50 Death Rate 9 Disinfection and Disinfestation 31 Drainage and Sewerage System 25 Drainage Plans 25 Factories and other premises 33 Food Inspection and Supervision 19 Sampling of Food and Drugs 19 Milk 20 59 Inspection at shops etc. 20 Method of Disposal of Condemned Food 20 Complaints 20 Ice Cream Samples 22 Number of food premises 22 General Statistics 9 Hairdressers and Barbers. Regulation of 32 Health Services by other authorities 37 Hospitals 37 Housing Repair, Maintenance and Sanitary Conditions 26 Housing Act, 1936, Part II 26 Housing Act, 1936. Part III Clearance Areas 27 Ministry of Health Table 27 Inspections during year 27 Remedy of defects 28 Action under Statutory Powers 28 Housing Act, 1949. Section 4 29 Housing Act, 1949 Section 20 29 Housing, Repairs and Rents Act 1954 29,30 Inspections arising from Rehousing 29 Rehousing and overcrowding 30 Laboratory Service 38 Maternal Mortality 9 Offensive Trades 33 Outwork 35 Personal Health Services 37 Pet Animals Act, 1951 32 Pharmacy and Poisons Act, 1933 32 Public Health Committee of Lambeth Borough Council 1 Pag Flock and Other Fillings Material Act, 1951 32 Registrations. 32 Rodent control 31 Sanitary Circumstances of the area 24 Slaughter of Animals Act, 1933 32 Staff of Public Health Department 7 Statistics 9,54 Water Supply 24 Printed by Lambeth Borough Council.