AC 4383 METROPOLITAN BOROUGH OF LAMBETH ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1957 F. SUMMERS, m.b.. B.S., m.r.c.s., l.r.c.p., d.P.h. Medical Officer of Health METROPOLITAN BOROUGH OF LAMBETH ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1957 F. SUMMERS, m.b., b.s., m.r.c.s., l.r.c.p., d.p.h. Medical Officer of Health CONTENTS OF REPORT Page Members of Public Health Committee 5 Staff of Public Health Department 6 Introductory Remarks of Medical Officer of Health 9 Section A Statistics and Social Conditions of the Area General 12 Births, Birth Rate, Still-births, Still-birth Rate 12 Deaths, Death Rate 13 Maternal Mortality 13 Infantile Mortality 14 Summary of Vital Statistics for the year 1957 16 Vital Statistics for years 1948 1957 17 Classification of Deaths 18 Notes on Vital Statistics 21 Deaths from Cancer of Lung and Bronchus 22 Road Traffic Accidents 24 Section B prevalence of, and Control over, Infectious and Other Diseases Notifications 27 Age Distribution of Infectious Diseases 29 Ward Distribution of Infectious Diseases 30 Distribution of Infectious Diseases according to Parliamentary Constituencies 31 Notes on Infectious Diseases 31 Diphtheria and Diphtheria Immunisation 33 Smallpox 34 Vaccination and Internationa] Certificates of Vaccination 35 Tuberculosis 36 Report of Chest Physician 40 Section C : General Provision of Health Services for the Area Care of the Aged 43-50 Action under Section 47 National Assistance Act, 1948 44 Holidays for the Elderly 45 Laundry Services for Aged Incontinent Persons 48 Lambeth Old Peoples Welfare Association 48 Section 50 National Assistance Act, 1948, Public Burials 50 Hospital Facilities 51 Health Services provided by the London County Council 51 Public Health Laboratory Service 52 P age Section D Sanitary Circumstances of the Area Water Supply 53 Section 95 Public Health (London) Act, 1936 54 Drainage 55 Repairs, Maintenance and Sanitary Condition of Houses 55 Housing Act, 1936 Appeal against Closing Order 62 Inspection of Dwelling Houses under Public Health Act 64 Rehousing and Overcrowding 64 Housing Repairs and Rents Act, 1954 65 Rent Act, 1957 65 London County Council (General powers) Act, 1955 66 Legal Proceedings Public Health (London) Act, 1936 67 Dangerous Structures 67 Rag Flock and Other Pilling Materials Act, 1951 67 Pet Animals Act, 1951 67 Hairdressers and Barbers 68 Offensive Trades 68 Drain Tests 68 Disinfection 68 Disinlestation 69 Rodent Control 69 Clean Air Act, 1956 70 Factories Acts, 1937 and 1948 70 Summary of Work of Public Health Inspectors 74 Section E : Inspection and Supervision of Food Food Premises 77 Milk (Special Designations) Regulations, 1949-1954 78 Sampling of Food and Drugs 78 Milk 79 Ice Cream Samples 79 Inspection of Food 79 Food Complaints 80 Pharmacy and Poisons Act, 1933 81 Street Markets 81 Slaughter of Animals Act 81 PRINTED BY LAMBETH BOROUGH COUNCIL 5 METROPOLITAN BOROUGH OF LAMBETH PUBLIC HEALTH COMMITTEE (Appointed by the Council on 24th May, 1957) The Worshipful the Mayor of Lambeth (Mr. Councillor Geo. Brownless J.P.) (ex-officio) Chai rman Mrs. Councillor M. Marock Vice-chairman Mrs. Councillor J.M. Melman, B.A. Aldermen C. S. Jordan W. Laverick Councillors : Mrs. D„ R. Colls S. A. Davey W. Driscoll Miss B. VV. High J. E, Janes Miss K.L. Jenner G.F. S. Light T- Robinson 6 STAFF OF THE PUBLIC HEALTH DEPARTMENT MEDICAL OFFICER OF HEALTH F. Summers, M. B., B. S., Mo R. C. S., L. R. C. P., D. P. H. PUBLIC ANALYST (PART-TIME) J. E. Woodhead, B. Sc., F. R. I. C., Ph. C CHIEF ADMINISTRATIVE ASSISTANT H.P. Wright (Retired 12.11.57) J.M. Roberts (Appointed 28.11.57 Commenced duties 6.1.58) PUBLIC HEALTH INSPECTORS (a) District Inspectors W. Bonnin (1) (2) H. F. Bryan (1) R. G. Cutler (1) D.J. Huggins (1) (2) E. E. Morgan (1) (2) R. A. Newton (1) (2) J. B. Sainsbury (1) S.G. Starling (1) (2) H. Taylor (1) (2) A. E. White (1) (2) (b) Food Inspectors S. Bradley (1) (2) C.W. Idle (1) (2) (c) Housing Inspectors S.G. Ford (1) (2) F.J. Heffield (1) (2) 7 (d) Rodent Officer S. F. Heal (1) (2) (e) Smoke Inspectors J. Bowers (1) (2) (3) P. Russell (1) (2) (3) (f) Women Inspectors Miss L. E. Auger (1) (4) (6) Miss A. F. Crombie (1) (4) (6) (g) Public Health Visitor Miss M. McNair (5) (6) CLERICAL STAFF C. Agate A. W. Bayley Mrs. J. Clark (Part time) Mrs. G. Hopkins N. A. Jupp E. F. Mannerson Mrs. M. Rogers E. Walker Mrs. K. Williams DISINFECTING STATION Wanless Road, Loughborough Junction, S. E. 5 Superintendent :- L. Brann GENERAL ASSISTANTS R. C. Ayl ing W. Deamer (Assistant Rodent Officer) L. Whiston (Rodent Operative) (1) Cert. S.I.E.B. (2) Cert. Meat and other Foods (3) Smoke Inspectors Certificate (4) Health Visitors Certificate (5) State Registered Nurse (6) State Certified Midwife 9 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Lambeth Mr. Mayor, Ladies and Gentlemen. I have the honour to present my Annual Report for the year 1957 on the health of the Borough of Lambeth. The vita] statistics for the year are satisfactory. For the first time fora number of years the Registrar Genera]"s estimated mid-year population has shown an increase. The death rate is fractionally lower than last year and diseases of the heart and circulation accounted for some 45% of the deaths. This is to be expected in an ageing population but a disturbing factor is the increase in number of persons, especially males in the 45 - 64 years age group, who fall victims to coronary disease. These persons are presumably at the stage of life when their accumulated experience and skill s could be of great benefit to the community. Thecausation of this disease is at present obscure but it appears to be associated with stress, psychological rather than physical. The increasing number of deaths from cancer may be to some extent a reflection of the ageing population but evidence suggests that the whole of this increase is not due to this factor. Cancer of the lung and bronchus is now an important cause of death in those under 60 years of age. Medical research suggests that heavy cigarette smokers are more liable to lung cancer than non smokers. It is also suggested that urbanisation may be a further factor. For the second time in the history of the Borough there has been no maternal death during the year. Infantile mortality shows a slight increase on last year, and is also above that forLondon as a whole and for England and Wales. As a result of the operation of Section 11 of the Clean Air Act 1956 the Council approved the creation of a smoke control area and reference is made to this in the body of the report. New legislation which came into force during theyear included the Housing Act 1957 and the Rent Act, 1957, The former with the exception of certain financial provisions, was an Act consolidating previous legislation, whilst thelatter threw a deal of extra work on the Department in connection with Certificates of Disrepair. 10 At this point it might be opportune to mention that in the past few years there has been a general shortage of Public Health Inspectors. This shortage is apparent in Lambeth and at the end of the year the inspectorial staff was two below establishment. This position is likely to persist as the more senior Inspectors reach retiring age and recruitment is poor. The welfare of the aged is a matter in which the Council has continued to take active interest by its generous financial assistance to the Lambeth Old People's Welfare Association whose work has continued to expand. The provision of holidays at the seaside for old age pensioners at reduced rates has been much appreciated and during the year 292 old folks availed themselves of this facility. In November Mr. H.P. Wright, Chief Administrative Assistant in the Department, retired on reaching the age of 65 years. Mr. Wright had been in the service of the Council in various capacities since November 1909. He was appointed to the Public Health Department as an assistant clerk in October 1937 and became Chief Administrative Assistant when the Department was reorganised in 1948 consequent upon the coming into force of the National Health Service Act. During that period he gave loyal and conscientious service to the Department and although one realises that retirement is inevitable it was with regret that I saw him go. Finally I would like to thank the Members of the Council and of the Public Health Committee for their support and encouragement during the year and also to acknowledge the loyal and conscientious service of my staff. I am, Mr. Mayor, Ladies and Gentlemen Your obedient servant, Medical officer of Health July, 1958 11 SECTION A STATISTICS AND SOCIAL CONDITIONS OF THE AREA The Borough of Lambeth is the fifth largest of the 28 Metropolitan Boroughs ; in terms of population - third. It has common boundaries with Battersea, Wandsworth, Croydon, Penge, Camberwell, Southwark, and the Cities of London and Westminster, and the total area is approximately 6% square miles. This area excludes tidal water and foreshore, but includes approximately 5 acres which have been added to the Borough as a result of the building of the new South Bank Embankment, part of the river area has been reclaimed. Among the world famous buildings within the boundaries are Lambeth Palace ; The Oval Cricket Ground ; The County Hall : The Royal Festival Hall and The Headquarters of the London Fire Brigade. The site of the South Bank Exhibition, focal point of the 1951 Festival of Britain, is also in the Borough. The land surface rises from 12 feet above sea level at the River to 50 feet at Brixton, 150 feet at West Norwood, and about 379 feet at and near the Crystal Palace. The perimeter of the Borough measures 1754 miles. For election purposes Lambeth is divided into three Parliamentary Divisions, each returning one Member of Parliament, and three members to the London County Council, and these Divisions are, in turn, divided into a total of 21 wards for the purpose of Borough Council elections. 12 STATISTICS GENERAL Area of the Borough 4,087.5 acres No. of Wards 21 No. of Parliamentary Constituencies 3 Population Figure supplied by Registrar General (Mid-year estimate 1957) 224,300 Density of Population i.e. number of Persons per Acre 54.8 Number of marriages during the year 2095 Marriage rate per 1,000 Population 9.34 Rateable Value of District (1957/1958) £3,909,898 Sum represented by a Penny Rate (1957/1958) £15,594 BIRTHS Live Births Legitimate Illegitimate Total Males 1927 271 2198 Females 1765 242 2007 Total 3692 513 4205 Live Birth Rate per 1,000 Home Population 18. 69 Birth Rate corrected for comparison with other Areas 16.82 Comparability Factor supplied b.v Registrar General 0. 90 Birth Rate per 1,000 Home Population County of London 16.2 Birth Rate per 1,000 Home Population England and Wales 16.1 Corresponding Rate for the Borough of Lambeth for year 1956 15.74 13 STILL BIRTHS Legitimate Illegitimate Total Males 53 14 67 Females 33 12 45 Total 86 26 112 Still Birth Rate per 1,000 Total Births (i.e. live and stil1) 25.94 Still Birth Rate per 1,000 Home Population 0. 50 Still Birth Rate per 1,000 total births, England and Wales 22.5 Still Birth Rate per 1,000 Home Population England and Wales 0. 37 DEATHS Male Femal e Total 1240 1119 2359 Death Rate per 1,000 Home Population 10.51 Death Rate corrected for comparison with other £li°681s ••• ••• ••• ••• ••• 10. 83 Comparability factor supplied by Registrar General 1.03 Death Rate per 1,000 Home population County of London ... ... ... ... ... ... 11.2 Death Rate per 1,000 Home Population England and Wales ... ... ... ... ... ... 11.5 Corresponding Rate for the Borough of Lambeth for the year 1956 ... ... 11.10 MATERNAL MORTALITY Number of Women dying in consequence of childbirth Nil Maternal Mortality Rate per 1,000 Total Births Nil 14 Maternal Mortality Rate per 1,000 Total Births County of London 0. 35 Comparative Figure for England and Wales 0. 47 INFANTILE MORTALITY Deaths of Infants under one year of age Legitimate Illegitimate Total Males 42 11 53 Females 41 4 45 Totals 83 15 98 Death Rate of Infants under 1 year of age per 1,000 1lve births 23. 30 Death Rate of Infants under 1 year of age per 1,000 live births County of London 21 Death Rate of Infants under 1 year of age per 1,000 live births England and Wales 23.1 Deaths of Infants under the age of 4 weeks Legitimate Illegitimate Total Males 31 8 39 Females 30 3 33 Totals 61 11 72 Neo-natal Mortality Rate per 1,000 live births 17. 36 Neo-natal Mortality Rate per 1,000 live births County of London 16.3 Neo-natal Mortality Rate per 1,000 live births England and Wales 16.5 An analysis of the causes of death and the age at time of death reveals the following figures. Under 1 day 1 - 7 days 1 - 2 weeks 2-3 weeks 3 weeks to 1 month TOTAL UNDER 1 month 1 - 3 months 3 - 6 months 6 - 9 months 9 12 months TOTAL UNDER 1 year Prematurity 13 7 1 21 21 Prematurity & Atelectasis 4 5 9 9 Prematurity & Haemorrhage 3 3 3 Respiratory Failure 3 2 5 5 Atelectasis 3 3 6 6 Asphyxia 2 1 3 2 5 Pneumonia 1 1 1 3 2 4 1 1 11 Bronchitis 1 1 1 1 3 Septicaemia and Broncho-Pneumonia 1 1 1 Intracranial Haemorrhage 3 3 6 6 Anoxia 2 1 3 1 3 Heart Conditions 1 1 2 2 3 8 Gastro-Enteritis 2 2 Purulent Meningitis 1 1 Hydrocephalus 1 1 Anencephaly 1 1 1 Anaemis due to Rhesus incompatibility 1 1 1 Subarachnoid Haemorrhage & Tentorial Tear 1 1 1 Placental Insufficiency 1 1 1 Liver Failure and Biliary Cirrhosis 1 1 Absence of Bowel 1 1 1 Encephalocel e 1 1 1 Atresia of Oesophagus 1 1 1 Fragilitas Ossium 1 1 1 Laryngeal Obstruction 1 1 Mongol with multiple congenitial deformities 1 1 1 Renal Failure 1 1 HaemoDtvsis & Lung Abscess 1 1 TOTALS 35 29 6 1 1 72 7 11 6 2 98 15 16 SUMMARY OF VITAL STATISTICS FOR THE YEAR 1957 England & Wales Borough of Lambeth Births Rates per 1,000 Home Popul at ion Live Births 16. 1 16. 82 Still Births 0. 37 0. 50 Deaths All Causes 11.5 10. 83 Typhoid and Paratyphoid Fever 0.00 - Whooping Cough 0.00 - Diphtheria 0.00 - Tuberculosis 0.11 0.10 Smallpox - - Acute Poliomyelitis & Polio-Encephalitis 0.01 - Pneumonia 0.52 0. 70 Influenza 0.15 0.14 flat es per 1, 000 Live Births All Causes under 1 year of age 23. 1 23.3 Rates per 1,000 Home Population Notifications (Corrected) Typhoid Fever 0.00 0.00 Paratyphoid Fever 0.00 - Meningococcal Infection 0.02 0.02 Scarlet Fever 0.65 0. 68 Whooping Cough 1.89 1.15 Diphtheria 0. 00 - Erysipelas 0. 07 0.04 Smallpox - - Measles 14.1 13.1 Pneumonia 0. 72 0.96 Acute Poliomyelitis Paralytic 0.07 0. 06 Non-Paralytic 0.03 0.01 Pood Poisoning 0.20 0. 26 Puerperal Pyrexia 15.99 (a) 25.01 (a) (a) Per 1,000 Total (Live & Still) Births 17 BOROUGH OF LAMBETH SUMMARY OF VITAL STATISTICS FOR THE TEN YEAR PERIOD 1948 - 1957 Year Population Deaths Death Rate Live Births Live Birth Rate Deaths of Infants under 1 year of age Infantile Mortality Rate Maternal Deaths Maternal Mortality Rate 1948 226,600 2,508 11.07 4,311 19.02 118 27 1 0. 23 1949 229,400 2,736 *12.04 4,108 17.91 119 29 Nil Nil 1950 231,000 2,725 *11.91 3,875 *15.60 111 28.6 1 . 25 1951 229,100 2,947 *12.86 3,829 *15. 40 96 25.07 2 .51 1952 230,200 2,824 *12.27 3,626 *14. 49 92 25.37 8 2. 17 1953 229,000 2,408 *10.62 3,649 *15.93 93 25.49 4 1.08 1954 226,200 2,298 *10.26 3,684 *14.33 86 23.34 6 1.59 1955 224,200 2,385 *10. 74 3,597 *14.12 74 20.57 4 1.08 1956 223,900 2,389 *11.10 3,915 *15.74 83 21.2 1 0. 25 1957 224,300 2, 359 *10.83 4,205 *16.82 98 23.30 Nil Nil * As adjusted by Comparability Factor 18 19 DEATHS OF LAMBETH RESIDENTS DURING 1957 CLASSIFIED ACCORDING TO AGE GROUPS AND SEXES CAUSES OF DEATH AGE GROUPS Under 1 year 1 - 4 years 5 - 14 years 15 - 24 years 25 - 44 years 45 - 64 years 65 - 74 years 75 years and over TOTALS 1. Tuberculosis, respiratory M 6 2 1 9 F 4 4 8 2. Tuberculosis, other M 3 3 F 1 1 2 3. Sylphilitic Disease M 1 2 3 1 7 F 1 1 4. Diphtheria M F 5. Whooping Cough M F 6. Meningococcal Infection M 1 1 2 F 7. Acute Poliomyelitis M F 8. Measles M F 9. Other Infective and Parasitic Diseases M 1 1 1 3 F 1 1 1 3 10. Malignant Neoplasm, Stomach 1 16 10 4 31 F 1 5 9 15 30 11. Malignant Neoplasm. Lung Bronchus M 4 53 30 14 101 F 2 8 2 12 12. Malignant Neoplasm, Breast M F 4 23 12 5 44 13. Malignant Neoplasm, Uterus M F 1 8 4 2 15 14. Other Malignant & Lymphatic Neoplasms M 5 32 40 40 117 F 2 1 3 44 29 41 120 15. Leukaemia, Aleukaemia M 1 1 2 2 6 F 1 1 1 1 4 16. Diabetes M 1 1 1 3 F 1 2 3 10 16 17. Vascular Lesions of Nervous System M 2 25 28 40 95 F 1 21 44 78 144 18. Coronary Disease, Angina M 5 93 74 51 223 F 2 22 44 60 128 19. Hypertension with Heart Disease M 1 6 7 11 25 F 2 14 33 49 20. Other Heart Disease M 1 5 17 28 64 115 F 3 10 25 126 164 21. Other Circulatory Disease M 2 11 18 18 49 F 1 10 15 35 61 22. Influenza M 4 3 1 8 F 1 1 12 2 7 23 23. Pneumonia M 6 1 2 18 21 40 88 F 5 12 14 40 71 24, Bronchitis M 1 1 32 33 41 108 F 1 1 7 11 32 52 25. Other Diseases of Respiratory System M 1 6 10 6 23 F 2 1 2 5 26. Ulcer of Stomach and Duodenum M 1 2 4 7 4 18 F 2 2 5 9 20  AGE GROUPS Under 1 year 1 - 4 years 5-14 years 15 - 24 years 25 - 44 years 45 - 64 years 65 - 74 years 75 years and over TOTAL 27. Gastritis, Enteritis and Diarrhoea M 1 1 4 6 V 1 1 3 5 28, Nephritis and Nephrosis M 2 2 1 5 F 1 4 1 6 29. Hyperplasia of Prostate M 1 7 8 16 F 30. Pregnancy, Childbirth, Abortion F 31. Congenital Malformations M 7 1 1 1 2 1 2 1 16 F 10 1 2 3 2 18 32. Other Defined & 111-defined Diseases M 36 1 3 2 5 16 15 21 99 F 25 1 9 19 22 28 104 33. Motor Vehicle Accidents M 1 1 4 3 2 2 13 F 1 2 3 34r All Other Accidents M 1 1 1 5 7 6 5 2 28 F 2 1 3 3 5 14 35. Suicide M 7 9 5 1 22 F 1 2 3 1 7 36, Homicide and Operations of War M 1 1 F 1 1 ALL CAUSES TOTALS M 53 7 6 11 62 371 352 378 1240 F 45 3 4 4 40 228 260 535 1119 GRAND TOTALS 98 10 10 15 102 599 572 913 2359 21 VITAL STATISTICS Population According to the figures supplied by the Registrar General the estimated mid year population for 1957 was 224,300. This is 400 more than the Registrar-General's estimate of Population for 1956 but 5,940 less than the Census figure for 1951. Births The number of live births recorded during the year was 4,205, an increase of 290 on the figure for 1956. This gives a corrected birth rate of 16.82 compared with 15.74 last year. The rate for the County of London is 16.2 and that for England and Wales 16.1. The number of still-births registered during the year was 112, an increase of 31 over the figure for 1956, giving an increased still-birth rate of 25.94 per 1, 000 total births and 0.50 per 1,000 Home Population compared with rates of 22.4 and 0.37 for England and Wales. Deaths The number of deaths decreased by 30, giving a corrected death rate of 10.83 compared with 11.10 per 1,000 Home Population in 1956. The death rate for Lambeth compares favourably with that for the County of London which is 11.2 and with that for England and Wales which is 11.5. Heart and associated diseases accounted for the largest number of deaths, 1,053 people dying from these causes. Second was Cancer and during the year 470 people died from all forms of this disease. Deaths from respiratory tuberculosis fell from 22 in 1956 to 17 in 1957, but deaths from other forms of the disease increased, five occurring in 1957 compared with none in 1956. Sixteen deaths resulted from motor vehicle accidents, the same as last year, but two more men died in this manner. Other accidents accounted for 42 deaths compared with 44 last year. There was an increase of two in the number of suicides, 29 people taking their own lives compared with 27 in 1956. 22 Infantile Mortality Ninety-eight children, 83 legitimate and 15 illegitimate, died in the first year of life compared with 83 in 1956 giving an infantile mortality rate of 23.30 per 1,000 live births. The rate for the Borough of Lambeth is slightly higher than that for the County of London which is 21 per 1,000 live births but approximates to that of England and Wales which is 23.1. Of the 98 children who died, 72 died before reaching the age of 4 weeks giving a neo-natal mortality rate of 17.36 per 1,000 live births compared with 16.3 for the County of London and 16.5 for England and Wales. Maternal Mortality For the second time in the history of the Borough, no mother died as a result of childbirth. The other occasion on which this occurred was in 1949 although in that year there were fewer total births. Deaths from Cancer of the Lung and Bronchus In 1950 the Registrar-General added to the list of causes of death "Cancer of the lung and bronchus Prior to 1950 these deaths were included in" Cancer of all other sites Since that date 876 deaths from lung cancer have occurred in the Borough of Lambeth. Over the same period the number of deaths from respiratory tuberculosis was 395. An increase in the number of deaths from cancer of the lung and bronchus and a diminution in the number of deaths from respiratory tuberculosis has been a feature of the RegistrarGeneral' s statistics for England and Wales during the last few years and it is of interest to note that here in Lambeth the graph shows a similar trend. 23 COMPARISON OF DEATHS FROM RESPIRATORY TUBERCULOSIS AND CANCER OF LUNG AND BRONCHUS 24 ROAD TRAFFIC ACCIDENTS The following tables show the road traffic accidents and casualties occurring within the Borough of Lambeth during the year 1957 and the comparative figures and casualties for the five year period 1953 - 1957. It should be noted that the figures shown refer not only to Lambeth residents but also to persons living in other areas who were involved in accidents within the Borough. The figures for fatalities shown in these tables may not agree, therefore, with those in the list of causes of death supplied by the Registrar-General. The Registrar-General's figures refer to Lambeth residents only, and the death may have occurred within the Borough of Lambeth or outside the district. ROAD TRAFFIC ACCIDENTS 1957 WITHIN THE BOROUGH OF LAMBETH Month No. of Accidents Adults Children Total Killed Seriously Injured Slightly Inj ured Killed Seriously Injured Slightly Inj ured January 91 20 75 1 10 106 February 88 13 77 1 8 99 March 84 1 17 56 3 17 94 April 80 9 73 21 103 May 123 3 19 103 5 18 148 June 117 1 22 107 1 5 18 154 July 96 12 79 1 15 107 August 102 1 12 97 2 17 129 September 108 3 14 85 19 121 October 107 1 15 93 3 14 126 November 104 1 24 96 1 8 130 December 112 1 19 111 2 10 143 TOTALS 1,212 12 196 1,052 1 24 175 1,460 Accidents per mile of road 8.56 25 BOROUGH OP LAMBETH COMPARATIVE FIGURES OF ACCIDENTS AND CASUALTIES FOR FIVE YEAR PERIOD 1953 1957 1953 1954 1955 1956 1957 Total number of accidents involving personal injury 863 1,032 1,246 1,272 1,212 Accidents per mile of Road 6. 13 7. 29 8. 80 8.98 8. 56 Casualty Figures Adults Killed 16 12 14 12 12 Seriously injured 106 180 187 174 196 Slightly injured 618 756 1,002 1,067 1,052 Total s 740 948 1,203 1,253 1,260 Children Killed 4 1 1 2 1 Seriously injured 26 30 35 29 24 Slightly injured 196 196 189 211 175 Totals 226 227 225 242 200 Combined Adults & Children Totals 966 1,175 1,428 1,495 1,460 I am indebted to the Town Clerk for supplying me with the figures 27 SECTION B PREVALENCE OF. AND CONTROL OVER. INFECTIOUS AND OTHER DISEASES The undermentioned diseases are compulsorily notifiable within the Borough of Lambeth. Anthrax Cholera Continued Fever Diphtheria Dysentery Encephalitis Lethargica, acute Enteric Fever Erysipelas Food Poisoning G1anders Hydrophobia Malaria Measl es Membranous Croup Ophthalmia Neonatorum Paratyphoid Fever Plague Pneumonia, acute influenzal Pneumonia, acute Primary Polio-Encephalitis, acute Poliomyelitis, acute Puerperal Pyrexia Relapsing Fever Scabies Scarlatina Scarlet Fever Smallpox Tuberculosis, all forms Typhoid Fever Typhus Fever Whooping Cough The following table shows the total number of corrected notifications, other than tuberculosis, received during the year. 28 NOTIFICATIONS Disease 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter TOTALS GRAND TOTAL M F M F M F M F M F Scarlet Fever 29 30 22 27 15 12 12 7 78 76 154 Whooping Cough 52 55 49 44 18 17 12 11 131 127 258 Acute Poliomyelitis Paralytic - 1 2 3 2 6 - - 4 10 14 Non-Paralytic 1 - - - 1 1 - - 2 1 3 Measles 914 912 573 479 48 38 2 3 1,537 1,432 2, 969 Dysentery 16 22 7 6 7 3 2 5 32 36 68 Meningococcal Infection - 1 - - - - 2 1 2 2 4 Pneumonia 27 15 27 8 23 11 77 29 154 63 217 Typhoid Fever - 1 - - - - - - 1 1 Erysipel as 1 - 1 1 1 1 - 3 3 5 8 Food Poisoning 3 4 4 7 11 11 9 9 27 31 58 Puerperal Pyrexia 39 - 31 - 21 17 - 108 108 Ophthalmia Neonatorum 1 - 2 1 1 3 1 1 5 5 10 Scabies 5 2 1 7 4 6 6 3 16 18 34 TOTALS 1,049 1,082 688 614 131 130 123 89 1,991 1,915 3,906 29 NOTIFICATION OF INFECTIOUS DISEASE - AGE DISTRIBUTION Age Group DISEASE TOTAL Scarlet Fever Whooping Cough Acute Poliomyelitis Paralytic Non Paralytic Measles Dysentery Meningoccocal Infection Scabies M F M F M F M F M F M F M F M F Under 1 year 14 12 1 1 67 54 3 1 1 154 1 year 3 1 15 20 175 175 2 5 1 397 2 years 5 4 25 16 1 1 230 194 6 4 1 1 488 3 - years 5 5 14 17 1 199 180 5 5 2 433 4 years 8 13 15 12 183 178 4 413 5-9 years 48 40 46 43 2 1 1 659 624 4 7 1 1 1 477 10 - 14 years 6 13 2 5 2 1 11 15 2 2 1 1 61 15 - 24 years 1 3 7 5 1 6 4 6 33 25 and over 2 2 1 1 6 7 5 6 1 9 8 48 TOTALS 78 76 131 127 4 10 2 1 1, 537 1, 432 32 36 2 2 16 18 3 504 Age Group Pneumonia Typhoid Fever Erysipelas Food Poisoning Puerperal Pyrexia Ophthalmia Neonatorum TOTAL M P M F M P M F M F M F Under 5 years 8 7 3 2 5 5 30 5 - 14 years 4 4 6 5 19 15 44 years 33 21 1 13 14 108 190 45 64 years 65 17 3 4 3 8 100 65 and over 44 14 1 2 2 63 TOTALS 154 63 1 3 5 27 31 108 5 5 402 GRAND TOTAL 3 906 30 WARD DISTRIBUTION NUMBER OP CASES OF INFECTIOUS DISEASE NOTIFIED IN EACH WARD OF THE BOROUGH Ward Scarlet Fever Whooping Cough Measles Pneumonia Meningococcal Infection Acute Poliom.vel itis Paralytic Acute Poliomyelitis Non Paralytic Dysentery Ophthalmia Neonatorum Puerperal Pyrexia Typhoid Fever Food Poisoning Erysipelas Scabies Total Marsh 9 7 139 11 1 5 82 1 255 Bishops 13 14 172 3 1 1 5 7 1 1 218 Princes 15 14 181 8 1 1 1 2 9 1 1 234 Oval 16 16 103 2 1 14 152 Springfield 19 14 155 2 3 11 2 206 Lansdowne 14 3 105 5 4 2 12 1 1 1 144 Minet 5 18 158 12 1 3 1 1 199 Angell 5 19 136 8 1 2 1 1 5 178 Vassall 4 31 167 13 1 2 1 1 3 2 225 Grove 5 14 66 9 1 1 5 101 Stockwell 3 13 108 7 1 2 134 Landor 10 9 180 88 1 1 2 1 2 4 298 Ferndale 5 2 103 9 2 1 3 125 Town Hall 1 8 145 19 1 3 1 1 3 182 Heme Hill 6 23 152 10 1 1 4 4 3 204 Effra 4 15 129 3 5 1 1 3 3 164 Tulse Hill 3 7 127 2 1 7 4 1 152 Thurlow Park 1 1 118 1 1 122 Romany 3 5 122 4 1 1 136 Leigham 5 15 230 1 5 1 1 258 Knight's Hill 8 10 173 1 3 23 1 219 TOTALS 154 258 2,969 217 4 14 3 68 10 108 1 58 8 34 3 906 31 PARLIAMENTARY CONSTITUENCIES Number of cases of Infectious Diseases notified in each Parliamentary Constituency of the Borough. Disease Parliamentary Constituency TOTAL Vauxhal1 Brixton Norwood Scarlet Fever 86 38 30 154 Whooping Cough 68 114 76 258 Measles 855 1,063 1,051 2,969 Pneumonia 31 165 21 217 Meningococcal Infection 1 3 - 4 Acute Poliomyelitis Paralytic 3 4 7 14 Acute Poliomyelitis Non Paralytic 1 1 1 3 Dysentery 9 13 46 68 Ophthalmia Neonatorum 5 4 1 10 Puerperal Pyrexia 99 3 6 108 Typhoid Fever 1 - - 1 Food Poisoning 43 9 6 58 Erysipelas 3 2 3 8 Scabies 4 23 7 34 TOTALS 1,209 1,442 1,255 3,906 NOTIFICATIONS OTHER THAN TUBERCULOSIS The total number of notifications received during the year, excluding tuberculosis, was 3,906. This was an increase of 2,253 on the figure for 1956. This increase is accounted for by an epidemic of measles which commenced at the end of 1956, and continued until the end of September of this year. A total of 2,969 cases of measles was 32 notified, compared with 572 in 1956. Measles tends to occur in epidemic form every two years. Another outbreak may be expected, therefore, in 1959. Scarlet Fever There was a reduction of 2 in the number of cases of Scarlet Fever, 154 occuring compared with 156 in 1956. Whooping Cough This disease showed a decrease on the 1956 figure, 258 cases being notified compared with 345 last year. Poliomyelitis 17 cases of poliomyelitis, (14 paralytic and 3 non-paralytic) were notified during the year. This compares with 15, (9 paralytic and 6 non-paralytic) in 1956. There were no deaths from poliomye1itis during the year. The disease was spread throughout the different wards as follows Marsh 1 Bishop's 2 Prince's 1 Oval Springfield Lansdowne Minet 1 Angell - Vassall 2 Grove Stockwell Landor 1 Ferndale - Town Hall 1 Heme Hill 2 Effra - Tulse Hill 1 Thurlow Park Romany 1 Leigham 1 Knight's Hill 3 33 The cases were spread throughout the year as follows : - First quarter 2 cases Second quarter 5 cases Third quarter 10 cases Fourth quarter Nil 11 females suffered from the disease, compared with 6 males. 12 of the cases occurred in children under the age of 14 years. Food Poisoning 58 Notifications of food poisoning were received during 1957. The cases were distributed throughout the year as follows :- First quarter 7 cases Second quarter 11 cases Third quarter 22 cases Fourth quarter 18 cases The agent was identified in six cases Salmonella typhi murium 5 Salmonella Thompson 1 In the remaining 52 cases notified the cause was unknown. All the cases occurred in different families, scattered throughout the Borough. Diphtheria No case of Diphtheria occurred during the year. Although this is very gratifying the need for immunisation is still as great as ever. In view of the comparative rarity of the disease many parents have become complacent and fail to appreciate the value of having their children immunised. It is interesting to note that Lambeth Borough Council inaugurated a scheme of immunisation as far back as 1928. Since 1948, however, immunisation has been the responsibility of the London County Council and I am indebted to the Divisional Medical Officer of Division 8, Dr. Wallace, for supplying me with the following figures showing the number of children resident in the Borough of Lambeth who received immunising injections during 1957. 34 BOROUGH OP LAMBETH IMMUNISATION - 1957 Completed cases Welfare Centres and Nurseries Genera] Practitioners Total Under 5 years 5 - 14 years Under 5 years 5 - 14 years Diphtheria prophylaxis only 117 69 82 11 279 Combined antigenDiphtheria and Whooping Cough 1,217 22 290 13 1,542 Triple antigenDiphtheria, Whooping Cough and Tetanus 957 6 178 10 1,151 Diphtheria Boosting doses - all ages 712 218 930 Whooping Cough - all ages only (completed cases) 23 39 62 Smallpox There were no cases of this disease in the Borough during the year, but in May an incident occurred which showed how easily the infection might have been introduced. A message was received from the Medical Officer of Health of another Metropolitan Borough to the effect that he had received notification that a German business man who had stayed in his area about a fortnight before had been diagnosed as suffering from smallpox on arrival in Hamburg. The sheets from his bed had been washed at a Lambeth laundry. A visit to the laundry elicited the information that only three persons handled the laundry before washing. As the time had already passed when vaccination would have been effective it was decided to keep an unobtrusive watch on the three persons concerned until the recognised period of surveillance had expired. Fortunately no signs of infection developed. 35 INTERNATIONAL CERTIFICATES OF VACCINATION International Certificates of vaccination for persons travel ling to certain countries abroad are required in respect of Smallpox, Yellow Fever and Cholera. Vaccination against any disease other than yellow fever can be done by a person's own doctor, or exceptionally (by arrangement) at a hospital. So long as vaccination is done under the National Health Service, whether by a person's own doctor or at a hospital, no charge may be made for it, but in either case the doctor concerned may charge for issuing an Internationa] Certificate. Yellow fever vaccination must, for international and technical reasons, be done only at a Centre designated by the Government ; in London the Hospital for Tropical Diseases, 4 St. Pancras Way, N. W. 1. An Internationa] Certificate of vaccination against yellow fever will be supplied, after vaccination, at the Centre at which the vaccination is done. The International forms for smallpox and cholera (for completion by the person's own doctor) must be obtained by the traveller himself and taken to the doctor : it is NOT for the doctor, or a Local Authority, or their Medical Officer of Health, to supply them. The forms can usually be obtained by the traveller from the Company arranging his transport, or he can get them from the Ministry of Health, Savile Row, London W.1. After completion by the Vaccinator, certificates must be franked with an approved stamp. Approved stamps have been prescribed for the United Kingdom. If the Vaccinator is not himself an authorised user of a stamp, the person vaccinated must take or send the certificate for stamping to a Local Authority. In England and Wales this is the Town Council, Urban District Council or Rural District in whose area the Vaccinator practices. It should be noted that this is not necessarily the area in which the person vaccinated lives. During the year, 1893 International Certificates of Vaccination were stamped by the Public Health Department. 36 TUBERCULOSIS Notification The following table shows the number of cases of tuberculosis notified for the first time during the year 1957, excluding transfers into the district and cases brought to notice other than by formal notification. Age Group Respiratory Non-Respiratory Total Male Female Male Female All Forms Under 5 years 3 4 - 2 9 5-14 years 4 2 - 3 9 15-24 years 21 18 1 1 41 25 44 years 45 32 1 2 80 45 65 years 38 12 - - 50 65 years 12 8 - - 20 TOTAL 123 76 2 8 209 These primary notifications were distributed amongst the Pariiamentary Constituencies as follows : Norwood 77 Brixton 70 Vauxhal1 62 In addition to the foregoing 79 cases (73 respiratory and 6 nonrespiratory) were brought to light other than by primary notification. 37 ADMITTANCES AND DISCHARGES FROM HOSPITAL, SANATORIA ETC. Respiratory Non-Respiratory Admitted Discharged Admitted Discharged Male Female Male Female Male Female Male Female 110 68 116 65 5 9 4 7 Respiratory Non-Respiratory Admitted Discharged Admitted Discharged Parliamentary Constituencies Vauxhall 78 92 6 4 Brixton 62 51 4 6 Norwood 38 38 4 1 TOTALS 178 181 14 11 The following table shows the primary notification of tuberculosis, excluding inward transfers, for the ten year period 1948 1957. Year Respiratory Non-Respiratory Total Notification Rate per 1,000 population 1948 344 25 369 1. 63 1949 433 29 462 2.01 1950 400 31 431 1.87 1951 396 31 427 1. 86 1952 323 34 357 1.55 1953 318 29 347 1.52 1954 352 17 369 1.63 1955 232 21 253 1. 13 1956 180 18 198 0.88 1957 199 10 209 0.93 38 Deaths According to the figures supplied by the Registrar Genera] the following deaths occurred from tuberculosis during the year. Tuberculosis of Respiratory system Other forms of Tuberculosis All forms of Tuberculosis Male Female Total Male Female Total Male Female Total 9 8 17 3 2 5 12 10 22 NUMBER OP DEATHS PROM TUBERCULOSIS : AND DEATH RATE PER 1,000 POPULATION FOR TEN YEAR PERIOD 1948 1957 Year Deaths from Respiratory Tuberculosis Deaths from Non-Respiratory Tuberculosis Total Rate per 1,000 Population 1948 128 7 135 .60 1949 120 13 133 .68 1950 88 12 100 .43 1951 96 7 103 .45 1952 60 5 65 . 28 1953 46 7 53 .23 1954 34 7 41 . 18 1955 32 4 36 .16 1956 22 22 . 11 1957 17 5 22 . 10 The number of cases of tuberculosis remaining on the Register at the end of the year is as follows Respiratory Non Respiratory Total M F M P M F 1805 1450 133 174 1938 1624 3255 307 3562 39 DEATH RATE FROM ALL FORMS OF TUBERCULOSIS PER 1,000 POPULATION AND NOTIFICATION RATE PER 1,000 POPULATION 40 TUBERCULOSIS I am indebted to Dr. Price, Chest Physician at St. Francis' Hospital for the following report on the work of this Chest Clinic during the year. The following Table is an extract of the Annua] Return of Chest Clinic Work sent to the Ministry of Health for the year 1957 and refers to the Clinic at St. Francis' Hospital. Table 1 Respiratory Tuberculosis Non-Respiratory Tuberculosis Men Women Children TOTAL Men Women Children TOTAL Total cases on Clinic Register at 31.12. 57 626 541 85 1,252 14 18 16 48 Number of cases diagnosed during the year 66 57 5 128 1 - 1 2 Recovered 5 6 1 12 - - - - Deaths 6 1 - 7 - 1 - 1 Deaths Deaths from Tuberculosis are the lowest ever recorded. Six men and only one woman died of Pulmonary Tuberculosis. One death occurred in an aged patient where non-respiratory disease was discovered posthumously. Non-Respiratory Tuberculosis Only two non-respiratory cases were added to the register during the year. The decline in non-respiratory disease continues and is associated with the compulsory pasteurisation of milk. Review of those cases on the register shows that the majority are secondary to a primary lung infection and are not due to bovine tuberculosis. The widening use of B.C.G. vaccination will reduce the numbers still further coincidently with the prevention of Tuberculosis. 41 Respiratory Tuberculosis During the year, 128 cases of respiratory Tuberculosis were diagnosed and added to the register, of these 62% were in the category of minimal disease and an appreciable number were discovered by Mass Radiography Unit examination. The continued use of these Units is to be encouraged to bring such readily treated cases to light. The work of the Mass Radiography Unit accounts for the increase of new cases over the previous year. Table 2 Year Total on Register New cases Diagnosed Deaths Recovered 1951 1,541 266 62 29 1952 1,512 152 38 19 1953 1,434 115 39 31 1954 1,395 159 20 27 1955 1,281 86 12 25 1956 1,242 80 21 9 1957 1,252 128 7 12 Table 2 shows the falling incidence of Tuberculosis over the past eight years and the remarkable reduction in mortality for which credit must be given to the universal use of chemo-therapy. The increase in total cases on the register for the year appears to be associated with the priority re-housing of Tuberculosis cases and preliminary figures for the first part of 1958 show that for the first time transfers in exceed those transferred out. Treatment The management of cases of Tuberculosis including all forms of treatment, the examination of contacts and provision of additional help is all arranged at the Chest Clinic. The advent of chemo-therapy has changed the pattern of treatment completely and during 1957 over 200 people were given drug treatment at home. Admission to Hospital or Sanatorium is still necessary on occasion, particularly where thoracic surgery is indicated. There were 55 such admissions during the year. Less and less use is being made of artificial lung collapse by pneumo-thorax or pneumoperitoneum, and 585 refills were performed at the Clinic in the year. There is no waiting list for in patient treatment. 42 The Lambeth (South) Chest Clinic This Clinic was established in fully equipped accommodation at St. Francis' Hospital early in 1951. It serves an estimated population of 112,000 in that part of Lambeth in the S.E. Metropolitan Hospital Board region and the boundary corresponds with Brixton Hill, Brixton Road and the eastern border of Kennington Park. Although it is situated outside the Borough, patients have not complained of difficulty in attending. Co-operation between Clinic and Public Health Department is good, and information concerning cases notified under the Tuberculosis Regulations is exchanged weekly. Work at the Clinic is still concerned mainly with the Tuberculosis problem but more and more cases of non-tuberculous disease, including carcinoma, are being seen. No special register of such cases is kept but the incidence of carcinoma is increasing and more cases are being referred for diagnosis and treatment. 43 SECTION C GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA CARE OF THE AGED In my Annual Report for 1956 I said that the care of the aged was a matter which was constantly engaging the attention of my department and it was apparent that more and more time would have to be spent in the following up of cases referred to the Public Health Department. In consequence a woman Public Health Visitor was appointed, primarily to follow up those cases which appeared to be in danger of social break up. The year under review is the first full year the woman visitor has worked and I am satisfied that her appointment was fully justified. Although it was necessary to use statutory power to effect removal in two cases only, a tremendous amount of work has been done by this lady in persuading old people to accept treatment voluntarily and by her constant supervision she has helped to ease the lot of many old people in the Borough of Lambeth. While paying tribute to the work of the Public Health Visitor I must also acknowledge the ready help given by Lambeth Old People's Welfare Association a report on whose work appears elsewhere in this report, and the London County Council through its Domestic Help and Nursing Service. The co operation of the Geriatricians and the Hospitals is also appreciated. To all these organisations I am extremely grateful. 44 Set out below is a summary of the work of the Public Health Visitor for the year 1957. No. of new cases 455 No. of cases removed to Hospital or Institution voluntarily 125 No. of cases removed under National Assistance Act 1948 and National Assistance (Amendment) Act 1951 2 No, removed by Duly Authorised Officer 6 Total no. of visits made by Visitor 1,971 No. of cases who received help 351 No. of cases where help was not required 63 No. of cases in which help was refused 27 No. of deaths 78 No. of cases on register 550 An analysis of the 455 cases reveals the following age groups. Age Group Male Female Total 65 69 21 51 72 70 74 22 52 74 75 79 29 57 86 80 84 32 70 102 85 89 30 70 100 90 94 4 14 18 95 100 1 2 3 TOTALS 139 316 455 NATIONAL ASSISTANCE ACT 1948 SECTION 47 NATIONAL ASSISTANCE (AMENDMENT) ACT 1951 Section 47 of the National Assistance Act 1948 deals with securing the necessary care and attention for persons who (a) are suffering from grave chronic disease or, being aged, infirm or physically incapacitated, areliving in insanitary conditions and (b) are unable to devote to themselves, and are not receiving from other persons, proper care and attention. 45 Action under this Act may be protracted, therefore the National Assistance (Amendment) Act 1951 was passed enabling the Medical Officer of Health, under delegated powers, to apply to the Court himself in an emergency. If the amending legislation is used a second medical certificate is required and the maximum period of detention is three weeks. During the year statutory action under the provisions of these Acts was taken in two cases. Case No. 1 This was an old lady of 88 years referred to the Public Health Department by the private practitioner. She was living alone in insanitary conditions, was in bed suffering from Broncho pneumonia and refused to go into a hospital or Institution. All persuasive methods failed and on two occasions ambulances were called but the old lady was adamant. She was removed on February 27th to hospital where she settled down and was later admitted to Part III accommodation. Case No. 2 This case, an old man of 76 years, had been found by the police lying on the floor where it was alleged he had been for 5 days. The premises were dirty, he had very little food and there was no-one to care for him or his dog. He refused to go into hospital and persuasive methods again failed. The appropriate action was taken under the National Assistance Act 1948 as amended and he was removed to St. Francis' Hospital where he died on 24th June, 1957. Holidays for the Elderly The Scheme to send old age pensioners to the sea-side for a week's holiday at a cost to them of £1 was continued during the year. In order to participate in the scheme a person must be an old age pensioner, have lived in the Borough of Lambeth for at least three years and during the same period must not have had a holiday. Holidays were arranged at Brighton in the Spring and Autumn, the first period being during May and the second in September. Parties of old people were sent to Brighton by coach at weekly intervals and on the outward and return journeys were accompanied by a State Registered Nurse. An officer of the Public Health Department went on each of the outward journeys. 46 All the places where the pensioners stayed were inspected by the Medical Officer of Health and were found to be clean and comfortable. All the rooms were fitted with hot and cold running water and the proprietors made all welcome. Among the various activities arranged were a coach trip and concerts and on one occasion the party was received by His Worship the Mayor of Brighton. From letters received it would appear that the old people were very appreciative of what was done and that they thoroughly enjoyed the change. A total of 441 application forms were issued for the Spring and Autumn Holidays. Of this number 380 were returned completed, and 292 old people eventually went on holiday the remainder being ineligible for various reasons or having failed to keep their appointment for interview by the Medical Officer of Health. Two hundred old people went for holiday in May and ninety-two in September. Included in the total are 34 married couples. The following table shows the age groups. Parliamentary Constituencies and sex. Age Groups in Years Parliamentary Constituencies 60 65 70 75 80 85 Total Grand Total F F M F M F M F M F M F M Vauxhall 3 15 1 24 9 12 8 5 6 2 1 61 25 86 Brixton 2 19 7 20 12 19 9 5 4 2 − 67 32 99 Norwood 3 22 6 23 11 19 8 10 4 1 − 78 29 107 TOTALS 8 56 14 67 32 50 25 20 14 5 1 206 86 292 48 LAUNDRY SERVICE FOR AGED INCONTINENT PERSONS In my last Annual Report I gave an account of the service which had been initiated in December 1956 to assist those old persons and their relatives who were unable to cope with the laundering of soiled linen. It will be recalled that a local laundry proprietor in addition to providing some linen was going to carry out the service free of charge for three months. In fact a free service was provided until the beginning of April. During the course of the year a further stock of linen was purchased and the laundry was done by the same laundry at a slightly reduced rate. The number of persons using the service fluctuated between 15 and 20. The service is much appreciated by all concerned with the welfare of these unfortunate elderly people. LAMBETH OLD PEOPLE'S WELFARE ASSOCIATION The work of the Lambeth Old People's Welfare Association continues to increase, and the services which it performs are manifold. It receives financial assistance from the Lambeth Borough Council, and acts as the Council's Agent in those welfare activities which the Council is unable to do directly. The following details of the work of the Association have been obtained from its latest report, and relate to the year ending 31st March, 1958 " The work of the Association has again shown a very considerable expansion in all branches. Within the past year wehave added 1914 new cases to our files as against 1472 last year. Many of these cases have needed considerable work on them and repeated visits have been undertaken. " Visiting The Association has now over 60 voluntary helpers, many of whom visit oldpeople regularly. The British Red Cross, the St. John's Ambulance Brigade, Toc Hand the boys of a local school all visit and help old people. 49 Holidays During the year 70 old people were helped to go away on holidays arranged by the Womens Holiday Fund and many more were recommended for holidays sponsored by the Borough Council, in which the Association has co-operated. 10 holidays were arranged for very infirm people. Meals on wheels During the year this service has again shown a considerable expansion. Owing to a grant made by the Borough Council to the Association it has been possible to purchase, equip and staff a second van, with the result that in the Northern end of the Borough 19,635 meals have been deliv ered as against 15,436 last year. The area of the Borough south of Clapham Road continues to be served by the Womens Voluntary Service. Chiropody Service This service has considerably increased, and six clinics are now working 21 sessions a week. The domicilliary service also has been increased to 4 sessions per week, and 119 old folk are being treated in their own homes. Old people's Clubs 27 clubs are now operating in the Borough and the thanks of the Association are due to all leaders and helpers in the work that they are doing. Two of these clubs, St. Anns and Northcote House are open for the service of dinners on four days a week, and the Springfield Club on one day a week. King George VI Memorial Club In the Report of the Association for last year it was stated that this experimental club for house-bound old people would be opening shortly. The Club, which opened to members in its new building in Coldharbour Lane on 1st July 1957, was officially opened on the 18th March 1958 by Her Royal Highness Princess Margaret. 50 From an attendance of under 100 members in the first months, the Club has now grown to a weekly attendance of 180 and is still expanding. The members are brought by the Club's own ambulance to spend the day and are served with dinner and light refreshments. Various activities are undertaken, as well as monthly entertainment and birthday parties, and outings planned for the summer. The members have elected their own advisory committees to help the Warden in arranging the programme. Work Scheme This year has been one of consolidation and expansion. There are now 2 centres, one at 58, Lansdowne Way, S. W. 8. and the other at 28, Chester Way, S.E. 11., employing 65 old people. Old people are sent by Hospital almoners, and after working at one of the centres once again become useful members of the community. In addition several of the elderly employees have returned to full time employment. Office The Office of the Lambeth Old People's Welfare Association is situated in Room 1 at the Town Hall, Brixton Hill,. S.W. 2. (Telephone Number Brixton 7755 Extension 18). The organising Secretary of the Association is Mrs. I.K. Frampton and the office hours are from 9. 30 a.m. 5p.m. Mondays to Fridays and 10 a.m. to 12 noon on Saturdays. NATIONAL ASSISTANCE ACT 1948 SECTION 50 - BURIALS Under section 50 of the National Assistance Act 1948, the Lambeth Borough Council is required to arrange for the burial or cremation of any person who has died or been found dead in their area if in such cases it appears to the Council that no suitable arrangements for the disposal of the body have been or are being made. 51 During the year 28 funerals were arranged involving 19" males and 9 females. The amount paid to the Funeral Contractors was £298.11.0., but the sum of £124.10.8 was recovered by way of Grants, Insurance Policies, Money found, and also by the sale of secondhand furniture. The actual cost to the Council was therefore £174.0.4 Hospitals Lambeth is within the catchment areas of two hospital groups, the Lambeth and Camberwell Groups. These in turn are administered by two different Regional Hospital Boards, the South West Metropolitan and South East Metropolitan respectively. 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 hospital s 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 Hospital 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 College 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.11 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, in the case of the Borough of Lambeth, the London County Council,either to provide these services or arrange for their provision by some other organisation. 52 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. 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.I, 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. Southwark, 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. 53 SECTION D 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 1957. The water is all River Thames derived. It is stored in the Board'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 chlorination and contact tanks are in operation at Hampton and Walton to ensure efficient disinfection of the water. The contact tank at the Surbiton works has not yet been completed. 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 plumbosolvent. " During the year 1882 samples of the water supplied to the Borough of Lambeth were taken for chemical examination and 3438 for bacteriological examination. The average results were as follows:- 54 Chemical Examination Milligrammes per litre (unless otherwise stated) Ammonia Nitrogen 0. 027 Albuminoid Nitrogen 0.074 Oxidised Nitrogen-Nitrate 3.9 Chloride as C1. 29. Oxygen abs. from Permanganate 4 hrs. at 27°C 1.16 Turbidity in terms of Silica 0.3 Colour m.m. brown 2 ft. Tube Burgesses Tintometer 11. Hardness (Total) 260 Hardness (non-Carbonate) 56 PH Value 7.9 Phosphate as P04 0.90 Silicate as Si02 10 Electrical Conductivity (Gemmhos) 550 Bacteriological Examination (After dilorination) Plate counts (average per ml.) Colonies counted on agar 37°C (20-24 hrs.) 6.4 Coliform test Percentage Samples negative in 100 ml. Coliform 99.33 E. Coli 99.91 SECTION 95 PUBLIC HEALTH (LONDON) ACT 1936 In 1957 Certificates of Habitation were issued in respect of 1,258 new dwellings in regard to the provision of a proper and sufficient water supply, 642 of these were for Borough Council property. 55 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 are nearly 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 All 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 bye-laws. 52 plans of new buildings and 95 plans of alteration to existing drains were deposited. In addition combined drainage was carried out in 11 cases. REPAIR, MAINTENANCE AND SANITARY CONDITION OF HOUSES RECORD OF WORK CARRIED OUT BY THE HOUSING INSPECTORS, YEAR ENDED 31st DECEMBER, 1957 HOUSING ACT, 1957 Section 4 (Repairs) Inspections Nil Statutory of Informal Schedules served Nil Section 17 (Unfit Individual Houses) Inspections 13 Representations (Demolition Orders) 4 56 Section 17 (Unfit individual Houses) continued Representations (Closing Orders) 3 To be represented 2 Demolition Orders made 3 Closing Orders made 3 Undertakings received 0 Represented but orders not yet made 2 Orders complied with or houses demolished or vacated after undertakings received 7 Orders not yet complied with 5 Premises surveyed but in which no action has been found necessary or action held in abeyance for various reasons 6 Section 18 (Underground rooms and Parts of Buildings) Inspections 20 Representations (Closing Orders) 7 To be represented 1 Closing Orders made 5 Undertakings received in lieu of Closing Orders 2 Represented but orders not yet made 4 Closing Orders complied with or rooms vacated after undertakings 23 Closing Orders not complied with 0 Underground rooms and parts of buildings made fit after formal action 5 Underground rooms and parts of buildings made fit after informal action 4 Underground rooms and parts of buildings work in progress at end of 1956 0 Underground rooms and parts of buildings surveyed but no further action found necessary or work not yet commenced 13 Section 42 (Clearance Areas) Preliminary Inspections made in respect of potential areas Clearance areas represented 1 (32 houses) Notice of intention to survey Nil Clearance Orders made 1 (32 houses) Clearance Orders confirmed by Ministry Nil 57 HOUSING ACT, 1957 PART II Section 9 (Repairs) No work has been undertaken under this section during the year. Section 17 Unfit Individual Buildings Representations 14 Carnac Street 18 Carnac Street 1 Charlotte Villas 3 Charlotte Villas 4 Charlotte Villas 3 Stockwell Grove 5 Stockwell Grove 7 To be represented 19 Southville 21 Southville 2 Demolition Orders made 14 Carnac Street 16 Carnac Street 18 Carnac Street 3 Closing orders made (whole House) 1 Charlotte Villas 3 Charlotte Villas 4 Charlotte Villas 3 Represented but orders not yet made 3 Stockwell Grove 5 Stockwell Grove 2 Demolition and Closing Orders complied with 16 Carnac Street Vacated 5 Carnac Street Vacated 2 Charlotte Villas Vacated 5 Charlotte Villas Vacated 13 Fenwick Place Demolished 9 Garden Close Demolished 42 Landor Road Vacated 7 58 Demolition and Closing Orders not complied with 14 Carnac Street 18 Carnac Street 1 Charlotte Villas 3 Charlotte Villas 4 Charlotte Villas 5 Made fit after action 7 Italian Walk 1 Premises surveyed but in which no action has been found necessary or action held in abeyance for various reasons 117 Clapham Road Dealt with under Public Health Act 1 Ethel red Street ditto 11 Ethel red Street ditto 49 Hercules Road ditto 51 Hercules Road ditto 122 Vauxhall Walk ditto 6 HOUSING ACT, 1957 Section 18 - Underground rooms parts of buildings Representations 145 Bedford Road 139 Dulwich Road 4 Radnor Buildings 5 Radnor Buildings 135 Tulse Hill 122 Vauxhall Walk 119 Wandsworth Road 7 To be represented 1 Pomfret Road 1 Closing Orders made 145 Bedford Road 129 Clapham Road 59 Closing orders made (continued) 54 Knowle Road 122 Vauxhall Walk 119 Wandsworth Road 5 Undertakings received 17 Cleaver Square Amended 15 Knollys Road 2 Orders not yet made 139 Dulwich Road 4 Radnor Buildings 5 Radnor Buildings 135 Tulse Hill 4 Closing Orders and Undertakings complied with 3, 18,32, 35,39 Burdett Chambers Rehoused by L.B.C. 15, 16,22,24,27, 28,29, 30,40 and 41 Burdett Chambers Pound own accommodation 129 Clapham Road 34 Jasper Road 54 Knowle Road Pound own accommodation 15 Knollys Road Undertaking 106 Lansdowne Way 220 South Lambeth Road 122 Vauxhall Walk 119 Wandsworth Road 23 Closing Orders not complied with Nil Made fit after Formal Action 80 Bartley Road 48 Gipsy Hill 3 Pomfret Road 7 Renfrew Road 36 Victoria Crescent 5 Made fit after Informal Action 20 Cleaver Square 21 Cleaver Square 19 Groveway 60 Made fit after Informal Action 31 Stockwell Park Road 4 Work in Progress Nil High Court Proceedings Owner's appeal against Closing Order 88 Herne Hill (Underground Rooms). Heard in the Court of Appeal on Friday, Monday and Tuesday 3rd, 6th and 7th May, 1957. Owners appeal upheld (see page 62) Inspected but no action found necessary or action deferred or worts not yet commenced 63 Acre Lane 82 Blenheim Gardens 314 Brixton Road 333 Brixton Road 357 Brixton Road 31 Goding Street 108a Lambeth Walk 11 Methley Street 158 Milkwood Road 295 Norwood Road 8 Popes Road 31 Railton Road 31 Southville 13 HOUSING ACT, 1957 (PART III) Section 42 - Clearance Areas Hamilton Grove Area 1-17 Hamilton Grove 9 2-16 Hamilton Grove 8 20-26 Hamilton Road 4 264-268 Rommany Road 3 277-277a-291 Rommany Road 8 32 61 Represented 4th November, 1957 Declared 20th November, 1957 HOUSING ACT, 1949 Section 4 - Loans Inspections Nil Loans Granted Nil HOUSING ACT, 1949 - SECTION 20 HOUSING REPAIRS AND RENT ACT 1954 SECTION 16 Improvement Grants - The Council decided to suspend the making of grants for twelve months from March, 1957. The following premises were surveyed and where the proposals did rank for grant the applicants were advised to apply to the London County Council. 76 Broxholm Road Dealt with under Public Health Act 1 1 Caron Almshouses, approved in Fentiman Road principle 1954 1 25 Woodland Hill 1 Total 3 Work completed 25 Gipsy Hill 1 Inspections arising from re-housing by Lambeth Borough Council 203 Total Inspections made during the year 271 Total Re-visits made during the year 560 62 HOUSING ACT, 1936 : SECTION 12: UNDERGROUND ROOMS OF NO. 88 HERNE HILL, S.E.24: OWNER' S APPEAL AGAINST THE CLOSING ORDER MADE BY THE LAMBETH BOROUGH COUNCIL The Pub] Health Committee, at its meeting on the 8th October, 1956, made a Closing Order under the Housing Acts in respect of the basement of No. 88 Herne Hill, on the grounds that the rooms did not comply with the Council's Underground Room Regulations as required by Section 12(2)(b) of the Housing Act, 1936. The owner appealed against the Order and the County Court Judge allowed the appeal on the ground that the Council's Underground Room Regulations could no longer be applied in determining unfitness for human habitation, since Section 9 of the Housing Repairs and Rents Act, 1954, which sets out the factors to be taken into consideration when determining whether a " house " is reasonably fit for occupation impliedly repealed the Council's Underground Room Regulations. On the advice of Counsel, an appeal against this decision was lodged in the Court of Appeal and was heard on Friday, Monday and Tuesday, the 3rd, 6th and 7th May, 1957, before the Master of the Rolls (Lord Evershed), Lord Justice Morris and Lord Justice Pearce. In the course of the legal argument, it transpired that Lord Justice Morris had been a member of the Court of Appeal which had heard the case of the Board of Governors of the London Hospital v. Jacobs. This was an unreported case heard in February, subse quent to the lodging of this Council's appeal. The case arose out of a claim by the Board of Governors of the London Hospital for arrears of rent consequent upon the service on the defendant of a notice of increase of rent under the Housing Repairs and Rents Act, 1954. Part of the case for the defendant was that, because one of the rooms in his premises was an underground room, having an average height of less than seven feet, it was, by virtue of the statutory provisions contained in Section 12 of the Housing Act, 1936, to be deemed to be unfit for human habitation and, therefore, could not be said to be reasonably fit for occupation for the purpose of the 1954 Act. Although it was stated that the point was not relevant to the decision, the Lords of Appeal in giving judgment, all concurred in the view that Section 9 of the Housing Repairs and Rents, Act, 1954, amended Section 12 of the Housing Act, 1936. 63 Accordingly, the Master of the Rolls, in giving judgment on the Council's appeal, stated that the Court was bound to answer the question raised in the owner's favour by reason of the decision in the case of the Board of Governors of the London Hospital v. Jacobs. The Master of the Rolls went on to say, however, that, having regard to the difficulties of the case and out of respect to the argument put forward on the Council's behalf by Counsel, he would make references to the relevant sections of the Acts. In reviewing the references which had been submitted by Counsel for both parties, the following remarks by the Master of the Rolls may be regarded as significant If, therefore, the matter has been res integra (i.e. under consideration on its merits without reference to any views previously expressed by the Court), I should have felt, to say the least, a strong inclination towards Counsel's view. But I think it would be wrong for us to arrive at a conclusion in conflict with what this court said in the case of the Board of Governors of the London Hospital v. Jacobs. " Later, the Master of the Rolls also referred to the fact that the Court which heard the arguments in the earlier case, was perhaps less fortunate than his Court which had had close arguments presented on both sides. The Housing Act, 1936, provides that, in appeals arising under Section 15, as this does, the decision of the Court of Appeal shall be final and no appeal shall lie to the House of Lords. The practical effect of the decision appears to be that the Council may still make Closing Orders in respect of underground rooms, but, in considering whether they are reasonably fit for occupation, the standards to be applied are those set out in Section 9 of the 1954 Act, instead of the standards laid down by the Underground Room Regulations, which, in relation to underground rooms were, of course, easier to apply. As the provisions of Section 9 of the 1954 Act were aimed at the same factors, e. g. ventilation, natural lighting, dampness, etc., it may be that, in general, aClosing Order can be justified under Section 9 provisions in a case where it can be justified under the Underground Room Regulations, but the question of proof that the defects are such that they cannot be remedied at a reasonable cost will undoubtedly be more difficult. 64 INSPECTION OF DWELLING HOUSES UNDER PUBLIC HEALTH ACT (a) Total number of dwelling houses inspected for housing defects 3,502 (b) Number of inspections made for the purpose 11,985 (c) Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 1,701 (d) Proceedings under Public Health Acts (i) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 1,021 (ii) Number of dwelling houses in which defects were remedied after service of formal Notices (a) By owners 959 (b) By Local Authority in default of owners 120 REHOUSING AND OVERCROWDING 1,122 cases have been investigated with the following results : London County Council Cases Overcrowding 5 Illness 13 Insanitary Conditions 10 Lambeth Borough Council Health (Medical Certificate) 564 Insanitary Conditions 102 Inquiries from other Authorities 16 Inquiries from other Sources 113 During this period the London County Council has rehoused 91 65 Lambeth Borough Council continued Cases During this period the Lambeth Borough Council has rehoused 208 * * Included in this figure are 16 Closing Order Cases HOUSING REPAIRS AND RENTS ACT, 1954 Certificates of disrepair issued 11 Certificates of disrepair refused - Application withdrawn 7 Revocation certificates issued 40 Revocation certificates refused 7 RENT ACT 1957 This Act became operative in July 1957, and the applications received and action taken are enumerated below. Number of Applications for Certificate of Disrepair 425 Number of decisions not to issue Certificates 1 Number of decisions to issue Certificates (a) in respect of some but not all defects 293 (b) in respect of all defects 96 389 Applications awaiting action at end of year 35 425 Number of Undertakings given by Landlords under paragraph 5 of the First Schedule of the Act 232 Number of Undertakings refused by Local Authority under proviso to paragraph 5 of the First Schedule - Number of Certificates of Disrepair issued 114 Number of Certificates still to be issued or Undertakings still to be received from owners 43 389 66 Applications for Certificates as to the remedying of defects specified in a Landlords Undertaking (a) by Landlords 4 (b) by tenants - 4 Certificates issued (a) Defects remedied 3 (b) Defects not remedied - (c) Application awaiting action at end of year 1 4 Application by Landlords to Local Authority for cancellation of Certificates of Disrepair 25 Certificates cancelled by Local Authority 16 Certificates refused 2 Applications still to be dealt with 7 In connection with the applications from Landlords for cancellation of Certificates of Disrepair objections to cancel 1 ations were lodged by 9 tenants. LONDON COUNTY COUNCIL (GENERAL POWERS) ACT 1955 The cost of repairs particularly to old property still remains a serious problem both for owners and for the Council who carry out the necessary work when a Court Order is ignored and recover the cost by collecting rents and registering a charge upon the property. Under Section 27 of the London County Council (General Powers) Act 1955 the Council may incases 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 work, the Council may after the 67 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. Twenty-two notices were served, of which 15 were abated by the Council. At the end of the year there were 150 cases outstanding from which some £7,311 was owing while in 18 others the estimated cost of work approved but not completed was £1,834. LEGAL PROCEEDINGS PUBLIC HEALTH (LONDON) ACT 1936 Of the 120 summonses returnable at the Lambeth Magistrates Court, abatement orders were made in respect of 37 cases, 38 cases were adjourned sine die and 45 were withdrawn the nuisances being abated by the respective owners by the date of the hearing. DANGEROUS STRUCTURES Information was forwarded to the District Surveyor on 82 occasions during the year of the presence of structures which were considered to be dangerous to life or limb. RAG FLOCK AND OTHER FILLING MATERIALS ACT 1951 Number of premises registered under the above mentioned Act 1 Number of inspections 3 PET ANIMALS ACT 1951 Number of premises registered 23 Number of Inspections 49 Number of Re-visits 27 68 LONDON COUNTY COUNCIL (GENERAL POWERS) ACT 1954 Hairdressers and Barbers On 6th July, 1955, theBorough Council made bye laws in respect of hairdressers and barbers under the above mentioned Act. During the year 6 registrations were made : The total number of premises and persons on the register at the end of the year was as follows : Premises 169 Persons 184 Number of inspections 91 Number of re visits 30 OFFENSIVE TRADES Establishment Orders have been granted to two companies who carry on the offensive trades respectively of (a) fellmonger and (b) fatboiler. These two orders are renewed annually. DRAIN TESTS Number of Drain Tests carried out during the year 3,266. District Inspectors 3,044 Rodent Officer 222 DISINFECTION The following is a summary of the work carried out by the staff of the Wan!ess Road Disinfecting Station. Number of premises sprayed in which cases of Infectious Disease have occurred 651 Number of rooms included in above 715 69 Total number of rooms sprayed for all purposes 2,544 Number of articles disinfected 5,855 Number of Library Books disinfected 283 Number of Disinfection Certificates issued 184 DISINFESTATION Bed Bugs Number of houses visited 158 Number of rooms sprayed 517 Number of houses re visited 44 The rooms were sprayed with "Vermacine", a preparation of 5 per cent. D. D. T. with Pyrethrum as a "Knockout". The total number of visits made by the staff of the Disinfecting Station for all purposes was 4,365. There were many complaints during the year of insect infestation, The usual offenders were wood boring beetles, ants, cockroaches, drug store beetles, carpet beetles, clothes moths weevils, clover mites and silver fish. PREVENTION OF DAMAGE BY PESTS ACT 1949 - RODENT CONTROL Rodent destruction in dwel 1ing houses and business premises is carried out under the direction of the Rodent Officer, an Assistant Rodent Officer and a Rodent operative working under his supervision. Sewer treatment is carried out by the Borough Engineer's department in conjunction with the Rodent Officer and his staff. In the cases of dwelling-houses treatment is undertaken by the Local Authority free of charge, while in the case of business premises, a charge based upon time, cost of materials and overhead expenses, is made. During the year 955 complaints were received. Of this number 73 were not justified, 716 were in respect of brown rats, one in respect of black rats and 165 in respect of mice. During the course of investigation, 926 baitings were made and ninety defective 70 drains discovered. Statutory Notices were served in sixty-seven cases under the Public Health (London) Act. 1936, and the Prevention of Damage byPests Act 1949. Thirty-one cases were referred to the Town Clerk for the necessary action. The number of inspections and revisits involved were as follows :- Inspections 1,202 Revisits 1,405 CLEAN AIR ACT 1956 ESTABLISHMENT OF AN INITIAL SMOKE CONTROL AREA During the year the Lambeth Borough Council decided to estab1ish an area of approximately one hundred acres, centrally situated within the Borough, as an initial Smoke Control Area. This area is bounded on the north by Prima Road, on the east by Brixton Road, on the south west by Stockwell Park Road and on the west and north-west by Clapham Road. This are a was considered suitable for the following reasons (i) It is comparatively small and compact. (ii) Its centra] situation within the Borough would make it eminently suitable for extension in due course. (iii) Its location is sufficiently distant from the Southern Region of British Railways. (iv) It is almost entirely residential, save for a relatively small number of commercial and industrial premises, and contains the Council's new housing estate at Caldwell Street. (v) It contains a small area which is zoned for future open space and a certain amount of the older property is scheduled for fairly early slum clearance. (vi) The area lying to the west and south-west (the direction of the prevailing wind) ismainly occupied by Borough Council andLondon County Council housing estates, and is to some extent, therefore, already smokeless. 71 It is proposed that the Smoke Control Order should be applied to all properties within the area, with the exception of four commercial and industrial premises (only one of which has been the subject of complaint in the past), where it is considered that the maximum amount of smoke permitted can be controlled by other sections of the Act now in force. Preliminary approval of the Minister of Housing and Local Government has been obtained. As a result of a preliminary survey it has been estimated that the number of adaptations to domestic fuel burning apparatus which may be required to avoid contravention of the Order is 3,100. Steps are being taken to carry out a detailed survey of the premises included within the area with a view to the Order coming into operation on 1st October, 1959. A publicity campaign is to be instituted and members of the public are being advised of the circumstances in which a grant will be available from the Local Authority towards the cost of adaptation required to domestic fuel burning apparatus in premises within the area. The following inspections were made by the Public Health and Smoke Inspectors during the year. Observations. (a) Timed-Industrial 42 (b) Untimed-Industrial 67 Other visits to Industrial Premises 85 Visits to Private dwellings 2,191 FACTORIES ACTS, 1937 AND 1948 The following is a report on the work carried out by the Public Health Inspectors during the year:- Part I of the Act 1. Inspections for the purposes of provisions as to health (including inspections made by Public Health Inspectors). 72 Premises Number on Register Number of Inspections Written Notices (i) Factories in which Sections 1, 2, 3,4 & 6 are to be enforced by Local Authorities 164 108 — (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authorities 624 390 25 (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers premises) 45 45 — TOTALS 833 543 25 No occupiers were prosecuted 73 CASES IN WHICH DEFECTS WERE FOUND Number of cases in which defects were found Found Remedied Referred To H. M. Inspector By H. M. Inspector Want of cleanliness (S. 1.) 15 15 — — Overcrowding (S. 2.) — — — — Unreasonable temperature (S. 3.) — - — — Inadequate Ventilation (S.4.) - - _ — Ineffective drainage of floors (S. 6.) — - — — Sanitary Conveniences (S.7.) — — — — (a) Insufficient — — — 2 (b) Unsuitable or defective 6 6 — — (c) Not separate for sexes — _ — — Other offences against the Act (not including offences relating to Outwork) 9 9 2 — TOTALS 30 30 2 2 In no case was a prosecution instituted. 74 PART VIII OF THE ACT OUTWORK (Sections 110 and 111) No. of Outworkers in August list required by Section 110 (1) (c) Wearing apparel - Making etc. 276 Household linen 5 Umbrellas etc. 1 Artificial flowers 4 Paper Bags 2 The making of boxes or other receptacles or parts thereof made wholly or partially of paper 41 Carding, etc., of buttons etc. 13 Stuffed Toys 1 Cosaques, Christmas crackers, Christmas stockings etc. 4 Lampshades 23 TOTAL 370 No notices were served or prosecutions instituted. SUMMARY Public Health inspectors Total number of inspections 9,358 Total number of re-inspections 15,119 Total number of intimation notices served 1,672 Total number of statutory notices served 956 75 Women public Health Inspectors Total number of visits and inspections (factories, workplaces, infectious disease etc.) 909 Total number of intimation notices served 63 Total number of statutory notices served — Total number of re-visits 841 Restaurants in which defects were found 56 Visits to old and infirm persons living in insanitary conditions 33 77 SECTION E INSPECTION AND SUPERVISION OF FOOD Food Premises During the year under review 2,298 inspections and revisits were made by the District Public Health Inspectors to food premises in the Borough. These inspections and revisits are made up as follows:- Inspections Revisits Bakehouses 53 24 Restaurants 292 746 Fried Fish Shops 24 3 Ice Cream 93 7 Milkshops 336 21 Licensed Houses 77 50 Street Traders 25 - Others 395 152 1,295 1,003 It was not found necessary to take 1 egal proceedings under the Food Hygiene Regulations in any case. The number of food premises by type of business in the area is as follows Greengrocers and Fruiterers 178 Fish shops wet, dry and fried 91 Bakers 97 Butchers 159 Restaurants 232 The number of premises registered under Section 16 of the Food and Drugs Act 1955 and the Milk and Dairies Regulation 1949 Ice Cream 553 Sausages and potted processed etc. meat 301 Registered Milk Distributors 261 78 Milk (Special Designations) Regulations 1949-1954 The following table shows the number of licences issued under these Regulations during 1957. Dealers Licences Tuberculin Tested 122 Pasteurised 198 Sterilised 273 Dealers Supplementary Licences Tuberculin Tested 21 Pasteurised 22 Sterilised 24 Dealers (Pasteuriser's) Licence 2 The following is a summary of the work of Food Inspectors during the year. SAMPLING OF FOOD AND DRUGS (a) For Chemical Analysis Number procured formally 200 Number procured informally 1,300 Of the 200 formal samples, 158 were of milk, 3 of which were adulterated, of the remaining 42 other samples two were found to be adulterated. (b) For Bacteriological and other Examinations The following shows the number and types of samples submitted for bacteriological and other examinations Ice cream and ice cream mix 337 Ice cream lolly 9 Hen egg albumen 2 * Iced cake 1 Milk 1 Royal icing 1 * Cooked chicken 1 * Meat rissole 1 Salted pig tails 1 Cherry nougat 1 * Jellied eels 1 356 * These articles were suspected of having caused food poisoning. 79 MILK Type of Test Samples No. procured No. passing test No. failing to pass test Methylene Blue 155 151 Nil Phosphatase 153 153 Nil Pour of these samples were void - Atmospheric Shade temperature was over 65° P. ICE CREAM SAMPLES (METHYLENE BLUE TEST) Year No. of samples Grade I Grade II Grade III Grade IV 1957 337 231 87 8 11 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 196 176 15 4 1 INSPECTION OF FOOD (i) At Shops, 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 : 36 tons 1 cwt. 1 qr. 14¾ lbs. (ii) The Method of Disposal of Condemned Food 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. 80 FOOD COMPLAINTS 96 complaints about food were investigated by the Food Inspector together with the district Inspector, 65 of which were justified, and a list of these is set out below. 1. Bread containing particles of iron 2. Bread containing mineral grease and soot 3. Lemonade deteriorated through age 4. Bread rolls containing particles of iron 5. Bread in dirty condition 6. Chocolates containing insect larvae 7. Evaporated milk blown tin 8. Bread containing brush bristles 9. Milk bottle containing rust spots 10. Milk containing wire 11. Jellied eels unpleasant taste 12. Milk containing cork 13. Milk containing mould growth and dirt 14. Bread containing match stick 15. Milk containing mould growth and dirt 16. Sweets containing foreign matter 17. Nougat unpleasant taste and smell 18. Bread containing foreign matter 19. Bread containing tobacco 20. Jam mould on surface 21. Milk containing glass 22. Cheese cakes unpleasant taste and smell 23. Meat pie containing wire 24. Bread containing lubricating grease 25. Bread roll containing string 26. Sausage rolls mouldy condition 27. Fish unfit to eat 28. Pastry mouldy condition 29. Orange drink unpleasant taste 30. Milk bottle in dirty condition 31. Bread rolls in dirty condition 32. Milk bottle in dirty condition 33. Milk bottle in dirty condition 34. Mushrooms infested with maggots 35. Chicken green and maggotty 36. Milk bottle containing cement and sand 37. Pork pies in mouldy condition 38. Bread in mouldy condition 39. Currants containing maggots 40. Bread containing glass 41. Doughnut containing insect 42. Bacon unpleasant taste 43. Chicken unfit to eat 44. Rusks unpleasant flavour 45. Flour containing tobacco 46. Milk bottle containing lime and sand 47. Butter rancid 48. Bread containing string 49. Drinking chocolate containing maggots * 50. Layer cake containing fly * 51. Bread bird excreta on crust 52. Drinking chocolate containing maggots 53. Sweets infested with insects 54. Sugar bitter taste 55. Milk containing glass 56. Bread roll containing nail 57. Milk bottle in dirty condition 81 58. Caraway seed in dirty container 59. Bread pudding containing nail 60. Milk bottle containing burnt milk 61. Trifle mouldy condition 62. Milk containing leaf debris 63. Tongue unfit to eat 64. Meat pie containing insect 65. Pork insufficiently brined * Legal proceedings were instituted in the under mentioned cases with the result shown : 50. Layer cake containing fly Withdrawn absence of witnesses 51. Bread bird excreta on crust Fined £20. £5.5.0. costs. 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. 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. Slaughter of Animals Act No application was made during the year for the issue of a 1icence under the provision of this Act.