AC. 4383. ach'd METROPOLITAN BOROUGH OF LAMBETH ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1958 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 1958 F. SUMMERS, m.b., b.s., m.r.c.s., l.r.c.p., d.p.h. Medical Officer of Health CONTENTS OF REPORT Paqe 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 14 Maternal Mortality 14 Infantile Mortality 15 Summary of Vital Statistics for the year 1957 17 Vital Statistics for years 1949 1958 18 Classification of Deaths 19 Notes on Vital Statistics 22 Deaths from Cancer of Lung and Bronchus 24 Road Traffic Accidents 26 Section B : Prevalence of, and Control over, Infectious and Other Diseases Notifications 29 Age Distribution of Infectious Diseases 31 Ward Distribution of Infectious Diseases 32 Distribution of Infectious Diseases according to Parliamentary Constituencies 33 Notes on Infectious Diseases 34 Diphtheria and Diphtheria Immunisation 37 Smallpox 38 Vaccination and International Certificates of Vaccination 39 Tuberculosis 40 Report of Chest Physician 44 Section C : General Provision of Health Services for the Area Care of the Aged 47 56 Action under Section 47 National Assistance Act, 1948 48 Laundry Services for Aged Incontinent Persons 49 Holidays for the Elderly 50 Lambeth Old Peoples Welfare Association 54 Hospital Facilities 57 Health Services provided by the London County Council 58 Public Health Laboratory Service 58 Page Section D : Sanitary Circumstances of the Area Water Supply 59 Summary of Visits and Inspections by Inspectors of Staff 61 Summary of Defects and Nuisances 62 Legal Proceedings Public Health (London) Act, 1936 63 Dwelling Houses Rendered Pit 64 Section 95 Public Health (London) Act, 1936 64 Drainage Plans 64 Disinfection 65 Disinfestation 65 Rodent Control 65 Factories Acts 1937 and 1948 66 Rent Act, 1957 69 Rehousing and Overcrowding 70 Repair, Maintenance and Sanitary Conditions of Housing 71 Housing Act, 1949 Improvement Grants 74 Atmospheric Pollution 75 Clean Air Act, 1956 78 Section E : Inspection and Supervision of Food Pood Hygiene Regulations, 1955-1957 81 Food Premises 81 Milk (Special Designations) Regulations, 1949-1954 82 Sampling of Food and Drugs 83 Inspection of Food 86 Food Complaints 89 Street Markets 90 Slaughter of Animals Act 90 Section F: General National Assistance Act, 1948 Section 50 Burials 91 Land Charges Act, 1925 91 Pharmacy and Poisons Act, 1933 91 Rag Flock and Other Filling Materials Act, 1951 91 Pet Animals Act, 1951 92 Hairdressers and Barbers 92 Exhumations 93 5 METROPOLITAN BOROUGH OF LAMBETH PUBLIC HEALTH COMMITTEE (Appointed by the Council on 23rd May, 1958) The Worshipful the Mayor of Lambeth (Mr. Councillor Tiras Cleasby, J.P.) (ex officio) Chairman Mrs. Councillor Mary Marock Vice Chairman Mr. Councillor G. F. S. Light Aldermen : C. S. Jordan W. Laverick Councillors Mrs. D. R. Colls S. A. Davey W. Driscoll Miss B.W. High J.E. Janes Miss K.L. Jenner Mrs. J. M. Melman, B.A. T. Robinson 6 STAFF OF THE PUBLIC HEALTH DEPARTMENT MEDICAL OFFICER OF HEALTH P. Summers, M.B. , B.S., M.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 J.M. Roberts 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) (Appointed Housing Inspector 17.7.58) (b) Pood Inspectors S. Bradley (1) (2) C.W. Idle (1) (2) (c) Housing Inspectors S. G. Ford (1) (2) F.J. Heffield (1) (2) (Retired 17.7.58) A. E. White (1) (2) (Apointed 17.7.58) 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) (Retired 2. 5. 58) Miss A. P. 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. P. Eden Mrs. G. Hopkins N. A. Jupp E. P. Mannerson Mrs. M. Rogers E. Walker Mrs. K. Williams DISINFECTING STATION Wanless Road, Loughborough Junction. S.E.5. Superintendent:- L. Brann 2 Drivers 2 Disinfectors 1 Stoker 1 Apparatus Attendant 8 GENERAL ASSISTANTS R. G. Ayling 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 Public Health Department, Lambeth Town Hall, Brixton Hill, S. W. 2. Tel : BRIxton 7755 July, 1959 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 1958 on the health of the Borough of Lambeth. The vital statistics are satisfactory and are commented upon in detail in the body of the report. The Registrar General's mid year estimate of the population showed a decrease of 700 after an increase of 400 in the previous year. The birth rate shows an increase on the previous year, but the general and infantile death rates are higher than in 1957. The control of the infectious diseases such as typhoid fever, tuberculosis and diphtheria by application of preventive methods and the advent of antibiotics and other chemo-therapeutic agents has brought about a marked reduction in deaths from these diseases, although some organisms notably the staphylococcus are developing resistance to these new drugs. The pattern of mortality is changing and more people are dying from heart disease, which is perhaps to be expected in an ageing population, cancer and road accidents. Whilst the cause of cancer generally is not yet clear, statistical evidence undoubtedly points to excessive cigarette smoking as a cause of cancer of the lung. Whereas in the past the control of diseases conveyed by water, milk and unsound food was achieved at source without the co-operation of the individual, the control of the diseases and causes of mortality which are now becoming prominent depend on 10 the participation of individuals in their prevention - not always the individual who is the victim, for example of a road accident or food poisoning episode. This is where health education can play an important part to bring home the dangers of excessive smoking, carelessness on the roads or unclean practices in the preparation of food. The work in connection with the welfare of the aged has continued to expand; both that done directly by the Public Health Department and by the Lambeth Old People's Welfare Association which receives generous financial assistance from the Council. The inspectorial staff was further depleted by the retirement of Miss L. E. Auger in May, and Mr. F.J. Heffield in July. Both of these officers had served the Council well for many years, and their retirement, although inevitable, was regretted by all. It is with much regret that I have to record the death of Mr. Heffield just prior to my writing this foreword less than a year after his retirement. Finally I would like to thank all members of the Council and 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, F. SUMMERS Medical Officer of Health 11 SECTION A STATISTICS AND SOCIAL CONDITIONS OF THE AREA Lambeth is one of the largest Metropolitan Boroughs, both in population and area. It has common boundaries with Battersea, Wandsworth, Croydon Penge, Camberwell, Southwark and the Cities of London and Westminster. The total area is approximately 6½ 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 building the new South Bank Embankment, part of the river 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 land surface rises from 12 feet above sea level at the River to 50 feet near Brixton, 150 feet at West Norwood, and about 379 feet at and near the Crystal Palace. The Borough has 291 acres of open space, including Brockwell, Kennington, Ruskin, Norwood, Archbishop's and Vauxhall Parks and Myatt's Fields. 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 Borough 4,087.5 acres No. of Wards 21 No. of Parliamentary Constituencies 3 Population Figure supplied by Registrar General (Mid year estimate 1958) 223.600 Density of Population i.e. number of Persons per acre 54,7 Number of marriages during the year 2017 Marriage Rate per 1,000 Population 9.02 Marriage Rate per 1,000 Population England and Wales 15.0 Rateable Value of District (1958/1959) £3,909.898 Sum represented by a Penny Rate (1958/1959) £16,050 Number of separately rated houses and flats (1958/1959) 55,810 BIRTHS Live Births Legitimate Illegitimate Totals Males 1981 289 2270 Females 1894 280 2174 Totals 3875 569 4444 Live Birth Rate per 1,000 Home Population 19.02 Birth Rate corrected for comparison with other areas 17.12 Comparability Factor supplied by Registrar General 0,90 13 Birth Rate per 1.000 Home Population County of London 16.7 Birth Rate per 1,000 Home Population England and Wales 16.4 Corresponding rate for the Borough of Lambeth for year 1957 16.82 Illegitimate Live Births per cent of Total live births 12.8% 14 STILL BIRTHS Legitimate Illegitimate Totals Males 47 7 54 Females 34 5 39 Totals 81 12 93 Still Birth Rate per 1,000 Total Births (i.e. Live and Still) 20.5 Still Birth Rate per 1.000 Home Population 0.41 Still Birth Rate per 1,000 Total Births, England and Wales 21.6 Still Birth Rate per 1,000 Home Populations England and Wales 0.36 DEATHS Male Pemal e Total 1304 1225 2529 Death Rate per 1,000 Home Population 11.31 Death Rate corrected for comparison with other areas 11.35 Comparability factor supplied by Registrar General 1.03 Death Rate per 1,000 Home Population County of London 11.9 Death Rate per 1,000 Home Population, England and Wales 11.7 Corresponding Rate for the Borough of Lambeth for the year 1957 10.83 MATERNAL MORTALITY Number of women dying in consequence of childbirth 1 Maternal Mortality Rate per 1,000 Total Births 0.22 15 Maternal Mortality Rate per 1,000 Total Births County of London 0,49 Comparative figure for England and Wales 0.43 INFANTILE MORTALITY Death of infants under one year og age Legitimate Illegitimate Totals Males 54 11 65 Females 43 3 46 Totals 97 14 111 Death Rate of Infants under 1 year of age per 1.000 live births 24.98 Death Rate of Infants under 1 year of age per 1,000 live births County of London 22.0 Death Rate of Infants under 1 year of age per 1,000 live births England and Wales 22.6 Legitimate Infantile Mortality Rate 25.31 Illegitimate Infantile Mortality Rate 24.62 Deaths of Infants under 4 weeks of age Legitimate Illegitimate Totals Males 38 11 49 Females 24 3 27 Totals 62 14 76 Neo natal Mortality Rate per 1.000 live births 17.1 Neo-natal Mortality Rate per 1,000 live births County of London 165 Neo-natal Mortality Rate per 1,000 live births England and Wales 16.2 16 CAUSES OF DEATH AND THE AGE AT TIME OF DEATH OF INFANTS UNDER 1 YEAR OF AGE CAUSE 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 19 9 28 1 29 Atelectasis and Prematurity 3 1 1 1 - 6 6 Intra-cranial Haemorrhage and Prematurity 6 2 1 1 1 11 11 Broncho-Pneumonia and Prematurity 1 1 2 1 3 Pneumonia 1 1 2 4 5 3 2 16 Asphyxia 5 5 1 1 7 Atelectasis 2 2 2 Cardiac Failure 1 2 2 5 2 7 Congenital Heart Disease 2 2 1 3 Subdural Haemorrhage 1 1 1 Polycystic Lungs 1 1 1 Pneumonocoecal Meningitis 1 1 Anancephalic Foetus 1 2 3 3 Pre-Viability 3 3 3 Haemolytic Disease of new born 1 1 1 Encephalitis 1 1 Bronchitis 1 1 1 3 Renal Failure 1 1 Meningitis 2 1 3 Hydrocephalus 1 1 1 2 Spina Bifida 1 1 1 Marasmus 1 1 Agensis of Diaphragm 1 1 1 Acute Enteritis 1 1 2 Anaemia 1 1 Unascertainable 1 1 1 TOTALS 43 18 8 4 3 76 13 14 6 2 111 17 SUMMARY OF VITAL STATISTICS FOB THE YEAR 1958 England & Wales Borough of Lambeth Births Rates per 1.000 Home Population Live Births 16.4 17.12 Still Births 21.6 20.5 Deaths All Causes 11.7 11.35 Typhoid and Paratyphoid Fever 0.00 _ Whooping Cough 0.00 0.00 Diphtheria 0.00 _ Tuberculosis 0.11 0.09 Smallpox - - Acute Poliomyelitis and Polio-Encephalitis 0.00 - Pneumonia 0.55 0.66 Influenza 0.05 0.04 Rates per 1,000 Live Births All Causes under 1 year of age 22.5 24.98 Notifications (corrected) Rates per 1,000 Home Population Typhoid Fever 0.00 0.00 Paratyphoid Fever 0.00 - Meningococcal Infection 0.02 0.00 Scarlet Fever 0.86 0.68 Whooping Cough 0.74 0.59 Diphtheria 0.00 0.00 Erysipelas 0.07 0.05 Smallpox 0.00 - Measles 5.75 2.68 Pneumonia 0.49 0.50 Acute Poliomyelitis Paralytic 0.03 0.02 Non-paralytic 0.01 0.00 Food Poisoning 0.20 0.23 Puerperal Pyrexia 14.26 (a) 15.42(a) (a) Per 1,000 Total (Live and Still) Births 18 BOROUGH OF LAMBETH SUMMARY OF VITAL STATISTICS FOR THE TEN YEAR PERIOD 1949 - 1958 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 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 1958 223,600 2,529 *11.35 4, 444 *17. 12 111 24.98 1 0.22 * As adjusted by Comparability Factor 19 DEATHS OF LAMBETH RESIDENTS DURING 1958. CLASSIFIED ACCORDING TO AGE GROUPS AND SEXES CAUSES OF DEATH 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 1 1 6 5 4 17 F 3 1 3 7 2. Tuberculosis, other M 2 2 F 3. Syphilitic Disease M 3 2 5 F 2 1 3 4. Diphtheria M F 5. Whooping Cough M 1 1 F 6. Meningococcal Infection M 1 1 F 7. Acute Poliomyelitis M F 8. Measles M F 9. Other Infective and Parasitic Diseases M 1 1 2 F 1 1 2 10. Malignant Neoplasm, Stomach M 25 16 12 53 F 1 3 9 11 24 20 CAUSES OF DEATH 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 11. Malignant Neoplasm, Lung Bronchus M 5 59 39 13 116 F 8 10 5 23 12. Malignant Neoplasm, Breast M 1 1 F 3 15 15 11 44 13. Malignant Neoplasm, Uterus M F 1 9 9 3 22 14. Other Malignant and Lymphatic Neoplasms M 1 2 8 43 42 35 131 F 6 36 43 32 117 15. Leukaemia Aleukaemia M 1 1 2 1 5 F 1 1 1 2 5 16. Diabetes M 1 3 4 F 1 2 4 7 17., Vascular Lesions of Nervous System M 4 34 38 54 130 F 1 28 53 110 19 2 18. Coronary Disease, Angina M 12 84 70 63 229 F 22 53 83 158 19. Hypertension with Heart Disease M 4 4 10 18 F 3 14 34 51 20. Other Heart Disease M 1 1 7 13 28 62 112 F 4 21 22 112 159 21. Other Circulatory Disease M 4 15 20 24 63 F 1 11 18 43 73 22. Influenza M 1 3 3 1 8 F 1 1 23. Pneumonia M 7 1 8 18 23 57 F 12 2 7 21 50 92 24. Bronchitis M 44 51 40 135 F 2 1 9 11 39 62 21 25. Other Diseases of the Respiratory System M 1 4 6 7 18 F 4 2 6 26. Ulcer of Stomach and Duodenum M 3 5 6 6 20 F 1 1 2 11 15 27. Gastritis, Enteritis and Diarrhoea M 1 1 F 2 3 3 1 9 28. Nephritis and Nephrosis M 1 2 1 1 1 F 3 2 4 2 11 29. Hyperplasia of Prostate M 1 4 3 F 30. Pregnancy, Childbirth and Abortion F 1 1 31. Congenital Malformations M 15 1 1 1 18 F 10 2 2 1 15 32. Other Defined and I11-Defined Diseases M 40 8 9 17 14 88 F 18 1 2 18 18 24 81 33. Motor Vehicle Accidents M 2 5 2 4 13 F 1 2 6 3 12 34. All other Accidents M 1 1 4 2 6 1 15 F 2 1 1 2 4 5 7 22 35. Suicide M 1 1 7 13 1 1 24 F 3 4 2 2 11 36. Homicide and Operations of War M 1 1 1 3 F ALL CAUSES TOTALS M 65 3 10 13 72 393 375 373 130 4 F 46 3 2 2 38 217 326 591 1225 GRAND TOTALS 111 6 12 15 110 610 701 964 2529 22 VITAL STATISTICS Population The estimated mid-year population according to figures supplied by the Registrar General is 223,600. This is 700 less than that for 1957 and 6640 less than the Census figure for 1951. Births The number of live births recorded during the year was 4444. This is an increase of 239 over the figures for 1957, giving a corrected birth rate of 17.12 compared with 16.82 for the last year. This rate is the highest to be recorded in the Borough of Lambeth since 1949 and is greater than that for England and Wales which at 16 4 per 1,000 home population is also the highest since 1949. The number of live births is in excess of the number of deaths giving a natural increase of 1915. In spite of this natural increase, however, the Registrar General' s estimate of the home population of the Borough of Lambeth for the year 1958 is 700 less than for 1957. This would seem to indicate that there has been some movement of population out of the Borough during the year. Still Births The number of still births recorded during the year declined; 93 occurring compared with 112 in 1957. This gives a rate per 1,000 total births of 20.5 compared with 25.94. This rate compares favourably with that for Engl and and Wales which at 21.6 per 1,000 total live and still births also shows a reduction on the 1957 figure. Deaths The number of deaths increased by 170 compared with last year. This coupled with a decrease in the estimated population gives an increased corrected death rate of 11.35 per 1,000 home population compared with 10.83 in 1957. The rate, although increased, compares favourably with that for England and Wales which is 11,7 per 1,000 home population. 23 Heart and associated diseases accounted for the largest number of deaths, 1185 people (552 males and 633 females) dying from these causes. During 1958, 301 males and 230 females died from all forms of malignant neoplasms, the second highest cause of death. Deaths from respiratory tuberculosis increased by 7, 24 deaths occurring from this form of the disease compared with 17 in 1957. Deaths from other forms of tuberculosis fell by 3, thus giving an overall increase of 4 from all forms of disease. Pneumonia, influenza, and bronchitis caused 355 deaths an increase of 5 compared with deaths from the same causes in 1957. The number of deaths from motor vehicle accidents increased by 56%. Twenty-five residents of Lambeth, 13 males and 12 females, lost their lives compared with 13 males and 3 females in 1957. Although deaths from motor accidents increased, those from all other accidents showed a reduction, 37 people dying compared with 42 last year. Prom the figures supplied by the Registrar General it would appear that the inhabitants of Lambeth were more suicide prone than in 1957. The number of people taking their own lives increased from 29 to 35. One of the suicides was a male under the age of 14 years, and another was in the age group of 15-24 years. Three deaths occurred as a result of homicide. Infantile Mortality Unfortunately there was an increase in infantile mortality, 111 children dying in the first year of life compared with 98 in 1957. Although there was an increase in the number of live births this gave an increased infantile mortality rate of 24.98 per 1,000 live births compared with 23.3 last year. Of the 111 deaths, 97 were of legitimate infants and 14 of illegitimate, giving a legitimate Infantile Mortality rate of 25.31 per 1,000 legitimate live births and an illegitimate Infantile Mortality rate of 24.62 per 1,000 illegitimate live births. The infantile mortality rate for the Borough of Lambeth is higher than that for England and Wales which at 22.5 per 1,000 live births is less than that for last year. 24 Of the 111 children who died, 76 died before reaching the age of 4 weeks, giving a neo-natal mortality rate of 17.1 per 1.000 live births compared with 16.6 for England and Wales. Although the neo natal mortality rate for the Borough of Lambeth is higher than that for the Country as a whole it is slightly less than the rate recorded for last year. Maternal Mortality One woman died as a result of childbirth, giving a maternal mortality rate of 0.22 per 1,000 total births. Although this does not equal last year, when for the second time in the history of the Borough there was no maternal death, the rate is one of the lowest on record. Deaths from Cancer of the Lung and Bronchus Deaths from cancer of the lung and bronchus numbered 139, 116 males and 23 females. This is an increase of 26 over the figure for 1957. Female deaths increased by nearly 100% and male deaths by nearly 15%. Sixty-seven of the deaths occurred between the ages of 45 years and 64 years and 5 between 25 and 44 years of age. The accompanying graph gives the comparison between the deaths from respiratory tuberculosis and cancer of the lung and bronchus, and from it will be seen the fact that the deaths recorded this year from cancer of the lung are the highest since 1950, in which year the Registrar General listed Cancer of the lung and bronchus' as a separate cause of death. 25 COMPARISON OF DEATHS FROM RESPIRATORY TUBERCULOSIS AND CANCER OF LUNG AND BRONCHUS Cancer of Lung and Bronchus Respiratory Tuberculosis— No. of Deaths 26 ROAD TRAFFIC ACCIDENTS The following tables show the road traffic accidents and casualties occurring within the Borough of Lambeth during the year 1958 and the comparative figures and casualties for the five year period 1954 - 1958. 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 1958 WITHIN THE BOROUGH OF LAMBETH Month No. of Accidents Adults Children Totals Killed Seriously Injured Slightly Injured Killed Seriously Injured Slightly Injured January 94 5 15 83 - - 9 112 February 83 2 9 67 - - 11 89 March 115 1 23 83 - 6 15 128 April 114 1 11 97 - 4 13 126 May 163 1 24 160 1 4 19 209 June 154 - 17 145 - 6 21 189 July 130 - 21 110 - 4 21 156 August 121 1 24 93 - 6 24 148 September 124 1 13 116 - 3 16 149 October 123 1 19 89 1 6 21 137 November 132 - 26 109 - 2 14 151 December 152 4 38 141 - 4 9 196 TOTALS 1505 17 240 1293 2 45 193 1790 Accidents per mile of road 12.6 27 BOROUGH OF LAMBETH COMPARATIVE FIGURES OF ACCIDENTS AND CASUALTIES FOR FIVE YEAR PERIOD 1954 - 1958 1954 1955 1956 1957 1958 Number of accidents involving personal injury 1,032 1, 246 1, 272 1, 212 1,505 Accidents per mile of road 7. 29 8.80 8. 98 8.56 12.6 Casualty Figures Adults Killed 12 14 12 12 17 Seriously Injured 180 187 174 196 240 Slightly Injured 756 1,002 1,067 1, 052 1, 293 Totals 948 1, 203 1, 253 1, 260 1, 550 Children Killed 1 1 2 1 2 Seriously Injured 30 35 29 24 45 Slightly Injured 196 189 211 175 193 Totals 227 225 242 200 240 Combined Adults and Children Totals 1, 175 1 428 1, 495 1, 460 1. 790 I am indebted to the Town Clerk for the above figures. 28 The figures of road accidents and casualties present a grim picture. Accidents involving personal injury have increased by 293 during the year. The number of fatalities increased from 13 to 19, the number of seriously injured from 220 to 285 and the number of slightly injured from 1227 to 1486. Forty more children and 290 more adults than in 1957 were involved in accidents in which death or injury occurred. The accident rate per mile of road increased from 8.56 to 12.6. It is interesting to note that during the five year period 1954 1958 there occurred in the Borough of Lambeth 6267 accidents involving personal injury, During the same period 74 persons were killed, 1140 seriously injured and 6134 slightly injured. In the same period the number of accidents per mile of road has risen from 7. 29 to 12. 6. If, during the same period, in the Borough of Lambeth, 74 deaths had occurred from a disease such as poliomyelitis it is not difficult to imagine public reaction. It would seem, however, that death on the roads has become to be accepted as a necessary evil in an age which has progressed immeasurably in certain preventive fields in the last 40 years. 29 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 Glanders Hydrophobia Malaria Measles 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 Snallpox 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. 30 NOTIFICATIONS (CORRECTED) Disease 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Totals Grand Total M F M F M F M F M F Scarlet Fever 24 22 20 14 19 12 25 17 88 65 153 Whooping Cough 10 13 16 12 18 22 17 24 61 71 132 Acute Poliomyelitis Paralytic - 1 1 2 - - 1 - 2 3 5 Non-Paralytic 1 - - - - - - - 1 - 1 Measles 17 22 95 96 124 115 62 69 298 302 600 Diphtheria - - - - 1 - - - 1 - 1 Dysentery 9 7 11 14 17 10 39 21 76 52 128 Meningococcal Infection - - 1 - - - - - 1 - 1 Pneumonia 24 19 29 4 3 5 14 16 70 44 114 Acute Encephalitis (Infective) - - 1 - 1 - - - 2 - 2 Typhoid Fever - - - - - 1 - - - 1 1 Erysipelas 1 - 4 1 - 1 1 3 6 5 11 Food Poisoning 9 5 6 5 8 6 7 6 30 22 52 Puerperal Pyrexia - 35 - 11 - 14 - 10 - 70 70 Ophthalmia Neonatorum 2 2 2 1 - - - - 4 3 7 Scabies 2 2 4 2 2 9 5 3 13 16 29 Malaria - - - - - - - 1 - 1 1 TOTALS 99 128 190 162 193 195 171 170 653 655 1308 3 1 NOTIFICATION OF INFECTIOUS DISEASE - AGE DISTRIBUTION Age Groups DISEASE Scarlet Fever Whooping Cough Acute Poliomyelitis Measles Diphtheria Dysentery Meningococcal Infection Scabies TOTALS Paralytic Non-Paralytic M F M F M F M F M F M F M F M F M F Under 1 year 1 - 4 12 - - - - 19 23 - - 8 2 - - - - 69 1 year 2 2 5 11 - 1 - - 45 53 - - 4 7 - - - 2 132 2 years 6 5 6 7 - - - - 36 36 - - 5 8 - - - - 109 3 years 4 6 16 4 - - - - 27 36 - - 6 2 - - - - 101 4 years 13 10 6 4 1 - - - 48 41 - - 6 3 - - 1 1 134 5-9 years 52 36 21 30 1 - - - 113 107 - - 25 7 - - 1 5 398 10-14 years 8 5 3 3 - - - - 4 1 - - 5 5 - - 2 1 37 15-24 years 2 1 - - - 1 - - 5 4 - - 3 3 - - 5 6 30 25 and over - - - - - 1 1 - 1 1 1 - 14 15 1 - 4 1 40 TOTALS 88 65 61 71 2 3 1 - 298 302 1 - 76 52 1 - 13 16 1050 Age Groups Pneumonia Typhoid Fever Acute Encephalitis (Infective) Erysipel as Food Poisoning Puerperal Pyrexia Ophthalmia Neonatorum Malaria TOTALS M F M F M F M F M F M F M F M F Under 5 years 4 7 - - 1 - - 1 7 5 - - 4 3 - - 32 5-14 years 4 5 - - 1 - - - 7 4 - - - - - 1 22 15-44 years 19 13 - - - - 1 2 12 9 - 70 - - - - 126 45-64 years 26 12 - • - - 3 1 4 3 - - - - - - 49 65 and over 17 7 - 1 - - 2 1 - 1 - - - - - - 29 TOTALS 70 44 - 1 2 - 6 5 30 22 - 70 4 3 - 1 258 GRAND TOTAL 1308 32 WARD DISTRIBUTION NUMBER OF CASES OF INFECTIOUS DISEASE (NOTIFIED)IN EACH WARD OF THE BOROUGH Ward Scarlet Fever Whooping Cough Acute Poliomyelitis Paralytic Acute Poliomyel itis Non Paralytic Measles Diphtheria Dysentery. Meningococcal Infection Pneumonia Acute Encephalitis (Infective) Typhoid Fever Erysipelas Food Poisoning Puerperal Pyrexia Ophthalmia Neonatorum Scabies Malaria Totals Marsh 14 - 1 1 70 1 9 - 9 - - - 5 34 1 - 1 146 Bishop' s, 25 4 - - 46 - 5 1 5 - - 1 5 - - 1 - 93 Princes 12 9 - - 57 - 7 - 4 - - 2 6 13 2 1 - 113 Oval 3 5 1 - 4 - 17 - 5 - - - 2 - - 1 - 38 Springfield 6 31 - - 23 - 20 - 4 - - 1 7 - - - - 92 Lansdowne 13 11 - - 26 - 24 - 3 - 1 - 4 18 - - - 100 Minet 2 - - - 28 - 3 - 1 1 - 3 4 - 1 - - 43 Angell 9 4 - - 46 - 1 - 6 - - - 2 1 - 6 - 75 Vassall 5 7 1 - 29 - 8 - 14 - - - 3 - 1 5 - 73 Grove 4 4 - - 18 - 3 - 9 - - - - - - - - 38 Stockwell 6 5 - - 14 - - - 3 - - - 1 - - 6 - 35 Landor 4 8 2 - 22 - 8 - 23 - - - 2 - 1 1 - 71 Ferndale 2 4 - - 27 - 4 - 1 1 - - 2 - - 2 - 43 Town Hall 11 2 - - 29 - 1 - 3 - - - 5 - - 2 - 53 Heme Hill 5 7 - - 39 - 1 - 13 - - 2 2 2 1 1 - 73 Effra 12 3 - - 8 - 5 - 4 - - 1 1 1 - - - 35 Tulse Hill 5 3 - - 16 - 1 - 2 - - - - 1 - - - 28 Thurlow Park 1 7 - - 5 - - - 1 - - 1 - - - 1 - 16 Romany 4 3 - - 1 - - - 1 - - - - - - 1 - 10 Leigham 7 2 - - 11 - 1 - 3 - - - 1 - - 1 - 26 Knight's Hill 3 13 - - 81 - 10 - - - - - - - - - 107 TOTALS 153 132 5 1 600 1 128 1 114 2 1 11 52 > 70 7 129 1 1308 33 PARLIAMENTARY CONSTITUENCIES Number of cases of Infectious Diseases notified in each Parliamentary Constituency of the Borough. Disease Parliamentary Constituency Totals Vauxhall Brixton Norwood Scarlet Fever 73 43 37 153 Whooping Cough 60 34 38 132 Measles 226 213 161 600 Diphtheria 1 - -- 1 Pneumonia 30 60 24 114 Acute Encephalitis (Infective) -- 2 - 2 Meningococcal Infection 1 -- -- 1 Acute Poliomyelitis Paralytic 2 3 - 5 Acute Poliomyelitis Non-Paralytic 1 - - 1 Dysentery 82 28 18 128 Ophthalmia Neonatorum 3 3 1 7 Puerperal Pyrexia 65 1 4 70 Typhoid Fever 1 - - 1 Food Poisoning 29 19 4 52 Erysipelas 4 3 4 11 Scabies 3 22 4 29 Malaria 1 - - 1 TOTALS 582 431 295 1308 34 NOTIFICATIONS OTHER THAN TUBERCULOSIS The total number of notifications received during the year, excluding tuberculosis, fell considerably, 1308 corrected notifications being received compared with 3,906 in 1957. This decrease is practically accounted for by a reduction of 2,369 in the number of cases of measles notified. In 1957 there was an epidemic of measles which commenced at the end of 1956. As measles tends to occur in epidemic form every two years it was to be expected that the incidence in 1958 would be considerably lower. It is anticipated, therefore, that the disease will again assume epidemic proportions in 1959, Scarlet Fever There was a reduction of 1 in the number of cases, 153 occurring compared with 154 in 1957. Whooping Cough This disease showed a decrease on the 1957 figure, 132 cases being notified compared with 258. Poliomyelitis It is pleasing to report that only 6 cases of poliomyelitis (5 paralytic and 1 non-paralytic) were notified during the year compared with 17 cases (14 paralytic and 3 non-paralytic) during 1957. No deaths occurred from this disease. The disease was spread throughout the different wards of the Borough as follows Marsh 2 Landor 2 Oval 1 Vassall 1 6 The cases were spread throughout the year as follows : First Quarter 2 Second Quarter 3 Third Quarter Nil Fourth Quarter 1 6 35 The cases were spread evenly between the sexes, 3 male and 3 female suffering from the disease, and were split into the following age groups : 1 year 1 4 years 1 5-9 years 1 15 - 24 years 1 25 years and over 2 6 Food Poisoning Fifty-two notifications of food poisoning were received during 1958. The cases were distributed throughout the year as follows First Quarter 14 Second Quarter 11 Third Quarter 14 Fourth Quarter 13 52 The agent was identified in seven cases. Salmonella typhi murium - 5 Slamonella St. Paul . 2 In the remaining 45 cases notified the agent was not identified. All the cases occurred in different families, scattered throughout the Borough. Six fewer notifications were received than in 1957. Typhoid Fever At the end of August information was received from an infectious diseases hospital that alady of 62, a resident of the Borough, had been admitted with typhoid fever. She had recently been on holiday, had visited various seaside resorts for single days and had consumed a variety of foods at these places. She was employed as a cleaner at a house in another Borough. 36 Enquiries were made at the resorts she had visited with negative results. It was, however, discovered that her employer had had an illness earlier in the year and it was eventually confirmed that this was typhoid fever. It was not possible, however, to establish that it was the same type in both cases although neither could the contrary be proved. Contacts of the patient both at home and at work were examined with negative results, and no secondary cases were reported. The patient eventually recovered after a severe illness. Puerperal Pyrexia There was a reduction of 38 in the number of notifications of Puerperal Pyrexia, 70 cases occurring compared with 108 in 1957. Dysentery There was a considerable increase in the number of cases of dysentery notified, 128 cases occurring compared with 68 in 1957. Nearly half of these cases occurred in the Oval, Springfield and Lansdowne Wards and 60 were notified in the last quarter of the year. Pneumonia Fewer cases of Pneumonia were notified during the year, 114 compared with 217 in 1957. Scabies It is still necessary, even in 1958, to treat people for Scabies. In this connection 29 notifications were received in the Public Health Department, This is a reduction of 5 on the number of cases notified in 1957. An arrangement exists with the Metropolitan Boroughs of Southwark and Battersea for the cleansing of such persons. Diphtheria One case of diphtheria occurred during the year. This was an adult male who entered the country from the Middle East. 37 He arrived by air in the early morning of the 8th August, 1958, He stayed part of the day with a friend in another Borough and then was admitted to a hospital in Lambeth with a letter of introduction to a Specialist for treatment for sinusitis. On the 12th August the patient was seen by the neurologist on account of a palatal paralysis and a provisional diagnosis of diphtheritic paralysis was made. The patient was isolated, and a swab taken proved positive to the diphtheria bacillus. Because of his general condition the patient was not removed to an isolation hospital but was efficiently barrier nursed in a side ward, The necessary precautions were taken, as were steps to trace possible contacts who had left the hospital, and the respective Medical Officers of Health of the districts to which possible contacts had gone were notified. The nursing staff who were immunised against diphtheria on entry to the hospital were given booster doses of T.A.F. and all contacts swabbed. The measures taken proved effective and no further case of diphtheria occurred. As far as could be ascertained the patient had not been immunised against the disease. Diphtheria Immunisation Diphtheria Immunisation is the responsibility of the London County Council and I am indebted to the Divisional Medical Officer of Division 8, Dr. W.H.S. Wallace, for supplying me with the following figures regarding immunisation carried out in the Borough of Lambeth during the year 1958. 38 BOROUGH OF LAMBETH IMMUNISATION - 1958 Completed cases Welfare Centres and Nurseries General Practitioners Totals Under 5 years 5 - 14 years Under 5 years 5 - 14 years Diphtheria Prophylaxis only 421 122 89 11 643 Combined antigen Diphtheria and Whooping Cough 682 10 165 9 866 Triple antigen Diphtheria, Whcoping Cough and Tetanus 1160 31 232 15 1438 Diphtheria Boosting doses - all ages 1011 233 1244 Whooping Cough only al1 ages (completed cases) 295 33 328 Smallpox No case of this disease occurred in the Borough during the year. There are, however, no grounds for complacency, A large section of the community remains unvaccinated and therefore unprotected against the disease, With the speed of air travel it is likely that smallpox could be introduced to the country from those areas in which it is prevalent. It is desirable, therefore, that as many as possible should be protected, and this can only be done by vaccination. Any propoganda which furthers this aim is well worth while, 39 INTERNATIONAL CERTIFICATES OF VACCINATION International Certificates of vaccination for persons travelling 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 may charge for issuing an International 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 International Certificate of vaccination against yellow fever will be supplied, after vaccination, at the Centre at which the vaccination is done. The International Certificates 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, Saville 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, 1982 International Certificates of Vaccination were stamped by the Public Health Department, 40 TUBERCULOSIS Notification The following table shows the number of cases of tuberculosis notified for the first time during the year 1958, excluding transfers into the district and cases brought to notice other than by formal notification. Age Group Respiratory Non-Respiratory Total all Forms Male Pemale Male Female Under 5 years 2 - 1 1 4 5 - 14 years 4 4 - 1 9 15 - 24 years 21 15 - 2 38 25 - 44 years 43 28 4 5 80 45 - 65 years 45 12 1 5 63 65 years and over 14 1 - 1 16 TOTAL 129 60 6 15 210 These primary notifications were distributed amongst the Parliamentary Constituencies as follows:- Norwood 56 Brixton 72 Vauxhall 82 In addition to the above, 89 cases (86 respiratory and 3 non-respiratory) were transferred into the district or were brought to light other than by primary notification. 41 ADMITTANCES AND DISCHARGES FROM HOSPITALS SANATORIA ETC Respiratory Non-Respiratory Admitted Discharged Admitted Discharged Male Female Male Female Male Female Male Female 118 43 130 57 5 3 4 5 Parliamentary Constituencies Respiratory Non-Respiratory Admitted Discharged Admitted Discharged Vauxhall 71 84 1 3 Brixton 57 71 5 2 Norwood 33 32 2 4 TOTALS 161 187 8 9 The following table shows the primary notification of tuberculosis, excluding inward transfers, for the ten year period 1949-1958. Year Respiratory Non-Respiratory Totals Notification Rate per 1.000 population 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 1958 189 21 210 0.94 42 According to the figures supplied by the Registrar General the following deaths from tuberculosis occurred during the year. Tuberculosis of Respiratory system Other forms of Tubercul osis All forms of Tuberculosis Male Female Total Male Female Total Male Female Total 17 7 24 2 - 2 19 7 26 NUMBER OF DEATHS FROM TUBERCULOSIS AND DEATH RATE PER 1,000 POPULATION FOR TEN YEAR PERIOD 1949 - 1958 Year Deaths from Respiratory Tuberculosis Deaths from Non-Respiratory Tuberculosis Totals Rate per 1.000 Population 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 1958 24 2 26 .13 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 F M F 1379 1029 122 167 1501 1196 2408 289 2697 43 DEATH RATE FROM ALL FORMS OF TUBERCULOSIS PER 1,000 POPULATION AND NOTIFICATION RATE PER 1,000 POPULATION 44 I am indebted to Dr. Price, Chest Physician at St. Francis' Hospital for the following report on the work of the Chest Clinic during the year. The following Table refers to the work of the Chest Clinic at St, Francis' Hospital and is an extract of the Annual Return of Chest Clinic Work sent to the Ministry of Health for the year 1958. TABLE 1 Respiratory Tuberculosis Non Respiratory Tuberculosis Men Women Children Total Men Women Children Total Total cases on CIinic Register at 31.12.58 633 503 78 1214 14 17 10 41 Number of cases diagnosed during the year 69 44 5 118 2 1 - 3 Recovered 15 12 5 32 - 4 - 4 Deaths 5 2 - 7 1 - - 1 Deaths There were eight deaths from Tuberculosis during the year, one of them a case now rarely seen of Meningitis complicating generalised Tuberculosis in an adult male, and it is recorded as a non respiratory death. Non-Respiratory Tuberculosis Three new cases of non-respiratory Tuberculosis were added to the register during the year, none of them due to bovine infection which is now almost eradicated following milk pasteurisation. The total number remaining on the register continues to fall as cases are removed cured. 45 Respiratory Tuberculosis There was a slight increase in the number of new adult male cases discovered during the year but this was more than offset by the decl in in the new women patients and the total was somewhat less than last year. Of the 118 new cases, 69 were male and this higher incidence of Tuberculosis in men reflects the position generally for the country as a whole, Fortunately 75%of the cases diagnosed were at an early minimal stage of infection, likely to respond well to treatment. Table 1 shows the genera] fall in Clinic register figures with the exception of the total of male cases where an increase is accounted for by the inward transfer of 32 men to the London County Council Hostel for chronic Tuberculosis cases opened at Knight s Hill in June. However, in spite of this, the total of cases transferred out of the Borough exceeded those transferred in and, as will be seen from Table 2, the total on the register continues to fall 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 1958 1,214 118 7 32 Treatment Out Patient management and treatment of Tuberculosis cases is now established and, in co-operation with General Practitioners, 400 patients were given chemo-therapy under Chest Clinic super vision and guidance during the year. Such treatment is now an important function of the Chest Clinic service, as in individual cases chemo-therapy may be prolonged for two or more years and is continued on occasion after the patient has resumed work. 46 Admissions to hospital or sanatorium continue to fall although hospital assessment and initial treatment are necessary on occasion where home circumstances are inadequate or where, particularly, surgery is contemplated. There were 40 such admissions during the year. The year saw an end to Chest Clinic artificial pneumo thorax and pneumoperitoneum refill sessions as this form of treatment is now used only in exceptional cases. In the earlier part of the year 64 refills were given but no patient was receiving such treatment at the year end. The Lambeth (South) Chest Clinic To provide full medical, medico social and welfare advisory services for Tuberculosis cases and contacts on established principles is still the main concern of the Clinic, In particular attention has to be paid to the question of disease prevention, and there is full co-operation with the Public Health Department of the Borough Council and of the County Council in the control of infection. Special provision has been made for the new Tuberculosis Hostel patients to attend at monthly intervals for treatment and advice. These cases are potentially infectious but with Chest Clinic guidance and Hostel care are less likely to endanger others than when living under conditions in common lodging houses from whence the majority came. The Chest Clinic continues to expand in service to include the diagnosis and treatment of other chest diseases, including pulmonary carcinoma, pneumonia, bronchitis and asthma, and it is likely that the future will see local General Practitioners making more and more use of the Clinic facilities for this purpose. 47 SECTION C GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA Care of the Aged Considerable attention has again been given to the care of the aged and the woman Public Health Visitor has made 345 more visits than in 1957. Some of this increase is due to the operation of the scheme for laundering soiled linen etc. for tinent persons. Notes on this scheme appear elsewhere in the report, A large number of the old people are very difficult, and a tremendous amount of work is done by the lady visitor in persuading them to accept help and treatment voluntarily, and this is confirmed by the fact that it was necessary to take statutory action in one case only, Individual cases have retired constant supervision, and it is interesting to note that five cases alone necessitated 115 visits, There is no doubt that this aspect of the work of the Public Health Department is steadily increasing. In addition to paying tribute to the work of the Public Health Visitor, I acknowledge the help given by Lambeth Old People's Welfare Association, a report on whose work appears elsewhere in the report, and the London County Council through its Domestic Help and Nursing Services. The co operation of the Geriatricians and the Hospitals is also apDreciated. To all these organisations I am extremely grateful. Set out below is a summary of the work of the Public Health visitor for the year 1958:- No. of new cases 421 No. of cases removed to Hospital or Institution voluntarily 147 No. of cases removed under National Assistance Act, 1948 as amended by National Assistance (Amendment) Act, 1951 1 No. removed by Duly Authorised Officer 7 TOTAL NO. OF VISITS MADE BY VISITOR 2316 48 No. of cases who received help 364 No. of cases in which help was not required 40 No. of cases in which help was refused 17 No. of deaths 163 No. of cases on Register at end of 1958 838 An analysis of the 421 new cases reveals the following age groups:- Age Groups Male Female Totals 65 - 69 24 54 78 70 - 74 25 46 71 75 - 79 31 68 99 80 - 84 42 63 105 85 - 89 9 39 48 90 - 94 1 14 15 95 - 100 1 4 5 TOTALS 133 288 421 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, are living in insanitary conditions and (b) are unable to devote to themselves, and are not receiving from other persons, proper care and attention. This Act enables a Local Authority, on the certificate of the Medical Officer of Health, to apply to a 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. 49 Action under the main 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 action was taken under the amended legislation in one case, details of which are set out below:- The case, a man of 62 years of age, was referred to the Public Health Department by the Domestic Help Organisar on 2nd June, He lived on the top floor of an old house, was bed bound and very weak. He had been in hospital suffering from broncho pneumonia and had chronic infection of the lungs which needed constant medical and nursing treatment, but took his own discharge. The man was doubly incontinent and there were faeces and expectoration in his bedding and on the floor. The Domestic Help was unable to cope with the cleaning of the room. The General Practitioner arranged for the District Nurse to attend daily, and, after persuasion, the case was readmitted to hospital on 2nd June, but he took his own discharge on July 8th. Invalid meals were arranged, also daily visits by the District Nurse and the man was admitted to hospital again on 17th July, Once again he pressed for his own discharge and returned home on 13th August, He was seen by the Medical Officer of Health on 14th August. His room was in an appalling condition. Although very ill, all methods of persuasion failed and he refused to return to hospital. The appropriate action was taken under the National Assistance Act, 1948 as amended. The man was removed on 15th August, and he died in hospital on 28th August, 1958. Laundry Service for Aged Incontinent Persons In December 1956 a service was initiated to assist those old persons and their relatives who were unable to cope with the laundering of soiled linen. As facilities were at that time not available, arrangements were made with a local laundry proprietor, who in the first instance carried out the service free of charge for three months, and then at a reduced rate. 50 These arrangements continued until 1st May 1958 when the Council was able to make arrangements with the Borough of Southwark for carrying out this service. Prior to the 1st May sheets, drawsheets and pillow cases only were dealt with, but after that date the service was extended to include personal articles and clothing. Before the service is granted, each case is visited by the lady visitor to ascertain whether it may be dealt with in accordance with Section 122 of the Public Health (London) Act, 1936, and collections and deliveries are made twice weekly. The total number of persons receiving benefit from the scheme during the year was 87, the total visits made was 1507, and the number of soiled articles collected and cleansed 10,707. The service is much appreciated by all concerned with the welfare of these unfortunate elderly people. Holidays for the Elderly The scheme to send old age pensioners to the sea side for a week's holiday at a cost of £1 each was continued during 1958. 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. The holidays were arranged at Margate in the Spring and Autumn, the first period being in May and the second in September. Parties of old people went to Margate 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. All accommodation was inspected and found to be clean and comfortable. One hundred and ninety two old people went for a holiday in the spring, and 178 in the autumn, making a total of 370. This was 78 more than in 1957. Included in the total were 53 married couples. 51 The following table shows the age groups, Parliamentary Constituencies and Sex : - SPRING Parliamentary Constituencies Age groups in years Totals 60 65 70 75 80 85 & over F M F M F M F M F M F Vauxhall 5 4 7 5 8 9 11 0 0 2 0 51 Brixton 6 3 14 5 17 4 8 2 2 0 2 63 Norwood 1 4 14 7 15 8 15 4 7 0 3 78 TOTALS 12 11 35 17 40 21 34 6 9 2 5 192 Included in these figures are 29 married couples. 52 AUTUMN Parliamentary Constituencies Age groups in years Totals 60 65 70 75 80 85 & over F M F M F M F M F M F Vauxhall 3 4 11 3 12 6 9 1 5 1 1 56 Brixton 3 2 6 3 18 6 9 5 3 0 1 56 Norwood 3 4 15 4 8 10 10 5 5 1 1 66 TOTALS 9 10 32 10 38 22 28 11 13 2 3 178 Included in these figures are 24 married couples 53 SPRING AND AUTUMN COMBINED Parliamentary Constituencies Age groups in years Totals 60 65 70 75 80 85 & over F M F M F M F M F M F Vauxhall 8 8 18 8 20 15 20 1 5 3 1 107 Brixton 9 5 20 8 35 10 17 7 5 0 3 119 Norwood 4 8 29 11 23 18 25 9 12 1 4 144 TOTALS 21 21 67 27 78 43 62 17 22 4 8 370 Included in these figures are 53 married couples. 54 LAMBETH OLD PEOPLE'S WELFARE ASSOCIATION The work of the Lambeth Old People's Welfare Association continued to progress steadily throughout the year. The association 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 refer to the year ending 31st March, 1959:- " It is with great pleasure once again that we report a continuation of the steady progress which has been a marked feature of past years. The number of names on our register has been increased by 1504 and although a considerable number of old people have been lost through death or by removal to other areas, many of the old cases are still needing considerable attention. For many the age of retirement brings fears of insecurity, a reduced standard of living, loneliness, failing health and a sense of being unwanted. One of the main tasks of the Association is to help in overcoming these fears, to ensure that material needs are met, to offer new interests and to provide friendship to the lonely. Visiting In order to help the staff to meet these needs, many voluntary workers have been enrolled, and the Association offers its sincere thanks to the many workers who give up their time to help. However, many more helpers are needed to meet the ever increasing demand. Holidays The various holiday schemes now operating for old people do much to alleviate loneliness, build up resistance and give them something to look forward to. During the year the Association arranged for 72 old people to have two weeks holiday at the sea, and eight infirm people were sent to sea-side convalescent homes for varying periods. Many more people were recommended for holidays under the scheme sponsored by the Borough Council. 55 The Geriatricians of the South Western and St, Francis Hospitals continued to help the Association by taking into their hospitals infirm old people for short periods so that relatives of the old folk may have a much needed holiday. Meals on Wheels During the year there was a much greater demand for meals. The Association delivered 24,705 meals in the Northern end of the Borough against 19,635 delivered in that area last year. This has meant a very severe strain on both staff and vehicles, and it is hoped that before long it will be possible to purchase a third van to relieve this strain and further expand the service. The area of the Borough south of Clapham Road continues to be served by the Women's Voluntary Services who have delivered 26,304 meals. Foot Clinics There is still a very big demand for foot treatment amongst the elderly in the Borough. Although six clinics are working in all, 23 sessions per week, each is working to capacity and several have waiting lists. The Domiciliary Service has been increased by two sessions to six, but even this does not meet the demand and there is a waiting list for appointments for this service also. Over 2,000 old people are receiving treatment either in centres or at home. Clubs Twenty nine clubs are now operating in the Borough. Wonderful work is carried on by club leaders and helpers who give up many hours of their time to this work. The usual inter-club competition and exhibition of work was held in October and 487 exhibits of a very high standard were on view. King George VI Memorial Club This club for the housebound of Camberwell and Lambeth continued to expand throughout the year. With the purchase of a second ambulance in August 1958 the club was able to cater for a considerably larger number of people each week, 56 having on the average a weekly attendance of 240 by the end of the year. Altogether during the year 423 members came to the club. Because of the Members' ages and infirmities, the annual loss through deaths and serious disablement is high, but despite this there was, at the end of the year, a waiting list of 69 people, for whom there was little prospect of a vacancy until the end of the summer. The club continued to provide services such as chiropody, bathing, hairdressing and shopping for the members, but a full expansion of some of these services is hampered by a lack of helpers with the requisite skills. Handicrafts have been encouraged and two very successful sales of members' work were held during the year. Other activities have included ten outings two for each club day in the summer of 1958 and a party for each club day at Christmas, at one of which the club was honoured by the presence of His Worship the Mayor of Lambeth, Work Centres There are now 60 people attending regularly the two centres situated at 58, Lansdowne Way, S. W. 8 and 28, Chester Way, S. S. 11. Of these 53 are women and 7 are men. Work for the women has been much easier to find and amongst the contracts there are four regular orders which are expected to last well into the future. These include packing, carding and labelling as well as darning for a theatrical costumier. Repairing of overalls and threading of thousands of text cards for the Overseas Mission have also been undertaken. The men are employed making seed boxes and contracts have also been promised for these. Regular contacts with local hospitals are maintained and three out patients from therapy and psychiatric wards, as well as one hospital in-patient, were assisted during the year. Several students from India, Pakistan and South Africa have visited the centres during the year and one tutorial class was held. 57 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 No. 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. to 5 p.m. Mondays to Fridays and 10 a.m. to 12 noon on Saturdays." 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 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 Governers. 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. KINGS COLLEGE HOSPITAL GROUP King's College Hospital, Denmark Hill, S.E.5. Bel grave 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. 58 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. 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.1. 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 59 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 1958. 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 Surbition works has not yet been commenced. 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 services 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 plumbo-solvent. " During the year samples of water supplied by the Metropolitan Water Board to the Borough of Lambeth were taken for chemical and bacteriological examination. The average results were as follows 60 Chemical Examination Milligrammes per litre (unless otherwise stated) Description of sample Thames derived filtered water Ammonia nitrogen Albuminoid nitrogen Oxidised nitrogen-nitrate Chlorides as C1 Oxygen abs. from Permanganate 4 hours at 27 ºC Turbidity in terms of silica Colour m.m. brown 2 ft tube Burgess's Tintometer Hardness (total) Hardness (non-carbonate) pH value Phosphate as PO4 Silicate as Si02 Sulphate as S04 Fluoride as F Magnesium as Mg Electrical Conductivity (Gemmhos) Bacteriological Examination after Chlorination (Water passing into supply) 0.027 0.077 4. 2 26. 1.26 0.3 12. 270. 66. 7.9 0.85 9. 58. 0. 15 5. 550. Plate counts (average per ml.) Colonies counted on agar 37 °C (20-24 hours) 9.7 Coliform count percentage samples negative in 100 ml 99.07 Escherichia count percentage samples negative in 100 ml 99.88 Hater from Wells There are a number of wells in use, the majority of which however supply water used only for industrial purposes. The water from two wells is used for drinking purposes, or for the preparation of food. Reports of the analyses of water from these wells are received regularly and have been satisfactory for the year under review. 61 SUMMARY OF VISITS AND INSPECTIONS BY INSPECTORIAL STAFF Visits Re-visits Dwellinghouses In respect of nuisances under Public Health (London) Act, 1936 2,961 8,306 In respect of Certificates under the Rent Act, 1957 540 663 In respect of Rehousing 169 39 In respect of Infectious Diseases 339 10 Other reasons 631 148 Clean Air Act, 1956 Timed Observations 25 - Untimed Observations 374 - Other visits, private and industrial premises 3,586 1,120 Bakehouses 105 40 Butchers Shops 410 - Restaurants 253 362 Fried Fish Shops 37 2 Ice Cream Premises 53 2 Milkshops 300 7 Public Houses 46 15 Street Traders 19 2 Other Food Premises 481 46 Factories Acts Factories with mechanical power 135 24 Factories without mechanical power 30 6 Outworkers 162 - Drainage New Buildings 20 2,233 Alteration to existing drainage, etc. 341 1,999 62 SUMMARY OF VISITS AND INSPECTIONS BY INSPECTORIAL STAFF (Continued) Visits Re-visits Animals improperly kept 32 7 Personal uncleanliness 55 16 Exhumations 3 - Hairdressers and Barbers 1ll 20 Pet Animals Act, 1951 32 1 Rodent Control 1,311 1,306 Unclassified 721 215 13,282 16,589 COMPLAINTS The number of complaints received, including rat and mouse infestations, was 3,576 DRAIN TESTING Number of Drains tested by District Inspectors 2,846 Number of Drains tested by Rodent Officer 166 3.012 * — DANGEROUS STRUCTURES Dangerous structures notified to London County Council 98 SUMMARY OF DEFECTS AND NUISANCES FOUND AS A RESULT OF ROUTINE INSPECTION AND INSPECTION FOLLOWING COMPLAINT Dirty Premises 58 Verminous Premises 310 Defective Roofs 850 63 SUMMARY OF DEFECTS AND NUISANCES FOUND AS A RESULT OF ROUTINE INSPECTION AND INSPECTION FOLLOWING COMPLAINT (Continued) Defective rainwater pipes and gutters 398 Damp Premises 679 Defective drainage and sanitary fittings 610 Choked drainage 293 Lighting and ventilation 435 Defective water supplies 89 Dustbins etc. 36 General defects and dilapidations 1,932 NOTICES SERVED Number of Intimation Notices Served 1,871 Number served under Public Health (London) Act, 1936 - Section 40 369 Section 82 571 Section 93 5 Section 108 195 Under the London County Council (General Powers) Act, 1955 Section 27 61 Under the Prevention of Damage by Pests Act, 1949 11 1,212 LEGAL PROCEEDINGS PUBLIC HEALTH (LONDON) ACT 1936 In respect of 135 summonses returnable to the Lambeth Magistrates Court and Petty Sessional Court, 32 Abatement Orders were made, 41 cases were adjourned sine die and 62 were withdrawn, the nuisances being abated by the respective owners by the date of the hearing. 64 DWELLING HOUSES RENDERED FIT Number of dwelling houses rendered fit in consequence of informal action 1,055 Number of dwelling houses in which defects were remedied after service of formal notice (a) by landlords 1,094 (b) by Council in default of landlords under the Fifth Schedule of Public Health (London) Act, 1936 17 Under Sections 40, 93 and 108 of the Public Health (London) Act, 1936 and Prevention of Damage by Pests Act, 1949 65 Under Section 27 of London County Council (General Powers) Act, 1955 15_ 97 Outstanding cases from previous year are included. SECTION 95 PUBLIC HEALTH (LONDON) ACT, 1936 In 1958 Certificates of Habitation were issued in respect of 896 new dwellings in regard to the provision of a proper and sufficient water supply. Out of 896 dwellings 340 were Borough Council property. 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. 51 plans of new buildings and 57 plans of alterations to existing drains were depositied. In addition combined drainage was carried out in 16 cases. 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. 65 DISINFECTION The following is a summary of the work carried out by staff of the Wanless Road Disinfecting Station :- Number of premises sprayed in which cases of Infectious Disease have occurred 534 Number of rooms included in above 585 Total number of rooms sprayed for all purposes 2,324 Number of articles disinfected 14,701 Number of 1ibrary books disinfect 193 Number of Disinfection Certificates issued 139 DISINFESTATION Bed Bugs Number of houses visited 228 Number of rooms sprayed 646 Number of houses revisited 46 The rooms were sprayed with 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 3547. 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 dwelling 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 department of the Borough Engineer in conjunction with the Rodent Officer and his staff. In all cases of dwelling houses treatment is undertaken by the Local Authority free of charge, but in the case of business 66 premises a charge is made. During the year 1035 complaints were received. of this number 91 were not justified. 788 were in respect of brown rats, and 156 in respect of mice. During the course of investigation 1021 baitings were made and 111 defective drains discovered. Of 28 Statutory notices served under the Public Health (London) Act, 1936 and Prevention of Damage by Pests Act, 1949, 9 were referred to the Town Clerk for the necessary action. FACTORIES ACT, 1937 AND 1948 PART 1 OF THE ACT 1. Inspections for purposes of provisions as to health (including inspections made by the Public Health Inspectors). Premises Number on Register Number of Inspections Written Notices (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities * 179 36 1 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 660 304 18 (iii) Other Premises in which Section 7 is enforced by the Local Authority ** (excluding outworkers' premises 61 61 - TOTAL 900 401 19 67 2. Cases in which Defects were found - Particulars Number of cases in which defects were found Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of Cleanliness (S. 1) 12 9 12 Overcrowding (S. 2) Unreasonable temperature (S. 3) 2 - 2 Inadequate ventilation Ineffective drainage of floors (S. 6) Sanitary Conveniences (S, 7) - (a) Insufficient (b) Unsuitable or defective 5 2 1 (c) Not separate for sexes 1 1 Other offences against the Act (not including offences relating to Outwork) 2 2 TOTAL 22 14 _ 15 NO PROSECUTIONS WERE INSTITUTED. 68 PART VIII OF THE ACT OUTWORK (Sections 110 and 111) No. of out-workers in August list required by Section Nature of Work 110 (1) (c) (3) Wearing Making, etc. Apparel Cleaning and washing 209 Curtains and furniture hangings 1 Artificial flowers 3 The making of boxes or other receptacles or parts thereof made wholly or partially of paper 31 Carding, etc., of buttons, etc. 17 Stuffed toys 3 Cosaques, Christmas crackers, Christmas stockings, etc. 5 Lampshades 20 Paper bags 2 TOTAL 291 NO NOTICES WERE SERVED OR PROSECTUIONS INSTITUTED. 69 RENT ACT, 1957 (a) Applications for Certificates of Disrepair 343 Applications outstanding from 1957 35 378 Decisions not to issue Certificates 1 Decisions to issue Certificates (a) in respect of some but not all defects 269 (b) in respect of all defects 80 349 Applications awaiting action at end of year 28 378 (b) Number of cases where decisions were made to issue Certificates but were awaiting action by the landlords at the end of 1957 43 Undertakings given by landlords under paragraph 5 of the First Schedule of the Act 208 Undertakings refused under proviso to paragraph 5 of the First Schedule of the Act 4 Certificates of disrepair issued 154 Certificates still to be issued or under takings still to be received from landlords at end of year 26 392 (c) Applications for Certificates as to the remedying of defects specified in a landlords undertaking (a) by landlords 106 (b) by tenants 130 (c) applications outstanding from 1957 1 237 Certificates issued (a) defects remedied 84 (b) defects not remedied 151 (c) applications awaiting action at end of year 2 237 70 (d) Applications by landlords for cancellation of Certificates of Disrepair 87 Applications outstanding from 1957 7 94 Certificates cancelled 71 Certificates refused 17 Applications still to be dealt with at end of year 6 94 In connection with the applications from landlords for cancellation of Certificates of Disrepair objections to cancellation were lodged in 25 cases. REHOUSING AND OVERCROWDING During the year the following cases have been investigated : London County Council Cases Overcrowding 3 Medical Grounds 10 Insanitary conditions 20 Lambeth Borough Council Medical Grounds 520 Insanitary conditions 131 Demolition and Closing Orders 17 Enquiries from other Local Authorities 8 Enquiries from other sources 70 During the same period cases have been rehoused by various authorities as under : - London County Council 133 Lambeth Borough Council 84* *Included in this figure are 8 Closing Order cases. 71 REPAIR MAINTENANCE AND SANITARY CONDITIONS OF HOUSES RECORD OF WORK CARRIED OUT BY THE HOUSING INSPECTORS, YEAR ENDED 31st DECEMBER. 1958 HOUSING ACT, 1957 Section 17 - Individual Unfit Houses Inspected - no action under Housing Act 26 Chapel Road Hope Cottage, Ernest Avenue 18 Lollard Street 74 Thorparch Road 1 Trigon Road Inspected in abeyance 166 Black Prince Road 1 Manor Cottages 2 Manor Cottages 6 Manor Cottages 4 Sydney Road Inspected - voluntarily closed 3 Seeker Street Represented Closing Order made 1 Ernest Avenue 57 South Island Place Represented Orders not yet made 19 Southville 21 Southville Represented 1957 - Demolition Order made 3 Stockwell Grove 5 Stockwell Grove Closing Orders - Work in progress to make fit 42 Landor Road 38 Wynne Road 72 Section 18 - Underground rooms and parts of buildings Inspected - no action under Housing Act 89 Camberwell New Road 288 Camberwell New Road 7 Canterbury Crescent 113 Clapham Road 23 Dulwich Road 37 Durand Gardens 2A Eastlake Road 87 Gipsy Hill 75 Hackford Road 160 Hamilton Road 147 Knights Hill 55 Knowle Road 27 Lansdowne Gardens 48 Lansdowne Gardens 21 Mayall Road 242 Milkwood Road 11 Penford Street 3 Radcot Street 6 St. John's Crescent 44 Stockwell Park Crescent 47 Thorne Road 24 Thurlow Park Road 115 Tulse Hill 2 Union Road 8 Victoria Crescent Inspected - in abeyance 13 Eastlake Road 33 Effra Road 1 Gilbert Road 10 Gilbert Road 22 Sandmere Road 24 Sandmere Road 41 Stockwell Park Road Inspected - voluntarily closed 4 Aveline Street 73 Represented - Closing Order made 122 Christchurch Road 108aLambeth Walk 78 Larkhall Lane (varied) 1 Pomfret Road 231 South Lambeth Road 208 Wandsworth Road Represented - Orders not yet made 2 Alaska Street 43 Durand Gardens 89 Fairbain Road 23 Industry Terrace 24 Industry Terrace 25 Industry Terrace 26 Industry Terrace 27 Industry Terrace 28 Industry Terrace 29 Industry Terrace 6 Medwin Street Represented 1957 - Closing Order made 139 Dulwich Road 4 Radnor Buildings 5 Radnor Buildings 135 Tulse Hill Made fit voluntarily 33 Cleaver Square 31 Lansdowne Gardens Made fit - Closing Order determined 23 Akerman Road 54 Knowle Road (1 room) Work in progress to make fit voluntarily 63 Acre Lane 2 Lunham Road 5 Mount Villas 85 Rosendale Road 74 Work in progress to make fit - Closing Orders 76 Bartley Road 109. Bedford Road 31 Ferndale Road Section 36 - Houses let in lodgings Inspected - in abeyance 47 Hanover Gardens Inspected - Voluntary action by owner 9 Langmead Street Part III Clearance Areas Preliminary Inspection 17 (odd) Somers Road (to be represented) In addition to the above preliminary inspection has been made of 50 houses. HOUSING ACT, 1949 Section 20 - Improvement Grants Inspected - no action Cleaver Street Buildings Work Completed 1 Caron Almshouses TOTAL INSPECTIONS AND REVISITS MADE DURING THE YEAR 651 75 ATMOSPHERIC POLLUTION There are seven combined smoke and sulphur dioxide atmospheric pollution stations in the Borough and details of the measurements of pollution are given in the following tables. Two types of pollution are measured, namely smoke and sulphur dioxide. Smoke pollution of the atmosphere includes all types of suspended matter collected on the filter paper (these filter papers are changed daily) but consists largely of smoke from the burning of coal. Smoke concentration is assessed by means of a Reflectometer and the results are expressed as milligrammes of smoke per 100 cubic metres. Sulphur dioxide which is given off in the burning of coal, coke and oil in varying amounts according to the amount of sulphur in the original fuel is measured by a chemical process. The amount of sulphur dioxide is determined by combining the sulphur dioxide in a known quantity of air with hydrogen peroxide to give a dilute solution of sulphuric acid. The concentration of sulphuric acid is determined by chemical titration and from this figure the amount of sulphur dioxide can be calculated, the results being expressed as parts of sulphur dioxide per hundred million parts of air. Atmospheric pollution in any given place depends on a number of important factors, e.g, rainfall, direction and speed of Prevailing wind, turbulence, and seasonal and daily variations, (daily variations may be considerable, but sometimes variation between night and day is even greater). There is one distinct advantage in the measurement of these types of pollution in that over a period of years changes in the general trend of pollution can be observed. 76 CONCENTRATION OF SMOKE AND SULPHUR DIOXIDE MONTH SMOKE (Parts per Hundred Million) SULPHUR DIOXIDE (Milligrammes per 100 Cubic Metres) MONTHLY AVERAGE HIGHEST DAILY AVERAGE MONTHLY AVERAGE HIGHEST DAILY AVERAGE 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 January 29 34 - 39 38 54 28 81 93 - 104 99 125 68 12 11 - 20 16 16 15 34 38 - 60 56 48 31 February- 25 25 - 31 27 43 11 60 49 - 59 54 69 20 10 8 - 15 12 11 6 23 14 - 26 39 18 11 March 28 24 - 33 33 44 24 82 69 - 69 62 138 46 13 8 - 15 12 11 12 32 20 - 29 23 28 29 April 20 15 - 20 18 31 12 39 31 - 36 30 58 24 10 6 - 9 8 9 8 21 10 - 16 14 17 14 May 7 5 - 12 12 11 9 8 15 - 35 32 23 21 2 4 - 9 7 4 6 6 12 - 22 19 13 18 June 8 5 8 12 11 9 9 17 8 19 43 21 12 16 4 6 3 7 6 4 6 8 10 7 14 12 7 13 July 10 7 20 10 10 8 9 21 15 59 32 30 14 19 5 6 5 7 5 3 5 14 15 15 16 14 6 14 August 8 8 7 10 10 8 8 20 16 23 36 27 11 15 3 5 4 6 5 3 5 9 11 12 14 9 5 12 September 15 10 14 15 16 10 11 37 24 46 36 35 18 19 5 8 7 9 8 4 8 12 19 18 27 27 8 25 October 17 20 23 27 24 23 21 37 48 77 70 58 50 64 9 13 10 12 10 8 11 35 26 20 28 27 13 25 November 42 39 53 51 41 60 33 142 128 159 153 122 192 100 17 19 20 18 16 15 16 42 49 49 41 41 42 40 December 35 36 48 55 39 60 37 76 85 140 155 82 120 88 17 18 19 18 16 18 18 44 46 49 46 41 40 45 STATION:- 1. LAMBETH TOWN HALL 2. LIBRARY, SOUTH LAMBETH ROAD 3. KENNINGTON SECONDARY SCHOOL 4. COUNTY HALL, LAB. ROOF 5. ROYAL FESTIVAL HALL 6. AMBULANCE STATION, LANDOR ROAD 7. COUNTY HALL, GROUND FLOOR 77 1958 ATMOSPHERIC POLLUTION DEPOSITS AND SULPHUR DIOXIDE MONTH STATION Rainfall in mm Deposited Matter in Tons per Square Mile SO2 in mgs. per Day on 100 Sq. cms. Insoluble Deposits Soluble Deposits Total Solids January Brixton Hill, Metropolitan Water Board, Archbishop's Park. 40 45 5.1 18.3 5.7 7.6 10.8 25.9 4.6 - February Brixton Hill, Metropolitan Water Board, Archbishop's Park, 50 55 5.6 18.1 6.3 6.4 11.9 24.5 3.8 - March Brixton Hill, Metropolitan Water Board. Archbishop's Park. 27 31 8.3 19.8 10.1 6.7 18.4 26.5 4.3 - April Brixton Hill, Metropolitan Water Board. Archbishop's Park. 21 37 7.0 11.8 8.6 5.8 15.6 17.6 3.0 - May Brixton Hill, Metropolitan Water Board. Archbishop's Park. 60 57 5.3 13.7 5.9 5.7 11.2 19.4 1.5 - June Brixton Hill, Metropolitan Water Board. Archbishop's Park. 97 122 5.9 14.3 8.4 9.0 14.3 23.3 1.4 - July Brixton Hill, Metropolitan Water Board. Archbishop's Park. 23 49 6.3 14.1 5.2 3.9 11.5 18.0 1.3 - August Brixton Hill, Metropolitan Water Board. Archbishop's Park. 52 86 4.8 13.4 3.6 11.2 8.4 24.6 1.1 - September Brixton Hill, Metropolitan Water Board. Archbishop's Park. 94 94 4.7 17.2 8.6 6.3 13.3 23.5 1.9 - October Brixton Hill, Metropolitan Water Board. Archbishop's Park. 62 95 4.0 12.7 6.4 6.5 10.4 19.2 2.8 - November Brixton Hill, Metropolitan Water Board. Archbishop's Park. 44 10 6.8 13.2 5.9 5.8 12.7 19.0 4.6 - December Brixton Hill, Metropolitan Water Board. Archbishop's Park. 63 - 7.5 - 8.6 - 16.1 - 4.6 - 78 CLEAN AIR ACT 1956 During 1958 the detailed survey of the Council's first Smoke Control Area was completed and the information collated in the form required, The Council made the Lambeth No.1 Smoke Control Order on 24th September, 1958 and the Order (together with maps and financial and other information) was submitted to the Ministry of Housing and Local Government for confirmation. The total estimated cost for the No,1 area is £26,000 and although confirma tion of the Order had not been received by the end of the year, it will, subject to Ministerial consent, come into operation on 1st October, 1959, On 16th June, 1958 a combined sulphur dioxide and smoke filter apparatus was set up at Kennington Secondary School, Hackford Road, S,W,9. almost in the middle of the No.1 Smoke Control Area. The results so far obtained seem to justify in some respects the choice of this area as the Council's first Smoke Control Area in that there is quite a high degree of pollution. It has been noted that an increasing number of householders are turning away from raw coal as a means of space heating and are in fact making their own individual contribution towards smoke control by the use of gas, electricity, oil and coke of various types. Prom the point of view of smoke free air, this is an excellent thing which it is hoped will continue. Economic factors play an important part in the Clean Air Campaign, for there seems to be little doubt that a smoke free atmosphere would be much more speedily and voluntarily obtained if it were possible to produce a more reactive type of coke in large quantities freely available at a price more nearly approximating to that of the summer price of the cheapest quality house coal than the prevailing cost of existing premium smokeless fuels, A number of industrial plants have been installed in the Borough during the year and here again the trend away from raw coal is evident especially in the larger plants where oil firing is most frequently employed. One point, although perhaps small in itself, but which nevertheless does call for considerable tact and discretion, is the complaint of the occasional bonfire in the garden. The complainant invariably quotes "Clean Air" to the officer 79 investigating the complaint, but it is a most difficult problem to bring home to the complainant that in the case of the occasional bonfire proof of the existence of a nuisance is impossible to obtain, and without such proof no statutory action can be taken. In these matters, much more is done by persuasion. It would appear to be unreasonable to suggest that the occasional bonfire cannot be lighted, but should it be so suggested, the occupants of premises precluded from lighting bonfires may propose that the Local Authority should collect the material which is normally burned in this way as part of the household refuse collection service. This may well then give rise to the problem of the collection of the material, and it should be added that it cannot always all be buried. The following are figures regarding work in connection with atmospheric pollution carried out by the Smoke Inspectors during the year:- Visits Re-visits Timed observations 25 - Untimed observations 374 - Other visits, private and industrial premises 3586 1120 80 CLEAN AIR ACT, 1956.. BOROUGH OF LAMBETH SMOKE CONTROL AREA No..1. 81 SECTION E INSPECTION AND SUPERVISION OF FOOD Food Hygiene Regulations 1955 - 1957 Systematic and detailed inspection of food premises under the above-mentioned Regulations was continued during the year, al though progress has been hindered by shortage in the establishment of Inspectors. In those premises where detailed inspections for infringements of the Regulations have been completed the main contravention was found to be the absence of constant hot water and hand washing arrangements separate from food and equipment washing facilities. With regard to personal cleanliness, it was necessary to institute a prosecution is one case under Regulation 9. The defendant was smoking whilst handling fish, and was fined.£3 with ten shillings costs. In the main, results have been achieved by encouraging by co-operation the Pood Traders and occupiers of food premises to comply with the regulations. On 1st June. 1958, the Pood Hygiene (Amendment) Regulations 1957 came into operation. These require, inter al ia, the registration of domestic premises which are used for the peeling of shrimps and onions. Two registrations have been effected in respect of the Peeling of onions. Food Premises During the year under review, 2,159 inspections and revisits Were made to food premises in the Borough. These inspections and revisits were made up as follows:- Inspections Re-Visits Bakehouses 105 40 Butchers 410 - Pried Pish Shops 37 2 Ice Cream Premises 53 2 Milk Shops 300 7 Public Houses 46 15 82 Food Premises (continued) Inspections Re-Visits Restaurants 253 362 Other 481 46 1,685 474 The approximate number of food premises by type of business in the area is as follows:- Grocery and provisions 394 Greengrocery and fruit 168 Fish shops, wet, dry and fried 91 Bakers 105 Butchers 159 Restaurants 233 Confectioners 271 Food and Drugs Act, 1955 - Section 16 Milk and Dairies Regulations, 1949 The number of premises registered under Section 16 of the Food and Drugs Act, 1955 and the Milk and Dairies Regulations, 1949 are as follows:- Ice Cream 567 Sausages and potted processed etc. meat. 316 Registered Milk Distributors 271 Milk (Special Designations) Regulations, 1949 - 1954 The following table shows the number of licences issued under the above-mentioned Regulations during 1958 Dealers' Licences:- Tuberculin Tested 118 Pasteurised 197 Sterilised 264 Dealers' Supplementary Licences Tuberculin Tested 21 Pasteurised 22 Sterilised 24 Dealers (Pasteuriser's) Licence 2 83 sampling of food and drugs Chemical Analysis 180 samples were procured formally, 155 of which were of milk, and 1,320 samples were procured informally. Set out below is a table of samples reported by the Public Analyst to be adulterated showing action taken in each case. Formal Sampl es Article Result of Analysis Action Taken Salted peanuts Rancid Dealt with as unsound food Dripping 48% of oleic acid Warning letter sent. Manufacturer/vendor interviewed. Further samples taken found to be genuine Whisky Contained 3% sugar Attention of vendor called to adulteration Informal Samples Salted peanuts Rancid Formal sample taken Sponge pudding mixture Infested by flour beetles Stock inspected and dealt with as unsound food Faggots Wrapper contained mouse excreta Prosecution ordered but not proceeded with on technical grounds Sponge pudding mixture Infested by flour beetles Stock inspected and dealt with as unsound food. Storage space sprayed with insecticide. Vendor warned Pork sausages Deficient in meat Formal sample taken - meat content satisfactory Dripping Free acid in excess Vendor warned. Formal sample taken. Pastry Contained about 10% of sodium carbonate Considered to be due to accidental addition of Sodium Bicarbonate. Analysis of ingredients showed that they were genuine. 84 Informal Samples (continued) Article Result of Analysis Action Taken Slice of bread Contained a cigarette stub Fine £30. £5. 5. 0. costs Mineral Water Odour and flavour of petrol Brought to the notice of manufacturer Currants Contained 1ive maggots Balance of stock inspected and dealt with as unsound food Milk bottle Contained cement material Brought to notice of dairyman Milk bottle Contained siimy mass of yeast ,cells Brought to notice of dairyman Sultanas Contained live maggots Balance of stock inspected and dealt with as unsound food Currants Contained a live maggot Balance of stock inspected and dealt with as unsound food Stout in bottle Pad of mould adhering to bottle Brought to notice of bottlers. M.O.H. in district where bottled notified Sultanas Contained live maggots Balance of stock inspected and dealt with as unsound food. Milk bottle Patches of mould adhering to bottle Brought to notice of dairyman Milk bottle Contained cement Brought to notice of dairyman Pearl barley Dirty; infested by weevils Stock inspected and dealt with as unsound food Bread Contained dirty material Brought to notice of baker 85 Informal Samples (continued) Article Result of Analysis Action Taken Mixed Peel Contained a stone Brought to notice of vendor S.R. Flour Deficient in sodium bicarbonate Unable to obtain formal sample. Stock exhausted. Attention of vendor called to the matter. Bread Contained dirty paper Attention of baker called to the matter Bacteriological and Other Examinations The following samples were submitted to the Public Health Laboratory for bacteriological examination. Articles marked with an asterisk were suspected of having caused food poisoning. No organisms likely to be responsible were found. Ice cream and ice cream mix 148 Ice cream lollies 13 *Gravy and joint 1 *Tongue 1 *Sandwich mixture 1 *Sponge 1 *Meat 1 *Pork Pie 1 †Milk 152 †Four of these samples were void. The atmospheric shade temperature was over 65°F. In addition to the above, 151 samples of milk were procured for submission to the phosphatase test. No sample failed to pass the tests. Of the 148 samples of ice cream which were submitted to the Methylene Blue Test 141 were placed in Grade 1 and 7 in Grade 11. It is gratifying to note that no samples fell into Grades III or IV during the year. This reflects the high standards of hygiene which have undoubtedly been achieved in the manufacture and handling of the commodity. 86 INSPECTION OF FOOD Public Health (Imported Food) Regulations, 1937 - 1948 Ihe Lambeth (Imported Food Regulations Order) 1957 This Order was made by the Minister of Agriculture, Fisheries and Food, and came into operation on 1st January, 1958. The Order requires the Lambeth Borough Council and its Officers to undertake the enforcement and execution of the Imported Food Regulations within the Borough. The request to the Minister to make the Order became necessary when Gabriels Wharf (which lies at the extreme northern boundary of the Borough) became separately owned from Nelsons Wharf (in the Borough of Southwark) which adjoined it and the two wharves ceased to have any working connection. Previously the two wharves, being in the same ownership, were by mutual agreement, administered by the Southwark Borough Council. The change-over of administration was smooth and the new arrangements are working satisfactorily. Inspection at Shops, Stores, Factories and Wharf Large quantities of food of all varieties were inspected and as a result the following food was surrendered as unfit for human consumption and unsound food certificates were issued. UNSOUND FOOD CONDEMNED Canned Tons Cwts. Qrs. Lbs. Meat 4 11 3 25½ Vegetables 19 - ¼ Fruit 3 2 3 2½ Soup 2 1 15¼ Fish 1 2 7½ Milk 2 - 27¾ Cream 7 Sausages 24 Spaghetti 20¼ Rice 18¼ Preserves 1 3¾ Milk Pudding 24 9 1 0 8 87 Fresh Tons Cwts. Qrs. ###] Meat 1 15 3 6½ Fish 18 2 18 Rabbits 1 2 Fish Roes 2 7 Shellfish 2 - 24 Offal 2 2 26 Poultry 1 9 - 23½ Potatoes 1 12 - 21 Winkles 4 2 - Fruit 2 3 12 6 9 - - Prepared Bacon 2 11 - 18 Salad Cream 1 - 25½ Cheese 3 3 12¼ Preserves 1 9½ Pickles 14¼ Faggots 1 11 Mincemeat 1 Sausages 1 12½ Dates 1 Sauce 1 -¼ Ham 3 3 13¾ Peas, dried 2½ Jelly -¼ Fruit, dried 3 25 Soup, mix 4 Butter Beans 1 - Fat 10 Butter 2 - ~ Fish 2 21 Sugar 2 Onions 1 Buttermilk powder 2 - Confectionery 1 24 Cocoa 3½ Rice 14 Sausage Meat 1 - 18 3 7 3 20¼ TOTAL WEIGHT 18 18 - -¼ 88 The Method of Disposal of Condemned Food Condemned animal products where possible were sent to firms specialising in the manufacture of glue and similar commodities. Vegetable waste which was suitable was converted where practicable into pig food under the Council's kitchen waste scheme. This scheme terminated on 5th December, 1958 and since that date such waste has been disposed of to an accredited pig feeding contractor. 89 FOOD COMPLAINTS 80 complaints about food were received and set out below is a list of 53 of these which, after investigation, were considered to be justified. 1. Faggots wrapper contained mouse excreta 2. Bread contained charred matter 3. Sponge mixture infested with flour beetles and larvae 4. Tinned roes apparent corrosion inside tin 5. Bread contained charred matter 6. Doughnut contained grease derived from machinery 7. Biscuit contained string 8. Tinned milk discoloured 9. Luncheon meat contained piece of wood 10. Sardines bitter flavour 11. Pie mouldy condition 12. Pineapple cubes contained earwig 13. Sausage rolls mouldy condition 14. Flour contained insects 15. Doughnut contained string 16. Ginger beer bottle exploded 17. Sausages contained metal 18. Bread contained cigarette stub 19. Bread rolls mouldy condition 20. Mineral water odour and flavour of petrol 21. Butter contained glass 22. Bacon contained maggot 23. Butter contained peice of wood 24. Stout in bottle pad of mould adhering to bottle 25. Smoked haddock miscured 26. Sweets contained maggot 27. Flour contained maggot 28. Corned mutton contained piece of wood 29. Milk bottle contained yeast cells 30. Pie mouldy condition 31. Fish paste blown tin 32. Cheese dirty condition 33. Beef contained maggots 34. Luncheon meat contained foreign matter 35. Orange drink mould inside bottle 36. Milk bottle contained cement material 37. Chicken decomposed 38. Bread contained foreign matter 39. Bread contained oil and metallic iron 40. Nut ring contained maggots 41. Cream slice contained dirty material from machinery 42. Mixed peel contained a small stone 43. Bread contained dirty paper 44. Flour unpleasant flavour 45. Tinned meat pie contained piece of bandage 46. Milk unpleasant flavour 47. Bread contained foreign matter 48. Toffees contained maggots 49. Bread contained metal screw 50. Milk contained glass 51. Chicken decomposed 52. Bread contained string 53. Bread dirty condition 90 All these complaints were investigated and careful consideration was given to the action which should be taken. As a result one prosectuion was instituted, details of which are set out elsewhere in this report. In all other cases, the majority of which were first complaints, the attention of the persons responsible was called to the nature of the complaint and to their 1iabilities. In most cases where foreign bodies were found in food, there is little doubt that they were introduced at some stage during its processing rather than during its distribution. Many of these foods were prepared outside the Borough, and a few overseas. In such cases the Medical Officer of Health of the district concerned, or, where appropriate, the Minister of Agriculture, Fisheries and Pood, was informed. 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 licence under the provisions of this Act. 91 SECTION F GENERAL 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 its 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. During the year, 34 funerals were arranged involving 15 males and 19 females. The amount paid to funeral contractors was £405. 14. 0d. but the sum of £217. 18. 3d. was recovered by way of Grants, Insurance Policies, Money found, and also by the sal e of second hand furniture. The actual cost to the Council was therefore £187. 15. 9d. LAND CHARGES ACT, 1925 During the year, 2,610 enquiries were received and dealt with in respect of searches under the above-mentioned Act. 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 162. RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951 Under this Act, it is unlawful in the course of business, to use filling materials to which the Act applies in any form of upholstery, the stuffing or lining of toys, baby carriages or articles of such other kinds as may be prescribed, except on Premises registered by a local authority. In the Borough of Lambeth 12 premises are registered under the Act. No further applications for registration were received during the year. 92 PET ANIMALS ACT, 1951 This Act, which came into operation on 1st January, 1952, provides that no person shall keep a pet shop except under the authority of a licence granted in accordance with the provisions of the Act. A local authority may, on application, grant to a person who is not for the time being disqualified from keeping a pet shop a licence to keep a pet shop at such premises in their area as may be specified in the application, and subject to compliance with such conditions as may be specified in the licence. In determining whether to grant a licence for the keeping of a pet shop, a local authority shall in particular have regard to the need for securing:- (a) that animals will at all times be kept in accommodation suitable as respects size, temperature, lighting, ventilation and cleanliness; (b) that animals will be adequately supplied with suitable food and drink and (so far as necessary) visited at suitable intervals; (c) that animals, being mammals, will not be sold at too early an age; (d) that all reasonable precautions will be taken to prevent the spread among animals of infectious diseases; (e) that appropriate steps will be taken in case of fire or other emergency. During the year, 21 licences were issued under the Act. No. of Inspections - 32 No. of Re-Visits - 1 LONDON COUNTY COUNCIL (GENERAL POWERS) ACT, 1954 Haidressers and Barbers On 6th July, 1955 the Lambeth Borough Council made bye-laws in respect of hairdressers and barbers under the above-mentioned Act. During the year 15 registrations were made. 93 The total number of premises and persons on the register at the end of the year was as follows:- Premises 185 Persons 196 Number of Inspections 111 Number of Re-Visits 20 Exhumation Orders The Home Secretary issued three Orders for the removal of human remains from graves in the district to others. A public health inspector was present on each occasion to see that the terms of the Order were fulfilled and that no nuisance or danger to the public health was permitted.