AC 4383 BHTD METROPOLITAN BOROUGH OF LAMBETH * ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1959 F. SUMMERS, M.B.. B.S., M.R.C.S., L.R.C.P.. D.P.H. Medical Ollicer of Health METROPOLITAN BOROUGH OF LAMBETH ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1959 * F. SUMMERS, M.B., B.S., M.R.C.S., L.R.C.P., D.P.H. Medical Officer of Health CONTENTS OF REPORT Page Members of Public Health Committee 5 Staff of Public Health Department 6 Introductory Remarks of Medical Officer of Health 9 Section A :Statistics and Social Conditions of the Area General 12 Births, Birth Rate, Still births, Still-birth Rate 12 Deaths, Death Rate 13 Maternal Mortality 14 Infantile Mortality 14 Vital Statistics for years 1950-1959 17 Classification of Deaths 18 Notes on Vital Statistics 21 Deaths from Cancer of Lung and Bronchus 23 Road Traffic Accidents 25 Section B :Prevalence of, and Control over, Infectious and Other Diseases Notifications 34 Age Distribution of Infectious Diseases 35 Ward Distribution of Infectious Diseases 36 Distribution of Infectious Diseases according to Parliamentary Constituencies 37 Notes on Infectious Diseases 38 Diphtheria and Diphtheria Immunisation 41 Smallpox 42 Vaccination and International Certificates of Vaccination 43 Tuberculosis 44 Report of Chest Physician 48 Section C General Provision of Health Services for the Area Care of the Aged 52 Action under Section 47 National Assistance Act, 1948 54 Home Bathing Service 56 Laundry Services for Aged Incontinent Persons 57 Holidays for the Elderly 58 Lambeth Old Peoples Welfare Association 60 Hospital Facilities 63 Health Services provided by the London County Council 64 Public Health Laboratory Service 65 Section D Sanitary Circumstances of the Area Water Supply 66 Summary of Visits and Inspections by Inspectors of Staff 68 Page Section D :Sanitary Circumstances of the Area (Continued) Summary of Defects and Nuisances 69 Legal Proceedings - Public Health (London) Act, 1936 70 Dwelling Houses Rendered Pit 70 Section 95 - Public Health (London) Act, 1936 71 Drainage Plans 71 Offensive Trades 71 Disinfection 72 Disinfestation 72 Rodent Control 72 Factories Acts 1937 and 1948 73 Rent Act, 1957 76 Rehousing and Overcrowding 77 Housing Act, 1957 Record of Work carried out by Housing Inspectors 78 Slum Clearance Programme 1956 60 80 Slum Clearance Programme 1961-65 81 Improvement Grants 81 Standard Grant 81 Discretionary Grant 83 Atmospheric Pollution 84 Clean Air Act. 1956 87 Clean Air Exhibition 90 Section E Inspection and Supervision of Pood Pood Hygiene Regulations 1955-1957 92 Pood Premises 92 Food and Drugs Act, 1955 Section 16 93 Milk and Dairies (General) Regulations 1959 93 Milk (Special Designations) Regulations 1949 1954 93 Sampling of Pood and Drugs 93 Inspection of Food 98 Unsound Food Condemned 99 Food Complaints 101 Street Markets 102 Slaughter of Animals Act 102 Section F General Public Swimming Baths 103 National Assistance Act 1948 Section 50 Burials 103 Land Charges Act, 1925 104 Pharmacy and Poisons Act. 1933 104 Rag Flock and Other Filling Materials Act. 1951 104 Pet Animals Act. 1951 104 Hairdressers and Barbers 105 Exhumations 106 Health Education 106 5 METROPOLITAN BOROUGH OF LAMBETH PUBLIC HEALTH COMMITTEE (Appointed by the Council on 20th May, 1959) The Worshipful the Mayor of Lambeth (Mr. Alderman James William Calder, J. P.,) (ex officio) Chairman Mr. Councillor Tiras Cleasby Vice Chairman Mr. Councillor G. F. S. Light Alderman Mrs. Mary Marock Councillors Mrs. D.R. Colls S. H. Gurney Miss. B. W. High Mrs. I. L. Hunt Miss. K. L. Jenner Mrs. E. M. Knapp Mrs. W. E. Privett Miss. J. Williams, A.M.I.A. D. Woodgate 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. P. 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) Four vacancies (b) Pood Inspectors S. Bradley (1) (2) C. W. Idle (1) (2) (c) Housing Inspectors S. G. Ford (1) (2) A. E. White (1) (2) (d) Rodent Officer S. F. Heal (1) (2) 7 (e) Smoke Inspectors J. Bowers (1) (2) (3) F. Russell (1) (2) (3) (f) Woman Inspector Miss A.F. Crombie(1) (4) (6) (g) Public Health Visitor Miss M. McNair (5) (6) CLERICAL STAFF C. Agate (Resigned 1.2.59) A.W. Bayley (Retired 17.8.59) Mrs. J. Clark J. F. Derham (Appointed 2.3.59 Transferred to Borough Treasurer's Dept. 4. 8. 59) Mrs. P. Dubury (Appointed 31.8.59) Mrs. P. Eden (Resigned 3.4.59) Mrs. G. Hopkins N. A. Jupp Mrs. L. Jones (Appointed 11.5.59) Resigned 21.6. 59) Mrs. J. Kincart (Appointed 4. 8. 59) E. F. Mannerson Mrs. K. M. 0'Sullivan (Appointed 23.11.59) Mrs. M. Rogers J.W. Tiffney (Appointed 31.8.59) E. Walker Mrs. K. Williams (Resigned 31.10.59) DISINFECTING STATION Wanless Roads Loughborough Junctions S. E. 5. Superintendent : - L. Brann 2 Drivers 2 Disinfectors 1 Stoker 1 Apparatus Attendant 8 GENERAL ASSISTANTS R. G. Ayling (Resigned September 1959) J. Martin (Appointed 23.11.59.) W. Deamer (Assistant Rodent Officer) L. V/histon (Rodent Operative) BATHING ATTENDANTS HOME BATHING SCHEME FOR OLD PEOPLE Mrs. L. Hawkes (Appointed 4. 5. 59) (Parttime) (Resigned 23.9.59) Mrs. F. Hones (Appointed 25. 5.59) (Parttime) Mrs. R. Bagge (Appointed 26.10. 59) (Parttime) (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, 1960 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 1959 on the health of the Borough of Lambeth. According to the estimate of the Registrar-General, the population of the Borough continued its slight fall, the mid 1959 being 223,300, a decrease of 300 on the previous year. The corrected birth rate at 19.09 per 1,000 home population is one of the highest to be recorded since the war, whereas the death rate and infant mortality rates are virtually unchanged from last year. Of the infant deaths 68% occurred in the first week of life and 80% in the first four weeks. For the second successive year there has been one maternal death recorded. As is to be expected heart diseases and cancer have accounted for the highest proportion of deaths, but a disturbing feature is the slow but steady increase in the number of deaths due to accidents, both on the road and elsewhere. It is worthy of note that the number of road accidents involving children has remained at a steady level for a number of years and the increase has taken place solely in the adult groups. It would seem that road sense inculcated in the children does keep the accident rate down, at least while they remain children. The notifications of respiratory tuberculosis show a marked fall, being 155 as against 189 last year. The Consultant Chest Physician mentions in his contribution to this report that the 10 maintenance of the figures at the higher levels for the past two or three years is due to the activities of the Mass Miniature Radiography Units. The work for old people in the Borough continues undiminished, both by the Lambeth Old People's Welfare Association and the Public Health Department. In my report for 1957 I was able to report the inauguration of a laundry service for the incontinent aged which is now working to capacity. This year I have to report that a service for bathing old people in their homes has been initiated and that too is working to capacity. In common with other local authorities up and down the country the Borough has a deficiency of Public Health Inspectors with the result that whilst it is possible to deal with complaints received sufficient time is not available for the routine duties which are part of the work of the Public Health Inspector. This year saw the retirement of Mr. Bayley. Senior Clerk in the Public Health Department, Mr, Bayley entered the service of the Council in June 1913 initially in the Town Clerk's Department. In March 1920 he transferred to the Public Health Department and served it well for 39 years. We wish him a long and happy retirement. In conclusion I am pleased to acknowledge the support given to me by members of the Council and of the Public Heal th Committee in particular. My thanks are due also to the other Chief Officers for their co operation during the year and to the members of the staff of the Public Health Department for their loyal and con scientious service. 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 of the Borough is approximately square miles. This area excludes tidal water and foreshore, but includes approximately five acres which have been added to the Borough as a result of the new South Bank embankment, part of the river area having been reel aimed. The land surface rises from 12 feet above sea level at the river to 50 feet at Brixton, 150 feet at West Norwood and about 379 feet at and near the Crystal Palace. The perimeter of the Borough measures 171/2miles. The Borough has approximately 328 acres of open space, including Brockwell, Kennington. Ruskin, Norwood, Archbishop's and Vauxhall Parks and Myatt's Fields. 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. For election purposes Lambeth is divided into three Parliamentary Divisions. Vauxhall, Brixton and Norwood, each returning one member of Parliament and three members to the London County Council. 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 1959) 223.300 Density of Population i.e. number of Persons per acre 54.6 Number of marriages during the year 1,826 Marriage rate per 1,000 Population 8.2 Marriage rate per 1,000 Population England and Wales 15.0 Rateable Value of District (1959/60) £4,249.714 Sum represented by a Penny Rate (1959/60) £17.150 Number of separately rated houses and flats (1959/60) 56,344 BIRTHS Live Births Legitimate Illegitimate Total s Males 2,113 331 2.444 Females 1,928 313 2,241 Totals 4,041 644 4,685 Live Birth Rate per 1.000 Home Population 20.98 Birth Rate corrected for comparison with other areas 19.09 Comparability Factor supplied by Registrar General 0.91 Birth Rate per 1.000 Home Population County of London 17.3 13 Birth Rate per 1,000 Home Population. England and Wales 16.5 Corresponding Rate for the Borough of Lambeth for the year 1958 17.12 Il1egitimate Live Births per cent of total 1ive births 13.7% STILL BIRTHS Legitimate Illegitimate Totals Males 36 10 46 Females 38 9 47 Totals 74 19 93 Still Birth Rate per 1 000 Total Births (i.e. live and still) 19.46 Still Birth Rate per 1.000 Home Population 9.42 Still Birth Rate per 1.000 Total Births, Engl and and Wales 20.7 DEATHS Males Females Total 1,285 1,198 2,483 Death Rate per 1.000 Home Population 11.16 Death Rate corrected for comparison with other areas 11. 38 Comparability factor supplied by Registrar General 1.02 Death Rate per 1,000 Home Population, County of London 12.1 Death Rate per 1.000 Home Population. England and Wales 11.6 Corresponding rate for the Borough of Lambeth for the year 1958 11.65 14 MATERNAL MORTALITY Number of women dying in consequence of childbirth 1 Maternal Mortality Rate per 1.000 Total Births 0.21 Maternal Mortality Rate per 1.000 Total Births. County of London 0.65 Comparative figure for England and Wales 0.38 INFANTILE MORTALITY Deaths of infants under 1 year of age Legitimate Illegitimate Totals Males 54 12 66 Females 36 14 50 Totals 90 26 116 Death Rate of Infants under 1 year of age per 1,000 live births 24.76 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 22.0 Legitimate Infantile Mortality Rate 22.24 Illegitimate Infantile Mortality Rate 40.37 Deaths of Infants under 4 weeks of age Legitimate Illegitimate Totals Males 46 11 57 Females 24 10 34 Totals 70 21 91 Neo-natal Mortality Rate per 1,000 live births 19.4 Neo-natal Mortality Rate per 1,000 live births. County of London 15.4 Neo-natal Mortality Rate per 1,000 live births. Engl and and Wales 15.8 15 Deaths of Infants under 1 week of age Legitimate Illegitimate Totals Males 40 11 51 Females 20 8 28 Totals 60 19 79 16 CAUSES OF DEATH AND 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 26 16 1 43 43 Atelectasis and Prematurity 6 1 7 7 Hypothermia and Prematurity 1 1 1 Pneumonia 1 2 3 5 4 1 13 Bronchitis 1 2 1 4 Congential Heart Disease and Abnormality 3 3 1 1 8 1 1 2 12 Cerebral Haemorrhage 4 3 7 7 Accidents 1 1 2 Anoxia 3 1 4 4 Asphyxia 3 3 3 Hyaline Membrane Disease 1 1 1 Peritonitis 1 1 Infective Hepatitis 1 1 1 Intestinal Obstruction 1 1 Placenta Praevia 1 1 1 Thrombosis of Inferior Vena Cava 1 1 1 Uraemia 2 2 2 Cardiac Failure 1 1 Muscular Dystrophy 1 1 Spina Bifida 1 1 1 Anencephaly 1 1 1 Erythroblastosis Foetalis 1 1 1 Meningomyelocele 1 1 Rhesus Incompatability 1 1 1 Terminal Meningitis 1 1 1 Haemolytic disease of newborn 1 1 1 Atelectasis 3 3 3 TOTALS 54 25 6 3 3 91 12 8 1 4 116 17 BOROUGH OF LAMBETH SUMMARY OF VITAL STATISTICS FOR THE TEN YEAR PERIOD 1950 - 1959 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 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 21.20 1 . 25 1957 224,300 2,359 10. 83 4, 205 16.82 98 23.30 Nil Nil 1958 223,600 2,529 11. 65 4,444 17.12 111 24. 98 1 .22 1959 223,300 2,483 11. 38 4,685 19.09 116 24. 76 1 . 21 * As adjusted by Comparability Factor 18 DEATHS OF LAMBETH RESIDENTS DURING 1959 CLASSIFIED ACCORDING TO AGE GROUPS AND SEXES CAUSES OP 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 6 8 4 19 F 4 1 2 1 8 2. Tuberculosis,, other M 1 1 F 1 1 3. Syphilitic Disease M 1 1 3 6 11 F 2 2 4. Diphtheria M F 5. Whooping Cough M F 6. Meningococcal Infection M 1 1 F 1 1 7. Acute Poliomyelitis M F 8. Measles M F 9. Other Infective and Parasitic Diseases M 1 1 F 1 1 1 1 4 10. Malignant Neoplasm., Stomach M 1 15 7 7 30 F 1 4 15 11 31 11. Malignant Neoplasm, Lung and Bronchus M 2 48 37 13 100 F 12 9 4 25 19 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 12. Malignant Neoplasm, Breast M F 4 24 15 12 55 13. Malignant Neoplasm, Uterus M F 2 11 4 4 21 14. Other Malignant and Lymphatic Neoplasms M 1 7 33 34 29 104 F 2 6 30 33 32 103 15. Leukaemia, Aleukaemia M 1 4 1 2 8 F 2 2 3 7 16. Diabetes M 1 2 2 5 F 2 3 7 12 17. Vascular Lesions of Nervous System M 4 28 31 42 105 F 2 27 33 95 157 18. Coronary Disease, Angina M 9 100 83 62 254 F 2 22 60 89 173 19. Hypertension with Heart Disease M 4 6 7 17 F 3 3 19 25 20. Other Heart Disease M 6 15 21 49 91 F 5 19 22 113 159 21. Other Circulatory Disease M 1 1 13 14 24 53 F 2 5 10 36 53 22. Influenza M 1 4 4 6 15 F 1 1 1 3 8 14 28 23. Pneumonia M 4 1 1 2 18 25 40 91 F 7 1 1 1 4 12 52 78 24. Bronchitis M 1 2 52 46 40 141 F 1 7 13 27 48 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 25. Other Diseases of the Respiratory System M 1 2 3 6 12 F 6 2 2 10 26. Ulcer of Stomach and Duodenum M 1 6 6 4 17 F 1 2 7 10 27. Gastritis, Enteritis and Diarrhoea M 1 1 2 F 1 1 1 2 3 4 12 28. Nephritis and Nephrosis M 1 1 3 5 F 1 1 3 5 29. Hyperplasia of Prostate M 6 8 14 F 30. Pregnancy, Childbirth and Abortion M F 1 1 31. Congenital Malformations M 13 4 1 1 1 20 F 5 1 1 1 8 32. Other Defined and Ill-Defined Diseases M 45 1 2 4 18 17 15 102 F 33 3 2 2 3 14 20 39 116 33. Motor Vehicle Accidents M 2 5 6 4 2 19 F 3 2 5 10 34. All other Accidents M 2 1 4 7 4 7 3 28 F 2 1 1 1 2 14 21 35. Suicide M 4 8 4 1 17 F 5 8 13 36. Homicide and Operations of War M 1 1 2 F 1 1 ALL CAUSES TOTALS M 66 12 4 12 55 388 371 377 1285 F 50 7 8 3 44 214 281 591 1198 GRAND TOTALS 116 19 12 15 99 602 652 968 2483 21 VITAL STATISTICS Population According to the estimated mid year figure supplied by the Registrar General the population of Lambeth fell by 300 the population being 223,300 compared with 223 600 in 1958. This is 1.000 less than the figure for 1957 and 6 940 than that shown in census for 1951. Births The number of 1ive births recorded during the year increased by 241 giving a corrected birth rate of 19.09 per 1,000 home population compared with 17,12 in 1958. This is one of the highest rates to be recorded since the war and is higher than that for England and Wales which at 16,5 per 1,000 home population is the highest since. 1949. The rate for the County of London is lower at 17.3 per 1,000 home population. The number of live births is in excess of the number of deaths giving a natural increase of 2,202 but owing to the fact that, according to the figure supplied by the Registrar General, the population decreased during the year, some movement of popu 1ation out of the Borough would seem to be indicated. Still Births The number of still births recorded was the same as for 1958 but owing to the. increase in the number of live births the still birth rate per 1,000 total births fell from 20.5 in 1958 to 19.46. This compares favourably with the rate for England and Wales which is 20.7. Deaths The number of deaths decreased by 46, giving a corrected death rate of 11.38 compared with 11.65 per 1,000 home population in 1958. The death rate for Lambeth compares favourably with that for the County of London which is 12.1 and with that for England and Wales which is 11.6. Heart and associated diseases, as is usual, accounted for the largest number of deaths, 1,087 people dying from these causes. All forms of malignant neoplasms caused 484 deaths. 22 Deaths from Respiratory Tuberculosis increased by 3 27 occurring from this form of disease compared with 24 in 1958. The number of deaths from other forms of Tuberculosis was 2, the same as for last year. Pneumonia. Influenza and Bronchitis caused 401 deaths, an increase of 46 on the 1958 figure. This is due to an increase of 34 in the number of deaths from Influenza and 20 from Pneumonia. There was a reduction of 8 in the number of deaths from Bronchitis. Motor vehicle accidents accounted for the lives of 29 Lambeth residents, 19 males and 10 females, compared with 25 last year. Six more men but 2 fewer women died from this cause than in 1958. In addition to the increase in the number of deaths from motor vehicle accidents 49 persons died from other forms of acc idents, an increase of 12 over the figure for 1958. In this connection, one wonders how many of these lives might have been saved if due care had been taken. The number of people taking their own lives decreased from 35 in 1958 to 30 during the year under review. Three deaths occurred as a result of homicide. Infantile Mortality Although more infants died before reaching one year of age, 116 compared with 111 in 1958, the increase in the number of live births produced a slightly reduced infantile mortality rate of 24.76 per thousand live births, compared with 24.98 last year. Of the 116 deaths, 90 were of legitimate infants, a reduction of 7 on the 1958 figure and 26 of illegitimate, an increase of 12. The infantile mortality rate for the Borough is higher than that for England and Wales which at 22.0 per 1,000 live births was less than in 1958. Ninety-one of the infants died before reaching the, age of 4 weeks giving a neo-natal mortality rate of 19.4 per 1,000 live births compared with 15.8 for England and Wales and 16.5 for the County of London. 23 Maternal Mortality One woman died as a result of childbirth giving a maternal mortality rate of 0.21 per 1 000 total births. Deaths from Cancer of the Lung and Bronchus The number of deaths from cancer of the lung and bronchus fell 125 occurring compared with 139 last year. The deaths among males was four times as great as amongst females, 100 compared with 25. Although male deaths fell by 16. female deaths increased by 2, The deaths were split amongst the various ages as follows: Males Females Totals 25-44 years 2 2 45-64 years 48 12 60 65-74 years 37 9 46 75 years and over 13 4 17 Totals 100 25 125 Since 1950, 1,140 deaths from lng cancer have occurred in the Borough of Lambeth Over the same period the number of deaths from respiratory tuberculosis was 446. The accompanying graph gives the comparison between the deaths from respiratory tuberculosis and cancer of the lung. 24 COMPARISON OF DEATHS FROM RESPIRATORY TUBERCULOSIS AND CANCER OF LUNG AND BRONCHUS 25 ROAD TRAFFIC ACCIDENTS The following tables show the road traffic accidents occurring within the Borough of Lambeth during the year 1959 and the comparative figures and casualties for the period 1954 - 1959, The figures shown refer not only to Lambeth residents but also to persons living in other areas who were involved in accidents in the Borough. The number of 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. Once again I have to thank the Town Clerk for his co-operation and for supplying me with the figures. 26 ROAD TRAFFIC ACCIDENTS 1959 WITHIN THE BOROUGH OF LAMBETH Month No. of Accidents Adults Children Total Killed Seriously Iniured Slightly Injured Killed Seriously Injured Slightly Injured January 134 3 22 125 - 3 11 164 February 70 2 10 58 - 3 5 78 March 139 2 24 119 - 2 20 167 April 136 1 23 116 - 7 21 168 May 162 4 15 134 - 4 27 184 June 166 1 22 153 - - - 176 July 166 - 22 166 - 2 22 212 August 126 - 7 102 1 6 24 140 September 168 1 24 144 1 6 23 199 October 159 1 16 141 - 4 23 185 November 142 3 26 121 - 4 14 168 December 171 3 43 156 - 3 14 219 TOTALS 1,739 21 254 1,535 2 44 204 2,060 Accidents per mile of road 14.6 27 BOROUGH OF LAMBETH COMPARATIVE FIGURES OF ACCIDENTS AND CASUALTIES FOR THE PERIOD 1954 - 1959 1954 1955 1956 1957 1958 1959 Number of accidents involving personal injury 1,032 1,246 1,272 1,212 1,505 1,739 Accidents per mile of road 7.29 8.80 8.98 8.56 12.6 14.6 Casualty Figures Adults Killed 12 14 12 12 17 21 Seriously Injured 180 187 174 196 240 254 Slightly Injured 756 1,002 1,067 1,052 1,293 1,535 Totals 948 1,203 1,253 1,260 1,550 1,810 Children Killed 1 1 2 1 2 2 Seriously Injured 30 35 29 24 45 44 Slightly Injured 196 189 211 175 193 204 Totals 227 225 242 200 240 250 Combined Adults and Children Totals 1,175 1,428 1,495 1,460 1,790 2,060 28 NUMBER OF ACCIDENTS INVOLVING PERSONAL INJURY PERIOD 1954 - 1959 29 NUMBER OF PERSONS KILLED PERIOD 1954 - 1959 ADULTS - CHILDREN - 30 ROAD TRAFFIC ACCIDENTS PERIOD 1954 - 1959 31 ROAD TRAFFIC ACCIDENTS PERIOD 1954 - 1959 TOTAL CASUALTIES - TOTAL ADULT CASUALTIES - TOTAL CHILD CASUALTIES - 32 The figures for road accidents and casualties again present a grim picture. The number of accidents occurring in Lambeth involving personal injury increased by 234 during the year. This increase, however, was not as great as that in 1958 when the figure was 293 but is still very disturbing. Compared with 1958 the number of fatalities increased from 19 to 23, the number of seriously injured from 285 to 298 and the number of slightly injured from 1,486 to 1,739. Ten more children and 260 more adults were involved in accidents in which death or injury occurred than last year. The accident rate per mile of road increased from 12.6 to 14.6. Whilst the over-all picture is most alarming, from the figures given for the last six years it would appear that the number of children involved in accidents in the Borough is not increasing at the same rate as that for adults. In fact the graphs appear to be fairly constant. Although a reduction in the number would be ideal, it would seem that instruction given in schools on the subject of road safety is having some effect. 33 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 Peurperal Pyrexia Relapsing Fever Scabies Scarlstina Scarlet Fever Smallpox Tuberculosis, all forms Typhoid Fever Typhus Fever Whooping Cough The following table shows the total number of corrected notifications, other than tuberculosis, received during the year. 34 NOTIFICATIONS (CORRECTED) Disease 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Totals Grand M F M F M F M F M F Total Scarlet Fever 25 19 19 17 14 16 33 34 91 86 177 Whooping Cough 6 10 6 9 12 26 25 27 49 72 121 Acute Poliomyelitis Paralytic 1 - - - 2 1 2 2 5 3 8 Non-Paralytic - - 1 1 1 - 4 1 6 2 8 Measles 691 651 455 406 72 83 15 18 1233 1158 2391 Dysentery 26 15 33 37 12 23 24 39 95 114 209 Meningococcal Infection - - - 2 1 - - - 1 2 3 Pneumonia 44 37 6 4 - 6 7 8 57 55 112 Paratyphoid Fever 1 1 1 2 - - - - 2 3 5 Erysipelas 1 3 - 1 - 2 1 - 2 6 8 Food Poisoning 4 5 8 6 10 4 3 - 25 15 40 Puerperal Pyrexia - 61 - 44 - 20 - 18 - 143 143 Ophthalmia Neonatorum 2 1 9 6 - 1 1 - 12 8 20 Scabies 5 12 5 3 7 5 5 3 22 23 45 TOTALS 806 815 543 538 131 187 120 150 1600 1190 3290 35 NOTIFICATION OF INFECTIOUS DISEASE - AGE DISTRIBUTION Age Groups Scarlet Fever Whooping Cough Acute Poliomyelitis Measles Dysentery Meningococcal Infection Scabies TOTALS Paralytic Non-Paralytic M F M F M F M F M F M F M F M F Under 1 year 1 - 9 7 - - - - 43 49 11 14 - 1 - - 135 1 year 1 - 5 8 - - - - 171 142 13 6 - - 1 1 348 2 years 10 3 8 9 1 - 1 - 198 170 9 7 - - 2 1 419 3 years 7 11 9 12 - 1 2 - 161 161 4 10 - - 3 - 381 4 years 7 12 1 9 - - - - 169 158 4 4 - 1 1 - 366 5-9 years 41 52 13 21 1 - 3 1 474 465 27 23 1 - 4 1 1127 10 - 14 years 23 6 4 4 - 1 - - 12 10 2 7 - - 1 1 71 15 - 24 years 1 1 - 1 2 1 - 1 3 1 15 19 - - 4 4 53 25 and over - 1 - 1 1 - - - 2 2 10 24 - - 6 15 62 TOTALS 91 86 49 72 5 3 6 2 1233 1158 95 114 1 2 22 23 2962 Age Groups Pneumonia Para-Typhoid Fever Erysipelas Food Poisoning Puerperal Pyrexia Ophthalmia Neonatorum TOTALS M F M F M F M F M F M F Under 5 years 5 3 - 1 - - 1 3 - - 12 8 33 5 14 years 7 6 2 1 - - 4 3 - - - - 23 15 - 44 years 17 18 - 1 2 2 14 4 - 143 - - 201 45 - 64 years 22 13 - - - 4 4 4 - - - - 47 65 and over 6 15 - - - - 2 1 - - - - 24 TOTALS 57 55 2 3 2 6 25 15 - 143 12 8 328 GRAND TOTAL 3290 36 WARD DISTRIBUTION NUMBER OF CASES OF INFECTIOUS DISEASE (CORRECTED NOTIFICATIONS) IN EACH WARD OF THE BOROUGH Ward Scarlet Fever Whooping Cough Acute Poliomyelitis Paralytic Acute Poliomyelitis Non-Paralytic Measles Dysentery Meningococcal Infection Pneumonia Para-Typhoid Fever Erysipelas Food Poisoning Puerperal Pyrexia Ophthalmia Neonatorum Scabies TOTALS Marsh 12 5 - 1 91 15 1 7 - 1 1 88 14 1 237 Bishop's 19 18 2 4 286 34 - 7 1 1 - - - 1 373 Prince's 20 13 1 - 138 29 - 20 - 1 2 29 2 2 257 Oval 16 13 1 - 116 15 - 7 - 2 2 1 - 7 180 Springfield 10 4 1 - 117 18 - 1 - 1 7 - - - 159 Lansdowne 5 12 - 1 115 11 1 4 - - 4 23 - 2 178 Minet 16 3 - - 118 5 - 3 1 - 1 1 - 1 149 Angell 3 4 - 1 71 2 - 2 - - - - - 1 84 Vassall 3 16 1 - 146 14 1 9 - 1 3 - - 1 195 Grove 1 5 1 - 120 9 - 3 - - 3 - - - 142 Stockwell 4 6 - - 46 4 - 8 - - - 1 - 8 77 Landor 2 6 - - 66 6 - 6 - - 1 - 1 3 91 Ferndale 6 4 - - 140 1 - 6 - - - - - 1 158 Town Hall 5 1 - - 119 14 - 7 - - 5 - - - 151 Heme Hill 2 3 - 1 92 5 - 6 1 - - - 1 3 114 Effra 8 2 - - 99 10 - 9 - - - - - 6 134 Tulse Hill 6 3 - - 119 1 - - - - 2 - 2 2 135 Thurlow Park 10 - - - 44 4 - 1 - - 1 - - - 60 Romany 6 2 1 - 113 - - 2 1 - 1 - - 4 130 Leigham 13 - - - 78 8 - 4 - - 5 - - 1 109 Knight's Hill 10 1 - - 157 4 - - 1 1 2 - - 1 177 TOTALS 177 121 8 8 2391 209 3 112 5 8 40 143 80 45 2200 37 PARLIAMENTARY CONSTITUENCIES Number of cases of Infectious Disease notified in each Parliamentary Constituency of the Borough. Disease Parliamentary Constituency Totals Vauxhal1 Brixton Norwood Scarlet Fever 82 40 55 177 Whooping Cough 65 45 11 121 Acute Poliomyelitis Paralytic 5 2 1 8 Acute Poliomyelitis Non Paralytic 6 1 1 8 Measles 863 826 702 2391 Dysentery 122 55 32 209 Meningococcal Infection 2 1 - 3 Pneumonia 46 44 22 112 Para Typhoid Fever 1 1 3 5 Erysipelas 6 1 1 8 Food Poisoning 16 13 11 40 Puerperal Pyrexia 141 2 - 143 Ophthalmia Neonatorum 16 1 3 20 Scabies 13 15 17 45 TOTALS 1384 1047 859 3290 38 NOTIFICATIONS OTHER THAN TUBERCULOSIS The total number of corrected notifications received during the year, excluding tuberculosis, was 3,290. This was an increase of 1,982 on the figure for 1958. This increase is practically accounted for by the increase in the number pf notifications of measles which assumed epidemic proportions during the year. A total of 2,391 cases of measles was notified compared with 600 in 1958 Scarlet Fever There was an increase in the number of cases of Scarlet Fever notified, 177 cases occuring compared with 153 in 1958. IVhooping Cough This disease showed a decrease on the 1958 figure. 121 cases being notified compared with 132 last year. Poliomyelitis Sixteen cases of Poliomyelitis (8 paralytic and 8 non-paralytic) were notified during the year. This is an increase on the figure for 1958 when 6 cases (5 paralytic and 1 non paralytic) occurred but is one less than in 1957. The disease was spread throughout the various wards of the Borough as follows:- Bishop's 6 Marsh 1 Prince's 1 Oval 1 Springfield 1 Lansdowne 1 Angel1 1 Vassall 1 Grove 1 Heme Hill 1 Romany 1 16 39 The cases were spread throughout the year as follows First Quarter 1 Second Quarter 2 Third Quarter 4 Fourth Quarter 9 16 Eleven males suffered from the disease compared with 5 females and eleven of the cases occurred in children under the age of 14 years. Food Poisoning There was a reduction of 12 in the number of cases of Food Poisoning notified. 40 cases compared with 52 in 1958. The cases were distributed throughout the year as follows : First Quarter 9 Second Quarter 14 Third Quarter 14 Fourth Quarter 3 40 The agent was identified in 7 cases. Salmonella Typhi-murium 5 Salmonella Kiambu 1 Salmonella Choierae-suis 1 In the remaining 33 cases notified the cause was unknown. The cases occurred in different families scattered throughout the Borough. In addition to the above mentioned cases which were notified, an outbreak of food poisoning was brought to the notice of the Public Health Department. On the 27th May the secretary of a factory reported illness among 12 members of the firm s staff which he attributed to food they had eaten in the canteen run by the firm. Each of the 12 complained of violent stomach pains followed by diarrhoea, maximum duration of 7 hours. The food suspected was the mid-day meal which consisted of roast beef, yorkshire pudding. 40 boiled cabbage, roast and boiled potatoes and gravy. eaten between 12.30 p.m. and 1,30 p.m. on 26th May, One of the twelve had cottage pie instead of roast beef, and a few had soup also. The sweets consisted of pineapple and evaporated milk or apple tart and custard. The number at risk was 40. The onset of the first symptoms was 12 hours and of the last symptoms 20 hours after consumption of the meal. Samples of the remains of the cooked beef and of the stock which formed the basic ingredient of the soup were submitted to the Public Health Laboratory at County Hall. No gravy was available for sampling. Samples of the beef and soup stock proved to be negative. Faeces specimens were obtained from 5 cases and 4 foodhandlers. Of the 5 cases, 3 were negative and 2 were positive for Clostridium Welchii. The four food handlers were negative. Repeat faeces specimens from the cases from whom the causative organism was isolated were examined and the reports were negative. For various reasons it was not found possible to obtain specimens from the remainder of the 12 cases. The meal consumed by the cases was prepared in the following way. The meat, which weighed 10½ lbs., was prepared and rolled ready for cooking by a local butcher, who sold it to the canteen on the morning of the 25th May. On the same morning it was boiled for 2 hours, then cooled in the kitchen for 2½ hours and afterwards placed in a refrigerator. About 16 hours later, on the morning of the 26th May, the meat was sliced and placed on plates. Gravy, made two hours previously with the liquor from the boiled beef, flour, browning and seasoning, was poured over the meat. Hot vegetables were then placed on the plates and the whole meal put on to a preheated hot plate for ¾ hour. Although the evidence is not conclusive it is probable that the origin of the infection was the gravy made from the liquor of the boiled brisket of beef, cooled and reheated. 41 The cooking and food preparation arrangements were discussed with the canteen manageress and the secretary of the firm and notes regarding the technique for cooking, preparing and storing food likely to give rise to food poisoning were supplied to them for reference. Dysentery The number, of cases of dysentery notified during the year again increased, 209 cases occurring compared with 128 in 1958. One hundred and twenty two of them occurred in the Vauxhall Parr liamentary Constituency, mainly in the Bishop's and Prince's wards, 55 in Brixton and 32 in Norwood. Paratyphoid b During the year 5 cases of paratyphoid fever were notified as occurring in the Borough. There was no apparent connection between them either in the time or place of their occurrence. Two of the organisms were typed and found to be of the phage type Taunton but these occurred at widely separated parts of the Borough and some 4 months apart. The ages of the patients ranged from 5 months to 17 years and no positive cultures were obtained from stools of contacts and in no instance was it possible to incriminate any particular article of food. Diphtheria No case of Diphtheria occurred during the year. While this is gratifying there are no grounds for complacency, The need for immunisation is still as great as ever. In view of the comparative rarity of the disease parents fail to appreciate the value of having their children immunised, Diphtheria immunisation is the responsibility of the London County Council but may also be carried out by general practitioners and I am indebted to the Divisional Medical Officer of Division Dr. W.H.S. Wallace, for supplying me with the fol lowing figures regarding immunisation- carried out in the Borough of Lambeth during the year 1959. 42 BOROUGH OF LAMBETH IMMUNISATION - 1959 Completed cases Wei fare Centres and Nurseries General Fractitioners Totals Under 5 years 5-14 years Under 5 years 5-14 years Diphtheria Prophylaxis only 179 83 59 11 332 Combined antigenDiphtheria and Whooping Cough 424 14 128 7 573 Triple antigenDiphtheria, Whooping Cough and Tetanus 1748 36 556 21 2371 Diphtheria Boosting doses - all ages 938 307 1245 Whooping Cough only al 1 ages (completed cases) 39 39 78 Smallpox No case of smallpox occurred in the Borough during the year. There is still the need, however, for increased vaccination. The number of people being vaccinated against smallpox is not as high as it should be and a large proportion of the population is therefore unprotected against the disease. 43 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. Yel low 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.I. , Medical Department. Unilever House. Blackfriars E.C. 4., and West London Designated Vaccinating Centre, 53. Great Cumberland Place. 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 Internationa] 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 Engl and and Wal es this is the Town Council. Urban District Council or Rural District in whose area the Vaccinator practices, t should.be noted that this is not necessarily the area in which the nerson vaccinated lives. During the year, 2891 International Certificates of Vaccination were stamped by the Public Health Department, 44 TUBERCULOSIS Notification The following table shows the number of cases of tuberculosis notified for the first time during the year 1959, excluding transfers into the district and cases brought to notice other than by formal notification. Age Group Respiratory Non-Respiratory Total all Forms Male Female Male Female Under 5 years 5 3 1 - 9 5-14 years 1 5 - - 6 15 - 24 years 10 13 2 2 27 25 - 44 years 31 26 5 4 66 45 - 65 years 37 11 - 1 49 65 years and over 13 - - - 13 TOTAL 97 58 8 7 170 These primary notifications were distributed amongst the Pariiamentary Constituencies as fol1ows : - Norwood 53 Brixton 65 Vauxhall 52 The number of cases of tuberculosis remaining on the Register at the end of the year is as follows Respiratory Non- Respiratory Total M 1675 F 1415 M 105 F 123 M 1780 F 1538 3090 228 3318 45 The following table shows the number of patients admitted or discharged from hospitals, sanatoria etc., during the year Parliamentary Constituency Respiratory Non Respiratory Admitted Discharged Admitted Discharged M F M F M F M F Vauxhall 25 7 28 5 1 1 1 1 Brixton 16 10 18 11 2 - 1 - Norwood 7 2 12 2 1 - 1 1 total 48 19 58 18 4 1 3 2 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 Tuberculosis All forms of Tuberculosis Male Female Total Male Female Total Male Female Total 19 8 27 1 1 2 20 9 29 The following table shows the primary notification of uberculosis for the ten year period 1950 1959. Year Respiratory Non-Respiratory Totals Rate per 1 000 population 1950 400 31 431 1. 87 195l 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 1959 155 15 170 0. 76 46 The following table shows the number of deaths from tuberculosis for the ten year period 1950 - 1959 Year Respiratory Non Respiratory Totals Rate per 1,000 population 1950 88 12 100 0.43 1951 96 7 103 0.45 1952 60 5 65 0.28 1953 46 7 53 0.23 1954 34 7 41 0.18 1955 32 4 36 0.16 1956 22 - 22 0.11 1957 17 5 22 0.10 1958 24 2 26 0.13 1959 27 2 29 0.13 47 DEATH BATE FROM ALL FORMS OF TUBERCULOSIS PER 1,000 POPULATION AND NOTIFICATION PATE PEB 1,000 POPULATION Deaths Ten Year Period Notifications • — — — — 1950 - 1959 48 I am indebted to Dr, Price. Consu]tant Chest Physician at St, Francis' Hospital for the following report on the work of the Chest Clinic during the year. Table 1 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 1959. TABLE 1 Respiratory Tuberculosis Non-Respiratory Tuberculosis Men Women Children Total Men Women Children Total Total cases on Clinic Register at 31.12.59 651 522 67 1240 15 20 8 43 Number of cases diagnosed during the year 49 25 12 86 1 2 2 5 Recovered 5 6 1 12 - - - - Deaths 7 1 - 8 - - - - Deaths During the year there were 8 tuberculosis deaths among patients known to the Clinic, all adult pulmonary cases. Analysis of these deaths shows that approaching old age. delay in taking medical advice and treatment were principle features contributing to the fatal result. Males suffered most ; of the 7 deaths, 3 were seventy years old or more, 2 were cases discovered at post mortem examination and had never been notified, 2 were middleaged men who had suffered extensive disease since first diagnosed five years previously. The only female death, a women 43 years old, was within a week of diagnosis. The disease was far too ad vanced to respond to treatment. 49 Non Respiratory Tuberculosis The few cases of non respiratory tuberculosis were all associated with cases of respiratory disease by contact and none was due to bovine infection, The two children recorded were both negroes and were cases of meningitis acauired by contact under overcrowded and unenlightened home conditions. Both survived with treatment. Respiratory Tuberculosis There were 86 cases of respiratory tuberculosis diagnosed and added to the register during the year, the majority were suffering from minimal disease likely to respond successfully to treatment, 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 1959 1.240 86 8 12 Table 2 gives a comparison of Clinic Register Figures over the Past nine years. It reflects the national fall in incidence death rates. This year the incidence rate reverts approximately to that of 1955 and 1956 before the temporary increase of the following two years due to the initial case finding of the Mass Radiography Units in the Borough. The greatest number of new cases continues to derive from those referred to the Chest Clinic or hospital by general practitioners for investigation and diagnosis. The routine tuberculin testing of children under the County 50 Council's scheme for the B,C.G. vaccination against tuberculosis of older groups of schoolchildren has revealed very few cases of primary contact infection causing disease. Strongly positive re actors are referred to the Chest Clinic for observation and diagnosis, and the routine examination of their contacts has revealed very few source cases of infection previously unknown. The number of negative reactors in older schoolchildren has increased in recent years and reflects success in reducing the number of infectious cases among the population. This is testimony to the efficacy of modern out patient treatment of those suffering from the disease. Treatment Whilst most new cases, of pulmonary tuberculosis require initial hospital treatment, the majority are able to continue with chemotherapy as Chest Clinic outpatients A small minority of suitable cases in need of surgical treatment are re admitted for operation. There was a total of 20 such admissions during the year. Old standing chronic cases, now usually in the older male age groups, need hospital treatment from time to time and 25 such admissions were arranged by the Chest Clinic during the year. Most of them were admitted to Dulwich Hospital from the Hostel for Tuberculous Men at Knight's Hill. A tuberculous ward for males is available at Dulwich Hospital under the clinical charge of the Consultant Chest Physician. The Tuberculosis Hostel provides excellent accommodation for chronic tuberculous men and experience over the past two years has confirmed the need for such establishments and its success in restricting the infector pool. Lambeth (South) Chest Clinic Although situated outside the area of South Lambeth, which it serves, the Clinic is well attended and is well used by local practitioners who refer their cases for diagnosis and treatment. There were 4476 patient attendances during the year. Whilst other diseases of the chest are diagnosed and treated, tuberculosis continues to be the main concern of the Clinic and its service is directed to deal with the tuberculosis problem. It provides 51 specialist treatment and advice for, sufferers of whom during the year there were, at any one time, about 250 cases receiving chemotherapy under Chest Clinic control and guidance. The provision of Tuberculosis Health Visitors and a Welfare organisation is a London County Council responsibility centred on the Chest CIinic,. During the year the Health Visitors paid 3 462 visits to homes, 409 patients were given extra nourishment in the form of milk, eggs and butter under a Council grant, and 28 cases were given home help assistance. 52 SECTION C GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA Care of the Aged Work in connection with the aged has continued to expand and the number of visits made by the Woman Public Health Visitor increased by 206. During the year 593 new cases were brought to the notice of the Public Health Department, an increase of 82 over the number of new cases for 1958. In addition a scheme for the home bathing of elderly people was inaugurated, details of which appear later in the report. It was necessary to take statutory action in only three cases and this emphasises the considerable amount of work which is done by the lady visitor in persuading old people to accept help and treatment voluntarily. Individual cases required constant supervision entailing many visits. The duties carried out by the Public Health Department in connection with the elderly are rapidly reaching a stage when it will be practically impossible for the Public Health Visitor to take on additional work. Consideration may have to be given, therefore, to providing her with assistance. A similar expansion is to be expected in the Home Bathing Service and in this connection also it may be necessary to increase the number of female bathing attendants employed on a part time basis or alternatively to employ the existing staff full time. As in previous years I pay tribute to the work done by the staff of the Public Health Department in connection with old people and acknowledge the help given by Lambeth Old People's Welfare Association, and the London County Council through its Domestic Help and Nursing Services. The co-operation of the Geriatricians and the Hospitals is also appreciated. I am very grateful to al1 these organisations for without their co operation and help the task of the Public Health Department would be much more difficult. 53 Set out below is a summary of the work of the Public Health Visitor during the year giving a comparison with 1958. 1959 1958 No. of new cases 503 421 No. of cases removed to Hospital or Institution (voluntarily) 143 147 No. of cases removed under National Assistance Act, 1948, as amended by National Assistance (Amendment) Act, 1951 1 1 No. of cases removed under National Assistance Act. 1948, Section 47 2 - No. of cases removed by a Duly Authorised Officer 2 7 TOTAL NO. OF VISITS MADE BY VISITOR 2, 522 2, 316 No. of cases who received help 412 364 No. of cases in which help was not required 54 40 No. of cases in which help was refused 37 17 No. of deaths 151 163 No, of cases on Register at end of year 1, 192 838 The 503 new cases fall into the following age groups Age Groups Male Female Total s 65 - 69 years 28 60 88 70 - 74 years 19 62 81 75 - 79 years 32 72 104 80 - 84 years 34 108 142 85 89 jrears 23 50 73 90 94 years 4 10 14 95 - 100 years 1 - 1 TOTALS 141 362 503 from these figures it might appear that the ladies are much more troublesome than the men! In fact however, there are more roales in the older age groups of the population, they appear be more subject to infirmity and disability and are more reluctant to surrender their independence than men. 54 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. 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 under review action was taken under the main Act in 2 cases and under the amended legislation in 1 case. Details of the cases are set out below : Case No, 1 This was an old lady of 81 years of age, crippled and living on the ground floor of a house which she owned. The rooms she occupied were very dirty, especially her bedroom and her bedding and mattress were filthy and heavily contaminated by urine and faeces.. Vermin were found in the mattress and a cat with young kittens was perpetually in the bed. The old lady was resentful of any offers of help but did agree to the mattress, bed and bedding being destroyed. This was done and the disinfestation and cleaning of the room was carried out. The bedding was replaced by means of gifts. The home bathing service was arranged but was 55 discontinued by the old lady after two baths. She once more became aggressive and refused all help offered. Conditions reverted to the original state. The premises were visited by the Medical Officer of Health. The old lady steadfastly refused to go into a home or accept help. Another clean mattress Was supplied and the bedding removed once again, A further visit was paid by the Medical Officer of Health with the private Practitioner and removal was enforced under Section 47 of the National Assistance Act. 1948. The old lady settled down in the home and was most appreciative of the comforts she enjoyed. Her cats were taken away by the Blue Cross Kennels. Case No. 2 This was an old lady aged 86 years. She first came to the notice of the Public Health Department in October 1956. Her speech was affected as a result of a stroke she had years previously. She occupied ground floor accommodation consisting of 2 rooms and a scullery but only lived in one room which was sparsely furnished and reasonably clean. Frequent visits were paid by the Public health Visitor between October 1956 and January 1959. Admission to hospital was arranged on two occasions and a home help was provided, the old lady being quite co-operative. However in January 1959. there was a marked deterioration in her condition, The old lady became difficult and refused to allow the Home Help to clean. Her bedding became verminous and she was incontinent on the floors and in the bed. These conditions continueduntil February when the Home Help Organiser stated that she could not get the Home Help to go into the house as the old lady was so dirty in her habits. The Medical Officer of Health visited but the old lady refused to go into a home. She was rapidly becoming emaciated and Enable to care for herself. Statutory action.was taken under Section 47 of the National Assistance Act, 19.48,. as amended by the National Assistance Amendment) Act, 1951. and removal was accomplished on 26th February. 1959. The old ady settled down fairly well but died on 11th April, 1959. 56 Case No. 3 This o]d lady, aged 79 years, became known to the Pub]ic Health Department in 1958, when she was quite mobile, clean, tidy and co-operative. In January 1959, her only daughter died and she became distrustful of people. In June 1959, due to drunkeness, the old lady had a fall in the street, was admitted to hospital and was discharged in August. She was unable to look after herself. The accommodation she occupied was sparsely furnished but reasonably clean. The old lady was seen after her discharge when she was. most aggressive and abusive to everyone who tried to help her, including another tenant in the house. She demanded constant attention day and night. Due to her habits and constant state of inebriation it became very difficult to obtain voluntary help. She was visited by the Duly Authorised Officer but no action could be taken under the Mental Health Acts. Conditions deteriorated to such an extent that it became necessary for the Medical Officer of Health to take action under Section 47 of the National Assistance Act, 1948. The old lady was removed to a home on 7th October, 1959, She did not settle in and was still aggressive and difficult. The Order for her detention was renewed on 18th November, 1959, and she was still in the home at the end of the year. In all 30 visits were made in connection with this case by the Public Health Visitor. Home Bathing Service In January 1959, the Public Health Committee submitted to the Council proposals for the provision of Home Baths for aged persons. These proposals were agreed to. Brief notes on the scheme are set out below. Authority for the provision of the scheme This is contained in Section 43 of the London County Council (General Powers) Act, 1953, as follows :- "Power to sanitary authority to cleanse aged and feeble persons in their homes - (1) where it appears to a sanitary authority upon a report from the Medical Officer of Health or a sanitary inspector for their district that any aged person within their district - (a) is verminous or is for any other reason in need of cleansing in order to prevent injury or the danger of injury t° health ; and 57 (b) is so enfeebled that he is unable to avail himself of any facilities for cleansing himself provided by the authority under any anactment or to cleanse himself properly, The authority may on the application or with the consent of that person (but not otherwise) cause him to be cleansed free of charge at the place where he resides or at any other suitable place. (2) A sanitary authority may make all such arrangements and provide all such apparatus and things as may be necessary for the convenient exercise of the powers conferred by the foregoing sub-section. (3) This section shall be read and construed as one with Part III of the Public Health (London)Act, 1936, " details of the Scheme Two part time female bathing attendants are employed on a sessional basis five mornings a week, Each woman, is provided with a bag containing the necessary kit, i.e. towel, soap, scissors, nail brush, etc. The facilities in the old person's house are utilised and the old person is given a blanket bath together with hair washing. Each old person is visited fortnightly. Allowing for travelling time each attendant deals with 3/4 cases in a morning. Before the baths are provided all applications are referred to the Public Health Visitor who visits to assess the need and the suitability of the old person. The scheme came into operation on 4th May, 1959, and has worked well with very few teething troubles, and the two attendants are working to capacity. Since the inception of the scheme 112 people have benefited. Of this number 10 have died, 15 are permanently in hospitals and homes and the baths have been cancelled in 16 cases. This leaves 71 old people on the register. The total dumber of baths given by the attendants is 747. Laundry Service for Aged Incontinent Persons The arrangements made with the Southwark Borough Council for carrying out this service continued during the year. Before the service is granted, each case is visited by the ady visitorto ascertain whether it may be dealt with in accordance with Section 122 of the Public Health (London) Act, 1936, 58 and collection and deliveries are made twice weekly. The total number of. persons receiving benefit from the scheme during the year was 101, the total visits made were 1,885, and the number of soiled articles collected and taken to the Southwark Cleansing Station was 17,337. The total weight of the laundry cleansed was 17.266 lbs, Holidays for the Elderly The scheme to send old age pensioners to the sea side for a week's holiday at the cost of £1 each was continued during 1959. 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 hoiiday. The holidays were arranged at Margate in the Spring and Autumn, the first period being in May and the second in September. Applications for the Spring holiday were received at a much greater rate than hitherto - 321 .forms being issued and 279 returned duly completed, Of this number 30 applicants proved ineligible on the grounds either of having had a holiday within the 3 years qualifying period, insufficient residential qualifications or too high an income. The remaining 249 old fol k were al 1 interviewed but subseauently 11 cancellations reduced the actual number of old people going on holiday to 238, as under :- Parliamentary Constituencies Males Femal es Totals Married Couples included in previous column 65/75 76/85 Over 85 60/75 76/85 Over 35 Vauxhall 11 7 - 36 15 - 69 8 Brixton 13 5 - 29 18 1 66 10 Norwood 12 8 1 50 32 - 103 12 TOTALS 36 20 1 115 65 1 238 30 59 Five further cancellations were made too late to fill the vacancies. In the Autumn. 160 old folk .were taken to Margate in two Parties on 12th and 19th September, respectively. While at Margate the second party was visited by His Worship the Mayor of.Lambeth accompanied by the Mayoress, the Chairman of the Public Health Committee and the Medical Officer of Health. The following particulars show the number of people who Participated in the Autumn holiday with age groups, Parliamentary Constituencies etc. Age Groups 60 65 70 75 o co over Totals sex F M P M P M F M F vauxh all 2 2 5 13 6 7 4 - 6 45 Bfixton 4 4 7 3 19 7 8 3 8 63 Norwood 3 5 6 6 14 3 9 5 1 52 totals 9 11 18 22 39 17 21 8 15 160 The above figures include 23 married couples. The following table shows the numbers, age groups and Parliamentary Constituencies for the Spring and Autumn holidays combined. Age Groups Males Femal es Totals Married Couples Included in previous columns 65/75 76/85 85 & over 60/75 76/85 85 & over Vauxhall 26 14 - 49 25 - 114 14 Brixton 20 15 - 59 34 1 129 17 Norwood 23 16 1 73 42 - 155 22 TOTALS 69 45 1 181 101 1 398 53 60 Lambeth Old People's Welfare Association The work of the Lambeth Old People's Welfare Association continued throughout the year. The Association receives consider able financial assistance from the Lambeth Borough Council and acts as the Council's agent in those activities which the Council is unable to carry on 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, 1960. " In reporting the steady progress which has taken place during the year under review it will be interesting to look back to the early days in the life of this Association and to see what has been accomplished. In December 1945, the inaugural meeting was held in Lambeth Town Hall and His Worship the Mayor presided as President of the Association, a tradition which has been continued each successive year by the Mayor in office. At this meeting it was agreed that the most important needs were the provision of meals and clubs and the visiting of lonely or sick people but it was not until September 1946 that the Meals Service started and it is reported that eleven people had meals twice a week - Tuesdays and Thursdays. Meals The present position is very different. In the Northern end of the Borough which is served by the Association the total number of meals served in the year under review was 28,276 of which 6,004 were served in bulk to clubs and 22,272 to individuals in their homes. In the Southern end of the Borough which is served by the W.V.S, 27, 460 meals were served all to old people in their homes, making a total of 55,736 and benefitting 235 individual people in the Borough, Clubs In April 1946 it was reported that the third Darby and Joan Club had just been opened and that the clubs were proving a great success, In Lambeth there are now 30 Darby and Joan Clubs all doing wonderful work. In recent years clubs have been opened Which are entirely run by the old folk themselves under the 1eadership of one of their members and in each case the experiment has proved a great success. 61 In November 1948 the first competition and exhibition of work was held and nearly 100 entries were received. This year well over 500 entries were exhibited, the Challenge Shield being won by the King George VI Memorial Club, In the early days the clubs were open only three hours once a week but in recent years it has been possible for some leaders to open their club all day for at least four days a week for the Purpose of serving mid day meals. Visiting During the year under review 842 welfare visits were made by the staff and in addition a considerable number ofvisits were made by voluntary visitors who do so much in befriending the house bound old people. Case Work 1,299 new cases were brought to notice during the year and in addition 2,436 cases previously known to the Association were again helped and advised. Foot Clinics In 1949 a Chiropody Service was started, the office of the Association in Chester Way being used, A chiropodist attended one afternoon a week and treated seven old people. Rapid strides have been made since then and now the Association has six Foot clinics working 28 wessions per week and a Domiciliary Service working 6 sessions per week. There are 2,551 old people receiving treatment in the Centres and 379 in their homes. Holidays In the early days of the Association holidays were arranged old a feW °"'d Pe°Ple under the age of 70 years but now very many old people are sent away under the various holiday schemes in Operation. During the year under review the Association arranged for 72 elderly people to have two weeks holiday by the sea and 20 infirm People were sent to seaside convalescent homes for variying Periods. In addition old people were recommended for holidays under the scheme sponsored by the Borough Council. 62 The Geriatricians of the South Western and St. Francis Hospitals continued to help the Association by taking into their hospital infirm old people for short periods so that their relations may have a much needed holiday secure in the knowledge that their old folk were being well cared for. King George VI Memorial Club This club for the homebound elderly, which is run jointly with Camberwell Old People's Welfare Association is now entering its fourth year. 382 members belonged to the club during the year, and 311 were still on the register at the end of the year. 57 of these being people who had first joined the club in its first weeks in 1957. Some of them have made quite startling improvements in general health in the intervening years. During the year there were 193 applications for membership and a formal waiting list had to be establ ished. The usual waiting period is about six months, but priority is given to those who appear particularly urgently in need of the club's services. 107 members joined during the year and 114 names were removed from the register, the majority by reason of the death of the member. Altogether the 382 members made 11,139 attendances between them at an average cost of 8s.9d. The members normally attend once a week, being fetched and taken home by the club's own ambulances. The club aims to provide as many auxiliary services as possible in order to make the fullest use of the transport, which accounts for about two fifths of the total running costs. These services include a hot midday meal, bathing, chiropody, shopping and hairdressing; some of them are limited by the amount of voluntary help available to staff themThrough its Adult Education Service, the London County Council provides a daily teacher for handwork classes which have always been a feature of the club's programme. Until this year the hand work classes were staffed by voluntary helpers* having a skilled instructor to organise the classes has been a great step forwardOther activities include summer outings, parties at Christmas and for the members birthdays the latter being collective affairs held once a month for each club day. Similarly each club day has a monthly concert or other entertainment. 63 Work Centre The numbers attending the Work Centre fell to 41 at the end of the year, largely owing to increasing infirmity and difficulties in travelling. There are 38 women and 3 men. Work for the women is easier to find but the employment of men has been more difficult especially as the use of a power tool has had to be discontinued due to the lability of the electricity circuits to take the load safely. Recently however a contract for box making which can be done by men as well as women has been obtained. The women still continue to do button carding and darning and during the year the packing of foam cistern floats and curtain taking has been carried out. Articles have also been made for direct sale and a sale of work was held on the 5th, December in Edition to a stall at the Autumn Pair, A handicraft instructor from the London County Council attends the Centre once a week. The subsidiary centre at Chester Way moved to the Duke of Clarence Club in Orsett Street on 30th November where 8 ladies attend in the morning only. The lease of the premises at 58 Lansdowne Way will expire next year but plans are well ahead for the building of a new centre, Office The Office of the Lambeth Old People's Welfare Association is situated in Room 1 at the Town Hal], Brixton Hill. S.W.2. (Telephone Brixton 7755. Extension 18). The Organisation Secretary of the Association is Mrs. I.K. Prampton and the office hours are from 9.30 a.m. to 5 p.m. Mondays to Fridays and 10 a.m. to 12noon on Saturdays. Hospitals Lambeth is within the catchment of two hospital groups, the Lambeth and Camberwell Groups. These, in turn are administered by two different Regional Hospital Boards, theSouth 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. 64 In addition to hospitals within the normal hospital framework of the National Health Service there are two teaching hospitals in the Borough, King's College Hospital and St. Thomas's Hospital each with its own board of Governors. The following is a list of hospitals within the Borough. LAMBETH HOSPITAL GROUP (S.W. REGIONAL HOSPITAL BOARD) Lambeth Hospital. Brook Drive, S.E.11. South Western Hospital, Landor Road, S.W.9. Annie McCall Maternity Hospital, Jeffreys Road, S.W.4. KING' S COLLEGE HOSPITAL GROUP King's College Hospital, Denmark Hill, S.E.5. Belgrave Hospital for Children, Clapham Road, S.W. 9. ST. THOMAS' S HOSPITAL GROUP St. Thomas's Hospital, Westminster Bridge. S.E.I. St. Thomas's Babies' Hostel, Black Prince Road, S.E.11. General Lying-in-Hospital, York Road, S.E.I. Royal Waterloo Hospital, Waterloo Road, S.E.I, 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.I and home nursing is carried out on behalf of the County Council by voluntary organisations. 65 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 Associations Public Health Laboratory Service The Public Heal th 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. 66 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 1959. 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'sworks 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. 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 samp]es of water supplied by the Metropolitan Water Board to the Borough of Lambeth were taken for chemical and bacteriological examination. The number of samples taken during the year from the Thames Valley Southern Group for chemical examination was 156 and the number taken for bacteriological examination 1748. The average results were as follows : - 67 Chemical Examination Milligrammes per litre Description of sample (unless otherwise stated) Thames derived filtered water Ammonia nitrogen 0.032 Albuminoid nitrogen 0.073 Oxidised nitrogen-nitrate 3.8 Chlorides as CI 29,0 Oxygen abs, from Permanganate 4 hours at 27 °C 1.06 Turbidity in terms of silica 0.4 Colour m.m. brown 2 ft tube Burgess's Tintometer 10.0 Hardness (total) 244.0 Hardness (non carbonate) 54.0 PH value 7.7 Phosphate as P04 1.0 Silicate as Si02 9.0 Sulphate as S04 54.0 Fluoride as F 0.2 Magnesium as Mg 4.0 Electrical Conductivity (Gemmhos) 525. 0 Becteriological Examination after CMorination Water passing into supply) Plate counts (average per ml.) Colonies counted on agar 37°C (20-24 hours) 8.1 Coliform count percentage samples negative in 100 ml 99.31 Escherichia count percentage samples negative in 100 ml 99.94 Water 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 two welIs arereceived regularlyand have been satisfactory the year under review. 68 SUMMARY OF VISITS AND INSPECTIONS BY INSPECTORIAL STAFF Visits Re-visits Dwel1inghouses In respect of nuisances under Public Health (London) Act, 1936 2,212 6,942 In respect of Certificates under the Rent Act 1957 149 194 In respect of Rehousing 124 54 In respect of Infectious Diseases 493 11 Other reasons 583 138 Clean Air Act 1956 Timed observations 17 - Untimed observations 788 - Other visits, private and industrial premises 1,219 1,895 Bakehouses 93 19 Butchers Shops 499 - Restaurants 416 53 Pried Pish Shops 56 1 Ice Cream Premises 127 5 Milkshops 274 5 Pub!ic Houses 50 5 Street Traders 1 - Other Pood Premises 426 30 Factories Acts Factories with mechanical power 408 15 Factories without mechanical power 148 - Outworkers 287 - Drainage New Buildings 36 1,769 Alteration to existing drainage, etc. 399 3,174 69 SUMMARY OF VISITS AND INSPECTIONS BY INSPECTORIAL STAFF (Continued) Animals improperly kept 32 18 Personal uncieanliness 52 17 Exhumations 1 - Hairdressers and Barbers 111 30 Pet Animals Act. 1951 28 3 Rodent Control 1,421 1.216 Unclassified 751 145 11.201 15.739 COMPLAINTS The number of complaints received, including rat and mouse infestations, was 3,678 DRAIN TESTING Number of Drains tested by District Inspectors 2,647 Number of Drains tested by Rodent Officer 150 2,797 DANGEROUS STRUCTURES Dangerous structures notified to London county Council 79 SUMMARY OF DEFECTS AND NUISANCES FOUND AS A RESULT OF ROUTINE INSPECTION AND INSPECTION FOLLOWING COMPLAINT Dirty Premises 47 Verminous Premises 432 Defective Roofs 384 Defective rainwater pipes and gutters 208 Damp Premises 458 Defective drainage and sanitary fittings 513 70 SUMMARY OF DEFECTS AND NUISANCES FOUND AS A RESULT OF ROUTINE INSPECTION AND INSPECTION FOLLOWING COMPLAINT (Continued) Choked drainage 316 Lighting and ventilation 266 Defective water suppl ies 66 Dustbins etc. 41 General defects and dilapidations 658 NOTICES SERVED Number of Intimation Notices Served 1,308 Number served under Public Health (London) Act, 1936 - Section 40 330 Section 82 316 Section 93 18 Section 108 187 Under the London County Council (General Powers) Act, 1955 - Section 27 43 Under the Prevention of Damage by Pests Act. 1949 10 904 LEGAL PROCEEDINGS PUBLIC HEALTH (LONDON) ACT, 1936 In respect of 54 summonses returnable to the Lambeth Magistrates Court and Petty Sessional Court. 13 Abatement Orders were made, 22 cases were adjoined sine die. I was dismissed and 18 were withdrawn, the nuisances being abated by the respective owners by the date of the hearing. DWELLING HOUSES RENDERED FIT Number of dwelling houses rendered fit in consequence of informal action 984 71 dwelling houses rendered fit (Continued) Number of dwelling houses in which defects were remedied after service of formal notice (a) by landlords 875 (b) by Council in default of landlords under the Fifth Schedule of Public Health (London) Act, 1936 16 Under Sections 40, 93 and 108 of the Public Health (London) Act, 1936 and Prevention of Damage by Pests Act, 1949 52 Under Section 27 of London County Council (General Powers) Act, 1955 14 82 Outstanding cases from previous year are included. Action 95 public health (London) act. 1936 In 1959 Certificates of Habitation were issued in respect of 396 new dwellings in regard to the provision of a proper and sufficient water supply. Out of 396 dwellings 52 were Borough council properties, 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. 40 plans of new buildings and 86 plans of alterations to existing drains were deposited. Combined drainage was carried out in 29 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. 72 DISINFECTION The following is a summary of the work carried out by the staff of the Wanless Road Disinfecting Station : Number of premises sprayed in which cases of Infectious Disease have occurred 368 Number of rooms included in abcve 445 Total number of rooms sprayed for all purposes 2,539 Number of articles disinfected 12,127 Number of library books disinfected 716 Number of disinfection certificates issued 236 DISINFESTION Bed Bugs Number of houses visited 287 Number of rooms sprayed 913 Number of houses revisited 81 The rooms were sprayed with a preparation of 5 per cent D.D.T. with Pyrethrum as a '•"knockdown". The total number of visits made by the staff of the Disinfecting Station for all purposes was 4,103. There were many complaints during the year of insect infest, ation. The. usual offenders were wood boring beetle, ants, cockroaches, drug store beetles, carpet beetles, clothes moths, weevils, clover mites and silver fish. PREVENTION OF DAMAGE BY PESTS ACT, 1949 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 73 PREVENTION OF DAMAGE BY PESTS ACT . 1949 RODENT CONTROL (Continued) the Local Authority free of charge, but in the case of business Premises a charge is made, During the year 997 complaints were received. Of this number 112 were not justified, One was in respect of blackrats, 744 were 1ft respect of brown rats, and 140 in respect of mice. During the °ourse of investigation 1009 baitings were made and 65 defective drains discovered. Of 27 Statutory Notices served under the Public Health (London) Act. 1936 and Prevention of Damage by Pests Act. 1949, 12 were referred to the Town Clerk for the necessary action. FACTORIES ACT. 1937 AND 1948 PART 1 OF THE ACT Inspections for purposes of provisions as to health (including inspections made by the Public Health Inspectors). Premises Number on Eegister Number of Inspections Written Notices (i) Factories in which Sections 1 2 3 4 and 6 are to be enforced by Local Authorities * 154 148 1 Factories not included in (i) in which Sect ion 7 is enforced by the Local Authority 682 535 14 Other Premises in which Section 7 is enforced by the Local Authority ** (excluding outworkers' premises) 64 64 * TOTAL 900 747 15 74 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.) 6 5 - 3 Overcrowding (S.2) - - - - Unreasonable temperature (S.3) - - - - Inadequate ventilation - - - - Ineffective drainage of floors (S.6) - - - - Sanitary Conveniences (S.7) - (a) Insufficient - - - - (b) Unsuitable or defective 5 3 - 5 (c) Not separate for sexes - - - - Other offences against the Act (not including offences relating to Outwork) 4 2 - 3 TOTAL 15 10 - 11 NO PROSECUTIONS WERE INSTITUTED 75 PART viii OF THE ACT OUTWORK (Sections 110 and 111) Nature of Work No. of out-workers in August list required by Section 110 (1) (c) (3) Wearing APparel Making, etc. Cleaning and washing 246 household linen 4 Curtains and furniture hangings 1 Artificial flowers 2 Paper bags 4 The making of boxes or other receptacles or parts thereof made wholly or partially of Paper 22 Carding, etc., of buttons, etc. 38 Cosaques, Christmas crackers, Christmas stockings, etc. 4 Lampshades 45 TOTAL 366 NO NOTICES WERE SERVED OR PROSECUTIONS INSTITUTED 76 RENT ACT. 1957 (a) Applications for Certificates of Disrepair App]ications outstanding from 1958 109 28 137 Applications withdrawn 29 Decisions not to issue Certificates 1 Decisions to issue Certificates (a) in respect of some but not all defects 68 106 (b) in respect of all defects 38 Applications awaiting action at end of year 1 137 (b) Number of cases where decisions were made to issue Certificates but were awaing action by the landlords at the end of 1958 26 Undertakings given by landlords under paragraph 5 of the First Schedule of the Act 65 Undertakings refused under proviso to paragraph 5 of the First Schedule of the Act 6 Certificates of disrepair issued 50 Certificates still to be issued or undertakings still to be received from landlords at end of year 11 132 (c) Applications for Certificates as to the remedying of defects specified in a landlord's undertaking (a) by landlords 54 (b) by tenants 18 (c) applications outstanding from 1958 2 74 Certificates issued (a) defects remedied 33 (b) defects not remedied 34 (c) applications awaiting action at end of year 7 77 rent act. 1957 (Continued) (d) Applications by landlords for cancellation of Certificates of Disrepair 62 Applications outstanding from 1958 6 68 Certificates cancelled 45 Certificates refused 19 Applications still to be dealt with at the of year 4 68 In connection with,the applications from landlords for cancellation of Certificates of Disrepair objections to cancelation were lodged in 24 cases. rehousing and overcrowding During the year the following cases have been investigated London County Council Cases 6 Overcrowding Medical Grounds 12 Insanitary conditions 6 Lambetb Borough Council 9 Overcrowding 453 Medical Grounds Insanitary conditions 83 Demolition and Closing Orders 21 Enquiries from other sources During the same period cases have been rehoused by various authorities as under :- London County Council 92 Lambeth Borough Council 13 78 HOUSING ACT 1957 RECORD OP WORK CARRIED OUT BY HOUSING INSPECTORS Section 17 - Individual Unfit Houses Inspected - no action under Housing Act 58 Claylands Road 56 Pitzalan Street 24 F1axman Road 33 Lollard Street 17 Old Paradise Street 19 Old Paradise Street 1 Weaver Walk Inspected - in abeyance 6 Pownall Terrace Inspected - to be represented 166 Black Prince Road Represented 1958 Closing Order made 19 Southville Closing Orders determined - premises made fit 42 Landor Road 38 Wynne Road Undertaking - premises made fit 26 Burton Road Section 18 - Underground rooms and parts of buildings Inspected - no action under Housing Acts 3 Alaska Street 35 Alderbert Terrace 170 Coldharbour Lane 75 Effra Road 4 Grove Way 11 Grove Way 157 Kennington Road 125 Mayal1 Road 1 Patmos Road 9 Penford Place 222 South Lambeth Road 58 Vauxhal1 Grove 124 Vauxhal1 Walk 79 Section 18 - Underground rooms and parts of buildings Inspected no action under Housing Acts (Continued) 142 Vauxhal] Walk 216 Wandsworth Road 1 Wincott Street Inspected in abeyance 38 Bellefields Road 42 Bellefields Road 9 Langmead Street 447 Norwood Road 18 St, Martins Road 14 St. Michaels Road Represented 1958 - Closing Orders made 2 Alaska Street 89 Fairbairn Road 23 Industry Terrace 26 Industry Terrace 28 Industry Terrace 29 Industry Terrace 6 Medwin Street Represented Orders not yet made 1 Brailsford Road 46 Eastlake Road 48 Eastlake Road 24 Thurlow Hill Represented Closing Order made 7 Langmead Street Made fit voluntarily 47 Burton Road 18 Knowle Road 63 Acre Lane 2 Lunham Road 5 Mount Villas 85 Rosendale Road Made fit Closing Orders determined 76 Bartley Road 109 Bedford Road 31 Ferndale Road 80 Section 18 - Underground rooms and parts of buildings Work in hand to make fit voluntarily 47 Effra Road 1 Ferndale Road 3 Perndale Road 6 Hannen Road 11 Methley Street 60 Victoria Crescent Section 36 - Houses let in lodgings Inspected - voluntary action by owner 47 Hanover Gardens PAST III - Slum Clearance Programme 1956-60 Somers Road Area 1-7 (odd) Somers Road Represented 12th January, 1959 Declared 28th January, 1959 Clearance Order made 30th June, 1959 Confirmed by the Minister without modification 8th October, 1959 Bowden Street Area 3 - 11 (odd) Bowden Street 56 Methley Street Represented 13th April. 1959 Declared 29th April. 1959 Compulsory Purchase Order made 24th November, 1959 Cambria Road Area 2-10 (Even) Cambria Road 13 - 19 (odd) Padfield Road 1 -7 (odd) Southwell Road Represented 7th September. 1959 Declared 23rd September, 1959 Compulsory Purchase Order made 28th March. 1960 Of the programme agreed with the London County Council for Slum Clearance during the period 1956-60. only two Areas remain to be dealt with by the Lambeth Borough Council. Preliminary 81 inspections have been made of thirty-four houses and the remainder Will be inspected during 1960. Slum Clearance Programme 1961-65 A preliminary survey of the Borough has been made with a view to formulating a programme for slum clearance during the third five year period 1961-65. As a result, approximately 700 Properties were listed for possible inclusion. After further Consideration and discussion with the London County Council the number of properties considered suitable has been reduced to a finally agreed total of 474. It is proposed that approximately a quarter of these should be dealt with by the Lambeth Borough Council. Improvement Grants In September 1959 the Council rescinded its former resolution to suspend the making of grants, During the period of suspension, where the premises were likely to rank for grant applicants were advised to consult the London County Council, Since the reintroduction of the scheme the number of applications for Discretionary Grants has increased but owing to the comparatively hi gh standard of fitness required only a small proportion have been recommended for approval. The main obstacles in the conditions imposed are that the premises must provide satisfactory housing for 30 years and must be self-contained. The restrictions imposed on rents have also caused some applications to be withdrawn. In June, 1959, a new Grant was formulated by the Ministry Housing and Local Government in the House Purchase and Housing Act, 1959. Known as a Standard Grant, it covers half the cost, up to a maximum of £155. of installing five basic a bath or shower, a wash-hand basin, a water closet, a hot water system and a food store. The conditions imposed are less onerous than those of a Discretionary Grant and many more applications are received and approved. either for all or some of the improvements. Grant Inspected - no action 47 Barnwell Road 1 Berridge Road 41 Bramah Road 82 Standard Grant Inspected no action (Continued) 45 Chancellor Grove 118 Dalyell Road 43 Elm Park 13 Endymion Road 54 Gipsy Hill 220 Gipsy Road 32 Goldsboro' Road 35 Kestrel Avenue 2 Leeson Road 12 Lower Marsh 76 Mayall Road 158 Mayall Road 18 Northway Road 93 Norwood Road 100 Norwood Road 122 Norwood High Street 27 Rail ton Road 144 Rosendale Road 29 St. Louis Road 10 St. Saviours Road 182 Stockwel1 Road 32 Thornlaw Road 32 Thurlby Road 97 Tradescant Road 176a Wandsworth Road In abeyance 55 Hackford Road To be approved 272 Brixton Road 7 Camden Hill Road 63 Dal berg Road 10 Ladas Road 43 Selsdon Road 22 Tindal Street Approved 4 Alderton Road 29 Dal berg Road 3-18 Daryngton House (10 Flats) 5 Elm Park 83 Standard Grant Approved (Continued) 72 Fitzalan Street 18 Heme Place 19 Lothian Road 193 Lyham Road 7 Mountford Place Discretionary Grant Inspected no action 172 Clapham Road 29 Durand Gardens 111 Helix Road 50 Lambert Road 12 Selsdon Road 52 Tulse Kill Inspected in abeyance 8 Brixton Road 9 Groveway 42 Groveway Approved 7 Caron Almshouses Loan - Repairs Inspected - no action 22 Beechdale Road TOTAL INSPECTIONS AND REVISITS DURING THE YEAR - 1125 84 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 sul phuric 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. 85 1959 ATMOSPHERIC POLLUTION DEPOSITS AND SULPHUR DIOXIDE MONTH Rainfal1 in mm Deposited Matter in Tons per Sauare Mile SO2 in mgs, per Day on 100 Sq. cms. Insoluble Deposits Soluble Deposits Total Sol ids 1 2 1 2 1 2 1 2 1 3 4 January 44 52 7.5 13.9 7.4 5.8 14.9 19.7 6.6 7.6 5.8 February — — —. 15.1 — 7.2 - 22. 3 5.9 6. 4 5.8 March 39 39 8.1 18.0 8. 5 6.0 16.6 24.0 3.1 4. 3 3. 5 April 38 49 4.9 17.1 6.3 7.1 11.2 24. 2 3, 0 3.9 3. 1 May 14 18 8.1 11.6 4.6 4.1 12.7 15,7 2.6 2. 5 2.2 June 13 27 9.0 14.4 3.6 4.9 12,6 19.3 1.7 2.1 1.8 July 29 33 8.0 12.3 4.4 4.6 12.4 16.9 0.6 1.7 1.2 August 49 26 7.6 9.9 5.5 3,4 13,1 13,3 1 8 1.9 1.7 September — 6 8.1 14.4 4.8 4.9 12.9 19. 3 2.6 2.5 2.4 October 45 51 5.8 15.4 5 8 7.3 11.6 22.7 2.9 4. 5 3.5 November 64 62 3.7 13.5 6.5 8.5 10.2 22,0 3.2 4. 7 3.5 December 72 75 3.7 12.0 6.5 7.3 10.2 19.3 3.7 4.8 2.7 Station controlled by Lambeth Borough Council: - Stations controlled by London County Council :- 2. Archbishop's Park 1. Metropolitan Water Board, 3. County Hall, N.E. Roof Brixton Hill 4. County Hall, S.W. Roof 86 1959 CONCENTRATION OF SMOKE AND SULPHUR DIOXIDE MONTH SMOKE (Milligrammes per 100 Cubic Metres) SULPHUR DIOXIDE (Parts per Hundred Million Parts of Air) 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 35 43 46 61 46 76 39 121 143 168 225 172 218 133 21 23 23 23 12 13 19 74 82 80 94 80 65 65 February 21 41 37 47 37 51 33 93 114 161 200 149 172 117 17 21 22 23 20 15 21 75 73 93 92 89 65 82 March 10 24 18 27 22 31 19 27 48 40 73 52 62 48 9 14 9 13 11 9 10 15 32 18 29 29 16 26 April 5 15 11 21 17 22 13 16 34 37 56 49 43 31 8 11 9 13 10 7 10 24 44 24 37 31 22 32 May 3 11 6 15 14 11 11 8 26 19 48 45 15 33 7 9 9 8 7 6 7 14 21 18 21 22 11 22 June 3 8 4 12 10 8 9 10 18 12 34 27 18 20 6 11 7 7 5 4 5 13 21 18 14 13 11 14 July 3 8 3 9 9 7 8 19 15 7 15 21 13 16 5 9 5 5 4 3 4 9 20 11 9 14 7 14 August 3 9 5 11 12 10 9 5 17 12 23 25 16 17 6 10 7 6 5 5 6 13 23 20 20 16 13 19 September 3 12 8 16 16 12 12 11 35 25 34 40 27 27 8 10 8 7 7 5 7 19 25 17 22 20 11 21 October 7 11 9 20 22 22 17 17 30 26 42 39 50 28 8 10 10 13 11 6 11 14 20 20 22 22 14 25 November 16 25 31 35 38 53 32 72 77 142 118 141 198 119 9 14 14 17 14 13 14 31 48 49 47 49 41 43 December 4 11 12 23 23 30 21 22 54 72 89 83 75 84 8 10 10 14 10 8 10 23 40 38 39 37 25 35 STATIONS CONTROLLED BY LAMBETH BOROUGH COUNCIL : - 1. LAMBETH TOWN HALL 2. LIBRARY, SOUTH LAMBETH ROAD 3. KENNINGTON SECONDARY SCHOOL, HACKFORD ROAD STATIONS CONTROLLED BY LONDON COUNTY COUNCIL :- 4. COUNTY HALL, LAB. ROOF 5. ROYAL FESTIVAL HALL 6. AMBULANCE STATION, LANDOR ROAD 7. COUNTY HALL, GROUND FLOOR 87 CLEAN AIR ACT, 1956 The Minister of Housing and Local Government confirmed The Lambeth (No.1) Smoke Control Order on 28th January, 1959. The Order came into operation on 1st October, 1959. In spite of assurances given by various Government Departments regarding supplies of smokeless fuel auite a number of owners and occupiers complain that they are unable to obtain adequate supplies of this type of fuel. During the year a circular was received from the Minister of Housing and Local Government inviting Councils in "Black Areas" to furnish information concerning the estimated number of Premises and acreage of land to be covered by Smoke Control orders made during 1959-63 (5 year Programme), the total number is intended ultimately to cover, and the target year for the completion of the programme. In addition to the declared Smoke Control Area No, 1, bounded on the north side by Prima Road, on the east by Brixton Road, on south-west by Stockwell Road and on the west and north-west ky Clapham Road, it has been decided to proceed with a further two areas adjacent to the present area as follows Area No.2 An area lying immediately to the south-west of Area No.1 being bounded on the north west by the south side of Stockwell Park Road, on the east by the west side of Brixton Road, on the south-west by Stockwell Road and on the west by the east side of Clapham Road. Area No. 3 An area lying immediately to the west and north west of Area No.-2. being bounded on the north by Harl eyfordRoad andKennington Oval, on the east by the west side of Clapham Road and on the south-west and west by South Lambeth Road. It is anticipated that with the area already declared, areas Nos.2 & 3 Will cover the period from 1959 to 1962. It is suggested that the years 1962 and 1963might be devoted to areas in which there are already large properties which do not require adaption, i.e. large blocks of flats built by the London 88 County Council and the Borough Council in which approved appliances are already installed. This arrangement would also provide some leeway for the completion of any work outstanding in respect of areas Nos.2 and 3. 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 17 - Untimed observations 788 - Other visits, private and industrial premises 1219 1895 90 CLEAN AIR EXHIBITION This Exhibition was held in the Assembly Hall from Friday, 19th February to Wednesday, 25th February, 1959 from 11 a.m. to 8 p.m. each day, including Sunday, from 2 p.m. to 6 p.m. The Exhibition was opened officially by His Worship the Mayor, who was supported on the platform by the Chairman of the Public Health Committee (Alderman Mrs. Mary Marock), the Chairman of the Public Relations Committee (Mr. Councillor E.J. Edwards), Mr. Alderman A.E. Cotton, the Deputy Town Clerk and the Medical Officer of Health. The Exhibitors included the London Electricity Board, the National Industrial Fuel Efficiency Service, the Coal Utilisation Council, the South Eastern Gas Board and the Lambeth Borough Council. The Borough Council's exhibit was prepared by the Public Relations Officer in conjunction with the Public Health Department. This particular stand proved a great attraction to officers of other local authorities who attended the Exhibition, and their comments were very favourable. The information desk was staffed throughout the Exhibition by the Smoke Inspectors. Whilst perhaps the number of people attending was not as large as one would wish, the number and type of enquiries received regarding smoke control areas, adaptions and the various types of appliances on view justified fully the amount of time and labour expended, and in this connection alone it would be true to say that the Exhibition was a success. The 'outside' exhibitors all expressed their satisfaction with the attendance and number of enquiries. 92 SECTION E INSPECTION AND SUPERVISION OF FOOD Food Hygiene Regulations 1955 - 1957 The inspection of food premises was continued throughout the year and it is gratifying that no major contravention of the Regulations was reported. Traders have continued to give their co-operation and where infringements were found the work necessary was generally carried out on the inspectors' request. Food Premises During the year under review, 2,059 inspections and revisits were made to food premises in the Borough. These inspections and revisits were made up as follows:- Inspections Re-visits Bakehouses 93 19 Butchers 499 —— Pried Pish Shops 56 1 Ice Cream Premises 127 5 Milk Shops 274 5 Public Houses 50 5 Restaurants 416 53 Other 426 30 1,941 118 The approximate number of food premises by type of business in the area is as follows Grocery and provisions 400 Greengrocery and fruit 168 Pish shops, wet, dry and fried 102 Bakers 96 Butchers 154 Restaurants 237 Confectioners 281 93 Food and Drugs Act. 1955 - Section 16 The number of registered pretrises is as follows:- Manufacture and/or sale of ice cream 576 Manufacture of sausages and preparation of preserved etc, food 324 Milk and Dairies (General) Regulations 1959 - Regulation 8 The number of registered distributors is 277 The number of registered dairies is 2 Milk (Special Designation) Regulations The following table shows the number of licences issued under the above mentioned Regulations during 1959, Dealers' Licences :- Tuberculin Tested 153 Pasteurised 228 Sterilised 262 Dealers' Supplementary Licences :- Tuberculin Tested 17 Pasteurised 19 Sterilised 21 Dealers (Pasteurisier's) Licence 2 SAMPLING OF FOOD AND DRUGS mical Analysis 200 samples were procured formally, 145 of which were of and 1,300 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 Samples Article Result of Analysis Action Taken Non-staining Iodine ointment 55% Deficient in iodine. Vendor prosecuted. Given absolute discharge on payment of costs. 94 Formal Samples (Continued) Article Result of Analysis Action Taken Non staining Iodine ointment 23% Deficient in iodine Vendor prosecuted. Case dismissed on warranty defence. Non al cohol ic Port Labelling offence None Informal Samples Milk bottle Small portions of dried leaf present Referred to Local Authority in whose area the bottling dairy was situated Meat pie Contained a threadless screw Brought to notice of manufacturer Glauber's Salt Almost free from water of crystallisation Stock sold out. Unable to obtain formal sample Corned beef Contained fine particles of cement Brought to notice of manufacturer and Ministry of Agriculture, Fisheries and Food Milk Added water. 2% Further samples taken and reported genuine Lemonade Some disinfectant cresol type present Brought to the notice of manufacturer Zinc and Castor oil B.P. 20% Deficient in zinc oxide Stock exhausted. Further samples taken Milk bottle Contained lime and sand Brought to notice of dairyman Jellied pork Corned beef supplied Considered isolated case in which genuine mistake was made. Further sample satisfactory Non staining Iodine ointment 42% Deficient in iodine. Formal sample taken 95 Informal Samples (Continued) Artie]e Result of Analysis Action Taken Non staining Iodine ointment 34% Deficient in iodine Formal sample taken Non staining Iodine ointment 22% Deficient in iodine Formal sample taken Milk bottle Active moulds over surface of bottle Brought to notice of vendor Milk bottle Cement on bottom of bottle Brought to notice of vendor Angel cake Mycelia and spores of fungi present Brought to notice of vendor Grants One live maggot found Balance of stock inspected and dealt with as unsound food Sul tanas One live maggot found Balance of stock inspected and dealt with as unsound food Chocolate ^ink Labelling offence Formal semple taken. Reported genuine Dried prunes A number of dead ants present Remainder of stock inspected. No infestation discovered Curry powder Rust from container: moulds Remainder of stock inspected and dealt with as unsound food Currant bread Cigarette end embedded. Manufacturer warned Borax Loss of water of crystallisation (5%) Further samples taken. Reported genuine Borax Loss of water of crystal 1isation (5%) Further samples taken. Reported genuine 96 Informal Samples (Continued) Article Result of Analysis Action Taken Bottle of Milk Dirt, including free sulphur Referred to Local Authority in whose area the bottling dairy was situated. Bottle of milk Dirty: Bottle insufficiently cleaned Brought to notice of bottling dairy Shredded suet Pat deficient (2.5%) Formal sample taken and found genuine Shredded suet Pat deficient (2.8%) Formal sample taken and found genuine Tea Contained rodent hairs: cat vomit Investigation cast some doubt as to authenticity of complaint 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 206 Ice lollies 31 * Bakers confectionery 10 *Egg albumen substitute 1 *Dried egg 1 *Canned frozen egg 1 *Meat stock 1 *Cooked brisket 1 Prawns (frozen) 1 *Egg white 1 *Whole egg 2 *Brisket of beef 2 *Gelatine 1 97 Bacteriological and other Examinations (Continued) Gelatine 2 Cream, double 1 Cream, single 1 *Ham and Lettuce sandwich 1 Whole milk powder 2 Skimmed milk powder 9 Egg yolk 1 Crab meat 1 Whole dried egg 17 Packing gland 1 Egg white solid spray 3 Dessicated coconut 3 Milk 6 Samples of milk were submitted to the Public Health Laboratory for examination under the Milk (Special Designations) Regulations, as fol1ows :- Methylene Blue Tests 189 (of which 16 were void, the atmospheric shade temperature being over 65°F) Phosphatase Tests 186 All samples were satisfactory. The 206 samples of ice-cream and ice-cream mix were submitted to the Methylene Blue Test, approximately 40% more than in 1958, This was partly because of the warmer summer and partly because some of the samples (25 in all) fell into grades 3 and 4. Investigations into the causes of these apparently less satisfactory results (nearly all from one manufacturer) necessarily increased the degree of supervision of the operation and cleaning of the plant involved, including the number and types of samples taken. The co operation of the Director of the Public Health Laboratory service the County Hall Laboratory was enlisted and Plate counts and examinations for coliform and heat resistant organisms were undertaken. Icecream mix at various stages of production, raw material ingredients and a part of the plant as 98 we]l as the final product were so examined in addition to the routine methlylene blue test on the ice cream and mix samples. The results of samples taken from the Manufacturer in auestion are summarised below:- Ice crean and Ice cream Mix Total No. of Samples - 48 Methylene Blue Test - Grade 1 - None Grade 2 - 33 Grade 3 - 10 Grade 4 - 5 Plate Count - Total No. of Samples - 30 Total Count Highest 2,500 cols/ml. Lowest less than 100 cols/ml. Bact. Coli All less than 100 cols/ml. Ingredients and Plant A heat resistant organism found in 5 samples of skimmed milk powder out of 11 submitted and in a packing gland in the homogeniser was identified as bacillus cereus. The countries of origin of the skimmed milk powder were Australia, New Zealand. Eire and England. The fact that the total count for these samples was predominantly low tends to confirm what is already maintained by laboratory workers in this field that even small numbers of this organism can influence the methylene blue gradings, therefore if its incidence in an important ingredient of ice cream is as high as suggested by this isolated example some revision in the interpretation of methylene blue results would appear to be desirable. INSPECTION OF FOOD 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. 99 UNSOUND FOOD CONDEMNED Canned Tons Cwts. Qrs. Lbs. Meat 3 4 3 5½ Fruit 2 10 2 6¼ Vegetables 1 - 1 14¾ Fish 3 - 19¾ Milk 2 1 17¼ Soup 4 - 2 Preserves 3 8 Cream 10½ Cereal 2 5¼ Spaghetti 26 Lard 2 - Fruit Juice 2 -½ Tomato Juice 1 - 7½ Pudding 15¾ Sausages 4 Beverage -½ 7 9 1 3½ Fresh pigs Heads 2 4 3 26 Fruit 1 10 - - Yams 15 - - pish 9 3 12 Meat 15 2 6 offal 4 2 26 ¼ Pou]try 10 2 22½ Rabbits 25 Milk 25 Vegetables 1 - 6 11 2 2¾ 100 Prepared Tons Cwts. Qrs. Lbs. Bacon 2 15 - 25¾ Cereals 1 1 -½ Sugar 1 4 Pickles 3 - 13¼ Suet 1 12½ Sauce 12 Ham 1 - 2 Pork 11½ Dried Fruit 3 5½ Preserves 7 Cheese 1 3 15 Coffee and Coffee Extract 5¼ Mustard 4¾ Sausages 8 - 16 Pies 1 8¼ Vinegar 1¼ Sal ad Cream 2 2 13 Margarine 24 Cakes and Biscuits 1 - 6½ Drinks 1 - 20½ Fish 2 - Confectionery 1 2 1½ Jelly 2 Spaghetti 1 12 Coconut ¾ Soup ¼ Flour 7 Meat and Vegetable Extract 1 Vegetables 1 3 Chips 3¼ Fish 1 18 Chicken 11¼ Almonds 1 4 1 - 17½ TOTAL WEIGHT 18 1 3 23¾ 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 diverted to approved sources for utilisation as pig food. 101 FOOD COMPLAINTS - 1959 94 complaints about food were received and set out below is a list of 66 of these whichs after investigation were considered to be justified. 1. Bread Contained a nut 2. Milk Contained small portions of dried leaf 3. Luncheon Meat Contained bristle 4. Meat Pie Contained screw 5. Canned Marmalade Apricot Jam 6. Corned Beef Contained foreign matter 7. Lemonade Foreign odour 8. Milk Sour 9. Bread Contained bristle 10. Butter Contained piece of parchment paper 11. Sausage Roll Mouldy 12. Milk Contained glass 13. Milk Contained lime and sand 14. Bread Contained fibres of sacking and string 15. Suet Rancid 16. Sausage Roll Mouldy 17. Pastry Mouldy 18. Bread Contained fibrous part of wheat flour 19. Orange Juice Unusual flavour 20. Meat Pattie Contained piece of bone 21. Bun Contained nail 22. Pie/Pastry Unpleasant taste 23. Pies Mouldy 24. Plastic water bottle Water turns pink 25. Bread Mouldy 26. Angel Cake Foreign matter 27. Milk Bottle Dirty on inside 28. Meat Contained bullet 29. Tin of Pineapple Contained wasp 30. Cauliflower Contained large caterpillar 31. Milk Bottle Dirty on outside 32. Snow Cake Mouldy 33. Sultanas Contained maggots 34. Bread Mouldy 35. Currants Contained maggots 36. Chocolate Contained maggots 37. Bread Contained oil 38. Milk Contained active moulds 39. Bread Mouldy 40. Bun Contained wasp 41. Meat Pie Mouldy 42. Churns of Milk Contained black specks, carbon 43. Churns of Milk Contained black specks, carbon 44. Bread Contained wasp 45. Meat Pie Mouldy 46. Lites Unwholesome smell 47. Bacon Contained cloth 48. Chocolate Contained maggots 49. Pastry Contained head of a moth 50. Fruit Pie Mouldy 51. Crumpets Mouldy 52. Oats Contained maggots 53. Cheesel'ets Stale 102 FOOD COMPLAINTS (Continued) 54. Soup, canned Contained stone 55. Milk Bottle Dirty 56. Bread Contained streaks of dirt 57. Milk Contained fungus and black specks 58. Bread Contained cigarette end 59. Mincemeat Mouldy 60. Mincemeat Mouldy 61. Bottle of Lemonade Foreign taste 62. Milk Contained glass 63. Doughnut Contained small piece of hair 64. Dried Fruit Contained caterpillar 65. Meat Pie Mouldy 66 Bacon Contained glass All complaints were investigated and careful consideration was given to the action which should be taken. As a result one prosecution was instituted in the undermentioned case with the result shown :- 16. Sausage Roll - Mouldy Pined £5 Costs £1. 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 liabilities. 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 Of ficer of Health of the district concerned or, where appropriate, the Minister of Agriculture, Fisheries and Food, 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. 103 SECTION F GENERAL Public Swimming Baths I am indebted to the Scientific Adviser of the London County Council for the following report on the London County Council Shimming Bath' situated in Brockwell Park. The bath of 750,000 gallons capacity is filled with Metropolitan Water Board mains water. The bath water is treated by continuous filtration with pressure type sand filters, together with break-point chlorination, alum and soda dosing and deration. The time of circulation is 5 hours and the bath is emptied once per year. The results obtained from the bacteriological examinations during 1959 were as follows:- Standards Agar Count 1 ml.37°C. 48 hrs. Presumptive coliform pollution without faecal Faecal coliform pollution 0-10 11-100 Over 100 No. of Samples 10 1 0 0 1 Almost 300,000 bathers used the bath during 1959, which was an exceptionally heavy year for bathing. The single case of faecal pollution found was due to a small technical fault which was soon rectified. In the circumstances the results of the bacteriological examinations are considered most satisfactory. NATIONAL ASSISTANCE ACT 1948 Section 50 Burials Under Section 50 of the National Assistance Act, 1948, the eth 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 arrangement for the disposal of the body have been or are being made. 104 Section 50 - Burials (Continued) During the year, 22 funerals were arranged involving 16 males, 4 females and two still-born children. The amount paid to funeral contractors was £241. 18s. 0d. the sum of £138. 12s. 1d. was recovered by way of grants, insurance policies and money found. The actual cost to the Council was therefore £103. 5s. 11d. LAND CHARGES ACT 1925 During the year, 2,819 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 153. 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 recevied during the year. 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. 105 PET ANIMALS ACT 1951 (Continued) A local authority may on applications 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 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£ 19 licences were issued under the Act. No. of Inspections - 28 No. of Re-visits - 3 LONDON COUNTY COUNCIL (GENERAL POWERS) ACT 1954 Hairdressers 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 14 registrations were made. 106 Hairdressers and Barbers (Continued) The total number of premises and persons on the register at the end of the year was as follows:- Premises 187 Persons 203 Number of Inspections 111 Number of Re-Visits 30 Exhumation Orders The Home Secretary issued one Order for the removal of human remains from a grave in this district, A public health inspector was present to see that the terms of the Order were fulfilled and that no nuisance or danger to public health was permitted. Health Education During the year a two day course for Public Health Inspectors on ''Modern Methods of Presenting Health Education" was held in the Town Hall. The Lambeth Borough Council provided the accommodation free of charge and the course was under the auspices of the Central Council for Health Education and the Public Health Department. The Chairman was the Medical Officer of Health and the Lecturer, Mr. D. Lynton Porter, Education Officer of the Central Council for Health Education. In addition to Public Health Inspectors from Lambeth those from neighbouring boroughs attended. The programme was as follows:- First Day 10 - 11 a. m. MODERN METHODS USING THE TOPIC AND PROBLEM CENTERED APPROACH 11. 15 a, m. - DEMONSTRATIONS OF SOME INTIMATE METHODS OF 12.30 p.m. HEALTH EDUCATION OF THE PUBLIC 2 - 3.30 p.m. THE USE OF FILMS IN HEALTH EDUCATION Films: Everybody's Business Guilty Chimneys 3.30 - 4 p.m. DISCUSSION AND PREPARATION FOR PRACTICAL WORK 107 health Education (Continued) Second Day 10 a.m. - PREPARATION OP PRACTICAL TASKS: 12.30 p.m. (i) Planning and presentation of Panel Discussion on "Clean Air, Today and Tomorrow", or "Clean Food, Today and Tomorrow". (ii) Illustration and presentation of talk to shopkeepers and food handlers on "Clean Pood (iii) Illustration and presentation of talk to ratepayers' association on "Clean Air" . (iv) Planning a Health Week. 2 - 4 p.m. PRESENTATION OP PRACTICAL WORK. It would appear that the course was entirely satisfactory and was enjoyed by those attending it. The lecturer was excellent and thanks are due to the Central Council for Health Education for providing the opportunity to hold the course in Lambeth.