METROPOLITAN BOROUGH OF LAMBETH annual report OF THE medical officer of health FOR THE YEAR 1960 * F. SUMMERS, M.B., B.S., M.r.C.S., L.R.C.P., D.P.H. Medical Officer of Health METROPOLITAN BOROUGH OF LAMBETH * annual report OF THE Medical officer of health FOR THE YEAR 1960 * 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 1951 1960 16 Classification of Deaths 17 Notes on Vital Statistics 20 Deaths from Cancer of Lung or Bronchus 21 Road Traffic Accidents 24 Section B :Prevalance 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 42 International Certificates of Vaccination 45 Tuberculosis 46 Report of Chest Physician 50 Section C :General Provision of Health Services for the area Care of the Aged 53 Action under Section 4.7 National Assistance Act, 1948 ^4 Laundry Service for Aged Incontinent Persons 55 Home Bathing Service 56 Holidays for the Elderly 56 Lambeth Old People's Welfare Association 58 Hospital Facilities 62 Personal Health Services Provided by London County Council 62 Public Health Laboratory Service 63 Section D :Sanitary Circumstances of the Area Water Supply 64 Sewers 65 Summary of Visits and Inspections by Inspectorial Staff 66 Complaints 67 Section D :Sanitary Circumstances of the Area (continued) Page Drain Testing 67 Dangerous Structures 67 Summary of Defects and Nuisances Found 67 Notices Served 68 Legal Proceedings - Public Health (London) Act, 1936 69 Dwelling Houses Rendered Fit 69 Section 95 Public Health (London) Act, 1936 69 Drainage Plans 69 Offensive Trades 70 Disinfection 70 Disinfestation 70 Rodent Control 70 Factories Acts, 1937 and 1948 71 Rent Act, 1957 74 Rehousing and Overcrowding 75 Housing Act, 1957 - Record of Work carried out by Housing Inspectors 76 Slum Clearance Programme, 1956 - 60 79 Slum Clearance Programme 1961- 65 80 Improvement Grants 80 Atmospheric Pollution 83 Clean Air Act, 1956 93 Section E :Inspection and Supervision of Food Food Hygiene Regulations, 1955- 60 96 Food Premises 96 Food and Drugs Act, 1955 - Section 16 97 Milk and Dairies (General) Regulations, 1959 97 Milk (Special Designation) Regulations 98 Sampling of Food and Drugs 98 Inspection of Food 102 Unsound Food 102 food Complaints 104 Street Markets 105 Slaughter of Animals Act 105 Section F :General Public Swimming Baths 106 National Assistance Act, 1948 - Section 50 - Burials 106 Land Charges Act, 1925 107 Pharmacy and Poisons Act, 1933 107 Rag Flock and Other Filling Materials Act, 1951 107 Pet Animals Act, 1951 107 Hairdressers and Barbers 108 Exhumations 108 Control of Movable Dwellings 109 5 METROPOLITAN BOROUGH OF LAMBETH PUBLIC HEALTH COMMITTEE (Appointed by the Council on 27thMay, 1960) The Worshipful the Mayor of Lambeth (Mr. Councillor Charles Frederick Hart, 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 Miss B.W. High Mrs. L.L. Hunt Miss K.L. Jenner Mrs. E.M. Knapp A.G. McCormack R.R.W. Nichols, M.R.C.S., L.R.C.P. Mrs. W.E. Privett Miss J. Williams , A.M.L.A. 6 STAFF OF THE PUBLIC HEALTH DEPARTMENT MEDICAL OFFICER OF HEALTH F. Summers, M.B., B.S., M.R.C.S., L.R.C.P., D.P.H. PUBLIC ANALYST (PART - TIME) J. E. Woodhead, B.Sc., F.R.I.C., Ph. C. CHIEF ADMINISTRATIVE ASSISTANT J. M. Roberts PUBLIC HEALTH INSPECTORS (a) District Inspectors W. Bonnin (1) (2) H.F. Bryan (1) R.G. Cutler (1) D.J. Huggins (1) (2) E.E. Morgan (1) (2) R.A. Newton (1) (2) J.B. Sainsbury (1) S.G. Starling (1) (2) H. Taylor (1) (2) Four vacancies (b) Food Inspectors S. Bradley (1) (2) C.W. Idle (1) (2) Retired 2.12.60. F.Russell (1) (2) (5) Appointed 7.12.60 (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) Appointed Food Inspector 7.12.60 After 6.12.60 1 vacancy (f) Woman Inspector Miss. A.F. Crombie (1) (4) (6) (g) Public Health Visitor Miss M. McNair (5) (6) CLERICAL STAFF Mrs. J. Clark H.C. Collins (Appointed 23.1.60) Mrs. P. Dubury Mrs. S.E. Foulds (Appointed 24.2.60) Mrs. G. Hopkins (Retired 27.1.60) N.A. Jupp Mrs. J. Kincart E.F. Mannetson Mrs. K.M. O'Sullivan Mrs. M. Rogers J.W. Tiffney E. Walker DISINFECTING STATION Wanless Road, Loughborough Junction, S.E.5. Superintendent L. Brann 2 Drivers 2 Disinfectors 1 Stoker 1 Apparatus Attendant 8 GENERAL ASSISTANTS W. Deamer (Assistant Rodent Officer) L. Whiston (Rodent Operative) J. Martin BATHING ATTENDANTS HOME BATHING SCHEME FOR OLD PEOPLE Mrs. R. Bagge (Part-time) Miss F. Hones (Part-time) (1) Cert. S.l.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, 1961 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Lambeth. Mr.Mayor, Ladles and Gentlemen, I have the honour to present my Annual Report for the year 1960 on the health of the Borough. The Registrar-General's estimated mid-year population is 224,080, an increase of 780 over last year. The death rate is lower than that of last year, 10.86 as compared with 11.38 and the birth rate at 19.55 per 1000 home population is the highest recorded in the Borough since 1947 when it was 23.10. One disturbing feature is the high proPortion of illegitimate births but against this the illegitimate infantile mortality has shown a marked fall compared with last year. The infantile mortality at 21.0 per 1000 live births is the second lowest in past ten years. The increase in the number of deaths from cancer of the lung which has been apparent for a number of years now continues. In the field of infectious disease I have to record the occurrence of a small Outbreak of diphtheria. These sporadic outbreaks have been occurring in various Parts of the country and no doubt reflect the attitude of parents who see no urgency to get their children protected against a disease of which they have only heard. Whilst perhaps many get their children immunised in infancy the need for reinforcing injections is not appreciated. The result is that the level of immunity the community falls and any infection which is introduced spreads more easily. The welfare of the aged is a matter in which the Council has continued to take an active interest by its generous financial assistance to the Lambeth Old people's Welfare Association whose work has continued to expand. The provision holidays at Margate for old age pensioners at reduced rates has been much appreciated and during the year 339 old persons availed themselves of this 10 In December, Mr. C. W. Idle, Food Inspector, who had been on the staff of the department for 35 years, retired. He was a very loyal and valued member of the department and we wish him a long and happy retirement. This retirement brought the number of vacancies on the inspectorial staff to five and, owing to the shortage of inspectors in the country generally, and London in particular, it is not likely that they will be filled easily. The Council has a training scheme for Public Health Inspectors, but as the course of training is four years it will be some time before the benefits will be felt in the department. Finally, I would like to thank the Members of the Council and of the Public Health Committee for their support and encouragement during the year and also to acknowledge the loyal and conscientious service of the staff of the department. 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 6½ 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 reclaimed. 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 17½ miles. The Borough has approximately 328 acres of open space, including Brockwell, Bennington, 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. 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 4,037.5 acres No. of Wards 21 No. of Parliamentary Constituencies 3 Population Figure supplied by Registrar General (Mid-year estimate 1960) 224,080 Density of Population i.e. number of Persons per acre 54.8 Number of marriages during the year 1901 Marriage rate per 1,000 Population . 8.5 Marriage rate per 1,000 Population England and Wales 15.0 Rateable Value of District (1960/61) £4,269,742 Sum represented by a Penny Rate (1960/61) £17,350 Number of separately rated houses and flats (1960/61) 56,462 BIRTHS Live Births Legitimate Illegitimate Totals Males 2,033 364 2397 Females 2,045 360 2405 Totals 4,078 724 4802 Live Birth Rate per 1,000 Home Population 21.43 Birth Rate corrected for comparison with other areas 19.55 Comparability Factor supplied by Registrar General 0.91 13 Birth Rate per 1,000 Home Population County of London 17.8 Birth Rate per 1,000 Home Population England and Wales 17.1 Corresponding Rate for the Borough of Lambeth for the year 1959 19.09 Illegitimate Live Births per cent of total live births 15.8% STILL BIRTHS Legitimate Illegitimate Totals Males 38 3 41 Females 41 6 47 Totals 79 9 88 Still Birth Rate per 1,000 Total Births (i.e. live and still) 18.00 Still Birth Rate per 1,000 Home Population 0.39 Still Birth Rate per 1,000 Total Births England and Wales 19.7 DEATHS Males Females Total 1273 1115 2388 Death Rate per 1,000 Home Population 10.65 Death Rate corrected for comparison with other areas 10.86 Comparability Factor supplied by Registrar-General 1.02 Death Rate per 1,000 Home Population, England and Wales 11.5 14 Corresponding rate for the Borough of Lambeth for the year 1959 11.38 Death Rate per 1,000 Home Population, County of London 11.5 MATERNAL MORTALITY Number of women dying in consequence of childbirth 2 Maternal Mortality Rate per 1,000 Total Births 0.41 Maternal Mortality Rate per 1,000 Total Births County of London 0.47 INFANTILE MORTALITY Deaths of infants under 1 year of age Legitimate Illegitimate Totals Males 53 7 60 Females 39 2 41 Totals 92 9 101 Death Rate of Infants under 1 year of age per 1,000 live births 21.0 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 21.7 Legitimate Infantile Mortality Rate 22.5 Illegitimate Infantile Mortality Rate 12.4 Deaths of Infants under 4 weeks of age:- Legitimate Illegitimate Totals Males 36 7 43 Females 28 1 29 Totals 64 8 72 15 Neo-natal Mortality Rate per 1,000 live births 14.99 Neo-natal Mortality Rate per 1,000 live births, County of London 15.9 Deaths of Infants under 1 week of age:- Legitimate Illegitimate Totals Males 34 6 40 Females 26 1 27 Totals 60 7 67 16 BOROUGH OF LAMBETH SUMMARY OF VITAL STATISTICS FOR THE TEN YEAR PERIOD 1951 - 1960 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 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 2385 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 1960 224,080 2,388 10.86 4,802 19.55 101 21.0 2 .41 * As adjusted by Comparability Factor 17 DEATHS OF LAMBETH RESIDENTS DURING 1960 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 8 3 11 F 1 1 2 4 2. Tuberculosis, other M F 1 2 1 2 6 3. Syphilitic Disease M 2 2 4 F 1 2 3 4. Diphtheria M F 5. Whooping Cough M F 6. Meningococcal Infection M 1 1 F 7. Acute Poliomyelitis M F 8. Measles M F 9. Other Infective and Parasitic Diseases M 1 2 2 5 F 1 1 10. Malignant Neoplasm, Stomach M 2 9 12 6 29 F 2 11 11 24 11. Malignant Neoplasm, Lung and Broncus M 2 7.3 56 18 149 F 2 10 3 4 19 18 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 3 25 9 11 48 13. Malignant Neoplasm, Uterus M F 1 5 6 4 1 17 14. Other Malignant and Lymphatic Neoplasms M 3 43 32 30 108 F 1 1 1 9 33 41 37 123 15. Leukaemia, Aleukaemia M 4 2 1 7 F 1 1 2 16. Diabetes M 1 1 1 1 4 F 1 5 4 10 17. Vascular Lesions of Nervous System M 24 38 29 91 F 1 25 38 92 156 18, Coronary Disease, Angina M 9 105 88 59 261 F 1 24 53 106 184 19. Hypertension with Heart Disease M 3 8 8 19 F 2 4 14 20 20. Other Heart Disease M 7 16 24 44 92 F 2 15 25 104 146 21. Other Circulatory Disease M 4 13 10 20 47 F 9 13 47 69 22. Influenza M 1 2 3 F 1 1 23.Pneumonia M 6 2 1 14 29 31 83 F 8 5 12 39 64 19 CAUSES OF DEATH Under 1 year 1 - 4 years 5 - 14 years 15- 24 years 25 - 44 years 45 -64 years 165 - 74 years '75 years and over TOTALS 24. Bronchitis M 4 1 24 36 31 96 F 1 2 9 22 34 25. Other Diseases of the Respiratory System M 3 5 5 13 F 1 1 1 3 6 26. Ulcer of Stomach and Duodenum M 6 9 10 25 F 1 4 6 11 27. Gastritis, Enteritis and Diarrhoea M 3 1 1 5 F 1 2 1 4 28. Nephritis and Nephrosis M 1 3 4 3 2 13 F 2 2 1 4 9 29. Hyperplasia of Prostate M 6 12 18 F 30. Pregnancy, Childbirth and Abortion M F 2 2 31. Congential Malformations M 7 2 1 1 1 1 1 1 1 5 F 7 1 1 1 1 11 32. Other Defined and Ill- Defined Diseases M 39 1 1 4 18 17 19 99 F 23 1 3 4 17 18 48 114 33. Motor Vehicle Accidents M 1 7 6 5 5 2 26 F 1 1 3 4 9 34. All other Accidents M 1 6 2 5 25 F 1 3 1 5 35. Suicide M I 7 7 6 2 23 F 1 6 2 2 11 36. Homicide and Operations of War M 1 1 F 1 1 2 ALL CAUSES TOTALS M 60 7 4 12 59 397 396 338 1273 F 41 2 4 6 35 194 268 565 1115 GRAND TOTALS 101 9 8 18 94 591 664 903 2388 20 VITAL STATISTICS Population According to the estimated mid-year figure supplied by the Registrar General the population of Lambeth rose by 780, the population being 224,080 compared with 223,300 in 1959. Births The number of live births increased by 120 giving a corrected birth rate of 19.55 per 1,000 home population compared with 19.09 in 1959. The birth rate is higher than those for England and Wales and the County of London which are 17.1 and 17.8 per 1,000 home population respectively. The number of illegitimate live births increased by 80, 724 occurring compared with 644 in 1959. The number of live births is in excess of the number of deaths giving a natural increase of 2414 but this is probably offset by movement of population out of the Borough as the population figure supplied by the Registrar General shows an increase of only 780. STILL BIRTHS The number of still births fell giving a reduced still birth rate of 18.00 per 1,000 total births. This compares favourably with the rate for England and Wales which is 19.7 per 1,000 total births. DEATHS The number of deaths decreased by 46, giving a corrected death rate of 10.86 compared with 11.38 per 1,000 home population in 1959. This compares favourably with the rates for England and Wales and the County of London which are both 11.5. Heart and associated diseases accounted for the largest number of deaths. All forms of malignant neoplasms caused 517 deaths, an increase of 33 over the figure for 1959. 21 Fifteen people died from respiratory tuberculosis compared with 27 last year, a decrease of 12, but the number dying from other forms of tuberculosis increased by 4, 6 deaths occurring compared with 2 in 1959. Unfortunately the deaths from motor vehicle accidents increased again this year, 35 deaths occurred compared with 29 last year. This increase is confined entirely to the men, 26 compared with 19. Nine women lost their lives in motor vehicle accidents compared with 10 in 1959. The number of people taking their own lives increased from 30 in 1959 to 34 during the year under review. Twenty-three males committed suicide compared with 11 females. Three deaths occurred as a result of homicide, the same as last year. Infantile Mortality The number of infants dying before reaching 1 year of life fell from 116 last year to 101, giving a reduced infantile mortality rate of 21.0 per 1,000 live births. This rate compares favourably with that for England and Wales which is 21.7 and that for the County of London which is 22.0 per 1,000 live births. Of the 101 deaths 92 were in respect of legitimate infants, an increase of 2 on the 1959 figure, and 9 in respect of illegitimate children a reduction of 17. The number of infants dying in the first four weeks of life fell from 91 to 72 giving a reduced neo-natal mortality rate of 14.99 per 1,000 live births. Maternal Mortality Two women died as a result of childbirth giving a maternal mortality rate 0.41 per 1,000 total births. Death8 from Cancer of the Lung and Bronchus Deaths from cancer of the lung and bronchus increased from 125 in 1959 to 168 during the year under review. , Forty-nine more men died from the disease but the figure for women fell by 6. The deaths among males was nearly eight times as great as those for females, 149 compared with 19. 22 The deaths were split amongst the various age groups as follows. The figures in brackets are those for the year 1959:- Males Females Totals 25 - 44 years 2 (2) 2 (-) 4 (2) 45 - 65 years 73 (48) 10 (12) 83 (60) 65 - 74 years 56 (37) 3 (9) 59 (46) 75 years and over 18 (13) 4 (4) 22 (17) 149 (100) 19 (25) 168 (125) ' In the last eleven years 1316 deaths have occurred from lung cancer, whilst over the same period the number of deaths from respiratory tuberculosis was 461. The accompanying graph gives the comparison between the deaths from cancer of the lung and respiratory tuberculosis. 23 comparison of deaths from respiratory tuberculosis and cancer of lung and bronchus 24 ROAD TRAFFIC ACCIDENTS The following tables show the toad traffic accidents occurring within the Borough of Lambeth during the year 1960 and the comparative figures and casualties for the period 1954 • 1960. 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. My thanks are due to the Town Clerk for supplying me with the figures. 25 ROAD TRAFFIC ACCIDENTS 1960 WITHIN THE BOROUGH OF LAMBETH Month No, of Accidents Adults Children Total Killed Seriously Injured Slightly Injured Killed Seriously Injured Slightly Injured J anuary 134 3 29 121 _ 1 20 174 F ebruary 128 - 20 105 1 3 18 147 March 149 1 21 128 - 3 15 168 April 156 1 26 127 - 4 21 179 May 161 1 19 121 - 7 28 176 June 167 4 16 149 1 5 31 206 July 164 - 16 152 1 5 25 199 August 158 - 19 134 - 9 35 197 September 166 3 23 138 - 6 22 192 October 179 2 26 167 - 4 25 224 November 178 2 33 177 - 7 19 238 December 150 1 25 149 - 5 17 197 totals 1,890 18 273 1668 3 59 276 2,297 Accidents per mile of road 16.2 26 BOROUGH OF LAMBETH COMPARATIVE FIGURES OF ACCIDENTS AND CASUALTIES FOR THE PERIOD 1954 1960 1954 1955 1956 1957 1958 1959 1960 Number of accidents involving personal injury 1,032 1,246 1,272 1,212 1,505 1,739 1,890 Accidents per mile of road 7.29 8.80 8.98 8.56 12.6 14.6 16.2 Casualty Figures Adults Killed 12 14 12 12 17 21 18 Seriously Injured 180 187 174 196 240 254 273 Slightly Injured 756 1,002 1,067 1,052 1,293 1,535 1,668 Totals 948 1,203 1,253 1,260 1,550 1,810 1,959 Children Killed 1 1 2 1 2 2 3 Seriously Injured 30 35 29 24 45 44 59 Slightly Injured 196 189 211 175 193 204 276 Totals 227 225 242 200 240 250 338 Combined Adults and Children Totals 1,175 1,428 1,495 1,460 1,790 2,060 2,297 27 NUMBER OF ACCIDENTS INVOLVING PERSONAL INJURY PERIOD 1954 - 1960 28 NUMBER OF PERSONS KILLED PERIOD 1954-1960 29 ROAD TRAFFIC ACCIDENTS PERIOD 1954 1960 30 ROAD TRAFFIC ACCIDENTS PERIOD 1954 - 1960 31 Although the number of adults killed on the roads decreased by 3, 18 Persons being killed compared with 21 in 1959, the number of seriously injured adults increased from 255 to 273 and the number of slightly injured from 1535 to 1668. The total adult casualties increased from 1810 to 1959. The figures for children also increased, 3 children being killed compared with 2 in 1959, 59 were seriously injured compared with 44 and 276 slightly injured compared with 204. The combined total casualties for adults and children rose from 2060 to 2297. The number of accidents per mile of road increased from 14.6 in 1959 to 16.2. During the last seven years the number of adult casualties has increased from 948 to 1959 and children from 227 to 338. The figure for all road casualties has risen from 1,175 to 2,297, in fact nearly doubled. This presents a grim picture. 33 SECTION B PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES The undermentioned diseases are compulsorily notifiable within the Borough °f Lambeth, Anthrax Cholera Continued Fever Diphtheria Dysentery Encephalitis, acute Enteric Fever Erysipelas Food Poisoning Glanders Hydrophobia Malaria Measles Membranous Croup Meningococcal Infection Ophthalmia Neonatorum Paratyphoid Fever Plague Pneumonia, acute influenzal Pneumonia, acute primary Poliomyelitis, acute Puerperal Pyrexia Relapsing Fever Scabies Scarlet Fever Smallpox Tuberculosis, all forms Typhoid Fever Typhus Fever Whooping Cough following tables show the total number of corrected notifications, other than tuberculosis, received during the year. NOTIFICATIONS (CORRECTED) EXCLUDING TUBERCULOSIS Disease 1st Quarter 2nd Quarter 3rd Quarter 4 th Quarter Totals Grand M F M F M F M F M F Total ^parlpl- Fpvpr 21 24 8 11 8 4 10 11 ,47 50 97 OLClliCl 1 CVC1 Whooping Cough 34 48 40 42 58 63 34 42 166 195 361 Acute Poliomyelitis Paralytic - 1 ■ - - - 2 1 2 2 4 Won- Paralytic - - - 3 - - - ~ 3 3 Measles 13 9 96 118 91 83 73 59 273 269 542 Diphtheria 2 - - - - - 1 2 1 3. Dysentery 66 79 55. 72 21 29 15. 24 157 204 361 o Meningococcal Infection - - 1 1 - 1 " 3 1 n 3 /I c Pneumonia 10 9 1 7 3 1 6. 2 26 19 9 Acute Encephalitis (Infective) - - 1 - " 1 ~ 2 Z o Paratyphoid Fever - - - - 3 - - 3 3 Erysipelas 2 - - - 2 3 2 " 6 3 oo 9 Food Poisoning 10 9 5 13 5 9 2 1 22 32, c 1 Puerperal Pyrexia - 16 - 12 - 3 3Q " 6L 61 A Ophthalmia T'eonatorum - - 1 Z - " 1 3 1 4 1 *7 Scabies 3 9 L, 1 - 1 3 3 4 8 9 17 TOTALS 161 197 215 278 195 198 149 176 720 849 1569 34 Notification of infectious disease- age distribution Age Groups Scarlet Fever Whooping Cough Acute Poliomyelitis Measles Diphtheria Dysentery Meningococcal Infection Scabies TOTALS Faralytic Non-Paraytic M F M F M F M F M F M F M F M F M F Under 1 year 1 2 20 30 - - - 3 10 13 - . 11 13 1 - . . 104 1 year 2 2 23 27 - - - - 29 47 - • 14 16 1 - - - 161 2 years 2 1 26 28 1 - - - 44 41 1 - 17 11 - - - 1 173 3 years 4 4 16 21 1 - - - 59 33 - - 6 8 - - 1 1 154 4 years 8 7 9 20 - - - - 31 24 - - ■ 8 9 1 - - - 117 5-9 years 22 29 67 62 - - - - 94 105 1 - 36 45 - - - 1 462 10 - 14 years 7 o «J 5 4 - - - - 4 3 - 1 11 15 - - - 1 54 15 to 24 years 1 1 - 1 - 2 - - 2 2 - - 11 39 - - 4 4 67 25 and over - 1 - 2 - - - - - 1 - - 43 48 - - 3 1 99 TOTALS 47 50 166 195 2 2 - 3 273 269 2 1 157 204 3 - 8 9 1391 Age Groups Pneumonia Acute Encephalitis (Infective) Paratyphoid Fever Erysipelas Food Poisoning Puerperal Pyrexia Ophthalmia Neonatorum TOTALS M F M F M F M F M F M F M F Under 5 years 5 - 2 - 2 - - - 5 1 - . 3 1 19 5-14 years 2 - - - 1 - - - 3 11 - . . - 17 15 - 44 years 4 7 - - - - 3 2 10 11 - 61 . - 98 45 - 64 years 11 9 - - - - 2 1 2 5 - • _ . 30 65 and over 4 3 - - - - 1 - 2 4 - - - 14 TOTALS 26 19 2 - 3 - 6 3 < 22 32 - 61 3 1 178 35 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 Diphtheria Dysentery Meningococcal Infection Scabies Pneumonia Acute Encephalitis Infective) Erysipelas Food Poisoning Paratyphoid Fever Puerperal Pyrexia Ophthalmia Neonatorum TOTALS Marsh 4 16 1 - 14 - 59 - 1 6 - 1 - - 34 1 137 Bishop's 9 16 1 - 31 1 49 - 1 - - 1 1 2 . . 112 Prince's 9 8 - 2 24 - 57 - 2 4 . 1 1 - 18 1 127 Oval 7 7 . * 16 2 23 - - 1 . 2 5 . . . 63 Springfield 1 25 1 - 7 ' 39 1 1 1 . 1 15 . 6 . 92 Lansdowne 9 24 . - 13 . 26 . . 3 . 11 . . . . Vlinet - 9 . - 16 . 10 . 1 . . . . . . 1 62 Angell 3 8 - - 40 . 7 . . 3 . . . . . 1 99 Vassal 2 47 . . 21 . 18 . 2 9 . 3 . 1 . 66 Grove 2 36 . . 10 . 9 1 . 3 . 1 3 . 1. . 58 Stockwell 7 9 - - 31 . 5 . . 3 . 30 . 1 . 62 Landor 5 14 . • 30 . 9 . . 1 1 1 . . . 90 Ferndale 5 21 . - 50 . 10 . 1 2 . 1 . . . 46 Town Hall 3 13 - 1 21 4 . - 2 ~ 1 1 . . . 46 Heme Bill 4 8 - - 24 . 5 . 3 1 1 . . 1 . 88 Effra 5 25 . . 44 . 9 1 1 2 . . . . . . 105 Tulse Hill 4 18 - - 77 . 2 . 2 1 . . 1 . . 1 Thurlow Park 5 4 . - 14 - 3 . 2 1 . . 8 . . 1 38 LeighaM 2 14 1 - 50 - 5 - 1 " - 3 " ~ 76 Knight's Hill 5 26 - - 5 * 10 . . . . . . 1 . . Romany 6 13 - - 4 . 2 . . 1 - 1 • . . . 27 TOTALS 97 361 4 3 542 3 361 3 17 45 2 9 54 3 61 4 1569 36 37 PARLIAMENTARY CONSTITUENCIES Number of cases of Infectious Disease notified in each Parliamentary Constituency of the Borough. Disease Parliamentary Constituency Totals Vauxhall Brixton Norwood Scarlet Fever 39 27 31 97 Whooping Cough 96 157 108 361 Acute Poliomyelitis . . . . Paralytic 3 - 1 4 Acute Poliomyelitis . . . . Non-Paralytic 2 1 - 3 Measles 105 219 218 542 Diphtheria 3 - - 3 Dysentery 253 72 36 361 Meningococcal Infection 1 1 1 3 Scabies 5 4 8 17 Pneumonia 15 23 7 45 Acute Encephalitis . . . . (Infective) - 1 1 2 Paratyphoid Fever 2 - 1 3 Erysipelas 6 2 1 9 Food Poisoning 33 9 12 54 Puerperal Pyrexia 58 2 1 61 Ophthalmia Neonatorum 2 1 1 4 TOTALS 623 519 427 1569 38 notifications other than tuberculosis The total number of notifications, excluding tuberculosis, received during the year fell considerably, 1569 corrected notifications being received compared with 3290 in 1959. This decrease is accounted for, in the main, by a reduction of 1849 in the number of cases of measles notified. The year 1959 was a "measles" year and as the disease tends to occur in epidemic form every two years it was to be expected that the incidence in 1960 would be low. It is anticipated, therefore, that measles will again assume epidemic proportions in 1961. Poliomyelitis It is pleasing to report that only 7 cases of Poliomyelitis (4 paralytic and 3 non-paralytic) were notified during the year compared with 16 cases (8 paralytic and 8 non-paralytic) during 1959. No deaths occurred from this disease. The cases were spread throughout the year as follows :- First Quarter 1 Second Quarter 3 Third Quarter NIL Fourth Quarter 3 7 The ward distribution was as follows :- Marsh 1 Bishop's 1 Springfield 1 Leigham 1 Princes 2 Town Hall 1 7 Two males suffered from the disease compared with five females in the in the following age groups 39  M. F. Total Under 1 year 3 3 2 years 1 - 1 3 years 1 - 1 15-24 years - 2 2 2 5 7 tables It is still necessary, even in I960, to treat people for Scabies. In this connection 17 notifications were received in the Public Health Department,This is, however, a reduction of 28 on the number notified during 1959. An arrangement exists with the Metropolitan Boroughs of Southwark and Battersea for the cleansing of such persons. Scarlet Fever There was a decrease in the number of cases of Scarlet Fever notified, 97 cases occurring compared with 177 in 1959. Whooping Cough This disease showed an increase on the 1959 figure, 361 cases being Notified compared with 121 last year. Pneumonia Considerably fewer cases of pneumonia were notified during tie year, 45 compared with 112 in 1959. Dysentery There was a considerable increase in the number of cases of dysentery notified, 361 cases occurring compared with 209 in 1959. More than two thirds of them occurred in the Vauxhall Parliamentary Constituency mainly in Marsh, Bishop's and Prince's Wards. Seventy two cases occurred in the Brixton Constituency and 36 in Norwood. 40 The cases were spread throughout the year as follows:- First Quarter 145 Second Quarter 127 Third Quarter 50 Fourth Quarter 39 361 Food Poisoning Fifty Four notifications of food poisoning were received during the year compared with 40 in 1959. In addition 9 cases were otherwise ascertained. The cases were distributed throughout the year as follows:- Notifications (corrected) as returned to Registrar-General. First Quarter 19 Second Quarter 18 Third Quarter 14 Fourth Quarter 3 54 Cases otherwise ascertained First Quarter Second Quarter Third Quarter 9 Fourth Quarter - 9 Included in the above mentioned 63 cases there was one outbreak of food poisoning involving 17 persons. The agent was identified in 22 cases. Salmonella Typhimurium 3 Salmonella Dublin 1 Salmonella Newport 1 Clostridium Welchii 17 41 The outbreak of food poisoning occurred in a Welfare Home for tie aged in the Borough. The food causing the outbreak was suspected to be ox tongue and the agent heat resistant Clostridium welchii. All the cases occurred at 4 a.m. on Saturday, 20th August, 1960, there were no fatilities. Clinical Features Average interval ingestion to onset - 16 hours Main Symptons - Pains in abdomen and diarrhoea, no vomiting Severity of illness - Moderately severe Duration of illness - 6 staff : 12 hours 11 elderly residents : 32 hours. Results of Laboratory Investigations (i) Cases : Faecal specimens obtainable only from ten persons - heat- resistant Clostridium welchii present in all specimens. (ii) Food handlers:- One cook included in the above ten (a second and subsequent test was negative). (iii) Food sample:- Ox tongue - no pathogenic organisms isolated. (The sample of ox tongue may not have been representative of that thought to have caused the outbreak). Reparation of Food causing illness Early on Wednesday, 17th August, I960, twenty seven pounds of ox tongues Were delivered to the home. They were steamed for eight hours and then placed ln a "cool room". Early the following morning the tongues were placed in a refrigerator. At about 11 a.m. half of them were sliced and covered with warm eravy. Lunch was served at 12.30 p.m. with no consequent illness. On Friday 19th August, the remainder of the ox tongues were removed from the refrigerator (excepting one whole tongue). They were sliced and served cold for lunch (No gravy served). Number of consumers at risk 75 elderly residents 6 staff Probable origin of infection or contamination of food Not Known 42 OUTBREAK OF EPIDEMIC NAUSEA AND VOMITING On the afternoon of 26th January, 1960, information was received of an outbreak of suspected food poisoning affecting mainly members of the nursing staff at a hospital in the Borough. At that time 17 cases had occurred. The following day a visit was paid to the hospital when the total had risen to 26. The onset was sudden, characterised by nausea, diarrhoea and vomiting, the course of the illness being about 48 hours. At that time the impression was obtained that there were two peaks, one about 21st and 22nd January and the second on the 25th and 26th January. Bacteriological investigations had yielded negative results. An inspection of the kitchens which served both patients and staff showed nothing abnormal, except that one kitchen employee had an unhealed vaccination on. her leg which she was dressing herself. This was swabbed, and the person temporarily put off duty. This swab failed to grow pathogens. The following day the total of cases was 37 and it was becoming obvious that this was not an outbreak of food poisoning, and the alternative diagnosis of epidemic nausea and vomiting was considered. By 29th December, 45 cases had occurred mostly amongst the staff, and detailed histories from a number of the victims was obtained. The onset was usually abrupt with nausea and/or vomiting although at least one case started with a bout of diarrhoea. There was some pyrexia and generalised aches and pains and it was reported that the patients usually "slept for hours" after going to bed. The illness usually lasted for about 48 hours, the victims being up and about although feeling a little exhausted at the end of that period. Apart from a few odd cases, the outbreak came to an end about 28th January, the last case reported occurring on the 3rd February. Retrospectively a few cases not originally reported were found and in all 58 persons were affected, 49 staff and 9 patients. Naturally, at the height of the outbreak the question of closing the hospital for admissions was raised, and after consideration it was agreed that admission should only be denied in. those cases where vomiting or diarrhoea would constitute a hazard e.g. those needing gastric surgery. Diphtheria In February a small outbreak of diphtheria occurred in the Borough involving three cases (two of which were notified) and seventeen carriers. 43 The original case was diagnosed clinically by a local general practitioner, in a boy of six years who had been immunised in infancy but not since. Upon notification of this case the London County Council arranged for the swabbing of the school contacts whilst the Borough Council staff investigated family contacts. As a result of these investigations ten positive swabs were obtained. This Was followed by investigation of the families of these earners when a further ten positive swabs were obtained although not all at the first attempt. All of these except one adult were admitted to hospital and two of them, Cases 2 and 3, were considered on admission to be clinically diphtheria. The family of Case 2 consisted of mother and father and seven children. The family was originally investigated as a result of finding a positive swab in a contact of Case 1. The first swab results of the family taken on the day of removal of the carrier were negative. A week later swabbing of the family gave five positive results and the Allowing day another member of the family returned a positive. Thus in this family of nine there were two cases and five carriers including father. The negative swabs were from the mother and a boy aged 7. The immunisation state of the parents was not discovered. The two cases in the family were not immunised. The remainder of the family were immunised in infancy and had boosters in 1956 with the exception of the boy aged 12 who had his booster in 1952. Another family with a school contact of Case 1 returned four positive swabs including the mother. Three members of the family returned negative swabs. The whole of this family with the exception of the parents gave ahistory immunisation. No other families had more than one carrier. The following table gives brief details of the cases:- 44 Date Sex Age Immunised Type Notes 1. 9.2.60 M 6 yrs. Infancy No booster Diphtheria Mitis "Toxa genie in the laboratory* 2. 26.2.60 M 2 yrs. Not Immunised Diphtheria Mitis Brother of school contact of above case. 3. 26.2.60 F 1 year Not Immunised Diphtheria Mitis Sister of Case 2 BOROUGH OF LAMBETH IMMUNISATION - 1960 Completed Cases Welfare Centres and Nurseries General Practitioners Totals Under 5 years 5-14 years Under 5 years 5-14 years Diphtheria Prophylaxis only 93 295 43 38 469 Combined Antigen Diphtheria and Whooping Cough 53 1 81 18 153 Triple Antigen Diphtheria, Whooping Cough and Tetanus 2795 44 849 95 3783 Diphtheria and Tetanus 45 85 3 8 141 Diphtheria - boosting doses - all ages 2056 632 2688 Whooping Cough only all ages (completed cases) 14 28 42 45 Diphtheria immunisation is the responsibility of the London County Council, but may also be carried out by general practioners and I am indebted to Dr. W.H.S. Wallace, Divisional Medical Officer of Division 8 for supplying me with the above figures. INTERNATIONAL CERTIFICATES OF VACCINATION International Certificates of vaccination for persons travelling to certain countries abroad are required in respect of Smallpox, Yellow Fever and Cholera. Vaccination against any disease other than yellow fever can be done by a Person's own doctor, or exceptionally (by arrangement) at a hospital. So long as vaccination is done under the National Health Service, whether by a person's own doctor or at a hospital, no charge may be made for it, but in either case the doctor may charge for issuing an International Certificate. Yellow fever vaccination must, for international and technical reasons, be done only at a Centre designated by the Government: in London the Hospital for Tropical Diseases, 4, St. Pancras Way, N.W.I., Medical Department, Unilever House, Blackfriars, E.C.4., and West London Designated Vaccinating Centre, 53, Great Cumberland Place, W.l. An International Certificate of vaccination against yellow fever will be supplied, after vaccination, at the Centre at which the vaccination is done. The International Certificates for smallpox and cholera (for completion by person's own doctor) must be obtained by the traveller himself and taken to 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.l. After completion by the vaccinator, certificates must be franked with an approved stamp. Approved stamps have been prescribed for the United Kingdom. If the Vaccinator is not himself an authorised user of a stamp, the person vaccinated must take or send the certificate for stamping to a Local Authority. In England and Wales this is the Town Hall, Urban District Council or Rural District in whose area the Vaccinator practices. It should be noted that this is not necessarily the area in which the person vaccinated lives. During the year, 1884 International Certificates of Vaccination were stamped by the Public Health Department 46 TUBERCULOSIS Notification The following table shows the number of cases of tuberculosis notified for the first time during the year I960, 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 2 2 1 - 5 5 - 14 years 1 1 1 3 15 - 24 years 19 14 - 1 34 25 - 44 years 21 16 3 3 43 45 - 65 years 41 10 - - 51 65 years and over 6 4 - - 10 TOTAL 90 47 5 4 146 These primary notifications were distributed amongst the Parliamentary Constituencies as follows Norwood 43 Brixton 64 Vauxhall 39 The number of cases of tuberculosis remaining on th e Register at the end of the year is as follows,- Respiratory Ron-respiratory Total Men 1665 75 1740 Women 1350 94 1444 Children 163 60 223 TOTAL 3178 229 3407 47 HOSPITAL ADMISSIONS AND DISCHARGES? Parliamentary Constituency Respiratory Non-respiratory Admitted Discharged Admitted Discharged M F M F M F M F Vauxhall 49 8 42 12 4 2 3 3 Brixton 50 17 34 13 1 - 4 1 Norwood 23 9 21 6 1 - 1 - TOTAL 122 34 97 31 6 2 8 4 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 11 4 15 - 6 6 11 10 21 The following shows the primary notification of tuberculosis for the ten year period 1951 - 1960 Year Respiratory Non-Respiratory Totals Rate per 1,000 population 1951 396 31 427 1.86 1952 323 34 357 1.55 1953 318 29 347 1.52. 1954 352 17 369 1.63 1955 232 21 253 1.13 1956 180 18 198 0.88 1957 199 10 209 0.93 1958 189 21 210 0.94 1959 155 15 170 0.76 1960 137 9 146 0.65 48 The following table shows the number of deaths from tuberculosis for the ten year period 1951 — 1960 Year Respiratory Non-Respiratory Totals Rate per 1,000 population 1951 96 7 103 0.45 1952 60 5 65 0.28 1953 1954 46 34 7 7 53 41 0.23 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 1960 15 6 21 0.09 49 50 I am indebted to Dr. Price, Consultant Chest Physician at St. Francis' Hospital for the following report on the work of the Chest Clinic during the year. Table 1 is an extract of the Annual Return of Chest Clinic work sent to the Ministry of Health for the year 1960, and refers to the Lambeth (South) Chest Clinic, situated in St Francis' Hospital. If the table is compared with that for 1959, it would be seen to show little change. It confirms the view that the time is not yet ripe for relaxation of any effort towards eradication of the disease. TABLE 1 Respiratory Tuberculosis Non-Respiratory Tuberculosis Men Women Children Total Men Women Children Total Total cases on Clinic Register at 31.12.1960. 675 500 64 1239 15 21 7 43 Number of cases diagnosed during the year, 59 24 6 89 - 2 1 3 Recovered 8 17 1 26 - - - - Deaths 8 4 - 12 1 - - 1 Deaths There were twelve deaths due to respiratory tuberculosis among Chest Clinic patients during the year. Most of them were over fifty years and had oldstanding disease whilst a considerable number had other diseases contributing towards their death. The one non-respiratory death occurred in a thirty year old negro, and was an obscure case of meningitis, ultimately presumed to be tuberculous. 51 Non-Respiratory Tuberculosis The three new cases diagnosed during the year were not due to bovine tuberculosis, of which no new case is recorded in the Borough. They were all secondary to an original pulmonary infection. Respiratory Tuberculosis There were eighty-nine new cases of pulmonary tuberculosis diagnosed and added to the Register during the year - representing no significant change in incidence over the past five years. Again there are just over twice as many cases in men as in women. In the majority the source of infection could not be traced and the population's hidden infector pool of infectious cases must to a large extent be held responsible. This view is supported by the reduced number of child cases, itself testimony to the efficacy of preventive measures in tuberculous households and to B.C.G. vaccination of contacts and school-children. 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 _ I960 1,239 89 12 26 Table 2 compares Chest Clinic figures over the past ten years - during which time chemo-therapy has been available, and it shows the initial reduction in the number of deaths up to 1957 associated with this form of treatment. Since then, however, the improvement has not been so impressive and the steady incidence of new cases has continued over the past three years. This levelling out of the curve of death rate and incidence illustrates resistance to both prevention and treatment. To what extent this follows the emergence of drug resistant strains of tubercle bacilli is not yet known and is the subject of research by the Medical Research Council. 52 Most new cases continue to be discovered as a result of chest X-ray examination advised by General Practitioners. A certain number are found by routine mass radiography unit examinations, but is a diminishing percentage as a higher proportion of examinations are repeat X-rays of individuals passed normal in previous years. On an estimated population of 120,000 served by the Lambeth (South) Chest Clinic, with a total of 1,239 cases on the Register, 1% of the community is in need of supervision and advice for tuberculosis. Treatment Approximately half the number of newly diagnosed cases were in need of initial hospital or sanatorium treatment, and there were 41 new case admissions during the year. Immediate vacancies were available. Most patients in need of long term treatment were given chemo-therapy under Chest Clinic outpatient sipervision, and there were 250 such patients treated during the year. Most were able to continue at work. The Chest Clinic was well attended by patients and used by General Practitioners during 1960, and there were 4,400 patient attendances. The London County Council tuberculosis health visitors paid 3,200 visits to patients' homes and at any one time during the year about 100 patients were receiving extra milk, butter and eggs provided by the Council. Many cases of non-tuberculous respiratory disease are now seen at the Chest Clinic, including chronic bronchitis where there is a casual relationship with the polluted London atmosphere. Cancer of the lung is becoming a more common finding and close liaison with King's College Hospital and the Specialist Chest Hospitals is maintained in arrangements for treatment. The Chest Clinic is taking part in the further investigation of smoking as a possible cause of this disease, organised by the Research Committee of the British Tuberculosis Association. 53 SECTION C GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA Care of the Aged The care of the aged is a matter which is constantly engaging the attention of the department. Unfortunately it is not always possible to intervene directly in the welfare of old people unless there is a nuisance or danger to health. However close contact is maintained with the officers of the Lambeth Old People's Welfare Association and through them it is often possible to assist. Similarly, officers of the Public Health Department are frequently able to help Old People's Welfare Association in dealing with cases. Factors which contribute to the unhappy state of many of these old people are varied. Many of the old people are often alone in the world, have a small fixed income and some are reluctant to apply for National Assistance. Consequently they live in one room, usually in a basement or at the top of the house, and get insufficient to eat. It often appears at first sight that some of those who have children are neglected by them. This may be true in some instances but on the other hand investigation may show that there is some real obstacle such as the housing circumstances of these children which will not permit them to give shelter to their parents. Another factor which is often overlooked is the independence of the old Persons themselves, who will carry on long after they should have had help, are reluctant to do anything which in the slighest way suggests a whittling away of their independence. It is pathetic when one comes across an old person who steadfastly refuses to accept the services which are available because it felt that independence will be lost by so doing. This is the type of case which usually becomes the subject of court-action under Section 47 of the National Assistance Act, 1948. This action is distasteful and is only taken after all methods of persuasion have During the year 474 new cases were brought to the notice of the Public Health Department, 29 fewer than in 1959, but the Woman Public Health Visitor made 200 more visits, 2722 compared with 2522 last year. 54 It was necessary to take statutory action in only one case, and this speaks highly of the persuasive powers of the lady visitor in getting old people into hospital or institutions voluntarily. Once more I acknowledge the considerable work done by various members of my staff in connection with old people. The co-operation of Lambeth Old People's Welfare Association, The London County Council through its Domestic Help and Nursing Services, the Geriatricians and the Hospitals has continued throughout the year. These organisations have helped to make the task of the Public Health Department less difficult and to them my thanks are due. Set out below is a summary of the work of the Public Health Visitor during the year giving a comparison with the years 1958 and 1959. 1960 1959 1958 No. of new cases 474 503 421 No. of cases removed to Hospital or Institution (Voluntarily) 121 143 147 No. of cases removed under National Assistance Act, 1948, as amended by National Assistance (Amendment) Act, 1951 1 1 1 No. of cases removed under Rational Assistance Act, 1948, Section 47 - 2 No. of cases removed by a Duly Authorised Officer 11 2 7 TOTAL NO. OF VISITS MADE BY VISITOR 2722 2522 2316 No. of cases who received help 420 412 364 No. of cases in which help was not required 39 54 40 No. of cases in which help was refused 15 37 17 No. of Deaths 151 151 163 No. of cases on Register at end of year 1519 1192 823 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 55 (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 amended legislation in 1 case. Details of this case are set out below:- This was an old lady of 86 years of age. She was practically housebound and lived alone in a furnished room. The landlord was anxious to obtain Possession. She was incontinent and refused any help offered. Visits paid by Public Health Visitor were resented and on 30th March, 1960, the General Petitioner attending her telephoned the Public Health Department to say that in her opinion the old lady should be moved. She was visited by the Medical officer of Health and the Public Health Visitor and in spite of persuasion refused to go into hospital. The Medical Officer of Health and the Public Health Visitor again called 4th April and conditions were such th at action had to be taken under Section 47 of the National Assistance Act, 1948 as amended by the National Assistance Amendment) Act, 1951. The necessary Order was obtained and the old lady was removed to hospital on 6th April. She died in hospital on 13th April, 1960. Laundry Service for aged Incontinent Persons The arrangements made with the Southwark Borough Council for carrying this service continued during the year. 56 Before the service is granted each case is visited by the lady visitor to ascertain whether it may be dealt in accordance with Section 122 of the Public Health (London) Act 1936, and collection and deliveries are made twice weekly. The total number of persons receiving benefit from the scheme during the the year was 140 (101), the total visits made were 2,152 (1,885) and the total number of soiled articles collected and taken to Southwark Cleansing Station 20,421 (17,337) . The total weight of the laundry cleansed was 19,137 lbs. (17,266 lbs.). The figures given in brackets are those for the year 1959. Home Bathing Service Notes on this scheme were set out in my Annual Report for 1959. An increasing number of aged persons are benefiting from this service. During the year 1791 Baths were given. This compares with a figure of 747 for the year 1959, but it should be remembered that the scheme did not come into operation until 4th May, 1959. Should the home bathing service continue to expand 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. H olidays for the elderly The scheme to send old age pensioners to the sea for a week's holiday at the cost of £1 each was continued during the year. In order to participate in the scheme a person must be an old age pensioner have lived in the Borough of Lambeth for at least three years and during the same period must not have had a holiday. These holidays were arranged at Margate in the Spring and Autumn, the first period being in May and the second in September. In the Spring 190 old people went on holiday and in the Autumn 149 making a total of 339 for the yet" as shown in the following tables. 57 OLD PEOPLE'S HOLIDAYS, 1960 SPRING Ward Males Females Married Couples Totals 65/70 71/75 76/80 Over 80 60/65 66/70 71/75 76/80 Over 80 Vauxhall 2 1 2 2 8 14 14 4 4 4 51 Brixton 4 5 2 4 10 14 13 7 6 6 65 Norwood 7 6 7 8 7 12 15 6 6 9 74 Totals 13 12 11 14 25 40 42 17 16 19 190 autumn Vauxhall 1 2 3 3 2 5 10 8 4 6 38 Brixton 5 6 6 1 7 16 3 6 2 11 52 Norwood 4 5 7 3 3 10 14 8 5 8 59 Totals 10 13 16 7. 12 31 27 22 11 25 149 Totals for Year 23 25 27 21 37 71 69 39 27 44 339 58 LAMBETH OLD PEOPLE'S WELFARE ASSOCIATION During the year under review 1,316 new people were brought to the notice of the Association. It is interesting to observe the changes since 1954. There was a steady increase in new clients from 535 in that year to a peak of 1,914 in 1958; the number fell to 1,504 in 1959 and since then has become steady at about 1,300. This would appear to be a healthy sign especially when coupled with the considerable increase in assistance given to people already known to the Association; 2,436 were dealt with last year and 3,613 during the year under review. It is hoped that help, or at least advice, can be given whatever the problem an elderly person may have. Some want no more than factual information about the services that are available, others have problems requiring case work, visiting and follow up. There are a few with problems which just cannot be solved and all that can be given is sympathy and a "shoulder to weep on". It is vital that all elderly members of the community should feel able to look to the Association for help, advice and support whatever their difficulty. Visiting The visiting undertaken or arranged by the Association falls into three main categories. Firstly, visits made to ascertain the needs of homebound people newly referred to the Association. Secaidly, periodical follow-up visits to the more infirm to ensure that they are still managing and to remind them to approach the Association if they should be in difficulty. Lastly, efforts are made to find voluntary workers who will "adopt" elderly people who are without relatives and friends nearby, this provides the feeling that somebody cares for them and they are still part of the community. The Association is indebted to all the voluntary workers who help to make this service possible, and is always anxious to recruit more workers and expand the service. Meals-on-wheels During the year under review 27,765 meals were delivered by the Association in the Northern part of the Borough: 23,530 to people in their own homes and 4,234 to lunch clubs. The Southern part of the Borough is served by the W.V.S. which delivered 28,981 meals, all to people in their own homes. Taking this Borough as a whole the largest number of people who were served on any one day was 338, of which 50 were at lunch clubs. Meals are delivered to people's homes on four days a week, and an extra meal for Saturday can be left on Friday. The lunch club at the Work Centre receives meals on four days, and the North cote House Senior Club on three days a week. 59 Through this service the Association is able to supervise quite closely the Welfare of the more helpless members of the community, most of whom look upon the meals staff as friends who render services which do not come within their official duties. It is hoped that every elderly person in the Borough, who through Alness or infirmity is unable to prepare or make provision for meals, is brought the notice of the Association. foot Clinics There appears to be an ever increasing demand for this service. The Assoclation has six clinics providing 27 three hour sessions per week and 7 sessions of mobile chiropody. During the year a total of 12,673 treatments were given. 2'012 people attended the clinics and 443 infirm people received treatment in their own homes. At the end of the year the period between appointments was lengthening and waiting lists had to be started. It is hoped that the L.C.C. will permit expansion in the near future. During the year under review the Association has been 100 per cent grant aided by the L.C.C. Treatment was free for only those in receipt of National Assistance until January when it became free for all those in receipt of retirement or old age pensions irrespective of other income. There is widespread appreciation of the service but expansion is essential to keep pace with growing demand. The Association would like to thank all those who act as voluntary receptionists at the clinics and thereby help to keep the service working efficiently and chiropodists who often provide a sympathetic ear as well as professional treatment. Holidays For most people a holiday is something to look forward to and something to remember. For elderly people, whose lives are becoming restricted through infirmity and limited means, holidays are especially important. This year 46 saved with the Association for two weeks summer holiday under the the auspices of the Women's Holiday Fund and two for ten days holiday at Cristmas' addition old people were recommended for holidays under the scheme sponsored by the Borough Council. Eight infirm people were also assisted. Inexpensive private addresses were given to those who wanted to make their own arrangements and where appropriate people were referred to other organisations and agencies which arrange holidays. The Association greatly appreciates the co-operation it receives in its efforts to secure holidays for as many people as possible. 60 Clubs The thirty clubs represented on the Association show considerable variety, 24 are open one afternoon a week, and one of these starts early with lunch; two are open three afternoons a week; one open four days a week and provides lunches and one opens six days a week but there is no provision for lunches. There are also a daily club held in a London County Council Old People's Home and the George VI Memorial Club for the housebound which is described elsewhere. Club activities cover a wide range including outings, concerts, parties and visiting of sick members. It is impossible to overemphasise the value of club activities, and the work put in by leaders and helpers. Through the co-operation of the clubs the Association is able to advertise its main annual activities: the Church Service and Inter-Borough Talent Competition in the Spring; the Inter-Club Competition and Exhibition of Work in the Autumn; and the Old People's Concert at Christmas. King George VI Memorial Club The Association has five representatives on the Management Committee of of this day club which is open to housebound people living in Camberwell and Lambeth. Normally attendance is limited to one day a week, and transport is provided by the club. During the year under review there was a record total of 12,037 attendances. 450 different people attended the club, but at any one time membership was about 300; 45 members attended on every possible occasion. 131 new people joined the club and 113 members were lost; 185 were put on the waiting list which is approximately the same number as last year. The waiting period for admission is about six months but priority is given to those urgently in need of the club's services. In addition to usual activities such as outings, parties and entertainments the club aims to provide bathing, chiropody, hairdressing, handicraft instruction and help with shopping. A number of summer holidays were arranged, some with financial help from the Association. Work Centre During the year the number of people attending the Centre has ranged between 37 and 47, of which only a few were men. Two men and one woman left on being found part-time jobs. Several people were forced to leave due to increasing age and infirmity but some struggled on because they found life rather dreary without their two hours a day at the Centre. 61 The bulk of the work done during the year has been on the three permanent contracts of button carding, theatrical hose darning and the packing of foam cistern floats. In addition members continue to sort tin foil donated by the Public. Various types of new work have been tried mostly comprising the assembly of cardboard containers and advertising materials. This type of work was not a great success as it had to be completed within a specified time. Such commitments are difficult to meet since the Centre has no transport of its own and the old people have in the past been encouraged to work at their own pace. Gifts of scrap materials were used to make articles for sale, and in March Employment Fellowship offered the Centre display space at an Exhibition and Market held in Marylebone where the work was commended. Everyone is looking forward eagerly to the opening of the new Centre which is under construction and should be ready for occupation during 1961-62. Finance The Association is grateful to the Borough Council for its generous grant Without which the work for elderly people in Lambeth could not be undertaken. It is hoped that the Borough Council will continue to show its confidence in this generous manner. The Association would also like to take this opportunity to thank those who have made donations. co-operation The task of helping elderly people would be very difficult indeed without the co-operation of the many statutory and voluntary bodies represented on the Old People's Welfare Association. Contact has been maintained with the National Old People's Welfare Council, the London Council of Social Service and the Central Consultative Committee on the Welfare of Old People from which much useful information has been received. The Association appreciates the help and advice received throughout the year from the Medical Officer of Health and other officers of the Borough Council. Office The office of the Lambeth Old People's Welfare Association is situated in Room 1 at the Town Hall, Brixton Hill, S.W.2. (Telephone BRIxton 7755, Extension 18). The office hours are from 9.30 a.m. to 5 p.m. Monday to Fridays and 10 a.m. to 12 noon on Saturdays. 62 HOSPITALS Lambeth is within the catchment area of two hospital groups, the Lambeth and Camberwell Groups. These in turn are administered by two different Regional Hospital Boards, the South West Metropolitan and South East Metropolitan respectively. The areas served by the two hospital groups extend beyond the Borough boundaries. The Lambeth group has premises outside the Borough whilst the Camberwell Group has none in it. In addition to hospitals within the normal hospital framework of the National Health Service there are two teaching hospitals in the Borough, King's College Hospital and St. Thomas's Hospital each with its own board of Governor's. The following is a list of hospitals within the Borough: Lambeth Hospital Group (S.W. Metropolitan Regional Hospital Board) Lambeth Hospital, Brook Drive, S.E.11. South Western Hospital, London Road, S.W.9. Annie McCall Maternity Hospital, Jeffreys Road, S.W.4. King's College Hospital Group King's College Hospital, Denmark Hill, S.E.5. Belgrave Hospital for Children, Clapham Road, S.W.9. St. Thomas's Hospital Group St. Thomas's Hospital, Westminster Bridge, S.E.1. St. Thomas's Babies Hospital, Black Prince Road, S.E.11. General Lying-in-Hospital, York Road, S.E.1. Royal Waterloo Hospital, Waterloo Road, S.E.1. PERSONAL HEALTH SERVICES It is the duty of the Local Health Authority, in the case of the Borough of Lambeth, the London County Council, either to provide these services or arrange for their provision by some other organisation. 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. 63 Vaccination and immunisation is also done by general practitioners. The midwifery, ambulance and mental health services are administered direct from the Public Health Department, County Hall, S.E.1, and home nursing is carried out on behalf of the County Council by voluntary organisations. The voluntary nursing associations working in the Borough are as follows:- Brixton District Nursing Association Camber well District Nursing Association Norwood & 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 Health Laboratory Service provides a comprehensive service for the examination of specimens submitted by local authorities and general Practitioners. The local Laboratory is situated at County Hall and is under the direction of Dr. A.J.H. Tomlinson. 64 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 Borough of Lambeth has been satisfactory both in quantity and quality during the year 1960. There were no new important extensions of trunk mains nor any changes in the general scheme of supply to your area during 1960 but the length of new mains laid amounted to 1539 yards. All new and repaired mains are chlorinated before being restored to service and samples of water from them are tested bacteriologically to ensure that its quality is up to that normally supplied" The 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 1874. The average results were as follows:- Chemical Examination Description of sample Thames derived filtered water Milligrames per litre (unless otherwise stated) Ammonia nitrogen 0.038 Albuminoid nitrogen 0.080 Oxidised nitrogen-nitrate 4.0 Chlorides as C1 28.0 Oxygen abs. from Permanganate 4 hours at 27°c 1.26 Turbidity units 0.3 Colour m.m. brown 2 ft. tube Burgess's Tintometer 14.0 Hardness (total) 254.0 Hardness (non-carbonate) 68.0 pH value 7.8 Phosphate as PO4 1.00 65  Milligrams per litre (unless otherwise stated) Silicate as Sio2 9.0 Sulphate as S04 58.0 Fluoride as F 0.25 Magnesium as Mg 4.0 Surface Active material as Manoxol 0.12 Electrical Conductivity (Gemmhos) 525.0 Bacteriological Examination after Chlorination (Water passing into supply) Plate counts (average per ml.) Colonies counted on agar 37°C (20-24 hours) 8.6 Coliform count percentage samples negative in 101 ml 99.57 Escherichia count percentage samples negative in 100 ml 100.0 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 wells are received regularly and have been satisfactory for the year under review. Sewers The Council's annual programme of reconstruction of sewers (£27,000 per annum for several year) is related to sewers which are very old and possibly defective and which may cause rat infestation. Definite improvement results from these schemes not only in the immediate locality, but also due to the greater capacity of the sewers with improved flow of sewage and storm water. During long periods of heavy rain of the last nine months there have been no reports of flooding of premises arising from defective sewers. Sewers in the following streets were reconstructed in 1960-61 (work in Christchurch Road in progress March 1961). Monkton Street Length 660 ft. average depth 11 ft. Cleaver Street Length 270 ft. average depth 15 ft. 66 Knowle Road Length 726 ft average depth 9 ft. Christchurch Road " 715 ft. " " 18 ft. The Council's programme of sewer reconstruction is additional to that for repair and maintenance of sewers (£10,000 per annum) and of gully maintenance and replacement (£10,000 per annum). I am indebted to the Borough Engineer for supplying me with the above information. SUMMARY OF VISITS AND INSPECTIONS BY INSPECTORIAL STAFF Dwellinghouses Visits Re-visits In respect of nuisances 2,333 6,839 In respect of Certificates under the Rent Act, 1957 83 122 In respect of Rehousing 122 70 In respect of Infectious Diseases 451 63 Other reasons 578 173 Clean Air Act, 1956 Timed observations 146 - Untimed observations 1,251 - Other visits, private and industrial premises 673 3,868 Bakehouses 86 10 Butchers Shops 506 - Restaurants 419 108 Fried Fish Shops 66 5 Ice Cream Premises 61 5 Milkshops 327 7 Public Houses 17 4 Other Food Premises 467 35 Factories Acts Factories with mechanical power 509 16 Factories without mechanical power 120 - Outworkers 203 - 67 Drainage Visits Re-visits New Buildings 32 1,507 Alteration to existing drainage, etc. 464 3,669 Animals improperly kept 23 6 Personal uncleanliness 28 7 Exhumations 1 9 Hairdressers and Barbers 109 40 Pet Animals Act, 1951 26 1 Rodent Control 1,329 1,208 Unclassified 402 82 10,822 17,854 complaints The number of complaints received, including tat and mouse infestations, was 3,571 drain testing Number of Drains tested by District Inspectors 2,173 Number of Drains tested by Rodent Officer 119 2,292 dangerous structures Dangerous structures notified to London County Council 112 summary of defects and nuisances found as a result of routine inspection and inspection following complaint Dirty Premises 33 Verminous Premises 412 68 SUMMARY OF DEFECTS AND NUISANCES FOUND AS A RESULT OF ROUTINE INSPECTION AND INSPECTION FOLLOWING COMPLAINT (Continued) Defective Roofs 519 Defective rainwater pipes and gutters 266 Damp Premises 473 Defective drainage and sanitary fittings 474 Choked drainage 310 Lighting and ventilation 240 Defective water supplies 76 Dustbins etc 31 General defects and dilapidations 591 NOTICES SERVED Number of Intimation Notices Served 1,357 Number served under Public Health (London) Act, 1936 - Section 40 306 Section 82 346 Section 93 16 Section 105 2 Section 108/9 173 Under the London County Council (General Powers) Act, 1955 - Section 27 83 Under the Prevention of Damage by Pests Act, 1949 12 Under the London County Council (General Powers) Act, 1956 - Section 63 Lambeth Borough Council Bye-laws 14 952 69 legal proceedings public health (london) act, 1936 In respect of 62 summonses returnable to the Lambeth Magistrates Court and Petty Sessional Court, 26 Abatement Orders were made, 18 cases were adjourned sine die and 18 were withdrawn, the nuisances being abated by the tespective owners by the date of the hearing. dwelling houses rendered fit Number of dwelling houses rendered fit in consequence of informal action 699 Number of dwelling houses in which defects were remedied after service of formal notice (a) by landlords 775 (b) by Council in default of landlords under the Fifth Schedule of Public Health (London) Act, 1936 14 Under Sections 40 and 108/109 of the Public Health (London) Act, 1936 and Prevention of Damage by Pests Act, 1949 103 Under Section 27 of London County Council (General Powers) Act, 1955 139 Outstanding cases from previous year are included. SECTION 95 public health (London) act, 1936 In 1960 Certificates of Habitation were issued in respect of 565 new dwellings in regard to the provision of a proper and sufficient water supply. out of 565 dwellings 198 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. 27 plans of new buildings and 97 plans of alterations to existing drains were deposited. Combined drainage was carried out in 16 cases. 70 OFFENSIVE TRADES An Establishment Order has been granted to a company which carries on the offensive trade of fellmonger. The order is renewed annually. 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 168 Number of rooms included in above 254 Total number of rooms sprayed for all purposes 2,996 Number of articles disinfected 5,825 Number of library books disinfected 1,144 Number of disinfection certificates issued 192 DISINFESTATION Bed Bugs Number of houses visited 268 Number of rooms sprayed 865 Number of houses re-visited 48 The rooms were sprayed with a preparation of 5 per cent D.D.T. with Pyrethrum as a "Knockdown*. There were many complaints during the year of insect infestation. The usual offenders were wood boring beetles, ants, cockroaches, drugstore beetles, carpet beetles, clothes moths, weevils and silver fish. The total number of visits made by the staff of the Disinfecting Station for all purposes was 3231. 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 71 by the department of the Borough Engineer in conjunction with the Rodent Officer and his staff. In all cases of dwelling houses treatment is undertaken by the Local Authority free of charge, but in the case of business premises a charge is made. During the year 988 complaints were received. Of this number 89 were not justified. 748 were in respect of brown rats, and 151 in respect of mice, During the course of investigation 1118 baitings were made and 66 defective drains discovered. 16 Statutory Notices were served under the Public Health (London) Act, 1936, and 12 under the Prevention of Damage by Pests Act, 1949. FACTORIES ACT, 1937 AND 1948 PART 1 OF THE ACT 1 Inspections for purposes of provisions as to health (including inspections made by the Public Health Inspectors). Premises Number on Register Number of Inspections Written Notices (i) Factories in which Sections 1, 2, 3, 4, and 6 are to be enforced by Local Authorities. 215 120 1 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 744 621 13 (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' Premises) 71 71 - TOTAL 1030 812 14 72 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.l.) 4 4 - 4 Overcrowding (S.2) - - - - Unreasonable temperature (S.3) - - - - Inadequate ventilation - - - - Ineffective drainage of floors (S.6) - - - - Sanitary Conveniences (S.7) - (a) Insufficient 2 2 - 2 (b) Unsuitable or defective 5 5 - - (c) Not separate for sexes - - - - Other offences against the Act (not including offences relating to Outwork) 6 6 - 2 TOTAL 17 17 - 8 NO PROSECUTIONS WERE INSTITUTED 73 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. 234 Cleaning and washing Household linen 2 Curtains and furniture hangings 1 Furniture and Upholstery 3 Artificial flowers 1 Paper bags 1 The making of boxes or other receptacles or Parts thereof made wholly or partially of Paper 21 Carding etc., of buttons etc. 36 Stuffed toys 50 Cosaques,Christmas crackers, Christmas stockings, etc. 3 Lampshades 65 TOTAL 417 NO NOTICES WERE SERVED OR PROSECUTIONS INSTITUTED. 74 RENT ACT, 1957 (a) Applications, for Certificates of Disrepair 59 Applications outstanding from 1959 1 60 Decisions not to issue Certificates - Decisions to issue Certificates (a) in respect of some but not all defects 40 (b) in respect of all defects 18 58 Applications awaiting action at end of year 2 60 (b) Number of cases where decisions were made to issue Certificates but were awaiting action by the landlords at the end of 1959 11 Undertakings given by landlords under paragraph 5 of the First Schedule of the Act 30 Undertakings refused under proviso to paragraph 5 of the First Schedule of the Act 2 Certificates of disrepair issued 27 Certificates still to be issued or undertakings still to be received from landlords at end of year 10 69 (c) Applications for Certificates as to the remedying of defects specified in a landlord's undertaking (a) by landlords 60 (b) by tenants 7 (c) applications outstanding from 1959 7 74 75 Certificates issued (a) defects remedied 29 (b) defects not remedied 33 (c) applications awaiting action at end of year 12 74 (d) Applications by landlords for cancellation of Certificates of Disrepair 43 Applications outstanding from 1959 4 47 Certificates cancelled 37 Certificates refused 6 Applications still to be dealt with at the end of year 4 47 In connection with the applications from landlords for cancellation of Certificates of Disrepair objections to cancellation were lodged in 14 cases. REHOUSING AND OVERCROWDING during the year the following cases have been investigated:- London County Council Cases Overcrowding 6 Medical Grounds 20 Insanitary conditions 12 Lambeth Borough Council Overcrowding 21 Medical Grounds 416 Insanitary conditions 73 76  Cases Enquiries from other sources 7 During the same period cases have been rehoused by various authorities as under - London County Council 57 Lambeth Borough Council 31 housing act, 1957 RECORD OF WORK CARRIED OUT BY HOUSING INSPECTORS Section 17 Individual Unfit Houses Inspected no action under Housing Act 164 Black Prince Road 79 Fitzalan Street 80 Fitzalan Street 3 Hamilton Road 53 Landor Road 131 Norwood Road 13 Stockwell Lane Represented - Closing Order made 44 Brooklands Road 166 Black Prince Road Section 18 - Underground rooms and parts of buildings Inspected - no action under Housing Act 17 Bloom Grove 152 Farmers Road 22 Oakden Street 24 Oakden Street 26 Oakden Street 6 St, G.othards Road 77 Section 18-Underground rooms and parts of buildings (cont.) To be represented 4 Morley Street Represented - Closing Order not yet made 12 Gipsy Hill 5 Gresham Road 198 Lambeth Walk 100 Lothian Road Represented 1959 - Closing Order made 1 Brailsford Road 46 Eastlake Road 48 Eastlake Road 24 Thurlow Hill Voluntarily closed 9 Langmead Street 75 Norwood High Street 208 South Lambeth Road 21 Wincott Street 23 Wincott Street 25 Wincott Street Made fit - Closing Order determined 122 Christchurch Road 42 Guildford Road 5 Victoria Crescent Made fit voluntarily 70 Acre Lane 72 Acre Lane 38 Bellefields Road 152 Brixton Road 154 Brixton Road 156 Brixton Road 158 Brixton Road 160 Brixton Road 78 Section 18 - Underground rooms and parts of buildings (cont.) Made fit voluntarily (cont .) 52 Durand Gardens 54 Durand Gardens 47 Effra Road 1 Ferndale Road 3 Ferndale Road 6 Hannen Road 48 Harleyford Road 52 Monkton Street 54 Monkton Street 56 Monkton Street 67 Monkton Street 69 Monkton Street 71 Monkton Street 73 Monkton Street 75 Monkton Street 77 Monkton Street 18 Wincott Street Work in hand to make fit 61 Acre Lane 62 Acre Lane 75 Akerman Road 49 Auckland Hill 63 Bedford Road 36 Cleaver Square 39 Dulwich Road 54 Fentiman Road 121 Gipsy Road 175 Gipsy Road 6 Irving Grove 7 Irving Grove 8 Irving Grove 152 Lambeth Road 41 Lorn Road 5 Maley Avenue 12 St. Michaels Road 14 St. Michaels Road 13 Treherne Road 79 Section 18 - Underground rooms and parts of buildings (cont.) Work in hand to make fit (cont.) 121 Tulse Hill 59 Vauxhall Grove PART III-Slum Clearance Programme 1956-1960 Somers Road Area 1-7 (odd)Somers Road Clearance Order made 30th June 1959 Confirmed without modification by the Minister 8th October, 1959 Demolished 1960 Bowden Street Area 3 - 11 (odd) Bowden Street 56 Methley Street Compulsory Purchase Order made 24th November 1959 Confirmed, with modifications, by the Minister, June, 1960 Cambria Road Area 2-10 (even) Cambria Road 13 - 19 (odd) Padfield Road 1-7 (odd) Southwell Road Compulsory purchase Order made 28th March 1960 Public Enquiry October 1950 Decision of the Minister awaited Flaxman Road Area 125 - 147 (odd) Flaxman Road 71 - 79 (odd) Liliord Road Represented 10th October, 1960 Declared 26th October, 1960 80 The one area remaining under this programme, comprising some 105 houses, will be dealt with in 1961. Slum Clearance Programme 1961-65 The joint proposals for a Slum Clearance Programme for 1961-65 have been discussed and agreement has been reached with the London County Council. The preliminary survey indicated that approximately 470 houses were suitable for clearance. The majority will be dealt with by the London County Council and the Lambeth Borough Council will be responsible for 132 houses. Improvement Grants The number of applications for Improvement Grants has continued to increase, but the proportion of Discretionary Grants approved is still low. This is mainly due to the comparatively high standard of fitness required as the premises must provide satisfactory housing for thirty years. Further obstacles are the restrictions imposed on rents and the necessity for the accommodation to be self-contained. Standard Grants, which were introduced under the House Purchase and Housing Act, 1959, cover half the cost, up to a maximum of £155, of installing five basic imrovements - a bath or shower, a wash-hand basin, a water closet, a hot water system and a food store. Grants may be made for all or some of of these improvements and the conditions imposed are less rigorous than those for Discretionary Grants. More applications have been received and the proportion approved is larger. Discretionary Grants Inspected - No action 1 Albert Square 45 Archbishops Place 69 Arlingford Road 188 Casewick Road 13 Herne Place 23 Herne Place 100 Knollys Road 17 Lancaster Avenue 158 Lowden Road 1-22 New Palace Buildings 159 Rosendale Road 63 St. Julians Farm Road 123 St. Julians Farm Road 81 Thurlestone Road 81 Approved 166 Knights Hill K Block Peabody Buildings (14 flats) In Abeyance 1-36 Mitre Road 1-18 Garden Houses St. Andrew's House, Roupell Street 47 Trinity Gardens Improvements subsequently 46 Trinity Gardens carried out without grant Standard Grants Inspected - No action 35 Albert Square 15 Arlesford Road 23 Birkbeck Hill 2 Blenheim Gardens 16 Brighton Terrace 265 Croxted Road la Distin Street 11 Durban Road 173 Gipsy Road 55 Hackford Road 71 Hamilton Road 348 Kennington Lane 16 Kimberley Road 141 knollys Road 25 Myatt Roa d 199 Norwood Road 237 Norwood Road 13 Penford Street 76 Richborne Terrace 64 Salters Hill 62 Sandmere Road 19 Stockwell Green 6 Stockwell Park Road 66 Thornlaw Road 18 Thorparch Road 15 Thurlestone Road 22 Tindal Street 2 Victoria Crescent 82 In Abeyance 26 Acre Lane 48 Barnwell Road 13 Cleaver Square 88 St. Julians Farm Road 21 Trinity Gardens 49 Wiltshire Road Approved 46 Archbishops Place 59 Barnwell Road 3 Brading Road 43 Brading Road 272 Brixton Road 7 Camden Hill Road 44 Canterbury Grove 24 Cleaver Square 37 Cleaver Square 36 Cleaver Street 29 Clive Road 63 Dalberg Road 31 Darlington Road 52 Hamilton Road 39 Handforth Road 6 Heme Place 10 Ladas Road 47 Mauleverer Road 32 Meadow Road 19 Rita Road 19 Peabody Cottages 20 Peabody Cottages 39 Roupell Street 4 Royal Circus 5 Shakespeare Road 43 Selsdon Road 26 Solon Road 2 Spencer Road 5 Theed Street 6 Theed Street 9 Tivoli Road 39 Tivoli Road 40 Tivoli Road 26 Whiteley Road 83 Approved (cont.) 26 Whittlesey Street 9 Wilkinson Street TOTAL INSPECTIONS AND REVISITS DURING THE YEAR - 1573 ATMOSPHERIC POLLUTION There are seven combined smoke and sulphur dioxide atmospheric Pollution stations in the Borough and details of the measurements of pollution are given in the following tables. Two types of pollution are measured, namely smoke and sulphur dioxide. Smoke pollution of the atmosphere includes all types of suspended matter collected on the filter paper (these filter papers are changed daily) but consists largely of smoke from the burning of coal. Smoke concentration is assessed by means of a Reflectometer and the results are expressed as milligrammes of smoke per 100 cubic metres. Sulphur dioxide which is given off in the burning of coal, coke and oil in varying amounts according to the amount of sulphur in the original fuel, is measured by a chemical process. The amount of sulphur dioxide is determined by combining the sulphur dioxide in a known quantity of air with hydrogen Peroxide to give a dilute solution of sulphuric acid. The concentration of sulphuric acid is determined by chemical titration and from this figure the amount of sulphur dioxide can be calculated, the results being expressed as Parts of sulphur dioxide per hundred million parts of air. Atmospheric pollution in any given place depends on a number of important factors, e.g. rainfall, direction and speed of prevailing wind, turbulence, and seasonal and daily variations, (daily variations may be considerable, but sometimes variation between night and day is even greater). There is one distinct advantage in the measurement of these types of Pollution in that over a period of years changes in the general trend of Pollution can be observed. 84 1960 ATMOSPHERIC POLLUTION DEPOSITS AND SULPHUR DIOXIDE MONTH Rainfall in mm Deposited Matter in Tons per Square Mile SOj in mgSo per Day on 100 Sq. cms. Insoluble Deposits Soluble Deposits Total Solids 1 2 1 2 1 2 1 2 1 3 4 January 35 37 5.6 15.0 4.6 6.6 10.2 21.6 4.0 4.7 3.7 February 36 42 5.9 13.0 5.0 6.1 10.9 19.1 4.2 4.5 3.4 March 35 42 6.9 18.5 9.4 8.2 16.3 26.7 4.5 4.6 4.3 April 14 11 4.0 10.7 3.8 4.2 7.8 14.9 2.4 2.5 2.2 May 32 41 8.0 13.2 5.2 5.8 13.2 19.0 2.7 2.6 2.5 June 25 30 6.2 12.9 5.0 4.6 11.2 17.5 1.8 2.0 1.8 July 72 72 3.0 14.6 4.4 4.7 7.4 19.3 1.0 1.7 1.2 August 71 73 5.5 11.1 5.4 3.8 10,9 14.9 1.2 1.6 1.2 September 93 129 6.0 11.9 5.9 8.4 11.9 20.3 2.0 2.5 2.0 October 123 123 5.9 10.5 8.1 8.5 14.0 19.0 3.1 3.7 3.1 November 85 82 2.5 11.2 5.0 5.9 7.5 17.2 3.0 4.8 2.7 December 62 63 7.1 24.2 6.0 7.0 13.1 31.2 4.5 5.3 3.9 Station controlled by Lambeth Borough Council :- 1. Metropolitan Water Board, Brixton Hill Stations controlled by London County Council :- 2. Archbishop's Park 3. County Hall, N.E. Roof 4. County Hall, S.W. Roof 85 19 60 RAINFALL IN MM. 86 1960 DEPOSITED MATTER IN TONS PEE SQUARE MILE 87 1960 SO2 IN MGS. PER DAY ON 100 SQ. CMS. 88 1960 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 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 January 26 16 27 36 33 32 45 27 128 58 132 134 129 111 168 111 17 15 20 11 16 14 13 14 120 44 56 34 49 46 44 44 February 21 12 18 19 30 27 40 23 116 35 101 84 84 78 125 62 11 12 12 11 14 11 10 11 38 29 36 30 28 26 30 25 March 14 20 14 15 25 23 27 19 29 39 31 30 50 44 48 36 12 13 13 10 13 11 8 12 25 28 25 20 27 27 19 25 April 9 15 6 9 11 10 15 9 35 40 28 55 34 34 47 27 7 11 9 8 9 7 6 9 21 29 21 36 19 19 21 17 May 4 12 5 7 11 10 9 9 9 26 13 14 27 24 16 18 10 12 10 8 10 9 6 9 31 38 31 21 26 23 11 23 June 3 6 2 3 7 6 5 5 9 10 3 8 15 27 7 12 6 8 7 5 7 5 4 6 16 22 20 12 25 13 12 21 July 1 8 1 2 5 5 4 4 4 13 5 4 10 12 6 8 4 8 5 4 5 4 2 4 7 12 9 8 7 5 3 8 August 3 8 2 3 8 7 5 7 8 13 7 8 15 12 10 12 5 7 5 5 5 5 3 4 17 15 19 15 8 13 6 7 September 4 10 4 6 13 11 9 10 16 17 12 21 27 24 17 23 6 8 7 4 8 7 5 7 12 14 15 9 19 17 8 17 October 12 17 10 12 19 18 20 16 41 49 38 36 42 37 63 31 18 24 17 16 13 11 8 11 51 70 78 54 26 19 20 22 November 12 21 13 12 20 18 26 19 54 73 53 48 90 82 86 57 24 29 27 19 15 11 9 11 52 93 78 54 34 28 23 27 December 24 33 23 25 27 24 39 29 60 66 52 67 55 50 80 89 15 17 17 15 18 14 14 16 41 44 36 41 43 37 40 45 STATIONS CONTROLLED BY LAMBETH BOROUGH COUNCIL 1. LAMBETH TOWN HALL 2. LIBRARY, SOUTH LAMBETH ROAD 3. KENNINGTON SECONDARY SCHOOL, HACKFORD ROAD 4. NORWOOD TECHNICAL, COLLEGE STATIONS CONTROLLED BY LONDON COUNTY COUNCIL:- 5. COUNTY HALL, LAB. ROOF 6, ROYAL FESTIVAL HALL 7. AMBULANCE STATION LANDOR ROAD 8. COUNTY HALL, GROUND FLOOR 89 1960 LAMBETH TOWN HALL 90 1960 LIBRARY, SOUTH LAMBETH ROAD 91 1960 KENNINGTON SECONDARY SCHOOL HACKFORD ROAD 92 1960 NORWOOD TECHNICAL COLLEGE 93 CLEAN AIR ACT, 1956 Smoke Control Area No. 1 is nearing completion. During the year 540 conversions were completed and the 7/10ths grant paid, and a further 457 estimates were approved. Area No. 2 is currently under detailed survey and No. 3 will follow shortly. Active co-operation with the Department of Scientific and Industrial Research has been maintained for the measurement of aerial pollution. The Standing Conference of Co-operating Bodies in the Investigation of Atmospheric Pollution (on which the Council's representatives are Mr. Councillor Goldbaum and the Medical Officer of Health) has set up a National Survey and this has received the approval of the Minister of Housing and Local Government. Lambeth falls within one of the selected areas. Four field stations are maintained daily at Norwood, Kennington, Brixton and South Lambeth and a fifth at Heme Hill is being set up shortly. Although it is perhaps too early to be more Positive the Kennington Station situated at Hackford Road Secondary School is beginning to indicate the success of smoke control as the station is situated in the centre of the area. 95 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 146 Untimed observations 1,251 Other visits, private and industrial premises 673 3,868 96 SECTION E INSPECTION AND SUPERVISION OF FOOD The Food Hygiene Regulations 1955-57 The Food Hygiene (General) Regulations 1960 The Food Hygiene (Docks, Carriers, etc.) Regulations 1960 The 1960 (General) Regulations amend and consolidate the 1955-57 Regulations and, with the exception of their application to ships, came into force on the 1st October, 1960. The Docks, Carriers, etc. Regulations came into force in the main on the 1st November. During the year there has been a growing concern regarding the increase in the bird population in the borough, and this has inevitably increased the danger of contamination of food especially in food factories. It is significant that almost simultaneously the specific provisions in the 1955 Regulations relating to preventing the entry of birds into food rooms have been omitted. In recent years there has been a general trend towards a greater concentration of the processing and packaging of food among the larger units in the food industry, and a proportionate diminution of the number of shopkeepers who themselves cook or otherwise prepare food on their own premises. This has been particularly marked in Lambeth and has called for some changes in the routine inspection of food premises and the methods of food production. In the case of some meat factories an increase in the output of the factories had resulted in some enroachment from the raw meat side to the cooked meat side and vice versa. Steps have been taken to minimise the possibility of cross infection of food poisoning organisms from raw to cooked meat by arranging for the two types of meat to be handled in separate parts of the factories by different personnel using equipment allocated only for raw meat or for cooked meat as the case may be. In addition closer supervision of food preparation, especially in the larger factories, has been undertaken. Food Premises During the year under review, 2,632 inspections and revisits were made to food premises in the Borough. 97 These inspections and revisits were made up as follows :- Inspections Revisits Food Factories 394 115 Bakehouses 86 10 Butchers 506 - Fried Fish Shops 66 5 Ice Cream Premises 61 5 Milk Shops 327 7 Public Houses 17 4 Restaurants 419 108 Other 469 35 2,343 289 The approximate number of food premises by type of business in the area is as follows:- Grocery and provisions 390 Greengrocery and fruit163 Fish shops, wet, dry and fried 99 Bakers 105 Butchers 153 Restaurants 210 Confectioners 270 Food and Drugs Act, 1955 - Section 16 The number of registered premises is as follows:- Manufacture and/or sale of ice cream 589 Manufacture of sausages and preparation of preserved etc. food 304 Milk and Dairies (General) Regulations, 1959 - Regulation 8 The number of registered distributors is 284 The number of registered dairies is 3 98 Milk (Special Designation) Regulations The following table shows the number of licences issuer :- Dealers' Licences:- Tuberculin Tested 168 Pasteurised 245 Sterilised 275 Dealers' Supplementary Licences:- Tuberculin Tested 17 Pasteurised 17 Sterilised 21 Dealers' (Pasteuriser's) Licence 2 SAMPLING OF FOOD AND DRUGS Chemical Analysis 200 samples were procured formally, 134 of which were of milk, 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 Instant Coffee Sulphur Dioxide 300 parts per million. flatter brought to notice of Importers who had already received assurances from producers that a revised method of production would prevent addition of S^ 99 Informal Samples Articles Result of Analysis Action Taken Milk Bottle Contained ingredients of mortar Brought to notice of dairyman. Leg of Lamb Calculi present; mainly calcium carbonate. Dealt with as unsound food. Bread Dirty, mineral grease. Brought to notice of baker. Sweets and Sweets tins Contaminated with sticky material used in sealing seams of tins. Dealt with under Regulation 6 of the Food Hygiene Regulations 1955. Lemonade Crystals Labelling offence. Brought to notice of packer. Soft Drink Contaminated with crude cresol. Brought to notice of manufacturer. Medicinal Paraffin Bottle contained dirty water. Br ought to notice of packer. Instant Coffee Sulphur Dioxide 230 parts per million See Formal Sample Pears Arsenic 7 parts per million Formal sample taken - genuine. Sodamint Tablets Labelling offence. Brought to notice of vendor. Subsequent sample complied with Labelling Order, Dairy Ice Cream Margarine Fat used. Brought to notice of vendor. Subsequent sample complied with Labelling Order, dripping Water 1.5%, Further sample taken - genuine. Minced Beef Sulphur Dioxide 360 parts per million. Further sample taken - genuine. Sal Volatile „ Ammonia 5% deficient „ Verbal warning to chemists followed by repeat samples which were genuine. 100 Informal Samples (Continued) Articles Result of Analysis Action Taken Shredded suet 5% deficient in beef fat Formal sample taken - genuine. Menthol and Wintergreen rub 16% deficient in methyl salicylate. Formal sample taken - genuine. Sausage Mould present on skin. This was a luncheon sausage. Brought to notice of vendor. Stock inspected and found in sound condition. Storage and rotation arrangements satisfactory. Rice Pearl Barley Pearl Barley Infested with mites Stock inspected and where necessary dealt with as unsound food. Jar of Marmalade Contained glass. Brought to notice of vendor and manufacturer. Marmalade in Sandwich Contained glass Brought to notice of vendor and manufacturer. Apples Lead 4 parts per million. Further samples taken - genuine. Peanuts Peanuts Rancid Stock inspected and dealt with as unsound food. Sliced Bread Dirt in crumb Brought to notice of baker. Sliced Bread Machinery dirt,in crumb. Brought to notice of baker. Loaf of Bread Lump of miscellaneous dirt. Brought to notice of baker Half Loaf of Bread Contained needle. Insufficient evidence to show that needle was baked in the bread or that it was in the loaf at time of sale Brought to notice of baker. 101 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 174 Ice Lollies 8 Pasteurised Milk (Frozen) 2 Whole Dried Egg 72 Skimmed Milk Powder 3 Whole Milk Powder . 1 *Sausages 1 Spray Dried Egg Albumen 18 *Cooked Beef 1 Frozen Strawberries and Sugar 1 Strawberry Puree 2 Samples of milk were submitted to the Public Health Laboratory for examination under the Milk (Special Designations) Regulations, as follows:- Methylene Blue Tests 186 (of which 2 were void, the atmospheric shade temperature being over 65 ˚F ) Phosphatase Tests 186 All samples were satisfactory. The 174 samples of ice-cream and ice-cream mix were submitted to the Ethylene Blue Test of which 22, 13%, were graded in provisional grades 3 and 4 as against 12% during 1959. As in 1958 the plate counts association with these low graded samples ware comparatively low, and there is little doubt that in the majority of cases the low methylene blue grading were due to a heat resistant organism such as bacillus cereus. Again, the greater number of these apparently less satisfactory results ware obtained from one manufacturer. The firm concerned was made fully aware of the results of the tests and decided to take the opportunity of renewing certain parts of its plant during the winter 1960/61. A new homogeniser, two new pumps, and a new stainless steel surface type mix cooler, with covers, are being fixed to replace the existing ones. Next season's results will be examined with interest. 102 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. Canned Tons Cwts. Qrs. Lbs. Meat 3 5 2 10¾ Fruit 9 11 2 5¾ Vegetables 1 3 3 7¼ Juice 4 2 27¼ Fish 4 3 253/4 Soup 3 3 8½ Milk 3 • 3 Spaghetti 1 - 21¼ Preserves 2 18½ Cereal 2 11½ Cream 93/4 Pudding 7 Sausages 3 15 0 0 19¼ Fresh Offal 6 4 1 11½ Grapes 6 - - - Bananas 4 - - - Meat 17 2 83/4 Potatoes 13 - - Poultry 7 - 4½ Fish 5 1 7 Winkles 3 1 - Rabbits 2 13 Tomatoes 1 8 18 11 1 243/4 103 Prepared Tons Cwts. Qrs. Lbs. Soup Mix 12 15 - - Fish, Frozen 2 2 2 14 Bacon 13 - 7 Sausages 5 2 10 Sugar 2 - 14 Salad Dressing 1 2 9¼ Rusks 1 - - Cheese 2 15½ Suet 2 - Sauce 1 17¼ Bread Improver 1 16 Dried Egg 1 8 Lard 1 - Meat Pies 20 Pickled Cabbage 12 Pickled Cucumber 123/4 Dried Fruit 9¼ Pickles 43/4 Miscellaneous 1 14 16 4 1 153/4 Total Weight 49 16 - 33/4 In addition, sixteen sacks of yams were seized and taken before magistrates who issued an order for condemnation and disposal. The method of disposal of food surrendered or condemned as unsound. 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. On the 1st November, 1960, the Meat (Staining and Sterilisation) Regulations 1960 came into force. Undertakings from processors and carriers of unfit meat and meat products to which the Regulations apply have been obtained that such meat collected or received by them will be sterilised as is laid down in Regulation 2. In appropriate cases information as to the adequacy of the Process has been obtained from the Medical Officer of Health of the district in which the plant is situated. 104 FOOD COMPLAINTS - 1960 75 complaints about food were received and set out below is a list of 50 of these which, after investigation, were considered to be justified. 1. Medicinal Paraffin Bottle stained 2. Meat Pie Mouldy 3. Settle of Milk Contained Lime Salts 4. Fruit Bun Contained piece of wire 5. Ice Cream Contained hairpin 6. Meat Contained lead pellets 7. Biscuit Contained bristle 8. Leg of Lamb Unwholesome condition 9. Bread Contained piece of metal 10. Part of lunch Contained flies and ash 11* Sauce Contained fragments of glass 12. Bread Contained dirty mineral grease 13. Bre ad Contained foreign matter 14. Pie Contained piece of glass 15. Bottle of Mineral Water Contaminated with disinfectant 16. Buttered Bun Contained piece of steel 17. Bread Contained piece of blade 18. Milk Contained insects 19. Milk Contained sand and cement 20. Bread Contained foreign matter 21. Tin of Ham Unwholesome smell 22. Bread Contained brush hair 23. Bread Mouldy 24. Lamb Unwholesome smell 25. Bread Contained nail 26. Milk Sour 27. Milk Contained piece of glass 28. Jam Sponge Contained wasps 29. Bread Mouldy 30. Chicken Unwholesome 31. Cake Contained piece of wire 32. Bacon Contained maggots 33. Meat Pasties Mouldy 34. Sweets Contained maggots 35. Porridge Contained Beetle 36. Sweets Contained maggots 37. Bread Contained mould 38. Milk Contained comb 39. Bun Contained piece of wire 40. Marmalade Contained piece of glass 41. Cake Contained finger marks 42. Bread Contained amorpheus organic particles 43. Rice Contained maggots 44. Bread Contained needle 45. Bread Contaminated by dirt 46. Bread Contained machinery dirt 47. Sausage Contained mould 48. Doughnut Contained insect 49. Chocolate Contained piece of wood 50. Milk Contained piece of glass 105 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. 25. Bread - contained nail. Absolute discharge with £5 5s. Od. costs. Legal proceedings were also recommended in the following case, the summons being returnable in 1961:- 38. Milk - contained comb. 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 Officer 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 provisions of this Act. 106 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 Swimming Bath situated in Brockwell Park. The bath, of 750,000 gallons capacity, is filled with Metropolitan Water Board mains water. The bath is treated by continuous filtration with pressure type sand filters, together with break-point chlorination, alum and soda dosing and aeration. The time of circulation is 5 hours and the bath is normally emptied once per year. The results obtained from the bacteriological examinations during 1960 were as follows:- Standards Agar Count 1 ml. 37°C. 48 hours. Presumptive coliform pollution without faecal Faecal coliform pollution 0-10 11-100 Over 100 No. of samples 6 2 0 0 0 Almost 150,000 bathers used the bath during 1960, approximately half the number during 1959 which was an exceptional year. NATIONAL ASSISTANCE ACT, 1948 Section 50-Burials Under Section 50 of the National Assistance Act, 1948, the Lambeth Borough Council is required to arrange for the burial or cremation of any person who has died or been found dead in its area if in such cases it appears to the Council that no suitable arrangements for the disposal of the body have been or are being made. 107 During the year, 16 funerals were arranged involving 8 males, 8 females. The amount paid to funeral contractors was £196 16s. 6d. The sum of £138 15s. 8d. was recovered by way of grants, insurance policies and money found. The actual cost to the Council was therefore £58 0s. 10d. LAND CHARGES ACT, 1925 During the year 3,145 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 154. RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951 Thirty samples of various filling materials were submitted to George Ginger, Esq., a prescribed analyst, for examination. One, of cotton felt, was reported as containing above the permitted maximum percentage of trash content. The matter was dealt with administratively with the supoliers who withdrew the balance of the consignment from the Lambeth firm concerned and a subsequent sample was found to be satisfactory. 11 premises are registered under this Act. PET ANIMALS ACT, 1951 This Act, which came into operation on 1st January, 1952, provides that no person shall keep a pet shop except under the authority of a licence granted in accordance with the provisions of the Act. A local authority may, on application, grant to a person who is not for the time being disqualified from keeping a pet shop a licence to keep a pet shop at such premises in their area as may be specified in the application, and subject to compliance with such conditions as may be specified in the licence. 108 In determining whether to grant a licence for the keeping of a pet shop, a local authority shall in particular have regard to the need for securing (a) that animals will at all times be kept in accommodation suitable as respects size, temperature, lighting, ventilation and cleanliness; (b) that animals will be adequately supplied with suitable food and drink and (so far as necessary) visited at suitable intervals; (c) that animals, being mammals, will not be sold at too early an age; (d) that all reasonable precautions will be taken to prevent the spread among animals of infectious diseases; (e) that appropriate steps will be taken in case of fire or other emergency. During the year, 15 licences were issued under the Act. No. of Inspections - 26 No. of Re-visits - 1 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 The total number of premises on the register at the end of the year was as follows :• Premises 200 Number of Inspections 111 Number of Re-Visits 30 Exhumatlons St. Matthew's Churchyard, Brixton Consequent upon the proposal to widen and re-align the carriageway in St. Matthew's Road it was necessary to excavate that portion of St. Matthew's Churchyard involved, and to exhume any human remains found therein. This was done under the supervision of the Public Health Department, and the remains of 26 (twenty six) persons were disinterred and re-interred in the Blackshaw Road Cemetery. 109 Although the depth of excavation anticipated was 12', the maximum depth excavated was about 6' as the whole site became inundated with water, and it is believed that this was caused by the proximity of the River Effra. In any case, the utmost diligence was employed to ensure that no human remains were left on the site. Most of the remains were considered to be those of comparatively young adults; this is perhaps indicative of the high death rate prevalent during the Period 1820-1860. Control of Movable Dwellings On the 18th November, 1959 the Public Health Committee's terms of reference were varied to include the administration of Section 22 of the London County Council (General Powers) Act, 1959. This section, covering the control caravan sites, came into operation on the 1st October, 1960. The Council adopted the standards drawn up by the Metropolitan Boroughs' Standing Joint Committee and the recommendations made by the London County Council, in relation to:- (i) Density (ii) Water Supply (iii) Sanitary Accommodation (iv) Disposal of waste (v) Fire-fighting equipment (vi) Footways and Hard Standing Since the operative date five applications for a licence have been received and considered by the Public Health Committee in close co-operation with the Housing and Town Planning Committee. In accordance with the requirements the Act notices were published in the local press and on the land concerned and no objection to licensing was received, and although each site did not strictly comply with the adopted standards the Council issued licences for a Period of one year subject to compliance with London County Council requirements concerning fire precautions. In each case the applicant was advised to seek approval under the relevant Panning acts and in two cases under the London Building (Amendments) act. 1939 concerning irregular structures.