AC 4383 Library 20.9.63 METROPOLITAN BOROUGH OF LAMBETH annual report OF THE medical officer of health FOR THE YEAR 1962 * F. SUMMERS. M B., U.S., M.R.C.S.. K.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 1962 F. SUMMERS. M.B., U.S., M.R.C.S., I.R.C.P., D.P.H. Medical Officer of Health 2 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 11 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 1952-1961 16 Classification of Deaths 17 Notes on Vital Statistics 20 Deaths from Cancer of Lung and Bronchus 22 Road Traffic Accidents 25 Section B : Prevalence of, and Control over, Infectious and other Diseases Notifications 30 Age distribution of Infectious Diseases 31 Distribution of Infectious Diseases according to Parliamentary Constituencies 32 Notes on Infectious Diseases 33 Poliomyelitis 33 Food Poisoning 34 Diphtheria Immunisation 36 International Certificates of Vaccination 37 Tuberculosis 38 Report of Chest Physician 42 Section C : General Provision of Health Services for the area 47 Care of the aged 47 Action under Section 47 National Assistance Act 1948 48 Laundry Service for aged Incontinent Persons 48 Home Bathing Service 48 Holidays for the Elderly 48 Lambeth Old People's Welfare Association 51 Hospital Facilities 59 Personal Health Services Provided by London County Council 60 Public Health Laboratory Service 61 Section D : Sanitary Circumstances of the Area 62 Water Supply 62 Sewers 65 Summary of Visits and Inspections by Inspectorial Staff 65 Complaints 66 3 Section D : Sanitary Circumstances of the Area (continued) Page Drain Testing 66 Dangerous Structures 66 Summary of Defects and Nuisances Found 66 Notices Served 67 Legal Proceedings • Public Health (London) Act 1936 68 Dwelling Houses Rendered Fit 68 Section 95 Public Health (London) Act 1936 68 Drainage Plans 68 Offensive Trades 69 Disinfection 69 Disinfestation 69 Prevention of Damage by Pests Act 1949 69 Factories Acts 1937 and 1948 70 Rent Act 1957 73 Rehousing and Overcrowding 74 Housing Act 1957 - Record of work carried out by Housing Inspectors 75 Slum Clearance Programme 1961-65 76 Improvement Grants 76 Atmospheric Pollution 78 Clean Air Act 1956 78 Section E : Inspection and Supervision of Food 81 Food Premises 81 Food and Drugs Act 1955- Section 16 82 Milk and Dairies (General) Regulations 1959 82 Milk (Special Designation) Regulations 1960 82 Sampling of Food and Drugs 82 Inspection of Food 88 Unsound Food 88 Food Complaints 92 Street Markets 93 Slaughter of Animals Act 93 Section F : General 94 Public Swimming Baths 94 National Assistance Act 1948-Section 50-Burials 94 Land Charges Act 1925 95 Pharmacy and Poisons Act 1933 95 Rag Flock and Other Filling Materials Act 1951 95 Pet Animals Act 1951 95 Hairdressers and Barbers 96 Control of Movable Dwellings. 96 5 METROPOLITAN BOROUGH OF LAMBETH PUBLIC HEALTH COMMITTEE (Appointed by the Council on 25th May, 1962) The Worshipful the Mayor of Lambeth (Mr. Councillor Donald Jack Packer, J.P. (ex officio) Chairman Mr. Councillor G.F.S. Light Vice-Chairman Mr. Councillor Tiras Cleasby Alderman Mrs. Mary Marock Councillors W.C. Burrett Mrs. D.R. Colls F. Kings A.G. McCormack J.T. Metcalfe B.J. Perkins Mrs. W.E. Privett R.E. Tucker Miss J. Williams A.M.I.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. (Resigned 30.6.62 Appointed Deputy Public Analyst for period 1.7.62 to 31.3.63) D.G. Forbes, B.Sc, F.R.I.C. (Appointed 1.7.62) CHIEF ADMINISTRATIVE ASSISTANT J.M. Roberts PUBLIC HEALTH INSPECTORS (a) District Inspectors W. Bonnin (1) (2) H.F. Bryan (1) F.W. Cutler (1) (2) (Commenced duties 3.9.62) R.G. Cutler (1) (Retired 3.4.62) A.R. Grimston (1) (2) (Commenced duties 14.5.62 D.J. Huggins (1) (2) E.E.Morgan (1) (2) H.J. Rogers (1) (Commenced duties J.B. Sainsbury (1) (Wandsworth M.B.C. 17.6.62 S.G. Starling (1) (2) H.Taylor (1) (2) Four Vacancies (b) Food Inspectors S. Bradley (1) (2) F. Russell (1) (2) (3) (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) R.A. Newton (1) (2) (f) Woman Inspector Miss A.F. Crombie (1) (4) (6) (g) Public Health Visitor Miss M. McNair (5) (6) CLERICAL STAFF L. Brann Mrs. J.Clark H.C. Collins Mrs. P. Dubury Miss A.P.Jones (Commenced duties 19.2.62. J.A. Keating (Commenced duties 3.9.62) Mrs. J. Kincart E.F. Mannerson Mrs. K.M. O'Sullivan Mrs. M. Rogers J.W.Tiffney (Student Public Health Inspector 4.6.62) E. Walker STUDENT PUBLIC HEALTH INSPECTORS J.W. Tiffney (Transferred from Clerical Staff 4.6.62) M.C.Gunton (Commenced duties 1.10.62) 2 Vacancies GENERAL ASSISTANTS W. Deamer (Assistant Rodent Officer) L. Whiston (Rodent Operative) J. Martin 8 BATHING ATTENDANTS HOME BATHING SCHEME FOR OLD PEOPLE Mrs. R. Bagge (Part-time) (Resigned 29.6.62) Mrs. F.M. Gilbert (Part-time) (Commenced duties 18.6.62) Mrs. F. Hones (Part-time) DISINFECTING STATION Wanless Road, Loughborough Junction, S.E.24. Superintendent :- C.E. Church 3 Drivers 2 Disinfectors 1 Stoker 1 Apparatus Attendant (1) Cert. S.I.E.B. (2) Cert. Meat and other Foods (3) Smoke Inspectors Certificate (4) Health Visitors Certificate (5) State Registered Nurse (6) State Certified Midwife 9 Public Health Department, Blue Star House, 234/244 Stockwell Road, S.W.9. Tel: BRIxton 7755 July 1963. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Lambeth Mr. Mayor, Ladies and Gentlemen, I have the honour to present my Annual Report for the year 1962 on the health of the Borough of Lambeth. The Registrar-General's estimated mid-year population for the Borough is 223,370 a decrease of 373 on the population as recorded in the 1961 census, a report on which was published in 1963. Some points from the census are included in the main body of this report. The number of live births increased and the proportion of illegitimate births has risen to 17.3% of the total. This figure probably reflects to some extent the fact that women from outside London come to the anonymity of the metropolis to have their babies in one of the several maternity hospitals in the Borough. Normally these births would be transferred to the home address of the mother, but where this is not known then the births are recorded in the Borough. There is no doubt however that there is a real increase in illegitimacy the causes of which are to be sought in such things as the changing attitudes towards sex, the earlier physical maturity of youth today without Corresponding emotional maturity and to some degree lack of parental control. These factors also account for the increase of venereal disease which has occurred in the past few years. At the beginning of the year several cases of smallpox occurred in various parts of the Country, mostly arriving by air from Pakistan. No cases occurred in the Borough but a number of contacts were kept under surveillance until it was considered there was no risk of their developing the disease. There was widespread demand for vaccination and the London County Council made clinic facilities available to all who requested vaccination. Work amongst the elderly continues to expand and an account of planned new services is to be found in the report of the Lambeth Old People's Welfare Association which is included in the body of this report. 10 The second public health visitor whose proposed appointment is mentioned in the report took up her duties early in 1963. My thanks are due once more to the Lambeth Old People's Welfare Association, the London County Council through its Domestic help and Nursing Services, the Geriatricians and the Hospitals for their continued co-operation throughout the year. I acknowledge also the considerable work done in connection with old people by various members of my staff. On 3rd April 1962 Mr. R.G. Cutler, Public Health Inspector, retired after forty-nine years service with the Council and another inspector resigned to take up employment with another Borough. Three appointments were made to the inspectorial staff. There were two further retirements in the early months of 1963 but one of the students has qualified as a Public Health Inspector and it is hoped that others will do so in 1964. One encouraging feature in the staffing position is that it is now possible to maintain the full complement of four student public health Inspectors. Finally I would like to thank all members of the Council and Public Health Committee for their support and encouragement during the year and also to acknowledge the loyal and conscientious service of the staff of the Public Health Department. I am, Mr. Mayor, Ladies & 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, Kennington, Ruskin, Norwood, Archbishop's and Vauxhall Parks and Myatt's Fields. Among the world famous buildings within the boundaries are Lambeth Palace; 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 4,087.5 acres No. of Wards 21 No. of Parliamentary Constituencies 3 Population Figure supplied by Registrar General (Mid-year estimate 1962) 223,370 Population figure Census 1961 223,763 Density of Population i.e. number of Persons per acre (Based on Registrar General Estimated Population) 54.6 Number of marriages during year 2,056 Marriage rate per 1,000 Population 9.2 Marriage rate per 1,000 Population England and Wales 14.9 Rateable Value of District (1962/63) £4,421,660 Sum represented by Penny Rate (1962/63) £18,575 Number of separately rated houses and flats (1962/63) 57,003 BIRTHS Live Births Legitimate Illegitimate Totals Males 2,184 437 2,621 Females 2,224 484 2,708 Totals 4,408 921 5,329 Live Birth Rate per 1,000 Home Population 23.85 Birth Rate corrected for comparison with other areas 21.94 Comparability Factor supplied by Registrar General 0.92 13 Birth Rate per 1,000 Home Population County of London 19.8 Birth Rate per 1,000 Home Population England and Wales 18.0 Corresponding Rate for the Borough of Lambeth for the year 1961 19.87 Illegitimate Live Births per cent of total live births 17.3% STILL BIRTHS Legitimate Illegitimate Totals Males 39 13 52 Females 37 12 49 Totals 76 25 101 Still Birth Rate per 1,000 Total Births (i.e. live and still) 18.6 Still Birth Rate per 1,000 Home Population 0.45 Still Birth Rate per 1,000 Total Births 18.1 England and Wales DEATHS Males Females Total 1298 1181 2479 Death Rate per 1,000 Home Population 11.l Death Rate corrected for comparison with other areas 11.1 Comparability Factor supplied by Registrar General 1.00 Death Rate per 1,000 Home Population England and Wales 11.9 Corresponding Rate for the Borough of Lambeth for the year 1961 11.65 14 Death Rate per 1,000 Home Population County of London 12.00 maternal mortality Number of Women dying in consequence of childbirth 5 Maternal Mortality Rate per 1,000 Total Births 0.92 Maternal Mortality Rate per 1,000 Total Births County of London 0.67 Maternal Mortality Rate per 1,000 Total Births England and Wales 0.35 INFANTILE MORTALITY Deaths of Infants under 1 year of age Legitimate Illegitimate Totals Males 42 10 52 Females 39 11 50 Totals 81 21 102 Death Rate of Infants under 1 year of age per 1,000 live births 19.15 Death Rate of Infants under 1 year of age per 1,000 live births County of London 20.8 Death Rate of Infants under 1 year of age per 1,000 live births, England and Wales 21.4 Legitimate Infantile Mortality rate 18.4 Illegitimate Infantile Mortality rate 22.8 Deaths of Infants under 4 weeks of age Legitimate Illegitimate Totals Males 29 7 36 Females 28 7 35 Totals 57 14 71 15 Neo-natal Mortality Rate (Deaths under four weeks per 1,000 live births) 13.3 Neo-natal Mortality Rate per 1,000 live births County of London 15.2 Neo-natal Mortality Rate per 1,000 live births England and Wales 15.0 Deaths of Infants under 1 week of age Legitimate Illegitimate Totals Males 27 7 34 Females 28 7 35 Totals 55 14 69 Early Neo-natal Mortality Rate (Deaths under one week per 1,000 live births) 12.9 Perinatal Mortality Rate (Stillbirths and deaths under one week combined per 1,000 total live and still births) 31.3 Perinatal Mortality Rate England and Wales 30.8 91 BOROUGH OF LAMBETH SUMMARY OF VITAL STATISTICS FOR THE TEN YEAR PERIOD 1953 - 1962 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 1953 229,000 2,408 10.62 3,649 15.93 93 25.49 4 1.08 1954 226,200 2298 10.26 3,684 14.33 86 23.34 6 1.59 1955 224,200 2,385 10.74 3,597 14.12 74 20.57 4 1.08 1956 223,900 2,389 11.10 3,915 15.74 83 21.20 1 .25 1957 224,300 2,359 10.83 4,205 16.82 98 23.90 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 1961 221,960 2,585 11.65 4,847 19.87 109 22.41 3 .61 1962 223,370 2,479 11.10 5,329 21.94 102 19.15 5 .92 * As adjusted by Comparability Factor DEATHS OF LAMBETH RESIDENTS DURING 1962 CLASSIFIED ACCORDING TO AGE GROUPS AND SEXES CAUSES OF DEATH Under 1 Year 1-4 years 5-14 years 15-24 years 25-44 years 45-64 years 65-74 years 75 Years and over TOTALS I. Tuberculosis, Respiratory M 1 3 8 6 2 20 F 2 2 2. Tuberculosis, Other M 1 1 F 1 1 3. Syphilitic Disease M 1 2 3 F 3 3 4. Diphtheria M F 5. Whooping Cough M F 6. Meningococcal Infection M 1 1 2 F 7. Acute Poliomyelitis M F 8. Measles M F 9. Other Infective and Parasitic Diseases M 1 1 2 F 1 1 10. Malignant Neoplasm, Stomach M 3 20 11 2 36 F 1 4 7 12 24 11. Malignant Neoplasm, Lung and Bronchus M 3 55 37 16 111 F 14 11 2 27 12. Malignant Neoplasm, Breast M F 6 24 10 8 48 17 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 13. Malignant Neoplasm Uterus M F 2 12 12 1 27 14. Other Malignant and Lymphatic Neoplasms M 2 9 28 28 35 102 F 4 30 31 33 98 15. Leukaemia, Aleukaemia M 1 2 3 F 1 1 2 1 5 16. Diabetes M 2 3 5 F 1 2 2 6 11 17. Vascular Lesions of Nervous System M 1 23 28 40 92 F 1 22 41 82 146 18. Coronary Disease, Angina M l 8 93 89 74 265 F 2 18 61 107 188 19. Hypertension with Heart Disease M 5 2 13 20 F 1 4 18 23 20. Other Heart Disease M 6 26 16 41 89 F 3 15 23 102 143 21. Other Circulatory Disease M 1 18 17 25 61 F 1 1 2 8 19 44 75 22. Influenza M 1 1 2 4 F 1 1 3 23. Pneumonia M 11 4 1 1 15 30 43 105 F 6 1 1 7 14 68 97 24. Bronchitis M 3 1 1 1 27 46 67 146 F 2 8 20 30 60 25. Other Diseases of the Respiratory System M 1 1 4 15 3 24 F 1 1 3 5 19 CAUSES OF DEATH Under 1 Year 1 - 4 years 5 - 14 years 15 - 24 years 25 - 44 years 45 - 64 years 65 - 74 years 75 Years and over TOTALS 26. Ulcer of Stomach and Duodenum M 2 5 5 12 F _ 1 1 4 6 27. Gastritis, Enteritis and Diarrhoea M 1 4 5 F 1 1 2 5 9 28. Nephritis and Nephrosis M 1 2 6 3 12 F 1 5 1 7 29. Hyperplasia of Prostate M 3 1 4 F 30. Pregnancy, Childbirth and Abortion M F 1 4 5 31. Congenital Malformations M 9 1 1 1 2 1 1 16 F 5 1 6 32. Other Defined and Ill-Defined Diseases M 27 1 2 2 20 15 13 80 F 36 2 3 4 20 17 36 118 33. Motor Vehicle Accidents M 5 7 5 1 2 20 F 1 1 1 4 7 34. All other Accidents M 2 5 8 2 7 24 F 2 6 4 11 23 35. Suicide M 1 8 15 6 2 32 F 1 1 6 2 1 11 36. Homicide and Operations of War M 1 F 2 2 2 ALL CAUSES TOTALS M 52 9 6 13 63 388 370 397 1298 F 50 5 3 8 38 205 291 581 1181 GRAND TOTALS 102 14 9 21 101 593 661 1978 2479 20 VITAL STATISTICS CENSUS 1961 (i) Population The report of the Registrar General on the Census of population taken in 1961 gives the following information in respect of the Borough. The population has declined from 296,147 in 1931 to 230,240 in 1951 and 223,763 in 1961. The decrease in the period 1951-61 is equivalent to a reduction of 0.28% per annum. The excess of births over deaths in the period is equivalent to an increase of 0.71% per annum. This would indicate an annual emigration from the Borough of nearly 1% per annum. The number of persons per room in 1961 was 0.79 compared with 0.83 in 1951. The percentage of persons living at a density of more than 1 1/2 persons per room was 12.1. No comparable figure is available for 1951 as the standard then adopted for recording was two per room. The number of persons of pensionable age recorded in tile Borough was 8,920 males and 22,434 females giving a total of 31,354 or almost 1 in 7 of the population. There were 39 persons of 95 years or over, 11 males and 28 females. The number of persons of pensionable age living in one person households was 7,898 (1,160 males and 6,738 females.). The number of 2person households with one or two persons of pensionable age was 8,673 and in 8,004 of these both members were of pensionable age. There were altogether 20,573 persons of pensionable age living in one or two person households. 22,808 persons were recorded as being born outside the United Kingdom. Of these there were 1,357 fromCyprus, 1,213 from India, 125 from Pakistan, 463 from Malta and 10,128 from the Carribean. (II) Housing There were 76,869 private households of which 23,582 were in shared dwellings. The persons in these private households numbered 214,719 and occupied 276,228 rooms. There were 63,556 structurally separate dwellings. Of these, 17,295 were owned by a local authority and 10,534 were owner occupied. 21 Analysis of the amenities in dwellings gives the following result. 79 (0.13%) had no piped cold water. 20,241 (32.9%) had no piped hot water supply. 15,478 (25.16%) had no fixed bath, and 392 (0.64%) had no water closet. BIRTHS The number of live births occurring during 1962 increased by 482 giving an increased corrected birth rate of 21.94 per 1,000 home population compared with 19.87 in 1961. This rate is higher than that for England and Wales which at 18.0 per 1,000 home population is the highest since 1947. Illegitimate births increased by 165, 921 occurring compared with 756 in 1961. The figure is 197 higher than that for 1960 and 277 more than in 1959. These figures, indicate that out of every five to six children born to women in the Borough of Lambeth one is illegitimate. still births The number of still births decreased from 106 to 101 and this coupled with the increase in the number of live births gives a still birth rate of 18.6 per 1,000 total births compared with 21.4 in 1961. This approximates to the rate for England and Wales which is 18.1 per 1,000 total births. deaths The total number of deaths was 2,479, 1,298 males and 1,181 females. This was a reduction of 106 on the number occurring in 1961 and gives a corrected death rate of 11.1 per 1,000 home population compared with 11.65 in 1961. This compares favourably with that for England and Wales which is 11.9 per 1,000 home population. Male deaths decreased by 58 and female by 48 compared with 1961. Male deaths exceeded female by 117. As is usual heart and associated diseases accounted for the largest number of deaths. With the exception of malignant neoplasms of the uterus, which increased from 18 in 1961 to 27 in 1962, the number of deaths from all forms of m alignant neoplasms decreased, 373 occurring compared with 563 in 1961. 22 These from leukaemia and aleukaemia also fall from 17 to 8. Two male children under five years of age died as a result of meningococcal infections. No death from measles occurred during the year. Syphilitic disease accounted for the same number of deaths as in 1961. Three males and three females died from the disease and five of them, 2 males and 3 females, were over the age of 75 years. Deaths from respiratory tuberculosis decreased from 27. to 22 while those from other forms of the disease were the same as in 1961. Fatalities from ulcers of the stomach and duodenum were not as numerous, 18 deaths occurring compared with 40 last year. Although the number of deaths is more than halved the ratio of men to women is still two to one. Deaths from motor vehicle accidents decreased by 4 during the year but those from other accidents increased by two. Six more people took their own lives compared with the figure for the year 1961 and two more died as the result of homicide. INFANTILE MORTALITY The number of infants who died in the first year of life was 102. This is seven less than in 1961 and gives an infantile mortality rate of 19.15 per 1,000 live births which is one of the lowest on record and compares very favourably with that for Englandand Wales which is 21.4 Seventy-one children died in the first four weeks of life compared with 83 in 1961 giving a neo-natal mortality rate of 13.3 per 1,000 live births compared with 15.0 for England and Wales. The early neo-natal mortality rate , i.e. deaths under one week per 1.000 live births, also fell, being 12.9 compared with 16.9 in 1961. MATERNAL MORTALITY Unfortunately the number of women dying as a result of childbirth increased. Five died compared with three in 1961. This gives an increased mortality rate of 0.92 per 1,000 total births compared with 0.61 last year and is the highest since 1955. DEATHS FROM CANCER OF THE LUNG AND BRONCHUS Deaths from cancer of the lung and bronchus fell, 138 occurring compared with 172 in 1961. 23 Twenty-eight fewer men and six fewer women died from the disease as compared with the figures last year. The deaths were split amongst the various age groups as follows. The figures in brackets are those for the year 1961. Males Females Totals 25-44 years 3 (5) - (2) 3 (7) 45 - 64 years 55 (66) 14 (15) 69 (81) 65 - 74 year 37 (48) 11 (7) 48 (55) 75 years and over 16 (20) 2 (9) 18 (29) 111 (139) 27 (33) 138 (172) During the last thirteen years 1,626 deaths have occurred from lung cancer whilst over the same period 510 people have died from respiratory tuberculosis. The following graph shows the comparison between the deaths from cancer of the lung and respiratory tuberculosis. 24 COMPARISON OF DEATHS FROM RESPIRATORY TUBERCULOSIS AND CANCER OF LUNG AND BRONCHUS Cancer of Lung and Bronchus Respiratory Tuberculosis YEAR 25 ROAD TRAFFIC ACCIDENTS The following tables show the road traffic accidents occurring within the Borough of Lambeth during the year 1962 and the comparative figures and casualties for the period 1955-1962. The figures shown refer not only to Lambeth residents but also to persons lying 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. he 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. 26 ROAD TRAFFIC ACCIDENTS 1962 WITHIN THE BOROUGH OF LAMBETH Month No. of Accidents Adults Children Totals Killed Seriously Injured Slightly Injured Killed Seriously Injured Slightly Injured January 129 2 22 102 - 5 15 146 February 112 1 19 97 - 1 11 129 March 141 6 18 131 - 4 17 176 April 139 2 22 130 - 5 12 171 May 154 1 18 135 - 2 28 184 June 181 2 17 147 - 9 34 209 July 143 - 18 104 - 4 41 167 August 143 1 15 144 - 5 27 192 September 156 2 13 124 - 7 29 175 October 178 1 29 123 - 4 34 191 November 166 2 15 156 1 3 23 200 December 140 8 27 118 - - 13 166 TOTALS 1782 28 233 1511 1 49 284 2106 Accidents per mile of road 12.71 Casualties per mile of road 15.02 27 BOROUGH OF LAMBETH COMPARATIVE FIGURES OF ACCIDENTS AND CASUALTIES FOR THE PERIOD 1955 - 1962 1955 1956 1957 1958 1959 1960 1961 1962 Number of accidents imvolving personal injury 1,246 1,272 1,212 1,505 1,739 1,890 1,819 1,782 Casualties per mile of road 8.80 8.98 8.56 12.6 14.6 16.2 16.2 15.02 Casualty Figures Adults Killed 14 12 12 17 21 18 19 28 Seriously Injured 187 174 196 240 254 273 281 233 Slightly Injured 1,002 1,067 1,052 1,293 1,535 1,668 1,550 1,511 Totals 1,203 1,253 1,260 1,550 1,810 1,959 1,850 1,772 Children Killed 1 2 1 2 2 3 1 1 Seriously Injured 35 29 24 45 44 59 58 49 Slightly Injured 189 211 175 193 204 276 292 284 Totals 225 242 200 240 250 338 351 334 Combined Adults and Children Totals 1,428 1, 495 1, 460 1, 790 2,060 2,297 2,201 2,106 29 SECTION B PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES The undermentioned diseases are compulsorily notifiable within the Borough of Lambeth. Anthrax Cholera Continued Fever Diphtheria Dysentery Encephalitis, acute Enteric Fever Erysipelas Food Poisoning Malaria Measles Membranous Croup Meningococcal intection 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 The following tables show the total number of corrected notifications, other than tuberculosis, received during the year. 30 NOTIFICATIONS (CORRECTED) EXCLUDING TUBERCULOSIS Disease 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Totals Grand M F M F M F M F M F Total Scarlet Fever 10 8 12 15 6 6 2 6 30 35 65 Whooping Cough 4 5 7 5 9 11 10 13 30 34 64 Acute Poliomyelitis Non-paralytic - - - - - 1 - - - 1 1 Measles 11 15 22 16 25 19 206 209 264 259 523 Dysentery 13 16 23 18 10 9 37 45 83 88 171 Meningococcal Infection 2 1 - 1 - - 1 - 3 2 5 Pneumonia 9 4 7 2 1 - 7 5 24 11 35 Acute Encephalitis (Infective) - - - - 1 - - 1 - 1 Acute Encephalitis (Post Infectious) - - - - - 1 - - - 1 1 Typhoid Fever - - 1 - 1 1 1 1 3 2 5 Paratyphoid Fever - 1 1 - - - - - 1 1 2 Erysipelas - - - 1 - 1 1 - 1 2 3 Food Poisoning 2 3 1 1 3 1 1 3 7 8 15 Puerperal Pyrexia - 23 - 26 - 10 - 3 - 62 62 Ophthalmia Neonatorum 3 5 13 9 1 - - - 17 14 31 Scabies 2 1 5 1 4 1 1 2 12 5 17 TOTALS 56 82 92 95 61 61 267 287 476 525 1001 31 NOTIFICATION OF INFECTIOUS DISEASE - AGE DISTRIBUTION Age Groups Scarlet Fever Whooping Cough Acute Poliomyelitis Non-Paralytic Measles Dysentery Meningococcal Infection Scabies TOTALS M F M F M F M F M F M F M F Under 1 year 1 - 5 4 - - 9 13 4 4 1 1 - 1 43 1 year - - 5 6 - 1 35 25 8 8 - - - - 88 2 years 1 3 4 6 - - 24 44 7 6 - - 1 - 96 3 years 1 4 4 4 - - 32 30 6 9 - - - - 90 4 years 4 3 2 2 - - 42 31 8 6 - - - 1 99 5-9 years 11 18 9 10 - - 109 106 29 24 - - - 1 317 10-14 years 5 5 1 2 - - 3 4 6 11 - - 2 - 39 15-24 years 6 2 - - - - 6 3 7 5 1 1 4 1 36 25 years and over 1 - - - - - 4 3 8 15 1 - 5 1 38 TOTALS 30 35 30 34 - 1 264 259 83 88 3 2 12 5 846 Age Groups Pneumonia Acute Encephalitis Typhoid Fever Paratyphoid Fever Erysipelas Food Poisoning Puerperal Pyrexia Ophthalmia Neonatorum TOTALS Infective Post Infectious M F M F M F M F M F M F M F M F M F Under 5 years 2 2 - - - 1 2 - - - - - 2 1 - - 17 14 41 5-14 years 2 1 - - - - - - 1 - - - - - • - - - 4 15-44 years 8 1 1 - - - 1 2 - 1 - - 3 3 - 62 - - 82 45-64 years 7 5 - - - - - • - - 1 1 2 2 - - - - 18 65 years and over 5 2 - - - - - - - - - 1 - 2 - - - - 10 TOTALS 24 11 1 - - 1 3 2 1 1 1 2 7 8 - 62 17 14 155 GRAND TOTAL 1001 32 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 30 10 25 65 Whooping Cough 15 38 11 64 Acute Poliomyelitis Non-Paralytic - 1 - 1 Measles 33 245 245 523 Dysentery 122 28 21 171 Meningococcal Infection 1 3 1 5 Scabies 4 6 7 17 Pneumonia 11 13 11 35 Typhoid Fever 1 2 2 5 Paratyphoid Fevers 1 1 - 2 Erysipelas 1 - 2 3 Food Poisoning 9 2 4 15 Puerperal Pyrexia 53 9 - 62 Ophthalmia Neonatorum 28 2 1 31 Acute Encephalitis (Infective) - 1 - 1 Acute Encephalitis (Post Infectious) - - 1 1 TOTALS 309 361 331 1001 33 NOTIFICATIONS OTHER THAN TUBERCULOSIS The total number of corrected notifications received during the year fell considerably, 1,001 being received compared with 4,024 in 1961. This was due mainly to the fact that 1960 was a "measles" year when 3,462 cases of the disease were notified. In addition there was a general decrease in the number of cases of other notifiable diseases as is indicated in the following table. Disease Number of cases notified in 1962 Number of cases in 1961 Increase Decrease Scarlet Fever 65 115 50 Whooping Cough 64 119 55 Dysentery 171 127 44 Meningococcal Infection 5 6 1 Pneumonia 35 63 28 Typhoid Fever 5 2 3 Para-typhoid Fever 2 1 1 Erysipelas 3 9 6 Food Poisoning 15 16 1 Puerperal Pyrexia 62 73 11 Ophthalmia Neonatorum 31 6 25 Scabies 17 23 6 Poliomyelitis One non-paralytic case only, a girl aged 1 year was notified during the year. This compares favourably with the incidence last year when 2 cases, both paralytic were notified, 1960 when 7 cases (4 paralytic and 3 nonparalytic) were notified and 1959 when 16 cases (8 paralytic and 8 paralytic) occurred. 34 Food Poisoning The fifteen cases of Food Poisoning were distributed throughout the year as follows- F irst Quarter 5 Second Quarter 2 Third Quarter 4 Fourth Quarter 4 15 They were single cases spread throughout the Borough and there were no outbreaks of food poisoning. The agent was indentified in 9 cases Salmonella Typhimurium 4 Salmonella Anatum 1 Salmonella Bredeney 2 Salmonella Heidelberg 1 Salmonella Newport 1 In the remaining six cases the agent was not identified. In addition to the notified cases, two symptomless excreters were discovered. The organism isolated from both was Salmonella Bredeney. Both these cases were connected with an outbreak of food poisoning originating in another London Borough. Typhoid Fever Five cases of Typhoid Fever were notified during the year. In one of these cases, a boy of 4 years, it was not possible to discover the source of the infection. Of the remainder, two, a man and wife, had recently been on holiday in Spain and one had returned from Italy where she had been visiting relatives. The latter case had been one of a party of four of which no others were affected. The remaining case occurred in a child of 15 months. Bacteriological examination of the family revealed that the grandmother was excreting the organism, although symptomless. She was an immigrant from the West Indies 35 it was not possible to get a history of previous infection with Typhoid. She was admitted to hospital but her carrier state persisted and she was eventually discharged under supervision. Shortly after discharge she moved out of the district and the health department into whose area she moved was notified. 36 BOROUGH OF LAMBETH IMMUNISATION - 1962 Welfare Centres and Nurseries General Practitioners Completed Cases Under 5 years 5- 14 years Under 5 years 5-14 years Totals Diphtheria Prophylaxis only 7 46 2 3 58 Combined Antigen Diphtheria and Whooping Cough - 4 1 1 6 Triple Antigen Diphtheria, Whooping Cough and Tetanus 2903 30 695 39 3667 Diphtheria and Tetanus 48 129 4 9 190 Diphtheria - boosting doses - all ages 2457 558 3015 Whooping Cough only all ages (completed cases) 1 3 4 37 Diphtheria immunisation is the responsibility of the London County Council, but may also be carried out by general practitioners 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 the person's own doctor) must be obtained by the traveller himself and taken to the doctor, it is NOT for the Doctor, or a Local Authority, or their Medical Officer of Health, to supply them. The forms can usually be obtained by the traveller from the Company arranging his transport, or he can get them from the Ministry of Health, Alexander Fleming House,Elephant and Castle, S.E.1. After completion by the vaccinator, certificates must be franked with an approved stamp. Approved stamps have been prescribed for the United Kingdom. If the vaccinator is not himself an authorised user of a stamp, the person vaccinated must take or send the certificate for stamping to a Local Authority. In England and Wales this is the Town 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, 5004 International Certificates of Vaccination were stamped by the Public Health Department. 38 TUBERCULOSIS Notification The following table shows the number of cases of tuberculosis notified for the first time during the year 1962 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 6 4 - - 10 5-14 years 3 3 - 2 8 15 - 24 years 7 6 1 1 15 25 - 44 years 19 18 2 3 42 45 - 65 years 36 6 - - 42 65 years and over 11 3 - 1 15 TOTAL 82 40 3 7 132 These primary notifications were distributed amongst the Parliamentary Constituencies as follows:- Norwood 41 Brixton 49 Vauxhall 42 The number of cases of tuberculosis remaining on the Register at the and of the year is as follows:- Respiratory Non-respiratory Total Men 1571 63 1634 Women 1252 78 1330 Children 127 44 171 TOTAL 2950 185 3135 39 HOSPITAL ADMISSIONS AND DISCHARGES Parliamentary Constituency Respiratory Non- respiratory Admitted Discharged Admitted Discharged m F m F m F m F Vauxhall 41 8 17 5 1 - 1 1 Brixton 24 10 11 2 1 4 - - Norwood 11 6 10 - 3 4 2 1 total 76 24 38 7 5 8 3 2 According to the figures supplied by the Registrar General, the following deaths from tuberculosis occurred during the year. Tuberculosis of Respiratory system Other forms of Tuberculosis All forms of Tuberculosis Male Female Total Male Female Total Male Female Total 20 2 22 1 1 2 21 3 24 The following table shows the primary notification of tuberculosis for the ten year period 1953-1962. Year Respiratory Non- respiratory Totals Rate per 1,000 population 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 1961 126 18 144 0.65 1962 122 10 132 0.59 40 The following table shows the number of deaths from tuberculosis for the ten year period 1953-1962. Year Respiratory Non- respiratory Totals Rate per 1,000 population 1953 46 7 53 0.23 1954 34 7 41 0.18 1955 32 4 36 0.16 1956 22 - 22 0.11 1957 17 5 22 0.10 1958 24 2 26 0.13 1959 27 2 29 0.13 1960 15 6 21 0.09 1961 27 2 29 0.13 1962 22 2 24 0.11 41 DEATH RATE FROM ALL FORMS OF TUBERCULOSIS PER 1,000 POPULATION AND NOTIFICATION RATE PER 1,000 POPULATION Deaths Ten Year Period Notifications 1953 - 1962 42 I am indebted to Dr. Price, Consultant Chest Physician at St. Francis' Hospital for the following report on the work of the ChestClinic during the year. REPORT ON CHEST CLINIC WORK 1962 For the year 1962 the Ministry of Health made certain modifications in the form of return covering the work at Chest Clinics and amended Chest Clinic registers so as to include observation cases with a tuberculous background not formally notified under the Tuberculosis Regulations. This has the effect of increasing the total number of cases on the register as recorded in the tables which follow although in fact there has been no increase in incidence of the disease and the steady decline in the total number of cases in the Borough has been maintained. Table 1 is an extract of the Annual return of Chest Clinic work as now prepared for the Ministry of Health. Table l.A. is presented in its original form to allow comparison with previous years and includes only those cases which have been notified under the Tuberculosis Regulations. TABLE 1. 1. Number of cases of tuberculosis (whether notified or not) on the register as beingunder treatment or supervision on 31st December. RESPIRATORY NON-RESPIRATORY Men Women Children Total Men Women Children Total 760 564 50 1,374 18 22 2 42 2. Number of cases (whether notified or not) added to the register during the year ended 31st December who have radiological evidence of respiratory tuberculosis. NOT BACTERIOLOGICALLY CONFIRMED BACTERIOLOGICALLY CONFlRMED Men Women Children Total Men Women Children Totals Group I 19 23 3 45 8 4 1 13 Group II 6 2 - 8 9 5 - 14 Group III - 1 - 1 4 2 - 3. Number of cases of non-respiratory tuberculosis (whether notified or not) added to Clinic Register. Men Women Children Totals 2 4 2 8 4. Number of cases included in 1. whose broncho-pulmonary ) secretion was positive during the year. )22 43 TABLE l.A. Respiratory Tuberculosis Non-respiratory Tuberculosis Men Women Children Total Men Women Children Total Total cases on Clinic Register at 31.12.62. 640 454 50 1144 18 22 - 40 Number of cases diagnosed during the year 33 26 1 60 2 4 2 8 Recovered 5 7 1 12 - - - - Deaths 14 4 - 18 - - - - Deaths As in previous years the majority of deaths occurred among men in the older age groups, 4 were of no fixed abode resident in the London County Council's hostel for tuberculous men at Knight's Hill. Of the total 18 deaths, 6 only were directly attributable to tuberculosis and in these cases, for various reasons the successful application of chemotherapy had been frustrated. Otherwise of the remaining 12, seven were over 70 years of age with senility playing its part and of the other five tuberculosis was of minor significance being secondary to other diseases including malignancy, diabetes, cardio-vascular degeneration and, in two cases, suicide. The 4 female deaths occurred in cases of long standing where permanent lung damage had been sustained before the advent of chemotherapy and again advancing years played a significant part. There were no deaths from non-respiratory tuberculosis. Respiratory Tuberculosis The continued decrease in the number of cases occurring in the Borough was reflected in the lower total of 60 new cases diagnosed and added to the register during the year. Two thirds of these cases were discovered in an early phase when not more than one third of either lung field was affectedgroup 1 in Table 1- and is a tribute to the use of chest X-ray examination at the Chest Clinic, at hospitals and mass radiography units. Found at this stage the disease responds quickly to treatment and usually proves curable. Among women the annual incidence of new cases has remained unchanged over the past 10 years - an average of 25 being added to the register- and the yearly reduction in total incidence has occurred entirely in males. This year there was little difference between the sexes - 33 males, 26 females being 44 added to the register of notified cases. There were also new observation cases placed on the clinic register - but again approximating equal numbers between men and women. The number of cases occurring in children was again small - 6 only being diagnosed in the year. This includes one observation case and two of nonrespiratory disease. All cases had a contact history and none had had B.C.G. vaccination. Non-Respiratory Tuberculosis No case of bovine infection was recorded - this form of tuberculosis has been eradicated by the heat treatment of milk and the tuberculin testing of cattle. The 8 new cases during the year could be traced to an initial primary lung infection of which the non-respiratory disease was a secondary manifestation. 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 1960 1,239 89 12 26 1961 1,159 77 23 28 1962 1,144 60 18 12 Table 2 compares chest clinic figures over the past 12 years and demonstrates the continued fall in incidence of pulmonary tuberculosis. The fall is slow compared with ten years ago, the hidden infector pool of chronic sputum positive carriers is still responsible for sporadic cases and is difficult to detect and treat - particularly as a considerable percentage have tuberculosis organisms resistant to drugs as a result of taking inadequate or frustrated treatment using anti-tuberculosis chemotherapy. This problem is to some extent met by the establishment of tuberculosis hostels such as the one at Knight's Hill administered by the London County Council. Here chronic infective ambulant cases are housed and cared for under medical supervision and attend the chest clinic regularly. They are encouraged to avoid presenting any casual infectious risk to other members of the community and yet suffer no obvious stigma of segregation. Here too are received cases previously uncooperative and reluctant to take treatment who, responding to the hostel environment and persuasion, ultimately accep chemotherapy and become non-infectious. During the year, of the 30 residents 6 only proved completely unresponsive to treatment and all of these were carriers of organisms resistant to chemotherapy. The risk to others lS greatly reduced when such men, often wanderers, are taken off the streets, lodging houses and reception centres to be placed in special hostel accommodation. 45 Treatment Chemotherapy is the mainstay of treatment - taken at home after perhaps two or three months initial assessment and treatment in hospital. A ward for male cases under the Chest Physician's supervision is available in Dulwich Hospital. Female patients may be admitted to Grove Park Hospital. Beds for both male and female cases are also immediately available in country chest hospitals. Long term treatment is now the rule with a minimum of two years Usually advised. At any one time an average of 150 chest clinic patients Were receiving chemotherapy. B.C.g. Vaccination This is now an established procedure in the general scheme for tuberculosis prevention. Vaccination is offered to all school children approaching school leaving age under arrangements by the London County Council. Children showing a positive reaction at school to the preliminary skin tuberculin test are referred to the Chest clinic for routine investigation including chest X-ray examination and examination of contacts to discover any possible source case of infection. B.C.G. vaccination is arranged at the chest clinic for contacts at special risk, for new born contacts andhospital staff; 120 such vaccinations were performed during the year. Notification In the Ministry's recognition of tuberculosis cases "whether notified or not'' is implied a modification of the regulations governing the formal notification of such cases under chest clinic supervision. It must be stressed owever that this does not in any way relieve General Practitioners, Hospital Medical Officers and Chest Physicians of the obligation, under the Tuberculosis Regulations, to notify cases on diagnosis to the Medical Officer of Health. Failure to do so could only result in breakdown of arrangements for examination of contacts and paralysis of the Tuberculosis Health Visiting service dependant as they are on information received through this channel and would lead to a regrettable increase in the number of non-notified deaths and posthumous notifications. Health visiting y The London County Council provides two fufll time Tuberculosis Health visitors, based on the chest clinic at St. Francis' Hospital, to cover duties in the South Lambeth area. Visits are paid to the homes of cases when newly notified and as a routine to all cases on the notification register whether attending the chest clinic or not. Other visits are made on instruction from the Chest Physician to patients who-are not notified but who are under chest clinic advice. On the Health Visitor's report an opinion can be formed on the Problem of housing adequacy and suitability and during the year the Chest Physician continued to make medical recommendations for preferential rehousing in selected cases. The Health Visitors paid 3,982 visits to patients homes during the year, Welfare With few exceptions the needs of patients are adequately met by the National Insurance and the National Assistance offices with whom close liason is maintained. Extra provision is made on the Chest Physician's recommendation for those suffering from respiratory tuberculosis.Necessitous patients may 46 also be referred to the London County Council for the supply of extra nourishment and during the year 94 such cases were provided with milk, butter and eggs. It has been found no longer necessary to employthe services of a full time Welfare Officer and this aspect of chest clinic work is covered in the duties of the Physician's Secretary who is also secretary to the Chest Clinic Samaritan Fund Committee. This voluntary fund is used to assist patients in immediate need and where such help is not available from official sources. It is supported by a donation from the Mayor of Lambeth and a contribution from the Sunday Cinematograph Fund. Help from the fund was given to 158 patients during the year. 47 SECTION C GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA Care of the Aged The work in connection with the care of the aged continued to increase, in fact it reached a point where it could no longer be covered adequately by the one woman public health visitor employed by the department Having regard to this the Council approved a proposal to appoint an additional visitor, the Officer to be a state registered nurse. It is hoped that this appointment will be made early in the new year. The number of visits made by the Public Health Visitor increased by 401, 3,500 being made compared with 3,099 last year. During the year 553 new cases were brought to the notice of the Public Health Department, an increase of 27 over the number of new cases for 1961. These cases were split up into the following age groups. Male F emale Totals 60 - 69 years 40 83 123 70- 74 years 30 62 92 75- 79 years 46 73 119 80 - 84 years 40 77 117 85 - 89 years 21 56 77 90 - 94 years 4 21 25 95 years and over - - - 181 372 553 A total of 526 persons received help in some form or another, in 26 cases no help was required and in 7 instances help was refused. One hundred and forty-nine old people were persuaded to enter hospitals and institutions voluntarily and two were removed by the Mental Welfare Officer. 48 No one was removed compulsorily under the National Assistance Act 1948 or the National Assistance (Amendment) Act 1951. This is a tribute to the persuasive powers of the Public Health Visitor. The number of cases on the register at the end of the year, including those from previous years, is 2,189. Laundry Service for Aged Incontinent Persons The arrangements made with the Southwark Borough Council for carrying out this service continued satisfactorily during the year. The total number of persons receiving benefit from the scheme was 146(154), the total visits made were 2,758 (3125) and the total number of soiled articles collected and taken to Southwark Cleansing Station was 28,412(29,159). The total weight of the laundry cleansed was 24,953 lb (26,163 lb). The figures given in brackets are those for the year 1961. Home Bathing Scheme An increasing number of aged persons is benefiting from this service and during the year 2,400 baths were given. This is an increase of 260 over the figure for 1961. Holidays for the Elderly This year Brighton was the chosen resort for the old age pensioners' holidays. Under this scheme approximately 400 old age pensioners, all of whom must have lived in Lambeth for the past three years, whose income is within certain defined limits, and who have not had any other holiday for the past three years (two in the case of pensioners over 76 years of age) are taken on holiday for one week, on payment of the nominal sum of £1. During March and April each pensioner who, after completing the necessary application form, was eligible to go on holiday was seen by the Medical Officer of Health. At this interview an assessment was made of the physical condition of the applicant and the need recorded for any special consideration such as ground floor accommodation, single room and diabetic injections. April saw the issue of travel and holiday documents, and also the inevitable cancellations caused through illness and hospital admissions. On each of the four successive Saturdays in May parties of 60 old folk were taken by coach to Brighton for their holiday, returning on the following Saturday. The first party was seen off by His Worship The Mayor, the Mayoress, Chairman of. the Public Health Committee and the Chairman of the Lambeth Old People's Welfare Association. 49 During July and August, similar arrangements were made for the Autumn holidays which took place in September. In September a Mayoral Party accompanied by the Medical Officer of health went to Brighton to see the old folk in their holiday accommodation and also to see the Director of the Company with whom the accommodation is reserved. As in previous years many letters of appreciation were received from the participants in the scheme. The tables overleaf show the numbers of old folk taken on the Spring and Autumn holidays, with their ages and parliamentary divisions. 50 OLD PEOPLE'S HOLIDAYS, 1962 SPRING Parliamentary Division Males Females Totals M.C.* 65/70 years 71/75 years 76/80 years 81 years & over 60/70 years 71/75 years 76/80 years 81 years & over Vauxhall 3 2 7 6 11 9 15 3 56 4 Brixton 4 5 5 3 21 9 20 11 78 6 Norwood 5 7 9 6 25 16 21 17 106 10 Totals 12 14 21 15 57 34 56 31 240 20 AUTUMN Vauxhall 1 4 0 3 9 9 9 5 40 3 Brixton 1 3 4 3 10 9 11 7 48 3 Norwood 4 4 5 4 14 16 17 8 72 11 Totals 6 11 9 10 33 34 37 20 160 17 * Married couples included in total. 51 I am indebted to the Chairman and Members of the Executive Committee of the Lambeth Old People's Welfare Association for allowing me to include the Allowing report on the activities of the Association. It should be noted that the Association's year covers the period from 1st April, 1962 to 31st March, 1963 and therefore does not co-incide strictly with the period covered by my Annual Report. REPORT The winter of 1962 will be vividly remembered by many elderly people as a time of hardship and suffering. However, the memory of their misery, will be balanced in the minds of the members of the Executive Committee by the knowledge that the winter demonstrated quite simply the appropriateness of its Prior decision to develop and extend the work of the Association. The new Executive Committee, at its first meeting in July, decided to set up a Sub-Committee to study the work of the Association in relation to the needs of the community it serves. The Sub-Committee has held a meeting in nearly every month since its inception. A special report on old people's Welfare in Lambeth was prepared in November and considered in detail by the Executive Committee and the Council's Public Health Committee. The consequences of this hard work and heart searching were threefold: first, it was decided to appoint a Deputy Organising Secretary, to be responsible for the establishment and working of a comprehensive welfare visiting service, and in the first instance three full-time welfare assistants to be trained as Welfare visitors; second, it was agreed that a part-time Accommodation Officer, and a part-time organiser for a new "Good Neighbour and Sitter-In Service" should be appointed. And finally, it was decided that active steps should be taken to acquire sites, or premises, for the establishment of a central kitchen for the meals services, and for day centres or day clubs available to people living in every part of the Borough. The last item is still at the planning stage, meanwhile the other developments are already in Progress, and more details on how they will affect the day to day work of the Association are contained in subsequent sections of this report. general Welfare Work The foundation of all the Association's work lies in the maintenance of close contact with elderly people; it is therefore gratifying to be able to report that during the year under review there were 8,550 new contacts with People already known to the Association, an increase of 3,500 over last year. in addition, 2,124 new people became known, 545 of whom called at the office for help or advice. The Association's staff continue to learn from the queries that are raised by the old people: and even on occasions when is finally found that an individual's problem cannot be solved, the investi gation by the staff on behalf of the person helps them to solve more readily another persor's difficulty. 52 | The office receives many and varied requests for help. Some people are found to be in need of simple material help such as clothes, furniture and bedding and the Association is often able to help immediately because of the many gifts it receives from members of the public. A fairly common request is for help with interior decorating. It has always been possible to get help for really desperate cases from voluntary organisations such as Toc H, but there are now two local groups of the International Voluntary Service which specialises in decorating, and it is therefore expected that help will be available to more people. The Association is constantly aware of its real challenge and that is the need to ensure that every elderly Lambethan who is in need of any sort of help or advice should know of, and feel able to approach, the AssociationExpansion and improvement of services and planned publicity drives should all help in this direction. Visiting Contact with the infirm can only be made by home visits. Similarly once a person is known to the Association it is possible in this way to keep in touch and ensure that any help required is made available. During the year under review 1,690 welfare visits were made by the Association's staff, almost twice as many as last year. Most of these visits were made at the request of social workers, family, friends, or neighbours to investigate particular problems. In addition, whenever time allowed, visits were made to older or infirm people with whom the Association had had no recent contactIn many cases it was found that they were in immediate need of help and services. This experience, plus the many cases of hardship revealed by the severe winter, reinforced the Executive Committee in its decision to attempt to establish a comprehensive visiting service. The Deputy Organising Secretary who is a trained and experienced social worker took up her duties on 1st April and three welfare assistants will start work in May. The results of the work of the visiting staff will be kept under close investigate0" and if considered justified, further appointments could be made before the end of the coming year. It is clear that with the expansion of welfare visiting there will be an ever increasing need for voluntary workers to undertake friendly visiting Many elderly people have no family or close friends living nearby, and the pleasure and help they receive from regular visits from a local resident introduced to them by the Association can be quite considerable. Association would like to thank all those organisations and individuals who are helping in this way and especially those who offered their services for the first time during this year. Every effort will be made to expand aspect of the work during the coming year and otters ot help will gratefully received. 53 Meals-onWheels During the year under review 51,203 meals were delivered by the Association in the Northern part of the Borough: 47,675 to people in their own homes and 3,528 to lunch clubs. The Southern part of the Borough was served by the Women's Voluntary Service which delivered 22,835 meals, all to People in their own homes. Taking the Borough as a whole the largest lumber of people served on any one day was 393, of which 48 were at lunch clubs. Taking just the Association's meals-on-wheels figures and comparing them with last year, it is found that the total number of meals served and the number of people receiving them, have both more than doubled during the year under review. To a certain extent this is due to the fact that the year started with the extension of deliveries from four to five days and the addition of one round taken over from the W.V.S. However, even apart from these additional commitments the expansion during the year has been considerable. The year started with four vans delivering up to 166 individual meals per day. By September the number had risen to 201, and it was essential to purchase a fifth van. In January the figure rose to 240 and a sixth van had to be put into operation bringing considerable relief to the delivery staff, who despite the hazards of the weather and the excessively high delivery figures, cheerfully carried on and never failed to do whatever was required of them. The Association never ceases to be aware of the extent to which the good humour, cooperation and help of its meals staff make this service much more than the mere supply of food. It is a unique opportunity to give daily support and encouragement to the most helpless Members of the community, and every effort is made to fulfil this function. It has been clear for some time that the Association's caterers will not be able to expand their supply indefinitely. Plans are therefore in hand for a central kitchen, but it does not appear to be likely that it will be in operation during the next two years. In order to bridge this gap the Executive Committee has arranged to rent a kitchen and canteen at Springfield Hall meethodist Church, Wandsworth Road, which will come into operation from 13th May. Not only will this be a supplementary source of supply for the meals-on-wheels service but it will enable the Association to gain experience of catering and running a lunch club. The setting up of this unit has been facilitated enormously by the guidance and help of the Officers and members of the Canteen Committee of Lambeth Municipal Officers'Guild which also agreed to allow the Association to hire the part-time services of the Guild's excellent Manageress. The Association would like to thank all those Whose co-operation made it possible to plan and start this new venture so quickly and efficiently. Chiropody Once again it was a depressing and stagnant year for this service. The Association's six foot clinics continued to provide 27 three hour sessions per week and together with the 7 weekly sessions of domiciliaiy treatment the service reached about 2,500 elderly people. 54 Nevertheless, throughout the year demand was so great that waiting lists had to be maintained and many patients had to wait between six to nine months before they could be given a first appointment. It is therefore with very great pleasure that the Association can report that in March the London County Council authorised, andpromised grant aid, for a fairly substantial expansion of the service. In consequence it has been possible to start the new year completely clear of waiting lists, and with funds available for furtherexpansion as, and when, the demand for treatment makes it necessary. This long needed expansion has been like an end of year bonus for the chiropodists who have given devoted service to the Association. The same of course, applies to the receptionists, whose unfailing voluntary service does so much to help the service along. Their efforts are greatly appreciated by the Association. Holidays Many elderly people find it difficult to get out and about during the winter months and therefore look forward with great pleasure to an opportunity to get away for a change during the summer. This year 40 women saved with the Association for two weeks holiday under the auspices of the Women's Holiday Fund which offers vacancies throughout the summer at holiday homes on the South Coast. The Lambeth Borough holiday scheme continues to be very popular and 400 people stayed for a week during the Spring or Autumn in Boarding Houses and small Hotels at Brighton. This year the rule about the waiting period between holidays was reduced from three to two years for people over seventy six, a change which was welcomed with great enthusiasm by older Lambethans. In addition help was given towards holidays for nine infirm people; and every effort was made to keep details of other holiday projects and arrangements to pass on to people who were not eligible for, or did not wish to participate in, the above schemes. The Association wishes to thank the Women's Holiday Fund and other similar organisations whose co-operation has been invaluable. Half Day Summer Outings Last year for the first time the Association arranged an Outing for older more infirm people who did not belong to clubs. The success of this first attempt was sufficient to encourage the extension of the programme for this year. There were three outings in May, one in June and one in July; a total of 110 people participated, and over half of them were more than eighty years of age. Two groups of ten people were entertained by the Kennington Toc H at a private house in Chessington, the Association's minibus being lent to them on both occasions. The other three outings were made possible by the generosity of the Hedgerly, Kingsnorth and Swalecliffe, and Chestfield Women's Institutes who each provided tea and entertainment; and the Rotary Club of Brixton which paid for all three coaches. Every effort was made to offer these outings to people who lead restricted lives because of physical or mental infirmity, and there is no doubt that they were greatly appreciate and of considerable value. The Association is glad to have an opportunity to thank the members of the Women's Institutes, the Rotary Club and Toc H without whose cooperation and help this type of service would be impossible 55 Lambeth Centre for the Elderly, 69/73 Knowle Road, S.W.9. The official opening of the Centre was performed by His Worship the Mayor on 18th June in the presence of Mr. Marcus Lipton, M.P.for Brixton; the members and friendsof the Association; the Lambeth Borough Councillors; and the representatives of regional and national old people's organisations Included in the ceremony was the presentation of a small gift to the retiring Honorary Treasurer, Mr. R.E. Doubleday who had given ten years loyal and hardworking service to the Association. During the year people from various Parts of the United Kingdom and abroad have visited the Centre and there have been favourable comments on the decor and comfort of the Centre. In March the Mayor made a return visit to the centre which made a fitting ending to its first year of life. Work Centre. The move to the new Centre at the beginning of the year resulted in some loss in members. During the year under review the membership rose steadily from 36 to 62, including at one time 13 men the largest number in the history of the work centre. The Council's Public Relations Officer prepared an excellent publicity leaflet which was circulated to local firms and resulted in a number of new contracts. Many jobs have been done in connection with the distribution of advertising literature which is clean, simple and interesting work. However most of the new contracts have been spasmodic and it has been useful to have button carding, hose darning and tin foil sorting to fill in the gaps. In December the wages of the members was increased from 10/- to 15/Per week (from 1/- to 1/6 per hour). The Chairman communicated this change to the members at the Christmas party and he also took this opportunity to explain the spirit behind the work being done in the Centre. He Trade it clear that every worker was expected to give of his or her best and that people who treated it merely as a club where one received wages would be expected to move upstairs to the Rest Room. The members greatly appreciated his frank words and have made every effort to take a responsible attitude towards the work they are doing which has served to improve the Quality and quantity of work produced. The Rest Room was opened on 18th June. At first only a few enquiries were received, but with the help of a publicity leaflet membership steadily increased, reaching by the end of the year the figure of 148. It was originally agreed that members should be restricted to attending two half days a week and that club members would be excluded. It was, however, found that People showed a marked reluctance to commiting themselves to attending at any particular time and it was also difficult to decide what type of group, Activity would be called a Club. The Executive Committee therefore decided to permit members to use the Rest Room at any time during the week, but all new members were warned that if the Rest Room became overcrowded entry wouldhave tobe restricted. In fact it has been found that there are rarely more than thirty people present at any one time. A relaxed companionable atmosphere has developed. Members play cards or other 56 games, watch T.V., listen to the radio, read, chat or just sit and stare, each according to his own tastes. Tea and biscuits are available in the morning and afternoon and both men and women volunteer to wash up afterwards. About a quarter of the members were not previously known to the Association. Many have comfortable and happy homes but nevertheless are grateful to have an attractive and comfortable place in which to meet friends or get out for a few hours. For people who live alone, or do not have very adequate accommodation, it has provided an excellent retreat fora few hours. Many of these people do not wish to join an old people's club because they do not like participating in organised activities. The Association would like to express its gratitude to all those who have made gifts to the Centre and also to the Lambeth Library which has supplied a good selection of books on semi-permanent loan. Clubs The thirty clubs represented on the Association show considerable variety, but each provides to its members the opportunity to meet others, to make new friends, to take part in outiiigs, parties, entertainments, and other activities. Through the clubs the Association is able to publicise the various activities and services available to the elderly. It is hoped that club leaders feel able to approach the Association for advice, or assistance, with the problems of individual members, or of the clubs activities in general. The club leaders and helpers are always ready to give help and support to the activities arranged during the year and their unfailing loyalty and generosity is greatly appreciated. Grants. During the year under review the Association received applications for financial help from 15 different clubs and made 10 grants towards rent or its equivalent; two grants for the purchase of equipment; and six grants of up to £5 to be spent on the fees or expenses of entertainers. Many of the clubs experienced financial hardship because of poor attendance during the winter, and this was one of the reasons for the increased number of rent grants made this year. It is hoped that no club has had to cut down on its activities because of lack of money. Inter-Borough Talent Contest. Five clubs were represented among the eleven entries for the Lambeth heats held in March. The judging most expertly carried out by the Mayor and two members of the Black and White Minstrel Show. The Association hired a coach to take a party of People to the main competition held in St Pancras Town Hall. The Inter-Club Competition and Exhibition of Work was held in OctoberFifteen clubs were represented among the prize winners and the Competition shield was won by the Springfield Club. Although nearly 450 articles were entered for the competition, apart from the handwriting section, the number of entries in almost all classes were considerably less than in the previous year. The painstaking skill of the five judges was greatly appreciated. Due to the generosity of Miss G. Cuthbertson it was possible to award eight special prizes for effort rather than skill. 57 The Christmas Concert by Old People for Old People held in December Was accompanied by dense fog. Neverhteless the twenty-one club members who braved the elements had a thoroughly enjoyable afternoon helped considerably by the lively compering of Mr. Dave Walker. King George VI Memorial Club (Camberwell and Lambeth) The Association is fortunate in sharing with Camberwell this almost unique day club for the infirm. Members normally attend one day a week and are taken to and from the club in its own two vehciles. The provision of transport is one of the expensive aspects of the Club and for this reason every effort is made to provide services on the premises as well as normal club activities; for example, bathing, chiropody, hairdressing, handicraft instruction, help with shopping and where necessary help with personal Problems. During the year under review there was a total of 10,544 attendances which is lower than last year largely due to fog and snow during the winter. The 428 members on an average attended the club on seven out of every ten club days, and 90 people missed only one out of every ten club days. This gives a clear indication of the attraction of the club as most of the members are people who find it quite an effort to get up early, wash and dress themselves, and undertake to be away from home for a whole day. This year 186 People were put on the waiting list for membership but only 124 new members could be accepted. The approximate waiting time for admission is seven months but priority is given to people who are urgently in need of the Club's Services. This was the first full year during which the club's special 'sitting down' shower has been manned by a full time bathing attendant. By the end of the year the number of showers taken was between 30 and 40 per week, Each member of the club was able to take part in three outings during the Summer; a Christmas party; and a handwork sale and competition in the Autumn. Holidays were arranged for 73 members through various agencies Including the Association. Planned New Services Both the services described below require the appointment of a parttime trained and experienced social worker. In addition they are the type of services which require a considerable amount of groundwork. It is imporrtant therefore to realise that it may be many months before the Association is in a position to say that the services are available to elderly Lambethans. Good Neighbour and Sitter-in-Service. The aim of this service is to assist Womain groups of people; those who are at present compelled to enter old People's homes or hospital because the domiciliary services and family support are not sufficient for them to remain at home under reasonable 58 conditions of safety and comfort; and those others who are living in squalor and discomfort because they are unable to care for themselves adequately but refuse nevertheless to leave their own homes. The service will provide assistance through two types of paid helpers. Firstly, the 'sitter-in' who will stay with an old person occasionally or regularly for a few hours, thus providing relief for the individual who normally cares for the old person concerned. Secondly, the 'good neighbour' who will call in regularly to see that the old person has not fallen or become ill, to get shopping, to ensure that food is available and eaten, to attend to fires and check the safety of heaters and gas taps etc; in effect to give all the help normally forthcoming from a relative if he or she were available. The aim of the 'good neighbour' would be to provide regular daily care, unobtrusive supervision and personal friendship, supplementing but not replacing the services of relatives, friends, neighbours and the domiciliary services. Accommodation Officer. Once again this service will be an alternative to people who at present have no choice but to enter an old people's home. Accommodation would be sought for the following main groups of people: those who should not live alone because they are unable to care for themselves properly; those who are isolated and lonely and who would prefer not to live alone; those who are homeless, e.g. tenants who are given notice to leave their accommodation and people who retire from resident jobs; and those who are blocking hospital beds because they fall into one of the above categories. The type of accommodation sought will depend on the mental and physical condition of the particular person being helped, examples are full board; bed-sitter accommodation with some services or supervision e.g. mid-day meals, checking that clothes are changed regularly; or a straightforward furnished tenancy for someone able to care for themselves with or without the assistance of a home help or meals-on-wheels. Acknowledgments Throughout the year the work of the Association is furthered by the support of many organisations and individuals some of whom are mentioned in the Reportand others in the list of Donations. In addition acknowledgment and thanks must be given to the following: The Lambeth Borough Council whose outstanding generosity has made it so easy for the Association to expand and extend its services; and the Medical Officer of Health and other Council staff who are always ready to give help and advice. The members and officers of the various voluntary and statutory bodies represented on the Association whose co-operation ensures that the most effective use is made of the resources and goodwill available for the assistance of the elderly. The undermentioned for their donations or coroperation in the distribution of gifts at Christmas time:- 59 The Worshipful the Mayor of Lambeth The Staff of the Central Office of Information The Staff of the Englehard Industries Ltd. S.E.ll. Mary Datchelor Girls' School Norwood Girls' School Anonymous donor of pre-packed Christmas Dinners Brixton Rotary Club Lambeth Endowed Charities Norwood and District Welfare Fund British. Red Cross Society Women's Voluntary Service Kennington & Vauxhall Girl Guides Mr. Hird and South London Advertiser Mr. Porter, Chatsworth Baptist Church Kennington Toc H. Telephone Girls, Westminster N.A.A.F.I. Kennings Way Rev. Osborne, St. Anselm, Kennington Temple Bowling Club. The Cowley and Durand Infants Schools and Priory Secondary School for Girls for their gifts at Harvest Festival. The many people who remember the Association when they wish to dispose of unwanted clothes, beds, bedding, wheelchairs, home nursing equipment etc. 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 206). The office hours are from 9.30 a.m. to 5 p.m. Mondays to Fridays and 10 a.m. to 12 noon on Saturdays. HOSPITALS Lambeth is within the catchment 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 Governors. 60 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.ll. South Western Hospital, Landor Road, S.W.9. Annie McCall Maternity Hospital, Jeffreys Road, S.W.4. King's College Hospital Group King's College Hospital, Denmark Hill, S.E.5. Belgrave Hospital for Children, Clapham Road, S.W.9. St. Thomas's Hospital Group St. Thomas's Hospital, Westminster Bridge, S.E. 1. St. Thomas's Babies 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, 2, Walworth Road, S.E.1. 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 organisation The voluntary nursing associations working in the Borough are as follows :- Brixton District Nursing Association Camberwell 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 61 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. 62 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 1962. The source of water supply is mainly river-dirived filtered water with a small admixture of water from Honor Oak well. There were no new sources of supply instituted by the Board in the Borough during the year but new trunk mains were laid in Lambeth to the extent of 1,086 yards. There were no changes in the general scheme of supply in the Borough but lengths of small service mains were laid amounting to 1,215 yards. All new and repaired mains are chlorinated before being restored to service, and samples of the water from them are tested bacteriologically to ensure that its quality is up to that normally supplied. The number of samples taken during theyear was as follows Chemical Examination Bacteriological Examination River Thames - Southern Group 156 1,889 Honor Oak 3 48 159 1,937 The average results were as follows 63 Average Results of Chemical Examination Milligrammes per litre (unless otherwise stated) Description of the Sample No. Samples Ammonia Nitrogen Albuminoid Nitrogen Oxidised Nitrogen Chlorides as C1. Oxygen abs. from Permanganate 4 hrs. at 27C. Nitrite Nitrate Southern Group River Thames 156 0.042 0.076 4.0 31 1.12 Honor Oak 3 0.017 0.018 0.1 16 0.04 Description of the Sample Turbidity units Colour m.m. brown 2ft. Tube Burgess's Tintometer Hardness (Total) Hardness (noncarbonate) PH Value Phosphate as PO4 Silicate as sio2 Southern Group River Thames 0.2 12 256 58 7.8 1.3 10 Honor Oak 0.7 7 322 60 7.1 Description of the Sample Surface Active Material as Manoxol Sulphate as SO 4 Natural Fluoride as F Magnesium as Mg. B.O.D. 5 days as 20C Electrical Conductivity (Micromhos) Southern Group River Thames Honor Oak 0.12 61 0.25 6 550 570 64 Bacteriological Results-Yearly Averages, 1962 Source of supply BEFORE TREATMENT Number of samples Agar plate count per ml. Coliform count Escherichia coli count 20-24 hours at 37°C. 3 days at 22°0. Per cent. samples negative in 100 ml. Count per 100 ml. Per cent. samples negative in 100 ml. Count per 100 ml. River Thames Southern Group Honor Oak 48 0.1 1 97.92 ­ 97.92 - Source of supply AFTER TREATMENT Number of samples Afar plate count par ml. Coliform count E. coli count 20-24 hours at 370C. 3 days at 220C. Per cent, samples negative 100 ml Per cent, samples legative in 100 ml. River Thames Southern Group 1,889 11.5 99.79 99.95 Honor Oak 50 13 4 100.0 100.0 65 Water from Walls There are a number of wells in use, the majority of which however, supply water used only for industrial purposes. The water from two wells is used for drinking purposes, or for the preparation of food. Reports of the analyses of water from these wells are received regularly and have been satisfactory for theyear under review. Sewers I am indebted to the Borough Engineer for supplying me with the following information with regard to sewers within the Borough. During 1962/63 the Borough Engineer's direct labour section was employed on maintenance, cleansing and flushing of the main sewers at a cost of £19,000 such work covering the 145 miles of sewers within the Borough. The work of reconstruction of sewers varying in size from 12" to diameter was carried out in Strathleven Road and Peran Road at a total cost of £18,470. A sum of £27,000 had been included in the Vote for such purpose but adverse weather conditions during the winter resulted in whole of the money not being spent. This work of sewer reconstruction is part of the Public Services Comittee's long term programme which has been in progress for several years at an approximate annual cost of £27,000. SUMMARY OF VISITS AND INSPECTIONS BY INSPECTORIAL STAFF Dwellinghouses Visits Re-visits In Aspect of nuisances In respect of Certificates under the 2,010 4,476 Rent Act, 1957 65 24 In respect of Rehousing 92 65 In Aspect of Infectious Diseases 302 12 Other reasons 575 121 Clean Air Act, 1956 Timed observations 266 . Untimed observations 611 . Other visits, private and industrial premises 7,202 2,133 Factories Acts factories with mechanical power 389 96 Factories without mechanical power 116 16 Outworkers 197 ¯ 66 Drainage Visits Re-visits New Buildings 155 1,273 Alteration to existing drainage, etc 1,559 2,089 Other Inspections Bakehouses 75 - Butchers Shops 604 - Restaurants 265 89 Fried Fish Shops 44 1 Ice Cream Premises 157 - Milk shops 212 - Public Houses 33 - Other Food Premises 655 5 Animals improperly kept - - Personal uncleanliness 2 - Exhumations - - Hairdressers and Barbers 127 77 Pet Animals Act, 1951 18 1 Rodent Control 1,239 1,306 Unclassified 945 213 Caravans 16 - 17,931 11,996 COMPLAINTS The number of complaints received, including rat and mouse infestations, was 3,750 DRAIN TESTING Number of Drains tested by District Inspectors 1,438 Number of Drains tested by Rodent Officer 149 1,587 DANGEROUS STRUCTURES Dangerous structures notified to London County Council 23 SUMMARY OF DEFECTS AND NUISANCES FOUND AS A RESULT OF ROUTINE INSPECTION AND INSPECTION FOLLOWING COMPLAINT Dirty Premises 13 Verminous Premises 85 Defective Roofs 771 Defective rainwater pipes and gutters 262 Damp Premises 357 Defective drainage and sanitary fittings 864 Choked drainage 468 67 summary of defects and nuisances found as a result of routine Inspection and inspection following complaint (Continued) Lighting and ventilation 20 Defective water supplies 75 Dustbins eta 45 General defects and dilapidations 570 notices served Number of Intimation Notices Served 1,050 Number served under Public Health (London) Act, 1936 - Section 40 188 Section 82 151 Section 93 20 Section 105 4 Section 108/9 102 Under the London County Council (General Powers) Act, 1955 - Section 27 86 Under the Prevention of Damage by Pests Act, 1949 6 Under the London County Council (General Powers) Act, 1956- Section 63 Lambeth Borough Council Bye-laws 1 Section 25(1) 64 Section 25(2) 30 Section 26 1 653 68 LEGAL PROCEEDINGS PUBLIC HEALTH (LONDON) ACT, 1936 In respect of 38 summonses returnable to the Lambeth Magistrates Court and Petty Sessional Court, 5 Abatement Orders were made, 9 cases were adjourned sine die and 17 were withdrawn, the nuisances being abated by the respective owners by the date of the hearing. DWELLING HOUSES RENDERED FIT Number of dwelling houses rendered fit in consequence of informal action 751 Number of dwelling houses in which defects were remedied after service of formal notice (a) by landlords 727 (b) by Council in default of landlords under the. Fifth Schedule of Public Health (London) Act, 1936 9 Under Sections 40, 108/109 and 93 of the Public Health (London) Act, 1936 and Prevention of Damage by Pests Act, 1949 41 Under Sections 2 7, 25(1) and 25(2) of London County Council (General Powers) Act, 1955 31 Outstanding cases from previous year are included. SECTION 95 PUBLIC HEALTH (LONDON) ACT,'1936 In 1962 Certificates of Habitation were issued in respect of 615 new dwellings in regard to the provision of a proper and sufficient water supply. 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. 43 plans of new buildings and 101 plans of alterations to existing drains were deposited. Combined drainage was carried out in 13 cases. 69 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 Number of rooms included in above 170 Total number of rooms sprayed for all purposes 2,442 Number of articles disinfected 7,104 Number of library books disinfected 1,022 Number of disinfection certificates issued 94 DISINFESTATION ®ed Bugs Number of houses visited 219 Number of rooms sprayed 624 Number of houses revisited 37 The rooms were sprayed with a preparation of 5 per cent D.D.T. Lindane with Pybuthrin 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 2,103. PREVENTION OF DAMAGE BY PESTS ACT, 1949 Rat destruction in dwelling houses and business premises is carried out under the direction of the Rodent Officer, an Assistant Rodent Officer and a Rodent operative working under his supervision. Sewer treatment is carried out by the department of the Borough Engineer in conjunction with the Rodent Officer and his staff. 70 In all cases of dwelling houses treatment is undertaken by the Local Authority free of charge, but in the case of businesspremises a charge is made. During the year 1,101 complaints were received. Of this number 99 were not justified; 766 were in respect of brown rats, and 164 in respect of mice. During the course of investigation 1,007 baitings were made and 89 defective drains discovered. 11 Statutory Notices were served under the Public Health (London) Act/ 1936, and 9 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 inspection® 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. 211 132 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 738 484 2 (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 69 69 - TOTAL 1018 685 2 71 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.) - - - - Overcrowding (S.2) - - - - Unreasonable temperature (S.3) - - - - Inadequate ventilation - - - - Ineffective drainage of floors (S.6) - • - - Sanitary Conveniences (S.7) - (a) Insufficient • - - - (b) Unsuitable or defective 3 3 - 3 (c) Not separate for sexes - - • - Other offences against the Act (not including offences relating to Outwork) 1 1 - 1 TOTAL 4 4 - 4 NO PROSECUTIONS WERE INSTITUTED 72 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 Making, etc. Apparel Cleaning and washing 174 Electrical 2 Handbags Cotton Bags 3 28 Paper Bags 1 Artificial flowers Bedding 1 7 Onions 3 Embroidery 3 The making of boxes or other receptacles or parts thereof made wholly or partially of paper 13 Carding etc., pf buttons etc. 85 Stuffed toys 16 Cosaques, Christmas crackers, Christmas stockings, etc. 1 Lampshades 42 TOTAL 379 NO NOTICES WERE SERVED OR PROSECUTIONS INSTITUTED 73 rent act, 1957 (a) Applications for Certificates of Disrepair 20 Applications outstanding from 1961 3 23 Decisions not to issue Certificates 2 Decisions to issue Certificates (a) in respect of some but not all defects (b) in respect of all defects 7 14 21 Applications awaiting action at end of year 23 (b) Number of cases where decisions were made to issue Certificates but were awaiting action by the landlords at the end of 1961 Undertakings given by landlords under paragraph 5 of the First Schedule of the Act 15 Undertakings refused under proviso to paragraph 5 of the First Schedule of the Act 1 Certificates of disrepair issued 5 Certificates still to be issued or undertakings still to be received from landlords at end of year 21 (c) Applications for certificates as to the remedying of defects specified in a landlord's undertaking (a) by landlords 15 (b) by tenants 3 (c) applications outstanding from 1961 - 18 Certificates issued (a) defects remedied 14 (b) defects not remedied 4 (c) applications awaiting action at end of years - 18 74 (d) Applications by landlords for cancellation of Certificates of Disrepair 12 Applications outstanding from 1961 - 12 Certificates cancelled 11 Cancellation refused 1 Applications still to be dealt with at the end of year - 12 In connection with the applications from landlords for cancellation Certificates of Disrepair objections to cancellation were lodged in 5 cases- REHOUSING AND OVERCROWDING During the year the following cases have been investigated London County Council Cases Overcrowding 2 Medical Grounds 8 Insanitary conditions 2 Lambeth Borough Council Overcrowding 10 Medical Grounds 707 Insanitary conditions 52 Enquiries from other sources 16 During the same period cases have been rehoused by various authorities as under London County Council 42 Lambeth Borough Council 74 75 housing act, 1957 RECORD OF WORK CARRIED OUT BY HOUSING INSPECTORS Section 16 - Individual Unfit Houses Inspected - no action under Part II of the Housing Act. 93 Clapham Road 1 Dalyell Road 1 Leopold Walk The Cottage, Mount Villas Section 18 - Underground rooms and parts of buildings Inspected • no action under Part II of the Housing Act. 25 Cranfield Villas 2 Elam Street 220 Kennington Lane 44 Rosen dale Road 65 Somerleyton Road 122 StockwellRoad 117 Tulse Hill Closing Order 9 Somerleyton Road -3 rooms Voluntarily closed 9 Wincott Street Voluntarily made fit 6 Oakden Street 10 do 18 do 20 do 76 Slum Clearance Programme 1961 - 1965 Bedford Road Area - 6 Houses. Represented 3rd December 1962 Declared 19th December 1962 Improvement Grants The number of applications received for Discretionary Grants 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 improvements - 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 these improvements and the conditions imposed are less rigorous than those for Discretionary Grants. Discretionary Grants Inspected 44 Loughborough Road Inspected and approved 2 Caron Almshouses 14 Carson Road St. Anselm's Vicarage 42 Tritton Road Standard Grants Inspected 3 2 Archbishops Place 25 Ballater Road 31 Brough Street 154 Camberwell New Road 317 Clapham Road 322 Clapham Road (5 flats) 21 Claylands Road 31 Claylands Road 11 Concanon Road 25 Doverfield Road 77 26 Ducie Street 68 Durban Road 66 Fentiman Road 71 Fentiman Road 192 Ferndale Road 167 Gipsy Road 36 Hetherington Road 116 Hubert Grove 10 Kenbury Street 42 Larkhall Lane 48 Larkhall Lane 18 Merredene Street 54 Methley Street 47 Northway Road 43 Parkhall Road 76 Richbome Terrace 12 Tintern Street 22 Winterwell Road Inspected and approved 3 Bristow Road 3 22 Clapham Road 3 Daryngton House 12 do 14 do 12 Deronda Road 100 Effra Parade 34 Elm Park 12 Ernest Avenue 61 Gipsy Road 231 do 38 Hargwyne Street 181 Kennington Lane 11 Kestrel Avenue 96 Lambeth Road 48 Margate Road 3 29 Norwood Road 18 Poplar Walk 8 Pratt Walk 26 Regent Road 281 Rosendale Road St. Andrews Use, Roupell Street 80 Saltoun Road 59 Southwell Road 20 Spenser Road 80 Strathleven Road 41 Sudbourne Road 64 Thurlow Park Road TOTAL INSPECTIONS AND REVISITS DURING THE YEAR - 1,263 78 ATMOSPHERIC POLLUTION CLEAN AIR ACT 1956 The year saw a marked increase in the acreage covered by proposed and confirmed Smoke Control Orders. In February, two important Ministry circulars were considered. The first (No. 3/62) modified and simplified the administrative procedures leading up to the preparation and declaration of Smoke Control Orders. The other (No. 4/62) invited the submission of a proposed 5-year Smoke Control Programme for the years 1962/1966. The programme is shown graphically on the sketch map (accompanying this report) on page 80) (overleaf). The following confirmed, operative or proposed Smoke Control Areas were in being by December, 1952 :- Area No. 1. 100 acres No. 2. 63.96 „ No. 3. 151.98 ,, No. 4. 40.83 , No. 5. 3 8.30 ,, No. 6. 155.56 550.56 ,, at an estimated total cost of £43,525. It is confidently anticipated that the Council's 5-year programme will be more than adequately covered before 1966. The proposed appointment of two technical assistants to the Smoke Inspectors will further accelerate progress, but a note of warning must be sounded in that administrative progress must keep step with the availability of building potential, materials and smokeless solid fuels. The pollution resulting from vehicular traffic continues to cause concern, but it is understood that active research is being carried out at the D.S.I.R. in this matter. Adverse atmospheric conditions resulted in a repetition of the Great Fog of 1952. During the period between Monday evening, 3rd December, 1962 and early Friday morning, 7th December, 1962, a fog blanketed South London and visibility was down to less than 10 yards in many places. The results shown by the Council's 5 Atmospheric Pollution Stations indicate that the atmospheric conditions causing the incidence of fog also favoured the accumulation of pollutants. A figure of 10 times normal has been quoted, but even this may be incorrect as it is considered that the simple volumetic measuring equipment in use, normally reasonably accurate, was literally over-loaded at this period. The number of deaths in the County of London 79 show a sharp rise during and immediately following this fog period and, while it is clear that deaths attributable to respiratory disease associated with "smog" were considerably less than those occurring in 1962, the whole incident served as a sharp reminder of the necessity of continued Smoke Control. The following figures show the number of visits and re-visits made by Smoke Inspectors during the year. Visits Re-visits Timed observations 266 - Untimed observations 611 - Other visits, private and industrial premises 7,202 2,133 80 81 SECTION E INSPECTION AND SUPERVISION OF FOOD AND FOOD PREMISES Among changes in the food processing industry in the borough the allowing are reported. Two ice-cream manufacturers with nation wide distribution have merged with another large manufacturer operating outside the district with the result that in West Norwood one factory has closed down and the other in North Lambeth is in the process of closing down. The increasing popularity of soft ice-cream has however brought with it a need for additional supervision and details of the work done in this connection may be found under the sub-heading "Bacteriological and other Examinations" in the Report. A butter factory has moved to new premises outside the borough. The vacated factory has since been occupied by a provisions company producing sausages and other meat products. Food Premises During the year under review 2,534 inspections were made to food Premises in the Borough. These inspections and revisits were made up as follows :• Inspections Re-visits Food Factories 309 85 Bakehouses 75 - Butchers 604 - Fried Fish Shops 44 1 Ice Cream Premises 157 - Milk Shops 212 - Public Houses 33 - Restaurants 265 89 Other 655 5 2,354 180 The approximate number of food premises by type of business in the area is as follows :- Grocery and provisions Greengrocery and fruit 164 Fish shops, wet dry and fried 94 Bakers 98 82 Butchers 142 Restaurants 205 Confectioners 211 Food and Drugs Act 1955 - Section 16 The number of registered premises is as follows:- Manufacture and /or sale of ice cream 603 Manufacture of sausages and preparation of preserved etc. food 312 Milk and Dairies (General) Regulations, 1959 - Regulation 8 Number of registered distributors 273 Number of registered dairies 3 Milk (Special Designation) Regulations 1960 The following table shows the number of licences in force:- * Dealers Licences (Pre-packed) Tuberculin Tested 165 Pasteurised 250 Sterilised 256 Dealers' (Pasteuriser's) Licence 2 Dealers' (Tuberculin Tested) Licence 2 * Licences issued are valid for a period of 5 years under the new Regulations SAMPLING OF FOOD AND DRUGS Chemical Analyis Two hundred samples were procured formally, 124 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 or otherwise unsatisfactory,showing action in each case. 83 Formal Samples Article Result of Analysis Action Taken Butter .1% excess water Attention of blenders and packers called to complaint which is the first one from this factory. Cherry Linctus Pastilles Deficient in chloroform Matter taken up with manufacturing chemists who state they will amend formula. '"formal Samples Milk bottle Contained iron rust in powder Attention of dairyman called to condition of bottle. Milk bottle Mortar on inside of bottle Warning letter sent to milk bottlers. Milk bottle Dirty Referred to Town Clerk for legal proceedings. Case dropped becanse of insufficient evidence. Attention of milk bottlers called to condition of bottle. Currants Some insect infestation Stock examined, one carton found to be slightly infested and dealt with as unsound food. Mi!k bottle Bottle contained mortar-like substance Dairy Company warned about the use of bottles in this condition and requested to overhaul procedure for inspection of bottles. Bottle of Soda Water Contaminated with chlorinated phenols Attention of manufacturers and bottlers called to complaint. Factory visited and processes of manufacture, bottle and stopper cleaning, and bottle filling inspected. "One trip" stoppers already in experimental stage. Bottle containing dirty milk Contained insect larvae and parts of dead animal matter. Recommended for legal proceedings. Fined £50 and 10 guineas costs to Council. 84 Informal Samples (continued) Article Result of Analysis Action Taken Buttered bread roll Roll spread with margerine Personal warning to vendor, further samples satisfactory. Steak and Kidney pie Unfit for human consumption Matter taken up with suppliers and manufacturers. Olives Unfit for human consumption Attention of " vendor called to complaint. Olives replaced. Buttered bread Butter content of fat not exceeding 30% Personal warning to vendor, further samples satisfactory. Iced sponge cake Mould present Attention of vendor called to c cmplaint. Hamburger Meat content 74.5% In the absence of a standard no prosecution was advised. Milk bottle Builders mortar present Warning letter to Dairy Bottle of Milk Insufficiently cleaned before filling. Matter taken up with Dairy. Pork sausages Meat content 56.5% Referred to Metropolitan Borough Standing Joint Committee with a recommendation that the Minister make a standard for the meat content of sausages. Buttered bread roll Butter virtually absent Personal warning to vendor, further samples satisfactory. Instant Coffee 30 parts of sulphur dioxide in excess Repeat sample taken formally - result genuine Roll and butter Outer surface contaminated with filth Attention of Cafe Proprietor called to offence. Cough sweets Deficient in chloroform at least 25% Formal sample purchased. Manufacturing chemist is amending formula. 85 Informal Samples (continued) Action Result of Analysis Action Taken Cough sweets Labelling offence Attention of manufacturing chemist called to complaint. Revised label to be used in future. Gateau Human hair and a little mould on surface Attention of restaurant proprietor and baker called to complaint. M.O.H. of District where manufactured also advised. Milk bottle Contained pieces of glass Attention of milk bottlers called to complain t. Reported to M.O.H. of district where bottled. Shredded suet 6% deficient in fat Discussed matter with Public Analyst. As a general rule formal samples only of shredded suet will be taken in future. Curry powder Damp, contaminated with rust from lid, and moulds Stock in shop inspected and found in good condition. Further informal sample satisfactory. Shredded suet 1.8% deficient in fat Discussed matter with Public Analyst. As a general rule only formal samples of shredded suet will be taken in future. Bread and butter Some 20% of fat other than butter Attention of vendor called to butter deficiency. Ovaltine Some insect infestation Insect identified and complaint taken up with manufacturers. Further samples satisfactory. Milk bottle Insufficiently cleaned mould hyphae and spores Attention of milk bottlers called to complaint. M.O.H. of district in which dairy is situated advised. Marzipan Damp, covered in places with mould growths. Shop inspected. Sales discontinued. 86 Nineteen sixty two saw no major changes in the pattern of food administration. Details of the work carried out during the year are set out under the several heads which follow. 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. Organisms likely to be responsible were found in nine samples. Ice Cream and Ice Cream Mix 183 Ice Lollies 7 * Veal and ham pie 2 ¢ Ham 2 * Gravy 1 *+ Smoked Gammon boiled bacon 1 * + Rolled bacon boiled bacon 1 * Bone in Gammon boiled bacon 1 * + Pressed Gammon boiled bacon 3 * + Roast leg of Pork 2 *¢ Staphylococcus *+ Salmonella Bredeney * No organisms isolated There has been an increasing number of freezers dispensing soft icecream in the Borough and the total of 183 samples of ice-cream and icecream mix includes 63 samples of soft ice-cream. These samples were taken from various situations and from different types of ice-cream mix. They were all submitted to the methylene blue test and, where applicable, colony counts. A summary of the samples and the results of examinations is set out below. Number Taken Type of Mix Provisional M.B. Grade Colony Count Per ml. Sterilised Heat Treated Complete Cold Mix In Shops 9 7 - - 1 (4) 100 (1) 3(1) 5,500 87 Number Taken Type of Mix Provisional M.B. Grade Colony Count Per nil. From Kiosks 29 Sterilised Heat Treated Complete Cold Mix 1 * 2 (1) 4,000 1 3 (1) 1,750 29 1 (14) - 2 (6) 500 1,000 5,750 >10,000 (3) 4 (6) 5,000 6,000 7,500 >10,000 (3) N ot graded (3) 3,250 >10,000 (2) In Catering demises 11 - 6 5 1 (2) - 2 (2) 2,500 (1) 4 (7) 1,000 1,750 4,750 5,000 >10,000 (3) Public Highway (Mobile) 12 - 9 - 1 (2) - 3* 2 (4) 1,500 (1) 1,000 (1) 3,000 3 (2) >10,000 (2) 4 (4) >10,000 (4) In Covered Market 1 - - 1 1 (1) - factory 1 Total 63 - 1 - 1 (1) - * Dairy Ice Cream 39 Samples were placed in provisional grades 1 & 2 21 (33%) in grades 3 and 4 and 3 were not graded. 88 The results indicate a higher proportion of lower graded samples than has been the experience in recent years. It confirms the opinion that an extension of any part of the manufacturing process which entails the cleaning and sterilisation of machines requires training and supervision which is not so easy to control when it takes place in widely separated situations as it is when concentrated in comparatively few factories. Of the balance of the samples taken and submitted to the methylene blue test 6% were graded in provisional grades 3 and 4 as against 14% during 1961. Although Bacillus Cereus was undoubtedly responsible for some of these lower grading a greater selectivity in the quality of ingredients has been responsible for the improved results. Samples of milk were submitted to the Public Health Laboratory for examination under the Milk (Special Designations) Regulations, as follows:- Methylene Blue Tests 211-(2 were void, the atmospheric shade, temperature being over 65°F) and 1 failed to satisfy the prescribed test Phosphatase Tests 210 -All samples were satisfactory. 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. Qtrs. Lbs. Meat ... 5 5 - 19¾ Vegetables ... 14 - 20¼ Fruit ... 19 - 22½ Fish ... 1 3 21½ Prunes ... - - 22½ Prawns ... - - 2½ Milk ... 4 3 4½ Creamed Rice ... 1 3 16½ Soup ... 6 2 19 ¼ Spaghetti ... - 3 16¼ Spaghetti Bolognaise ... - - 7 3¼ Sweet Com ... - - 41/4 Fruit Juice ... 1 3 18 ½ Tomato Juice ... - - 22 Vegetable Juice ... - - 3 ¾ Sago ... - - 1 ¼ Vegetable Salad ... - - 19½ .. Rice ... - - 1¼ Cheese Flaps - - 1¼ 89 Canned (continued) Tons Cwts. Qrts. Lbs. Tomato Puree - 2 1 Ravioli - - 6 Syrup - « 2 Baby Food - 3 1 20½ Fruit Cocktail - 1 25¾ Sponge pudding - 1 21¼ Ovaltine - - 2 Tomato paste - 2 14 Cream - 21¾ Potato Salad - 16 Ground Almonds - ¾ Marmalade - 2 Jam - 19¾ Steak pudding - - 2½ Steak pie - - 1½ Chicken - - ¼ Gammon - - 27¾ Frozen whole hen eggs - 1 24 Bean and Pork sausages - - 22½ Sausages - - 1½ Irish Stew - - 14 Peas Pudding - - 4 Stewed Steak - - 5 Cteamed Macorani - - 6½ 8 2 2 14 Fresh Meat 17 - 16½ Rabbit - 1 24 Poultry - 2 25½ Vegetables - 2 20 Okro 8 - - Cabbages 6 7 - - Yams 8 Melons 1 13 - - Fish 2 2 23 Scampi 2 2 - Winkles 7 3 16 Chestnuts 2 - - - 12 - - 21 90 Prepared Tons Cwts. Qrts. Lbs. Bacon ... 1 11 3 10 Roast Pork ... 3 4 Fish Paste ... - ¼ Red Beans ... - 11 Soap ... - 24 Jellies ... - 4 Bisto ... - 3 Sage and Onion Stuffing ... - 3 Bicarbonate of Soda ... - ½ Yeast ... - 6 Cheese ... 2 19 Cake Mix ... - 10 Aspro ... - 1¼ Suet ... - 1 Biscuits ... - 16½ Lard ... 1 6 - Margarine ... - 20 Butter ... - 16 Gani ... - 6 Orange Crush ... - 11½ Oxo ... - 10½ Dried Fruit ... - 12 Herbs ... - 6 Peanut butter ... - ½ Garlic ... - 4 Dried Shrimps ... - 2 Blancmange Powder ... - 1½ Tea ... 15¼ Flour ... - 3 25 Bread ... - - 10 Sugar ... 1 2 - Egusi ... - - 2½ Rice ... - 1 26½ Commeal ... - - 18 Meat pies ... - - 7 Peas ... - - 6 Fig Rolls ... - - ½ Marmalade ... - - 6 Bramble Jelly ... - - 2 Jam ... 2 - 19 Lemon Curd ... - - 1/¼ Honey ... - 1 6 Salt ... - 1 21½ Cereals ... - 1 23¼ Cakes ... - - 4¼ C/F 2 4 1 6 91 Tons Cwts. Qrts. Lbs. B/F 2 4 1 6 Prepared (continued) - Mincemeat ... - - ½ Vegetables ... - - 3¼ Full Cream Milk powder ... - 3 19 Chocolate Creain bars ... 4 15 - - Pork Salami ... 2 2 20 Chicken ... - - ¾ Sandwich spread ... - - 7 Mayonnaise ... - 1 2¼ Frozen Food ... 19 - 13¾ Spray dreid whole eggs ... - 3 14 Sweets ... - - 10 Lobstert spread ... - - ¼ Tomato spread ... - - 1¾ Fish paste ... - - 1¼ Macaroni ... - - 8 Spaghetti ... - - 6 Spice ... - - ½ Salad Cream ... - 1 24¼ Tomato Chutney ... - - 1 Tomato Ketchup ... - 1 16½ White Onions ... - - ½ Bottled Cucumbers - - 7½ Pickle ... - - 24¼ Sauce ... - - 5¼ Marmite ... - - ¼ Chocolate ... - - ½ Salmon Soread ... - - ½* Figs ... - 1 4 Milk ... - - 27½ 8 4 1 2¼ Total Weight 28 7 - 9¼ The method of disposal or 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 s for utilisation as pig food. The balance was destroyed by incineration in accordance with arrangements entered into with Camberwell Borough Council. 92 FOOD COMPLAINTS - 1962 1. Bag of chipped potatoes 2. Bottle of milk 3. Kup Cake 4. "Snowball" sweet 5. Milk Bottle 6. ½ pt. bottle of milk 7. Soda water 8. Ox Liver 9. Bottle of milk 10. Tomatoes 11. Meat Pie 12. Bottle of Pasteurised milk 13. Weetabix 14. Bread 15. Butter 16. White bread 17. Milk bottle 18. Sausage 19. Tin of Fruit Salad 20. Sausage rolls 21. Chocolate puddings 22. Cheese 2 3. Butter 24. Sausage rolls 25. Bread 26. Sausage roll 27. Bottle of milk 28. Bottle of milk 29. Strawberries 30. Cake 31. Bacon 32. Bottle of Milk 33. Steak & Kidney Pie 34. Jar of Olives 35. Ham 36. Milk Bottle 37. Weetabix 38. Shredded Wheat 39. Chocolate Drink 40. Jar of Bone Broth 41. Bacon 42. "Munchies" 43. Tin of Fruit Cocktail 44. Bread 45. Ham 46. Fruit & Malt loaf 47. Butter 48. Milk Bottle 49. Bread 50. Ovaltine 51. Bread 52. Pork Pie 53. Chocolate Gateau 54* Milk Bottle 55. Sugar Contained glass Black coloured stains on inside wall and lip of bottle Contained hairs Contained splinter of wood Foreign deposit Dirty matter on inside of bottle Odour of disinfectant Sold as calves' liver Contained metal foil Not up to standard Contained foreign matter Contained insects Contained insects Contained foreign object Ra ncid Contained foreign matter Dirty Contained bristle Contained glass Mouldy Mouldy Mouldy Contained foreign body Mouldy Contained fly Mouldy Dirty internal surfaces Contained glass Not up to standard Contained scale weight Mouldy Foreign deposit Mouldy Sub-standard Fly blown Internal surfaces dirty Contained insect Contained piece of pencil Sour Contained glass Unfit Contained maggots Contained maggot Contained foreign object Caused food poisoning Contained glass Contained maggot Dirty Contained fly Contained foreign matter Contained metal object Mouldy Mouldy Contained glass Contained foreign matter No. of Justified Complaints in 1962 - 55 No. of Complaints - 81 93 All complaints were investigated and careful consideration was given to the action which should be taken. As a result three prosecutions were instituted the legal proceedings being as follows 12. Bottle of Pasteurised milk - contained insects. The defendant pleaded guilty, a fine of £50. 0. 0. was imposed and the defendant ordered to pay 10 guineas costs. 14. Bread - contained foreign object. The defendant pleaded guilty and was given an obsolute discharge on payment of 5 guineas costs to the Council. 44. Bread - contained foreign object. The defendant pleaded guilty and was given an obsolute discharge on payment of 5 guineas costs to the Council. Bread • Mouldy; complaint No. 48 reported in the Annual Report for the year 1961 page 97, the result of the legal proceedings is as follows:- The defendant pleaded guilty, a fine of £5. 0. 0. was imposed and the defendant ordered to pay £1. 0. 0. costs. In all the other cases, the majority of which were just complaints, the attention of the persons responsible was called to the nature of the complaint and to their liabilities. Where appropriate,advice was given directed towards avoiding a repetition of the complaint. Some 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 the Provisions of this Act. 94 SECTION F GENERAL Public Swimming Bath I am indebted to the Scientific Adviser of the London County Council for the following report on the results of Bacteriological Examinations of the water from Kennineton Park and Biockwell Park Swimming Baths. These samples were taken during the year 1962 and cover the summer ana winter seasons. No. of samples Agar count 1 ml. 37° C. 48 hrs. Presumptive coli. pollution without faecal Faecal colpollution 0-10 11-100 Over 100 Kennington Park Summer 12 10 Nil 2 Nil Nil W inter 8 6 Nil 2 Nil Nil Brockwell Park Summer 12 9 3 Nil Nil Nil Winter 8 6 Nil 2 Nil Nil NATIONAL ASSISTANCE ACT 1948 Section 50-Burials Under Section 50 of the National Assistance Act 19*8, the Lambeth Borough Council is required to arrange for the burial or cremation of any person who has died or been found dead in its area if in such cases it appears to the Council that no suitable arrangements for the disposal of the body have been or are being made. During the year 44 funerals were arranged involving 3 1 males and 13 females. The amount paid to funeral contractors was £505. Is. Od. The sum of £416. 4s. 3d. was recovered by way of grants, insurance policies and money found. The actual cost to the Council was therefore £91. 16s. 9d. 95 LAND CHARGES ACT 1925 During the yea: 3,000 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 end Poisons Act, 1933 (Section 21) Part II was 146. Two samples were taken - Spirits of Salts and Descaling fluid. Two labelling offenses were dealt with administratively and rectified without course to legal proceedings. 96 During the year 14 licences were issued under the Act. No. of Inspections - 18 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 219 Number of inspections 127 Number of re-visits 77 LONDON COUNTY COUNCIL (GENERAL POWERS) ACT 1959 Control of Movable Dwellings Section 22 of the above mentioned Act covers the control of caravan sites and 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. At the end ot 1961 three caravan sites were in existence. Applications for renewal of the licence was received in 2 cases and granted and in the third case no such application was received. A fresh applicant applied for a licence in respect of another site and was refused.