Borough of Southwark. ANNUAL REPORT OF THE Medical Officer of Health FOR THE YEAR 1932. William Stott, m.b., b.s., d.p.h., Medical Officer of Health, Administrative Tuberculosis Officer, Administrative Officer for Maternity and Child Welfare LONDON: Tee & Whiten and J. Mead, Ltd., 268-282, Waterloo Road, S.E.1 INDEX. A. Page Acts and Bye-Laws 42-4.3 Acute Influenzal Pneumonia 108 Acute Primary Pneumonia 108 Ambulance Services 9 Ante-Natal Clinics 7, 113-118 Area of Borough 3, 19 Artificial Cream Act, 1929 96 Agricultural Produce (Grading and Marking) Act 79 B. Bacon Stoves 78 Bacteriological Specimens 9 Bakehouses 48, 94 Births 19-21 ,, Illegitimate 3, 25 Birth-rates 20-21 Black Smoke 43-44 Blind Persons Act, 1920 108 Brushmakers 48 Butter and Margarine Factories 95 c. Cancer 108 Census, 1931 3, 10-17 Cerebro-Spinal Fever 108 Children's Act, 1908 9 Clinics 7, 115-118 Convalescent Treatment 114 Coroners' Courts 52 Cowsheds 94 Customs and Inland Revenue Act, 1890 44 D. Day Nurseries 8 Deaths 21, 22, 23 Deaths, Causes of, Table 24 ,, Infants 25-26 ,, In Public Institutions 24, 29 ,, In Wards 21 ,, Zymotic Mortality 32 Death Rates 21, 22, 23, 27 Density of Population 10, 19 Diarrhoea 106 Diphtheria 104 • • 11 Page Diphtheria Schick Test 104-105 Disinfection 112 Disposal of Unsound Food 70 Dressmakers, Milliners, Etc. 48 E. Eating Houses 48, 87, 88, 89 Encephalitis Lethargica 108 Enteric Fever 104 F. Factories and Workshops 46, 48 Families 3, 11, 14, 15, 16 Food and Drugs, Tables of Samples 99-102 Food Inspection and Tables 71-84 Food Factories 78 Fried Fish Shops 89 g. General Hospitals 5-6 Graded Milk 92 H. Health Services, Hospitals, etc. 5-7 ,, Visitors, Summary 119-121 ,, Visiting 9, 113 House-to-House Inspections 34, 35 Housing 38, 39, 53-66 ,, and Town Planning Act 44 Houses let in Lodgings 44 Home Workers, Table 47 I. Ice Cream Premises 48, 90 Imported Food 67-70 Infant Mortality 21, 25, 26 ,, ,, of Illegitimates 3 Infectious Diseases, Control of 103-108 Influenza 107 Informal Samples 102 Inhabited Dwellings 3, 14-16 Inspections 34, 35, 53 L. Laboratory Facilities 9 Laundries 48 Legal Proceedings 40, 41, 97, 98 London County Council Bye-Laws 43 iii Page M. Maternity and Child Welfare 113-121 „ Nursing Homes 9 Maternal Mortality 9, 113-114 Measles 106 "Merchandise Marks" Act 79 Midwives 8 Milk and Dairies (Amendment) Act, 1922 91, 92 Milksellers 92, 93 Mortality Statistics 21-32 Mortuaries 52 Municipal Day Nursery 8 n. Notices served 36, 53, 54 Notifiable Diseases 109 Nursing in the Home 8 o. Offensive Trades 94 Ophthalmia Neonatorum 107 Orthopaedic Clinics 8 Outlying Deaths 22 P. Part-time Officers 4 Population 18 „ in Wards 19 Poliomyelitis 108 Puerperal Fever 107, 114 „ Pyrexia 107, 114 „ Sepsis, Deaths 3, 24, 107, 114 Public Cleansing 35 Public Health Officers 4-5 „ „ (Condensed Milk) Regulations, 1923 and 1927 96 „ „ (Dried Milk) Regulations, 1923 and 1927 96 „ „ (Preservatives in Food) Regulations 85,86,96 Public Vaccinators 5 R. Rag Flock Acts, 1911 and 1928 45 Rateable Value 3 Rats and Mice (Destruction) Act 49 Reception House, Families Admitted 110-111 Registered Births and Deaths 28 Registered Workshops 48 iv Page s. Sale of Food and Drugs Acts 96 Separate Occupiers 3, 15, 16 Scabies 51 Scarlet Fever 103 Schick Test and Inoculation against Diphtheria 104, 105 School Clinics 8 Slaughterhouses 78 Smallpox 103 Smoke Abatement 43-44 Southwark Invalid Kitchens Society 114 Sputum, Examinations of 9 Statistics and Social Conditions 3 Still Births 3 Street Traders 77 Sunlight Treatment 114 T. Tailoring 48 Tuberculosis 122-133 u. Underground Bakehouses 48, 95 Unmarried Mothers 9 Unsound Food 67-76, 80-84 Ultra-Violet Rays Treatment 114 v. Vaccination Acts 33 Vaccination Officers 5 Venereal Disease Clinics 8 Verminous Persons and Children 51-52 ,, Rooms and Bedding 50-51 Vital Statistics, Summary of 3 Table 30-31 w. Ward Distribution (Population) 19 Water Supply (P. H. Act, Sec. 48) (L.C.C. G.P. Act, 1907) 45-46 Whooping Cough 106 Workshops (Women's) 48 Works Completed 36, 37 z. Zymotic Mortality 32 Borough of Southwark Public Health Department, Town Hall, Walworth Road, S.E.17. To His Worship the Mayor, Aldermen and Councillors. Sir, Ladies and Gentlemen, The year under review has been one of great activity and reorganisation. In the early part of the year a Special Health Services Committee was appointed to consider the question of reorganisation, and much useful work was done. The Sanitary districts were readjusted, releasing two Inspectors to devote their special attention to food and food premises. The Mortuary and the Disinfecting Station at Manor Place were closed down, the disinfecting being transferred to King James Street Station in order to centralise the whole of the work. New card recording systems were commenced in regard to Housing, whereby a complete record of each house in the Borough is being tabulated, and in course of time every house will be recorded. The general health of the Borough during the year was satisfactory, although not quite so good as in the previous year, owing to epidemics of smallpox and measles. The mortality from smallpox was nil, but measles alone was responsible for 53 deaths in children under five years of age. Other infectious diseases showed a slight tendency to increase, but the mortality figures from these remained low and about the normal. The general death rate of 13 per 1,000 population was slightly lower than the previous year, and is due to a decrease in the number of deaths from heart disease, which were almost 100 less than the previous year, and by the decrease in deaths from Cancer and Tuberculosis. The Infant Mortality rate has risen slightly, and is chiefly accounted for by the increase in deaths from Measles and Diarrhoea; on the latter further remarks will be found later in this report. 2 The population figure, as ascertained by the Census, shows a decrease on previous years, and the Registrar General again gives us a smaller figure for the year under review as calculated to mid June. It is on this latter figure that the rates throughout this report are calculated. The contracting population is partially due to the removal of many families to outer London estates; this is all to the good, and should make more room for those who must of necessity live within a short distance of their occupation. One feature of this year's report is a digest of the Census figures, 1931. These figures show the area to be densely populated, but the density per se is of little or no consequence provided that the people have sufficient room space. Unfortunately this does not prove to be the case; large numbers of our citizens are huddled together in one or two-roomed dwellings in a most unhealthy and immoral manner. To me this is a most serious factor and one of the housing problems with which it is most difficult to deal. This state of affairs is one of grave concern, and calls for urgent and immediate action; the clearance of the slums will only touch the fringe and will by no means eradicate overcrowding. The overcrowding in this Borough is found chiefly in the larger and better houses, which, not many years ago, were occupied by single families. In some cases one finds that these have now been converted and let in flats, but more often they are taken as single dwellings by unscrupulous persons, who sparsely furnish and let each room to a family, irrespective of numbers, at exorbitant rents. This is the state of affairs with which we are battling daily in the Health Department with very little satisfaction or progress. Once again I should like to place on record my appreciation of the good will and support given to me by the various Chairmen and Committees under whom I serve, and particularly do I wish to thank Mr. Fisher, the Chief Sanitary Inspector, Mr. Bell, the Chief Clerk, and in fact the whole of the Health Staff, including the Maternity and Child Welfare and Tuberculosis sections, for their valuable and very willing assistance at all times. I have the honour to be, Sir, Ladies and Gentlemen, Yours obediently, W. STOTT. 3 STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres) 1,131 Population (Census, 1931) 171,695 Population (estimated, 1932) 168,900 Number of inhabited houses (Census, 1931) 27,417 Number of inhabited houses (end of 1932) according to rate books 27,441 Number of families or separate occupiers (Census, 1931) 46,372 Rateable value £1,298,806 Sum represented by penny rate £5,228 SOCIAL CONDITIONS. The population is chiefly a working class one, and a large proportion are employed in the printing and manufacturing trades, whilst others are engaged as waterside labourers or casual workers. None of these occupations have any definite effect on the health of the people. Unemployment is still to be reckoned with, and according to the latest Board of Trade Gazette, 7,865 males, 2,313 females and 400 juveniles living in the Borough were out of employment. Of the males, between 1,000 and 1,500 are classified as casual workers. VITAL STATISTICS. Total. M. F. Live Births—Legitimate 2,612 1,316 1,296 Birth Rate, 16.2 Live Births—Illegitimate 117 61 56 Still Births, 86. Deaths, 2,219. Rate per 1,000 total births, 32. Death Rate, 13.1 Percentage of total deaths occurring in Public Institutions, 52.5. Number of women dying in, or in consequence of childbirth:— From Sepsis 4 Other causes 7 Death rate of infants under 1 year of age per 1,000 live births:— Legitimate 69 Illegitimate 145 Deaths from Measles (all ages) 53 Do. Whooping Cough (all ages) 20 Do. Diarrhoea (under 2 years of age) 34 No excessive or unusual mortality has occurred during the year. 4 PUBLIC HEALTH OFFICERS TO WHOSE SALARY CONTRIBUTION IS MADE. William Stott, M.B., B.S. (Hnrs.), D.P.H., Medical Officer of Health. E. Fairfield Thomas, M.D., Ch.B., D.P.H., Deputy Medical Officer of Health (from April' 6th, 1932). Margaret Bergin, M.B., B.Ch., B.A.O. (N.U.I.), D,P,H., Assistant Medical Officer, Maternity and Child Welfare. John T. Crowe, L.S.A., L.M.S.S.A., Tuberculosis Officer. Sanitary Inspectors. ‡||G. Fisher (Senior Inspector). *‡||J. C. Nicholson (Food and Drugs Inspector). ‡||J. A. Syms. ‡||A. C. White. ‡||W. H. Banham. ‡||A. Ede. ‡||H. E. Hattersley. ||J. R. Findley. || Cert. Sanitary Inspector. ‡||H. S. Steele. ‡||F. J. Bryant. ‡||F. Mayhew. ‡||S. Bowers. ‡||G. H. Duffield (Assistant Food Inspector). ||Margaret Burrows (Women's Workshops). ‡ Meat and other Foods. * 1st Class Engineer (Board of Trade). Health Visitors. ||a Annie Rogers. †*a Clare Cottrill. *a Winifred Sayer. ||*a Kathleen Hinde. *a Florence Adair. †*a Mary Freeth. †a Mary George, †*a Annie Kingsmill. ||*a Winifred Cleverley. a Cert. Health Visitor. || Cert. Sanitary Inspector. * C.M.B. † Nursing. (1 Storekeeper, 1 Home Help). Part Time Officers. Dorothy Shepherd, M.B., Ch.B., Maternity and Child Welfare Clinic. Arabella C. Stevens, M.B., B.Ch., B.A.O. do. do. Fredk. Porter-Smith, M.R.C.S., L. R.C.P., Schick Immunisation Clinic. 5 Public Vaccinators. P. O'Malley, M.B., B.Ch., B.A.O., N.U.I. G. G. Lawson, M.B., Ch.B., D.P.H. D. M. Clune, M.B., B.Ch., B.A.O., N.U.I. A. M. Foxe, M.B., B.Ch., B.A.O., N.U.I. Vaccination Officers. E. J. A. Holt, C. R. Fifer. Other Officers. Cyril Dickinson, B.Sc., F.I.C., F.C.S. (Public Analyst). Tuberculosis Dispensary. Secretary and Dispenser, Florence Nightingale (Certificate of Apothecaries Society, London). Nurses. M. E. Bennett, Cert, of Sanitary Institute, S.R.N. F. C. Rogers, C.M.B., S.R.N. F. K. Jay, C.M.B., S.R.N. GENERAL PROVISION OF HEALTH SERVICES. Hospitals.—Southwark is fortunately situated as regards hospital accommodation of all descriptions. Hospitals for infectious diseases and Tuberculosis cases are provided by the London County Council. The following General Hospitals are within the area:— Guy's Hospital. Evelina Hospital for Children. Royal Eye Hospital. All Saints' Hospital. The Hospitals available but beyond the borders are:— St. Thomas's Hospital. King's College Hospital. Royal Waterloo Hospital. General Lying-in Hospital, York Road. The Belgrave Hospital for Children. Guy's Hospital. Is situated within two minutes of London Bridge Station, contains 646 beds, of which the majority are allocated to General Medical and Surgical cases. Adequate accommodation is provided for the Special Departments, including Obstetrics and Gynaecology, 6 Children's Diseases; Diseases of the Eye, of the Ear, Nose and Throat, and of the Skin; Orthopaedics, Neurology, Genito-Urinary Diseases, etc. The Post-Mortem Room has recently been rebuilt, and new Clinical Laboratories have recently been completed. This hospital is largely used by the inhabitants of Southwark, roughly a fifth of the in-patients are from this Borough, and a very much larger proportion of the out-patients. Evelina Hospital, Southwark Bridge Road. For children, 80 cots. Royal Eye Hospital (London School of Ophthalmic Surgery), St. George's Circus, Southwark. 40 beds, 2 cots. All Saints' Hospital, Austral Street. Genito-Urinary Diseases, with X-Ray department, 55 beds. St. Thomas's Hospital. This hospital is situated about ¼ mile beyond the Southwark boundary, and contains 640 beds and a large, well organised Out-patient Department. It is made considerable use of by Southwark patients who live adjacent to it or who find facilities for access easy. Its open situation makes it well known and adds to its popularity. Special Departments.—Diseases of the Eye, Ear, Throat, Skin, Teeth, and of Children, Nervous Diseases, Mental Diseases, Tuberculosis, Venereal Disease, Orthopaedic, Electro-Cardiographic, Massage, Electro-Therapeutic, Remedial Exercises, Radiology, also a Maternity Ward. King's College Hospital, Denmark Hill. Special and General Hospital, with 384 beds. Midwifery cases are attended at their own homes, and there is a Special Maternity Ward which is utilised by a few Southwark patients. Royal Waterloo Hospital, Waterloo Road. For Women and Children, 130 beds. Belgrave Hospital, 1, Clapham Road. For Children, 76 beds. General Lying-in Hospital, York Road. For Women, 45 beds. 7 During the year Southwark mothers were treated and confined at the following local hospitals : General Lying-in Hospital, 303; Guy's Hospital, 180; St. Thomas's Hospital, 180; King's College Hospital, 68; Lambeth Hospital, 140; St. Giles' Hospital, 84. In addition, 145 mothers were confined in hospitals away from the neighbourhood. Our Health Visitors are responsible for the supervision of the homes of these cases, and the preparation for their coming confinement; they are also followed up on their return from hospital. CLINICS AND TREATMENT CENTRES. (1) Maternity and Child Welfare.—There are in all fourteen Centres which may be classified as follows:— Municipal Centres (Eight)— Sutherland House, Sutherland Square (St. Mary's). Sutherland House, Sutherland Square (St. Paul's). Boys' Club, Villa Street. All Saints' Parish Room, Surrey Square. Lady Margaret Parish Room, Chatham Street. Lansdowne Place Mission Hall. St. George's Dispensary, Pocock Street. St. Mary's Girls' Club, Union Street. Partly Municipal, Partly Voluntary (Two)— Crossways Mission, New Kent Road. Welfare Centre, 56, Lambeth Road. Wholly Voluntary (Four)— St. John's Institute, Larcom Street. Roman Catholic Centre, 148, New Kent Road. Salamon's Centre, Newcomen Street. St. George's Welfare Centre (86, Borough Road). Ante-Natal Clinics— Sutherland House, Monday, 10 a.m. (Dr. D. Shepherd). Sutherland House, Friday, 10 a.m. (Dr. M. Bergin). 56, Lambeth Road, 1 session monthly. (Dr. D. Shepherd). 8 (2) Day Nurseries.—There are 3 in the Borough. One is Municipal, and is situated at 63, Kennington Park Road. This accommodates 45 children and is supervised by a Committee of Nursery Managers, a Sub-Committee of the Maternity and Child Welfare Committee. The number of attendances during the year was 4,834. Guy's Hospital have in connection with their Maternity scheme a Day Nursery which is used by children from Southwark and Bermondsey, and has accommodation for 40 children. The number of attendances during the year was 6,748. Crossways Mission, New Kent Road, has a Day Nursery accommodating 46 children, and the number of attendances during the year was 8,605. (3) School Clinics.—As all the children attending the centres are under 5 years of age, there is no connection with the School Medical Service until they are transferred to school. (4) Orthopaedic Clinics.—This is undertaken by the London County Council and the General Hospitals in the Borough. (5) Tuberculosis Dispensary.—The Municipal Dispensary is at 82 and 84, Newington Causeway. (7) Schick Immunisation Clinic.—Sutherland House. Sessions every Thursday afternoon at 2.30. (6) Venereal Disease Clinics.—These are held at the General Hospitals, they are free and are conducted under conditions of secrecy. The times of attendances may be obtained on application to the Medical Officer of Health, and they are also displayed in the Public Conveniences. NURSING IN THE HOME. General Nursing is carried out by the Ranyard Nurses, the Benson Nursing Association (which is subsidised by the Newington Charities to the extent of £400 per annum) and the Catholic Nursing Home, 60, Lambeth Road. A few parishes also have their own private nurses. Infectious diseases are not nursed in their own homes, but cases of puerperal pyrexia are nursed at home, if necessary, by arrangement with one of the aforesaid Associations. MIDWIVES. The number of midwives practising in the Borough is approximately 38. CHILDREN'S ACT, 1908. The functions under Part I of this Act are at present being carried out by the London County Council. 8 (2) Day Nurseries.—There are 3 in the Borough. One is Municipal, and is situated at 63, Kennington Park Road. This accommodates With the Compliments of the Medical Officer of Health. Southwark Town Hall, Walworth Road, S.E.17 9 No arrangements have been made for the employment of, or for subsidising midwives. LABORATORY FACILITIES. The Chemical and Bacteriological laboratories are maintained by the Council under the direct control of the Public Analyst, who is a fulltime officer. Chemical analyses are undertaken of all samples submitted under the Food and Drug Acts and Regulations, together with any other analytical work or investigations required. Bacteriological examinations of Sputa for Tubercle, Swabs for Diphtheria and Blood for the Widal reaction for Typhoid are made for Medical Practitioners in the Borough and for the Tuberculosis Dispensary. MATERNITY AND NURSING HOMES. There are no Municipal Maternity and Nursing Homes in the Borough. INSTITUTIONAL PROVISION FOR UNMARRIED MOTHERS, ETC. Cases coming to the knowledge of the Medical Officer of Health are referred to the Southwark Diocesan Society, to which the Council have this year made a grant of £25. AMBULANCE FACILITIES. The arrangement for the removal of (a) infectious cases and (b) maternity patients, are satisfactory, and no change has been made during the year. MATERNAL MORTALITY. 1 he Council have made full provision for expectant and nursing mothers by the establishment of Ante-Natal Clinics, Consultants and Nurses for cases of Puerperal Fever and Puerperal Pyrexia, sterilised maternity outfits, and the appointment of a whole-time home help. In addition, the Borough is well served by general and lying-in hospitals. HEALTH VISITING. The arrangements made for visiting of children between the ages of 1 and 5 years will be found on page 113 (Maternity and Child Welfare Services). CHILDREN'S ACT, 1908. The functions under Part I of this Act are at present being carried out by the London County Council. 10 CENSUS, 1931. During the past decennium, the population has declined in twentyone of the Metropolitan Boroughs (including the City) as compared with fourteen in the preceding decade; the losses tend to be individually smaller on this occasion, but are more widely spread. In the City, with a population of only one quarter per cent. of that of the whole county, the greatest decrease is shown, viz., 19.8 per cent. as compared with 30.3 per cent. in the preceding period, this being followed by the decrements of the inner Boroughs of Holborn (—10.0 per cent.), Stepney (—9.8 per cent.), Westminster (—8.5 per cent.) and Finsbury (—8.0 per cent.), all of which returned higher rates of loss in the earlier decade. Present declines succeed immediately preceding increases in Camberwell, Deptford, Fulham, Islington, Lambeth, Poplar and Stoke Newington, though in all of these save Camberwell and Fulham a decline was registered in the 1901-11 decade. In Lewisham an outstanding increase of 26.3 per cent. is due to the development of the London County Council housing estate at Downham; and this is followed in order by the much smaller increments in Wandsworth (7.5 per cent.), Woolwich (4.6 per cent.), Hammersmith (4.0 per cent.) and Hampstead (3,2 per cent.). DENSITY. For the county as a whole the density is 58.7 persons per acre, as compared with 60 in 1921. Taking the Metropolitan Boroughs as separate units for this purpose it will be seen that the densities vary widely from the average, being at a maximum in the Central Boroughs of Southwark, Shoreditch, Bethnal Green and Stepney, where averages of 151.7, 147.5, 142.4 and 127.5 are reached. The densities diminish with progression outwards until, in the outermost areas, particularly in the South West and South East, they become as low as 17.7, 26.2, 31.4 and 38.8 in Woolwich, Greenwich, Lewisham and Wandsworth respectively. In the City itself, with its rapidly diminishing night population, the density is only 16.2 per acre. In individual Wards the variations are even greater; densities exceeding 200 per acre are reached in seven of the Borough Wards, the position of highest distinction in this respect being achieved by the St. George's in the East (North West) Ward of Stepney (237.8) with St. John's Ward of Southwark second at 230.9 and the Golborne Ward of Kensington third at 209.6 persons per acre. It must be noted that, in the calculation of densities, the acreage used is that of all land and non-tidal water together. The presence of parks, commons, docks, etc., sometimes covering extensive areas, will tend to an under-statement of the population pressures in areas comprising them, particularly if they bulk largely in proportion to the occupied balance of the total area. 11 The density, calculated in relation to a total acreage, is, of course, nothing more than an index to the propinquity or congestion of individuals. It may be a material factor in the control', for example, of infectious disease, in the matter of general transport facility or in the distribution of foods or other commodities of universal consumption ; but it will not be necessarily a guide to the adequacy or otherwise of housing conditions. These depend on the sufficiency of individual dwellings or rooms and are treated from this point of view in a later section of this comment. The development of the block construction type of housing has been probably slower in this country than amongst other industrial communities, but it has attained considerable proportions in the central area of the metropolis; and since vertical height is an essential factor in such cases, it is obvious that its full effect will not be measured by an index based on surface extent alone. Strong co-relation will no doubt be found to exist between housing pressure and the acreage density, especially at the higher reaches of the latter, but the tables will also provide examples of the association of relatively favourable housing conditions with high acreage densities and the converse association of overcrowding with low over-all acreage density. DWELLINGS, ROOMS AND FAMILIES. Except for one small and relatively unimportant departure, the treatment of this section of the Census enquiry follows almost precisely the same lines as those followed in 1921, and thus provides the fullest material for an examination of the changes which have occurred during the intervening period. The departure referred to is the omission on this occasion of the record of " buildings." The heterogeneous collection of structures met with throughout the area, of almost infinite variety as regards shape, size or purpose, has little statistical application in connection with a population study; and no account has been taken of buildings as such apart from the exhaustive administrative procedure of identifying them and their contents in order to ensure the completeness of the enumeration. Nor has any attempt been made to obtain a record of dwellings or buildings in course of erection : such statistics would inevitably be imperfect and of doubtful validity. Concentration has rather been centred upon the more direct features of the housing situation, the actual dwellings available, their relative size in terms of the number of rooms therein, the families occupying them and the size of the families in relation to the rooms occupied, together with all' the valuable information derivable from the combination in various ways of these particulars. HOUSING ACCOMMODATION IN METROPOLITAN BOROUGHS. In respect of room accommodation, Hampstead claims first place with a general average of 7.59 rooms per dwelling, while immediately 12 following are Paddington (7.24), Kensington (6.80), Stoke Newington (6.74), Islington (6.41) and St. Pancras (6.34), an order similar to that of 1921, but on a slightly lower scale. At the other extreme stands the City with a minimum of 3.52 rooms, followed by Holborn (4.15) and the inner Eastern Boroughs of Bethnal Green (4.32), Stepney (4.53), Finsbury (4.59), Bermondsey (4.73), Southwark (4.73) and Shoreditch (4.78). Housing pressure as measured by the proportion of families to dwellings is greatest in St. Pancras, where there are on the average 2.28 families to each dwelling, and where only 18.4 per cent. of the families are in undivided occupation of separate dwellings : Islington and Paddington are the only other Boroughs with averages of more than two families per dwelling. In these Boroughs, however, houses are larger and the families smaller than in the county generally, the combination of these factors improving their relative positions as expressed by the persons per room ratio. In contrast with these high rates of family occupation is the City, with its comparatively small dwellings occupied by 1.06 families on average, followed by the outer Boroughs of Lewisham (1.26), Woolwich (1.28) and Wandsworth (1.33). Even in these Boroughs (not including the City) families occupying separate dwellings to themselves number only 58 per cent. of the whole. The average size of families in the several Boroughs varies from 3.92 to 2.94 persons. The largest are found in the poorer Eastern Boroughs, viz., Stepney (3.92), Poplar (3.85), Bethnal Green (3.79), Bermondsey and Shoreditch (3.77 each); the smallest in Holborn (2.94), the City (3.04), Westminster (3.07) and Paddington (3.08). In the case of each Borough, without exception, the family is smaller than it was 10 years ago. In the matter of room density, it will be observed that the County average of 0.98 persons per room is a mean of variations in individual Boroughs varying within the wide limits of 0.70 and 1.45. The East End Boroughs generally exhibit the worst conditions, Shoreditch being the most unfavourably placed with the highest average of 1.45 persons per room, followed by Finsbury (1.42), Bethnal Green (1.35), Stepney (1.33) Southwark (1.28), Bermondsey and Poplar (1.25 each). In the Old Street Ward, City Road East Ward and Pentonville Ward of Finsbury the averages rise to as much as 1.70, 1.62 and 1.60 persons per room respectively. The Boroughs showing the most favourable densities are Hampstead (0.70), Westminster (0.76), Chelsea and Wandsworth (0.79 each) and Kensington (0.80). It is worthy of note that, compared with 1911, the density figure shows an improvement in every Borough with the exception of Lewisham. But, as explained for the County as a whole, the change is largely a consequence of the reductions in the size of families, and is incomplete as a general index to housing conditions. Overcrowding has been reduced in all Borough areas without exception, and in some, particularly in the worst districts, the improvement shown for the decennium has been considerable, though it is feared that the Inner Eastern Boroughs must still rank amongst the 13 most unsatisfactory areas in the country so far as housing conditions are concerned. As measured by the conventional "more than two persons per room" index, the overcrowded element is at its maximum in Finsbury, where 29.4 per cent. of the population fall within the category. But the proportion has been reduced thereto from the materially higher figure of 34.0 per cent. registered ten years ago. The proportion is only slightly less in Shoreditch (29.1 per cent.), after which come Bethnal Green and Stepney (23.6 per cent. each), Bermondsey (21.8 per cent.), Southwark (21.6 per cent.), and Poplar (20.1 per cent.). Kensington, owing to the presence of its notorious Golborne Ward, ranks as the twelfth worst or the eighteenth best in the series with 12.6 per cent. overcrowded; and at the favourable end of the range come Hampstead and Lewisham (4.1 per cent. each), Wandsworth (5.2 per cent.), the City (5.6 per cent.) and Woolwich (5.7 per cent.). INDUSTRIAL FEATURES. As industrial features begin to assume prominence the populations become younger, and the proportion of males increases, features which are at their maximum effect in Bermondsey, Bethnal Green, Deptford, Finsbury, Greenwich, Poplar, Shoreditch, Southwark and Stepney. There the male population approaches the female in numbers, and a high proportion of children and an under average proportion of adults at ages over 40 renders the populations distinctly younger than in other parts of the county. The City of London and, to a lesser extent, Holborn, stand rather apart from the other Boroughs owing to the general unsuitability of their dwellings for private family occupation. The proportion of males is above the average—there being an actual excess in the City itself; there are few young children and the populations are above the normal as regards average age. But, notwithstanding, the married are fewer rather than higher, proportionately, than those of other Boroughs or of the county as a whole. 14 TABLE 1. ACREAGE, POPULATION, PRIVATE FAMILIES AND DWELLINGS. Acreage (Land and Inland Water) TOTAL POPULATION. Private Families and Dwellings, 1931. 1921. 1931. Private Families. Population in Private Families. Structurally Separate Dwellings occupied Rooms occupied. Persons per Room. Persons. Persons. Males. Females Persons per Acre. Southwark Met. B. 1,132 184,404 171,695 84,661 87,034 151.7 46,372 164,274 27,168 128,558 1.28 Wards: Christchurch 77 8,296 6.898 3,609 3,289 89.6 1,873 6,172 982 4,571 1.35 St. George's 99 17,814 16.619 8,179 8,440 167.9 4,166 16,504 2,715 11,681 1.41 St. John's 118 29,367 27,252 13,162 14,090 230.9 7,467 26,905 4,598 19,761 1.36 St. Jude's 97 13,759 12,701 6,217 6,484 130.9 3,985 12,362 1,486 9,301 1.33 St. Mary's 127 22,650 22,117 11,073 11,044 174.1 6,118 20,773 3,169 17,349 1.20 St Michael's 93 20,541 19.232 9.802 9,430 206.8 4,654 17,862 3,578 11,867 1.51 St. Paul's 133 19,177 18,015 8,828 9,187 135.5 5,373 17,675 2,703 16,763 1.05 St. Peter's 146 27,751 25,442 12,347 13,095 174.3 6,931 24,454 3,866 20,352 1.20 St. Saviour 133 9,007 8,553 3,930 4,623 64.3 1,889 7,216 1,641 5,342 1.35 Trinity 109 16,042 14,866 7,514 7,352 136.4 3,916 14,351 2,430 11,571 1.24 15 TABLE 2. DWELLINGS, ROOMS AND FAMILIES. Structurally Separate Dwellings of Number of Rooms. 1 Room 2 Rooms 3 Rooms 4 Rooms 5 Rooms 6-8 Rooms 9 or more Rooms All Sizes Total. Occupied Vacant. Furnished Others Cols. a b c d e f g h i j k 1 m SOUTHWARK MET. B. Dwellings occupied by 1 private family 845 4,186 5,258 3,205 1,061 1,569 150 16,274 54,717 54,324 161 232 Dwellings occupied by 2 private families 1 40 161 775 797 3,555 157 5,486 32,260 32,022 126 112 Dwellings occupied by 3 or more private families — — 11 104 223 3,343 1,727 5,408 42,492 42,212 180 100 Total dwellings occupied 846 4,226 5,430 4,084 2,081 8.467 2,034 27,168 129,469 128,558 467 444 Dwellings wholly furnished 17 28 23 8 2 4 — 82 210 — 210 — vacant others 18 32 27 45 10 33 4 167 650 — — 650 Total dwellings occupied and vacant 879 4,286 5,480 4,137 2,093 8,504 2,038 27,417 130,329 128,558 677 1,094 Number of private families therein 847 4,266 5,613 5,074 3,368 20,014 7,160 46,372 — - — - Miscellaneous habitations and institutions housing non-private families 246 16 TABLE 3. PRIVATE FAMILIES. Number of Persons in Family. Number of Private Families occupying the following Number of Rooms. Total Private Families Population in Private Families Rooms Occupied Density of Occupation. 1 2 3 4 5 6-7 8-9 10 or more. Average Number of Persons per Room. Population at following densities of occupation (Persons per Room). over 3 3 and over 2. 2 and over 1½ 1½ and over 1. 1 4,405 1,464 535 153 22 17 3 4 6,603 6,603 9,836 0.67 — — — — 2 1,916 4.251 2,701 882 204 114 30 5 10,103 20,206 24,073 0.84 — — 3,832 — 3 943 3,386 3,277 1,517 341 244 41 11 9,760 29,280 27.274 1.07 — 2,829 — 10,158 4 455 2,155 2,544 1,566 432 299 42 12 7,505 30,020 23,143 1.30 1,820 8,620 10,176 5 186 1,276 1,629 1,134 431 300 32 11 4,999 24,995 16,554 1.51 930 6,380 8,145 5,670 6 71 660 980 842 342 250 30 8 3,183 12,098 11,272 1,69 426 3,960 5,880 7,104 7 32 363 548 528 229 189 29 6 1,924 13.468 7,141 1.89 2,765 3,836 3,696 2,702 8 12 162 316 301 148 108 14 5 1,066 8,528 4,082 2.09 1,392 2,528 3,592 864 9 5 102 153 218 98 67 7 7 657 5,913 2,590 2.28 963 3,339 882 621 10 — 38 69 93 49 42 12 4 307 3,070 1,301 2.36 1,070 930 840 190 11 — 7 33 46 28 31 1 3 149 1,639 691 2.37 440 814 341 11 12 — 4 11 16 22 10 7 4 74 888 382 2.32 180 456 120 96 13 — 1 5 6 4 8 3 1 28 364 145 2.51 156 130 65 13 14 — 1 1 2 2 3 1 — 10 140 50 2.80 56 70 14 — 15 and over — — — 1 1 1 1 — 4 62 23 2.70 32 15 15 — 2 Persons and over 3,620 12,406 12,267 7,152 2,331 1,666 250 77 39,769 157,671 118,721 1.33 10,230 25,287 36,042 37,605 Total Private Families 8,025 13,870 12,802 7,305 2,353 1,683 253 81 46,372 — — — — — — — — 164,274 — 1.28 10,230 25,287 36,042 37,605 Population In Private Families 14,607 44,371 48,974 33,269 12,216 9,005 1,355 477 — — 128,557 — — — — — Rooms occupied 8,025 27,740 38,406 29,220 11,765 10,367 2,085 949 17.3 29.9 27.6 15.8 5.1 3.6 0.5 0.2 100.0 1931 Percentage of Families living in various units of occupation 18.8 28.6 26.8 15.9 5.1 3.9 0.7 0.2 100.0 1921. „ „ „ „ 17 TABLE 4. AGES (GROUPED) BY MARITAL CONDITION. Age last Birthday Persons Males Females Total Single Married Widowed Divorced Total Single Married Widowed Divorced SOUTHWARK MET. B. All Ages 171,695 84,661 46,930 34,202 3,437 92 87,034 43,842 34,202 8,821 109 0—4 13,592 6,890 6,890 — — — 6,702 6,702 — — — 5—9 15,291 7,735 7,735 — — — 7,556 7,556 - - — 10—14 14,417 7,313 7,313 — — — 7,104 7,104 - - — 15—19 16,966 8,407 8,373 34 — — 8,559 8,373 186 8 — 20—24 16,878 8,293 6,940 1,344 9 — 8,585 6,231 2,344 57 2 25—29 14,528 7,301 3,353 3,911 32 5 7,227 2,717 4,442 149 11 30—34 12,220 5,939 1,369 4,508 56 6 6,281 1,378 4,741 328 13 35—39 10,890 5,134 807 4,243 80 4 5, 756 901 4,514 600 13 40—44 10,668 5,082 726 4,186 153 17 5,586 665 4,298 765 23 45—49 10,435 5,042 739 4,057 223 23 5,393 553 4,060 918 15 50—54 9,604 4,793 707 3,760 311 15 4,811 451 3,431 1,072 11 55—59 8.249 4,199 613 3,150 431 5 4,050 338 2,631 1,226 9 60—64 6,601 3,326 533 2,278 508 7 3,275 2278 1,764 1,292 7 65—69 5,062 2,449 414 1,469 559 7 2,613 251 1,069 1,292 1 70—74 3,373 1,533 242 809 480 2 1,840 192 534 1,111 3 75—79 1,861 828 131 339 357 1 1,033 98 191 743 1 80—84 765 295 32 91 172 — 470 42 52 376 - 85—89 243 89 11 23 55 — 154 9 4 l41 - 90—94 43 13 2 — 11 — 30 3 1 26 - 95 & over 9 — — — — — 9 - - 9 - 18 POPULATION. The enumerated population of the Borough (Census 1931) was 171,695. The estimated population as supplied by the Registrar General for mid-year, 1932, is 168,900, and the various rates in my Report have been calculated on this figure. It will be seen by the Table hereunder, that the population of the Borough is steadily decreasing. The diminution in the number of inhabitants has not been uniform throughout the Borough. The northern end or riverside districts have suffered most in comparison since the 1921 Census, which is accounted for by the fact that this portion of the Borough is becoming more commercialised eaqh year. The population of the several divisions of the Borough at each Census since 1851, and also the estimated population for 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930 and 1932 are as follows Newington. St. George's. St. Saviour's and Christchurch. 1851 64,816 51,824 35,731 1861 82,157 55,510 36,169 1871 88,691 56,083 31,294 1881 107,831 58,652 31,628 1891 115,663 59,740 27,116 1901 121,863 60,998 23,319 1911 116,819 55,782 19,316 1921 114,987 52,114 17,303 1922 116,683 52,996 17,541 1923 117,200 52,690 17,574 1924 117,500 52,610 17,604 1925 118,300 52,980 17,720 1926 118,120 52,760 17,720 1927 115,500 51,650 17,100 1928 113,850 50,730 16,720 1929 112,350 49,900 16,250 1930 112,350 49,900 16,250 1931 107,692 48,552 15,451 1932 105,873 47,836 15,191 19 The Ward distribution was as follows:— TABLE 5. WARD. Area in Acres. Males. Population. Total. Persons to the Acre. Females. St. Mary 127 10,890 10,840 21,730 171 St. Paul 133 8,684 9,025 17,709 133 St. Peter 146 12,146 12,870 25,016 171 St. John 118 12,954 13,856 26,810 227 Trinity 109 7,392 7,216 14,608 134 St. Michael 93 9,701 9,311 19,012 204 St. Jude 97 6,116 6,371 12,487 129 St. George 99 8,046 8,291 16,337 165 Christchurch 77 3,550 3,224 6,774 88 St. Saviour 133 3,866 4,551 8,417 63 Whole Borough 1,132 83,345 85,555 168,900 149 BIRTHS. The number of Births registered in the Borough during 1932 was 2,223, of which 1,109 were males, and 1,114 females. This represents a birth-rate of 13.2 per 1,000 inhabitants. The number of births registered in the individual parishes was as follows:—Newington, 1,023; St. George the Martyr, 530; Christchurch and St. Saviour's, 670. Of the 2,223 births registered in the Borough, 339 were transferred away, the permanent residence of the parents being outside the Borough. 845 births occurring in various lying-in and other institutions outside the Borough, but belonging to Southwark parents, were notified to me by the Registrar-General. When the 339 "outward" transfers are deducted and the 845 "inward" transfers are added to the 2,223 births actually registered in the Borough, the net amount of births belonging to Southwark for the year is found to be 2,729. This gives a corrected birth-rate of 16.2. 20 TABLE 6. Birth-Rate for the last Thirty Years for the Three Divisions of the Borough as formerly existed. Newington. St. George's. St. Saviour's and Christchurch. Whole Borough. 1903 33.3 31.3 30.0 32.3 1904 32.3 31.2 27.6 31.5 1905 30.3 30.6 26.2 30.0 1906 29.0 30.5 25.2 29.1 1907 29.1 29.2 25.1 28.7 1908 28.7 28.6 23.2 28.1 1909 27.7 27.5 23.0 28.3 1910 28.2 28.1 24.3 27.8 1911 29.0 31.7 27.9 29.6 1912 29.0 30.7 28.0 29.4 1913 31.8 32.7 26.0 31.5 1914 29.7 31.4 25.5 29.7 1915 28.8 30.2 29.2 29.2 1916 28.4 27.1 24.4 27.6 1917 25.2 24.8 20.2 24.6 1918 21.8 21.0 18.4 21.3 1919 24.1 23.6 16.8 23.2 1920 32.1 32.2 28.5 31.8 1921 27.7 28.7 21.3 27.3 1922 24.0 25.5 24.3 24.4 1923 23.9 25.4 23.7 24.3 1924 22.0 23.6 22.4 22.5 1925 20.1 23.9 21.1 21.2 1926 19.9 21.6 18.1 20.2 1927 18.6 20.6 17.4 19.0 1928 18.0 21.1 19.4 19.2 1929 17.4 20.1 17.1 18.1 1930 16.0 18.6 16.4 16.8 1931 16.2 18.8 16.5 16.9 1932 15.3 17.7 16.9 16.2 21 TABLE 7. Number of Births and Deaths belonging to each Ward, with the Birth and Death Rates, also the Infantile Mortality Rate, 1932. WARD. Births. Infantile Mortality Deaths. Males. Females. Total. Birth-rate. Males. Females. Total. Death-rate. St. Mary 163 184 347 16.0 63 181 123 304 14.0 St. Paul 123 113 236 13.3 68 122 99 221 12.5 St. Peter 174 186 360 14.4 72 156 160 316 12.6 St. John 234 195 429 16.0 54 203 156 359 13.4 Trinity 122 131 253 17.3 71 114 80 194 13.3 St. Michael 143 170 313 16.5 93 161 125 286 15.0 St. Jude 105 102 207 16.6 116 83 75 158 12.7 St. George 172 155 327 20.0 64 101 74 175 10.7 Christchurch 70 57 127 18.7 79 57 63 120 17.7 St. Saviour 71 59 130 15.4 62 49 37 86 10.2 Borough 1377 1352 2729 16.2 72 1227 992 2219 13.1 22 DEATHS. 1,603 deaths were registered in the sub-districts of the Borough during 1932. 25 deaths occurred in the street, or on the way to hospital. 918 deaths occurred in Public Assistance Institutions, the various hospitals, and other public places for the treatment of the sick found within our boundaries. These deaths in institutions comprised 368 belonging to Southwark and 550 to other sanitary districts. The number of inhabitants belonging to the Borough dying away from home—that is, outside our boundaries in the various hospitals and infirmaries—was 1,166. When the 550 deaths of those persons who were non-parishioners, but who died in our Borough, have been deducted, and the 1,166 "outlying" deaths added, the actual or "corrected" number of deaths belonging to the sanitary area is found to be 2,219, of which number 1,227 were males and 992 females. The death-rate, when calculated on this "corrected" number, is 13.1 per 1,000 inhabitants for the whole Borough for the year 1932, as against a rate of 14.0 for 1931. The percentage of persons dying away from Southwark in relation to the total number of deaths belonging to the Borough was 52.5. The principal localities in which the "outlying" deaths occurred are as follows:— Southwark Hospital 97 Mental Hospitals 116 St. Thomas's Hospital 53 Lambeth Hospital 395 Belgrave Hospital 7 King's College Hospital 14 Royal Waterloo Hospital 9 In the Street and other Institutions 475 Total 1,166 23 TABLE 8. Death Rates for the last Thirty Years for the Three Divisions of the Borough as formerly existed. Newington. St. George's. Christchurch and St. Saviour's Whole Borough 1903 17.6 18.6 18.6 18.1 1904 19.0 21.4 21.6 20.0 1905 17.9 19.2 18.7 18.5 1906 17.8 18.5 17.5 18.0 1907 17.6 19.3 16.4 18.0 1908 16.1 17.2 14.3 16.3 1909 15.8 18.6 16.6 16.7 1910 15.9 15.6 16.5 15.9 1911 17.3 19.7 21.1 18.4 1912 15.8 18.5 17.4 16.8 1913 16.5 20.0 20.2 17.9 1914 16.5 19.6 20.7 17.8 1915 19.3 23.4 22.0 20.8 1916 16.5 18.4 17.3 17.1 1917 17.9 19.5 17.9 18.3 1918 22.9 23.7 23.1 23.2 1919 14.6 16.1 15.5 15.1 1920 14.4 14.6 12.9 14.4 1921 14.3 14.6 13.1 14.3 1922 15.2 16.1 15.4 15.5 1923 12.2 13.6 13.7 12.8 1924 13.5 15.3 15.1 14.2 1925 12.4 13.8 15.5 13.1 1926 12.3 13.3 14.1 12.7 1927 13.0 14.3 13.3 13.4 1928 12.3 13.4 13.8 12.7 1929 15.1 16.5 16.2 15.6 1930 12.6 12.8 11.2 12.5 1931 13.7 14.5 15.6 14.0 1932 13.2 12.9 13.6 13.1 24 TABLE 9. Deaths belonging to the Sanitary Area, with the Causes of Death at all Ages during 1932. Causes of Death. Nett Deaths at the subjoined ages of "Residents" whether occurring within or without the District. Institutions. All Ages. 0 1. 2. 5 15. 25. 35. 45. 55. 65. 75 All causes 2219 197 55 44 53 96 88 135 222 343 517 469 - 1. Typhoid and Paratyphoid Fevers - - - - - - - - - - - - - 2. Measles 53 9 26 15 3 - - - - - - - - 3. Scarlet Fever 4 — 2 1 1 - - - - - - - - 4. Whooping Cough 20 11 5 2 2 — - - - - - - 3 5. Diphtheria 14 1 — 7 6 - — - - - - - - 6. Influenza 43 1 1 1 2 1 2 5 4 11 9 6 4 7. Encephalitis Lethargica 1 — — — — —- — — — 1 — - — 8. Cerebro-Spinal Fever 4 2 - - - - - - - - - 1 6 9. Tuberculosis of Respiratory System 171 3 1 — 2 33 35 26 35 27 6 3 19 10. Other Tuberculous Diseases 19 2 1 2 2 7 2 2 — l — — 17 11. Syphilis 16 3 1 — — 1 1 3 3 2 1 1 4 12. Gen. Paralysis of Insane, Tabes Dorsalis 25 - - — - 1 - 6 6 9 3 — — 13. Cancer, Malignant Disease 263 1 — — — 2 5 15 38 73 88 41 132 14. Diabetes 21 — — — — 2 1 — — 8 6 4 11 15. Cerebral Haemorrhage etc. 64 — — — 1 — — 1 9 12 23 18 28 16. Heart Disease 583 — — — 2 10 6 22 37 86 197 223 173 17. Aneurysm 13 - - - - - 1 1 5 2 3 1 8 18. Other Circulatory Diseases 59 - - - - - - 1 7 13 24 14 25 19. Bronchitis 67 4 1 — — 2 1 4 5 6 20 24 26 20. Pneumonia (all forms) 169 32 7 7 6 4 6 15 21 18 33 20 67 21. Other Respiratory Diseases 17 2 — — 2 — — — 3 4 4 2 3 22. Peptic Ulcer 24 — — — — — — 2 7 7 7 1 28 23. Diarrhoea, etc. 40 32 2 1 — 3 — — — — 1 1 22 24. Appendicitis 9 — — 2 2 1 1 — 1 2 — — 11 25. Cirrhosis of Liver 7 — — — — — — 2 1 2 2 — 8 26. Other Diseases of Liver 7 — — — — — — — 3 2 2 — 3 27. Other Digestive Diseases 33 3 1 1 4 — 1 — 3 4 8 8 2 28. Acute and Chronic Nephritis 100 — — — — 5 7 3 11 14 30 30 61 29. Puerperal Sepsis 4 — — — — — 2 1 1 — — — 5 30. Other Puerperal Causes 7 — — — — — 3 4 — — — — 5 31. Congenital Debility and Malformation, including Premature Birth, etc. 78 75 1 - - 2 - - - - - - 56 32. Senility 31 - - - - - - - - - 4 27 1 33. Suicide 28 — — — — 3 3 - 8 10 4 — 8 34. Other Violence 64 3 3 4 8 5 7 2 3 9 4 16 42 35. Other Defined Diseases 160 12 3 1 10 14 4 19 11 20 38 28 139 36. Causes ill-defined or unknown 1 1 — — — — — — — — — — 1 Totals 2219 197 55 44 53 96 88 135 222 343 517 469 918 25 TABLE 10. BOROUGH OF SOUTHWARK. INFANT MORTALITY, 1932. Nett Deaths from stated causes at various ages under 1 Year of age. CAUSE OF DEATH. Under 1 week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 month. 4 weeks and under 3 Months 3 Months and under 6 6 Months and under 9 9 Months and under 12. Total Deaths under 1 Year. All causes 48 4 6 4 62 34 41 31 29 197 Measles — — — — — — 1 2 6 9 Diphtheria — — — — — — — 1 — 1 Whooping Cough — — — 1 1 — 3 2 5 11 Diarrhoea — — — — — 3 15 8 5 31 Enteritis — — — — — — 1 — — 1 Influenza — — — — — — — 1 — 1 Cerebro-Spinal Fever — — — — 1 — 1 — — 2 Scarlet Fever — — — — — — — — — — Phthisis — — — — — — 1 1 1 3 Other Tuberculosis — — — — — 1 1 — — 2 Congenital Malformations 8 — — 1 9 4 — 1 — 14 Premature Birth 34 3 3 — 40 10 4 — — 54 Atrophy, Debility and Marasmus — — — 1 1 2 2 2 — 7 Atelectasis 2 — — — 2 — — — — 2 Erysipelas — — — — — — — — — — Syphilis 1 — — — 1 1 1 — — 3 Rickets — — — — — — — — — — Meningitis — — 1 — 1 — — — — 1 Laryngitis — — — — — — — — — — Convulsions — — — — — — — — — — Gastritis — — — — — — — — — — Intussusception — — — — — — 1 1 — 2 Dentition — — — — — — — — — — Dermatitis — — — — — — — — — — Bronchitis — — — — — — 3 1 4 Pneumonia — — — — — 1 — 1 — 2 Broncho-Pneumonia 1 1 — — 2 7 4 6 8 27 Lobar-Pneumonia — — — — — — l 1 1 3 Suffocation (overlying) — — — — — — 1 1 1 3 Accident (other) 2 — — — 2 1 — — — 3 Nephritis, Acute — — — — — — — — — — Icterus Neonatorum — — — — — — 1 — — 1 Septic Pyaemia — — — — — — — — — 1 Otitis and Mastoiditis — — — — — — — 2 — 2 Other Causes — — 1 1 2 4 — 2 2 10 Not classified above — — — — — — 1 — — 1 48 4 6 4 62 34 41 31 29 197 Nett Births in the year Legitimate 2612 Illegitimate 117 Nett Deaths in the year Legitimate Infants 180 Illegitimate Infants 17 26 TABLE 11. DEATHS OF INFANTS UNDER ONE YEAR OF AGE. The deaths of Infants under one year of age to 1,000 births were 72 during the year 1932. The deaths under one year of age to 1,000 births for the last thirty years were as follows:— 1903 ... 148 1918 124 1904 ... 174 1919 95 1905 ... 148 1920 86 1906 ... 144 1921 90 1907 ... 142 1922 79 1908 ... 131 1923 68 1909 ... 119 1924 71 1910 ... 115 1925 77 1911 ... 145 1926 70 1912 ... 105 1927 61 1913 ... 115 1928 70 1914 ... 123 1929 81 1915 ... 132 1930 57 1916 ... 98 1931 61 1917 ... 111 1932 72 The average number of Infantile deaths for the last thirty years is 104. TABLE 12. Death Rates for the various Districts for the last Ten Years (1922-1931), and 1932. Ward 1922. 1923. 1924. 1925. 1926. 1927. 1928. 1929. 1930. 1931. 1932. St. Mary 160 14.6 14.4 12.8 12.2 13.5 13.7 16.2 13.6 16.4 14.0 St. Paul 15.6 12.3 14.5 12.7 12.0 12.7 11.8 15.9 11.6 14.2 12.5 St. Peter 13.8 10.0 12.0 11.9 12.3 10.8 9.1 12.3 10.1 11.0 12.6 St. John 16.5 12.8 14.0 13.8 13.0 13.6 13.4 17.1 14.4 11.7 13.4 Trinity 16.9 13.1 14.8 11.7 13.4 16.1 13.3 14.9 13.8 13.9 13.3 All Saints 12.8 10.4 11.8 11.2 10.9 11.6 11.5 13.8 11.7 14.5 — St. Michael 17.4 14.2 16.7 15.6 14.2 14.6 14.7 17.2 13.7 15.5 15.0 St. Jude 15.3 14.3 15.4 12.9 12.6 16.1 13.4 18.2 13.1 15.3 12.7 St. George 15.1 12.4 13.5 12.4 12.9 12.6 11.8 14.5 11.5 12.4 10.7 Christchurch 17.9 16.0 19.2 18.2 16.6 13.3 16.5 17.5 13.4 18.0 17.7 St. Saviour 13.0 11.7 11.3 12.9 11.8 13.2 11.4 15.0 9.2 12.6 10.2 27 28 TABLE 13. Births and Deaths Registered in the Sub-Dist ricts of the Borough in 1932. First Quarter. Second Quarter. Births. Deaths. Sub-Districts. Births. Deaths. Sub-Districts. Male. Female. Male. Female. Male. Female. Male. Female. Newington 140 146 136 123 Newington 143 138 91 69 St. George the Martvr, West 70 63 33 43 St. George the Martyr, West 73 75 23 28 Christchurch and St. Saviour 80 80 118 70 Christchurch and St. Saviour 110 76 91 68 Totals 290 289 287 236 Totals 326 289 205 165 Third Quarter. Fourth Quarter. Newington 116 130 63 82 Newington 104 106 67 89 St. George the Martyr, West 63 65 24 28 St. George the Martyr, West 51 70 40 31 Christchurch and St. Saviour 93 88 72 47 Christchurch and St. Saviour 66 77 96 71 Totals 272 283 159 157 Totals 221 253 203 191 Births. Deaths. M. F. M F. In 1st Quarter ... ... ... ... 290 289 287 236 In 2nd Quarter ... ... ... ... 326 289 205 165 In 3rd Quarter ... ... ... ... 272 283 159 157 In 4th Quarter ... ... ... ... 221 253 203 191 Totals ... ... ... ... 1109 1114 854 749 29 TABLE 14. Showing the number of Deaths that occurred in Public Institutions in the Borough during the year 1932. Institution. In 1st Quarter. In 2nd Quarter. In 3rd Quarter. In 4th Quarter. During Year. Newington Institution 110 60 53 57 280 Christchurch do. 1 — — — 1 Evelina Hospital 18 10 9 9 46 Guy's Hospital 143 142 111 160 556 60, Lambeth Road (Catholic Nursing Home) 4 3 1 3 11 Royal Eye Hospital — — 1 — 1 All Saints' Hospital — — 10 13 23 Other Addresses — — — — — Total 276 215 185 242 918 30 31 TABLE 15. Vital Statistics of Separate Localities (1922-1931) Ten Years. BOROUGH OF SOUTHWARK. Names of Localities. 1. St. Mary's Ward. 2. St. Paul's Ward. 3. St. Peter's District. 4. St. John's District. 5. Trinity Ward. 6. All Saints' District. Year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. 1922 22,882 448 366 47 19.362 386 302 27 1 7.170 4.08 239 35 19.218 554 317 49 16,315 456 275 1 21,536 546 275 31 1923 22,934 524 335 41 19.429 408 237 21 1 7,458 375 175 18 19.314 513 247 17 16.409 449 215 31 21,656 534 225 32 1924 22,092 461 330 31 19,479 396 282 34 17,502 326 210 29 19,364 498 271 31 16,451 418 243 26 21 712 485 256 33 1925 23,154 440 298 35 19,561 383 248 21 17,619 329 210 27 19,538 451 269 46 16,566 354 194 26 21,862 441 244 30 1926 23,119 417 283 34 19,532 399 235 30 17,592 308 217 14 19,509 446 253 20 16,451 358 222 15 21,827 420 239 33 1927 22,598 373 304 25 19,100 360 243 18 17,204 272 186 20 19,077 424 259 18 16,174 337 261 12 21,147 381 247 31 1928 22,274 4,97 305 24 18.827 276 223 21 16,960 259 166 19 18,806 41 4 252 35 15,942 302 212 19 21,041 370 243 23 1929 21,981 347 357 18 18,579 330 295 18 16,736 297 206 26 18,559 378 317 36 15,732 288 235 19 21,041 370 243 23 1930 21,981 327 300 19 18,579 285 216 16 16,736 247 169 11 18,559 371 268 21 15,732 280 217 18 20,763 292 243 16 1931 21,077 350 355 22 18,353 309 261 16 16,714 230 184 12 19,112 344 223 20 15,352 243 213 16 17,223 277 256 17 Averages of Years 1922 to 1931 22,359 413 323 29 19,080 351 254 22 17,189 305 196 21 19,106 439 268 31 16,112 349 229 22 20,973 406 252 28 7. St. Michael's Ward. 8. St. Jude's Ward. 9. St. George's Ward. 10. Christchurch Ward. 11. St. Saviour's Ward. 1922 20,795 517 362 40 14,012 273 215 27 18,189 562 275 40 8,389 184 150 9 9,152 242 119 23 1923 20,683 522 293 47 13,939 341 199 23 18,068 476 224 36 8,401 217 134 14 9,173 199 107 10 1924 20,644 442 345 42 13,912 342 214 19 18,045 458 244 31 8,424 207 162 13 9,180 187 104 14 1925 20,788 468 324 44 14,018 334 181 18 18,174 463 227 34 8,478 197 154 15 9,242 177 119 13 1926 20,702 425 294 39 13,901 311 176 25 18,097 405 234 34 8,480 170 141 13 9,240 151 109 8 1927 20,264 434 295 20 13,666 265 220 23 17,720 364 223 28 8,183 155 109 8 8,917 143 118 12 1928 19,903 404 292 28 13,523 290 181 21 17,304 410 205 13 8,000 152 132 15 8 720 172 99 7 1929 19,577 338 337 33 11,109 279 242 28 17,021 386 246 10 7,775 150 136 16 8 475 128 1 97 10 1930 19,577 366 268 24 13,302 246 174 17 17,021 316 195 17 7,775 119 104 5 8 475 148 78 Q 1931 19,385 317 300 20 12,796 272 196 17 16,747 330 207 20 6,943 125 125 9 8,598 131 108 10 Averages of Years 1922 to 1931 20,235 423 331 34 13,642 295 200 22 17,649 417 228 28 8,085 168 135 12 8,917 168 109 12 32 TABLE 16. Deaths in the Sanitary Area from the principal Zymotic Diseases in the various Wards for 1932. WARD. Smallpox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhoea. St. Mary — 6 — 2 2 — 4 St. Paul — 7 1 — 2 — 4 St. Peter — 7 2 1 4 — 6 St. John — 14 — 2 1 — 6 Trinity — 2 — 1 2 — 2 St. Michael — 6 — 3 5 — 2 St. Jude — 3 1 1 1 — 4 St. George — 6 — 3 2 — 7 Christchurch — 1 — — 1 — 4 St. Saviour — 1 — 1 — — 1 Borough — 53 4 14 20 — 40 TABLE 17. ZYMOTIC MORTALITY FOR THE SANITARY AREA, 1932. Showing the localities where the deaths occurred. Locality. Smallpox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhoea. The Borough — 9 — — 2 — 8 Southwark Hospital — — — — — — — Lambeth Hospital — 3 1 1 — — 9 Newington Institution — — — — — — — Evelina Hospital — — — — 1 — 1 Guy's Hospital — — — — 1 — 6 St. Thomas's Hospital — — — — — — 2 Belgrave Hospital — — — 1 1 — — Royal Waterloo — — — — — — 2 L.C.C. Hospitals, etc. — 41 3 12 15 — 12 Total — 53 4 14 20 — 40 33 TABLE 18. Vaccination Officers' Return respecting the Vaccination of Children whose Births were Registered in 1931. Date. Registration subdistricts comprised in vaccination officers' district. Number of births returned in birth list sheets. Number of these births duly entered in Columns 1, 2, 4 and 5 of the vaccination register (birth list sheets), viz.:— Number of these births which are not entered in the vaccination register, on account (as shown by report book), of Total number of certificates of successful vaccination received during the calendar year 1932. Column 1, successfully vaccinated. Column 2. Insusceptible of vaccination. Column 4. Certificate of conscientious objection. Column 5, dead, unvaccinated. Postponement by medical certificate. Removed to other districts and notified to vaccination officers of the districts. Removal to places 1 unknown, or which cannot be reached, and cases not having been found. Cases remaining or temporarily unaccounted for. 1931. 1 2 3 4 6 7 8 9 10 11 12 1st Jan. to 31st Dec. Northern Division 1,227 550 7 419 58 1 61 51 80 910 Southern Division 1,316 640 4 487 50 7 34 60 34 1,010 Total 2,543 1,190 11 906 108 8 95 111 114 1.920 34 SANITARY WORK. House-to-house inspections were carried out in the following localities:— No. 1 DISTRICT. Arcot Place, Black Prince Court, Brune Place, Clock Place, Collitch Place, Doddington Grove, Horse and Groom Court, Hurlbutt Cottages, Hurlbutt Place, Manor Place, Peacock Street, Peacock Square, Roy Place, Sherston Place, Wesley Place. No. 2 DISTRICT. Beresford Buildings, Beresford Street, Camberwell Gate, Cooks Road, Cyril Street, Dartford Street, Heiron Street. No. 3 DISTRICT. Kingsbury House, Kingston Street, Trafalgar Street. No. 4 DISTRICT. Chatham Street, Heygate Street, Rodney Road, Walcorde Avenue. No. 5 DISTRICT. Balin Place, Bath House, Chapel Court, Devonshire House, Laxon Court, Laytons Grove, New Kent Road, McBean's Buildings, Mermaid Court, Price's Buildings, Ralph Street, Rockingham Street, Tennis Court, Uxbridge Place. No. 6 DISTRICT. Brockley Terrace, Claremont Terrace, Hendree Cottages, Salisbury Row, Surrey Square, York Place. No. 7 DISTRICT. Borough Road, Friar Street, Little Surrey Street, Sussex House, Waterloo Road. 35 No. 8 DISTRICT. Earl Street, Keyworth Street, Mansfield Street, Marshall Street, Ontario Passage, Westminster Bridge Road, White Horse Yard. No. 9 DISTRICT. Broadwall, Hatfield Street, Mander Place, Price's Street, St. Margaret's Court, Sumner Street, Union Street. PUBLIC CLEANSING. (a) Generally speaking, weekly collection is in operation, although more frequent collections are made from tenement buildings, eating houses and places where food is prepared. (b) The whole of the refuse is brought to the Council's depot at Manor Place, Walworth, for transport by rail to the country depots at Longfield and Sevenoaks, Kent. Approximately 50 per cent. of the house refuse is passed through pulverising machines, the crushed material being disposed of partly by sale to Kent farmers as a dressing for heavy soil, and the remainder is used for covering the rough dust at the tips. At Longfields controlled tipping is operated satisfactorily. The Sevenoaks Depot will shortly be closed, the available space having been filled in. There are no cesspools, earth closets or privies in the Borough. 36 37 TABLE 19. Summary of Sanitary Works Completed under the Public Health Act, during the year 1932. DISTRICT. Intimation Notices Complied with Statutory Notices Complied with Drain reconstructed. Drain repaired. Drain Intercepted and Ventilated. Drain Unstopped. Gullies provided. Soilpipe provided or repaired. Closet provided. Closet Pan and Trap. Water apparatus repaired. Sink, Lav. & Waste Pipes. Rain Water Pipes repaired, etc. Water supply to upper floors. Draw Tap on Main. New Water Supply. Roof and Gutters repaired. Paving repaired. Dampness abated. Rooms cleansed Sub-Floor Ventilation. Basement concreted. Staircase Ventilated. Dust-bin provided. Overcrowding abated. Miscellaneous Nuisances abated. No. 1 Mr. Bryant 636 200 19 49 14 48 82 21 43 174 120 160 68 2 58 — 170 114 54 1146 36 3 18 102 3 493 No. 2 Mr. Mayhew 596 205 16 34 4 22 13 4 12 67 45 67 21 — — — 192 61 63 730 12 - 2 218 6 367 No. 3 Mr. Banham 547 169 4 16 1 14 5 — — 29 38 40 55 — 1 1 217 56 92 596 6 1 - 184 - 423 No. 4 Mr. White 406 112 13 12 8 15 31 20 60 113 101 146 22 1 — — 181 22 32 551 7 5 1 99 2 369 No. 5 Mr. Findley 734 221 7 53 2 79 50 10 20 96 104 86 96 3 8 2 441 144 149 1269 33 4 4 162 19 845 No. 6 Mr. Steele 671 222 13 33 5 28 21 13 12 44 75 67 73 1 1 — 303 50 70 645 7 - - 230 1 518 No. 7 Mr. Hattersley 392 89 — 15 3 29 — 3 — 50 31 16 44 — — — 154 29 49 970 5 - - 139 1 302 No. 8 Mr. Syms 328 55 12 17 1 33 16 5 2 51 58 79 41 4 1 1 123 53 32 659 15 3 - 103 9 351 No. 9 Mr. Ede 225 97 11 22 9 20 40 25 73 82 87 139 21 1 1 - 118 34 22 435 113 - - 63 2 299 Total 4535 1370 95 251 47 288 258 101 222 706 659 800 441 12 70 4 1899 563 563 7001 234 16 25 1300 43 3967 4,838 Intimation Notices were served during the year. 1,370 Statutory Notices were served during the year. 38 39 TABLE 20. Sanitary Works completed under the Housing Acts, during the year 1932. DISTRICT. Formal Notices complied with. Chimney flues repaired. Brickwork and pointing repaired. Window reveals and sills. Window sash repaired. New Sash Lines. Doors and woodwork repaired. Stair Treads and Risers repaired. Handrail and Balusters repaired. Floors repaired. Provision of ventilated food Storage. Plaster repaired. Stove and Fireplace repaired. Copper repaired. Stone Steps repaired. Skylight repaired and new Cords. Houses Let in Lodgings. Separation of Sexes and Overcrowding. Cleansing by Tenants and Lodgers. Cleansing of Bed Linen. Cleansing of Receptacles. Removal of Refuse Daily. Ventilation of Rooms by Lodgers. Animals in Tenements. Rooms cleansed. No. 1 8 17 102 101 76 245 129 335 37 76 — 154 118 45 15 6 - - - - - - - - No. 2 26 4 44 63 79 83 70 10 11 32 — 12 89 2 — 3 - - - - - - - - No. 3 14 5 28 11 37 51 81 10 19 29 — 43 50 9 4 - - - - - - - - - No. 4 6 2 16 11 15 39 47 2 11 20 — 16 79 13 6 - - - - - - - - 4* No. 5 68 44 84 51 63 69 112 44 19 86 11 65 122 41 8 7 - - - - - - - 1* No. 6 6 8 3 7 11 25 25 2 7 27 — 3 70 8 — 1 - - - - - - - - No. 7 24 5 25 44 169 53 138 30 3 34 — 24 83 20 — 1 - - - - - - - - No. 8 6 10 46 25 80 92 48 73 29 25 — 67 51 13 2 10 - - - - - - - - No 9 4 - 8 6 8 13 18 18 4 38 - 5 26 9 - - - - - - - - - - Total 162 95 356 319 538 670 668 524 140 367 11 389 688 160 35 28 - - - - - - - 5* * April Cleansing Notices. 40 PROCEEDINGS TAKEN UNDER THE PUBLIC HEALTH AND OTHER ACTS. 6 summonses were taken out during the year 1932 in respect to offences, particulars of which are set out below. The following table shows the number of summonses taken out in each of the several districts:— TABLE 21. DISTRICT. Total. No. 1. No. 2. No. 3. No. 4. No. 5. No. 6. No. 7. No. 8. No. 9. Number of Summonses taken out 1 4 ... ... ... 1 ... ... ... 6 The above summonses had reference to the following:— Ordinary Nuisances 6 TABLE 22. These proceedings resulted as follows:— Summonses withdrawn (with costs), the Council's requirements having been complied with 3 Magistrates' Orders made 3 6 41 TABLE 23. Proceedings taken under the Public Health and Other Acts. Defendant. Cause of Proceedings. Result. Rose Dawson, 228, Old Kent Road, S.E. Neglecting to cleanse first floor front room at 228, Old Kent Road Ordered to abate nuisance in 7 days, no costs. Chas. Benabo & Sons, 240, Mile End Road, E.l. Neglecting to amend defective roof at 13, Chapter Terrace Ordered to do work within 14 days, with 31/6 costs. Chas. Benabo & Sons, 240, Mile End Road, E.l. Neglecting to amend defective roof at 15, Chapter Terrace Summons withdrawn, work done, 10/6 costs. Edward H. Pearce, 7, Ferndene Road, S.E. Neglecting to abate nuisance caused by dampness, etc., at 55, Doddington Grove Summons withdrawn, work done, 10/6 costs. Chas. Benabo & Sons, 240, Mile End Road, E.l. Neglecting to provide sufficient ashpit accommodation at 15, Chapter Terrace Summons withdrawn, ash-pit provided, 10/6 costs. Chas. Benabo & Sons, 240, Mile End Road, E.l. Neglecting to amend defective roof at 17, Chapter Terrace. Ordered to do work within 14 days, 21/- costs. 42 ACTS AND BYE-LAWS ADMINISTERED BY THE PUBLIC HEALTH DEPARTMENT. Acts of Parliament— Infectious Diseases (Prevention) Act, 1890. The Public Health (London) Act, 1891. The Metropolis Management Act, 1855. The Factory and Workshops Acts, 1901 to 1907. The Rag and Flock Act, 1911 and 1928. Rats and Mice (Destruction) Act, 1919. Public Health (Smoke Abatement) Act, 1926. Sale of Food and Drugs Act, 1875 and 1927. Milk and Dairies (Consolidation) Act, 1915. Milk and Dairies (Amendment) Act, 1922. Sale of Horse Flesh Regulation Act, 1889. Increase of Rent and Mortgage Interest (Restrictions) Acts, 1920. and 1923. Local Government Act, 1929. Agricultural Produce (Grading and Marking) Act, 1928. Food and Drugs (Adulteration) Act, 1928. Housing Acts, 1925-1930. London County Council (General Powers) Acts, 1893 to 1932. Cleansing of Persons Act, 1897. Merchandise Marks Act, 1926. Artificial Cream Act, 1929. Rent Restrictions Act. Regulations— Regulations (Shell Fish), 1915. Sale of Milk Regulations, 1901 and 1912. Sale of Butter Regulations, 1902. Public Health (Condensed Milk) Regulations, 1923 and 1927. Public Health (Dried Milk) Regulations, 1923 and 1927. Public Health (Preservatives in Food, &c.) Regulations, 1925 to 1927. Public Health (Tuberculosis) Regulations, 1912 to 1930. Public Health (Meat) Regulations, 1924. Public Health (Imported Milk) Regulations, 1926. Public Health (Acute Encephalitis Lethargica and Acute Polio- Encephalitis) Regulations, 1918. Public Health (Ophthalmia Neonatorum) Regulations, 1926-1928. Public Health (Notification of Puerperal Fever and Puerperal Pyrexia) Regulations, 1926-1928. Infectious Diseases (London) Regulations, 1927. Public Health (Imported Food) Regulations, 1925. Housing Acts (Form of Orders and Notices) Regulations, 1932. 43 London County Council. Vendors of Fried Fish, 1914. Fish Curers, 1914. Dressers of Fur Skins, 1922. Rag and Bone Dealers, 1923-1928. Houses divided into separate tenements, &c., 1926. Removal of offensive matter, 1901. Closing and filling of cesspools and removal of refuse, 1893. Ashpits, manure receptacles, &c. , 1893. Construction of drains and W.C.'s, 1929. Business of a slaughterer of poultry, 1923. Slaughterhouses, 1891-1923. Water closets, &c., 1913-1930. Offensive trades. Conveyance of dead horses. Orders— Tuberculosis Orders (Cattle), 1925 (1) and (2). Factory and Workshop Welfare Order, 1927 (Bakehouses). Do. do. do. 1927 (Biscuit Factories). Registration of Margarine Factories, 1900. Registration of Butter Factories, 1907. Milk and Dairies Order, 1926. Milk (Special Designations) Order, 1922-1923. Milk (Special Designations) Amendment Order, 1922. Sale of Food Order. Part (3), 1921. Sanitary Accommodation Order, 1903. Home Work Orders, 1911, 1912, 1913. Merchandise Marks (Imported Goods) Order, No. 3, 1928. Merchandise Marks (Imported Goods) Order, No. 5, 1928. Do. do. Order No. 4, 1929. Do. do. Order No. 1, 1932. Sanitary Officers' Order, 1922. Other Acts referring to works of the Public Health Department Notification of Births Act, 1907-1915. Maternity and Child Welfare Act, 1918. Southwark Borough Council— Fouling of footway by dogs. Regulations, underground rooms. Paving of Yards. BLACK SMOKE. During the year 1932 one complaint was received at the Public Health Office from persons other than the Council's Inspectors. 44 TABLE 24. Showing the Number of Observations, etc., in regard to Smoke Nuisances made by the several District Inspectors during 1932. DISTRICT Total for Borough. No. 1. No. 2. No. 3. No. 4. No. 5. No. 6. No. 7. No. 8. No. 9. No. of observations made by the Inspectors ... ... ... 3 ... ... ... ... ... 3 No. of Nuisances observed ... ... ... 1 ... ... ... ... ... 1 No of intimation Not ices served ... ... ... 1 ... ... ... ... ... 1 No of Statutory Not ices served ... ... ... 1 ... ... ... ... ... 1 No. of Summonses taken out ... ... ... ... ... ... ... ... ... ... HOUSES LET IN LODGINGS. Notices are sent to those concerned to proceed with the cleansingeach April, and from time to time leaflets are distributed to tenants and lodgers, drawing their attention to their obligations under these Regulations. CUSTOMS AND INLAND REVENUE ACT, 1890. No Certificate for exemption from Inhabited House Duty was granted during the year 1932. HOUSING, TOWN PLANNING, ETC., ACT, 1909. No certificate for exemption from Inhabited House Duty in respect to lodging houses for working classes was granted during the year. 45 RAG FLOCK ACTS, 1911 and 1928. The Act requires that the amount of Chlorine found shall not exceed 30 parts in 100,000 parts of flock. Visits under the Act have been made by the several inspectors to premises, but rag flock is not being sold at any of them at the present time. WATER SUPPLY. PUBLIC HEALTH (LONDON) ACT, 1891. Section 48. Certificates in regard to water supply have been granted in respect of the under-mentioned (new) houses during the year. Premises. Certificates granted to. 145, Old Kent Road Messrs. H. Somerford & Sons, 104, Manor Street, S.W. 131/178, Pilton Plate (48 flats) E. Percy Kendall, Esq., 11, Gt. Turnstile, W.C.I. 13/15, Borough Road Messrs. C. H. Gibson, Ltd., 509, London Road, Croydon. The " Gladstone " P.H. Lant St. Messrs. H. J. Taylor, Hither Green Lane, S.E. 181/182, Great Dover Street (7 Messrs. F. Cope & Co., tenements) 5, Whitcombe St., W.C.2. 9/13, Camberwell Road (2 flats) F. G. Holman, Esq., 9, Camberwell Road, S.E. 51/100, Winchester Buildings V. Wilkins, Esq., (50 flats) 12, York Buildings, W.C.2. 1/36, Pilgrim House (24 flats) Messrs. Gee, Walker & Slater, 32, St. James Street, S.W.1. Blocks A & B, Doddington Grove The Mayor, Aldermen and Coun(65 flats) cillors of the Borough of Southwark. 46 WATER SUPPLIES TO TENEMENT HOUSES. London County Council (General Powers) Act, 1907. Sixteen additional water supplies were provided to houses during the year 1932. TABLE 25. Factories, Workshops, Laundries, Workplaces and Homework. 1.—Inspection (including Inspections made by Sanitary Inspectors). Premises. Number. Inspections. Written. Notices. Prosecutions. Factories (including Factory Laundries) 245 14 ... Workshops (including Workshop Laundries) 319 13 ... Workplaces 357 26 ... Homeworkers' Premises (including Outworkers) 282 ... Total 1203 53 ... 2.—Defects Found. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. *Nuisances under the Public Health Acts :— Want of Cleanliness 93 111 Want of Ventilation 1 1 ... ... Overcrowding 1 ... ... ... Want of drainage of floors 1 1 ... ... Other nuisances 107 178 ... ... Sanitary accommodations: Insufficient 4 2 ... ... Unsuitable or defective 13 17 ... ... Not separate for sexes 2 2 ... ... Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (S. 101) ... ... Breach of special sanitary requirements for bakehouses (SS.97-100) ... ... Other offences ... ... Total 222 312 ... ... *Including those specified in Sections 2, 3. 7 and 8 of the Factory Act as remediable under the Public Health Acts. 47 TABLE 26. 3.—Home Work. Nature or Work. Outworkers' Lists, Section 107. Number of Inspections of Outworkers' Premises. Outwork in Unwholesome Premises, S. 108. Outwork in Infected Premises, Sections 109-10 Lists received from Employers. Nos. of Addresses of Outworkers received from other Councils. Nos. of Addresses of Outworkers forwarded to other Councils. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made (S. 110). Prosecutions. (Ss. 109, 10). Twice in the year. Once in the year. Failing to keep or permit inspections of lists. Failing to send lists. Lists. Outworkers Lists. Outworkers Wearing Apparel— (1) Making, &c. 54 26 52 43 281 345 - - 147 2 - - - - - (2) Cleaning and washing - - - - - - - - - - - - - - - Lace, lace curtains & nets - - - - - - - - - - - - - - - Furniture and Upholstery 1 3 1 4 2 2 - - - - - - - - - Fur pulling - - - - - - - - - - - - - - - Umbrellas 1 — — — 7 1 — - 4 — - - - - - Paper Bags and Boxes 7 16 7 14 5 11 — - 34 1 - - - - - Brushmaking 5 6 5 7 4 8 — - 19 — - - - - - Stuffed Toys 1 2 1 2 — 2 - - 1 - - - - - - File making - - - - - - - - - - - - - - - Electro Plate - - - - - - - - - - - - - - - Cables and Chains - - - - - - - - - - - - - - - Anchors and Grapnels - - - - - - - - - - - - - - - Cart Gear - - - - - - - - - - - - - - - Locks, Latches and Keys - - - - - - - - - - - - - - - Miscellaneous 22 29 9 17 66 37 - - 77 - - - 1 - - Total 91 82 75 87 365 406 - - 282 3 - - 1 - - 48 TABLE 27. 4.—Registered Workshops. Workshops, Workplaces, etc., on the Register (S. 131) at the end of the year. Number. Bakehouses 94 Factory Bakehouses Eating houses and places where food is prepared for sale 421 Ice Cream Shops 209 Laundries 12 Dressmakers, Milliners, etc. 14 Tailoring 15 Brushmakers 13 Miscellaneous 1877 Total number of Workshops, Workplaces, etc., on Register ... 2655 5.—Other Matters. Class. Number. Matters notified to H.M. Inspectors of Factories:— Failure to affix Abstract of the Factory and Workshop Aot (S. 133) 1 Action taken in matters referred by H.M. Inspectors as remediable under the Public Health Acts, but not under the Factory Act (S. 5): Notified by H.M. Inspector 9 Reports (of action taken) sent to H.M. Inspectors 4 Other — Underground Bakehouses (S. 101) In use at end of the year 27 WOMEN S WORKSHOPS. The supervision of the Women's Workshops was carried out during the year by Miss Burrows. 715 inspections and 488 re-inspections were made. The following defects were discovered, and 5 intimations and 1 statutory notices were served in order to obtain the abatement of the nuisances complained of:— Closet provided 2 Water apparatus defective 20 Roofs defective 6 Rooms dirty 53 Closet Pans and Traps 3 Miscellaneous nuisances 56 Total 140 All the above-mentioned nuisances were remedied. Miss Burrows also made 1,594 inspections of the women's conveniences throughout the Borough. TABLE 28. RATS AND MICE (DESTRUCTION) ACT, 1919. Summary showing investigations and inspections made during the year 1932. DISTRICT Inspections Re-inspections. Premises where Rats were found. Action taken. Probable Source. Notices. By Council's Official. By Occupiers. By Inspectors By Rat Officer. By Inspectors By Rat Officer. Baits laid by Rat Officer with poison Wire Traps Set. Breakback. Traps Set. Cats or Dogs. Ferrets. Rat Runs and Holes. Defective Drains. Defective Sewers. No. 1 32 39 15 190 12 925 48 186 3 - 13 9 - 1 No. 2 25 39 43 307 13 1313 35 171 3 — 15 4 - 1 No. 3 38 38 30 211 19 1146 39 237 1 — 11 1 - 2 No. 4 50 54 163 518 36 2313 57 422 5 - 28 8 - 13 No. 5 42 68 105 532 26 1941 35 343 2 - 25 5 2 12 No. 6 33 31 73 527 24 2408 66 445 1 - 16 2 — 3 No. 7 69 81 82 721 50 2266 21 744 5 - 22 9 — 3 No. 8 13 10 9 128 4 544 1 74 — - 1 — - No. 9 85 76 35 201 18 1212 74 220 5 - 17 8 i - Total 387 436 555 3335 202 14068 376 2842 25 — 148 46 3 35 Number of Rats destroyed 1225 50 Cleansing of Verminous Rooms and their Contents. During' the year 1932 the number of verminous rooms with the bedding and other articles cleansed and disinfected in accordance with the requirements of the London County Council (General Powers) Acts, 1907 and 1922, has decreased in comparison with 1931. I append a table showing the number of notices served upon the owners or occupiers of the several premises in question, and the number of verminous rooms stripped and cleansed by the owners, and fumigated by the Council's disinfecting staff, respectively. I also submit tables showing the number of articles dealt with at the disinfecting stations. TABLE 29. Verminous Rooms Cleansed. DISTRICT. No. of Intimation Notices served. No. of Statutory Notices served. Police , Court proceedings taken. Verminous rooms treated. (a) by Owners of Premises. (b) by the Council's Disinfecting Staff. No. 1 95 39 - 119 135 No. 2 57 12 - 68 102 No. 3 23 5 — 27 43 No. 4 22 15 - 30 52 No. 5 123 39 - 151 223 No. 6 16 6 - 27 142 No. 7 29 8 - 35 57 No. 8 24 9 - 25 42 No. 9 15 14 - 17 87 TOTAL 404 147 - *499 943 * Note—These 499 rooms were stripped by the owners. 51 TABLE 30. Verminous Bedding, etc., Disinfected at the Council's Stations during 1932. Articles. Disinfected. Destroyed. Beds 184 2 Palliasses 49 1 Bolsters and Pillows 291 — Cushions 18 — Blankets 450 — Sheets 456 — Quilts 205 - Articles of Clothing, etc. 29,121 - Books 55 - Total 30,829 3 In addition, four attache cases were disinfected. VERMINOUS PERSONS CLEANSED DURING 1932. During the year 4,836 persons were cleansed at the station in King James Street. Of these, under our agreement with the London County Council, were 3,131 children. Many of the children treated were suffering from Scabies. In every case the treatment at our Station was thoroughly efficacious, and no recurrence of the trouble was experienced. 52 1,705 adults sent from the various common lodging houses and other places in our borough were cleansed during the year, as against 1,693 dealt with under the provisions of the Cleansing of Persons Act, 1897, in 1931. MORTUARIES. TABLE 31. During the year 234 bodies were received into the Mortuaries:— Reasons bodies were brought to Mortuary. Collier's Rents Mortuary. Manor Place Mortuary Total. Bodies brought in upon which Inquests were held 141 1 142 Bodies brought in for convenience 16 59 75 Bodies brought in in cases where death had occurred from Infectious Disease 12 5 17 Total 169 65 234 During the year Manor Place Mortuary was abolished, and all bodies are now moved to Collier's Rents, where inquests are held when necessary. 53 TABLE 32. HOUSING. 1 Inspection of Dwelling Houses:— (1) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 5738 (b) Number of inspections made for the purpose 6733 (2) (a) Number of dwelling houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 1407 (b) Number of inspections made for the purpose 1407 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 61 (4) Number of dwelling houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 4283 2. Remedy of Defects without Service of formal Notices:— Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their officers 910 3. Action under Statutory Powers during the Year:— A. Proceedings under Sections 17, 18 and 23 of the Housing Act, 1930. (1) Number of dwelling houses in respect of which notices were served requiring repairs 190 (2) Number of dwelling houses which were rendered fit after service of formal notices:— (a) by owners 162 (b) by Local Authority in default of owners Nil. 54 TABLE 32.—continued. B. Proceedings under Public Health Acts:— (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 3,979 (2) Number of dwelling houses in which defects were remedied after service of formal and informal notices (a) by owners 3,370 (b) by Local Authority in default of owners Nil C. Proceedings under Sections 19 and 21 of the Housing Act, 1930:— (1) Number of dwelling houses in respect of which Demolition Orders were made 11 (2) Number of dwelling houses demolished in pursuance of Demolition Orders 3 (3) Number of dwelling houses rendered fit (Sub. Sec. 2) 9 D. Proceedings under Section 20 of the Housing Act, 1930:— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made 20 (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit 5 (3) Number of separate tenements or underground rooms which have been closed, without making of orders 9 (4) Number of separate tenements or underground rooms which have been rendered fit, without making of orders 2 55 HOUSING. One of the most acute and pressing problems, certainly as regards health, with which the Council is faced, is the shortage of houses which can be let at rentals within the means of the lowest paid workers. The Housing problem, so far as Central London and its immediate surroundings are concerned, is entirely different from that in any other part of the country, and will have to be dealt with in an entirely different manner. The sooner the idea of judging the overcrowding or health of an area by the number of persons per acre is forgotten, the better, as experience has proved it is utterly fallacious, and what really matters is the number of persons per room. It is agreed from everyone's point of view that the ideal accommodation is a small self-contained house with garden; but this cannot be done in London owing to lack of space and the enormous land values. Certainly those persons who can afford to live a little way out from their work and pay the travelling expenses ought to do so, so as to make more room for the less fortunate. This method of re-housing persons away from Central London has been the policy of the L.C.C. for several years past, but so far as this Borough is concerned, the majority of those that can afford to live away, and those whose work does not demand their living in Central London, have been moved, and we are now left with a large number who earn anything from 30/- to £3 10s. per week, many with large families and therefore unable to pay high rents, yet requiring the greatest accommodation; around this central factor revolve the problems of re-housing yet to be solved, namely, shortage, expensive sites and cost of building. Until a solution is found the inevitable must happen, viz., sub-letting of already well filled houses, whereby the poorer citizens become huddled together, not only in an unhealthy, but also in a disgraceful, immoral and degrading manner. The evils arising from such conditions are already so well known that it is unnecessary to describe them. Some little idea of the overcrowding in this Borough can be obtained from a digest of the census figures, as outlined in an earlier part of this report; from these figures it will be seen that there are at least between 2,000 and 3,000 serious cases of overcrowding. 56 Whilst realising that it is impossible to re-house the heavy population of Southwark under the ideal method discussed above, I am convinced that the present number of families can be housed in the Borough. This could be brought about by rebuilding larger houses on sites which at present are occupied by small single type houses with long gardens, of which there are many in the district; by careful planning several flats could be erected to replace the one dwelling. This appears to me to be the inevitable method of re-housing in Central London, and will have to be considered sooner or later, if those who must live on top of their work, and those who cannot afford to live away from their work are to be suitably and adequately housed, and the overcrowded conditions of to-day abolished, or reduced to the absolute minimum. I have already reported to the Housing Committee on several aspects of the present housing problems, particularly that of overcrowding, and hereunder I submit extracts from these reports. (1) HOUSING PROBLEMS. During the last 10 months, I have made surveys of the Borough for the purpose of making myself thoroughly acquainted with the housing conditions existing therein. In the course of these surveys three problems present themselves, which I particularly wish to bring to the notice of the Housing Committee. They are as follows:— (a) Overcrowding; (b) Courts and alley-ways in the Borough, which are closely confined and ill-arranged. (c) Areas for larger clearance and re-housing schemes. REMEDIES:— Having regard to the fact that within the next few months 3 blocks of flats will be erected in Doddington Grove, it is desirable that the Council should formulate a definite housing policy for the guidance of the officials, and particularly in view of the resolution of the Council of July 30th, 1930, which was as follows:— "That this Council express their intention, when considering applications for housing accommodation on housing estates to be constructed by them, of giving preference to:— 57 (1) persons to be dehoused by any clearance schemes to be undertaken by them, and (2) persons residing in overcrowded conditions in the Borough." Taking the problems under headings (a) and (b) of this report, it is obvious that the accommodation at Doddington Grove is quite insufficient to deal with either completely. Moreover, if such a policy were decided upon, the only outlet which has presented itself for many years would be "choked," and any action which may be desired to be taken under heading (c), either now or in the future, with regard to a Clearance Scheme, would be rendered impossible owing to the fact that under the Housing Act, 1930, before dealing with any Clearance Scheme, alternative accommodation must be available for displaced persons. I have discussed the present situation with the Town Clerk, and we are both agreed that in order to deal collectively with all the problems outlined in this report and to alleviate by a gradual process the serious overcrowding and extinction of unfit dwellings, the long viewed policy is the best—namely, Clearance and Re-housing Schemes, by which a surplus of flats can be gradually accumulated. This policy we recommend to the Council, and accordingly it is desirable that the flats now in course of erection at Doddington Grove should be earmarked for this purpose. (2) HOUSING—Various Points Stressed in the Latest Annual Report of the Ministry of Health, 1931-1932. HOUSING POLICY. It is essential in existing financial circumstances to ensure that all new expenditure on housing should be used to the best advantage, and it is agreed that the outstanding need at the present time is for the building of houses which can be let at rents within the means of the poorer paid workers. The report of the Departmental Committee on the Rent Restriction Act bears out the above statements; moreover, the Committee reported that " Some Local Authorities are now building, under the Housing Act, 1924, a three bedroomed house to let at a rent of 10/- inclusive, and there is no doubt that a large supply of houses at this rent would go a long way towards solving the problem." The view taken by the Ministry of Health since 1919 is that adequate accommodation for the ordinary family with children can be provided in a house of the three bedroomed non-parlour type within a superficial area of 760 square feet. 58 In Circular 1238, issued in January, 1932, the Minister suggests that Local Authorities should concentrate their efforts on the provision of houses of this type and not exceeding the size mentioned in the previous paragraph; and expressed the hope that this concentration would lead to the provision by private enterprise, without subsidy, of houses of other types. The two main objects of the policy indicated in this Circular are:— (1) The concentration of the activities of the Local Authorities on the provision of houses to let at the lowest possible rents, and (2) The encouragement of private enterprise to build the larger houses. Some Local Authorities with lengthy housing experience find it possible to build a suitable three bedroomed non-parlour type house with a superficial area considerably below 760 square feet. The Ministry points out that larger houses will only be approved in special cases, but on the other hand a reasonable number of two bedroomed non-parlour type houses with a superficial area not exceeding 650 square feet may in some cases be justified. The provision of new houses should be limited to the number required to meet the urgent need of applicants with children who are living under overcrowded conditions or in insanitary houses, and whose financial position is such that they cannot obtain the necessary accommodation in the absence of provision by the Local Authority. Circular 1238 clearly requires that the Local Authority should pay regard not so much to the rent, paying capacity of tenants as to the need of removing unhealthy conditions. At the same time, it is correct that a subsidised rent should only be enjoyed by those who really need it. Furthermore, the Ministry indicates that, so far as possible, accommodation should be rationed in accordance with the needs of the occupants (for example, three-bedroomed houses should not be allocated to tenants whose families have left them) and that in general such elasticity should be used in the management of the houses as will enable these objects to be secured. The Ministry's Report further suggests that the utmost economy must be secured in the selection and lay-out of site, and the planning and building of houses. 59 Suggestions on more economical building is made in Appendix 6, page 281 of the Report in question. Undoubtedly many of the references can only apply to the Provinces; nevertheless, one is not without hope that some form of cheaper houses can be devised and built in London, particularly if due regard is given to the recommendation of the Ministry and contracts placed to open competition. THE YEAR'S WORK. Owing to the lengthy procedure of necessity required to deal with housing matters under the Housing Acts, it would appear to those of us who are keen to "get a move on," that "nothing doing" could quite well be written under this heading, and finish at this. However, when one comes to take stock of what has been done under the Public Health Act and the various sections of the Housing Acts, it becomes evident that a large amount of very useful work has been accomplished. In addition to formal action, much has been done and many improvements obtained by informal action by your Medical Officer of Health and his inspectoral staff. This has been brought about by interviewing owners of property, and the chairmen and secretaries of the larger Housing Trusts. PUBLIC HEALTH ACT. During the year, 3,370 unfit houses have been rendered fit. HOUSING ACT, 1930 (Sec. 1). The following areas were represented for clearance and re-housing schemes:— (1) Amery Place—Kinglake Street area. (2 Kinglake Street—No. 1 area. (3) Orb Street—No. 2 area. (4) South Street area. (5) Alvey Street area. (6) Gerridge Street area. (7) Zoar Street area. Amery Place—Kinglake Street Area. The Council have already declared this as a Clearance Area, and it will be proceeded with after the sanction of the Minister of Health has been obtained. 60 Kinglake Street—No. 1 Area. The Council recommended that the London County Council be notified that at the expiration of 2 months they would take into consideration the making of a Clearance Order. The London County Council intimated that they did not intend themselves to deal with this area. Since making this representation, we find that the owners have been reconditioning many of the houses in this area. It would appear that the action taken by this department has stimulated the owners to improve their property, which is all to the good in one sense, but renders any immediate action by the Council or its officers extremely difficult and remote. Orb Street and South Street Areas. The London County Council have intimated that they are prepared to consider dealing with these areas when circumstances permit, as a County Scheme. Alvey Street Area. The Council recommended that the London County Council be notified that at the expiration of 2 months they will take into consideration the making of a Clearance Order. The London County Council are of opinion that this area should be dealt with on the lines of an Improvement Scheme rather than one of clearance. Gerridge Street Area. The Council recommended that the London County Council be notified that at the expiration of 2 months they will take into consideration the making of a Clearance Order. The London County Council intimated that they did not intend themselves to deal with this area. Since this area was represented, a portion of the land has been sold by the owner for industrial purposes, which has rendered the site unsuitable for re-housing purposes. The remaining property has been reconditioned at much expense by the owner and rendered fit for human habitation. Zoar Street Area. This area was represented for clearance, owing to congestion, bad arrangement, and general disrepair of the property. In the opinion of the London County Council, the site was only suitable for industrial purposes. HOUSING ACT, 1930 (Sec. 17). The number of dwelling houses in respect of which notices were served requiring repairs, was 190. 61 Of this number, 162 were rendered fit—leaving 28 outstanding at the end of the year. HOUSING ACT, 1930 (Sec. 19). The following properties were represented for demolition:— 1, la, Law Street. 52, 54, Sumner Street. 25, 26, Chapel Court. 2, 3, 4, 5, 6, Cavan Terrace. 49, Friar Street. 20, Townley Street. 3, Peacock Square. 58, 59, St. Margaret's Court. 7, 8, 14, 15, 16, 17, 18, 19, 20, Barrons Place. 1, la, LAW STREET. 3, PEACOCK SQUARE. In pursuance of the orders made by the Council these premises have now been demolished. 2, 3, 4, 5, 6, CAVAN TERRACE. 49, FRIAR STREET. In pursuance of the orders made by the Council, these premises are now empty, and will be demolished in due course. 20, TOWNLEY STREET. By arrangement with the owner the order was not made. The premises are now closed, and will be demolished in due •course. 52, 54, SUMNER STREET. 25, 26, CHAPEL COURT. By arrangement with the owners, the orders were not made, an undertaking being given to carry out such works as would render the houses fit for human habitation. The specification of works set out in the schedule of dilapidations were accepted by the respective owners, and the premises have now been rendered fit. 58, 59, ST. MARGARET'S COURT. In regard to these premises, action has been delayed in order to allow the owner to render the houses fit for human habitation. This, however, has not been successful, and Demolition Orders have now been made. 62 7, 8, 14, 15, 16, 17, 18, 19, 20; BARRONS PLACE. By arrangement with the owners of this property, the orders were not made, as an undertaking was given that the premises will not be used for human habitation but for storage purposes only, and until such time as the whole site becomes available for development of business premises. (A) HOUSING ACT, 1930 (Sec. 20). The following underground rooms and parts of premises were inspected during the year.. Closing Orders were made in 20 cases, as follows:— 268, 310, 312, 314, 316, Munton Road. 358, 360, 362, 364, 434, 434a, 436, 436a, Munton Road. 99, Sumner Street. 75, Union Road. 17, Bear Lane. 104, Upper Grange Road. 28, Hatfield Street, 91, East Street. 147, Kennington Park Road. 268, 310, 312, 314, 316, MUNTON ROAD. These basements have been entirely reconstructed and made habitable. The Closing Orders were therefore determined. 358, 360, 362, 364, 434, 434a, 436, 436a, MUNTON ROAD. These basements are in the course of reconstruction, and the Closing Orders will be determined in du.e course. 99, SUMNER STREET. 75, UNION ROAD. 104, UPPER GRANGE ROAD (part of premises). These underground rooms and part of premises have now been closed. 17, BEAR LANE (part of premises). 28, HATFIELD STREET. 91, EAST STREET. 147, KENNINGTON PARK ROAD. The underground rooms and parts of premises above mentioned will be vacated in due course. 63 (B) HOUSING ACT, 1930 (Sec. 20). The following underground rooms were deemed to be unfit for human habitation, but as the owners gave an undertaking that they would not again be let for sleeping purposes, the rooms were not represented for Closing Orders. They were accordingly vacated. 48, Dolben Street. 28, Stamford Street. 26, Bear Lane. 168, East Street. 174, 194, 196, 245, 269, Southwark Bridge Road. (C) In regard to the following underground rooms, which were also deemed to be unfit for human habitation, the owners gave an undertaking to render them fit. They were accordingly not represented for Closing Orders:— 127, Kennington Park Road. 57, Delverton Road. These rooms have since been made fit. OTHER HOUSING SCHEMES AND ACTIVITIES. During the year under review I have made an extensive survey of the houses belonging to the Bridge House Estates (City Corporation), and am of opinion that it is extremely difficult to formulate a comprehensive scheme for dealing with the whole of this property owing to:— (1) The scattered nature of the property; (2) The various terms of letting (some weekly, some monthly, and others leasehold). Whilst it may be generally stated that all the property which has been investigated is old, it can roughly be placed under three headings:— (A) Property which is in fair condition and would stand for many years; (B) Property which can be dealt with under Sec. 1 or Sec. 19 of the Housing Act, 1930. (C) Property which comes between these two types and can be given a fresh lease of life by reconditioning. With regard to (A) little comment is needed. In group (B) the following properties are indicated:— 23, 25, 31, 33, 35, King James Street. 1 to 42, Tupman Place. 23 to 35 (odd), Ontario Street. 36, 39, Keyworth Street. 29 to 59 and 65 to 77, Pocock Street. 81 to 89, Webber Row. 10, 11, 12, Valentine Row. 64 8 to 30, Great Suffolk Street. 45, 46 and 80, Borough Road. 1 and 3, 56 to 62 (even), Earl Street. 12 to 22, Friar Street. 53, 55, 56, 58, Zoar Street. la, Mansfield Street. Group (C). 1 to 13, Gerridge Street. 65 to 71, Webber Row. 1 to 13, Lancaster Street. 1 to 7, Library Street. 8 to 11, St. George's Circus. I to 5, Borough Road. 96 to 102, St. George's Road. 8 to 46, Garden Row. 158 to 167, Blackfriars Road. Several discussions have taken place during the year between the Bridge House Estates Committee and representatives of the London County Council and this Council regarding the various properties under the control of the City Corporation. Informal discussions have since taken place between the various officers of the above Authorities, with a view to formulating concrete schemes for re-housing purposes. As a result of these meetings, the majority of the houses in Tupman Place have already been emptied, and the families re-housed in the new flats in Sumner Street, which belong to the Bridge House Estates; in due course the Tupman Place site will be cleared and blocks of flats erected. At the time of writing this report several other schemes are being investigated, which will be reported upon in due course. HARD STREET AREA. In July, 1932, the Ministry of Health enquiry was held prior to the making of a Clearance Order, the result of which has not yet been published. This area forms a portion of a larger area known as the East Street area, which was represented by Dr. Millson in 1919. The Hard Street area contains 165 houses with a population of 785. Objection was raised that a small portion of property shown on the map and which only touched at one corner was not inside the area. The following were the main points raised at the enquiry:— At the opening of the enquiry, Mr. Hill stated that in his opinion, before an area was scheduled for clearance, the following fundamental tests should be applied to all the houses in that area:— 65 (1) Is the general arrangement of the houses in the area such as to block free access of air and light to a large number of houses in the area? (2) If the general arrangement of the houses in the area is bad, could it be satisfactorily remedied by a partial demolition scheme? (3) Are the houses generally speaking worn, that is to say, are they in such a state of disrepair that the defects could not be remedied at a reasonable expense? (4) Is there serious dampness of the houses? If so, what is the cause? And can it be remedied at a reasonable cost? It was therefore agreed by all parties concerned that the above defects as set out in their order of importance were those which would render houses suitable for inclusion in a Clearance Scheme. It was further agreed that the following defects, which are also of importance, should be taken into account after the four fundamental tests stated above had been applied. (1) The absence of a damp-proof course. (2) Through ventilation. (3) Indoor sanitation. (4) Absence of fitted sink. (5) Absence of food store. LAW STREET, LANSDOWNE PLACE and WESTCOTT STREET. These properties were represented by Dr. Millson in 1909 as unfit for human habitation for inclusion in the Tabard Street area. I inspected these premises recently, more particularly certain properties in Lansdowne Place belonging to the Hopkins Trust, and was given to understand by the Trust that the L.C.C. were taking over the estate in April next, and that certain reconditioning was to take place for re-housing the very poorest of persons. Whilst in no way wishing to create more difficulties for the L.C.C. on this important problem, I am of opinion that the property in question is totally unfit for reconditioning or perpetuating for any lengthy period, and I feel that the Borough Council should ascertain the intentions of the L.C.C., particularly as regards the earliest date when this block of properties can be demolished and replaced bv more suitable dwellings. 76, 77, 78, 79, 80, TOWER STREET. This property was represented by the late Dr. Wilson in 1930, but no action was taken at that time. During the present year I received a communication from the owners stating that they were prepared to render the premises fit for human habitation. A schedule of dilapidations was prepared and the houses have now been rendered fit to my satisfaction. 66 MOWBRAY BUILDINGS. I made an examination of these premises in the Autumn, and found them in a very unsatisfactory and insanitary condition. The landings were dark and ill-ventilated, and in many cases soil pipes were broken and leaking and without anti-syphonage; rain water pipes were also choked and broken and the dust shoots insanitary. I communicated with the owners, pointing out these defects, and at the same time intimating that notices would be served if the existing conditions were not remedied. Since that time I have had several interviews with the Secretary and the Chairman of the Board, with the result that the conditions found existing are being remedied and modern sanitary arrangements are to be installed. BLENDON ROW—TENEMENT BUILDINGS. A survey of these buildings, and a count of the population occupying them, has revealed that on many landings there are more than 12 persons using one water closet, in contravention of the London County Council Bye-laws. I accordingly interviewed the Secretary of the Company, and heinformed me that plans and specifications were being prepared with a view to installing water closets on each landing, and water supplies to wash houses where required. PONSONBY BUILDINGS. This property belongs to the same owners as the Mowbray Buildings and was inspected at the same time. Many sanitary defects were found, and an interview with the secretary and chairman of the Trust was arranged. After some discussion they gave me an undertaking that the defects would be remedied forthwith. FLATS AND DWELLINGS ERECTED DURING THE YEAR. 131-178, Pilton Place 48 flats 13/15, Borough Road 2 flats 181-182, Gt. Dover Street 7 tenements 9-13, Camberwell Road 2 flats 51-100, Winchester Buildings 50 flats 1-36, Pilgrim House 24 flats A Block, Doddington Grove 39 flats B Block, Do 26 flats From the brief resume herewith, it is evident that there has been considerable activity in housing matters during the year, not only by the Borough Council, but also by the City Corporation, the London County Council, and by private enterprise. 67 IMPORTED FOOD. I have received the following' report from Mr. Fisher:— Southwark is one of the few Boroughs in London which is charged with special powers as a Riparian Authority in conjunction with the Port Sanitary Authority. There is nearly two miles of river frontage along which is situated about 30 wharves, including 4 large cold stores. At the wharves all kinds of tinned, frozen and chilled foods, flour, cereals, and provisions are landed; these are brought into the Borough by barges from the London docks and ships which discharge in the Thames. Customs officers are stationed at most of the wharves, and it is the duty of the officers of the Sanitary Authority to keep in constant touch with them. The geographical position of the Borough, with its river frontage, its proximity to the tinned food market in Eastcheap, the Central Meat Markets at Smithfield and the provision markets at London Bridge, has made it second only to the City of London in importance as a food centre. In 1908 the Ministry of Health issued the first regulations which gave the Sanitary Authority power through its Medical Officer of Health to control and supervise all foods landed within its area. From that time until 1925 one inspector carried out this important branch of Public Health work, in which was included the supervision of all premises used for the preparation and sale of food in all parts of the Borough. At the end of 1925 it was found impossible to cope with the work, and an assistant food inspector was appointed. During the present year, owing to the increase in the amount of food landed, it was found necessary in the re-organisation of the inspectoral staff to allocate a portion of the time of an additional inspector to this work. There is much to be said for the vigilance of this service, seeing that the food is distributed over the whole of the country, as during the period (1908-1932) it is recorded that only two parcels of doubtful food have been sent out of the Borough without the inspectors' knowledge. This has only been made possible by reason of the close cooperation between the Officer of Customs, the Sanitary Authority, and the wharfingers, and I should like to express my thanks to the wharfingers, who have shown the greatest courtesy to the examining officers, and at all times given them every assistance in tracing parcels of unsound food. 68 A large amount of the work done on the wharves is sampling; this branch is highly technical and requires considerable tact, skill and experience. Since the appointment of two additional food inspectors, more detailed supervision has been possible, and 1 feel confident that food supplies of every description are being more efficiently dealt with. The value of the Imported Food Regulations is evinced by the fact that previous to their issue, i.e., 1901-8, the average yearly tonnage of imported food destroyed was approximately 117 tons, since that time (1908) the figure has increased fourfold, which amply illustrates their usefulness in protecting the food supply of the inhabitants of the Borough and of the country generally. Further, many large consignments of imported food have been subject to special examination, and a resume of these, with the action taken, is appropriate. ONCHOCERCIASIS. This condition is described as worm nests in beef, and for its detection necessitated cutting deep into the tissue of each frozen carcase with a shave hook. This method of dealing with the carcases was regarded as unsatisfactory, besides entailing an enormous amount of work. It was therefore decided to remove those parts of the carcase affected, namely, the flanks and brisket completely. This process, however, caused a great amount of good beef to be wasted, and after consultation it was agreed that the affected parts should be removed in the country of origin, where the portions could be utilised. The result of this arrangement proved satisfactory, as the disease is very rarely found in imported carcases arriving in this country to-day. OESOPHAGASTOMA COLUMBIANUM. This condition is a small worm found in sausage casings. Each consignment had, of necessity, to be sorted, which entailed an enormous amount of work for the inspector. It was therefore arranged with the Australian and South American authorities that the casings should be thoroughly examined before shipment, with the result that this disease is now seldom found. ACTINOMYCOSIS. This disease, which can be described as a parasitical abscess, appeared in large consignments of frozen ox tongues from South America, 5 to 10 per cent, of which were found affected. The importers were communicated with, since when the examination in the country of origin has been more stringent, and very few tongues are now found to be affected on arrival on this side. 69 CASEOUS LYMPHADENITIS. This disease appeared in 1926 during the examination of frozen carcases of mutton. To discover this condition it was necessary to cut six of the superficial lymphatic glands in each carcase. In view of the fact that approximately 700,000 carcases were arriving in the Borough during the season, it was found impossible to cope with this examination with our own staff. Arrangements were made with the importers to supply butchers to do the necessary cutting under the supervision of your inspectors. This 100 per cent, examination led the importers to consider that more stringent supervision in the country of origin was necessary, and they accordingly communicated with the shippers on this subject, since which time there has been a general improvement in all the carcases arriving from exporting countries. In August, 1932, on representations made to the Ministry of Health by the Port Medical Officers to the effect that the incidence of Caseous Lymphadenitis in carcases of imported mutton arriving in their districts is now small, and that there is no significant difference between carcases arriving from Australia and elsewhere, it was decided that : (1) 5 per cent, of all carcases, irrespective of country of origin, be examined. (2) 100 per cent, of all pieces, whatever the country of origin, be examined. In regard to the joints and pieces, it will be noticed that a 100 per cent, examination is still necessary, which is significant. RENDERED FATS. The Regulations require that all rendered fats shall be accompanied by a veterinary certificate, stating that they had been obtained from healthy animals. Merchants found certain difficulties regarding importation of uncertified fats, and accordingly had them labelled Inedible," trusting that this would place them outside the scope of the Regulations. The matter was taken up with the Ministry of Health and the importers, with the result that all consignments so marked are now placed under detention and subsequently released upon the provision of a suitable guarantee that they are to be used for technical purposes only. This class of "Fat" is kept under very close scrutiny by the Health Department. RICE. About 2,000 bags of rice recently arrived from Italy; some of them were marked with a red cross, the marked portions were cut 70 away, and it was found that the colour had penetrated through the material to the rice. On analysis the colour was found to be red lead. This discovery increased the difficulty of examination and the final disposal of the rice. The parcel is at present under detention. GENERAL OBSERVATIONS. The Ad Valorem Duty.—This duty, imposed during 1932, has increased the work of the Inspectors by reason of the fact that to enable importers to apply for a refund of the duty on unsound food, a voucher is required from the Health Department stating that it has been condemned and destroyed. This voucher is delivered to H.M. Surveyor of Customs. A slight difficulty arose when this duty was first imposed on imported fruit at the "Grand Vitesse Depot" of the Southern Railway. During the season many thousands of packages of soft fruit arrive daily at this depot from the Continent. The original practice was to label all packages "to be sold for sorting" if they were not sufficiently unsound to be destroyed, but the merchant refused to accept such goods on the ground that they were not worth the amount of duty. The Officer of Customs then required a voucher from the Medical Officer of Health stating that the whole of the goods were unsound ; this placed the Health Department in a difficult position, and it was eventually arranged that the Crown should take over the goods and sell them through an agent for sorting under supervision. By this means the sound fruit was saved and the Crown collected a part of the duty. In this connection the provision of a sorting room at the railway depot seems worthy of consideration, where fruit could be rapidly sorted under the supervision of your inspectors in cooperation with H.M. Customs. DISPOSAL OF UNSOUND FOOD. A large quantity of unsound food after condemnation is released under suitable guarantees for animal food and technical purposes. This arrangement has been working satisfactorily for over 20 years without any complaint having been received of a parcel being misused. This system allows the owner to recoup a little of his loss. In conclusion, I should like to point out that the examination of food is not only systematic, but is standardised at all the large ports throughout the country. The standards adopted are agreed upon by the Ministry of Health and the Port Medical Officers after consultation. The following table shows the quantity of food examined and destroyed during the year at the various wharves, etc., on the riverside. 71 FOOD INSPECTION AND FOOD PREMISES. The following report has been received from Inspectors Bowers and Duffield, who, in addition to supervising imported food at the wharves, inspect all food prepared and sold in the district. The outstanding feature of the year has been the registration of certain premises under the L.C.C. General Powers Act, 1932. Butchers and provision shops are also inspected under the Public Health (Meat) Regulations, 1925. An improvement worthy of note since the above regulations came into force is the number of glass fronts that have been provided to these shops, but there are still a few which would benefit through this fitment, which is the only means of preventing contamination from dust. BUTCHERS' PREMISES. There are 94 of these; 75, which manufacture sausages and preserved meats, are registered under the General Powers Act, 1932. These premises are regularly visited and many improvements have been effected. PROVISION SHOPS There are 49 of these, and 45 where meat is cooked are registered. These premises, generally speaking, are in good condition. STREET TRADERS. The compulsory licensing of these traders has facilitated the supervision of the foodstuffs sold by them. The stalls generally are maintained in a good and cleanly condition, but more protection from contamination is required, especially with such goods as sweets, cakes, etc.; glass covers could be fixed at little cost and arranged with service openings at the back. In regard to meat and bacon, control is given under the Meat Regulations to insist on protection from dust, flies and dirt. The method of storage adopted by these traders was in several cases very unsatisfactory, but much improvement has been effected during the year. THE STREET MARKETS. These are visited by two district Inspectors every Saturday night and Sunday morning. The food Inspectors visit them occasionally during week day evenings. 72 73 TABLE 33. Showing the quantity of foodstuffs examined at the wharves, the amount found to be unsound, the notices served, and the method of disposal of the unsound portion. Foodstuffs. Quantity and Weight examined. Weight found to be unsound. Surrendered by Owner. Seized by Inspector. Notices served. How unsound portion disposed of. (a) Detention. (b) Release. Quantity. Weight. T. c. Q. L. T. c. Q. L. Almonds 17 bags 1 14 0 0 6 0 0 Yes - - - Destroyed on Barge. Apples 380 cases, 40 boxes 9 17 0 6 1 0 0 0 Yes - - - Destroyed at the Council's Depot. Apples, dried — 1 0 0 Yes - - - Do do Apples, tinned - 3 2 16 3 2 16 Yes - - - Destroyed on premises where found. Apricots 219 crates, 166 billots 4 1 1 9 2 10 1 25 Yes - 2 2 Destroyed at the Council's Depot Apricots, dried 679 boxes, 65 bundles 17 19 2 8 2 1 0 8 Yes - - - Do do Apricot Pulp, tinned 13 cases 8 2 0 8 2 0 Yes - - - Destroyed on premises where found. Artichokes 26 crates 5 0 0 5 0 0 Yes - 1 1 Released for technical purposes Bacon 920 bales, 67 boxes 102 14 0 15 15 Yes - 12 12 do. do. Beef - 165 7 0 21 2 9 3 14 - - - - - Beef, salted 111 barrels, 10 casks 9 8 2 24 — Yes - 6 6 10 tons 4 Cwts. 3qrs were released for technical purposes, and 2 tons 12 cwts. 24 lbs. were destroyed at the Council's Depot. Beef, tinned Cases and tins 23 7 0 5 12 16 3 25 Yes - - - Destroyed in a Railway Truck Blackcurrants 10 sieves, 5 billots 4 0 12 4 0 12 - - - - Butter 185 boxes, 70 casks 5 16 1 0 — - - - - - Casings, hog 15 tierces 3 0 0 0 — - - 2 2 - Casings, ox 45 tierces 11 0 0 0 — Yes - 1 1 Destroyed at the Council's Depot. Casings, sheep 20 tierces, 5 barrels 8 5 0 0 1 5 0 0 - - 1 - Still under " Stop." Caviare 4 casks 12 0 0 - Yes - 1 1 1 Cwts. 2qrs were destroyed at the Council's Depots, and 1 qrs 16 lbs. were destroyed on premises where found Cheese Boxes, bundles 2 4 3 20 2 0 12 Yes - - - Destroyed at the Council's Depot Cherries Condensed Milk 1 cask 419 cases 9 4 17 0 1 0 0 9 4 8 0 2 0 12 Yes - - - 7 tons 4 cwts. 1 qr. 20 lbs. were released for technical purposes, and 2 tons 4 cwts. 20 lbs. were destroyed at the Council's Depot. Dates 89 cases 15 3 16 10 3 26 Yes - - 1 Under "Stop" from 1931. Released for technical purposes. Dripping 372 crates 9 16 0 0 - - - 1 1 - Ducks 50 boxes 1 1 1 20 - - - - — - Eggs 40 cases 5 0 0 - Yes - 1 1 5 tons 17 cwts. 3 qrs. 12 lbs. were released for technical purposes, and 1 cwt. 2 qrs. 8 lbs. were destroyed on premises where found. Egg liquid 677 tins 7 18 2 26 1 20 Carried forward 396 7 3 2 3 17 28 28 74 75 Foodstuffs. Quantity and Weight examined. Weight found to be unsound. Surrendered by Owner. Seized by Inspector. Notices served. How unsound portion disposed of. Quantity. Weight. (a) Detention. (6) Release. T. c. Q. L. T. c Q. L. Brought forward 396 7 3 2 39 15 3 17 28 28 Emulsion 432 cases 8 0 0 0 8 0 0 0 Yes — — — Destroyed at the Council's Depot. Flour 56 bags 2 11 1 20 — — — — — — Fowls 150 cases 3 7 3 12 — — — — — — Fruits, dried cases 1 8 1 20 — — — — — — Fruit pectin 112 barrels, 10 casks 19 8 0 0 — — — — — — Fruit pulp 307 tins, 3 cases 11 0 11 7 0 11 Yes — — — Do. do. Fruit, tinned 3,123 cases 65 7 1 16 4 13 3 16 Yes — — — Do. do. Grape fruit, tinned 2 cases 3 12 3 12 Yes — — — Do. do. Greengages 374 billots, 105 crates 4 16 3 5 4 6 0 9 Yes — — — Destroyed on premises where found. Hams Cases, boxes 15 4 3 24 6 9 3 14 Yes 1 1 5 tons 1 cwt. 1 qr. were released for technical purposes, and 1 ton 8 cwts. 2 qrs. 14 lbs. were destroyed at the Council's Depot. Lard 206 boxes 3 5 2 0 — — — — — — Lard oil 90 tierces, 38 barrels 28 12 0 0 15 0 0 0 Yes - 1 2 15 tons under "Stop" from 1931 were released for technical purposes, 6 tons still under " Stop." Loganberries, tinned 200 cases 4 5 2 24 — — — — — Malt 1 cask 5 1 10 5 1 10 Yes — — - Destroyed at the Council's Depot. Mangoes 2173 19 8 0 0 3 1 6 Yes — — - Destroyed on premises where found. Meat extract 352 cases 10 17 0 0 - — — — — Melons 5 crates 2 4 2 4 Yes — — - Destroyed in a Railway Truck. Mutton Carcases & Pieces 1658 10 2 27 15 0 3 11 Yes - 409 409 15 tons 1 qr. 9 lbs. were released for technical purposes, and 2 qrs. 2 lbs. were destroyed on premises where found. Offal - 10 8 3 15 2 6 0 16 Yes - - - 2 tons 4 cwts. 24 lbs. were released for technical purposes, and 1 cwt. 3 qrs. 20 lbs. were destroyed on premises where found. Oleo oil 30 tierces 5 12 2 0 — — — — — — Onions 1 basket 10 10 Yes — — — Destroyed on premises where found. Ox gall 4 barrels 7 0 16 — — — — — — Peaches 300 cases, 52 crates 7 0 0 10 4 0 3 20 Yes 4 tons 2 qrs. 8 lbs. were destroyed at the Council's Depot, and 1 qr. 12 lbs. were destroyed in a Railway Truck. Peaches, dried — 1 0 0 — — — — — Peaches, tinned 11 cases 4 2 24 4 2 24 Yes — — — Destroyed at the Council's Depot. Pears 2800 boxes, 93 cases 69 16 0 22 5 8 0 16 Yes 4 tons 6 cwts. were destroyed on premises where found, 19 cwts. 1 qr. 4 lbs. were destroyed at the Council's Depot, 2 cwts. 3 qrs. 12 lbs. were destroyed in a Refuse Carried forward ... 2336 0 0 4 106 3 3 0 439 440 Barge. 76 77 Foodstuffs. Quantity and Weight examined. Weight found to be unsound. Surrendered by Owner. Seized by Inspector. Notices served. How unsound portion disposed of. (a) Detention. (b) Release. Quantity. Weight. T. c. Q. L. T. c. Q. L. Brought forward 2336 0 0 4 106 3 3 0 439 440 Pears, dried - 1 0 0 — - - — — - Pears, tinned 50 cases 1 1 1 20 — - — — — - Peas 57 bags 9 1 24 1 2 2 Yes — — — Destroyed on premises where found. Pilchards, tinned 25 cases 11 3 4 1 3 4 Yes — — — Destroyed at the Council's Depot. Pineapple, tinned 29 cases 13 0 22 11 0 6 Yes — — — Do. do. Plums 2133 crates, 74 billots 22 16 3 24 21 12 3 18 Yes — — — Destroyed on premises where found. Pork 33 carcases 1 12 3 2 2 3 2 Yes — 1 1 Released for technical purposes. Potatoes 3643 bags 173 10 2 0 166 5 2 0 Yes - - - 127 tons 5 cwts. 2 qrs. were destroyed in a barge, and 39 tons were destroyed at the Council's Depot. Poultry 50 boxes 17 3 2 — — — — — — Prunes 130 boxes 2 12 2 8 1 10 0 0 Yes — 1 1 Destroyed on premises where found. Quails 53 cases 18 3 20 — — — — — — Quinces 5 bundles 1 3 4 1 3 4 Yes — — — Do do Rabbits 1196 crates 39 12 1 24 — — — — — - Raisins 96 boxes 1 1 3 16 25 Yes — 1 1 Do. do. Redcurrants 100 crates 1 1 1 20 — — — — — - Rice 1540 bags 77 8 1 4 8 1 4 Yes - 2 1 8 cwts. 1 qr. 4 lbs. were released for technical purposes, 75 tons still under " Stop." Salmon, tinned 513 cases 9 8 3 25 4 19 2 21 Yes 4 4 Destroyed at the Council's Depot. Sardines, tinned 10 cases 5 0 0 — — — — - Soup, tinned 7 cases 2 2 8 2 2 8 Yes — — — Do. do. Strawberry pulp 80 barrels 16 0 0 0 — — — — — — Strawberries, tinned 10 cases 4 1 4 4 1 4 Yes — — — Do. do. Sturgeon, tinned 500 cases 10 14 1 4 — — — — — - Suet 678 cases 33 18 0 0 33 18 0 0 Yes — — — Released for technical purposes. Sultanas Cases and Boxes 21 4 1 21 5 3 0 Yes 4 cwts. 2 qrs. were destroyed on premises where found, and 1 cwt. lqr. were destroyed at the Council's Depot. Sweetbreads 33 boxes 4 0 0 1 0 0 Yes — — — Released for technical purposes. Sweets 10 tubs 5 0 0 — — — — — - Tomatoes, tinned 61 cases 1 10 2 24 9 1 4 Yes — — — Destroyed at the Council's Depot. Tongues, ox 171 cases, 23 bags 6 6 3 22 0 4 3 2 Yes 2 cwts. 1 qr. 20 lbs. were destroyed at the Council's Depot, and 2 cwts. 1 qr. 10 lbs. were released for technical purposes. Tongues, Pork 27 tierces 4 10 0 — — — — — - Tongues, tinned 484 cases, 56 tins 6 7 2 12 6 3 24 Yes 1 1 5 cwts. 3 qrs. 4 lbs. were destroyed at the Council's Depot, and 1 cwt. 20 lbs. were released for technical purposes. Turkeys 210 cases 10 10 0 0 - - — 1 — — Total 2782 10 0 10 337 11 3 16 450 449 78 FOOD FACTORIES. There are 18 food factories in the Borough—2 sweets and confectionery, two coffee extract, one sausage and pie, one salted beef, four meat canning, two meat extract, one cheese, two ham boiling, one jam and two lemonade. These are under constant supervision; most of them are equipped with the most modern machinery. In one sweet factory extensive alterations have been made. With regard to the sausage factory, owing to the increase of business, the owners are erecting a large modern factory which will facilitate the work. BACON STOVES. There are five of these premises, each one being fitted with the latest appliances for washing and smoking bacon and hams; the premises are constantly visited. SLAUGHTER HOUSES. There are four in the Borough which are licensed annually. All animals are slaughtered with the humane killer. Notice is given to the Health Department when animals are to be slaughtered, and all carcases and viscera are examined before being offered for sale. These premises are limewashed four times each year and any defect found is immediately remedied. The following are the premises and the licensees:— Situation of Premises. 129, Hillingdon Street 70, Union Road 244, Walworth Road 283-5, Walworth Road Name of Licensee. Messrs. Newbury & Manktelow. George Challis. Messrs. Chalk & Cox, Ltd. Messrs. R. C. Hammett, Ltd. During the year 253 oxen, 2,938 sheep and 119 pigs were slaughtered. The total weight found to be unsound was 9 cwts. 2 qrs. 21 lbs., of which 7 cwts. 2 qrs. 27 lbs. were destroyed on premises where found, 1 cwt. 1 qr. 8 lbs. were destroyed at the Council's Depot, and 2 qrs. 14 lbs. were released for technical purposes. 79 BOROUGH MARKET. The Borough wholesale fruit and vegetable market is under constant supervision ; it gives the Health Department some little concern owing to the fact that no premises are provided where sorting can be undertaken. Occasionally we receive complaints from outside Authorities and also from local dealers that parcels of food which they have purchased have been wholly unsound at the time of sale. The conditions of sale "with all faults" at the market, places the risk as to their soundness upon the buyer; it would, therefore, be better for all goods sold "with all faults" to be sorted under supervision at some premises at or near the market. "MERCHANDISE MARKS" ACT, 1926. Section 9 of the above Act confers on Food and Drugs Authorities (in London, the Borough Councils) the power to execute all provisions of the Act (except those relating to importation) in respect of foodstuffs which are subject to an Order in Council made under the Act. The Sanitary Inspectors have been empowered by the Council to undertake the duties imposed by the above Act, in regard to food exposed for sale, and have in many instances called the attention of traders to the fact where they have discovered negligence in the marking of their goods, and have had the omission rectified. Six hundred and forty-two visits were made by the several Inspectors during the year. In addition, printed notices have been circulated from time to time calling attention to the Orders mentioned above. On the whole the Orders are being carried out satisfactorily throughout the Borough. AGRICULTURAL PRODUCE (GRADING AND MARKING) ACT, 1926. This Act provides for the grading and marking of agricultural produce and gives power to the Ministry of Agriculture and Fisheries by regulations to prescribe "designations" and "marks" to indicate the quality of such produce. Four cold stores in this district are registered under the 1930 Regulations, for the storage of English eggs. Many parcels have been marked in accordance with the Regulations under the supervision of the Inspectors. 80 81 EXAMINATION OF FOOD. TABLE 34. Showing the quantity of Foodstuffs found unsound during the y ear 1932 by the several Inspectors throughout the Borough. Foodstuff 8. Quantity and Weight found Unsound. Surrendered by Owners. Seized by Inspector. Remarks Quantity. Weight Quantity. Weight. Quantity. Weight T. c. Q. L. T. c. Q. L. T. C. Q- L. Apples 156 boxes, 15 cases 3 2 0 24 156 boxes, 15 cases 3 2 0 24 — — Destroyed at the Council's Depot. Bacon 2 18 1 11 • • . 2 18 1 11 - - 1 ton 1 cwt. 2 qrs. 12 lbs. were released for technical purposes, and 1 ton 16 cwt. 2 qrs. 27 lbs. were destroyed at the Council's Depot. Bananas 17 crates 8 1 6 17 crates 8 1 6 — — Destroyed at the Council's Depot. Beans 56 bags 1 0 0 0 56 bags 1 0 0 0 - - Do. do. Beef 1 3 3 — 1 3 3 — - Destroyed on premises where found. Beef, cooked 1 piece 4 1 piece 4 - - Do. do. Beef, tinned 81 tins 4 1 10 81 tins 4 1 10 - - Destroyed at the Council's Depot. Cabbage 55 bags 1 1 1 0 55 bags 1 1 1 0 - - Do. do. Cauliflower 21 crates 8 0 0 21 crates 8 0 0 - - Do. do. Chestnuts 2 bags 2 0 0 2 bags 2 0 0 - - Do. do. Chocolates 2 boxes 8 2 boxes 8 - - Do. do. T~V Cod Fillets 1 Box 14 1 Box 14 - - Do. do. Condensed Milk 51 tins 1 16 51 tins 1 16 - - Do. do. Ducks 151 5 1 22 151 5 1 22 - - 4 cwt. 2 lbs. were destroyed at the Council's Depot, and 1 cwt. 1 qr. 20 lbs. were released for technical purposes. Fowls 1782 3 0 2 17 1782 3 0 2 17 - - 2 tons 18 cwt. 2 qrs. 5 lbs. were destroyed at the Council's Depot and 2 cwt. 12 lbs. were released for technical purposes. Fruit dried 14 cases 3 2 0 14 cases 3 2 0 - - Destroyed at the Council's Depot. Fruit, tinned 24 cases 9 0 24 24 cases 9 0 24 - - Do. do. Geese 14 3 8 14 3 8 - - Do. do. Grapes 2 boxes 1 12 2 boxes 1 12 - - Destroyed on premises where found. Hams 13 1 1 10 13 1 1 10 - - 1 cwt. 25 lbs. were destroyed on premises where found, and 13 lbs. were destroyed at the Council's Depot. Hams, tinned 61 tins 7 0 18 61 tins 7 0 18 - - 6 cwts. 4 lbs. were destroyed on premises where found, and 1 cwt. 14 lbs. were destroyed at the Council's Depot. Carried forward 13 15 1 11 13 15 1 11 - - 82 83 Foodstuffs. Quantity and Weight found Unsound. Surrendered by Owners. Seized by Inspector. Remarks. Quantity. Weight. Quantity. Weight. Quantity. Weight. T. c. Q. L. T. c. Q. L. - T. C. Q. L. Brought forward 13 15 1 11 13 15 1 11 Heads, Pigs 8477 24 9 2 27 8477 24 9 2 27 - - 24 tons 9 cwt. 2 qrs. 15 lbs. were released for technical purposes, and 12 lbs. were destroyed at the Council's Depot. Honey 1 cask 3 0 0 1 cask 3 0 0 - — Destroyed at the Council's Depot. Margarine Part of tub 1 7 Part of tub 1 7 - — Do. do. Melons 45 trays 7 0 26 45 trays 7 0 26 - - Do. do. Mussels 1 bae 1 0 0 1 bag 1 0 0 - - Do. do. Mutton Carcases & Pieces 4 3 4 Carcases & Pieces 4 3 4 - - 4 cwts. 16 lbs. were destroyed at the Councils Depot, and 2 qrs. 16 lbs. were released for technical purposes. Offal - 9 2 21 9 2 21 - - 7 cwts. 2 qrs. 27 lbs. were destroyed on premises where found ; 1 cwt. 1 qr. 8 lbs. were destroyed at the Council's Depot, and 2 qrs. 14 lbs. were released for technical purposes. Oranges 11 cases 11 0 0 11 cases 11 0 0 - - Destroyed at the Council's Depot. Partridges 3 4 3 4 - - Do. do. Peaches 26 boxes 1 0 0 26 boxes 1 0 0 - - Do. do. Pears 58 boxes, 7 barrels 19 2 6 58 boxes, 7 barrels 19 2 6 - - Do. do. Pigeons 12 4 12 4 - - Do. do. Plums 17 crates. 15 boxes 6 3 24 17 crates, 15 boxes 6 3 24 - — Do. do. Pork Carcases & Pieces 20 4 1 5 Carcases & Pieces 20 4 1 5 - - Released for technical purposes. Potatoes 722 bags 35 17 0 0 722 bags 35 17 0 0 - - 26 tons 2 cwts. were released for technical purposes, and 9 tons 15 cwts. were destroyed at the Council's Depot. Rabbits - 4 2 18 - 4 2 18 - - Destroyed at the Council's Depot. Raspberries 1 tub, 1 basket 1 5 1 tub, 1 basket 1 5 - - 1 qr. 2 lbs. were destroyed at the Council's Depot, and 3 lbs. were destroyed on the stall where found. Roe 12 boxes, 7 cases 8 2 0 12 boxes, 7 cases 8 2 0 - — Destroyed at the Council's Depot. Salmon, tinned 46 tins 1 14 46 tins 1 14 - — Do. do. Skate 1 box 2 0 1 box 2 0 - - Destroyed on premises where found. Tomatoes 23 bundles, 9 boxes 6 3 4 23 bundles, 9 boxes 6 3 4 - — Destroyed at the Council's Depot. Turkeys 383 2 4 3 10 383 2 4 3 10 - - Do. do. Winkles — 2 0 2 0 — — Do. do. 100 17 1 22 100 17 1 22 84 TABLE 35. Inspections of Food at Wharves, Markets and other places where food is stored, and the action taken by the officials during the year 1932. INSPECTION OF WHARVES, Etc. FOOD EXAMINED, Etc. WARD or DISTRICT. Inspections of Wharves and Warehouses. Inspections of Markets. Inspections of Shops or Street Stalls. Slaughter Houses. Parcels of Food Examined. Parcels of Food Stopped. Parcels of Food Released. Parcels of Food destroyed by consent of owner. Parcels of Food seized by Inspector. Parcels of Food condemned by Magistrate. Summonses taken out. Mr. Bowers 661 — 852 186 1825 19 19 438 — — — Mr. Duffield 850 — 545 104 1879 431 430 682 - — — Market Inspections 7786 6 — 7792 — — 6 — — — Total 1511 7786 1403 290 11496 450 449 1126 — — — 85 PUBLIC HEALTH (PRESERVATIVES IN FOOD) REGULATIONS. The above Regulations had not been enforced at the port of entry until the year now under review. It was owing to certain facts coming to light as a result of sampling foods under the Food and Drugs Adulteration Act, that I considered it desirable foods should be examined at the source before being actually exposed for sale in shops. With the portion of time of a third Inspector devoted to port work, this was found possible, and samples under these Regulations are now taken on the wharves regularly and submitted to the Borough Analyst for examination. The Preservative in Food Regulations prohibit the use of preservatives except Sulphur Dioxide and Benzoic Acid, and then only in certain foodstuffs and in certain proportions which must not be exceeded. During the period under review 44 samples were taken. As a result of our action several interesting facts came to light and were reported upon to the Ministry of Health. CAVIARE. In the early part of the year a sample of this food was taken for analysis and found to be preserved with boracic (28.7 grains per 1 lb.), which was in contravention of the Regulations. The owner admitted the fact, and stated that this food could only be preserved by one of four methods, viz. : salting, borax, salicylic acid or urotropine, and that borax was preferable to any. The two preservatives allowed by the Regulations were useless, and freezing was impracticable. The chief point of interest, however, in this case arose in the fact that the owner had only to declare that the food was for " exportation only " or for " ships' stores " to evade the Regulations. This, of course, he did. It is quite obvious that unless the borax had been discovered in this particular batch of caviare it could have been sold for consumption in this country. There is no doubt that much does escape the notice of the Customs and the Inspectors, as caviare can be obtained in all the high class restaurants and hotels. 86 These various facts were reported to the Ministry of Health, and as the trade figures show an amount between £100,000 and £250,000 per annum, I suggested that a luxury food of this nature, eaten only in small quantities, might well be excluded from the provisions of the Regulations, provided always that the borax did not exceed a given amount. Further, I suggested that parcels of foodstuff intended for " exportation only " or for " ships' stores " at least should be labelled as such before arrival in this country. DRIED FRUIT. During the year 34 samples were taken at the wharves and submitted for analysis. Of these, 17 were taken early in the year, 6 of which were found to contain very much in excess of the preservatives allowed, the worst cases coming from California. The Ministry of Health were informed, and steps were taken to communicate with the shippers in the country of origin. Later in the year, when the Christmas fruit was arriving, a further 17 samples of fruit coming from similar sources as the original 17 were taken and submitted for analysis. In no case was the amount of preservative allowed exceeded, showing that our action in the first case had the desired effect. All the aforementioned samples have been tested for preservatives by the Public Analyst. 51 food samples taken from cargoes landed in the Borough have also been examined during the year. 87 EATING HOUSES. The work of supervising these premises was transferred to Mr, Syms in the early part of the year. He reports as follows:— RESTAURANTS ON LICENSED PREMISES. There is a tendency to develop the luncheon trade in many of these houses, which in the main are well equipped and managed; at the present time there are 61 under supervision. Extensive alterations have been carried out in 3 instances, and spendidly fitted kitchens provided on the upper floors in place of those in the basement. There are now only 2 basement kitchens in use. Cleansing has been carried out in 11 cases and small improvements in 5 others. 16 have some form of cold storage. RESTAURANTS. These are so called on account of the trade carried on in them being above that of the coffee house type. In general the premises are conducted on satisfactory lines, but the structural condition of some of the older establishments will need considerable improvement in the near future to bring them up to the required standard. Among them are 11 basement kitchens which will be difficult to make satisfactory. In some, natural lighting and ventilation are practically impossible. 2 premises have been closed during the year, whilst one has been newly established, and one considerably improved. Cleansing has been carried out in 8 cases. 22 have some form of cold storage. COFFEE HOUSES. There are 116 of these premises, which cater for the industrial section of the day population of the Borough. As a class, they present many difficulties. 19 are conducted in old premises which leave a great deal to be desired from a structural standpoint. 8 of them have underground kitchens; 2 have been closed during the year, and 2 have been completely gutted and refitted with modern hygienic fittings, marking a distinct advance. Minor improvements have been carried out in 18 shops, and 38 have been cleansed; in 8 sink wastes have been trapped, and 27 have some form of cold storage. The storage of raw and cooked food is a matter which needs constant supervision. 88 Much carelessness in regard to the maintenance and use of flyproof larders is common, and I have repeatedly had to call attention to the need of repair of these fitments. There is room for considerable improvement in this direction. CAFES. 75 of these premises have been regularly inspected, and include refreshment bars in billiard halls. The rapidity with which they spring up and change hands continually is remarkable. 9 have been newly opened and 3 have been closed ; 8 have undergone improvements; 11 have been cleansed; 9 have had water and sinks provided. New dustbins have been provided in 3 cases, and 4 food safes installed. Only 6 have cold storage; 4 are using basement kitchens, and 11 have no washing-up accommodation at the counter. Many of these establishments do little or no cooking, and the type of business is very similar to that of the coffee stall. They need frequently visiting to ensure the maintenance of proper cleanliness. STEWED EELS AND EEL PIE SHOPS. 16 of these premises are under supervision. 2 have been closed and one newly established. One shop has been gutted and refitted with modern and up-to-date appliances. 3 have basement kitchens and 6 are provided with cold storage. Owing to the change of ownership, one shop still remains unregistered, pending alteration and improvement. Generally these premises are well conducted and clean. Meat and fruit pies, and in some instances tripe, are also retailed. COOKED FOODS. There are 8 of these premises, which include chip potato and crumpet makers. 6 of them have been registered and the general conditions satisfactory. One factory is engaged in the wholesale production of chip potatoes to be retailed in grease-proof bags. 89 COFFEE STALLS. There are 8 of these, of which 3 are moveable and 5 fixed, the latter doing business during the day. One complaint was received during the year in respect of a moveable stall, and was dealt with by cleansing and minor improvements. One stall has been pulled down and the business discontinued, after repeated efforts to obtain a water supply and sink. FRIED FISH SHOPS. 62 of these premises are under supervision, of which number 57 have been registered. The remainder need structural improvements before it will be possible for them to be registered. Every consideration has been given to the proprietors of fish shops, in view of the serious condition of the trade in general during the year. Most of the smaller shops were established fifty to eighty years ago, and the structural condition leaves much to be desired. The London County Council Bye-Laws are not retrospective, but as far as possible endeavours have been made to raise the level of these shops to the standard of the bye-laws. During the year 5 have been closed and 2 newly established. Considerable improvements have been carried out in 8 premises, and 4 have been cleansed; 6 new benches have been constructed to conform with the bye-laws. 19 have some form of cold storage, and only one has a basement gutting room. Furnaces which eliminate all steam and vapours are now obtainable, the most modern range being the one that is worked by breeze, gas grill and electric blower, and it is claimed that running costs are low. There are 5 modern and up-to-date shops in the borough, and it is hoped that this number will soon be increased. 2 new shops are in course of construction. FISH CURERS. 42 premises have been under supervision, 4 of them are situated in areas scheduled for demolition. Structural improvements have been carried out in 17 instances, and 4 premises have been cleansed. 7 have some form of cold storage. 90 It is admitted that considerable improvements will have to be carried out at some of these premises before the desired standard is reached, but the work is steadily progressing. ICE CREAM PREMISES. Ice Cream is a food of considerable value during the warmer months of the year, particularly amongst children. The supervision of this commodity during manufacture and sale is therefore of the highest importance, as it is essential for the public welfare that it should be pure and wholesome. It is regrettable that there is no defined chemical or bacterial content, as is the case in the higher grades of milk, therefore the quality of the mixture sold as ice cream varies considerably, in some cases being little more than frozen water. Cleanliness of person, premises and utensils is of the utmost importance, and it will be readily understood that much time of an inspector is involved in dealing with the large number of small and often undesirable dealers of this commodity. The London County Council General Powers Act, 1932, has been of considerable value, as it allows for removal from the Register of those premises which are unsuitable. In the early part of this year when the work of the inspectoral staff was re-arranged, Mr. Syms was given as part of his duties the task of supervising ice cream premises and barrows. He reports as follows:— The records show that there are— 2 Wholesale Factories. 98 Ice Cream Makers. 59 Shops where Ice Cream is sold. 50 Itinerant Vendors. Of the 98 makers, 28 are using modern freezing plants, and 70 still use the salt and ice freezing mixture in tubs. Improvements have been effected in 24 premises during the year, and one Italian maker has entirely rebuilt his premises, which were previously unsatisfactory. Efforts have been made to improve the conditions under which ice cream has been retailed in the streets. The dangers of the exposure to dust and dirt of the cream and the biscuit cups or containers has been stressed at every opportunity; the practice of making a large display of biscuit cones has been deprecated, but there is considerable opposition among the Italian traders. I am of the opinion that suitable cautionary letters should be served during the coming season where this practice is common, and prosecutions instituted for unnecessary exposure in those cases where this is persisted in. 91 MILK AND DAIRIES (AMENDMENT) ACT, 1922, AND ORDERS MADE THEREUNDER. At the end of the year 1931 the number of milksellers and premises on the Registers were as follows:— Retail 381 names 378 premises Wholesale 37 ,, 37 ,, Outsiders who sell milk in Southwark: Retail, 51 Do. do. do. do. Wholesale, 29 During the year 1932, 72 applications from 72 persons respecting 69 premises were received for registration as Retail Milksellers. These were duly entered in register as follows:— Particulars Entered in Retail Register. Entered in Register. Removal from Register. Not, Registered. (Unsuitable, etc.) Total Applications. Names. Premises. Names. Premises. Names. Premises. Names. Premises. 72 69 59 59 — — 72 69 The sale of milk (Retail) was started afresh at 20 premises The sale of milk was discontinued at 10 ,, Total number of Milksellers on Retail Register at end of 1932 394 Total number of Milksellers' premises ,, ,, 388 No applications for Registration as Wholesalers were received during the year. One retailer, who was also a wholesaler, and whose premises and method of business were unsatisfactory, was, after due service of notice under the provisions of the above Act, removed from the Register. Total number of Wholesale Milksellers on Register at end of 1932 36 Total number of Wholesale premises ,, ,, 36 Particulars of the 388 Retail Milksellers' premises are as follows:— Dairies 221 Milk sold in containers as received 142 Milk sold for consumption on premises only 16 Premises used as Depots only 9 388 92 Nearly all the loose milk sold in the Borough has been through the Pasteurising process. During the year applications were received for registration to sell milk in the Borough from persons whose premises are outside the Borough of Southwark. Upon ascertaining that they were registered in their own particular district, their names were duly entered in the respective registers, as follows:— Applications Entered in Register. Removed from Register. Total on Register end of 1932. Retail 15 15 4 62 Wholesale 4 4 3 30 There are two premises licensed to bottle and sell Grade A (TT) milk, and one for the pasteurisation of milk, wholesale and retail. At these premises 4 samples of Grade A (TT) milk and 2 samples of Pasteurised milk were procured and submitted to the Public Analyst for Bacteriological examination. They were certified to be in accordance with the requirements of the Milk (Special Designations) Order, 1923. Total number of persons and premises licensed for the sale of Graded Milk as follows:— Certified 7 premises. Grade A (T.T.) 18 Grade A 4 ,, Pasteurised 15 ,, Total 44 ,, MILKSELLERS. 1,320 inspections of the various milkshops, dairies, etc., were made. The following nuisances were discovered, in respect of which seven intimation notices were served:— Dirty condition of walls 5 cases Dirty condition of ceilings 4 cases Other miscellaneous items 10 cases Total 19 cases 93 The following- is a short account of some of the works carried out without Notice:— Dirty walls 35 Dirty ceilings 32 Other miscellaneous items 28 Total 95 During the year, in company with Mr. Nicholson, I visited the greater part of the milkshops in the Borough. In the course of this inspection 1 found some of the shops admirably suited for the purpose, and could be classed as "high grade," whilst others were not so satisfactory, and needed bringing up to modern standards. This is being done by a gradual process, and in this connection the following alterations and additions, under the supervision of Mr. Nicholson, Food and Drugs Inspector, have been carried into effect:— No. I, Manor Place. The premises were found to be totally unsatisfactory and removed from the Register. No. 25, Deacon Street. To speed up work, a bottle washing machine was installed with a capacity of 1,000 bottles per hour. 79, Tower Street. Shop unsuitable for the sale of loose milk, bottled milk only being allowed. No. 129, Walworth Road. Water closet found to open directly into Dairy at rear. This was demolished. No. 11, Trinity Street. At these premises a few bottles of milk were filled in the shop and the milk kept in a churn in the open shop. Arrangements have been made so that the bottled milk is obtained direct from the Wholesaler, and the churn of milk is stored in a small store (cupboard) in the shop. Rear of 26, Villa Street. A gas copper, draining and filling (bottles) bench and trough were provided ; paving amended; walls and ceiling repaired. No. 103, Villa Street. Additional draining racks provided. No. 2, Standard Street. Milk store and premises provided for washing and filling bottles, etc. Gas copper, washing trough, bottle draining and filling bench, storage in milk store for bottles on shelves, etc. 94 NOXIOUS TRADES. There are four premises in the Borough upon which noxious businesses or trades are carried on. The following are the premises:— Situation. Business Promises. Occupiers. Inspts. Notices. 24/5 Gt. Suffolk Street Tripe Boilers J. Martin. 4 - 5, Hatfield Street Fat Melters J. Ewen & Son, Ltd. 4 - Wansey Street Soap Boilers Holders Soap Works, Ltd. 4 - Harrow Street Furriers and Skin Dressers Messrs. Leeding & (3o. 4 - Sixteen inspections of these premises were made during the year. The periodical process of limewashing and cleansing was duly carried out. COWSHEDS. No cows are being kept in the Borough at the present time. BAKEHOUSES. During the year 349 inspections were made of the various bakehouses and factories. The following defects were discovered and 19 intimation and 2 statutory notices were served in order to obtain the abatement of the nuisances complained of: — Dirty ceilings 8 cases Dirty walls 8 cases Dirty floors 7 cases Dirty utensils 7 cases Dirty W.C.'s, etc. 11 cases Dirty gullies 7 cases Dustbins provided 13 cases Miscellaneous items 26 cases Total 87 cases All the above-mentioned nuisances were remedied. Each bakehouse was limewashed or the walls washed as required. During the year, 2 premises were removed from the List of Bakehouses, the businesses being that of Eating Houses. 3 bakehouses were discontinued. 1 bakehouse was newly started. 95 PARTICULARS OF BAKEHOUSES (FACTORIES AND WORKSHOPS). Conditions existing on the 20th October, 1932:— Position. Good. Fair. Not satisfactory. Not in use. In use. Totals. Above ground 13 28 — 19 41 60 Underground 10 16 1 7 27 34 Total 23 44 1 26 68 94 BUTTER AND MARGARINE FACTORIES, ETC. Five inspections were made of the Butter Factories and 4 samples were procured (butter) and submitted to the Public Analyst. They were certified as genuine. 22' inspections were made of t,he premises of Wholesale Margarine dealers.. Cleansing was carried out as required. Wholesale dealers in Margarine discontinued at 5 premises. ,, ,, ,, changed occupiers at 1 premises. Total number of Registered Wholesale Margarine Dealers' premises at the end of 1932—19. TOTAL INSPECTIONS DURING 1932. Premises. No. of Inspections. Notices. Intimation. Statutory. Milkshops 1320 7 — Bakehouses 349 19 2 Tripe Boilers 4 — — Fat Melters 4 — — Butter Factories 5 — — Skin Dresser 4 — — Soap Boilers 4 — — Wholesale Margarine Dealers 22 - — Total 1712 26 2 96 ARTIFICIAL CREAM ACT, 1929. PUBLIC HEALTH (CONDENSED MILK) REGULATIONS, 1923-1927 PUBLIC HEALTH (DRIED MILK) REGULATIONS, 1923-1927. 11 Samples under the above Regulations were purchased during 1932, and certified to comply with the Order. Artificial Cream and Dried Milk do not appear to be on sale in the retail shops in the Borough. PUBLIC HEALTH (PRESERVATIVES, ETC., IN FOOD) REGULATIONS. "MERCHANDISE MARKS" ACT, 1926. FOOD AND DRUGS (ADULTERATION) ACT, 1928, PART 2, etc. Special attention has been given at the various premises visited with regard to the observance of the requirements under the abovementioned Acts and Regulations. SALE OF FOOD AND DRUGS ACT. During the year ended 31st December, 1,265 "official" samples were taken by the Inspector. The following Table shows the localities in which these samples were taken:— TABLE 36. Showing the number of samples taken in each District of the Borough during the year. No. 1. No. 2. No. 3. No. 4. No. 5. No. 6. No. 7. No. 8. No. 9. Total. Number of samples taken 151 134 147 164 179 128 157 96 109 1265 22' of these samples were certified as adulterated, a percentage of 1.74, as compared with 1.35 in 1931. Particulars of the samples taken, together with the results of the analyses are given in Tables 39 and 40. 97 POLICE COURT PROCEEDINGS TAKEN UNDER THE FOOD AND DRUGS ACT. 17 summonses were taken out during the year 1932. TABLE 37. Showing the Districts in which proceedings were taken under the Food and Drugs Act. No. 1. 1 No. 2. No. 3. No. 4. No. 5. No. 6. No. 7. No. 8. No. 9. Total. Number of Summonses taken out 4 2 — 3 4 — 2 - 2 17 The offences for which the above-mentioned summonses were taken out are tabulated hereunder:— Milk deficient in fat 6 cases Milk (added water) 1 case Rum (under proof) 2 cases Vinegar (deficient in acetic acid) 7 cases Dripping (added water) 1 case Total 17 cases The proceedings taken before the Magistrates resulted as follows:— 98 TABLE 38. SALE OF FOOD AND DRUGS AND OTHER ACTS. Proceedings taken, with the Result. Name and Address of Vendor. Sample and No. Result of Analysis. Result of Proceedings. George Applebee, 79, Tower Street Milk 1228 7 per cent, deficient in milk fat Dismissed with a caution 10/6 costs. Alfred J. Leatherdale, 56, Crampton St. Milk 173 20 per cent, deficient in milk fat Dismissed on payment of 40/- costs. Joseph P. Hall, 257, Walworth Road ... Milk 229 5 per cent, deficient in milk fat Dismissed on payment of 40/- costs. Daniel Lloyd, 11, Tabard Street Milk 265 4 per cent, deficient in milk fat Summons withdrawn on Warranty. Thos. Chas. Woodward, 2, Harper Street Milk 289 7 per cent, deficient in milk fat Dismissed with a caution 21/- costs. Arthur Slade, 39, Warner Street Milk 300 5.4 per cent, added water Dismissed with a caution, 21/- costs. Wm. Chas. Lewis, 49a, Hillingdon St. Milk 369 11 per cent, deficient in milk fat Dismissed with a caution, 12/6 costs. Wm. Chas. North, 21, Crampton Street Rum 388 41 degrees under proof Dismissed under 1st Offenders Act, £3 3 0 costs. Wm. Neal Hammond, 21, Crampton St. Rum 388 41 degrees under proof Summons withdrawn (see above). Albert Lightning, Rear of 23 Deacon St. Vinegar 437 12 per cent, deficient in Acetic Acid Dismissed on payment of 15/- costs. Edith Beresford, Rear of 23 Deacon St. Vinegar 437 12 per cent, deficient in Acetic Acid Summons withdrawn (see above). Harry Carpentier, 7, Chapter Road Vinegar 438 48 per cent, deficient in Acetic Acid Dismissed with a caution, 15/- costs. Ellen Carpentier, 7, Chapter Road Vinegar 438 48 per cent, deficient in Acetic Acid Withdrawn (see above). Alice Bishop, 50, Gravel Lane Vinegar 451 39 per cent, deficient in Acetic Acid Dismissed on payment of 17/6 costs. Frederick Heywood, 123, Gt. Dover St. Vinegar 476 40 per cent, deficient in Acetic Acid Dismissed on payment of 17/6 costs. Albert J. Broyd, 26, Gt. Charlotte St. Dripping 881 6 per cent, water Dismissed with a severe warning. John C. Hare, 9, Gt. Suffolk Street Vinegar 927 28 per cent, deficient in Acetic Acid Dismissed under 1st Offenders Act, 21/- costs. 99 FOOD AND DRUGS ACTS. TABLE 39. Return of Official Samples for the Year ending 31st December, 1932, showing the number taken, and the percentage of adulterated Samples for the year. Article. Number of Samples taken. Adulterated. Milk 432 10 Condensed Milk 11 - Butter 96 - Cheese 9 - Margarine 93 - Lard 67 - Coffee 7 - Cocoa 12 - Sugar 44 - Mustard 10 - Port Wine 6 - Sherry 2 - Whisky 16 1 Gin 8 1 Rum 8 1 Brandy 8 — Rice 33 — Tapioca 23 — Mixed Spice 3 — Dripping 26 1 Mustard Compound 2 — Currants 2 — Sultanas 1 1 Prunes 4 — Sun Maid Raisins 1 — Raisins 2 — Mixed Peel 1 — Mixed Fruits 1 — Tea 25 — Cinnamon 1 — Curry Powder 3 — Table Salt 8 - Carried forward 965 15 100 Article. Number of Samples taken. Adulterated. Brought forward 965 15 Self-raising Flour 32 - Eccles Cakes 1 - Ox Tail Soup 6 - Cornflour 14 - Milk Pudding 1 - Pea Soup Flour 11 - Ginger-bread 1 - Table Jelly 15 - Baking Powder 1 - Fish Paste 12 - Breakfast Sausage 5 - Luncheon Sausage 3 - Preserved Sausage 6 - Jam Roll 3 - Cake 14 - Jam Sandwich 3 - Assorted Chocolates 2 - Sweets 8 - Brawn 3 - Prepared Barley 9 - Corned Beef 4 - Quaker Oats 2 - Mixed Herbs 1 - Green Peas (Dried) 2 - Macaroni 2 - Mixed Spice 6 - Tomato Soup 2 - Dried Mint 2 - Crushed Linseed 2 - Pearl Tapioca 2 - Sage 1 - Gravy Salt 4 - Saxa Salt 4 - Custard Powder 8 - Bisto 7 - Quick Oats 2 - Broth Mixture 1 - French Coffee 1 - Sponge Mixture 5 - Carried forward 1173 15 101 Article. Number of Samples taken. Adulterated. Brought forward 1173 15 Oatmeal 2 - Rolled Oats 2 - Ground Rice 4 - Arrowroot 6 - Jelly Crystals 1 - Pearl Barley 8 - Suet and Rice Flour 5 - Cakeoma 1 - Saline 1 - Crushed Linseed 3 - Veal Loaf 1 - Boracic Powder 4 - Bicarbonate of Soda 2 - Blanc Mange 4 - Brawn 7 - Gofa 1 - Cheese Cakes 2 - Desiccated Soup 2 - Orangeade 2 - Prepared Groats 1 - Breakfast Sausage 4 - Toffees 1 - Ground Ginger 1 - Ground Rice 3 - Bun Flour 2 - Gravy Thick 4 - Lentils 2 - Oxade Lemonade 1 - Curry Powder 1 - Semolina 3 - Lemonade Powder 1 - Vinegar 7 7 Krusto 1 - Desiccated Coconut 2 - Total 1265 22 Percentage of adulterated samples for the year—1.74. 102 INFORMAL SAMPLES. In addition to the samples taken under the Food and Drugs Acts as shown in Table 39, 749 samples were purchased informally by the Inspector through his several agents. The whole of these samples were submitted to the Public analyst for analysis, with the following result:— TABLE 40. Articles. Number of samples purchased by Agents. Result of Analysis. Percentage of adulterated samples. Genuine. Adulterated. Milk 76 75 1 1.3 Cream 5 5 - - Butter 311 311 - - Cheese 2 2 - - Margarine 1 1 - - Lard 101 101 - - Coffee 1 1 - - Cocoa 3 3 - - Dripping 11 11 - - Sultanas 15 11 4 26.6 Fish Paste 3 3 - - Lobster Paste 1 1 - - Bloater Paste 1 1 - - Ham and Chicken Paste 1 1 - - Preserved Sausage 2 2 - - Rock Cake 1 1 - - Sausages 22 21 1 4.5 Lemon Cheese 1 1 - - Coffee & Chicory Ess 3 3 - - Apricots (Canned) 1 1 - - Cherries (Canned) 1 1 - - Green Peas (Canned) 1 1 - - Beans (Canned) 1 1 - - Honey 3 3 - - French Capers 2 2 - - Salad Cream 2 2 - - Sauces & Pickles 8 8 - - Corned Beef 3 3 - - Brawn 11 11 - - Zinc Ointment 1 1 - - Boracic Ointment 1 1 - - Eucalyptus Oil 2 2 - - Camphorated Oil 2 2 - - Glycerine 1 1 - - Castor Oil 3 3 - - Cream of Tartar I 1 - - Compound Liquorice Powder 1 1 - - Borax 1 1 - - Boracic Powder 1 1 - - Olive Oil 1 1 - - Bicarbonate of Soda 1 1 - - Epsom Salts 1 1 - - Indigestion Tablets 1 1 - - Tincture of Iodine 1 1 - - Vinegar 133 118 15 11.3 Certo 1 I - - Strawberry Jam 1 1 - - Raisins 1 1 - - 749 728 21 2.8 103 INFECTIOUS DISEASES. The first half of this year was a particularly busy one, owing to the concurrent epidemics of measles and smallpox. The measles epidemic was heavy, but owing to the facilities for home nursing and the arrangements made by the L.C.C. for removal of severe cases to Hospital, the deaths were fewer than in previous epidemics. Other infectious and contagious diseases showed a slight tendency to increase on the previous year. One of the most alarming features is the considerable increase in the number of deaths from diarrhoea, particularly those in infants under 2 years. This increase has led to a special inquiry into home conditions and methods of feeding. SMALLPOX. 1928 19 1929 153 Case rate England and Wales 0.05 1930 106 Cases Notified. ,, ,, Borough 0.09 1931 311 1932 161 Deaths—Nil. Smallpox continues to be of a very mild character and of low infectivity Apart from the initial attack of headache and pain in the back, the patients appear to suffer little or no inconvenience No children who have been vaccinated have suffered from the disease, and very few adults who have been vaccinated once in infancy have been attacked, and then only so mildly that the disease has been extremely hard to diagnose. No action has been taken under Smallpox Prevention Regulations, 1917. SCARLET FEVER. 623 cases of this disease were notified during the year. The case rate for England and Wales was 2.12, and for the Borough, 3.7. I he number of cases notified and the number of deaths during the last five years were as follows:— Notified. Deaths. 1928 673 3 1929 662 3 1930 763 4 1931 514 3 1932 623 4 104 ENTERIC FEVER. 2 cases of Enteric Fever were notified during the year. The number of cases notified and the number of deaths during the last five years were as follows:— Notified. Deaths. 1928 2 1 1929 5 1 1930 2 1 1931 5 1 1932 2 - DIPHTHERIA. 448 cases of this disease were notified, the case rate being 2.7 as against 1.08 for England and Wales. The number of cases of Diphtheria notified and the number of deaths during the last five years were as follows:— Notified. Deaths. 1928 668 13 1929 603 22 1930 667 17 1931 426 8 1932 448 14 SCHICK TESTING AND IMMUNISATION CLINIC. This Clinic was held as usual on Thursday afternoons at Sutherland House. A somewhat lengthy description as to the value of this preventive work was given in last year's Annual Report, and I made suggestions to the Council which I hoped would help to educate the citizens of the Borough on the subject, and so increase the work of this Clinic. An intensive campaign was launched in the early part of the year, and still continues, and there is evidence, from the figures which follow, that the desired result is gradually being brought about. The number of persons immunised for the year under review has increased in comparison with the previous year. 105 TABLE 41. SHOWING THE NUMBER OF ATTENDANCES AT THE SCHICK CLINIC, 1932. A. Schick Test. New Cases. Number Tested. Protection Inoculation given without Test. Children, 0-5 67 Children, 0-5 66 Children, 5-14 83 Children, 5-14 1 Adults - Adults - Old Cases (Reading of Schick Test). Immune. Susceptible. Children, 0-5 11 Children, 0-5 42 Children, 5-14 39 Children, 5-14 40 Adults - Adults - Miscellaneous Readings. Children, 0-5 14 Children, 5-14 4 Adults - B. Protective Inoculations given to old Cases. Cases. Inoculations. Children, 0-5 122 120 had 3 1 do. 4 1 do. 5 Children, 5-14 45 41 had 3 2 do. 4 2 do. r U C. Number Re-Tested after 3 months. Found Immune. Children, 0-5 98 Children, 0-5 88 Children, 5-14 53 Children, 5-14 47 Adults - Adults - Found Susceptible. Miscellaneous Readings. Children, 0-5 1 Children, 0-5 9 Children, 5-14 3 Children, 5-14 3 Adults - Adults - Total Attendances. Children, 0-5 640 Children, 5-14 376 Adults —Total 1,016 106 MEASLES. The number of cases of this disease notified during the year was 2,398. Of these, 1,505 were under 5 years of age, and 555 were removed to hospital. 137 of those over 5 were also removed to hospital. All cases treated in their homes were visited by the Health Visitors, who gave advice and instruction where necessary. The number of deaths from Measles during the last five years were as follow:— 1928 72 1929 16 1930 77 1931 3 1932 53 DIARRHOEA. In this Borough summer diarrhoea is notifiable during the months of July, August and September, and in these three months 7 cases were notified, 3 of which were removed to hospital. Deaths from diarrhoea during the last 5 years were as follows:— 1928 31 1929 41 1930 24 1931 16 1932 40 34 of the 40 deaths occurred in children under 2 years of age. As previously stated, all infant deaths and deaths from diarrhoea are specially enquired into by the Health Visitors and recorded. Of the 34 infants who died, only 10 had attended one of the Welfare Centres, and the reports, with few exceptions, indicate wrong feeding and poor mothercraft. WHOOPING COUGH. Although this disease is not notifiable in the Borough, 83 cases were removed to the hospital during the year. These cases come to our notice either from the various hospitals or the local Medical Practitioners. 107 The number of fatal cases during the last 5 years was as follows: — 1928 26 1929 49 1930 10 1931 18 1932 20 INFLUENZA. The deaths from Influenza during the last 5 years were as follows:— 1928 29 1929 135 1930 20 1931 35 1932 43 PUERPERAL FEVER AND PUERPERAL PYREXIA. 7 cases of Puerperal fever and 24 cases of Puerperal pyrexia were notified during the year, as against 12 and 36, respectively. The whole of the cases of the former were sent to hospital and 23 of the latter. There were 4 deaths from Puerperal Fever, and 7 from other Puerperal causes. The case rates expressed per 1,000 total births, compared with England and Wales, are as follows:— England & Wales Puerperal fever, 3.3. Puerperal pyrexia, 8.5. Borough Puerperal fever, 2.4. Puerperal pyrexia, 8.5. OPHTHALMIA NEONATORUM. 26 cases occurred during the year, as against 20 in 1931. An analysis of the cases will be found hereunder:— Notified. Cases treated Vision unimpaired. Vision impaired. Total Blindness. Deaths. At home. Hospital. 26 5 21 26 Nil Nil Nil 108 PREVENTION OF BLINDNESS. A record is kept under the Blind Persons Act, 1920, of all cases under 5 years of age reported from the Welfare Centres. These are referred to the Metropolitan Society for the Blind CEREBRO SPINAL FEVER, ENCEPHALITIS LETHARGICA AND POLIOMYELITIS. 8 cases of Cerebro-spinal fever were notified during the year, 4 of which died 5 cases of Polio-myelitis were also notified, of which 3 were sent to hospital I case of Encephalitis Lethargica was notified with 1 death. ACUTE PRIMARY AND INFLUENZAL PNEUMONIA. 186 cases were notified during the year. 68 of these were removed to hospital. There were 37 deaths. CANCER. Number of deaths during last 5 years:— 1928 252 1929 254 1930 250 1931 290 1932 263 The greatest number of deaths occurred in males. The principal sites of the cancer were the stomach and intestines in the male, and the breast and genital organs in the female. 109 TABLE 42. NOTIFIABLE DISEASES (other than Tuberculosis) during the year 1932. Disease. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- Males. Females. Total. Cases admitted to Hospital Total Deaths Scarlet Fever 6 208 246 105 21 16 12 8 1 - - - - 279 344 623 593 4 Smallpox 4 10 28 33 23 18 14 9 8 7 6 1 - 84 77 161 161 - Diphtheria 7 131 177 58 20 28 20 4 2 - - - - 212 235 447 446 14 Memb. Croup - 1 - - - - - - - - - - - 1 - 1 1 - Enteric Fever - - - 1 - 1 - - - - - - - 1 1 2 2 - Paratyphoid - - - - - - - - - - - - - - - - - - Puerperal Fever - - - - 1 2 3 1 - - - - - - 7 7 7 4 Puerperal Pyrexia - - - - 2 8 10 4 - - - - - - 24 24 23 - Cerebro-Spinal Fever 2 3 - - - - 1 1 - - - 1 - 6 2 8 8 4 Measles 126 1379 839 29 8 11 3 2 1 - - - - 1209 1189 2398 692 53 Malaria - - - - - - 1 - - - - - - 1 - 1 - - Dysentery - - 2 - - - - - - - - - - 1 1 2 - - Epidemic Diarrhoea 7 - - - - - - - - - - - - 4 3 7 3 4 Encephalitis Lethargica - - - - - 1 - - - - - - - 1 - 1 1 1 Pneumonia 6 20 20 8 12 11 23 28 29 12 17 - - 118 68 186 68 37 Ophthalmia Neonatorum 26 - - - - - - - - - - - - 14 12 26 8 - Erysipelas 4 3 - 3 3 4 10 14 15 12 7 2 - 38 39 77 40 1 Polio-Encephalitis - - - - - - - - - - - - - - - - - - Polio-Mvelitis 1 2 - - 1 - 1 - - - - - - 4 1 5 3 1 Chickenpox - - - - - - - - - - - - - - - - - - Anthrax - - - - - - - - - - - - - - - - - - Totals 189 1757 1312 237 91 100 98 71 56 31 30 4 - 1973 2003 3976 2056 123 110 TABLE 43. Return of Families Admitted into the Council's Reception House during the year 1932. 1932. Scarlet Fever. Diphtheria. Smallpox. Other Diseases, etc. Verminous Persons. Week ending No. of Families No. of Persons No. of Days No. of Families No. of Persons No. of Days No. of Families No. of Persons No. of Days No. of Families No. of Persons No. of Days No. of Families No. of Persons No. of Days Jan. 2 - - - - - - 7 28 71 - - - - - - „ 9 - - - - - - - - - - - - - - - „ 16 - - - - - - 4 10 21 - - - - - - „ 23 - - - - - - 4 12 35 - - - - - - „ 30 - - - - - - 1 5 20 - - - - - - Feb. 6 - - - - - - 2 7 17 - - - - - - „ 13 - - - - - - 2 8 28 - - - - - - „ 20 - - - - - - 5 10 23 - - - - - - „ 27 - - - - - - 3 12 40 - - - - - - Mar. 5 - - - - - - - - - - - - - - - „ 12 - - - 1 2 6 3 8 24 - - - - - - „ 19 - - - 1 1 2 - - - - - - - - - „ 26 - - - - - - 2 2 2 - - - - - - April 2 - - - - - - 4 13 34 - - - - - - „ 9 - - - - - - - - - - - -- - - - „ 16 - - - - - - 2 7 19 - - - - - - „ 23 - - - - - - 9 38 101 - - - - - - „ 30 - - - - - - 2 8 16 - - - - - - May 7 - - - - - - 4 8 21 1 2 4 - - - „ 14 - - - - - - 1 2 6 - - - - - - „ 21 - - - - - - 4 20 40 - - - - - - „ 28 - - - - - - 1 2 4 - - - - - - June 4 - - - - - - 2 9 18 - - - - - - „ 11 - - - - - - 2 6 15 - - - - - - „ 18 - - - - - - - - - - - - - - - „ 25 - - - - - - 2 6 17 - - - - - - 111 July 2 - - - - - - - - - - - - - - - „ 9 - - - - - - - - - - - - - - - „ 16 - - - - - - 1 3 9 - - - - - - „ 23 - - - - - - - - - 2 7 14 - - - „ 30 - - - - - - - - - - - - - - - Aug. 6 - - - - - - - - - - - - - - - „ 13 - - - - - - - - - - - - - - - „ 20 1 5 15 - - - - - - - - - 1 2 2 „ 27 - - - 1 2 6 - - - - - - 1 1 2 Sept. 3 - - - 1 2 4 - - - - - - - - - „ 10 2 9 24 - - - - - - - - - - - - „ 17 - - - 1 1 2 - - - - - - - - - „ 24 1 4 8 - - - - - - - - - - - - Oct. 1 - - - - - - - - - - - - - - - „ 8 2 6 18 - - - - - - - - - - - - „ 15 - - - - - - 1 3 12 - - - - - - „ 22 - - - - - - - - - - - - - - - „ 29 - - - - - - - - - - - - - - - Nov. 5 - - - - - - - - - - - - - - - „ 12 1 3 6 - - - - - - - - - - - - „ 19 2 4 8 - - - - - - - - - - - - „ 26 - - - - - - 1 6 12 - - - - - - Dec. 3 1 2 4 - - - - - - - - - - - - „ 10 - - - - - - 1 6 21 - - - - - - „ 17 - - - - - - - - - - - - - - - „ 24 - - - - - - - - - - - - - - - „ 31 - - - - - - - - - - - - - - - Total 10 33 83 5 8 20 70 239 626 3 9 18 2 3 4 112 DISINFECTION. The total number of disinfections of rooms during the year by the Council's disinfecting staff was 2,155. Of this number 1,912 rooms were disinfected after the occurrence of the ordinary notifiable infectious diseases, and 243 after cases of phthisis. 943 verminous rooms were sulphured and otherwise cleansed by the Council's staff during the year, as against 604 in 1931. Among the total number of disinfections (2,155) it was found necessary to strip 16 rooms. TABLE 44. Bedding, etc., disinfected and destroyed after the occurrence of Infectious Disease during the year 1932. Articles. No. Disinfected. No. Destroyed. Beds 1,029 60 Palliasses 843 83 Bolsters 731 16 Pillows 2,136 53 Cushions 356 10 Blankets 2,000 23 Sheets 1,410 9 Quilts 1,342 11 Articles of Clothing, etc. 6,628 568 Books 450 9 Total 16,925 842 In addition, 1 box, 2 parcels and 1 bag of clothing, 3 cases of hair weighing 575 lbs. were disinfected, and 1 bag of old boots was destroyed. 113 MATERNITY AND CHILD WELFARE. At the present time the Maternity services of the Borough are carried on with eight municipal, two partly municipal and partly voluntary, and four voluntary centres. HEALTH VISITING. The arrangements made for the visiting of children between the ages of 1 and 5 years for the present appear to be fairly satisfactory. During the year under consideration 488 more children between these ages have been visited in their homes by the Health visitors. Cases of measles, whooping cough, pneumonia, ophthalmia neonatorum, etc., are visited and reported on by the health visitors employed by the Council; likewise enquiries into cases of puerperal pyrexia, maternal and infant deaths. ANTENATAL CLINICS. Antenatal Clinics are held at Sutherland House every Monday and Friday mornings, and one session is held monthly at St. Jude's Centre, Lambeth Road, The attendances for the years are as follow:— SUTHERLAND HOUSE. (Monday, Dr. Shepherd). During the year 138 mothers were seen and given advice, they made 374 attendances. Of this number, 37 were sent by midwives, 62 by the health visitors, 2 by various hospitals, 5 by private practitioners, and 32 came of their own accord. SUTHERLAND HOUSE. (Friday, Dr. Bergin). 202 mothers were seen and given advice; they made 500 attendances. The majority of cases attending are referred by midwives, the figures for 1932 being—178 sent by midwives; 6 by Health Visitors; 10 by various hospitals; 6 by private practitioners; and 2 came of their own accord. ST. JUDE'S CENTRE, LAMBETH ROAD. (1 session monthly, Dr. Shepherd). 91 mothers were seen and given advice; they made 275 attendances. MATERNAL MORTALITY. The number of deaths during 1932, due directly to pregnancy or childbirth, was 11; of these 4 were due to septic causes and 7 from other causes. 114 All cases of Maternal Deaths are visited by your Health Visitors, and reported upon. Maternal mortality rates per 1,000 total births are as follows: — London (Administrative County). Southwark. Puerperal sepsis 1.33 1.42 Other accidents and diseases of pregnancy and parturition 1.66 2.49 ARTIFICIAL LIGHT TREATMENT. The arrangement with Guy's Hospital, whereby Ultra Violet Rays are applied to ailing and delicate children is still carried on, and during the year the number of cases sent for treatment was 78. Many of the children have made good progress, particularly in cases of rickets, malnutrition and wasting, and in the winter, when natural sunlight is deficient, this treatment is of undoubted use and is worthy of continuance. CONVALESCENT TREATMENT. An arrangement was entered into between the Borough Council and the Invalid Children's Aid Association by which the Council undertook part payment for children under 5 years of age sent to Convalescent Homes by that Association, and 32 children were thus assisted to have the necessary treatment and fresh air to restore them to health. 12 children were referred to the Public Assistance Committee for convalescence. The treatment of convalescent children has been carried out by the Invalid Children's Aid Association for some years, but by the arrangements mentioned above, the Council now bears part of the cost incurred up to £150 per annum for children attending our centres requiring convalescence. DINNERS TO NECESSITOUS MOTHERS. Dinner Coupons were given to necessitous mothers who were referred to the Southwark Invalid Kitchen, at a cost to the Council of £4 16s. 6d. for the year. 115 MATERNITY AND CHILD WELFARE CENTRES. Assistant Medical Officer of Health (Maternity and Child Welfare) Dr. Margaret Bergin. 1a CENTRE (Voluntary). St. John's Institute, Larcom Street. District served by Centre St. John's Ward. Sessions held every Wednesday and Thursday 2—4.0. Medical Officers Dr. E. M. Saxton and Dr. M. O. Cruickshank. Superintendent Mrs. A. Parkins. 1b CENTRE (Municipal). Sutherland House, Sutherland Square. District served by Centre St. Mary's Ward. Sessions held every Tuesday 10.0—12. 2.0—4.0. Medical Officer Dr. Dorothy Shepherd. Health Visitor Mrs. Kingsmill. 2a CENTRE (Municipal). Sutherland House, Sutherland Square. District served by Centre St. Paul's Ward. Sessions held every Wednesday 10.0—12. 2.0—4.0. Medical Officer Dr. Dorothy Shepherd. Health Visitor Miss W. Sayer. 2b CENTRE (Municipal). Working Boys' Club, Villa Stre«t. District served by Centre St. Peter's District. Sessions held every Wednesday 10.0—42. 2.0—4.0. Medical Officer Dr. Margaret Bergin. Health Visitor Miss W. F. Cleverley. 116 3a CENTRE (Municipal). All Saints' Parish Room, Surrey Square. District served by Centre The Southern portion of All Saints' District and the portion of St. George's Ward between East Street and Albany Road. Sessions held every Thursday 10.0—12. 2.0—4.0. Medical Officer Dr. A. G, Stevens. Health Visitor Miss A. Rogers. 3b CENTRE (Municipal). Lady Margaret Church Parish Room, Chatham Street. District served by Centre The Northern half of All Saints' District and the portion of St. George's Ward between East Street and New Kent Road. Sessions held every Thursday 10.0—12. 2.0—4.0. Medical Officer Dr. Margaret Bergin. Health Visitor Miss A. C. Cottrill. 4a CENTRE (Partly Municipal and partly Voluntary). Crossways Mission Hall, New Kent Road. District served by Centre Trinity Ward. Sessions held every Wednesday 10.0—12. 2.0—4.0. Medical Officer Dr. A. C. Stevens. Health Visitor Miss K. L. M. Hinde. 4b CENTRE (Municipal). Mission Hall, Lansdowne Place. District served by Centre The Northern half of St. George's Ward and the streets between Trinity Street and Tabard Street. Sessions held every Friday 10.0—12. 2.0—4.0. Medical Officer Dr. A. C. Stevens. Health Visitor Miss F. M. Adair. 117 5 CENTRE (Partly Municipal and partly Voluntary). 56, Lambeth Road. District served by Centre A part of St. Jude's and St. Michael's Wards. Sessions held every Monday and Thursday 2—4.0. Medical Officer Dr. Dorothy Shepherd. Health Visitor Miss Pearson. 6a CENTRE (Municipal). St. George's Dispensary, Pocock Street. District served by Centre Christchurch Ward and a part of St. Michael and St. Jude's Wards. Sessions held every Tuesday 10.0—12. 2.0—4.0. Medical Officer Dr. Margaret Bergin. Health Visitor Miss M. Freeth. 6b CENTRE (Municipal). St. Mary's Girls' Club, Union Street. District served by Centre St. Saviour's Ward. Sessions held every Monday 10.0—-12. 2.0—4.0. Medical Officer Dr. Margaret Bergin. Health Visitor Mrs. M. E. George. 6c CENTRE (Voluntary). 86, Borough Road. District served by Centre A part of St. Michael's Ward. Sessions held every Monday 2.0-—4.0. Medical Officer Dr. Vernon. Health Visitor Miss Oxley. In addition to the above, the Roman Catholic Centre, 148, New Kent Road (Voluntary), holds a session every Thursday from 2.30—4, and Salamon's Centre, 28, Newcomen Street (Voluntary), holds two sessions, Monday, 2—5, and Thursday, 10—12. 118 ANTE-NATAL CLINICS. Sutherland House, Sutherland Square. District served by Clinic St. Mary and St. Paul Wards. Sessions held every Monday 10.0—12.0. Medical Officer Dr. Dorothy Shepherd. Sutherland House, Sutherland Square. Districts served by Clinic St. Peter, St. John, Trinity, All Saints, St. Michael, St. George, Christchurch and St. Saviour's Wards. Sessions held every Friday 10.0—12.0. Medical Officer Dr. Margaret Bergin. 56, Lambeth Road. District served by Clinic St. Jude's Ward. Sessions held One monthly. Medical Officer Dr. Dorothy Shepherd. The local Midwives refer all cases needing advice and treatment to the above Clinics. 119 HEALTH WORK. The number of visits made by the Health Visitors and other officers of the Public Health Department to houses in connection with Births, and other Health Work during 1932. TABLE 45. Original Visits. Revisits. Visits to AnteNatal Cases. Visits to PostNatal Cases. Visits to Delicate Infants. Visits to Cases of Diarrhoea and Sick Children. Attendances at Welfare Centres. Visits where Mothers were found to be out. Special Visits, etc. Puerperal Pyrexia. Total. Births. Measles. Ophthalmia Neonatorum. Births. Measles. Ophthalmia Neonatorum. Mrs. Kingsmill 264 234 4 1385 30 - 184 - - 2 146 35 17 2 2303 Miss Sayer 343 292 - 1013 11 - 134 - - - 98 130 1 - 2022 Miss Cleverley 236 251 2 666 1 - 96 - - - 133 213 16 1 1615 Miss Rogers 221 272 - 858 11 - 99 - - - 98 123 37 2 1721 Miss Cottrill 227 287 8 1332 25 - 57 1 - 3 94 26 1 3 2064 Miss Hinde 217 316 4 914 57 - 47 - - 2 98 579 45 7 2286 Miss Adair 218 281 3 1610 14 - 98 - - - 104 18 - 6 2352 Miss Freeth 304 282 10 1775 84 - 160 5 - - 95 66 26 - 2807 Mrs. George 229 195 2 787 30 - 56 - - 9 74 111 13 6 1512 Mrs. George (home help) - - - - - - - - - - 449 - 22 - 471 Total 2259 2410 33 10340 263 - 931 6 - 16 1389 1301 178 27 19153 120 121 MATERNITY AND CHILD WELFARE CENTRES. Showing the Attendances at the Several Centres and Visits paid to the homes of Mothers and Children by Health Visitors. TABLE 46. St. John 1a. St. Mary. 1b. St. Paul. 2a. St. Peter. 2b. All Saints. 3a. Lady Margaret 3b. Crossway. 4a. St. Stephens. 4b. St. Jude. 5. St. Michael. 6a. St. Saviour. 6b. St. George. 6c. Guy's. 7. Total. Number of Births notified during the year 331 272 328 231 206 207 221 188 217 281 207 110 46 2845 Number of individual children attending the Centre during the year 658 490 525 252 317 352 383 361 357 431 318 99 69 4612 Number of Sessions held during the year 96 96 94 84 94 96 86 94 93 94 92 46 92 1157 Number of children coming into (1-5) age group during the year 397 219 245 63 168 176 218 185 87 219 128 - - 2105 Number of new cases attending the Centres during the year— (1) Expectant Mothers 167 - 12 - 20 9 - 47 2 45 3 1 918 1224 (2) Infants under 1 year 225 229 247 145 126 159 144 140 199 185 161 85 45 2090 (3) Seen by Doctor 225 229 247 145 126 159 144 140 199 185 161 85 45 2090 (4) Children 1 to 5 years 36 42 33 64 33 17 31 36 51 27 29 14 4 417 (5) Seen by Doctor 36 42 33 64 33 17 31 36 51 27 29 14 4 417 Method of Feeding— (a) Breast 367 249 262 110 133 202 128 165 178 221 209 73 51 2348 (b) Breast and Bottle 14 17 12 22 14 23 15 12 23 11 17 7 8 195 (c) Bottle 33 85 85 32 24 24 56 23 24 23 22 5 6 442 (d) Ordinary diet 244 139 166 88 146 103 184 161 132 176 70 14 4 1627 Total number of attendances at the Centres during the year— (1) Mothers 8102 5986 5785 4262 3865 4768 4441 4289 6498 5357 4310 2248 93 60004 (2) Expectant Mothers 423 1 20 - 69 42 - 123 2 111 59 2 3637 4489 (3) Infants under 1 year 5320 3501 4064 2263 2208 3080 1878 2431 2601 3372 2545 1265 1852 36380 (4) Children 1 to 5 years 1558 2336 1869 1553 1535 1695 2348 1844 4228 1679 1661 1094 951 24351 (1) Average number of attendances 84.4 61.3 61.5 50.7 41.0 49.7 51.6 45.6 69.9 57.0 46.8 48.9 - - (2) do. do. 4.4 - - - - - - - - - - - - - (3) do. do. 55.4 37.7 43.2 26.5 23.5 31.1 21.8 25.9 18.0 35.8 27.7 27.5 20.1 - (4) do. do. 162 24.3 19.9 18.6 16.2 16.6 27.3 19.6 45.5 17.9 18.0 23.8 10.3 - (5) Total number of attendances of Infants seen by Doctor during the year 1365 1457 2081 905 1024 1260 677 1463 1330 1333 1141 625 992 15653 (6) Total number of attendances of children 1 to 5 years seen by Doctor during the year 537 873 793 621 668 787 628 928 1130 712 730 487 615 9509 (7) Total number of Expectant Mothers seen by Doctor 167 - 12 - 20 9 - 47 2 45 3 1 918 1224 (8) Children weighed 5504 5544 5723 3874 3681 4552 4201 3867 1524 6283 3915 2246 2699 53613 (9) Post-natal cases 1901 - 443 - 15 51 - 313 2301 144 23 300 461 5952 Total number of first visits paid by Health Visitors to homes of- (1) Expectant Mothers 192 106 130 90 85 57 45 98 197 160 54 50 767 2031 (2) Infants under 1 year 304 250 302 215 185 188 200 160 198 260 180 78 42 2562 (3) Children 1 to 5 years 248 - - - - - - - 8 - - 85 6 347 Total number of revisits paid by Health Visitors to homes of— (1) Expectant Mothers 206 78 4 6 14 - 2 - 265 - 2 122 1148 1847 (2) Infants under 1 year 1860 1399 1054 687 894 1371 j 931 1668 1639 1819 836 852 645 15655 (3) Children 1 to 5 years 2858 1957 1359 1527 1558 1394 1296 1642 2866 1743 1500 2799 1923 24422 Sewing Classes were held during the year at Sutherland House with a total attendance of 337. 122 TABLE 47. TUBERCULOSIS. Age Periods. New Cases.* Deaths. Pulmonary. NonPulmonary. Pulmonary. NonPulmonary. 0 1 5 3 2 1 — 11 1 3 5 8 20 2 2 15 85 11 33 7 25 77 8 35 2 35 58 6 26 2 45 55 1 35 — 55 35 1 27 1 65 and upwards 10 3 9 - Total 329 66 171 19 (1) The ratio of non-notified tuberculosis deaths to total tuberculosis deaths is 1 in 13. This figure is represented in 13 deaths; of this number 9 were found to be suffering from tuberculosis as a result of post-mortem examination, and 4 died in institutions outside the Borough. There is no evidence of wilful neglect on the part of the private practitioner to notify, neither is there evidence of excessive incidence of or mortality from tuberculosis, in any particular occupation in the Borough. 123 TABLE 48. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of Notifications during the period from the 3rd January, 1932, to the 31st December, 1932, in the Metropolitan Borough of Southwark. Age-periods Notifications on Form A. Number of Primary Notifications. Total Notifications on Form A. 0-1 1-5 5-10 10-15 15-20 20-25 25-35 35-45 45-55 55-65 65 and upw'rds Total Primary Notifications. Pulmonary Males — — 1 2 15 19 35 38 39 20 6 175 218 „ Females — — 2 2 16 26 24 14 5 5 2 96 123 Non-Pulmonary Males — 3 7 6 3 — 2 2 — 1 — 24 3J „ „ Females 2 5 3 3 4 2 3 4 1 — 1 28 38 Primary Notifications relate to patients who have not previously been formally notified in the area to which the return relates. Any additional notification of a case which has been previously notified in the area is to be regarded as duplicate. 124 TABLE 49. SUPPLEMENTAL RETURN. New cases of Tuberculosis coming to the knowledge of the Medical Officer of Health or Chief (Administrative) Tuberculosis Officer during the period from the 3rd January, 1932, to the 31st December, 1932, otherwise than by notification on Form A or Form B under the Public Health (Tuberculosis) Regulations, 1912. Age Periods 0-1 1-5 5-10 10-15 15-20 20-25 25-35 35-45 45-55 55-65 65 & upwards Total Cases Pulmonary Males 1 — — — - 2 10 5 9 7 2 36 „ Females — — 1 — 1 6 8 1 2 3 — 22 Non-pulmonary Males 1 1 — 1 1 1 — — — — 5 „ „ Females 2 2 - 1 - — 2 — — — 2 9 125 DEATHS FROM PULMONARY TUBERCULOSIS. TABLE 50. Shewing the number of Patients who died in their own homes and the number who died away from home in Hospitals or other Institutions, 1932. 0- 1- 2- 5- 15- 25- 35- 45- 55- 65- 75- All Ages. Males. Females. Total. Number of patients who died at home - - - - 9 10 7 7 8 3 1 27 18 45 Number of patients who died in hospitals, etc. 3 1 — 2 24 25 19 28 19 3 2 83 43 126 3 1 — 2 33 35 26 35 27 6 3 110 61 171 Of the total number of deaths from Pulmonary Tuberculosis 73.1 per cent. occurred in hospitals or other institutions. 126 The number of notified cases and deaths for the last five years is as follows:— Notified. Deaths. 1928 319 194 1929 339 232 1930 339 210 1931 312 208 1932 329 171 The mortality rate was 0.96 per 1,000, as against 1.20 per 1,000 in 1931. The following tables give, in tabular form, the number of cases of Tuberculosis on the Medical Officer's Register; the number of new cases coming to the knowledge of the Medical Officer of Health, and the number of deaths from Tuberculosis for the period under review. TABLE 51. Notification Register. Pulmonary. Non-Pulmonary. Total Cases Males Females Total Males Females Total Number of cases of Tuberculosis remaining at the 31st December, 1932, on the Registers of Notifications kept by the Medical Officer of Health of the Metropolitan Borough 789 490 1279 283 222 505 1784 Number of cases removed from the Register(s) during the year by reason inter alia of:— (1) Withdrawal of notification 59 32 91 20 12 32 123 (2) Recovery from the disease 17 13 30 18 12 30 60 (3) Deaths 95 45 140 12 8 20 160 127 Disinfection was carried out as follows:— TABLE 52. The Locality of the Rooms Disinfected after the occurrence of Phthisis. No. 1. No. 2. No. 3. No. 4. No. 5. No. 6. No. 7. No. 8. No. 9. Total. Disinfected 37 24 41 36 19 24 29 12 21 243 WORK OF THE TUBERCULOSIS DISPENSARY. I have received the following report from Dr. Crowe, your Clinical Tuberculosis Officer. The work of the Dispensary was carried out as usual during the year, sessions being held as follow:— Tuesday Wednesday Thursday Saturday 9.30—12. Tuesday Thursday 6—8 p.m. The number of new cases examined and the total number of attendances, etc., at the Dispensary will be found in Table 53. Increased efficiency in the administrative work of the Dispensary has been evolved by (a) abolishing one session for patients and in its stead special visits made to the homes of domiciliary cases by the Clinical Tuberculosis Officer; (b) visits to special cases sent by general practitioners; (c) special reports to Medical Officer of Health in cases of T.B. where overcrowding conditions exist, with a view to better housing conditions; (d) the establishment of a handicraft centre. In this connection, 188 patients were visited in their homes, and 31 cases revewed for rehousing. The Handicrafts Centre established under the auspices of the Tuberculosis Care Committee for the benefit of discharged T.B. patients, who, by reason of the state of the industrial market, and also on account of their illness, are unable to obtain employment, and therefore 128 have considerable time on their hands, has been a boon, and since its inception in September last 16 have attended. The class is purely a voluntary one, and donations were required to make a start. In this connection £10 was very kindly subscribed from the Mayor's Fund, together with a donation of £10 from the National Association for the Prevention of Tuberculosis. A qualified teacher was provided by the London County Council, and an Honorary Organiser was also appointed. In December a sale of work was held of the various articles made by the patients attending the class, which realised £11 10s. This amount was divided between the general fund and the patients. DIAGNOSIS OF TUBERCULOSIS. For purposes of investigation and diagnosis, 52 patients were sent up to Guy's Hospital for X-ray examinations, and 518 specimens of sputum were also examined for Dispensary patients. PROVISION OF EXTRA NOURISHMENT. In accordance with the instructions of the Ministry of Health, allowances of milk, cod-liver oil, etc., can be granted to necessitous patients attending the Dispensary. During the year 15 such patients were granted extra nourishment. The Public Assistance Committee of the L.C.C. is most prompt in providing assistance in the way of relief, food and clothing to patients who are recommended by me for their consideration. Most valuable help has also been given in numerous ways by the Charity Organisation Society, the British Red Cross, United Services Fund, and the National Association for the Prevention of T.B. SUPERVISION OF HOME CONDITIONS. Three T.B. nurses on the Staff of the Dispensary carry out this very good and most important work. They make reports to the Clinical T.B. Officer as to the conditions under which notified cases of T.B. are living. Upon visiting the home of a patient the nurse instructs the relatives regarding precautions to be taken to prevent the spread of disease amongst other members of the family. Suggestions are made with regard to any improvements which could easily be carried out, and which would benefit the patient and his family. 129 Contacts are persuaded to attend the Dispensary, without delay, for examination. Re-visits are paid to the homes at frequent intervals to see that precautionary measures are being carried out satisfactorily. The number of visits paid during the year by the three nurses was 4,484. ISSUE OF SHELTERS, ETC. Bedsteads have been lent to patients who were unable to afford the extra expense to enable the patient to sleep alone. Shelters have also been lent out to patients who have had suitable accommodation in the way of either yards or gardens. HOME NURSING. The Ranyard Nursing Association and the Benson Nurses Home carry out home nursing to bed-ridden patients, when it is required. CO-ORDINATION OF DISPENSARY WITH OTHER HEALTH SERVICES. There is complete co-ordination between the School Medical Services of the L.C.C., the M. and C.W. Services of the Borough and the Dispensary. Children are seen on a Saturday morning, the session being devoted entirely to them. Children who are examined as Contacts of a definite case of P. Tuberculosis are referred to the School Medical Service, in order that they may be under the constant supervision of the School Medical Officer. Relations between the Ministry of Pensions, the L.C.C., Medical Practitioners and ourselves are well maintained. INSTITUTIONAL TREATMENT. Institutional treatment through the L.C.C. was recommended for 293 persons. 37 persons were recommended to the same authority for admission to Hospital for the purposes of observation and diagnosis. 9 children were recommended for attendance at Open-Air School after their discharge from Sanatoria. 38 cases unsuitable for Sanatorium treatment were recommended to the Relieving Officer for admission to one of the L.C.C. Hospitals. 130 NON-PULMONARY TUBERCULOSIS. Surgical cases, such as Tuberculosis of Bones, Joints and Glands, are admitted by the L.C.C. to Sanatoria, which deal specially with such cases. On their return home, the supervision of the case is carried out at either an Orthopaedic Dept. of a General Hospital, or else at the AfterCare Clinic of the Sanatorium at which they received treatment. These After-Care Clinics are held in London, and the patient thus continues to be under the care of the Medical Superintendent of the Sanatorium. One patient, not requiring Sanatorium treatment, received Artificial Sunlight Treatment at Guy's Hospital. The Council's liability being 1s. for each attendance made by the patient. Two patients, suffering from Lupus of the Face, received Finsen Light Treatment, the conditions in each case improved very considerably as a result of the treatment. For this special form of light treatment the liability of the Council is 5s. per treatment per patient. ARTIFICIAL PNEUMO THORAX TREATMENT. During the period under review this form of treatment has become more generally used, and the results have proved very satisfactory. The patients receive refills at periods varying from one week to one month, according to the condition of the lungs. 26 patients are receiving such treatment in the Out-Patient Department of Brompton, Guy's, St. Thomas' and other Hospitals. The Borough Council remunerates the Hospital authorities at the rate of 10s. 6d. for each refill given. During the year the total cost of this form of treatment was £155 18s. 6d. COLONY TRAINING. In January, 1932, a woman patient, aged 21 years, was admitted to the Papworth Colony by the London County Council. She is reported to be happy and doing very well. INVALID CHILDREN'S AID ASSOCIATION. Very great assistance is given us by this Association, and many delicate children, who have attended this Dispensary as suspected cases of Tuberculosis, but who on investigation have been proved to be non-Tuberculous, have been sent away to the country or sea-side for periods of convalescent treatment. 131 The Association also deals with all children who, as Contacts of infectious cases of Pulmonary Tuberculosis, have been recommended by me to the L.C.C. for boarding out under the " Contact Scheme.'' The Invalid Children's Aid Association makes all arrangements for the care of these children while they are away from home. 16 children were dealt with under this scheme during the year. TUBERCULOSIS CARE COMMITTEE. This Committee has met weekly during the year, and much useful work has been done with regard to helping necessitous cases. The full report of the Committee follows hereafter. In detailing the work of this Committee during the past year, we are very glad to relate that, through the kindness of the Borough Council, the Society for Prevention of Tuberculosis, and others, we have been enabled to start a handicraft class for patients, men and women, who are prevented by their health from following ordinary work, but who are very glad to have interesting occupations for their enforced leisure. The L.C.C. has provided an excellent teacher, and an Hon. Organiser has undertaken this branch of our work. She visits the homes of patients who are considered suitable by our Tuberculosis Officer, and interests them in the plan. She has our warmest thanks for collecting a clan of enthusiastic students, so much so, that, although only started in November, we were able before Christmas to have a sale of really artistic and useful articles, which although sold at very reasonable prices, brought in over £11, which was divided among the makers and a fund for buying more materials. Our ordinary work has gone on as in former years. Our Committee meets weekly. It consists of representatives of various forms of social work in the Borough—the Borough Council, the Public Assistance Committee, the L.C.C. Organiser of Children's Care Committees, the three nurses from the Tuberculosis Dispensary, and our Tuberculosis Officer as Chairman. Our objects are (1) That anyone going for treatment under the L.C.C. Tuberculosis Scheme, can do so with the knowledge that the family will be looked after in the absence of the bread winner or the mother. That in necessitous cases, clothes will be provided, and any special difficulties carefully looked into. We have no funds, but by interesting various societies in the needs of the patients and their families, we do our utmost to prevent them going short in any way. (2) When the heads of families are in a position to do so, the L.C.C. requires them to contribute towards the cost of the treatment; the amount is assessed by this Committee and approved by the L.C.C. In the case of adults it is collected by our Hon. Organiser; in the case of children, the two Southwark branches of the I.C.A.A. kindly 132 undertake this work, as well as general care and supervision of all the children's cases, for which we give them hearty thanks. We also wish to thank the Army Societies, United Services Fund, British Legion, Soldiers and Sailors Help Society, the Red Cross Emergency Committee, Royal Naval Benevolent Trust, and various Regimental agencies, also the Charity Organisation Society, which keeps closely in touch with us and helps our civilian cases. Very often (men especially) would return to try and support their families when quite unfit to do so, but for help given. We also wish to thank the Invalid Kitchen Committee, which provides just the right form of nourishment, both before and after treatment, if advised by our Tuberculosis Officer. Our Committee have dealt during the year with 344 cases, recommended by our Tuberculosis Officer to the L.C.C. for Institutional Treatment. Of these, 271 were adults, and 73 children. The families of 38 adults and 24 children were asked to contribute towards the cost, in sums ranging from 2s. to 20s. weekly. These are generally very willingly paid; some say they wish they could give more, to show how they appreciate the treatment received. It will be noted that only a small number, especially among the adults, pay anything at all. This is accounted for by the poverty of the Borough, and the great quantity of unemployment—as well as the great care taken by our Committee that the payments should not be a burden. We visit all the cases on their return, to see how they are, and if help is needed. Some return fit for work and have to be tided over till wages are paid. Some few, we only wish they were more, have succeeded in moving to better surroundings, and require help with furniture or the moving. Time is given at every Committee to consider special needs, and the Tuberculosis nurses, the I.C.A.A. Secretaries, the Hon. Organiser and other members of Committee bring up for special help and consideration any patients whose needs have come to their notice during the week. Our Committee is on the whole well attended and is a very "live" one, as so many of us know, and are keenly interested in the cases we discuss. We only wish we could do more for these cases, but if tempted to be disheartened we only have to look back and see the wonderful growth of the work during the last few years, and look forward with hope for increasing growth in the future. L. ASHE, Hon. Organiser. 133 TABLE 53. RETURN FOR THE YEAR 1932 SHOWING THE WORK OF THE TUBERCULOSIS DISPENSARY. Diagnosis. Pulmonary. Non-Pulmonary Total. Grand TotaL Adults Children Adults Children Adults Children M. F. M. F. M. F. M. F. M. F. M. F. A.—New Cases examined during the year (excluding contacts):— (a) Definitely tuberculous 107 69 3 2 13 11 12 14 120 80 15 16 231 (b) Diagnosis not completed 4 3 4 1 — — — 2 4 3 4 3 14 (c) Non-tuberculous 59 52 11 21 — — 9 2 59 52 20 23 154 B.—Contacts examined during the year:— (a) Definitely tuberculous 6 6 — — — — 1 3 6 6 1 3 16 (b) Diagnosis not completed — — 1 1 — 1 — — — 1 1 1 3 (c) Non-tuberculous 43 74 92 83 — — 3 1 43 74 95 84 296 C.—Cases written off the Dispensary Register as:— (a) Recovered 16 12 1 - 10 5 7 4 26 17 8 4 55 (b) Non-tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous) 107 128 106 110 13 5 107 128 119 115 469 D.—Number of Cases on Dispensary Register on December 31st:— (a) Definitely tuberculous 328 229 19 16 23 27 25 30 351 256 44 46 697 (b) Diagnosis not completed 4 3 5 2 — 1 — 2 4 4 5 4 17 1. Number of cases on Dispensary Register on January 1st 730 2. Number of cases transferred from other areas and cases returned after discharge under Head 3 in previous years 46 3. Number of cases transferred to other areas, cases not desiring further assistance under the scheme, and cases "lost sight of" 146 4. Cases written off during the year as Dead (all causes) 106 5. Number of attendances at the Dispensary (including Contacts) 3324 6. Number of Insured Persons under Domiciliary Treatment on the 31st December 103 7. Number of consultations with medical practitioners:— 8. Number of visits by Tuberculosis Officers to homes (including personal consultations) 188 (a) Personal 3 (6) Other 240 9. Number of visits by Nurses or Health Visitors to homes for Dispensary purposes 3551 10. Number of:— (a) Specimens of sputum, etc., examined 551 (6) X-ray examinations made in connection with Dispensary work. 52 11. Number of "Recovered" cases restored to Dispensary Register, and included in A (a) and A (b) above 3 12. Number of "T.B. plus" cases on Dispensary Register on December 31st 320