AC 4379 Sou 58 METROPOLITAN BOROUGH OF SOUTHWARK REPORT of the MEDICAL OFFICER OP HEALTH FOR THE YEAR 1948 W. STOTT, M.B., B.S., D.P.H CONTENTS VITAL STATISTICS Page 4 SANITARY CIRCUMSTANCES „ 8 HOUSING „ 16 POOD „ 19 & 37 INFECTIOUS DISEASES „ 23 MATERNITY & CHILD WELFARE „ 32 METROPOLITAN BOROUGH OF SOUTHWARK. Public Health Department, Walworth Road, S.E.17. The Mayor, Aldermen, and Councillors, Metropolitan Borough of Southwark. Your Worship, Ladies Gentlemen, I have pleasure in submitting my Annual Report for the year 1948. This year wa3 notable chiefly for the coming into operation of the National Health Service, and National Assistance Acts, which caused a considerable readjustment of the Public Welfare Services, and of the administration of the Public Her„lth Department, Prom this latter aspect the whole of the Maternity and Child Welfare Services, with the functions of the Almoner, Home Help Organiser, and the special Physio-Therapy, Gynaecological, Chest X-ray, and Dental Clinics were all transferred to the control of the London County Council or the Regional Hospitals Board. Similar changes affectcd Fublic Vaccination, Public Assistance, and other Social Welfare services, whioh, while not directly the province of the Public Health Department, worn closely linked with its work and purpose. It was to be expected that such far reaching administrative changes would inevitably cause no small measure of initial confusion. But it was also obvious that although the Public Health Department wa3 to be relieved of the organisation and control of those large and important services for v/hich it had so long been responsible, they would remain directly or indirectly - a ma.ior part of its primary, if statutorily undefined, obligation as guardian of the health of the community. In short, although these personal health services were no longer to be part of the Public Health Department, they were still part of Public Health, and as such it was inevitable that the public should still seek assistance and guidance on these matters from us. In the public interest the closest co-operation must be maintained between the Borough Council, and these other authorities, not only on tho broad distinction of policy, but also down to routine inter-departmental procedure. It is sincerely to bo hoped that the centralisation envisaged of these services will not, in their expansive scope, tend to sweep aside local factors which differ 30 widely with each district. To preserve this intimacy, the Medical Officer of Health, and the Fublic Health Department must continue to fulfil an indispensable function as liaison agents between the public and the new responsible bodies. This becomes particularly obvious when one -2- considers, for instance, that whilst in Southwark, at least, the recording of infectious disease notifications remains the responsibility of the Public Health Department, Diphtheria and Whooping Cough immunisation and investigation into certain infantile diseases as well as puerperal sepsis are undertaken by Health Visitors now controlled by the London County Council; likewise, the clinical treatment of tuberculosis is now dealt with by the Regional Hospitals Board. At the same time, it must be emphasised that the personal health services, important and progressive as they are, are not the whole essence of Public Health. The earlier functions of the abatement of sanitary nuisances, the safe-guarding of the purity of our food, the control of infectious diseases, and the medical, overcrowding, and sanitary aspects of housing, are still the responsibility of the public Health Department as fundamentals upon which the whole structure of Public Health and Social Welfare are built. The work of the individual sections of the Department is reported upon in detail in the following pages, but I feel constrained to refer here to the problem - perhaps one of our most difficult and distressing - of the aged and infirm. There are many hundreds of old people living alone without relatives, or at least without anyone who is either able or willing to help them. Many are afflicted with some degree of physical or mental sickness and existing in deplorable conditions through their age, infirmity or lack of assistance; almost all of them arc suffering from the psychological devastation of helpless old age, bereft of companionship or care. The imaginary thread of independence to which they cling somotimes an obstinate pride and sometimes a fear of becoming an unwanted burden to others - only serves to make more difficult the sadly limited assistance it is sometimes possible to offer. The continuing difficulty of the hospital situation, with it3 grievous lack of accommodation and trained staff, offers practically no help for these old people. Whilst many of them are not chronic sick cases, they are also not fit to bo left alone, and the frequent and immediate medical attention desirable cannot adequately be provided by harassed general practitioners. The Social Welfare Department of the London County Counoil is coping admirably with the provision of institutional facilities, and in a short while have done much to banish the stigma of the old "Workhouse" by providing hostels where these old people can retain their personal freedom without degradation or undue restrictions, and enjoy comfort, companionship and proper care and attention. Unfortunately, however, there are at present far too few of these hostels, and they are obviously tinable to cater for the aged who are unable to look after themselves, and in need of constant medical attention. Their problem remains at present pathetically irremediable. -3- It is necessary for me to record here most grateful appreciation of the splendid work undertaken by the Nurses of the Catholic Nursing Institute, 60, Lambeth Road, whose selfless devotion and skill are always forthcoming, despite the overwhelming demands where nursing assistance is essential, but hospital treatment impossible. In addition to the initial disorganisation caused by the operation of new legislation during the year, the Department ha3 suffered further serious handicap in regard to staff. At the beginning of the year, the Sanitary Inspectors' staff was so depleted that there was a constant threat of mounting arrears of work, although fortunately this situation was relieved later in the year. Further, the transfer of services to the London County Council ha3 also involved the transfer of several officers whose qualifications and experience of Public Health administration generally,beyond the scope of their actual transferable duties,were such that their loss is by no means compensated by the loss of direct responsibility for the transferred services which constituted only part of their duties. For some time past there has been a constant drift and change of experienced officers to higher graded posts elsewhere, whilst the younger clerical officers have sought more soope for advancement than is at present offered in the clcrical section, by studying to qualify as Sanitary Inspectors. These circumstances are a matter of the gravest concern for the future efficiency of the clerical administration of the department. In conclusion I must again express to all Members of the Council my thanks for their consideration and help; and to the staff of the Public Health Department, as well as other Departments of the Council, my keen appreciation of their loyal co-operation during a year which has been both eventful, and difficult in the increased and unfamiliar duties which have ensued. I am, Ladies and Gentlemen, Your obedient Servant, WILLIAM STOTT. Medical Officer of Health. -4- VITAL STATISTICS. I During the year there has been an appreciable decrease in the number of live births, and also in the number of deaths recorded. In spite of this, there has been a marked increase in the estimated civil population of the Borough, presumably due to the entry of new families into the Borough. The slightly lower number of infant deaths was not altogether satisfactory when compared with the decrease of 400 live births. It is however, gratifying to record that stillbirths were only about half of the previous years figure. The total number of deaths were 200 less than in 1947, which is satisfactory in relation to the increased population. AREA. 1132 aores. ESTIMATED NUMBER OF DWELLINGS . 23,124. RATEABLE VALIR. (APPROXIMATE) . £998,300. POPULATION. Estimated 97,000 Registrar General's estimate 94,630 Estimated population, 1947 92,070. 1947 1948 LIVE BIRTH RATE per 1,000 population 26.4 21.7 STILL BIRTH RATE per 1,000 total Births 26.1 17.1 DEATH RATE per 1,000 population 15.6 12.8 MATERNAL DEATH RATE per 1,000 live and still births Puerperal Sepsis 0.0 0.47 Other puerperal causes 1.60 0.95 INFANT DEATH RATE All infants per 1,000 live births 39. 36.8 Legitimate infants per 1,000 live legitimate births. 38. 37.6 Illegitimate infants per 1,000 live illegitimate births. 60. 26.5 -5- LIVE BIRTHS: MALES. 1947. 1948. Legitimate 1,188 1,012 Illegitimate 106 73 1,2941,085 FEMALES . Legitimate 1,064 898 Illegitimate 76 78 1,140 976 TOTAL LIVE BIRTHS . Legitimate 2,252 1,910 Illegitimate 182 151 2,434 2,061 ST ILL-BIRTHS: MALES . Legitimate 36 17 Illegitimate 1 13 Total - 37 30 FEMALES. Legitimate 27 2 Illegitimate 1 4 Total - 28 6 TOTAL STILL-BIRTHS. Legitimate 63 19 Illegitimate 2 17 Total - 65 36 DEATHS. TOTAL 1,436 1,214 MATERNAL Puerperal Sepsis - 1 Other Puerperal causes 4 2 INFANT DEATHS. Under 1 year. All Infants 96 76 Legitimate 85 72 Illegitimate 11 4 -6- CLASSIFICATION OF DEATHS. The causes of death (664 males, and 550 females) were as follows: Cerebro-spinal-fever. 4 Whooping Cough 3 Diphtheria 1 Tuberculosis of the respiratory system 81 Other Tuberculous diseases 5 Syphilitic diseases 9 Influenza 2 Cancer 222 Diabetes 7 Intra-cranial vascular lesions 105 Heart diseases 304 Other circulatory diseases 54 Bronchitis 113 Pneumonia 67 Other respiratory diseases 12 Peptic ulcer 9 Diarrhoea (under 2 years) 6 Appendicitis 4 Other digestive diseases 24 Nephritis 21 Measles 4 Acute poliomyelitis and polioencephalitis 1 Acute infantile encephalitis 2 Puerperal and post-abortive sepsis 1 Other maternal causes 2 Premature births 15 Congenital malformations and birth injuries 31 Suicide 9 Road Traffic accidents 10 Other violent causes 25 All other causes 61 Total deaths at all ages. 1214. -7- DEATHS - AGE GROUPS. Under 1. 1-4. 5-14. 15-44. 45-64. 65 and over. Total. Males 41 9 7 65 191 351 664 Females 35 5 4 48 113 345 550 76 14 11 113 304 696 1214. INFANT MORTALITY. The total number of deaths of Infants under one year of age was 76, the Causes of death being as follows: Cerebro-spinal-fever. 2 Whooping Cough 3 Tuberculosis of respiratory system 1 Influenza 1 Measles 2 Diseases of circulatory system other than heart diseases 1 Bronchitis 3 Pneumonia 8 Other respiratory diseases 1 Diarrhoea 6 Other digestive diseases 3 Premature birth 15 Congenital malformations end birth injuries. 28 Other violent causes. 1 All other causes. 1 Total deaths under one year of age: 76 MATERNAL MORTALITY . The deaths of two women due to causes other than puerperal sepsis were recorded during the year. -8- SANITARY CIRCUMSTANCES OF THE AREA. The difficulties experienced in 1947 in regard to the shortage of sanitary inspectors was to some extent relieved in 1948, although in the first half of the year there were only 5 District Inspectors, whereas the full establishment is 12. From June onwards, an additional 5 inspectors were appointed, but the section was still below strength at the end of the year. Despite this handicap, an immense increase was achieved in the work of this seotion, which is particularly reflected in a substantial increase of several thousand more inspections than in 1947, with 1100 more intimation and statutory notices, and 4000 more defects found and remedied. Summary of Inspections carried out during the year. Inspections upon receipt of complaint 5667 Drainage and miscellaneous inspections. 2496 Inspection of war damaged properties 1 Inspection of Factories 353 Inspection of outworkers 101 Inspection of Common Lodging Houses 30 Re-housing visits 1814 Housing Act Inspections 378 Smoke Observations. 32 Rodent visits 368 Inspection of Food at Wharves etc. 328 Inspection and sampling of Food at Shops, Warehouses etc. 1523 Visits to Bakehouses 118 Visits to eating Houses 299 Visits to Ice Cream premises 137 Visits to Fried Fish Shops 31 Visits to Fish Curers Premises 6 Visits to other Food Premises 90 Revisits 12665 NOTICES . Intimation Notices served 3754 Statutory Notices Served 927 Defects in Council controlled property, reported to Housing Manager. 124 Intimation Notices complied with 3000 Notices re-served 67 -9- RENT RESTRICTIONS ACTS. 67 certificates were issued during the year under the above mentioned Acts. COMMON LODGING HOUSES. There are four women's, and two men's common lodging houses in the Borough, whioh are fully occupied nightly. 30 inspections of these premises were made by the sanitary inspectors during tho year. RODENT CONTROL. Rodent control is a matter of paramount importance in a Borough 3uch as this, with the river as its northern boundary, and with its large number of food warehouses, etc. An efficient staff, working under the direction of tho Chief Sanitary Inspector ha3 surveyed the whole of the Borough, and the procedure recommended by the Ministry of Agriculture and Fisheries has been rigidly adhered to. Domestic. Business. Visits by Sanitary Inspector 357 11 Visits by Rodent Officer 349 337 Visits by Rodent Investigators 3735 2514 Visits by Rodent Operatives 3290 2263 Drains tested 469 65 Drains defective 54 10 Drains repaired. 24 3 Drains opened for examination. 21 4 Premises infested 927 300 Premises cleared. 460 290 Prebaits laid 1060 23022 Poison baits 6240 7328 Bodies recovered 242 625 Sewer maintenance treatment numbers 7 and 8 were carried out in June and November at approximately 800 manholes. PUBLIC HEALTH (LONDON) ACT, 1936. - SECTION 95. 438 certificates in regard to the provision of proper and sufficient water supply were issued in respect of newly erected premises. OFFENSIVE TRADES. There are five premises engaged in offensive trades in the Borough. -10- FACTORIES ACT, 1957. 353 Inspections of Factories were made during the year, and 33 notices were served. There are now 805 factories of all types on the register, comprising 181 factories without mechanical power, and 624 factories with mechanical power. Premises. Number. Inspections. Notices. Prosecutions. Factories in which sects. 1,2,3,4,6,7 181 86 5 Nil are enforced by L .A. Factories not included in above in which 624 267 28 Nil. Sect. 7 is enforced by L.A. Total 805 353 33 Nil Defects found and remedied. Found. Remedied. Want of cleanliness 16 10 Inadequate ventilation 2 - Sanitary Conveniences: a) Insufficient. 6 5 b) Unsuitable or defective. 21 14 Other Offences 15 13 (Not including offences relating to Home work, or offences under the sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921 and re-enacted in the Third Schedule to the Factories Act, 1937) 60 42. In no cases were prosecutions instituted. -11- OUTWORKERS. 101 inspections of homos of outworkers were made during the year. The conditions generally were found to be quite satisfactory, and it was not found necessary to serve any notices or institute any prosecutions, for work carried on in unwholesome premises. OUTWORKERS' LISTS Section 110. Nature of Work. List3 received from Employers Nos. of addresses of Outworkers received from other Councils Nos of addresses of Outworkers forwarded to other Councils Number of inspections of Outworkers premises February August List List Lists OutWkrs. Lists Out Wkrs Leather work 2 5 2 5 - 10 2 Umbrellas - - - - - - - Bed ticks - - - - - - - Boxes and bags 8 56 8 49 5 75 13 Brushes 1 1 2 7 6 5 - Wearing apparel 12 45 9 25 50 57 20 Fancy Goods 1 3 1 4 14 4 16 Machinery - - - - - - - Card Lacing 2 21 2 16 1 23 0 Tailoring 9 46 8 48 26 87 5 Misc. 5 31 5 15 31 34 45 TOTAL 40 208 37 169 133 295 101 -12- PUBLIC HEALTH (LONDON) ACT, 1936 - LEGAL PROCEEDINGS. DATE. DEFENDANT. OFFENCE. RESULT OF PROCEEDINGS. March 4. Mr. P. Gulliford, 30, Fitzwilliam Road, S.W.4. Failing to abate a nuisance at 160, Boyson Road. Abatement Order, 21 days. March 4. Rebecca Benabo, t/a.C. Benabo & Sons, 3, Saint Stephens Pde. S.W.1. Failing to abate a nuisance at 151, Lorrimore Road. Adjourned "sine die", on payment of £l.ls.0d. costs. March 4. Rebecca Benabo, t/a C. Benabo & Sons, 3, Saint Stephens Pde. S.W.1. Failing to abate a nuisance at 86, Mann Street. Adjourned "sine die", on payment of £1. 1s. 0d. costs. May 11. Waters & Waters, 1, Gresham Road, S.W.9. Failing to abate a nuisance at 115, Grosven or Terrace. Summons withdrawn on completion of work. £1. 1s. 0d. costs. May 20. Waters & Waters, 1, Gresham Road, S.W.9. Failing to abate a nuisance at 75, Boyson Road. Abatement Order, 21 days, and £1. 1s. 0d. costs. -13- DATE. DEFENDANT. OFFENCE. RESULT OF PROCEEDINGS. May 20 Waters & Waters, 1, Gresham Road, S.W.9. Failing to abate a nuisance at 97, Boyson Road. Abatement order, 28 days, and £l.ls.0d. costs. May 27. Waters & Waters, 1, Gresham Road, S.W.9. Failing to abate a nuisance at 27, Lorrirmore Road. Abatement Order, 42 days, and £1. Is. 0d. costs, May 27. C. Benabo & Sons, 3, St. Stephens Pde., S.W.1. Failing to abate a nuisance at 99, Farmers Road. Summons withdrawn on completion of work. £1. 1s. 0d. costs. Oct. 7. Mrs. V. Tanner, 22, Limpsfield Ave., Thornton Heath. Failing to abate nuisances at 76, Bethwin Road,) 90, Bethwin Road,) 92, Bethwin Road.) (Withdrawn on completion of (work, £1. 1s. 0d. costs in (each case. Oct. 7. Mrs. V. Tanner, 22, Limpsfield Ave, Thornton Heath. Failing to abate a nuisance at 94, Bethwin Road. Adjourned "sine die" on payment of £1. l1s. 6d. costs Nov. 11. Benabo & Co., 3, St. Stephens Pde, S.W.1. Failing to abate a nuisance at 128, Trafalgar Street. Withdrawn on completion of work, £l.ls.0d. costs. -14- SMOKE ABATEMENT. During the year 23 complaints of smoke nuisances were received, and 32 observations carried out by Sanitary Inspectors. In a number of cases the trouble was due to the supply of unsuitable fuel. Representations were made to the Fuel Authorities, and more suitable coal was made available, resulting in an appreciable abatement of smoke emission. Other difficulties were due to the worn out state of plants, and untrained firemen. Summary of Sanitary works completed during the year. Defects found and remedied(As under). 11095 Drains repaired. 88 Drains intercepted and ventilated. 16 Drains unstopped. 125 Gullies provided. 8 Soil pipes provided or repaired. 56 Closets provided. 5 Closet pans or traps repaired or renewed. 299 Water apparatus repaired. 172 Sinks, lavatories and waste pipes repaired or renewed. 192 Rainwater pipes repaired, etc. 198 Water supply provided to upper floors. 9 Draw taps on mains provided. 9 New water supplies. 8 Roofs and gutters repaired. 1264 Paving repaired. 67 Dampness abated. 1024 Rooms cleansed. 1540 Sub floor ventilation provided. 5 Dustbins provided. 115 Miscellaneous nuisances abated. 5895 Various works done without notice. 135 -15- NATIONAL ASSISTANCE ACT, 1948, Aged and Infirm persona. The provisions of Section 224 of the Public Health (London) Act, 1936, are now included in Section 47 of the above Act. This relates to the removal of chronic sick, aged or infirm persons, living in insanitary conditions without proper care and attention. During the year 2 oases were compulsorily removed to institutions, but numerous visits were also made by the Sanitary Inspector in connection with the voluntary removal of old people living alone, admissions to hospitals, and provision of Home Help and home nursing facilities. Burials. Under Section 50 of the National Assistance Act, the Council is required to arrange for the burial or cremation of all persons found dead in the Borough whore there are no other arrangements for the disposal of the body. This provision came into force in July 1948, and since that date the Council has arranged for the burial of 14 bodies which were interred at Streatham Park Cemetery. In these cases there wore either no known relatives of the deceased, or the relatives were unable to defray private funeral costs. In the few instances whore any effects of value were found belonging to the deceased, these were sold by the Counoil to defray the expenses incurred. MORTUARY AND CORONER'S COURT. The following is a statement of the work of the Mortuary and Coroner's Court during the year. Post Mortems without inquests 830 Post Mortems with inquest, 252 Inquests with Post Mortems elsewhere 1 Bodies Brought in for convenience 1 1084 t HOUSING WORK OF THE DEPARTMENT The Housing work undertake in by the Department falls into two main categories. The Department is called upon to undertake action under various parts of the Housing Act 1936, in particular action on individual insanitary houses or parts of houses, action on groups of unfit houses, and action in the case of overcrowded dwellings. In addition reports are continually being called for by the various re-housing authorities, the principal authorities being the London bounty Council and the Housing Department of this Council Enquiries are received from these authorities concerning housing applications in which the applicants seek special priority on grounds of cither overcrowding, medical necessity, or sanitary defects in their accommodation. In each of these cases a visit is made to the accommodation by the Sanitary Inspector, Rehousing Since ray last report there has boon no apparent improvement in the general shortage of houses mentioned then. There have been many fresh applications to the various Councils for housing accommodation, most of which sought some degree of priority on grounds of either overcrowding, medical necessity, or the sanitary condition of their accommodation, A great number of the applications originating from persons living in this Borough was referred to this Department for investigation, and in all 1450 cases were investigated involving 1814 visits by the Sanitary Inspectons, In the ma jority of these cases sanitary defects were found and hose wore deal! with chiefly under the nuisance sections of the Public Health (London) Act, 1936,, The majority of the enquiries was made on behalf of the London County Council, but many "ore for this Council's Housing Department, and some for other Councils Cases seeking priority on grounds of medical necessity presented a great problem, In dealing with them care has boon taken to ensure that priority has been recommended only in cases having the greatest need. During the year 205 cases have been recommended to the London County Council as warranting preferential consideration, 13C on grounds of tuberculosis, and 69 for other medical reason. During the same period 103 cases previously recommended on medical grounds were rehoused. Of these 77 were rehoused by the London County Council, 49' on grounds of tuberculosis and 88 on other medical greunds. The remaining 26 cases were rehoused by this Council's Housing Department, 4 on grounds of tuberculosis and 22 on other medical grounds. -17- Overcrowding. During the year thero has boon an increase in the number of premises overcrowded. In all overcrowding was abated in 196 dwellings, but 259 fresh cases were discovered. At the end of • the year there were 1064- overcrowded dwellings in the Borough, involving 1244 families and 5952 persons. The increase shown is probably due in some degree to the return of families home after the Ear. In many cases, son3 and daughters have married whilst in H.M,Forces, and on their demobilisation have returned to their parents homos until they can find their own accommodation. There have been some cases of whole families moving into the Borough from other districts, usually right outside London, over crowding themselves and then seeking the assistance of the local authorities to find them accommodation as priority cases. Fortunately there have not been many of such cases, and illegal overcrowding as a whole has not been extensive, The shortage of accommodation has made the strict enforcement of the overcrowding sections of the Act difficult, and it has been the procedure of the department to deal with such cases informally where possible In all cases the co-operation of owners and landlords has been sought, and each time the overcrowding has boon abated to the satisfaction of all concerned without recourse to legal action, The overcrowding figures given still indicate a far too high percentage of dwellings occupied by members of more than one family. There must bo many more dwellings in the Borough which are so occupied without being overcrowded. This is a grave social evil to which the only remedy appears to be the provision of more,and more houses. During the year 253 families living In overcrowded conditions applied to the London County Council for rehousing. The appropriate recommendation form was submitted in each case. Details of overcrowding in the Borough are given below;- Premises. Families. Persons On register at end of 1947 1001 1158 5662 New cases reported 259 338 1442 Total 126 0 1496 7104 Overcrowding abated 196 252 1152 On register at end of 1948 1064 1244 5952 Overcrowding abated. Rehoused by L.C.C. 161 212 962 Rehoused by S.B.C. 21 25 116 Rehoused by Owners 4 4 23 Moved away 9 9 45 Found own accommodation. 1 2 6 196 252 1152. -18- Action taken under the Housing Act 1936,Parts II and HI, Inspections under Section 9 of the Housing Act, 1936, were recommenced during the year. Rather than proceeding with formal action immediately it has been decided that' informal notices should be served on the various owners, indicating the defects existing and pointing out the desirability of avoiding formal action, 118 informal notices were served, mostly in respect of the older blocks of flats in the Borough, No formal action; by the Council was necessary during the year. The shortage of housing accommodation, and the resulting difficulties in obtaining the rehousing of families displaced, has limited action under Sections 11 and 12 of the Housing Act, 1936, to only the essential cases. During the year' demolition orders were made in respect of two properties, but in both cases an undertaking from the ownor to make them fit for habitation was accepted by the Council, Three promises were affected by closing orders, involving five underground rooms, The families occupying those rooms wore either rehousod, or managed to find their own accommodation. During the year, the Council made one compulsory purchaso order; the area concerned was fully inspected, and the relevant reports compiled. In all, the Sanitary Inspectors made 378 visits under the Housing Act,1936 during the year. Details of action taken are as follows: premises represented under Section 11. 4, Nicholson Stroet - Undertaking accopted from owner to make fit 7, Nicholson Street - Undertaking accepted from ownor to mako fit Promises closed under Section 12. 39, Hopton Street, - Underground room. 51, Dolbcn Street, - Front and back underground rooms. 49, Dolben Street, - Front and back underground rooms. Closing Orders Cancelled, 9, Gaywood Street,- Destroyed by enemy action. 265, Union Street, - Destroyed by enemy action. 233, 3ast Street, - Premises demolished and rebuilt without basement. Compulsory Purchase Order. East Street Number 2 area, - Approval obtained to proceed, after Ministerial enquiry. 19. POOD. THE INSPECTION AND SUPERVISION OF FOOD. As a result of inspections of food at wharves, warehouses, shops, etc. in the Borough, 423 tons, 15 cwts, 1 qr. 10-g- lbs. were found to be unfit for human consumption, and were suitably disposed of. Food Inspected and found unfit for human consumption. How disposed of. Inspected at Shops, etc. Inspected at Wharves. Total food condemned. Ton Cwt Qr . Lb. Ton Cwt Qr .Lb. Ton Cwt Qr. Lb. DESTROYED AT DEPOT 32 12 2 26 29 5 2 12 61 18 1 10 DESTROYED AT PREMISES 2 1 0 3¾ 3 15 1 9 5 16 1 12¾ USED FOR ANIMAL FEEDING 72 14 1 9¼ 8 2 1 5 80 16 2 14¼ TECHNICAL PURPOSES 13 5 0 15½ 1 7 3 1 14 12 3 16½ MANUFACTURING PURPOSES 53 12 1 7 12 2 2 12 65 14 3 19 SALVAGED 193 15 0 O½ 1 1 0 21½ 194 16 0 22 TOTALS 368 0 2 6 55 14 3 4½ 423 15 1 10½ FOOD PREMISES. There are 261 Eating Houses and places where food is prepared for sale, and 197 Ice cream premises in the Borough, Close co-operation ha3 been maintained with the local Food Offioo in connection with the proposed new food premisee and traders, to ensuro that promises comply with our requirements before the issue of food licences. BAKEHOUSES. There are 40 Bakehouses in Southwark, of which 14 are underground. During the year, 118 inspections of these premises were carried out. -20- MILK (SPECIAL DESIGNATIONS) REGULATIONS. 1936 - 1943. Dealers' liccnoes were granted authorising the use of the special designations "Pasteurised" in 38 cases, and Dealers' licences were granted authorising the use of the speoial designation "Tuberculin Tested" in 13 cases. 8 supplementary licences in respect of "Pasteurised" Milk and 7 in respeot of "Tuberculin Tested" Milk were granted to dealers selling from premises outside the Borough, the prinoipal licenoe3 having bean issued by the appropriate licencing authority in eaoh oase. During the year 37 samples of graded milks we re taken and submitted to the Public Analyst for bacteriological examination and chemical analysis. AI30 43 samples of milk supplied to local schools were examined by the Public Analyst. MILK SELLERS . At the close of the year there were 186 registered retailers and wholesalers in the Borough, whilst the number of retailers and wholesalers purveying milk in the Borough from registered premises elsewhere was 43. 519 inspections of Milkshops and Dairies were made during the year. PUBLIC HEALTH (CONDENSED MILK) REGULATIONS, 1923. and 1947. 13 samples of condensed milk were purchased under the above regulations for analysis. They were all certified by the Public Analyst to comply with the said regulations. SLAUGHTERHOUSES . There is only one licenced slaughterhouse in the Borough, and 4 inspections of the premises were made, during the year. PHARMACY AND POISONS ACT , 1933. During the year 94 visits were paid to the various premises listed by the Council for the sale of Part II Poisons under the above Act. There are 63 names of persons on the Council's List of Sellers of Part II Poisons. -81- POOD & DRUGS ACT, 1938 - LEGAL PROCEEDINGS Defendant Cause of Proceedings Result Stanley S.Kirkham, "Royal Oak" P.H, 44. Tabard Stroct Soiling Gin 44 dogree3 under proof Pined £10 and £3.3s. costs William Wood "St.Paul's Tavorn" 72, Villa Street Soiling Whiskey 40 degrees under proof P'ined £5 and £5 .5s. costs Mrs. Jessie F, Bur go, "Trinity Arms" P.H, 29,Swan Street Selling Hum 40 deg'reos under proof Fined £5 and £3.3s .costs Walter Dyo "Thomas a'Beckett P.H. 320,Old Kent Road Selling Gin 43' dogroos undor proof Pined £2 and £2,2s, costs ditto Selling Rum 42 dogroos undor proof Pined £2. John Best (London)Ltd. 321, Walworth Road Soiling Fork Sausages 28% deficient in Moat Finod £3 and £5.5s. costs David Walter "Cafe Comity" 18,St,Goorgos Road Failirg to display a notice that Horseflesh was sold on tho promises Fined £5 Howard E,Friend Now Victory Cafo 94,Now Kent Road ditto Finod £5 and £2,2s. costs Antonio Zucconi Albert's Quick Servico Cafo, 273,Old Kent Road ditto Fined £8 and £4.4s. costs George A,Whale, 395,Walworth Road Selling Prosorvod Boof Sausagos 45% deficient in Moat Finod £2 and £3,3s. costs B . Gardner, h.A, Buc loner & C.Cornell, 21,Deacon Street Failing to display a notice that Horseflesh was sold on the premises Dismissed James Richardson, 19,Tower Bridge Road Soiling Pork Sausage Meat 20$def icient in Meat Fined £2 and £3,3s. costs Sandors Bro3 . (Stores ) 243,Walworth Road Selling Mustard 64% deficient in allyl isothiocyanato Finod £3 and £3.3s, costs Five cautionary letters wore sent in respect of othur non-genuine samples. -22- ICE CREAM Particular attention Ka's been paid this year to the bacteriological results of ice cream samples taken. These results have not been wholly satisfactory, although samples with very low bacterial counts have often been graded III or IV according to the methylene blue test. Special separate sampling at each stago of the process has, however, often helped to detect and remedy some fault with satisfactory reaults„ Tho majority of ico croam makors in this borough are small one-man businessos, and thoso offorts to assist thom have been apprecitatod. Copies of tho Public Analyst's roports on samples takon havo boon sont to tho vendor concornod, within tho case of Grado III or IV rosults) a spocial lottor emphasising tho neod fljr strictor caro in tho hygiono of manufacture, handling and distribution. Inspoctions havo been carriod out bofore now registrations are granted to onsuro that tho promises aro satisfactory and tho requirements of tho Hoat Troatmont Regulations aro fully understood. In many cases it has boon noco3sary to rostrict the sale to pro-packod ico croam from approvod sources, A code of standards has boon sont to oach maker and doalor and tho trado gonorally havo co-oporated in improving the standards of hygiono and purity, with tho installation of much now equipment, 86 samples of ico cream wero takon during tho year,and:17 sonplcs wero graded I 20 samples were gradod III 27 " " " II 17 " " " IV 5 samples were not examined by the mothylono bluo test. FOOD HYGIENE This subjoct continuos to occupy tho caroful and constant attention of tho Dopartmont, and spocial offorts havo boon directod to propaganda. An attempt to organise lectures for thoso ongaged in food premisos otc unfortunately proved unsuccessful, but a Codo of Standards for food promisos and oafcing housos, and anothor for Ico croam makerd and doalers.wero later compiled and distributed, Sorao of tho largor firms have arranged for th61r staffs to recoiyo export instruction in this subject, but it cannot yet bo claimed that there is any substantial improvement in the standards of the smaller businesses,! It is, howevor, anticipated that thoso continuous offorts, aided by similar publicity for tho general public and the national press campaigns ,• will result in improved conditions beyond tho -S'copo of the somuwhat restricted legislation at present applicable. -23- INFECTIOUS DISEASES". There was a considerable increase in the number of infeotious diseases notifications during the year, as compared with the total for both 1947 and 1946. This was duo almost entirely to a heavy incidence of MEASLES, of which there were 1166 cases after diagnosi; corrections, as against 705 the previous year and 775 in 1946. Other than this, however, there has been relatively little change since the generally satisfactory 1947 figures. DYSENTERY OPHTHALMIA NEONATORUM, PUERPERAL SEPSIS, after corrections of diagnoses, v/ere practically exactly the same as for tho previous year. There wero only very slight increases in SCARLET FEVER and PNEUMONIA, but SCABIES showed a marked decrease to only half the 1947 total, which was also less than half the number of cases reported in 1946. In this connection the Scabies Order, 1941 introduced as an emergency measure during the grave spread of thi3 complaint in the war years - ceased to be operative as from the beginning of the year. Compulsory inspection and treatment of patients and contacts was thereby discontinued, although statutory notification remains in force, but it is now safe to assume that this disease no longer constitutes any serious threat to public health in thi3 Borough. Despite population increases, there is relatively little change in TUBERCULOSIS notifications or deaths, although there is certainly a noticeable decline in non-re3piratory oases. Amended regulations wore also made in regard to compulsory notification of Measles and Whooping Cough during the year. This was introduced during the war, and regarded at the time a3 likely to be a temporary measure, but the Minister of Health has now decided that this compulsory notification should be maintained These diseases continue to be troublesome. MEASLES rose to 1166 compared with the 1946/47 average of 740; this was due to the normal cyclic epidemic, and as such was probably not unduly serious, although four deaths were reported. 17H00PING COUGH again continued to rise slightly despite immunisation efforts; there were three deaths, a3 also occurred last year. Whooping Cough Immunisation. Children immunised during 1948: - Under 5 years of age 1515 Over 5 years of age 22 Immunised children who contracted the disease 60 -24- CEREBRO SPINAL MENINGITIS aocounted for one more death than in 1947, despite two less cases, but POLIOMYELITIS, after the disturbing 1947 outbreak, claimed only 1 confirmed case. l Whilst there were no cases of POOD POISONING during the year and notifications of ZYGOTIC ENTERITIS were satisfactorily lov; during the notifiable period (July to September), it has boon found that the latter disease maintained a consistent regularity amongst infants throughout tho whole of the year. Careful investigations were made into each case reported but generally the home conditions and methods of feeding were satisfactory. Confirmed cases of DIPHTHERIA totalled 33 as compared with 40 in 1947 and 27 in 1946. There was an increase both in the number of initial immunisation injections and also 'booster' injections during the year. The noticeable decline in the notified cases between tho ages of 3 and 5 seems adequate proof of the effectiveness of initial immunisation. The highest incidence, however, remains in the 5 to 10 age group, which points unmistakably to a dangerous disregard or ignorance of the importance of reinforcing injections about the school commencing age. A feature of Diphtheria in thi3 Borough during 1948 was that there wore 6 cases over the age of 15 years, 2 of whom were in the 25/35 age group, as compared with only 1 case over 15 in 1947. There was one death from this disease, which had not been immunised. Diphtheria immunisation was carried out during 1948 as follows :• Under 1 year 155 children 4 years 40 children 1 year 1263 " 5-10 years 112 " 2 years 262 " Over 10 6 " 3 years 66 " Live births Confirmed cases of Diphtheria Immuni- 'Booster' 0-3 3-5 5-10 10-15 15 & over satlons (over 5) 1947: 2434 6 10 19 4 1 1745 34 1948: 2061 7 2 16 2 6 1904 74 -25- Diphtheria (continued) Age No. of Cases Notified cases where Immunisation complete Diphtheria deaths Deaths after Immunisation 0- 1 - _ - 1- 4 1 - - 2- 2 — - - 3- - - - - 4- 2 1 - - 5-9 16 5 1 - 10-1 4 2 1 - - Having regard to the general conditions in this Borough, the overall statistics for infectious disease during the year nay be regarded as quite satisfactory. INFECTIOUS DISEASE NOTIFICATIONS. Disease C original eases . Admitted •Hosp ital Numbers after Correct ion Deaths Notified tJn-notfd. 1947 1948 cases oases Scarlet FevOr 259 81 229 242 - - pneumonia 54 4 47 60 2 11 Diphtheria 62 61 x 40 33 1 - Erysipelas 42 14 32 41 - - Dysentery 16 13 11 13 - - Opht ha In la IT con: 9 8 9 9 - - luerperal Sepsis 13 10 19 12 - 1 C erebro-spinal Men in git is 8 8 8 6 1 3 Zymotic Enteritis .(July-Sept.) 22 16 22 23 1 - Iaratyphoid 1 1 - - - - Malaria (Induced) 2 2 5 2 - - Food Poisoning - - 1 - - - Enc ephalitis Lethargica - - - - - 2 Scabies 95 - 198 95 - - Measles 1166 12 9 705 1166 2 2 Whooping Cough 319 57 286 310 3 - Enteric Fever - - 1 - - - ioliomyelitis 3 3 26 1 - 1 TOTALS: 2071 407 1639 2013 10 20 (x: One case of Diphtheria not removed t'o hospital. A second throat swab proved negative), -26- INFECTIOUS DISEASE DEATHS. Disease. Age Groups: 0- 1- 5- 15 25- 54 3544 4554 5564 6574 75- MEASLES notified cases 1 1 un-notfd " 1 1 WHOOPING COUGH notified cases 3 CEREBRO-SPINAL MEN INGIT IS notified cases 1 un-notfd " 2 1 PNEUMONIA notified cases 1 1 un-notfd." 1 1 1 4 1 3 DIPHTHERIA notified cases 1 ZYMOTIC ENTERITIS notified cases ENCEPHALITIS 1 LETHARGICA un-notfd cases 1 1 POLIOMYELITIS un-ntfd cases 1 PUERPERAL SEIS] un-notfd cases CS 1 TOTALS . notil'ied cases 6 2 1 - - - - 1 - un-notfd " 4 2 1 3 1 1 4 1 3 TOTAL- 10 4 2 3 1 1 4 2 3 = 30 TOTALS - 1947. notified cases 2 2 - - - - 3 — 4 un-notfd" 3 - - - 3 3 9 7 4 5 2 - - 3 3 12 7 8 = 40 -27- TUBERCULOSIS Age Groups :- 0- 1- 5- 10- - 15- 20- 25- 35- 45- 55- 65- TOTAL. PULMONARY Primary Notifications M: 1 4 5 1 14 15 25 22 10 14 9 120 F: - 3 3 5 17 28 14 4 2 2 2 80 New cases other than by formal notfcn M: 1 2 9 12 3 8 4 4 43 F: 1 2 - - 1 10 8 3 — 1 1 27 - - - - - - - - - - - - - Totals. 1948 2 9 8 7 34 62 59 32 20 21 16 270 1947 3 7 10 7 39 49 53 31 34 27 9 269 Deaths Notfd. cases M: - - - - 3 2 3 10 9 9 10 46 F: — — 1 — — 5 11 2 2 2 2 25 Un-notified) cases ) M: - - - - - - - p 1 3 3 9 F: - 1 - - - 1 - - - 1 1 5 Totals 1948 1 1 1 - 3 8 14 14 12 15 16 85 1947 1 1 - - 4 8 9 13 15 15 11 77 NON-PULMONARY Primary Notifications M: - 1 2 - 2 1 - - - - - 6 F: — - - 1 3 1 2 - - - - 7 New cases other than by formal notfcn Ms — 1 1 - - - 1 1 - - - 4 F: - - — — 1 - — - - _ — 1 Totals. 1948 - 2 3 1 6 2 3 1 - — - 18 1947 6 6 3 5 5 6 5 1 - - 1 38 Deaths Notfd. cases M: - - - - - - - - - - 1 1 F: - - - - - 1 - - - - - 1 Un-notified) oases ) M: _ _ — - - - 1 - - - - 1 F: - - - - - - - - - - - - Totals 1 1 948 _ _ — - 1 1 - - - 1 3 947 - 2 - - 2 1 - - - - - 5 1 notified Pulmonary case (M.44) committed suicide. 1 notified Non-Pulmonary case (M.42) died from shock following operation. 28 TU VERCULOSIS DISPENSARY . The number of notified cases of Tuberculosis shows very little change from last year, and the work of the Dispensary, under Dr. Pritchard continues to be exceptionally heavy. The Scheme for Domiciliary treatment of Tuberculosis Patients has continued successfully during the year and has grown. Whilst it is not suggested that this form of treatment is better than a Sanatorium or Hospital, it is of extreme value in an attempt to control the disease in view of the very long waiting period which is still necessary before admission to a Sanatorium or Hospital. Further an analysis since 1946 shows the great value of the scheme and very good results comparable with those obtained in hospital. This, of course, has involved a groat deal of extra work for the whole of the clinioal staff - doctors, health visitors and clerks. The London County Council has co-operated by supplying two ambulanoes a week for the transport of patients to and from the Clinic. Return relating to the work of the Dispensary for the six months ended 30th. Juno, 1948. PULMONARY NON-PULM: TOTAL Dofinito oases of T .B . on tho Register at the beginning of year 851 80 931 Transfers from other areas 24 - 24 Nov; oases diagnosed as Class T.B. Minus 53 - 53 Class T.B. Plus 44 - 4 4 Non-pulmonary - 11 11 Cases written off as Recovered 16 - 16 Doad (all oausos) 23 - 23 Moved to other aroas Definite cases of T.B, on the Register at Juno 30th 1948 52 - 52 881 91 972 A.P. Refills 1959 Total attendances 6003 X-ray exams. 5571 Homo visits by Health Visitors 1687 From July ^th 1948, the work of tho Tuberculosis Dispensary has passed from the control of the Borough Council to the Regional Hospitals Board. -29- TREATETIT & BATHING CENTRE Scabies and Verminous Treatment The cessation of the compulsory medical examination of Scabies contacts under the Scabies Order has caused a marked decrease in the treatments given for this disease at the above Centre. 11 Scabies medical sessions were held up to April 1st. 1948, when these were' discontinued, and 42 patients wore examined by the Medical Officer of Hoalth. Unfortunately, however, tho number of verminous cases dealt with was the highest for tho past six years, the major increase being amongst schoolchildren. Dislnfestation There has been an increase in the amount of verminous bedding. During tho year 73 consignments of bedding and soft goods from families rehoused in the Council* s now flats have been disinfestod. This has involved considerable oxtra work, particularly in view of the difficulties which have beon experienced In delays in the arrival of those consignments from removal contractors, and tho urgency for their immediate treatment and speedy return. 5 percent D.D.T. Insecticide solution has been continued throughout the year for the disinfo station of promises, and no failures have been reported. Infestations from cockroaches havo invariably been treated with ganmaxine. . Infoctious Disease Disinfection There has beon a slight decrease In the number of infoctious disease enquiries and disinfections dealt with at the Centre during the yoar. The large number of Scarlet Fever cases nursed at homo involved the personal attendant on the case in the maintenance of current disinfection, and washing of bod linen etc. In view of this the terminal disinfection has beon reduced to a minimum. No Smallpox or Typhus cases or oontacts have been reported in the Borough during tho year, nor have any oontacts from infected areas abroad arrived in this area. During tho year 29 demonstrations of work at the Centre have been given to approximately 212 students. Additional work has been caused in connection with enquiries, collection, disinfection, storage and disposal of effects of persons buriod by the Council in accordance with the National Assistanoo Act. 11 such cases have been dealt with by this Centre. -30- Treatment and Bathing Centre. Analysis of work carried out during the year. SCABIES AND VERMIN TREATMENTS SCABIES Males Females Total Lambeth oases 89 221 310 treatments 168 379 547 Southwark oases 87 190 277 trea time nts 159 356 515 L.C .C . Sohoolchildren 1070 Total Soabios treatments: 2132 VERMINOUS PERSONS Lambeth oase3 167 123 290 treatments 182 141 323 Southwark oases 278 258 536 treatments 279 265 544 L.C.C. Sohoolohildron 3101 Total Verminous treatments. 3968 Verminous Treatments Males Females Embankment Fellowship 151 219 New Kent Rd Salvation Army Hostel 91 (Hostel) 3 Rowtion House 91 Cooil Houg e Hostel 16 Marshalsea Rd» Common Elizabeth Baxter" 2 Lodging House 14 83 Blaokfriars Rd Hungerford Club 1 (Common Lodging Hse )43 Southwark oasualo Faotories and private 74 78 Camberwoll Rd, (Common Lodging Hse) 10 residents 39 Factories and priva residents te 323 TOTALS: 461 397 -31- TREATMENT OF VERMINOUS AND INFECTED ARTICLES. Verminous Verminous Infected icles treated. icles destroyed. icles treated. Beds 1.69 57 17 Palliasses 400 48 163 Bolsters 130 16 6 Pillows 643 72 304 Cushions 95 9 6 Blankets 1370 14 238 Sheets 360 11 20 Quilts 237 16 18 P ieces . 22821 905 55 VERMINOUS ROOMS SPRAYED (D.D.T.). 1,495 VERMINOUS HOUSEHOLD GOODS DESTROYED. 1 ton, 5 cwt, 84 lbs. INFECTED ROOMS SPRAYED (FORMALDEHYDE). 339 INFECTED ARTICLES DESTROYED. Nil HOSPITAL WARDS DISINFECTED. 30 ROOMS DISINFECTED BY REQUEST. (Tuberculosis. Measles, Cancer deaths, etc.) 79 LIBRARY BOOKS DISINFECTED. 185 INFECTIOUS DISEASE CASES DEALT WITH BY THE TREATMENT AND BATHING CENTRE . Total 568 as under: Scarlet Fever 248. Erysipelas 38. Poliomyelitis 2. Diphtheria 63. Dysentery 8. Corebro-spinal meningitis. 9. Scarlet Fever Cases kept at home: 171. -32- MATERNITY & CHILD WELFARE In consequence of the new National Health Service Act, tho whole of tho Maternity and Child Welfare services were transferred from tho Borough Council to the London County Council on July fth* 1948. Tho following report relates only to the period up to this date. NOTIFICATION OF BIRTHS Mothers Live Still Total confined births births bir ths. Born at Home and attended by- Midwifes 388 389 2 391 Private doctors 2 2 - 2 Born at Hospitals In the Borough 176 179 4 183 Outside the Borough 517 513 11 5 24 1083 1083 17 1100 Included in tho above wero 17 cases of twins. ERBMATURE INFANT S The number of premature babies notified during this period was as follows:- Outside Residing Born in Southwark in Southwark Born outside Southwark Residents Born In Southwark Born at Home 23 - - Born in Guy's Hospital 17 - 13 Born in Hospitals outside the Borough - 31 - Totals 40 31 13 BCRN AT HOME Died during first 24 hours - - - Died within 28 days 4 - - Survived at the end of first 28 days 19 - - BCRN IN HOSPITAL Died during first 24 hours - 3 - Died within 28 days 3 3 1 Survived at the end of first 28 days 14 25 12 40 31 13 BORN AT HOME Nursed entirely at homo 18 - - 33- DAY NURSERIES . There were three Day Nurseries unaer tne uontroi ox the Council in the Borough, and the following is a summary of the attendances up to July 5th 1948. Monday to Friday. Saturday Morning Total Attendances Daily Average. Mon. - Fri. Average Sat. Morn. BISHOP'S HOUSE 7711 321 8032 60.7 12.8 ST . GEORGE 1S 5539 225 5764 43.6 9.0 CROS S'TAYS 4654 162 4816 36.6 6.5 Tot als. 17904 708 18612 FLAY CENTRES. Owing to the poor attendances at the part time Centres (an average of only 4 attendances per session), it was decided to transfer these centres to Sutherland House. These transfers took place 26th January 1948 in the case of Villa Street Centre, and 2Cth February 1948 in the case of Focock Street Centre. Sutherland House rlay Centre. This Centre was opened to assist the appeal by the Government for part-time women workers. As from 26th January, 1948, afternoon sessions only were held but a full-time basis oame into operation on 1st March, 1948. The total number of sossions held up to 5th July, 1948 v/as 199 with 5056 toddlers attending. This represents an average attendance of 25.4 per session. SOLARIUM. 436 expectant and nursing mothers, and children under five years received treatment in the Solarium. The total number of attendances was 2,4C0. GYNAECOLOGICAL CLINIC . 13 Sessions were held and 104 patients seen by the Specialist, who gave advice and arranged treatment where necessary. This represents an average attendance of 8 patients per session. -34- DENTAL CLINIC . Expectant cz Nursing Mothers. Pre-Sohool Children . Total. Attendanc es 400 308 708 New Patients 91 90 181 Fillings in Teeth 66 73 139 Scalings 23 - 23 Local Anaesthesia 85 5 90 General " - 44 44 Teeth extracted. 172 58 230 Upper Dentures fitted 12 - 12 Lower " 9 - 9 Repairs 7 - 7 Dressings 10 4 14 Advice 119 146 265 Miscellaneous visits 94 - 94 CHILD LIFE PROTECTION. Up to July 5th, there were 14 registered Foster Mothers and 14 Foster Children. The Health of the children was good, except for occasional minor ailments. Ill visits were paid to Foster Mothers and to the Schools which some of the older children attend. HOME NURSING. The nursing of sick children and home confinement cases and infectious disease was undertaken by the following Associations. The number of visits made was as follows: - Catholic Nursing Association. 655 Southwark, Newington and Ranyard Nurses ; 71 Walworth District Nursing Association. 714 Total visits 1440. HOME HELPS. Owing to the large increase in th6 number of requests for Home Help assistance, a full time Home Help Organiser was appointed early in the year. Much progress was made both In the recruitment of additional Home Helps, and also the number of cases assisted. At the end of the above period, there were 16 full time and 13 part time Home Helps: 66 cases were dealt with, and the average total hours assistance per week was 595. CONVALESCENT TREATMENT. 14 mothers and 21 children were sent for treatment under the Women's Country Holiday Fund Scheme, and 29 children through the Invalid Children's Aid Association, EXTRA NOURISHMENT . The Invalid Kitchens of London, undor arrangements made with tho Council, supplied 122 dinners to children, necessitous, expectant and nursing mothers, upon the recommendation of the Council's Medical Officers. I w cn I • INFANT WELFARE CENTRES (to 5th July 1948). Centre Numbe r cf sessions ATTENDANCES IsEEN BY DOCTOR Under 1 1 to 5 Total Under 1 1 to 5 Total. Pocook Street 61 2574 721 3295 738 228 966 Lambeth Road 26 1081 213 1294 197 56 253 Salomons Centro 47 1196 714 1910 392 350 742 Cro ssways 26 1132 552 1684 354 189 543 Health Services 109 3704 1470 5174 531 197 728 Sutherland House 57 3067 903 3970 482 215 697 Villa Street 75 3186 636 3822 776 170 946 TOTAL 401 15940 5209 21149 3470 1405 4875 AVERAGE ATTENDANCE PER SESSION Pocock Street 42.19 11.82 54.01 12.09 3.74 15.83 Lambeth Road 41.58 8.19 49.77 7.58 2.15 9.73 Salomons Centre 25.45 15.19 40.64 8.34 7.78 16.12 Crossv/ays 43.54 21.23 64.77 13.62 7.27 20.89 Health Services 33.98 13.49 47.47 4.87 1.81 6.68 Sutherland House 53.81. 15.84 69.65 8.46 3.82 12.28 Villa Street 42.48 8.48 50.96 10.35 2.27 12.62 -36- MATERNITY CLINICS. During tho period 282 Sossions wore hold with total attendances of 4399, Now Cases Re-attendancos Post-Natal Oases Total Pocook Street. 157 494 6 657 Guy's Hospital. 272 1869 191 2332 Health Services Dept. 128 424 31 583 Sutherland Houso. 121 311 16 448 Villa Street. 113 230 36 379 791 3328 280 4399 VISITS MADE BY HEALTH VISITORS. Original - under 1 year. 1100 Post-natal. 164 Revisits - undor 1 year. 7409 Measles. 1013 Revisits - over 1 year. 8857 Diarrhooa 26 Original - ante-natal. 1155 Tuberculosis. 175 Revisits - ante-natal. 644 Whooping Cough. 154 Ophthalmia Neonatorum. 9 Puorporal Sepsis 3 Child Life Protection. 111 Othor visits. 320 Housing and Sanitary. 156 Total. 21296 VACCINATTON. Tho Vaccination Acts wero ropealod by tho National Hoa 1th Service Act, 1946. Up to tho 5th. July, 1948, 689 children wore vaccinated. REPORT OF THE LADY ALMONER. During the six months to tho ond of June, 1948, a considerable number of mothors and babies were sent away, some with two or moro children, and arrangements were made, when necessary, for tho supply of invalid dinners to the aged sick, expectant and nursing mothors, and any other person in the Borough who would havo bonofitod by tho service. Constant enquirios wore roceivod for Day Nursery vacancies, and the numbers on tho waiting list incroasod steadily. A considerable amount of Care work was done in connection with the Tuberculosis Dispensary, and help was obtained from voluntary sourcos, and grants, whon nocossary, wore made from tho Care Committoo Fund. -37- REPORT OP PUBLIC ANALYST j ANALYSES OP SAMPLES - POOD & DRUGS ACT, 1938. j Samples Examined. Aduleteratod etc. P0rmal Informal Formal Informal Milk 241 12 1 - Designated Milk - 37 - 5 Condensed Milk - 13 - - Butter, Margarine, Lard 57 69 - - Meat oc Pish Preparations 96 146 3 10 Flour & Cereal Preparations 132 160 2 8 Tea, Coffee, & Cocoa 63 62 2 2 Vinegar 19 34 - 1 Sweets & Chocolate 49 54 1 - Spices & Condiments 59 62 2 - Plcklcs'cc Sauces 58 73 3 3 Jams & Preserves 41 34 1 2 Wines, Spririts & Beverages 25 129 2 6 Drugs & Medicinal Preparations 22 86 - 4 Miscellaneous Samples. 56 74 2 4 918 1045 19 45 WATER SUPPLY. Tho domestic water of the Borough is supplied by tte Metropolitan Water Board. During the year there havo been no complaints regarding quality or quantity. MASS RADIOGRAPHY. The London County Council Mobile Unit for Mass Miniature Radiography was again operating from the South Eastern Hospital, New Cross, from September until the end of the year, and local business organisations were invited to afford their employees facilities for this examination. The Department arranged appointments and provided free transport for the examination of over 1500 persons working in the Borough.