LIBRARY Sou 59 METROPOLITAN BOROUGH OF SOUTHWARK Annual Report OF THE Medical Officer of Health FOR THE YEAR 1949 W. STOTT, M.B., B.S., D.P.H. Medical Officer of Health CONTENTS VITAL STATISTICS Pages 4 INFECTIOUS DISEASES 8 TREATMENT & BATHING CENTRE 11 SANITARY CIRCUMSTANCES 11 „ 33 FOOD 20 HOUSING 30 NATIONAL ASSISTANCE ACT pa??? BOROUGH OF SOUTHWARK Public Health Department, . Walworth Road, S.E.17. The Mayor, Aldermen and Councillors, Metropolitan Borough of Southwark. Your Worship, Ladies and Gentlemen, I have the honour to submit my Annual Report for the year 1949. This is the first printed report for several years, and although it contains all necessary information it remains in somewhat abridged form. Personally, however, I feel no regret at the loss of those formidable tomes of minute detail which were the conventional annual reports in days when money and manpower were in greater abundance, and I think it would be an advantage if the present limits were adopted as a permanent standard. Although statistics reveal disturbing prospects by the increasing population in this already heavily overcrowded area, the diminution of the birth rate which may conceivably result in a nation of old people with an ever dwindling younger generation, and the continued acute distress of the housing problem, the following pages also reveal a gratifying decline in the toll of infectious diseases and a year of most satisfactory achievement in the work of the Sanitary Inspectors. In this first full year of the working of the National Health Act since the transfer of powers in 1948, there has been overwhelming proof of the necessity which I mentioned in my last report that "... the Medical Officer of Health and the Public Health Department must continue to fulfil an indispensable function as liaison agents between the public and the new responsible bodies." This, however, does not infer that the Public Health Department is merely a centralised enquiry bureau ; indeed, the loss of the transferred services has been supplemented by other duties and increased legislation, and there is no sign whatever, as some said in 1948, that the Public Health Departments would have nothing left to do. Certain serious defects still exist in the new Health Act, particularly in regard to the care and welfare of aged and infirm persons and the confusing division of responsibilities for certain medical services ; there should be no need to upset the scheme as a whole in order to rectify those parts of it which are in such urgent need of improvement. 2 The following pages contain more detailed comments on th work of the separate sections of the Department, and i conclusion I must again express my appreciation to all Member of the Council, the staff of the Public Health Department, ant Chief Officers and staffs of other Departments of the Council for their unfailing support and co-operation during the year I have the honour to be; Your obedient servant, W. STOTT, Medical Officer of Health 3 PUBLIC HEALTH COMMITTEE (As at December 31st, 1949). Chairman—Alderman A. J. Gillian. Aldermen : Mrs. E. L. Maddison. J. F. Stroud. Rev. H. Runacres, k.a. L. .J. Styles, j.p. (Ex Officio) Councillors : A. Barnes. J. Booker. Mrs. G. Charles. K. Farrow. Mrs. M. Hodges. D. Low (Ex Officio) Mrs. G. Luetchford. H. Ray. J. Sheen. H. Stillman. Mrs. M. Wright. E. Bartlett. C. Carley. G. Darvell. J. Habbor. J. Keen. Mrs. C. Martin. E. Ridge. Miss F. Stroud, j.p. (Ex Officio) Mrs. G. Styles. G. Young. Ex Officio: Councillor Mrs. C. Gates, j.p.—Mayor. PUBLIC HEALTH DEPARTMENT OFFICERS, 1949 Medical Officer of Health: W. StOTT, m.b.. U.s., d.p.h. Chief Sanitary Inspector: G. H. E. Duffield. Sanitary Inspectors: District Inspectors: Clark, K. Drinkwater, P. (from December, 5th). Halstead, K. Jones, Miss A. (to October, 31st). Kirrage, G. (from June 7th). Lassman, S. (to November, 6th). Paine, J. Rivett, L. Robinson, G. (from June 13th). Steele, H. Syms, J. Warboys, R. Food Inspectors: Johnson, A. Stubbs, G. Housing Act Inspectors: Hattersley, H. Adamson, E. Rodent Control: Jenkins, t. Ross, Mrs. H. (Temporary). Smith, Mrs. B. (Temporary). Assistant to Inspectors: Senior Clerk: E. A. Clark (from March 15th. Formerly F. Spearing). Clerical Staff: Infectious Diseases: Irvine, D. (from July 19th). Housing : Tompkins, J. (Transferred to Sanitary Inspectors, December, 19th). Sanitary Records: Biggins, W. (to October, 24th). Cass, Miss W. (from October 24th—Temporary). Davies, E. (Temporary). Robertson, J. Rose, R. (to October 18th). Stevens, R. (from October 31st). Worden, R. Shorthand Typist: Sutherland, J. Junior: Connor P. (from May 2nd— Temporary). Treatment and Bathing Centre : Axtell, Miss E. Mortuary Attendant: West, H. Halllceepers: Witten, R. Bishop, W. 4 VITAL STATISTICS The local birth rate continues to decrease and there is but a small increase in the number of deaths. Nevertheless the estimated population again shows a very substantial increase The infant death rate continues its downward trend but unfortunately, despite the fewer births during the year, the still birth rate was higher than in 1948. Area 1,132 acres Estimated Number of Dwellings 23,473 Rateable Value—(Approximate) £1,021,830 Population: Estimated 99,795 Registrar General's estimate 96,810 Estimated population, 1948 97,000 1949 1948 Live Birth Rate per 1,000 population 19.5 21.7 Still Birth Rate per 1,000 total Births 27.1 17.1 Death Rate per 1,000 population 13.0 12.8 Maternal Death Rate per 1,000 live and still births: Puerperal Sepsis Nil 0.47 Other Puerperal causes 1.0 0.95 Infant Death Rate: All infants per 1,000 live births 28.9 36.8 Legitimate infants per 1,000 live legitimate births 25.6 37.6 Illegitimate infants per 1,000 live illegitimate births 71.4 26.5 Estimated Population Birth Rate Death Rale Infant Death Rate Legitimate Illegitimate Total Still Birth Rate 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 145,300 141,120 101,900 69,740 66,480 68,470 67,220 71,160 86,280 92,070 94,630 96,810 14.0 14.0 17.3 15.9 19.2 18.3 19.4 18.3 24.3 26.4 21.7 19.5 12.5 13.9 24.1 27.5 18.9 18.8 21.7 16.1 15.7 15.6 12.8 13.0 57 47 48 82 60 48 51 43 45 38 38 26 66 38 68 59 76 62 57 57 62 60 26 71 57 47 49 80 61 49 51 39 46 39 37 29 32.0 30.8 28.6 34 31.1 24.1 24.7 26.1 25.6 26.1 17.1 27.1 5 Leqitimate Illegitimate Totals Male Female Total Male Female Total Male Female Total Live Births 1948 1,012 898 1,910 73 78 151 1,085 976 2,061 1949 900 857 1,757 80 60 140 980 917 1,897 Still Births 1948 17 2 19 13 4 17 30 6 36 1949 29 19 48 2 3 5 31 22 53 Infant deaths fiinriar 1 voar) (unaer 1 year) 1948 40 32 72 1 3 4 41 35 76 1949 30 15 45 4 6 10 34 21 55 DEATHS Male and Female Age Groups. Under 1 1-4 5-14 15-44 45-64 65 and over Total Males 34 3 8 61 195 402 703 Females 21 3 4 43 107 380 558 55 6 12 104 302 782 1,261 Infant Mortality. The total number of deaths of infants under one year of age was 55, the causes of death being as follows: Influenza 1 Pneumonia 6 Diarrhoea 3 Other digestive diseases 1 Premature birth 11 Congenital malformations and birth injuries 29 Other violent causes 3 All other causes 1 Total deaths under 1 year of age 55 Maternal Mortality. The deaths of two women due to causes other than puerperal sepsis were recorded during the year. Cancer deaths 231 Whooping Cough deaths 1 Measles deaths 1 Diarrhoea (under 2 years) deaths 3 6 CLASSIFICATION OF DEATHS Causes of Death Total Deaths 1948 Total Deaths 1949 Age Groups :—1949 0— 1— 5— 15— 45— 65— All Causes Males 664 703 Females 550 558 Typhoid and Paratyphoid Fever – – Cerebro-Spinal Fever 4 – Scarlet Fever – – Whooping Cough 3 1 1 Diphtheria 1 – Tuberculosis of Respiratory System 81 60 21 26 13 Tuberculosis—other forms 5 6 2 3 1 – Syphilitic Disease 9 8 1 5 2 Influenza 2 16 1 1 2 4 8 Measles 4 1 1 Acute Poliomyelitis and Polioencephalitis 1 2 1 1 Acute Infectious Encephalitis 2 2 2 Cancer of Buccal Cavity and (Esophagus (Males) and Uterus (Females) 21 24 2 9 13 Cancer of Stomach and Duodenum 35 39 1 17 21 Cancer of Breast 22 14 4 3 7 Cancer of all other sites 144 154 12 47 95 Diabetes 7 5 1 4 Intra-cranial Vascular Lesions 105 110 1 24 85 7 Classification of Deaths (continued) Causes of Death Total Deaths 1948 Total Deaths 1949 Age Groups :—1949 0— 1— 5— 15— 45— 65— Heart Disease 304 347 13 60 274 Other Diseases of the Circulatory System 54 63 3 18 42 Bronchitis 113 108 29 79 Pneumonia 67 75 6 1 3 10 55 Other Respiratory Diseases 12 11 1 3 7 Ulceration of the Stomach or Duodenum 9 19 3 8 8 Diarrhoea (under 2 years of age) 6 3 3 Appendicitis 4 2 2 Other Digestive Diseases 24 24 1 4 7 12 Nephritis 21 15 1 5 9 Puerperal and Post-abortive Sepsis 1 – Other Maternal Causes 2 2 2 Premature Births 15 11 11 Congenital Malformations, Birth Injury, Infantile Diseases 31 36 29 2 5 Suicide 9 8 6 2 Road Traffic Accidents 10 3 1 1 – 1 Other Violent Causes 25 28 3 2 1 6 3 13 All other Causes 61 64 1 – 7 9 13 34 Totals 1,214 1,261 55 6 12 104 302 782 8 INFECTIOUS DISEASES The final corrected diagnoses of infectious disease cases in this borough during 1949 was nearly 400 less than in 1948, and the lowest for at least four years. Diphtheria cases were the fewest for this same period, and the decline of Scabies continued, to almost negligible proportions. Measles figures were considerably less than in 1948, though more than the previous year; Whooping Cough, however, also decreased appreciably in comparison with the past two years. There was one death each from these two latter diseases (both un-notified cases) compared with four Measles deaths and three from Whooping Cough in 1948. After a lapse of Poliomyelitis last year—with only one case following the 26 in 1947—this disease claimed 14 confirmed cases during 1949; as in 1948, there was again one death. The most detailed investigations were made into each case, but there appeared to be no tangible clue as to the source of infection or any connecting link between the cases. During the year, one case each of suspected Anthrax and Smallpox were notified, but fortunately neither of these was confirmed. One case each of Food Poisoning and Paratyphoid, and 10 of Dysentery, amongst the younger age groups, were also confirmed, but it was not possible to define the causes with any certainty. All manner of usually suspect foods appeared in the reports on these cases, but rarely was there any identical factor, and analysis of the food (when practicable after the time lag of calhng in the doctor and receipt of the notification) was invariably negative. The full results of the extensive Diphtheria immunisation propaganda of recent years are now evident in that only two of the confirmed cases in 1949 had been previously immunised. Both these cases were in children under five years of age. Of the 131 confirmed Whooping Cough cases, only 23 were patients who had been previously immunised against this disease, and in all these instances the attacks were mild. IMMUNISATION I mmunisation completed Whooping Cough Diphtheria Combined Conf irmed diagnoses of previously Immunised Whooping Cough Diphtheria Under 5 years of age 20 445 1,205 17 2 Over 5 ,, ,, ,, 2 785 – 6 – Total 22 1,230 1,205 23 2 Total 2,457 Total 25 9 Summary of notifications, age groups of confirmed cases, and hospital admissions. Disease Cases notified Rem. to Hospital CONFIRMED DIAGNOSES Age groups:—1949 Total 1948 Total 1949 0— 1— 3— 5— 10— 15— 20— 25— 35— 45— 55— 65— 75— Anthrax 1 1 – – Cerebro-spinal meningitis 6 6 6 2 1 1 Diphtheria 46 46 33 13 3 2 1 1 3 1 2 Dysentery 12 8 13 10 2 3 4 1 Enteric Fever 1 1 – – Erysipelas 17 8 41 16 2 1 2 7 1 2 1 Food Poisining 10 – – 1 1 Malaria (Induced) o 1 2 2 2 Measles 950 27 1,166 948 62 376 271 231 5 1 1 1 Ophthalmia Neonatorum 15 14 9 15 15 Paratyphoid 2 2 – 1 1 Pneumonia 41 5 60 41 2 2 5 2 1 1 3 7 5 7 4 2 Poliomyelitis 22 22 1 14 2 7 1 1 2 1 Puerperal Pyrexia 13 13 12 12 3 2 6 1 Scabies 38 – 95 38 2 3 5 5 5 9 5 1 2 1 Scarlet Fever 220 85 242 209 2 26 48 103 19 3 2 3 1 2 Smallpox 1 1 – – Whooping Cough 132 23 310 131 24 47 21 34 3 1 1 *Zymotic Enteritis 29 25 23 25 19 4 1 1 Totals 1,558 288 2,013 1,478 128 471 353 380 36 13 18 24 20 15 8 8 4 (*Notifiable from July to September only). 10 SUMMARY OF DEATHS FROM INFECTIOUS DISEASES Disease Age groups :— Total 0- 1- 5- 16- 25- 35- 45- 55- 65- 75- Measles : notified cases un-notified cases 1 1 Whooping Cough: notified cases un-notified cases 1 1 Cerebro-spinal Meningitis notified cases 1 1 Pneumonia: notified cases 1 21 un-notified cases 2 5 10 3 Poliomyelitis: notified cases 1 1 un-notified cases Totals: notified cases 1 1 1 3 un-notified cases 2 2 5 10 3 22 2 3 1 6 10 3 25 Totals—1948: notified cases 6 2 1 1 10 un notified cases 4 2 1 1 1 4 1 3 20 10 4 2 3 1 1 4 2 3 30 The above statistics are from death returns in respect of the year 1949. In some cases these include deaths which occurred or were registered during the previous year; similarly some deaths occurring or registered in 1949 will be shewn in the 1950 returns. TUBERCULOSIS The functions of the Dispensary are now divided between the Regional Hospital Board (clinical administration), Public Health Department (notifications) and the L.C.C. (Health Visitors). The most cordial co-operation has been maintained between these sections. 1'ulmonary Non-Pulmonary ♦Notified cases, 1949 (including transfers, posthumous and primary notifications) Deaths from Tuberculosis during 1949 of notified * cases ... Cases moved away, recovered, etc. Notified cases remaining at end of 1949 ... 257 65 111 1,077 16 4 12 172 11 There was a slight decrease in notifications of, and deaths from, Pulmonary Tuberculosis. Non-Pulmonary notifications and deaths showed practically no change from the previous year, although notifications were 22 less than in 1947. Aoe Grouvs 0– 1– 5– 10– 15– 20– 25– 35– 45– 55– 65– Total Pulmonary: Primary Notifications M. 1 3 2 2 13 13 24 17 18 20 7 120 F. 1 3 2 3 16 11 13 6 3 4 2 64 New cases other than by formal notification. M. – 1 – – – 7 8 6 5 7 3 37 F. – 1 – – – 10 12 6 – 3 4 36 Totals 1949 2 8 4 5 39 41 57 35 26 34 16 257 1948 2 9 8 7 34 62 59 32 20 21 16 270 Deaths: Notified cases M. – – – – – 2 2 7 11 11 7 40 F. – – – – – 2 1 5 2 1 3 14 Un-notified cases. M. – – – – – – – – 1 1 2 4 F. – – – – – – 1 1 – 2 3 7 Totals 1949 – – – – 4 4 13 14 15 15 65 1948 1 1 1 – 3 8 14 14 12 15 16 85 Non-Pulmonary: Primary Notifications M. – 1 – – – 1 – 1 – – 1 4 F. – 1 – 1 – 2 1 – 1 – 1 7 New cases other than by formal notification. M. – – 1 – – 1 – – – – – 2 F. – – 1 1 – – 1 – – – – 3 Totals 1949 – 2 2 2 – 4 2 1 1 – 2 16 1948 – 2 3 1 6 2 3 1 – – – 18 Deaths : Notified cases" M. – – 1 – – 1 1 – – – – 3 F. – – 1 – – – – – – – – 1 Un-notified cases. M. – – – – – – – – – – – – F. – – – – – – – – – – – – Totals 1949 – – 2 – – 1 1 – – – – 4 1948 – – – – – 1 1 – – – 1 3 TREATMENT & BATHING CENTRE The work of disinfection and disinfestation carried out at the above Centre was again extensive, involving as it does not only the treatment of infectious and verminous premises, but 12 also medical bath treatments for Scabious and verminous persons and schoolchildren from both Southwark and Lambeth. The Scabies treatments, of course, are fast decreasing, and although the treatments for verminous persons were less than in 1948, there were substantial increases both of verminous bedding and verminous rooms disinfested, as well as of the quantity of goods destroyed. In addition to a large quantity of unwanted household articles, usually dirty or verminous, which were removed and destroyed by this section, there were 96 cases during the year where the entire effects of persons who had died or been removed to institutions, etc., had to be destroyed. This entailed a considerable amount of work in the complete stripping and disinfestation of the rooms and articles, and sorting of the various items prior to removal and destruction. In many of these instances there were considerable quantities of filthy rubbish—paper, rags and various odd collections—all of which had to be carefully examined, before destruction, for any articles or documents of value. The Superintendent of the Treatment and Bathing Centre investigates most cases of infectious diseases where disinfection is involved, and although the number of infectious diseases generally was fewer than in 1948, his total visits showed little change. These cases often necessitated more than one visit; the Smallpox and Anthrax cases notified during the year alone accounted for numerous inspections in the investigation and supervision of contacts, whilst several instances of persons arriving in this Borough by air from Smallpox areas abroad or Smallpox infected vessels also entailed much time in periodical visiting. A considerable amount of work is also concerned with enquiries into cases for burial under the National Assistance Act, and the disinfection, storage and sale, disposal or destruction of the effects of these persons. Demonstrations of the work of this Station are always in frequent demand, and during 1949, 23 such sessions were arranged for approximately 160 students. Analysis of work carried out durinq the year: Verminous Rooms Sprayed (D.D.T.) 2,079 Verminous Household Goods Destroyed 3 tons, 3£ cwts. Infected Rooms Sprayed (Formaldehyde) 229 Infected Household Goods Destroyed Nil Hospital Wards disinfected 56 Common Lodging Houses disinfected 18 rooms Rooms disinfected by request (Tuberculosis, Measles, Cancer deaths, etc.) 97 Trade goods disinfected (steam) 520 mattresses, 12 sacks hair, 280 Service jackets, Library books disinfected 130. 13 Infection Disease Cases Dealt with by The Treatment & Bathing Centre. Total—301 as under: Scarlet Fever 219 Erysipelas 16 Diphtheria 50 Dysentery 2 Enteritis 2 Smallpox 1 Poliomyelitis 1 Meningococcal infections 8 Typhoid 2 Scarlet Fever cases kept at home : 139 Smallpox Revisits : 32 Treatment of Verminous and Infected Articles. Verminous articles treated Verminous articles destroyed Infected articles treated Infected articles destroyed Beds 295 78 12 2 Palliasses 1,207 71 92 2 Holsters 275 29 10 – Pillows 1,186 84 189 – Cushions 236 20 6 – Blankets 1,528 41 233 – Sheets 579 19 61 – Quilts 553 16 34 – Pieces 16,719 1,133 130 11 Scabies and Vermin Treatments. Scabies Vermin • Males Females Males Females Lambeth cases. 44 83 21 127 treatments 75 164 25 149 Southwark cases 44 120 427 254 treatments 100 241 429 259 L.C.C. Schoolchildren (Male and Female) 461 2,914 Total treatments 1,041 3,776 Verminous Treahnent from Hostels, Common Lodging Houses, etc. Males: Females : Salvation Army Hostel 89 83, Blackfriars Road 50 Rowton House, Churchyard Row 122 78, Camberwell Road 9 Cecil House 4 Rowton House, Vauxhall 4 Elizabeth Baxter Hostel 1 Marshalsea Road Common Lodging House 23 Hungerford Club 2 Southwark casuals 3 Hungerford Club 4 Factories and private residents 339 Southwark casuals 169 Factories and private residents 43 Totals 454 408 14 SANITARY CIRCUMSTANCES OF THE AREA The improvement during the year in the previous serious staffing difficulties of the Sanitary Inspectors' Department is reflected in a very considerable increase in the work of this section. The following details represent over 1,600 more inspections of drainage and complaints, and 1,500 more visits to food premises than in 1948, whilst the total of works completed shews an increase of 670 over the previous year. SUMMARY OF INSPECTIONS CARRIED OUT DURING THE YEAR Inspections upon receipt of complaint 6,181 Drainage and miscellaneous inspections 3,653 Inspection of Factories 319 Inspection of Outworkers 52 Inspection of Common Lodging Houses 39 Rehousing visits 2,298 Housing Act Inspections 1,009 Smoke Observations .14 Rodent visits (Sanitary Inspectors) 333 Inspection of Slaughterhouses 4 Inspection of Offensive Trades Premises 30 Inspection and food sampling visits, shops and markets 1,636 Inspection and sampling visits, Catering and Ice Cream Premises 840 Inspection of food at Wharves and Warehouses 1,319 Visits to Bakehouses 115 Visits to Fried Fish Shops 37 Visits to Fish Curers'premises 11 Revisits 18 189 NOTICES Intimation Notices served 3,579 Statutory Notices served 1,414 Defects in Council controlled property reported to Housing Manager 169 Notices complied with 3,397 RENT & MORTGAGE INTEREST RESTRICTIONS ACTS, 1920-1939 Sixty-one certificates as to the state of repair of dwelling houses were issued during the year under the above Acts. COMMON LODGING HOUSES There are four women's and two men's common lodging houses in the Borough, which are fully occupied nightly. Thirty-nine inspections of these premises were made by the Sanitary Inspectors during the year, 14 of men's lodging houses and 25 of women's. 15 SMOKE During the year 14 observations have been carried out by the Sanitary Inspectors. Considerable concern has been felt at the constant serious nuisance of atmospheric pollution by smoke. It is gratifying to record that representations made earlier to the Ministry of Fuel were successful, and despite the difficulties involved, a more suitable type of coal was made available for industrial and other large scale plant. Whilst this certainly resulted in some improvement, the problem is still an acute one, and during the year under review the Council agreed to suggestions for the installation of measuring and recording apparatus at three sites in the Borough—Walworth Road, Borough High Street, and Bankside. The selection of these sites and the standardised equipment— comprising deposit gauges, lead peroxide instruments, volumetric apparatus and smoke filters—was approved by the Fuel Research Station, Greenwich, from which the apparatus was obtained. The installations will be put into operation on January 1st, 1950. RODENT CONTROL This work has been maintained with the fullest vigour; the following summary of its activities during the year represents an increase of 4,000 visits over the previous year. Domestic Business Visits by Sanitary Inspectors 325 8 Visits by Rodent Officer 448 160 Visits by Rodent Investigators 6,839 1,824 Visits by Rodent Operatives 4,996 2,272 Drains tested 427 54 Drains defective 55 16 Drains repaired 20 3 Drains opened for examination 11 – Premises infested 1,222 334 Premises cleared 792 334 Prebaits laid 2,119 15,902 Poison baits 6,322 5,460 Bodies recovered 254 554 Two maintenance treatments were carried out in June and November at approximately 800 manholes. OFFENSIVE TRADES There are seven premises engaged in offensive trades in the Borough as follows :— Fellmongers, 5—Tripe Boiler, 1—Soap Boiler, 1. During 1949, 30 inspections were made and one notice served. 16 WATER SUPPLY The domestic water supply of the Borough is supplied by the Metropolitan Water Board, and has been satisfactory in quality and quantity. During the year, three complaints were received regarding the taste of water. The Metropolitan Water Board was informed and samples analysed, but in each instance they were found to be satisfactory. Public Health (London) Act, 1936 - Section 95 Certificates have been issued in respect of the provision of a proper and sufficient supply of water at 381 new dwellingw as follows :— St. Peter's House, Queens Row, S.E.17 30 flats Innis House, Alvey Mews, S.E.17 29 „ Bramwell House, Rockingham Estate, S.E.1 57 ,, Conant House, St. Agnes Place, S.E.17 20 ,, Longridqe House, Rockingham Street, S.E.1 86 ,, Conant House, St. Agnes Place, S.E.17 56 ,, Avery House, Red Cross Way, S.E.1 4 ,, Babinoton House, Red Cross Way, S.E.1 20 ,, Doddinqton Grove Flats, Doddington Grove, S.E.17 24 ,, Tabard Street S.E.1 3 ,, Martin House, Rockingham Estate, S.E.1 52 ,, Public Health (London) Act, 1936 - Section 98 During the year 77 notifications of the withdrawal of water supply were received from the Metropolitan Water Board. FACTORIES Three hundred and nineteen inspections of Factories were made during the year, and 53 notices were served. There are now 842 factories of all types on the register, comprising 215 factories without mechanical power, and 627 factories with mechanical power. 17 Inspections. Premises Number on Register A umber of:— Inspections Notices Prosecutions (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 215 58 14 – (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 627 260 39 – (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding outworkers premises) – 1 – – Total 842 319 53 – Defects found and remedied. No. of cases in which defects were :— Particulars found remedied referred to H.M. Insp. referred by H.M. Insp. Prosecutions Want of cleanliness (Si) 29 10 – – – Overcrowding (S2) – – – – – Unreasonable temperature (S3) – – – – – Inadequate ventilation (S4) 6 4 Ineffective drainage of floors (S6) – – – – – Sanitary Conveniences (S7) (a) insufficient. 5 – – – – (b) unsuitable or defective 40 29 (c) not separate for sexes – – – – – Other offences against the Act (not including offences relating to Outwork) 18 5 Total 48 – – – OUTWORKERS Fifty-two inspections and 25 revisits of homes of outworkers were made during the year. The conditions generally were found to be quite satisfactory. There were no cases of default in sending lists of outworkers to the Council, nor was it necessary to serve any notices or institute any prosecutions for work carried on in unwholesome premises (Sec. 111). 18 Nature of work No. of outworkers in August list required by Section 110 (1) (c) Wearing Apparel Making, etc. 81 Cleaning and washing Household Linen – Lace, lace curtains and nets 1 Curtains and furniture hangings – Furniture and upholstery – Electro-plate – File making – Brass and brass articles – Fur pulling – Iron and steel cables and chains – Iron and steel anchors and grapnels – Cart gear – Locks, latches and keys – Umbrellas, etc. – Artificial flowers – Nets, other than wire nets – Tents – Sacks – Racquets and tennis balls – Paper bags 11 The making of boxes or other receptacles or parts thereof made wholly or partially of paper 80 Brush making– Pea picking – Feather sorting – Carding, etc., of buttons, etc. – Stuffed toys – Basket making– Chocolates and sweetmeats – Cosaques, Christmas crackers, Christmas Stockings, etc. 14 Textile weaving – Lampshades – Total 187 PUBLIC HEALTH (LONDON) ACT, 1936— LEGAL PROCEEDINGS Defendant Bisley & Sons, 284,'Jamaica Road, London, S.E.16. Offence Failure to abate a nuisance at : 24, Ripley Street. Result W ork done, summons withdrawn on payment on £1 Is. costs. Mr. J. J. Grimes, 82, Vassall Road, London, S.W.9. Failure to abate a nuisance at : 85, Gurnev Street. Adjourned sine die 2nd June. Work in progress. F. Butler & Partners, Robert Adam Street, London, W.C.l. Failure to abate a nuisance at : 20, Albany Road. Adjourned to 5th May. Work now completed. Mrs. M. Kerrigan, 77, Mann Street, London, S.K.I7. Failure to abate a nuisance at : 103, Mann Street. Abatement order 28 days. £2 2s. costs. 19 Defendant Offence Result Mrs. Vincent, 1, Tadworth Road, London, N.W.2. Failure to abate a nuisance at: 114, Westmoreland Road. Adjourned sine die on payment of £1 1s. costs. Work completed. Charles Benabo & Co., 3, St. Stephens Parade, London, S.W.I. Failure to abate a nuisance at : 161, Boyson Road. Adjourned sine die on payment of £1 1s. costs. Work completed. Mr. Fisher, 37, Aldred Street. London, S.E.I7. Failure to abate a nuisance at : 40, Royal Road. Adjourned sine die on payment of £1 1s. costs. Work completed. Mr. E. J. J. Lane, 92, Newington Causeway, London, S.E.I. Failure to abate a nuisance at : 81, Gurney Street. Summons withdrawn on payment of £1 1s. costs. Work completed. Mr. Rex worthy Warren, 74, Henshaw Street, London, S.E.17. Failure to abate a nuisance at : 74, Henshaw Street. Abatement order 14 days. Charles Benabo & Co., 3, St. Stephens Parade, London, S.W.I. Failure to abate a nuisance at : 124, Trafalgar Street. Summons withdrawn on payment of £1 1s. costs. Work done. Charles Benabo & Co., 3, St. Stephens Parade, London, S.W.I. Failure to abate a nuisance at : 150, Westmoreland Road. Summons withdrawn on payment of £1 1s. costs. Work done. Mrs. Kerrigan, 77, Mann Street, London, S.E.17. Failure to comply with an Abatement order on 103, Mann Street. £1 fine. £2 2s. costs. Mr. Rex worthy Warren, 74, Henshaw Street, London, S.E.17. Failure to comply with an Abatement order on 74, Henshaw Street. £2 2s. fine. Mrs. Egan, 161, Kennington Park Road, London, S.E.I 1. Failure to abate a nuisance at:161, Kennington Park Road. Adjourned sine die. Work in progress. Miss E. M .Ansley, 3, Ringford Road, London, S.W.I8. Failure to abate a nuisance at:33, Tamerton Street. Abatement order 28 days, £3 3s. costs. J. S. Millborow, 17, Wellesley Road, Ilford, Essex. Failure to abate a nuisance at 30, Shorncliffe Road. Adjourned sine die. Richard Oughton, 340, Brixton Road, London, S.W.9. Failure to abate a nuisance at:115, Hillingdon Street. Nuisance order 14 days. £2 2s. costs. 20 Defendant Offence Result Mrs. M. Kerrigan, 77, Mann Street, London, S.E.17. Failure to comply with Abatement order on 103, Mann Street. Fine £2. £1 1s. costs. Mr. E. G. Powell, T/A. W. H. King, 64, Surrey Square, London, S.E.17. Failure to abate a nuisance at:26, Runham Street. Adjourned sine die. £1 1s. costs. Work done. SUMMARY OF SANITARY WORKS COMPLETED DURING THE YEAR House drain addition or reconstruction 10 Drains repaired 176 Drains unstopped 149 W.C. pan and seats repaired or renewed 236 Flushing apparatus repaired or renewed 215 Soil pipes repaired or renewed 13 Soil pipes provided 6 Vent pipes provided 4 Baths provided 1 Sinks provided 94 Waste pipes provided 32 Waste pipes repaired 120 Taps fixed on rising main 18 Yards paved, repaired or drained 53 Dustbins provided 125 Accumulation of filth, etc., removed 65 Roofs and gutters repaired 1,152 Rain water pipes repaired or renewed 126 Dwellings provided with water 16 Dampness remedied 1,046 Window frames, sashes and glazing repaired 332 Cills and reveals repaired 97 Sashcords renewed 239 Fireplaces and flues repaired 321 Floors repaired or renewed 235 Brickwork and pointing repaired 32 Staircases repaired 18 Rooms cleansed 2,108 Walls and ceilings repaired 2,580 Other sanitary works executed 2,147 Total 11,766 FOOD HYGIENE Particular attention has been paid to the question of hygiene in all catering premises and premises where food is prepared. Special Sanitary Inspectors have been detailed for this purpose and careful records compiled of all such premises and the conditions found upon inspection. 21 FOOD THE INSPECTION AND SUPERVISION OF FOOD As a result of inspections of food at wharves, warehouses, shops, etc., in the Borough, 293 tons 11 cwts. 12 lbs. were found to be unfit for human consumption, and were suitably disposed of, as follows:— Destroyed,—176 tons 8 cwts. 2 qtrs. 19 lbs. comprising mainly— 40 tons fruit. 25 tons puree, pulp and fruit juices. 24 tons fruit cake. 18 tons pickles. 14 tons vegetables. 10 tons meat and meat products. 9 tons tinned milk. 7 tons fish. 1 ton tinned soups. 21 tons whalemeat. 3 tons bacon. Inspected at shops, etc. 8 tons 6 cwts. 1 qtr. 18 lbs. „ ,, wharves and warehouses 168 tons 2 cwts. 1 qtr. 1 lb. Released, for animal feeding—61 tons 2 cwts. 1 qtr. 8 lbs. comprising mainly— 25 tons fruit cake. 19 tons vegetables. 7 tons meat and meat products. 3 tons whalemeat. 3 tons tinned milk. 2 tons puree, pulp and fruit juices. 1 ton fruit. 1 ton fish. Inspected at shops, etc. 8 tons 11 cwts. 1 qtr. 23 lbs. „ ,, wharves and warehouses 52 tons 10 cwts. 3 qtrs. 13 lbs. Released for technical purposes—17 tons 5 cwts. 25 lbs. comprising mainly— 8 tons bacon. 5 tons meat. 4 tons poultry. Inspected at shops, etc. 6 cwts. 2 qtrs. 22 lbs. ,, „ wharves and warehouses 16 tons 18 cwts. 2 qtrs. 3 lbs. 22 Released for manufacturing purposes—-28 tons 17 cwts. 1 qtr. 19 lbs. comprising mainly— 20 tons jam. 6 tons dried fruit. 1 ton meat. 1 ton tinned fruit. Inspected at shops, etc. 4 cwts. 1 qtr. 6 lbs. ,, ,, wharves and warehouses 28 tons 13 cwts. 13 lbs. Food salvaged—9 tons 17 cwts. comprising mainly— 7 tons meat. 2 tons tinned milk. Inspected at shops, etc. ,, ,, wharves and warehouses 1 qtr. 25 lbs. 2 cwts. 2 qtrs. 20 lbs. 9 tons 14 cwts. 3 qtrs. 5 lbs. IMPORTED PEARS During the year large quantities of fruit were imported from the continent and distributed from the Grand Vitesse Station, Great Suffolk Street. , On the afternoon of Friday, 29th July, the Chief Sanitary Inspector inspected a consignment of pears which had been imported from Italy. He noticed in some cases that they had a "blue-grey appearance." Samples were taken from these trucks and submitted to the Public Analyst who reported that they had been contaminated by spraying in the fruit stage with an insecticide containing arsenic in such amounts as to constitute a possible danger to health, the quantity found on some specimens being in excess of 1/100th of a grain of arsenic per lb. of fruit. This contamination may be recognised on many specimens of fruit as a blue-grey or white deposit. After investigation, it was found that it could be removed sufficiently by washing, and if that was found impracticable, merely polishing the fruit by means of a dry cloth would remove most of the deposit of insecticide and render it fit for human consumption. A meeting of all interested parties, including representatives of the Ministry of Food, was arranged, and it was decided that if the owners gave a written guarantee for the pears in question to be dealt with under the supervision of the Public Health Departments in the districts to which they were consigned, the fruit would be released, otherwise it would be seized. This undertaking was agreed to by the owners. 23 The total quantity of pears received and inspected was 227 trucks containing approximately 1,248 tons. Samples were taken from 31 trucks, representing 305 tons. Ninety-two written undertakings were received from the owners giving guarantees that the pears would be treated under the supervision of other local authorities, and each of these districts was notified. The quantity found unfit and destroyed in the Council's Depot was 4 trucks representing 22 tons. WHALEMEAT The Food and Drugs (Whalemeat) Regulations, 1949 came into operation in March, and prohibit the importation of whalemeat and whalemeat products for human consumption unless accompanied by a veterinary certificate. These Regulations also include provision for securing whalemeat against contamination in shops and stalls, and during transport or handling in wholesale markets, cold stores, etc. This matter has received the most careful attention of the Food Inspectors, and during the year, a consignment consisting of 3,200 cases of whalemeat (canned steak), from New Zealand, was detained for full examination. A preliminary inspection showed that 36 per cent. was unfit for human consumption, and this was accordingly destroyed. MINERAL OILS The Mineral Oil in Food Order, 1949, which came into operation in April, prohibits the use of mineral oil in the preparation of any article intended for human consumption, or the sale for human consumption of any article of food containing mineral oil. There is an exemption where the oil content in food does not exceed 0.2 per cent. by weight of the article and its presence is due to its use as a lubricant or greasing agent on a surface with which the article of food necessarily comes into contact during preparation. Investigations have revealed no infringements of these regulations. FRENCH SWEETS A consignment of about 10 tons of French sweets, which had been imported on licence by the Ministry of Food, was found to be dangerously contaminated by copper. Whilst the sweets themselves were quite wholesome they were wrapped in attractively coloured wrappers with gilt printing and it was found that on taking off the wrapper, this gilt easily rubbed off on the fingers and contaminated the sweets. This matter was reported to the Ministry of Food, and as a result it was decided that these licences would not in future be issued. 24 CONDENSED MILK In August, a consignment of full cream sweetened condensed milk, imported from Rotterdam, was found entering the Borough through the wharves. In view of previous information received regarding these goods, tests were made, and although no harmful organisms were found, the milk was obviously contaminated, and apparently under-processed, rendering it unfit for invalids and children. In co-operation with the Medical Officer of Health of the Corporation of the City of London, where large consignments were also found, it was agreed that this milk should be used only for manufacturing purposes, where it would be re-heated in the processes, and any dangerous organisms or toxins thereby killed. ICE CREAM There are 121 ice cream dealers and 24 manufacturers in this Borough. During the year 97 samples of ice cream have been taken with the following results :— 25 samples were graded I 23 II ,, ,, ,, 17 ,, ,, ,, III 31 ,, ,, ,, IV 1 sample was not examined by the methylene blue test. These results are not entirely satisfactory, but it has been found in several'instances that samples with very low bacterial counts have been graded III or IV by the methylene blue test. In all cases giving Grade III or IV results, special visits have been made to the premises when careful investigations were made and, where necessary, sampling at each separate stage of the processes carried out, in an effort to detect some fault which was not ordinarily apparent but which may have been causing the unsatisfactory gradings. Improvements were often noted in subsequent results. A code of standards has been sent to each maker and dealer in the Borough, and copies of the Public Analyst's reports on samples taken forwarded to the vendors concerned ; in the case of Grade III or IV samples special attention has been drawn to the necessity for stricter care in the hygiene or manufacture, handling and distribution. Inspections are carried out before the registration of any new premises to ensure that they are satisfactory and that the requirements of the Heat Treatment Regulations are fully understood. In many cases it has been necessary to restrict the sale to pre-packed ice cream. 25 The majority of ice cream makers in this Borough are small one-man businesses, and generally the trade has co-operated in an endeavour to improve hygiene and purity standards. There were, however, three instances where samples had revealed consistently bad standards of bacterial cleanliness and also the presence of faecal bacillus coli. The makers concerned were interviewed by the Public Health Committee and the matter referred to the Metropolitan Standing Joint Committee with a request that the Minister of Health be asked to consider giving local authorities more effective powers in this direction. It is a matter for regret that there are still no statutory standards for ice cream. DESIGNATED MILK During the year, whilst the Milk (Special Designation) Regulations, 1936-1948, were in operation, 46 Dealers' Licences for Pasteurised Milk and 20 Dealers' Licences for Tuberculin Tested Milk were issued. In addition, 5 Supplementary Licences were granted in respect of Pasteurised and 4 in respect of Tuberculin Tested Milk, to dealers selling from premises outside the Borough, the Principal Licences having been issued by the appropriate licensing authorities. On 1st October, 1949, the Milk and Dairies Regulations, 1949 ; the Milk (Special Designation) (Raw Milk) Regulations, 1949, and Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949, came into operation. Under these regulations 100 Dealers' Licences for Sterilised Milk and 1 Supplementary Licence for Sterilised Milk were granted. During 1949, 54 samples of Designated Milks were taken and submitted to the Public Analyst for examination. Seven of these did not satisfy the prescribed test, and the local authority for the area in which the milk was bottled was informed. Forty-seven samples of Pasteurised Milk supplied to local schools were also examined by the Public Analyst, and the London County Council informed of the results. MILK SELLERS At the close of the year there were 179 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. Four hundred and eighty-seven inspections of Milkshops and Dairies were made during the year. 26 PUBLIC HEALTH (CONDENSED MILK) REGULATIONS, 1923 and 1947 Eleven 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 licensed slaughterhouse in the Borough, which is not in use. Four inspections of the premises were made during the year to ensure that no slaughtering was in operation. FOOD PREMISES There are 351 Eating Houses and places where food is prepared for sale, and 145 Ice Cream premises in the Borough. Close co-operation has been maintained with the local Food Office in connection with the proposed new food premises and traders, to ensure that premises comply with our requirements before the issue of food licences. BAKEHOUSES There are 38 Bakehouses in Southwark, of which 14 are underground. During the year 115 inspections of these premises were carried out. PHARMACY & POISONS ACT, 1933 During the year 101 visits were paid to the various premises listed by the Council for the sale of Part II Poisons under the above Act. There are 65 names of persons on the Council's list of Sellers of Part II Poisons. FOOD & DRUGS ACT, 1938 - LEGAL PROCEEDINGS Defendant Cause of proceedings Result Frank J. Hyde, "Northumberland" P.H. 88, Brandon Street. Selling Rum 39.5 degrees under proof. Fined £5 and £4 4s. costs. Frank J. Hyde, "Northumberland "P.H. 88, Brandon Street. Selling Brandy 39 degrees under proof. Fined £5. G. Willscheid de Roost, Ltd., Selling Pork Sausage Meat 36 per cent, deficient in meat. Fined £10 10s. 8/10, Congreve Street. 27 G. Willscheid de Roost, Ltd., 8/10, Congreve Street. Selling Pork Sausage Meat containing Preservative and not labelled. Fined £10 10s. and £5 5s. costs. Meat Products, Ltd., Beresford Avenue, Wembley. Selling Meat Paste 18 per cent. deficient in meat. £10 10s. costs. Arthur Kirby, 32, Eleanor Grove, Barnes, S.W.I3. Selling Pork Sausages 24 per cent. deficient in meat. £3 3s. costs. Frederick Powell, 68, St. Georges Road. Slaughtering a pig without giving prior notice to the Council. Fined £2. Ten cautionary letters were sent in respect of other non-genuine samples. FOOD SAMPLING During the year under review, 873 formal samples were taken, whilst 1,075 informal samples were purchased by the Inspector through his agents. Of these, 21 and 35 respectively, revealed adulteration or other infringements, as follows:— Samples Formal Examined Informal Adulterated Formal Samples Informal Milk 226 11 3 — Designated Milks — 54 — — Condensed Milk — 11 — — Butter, Margarine and Lard 42 58 — — Meat and Fish preparations 74 137 4 11 Cake Mixtures, etc. 89 117 1 3 Cereal preparations 56 69 3 4 Tea, Coffee and Cocoa 60 46 2 2 Vinegar 44 42 2 2 Herbs 54 81 — 2 Sweets and Chocolates 24 38 1 1 Spices and Condiments 56 84 1 — Pickles and Sauces 51 50 1 — James and Preserves 28 19 1 Wines, Spirits and Beverages 5 128 2 3 Drugs and Medicine Preparations 20 93 1 5 Miscellaneous Samples 44 37 — 1 873 1,075 21 35 Formal samples : No. Sample of Result Action taken 642 Pork Sausage Meat. 36 per cent, deficient in meat. Summons. 666 Milk. 4.5 per cent, added water. Cautionary letter. 672 Milk. Deficient in non fatty solids. Cautionary letter. Summons. 734 Meat Paste. 18 per cent, deficient in meat. 740 Whisky. 36 degrees under proof. Cautionary letter. 814 Milk. 2.2 per cent, added water. Cautionary letter. 866 Glauber Salts B.P. Was effloresced. Stock withdrawn. 28 Formal Samples (cont.): No. Sample of Result Action taken 44 Pearl Barley. Contained living acari. Used for poultry food. 84 Coffee and Chicory Essence. 32 per cent. deficient in caffeine. Records at factory inspected. Over minimum amount of coffee used. 96 Pork Sausages. 24 per cent. deficient in meat. Summons. 125 Beef Sausages. Contained preservative not labelled. Cautionary letter. 155 Orange Squash. Contained excess preservative. Cautionary letter. 204 Pearl Barley. Contained acari, their ova and excreta. Used for poultry food. 227 Tomato Sauce. Copper, 130 parts per million. Local authority informed. 285 Coffee and Chicory Essence. 16 per cent. deficient in caffeine. Records at factory inspected. Over minimum amount of coffee used. 290 Sweets. Copper, 38 parts per million. Report sent to Ministry of Food. 307 Pearl Barley. Contained dead acari ova and excreta. Used for poultry food. 484 Imitation Almond. Description misleading. Cautionary letter. 489 Vinegar 2 per cent. deficient in acetic acid. Cautionary letter. 497 Vinegar. 1 per cent. deficient in acetic acid. Cautionary letter. 592 Self-raising flour. 15 per cent. deficient in available Carbon Dioxide. Cautionary letter. Informal Samples : No. Sample of Result Action taken 823a Meat Paste. Deficient in meat. Formal sample taken. 848a Pearl Barley. Contained living acari and their ova. Used for poultry food. 854a Self-raising Flour. Deficient in available Carbon Dioxide. Repeat sample taken. Genuine. 889a Whisky. 37 degrees under proof. Formal sample taken. 952a Sago. Contained mixture of sago and semolina. Retailer advised. 999a Pork Sausage. Deficient in meat. Formal sample taken. 1039a Herring Spread. Can was blown. Stock surrendered. 36a Currant Sugar Sweet Spread. Was not labelled in accordance with the Labelling of Food Order. Labelling Order did not apply to this sample. 29 Informal Samples (cont.): No. Sample of Result Action taken 52a Pork Sausages. Deficient in meat. Repeat sample taken. 65a Cocoa. Inferior quality and deficient in fat. No more in stock. 67a Health Salts. Ingredients did not react or effervesce. Stock withdrawn. 92a Preserved Pork Sausages. Deficient in meat. Formal sample taken. 96a Orange Squash. Contained sulphite preservative equivalent to 580 parts of SO2 per million. Formal sample taken. 133a Mixed Herbs. Incorrectly labelled. Firm notified. 139a Orange Squash. Contained excess preservative. Formal sample taken. 144a Coffee Essence. Deficient in caffeine. Formal sample taken. 194a Sausages. Deficient in meat. Repeat sample taken. 218a Pearl Barley. Contained acari ova and their excreta. Used for poultry food. 265a Junket Powder. Incorrectly labelled. Old Stock. Withdrawn from sale. 272a Royal Dessert Powder. Incorrectly labelled. None left in stock. 324a Sausage Meat. Deficient in meat. Further sample taken. 329a Savouries. Deficient in meat. Sold as savouries. 348a Vinegar. Contained a fungoid growth. Stock examined. All sound. 350a Sausage Meat. Deficient in meat. Repeat sample taken. 414a Mixed Herbs. Incorrectly labelled. Arranged for stock to be re-labelled. 420a Sausage Meat. Deficient in meat. Repeat sample taken. 423a Ammoniated Tincture of Quinine. Contained 0.69 per cent. ammonia. Stock withdrawn. 483a Herbs. Did not comply with the Labelling Order. No more in stock. 495a Beef Sausages. Contained 160 parts of sulphur dioxide per million. Formal sample taken. 574a Pearl Barley. Contained acari, ova and excreta. Used for poultry food. 590a Cherry Linctus. Contained no Ascorbic acid. Stock withdrawn. 620a Vinegar. Deficient in Acetic acid. Formal sample taken. 680a Tincture of Iodine B.P. Deficient in Iodine an J Potassium Iodide. Stock withdrawn. 738a Self-raising flour. Deficient in available carbon dioxide. Formal sample taken. 803a Zinc and Castor Oil Cream. Deficient in castor oil. Formal sample taken. 30 HOUSING The Housing duties of this Department are divided between action under the Housing Act in regard to insanitary, unfit, or overcrowded premises, and enquiries from the London County Council, the Council's Housing Manager, and other authorities in connection with priority recommendations for applicants living in overcrowded or insanitary conditions, or for reasons of medical necessity. The continued shortage of housing accommodation has again resulted in an increase in the number of applications. Unfortunately there is still relatively very little progress in rehousing, even of these priority cases, and even less hope for the many more whose need for better housing on sociological • grounds is hardly less urgent. Another serious factor is the obvious influx of persons into the Borough—as revealed by the considerable increase in population figures despite the lower birth rate—which is making it impossible to reduce overcrowding figures. 1947 1948 1949 Cases investigated on overcrowding, medical, and sanitary grounds 933 1,450 1,669 Number of visits involved 1,263 1,814 2,298 Medical. In dealing with the increased number of housing applicants submitting medical certificates for priority recommendation, regard has to be made to the general housing shortage, and the most careful scrutiny of each case is therefore necessary. Applicants suffering from diseases affecting the heart, rheumatism, congenital deformities, etc., who are housed in top storey dwellings are recommended for accommodation on a lower floor. Tuberculosis patients are recommended for rehousing in the outer London area, where the cleaner air is more conducive to their recovery. Cases of bronchitis are numerous, and where housed in damp dwellings they are also recommended for rehousing. There have been numerous cases seeking recommendation on grounds of neurosis and associated nervous conditions. From consultations with local doctors, it would appear that approximately one-third of their patients under treatment are suffering from some form of nervous condition due to their housing problems. This is a most serious prospect, but unfortunately again so many cases with more serious diseases require rehousing that special recommendations can be made only in extreme instances of mental debility, aggravated by their environmental conditions. 31 Recommendations 1947 1948 1949 Cases recommended to L.C.C. on grounds of Tuberculosis 101 136 51 Cases recommended to L.C.C. on other medical grounds 48 69 101 Cases recommended to Southwark Borough Council on Medical Grounds 24 92 107 Total cases recommended 173 297 259 Rehoused 1947 1948 1949 Cases rehoused by L.C.C. on grounds of Tuberculosis 33 49 43 Cases rehoused by L.C.C. on medical grounds 16 28 48 Cases rehoused by Southwark Borough Council on grounds of Tuberculosis 19 4 Nil Cases rehoused by Southwark Borough Council on medical grounds 6 22 24 Total cases rehoused 74 103 115 Overcrowding. The problem of overcrowding in present day conditions is now a matter more of degree and circumstances rather than technical enforcement of the Housing Act. Overcrowding caused merely by increases in family or in their ages are dealt with as soon as possible, but obviously with the present restricted accommodation, much that is socially undesirable and technically illegal cannot unfortunately be remedied as quickly as one would wish. The question of degree also arises in cases of illegal overcrowding. There is for instance, the family who takes pity on a relative who for some reason is temporarily homeless; or the mother and father from the provinces who leave their family at home while they come to London, and having ultimately found some accommodation for themselves, later send for their family to come and live with them in the most overcrowded conditions, without the knowledge or consent of the owner. There are similar, but even more wilful cases where persons overcrowd themselves under the impression that the local authority is therefore obliged to rehouse them. Fundamentally 32 the reasons for these flagrant offences are a matter for deep concern and sympathy, but whilst any extenuating circumstances are given careful consideration, it is obviously unjust to give the same treatment of recommendation for rehousing to these offenders, who try to jump the queue over legitimate applicants who have been waiting their turn for long periods. At the same time, in view of the acute shortage of accommodation it is not practicable to institute legal proceedings except in the most wilful cases, or where alternative accommodation is unreasonably refused. Another difficult problem is that of young married applicants who are obliged to live with parents or relations. Even with the best of intentions this invariably results in domestic friction, but at the same time existing conditions leave no alternative but to regard these people as sharing the accommodation of the whole house. This eliminates the possibility of gaining priority on overcrowding grounds, where in fact they share adequate accommodation with their families. This is admittedly a grave social evil, but it will not be possible to overcome it until more permanent accommodation becomes available. SUMMARY OF OVERCROWDING CASES 1947 1948 1949 Premises Families Persons Premises Families Persons Premises Families sons New Cases: Remaining on register at end of 1946 877 976 4,996 1,001 1,158 5,662 1,064 1,244 5,952 New Cases reported 266 872 1,532 259 3: 8 1,442 224 282 1,168 Total 1,143 1,348 6,528 1,260 1,496 7,104 1,288 1,526 7,120 Overcrowding abated 142 190 866 196 252 1,152 207 257 1,114 Remaining on register 1,601 1,158 5,662 1,064 1,244 5 952 1,081 1,269 6,006 Overcrowding abated: Rehoused by L.C.C. 102 141 621 161 212 962 150 187 808 Rehoused by Borough Council 23 28 123 21 25 116 18 23 88 Rehoused by other Boroughs 1 1 5 — — — — — — Rehoused by owners 4 5 18 4 4 2 3 2 2 8 Moved away 8 11 55 9 9 45 33 41 190 Found own accommodation — — — 1 2 6 Families reduced in size owing to death, etc. 4 4 44 — — — 4 4 25 Total eases abated 142 190 866 196 252 1,152 207 257 1,114 It should be noted that the overcrowding abated may not be a true picture of the actual abatement as the Department is not normally informed of cases where the families have been rehoused by their own efforts. A check of families known to be overcrowded will be carried out during the coming year, in order to arrive at a more accurate figure. 33 HOUSING ACT, 1936 - SECTIONS 9- 12 Two inspectors were appointed in May for work in connection with the Housing Act, including inspections under Section 9. One was absent from the end of August and eventually retired owing to ill health, but nevertheless a considerable amount of work has been done during the year. Whilst it has not been practicable to resume the service of Notices under Section 9 of the Housing Act, 1936, 248 "informal " notices have been issued requesting voluntary action by the owner. 460 revisits and 204 clearance area survey inspections were made during the year. No formal action by the Council was necessary during the year. Action under Sections 11 and 12 has still to be limited because of the difficulties in rehousing people displaced. However, demolition orders were made in respect of five premises, and in two of these undertakings not to relet were accepted from the owners.. Five premises were affected by closing orders, and the closing orders in respect of two others were cancelled. Details of action taken are as follows:— Premises represented under Section 11. 31, Burman Street Reported to Committee 30/11/49 (Demolition Order made 15/2/50). 33, Burman Street Order made 4th May. (Demolished). 15, Comus Place Undertaking not to re-let accepted from the owner. 7, Congreve Street Order made 17th November. (Demolished). 20, Ripley Street Undertaking not to re-let accepted from the owner. Premises closed under Section 12. 1 and 2, Arch Street Buildings. 83, Gurney Street Basement front room. 77, Gurney Street Basement front room. 81, Boyson Road Basement rooms. 86, Boyson Road Basement rooms. Closing orders cancelled. 55 and 57, Nelson Square.—These premises were later demolished for purposes of the Nelson Square Housing Scheme. 34 No. of Dwellings in Borough 23,473 1. Inspection of Dwelling Houses :— (1) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 6,442 (b) Number of inspections made for the purpose 25,722 (2) (a) Number of dwelling houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 261 (b) Number of inspections made for the purpose 721 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 5 (4) Number of dwelling houses (exclusive of those referred to under the preceding subhead) found not to be in all respects reasonably fit for human habitation 3,827 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 its officers 2,424 3. Action under Statutory Powers during the Year:— A. Proceedings under Sections 9. 10 and 16 of the Housing Act, 1936:— (1) Number of dwelling houses in respect of which notices were served requiring repairs Nil (248 "informal" section 9 notices were issued). (2) Number of dwelling houses which were rendered fit after service of formal notices:— (а) By owners Nil (b) By Local Authority in default of owners Nil B. Proceedings under Public Health Acts:— (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 3,579 35 (2) Number of dwelling houses in which defects were remedied after service of formal notices:— (a) By owners 973 (b) By Local Authority in default of owners Nil C. Proceedings under Sections 11 and 13 of the Housing Act, 1936 :— (1) Number of dwelling houses in respect of which Demolition Orders were made 5 (2) Number of dwelling houses demolished in pursuance of Demolition Orders 2 D. Proceedings under Section 12 of the Housing Act, 1936:— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made 6 (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit Nil WELFARE OF THE AGED The problems appertaining to the care and welfare of aged persons have evoked much public concern, and in endeavouring to overcome serious difficulties caused by the displacement of Relieving Officers and District Medical Officers, an opportunity is now also afforded for making other and wider improvements in aspects of this subject which had hitherto not received adequate attention. In the meantime, close liaison is being maintained between the Public Health Department and the London County Council, local hospitals, and general practitioners. Cases of old people reported to be in need of care and attention are visited by Health Visitors to ascertain the exact nature of the appropriate assistance needed. Much progress is being made in regard to institutions for old people, which are far removed from the former poor law workhouses. This prejudice must be broken down, but it must also be remembered that sentimental associations of home ties and possessions, however humble, are usually held in high regard by the aged, who are often loth to leave them for the greater care and comfort of these excellent institutions. 36 For this reason, future steps must be planned with a greater emphasis on domicilary care to prevent rather than remedy the appalling results of protracted loneliness and neglect. An extension of the institution scheme to provide sub-hospital medical facilities, and a system of regular and frequent home visiting of all old people, are necessary steps which will probably be instituted in the near future. NATIONAL ASSISTANCE ACT Compulsory Removals. During the year, two cases were dealt with under Section 47, which provides for the removal of persons in need of care and attention. Both of these cases were found to be infirm, living under insanitary conditions owing to neglect, in need of proper care and attention, and with no known relatives. Both of these persons—a woman aged 88 and a man aged 78—had refused to enter an institution voluntarily, and Court Orders were made in January and September respectively, for their removal to an institution for three months. At the end of this period, they were found to have settled comfortably in the institution, and no extension of the Orders was necessary. In addition to the above, a number of cases in similar circumstances were admitted to various institutions voluntarily. Burial of the Dead. During the year, the Council arranged for 23 burials under Section 50 of the above Act, at a total cost of £174 l1s. 6d. In July, 1949, the Death Grant Scheme came into operation, by which the Borough Council is enabled to claim a proportion of the normal sum payable, for burials undertaken by the council.