sou 69 7 - NOV 1960 METROPOLITAN BOROUGH OF SOUTHWARK ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1959 A. D. C. S. CAMERON, M.B., CH.B., D.P.H. Medical Officer of Health INDEX Aged persons iv, 21, 59-64 Area 1 Air pollution 39-41 Bakehouses 53 Births i. 1-3 Burials 24, 59 Cancer 5 Caravans 35 Catering premises 53-55 Clean Air Exhibition iii, 39, 64 Clearance areas 42-44 Closing Orders 42-44 Common Lodging Houses 27 Compulsory removals 59 Deaths i, 1-9 Demolitions 42-44 Disinfection 20-22 Disinfestation 21-24 Dwellings 1 Factories 38 Pood Hygiene 58 Imported, Inspections Sampling, Unsound 46-58 Poisoning ii Premises, Regn. 53-55 Furniture and Fittings 35 Hairdressers 34 Health Education iii House Purchase 35 Housing 42-44 Ice Cream 50 Immigrants v Immunisation ii, 13-13 Infectious Diseases, i, 5-8, 10-22 Inspections 25, 42-44 Laundry 21-24 Legal Proceedings 27 Medical examinations Staff 67 Immigrants v Merchandise & Marks Act 48 Milk, Milksellers 51-52 Mortuary iii, 66 Movable dwellings 35 National Assistance Act 24, 59 Noise abatement 37 Notices 25, 42-44 Offensive Trades 27 Outworkers 29 Overcrowding 45 Pet Animals Act 27 Pharmacy & Poisons 59 Poison, Sale of 36 Population i, 1 Public Health Committee viii Radioactivity iii Rags 35 Rag Flock Act 32 Rateable value 1 Refuse storage 37 Rehousing v, 20-22, 44-45 Rent Act 31- 32 Rodent control 30-31 Sanitary conveniences 36 Sink waste disposal 37 Slaughterhouses 53 Staff viii Street Trading 34 Swimming Baths 32-34 Toilets in Restaurants 36 Treatment & Bathing Centre 20 Tuberculosis i, v, 5-15 Unfit premises 42-44 Water supply 28-29 Well water 32 Work completed 26, 42-44 i METROPOLITAN BOROUGH OF SOUTHWARK PUBLIC HEALTH DEPARTMENT, WALWORTH ROAD, S.E.17. Telephone: RODNEY 5464 To The Mayor, Aldermen and Councillors of the Metropolitan Borough of Southwark. YOUR WORSHIP, LADIES AND GENTLEMEN, I have the honour to present the Annual Report of the Medical Officer of Health for the year 1959. Vital Statistics The Registrar General's estimate of the population resident in the Metropolitan Borough at mid-year 1959 was 88,720, which is 1,200 less than the estimated population at mid-year 1958, and 8,471 less than the census figure in 1951 which was 97,191. The birth rate, after adjustment by the comparability factor, was 15.3 as compared with 16.5 for England and Wales. There were 1,211 deaths giving an adjusted death rate of 11.5 compared with 10.2 last year, and 11.6 for the country as a whole. Of the 43 infant deaths 25 occurred during the first four weeks of life. The infant mortality rate was 28.2 compared with 26.7 last year and 22.0 for England and Wales. The still birth rate which in 1958 was 20.1, was reduced to 18 and was lower than the figure for England and Wales which was 20.7. There were no maternal deaths during the year. The principal causes of death during 1959 were diseases of the heart and circulatory system, followed by diseases of the respiratory system and malignant diseases each of the two latter being responsible for almost the same number of deaths. There was once again a reduction in the number of deaths from tuberculosis which now form only one per cent of the total deaths compared with almost five per cent ten years ago. Pulmonary tuberculosis caused 11 deaths whereas motor vehicle accidents and all other accidents caused 16 and 19 deaths respectively. Infectious Diseases In my report last year, attention was drawn to the importance of children being protected against those infectious diseases, namely ii smallpox, diphtheria, whooping cough, tetanus and poliomyelitis, for which vaccination or immunisation is available. It was pointed out that this entailed parents in considerable, though well worth while effort. After much thought and deliberation in the early part of 1959, leading authorities in this country have suggested a suitable programme for the administration of these inoculations, some separately and some in combination, and parents are again urged to ensure that their children derive the greatest possible advantage from the facilities available. The programme provides for protection against tuberculosis for older school-children through the use of B.C.G. vaccine, and of course everyone under forty years of age is now eligible for poliomyelitis vaccination. No case of diphtheria was notified in Southwark during 1959. Of the seven cases of poliomyelitis which occurred, only one had been vaccinated. Measles was more prevalent and there were sixty cases of whooping cough. There were no deaths from these conditions. Bacteriophages are viruses that parasitize bacteria. The fact that different strains of the same organism are sensitive to different phages has made it possible for a phage-typing scheme to be developed which is of particular value in tracing the source of alimentary conditions due to infection with a member of the salmonella group of organisms. The leading exponent of this method of 'fingerprinting' different strains of salmonellae is Dr. W.S. Anderson, Director of the Central Enteric Reference Laboratory at the Central Public Health Laboratory, Colindale, and I am grateful to him and to his staff for the phage typing which was undertaken in relation to eighteen cases of paratyphoid fever which occurred in Southwark during the second quarter of the year. The organism isolated was in each case Salmonella paratyphi B phage type taunton. All of the patients as well as three associated cases in a neighbouring Borough, had consumed confectionery purchased from an establishment in which the night baker was found to be harbouring Salmonella paratyphi B of the same phage type. The exclusion of this baker from duty along with the disinfection and cleansing of the bakehouse concerned, at an early stage in the investigation, brought the outbreak to a close. It is noteworthy that of the 18 cases no fewer than 13, or 68 per cent occurred in four households, the dates of onset suggesting that they were secondary cases. In addition to being a very valuable aid in tracing the source of an outbreak of infection due to the various strains of salmonellae, phage typing can also, on occasion, give an indication of the type of foodstuff which may be involved. In this instance.it is noteworthy that Salmonella paratyphi B phage type taunton has in the past been found in samples of the particular imported egg product which was favoured by the baker concerned. Pasteurisation, or some form of heat treatment of egg products has long been advocated and was mentioned in my report iii for 1958. The absence of a suitable test which would ensure that adequate pasteurisation had been carried out has been a difficulty but it is understood that this has now been satisfactorily overcome. Towards the end of the year an increased number of notifications of dysentery were received. Here again investigation disclosed a high rate of spread within the family. As I indicated in my report last year a high standard of personal hygiene (and this applies especially to young children and to school children) is required to control this highly infectious condition. Health Education The highlight in regard to Health Education was the 'Cleaner Air in Southwark' Exhibition which is referred to in the body of this report and was held during the month of April. The exhibition aroused a great deal of interest in this very Important subject. The exhibition included a most valuable section on Home Safety. In addition the Council took part in the Annual Home Safety Week organised by the London County Council and a great deal of "Check that Fall" publicity material provided by the Royal Society for the Prevention of Accidents was displayed and distributed. Publicity material dealing with the many aspects of Pood Hygiene was also issued to Catering Establishments and every opportunity was taken by the Public Health Inspectors to bring home the importance of these various health matters. Large quantities of leaflets on the prevention of infectious disease, with special reference to the alimentary infections, were distributed to parents complementing the constant health education carried out in schools on this subject by the Education Authority. Mortuary and Coroner's Court The accommodation at St. George's Churchyard which houses the mortuary and Coroner's Court, serving in addition to Southwark, the Metropolitan Boroughs of Bermondsey, Lambeth and Camberwell, was the subject of a report to the Public Health Committee. The modernisation and extension of the premises was under active consideration at the end of the year. Radioactivity The question of radioactivity both in relation to the radioactive contamination of food and to the hazards of radioactivity generally iv was considered by the Public Health Committee from time to time throughout the year. With the issue of Ministry of Health Circular 57/59 and the Radioactive Substances Bill 1959, now an Act, it became clear that the Government had decided in favour of central, as opposed to local control. In regard to the discharge of radioactive waste substances, however, local authorities are to receive copies of certificates of registration relating to all premises in their area, and of certificates of authorisation for radioactive waste disposal in their areas. No account is to be taken by local authorities of radioactivity in the exercise of their powers in relation to nuisances, pollution and the discharge of waste. The increasing use of radioactive substances will bring great benefits. Although responsibility is to lie with the Central Departments it will continue to be essential for medical officers of health to keep a watchful eye on the local position. This view is endorsed by the Report of the Committee on Training in Health and Safety, under the Chairmanship of Sir Douglas Veale which was published this year and recommends suitable courses of training for local authority staffs. Your Medical Officer of Health as well as the Chief Public Health Inspector and one other Inspector attended courses on radioactivity during the year. Welfare of the Elderly The Ninth Annual Report of the Southwark Old People" s Welfare Committee prepared by the Organising Secretary, Miss Beer, is largely reproduced at the end of this report. A perusal of this document gives an indication of the great increase in the work undertaken by the Committee for the benefit of the old people, which followed the transfer of premises in the middle of the year from the Gate House to St. Alban's Hall. As Miss Beer so ably points out, the various activities organised at St. Alban" s Hall are designed to alleviate the loneliness which is such an unfortunate feature of this time of life, and to keep the old people happier, and incidentally healthier. The Committee receives substantial grants from this Council. In addition the accommodation and facilities at St. Alban's Hall have been made available to the Committee by the Borough Council on nominal terms. The Council itself provides directly, through the Public Health Department, a laundry service for incontinent persons being nursed at home, and valuable work was undertaken during the year. The care of old people in a metropolitan borough, is, from the local authority point of view, divided between the health and welfare departments of the.London County Council, who have the major responsibility, the Old People's Welfare Committee, to which the Borough Council makes grants, and the Borough Council's own Public Health Department. The wide range of activities provided for the elderly by the Southwark Old People's Welfare Committee and by the old people's V clubs associated therewith, play an important part in preventing old people becoming withdrawn and housebound, and by the provision of meals on wheels, for example, in easing the lot of those who unfortunately for a variety of reasons have become confined to their homes. Quite apart from other considerations, the provisions of Section 47 of the National Assistance Act 1948, as well as of the National Assistance (Amendment) Act 1951, which devolve on the Borough Council, make it imperative for that Authority and its officers to have particular regard to the conditions under which this section of the elderly are living, and to the services which not only they themselves, but the other Authorities concerned, are providing for their amelioration. Ascertainment and subsequent frequent and regular visitation are necessary measures for the well-being of the more infirm elderly and to ensure that action under this legislation is reduced to the minimum. A great deal of visiting is already undertaken by Miss Beer and her staff, by voluntary workers, and by officers of the London County Council and of this Authority. Nevertheless there is undoubted scope for visitation, which can be time consuming, to be extended, and one must support the eloauent plea, contained in Miss Beer's report, for more visitors to join in this work. Housing By the end of the year under review representations had been received by the Council with regard to the entire slum clearance programme for the five years 1956 to 1960. In addition, in order to synchronise with new properties becoming available for occupation, an appreciable number of individual unfit houses had been dealt with. Once more a great deal of detailed consideration was given to applications for priority for rehousing on medical grounds. Many of these cases presented urgent problems but unfortunately only a few cases could be rehoused. Many cases of legal overcrowding, with all that this entails in hardship to the parents, and danger to the health of children, came to notice and here again little effective action could be taken. It is clear that in a Borough of this character, despite the large estates which have been built both by this Council and the London County Council, housing continues to be the most urgent social problem. Similarly, although a large number of single roomed flats suitable for old people have been constructed a great deal more are still required. Too many of the elderly are house bound because of stairs. Many of those in so called ground floor accommodation must negotiate a steep flight of steps to the toilet or to the street. Medical Examination of Immigrants In June 1959, the Public Health Committee, concerned that, although the incidence of pulmonary tuberculosis was known to be high vi among certain groups of immigrants to this country, no legal powers, similar to those in force in the United States of America and certain Commonwealth countries, were available to require a medical examination and chest x-ray of immigrants, referred the matter to the Association of Sea and Air Port Health Authorities of the British Isles of which this Council is a member. Unfortunately the Medical Committee of the Association did not feel able to recommend that further representations should be made in the matter. The Metropolitan Boroughs' Standing Joint Committee had already made unsuccessful representations to the Minister on the subject. The Standing Tuberculosis Advisory Committee of the Central Health Service Council in the report for the year ended 31st December, 1959 state - " The Committee, having examined the problem of tuberculosis among immigrants on a number of occasions, agreed to put on record their opinion that nothing short of a system of strict medical control of immigration by the admitting country, such as was practised by the United States and by several Commonwealth countries, was likely to be fully effective in removing the danger of the spread of tuberculosis in this country by infected persons entering it. If, as the Committee was assured, this was not practicable in this country because of its position as the centre of a Commonwealth, all of whose citizens had joint United Kingdom citizenship, it followed that the impossibility of the effective control of immigrants as a source of tuberculous infection rested mainly upon political rather than medical consideration; and that the only practicable steps which could be taken to mitigate the danger were, first, to seek the co-operation of the appropriate authorities in other countries in measures to be applied before intending immigrants left their countries of origin and, secondly, to ensure that existing facilities for the diagnosis, treatment and control of tuberculosis in this country were brought to bear in the most effective way in relation to immigrants after their arrival." The matter is to be the subject of further investigation by the Standing Tuberculosis Advisory Committee in September 1960. Conclusion May I extend my thanks to the Chairmen and Members of the various Committees for their consideration and encouragement throughout the vii year. I am most grateful to the Chief Officers for their co-operation. My sincere thanks are also due to the Chief Public Health Inspector, Mr. H. Archer, to Mr. E.A. Clark, Senior Clerk, as well as to the entire staff of the Public Health Department for their enthusiastic support and assistance. I have the honour to be Mr. Mayor, Aldermen and Councillors, Your obedient servant, A.D.C.S. CAMERON Medical Officer of Health viii PUBLIC HEALTH COMMITTEE (As at 31st December, 1959) Mayor — G. DARVELL, J.P. Chairman - H. STILLMAN, L.C.C. Aldermen- A.E. Barnes; A.J. Gates, 0. B. E., J. P. (Ex-Officio)\ Rev. H.F. Runacres, B. A.; Miss P. Stroud, J.P. (Ex-Officio). Councillors: Mrs. L. Booker, Mrs. C. Clunn, H. G. Coppen, Mrs. E.G. Doswell, C. A. Farrow, W.J. Fewtrell, D. Fifer, W. Hansell, F. Irons, D.C. Low (ExOfficio), Mrs. G. Luetchford, S. McCulloch, Mrs. J. Matheson, W.A. Miller, J.H. Pascall, E.H. Ridge, J. Sheen (Vice-Chairman), J. A. Tallon, N.H. Tertis, Mrs. M. Wright. PUBLIC HEALTH DEPARTMENT OFFICERS Medical Officer of Health: A.D.C.S. Cameron, M.B., Ch.B., D.P.H. Public Analyst - D. Button, A.R. C.S., .F. R. I.C. Chief Public Health Inspector H. Archer, F.R.S.H. , F.A.P.H.I. Public Health Inspectors: E. Adamson J. Ashmore R. Bishop (T) (To Nov. 30th) R. French (T) Miss G. Gourley D. Head G. Heath (T) D. Hopgood (From July 16th) A. Johnson T. Lloyd, T.D. B. Naylor (To June 28th) G. Pike E. Potts (To Dec. 13th) F. Saunders J. Saville A. Shields (From July 16th) D. Simpson G. Stubbs, F.A.P.H.I. R. Warboys W. Wilcox (From July 16th) W. Willimott (T) Senior Clerk E.A. Clark Clerical Staff: E. Davies Mrs. T. Collet (T) F. Goddard B. Goddard (To Aug. 20th) D. Marsh (T) (From Aug. 4th) Mrs. F. Robertson (T) J. Robertson Mrs. B. Stevens (T) R. Stevens J. Sutherland D. Webb (T) (From Sept. 7th) (T) - Temporary Staff Rodent Investigators: Mrs. H. Ross (T), Mrs. B. Smith (T). Mortuary Attendant: H. West 1 VITAL STATISTICS Land Area 1,131 acres Estimated Number of Dwellings 24,836 Dwellings Erected by Borough Council During Year (89 houses, 109 flats and maisonettes) 198 Approximate Rateable Value (Total) £2,043,799 (Dwellings) £552,706 Sum represented by a Penny Rate £8,170 Population: Registrar General's estimate (mid-1959) 88,720 This represents a decrease in the figure for 1958 of 1,200. The natural increase in population - that is, the excess of births over deaths - was 312, compared with 456 for the previous year. 1949 - 96,810 1950 - 97,080 1951 - 97,930 1952 - 97,970 1953 - 96,870 1954 - 95,370 1955 - 93,820 1956 - 92,300 1957 - 91,140 1958 - 89,920 Live births - 1523 : Rate per 1,000 pop. 17.1 Adjusted by comparability factor (0.90) 15.3 Still births - 28: Rate per 1,000 total births 18.0 Total births - live and still 1,551 Total deaths - 1211: Rate per 1,000 pop. 13.6 Adjusted by comparability factor (0.85) 11.5 Infant deaths - 43: Rate per 1,000 live births 28.2 Rate per 1,000 live births, legitimate 27.6 illegitimate 36.3 Neo-Natal mortality - 25 (under 4 weeks) Rate per 1,000 live births 16.4 Illegitimate Live Births - 110 Percentage of total live births 7.2 Maternal Deaths (including abortion) Nil Rate per 1,000 live and still births Nil Perinatal mortality - Rate per 1,000 total births 34.1 2 comparative adjusted birth and death rates 1951 1952 1953 1954 1955 1956 1957 1958 1959 Live Births Southwark 17.8 17.2 14. 7 15.2 14. 9 15.4 16.1 15.8 15.3 England and Wales (per 1,000 population) 15.5 15.3 15.5 15.2 15.0 15.7 16.1 16.4 16.5 Total Deaths Southwark 13.6 14. 1 12.7 11.8 14.1 11.6 10.8 10.2 11.5 England and Wales (per 1,000 polulation) 12.5 11.3 11.4 11.3 11. 7 11.7 11.5 11.7 11.6 Infant Deaths Southwark 18.6 28.9 32.3 20.6 28.1 16.0 22.3 26.7 28.2 England and Wales (per 1,000 Live" Births) 29.6 27.6 26.8 25.4 24.9 23.7 23. 0 22.5 22.0 Still Births Southwark 23.2 21.4 23.3 27.5 22.1 18.7 24.7 20.1 18.0 England and Wales (per 1,000 Total Births) 23.0 22.7 22.5 23.5 23.2 22.9 22.4 21.6 20.7 Neo-Natal Mortality (under 4 weeks) Southwark 15.28 16.76 20.35 12.98 20. 80 11.08 15.69 18.68 16.4 England and Wales (per 1,000 Live Births) 18.8 18.3 17.7 17.7 17.3 16.8 16.5 16.2 15.8 Maternal Mortality Southwark 1.6 0.5 0.5 1.1 1.1 Nil Nil 0.6 Nil England and Wales .. (oer 1,000 Live & Still Births) 0.81 0.72 0.75 0.7 0.64 0.56 0.47 0.43 0. 38 legitimate illegitimate total vear Male Female Total Male Female Total Male Female Total LIVE BIRTHS 1955 789 715 1,504 71 59 130 860 774 1,634 1956 744 758 1,502 66 55 121 810 813 1.623 1957 810 742 1,552 56 49 105 866 791 1,657 1958 773 728 1,501 56 49 105 829 777 1,606 195? 735 678 1,413 62 48 110 797 726 1,523 STILL BIRTHS 1955 13 21 34 1 2 3 14 23 37 1956 13 15 28 1 2 3 14 17 31 1957 21 18 39 1 2 3 22 20 42 1958 16 13 29 3 1 4 19 14 33 1959 11 15 26 1 1 2 12 16 28 INFANT DEATHS (under 1 year 1955 28 10 38 5 3 8 33 13 46 1956 9 17 26 - 9 17 26 1957 16 17 33 1 3 4 17 20 37 1958 20 18 38 3 2 5 23 20 43 1959 20 19 39 3 J 4 23 20 43 4 DEATHS Male and Female Age Groups. Under 1 1-4 5-14 15-44 45-64 65 and over Total Males 23 2 6 36 171 372 610 Females 20 2 2 21 74 482 601 43 4 8 57 245 854 1,211 Infant Mortality The total number of deaths of infants under one year of age was 43, the causes of death being as follows:- Pneumonia 2 Bronchitis 3 Other diseases of respiratory system 1 Gastritis Enteritis and Diarrhoea 1 Congenital malformations 8 Other defined and ill defined diseases 25 Accidents, other than by vehicles 3 Total 43 25 of these deaths occurred under the age of one week, as follows. There were no additional deaths between the ages of one and four weeks. Legitimate: males 12, females 10. Illegitimate: " 2, " 1. Maternal Mortality No deaths occurred relating to pregnancy, childbirth or abortion. CANCER DEATHS Year Cancer of:Lung and Bronchus Other Organs Total Cancer Deaths per 1,000 pop. Percent: of total deaths Male Female Total 1951 40 9 49 187 236 2.4 17.8 1952 40 11 51 158 209 2.1 15.1 1953 55 7 62 149 211 2.1 17.5 1954 58 7 65 150 215 2.2 19.5 1955 49 8 57 157 214 2.2 16.4 1956 54 7 61 170 231 2.5 19.3 1957 53 7 60 154 214 2.3 19.5 1958 62 9 71 133 204 2.2 17.7 1959 59 5 64 136 200 2.2 16.5 TUBERCULOSIS DEATHS Year Pulmonary Other forms Total Deaths per 1,000 pop. Percent: of all deaths Pulm. Other 1951 32 7 39 .32 .07 2.9 1952 45 4 49 .45 .04 3.5 1953 21 2 23 .21 .02 1.9 1954 22 1 23 .23 .01 2.0 1955 23 3 26 .24 .03 2.0 1956 21 1 22 .22 .01 1.8 1957 14 4 18 .16 .04 1.6 1958 19 - 19 .21 - 1.6 1959 11 2 13 .12 .02 1.0 6 DEATH RATES PER THOUSAND POPULATION 7 CLASSIFICATION OF DEATHS Causes of Death Total Deaths 1959 Total Deaths 1958 Nos. All causes - Males, Females 1 Tuberculosis of Respiratory System 11 19 2 Tuberculosis - other forms 2 – 3 Syphilitic Disease 2 2 4 Diphtheria – – 5 Whooping Cough – – 6 Meningococcal Infections – 2 7 Acute Poliomyelitis – – 8 Measles – 1 9 Other Infective and Parasitic diseases 2 3 10 Malignant neoplasm stomach 24 35 11 „ „ lung, bronchus 64 71 12 „ „ breast 15 13 13 „ „ uterus 9 8 14 Other malignant and lymphatic neoplasms 88 77 15 Leukaemia, Aleukemia 3 3 16 Diabetes 8 7 17 Vascular lesions of nervous system 120 111 18 Coronary disease, angina 149 156 19 Hypertension with Heart disease 15 22 20 Other Heart disease 206 204 21 Other Circulatory disease 64 62 22 Influenza 30 3 23 Pneumonia 102 80 24 Bronchitis 113 83 25 Other diseases of Respiratory system 17 17 26 Ulcer of the Stomach and Duodenum 19 12 27 Gastritis, Enteritis and Diarrhoea 3 10 28 Nephritis and Nephrosis 8 6 29 Hyperplasia of prostate 8 3 30 Pregnancy, Childbirth, Abortion – 1 31 Congenital Malformations 14 15 32 Other defined and ill-defined diseases 71 79 33 Motor Vehicle Accidents 16 8 34 All other accidents 19 26 35 Suicide 9 10 36 Homicide and operations of war – 1 TOTALS 1,211 1, 150 8 Age Groups and Sex : - CLASSIFICATION OF DEATHS Cause No. 0- 1- 5- 15- 25- 45- 65- 75- M F M F M F M F M F M F M F M P 1 – 1 4 – 2 – 4 – 2 1 – - 1 3 2 – 4 5 6 7 8 9 – 1 – 1 10 1 1 7 1 3 3 3 5 11 2 – 28 2 22 2 7 1 12 – 2 – 5 – 6 – 2 13 – 1 – 3 – 1 – 4 14 1 – 2 2 14 7 20 7 17 18 15 – 1 – 1 – 1 16 – 3 – 5 17 3 – 10 9 15 17 16 50 18 6 1 36 13 32 22 19 20 19 – 2 2 1 2 8 20 – 1 6 4 7 5 12 6 47 118 21 8 1 11 13 5 26 22 1 1 3 2 2 2 5 14 23 – 2 1 – 10 2 15 9 24 39 24 2 1 22 3 29 11 18 27 25 1 – – 1 4 2 2 5 1 1 26 1 – 2 2 6 2 4 2 27 1 – – 1 – 1 28 1 – 1 – 1 1 1 – 1 2 29 1 – 7 – 30 31 5 3 – 1 2 1 – 1 1 – 32 13 12 1 – 2 1 5 8 4 6 6 13 33 4 – 3 – 2 – – 2 1 4 34 1 2 1 – 1 – 1 1 1 1 2 1 2 5 35 2 1 4 – 1 – 1 – 36 Totals 23 20 2 2 6 2 5 1 31 20 171 74 182 117 190 365 9 DEATHS IN WARDS Ward Estimated Population No. of Deaths Death rate peR 1000 estimateD Ward pop. NORTHERN St. Saviour 5,940 58 9.7 Christchurch 2,410 36 14.9 St. Michael 8,380 103 12.2 CENTRAL St. Jude 5,690 61 10.7 Trinity 9,360 104 11.1 St. Mary 13,880 155 11.1 St. John 12,780 122 9.5 SOUTHERN St. Paul 9,020 94 10.4 St. Peter (excluding Newington L.C.C. Institution) 10,730 141 13.1 St. George 9, 680 90 9.2 10 INFECTIOUS DISEASES Scarlet Fever There were 97 cases of Scarlet Fever during 1958 as compared with 157 during the previous year. Children of school age were mainly affected. Diphtheria No confirmed cases of Diphtheria occurred in Southwark during the year. Measles The bi-annual periodicity of measles was maintained, the number of notifications being almost double that of the previous year. Fortynine of the children infected were under one year of age. Sixty-two children were treated in hospital. There were no deaths. Whooping Cough 60 cases of Whooping Cough occurred, 40 being under the age of 5 years, and 5 under the age of one year. There were no deaths from this condition. Erysipelas Of the seven cases of Erysipelas which were notified, one was over 65 years of age and five were between 45 and 65 years of age. Meningococcal Infection Two cases were notified both between 1 and 2 years of age; there were no deaths from this condition. Ophthalmia Neonatorum One child was reported as suffering from this condition during the year. 11 Poliomyelitis Five paralytic and two non-paralytic cases of poliomyelitis were notified. All of the patients were children, the oldest being seven years and the youngest nine months. In only one instance was the paralyses at all extensive. The cases occurred during the months of May, July, August, (three cases) September and November. Only one of the children gave a history of having received poliomyelitis vaccine. A girl who became ill in August was a contact of a boy, prior to his admission to hospital, who developed the condition in July. Zymotic Enteritis There were only 5 cases of Enteritis compared with 21 in 1958. This condition is notifiable in Southwark during the quarter July to September inclusive for children under 5 years of age. Pneumonia 80 cases of Pneumonia were notified, an increase of 29 from the previous year. 50 of these occurred over the age of 45 years. Puerperal Pyrexia All of the thirty-one notifications of Puerperal Pyrexia were received from hospital. This total was one more than in 1958. Encephalitis One case of Infective Encephalitis occurred in a child between 5and l0 years old. There were no cases of post-infectious Encephalitis. Scabies Only the first case of Scabies in a household in any four-week Period is notifiable in London and 21 such cases were so notified, an increase of 2 from the previous year. 12 Typhoid At the beginning of the year, typhoid fever was diagnosed in an expectant mother with four children. The patient was married to a Pakistani and six other Pakistanis were resident in the same house, One of these was found to be harbouring a typhoid bacillus of the same phage type in his stools, and it was considered that he had been a typhoid carrier for many years. He had been in this country since 1957, This man was admitted to hospital and removal of his gall bladder was necessary to relieve his carrier state. A technician in a laboratory in which cultures of typhoid bacilli were used to test bacteriological culture media manufactured by a firm, developed typhoid fever, the organism which was isolated belonging to a strain resembling that of the stock laboratory cultures. The patient, who worked but did not reside in Southwark, had been inoculated against this condition during his Army service and was not seriously ill. Para-typhoid fever Nineteen cases of para-typhoid fever were notified during 1959. The phage type of the causal organism in the first case which occurred was different from that of the later cases. The phage type in all of the remaining eighteen cases was 'Taunton'. The patients were resident in one part of the Borough, and the immediate cause of this small outbreak was considered to be a night baker who was found to be excreting an organism of the same strain. Three persons who although not resident in Southwark had consumed confectionery from the same baker, also became infected. The carrier was successfully treated in hospital. Thirteen of the eighteen cases were members of four households. Food Poisoning The great majority of the twenty-seven cases of food poisoning were single cases. Multiple infection, however, occurred in three families. A mother and her ten months old child both became ill at the same time. In another family, two sisters and a brother developed the condition, while in a third family the mother and four children were affected. In not one instance was the actual food giving rise to the trouble identified. The causal organism was Salmonella typhi-murium in sixteen cases, Salmonella St. Paul in five cases, (one family), Salmonella Anatum in two cases, and Salmonella Thompson in one case. In the remaining cases no organism was isolated. Four of the twentyseven cases were admitted to hospital. 13 Dysentery Dysentery, due to infection with shigella sonnei, was prevalent during the year, 341 cases being confirmed compared with 230 during the previous year. Of those infected, 162 were under five years of age, 130 between five and fifteen years of age, and 49 were adults. Diagnosis of Smallpox When suspicion of smallpox arises the family doctor informs the Medical Officer of Health with whom rests responsibility for the final decision regarding the diagnosis and the action which follows. The advice of a panel of consultants is available to the Medical Officer of Health. Suitable specimens can be submitted to the Public Health Laboratory Service at Colindale for examination. A diagnosis of smallpox was excluded in two such cases which were referred during the year. Complications of Vaccination Generalised vaccinia is one of the occasional complications of vaccination against smallpox. Due to its association with eczema the presence of or a history of such a condition is an absolute bar to vaccination. In the first half of the year a child aged two years, who had been undergoing treatment for eczema, developed generalised vaccinia from which she died. The child herself had not been vaccinated. Her brother had been vaccinated some two to three weeks previously. IMMUNISATION I am indebted to Dr. W.H. Wallace, Divisional Medical Officer of the London County Council, for the following details. Under 1 Year 1 Year 2-4 Year 5-14 Years Adults Total Smallpox Welfare Centres 745 15 4 4 - 768 Private Doctors 323 25 13 2 8 371 14 Welfare Centres and Nurseries Private Doctors Under 5 Years 5-14 Years Under 5 Years 5-14 Years Total Diphtheria 32 72 2 1 107 Diphtheria and Whooping Cough 118 4 31 2 155 Diphtheria, Whooping Cough and Tetanus 842 19 199 7 1,067 Whooping Cough (all ages). 6 1 7 'Booster' injections (all ages) 810 111 921 15 TUBERCULOSIS Including inward transfers, there were 75 fewer new cases of Tuberculosis than last year; 71 pulmonary and 4 non-pulmonary. Pulmonary Non-Pulmonary (all forms) Cases at end of 1958 1,568 167 New cases 1959 98 6 Inward transfers 1959 74 - Less removals from Register 204 7 Cases at end of 1959 1,536 166 Age Groups Pulmonary: 0- 1- 2- 3- 4- 5- 10- 15- 25- 45- 65- Total Primary M 1 1 1 1 1 2 9 16 29 4 65 Notifications F 1 1 1 3 6 11 3 1 27 *New cases other than M 1 1 3 5 by formal notification F 1 1 Totals 2 1 1 2 2 4 2 15 27 34 8 98 Non-Pulmonary /Primary M 1 1 2 Notifications F 2 1 1 4 /*New cases other than M - by formal notification F - Totals 2 1 1 2 6 * Local and inward transferable Death Returns and posthumous notifications. / Include meninges and Central Nervous System. (Nil). 16 INFECTIOUS DISEASES DISEASE CONFIRMED CASES SOUTHWARK RESIDENTS Removed to Hospital 1959 Diagnosed in or outside Borough - Age Groups, 1959. Total Total 0- 1- 2- 3- 4- 5- 10- 15- 25- 45- 65- 1959 1958 Anthrax _ _ Diphtheria _ 1 Dysentery 20 31 51 31 29 95 19 16 38 8 3 341 230 134 Encephalitis: Infective 1 1 _ 1 Post infectious _ 1 Erysipelas 1 5 1 7 9 Pood Poisoning: Bacterial 3 3 _ 2 _ 4 _ 4 8 2 1 27 42 4 •Malaria _ 1 Measles 49 115 171 167 140 379 5 _ 3 1029 574 62 Meningococcal Infection 2 2 4 2 Ophthalmia Neonatorum 1 1 1 1 Paratyphoid 1 1 1 1 2 4 2 3 3 1 19 1 19 Pneumonia . 1 2 _ _ 3 4 1 5 14 34 16 80 51 5 17 Infectious Diseases (continued) DISEASE CONFIRMED CASES, SOUTHWARK RESIDENTS Diagnosed in or outside Borough - Age Groups, 1959. Total Total Removed to Hospital 1959 0- 1- 2- 3- 4- 5- 10- 15- 25- 45- 65- 1959 1958 Poliomyelitis: Paralytic 1 3 1 5 1 5 Non-paralytic 1 1 2 1 2 Puerperal Pyrexia 18 13 31 30 31 Scabies 1 2 2 7 5 4 21 19 Scarlet Fever 1 3 8 7 10 53 15 97 157 5 Typhoid Fever 1 1 1 1 Whootfing Cough 5 11 9 9 6 15 4 1 60 64 6 Zymotic Enteritis (July-Sept.) 4 1 5 21 5 TOTALS 86 168 241 221 192 558 48 54 86 53 22 1729 1209 283 These figures include 45 Southwark residents notified to other Boroughs. *Contracted abroad. 18 INFECTIOUS DISEASES COMPARATIVE TABLE OP SOUTHWARK CASES FROM 1949 to 1959 DISEASE 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 Anthrax _ 2 _ _ _ _ _ 1 _ _ _ Diphtheria 13 _ 1 4 _ _ _ _ _ 1 _- Dysentery 10 71 191 38 175 163 231 716 37 230 341 Encephalitis: Infective _ 1 1 _- _- _- _- _- _- _- 1 Post Infectious _ 1 _ _ _ _ _ _ _- 1 _ Erysipelas 16 18 12 18 12 12 14 10 5 9 7 Food Poisoning 1 27 6 20 20 27 26 9 21 42 27 Malaria 2 _ 1 1 2 _ _ _ 1 1 _ Measles 948 806 1790 994 1075 233 2142 447 1179 574 1029 Meningococcal Infection 2 8 5 5 3 3 1 1 1 4 2 Ophthalmia Neonatorum 15 6 4 10 5 14 3 3 1 1 1 Paratyphoid 1 1 _ _ 1 _ 2 2 2 _ 19 19 Infectious Diseases 1949 to 1959 (continued) Comparative Table DISEASE 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 Pneumonia 41 23 40 58 68 54 86 64 70 51 80 Poliomyelitis: - Paralytic 14 10 3 4 6 1 41 5 4 1 5 Non-paralytic _- 4 1 4 1 _- 23 2 7 1 2 Puerperal Pyrexia 12 8 23 30 46 76 39 38 49 30 31 Scabies 38 19 14 34 13 20 33 38 35 19 21 Scarlet Fever 209 149 143 292 160 96 185 259 142 157 97 Typhoid Fever _- 1 1 _- _- _- _- _- 1 1 1 Whooping Cough 131 354 289 177 372 229 141 144 188 64 66 Zymotic Enteritis (July-Sept.) 25 30 7 7 19 5 4 5 16 21 5 TOTALS 1,478 1, 539 2,532 1,696 1,978 933 2,971 1,743 1,759 1,209 1,729 20 TREATMENT AND BATHING CENTRE (Superintendent - Mr. T. Lloyd T.D.) There was a welcome decrease in the overall number of treatments for verminous infestations of the person, carried out at the Centre during the year. However, the number of treatments necessary for this condition remains, in all groups, at a quite considerable level. Of the 2,254 treatments for lice infestations, 1,315 were for children attending school and were mainly head louse infestations. It must be remembered that, in addition to Southwark schools, children also attend the centre from some Lambeth and Bermondsey schools. In the case of adults and children under school age, the majority of the treatments for women and children were also for head louse infestations; but for adult male persons, each case treated was an active or a suspected infestation of body lice. The number of persons requiring treatment for scabies was somewhat larger than those treated last year. In every case when persons attend for treatment for this condition, they are advised to ensure that their immediate family contacts attend their family doctor for examination, with subsequent attendance at this centre for treatment, if found necessary. The long, hot summer resulted in increased insect breeding, and a great deal of work was involved in dealing with the many calls for assistance in eradicating infestations of domestic insect pests. The greater number of the infestations dealt with were of bed bugs, but there was also a considerable number of fly, beetle and other pest infestations concerned. A number of business firms requested assistance in dealing with infestations of cockroaches and fleas on their premises. A charge covering labour, transport and cost of the insecticides used, is made in these cases. As a result of the extended re-housing programme of both the Southwark Borough Council and the L.C.C. during the year, the precautionary disinfestation of bedding and soft goods was carried out in regard to 331, families re-housed by the Borough Council, and 118, families re-housed by the L.C.C. 21 During the past year, 44 new cases were added to those receiving the incontinent laundry service. Many receiving this service are of course, very old and some others are acutely ill. As a result there are, unfortunately, frequent deaths amongst them and there are others admitted and re-admitted to hospital. A weekly average of 27 cases receiving the service was maintained, and for most of these it was necessary to collect the laundry three times each week. In addition, an average number of 41 bags of incontinent laundry was delivered here from Lambeth each week. This service has proved to be of very great value to many old and sick people when faced with the additional worry and inconvenience of functional incontinence. 22 Infectious Disease Cases: Enquiries and Visits Total - 449 as under: Tuberculosis deaths and removals - 25 Scarlet Fever 93 Food Poisoning 23 Poliomyelitis 22 Erysipelas 8 Dysentery (bacilliary) 273 Meningococcal infections 8 Typhoid fever 1 Paratyphoid 21 Disinfection following infectious diseases Rooms treated (Formalin solution) 115 Library books treated 126 Other disinfection, Tuberculosis, etc. 5 Treatment of Verminous and Infected Articles (including precautionary disinfestation) Verminous articles treated Verminous articles destroyed Infected articles treated Infected articles destroyed Beds 328 - - - Palliasses 1,154 3 149 - Bolsters 216 - 22 - Pillows 1,859 - 349 - Cushions 154 - 19 - Blankets 2,197 - 622 - Sheets 1,150 - 291 - Quilts 1,101 - 98 - Other articles (clothing, etc.) 10,641 120 1,110 - Rehousing Precautionary disinfestation of soft goods and bedding (Including 118 families rehoused by L.C.C.) - 331 families. 23 Scabies and Vermin Treatments Scabies Vermin Males Females Males Females Lambeth cases 19 49 13 150 treatments 29 80 13 158 Southwark cases 24 29 504 264 treatments 66 56 504 264 L.C.C. Schoolchildren (Male and Female) 58 1,315 treatments* 122 1,315 Total treatments 353 2,254 Bermondsey schoolchildren. Teatments (included in total*) 158 Verminous Treatments from Hostels, Common Lodging Houses, etc. (Included in above) Males: Females: Salvation Army Hostel 192 83, Blackfriars Road 16 Rowton House, Churchyard Row 76 78, Camberwell Road 15 Rowton House, Vauxhall 5 Cecil House 8 Marshalsea Road Common Lodging House 11 96, Gt. Guildford Street 8 Norwood House 2 Southwark Casuals 179 Newington Lodge 15 Total 463 Casuals 15 Total 79 24 Departmental Laundry In addition to the washing of towels, wraps etc., used during the treatment of cases, the following articles were laundered: Hand towels 6,678 Roller towels 485 Dusters 470 Swabs 31 Sheets 21 Effects destroyed on request or following death. Verminous 2 tons % cwts. Disinfestation of Premises and Trade Goods Usual vermin infestations (Bed bugs, fleas etc.) .. Domestic dwellings - 1,392 rooms Other infestations - Internal (Cockroaches, moths, flies, beetles etc.) Domestic dwellings - 290 rooms Institutions etc. - 55 rooms and passages Business premises - 21 premises Other infestations - External (Clover mites, caterpillars, flies etc.) - 9 premises Export goods - 1 parcel clothing (Formaldehyde) National Assistance Act (Burials) Enquiries on 18 deaths. Incontinent Laundry Service Articles Laundered (Southwark) 18,750 Sheets 3,795 Draw slips 5,258 Pillow slips - 2,506 Blankets 288 Clothing 6,903 Articles Laundered (Lambeth) Total weight 16,309 lbs. 25 SANITARY CIRCUMSTANCES OF THE AREA Inspections and Sampling Visits House to House 1,050 Housing survey 1,438 I Rehousing cases 347 Rent Act 312 Complaints 2,738 Drainage 2,490 Rodents: industrial premises 281 dwellings 629 Smoke observations and visits 305 Factories and Workplaces 847 Outworkers 294 Common Lodging Houses 103 Offensive Trades premises 12 Pet Animals Act 133 Hairdressers' premises 50 Aged persons and burial cases 369 Infectious diseases 486 Milk premises and Dairies 270 Catering and Ice Cream premises 1,997 I Food at wharves and warehouses 2,866 I Fishmongers' and fried fish premises 65 Bakers' premises and bakehouses 92 Week end markets 87 Other food premises etc. (including Shops Act) 1,965 Rag Flock and other filling materials 2 Trade effluents 16 Miscellaneous 4,636 I Re-inspections 6,539 NOTICES Intimation Notices 1,054 Statutory Notices 541 Defects in Council controlled property reported to Housing Manager 25 Intimation Notices complied with 1,007 Statutory Notices complied with 387 Work carried out by Local Authority in default of owner 26 26 SUMMARY OF SANITARY WORKS COMPLETED DURING THE YEAR Roofs and gutters repaired or renewed 516 Dampness remedied 738 Brickwork and pointing repaired 91 Floors repaired or renewed 154 Window frames, glazing and sashes repaired 185 Cills and reveals repaired 134 Sashcords renewed 484 Fireplaces and flues repaired or renewed 120 Staircases repaired 65 Walls and ceilings repaired 580 Rooms cleansed and redecorated 1561 House drains additions and reconstructions 144 Length of new drainage - 15,806 feet _ Drains repaired 161 Drains unstopped 130 Intercepting traps provided 54 Inspection chambers constructed 280 Clearing eyes to drains provided 50 Fresh air inlets provided 41 Ventilating shafts provided 107 Soil pipes provided 193 Gullies provided 402 Waste pipe and traps provided 2,348 Waste pipes repaired 68 Sinks provided or renewed 622 Baths provided 530 Lavatory basins provided 745 Water closet pans and seats, provided or renewed 913 Water closet flushing cisterns provided or renewed 837 Urinals provided or renewed 41 Rain water pipes provided, repaired or renewed 304 Yards paved, repaired or drained 68 Accumulations removed 71 Dustbins provided 98 Dwellings provided with water 642 Miscellaneous repairs 188 Separate statistics under certain of the headings in the foregoing section are given in the Food Section. 27 PUBLIC HEALTH (LONDON) ACT, 1936-LEGAL PROCEEDINGS Failure to Abate Nuisances Nuisance Orders: 14 days 8 21 days 7 28 days 4 Summons withdrawn 7 (Work completed). Summons adjourned sine die 2 Summons adjourned 1 COMMON LODGING HOUSES There are four women's and two men's common lodging houses in the Borough, which are fully occupied nightly. 103 inspections of these premises were made by the Public Health Inspectors, 27 of men's lodging houses and 76 of women's. Pour intimation notices were served, all of which have been complied with. OFFENSIVE TRADES There are now two premises engaged in offensive trades in the Borough as follows:- Skin Dressers 1, Manure Manufacturer 1. During 1959, 12 inspections were made. The offensive business of "Dresser of Pur Skins" at 136 Southwark Street, S.E.I., was discontinued for a period of more than nine months and the premises were accordingly removed from the Register of Offensive Businesses in accordance with the provisions of the Public Health (London) Act, 1936 - Section 140 (5). PET ANIMALS ACT, 1951 Thirteen applications were received for registration under the Act, all of which were satisfactory. 133 inspections were made during the year. 28 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. The Metropolitan Water Board was informed and samples analysed, which were found satisfactory. Public Health (London) Act, 1936 - Section 98 During the year 16 notifications of the withdrawal of water supply were received from the Metropolitan Water Board. 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 642 new dwellings as follows:- Lorrimore Road, 53-95 (odd), 73a, 73b, 77a, 79b, 81a, 83a, 85a, 89a 34 Dwellings Ambergate Street, 45-67 (odd), 88-126 (even) 77-107 (odd) 48 Dwellings Kennington Park Road, 117 (5 Dwellings) 5 Dwellings Falmouth Road, 41-121 (odd) 39 Dwellings Swann Street, 21-27 (odd) 8 Dwellings Harry Hinkins House, Trafalgar Street 24 Dwellings James Stroud House, Trafalgar Street 24 Dwellings 29 Pallant House, Tabard Street 57 Dwellings Harper Road, 151-189 (odd) 20 Dwellings Bronti Close, 1-5 (inclusive) 5 Dwellings Salisbury Row, 18 2 Dwellings Broomfield House, Congreve Street 20 Dwellings Symington House, Harper Road 105 Dwellings Boundary House, Bethwin Road 34 Dwellings Waterloo Road, 246-260 (Caretaker's Flat) 1 Dwelling Penrose Street, 94-190 (even) 49 Dwellings Southwark Street, 142 (Caretaker's Flat) 1 Dwelling Alberta Street, 1-23 (odd), 45-67 (odd) 24 Dwellings Penton Place, 2-18 (even) 9 Dwellings Cooks Road, 1-36 (inclusive) 36 Dwellings Trinity Street, 14 4 Dwellings Bronti Close, 38 1 Dwelling Dunnico House, East Street 24 Dwellings Cornish House, Brandon Estate 68 Dwellings Total 642 OUTWORKERS 294 inspections of homes of outworkers were made during the year. The conditions generally were found to be quite satisfactory. It was not necessary to serve any notices or institute proceedings. Nature of work No. of outworkers in August list required by section 110(i)fc) Wearing Apparel Making, etc 26 Cleaning and washing - Artificial flowers 1 The making of boxes or other receptacles or parts thereof made wholly or partially of paper 102 Cosaques, Christmas crackers & stockings, etc. 16 Paper bags 5 Total 150 30 PREVENTION OF DAMAGE BY PESTS ACT, 1949 (Rodent Officer - Mr. R. Warboys) (Report for nine months, April 1st - Dec. 31st, 1959) Type of Premises Local Authority Dwe11ings Business & Others Total I Total properties 16 24, 806 5, 182 30,004 II Properties inspected as a result of:- (a) Notification 5 559 178 742 (b) Survey under Act 1,458 637 2,095 (c) Otherwise 98 88 186 III Total Inspections of above (including Reinspections) 35 2, 115 903 3,053 IV Properties inspected infested by:- Rats Major 1 _ _ 1 Minor 2 250 175 427 Mice Major _ _ _ _ Minor 2 407 91 500 V Number of infested properties (IV) treated by local authority 5 657 266 928 VI Total Treatments 47 1, 106 315 1,468 VII Notices served under Sec. 4:- (a) Treatment _ _ _ _ (b) Structural, i.e. proofing _ 4 _ 4 VIII Number of cases in which default action taken by local authority following Sec. 4 notice _ _ _ _ IX Legal Proceedings _ _ _ _ X Number of " Block " control 65 - 2095 visits (1,458 dwelling houses and 637 business premises) NOTES:- (a) Council houses are indicated in "Dwellings" (b) Sewers are not included in above table. 31 Domestic Business Inspections by Rodent Officer 629 281 Inspections by Rodent Staff 3,451 942 Drains tested 133 38 Drains defective 65 4 Drains repaired 78 4 Drains opened for examination 101 4 Prebaits laid 6,796 Poison baits 5,190 3,732 Bodies recovered 210 163 Works completed by arrangement 104 13 DISTRIBUTION OF THE SHIP RAT IN THE UNITED KINGDOM Two years ago Local Authorities, including Southwark, co-operated with the officers of the Ministry of Agriculture, Fisheries and Food in a survey, to determine the distribution of Rattus Rattus, the ship rat, in the United Kingdom. The data has been collated and the following interim summary of the results of the survey have been circulated:- 1. In 1951 the ship rat was reasonably well established ashore in the London area and in about 40 localities outside it and occurred sporadically in about 30 other places. 2. By 1956 it had decreased in range and frequency in most localities and disappeared from some. 3. The main factors responsible for its loss of ground between 1951 and 1956 are thought to be the continuous reduction in the number of rats arriving in the ports in ocean-going vessels, the introduction of measures to reduce rat infestation on coastal vessels, improvements in dockside buildings construction and improved methods of rat control on land. 4. It is thought that the ship rat will lose more ground in the next few years but can be expected to persist for a considerable time yet, at least in London, Bristol and Liverpool, and perhaps in Leith and Belfast. RENT ACT, 1957 The following table gives a summary of the action taken in regard to the issue of Certificates of Disrepair. 32 Applications 44 Decisions to issue certificates 49 Undertakings by landlords to carry out repairs 24 Certificates issued 21 Certificates refused Applications withdrawn Applications by landlords for cancellation of certificates 7 Objections by tenants to cencellation of certificates Decision by Local Authority to cancel in spite of tenants objections Certificates cancelled by Local Authority 4 RAG FLOCK & OTHER FILLING MATERIALS ACT, 1951 During the year four samples were taken and submitted to the prescribed Analyst, Mr. G. Ginger, F.C.S., Chiltern Research Laboratories, Ltd., Mar low. All these samples complied with the requirements of the Regulations. Six premises are registered for the use of filling materials, and two licensed for manufacture or storage of Rag Flock. WELL WATER The three private wells in the Borough are still in use for industrial purposes. The supply in each case is satisfactory. PUBLIC SWIMMING BATHS The only public swimming baths are those situated at Manor Place in a densely residential part of the Borough, under the management of the Council's Baths Committee. There are three pools with sizes and capacities as follows:- 33 (a) lst-Class Swim Length 120 ft. Width 40 ft. Capacity 157,000 gallons. (b) 2nd-Class Swim Length 144 ft. Width 35 ft. Capacity 164,898 gallons. (c) Small Swim Length 60 ft. Width 25 ft. Capacity 49,000 gallons. Method of Treatment Filtration through sand filters installed by Paterson Engineering Co. in 1935. Breakpoint Chlorination with Chlorine Gas Plants. Frequency of Change 3½ hour turnover on each Pool. Source of Supply Metropolitan Water Board. 21 bath samples were analysed by the Public Analyst. It is standard practice to record the number of bathers who have used the bath prior to the sample being taken and the number of bathers in the pool at the time of sampling, and the appearance of the water. In 19 cases, the appearance was clear and as regards the other two, the baths were being used by an unusually large number of bathers, when the appearance was slightly cloudy. The analyses, however, revealed bacterial counts of under 5 and free chlorine 1-5 p.p.m. and 3 p.p.m. respectively. Bacteriological Examination (a) Bacillus coli - Not found in 50 mls. - 21 (b) Number of bacteria per ml. No growth - 5 Under 5 - 12 Under 10 - 2 15 - 1 150 - 1 34 (c) Free Chlorine - Less than 0.3 p.p.m. - Nil. Whilst the majority of the samples were under 1 p.p.m. some were a little higher, the maximum recorded was 3.4 p.p.m. (d) Chloramine - Varied from 0.1 to 0.6 p.p.m. but in three samples there was a Nil recording. Regular tests are made at approximately 8.0 a.m., 12.30 p.m. and 4.0 p.m. each day by the Baths Filtermen who control the temperature and cleanliness and spot checks are made from time to time by the Baths Superintendent. HAIRDRESSERS AND BARBERS In accordance with Section 18 of the L.C.C. (General Powers) Act, 1954, relating to hairdressers and barbers' establishments, five such premises were registered during the year. The total premises registered at the end of the year were 74. STREET TRADING The stalls in East Street, Westmoreland Road and the surrounding areas have been the subject of more concentrated inspection; inspections have been made daily Tuesday to Saturday, and on every Sunday morning a Public Health Inspector has been on duty in the market. The stall holders dealing in foodstuffs have again been given extracts from the regulations so that they might be cognizant of the requirements, and personal advice has been given to them by the Public Health Inspectors. There has been a marked improvement and in most cases the Food Hygiene Regulations are being complied with. Generally speaking, the regular traders are co-operating satisfactorily, but some occasional traders are presenting problems. STREET TRADING BYE-LAWS The Secretary of State has approved draft bye-laws for both registered street traders and licensed street traders, which are being considered by the Works Sub-Committee of the Metropolitan Boroughs' Joint Committee. 35 LONDON COUNTY COUNCIL (GENERAL POWERS) ACT, 1959. CONTROL OF MOVABLE DWELLINGS. Section 22 of this Act requires a licence to be obtained from the I borough council for the occupation of a caravan or other movable HOUSE PURCHASE AND HOUSING ACT, 1959 I This Act came into operation on 15th June, 1959, and empowers local authorities to advance to prospective purchasers the full value of a dwelling house. A new type of improvement grant, known as a "standard grant", was introduced, which must be paid by a local authority on application towards the cost of providing certain standard amenities, namely, a fixed bath or shower, wash-hand basin, hot water supply, water closet and satisfactory facilities for storing food, in a house not already so provided. The amenities must be for the sole use of the occupants of the dwelling, the applicant must have a freehold or leasehold interest of at least 15 years, and the local authority must be satisfied that the house will be fit for human habitation for at least that period. The amount of the grant will be half the actual cost of the work up to a maximum grant of £155, reduced by certain amounts for each amenity with which the dwelling is already provided. LANDLORD AND TENANT (FURNITURE AND FITTINGS) ACT, 1959 This Act makes it an offence to offer, in conjunction with the granting, renewal, continuance or assignment of a tenancy to which the Rent Acts apply, furniture, fittings or other articles at a price which the vendor knows or ought to know is unreasonably high. A local authority with reasonable grounds for suspecting that this offence has been committed may, - after giving not less than 24 hours' notice to the person entitled to possession or his agent that facilities for inspecting the furniture and fittings will be required, - authorise entry on the premises for that purpose. The Chief Public Health Inspector and other Public Health Inspectors were authorised to enter premises for the purpose of inspecting furniture and fittings in pursuance of section 1 (2) of this Act. IMPORTATION OF RAGS The Metropolitan Boroughs' Standing Joint Committee have made representations to the Ministry of Health that increased powers should be taken under the Anthrax Prevention Act, 1919, for the sterilisation of imported rags. 36 The Ministry state that although it is not impossible that infectious diseases might be spread by rags, there is no definite evidence One importer is, however, to report to the Waste Trades Federation with a view to the members of that body bringing joint pressure on j offending exporters in order to achieve improvement in the cleanliness of bales and their binding. If there are further complaints the matter will be taken to the International Organisation of the Waste Trades Industry. SANITARY CONVENIENCES AT INNS, ETC. Section 25 (3) of the London County Council (General Powers) Act, 1959, relating to the provision and maintenance of sanitary conveniences at inns, refreshment houses or places of public entertainment, enables the Borough Council by notice to require the owner or occupier to provide and maintain in a suitable position a reasonable number of sanitary conveniences for the use of persons frequenting the premises, It does not apply to premises licensed for music or dancing, cinematograph performances or stage plays, premises where there is in force a Justices' Licence for the sale of intoxicating liquor for consumption on the premises or premises forming part of a railway station, and it therefore appears that in this Borough it will apply principally to restaurants and cafes. SALE OF CORROSIVE POISONS TO CHILDREN In January, on the recommendation of the Accident Prevention and Child Safety Committee, the Council agreed to request the Association of Municipal Corporations to consider taking steps to secure the prohibition of the sale of corrosive poisons to children under 16 years of age, and to invite the Metropolitan Boroughs' Standing Joint Committee to support the Council's view. The Standing Joint Committee agreed with the Council on this matter, but suggested that the upper age limit should be reduced from 16 years as suggested by this Council, to 14 years. The Association of Municipal Corporations, whilst appreciating the Council's concern, felt that there was no reason to suppose that the sales of corrosive poisons to children were other than exceptional, and that in general parents did not send children to purchase such dangerous substances. In the absence of sufficient evidence to justify prohibition on the lines suggested, the Association were unable to take the matter further. In order to secure evidence in support of the Council's view, the Accident Prevention and Child Safety Committee arranged for a 37 dential enquiry to be addressed to retailers of Part II poisons. This enquiry was circulated at the end of July, and retailers were asked to indicate the approximate number of occasions since the 1st January 1959, upon which children under 14 years had asked to be served with bottles of corrosive poisons. 33 replies were received from retailers who stock corrosive poisons. 24 retailers stated that they had not been asked to serve any children under 14, but the remaining 9 estimated that requests for such sales had been made on a total of approximately 63 occasions. Accordingly the Council requested the Association of Municipal Corporations to reconsider the matter having regard to the evidence obtained. SINK WASTE DISPOSAL UNITS The Public Health Committee have drawn the attention of the Metropolitan Boroughs' Standing Joint Committee to the growing practice of installing sink waste disposal units. While it was suggested that such machines should be brought within the scope of the drainage bye-laws, there is not at present sufficient evidence of the working of these machines to warrant the inclusion of such provisions in the drainage bye-laws. NOISE ABATEMENT SOCIETY The Council has accepted an invitation to become a member of the Noise Abatement Society. The Society aims to eliminate excessive and unnecessary noise from all sources, by means of publicity, pressing for the enforcement of existing laws and for new bye-laws where existing laws appear inadequate. REFUSE STORAGE ACCOMMODATION Section 24 of the London County Council (General Powers) Act, 1959, gives to metropolitan Borough Councils a measure of control over arrangements for the storage of dustbins for house refuse in any building which is erected, rebuilt, converted or adapted on or after 1st April, 1960, or in respect of which there is a change in the use or occupation, involving works of a structural nature. 38 FACTORIES ACTS Seven hundred and eighty-six inspections of Factories were made during the year, and 24 notices were served. There are now 905 factories of all types on the register, comprising 197 factories without mechanical power, 671 with mechanical power, and in addition 37 building sites, for which a further 51 inspections were made, but no notices served. Number on Register Number of:- Inspections Notices Prosecutions (i) Factories in which Sections 1,2,3,4 and 6 are to be enforced by Local Authorities 197 70 1 - (11) Factories not included in (i) in which Section 7 is enforced by the Local Authority 671 716 23 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding outworkers premises) 37 51 - - Total 905 837 24 Defects found and remedied: No. of cases in which defects were:- Particulars found remedied referred to H.M. Insp. referred by H.M. Insp. No. of Prosecutions Want of cleanliness (SI) 1 1 1 - - Overcrowding (S2) - - - - - Unreasonable temperature (S3) — — — — - Inadequate ventilation (S4) — - — - - Ineffective drainage of floors (S6) _ — — — - Sanitary Conveniences (7):- (a) insufficient 1 1 - - - (b) unsuitable or defective 68 67 - 1 - (c) not separate for sexes — — - — - Other offences against the Act (not including offences relating to Outwork) 30 20 - - - Total 100 89 1 1 - 39 AIR POLLUTION (Smoke Abatement Officer - Mr. G. Stubbs) The figures of deposited matter in the Borough, as recorded by the Council's instruments, show a slight improvement. There was, however, an increase in the amount of smoke as compared with the previous year, and the sulphur dioxide figures, both from the lead peroxide instruments and the daily volumetric apparatus, have again shown a higher average. During the latter part of the year the old Bankside Power Station was demolished by the Central Electricity Generating Board to facilitate the completion of the new Power Station. A "Cleaner Air in Southwark" Exhibition was held at the Newington Public Hall, Manor Place from April 13th to 18th. In addition to the models constructed by the staff of the Public Health Department on the theme "smoke through the ages", there were exhibits depictingthe harmful effects of smoke pollution, particularly from the domestic use of raw coal, and showing alternative methods of heating by smokeless fuels, gas, electricity and oil. The apparatus used for the measurement of atmospheric pollution were demonstrated and explained. A variety of films, both instructive and entertaining, were shown throughout each day and proved very popular. These films were made available by the various exhibiting organisations. The publicity for the exhibition was widely covered by hand-bills, posters, slides in cinemas, advertisements in local newspapers and in the Council's "Civic News" distributed to every dwelling in the Borough. The B.B. C. referred to the Exhibition in local news bulletins and considerable publicity was given by the local Press. There was a satisfactory standard of attendances and special arrangements were made for conducting parties of school-children and technical students round the Exhibition. During the year several complaints were received of smoke emissions from incinerators burning waste products. As a result of visits by the Inspector, one modern incinerator was installed and two others were renovated, and two firms decided to discontinue burning their trade wastes. Fifteen notifications were received of proposals to install new furnaces, and plans and specifications in'respect of three other instalations were submitted and approval given. One other application for approval is the subject of negotiations. 40 The Council has in use two Standard Deposit Gauges, three Lead Peroxide Instruments and one Smoke and Volumetric Sulphur-Dioxide apparatus. The Central Electricity Generating Board has two Standard Deposit Gauges in Southwark and has installed a Lead Peroxide Instrument on the jetty of the Bankside Power Station. During the year 17 complaints were received regarding smoke emission, 233 special observations and inspections were made by the Inspector. 11 Intimation Notices were issued and it is pleasing to record that the managements took remedial action on all occasions. 41 SULPHUR DIOXIDE (Lead Peroxide Method) (mgm. S03 100 sq. cm./day) Mean Daily Concentration of SULPHUR DIOXIDE Parts per 100 million SMOKE mgms/ per 100 cub. mtrs. 1959 Walworth Road St. George 's Bankside Walworth Road January 6.7 5.0 7.7 24.0 51.4 February 6.5 4.8 7. 1 21.5 43.7 March 3.4 2.4 3.7 9.8 30.3 April 3.6 2.6 3.5 8.7 19.8 May 2.5 2. 1 2.7 8.2 16.7 June 2.2 2.0 2.2 5.9 12.6 July 1.6 1.1 1.8 3.9 11.2 August 2.2 1.6 2.4 4.7 16.2 September 2.6 1.7 2.7 7.2 21.4 October 4.4 2.5 4.2 9.8 30.3 November 4. 1 2.6 4.4 17.7 55.3 December 3.9 3.1 4.1 8.7 19.8 Deposited matter at following sites:- 1959 Rainfall (inches) baNkside walworth road GREENMORE WHARF bankside jetty (Recorded by Borough Council) (Recorded by Central Electricity Generating Board) tons per square mile January 1.81 27.5 24.4 26.9 24.1 February 0.04 37.7 20.2 70.1 35.6 March 2.05 31.9 26.8 54.5 62.7 April 1.85 25.7 18.5 37.9 28.4 May 0.79 16.3 12.4 47.9 20.1 June 0.99 22.8 16.9 33.0 26.2 July 1.18 26.4 14.1 24.6 14.4 August 1.73 23.4 13.0 26.1 22.0 September 0.08 13.4 11.0 8.9 12.5 October 1.85 35.1 27.0 15.1 31.0 November 2.56 33.7 24.2 72.6 27.9 December 3.03 23.1 16.0 24.8 20.1 42 HOUSING The duties of the Housing section of the Public Health Department are divided between action under the Housing Act in relation to overcrowded, unfit and insanit&ry premises, and negotiations between the London County Council, the Council's Housing Manager and other authorities in connection with applications for rehousing on grounds of medical necessity, overcrowding and insanitary conditions. HOUSING ACT, 1957 1.- Individual unfit houses incapable of repair at reasonable expense Representations (Section 16) 46 Undertakings to demolish accepted (Section 16)1 Demolition Orders made (Section 17) 6 Closing Orders made (Section 17) 5 Houses demolished as a result of formal or informal procedure 75 Houses closed in pursuance of an undertaking given by the owners and still in force Houses made fit by owner (Section 16) 1 2.- Parts of buildings unfit for human habitation (i) Underground rooms closed (Section 18) 34 (ii) Other rooms (Section 18) 68 (iii) Undertakings 40 3.- Clearance areas Dwelling houses demolished Unfit houses 42 Other houses 4 43 HOUSING STATISTICS No. of Dwellings in Borough 24,806 1. Inspection of Dwelling Houses during the year:- (1) (a) Dwellings inspected for housing defects (under Public Health or Housing Acts) 7,133 (b) Inspections made for the purpose 13,362 (2) Dwellings inspected and recorded under Housing Consolidated Regulations, 1925 1,169 (3) Dwellings found to be in a state so dangerous or injurious to health as to be unfit for human habitation 276 (4) Dwellings found not to be in all respects reasonably fit for habitation 1,079 2. Remedy of defects during the year without service of formal notices Dwellings rendered fit in consequence of informal action by the local authority or their officers 1,007 3. Action under statutory powers during the year:- (a) Proceedings under Sections 9, 10 and 12 of the Housing Act, 1957 - Dwellings in respect of which notices were served requiring repairs (b) Proceedings under Public Health Acts - (1) Dwellings in respect of which notices were served requiring defects to be remedied 1,054 (2) Dwellings in which defects were remedied after service of formal notices - (i) By owners 887 (ii) By local authority in default of owners 26 (c) Proceedings under Sections 16 and 23 of the Housing Act, 1957 - (1) dwellings in respect of which Demolition Orders were made 6 (2) Dwellings demolished in pursuance of Demolition Orders 74 44 (d) Proceedings under Section 18 of the Housing Act, 1957 - (1) Separate tenements or underground rooms in respect of which Closing Orders were made 102 (2) Closing Orders determined, the tenements or rooms having been rendered fit 1 (e) Proceedings under Section 42 of Housing Act, 1957 - (1) Number of houses included by representation by Medical Officer of Health 73 (2) Number of houses demolished in pursuance of representations 46 (f) Proceedings under Section 28 of the Housing Act, 1957 - (1) Closing Orders made- (2) Closing Orders determined 4. Housing Act, 1957, Part IV - Overcrowding:- (1) Number of overcrowded families on register at beginning of year 268 (2) Number of new cases encountered during year 26 (3) Number of cases relieved during the year 35 (4) Number of overcrowded families on register at end of year 259 REHOUSING MEDICAL CASES Recommendations 1958 1959 To L.C.C. on grounds of Tuberculosis - 2 To L.C.C. on other medical grounds 1 11 To Southwark Borough Council on medical grounds 100 120 To Southwark Borough Council on grounds of Tuberculosis 5 3 Total cases recommended 106 136 45 Rehoused 1958 1959 By L.C.C. (Tuberculosis cases) 18 10 By L.C.C. (other medical cases) 49 36 By Southwark Borough Council (Tuberculosis cases) 6 4 By Southwark Borough Council (other medical cases) 25 47 Tuberculosis cases rehoused by own efforts 13 6 Other medical cases rehoused by own efforts 9 10 Total cases rehoused 120 113 OVERCROWDING 1958 1959 Families Persons Families Persons Remaining on register 319 7,270 268 1,002 New Cases 27 140 26 143 Total 346 1,410 294 1,145 Overcrowding abated 78 408 35 195 Remaining on register 268 1,002 259 950 Overcrowding abated: Rehoused by L.C.C 30 152 18 97 Rehoused by Borough Council 8 41 6 37 Found own accommodation 18 82 11 61 Cases removed by overcrowding survey 22 133 - - Total 78 408 35 195 46 FOOD THE INSPECTION AND SUPERVISION OF FOOD During the year, 279,659 tons of imported food were inspected under the Public Health (Imported Food) Regulations 1937 and 1948, and the Public Health (Preservatives etc. in Food) Regulations, 1925 to 1953. The consignments imported were as follows:- Discript ion Tonnage Fresh & Chil-led Meat 47,971 Meat Products etc. 20,569 Offal 8,752 Poultry & Rabbits 1,987 Bacon 546 Butter 31,527 Margarine 2,333 Lard 10,481 Milk Products 4,427 Egg Products 3,202 Cheese 20,948 Fresh Fruit 34,033 Dried Fruit 11,208 Canned Fruit 33,240 Purees, Pulp & Fruit Juices 1,800 Fresh Vegetables 11,366 Canned Vegetables 4,140 Canned Fish 9,793 Preserves 408 Cocoa Butter 1,160 Des. Coconut 1,056 Palmkernel Oil 1,318 Nuts 4,978 Licorice Paste 287 Flour etc. 9,700 Chicory 443 Confectionery 229 Cocoa 144 Peppers 68 Suger 1,489 Canned Soups 46 Miscellaneous 20 Total 279,659 47 Samples Submitted: Chemical Analysis Samples of: Number submitted Canned Fruit 39 Canned Meat Products 14 Canned Fish 37 Canned Cereals 1 Canned Vegetables 2 Total 93 Bacteriological Examination Egg Products: Danish 216 Australian 181 Dutch 376 American 529 Canadian 194 Chinese 451 Brazilian 39 Czechoslovakian 140 Norwegian 6 Polish 1 Swedish 1 Canned Goods etc 36 Total 2,170 PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS 19'37 AND 1948 PUBLIC HEALTH (PRESERVATIVES ETC. IN FOOD) REGULATIONS, 1925 TO 1953 Chinese Mangoes in Syrup Because of unsatisfactory chemical reports, two consignments comprising 240 cases and 750 cases (48 x 20 oz. tins) of Chinese Mangoes were detained, pending negotiations as to their ultimate disposal. Australian Butter 9 x 56 lbs. cartons of Australian Butter, contaminated by river water were detained and later released for refining purposes. 48 New Zealand Butter 9 x 56 lbs. cartons of New Zealand Butter, contaminated by river water were detained and later released for refining purposes. Pork Rib, Pork Rib Roll & Liver Sausage On examination, 6 cases (approx. weight 3 cwts. 2 qtrs.) were found to be in a state of decomposition and were surrendered for destruction at the Council's Depot. New Zealand Butter Consignments comprising 523 x 56 lb. boxes were contaminated by river water and detained. They were later released for trimming and blending purposes. MERCHANDISE MARKS ACT, 1926 At the time of inspection of foodstuffs on importation, and in shops and on street stalls, attention has been given to the requirements relating to Indication of Origin. Most products to which the Act applies, including meat, oat products, and dried fruit appear to have been satisfactorily marked. There have been occasions when the vendors have had to be requested to indicate the origin of tomatoes and apples, but legal proceedings have not been necessary. UNSOUND FOOD During the year 165 tons 6 cwts. 27 lbs. of food examined at wharves, warehouses and shops were found unfit for human consumption and disposed of as follows:- Food condemned at wharves and warehouses:- Destroyed: Tons Cwts. Qtrs. Lbs. Fresh & Chilled Meat 1 20 Poultry & Rabbits 4 3 4 Meat Products 27 13 3 10 Bacon 7 Canned Fish 3 8 2 17 Fresh Fruit 26 18 3 26 Canned Fruit 27 1 1 4 Dried Fruit 13 - 22 Purees, Pulp & Fruit Juices 12 19 1 11 Fresh Vegetables 5 12 3 11 49 Destroyed: Tons Cwt s. Qtrs. Lbs. Canned Vegetables 4 2 3 17 Cheese 17 1 6 Canned Milk 1 9 - 23 Cereals 19 3 19 Preserves 1 2 14 Biscuits 15 - 14 Canned Soups 3 2 10 Frozen Egg 1 2 26 Confectionery 2 - 1 7 Peppers 6 1 5 Nuts 11 14 2 20 Gherkins 1 - 6 Offal 10 1 26 Miscellaneous ~ 1 22 Total 128 5 - 12 Food released for Non-edible Manufacturing Purposes:- Fresh & Chilled Meat 10 7 - 17 Offal 17 1 1 Bacon 9 4 1 16 20 8 3 6 Food condemned at shops and destroyed:- Destroyed: Fresh & Chilled Meat 13 1 11 Meat Products 8 1 27 Poultry 2 - 11 Offal - 3 12 Fish - - 20 Canned Fish - - 26 Canned Fruit 4 2 2 Purees, Pulp & Fruit Juices 1 1 14 Canned Vegetables 1 - 6 Preserves - - 6 Miscellaneous - - 14 1 12 1 9 50 Released for Animal Feeding:- Tons. Cwts. Qtrs. Lbs. Yams 15 ICE-CREAM There are 285 ice-cream dealers and 10 manufacturers in this Borough, an increase of 21 dealers, since last year. Most of the dealers sold only pre-packed ice cream, obtained from the large manufacturers. 32 samples of ice-cream were taken with the following results:- 23 samples, Grade I 5 samples, Grade II 3 samples, Grade III 1 sample, Grade IV In addition: 27 samples were chemically examined for compliance with the prescribed standards of composition, and all were found to be satisfactory. Periodical inspections were made to all premises and copies of the Public Analyst's reports on samples taken were forwarded to the vendors concerned. In the case of Grade III and IV samples, special investigations were made at the premises in an effort to detect the causes of the unsatisfactory gradings. ICE CREAM (HEAT TREATMENT) REGULATIONS, 1959 Under these Regulations, ingredients used in the manufacture of ice cream must be pasteurised by one or other of three specified methods or sterilised, and thereafter kept at a temperature below 28 degrees Fahrenheit until the freezing process is commenced. Certain types of water ices and iced lollies sufficiently acid to render this treatment unnecessary are exempted from the Regulations. ICE CREAM REGULATIONS The Food Standards (Ice Cream) Regulations, 1959, replace the previous Order and introduce separate standards for dairy ice-cream 51 and milk ice, providing that such ices shall contain no fat other than milk fat, except such as may be introduced by the use of any egg, flavouring substance or emulsifying or stabilising agent. The Regulations also provide thatnotype of ice-cream shall contain any artificial sweetener. The Labelling of Food (Amendment) Regulations, 1959, contain new provisions relating to ice-cream, prohibiting the labelling, marking or advertising of ice-cream in a manner suggestive of buttftr, cream, milk or anything connected with the dairy interest unless it conforms with the provisions relating to dairy ice-cream or milk ice referred to above. After 30th November, 1959, it will be an offence to sell under the description "ice-cream" any pre-packed ice-cream which contains fat other than milk fat unless it bears on the wrapper or container a declaration "Contains non-milk fat" or "Contains vegetable fat", as the case may be. MILK AND DAIRIES (GENERAL) REGULATIONS, 1959 These Regulations which replace the former Regulations include the following principal changes:- (a) The definition of "notifiable disease" has been amended by the inclusion of "food poisoning". (b) Distributors are required to be registered only with the local authority in whose area the premises from which the milk is distributed are situated. (c) Provision is made for the local authority to pay compensation to a person who sustains damage or loss through being debarred by the Medical Officer of Health from certain employment connected with milk because he is suffering, or had been in contact with a person who is suffering, from a disease liable to cause infection of milk. (d) A notice prohibiting the sale of milk infected, or suspected of being infected, with tuberculosis will operate until it is withdrawn. (e) The Medical Officer of Health is required to notify the Minister of the withdrawl of an infected milk notice, as well as providing the Minister with a copy of notices served. (f) Compensation will now be payable to a dairy farmer who had suffered loss or damage as a result of being served with an infected milk notice only when the notice has been wrongly served or has not been withdrawn as soon as possible. 52 (g) Persons engaged in the milking of cows or otherwise having access to milk in open containers must wear clean and washable hand covering and overalls. Open cuts must be kept covered with a waterproof dressing and spitting and the use of tobacco is prohibited. Occupiers of dairies and dairy farms must provide first aid equipment. DESIGNATED MILK The following Licences were issued under the Milk (Special Designation) (Raw Milk) Regulations, 1949 to 1954 and Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949 to 1953:- 129 Dealers' Licences for Pasteurised Milk. 120 Dealers' Licences for Sterilised Milk. 91 Dealers' Licences for Tuberculin Tested Milk. Twenty-eight samples of Designated Milks were submitted to the Public Analyst for examination, all of which satisfied the prescribed tests. Twenty samples of Pasteurised milk supplied to local schools were also examined by the Public Analyst, and the London County Council were informed of the results which were satisfactory in each case. MILK SELLERS There were 148 registered milk distributors in the Borough, whilst the number of distributors purveying milk in the Borough from registered premises elsewhere was 19. 270 inspections of Milk shops and Dairies were made during the year. PUBLIC HEALTH (CONDENSED MILK) REGULATIONS Four samples of condensed milk were purchased for analysis and all were certified to comply with the regulations. CONDENSED MILK REGULATIONS, 1959 Minimum percentages of milk fat and milk solids including fat for condensed partly skimmed (half cream) milk are prescribed in the above Regulations, which became operative in June 1959, and re-enact the previous regulations controlling the manufacture, labelling and sale of condensed milk. 53 SLAUGHTERHOUSES There are now no slaughterhouses in the Borough. CATERING ESTABLISHMENTS There are 391 catering establishments in the Borough. These include riverside snack bars, cafes, coffee stalls, mobile snack bars, public house restaurants, and industrial canteens. All have received systematic inspection and close supervision during the year, and a satisfactory standard has been maintained. REGISTRATION OF FOOD PREMISES (Food and Drugs Act, 1955) There are now 82 premises registered for the purpose of the Preparation or Manufacture of Sausages or Potted, Pressed, Pickled or Preserved Food intended for Sale. BAKEHOUSES There were 16 Bakehouses in use of which 3 were Basement Bakehouses. 39 inspections were made by the Public Health Inspectors. MEAT UNFIT FOR HUMAN CONSUMPTION Regulations due to come into effect on April 1st 1959 for the staining and sterilising of all meat unfit for human consumption were subsequently revoked. It is understood, however, that they may be reexamined in the light of representations made the bodies affected. MEAT CONTENT OF SAUSAGES The Metropolitan Boroughs' Standing Joint Committee was requested to press for the introduction of standards for the meat content of sausages. The Standing Joint Committee, however, stated that the matter was under consideration by the Ministry of Agriculture, Fisheries and Food. 54 PERISHABLE FOODSTUFFS A suggestion was made to the Metropolitan Boroughs' Standing Joint Committee that it should be made compulsory to mark the containers of perishable foodstuffs with the date of manufacture or the date by which the contents should be consumed. The matter was considered by the General Purposes Sub-Committee of the Standing Joint Committee, and the Medical Advisory Body expressed the view that the suggestion was not practicable. They pointed out that there is ample legislation under the Food and Drugs Act and the Food Hygiene Regulations dealing with the sale of food unfit for human consumption, and that prosecutions have nearly always had a salutary effect on traders. In view of these observations the Sub-Committee were not prepared to take any action in the matter. ARSENIC IN FOOD REGULATIONS, 1959 These regulations, which came into operation August 1959, make it an offence to sell, consign, deliver or import into England and Wales any food which contains more than 1.0 part per million of arsenic. Variations of this limit are specified for certain substances which include beverages, soft fruit concentrates, ice cream, essences etc. FOOD SHOPS Public houses 152 Cafes 122 Factory canteens 117 Butchers 65 Fish shops (wet and dry) and fried fish shops 32 Bakehouses 16 Greengrocers 57 Grocers 132 Ice-cream dealers and manufacturers 295 Schools providing food 50 Milk distributors 148 55 ANALYSIS OF WORK CARRIED OUT IN FOOD PREMISES Food rooms repaired and redecorated 196 Equipment provided or improved 122 Lighting improved 26 Ventilation improved 26 Food cupboards provided 49 Refrigerators provided or repaired 41 Accommodation for clothing improved 37 Wash-hand basins provided or renewed 41 Hot water supplies provided 45 Sinks provided or renewed 68 Sanitary conveniences repaired and redecorated 67 Drainage systems repaired or improved 35 Roofs and gutters repaired 41 Yards repaired and cleansed 41 Accumulation of refuse removed 66 Dustbins provided 80 FOOD SAMPLING 430 formal samples and 760 informal samples were submitted to the Public Analyst. Of these, 5 and 12 respectively revealed adulteration or other infringements, as follows:- 56 Samples Examined Formal Informal Non-genuine Samples Formal Informal Milk 81 28 - - Condensed Milk - 4 - - Ice Cream 32 27 - - Fats, etc. 39 28 - - Meat & Fish Preparations 56 137 1 1 Cereals etc. 22 58 - 3 Vinegars & Non-Brewed Condiments 19 20 2 1 Herbs 12 31 - - Spices & Condiments 21 42 - - Pickles, Sauces etc. 14 47 - - Jams & Preserves 16 18 - - Wines, Spirits, Ales 13 24 - - Soft Drinks 1 22 - 1 Medicine & Drug Preparations 4 87 - 2 Fruit, etc. Canned and Dried 37 58 1 1 Canned Vegetables etc. 1 23 1 - Canned Soups etc. 4 17 - - Custard Powder, Jellies etc. 3 19 - - Confectionery 26 28 - 3 Tea, Coffee, Cocoa etc. 21 25 - - Cake & Pudding Mixtures 8 14 - - Miscellaneous - 3 - - 430 760 5 12 57 Non-Genuine Samples Informal samples Result of analysis Action taken No. Sample of 697a Canned Tomato Paste Tin - 3.3 grains per pound Formal sample taken 12a Wine Vinegar 7.5 per cent deficient in Acetic Acid Formal sample taken 24a Self-raising Flour Deficient in Creta Praeparata Stock withdrawn from sale 60a Self-raising Flour Deficient in Creta Praeparata Stock withdrawn from sale 88a Lobster Spread 28 per cent deficient in lobster Further samples satisfactory 106a Indigestion Tablets Incorrectly labelled Manufacturers undertook to amend label 137a "Rivella" Misleading label Wording of label amended 219a Cornmeal Contained maggots and webbing Stock destroyed 226a Butter Mints 50 per cent deficient in Butter Fat Subsequent sample correctly described as 'Butter Flavoured' 231a Aniseed Balls Contained non-permitted colour Old stock destroyed 380a Glauber's Salt Effloresced Stock destroyed 408a Chocolate Cigarettes Wrapped in metal foil containing 19 per cent copper Ministry of Health informed Formal samples 1 Canned Tomato Paste Tin - 4 grains per pound Cautionary letter 20 Wine Vinegar 8-5 per cent deficient in Acetic Acid Cautionary letter 83 Saveloy Sulphur dioxide 260 parts per million Cautionary letter 253 Non-Brewed Condiment 12.5 per cent deficient in Acetic Acid Cautionary letter 283 Cocktail Onions Not labelled with ingredients Cautionary letter 58 CONTRAVENTIONS OF FOOD HYGIENE REGULATIONS, 1955 LEGAL PROCEEDINGS Defendant Offence Result Street Trader Failing to exhibit name and address. Reg. 26(1)(a). £2.0.0. Fine £1.0.0. Costs Street Trader Permitting food to be exposed to risk of contamination. Reg. 5. £1.0.0. Fine Street Trader Failing to protect food from risk of contamination. Reg. 8(a). £2.0.0. Fine £1.0.0. Costs Street Trader Failing to protect food from risk of contamination. Reg. 8(a). £5.0.0. Fine £1.0.0. Costs Street Trader Using tobacco whilst handling food. Reg. 9(e). 10.0. Fine Street Trader Using tobacco whilst handling food. Reg. 9(e). £2.0.0. Fine £2.2.0. Costs Street Trader Using tobacco whilst handling food. Reg. 9(e). £3.0.0. Fine Street Trader Using tobacco whilst handling food. Reg. 9(e). £3.0.0. Fine Street Trader Use of tobacco while handling open food. Reg. 9(e). 10.0. Fine Street Trader Failing to exhibit Name and Address. Reg. 26(1)(a) 10.0. Fine Street Trader Use of tobacco while handling open food. Reg. 9(e). £1.10.0. Fine 10.0. Costs Street Trader Failing to exhibit Name and Address. Reg. 26(1)(a). £1.10.0. Fine Street Trader Use of tobacco while handling open food. Reg. 9(e). £1.10.0. Fine 10.0. Costs Thirteen cautionary letters were sent in respect of other non-genuine samples and other articles of food complained of by the Public. 59 PHARMACY & POISONS ACT, 1933 There are 61 names of persons on the Council's list of Sellers of Part II Poisons, in connection with which 102 inspections were made. NATIONAL ASSISTANCE ACT Compulsory Removals Action was taken under the National Assistance (Amendment) Act, 1951, for the compulsory removal to hospital of an aged person in need of care and attention. Burial of the Dead During the year the Council arranged for 22 burials under Section 50 of the National Assistance Act, 1948, at a cost of £243.2s.6d. A total of £l24.17s.4d. was recovered from the effects of the deceased persons. WELFARE OF THE AGED The following is an extract from the Annual Report of Miss D. Beer, A.I.S.W., Organising Secretary of the Southwark Old People's Welfare Committee:- "We present the Ninth Annual Report for the Southwark Old People's Welfare Committee for the year 1959/1960 and in doing so we would like to express our gratitude to the Borough Council for its valuable support and for the generous grants which it has made to us during the past year; to the Mayor for his support and encouragement, and to all those, both young and old, who have given donations and practical help to the aged in so many different ways. The Southwark Old People's Welfare, in dealing with the problem of the aged, seeks to secure to the full extent such degree of normality of life as is possible to old people within the limits of their physical and mental capacity. A great deal can be done in this direction when once the measure of handicap is understood. Loneliness is one of the most dreaded accompaniments of old age. Old friends die, relatives move to other parts of the country and the old people find that they are becoming more and more left by themselves. It is difficult, perhaps, to find new friends and the easiest course is to stay at home, and to live in the past. This can lead to a degree of unhappiness that is 60 dreadful to see, and to a physical and mental decay and disintegration which leads to the rapid onset of a really senile state, when all selfrespect is lost. Old people then become careless about themselves; they neglect their personal appearance and make no attempt to take proper meals, and mentally then soon become hostile and suspicious. Loneliness, one of the greatest curses of our social life, cannot be tackled by legislation. No act of Parliament can deal with this evil - it is a curse which can only be eradicated by society itself, Old people should not be treated as a separate section of the community, a section of no further use. Old people should be assisted to maintain their place in the community and be helped to continue to take their share in the responsibilities and in the enjoyment of the privileges which are an essential feature of remaining an active member of the community. This then is the aim of the Southwark Old People's Welfare Committee to enable as many old people as possible to continue to live happy and independent lives in their own homes for as long as possible. This year has been one of progress. On the 30th June we moved into our new Headquarters at St. Alban's Hall where we have very much more room to expand and a much larger restaurant with seating capacity for 136. With an increase in the expectation of life seems to have come an increase in the youthful activity of the elderly and at St. Alban's Hall we have plenty of opportunities of satisfying these demands. Classes are held each week in handcrafts - leather work, rugmaking, dressmaking - also Old Time Dancing. A choir has been formed and great progress has already been made in this direction. Many lonely old men and women have found that life has begun afresh for them. Mixing again in society, having papers to read and discuss, and games to play, encourage old people to remain active mentally as well as physically. During the past year many old people have come to us for help. They bring with them a variety of problems, often complicated, needing tactful investigation and involving family relationships, but with much patience and careful thought a solution is usually found. The old people are happy to trust us, confident that we shall do everything possible to overcome their difficulties. In many cases, where an old person is senile or very infirm, we act as agents to draw their pension, pay their rent and do their shopping. It is no easy task to plan a budget covering necessary expenditure-with a small margin for personal allowance - when there is only the old age pension. Visiting The regular, expected visit makes a big difference to many a lonely homebound old person, for there are many who never see a new 61 face or have a visitor from year's end to year's end. Then, too, the regular visitor may be able to detect any early deterioration in the health of an elderly person, and can often arrange for medical advice and treatment to be obtained in time to prevent some incipient disease or deformity from becoming crippling. Unfortunately visitors are scarce; it would seem as though people are afraid to associate themselves with the problem of the aged and yet if life goes on everyone will find themselves in the same state. Let all who read this report accept the challenge of the problem of old age and be prepared to take their share in solving it. If every man and woman in Southwark would give an hour a week to visiting a lonely old person, much suffering would be relieved in this Borough of ours. Restaurant and Meals-on-Wheels Service The restaurant at St. Alban's Hall is decorated in cheerful colourings and furnished with small tables each accommodating four. The old people begin to arrive soon after nine o' clock for morning coffee and biscuits - some even bring their breakfast - and enjoy a leisurely chat with friends in an atmosphere of warmth and cordiality which is especially welcome to those who live alone, perhaps in one room, and this helps them to feel that they still have a place in the world. If they have a problem to discuss or a contribution to pay in towards the holiday scheme, they take the opportunity of calling in at the office. As dinner-time approaches the hall fills up. The meal is served at 12.15 and a second sitting at 1 p.m. when all is cleared there is a cup of tea for those who wish to linger - either to pass an hour or two in the television room or simply just to talk and enjoy companionship. The Meals-on-Wheels service is growing each week, and the transPort is carrying far more than the maximum number of meals for its capacity, but our drivers and helpers never complain. Their one desire is to take a meal to every old person who is in need, and they give unstinted service, always on the watch to report any cases which seem to require special attention, or a visit. One reason for the increase in the number of meals delivered derives from the fact that many of the old people who have hitherto been able to come to the restaurant now find it impossible to leave their homes; some have been in hospital and after discharge are unfit to walk to the Hall. Such cases are constantly reported to us by doctors and almoners, and for all of them meals-on-wheels are an absolute necessity. Until this year the meals-on-wheels service functioned only four days a week but after investigation it was found that there was a very real need for dinners to be delivered on Mondays, and on Monday, 7th December a five-day service was inaugurated over most of the Borough. 62 Unfortunately the W.V.S., who continue to provide transport and helpers to cover the north of the Borough, are not yet in a position to deliver meals on Mondays, but they are hoping to do so in the near future. We are very grateful to Mrs. Meekins and her helpers for their invaluable assistance in this very vital branch of our work. The luncheon club at the Women's University Settlement continues to be well patronised, and on 7th March a new luncheon club was opened at Quinn's Square and from a small beginning the numbers are increasing steadily. 71,589 meals were cooked and served in the restaurant or sent out to the luncheon clubs and housebound during the year. This is an increase of 11,000 over the previous year. We should like to thank Mr. Bloomfield and his drivers for their co-operation and sympathetic help in the efficient working of this service, and thanks are also due to Mr. Durrant who for so long undertook the transport of Meals-on-Wheels. Transport We have many requests for transport and often find it difficult, through lack of voluntary drivers, to fit in all the journeys we should like to undertake. It means much to an old person who is herself unfit to battle with public transport to be able to visit a sick husband in a distant hospital, if only at rare intervals; or for a housebound invalid to be driven in comfort to the seaside to holiday or convalescent home. This is a service which is in a way complementary to the benefits offered by the State and contributes so much to the contentment of those who cannot travel in the normal way. We should like to thank Mr. Beckingsale and Mr. Morton, both postmen, also John Atherton of Cambridge House, who give up so much of their spare time to act as voluntary drivers in this work. We should welcome more offers from drivers who are free during the day to enable us to fulfil all the requests we receive. Chiropody Chiropody is a very important service for many of the old people. The clinic is still supervised by Miss Addiscott who, in her kindly and able manner, shows a personal interest in all those who attend. For those who are brought in by car, foot clinic day provides a happy change of atmosphere and a chat with old friends, besides an improvement in walking which is so encouraging to the homebound. 63 We are getting more applications than we can deal with, and unfortunately our domiciliary service can only be a three-monthly one. We were disappointed that with the introduction of chiropody into the Health Service we were not able to expand this branch of our work. There is a real need for several more sessions a week, but up to date we have not been given a grant sufficient to expand. Outings Outings have been numerous during the year. Coach trips to Brighton, Wittering, Albourne, Southsea; a river trip from Reading to Henley; visits to the Palladium and the Whitehall Theatre by coach these are some of the high-lights, and in addition there have been many parties and entertainments at St. Alban's Hall. Choir Festival The Festival for old people's choirs for South London was once again held in Crossways Mission and again Southwark took part, Seaside Holidays On Saturday, 16th May, 118 old people went to Bognor for a two weeks' stay by the sea. We were again able to take three very severe arthritics who were accommodated in a convalescent home belonging to the Bermondsey Mission. They were taken down in our own car and driven around during their stay. They were able to join the rest of the party at functions and outings specially arranged for their entertainment. We were glad for these badly crippled old people to have the opportunity of a holiday - accommodation for arthritics is difficult to find as all too few ground floor rooms are available in the hotels. We are indebted to the Mayor of Southwark for his grant of £500. This made it possible for so many old people to have a holiday at such a low cost. Comforts Fund During the year we have supplied, out of our Comforts Fund, a variety of articles, among others invalid foods, blankets, clothing, and have paid for convalescent holidays in needy cases. In addition, old people visited in hospital have received gifts of flowers, sweets and fruit. We have been able to meet all genuine requests for help largely thanks to the generosity of those who have sent donations to the Old People's Welfare Committee during the year. We hope that many more people who are interested in the welfare of the elderly will support us by sending donations, so that we may be able to widen the scope of this very important side of our work. 64 Christmas Party On Friday evening. 18th December a party was organised for homebound old people by the Mayor of Southwark and some of his friends at St. Alban's Hall. A most enjoyable tea was followed by an entertainment by members of the East Wittering Women's Institute, who came up from East Wittering, Sussex, especially for the purpose. Transport was arranged by members of the Southwark Branch of Rotary and by the L.C.C. Welfare Department. Library Service In addition to the library service to the homebound provided by the Public Libraries Committee of the Borough Council, a mobile library is set up at St. Alban's Hall every Friday, in the restaurant. Our grateful thanks are due to Mr. Boone, the Borough Council Librarian, and his staff, for this service, which enables the old people to enjoy a varied choice of reading without the effort of walking to the Public Library. Dickens Fair On Saturday, 21st November, we once again held a very successful Dickens Fair at the Manor Place Baths. Our grateful thanks are due to Mr. Wallis who put so much time and hard work into organising the Fair. Our grateful thanks are also due to all the kind friends who supported Mr. Wallis and worked so hard to make the day a success," CLEAN AIR EXHIBITION The "Cleaner Air in Southwark" Exhibition was held at the Newington Public Hall, Manor Place, from April 13th to 18th. The official opening was performed by His Worship the Mayor of Southwark, Councillor F.W. Combes, J.P., The Chairman of the Public Health Committee, Councillor J.J. Sheen, being in the Chair. A vote of thanks to the Mayor was moved by the Leader of the Council, Councillor A.J. Gates, O.B.E., J.P., and seconded by Councillor P.W. Fuller, Chairman of the Accident Prevention and Child Safety Committee. Mr. W.G. Fiske, C.B.E., Chairman of the London County Council Housing Committee, spoke on the purpose of the L.C.C. Exhibition on the Decentralisation of Industry. The opening ceremony and reception was attended by approximately 100 invited representatives from other authorities and the various organisations connected with the Exhibition. 65 In addition to exhibits relating to the dangers caused by smoke pollution of the air, through burning raw coal, and showing alternative methods of domestic heating by smokeless fuels, gas, electricity and oil, the Exhibition included an excellent display on the prevention of home accidents, the new Elephant & Castle development scheme, and the movement of industry to less congested areas outside London. There was a satisfactory standard of attendances, and special arrangements were made for conducting parties of schoolchildren and technical students over the exhibition, totalling over 350. Film displays were shown almost continually throughout each day of the week attracting large audiences. A wide variety of films, specially selected to appeal to children, adults and technical students, were made available through the courtesy of the various exhibiting organisations. Several of the models were constructed by the Public Health Department staff, and the fullest co-operation was accorded by all exhibitors and other interested bodies. Valuable publicity was also given by the local press and the B. B. C., who referred to the Exhibition in local news. The management of local cinemas kindly arranged for publicity regarding the Exhibition to be displayed on their screens. 66 MORTUARY Post-mortems without Inquest 1,017 Post-mortems with Inquest 167 Inquests without Post-mortems * Inquests, Post-mortems held elsewhere * Bodies brought in for convenience 1 Infectious disease deaths - 1,185 Bodies brought to Southwark Mortuary:- From Private addresses From Hospitals Southwark 118 18 Lambeth 272 186 Camberwell 203 260 Bermondsey 59 69 Total 652 533 Bodies brought from hospitals and institutions:- Guy's Hospital 6 Southwark Evelina Hospital 6 Newington Institution 6 Lambeth Hospital 66 Lambeth South Western Hospital 25 St. Thomas' Hospital 65 Waterloo Hospital 8 Belgrave Hospital 5 King's College Hospital 17 St. Giles' Hospital 119 Camberwell St. Francis' Hospital 20 Dulwich Hospital 121 St. Olave's Hospital 68 Bermondsey Bermondsey Medical Mission 1 Total 533 At the end of the year the Public Health Committee had under consideration the question of improving the accommodation at the Mortuary. 67 MEDICAL EXAMINATIONS The following medical examinations were carried out by the Medical Officer of Health:- Appointment to Staff: Officers 87 Manual staff 51 Special examinations: (sickness, permanent disability etc.) 7 145