24372 Public health dept. REPORTS COLLECTION COPY Public Health Act 13-10-52 Woo 51 METROPOLITAN BOROUGH OF WOOLWICH ANNUAL REPORT on the Health of the Metropolitan Borough of Woolwich for the Year 1951 BY T. STANDRING, M.D., B.S., D.P.H., M.R.C.S., L.R.C.P. Medical Officer of Health 2 TABLE OF CONTENTS page Health Committee 2 Preface 3 Staff 5 General Statistics 6 Vital Statistics 7 Sanitary Administration 12 Housing 21 Health Education 24 Inspection and Supervision of Food 28 Prevalence and Control of Infectious Disease (including Disinfection, Disinfestation and Personal Cleansing) 38 Laboratory Facilities 43 HEALTH COMMITTEE At 31st December, 1951. THE WORSHIPFUL THE MAYOR (Councillor J. Newman, O.B.E., J.P.) Alderman Mrs. J. R. Whiting (Chairman) Councillor G. E. Offord (Vice-Chairman) Councillors— T. G. Blann D. J. O'Byrne Mrs. E. Brooks Mrs. M. E. Polley N. G. Burbridge D. S. Ramsey G. S. Dean Mrs. K. M. Rance A. H. Gilder, M.B.E., J.P. D. S. Ritchie Mrs. A. E. Maxwell D. P. Walsh Mrs. E. R. M. Middleton T. STANDRING, M.D., D.P.H., M.R.C.S., Medical Officer of Health Telephone: WOOlwich 1121. TOWN HALL, WOOLWICH, S.E.18 Healths Compliments PREFACE To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Woolwich. Madam Mayor, Ladies and Gentlemen, I have the honour to submit the Fifty-first Annual Report on the health of the Borough of Woolwich. The Report is again prepared along the lines indicated by the Ministry of Health. There was no serious outbreak of any infectious disease during the year, and generally speaking, it can be said that the health of the Borough has remained satisfactory. The Registrar-General's estimate of the home population (which includes members of the Forces stationed in the district) in mid-1951 was 149,800, being 800 more than the previous year's estimate. A preliminary census report for the Borough has been issued, and this gives the population as 147,824, being 72,330 males and 75,494 females. The census figure is an increase of 943 on the 1931 census figure. Apart from the year 1940, total deaths of Woolwich residents (1,838) exceeded those occurring in any year since 1918. This was partly due to an increase of 43 deaths from heart disease, but resulted principally from cases of pneumonia, bronchitis and influenza which occurred in the first three months of the year. Compared with the previous year, there were 41 more deaths from bronchitis and more deaths from pneumonia and influenza occurring in persons over the age of 45 years. As will be seen from Table No. 4, the birth and death rates compare favourably with the national rates and with those for the County of London. Infant mortality at 27.7 is somewhat higher than in 1950 (24.4) there having been 10 more deaths of infants. From the table on page 8 there will be seen details of the increased number of deaths occurring locally from cancer of the lung and bronchus. Since 1945, whilst the total number of deaths from cancer has been almost equal in men and in women, 82 per cent. of the deaths of Woolwich persons from cancer of the lung and bronchus were in men. There is evidence that this is not peculiar to Woolwich. A number of explanations have been proffered, and it has been pointed out in The Lancet that deaths from cancer of the lung and bronchus in the majority of the Metropolitan Boroughs were, during 1950, more numerous than deaths from respiratory tuberculosis. With regard to infectious diseases, the number of confirmed cases of poliomyelitis showed a reduction compared with the experiences of the past two years, when there were over 50 confirmed cases each year. This year only four of the cases notified were subsequently confirmed. Woolwich has again been without a confirmed case of diphtheria, and the credit for this must go to the work being carried out locally to see that the majority of children are immunised. However, in spite of efforts to emphasise the value of immunisation, it is apparent that the number of children being immunised has dropped considerably during the past two or three years, and the neglect of those parents concerned gives rise to some anxiety. Despite the lack of cases locally, it is timely to appeal to all parents to avail themselves of the immunisation service and thus do their part in trying to avoid a future recurrence of this dangerous and insidious disease. There was no serious outbreak of food poisoning occurring in the Borough, the cases notified being confined to three or four families. 3 In spite of recent welcome trends in improvement, tuberculosis remains a serious infectious disease. There are, however, reasons for thinking that this improvement over the last few years may continue. An average of about 250 new cases come to light in the Borough annually, and deaths attributable to this disease total approximately 60 each year. The year 1951 saw several important changes in Public Health Law. Amongst new legislation was an Act requiring all pet shops to be licensed and supervised by the local authority, and also an amendment to previous rag flock legislation extending the kinds of filling subject to cleanliness control. The work of the district Sanitary Inspectors concerned with the repair and maintenance of house property proceeded fairly smoothly. There was a marked decrease in the number of complaints received (2,670) compared with 4,023 the previous year. However, much more time is now being spent in effecting the necessary repairs to house property than was formerly the case. In many instances, where at one time the repairs desired could be secured by an informal approach, it is now often necessary to resort to the issue of a statutory notice to abate the nuisance. The large amount of repairs essential to the continued life of property which is being carried out in the Borough is not always appreciated. It was possible for the house-to-house inspection programme to be continued on a larger scale than in previous post-war years, 382 houses being inspected for housing defects. During the year 27 individual unfit houses were represented and the occupants, comprising 98 persons, required other accommodation. At the time of writing the majority of these persons have been re-housed either by the Borough Council or the County Council or have found their own accommodation. In cases where it is considered that an unfit house, although it can by no means be rendered fit, can be patched up to last another year or two, the owner is requested to remedy the most blatant defects. However, the number of owners asking the Council to close houses increases annually, and 13 of the 27 properties dealt with during the year were cases of this nature. With building costs now three to four times more than before the war, and with no increase in rents, except to cover rate increases, owners are increasingly unwilling to spend money on the patching up of worn-out properties. The broad proposals with regard to slum clearance in the London area were made known during the year. The detailed programme for slum clearance for the next five years has now been prepared and the areas have been graded for representation in order of priority. Full details of the programme will be found in the section dealing with housing. The Council's Health Education work is now well known locally and another full winter programme of health education sessions, at which sound films and talks are given, has been undertaken. The unit visits many varied types of organisation in all parts of the Borough. The practice of taking the unit to the usual meeting place of the organisations instead of inviting members of the public to public film programmes and talks which often give disappointing results, has again proved its value. The numbers being reached in this way are continually increasing, and it is estimated that this year some 3,850 persons were present at health education sessions in addition to the 5,000 who attended the cinema at the Civic Exhibition held in the autumn of 1951. This is 1,500 more than in the previous year. One of the most successful sessions was that when the unit visited the Abbey Wood branch of the National Old Age Pensioners' Association, where 210 members were given a programme dealing with the work of the Health Department. A new departure in this work has been the holding of three successful courses of lectures to food handlers working in the Borough, and also a series of lectures to the canteen staff at one of the largest Woolwich factories. Various aspects of the work of the Health Department were brought to the notice of the public at the Civic Exhibition. 4 Improvements at food premises to bring them into line with modern hygienic conditions are being carried out at the instigation of the Department. Detailed inspections of local public houses, of which there are 149 in the Borough, were also carried out. Revised Bye-laws for the protection of food in the Metropolitan area have not yet been issued. It is hoped that these will assist the efforts of public health officers and of the food traders themselves in improving the standard of cleanliness of food. In order to encourage personal hygiene, the Council continued its provision of free washing facilities in all of its main public conveniences. Much useful work is being undertaken locally both by local authority and by voluntary workers on behalf of those elderly persons living alone. The year 1951 saw the establishment of the Eltham Lunch Club, formed to meet the need in that part of the Borough. A detailed report on the work carried out will be found in the body of the report. A large proportion of the complaints received by the Department relates to rats and mice. This work proceeds quietly and much good work is undertaken every year to keep the rat population under control. There has again been a large increase in the number of animals inspected at the Abattoir. Almost 7,000 more carcases have been inspected than in the previous year. This was due to a large increase in the number of pigs being slaughtered. I have continued to act for the Local Health Authority in the day-to-day administration of their personal health services, and co-operation between the Divisional Health Office and ourselves is extremely good. 1 am conscious of the help and consideration given to me by the Chairman and Members of the Health Committee, and indeed by the Council generally, in dealing with the many health problems which required attention during the year, and I am glad of the opportunity of expressing my indebtedness to them. I desire to thank members of the staff for valuable work during the year and for the help they have given me personally. I am, Madam Mayor, Ladies and Gentlemen, Your obedient Servant, T. STANDRING. HEALTH DEPARTMENT STAFF Medical Officer of Health— t. standring, m.d., b.s., d.p.h., m.r.c.s., l.r.c.p. Administrative and Clerical— Chief Administrative Assistant—T. H. Prescott. Senior Clerk—A. Healbey. Clerical Assistants— R. E. Sweett R. H. Thomas Mrs. E. M. Page (resigned 18th March, 1951) Miss E. C. Nicolson Miss M. H. Rentall (appointed 2nd April, 1951) Miss M. N. Prigmore Miss M. A. Reavil (resigned 31st July, 1951) C. Burgess G. C. Ryan J. E. Kay K. E. Doubleday (temporary) Miss E. E. Phillips (appointed 3rd September, 1951) A. Swainsbury (temporary ; appointed 29th October, 1951). 5 Sanitary Inspectors— Chief Sanitary Inspector—- C. J. Couch, F.R.San.I.; Cert. San. Insp. Exam. Board; Cert. Royal San. Inst.; Cert. Meat and Other Foods ; Cert. Smoke Insp., R.S.I.; Cert. Advanced Inspectors, R.S.I. Sanitary Inspectors— H. W. Pendrill, Cert. San. Insp. Exam. Board; Cert. Advanced Inspectors, R.S.I.; Cert. Meat and Other Foods; Cert. Smoke Insp., R.S.I. F. A. Andrew, Cert. San. Insp. Exam. Joint Board; Cert. Meat and Other Foods. H. M. Kersey, Cert. San. Insp. Exam. Joint Board; Cert., Meat and Other Foods ; Cert. Smoke Insp., R.S.I. F. J. Hoines, Cert. San. Insp. Exam. Joint Board; Cert. Meat and Other Foods. W. F. R. Wheal, Cert. San. Insp. Exam. Joint Board: Cert. Meat and Other Foods. W. E. McLelland, Cert. San. Insp. Exam. Joint Board; Cert. Meat and Other Foods. E. R. Rees, Cert. San. Insp. Exam. Joint Board; Cert. Meat and Other Foods. Miss M. F. Thomas, Cert. San. Insp. Exam. Joint Board; Cert. Meat and Other Foods; State Registered Nurse; State Certified Midwife; Health Visitors' Cert. Miss B. Hatfield. Resigned 19th August, 1951. R. A. Leach, Cert. San. Insp. Exam. Joint Board; Cert. Meat and Other Foods. W. F. Troughton, Cert. San. Insp. Exam. Joint Board; Cert. Meat and Other Foods. R. Lincoln, Cert. San. Insp. Exam. Joint Board; Cert. Meat and Other Foods. K. S. Cooper, Cert. San. Insp. Exam. Joint Board; Cert. Meat and Other Foods. K. J. Coppin, Cert. San. Insp. Exam. Joint Board. J. A. Orrell, Cert. San. Insp. Exam. Joint Board; Cert. Meat and Other Foods. K. A. Bennett, Cert. San. Insp. Exam. Joint Board. J. B. O'Connell, Cert. San. Insp. Exam. Joint Board. R. H. Pasterfield, Cert. San. Insp. Exam. Joint Board; Cert. Meat and Other Foods. D. W. Townsend, Cert. San. Insp. Exam. Joint Board; Cert. Meat and Other Foods. (Appointed 20th December, 1951). Public Analyst (Part-time)— H. Amphlett Williams, ph.d. (Lond.), A.C.G.F.C., F.R.I.C. GENERAL STATISTICS Area of Borough 8,282 statute acres Number of Houses 39,105 Number of persons per acre 18.1 Rateable Value £1,202,783 Sum represented by a Penny Rate £5,011 6 7 VITAL STATISTICS Extracts from the vital statistics for the year are shown below:— Table No. 1. Population (Home, i.e., including members of H.M. Forces stationed in the district) 149,800 Live Births—Legitimate 2,163 Live Births—-Illegitimate 110 Total Live Births 2,273 Birth Rate 15.1 Stillbirths 39 Stillbirths—Rate per 1,000 total births 17.1 Deaths 1,838 Death Rate per 1,000 population 12.3 Maternal Deaths 1 Death Rate from Puerperal Causes per 1,000 total births .44 Deaths of Infants under one year 63 Death Rate of Infants under one year of age 27.7 Deaths from Tuberculosis (all forms) 57 Deaths from Cancer (all ages) 288 Deaths from Whooping Cough 1 Births. The number of live births registered in Woolwich during 1951 was 1,951. After correction for inward and outward transfers, the net number of Woolwich live births was 2,273, being 101 more than in the previous year. Of the total births, 1,180 were boys and 1,093 girls. It is known that 1,454 births took place in public institutions in the Borough, of which 900 concerned Woolwich mothers. The birth rate was 15.1, which, when adjusted to allow for the differing age and sex distribution of the population in various parts of the country, gives a birth rate of 15.7 compared with the birth rate for England and Wales of 15.5 and for London of 17.8. There were 39 stillbirths during the year under review. Natural Increase in Population (i.e., Excess of Births over Deaths). In 1951 the natural increase in population was 435. In 1950 it was 500, and in 1949, 932. Deaths. The number of deaths registered in Woolwich was 1,425, and after correction for inward and outward transfers the net number was 1,838, giving a death rate of 12.3 for the Borough. This figure is higher than for the previous year (11.2) The adjusted death rate for Woolwich was 11.7, compared with 13.1 for London, and 12.5 for England and Wales. Deaths of Woolwich residents in hospitals in the Borough totalled 369, whilst 472 died in other hospitals outside the Borough. Road Safety. There were twelve deaths of Woolwich residents during the year due to motor vehicle accidents. No fatal accidents occurred to a child under five years of age. Two of the deaths concerned children of school age and five of persons between the ages of 15 and 25 years. Assistance was given to the Council's Road Safety Committee by the showing of films on this subject at a number of the film sessions presented by the Health Department. Deaths from Cancer. Of the total number of deaths, 288 were from Cancer, of which 149 occurred in men and 139 in women. A total of 152 took place in hospital. Since the end of the last war there has been a noticeable increase in the number of deaths occurring locally from cancer of the lung and bronchus, and the following table gives details of this increase and of the increased number of deaths of men from this disease. Table No. 2. Deaths from Caneer of the Lung and Bronchus, 1945-51 Year. Men. Women. Total Deaths. Deaths in Hospitals. 1945. Lung 17 3 20 7 Bronchus 4 4 8 4 1946. Lung 10 4 14 9 Bronchus 15 2 17 12 1947. Lung 12 7 19 6 Bronchus 18 1 19 15 1948. Lung 13 1 14 3 Bronchus 20 1 21 14 1949. Lung 15 2 17 8 Bronchus 24 5 29 20 1950. Lung 26 4 30 8 Bronchus 33 8 41 36 1951. Lung 17 5 22 9 Bronchus 38 7 45 29 Deaths from Cancer (including all other specified Malignant Tumours). Year. Men. Women. Total Deaths. Deaths in Hospitals. 1945 134 133 267 88 1946 123 115 238 143 1947 130 130 260 135 1948 138 141 279 138 1949 172 128 300 159 1950 175 155 330 173 1951 149 139 288 152 Maternal Deaths. There was only one maternal death during the year, compared with two the previous year. Inquests. There were 75 inquests held on Woolwich residents during the year, and 423 post-mortems on Woolwich residents were carried out on behalf of the Coroner. Infant Mortality. During 1951, 63 deaths occurred in children under one year, giving an infant death rate of 27.7 per 1,000 live births, compared with 24.4 in 1950 and 28.7 in 1949. The number of deaths occurring in the first month of life was 41. Marriages. There were 1,362 marriages in the Borough during 1951, of which 868 took place in churches. The remaining 494 took place at the Woolwich Register Office. Of the number of marriages which took place in churches in the Borough, Registrars of Marriages attended on 125 occasions. 8 9 Table No. 3. Nett Deaths during the Calendar Year 1951. Nett Deaths at the subjoined ages of "residents " whether occurring within or without the district. All Ages. Under 1 year. 1 and under 5 years. 5 and under 15 years. 15 and under 25 years. 25 and under 45 years. 45 and under 65 years. 65 and under 75 years. 75 years and upwards. All Causes 1838 63 14 7 14 80 435 509 716 Tuberculosis, respiratory 51 - - - 2 16 22 10 1 Tuberculosis, other 6 - 3 1 — - - 2 — Syphilitic disease 8 — — — — — 5 1 2 Diphtheria — — — — — — — — — Whooping Cough 1 — 1 — — — — — — Meningococcal infections - — — — — — — — — Acute poliomyelitis — — — — — - — — — Measles 1 1 — — - - - - - Other infective and parasitic diseases 2 - — — 1 1 - - - Malignant neoplasm, stomach 40 — — — — 1 16 12 11 Malignant neoplasm, lung, bronchus 67 - — - — - 38 19 10 Malignant neoplasm, breast 32 — — — — 3 14 7 8 Malignant neoplasm, uterus. . 14 — — — — 1 6 4 3 Other malignant and lymphatic neoplasms 163 — — 1 — 10 54 58 40 Leukaemia, aleukaemia 9 - - 1 1 - 2 4 1 Diabetes 15 1 - - - - 3 4 7 Vascular lesions of nervous system 187 — — — — 7 44 53 83 Coronary disease angina 225 - — — — 6 58 81 80 Hypertension with heart disease 45 - — — - 1 12 12 20 Other heart disease 322 - - - 1 11 30 88 192 Other circulatory disease 61 - - - - 2 11 16 32 Influenza 23 - - - - - 5 8 10 Pneumonia 100 6 2 - - 1 20 26 45 Bronchitis 121 — 1 - - 2 21 39 58 Other diseases of respiratory system 25 1 1 1 — - 7 11 4 Ulcer of stomach and duodenum 35 - - - - 1 12 11 11 Gastritis, enteritis and diarrhoea 12 6 - - - - 3 1 2 Nephritis and Nephrosis 14 - — — - 1 7 3 3 Hypherplasia of prostate 22 - — - - - — 9 13 Pregnancy, childbirth, abortion 1 - - - - 1 - - - Congenital malformations 13 9 2 - - - 2 - - Other defined and ill-defined diseases 163 37 3 - 3 7 29 23 61 Motor vehicle accidents 12 - - 2 5 2 2 - 1 All other accidents 37 2 1 1 1 4 6 5 17 Suicide 10 - - - - 2 5 2 1 Homicide and operations of war 1 — — — - — 1 — — 10 Table No. 4. Birth Rates, Death Rates and Analysis of Mortality in the Year 1951. Rate per 1,000 Population. Annual Death Rate per 1,000 Population. Rate per 1,000 Live Births. Live Births. Still Births. All Causes Tuberculosis Acute Poliomyelitis including Polio encephalitis Smallpox Whooping Cough Diphtheria Influenza Pneumonia Typhoid Paratyphoid Fevers. Diarrhoea and Enteritis (under 2 years) Total Deaths under 1 year. England and Wales 15.5 0.36 12.5 0.31 0.00 0.00 0.01 0.00 0.38 0.61 0.00 1.4 29.6 126 County Boroughs and Great Towns, including London 17.3 0.45 13.4 0.37 0.01 0.00 0.01 0.00 0.36 0.65 0.00 1.6 33.9 148 Smaller Towns (Resident Populations, 25,000 to 50,000 at Census, 1931) 16.7 0.38 12.5 0.31 0.01 0.00 0.01 0.00 0.38 0.63 0.00 1.0 27.6 London 17.8 0.37 13.1 0.38 0.00 — 0.01 0.00 0.23 0.61 0.00 0.7 26.4 WOOLWICH 15.7 0.27 11.7 0.38 0.00 — 0.01 0.00 0.15 0.66 0.00 2.6 27.7 The birth and death rates locally and nationally are compared in the following table:— The chief Vital Statistics since 1921 are given in the following Table:— Table No. 5. Year. (1) Population estimated to middle of each Year. (2) Births. Nett Deaths belonging to the District. Nett. Under Year. At all Ages. Number. (3) Rate. (4) Number. (5) Rate per 1,000 nett Births. (6) Number. (7) Rate. (8) 1921 a 141,700 3,197 23.2 197 62 1,594 11.6 b 137,604 1922 a 142,350 2,941 21.3 184 63 1,603 11.6 b 138,254 1923 a 143,530 2,867 20.5 123 43 1,387 9.9 b 140,000 1924 a 144,400 2,590 18.5 168 65 1,543 11.0 b 139,980 1925 a 145,440 2,582 18.3 141 55 1,519 10.8 b 140,740 1926 a 146,200 2,463 17.4 107 43 1,450 10.2 6 141,900 1927 a 144,770 2,242 15.9 95 42 1,491 10.6 b 140,770 1928 a 146,600 2,269 16.1 114 50 1,554 11.0 b 141,100 1929 a 146,800 2,312 16.3 144 62 1,780 12.6 b 141,600 1930 a 146,800 2,188 15.5 91 42 1,547 10.9 b 141,600 1931 a 147,400 2,155 15.1 128 59 1,654 11.6 6 142,600 1932 a 146,400 2,054 14.0 123 60 1,635 11.1 1933 a 146,200 1,857 12.7 116 62 1,634 11.2 1934 a 145,520 2,000 13.7 127 63 1,650 11.3 1935 a 146,400 2,053 14.0 91 44 1,500 10.2 1936 a 146,500 2,017 13.8 121 59 1,649 11.2 1937 a 149,400 2,125 14.2 86 40 1,660 11.1 1938 a 150,900 2,057 13.6 102 50 1,576 10.4 1939 a 150,800 2,133 14.1 103 49 1,592 11.1 1940 b 124,340 1,846 14.8 66 36 1,854 14.9 1941 b 103,630 1,459 14.0 65 42 1,627 15.7 1942 b 110,140 2,036 18.5 71 34 1,410 12.8 1943 6 112,700 2,174 19.3 77 35 1,558 13.8 1944 b 110,970 2,037 18.3 83 40 1,611 14.5 1945 6 115,270 2,021 17.5 83 41 1,478 12.8 1946 b 134,420 2,903 21.6 91 31 1,531 11.4 1947 b 140,150 3,193 22.8 87 27.25 1,626 11-6 1948 b 142,800 2,527 17.7 74 29.28 1,573 11.0 1949 b 144,000 2,504 17.4 72 28.75 1,572 10.9 1950 c 149,000 2,172 14.6 53 24.40 1,668 11.2 1951 c 149,800 2,273 15.1 63 27.70 1,838 12.3 a—Total population. b—Civil population, c—Home population. 11 Vital Statistics for 1951 for the Wards of the Borough:— Table No. 6. Wards. Births. Deaths. Legitimate. Illegitimate Stillbirths. Under 1 year. All Ages. Dockyard 51 5 — 1 66 St. Mary's 60 5 — 2 55 River 107 4 1 5 113 St. George's 122 5 1 6 37 WOOLWICH 340 19 2 14 271 Burrage 101 9 — 4 99 Herbert 181 8 6 7 137 Glyndon 90 10 2 3 107 St. Margaret's 191 11 6 6 187 Central 87 4 — 4 112 St. Nicholas 196 5 1 3 154 Abbey Wood 153 8 4 2 136 PLUMSTEAD 999 55 19 29 932 Well Hall 134 9 1 3 167 Avery Hill 327 12 7 6 240 Sherard 363 15 10 11 228 ELTHAM 824 36 18 20 635 BOROUGH 2,163 110 39 63 1,838 SANITARY ADMINISTRATION Sanitary Inspection of the Area. The Sanitary Inspectors carried out 33,676 inspections, including re-inspections, during the year. The nature of these inspections is shown in Table No. 7 and details of nuisances abated are given in Table No. 8. As a result of these inspections, 2,143 intimation notices and 1,142 statutory notices were served. Complaints. There was a marked decrease in the number of complaints received during the year, only 2,676 compared with 4,023 in 1950. The necessary action was taken where complaints were made or nuisances discovered. Water Supply. At the end of the year there were estimated to be 39,105 houses in the Borough and water for drinking is supplied direct to all houses from the public water mains by the Metropolitan Water Board. The water supply has proved to be satisfactory in quality and quantity throughout the year. The few complaints received were found to be due to causes other than the quality of the water, e.g., defective cisterns. There are eight wells in the Borough being used for trade purposes. 12 Table No. 7. Inspections. Complaints investigated 2,676 Complaints reinspections 8,562 Outworkers' premises 223 Houses re Overcrowding 226 New houses re water supply 718 Houses re infectious disease 536 Houses re smallpox contacts 42 Houses re verminous cases 2,454 Houses re scabies cases 36 Houses re other diseases 9 Houses re Housing Acts 745 House-to-house inspections 382 Rent Restrictions Acts 9 Aged and infirm persons 1,620 Common Lodging Houses 16 Hostels 1 Tents and Vans 4 Factories 276 Workplaces 17 Shops Act 221 Food premises 2,183 Itinerant Vendors 24 Complaints re food 48 Pharmacy and Poisons 22 National Assistance Act 18 Water sampling and testing 58 Rodent control 2,878 Smoke observations 694 Theatres and cinemas 10 Urinals accessible to the public 25 Women's lavatories 69 Rag and Bone Dealers 1 Miscellaneous 4,193 Non-effectual visits 4,528 Table No. 8. Nuisances Abated. Dirty conditions 1,297 Damp conditions 4,740 Dilapidations 5,422 Verminous rooms cleansed 636 Defective lighting 536 Defective ventilation 526 Defective paving 148 Drainage defects 1,271 Water closet defects 1,210 Dustbins provided 131 Water supply defects 133 Foul accumulations removed 41 Overcrowding remedied 74 Miscellaneous 434 Drainage. The Borough Engineer is responsible for the inspection and supervision of new drainage work. The reconstruction and repair of existing drainage is supervised by the Health Department. The Sanitary Inspectors supervised the remedying of some 1,271 drainage defects during the year and 141 combined drains were cleared by the Department. Five private drains were also cleared, and for this work charges totalling £5 10s. 0d. were made upon the responsible persons. Provisions of Dustbins. Under Section 105 of the Public Health (London) Act, 1936, if any house is found to be without an adequate dustbin the Council may serve a notice on the owner or the occupier requiring the supply of a dustbin at the house. A person aggrieved may appeal to the London County Council (now the Magistrate's Court). For many years, except in exceptional circumstances, the Council has regarded the provision of a dustbin as a matter for the owner of the house. However, following decisions in recent court cases, the Health Committee decided in 1951 that in future where an objection was raised by a person receiving a notice under the Bye-laws requiring him to provide a dustbin, the circumstances of each case should be reported to the Committee, together with information as to the type of tenancy, the rental, number of tenants, details of any sub-letting, whether there had been any negligent usage of the previous dustbin; the financial circumstances of the occupier and the owner; and any other relevant information, to enable the Committee to decide whether the notice should be served on the owner or on the occupier. Building Licences. During the year, 1,444 applications for building licences were received by the Borough Engineer, compared with 1,983 during 1950. Licences were issued in respect of 1,128 of these applications. 13 Pharmacy and Poisons Act, 1933. This Act places upon Metropolitan Borough Councils the duty of enforcing the provisions of the Act relating to poisons in Part II of the Poisons List. At the end of the year the number of sellers of Part II Poisons (other than registered Pharmacists) on the list maintained by the Council was 147. This number includes 14 new registrations during the year. Rent and Mortgage Interest (Restrictions) Acts. During 1951 the Health Committee authorised the issue of certificates in respect of four dwelling houses, the houses in question not being in a reasonable state of repair. The Committee also considered five applications for revocation of existing certificates of unfitness and authorised the issue of three such certificates on being satisfied that the necessary repairs to put the houses concerned in a reasonable state of fitness had been executed. Factories Act, 1937. Table No. 9. Details of Inspections carried out during 1951 are as follows:— Premises. No. on Register. Number of Inspections. Written Notices. Occupiers prosecuted. (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 42 45 5 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 349 231 28 - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) - - - - Total 391 276 33 — Cases in which Defects were found and remedied Particulars. Number of Cases in which defects were found Number of cases in which prosecutions were instituted. Found. Remedied. Referred To H.M. Inspector. By H.M. Inspector. Want of cleanliness 7 7 - - - Overcrowding - - - - - Inadequate ventilation - - - - - Ineffective drainage of floors 2 2 - - - Sanitary Conveniences:— (a) Insufficient 7 7 - 2 - (b) Unsuitable or defective 104 104 - 20 - (c) Not separate for sexes 2 2 - - — Other offences against the Act (not including offences relating to Outworkers) - - 5 - - Total 122 122 5 22 - 14 Outworkers. Outworkers within the Borough are visited periodically by the Sanitary Inspectors. The number of outworkers and the nature of the work carried on, in the list prepared in August, 1951, was as follows:— Wearing apparel 112 Household linen, etc. 19 Cosaques, Christmas crackers and similar 3 Lampshades 72 Brush-making 1 Carding of buttons, etc. 1 Stuffed toys 2 Rodent Control. Measures for the destruction of rats and mice were continued during the year. The number of complaints received totalled 1,256. In addition to investigating premises involved in complaints, a systematic inspection under the "block control" principle was carried out covering the inspection of 11,281 premises. The number of properties infested by rats and mice amounted to 1,776, including 156 business and industrial premises. All infestations coming to light are systematically treated. Where the cause of the trouble is found to be due to defective drains or other defects in the building, the owner is called upon to effect the necessary repairs. During the year warfarin was added to the list of poisons available for rodent control. It is a blood anti-coagulant and was originally found to exist in spoiled sweet clover, the eating of which causes a fatal haemorrhagic disease in cattle. It is claimed to be relatively harmless to man and domestic animals in the concentrations used and to create no prejudice or bait shyness in rats. It is too early to say whether it is more effective than the other poisons available but it is a welcome alternative poison. The Council continued its practice of carrying out free treatment for the destruction of rats and mice in private dwellings. A charge is made in respect of treatment carried out by the Council's Rodent Control Service at business premises. With the co-operation of the Borough Engineer's Department, two sewer treatments and one test baiting were undertaken during 1951, and in this way the number of rats in the sewers has been kept under control. In large areas of the Borough the sewers are modern and are clear of rats, but in the older parts of the Borough the rat population seems to remain static. In spite of the kill obtained at each treatment there is a build-up between treatments and so long as the poison does not reach the whole of the rat population the survivors will continue to breed. The only limiting factors appear to be the length of time elapsing between treatments and the amount of food available. The following table shows the percentage of takes recorded in the maintenance treatments:— Table No. 10. Maintenance Treatments for Rodent Infestation. Year. Month. Baits taken. 1945. January 43 per cent. June 39 „ „ 1946. January 47 „ „ June 43 ,, ,, December 55 „ „ 1947. June 52 „ „ December 69 „ „ 1948. May 57 „ „ November 62 „ „ 1949. June 64 „ „ December 57 „ „ 1950. June 55 „ „ December 61 ,, ,, 1951. June 54 „ „ December 52 „ „ 15 The Council's refuse destructor tips are treated monthly. The Sanitary Inspector in charge of this work is assisted by four rodent operatives and also by two investigators who make the initial inspection to assess the extent of infestation. The Council's work relating to the destruction of rats and mice is subsidised by a grant of 50 per cent. approved net expenditure from the Ministry of Agriculture and Fisheries. An Order in Council applying the Prevention of Damage by Pests Act to shipping, with appropriate modifications, came into operation during the year. The duties of local authorities in relation to rats and mice on land were extended to include the requirement to secure, as far as practicable, that any vessel in their district that is not a sea-going ship is kept free from rats and mice. Powers of entry and inspection are afforded and it is the duty of those in control of such vessels which are rat infested to notify the local authority. Rag and Bone Bye-laws. During 1951 the Council instituted proceedings against a man for an offence against the London County Council Bye-laws respecting the business of rag and bone dealer. He was seen by a police constable at Ealdham Square, Eltham, to exchange toys with small children for bundles of old rags. A fine of 10s. 0d. was imposed. Rag Flock. The former Rag Flock legislation has now been repealed and consolidated in the Rag Flock and Other Filling Materials Act, 1951, which makes it an offence to use unclean filling materials. Premises where upholstery is carried out are required to be registered and licences are granted to manufacturers of rag flock and to occupiers of rag flock stores. It is an offence to purchase rag flock from unlicensed premises. Occupiers of registered and licensed premises are required to keep records of all filling materials received at or sent from the premises. One application was received for the issue of a licence to manufacture rag flock and three applications for registration of premises. These applications were all approved. Regulations made under the Act prescribe tests and fix the amount of the fees which may be charged by an analyst making a test. The analyses of samples of rag flock must now be undertaken by a Prescribed Analyst. For many years the analysis of such samples obtained in the Borough was carried out by the Council's Public Analyst. Satisfactory reports were received from him on four samples of rag flock analysed before the coming into force of the new legislation. Offensive Trades. During the year the Council approved an application for the renewal of one tripe boiler licence. There is one other offensive trade, that of slaughterer of poultry, carried on in the Borough. The Council have approved the re-establishment of this business. Mosquito Control. Although during the year fewer complaints were received of mosquitoes in the marshland areas at Abbey Wood, spraying operations of stagnant ponds, marsh ditches and allotment holders' water butts were again carried out in early summer as a preventive measure. Common Lodging Houses. These are licensed annually by the Borough Council, in accordance with the provisions of the Public Health (London) Act, 1936. There are now only two licensed Common Lodging Houses in the Borough. The number of inspections made during the year was 16. Details of the accommodation available are as follows:— Premises. Accommodation. 60, Beresford Street 50 (Men) 102, Woolwich High Street 22 (Men) 16 Public Houses. Two of the Department's Inspectors carry out the supervision of the hygienic conditions in public houses, each of the 149 licensed premises being visited at least twice a year. There are 44 public houses undertaking main meals. Particular attention is paid to the availability of an adequate supply of hot water, and at four premises a hot water supply was supplied during the year at the instigation of the Department. Arrangements for washing glasses were improved in 18 premises during the year by the installation of automatic detergent doses, which operate in conjunction with the water supply to the bar well sink. Owing to the restrictions on building works, improvements involving work of a structural nature, particularly with regard to sanitary conveniences, have been confined to 10 public houses for defects of a serious nature. Pet Animals Act, 1951. This Act requires that no person shall keep a pet shop except under the authority of a licence granted by the local authority in accordance with the Act. It is an offence to sell any pet animals in any part of a street or public place (except at a stall or barrow in a market) or to sell pet animals to persons under 12 years of age. In determining whether to grant a licence, a local authority shall have regard to the need for securing that animals will at all times be kept in accommodation suitable as respects size, temperature, lighting, ventilation and cleanliness; that they will be adequately supplied with food and drink and visited as necessary; that all suitable precautions will be taken regarding infectious disease; and that the animals will not be sold at too early an age. The administration of this Act is to be carried out by the Health Department. The Council has adopted a series of general conditions for inclusion in licences to be issued under the Act. There are 8 pet shops in the Borough, and these will be visited periodically by the Sanitary Inspectors. Legal Proceedings. During 1951 it was found necessary to institute legal proceedings in 41 cases in order to obtain compliance with notices served by the Sanitary Inspectors under the Public Health (London) Act, 1936, and other relevant Acts, Regulations and Bye-laws. Of the total summonses, 12 were withdrawn, the work necessary to comply with the notices being in hand at the time of the hearing, and a further 24 summonses were adjourned. Four abatement orders were obtained and in the remaining cases fines totalling £5, with 2 guineas costs, were imposed. Persons in Need of Care and Attention. During the year it was found necessary to apply to the Court for a removal order in respect of an elderly Eltham man who was found to be living in insanitary conditions and in need of care and attention. This man had been living under insanitary conditions for some years and the conditions had been getting steadily worse. His room was overcrowded with furniture and in a deplorable condition. His personal condition was far from satisfactory and his clothes were very dirty and smelled objectionably. Over a long period many Home Helps had been engaged to help but in every case they had resigned until it was found impossible to provide the services of a Home Help. Repeatedly the man had been offered accommodation in a County Council Old People's Home but he had persistently refused. An Order for his removal to Ladywell Lodge for three months was made by the magistrate. He continued to reside there without further application to the magistrate. A number of other reports were received to the effect that elderly people were thought to be needing institutional care. Even where in such cases removal was clearly imperative, no Court application was necessary as it was possible to arrange their voluntary removal to a hospital or institution. 17 Legislation passed during the year gives local authorities further powers to enable them to deal expeditiously with certain cases of persons in need of care and attention. Where the Medical Officer of Health and another registered medical practitioner certify that in their opinion it is necessary that a person should be removed without delay (as provided for by Section 47 of the National Assistance Act, 1948), an application for a removal order may be made to the Court or to a single justice without giving the person whose removal it is desired to secure the requisite seven days' notice, as required by the Act of 1948. The Council have authorised me to make any such applications and to take all the necessary steps in those cases to which the amendment Act applies. Welfare of Aged and Infirm Persons. Much useful work in helping old people to live contented and interesting lives has again been carried out by the several official and voluntary bodies concerned. The Council's woman inspector devotes almost all her time to this work, and altogether during 1951, 1,620 visits were made to the homes of the elderly. This is some 458 more visits than were made the previous year. Once again the necessary close co-operation between the Department, general practitioners, hospitals and institutions, the National Assistance Board, the Home Help service, the district nurses and others has been maintained. I should like to take this opportunity of acknowledging the unfailing help received from these individuals and organisations. Their ready assistance has helped on many an occasion to solve a pressing problem. It must not be thought that there is any overlapping in visiting between the Health Department, the Council of Social Service and other visitors. While all requests for a visit are met, the Department is primarily concerned with the health and hygiene of the old person and his accommodation. Where this is or may soon become a problem all assistance is given and subsequent visits made as necessary. Where it is not a problem the old person is put in touch with the agency appropriate to his requirements. An average of 60 visits per week are made to elderly people by visitors on behalf of the Council of Social Service through its Old People's Welfare Committee. All visitors are supplied with notes for guidance and report forms to return. The visitors call regularly and give special help when any particular need arises. Some do shopping, change library books, carry in coals, write letters, undertake repairs to wireless sets, etc., and arrangements are made with the National Assistance Board in some cases for pensions to be drawn on behalf of the old people. A good meal is of major importance and a great deal is being done in the Borough by the Plumstead Lunch Club and by the recently formed Eltham Lunch Club. The Plumstead Lunch Club has now been in existence since 1943, and meets the needs of old people for a hot mid-day meal at a reasonable cost. The Eltham Lunch Club was formed at the end of 1951 and it is already well established and proving itself to be indispensable. I am indebted to the Woolwich Council of Social Service for the following details of the work of the Eltham and Plumstead Lunch Clubs:— Plumstead Lunch Club. This Club serves a two-course meal to old age pensioners on six days a week for a charge of 8d. per head. Since the closure during 1951 of the County Council's Pippin Restaurant on the premises, the meals have been supplied from the Borough Council's Civic Restaurant at the Plumstead Baths at a cost of 1s. 2d. per head. The County Council Welfare Committee makes a contribution of 6d. per meal to meet the full cost, on condition that the old people pay not more than 8d. The Lunch Club is managed by a paid supervisor and the meals are served by a team of voluntary workers who attend on a rota basis. The present membership of the Club is approximately 250, and the number of meals served each month averages 2,000. A grant of £411 has been made by the Borough Council for the year 1951-52. 18 Eltham Lunch Club. This Club operates from the Woolwich Labour Party Hut in Well Hall Road. A new departure was made at Eltham by asking old people to register as members. Eighty old people registered on the opening and within a very short time the number had risen to 226. The decision to limit the number of meals served to 50 a day was made in the first instance because of limited space at the hut, but it was soon evident that more meals were required. The meals are supplied by the County Council restaurant in Eltham High Street at a price of 1s. 2d., and are transported to the hut by the Borough Council staff. As at the Plumstead Club, the old people pay 8d. for their meal. The Eltham Club is managed by a paid supervisor and there are 20 voluntary helpers who serve the meals and wash the dishes. The Club is open on six days a week and the average number of meals served daily is 1,300. The Borough Council has also made a grant of £286 for the working of this Club. Certain of the office work connected with the two Clubs is carried out from the office of the Woolwich Council of Social Service, although the domestic details and day-to-day management are in the hands of the supervisors. Atmospheric Pollution. Investigations on atmospheric pollution were continued throughout the year and altogether 694 observations were carried out. Fifty-seven complaints were received and seven intimation notices and four statutory notices were served. Regular visits to various factories giving cause for complaint have been made and the advice given has in several cases produced improvement. However, complaints continue to be received. Complaints of carbon dust emitted from a factory in the Plumstead area resulted in many visits to the factory by officers of the Council during 1951. Various suggestions made by the Council's Health Committee to mitigate this trouble have been acted upon by the factory owner, including the installation of special machinery and apparatus to deal with the dust. The matter continues to be carefully watched for any breach of the statutory provisions. However, in the view of the Council, the only complete solution to the problem appears to be for the factory to be removed from what is now a zoned residential area to an industrial area. An intimation notice was served upon the occupiers of one of the largest factory premises in the Borough in respect of a nuisance caused by the emission of smoke from the factory chimneys. The nature and usage of the Company's coal supplies and the operating instructions in force in their main boiler-house were investigated. An electronic smoke detecting device designed to give audible warning when excess smoke is being discharged is to be installed by the Company. Observations of a factory in the Abbey Wood area situate near the railway station have been carried out by the Council's smoke inspector. Complaints of smoke have been made from time to time and during the year the station staff and passengers using this station complained of the fumes being emitted from the factory. Improvements in the plant used have been made, but the complaints still persist and notices have been served on the Company. Complaints of industrial smoke and grit from a factory on the riverside were also investigated. The excessive smoke was thought to be due to the removal for repair of the firm's mechanical stoker. Investigations with regard to the nuisance continue. At the National Smoke Abatement Society's annual conference, a resolution was passed expressing appreciation of the action of the Government in ensuing that approved fuel-burning appliances only are installed in houses built, either by local authorities or by private builders under licence. The Conference urged the prohibition or active discouragement of the manufacture and sale of appliances that do not meet minimum standards of efficiency. The Borough Council considered these resolutions and informed the Society that all possible measures are taken within the Borough to counteract the smoke nuisance and to secure that approved solid fuel-burning fires are installed in new houses built in the Borough. 19 Boating and Paddling Pools. A series of macroscopical and bacteriological tests of the water in the four paddling and boating pools carried out during the year showed that the standard of the water in the pools should be improved. At my request, the pools were emptied, cleansed and refilled with clean water more frequently, which resulted in some improvement. It has indicated, however, the necessity of some more effective form of purification and arrangements were made for this to be instituted at the beginning of the next season. Mortuary. Public mortuary facilities are provided at the Council's premises at Sunbury Street. These facilities have been little used in recent years owing to the centralisation in London of Coroners' Courts. Exhumations. Four exhumations, two at Plumstead Cemetery and two at Eltham Cemetery, were carried out during the year on the authority of Exhumation Licences issued under the Burial Act, 1857, by the Home Secretary. A sanitary inspector attended on each occasion and all necessary precautions to safeguard the public health were observed. Burial or Cremation of the Dead. Under Section 50 of the National Assistance Act, 1948, the Borough Council has a duty as sanitary authority to arrange for the burial or the cremation of a person who has died or is found dead in the area, where no other arrangements have been made for the disposal of the body. The Council is empowered to recover the cost of burial from the estate of the deceased person. During the year 16 burials were undertaken by the Borough Council at a total cost of £110 8s. 6d., of which £67 15s. 2d. was recovered, leaving a net cost to the Council of £42 13s. 4d. Cemeteries. Three cemeteries are owned by the Borough Council and administered by the Town Clerk's Department. The following table gives details of interments during the last three years at these cemeteries:— Table No. 11. Cemetery. Number of Interments. 1949. 1950. 1951. Woolwich 416 416 503 Plumstead 586 600 641 Eltham 357 348 386 Street Cleansing and Refuse Disposal. During 1951, 44,142 tons of house and trade refuse were collected and, with the trade refuse delivered by various tradesmen, a total of 51,556 tons was dealt with at the Council's destructor. The salvaged material, weighing 1,712 tons, yielded £11,719 when sold. The raw kitchen waste dealt with was 2,987 tons and realised £49,343. At the piggery, 423 pigs were maintained and the sale of pigs realised £4,610. 20 Free Washing Facilities in Public Conveniences. During 1950 the Council approved a Committee recommendation that free washing facilities, in addition to the paid service, be provided at five of the largest men's public conveniences and six of the women's conveniences in the Borough. This became operative during 1951 and instructions were issued to the attendants to ensure that the service was made readily available to the public, without the necessity of having to approach the attendant. The arrangements are working satisfactorily. Public Conveniences. Fourteen conveniences for men and a similar number for women are maintained throughout the area, hours of opening and closing varying with local requirements. In the town centre, for example, the conveniences are open from 5.30 a.m. Normally, however, this service is available between the hours of 6.30 a.m. and 11 p.m. These conveniences were inspected regularly during the year. The information regarding the street cleansing, refuse disposal and public conveniences, has been kindly supplied by the Borough Engineer. Public Baths and Washhouses. The Council has four bathing establishments in the Borough. A full description of this service, which includes swimming baths, slipper baths, Turkish baths and massage, wash-houses and the use of the premises for social and sporting activities during the winter months, was included in my Annual Report for 1919. Seventy-one samples of bath water were submitted for bacteriological examination to the Public Health Laboratory service and no unsatisfactory reports were received. At the same time as the samples were obtained, the Department carried out its own tests for free chlorine estimation. Colorimetric tests for the pH value were also carried out. HOUSING In December, 1951, there were estimated to be 39,105 houses in the Borough. The number inspected for housing defects under the Public Health or Housing Acts was 11,238, compared with 14,849 in the previous year. The number found not to be in all respects reasonably fit for habitation was 2,243. Some 1,028 houses were rendered fit in consequence of informal action by the Sanitary Inspectors, including the service of intimation notices. House-to-house inspections were carried out under the Housing (Consolidated) Regulations, 1925, 382 dwelling houses being inspected under these Regulations in 1951. Overcrowding. The Council is under an obligation, upon application being made by either landlord or occupier, to give in writing the permitted number of persons in respect of any dwelling house, and measurements were taken of dwellings on 718 occasions, compared with 640 in 1950. In all, 97 families were found to be living in overcrowded conditions. Overcrowding reports were made to the London County Council on behalf of these persons and in 47 cases other accommodation was obtained. Individual Unfit Houses. Twenty-three houses were represented during the year as being unfit for human habitation and incapable of being made fit at reasonable expense, and formal notices were served on the owners under the provisions of the Housing Acts, 19361949. After consideration of each case Demolition Orders were made by the Council in respect of ten of these houses and undertakings not to use the premises for human habitation were accepted in respect of the remaining thirteen houses. Formal action under the Housing Acts was also being taken at the end of the year in respect of a further three individual unfit houses. 21 Unfit Underground Rooms. Representations were made to the Council in respect of four unfit underground rooms at three houses and the Council made Closing Orders in respect of each room. At the end of the year consideration was being given to the closure of unfit underground rooms at a further seven houses. Underground Rooms. There is a number of underground rooms in the Woolwich, Plumstead and Abbey Wood areas and many of them, although used as dwellings, do not conform in all respects to the statutory requirements relating to underground rooms and they cannot, without major alterations, be made to do so. Closure on a large scale is not, however, practicable in the present circumstances, and a number of owners have co-operated in making these rooms reasonably fit. The Director of Housing refers to me for investigation cases relating to the unfitness of basement rooms. London Slum Clearance Programme, 1951-1955. During 1951 a Conference was held between representatives of the Metropolitan Boroughs' Standing Joint Committee and the London County Council, at which a detailed programme for slum clearance in the London area for the next five years was discussed. Resulting therefrom, a three-part programme was evolved. The first five-year programme consists of areas comprising houses immediately representable, with a further batch after five years and a third after the tenth year. For the first five years, the former Minister of Health approved clearance at the rate of about 3,000 houses a years being the allocation for the whole of the County area, including clearance to be carried out by the Borough Councils. The tentative programme, which was referred to each of the Metropolitan Boroughs for consideration, deals with a total of 10,131 unfit houses, of which 6,686 would be dealt with by the County Council and 3,445 by the 28 Boroughs. In formulating these figures it has been recognised that, in practice, it is necessary to deal with some 20 per cent. additional houses, not actually "unfit," in order to obtain a satisfactory cleared area for redevelopment. This would then bring the yearly programme approximately into line with the Ministry quota and the total allocated for the first five years. There is no direct connection between this slum clearance quota and the new housing quota, although new houses erected on cleared sites will be regarded as part of the new housing quota. The detailed proposals for Woolwich are as set out below and the agency for the carrying out of the work is indicated in the brackets:— First year, 1951:— Warwick Street (W.B.C.) 328 Total 328 Second year, 1952:— Ropeyard Rails (L.C.C.) 158 John Wilson Street (W.B.C.) 29 Parry Place (W.B.C.) 2 Hull Place (L.C.C.) 18 Jubilee Cottages (W.B.C.) 28 Total 235 Third year, 1953:— Palmerston Crescent (L.C.C.) 2 Greenlaw Place (W.B.C.) 162 Walpole Place (L.C.C.) 29 Fenwick Street (L.C.C.) 4 Arthur Grove (L.C.C.) 18 Total 215 22 Fourth year, 1954:— Marshalls Grove (W.B.C.) 4 Morris Walk (L.C.C.) 14 Corn Street (L.C.C.) 52 Pett Street (L.C.C.) 30 Perrott Street (L.C.C.) 63 Spearman Street (L.C.C.) 42 Total 205 Fifth year, 1955:— Ann Street (L.C.C.) 85 Total 85 After considering these proposals, the Health Committee was of the opinion that, although the first five-year programme allegedly deals with houses in the County immediately representable, there are at least double the 1,068 allocated to this Borough which could be represented as unfit within this period. It is recognised, however, that practical considerations will probably forbid a larger number being dealt with during this period. The County Council has reported that it will help in rehousing in the following terms:— "The Council is anxious to be fully co-operative in providing rehousing assistance in respect of areas exceeding ten houses. In Boroughs where the need was greatest, the Council would hope to contribute up to 50 per cent. of the additional rehousing necessary stage by stage, or even more where the position is really serious. On the other hand, it will be expected that some Boroughs will not need any special assistance." The Health Committee had no particular observations on the above-mentioned programme, but pointed out that the figures given for "unfit" houses in the Lord Warwick Street and Ropeyard Rails areas are now somewhat more than actual, as they would appear to be based on pre-war calculations. Of the original 328 houses in the Lord Warwick Street Clearance Area, only 308 remain to-day and of the 158 in Ropeyard Rails, there are only 95 houses now standing. Again, although 85 houses are shown in Ann Street as "unfit" and programmed for clearance by the London County Council in 1955, they form only part of what will be described as the Glyndon Clearance Area, where there are already at least 250 representable houses which ought properly to be demolished at the earliest opportunity. The Committee noted that the tentative 1955 Slum Clearance programme shows that there is no concurrent action being taken by the Borough Council elsewhere in the Borough and it has informed the County Council that once the work in the St. Mary's Redevelopment Area is well under way, it may be possible for the Council to deal similarly with the Glyndon Area properties and to carry out the clearance of the Ann Street houses itself, so releasing the County Council's building potential for work elsewhere in the Metropolis. New Houses. The number of certificates issued in respect of new dwelling houses, including flats, as having a proper and sufficient supply of water was 889, being 169 more than the previous year. Despite increasing difficulties, the proud record of the Borough of Woolwich with regard to the provision of post-war houses was maintained during the year 1951. The number of new houses built in the Borough during the year is summarised as follows:— By Woolwich Borough Council, 227; by private enterprise, 103. In addition, 88 flats erected by the London County Council on the Barnfield Estate became available for letting during the year. On the large new Avery Hill Estate, 90 flats and 430 houses were completed during the year by the County Council, the size of these houses ranging from the one-bedroomed type to the fourbedroomed type of house. 23 Apart from the erection of houses and flats by the County Council at the end of the year schemes were in hand for the erection of a further 408 dwellings by the Borough Council. Number of applicants on Register at 1st January, 1951 6,520 Number of applications received during year 1,240 7,760 Number of applicants rehoused during year:— (1) By Borough Council 299 (2) By nomination to L.C.C. 41 (3) Direct by L.C.C. 122 462 7,298 Number of applications cancelled or withdrawn (applicants moved, found own accommodation, etc.) 1,813 Number of applicants on "live" Register at 31st December, 1951 5,485 Properties under Council's control:— 1950. 1951. At 31st December, tenancies totalled :— In pre-war houses 4,317 4,317 In rebuilt houses 146 147 In new post-war houses 1,321 1,548 In temporary dwellings 986 986 In S.D.A.A. Properties in Possession 35 35 In requisitioned properties 1,080 1,043 In other properties 94 71 7,979 8,147 The weekly rent roll at the end of 1951 was £8,289 8s. 4d., compared with £8,024 11s. 11d. at the end of 1950. I am indebted to the Director of Housing for the above information concerning the Borough Council's housing progress. HEALTH EDUCATION Informal Talks and Film Shows. The Council's new 16 m.m. film projection equipment purchased during 1950 was fully utilised during the year and it was possible for a complete programme of health education sessions to be undertaken. Two types of programme were given: a lecture with sound films and followed by discussion led by a member of the staff of the Department; and the showing of films only. Each programme of films lasted approximately one hour and was designed to have a general health theme; for example, personal hygiene; clean food; the spread of disease, etc. Visits were made during the year to a number of women's organisations throughout the Borough, and films dealing with cookery and diet were introduced as additional interest. This type of audience proved to be among the most appreciative, and the members entered into discussion with considerable zest, especially when topics such as clean food and pest control were discussed. Audiences were generally most appreciative of the efforts of the health education unit, and a steadily increasing demand for programmes was dealt with during the year. Once visited, most organisations requested another visit by the unit. It is felt that these visits have helped considerably in drawing attention to the local health services, and not the least popular of all subjects dealt with was the work of the local health department. The following table gives details of the fifteen informal talks and fifity-one film shows given during the year:— 24 Date. Details of Informal Talks. Details of Film Programmes. January 2 - The work of the Health Department. 3 - do., do. 4 - The spread of Disease. 5 - do., do. 8 - Local Government Services. 11 - Pest Control. 15 - Health Services. 18 - Housing and Town Planning. 19 - Health and Hygiene. 25 - do., do. February 2 The Work of the Health Department Local Health Services. 2 do., do. do., do. 7 - Housing and Town Planning. 8 - Child Welfare. 9 - Health and Hygiene. 12 - Local Government Services. 14 Clean Food Health Services. March 2 - Housing and Town Planning. 7 - Pest Control. 12 The work of a Sanitary Authority Health Services. 13 - Clean Water Supply. 14 - do., do. 15 Infectious Disease The Spread of Infection 20 - The work of the Health Department. 21 The work of the Health Department do., do. April 19 - Local Government Services. 26 - The spread of disease. May 9 Clean Milk Clean Milk Production and Supply. June 14 - Clean Food 14 Clean Food do. September 13 Housing and Town Planning Housing 26 - Clean Water Supply 27 Spread of Infection by Food Clean Food. October 1 Refuse disposal Refuse disposal. November 7 - Local Government services. 13 - Accident prevention. 14 - do., do. 14 Tuberculosis Tuberculosis and Mass X-ray. 15 - Road Safety. 16 The Spread of Infection Child Care. 19 - Personal Hygiene. 22 - Clean Water Supply. 26 - Personal Cleanliness. 27 - Health and Hygiene. 28 - Local Government Services. 29 - Health and Hygiene. December 4 Smoke Abatement Personal Hygiene. 5 - The Spread of Disease. 12 Clean Food Clean Food 13 - The Replanning of London. 17 - The Human Body. 25 Lectures to Food Handlers. On the 30th January, 1951, a course of eight lectures to local butchers and restaurant staffs was commenced. There were 45 enrolments for this course, and the syllabus included Personal Hygiene, the Spread of Infection, Cleanliness of Premises, Rodent and Pest Control, the Use of Detergents and Sterilants, and a brief outline of the law relating to food handling. The lectures were illustrated by sound films, film strips and exhibits, and the recently purchased "Epivisor" film strip projector and diascope combined was in regular use. A second course for the staffs of some of the smaller restaurants was then arranged and for this course the syllabus was condensed and consisted of six lectures. Twenty-two persons enrolled for this course, which was completed early in the month of March. Both the courses were held in the Woolwich district, and in order to obtain the cooperation of employers in the Eltham area a further series of lectures was held in Eltham, in a hall kindly made available by the London Electricity Board. Certificates were issued to all food handlers who regularly attended the lectures. A new approach was then made, by taking the health education unit to one of the large local factories where a course of lectures was given to the canteen staff, and the results were most encouraging. Local Government Exhibition—October, 1951. A feature of the Health Stand during the Council's Exhibition was the brightly painted back cloth which portrayed panoramically some of the advances in the public health during the last fifty years. A sketch of dirty, narrow streets was followed by an illustration of the first world war and the rebuilding which took place between the two wars, including the planning and building of Health Centres, the Council's new Housing Estates and modern schools and playing fields alongside the new, wide roads. Then followed the second world war, the blitzed homes being demolished and replaced by temporary dwellings, prefabricated bungalows and the new Council estates. Under the title "The Sanitary Inspector Investigates," a model house, constructed by members of the staff, presented typical dilapidation and disrepair. The model was surrounded by a number of well-chosen photographs dealing with housing inspections and bad conditions, together with a description of the principal defects in the model house on view. Members of the staff had constructed models of old and reconstructed drainage systems. Old type and modern drainage appliances were on view. Photographs showed clean and dirty drainage fittings. Display panels illustrated the dangers to health of contamination of food and of the smoke nuisance. Specimens illustrating the control of the fly nuisance were on view on the disinfection and disinfestation stand. Two eighteen-inch paper transparencies of the bed bug and the cockroach had been mounted by members of the staff between sheets of glass and placed in front of lights; four display cases containing various insects loaned by the British Natural History Museum were displayed and photographs showed the preventive measures against mosquitoes which are taken in the Abbey Wood marsh area. A model old-type slaughter house had also been made by a member of the staff, alongside which was displayed a model bacon factory in which was shown the many stages and the processes involved in the manufacture of bacon. Another interesting exhibit was a model ice cream factory unit, complete with sterilising chamber, pasteuriser and cooler, freezing chamber and block-cutting machine with table. On this stand the exhibits included a cup ice cream server and rubber lolly mould. There was an interesting display of dairy equipment on view. Photographs and exhibits were lit by strip lighting, the exhibits being mounted on three shelves. To complete the dairy exhibition there was a model milk pasteurising plant. 26 The Department's large waiting room was utilised to present the Home Safety exhibit "Trouble House." This exhibit was in the form of an open-sided house, the rooms and contents being in full view. Each room was fully furnished and complete with model figures staged in a manner to demonstrate the hazards created by the misuse or faulty arrangement of household equipment. The story was told in sequence, a series of red electric bulbs, adjacent to each incident, lighting up in turn with illuminated panels descriptive of the incident portrayed. Also, in the Home Safety exhibit in the waiting room, were posters dealing with accidents in the home and a coloured frieze round the walls. Two sets of contrasting rooms of houses (old and modern kitchen and old and modern bedroom) were popular with members of the public. In one corner a display panel portrayed the changes which have taken place in the local ambulance service since 1930. Photographs of a horse-drawn ambulance and of the first motor ambulance to be used were on view alongside photographs of one of the latest Daimler ambulances operated by the London County Council. At the enquiry counter an attractive display of flowers and plants was presented. At the entrance to this room a coloured sign pointing the way to "Trouble House" had been erected. This sign had been constructed by members of the staff. On the health education stand the Council's new epidiascope was displayed. It was surrounded by leaflets and there were photographs of a health education lecture in progress and of one of the Department's large poster sites in Woolwich. By means of a display of coloured illuminated boxes with flashing electric signs the vital statistics of the Borough (infant death rate, Tuberculosis death rate and deaths from certain diseases) during the last fifty years were effectively presented. These boxes were designed and made by members of the staff. With the assistance of photographs and illuminated photographs, the Maternity and Child Welfare work of the Council during the greater part of the present century was shown. The growth of this service from its inception until its transference in 1948 was shown by means of photographs of some of the Welfare Centres established by the Council during the period between the two world wars. A number of culture plates were on show. An attractive display of fish was maintained in an automatic refrigerating unit. This unit was also used for the display of diseased meat specimens which had been condemned by the Council's Food Inspectors at the Plumstead Abattoir. The fish section was dressed daily and specimens of meat obtained from the Abattoir were renewed at intervals during the week and proved of unusual interest. Photographs taken during the inspection of meat at the Abattoir were on view, together with photographs of modern refrigerating units. By means of photographs it was possible to present an interesting comparison in the advances made in hygienic practice during the last fifty years by a local firm of food dealers. An electric glass-washing machine was used to indicate the latest technique in glass-washing. A section of a bar was set up complete with shelves, counter, glasses and bottles and a rotary motor pump was installed. The glass-washing machine was demonstrated throughout the week. Altogether, some sixty photographs were on view on the Department's stand and these photographs had been mounted and were displayed on chromium and glass display fittings. At the entrance to the stand there was an illuminated glass panel in the shape of an arrow, which had been constructed by members of the staff, bearing the words, " Here's Health." Leaflets and Posters. During the Exhibition week an opportunity was taken of distributing a large number of leaflets to members of the public. So great was the demand for leaflets dealing with the dangers of food infection that the large stock was soon exhausted. Several thousand leaflets drawing attention to the dangers of accidents in the home were distributed on the Home Safety exhibit stand. 27 As in previous years, 500 copies of the booklet Better Health were distributed monthly, and the large poster sites in the Borough were used for displaying posters obtained from the Central Council for Health Education. Arrangements were also made with the local food offices to display crown posters, and in co-operation with the Borough Librarian and the local Pood Executive Officer a largo number of leaflets and bookmarks on health subjects, particularly with regard to diphtheria immunisation, were distributed throughout the year. The Council have again made an annual contribution of £20 to the funds of the Central Council for Health Education. INSPECTION AND SUPERVISION OF FOOD Premises where Food is Prepared or Offered for Sale. All premises in the Borough where food is manufactured, stored or sold arc regularly visited by the Sanitary Inspectors. All the district Sanitary Inspectors are concerned with the inspection of food in shops and in the streets from stalls and barrows, and routine inspections of bakehouses, butchers' shops and fried fish shops are carried out. There are five food inspectors whose duties, in addition to the inspection of all carcases at the Plumstead Abattoir, are concerned with the sampling of food, the supervision of ice cream and milk processing plants and the inspection of markets and street traders. Two other specialist food inspectors regularly inspect restaurants and works canteens, licensed premises and milk shops and dairies. The total number of inspections of food premises during the year amounted to 2,255. In addition to canteens there are some 595 restaurants and eating houses in the Borough. The number of premises registered for the preparation or manufacture of sausages and potted, pressed, pickled or preserved food at the end of the year was 212. The following is a summary of the registered food premises in the Borough at the end of 1951 with the number of inspections carried out in the year:— Table No. 12. Description. Number in Borough on 31st December. Number of Inspections. Dairies 5 283 Distributors of Milk 112 Ice Cream Premises 296 388 Premises where Food is Prepared other than above 221 435 Restaurants and Eating Houses 595 631 Markets 2 Daily Bakehouses 29 49 Itinerant Vendors — 24 Milk Supply. There are 85 registered distributors of milk in the Borough and five dairy premises. The Council has also approved the registration of a further 27 distributors of milk who sell milk in the Borough from premises outside the Borough. One hundred and fifty-three dealer's licences and 08 supplementary licences were issued under the provisions of the Milk (Special Designations) Regulations, 1949, authorising the use of special designations. 28 With the exception of one sample, all of the 228 samples of milk submitted for chemical analysis contained 3 per cent. or more of fat. Actual figures were:— Number of Samples. 4.5 per cent. and over 1 4 per cent. and under 4.5 per cent. 3 3.5 per cent. and under 4 per cent. 121 3 per cent. and under 3.5 per cent. 102 Below 3 per cent. 1 228 The Public Analyst observes that the apparent improvement in average fat content as compared with the three preceding years is probably due mainly to the sampling, the majority of the samples having been taken in the winter months when the fat is normally at its highest level (148 in September-February compared with 80 in March-August). During the year 180 samples of milk (Pasteurised and Tuberculin Tested Pasteurised) were submitted to the Methylene Blue test for the keeping quality of milk. All samples were reported as satisfactory. Of the 183 samples of Pasteurised and Tuberculin Tested Pasteurised milk submitted to the phosphatase test for adequate pasteurisation, the test was satisfied in 181 cases. In the two cases where an unsatisfactory report was received further samples were immediately obtained and were reported as satisfactory. Seven samples of Sterilised and Tuberculin Tested Sterilised milk were submitted for the turbidity test in accordance with the Milk (Special Designations) (Pasteurised and Sterilised Milk) Regulations, 1949, and satisfactory reports were received in each case. In accordance with the practice carried out for many years in Woolwich, samples of milk were obtained from milk roundsmen in the course of early morning deliveries to schools, hospitals and institutions in the Borough. Altogether, 80 such samples were obtained. Of these samples, 36 were submitted for chemical examination, 27 for the Phosphatase test and 27 for the Methylene Blue test. Analysis of Samples of Milk. During the year four samples of milk taken informally and three samples taken formally were reported by the Public Analyst to contain a deficiency of milk solids other than fat, corresponding to the presence of 1 per cent. of added water. By way of explanation the dairy company concerned stated that when the solids-not-fat of milk is at, or at times even below, the presumptive standard, the calculation of the total solids will often give results from which one would presume minute traces of added water. The company stated that the period in the early part of the year during which the solids-not-fat in milk are normally near to or even below the presumptive standard had been greatly extended during the spring of 1951 owing to the abnormally severe weather conditions experienced. In consequence the company said they were receiving much genuine milk which fell below 8.5 per cent, solids-not-fat and even by bulking they had found themselves at times unable to reach the presumptive Government standard. The poor-quality milk due to the above-mentioned reasons was also experienced during the early part of the year by other milk distributors. Milk (Special Designations)—Specified Areas. By the Food and Drugs (Milk, Dairies and Artificial Cream) Act, 1950, the Ministry of Food is empowered to make orders specifying areas within which the use of special designations relating to milk sold by retail becomes obligatory. Until this year the use of a special designation has been a voluntary act. Following a survey by the Ministry of Food, the Minister informed local authorities that he was satisfied that the consumer demand in the London area could be met by the supply of special designated milk and after consultation with appropriate repre- 29 sentative organisations the Minister laid Orders before Parliament, the effect of which was that from the 1st October, 1951, all milk sold by retail within the London area must be special designated milk (that is, sterilised, pasteurised, tuberculin tested or accredited milk from a single herd). For some considerable time now only special designated milk has been on sale in the Borough of Woolwich. Public Health (Imported Food) Regulations, 1937. Towards the end of the year the Council's Food Inspectors attended as necessary to inspect imported food being landed from a ship at a wharf in Warspite Road, Woolwich, where a Customs Office has recently been established. As specific ministerial approval is required to enable a Metropolitan Borough Council and its officers to undertake such duties, the Council decided to make application to the Ministry of Food for the making of an Order permitting it to enforce and execute the provisions of these Regulations. Merchandise Marks Act, 1926—Marking of Imported Produce. Before the war, Orders prohibiting the sale or exposure for sale in the United Kingdom of imported goods, unless the goods bore an indication of the country of origin clearly visible to intending purchasers, were made in respect of fresh apples, raw tomatoes, shell eggs, dried eggs, dried fruit, oat products, honey, frozen or chilled salmon or sea trout, meat, butter, margarine, dead poultry and bacon and ham. However, as a general rule, imported produce does not require marking when displayed for sale in quantities exceeding 14 lbs. During the war the Marking Orders relating to eggs, bacon, butter, dried fruit, meat and poultry were suspended, but during 1951 these war-time suspensions were discontinued, except in relation to butter, which continued in force until May, 1952. The market traders in Woolwich were informed of these changes. Catering Establishments. Details of applications for new catering licences are forwarded to the Department by the Ministry of Food in order that the premises may be inspected by officers of the Council to ensure that they comply with the Department's requirements before the issue of food licences. The proprietors of a number of these food establishments were required by notice to carry out essential work to their kitchens and food storage rooms in order to bring them up to the required standard. Hygiene in Catering Establishments. During the year the Report of the Catering Trade Working Party was published. The report recommended that all catering establishments should be registered by the local authority as an essential prerequisite to any real effort to improving hygienic conditions in these establishments. The Working Party was divided on the exact form of registration. Some members thought that a satisfactory prior inspection should be a condition, while others were of opinion that there should be a right to registration on mere application of intention to operate a catering establishment. In any case, powers to cancel the registration of any premises which were unsatisfactory were suggested. The Working Party set out suggested Codes of Practice; the Standard Code contained essential requirements only, and it was suggested that this Code should be legally enforceable. The Target Code set out what was considered necessary for securing that food served in catering establishments was prepared under the best practicable conditions, and was a Code which should be aimed at by all catering establishments, although the Working Party appreciated that it could not be obtained by all at once. 30 Food Complaints—Foreign Bodies in Food. Fifty-eight complaints relating to alleged unsound food were received and investigated. Whilst several of the items of food complained of were found to be sound, a number of complaints related to bread delivered in a dirty condition and 10 complaints concerned bread containing foreign bodies such as weevils, wire, a fly, a cigarette end, mildew, glass, wood and mice dirt. Other complaints related to: dirt in cheese; a cigarette end in a doughnut; a nail in a meat pie; glass in jam; dirt in ice cream; dirt and glass in milk; a metal tack in cake, and also in a biscuit, a nail in butter; a maggot in teacake; and mould in a pork pie (two cases). In a number of these complaints there was insufficient evidence available to ensure a prosecution in the courts, and those responsible for the food were warned. Various suggestions for bringing about improvements in the preparation of the food in the offending kitchen were made where necessary. I am pleased to report that the several complaints received of glass in milk bottles during 1950 were not repeated during the year under review. Most of these complaints concerned milk supplied by one of the large dairy companies, suggested alterations to the plant having apparently remedied this matter. Meat Supply. Meat inspection has once again been carried out on a very large scale at the Plumstead Abattoir. Since the end of the war there has been a marked increase in the number of animals inspected by officers of the Council at this abattoir. Compared with the year 1948, 23,095 more carcases were inspected in 1951, the total kill for the year amounting to 58,710. This figure includes an increase on the previous year of 13,220 in the number of pigs slaughtered. There is also an increase of 6,386 over the previous year in the number of cattle killed, but fewer sheep and lambs were slaughtered during 1951. The following table gives details of the number of animals slaughtered during the year:— Table No. 13. Carcases Inspected and Condemned, 1951. Cattle, excluding Cows. Cows. Calves. Sheep and Lambs. Pigs. Number killed 19,024 2,973 1,901 19,200 15,612 Number Inspected 19,024 2,973 1,901 19,200 15,612 All diseases except Tuberculosis:— Whole carcases condemned 5 7 - 10 6 Carcases of which some part or organ was condemned 5,167 975 8 1,070 1,025 Percentage of number inspected affected with disease other than Tuberculosis 27.1 33.0 .32 5.6 6.6 Tuberculosis only:— Whole carcases condemned 73 60 5 — 63 Carcases of which some part or organ was condemned 2,163 1,040 4 — 866 Percentage of the number inspected affected with Tuberculosis 11.8 37.0 .47 — 6.0 31 It will be seen from the above table that of the 19,024 cattle (excluding cows) inspected, 11.8 per cent. (Tuberculosis) and 27.1 per cent. (other diseases) were found to be diseased. However, only 78 whole carcases, or 0.4 per cent. of the total number of cattle (other than cows) inspected had to be condemned. Of the 19,200 sheep and lamps slaughtered, only 10 whole carcases were condemned. Dogs in Food Shops. During 1951 the Ministry of Food asked local authorities to consider issuing a notice under the name of the Medical Officer of Health for display in food premises, pointing out that in the interests of food hygiene customers should be requested not to take their dogs into premises where food is sold. The Health Committee felt that local traders would support the display of such notices and a supply of 300 notices has been obtained for distribution to local food shops. At the time of writing over 200 of these notices have been distributed. Slaughter of Animals Act, 1933. Slaughterhouses are subject to annual licensing and there are now only two licensed slaughterhouses in the Borough, one of which is not being used at the present time. Two new licences were granted to persons working in the Borough to act as slaughtermen, and 16 applications for renewal of existing slaughtermen's licences were approved. New legislation amending the Slaughter of Animals Act, 1933, came into operation on the 1st October, 1951, making it an obligation to water and feed animals in slaughterhouses and in knackers' yards and whilst in lairages awaiting slaughter. Unsound Food. The Council's food inspectors are required to examine food suspected of being unsound and if considered unfit for human consumption the food is surrendered and a certificate of condemnation issued. Once again a large number of such certificates was issued during the year. Whilst no food was seized and formally condemned during the year, some 41,716 articles of food, weighing approximately 170 tons, were surrendered as unfit for human consumption. The majority of these articles, weighing approximately 150 tons, were from the large abattoir in the Borough. The food was utilised for animal feeding or for fertilisers. Ice Cream. The number of ice cream premises registered in the Borough at the end of the year was 296, of which 19 were for manufacture. Most of the dealers sold only prepacked ice cream. Periodical visits were made to all premises and inspection of all new premises was carried out before registration was approved, to ensure that they were satisfactory and that the requirements relating to heat treatment were fully understood. During the year, 53 samples were submitted for grading by the methylene blue test and the results were satisfactory, 40 samples being graded in Grade 1, six in Grade 2, six in Grade 3 and only one in Grade 4. In addition, 37 samples were submitted for chemical analysis and the fat content of the samples was as follows:— Over 20 per cent. fat nil 15-20 per cent. fat 1 10-15 per cent. fat 12 5-10 per cent. fat 24 Under 5 per cent. fat nil The average fat content of the samples was 9.4 per cent., which was slightly higher than last year (9.1 per cent.). 32 The Food Standards (Ice Cream) Order, 1951, provides that ice cream must contain at least 5 per cent. fat, 10 per cent. sugar and 7½ per cent. milk solids other than fat. However, at the time of writing it is understood that a new Order is being made providing that ice cream shall contain at least 4 per cent. of fat, 10 per cent. of sugar and 5 per cent. milk solids other than fat. From the 1st March, 1951, all manufacturers of ice cream were required to use such recording and indicating thermometers during the various processes in the manufacture of ice cream as the local authority consider requisite. Guidance on the location and checking of the thermometers and on the temperatures which should be attained during the various stages of the manufacture was made available to local authorities. Sophistication of Food. During the year ended 31st December, 1951, 965 samples (i.e., 741 informal and 224 formal samples) were submitted for analysis to the Public Analyst. Of these, 17 formal and 22 informal samples were reported to be adulterated, giving a percentage of 4.0, compared with 4.06 in 1949 and 7.1 in 1950. The foods examined were:— Ales and Stout 3 Amonds, Ground 6 Almond Paste 2 Aspic Jelly Powder 1 Aspirin Tablets 10 Bacon 9 Baking Powder 5 Barley, Pearl 1 Blackcurrant Syrup 2 Biscuits 23 Blancmange and Dessert Powders 4 Bread 15 Butter 4 Cakes, Buns and Pastries 68 Cake and Pudding Mixtures 13 Cake Decorations 7 Camphorated Oil 3 Caraway Seeds 1 Castor Oil 2 Cereal (Rice Toasties) 1 Cheese 7 Cheese and Biscuits 1 Cheese, Spread 1 Cider 4 Cocoa 4 Coconut, Desiccated 3 Coconut, Shredded in Syrup 2 Cod Liver Oil Compound 2 Coffee 14 Coffee and Chicory Essence 6 Colouring Matter 2 Confectionery, Sugar 16 Confectionery, Chocolate 4 Cooking Fat and Oil 5 Cordial 1 Cough Syrup 1 Cream, Artificial 6 Crumpets 1 Curry Powder 3 Custard Powder 8 Dates 4 Drinks, Soft 6 Dripping 1 Epsom Salts 4 Farinoca 1 Fish 2 Fish, Canned 15 Fish Cakes 2 Fish Paste 12 Flavouring Essences 13 Flour (Self Raising) 2 Fruit, Bottled 2 Fruit, Canned 11 Fruit, Dried 9 Fruit, Candied and Crystallised 3 Fruit, Juice 1 Fruit, Glace 1 Ginger, Crystallised 3 Glycerine 1 Gravy Preparations 3 Health Salts 1 Herbs (Dried) 3 33 Honey (including 1 mixture) 4 Ice Cream 37 Ice Cream Mixture 1 Ice Lollipops 18 Icing Compound 1 Infant Foods 2 Jams 13 Jelly Tablets and Crystals 17 Junket Preparations 4 Lemonade Powders 3 Lemon Curd 13 Lemon Juice 1 Macaroni 1 Magnesia (Bisurated) 1 Margarine 4 Marmalade 4 Marzipan 1 Mayonnaise 1 Meat (Raw) 1 Meat Paste 3 Meat and Vegetable Extract 1 Meat Products 13 Meat Products (Canned) 16 Meringue Mixture 2 Milk 228 Milk (Condensed) 9 Milk Whipping Compound 1 Mincemeat 7 Mustard 2 Nuts, Mixed 2 Oats, Rolled and Oatmeal 6 Olive Oil 1 Paraffin, Medicinal 5 Parrish's Food 3 Pastry, Uncooked 2 Peanut, Butter 1 Peas, Dried and Split 1 Pectin 1 Pepper 16 Pepper Compound 4 Pickles 13 Popcorns 1 Potato Crisps 5 Proprietary Food 3 Proprietary Medicine 1 Puddings, Christmas 2 Rice 6 Sago 2 Salad Cream 5 Salt 3 Sandwich Spread 1 Sauces 12 Sausages 4 Sausage, Cooked 2 Sausage Rolls 2 Semolina 3 Soda, Bicarbonate of 5 Soup, Canned 4 Soup Powder 3 Spaghetti, Canned 1 Spices 4 Stomach Powder 1 Suet, Shredded 2 Sugar 3 Syrup, Golden Spread 1 Tartaric Acid 6 Tea 4 Throat Pastilles 1 Tomato Paste, Canned 1 Tomato Puree I Treacle 1 Vegetables, Canned 21 Vinegar 10 Whisky 4 Wines, Non-Alcoholic 2 Yeast 1 34 The following Table No. 14 gives details of adulterated samples:— Table No. 14. Adulterated Samples. Sample No. Article. Formal or Informal. Result of Analysis. Result of legal proceedings or other action. 782 Sugared Seeds for Cake decorations. Informal Consisted of coloured and flavoured balls made from sugar, but contained no seeds. Described on the packet as "Edible Crystallised Seeds." Formal sample obtained. 759 Lemon Cheese (Lemon Curd) Informal Contained fat, 3.6 per cent. by weight. Fruit Curd should contain not less than 4 per cent. of fat. Formal sample obtained. 628 Milk Formal The fat and solids not fat content corresponded to the presence of 1 per cent. of added water. Warning letter sent to Vendors. 630 Milk Formal ditto 713 Milk Informal ditto Formal samples obtained. 741 Milk Informal ditto 745 Milk Informal ditto 746 Milk Informal ditto 764 Milk Formal ditto Warning letter sent to Vendor. 509 Condensed machine skimmed milk, sweetened. Formal Composition satisfactory, but label contravened the Condensed Milk Regulations. No further action. 589 Rolled Oats Informal Unsound. The sample had been attacked by insects. Stock sold. No formal sample was obobtained. 776 Tomato Paste, Canned. Informal Contained tin, 3.2 grains per pound. Tin excessive. Formal sample obtained. 35 Edible Crystallised Seeds. Formal Consisted of coloured and flavoured balls made from sugar, but contained no seeds. No further action taken. 58 Fish Informal Contained aluminium, 220 parts per million, an excessive proportion. The surface of the fish was discoloured owing to contamination by metallic aluminium. Suppliers informed of presence of particles of aluminium. 70 Table Jelly Informal When made up with water the samples failed to set satisfactorily, thereby failing to comply with the requirements of the Food Standards (Table Jellies Order, 1949. Formal sample obtained. 89 Jelly Informal 170 Jelly Crystals Informal 35 Sample No. Article. Formal or Informal. Result of Analysis. Result of legal proceedings or other action. 11 Lemon Cheese (Lemon Curd). Formal Contained fat 3.6 per cent. by weight. Fruit Curd should contain not less than 4 per cent. of fat. Warning letter sent to Vendor. 17 Lemon Curd Informal Contained fat, 3.3 per cent. by weight. Communicated with vendors and manufacturers. A revised arrangement of the mixing of the curd in the boiling process has been carried out. 55 Lemon Curd Formal Contained fat 3.6 per cent. by weight. 12 Milk Formal The fat and solids not fat content corresponded to the presence of 1 per cent. of added water Letter sent to vendors pointing out deficiency in milk solids. 14 Milk Formal ditto 57 Milk, hot Formal Contained fat, 1.66 per cent., solids - not - fat 7.16 per cent., corresponding to the presence of 15 per cent. of added water and the abstraction of 34 per cent. of milk-fat. The presence of added water was confirmed by the freezing point and nitrate tests. Prosecution. Firm granted discharge, subject to the payment of costs. 29 Tomato Puree Formal Contained tin, 2.8 grains per pound; copper 34 parts per million, equal to 92 parts per million calculated on the dried total solids. The proportions of tin and copper were excessive. Remaining stock withdrawn from sale. Warning letter sent to vendor. 320 Apricot Jam Informal The analysis indicated the presence of 27 per cent. of apricots of average composition, or, allowing for extreme natural variation in composition, not more than 36 per cent. Apricot jam should contain not less than 40 per cent. of apricots. Formal sample obtained. Satisfactory report received. 197 Meringue mixture Informal An imitation Meringue mixture consisting of a coloured and flavoured solution of synthetic gum (methyl cellulose). Genuine meringues are made from sugar and white of egg, and since the samples contained neither, and were virtually devoid of nutritive value, the term "Meringue Mixture" was in the Public Analyst's opinion a false description. Formal sample obtained. 219 Meringue mixture Formal Communicated with Ministry of Food. 36 Sample No. Article. Formal or Informal. Result of Analysis. Result of legal proceedings or other action. 330 Potato Crisps Informal Deteriorated Potato Crisps. The crisps had an unpleasant taste, due to the development of incipient rancidity in the fat. Formal sample obtained. The Public Analyst reported that the sample was not regarded as unfit for human consumption. 545 Biscuits, Fruit Rolls Informal The fig part fillings of the biscuits contained carcases and remains of small insects. Formal sample obtained. 578 Biscuits, Fruit Rolls Formal In communication with manufacturers 445 "Butter Creams" (Sugar Confectionery) Informal Contained 0.4 per cent. vegetable fat and less than 0.1 per cent. butter fat. These sweets should not be sold as "Butter Creams" (or "Buttercreams") since they contain no appreciable amount of butter. Formal sample obtained. 480 "Butter Creams" Informal Contained 0.4 per cent. vegetable fat and less than 0.1 per cent. of butter fat. 492 "Butter creams" Formal Contained 0.5 per cent. vegtable fat, and less than 0.1 per cent. butter fat. Communicated with Ministry of Food. 374 Dates, stoned Informal Damaged by insects and black mould. Formal sample obtained and reported to be genuine. 577 Dried Fruit and Sugar Mixture. Informal Contained sand, 0.15 per cent. The presence of this quantity of sand in a mixture intended for use without being washed is objectionable, since it causes grittiness in the cooked products. No further action. 611 Parrish's Food Informal Judged by the standard of the British Pharmacopoeia, the proportion of calcium in the sample was 46 per cent. excessive. Formal sample obtained. 663 Parrish's Food Formal Judged by the standard of the British Pharmacopoeia, the proportion of calcium in the sample was 37 per cent. excessive. Warning letter sent to manufacturer. 561 Pork Sausages Formal Contained preservative, viz., sulphur dioxide, 180 parts per million. Sausages should not contain preservative unless its presence is declared. Communicated with manufacturers asking for explanation. 562 Beef Sausages Formal Meat content, 46 per cent. Beef Sausages should contain not less than 50 per cent. of meat. Details reported to Ministry of Food. 37 PREVALENCE AND CONTROL OF INFECTIOUS DISEASE The following diseases are notifiable in the Borough: Anthrax, Cholera, Continued Fever, Diphtheria, Dysentery, Encephalitis Lethargica, Erysipelas, Enteric Fever, Food Poisoning, Glanders, Hydrophobia, Malaria, Measles, Membraneous Croup, Meningococcal Infection (C.S.M.), Ophthalmia Neonatorum, Pneumonia Acute Primary, Pneumonia Acute Influenzal, Poliomyelitis (Acute), Polioencephalitis (Acute), Plague, Puerperal Pyrexia, Relapsing Fever, Scabies, Scarlet Fever (or Scarlatina), Smallpox, Tuberculosis (all forms), Typhoid Fever (including Paratyphoid), Typhus Fever, Whooping Cough, Zymotic Enteritis. Although notification of an infectious disease in a house is incumbent not only upon the medical practitioner in attendance but also upon the head of the family or the nearest relative or person in charge of the patient, in fact, it is a rare thing for a " lay " notification to be received. If the patient is an inmate of a hospital, in most cases the certificate has to be sent to the Medical Officer of Health of the district in which the usual residence of the patient is situated, but cases of malaria, dysentery and the acute pneumonias, are always notifiable to the Medical Officer of Health of the district in which the patient is residing at the time he is notified. Measles and Whooping Cough. During 1951, measles was easily the most common notifiable disease. The epidemic which began in the last quarter of 1950 continued into the early part of the year. Of the 2,940 cases notified during the year, 2,380 occurred during the first quarter of the year. It was necessary for 106 patients to be admitted to hospital. One death was attributable to measles. The total number of cases of whooping cough notified during the year was 524, a similar number to the previous year. Scarlet Fever. Of the 206 notified cases of scarlet fever, as many as 127, or 61 per cent. of the patients, were isolated at home. In the majority of cases the illness was of a mild nature. Frequent visits are made by the district Sanitary Inspectors to the homes of the patients in order to ensure that proper precautions are being taken. Dysentery. During 1951 the number of cases of dysentery was 70, an increase of 51 on the previous year's total. Food Poisoning. There were no major outbreaks of food poisoning in the Borough during the year. Notifications totalled 15 and no deaths were attributed to food poisoning. All the four outbreaks were of undiscovered cause and involved a total of only 10 persons. There were five single cases. The main symptoms were vomiting and diarrhoea, the severity of the illness being slight. Bacteriological investigations failed to reveal any causal organisms. Poliomyelitis. Fortunately, we did not have a repetition during the summer months of 1951 of the high incidence of cases of poliomyelitis which had occurred during 1950, when there were 53 confirmed cases. During 1951 there were only four confirmed cases. However, notifications were received in respect of a further 15 patients, of whom 14 were removed to hospital but were found not to be suffering from poliomyelitis. The final diagnosis in the majority of cases was tonsillitis. 38 39 Table No. 15. Notification of Infectious Diseases (excluding Tuberculosis), 1951. Diseases. Number of Cases (after correction of diagnosis) Age Groups. Under 1 year. 1 and under 3 years. 3 and under 5 years. 5 and under 10 years. 10 and under 15 years. 15 and under 25 years. 25 and under 35 years. 35 and under 45 years. 45 and under 65 years. 65 and over. Total Total No. admitted to Hosp. Diphtheria — — — — — — — — — — — — Scarlet Fever 1 13 58 121 7 3 4 1 — — 208 81 Paratyphoid Fever — — — 2 — — — 1 — — 3 3 Meningococcal Infection — 2 — 1 — 2 2 — — — 7 7 Acute Poliomyelitis — — — 3 — 1 — — — — 4 4 Erysipelas — 1 — — — — — — 8 3 1Z 7 Dysentery 2 17 11 22 3 1 5 4 1 4 70 23 Zymotic Enteritis 33 15 5 4 1 — 1 1 3 1 64 48 Acute Pneumonia 10 13 11 7 5 2 14 14 32 23 131 11 Food Poisoning — — — 1 2 — 1 3 4 4 15 — Puerperal Pyrexia — — — — — 1 27 3 — — 31 30 Ophthalmia Neonatorum 8 — — — — — — - - - 8 2 Whooping Cough 62 144 164 147 3 — 2 1 1 — 524 49 Measles 89 702 995 1,107 32 5 7 2 1 — 2,940 106 Typhoid Fever — — — 1 — — 1 — — — 2 2 Malaria - - - 2 1 - 1 1 - - 5 3 Diphtheria. For the second year in succession there Were no known cases of diphtheria in the Borough. Medical practitioners notified four suspected cases, but all proved not to be diphtheria, Vincent's angina, tonsillitis and thrush being the revised diagnoses. Tuberculosis. The deaths from respiratory tuberculosis in Woolwich during 1951 were 51 compared with 58 in 1950. Table No. 16. Tuberculosis Register, 1951. Pulmonary. Non-Pulmonary. M. F. Total. M. F. Total. Cases notified for the first time 135 97 232 7 7 14 Other additions to Register during the year, including transfers of patients from other areas 61 86 147 6 - 6 Cases on Register at 31st December, 1951 836 685 1,521 110 98 208 The number of primary notifications of tuberculosis (246) was an increase of 41 on the previous year's total. The following table shows the decline in deaths from tuberculosis during the last ten years, during which the number of deaths from this disease has been halved. Table No. 17. Table of Notifications and Deaths compared with Population. Year. Estimated Civilian Population excluding Army. Primary Notifications. Deaths from Tuberculosis. Deaths per 1,000 of population. Total Deaths all causes. Percentage of Tuberculosis Deaths against all Deaths. 1941 103,630 258 127 1.22 1,627 7.8 1942 110,140 249 102 .92 1,410 7.2 1943 112,700 292 102 .90 1,558 6.5 1944 110,970 248 100 .90 1,611 6.2 1945 115,270 260 90 .70 1,478 6.0 1946 134,420 247 83 .61 1,531 5.4 1947 140,150 297 101 .72 1,626 6.2 1948 142,800 230 82 .57 1,573 5.2 1949 144,000 256 59 .41 1,572 3.7 1950 144,000 205 58 .40 1,670 3.4 1951 144,000 246 57 .39 1,838 3.1 Prevention of Tuberculosis. The Borough Council has statutory duties under the Public Health Acts concerned with the prevention of the spread of tuberculous infection, whilst the London County Council also carries out duties relating to the prevention of this disease, and the care and after-care of tuberculous persons. Disinfection of patients' rooms and possessions is carried out by the Health Department as and when necessary. 40 Chest Clinics. There are two Chest Clinics in the Borough, at Maxey Road, Plumstead, and Carnecke Gardens, Eltham, the administration of which is now carried out by the Regional Hospital Board. Puerperal Pyrexia. Regulations issued during 1951 make a slight modification to the definition of this disease in order to maintain the effectiveness of existing legislation in view of modern advances in treatment. Local authorities remain responsible for investigating the causation and course of outbreaks of infection. International Certificates of Vaccination and Inoculation. Arrangements continued during the year for the authentication by the Medical Officer of Health of international certificates of vaccination and inoculation completed by local medical practitioners. These certificates are required by passengers proceeding abroad from this country, and the purpose of the authentication is to provide proof to those health authorities abroad who desire it, that the signature of the person issuing the certificate is that of a registered medical practitioner known to the Medical Officer of Health. During the year a large number of such certificates was authenticated by me. Disinfection and Disinfestation. The Council's Disinfecting Station is situated at White Hart Road, Plumstead, where there are installed two Washington-Lyon steam disinfectors, one steam washing machine and a room for disinfecting articles which cannot be subjected to heat. Infected articles of bedding, clothing, etc., and articles infested with bugs, are disinfected at the station, but personal clothing of persons treated at the two Cleansing Stations is disinfected at these two stations. During 1951, the Department carried out disinfection of 397 rooms after cases of infectious disease, and of these, 105 premises had been occupied by tuberculous persons. Some 2,454 inspections regarding verminous conditions were made and 712 rooms were disinfested for vermin. Fifty-one vanloads of furniture were fumigated during the year. The number of articles disinfected at the Disinfection Station was 15,003, details of the type and number of articles disinfected there being as follows Beds 198 Palliasses 828 Pillows 1,453 Bolsters 156 Quilts 370 Sheets 566 Blankets 1,354 Curtains 16 Carpets 6 Rugs 15 Books 269 Bags 111 Wearing apparel 8,090 Boots 12 Slippers 8 Toys 140 Cushions 103 Sundries 1,308 41 Personal Cleansing. The personal Cleansing Stations are situated adjacent to the Turkish Baths in Plumstead High Street and at the Eltham Hill Health Centre, Sherard Road. The number of persons cleansed was 1,459 and the number treated for scabies was 98. Each case of scabies is visited by the Sanitary Inspector and wherever possible all the members of the family concerned attend for treatment. The total number of attendances at the Cleansing Stations was 1,670. Details of the number of cases and attendances at the two Cleansing Stations are given below:— Treatment of Verminous Persons. Pre-school Children. School Children. Adults. Totals. Boys. Girls. Boys. Girls. Men. W omen. Number of Cases 15 55 301 974 13 101 1,459 Number of Treatments 15 59 312 1,021 13 104 1,524 Treatment of Scabies. Pre-school Children. School Children. Adults. Totals. Boys. Girls. Boys. Girls. Men. Women. Number of Cases 10 12 25 15 15 21 98 Number of Treatments 15 15 43 26 17 30 146 Many requests were received from residents wishing to dispose of bedding and furniture often dirty and sometimes verminous and formerly used by persons removed to hospitals or institutions, or deceased. Arrangements were made for such furniture and bedding to be removed and destroyed at the Plumstead Destructor. Over one hundred such cases were dealt with during the year, and the following articles were removed and destroyed:— Beds 50 Mattresses 70 Pillows 41 Blankets 12 Wearing Apparel 90 Bedsteads and Springs 20 Bedsteads 15 Chairs 34 Miscellaneous 30 Bolsters 15 Settees 13 Cushions 10 Overlays 11 Mats 3 Overmantels 3 Sheets 1 Eiderdowns 1 42 LABORATORY FACILITIES A large part of the Council's pathological and allied work in relation to the diagnosis, prevention and control of infectious diseases is now undertaken at the Southern Group Laboratory at the Park Hospital, Lewisham. This service is provided by the Public Health Laboratory Service on behalf of the Medical Research Council. Specimens sent to this laboratory include samples of milk and ice cream, samples of food in suspected food poisoning cases, specimens of meat from the abattoir and samples of swimming bath water. The following summary relates to the work carried out by the laboratory on behalf of the Council during 1951:— Food (which includes animal specimens from abattoirs, etc.) 50 Ice Cream (Methylene Blue Test) 53 Milk (Methylene Blue and Phosphatase Tests) and milk bottles (Colony count) 214 Faeces 31 Blood for agglutinations 5 Sputum 2 Water, from Swimming Baths, Children's paddling pools and boating lakes 71 Urine 1 427 Examination of specimens of human origin (mainly swab examinations) for the general practitioners of the Borough, and also specimens referred to the hospital from local clinics, is undertaken by the Woolwich Memorial Hospital. During the year 346 such examinations were carried out. Details are as follows:— Referred by : General Practitioners. Others. Sputum 47 121 Nasal and Throat Swabs 136 42 43 "K.I." Printing Works (T.U.) Woolwich. S.E.18