Library BARN 28 BOROUGH OF BARNES ANNUAL REPORT OF THE Medical Officer of Health For the Year 1960 BOROUGH OF BARNES THE ANNUAL REPORT OF THE Medical Officer of Health FOR THE YEAR 1960 ERIC PEREIRA, M.B., B.S., D.P.H., Medical Officer of Health. 3 STAFF OF THE PUBLIC HEALTH DEPARTMENT. Medical Officer of Health :— Eric Pereira, M.B., B.S., D.P.H. Deputy Medical Officer of Health :— C. J. Radway, B.M., B.Ch., D.P.H. Chief Public Health Inspector :— William L. Leach, D.P.A. (London), M.A.P.H.I.*†‡ Deputy Chief Public Health Inspector :— P. J. Shannon, M.A.P.H.I.*† District Public Health Inspectors :— F. A. Sadler, M.A.P.H.I.*†‡ (R. J. Hamilton, M.A.P.H.I.*) C. E. Mallett, M.A.P.H.I.*† * Certificate of Public Health Inspectors' Board (formerly R.S.I, and J.S.I.B.). † Certificate of Royal Society of Health as an Inspector of Meat and Other Foods. ‡ Certificate of Sanitary Science as applied to Buildings and Public Works. T echnical Assistant (Clean Air):— T. S. Rodwell. Clerical Staff :— G. W. Nickolls. Mrs. J. D. Wallis. Mrs. E. R. Gathard. Public Analyst :— D. D. Moir, Esq., M.Sc., F.R.I.C. PUBLIC HEALTH COMMITTEE 1960-1961. Councillor Mrs. M. E. Hull (Chairman). Councillor D. Lee (Deputy Chairman). The Mayor (Councillor E. T. Rann). Alderman F. W. Moore. Alderman E. S. Stevens. Councillor A. Beilby. Councillor E. S. Bolton. Councillor Miss E. P. Clarke. Councillor F. A. Coldman. Councillor F. R. Cooper. Councillor F. A. W. Counter. Councillor Mrs. P. K. M. Lomer. Councillor G. B. Naylor. Councillor G. H. Needs. 4 Telephone: PROspect 3443. Public Health Department, Municipal Offices, Sheen Lane, S.W.14. To the Mayor, Aldermen and Councillors of the Borough of Barnes. Mr. Mayor, Ladies and Gentlemen, I have the honour to present the Annual Report of the Medical Officer of Health for the year 1960, upon the Sanitary Circumstances, Sanitary Administration and Vital Statistics of the Borough. The form of the Report is in accordance with instructions of the Minister of Health and special mention is made of certain subjects at the Minister's request. The report shows that the health of the population has been good; that there have been remarkably few cases of notifiable disease; and that the mortality rate compares favourably with other parts of the Country. In March, Dr. C. J. Radway commenced duty as Deputy Medical Officer of Health to the Boroughs of Barnes and Richmond, and Deputy Divisional Medical Officer. This appointment has worked well and assists the co-ordination of Environmental Health and the Personal Health Services. I am indebted to Mr. W. L. Leach, Chief Public Health Inspector, who has submitted his report on the Sanitary Circumstances of the District, and to Mr. Nickolls who dealt with the statistics and has prepared the report for the printers. Finally, I wish to record my appreciation of the help and support I have received from the Chairman and Members of the Health Committee, and from my Colleagues and the Staff of the Public Health Department. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, ERIC PEREIRA, Medical Officer of Health. 14th July, 1961. 5 PREFACE STAFF AND DUTIES In April 1960, Mr. Sadler resigned his post as District Public Health Inspector and transferred to another Authority early in May. The vacancy was advertised but, unfortunately, there were no suitable applicants. Later the advertisement was repeated with similar results. In advertising the post for the third time there was an application from Mr. R. J. Hamilton who had recently qualified, and who had little practical experience. Mr. Hamilton was appointed and commenced duty in December. He is rapidly gaining experience and becoming a valued member of the staff. Unfortunately, therefore, the Department was short of one Inspector for six months and consequently a reduction in routine work is reflected in the tables. SECTION 'A' — STATISTICS AND SOCIAL CONDITIONS OF THE AREA Population. The Registrar General's estimate of the population in 1960 was 38,800 which can be compared with the 1951 census population of 40,558 and the population for 1959 which was 38,880. Births. During the year 468 births were recorded. This figure may be compared with 476 in 1959. Both the still-birth and the infant mortality rates have risen slightly compared with the previous year, and in both cases the rates are higher than those for London and for England and Wales. There were, in fact, 12 infant deaths compared with a total of 8 in 1959. Of the 12 deaths, no less than 8 occurred within a few hours of birth, and were due to congenital abnormalities, prematurity, and birth accidents; and two rather older infants who died from pneumonia also suffered from congenital defects. Deaths. The total number of deaths occurring amongst residents was 475 compared with 535 in 1959. This rate, when corrected to allow for the high proportion of elderly residents, was 10.28 per thousand population which compares favourably with other towns in the country. There were no maternal deaths. The number of deaths due to carcinoma of the lung has fallen to 19 compared with 30 in the previous year, but I do not think that this is of much significance. 6 Social Conditions. The Borough of Barnes, in the County of Surrey, is situated on the South Bank of the River Thames between Richmond and Putney. One of the great advantages of the Borough is the fact that open spaces comprise almost half of its area, including Richmond Park, the River Thames, Barnes Common, Sheen Common, and other parks and recreation grounds. The Borough is mainly residential in character with some light industry. SECTION 'B' — GENERAL PROVISION OF HEALTH SERVICES IN THE AREA (a) Services Provided by the Surrey County Council. These are organised on a Divisional Basis, the Northern Division comprising the boroughs of Barnes and Richmond. The Medical Officer of Health for the Districts is also the Divisional Medical Officer, and this arrangement assists co-ordination of the personal health services and environmental health. Administrative, Infant Welfare and School Medical functions are carried out from the following Centres :— Divisional Health Office and Welfare Centre, King's Road, Richmond. Welfare Centre, Essex House, Barnes. Welfare Centre, North Worple Way, Mortlake. Health Visitors are employed and are based at the above centres. District Nurses and Midwives are provided and their main centre in Barnes is the Nurses Home, 31/32, Ranelagh Avenue, Barnes. They work under the direct supervision of the general practitioners. Moral Welfare or the care of unmarried mothers and illegitimate children, is undertaken by an officer based at the Divisional Health Office. A Home Help Service provides for domestic help in the home in cases of home confinement or illness. The service is under the management of the Home Help Supervisor who is based at the Divisional Health Office. An Ambulance Service is provided from the Station in King's Road, Richmond, which operates under the Control Station in Maiden. A Day Nursery for the care of children up to the age of 5 years is located at 45, Castelnau, Barnes. 7 (b) Services Provided by the Regional Hospital Board. Hospitals. The Royal Hospital and Kingston Hospital provide general treatment for both in-patients and out-patients. In addition, many residents make use of the West London Hospital, Hammersmith and other London Hospitals. Patients suffering from infectious diseases are admitted to the South Middlesex Fever Hospital, to Tolworth Isolation Hospital, and to the Western Fever Hospital, Fulham. Psychiatric Services. The Medical Staff of Banstead Hospital hold out-patient clinics at the Royal Hospital on Tuesdays and Fridays for residents of Barnes and Richmond. Diseases of the Chest. A Chest Clinic is run jointly by the Regional Hospital Board and the Surrey County Council, and is located over the Welfare Centre, North Worple Way, Mortlake. Laboratory Facilities. The Laboratory of the Royal Hospital is available for specimens sent in by general practitioners. The Public Health Laboratory, Epsom is available for the examination of samples of milk and ice-cream, and any pathological specimens. The Staff is always available to assist the Medical Officer of Health in the case of epidemics or outbreaks of food poisoning. The Central Public Health Laboratory, Colindale, is available for advice, special immunizing agents and special investigations. Mortuary. This is provided and maintained by Richmond Borough Council on a site close to the Petty Sessions Court. It is well equipped with two post-mortem tables. Barnes Borough Council make an annual payment for this service. (c) Services Provided by the Surrey Executive Council. The Surrey Executive Council provides General Medical and Dental Services, Pharmaceutical Services and Supplementary Ophthalmic Services. 8 More than twenty doctors living within the borough have under taken to provide General Medical Services. Several of these have also undertaken to provide Maternity Medical Services. Care of the Aged and the Chronic Sick. The scheme for the care of the aged and the chronic sick is working fairly well. The Geriatrician based at Kingston Hospital has the services of a full-time Health Visitor and is able to visit and assess the needs of all cases reported as requiring admission to hospital. Continued shortage of beds in Hospitals and Homes causes delay in admission during certain months of the year, but a desperate case is invariably admitted in a very short time. Cases awaiting admission are supervised by the Geriatric Health Visitor while those who are in frail health are visited by the general Health Visitors. A great deal is done to assist the aged by the local voluntary services through schemes such as "Meals on Wheels", Old Peoples Clubs, Chiropody, etc. The Barnes Day Club was first opened in March, 1958 in an attempt to alleviate the pain and loneliness of severely handicapped men and women living in the borough. It soon proved to be an outstanding success and in 1960 it was transferred to its own well equipped premises on a site at Mortlake Green. It now opens on three days each week and the whole organization is a remarkable example of the excellent results that can be obtained by enthusiastic voluntary workers. Laundry Service. The Council acts as an Agent for the County Council in providing this service. It is confined exclusively to patients who are incontinent, and articles laundered are limited to sheets and draw sheets. Although the number of cases served is small, the benefits to exhausted relatives are enormous. It enables them to nurse at home in comfort a patient who otherwise would have had to be admitted to hospital. During the year 1,475 soiled sheets were collected, laundered and re-issued. National Assistance Act, 1948, Section 47. In some cases the old people create their own problems by refusing to leave their homes when they can only be properly cared for in a Hospital or a Home. Under these circumstances it becomes necessary for the Council to apply to the Court for an Order for the compulsory removal of the patient to a hospital or other suitable accommodation. During the year 20 cases of old people in need of 9 care and attention were investigated, but formal action under this section of the Act was taken only in one instance. This was the case of an elderly woman living alone in a small house. Neighbours noticed that she had failed to take in her milk and informed the Health Department. When entry was gained she was found to be in a very neglected state and quite incapable of caring for herself. In the circumstances application was made for a Removal Order under the National Assistance Amendment Act, 1951 and she was removed to Grove Road Hospital. In hospital she improved in general health but it became clear that she would never again be fit enough to return home and care for herself. However, she retained the tenancy of her house, and continued to insist that she would soon return home; accordingly, an extension of the Order was applied for and obtained. Soon after that she became fit enough to be transferred to Part III accommodation in the adjacent Old People's Home, Kingsmead, but this could not be done without applying to the Court for a variation of the Order. By the time this was arranged she was again in poor health and the matter was dropped. She has now been occupying a hospital chronic sick bed since early in May, and for a considerable part of this time her health has been such that she could have been cared for in Part III accommodation. There would appear to be a weakness in the Act in so far as transfer from one type of accommodation to another cannot be effected without formal application to the Court. SECTION 'F' — PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES Measles. Following the epidemic of 1959 there were only 8 cases in 1960 and these were only of moderate severity. Whooping Cough. Only 16 cases were notified and these were not severe enough to require admission to hospital. The majority of infants are immunized against this disease and this is helping substantially to reduce the incidence and mortality rate. Poliomyelitis. There was not a single case of this disease during the year. I think that it is reasonable to believe that the very high proportion of children immunized is largely responsible for this very satisfactory state of affairs. 10 Dysentery. Six cases of dysentery were notified but in four instances the causal organisms were not identified. The other two cases were due to Shigella sonnei which is a dysentery organism widespread through' out the country. There was no connection between any of the cases and no outbreak of this disease resulted. Food Poisoning. On the 29th April, 1960 a general practitioner informed the Health Department that the wife of the proprietor of a local public house was suffering from food poisoning, and that culture of a specimen had grown an organism of the Salmonella group. Enquiries revealed that she had developed symptoms of gastroenteritis on the 25 th April and that her husband had been similarly affected on the 23rd April. There was a daughter who had had similar symptoms, a son and four daily staff of whom two had had symptoms. It seemed probable that all who had had symptoms were infected with the Salmonella organism, and that those who were symptomless might well be carrying the germ. Apart from the sale of drinks, about 80 meals were served daily to the public, and quantities of sandwiches were sold over the counter. The situation was potentially dangerous with a considerable outbreak of food poisoning as a possibility. Exclusion of all patients and contacts would have closed the house, and since the organism had already been present more than six days before notification, it seemed unreasonable to forbid the sale of all food. Examination of specimens from the entire family and staff confirmed that everyone was infected with Salmonella Anatum. A strict routine of hygiene was commenced at once, and the sale of food was restricted entirely to freshly cooked meat and vegetables. Re-heated roasts, cold meat and sandwiches were stopped. On the 6th May information was received from Wandsworth Public Health Department that a man living there had eaten at this public house on 28th April, 1960 and was infected with a Salmonella organism. This was the first secondary case, and fortunately no further such cases came to our notice. Strict precautions were maintained until all patients and carriers were negative and no further trouble arose. Smallpox. On 7th October, 1960 I was informed that a Dutchman had flown into London Airport on 3rd October and had been found to be suffering from Smallpox on 5th October. All passengers on the 11 aircraft were close contacts and there were numerous other contacts made during the days 3rd to 5th October. I was notified of the names and addresses of contacts resident in the borough, and was able to re'vaccinate them where necessary and to keep them under surveill' ance. One resident was a business associate who had been with the patient in Colombo, in the aircraft, and in their London Office. He was quarantined at home and kept under close surveillance. No further cases were reported. IMMUNISATION AND VACCINATION This work is organized from the Divisional Health Office, Sheen Road, Richmond, and is carried out at the Clinics and in the Schools. Prevention of Diphtheria and Whooping Cough. The majority of babies are immunized against these two diseases. Every effort is made to get as high a proportion as possible protected in the first year of life, but use of separate antigens during the warm quarters of the year makes this very difficult. Prevention of Smallpox. It is estimated that 62.8% of babies under one year old were vaccinated. This is not high enough but is considerably better than in many parts of the country. Prevention of Poliomyelitis. During the week 16th to 21st May a "Polio Week" was held in an effort to encourage all those eligible to be vaccinated against poliomyelitis. Vaccination centres were set up in appropriate parts of the borough and were open at times judged to be convenient to the public. The scheme was advertised in the local paper, by posters and hoardings, by the local cinemas and by the B.B.C. The local Civil Defence organization was most helpful in providing a mobile vaccination centre, a loudspeaker van which provided admirable publicity and many enthusiastic volunteers who did much to persuade the public. In addition valuable assistance was given by members of the B.R.C.S. and St. John Ambulance Brigade as well as the District Nurses, Health Visitors and staff of the Health Department. 1,132 residents were inoculated during this week and subsequently arrangements were made for them to receive their second and third doses. 12 Prevention of Tuberculosis. B.C.G. inoculation is offered to all children who are in their 13th year. The object is to provide artificial immunity during the adolescent period when young people are most susceptible to this disease. Mobile Radiography Unit. The Mobile Chest Radiography service for general practitioners has proved to be a great convenience to the local doctors and their patients and good use has been made of the service. The Unit operates outside the Municipal Offices every Monday evening from 5.45 to 6.45. Patients are X-Rayed expeditously and the Unit can readily cover the demand. Prospective Council employees who have not proof of recent Chest X'Ray are referred to the Unit, and the report can be of considerable help in assessing their fitness for employment. During the year 52 employees were examined prior to inclusion in Sickness and Superannuation Schemes. 13 THE REPORT OF THE CHIEF PUBLIC HEALTH INSPECTOR Mr. W. L. LEACH, IS CONTAINED IN THE FOLLOWING SECTIONS 'C', 'D' and 'E'. SECTION 'C' — SANITARY CIRCUMSTANCES OF THE AREA WATER SUPPLY. There has been no change in the method of collection, purification and storage of the domestic water supply for the district. Daily samples are taken by officers of the Metropolitan Water Board at each stage, and the average result of the bacteriological examinations of 1,101 samples is given in Table 12. A uniformly high standard of purity and quality was maintained. The only complaints are in respect of drinking water supplied from storage cisterns. It should be obligatory for all water used for drinking purposes to be taken direct from the mains, as the storage cisterns are virtually the only remaining sources of potential contamination. The Board's waters are not plumbo-solvent and are derived from the non-tidal portion of the River Thames, stored in the Metropolitan Water Board reservoirs at Staines, Littleton and Walton, and filtered and chlorinated at the Hampton Works. We are indebted to Dr. Windle Taylor, Director of Water Examination to the Board, for the information in Table 12. SEWERAGE AND SEWAGE DISPOSAL No complaints of smells were received from the Sewage Works. There were no long spells of hot, dry weather to make conditions difficult. In spite of modern methods of control there were one or two complaints of small flies in the vicinity of the Works. In the light of present knowledge this kind of infestation is particularly difficult to deal with. The main sewers in the Borough are now receiving more systematic inspection and cleansing, especially where flat lengths have tended to become silted up over the years. The purchase of special apparatus for this purpose has proved well worth while. Substantial works of improvement and repair of certain lengths of main sewer are being undertaken. VERMINOUS PREMISES ETC. Rodent Control. With a full staff of rodent operators it was possible to make more survey visits. As a result there was a corresponding increase in the 14 number of infestations treated. The rodent problem is well under control and householders appear very satisfied with the free service. The incidence of infestation in business premises is very low. There were no major infestations by either rats or mice encountered during the year. The control of rats in the sewers was taken a stage further, and it was possible to carry out intensive treatments in relatively small areas where there was residual infestation. Other Pests. With the discontinuance of the Water Boards operations at Lonsdale Road, the complaints of swarms of 'midges' (chironomidæ) have also stopped, thereby confirming that the source of the infestation was the reservoirs. The Commons and Open Spaces were sprayed or treated with residual insecticides where marshy ground or stagnant water might provide breeding grounds for troublesome insects. The school kitchens were also treated in the Spring as a routine measure. ATMOSPHERIC POLLUTION The full survey of the No. 1 Smoke Control Area, comprising that part of the Borough in the Castelnau Area and extending southwards from Hammersmith Bridge to Washington Road, was completed in May, 1960. The Barnes No. 1 Smoke Control Order, 1960 was made by the Council on 15/6/60 and was confirmed by the Ministry of Housing and Local Government in January, 1961. The procedural delays were longer than anticipated and the date for the coming into operation of the Order was fixed by the Ministry for 1st November, 1961. The survey of the No. 2 Area was commenced immediately after the No. 1 Order had been made and was completed by the end of the year. It was hoped that the second area would be in operation by December, 1961 but this is not now likely to materialise. Generally speaking the advent of these areas has been favourably received. The complicated administrative procedure and the close timetable for the payment of grants baffles many of the residents affected. Often payments are made, especially by elderly people, in circumstances where no grants can be forthcoming. This still occurs in spite of publicity, calls, and clearly worded advice in the Smoke Control booklet, a copy of which has been sent to every house in the No. 1 Area. Further copies are being distributed in Areas Nos. 2 and 3. 15 Close co-operation with the Gas and Electricity Boards has been obtained and it is hoped that the present rate of conversion work will be maintained. It is confidently expected that the few furnaces which occasionally give trouble will be converted to smokeless operation during the current year. As the Refuse Destructor chimney is also approaching the end of its useful life there will then be no chimney stacks left in the area which could give rise to complaint. However, even with modern fuels, such as oil, careless management can produce unpleasant emissions. SECTION 'D' — HOUSING The number of complaints regarding housing conditions has again been affected by the nervousness of tenants in their dealings with landlords. In spite of the general acceptance of rent control for dwellings of a rateable value of less than £40, individual tenants, especially the elderly, are often very apprehensive about their security of tenure. Although, of course, tenants are always advised to make amicable arrangements with landlords about repairs, nevertheless it is often found that many complainants seek merely to explore the possibilities of enforcement action and to find out just what their position is. There has been an almost complete falling off in applications for Certificates of Disrepair. In fact, only one Certificate was issued during the whole of the year. Whilst it may be true that more money is now being spent on repairs, this is certainly not so in every case and one can only assume that tenants have been intimidated either by the uncertainties of the future of rent control or by the cumbersome procedure for the enforcement of repairs. Our programme of dealing with unfit basement dwellings has been slowly pushed ahead. An interesting feature of these is the amount of money which can be spent on reconditioning work when once control of the rent is lifted with vacant possession. The action of the Council in re-housing tenants frees the deadlock in dealing with these unfit dwellings, but it seems hardly fair that private landlords should be able to make above-average profits at the expense of many needy families on the housing waiting list. Owing to shortage of staff for six months of the year, it was not found possible to continue with the house to house inspection for housing defects. A start was made and about 50 houses were surveyed. Although externally the houses appeared neglected the amount of serious disrepair was found to be not extensive. In only a few cases was it necessary to serve statutory notices and to take action in default. 16 OVERCROWDING The position with regard to statutory overcrowding is reasonably satisfactory, owing to the special consideration which such cases receive when allocations of Corporation dwellings are made. The number of overcrowded families re-housed during the year was 13. SECTION 'E' —INSPECTION AND SUPERVISION OF FOOD The standard of food handling was reasonably satisfactory. It is quite obvious that the majority of workers in the food trades cannot be expected to appreciate the different degrees of risk of contamination as between different commodities. Whilst the cardinal principle should be, of course, scrupulous cleanliness in all aspects of food handling, the interpretation of the Food Hygiene Regulations by the Courts has lead to the position where complainants may often have to be told that some practice, of which they complain, may be most reprehensible according to the ordinary concepts of cleanliness, nevertheless the degree of risk of contamination is so slight that official action cannot be taken. Examples of this are unwrapped loaves of bread and articles of food wrapped in thin cellophane bags, both types of food which are often handled, with comparatively little risk, under rather dirty conditions. It is rarely that complaints are received nowadays of the sale of unfit food. Usually it is found that there has been some oversight or carelessness in securing the proper rotation of stocks in the retail shops. Inspections are now being made to check the relative freshness of certain prepacked meat products, in which effort we are receiving the wholehearted co-operation of the manufacturers. BOROUGH OF BARNES APPENDIX TO THE ANNUAL REPORT OF THE Medical Officer of Health 1960 21 SECTION 'A' — STATISTICS AND TABLES The following statistical information relating to the Borough has been completed on receipt of the Local and National Statistics issued by the Registrar-General in connection with Population, Birth-rate, Death-rates, Maternal Mortality, Infantile Mortality, and Incidence of Notifiable Infectious Disease. TABLE 1. — STATISTICAL SUMMARY, 1960. Area 2,650 acres Population:— Census, 1931 42,440 Census, 1951 40,558 Registrar General's estimate, mid-1960 38,800 Rating:— Number of inhabited houses 12,443 Rateable Value £888,907 Product of a penny rate £3,630 Mortality:— Males Females Total Number of Deaths 237 238 475 Death Rate per 1,000 population:— Uncorrected 12.24 Corrected (Comparability Factor 0.84) 10.28 Deaths from Cancer (all ages) 92 Deaths from Measles (all ages) NIL Deaths from Whooping Cough (all ages) NIL Deaths from Diarrhoea (under 2 years of age) NIL Live Births:— Number 458 Rate per 1,000 population 11.8 Illegitimate Live Births per cent of total live births 5.9 Stillbirths:— Number 10 Rate per 1,000 total live and stillbirths 21.4 Total Live and Stillbirths 468 Infant Deaths (deaths under 1 year) 12 Infant Mortality Rates:— Total infant deaths per 1,000 total live births 26.2 Legitimate infant deaths per 1,000 legitimate live births 27.8 Illegitimate infant deaths per 1,000 illegitimate live births NIL Neo-natal Mortality Rate (deaths under 4 weeks per 1,000 total live births) 17.5 Early Neo-natal Mortality Rate (deaths under 1 week per 1,000 total live births) 17.5 Perinatal Mortality Rate (stillbirths and deaths under 1 week combined per 1,000 total live and stillbirths) 38.5 Maternal Mortality (including abortion):— Number of deaths NIL Rate per 1,000 total live and stillbirths NIL 22 Table 2.— Vital Statistics of the Borough of Barnes during 1960 and previous 5 Years. Year Registered Births Total Deaths Registered in the District. Transferable Deaths Nett Deaths belonging to the District Total Live Births Of nonresidents registered in the District Of residents registered outside the District Under 1 year of age At all ages Number Rate per 1.000 Population Number Rate per 1,000 Population Number Rate per 1,000 live births Number Rate per 1,000 Population 1 2 3 4 5 6 7 8 9 10 11 12 1955 437 430 10.7 334 8.3 20 218 5 11.6 532 13.2 1956 484 475 11.8 345 8.6 29 208 5 10.5 524 13.05 1957 446 441 11.2 313 7.9 17 220 9 20.4 516 13.1 1958 456 440 11.2 284 7.2 35 237 8 18.2 486 12.4 1959 476 468 12.04 333 8.6 47 249 8 17.1 535 13.8 1960 468 458 11.8 271 7.0 43 247 12 26.2 475 12.2 23 Table 3. — Birth-rate, Death-rate, and Analysis of Mortality from Certain Causes during the Year 1960, with corresponding rates for England and Wales, and for the County of London for comparison. AREA AND POPULATION Live Births Deaths (excluding Stillbirths) DEATHS FROM Stillbirths Deaths of Infants under 1 year of age Malignent neoplasm lung, bronchus Whooping cough Diphtheria Tuberculosis (all forms) Influenza Acute Poliomyelitis Pneumonia Coronary and arteriosclerotic heart disease England and Wales (45,755,000) 17.1 11.5 0.48 0.00 0.00 0.07 0.02 0.00 0.55 2.01 19.8 21.9 London (3,194,480) 17.8 11.4 0.70 0.00 0.00 0.08 0.01 0.00 0.65 2.02 17.9 21.6 Barnes Borough (38.800) 11.8 10.3 0.49 — — 0.05 0.05 — 0.59 2.47 21.4 26.2 Live birth and death rates per 1,000 population. Stillbirth rates per 1,000 total (live and still) births. Infantile mortality rates per 1.000 live births. 24 Table 4. — Causes of Death during the Year 1960. Causes of Death (Registrar-General's short list of causes) Total Deaths Male Female 1 Tuberculosis, respiratory 1 1 - 2 Tuberculosis, other 1 - 1 3 Syphilitic diseases 3 3 - 4 Diphtheria - - - 5 Whooping Cough - - - 6 Meningococcal infections - - - 7 Acute poliomyelitis - - - 8 Measles - - - 9 Other infective and parasitic diseases 1 1 - 10 Malignant neoplasm, stomach 13 5 8 11 Malignant neoplasm, lung, bronchus 19 16 3 12 Malignant neoplasm, breast 6 - 6 13 Malignant neoplasm, uterus 1 - 1 14 Other malignant and lymphatic neoplasms 53 29 24 15 Leukaemia, aleukœmia 4 2 2 16 Diabetes 1 - 1 17 Vascular lesions of nervous system 62 22 40 18 Coronary disease, angina 96 64 32 19 Hypertension with heart disease 6 4 2 20 Other heart disease 54 20 34 21 Other circulatory diseases 39 14 25 22 Influenza 2 1 1 23 Pneumonia 23 6 17 24 Bronchitis 26 19 7 25 Other diseases of respiratory system 2 1 1 26 Ulcer of stomach and duodenum 5 1 4 27 Gastritis, enteritis and diarrhœa 2 1 1 28 Nephritis and nephrosis 2 1 1 29 Hyperplasia of prostate 4 4 - 30 Pregnancy, childbirth abortion - - - 31 Congenital malformations 4 - 4 32 Other defined and ill-defined diseases 27 12 15 33 Motor vehicle accidents 4 3 1 34 All other accidents 6 3 3 35 Suicide 8 4 4 36 Homicide and operations of war - - - All Causes 475 237 238 25 Table 5.—Infant Mortality during the Year 1960. Causes of death, at various ages, of infants under one year. Cause of Death Under 1 Week 1-2 Weeks 2-3 Weeks 3-4 Weeks Total under 4 W'ks 1-3 Months 3-6 Months 6-9 Months 9-12 Months Total under 1 year Deaths in the Borough Deaths outside Borough Acute Bronchitis - - - - - - - - 1 1 - 1 Asphyxia 1 - - - 1 - - - - 1 - 1 Bronchopneumonia - - - - - - 2 - - 2 - 2 Congenital Diaphragmatic Hernia 1 - - - 1 - - - - 1 - 1 Congenital Heart 1 - - - 1 - - - - 1 - 1 Cerebral Haemorrhage 1 - - - 1 - - - - 1 - 1 Cerebral Compression 1 - - - 1 - - - - 1 - 1 Prematurity 3 - - - 3 - - - - 3 - 3 Uraemia - - - - - - - 1 - 1 - 1 8 - - - 8 - 2 1 1 12 - 12 26 SECTION 'F' — PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. Table 6. — Notifiable Infectious Diseases, 1950 to 1960. Year 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 Anthrax - - - - - - - - - - - Cholera - - - - - - - - - - - Diphtheria - - - - - - - - - - - Dysentery 3 4 11 25 75 - 4 - 3 5 6 Encephalitis Acute - - - - - - - - - - - Enteric (Typhoid or Paratyphoid Fever) 1 2 1 - 1 2 - 1 - 1 - Erysipelas 4 2 8 7 2 7 2 1 1 - 1 Food Poisoning - - 1 11 5 10 - 11 5 1 2 Malaria - - - 2 1 1 - 2 2 - Measles 124 541 249 306 5 489 16 606 136 433 8 Membranous Group - - - - - - - - - - - Meningococcal Infect'n - 2 - - 2 - - - - - - Ophthalmia Neonatorum - - - - - - 1 - - - - Plague - - - - - - - - - - - Pneumonia 13 29 21 27 11 31 25 28 47 61 11 Poliomyelitis, Paralytic 1 - 8 3 1 7 4 1 1 - - „ Non-Paralytic - - - - - 1 2 - - 1 - Puerperal Pyrexia 1 - 4 1 - 3 3 1 - - - Relapsing Fever - - - - - - - - - - - Scarlet Fever 27 17 42 21 29 7 8 5 10 9 24 Small-pox - - - - - - - - - - - Tuberculosis, Pul. 37 38 39 37 27 23 18 19 28 19 19 „ Non-Pul. 2 1 7 3 3 3 3 4 - 1 1 Typhus Fever - - - - - - - - - - - Whooping Cough 58 82 19 136 25 42 17 37 6 2 16 27 Table 7. — Certain Infectious Diseases: Incidence per 1,000 of the Population in 1960. Disease Barnes London (a.c.) England and Wales Scarlet Fever 0.61 0.47 0.70 Diphtheria - 0.01 0.00 Enteric Fever - 0.02 0.01 Acute Pneumonia 0.28 0.28 0.32 Dysentery 0.15 1.61 0.95 Acute Poliomyelitis— Paralytic - 0.02 0.01 Non-Paralytic - 0.01 0.00 Food Poisoning 0.05 0.38 0.17 Tuberculosis— Respiratory 0.49 0.78 0.46 Others 0.03 0.08 0.06 Table 8. — Infectious Diseases Notified during the Year, 1960. Diseases Total Cases Notified Ages, in years Parish Removed to Hospital Under 1 year i 1 to 2 2 to 3 3 to 4 4 to 5 5 to 9 10 to 14 15 to 19 20 to 24 25 to 34 35 to 44 45 to 64 | 65 and over Barnes Mortlake Dysentery 6 - - - - - 1 - - - 2 2 - - 4 2 - Erysipelas 1 - - - - - - - - - - - 1 - - 1 - Food Poisoning 2 - - - - - - - - - 2 - - - - 2 - Measles 8 - 1 2 2 1 1 1 - - - - - - 3 5 - Pneumonia (Acute) 11 - - - - - - - - - - 2 3 6 2 9 - Scarlet Fever 24 - - - 2 3 17 2 - - - - - - 6 18 - Tuberculosis, Pul. 19 - - - - - - - 1 2 1 - 11 4 10 9 9 Tuberculosis, Non-Pul. 1 - - - - - - - - - - - 1 - 1 - 1 Whooping Cough 16 1 3 - 2 — 8 2 - - - - - — 9 7 — 88 1 4 2 6 4 27 5 2 2 5 4 16 10 35 53 10 28 TUBERCULOSIS. Notification Register. The Register of Notifications has been kept revised in accordance with the requirements of the Public Health (Tuberculosis) Regulations, 1952. The number of cases added to or removed from the Register during the year and the number remaining on the Register on December 31st, 1960 are as under:— Table 9.—Tuberculosis Register. Form of Disease On Register, 1st Jan., 1960 Cases Added Removed from Register Remaining on Register, 31st Dec. 1960 Primary Notif'ns Otherwise Restored Total NonPul. Cured Left District * Dead Total Pulmonary 175 19 18 - 212 1 32 13 5 51 161 Non-Pulm'y 19 1 - - 20 1 2 1 1 5 15 Totals 194 20 18 - 232 2 34 14 6 56 176 * Includes 4 Pulmonary cases deceased from other causes. Table 10. — Tuberculosis: New Cases and Mortality, 1960. Age-Periods New Cases* Deaths Pulmonary NonPulmonary Pulmonary NonPulmonary Male Fem'le Male Fem'le Male Fem'le Male Fem'le 1- 5 years - - - - - - - - 5-14 „ - - - — - - - - 15-24 „ 3 6 — — - - — - 25-44 „ 7 3 - - - - - - 45-64 „ 11 2 1 - 1 - - - 65 „ and over 4 1 - — — — - 1 All ages 25 12 1 - 1 - - 1 * In addition to primary notifications, all other new cases coming to the knowledge of the Medical Officer of Health are included in these figures. *Incidence-rate—Pulmonary 0.95 All forme 0.98 (per l,ooo population) Non-Pulmonary 0.03 Death-rate—Pulmonary 0.03 (per l,000 population) Non-Pulmonary 0.03 PULMONARY TUBERCULOSIS 30 Table 11.—IMMUNISATION and VACCINATION. Diphtheria Immunisation. The following Table shows the state of Diphtheria Immunisation of the Children of Barnes:— Infants 0-4 inclusive School Children 5-14 inclusive Estimated Child Population 1960 2,411 4,330 Number immunised during 1960 393 23 Number re-immunised during 1960 80 615 Total number immunised at 31st December, 1960 1,589 4,232 Percentage immunised at 31st December, 1960 65.9% 97.7% Whooping Cough Immunisation. Number of children immunised by primary course 382 Vaccination against Smallpox. Number of Vaccinations carried out during 1960:— Children Primary Vaccination 327 Re-vaccination 5 Number of Vaccinations carried out at Clinics 225 Number of Vaccinations done by private doctors 107 Figures showing percentage of children under 1 year vaccinated during 1960:— Number Vaccinated under 1 year 290 Estimated Mid-year population under 1 year 462 Percentage Vaccinated 62.8% 31 SECTION 'C' —SANITARY CIRCUMSTANCES OF THE AREA Table 12. — Water Supply — Bacteriological Sampling. Type of Test WATER PASSING INTO PUBLIC SUPPLY— Hampton Works. Plate Count per milliliter on agar 20/24 hrs. at 37°C Average Result 7.4 Coliform Test (Count per 100 ml). 99.55% Negative Escherichia Coli Test (Count per 100 ml). 100% Negative Table 13. —Infected Rooms and Articles (dealt with by the Council). Premises disinfected 2 Lots of bedding disinfected 4 „ „ destroyed 12 Table 14. — Disinfestations (Dealt with by the Council). Disinfestation by spraying or fumigation was carried out at various premises for the following infestations:— Mosquitoes 4 Flies 15 Bugs 14 Crickets 1 Wasps 74 Ants 8 Fleas 3 Beetles 8 Silverfish 1 Lice 2 Table 15. —Rodent Control. Summary of work carried out:— Premises visited 385 Inspections made 492 Treatment visits 636 Premises treated 140 Minor infestations of Rats 137 Minor infestation of Mice 8 32 Table 16.—Atmospheric Pollution. Deposit Gauges. Average Total Deposit expressed as Tons per sq. mile: Year. 1956. 1957. 1958. 1959. 1960. Castelnau 12.67 14.25 14.11 11.99 13.8 Furness Lodge 9.25 9.2 10.97 9.27 10.4 Lead Peroxide Instruments. Average Sulphur Dioxide (Mgms per 100 sq. cms exposed): Year. 1956. 1957. 1958. 1959. 1960. Castelnau 1.75 2.129 2.4 2.63 2.53 Furness Lodge 2.8 2.125 2.05 2.21 2.05 Volumetric Apparatus. Average Smoke (Mgms per 100 cu metres): 1956. 1957. 1958. 1959. 1960. 19.03 20.24 14.9 14.0 10.3 Average Sulphur Dioxide (per 100 million parts of Air): 1956. 1957. 1958. 1959. 1960. 6.15 4.53 4.5 5.23 4.35 ROUTINE INSPECTIONS. The following premises are subject to inspection from time to time as a routine measure. Registers are maintained of these premises and appropriate action taken where conditions warrant it. Table 17.—Factories. Premises Number on Register Number of Inspections Written notices Occupiers prosecuted (1) (2) (3) (4) (5) (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 21 3 - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 151 74 5 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 9 9 - - Total 181 86 5 — 33 Cases in which DEFECTS were found:— 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 (1) (2) (3) (4) (5) (6) Want of cleanliness (S.l) - - - - - Overcrowding (S.2) — - - - - Unreasonable temperature (S.3) - - - - - Inadequate ventilation (S.4) - - - - - Ineffective drainage of floors (S.6) - - - - - Sanitary Conveniences (S.7): (a) Insufficient - - - - - (b) Unsuitable or defective 3 3 - 3 - (c) Not separate for sexes 2 1 - 2 - Other offences against the Act (not including offences relating to Outwork) - - - - - Total 5 4 — 5 - Table 18.—Out Workers. Work Undertaken No. on Register Notices Served Wearing apparel 75 - Lamp Shades 13 — Curtain makers 4 — Stuffed Toys and Nursery Articles 1 - Xmas Crackers etc. 12 — Artificial Flowers 1 — Carding of buttons 5 — Household linen 2 — Total 113 - Legal proceedings under Factories Act:— No legal action was necessary during 1960. 34 Table 19. — Other Premises. Nature of inspection Number of premises Number of visits Notices issued and complied with Schools 20 - - Public Houses, Public Halls, Cinemas and Public Conveniences 40 14 - Stable Yards 4 — — In addition to the above, 54 visits were made by Public Health Inspectors to premises in connection with infectious disease. Altogether, 226 non-effective visits were made to premises of all types where no access was gained. SECTION 'D' — HOUSING Table 20.— Housing Inspections. Number of houses inspected in respect of defective conditions 342 Number of re-inspections 1,058 Number of houses inspected in respect of unsatisfactory living conditions, but where no repairs were required 96 Number of re-inspections 82 Number of Informal Notices served 202 Number of Informal Notices complied with 140 Table 21.—Rent Act, 1957. Applications for Certificates of Disrepair. Period ended:— Dec. 57: Dec. 58: Dec. 59: Dec. 60: 1. No. of applications for Certificates 44 31 16 8 2. No. of decisions not to issue Certificates — — — — 3. No. of decisions to issue Certificates 44 31 16 8 (a) in respect of some but not all defects 31 26 8 5 (b) in respect of all defects 13 5 8 3 4. No. of undertakings given by landlords under para. 5 of the First Schedule 24 21 9 5 5. No. of undertakings refused by local authority under proviso to para. 5 of the First Schedule - - - - 6. No. of Certificates issued 10 18 8 1 35 Applications for Cancellation of Certificates. Period ended:— Dec. 57: Dec. 58: Dec. 59: Dec. 60: 7. Applications by landlords to local authority for cancellation of Certificates 1 14 9 4 8. Objections by tenants to cancellation of Certificates - 6 5 - 9. Decisions by local authority to cancel in spite of tenant's objection - - 2 - 10. Certificates cancelled by local authority — 8 6 1 SECTION 'E'—INSPECTION AND SUPERVISION OF FOOD Table 22.—Food Premises. The following inspections were made in respect of premises where food is handled and distributed:— Nature of inspection Number of premises Number of visits Notices issued and complied with Bakehouses 6 12 2 Bread and Cakes 16 5 - Butchers 29 65 - Cafes, Restaurants, etc. 41 68 4 Canteens, etc. 10 5 - Cooked Meats 70 33 - Dairies and Milk Shops 25 11 - Fishmongers 13 28 - Fried Fish Shops 2 5 1 Greengrocers 40 49 - Grocers 75 159 2 Ice Cream:— Retailers 93 55 2 Public Houses 29 8 - Street Traders 8 3 — Sweets, Confectionery 64 55 — Table 23. — Sampling of Other Food and Drugs. (a) Chemical Analysis. — 55 Samples procured under the provisions of the Food and Drugs Act, 1955, included:— Butter Pastes Coffee Pies Cheese Sweets Flour Sauces Milk Soups Cakes and Confectionery Canned Meats Fruit Drinks „ Fish Jams „ Fruit Medicines „ Veg. Packaged Food Mixes 36 (b) Hereunder I give the Public Analyst's reports on the two samples examined which were found to be irregular or sub-standard. Whilst no legal proceedings were instituted the matters complained of were taken up with the manufacturers concerned with satisfactory results, as indicated:— Sample No. 300. — Brown Rice. "The Analyst was of the opinion that this was a sample of unpolished white rice of inferior quality. Brown rice is understood to be rice which has had the outer husk or hulls removed, but which still includes the brown outer skin. This sample, except for a few isolated grains, consisted of skinned or white rice, but it did not appear to have been polished. On cooking with water, this rice developed a most unpleasant putrid odour and taste. There was no evidence that this was due to mould growth or other external contamination." Inquiries made revealed that this type of rice is imported specially for consumption by certain coloured immigrants who express a preference for it. The rice is specially treated, being stored for part of the time in underground vessels. Discussions took place with the importers and it is expected that the labelling of this product will be altered in future to indicate more precisely the nature of the food. Sample No. 304.—Lactic Cheese. "This was a sample of lactic cheese contaminated on one side with a green mould growth. In Analyst's opinion a purchaser would not expect to find mould development of this nature on fresh lactic cheese." The manufacturers, on being approached about this sample, expressed great regret. Their enquiries revealed that a newly imported packing machine had developed a fault and had damaged the wrapping foil in the packing operation. All traceable stocks of this consignment were called in and it is hoped that there will be no recurrence. Table 24. — Unsound Food. The following articles were voluntarily surrendered and destroyed as beinc unfit for human consumDtion:— Where quantities are insufficient for salvage all unsound food is collected and disposed of at the Council's Refuse Destructor, by incineration. Meat. lbs. Vegetables. lbs. Bacon 21 Canned Tomatoes 7 Offal 104 Canned Vegetables 12 Canned Meat 97 Jersey Potatoes 56 Mutton 30 Fish. Other Foods. Canned Fish 5 Cheese 24 Dog-fish 84 Milk 25 Skate 12 Marmalade 2 Fruit. Various 8 Canned Fruit 199 J. H. broad & CO. ltd., printers, richmond.