LIBRARY BEC 11 BOROUGH OF BECKENHAM REPORT ON THE HEALTH OF THE DISTRICT DURING 1944 INCLUDING THE Report of the Medical Inspection of Children in the Elementary Schools BY T. PHILIPS COLE, M.B., D.P.H. Medical Officer of Health, School Medical Officer. BOROUGH OF BECKENHAM REPORT ON THE ♦ HEALTH OF THE DISTRICT DURING 1944 INCLUDING THE Report of the Medical Inspection of Children in the Elementary Schools BY T. PHILIPS COLE, M.B., D.P.H. 0 Medical Officer of Health, School Medical Officer. STAFF OF PUBLIC HEALTH DEPARTMENT Medical Officer of Health and School Medical Officer T. Philips Cole, M.B., D.P.H. Deputy Medical Officer Miss Sheila Thomson, M.B., D.P.H. School Dental Officer R. A. Waters, L.D.S., R.C.S. Chief Sanitary Inspector E. G. Moore, Cert. R.San.I., M.S.I.A. (Retired July, 1944). G. A. Webber, Cert. R.San.I. and Sanitary Inspectors' Joint. Examn. Board. Certificated Food Inspector M.S.I.A. (Appointed September, 1944). Sanitary Inspectors H. G. Richards, A.R.San.I., A.R.P.S., Cert. Food Inspector. E. U. Williams, Cert. R.San.I., Cert. Food Inspector, L.A.R.P. (On Military Service from 11/8/42). R. C. Rogers, Cert. R.San.I. (On Military Service from 6/3/41). W. Newman, Cert. R.San.I. Health Visitors Miss E. F. Smith, S.R.N., S.C.M., H.V.'s Cert. Miss M. G. Kendall, S.R.N., S.C.M., H.V.'s. Cert. Mrs. M. Walmsley, S.R.N., S.C.M., H.V.'s Cert. Miss B. N. Chandler, S.R.N., S.C.M., H.V.'s Cert. (Appointed 1/1/44). School Nurses Miss B. D. Sizer, S.R.N., S.C.M. Miss I. M. Monck, S.R.N. (On Military Service from 5/12/40). Matron of Maternity Hospital Miss D. Beard, S.R.N., S.C.M. Assistant Matron Miss H. Lomax, S.R.N., S.C.M. Chief Clerk S. W. Collett, Cert. R.San.I., Cert. Food Inspector. Assistants J. Dungay (On Military Service from 13/2/42). S. P. Lewis (Killed on Military Service 17/7/44). The list of Specialist Officers in connection with School Medical work appears at the beginning of the School Report. 2 INTRODUCTION TO ANNUAL REPORT FOR 1944 The dominating feature of 1944 was the Flying Bomb attack in the summer. Evacuation, both privately conducted and government sponsored, was more extensive than during the winter of 1940-41, and the return of those evacuated was more gradual. All of this is reflected in the record of the work done in the various branches of the Public Health Services. Although the Elementary Schools were never actually closed, for a number of weeks no school department had more than a handful of children in attendance ; under such circumstances Routine Medical Inspections at the schools, and attendance at.the School Clinics ceased. The same was true for the Maternity and Child Welfare Service : attendances at the Infant Welfare Centres were negligible and the number of effective home visits by the Health Visitors was greatly reduced. Arrangements were made for the evacuation of many expectant mothers, and at the request of the Ministry of Health the Beckenham and Penge Joint Maternity Hospital Committee at the beginning of September agreed to the removal of the Maternity Hospital to Wales. During the last four months of the year the attendances at the schools gradually increased, and increasing use was made of the various clinics ; but conditions had not reached normal by the end of the year. The Maternity-Hospital returned from Wales in December, and a few patients were admitted during that month. The effect on the incidence of Infectious Disease was remarkable. The notifications of the four commonest notifiable infectious diseases of childhood were : in May—46, June—45, July—5, August—2, September—3, October—4, November—12, and December—67. This record was influenced not only by evacuation but by dispersal— a factor which, as I have pointed out before, is of great importance. The most difficult question of all is the housing of our people : it becomes more acute with every week which passes. The complete cessation of the building of houses for over five years, the destruction of house property, and the gigantic task of repair of wardamaged houses present the Public Health Department with an, at present, insoluble problem. Each day brings to the notice of the Department cases of hardship and distress which it is impossible to relieve or even to mitigate. Only the most urgent matters of dilapidation and disrepair can be remedied, with the result thatunfit houses must inevitably be kept in occupation and many other houses perforce allowed to deteriorate. This means that in addition to the shortage of houses in the Borough before the war, houses destroyed and the cessation of building, a large number of houses will have to be demolished as being no longer-fit for habitation. This does not imply neglect at any level ; it is just a part of the price exacted by war. Although all of the different clinics and personal health services have real value, the foundation of a healthy and happy life is the home, and no Public Health Authority can face the insistent problem of housing with anything but grave anxiety. Mr. E. G. Moore, the Senior Sanitary Inspector, who had given 3 44 years' service in the Public Health Department, retired in July, taking with him the respect and affection of all with whom his work had brought him in contact. I should like to thank the Assistant Medical Officer of Health Dr. Thomson, and all the professional and clerical members of the staff of the Public Health Department for loyal and efficient service, throughout a difficult year. NATURAL AND SOCIAL CONDITIONS Details of the area and character of the district have been given in previous reports. 'Information on Vital Statistics is not yet available and will be added later. PUBLIC- MORTUARY. There were 42 cases of sudden death in the district during 1944, where the public mortuary was used. VENEREAL DISEASES. There is no treatment centre in the area for these diseases. The K.C.C. provide a Clinic at Dartford. INFANTILE MORTALITY. The attached Table gives details of 33 local cases, of which records are available :— Under 1 week 1-2 wks. 2-3 wks. 3-4 wks. Total under one mth. 1-3 mths. 4-6 mths. 7-9 mths. 10-12 mths. Total under one year A. Congenital Heart 1 1 _ 1 3 _ _ _ _ 3 Spina Bifida 1 - - - 1 1 - - - 2 Spina Bifida & Meningocele - 1 - - 1 - - - - 1 B. Prematurity 13 - - - 13 1 - - - 14 Atelectasis 1 — — — 1 — — — — 1 Precipitate Labour Cerebral Haemorrhage 1 _ _ _ 1 _ _ _ _ 1 C. Gastroenteritis _ _ _ _ _ 2 _ 1 _ 3 Bronchopneumonia _ 1 _ _ 1 _ _ _ 1 .2 Lobar Pneumonia _ _ _ _ _ 2 2 _ _ 4 D. Violence _ _ _ _ _ _ _ 1 _ 1 Lack of attention at birth 1 - - - 1 - - - - 1 18 3 1 22 6 2 2 1 33 4 The number of deaths recorded as due to Prematurity is unusually large, but it must be remembered that every child who shows signs of life after delivery is registered as a live birth irrespective of the duration of pregnancy. Children who are born ten weeks or more before full term have practically no chance of survival, and among the fourteen cases included in the Table eight were born at or before the thirtieth week of pregnancy. Prematurity always occupies a prominent place in the causes of infant deaths : it is the certified cause of death in over a quarter of the total numbers of infant deaths in Beckenham : the actual percentages since 1928 are: 1928-1932, 28.57%; 1933-1937, 26.56% ; 1938-1942, 26.4%. Prematurity can be caused by many different conditions, some of which are well-established and others only suspected : some of these conditions are preventable, others, in the present state of our knowledge, are not. It is usually very difficult to determine precisely which condition has been responsible in any particular case. NURSING HOMES REGISTRATION ACT, 1927. At the end of the year there were 2 homes on the register. The Medical Officer of Health and Assistant M.O.H. paid 16 visits of inspection to the premises and found the records and equipment satisfactory. Local paper's were scrutinised for advertisements of unregistered homes. BOARDED OUT CHILDREN. At the beginning of the year there were 13 registered Foster Mothers having charge of 18 children. At the end of 1944 there were 16 children under the care of 11 Foster Mothers. The Health Visitors made inspections of the premises on the register, and most of the children were seen at the Welfare Centres. MATERNITY AND CHILD WELFARE This service deals with the ante-natal care of expectant mothers and the supervision of nursing mothers and children up to the age of five years. NOTIFICATION OF BIRTHS. The births registered were slightly higher than in 1943. ANTE-NATAL WORK. In 219 of the births in and belonging to the area, the services of a private medical practitioner were engaged, and the remainder were attended by midwives. It is for these latter cases that examination and supervision at the Ante-Natal Clinic is intended. All assessments for the Maternity Hospital are made through the Office, and a visiting card is made out so that advice can be given by the Health Visitors; this work necessitated 793 visits 5 ANTE- AND POST-NATAL PANEL. The scheme approved by the Council whereby the ante-natal examination of expectant mothers would be conducted by medical practitioners practising in the district, continued in operation during the year, and the total attendances were 622 compared with 1,014 in 1943. The panel contains the names of most doctors practising in the district. During the year the following work was done under the scheme:— Mat. Hosp. Town Hall Total Sessions held 32 20 52 Number of mothers attending for examination 186 39 225 Number of attendances made— Ante-Natal 344 79 423 Post-Natal 171 28 199 The arrangements worked smoothly and the appointments were well kept by doctors and patients. The Assistant Medical'Officer saw 243 new cases, made 731 re-examinations of expectant mothers, and made 62 post-natal examinations; when the Maternity Hospital was evacuated Dr. Thomson took over the supervision of ante-natal cases. The Obstetric Specialist, Mr. D. M. Linsday, held 9 sessions and saw 11 ante-natal cases and 51 post-natal cases who made 56 attendances. HOME HELPS. Owing to the employment of women in industry it is now practically impossible to get suitable people to act as Home Helps, although the need is a very real one. HOME VISITING This work is carried out by the Health Visitors. During 1944 the Health Visitors made a home visit to 910 new cases. the Health Visitors made a home visit to 910 new cases. The work done is summarised below and the total visits 9,753 compare with 7,943 in 1943, but include no less than 2,404 unavailing visits due to movement of the population. Home Visits, New Under One 1 to 5 Special Illness Expectant Mothers Other Visits No Reply Total Visits Miss Smith 226 530 559 367 187 52 487 2,356 Miss Noble 297 702 1,053 171 351 222 287 2,661 Miss Kendall 179 342 858 395 126 65 646 2,456 Mrs. Walmsley 208 245 334 241 178 137 984 2,190 Total 910 1,819 2,804 1,174 842 476 2,404 9,753 6 INFANT WELFARE ATTENDANCES Town Hall C'tre Alexandra C'tre Elmers End C'tre Wickham C'tre Coney Hall C'tre Ch'chfields C'tre Short lands Comparative Total 1944 1943 Total Attendances 2,942 2,588 5,064 4,458 2,482 3,820 351 21,675 33,674 New Cases 153 94 168 213 85 155 58 926 1,062 Average Sessional Attend'nce 56 49 50 45 48 41 12 35 72 Sessions 52 52 101 98 51 92 28 474 462 Sessions Attended by M.O. 52 47 / 51 46 51 47 294 307 Cases seen by M.O. 409 689 759 603 294 990 3,744 5,448 AverageNo. per Session seen by M.O. 7 14 14 13 5 21 13 17 FOLLOWING-UP OF 2 TO 5 YEARS OLD CHILDREN. The following figures show the attendances of children in age groups. Year born Attendances made 1938 4 1939 460 1940 883 1941 1,376 1942 3,522 1943 9,549 1944 588 Total 21,675 PROVISION OF MILK, MILK FOODS, ETC. A stock of dried milks and other foods is kept at the Centres and sold to the mothers at cost price. During the year foods to the value of approximately £2,000 were sold. During the year the issue of Fruit Juices and Cod Liver Oil to children up to 5 years of age was undertaken at Welfare Centres and First Aid Posts at the request of the Ministry of Food. A very high proportion of the children in the area had these regular additions to their diet. FREE MILK TO NECESSITOUS CASES. The supply of milk for children under 5 has been taken over by the Milk Board, and the Council retain only the option of supplementing supplies in special cases. The Milk Officer reports that since the Scheme came into operation, a very large number of permits have been issued. VOLUNTARY HELPERS. We are much indebted to the many ladies who give most valuable assistance at the Beckenham Welfare Centres. At all 7 Centres a great deal of assistance is also given by volunteers from the Aid Posts. SPECIAL TREATMENT. Arrangements have been made for children from 1—5 years of age to participate in the special services available for school children and the use made is shown by the following attendances :—■ Eye U.V. Ray Orthopae- Aural Clinic. Clinic. die Clinic Clinic. 1944, Infants 61 427 219 11 PREMATURE INFANTS. The Council have approved special arrangements for the care of premature infants. A small ward at the Maternity Hospital has been specially equipped and arrangements made for the admission to the Hospital of any premature infant requiring medical attention. UNMARRIED MOTHERS. The Council have undertaken to make a financial contribution in respect of local cases to the work of the Rochester Dioscesan Society for Moral Welfare, and the Evangelical Free Churches Women's Council,'in providing hostels for unmarried mothers. MATERNITY AND CHILD WELFARE DENTAL REPORT, 1944 The sessions were held on Friday afternoons and at such other times as circumstances demanded. The estimated number of sessions is 72. Although the Friday afternoon sessions were allocated during the flying bomb attack the attendances in that period, approximately from June 19th to September 15th were only 31. The total attendances for the year were 448 compared with 430 in 1943. The number of children treated was 63 compared with 85 in 1943, and the number of adults 117 compared with 111. Adults Children Attendances 347 101 Number treated 117 63 Extractions 296 96 Fillings 92 20 Dressings 79 42 Silver Nitrate — 17 Local Injections 18 — Nitrous Oxide administrations 70 26 Ethyl Chloride administrations — 11 Impressions, etc 81 — Scalings 13 — Dentures 44 — Repair 1 — 8 BECKENHAM AND PENGE JOINT MATERNITY HOSPITAL The number of admissions in 1944 was 373 compared with 581 in 1943, and 510 in 1942. No patients were admitted from September 1st to December 15th. 1 ANTE-NATAL SUPERVISION. The Matron holds a Clinic on three days a week and saw 363 cases who made 1,812 attendances. DISTRICT CASES. Cases who do not wish to enter the Maternity Hospital for confinement and cannot afford the services of a private doctor* can have the attendance of a County Midwife who may refer her patient to the Clinic under the Ante-Natal Scheme. TRAINING OF PUPIL MIDWIVES. During the year the Hospital was recognised by the Central Midwives Board as a training institution for Pupil Midwives, and at the end of the year 15 pupils were in training. CONSULTING STAFF. Dr. N. M. Jacoby, was appointed Consulting Paediatrician to the Hospital: his advice will be especially welcome on the care of premature infants. ANNUAL STATISTICS FOR 1944 Relating to the Beckenham and Penge. Joint Maternity Hospital Information Required Particulars 1. Name and Address of Institution Beckenham and Penge Joint Maternity Hospital, Stone Park Avenue, Beckenham. 2. Number of maternity beds in the Institution (exclusive of isolation and labour beds) 30 2a. Number of such beds used for Ante-Natal cases 4 3. Number of Maternity cases admitted during the year Beckenham 2771 Penge 84 373 Out District 12 J 4. Average duration of stay ... 14.1 days 5. Number of cases delivered by : (a) Midwives 283 (b) Doctors 80 1 Born before admission. 2 Abortions. 9 Information Required Particulars 6. Number of cases in which medical assistance was sought by a midwife in emergency 131 7. Number of cases notified as : (a) Puerperal Fever Nil (b) Puerperal Pyrexia ... 10 8. Number of cases of Pemphigus Neonatorum Nil 9. Number of infants not entirely breast-fed while in Institution 85 10. (a) Number of cases notified as Ophthalmia Neonatorum Nil (b) Result of treatment in each case ' 11. (a) Number of Maternal Deaths Nil 12. (a) Number of Foetal Deaths : (i) Stillborn 7 (ii) Within 10 days of birth . 6 OBSTETRIC CONSULTANT'S SERVICE. Mr. Douglas Lindsay saw eighteen cases at the request of local Doctors, sixteen at the Maternity Hospital, one in a private Nursing Home and one in her own home. The conditions are summarised below :— Toxaemias of Pregnancy: Albuminuria 2 Hyperemesis Gravidarum 1 Caesarean Section : Contracted Pelvis 4 Placenta Praevia 1 Abnormal Presentation: Brow 1 Transverse 1 Extended Breech 1 Extended occipito-posterior 2 Adherent Placenta 3 Perineal Repair 2 Hydatidiform Mole and Post Partum Sepsis 1 10 CLINIC ATTENDANCES. The Consultant's clinic was held at the Maternity Hospital on 9 occasions during the year and the attendances were :— Ante-Natal Post-Natal Re-examinations Total Average per cases cases session 11 51 5 67 7.4 WAR-TIME DAY NURSERIES The provision of a third Day Nursery to serve the Coney Hall area was recommended by the Ministry of Labour, and a prefabricated building was provided and erected, and was ready for occupation in June, 1944, but owing to enemy action was not opened. The# attendances at the two existing Nurseries was greatly reduced owing to evacuation, and the following table shows the monthly averages. The demand for accommodation at the Wickham Nursery has returned almost to normal, and owing to the fact that the Coney Hall Nursery has not been opened, a number of children from that area-are accommodated at the Wickham Nursery. The attendances at Beckenham Road have remained low up to the end of the year, but now show signs of increasing. Considerable difficulty has been experienced with staffing the Nurseries, and the Matrons, are to be congratulated on the high standard of care and welfare thev have maintained. Dr. Thomson has supervised the health of the children in attendance and all children have been immunised against Diphtheria and Whooping Cough. Month Summary of Attendances SPRINGFIELD BECKENHAM ROAD Under 2 years 2-5 years Total Days open Average Under 2 years 2-5 years Total Days open Average J anuary 225 672 897 26 34.5 132 563 695 26 26.7 February 230 659 889 25 35.1 190 654 844 25 33.8 March 247 727 974 27 36.0 219 868 1,087 27 40.2 April 192 651 843 24 35 1 200 554 754 24 31.4 May 173 702 875 26 33.6 221 696 917 26 35.2 June 173 613 786 26 30.2 129 481 610 19 32.1 July 93 349 442 26 17.0 48 81 129 25 5.1 August 118 224 342 26 13.1 30 90 120 25 4.8 September 140 296 436 26 16.7 99 141 240 26 9.2 October 249 401 650 26 25.0 160 195 355 26 13.6 November 311 516 827 26 31.8 170 244 414 26 15.9 December 280 465 745 23 32.3 167 187 354 22 16.0 INFECTIOUS DISEASE As mentioned in the introduction to this report the incidence of Infectious Disease dropped to a low level in the Summer and Autumn. For the second year in succession no case of Typhoid or Paratyphoid Fever was notified and this was the first war year in which no case of Cerebro-Spinal Meningitis was notified. 11 Infectious Disease Summary, 1944. Disease Beck. ww. Service Total 0/1 1/2 2/3 3/4 4/5 5/ 10 10/ 15 15/ 20 211 35 35/ 45 45/ 65 Over 65 Scarlet Fever 80 87 167 2 4 9 9 12 76 33 11 7 3 2 — Diphtheria 18 5 3 26 1 1 — 2 1 4 3 6 5 3 _ — Erysipelas 6 7 — 13 — 1 — — — 1 1 1 1 — 3 5 Pneumonia 29 11 — 40 — 1 1 — — 4 3 2 4 5 13 7 Poliomyelitis 1 — — 1 1 — — — — — — — — — — — Dysentery 2 — — 2 — — — — — — 1 — 1 — — — Puerperal Pyrexia 10 — 10 — — — . — — — — 10 — — ' — Measles 113 15 3 131 2 5 10 5 14 84 5 3 2 2 1 — Mumps 2 2 — 4 — — — — — 2 2 — — — — — Chickenpox 46 18 — 64 1 1 — 2 2 50 8 — — — — — Whooping — — — — — — — — — — — — — — Cough 39 11 — 50 5 5 3 5 6 24 1 — — 1 — — DIPHTHERIA Twenty-six cases of Diphtheria were notified compared with sixteen in 1943. Two cases were Diphtheria carriers and not clinical cases of the disease. Eighteen cases (including one carrier) occurred in the original Beckenham area ; five (including one carrier) in West Wickham and there were three cases among members of the Forces. Six of the cases had received protective injections but only two had been tested after the injections and found to be protected ; one of the four remaining cases contracted the disease within a few days of the completion of the course of injections and so had no time to acquire any protection : one of these six cases was not a clinical case but a carrier. The period elapsing between completion of course of injection and the onset of the disease varied from twelve months to seven years, The age incidence of the cases was as follows (carriers excluded): 0—4 5—14 15—24 25—40 4 6 9 5 This is a most unusual age distribution, nearly 60% of the cases being over the age of fourteen. The type of infection was, as in 1943, a very virulent one and but for the high degree of protection conferred by immunisation among children under the age of fifteen, I am convinced that the number of cases occurring at those ages would have been very much larger. SCARLET FEVER. Scarlet Fever was prevalent in 1943, reaching its peak in the winter : the incidence gradually declined during the spring of 1944, and as mentioned before, practically disappeared in the summer and autumn ; the incidence was still low at the end of the year. 12 The age incidence was as follows : 0—4 5—14 15 and upwards Beckenham 20 45 15 West Wickham 16 60 11 The total number of cases notified 167 compares with 261 in 1943. MEASLES. The incidence in Beckenham was low and in West Wickham negligible: incidence started to rise in Beckenham in December and was confined almost entirely to the Eden Park Ward : it fell considerably in the first month of 1945. As mentioned in previous Annual Reports, Measles has departed from its very regular biennial cycle during the war ; it will be interesting to observe if it returns to its regular rhythm when large-scale fluctuations in the child population have ceased. BACTERIOLOGICAL WORK. The number and results of the examinations made at the Public Health Department Laboratory during 1944 was :— Disease suspected Total 1944 Results Comparative Total for 1943 Positive Negative Diphtheria 299 14 285 214 Tuberculosis 55 2 53 81 Other Diseases 5 5 6 Total 359 16 343 301 PUERPERAL PYREXIA. Ten cases were notified: 9 occurred in the Beckenham and Penge Joint Maternity Hospital, and 1 in the patient's own home. OPHTHALMIA NEONATORUM. No cases were notified. TUBERCULOSIS. The total of 79 cases compares with 71, 76, 58, 65 and 66 in the preceding five years. In addition to the 79 new cases there were 9 definite cases transferred from other areas. 8 cases were not notified until after death. At the end of the year the number of notified cases in the area was:— 180 Pulmonary Males, 175 Pulmonary Females, 37 nonPulmonary Males and 27 non-Pulmonary Females ; a total of 419 cases, which compares with 447 last year. 116 cases were placed off the register for the following reasons : Died, 42 ; Cured, 16; Left area, 58. Notification.—In 8 cases notification was not made until after death. 13 Care. Committee.—The Voluntary Tuberculosis Care Committee has given considerable assistance to patients in ways which are outside the scope of official schemes. PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925. No occasion has arisen during the year to exercise the powers conferred by these Regulations of prohibiting any person engaged in the milk trade from continuing his employment. PUBLIC HEALTH ACT, 1936 (SECTION 139). . It has not been necessary to apply for an Order under this Section for the removal of a patient to hospital. WHOOPING COUGH. 49 cases were notified during the year by the doctors in attendance. CHICKENPOX. 64 cases were notified by doctors. MUMPS. 4 cases of Mumps were brought to the notice of the Department during the year. , EPIDEMIC DIARRHOEA. This disease becomes notifiable annually during the period 15th July to 15th October. No cases were notified. SMALLPOX. No cases were notified during the year. 589 children were vaccinated by the Public Vaccinator during the year. SCABIES. During the war years there has been a considerable increase in the cases of scabies requiring treatment. Arrangements have been made for the treatment to be given at the Baths First Aid Post by the Staff on duty there, and the following statement shews the number of cases dealt with ; there were very few cases of reinfestation. The staff of the Aid Post are to be congratulated on the excellent results of the treatment and the way they have dealt with this task. Treatment of Scabies at Baths Cleansing Station. Attendances Persons Treated Males Females Re-infested 30 days interval Under 14 yrs. Over 14 yrs. Under 14 yrs. Over 14 yrs. 1942 556 357 74 46 102 135 4 1943 733 429 98 50 115 166 32 1944 606 314 65 77 49 123 27 14 SANITARY INSPECTION OF THE DISTRICT, 1944. Summary of Inspections and Visits Visits and Inspections Overcrowding 5 Nuisances 1,699 Cowsheds 46 Milkshops 108 . Bakehouses 79 Butchers' Shops 207 Slaughterhouses 23 Places where food is prepared 80 Shops where food is stored 411 Factories 103 Outworkers 24 Rats and Mice Act 169 Stables and Piggeries 48 Fried Fish Shops 39 Verminous premises 43 Drainage 468 Infectious disease 232 Samples taken under Sale of Food & Drugs Act 108 Samples of Milk taken for Bacteriological Examination 9 Samples of Water 52 ■ Shops Acts 57 Miscellaneous 443 Interviews 1,329 Civil Defence A.R.P. Lectures and Demonstrations 32 Bomb damage to drains 1,008 Bomb damage to premises 293 Bomb damage to food 752 2,085 Total 7,867 Nature of Nuisance or Defects Remedied No. of defects remedied Choked drains or interceptors 206 Drains defective or altered 497 Defective or choked gullies 11 Defective W.C. pans or choked W.C.s 20 Flushing apparatus to W.C. defective 15 W.C. apartments, dirty or defective 10 Waste pipes and R.W.D.P. defective or untrapped 29 House sinks, defective 4 Soil pipes, defective 2 ' Ventilating shafts, choked or defective 2 Manhole covers, defective, unsealed or absent 10 15 No. of defects remedied Hot water tanks, water supply cisterns, uncovered, dirty or defective, or defective valves 8 Galvanised iron dustbins, defective or absent 20 Dampness 62 Rain-water pipes, defective 5 Defective or absent gutters 20 Defective roofs 37 Defective walls 27 Defective floors or skirting 43 Defective ceilings 28 Dirty walls 19 Dirty ceilings 21 Yard paving defective or absent, 2 Defective or absent stoves or grates 22 Defective windows and fittings 35 Defective or absent doors or locks 9 Accumulation of offensive material 6 Verminous rooms 7 Defective stairs and handrails and door-steps 7 Leakage from water supply pipe 6 Absence of statutory information in rent book 2 Miscellaneous Shops Acts, defects 2 Defective brickwork 4 Defective chimney stacks 2 Defective coppers 2 Defective pointing 2 Absence of water 3 Absence of larder 1 Dirty stables 1 Absence of cover to manure pit 1 Total 1,204 Premises Controlled by Bye-laws, etc. The following Table supplies particulars of the premises and occupations in the district which are controlled by Bye-laws or Regulations:— Character of Premises Action Taken and Result Cowsheds and Milkshops 154 inspections. 5 defects remedied. Eakehouses 79 inspections. 1 defect remedied. Fried Fish Shops 39 inspections. 2 defects remedied. Meat Shops (Butchers) 207 inspections. 1 defect remedied. Places where food is pie pared 80 inspections. All satisfactory. Shops where food is stored 411 inspections. 1 defect remedied. Slaughterhouses 23 inspections. All satisfactory. Stables and Piggeries 48 inspections. 1 defect remedied. 16 THE SHOP ACTS. During the year 57 visits were made under, the above- Acts The following defects were remedied during the year :— Opening on Early Closing Day 1 Dirty W.C. Apartment 1 Defective seat to W.C. 1 FACTORIES. During the year 103 visits were made to premises on the Register. At 4 premises, nuisances were remedied after the service of informal notices, as under :— Dirfy or defective W.C. Apartment 3 Absence of water supply to W.C. 1 Dirty W.C. Pan 1 Missing or defective seat to W.C. 2 Choked W.C. 1 Defective flushing apparatus to W.C. 1 HOUSING STATISTICS. 1.—INSPECTION OF DWELLING-HOUSES DURING THE YEAR:— (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 409 (b) Number of inspections made for the purpose 1,445 (c) Number of dwelling-houses (included under head (1) above) which were inspected and recorded under the Housing Consolidated Regulations,. 1925 and 1932 Nil (d) Number of inspections made for the purpose Nil (e) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (/) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found to be not in all respects reasonably fit for human habitation 170 2.—REMEDY OF DEFECTS DURING THE YEAR WITHOUT SERVICE OF FORMAL NOTICES (s>) Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or its Officers 197 INSPECTION AND SUPERVISION OF FOODS SAMPLING. 114 samples of food were taken during the year : details are set out below. All were found to be " genuine." Baking Powder 1 Brought forward 4 Batter Flour 1 Pancake & Yorkshire Mixture 1 Beef Sausages 1 Pcik Ssussges 2 Beef Vegetable Extract 1 Raisins 1 Carried forward 4 17 Carried forward 8 Brought forward 8 Brought forward 100 Bun Flour 1 Sausage Meat (preserved) 4 Butter 7 Sausage meat (not preserved) 2 Cake Mixture 2 Savoury Fish Roll 1 Cake & Pudding Mixture 1 Scone Mixture 1 Currants 1 Semolina 1 Demerara Sugar 2 Soya Flour 1 Golden Syrup 1 Sponge Mixture 1 Granulated Sugar 2 Sultanas 1 Honey 1 Tea 1 Lard 4 Yorkshire Pudding 1 Lemon Cheese 1 Malt Vinegar 1 Formal Samples 114 Margarine 2 Milk 65 Informal Samples ... 0 Mustard, loose 1 Carried forward 100 Total 114 MEAT INSPECTION. Except for " emergency killing " the slaughterhouses in the district are closed. On 17 occasions animals were dressed for food when 50 pig's were slaughtered. In 1 case diseased conditions were found. OTHER FOODS. 18 The shops and premises where food is kept were frequently inspected and a large quantity of food unfit for human consumption was surrendered. A considerable proportion was put to some useful purpose. Article No. of Tins, Packages, etc. Lbs. Pork 403½ Sausage Meat or Sausages 158 ¼ Beef 238 Mutton or Lamb 163¼ Liver 92 Brawn 10 Sirloin 14 Veal 737 Hearts 46 Pluck 8 Forequarter 172 Turkey . 1 12 Tongues 12 Polony 10 Fowls 1 case 100 Sausage Rusk 784 Forcemeat 9 2¼ — 11 2,960 Fresh Fish, etc. 2,679 Fats, etc 1 677 1,800¼ Cereal Goods ,etc. 4.215 6,607 Tinned Fish 505 330½ Tinned and Fresh Fruit 80 1,632¼ Tinned and Fresh Vegetables 363 5,551 Tinned Meat and Other Preserves 1,208 1,985 Miscellaneous 4.043 1,996¼ 12,102 25,541¼ Total 11 tons, 8 cwts., 7½ lbs. RAT DESTRUCTION The rat reporting Campaign inaugurated in October, 1943, had brought in 390 complaints up to the end of December, 1943, and a further 87 complaints continued to come in until March, 1944. A rat catcher was employed for 40 hours a week to deal with works on Council properties and private properties on payment by the occupiers. The work was interrupted by the illness of the Rat Catcher and it was found impossible to get other expert help. Up to April the following work had been done :— Council Properties—37 separate spells of pre-baiting and poisoning. Army billets—2 premises cleared. Private Properties—102 separate premises and blocks of premises inspected, pre-baited and poisoned. In the latter part of the year it was not possible to continue the work and inspections showed that the rat population has again increased. A special check was made of work done at the Electricity Works and dust destructor and the following report shows very clearly the efficacy of this method :— RAT REPRESSION, CHURCHFIELDS DEPOT. The attached siummary relates to measures oi rat repression instituted at Churchfields Road Depot between the 29th October and the 8th November, 1944. The work was carried out by a private contractor, Mr. A. Wiles, who worked under my direction. Mr. Wiles has in the past done a considerable amount of work on rat repression for the Council. The details given have been obtained from daily record sheets which the operator was required to keep. The estimated number of rats killed (478) may appear to compare unfavourably with the actual number of dead rats found (72) ; nevertheless it should, quite properly, be assumed that a more factual index to the success of the operation is given by the figure quoted as the estimated kill. This estimate is based upon a formula obtained by accurate research. Rats suffering from the effects of poisoning do their utmost to get back to their nests) and by far the greater majority succeed in so doing before they die. The infestation is now reduced to a minimum, and the premises may be said to be as free from rats as is " reasonably practicable " having regard to the nature of the business carried on. It is not advisable that the matter should now be left. In such premises regular inspection and constant work of repression is necessary. A suggestion that the premises should be subjected at intervals of two months to such measures of disinfestation as have been included in the operations reported upon, has been made to the Borough Electrical Engineer. If the suggestion is adopted, the severe rat infestation existing before these operations commenced need never recur. G. A. Webber, Chief Sanitary Inspector. 19 Rat Repression—Churchfields Depot. Summary of Operations for Rat Repression, conducted at the Churchfields Depot from the 29th October to the 8th November, 1944. First Operation Prebait—Sausage Rusk. Pcison-Zinc Phosphide. Postbait—Bread Mash. 29th Oct. to 3rd Nov., 1944 (inclusive). Second Operation Prebait—Bread Mash. Poison-Barium Carbinate Postbait—Sausage Rusk 3rd Nov. to 8th Nov., 1944 (inclusive) No. of Points baited 1st day (sound bait) 160 160 No. of Full Takes 118 0 No. oi Good Takes 8 8 No. of Small Takes 2 14 No. of No Takes 32 138 160 160 No. of Points baited 4th day (sound bait) 160 160 No. of Full Takes 123 0 No. of Good Takes 0 2 No. of Small Takes 0 28 No. of No Takes 37 130 160 160 Minimum No. of rats feeding 4th day 164 22 No. of Points baited 5th" day (poison bait) 135 . 160 No. of Full Takes 10 0 No. of Gpod Takes 32 ft No. of Small Takes 70 17 No. of No Takes 23 143 135 160 No. of Dead Rats found... 65 7 No. of Rats estimated killed 435 43 No. of Points baited 6th day (sound bait) 160 160 No. of Full Takes 0 0 No. of Good Takes 8 0 No. of Small Takes 14 8 No. oi No Takes 138 152 160 160 Minimum No. of rats feeding on 6th day 20 6 Advice and supplies of rusk and poison are now being provided for the public and if the directions are carefully observed equally good results can be obtained. There is great need for public interest and action in this matter. Individuals can rid their premises if they will take the trouble. With the present difficulty of getting staff the department cannot undertake work at private properties. The practice now in force of dumping house refuse instead of burning it is likely to provide breeding grounds for rats and these dumps will need to be watched and preventive action taken. 20 REPORT ON SCHOOL MEDICAL SERVICE STAFF ENGAGED IN MEDICAL INSPECTION School Medical Officer (approximately 1/3rd time) : T. Philips Cqle, M.B., D.P.H. Assistant to S.M.O. : Miss S. Thomson, M.B., D.P H. School Dental Surgeon (5/6ths lime to School work) : R. A. Waters, L.D.S., R.C.S. (Eng.). Anaesthetist to Dental Clinic (part-time) : Gordon Lyle, M.R.C.S., L.R.C.P., L.D.S. (Eng.) Ophthalmic Surgeon (part-time) : A. E. A. Looseley, F.R.C.S. (Eng.). Orthopaedic Surgeon (part-time) : J. A. Cholmeley, F.R.C.S. (Eng.). Aural Specialist (part-time) : G. H. Howells, F.R.C.S. (Eng.). School Nurse : Miss B. D. Sizer, S.R.N., S.C.M. School Nurse Part-time : (Temporary). Miss O. Smith, S.R.N., S.C.M. Dental Attendant (5l6ths time to School work) : Miss G. Bradford. Orthopaedic Nurse (part-time) : Miss E. N. Sutton, C.S.M.M G WORK OF THE SCHOOL NURSES The home visits to cases of infectious disease, absentees from school, cases who fail clinic appointments, etc., are made by the School Nurse, in addition to attendance at the Minor Ailment, Inspection and Special Clinics; the following figures give some * indication of the amount of work done during the year :— Home Visits: Total 1943 Total 1944 To cases of Infectious Disease 806 469 Other Cases 2,608 1,866 Total Home Visits 3, 414 2,335 21 Total 1943 Total 1944 Visits to Schools: re Personal Hygiene 81 76 Children examined 13 666 12,037 Found Unclean 30 74 Children seen at other visits 2,255 3,202 Clinic Sessions Attended : Minor Ailment Clinics 315 238 Inspection Clinics 130 102 Eye Clinics 35 8 Aural Clinics 7 3 MEDICAL INSPECTION (a) Routine Inspections. Routine Inspections are those made on the school premises of the groups of children prescribed for examination by the Board of Education. The number of children examined at these inspections during the year was :—- 1943 1944 Entrants 565 506 Intermediate 639 282 Leavers 721583 Other Routine Inspections — — 1,925 1,383 72 sessions were held at the Schools and 300 children were found to have some defect requiring treatment or observation. (b) Other Inspections. In addition to the above groups, 277 "Special" Inspections were made of children referred to the Medical Inspector either at the School or the Clinic, or to Specialist Clinics for examination. 2,016 re-inspections were made of the above routine or special cases, compared with 3,490 in 1943. (c) Following up. In connection with children found defective at Routine or Special Examinations, steps are taken to see that they are followed up until treatment is obtained. Written appointments are given for all the Specialist Clinics. FINDINGS OF MEDICAL INSPECTION The results of Medical Inspection and Treatment are summarised at the end of the Report in Tables I—V. The only special condition calling for comment is the number of children found with verminous heads. The total of 74 is not large, but it is an increase over the numbers in previous years and the majority of these cases were children who had recently returned from evacuation. 22 SCHOOL CANTEENS. At the end of the year School Canteens were in operation at the following Schools and .an average of 1,500 meals were being served daily when the school attendance was normal of 4,000 approx. It is still desirable that arrangements should be made for these meals to be available in holiday periods :— Stewart Fleming. Wickham Common. Marian Vian—All Departments. Alexandra—Senior, Junior and Infants. Bromley Road—Infants, Junior and Senior. Hawes Down—All Departments. Balgowan School—All Departments. Churchfields—All Departments have use of British Restaurant adjoining School and meals are sent into the School. Approximately 250 children received free meals at school. MILK AT SCHOOL. The issue of milk to schools continued, and the percentage of children in attendance who received milk varied from 76% to 84%.' WORK OF THE SPECIAL CLINICS TREATMENT OF MINOR AILMENTS. The attendances during the year are shown below, with comparative figures for 1943 :— School. Sessions Held. Attendances. Average Per Session. 1943 1944 1943 1944 1943 1944 Alexandra 44 33 954 649 21.6 19.3 Churchfields 44 31 1,601 849 36.3 27.3 Hawes Down 47 43 1,379 947 29.3 22.0 Marian Vian 46 37 1,411 1,088 30.6 28.8 Wickham Common 42 39 1,143 716 20.7 18.3 Stewart Fleming 44 32 881 715 20.0 22.3 Town Hall 48 55 491 341 10.2 6.2 Totals 315 274 7,860 5,305 24.9 18.6 INSPECTION CLINIC. An Inspection Clinic was held on Tuesdays, Wednesdays and Thursdays throughout most of the year. The total attendances were 1,511 compared with 2,578 in 1943. The Sessions held were 102, the average attendance being 14.8 per session. 23 EYE CLINIC 8 Sessions were held, and on all of these the Surgeon put in an extra half-session, making three instead of two hours. . I.W.C. S.M.S. . County Total Attendances by new cases 19 103 33 155 Attendances by other cases 42 414 135 591 Totals 61 517 168 746 DENTAL REPORT To the Chairman and, Members of the Education Committee. I have the honour to present the Dental Report for the year 1944. All the Elementary Schools were inspected during the year and treatment was completed, with the exception of 148 cases awaiting appointments. These were treated in January, 1945. The results of the inspections were as follows :— Number of children inspected 3,430 „ „ ,, referred for treatment 2,179 ,, ,, ,, refused treatment 420 inspected but not treated 148 The results of treatment :— * Attendances 2,365 Children treated 1,759 Fillings 1,893 Extractions 1,750 Other operations 816 .The extraction of permanent teeth was 207 and of these 60 were sound teeth removed for regulation purposes and 4 were supernumerary teeth, a total of 64, thus, reducing the loss of permanent teeth due to caries to 143. The number of cases of irregularity treated by extraction was 42, and the number treated by mechanical appliances was 11. Summary of Terminal Reports Children inspected 3,430 Attendances: New Cases 1,759 Old Cases 606 Total Attendances 2,365 24 Fillings: Permanent Teeth 1,331 Temporary Teeth 560 Post Fillings 2 Total Fillings 1,893 Extractions: Permanent Teeth 207 TempOrary Teeth 1,543 Total Extractions 1,750 Dressings 334 Silver Nitrate 183 Scalings 54 Regulation Appliances 11 Nitrous Oxide Administrations 459 Local Injections 334 The treatment of the Secondary Schools was carried out by the Dental Surgeon of the Kent Education Committee at the Town Hall Clinic each Wednesday. My thanks are due to Dr. Gordon Lyle, and Dr. Sheila Thomson for the administrations of anaesthetics, to Miss Bradford, the Dental Attendant, and to the Head Teachers for their support during the year. I cannot end the report without reference to the flying-bomb attack. During that period, approximately from June 19th to September 15th, routine dental treatment was impossible, in fact during the whole of that time, only 45 attendances were made. When the evacuation of elementary and secondary school children, an"d of mothers with young children, was decided upon, having obtained Dr. Cole's approval, I offered my services to Mr. Scarr, the Divisional Dispersals Officer. In short, the routine arrangements locally, for the evacuation, devolved upon me. I would like to express my appreciation of Miss Bradford's help at this period. She undertook all the typing, preparation of daily lists of those to be evacuated and the completed list necessary for the Kent County Council for the recovery of billeting charges. (Sgd.) Robert A. Waters, L.D.S., R.C.S. (Eng.) REPORT ON WORK OF AURAL CLINIC IN 1944 Sessions held Total Attendances New Cases Re-examinations Infants School Infants School 1944 3 111 4 24 7 76 1943 7 282 11 82 15 174 25 REPORT ON BECKENHAM ORTHOPAEDIC CLINIC 1944 The following summary shows the work of this Clinic during 1944, and comparative figures are given for the two preceding years :— Sessions Surgeons Examinations New cases Re-examinations School Infants School Infants 1944 76 44 18 109 55 1943 127 49 30 244 73 1942 130 56 40 182 93 Year Treatment by Nurse Electrical and other treatments Fees Paid Massage Exercises School Infants School Infants School Infants f, s. d. 1944 127 128 605 17 125 1 8 0 6 1943 160 128 1,331 164 171 14 20 0 10 1942 66 107 986 79 235 17 21 19 8 The progress of children admitted to Hospital for the correction of various deformities has been satisfactory in every case. ULTRA VIOLET RAY CLINIC The sessions held totalled 44 and the attendances 425 school children and 427 infants. A fee per attendance is charged in all but necessitous cases, and a total amount of £24 12s. 8d. was received during the year. John A. Cholmeley, F.R.C.S. OTHER WORK OF THE SCHOOL MEDICAL SERVICE DIPHTHERIA IMMUNISATION. This work has been carried out amongst children since 1928, and the percentage of children of school age who have been artificially immunised is very satisfactory. MALNUTRITION AND DEBILITY. The statistical tables at the end of this report include one giving the classifications into four groups of all children who were examined at routine medical inspections during the year. The groups are J— A=Excellent. Normal. C=Slightly subnormal. D=Bad. . In classifying the cases the general well-being of the child and not the height and weight only were taken into consideration. 26 The table shows that 8.972 per cent, of the children examined were found to be sub-normal and one child only considered as coming within the fourth group as " Bad Nutrition." SECONDARY SCHOOL CHILDREN. The Committee's Specialist Clinics are available for children attending the Secondary Schools. The attendances made during 1944 were :— Orthopaedic Clinic 3 cases made 14 attendances. Eye Clinic 41 „ „ 168 FEES PAYABLE. The scale for all forms of treatment is set out on page 153, vol. 29 of the Education Minutes. EMPLOYMENT OF CHILDREN AND YOUNG PERSONS. Under the Committee's Bye-laws 34 certificates were issued during the year. This number compares with 66 in 1943. The Committee have decided not to issue licences to take part in Stage Plays. SPECIAL SCHOOL FOR MENTALLY DEFECTIVE CHILDREN. The Special School, under the direction of Miss L. Ross, has returned during the year to its original premises. 9 children have been admitted during the year, and 10 have left and 4 were still evacuated at the end of the year. The number of children on the roll at 31st December, 1944, was 15 : 11 Beckenham, 2 Penge, and 2 Bromley. MEDICAL INSPECTION RETURNS, 1944 TABLE I. Medical Inspection of Children Attending Elementary Schools. * A - Routine Medical Inspections. Number of Inspections in the prescribed Groups :— Entrants 506 Second Age Group 282 Third Age Group 583 Total 1,383 B.—Other Inspections. Number of Special Inspections and Re-Inspec.tions 2,293 27 TABLE II. Classification of the Nutrition of Children Inspected during the Year in the Routine Age Groups. No. of children inspected 'A' Excellent 'B' Normal 'C' Slightly sub-normal 'D' Bad No. % No'. % No. % No. % 1944 1,304 380 29.143 806 61.809 117 8.972 1 0.076 1943 1,925 560 29.09 1,163 60.416 199 10.338 3 0.156 TABLE III. Treatment of Minor Ailments. Total Number of Defects treated or under treatment during the year under the Authority's Scheme was 2,009. Treatment of Defective Vision and Squint. Errors of Refraction dealt with under the Authority's Scheme were 417. The number of children for whom spectacles were prescribed was 115, and for whom they were obtained was 110. Treatment of Defects of Nose and Throat. 24 children received operative treatment under the Authority's Scheme, and 82 received other forms of treatment making a total of 106. 25 cases recommended for operative treatment cancelled on evacuation. TABLE IV. Dental Inspection and Treatment. Particulars of treatment under this heading will be found in the Dental Surgeon's Repprt. TABLE V. Verminous Conditions. (1) Average number of visits per school made during the year by the School Nurse 11 (2) Total number of examinations of children in the Schools by School Nurse 12,037 (3) Number of individual children found unclean 74 Freame, Manning & Co., Printers (T.U.), 12a, Lee High Road, Lewisham, S.E.13 28 BOR[???] OF BECKENHAM. Annual Report of M,O.H. Please circulate as quickly as possible (l) Miss Newham (for Dr. Hutchinson) (2)Dr. Norman - Smith (3) Dr. Lethom (4) Dr Donelam P.R.M.O. ( REGION 5 to retain.) Dr. Butler to retain. Form 26 C/Reg. (33) PLEASE INSERT IN 1944 ANNUAL REPORT. These figures have not been interesting tendencies and india comparative rates given reveal some lation figures:- Year. Population as estimated at mid - June by Registrar eral. Births. Deaths of Infants under one year mate. mate. Total Legitimate . Illegitimate . Total Rate per 1000 cf populate 1939. 71,010 897 1 27 24 6 30 32.96 1940. 64,500 757 - 20 22 1 23 30.06 1941. 53,313 548 3 1 3 17 3 20 36.70 19.42 56,300 890 — 27 24 1 25 26.77 1943. 58,300 950 1 2b 29 1 30 30.15 1944. 55,540 848 3 24 24 2 26 29.28 Year Deaths of Civiliana [???] causes including enemy [???] [???] childbirth. [???] Imonary Deaths from all forms of Cancer. Number. Rate per 1000 of population. Number. Number. Rate per 1000 of population. Number. Rate per 1000 of population. 1939. 677 9.771 1 26 0,366 110 1.580 1940. 851 13.190 3 22 0.341 115 1.733 1941. 726 15.637 NIL 28 0.525 92 1.725 1942. 673 11.953 NIL 25 0.444 122 2.166 1943. 663 11.071 NIL 17 0.292 121 2.033 1944. 717 12.909 NIL 33 0.594 107 1.926 Public Health Department, EECKENHAi-I. 18 » ■ 5. BOR [???] OF BECKENHAM. VITAL STATISTICS FOR YEARS 1909 TO 1944. PLEASE INSERT IN 1944. ANNUAL REPORT. These figures have not been available during the War Years and the comparative rates given reveal some interesting tendencies and indicate the effect of Evacuation on. the Population figures Year. Poputlation as estimated at mid- June by Registrar eral. Live Births Registered. Still Births. I Deaths of Infants undor one vear- . : mate, Illegitimate. Total Rate per 1000 of population. Legiti- mate. Illegitismate. Total Legitimate. mate. Total Rate per 1000 of lation 1939. 71,010 897 14 911 12.827 26 26 27 24 6 30 32.96 1940. 64,500 757 22 779 12.079 20 20 20 22 1 23 30.06 1941. 53,310 548 33 591 10.898 10 10 13 17 3 20 36.70 1942. 56,300 890 44 93U 16.0589 27 - 27 24 1 21, 26.77 1943. 56,030 950 45 995 17.131 25 1 26 29 1 30 30.15 1944. 55,540 848 40 868 15.988 21 3 24 24 2 26 29.20 Year Deaths of Civilans from all causes including ev.omy action. Deaths of Mothers in childbirth. Dvaths from Pulmonary Tuberculosis. Deaths from all forms of Cancer. Number» Rate per 1000 of population. Number. Number. Rate per 1000 of population. Number. Rate per 1000 of population. 1939. 677 9.771 1 26 0. 366 110 1.580 1910. 851 1 3.190 3 22 0.341 115 1.733 1941. 726 15.637 NIL 28 0.525 92 1.725 1942. 673 11.953 NIL 25 0.444 122 2.166 1943. 663 11.071 NIL 17 0.292 121 2.033 1944. 717 12.909 NIL 33 0.594 107 1.92b Public Health Department, BECKENHAM. 1.8.45. BOROUGH OF BECKENHAM. VITAL STATISTICS FOR YEARS 1939 TO 1944. PLEASE INSERT IN 1944 ANNUAL REPORT. These figures have not been available during the War Years and the comparative rates given reveal some interesting tendencies and indicate the effect of Evacuation on the Population figures:- Year. Population as estimated at mid-Jume by Registrar Gene eral. Live Births Registered. Still 1 irths. | Deaths of Infants uncler ! one veai*. Legitimate. mate. Total Rate per 1000 of population. Legitimate. Illepiti- mate Total Legiti mate. Illegitimate. Total Rate per 1000 of lation 1939. 71,010 897 14 911 12.827 2.6 1 27 24 6 30 32.96 1940. 64,500 757 22 779 12.079 20 - 20 22 1 23 30.06 1941. 53,310 548 33 591 10.898 10 3 13 17 3 20 36.70 1943. 56,300 890 44 934 16.589 27 - 27 24 1 25 26.77 1942. 58,060 950 45 995 17.131 25 1 26 29 1 30 30.15 1944. 55,540 848 40 888 15.988 21 3 24 24 2 26 29.26 Year. Death of Civilians from all causes including enemy action. Deaths of Mothers in childbirth. Deaths f) m Pulmonary Tuberculosis. Deaths from all forms of cancer. Number. Rate per 1000 of population. Number. Lumber. Rate per 1000 of population. Number. Rate per 1000 of population. 1939. 677 9.771 1 26 0.366 110 1.580 1940. 851 13.190 3 22 0.341 115 1.783 1941. 726 13.637 NIL 28 0.525 92 1.725 1942. 673 11.953 NIL 25 0.444 122 2.166 1943. 663 11.071 NIL 17 0.292 121 2.033 1944. 717 12.909 NIL 33 0.594 107 1.926 Public Health Department, BECKENHAM. 1. 8. 45