BOROUGH OF BECKENHAM REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1961 BY L. R. L. EDWARDS, M.D. (Lond.), D.P.H. Medical Officer of Health BOROUGH OF BECKENHAM REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1961 BY L. R. L. EDWARDS, M.D. (Lond.), D.P.H. Medical Officer of Health " The chief function of the Medical Officer of Health is to safeguard the health of the area for which he acts by such means as are at his disposal, and to advise his Authority how knowledge of public health and preventive medicine can be made available and utilised for the benefit of the community . . . " While he has special duties for the prevention of infectious diseases, all morbid conditions contributing to a high sickness rale or mortality in the area should be studied with a view to their prevention or control". (From the Ministry of Health memorandum on the duties of Medical Officers of Health.) MEMBERS OF THE PUBLIC HEALTH COMMITTEE FROM JUNE, 1961 Chairman Councillor R. J. Butcher. Deputy Chairman : Alderman Boyd Boyd. Alderman R. S. Jackson. Alderman W. Duncan. Alderman G. M. R. Lord, J.P. Councillor A. T. Johnson. Councillor R. G. Foster. Councillor E. R. Smithers. Councillor W. E. Palmer. Councillor A. C. Garrett. Councillor R. F. Lloyd. Councillor M. Williams Councillor Mrs. D. E. L. West, M.B.E. Councillor Mrs. O. L. Roberts. Ex-Officio: The Mayor STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health L. R. L. Edwards, M.D. (Lond.), D.P.H. Chief Public Health Inspector G. A. Webber, Certificate of the Royal Sanitary Institute and the Sanitary Inspectors' Examination Joint Board. Certificated Food Inspector. Deputy Chief Public Health E. U. Williams, Cert. R.S.I, and Inspector S.I.E.J.B. Certificated Food Inspector. District Public Health Inspectors W. T. G. Woodard, Cert. R.S.I. and S.I.E.J.B. Certificated Food Inspector. W. F. Forrest, Cert. R.S.I, and S.I.E.J.B. Certificated Food Inspector. Certified Smoke Inspector. D. W. Foster, Cert. R.S.I, and S.I.E.J.B., Certificated Food Inspector. Certified Smoke Inspector. C. J. Utting, Cert, of Public Health Inspectors' Education Board. Certificated Food Inspector (Commenced 1/6/61). Clerical Staff : Secretarial Assistant Mrs. E. A. Best (Resigned 30/5/61). Shorthand Typist Mrs. E. D. Soars (Commenced 29/5/61). Clerks Miss Y. V. Read. Mrs. J. Newman Mrs. H. Whipp. Rodent Operators W. J. E. wlckenden. E. J. Read. Disinfector-General Assistant M. Hindson. Mortuary Attendant—General Assistant .. T. J. Field (Resigned 10/3/61). C. C. Evans (Commenced 1 0/4/61). CONTENTS PAGE Introductory Letter 5 Section A. Vital Statistics Environmental Conditions and Control 8 Summary of Vital Statistics 10 Total Deaths 11 Cancer Deaths, 1957 to 1961 12 Notifications and Deaths from Tuberculosis 13 Infantile Mortality 14 Section B. Health and Social Services Hospitals and Clinics 15 County Council Health Services 15 Private and Voluntary Services 16 Local Clinics for Maternity and Child Welfare 17 Report of District Officer 19 Report of Home Help Organiser 19 Report of Chest Physician 20 Tuberculosis Care Committee 21 Old People's Welfare Services 22 Women's Voluntary Service 25 Home Safety Committee 27 National Assistance Act, 1948 (Section 47) 29 Beckenham Accident Prevention Committee 28 Housing—Medical Applications 30 Sections C, D and E. Environmental Services Housing Inspections Nuisances 31 Food and Drugs 32 Unsound Food 33 Ice Cream 33 Rent Act, 1957 34 Disinfection 34 Mortuary 34 Moveable Dwellings 34 Factories Act 1937-1959 35 Water Supply Drainage 37 Rodent Control 37 Shops Act, 1950 37 National Assistance Act, 1948 (Section 50) Smoke Control 38 Water Supply Examination 39 Section F. Infectious Diseases Control Age and Sex Incidence 43 Monthly Prevalence 44 District Distribution 45 Smallpox Vaccination and Whooping Cough and Diphtheria Immunisation 46 Poliomyelitis Vaccination 46 4 INTRODUCTION To the Chairman and Members of the Public Health Committee. 1 have the honour to present my report on the health of the Borough during 1961. There were improvements in many respects. Development of new housing sites led to an increase of 1,090 in the population and to an increase of the population density to 7 persons per acre. Though the 12.91 birth rate was 3.8 per 1,000 less than that of England and Wales and there were 12 fewer births this year, the general death rate was 1.2 less than the national average. 361 of the total of 877 deaths were from heart and circulatory diseases including coronary thrombosis and 193 deaths were from all forms of cancer. 41 deaths were due to cancer of the lung but deaths from this cause have shown a slight decrease over the past few years. Deaths from respiratory tuberculosis have also diminished. Notification of new cases of tuberculosis were 35, compared with twice the number recorded in my first annual report for Beckenham in 1951. The number of deaths of infants under one year old was one less and the infant mortality rate diminished by 2.74. A table shows that prematurity with an associated pre-natal cause was responsible for 12 deaths and congenital abnormality for 5 deaths of the total of 19 deaths. For the first time since 1956 no infant death from rhesus incompatibility was reported. The reports of the Home Help Organiser and the District Officer show the steady expansion of the Home Help Service and the progress made in helping the mentally ill and physically handicapped. The many health and social services available in this area are also shown in the report. Earlier in my letter the reduction in notifications of tuberculosis was noted and in the report on the work of the Chest Clinic, Dr. Madigan comments on the success of new antibiotics. The need for continued energetic preventative measures is stressed. An important preventative measure lies in helping the families of tubercular patients and this valuable service is described in the report of the Secretary of the Care Committee. The report on the Old Persons' Welfare Services has been revised and brought up to date. The provision of a second meals van by the Borough Council for the Meals on Wheels Service, and the introduction by the County Council of a chiropody service were important events during 1961. In the report of the Centre Organiser of the Women's Voluntary Service reference is made to the start of a fund through a Townswomen's Guild to enable elderly persons, not wishing to go on holiday with a club, to be able to go away. So far four persons have enjoyed such a holiday. 5 Included this year for the first time is an account of the work of the Accident Prevention Committee, for which I thank Mr. Bretton, Accident Prevention Officer. The figures for accidents and casualties in this borough alone are very revealing and the number of accidents to children 15 years and under were only 20 less than the number of accidents to elderly persons over 50 years of age. The number of accidents in the home involving children was very much greater and the report of the Home Safety Committee recommends the appointment of a full-time Home Safety Officer. The report on the work of the Public Health Inspectors includes a detailed 10 year programme for Smoke Control Areas, together with a map of their location in the Borough. Work under the Clean Air Act is still a major preoccupation requiring overtime visiting and often many interviews and much correspondence. In the first area 75 per cent of householders have approved appliances or alterations and have received a grant. The remaining householders have either fitted their own approved appliances without grant or have taken no action. Re-organisation of office accommodation during 1962 will materially improve the present cramped working conditions, which have followed the appointment of one more Public Health Inspector to bring the number to full establishment. During the year a new Mortuary Attendant and General assistant was appointed. He has much improved the mortuary reception arrangements and the facilities for visiting pathologists. The report on infectious disease control records an epidemic of measles in the early part of the year. The illness was moderately severe, boys and girls, school children or younger children were equally affected but none needed to be admitted to hospital. In December notification was received of the arrival from Pakistan to this country, through London, of two persons suffering from smallpox. This led to increased requests from the general public for smallpox vaccination. Three possible contacts from Bradford who were studying at a local college, were vaccinated and later the remaining students at the college were vaccinated. Additional supplies of smallpox vaccine were obtained and reserved for emergency vaccination of travellers abroad and of contacts of any suspicious case. Much anxiety was allayed by the restraint and advice of local medical practitioners to their patients and of reporters of our local press to the general public. The incidence of other infectious diseases needs no special comment except in regard to Poliomyelitis and Whooping Cough. No case of paralytic poliomyelitis has been reported for the past three years and the annual number of cases of Whooping Cough has diminished from 153 in 1957 to an average today of less than 50 a year. The immunisation scheme has shown continued progress and in particular the response to poliomyelitis prevention has remained excellent. A total of 3,793 persons completed their third poliomyelitis 6 immunisation injection, while a total of 4,767 children under 12 years of age received a fourth immunisation injection. The number of immunisations with whooping cough vaccine, which was introduced into infant clinics in 1958, now exceeds a thousand a year. The number of diphtheria immunisations also exceeds this figure and, in 1961, there was an increase of 606 in the number of reinforcing injections given against this disease. There are sound reasons for hoping that in the future a new vaccine, prepared by a local industry, will be proved effective against Measles and will be available for field trials and later for general use. For the past two years the Health Department has co-operated with the Medical School, Guy's Hospital, with local medical practitioners and with the Wellcome Laboratories, Langley Park, in showing the work of the department to a group of 40 final year students from the school. This year two medical practitioners from the London School of Hygiene and Tropical Medicine also visited the department and were shown the work of inspectors and health visitors in the Borough. An exhibition of the work of the Department was shown in October as part of the Charter Commemoration of the Borough. The "Welcome to Young Citizens" exhibition was staged by various departments of the Corporation in conjunction with Members of the Council and was inaugurated last year. In conclusion, I wish to express my thanks to the Chairman and Members of the Health Committee for their support and interest in the work of the Department, to my colleagues in general practice, and the hospital service for their co-operation in the control of infectious diseases, and lastly to my own staff for their efficiency and enthusiasm through 1961. L. R. L. EDWARDS, Medical Officer of Health. 7 SECTION A ENVIRONMENTAL CONDITIONS AND CONTROL The Borough lies on the outskirts of London and occupies part of the extreme North-west corner of Kent. It has an area of 5,935 acres of which 2,000 acres are open spaces consisting of Parks, Recreation Grounds, Playing Fields and privately owned Sports Grounds. It contains 270 acres of public open spaces of various kinds, and over 300 acres of other open land without full public access. From North to South of the Borough is a chain of open spaces while farmland and woods to the South form a green belt. The Town extends from the Crystal Palace Grounds to the fringe of the Kentish farmlands and its neighbours are Lewisham (Sydenham and Catford) to the North, Bromley and Hayes to the East—Penge and Croydon to the West and Orpington to the South. The contours fall in height from South to North, so that the district of West Wickham on the South side of the borough averages 210 feet above sea level, whereas Beckenham itself averages 150 feet above sea level. Running from South to North are four streams—the Ravensbourne, the Beck, the Chaffinch Brook, and Pool River. These are culverted through the greater part of their course which is through beds of " valley gravel Half of the area geologically consists of " Blackheath Pebble Beds ", and the remaining half of " London Clay ". These valleys create a series of undulations. The Ravesbourne in the East forms part of the boundary between Bromley and Beckenham, but otherwise lies outside the borough. The Pool River is a stream formed by the junction of the Boundary Brook with the Beck. It leaves the borough in the Worsley Bridge Area. The Chaffinch Brook is formed from the South Norwood and St. James tributaries in the South of the Borough and joins the Beck in Cator Park. The climate is comparatively mild, and the annual rainfall is low. The total for 1961 was 25.05 inches. The population has grown from 26,330 in 1901 to 74,834 in the 1951 Census (Estimated population in June 1961 was 76,600). Areas of West Wickham and Hayes were added to the former Urban District in 1934 and in 1955 the Registrar General estimated the population of the West Wickham area as 20,600. Beckenham is now a coherent and well-ordered borough with a wide variety of houses most of which are owner occupied and have been built between the wars. Many of the larger older houses have been converted or replaced by self-contained flats or maisonettes. The Borough has a total of approximately 700 shops which are largely sited along the four main roads in the Borough in two main shopping centres. The water supply of the Borough is a mixture of well water from the West Wickham, Orpington and Shortlands pumping stations, mixed with River Thames derived filtered water. The wells are in chalk strata and the Shortlands well is 250 feet deep. 8 No new sources of supply were instituted during 1961 and there were no changes in the general scheme of supply but a total length of 903 yards of new mains was laid. Samples are collected by staff of the Water Board at least five times a week and the average chemical and bacteriological quality of the water before and after treatment is set out in the tables at the end of Section E of this report. In addition our own inspectors collect samples if water for bacteriological examination. The natural fluoride content of all four sources is variable but at best is only one quarter of the optimum. Estimated amounts in milligrammes per litre are 0.05-0.15 West Wickham, below 0.05-0.25 Orpington, 0.05-0.25 Shortlands and 0.2-0.25 River Thames derived filtered water. The water is moderately hard and is not plumbo solvent. In the north-west of the borough the Corporation provides a building (modernised in 1938) containing three swimming baths of 100 ft., 80 ft., and 70 ft. length. Water is supplied from a borehole well sunk 300 feet into chalk strata. Water is cleaned by rapid pressure filtration and chlorination with a change over period of one in four hours duration. As a check on the efficiency of chlorination plant, every two weeks, and more frequently at times of excessive load, a 100 c.c. sample of water from the exit end of the Baths is taken in the middle part of the day and tested for B. Coli in the Laboratory of the Establishment. Three or four times a year, full bacteriological examination at a Public Health Laboratory is carried out. Results even at times of heaviest bathing loads have been very satisfactory. The West Kent Main Sewerage Board is responsible for main sewerage and sewerage disposal. Beckenham possesses quite a large number of Industrial and Commercial Firms, but most of the Industries fall in the category of " Light Industry ", and the majority come under the general heading of Engineering. The Industries are almost confined to two main zones of the Borough on the northern and southern edges, and in all, employ 7,000 persons, the greatest number being in the engineering firms. Twenty-four establishments employ 50 or more employees. The main industries are concerned with the production of drugs, serums, vaccines, chemical apparatus, electric tools and electric motors, electronic equipment, compressed air equipment, including spray guns for paint or cellulose, bronze nameplates, vitreous enamelled, perspex and plastic signs and letters, bronze founding, metal founding, sheet metal work, general engineering and grading of scrap metals, office accessories, motor accessories, glues and adhesives, cellulose lacquers, leather products, protective food packaging, dyers and cleaners and almond nullers. Smaller firms are concerned with printing, film bag manufacture, landscape gardening and rustic work. Tables in Section C set out the work of inspection and supervision of these industries. 9 SUMMARY OF VITAL STATISTICS, 1961 Area of District in acres 5,935 Estimated mid-year population 76,600 Population Density—persons per acre 12.91 Rateable Value at 1st April, 1962 £1,525,000 Number of Inhabited Dwellings 24,524 Product of a Penny Rate (Estimated 1962/63) £6,220 Male Female Live Births 541 503 Total 1,044 Live Birth rate per 1,000 population 13.63 illegitimate Live Births per cent of total live births (41) 3.93 Male Female Still-births 8 4 Total 12 Still-births rate per 1,000 live and still-births 11.36 Total live and still-births 1.096 Infant Deaths (deaths under 1 year) 9 Total infant deaths per 1,000 total live births 8.62 Legitimate infant deaths per 1,000 legitimate live births 8.97 Illegitimate infant deaths per 1,000 illegitimate live births 0.00 Neonatal Mortality Rate (deaths under 4 weeks per 1,000 total live births) 6.70 Early Neonatal Mortality Rate (deaths under 1 week per 1,000 total live births) 5.75 Perinatal Mortality Rate (Stillbirths and deaths under 1 week combined per 1,000 total live and stillbirths) 17.04 Maternal Mortality (including abortion) 1 Maternal mortality rate per 1,000 live and still-births .95 Death Rate per 1,000 population from Cancer (193 deaths) 2.52 Death Rate per 1,000 population from Pulmonary Tuberculosis (1 death) 0.01 Death Rate per 1,000 population from Non-Pulmonary Tuberculosis (0 death) 0.00 Death Rate per 1,000 population from Accidents (16 deaths) 0.21 Birth Rate (including Stillbirths) per 1,000 population : Crude 13.79 Corrected (X 1.06) 14.62 Male Female All Deaths Registered 387 490 Total 877 Death Rate per 1,000 population : Crude 11.45 corrected (x 0.94) 10.76 Natural Increase : Births exceeded deaths by 167. 10 TOTAL DEATHS, 1961 (Registrar-General's Official Returns). All causes—877. Male, 387 Female, 490. causes of death males females 1. Tuberculosis, respiratory 1 — 2. Tuberculosis, other — — 3. Syphilitic disease — — 4. Diphtheria — — 5. Whooping Cough — — 6. Meningococcal infections — — 7. Acute poliomyelitis — — 8. Measles — — 9. Other infective and parasitic diseases — 1 10. Malignant neoplasm, stomach 12 13 11. Malignant neoplasm, lung, bronchus 29 12 12. Malignant neoplasm, breast — 25 13. Malignant neoplasm, uterus — 8 14. Other malignant and lymphatic neoplasms 44 50 15. Leukaemia, aleukaemia 4 4 16. Diabetes 1 3 17. Vascular lesions of nervous system 42 81 18. Coronary disease, angina 101 63 19. Hypertension with heart disease 7 17 20. Other heart disease 38 91 21. Other circulatory disease 20 24 22. Influenza 4 1 23. Pneumonia 19 28 24. Bronchitis 22 13 25. Other diseases of respiratory system 2 3 26. Ulcer of stomach and duodenum 7 2 27. Gastritis, enteritis and diarrhoea 3 6 28. Nephritis and nephrosis 1 3 29. Hyperplasia of prostate 7 — 30. Pregnancy, childbirth, abortion — 1 31. Congenital malformations 3 1 32. Other defined and ill-defined diseases 12 26 33. Motor vehicle accidents 3 4 34. All other accidents 4 5 35. Suicide 1 5 36. Homicide and operations of war — — Totals 387 490 11 CANCER DEATHS 1957 1958 1959 1960 1961 Cancer of Lung 29 47 49 48 41 Males 170 Females 44 Total 214 Cancer of Breast 26 13 15 19 25 98 Cancer of Uterus 8 6 10 8 8 40 Cancer of Stomach 23 21 14 24 25 Males 60 Females 47 Total 107 Other Malignant Neoplasms 83 90 98 83 94 Males 222 Females 226 Total 448 Total Deaths from Cancer 169 177 186 182 193 Males 452 Females 455 Total 907 For comparison, deaths from Respiratory Tuberculosis are shown :— 1957 1958 1959 1960 1961 3 1 2 1 1 Males 5 Females 3 Total 8 12 13 TUBERCULOSIS—Table of Notifications and Deaths, 1961, from Local Records. Sex Total Ages Wards* 0 to 5 6 to 10 11 to 15 16 to 20 21 to 25 26 to 35 36 to 45 46 to 55 56 to 65 66 and over Age unknown L.Pk. and K.H. M.H. C.C. C.H. E.P. Shortlands W.W. (Nth.) W.W. (Sth.) M. F. notifications New Cases only Pulmonary 20 12 32 — — — 1 1 6 8 8 6 2 — 2 7 2 5 3 3 6 4 Non-Pulmonary 1 2 3 — — — 2 — — — 1 — — — 1 1 — — — 1 — — Totals 21 14 35 — — — 3 1 6 8 9 6 2 — 3 8 2 5 3 4 6 4 Deaths Pulmonary 4 2 6 — — — — — — — 3 2 1 — — 3 1 1 1 — — — Non-Pulmonary — — — — — — — — — — — — — — — — — — — — — — Totals 4 2 6 — — — — — — — 3 2 1 — — 3 1 1 1 — — — *L.Pk. and K.H.—Lawrie Park and Kent House. M.H.—Manor House. C.C.—Copers Cope. C.H.—Clock House. E.P.—Eden Park. W.W. (North)—West Wickham North. W.W. (South)—West Wickham (South). 14 INFANTILE MORTALITY, 1961 The number of deaths of infants under the age of 12 months, for which full records exist, was 19, as compared with 10 in 1960. The Registrar-General returns 9 infant deaths and the infant mortality rate for the year was 8.62 per 1,000 live births. The following Table shows the age at death and cause of death in the 19 cases allocated to Beckenham before transfer by residence. 12 hours or under Under 1 week Under 1 month Under 1 year Total Place of Death M F M F M F M F M F Congenital : Heart — 1 1 — — — — — 1 1 Stone Park Maternity Hospital 14 Lungs — — — — — — — — — — Brain (hydrocephalus) — 1 — — — — — — — 1 Farnborough Hospital 2 Oesophageal atresia — — — 1 — — — — — 1 Bile duct atresia — — — — — — 1 — 1 — Bromley Hospital (Masons Hill Unit) 1 Prenatal : Prematurity and Atelectasis *4 3 — 1 — — — — 4 4 Prematurity and Twins 1 — — 1 — — — — 1 1 Kings College Hospital 1 Prematurity and Toxaemia 1 — — — — — — — 1 — Prematurity, bicornute uterus, malpresentation. caesarean operation — — — 1 — — — — — 1 Croydon General Hospital 1 Birth injury— Cord around neck, haemorrhage — — 1 — — — — — 1 — Post Natal: Enteritis — — — — — — — — — — Pneumonia — — — — — — — — — — Neglect — — — — — — — — — — Progressive encephalopathy — — — — — — 1 — 1 — Accidental and Violence — — — — — | — — — — — Totals 6 5 2 4 — — 2 — 10 9 * One baby weighted 14 ounces SECTION B. HEALTH AND SOCIAL SERVICES In this section are included hospitals and clinics serving the Borough but not all of which are situated within the Borough. Many of these services, including the provision and supervision of old persons homes within the Borough, are directly administered by the County, and the District Officer and District Organiser of the Home Help Service have contributed information for which I am grateful. 1 am indebted to Mr. Forster and to Mrs. Fisher for their accounts of the work of the T.B. Care Committee and the Women's Voluntary Service. 1. Hospitals and Clinics Beckenham Hospital—Croydon Road, Beckenham. Beckenham Maternity Hospital—Stone Park Avenue, Beckenham. Bethlem Royal Hospital, Monks Orchard Road, Beckenham. Bromley Chest Clinic—Tiger Lane, Mason's Hill, Bromley. Bromley Hospital—Cromwell Avenue, Bromley, Kent. Brook General Hospital—Shooters Hill, S.E.I8. Cane Hill Hospital—Coulsdon, Surrey. Children's Hospital—Sydenham, S.E.26. Cheyne Hospital—West Wickham, Kent. Farnborough Hospital—Farnborough, Kent. Joyce Green Hospital—Dartford, Kent. Lennard Hospital—Bromley Common, Bromley. Leybourne Grange Colony—West Mailing, Kent. Netherne Hospital—Coulsdon, Surrey. Orpington Hospital—Sevenoaks, Orpington, Kent. Penge Chest Clinic—1, Westbury Road, Penge, S.E.20. Sundridge Hospital/Sundridge, Nr. Sevenoaks, Kent. Widmore Road and Mason's Hill Maternity Units, Bromley, Kent. 2 Other Services (Kent County Council). Home Helps. Beckenham District Office, 12, Beckenham Road, Beckenham. Home Nurses. Beckenham District Office, 12, Beckenham Road, Beckenham. Midwives. Beckenham : 12, Beckenham Road, Beckenham. West Wickham : 4, Grosvenor Road and 105a, Station Road. 15 Ambulances. Through Hospital or Beckenham District Office Old People's Homes " Craigie Vane 3, Durham Rd., Shortin Borough. lands. (Private). 24, Cromwell Road, Beckenham. (Private),. Durham House, 50, Durham Avenue. Shortlands (K.C.C.). 13, Gwydor Road, Beckenham (Private) Rest Haven, 99, Venner Road, Sydenham. S.E.26 (Private). Rutland Lodge, 6, Mays Hill Road, Short- lands (Private). Thornton House, 75, Bromley Road Beckenham (Voluntary). Mental Welfare. District Offices, 12, Beckenham Road, Beckenham. General Welfare. District Offices, 12, Beckenham Road, Beckenham. Clinics for Maternity and Child Welfare. The District Officer and his staff are available to assist in the event of any difficulty arising in the arranging of any of the aforesaid County Health Services. Chiropody Clinic. Clinic Block, Town Hall, Beckenham. Clinic Block, Hawes Lane, West Wickham. 3. Private and Voluntary Services. Private Nursing Homes. (1) " Fairlawn," 34, Albemarle Road, Beckenham. (2) " Inglewood," 25, Durham Avenue, Bromley, Kent. (3) " Petersfield Lodge," 69, Crystal Palace Park Road, S.E.26 (4) " Sloane," 131, Albemarle Road, Beckenham, Kent. (5) " Waverley," 51, Albemarle Road, Beckenham, Kent. Registration and supervision is delegated to the Borough Council. Children's Homes. (1) Dr. Barnardo's Home, 16, Park Road, Beckenham. (2) Maude Nathan Home, 72, Crystal Palace Park Road, S.E.26. (3) St. Hilda's Home, Crescent Road, Beckenham. (4) Salvation Army Children's Home, 42, Crystal Palace Park Road, S.E.26. Medical Loan Depot of B.R.C.S. 45, Beckenham Road, Beckenham. Women's Voluntary Services. 12, Bromley Road, Beckenham. 103, High Street, West Wickham, Kent. 16 LOCAL CLINICS FOR MATERNITY AND CHILD WELFARE Service Days and Times Premises in Use By Appointment. Clinic Block, Town Hall, Beckenham. By Appointment. Clinic Block, Hawes Lane, West Wickham. Mondays 10 a.m.-12 noon and Maternity Hospital, Stone Park Ante Natal 2 p.m.-4 p.m. (by appoint- Avenue, Beckenham. ment). Wednesdays and Thursdays Maternity Hospital, Stone Park 10 a.m.-12 noon (by Avenue, Beckenham. appointment). Bookings—Tuesdays and Maternity Hospital, Stone Park Wednesdays, 2-3 p.m. Avenue, Beckenham. Mondays, 2—4 p.m. Chulsa Clinic, Hurst House, (1st, 3rd and 5th in Chulsa Road, S.E.26. month). Mondays, 2—4 p.m. Clinic Block, Hawes Lane, West Wickham Tuesdays, 2—4 p.m. (a) Baths Annexe, Beckenham Road (b) Civil Defence Centre, Croydon Road, West Wickham Wednesdays, 2—4 p.m. (a) Church Hall, Langley Road, Child Elmers End Welfare (b) Church Hall, Valley Road, Shortlands Thursdays, 2—4 p.m. (a) Church Hall, Lennard Road, Penge (b) Clinic Block, Town Hall, Beckenham Fridays, 2—4 p.m. (a) Church Hall, Langley Road, Elmers End (b) Clinic Block, Hawes Lane, West Wickham By Appointment. Clinic Block, Town Hall, Beckenham. Post Natal 1st, 3rd and 5th Monday Clinic Block, Hawes Down, mornings (by appointment). West Wickham. Every Friday 10 a.m.— Maternity Hospital, Stone Park 12 noon. Avenue, Beckenham. Vaccination Vaccination and poliomyelitis Held during Infant Welfare and immunisations (by appoint- Sessions at above Clinics Immunisation ment); Diphtheria and except Chulsa Clinic. Clinics whooping cough immunisa- (Langley Road—Friday tions without appointment. afternoons only). Dental (Infant By appointment. Clinic Block, Town Hall, Welfare Cases) Beckenham. By appointment. Clinic Block, Hawes Lane, West Wickham. 17 LOCAL CLINICS FOR MATERNITY AND CHILD WELFARE Service Days and Times Premises in Use Speech Mondays to Fridays inclusive Clinic Block, Town Hall, (by appointment) Beckenham. Orthopaedic Wednesday mornings (twice Clinic Block. Town Hall per month) (by appoint- Beckenham ment) Surgeon in attendance Treatment. The Physiotherapist attends by appointment as follows Monday afternoons Thursday afternoons Clinic Block, Town Hall, Beckenham Mothercraft Friday afternoons, 2 p.m. Clinic Block, Town Hall, Classes Beckenham and Relaxation Thursday afternoons, 2 p.m. Clinic Block, Hawes Lane Exercises West Wickham Mid wives Monday afternoons, 2 p.m. Clinic Block, Town Hall, Ante-Natal Beckenham Thursday afternoons, 2.15 p.m. Clinic Block, Hawes Lane. West Wickham 18 REPORT OF THE DISTRICT OFFICER The following report has been submitted by Mr. C. J. Moore, District Officer, for which I express my thanks. " The year under review has been one of steady if unspectacular progress and expansion. It covers the first complete year of the full working of the Mental Health Act, 1959, and a pattern is beginning to evolve. The Mental Welfare Officer is becoming less concerned with arranging hospital admissions and more and more of his time is being devoted to community care and aftercare. A further step in the expansion of the scheme for the welfare of the physically handicapped has been the appointment of a Craft Instructor in this area. Not only are patients taught diversional occupations, but saleable goods are made, and in suitable cases outwork which can be done in the home has been obtained from local business concerns. I would like to refer back to my report for the year 1959, and I am pleased to say that the number of patients in the district suffering from tuberculosis, and seeking assistance through the County Council's care and aftercare scheme continues to show a downward trend." REPORT OF HOME HELP ORGANISER My thanks are due to Miss Hocking for the report on this service for the Beckenham and Penge area. " During the year 1961 demands for this service increased steadily and there is now an average of 420 cases receiving help weekly. A total of 554 new cases were serviced during the year. Ten cases received help under the Family Care Service and one under the Family Welfare Service. All applications for Domestic Help Service should be made to the District Organiser, 12, Beckenham Road, Beckenham." 19 WORK OF THE CHEST CLINICS I have pleasure in submitting the following report and Table on the work of the Chest Clinics during the year under review, forwarded to me by Dr. D. G. Madigan, Chest Physician, to whom I express my thanks :— " There has been a decrease in numbers referred for full clinical investigation. This decline has been offset by an increasing number of patients referred for Chest X-ray only. This is a special service, using the 100 mm. film technique, designed to detect early chest disease. It is a paramount, quick, informal method for excluding the first stages of such disease, notably pulmonary tuberculosis, pulmonary cancer, sarcoidosis, and other conditions. This service is of inestimable value to doctors in General Practice, and it should be used to maximum benefit. 1961 has also been the first time that combinations of new antibiotic drugs have shown definite promise. Now, when combined Streptomycin, P.A.S., and I.N.A.H. have failed to render a patient's sputum free of tubercle bacilli, resort to these later drugs, commonly known as second line drugs, has proved efficacious in achieving sputum conversion, but what is of signal importance is the fact that they may be effective against the tubercle bacilli which have become resistant to Streptomycin, P.A.S. and I.N.A.H. Further new antibiotics are anticipated, but energetic Public Health preventative measures continue to be of the greatest importance." New Cases attending the Chest Clinics for the first time during 1961 Adults Children under 15 years Male Female Male Female Pulmonary Tuberculosis 20 14 — — Non-Pulmonary Tuberculosis — 1 — — Non-Tuterculous 89 71 33 32 Non-Tuberculous Tuberculous New Contacts Examined 152 Nil B.C.G. Vaccination of contacts : 66. Number of Tuberculous Patients admitted to Hospital or Sanatorium during 1961: 29. 20 BECKENHAM DISTRICT TUBERCULOSIS CARE COMMITTEE The following report on the work of the local Tuberculosis Care Committee has been submitted by the Hon. Secretary, Mr. M. E. Forster, to whom I express my thanks. " During 1961 the Beckenham District Tuberculosis Care Committee which is associated with the Kent Council of Social Service, continued its welfare work amongst the tubercular patients and their families in the Borough of Beckenham. Over £500 was spent—giving 92 grants, which included one grant of £100 loan towards the purchase of a house. Other grants were—Christmas Gifts 27 ; Christmas Grants 2 ; Meat 12 ; Fares 12 ; Clothing/Shoes 12 ; Coal 7 ; Milk/Groceries 4 ; Foster parents 4 ; Holidays 2 ; Removals 2 ; Emergency help 2 ; Holiday Fares 1 ; Electricity Bill 1 ; Debts 2 ; Storage of Furniture 1. All the patients who received the above grants were recommended to the Committee by the Chest Clinic and were visited by one of the Committee's Liaison Officers who have authority to spend up to £5 on emergency help, but more complicated cases are brought before the Committee who meet each month. They are given very careful consideration by the Committee, whose members are drawn from Business Houses, W.V.S., British Red Cross Society, S.S.A.F.A., Citizens' Advice Bureau, Firemen's Benevolent Society, Rotary Club, Women's Institute, Townswomen's Guild, West Wickham Community Council, Women's Citizens, British Legion, Beckenham & Penge Free Church Women's Council, Trades Council and Welfare Department. Fund Raising Organisers brought in over £330 during the year by the sale of £d. Christmas Seals and a Jumble Sale." 21 BECKENHAM OLD PEOPLE'S WELFARE SERVICES Since 1957 a section in this report has been reserved for a description of the various services available for elderly persons. These can be summarised as :— 1. Meals. 2. Clubs. 3. Chiropody. 4. Outing and holidays. 5. Personal service. 6. Visiting. 7. Grants (cash or goods). 8. Parties and entertainment. 9. Emergency help. 10. Information handbook. Meals These are cooked at two centres and in insulated containers are delivered by two special vans to the homes of those unable to cook for themselves. 30/40 meals are provided three times a week in West Wickham, but for the larger area of the rest of Beckenham about 46 meals can only be provided twice a week. In the smaller area it is also possible to provide a Luncheon Club once a week and this meets between 9.30 a.m. and 4 p.m. To extend these services more volunteers are needed as cooks. The Borough Council provided a second equipped meals van during the summer and with additional volunteers to cook and to drive it will be possible to increase the Beckenham service to three days a week. Maintenance and repair of vehicles, estimated at £75-£ 100 per annum per vehicle, is carried out by the Borough Council who also make an annual contribution of £52 per annum, helping voluntary contributions, to subsidise the cost of meals which are provided at a very small charge, ranging from a 1s. to 1s. 6d. Clubs The Borough Council pays grants in respect of the annual rents of the following clubs which meet weekly at various premises in the borough :— Coney Hall over 60's (Thursday afternoons) West Wickham over 60's (Monday afternoons) Darby and Joan (Tuesday afternoons) Darby and Joan (Thursday afternoons) Darby and Joan (Tuesday afternoons) Veterans' Club (Thursday afternoons) Civil Defence " C " Centre, Croydon Road. (formerly Assembly Hall). Lecture Hall, Sussex Road. West Beckenham Hall, Sidney Road. West Beckenham Hall, Sidney Road. Azelia Hall, Croydon Road. Azelia Hall, Croydon Road. These clubs enable pensioners to lead a happy communal life once a week and the activities of the clubs are directed by its own members committees assisted by a W.V.S. Leader and W.V.S. Secretary. 22 Three clubs below provide contacts for specially disabled persons, some of who are elderly :— Social Club for the Blind (Alternate Wednesday afternoons) Samaritan Club for Disabled (1st and 3rd Thursday afternoons) Club for Handicapped People (2nd and 4th Friday afternoons) Azelia Hall, Croydon Road. St. Mary's Church Hall, Shortlands. Emmanual Church Hall, The Grove, West Wickham. Chiropody At the end of the year the Beckenham Road Foot Clinic for old people, dealing with 123 patients and organised twice a week by the British Red Cross Society, closed down. The British Red Cross Society, West Wickham Clinic, dealing with 80 patients and held once a week, has continued. The County Council has introduced a service, with a whole time chiropodist serving Bromley, Beckenham and Penge. He holds clinics on Monday and Thursday mornings at the Town Hall Infant Welfare Clinic and on Tuesday mornings and Wednesday afternoons at Hawes Down Infant Welfare Clinic, West Wickham. Together with a part-time chiropodist he visits the homes of those unable to attend the centres, so that it is now no longer necessary to organise a voluntary car service for this purpose. Appointments for treatment are made by the District Officer at 12, Beckenham Road, and there is a maximum charge of 4/- for treatment or treatments given in any one week. In the majority of elderly persons, as the result of assessment, treatment is given free of charge. Outings and Holidays Members of Darby and Joan Clubs pay 6d. to 1/- a week to a holiday fund and the balance is made up by the Women's Voluntary Service, who organise outings to the seaside and holidays at reduced rates. They are also arranged by other voluntary organisations, such as the Old People's Welfare Committee, Rotary Club, the Soroptimist Club, the Beckenham Veterans Club, the West Wickham Community Council and the West Wickham British Legion. Personal Service (Visiting, Information and Emergency help) The development of these services depends on the success of the follow-up of the Emergency Call Scheme (Beckenham) and the continued successful efforts of the Beckenham Old People's Welfare Committee, which is re-issuing supplies of its comprehensive handbook to all organisations. 23 Following the issue of the Lifebelt Emergency Call Card to each person, information is being collected by a member of the Committee and will form the basis for further visiting and other personal services. This scheme, therefore, goes a stage further than the National Lifebelt Emergency Call Scheme which has recently been set up. In the meantime visiting is carried out by members of various organisations such as the W.V.S., Rotary and Inner Wheel Club and various Townswomen's Guilds. Elderly persons may then be accompanied while shopping or taken out for walks. The need for grants in cash or goods or assistance of various kinds is determined at these visits. Selective and emergency visits of qualified nurses to old persons are made by health visitors of the County Health Authority. At these visits the nature of the emergency is determined and information obtained concerning details of relatives, membership of club, provision of services, income and means of accident prevention and need for admission to old people's homes. Care in Homes Admissions to old people's homes are either arranged privately, or if to county maintained homes, by the family doctor through the District Officer. A comprehensive list of the 42 Rest Homes and Old People's Homes and 32 Nursing Homes within a 5 mile radius is also maintained in the Beckenham Health Department. A domestic help service, which includes a night attendant and evening service, is provided by the County Health Authority in suitable cases and for an assessed charge. Where possible, nursing requisites, aids, equipment and bedding are provided and Home Nurses attend to give treatments for those nursed at home, by arrangement between the family doctor and the District Officer. Help with laundry and baths, when required, is provided by the special concessions to pensioners provided by two launderettes and facilities at the Central Baths at reduced charges. The Librarian arranges for the collection and change of books if elderly persons are unable to make the journey to the libraries. Housing Accommodation For elderly persons on their housing list points scheme the Council have over the years provided more than 200 flats or flatlets on various estates through the Borough. Accommodation in private houses in suitable cases may be arranged by the North-West Kent Council of Social Service. 24 WOMEN'S VOLUNTARY SERVICE I am very grateful to Mrs. J. M. Fisher, Centre Organizer of the W.V.S. who has kindly submitted the following interesting report— Darby and Joan Clubs Three Darby and Joan Clubs in Beckenham and two Over 60's Clubs in West Wickham are still running in the Borough. Of the Beckenham Clubs, two are held on Tuesday and one on Thursday from 1.45 to 4.15 p.m. Membership of the three Clubs in Beckenham is about 500, and all the members are over 60 years of age. Tshe membership fee is 1d., and a charge of 3d. is made for tea. Whist Drives, Darts Matches and Raffles are held each week, and at last two of the Clubs have talented choirs which entertain not only their own members, but other organisations as well. A free library is available to members and there are also plenty of magazines for reading. Spring and Autumn outings are arranged for the Club members and in the winter visits are made to pantomimes and ice shows. Members also have holidays at reduced rates—out of season—at the seaside. A savings group is run for members who wish to save weekly towards holidays, outings, etc. The Clubs are subsidised by voluntary subscriptions. The two Over 60's Clubs are run in West Wickham with an average membership of 130/150. Meals on Wheels Meals are served twice a week, Tuesdays and Fridays. The service is run principally for the benefit of invalids and elderly people who live alone and cannot cook for themselves. The meals are cooked in the Centre by members of the W.V.S. Appeals for meals usually come from Hospital Almoners, Doctors, and through the Darby and Joan Clubs. An allowance towards the cost of transport is made through the local and County authorities. Cost of the meals is subsidised by voluntary funds, and those in need are only required to pay a very small sum for the service. About 80 meals are served each week. West Wickham Luncheon Club Meals for this Luncheon Club are cooked by W.V.S. and only a nominal charge is made. An average of 35 meals are served weekjy in addition to an average of 16 Meals on Wheels three times a week. Old People's Welfare Visits are made to elderly people who live alone, and assistance is given with regard to clothing which is supplied free on the authority of the National Assistance Board, District Nurses, etc. Through one of the Townswomen's Guilds we have been able to start a fund to send a few old people away—the type of person who doesn't want to go away en bloc with the Clubs. Last summer we were able to send four away, and we hope to increase the number this year. 25 Hospital Work Work in connection with Beckenham Hospital has been much appreciated and consists of help with the Library, flowers and magazines. We also run a trolley shop at Durham House and this is much appreciated by the old people living there. Maternity Work Many baby garments have been knitted and we now have a Guild of Service which will help the Matron. This Guild consists of W.V.S., and Non-W.V.S., from Beckenham and Penge. Baby Clinics Helpers are supplied at three of the baby clinics in the Borough and assist in the selling of Welfare Foods, weighing the babies and clerical work. Clothing Depot We hold a good stock of second-hand clothing which is available for the old and sick people in the Borough who come to us with a note from the National Assistance Board, Doctor or Health Visitor. We are also able to help younger people with baby clothes. The Children's Clothing exchange is being run until Whitsun 1962. For some time we have been the only clothing exchange in London and Metropolitan Kent. Welfare Foods The Centre dispenses National Dried Milk, Orange Juice, Cod Liver Oil and Vitamin tablets. Periodicals for the Forces We send 30 parcels of books and magazines each month to our Forces in the Middle and Far East. We get a small grant from the County Office towards postage and the remainder has to be found by the Centre, usually from any money we obtain from the sale of salvage. Services Club One of our members attends the Victory Club each Friday, where she works in the library. Canning Members from the West Wickham Centre canned a large quantity of fruit for the Maternity Hospital during the summer. Children's Holidays We have been able to arrange holidays for seven children who were recommended to us by the Children's Officer and Health Visitors. In addition to the aforementioned activities the W.V.S. is closely connected with the Tuberculosis After-Care Committee, Area Pension Officer, British Legion, The Disabled Persons' Committee and Children's Homes. 26 BECKENHAM HOME SAFETY COMMITTEE The Home Safety Committee meets bi-monthly to consider the way in which the National Campaigns can be supported, to discuss the local accident statistics, and to decide upon special approaches and campaigns. During the last year there have been four national campaigns: " Danger of Poisons in the Home " Water Safety " Fire Prevention " and " Broken Glass Last Spring a distribution was made of 2,000 Home Safety Handbooks, through Clinics, Parent-Teacher Associations, Residents and Ratepayers Associations. Doctors' and Dentists' waiting rooms, Libraries, etc. In May of this year an Exhibition will be held on Home Safety, Road Safety and Crime Prevention, with the collaboration of the Accident Prevention Committee and the Police Force. This will take place at three different Halls in turn, in order to cover the Borough more effectively. An analysis of the accident figures from Beckenham Hospital shows that home accidents continue to exceed road accidents in the ratio of 4 or 5 to 1. In addition, it should be remembered what whilst all road accidents must be reported, and consequently appear in statistics, there are many home accidents which are treated either at home or in doctors' surgeries, and of which there is no record. In 1961 Beckenham Hospital recorded 1,075 home accidents, of which 743 were children. This compares with 391 road accidents throughout the year. A high proportion of accidents in the home could be avoided by the use of a little more care and forethought. The members of the Committee feel that they are not able to devote sufficient time to the problem of making a considerable impact on local public opinion and they strongly recommend the appointment of a full-time Home Safety Officer, to be assisted by the existing Committee. Such an appointment would be in line with the Government policy of fostering home safety work, as set out in the Home Safety Act, 1961. The Home Safety Committee is composed of representatives of the following:— Accident Prevention Committee. Beckenham Hospital. Conservative Association : Women's Advisory Council. Federation of Townswomen's Guilds : North-West Kent. Health Department : Beckenham Borough Council. Health Department : Kent County Council. Junior Accident Prevention Council. Kent Fire Brigade. London Electricity Board. Labour Party : Women's Section. Local Press. Pharmaceutical Society : West Kent Branch. Ratepayers' and Residents' Associations. Soroptomists. South Eastern Gas Board. Women's Citizens' Association. Women's Co-operative Guild. Women's Gas Federation. 27 BECKENHAM ACCIDENT PREVENTION COMMITTEE The Accident Prevention Committee for the Borough of Beckenham, meets bi-monthly, to consider the way in which National and Local Campaigns can best be approached and supported, to discuss the road accident statistics (Personal Injury) as supplied by the Police Authorities, and to decide on what local remedies can be adopted. This Committee is supported most effectively by the Junior Accident Prevention Committee, who meet monthly. This Committee has a membership at present of 47, many of these being pupils of various senior schools within the Borough. Many of these schools have their own Accident Sub-Committee, with the result that at every meeting of the Juniors, various aspects of Accident Prevention and suggestions are brought forward for full discussion. In this way it is realised that the whole area of the Borough is thoroughly and effectively covered. The theme for the 1961 Campaign was " Personal Responsibility" whilst the present theme is " Learn to Live, Training for Road Safety ". This present campaign is devoted chiefly to the following age groups. (1) Extension of Child Service at Schools. (2) Formation of the Under-Fives, Toddlers or Tufty Clubs. (3) Doubling of the number from 30,000 to 60,000 of child cyclists trained and tested in the Cycling Proficiency Scheme. (4) To interest the Youth in Road Safety, by the setting up of more Junior Accident Prevention Committees. (5) Setting up of further R.A.C./A.C.U. training centres to cater for the learner motor cyclist and scooterist. Cycling Proficiency Scheme During 1961 a total of 615 school children were trained and tested in this scheme, of which 570 passed their test at the first attempt, thanks to the excellent training given at various schools by teachers and senior students, etc., whilst many of the failures have since been re-tested and have now qualified. It is gratifying to note from the National Statistics, that 44 per cent more children were trained in 1961, than in the previous year, and that the casualty figures for these youngsters has been greatly reduced. 28 Accident Statistics An analysis of personal injury road accidents, throughout the Borough, as supplied by the Police Authorities, is shown below, with comparisons for the previous year. 1960 1961 ACCIDENTS reported 395 408 CASUALTIES, resulting 534 544 FATAL .. 4 8 SERIOUS 92 77 SLIGHT 438 459 Age Groups 15 years and under 71 83 16-50 years of age 369 359 Over 50 years of age 94 102 Classes of Road User involved, 1961 Motor Cars and passengers 194 Motor Cyclists and pillion passengers 122 Scooters, Moped and pillion passengers 52 Pedal Cyclists 92 Pedestrians 84 Total 544 NATIONAL ASSISTANCE ACT, 1948—SECTION 47 Under Section 47 of the above Act, as amended by the National Assistance (Amendment) Act, 1951, persons suffering from grave chronic disease, or who are aged, infirm or physically handicapped, and who are living in insanitary conditions and unable to devote to themselves, and not receiving from other persons, proper care and attention, may be compulsorily removed. No cases were reported for action during the past year but four possible cases were visited and investigated. 29 HOUSING—MEDICAL APPLICATIONS From 12th January, 1961, to 6th December, 1961, 44 applications with supporting medical certificates were received. There were four re-applications. For two of these additional points were recommended. Maximum points were recommended in 24 cases, of which 21 required ground floor accommodation. The medical causes are classified in the following groups:— Nervous Disorder Functional (emotional strain) 9 Organic 1 Illness of Children Bronchitis or Asthma 3 Congenital defect face and ears (Treacher-Collins Syndrome) 1 Arthritis hip 1 Virus meningitis 1 General Debility 1 Tuberculosis 3 Cardiovascular Coronary disease or angina 3 Hypertension 2 Hemiplegia 1 Myocardial failure 2 Auricular fibrillation (Thyrotoxic) 1 Chest Diseases Asthma 1 Bronchitis and Emphysema 3 Crippling Conditions of Limbs Arthritis 5 Old Poliomyelitis 1 Varicose ulcers with elephantiasi 1 Operation for enlarged glands 1 Old age and debility 1 Eyes Defective vision due to cataracts 1 Unilateral blindness—Diabetic cataract 1 Miscellaneous Pernicious Anaemia 3 Chronic nephritis 1 Compared with the previous year Medical Certificates were reduced by three for illness of children and by seven for nervous illness of the parent. There was an increase of medical certificates for crippling conditions and cardiovascular or chest diseases. 30 REPORT ON THE WORK OF THE PUBLIC HEALTH INSPECTORS FOR THE YEAR 1961 I am very grateful for the following Report and Tables from Mr. G. A. Webber, Chief Public Health Inspector, which sets out the work of the Inspectors during the year. SECTIONS C, D, E. Statistical information relating to the work of the Inspectors is appended:— Housing—Inspection of Dwelling Houses during the Year. Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1,500 Number of inspections made for the purpose 2,382 Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 274 Number of inspections made for the purpose 298 Number of dwelling-houses (exclusive of those referred to under the following sub-head) found not to be in all respects reasonably fit for human habitation 95 Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation.. 0 Number of dwelling-houses in respect of which informal notices were served 95 Number of dwelling-houses in which defects were remedied after service of informal notices 88 Number of dwelling-houses in respect of which formal notices were served requiring defects to be remedied 51 Number of dwelling-houses in which defects were remedied after service of formal notices : (a) by owners 62 (b) by Local Authority in default of owners 0 Number of complaints received 1,381 Number of initial visits 6,144 Number of re-visits 2,423 Nuisances Remedied Structural Defects of properties—External 56 Internal 134 Insanitary conditions other than vermin 8 Verminous conditions 10 Smoke Nuisances 17 Choked drains 294 Other drainage defects 134 Defective sanitary appliances 22 Insufficient or unsuitable water supply 9 Absence of dustbin accommodation 8 Offensive accumulations 15 31 Food and Drugs Sampling Two hundred and five samples of food and drugs were submitted to the Public Analyst. Details are appended:— article formal informal Almonds (Ground) 7 1 Almond and Brazil Fudge — 1 Almond Extract — 1 Blackcurrant Glucose Vitamin "C" Health Drink — 1 Blackcurrant Health Drink — 1 Blackcurrants in Heavy Syrup — 1 Brawn (Pork) — 1 Butter Mints — 1 Butter (Peanut) — 1 Buttered Assortment — 1 Cheese Spread — 1 Cherry Bark and Blackcurrant Linctus — 1 Chicken — 3 Chocolate Flavoured Drink — 1 Cinnamon — 1 Coffee — 2 Compound Syrup of White Pine with Tar — 1 Cranberry Sauce — 1 Cream — 3 Cream (Sterilised) — 1 Glace Cherries — 1 Herring Tidbits in Wine Sauce — 1 Honey — 2 Ice Cream — 17 Jam — 4 Jelly with Port Wine — 1 Lemon Flavoured Linctus — 1 Lemon Squash — 1 Luncheon Meat — 5 Margarine — 1 Marmalade — 1 Marzipan — 1 Milk (Pasteurised) 53 6 Milk (Sterilised) 18 — Milk (T.T.) 6 — Milk Chocolate Rum Truffles — 1 Minced Chicken in Jelly — 3 Orange — 1 Orange Squ ash — 5 Pancake M 'xture — 2 Peas — 2 Pilchards in Tomato Sauce — 3 Pork and Meat Roll — 1 Pork Roll — 1 Potted Salmon with Butter — 1 Rice Pudding — 3 Salmon (Pink) — 2 Salmon Spread with Butter — 1 Sauce (Rum) — 1 Sausages (Pork) 12 — Smokers Cough Pastilles — 1 Steak (Casseroled) — 1 Stewed Steak — 4 Strawberries in Heavy Syrup — 2 Syrup — 2 Tomato Ketchup — 1 Vinegar — 4 No instances of adulteration were found. 32 In addition to the sampling of milk for chemical analysis, samples are also taken and submitted to the Public Health Laboratory Service for examination for keeping quality, and, in the case of pasteurised milk, for the adequancy of heat treatment. In 1961, 86 samples were submitted. One failed the keeping quality test, but an immediate repeat sample from the dairy concerned proved satisfactory. The remainder passed the tests to which they were submitted. Food privately purchased, and alleged by the purchaser to be unsound Instances of alleged unsound or contaminated food sold to the public which came to our notice were investigated, and reported to the Public Health Committee. Details are appended:— alleged complaint result February, 1961. Metal in Bread. Baker fined £20 and £10 10s. Od. costs. Sacking fibres in Meat Pasty. Manufacturer fined £15 and £8 costs. March, 1961. Mouldy Bread. Baker fined £15 and £7 15s. costs. Bread contaminated with iron and oil. Baker fined £15 and £7 15s. costs. Dirty milk bottle. Dairyman fined £20 and £7 15s. costs. April, 1961. Mould in Cornish Pasty. Retailer fined £10 and £5 5s. costs. Mould in Chicken and Ham Croquette. Retailer fined £3 and £10 10s. costs. Cigarette in Currant Bun. No legal action possible owing to conflicting evidence. June, 1961. Loaf contaminated with Oil. Warning letter to Baker. September, 1961. Piece of metal in bottle of milk. Dairyman fined £20 and £10 10s. costs. October. 1961. Wasp in soft Bread Roll. Jar of Pickles containing Glass. Warning letter to Baker. Evidence did not warrant any action. Ice Cream Seventeen samples of Ice Cream were submitted to chemical analysis during 1961 and all were found to comply with the statutory standard for this product. Sixteen samples were submitted to bacteriological examination, as a result of which the samples are graded into four degrees of bacterial cleanliness. The results were as follows:— Grade 1 Grade 2 Grade 3 Grade 4 14 2 — — Only samples falling into Grades 3 and 4 are regarded as unsatisfactory, indicating some bacterial contamination either in the manufacture or the retail serving of the product. 33 Rent Act, 1957 The details of the administration of this Act were referred to fully in the 1957 Annual Report. Five applications were received for Certificates of Disrepair during the year 1961, bringing the total number of applications to 146 since the Act came into operation in June, 1957. Disinfection The Council undertakes, free of charge, the disinfection of rooms, articles of clothing and bedding after cases of Tuberculosis and occasionally other Infectious Diseases. Requests for the steam disinfection of bedding, etc., other than for notifiable illness, are met but a charge is made for the service. During 1961, 49 applications were received and accounts rendered for £58 16s. During the year, 95 Library books were collected from homes and hospitals where infectious disease had occurred, disinfected and returned to the Library of origin. Mortuary The administration of the Beckenham Mortuary is the responsibility of the Public Health Department, the Mortuary Attendant being a member of the Medical Officer's staff. During 1961, 164 bodies were brought to the Mortuary where post-mortem examinations were conducted by a Home Office Pathologist. Fourteen Inquests were held in the Town Hall. Movable Dwellings Thirteen families occupied movable dwellings under licence from the Council during 1961. Nine inspections of the sites of the caravans were made, and in no instance was a Public Health nuisance discovered. 34 Factories Act, 1937-1959 Prescribed Particulars on the Administration of the Factories Act, 1937 Part 1 of the Act 1.—INSPECTIONS for purposes of provisions as to health (including inspections made by Public Health Inspectors). Premises (1) Number on Register (2) Number of Inspections (3) Written Notices (4) Occupiers prosecuted (5) (i) Factories in which Sections 1, 2, 3,4 and 6 are to be enforced by Local Authorities 27 4 — — (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 172 51 — — (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) — — — — Total 199 35 2.—Cases in which DEFECTS were found. Particulars (1) Number of cases in which defects were found Number of cases in which prosecutions were instituted (6) Found (2) Remedied (3) Referred To H.M. Inspector (4) To H.M. Inspector (5) Want of cleanliness (S.l.) 3 2 — — — Overcrowding (S.2) Nil Nil Nil Nil Nil Unreasonable temperature (S.3) Nil Nil Nil Nil Nil Inadequate ventilation (S.4) Nil Nil Nil Nil Nil Ineffective drainage of floors (S.6) Nil Nil Nil Nil Nil Sanitary Conveniences (S.7)— (a) Insufficient Nil Nil Nil Nil Nil (b) Unsuitable or defective 1 1 — — — (c) Not separate for sexes Nil Nil Nil Nil Nil Other offences against the Act (not including offences relating to Outwork) Nil Nil Nil Nil Nil Total 4 3 — — — Part VIII of the Act Outwork (Sections 110 and 111) Nature of Work Section 110 Section 111 Number of outworkers in August list required by Section 110(1) (c) Number of cases of default in sending lists to the Council Number of prosecutions for failure to supply lists Number of instances of work in unwholesome premises Notices served Prosecutions (1) (2) (3) (4) (5) (6) (7) Wearing apparel, making, etc. 27 — — —- — — 36 Water Supply The water supply of the area has been satisfactory in quality and quantity, the Metropolitan Water Board supplying all properties in the area by main. Bacteriological examination has been regular, 36 samples being taken during the year. All proved to be satisfactory. Drainage As will be seen from the Table of nuisances remedied, 294 instances of choked drains were reported during the year. A great many of these chokages related to public sewers, i.e. drains receiving wastes of two or more houses. The Council accepts as a legal responsibility, the clearance of public sewers, and the work is undertaken without any charge being made to the owners or occupiers of the properties. Of the 294 cases discovered, however, 187 related to private drainage, and in these cases a charge is made for the work undertaken. Accounts were rendered for £130 18s. Od. for this work. The Smoke Testing of the house drains of 6 properties was undertaken at the request of owners and accounts were rendered for £12 12s. Od. Infestation by Rats and Mice Seven hundred and ninety-two complaints were received in 1961 of which 78 related to business premises. A charge is made for the service provided in respect of business premises, whereas private residential property is served free of charge. During the year, accounts for £121 19s. 6d. were rendered in respect of business premises. Baiting of certain sections of the main sewers known to be rat infested, has been maintained during the year. Shops Act, 1950 The duties of the Public Health Inspectors under this Act differ very widely in character. The health and welfare provisions embrace sanitation, heating, ventilation, rest facilities, etc., but the Inspectors are also the Council's authorised Officers for enforcing the statute so far as it relates to hours of opening and closing, the weekly halfholiday and early closing day, Sunday trading, the type of goods which are prohibited from sale at certain times, the employment of young persons, and the keeping of records. During 1961 252 visits were made to shops in the Borough, and 1 contravention remedied. National Assistance Act, 1948 Burial and Cremation of Dead Section 50 of this Act places responsibility on a local authority for the burial of persons who have died, or been found dead, in their area where it appears that no suitable arrangements for disposal have been made. During 1961, it was necessary to take action under this Section on two occasions only. 37 CLEAN AIR ACT, 1956 SMOKE CONTROL AREAS The Beckenham Smoke Control Order, 1960, covering 2,297 properties came into operation on the 1st November, 1961, and much of the Inspectors' time was taken up by the inspection of properties where new and approved appliances were being fitted. Administration concerned with the approval of estimates and the allocation of grant facilities, etc., added considerably to the duties of the Department. Also, during 1961, the detailed survey of the proposed second area embracing 2,500 dwellings was commenced. It is anticipated that an Order covering the second area will come into operation in 1963, subject to the approval of the Minister of Housing and Local Government. At the request of the Minister the Council submitted its proposed programme for eventually covering the whole Borough as a smokeless area in the following approved form:— Approximate number of premises in the area : 27,800. Acreage of local authority area : 5,935. 83 Number of premises and acreage of land in smoke control areas. (1) (2) Covered by Orders made up to 31.12.61 (3) Estimated additions covered by Orders to be made during 1962 (4) Estimated additions covered by Orders to be made during 1963 (5) Estimated additions covered by Orders to be made during 1964 (6) Estimated additions covered by Orders to be made during 1965 (7) Estimated additions covered by Orders to be made during 1966 (8) Final objective (the total numbers it is intended ultimately to cover) (9) Target Year for completion of programme Premises 2,667 — 2,870 2,260 2,220 2,710 27,800 1971 Dwellings 2,297 — 2,500 1,890 1,850 2,340 24,088 Acres 307-2 — 534.2 1,015.9 433.7 804.4 5,935 A map of the Borough is appended giving the boundaries of the various areas proposed and the expected date ot the operation of each area. 39 METROPOLITAN WATER BOARD-WATER EXAMINATION DEPARTMENT BACTERIOLOGICAL RESULTS—YEARLY AVERAGES 1961 I am grateful to Dr. E. Windle Taylor, Director of Water Examination for the following tables:— Source of Supply BEFORE TREATMENT Number of Samples Agar plate count per ml. Coliform count Escherichia coli count 20-24 hours at 37°C. 3 days at 22°C. Per cent Samples negatives in 100 ml. Count per 100 ml. Per cent Samples negative in 100 ml. Count per 100 ml. Thames-derived Southern Group — — — — — — — Shortlands No. 1 74 1.0 3 100.0 — 100.0 — Shortlands No. 2 108 0.1 7 100.0 — 100.0 — Shortlands No. 3 223 0.1 9 100.0 — 100.0 — West Wickham 211 0.1 16 96.21 0.1 99.53 — Orpington 250 0.2 14 94.00 0.1 100.0 — Source of Supply AFTER TREATMENT Number of Samples Agar plate count per ml. Coliform count Escherichia coli count 20-24 hours at 37°C. 3 days at 22°C. Per cent Samples negative in 100 ml. Per cent Samples negative in 100 ml. Thames-derived Southern Group 1,835 100 — 99.84 99.89 Shortlands No. 1 — — — — — Shortlands No. 2 255 — 2 100.0 100.0 Shortlands No. 3 — — — — — West Wickham 217 — 52 100.0 100.0 Orpington 255 1.8 22 99.6 99.6 40 AVERAGE RESULTS OF THE CHEMICAL EXAMINATION OF WATER SUPPLIED TO THE BOROUGH OF BECKENHAM DURING 1961 Milligrammes per litre (unless otherwise stated) Description of Samples Thames-derived Southern Group Shortlands West Wickham Orpington Number of Samples 156 8 4 4 Ammonia Nitrogen 0. 041 0.019 0.015 0.018 Albuminoid Nitrogen 0. 076 0 .041 0 .036 0 .040 Oxidised Nitrogen—Nitrite — — — — Oxidised Nitrogen—Nitrate 4.1 4.6 5.2 6.8 Chlorides as CI. 27 18 13 18 Oxygen abs. from Permanganate (4 hrs. at 27°C.) 1.06 0.04 0.10 0.18 Turbidity Units 0.2 Nil Nil Nil Colour mm. brown 2 ft. Tube (Burgess's Tintometer).. 13 Nil Nil Nil Hardness (Total) 262 284 272 300 Hardness (non-carbonate) 52 52 28 60 pH Value 7.9 7.2 7.2 7.2 Phosphate as P04 1.0 — — — Silicate as SiO2 9 — — — Surface active material as Manoxol 0.11 — — — Sulphate as SO2 50 — — — Natural Fluoride as F. 0.20 — — — Magnesium as Mg. 6 — — — Free CO2 — 30 32 38 Electrical Conductivity micromhos 525 525 475 550 SECTION F INFECTIOUS DISEASES CONTROL Measles showed a biennial epidemic increase and there were 1,053 more cases than in 1960. Tables at the end of this report show that 6,741 persons were immunised against Poliomyelitis, 2,362 persons were immunised against Diphtheria, 1,005 persons were immunised against Whooping Cough and 875 persons were vaccinated against Smallpox. In May a child aged 5½ years was admitted to hospital with suspected laryngeal diphtheria but the diagnosis was not confirmed. The last confirmed case of diphtheria in Beckenham occurred in 1952. From 1945-1949 inclusive there were 11 cases and 1 death ; from 1950-54 inclusive there was 1 case and 1 death. The percentage of children under 15 immunised against diphtheria in 1947 was 54.8 per cent. This followed a consistent scheme for diphtheria immunisation which began in Beckenham in 1928. Today over 90 per cent of 5-year old children are immunised before entering school and records for reinforcing injections show that these are well maintained. Further investigations in cases of Scarlet Fever showed that 36 families were visited by public health inspectors. In nine families the children attended maintained schools in the Borough. Investigations into possible sources of infection revealed in a few cases links between different schools through other children in the family. In three schools there was evidence of continuing infection over many weeks. In St. Anthony's School three children, aged 6, 6 and 7 years respectively of different families were notified on the 18th July, 12th August and 27th September. In Balgowan School two children aged 9 and 5 years were notified on 13th and 25th January. In Alexandra School two children aged 5 and 6 years were notified on the 1st and 27th November. In addition a nurse who had recently come off duty from a fever ward in a London Teaching Hospital developed scarlet fever. The difficulty of control of scarlet fever these days through the mild and atypical nature of the illness was shown in one case where the diagnosis was not made until desquamation had occurred and the Health Department was notified 16 days after the onset of the disease; in a second case where there was a previous history of scarlet fever; in a third case where the diagnosis was revised to strephoccal tonsillitis by the family doctor. Notifications continued to be reasonably prompt and the interval between the onset of the disease or rash and notification to the Medical Officer of Health was 4 days or less in 21 cases and 7 days or less in 30 out of 35 cases. 41 There were no cases of poliomyelitis and the scheme for poliomyelitis immunisations is now confined to those performed in infant welfare clinics or clinics conducted in their own surgeries by most medical practitioners and at the monthly central evening clinic in the Town Hall Annexe which two health visitors attend. It is anticipated that in 1962 oral poliomyelitis vaccine will be available. Two cases of meningococcal meningitis were notified after admission to hospital but in one case the diagnosis was later revised to Pneumonia. During the course of an investigation in a London borough into an outbreak of salmonella food poisoning, a carrier of paratyphoid " B " was reported to us. After antibiotic treatment by his own doctor three consecutive negative faeces specimens were obtained. Investigation of other family contacts proved negative. One case of salmonella typhimurim food poisoning was reported and investigated. Arrangements have continued for the examination of faeces for bact. coli. serotypes of admissions to St. Hilda's Nursery. Thirty-five specimens were examined and Bact. Coli. were isolated from two babies. One was type 0199/B14—the other could not be typed by the laboratory. 42 43 INFECTIOUS DISEASE (1) disease 0-4 years 5—14 years 15 years and over Age Unknown admitted to Hospital total total M. F. M. F. M. F. M. F. M. F. M. F. Measles 291 279 329 292 1 6 2 3 — — 623 580 1203 Scarlet Fever 6 3 13 12 1 1 — — 1 — 20 16 36 Whooping Cough 4 7 4 6 — 2 — — — — 8 15 23 Meningococcal Infection — — 1 — — — — — 1 — 1 — 1 Puerperal Pyrexia — — — — — 7 — 1 — 8 — 8 8 Pneumonia 1 1 — 1 10 5 — — 1 — 11 7 18 Erysipelas — — — — 1 3 — — — — 1 3 4 Food Poisoning — — — — 1 — — — — — 1 — 1 Encephalitis — — 1 — — — — — 1 — 1 — 1 Para Typhoid B — — — — 1 — — — — — 1 — 1 44 INFECTIOUS DISEASE (2) The following Table gives the number of cases notified during the year. disease jan. feb. mar. apr. may june july aug. sept. oct. nov. dec. total Measles 31 142 389 364 95 141 21 15 2 1 1 I 1203 Scarlet Fever 4 5 7 4 1 2 2 1 1 3 3 3 36 Whooping Cough 8 — 3 4 2 1 2 2 1 — — — 23 Meningococcal Infection — — — — — — — — — 1 — — 1 Puerperal Pyrexia — — 1 — — — — — — —- 4 3 8 Pneumonia .. 5 9 1 — I — — — 1 — — 1 18 Erysipelas — 1 1 — — 1 — — 1 — — — 4 Para Typhoid B — — — 1 — — — — — — — — 1 Food Poisoning — — 1 — — — — — — — — — 1 Encephalitis — — — 1 — — — — — — — — 1 Totals 48 157 403 374 100 145 25 18 6 5 8 8 1296 45 INFECTIOUS DISEASE (3) disease wards* L. Pk. and K.H. C.C. C.H. M.H. E.P. Shortlands W.W. (North) (South) Measles 241 146 206 149 137 109 126 89 Scarlet Fever 8 1 4 5 3 — 5 10 Whooping Cough 1 3 3 7 2 1 5 1 Meningococcal Infection 1 — — — — — — — Puerperal Pyrexia — — — — 8 — — — Pneumonia 4 1 — 8 2 1 2 — Erysipelas — 1 — 2 1 — — — Food Poisoning — — — — — 1 — — Para Typhoid B — — 1 — — — — — Encephalitis — — — — 1 — — — Totals 255 152 214 171 154 112 138 100 *L. Pk. and K.H.—Lawrie Park and Kent House. M.H.—Manor House. C.C.—Copers Cope. C.H.—Clock House. E.P.—Eden Park. W.W. (North)—West Wickham North. W.W. (South)—West Wickham South. IMMUNISATION AND VACCINATION I have set out below the Diphtheria Immunisation, Whooping Cough Immunisation and Smallpox Vaccination figures for 1961 based on record cards. Year of Birth Diphtheria Immunisation (Singly or in combination) Whooping Cough Immunisation (Singly or in combination) Primary Reinforcing Primary 1961 428 — 428 1960 470 29 449 1959 49 133 34 1958 23 95 17 1957 15 86 9 1952-1956 66 750 44 1947-1951 32 186 24 Total 1,083 1,279 1,005 Age at Date of Vaccination Number Vaccinated Number Re-Vaccinated Under 1 707 1 67 — 2 to 4 38 — 5 to 14 27 7 15 or Over 15 14 Total 854 21 POLIOMYELITIS VACCINATION The following table shows the number of injections given in the various priority groups during the year ended 31st December, 1961. Priority Group 2nd Injections 3rd Injections 4th Injections 1957-1961 973 986 — 1946-1956 199 453 — 1943-1945 32 62 — 1933-1942 433 428 — 1921-1932 1,270 1,820 — Others 41 44 — School children under 12 years — 4,767 Total 2,948 3,793 4,767 46