C 4412(1) BEC 29 Library BOROUGH OF BECKENHAM REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962 BY L. R. LTEDWARDS, M.D. (Lond.), D.P.H. Medical Officer of Health BOROUGH OF BECKENHAM REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962 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 rate 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, 1962 Chairman Councillor A. T. Johnson, J.P. Deputy Chairman Councillor M. Williams Alderman T. Boyd Boyd Alderman W. Duncan. Alderman G. M. R. Lord, J.P. Councillor R. E. Baskett. Councillor R. G. Foster. Councillor P. G. Gordon Smith Councillor W. E. Palmer. Councillor A. C. Garrett. Councillor F. R. Stevens Councillor J. M. Smith. Councillor Mrs. D. E. L. West, M.B.E Councillor Mrs. O. L. Roberts. Ex-Offtcio: The Mayor 3 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 Inspector E. U. Williams, Cert. R.S.I, and 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. Certificated Smoke Inspector. D. W. Foster, Cert. R.S.I, and S.I.E.J.B. Certificated Food Inspector. Certificated Smoke Inspector. C. J. Utting, Cert, of Public Health Inspectors' Education Board. Certificated Food Inspector. Clerical Staff: Shorthand Typist Mrs. E. D. Soars. Clerks.. Miss Y. V. Read. Mrs. J. Newman Mrs. H. A. Whipp (Resigned 1/6/62). Miss D. C. Reeves (Commenced 4/6/62). Rodent Officer E. J. Read. Rodent Operators W. J. E. Wickenden (Retired 11/6/62). L. G. Hodges (Commenced 28/5/62). Disinfector—General Assistant M. Hindson. Mortuary Attendant—General Assistant C. C. Evans. 4 CONTENTS PAGE INTRODUCTORY LETTER 5 Section A. Vital Statistics Environmental Conditions and Control 9 Summary of Vital Statistics 11 Total Deaths 12 Cancer Deaths, 1958 to 1962 13 Notifications and Deaths from Tuberculosis 14 Infantile Mortality 15 Section B. Health and Social Services Hospitals and Clinics 16 County Council Health Services 16 Private and Voluntary Services 17 Local Clinics for Maternity and Child Welfare 18 Report of District Officer 20 Report of Home Help Organiser 20 Report of Chest Physician 21 Tuberculosis Care Committee 22 Old People's Welfare Services 23 Women's Voluntary Service 27 Home Safety Committee 29 Beckenham Accident Prevention Committee 30 Housing—Medical Applications 32 Sections C, D and E. Environmental Services Housing Inspections 33 Nuisances 33 Food and Drugs 34 Unsound Food 36 Ice Cream 36 Rent Act, 1957 36 Disinfection 37 Mortuary 37 Moveable Dwellings 37 Factories Act 1937-1959 38 Water Supply 40 Drainage 40 Rodent Control 40 Shops Act, 1950 40 National Assistance Act, 1948 (Section 50) 40 Smoke Control 41 Water Supply Examination 42 Section F. Infectious Diseases Control Age and Sex Incidence 45 Monthly Prevalence 46 District Distribution 47 Smallpox Vaccination and Whooping Cough and Diphtheria 48 Immunisation 48 Poliomyelitis Vaccination 48 5 INTRODUCTION To the Chairman and Members of the Public Health Committee. I have the honour to present my report on the health of the Borough during 1962. The year was memorable in many respects. A final decision has been taken in delineating the area to constitute in 1965 a new London Borough of which Beckenham joined to Penge will constitute the north-western sector. To the new Health Authority will come control of the Maternity and Child Welfare Service, the Welfare and the Children's Service. Welfare incorporates those special services which provide for the elderly including the maintenance of old persons homes and those services which provide for the Blind and Partially Sighted, the Deaf and Hard of Hearing and the Physically Handicapped. The Children's Service supervises adoptions and provides foster homes, family group homes and nurseries for children in care or deprived of parental care and remand homes and approved schools for children referred by Juvenile Courts. Thus the new Health Committee will have tremendous community health responsibilities for closely linked functions in the Children's Services, Personal Health and Welfare Services, while retaining the same responsibilities to a population five times larger than at present for the environmental services of Food Hygiene, Housing, Clean Air, Health and Sanitation. In the light of these changes it is pleasing to record the steady progress during the year of the Clean Air Programme, of the hygienic control of food and drugs during which no adulteration was found, of the work of the Old Peoples Welfare Committee whose voluntary efforts to provide day centres and increased housing and meals, has the full financial support of the Council and of the development of health education in the special sphere of the Home Safety Programme by the approved appointment of additional staff. This progress emphasises that the Committee through the Council keeps itself up to date in providing for the needs of today in the more limited field of health and welfare. Vital Statistics The report reveals a slow but steady growth in population, a Death Rate of 11.53 which compares favourably with that of 11.9 for the rest of England and Wales, and an increase of live births which now number over one thousand a year. The birth rate of 13.6 is still less than that for England and Wales (18.0). Cancer deaths show a steady increase over the past five years as do deaths from Tuberculosis but the cause in both events may be due to earlier diagnosis and increasing longevity. The Death Rate from accidents has increased and there has been a regrettable increase in illegitimate births, illegitimate infant deaths and of still births. While 6 the causes of road accidents, industrial accidents and home accidents have been investigated and publicised for many years, it is only during recent years that attention has been directed to the cause of still births and especially to the social causes of the increasing illegitimacy rate and its consequences. When larger units of Local Government have been established facilities for such investigations may be increased and there may be more intensive local propaganda on the prevention of these social problems. Infectious Diseases In the early part of the year the threat of an outbreak of Smallpox arising from indirect contact with a reported case in Woolwich and another in Hornchurch was ever present. Beckenham was fortunately spared the experiences of Bradford and South Wales. Nevertheless the threat resulted in a greatly increased demand for Smallpox vaccination, especially for those travelling to Europe. There was generally a greater awareness of the value of vaccination. The restrained advice of Medical Practitioners and the excellent co-operation and information service of the press obviated a great deal of alarm in the Borough which was developing although no suspected case had been reported. Considering the number who holiday in out of the way places on the Continent especially in parts of Spain and on the Mediterranean Coast the occasional importation of a case or carrier of Typhoid Fever is not surprising. It is fortunate that treatment can now be so successful and the criteria of cure can be so exact as is illustrated by the history of two cases described in the Infectious Diseases Section of the report. The Authority received in March a valuable booklet on active immunisation against Infectious Diseases which among other matters advised that all persons who intended to travel to countries where there was risk of contracting these infections should be effectively vaccinated against Typhoid and Paratyphoid Fevers. Reaction to these injections though common is rarely severe. Referring to the vaccination of travellers who might have to go abroad at short notice the Ministry was not able to lay down hard and fast rules but stated that vaccination though incomplete, given prior to departure, might be of some protection against infection on arrival. The booklet also advised that both inactivated and attenuated vaccines against Measles have been prepared but they are still in the experimental stage and none is at present available for general use. Though Measles has become a milder disease it remains extremely infectious and debilitating and a vaccine at least as effective as that in present-day use for Whooping Cough prevention would be welcome. No cases of Poliomyelitis were reported and generally there was little notifiable infectious disease. It is impossible to record the number of viral infections but today these constitute the main infectious hazard to health. Fortunately the majority are mild and therapy is specific. 7 Few food poisoning incidents were severe enough to be reported. It must be remembered that food when imported and canned may accidentally become the vehicle for the enteric and salmonella infections but therapy in the treatment of these diseases has made great strides. Old Peoples Welfare A comprehensive and up-to-date report on these Services is included in this report and it will show the progress that is taking place in at least two directions—the Meals Service and the provision of housing accommodation as the result of the joint efforts of the Beckenham Old Peoples Welfare Committee, the Abbeyfield Society and the Borough Council. Voluntary Organisations The activities of many voluntary organisations are mentioned in the reports on old people's welfare, the work of the Tuberculosis Care Committee and of the Women's Voluntary Service and the splendid efforts of these organisations is greatly appreciated. Home Safety and Accident Prevention The " Tufty Clubs " provide for instruction to children under five years of age and the report will show that in their first year in Beckenham they have been very successful. There has been a reduction of over 250 in accidents to children in their homes. Pollution from Smoke Most satisfactory progress can be recorded in the survey of a further 2,500 dwellings to establish a second Smoke Control Area in Beckenham. No action has been required to deal with any nuisance from a domestic chimney and statutory powers have been used to enable householders who had delayed the installation of approved appliances to do so with a much smaller grant and with no choice. Grant aid was given to needy cases. The general beneficial effect of this work is already apparent in the south of the Borough, where the clean and clear air and the absence of smoke haze is noticeable on winter afternoons. Following the advice of a Consultant of the National Coal Board, the co-operation of the owner and the supervision of the Health Department a source of industrial smoke was very considerably minimised and the Committee were satisfied that all practicable means had been taken to control this air pollution. Caravan Site and Control of Development (1960) The Committee considered model standards on health and fire precautions prepared under the above Act and visited a site in the Borough. A conditional licence was issued and the appeal which ultimately went to the High Court on a point of law was given in favour of the Council. 8 Health Education The Committee received a letter from the Ministry of Health drawing attention to the report on " Smoking and Health " published by the Royal College of Physicians, and accepted posters for distribution in the Borough. The letter was set out in detail in the minutes of the Report of the Committee for Education. Progress of this health measure is hindered by the inability of many to review the evidence objectively and dispassionately. The work of the Public Health Department was set out and explained for the third year in succession in the Municipal " Welcome to Young Citizens " Exhibition. In April a party of 37 undergraduate medical students from Guys Hospital visited the Health Department and the services were explained by myself, by Mr. Webber, by Mr. Moore and by a senior Health Visitor. The students were able to view the Council Chamber and Civic Insignia and then to visit in groups seven or eight medical practices in the area. The visit to Beckenham concluded with a tour of the Wellcome Laboratories at Langley Park. This was the third visit and each year's visit has been greatly appreciated by the Teaching Staff of the Social and Preventive Medicine Unit and students of Guys Hospital. A lecture on the Health Services was also given to junior Local Government Officers in the post-entry training scheme. In conclusion I thank the Chairman and all the members of the Health Committee for their continued enthusiasm and interest and especially the new members of the Committee for their quick understanding of the practical problems and details of administration of the Department. This year my thanks to my medical colleagues in hospital and in general practice are especially due for their co-operation and forebearance in the difficult early part of the year. Lastly 1 thank my own staff for their work as a team and for sustaining patience in enquiries with zeal and efficiency in their day-today work throughout a most rewarding year. L. R. L. EDWARDS, Medical Officer of Health. 9 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 grave". 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 1962 was 22.83 inches. The population has grown from 26,330 in 1901 to 74,834 in the 1951 Census (Estimated population in June 1962 was 76,930). 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. 10 No new sources of supply were instituted during 1962 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 of 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 bahjs 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 lacquer leather products, protective food packaging, dyers and cleaners and almond Millers. 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. 11 SUMMARY OF VITAL STATISTICS, 1962 Area of District in acres 5,935 Estimated mid-year population 76,930 Population Density—persons per acre 12.96 Rateable Value at 1st April, 1963 £4,281,973 Number of Inhabited Dwellings 25,212 Product of a Penny Rate (Estimated 1963/64) £17,650 Male Female Live Births 548 498 Total 1,046 Live Birth rate per 1,000 population 13.60 Illegitimate Live Births per cent of total live births (61) 5.38 Male Female Still-births 10 6 Total 16 Still-births rate per 1,000 live and still-births 15.06 Total live and still-births 1,062 Infant Deaths (deaths under 1 year) 16 Total infant deaths per 1,000 total live births 15.20 Legitimate infant deaths per 1,000 legitimate live births 15.23 Illegitimate infant deaths per 1,000 illegitimate live births 32.77 Neonatal Mortality Rate (deaths under 4 weeks per 1,000 total live births) 12.43 Early Neonatal Mortality Rate (deaths under 1 week per 1,000 total live births) 10.52 Perinatal Mortality Rate (Stillbirths and deaths under 1 week combined per 1,000 total live and stillbirths) 25.42 Maternal Mortality (including abortion) 1 Maternal mortality rate per 1,000 live and still-births 94 Death Rate per 1,000 population from Cancer (199 deaths) 2.58 Death Rate per 1,000 population from Pulmonary Tuberculosis (4 deaths) 0.05 Death Rate per 1,000 population from Non-Pulmonary Tuberculosis (1 death) 0.01 Death Rate per 1,000 population from Accidents (23 deaths) 0.30 Birth Rate (including Stillbirths) per 1,000 population: Crude 13.80 Corrected (x 1.05) 14.49 Male Female All Deaths Registered 415 529 Total 944 Death Rate per 1,000 population: Crude 12.27 Corrected(X 0.94) 11.53 Natural Increase: Births exceeded deaths by 102. 12 TOTAL DEATHS, 1962 (Registrar-General's Official Returns). All causes—944. Male, 415 Female, 529. causes of death males females 1. Tuberculosis, respiratory 4 2. Tuberculosis, other 1 — 3. Syphilitic disease — — 4. Diphtheria — — 5. Whooping Cough — — 6. Meningococcal infections — — 7. Acute poliomyelitis — — 8. Measles — — 9. Other infective and parasitic diseases 1 1 10. Malignant neoplasm, stomach 16 12 11. Malignant neoplasm, lung, bronchus 40 10 12. Malignant neoplasm, breast — 25 13. Malignant neoplasm, uterus — 10 14. Other malignant and lymphatic neoplasms 40 46 15. Leukaemia, aleukaemia 4 3 16. Diabetes 2 3 17. Vascular lesions of nervous system 36 85 18. Coronary disease, angina 109 85 19. Hypertension with heart disease 7 5 20. Other heart disease 27 93 21. Other circulatory disease 14 32 22. Influenza 1 1 23. Pneumonia 16 38 24. Bronchitis 34 31 25. Other diseases of respiratory system 10 1 26. Ulcer of stomach and duodenum 9 2 27. Gastritis, enteritis and diarrhoea 3 — 28. Nephritis and nephrosis — 2 29. Hyperplasia of prostate 4 — 30. Pregnancy, childbirth, abortion — 1 31. Congenital malformations 2 2 32. Other defined and ill-defined diseases 18 28 33. Motor vehicle accidents 3 3 34. All other accidents 10 7 35. Suicide 4 3 36. Homicide and operations of war — —' Totals 415 529 13 CANCER DEATHS 1958 1959 1960 1961 1962 Cancer of Lung 47 49 48 41 50 Males 184 Females 51 Total 235 Cancer of Breast 13 15 19 25 25 97 Cancer of Uterus 6 10 8 8 10 42 Cancer of Stomach 21 14 24 25 28 Males 62 Females 50 Total 112 Other Malignant Neoplasms 90 98 83 94 86 Males 216 Females 235 Total 451 Total Deaths from Cancer 177 186 182 193 199 Males 462 Females 475 Total 937 For comparison, deaths from Respiratory Tuberculosis are shown:— 1958 1959 1960 1961 1962 1 2 1 1 4 Males 7 Females 2 Total 9 14 TUBERCULOSIS—Table of Notifications and Deaths, 1962, 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 22 11 33 4 1 — 2 4 3 4 6 3 6 — 6 2 — 4 3 6 4 8 Non-Pulmonary 1 1 2 — — — — — 2 — — — — — 1 — 1 — — — — — Totals 23 12 35 4 1 — 2 4 5 4 6 3 6 — 7 2 1 4 3 6 4 8 Deaths Pulmonary 6 — 6 — — — — — — — 1 3 2 — 1 2 — 1 — 1 1 — •^on-Pulmonary — 1 1 - - - 1 - - - - - - - - - - - - 1 — — Totals 6 1 7 — — — 1 — — — 1 3 2 — 1 2 — 1 — 2 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). 15 CHILD AND INFANT MORTALITY 1962 The number of deaths of infants under the age of 12 months for which full records exist was 19, compared with 19 in 1961. The Registrar-General returns 16 infant deaths and the infant mortality rate for the year was 15.20 per 1,000 live births. Deaths of children under 15 numbered 2 due to Leukaemia and Malignant Brain Tumour. 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 — Stone Park Maternity Kidney† 1 — — — — — — — 1 — Hospital 9 Prenatal: Prematurity 5 2 2 — — — — — 7 2 Farnborough Hospital 3 Atelectasis 1 — — 1 — — — — 1 1 BromleyJHospital 3 Natal: Cord around neck — — 1 — — — — — 1 — Queen Mary's Carshalton 1 Post Natal Pneumonia — — — — — — 2 — 2 Children's Hospital, Sydenham 2 Bronchitis — — — — — — 1 — 1 — At Home 1 Enteritis — — — — 1 — — — 1 — Accidental‡ — — — — — — 1 — 1 — Totals. 7 2 3 1 2 — 4 — 16 3 *Anomaly of Coronary artery. † Hydronephrosis. ‡ Impramine poisoning. 16 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. I 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. Hither Green Hospital—Hither Green, S.E.13. 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. 17 Ambulances. Through Hospital or Beckenham District Office Old People's Homes in Borough. Red House, Southend Road (Middlesex C.C.). Kingswood House, Shortlands (Kent C.C.). Durham House and Annexe, Shortlands (Kent C.C.). Thornton House, Bromley Road (S.O.S. Society). Ribblesdale, Crystal Palace Park Road (Salvation Army). Rutland Lodge, Mays Hill Road, Short- lands (Private). 3, Durham Road (Private). 13, Gwydor Road (Private). 99, Venner Road (Private). Mental Welfare. ham. District Offices, 12, Beckenham Road, Becken- General Welfare. ham. District Offices, 12, Beckenham Road, Becken- Chiropody Clinics. West Wickham and 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. 3. Private and Voluntary Service. Private Nursing Homes. (1) "Fairlawn," 34, Albemarle Road, Beckenham. (2) "Inglewood," 25, Durham Avenue, Bromley, Kent. (3) "Sloane," 131, Albemarle Road, Beckenham, Kent. (4) "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. 18 LOCAL CLINIC SERVICES Service Days and Times Premises in Use Ante Natal Mondays 10a.m.-12 noon and 2 p.m.-4 p.m. (by appointment). Maternity Hospital, Stone Park Avenue, Beckenham. Wednesdays and Thursdays 10 a.m.-12 noon (by appointment). Maternity Hospital, Stone Park Avenue, Beckenham. Bookings—Tuesdays and Wednesdays, 2-3 p.m. Maternity Hospital, Stone Park Avenue, Beckenham. Child Welfare Mondays, 2—4 p.m. (1st, 3rd and 5th in month). Chulsa Clinic, Hurst House, Chulsa Road, S.E.26. (Health Visitors consultation only). 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, Elmers End (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 Cb) Clinic Block, Hawes Lane, West Wickham Post Natal Every Friday 10 a.m.— 12 noon. Maternity Hospital, Stone Park Avenue, Beckenham. Vaccination and Immunisation Clinics Vaccination and poliomyelitis immunisations by appointment; also diphtheria, whooping cough and tetanus immunisations. Held during Infant Welfare Sessions at above Clinics except Chulsa Clinic. (Langley Road—Friday afternoons only.) Dental (Infant Welfare Cases) By appointment. Clinic Block, Town Hall, Beckenham. By appointment. Clinic Block, Hawes Lane West Wickham. 19 LOCAL CLINIC SERVICES Service Days and Times Premises in Use Speech Mondays to Fridays inclusive (by appointment) Clinic Block, Town Hall Beckenham. Orthopaedic Second Wednesday in each month (by appointment) Surgeon in attendance Clinic Block, Town Hall, Beckenham. Treatment. The Physiotherapist attends by appointment as follows Monday afternoons Clinic Block, Town Hall, Beckenham Thursday afternoons Mothercraft Classes and Relaxation Exercises Friday afternoons, 2 p.m. Clinic Block, Town Hall, Beckenham Thursday afternoons, 2 p.m. Clinic Block, Hawes Lane, West Wickham Mid wives Ante-Natal Monday afternoons, 2 p.m. Clinic Block, Town Hall, Beckenham Thursday afternoons, 2.15 p.m. Clinic Block, Hawes Lane, West Wickham Chiropody Clinic Monday and Thursdays, 9-12 noon (by appointment) Alternate Tuesdays, 9-12 noon (by appointment) Clinic Block, Town Hall, Beckenham. Clinic Block, Hawes Lane, West Wickham. 20 REPORT OF THE DISTRICT OFFICER The following report has been submitted by Mr. C. J. Moore, District Officer, for which I express my thanks. "In my report last year I mentioned Community Care and Aftercare for those suffering from mental illness. While, so far as numbers of patients is concerned, this service has not developed as rapidly as had been anticipated, a wide variety of patients have been referred mainly from hospitals or from general practitioners. As a result of the present general policy that wherever possible sick and handicapped persons should be cared for in their own homes rather than in hospitals, there has during the past year been a marked increase in the demand for various nursing requisites and aids for the handicapped. The items provided and in common use range from a simple bath rail to a hydraulic hoist for lifting and moving patients. These appliances are provided on medical recommendation on loan free of charge. This service is complementary to the Medical Loan Depots which the British Red Cross Society operate as agents of the County Council. During the year the accounting for the Domestic Help Service was transferred from the Central Office to the District Offices. This has, I think, been appreciated by those using the service. They are now able to discuss their queries on accounts either by a personal call or a telephone call. It has also facilitated the collection of outstanding arrears. REPORT OF HOME HELP ORGANISER My thanks are due to Miss Hocking for the report on this service for the Beckenham and Penge area. "1962 has produced a still greater demand for this service. Approximately 400 per week received assistance and over 550 new cases were given service during the year. No family received guidance under the Family Welfare Service. Eighteen cases in Beckenham and Penge were helped under the Family Care Service. One application was received from Evening Service but none for Night Attendance." All applications for Domestic Help Service should be made to the District Organiser, 12, Beckenham Road, Beckenham." 21 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:— "Very little comment on the actual figures is necessary, except to note that five new contacts were found to be suffering from Tuberculosis out of a total of 185 examined. This emphasises the importance of routine contact examination. My remarks in previous Annual Reports regarding the necessity for complete co-operation of the patient in taking anti-Tuberculosis drugs must still be underlined. The progress already achieved in the control of the disease will be difficult to maintain without this co-operation." New Cases attending the Chest Clinics for the first time during 1962 Adults Children under 15 years Male Female Male Female Pulmonary Tuberculosis 21 16 — — Non-Pulmonary Tuberculosis — — — — Non-Tuberculous 96 60 28 42 Non-T uberculous Tuberculous New Contacts Examined 180 5 B.C.G. Vaccination of contacts: 92. Number of Tuberculous Patients admitted to Hospital or Sanatorium during 1962: 26. 22 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. " The Committee has just completed 25 years service amongst the tubercular patients and their families in the Borough of Beckenham. Fullest co-operation with the Chest Clinics has been maintained and only patients recommended by them are given consideration. Close contact is kept with the Kent Council of Social Service through the County Tuberculosis Care Committee. Over £428 was spent, giving 87 grants to 25 families—7 of these were new cases. One grant was in the form of an interest-free loan of £125 to help with a Hire Purchase Agreement debt. Other grants were:— 24 Christmas gifts ; 26 meat grants ; 10 fares ; 5 holidays; 5 coal; 4 clothing ; 3 Electricity Bills ; 2 Foster parents; 1 grant towards a holiday ; 2 milk and groceries ; 1 water colours ; 1 radio licence. The Committee has three radios which are on free loan. The Committee's two Liaison Officers made numerous calls on patients and were able to settle small problems on the spot. The more complicated ones were brought before the Committee at one of its eleven meetings. The Committee is fortunate in having representatives in the following Organisations:—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 and Penge Free Church Women's Council and Welfare Department Fund raising Organisers brought in over £350 during the year by the sale of ½d , Christmas Seals and a Jumble Sale Donations were over £38 23 BECKENHAM OLD PEOPLE'S WELFARE SERVICES The various services available for elderly persons can be summarised as:— 1. Meals. 2 Clubs for recreation 3. Chiropody. 4. Outing and holidays. 5. Personal service. o. Visiting. 7. Grants (cash or goods). 8. Parties and entertainment. 9. Emergency help. 10. Information handbook. Meals These are cooked at two centres. They are delivered in insulated containers on two special vans to the homes of those who from illness or infirmity are unable to provide for themselves hot meals. In West Wickham 30/40 meals are delivered three times a week and in addition a Luncheon Club meets between 9.30 a.m., and 4 p.m. once a week. For the rest of Beckenham 46 meals are delivered twice a week. The Old People's Welfare Committee hopes to provide a Day Centre which, unlike the Clubs mentioned later in this report, will be open every day of the week to provide social and recreational activities and a Luncheon Club. In addition the kitchen facilities at this centre may enable a daily delivery of hot meals to be made and so increase the numbers of homes included in this service. The Borough Council are helping the Committee with this project, and in addition, having provided a second equipped meals van in 1961 are helping with the maintenance and repair of the two vehicles at an estimated total cost of £150-£200 per annum. The Council also make an annual contribution of £52 to subsidise the cost of meals which are provided at a charge of 1s. Od. to 1s. 6d. Nevertheless very considerable voluntary help both financially when appeals are made and actively by assisting at the Centre and helping with the Meal Service will be required from the Borough to set up and maintain the Day Centre which could become the pivot of the service. 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) Civil Defence "C" Centre, Croydon Road, (formerly Assembly Hall). West Wickham over 60's (Monday afternoons) Lecture Hall, Sussex Road. Darby and Joan (Tuesday afternoons) West Beckenham Hall, Sidney Road. Darby and Joan (Thursday afternoons) West Beckenham Hall, Sidney Road. Darby and Joan (Tuesday afternoons) Azelia Hall, Croydon Road. Veterans' Club (Thursday afternoons) Azelia Hall, Croydon Road. These clubs enable pensioners to lead a happy communal the 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. The Veterans Club was a community service project of the Rotary Club of Beckenham. 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, Shortiands. Emmanual Church Hall, The Grove, West Wickham. Chiropody The British Red Cross Society Clinic, dealing with 70-80 patients and held every other week on alternate Wednesday mornings has continued at the Emmanuel Church Hall, West Wickham. Elderly persons needing home visits are referred by the Society to the District Officer of the Kent County Council and domiciliary visits are carried out under the County scheme. A whole time chiropodist employed by the Kent County Council holds a clinic on alternate Tuesday mornings at the Hawes Down Infant Welfare Clinic, West Wickham, on Monday and Thursday and mornings at the Infant Welfare Clinic, Town Hall, Beckenham. Domiciliary visits for those unable to attend the centres are arranged through the District Officer who also arranges appointments for treatment and assessments of charge up to a maximum of 4s. for treatments in any one week. The Red Cross Clinic at West Wickham and the Town Hall Welfare Clinic, Beckenham, are conveniently situated close to main bus routes. 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. Outing 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) Following upon visits, the need for other personal help, such as shopping or gardening is ascertained. The need for grants in cash or goods or assistance of various kinds including the provision of books for the library, the need for outings or holidays for those not attending clubs, or out of touch with relatives and needing companionship is discovered at these times. 24 Information in a guide handbook for old people has been issued widely by the Old People's Welfare Committee through sub-post offices, libraries and shops and by Officers of the National Assistance Board and by voluntary organisations. With the establishment of a Day Centre more old people will become known and in time a fairly comprehensive register will be available. The Emergency Call Scheme (Beckenham) has proved its worth and the voluntary committee operating it have produced a flashing warning light for attachment to the Help Card and use at night which may be generally adopted. 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. Visiting is carried out by members of various organisations such as the W.V.S. Rotary and Inner Wheel Clubs and various Townswomen's Guilds. 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 is obtained concerning details of relatives membership of clubs, provision of services, means of income, accident prevention safeguards, ability to manage at home or need for admission to old peoples 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. Hospital Visiting The Rotary Club co-operates with a voluntary Committee in the north-western area of the Borough in arranging transport for infirm Persons wishing to visit hospital. 25 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. The Abbeyfield Society have established one home and will soon be opening another. The Beckenham Old People's Welfare Committee have a project for building a block of flatlets with communal room and wardens quarters. Accommodation in private houses in suitable cases may be arranged through the North-West Kent Council of Social Service. This scheme provides mainly for those in hospital who have a home of their own but whom the hospital cannot release because there is no one to care for them and for similar types of need. Nursing at Home No night nursing is provided by the District Nurses but day home nursing is provided by one male nurse and thirteen female nurses employed by the County Council for the area of Beckenham, Penge and Anerley. 26 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. The membership fee is Id., and a charge of 3d. is made for tea. Whist Drives, Darts Matches and Raffles are held each week, and at least 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 still served twice a week, Tuesdays and Fridays, and from the West Wickham centre three times a week, on Tuesdays, Wednesdays 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 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 40 meals are served each time from Beckenham and about 30 from West Wickham. 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 weekly 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. Owing to a fund started by one of the Townswomen's Guilds we are now able to send a few special cases of old people away to the sea for out of season holidays. This year we are able to send ten away. 27 Hospital Work Work in connection with Beckenham Hospital has been much appreciated and consists of help with the library, flowers and magazines. 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 West Wickham. 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 clothes and mothers with baby clothes. We are also in liaison with the Prison authorities. Welfare Foods The Centre dispenses National Dried Milk, Orange Juice, Cod Liver Oil and Vitamin tablets. Periodicals for the Forces We send 5 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 a number of children who are recommended to us by the Tuberculosis After Care Committee and Health Visitors. Last summer nine children benefited from a holiday at the seaside or in the country. The parents pay what they can towards the holiday and we find the rest. 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. We also run a Trolley shop at Durham House and at Kingswood House. 28 BECKENHAM HOME SAFETY COMMITTEE I have pleasure in submitting the following report on the work of the Beckenham Home Safety Committee, forwarded to me by Mr. J. Bretton, Local Safety Officer. "During the past year, the Home Safety Committee has supported the National Campaign on general Home Safety aspects, but particularly on 'Danger of poisons in the Home', 'Water Safety', the latter, with the excellent co-operation of the Baths authorities, in their promotion of more winter training for all age groups. Home Safety Training Year will continue throughout 1963. The first three months will concentrate on the training of young people through those organisations which provide home safety training courses. From April to December, 'Consumer Education' will be the theme. This will be achieved by distributing suitable leaflets through many organisations and by home safety weeks in shops and stores. Encouraged by the appeal for more Home Safety subscribers, the recruitment drive will continue. It is hoped by the end of the year to have at least 75 per cent membership of the home safety section by Local Authorities. It is proposed in the Spring of this year, the Road/Home Safety Committees, will promote the publication of a joint SAFETY Handbook, which will be distributed through the channels of ParentTeachers Associations, Ratepayers Associations, Clinics, Libraries and local offices. Various Quiz Units and Portable Displays were shown at many Summer Fetes and Shows, whilst small exhibitions were held at many Clinics, Libraries and schools. A considerable amount of publicity material was displayed throughout the Borough during the year, particularly in school premises, this with the valued assistance of many members of the Junior Accident Prevention Council. An analysis of the accident figures from Beckenham Hospital shows that home accidents continue to exceed road accidents in a ratio of 4 or 5 to 1. In addition it must be remembered that whilst all road accidents involving personal injury must be reported, and therefore appear in statistics, there are many home accidents which are treated either at home or in the doctor's surgeries, and of which there are no records available. In 1962, Beckenham Hospital recorded 1,079 home accidents, of which 490 were children. This compares with 1,075 home accidents in 1961, of which 743 were children. It is pleasing to see such a good reduction in the numbers of children who were injured. As mentioned in the 1961 report, the appointment of a full time Home Safety Organiser was approved in principle. It being agreed that the present Road Safety Officer be appointed Local Safety Officer, and to include all Home Safety problems in his duties but to have an assistant for three days part-time. 29 BECKENHAM ACCIDENT PREVENTION COMMITTEE The following report on the work of the Beckenham Accident Prevention Committee has been submitted by Mr. J. Bretton, Local Safety Organiser. "National Road Safety Campaign 1963. 'Get fit for the Road'. The present campaign with its theme 'Training for Road Safety' will continue until the end of March 1963, when it will be replaced on the 1st April, with the new campaign, the theme being 'Get Fit for Road Safety We are all road users and 1963 plans to cover the extension of training for pedestrians, riders and drivers. The 'Tufty Club' has done exceeding well in its first year, but we must press on a long way to attain our target of ensuring that every child under five is a member. The Child Safety Service will continue its valuable aids for the teaching of school children. There must be further extensions of the National Cycling Proficiency Scheme, the R.A.C./A.C.U. scheme for learner motor cyclists and the various driver training schemes. In April the new Campaign, 'Get Fit for the Road' will be launched. It is the natural successor of Road Training Year. The new campaign will cover mental and physical fitness and the importance of a standard of competence which will ensure fitness to drive. It will also emphasise the necessity for vehicle fitness. To meet the desires of many people concerned with Accident Prevention for a campaign pin-pointing one hazard, the months of July, August and September, will be devoted to a 'TURNING RIGHT' campaign. Many encouraging signs portend that 1963 will be a year of progress for Accident Prevention. There is growing recognition that RoSPA does not seek to wrap up man in cotton wool safe from all harm, but aims to equip him with the necessary aptitude and skill to live, work and play with maximum efficiency in this highly mechanised age. Safety-consciousness daily becomes more fashionable, with the result that the accent on training becomes more pronounced. Cycling Proficiency During the past year, approximately 810 children from various schools within the Borough have been trained and tested for their cycling certificates and badge. This shows a most gratifying increase against a total of 615 for the year 1961. This increase has only been attained with the excellent co-operation afforded me from the Head Teachers and staff of the many schools concerned, for which I am extremely grateful. It is also pleasing to note from National statistics that the 1961 total of 134,746 child cyclists who have been trained, was passed on the 21st November, 1962, when the figure at that time stood at 145,000 Although these figures are most encouraging, it is accepted that this increase must continue until every child who rides a bicycle has been trained incycling and road proficiency, and from statistics, this figure is believed to be 310,000. 30 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. 1961 1962 ACCIDENTS reported 408 390 CASUALTIES, resulting 544 512 FATAL 8 4 SERIOUS 77 66 SLIGHT 459 442 Age Groups 15 years and under 16-50 years of age Over 50 years of age 83 359 102 71 359 82 Classes of Road User involved, 1962 Motor Cars and passengers 193 Motor Cyclists and pillion passengers 104 Scooters, Moped and pillion passengers 56 Pedal Cyclists 81 Pedestrians 78 Total 512 31 HOUSING—MEDICAL APPLICATIONS From 5th January, 1962, to 13th December, 1962, 31 applications with supporting medical certificates were received. There was one re-application but no additional points were recommended. Maximum points were recommended in 8 cases, of which 6 required ground floor accommodation. The medical causes are classified in the following groups:— Nervous Disorder Functional (Anxiety State) 9 The cause of anxiety was general in four cases, unfit for work as housekeeper in one case, overcrowding in two cases, associated with medical conditions in three cases. Organic 0 Illness of Children Recurrent Bronchitis 3 Asthma 1 "Fits" 1 Enteritis 1 Nephritis 1 Tuberculosis 3 Cardiovascular Coronary disease or angina 2 Valvular Disease 1 Hypertension 2 Congenital 1 Hemiplegia 1 Chest Diseases Asthma 2 Crippling Conditions of Limbs Rheumatism 2 Rheumatoid arthritis 1 Osteoarthritis 1 Miscellaneous Perianal abscess 1 Cystitis 1 Ileostomy 1 Though there has been a reduction of 13 in applications there is generally little change in classifications compared with the previous year. 32 REPORT ON THE WORK OF THE PUBLIC HEALTH INSPECTORS FOR THE YEAR 1962 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) 1,564 Number of inspections made for the purpose 2,536 Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 14 Number of inspections made for the purpose 20 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 156 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 156 Number of dwelling-houses in which defects were remedied after service of informal notices 117 Number of dwelling-houses in respect of which formal notices were served requiring defects to be remedied 39 Number of dwelling-houses in which defects were remedied after service of formal notices: (a) by owners 37 (b) by Local Authority in default of owners 1 Number of complaints received 1,243 Number of initial visits 6,804 Number of re-visits 1,931 Nuisances Remedied Structural Defects of properties—External 47 Internal 56 Insanitary conditions other than vermin 3 Verminous conditions 13 Smoke Nuisances 9 Choked drains 388 Other drainage defects 121 Defective sanitary appliances 17 Insufficient or unsuitable water supply 9 Absence of dustbin accommodation 10 Offensive accumulations 8 33 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:— January, 1962 March, 1962 April, 1962 June, 1962 September, 1962 October, 1962 alleged complaint Two dirty milk bottles. Metal in mince pie Mould in ginger beer. Glass in margarine. Mercury in boiled sweet. Maggot on sausage. Mould on wrapped sliced loaf. Mineral oil in bread Mould on puff pastry. Mould on sausages. Insect on wrapped bread. Insect in frozen peas. result Evidence did not warrant instituting legal proceedings Manufacturer fined £25 and £15 15s. costs. Warning letter to Manufacturer. Investigation showed contamination could not have occurred at place of manufacture. A warning letter to Manufacturer. No evidence to prove contamination at place of manufacture. Warning letter to baker. Warning letter to baker. Vendor fined £10 and £5 5s. costs. Vendor fined £10 and £1010s. costs. Baker fined £10 and £3 5s. costs. No evidence to show that contamination occurred at place of preparation. Ice Cream Twenty-one samples of Ice Cream were submitted to chemical analysis during 1961 and all were found to comply with the statutory standard for this product. Seventeen 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 16 1 — — 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. Rent Act, 1957 The details of the administration of this Act were referred to fully in the 1957 Annual Report. Four applications were received for Certificates of Disrepair during the year 1962, bringing the total number of applications to 150 since the Act came into operation in June, 1957. 36 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 1962, 36 applications were received and accounts rendered for £35 8s. During the year, 70 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 1962, 207 bodies were brought to the Mortuary where post-mortem examinations were conducted by a Home Office Pathologist. Twentyfour Inquests were held in the Town Hall. Movable Dwellings Thirteen families occupied movable dwellings under licence from the Council during 1962. Ten inspections of the sites of the caravans were made, and in no instance was a Public Health nuisance discovered. 37 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, 388 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 388 cases discovered, however, 246 related to private drainage, and in these cases a charge is made for the work undertaken. Accounts were rendered for £184 17s. Od. for this work. The Smoke Testing of the house drains of 3 properties was undertaken at the request of owners and accounts were rendered for £6 6s. Od. Infestation by Rats and Mice Six hundred and sixteen complaints were received in 1962 of which 58 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 £102 15s. Od. 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 1962 225 visits were made to shops in the Borough, 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 1962, it was necessary to take action under this Section on two occasions only. 40 41 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 and 1962, 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. 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 Dwellings 2,297 — 2,500 1,890 1,850 2,340 24,088 1971 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 of the operation of each area. 42 METROPOLITAN WATER BOARD—WATER EXAMINATION DEPARTMENT BACTERIOLOGICAL RESULTS—YEARLY AVERAGES 1962 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 58 0.0 1 100.0 — 100.0 — Shortlands No. 2 74 00 1 98.65 — 98.65 — Shortlands No. 3 239 0.0 i 98.58 — 99.58 — West Wickham 175 0.0 142 97.14 0.1 100.0 — Orpington 243 0.2 11 98.77 — 99.59 — 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 1,889 11.5 — 99.79 99.95 Shortlands No. 1 — — — — — Shortlands No. 2 254 0.0 9 100.0 100.0 Shortlands No. 3 — — — — — West Wickham 178 0.0 39 99.44 100.0 Orpington 248 0.5 35 99.60 100.0 43 AVERAGE RESULTS OF THE CHEMICAL EXAMINATION OF WATER SUPPLIED TO THE BOROUGH OF BECKENHAM DURING 1962 Milligrammes per litre (unless otherwise stated) Description of Samples Thames-derived Southern Group Shortlands West Wickham Orpington Number of Samples 156 10 3 4 Ammonia Nitrogen 0 .042 0.013 0.016 0.014 Albuminoid Nitrogen 0 .076 0 .024 0.013 0.020 Oxidised Nitrogen—Nitrite — — — — Oxidised Nitrogen—Nitrate 4.0 4.4 5.2 6.4 Chlorides as Cl 31 18 13 15 Oxygen abs. from Permanganate (4 hrs. at 27°C.) 1.12 0.08 0.06 0.08 Turbidity Units 0.2 — — 0.1 Colour mm. brown 2 ft. Tube (Burgess's Tintometer) 12 — — — Hardness (Total) 265 282 266 286 Hardness (non-carbonate) 58 54 20 34 pH Value 7.8 7.2 7.3 7.2 Phosphate as P04 1.3 — — — Silicate as SiO2 10 — — — Surface active material as Manoxol 0.12 — — Sulphate as S04 61 — — — Natural Fluoride as F 0.25 — — — Magnesium as Mg. 6 — — — Free CO2 — — — — Electrical Conductivity micromhos 550 530 480 520 SECTION F INFECTIOUS DISEASES CONTROL The contacts of two cases of enteric fever admitted to the Lennard Hospital and Hither Green Hospital were investigated and proved clear from infection. The case admitted to Lennard Hospital was due to Salmonella Paratyphoid "B" contracted on holiday either in France or the Costa Brava region of Spain from which she returned by air. The organism was isolated from the faeces and confirmed by Widal 1 in 320 for H and O agglutination of blood. The case admitted to Hither Green Hospital was confirmed as Typhoid Fever by the isolation of Salmonella typhi from the faeces and from three blood cultures. Widal test showed agglutination to Salmonella typhi "H" 1 in 480. Vi agglutination was positive at 1 in 40. Previous history showed that though he had received several courses of TAB from 1941 to 1945 he contracted attacks of unexplained fever in West Africa in 1941 and subsequently in 1950, 1952, 1954, 1957 and 1960. On discharge from hospital his Vi agglutination was less than 1 in 5 after treatment with Chloramphenicol and Penbritin and with the "O" and "H" agglutination confirmed that he would not be a carrier. Enquiries were made by Public Health Inspectors into three incidents reported as due to food poisoning. One incident involved five persons in a household who developed diarrhoea and vomiting 6-12 hours after the consumption of Rock Salmon which had been covered with lemon juice and left to soak before frying. It was not possible by examination to confirm the bacteriological cause of this incident. Confirmation was not possible in the other two incidents one of which occurred during a visit to Egypt and was notified 15 days after onset and the other was notified 8 days after onset. Visits were made to five households in which a case of Sonne Dysentery had been confirmed and a total of 12 contacts were investigated for freedom of infection. Thirteen households from which a case of Scarlet Fever had been notified were visited. All cases were mild and were being nursed at home. Arrangements have continued for the examination of faeces for bact coli serotypes of admissions to St. Hilda's Nursery. Twelve specimens were examined and no bact coli were isolated. One specimen submitted was positive for Shigella Sonnei. 44 45 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 44 41 57 29 2 2 2 2 — — 105 74 179 Scarlet Fever 3 5 2 4 — — — — — — 5 9 14 Whooping Cough 2 5 — 3 — — — — — — 2 8 10 Dysentery 1 — — 1 2 2 — — 1 — 3 3 6 Puerperal Pyrexia — — — — — 13 — — — 12 — 13 13 Pneumonia — — — — 5 4 — — 1 1 5 4 9 Erysipelas — — — 1 1 — — — — 1 1 2 Para Typhoid B — — — — 1 1 — — 1 1 1 1 2 Food Poisoning — — — 1 — 1 — — — — — 2 2 46 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 2 — 3 1 7 64 58 32 8 — 2 2 179 Scarlet Fever — 2 — 1 2 2 2 — — — 5 — 14 Whooping Cough — 1 — 1 5 — 1 1 — 1 — 10 Dysentery — 2 — — — 1 — — — 1 2 — 6 Puerperal Pyrexia 3 — — 4 2 2 1 — — — 1 — 13 Pneumonia 2 — 4 — — 2 1 — — — — — 9 Erysipelas — — — 1 — — 1 — — — — — 2 Para Typhoid B — — — — — — — — 1 — — 1 2 Food Poisoning — — — — — — — — — 1 1 — 2 Totals 7 5 7 8 16 71 64 33 9 3 11 3 237 47 INFECTIOUS DISEASE (3) disease wards* L. Pk. and K.H. C.C. C.H. M.H. E.P. Shortlands W.W. (North) W.W. (South) Measles 10 44 5 6 7 9 30 68 Scarlet Fever 3 3 4 1 1 — 2 — Whooping Cough 3 — — 2 1 3 1 — Dysentery 1 2 1 1 — 1 — — Puerperal Pyrexia 1 — — — 12 — — — Pneumonia — — — 2 2 1 2 2 Erysipelas — — 2 — — — — — Para Typhoid B — — — — — 1 — 1 Food Poisoning 1 — — — — 1 — — Totals 19 49 12 12 23 16 35 71 *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 1962 based on record cards. Year of Birth Diphtheria Immunisation (Singly or in combination) Whooping Cough Immunisation (Singly or in combination) Primary Reinforcing Primary 1962 413 — 413 1961 441 9 440 1960 26 220 26 1959 9 86 7 1958 3 62 2 1953-1957 21 402 14 1948-1952 4 14 3 Total 917 795 905 Age at Date of Vaccination Number Vaccinated Number Re-Vaccinated Under 1 773 — 1 107 9 2 to 4 162 98 5 to 14 591 1,017 15 or Over 1,257 3,202 Total 2,890 4,326 POLIOMYELITIS VACCINATION The following table shows the number of injections given in the various priority groups during the year ended 31st December, 1962. Year 2 Injections (Salk) 3rd Dose (Salk and Oral) 4th Dose (Salk & Oral) 3 Orals (Complete Course) 1962 — 1 — 128 1961 112 396 — 418 1957-1960 63 371 — 70 1943-1956 18 255 463 52 1933-1942 42 302 — 74 Others 52 932 — 123 Total 287 2,257 463 865 48