REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1963 BY L. R. L. EDWARDS, M.D. (Lond.), D.P.H. Medical Officer of Health BOROUGH OF BECKENHAM AC 4412 (1) BEC 30 Library BOROUGH OF BECKENHAM REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1963 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, 1963 Chairman Councillor A. T. Johnson, J.P. Deputy Chairman Councillor M. Williams Alderman T. Boyd Boyd Alderman W. Duncan. Councillor R. E. Baskett. Councillor P. J. Dover. Councillor R. G. Foster. Councillor P. G. Gordon Smith Councillor A. W. Halse. Councillor J. M. Smith. Councillor E. R. Smithers. Councillor F. R. Stevens Councillor Mrs. M. J. Higgins. 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. 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. Pupil Public Health Inspector D. E. Luke (Commenced 16/9/63). Clerical Staff: Shorthand Typist Mrs. E. D. Soars (Resigned 8/3/63). Miss P. C. Spivey (Commenced 29/7/63). Clerks Miss Y. V. Read. Mrs. J. Newman Miss D. C. Reeves (Resigned 13/9/63). Miss L. J. E. Turner (Commenced 16/9/63). Rodent Officer E. J. Read. Rodent OperatorL. G. Hodges. Disinfector—General Assistant M. Hindson Mortuary Attendant—General C. C. Evans. Assistant 3 CONTENTS PAGE INTRODUCTORY LETTER 5 Section A. Vital Statistics Environmental Conditions and Control 8 Summary of Vital Statistics 10 Total Deaths 11 Cancer Deaths, 1959 to 1963 12 Notifications and Deaths from Tuberculosis 13 Infantile Mortality 14 Stillbirths 15 S ection 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 31 Housing—Medical Applications 33 Sections C, D and E. Environmental Services Housing Inspections 34 Nuisances 34 Food and Drugs 35 Unsound Food 37 Ice Cream 37 Rent Act, 1957 37 Disinfection 38 Mortuary 38 Moveable Dwellings 38 Factories Act 1937-1959 39 Water Supply 41 Drainage 41 Rodent Control 41 Shops Act, 1950 41 National Assistance Act, 1948 (Section 50) 41 Smoke Control 42 Water Supply Examination 43 Section F. Infectious Diseases Control Age and Sex Incidence 46 Monthly Prevalence 47 District Distribution 48 Smallpox Vaccination and Whooping Cough and Diphtheria 49 Immunisation 49 Poliomyelitis Vaccination 49 4 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 1963. The year was of particular interest to the Officers because of meetings for joint consultation with the Officers of other authorities about to form the New London Borough. Following these meetings it was possible to prepare for the Joint Committee an informative report on the environmental service and to include this in a larger informative report on the proposed health services in the new Borough. At this stage the only comments are that these meetings showed the wide range of experience that will be possible in the new Borough to trainees and Inspectors and if the problem of size can be measured up to the present, efficient services should be evenly distributed and maintained. In the past twelve years changes of emphasis in environmental health have appeared. Among infectious diseases it was usual to report a large number of cases of poliomyelitis, 33 cases occurred in the epidemic of 1947 and from 1947 to 1957 there were 118 confirmed cases inBeckenham. Whooping Cough was much more prevalent. Nowadays epidemics of diseases such as Mumps and Chickenpox seem much more prevalent and Poliomyelitis occurs not at all. Mass Radiography units now have fixed centres convenient to the Borough and there is a greater emphasis on Chest X-rays for persons over 45 years of age. Hygienic practices in food shops are more apparent and the causes of Food Poisoning are better understood. Smoke Control Areas, Home Safety Campaigns, Old People's Welfare Services, Unsound Food prosecutions, and Improvement Grants feature more prominently in today's annual review. Vital Statistics These statistics are given later in the report in the form of a summary and Tables showing total Deaths, Cancer Deaths and Tuberculosis mortality. The Maternal mortality rate was nil but infant mortality rate showed a slight increase from 15.20 to 16.13. The Birth rate increased from 13.60 to 14.49 and the Death rate decreased from 11.53 to 10.96 reflecting 1,116 live births and 908 deaths during 1963. Satisfactory features of these rates are the reduction of stillbirths from 16 to eight, and of the perinatal mortality rate from 25.42 to 16.01. Other death rates with a decrease were those of Cancer, Pulmonary Tuberculosis, Non-Pulmonary Tuberculosis and the neonatal mortality rate. Of 22 deaths from accidents, 14 were due to motor vehicles; the accident death rate of 0.3 per 1,000 population remained the same as for 1962; there were six deaths from suicide compared with seven in the previous year. Deaths from Cancer of the Lung continue to increase over the past three years by 16 whereas deaths for all forms of Cancer show an increase of only three over the same period. Deaths from Respiratory Tuberculosis decreased by two and the low figure of two deaths is the same as in 1959. The peak ages for notifications of Pulmonary Tuberculosis were at 20 to 35 years and over 55 years. With two exceptions the cases were evenly distributed throughout the wards of the Borough. Old People's Welfare The Abbeyfield Society have continued to provide new homes in the Borough but the project of the Beckenham Old People's Welfare Committee for the provision of flatlets has been held up in the planning stage though it is believed that soon but with fewer flatlets it will be able to proceed. The Beckenham Old People's Welfare Committee and Beckenham Council's project for the first purpose-built combined kitchen and day centre in Beckenham is well advanced and building is likely to start in August 1964. The strenuous efforts of this Committee under virile and imaginative leadership are bearing fruit and it is to be hoped that the competitive efforts of all the Old People's Welfare Committees will be carried harmoniously into the new Borough without any loss of individuality. Voluntary Organisations Many of the organisations which support old peoples welfare work are also interested in many other aspects of social work. The report mentions in particular the Tuberculosis Care Committee and the Women's Voluntary Service. But the many other local organisations who are represented at an annual meeting convened by the North West Kent Council of Social Service and are responsible for various aspects of welfare work for handicapped persons are deserving of great appreciation for their efforts. Home Safety Accident prevention in the house is a particular form of health education which is becoming of increasing importance. The report of the Home Safety Officer refers to the alarming fact that exactly twice as many home accidents as last year were treated at Beckenham Hospital. Most of these were due to cuts, fractures and burns. In connection with burns it is likely that regulations under the Consumer Protection Act will be made which will prevent the sale of inflammable nightwear and prescribe standards and non-flammability tests oi materials to which manufacturers must conform. 6 Health Education Exhibits setting out the scope of the service provided by the Health Department were on show in the " Welcome to Young Citizens" exhibition. This year the exhibits were set out in the various rooms of the Clinic instead of in the main hall as in previous years, and this was found to be a more interesting method of demonstration. A party of final year medical students from Guys Hospital visited the Health Department and were given short talks by Members of the staff before inspecting the Clinic and proceeding to the Council Chamber to view the Civic Insignia. Pollution from Smoke Progress has continued with the development of smoke control areas. In March the Minister confirmed No. 2 Smoke Control Order without modification and a second area of Beckenham became smoke controlled on 1st October, 1963. A survey of the third area is now proceeding and with experience the administrative procedure has been considerably simplified. It is probable that some delay in confirmation of the Order will take place owing to reassessment of the position created by greater use of gas and electricity and temporary shortage of gas coke and approved solid fuels. It is believed that these difficulties will prove quite transient. In conclusion, I wish to thank the Chairman and all Members of the Health Committee for their support and interest throughout the year, and in particular for their help on problems of safe control of food and on improvement of housing standards. My staff have worked with enthusiasm and though a small team they are a happy one, helping each other in illness and accepting new responsibilities with efficiency and zeal. 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 gravelHalf 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 1963 was 23.52 inches. The population has grown from 26,330 in 1901 to 74,834 in the 1951 Census (Estimated population in June 1963 was 77,010). 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 West Wickham, Orpington, Shortlands, and Merton Abbey mixed with River Thames derived filtered water. The wells are in chalk strata and the Shortlands well is 250 feet deep. 8 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 sources is variable but at best is only one quarter of the optimum. 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 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. 9 SUMMARY OF VITAL STATISTICS, 1963 Area of District in acres 5,935 Estimated mid-year population 77,010 Population Density—persons per acre 12.98 Rateable Value at 1st April, 1964 £4,356,431 Number of Inhabited Dwellings 25,345 Product of a Penny Rate (Estimated 1964/65) £17,850 Male Female Live Births 580 536 Total 1,116 Live Birth rate per 1,000 population 14.49 Illegitimate Live Births per cent of total live births (58) 6.00 Male Female Still-births 5 3 Total 8 Still-births rate per 1,000 live and still-births 7.12 Total live and still-births 1,124 Infant Deaths (deaths under 1 year) 18 Total infant deaths per 1,000 total live births 16.13 Legitimate infant deaths per 1,000 legitimate live births 15.12 Illegitimate infant deaths per 1,000 illegitimate live births 34.48 Neonatal Mortality Rate (deaths under 4 weeks per 1,000 total live births) 10.75 Early Neonatal Mortality Rate (deaths under 1 week per 1,000 total live births) 8.96 Perinatal Mortality Rate (Stillbirths and deaths under 1 week combined per 1,000 total live and stillbirths) 16.01 Maternal Mortality (including abortion) 0 Maternal mortality rate per 1,000 live and still-births 0.00 Death Rate per 1,000 population from Cancer (196 deaths) 2.55 Death Rate per 1,000 population from Pulmonary Tuberculosis (2 deaths) 0.03 Death Rate per 1,000 population from Non-Pulmonary Tuberculosis (0 death) 0.00 Death Rate per 1,000 population from Accidents (22 deaths) 0.30 Birth Rate (including Stillbirths) per 1,000 population: Crude 14.60 Corrected (X 1.05) 15.33 Male Female All Deaths Registered .. 425 483 Total 908 Death Rate per 1,000 population Crude 11.79 Corrected (x 0.93) 10.96 Natural Increase : Births exceeded deaths by 208. 10 TOTAL DEATHS, 1963 (Registrar-General's Official Returns). All causes—908. Male, 425 Female, 483 causes of death males females 1. Tuberculosis, respiratory 2 2. Tuberculosis, other — – 3. Syphilitic disease — 1 4. Diphtheria — — 5. Whooping Cough — — 6. Meningococcal infections — 1 7. Acute poliomyelitis — — 8. Measles — — 9. Other infective and parasitic diseases 1 1 10. Malignant neoplasm, stomach 9 9 11. Malignant neoplasm, lung, bronchus 45 12 12. Malignant neoplasm, breast 1 17 13. Malignant neoplasm, uterus — 6 14. Other malignant and lymphatic neoplasms 38 59 15. Leukaemia, aleukaemia 4 6 16. Diabetes 5 2 17. Vascular lesions of nervous system 40 76 18. Coronary disease, angina 116 72 19. Hypertension with heart disease 6 10 20. Other heart disease 29 72 21. Other circulatory disease 21 26 22. Influenza 2 1 23. Pneumonia 34 30 24. Bronchitis 20 14 25. Other diseases of respiratory system 4 3 26. Ulcer of stomach and duodenum 1 2 27. Gastritis, enteritis and diarrhoea 2 6 28. Nephritis and nephrosis 1 2 29. Hyperplasia of prostate 3 — 30. Pregnancy, childbirth, abortion — — 31. Congenital malformations 6 2 32. Other defined and ill-defined diseases 18 42 33. Motor vehicle accidents 10 4 34. All other accidents 5 3 35. Suicide 2 4 36. Homicide and operations of war — — Totals 425 483 11 CANCER DEATHS 1959 1960 1961 1962 1963 Cancer of Lung 49 48 41 50 57 Males 188 Females 57 Total 245 Cancer of Breast 15 19 25 25 18 Males 1 Female 101 Total 102 Cancer of Uterus 10 8 8 10 6 42 Cancer of Stomach 14 24 25 28 18 Males 57 Females 52 Total 109 Other Malignant Neoplasms 98 83 94 86 97 Males 216 Females 242 Total 458 Total Deaths from Cancer 186 182 193 199 196 Males 462 Females 494 Total 956 For comparison, deaths from Respiratory Tuberculosis are shown :— 1959 1960 1961 1962 1963 2 1 1 4 2 Males 8 Females 2 Total 10 13 TUBERCULOSIS—Table of Notifications and Deaths, 1963, 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 17 14 31 1 2 2 3 5 5 3 2 5 3 — 9 4 5 3 — 5 4 1 Non-Pulmonary — 3 3 — — — — 1 — — — 2 — — — 1 2 — — — — — Totals 17 17 34 1 2 2 3 6 5 3 2 7 3 — 9 5 7 3 — 5 4 1 Deaths Pulmonary — 2 2 — — — — — — — — — 2 — — 1 — — — — 1 — Non-Pulmonary — — — — — — — — — — — — — — — — — — — — — — Totals — 2 2 — — — — — — — — — 2 — — 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 INFANT MORTALITY 1963 The number of infant deaths under the age of 12 months for which full records exist was 21, compared with 19 in 1962. The Registrar-General returns 18 deaths and the infant mortality rate for 1963 was 16.13 per 1,000 total live births. There were 8 stillbirths giving a stillbirth rate ot 7.13 compared with 15.06 in 1962. Particulars ot known causes stillbirths are set out. 12 hours or under Under 1 week Under 1 month Under 1 year Total M. F. M. F. M. F. M. F. M. F. Congenital: Brain-Anencephaly 1 — 1 — — — — — 2 — Heart 1 1 — — — — 1 1 2 2 Antenatal: Prematurity 2 1 2 — — — — — 4 1 Natal: Asphyxia Neonatorum 1 — — — — — — — 1 Adrenal Haemorrhage — 1 — — — — — — — 1 Tentorial Haemorrhage — 1 — — — — — — — 1 Postnatal: Pneumonia — — — — — 2 1 1 1 3 Bronchitis — — — — — — 1 — 1 — Inattention at Birth 1 — — — — — — — 1 — Accidental — — — — — — 1 — 1 — Totals 6 4 3 — — 2 4 2 13 8 15 STILLBIRTHS, 1963 Main Causes Sub-Section Male Female Certification by Medical Practitioner Midwife Foetal Abnormality Thoracopagus Anencephaly with 1 - 1 — Spina bifida — 1 — 1 Pre-eclamptic Toxaemia 1 1 2 — Intrauterine death 1 — 1 — Placental infarction — 1 1 — Totals 3 3 5 1 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.I3. Joyce Green Hospital—Dartford, Kent. Lennard Hospital—Bromley Common, Bromley. Leybourne Grange Colony—West Mailing, Kent. Netherne Hospital—Coulsdon, Surrey. Orpington Hospital—Sevenoaks Road, 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. 16 Ambulances. Through Hospital or Beckenham District Office Old People's Homes Red House, Southend Road (Middlesex in Borough. 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, lands (Private). 3, Durham Road (Private). 13, Gwydor Road (Private). 99, Venner Road (Private). Mental Welfare. District Offices, 12, Beckenham Road, Beckenham. General Welfare. District Offices, 12, Beckenham Road, Beckenham. 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. 17 LOCAL CLINIC SERVICES Service Days and Times Premises in Use Ante Natal By Appointment— Mondays and Wednesdays, Maternity Hospital, Stone Park 9—12 noon and 2—3.30 Avenue, Beckenham. p.m. Tuesdays, 9—12.30 p.m. Maternity Hospital, Stone Park Thursdays, 9—12 noon. Avenue, Beckenham. Fridays, 9—10 a.m. Bookings—Tuesdays and Maternity Hospital, Stone Park Thursdays, 2—3 p.m. Avenue, Beckenham. Child Welfare Mondays, 2—4 p.m. Clinic Block, Hawes Lane, West Wickham Tuesdays, 2—4 p.m. (a) Baths Annexe, Beckenham Road (6) Assembly Hall, Gates Green 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 (b) Clinic Block, Hawes Lane, West Wickham Post Natal Every Friday 10 a.m.— 12.30 p.m. By appointment. 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. 18 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) Clinic Block, Town Hall Beckenham. Surgeon in attendance Treatment. The Physiotherapist attends by appointment as follows Monday afternoons Thursday afternoons f J Clinic Block, Town Hall, Beckenham 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 Midwives 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 Cunic Monday and Thursdays, 9-12 noon (by appointment) Clinic Block, Town Hall, Beckenham. Alternate Tuesdays, 9-12 noon (by appointment) Clinic Block, Hawes Lane, West Wickham. 19 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 1963 saw the opening of Kingswood House at Shortlands. This is a new residential establishment provided under Part III of the National Assistance Act, 1948, and caters for elderly people who have a substantial disability. It is a purpose-built home, and in its design the needs of those for whose use it is intended have been borne constantly in mind. The home accommodates 57 residents, both men and women, and is a further contribution towards ensuring that our local people are as far as possible accommodated in their own district. I understand that several Councillors have already visited Kingswood House and the matron is always willing to show it to any others who may be interested. During 1963 there were 121 applications in this district for admission to Old People's Homes. Of these 50 were admitted to suitable homes, either County or voluntary, in four cases the person's condition deteriorated and they were admitted to long-stay hospital care, seven died before admission, and in 21 cases for various reasons the application was subsequently withdrawn. There was also a marked increase in the number of people suffering from mental disorder who were referred to community care, and also a steady increase in the number of requests for various aids for the physically handicapped." REPORT OF HOME HELP ORGANISER My thanks are due to Miss Hocking for the report on this service for the Beckenham and Penge area. "1963 has brought forth a still greater demand for help in the home. Approximately 425 cases per week received assistance and over 600 new cases were given service during the year. Sixteen families were given service under the Family Care Service but no family received help under the Family Welfare Service. One old person was given Evening attention until admission to hospital. All applications for Domestic Help Service should be made to the District Organiser, 12, Beckenham Road, Beckenham." 20 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:— "Statistical details of new patients from Beckenham Borough attending the Chest Clinics during 1963 are given in the attached table. No particular comment upon the figures is called for, as they reflect the pattern of recent years. In the field of Tuberculosis control there appears to be undue complacency in Britain today, and this is an attitude towards the disease that must be challenged assiduously. Some enlightened countries are beginning to talk about eradication of Tuberculosis, but I do not think we can begin to talk about eradication in this country until we have tightened up our methods of control. Adequate co-operation from all sections of the community depends upon all being imbued with a sense of purpose, and this can only be achieved by well directed and persistent propaganda to this end. Complacency may well cause us to lose ground in the fight against this disease, whereas we should be advancing towards a position whence an all-out effort at eradication could be embarked upon. Immigration has introduced a serious problem in certain industrial centres, and may have adverse repercussions on Tuberculosis control. The danger arising out of patients not taking drugs as prescribed is also a problem which still persists." New Cases attending the Chest Clinics for the first time during 1963 Adults Children under 15 years Male Female Male Female Pulmonary Tuberculosis 18 10 — 1 Non-Pulmonary Tuberculosis 5 Non-Tuberculous 73 74 42 36 Non-Tuberculous Tuberculous New Contacts Examined 169 3 B.C.G. Vaccination of contacts : 81. Patients admitted to Hospital or Sanatorium suffering from Tuberculosis during 1963 : 32. 21 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 the year the Beckenham District Tuberculosis Care Committee continued its work amongst the tubercular patients and their families in Beckenham and West Wickham, keeping in close contact with the Health Visitors from the Chest Clinics. Patients who are in need of help have their cases referred to the Committee at its monthly meeting. Any emergency can be dealt with by one of two Liaison Officers who are allowed to spend up to £5. If further help is needed an emergency committee can deal with this. Over £370 was spent on giving 92 grants during the year. These are made up as follows :— Christmas Gifts 29; Free meat issues 22; Fares for families to visit hospitals 18; Electricity bills 3; Coal bills 2; Extra food 2; Holidays 2; Temporary loans 2; Moving expenses 2; Rent for a bed-rest 1; Extra clothing 1; Fees for correspondence course 1; Gas bill 1; Hire purchase debt 1; House decorations 1; One week's rent 1; Wireless licence 1. The Sale at Christmas-time of Seals brought in over £295; this, together with donations and the proceeds of a Jumble Sale, are the main sources of income. A great number of local Organisations have representatives on the Committee, so close co-operation is maintained with other Voluntary Committees. Sometimes help can be obtained from them. On the whole less money was spent during the year, but it is thought that the Committee will be needed for a long time yet." 22 BECKENHAM OLD PEOPLE'S WELFARE SERVICES The various services available for elderly persons can be summarised as :— 1. Meals. 6. Visiting. 2 Clubs for recreation 7. Grants (cash or goods). 3. Chiropody. 8. Parties and entertainment. 4. Outing and holidays. 9. Emergency help. 5. Personal service. 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. Meals are served three times a week from West Wickham and Beckenham. Thirty-five meals are taken out each time from West Wickham and 40 from Beckenham. There are now two Luncheon Clubs, the meals are cooked by W.V.S. and only a nominal charge is made. Thirty-five meals are served by each Club. 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 Is. Od. to Is. 6d. Nevertheless very considerable voluntary help 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 Civil Defence " C " Centre, Croydon Road. (Thursday afternoons) (formerly Assembly Hall). West Wickham over 60's Lecture Hall, Sussex Road. (Monday afternoons) Darby and Joan West Beckenham Hall, Sidney Road. (Tuesday afternoons) Darby and Joan West Beckenham Hall, Sidney Road. (Thursday afternoons) Darby and Joan Azelia Hall, Croydon Road. (Tuesday afternoons) Veterans' Club Azelia Hall, Croydon Road. (Thursday afternoons) 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. The Veterans Club was a community service project of the Rotary Club of Beckenham. 23 Three clubs below provide contacts for specially disabled persons, some of who are elderly :— Social Club for the Blind Azelia Hall, Croydon Road. (Alternate Wednesday afternoons) Samaritan Club for Disabled St. Mary's Church Hall, (1st and 3rd Thursday afternoons) Shortlands. Club for Handicapped People Emmanual Church Hall, (2nd and 4th Friday afternoons) 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, and on Monday and Thursday 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. Outings 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 set up three homes and a fourth will be opened early in 1964. The Beckenham Old People'sWelfare 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 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 three times a week from West Wickham and Beckenham. Thirty-five meals are taken out each time from West Wickham and 40 from Beckenham. 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. West Wickham Luncheon Club There are now two Luncheon Clubs, the meals are cooked by W.V.S. and only a nominal charge is made. Thirty-five meals are served by each Club. 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 were able to send eight away. 27 Hospital Work Work in connection with Beckenham Hospital has been much appreciated and consists of help with the library, flowers and magazines. Members at West Wickham serve teas for the parents of children at Cheyne Hospital. Maternity Work Many baby garments have been knitted and we now have a Guild of Service which will supply help personally to the Matron. This Guild consists of W.V.S. and non-W.V.S. from Beckenham and West Wickham. Members from West Wickham also run a trolley service at the Home. Baby Clinics Helpers are supplied at three of the baby clinics in the Borough and assist on the selling of Welfare Foods, weighing and clerical work. Clothing Depot Good stocks of second-hand clothing are held at West Wickham and Beckenham which are available for the old and sick people in the Borough who come to us with a note from the National Assistance Board, Doctors or Health Visitors. We are also able to help younger people with clothes and mothers with baby clothes. We work in liaison with Prison authorities. Welfare Foods The Centre dispenses National Dried Milk, Orange Juice, Cod Liver Oil and Vitamin tablets. Periodicals for the Forces We send five large parcles of books and magazines each month to our Forces in the Middle and Far East, and West Wickham send 12 smaller parcels a month. 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 seven 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. Civil Defence Eight members of the West Wickham Centre belong to the Food Flying Squad and three from Beckenham. 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 Sub-Committee has supported the National Campaign on general home safety aspects, but particularly on the theme, 'Buy for Safety', this being the opportunity of using the retail outlets to present safety to the public. The retailers must play a vital role in the safety campaign and this particular drive should make managements and employees far more aware of the great need to emphasise safety factors to the customers, not only to ensure that they buy the approved or branded product, but also to see they know how to handle and look after it once the purchase has been made. This buying and selling campaign has continued with ever increasing momentum, via Press, Radio, Television and other media, with the results that now the consumer Protection Act 1961 has been approved, therefore regulations can now be imposed in respect of any prescribed class of goods, to prevent or reduce the risk of death or personal injury, and to ensure by any prescribed warning or instructions. From January to March, 1964, it is proposed to hold a ' Sight Testing' campaign. It is hoped through this campaign to make all people conscious of the appalling rate of eye injuries which occur almost daily. Nearly all home accidents can kill, many non-fatal injuries leave permanent disability, especially burns and scalds and fractures, but tragic though these consequences are, they often seem less serious than the accident which causes eye injury or blindness, so depriving the victim of all or part of the sense of sight. As mentioned in the 1963 annual report, the joint Road/Home safety handbook for the Borough has now been received from the printers, and arrangements made for full publicity of this booklet, through the good services of local Libraries, Clinics, Doctor's Surgeries, W.V.S., and other public spirited organisations. Various Quiz Units and portable displays were shown at many Summer Fetes and Shows, whilst large and small exhibitions were held at Clinics and Schools. A considerable quantity of publicity material was displayed throughout the Borough during the year, particularly on school premises, this with the valued assistance of head teachers and their staff, and members of the Junior Accident Prevention Council. A Road/Home Safety exhibition was one of the features at the Town Hall during the visit of the 'Young Citizens' on the 18th October, 1963. The Local Safety Officer was in attendance, and many interesting questions were asked and various discussions took place among these young men and women. Training equipment and propaganda material was on view, the latter being freely distributed. 29 It is gratifying to note that as a result of these exhibitions, displays, etc., many requests have been made to the Local Safety Officer for lectures on both Road and Home Safety problems to be given to Youth Clubs, Parent Teachers Association, St. John Ambulance, Scouts and Guides, in the latter case, many being required as part of the syllabus for the Duke of Edinburgh's Award. In 1963 Beckenham Hospital recorded 2,158 home accidents of which 759 were children, this compares for 1962 with 1,079 of which 490 were children. It is noted with regret that both the figures for children and adults have increased considerably, but from the record it would appear that cuts, fractures and burns predominate as the causes of home accidents. 30 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 Officer. 'National Road Safety Campaign 1964—'Think Ahead'. The present campaign with its theme 'Get Fit for the Road' will continue until the end of March 1964, when it will be replaced on the 1st April with the new campaign, the theme being 'Think Ahead'. As everyone are road users, the 1964 plans to cover the extension of training for pedestrians, riders and drivers. The 'Tufty Club' which started in December 1961, had caught on like wildfire. Interest in the club was steadily increasing and would show a substantial road safety dividend year by year. 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. Experience has shown that the schemes shown above have been most instrumental in the reduction of road accidents, and in particular those affecting child cyclists. The National Road Safety Campaign, designed and organised by R.o.S.P.A., on behalf of the Ministry of Transport took the form of one theme for the year which was dubbed 'Road Training Year' and as shown above, the slogan commencing on the 1st April will be 'Think Ahead'. The campaign will cover all facets of accident prevention, and in particular those concerned with Physical fitness, competence of driver, drink and the necessity of vehicle fitness. During the campaign and to meet the desires of the many people concerned with Road Safety, certain parts of the campaign year will be devoted to a pin-point event, covering lights on vehicles, crash helmets, turning right and many others. It is hoped by the furtherance of these schemes and ideas, that 1964 will be a year of progress for accident prevention. Safety consciousness daily becomes fashionable, with the result that the accent on training becomes more pronounced. Cycling Proficiency Nowadays, cycling by young people plays a tremendously important part in their development as proficient road users for the futureMany casualties on the highway are caused by ignorance of road laws, incorrect or slip-shod signalling, lack of understanding of the machines being driven, or just plain thoughtlessness. Expert roadmanship calls for a variety of skills that can be learned under the National Cycling Proficiency Scheme. From April 1963 to date, approximately 722 children from various schools within the Borough, have been trained and tested for their certificate and badge. 31 This figure is slightly below the same period for 1962, due to the extreme weather conditions in the early months of the year. Although in many cases class-rooms were made available where lectures could be given, proper training had to wait until the weather conditions could enable the children to have practical training in the school playgrounds. The figures above were only attained through the excellent co-operation afforded me by the Head Teachers and their staff of the schools concerned, for which I extremely grateful. General (a) Many Junior and Infant schools were visited prior to the Christmas holidays, lectures and demonstrations given, whilst a considerable amount of propoganda material, in the form of games, painting books puzzles, etc., were distributed to the children. (b) The 'Tufty Club' at the West Wickham Clinic, has now a membership of 160 children, all under the age of five years. Great assistance and co-operation has been given to the Local Safety Officer by the Clinic Staff and parents of these young children in the preparation of demonstrations. (c) The new Road/Home Safety handbook for the Borough has now been received from the printers, and arrangements made for the full distribution of this excellent booklet, through the good offices of the W.V.S., Schools, Libraries, Clinics, and other public services. (d) Series of lectures on Road and Home Safety have been given by the Local Safety Officer to Youth Clubs, St. John Ambulance, Rangers etc., during the past few weeks. Many of these lectures and demonstrations are needed as part of the syllabus required to qualify for the Duke of Edinburgh's Award. 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. 1962 1963 ACCIDENTS reported 390 400 CASUALTIES, resulting 512 504 FATAL 4 13 SERIOUS 66 76 Age Groups 15 years and under 71 88 16-50 years of age 359 321 Over 50 years of age 82 95 Classes of Road User involved, 1963 Motor Cars and passengers 197 Motor Cyclists and pillion passengers Scooters, Moped and pillion passengers Pedal Cyclists 90 Pedestrians 78 Total 504 32 HOUSING—MEDICAL APPLICATIONS From 16th January, 1963, to 20th December, 1963, 47 applications with supporting medical certificates were received. Six re-applications were received and additional points were recommended in one case. Maximum points were recommended in 14 cases of which 11 required ground floor accommodation. The medical causes are classified in the following groups :— Nervous Disorder Anxiety State 14 Psychosis Depression 6 Threatened Suicide 1 Illness of Children 8 Tuberculosis 2 Crippling Conditions Rheumatoid arthritis 3 Back Strain 1 Chest Diseases Asthma 3 Bronchitis 3 Cardiovascular Aortic incompetence 1 Hemiplegia 1 Hypertension 1 Angina 1 Chronic Cardiac Failure 1 Miscellaneous Anal fissure 1 Chronic renal failure 1 Congenital paralysis bladder 1 Diabetes Gastrectomy 1 Nephrectomy 1 33 REPORT ON THE WORK OF THE PUBLIC HEALTH INSPECTORS FOR THE YEAR 1963 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) 1,447 Number of inspections made for the purpose 2,552 Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 20 Number of inspections made for the purpose .. 26 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 131 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 131 Number of dwelling-houses in which defects were remedied after service of informal notices 92 Number of dwelling-houses in respect of which formal notices were served requiring defects to be remedied 42 Number of dwelling-houses in which defects were remedied after service of formal notices : (a) by owners 41 (b) by Local Authority in default of owners .. 0 Number of complaints received 1,507 Number of initial visits 7,507 Number of re-visits 3,044 Nuisances Remedied Structural Defects of properties—External 74 Internal Insanitary conditions other than vermin Verminous conditions 6 Smoke Nuisances 12 Choked drains 495 Other drainage defects 145 Defective sanitary appliances 36 Insufficient or unsuitable water supply Absence of dustbin accommodation Offensive accumulations 15 34 Food and Drugs Sampling Two hundred and fifty samples of food and drugs were submitted to the Public Analyst. Details are appended:— article formal informal Anchovies — 1 Almonds, Ground 2 2 Bicarbonate of Soda — 1 Bronchial Elixir — 1 Butter 1 3 Butter Sweets — 1 Cabbage in Vinegar — 1 Celery Salt — 1 Cheese — 3 Cheese Spread — 3 Cheese, with Beer — 1 Cherries, Glace — Chicken Paste — 1 Chutney — 1 Cochineal Food Colour — 1 Cods Roe — 1 Coffee — Corned Beef — Crab, Dressed — 1 Cream — 3 Cream Cakes 4 Flour, Self Raising — 1 Fruit Salad — 1 Game Soup — 1 Gin 4 — Honey — 1 Ice Cream — Jam — 3 Lemon Curd — 1 Lemon Juice — 1 Loganberries, (Tinned) — 1 Margarine — 1 Mayonnaise — 1 Marmalade — 4 Meat, Pork Luncheon — 4 Mentholated Balsam — 1 Milk, Pasteurised 21 7 Milk, T.T. Pasteurised 12 — Milk, Channel Islands 18 — Milk, Sterilised 12 — Milk, T.T. Attested 18 — Mincemeat — 2 Minced Steak 2 Mushrooms, Tinned — 1 Mustard — 1 Noodles, with egg — 1 Olive Oil — 1 Orange Juice — Orange Squash — 1 Pheasant Savoury — 1 Piccalilli — 1 Pickle 1 Potted Beef 1 Prawns 1 Raspberry Syrup — 1 Sago Pudding (Tinned) — 1 35 article formal informal Salad (Tinned) 1 Salmon Spread — 1 Sauce — 4 Sausages 40 4 Sherry 1 — Sild — 1 Sliced Beetroot — 1 Steak and Kidney Pudding — 2 Sweet Corn — 1 Tartare Sauce — 1 Tea — 2 Tomatoes (Tinned) — 1 Tuna Fish — 2 Turkey Paste — 1 Vinegar 1 1 Whisky 2 — Yoghourt — 1 Two samples of sausages, both obtained from the same ButchcManufacturer, were found to be adulterated, in that the meat conteru was considerably below 65 per cent, which is regarded as a reasonable minimum standard. Legal proceedings were instituted against the Butcher-Manufacturer, who was fined £5 with £31 10s. costs. 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 adequacy of heat treatment. In 1963 113 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. 36 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 April, 1963 Foreign matter in Bread. Legal proceedings instituted against Baker-Retailer. Fined £10 and £5 5s. costs. Mould on Bread. Legal proceedings instituted against Retailer. Fined £15 and £7 7s costs. May, 1963 Mould on wrapped meat pie. Warning letter to Retailer. July, 1963 Mould on Sausages. Legal proceedings instituted against Retailer. Fined £10 and £4 4s. costs. September, 1963 Mould on Bread. Legal proceedings instituted against Retailer. Fined £25 and £10 10s. costs. November, 1963 Foreign matter in Bread. Warning letter to Baker. Foreign matter in Bread. Circumstances not considered to warrant any formal action. Dirty milk bottle. Circumstances not considered to warrant any formal action. Cake contaminated with insects. No evidence that contamination occurred whilst cake was in the Vendor's possession. Ice Cream Eight samples of Ice Cream were submitted to chemical analysis (luring 1963 and all were found to comply with the statutory standard for this product. Sixty-two 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 50 12 — — 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. Two applications were received for Certificates of Disrepair during the year 1963, bringing the total number of applications to 152 since the Act came into operation in June, 1957. 37 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 1963, 26 applications were received and accounts rendered for £36 18s. During the year, 125 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 1963, 218 bodies were brought to the Mortuary where post-mortem examinations were conducted by a Home Office Pathologist. Twenty-five Inquests were held in the Town Hall. Movable Dwellings Thirteen families occupied movable dwellings under licence from the Council during 1963. Six inspections of the sites of the caravans were made, and in no instance was a Public Health nuisance discovered. 38 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 Number on Register Number of Inspections Written Notices Occupiers prosecuted (1) (2) (3) (4) (5) (i) Factories in which Sections 1, 2,3,4 and 6 are to be enforced by Local Authorities 17 1 __ (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 163 204 (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) - - - - 39 2.—Cases in which DEFECTS were found. Number of cases in which defects were found Number of cases in which prosecutions were instituted Particulars Referred Found Remedied FromH.M. Inspector To H.M. Inspector (1) (2) (3) (4) (5) (6) Want of cleanliness (S.l.) 1 1 - - — 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 2 2 1 Nil Nil (b) Unsuitable or defective 9 9 — — — (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 12 12 1 — - Part VIII of the Act Outwork (Sections 110 and 111) Section 110 Section 111 Nature of Work (1) Number of outworkers in August list required by Section 110(1) (c) (2) Number of cases of default in sending lists to the Council (3) Number of prosecutions for failure to supply lists (4) Number of instances of work in unwholesome premises (5) Notices served (6) Prosecutions (7) Wearing apparel, making, etc. 33 — 40 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, 495 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 495 cases discovered, however, 366 related to private drainage, and in these cases a charge is made for the work undertaken. Accounts were rendered for £311 1s. 0d. for this work. Infestation by Rats and Mice Six hundred and three complaints were received in 1963 of which 52 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 £74 8s. 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 1963 221 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 1963, it was necessary to take action under this Section on three occasions only. 41 42 CLEAN AIR ACT, 1956 SMOKE CONTROL AREAS The Beckenham Smoke Control Order, 1960, embracing 2,297 properties has been in force since 1st November 1961. The Beckenham (No. 2) Smoke Control Order, 1962, covering a further 2,500 properties came into operation, on the 1st October, 1963. During 1963 the detailed survey of the proposed third area was completed. 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. BOROUGH OF BECKENHAM 43 METROPOLITAN WATER BOARD—WATER EXAMINATION DEPARTMENT BACTERIOLOGICAL RESULTS—YEARLY AVERAGES 1963 I am grateful to Dr. E. Windle Taylor, Director of Water Examination for the following tables:— BEFORE TREATMENT Source of Supply 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 South of River - - - - - - - Shortlands No. 1 well 44 00 13 1000 -_ 1000 - Shortlands No. 2 well 79 00 1 1000 - 100.0 - Shortlands No. 3 well 241 01 3 1000 1000 West Wickham well 235 01 16 9715 - 99-57 - Orpington well 232 00 14 98-71 100-0 Source of Supply AFTER TREATMENT Number of Samples Agar plate count per ml. Coliform count Per cent Samples negative in 100 ml. Escherichia coli count Per cent Samples negative in 100 ml. 20-24 hours at 37°C. 3 days at 22°C. Thames-derived South of River 1,873 12.5 99.41 99.47 Shortlands No. 1 well - - - - - Shortlands No. 2 well 253 0.7 99.21 99.21 Shortlands No. 3 well - West Wickham well 239 0.0 14 100.0 100.0 Orpington well 237 1.7 97 99.58 j 99.58 44 AVERAGE RESULTS OF THE CHEMICAL EXAMINATION OF WATER SUPPLIED TO THE BOROUGH OF BECKENHAM DURING 1963 Milligrammes per litre (unless otherwise stated) Description of Sample Thames derived South of River Shortlands West Wickham Orpington Merton Abbey Number of Samples 156 11 4 4 2 Ammoniacal Nitrogen 0.20 0012 0013 0014 0140 Albuminoid Nitrogen 0 079 0016 0 022 0 022 0 020 Nitrate Nitrogen 3.8 4.4 4.2 5.8 01 Chloride as CI. 32 17 13 16 15 Oxygen abs. from KMnO, 4 hrs. at 27°C 118 004 004 004 016 Turbidity units 0.3 Nil Nil Nil 0.6 Colour (Burgess) scale 10 Nil Nil Nil 10 Hardness (total) 266 288 266 282 236 Hardness (non.carbonate) 66 62 22 34 8 pH value 7.8 7.2 7.2 7.1 7.3 Phosphate as P04 1.3 — — — — Silicate as Si02 11 — — — — Sulphate as S04 62 — — — — Magnesium as Mg 5 — — — — Natural Fluoride as F. 0.25 — — — — Free CO, .. — — — — — Surface.active material as Manoxol OT. 008 — — — — B.O.D. 5 days at 20°C. — — — — — Sodium as Na. 25 12.0 8.0 10.0 12.0 Potassium as K. 5.2 1.8 1.2 1.7 4.8 Electrical Conductivity (micromhos) 550 520 460 510 440 SECTION F INFECTIOUS DISEASES CONTROL Enquiries were made into a complaint by a resident of Food Poisoning from eating mussels purchased in Heme Bay. Samples of the mussels and of faeces from the patient were submitted for bacteriological examination and in both instances the results were negative. The mussels had been obtained originally from a Danish Company and had been bottled by the shopkeeper. The shop was inspected and found satisfactory and there was no illness among staff, neither had other cases been notified. Appreciation was expressed by the Health Department at Heme Bay for the liaison between the two Departments. In another instance Food Poisoning was probably due to a soup which had been prepared from an oven-ready chicken. The soup had been kept in the refrigerator over the weekend and then reheated on two occasions the following week. Faeces examination of the household were negative. A member of the household was withdrawn from food handling as a member of the domestic staff of a local hospital. In two other enquiries investigations revealed no definite cause. In 7 out of 11 cases of Sonnie Dysentery notified faeces examinations were positive. Faeces for contacts of other members of the families were examined and in six cases were found to be positive. Five cases of Meningococcal Infection were notified but in two cases the diagnosis was not confirmed. Seventeen cases of Scarlet Fever were notified compared with 14 cases last year. Sixteen cases were nursed at home. Permission was given for a parent to continue his work as a warehouseman in a food company, a kitchen assistant at a private school was excluded from work for a week. Surveillance of air passengers not in possession of a certificate of vaccination against Smallpox and arriving from declared Smallpox areas was carried out and three addresses were visited in one instance the new address of a contact was forwarded to the Authority. 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. VIeasles 245 248 249 209 6 5 3 3 2 503 465 968 Scarlet Fever 5 1 5 4 1 1 — — 1 11 6 17 Whooping Cough 6 5 5 8 1 1 — — — 12 14 26 Dysentery 5 5 1 1 1 3 — i 2 7 9 16 Meningococcal Infection 1 — 2 — 2 — — 5 — 5 — 5 Puerperal Pyrexia — — — — — 1 1 — 2 — 2 2 Pneumonia 1 1 2 2 6 6 — 3 4 9 9 18 Erysipelas — — — — 1 2 — — — 1 2 3 Food Poisoning 1 — — 1 2 — — — 2 2 4 Ophthalmia Neonatorum 1 2 1 1 1 3 4 47 INFECTIOUS DISEASE (2) The following Table gives the number of cases notified during the year. disease jan. feb. mar. apr. may june july auo. sept. oct. nov. dec. total Measles 52 205 245 140 109 111 56 45 3 2 968 Scarlet Fever 1 1 1 3 3 2 1 1 3 1 17 26 Whooping Cough 1 1 1 1 3 3 5 3 3 2 3 - Dysentery — 4 — 1 1 7 2 1 16 5 Meningococcal Infection _ 3 - - - - 2 - - - - - Puerperal Pyrexia 2 _ - - - - - - - - - - 2 Pneumonia — 9 1 1 — 1 1 3 - 2 18 Erysipelas — — — 1 — — 2 3 Food Poisoning — 1 — — — — 1 2 4 Ophthalmia Neonatorum 1 — 2 - — — — 1 — — — — 4 Totals 57 224 250 147 116 122 69 53 7 8 4 6 1063 48 INFECTIOUS DISEASE (3) disease L. Pk. and K.H. C.C. C.H. wards* M.H. E.P. Shortlands W.W. (North) W.W. (South) Measles 159 98 151 217 143 84 44 72 Scarlet Fever 4 2 2 1 2 2 1 3 Whooping Cough 4 6 1 2 4 2 2 5 Dysentery 3 5 4 — — — 1 3 Meningococcal Infection — — 2 1 2 — — — Puerperal Pyrexia — — — — 2 — — — Pneumonia 3 1 — 2 3 3 1 5 Erysipelas — 1 1 1 — — — — Food Poisoning 1 2 — — 1 — — — Ophthalmia Neonatorum 3 1 Totals 177 115 161 224 158 91 49 88 *L. Pk. and K.H.—Lawrie Park and Kent House. M.H.—Manor House. C.C.—Copers Cope. C.H.—Qock 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 1963 based on record cards. Year of Birth Diphtheria Immunisation (Singly or in combination) Whooping Cough Immunisation (Singly or in combination) Primary Reinforcing Primary 1963 443 443 1962 422 43 419 1961 26 314 26 1960 1 99 1 1959 3 64 3 1954-1958 4 482 1 1949-1953 15 — Total 899 1,017 893 Primary Vaccination 1 year Re-Vaccination School Age under 8 years 232 — POLIOMYELITIS VACCINATION The following table shows the number of injections given in the various priority groups during the year ended 31st December, 1963. Year 2 Injections (Salk) 3rd Dose (Salk and Oral) 4th Dose (Salk & Oral) 3 Orals (Complete Course) 605 1963 195 1962 7 27 620 1961 3 99 74 1957-1960 1 21 32 1943-1956 33 31 1933-1942 1 25 33 Others 1 72 — 57 Total 13 277 605 1042 49