BED 18 BOROUGH OF BEDDINGTON & WALLINGTON ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the YEAR 1953 BOROUGH OF BEDDINGTON & WALLINGTON ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the YEAR 1953 TABLE OF CONTENTS Public Health Committee 5 Representatives on Mid-Eastern Divisional Health Sub-committee 5 Representatives on the Wandle Valley Joint Sewerage Board 5 Staff 6 Statistics and Social Conditions 11 Extracts from Vital Statistics 12 Vital Statistics: Comparative Birth-rates, Death-rates, Analysis of Mortality, etc., 1953 13 Registered Causes of Death 14 Violence and Accident 15 Maternal Mortality 15 Infantile Mortality 15 General Provision of Health Services for the Area: Laboratory Facilities 17 Ambulance Facilities 17 Nursing in the Home 17 Treatment Centres and Clinics: Care of Mothers and Young Children 18 Tuberculosis 18 Immunisation against Diphtheria 19 Immunisation against Whooping Cough 19 School Clinics 19 Venereal Diseases Clinics 20 Cleansing of Persons 20 Hospitals 20 Disinfection 21 Sanitary Circumstances of the Area: Water Supplies 21 Drainage and Sewerage 21 Rivers and Streams 22 Closet Accommodation 22 Public Cleansing 22 3 Report of the Chief Sanitary Inspector for the Year 1953: Housing 23 Milk and Dairies 23 Ice Cream 24 Slaughterhouses 24 Food Premises 24 Unsound Food 25 Food and Drugs Act, 1938 26 Factories 27 Bakehouses 29 Workplaces, Shops and Offices 29 Complaints 30 Smoke Abatement 30 Infectious Disease and Disinfection 30 Offensive Trades 30 Rats and Mice 30 Notices 31 Sanitary Improvements 31 Summary of work done during the year 32 Swimming Bath 33 Schools 33 Outbreaks of Food Poisoning and Clean Food Campaign 34 Nutrition 34 Shell Fish (Molluscan) 34 Adoptive Acts and Bye-Laws 35 Prevalence and Control over Infectious and other Diseases: Notifiable Diseases (other than Tuberculosis) 36 Incidence of Infectious Diseases in Age Groups and Wards 37 Monthly Incidence of Infectious Disease 38 Tuberculosis 39 Transferred Functions under the National Health Service Act, 1946: The Care of Mothers and Young Children 41 Ante-natal and Post-natal Supervision 41 Infant Welfare Services 41 Institutional Confinements 41 Domestic Help Service 41 Treatment: Minor Ailments 42 Dental 42 Orthopaedic 42 Physiotherapy 43 Health Visiting 43 Child Life Protection 43 Care of Premature Infants 44 Care of Illegitimate Children 44 4 BOROUGH OF BEDDINGTON AND WALLINGTON PUBLIC HEALTH COMMITEE December, 1953 Members: Councillor A. Stammers (Chairman) Councillor H. Rennison (Mayor) Councillor D. H. de Voil. (Deputy Mayor) Councillor Mrs. V. M. Boyce Councillor Miss K. C. Bratt Councillor G. H. Hyett, O.B.E. Councillor W. F. N. Joynes Councillor F. G. Lee Councillor S. G. Reading Councillor Miss R. M Smith Councillor V. M. H. St. J. Todd REPRESENTATIVES ON MID-EASTERN DIVISIONAL HEALTH SUB-COMMITTEE December, 1953 Members: Councillor Mrs. V. M. Boyce (Chairman) Councillor Miss K. C. Bratt Councillor D. H. de Voil Councillor G. H. Hyett, O.B.E. Councillor A. Stammers REPRESENTATIVES ON THE WANDLE VALLEY JOINT SEWERAGE BOARD December, 1953 Members: Councillor H. Rennison (Mayor) Alderman J. Vale Councillor A. H. Pearce Councillor A. H. Prior 5 STAFF OF PUBLIC HEALTH DEPARTMENT Medical Officer of Health: Patrick J. O'Connell, M.D., B.S., D.P.H., B.Hy. Chief Sanitary Inspector: F. H. Lennard, A.M.I.S.E., M.R.S.I., M.S.I.A. (Resigned 30.9.53) (a.b.c.) H. G. Cripps, M.S.I A. (Commenced 1.10.53) Additional Sanitary Inspectors: A. F. Leaney, M.R.S.I. (Resigned 28.2.5j) (a.b.) A. J. Hattersley, M.S.I.A. (a.b.) E. C. Gforge, A.R.San.I., M.S.I.A. (Commenced 1.4.53) (a) Sanitary Inspector's Certificate (R.S.I. & S.I.E.J. Board). (b) Meat and Other Foods Certificate (R.S.I.) (c) Smoke Certificate (R.S.I.) Clerks: R. F. Burns (Chief Clerk) E. D. Evezard B. E. Bignall K. I. Payne (Resigned 20.6.53) C. I. Phillips (Commenced 10.8.53) STAFF EMPLOYED BY THE SURREY COUNTY COUNCIL IN THE BEDDINGTON AND WALLINGTON HALF OF THE MID-EASTERN DIVISION OF THE COUNTY Divisional Medical Officer and Medical Officer to the Divisional Executive for Education: Patrick J. O'Connell, M.D., B.S., D.P.H., B.Hy. Assistant Clinical Medical Officers: Margaret G. Falla, M.B., Ch.B. Ann T. Harling, M.R.C.S., L.R.C.P. Mauhien Adams, M.B , B.S., M.R.C.S., L.RC.P. Health Visitors: Mrs. V. Beatt, S.R.N., S.C.M., R.F.N., H.V.Cert. (Commenced 16.9.53) Mrs. M. N. Chenery, S.R.N., S.C.M., H.V.Cert. Miss E. O. Ellis, S.R.N., S.C.M., R.F.N., H.V.Cert. (Resigned 31.1.53) Miss N. M. Lines, S.R.N., S.C.M., H.V.Cert. Mrs. M. Maynard, S.R.N., S.C.M., R.F.N., H.V.Cert. Miss A. Murphy, S.R.N., S.C.M., H.V.Cert. (Commenced 22.1.53, Resigned 12.9.53) Physiotherapists: Miss G. Allen, M.C.S.P. (Part-time) Mrs. H. M. Henn, M.C.S.P. (Part-time) Assistant to Physiotherapists: Miss D. V. Raymond Administrative Assistant: R. F. Burns Clerks: E. D. Evezard Miss J. D. Boorman Home Help Supervisor: Mrs. H. M. Long (Part-time) (Commenced 7.9.53) 6 Public Health Department, Town Hall, Wallington. To the Worshipful the Mayor, Aldermen and Councillors of the Borough of Beddington and Wallington. Ladies and Gentlemen, I have the honour to present my annual report for 1953. The report is drawn up in accordance with the suggestions made by the Minister of Health in his Circulars 1/54 and 42/51. The vital statistics are based on information supplied by the Registrar-General. The presentation follows that adopted for the previous four years, and those services which are under the control of the Surrey County Council, the Local Health Authority under the National Health Service Act, 1946, are reported upon in a brief statistical statement appended to the report. The services dealt with in this addendum are: Care of Mothers and Young Children; Health Visiting; Home Nursing; Vaccination and Immunisation; Ambulance Services; Prevention of Illness, Care and After-Care; and Domestic Help. The Registrar-General's estimate of the population of Beddington and Wallington at mid-year 1953 is 32,510, and this figure is used in the compilation of the vital statistics. It will be noted that the population is exactly the same as that estimated by the Registrar-General for mid-year 1952. The census of population taken in 1951 was 32,751. The birth rate per 1,000 total population shows an increase at 12.65 in 1953, as compared with 10.74 in 1952. This rate is below that for England and Wales, which is 15.5. The stillbirth rate of 0.12 per 1,000 total population is similar to that recorded in 1952. The corresponding figure for England and Wales is 0.35. Expressed as a rate per 1,000 total births, the stillbirth rate is 10-20. In 1952 this rate was 10.99. The number of children stillborn in the district was 4, out of a total of 392 births. This figure is commendably low, but stillbirths will continue to occur, as in many cases they are inevitable, and they take place in spite of everything the maternity and ante-natal services can do. 7 The death rate from all causes per 1,000 total population is 9.23, compared with 11.01 in 1952 and 11.4 for England and Wales. Of the 337 deaths, diseases of the heart and circulatory system accounted for 106 (31.45 per cent. of total deaths), cancer 64 (18.99 per cent. of total deaths), and tuberculosis 8 (2.37 per cent. of total deaths). The birth rate has shown a considerable increase in 1953, while the death rate has fallen by a comparable degree. The recorded figures show an excess of births over deaths of 55. This is a very good record when it is recollected that in 1952 deaths exceeded births by 25. Diseases of the heart and circulatory system still account for a very high percentage of total deaths, while deaths due to cancer appears to be on the increase. The average age at death continues to be relatively high. The number of deaths from coronary disease again shows an increase. This is in accordance with statistical observations made throughout the country generally. Deaths from accidents, including motor vehicle accidents, are notably low, and it is gratifying to record that this year deaths from violence have decreased from 14 in 1952 to 6 The fog conditions, which prevailed at the end of 1952, and which accounted for a considerable increase in deaths of old persons from respiratory disease, were not repeated in 1953, and probably this accounts, in part, for the considerable reduction in the death rate. The maternal mortality rate per 1,000 total births is Nil, as compared with 0.67 for England and Wales. This nil return continues the record, which had been noted in the five years previous to 1952. Considerable thought and care are given to the arrangements by which mothers can be assured of safer childbirth, and the fact that no maternal deaths took place in 1953 again reflects great credit upon all the services engaged in midwifery in the district. The infantile mortality rate again shows a considerable decrease, at 12.89 per 1,000 live births. Only five infants died under the age of 1 year in 1953, out of 388 live births. On page 16 will be found an analysis of the causes of death. It will be seen that the causes of death in these infants were for the most part congenital defects, which could not be remedied. Work on behalf of old people, in an ever-ageing population, continued to occupy the attention of both voluntary services and Public Health staff throughout the year. The Home Help Service continued to relieve the lot of old people living in straitened circumstances, who were unable to look after themselves and unable to obtain domestic help. The Wallington Old People's Welfare Committee, under the Chairmanship of Councillor Mrs. V. M. Boyce, continued their good social work for the old people, and the ladies of the W.V.S., under the able guidance of Mrs. O. L. Wiles, were in constant support of all efforts undertaken for the care of the aged. 8 No new schemes for old people's welfare were introduced during the year. The impression was gained that more old people without relatives were living under conditions of considerable hardship, with inadequate meals and home conditions in many cases sinking to a very low level of sanitation. The total number of notified cases of infectious disease rose considerably during the year, and was actually more than twice the number recorded in 1952. The principal infectious diseases showing a marked increase were measles and whooping-cough, the incidence being highest amongst school children. Scarlet fever reached a very low level, and four cases of poliomyelitis were notified. More parents availed themselves of the immunisation service, and considerable appreciation is shown of the new combined immunising material which protects against whooping-cough as well as diphtheria. This may account in part for the low attack rate of whooping-cough amongst young infants, most of the cases being amongst school children, who have not had the benefit, in earlier years, of whooping-cough immunisation. While there were a great many cases of measles, the disease does not appear to have been of a very severe type, and admissions to hospital were few, only 9 out of a total of 455 cases notified. It is also gratifying to note that there were no deaths from any of these zymotic diseases of childhood. While there were no cases of poliomyelitis in 1952, four cases occurred in 1953, the number of cases recorded for the whole of the country being higher this year than in the previous year. The age incidence of attack is interesting, as only one of the 4 cases was a child below school age. Fortunately, permanent disability was recorded in only one of the cases. Research work to find a vaccine has continued unabatedly, both in this country and in America, during the whole year. The discovery of a method of growing the virus has made this work possible, and great hopes are entertained for the ultimate discovery of some means of immunising the population, at least during the most susceptible years and in times of epidemic. In the meantime, the disease continues to show a slight increase annually, and, what is more disturbing, an increasing attack rate for the higher age-groups. No longer can the name " infantile paralysis " be regarded as a true description of the disease. All persons, health visitors, doctors, nurses and others coming in contact with children in the district, have been struck by the increasing standards of good general health and high average nutrition. The Corporation can be congratulated on having completed another year in which excellent health was enjoyed by the majority of the population, particularly children. 9 During 1953, the swimming bath at Beddington Orphanage (now the Carew Manor School) continued to provide facilities for residents in the Borough, under similar administrative arrangements to those which previously obtained. The Surrey County Council, into whose hands the Orphanage has now passed, were very helpful in continuing the arrangements by which the Corporation are allowed to make use of the bath in the summer months. In conclusion, I wish to place on record my appreciation of the loyal service and valuable assistance I have received from all the members of my staff throughout the year. I am, Ladies and Gentlemen, Your obedient servant, PATRICK J. O'CONNELL, July, 1954. Medical Officer of Health. 10 STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (in acres) 3,048 Population, census, 1931 26,249 Population, census, 1951 32,751 Registrar-General's estimate of resident population for 1953 32,510 Number of inhabited houses, 1931 7,092 Number of inhabited houses, 1953 9,705 Rateable Value, December, 1953 £414,385 Sum represented by penny rate, December, 1953 £1,665 The Urban District of Beddington and Wallington was constituted in 1915 by an Order of the Surrey County Council, the area up to that time being part of the Croydon Rural District. By an Order in Council, dated 20th August, 1937, H.M. King George VI granted a charter to Beddington and Wallington, which was presented on the 15th September, 1937, by the Lord Lieutenant of the County of Surrey. The Borough is bounded on the east by the County Borough of Croydon, to the north by the Borough of Mitcham, to the west by the Carshalton Urban District, and to the south by the Urban District of Coulsdon and Purley. The maintenance of parks and open spaces throughout the district continues to lend a very pleasing atmosphere. The demand for recreational facilities for school children, youth organisations and industrial sports clubs, continues to be met. During the year the district was very fortunate in being able to meet the needs of both young and old. During the summer months, Beddington Park and Grange Park have proved an inestimable boon to parents and children alike, and during August hundreds of children, both from Beddington and Wallington and neighbouring districts, whose parents are unable to take them away for holidays, spend many happy hours of healthful relaxation in these delightful open spaces. The Council's housing and development policy is also improving many parts of the district. For the most part, the district retains its good residential /character, and provides a pleasant dormitory for many city workers. The Public Health Department continued to administer, as in previous years, the swimming facilities provided by the Corporation, through the courtesy of the Surrey County Council, at the Beddington Orphanage bath. 11 EXTRACTS FROM VITAL STATISTICS Total M F. Birth Rate per 1,000 of the estimated resident population Live Births—Legitimate 377 197 180 11.93 (Crude) „ „ Illegitimate 11 6 5 12.65 (Corrected) Total 388 203 185 Rate per 1,000 total (live and still) births Still Births 4 4 10.20 Death Rate per 1,000 of the estimated resident population Deaths 337 145 192 10.37 (Crude) 9.23 (Corrected) Rate per 1,000 (live and still births Deaths attributable to: Pregnancy, Childbirth, Abortion, rate per 1,000 live and still births Nil Death Rate of Infants under one year of age: All Infants per 1,000 live births 12.89 Legitimate Infants per 1,000 legitimate live births 13.26 Illegitimate Infants per 1,000 illegitimate live births Nil Deaths from Cancer (all ages) 64 Deaths from Measles (all ages) Nil Deaths from Whooping Cough (all ages) Nil Deaths from Diarrhoea, etc. (under two years of age) 1 12 Comparative birth rates, civilian death rates, analysis of mortality, maternal mortality and case rates for certain infectious diseases in the year 1953: England and Wales. 160 County Boroughs and Great Towns including London. 160 Smaller Towns (Resident Populations 25,000 to 50,000 at 1951 Census). London Administrative County. Borough of Beddington and Wallington. Births— Rates per 1,000 Population. Live 15.5 17.0 15.7 17.5 12.65 Still 0.35 0.43 0.34 0.38 0.12 Deaths— All Causes 11.4 12.2 11.3 12.5 9.23 Typhoid and Paratyphoid Fevers 0.00 0.00 – – 0.00 Whooping Cough 0.01 0.01 0.00 0.00 0.00 Diphtheria 0.00 0.00 0.00 — 0.00 Tuberculosis 0.20 0.24 0.19 0.24 0.22 Influenza 0.16 0.15 0.17 0.15 0.09 Smallpox 0.00 0.00 0.00 — — Acute Poliomyelitis (including Polioencephalitis) 0.01 0.01 0.01 0.01 0.00 Pneumonia 0.55 0.59 0.52 0.64 0.43 Notifications— Typhoid Fever 0.00 0.00 0.00 0.01 0.00 Paratyphoid Fever 0.01 0.01 0.01 0.01 0.00 Meningococcal Infection 0.03 0.04 0.03 0.03 0.03 Scarlet Fever 1.39 1.50 1.44 1.02 0.92 Whooping Cough 3.58 3.72 3.38 3.30 4.89 Diphtheria 0.01 0.01 0.01 0.00 0.00 Erysipelas 0.14 0.14 0.13 0.12 0.09 Smallpox 0.00 0.00 0.00 — — Measles 12.36 11.27 12.32 8.09 13.96 Pneumonia 0.84 0.92 0.76 0.73 0.65 Acute Poliomyelitis (including Polioencephalitis) Paralytic 0.07 0.06 0.06 0.07 0.06 Non-Paralytic 0.04 0.03 0.04 0.03 0.06 Food Poisoning 0.24 0.25 0.24 0.38 0.06 Deaths under 1 year of age Rates per 1,000 Live Births. 26.8 30.8 24.3 24.8 12.89 Deaths from Diarrhoea and Enteritis under 2 years of age 1.1 1.3 0.9 1.1 2.58 Notifications— Rates per 1,000 Total Births (i.e., Live and Still). Puerperal Pyrexia 18.23 24.33 | 12.46 28.61 7.65 Maternal Mortality Sepsis of pregnancy childbirth and the puerperium Abortion with toxaemia Other toxeemias of pregnancy and the puerperium Haemorrhage of pregnancy and childbirth Abortion without mention of sepsis or toxaemia Abortion with sepsis Other complications of pregnancy childbirth and puerperium England and Wales 0.01 0.01 0.24 0.13 0.04 0.06 0.18 Beddington and Wallington 0.00 0.00 0.00 0.00 0.00 0.00 0.00 13 REGISTERED CAUSES OF DEATH The following table, supplied by the Registrar.General, gives the causes of death of residents in the Borough during 1953: Causes of Death Males Females Total All Causes 145 192 337 1. Tuberculosis, respiratory 5 — 5 2. Tuberculosis, other 1 1 2 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 4 4 8 11. Malignant neoplasm, lung, bronchus 8 — 8 12. Malignant neoplasm, breast — 5 5 13. Malignant neoplasm, uterus — 3 3 14. Other malignant and lymphatic neoplasms 21 19 40 15. Leukaemia, aleukæmia 1 1 2 16. Diabetes 1 — 1 17. Vascular lesions of nervous system 11 33 44 18. Coronary disease, angina 31 28 59 19. Hypertension with heart disease 1 3 4 20. Other heart diseases 13 50 63 21. Other circulatory diseases 10 9 19 22. Influenza 1 2 3 23. Pneumonia 5 9 14 24. Bronchitis 7 7 14 25. Other diseases of respiratory system 2 — 2 26. Ulcer of stomach and duodenum 2 1 3 27. Gastritis, enteritis and diarrhœa — 1 1 28. Nephritis and nephrosis 2 4 6 29. Hyperplasia of prostate 5 — 5 30. Pregnancy, childbirth, abortion — — — 31. Congenital malformations 2 — 2 32. Other defined and ill-defined diseases 10 7 17 33. Motor vehicle accidents 1 — 1 34. All other accidents 1 2 3 35. Suicide — 2 2 36. Homicide and operations of war — — — 14 The following table shows the principal causes of death with the rate per cent. of total deaths: Cause of Death Number of Deaths Rate per cent. of Total Deaths Heart Disease 106 31.45 Cancer 64 18.99 Intra-Cranial Vascular Lesions 44 13.06 Tuberculosis (All Forms) 8 2.37 Pneumonia 14 4.15 Bronchitis 14 4.15 Other Diseases of the Circulatory System 19 5.64 VIOLENCE AND ACCIDENT Details of all deaths under this heading are as follows: Cause of Death Male Female Total Suicide – 2 2 Other Violent Causes 2 2 4 Totals 2 4 6 MATERNAL MORTALITY Members of the Council will be pleased to note that in 1953 there were no deaths in childbirth, either from puerperal sepsis or other maternal causes, giving a Nil maternal mortality rate. In 1952, unfortunately, we recorded a maternal mortality rate of 5.49, which broke the record of the Borough in having no maternal deaths for the previous five years. INFANTILE MORTALITY The infantile mortality rate for 1953 was 12.89 per 1,000 live births. The comparable rate for England and Wales is 26.8. Great credit is due to the services operated in the Borough for the care of mothers and young children, which have made the attainment of such a low rate possible. Of the total of 388 live births, only 5 deaths of infants under one year of age (3 males and 2 females) were registered. Three of the deaths (2 males and 1 female) died within the first four weeks of life. 15 The following table gives the age and cause of death of each infant who died: Age Sex Cause of Death 10 minutes F. Hæmolytic disease of new born. 7 hours M. Atelectasis, prematurity. 2 days M. Congenital pulmonary stenosis. 4 weeks M. Congenital atresia of bile ducts. 2 months F. Marasmus, gastro-enteritis, feeding difficulty. 16 GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA LABORATORY FACILITIES The Corporation's arrangements for the examination of swabs, sputa and other pathological material continue as heretofore. During 1953, H. Amphlett Williams, Esq., Ph.D.(Lond.), A.C.G.F.C., F.R.I.C., Public Analyst, 1 Southwark Street, S.E.I, continued the arrangement made in 1946 for the examination of milk, water and ice-cream. In general, pathological specimens are sent to the Pathological Laboratories at St. Helier Hospital. Samples of milk and water are submitted for bacteriological examination to the Ministry of Health laboratories at Epsom, reports being received free of charge under the National Health Service Act, 1946. AMBULANCE FACILITIES General and Accident Cases. Reorganisation of the ambulance services was undertaken by the Surrey County Council on their transfer on 5th July, 1948. The main ambulance station is situated at St. Helier Hospital, with a sub-station, covering the Beddington and Wallington area, located in Carshalton. NURSING IN THE HOME The Beddington and Wallington District Nurses' Home, administered by the Surrey County Council continues to offer excellent facilities for nursing as in previous years, the day-to-day administration being in the hands of the Divisional Medical Officer for the Beddington and Wallington part of the Mid-Eastern Division. During the year the District Nurses attended 928 cases, including 96 maternity and 13 midwifery patients. A total of 18,915 visits was made. Interviews at the Nurses' Home numbered 2,068. 17 TREATMENT CENTRES AND CLINICS Care of Mothers and Young Children Child Welfare Centres When held Hackbridge Centre, The Grange, London Road. Every Monday, 2.0-4.0 p.m. Ban don Hill Centre, Methodist Hall, Sandy Lane North. Every Tuesday, 2.0-4.0 p.m. Beddington Centre, Village Hall, Beddington. Alternate Wednesdays, 2.0–4.0 p.m. Wallington Centre, Baptist Hall, Queen's Road. Alternate Wednesdays, 2.0–4.0 p.m. Maternity Clinics Ante-natal Clinic Post-natal Clinic, Every Thursday, 2.0–4.0 p.m. District Nurses' Home, 57 Montagu Gardens, Wallington. Physiotherapy Clinic, Dental Clinic, The Grange, London Road. By appointment. During the year voluntary help was again generously given by many ladies in the district, in assisting in the operation of the infant welfare centres. Among these, special mention should be made of the members of the British Red Cross Society, who continued to supply the great majority of the voluntary help given. Tuberculosis The responsibility for the treatment of cases of Tuberculosis, previously undertaken by the Surrey County Council, passed to the Regional Hospital Board on the 5th July, 1948. Dispensary facilities continue to be available for residents of the Borough at the St. Helier Hospital, Carshalton. 18 Immunisation Against Diphtheria Four clinics are held weekly to give immunisation against diphtheria. These are held at each of the three Infant Welfare Centres and at the Medical Officer of Health's Department at the Town Hall. The following table gives the number of children residing in the Borough who were treated during the year and the number of children known to be immunised in both age groups: 0-5 years 5-15 years Total 0-15 years Approximate number of children in the Borough at 31st Dec., 1953 2,000 4,550 6,550 Number of children known to be immunised at 31st Dec., 1953 1,026 3,947 4,973 Percentage of children immunised 51.3 86.7 75.9 Alum precipitated toxoid (A.P.T.) is provided free from the Government's Central Laboratories and has been used throughout the year in our immunisation scheme. No cases of illness have resulted from the injections and no child has been prevented from following his daily routine on treatment days. This is one of the services transferred to the local health authority on 5th July, 1948. In addition to the work conducted by the Divisional Medical Officer, general practitioners have been brought into the scheme, and they forward returns of completed cases of immunisation to the Divisional Medical Officer, for which they receive a fee. Whooping Cough Immunisation This service was continued throughout the year by the local health authority, to whom it was transferred on the 5th July, 1948. During the year, 160 children were immunised at County Council clinics. In addition, notifications have been received from general practitioners of 97 children receiving this immunisation at their hands. The new whooping-cough vaccine, combined with diphtheria prophylactic in a mixed vaccine continued to be used, especially amongst young children in attendance at infant welfare centres. Mothers have shown themselves very appreciative of whooping-cough immunisation, and the percentage of parents availing themselves of this service seems to have increased. This service continues to be offered free of charge. School Clinics With the coming into operation of the 1944 Education Act, the Medical Officer of Health was appointed in September, 1945, Divisional Medical Officer for the Beddington and Wallington half of the MidEastern Divisional Executive of the County of Surrey. School clinics 19 continue to be conducted at The Grange Mansion, Wallington, Rochester Road and Phoenix Flats, Carshalton. The services provided at these clinics are now general medical inspection and treatment, dental treatment, speech therapy and physiotherapy. Venereal Diseases Clinics The Surrey County Council was, until the 5th July, 1948, responsible for the control and treatment of venereal diseases in the area, and was a member of the London and Home Counties Scheme. This service was taken over on the 5th July, 1948, by the Regional Hospital Board, who continue to provide free diagnosis and treatment at the Croydon General Hospital, at clinics established at St. Helier Hospital, the Royal Surrey Hospital, Guildford, the East Surrey Hospital, Redhill, and at hospitals previously under the London and Home Counties Scheme. Cleansing of Persons During 1953 the Corporation Cleansing Station, situated near the Grange Mansion, provided facilities for cleansing infested persons. The general standard of cleanliness throughout the Borough remains at a high level, special attention being paid to this matter by the Health Visitors and Sanitary Inspectors during their routine visits and in their contact with the public at the Town Hall. During the year the following treatments were carried out: Scabies — Pediculosis 4 HOSPITALS Infectious Cases. The South-West Metropolitan Regional Hospital Board make provision for the admission and treatment of cases of infectious disease in hospitals under their control. Most of the cases from Beddington and Wallington continue to be admitted to the Wandle Valley Isolation Hospital. Smallpox. The Regional Hospital Board have made arrangements for the admission of cases of smallpox to their hospital at Joyce Green, Dartford. General and Accident Cases. Cases from this area are admitted to: Carshalton, Beddington and Wallington District (War Memorial) Hospital. St. Helier Hospital, Carshalton. Croydon General Hospital. The Wilson Hospital, Mitcham. Maternity Cases. The Regional Hospital Board continue the provision at St. Helier Hospital for maternity cases in the Borough requiring institutional confinements. Some patients continue to be admitted to the Carshalton, Beddington and Wallington (War Memorial) Hospital under arrangements made by their practitioners under the National Health Service Act, 1946. 20 DISINFECTION The disinfection of houses has been undertaken by the Council during the year and the Wandle Valley Hospital has continued to co-operate in the disinfection of bedding. Disinfection which is not absolutely essential in the interests of the public health is also undertaken upon a payment of £1 per load for bedding, etc., and 7s. 6d. for the first room and 3s. 9d. for each additional room as applied to house disinfection. SANITARY CIRCUMSTANCES OF THE AREA WATER SUPPLIES The water supply is piped throughout the district from the Sutton District Water Company. All dwelling-houses (9,705) in the area are connected to public water mains. None of the inhabitants rely upon stand pipes. During the year the supply has been satisfactory both in quality and quantity. It is understood that the Water Company carry out routine bacteriological examinations of the raw and finished water daily from the wells at Sutton and Woodmansterne, and also of the treated water going into supply. Routine chemical examinations are also carried out. The raw water from the deep wells is of a relatively high degree of hardness. The company are under a statutory obligation (Sutton District Waterworks Act, 1903) to deliver water of not more than 9 degrees of hardness, and an elaborate softening plant is in use. During the year 40 samples of water were examined by the Public Analyst or the Public Health Laboratory Service. From the reports the water supply is shown to be satisfactory both in chemical and bacteriological purity, and no cases of illness associated with pollution of water supplies were recorded during the year. The chlorination of water from private wells situated in industrial premises was continued throughout the year. DRAINAGE AND SEWERAGE During the year nine blockages on combined drains were dealt with. In February and March, 1953, a specialist firm was called in to deal with two serious main sewer blockages, one in Stanley Park Road and one in Park Road. In the former case a new manhole was built at the head of the sewer. Several other minor blockages occurred in the area; Melbourne Road, Belmont Road, Park Road and Maldon Road, all were quickly cleared, preventing more serious trouble. The work of relief storm drainage to Woodcote Road and Manor Road was completed. 21 RIVERS AND STREAMS Normal cleansing of the River was carried out. Work will be undertaken in 1954 to remove the mud in the upper portion of Grange Park Lake. CLOSET ACCOMMODATION Practically the whole of the area is on the water carriage system, draining into public sewers. There are a few chemical and earth closets, chiefly for use on sports grounds within the district, whilst four cesspools were in use in the district at the end of the year. PUBLIC CLEANSING The collection of house refuse throughout the Borough was maintained during the year on a weekly basis. The type of receptacle in use throughout the Borough continues to be the portable galvanised iron covered bin. The collection of trade refuse was also continued as required. Cesspools and earth closets are dealt with by occupiers of the premises concerned, which continued arrangement is satisfactory. 22 SANITARY INSPECTION OF THE AREA The following statement by the Chief Sanitary Inspector gives statistics as to the number of complaints received, inspections made, defects remedied, and other work carried out by the Sanitary Inspectors. REPORT OF THE CHIEF SANITARY INSPECTOR FOR THE YEAR, 1953 HOUSING Inspections of houses followed, in the main, the receipt of complaints or the investigation of infectious disease. At the end of the year, however, a systematic inspection of houses under the Housing (Consolidated) Regulations was commenced. No houses were closed or demolished during the year. One hundred and forty-seven houses were rendered fit. In only six cases was it necessary to resort to statutory action. Number of inspections of dwelling-houses 441 Number of inspections recorded under Housing Regulations 21 MILK AND DAIRIES Number of distributors of milk on register 17 Number of dairy premises other than dairy farms on register 6 Number of above premises upon which loose milk is handled Nil Number of inspections of premises 35 Defects in dairy premises discovered Nil Infringements of Acts and Regulations Nil Number of licences issued under Milk (Special Designation) Regulations: Tuberculin Tested Milk—Dealers' Licences 6 „ „ „ Supplementary Licences 15 Pasteurised Milk—Dealers' Licences 6 „ „ Supplementary Licences 15 Sterilized Milk—Dealers' Licences 12 „ „ Supplementary Licences 16 — 70 BACTERIOLOGICAL EXAMINATION OF MILK Eighty-seven samples of milk were submitted for examination. The results of the tests are set out below: Designation No. of Samples Methylene Blue Test Phosphatase Test Turbidity Test Satisfactory Unsatisfactory Satisfactory Unsatisfactory Satisfactory Unsatisfactory Pasteurized 60 60 — 60 — — — T.T. Pasteurized 21 21 — 21 — — — Sterilized 5 — — — — 5 — Tuberculin Tested (Farm Bottled) 1 1 – – – – – 23 CHEMICAL ANALYSES OF MILK Tenty-six samples of milk were submitted to the Public Analyst. All were reported genuine. The average composition was as follows: Fat % 3.83 Solids-not-fat % 8.84 Total Solids % 12.67 ICE CREAM Number of premises registered for the sale of ice cream 79 Number of manufacturers 1 Number of inspections of premises 177 Twenty-five samples of ice cream (including seven ice lollies) were procured and submitted for bacteriological examination. the results are set out in the following table:— Type No. of Samples Methylene Blue Test Coliforms Faecal Coli present Grade 1 Grade 2 Grade 3 Grade 4 Present in 1/10 ml. Ice cream 18 18 — — — 3 — Ice lolly 7 7 — — — 1 — CHEMICAL ANALYSES OF ICE CREAM Ten samples of ice cream were submitted for analysis. Two failed to comply with the standard. The average fat content of the samples varied between 2-8% and 11-3%. The average fat content was 7-8%. SLAUGHTERHOUSES Number of licensed slaughterhouses Nil FOOD PREMISES Total number of visits 879 Total number of defects discovered and remedied 44 FOOD PREMISES IN THE DISTRICT Bakers 12 Butchers 24 Catering Establishments 44 Chemists 12 Confectioners (sweets) 29 Fishmongers (including friers) 12 Greengrocers 33 Grocers 70 Licensed Premises 13 24 FOOD PREMISES REGISTERED UNDER SECTION 14 OF THE FOOD & DRUGS ACT, 1938 Sausage manufacturers 26 Fish friers 7 Jam manufacturers 1 Ice cream (sale only) 79 Ice cream (manufacture and sale) 3 INSPECTIONS OF REGISTERED FOOD PREMISES Ice cream (manufacture and sale) 177 Fish friers 27 Sausage manufacturers 100 Jam manufacturers 4 CONTRAVENTIONS As a result of the inspections the under-mentioned conditions were discovered and remedied by informal action. Dirty or defective surfaces 22 Dirty utensils 5 Unsatisfactory washing accommodation 8 Food not adequately protected 5 Unsatisfactory refuse storage 2 Unsatisfactory ventilation 1 Sale of ice cream from unregistered premises 1 UNSOUND FOOD Destroyed or released for animal feeding:— lbs. Bacon 4 Biscuits 7 Cereals 8 Cheese 1 Egg Noodles 41 Fish 294 Fish, canned 7 Fruit, canned 630 Fruit juice, canned 3 Jam and marmalade 73 Meat 960 Meat, canned 332 Milk, condensed 23 Milk, evaporated 60 Paste, Tomato 50 Pickles and sauces 3 Puddings.. 1 Sausages 56 Soup, canned 9 Suet, beef 10 Vegetables, canned 108 Total 2,680 25 FOOD AND DRUGS ACT, 1938 On 1st April, 1940, the Corporation became the Food and Drugs Authority for the Borough, and took over the duties under the Act from the Surrey County Council. Dr. H. Amphlett Williams, Ph.D.(Lond.), A.C.G.F.C., F.R.I.C., of 1 Southwark Street, London, S.E.I, is Public Analyst for the Borough. FOOD ANALYSES Number of samples analysed by Public Analyst 106 Number of samples reported against 8 The following table gives details or the samples obtained within this district during the year: Articles No. Examined Adulterated Prosecu tions Convic tions Formal. Informal. Total Formal. Informal. Total Aspirin Tablets — 1 1 — — — — — Blancmange Powder — 1 1 - - - - - Bread — 3 3 - - - - - Butter — 4 4 - - - - - Coffee & Chicory Essence — 3 3 - - - - - Colouring matter — 1 1 - - - - - Confectionery, Flour — 2 2 - - - - - „ , Sugar 1 — 1 - - - - - Cooking fat — 4 4 - - - - - Cough mixture — 1 1 - - - - - Cream, Imitation, canned — 1 1 - - - - - Drinks, Soft (orange squash) 2 2 - - - - - Fish, canned — 3 3 — 1 1 — — Flavouring Essence — 3 3 — — — — — Fruit, canned — 1 1 - - - - - , curd — 1 1 - - - - - Gelatine — 1 1 - - - - - Horseradish, Grated 1 — 1 - - - - - Ice cream 1 9 10 1 1 2 — — Ice lollies — 2 2 - - - - - Jam — 2 2 — 1 1 — — Lemon juice — 1 1 - - - - - Lemonade powder — 1 1 - - - - - Margarine — 4 4 - - - - - Marzipan — 1 1 - - - - - Milk 15 10 25 - - - - - „ , Evaporated — 1 1 - - - - - Mincemeat 1 1 2 - - - - - Oatmeal — 1 1 - - - - - Pastry, Uncooked — 1 1 - - - - - Pepper — 3 3 - - - - - Pudding mixture — 1 1 — 1 1 - — Rennet, Essence of — 1 1 - - - - - Rose hip syrup — 1 1 - - - - - Sago — 2 2 - - - - - Sausages 2 1 3 2 1 3 - — Semolina — 2 2 - - - - - Soup powder 1 — 1 - - - - - Spices — 2 2 - - - - - Suet, Shredded 1 — 1 - - - - - Vinegar — 3 3 - - - - - Wine, Non-alcoholic — 1 1 - - - - - Total 23 83 106 3 5 8 - — 26 ADULTERATED SAMPLES The following is a detailed statement of the adulterated samples and the action taken:— Sample No. Sample of 1 Pudding Mixture (Informal) 2 Pork Sausages (Informal) 3 Pork Chipolata sages (Formal) 4 Pork Chipolata sages (Formal) 5 Strawberry Jam (Informal) 31 Ice cream (Informal) 34 Ice cream (Formal) 60 Sardines in oil (Informal) Contained gramme. Remarks carcases of mites Stock withdrawn. 360 per Contained meat 52% by weight. A deficiency of 20% as judged by the standard of Meat Products (No. 3) Order, 1952. Further sample unobtainable. Contained undeclared preservative-sulphide calculated as sulphur dioxide—85 parts per million by weight. Vendors warned. Contained undeclared preservative-sulphide calculated as sulphur dioxide—285 parts per million by weight. Vendors warned. Contained sulphur dioxide in excess of the Public Health (Preservatives, etc., in Food) Regulations. Referred to the Ministry of Food. 30% deficient in fat. Formal sample obtained No. 34. 36% deficiency in fat. Manufacturers warned. Further samples proved genuine. Contained lead. Eight parts per million. Referred to Ministry of Food. COMPLAINTS RELATING TO FOREIGN BODIES IN FOOD Nine complaints were received and investigated during the year relating to foreign matter in food. Legal proceedings were not instituted but appropriate warnings were given, this action generally resulted in improvements at the manufacturing premises which should prevent repetition. FACTORIES Number of factories on register (including bakehouses) 134 Number of inspections 294 Number of defects discovered and remedied 31 27 FACTORIES ACT, 1937 The following tables give details of inspections made and detects found: Part I of the Act Inspections for purposes of provisions as to health (including inspections made by Sanitary 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 10 25 - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 124 269 6 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) - - - - Total 134 294 6 — Part VIII of the Act Outwork Nature of Work Section 110 Section 111 No. of outworkers in August list required by Sect. 110 (1) (c) No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwholesome premises Notices served Prosecutions (1) (2) (3) (4) (5) (6) (7) Making of wearing apparel 8 - - - - - Stuffed toys 11 — — — — - Cosaques, Christmas crackers,Christmas stockings, etc. 8 — - - — - Total 27 — — — — — 28 Cases in which Defects were found: Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector (1) (2) (3) (4) (5) (6) Want of cleanliness (S. 1) 5 5 - - - Overcrowding (S.2) — — — — - Unreasonable temperature (S.3) - - - - - Inadequate ventilation (S.4) - - - - - Ineffective drainage of floors (S.6) - - - - - Sanitary conveniences (S.7): (a) Insufficient 2 2 — — - (b) Unsuitable or defective 16 15 - - - (c) Not separate for sexes 4 4 - - - Other offences against the Act (not including offences relating to Outwork) 5 5 2 - - Total 32 31 2 — — BAKEHOUSES Number of bakehouses in district 10 Number of inspections 43 Number of defects discovered 10 WORKPLACES, SHOPS AND OFFICES Number of inspections 758 Number of defects discovered and remedied 8 29 COMPLAINTS Complaints received and dealt with during the year were due to the following causes: Rats and Mice 138 Housing defects 86 Choked drains and sewers 79 Defective dustbins 69 Defective drainage (including closets) 23 Unsound or adulterated food 20 Atmospheric Pollution 20 Insect pests 14 Offensive accumulations 12 Miscellaneous 33 494 SMOKE ABATEMENT Number of observations 312 Nuisances observed 4 INFECTIOUS DISEASE AND DISINFECTION Number of visits re cases of infectious diseas 111 Number of rooms disinfected 83 Lots of bedding and clothing disinfected 54 Number of library books disinfected 264 OFFENSIVE TRADES Number of offensive trade premises in district Nil RATS AND MICE Number of premises inspected 1,719 Number of visits to premises 3,579 Number of premises upon which rats or mice were found and remedial action taken 227 Number of baits laid 3,537 SEWER RAT CONTROL Following a ten per cent. test of sewer manholes in May, two maintenance treatments were carried out, one in July and one in December. The results are summarised below: July Treatment December Treatment Manholes baited 211 65 Manholes in which takes were recorded 30 26 Percentage of manholes showing infestations 14 40 30 NOTICES Number of informal notices served (including verbal intimations) 276 Number of statutory notices served Public Health Act, 1936, Section 93 (Nuisances) 11 Public Health Act, 1936, Section 75 (Dustbins) 2 Public Health Act, 1936, Section 39 (Drains) 1 Public Health Act, 1936, Section 45 (Closets) 1 15 SANITARY IMPROVEMENTS Water Supply Water pipes and fittings repaired or renewed 12 Drains Drains re-laid or repaired 28 Drains unstopped and cleansed 58 Intercepting traps provided with rod-eye stoppers 9 Manholes provided or repaired 17 Soil or ventilation pipes repaired or renewed 4 Gully kerbs and channels repaired 4 New soakaways constructed 2 Closets Provided 3 Buildings repaired 2 New pans fixed to water closets 6 Water supply re-instated 1 Flushing cisterns repaired or renewed 4 Flush pipes and pan joints repaired or renewed 4 Seats repaired or renewed 4 Urinals cleansed 4 Sinks Waste pipes repaired or renewed 3 Yards Yards newly paved or repaired 2 Dust Receptacles New dustbins provided 12 Dampness Roofs repaired 31 Rainwater gutters repaired or renewed 21 Rainwater downspouts repaired or renewed 11 Damp-proof courses provided 1 Windows, sills and doors made weatherproof 2 External walls repaired, repointed or rendered 10 Ventilation provided under floors 1 31 General Repairs Rooms cleansed 17 Walls and ceilings repaired 35 Floors repaired 12 Stoves repaired or renewed 2 Windows repaired 29 Chimneys repaired 4 Number of premises disinfested from bed bugs 1 Other repairs 12 SUMMARY OF WORK DONE DURING THE YEAR Number of inspections of dwelling-houses 441 Number of re-inspections of premises 688 Number of visits to work in progress 188 Number of miscellaneous visits and inspections 591 Number of visits to schools 12 Number of visits to dairies 35 Number of visits to ice-cream premises 177 Number of visits to refreshment rooms 114 Number of visits to fried-fish shops 27 Number of visits to bakehouses 43 Number of visits to other food premises 491 Number of visits to factories 294 Number of visits to shops, offices and workplaces 758 Number of visits to stables and yards 64 Number of visits to market gardens, etc. 72 Number of inspections of urinals 84 Number of visits to piggeries 15 Number of visits re infectious diseases 111 Number of visits re insect pests 61 Number of inspections and visits re rats 3,579 Number of visits to streams 68 Number of visits re smoke abatement 312 Number of inspections of swimming bath 15 Number of complaints received and investigated 494 Number of informal notices served 276 Number of statutory notices served 15 Number of interviews re nuisances, etc. 611 Number of drain tests applied 76 Number of rooms disinfected 83 Number of lots of bedding and clothing disinfected 59 Number of library books disinfected 264 Number of samples of foodstuffs, water, etc., taken for examination 264 H. G. CRIPPS, Chief Sanitary Inspector. 32 SWIMMING BATH The Corporation rented from the Surrey County Council (for the 1953 Summer season) the open-air swimming bath situated in the grounds of the Royal Female Orphanage. The supervision and arrangement of sessions were under the control of the Public Health Department. Facilities were given to schools, youth organisations, and residents as in previous years. During the season, which covered a period of 18 weeks, the following attendances were recorded: Youth organisations 2,943 School children 5,593 Season Ticket Holders, etc.: Adults 12,792 Children 6,137 Total 27,465 SCHOOLS School Closure. Infectious diseases common to childhood were not prevalent in epidemic form in any of the schools during the year. As a result it was not found necessary for any school to be closed by the local sanitary authority to prevent the spread of infectious disease. Medical Inspection. Under the 1944 Education Act the Assistant Medical Officer of the County Council continued to carry out routine and special medical inspections of schoolchildren in the maintained schools. This work is under the general supervision of the Medical Officer of Health, in his capacity of Divisional School Medical Officer for the Mid-Eastern Divisional Executive of the Surrey County Council. Water Supply and Sanitary Conditions. All the schools are supplied with water from the public mains and are connected with the sewers. During the year some progress was made in bringing the maintained schools up to pre-war standards of decoration. No major sanitary defects were found. Considerable thought has been given to the maintenance of good standards of hygiene in school canteens. The serving of meals on a large scale in establishments such as schools, represents a danger-point for the occurence of food poisoning. The maintenance of high standards of hygiene and sanitation is dependent upon the intelligent co-operation of every individual member of a canteen staff. The Ministries of Health and Education are constantly devising methods of educating staff to realise the importance of a high standard of personal hygiene, in order to avoid outbreaks of food poisoning. 33 OUTBREAKS OF FOOD POISONING, AND CLEAN FOOD CAMPAIGN The department continued to pursue actively all measures directed to ensuring clean food, both in preparation and as served in cafes and eating houses, and this is reflected in the increased number of visits paid to food premises during the year, as recorded on page 24 and 25. No prosecutions were brought against any person under the Food and Drugs Act or the bye-laws during the year. Under present legislation, it is generally considered that good standards of hygiene are maintained throughout the Borough in all the food trades. During the year food poisoning notifications were received as follows:— Notifications— 1st quarter 1 Total 2 2nd quarter 1 Outbreaks due to identified agents Nil Outbreaks of undiscovered cause Nil Single Cases— Agent identified 1 Total 2 Unknown cause 1 The case in which the agent was identified (shepherd s pie, containing staphylococcal toxin) involved a bank manager, who became ill after consuming his lunch at a bank canteen in London. It is understood that an outbreak took place in association with this canteen, which was fully investigated by the Medical Officer of Health for the City of Westminster. The case in which no article of food could be identified was found to be excreting salmonella typhimurium. She was a female child of 7 years, and the carrier state continued for some months. NUTRITION With the gradual discontinuance of food rationing, the impression is gained, by the examination of children, that nutritional standards are even higher than previously recorded. This probably reflects the consumption of a higher proportion of protein (meat, fish and eggs) in the general diet. The Government scheme for the provision of welfare foods has been continued throughout the year, and in addition, proprietary brands of vitamin preparations have been provided through the Surrey County Council's welfare centres. SHELL FISH (MOLLUSCAN) Only a small quantity of shell fish is marketed in the district, and is obtained chiefly from Billingsgate Market, London. 34 ADOPTIVE ACTS AND BYE-LAWS The following Acts have been adopted: Public Health Acts (Amendment) Act, 1890, Parts I, II and III. Public Health Acts (Amendment) Act, 1907, Parts I to VI and VIII to X. Private Street Works Act, 1892. Public Health Act, 1925. Public Libraries Acts, 1892-1919. Small Dwellings Acquisition Acts, 1899-1923. Bye-laws in respect to the following are in force: Advertisements. Allotment Gardens. Animals, The Keeping of. Buildings. Clean Handling of Food. Fish-frying and Offensive Trades. Good Rule and Government. House Refuse, etc., Removal. Houses Let in Lodgings. Houses of the Working Classes. New Streets. Nuisances. Offensive or Noxious Matter. Parking Place off Woodcote Road. Pleasure Grounds. Public Sanitary Conveniences. Slaughterhouses. Slot Machine Sale of Contraceptives. Smoke Abatement. Tents, Vans, Sheds, etc. Underground Rooms. 35 PREVALENCE AND CONTROL OVER INFECTIOUS AND OTHER DISEASES The following table shows the incidence of infectious disease in the Borough in 1953, the number of cases removed to hospital and the number of deaths attributed to these diseases, excluding Tuberculosis: Disease Number Notified Removed to Hospital †Deaths Scarlet Fever 30 20 - Measles 454 9 — Whooping Cough 159 2 — Erysipelas 3 — — Pneumonia 21 3 14* Dysentery 2 2 — Poliomyelitis 4 4 — Puerperal Pyrexia 3 — — Infective Hepatitis 1 — — Food Poisoning 2 1 — Cerebro-Spinal Meningitis 1 1 Totals 680 42 14* * Includes deaths from all forms of pneumonia. † Includes deaths of residents in homes and institutions outside the Borough. 36 The succeeding table shows the age incidence of the diseases and the distribution throughout the Wards of the Borough of the various infections: Cases of Infectious Disease Notified During the Year 1953 (excluding Tuberculosis) Disease Total Number of Cases Number of Cases Notified At Ages—Years Number of Cases Notified in each Ward Cases removed to Hospital Deaths (including deaths of residents outside the Borough) j Under 1 year 1 to 2 years 2 to 3 years 3 to 4 years 4 to 5 years I 5 to 10 years 10 to 15 years 15 to 20 years 20 to 35 years 35 to 45 years 45 to 65 years 65 and over Beddington Wallington North West Central South North Central South Scarlet Fever 30 - - 1 1 2 24 1 1 - - - - 2 4 3 4 10 5 2 20 - Measles 454 7 32 43 52 41 259 12 1 3 3 1 — 67 48 80 52 105 61 41 9 — Whooping Cough 159 10 10 13 17 21 82 3 - - 2 1 - 64 11 18 19 27 9 11 2 - Erysipelas 3 - - - - - - - - - - 2 1 2 — — — 1 — — - — Pneumonia 21 — 1 2 — — 1 — 1 — 1 9 6 5 - 4 — 4 2 1 3 14* Dysentery 2 - - - - - - 1 - - - - 1 - - - - 1 — 1 2 — Poliomyelitis 4 — — — 1 — — — 1 1 1 — — 2 — 1 — — — 1 4 — Puerperal Pyrexia 3 - - - - - - - - 2 1 - - 2 - 1 - - - - - - Infective Hepatitis 1 - - - - - 1 - - - - - - - - 1 - - - - - - Food Poisoning 2 - - - - - 1 - - - - 1 - - - 1 1 - - - 1 - Cerebrospinal Meningitis Totals 1 - - - - - 1 - - - - - - - 1 - - - - - 1 — 680 17 43 59 71 64 369 17 4 6 8 14 8 144 69 109 76 148 77 57 42 14 *Includes all forms 37 The Monthly Incidence of Infectious Disease, 1953 (excluding Tuberculosis) Disease Jan. Feb. Mar. April May June July Aug. Sept. Oct. Nov. Dec. Total Scarlet Fever 5 1 3 3 4 4 - — 2 3 2 3 30 Measles 69 138 176 57 10 1 1 — — — — 2 454 Whooping Cough 9 15 30 9 8 27 37 11 5 5 3 — 159 Erysipelas - - - 1 - - - - - 1 1 — 3 Pneumonia 7 8 2 - - - - - 1 — 2 1 21 Dysentery — — — — — — 2 — — — — — 2 Poliomyelitis — — — — — — — 2 1 — 1 — 4 Puerperal Pyrexia — — — — 1 1 — — — — 1 — 3 Infective Hepatitis - - - - - 1 - - - - - - 1 Food Poisoning — — - - 2 — — — — — — - 2 Cerebro-Spinal Meningitis - - 1 - - - - - - - - - 1 Totals 90 162 211 70 25 34 40 13 9 9 10 6 680 38 Tuberculosis There were 30 new cases notified during the year, this being a decrease of 8 on the number of cases notified in 1952. The following table gives the number of new cases notified during the past five years: New Cases 1949 1950 1951 1952 1953 M. F. M. F. M. F. M. F. M. F. Pulmonary 19 17 27 1 21 10 23 12 16 12 Non-Pulmonary 1 2 2 4 2 3 1 2 1 1 Totals 20 19 29 5 23 13 24 14 17 13 Annual case rate per 1,000 of the estimated population: 1950 1951 1952 1953 Pulmonary 0.85 0.95 1.08 0.86 Non-pulmonary 0.18 0.15 0.09 0.06 The following table gives the number of deaths from this disease during the past five years: Deaths 1949 1950 1951 1952 1953 M. F. M. F. M. F. M. F. M F. Pulmonary 8 4 7 1 4 - 4 3 6 - Non-Pulmonary — 1 1 1 1 1 — — 1 I Totals 8 5 8 2 5 1 4 3 7 1 It will be seen from the foregoing table that 8 Tuberculous patients died during the year, this being an increase of one on the corresponding figure for the previous year. The figures correspond to a death rate per 1,000 of population of 0 25. The following table, compiled from local records, shows the number of new cases of Tuberculosis notified during the year, together with the deaths at various age periods: 39 Age Periods New Cases Deaths Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary M. F. M. F. M. F. M. F. Under 1 year - - - - - - - - I and under 5 - - - - - - - - 5 and under 10 - - - - - - - - 10 and under 15 1 - - - - - - - 15 and under 20 2 2 - - - - - - 20 and under 25 2 3 - - - - - - 25 and under 35 3 4 — 1 — — — — 35 and under 45 — 3 1 — 3 — — — 45 and under 55 1 — — — 2 — — — 55 and under 65 4 - - - - - - - 65 and upwards 3 — — — 2 — — — Totals 16 12 1 1 7 — — - The new cases were distributed amongst the Wards as follows: Beddington Wallington North West Cent. South North Cent. South Pulmonary 3 2 9 1 4 5 4 Non-Pulmonary — 1 — — — 1 — Totals 3 3 9 1 4 6 4 Specimens of sputa from cases, or suspected cases, are sent for examination to the Pathological Laboratory at St. Helier Hospital. Treatment for cases of Tuberculosis is the responsibility of the Regional Hospital Board, who provide both sanatorium and dispensary treatment. The Tuberculosis After-Care Committee continued its magnificent work in the district during 1953 As in previous years, the major effort of the Committee was directed towards alleviating the lot of tuberculous patients and their families. Money grants, supplements of clothing and nourishing foods, help with the debts and the multifarious difficulties of necessitous families were given, and the work was greatly appreciated. 40 LOCAL HEALTH AUTHORITY TRANSFERRED FUNCTIONS As was explained in the preamble to the report, the following brief statement summarises the work of the local health authority in respect of the transferred functions. The Care of Mothers and Young Children. Infant welfare clinics and general supervisory control through health visiting were continued by the Surrey County Council during the year. In general, a high standard of visiting and a smooth and efficient service were maintained. Ante-natal and Post-natal Supervision. This clinic, as in previous years, continued to be held at the Nurses' Home, 57 Montagu Gardens. During the year, 178 women made 702 pre-natal attendances. This represents an attendance of 45.41 per cent. of the total number of confinements which occurred during 1953. Post-natal examinations were also conducted at this clinic, 17 patients making 17 attendances. As mentioned in previous reports, however, considerably more women have post-natal supervision than are recorded here. Those who have institutional confinements usually return to hospital as a routine a few weeks after their discharge, and have their post-natal examination conducted by the hospital Medical Officers. Infant Welfare Services. No changes were made during the year in the operation of the four infant welfare centres, and the number of attendances showed results comparable with those of previous years. Number attending Total attendances Children under 1 year 332 4,257 Children, 1-5 years 612 3,075 Total attendances 944 7,332 Institutional Confinements. Two hundred and ninety-five, or 75.26 per cent. of births allocated to this district, took place in hospitals and nursing homes, this being a higher percentage than recorded in the previous year. Patients going into hospital for a confinement are classified under two headings, those whose admission is essential on medical grounds and those who have unsatisfactory homes in which it would be inadvisable to conduct a domiciliary confinement. Every case is properly investigated, and it is only after a visit from the Health Visitor that patients requiring admission on social grounds are put forward for consideration by the hospital. Domestic Help Service. This important branch of social service continued to meet a great need during the year, both for confinements and illness in the home. The service is administered by the Divisional Medical Officer from the Wallington Town Hall, and during the year one of the W.V.S. ladies continued to act as Home Help 41 Supervisor under the general direction of the Divisional Medical Officer. Close liaison was kept up with the almoners of hospitals, and it was found possible to meet the many requests received for tuberculous patients and the care of the aged under the St. Helier Hospital geriatric service. The cases attended were as follows: Total Maternity 44 General Medical 178 Tuberculosis 9 231 Treatment. Minor Ailments. Seventy-six cases were referred from the Infant Welfare Centres to Hospital Specialists for investigation and treatment during the year. The principal defects were as follows: Ear conditions 3 Eye conditions 20 Tonsils and adenoids 11 Orthopaedic defects 13 Nævi 2 Circumcisions 7 Feeding difficulties 5 Skin conditions 5 Dental. The Grange dental clinic for school children and children below the age of five years, as well as nursing and expectant mothers, continues to perform a very essential service. The accompanying table illustrates the work carried out. No. of Cases Extractions Fillings Scaling & Gum Treatment Provision of Dentures Full Partial Expectant Mothers 9 9 2 1 2 2 Nursing Mothers 4 1 5 1 — — Children, 0-5 63 100 113 — — — Totals 76 110 120 2 2 2 Orthopædic. Patients attending infant welfare centres who require treatment for orthopsedic defects are referred by the Clinic Medical Officer to orthopaedic surgeons at St. Helier or other hospitals. During 1953, 13 cases were referred for treatment. 42 Physiotherapy. This department continues to do very useful work, and a high standard of attendance was maintained throughout the year. In addition to ultra-violet light and infra-red irradiation, massage, manipulation and corrective treatments were given. Classes for remedial exercises for children suffering from minor orthopsædic and postural defects were conducted during the year. The Physiotherapist was also able to arrange classes for pregnant mothers desiring a course of relaxation exercises. The following table gives details of attendances: Total attendances Irradiations Corrective treatments Children, 0-5 years 3,096 1,287 Children, 5-15 years 2,462 2,758 Expectant and Nursing Mothers — 195 5,558 4,240 Health Visiting. Four health visitors are employed by the Surrey County Council for the supervision of infants up to 5 years of age and expectant and nursing mothers, both at home and at the infant welfare and ante-natal clinics. These health visitors are also responsible for the supervision of children attending schools in the Borough, and assist the Medical Officer at immunisation sessions. Visits during the year were made as follows: First visits Total visits Expectant Mothers 165 295 Children, 0-1 year 397 1,654 Children, 1-5 years 15 2,900 Other Cases 39 108 616 4,957 Child Life Protection. This function is now governed by the Children Act, 1948, which came into operation on the 5th July, 1948. A Children's Officer is appointed by the Surrey County Council to supervise all children coming within the provisions of the Act. The health visitors, however, visit on behalf of the Children's Officer deprived children under 5 years of age and certain other children in registered residential establishments. 43 Care of Premature Infants. The arrangements made for the care of premature infants continued during 1953. Equipment is kept at the District Nurses' Home, the headquarters of the local Midwives, where it is ready for immediate use when required. Seventeen premature live births were notified during the year, all of which occurred in hospital. Two of the infants died within 24 hours of birth. Care of Illegitimate Children. The Surrey County Council make an annual grant to the Sutton and District Girls' Aid Association, whose visitor follows up cases occurring in the Borough. A grant is also made to homes for mothers and babies in Surrey where the unmarried mother can be admitted before the birth of her child, and cared for some months after birth. Ladies of the Women's Voluntary Services and the health visitors continue to co-operate in the alleviation of the lot of these unfortunate mothers. 44 B. JOHNSON, Printer, 11, Manor Road, Wallington.