February BED 25 BOROUGH OF BEDDINGTON & WALLINGTON ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the YEAR 1960 BOROUGH OF BEDDINGTON & WALLINGTON ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the YEAR 1960 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: Registered Causes of Death 13 Cancer of the Lung and Bronchus 14 Violence and Accident 14 Maternal Mortality 14 Infantile Mortality 14 General Provision of Health Services for the Area: (Including Transferred Functions under the National Health Service Act, 1946). Nursing in the Home 16 Domestic Help Service 16 Chiropody 16 Care of Mothers and Young Children 17 Immunisation and Vaccination 21 School Clinics 22 Cleansing of Persons 22 Laboratory Facilities 22 Hospitals 23 Ambulance Facilities 23 Disinfection 23 Housing . . 24 Sanitary Circumstances of the Area: Water Supplies 25 Drainage and Sewerage 25 Rivers and Streams 25 Closet Accommodation 25 Public Cleansing 25 3 Report of the Chief Public Health Inspector for the Year 1960: Inspection & Supervision of Food Milk and Dairies .. 26 Ice Cream 27 Slaughterhouses 27 Food Premises 27 Food Hygiene (General) Regulations 1960 28 Unsound Food 28 Sampling 28 Factories Act 1937-1959 Inspections 32 Outwork 32 Defects .. 33 Workplaces, Shops and Offices .. 33 Infectious Disease & Disinfection 34 Offensive Trades 34 Clean Air Act, 1956 Smoke Control Areas 34 Industrial Premises 35 Prevention of Damage by Pest Act, 1949 Sewer Rat Control .. 36 Petroleum (Regulation) Acts 37 Shops Act, 1950 37 Pet Animals Act, 1951 37 The Game Act, 1831 37 Heating Appliances (Fireguards) Act, 1952 .. 37 Rag Flock & Other Filling Materials Act, 1951 37 Caravan Sites & Control of Devolopment Act, 1960 37 Noise Abatement Act, 1960 37 Summary Complaints .. 38 Notices served .. 38 Sanitary Improvements 38 Visits, etc. .. 40 Swimming Bath 41 Schools 42 Outbreaks of Food Poisoning and Clean Food Campaign 43 Nutrition 43 Shell Fish (Molluscan) 43 Adoptive Acts and Bye-Laws 44 Prevalence and Control over Infectious and other Diseases: Notifiable Diseases (other than Tuberculosis) 45 Incidence of Infectious Diseases in Age Groups and Wards 46 Monthly Incidence of Infectious Disease 47 Tuberculosis 48 4 BOROUGH OF BEDDINGTON AND YVALLINGTON PUBLIC HEALTH COMMITTEE December, 1960 Members: Councillor Mrs. A. R. Barty (Chairman) Councillor E. W. Harding (Mayor) Councillor P. A. Bishop Councillor Mrs. H. Bridger Councillor A. G. Greenhead Councillor H. Haydon Councillor J. L. Izard Councillor E. W. Popplestone Councillor Mrs. J. L. K. Thurston Councillor G. K. Turner REPRESENTATIVES ON MID-EASTERN DIVISIONAL HEALTH SUB-COMMITTEE December, 1960 Members: Alderman D. H. de Voil Alderman H. Rennison Councillor Mrs. A. R. Barty Councillor Mrs. H. Bridger Councillor E. W. Popplestone REPRESENTATIVES ON THE WANDLE VALLEY JOINT SEWERAGE BOARD December, 1960 Members: Councillor E. W. Harding (Mayor) Alderman F. G. Bryant Alderman S. W. C. Sprunt Councillor F. G. Manning 5 STAFF OF PUBLIC HEALTH DEPARTMENT Town Hall, Wallington. Telephone: Wallington 4500 Medical Officer of Health: Patrick J. O'Connell, M.D., B.S., D.P.H., B.Hy. Chief Public Health Inspector: (a.b.c.) H. G. Cripps, M.R.S.H., M.A.P.H.I. Additional Public Health Inspectors: (a.b.) D. A. Eves, M.A.P.H.I. (a.) V. L. Lerigo, A.R.S.H., M.A.P.H.I. (Resigned 10.4.60) (a.) S. S. Lowe, M.R.S.H., M.A.P.H.I. (Commenced 29.8.60) (a) Sanitary Inspector's Certificate (R.S.H. & S.I.E.J. Board). (b) Meat and Other Foods Certificate (R.S.H.) (c) Smoke Certificate (R.S.H.) Assistant to Public Health Inspectors: R. W. Bradstock Clerks: R. F. Burns (Chief Clerk) Mrs. L. A. Capon C. I. Phillips Miss M. Edmonston (Resigned 10 4.60) Mrs. B. S. Lear (Commenced 11.4.60) 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. Maureen Adams, M.B., B.S., M.R.C.S., L.R.C.P. Norah G. Johns, M.B., B.S., M.R.C.S., L.R.C.P. Lilian M. O'Connell, M.B., B.S., B.Sc., M.R.C.S., L.R.C.P. Health Visitors: Mrs. M. N. Chenery, 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 M. E. Bennett, S.R.N., S.C.M., H.V.Cert. Miss W. Warren Perry, S.R.N., S.C.M., H.V.Cert., (Com. 13.4.60) Physiotherapists: Mrs. H. M. Henn, M.C.S.P. (Part-time) Mrs. B. Manwaring, M.C.S.P. (Part Time) Assistant to Physiotherapists: Miss D. V. Raymond Administrative Assistant: R. F. Burns Clerks: Mrs. L. A. Capon Mrs. J. F. Smith Mrs. 1. M. Kingsley (School Health) Mrs. M. J. Osborne Mrs. M. Meadows (Part Time) Home Help Supervisor: Mrs. V. Beatt S.R.N., S.C.M., R.F.N., H.V.Cert (Part Time) 6 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 1960. The report is drawn up in accordance with the suggestions made by the Minister of Health in his Circular 1/61. The vital statistics are based on information supplied by the Registrar-General. The report includes those services, which are under the control of the Surrey County Council, the Local Health Authority under the National Health Service Act, 1946, under the heading of General provision of Health Services for the Area. These services are:— Nursing in the Home; Domestic Help Service; Chiropody; Care of Mothers and Young Children; Immunisation and Vaccination; Ambulance Facilities. The Registrar-General's estimate of the population of Beddington and Wallington at mid-year 1960 is 32,330, and this figure is used in the compilation of the vital statistics. The figure shows an increase of 80 compared with the Registrar-General's estimate for mid-year 1959. The census of population taken in 1951 was 32,751. The live birth rate per 1,000 total population shows a decrease at 13.54 in 1960, as compared with 14T6 in 1959. This rate is below that for England and Wales, which is 17.10. The stillbirth rate per 1,000 total births is 14.32, compared with 6.91 in 1959. This is lower than that for England and Wales, which is recorded as 19.80. The number of children stillborn in the district was 6, out of a total of 419 births, as compared with 3 in 1959 out of 434 births. The death rate from all causes per 1,000 total population is 10.95 compared with 9.92 in 1959 and 11.50 for England and Wales. Of the 365 deaths, diseases of the heart accounted for 123 (33.70 per cent of total deaths), cancer 74 (20.27 per cent of total deaths), and tuberculosis 3 (0.82 per cent of total deaths). It will be seen from the table on page 13, showing causes of death, that there were 123 deaths from heart disease, and that other diseases of the circulatory system accounted for 17 deaths, while vascular lesions of the nervous system (stroke) accounted for 58 deaths, making a total of 198 deaths. Most of these deaths took place in people past middle-age, which follows the usual pattern of mortality in this district. The 74 deaths from cancer were also in people of advancing years. Inflammatory chest diseases accounted for 45 deaths, as against 31 in 1959. This increase may be accounted for by the inclement weather during a considerable part of the year, with accompanying heavy rainfall. No deaths were recorded from motor vehicle accidents, compared with 3 in 1959. All other accidents accounted for 5 deaths, the same number as in 1959. Suicides totalled 2 cases, compared with 4 in 1959. 7 No mothers died in childbirth during 1960, and this gives a maternal mortality rate per 1,000 total births of nil, as compared with 0-39 for England and Wales. The infantile mortality rate shows a decrease at 16.95 per 1,000 live births, as compared with 18.56 in 1959. Seven infants died under the age of 1 year in 1960 out of 413 live births. On page 15 will be found an analysis of the causes of death. The corresponding rate for England and Wales is 21 -90. The incidence of infectious disease generally throughout the year, has been low, measles giving the highest figure with 149 notified cases. Scarlet fever, with 61 notified cases was next in order of incidence, but this was lower than the previous year. Twenty-four cases of whooping cough were notified. It is felt that the attention of parents should again be drawn to the need for immunisation against whooping cough. The immunising material used throughout the year against diphtheria, contained immunising material against whooping cough and tetanus. It is pleasing to record that during the year no cases of poliomyelitis occurred in the Borough. This is the second year in succession in which we have been able to make this comment. Poliomyelitis inoculation was well received during the year. Since the scheme began in 1956 9,948 persons had been given two injections, and 8,429 a third injection, by the end of the year under review. The Minister of Health has announced the introduction of a fourth poliomyelitis injection for children over five years of age and who have not yet attained the age of twelve years. The records in respect of this, however, belong to the year 1961. Comment has been made in the medical and national press concerning the introduction of a new vaccine to be taken by mouth. The Minister's Medical Officers are still investigating the possibility of introducing this type of vaccine, which has been used in large quantities in Russia and some other countries. Both vaccines, that is, the Sabine, which is taken by month, and the Salk, which is injected, have given a good measure of protection. It is possible, however, that in the presence of epidemics both types have a different role to play, it being felt that the oral vaccine might present a rapid method of immunising a population in the event of an epidemic. The Minister of Health, however, has made no specific announcement on the introduction of oral vaccines, and is awaiting further work by English Medical Officers, before committing the Ministry. It is generally agreed that the incidence of poliomyelitis has fallen since the immunisation scheme was commenced. In Surrey alone, it is pleasing to record a reduction in incidence, from 353 cases notified in 1955, (amongst these 9 deaths) to 17 cases in 1959, amongst whom only 2 deaths occurred. One cannot escape the conclusion that this striking fall in incidence, which has coincided with the introduction of the immunisation scheme, is a direct result therefrom. 8 For the twelfth year there were no cases of diphtheria notified. The immunisation against this disease continues to occupy a large place in the work of the department, both in children attending Infant Welfare Centres and Schools in the Borough. During the year the work of the department increased considerably with excursions into the field of social medicine. The care of the aged, with all the complications of geriatric services, kept the staff very well occupied. In addition, the Co-ordinating Conferences for the Prevention of the Break-up of Families were held regularly, and arising out of these, a considerable degree of social work, involving the Health Visitors, the County Council's Social Worker, and the Women's Voluntary Service, was undertaken. At these Conferences, the presence of a representative of the Corporation's Housing Department has been of the utmost value. Many of the problems arising at the Conferences were associated with housing, and it is sad to recall that so many years after the war, a great amount of unhappiness and hardship is still experienced through the inadequate housing of many families. In some cases, re-housing in New Towns has given young people a fresh start in life, free from "in-law" problems. Some cases have also been re-housed within the Borough, to enable children, for the first time, to enjoy the benefits of a garden and the society of their parents, without other interference. This new beginning, too, has enabled young married people to appreciate each other better, and has prevented, in some instances, a deterioration in the husband and wife relationship, with the threat of a family break up. It is also unfortunate to record that a few old people living alone, have shown a complete lack of a spirit of co-operation with those willing and anxious to help them. In the year under review two such cases were removed, under Section 47 of the National Assistance Act, through a Magistrate's Order. The circumstances in which these poor old people had allowed themselves to drift, made such an action imperative. The fire at the Grange Mansion, which disrupted the whole of the County Council's clinic services, was commented upon in last year's report, and the new deployment of the services throughout the town was given prominence. During the year under review, plans for providing, under one roof, a unified comprehensive clinic, were discussed by the County Council, and also by the Borough Council. Agreement has been reached for the provision of a comprehensive new clinic adjacent to, and on the south side of the Town Hall, on a plot being acquired by the Beddington and Wallington Corporation, at the corner of Shotfield and Stanley Park Road. This area comprises approximately one acre, and gives ample opportunity for spacious clinic development. It is hoped that the architectural design will be in keeping with the Town Hall, and the new work being contemplated by the Corporation comprising an additional storey to the present Library building. The gardens will be re-designed, and it is hoped to achieve a pleasant vista from Stanley Park Road, looking down to the ornamental fish pond. 9 Various services, sewage disposal, collection of refuse, and the provision of an adequate and wholesome water supply are taken so much for granted to-day, that members of the general public are apt to overlook the care and thought which has to be given to maintain an adequate service in all these branches of hygiene and public health. An event of some importance took place during the year, when the Sutton District Water Company opened the new North Looe Reservoir, on Friday, 23rd September, 1960. As is well known, the Water Company obtains its water from deep wells sunk in the chalk at Sutton, Woodmansterne and Cheam. The water is softened and sterilized before being pumped to supply, and strict chemical and bacteriological control is maintained over all these supplies, which are supplemented at times of peak demand by a bulk supply by agreement with the Epsom Corporation. The new reservoir is constructed of reinforced concrete and has a capacity of 6,200,000 gallons with a top water level of 285 O.D. It is 283 ft. 6 in. long by 192 ft. wide, and when full contains a depth of water of 20 feet. The site is sufficiently large to permit the reservoir to be extended if required. It is a matter of considerable satisfaction to all the sanitary districts within the Sutton District Water Company's supply area, that this provision has been made, which should satisfy both industrial and domestic needs within the large residential population involved, for many years to come. 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. 1 have the honour to be, Ladies and Gentlemen, Your obedient servant, PATRICK J. O'CONNELL, Medical Officer of Health. Public Health Department, Town Hall. Wallington. Telephone: Wallington 4500. July, 1961. 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 1960 32,330 Number of inhabited houses, 1931 7,092 Number of inhabited houses, 1960 10,253 Rateable Value £733,998 Sum represented by penny rate £2,980 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 Borough is practically fully developed, but the Council has preserved much of the open character of the area, by the extensive use of its powers in providing parks and open spaces. The area is mainly residential, but there are factories in the Borough, providing employment for some 9,000 people, these being situated mostly in the northern part of the Borough. During recent years there has been considerable residential development in the southern part of the Borough, with the provision of new roads of detached houses. All this development, in one of the best parts of the district, has been carried out on a policy of low density of houses to the acre, and the whole character of the scheme is in keeping with the accepted standards of the southern part of the Borough. Parks and open spaces continue to be well maintained, and give breathing space and facilities for open-air recreational activities. Beddington Park and Grange Park are used as much as ever, and are an inestimable boon during the holiday months to children and parents, who are unable to go away for a holiday. The pleasing residential character of the district is well maintained, and is much appreciated by many City workers, who return home to pleasant relaxation in their gardens and allotments in the evenings. 11 EXTRACTS FROM VITAL STATISTICS Resident Population—Estimated mid-year 1960 32,330 Live Births Males Females Total Legitimate 189 199 388 Illegitimate 9 16 25 Total 198 215 413 Live Birth Rate per 1,000 population 12.77 Adjusted Birth Rate 13.54 England and Wales Live Birth Rate 17.10 Illegitimate Live Births per cent of total Live Births 6.05 Still Births Legitimate 3 3 6 Illegitimate — — — Total 3 3 6 Rate per 1,000 total Live and Stillbirths 14-32 England and Wales Stillbirth Rate 19-80 Live and Stillbirths Legitimate 192 202 394 Illegitimate 9 16 25 Total 201 218 419 Deaths 189 176 365 (i) Death Rate per 1,000 population 11.29 Adjusted Death Rate 10.95 England and Wales Death Rate 11.50 (ii) Infant Deaths—under 1 year of age Total No. of Deaths 7 Infant Mortality Rate per 1,000 Live Births 16.95 Infant Mortality Rate per 1,000 Live Births: Legitimate 18.04 Illegitimate Nil Infant Mortality Rate for England and Wales 21.90 Neo Natal Mortality Rate per 1,000 Live Births 12.11 (Under 4 weeks of age) Early Neo-natal Mortality Rate per 1,000 Live Births 9.69 (Deaths under 1 week) Peri-natal Mortality Rate per 1,000 Live and Stillbirths 23.87 (Stillbirths and deaths under 1 week) (iii) Maternal Deaths (including abortion) total Nil Maternal Mortality Rate per 1,000 Live and Stillbirths Nil England and Wales Maternal Mortality Rate 0.39 12 REGISTERED CAUSES OF DEATH The following table, supplied by the Registrar-General, gives the causes of death of residents in the Borough during 1960: Causes of Death Males Females Total All Causes 189 176 365 1. Tuberculosis, respiratory 3 — 3 2. Tuberculosis, other — — — 3. Syphilitic disease — 1 1 4. Diphtheria — — — 5. Whooping Cough — — — 6. Meningococcal infections — — — 7. Acute poliomyelitis — — — 8 Measles — — — 9. Other infective and parasitic diseases — — — 10 Malignant neoplasm, stomach 6 4 10 11. Malignant neoplasm, lung, bronchus 15 2 17 12. Malignant neoplasm, breast.. — 8 8 13. Malignant neoplasm, uterus.. — 3 3 14. Other malignant and lymphatic neoplasms 17 19 36 15. Leukaemia, aleuksemia 1 2 3 16. Diabetes — 4 4 17. Vascular lesions of nervous system 24 34 58 18. Coronary disease, angina 38 27 65 19. Hypertension with heart disease 3 4 7 20. Other heart diseases 20 31 51 21. Other circulatory diseases 12 5 17 22. Influenza — — — 23 Pneumonia 13 13 26 24. Bronchitis 16 3 19 25. Other diseases of respiratory system 1 2 3 26. Ulcer of stomach and duodenum 4 1 5 27. Gastritis, enteritis and diarrhoea — 1 1 28. Nephritis and nephrosis 1 — 1 29. Hyperplasia of prostate 1 — 1 30. Pregnancy, childbirth, abortion — — — 31. Congenital malformations — 2 2 32. Other defined and ill-defined diseases 9 8 17 33. Motor vehicle accidents — — — 34. All other accidents 4 1 5 35. Suicide 1 1 2 36. Homicide and operations of war .. - - - 13 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 123 33.70 Other Diseases of the Circulatory System 17 4.66 Vascular Lesions of Nervous System 58 15.89 Cancer 74 20.27 Bronchitis 19 5.21 Pneumonia 26 7.12 Tuberculosis (All Forms) 3 0.82 Cancer of the Lung and Bronchus Males Females Total Number of deaths in 1960 15 2 17 Rate per 1,000 population 0.53 England and Wales Rate 0.48 VIOLENCE AND ACCIDENT Details of all deaths under this heading are as follows: Cause of Death Male Female Total Suicide 1 1 2 Other Violent Causes 4 1 5 Totals 5 2 7 MATERNAL MORTALITY No deaths in childbirth, either from puerperal sepsis or other maternal causes, were recorded during the year. The maternal mortality rate for England and Wales per 1,000 live and still births was 0.39. INFANTILE MORTALITY The infantile mortality rate for 1960 was 16.95 per 1,000 live births. The comparable rate for England and Wales is 21.90. Great credit is due to the services operated in the Borough for the care of mothers and young children. Of the total of 413 live births, only 7 deaths of infants under one year of age (5 males and 2 females) were registered. 14 The following table gives the age and cause of death of each infant who died: Age Sex Cause of Death 3 mins. M Sub-tentorial haematoma post-maturity 43 mins. M Atelectasis Prematurity 8 hours F Congenital internal hydrocephaly 16 hours M Tentorial tear, post-maturity 15 days M Broncho-pneumonia, Prematurity 3 months F Pulmonary oedema, Cardiac failure Congenital heart disease, Septicaemia 3 months M Broncho-pneumonia 15 GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA (Including transferred functions adminstered by the local health authority — The Surrey County Council.) NURSING IN THE HOME The Beddington and Wallington District Nurses' Home, 57 Montagu Gardens, 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 Mid-Eastern Division. During the year the District Nurses attended 812 cases, including 107 maternity and midwifery patients. A total of 22,805 visits was made. As pointed out in the preface, since the destruction of the Grange Mansion, the school health service has been housed in the Nurses Home, and in addition, physiotherapy, and ante-natal relaxation exercises are carried out on the premises. 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 at the Wallington Town Hall, and a part-time supervisor, who acts under the general direction of the Divisional Medical Officer, is employed. Close liaison was kept up with the almoners of hospitals, and it was found possible to meet the many requests received for Medical and Surgical patients and the care of the aged under the St. Helier Hospital geriatric service. The cases attended were as follows: Total Maternity 43 Chronic Sick (including aged and infirm)194 Acute Sick 40 Tuberculosis 277 CHIROPODY A chiropody service introduced in 1958 through the active co-operation of the W.V.S. and the British Red Cross, continued to operate in I960, as follows:— (1) The chiropodist attends one morning a week at British Red Cross House, in Woodcote Road, and for a small fee, old people can come and have their feet treated. (2) Arrangements are made through the Beddington and Wallington Fund for the Aged and Infirm, for a chiropodist to visit the homes of old people, who are unable to get out, and treatment is carried out in their own homes, at an agreed cost to the Fund. 16 (3) A member of the W.V.S. qualified in chiropody, occasionally gives treatment voluntarily, to home-bound and aged persons. The County Council, in February 1960, approved arrangements for the provision of chiropody for the elderly, and for expectant mothers and physically handicapped persons. The scheme came into operation in May, 1960. So far as the elderly are concerned, the County Council invited voluntary bodies administering schemes for chiropody treatment, to continue and expand their schemes, with financial help from the Council. The Divisional Medical Officer was asked to administer the scheme for expectant mothers and handicapped persons, through chiropodists practising in the area who had agreed to participate in the scheme. The chiropodist is paid a uniform fee of 7s. 6d. for each treatment undertaken in the surgery. The patient is required to contribute a standard fee of 3s. In approved cases the Divisional Medical Officer may authorise treatment free of charge. Negotiations were proceeding at the end of the year for an appropriate fee for domiciliary visits in necessitous cases. In the meantime a fee of 8/6d. is paid to a chiropodist for a domiciliary visit, where this is agreed, on medical grounds. THE CARE OF MOTHERS AND YOUNG CHILDREN 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, 146 women made 541 pre-natal attendances. This represents an attendance of 34.84 per cent of the total number of confinements which occurred during 1960. Post-natal examinations were also conducted at this clinic, 14 patients making 16 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. Institutional Confinements. Three hundred and eight or 73.51 per cent. of births allocated to this district, took place in hospitals and nursing homes, compared with 72.35 per cent 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. 17 Treatment Centres and Clinics Child Welfare Centres When held Every Monday, 2.0-4.0 p.m. Hackbridge Centre, All Saints Church Hall, New Road. Bandon Hill Centre, Methodist Hall, Sandy Lane North. Every Tuesday, 2.0-4.0 p.m. Bbddington Centre, The Scout Hall, Guy Road. Every Wednesdays, 2.0-4.0 p.m. Wallington Centre, Baptist Hall, Queen's Road. Every Wednesday, 2.0-4.0 p.m. Maternity Clinics Ante-natal Clinic Post-natal Clinic, District Nurses' Home, 57 Montagu Gardens. Every Thursday, 2.0-4.0 p.m. Physiotherapy Clinic, By appointment. 57 Montagu Gardens. Dental Clinic, Rochester Road, Carshalton. 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. The ladies of the W.V.S. continued to organize the sales and distribution of the Welfare Foods, previously administered by the Ministry of National Insurance. Infant Welfare Services. 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. Following the disastrous fire which destroyed the Grange Mansion in January 1960, it was found necessary to provide a new Infant Welfare Clinic at All Saints Church Hall, New Road, Mitcham Junction to serve the residents in the Hackbridge and Mitcham Junction areas. This clinic was opened on the 1st February, 1960. In addition, weekly sessions were commenced at the Baptist Church Hall, Queens Road, Wallington, on 13th January, to meet the increased demand from mothers in the area who had been attending the Grange Mansion clinic. 18 Later in the year, the fortnightly clinic held at the Beddington Village Hall, was transferred to The Scout Hall, Guy Road. It was agreed that a clinic on this site would provide facilities for a larger number of mothers and young children, and on the 7th December weekly sessions were commenced. The number of attendances recorded at the four clinics during the year was as follows:— Number attending Total attendances Children under 1 year 333 4,861 Children, 1-5 years 839 3,329 Total attendances 1,172 8,190 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. During the year under review, difficulty was experienced in maintaining the establishment of four health visitors. Following the resignation of one health visitor, to take up a senior appointment, no candidates came forward for a period of four months in response to repeated advertisements. In addition, one health visitor had a long period of sickness. Visits during the year were made as follows: First visits Total visits Expectant Mothers 236 437 Children, 0-1 year 434 2,003 Children, 1-5 years — 3,743 Other Cases — 201 Ineffectual — 925 670 7,309 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. Care of Premature Infants. The arrangements made for the care of premature infants continued during 1960. Equipment is kept at the District Nurses' Home, the headquarters of the local Midwives, where it is ready for immediate use when required. Sixteen premature live births were notified during the year, 15 of which occurred in hospital. One infant died within 24 hours of birth. One infant died before the 28th day. The remaining 14 children survived. 19 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. Treatment. Minor Ailments. Forty-seven cases were referred from the Infant Welfare Centres to Hospital Specialists for investigation and treatment during the year. The principal defects were as follows: Eye conditions 12 Tonsils and adenoids 15 Orthopaedic defects 8 Nævi and skin conditions 4 Circumcisions 2 Dental. The year's work at the Grange Dental Clinic, which provided for school children and children below the age of five years, as well as nursing and expectant mothers, is summarised in the following table: No. of Cases Extractions Fillings Scaling & Gum Treatment Provision of Dentures Full Partial Expectant and Nursing Mothers 5 5 7 6 - - Children, 0-5 43 51 77 — — — Totals 48 56 84 6 — — As has been pointed out elsewhere, this service is now accommodated at Rochester Road, Carshalton, and will continue on these premises until the County Council's new clinic project is ready. Orthopedic. Patients attending infant welfare centres who require treatment for orthopaedic defects are referred by the Clinic Medical Officer to orthopaedic surgeons at St. Helier or other hospitals. During 1960, 8 cases were referred for treatment. 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 are given. Classes for remedial exercises for children suffering from minor orthopaedic and postural defects were conducted during the year. The Physiotherapist continued to arrange classes for pregnant mothers desiring a course of relaxation exercises. 20 The following table gives details of attendances: Total attendances Irradiations Corrective treatments Children, 0-5 years 268 201 Children, 5-15 years 472 1,933 Expectant and Nursing Mothers 1 313 741 2,447 Immunisation and Vaccination This is one of the services transferred to the local Health Authority on 5th July, 1948. In Beddington and Wallington the work is conducted by the Divisional Medical Officer. In addition, general practitioners have been brought into the scheme and they forward returns of completed cases ofimmunisation to the Divisional Medical Officer, for which they receive a fee. Smallpox Vaccination. During 1960, 348 persons including 300 children under 5 years of age, were vaccinated and 58 persons were re-vaccinated, at the weekly clinic held at the Town Hall, or by their general practitioner. Diphtheria Immunisation. Four clinicsare heldweekly 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 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., 1960 1,830 4,600 6,430 Number of children known to be immunised at 31st Dec., 1960 1,341 4,467 5,808 Percentage of children immunised 73.3 970 90.3 It is customary now to include immunisation against both whooping cough and tetanus in the injection given to immunise against diphtheria. Children immunised primarily against diphtheria, therefore, are automatically immunised against whooping cough and tetanus at the same time. 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, 395 children were immunised at County Council clinics or by their general practitioner. Tetanus Immunisation. Children are immunised against Tetanus at County Council clinics, or by their general practitioner. During 1960, 357 children completed a primary course and 19 children received a reinforcing dose. 21 Poliomyelitis The Poliomyelitis vaccination scheme, introduced in January 1956 continued, within the prescribed age groups, throughout 1960. The following is a summary of the persons who had been vaccinated by the end of the vear: Two Injections Three Injections Children born 1943—1960 6858 6472 Persons born 1920—1942 2620 1570 Expectant Mothers 410 355 General Practitioner and Ambulance Staff 60 32 9948 8429 An extension to the scheme for vaccination against poliomyelitis was made on 1st February, 1960, when the Minister of Health offered vaccination to persons up to their fortieth birthday. These persons are now included amongst the priority groups for whom the Local Health Authority may carry out vaccination. The response from the groups for whom poliomyelitis vaccination has been made available, has continued at a satisfactory level throughout the year. However, persons within the new age group up to forty years of age, have not come forward in such numbers as the Minister had hoped. It should be emphasized that, while poliomyelitis has generally been accepted as principally a disease of the young, statistics have shown in recent years, that many paralytic cases had occurred between the ages of twenty and forty. 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 were conducted at 57 Montagu Gardens Wallington, Rochester Road and Phoenix Flats, Carshalton. The services provided at these clinics were general medical inspection and treatment, dental treatment, speech therapy and physiotherapy. Cleansing of Persons During 1960 the Corporation continued to provide facilities for cleansing infested persons. LABORATORY FACILITIES The Corporation's arrangements for the examination of swabs, sputa and other pathological material continue as heretofore. During 1960, H. Amphlett Williams, Esq., Ph.D.(Lond.), A.C.G.F.C., F.R.I.C., Public Analyst, City of London Laboratories, King's Head Yard, Borough High Street, London, 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. 22 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. 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. 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. 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 163 Kingston Road, New Maiden, with a sub-station, covering the Beddington and Wallington area, located in Carshalton. 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. 23 HOUSING I am indebted to the Town Clerk, the Borough Engineer and Surveyor, and the Chief Public Health Inspector for the following information, which is given in connection with rehousing, the erection of new houses, and overcrowding:— Rehousing Number of houses requisitioned since the beginning of the war and still held under requisition Nil Number of prefabricated bungalows provided since the end of the war 94 Number of families rehoused by the Council or by private owners at the Council's instigation since the beginning of the war 1185 Number of live applications on the housing list for accomodation in Beddington and Wallington:— On the general waiting list 353 On the aged persons' list220 For accommodation in Frimley and Camberley 32 New houses erected, etc. Number of new houses and flats erected in 1960:— Private enterprise 53 Local Authority Nil Number of flats erected by conversion in 1960:— Private enterprise 5 Local Authority 11 Number of houses and flats purchased in 1960 and let .. 23 Housing Act, 1957 Eighty nine houses were rendered fit as a result of informal or statutory action under the Public Health Act, 1936 and Housing Act, 1957. Number of inspections of dwelling-houses .. 223 Number of inspections recorded under Housing Regulations 18 In the absence of a complete survey of the Borough, it is impossible to give accurate figures relating to the number of cases of overcrowding. Evidence available indicates that the number is low. The table below sets out information concerning cases of overcrowding which have come to the knowledge of the Health Department. Number of dwellings overcrowded at the end of the year 5 Number of families dwelling therein 5 Number of persons dwelling therein 31 Number of new cases of overcrowding reported 2 Number of cases of overcrowding relieved 1 Number of persons concerned 4 Number of dwellinghouses in respect of which the Local Authority have taken steps for the abatement of overcrowding and which have again become overcrowded Nil Rent Act 1957 Three applications for Certificates of Disrepair were received. Three notices of intention to issue Certificates of Disrepair were sent out. Two Certificates of Disrepair were issued. 24 SANITARY CIRCUMSTANCES OF THE AREA WATER SUPPLIERS The water supply is piped throughout the district from the Sutton District Water Company. All dwelling-houses 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 93 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 the arrangements for sewerage and sewage disposal continued to be adequate. The sewers have been systematically cleaned and flushed, and no major difficulties were experienced in the maintenance and cleansing of soil and storm water drainage systems, during the year. RIVERS AND STREAMS Normal cleansing of the River Wandle was carried out. 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 During the year under review, the Borough Surveyor was able to continue refuse collection on a weekly basis. 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. None of these premises are dwelling houses. 25 SANTARY INSPECTION OF THE AREA The following statement by the Chief Public Health Inspector gives statistics as to the number of complaints received, inspections made, defects remedied, and other work carried out by the Public Health Inspectors. REPORT OF THE CHIEF PUBLIC HEALTH INSPECTOR FOR THE YEAR, 1960 INSPECTION AND SUPERVISION OF FOOD MILK AND DAIRIES Number of distributors of milk on register 15 Number of milk depots other than dairy farms on register 3 Number of above premises upon which loose milk is handled Nil Number of inspections of premises 3 Number of licences issued under Milk (Special Designation) Regulations: Tuberculin Tested Milk—Dealers' Licences 9 „ „ „ Supplementary Licences 16 Pasteurised Milk—Dealers' Licences 9 „ „ Supplementary Licences 16 Sterilized Milk—Dealers' Licences 10 „ „ Supplementary Licences 17 77 BACTERIOLOGICAL EXAMINATION OF MILK Ninety-two 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 59 59 — 59 — — — T.T. Pasteurized 18 18 — 18 — — — Sterilized 10 — — — — 10 — Tuberculin Tested (Farm Bottled) 5 5 — — — — — Six samples of Tuberculin Tested milk were submitted for biological examination - Tubercle bacilli were not isolated. 26 CHEMICAL ANALYSES OF MILK Fifteen samples of milk were submitted to the Public Analyst. All were reported genuine. The average composition was as follows: Fat %3.51 Solids-not-fat % 8.61 Total Solids % 12.12 ICE CREAM Number of premises registered for the sale of ice cream 99 Number of manufacturers Nil Number of inspections of premises 26 Twenty-two samples of ice cream were procured and submitted for bacteriological examination. The results are set out in the following table:— Type No. of Samples Methylene Blue Test Grade 1 Grade 2 Grade 3 Grade 4 Ice cream 22 21 1 - — Three samples of Ice lolly were submitted for bacteriological examination and passed the tests applied to them. CHEMICAL ANALYSES OF ICE CREAM Two samples of ice cream were submitted for analysis. Both complied with the standard. SLAUGHTERHOUSES Number of licensed slaughterhouses .. Nil FOOD PREMISES IN THE DISTRICT Bakehouses 6 Bakers 11 Butchers 25 Catering Establishments 82 Chemists10 Confectioners (sweets) 44 Fishmongers (including friers) 10 Greengrocers 27 Grocers 67 Licensed Premises 11 Bakehouses 6 Food Factories 4 Total number of visits 384 27 FOOD PREMISES REGISTERED UNDER SECTION 16 OF THE FOOD & DRUGS ACT, 1955 Sausage manufacturers 27 Fish friers 6 Jam manufacturers 1 Ice cream (sale only) 99 Food Hygiene (General) Regulations, 1960 Inspections of food premises continued during I960. The type of premises visited and number of inspections are set out below: Bakehouses12 Bakers 43 Butchers 35 Catering Premises 47 Confectioners (sugar)18 Fishmongers 26 Greengrocers 24 Grocers 71 Milk Shops 3 Registered Premises 45 Other Food Premises 72 As a result of these visits, shopkeepers were persuaded to carry out the improvements listed on page 37. It was not necessary to institute legal proceedings. UNSOUND FOOD Destroyed or released for animal feeding:— lbs. Cereals 5 Cheese 4 Fish, canned 2 Fruit, canned 57 Meat and Offal 98 Meat, canned 1064 Milk, canned 8 Preserves 9 Vegetables, canned 3 Total 1250 SAMPLING. 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 City of London Laboratories, King's Head Yard, Borough High Street, London, S.E.I, is Public Analyst for the Borough. 28 FOOD ANALYSES The following table gives details of samples submitted for analysis during the year: Totals 1960 Articles No. Examined Adulterated Prosecu tions Convic tions Formal. Informal Total Formal Informal Total Ale 1 - 1 - - - - - Blancmange powder — 1 1 - - - - - Bread — 6 6 — 6 6 — — Butter 1 — 1 - - - - - Coffee essence 1 — 1 - - - - - Confectionery Sugar 1 14 15 - - - - - Cream — 1 1 - - - - - Curry powder — 1 1 - - - - - Drink, soft 1 2 3 - - - - - Fish cakes, frozen — 1 1 - - - - - Fish paste — 2 2 - - - - - Flour (plain) — 1 1 — 1 1 — — Fruit, canned — 3 3 - - - - - Gin 1 — 1 - - - - - Gravy preparation — 1 1 - - - - - Ice cream 2 — 2 - - - - - Ice lolly — 1 1 - - - - - Jam — 3 3 - - - - - Jelly tablet — 1 1 - - - - - Lard 1 — 1 - - - - - Margarine 1 — 1 - - - - - Meat (minced beef) 1 — 1 - - - - - Meat products — 4 4 - - - - - Meat products, canned — 6 6 -— 1 1 — — Milk 8 7 15 — — — — — Milk, condensed 1 2 3 — — — — — Milk, evaporated — 1 1 - - - - - Peel, candied 1 — 1 — — — — — Proprietary Medicine — 2 2 — 1 1 — — Rum 1 — 1 - - - - - Salad cream - 2 2 — — — — — Sausages 3 2 5 — — — — — Soup, canned 1 — 1 - - - - - Spices 2 1 3 — 1 1 — — Suet, shredded 2 2 4 1 2 3 — — Sugar 2 — 2 - - - - - Tapioca 1 — 1 - - - - - Vegetables, canned — 3 3 - - - - - Vinegar 1 — 1 1 — 1 — — Whisky 1 - 1 - - - - - Total 35 70 105 2 12 14 — — 29 UNSATISFACTORY SAMPLES Informal Sample No. 17—Bread (Submitted as a result of a complaint) The bread was discoloured by a dark streak, caused by the presence of minute particles of iron and mineral grease. The Public Health Committee recommended that no action be taken on this occasion. Informal Sample No. 40—Shredded Beef Suet The suet contained 80.5% fat and 19.5% flour. Shredded suet should contain not less than 83% of fat. A formal sample was obtained. Formal Sample No. 43—Shredded Beef Suet The suet contained 81.4% fat and 18.6% flour. Shredded suet should contain not less than 83 % of fat. A warning letter was sent to the manufacturer. Informal Sample No. 46—Portion of Bread Roll (Buttered) The bread roll contained foreign matter, consisting of a small grey mass of flour, butter and dust. The Public Health Committee recommended that no action be taken. Informal Sample No. 50—Shredded Beef Suet The suet contained 77.5% fat and 22.5% farina. Shredded suet should contain not less than 83 % of fat. A formal sample was obtained which complied with the Food Standards (Suet) Order, 1952. Informal Sample No. 52—Proprietary Medicine: "Charabs" The "Charabs" contained 0.075 gr. per tablet of quinine sulphate and 0.125 gr. per tablet of sodium salicylate. Compared with the formula on the label, the analysis indicated a deficiency of 25 % of the quinine sulphate, and 50% of the sodium salicylate. A letter was sent to the manufacturers who stated that they expected to commence manufacture to an improved formula shortly. Informal Sample No. 53—Portion of White Loaf (Submitted as a result of a complaint) The bread contained foreign matter, consisting of small black masses of grease, flour and finely divided particles of iron. A warning letter was sent to the manufacturer. Informal Sample No. 54—White Loaf (Submitted as a result of a complaint) The bread contained foreign matter, which appeared to consist of stale dough and formed grey discoloured streaks penetrating the crumb. The Public Health Committee recommended that no action be taken. Informal Sample No. 67—Pork Luncheon Meat, Canned The pork luncheon meat contained 67 % of meat. Pork luncheon meat ordinarily contains at least 80 % of meat. Correspondence with the manufacturers indicated that this sample was of meat manufactured prior to 1st October, 1959. 30 Informal Sample No. 71—Slices of White Loaf (Submitted as a result of a complaint) The slices contained a discoloured streak caused by the presence of a large number of minute particles of iron. The iron may have resulted from the accidental introduction of a small quantity of used lubricating oil. It was decided that no further action should be taken. Informal Sample No. 82—Plain Flour (Submitted as a result of a complaint) The flour contained a small particle of black rubber, a small quantity of insect webbing and a live caterpillar (ephestia kuehniella). A warning letter was sent to the manufacturer. Formal Sample No. 86—Vinegar The vinegar contained a deposit of foreign matter, consisting of a slimy, cohesive mass of bacteria, fungi and dust. A warning letter was sent to the manufacturer. Informal Sample No. 88—Ground Nutmegs The nutmegs contained insect fragments derived from various species of beetles, 360 per ounce. Following representations the packers agreed to alterations to their plant. A further sample was obtained and proved satisfactory. Informal Sample No. 100—Sliced White Loaf The bread contained a small dead caterpillar embedded in the bread, in which it had been baked. The caterpillar referred to is larval stage of the flour moth. It was decided to take no action. 31 FACTORIES ACT, 1937—1959 The following tables give details of inspections made and defects found: Part I of the Act 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 5 3 - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 159 96 4 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 4 6 1 - Total 168 105 5 — Part VIII of the Act Outwork Section 110 Section 111 Nature of Work 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) Stuffed toys 10 - - - - - Wearing apparel: Making, etc. 3 - - - - - Total 13 — — — — — 32 Cases in which Detects 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.l) 1 1 - - - Overcrowding (S.2) — — - - - Unreasonable temperature (S.3) - - - - - Inadequate ventilation (S.4) - - - - - Ineffective drainage of floors (S.6) - - - - - Sanitary conveniences (S.7): (a) Insufficient 1 1 — — - (b) Unsuitable or defective 2 2 - 1 - (c) Not separate for sexes - - - - - Other offences against the Act (not including offences relating to Outwork) - - - - - Total 4 4 - 1 — WORKPLACES, SHOPS AND OFFICES Number of inspections 240 Notices served 2 33 INFECTIOUS DISEASE AND DISINFECTION Number of visits re cases of infectious disease 436 Number of rooms disinfected 65 Number of library books disinfected 443 OFFENSIVE TRADES Number of offensive trade premises in district Nil CLEAN AIR ACT 1956 Smoke Control Areas Two areas of the Borough have now been declared Smoke Control Areas by Orders made by the Borough Council viz: Beddington and Wellington No. 1 Smoke Control Order relating to that part of the Borough bounded by the boundary with the Urban District Councils of Carshalton and Coulsdon & Purley, and by Woodcote and Heathdene Roads. This Order designating this area has been confirmed by the Minister of Housing and Local Government following a Local Enquiry held in June. It will come into force on the 1st November, 1961. The area contains 359 houses and covers an area of 270 acres. Beddington and Wallington No. 2 Smoke Control Order relating to the area bounded by the County Borough of Croydon and the Urban District of Coulsdon & Purley, and by Woodcote Road, Sandy Lane South and Stafford Road. The preliminary survey of premises in this area was continued during the year and an Order was made and forwarded to the Minister for confirmation early in 1961. This Order, when confirmed, will come into operation on the 1st October, 1962, or such later date as the Minister may decide. A summary of the information submitted to the Ministry of Housing and Local Government is set out below. Total number of dwellings 13(0 (including dwellings built since July, 1956) Acreage of Area 700 Industrial premises 5 Commercial and other premises 12 Present annual tonnage of bituminous Domestic Industrial coal and other smoky fuels 985 tons 550 tons Annual tonnage not to be replaced 550 tons Estimated additional fuels required annually: (1) Electricity 59,000 kws. (2) Gas 1 1,000 therms. (3) Oil etc. Nil (4) Solid smokeless fuel (open fires) 790 tons (5) Solid smokeless fuel (stoves and boilers) 1 ton 34 Schedule of Estimated Costs of Adapting and Replacing Fireplaces Number of existing appliances requiring replacement or adaptation (appliances in regular use only): (1) Open fires 1,166 (including new properties) (2) Open fires with boilers 41 (3) Combination grates and solid fuel cookers Nil (without boilers) (4) Combination grates and solid fuel cookers 2 (with boilers) (5) Washboilers Nil Numbers and costs of new appliances required: New Appliances Open Fires Gas or Electric hires Open Fires with Boilers Other Appliances Totals No. of Appliances 731 13 6 2 752 Total Cost of Appliances £4062 £88 £33 £26 £4,209 Range of cost per appliance £4.10-£19 £5—£13 £5-10-0 £13 — Total cost of other works attributable to installation of new appliances £2,964 £34 £24 £15 £3,037 Cost of other work not attributable to installation of new appliances: Adaptation of Existing Appliances Provision of Gas and Electric Points No. of Appliancee Total cost No. of points Total cost 457 £2040 24 £80 INDUSTRIAL PREMISES During the year 137 observations were made on the chimneys of Industrial premises. No contraventions of the Dark Smoke (Permitted Periods) Regulations were reported. Advice was given when consulted, on the heights of new chimneys and new furnaces to be installed. 35 PREVENTION OF DAMAGE BY PESTS ACT, 1949 Report for 12 months ending 31st December, 1960 Type of Property Local Authority Dwelling Houses Business (& other premises) Total Agricultural Number of Properties in Local Authority's district 37 10,196 1,490 11,723 33 Number of Properties inspected as a result of: (a) Notification 1 90 32 123 1 (b) Survey under the Act 36 289 117 442 32 (c) Primarily for some other purpose — 332 467 799 42 Properties found to shew major rat infestations — — — — — Properties found to shew minor rat infestations 4 67 22 93 — Properties found to shew major mice infestations — — — — — Properties found to shew minor mice infestations — 17 12 29 — Total Infestations 4 84 34 122 — SEWER RAT CONTROL During the year, three maintenance treatments were carried out. These were in the months of February, June and December. The results are summarised below: February Treatment June Treatment December Treatment Manholes baited 67 70 80 Manholes in which takes were recorded 23 19 17 Percentage of manholes showing infestations 34 27 21 58 manholes were test baited during January. 8 takes were recorded. 36 PETROLEUM (REGULATION) ACTS 72 Licenses were issued to keep petroleum spirit and/or petroleum mixture at 61 premises. The maximum quantities of these substances which may be kept under licence in the Borough are as follows: Petroleum Spirit 74,070 gallons (51 licences) Petroleum Mixture 12,345 gallons (21 licences) 46 inspections of premises were made. SHOPS ACT, 1950 The total number of inspections during the year was 225. Heating, lighting and ventilation, together with provision of sanitary and washing accommodation, have been kept under observation. Routine visits have been made in connection with general closing hours, weekly half-holidays and Sunday trading. PET ANIMALS ACT, 1951 One application for a licence to keep a pet shop was received. This was withdrawn following failure to obtain planning approval. THE GAME ACT, 1831 Three licences to deal in game were issued. HEATING APPLIANCES (FIREGUARDS) ACT, 1952 Inspections of appliances, particularly in second-hand shops have been made. One contravention was noted. RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951 No applications were received under this Act. CARAVAN SITES AND CONTROL OF DEVELOPMENT ACT, 1960 There are no caravan sites. Constant watch is kept for the appearance of unauthorised vans on land in the Borough. These are removed with the co-operation of the land owners. NOISE ABATEMENT ACT, 1960 This Act came into force during November. No complaints of noise were received during the period up to the end of the year. Two complaints of noise were received earlier in the year and informal action was attempted. 37 SUMMARY COMPLAINTS The total number of complaints received was 632. They were due to the following causes: Rats and Mice 125 Housing defects . 74 Choked drains and sewers 112 Defective dustbins 44 Defective drainage (including closets) 15 Unsound or adulterated food 28 Atmospheric Pollution 26 Insect pests 139 Offensive accumulations . 12 Miscellaneous 57 632 NOTICES SERVED Number of informal notices served (including verbal intimations) 152 Number of statutory notices served Public Health Act, 1936—Section 93 (Nuisances) 9 Housing Act —Section 9 1 10 SANITARY IMPROVEMENTS (1) Dwelling Houses Brickwork repaired or repointed 3 Ceilings— Repaired, renewed or cleansed 15 Chimneys— Stacks and flues repaired 6 Dampness remedied— (a) Roofs repaired 27 (b) Damp-proofing works 21 (c) Gutters and rainwater pipes repaired and unstopped 29 Doors—repaired or renewed 11 Drainage— (a) Obstructions cleared 72 (b) Repaired and relaid 17 (c) Inspection chambers provided and repaired 6 (d) F.A.I, provided, etc. 1 (e) Waste-pipes repaired and renewed 3 (/) Rainwater drainage provided, repaired or renewed 5 Dustbins provided 49 Fireplaces and stoves repaired or renewed 5 Floors— (a) Repaired or renewed 9 (b) Ventilation provided or improved 1 Walls- fa) Repaired or rebuilt 37 (b) Plaster repaired and redecorated 11 38 W.C. Accommodation— (a) Cisterns repaired or renewed 3 (b) Flush pipe joint repaired 1 (c) Pans provided or replaced 1 (d) Seats repaired or renewed 3 (e) Structural repairs 1 Windows— (a) Frames and sashes repaired or renewed 22 (b) Sashcords and beading renewed 16 (c) Glazing and putties renewed 7 (d) Cills repaired 21 Yard paving repaired or renewed 3 Other Sanitary improvements 6 (2) Factories Cleansed 1 Sanitary Accommodation— Provided 1 Improved 2 Other Improvements 4 (3) Food Premises Protection for food stuff provided 2 Displays improved 19 Drainage Improved and Repaired 1 Sanitary accommodation improved 4 Sanitary notices provided 2 Water supplies improved 2 Ablution facilities provided or improved 2 Accommodation for Assistants Clothing Provided 5 Sinks and hot water provided 2 Premises repaired 1 Cleaned and redecorated 6 Lighting and ventilation improved 1 Refrigeration provided or Control of Temperature Improved 1 Dustbins provided 1 Personal Cleanliness Improved 4 Flooring improved 2 Yards paved 3 Other unsatisfactory conditions remedied 3 (4) Shops Sanitary accommodation provided 1 Structural defects remedied 1 39 SUMMARY OF VISITS ETC. DURING THE YEAR Number of inspections of dwelling-houses 276 Number of re-inspections of premises 515 Number of visits to work in progress 35 Number of miscellaneous visits and inspections 163 Number of visits to food premises 384 Number of visits to factories 105 Number of visits to shops, offices and workplaces 240 Number of visits to watercress beds, smallholdings, etc. 42 Number of inspections of public conveniences 8 Number of visits re infectious diseases 436 Number of visits re insect pests 73 Number of inspections re rats and mice 3056 Number of sewer manholes treated 217 Number of visits to streams 39 Number of visits re clean air 1655 Number of inspections of swimming bath 10 Number of complaints received and investigated 632 Number of informal notices served 152 Number of statutory notices served 10 Number of interviews re nuisances, etc. 329 Number of visits re drainage 562 Number of drains tested 34 Number of drainage obstructions cleared 72 Number of rooms disinfected 65 Number of lots of bedding and clothing disinfected 67 Number of library books disinfected 443 Number of samples of foodstuffs, water, stools etc., taken for examination 540 Number of visits re food and other samples 333 Number of visits to premises used for the storage of Petroleum Spirit 46 H. G. CR1PPS, Chief Public Health Inspector. 40 SWIMMING BATH The Corporation rented from the Surrey County Council (for the 1960 Summer season) the open-air swimming bath situated in the grounds of what was formerly the Royal Female Orphanage, now the Carew Manor School. Sessions are arranged for the general public, school children, and youth organisations in the Borough. During the 1960 season, which covered a period of 18 weeks, the following attendances were recorded: Youth organisations 2,544 School children 5,784 Season Ticket Holders, etc.: Adults 20,646 Children 4,182 Total 33,156 The water supply for the Carew Manor School Swimming Bath is drawn from a well sunk in the grounds of the institution. After filling up, the water is only topped up, and complete emptying of the bath does not take place during the whole of the season. Chlorination is by means of a chlorine gas injector; the standard of chlorination maintained is 0.7 parts per million in the shallow end, and 0.4 parts per million in the middle of the bath. Filtration is carried out by pressure through a sand filter. Samples of the swimming bath water are submitted for bacteriological examination throughout the season. Those submitted in 1960 (10), were returned as bacteriologically sterile. 41 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 Officers 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 occurrence 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. In order to further the interests of hygiene, and encourage washing after the use of the toilet, all Infants' schools in the Mid-Eastern Division have now been provided with a constant hot water supply to the taps supplying the wash basins in the school cloak rooms. 42 OUTBREAKS OF FOOD POISONING, AND CLEAN FOOD CAMPAIGN No cases of food poisoning were notified during the year. NUTRITION The nutritional standards of school children, as observed at routine examinations, and children below school age, as observed at infant welfare centres, are maintained at a very high level, the general impression gained being that children tend to be taller and heavier in the respective age-groups than formerly. The Local Health Authority continued the scheme for the distribution of welfare foods since it was handed over by the Ministry of Food in June, 1954. Local issues are made from an office situated in the Corporation Car Park by the Divisional Medical Officer's staff and ladies of the W.V.S. Issues were also made at infant welfare centres and at the branch library in Beddington. Grateful thanks are due to the many volunteers, who so willingly co-operate in this important service for mothers and infants. Proprietary brands of vitamin preparations and some dried milk foods continue to be available to mothers at infant welfare centres and at the Town Hall. SHELL FISH (MOLLUSCAN) Only a small quantity of shell fish is marketed in the district, and is obtained chiefly from Billingsgate Market, London. 43 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. 44 PREVALENCE AND CONTROL OVER INFECTIONS AND OTHER DISEASES The following table shows the incidence of infectious disease in the Borough in 1960, 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 61 — — Measles 149 — — Whooping Cough 24 — — Pneumonia 6 — 26* Dysentery 28 — — Erysipelas 6 — — Typhoid Fever 1 — Totals 275 — 26 * Includes deaths from all forms of pneumonia. † Includes deaths of residents in homes and institutions outside the Borough. 45 46 Cases of Infectious Disease Notified During the Year 1960 (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) Under 1 year 1 to 2 years 2 to 5 years 5 to 10 years 10 to 15 years 15 to 25 years 25 to 45 years 45 to 65 years 65 and over Beddington Wallington North West Central South North Central South Scarlet Fever 61 — — 12 37 12 — — — — 11 10 11 1 16 4 8 17 — Measles 149 3 13 53 78 9 — — — — 42 22 3 3 68 5 6 3 — Whooping Cough 24 3 2 4 14 1 — — — — 3 4 8 5 1 — 3 1 — Pneumonia 6 — — 1 — — 2 — — 3 3 3 — — — — — — 26* Dysentery 28 2 1 7 5 2 1 10 — — 7 2 7 — 6 6 — 2 — Erysipelas 6 — — — — — — — 3 3 1 1 1 — 3 — — 1 — Typhoid Fever 1 — — — — 1 — — — — 1 — — — — — — 1 — Totals 275 8 16 77 134 18 3 10 3 6 68 42 30 9 94 15 17 25 26* The succeeding table shows the age incidence of the diseases and the distribution throughout the Wards of the Borough of the various infections: *ncludes all forms 47 The Monthly Incidence of Infectious Disease, 1960 (excluding Tuberculosis) Disease Jan. Feb. Mar. April May June July Aug. Sept. Oct. Nov. Dec. Total Scarlet Fever 8 12 9 4 13 6 4 — 1 2 1 1 61 Measles — 1 — — — 1 2 5 3 38 38 61 149 Whooping Cough — 3 — 5 2 7 3 — 4 — — 24 Pneumonia 2 — — — — — — — 1 1 2 — 6 Dysentery — 10 1 2 7 6 — — — 2 — — 28 Erysipelas — — — 1 1 — 2 — 1 — 1 — 6 Typhoid Fever — — — — — 1 — — — — — — 1 Totals 10 26 10 7 26 16 15 8 6 47 42 62 275 Tuberculosis There were 9 new cases notified during the year, this being a decrease of 1 on the number of cases notified in 1959. The following table gives the number of new cases notified during the past five years: New Cases 1956 1957 1958 1959 1960 M. F. M. F. M. F. M. F. M. F. Pulmonary 17 5 11 5 6 6 7 2 8 1 Non-Pulmonary — — — — — 1 1 — — — Totals 17 5 11 5 6 7 8 2 8 1 Annual case rate per 1,000 of the estimated population: 1956 1957 1958 1959 1960 Pulmonary 0.68 0.49 0.37 0.28 0.28 Non-pulmonary 0.00 0.00 0.03 0.03 0.00 The following table gives the number of deaths from this disease during the past five years: Deaths 1956 1957 1958 1959 1960 M. F. M. F. M. F. M. F. M. F. Pulmonary 3 — 1 — 2 1 2 — 3 — Non-Pulmonary — — 1 — — — 1 — — — Totals 3 — 2 — 2 1 3 — 3 — It will be seen from the foregoing table that 3 Tuberculous patients died during the year, this being the same as the corresponding figure for the previous year. The figures correspond to a death rate per 1,000 of population of 0 09. 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: 48 Age Periods New Cases Deaths Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary M. F. M. F. M. F. M. F. Under 1 year — — — — — — — — 1— 2 years — 1 — — — — — — 3— 4 years — — — — — — — — 5— 9 years — — — — — — — — 10—14 years — — — — — — — — 15—24 years 2 — — — — — — — 25—44 years 1 — — — — — — — 45—64 years 4 — — — 1 — — — 65 and over 1 — — — 2 — — — Totals 8 1 — — 3 — — — The new cases were distributed amongst the Wards as follows: Beddington Wallington North West Cent. South North Cent. South Pulmonary 1 1 2 — 2 3 — Non-Pulmonary — — — — — — — Totals 1 1 2 — 2 3 — 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 and The Chest Clinic at The Cumberland Hospital, Mitcham. 49 BERTRAM JOHNSON LTD. 11, Manor Road, Wellington. BERTRAM JOHNSON LTD. 11, Manor Road, Wallington.