BED 26 Library BOROUGH OF BEDDINGTON & WALLINGTON ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the YEAR 1961 BOROUGH OF BEDDINGTON & WALLINGTON ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the YEAR 1961 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 14 Extracts from Vital Statistics 15 Vital Statistics: Registered Causes of Death 16 Cancer of the Lung and Bronchus 17 Violence and Accident 17 Maternal Mortality 17 Infantile Mortality 17 General Provision of Health Services for the Area: (Including Transferred Functions under the National Health Service Act, 1946). Nursing in the Home 19 Domestic Help Service 19 Chiropody 19 Care of Mothers and Young Children 20 Immunisation and Vaccination 24 School Clinics 25 Cleansing of Persons 25 Laboratory Facilities 25 Hospitals 26 Ambulance Facilities 26 Disinfection 26 Housing 27 Sanitary Circumstances of the Area: Water Supplies 28 Drainage and Sewerage 28 Rivers and Streams 28 Closet Accommodation 28 Public Cleansing 28 3 Report of the Chief Public Health Inspector for the Year 1961: Inspection & Supervision of Food Milk and Dairies 29 Ice Cream 30 Slaughterhouses 30 Food Premises 30 Food Hygiene (General) Regulations 1960 31 Unsound Food 31 Sampling 31 Factories Act 1937-1959 Inspections 34 Outwork 34 Defects 35 Workplaces, Shops and Offices 35 Infectious Disease & Disinfection 36 Offensive Trades 36 Clean Air Act, 1956 Smoke Control Areas 36 Industrial Premises 36 Prevention of Damage by Pest Act, 1949 Sewer Rat Control 37 Petroleum (Regulation) Acts 38 Shops Act, 1950 38 Pet Animals Act, 1951 38 The Game Act, 1831 38 Heating Appliances (Fireguards) Act, 1952 38 Rag Flock & Other Filling Materials Act, 1951 38 Caravan Sites & Control of Devolopment Act, 1960 38 Noise Abatement Act, 1960 38 Summary Complaints 39 Notices served 39 Sanitary Improvements 39 Visits, etc. 41 Swimming Bath 42 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 WALLINGTON PUBLIC HEALTH COMMITTEE December, 1961 Members: Councillor Mrs. H. Bridger (Chairman) Alderman E. P. Vaughan (Mayor) Councillor D. C. E. Aldridge Councillor H. E. Austin Councillor P. A. Bishop Councillor H. J. Brittain Councillor W. R. Hadden Councillor J. L. Izard Councillor F. G. H. Sivyer Councillor Mrs. J. L. K. Thurston REPRESENTATIVES ON MID-EASTERN DIVISIONAL HEALTH SUB-COMMITTEE December, 1961 Members: Alderman D. H. de Voil Alderman E W. Harding Councillor Mrs. H. Bridger Councillor G. E. W. Eve Councillor E. W. Popplestone REPRESENTATIVES ON THE WANDLE VALLEY JOINT SEWERAGE BOARD December, 1961 Members: Alderman E. P. Vaughan (Mayor) Alderman F. G. Bryant Alderman E. W. Harding 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.) S. S. Lowe, M.R S.H., M.A.P.H.I. (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 Mrs. M. B. Bevan (Commenced 16.1.61) 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: 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., (Res. 12.4.61) Mrs. S. M. Scott S.R.N., S.C.M., H.V.Cert., (Com. 31.7.61) 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. I. M. Kingsley (School Health) (Resigned 3.4.61) Mrs. P. J. Carter (School Health) (Commenced 17.4.61) 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 1961. The report is drawn up in accordance with the suggestions made by the Minister of Health in his Circular 1/62. 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. This report is the twenty-fifth for which your Medical Officer of Health has been responsible and as it coincides with the Corporation's Jubilee Year, the Report will be extended to include some comparative statistical data throwing light on the history of the Borough over the past twenty-five years. The comparable year which has been chosen is 1937, this being the year reviewed in his first report by your Medical Officer of Health. In that report the history of the urban district from the years 1915-1937 was reviewed, 1937 being the year in which 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. It is interesting to note that if the present Government's plans for the re-organisation of local government come to full fruition, the Borough will cease to exist as a separate unit of local government administration in the year 1965. This report could, therefore, be looked upon as almost completing the history of Public Health in the Borough of Beddington and Wallington. The Registrar-General's estimate of the population of Beddington and Wallington at mid-year 1961 is 32,590 and this figure is used in the compilation of the vital statistics. The figure shows an increase of 260 compared with the Registrar-General's estimate for mid-year 1960. The census of population taken in 1961 was 32,588. The Registrar-General's estimate of the resident population for 1937 was 30,590, from which it will be seen that the population has increased over the 25 year period, but not substantially. It is likely that the population will increase with building development on the airport and a figure of 45,000 for the population of the Borough, has been mentioned as one which may eventually be anticipated. The live birth rate per 1,000 total population shows an increase at 14.44 in 1961 compared with 13.54 in 1960. This rate is below that for England and Wales which is 17.40. The birth rate is higher than was recorded for 1937, which was 12.91, although not as high as in the immediate post-war 7 years, for example in 1946 it was 18.63. The rate has shown a tendency to rise over the last few years, having increased steadily from the lowest rate recorded since the war 10.74 in 1952. The stillbirth rate per 1,000 total births is 8.85 compared with 10.95 in 1960 and 18.70 for England and Wales. This shows a considerable improvement as compared with the stillbirth rate recorded for the year 1937 which was 38.93. Undoubtedly this reflects great credit upon the maternity and child welfare services. The death rate from all causes per 1,000 population is 10.31 compared with 10.95 in 1960 and 12.00 for England and Wales. Of the 350 deaths, diseases of the heart accounted for 114 (32.57 per cent of total deaths), cancer 87 (24.86 per cent of total deaths), and tuberculosis 3 (0.86 per cent of total deaths). The death rate from all causes has not shown much variation over the 25 year period as it was 10.00 in 1937. As already mentioned, there were 114 deaths from heart disease and that other diseases of the circulatory system accounted for 19 deaths, while vascular lesions of the nervous system (stroke) accounted for 42 deaths, making a total of 175 deaths. Over the years one of the principal causes of death in this district has been heart disease and other vascular diseases. In 1937 the number of deaths from heart disease was 69, from other circulatory diseases 18, giving rates of 22.55 and 5.88 respectively. In 1937 there were 71 deaths from cancer giving a rate per cent of total deaths of 23.20. The number of deaths in 1961 from cancer of all kinds was 87, giving a rate of 24.86; deaths from lung cancer accounting for 24 cases. It has been now firmly established that cigarette smoking bears a very direct relationship to the number of deaths from cancer of the lungs. In America it has been shown that cigarette smoking, in addition to causing deaths from lung cancer, is largely a contributory factor in that country to deaths from coronary thrombosis and heart disease generally. The whole review, however, of this matter belongs to the year 1962, when the Royal College of Physicians published their comprehensive report "Smoking and Health". A disease, which through the years has been responsible for many deaths is tuberculosis, in particular tuberculosis of the lungs. In 1937 there were 12 deaths from pulmonary tuberculosis, giving a rate per cent of total deaths of 3.92. In 1961 only 3 deaths were attributed to this cause, giving a rate of 0.86. Tuberculosis is now a rapidly declining disease in this country, the result of a vigorous campaign to recognise cases early and the introduction of new drugs capable of curing the disease. Chest Physicians generally are hopeful that in the next two or three decades it may be possible practically to eliminate the disease. No mothers died in childbirth during 1961 and this gives a maternal mortality rate per 1,000 total births of nil, as compared with 0.33 for England and Wales. In 1937 two deaths occurred in women from puerperal causes, giving a rate per 1,000 births of 4.87. This again, shows considerable improvement as, for some years, no deaths in this district have been attributed to puerperal causes. The deaths in infants under one year are higher than we have recorded for some years. The infantile mortality rate shows an increase at 20.09 per 1,000 live births, compared with 16.95 in 1960. Nine infants died under the age of 1 year in 1961 out of 448 live births. The table on page 18 8 analyses these causes. The rate of 20.09 is very much higher than the lowest rate recorded in 1958 at 7.50. In 1937 the death rate of infants under one year of age was 58.23 per 1,000 live births. Here again, the development of services for the care of young infants has proved its worth in achieving a great reduction. The incidence of infectious disease generally throughout the year, has been low, measles giving the highest figure with 343 notified cases. Scarlet fever with 13 notified cases is next in order of incidence and this is considerably lower than the previous year, when 61 cases were recorded. In 1937 65 cases of scarlet fever were notified. No deaths from the disease occurred, but in 1936 one child died. The principal comment to make in comparing scarlet fever in 1937 with 1961 concerns the character of the disease. Over the years, scarlet fever has become very mild and has no significance now as a cause of death. This is illustrated by the fact that in 1937 it was found necessary to remove 59 cases to hospital for nursing out of 65 notified. In the year under review of 13 cases notified only 5 were removed to hospital and no person died from the disease. For the thirteenth year in this Borough there were no cases of diphtheria notified. Probably one of the most striking results seen in the past 25 years in the prevention of infectious disease and particularly in the post-war period, has been the successful immunisation of children against diphtheria. In 1937, when your Medical Officer first took up his duties in the district, immunisation against diphtheria was introduced. The relevant extract from the report of that year reads as follows:— "The Council in May approved a scheme of immunisation whereby patients could be treated by the Medical Officer of Health at his Town Hall premises, free of charge. Such treatment was commenced in November, when the laboratory facilities became available. No cases completed their treatment during the year under review, but at the end of the year 12 patients were attending and will be reported on in 1938." At the end of 1961 5,699 children out of a total of 6,300 were known to be immunised, giving a percentage of children immunised of 90.3 of the child population. Immunisation against this disease will continue to occupy a large place in the work of the Department, both in children attending Infant Welfare Centres and schools in the Borough. It is understood that the Minister of Health will introduce in 1962 a new drive for immunisation against this disease, particularly aimed at those Boroughs showing a poor response. Seven 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. In 1937 no method of immunising against whooping cough was available. Over the last few years, however, whooping cough vaccination has reached a high standard of reliability. Nowadays, all children presented for immunisation against diphtheria are also offered in the one injection immunisation against whooping cough and tetanus. As a result, the number of cases of whooping cough has steadily declined and the severity of this illness when it does occur is considerably reduced. It is pleasing to record that during the year no case of poliomyelitis 9 occurred in the Borough. This is the third year in succession in which we have been able to make this comment. This shows a striking improvement on the year 1937 when no method of immunising against poliomyelitis was known. One severe case occurred during that year, resulting in considerable disability. Poliomyelitis inoculation was well received during 1961. Since the scheme began in 1956, 11,400 persons had been given two injections, and 10,098 a third injection by the end of the year under review. The Minister of Health introduced a fourth poliomyelitis injection for children over five and under twelve years of age. The scheme was commenced here in May, 1961, and at the end of the year 2,376 children had received their fourth injection. Further improvements in the production of vaccine suitable for taking by mouth were brought into use in many parts of the world and the introduction of the vaccine into the British Isles belongs to the year 1962. Once again it is necessary to mention that the care of the aged, with all the work associated with geriatric services generally, kept the staff of the Department very well occupied. This is new work compared with the activities of the Department in 1937 and in many respects represents a considerable advance in public health services. As one of the ancillary services for the aged it is necessary to mention the Home Help Service. In 1937 the Borough conducted a Home Help Service comprising four home helps who received a retaining fee when not working. These employees were engaged in maternity cases only. Since the war it was found necessary to introduce more home helps to meet the demands of sickness in the home, especially where mothers become ill and unable to carry out their home functions and, more recently, to enable old persons, who are able, to carry on with their own home lives to do so, and thus avoid the necessity of being admitted to institutional care. In 1961, 26 home helps were employed, being equivalent to 15.8 full-time employees. This section of the work, which is assuming much greater importance, represents a real expansion in public health services and has been an inestimable boon both to the sick and the aged. We are very pleased to have to record the considerable help given by the W.V.S. headed by our new Freeman of the Borough, Mrs. O. L. Wiles. Her gallant team came into operation during the war years and are now responsible for assisting with the sale of welfare foods, the distribution of meals on wheels to the aged and a restaurant service for old people, as well as many other social activities. One aspect of the work of the Department, which has become of ever increasing importance has been the introduction of co-ordinating conferences to consider the prevention of the break-up of families. The pattern of social behaviour described in reports submitted to the Conferences, appears to be very different from what it was in 1937, there having been a considerable deterioration in family relationships. The necessity in many cases of taking children of such families into care and the considerable expenditure incurred, has made it necessary to give the most earnest consideration as to how families can be kept together and parents made to realise their obligations and the need to provide a good home life for the rearing of their children. Housing, too, is a problem very different from what it was in 1937 and is a frequent cause of the break-up of families. Of all the evils, which 10 have afflicted the post-war generation, housing is amongst the worst. The result of bad housing can be seen in nearly all social problems the Department is called upon to investigate. During the period 1920 to 1961 the Corporation provided 938 houses and flats. They also took part in a new town development at Frimley and Camberley. Other aspects of growth in the services include the provision of new clinics. In 1946 a comprehensive clinic system was provided at the Grange Mansion, unfortunately burned down in January, 1960, which comprised: Infant Welfare Clinic Relaxation and Mothercraft Classes School Health Inspection and Minor Ailment Clinics Dental Clinic for Schoolchildren, Expectant and Nursing Mothers and children under 5 years of age Physiotherapy Department, including a Solarium Speech Therapy Clinic. The County Council scheme for providing a new comprehensive Clinic on land recently acquired near the Town Hall, is being actively pursued and it is hoped that in a year or two complete replacement of the services provided at the Grange will be made available on this site. Between the wars a very efficient District Nursing Service was built up in Beddington and Wallington on a basis of voluntary subscription. In 1936 a new district nurses' home, including commodious ante-natal clinic premises for use in connection with the maternity and child welfare services of the Corporation, was built at 57, Montagu Gardens. Both district nurses and midwives lived at the home and a domiciliary visiting service covering the whole of the town was in operation. In 1948, under the National Health Service Act of 1946, the whole of this service passed to the local health authority, the Surrey County Council. The Divisional Medical Officer, reporting to the Mid-Eastern Divisional Health Sub-Committee, took over the day-to-day administration of the home and the services. No history of the Public Health Services would be complete without making a brief mention of the part played by the Department during the war years, 1939 to 1946. During these years the Department not only continued to carry on the routine services required under the relevant legislation but, in addition, undertook the organisation and control of the following:— First Aid Posts; Mobile First Aid Unit; Ambulance Services; Stretcher Party Depot; Civil Defence Mortuary. Officers of the Department continued to supervise all these services until the cessation of hostilities in 1945. The Civil Defence Ambulance Service, however, was continued at the end of the war by the Borough as their own ambulance service, operating from the fire station, which the Corporation built in 1937 in Belmont 11 Road. This service continued until 1948, when it was handed over to the County Council under the provisions of the National Health Service Act, 1946. It should be mentioned that your Medical Officer was responsible for bringing into public use in 1940, the swimming bath at the Royal Female Orphanage, Beddington, which was evacuated in 1939. The Department continued after the war to keep the bath in use for schoolchildren, youth organisations and the general public until 1959, when difficulties in recruiting adequate labour to maintain the bath made it impossible for the Public Health Department to continue this service. Future years will show many changes in the development of public health in this party of Surrey. One can only hope that the foundations so well laid since 1915 will be maintained by future administrations and that the people of Beddington and Wallington will continue to enjoy the excellent health and expectation of life, which statistical summaries of the last few years have illustrated. One aspect of post-war development in the prevention of disease has been the energetic pursuit of methods of improving food hygiene. This has entailed the submission of very many more samples of raw and cooked food, milk and other comestibles for both chemical and bacteriological analyses. in addition, the regular chemical and bacteriological analysis of water has been undertaken. In 1937 when your Medical Officer first took up his appointment, the necessity for routine water examinations was only just being appreciated, following the outbreak of intestinal disease associated with polluted water supply in the district in 1936. One of the first re-organisations your Medical Officer achieved was the introduction of a laboratory at the Town Hall, where he himself conducted the bacteriological examinations of samples of water and milk with the help of a trained laboratory assistant. After the war, with the increasing cost of chemical materials and the rate of pay demanded by trained laboratory assistants, the Corporation felt obliged on economic grounds to transfer this work to the Public Health Laboratory Service. On page 29 will be found a report on the analyses carried out in 1961. I wish to thank all past and present members of the Department, who have worked to make success possible. Particular mention should be made of the Chief Clerk of the Department, Mr. Robert F. Burns, who has been with us since 1938. Mr. Burns has an excellent record of long and efficient service with the Corporation and also has been well-known for activities in a voluntary capacity in many local organisations. The Department has been very fortunate in the longevity of service of some of its officers. Since 1921 there have been only two Chief Public Health Inspectors in the Department. The late Mr. F. H. Lennard covered the period from 1921 to 1953 and the present holder of the office, Mr. H. G. Cripps, took over from Mr. Lennard in that year. Mr. Cripps is to be congratulated, amongst other things, for the very efficient manner in which the Council's smoke control areas have been brought into operation. He and his very viligant staff are supervising this work most satisfactorily, as well as ensuring the success of the campaign 12 in the realm of food hygiene. In conclusion, it is pleasing to recall the many Aldermen and Councillors who have come and gone over twenty-five years, many of whom have been members of the Public Health Committee, and have shown a very keen interest in the work of the Department. The happiest of relationships have always existed both with members of the Council and other staffs, without which this record of progress could not have been written. I 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, 1962. 13 STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (in acres) 3,048 Population, census, 1931 26,249 Population, census, 1961 32,588 Registrar-General's estimate of resident population for 1960 32,590 Number of inhabited houses, 1931 7,092 Number of inhabited houses, 1961 10,311 Rateable Value £736,582 Sum represented by penny rate £2,990 The Urban District of Beddington and Wellington 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. 14 EXTRACTS FROM VITAL STATISTICS Resident Population—Estimated mid-year 1961 32,590 Live Births Males Females Total Legitimate 219 204 423 Illegitimate 11 14 25 Total 230 218 448 Live Birth Rate per 1,000 population 13.75 Adjusted Birth Rate 14.44 England and Wales Live Birth Rate 17.40 Illegitimate Live Births per cent of total Live Births 5.58 Still Births Legitimate 3 1 4 Illegitimate — — — Total 3 1 4 Rate per 1,000 total Live and Stillbirths 8.85 England and Wales Stillbirth Rate 18.70 Live and Stillbirths Legitimate 222 205 427 Illegitimate 11 14 25 Total 233 219 452 Deaths 173 177 350 (i) Death Rate per 1,000 population 10.74 Adjusted Death Rate 10.31 England and Wales Death Rate 12-00 (ii) Infant Deaths—under 1 year of age Total No. of Deaths 9 Infant Mortality Rate per 1,000 Live Births 20.09 Infant Mortality Rate per 1,000 Live Births: Legitimate 21.28 Illegitimate Nil Infant Mortality Rate for England and Wales 21.40 Neo Natal Mortality Rate per 1,000 Live Births (Under 4 weeks of age) 11.16 Early Neo-natal Mortality Rate per 1,000 Live Births (Deaths under 1 week) 11.16 Peri-natal Mortality Rate per 1,000 Live and Stillbirths (Stillbirths and deaths under 1 week) 19.91 (iii) Maternal Deaths (including abortion) total Nil Maternal Mortality Rate per 1,000 Live and Stillbirths Nil England and Wales Maternal Mortality Rate 0.33 15 REGISTERED CAUSES OF DEATH The following table, supplied by the Registrar-General, gives the causes of death of residents in the Borough during 1961: Causes of Death Males Females Total All Causes 173 177 350 1 Tuberculosis, respiratory 2 1 3 2. Tuberculosis, other — — — 3. Syphilitic disease — 2 2 4, Diphtheria — — — 5. Whooping Cough — — — 6. Meningococcal infections — — — 7. Acute poliomyelitis — — — 8 Measles — — — 9. Other infective and parasitic diseases — — — 10. Malignant neoplasm, stomach 8 3 11 11. Malignant neoplasm, lung, bronchus 21 3 24 12. Malignant neoplasm, breast — 9 9 13. Malignant neoplasm, uterus — 3 3 14. Other malignant and lymphatic neoplasms 18 22 40 15. Leukæmia, aleukæmia 2 — 2 16. Diabetes 1 3 4 17. Vascular lesions of nervous system 20 22 42 18. Coronary disease, angina 30 36 66 19. Hypertension with heart disease 1 1 2 20. Other heart diseases 15 31 46 21. Other circulatory diseases 8 11 19 22. Influenza 1 — 1 23 Pneumonia 10 10 20 24. Bronchitis 17 6 23 25 Other diseases of respiratory system — 1 1 26. Ulcer of stomach and duodenum 3 — 3 27. Gastritis, enteritis and diarrhœa — 1 1 28. Nephritis and nephrosis 1 1 2 29. Hyperplasia of prostate 1 — 1 30. Pregnancy, childbirth, abortion — — — 31. Congenital malformations 2 1 3 32. Other defined and ill-defined diseases 11 4 15 33. Motor vehicle accidents — — — 34. All other accidents — 3 3 35. Suicide 1 2 3 36. Homicide and operations of war — 1 1 16 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 114 32.57 Other Diseases of the Circulatory System 19 5.43 Vascular Lesions of Nervous System 42 12.00 Cancer 87 24.86 Bronchitis 23 6.57 Pneumonia 20 5.71 Tuberculosis (All Forms) 3 0.86 Cancer of the Lung and Bronchus Males Females Total Number of deaths in 1961 21 3 24 Rate per 1,000 population 0.74 England and Wales Rate 0.49 VIOLENCE AND ACCIDENT Details of all deaths under this heading are as follows: Cause of Death Male Female Total Homicide - 1 1 Suicide 1 2 3 Other Violent Causes — 3 3 Totals 1 6 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 0.33. INFANTILE MORTALITY The infantile mortality rate for 1961 was 20.09 per 1,000 live births. The comparable rate for England and Wales is 21.40. Great credit is due to the services operated in the Borough for the care of mothers and young children. Of the total of 448 live births, only 9 deaths of infants under one year of age (6 males and 3 females) were registered. 17 The following table gives the age and cause of death of each infant who died: Age Sex Cause of Death 5 hours M Foetal abnormality, Achondroplasia. 10 hours F Myocardial failure, Atelectasis. 13 hours M Prematurity. 3 days M Broncho-pneumonia, Prematurity 5 days M Broncho-pneumonia, Imperforate Anus. 6 weeks F Congestive heart. 2 months M Fulminant Broncho-pneumonia 5 months M Broncho-pneumonia, Congenital disease of heart Septic defects in ventricles and auricles 10 months F Asphyxia by smothering with bedclothes 18 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 802 cases, including 149 maternity and midwifery patients. A total of 22,148 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 59 Chronic Sick (including aged and infirm) 208 Acute Sick 37 Tuberculosis 1 305 CHIROPODY The County Council, in February 1960, approved arrangements for the provision of chiropody for the elderly, for expectant mothers and physically handicapped persons. The scheme came into operation on the 9th May, 1960. So far as the elderly were 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. As 19 from the 1st July, 1961, elderly persons, the registered blind and partially sighted were included in the scheme operated by the Divisional Medical Officer. The Chiropodist is paid a uniform fee of 7/6 for each treatment undertaken in the surgery and 10/6 for a domiciliary visit. The patient is required to contribute a standard fee of 3/- per treatment. In approved cases the Divisional Medical Officer may authorise treatment free of charge. In 1961 the following treatments were undertaken Elderly persons 34 Handicapped persons 56 Expectant mothers 1 Total 91 The chiropody service introduced in 1958 thiough the active cooperation of the W.V.S. and the British Red Cross Society, continued to operate in 1961. In addition arrangements were made through the Beddington and Wallington Fund for the Aged and Infirm, for a Chiropodist to visit the homes of sick people who were unable to get out and treatment was carried out at an agreed cost to the Fund. 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, 150 women made 524 pre-natal attendances. This represents an attendance of 33.2 per cent of the total number of confinements which occurred during 1961. Post-natal examinations were also conducted at this clinic, 12 patients making 12 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 fifteen or 69.69 percent. of births allocated to this district, took place in hospitals and nursing homes, compared with 73.51 percent 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. 20 Treatment Centres and Clinics Child Welfare Centres Hackbridge Centre, All Saints Church Hall, New Road. Bandon Hill Centre, Methodist Hall, Sandy Lane North. Beddington Centre, The Scout Hall, Guy Road. Wallington Centre, Baptist Hall, Queen's Road. Maternity Clinics Ante-natal Clinic Post-natal Clinic, Relaxation and Mothercraft Classes. District Nurses' Home, 57 Montagu Gardens. Physiotherapy Clinic, 57 Montagu Gardens. Dental Clinic, Rochester Road, Carshalton. When held Every Monday, 2.0-4.0 p.m. Every Tuesday, 2.0-4.0 p.m. Every Wednesday, 2.0-4.0 p.m. Every Wednesday, 2.0-4.0 p.m. Every Thursday, 2.0-4.0 p.m. ,, ,, ,, By appointment By appointment. 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. The number of attendances recorded at the four clinics during the year was as follows:— Number attending Total attendances Children under 1 year 398 5,514 Children, 1-5 years 873 3,560 Total 1,271 9,074 21 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. Visits during the year were made as follows: First visits Total visits Expectant Mothers 237 423 Children, 0-1 year 461 2,338 Children, 1-5 years — 3,453 Other Cases — 199 Ineffectual — 867 Total 698 7,280 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 1961. Equipment is kept at the District Nurses' Home, the headquarters of the local Midwives, where it is ready for immediate use when required. Twenty premature live births were notified during the year, 15 of which occurred in hospital. Two infants died within 24 hours of birth. One infant died before the 28th day. The remaining 17 children survived. 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. 22 Treatment. Minor Ailments. Fifty-two 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 11 Ear, Nose and Throat 22 Orthopaedic defects 7 Dental. The year's work at the 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 9 9 3 — — Children, 0-5 39 33 104 — — — Totals 44 42 113 3 — — 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. Orthopaedic. 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 1961, 7 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. During the year the demand for this service increased and it was found necessary to introduce an additional weekly session. 23 The following table gives details of attendances: Total attendances Irradiations Corrective treatments Relaxation Exercises Children, 0-5 years 269 176 — Children, 5-15 years 667 2,065 — Expectant and Nursing Mothers 44 — 539 Total 980 2,241 539 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 1961, 369 persons including 344 children under 5 years of age, were vaccinated and 87 persons were re-vaccinated, at the weekly clinic held at the Town Hall, or by their general practitioner. Diphtheria Immunisation. Five clinicsare heldweekly to give immunisation against diphtheria. These are held at each of the four 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., 1961 1,880 4,420 6,300 Number of children known to be immunised at 31st Dec., 1961 1,482 4,206 5,699 Percentage of children immunised 78.8 951 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, 417 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 1961, 422 children completed a primary course and 81 children received a reinforcing dose. 24 Poliomyelitis The Poliomyelitis vaccination scheme, introduced in January 1956 continued, within the prescribed age groups, throughout 1961. The following is a summary of the persons who had been vaccinated by the end of the year: Two Injections Three Injections Children born 1943—1961 7508 6872 Persons born 1920—1942 3892 3226 Total 11400 10098 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. A fourth injection for children over five years and under twelve, was introduced in May 1961. At the end of the year 2376 children had received their fourth injection. 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 paralytio 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 Phcenix Flats, Carshalton. The services provided at these clinics were general medical inspection and treatment, dental treatment, speech therapy and physiotherapy. Cleansing of Persons During 1961 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 1961, 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. 25 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. All ambulances are equiped with short wave radio communication, and are readily available for direction in case of emergency. 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. 26 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 27 Number of families rehoused by the Council or by private owners at the Council's instigation since the beginning of the war 1240 Number of live applications on the housing list for accomodation in Beddington and Wallington:— On the general waiting list 271 On the aged persons'list 244 For accommodation in Frimley and Camberley 26 New houses erected, etc. Number of new houses and flats erected in 1961:— Private enterprise 69 Local Authority 42 Number of flats erected by conversion in 1961:— Private enterprise 4 Local Authority 3 Number of houses and flats purchased in 1961 and let 7 Housing Act, 1957 Fifty-six 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 178 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 2 Number of families dwelling therein 2 Number of persons dwelling therein 19 Number of new cases of overcrowding reported Number of cases of overcrowding relieved 2 Number of persons concerned 9 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 One application for Certificate of Disrepair was received. One notices of intention to issue Certificate of Disrepair was sent out. One Certificate of Disrepair was issued. 27 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 65 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 continue to be adequate but attention should be directed at the former in order that the system should remain so in the future. 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 The River Wandle received its usual attention with particular reference to the cleansing between Wandle Mills and Carew Manor by direct labour. A section of culvert at Carew Manor was reconstructed by Surrey County Council labour, curing a liability to flood at this point. The ditches in Therapia Lane and Beddington Lane received special attention resulting in improved land drainage and lessening the tendency to flood. 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 Problems arising out of the dearth of labour for road sweeping and cleansing has necessitated constant review of modern methods, and a number of appliances of the vacuum suction sweeper type have been demonstrated by the manufacturers, resulting in a order being placed for a machine which will be in operation in the near future. A pilot scheme for refuse collection has been brought into operation whereby some 180 Council properties on Bute Road and Demesne Road Estates have been provided with brackets for paper bags to contain household refuse. This appears to reduce fatigue and speed up the rate of collection, and is the solution to the scattering of refuse and air pollution on windy days. 28 SANITARY 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, 1961 INSPECTION AND SUPERVISION OF FOOD MILK AND DAIRIES Number of distributors of milk on register 9 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 9 Number of licences issued under Milk (Special Designation) Regulations: Tuberculin Tested Milk—Dealers' (Pre-packed) 15 Pasteurised Milk—Dealers'(Pre-packed) 15 Sterilized Milk—Dealers' (Pre-packed) 20 — 50 BACTERIOLOGICAL EXAMINATION OF MILK Sixty-nine 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 47 40 — 47 — — — T.T. Pasteurized 8 6 — 8 — — — Sterilized 6 — — — — 6 — Tuberculin Tested (Farm Bottled) 8 6 2 — — — — Five samples of Tuberculin Tested milk were submitted for biological examination - Tubercle bacilli were not isolated. 29 CHEMICAL ANALYSES OF MILK Ten samples of milk were submitted to the Public Analyst. All were reported genuine. ICE CREAM Number of premises registered for the sale of ice cream 102 Number of manufacturers Nil Number of inspections of premises 48 Thirty-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 32 31 — 1 — CHEMICAL ANALYSES OF ICE CREAM Four samples of ice cream were submitted for analysis. All complied with the standard. SLAUGHTERHOUSES Number of licensed slaughterhouses Nil FOOD PREMISES IN THE DISTRICT Bakehouses 6 Bakers 11 Butchers 24 Catering Establishments 82 Chemists 11 Confectioners (sweets) 45 Fishmongers (including friers) 10 Greengrocers 27 Grocers 64 Licensed Premises 11 Food Factories 3 30 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) 102 Food Hygiene (General) Regulations, 1960 Inspections of food premises continued during 1961. The type of premises visited and number of inspections are set out below: Bakehouses 8 Bakers 18 Butchers 39 Catering Premises 43 Confectioners (sugar) 57 Fishmongers 11 Greengrocers 30 Grocers 79 Milk Shops 9 Registered Premises 57 Other Food Premises 44 As a result of these visits, shopkeepers were persuaded to carry out the improvements listed on page 40. It was not necessary to institute legal proceedings. UNSOUND FOOD Destroyed or released for animal feeding:— lbs. Fish, 30 Fruit, canned 69 Meat and Offal 267 Meat, canned 116 Milk, canned 2 Preserves 3 Vegetables, canned 7 Total 494 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. 31 FOOD ANALYSES The following table gives details of samples submitted for analysis during the year: Totals 1961 Articles No. Examined Adulterated Prosecu tions Convic tions Formal. Informal Total Formal Informal Total Aspirin — 1 1 — — — — — Baby food, canned — 1 1 — — — — — Bacon 1 — 1 — —— — — — Beer — 2 2 — — — — — Biscuits 1 — 1 — — — — — Bottle, Cream — 1 1 — 1 1 — — Brandy 1 — 1 — — — — — Bread — 2 2 — 2 2 — — Butter 2 3 5 — — — — — Cake mixture — 1 1 — — — — — Cereal food — 1 1 — — — — — Coffee 1 — 1 — — — — — Coffee extract — 2 2 — — — — — Confectionery: Sugar — 5 5 — — — — — Cough mixture — 2 2 — — — — — Cream — 2 2 — — — — — Custard powder 1 — 1 — — — — — Drink, soft 4 1 5 1 — 1 — — Fish paste — 2 2 — — — — — Flour self- raising 1 1 2 — — — — — Fruit, canned — 2 2 — — — — — Fruit, dried 2 2 4 1 1 2 — — Fruit, fresh — 1 1 — — — — — Fruit juice (lemon) — 1 1 — — — — — Fruit pie 2 — 2 — — — — — Gin 1 — 1 — — — — — Halibut liver oil tablets — 1 1 — — — — — Ice cream — 4 4 — — — — — Ice lolly — 2 2 — — — — — Jam 1 4 5 — — — — — Jelly tablet — 1 1 — — — — — Lager, canned — 2 2 — — — — — Lemon meringue pie — 1 1 — — — — — Margarine — 1 1 — — — — — Marzipan — 1 1 — — — — — Meat paste — 2 2 — — — — — Meat products 3 — 3 — — — — — Meat products, canned — 1 1 — — — — — Milk 3 7 10 — — — — — Milk, evaporated — 1 1 — — — — — Milk shake syrup — 1 1 — 1 1 — — Mincemeat — 1 1 — — — — — Pepper — 1 1 — — — — — Pickles — 1 1 — — — — — Proprietary Medicine (Senakot) — 1 1 — — — — — Pudding mixture — 1 1 — — — — — Salt 1 — 1 — — — — — Sausages 1 1 2 — — — — — Soup,canned — 1 1 — — — — — Soup, preparation — 2 2 — 1 1 — — Spice (nutmeg) — 1 1 — — — — — Sugar — 2 2 — 2 2 — — Syrup, golden — 1 1 — — — — — Tea 2 1 3 — — — — — Treacle — 1 1 — — — — — Vegetables, canned 1 2 3 — — — — — Vinegar I — 1 — — — — — Whisky 1 — 1 — — — — — Total 31 79 110 2 8 10 — — 32 UNSATISFACTORY SAMPLES Formal Sample No. 28—Lemon Smash The sample contained lemon juice not more than 15%. The Public Health Committee recommended that no action be taken in view of the satisfactory explanation submitted on behalf of the manufacturer. Informal Sample No. 30—Milk Shake Syrup The sample contained sulphur dioxide, 260 parts per million. The Public Health Committee considered that no action should be taken since, they were informed, amending regulations would shortly be made prescribing a maximum of 350 parts per million Informal Sample No. 41—Cream of Champignon Soup (Packeted) The soup when made up ready for use contained only 1% of fat, which proportion was considered insufficient to justify the description "Cream Soup". A letter from the importing agent was submitted to the Public Health Committee indicating that for many months imports of this soup had been labelled "Mushroom Soup". It was decided that no further action was necessary. Informal Sample No. 64 & Formal Sample No. 65—Washed Currants The currants had been attacked by insects and contained ephestia larvae, insect webbing and droppings. Investigation proved that the currants had been stored at the retail premises for seven months. The remaining stock was inspected and all affected was surrendered. In addition, the following specimens were submitted to the Public Analyst for his assistance in investigating complaints by members of the public. In every case the vendor and/or the manufacturer was afforded an opportunity of examining the specimen. Serial No. S.4—Bread The bread contained a piece of thick knotted string, 6 inches long, which had been baked in the loaf. A warning letter was sent to the manufacturer. Serial No. S.5—Cream Bottle The bottle contained sour cream dregs and several small deposits of sand bound together with dried milk solids. A warning letter was sent to the bottling company. Serial No. S.6—Cut Wrapped Loaf The bread contained a number of brown streaks. These were found to have been caused by the introduction of a small quantity of wholemeal flour or dough before baking. Serial No. 7a and 7b—Sugar These specimens were taken, following complaints at a local cafe, from a consignment after it had been transferred to a container at the cafe. The sugar was found to contain sodium carbonate and sodium sulphate. The wholesaler was notified and the sugar was replaced. 33 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 4 1 1 — (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 154 69 6 — (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 8 8 — — Total 166 78 7 — 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) Stuffed toys 9 — — — — — Wearing apparel: Making, etc. 2 — — — — — Total 11 — — — — — 34 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.l) 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 — — (b) Unsuitable or defective 1 1 — — — (c) Not separate for sexes — — — — — Other offences against the Act (not including offences relating to Outwork) 2 2 — — — Total 3 3 2 — — WORKPLACES, SHOPS AND OFFICES Number of inspections 216 Notices served 7 35 INFECTIOUS DISEASE AND DISINFECTION Number of visits re cases of infectious disease 194 Number of rooms disinfected 17 Number of library books disinfected 434 OFFENSIVE TRADES Number of offensive trade premises in district Nil CLEAN AIR ACT 1956 The work in connection with the setting up of Smoke Control Areas has proceeded with increased momentum during the year and now forms a major part of the work of the Public Health Inspectors' Section. During the year nearly two thousand visits were made to houses, which have been, or it is proposed will be, included in such areas. Two parts of the Borough have now been declared smoke contol areas. They are:— (1) That part of the Borough bounded by the boundary with the Urban District Councils of Carshalton and Coulsdon and Purley and by Woodcote and Heathdene Roads. The order relating to this area came into force on the 1st November, 1961. (2) That part of the Borough bounded by the County Borough of Croydon and the Urban District of Coulsdon and Purley and by Woodcote Road, Sandy Lane South and Stafford Road. The order relating to this area was made and confirmed in 1961 and will come into force on the 1st October, 1962. During the year houses in a third part were visited with a view to their inclusion in a third smoke control order. The area is that bounded by Woodcote Road, Sandy Lane South and Stafford Road. INDUSTRIAL PREMISES During the year 104 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. 36 PREVENTION OF DAMAGE BY PESTS ACT, 1949 Report for 12 months ending 31st December, 1961 Type of Property Local Authority Dwelling Houses Business (& other premises) Total Agricultural Number of Properties in Local Authority's district 46 10,255 1,450 11,751 31 Number of Properties inspected as a result of: (a) Notification — 94 23 117 1 (b) Survey under the Act 46 193 113 352 30 (c) Primarily for some other purpose — 228 552 780 — Properties found to shew major rat infestations — — — — — Properties found to shew minor rat infestations 3 67 9 79 3 Properties found to shew major mice infestations — — — — — Properties found to shew minor mice infestations — 30 5 35 — Total Infestations 3 97 14 114 — SEWER RAT CONTROL During the year, two maintenance treatments were carried out. These were during the months of April/May and September. The results are summarised below: Apr./May Treatment September Treatment Manholes baited 64 60 Manholes in which takes were recorded 22 15 Percentage of manholes showing infestations 34 25 75 manholes were test baited during April. 20 takes were recorded. 37 PETROLEUM (REGULATION) ACTS 70 Licenses were issued to keep petroleum spirit and/or petroleum mixture at 57 premises. The maximum quantities of these substances which may be kept under licence in the Borough are as follows: Petroleum Spirit 75,130 gallons (51 licences) Petroleum Mixture 12,250 gallons (19 licences) SHOPS ACT, 1950 The total number of inspections during the year was 204. 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 and approved. 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. 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. Fourteen visits were made during the year. NOISE ABATEMENT ACT, 1960 Twenty-one complaints of noise were received and investigated during the year. The complaints related to twelve sources of noise, two of which are situated in adjoining districts. In the main the noises were from industrial or commercial premises and informal action has achieved improvements. It was not necessary to institute legal proceedings. 38 SUMMARY COMPLAINTS The total number of complaints received was 637- They were due to the following causes: Rats and Mice 25 Housing defects 60 Choked drains and sewers 127 Defective dustbins 52 Defective drainage (including closets) 14 Unsound or adulterated food 46 Atmospheric Pollution 76 Insect pests 52 Offensive accumulations 27 Miscellaneous 58 637 NOTICES SERVED Number of informal notices served (including verbal intimations) 1135 Number of statutory notices served Public Health Act, 1936—Section 39 (Drainage) 2 Section 56 (Yard drainage and paving) 2 Section 93 (Nuisances) 8 Clean Air Act, 1956—Section 12 2 — 14 SANITARY IMPROVEMENTS (1) Dwelling Houses Brickwork repaired or repointed 4 Ceilings— Repaired, renewed or cleansed 3 Chimneys— Stacks and flues repaired 3 Dampness remedied— (a) Roofs repaired 13 (b) Damp-proofing works 8 (c) Gutters and rainwater pipes repaired and unstopped 7 Doors—repaired or renewed 2 Drainage— (a) Obstructions cleared 62 (b) Repaired and relaid 10 (c) Inspection chambers provided and repaired 6 (d) F-A-I, provided, etc- 1 (e) Waste-pipes repaired and renewed 2 (f Rainwater drainage provided, repaired or renewed 2 Dustbins provided 54 Fireplaces and stoves repaired or renewed 3 Floors— Repaired or renewed 2 Walls- (a)Repaired or rebuilt 12 (b) Plaster repaired and redecorated 1 39 W-C- Accommodation— (a) Cisterns repaired or renewed 2 (b) Flush pipe joint repaired 1 (c) Pans provided or replaced 1 (d) Seats repaired or renewed 1 Windows— (a) Frames and sashes repaired or renewed 2 (b) Sashcords and beading renewed 11 (c) Glazing and putties renewed 2 (d) Cills repaired 4 Yard paving repaired or renewed 2 Other Sanitary improvements 5 (2) Factories Sanitary Accommodation— Improved 1 Other Improvements 2 (3) Food Premises Fittings-equipment (Improved) 2 Protection for food stuff provided 6 Displays improved 1 Drainage Improved and Repaired 4 Sanitary accommodation improved 4 Water supplies improved 1 Ablution facilities provided or improved 2 Sinks and hot water provided 3 Premises repaired 1 Cleaned and redecorated 2 Lighting and ventilation improved 2 Accumulations removed 1 Personal Cleanliness Improved 3 Flooring improved 1 Yards paved 1 Other unsatisfactory conditions remedied 2 (4) Shops Redecoration and cleansing 3 Forms Exhibited 4 40 SUMMARY OF VISITS ETC. DURING THE YEAR Number of inspections of dwelling-houses 208 Number of re-inspections of premises 128 Number of visits to work in progress 23 Number of miscellaneous visits and inspections 269 Number of visits to food premises 406 Number of visits to factories 92 Number of visits to shops, offices and workplaces 216 Number of visits to watercress beds, smallholdings, etc- 21 Number of inspections of public conveniences 24 Number of visits re infectious diseases 194 Number of visits re insect pests 50 Number of inspections re rats and mice 3265 Number of sewer manholes treated 199 Number of visits to streams 32 Number of visits re clean air 1982 Number of inspections of swimming bath 5 Number of complaints received and investigated 637 Number of informal notices served 1135 Number of statutory notices served 14 Number of interviews re nuisances, etc- 374 Number of visits re drainage 397 Number of drains tested 32 Number of drainage obstructions cleared 58 Number of rooms disinfected 18 Number of lots of bedding and clothing disinfected 17 Number of library books disinfected 434 Number of samples of foodstuffs, water, stools etc-, taken for examination 447 Number of visits re food and other samples 265 H- G- CRIPPS, Chief Public Health Inspector- 41 SWIMMING BATH During the year under review the swimming bath at the Carew Manor School was maintained by the local Education Authority for the use of school.children exclusively. The water supply for the 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 1961 (9), were returned as bacteriologically satisfactory. 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 During the year no outbreaks of food poisoning occurred. The Chief Public Health Inspector and his staff continue to press for improved standards amongst shopkeepers and food handlers generally. The Inspectors, on their repeated visits to food premises, endeavour to induce a conscientious attitude towards the prevention of disease, by giving advice and distributing literature to all persons handling food. Instruction is given to shopkeepers and their assistants on personal hygiene and the dangers associated with disease and unclean habits in connection with their occupation. 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: Allotment Gardens. Animals, The Keeping of. Buildings. Clean Handling of Food. Fish.frying and Offensive Trades. Good Rule and Government. House Refuse, etc., Removal. New Streets. Nuisances. Offensive or Noxious Matter. Parking Place off Woodcote Road. Pleasure Grounds. Public Sanitary Conveniences. Slaughterhouses. Slot Machine Sale of Contraceptives. Tents, Vans, Sheds, etc. Underground Rooms. 44 PREVALENCE AND CONTROL OVER INFECTIOUS AND OTHER DISEASES The following table shows the incidence of infectious disease in the Borough in 1961, 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 13 5 - Measles 343 - - Whooping Cough 7 - - Pneumonia 2 2 20* Dysentery 5 — — Erysipelas 1 — — Ophthalmia Neonatorum 1 - - Totals 372 7 20* * Includes deaths from all forms of pneumonia. †Includes deaths of residents in homes and institutions outside the Borough. 45 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 1961 (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 13 - 1 4 7 1 - - - - 3 - 1 - - - - 5 Measles 343 4 27 149 153 7 3 - - - 93 62 44 47 26 17 54 - - Whooping 7 — 1 5 1 — — - - - 1 — 3 — - 3 - - - Pneumonia 2 - - - - - - - - 2 1 1 - - - -- - 2 20* Dysentery 5 1 2 — - — — 2 - - - 1 - 2 2 - - Erysipelas 1 - - - - - - - - - - - - - - - - - - Opthalmia Neonatorun 1 1 - - - - - - - - - - - - - - - - - Totals 372 6 31 158 161 8 3 2 — 3 99 64 48 49 38 20 54 7 20* 46 * Includes all forms The Monthly Incidence of Infectious Disease, 1961 (excluding Tuberculosis) Disease Jan. Feb. Mar. April May June July Aug. Sept. Oct. Nov. Dec. Total Scarlet Fever 2 — 4 1 1 — — — 1 — — 4 13 Measles 88 29 39 45 34 65 31 9 2 1 — — 343 Whooping Cough 1 1 4 - - - - - - - - 1 7 Pneumonia 1 1 — — — — - — — — — — 2 Dysentery — 1 — — — 2 1 — — — — 1 5 Erysipelas — — — — 1 — — — — — — — 1 Opthalmia Neonatorum 1 - - - - - - - - - - - 1 Totals 93 32 47 46 36 67 32 9 3 1 — 6 372 47 Tuberculosis There were 11 new cases notified during the year, this being a decrease of 2 on the number of cases notified in 1960. The following table gives the number of new cases notified during the past five years: New Cases 1957 1958 1959 1960 1961 M. F. M. F. M. F. M. F. M. F. Pulmonary 11 5 6 6 7 2 8 1 8 2 Non.Pulmonary — — — 1 1 — — — — 1 Totals 11 5 6 7 8 2 8 1 8 3 Annual case rate per 1,000 of the estimated population: 1957 1958 1959 1960 1961 Pulmonary 0.49 0.37 0.28 0.28 0.31 Non.pulmonary 0.00 0.03 0.03 0.00 0.03 The following table gives the number of deaths from this disease during the past five years: Deaths 1957 1958 1959 1960 1961 M. F. M. F. M. F. M. F. M. F. Pulmonary 1 — 2 1 2 — 3 — 2 1 Non.Pulmonary 1 — — — 1 — — — — — Totals 2 — 2 1 3 — 3 — 2 1 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 - - - - - - - - 3— 4 years - - - - - - - - 5— 9 years - - - - - - - - 10—14 years - - - - - - - - 15—24 years 1 1 - - - - - - 25—44 years 3 1 - - - - - - 45—64 years 4 - - - - - - - 65 and over - - - 1 2 1 - - Totals 8 2 — 1 2 1 — — The new cases were distributed amongst the Wards as follows: Beddington Wallington North West Cent. South North Cent. South Pulmonary 3 1 2 1 1 1 1 Non-Pulmonary — — 1 — — — — Totals 3 1 3 1 1 1 1 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 LTD11, Manor Road, Wallington- BERTRAM JOHNSON LTD11, Manor Road, Wallington-