BED 27 3.10.03 BOROUGH OF BEDDINGTON & WALLtNGTON ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the YEAR 1962 BOROUGH OF BEDDINGTON & WALLINGTON ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the YEAR 1962 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 1962: 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 31 Outwork 31 Defects 32 Workplaces, Shops and Offices 32 Infectious Disease & Disinfection 33 Offensive Trades 33 Clean Air Act, 1956 Smoke Control Areas 33 Industrial Premises 33 Prevention of Damage by Pest Act, 1949 Sewer Rat Control 34 Petroleum (Regulation) Acts 35 Shops Act, 1950 35 The Game Act, 1831 35 Heating Appliances (Fireguards) Act, 1952 35 Rag Flock & Other Filling Materials Act, 1951 35 Caravan Sites & Control of Devolopment Act, 1960 35 Noise Abatement Act, 1960 35 Summary Complaints 36 Notices served 36 Sanitary Improvements 36 Visits, etc 38 Swimming Bath 39 Schools 39 Outbreaks of Food Poisoning and Clean Food Campaign 40 Nutrition 40 Shell Fish (Molluscan) 40 Adoptive Acts and Bye-Laws 41 Prevalence and Control over Infectious and other Diseases: Notifiable Diseases (other than Tuberculosis) 42 Incidence of Infectious Diseases in Age Groups and Wards 43 Monthly Incidence of Infectious Disease 44 Tuberculosis 45 4 BOROUGH OF BEDDINGTON AND WALLINGTON PUBLIC HEALTH COMMITTEE December, 1962 Members: Councillor Mrs. H. Bridger (Chairman) Alderman S. W. C. Sprunt (Mayor) Alderman F. G. Lee Councillor D. C. E. Aldridge Councillor H. E. Austin Councillor G. E. W. Eve Councillor E. W. Farr Councillor J. L. Izard Councillor J. C. Ross Councillor R. L. Shove REPRESENTATIVES ON MID-EASTERN DIVISIONAL HEALTH SUB-COMMITTEE December, 1962 Members: Alderman D. H. de Voil Alderman E. W. Harding Councillor Mrs. H. Bridger Councillor N. J. Brittain Councillor G. E. W. Eve REPRESENTATIVES ON THE WANDLE VALLEY MAIN DRAINAGE AUTHORITY December, 1962 Members: Alderman S. W. C. Sprunt (Mayor) Alderman E. W. Harding Councillor H. E. Austin 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. Deputy Chief Public Health Inspector: (a.b.) D. A. Eves, M.A.P.H.I. Additional Public Health Inspectors: (a.b.) S. S. Lowe, M.R S.H, M.A.P.H.I. (a) R. W. Bradstock, M.R.S.H. (appt. 1-8-62, resgn. 5-12-62). (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 (Resigned 31-7-62) Clerks: R. F. Burns (Chief Clerk) 40% C. I. Phillips Mrs. M. B. Bevan Mrs. V. J. Scotter 25% 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. Mrs. S. M. Scott S.R.N., S.C.M., H.V.Cert., Physio therapists : 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. P. J. Carter (School Health) Mrs. M. J. Osborne (Resigned 29.1.62) Mrs. V. J. Scotter (Commenced 1.3.62.) Mrs. M. Meadows (Part time) Mrs. M. Richardson (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 1962. The report is drawn up in accordance with the suggestions made by the Minister of Health in his Circular 1/63. 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 1962 is 32,600, and this figure is used in the compilation of the vital statistics. The figure shows an increase of 10 compared with the Registrar-General's estimate for mid-year 1961. The census of population taken in 1961 was 32,588. The live birth rate per 1,000 total population shows an increase at 15.20 in 1962, as compared with 14.44 in 1961. This rate is below that for England and Wales, which is 18.00. The stillbirth rate per 1,000 total births is 8.40 compared with 8.85 in 1961. The figure for England and Wales is recorded as 18.10. The number of children stillborn in the district was 4 out of a total of 476 births. The death rate from all causes per 1,000 total population is 10.95 compared with 10.31 in 1961 and 11.90 for England and Wales. Of the 372 deaths, diseases of the heart accounted for 135 (36.29 per cent of total deaths), cancer 78 (20.97 per cent of total deaths), and tuberculosis 1 (0.27 per cent of total deaths). It will be seen from the table on page 13 showing causes of death, that there were 135 deaths from heart disease, and that other diseases of the circulatory system accounted for 18 deaths, while vascular lesions of the nervous system (stroke) accounted for 53 deaths, making a total of 206 deaths. Most of these deaths took place in people past middleage, which follows the usual pattern of mortality in this district. The 78 deaths from cancer were also in people of advancing years. No mothers died in childbirth during 1962, and this gives a maternal mortality rate per 1,000 total births of nil, as compared with 0.35 for England and Wales. The infantile mortality rate shows a decrease at 19.07 per 1,000 live births, as compared with 20.09 in 1961. Nine infants died under the 7 age of 1 year in 1962 out of 472 live births. On page 15 will be found an analysis of the causes of death. The corresponding rate for England and Wales is 21.40. The incidence of infectious disease generally throughout the year, has been low, measles giving the highest figure with 23 notified cases. Whooping cough with 16 notified cases was next in order of incidence. Fifteen cases of scarlet fever 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 fourth year in succession in which we have been able to make this comment. The annual reports for the years 1937 and 1961 covered periods respectively when the District was an Urban District and the 25 years after the District became a Borough. In looking over the records of the District since 1915 one is struck by the changing outlook and character of the work of the Public Health Department. The introduction of immunising procedures against diphtheria, whooping cough, poliomyelitis and tuberculosis has so reduced the number of cases of all these diseases now notified as to make the work of prevention very much easier. In the case of tuberculosis there has been an enormous reduction of mortality from the disease as well as the incidence. Much of the time thus made available to Public Health staff has to be spent in the field of social medicine. In particular, the Medical Officer of Health in his capacity of Divisional Medical Officer for the MidEastern Division of the Surrey County Council, has to devote a great deal of his energies to the alleviation of families suffering from social malaise. The changing pattern of the life of many people, together with the altered moral outlook has created social problems, which are giving a great deal of anxiety to both Central and Local Governments. The number of juvenile delinquents, which every year shows a great increase, has affected the work of Medical Officers as well as educationalists. The appointment of social workers, together with an increasing number of probation officers, has made it necessary to co-ordinate all aspects of social services in an endeavour to improve the worsening situation. The break up in family life resulting from divorce and temporary arrangements between men and women outside the marital bond brings enormous problems in its train. Increase in illegitimacy with the need to make provision either in foster homes or institutions for neglected and unwanted children throws a considerable burden on local Health Authorities. In an endeavour to co-ordinate the work of all persons trying to improve the social outlook, the County Council set up in 1957 co-ordinating Conferences under the chairmanship of the Divisional Medical Officers throughout the county, and this has already been reported upon in previous annual reports. These Conferences, at which every aspect of problem families are reviewed, have proved very effective in dealing with problems which had at first sight seemed insoluble. 8 Local Health Authorities, through their Children's Department, have to spend a considerable proportion of the rate on the provision of homes to take children into care as well as appointing more Child Care officers to assist in the supervision of bad homes. The work of the Public Health Inspectors too has altered very considerably over the years. The introduction of new legislation, i.e. Smoke Abatement Acts, the extension of the Food and Drugs Act and New Housing Acts have made the work of this section of the Department very much more responsible than it was previously. The impact of establishing Smoke Control Areas has had a considerable effect upon the work and the deviation of responsibility of the Department. The work of the Clean Air Act, which has so far been undertaken without the appointment of additional staff has increased to such an extent that it now takes up a disproportionate amount of the time of the available staff. This can be seen from the following table which shews the number of visits made in connection with duties under the Clean Air Act, mainly in connection with Smoke Control Areas, and the number of inspections of houses, food premises and factories. While the total figure indicates that the volume of work is now greater than heretofore, the other figures shew that the emphasis has so changed that certain aspects of the work are not receiving the attention they warrant and formerly received. INSPECTIONS Year Houses Food Premises Factories C.A.A. TOTAL 1958 680 677 102 335 1,794 1959 524 474 150 1,105 2,253 1960 276 384 105 1,655 2,420 1961 208 406 92 1,982 2,688 1962 164 345 65 2,104 2,678 During the year the problem dealing with the aged and chronic sick has demanded a considerable deal of administrative time and field work from the members of the Public Health Department. The provision of home help, district nursing, meals on wheels and other services for the aged has alleviated the lot of many lonely, sick and old persons. The admission to hospital of many cases has been arranged through the kindly help of the Geriatric Department at St. Helier's Hospital. During the year under review no Magistrate's Orders had to be sought for the removal of an old person. Most of the cases dealt with were only too pleased to accept the administration arrangements made on their behalf. Once again we must record the appreciation of all for the very considerable help given by the W.V.S. in this connection under the able guidance of Mrs. O. L. Wiles. 9 The number of attendances at the various Infant Welfare Centres throughout the town has, over the past few years, shown a remarkable increase. The rising birth rate has, no doubt, contributed considerably to this but also it is generally felt that ratepayers are more and more inclined to take advantage of the various services for the health of mothers and children provided by the Local Health Authority. In September 1962 a new Maternity and Child Welfare Clinic was established at the British Red Cross House in Woodcote Road. The object of introducing a new Clinic at this site was to meet the demand of young parents now occupying new properties in the Southern part of the Borough. There has been much expansion of private dwellings in this area and many new families are growing up who require these services. With an average attendance of 50 now in this new Clinic it is felt that the venture has amply justified itself. A new Clinic to provide services previously enjoyed at the Grange Mansion, burnt down in January 1960, is being built in Shotfield and should be completed early in 1965. It is hoped in these new premises to combine the School Medical Service, Dental and Physiotherapy clinics as well as most of the services for Maternity and Child Welfare including ante-natal clinics and Infant Welfare clinics, together with the sale of Infant Welfare foods and medicaments. On Page 21 where records of immunising procedures are recorded, it will be noticed that during the early part of the year under review there was a considerable increase in the number of smallpox vaccinations carried out. This increase is accounted for by the considerable demand which arose after occurrences of smallpox in Wales and the North of England. In conclusion, I wish to place on record my appreciation of the loyal service and valuable assistance I have received from all members of my staff throughout the year. 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, 1963. 10 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 1962 32,600 Number of inhabited houses, 1931 7,092 Number of inhabited houses, 1962 10,417 Rateable Value £2,253,441 Sum represented by penny rate £9,130 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 1962 32,600 Live Births Males 1 Females Total Legitimate 244 205 449 Illegitimate 11 12 23 Total 255 217 472 Live Birth Rate per 1,000 population 14.48 Adjusted Birth Rate 15.20 England and Wales Live Birth Rate 18.00 Illegitimate Live Births per cent of total Live Births 4.87 Still Births Legitimate 3 1 4 Illegitimate — — — Total 3 1 4 Rate per 1,000 total Live and Stillbirths 8.40 England and Wales Stillbirth Rate 18.10 Live and Stillbirths Legitimate 247 206 453 Illegitimate 11 12 23 Total 258 218 476 Deaths 200 172 372 (i) Death Rate per 1,000 population 11.41 Adjusted Death Rate 10.95 England and Wales Death Rate 11.90 (ii) Infant Deaths—under 1 year of age Total No. of Deaths 9 Infant Mortality Rate per 1,000 Live Births 19.07 Infant Mortality Rate per 1,000 Live Births: Legitimate 20 04 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) 14.83 Early Neo.natal Mortality Rate per 1,000 Live Births (Deaths under 1 week) 14.83 Peri.natal Mortality Rate per 1,000 Live and Stillbirths (Stillbirths and deaths under 1 week) 23.11 (iii) Maternal Deaths (including abortion) total Nil Maternal Mortality Rate per 1,000 Live and Stillbirths Nil England and Wales Maternal Mortality Rate 0.35 12 REGISTERED CAUSES OF DEATH The following table, supplied by the Registrar-General, gives the causes of death of residents in the Borough during 1962: Causes of Death Males Females Total All Causes 200 172 372 1. Tuberculosis, respiratory 1 — 1 2. Tuberculosis, other — — — 3. Syphilitic disease — — — 4. Diphtheria — — — 5. Whooping Cough — — — 6. Meningococcal infections — — — 7 Acute poliomyelitis — — — 8 Measles — — — 9. Other infective and parasitic diseases — — — 10 Malignant neoplasm, stomach 6 3 9 11. Malignant neoplasm, lung, bronchus 14 3 17 12. Malignant neoplasm, breast.. — 5 5 13. Malignant neoplasm, uterus.. — 3 3 14. Other malignant and lymphatic neoplasms 23 21 44 15. Leukaemia, aleukasmia — 2 2 16. Diabetes — — — 17. Vascular lesions of nervous system.. 19 34 53 18 Coronary disease, angina 53 28 81 19. Hypertension with heart disease 3 5 8 20. Other heart diseases 20 26 46 21 Other circulatory diseases 10 10 20 22. Influenza — — — 23 Pneumonia 6 5 11 24. Bronchitis 12 2 14 25. Other diseases of respiratory system 1 2 3 26. Ulcer of stomach and duodenum .. 1 — 1 27. Gastritis, enteritis and diarrhoea .. — 6 6 28. Nephritis and nephrosis 2 2 4 29. Hyperplasia of prostate 6 — 6 30. Pregnancy, childbirth, abortion — — — 31. Congenital malformations .. 3 2 5 32. Other defined and ill-defined diseases 11 8 19 33. Motor vehicle accidents — 1 1 34. All other accidents 3 2 5 35. Suicide 6 2 8 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 135 36.29 Other Diseases of the Circulatory System 18 4.84 Vascular Lesions of Nervous System 53 14.24 Cancer 78 20.97 Bronchitis 14 3.76 Pneumonia 11 2.96 Tuberculosis (All Forms) 1 0.27 Cancer of the Lung and Bronchus Males Females Total Number of deaths in 1962 14 3 17 Rate per 1,000 population 0.51 England and Wales Rate 0.51 VIOLENCE AND ACCIDENT Details of all deaths under this heading are as follows: Cause of Death Male Female Total Homicide Suicide 6 2 8 Other Violent Causes 3 3 6 Totals 9 5 14 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 0.35. INFANTILE MORTALITY The infantile mortality rate for 1962 was 19 07 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 472 live births, only 9 deaths of infants under one year of age (5 males and 4 females) were registered. 14 The following table gives the age and cause of death of each infant who died: Age Sex Cause of Death 1 hour M Multiple Congenital Abnormalities. 1 hour F Prematurity. 6 hours M Pulmonary haemorrhage. Newborn child (36 weeks). Diabetic mother. 7 hours F Multiple Congenital Abnormalities. 14 hours M Congenital morbus cordis. 2 days M Intercranial damage, haemorrhagic disease of the newborn. 5 days F Acute Meningitis, Septicaemia, Listeria infection 2 months M Congenital morbus cordis Broncho- pneumonia 4 months F Fulminating Gastro-enteritis. 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 893 cases, including 128 maternity and midwifery patients. A total of 21,062 visits was made. 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 45 Chronic Sick (including aged and infirm) 200 Acute Sick 36 Tuberculosis 1 282 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 16 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 12/6 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 1962 the following persons were treated:- Elderly persons 72 Handicapped persons 12 Total 84 A total of 383 treatments were given (232 at surgery and 151 at the patients home). The chiropody service introduced in 1958 through the active cooperation of the W.V.S. and the British Red Cross Society, continued to operate in 1962. 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, 114 women made 466 pre-natal attendances. This represents an attendance of 24.0 per cent of the total number of confinements which occurred during 1962. 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 forty or 72.0 per cent. of births allocated to this district, took place in hospitals and nursing homes, compared with 69.69 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 Woodcote Road Centre When held Red Cross House, Woodcote Road. Every Monday, 2.0—4.0 p.m. (commenced 24.9.63) Hackbridge Centre, All Saints Church Hall, New Road. Every Monday, 2.0-4.0 p.m. Bandon Hill Centre, Methodist Hall, Sandy Lane North. Every Tuesday, 2.0-4.0 p.m. Beddington Centre, The Scout Hall, Guy Road. Every Wednesday, 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 Every Thursday, 2.0-4.0 p.m. Post-natal Clinic, „ „ „ Relaxation and Mothercraft Classes. By appointment District Nurses' Home, 57 Montagu Gardens. Physiotherapy Clinic, 57 Montagu Gardens. By appointment. 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. The number of attendances recorded at the four clinics during the year was as follows:— Number attending Total attendances Children under 1 year 436 5,969 Children, 1-5 years 840 3,565 Total 1,276 9,534 18 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 202 384 Children, 0-1 year 452 2,201 Children, 1-5 years — 3,036 Other Cases — 138 Ineffectual — 637 Total 654 6,396 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 1962. Equipment is kept at the District Nurses' Home, the headquarters of the local Midwives, where it is ready for immediate use when required. Thirty-one premature live births were notified during the year, 29 of which occurred in hospital. Two infants died within 24 hours of birth. The remaining 29 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. 19 Treatment. Minor Ailments. Twenty-six cases were referred from the Infant Welfare Centres to Hospital Specialists for investigation and treatment during the year. The principal defects were as follows: Eye conditions 7 Ear, Nose and Throat 8 Skin Conditions 3 Hernia 3 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 3 1 3 - - - Children, 0-5 33 37 93 — — — Totals 36 38 96 — — — 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. 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. The following table gives details of attendances: Total attendances Irradiations Corrective treatments Relaxation Exercises Children, 0-5 years 218 129 — Children, 5-15 years 494 1,802 — Expectant and Nursing Mothers 18 — 449 Total 730 1,931 449 20 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 1962, 1097 persons including 491 children under 5 years of age, were vaccinated and 657 persons were re-vaccinated at the weekly clinic held at the Town Hall, or by their general practitioner. Diphtheria Immunisation. Six clinicsare heldweeklyto give immunisation against diphtheria. These are held at each of the five 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., 1962 1,949 4,272 6,221 Number of children known to be immunised at 31st Dec., 1962 1,668 4,085 5,753 Percentage of children immunised 85.6 95.6 92.5 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, 400 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 1962, 430 children completed a primary course and 67 children received a reinforcing dose. 21 Poliomyelitis. The Poliomyelitis vaccination scheme, introduced in 1956, continued, within the prescribed age groups, during 1962. In March of this year, the Minister of Health introduced the new oral vaccine known as the Sabine vaccine. It is held by the experts that this is a better vaccine than the injection of Salk, as not only is a general immunity in the blood stream set up, but also a local immunity in the intestinal tract. It is thought that this vaccine will take over completely from the Salk injections. During the year considerable use was made of this vaccine, especially by children. The following figures show the number of persons vaccinated by the end of 1962. Salk Vaccine No. of children born 1943-62 who have received two injections of Salk Vaccine 7644 No. of persons born 1920-42 who have received two injections of Salk Vaccine 3977 No. of persons who received a 3rd injection of Salk after two former injections 10803 No. of children between the ages of 5-12 years who received a 4th dose of Salk Vaccine after a former 3 injections. 2394 Oral Vaccine No. of children born 1943-62 who received a primary course of three doses of Oral Vaccine 250 No. of persons born 1922-42 who received a primary course of three doses of Oral Vaccine 85 No. of persons who received 3rd dose of Oral Vaccine after two injections of Salk 378 No. of children who received 4th dose of Oral Vaccine after three injections of Salk 560 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 1962 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 1962, 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. 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. 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 same demolished at end of 1962 38 Number of families rehoused by the Council or by private owners at the Council's instigation since the beginning of the war 1276 Number of live applications on the housing list for accomodation in Beddington and Wallington:— On the general waiting list 356 On the aged persons' list 238 For accommodation in Frimley and Camberley 28 New houses erected, etc. Number of new houses and flats erected in 1962:— Private enterprise 81 Local Authority Nil Number of flats erected by conversion in 1962:— Private enterprise 6 Local Authority 13 Number of houses and flats purchased in 1962 and let 3 Housing Act, 1957 Ninety-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 164 Number of inspections recorded under Housing Regulations 36 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 4 Number of families dwelling therein 5 Number of persons dwelling therein 33 Number of new cases of overcrowding reported 2 Number of cases of overcrowding relieved 1 Number of persons concerned 8 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 notice of intention to issue Certificate of Disrepair was sent out. 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 43 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 the usual attention, but no major works were undertaken pending the reconstruction to be carried out by Surrey County Council. 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 a Bedford Lacre suction sweeper was brought into operation on the highways and proved to be a more satisfactory method of cleansing than hand sweeping. Footpaths have continued to be swept by hand. The pilot scheme for refuse collection using paper bags instead of dustbins, which was carried out in 1960, proved successful and has been extended to other Council housing estates, 400 houses now being provided with brackets for paper bags. 25 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, 1962 INSPECTION AND SUPERVISION OF FOOD MILK AND DAIRIES Number of distributors of milk on register 10 Number of milk depots other than dairy farms on register 1 Number of above premises upon which loose milk is handledNil Number of inspections of premises 3 Number of licences issued under Milk (Special Designation) Regulations: Tuberculin Tested Milk—Dealers'(Pre-packed) 2 Pasteurised Milk—Dealers' (Pre-packed) 2 Sterilized Milk—Dealers' (Pre-packed) 0 4 Number of licences outstanding under Milk (Special Designation) Regulation: Tuberculin Tested Milk—Dealers'(Pre-packed) 8 Pasteurised Milk—Dealers' (Pre-packed) 8 Sterilized Milk—Dealers'(Pre-packed) 13 29 BACTERIOLOGICAL EXAMINATION OF MILK Sixty-five 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 49 44 - 49 - - - T.T. Pasteurized 9 5 - 9 - - - Sterilized 4 - - - - 4 - Tuberculin Tested (Farm Bottled) 3 3 - - - - - Three samples of Tuberculin Tested milk were submitted for biological examination - Tubercle bacilli were not isolated. 26 CHEMICAL ANALYSES OF MILK Fourteen 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 103 Number of manufacturersNil Number of inspections of premises 35 Eighteen 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 18 18 - - - 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 Bakehouses6 Bakers 10 Butchers 24 Catering Establishments 81 Chemists 11 Confectioners (sweets) 45 Fishmongers (including friers) 10 Greengrocers27 Grocers63 Licensed Premises11 Food Factories 3 27 FOOD PREMISES REGISTERED UNDER SECTION 16 OF THE FOOD & DRUGS ACT, 1955 Sausage manufacturers26 Fish friers 6 Jam manufacturers1 Ice cream (sale only) 103 Food Hygiene (General) Regulations, 1960 Inspections of food premises continued during 1962. The type of premises visited and number of inspections are set out below: Bakehouses10 Bakers21 Butchers28 Catering Premises25 Confectioners (sugar)38 Fishmongers13 Greengrocers29 Grocers68 Milk Shops3 Registered Premises48 Other Food Premises54 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. Eggs 27 Fish,28 Flour14 Fruit9 Fruit, canned24 Meat and Offal 274 Meat, canned50 Preserves 9 Vegetables, canned14 Total 449 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 1962 Articles No. Examined Adulterated Prosecu tions Convic tions Formal. Informal Total Formal Informal Total Arrowroot - 1 1 - - - - Baby food 1 - 1 - - - - - Biscuits - 3 3 - - - - - Bread - 3 3 - 3 3 - - Breakfast cereal - 1 1 - - - - - Butter 1 - 1 - - - - - Cake mixture - 1 1 - - - - - Calf's foot jelly - 1 1 - - - - - Cocoa - 1 1 - - - - - Coffee & Chicory essence - 3 3 - - - - - Confectionery: flour 1 - 1 - - - - - Confectionery: Sugar 1 9 10 - - - - - Cream - 1 1 - - - - - Drink, soft 2 4 6 - - - - - Dripping - 1 1 - - - - - Fish (fingers) - 1 1 - - - - - Fish, potted - 1 1 - - - - - Flavouring essence - 1 1 - - - - - Flavouring syrup 1 1 2 1 1 2 - - Fruit, (greengages) - 1 1 - - - - - Fruit pie filling canned . - 1 1 - - - - - Gin 1 - 1 - - - - - Honeycomb - 1 1 - - - - - Ice cream 4 - 4 - - - - - Ice lolly 1 - 1 - - - - - Jam - 2 2 - - - - - Jelly tablet - 1 1 - - - - - Margarine - 2 2 - - - - - Meat products 1 2 3 - - - - - Meat products, canned - 1 1 - - - - - Milk 3 11 14 - - - - - Milk, dried full cream - 2 2 - - - - - Milk, evaporated - 1 1 - - - - - Mincemeat 1 1 2 - - - - - Mussels, bottled - 1 1 - - - - - Pickles - 1 1 - - - - - Proprietary Medicine - 2 2 - - - - - Pudding, Christmas - 1 1 - - - - - Salad cream - 1 1 - - - - - Sauce - 2 2 - - - - - Sausages 3 2 5 - 2 2 - - Spread (patum peperium) - 1 1 - - - - - Stout 1 - 1 - - - - - Stuffing Mixture - 1 1 - - - - - Tea 1 1 2 - 1 1 - - Vinegar, malt - 2 2 - - - - - Whisky 1 - 1 - - - - - Yeast tablets - 1 1 - - - - - Yogurt 1 - 1 - - - - - Total 25 75 100 1 7 8 - - 29 UNSATISFACTORY SAMPLES Informal Sample No. 5—Pork Sausages The sample contained fat, 35.3%, fat-free meat, 33.1%, total meat content, 64.4%. In the opinion of the Public Analyst the proportion of fat in sausages should not exceed 50% of the meat content. The attention of the manufacturer was directed to this matter; a further sample was obtained which proved satisfactory. Informal Sample No. 17—Tea This sample was submitted to the Public Analyst following a complaint. The sample had an objectionable taint and was unsuitable for drinking purposes. A further sample was obtained which proved satisfactory. Informal Sample No. 58—Milk Shake Syrup The sample contained sulphur dioxide, 240 parts per million; an added preservative not permitted in this article. A formal sample was taken. Formal Sample No. 61—Milk Shake Syrup The sample contained sulphur dioxide, 250 parts per million. This was reported to the Public Health Committee who recommended that no action be taken in view of new regulations permitting added preservative (sulphur dioxide) in this commodity. Informal Sample No. 90—Pork Sausages, Preserved The sample contained fat, 35.4%, fat-free meat, 30.3%, total meat content, 65.7%. A formal sample was obtained which proved satisfactory. 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.l—Bread The specimen included a small dead beetle, which had apparently been baked in the loaf. A warning letter was sent to the manufacturer. Serial No. S.2—Wholemeal Loaf The specimen contained several dark brown streaks and in a central pocket a sticky black mass of caramel. The manufacturer was informed and has improved the method of storage of caramel powder to prevent a repetition. Serial No. S.3—Portion of Hovis Loaf The specimen contained a black streak in the middle of the crumb, caused by the presence of a small quantity of charred bread and grease. A letter was sent to the manufacturer. 30 FACTORIES ACT, 1961 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 3 2 - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 155 50 1 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 13 13 - Total 171 65 1 - Part VIII of the Act Outwork Nature of Work Section 110 Section 111 No. of outworkers in August list required by Sect. 110 (l)(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 8 - - - - - Wearing apparel: Making, etc. 2 - - - - - Total 10 - - - - - 31 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 1 - - - Overcrowding (S.2) - - - - - Unreasonable temperature (S.3) - - - - - Inadequate ventilation (S.4) - - - - - Ineffective drainage of floors (S.6) - - - - - Sanitary conveniences (S.7): (a) Insufficient - - - - - (b) Unsuitable or defective - - - - - (c) Not separate for sexes - - - - - Other offences against the Act (not including offences relating to Outwork) - - - - - Total 1 1 - - - WORKPLACES, SHOPS AND OFFICES Number of inspections 210 Notices servedNil 32 INFECTIOUS DISEASE AND DISINFECTION Number of visits re cases of infectious disease211 Number of rooms disinfected16 Number of library books disinfected337 OFFENSIVE TRADES Number of offensive trade premises in districtNil 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. Three 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 came into force on the 1st October, 1962. (3) That part of the Borough bounded by Woodcote Road, Sandy Lane South and Stafford Road. The order relating to this area will come into force on the 1st October, 1963. During the year houses and other premises in a fourth area were visited with a view to their inclusion in a fourth smoke control order. The area is that bounded by Woodcote Road, Heathdene Road, Boundary Road the Sutton to West Croydon railway, Demesne Road and Stafford Road. INDUSTRIAL PREMISES During the year 97 observations were made on the chimneys of Industrial premises. One contravention of the Dark Smoke (Permitted Periods) Regulations was reported and brought to the notice of the Company. Advice was given when consulted, on the heights of new chimneys and new furnaces to be installed. 33 PREVENTION OF DAMAGE BY PESTS ACT, 1949 Report for 12 months ending 31st December, 1962 Type of Property Local Authority Dwelling Houses Business (& other premises) Total Agricultural Number of Properties in Local Authority's district 46 10,395 1,532 11,973 30 Number of Properties inspected as a result of: (a) Notification - 104 22 126 - (b) Survey under the Act 46 236 109 391 30 (c) Primarily for some other purpose - 236 461 697 - Properties found to shew major rat infestations - - - - - Properties found to shew minor rat infestations 12 72 20 104 - Properties found to shew major mice infestations - - - - - Properties found to shew minor mice infestations 1 22 5 28 - Total Infestations 13 94 25 132 - SEWER RAT CONTROL The introduction some years ago of Warfarin bait for sewer maintenance treatments resulted in an immediate reduction in the number of manholes showing evidence of infestation. At the time of the treatment in April, 1962, 13 manholes showed a take of bait. It was felt that a change of poison and procedure might effect an improvement and in the treatment carried out in November, fluoracetamide was used for the first time. The result of this change is not normally assessed until at least three treatments have been carried out and the result of a further test baiting examined. 34 PETROLEUM (REGULATION) ACTS 67 Licenses were issued to keep petroleum spirit and/or petroleum mixture at 55 premises. The maximum quantities of these substances which may be kept under licence in the Borough are as follows: Petroleum Spirit 122,100 gallons (49 licences) Petroleum Mixture 12,155 gallons (18 licences) SHOPS ACT, 1950 The total number of inspections during the year was 201. 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. 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. 43 visits were made during the year. NOISE ABATEMENT ACT, 1960 Thirty-one complaints of noise were received and investigated during the year. The complaints related to eleven sources of noise, one of which is situated in an adjoining district. 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. 35 SUMMARY COMPLAINTS The total number of complaints received was 624. They were due to the following causes: Rats and Mice131 Housing defects53 Choked drains and sewers 177 Defective drainage (including closets)13 Unsound or adulterated food41 Atmospheric Pollution51 Insect pests45 Offensive accumulations 16 Miscellaneous97 624 NOTICES SERVED Number of informal notices served (including verbal intimations) 828 Number of statutory notices served Public Health Act, 1936—Section 39 (Drainage) 3 Section 56 (Yard drainage and paving)1 Section 93 (Nuisances)6 Clean Air Act, 1956—Section 127 - 17 SANITARY IMPROVEMENTS (1) Dwelling Houses Brickwork repaired or repointed 7 Ceilings— Repaired, renewed or cleansed5 Chimneys— Stacks and flues repaired1 Dampness remedied— (a) Roofs repaired9 (b) Damp-proofing works 13 (c) Gutters and rainwater pipes repaired and unstopped 11 Doors—repaired or renewed 4 Drainage— (a) Obstructions cleared 96 (b) Repaired and relaid 6 (c) Inspection chambers provided and repaired 5 (d) F.A.I, provided, etc.1 (e) Waste-pipes repaired and renewed5 (f) Rainwater drainage provided, repaired or renewed 8 Dustbins provided 4 Fireplaces and stoves repaired or renewed 6 Floors— Repaired or renewed 3 Walls- (a) Repaired or rebuilt14 (b) Plaster repaired and redecorated2 36 W.C. Accommodation— (a) Cisterns repaired or renewed 2 (b) Flush pipe joint repaired2 (c) Pans provided or replaced 3 (d) Seats repaired or renewed 1 Windows— (a) Frames and sashes repaired or renewed 10 (b) Sashcords and beading renewed 18 (c) Glazing and putties renewed 10 (d) Cills repaired12 Other Sanitary improvements 9 (2) Factories Cleansed1 Sanitary Accommodation— Artificial Lighting Provided 1 (3) Food Premises Fittings-equipment (Improved) 1 Protection for food stuff provided 2 Drainage Improved and Repaired1 Sanitary accommodation improved2 Ablution facilities provided or improved 1 Sinks and hot water provided 4 Cleaned and redecorated 2 Accumulations removed 1 Dustbins Provided 1 Personal Cleanliness Improved 2 (4) Shops Washing Accomodation Provided 2 Redecoration and cleansing 2 Seats Provided 1 Artificial Lighting improved 1 37 SUMMARY OF VISITS ETC. DURING THE YEAR Number of inspections of dwelling-houses 164 Number of re-inspections of premises 367 Number of visits to work in progress 25 Number of miscellaneous visits and inspections 174 Number of visits to food premises 345 Number of visits to factories 68 Number of visits to shops, offices and workplaces210 Number of visits to watercress beds, smallholdings, etc.24 Number of inspections of public conveniences 19 Number of visits re infectious diseases 211 Number of visits re insect pests 67 Number of inspections re rats and mice 2740 Number of sewer manholes treated 582 Number of visits to streams 27 Number of visits re clean air2104 Number of inspections of swimming bath 3 Number of complaints received and investigated624 Number of informal notices served 828 Number of statutory notices served 17 Number of interviews re nuisances, etc.406 Number of visits re drainage 352 Number of drains tested10 Number of drainage obstructions cleared85 Number of rooms disinfected16 Number of lots of bedding and clothing disinfected 4 Number of library books disinfected337 Number of samples of foodstuffs, water, stools etc., taken for examination 391 Number of visits re food and other samples 276 H. G. CRIPPS, Chief Public Health Inspector. 38 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 1962 (7), 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. 39 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. 40 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. » 41 PREVALENCE AND CONTROL OVER INFECTIOUS AND OTHER DISEASES The following table shows the incidence of infectious disease in the Borough in 1962, 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 15 4 - Measles 23 - - Whooping Cough 16 - - Pneumonia 6 3 11* Dysentery 5 - - Erysipelas 2 - - Puerperal Pyrexia 2 - - Quartan Malaria 1 1 Totals 70 8 11* * Includes deaths from all forms of pneumonia, † Includes deaths of residents in homes and institutions outside the Borough. 42 43 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 1962 (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 15 - - 4 11 - - - - - 3 3 1 1 5 1 1 4 - Measles 23 - 7 7 13 1 - - - - 4 2 7 4 3 3 - - Whooping Cough 16 1 2 3 7 3 - - - - 1 5 ? 3 4 1 - - Pneumonia 6 - - 1 - 1 - 1 - 3 7 1 - 1 1 1 - 3 11* Dysentery 5 - - 2 2 - - 1 - - - - - - 5 - - - - Erysipelas 2 - - - - - - - 2 - - - - - - - - - Puerperal Pyrexia 2 - - - - - 1 1 - - 1 - - - - - 1 - - Quartan Malaria 1 - - - - - - 1 - - - - - - - - 1 - - Totals 70 1 4 17 33 5 1 4 2 3 13 11 8 8 17 6 7 7 11* * Includes all forms 44 Tbe Monthly Incidence of Infectious Disease, 1962 (excluding Tuberculosis) Disease Jan. Feb. Mar. April May June July Aug. Sept. Oct. Nov. Dec. Total Scarlet Fever 3 1 1 1 2 2 1 1 1 - - 2 15 Measles 3 - - - 3 4 2 - 2 - - 9 23 Whooping Cough 2 1 4 3 2 - - - 3 1 - - 16 Pneumonia 3 - 1 - - - - - - - 1 1 6 Dysentery - - - - - - - - - 5 - - 5 Erysipelas 1 - 1 - - - - - - - - - 2 Puerperal Pyrexia - - - - 1 - - - 1 - - - 2 Quarton Malaria - - - - 1 - - - - - - - 1 Totals 12 2 7 4 9 6 3 1 7 6 1 12 70 Tuberculosis There were 8 new cases notified during the year, this being a decrease of 3 on the number of cases notified in 1961. The following table gives the number of new cases notified during the past five years: New Cases 1958 1959 1960 1961 1962 M. F. M. F. M. F. M. F. M. F. Pulmonary 6 6 7 2 8 1 8 2 3 4 Non-Pulmonary - 1 1 - - - - 1 - 1 Totals 6 7 8 2 8 1 8 3 3 5 Annual case rate per 1,000 of the estimated population: 1958 1959 1960 1961 1962 Pulmonary 0.37 0.28 0.28 0 0.31 0.21 Non-pulmonary.. 0.03 0.03 0.00 0.03 0.03 The following table gives the number of deaths from this disease during the past five years: Deaths 1958 1959 1960 1961 1962 M. F. M. F. M. F. M. F. M. F. Pulmonary 2 1 2 - 3 - 2 1 1 - Non-Pulmonary - - 1 - - - - - - - Totals 2 1 3 - 3 - 2 1 1 - It will be seen from the foregoing table that 1 Tuberculous patient died during the year, this being one of the lowest figures yet recorded. The figures correspond to a death rate per 1,000 of population of 0.03. 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: 45 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 1 - - - - - - - 15—24 years - 1 - - - - - - 25—44 years - 1 - 1 - - - - 45—64 years 2 1 - - 1 - - - 65 and over - 1 - - - - - - Totals 3 4 - 1 1 - - - The new cases were distributed amongst the Wards as follows: Beddington Wallington North West Cent. South North Cent. South Pulmonary 2 1 1 2 1 - - Non-Pulmonary - 1 - - - - - Totals 2 2 1 2 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. 46 BERTRAM JOHNSON LTD. 11, Manor Road, Wallington.