bed 28 BOROUGH OF BEDDINGTON & WALLINGTON ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the YEAR 1963 BOROUGH OF BEDDINGTON & WALLINGTON ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the YEAR 1963 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 10 Extracts from Vital Statistics 11 Vital Statistics: Registered Causes of Death 12 Cancer of the Lung and Bronchus 13 Violence and Accident 13 Maternal Mortality 13 Infantile Mortality 13 General Provision of Health Services for the Area: (Including Transferred Functions under the National Health Service Act, 1946). Nursing in the Home 15 Domestic Help Service 15 Chiropody 15 Care of Mothers and Young Children 16 Immunisation and Vaccination 20 School Clinics 21 Cleansing of Persons 21 Laboratory Facilities 21 Hospitals 22 Ambulance Facilities 22 Disinfection 22 Housing 23 Sanitary Circumstances of the Area: Water Supplies 24 Drainage and Sewerage 24 Rivers and Streams 24 Closet Accommodation 24 Public Cleansing 24 3 Report of the Chief Public Health Inspector for the Year 1962: Inspection & Supervision of Food Milk and Dairies 25 Ice Cream 26 Slaughterhouses 26 Food Premises 26 Food Hygiene (General) Regulations 1960 27 Unsound Food 27 Sampling 27 Factories Act 1937-1959 Inspections 30 Outwork 30 Defects 31 Workplaces, Shops and Offices 31 Infectious Disease & Disinfection 32 Offensive Trades 32 Clean Air Act, 1956 Smoke Control Areas 32 Industrial Premises 32 Prevention of Damage by Pest Act, 1949 Sewer Rat Control 33 Petroleum (Regulation) Acts 34 Shops Act, 1950 34 The Game Act, 1831 34 Heating Appliances (Fireguards) Act, 1952 34 Rag Flock & Other Filling Materials Act, 1951 34 Caravan Sites & Control of Devolopment Act, 1960 34 Noise Abatement Act, 1960 34 Summary Complaints 35 Notices served 35 Sanitary Improvements 35 Visits, etc. 37 Swimming Bath 38 Schools 38 Outbreaks of Food Poisoning and Clean Food Campaign 39 Nutrition 39 Shell Fish (Molluscan) 39 Adoptive Acts and Bye-Laws 40 Prevalence and Control over Infectious and other Diseases: Notifiable Diseases (other than Tuberculosis) 41 Incidence of Infectious Diseases in Age Groups and Wards 42 Monthly Incidence of Infectious Disease 43 Tuberculosis 44 4 BOROUGH OF BEDDINGTON AND WALLINGTON PUBLIC HEALTH COMMITTEE December, 1963 Members: Councillor Mrs. H. Bridger (Chairman) Councillor H. Haydon (Mayor) Alderman S. W. C. Sprunt (Deputy Mayor) Alderman F. G. Lee Alderman E. P. Vaughan Councillor D. C. E Aldridge Councillor J. Cumming Councillor E. W. Farr Councillor Mrs. N. R. MacPhee Councillor Miss R L. Shove Councillor Miss I. S. E. Tomlin REPRESENTATIVES ON MID-EASTERN DIVISIONAL HEALTH SUB-COMMITTEE December, 1963 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, 1963 Members: Councillor H. Haydon (Mayor) Alderman E. W. Harding Alderman S. W. C. Sprunt Councillor H. E. Austin 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., F.A.P.H.I. Deputy Chief Public Health Inspector: (a.b.c.) 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) 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: J. Stillwell (Commenced 11.3.63) Clerks: R. F. Burns (Chief Clerk) 40% C. I. Phillips Mrs. M. B. Bevan Mrs. V. J. Scotter 25% (Resigned 29.7.63) Mrs. B. Phillips 25% (Commenced 9.9.63) 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., M.R.C.S., L.R.C.P. Hazel Wiseman, M.B., Ch.B , DObst.R.C.O G. 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., 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. P. J. Carter (School Health) Mrs. V. J. Scotter (Resigned 29.7.63) Mrs. B. Phillips (Commenced 9.9.63) 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 1963. This report is the 27th and will probably be the last to be submitted to the Members of the Beddington and Wallington Borough Council. By the time the report for the year 1964 is ready for presentation, the new London Borough of Sutton will be functioning. The report includes those services, which are under the control of the Surrey County Council, the Local Health Authority under the National Health Services 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 1963 is 32,560, and this figure is used in the compilation of the vital statistics. The figure shows a decrease of 40 compared with the Registrar General's estimate for mid-year 1962. The census of population taken in 1961 was 32,588. The live birth rate per 1,000 total population shows a slight increase at 15.47 in 1963, as compared with 15.20 in 1962. This rate is below that for England and Wales, which is 18.20. The stillbirth rate per 1,000 total births is 8.56 compared with 8.40 in 1962. The figure for England and Wales is recorded as 17.20. The number of children stillborn in the district was 4 out of a total of 466 births. The death rate from all causes per 1,000 total population is 10.51 compared with 10.95 in 1962 and 12.20 for England and Wales. Of the 360 deaths, diseases of the heart accounted for 129 (35.83 per cent of total deaths), cancer 76 (21.10 per cent of total deaths). There were no deaths from tuberculosis. As has been reported in previous years, heart disease and other diseases of the circulatory system and vascular lesions of the nervous system (stroke) accounted for a great proportion of the deaths. The table on Page 12 gives the number of deaths from these various causes. It will be seen that the pattern is very comparable with what has taken place in previous years. The number of deaths from cancer of the lung was 18, showing an increase of one on the previous year. The total number of deaths from cancer was 76. 7 No mothers died in childbirth during 1963, and this gives a maternal mortality rate per 1,000 total births of nil, as compared with 0.28 for England and Wales. The infantile mortality rate shows a decrease at 17.32 per 1,000 live births, as compared with 19.07 in 1962. Eight infants died under the age of one year in 1963 out of 462 live births. On page 14 will be found an analysis of the causes of death. The corresponding rate for England and Wales is 21.10. The incidence of infectious disease generally throughout 1963 has been low. The year, however, can be described as a "measles year". There was a very high incidence during the months of February, March and April, there being 472 cases notified during the year. For the most part, cases were relatively mild. No patient died from the disease,, only four cases being removed to hospital for nursing. Eight cases of scarlet fever and 7 cases of whooping cough were notified. It is felt that the attention of parents should again be drawn to the need for immunisation against whooping cough. The immunising material used throughout the year against diphtheria, contained immunising material against whooping cough and tetanus. It is again pleasing to record that during the year no cases of poliomyelitis occurred in the Borough. This is the fifth year in succession in which we have been able to make this comment. Smoke control areas under the Clean Air Act continue to be introduced at approximately the rate of one new area per annum. During 1963 the third area, bounded by Woodcote Road, Sandy Lane South and Stafford Road, was brought into operation on the 1st October. The department was again fully deployed on the care of the aged and chronic sick. Many lonely, sick and old persons were given home help service, district nursing and meals on wheels, to ease the burden of their lives and postpone the day when admission to hospital or old people's homes should become necessary. 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. In conclusion, it will be the earnest endeavour of all of us to ensure that the excellent services, which have been built up in Beddington and Wallington over the years, and for which the general public have shown so much appreciation, will be continued under the new administration, which comes into operation after the 31st March, 1965. 8 I would also like 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, 1964. 9 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 1963 32,560 Number of inhabited houses, 1931 7,092 Number of inhabited houses, 1963 10,417 Rateable Value £2,253,441 Sum represented by penny rate £9,400 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. By the London Government Act of 1963, under which there are established new administrative areas to be known as London Boroughs, Beddington and Wallington will cease as and from the 1st April, 1965, to be a separate unit of local government administration. From that date it will be joined up with the former Urban District of Carshalton and the Municipal Borough of Sutton and Cheam. to form the new London Borough of Sutton. During the 27 years of existence, the Borough has shown very considerable development. The mainly residential character has been maintained and expanded, mostly in the southern part. The centre of the town in recent years, however, has shown a newer type of residential development with the introduction of blocks of flats. Reorganised shop centres are under construction and there has also been an expansion of office accommodation. While the town can be described as in part a London dormitory, there is much more employment available locally. Factories in the Borough provide employment for some 10,000 people, these being situated mostly in the northern part of the Borough. New development is contemplated on the site of the former Croydon Aerodrome. A very comprehensive plan has been approved and it is hoped in a few years to see a completely developed new area comprising houses, schools, shops and offices. This site has an area of 407 acres, and it is proposed to house 5,230 persons, the total number of houses being 1,848. Parks and open spaces continue to toe 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 estimable 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. 10 EXTRACTS FROM VITAL STATISTICS Resident Population—Estimated mid-year 1963 32,560 Live Births Males Females Total Legitimate 242 201 443 Illegitimate 12 7 19 Total 254 208 462 Live Birth Rate per 1,000 population 14.19 Adjusted Birth Rate 15.47 England and Wales Live Birth Rate 18.20 Illegitimate Live Births per cent of total Live Births 4.11 Still Births Legitimate 2 2 4 Illegitimate — — — Total 2 2 4 Rate per 1,000 total Live and Stillbirths 8.56 England and Wales Stillbirth Rate 17.20 Live and Stillbirths Legitimate 244 203 447 Illegitimate 12 7 19 Total 256 210 466 Deaths 176 184 360 (i) Death Rate per 1,000 population 11.06 Adjusted Death Rate 10.51 England and Wales Death Rate 12.20 (ii) Infant Deaths—under 1 year of age Total No. of Deaths 8 Infant Mortality Rate per 1,000 Live Births 17.32 Infant Mortality Rate per 1,000 Live Births: Legitimate 18.06 Illegitimate Nil Infant Mortality Rate for England and Wales 21.10 Neo Natal Mortality Rate per 1,000 Live Births 12.99 (Under 4 weeks of age) Early Neo-natal Mortality Rate per 1,000 Live Births 12.99 (Deaths under 1 week) Peri-natal Mortality Rate per 1,000 Live and Stillbirths 21.24 (Stillbirths and deaths under 1 week) (iii) Maternal Deaths (including abortion) total Nil Maternal Mortality Rate per 1,000 Live and Stillbirths Nil England and Wales Maternal Mortality Rate 0.28 11 REGISTERED CAUSES OF DEATH The following table, supplied by the Registrar-General, gives th causes of death of residents in the Borough during 1963: Causes of Death Males Females Total All Causes 176 184 360 1 Tuberculosis, respiratory — — — 2. Tuberculosis, other — — — 3. Syphilitic disease — 1 1 4. Diphtheria — — — 5. Whooping Cough — — — 6. Meningococcal infections — — — 7 Acute poliomyelitis — — — 8 Measles — — — 9. Other infective and parasitic diseases 2 1 3 10 Malignant neoplasm, stomach 2 4 6 11. Malignant neoplasm, lung, bronchus 17 1 18 12. Malignant neoplasm, breast — 2 2 13. Malignant neoplasm, uterus — 5 5 14. Other malignant and lymphatic neoplasms 24 21 45 15. Leukaemia, aleukaemia 4 — 4 16. Diabetes 1 4 5 17. Vascular lesions of nervous system 15 22 37 18. Coronary disease, angina 45 33 78 19. Hypertension with heart disease 2 4 6 20. Other heart diseases 8 37 45 21. Other circulatory diseases 12 10 22 22. Influenza — — — 23 Pneumonia 8 13 21 24. Bronchitis 9 5 14 25. Other diseases of respiratory system 2 1 3 26. Ulcer of stomach and duodenum 2 1 3 27. Gastritis, enteritis and diarrhoea 1 2 3 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 9 11 20 33. Motor vehicle accidents 2 — 2 34. All other accidents 3 2 5 35. Suicide 4 2 6 36. Homicide and operations of war - - - 12 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 129 35.83 Other Diseases of the Circulatory System 22 6.11 Vascular Lesions of Nervous System 37 10.28 Cancer 76 21.11 Bronchitis 14 3.89 Pneumonia 21 5.83 Cancer of the Lung and Bronchus Males Females Total Number of deaths in 1963 17 1 18 Rate per 1,000 population 0.55 England and Wales Rate 0.52 VIOLENCE AND ACCIDENT Details of all deaths under this heading are as follows: Cause of Death Male Female  Homicide - - - Suicide 4 2 6 Other Violent Causes 5 2 7 Totals 9 4 13 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 0.28. INFANTILE MORTALITY The infantile mortality rate for 1963 was 17.32 per 1,000 live births. The comparable rate for England and Wales is 21.10. Great credit is due to the services operated in the Borough for the care of mothers and young children. Of the total of 462 live births, only 8 deaths of infants under one year of age (6 males and 2 females) were registered. 13 The following table gives the age and cause of death of each infant who died: Age Sex Cause of Death 10 minutes F Hydrops foetalis: rhesus incompatibility. 1 hour F Prematurity: intra-partum haemorrhage. 2 hours M Tentorial tears: spontaneous precipitate labour: prematurity. 9 hours M Prematurity. 16 hours M Respiratory failure: multiple congenital abnormalities. 2 days M Cerebral haemorrhage: precipitate labour: prematurity 6 weeks M Congenital hydrocephalus: lumbosacral meningomyelocele. 9 months M Purulent bronchitis: pulmonary collapse: cerebral leucodystrophy. 14 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 788 cases, including 129 maternity and midwifery patients. A total of 21,706 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 46 Chronic Sick (including aged and infirm) 216 Acute Sick 64 Tuberculosis 1 327 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 15 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 9/- for each treatment undertaken in the surgery and 15/- 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. A total of 627 treatments were given (326 at surgery and 301 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 1963. 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, 128 women made 408 pre-natal attendances. This represents an attendance of 24.0 per cent of the total number of confinements which occurred during 1963. Post-natal examinations were also conducted at this clinic, 9 patients making 9 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 fifty-seven or 76.6 per cent. of births allocated to this district, took place in hospitals and nursing homes, compared with 72.0 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. 16 Treatment Centres and Clinics Child Welfare Centres Woodcote Road Centre Red Cross House, Woodcote Road. When held Every Monday, 2.0—4.0 p.m. 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 Post-natal Clinic, Relaxation and Mothercraft Classes. Every Thursday, 2.0-4.0 p.m. " " " By appointment 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 children attending at the five clinics during the year was as follows:— Children born in 1963 410 Children born in 1962 383 Children born in 1958-61 584 Total 1377 17 Health Visiting. Four health visitors are employed by the Surrey County Council for the supervision of infants up to 5 years of age and expectant and nursing mothers, both at home and at the infant welfare and ante-natal clinics. These health visitors are also responsible for the supervision of children attending schools in the Borough. During the year the following cases were visited: Children born in 1963 456 Children born in 1962 452 Children born in 1958-61 1362 Total 2270 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 1963. Equipment is kept at the District Nurses' Home, the headquarters of the local Midwives, where t is ready for immediate use when required. Thirty-one premature live births were notified during the year, 29 of which occurred in hospital. Four infants died within 24 hours and 1 within 7 days of birth. The remaining 26 children survived. 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. 18 Treatment. Minor Ailments. Thirty 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 8 Ear, Nose and Throat 7 Orthopaedic Defects 5 Hernia 3 Circumcision 3 Dental. The year's work at the Dental Clinic, which providec 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 - 20 3 - 1 Children, 0-5 38 51 120 - - - Totals 43 51 140 3 - 1 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. Orthopædic. 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 248 148 - Children, 5-15 years 358 1,489 - Expectant and Nursing Mothers - - 596 Total 606 1,637 596 19 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 of immunisation to the Divisional Medical Officer, for which they receive a fee. Smallpox Vaccination. During 1963, 72 persons including 60 children under 5 years of age, were vaccinated and 19 persons were re-vaccinated at the weekly clinic held at the Town Hall, or by their general practitioner. Diphtheria Immunisation. Seven clinics are held weekly to give immunisation against diphtheria. These are held at each of the six 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., 1963 2,230 4,200 6,430 Number of children known to be immunised at 31st Dec., 1963 1,785 4,045 5,830 Percentage of children immunised 80.0 96.3 90.7 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, 522 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 1963, 509 children completed a primary course and 175 children received a reinforcing dose. 20 Poliomyelitis. The Poliomyelitis vaccination scheme, introduced in 1956, continued, within the prescribed age groups, during 1963. The oral vaccine, introduced in 1962, was given in very large quantity throughout the year and this has now almost displaced the SALK vaccine which was injected. The following figures show this very clearly. Salk Vaccine No. of children born 1943-63 who have received two injections of Salk Vaccine 7648 No. of persons born 1920-43 who have received two injections of Salk Vaccine 3977 No. of persons who received a 3rd injection of Salk after two former injections 10811 No. of children between the ages of 5-12 years who received a 4th dose of Salk Vaccine after a former 3 injections. 2399 Oral Vaccine No. of children born 1943-63 who received a primary course of three doses of Oral Vaccine 715 No. of persons born 1922-42 who received a primary course of three doses of Oral Vaccine 117 No. of persons who received 3rd dose of Oral Vaccine after two injections of Salk 445 No. of children who received 4th dose of Oral Vaccine after three injections of Salk 1001 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 Alexandra Gardens, Carshalton. The services provided at these clinics were general medical inspection and treatment, dental treatment, speech therapy and physiotherapy. Cleansing of Persons During 1963 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 1963, 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. 21 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. 22 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 1963 43 Number of families rehoused by the Council or by private owners at the Council's instigation since the beginning of the war 1317 Number of live applications on the housing list for accomodation in Beddington and Wallington:— On the general waiting list 297 On the aged persons' list 256 New houses erected, etc. Number of new houses and flats erected in 1963:— Private enterprise 55 Local Authority Nil Number of flats made available by conversion in 1963:— Private enterprise 8 Local Authority 13 Number of houses and flats purchased in 1963 and let 10 Housing Act, 1957 One hundred and four 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 159 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 4 Number of families dwelling therein 5 Number of persons dwelling therein 33 Number of new cases of overcrowding reported Nil Number of cases of overcrowding relieved Nil Number of persons concerned Nil 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. 23 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 44 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 The arrangements for sewerage and sewage disposal continue to be adequate for immediate needs, but the future impact of Croydon Airport development became urgent during the year, and equipment for gauging the existing flows in sewers was purchased, and a start made on investigation of flows and sewer capacities; the investigation is proceeding and proposals for diversion of certain sewers is under consideration. No major difficulties have arisen in the maintenance and cleansing of soil and storm water drainage systems during the year. RIVERS AND STREAMS The River Wandle Improvement Scheme undertaken by the Surrey County Council as far as it affects this district commenced during the year, comprising automatic control gates, the rebuilding of the bridge at Culvers Avenue connecting the Borough section with Carshalton, rebuilding of river banks at selected points, and regrading the river bed. Works proceeding for the installation of an automatic gate at the outlet to Grange Park Lake necessitated the emptying of the lake, and as part of the main scheme Surrey County Council demudded an area around the island's upstream of the lake and the Council took the opportunity of demudding the lake itself, work commencing towards the close of the year. CLOSET ACCOMMODATION Practically the whole of the area is on the water carriage system, draining into public sewers. There are a few chemical and earth closets, chiefly for use on sports grounds within the district, whilst four cesspools were in use in the district at the end of the year. PUBLIC CLEANSING The continued use of a Bedford Lacre suction sweeper has been supplemented by Munivacs footpath suction sweepers which have not proved altogether successful, and have had to toe supplemented by hand sweeping. Refuse collection using paper bags instead of dustbins continues to be extended to the ultimate goal of general use throughout the district. 24 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, 1963 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 handled Nil Number of inspections of premises 5 Number of licences issued under Milk (Special Designation) Regulations: Tuberculin Tested Milk—Dealers' (Pre-packed) 1 Pasteurised Milk—Dealers' (Pre-packed) 2 Sterilized Milk—Dealers' (Pre-packed) 1 — 4 Number of licences outstanding under Milk (Special Designation) Regulation: Tuberculin Tested Milk—Dealers' (Pre-packed) 9 Pasteurised Milk—Dealers' (Pre-packed) 9 Sterilized Milk—Dealers'(Pre-packed) 12 — 30 BACTERIOLOGICAL EXAMINATION OF MILK Forty-three 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 30 30 - 30 — — — T.T. Pasteurized 7 7 - 7 — — — Sterilized 4 — — — — 4 — Tuberculin Tested (Farm Bottled) 2 1 1 — — — — One sample of Tuberculin Tested milk was submitted for biological examination - Tubercle bacilli were not isolated. 25 CHEMICAL ANALYSES OF MILK Thirteen samples of milk were submitted to the Public Analyst. One sample failed to satisfy the tests applied to it. ICE CREAM Number of premises registered for the sale of ice cream 101 Number of manufacturers Nil Number of inspections of premises 17 Thirteen 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 13 12 — 1 — CHEMICAL ANALYSES OF ICE CREAM One sample of ice cream was submitted for analysis. It complied with the standard. SLAUGHTERHOUSES Number of licensed slaughterhouses Nil FOOD PREMISES IN THE DISTRICT Bakehouses 6 Bakers 10 Butchers 23 Catering Establishments 75 Chemists 8 Confectioners (sweets) 43 Fishmongers (including friers) 10 Greengrocers 26 Grocers 54 Licensed Premises 11 Food Factories 3 26 FOOD PREMISES REGISTERED UNDER SECTION 16 OF THE FOOD & DRUGS ACT, 1955 Sausage manufacturers 25 Fish friers 6 Ice cream (sale only) 101 Food Hygiene (General) Regulations, 1960 Inspections of food premises continued during 1963. The type of premises visited and number of inspections are set out below: Bakehouses 10 Bakers 15 Butchers 13 Catering Premises. . 10 Confectioners (sugar) 14 Fishmongers 8 Greengrocers 23 Grocers 73 Milk Shops 5 Registered Premises 27 Other Food Premises 29 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. Cereals 14 Fish, 190 Flour 34 Flour Confectionery 49 Fruit 8 Fruit, canned 22 Meat and Offal 153 Meat, canned 131 Sugar 6 Vegetables, canned 2 Vegetables, frozen 155 Total 764 COMPLAINTS OF UNSOUND OR ADULTERATED FOOD Forty-seven complaints were received and investigated. In appropriate cases, the circumstances were reported to the Health Committee. 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.1, is Public Analyst for the Borough. 27 FOOD ANALYSES The following table gives details of samples submitted for analysis during the year: Totals 1963 Articles No. Examined Adulterated Prosecu tions Convic tions Formal. Informal Total Formal Informal Total Ale 1 - 1 - - - - - Almonds — 1 1 - - - - - Baby food, canned — 1 1 - - - - - Bread — 1 1 — 1 1 — — Bread roll — 1 1 — 1 1 — — Bread and butter — 1 1 — 1 1 — — Butter 1 3 4 — - — — — Coconut, desiccated — 1 1 — — — — — Coffee 1 2 3 - - - - - Colouring matter — 1 1 - - - - - Confectionery, chocolate 1 3 4 — 1 1 — — Confectionery: flour — 1 1 — 1 1 — — Confectionery: Sugar 1 2 3 - - - - - Cream — 3 3 - - - - - Drink, soft 2 2 4 - - - - - Fish paste — 2 2 - - - - - Flavouring almond — 1 1 - - - - - Fruit, — 2 2 - - - - - Fruit, canned — 2 2 - - - - - Fruit, dried — 2 2 - - - - - Fruit, juice — 2 2 - - - - - Fruit juice, canned — 2 2 - - - - - Gin 1 — 1 — — — — — Ice cream — 1 1 - - - - - Jelly tablet — 1 1 - - - - - Margarine — 1 1 - - - - - Meat (steak) — 1 1 - - - - - Meat products 3 - 5 - - - - - Meat products, canned 1 1 2 - - - - - Medicine (glycerine, lemon and honey) - 1 1 - - - - - Milk 10 3 13 1 — 1 — — Milk, evaporated — 1 1 — — — — — Nutmegs, ground — 1 1 - - - - - Oil, cooking — 2 - - - - - Pepper — 1 1 - - - - - Pickle (mixed sweet) — 1 1 - - - - - Proprietary food ('Froment') — 1 1 - - - - - Pudding, Christmas — 1 1 - - - - - Salad cream — 1 1 - - - - - Sauce (tomato) — 1 1 — — — — — Sausages 4 1 5 1 — 1 — — Stuffing Mixture — 1 1 - - - - - Tea — 1 1 - - - - - Vegetables, canned — 7 7 - 1 1 - - Vinegar 2 — 2 - - - - - Whisky 1 — 1 - - - - - Total 29 67 96 2 6 8 - - 28 UNSATISFACTORY SAMPLES Formal Sample No. 22—Pork Sausages The sample contained fat, 37%, fat-free meat, 34%, total meat content, 71%. In the opinion of the Public Analyst the proportion of fat in sausages should not exceed 50% of the total meat content. The attention of the manufacturer was directed to this matter. Formal Sample No. 29—Channel Islands Milk The sample contained fat, 3.96%, solids-not-fat, 8.92%, which corresponds to a deficiency of 1% of the milk-fat, since Channel Islands Milk should contain at least 4% of milk-fat. A further sample was obtained which proved satisfactory. The matter was drawn to the attention of the Dairy Company concerned. OTHER SPECIMENS 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—Small Bread Roll The roll contained a small fragment of glass, measuring 3 x 1 mm., which had been baked in the bread. A warning letter was sent to the manufacturer. Serial No. S.2—Bread and Butter The specimen consisted of a slice of bread and butter containing a small dead brown beetle which was partly embedded in the butter. The Public Analyst reported that there was no evidence that the beetle had been baked in the loaf. No further action was taken. Serial No. S.4—Canned Peas The specimen included a foreign black elongated body, 1½ inches long and ¼ inch diameter, which was composed of dirty disintegrated vegetable matter. A warning letter was sent to the Canning Company concerned. Serial No. S.5—Crackermilk Chocolate The chocolate contained a considerable number of microscopic specks of gold leaf, mainly on the bottom of the block, probably derived from the gold lettering used on the wrapping. The Public Analyst has observed that metallic gold is not regarded as a toxic substance, but cases of hypersensitivity to compounds of gold have been reported. The manufacturing company's attention was drawn to this matter. Serial No. S.9—Bread The bread contained in the middle of two of the slices greyish streaks caused by the introduction of a small quantity of iron dust. A letter was sent to the manufacturer. Serial No. S.11—Fruit Bun The specimen consisted of a spiced fruit bun cut in half and contained embedded in it a crumpled piece of brown paper (4¼ x 4 inches). A warning letter was sent to the manufacturer. 29 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 inspection; 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 2 1 - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 150 65 1 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 22 8 - - Total 174 74 1 — 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 8 - - - - - Wearing apparel: Making, etc. 2 - - - - - Total 10 - - - - - 30 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 ToH.M. Inspector BY H.M. Inspector (1) (2) (3) (4) (5) (6) Want of cleanliness (S.l) 2 2 - - - Overcrowding (S.2) — — - - - Unreasonable temperature (S.3) - - - - - Inadequate ventilation (S.4) - - - - - Ineffective drainage of floors (S.6) - - - - - Sanitary conveniences (S.7): (a) Insufficient 1 1 — — - (.b) Unsuitable or defective - - - - - (c) Not separate for sexes - - - - - Other offences against the Act (not including offences relating to Outwork) - - - - - Total 3 3 — — — WORKPLACES, SHOPS AND OFFICES Number of inspections 334 Notices served 1 31 INFECTIOUS DISEASE AND DISINFECTION Number of visits re cases of infectious disease 112 Number of rooms disinfected 10 Number of library books disinfected 504 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 during the year and now forms a major part of the work of the Public Health Inspectors' Section. During the year more than two thousand visits were made to houses, which have been, or it is proposed will be, included in such areas. Four 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 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 came into force on the 1st October, 1963. (4) That part of the Borough bounded by Woodcote Road, Heathdene Road, Boundary Road, the Sutton to West Croydon railway, Demesne Road and Stafford Road. The order relating to this area will come into force on 1st October, 1964. During the year houses and other premises in a fifth area were visited with a view to their inclusion in a fifth smoke control order. The area is that bounded by Demesne Road, the Sutton to West Croydon railway, the Borough Boundary with the County Borough of Croydon and Stafford Road. INDUSTRIAL PREMISES During the year 115 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. 32 PREVENTION OF DAMAGE BY PESTS ACT, 1949 Report for 12 months ending 31st December, 1963 Type of Property Local Authority Dwelling Houses Business (& other premises) Total Agricultural Number of Properties in Local Authority's district 46 10,344 1,538 11,928 32 Number of Properties inspected as a result of: (a) Notification - 110 35 145 - (b) Survey under the Act 46 228 64 338 32 (c) Primarily for some other purpose 200 267 467 — Properties found to shew major rat infestations - — — — — Properties found to shew minor rat infestations 12 66 22 100 — Properties found to shew major mice infestations — — — — — Properties found to shew minor mice infestations 1 27 11 39 — Total Infestations 13 93 33 139 — SEWER RAT CONTROL The change in baiting procedure started in November 1962, was continued with treatments in April, September and December. Results will be assessed after test baits have been examined during the forthcoming year. 33 PETROLEUM (REGULATION) ACTS 68 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 121,085 gallons (46 licences) Petroleum Mixture 11,130 gallons (22 licences) SHOPS ACT, 1950 The total number of inspections during the year was 331. Healing, 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. 50 visits were made during the year, and action was initiated resulting in the removal of 14 vans. NOISE ABATEMENT ACT, 1960 Twenty-one complaints of noise were received and investigated during the year. The complaints related to eight sources of noise 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. 34 SUMMARY COMPLAINTS The total number of complaints received was 783. They were due to the following causes: Rats and Mice 153 Housing defects 79 Choked drains and sewers 259 Defective drainage (including closets) . 20 Unsound or adulterated food 47 Atmospheric Pollution 57 Insect pests 64 Offensive accumulations 21 Noise 21 Miscellaneous 62 783 NOTICES SERVED Number of informal notices served (including verbal intimations) 514 Number of statutory notices served Public Health Act, 1936—Section 39 (Drainage) 10 Section 45 (Defective closets) 1 Section 93 (Nuisances) 6 Clean Air Act, 1956—Section 12 13 — 30 SANITARY IMPROVEMENTS (1) Dwelling Houses Brickwork repaired or repointed . 1 Ceilings— Repaired, renewed or cleansed 7 Chimneys— Stacks and flues repaired 3 Dampness remedied— (a) Roofs repaired 13 (b) Damp-proofing works 7 (c) Gutters and rainwater pipes repaired and unstopped 14 Doors—repaired or renewed 1 Drainage— (a) Obstructions cleared 154 (b) Repaired and relaid 16 (c) Inspection chambers provided and repaired 21 (d) F.A.I. provided, etc. 5 (e) Waste-pipes repaired and renewed 7 (f) Rainwater drainage provided, repaired or renewed 10 Fireplaces and stoves repaired or renewed 8 Floors— Repaired or renewed 5 Walls- fa) Repaired or rebuilt 12 (b) Plaster repaired and redecorated 3 35 W.C. Accommodation— (a) Flush pipe joint repaired 4 (b) Pans provided or replaced 5 Windows— (a) Frames and sashes repaired or renewed 8 (b) Sashcords and beading renewed 5 (c) Cills repaired 2 Other Sanitary improvements 20 (2) Factories Cleansed 2 Sanitary Accommodation— Provided 1 Artificial Lighting Provided 2 (3) Food Premises Fittings-equipment (Improved) 1 Protection for food stuff provided 3 Displays Improved 2 Drainage Improved and Repaired 3 Sanitary accommodation improved 3 Water Supplies Improved 1 Ablution facilities provided or improved 3 First Aid Equipment Provided 2 Sinks and hot water provided 2 Premises Repaired 4 Cleaned and redecorated 6 Lighting and Ventilation Improved 1 Accumulations removed 2 Dustbins Provided 3 Personal Cleanliness Improved 1 Flooring Improved 5 Other Unsatisfactory Conditions Remedied 2 (4) Shops Sanitary Accomodation Provided 2 Washing Accomodation Provided 2 Structural Defects Repaired 2 Seats Provided 1 Forms Exhibited 9 Artificial Lighting improved 1 36 SUMMARY OF VISITS ETC. DURING THE YEAR Number of inspections of dwelling-houses 159 Number of re-inspections of premises 313 Number of visits to work in progress 28 Number of miscellaneous visits and inspections 224 Number of visits to food premises 221 Number of visits to factories 38 Number of visits to shops, offices and workplaces 334 Number of visits to watercress beds, smallholdings, etc. 4 Number of inspections of public conveniences 28 Number of visits re infectious diseases 112 Number of visits re insect pests ' 50 Number of inspections re rats and mice 2067 Number of sewer manholes treated 614 Number of visits to streams 11 Number of visits re clean air 2562 Number of inspections of swimming bath 3 Number of visits re drainage 540 Number of drains tested 11 Number of drainage obstructions cleared 135 Number of rooms disinfected 10 Number of lots of bedding and clothing disinfected 1 Number of library books disinfected 504 Number of samples of foodstuffs, water, stools etc., taken for examination 290 Number of visits re food and other samples 205 Number of visits re noise 88 Number of complaints received and investigated 783 Number of informal notices served 514 Number of statutory notices served 30 Number of interviews re nuisances, etc. 315 H. G. CRIPPS, Chief Public Health Inspector. 37 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 1963 (3), 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. 38 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. 39 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. 40 PREVALENCE AND CONTROL OVER INFECTIOUS AND OTHER DISEASES The following table shows the incidence of infectious disease in the Borough in 1963, 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 8 Measles 472 4 - Whooping Cough 7 - - Pneumonia 5 1 21* Dysentery 3 1 - Paratyphoid Fever 1 1 - Totals 496 7 21* *Includes deaths from all forms of pneumonia. †Includes deaths of residents in homes and institutions outside the Borough. 41 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 1963 (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 8 - - 2 5 - - 1 - - 1 5 - 1 1 - - - - Measles 472 8 38 172 233 13 7 1 - - 45 80 59 72 97 51 68 4 - Whooping Cough.. 7 - - 4 - - - - - - 4 - - 1 2 - - - - Pneumonia 5 - - - - - 1 1 2 1 2 - - - 2 1 - 1 - Dysentery 3 - 1 - - - 2 - - - 1 - 1 1 - - - 1 - Paratyphoid Fever 1 - - - - - 1 - - - 1 - - - - - - 1 - Totals 496 8 39 178 241 13 11 3 2 1 54 85 60 75 102 52 68 7 - *Includes all forms 42 The Monthly Incidence of Infectious Disease, 1963 (excluding Tuberculosis) Disease Jan. Feb. Mar. April May June July Aug. Sept. Oct. Nov. Dec. Total Scarlet Fever - 1 - - 2 - 3 - - 1 1 - 8 Measles 17 108 160 126 4 31 12 5 1 4 1 3 472 Whooping Cough 1 - - - - - - - 2 3 - 1 7 Pneumonia - - 1 2 - - - - - - 2 - 5 Dysentery - - 1 - - - 1 - - - 1 - 3 Paratyphoid Fever - - - 1 - - - - - - - - 1 Totals 18 109 162 129 6 31 16 5 3 8 5 4 496 43 Tuberculosis There were 8 new cases notified during the year, this being the same number of cases notified in 1962. The following table gives the number of new cases notified during the past five years: New Cases 1959 1960 1961 1962 1963 M. F. M. F. M. F. M. F. M. F. Pulmonary 7 2 8 1 8 2 3 4 6 1 Non-Pulmonary 1 - - - - 1 - 1 1 - Totals 8 2 8 1 8 3 3 5 7 1 Annual case rate per 1,000 of the estimated population: 1959 1960 1961 1962 1963 Pulmonary 0.28 0.28 0.31 0.21 0.21 Non-pulmonary 0.03 0.00 0.03 0.03 0.03 The following table gives the number of deaths from this diseas during the past five years: Deaths 1959 1960 1961 1962 1963 M. F. M. F. M. F. M. F. M. F. Pulmonary 2 — 3 — 2 1 1 — — — Non-Pulmonary 1 - - - - - - - - - Totals 3 — 3 — 2 1 1 — — — During the year under review, there were no deaths in the district attributed to tuberculosis, either pulmonary or non-pulmonary. There was only one death registered in 1962, but this is the first year in the history of the Borough in which there have been no deaths. 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: 44 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 - - - - - - - 25—44 years 1 1 1 - - - - - 45—64 years 2 - - - - - - - 65 and over 2 - - - - - - - Totals 6 1 1 - - - - - The new cases were distributed amongst the Wards as follows: Beddineton Wallington North West Cent. South North Cent. South Pulmonary 1 2 - 1 3 - - Non-Pulmonary — 1 - - - - - Totals 1 3 - 1 3 — — The responsibility for the treatment of cases of Tuberculosis, previously undertaken by the Surrey County Council, passed to the Regional Hospital Board on the 5th July, 1948. Dispensary facilities continue to be available for residents of the Borough at the St. Helier Hospital, Carshalton and The Chest Clinic at The Cumberland Hospital, Mitcham. 45 BERTRAM JOHNSON LTD. 11, Manor Road, Wallington. BERTRAM JOHNSON LTD. 11, Manor Road, Wallington.