Library BEX 27 AC 4412 (1) BOROUGH OF BEXLEY Annual Report of the Medical Officer of Health and Report on the School Health Service For the Year 1962 JOHN LANDON, m.r.c.s., l.r.c.p., d.p.h., Medical Officer of Health BOROUGH OF BEXLEY Annual Report of the Medical Officer of Health For the Year 1962 JOHN LANDON. m.r.cs., l.r.c.p., d.p.h , Medical Officer of Health Borough of Bexley. Mayor: Alderman E. S. Newton, J.P. Deputy Mayor: Councillor J. C. Canton. HEALTH COMMITTEE Chairman : Alderman Mrs. H. F. Piggott. Vice-Chairman: Councillor S. H. Philpot. Alderman M. J. Corr. Councillor Mrs. M. P. Monk. Alderman Mrs. E. M. Sheppard. Councillor M. F. Townsend. Councillor Mrs. J. T. Barker. Councillor W. P. Webster. Councillor F. G. Donovan. 2 PUBLIC HEALTH STAFF 1962 Medical Officer of Health John Landon, M.R.C.S., L.R.C.P., D.P.H. (Joint appointment with Borough of Erith and U.D. Crayford). Chief Public Health Inspector, *† G. Hind, M.A.P.H.I. Public Cleansing Officer and Shops Acts Inspector. Deputy Chief Public Health *†J. T. Boocock. Inspector. District Public Health Inspectors *† W. E. Moses. *† D. T. Rees. *†K. E. Doubleday. Administrative Assistant G. A. Pearson. Senior Clerk E. M. Pearmine (Miss). Clerks A. Frostick (Miss) E. F. Terry (Miss) (Shorthand Typist). Public Analyst H. E. Monk, B.Sc., F.R.I.C. Refuse Foreman G. E. Packman. Public Health General Assistants A. C. Ward. W. Early. * Certificate for Inspection of Meat and other Foods. † Certificate of Royal Sanitary Institute and Sanitary Inspector? Joint Board. 3 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH To the Mayor, Aldermen and Councillors of the Borough of Bexley. Mr. Mayor, Ladies and Gentlemen, I have the honour to submit my Annual Report year 1962 which has been prepared on the lines set Circular 1/62 of the Ministry of Health. The Registrar General's estimate of the mid-year Population is 89,910 (89,670 in 1961). The vital statistics supplied annually by the General Register Office indicate that the general trend of the health of the Borough remained satisfactory. The standardised death rate, which allows of comparisons with other areas, was 11.6 per 1,000 of the home population (11-7 in 1961) compared with 11.9 for England and Wales. The standardised birth rate was 15.4 per 1.000 home population (15.1 in 1961) compared with a rate of 18.0 for the country as a whole. The number of infants who died during the first year of life. was 20 (18 in 1961) giving an infant mortality rate of 14.8 per 1,000 live births (13.7 in 1961) compared with 21-6 per 1,000 for England and Wales. 4 For the sixth successive year there was no maternal death associated with childbirth. Considering that during the past six years there were 7,847 births in the Borough it may be said that the antenatal and obstetric services in the area have worked to a high standard of efficiency. The stillbirth rate per 1,000 total (live and still) births rose, however, to 20.4 (compared to 14.9, 14.9, 15.2 and 19.9 in the previous four years). The number of illegitimate births rose again to 51 compared with 45, 34, 37, 23, 33, 34, 30, 35 and 34 in the previous nine years. Deaths from cancer of the lung numbered 53 (46 in 1961). For the thirteenth year in succession there was no case of diphtheria in the Borough and no case of poliomyelitis in the year under review. The years 1961 and 1962 will be remembered for the fact that on five separate occasions during this period smallpox was brought into this country by air travellers from Karachi resulting in 62 cases in England and Wales of which 24 proved fatal. Although there was no real threat to the Borough an indirect effect of these cases was an overwhelming public demand for vaccination. The occurrence of a single case of smallpox in Woolwich in January 1962 caused a local agitation for vaccination clinics to be opened in Be.xley but this was successfully resisted. Nevertheless many hundreds of people in the Borough received vaccination through their family doctors and many cases of vaccinia occurred some of which simulated smallpox and raised difficult problems of diagnosis. I should like to place on record the help which we received in this connection from Dr. J. V. Armstrong of the Brook Hospital one of our local smallpox consultants. 5 It is a matter of continual surprise that public anxiety on such occasions can be so great but that, during quiescent periods, there should be so much neglect of routine vaccination. There are good reasons why parents should ensure the primary vaccination of their children in infancy, not the least being the risk of severe reactions and the possibility, however small, of post-vaccinal encephalitis when primary vaccination against smallpox is carried out in adolescence or in later life. In March, 1962 the report of the Royal College of Physicians on Smoking and Health was published and confirmed very convincingly the association that exists between heavy cigarette smoking and cancer of the lung. Its initial impact on the public was considerable but there is now a real dang that the report, with all its implications, will be forgotten unless vigorous action is taken by the Government, local authorities and other responsible bodies to keep the issue alive as one of the outstanding public health problems of the day. At the time of writing a five-day visit to the area of a mobile unit of the Central Council for Health Education is being planned to act as a spearhead in a week's campaign concerned, mainly, with the problem of smoking by schoolchidren. We are approaching the end of an era in local government in the Greater London Area. With the London Government Act, 1963 on the Statute Book one is becoming increasingly pre-occupied with the future, of the Health and Welfare Services in the proposed London Borough 18. The orderly take-over of these services will need careful thought and preparation, particularly in regard to the basic administrative structure to be adopted. This should be the as to allow for the organic growth of these services in the years to come. 6 In conclusion, I wish to thank the Chairman and Members of the Health Committee for their support and encouragement, and the Chief Public Health Inspector, Administrative Assistant, and all members of the Health Department for the good work which has been done during the year. I am, Your obedient servant, JOHN LANDON, Medical Officer of Health. 7 SECTION A.—STATISTICS AND SOCIAL CONDITIONS OF THE BOROUGH Area. 4,869 acres. Population. Registrar General's Estimate midyear, 89,910 New Dwellings Erected. Houses 173 Relative figures for previous years. Population—Mid-Year New Houses Erected 1952 88,160 1952 355 1953 87,990 1953 265 1954 88,180 1954 503 1955 88,780 1955 529 1956 89,300 1956 423 1957 90,020 1957 384 1958 90,330 1958 313 1959 90,500 1959 287 1960 91,000 1960 367 1961 (Census) 89,670 1961 246 Number of inhabited houses at the end of 1962 (according to Rate Books) approximately 29,0076 Rateable Value £1,365,59 Sum represented by a penny rate £5,550 Unemployment. Men Women Boys Girls Total December 31st, 1961 161 60 5 14 240 December 3.1st, 1962 228 49 27 7 311 Social Conditions and Amenities. The Borough of Bexley continues to be a healthy residential district and is specially favoured in that it has ample open spaces and recreational facilities for. its inhabitants. Like other districts, however, whose population, has increased considerably, housing shortages, at present, constitute the main barrier to the health of a relatively large number of its citizens. The housing programme has been accelerated as much as possible and it can only be hoped that the housing position of the Borough will gradually reach the optimum standards for which the Council are striving. 8 The following public open spaces have been provided by the Corporation:— Bexley Woods, Parkhill Road, Bexley 27.00 acres Bigs Hill Wood, Watling Street, Bexleyheath 8.68 „ Brampton Park Recreation Ground, Avenue Road, Bexleyheath 1.66 „ Bursted Wood, Erith Road, Bexleyheath 30.10 „ Danson Park, Bexleyheath 185.9 Danson Mead, Welling 1.1042 „ Derwent Crescent, Bexleyheath .20 „ East Wickham Land, Glenmore Road/ Wickham Street, Welling 6.80 „ Eastcote Gardens, Eastcote Road, Welling 1.00 „ Hall Place, Bourne Road, Bexley 159.67 „ Hudson Road Playing Ground, Long Lane, Bexleyheath 953 „ Hurst Recreation Ground, Shirley Avenue, Bexley 3.50 „ King George's Field, Broadway, Bexleyheath Lodge Hill, Welling 1.235 „ 1.43 „ Oxleas Close, Welling .13 „ Palmar Gardens, Bexleyheath 1.30 „ Parkhurst Gardens, Bexley 70 „ Riverside Walk, Bexley 10.50 „ Russell Park, Woolwich Road, Bexleyheath 12.787 ,. Rutland Shaw, Bexley 4.85 ., St. Mary's Recreation Ground, Bexley 9.925 ,. Sheldon Sports Ground, Bexleyheath 4.3883 ,. Shoulder of Mutton Green, Welling 4.00 „ Sports Ground, Park View Road, Welling 7.03 ,. Steeple Avenue Memorial Garden, Bexleyheath 1.50 „ Stevens Park, Wrotham Road, Welling 9.36 „ The Green, Bexleyheath 1.44 „ The Green, Welling 1.64 „ The Grove, Bexleyheath 25 „ The Warren, Broomfield Road, Bexleyheath 12.47 „ Westwood Estate Children's Playground, 60 „ Welling - Total 512.1025 „ Facilities for outdoor games are provided in many of these open spaces, including the large Swimming Pool in Danson Park, opened in July, 1936. 9 GRAPH SHOWING RISE IN POPULATION SINCE 1931 SUMMARY OF VITAL STATISTICS England and Wales. Borough of Bexley. Hates per 1,000 Home Population. Births- Live 18.0 14.97 Still 0.33 0.31 18.1(a) 20.4(a) Deaths All Causes 11.0 9.5 Typhoid and Paratyphoid 0.00 — Whooping Cough 0.00 — B Diphtheria 0.00 — Tuberculosis 0.07 0.09 Influenza 0.07 0.03 Smallpox 0.00 — Acute Poliomyelitis (including Polioencephalitis) 0.00 Pneumonia 0.68 0.63 Notifications (corrected) Typhoid Fever 0.00 — Paratyphoid Fever 0.00 — Meningococcal Infection 0.01 0.03 Scarlet Fever 0.33 0.26 Whooping Cough 0.18 0.01 Diphtheria 0.00 — Erysipelas 0.04 0.08 Smallpox 0.00 Measles 3.96 1.10 Pneumonia 0.27 0.11 Acute Poliomyelitis (Including Polioencephalitis) Paralytic 0.00 - Non-Paralytio 0.00 — Food Poisoning 0.11 0.02 Puerperal Pyrexia 8.33(a) 8.01(a) Rates per 1,000 Live Births. Deaths All causes under one year of age 21.6 14.86 Enteritis and Diarrhoea under two years of age 0.6 — (a) Per 1,000 Total (Live and Still) Births. A dash (—) signifies that there were no deaths or notifications. 11 Maternal Mortality England and Wales Borough og Bexley Rates per 1,000 still total live and births Maternal causes, excluding abortion 0.28 Nil Due to abortion 0.07 Nil Total maternal mortality 0.35 Nil EXTRACTS FROM VITAL STATISTICS FOR THE Year 1962 The Registrar General's Estimate of home population for the mid-year is 89,910 and this figure is assigned purpose of calculation of all rates. Births. Males Females Total Live Births—Total 685 661 1,346 Legitimate 658 637 1,295 Illegitimate 27 24 51 Birth Rate. Rate per 1,000 estimated home population 14.97 The following relates to the Birth Rate during the Past ten years: — 1952 Birth Rate 12.00 per thousand 1953 „ „ 12.70 „ „ 1954 „ „ 11.80 „ „ 1955 „ „ 12.60 „ „ 1956 „ „ 13.2 „ „ 1957 „ „ 13.6 „ „ 1958 „ „ 13.6 „ „ 1959 „ „ 14.4 „ „ 1960 „ „ 14.5 „ „ 1961 „ „ 14.7 „ „ 18-0 Rale per 1,000 for England and Wales 12 The The Registrar-General has supplied a comparability factor for 1962. The standardised birth rate which allows for mparison with other parts of the country is 15.4. 51 illegitimate live births were registered against 45 in 1961 giving a percentage of 3.8 of total live births. Stillbirths Males Females Total Total 19 9 28 Rate per 1,000 total (live and still) births 20.4 28 Stillbirths were registered during the year. This presents a rate of 0.31 per 1,000 population against 0.2 per1,000 population in 1961. The following relates to the Stillbirth Rate during the Past ten years Rate per Thousand Year Total Live and Still Births Population 1952 12.18 0.18 1953 12.94 0.28 1954 13.26 0.16 I955 16.7 0.21 '956 20.8 0.28 1957 19.2 0.37 1958 19.9 0.28 1959 15.2 0.22 1960 14.9 0.22 1961 14.9 0.2 Rate per 1,000 for England and Wales 1962 0.33 T here were two Stillbirths registered as illegitimate. Males Females Total There Live and Stillbirths 704 670 1,374 13 The following relates to the Infant Mortality Rate dur ing the past ten years:— 1952 11.34 per 1.000 live births. 1953 14.36 „ „ „ „ 1954 22.1 „ „ „ „ 1955 17.0 „ „ „ „ 1956 24.6 „ „ „ „ 1957 22.9 „ „ „ „ 1958 13.0 „ „ „ „ 1959 13.1 „ „ „ „ 1960 12.9 „„ „ „ 1961 13.7 „ „ „ „ 14 Infant Deaths. Males Females Total Deaths of Infants under one year of age 11 9 20 Legitimate 11 9 20 Illegitimate — — — Death rate of Infants under one year of age: Total per 1,000 live births 14.86 Legitimate per 1,000 legitimate live births 15.4 Illegitimate per 1,000 illegitimate live births Neo-natal Deaths per 1,000 live births 9.66 Early Neo-natal Deaths 8.92 Perinatal Deaths 29.11 15 INFANT MORTALITY, 1962 DEATHS FROM STATED CAUSES AT VARIOUS AGES UNDER 1 YEAR OF AGE. These relate to deaths occurring in 1962 but not necessarily registered in that year. Causes of Death as Certified. Days Mouths 0- 1- 2_ 3- 4- 5- 6- 7- 14- 21- 28- 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- 12 Congenital Heart Disease 2 1 Prematurity 2 1 1 1 1 Atelectasis 2 2 Pneumonia 1 1 1 Acute Capillary Bronchitis 1 Hyaline Pulmonary Hembrain 1 Hemolytic Disease of New Born 1 1 Totals 5 3 2 2 — — — — 1 — — 4 1 1 1 The number of infants under one year of age who died during the year 1962 as shown by the table is 20. 13 of these deaths, that is 65 per cent, occurred in the neonatal period (within one month of birth). In 1961 the corresponding figure was 65 per cent. Maternal Deaths. There were no maternal deaths during the year. Number of women dying in, or in consequence of childbirth : From Puerperal and Post Abortive Sepsis Nil. From other Puerperal causes Nil. Death rate per 1,000 total (live and still) births Nil. Rates over previous years have been:— 1952 0.93 per 1,000 live and stillbirths 1953 2.63 „ „ „ „ ,, 1954 Nil „ „ „ „ ,, 1955 0.88 „ „ „ „ ,, 1956 Nil „ „ „ „ ,, 1957 Nil „ „ „ „ ,, 1958 Nil „ „ „ „ ,, 1959 Nil „ „ „ „ ,, 1960 Nil „ „ „ „ ,, 1961 Nil „ „ „ „ ,, Deaths All Causes. Males Females Total All causes 468 383 851 Death rate per 1,000 of estimated home population 9.5 Deaths from Measles (all ages) — — - ,, ,, Whooping Cough (all ages) __ _ - „ „ Diarrhoea (under 2 years of age 1 Cancer (all ages) 105 83 188 Death rate per 1,000 for England and Wales, 1962 11.9 16 Death Rate of Area during last ten years: — 1952 9.14 per thousand 1953 8.8 „ „ 1954 8.1 „ „ 1955 9.1 „ „ 1956 9.4 „ „ 1957 9.2 „ „ 1958 9.48 „ 1959 8.76 „ 1960 8.7 .. 1961 9.6 „ The rate for Bexley compares favourably with that for England and Wales. The Registrar-General has supplied a comparability factor for 1962. The standardised death rate which allows for comparison with other parts of the country is 11.6. 17 CAUSES OF DEATH IN THE BOROUGH REGISTERED DURING THE YEAR 1962 Causes of Death. M. F. Total All Causes 468 383 2 851 1 Tuberculosis, respiratory 5 1 7 2 Tuberculosis, other — - 1 3 Syphilitic disease 2 - 2 4 Diphtheria — - - 5 Whooping Cough — - - 6 Meningococcal infections 1 - 1 7 Acute poliomyelitis — - - 8 Measles — 1 - 9 Other infective and parasitic diseases 9 1 10 Malignant neoplasm, stomach 20 6 29 11 Malignant neoplasm, lung, bronchus 47 16 53 12 Malignant neoplasm, breast 1 16 17 13 Malignant neoplasm, uterus — I 1 11 14 Other malignant and lymphatic neoplasms 37 41 78 15 Leukaemia, aleukaemia 2 1 3 16 Diabetes 2 1 3 17 Vascular lesions of nervous system 36 51 87 18 Coronary disease, angina 137 68 205 19 Hypertension with heart disease 7 16 23 20 Other heart disease 27 33 60 21 Other circulatory disease 19 14 33 22 Influenza 2 1 3 23 Pneumonia 26 31 57 24 Bronchitis 31 14 45 25 Other diseases of the respiratory system 3 1 4 26 Ulcer of stomach and duodenum 8 2 10 27 Gastritis, enteritis and diarrhoea 4 - 4 28 Nephritis and nephrosis 2 1 4 6 29 Hyperplasia of prostate - 1 30 Pregnancy, childbirth, abortion — - - 31 Congenital malformations 3 3 6 32 Other defined and ill-defined diseases 32 30 62 33 Motor vehicle accidents 6 2 8 34 All other accidents 5 13 18 35 Suicide 2 1 3 36 Homicide and operations of war — — - 19 DEATHS REGISTERED (IN AGE GROUPS) IN 1962 Under 1 year 1-4 years 5-14 years 15-24 years 25-44 years 45-64 years 65-74 years 75 years and over Total M F M F M F M F M F M F M F M F M F 1. Tuberculosis, respiratory ... ... ... ... ... ... ... ... ... 1 3 1 2 ... ... ... 5 2 2. Tuberculosis, other ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 3. Syphilitic disease ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 2 ... 4. Diphtheria ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5. Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6. Meningococcal infections ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 7. Acute poliomyelitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 8. Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 9. Other infective and parasitic diseases ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 10. Malignant neoplasm, stomach ... ... ... ... ... ... ... ... ... ... 12 2 4 4 4 3 20 9 11. Malignant neoplasm, lung, bronchus ... ... ... ... ... ... ... ... 1 ... 23 6 21 ... 2 ... 47 6 12. Malignant neoplasm, breast ... ... ... ... ... ... ... ... ... 1 ... 10 ... 1 1 4 1 16 13. Malignant neoplasm, uterus ... ... ... ... 2 ... ... ... 2 ... 0 ... ... ... ... 11 14. Other malignant and lymphatic neoplasms ... ... ... ... 1 ... ... ... 2 7 11 9 6 10 16 13 37 41 15. Leukaemia, aleukaemia ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... 1 ... 2 1 16. Diabetes ... ... ... ... ... ... ... ... ... ... 2 1 ... ... ... ... 2 1 17. Vascular lesions of nervous system ... ... ... ... ... ... ... ... 1 8 5 12 11 15 34 36 51 18. Coronary disease, angina ... ... ... ... ... ... ... ... 4 ... 58 8 47 25 28 35 137 68 19. Hypertension with heart disease ... ... ... ... ... ... ... ... ... ... 2 2 2 7 3 7 7 16 20. Other heart disease ... ... ... ... ... ... ... ... ... 1 5 7 8 9 13 26 27 43 21. Other circulatory disease ... ... ... ... ... ... ... ... 2 ... 3 1 4 3 10 10 19 14 22. Influenza ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... 1 2 1 23. Pneumonia ... ... ... ... ... ... ... ... ... ... 1 1 8 4 15 22 26 31 24. Bronchitis ... ... ... ... ... ... ... ... ... ... 10 1 11 4 10 9 31 14 25. Other diseases of the respiratory system ... ... ... ... ... ... ... ... 1 ... 1 1 ... ... 1 ... 3 1 26. Ulcer of stomach and duodenum ... ... ... ... ... ... ... ... 1 ... 3 1 3 ... 1 1 8 2 27. Gastritis, enteritis and diarrhoea ... ... ... ... ... ... ... ... ... ... 1 ... 2 ... 1 ... 4 28. Nephritis and nephrosis ... ... ... ... ... ... ... 1 ... ... 1 1 1 ... ... 2 2 4 29. Hyperplasia of prostate ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... 30. Pregnancy, childbirth, abortion ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 31. Congenital malformations 2 2 ... ... ... 1 1 ... ... ... ... ... ... ... ... ... 3 3 32. Other defined and ill dfefined diseases 9 3 ... 2 ... ... ... 1 ... 2 9 6 6 5 8 11 32 30 33. Motor vehicle accidents ... ... ... ... ... ... 2 1 2 ... 1 ... 1 ... ... 1 6 2 34. All other accidents ... ... 1 ... ... ... ... ... 2 2 2 1 ... 1 ... 9 5 15 35. Suicide ... ... ... ... ... ... ... ... ... ... 1 ... 1 1 ... ... 2 1 36. Homicide and operations of war ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Total 11 9 3 2 3 3 5 3 16 19 159 70 141 85 130 192 468 383 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE BOROUGH Isolation Hospital Accommodation. Patients suffering from infectious disease are admitted to hospitals controlled by the Woolwich and Dartford Hospital Management Committees (S.E. Metropolitan Regional Hospital Board). General Hospitals. Provision made by S.E. Metropolitan Regional Hospital Board. AMBULANCE FACILITIES. The provision of these facilities now rests with the kent County Council as Local Health Authority. NATIONAL ASSISTANCE ACT, 1948. Action taken under Section 47. During the year a number of cases of elderly person not receiving proper care and attention (reported to the department) were visited. In one case it was necessary for action to be taken under the Act for removal of an elderly person to hospital. Action taken under Section 50. It was not necessary to arrange for any burial under this Section during the year. PUBLIC MORTUARY. In 1951 the public mortuary was enlarged and equipped with refrigeration for six bodies. The total work was completed in February, 1952. The mortuary is also used by Erith and Crayford Authorities by arrangement with the Bexley Borough Council. During the year 208 bodies were admitted and 20 post mortem examinations were made; 14 inquests were held. 20 DISINFECTION AND DISINFESTATION SERVICE The joint scheme with the Erith and Crayford Councils for the disinfection of bedding following cases of Infectious Diseases, T.B. and Cancer, and for the disinfestation of bedding of verminous persons was discontinued during 1961 on account of the need to replace the vertical boiler at Bexley, and the fact that the Bexley Council had plans for the demolition of the Cleansing Station. The joint application by Bexley, Erith and Crayford Councils was successfully made to the Woolwich Borough Council for the use of their facilities and these arrangements have continued. LABORATORY FACILITIES Pathological and bacteriological specimens are sent to the Public Health Laboratory at Maidstone. This service ceased to be the responsibility of the County Council as from the 1st October, 1955, when it was taken over by the Public Health Laboratory Service, directed by the Medical Research Council for the Ministry of Health. NURSING HOMES Registration of Nursing Homes, Public Health Act, 1936. (Authority of Registration transferred from Kent County Council to the Bexley Borough Council—17.4.39). No. of Homes on the Register at beginning of year 2 No. of patients provided for:— Maternity — Others 28 Total 28 No. of Homes first registered during year 1 No. of patients provided for:— Maternity — Others 22 Total 22 No. of Homes on the Register at end of year 2 No. of patients provided for:— Maternity - Others 36 Total 36 21 SECTION C. SANITARY CIRCUMSTANCES OF THE BOROUGH List of Adoptive Acts, etc., in force. Acts. Date Adopted Public Health Acts (Amendment) Act, 1890 Parts 1, 2, 3 and 5 Apr. 1891 Infectious Diseases (Prevention) Act, 1890 Apr. 1891 Public Libraries Act,1892-1919 Oct.1896 Private Street Works Act, 1892 Jan. 1899 Public Health Acts Amendment Act, 1907, Parts 8 and 9 Apr.1909 Part 2—the whole May 1909 „ 6—the whole Public Health Act, 1925, Part 2 Jan. 1926 Slaughter of Animals Act, 1933 Jan. 1934 Byelaws. Wireless Loudspeakers, Gramophones, etc. Mar. 1939 Baths, Wash-houses, Swimming Baths and Bathing Places Aug.1938 Parks and Pleasure Grounds May 1939 and 1959 Defacing of Pavements Nov. 1939 Deposit of Litter to the Detriment of Public amenities ,, Deposit of Dangerous Substances ,, Organs ,, Loitering at Church Doors ,, Indecent Language, etc ,, Noisy Hawking ,, Touting ,, Noisy Animals ,, Nursing Homes June 1940 Sale of Contraceptives in Slot Machines Dec. 1949 Handling, Wrapping and Delivery of Food and Sale of Food in the Open Air May 1950 Improper Behaviour on School Premises May 1951 The Flying of Model Aircraft Nov 1951 Public Libraries Jan.1953 Building Apr.1954 and 1961 Parking Places for Vehicles May 1960 Fouling by Dogs of Footways oct 1960 Unruly Behaviour in Places of Entertainment July 1961 22 1. (i) Water Supply. The water to the district is supplied by the Metropolitan Water Board and is derived from several sources namely Bexley, Crayford, Darenth and Wilmington wells together with River Thames derived filtered water. The water supply to this area has been satisfactory in both quality and quantity during the year. There have been no specific cases of contamination and the waters are not liable to have a plumbo-solvent action. No new source of public water supply was instituted in the Borough1 of Bexley during 1961. There were no important extensions of trunk mains but new service mains were laid to the extent of 492 yards. During the year 9 samples of water from piped supplies were taken and submitted to the Public Health Laboratory for bacteriological examination and all were found to be satisfactory. (ii) Drainage and Sewerage. No new drainage and sewerage works were carried out during the year. Number of cesspools emptied, 10. The total number of emptyings, 29. Number of cesspools abolished, 1. 2. Rivers and Streams. No serious pollution was found in rivers or streams during the year. 23 CHIEF PUBLIC HEALTH INSPECTOR'S REPORT Health Department, 8, Brampton Road, Bexleyheath. To the Mayor, Aldermen and Councillors of the Borough of Bexley. Mr. Mayor, Ladies and Gentlemen, I have pleasure in submitting my Annual Report as Chief Public Health Inspector and Public Cleansing Officer to your Council for the year 1962. The report consists mainly of a tabulated record work carried out by the Public Health Inspectors. 24 TABLE No. 1. Details of Inspection Work Carried Out. Inspections Re-inspections Houses inspected (all particulars recorded) 18 239 Houses inspected (defects only recorded) 90 618 Houses inspected (certificates of disrepair) 20 64 Houses inspected (improvement grants) 49 2 Houses inspected (Housing Act, 1936, Overcrowding) 10 18 Houses inspected re Infectious Disease (including scabies) 78 49 Factories with mechanical power 172 22 Factories without mechanical power 26 5 Outworkers' premises 54 9 Other premises under the Act 5 4 Bakehouses 53 23 Water Samples 21 — Food and Drugs Act Samples 254 21 Dairies and distributors 19 10 Ice Cream premises 221 99 Restaurants, etc 219 102 Fish premises 139 56 Meat Shops 297 72 Public Houses 32 28 Shops re unsound food 333 73 Other premises where food is prepared 1,201 119 Offensive accumulations 100 114 Stables 7 7 Keeping of Animals 24 4 Rats 274 169 Drains inspected 724 483 Drains tested (water, smoke or colour) 100 2 Dustbins 5 3 Verminous premises 27 58 Smoke observations 72 5 Tents, Vans and Sheds 7 10 Refuse Tips 153 2 Refuse Removal and Salvage 547 15 Conveniences 239 8 Pet Animals Act, 1951 32 15 Council House applicants 145 62 Shops Act, 1950 1,042 18 National Assistance Act, 1948—Sec. 47 13 21 Miscellaneous inspections 679 163 Clean Air Act, 1956 120 53 25 TABLE No. 2. Improvements effected and defective sanitary conditions remedied. No. Houses— 13 Provided with sufficient w.c. accommodation Provided with sufficient ashplace accomdation 2 Provided with sufficient water supply 7 Houses Improved Internally— Walls and ceilings repaired 119 Dampness in rooms remedied 49 Defective floors repaired 13 Ventilation of Rooms improved 34 Windows repaired 44 Stoves, fireplaces, etc. provided or repaired 7 Houses Improved Externally— Roofs repaired 23 Eaves gutters and down spouts fixed or repaired 42 Yards paved or repaired 2 Chimney stacks repaired 9 Walls repointed or repaired 17 Miscellaneous repairs 29 Drainage— 7 89 Drains cleansed or repaired - New drains constructed 1 New gullies provided 3 Ventilation of drainage system improved 11 Inspection chambers built or repaired 7 Waste pipes provided or repaired 1 New sinks provided 9 Offensive accumulations removed 2 Nuisances from animals abated 10 Other nuisances abated TABLE No. 3. Infectious Diseases. Cases removed to Isolation Hospitals 15 Houses visited including revisits 127 Rooms disinfected - Noticcs delivered to Education Authorities, etc. 29 26 TABLE No. 4. Food Inspection. The following is a summary of unsound food surrendered and destroyed: Corned Beef lbs. 557¼ Tinned Ham ,, 296 Cooked Ham „ 191¾ Beef ,, 703 Pork ,, 224 Lamb ,, 50 Poultry ,, 386½ Veal ,, 25 Offal „ 783½ Bacon „ 35 Rabbit ,, 216½ Fish ,, 70 Tea ,, 12¼ Flour 360 Fruit and Fruit Juices tins 1,904 Vegetables ,, 1,675 Meat ,, 537 Fish ,, 453 Milk ,, 553 Meat Pies ,, 23 Preserves tins or jars 31 Pastes ,, „ 66 Cream ,, „ 107 Beef Puree tins 4,938 Frozen Foods pkts. 1,781 Miscellaneous items 146 27 TABLE No. 5. Factories Act, 1937 and 1948. 1. Inspections for Purposes of Provisions as to Health. Including Inspections made by Public Health Inspectors. Number of : Premises. 1 Inspections. 2 Written Notices. 3 Prosecutions 4 Factories without mechanical power 94 — — Factories with mechanical power 270 1 - *other Premises under the Act (including works of building and engineering construction but not including outworkers' premises) *Electrical Stations should be reckoned as factories. 9 5 - Total 373 6 - 2. Defects Found. Number of Defects. Number of Prosecutions. 6 Particulars. 1 Found. 2 Remedied. 3 Referred to H.M. Inspector. 4 Want of cleanliness (S.l) 6 6 — — Overcrowding (S.2) — — — — Unreasonable temperature (S.3) — — — — Inadequate ventilation (S.4) — — — — Ineffective drainage of floors (S.6) — — — — Sanitary Conveniences (S.7)— Insufficient — — — — Unsuitable or defective 2 2 — — Not separate for sexes — — — — Other Offences (Not Including offences relating to Home Work or offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921, and re-enacted in the Third Schedule to the Factories Act, 1937.) 4 4 — — Total 12 12 — — 28 PUBLIC CLEANSING SERVICE The Health Committee is responsible for the collection and disposal of house and trade refuse, the collection and sale of salvageable materials and the cleansing and maintenance of public conveniences. Refuse Collection and Disposal. The collection and disposal of house refuse is carried out by direct labour, and a weekly collection is made. Trade refuse is cleared from shops and factories by arrangement with the occupiers. A charge is made for this service, based on the average quantity to be removed each week. During the year a weekly collection was well maintained, and the bonus scheme continued to give good results in ensuring a regular service. The labour position was at times not altogether satisfactory, particularly during the summer months when the regular men were taking their annual leave, and it was difficult to obtain suitable casual labour. The Council operate a Salvage Scheme, and waste paper, textiles, scrap metals, etc., are collected by means of trailers attached to the refuse vehicles. All refuse was disposed of by controlled tipping at Stone, involving an average haul of 7½ miles to the disposal point. Salvage. Details of salvage sales for the financial year ended 31st March, 1963 are set out below. Tons. cwts. qrs. £ s. d. Waste Paper 346 3 3 2,619 2 3 Textiles 8 15 1 83 7 5 Ferrous Metals 1 18 1 11 11 7 Non-Ferrous Metals 1 2 4 0 8 Miscellaneous 9 0 6 10 9 357 7 3 2,724 12 8 29 Kitchen Waste. There are some 250 waste food bins in various roads in the Borough for the reception of kitchen waste, and these are cleared 2-3 times weekly by a contractor. A number of bins were either withdrawn or resited during the year as a result of complaints. Public Conveniences. Public Conveniences for men and women are situated at the following sites:— Market Place, Bexleyheath. Townley Road, Bexleyheath. Brampton Road, Bexleyheath. Danson Park, Welling. (4 men's, 4 women's). Library Building, Bellegrove Road, Welling. High Street, Bexley. St. Mary's Recreation Ground, Bexley. Hall Place, Bourne Road, Bexley. Riverside Walk, Bexley Russell Park, Bexleyheath. Avenue Road, Bexleyheath. Wrotham Road, Welling. Falconwood Parade, The Green, Welling. Westwood Lane, Blackfen. (Maintained jointly by the Chislehurst and Sidcup Urban District Council and Bexley Corporation). 30 ATMOSPHERIC POLLUTION. The Council is represented on the Thameside Advisory Committee for the Abatement of Atmospheric Pollution. By arrangement with this Committee a deposit gauge is installed on the roof of the Education Office in Brampton Road, Bexleyhealth, and the following table gives the results obtained during 1962. TONS PER SQUARE MILE. MONTH Rainfall inches Total water insoluble matter Soluble in C.S.2. Ash Other combustible matter Total water soluble matter Calcium Chlorine Sulphates Total solids January 2.94 6.39 0.14 4.68 1.57 8.86 0.67 2.24 2.38 15.25 February 0.41 3.07 0.12 2.08 0.87 3.10 0.54 0.84 1.27 6.17 March 1.61 9.80 0.09 7.39 2.32 10.87 2.11 1.07 3.75 20.67 April 1.73 6.85 0.10 4.85 1.90 6.78 1.29 0.91 2.86 13.63 May 1.77 5.52 0.11 4.58 0.83 4.50 0.64 0.67 2.02 10.02 June 0.33 4.61 0.06 3.37 1.19 4.80 1.05 0.34 1.41 9.41 July 2.19 6.97 0.09 4.96 1.92 7.01 1.25 0.81 2.54 13.98 August 1.36 4.05 0.08 3.01 0.96 4.16 0.78 0.54 2.31 8.21 September 2.38 6.40 0.00 5.00 1.34 5.30 0.77 0.74 1.84 11.70 October 1.11 8.53 0.07 6.31 2.16 17.05 4.24 0.84 7.77 25.58 November 1.28 4.65 0.07 3.37 1.21 6.58 0.75 1.07 2.21 11.23 December 1.76 11.99 0.33 8.07 3.59 9.36 1.19 1.68 3.71 21.35 A Lead Peroxide instrument for estimating atmospheric suphur-dioxide is situate near the deposit gauge and the result for the year are set out below.— MONTH Area Exposed Weight of Ba SO4 Wt. of SO3 Collected Mg. of SO3/day Collected by 100 sq. cm. of Batch A Pb O2 (Louvered Cover) In Sample In Control Due to Exposure Sq. Cm. Ms. Mg. Mg. Mg /100 sq. Cm./day January 100 172.4 2.8 169.6 1.62 1.46 Febuary 95 142.8 1.7 141.1 1.82 1.64 March 90 226.2 2.5 223.7 2.66 2.39 April 100 131.4 1.2 130.2 1.54 1.39 May 100 112.6 0.9 111.7 1.24 1.12 June 95 81.2 1.0 80.2 0.93 0.84 July 100 91.6 1.2 90.4 1.03 0.93 August 90 50.4 1.0 49.4 0.57 0.51 September 100 80.6 1.2 79.4 0.97 0.87 October 95 205.8 1.3 204.5 2.38 2.14 November 100 220.8 1.8 219.0 2.35 2.12 December 95 258.8 3.8 255.0 3.17 2.85 31 A volumetric apparatus for the measurement of sulphur dioxide and smoke is installed at the Health Department Brampton Road, and a summary of the results obtained is set out below. Concentration of Smoke and Sulphur Dioxide. Smoke Cone, mg/100 m3 Sulphur Dioxide Cone. Average Value Highest Value Lowest Value Average Value Hig'nest Value Lowest value January 129 600 31 150 911 18 February 100 293 33 130 378 25 March 111 259 39 174 392 32 April 62 136 21 95 337 13 May 60 92 4 71 197 65 June 15 47 2 70 159 18 July 18 61 4 68 185 19 August 13 53 2 41 127 13 September 31 100 Nil 52 123 13 October 90 308 4 147 292 26 November 160 490 19 179 615 27 December 131 673 24 232 1,262 70 Clean Air Act, 1956—Smoke Control Areas. The Borough of Bexley (No. 1) Smoke Control Order 1962 was made by the Council on the 6th November, 1962 and confirmed by the Minister of Housing and Local Government on the 11th February, 1963. This area comprises 1,382 dwelling houses, shops, etc., and the Order comes into operation on the 1st October, 1963. PREVENTION OF DAMAGE BY PESTS ACT, 1949. One full time Rodent Operative is employed by the Department for the treatment of surface infestations, and the test baiting and maintenance treatment of sewers is carried out by the sewermen under the supervision of the Department No charge is made for treatment carried out at private dwelling houses, but the occupiers of business premises are charged for disinfestation work. 32 Details of surface infestations dealt with during the year are set out below. Number of Properties Inspected 701 Number of Inspections 2,228 Number of Infestations found: Rats—Major Nil Minor 233 Mice 45 Number of Properties Treated Rats Mice Local Authority's premises 2 2 Dwelling Houses 205 29 Business Premises 26 14 PET ANIMALS ACT, 1951. Licences to keep pet shops were issued to 9 persons under the Act. No contraventions were observed during the year. SHOPS ACT, 1950. The following Closing Orders are in operation in the area:— Bexley Urban District (Butchers) No. 6 Order, 1920. Bexley Urban District (Grocers and Provisions Merchants) No. 7 Order, 1923. Bexley Urban District (Miscellaneous Trades) No. 8 Order, 1923. The Bexley Hairdressers and Barbers Shops Closing Order, 1946. There were approximately 800 shops on the Council's Register at the end of the year. During the year, 1,060 inspections were made under the Shops Act, 1950, and no legal proceedings were instituted I am. Ladies and Gentlemen, Yours obediently, G. HIND, Chief Public Health Inspector. 33 Swimming Pool. The only swimming pool in the Borough open to the Public is in Danson Park and is owned by the Council. The layout includes three open-air pools, one large for adults and two small pools for children. Showers and foot baths are provided for the pre-cleansing of bathers. The water is kept pure by continuous filtration and sterilisation by means of the latest method of break-point chlorination. There are, in addition, two small swimming pools at two schools in the Borough. The purity of the water was well maintained during the year. Samples of water are taken by this department monthly during the time the pools are open and the results or bacteriological examinations have been satisfactory on all occasions. Verminous Premises. During the year 7 premises were found to be infested with bed bugs and these were treated with satisfactory results. Infestations at other premises were dealt with as follows: — Mite 1, Flies 1, Ants 10. Fleas 3, Moths 2. Cochroaches1. Furniture Beeles 1. Wasps. The destruction of wasps nests is undertaken by the Department and during the year 20 nests were destroyed. A charge of 7s. 6d. was made for this service. Schools. There are 32 County Secondary and County Primary Schools, 2 Day Technical Schools and a Grammar School in the Borough. 34 SECTION D—HOUSING The following particulars relate to the houses owned by the Council on the various Estates at 1st April, 1963:— Welling- Houses Flats Welling Estate 424 Westwood Lane Estate 126 Carlton Road 16 Dovedale Close 11 John Newton Court — 132 Marwood Estate — 22 Lodge Hill 353 Wickham Street 74 East Wickham— Re-development 380 Glenmore Road No. 1 115 Glenmore Road No. 2 84 Bexleyheath— Highland Road Estate and Pickford Road Estate 303 Cannon Road — 28 Alers Road 84 Halcot Estate No. 1 200 Halcot Estate No. 2 (including Bungalows) 126 Halcot Estate No. 3 84 Faygate Estate 52 60 Bristow Road — Upton Close 13 28 Fairfield Road — Tower Road — 48 Bexley— Hartford Road Estate and Albert Road Estate 53 Royal Park Estate 114 Midhurst Hill 16 Newick Close 10 Henfield Close 7 Rye Close Extension 35 Glenhurst Avenue 27 Hurst Place Estate 234 S.D.A Houses 7 Houses Purchased 7 2,955 318 35 1. Inspection of Dwelling Houses during the year. (1) (a) Total number of dwelling houses in- spected for housing defects (under Public Health or Housing Acts) 108 (b) Number of inspections made for the purpose (including re-inspection) 965 (2) Number of dwelling houses to be in a state so dangerous or injurious to health as to be unfit for human habitation 18 (3) Number of dwelling houses (exclusive of those referred to under the preceding subhead) found not to be in all respects reasonably fit for human habitation 90 2. Remedy of Defects during the year without service of Formal Notice. Number of defective dwelling houses rendered fit in consequence of informal action 93 3. Action under Statutory Powers during the year- A. Proceedings under the Housing Act. 1957 Number of dwelling houses which were rendered fit after service of formal notices: (a) By owners 5 (b) By local authority in default of owners - B. Proceedings under Public Health Acts— Number of dwelling houses in which defects were remedied after service of formal notices— (a) By owners 2 (b) By local authority in default of owners - C. Proceedings under Sections 16 and 17 of Housing Act, 1957— (1) Number of dwelling houses in respect of which Demolition Orders were made 14 (2) Number of dwelling houses demolished in pursuance of Demolition Orders 17 (3) Number of houses in respect of which Closing Orders were made - D. Proceedings under Section 18 of the Housing Act, 1957— parts of buildings closed 2 36 Improvement Grants. Discretionary Standard Number of applications for improvement grants 20 40 Total amount of grants made £3,152 7 1 £1,031 12 10 Rent Act, 1957. Number of applications for certificates of disrepair 3 Number of decisions not to issue certificates 1 Number of decisions to issue certificates 2 (a) in respect of some but not all defects 2 (b) in respect of all defects - Number of undertakings given by landlords 2 Number of undertakings refused by the Local Authority - Number of Certificates issued 1 Applications by landlords for cancellation of certificates - Obections by tenants to cancellation of certificates - Decisions by Local Authority to cancel in spite of tenants' objection - Certificates cancelled - 37 SECTION E.—INSPECTION AND SUPERVlSION OF FOOD (a) Milk Supply. The milk retailed for consumption in the area is all pasteurised and bottled. No. of Distributors with Dairy Premises 4 No. of Distributors with Shop Premises 27 No. of Distributors from outside area 7 Licences granted by the Council under the Milk (Special Designation) Regulations, 1960 :— Dealers' Licences:— Pasteurised Milk 30 Tuberculin Tested Milk 34 Sterilised Milk 37 24 samples of milk were forwarded to the Public Health Laboratory for the Methylene Blue and phosphatase Tests, of which 8 failed. The milk was taken from milk-vending machines which have since been discontinued. (b) Slaughterhouses. There are no slaughterhouses in the area, and the majority of the butchers obtain their supplies through Smithfield Market. 38 (c) Adulteration of Food. Food and Drugs Act, 1955. The following table summarises the 207 samples taken during the year. Corned Beef 1 Meat Pies and Puddings 18 Sausages 3 Patent Medicines 8 Condiments, Sauces, Pickles, Spices, etc 43 Butter and Fats, Cooking Oil, etc. 3 Soups 11 Minerals and Cordials, etc. 6 Bread, Flour, Biscuits 10 Glace Cherries 1 Sweets and Confectionery 9 Pure Coffee, Coffee Extracts, Coffee and Chicory 4 Preserves 17 Cream 11 Pastes, Spreads, Potted Meat and Fish 14 Vegetables 6 Flavouring and Essences 7 Fruit, Fruit Juice 10 Condensed and Evaporated Milks 5 Baking Powder 3 Desiccated Coconut 3 Jellies, Custard Powders, etc 4 Rennet 1 Tea 3 Rice Puddings, etc 6 39 Legal Proceedings. Foreign matter in marmalade—Fined £20 plus £4 4s. Od. costs. Mouldy Vanilla Slice—Fined £15 plus £3 3s. Od. costs. Dirty Milk Bottle—Company discharged subject to payment of £10 10s. Od. to Council. Mouldy Bread—Fined £30 plus £4 4s. Od. costs. Mouldy Apple Pie—Fined £30 plus £4 4s. Od. costs. (d) Food Shops and Food Manufacturing Premises. The classification of the various food shops and food manufacturing premises in the Borough is as follows: — Butchers 46 Cafes and Restaurants 26 Greengrocers 46 Sweet Shops 66 General Provisions 80 Bakers and Confectioners 25 Wet and Fried Fish Shops 23 Public Houses 40 352 40 The following table is a summary of the improvements carried out as a result of action by the Department, under the Food Hygiene Regulations, 1960. Hot water supply provided or improved 6 Floors, walls, ceilings, etc., repaired 27 Infestations dealt with 2 Rooms cleansed 31 Water Closet accommodation improved 5 Accumulation of refuse removed 3 Accommodation for storage of refuse improved 3 Washing accommodation improved 2 Drainage repaired or improved 2 Food storage accommodation improved 10 Yard cleansed or repaired 2 Sinks renewed 10 Other contraventions 6 Unsatisfactory equipment cleansed or renewed 1 Registration of Premises under Food and Drugs Act, 1955. No. of premises registered for:— Manufacture and Sale of Ice Cream 2 Sale of Ice Cream 164 Preparation of Sausages, etc 50 23 samples of Ice Cream were submitted for examination under the Ice Cream (Heat Treatment) Regulations, 1947. All were satisfactory. 41 SECTION F.—PREVALENCE OE AND CONTROL OVER INFECTIOUS DISEASE AND OTHER DISEASES Scarlet Fever. During the year 23 cases were notified as compared with 37 the previous year. No cases were treated in hospital No. of deaths Return cases from Hospital cases Nil Return cases from home nursed cases Nil During the past 15 years the character of this disease has changed from one of considerable severity to one of extreme mildness. The acute stage is, nowadays, in most cases, short and unaccompanied by high pyrexia and complications are in most cases mild or completely absent Scarlet fever can now be disregarded as an important cause of acute endocarditis and acute nephritis which, in the past were frequently encountered. Diphtheria. No cases were notified during the year. The following figures on Diphtheria and Cough Immunisation and Smallpox and Polioinyelitis Vac cination have been supplied by the County Medical Officer 42 IMMUNISATION The following table shows the diphtheria immunisation and whooping cough immunisation figures for 1962 based on the returns submitted to the Ministry of Health. Year of Birth Diphtheria Immunisation (Singly or in combination) Whooping Cough Immunisation (Singly or in combination) Primary Reinforcing Primary 1962 604 Nil 602 1961 641 19 638 1960 19 455 16 1959 9 149 8 1958 5 70 2 1953-1957 23 634 10 1948-1952 3 12 Nil Total 1,304 1,339 1,276 POLIOMYELITIS VACCINATION The following table shows the number of injections given in the various groups during the year ended 31st December, 1962. Year of Birth 2nd Injections (Salk) 3rd Dose (Salk and Oral) 4th Dose (Salk and Oral) 3 Orals (Complete Course) 1962 1 1 — 158 1961 41 313 — 691 1957-1960 151 634 — 93 1943-1956 46 367 1,028 67 1933-1942 62 317 — 99 Others 147 1,259 — 276 Total 448 2,891 1,028 1,384 43 SMALLPOX VACCINATION The following table shows the smallpox vaccination figures for 1962 based on the return submitted to the Ministry of Health. Age at Date of Vaccination Number Vaccinated Number Re-Vaccinated Under 1 1,106 1 146 13 2 to 4 373 259 5 to 14 1,492 1,905 15 or over 2,647 5,617 Total 5,764 7,794 Typhoid Fever and Paratyphoid Fever. There were no cases notified during the year. Puerperal Pyrexia. 11 cases were notified during the year, 10 of which were from Bexle.yheath Maternity Hospital, where they were isolated and treated. One case was treated at home. Ophthalmia Neonatorum. No cases were notified during the year. Measles. 99 cases were notified during the year. No cases were treated in hospital. Whooping Cough. 1 case was notified during the year. It was not treated in hospital. Acute Poliomyelitis. No cases were notified during the year. Scabies. No cases were notified during the year. Food Poisoning. 2 cases were notified during the year. No cases were treated in hospital. Malaria. No cases were notified during the year. Dysentery. No cases were notified during the year. 44 The following table gives the particulars concerning the cases of Infectious Diseases (other than Tuberculosis) notified in the area during the year. NOTIFIABLE DISEASES (Other than Tuberculosis) DURING THE YEAR 1962. DISEASE. Total cases notified Under 1 1 2 3 4 5 to 9 10 to 14 15 to 24 25 & over Age unknown Cases admitted to Hospital Total Deathr Smallpox __ — _ Scarlet Fever 23 — 2 1 2 5 9 3 1 — — — — Diphtheria — — — — — — — — — — — — — Puerperal Pyrexia 11 — — — — — — — 4 7 — 11 — Ophthalmia Neonatorum — — — — — — — — — — — — — Acute Paralytic Poliomyelitis — — — — — — — — — — — — — Acute Non-Paralytic Poliomyelitis - - - - - - - - - - - - - Pneumonia 10 - - - - - - - 1 9 — 1 1 Erysipelas 7 — — — — — — — — 7 — — — Food Poisoning 2 — — — — — — — — 2 — — — Dysentery — — — — — — — — — — — — — Typhoid Fever — — — — — — — — — — — — — Paratyphoid Fever — — — — — — - - - - - — — Meningococcal Infection 3 — — — 1 — 2 — — — — 3 — Measles 99 — 6 8 7 14 61 2 — 1 — — — Whooping Cough 1 — — — — — 1 — — — — — — Scabies — — — — — — — — — — — - —. Encephalitis — — — — — — — — — — — — — Malaria — — — — — — — — — — — — — Totals 156 - 8 9 10 19 73 5 6 26 — 15 1 45 TUBERCULOSIS. During the year 29 new cases were notified. Particulars relating to the same, and also to the deaths which occurred during 1962 are contained in the following table:— Age Period New Cases Deaths Respiratory Non Respiratory Respiratory Non Respiratory M. F. M. F. M. F. M. F. Under 5 - - - - - - - - 5—14 - - - - - - - - 15—24 2 1 — 1 — — — — 25—44 6 2 1 4 — 1 — — 45—64 4 2 1 1 3 1 — — 65 and over 3 — — 1 2 — — 1 Totals 15 5 2 7 5 2 — 1 There were no deaths from un-notified cases. 46 BOROUGH OF BEXLEY COMMITTEE FOR EDUCATION Annual Report on the School Health Service For the Year 1962 JOHN LANDON, m.r.c.s., l.r.c.p., d.p.h.. Medical Officer of Health EXCEPTED DISTRICT OF BEXLEY WELFARE AND SCHOOL ATTENDANCE SUB-COMMITTEE Chairman: Councillor Mrs. M. P. Monk. Vice-Chairman: Miss M. Woodward, L.L.A.. l..G.S.M.(Eloc.) Alderman Mrs. E. M. Sheppard. Councillor S. H. philpot Councillor J. C. Canton. Councillor M. F Townsend. Councillor B. Francis. Councillor W. P. Webster. Councillor C. Jamieson Harvey, M.B.E., J.P. Co-opted Members: Revd. E. Maynard Wilson. Canon C. E. Youngman,M.A. Borough Education Officer W. E D. Stephens. M.A.,Ph.D. Deputy Borough Education Officer R. R. Sutton. SCHOOL HEALTH SERVICE Medical Officer of Health John Landon, M.R.C.S., L.R.C.P., D.P.H. Assistant Medical Officers Nora Walter, M.B., B.Ch.,b.ao,. D.C.H. (Part-time). Stella M. Ring, M.R.C.S., L.R.C.P D.C.H (Resigned 30.3.62). Sybil R. Yeates, M.B.,B.S., M.R.C.S., L.R.C.P. Dorothy F. Bate. M.B., Ch.B., D.C.H., D.(obs.) R.C.O.G. (Appointed 1.6.62). May B. Edge. M B.. Ch.B., D.P.H (Appointed 1.3.62). Ophthalmic Surgeon Roland M. Chambers, M Chambers, M.B., B.S., D.O.M.S. Dental Officers Mrs. A. B. Perkins, L.D.S., R.F.P.S. (Glas.). Mrs. E. A. Williams, B.D.S.,L.D.S (Four sessions weekly). 48 Dental Officers (continued): Dr. W. G. S. Neely, L.D.S. (Appointed 5.3.62). (Five sessions weekly). Mr. E. Seal, B.D.S., L.D.S., R.C.S. (Appointed 13.3.62). (Four sessions weekly). Miss C. Croome, Dental Ancillary. (Appointed 20.9.62). Health Visitors Miss B. Hart. S.R.N., S.C.M.. and Health Visitor's Certificate (Parttime). Mrs. A. E. Matthews, S.R.N., S.C.M., S.R.F.N. Miss W. M. Humphries, S.R.N., S.C.M., S.R.F.N. Miss L. G. Exley, S.R.N., S.C.M., and Health Visitor's Certificate (Part-time). Mrs. G. M. Blackmore, S.R.N.. S.C.M., and Health Visitor's Certificate (Part-time). Mrs. Wright, S.R.N., S.C.M., and Health Visitor's Certificate. (Part-time) Miss E. C. Richardson, S.R.N.. S.C.M., Health Visitor's Certificate. (Part-time). Physiotherapists Miss R. Cheeseman, M.C.S.P. Mrs. I. O. M. Poynder, C.S.P. Speech Therapists Mrs. E. Rollo, L.C.S.T. Mrs. R. Goodwins, L.C.S.T. Dental Attendants Miss K. Dunkley. Mrs. V. Sproul. Miss J. A. Smith — Hygienist. School Health Service Clerk Miss O. G. Turnbull. General Clerks Miss E. Turner. Mrs. D. Starling Miss P. M. Phillips. (Appointed 1.1.62). 49 REPORT ON THE SCHOOL HEALTH SERVICE DURING THE YEAR 1962 To the Chairman and Members of the Welfare and School Attendance Sub-Committee. Madam Chairman, Ladies, and Gentlemen, I have the honour to submit my Annual Report for the year 1962. During the year the School Health Service continued to provide a full range of services, details of which are set out in the body of the report. It has often been stressed that the School Health Service is, essentially, a preventive service and this is why, after so many years, we continue to give regular medical examinations to our schoolchildren, in most cases four times in the course of their school lives. We do our utmost to ensure that these examinations do not become too " routine" and the co-operation of parents and teaching staffs at these examinations does much to ensur most is made of this opportunity to assess the healt status of the child as an individual both in his) home and in his 'school environment. We have so far, refrained from advoeating the more selective methods of medical inspect now being pursued experimentally in a number of districts with varying degrees of success. The preventive nature of the service is show also in the work which is done in maintaining the immunity of the schoolchild by vaccination and immunisation against diphtheria, poliomyelitis, tuberculosis and other infectious dieases all of which have been pleasingly conspicuous by their absence or low incidence during the year. T have commented, freely, in past years on local and national trends affecting the School Health Service and many of these have now become an accepted part of the Borough service. As examoles of this may be quoted routine Pure -tone audiometry for all children at the age of seven years- B.C.G. vaccination against tuberculosis, the early ascertainment of physical and mental handicap (often at the age of about two vears) the supplementation of the School Dental Service by 50 dental auxiliaries and the introduction of the new type of air rotor high speed drill which increases the comfort of dental treatment and makes the best use of our dental surgeons and ancillary workers. The School Health Service has, further, played its full part in the supervision and assessment of educationally subnormal and maladjusted children and has worked in close conjunction with the Child Guidance Clinic and the School Psychological Service, and, through the Borough Education Officer, with the special, nursery and tutorial classes in ordinary schools. These wise provisions have given to the care of children suffering from educational and emotional problems a flexibility which is extremely valuable. We still do not do enough in the field of formal Health Education among schoolchildren and the need for this is be.coming more apparent each year. The earlier maturation of children and the greater social freedom which they nowadays enjoy has brought to the fore once again the need for sex education—a thorny problem indeed. We are still concerned with the smoking habits of schoolchildren and the need to perservere with health education in this difficult and, on the whole, neglected field. At the time of writing a Mobile Unit of the Central Council for Health Education is operating in the Borough and bringing to the notice of the secondary schoolchildren (and it is hoped of many adults as well) the general undesirability and the long-term hazards of cigarette smoking. A letter has been sent to the parents of all such children asking them not to smoke when with their children or, even better, to give up the habit altogether. Above all, they are being exhorted not to do anything to encourage their children to smoke or to make it easy for them to obtain supplies of cigarettes. The report of the Chief Medical Officer of the Ministry of Education for the years 1960 and 1961 quotes an extreme example from the annual report of a principal school medical officer of a southern county in which a boy of 14½ years is reported as having said, " My mum gives me a packet of ten e.very morning when I catch the school bus ". From the same source come two further examples. Another boy of 14½ years, after bringing tea into the staff room thick with tobacco smoke, is reported to have said to the Headmaster, " Sir, are you going to give them (the staff) a talk like you 51 did to us? They sure need it" And, lastly, a third example from a girl aged 15 ye.ars, " There can't be much harm in it for our doctor is always smoking cigarettes". These examples illustrate the responsibilities of adult society in this matter and the extent of this important problem which must, somehow, be kept alive by periodical campaigns as well as by the daily example of those responsible for the healthy upbringing of the younger generation. I wish to record the excellent team work of all members of the staff on which the success of the School Health Services so largely depends and, also, to express my appreciation of the help which I have received during the year from the Chairman and Members of the Committee, from Miss Turnbull, the Senior Clerk, from the County Medical Officer and his staff and from the Borough Education Officer and his Department. I am, Madam Chairman, Ladies and Gentlemen, Your obedient servant, JOHN LANDON, Medical Officer of Health 52 KENT EDUCATION COMMITTEE EXCEPTED DISTRICT OF BEXLEY Schools. (Average number on Roll at 31st December, 1962) Bexley Grammar School 643 Bexley County Technical School for Girls 688 Bexley & Erith Technical School for Boys 557 Eight County Secondary Schools 3,570 Twenty-four County Primary Schools 6,831 Clinics. Minor Ailments. Welling—Little Danson, Dansington Road. Tuesday and Wednesday, 1.30-3.30 p.m. Doctor in attendance—Wednesday. Welling—Wrotham Road. Tuesday, 9.30-11 a.m. Thursday, 1.30-3.30 p.m. Doctor in attendance—Thursday. Bexleyheath—315, Broadway. Tuesday, 1.30-3.30 p.m. Monday and Friday 9-10 a.m. Wednesday, 9-11 a.m. Doctor in attendance—Tuesday. Bexley—Murchison Avenue. Tuesday, 9.30-11 a.m. Friday, 1.30-3.30 p.m. Doctor in attendance—Friday. 53 Dental. Welling—Little Danson, Dansington Road. Daily—9.30-11 a.m., 2-4 p.m. Bexleyheath—315, Broadway. Tuesday, Wednessday, Thursday, Friday, 9.30-11 a.m. Daily—2-4 p.m. Bexley—Murchison Avenue. Monday and Tuesday, 9.30-11 a.m., 2-4 P.m. Specialist's Clinics. Ophthalmic. Welling—Little Danson, Dansington Road. Monday and Friday, 9.30-11 a.m., 2-4 p.m Thursday, 2-4 p.m. Orthopedic. Welling—Station Approach. Tuesday and Thursday morning 9.30-11a.m Specialist in attendance 1st and 3rd Wenesday in month at 10 a.m. Bexley—Murchison Avenue. Monday, 2-4 p.m. Thursday 9.30-11 a.m. Specialist in attendance once per month by special arrangement. Speech. Woodside Road, Crayford. Monday, Tuesday, Wednesday, 2-4 p.m. Murchison Avenue, Bexley. Friday, 9.30-11.30 a.m., 2-4 p.m. Child Guidance. 18, Crook Log, Bexleyheath. Clinics held daily. Appointments made through County Medical Officer by the Borough Medical Officer of Health 54 CO-ORDINATION. In spite of the transfer of the Maternity and Child Welfare Services from the local Council to the Kent County Council, a satisfactory degree of co-ordination of effort between the School Health Service and the Infant Welfare Services has been maintained as a result of the co-operative attitude of all members of the Staff concerned. Periodic Medical Inspections. See Table A. The successful carrying out of routine medical inspections was made possible by the excellent co-operation of Head Teachers and their staffs and it is true to say that this is now regarded as an integral part of the school curriculum. It is at these inspections that the greatest number of defects is discovered and where a great deal of information is obtained in regard to the school children by discussions with the parents. Generally speaking, it was found that entrants, 8-yearolds and 11-year-olds showed a uniformly high standard of personal hygiene. Clothing was good and clean and the incidence of skin diseases very low. The attendance of parents at routine medical inspection was good, being practically 100 per cent, in the case of entrants, but as might be expected there was a falling off in the case of senior children. Reference to the Statistical Table on Page 67 emphasizes the number of defects discovered. Bearing in mind that these defects are nearly always diagnosed in the early stages and observation or treatment instituted at once, periodic inspections will be seen to represent the truly preventive aspect of School Health Work. School Meals Service Meals are now served in all Primary and Secondary Schools in the Borough. A scullery was opened at Bridgen C. of E. School last Summer and a new scullery brought into use at St. Stephen's last September. A choice of meals is offered at two Technical High Schools and three County Secondary Schools. 55 Milk and Meals Return for 1962 Average number of pupils taking meals daily:— Primary Schools Secondry school Payment 2,858 3,630 Free 40 62 2,898 3,692 Average number of pupils taking milk daily:— Primary Schools Secondary school 5,989 3,475 School Dental Service. The following reports have been received from the School Dental Surgeons:— Mrs. A. Perkins, L.D.S., Danson Clinic, Welling- . In 1962, 4,623 children were inspected at school and of these 71% required treatment. A further 188 attended the clinic as specials :- In the latter part of the year a Dental Auxiliary was appointed at the clinic for two days per week. Miss croome's standard of work is very high and she also did very useful work in the field of dental health education in the from of talks and the showing of films and slides in several school. An orthodontic specialist now attends the clinic once a month. Mrs. Williams, B.D.S., L.D.S., Murchison Avenue Bexley. I have very much enjoyed working here and find the clinic most pleasant and well equipped. Practically all the children who commence treatment follow it through to completion, and most attend at regular intervals for check-ups 56 There is one great disadvantage in that several of our schools (e.g., Days Lane and Blackfen) are at such a distance from the clinic that we get very few acceptances because of the inconvenience of travelling. We also get very few Orthodontic cases due, no doubt, to the fact that the bulk of our attenders are too young. Dr. G. Neely, M.R.C.S., L.R.C.P., L.D.S., 315 Broadway Clinic, Bexleyheath. The clinic runs smoothly and my Nurse is excellent. The new high speed motor drill saves much time and effort and I could deal with, say, fifteen appointments per session. Orthopaedic Clinics. I am indebted to Mr. B. Lawson, F.R.C.S., for the following report:— The attendances at the clinic have maintained a steady pattern except for the addition of scattered anomalies of bone growth. The number of patients attending during the year was 119. Of these, 3 were placed on the waiting list for operation. Ophthalmic Clinic I am indebted to Mr. R. M. Chambers, M.B., B.S., D.O.M.S., for the following report:— The attendance figures have been satisfactory and do not differ significantly from those of previous ye.ars. My suggestion made in an earlier report that a small map of the locality be included when new patients are asked to attend, is again repeated. This would surely be useful for those attending the other clinics also. It would be an advantage if some form of sound-proofing could be given to the door leading to the waiting room. When full of ophthalmic and dental patients the noise can be most disconcerting and adds to the difficulty of communicating with an anxious, whispering child. Is highly polished linoleum the best surface for the floor of the waiting room? The not infrequent sound of falling bodies, especially if snow is on the ground, suggest the need of a non-slip surface. 57 Analysis of cases other than refractive errors: Congenital. 1 Ptosis 2 Nystagmus 2 Le.ns opacities l5 Epicanthus 1 Retinal Folds Acquired. Constitutional 13 Migraine 1 Retinitis Pigmentosa 1 Myopic Degeneration Infective 5 Conjunctivitis 3 Blepharitis 3 Stye 1 Anterior Choroiditis Others. 2 Optic Atrophy 2 Melanosis Conjunctivae 5 Maculopathy 3 Sinusitis 1 Allergy to spectacle frames 1 Anaemia 2 Foreign bodies 19 Cases referred to hospital 125 Cases other than refractive errors Child Guidance Clinic. Number of children referred durinc 1962. 1961 1962 Boys Girls Total Boys Girls Total Under 5 2 2 — 1 1 5—7 9 4 13 7 3 10 8—10 11 11 7 4 11 11 and over 3 5 8 4 11 15 25 9 34 18 19 37 58 Sweep Frequency Pure Tone Audiometry. During 1962, 783 children were tested during their last year in the Infants' School, i.e., during their seventh year. Of this number 688 passed and 95 failed. The latter children were referred to the School Medical Officers for investigation and any minor conditions causing temporary deafness were treated. In addition 136 children of all age groups were tested as special casea referred from various sources including teachers, and of this number 62 passed and 74 failed. The 136 children mentioned above included those, children in the main survey who had been examined by the School Medical Officers and found to require a re.-test following treatment or otherwise. The 169 failed children were referred back to the School Medical Officers for further examination and treatment. Lastly, 145 children attended for a final audiometric test and this number included children seen in 1961 who had been referred by the School Medical Officers for a final test in 6 to 12 months time. Of these 145 children, 64 passed and 81 failed. Further treatment was instituted for the latter children either at the School Clinics or at the Ear, Nose and Throat Department of the West Hill Hospital, Dartford, or other Hospitals in the metropolis. Speech Therapy. I am indebted to Miss Joan Pollitt, Senior Speech Therapist to the Kent Education Committee for the following report: Seventy-nine children attending Bexley schools have been dealt with within the County Speech Therapy Services during the year. The cases of thirty-eight of these children have been closed during the year and forty-one will attend into 1963. Of the thirty-eight closed cases, twenty-four have been dealt with in the Murchison Avenue Clinic, eleven at the Woodside Road Clinic and three at the Sidcup Clinic. 59 20 Satisfactory progress Treatment incomplete—parents unco-operative and attendance lapsed, or left school and could 4 not continue to attend 1 Transferred to Child Guidance Clinic 5 Found improved whe.n first seen Report improved prior to appointments being 5 offered Left district prior to investigation being com 1 pleted 1 Appointments offered but never kept Treatment arranged elsewhere prior to appoint- ments being offered 38 Twenty-three of the forty-one children attending Bexley schools who will continue to attend into 1963 are being seen at the Murchison Avenue Clinic, sixteen are being seen at the Woodside Road Clinic and two are being seen atSidcup Fifty-eight children attending Bexley schools were on the waiting lists at the end of 1962; forty-two await appointments at the Woodside Road Clinic, eleven at the Murchison Avenue Clinic and five at the Sidcup Clinic. Mrs. Rollo has continued to work at the Murchhson Avenue and Woodside Road Clinics; Miss Formby sees children at the Woodside Road Clinic and Mrs. Goodwins at Murchison Avenue and Sidcup Clinics. Cleanliness Inspections. (See Table D). A feature of the health of schoolchildren in the Borough for many years has been the exceptionally low rate of infesta tionof schoolchildren with vermin. This is now being recognised by a substantial reduction in the number of school inspections by Health Visitors for this purpose. Cleanliness inspections are now carried out in secondary schools only when they are requested by head teachers. In primary school regular cleanliness inspections have been discontinued where at three consecutive inspections, no cases of uncleanliness have been found but further inspections are made if requested by the head teacher or it appears that special circumstances warrant an intensification of this work. 60 PHYSICAL EDUCATION I am indebted to the Physical Education Advisers, Mr. J. Hopkins and Miss E. A. Osgathorp for the following report:— Children are bigger, stronger and healthier than ever. This gift of poisitive health possessed by our young is seen locally as an abundance of vitality and a surplus of energy which presents a challenge and a problem to the Physical Education Teache.rs in the Borough's Schools. Every year these dedicated people include something new, something exciting in the already large and complex subject called Physical Education, so that an overall view would show that boys and girls in the area enjoy a selection from a list which includes Association Football, Hockey, Rugby, Netball, Cricket, Badminton, Swimming, Life Saving, Basket Ball, Dancing, Boxing, Tennis, Table Tennis, Gymnastics, Rounders, Canoeing, Camping, Rock Climbing, Orientering, Lacrosse, Fencing and Skiing. The complexity of the task facing the teachers is evident when it is remembered that some schools cover fifteen of these activities during the school year. Although the syllabus has widened out of all recognition when compared with pre-war days, the length of time available remains roughly the same and very rarely exceeds three periods weekly for each class. It is a strange reward for growing up in a school that as the children's physical powers develop, so that they are capable of defeating not only their own contemporaries but even the World's best, less time is found within the school timetable for their physical development. The better their intellectual attainment the more the time available is encroached upon because of academic needs and pressure. Yet in this mentally sick age nothing is more important than a healthy shrine to encompass the mind and soul of the growing child, and the mind is often better treated by the therapy of play than by the pill. Even before the war, thirty-four years ago, four periods plus an additional period for swimming was recommended, but schools somehow have never found it possible to achieve this. There is no subject on the curriculum that can cater better for the child's natural birthright to have fun during the process of growing up than physical education, and there are no facilities provided by the school that get fuller use or produce better results for the money spent. 61 It is a good sign to see schools not only developing stat teams, but also, making it possible for the ordinary boy or girl to play a properly organised game after school in or school colours. Thus third, fourth and fifth string team are turned out so that no longer is it true to say that only the gifted boy or girl gets recognition. This added enthuiasm brings added wear to the schools' playing fields, and ground staffs are to be complimented on the way they make it possiblc for play to continue almost unceasingly throughout the academic year. The Borough still lacks a heated swimming indoor bath which would enable swimming to continue all the year round If the evidence of the two Junior Schools that have installed their own teaching pools is considered, there will be a great pressure for swimming facilities, which should be rewarded. Last year East Wickham only 3 of the 80 leavers at 11 plus could not swim and at Fosters, where a pool functioned for the first time some 85% of the top class learned to swim. It is interesting to compare this with the national average of a once a week, ten week course in swimming which results in 30% learning to swim. Learnei pools are undoubtedly the answer to the problem of making every child a swimmer. Swimming is important to the blind and the spastic, and is perhaps the best 'family' sport of them all. Time and money spent on its furtherance is worth while and the two schools concerned with implementing their swim ming programme are to be congratulated on their result. This year opportunities have been provided for teachers to attend courses of instruction in Swimming. Life Saving. Dancing, Basketball, Rebound Tumbling. Canoeing and Olympic Gymnastics. These courses were well attended, and the teachers enthusiasms are reflected in an ever rising standard of performances in games and sports. There is a growing interest in the Duke of Edinburgh Award scheme in several secondary schools. This idea canalises the best desires of the young. They learn to face danger, endure some hardships, work at some skill until they are found worthy, and finally learn to serve their fellows in some capacity, so that they achieve strength and temper it with feelings of compassion. The guiding of the boys and girls through this rather complex series of skills. 62 training schemes and expeditions is not an easy task, and the scnools making the attempt are to be congratulated for taking on such an onerous duty. In this field, the work of the Bexleyheath Boys' Brigade has been of outstanding merit and the Company is to be complimented on its share of Palace honours. Canoeing and camping have progressed over the last year, and the K.E.C. Site at Foots Cray has been well used by Bexley Scouts and Boys' Brigade Companies. At this site there are. opportunities for simple canoeing and climbing as well as the more traditional forms of outdoor life. The new Bexley-Erith Technical School has become the venue for the Bexley Gymnastic Club. This club has expanded until it now has 150 boys and girls as well as a good number of adults and teachers practising Gymnastics every week. Two of its members, a boy and a girl, appropriately enough, are now Southern Area Gymnastic Champions. The club has definitely influenced the standard of gymnastics in the local schools, and stimulated intelligent competition, as well as providing a meeting place for teachers to study the more complex forms of apparatus work. This development has been of considerable importance, and the. Headmaster is to be thanked for his knowledgeable understanding of the place of gymnastics in and out of school. In the after school youth world there is a steady expansion of the programme to include the more unusual activities and some of the older historical skills are coming back, such as fencing and archery. Fencing in particular is a well coached and much practised local sport and the Schools and the Adult Centre produce some very fine fencers worthy of National recognition. Judo is another sport that attracts the school leaver but is handicapped for lack of instructors. It does seem that many of the clubs attempt to teach too many sports without adequate staff, causing first a decline in interest and later a wastage of equipment. It indicates that the formation of specialist clubs would give better service for less money than the general purpose organisation in the field of youth physical education. The Advisers wish to thank the physical education personnel of all the schools, for their fine efforts in and out of school during the past year, and the Borough Education Officer and his staff for his friendly co-operation and ready help and loyal support at all times. 63 SCHOOL HEALTH SERVICES. Statistical Tables. Part 1 — Medical Inspection of Pupils attending Main tained Primary and Secondary Schools. Table A. Periodic Medical Inspections. B. Pupils found to require treatment. C. Other Inspections. „ D. Infestation with Vermin. Part II — Return of Defects found by Medical Inspection. Table A. Periodic Inspections. „ B. Special Inspections. Part III — Treatment Tables. Table A. Eye Diseases, Defective Vision and Squint „ B. Diseases and Defects of Ear, Nose and Throat. C. Orthopaedic and Postural Defects. D. Diseases of the Skin. „ E. Other Treatment given. Part IV — Dental Inspection and Treatment including Orthodontics. Part V — Handicapped Children. 64 PART I. Medical Inspection of Pupils Attending Maintained and Assisted Primary and Secondary Schools. A.— Periodic Medical Inspections. Age Groups Inspected (By years of birth) Number of Pupils Inspected Physical Condition of Pupils Inspected Satisfactory Unsatisfactory No. % of Col. (2) No. % of Col. (2) (l) (2) (3) (4) (5) (6) 1958 & later 13 13 100 — — 1957 459 459 100 — — 1956 504 504 100 — — 1955 241 241 100 — — 1954 522 521 99.8 1 .2 1953 491 491 100 — 1952 192 192 100 — — 1951 565 564 99.8 1 .2 1950 918 916 99.8 2 .2 1949 334 334 100 — — 1948 144 144 100 — — 1947 & earlier 1564 1563 99.94 1 .06 Total 5947 5942 99.945 5 .065 65 B.— Pupils Found to Require Treatment at Periodical Medical Inspections. Age Groups Inspected (by year of birth) For defective vision (excluding squint) For any of the other conditions recorded in Part II Total individual pupils (1) (2) (3) (4) 1958 & later 1 1 1957 25 63 78 1956 48 71 94 1955 11 26 34 1954 59 68 110 1953 62 64 120 1952 20 29 46 1951 69 77 121 1950 159 149 255 1949 54 54 62 1948 42 47 73 1947 & earlier 279 235 443 Total 828 884 1437 C.— Other Inspections. Number of Special Inspections 1,676 Number of re-Inspections 1,847 Total 3,523 D.— Infestation with Vermin. (a) Total number of individual examinations of pupils in schools by school nurses or other authorised persons 2,285 (b) Total number of individual pupils found to be infested 2 (c) Number of individual pupils in respect of whom cleansing notices were issued (Section 54(2), Education Act, 1944) - <d) Number of individual pupils in respect of whom cleasing orders were issued (Section 54(3), Education Act, 1944) - 66 67 PART II. - Return of Defects Found Found by Medical Inspection in the Year Defect Code No. Defect or Disease A. PERIODIC INSPECTIONS B. SPECIAL INSPECTIONS Entrants Leavers Others TOTAL Requiring Treatment Requiring Observation Requiring Treatment Requiring Observation Requiring Treatment Requiring Observation Requiring Treatment Requiring Observation Requiring Treatment Requiring Observation 4. Skin 21 40 101 89 109 130 231 259 45 7 5. Eyes— a. Vision 68 74 254 69 412 186 734 329 44 17 b. Squint 16 11 8 10 44 39 68 60 2 - c. Other 5 7 25 30 64 48 94 85 4 13 6. Ears— a. Hearing 6 78 5 34 15 126 26 238 36 101 b. Ottis media 5 23 2 20 4 46 11 89 3 7 c. Other 11 18 17 9 67 41 95 68 4 1 7. Nose and Throat 25 234 14 76 35 360 74 670 45 23 8. Speech 8 38 1 1 6 9 63 18 117 13 11 9. Lymphatic Glands 3 152 38 3 258 6 448 — 3 10. Heart 2 12 1 25 3 59 6 96 6 26 11. Lungs 6 63 10 68 14 150 30 281 11 44 12. Developmental— a. Hernia 1 8 — 4 3 15 4 27 6 1 b. Other 1 40 3 15 12 95 1 6 150 4 25 13. Orthopaedic— a. Posture 2 17 15 51 50 134 67 202 - 4 b. Feet 13 69 11 63 53 185 77 317 20 5 c. Other 7 65 16 1 81 47 280 70 526 2 32 14. Nervous System— a. Epilepsy — 5 2 4 4 7 6 1 6 — 4 b. Other — 7 4 10 1 13 5 30 3 5 15. Psychological— a. Development — 16 — 15 — 69 — 100 34 73 b. Stability — 76 1 40 5 251 6 367 46 74 16. Abdomen 3 18 1 17 3 79 7 114 7 16 17. Other 5 34 23 100 33 178 61 312 70 78 PART III. A.— Eye Diseases, Defective Vision and Squint. Number of cases known to have been dealt with External and other, excluding errors of refraction and squint 94 Errors of refraction (including squint) 1,650 Total 1,744 Number of pupils for whom spectacles were prescribed 718 B.— Diseases and Defects of Ear, Nose and Throat. Number of cases known to have been dealt Received operative treatment (a) for diseases of the ear 2 (b) for adenoids and chronic tonsilitis 105 (c) for other nose and throat conditions 10 Received other forms of treatment 158 Total 275 Total number of pupils in schools who are known to have been provided with hearing aids (a) in 1962 1 (b) in previous years 22 C— Orthopaedic and Postural Defects. Number of cases known to have been treated (a) Pupils treated at clinics or out-patients departments 229 (b) Pupils treated at school for postural defects — Total 229 68 D.—Diseases of the Skin. Number of cases known to have been treated Ringworm—Scalp — Body — Scabies 1 Impetigo 1 Other skin diseases 58 Total 60 E.— Other Treatment Given. Number of cases known to have been dealt with (a) Pupils with minor ailments 479 (b) Pupils who received convalescent treatment under School Health Service arrangements — (c) Pupils who received B.C.G. vaccination 897 (d) Other than (a), (b) and (c) above — Total (a)—(d) 1,376 69 PART IV— Dental Inspection and Treatment (1) Number of pupils inspected by the Authority's Dental Officers— (a) Periodic inspections 9,564 (b) Specials 617 Total (1) 10,181 (2) Number found to require treatment 5735 (3) Number offered treatment 4,756 (4) Number actually treated 1,565 (5) Attendances made by pupils for treatment, including those recorded at heading 11(h) 6,422 below 5l (6) Half days devoted to: Inspection 951 Treatment Total 1,002 (7) Fillings: Permanent Teeth 3,896 Temporary Teeth 950 Total (7) 4,846 (8) Number of teeth filled: Permanent Teeth 3,337 Temporary Teeth 833 Total (8) 4,170 (9) Extractions: Permanent Teeth 252 Temporary Teeth 970 Total (9) 1,122 (10) Administration of general anaesthetics for 477 extraction (11) Orthodontics: (a) Cases commenced during the year 22 (b) Cases carried forward from previous year 86 (c) Cases completed during the year 14 (d) Cases discontinued during the year 20 (e) Pupils treated with appliances 20 (0 Removable appliances fitted 31 (g) Fixed appliances fitted - (h) Total attendances 392 „ (12) Number of pupils supplied with artificial dentures 8 (13) Other operations: Permanent Teeth 2,070 Temporary Teeth 1,234 70 Total (13) 3,304 PART V handicapped Pupils requiring Education at special Schools or boarding in Boarding Homes. (1) Blind (2) Partially sighted (3) Deaf (4) Partially Deaf (5) Physically Handicapped (6) Delicate (7) Maladjusted (8) E.S.N. (9) Epileptic U0) Speech Defects Total (1) to (10) (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) A. How many handicapped pupils were newly assessed as needing special educatinal tratment at special schools or in borading homes 1 — — 16 9 8 — — 34 B. (i) of the children included at A. how many were newly placed in special schools (other than hopistal special schools)or boarding homes — 1 — — 10 5 7 — — 23 (ii) of the children assessed prior to 1-1-1962, how many were newly placed in special schools (other than hospitalspecial schools) or boarding homes — — — — 10 3 2 — — 15 Total (B) — — 2 — — 36 17 17 — — 72 On or about 20-1-1963, how many hadicapped pupils from Authority's area : C. (i) were requiring places in special schools :- TOTAL (a) day palces — — — — 1 1 1 — — 3 (b) boarding places — — — — — 5 3 — — — 8 (ii) included at (i)who had reached the age of 5andwere awating: (a) day palces — — — — — — — — — — — (b) board places _ — — — — — — — (ii) included at (i)who had reached the age of 5, but whose parents had refused consent to their admission ot a special school, were awating: (a) day palces — — — — — — — — — — — (b) board places — — — — — — — — — — — 71  1 (1) Blind (2) Partially sighted (3) Deaf f4) Partially Deaf (5) Physically Handicapped (6) Delicate (7) Mai- adjusted (8) B.S.N. (9) Epileptic (10)Speech Defects Total (1) to (10) D. (i) were on the registers of: (i) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) 1. maintained special schools as: (a) day pupils — 5 4 4 5 — 1 36 — — 55 (b) boarding pupils — — 1 — 1 1 1 1 — — 5 2. non-maintained special schools as: (a) day pupils — — — — — — — — — — — (b) boarding pupils 2 — 3 3 5 11 4 5 — — 33 (ii) were on the registers of independent schools under arrangements made by the Authority — 1 1 13 1 — — 16 (iii) were boarded in homes and not already included under (i) or (ii) — — — — — — — — —- — — Total (D) 2 5 8 8 11 13 19 43 — — 109 E. On or about 20-1-1963, how many handicapped pupils (irrespective of the areas to which they belong) were being educated under arrangements made by the Authority in accordance with Section 56 of the Education Act, 1944: (i) In hospitals — — — — — — — — — — — (ii) In other groups (e.g. units for spastics, convalescent homes) — — — — — — — — — — — (iii) At home — — — — 3 3 — 1 — — — During the calendar year ended 31-12-62: (i) how many children were the subject of new decisions recorded under Section 57(4) of the Education Act, 1944 — — (ii) how many decisions were cancelled under Section 57A (2) , Education Act, 1944 — 4 72 INDEX. ITEM PAGE Health Committee 2 Public Health Staff 3 Foreword 4—7 STATISTICS AND SOCIAL CONDITIONS. Acreage 8 Population 8 New Houses Erected 8 Unemployment 8 Social Conditions and Amenities 8—9 Population Graph 10 Summary of Vital Statistics 11—12 Extracts from Vital Statistics— Births and Birth Rates 12—13 Stillbirths and Stillbirth Rates 13 Total Live and Still Births 13 Infant Deaths and Death Rates 14—15 Maternal Deaths 16 Death All causes 16—18 Causes of Death in Age Groups 19 GENERAL PROVISIONS OF HEALTH SERVICES. Isolation Hospital Accommodation 20 General Hospitals 20 Ambulance Facilities 20 National Assistance Act, 1948 20 Public Mortuary 20 Disinfection and Disinfestation Service 21 Laboratory Facilities 21 Registration of Nursing Homes 21 SANITARY CIRCUMSTANCES OF THE BOROUGH. Adoptive Acts and Byelaws 22 Water Supply 23 Drainage and Sewerage 23 Rivers and Streams 23 Chief Public Health Inspector's Report— Tables of Inspections and Improvements, etc. 25—26 Food Inspection 27 Tables—Factories Act, 1937 and 1948 28 Public Cleansing Service 29 Refuse Collection and Disposal 29 Salvage 29 Kitchen Waste 30 Public Conveniences 30 Atmospheric Pollution 31—32 Clean Air Act, 1956 Smoke Control Area 32 Prevention of Damage by Pests Act, 1949 32—33 Pet Animals Act, 1951 33 Shops Act, 1950 33 Swimming Pool 34 Verminous Premises 34 Wasp Destruction 34 Schools 34 73 ITEM PAGE HOUSING. 35 Council Estates 36 Inspection of Dwelling Houses 36 Remedy of Defects without formal notice 36 Action under Statutory Powers 37 Improvement Grants 37 Rent Act, 1957 INSPECTION AND SUPERVISION OF FOOD. 38 Milk Supply 38 Slaughterhouses 39—40 Adulteration of Food— Food & Drugs Act, 1955 40 Food Shops and Food Manufacturing Premises 41 Food Hygiene Regulations, 1960 41 Registration of Premises PREVALENCE AND CONTROL OVER INFECTIOUS AND OTHER DISEASE. 42 Scarlet Fever 42 . Diphtheria 43-44 Diphtheria and Whooping Cough Immunisation, Smallpox and Poliomyelitis Vaccination 44 Typhoid Fever and Para Typhoid Fever 44 Puerperal Pyrexia 44 Ophthalmia Neonatorum 44 Measles 44 Whooping Cough 44 Acute Poliomyelitis 44 Scabies 44 Food Poisoning 44 Malaria 44 Dysentery 45 Tables of Infectious Diseases Notified 45 Tuberculosis SCHOOL HEALTH SERVICES REPORT, 1961. Welfare and School Attendance Sub-Committee 48 Staff 48-49 Foreword 50-52 Schools 53 Clinics 53-54 Co-ordination— Periodic Medical Inspections 55 School Meals Service 55-56 School Dental Service 56-57 Orthopæsdic Clinic 57 Ophthalmic Clinic 57-58 Child Guidance Clinic 58 Sweep Frequency Pure Tone Audiometry 59 Speech Therapy 59-60 Cleanliness Inspections 60 Physical Education 61-63 Statistical Tables 64-72 74