??? BEX 27 BOROUGH OF BEXLEY ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH For the Year 1964 JOHN LANDON, M.R.C.S., L.R.C.P., D.P.H., Medical Officer of Health 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 present the Annual Report for 1964. Owing to the coming into operation of the London Government Act, 1963 and the creation of the London Borough of Bexley on April 1st, 1965, the usual form of presentation has had to he modified, the contents being largely statistical and intended to preserve continuity with previous reports. My thanks are due to the Members of the Authority and Staff of the Department for their unfailing help and encouragement over the years. I am, Your obedient servant, JOHN LANDON, Medical Officer of Health. section a. - statistics and social conditions of the borough area. 4,869 acres POPULATION. NEW DWELLINGS ERECTED Registrar General's Houses 393 Estimate midyear, 90,160 Number of inhabited houses at the end of 1964 (according to Rate Books) approximately 29,422 Rateable Value £3,729,136 Sum represented by a penny rate £15,300 UNEMPLOYMENT. Men Women Boys Girls Total December 31st, 1963 234 68 17 9 328 December 31st, 1964 156 30 9 2 197 SUMMARY OF VITAL STATISTICS England and Wales Borough of Bexley Rates per 1,000 Home Population BIRTHS:- Live 18.4 16.43 Still 0.31 0.29 16.4(a) 17.25(a) DEATHS:- All Causes 11.3 9.86 Typhoid and Paratyphoid 0.00 – Whooping Cough 0.00 - Diphtheria - - Tuberculosis 0.05 0.02 Influenza 0.02 0.01 Smallpox - - Acute Poliomyelitis (including Polio-encephalitis) 0.00 Pneumonia 0.63 0.72 NOTIFICATIONS (corrected) Typhoid Fever 0.00 0.01 Paratyphoid Fever 0.00 - Meningococcal Infection 0.01 0.01 Scarlet Fever 0.42 0.68 Whooping Cough 0.67 0.60 Diphtheria 0.00 - Erysipelas 0.04 0.03 Smallpox - - Neasles 6.47 4.92 Pneumonia 0.19 0.03 Acute Poliomyelitis (including Polioencephalitis) Paralytic 0.00 - Non-Paralytic 0.00 - Food Poisoning 0.11 0.01 Puerperal Pyrexia 6.67(a) 7.96(a) Rates per 1,000 Live Births DEATHS:- All causes under one year of age 20.0 12.83 Enteritis and Diarrhoae under two years of age 0.57 - (a) Per 1,000 Total (Live and Still) Births A dash ( - ) signifies that there were no deaths or notifications MATERNAL MORTALITY England and Wales Borough of Bexley Rates per 1,000 total live and still birth3 Maternal causes, excluding abortion 0.20 0.66 Due to abortion 0.06 - Total maternal mortality 0.25 0.66 EXTRACTS FROM VITAL STATISTICS FOR THE YEAR 1964 The Registrar General's Estimate of home population for the mid-year is 90,160 and this figure is assigned for the purpose of calculation of all rates. BIRTHS. Males Females Total Live Births - Total 772 709 1481 Legitimate 727 678 1405 Illegitimate 45 31 76 BIRTH RATE. Rate per 1,000 estimated home population 15.32 Rate per 1,000 for England & Wales 18.4 The Registrar-General has supplied a comparability factor for 1964. The standardised birth rate which allows for comparison with other parts of the country is 15.78 76 illegitimate live births were registered against 54 in 1963 giving a percentage of 5.13 of total live births. STILLBIRTHS. Males Females Total Total 11 15 26 Rate per 1,000 total (live and still) births 17.25 26 Stillbirths were registered during the year. This represents a rate of 0.29 per 1,000 population against 0.23 per 1,000 population in 1963. Rate per 1,000 for England and Wales 1964 0.31 There was one Stillbirth registered as illegitimate. Males Females Total Total Live and Stillbirths 783 724 1,507 INFANT MORTALITY, 1964 DEATHS FROM STATED CAUSES AT VARIOUS AGES UNDER 1 YEAR OF AGE These relate to deaths occurring in 1964 but not necessarily registered in that year. Causes of Death as Certified DAYS MONTHS 0- l- 2- 5- 4- 5- 6- 7- 14- 21- 28- 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- 12- Congenital Malformation 1 - - l - - - l - - - - - - - - - - - - - - Prematurity 4 - 2 - - - - - - - - - - - - - - - - - - - Broncho Pneumonia - - - - - - - - 1 - - 1 - - - - - - - - - - Pyelocystitis - - - - - - - 1 - - - - - - - - - - - - - - Encephalitis - - - - - - - - - - - - 1 - - - - - - - - - Acute Capillary Bronchitis - - - - - - - - - - - - 1 - - - - - - - - - Asphyxia 4 1 - - - - - - - - - - - - - - - - - - - - TOTALS 9 l 2 1 - - - 2 1 - - 1 2 - - - - - - - - - The number of infants under one year of age who died during the year 1964 as shown by the table is 19. 16 of these deaths, that is 88 per cent, occurred in the neonatal period (within one month of birth). In 1963 the corresponding figure was 77 Per cent. INFANT DEATHS. Males Females  Deaths of Infants under one year of age 11 8 19 Legitimate 11 8 19 Illegitimate - - - Death rate of Infants under one year of age: Total per 1,000 live births 12.83 Legitimate per 1,000 legitimate live births 13.52 Illegitimate per 1,000 illegitimate live births - Neo- natal Deaths per 1,000 live births 10.13 Early Neo- natal Deaths 8.78 Perinatal Deaths 25.88 MATERNAL DEATHS. There was one maternal death during the year . Number of women dying in, or in consequence of childbirth: From Puerperal and Post Abortive Sepsis - From other Puerperal causes 1 Death rate per 1,000 total (Live and Still)births 0.66 DEATHS ALL CAUSES. Males i Females Total All Causes 479 410 889 Death rate per 1,000 of estimated home population 9.86 Deaths from Measles (all ages) - - - Deaths from Whooping Cough (all ages) - - - Deaths from Enteritis (under 2 years of age) - - - Deaths from Cancer (all ages) 120 96 216 Death rate per 1,000 for England and Wales, 1964 11.3 The rate for Bexley compares favourably with that for England and Wales. The Registrar-General has supplied a comparability factor for 1964. The standardised death rate which allows for comparison with other parts of the country is 11.34 CAUSES OF DEATH IN THE BOROUGH REGISTERED DURING THE YEAR 1964 CAUSES OF DEATH. Male Female Total All Causes 479 410 889 1. Tuberculosis, respiratory 2 _ 2 2. Tuberculosi s, other - - - 3. Syphilitic disease 3 1 4 4. Diphtheria - - - 5. Whooping Cough - - 6. Meningococcal infections - - - 7. Acute poliomyelitis - - - 8. Measles - - - 9. Other infective and parasitic diseases - - - 10. Malignant neoplasm, stomach 18 13 31 11. Malignant neoplasm, lung, bronchus 47 9 56 12. Malignant neoplasm, breast - 27 27 13. Malignant neoplasm, uterus - 5 5 14. Other malignant and lymphatic neoplasms 55 42 97 15. Leukaemia, aleukaemia 2 1 3 16. Diabetes 2 1 3 17. Vascular lesions of nervous system 37 52 89 18. Coronary disease, angina 128 80 208 19. Hypertension with heart disease 9 14 23 20. Other heart disease 26 43 69 21. Other circulatory disease 26 21 47 22. Influenza - 1 1 23. Pneumonia 28 37 65 24. Bronchitis 31 7 38 25. Other diseases of the respiratory system 5 3 8 26. Ulcer of stomach and duodenum 3 3 6 27. Gastritis, enteritis, and diarrhoea 2 1 3 28. Nephritis and nephrosis 2 2 4 29. Hyperplasia of prostate 2 - 2 30. Pregnancy, childbirth, abortion - 1 1 31. Congenital malformations 4 3 7 32. Other defined and ill-defined diseases 25 33 58 33. Motor vehicle accidents 12 l 13 34. All other accidents 6 5 11 35. Suicide 4 4 8 36. Homicide and operations of war - - - DEATH REGISTERED (IN AGE GROUPS) IN 1964 CAUSE OF DEATH Total All Ages. Under 4 weeks 4 weeks & under one yr. AGE IN Y E A RS 1 - 5 - 15- 25 - 35 - 45 - 55 - 65 - 75 & ove. M. F. M F M F M F M F M F M F M F M F M F M F M F 1. Tuberculosis, respiratory 2 - - - - - - - - - - - - - 1 - - - 1 - - - - - 2. Tuberculosis, other - - - - - - - - - - - - - - - - - - - - - - - - 3. Syphilitic disease 3 1 - - - - - - - - - - - - - _ - - 1 - 2 - - 1 4. Diphtheria - - - - - - - - - - - - - - - - - - - - - - - - 5. Whooping Cough - - - - - - - - - - - - - - - - - - - - - - - - 6. Meningococcal infections - - - - - - - - - - - - - - - - - - - - - - - - 7. Acute poliomyelitis - - - - - - - - - - - - - - - - - - - - - - - - 8. Measles - - - - - - - - - - - - - - - - - - - - - - - - 9. Other infective & parasitic diseases - - - - - - - - - - - - - - - - - - - - - - - - 10.Malignant neoplasm, stomach 18 13 - - - - - - - - - - - - - - 1 - 6 4 6 3 5 6 11.Malignant neoplasm, Lung, Bronchus 47 9 - - - - - - - - - - 1 - - - 4 1 19 4 16 3 7 1 12.Malignant neoplasm, Breast - 27 - - - - - - - - - - - l - 2 - 4 - 9 - 9 - 2 13.Malignant neoplasm, Uterus - 5 - - - - - - - - - - - - - - - 1 - 2 - 1 - 1 14.0ther malignant and lymphatic neoplasms 55 42 - - - - - 1 - - 1 - - 2 1 1 7 9 13 8 19 7 14 14 15.leukaemia, aleukaemia 2 1 - - - - - - - - - - - - - - 2 - - - - 1 - - 16.Diabetes 2 1 - - - - - - - - - - - - - - 1 1 - - 1 - - - 17.Vascular lesions of nervous system 37 52 - - - - - - - - - - - - - - - 2 8 6 12 9 17 35 18.Coronary disease, Angina 128 80 - - - - - - - - - - - - 4 - 13 4 41 4 36 24 34 48 19.Hypertension with heart disease 9 14 - - - - - - - - - - - - - - - - 2 - 2 5 5 9 20.Other heart disease 26 43 - - - - - - - - - - - - 1 - 1 2 2 2 7 12 15 27 21.Other circulatory disease 26 21 - - - - - - - - - - 1 - - - 1 2 7 2 9 1 8 16 22.Influenza - 1 - - - - - - - - - - - - - - - - - - - - - 1 23.Pneumonia 28 37 1 - 1 1 - - - - - - - - - - 1 1 5 - 6 8 14 27 24.Bronchitis 31 7 - - - - - 1 - - - - - - - - - - 7 - 17 2 7 4 25.Other dieases of respiratory system 5 3 - - - - - - - - - - - - - - 1 - 1 - 1 2 2 1 26.Ulcer of stomach and duodendum 3 3 - - - - - - - - - - - - - - - - - 1 3 1 - - 27.Gastritis, Enteritis and Diarrhoea 2 1 - - - - - - - - - - - - - - 1 - l - - 1 - - 28.Nephritis and nephrosis 2 2 - - - - - - - - - - 1 - - - - - 1 - - 1 - 1 29.Hyperplasia of Prostate 2 - - - - - - - - - - - - - - - - - - - - - 1 - 30.Pregnancy, Childbirth, Abortion - 1 - - - - - - - - - - - - - - - 1 - - - - - - 31.Congenital malformations 4 3 1 2 - - 1 - - - - - - - - 1 1 - l - - - - - 32.Other defined and ill-defined diseases 25 33 7 4 1 1 - - - 1 1 1 - 1 - - 1 3 l 1 9 4 5 17 33.Motor vehicle accidents 12 1 - - - - - - 1 - 3 - 1 - 2 - 1 - 3 - - - 1 1 34.All other accidents 6 5 - - - - - - 1 - - - - - - - 1 1 2 1 1 1 1 2 35.Suicide 4 4 - - - - - - - - - - - - - - - 2 2 2 - - 2 - 36.Homicide and operations of war - - - - - - - - - - - - - - - - - - - - - - - - TOTAL ALL CAUSES 479 410 9 6 2 2 1 2 2 1 5 1 4 4 9 5 37 34 124 46 148 95 138 214 SECTION B. GENERAL PROVISION OP HEALTH SERVICES FOR THE BOROUGH NATIONAL ASSISTANCE ACT, 1948 Action taken under Section 47. During the year a number of cases of elderly persons not receiving proper care and attention (reported to the department) were visited. It was necessary for action to be taken under the Act for removal of one person to hospital. Action taken under Section 50. It was not necessary to arrange for any burial under this Section during the year. 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 36 Total 36 No. of Homes first registered during year - No. of patients provided for:- Maternity - Others - Total - No. of Homes on the Register at end of year 2 No. of patients provided for:- Maternity — Others 36 Total 36 SECTION C. SANITARY CIRCUMSTANCES OF THE BOROUGH. 1. (i) Water Supply. The water supply 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 plumbo-solvent action. No new sources of piped water supply were instituted in the Borough of Bexley during 1964, but 1178 yards of new service mains were laid. During the year 6 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. New drainage and sewage works were carried out during the year as follows: East Welling Surface Water Scheme - In progress. Comprises length of concrete culvert in Danson Park and continues in 63"-42" pipe line via Danson Lane, Roseacre Road, Park View and Gipsy Roads (a completed distance of 1,830 1 in.yd) and involved thrust boring under Railway, relaying 200 lin. yd. of foul sewer, manholes and incidentals. Danson Road to River Shuttle Surface Water Outfall - In progress The clearance, excavation and regrading of existing water course. The construction of brick and reinforced concrete culverts and the thrust boring of 72" concrete pipe under the A.2., a completed distance of 1,450 lin. yd., including reinstatements and renewals to private properties. Gravel Hill Improvement - In progress 830 lin. yds. of pipes varying from 45" to 24" in dia. have been laid in the surface water sewer. 300 lin yds. of 12" pipes have been laid in the foul sewer. Wansunt Road Surface Water Outfall - Completed A 24" and 21" concrete pipe line extending from Wansunt Road via Heath Road (made up) to watercourse bounding Mr. Maybanks farm. Length 420 lin. yds. including manholes. Wansunt Road and Heath P.S.W.Surface Water Drainage - Completed. All pipe lines varying from 21" to 9" have been laid for a length of 650 lin. yds. including manholes and guliey connections. Yew Tree Close Surface Water Drainage - Completed The pipe lines comprised 130 lin. yds. of 24" and 85 lin. yds. of 9" together with manholes. I am indebted to the Chief Public Health Inspector for the following report: table no. 1. DETAILS OF INSPECTION WORK CARRIED OUT Inspections. Re-inspections Houses inspected (all particulars recorded) 17 173 Houses inspected (defects only records) 142 389 Houses inspected (certificates of disrepair) Houses inspected (improvement grants) 32 - Houses inspected (Housing Act, 1936, Overcrowding) 4 2 Houses inspected re Infectious Disease (including scabies) 844 266 Factories with mechanical power 96 19 Factories Without Mechanical power 3 - Outworkers' premises 33 3 Other premises under the Act 1 - Bakehouses 51 42 Water Samples 24 1 Food and Drugs Act Samples 123 1 Dairies and distributors 23 1 Ice Cream premises 185 2 Restaurants, etc, 218 99 Fish premises 84 47 Meat Shops 296 127 Public Houses 68 23 Shops re unsound food 339 54 Other premises where food is prepared 1589 267 Offensive accumulations 72 133 Stables 12 4 Keeping of Animals 45 17 Rats 173 100 Drains inspected 633 360 Drains tested (water, smoke or colour) 87 - Dustbins 1 2 Verminous premises 41 51 Smoke observations 6 6 Tents, Vans and Sheds 30 92 Refuse Tips 145 - Refuse Removal and Salvage 387 9 Conveniences 67 32 Pet Animals Act, 1951 26 7 Council House Applicants 158 10 Shops Act, 1950 558 2 Employment of Young Persons Act, 1938 - 2 National Assistance Act, 1948 - Sec.47 9 6 Miscellaneous inspections 437 13 Clean Air Act, 1956. Smoke Control Areas 537 179 Clean Air Act (Other than Smoke Control Areas) 6 1 Rent Act 20 45 Noise Abatement Act 26 58 Offices, Shops ana Railway Premises 151 22 Boarding of Animals Act 8 5 Housing Act 1961. (Houses let in multiple occupation) 3 9 Litter Act. 1 - Glenmore Road Surface Water Outfall - Completed. The work consisted of regrading and diverting part of the old watercourse into a 42" concrete pipe line for a distance of 210 lin. yds. Crook Log and Devonshire Road Renewal of Foul Sewer (section) - Completed The work was carried out exclusively in tunnel and involved laying 27" and 24" pipes for a length of 240 lin. yds. with new manholes, tunnelling shafts and marrying in to existing sewer. Northdown Road Renewal of Surface Water Sewer (section) - Completed. The work involved taking up and renewing a length of 43 lin. yds. of 42" pipe mainly situated on private premises. Wates Estate Section II Surface Water Drainage - Completed The provision of 1,607 lin. yds. of pipeline varying from 15" to 7" in diameter with manholes, gullies and alterations to soil sewer connections. The new sewer replaces existing soakaway system. Bourne Road Surface Water Sewer - Completed Number of cesspooles emptied 9 The total number of emptyings 18 TABLE No.3. POOD INSPECTION. The following is a summary of unsound food surrendered and destroyed: Corned Beef • • • • • • lbs 179¾ Cooked Ham • • • • • • „ 326½ Veal • • • • • • „ 5½ Beef • • • • • • „ 999½ Pork • • • • • • „ 572 Lamb • • • • • • „ 1006¼ Poultry • • • • • • „ 179¾ Offal • • • • • • „ 506½ Bacon • • • • • • „ 59 Rabbit • • • • • • „ 60 Fish • • • • • • „ 238 Sausages • • • • • • „ 8 Flour • • • • • • „ 30 Fats • • • • • • „ 60 Sugar • • • • • • „ 280 Fruit and Fruit juices • • • • • • tins 256 Vegetables • • • • • • „ 136 Meat • • • • • • „ 77 Fish • • • • • • „ 25 Milk • • • • • • „ 29 Soups • • • • • • „ 14 Cream • • • • • • „ 4 Preserves • • • • • • „ 4 Preserves • • • • • • jars 37 Biscuits • • • • • • pkts 26 Frozen Foods • • • • • • „ 5486 Frozen Foods • • • • • • lbs 2062½ Miscellaneous items • • • • • • 18 TABLE No.2. IMPROVEMENTS EFFECTED AND DEFECTIVE SANITARY CONDITIONS REMEDIED HOUSES:- No. Provided with sufficient w.c. accommodation 1 Provided with sufficient ashplace accomodation – Provided with sufficient water supply 16 HOUSES IMPROVED INTERNALLY:- Walls and ceilings repaired 121 Dampness in rooms remedied 45 Defective floors repaired 21 Ventilation of Rooms improved 32 Windows repaired 61 Stoves, fireplaces, etc. provided or repaired 1 HOUSES IMPROVED EXTERNALLY:- Roofs repaired 22 Eaves gutters and down spouts fixed or repaired 40 Yards paved or repaired 2 Chimney stacks repaired 13 Walls repointed or repaired 29 Miscellaneous repairs 23 DRAINAGE:- Drains cleansed or repaired 591 New drains constructed 3 New gullies provided – Ventilation of drainage system improved 4 Inspection chambers built or repaired 10 Waste pipes provided or repaired 2 New sinks provided 2 Offensive accumulations removed – Nuisances from animals abated – Other nuisances abated 2 TABLE No. 4. factories act, 137 and 1948 1. INSPECTIONS FOR PURPOSES OF PROVISIONS AS TO HEALTH, INCLUDING INSPECTIONS MADE BY PUBLIC HEALTH INSPECTORS. Premises Number of: Inspections . Written Notices Prosecutions . 1 2 3 4 Factories without mechanical power 3 – – Factories with mechanical power 347 3 – *Other Premises under the Act (including works of building and engineering construction but not including outworkers' premises) *Electrical Stations should be reckoned as factories. 1 – – Total 151 3 – 2. DEFECTS FOUND. Particulars Number of defects Found Remedied Keferred to H.m. Inspector. Number of Prosecutions . 1 2 3 4 5 Want of cleanliness(S.1) 2 2 – – Overcrowding Unreasonable temperature(s.3) Inadequate ventilation(S.4) Ineffective drainage of floors (S.6) Sanitary Conveniences (s.7) Insufficient 3 3 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) TOTAL 7 7 – – 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. CLEAN AIR ACT. 1956 - SMOKE.CONTROL AREAS The Borough of Bexley (No.l.) Smoke Control Order, 1962, came into operation on the 1st October, 1963. During 1964 a survey of the second area was continued. PREVENTION OF DAMAGE BY PESTS ACT. 1949 Details of surface infestations dealt with during the year are set out below :- Number of Properties inspected 765 Number of Inspections 2126. Number of Infestations found - Rats Major - Minor 224 Mice 49 Number of Properties Treated Rats Mice Local Authority's premises • • • 2 1 Dwelling Houses • • • 204 32 Business Premises • • • 18 16 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 There were approximately 800 shops on the. Council's Register at the end of the year. During the year, 558 inspections were made under the Shops Act, 1950, and no legal proceedings were instituted. SECTION D - HOUSING. 1. Inspection of Dwelling Houses during the year. (l) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 159 (b) Number of inspections made for the purpose (including re-inspection) 721 (2) Number of dwelling houses to be in a state so dangerous or injurious to health as to be unfit for human habitation 17 (3) Number of dwelling houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 142 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 10 (b) By local authority in default of owners 1 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 1 C. Proceedings under Sections 16 and 17 of Housing Act, 1957 - (l) Number of dwelling houses in respect of which Demolition Orders were made 11 (2) Number of dwelling houses demolished in pursuance of Demolition Orders 11 (3) Number of houses in respect of which Closing Orders were made 2 D. Proceedings under Section 18 of the Housing Act, 1957 - parts of buildings closed — IMPROVEMENT GRANTS Discretionary Standard Number of applicants for improvement grants 7 34 Total amount of grants made £1,505.18.4 £3,009.18.7 SECTION E. - INSPECTION AND SUPERVISION 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 • • • 29 No. of Distributors from outside area • • • 7 Licences granted by the Council under the Milk (Special Designation) Regulations, 1960:- Dealers' Licences:- Pasteurised Milk • • • 34 Tuberculin Tested Milk • • • 36 Sterilised Milk • • • 39 21 samples of milk were forwarded to the Public Health Laboratory for the Methylene Blue and Phosphatase Tests. All were satisfactory, (b) ADULTERATION OF FOOD. FOOD AX IT DRUGS ACT, 1955. 139 samples were taken during the year. THE FOOD HYGIENE (GENERAL) REGULATIONS, 1960 During the year further improvememts were carried out at food shops and generally speaking co-operation of food traders was satisfactory. 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 • • • 168 Preparation of Sausages, etc. • • • 52 31 samples of Ice Cream were submitted for examination under the Ice Cream (Heat Treatment) Regulations, 1947. Two were unsatisfactory. SECTION F. - PREVALENCE OF AND CONTROL OVER INFECTIOUS DISEh.SE AND OTHER DISEASES IMMUNIZATION The following table shows the diphtheria immunisation and whooping cough immunisation figure for 1963 based on the returns submitted to the Ministry of Health. Year of Birth. Diphtheria Immunisation (Singly or in combination) Whooping Cough Immunisation (Sihgly or in combination) Primary Reinforcing Primary 1964 725 – 724 1963 720 11 710 1962 32 683 32 1961 12 240 11 1960 3 100 3 1955-1959 7 888 4 1950-1954 – 7 – TOTAL 1,499 1,929 1,484 POLIOMYELITIS VACCINATION. The following table shows the number of injections given in the various groups during the year ended 31st December, 1964 Year of birth 3rd and 4th Dose (Salk and Oral). 3 Orals (Complete course) 1964 1 296 1963 15 1061 1962 18 112 1961 2 55 1949 - 1960 1376 98 1933 - 1948 356 27 Others 2 26 TOTAL 1,770 1,675 SMALLPOX VACCINATION The following table shows the smallpox vaccination figures for 1964 based on the return submitted to the Ministry of Health. Primary Vaccination 1 year Re-vaccination School Age but under 8 years 996 – The following table gives the particulars concerning the cases of Infectious Diseases (other than Tuberculosis) notified in the area daring the year. NOTIFIABLE DISEASES (Other than Tuberculosis) DURING THE YEAR 1964 Total Cases Notified Under 1 1 2 3 4 5 to 9 10 to 14 15 to 24 25 and over Cases Admitted to hospital Total Deaths Scarlet Fever 61 – – 2 4 8 41 4 1 1 – – Puerperal Pyrexia 12 – – – – – – – 8 4 12 – Pneumonia 3 – – – – 1 – – – 2 – – Irysipelas 3 _ – – – – – – – 3 – – Iood Poisoning 1 – – _ – – 1 – – – – – Iysentery 17 1 1 1 – 1 4 l 1 7 – – Typhoid Fever 1 – – – – – – – 1 – 1 – Meningococcal Infection 1 1 – – – – – – – – 1 – Measles 444 9 43 52 58 70 198 9 5 – – – Whooping Cough 54 5 7 9 8 5 18 1 – 1 – – Scabies 2 – – 1 – – – – – 1 – – TOTALS 599 16 51 65 70 85 262 15 16 19 14 – TUBERCULOSIS During the year 25 new cases were notified. Particulars relating to the same, and also to the deaths which occurred during 1964 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 1 - - - - - - - 15-24 1 1 - - - - - - 25-44 5 4 - 4 1 - - - 45 - 64 6 1 - - 1 - - - 65 and over 1 3 - - - - - - TOTALS 12 9 - 4 2 - - - . BOROUGH OF BEXLEY COMMITTEE FOR EDUCATION ANNUAL REPORT ON THE SCHOOL HEALTH SERVICES FOR 1964 JOHN LANDON, M.R.C.S., L.R.C.P., D.P.H., MEDICAL OFFICER OF HEALTH . PART 1. MEDICAL INSPECTION OF PUPILS ATTENDING MAINTAINED AND ASSISTED PRIMARY & SECONDARY SCHOOLS . A. PERIODIC MEDICAL INSPECTIONS Age Groups Inspected (By years of birth). No. of pupils inspected. Physical condition of pupils inspected. SATISFACTORY UNSATISFACTORY No. % of Col.2 No. % of Col.2 (1) (2) (3) (4) (5) (6) I960 and later 84 83 98.8% 1 1.2% 1959 548 546 99.6% 2 .4% 1958 645 639 99.1% 6 .9% 1957 326 325 99.7% 1 .3% 1956 514 514 100% - - 1955 429 429 100% - - 1954 150 150 100% - - 1953 483 483 100% - - 1952 379 379 100% - - 1951 102 102 100% - _ 1950 85 85 100% - - 1949 and earlier 712 710 99.7% 2 .3% TOTAL 4457 4445 99.7% 12 .3% B. - Pupils Found to Require Treatment at Periodic Medical Inspections Age groups Inspected (by year of birth) (1) For defective vision (excluding squint) (2) For any of the other conditions recorded in Part II (3) Total individual pupils (4) 1960 and later - 5 5 1959 41 78 107 1958 71 89 142 1957 24 30 50 1956 42 46 79 1955 36 40 67 1954 11 13 24 1953 57 54 97 1952 45 47 81 1951 12 10 17 1950 11 14 22 1949 and earlier 107 79 156 Total 457 505 847 C. - Other Inspections Number of Special Inspections 1,518 Number of re-Inspections 1,703 Total 3,221 D. - Infestation with Vermin (a) Total number of individual examinations of pupils in school by school nurses or other authorised persons 2,790 (b) Total number of individual pupils found to be infested 13 (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 cleansing orders were issued (Section 54(3), Education Act, 1944) PART II - Return of Defects Found by Medical Inspection in the Year A.- PERIODIC INSPECTIONS Defect Code No. (1) Defect or Disease (2) PERIODIC INSPECTIONS ENTRANTS LEAVERS OTHERS TOTAL (T) (3) (O) (4) (T) (5) (O) (6) (T) (7) (O) (8) (T) (9) (O)* (10) 4 Skin 26 69 37 54 59 113 122 256 5 Eyes - a. Vision 110 154 102 33 218 189 430 376 b. Squint 37 31 7 8 31 29 75 68 c. Other 8 2 6 9 19 23 33 14 6 Ears - a. Hearing 23 93 2 17 17 81 42 191 b. Otitis Media 7 65 - 11 7 49 14 125 c. Other 12 18 7 1 14 20 33 39 7 Nose and Throat 22 327 3 64 16 341 41 732 8 Speech 9 62 — 5 6 37 15 104 9 Lymphatic Glands 2 258 — 22 — 205 2 485 10 Heart — 31 1 18 4 53 5 102 11 Lungs 21 83 — 23 8 109 29 215 12 Developmental a. Hernia 4 26 — — 2 19 6 45 b. Other — 55 1 9 12 78 13 142 13 Orthopaedic - a. Posture 2 35 2 30 16 116 20 181 b. Feet 27 91 1 25 39 222 67 338 c. Other 8 64 7 87 20 140 35 291 14 Nervous System - a. Epilepsy 3 10 1 3 2 11 6 24 b. Other 1 7 — 1 — 12 1 20 15 Psychological - a. Development 1 55 — 11 — 80 1 146 b. Stability 2 111 4 28 2 237 8 376 16 Abdomen 1 13 — 7 1 44 2 64 17 Other 8 23 4 49 14 107 26 179 * (T) - Requiring Treatment (0) - Requiring Observation PART II. - Return of Defects Found by Medical Inspection in the Year A.-SPECIAL INSPECTIONS Defect Code No. (1) Defects or Disease (2) SPECIAL INSPECTIONS Pupils 'requiring Treatment (3) Pupils requiring Observation (4) 4 Skin 20 14 5 Eyes - a. Vision b. Squint 37 2 31 c. Other 7 4 6 Ears - a. Hearing 27 57 b. Otitis Media 2 2 c. Other 5 2 7 Nose and Throat 41 52 8 Speech 6 8 9 Lymphatic Glands 2 — 10 Heart 3 27 11 Lungs 6 35 12 Developmental - a. Hernia 1 3 b. Other 1 16 13 Orthopaedic - a. Posture 3 15 b. Feet 3 8 c. Other 11 35 14 Nervous System - a. Epilepsy l 9 b. Other 4 1 15 Psychological - a. Development 31 66 b. Stability 24 70 16 Abdomen 5 8 17 Other 33 93 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 249 Errors of refraction (including squint) 1,550 Total 1,799 Number of pupils for whom spectacles were prescribed 635 B. - Diseases and Defects of Ear, Nose and Throat Number of cases known to have been dealt with Received operative treatment (a) for diseases of the ear 2 (b) for adenoids and chronic tonsilitis 126 (c) for other nose and throat conditions 5 Received other forms of treatment 129 Total 262 Total number of pupils in schools who are known to have been provided with hearing aids (a) in 1964 2 (b) in previous years 25 C. - Orthopaedic and Postural Defects Number of cases known to have been treated (a) Pupils treated at clinics or out-patients departments 177 (b) Pupils treated at school for postural defects - Total 177 D. - Diseases of the Skin Number of cases known to have been treated Ringworm - Scalp - Body - Scabies - Impetigo - Other skin diseases 69 Total 69 E. - Other Treatment Given Number of cases known to have been dealt with (a) Pupils with minor ailments 511 (b) Pupils who received convalescent treatment under School Health Service Arrangements – (c) Pupils who received B. C. G. vaccination 787 (d) Other than (a), (b) and (c) above - Total 1,298 PART IV - Dental Inspection and Treatment (l) Number of pupils inspected by the Authority's Dental Officers - (a) Periodic inspections 7,063 (b) Specials 555 Total (1) 7,618 (2) Number found to require treatment 4,437 (3) Number offered treatment 3,543 (4) Number actually treated 1,277 (5) Attendances made by pupils for treatment, including those recorded at heading 11(h) below 5,666 (6) Half days devoted to: Inspection 46 Treatment 1,061 Total (6) 1,107 (7) Fillings: Permanent Teeth 3,430 Temporary Teeth 917 Total (7) 4,347 (8) Number of teeth filled: Permanent Teeth 3,019 Temporary Teeth 836 Total (8) 3,855 (9) Extractions: Permanent Teeth 189 Temporary Teeth 515 Total (9) 704 (10) Administration of general anaesthetics for extraction 288 (ll) Orthodontics: (a) Cases commenced during the year 44 (b) Cases carried forward from previous year 51 (c) Cases completed during the year 16 (d) Cases discontinued during the year 21 (e) Pupils treated with appliances 61 (f) Removable appliances fitted 65 (g) Fixed appliances fitted 9 (h) Total attendances 664 (12) Number of pupils supplied with artificial dentures 13 PAST V. Handicapped Pupils requiring Education at Special Schools or boarding in Boarding Homes Blind Partially sighted Deaf Partially deaf Physically Handicapped. Delicate Maladjusted E.S.N. Epileptic Speech Defects TOTAL (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) A. How many handicapped pupils were newly assessed as needing special educational treatment at special schools or in boarding homes 1 1 2 1 9 4 6 19 – – 43 B. (i) of the children included at A, how many were newly placed in special schools (other than hospital special schools) or boarding homes – 2 1 1 7 2 2 11 – – 26 (ii) of the children assessed prior to 1.1.1964 how many were newly placed in special schools (other than hospital special schools) or boarding homes – – – – 2 – 5 2 – – 9 Total (b) — 2 1 1 9 2 7 13 - - 35 Or or about 28.1.65 how many handicapped pupils from Authority's area: C. (i) were requiring places in special schools:- TOTAL (a) day – – – – – – – 4 – – 4 (b) boarding - - - - - 1 4 2 - - 1 (ii) Included at (i) had not reached the age of 5 and were awaiting: – – – – – – – – – – – (a) day places - – — — — — — — — — – (b) boarding places - - — — — — — — — – – (iii)included at (i) who had reached the age of 5,but whose parents had refused consent to their admission to a special school, were awaiting: (a) day places - - - — - — - — — — – (b) boarding places – – – – – - – – – – – PART V. (Continued) (l) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) D. (i) were on the registers of: 1. maintained special schools as: (a) day pupils - 7 4 - 11 2 - 39 - — 63 (b) boarding pupils — - - - 6 4 - 7 - - 17 2. non-maintained special schools as: (a) day pupils – – – – – – – – – – – (b) boarding pupils 2 - - 3 3 6 3 – - - 17 (ii)were on the registers of independent schools under arrangements made by the Authority – – 1 – – – 21 1 – – 23 (iii)were boarded in homes and not already included under (i) or (ii) - – – – – – - - – _ – Total (D) 2 7 5 3 20 12 24 47 – – 120 E. On or about 20.1.65, 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 – – – - 1 1 – – - - 2 During the calendar year ended 31.12.64: (i) how many children were the subject of new decisions recorded under Section 57(4) of the Education Act, 1944 4 (ii) how many decisions were cancelled under Section 57A(2) of the Education Act, 1944 ??? '