AC 4412(1) BROMLEY BRO 4 BOROUGH OF BROMLEY ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH on the HEALTH OF THE BOROUGH OF BROMLEY 1952 INCLUDING ANNUAL REPORT ON THE SCHOOL HEALTH SERVICES Printed by Bromley Office Supplies and Printing Co., Ltd. 39 & 46 East Street, Bromley, Kent BOROUGH OF BROMLEY ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH on the HEALTH OF THE BOROUGH OF BROMLEY 1952 INCLUDING ANNUAL REPORT ON THE SCHOOL HEALTH SERVICES 3 CONTENTS. Page Members of the Health Committee 7 Staff 7 Prefatory Letter 9 Section A. Vital and Other Statistics and Social Conditions of the Area. Vital Statistics 14 Population 15 Births 15 Illegitimate Births 16 Stillbirths 16 Deaths 17 Maternal Mortality 18 Infantile Mortality 18 Unemployment 19 Meteorological Conditions 20 Open Air Recreational Amenities 20 Section B. General Provision of Health Services for the Area. Nursing Homes 22 Hospitals 22 Ambulance Service 22 Home Nursing Service 23 Health Visiting 23 Midwifery (Domiciliary) 23 Day Nurseries 23 Laboratory Service 23 Public Mortuary 24 Medical Loan Depots 24 Womens' Welfare Clinic 24 Domestic Help Service 24 Venereal Diseases 25 Local Clinic Services 25 National Assistance Act, 1948 26 Old People's Homes 26 Section C. Sanitary and Environmental Circumstances. Water Supply 34 Drainage and Sewerage 35 Cesspools 35 Rivers, Streams and Lakes 36 Swimming Baths and Pools 36 Public Cleansing, Refuse Collection and Disposal 36 Factories Acts, 1937 and 1948 36 Sanitary Inspection of the Area 37 Smoke Abatement 37 Shops Act, 1950 38 Petroleum Acts 38 Verminous Conditions and Uncleanliness 38 Rodent Control 38 Diseases of Animals Acts 39 Registries for Female Domestic Servants 40 Rag, Flock and other Filling Materials Act, 1951 40 Pet Animals Act, 1951 40 Retail Market 40 4 Page Section D. Housing. Housing Inspections and Abatements 42 Rehousing 42 Section E. Inspection and Supervision of Foods. Food and Drugs Act, 1938—Food Sampling 46 Bacteriological Examinations 48 Ice Cream 49 Special Enquiries 49 Unsound Food 50 Food Preparing Places 51 Inspection of Food Premises 51 Milk Licences 52 Meat Inspection 52 Section F. Prevalence of, and Control Over, Infectious and Other Diseases. Smallpox 56 Vaccination 56 Anterior Poliomyelitis 56 Scarlet Fever 56 Diphtheria 57 Diphtheria Immunisation 57 Typhoid Fever 57 Puerperal Pyrexia 57 Ophthalmia Neonatorum 57 Pemphigus Neonatorum 57 Measles 58 Whooping Cough 58 Tuberculosis 58 Food Poisoning 59 Other Infectious Diseases 59 APPENDIX—STATISTICAL TABLES. Table I.— Summary of Statistics 63 „ II.— Causes of Death 64 „ III.— Infant Mortality 65 „ IV.— Analysis of Causes of Infant Deaths 66 „ V.— Notifiable Infectious Diseases. Sex and age Distribution 67 „ VI.— Notifiable Infectious Diseases—Ward Distribution, Attack and Mortality Rates 68 „ VII.— Notifiable Infectious Diseases—Seasonal Incidence 69 „ VIII.—1Tuberculosis—Neiw Cases and Mortality 70 „ IX.— Housing Statistics 71 „ X.— Summary of the work of the Sanitary Inspectors 72 „ XI.— Factories Acts, 1937 and 1948 75 „ XII.— Nuisances, Defects and Contraventions Abated 76 5 SCHOOL HEALTH SERVICE, 1952. Page Members of Welfare Committee 80 Officers of the Committee 80 Staff 80 Introduction 81 General Information 82 School Hygiene 83 Medical Inspections at Schools 84 Special Examinations 84 Dental Service 85 Ophthalmic Clinic 85 Orthoptic Clinic 86 Ear, Nose and Throat Defects 86 Orthopaedic Clinic 87 Physiotherapy and Sunlight Clinic 87 Speech Clinic 88 Vermin and Uncleanliness Inspection 88 Exceptional and Handicapped Children 89 Child Guidance 89 Milk in Schools 89 School Meals Service 89 Employment of Children and Young Persons 90 Bromley Schools' Boot Club 90 Provision of Clothing 90 Infectious Diseases in Schools 90 Juvenile Delinquency 91 Physical Education 91 STATISTICAL TABLES. Table I.— Medical Inspection of Pupils attending Maintained Primary and Secondary Schools— A. Periodic Medical Inspections 97 B. Other Inspections 97 C. Pupils found to require treatment 97 „ II.— A. Return of Defects found by Medical Inspection in the year 1952 98 B. Classification of the General Condition of Pupils Inspected during the year, in age groups 98 „ III.— Group I. Diseases of the Skin 99 Group II. Eye Diseases, Defective Vision and Squint 99 Group III. Diseases and Defects of Ear, Nose and Throat 99 Group IV. Orthopædic and Postural Defects 100 Group V. Minor Ailments 100 „ IV.— Dental Inspections, Treatment, and Orthodontics 100 „ V.— Infestation with Vermin 101 „ VI.— Orthoptic Clinic 102 „ VII.— Handicapped Pupils 102 „ VIII.— Independent Schools 104 7 MEMBERS OF THE HEALTH COMMITTEE. Alderman Marion Green, J.P. (Mrs.) (Chairman). Alderman J. S. Marriott (Vice-Chairman). The Worshipful the Mayor (Alderman J. L. Venner, J.P.). Alderman M. Stafford Smith, M.B.E., B.A. (Miss). Councillors: J. C. Clayton. S. Lane. M. L. Dempster (Mrs.). G. H. Russell. L. L. Irwin, M.A., LL.B., J.P. C. W. Wilmot. STAFF OF THE PUBLIC HEALTH DEPARTMENT. as at 31st December, 1952. "*" denotes Officers employed by the Kent County Council. Medical Officer of Health: K. E. TAPPER, o.b.e., g.m., m.b., ch.b., d.p.h. Deputy Medical Officer of Health: H. B. C. CARTER-LOCKE, m.b., b.s., m.r.c.s., l.r.c.p., d.p.h. Assistant Medical Officers: * P. A. CURRIE, m.r.c.s., l.r.c.p. * A. ORGLER, m.d. (Berlin). (Retired 30.9.52.) * Miss G. H. STINSCXN, m.r.c.s., l.r.c.p. (Retired 1.7.52.) * Mrs. S. A. LAING, m.r.c.s., l.r.c.p., d.c.h. (Appointed 1.7.52.) Chief Sanitary Inspector, Chief Sampling Officer, Inspector under the Petroleum Acts, Diseases of Animals Acts, and the Shops Act: G. R. WOODS (1, 2, 3, 4, 5). District Sanitary Inspectors and Sampling Officers: T. C. TOWERSEY (1,2,3). P. R. LIGHT (1, 2, 3). D. K. EVANS (1, 2, 3, 6). H. COOPER (1, 2, 11). Health Visitors and School Nurses: * Mrs. N. M. TAYLOR (7, 8, 9). * Miss W. G. HEMMINGS (7, 8, 9). * Miss H. M. HOGGER (7, 8, 9). * Miss E. CHENERY (7, 8, 9). * Mrs. M. BLOOMFIELD (7, 8, 9). (Appointed 11.8.52. Resigned 31.10.52) * Miss M. E. WOOTTON (8, 9, 10). * Miss K. OWENS (7, 8, 9). * Mrs. M. HOCKING (7, 8, 9). 8 CLERICAL STAFF: Chief Clerk: S. F. JUDD. E. P. J. WYTHE (Senior Clerk). Mrs. B. B. LAMPARD. Mrs. D. COX. Mrs. W. J. FOOT. Mrs. M. J. COX. Mrs. R. C. TYE. Miss E. W. LEPPER (11). Miss M. N. CROXSON. Other Appointments: Assistant Rodent Officer: J. L. GOUGH. Outdoor Staff: Disinfector and Drain Tester: J. W. SEAGER. Rodent Operative: R. H. MITCHELL. Market Superintendent: W. THRIFT (Part-time). The figures denote:— 1. Certificate of the Royal Sanitary Institute and Sanitary Inspectors' Examination Joint Board. 2. Royal Sanitary Institute Certificate for Meat and Other Foods 3. Royal Sanitary Institute Smoke Certificate. 4. Certificate of Examination Board of the Sanitary Inspectors' tion. 5. Diploma of Institute of Hygiene (London). 6. Royal Sanitary Institute Certificate for Sanitary Science as applied to Public Works and Buildings. 7. State Registered Nurse. 8. State Certified Midwife. 9. Health Visitors' Certificate of the Royal Sanitary Institute. 10. State Registered Children's Nurse. 11. Unestablished or Temporary Staff. 9 To the Mayor, Aldermen and Councillors of the Borough of Bromley. Mr. Mayor, Ladies and Gentlemen, In submitting the Annual Report for the year 1952, which is my 28th report to you, I have followed very much the form of previous years. I have thought it advisable to continue the statistical tables, if only for the reason of making yearly local comparisons, although it is true that, based solely on statistics, such comparisons are apt to lead to false conclusions. If these statistics over the years prove anything, they prove that infectious diseases as a cause of death in Bromley are to-day negligible and that the greatest danger to life lies in those groups of diseases which are classified as cancer, cardiovascular and respiratory, and that with the increasing average age of the population, this danger becomes more apparent. It is, perhaps, regrettable that I am unable to submit statistics which can give a clear picture of the capacity of the people or of the individual to work or to live a full life of happiness. Neither are there any figures to prove or disprove the too often expressed view that there is an increasing mental disbalance in spite of the improving standards in physically healthy people. One can, however, deny the statement that the young person of to-day has not the physical and moral stamina of his or her forebears. It is an old custom and a privilege given to the older generation to criticise the new. We live once again in times of change. The services which began with environmental hygiene as the way to health, have passed through the period where the prevention of infant deaths was given priority, and we are now faced with the priority for the prevention of illnesses of middle life which lead to incapacity or to deaths from cancer, coronary thrombosis and gastric and peptic ulcers. The social services have extended to the care of the aged, and to some extent, are replacing the social services applicable to the newborn child. Owing to the comparatively high cost of treatment under the National Health Service Act, public opinion is once again being directed to the need for preventive services. The past successes of the preventive services are many and, as examples, one can cite the triumphs already obtained in the almost complete abolition of Diphtheria deaths from the yearly returns, the great reduction of deaths from Tuberculosis, one of the many reasons of this being the 10 early disclosure of Tuberculosis by Mass X-ray; the improvement in the physique of the school child; and the rarity of Tuberculosis in the school child, and the great and astonishing reduction in infant deaths during the past 30 years. We tend to give new and high sounding names to old conditions, eapecially since psychology has become the study of all and sundry. Psychosomatic may be an excellent term but it has always been known from time immemorial, and without the issue of labels, that there is a co-relation in illness between mind and body. The old type family doctor well knew that the way to cure was through the confidence of the patient. It may be that to-day we tend to weaken this confidence by broadcasting to all and sundry, either by wireless, television or press, the medical details of diseases that affect mankind. It would, in my opinion, be better if we reserved our propaganda for the ways to prevent disease and to promote health, leaving it to the family doctor to tell the patient only what is, in his opinion, good for his cure. The task of the preventive services in future years will not be an easy one but it is full of promise. In my view, the task can only be lightened by truly local government, where the people, the elected representative, and the official, live and work together. In my first Annual Report to you 28 years ago, I wrote, however badly it may have been expressed:— "Local Government appears, by recent declaration in Parliament, to be again in the melting pot; new large Health authorities are to be formed However necessary this may appear to be. I believe it is probably agreed that too much overlapping of authority does exist, there is a distinct danger to the efficient but sometimes small authority being swamped in an authority which will lose touch with the unit of population. It is on this individuality that the whole success of Pulblic Health has resulted, to destroy it will, I fear, defeat our ends." There has not yet been a return to the Town Council of the duty to function any of the Part III Services, taken from us in 1948 by the National Health Service Act. It is easy for one to generalise, but a review of the Public Health Services must surely show that what is needed in an industrial area is not necessarily good for or needed in a residential area such as Bromley; we tend too much to run to pattern and to continue that pattern over too long a period. An extension of the Mass X-ray and an extension of Home Nursing are two services which are desirable in Bromley, both of which 11 would lead to economy—the first by preventing the insidious development of undiscovered tuberculosis, and so preventing expensive hospital care; the second as a relief to the strain on hospital beds; an in-patient day saved would reduce the cost per patient; it is cheaper to nurse at home than it is to nurse in hospital. The vital statistics show a low death rate, a reasonably high birth rate and a low infantile mortality rate, although higher than the previous two years. The sickness rate was high during the early months of the year, due to Influenza of a mild type, and was a carry over from the previous year. Under the item of causation of deaths, it will be seen that there is an increase in the deaths from cancer of the lung, a fact which is general throughout most of the country and which, during the year, received much publicity. There is no conclusive proof that this increase is due to cigarette smoking, no more conclusive proof than that it is attributable to smoke laden atmosphere. The statistical return of infectious diseases during 1952 was noteworthy in the high incidence of Measles and of Whooping Cough, two diseases which so far we have been unable to keep in check. It was fortunate that both diseases were comparatively mild in nature, there being no deaths in 545 cases. As it has been with Diphtheria, the future of these diseases will, no doubt, be controlled by an immunisation service. Dysentry showed an increase in notifications and was due largely to a Sonne infection, very largely a family infection. ' Food Poisoning notifications were less than previous years and there were no outbreaks of any note. Those cases brought to my attention by notification were received too late to be of value in tracing the origin of the infecting organism. There were six sporadic cases of Infantile Paralysis. The work of the Sanitary Inspectors is recorded in the body of the Report. The importance of their work cannot be overstressed; it has been the keystone of Public Health since the Act of 1875. There is still much for them to do, especially in the field of inspection and repair of those many houses which are showing signs of decay from old age. Mr. Woods, the Chief Sanitary Inspector, has worked with me in Bromley for 27 years, and I have nothing but praise for the work he has done to maintain the high Public Health repute that Bromley holds in the Municipal world. 12 Contained in this Annual Report is the report on the health of the school child, a service which should not be separated from the environmental services, or from the services applicable to the mother and child. It is only by the team work of doctors, sanitary inspectors and health visitors that full effect can be given to the services and full benefit received from the money raised from the rates. In this report on the school child is the report of the physical training organisers, whose excellent work to promote health does not receive, in my opinion, sufficient publicity. I am indebted once again to the help received throughout the year from each member of the staff of the Department, professional and clerical, and finally to the Chairman and Members of the Committees who have shown tolerance and helpfulness when my advice has been tendered. I am, Your obedient Servant, K. E. TAPPER, June, 1953. Medical Officer of Health. SECTION A. VITAL AND OTHER STATISTICS AND SOCIAL CONDITIONS OF THE AREA. 14 SECTION A. VITAL AND OTHER STATISTICS AND SOCIAL CONDITIONS OF THE AREA. The area of the Borough is 6,519 acres. Registrar General's estimate of total population (mid-year), 1952 64,350 Population at time of Census, 1951 64,178 Censal Increase, 1931/1951 16,480 Number of Valuation assessments as at 31st March, 1952:— (a) Houses and Flats:— Not exceeding £10 Rateable Value 342 £11 to £13 Rateable Value 552 £14 to £20 Rateable Value 4,856 £21 to £30 Rateable Value 6,896 £31 to £40 Rateable Value 2,577 £41 to £50 Rateable Value 1,411 £51 to £75 Rateable Value 1,271 £76 to £100 Rateable Value 402 Exceeding £100 Rateable Value 339 18,646 (b) Commercial 1,376 (c) Licensed Premises 40 (d) Entertainment and Recreational 88 (e) Public Utility 27 (f) Educational and Cultural 28 (g) Industrial 53 (h) Miscellaneous 199 Total 20,457 Rateable Value at 31st March, 1952 £768,283 Rateable Value at 31st March, 1953 £778,033 Estimated Product of a Penny Rate for the year ending 31st March, 1954, is £3,160 Vital Statistics. Live Births. Total. Male. Female. Legitimate 873 449 424 Birth Rate 14.1 per 1,000 total population. Illegitimate 35 21 14 908 470 438 Stillbirths. Total. Male. Female. Legitimate 17 8 9 Stillbirth Rate 0.28 per 1.000 total population and 19.4 per 1,000 (live and still births). Illegitimate 1 1 - 18 9 9 15 Deaths. Total. Male. Female. 720 336 384 Death Rate 11.2 per 1,000 total population. Deaths from Puerperal Causes. Puerperal Sepsis Nil Maternity Mortality Rate Nil per 1,000 live and still births. Other Puerperal Causes Nil Deaths of Infants under 1 year of age. Total. Male. Female. Legitimate 17 8 9 Infant Mortality Rate 22.0 per 1,000 live births. Illegitimate 3 1 2 20 9 11 Death Rates of Infants under 1 year of age. All infants per 1,000 live births 22.0 Legitimate Infants per 1,000 live legitimate births 19.5 Illegitimate Infants per 1,000 live illegitimate births 85.7 Comparative statistics for the year 1952:— Birth rate (per 1,000 total population). Death Rate (per 1,000 total population) Infant mortality rate (per 1,000 live births) Live Births Still Births Bromley 14.1 0.28 11.2 22.0 England and Wales 15.3 0.35 11.3 27.6* London Administrative County 17.6 0.34 12.6 23.8 * Per 1,000 related live births. POPULATION. The Registrar General's estimate of the total population (civilian and non-civilian) of the Borough, mid-year 1952, is 64,350, a decrease of 200 over the year 1951. This population figure gives a density of 9.9 persons to the acre. The natural increase of population (measured by the excess of births over deaths), for the year was 188. The change in population of the Borough during the last five years is shown below:— Year. Registrar General's estimate of mid-year population. Total increase over previous year. 1948 63,360 720 1949 64,140 780 1950 64,610 470 1951 (Census) 64,550 decrease 60 1952 64,350 decrease 200 BIRTHS. The Birth Rate for 1952, is 14.1 per 1,000 total population, which is a decrease on that of the previous year, but compares 16 favourably with the rate of 15.3 for England and Wales and 16.9 for the 160 County Boroughs and large towns, including London. 908 live births were registered during the year, there being 470 males and 438 females, eight less than in 1951. Comparative rates during the past ten years are:— Year. Bromley. England & Wales. 1943 17.5 16.5 1944 16.5 17.6 1945 16.6 16.1 1946 19.4 19.1 1947 20.9 20.5 1948 16.4 17.9 1949 16.1 16.7 1950 13.8 15.8 1951 14.2 15.5 1952 14.1 15.3 The average yearly Birth Rate during the past ten years was Bromley 16.5, England and Wales 17.1. Illegitimate Births. The illegitimate birth rate, per 1,000 live and still births, for the year 1952, is 37.8. There were 35 illegitimate births (21 males and 14 females). Stillbirths. The total number of stillbirths allocated to the Borough during the year was 18. This represents a stillbirth rate per thousand live and stillbirths of 19.4, and a rate of 0.28 per thousand total population. The following tabulation gives the number of stillbirths and rates per 1,000 (live and still) births, and comparative rates per 1,000 population with England and Wales, for the past ten years:— Year No. of Stillbirths Rate per 1,000 births Rate per 1,000 population Bromley England & Wales 1943 22 23.8 0.42 0.52 1944 20 23.8 0.40 0.50 1945 15 16.9 0.28 0.46 1946 33 27.2 0.54 0.53 1947 34 25.3 0.54 0.50 1948 24 22.5 0.38 0.42 1949 23 21.8 0.36 0.39 1950 21 23.0 0.32 0.37 1951 15 16.1 0.23 0.36 1952 18 19.4 0.28 0.35 If one is interested in local statistics, I would refer you to previous Annual Reports, especially 1944 and 1946, where I have discussed the problem of continued high still birth rate in spite of the marked reduction of infantile mortality that has taken place since 1928. 17 DEATHS. The total number of deaths belonging to the Borough and registered during the year was 720. Of this number, 336 were males and 384 were females. The Death Rate for the year 1952 is 11.2 per 1,000 total population. The rate for England and Wales is 11.3 and 12.6 for the Administrative County of London. Comparative death rates for Bromley and England and Wales for the past ten years are as under:— Year Bromley Rate England & Wales 1943 11.7 12.1 1944 13.3 11.6 1945 12.5 11.4 1946 10.8 11.5 1947 11.7 12.0 1948 9.9 10.8 1949 10.9 11.7 1950 11.4 11.6 1951 11.4 12.5 1952 11.2 11.3 An analysis of the age at death shows that of the 720 deaths registered:— M. F. 20 were under 1 year of age 9 11 2 were 1 and under 5 years of age 1 1 2 were 5 and under 15 years of age 1 1 3 were 15 and under 25 years of age 3 — 25 were 25 and under 45 years of age 15 10 169 were 45 and under 65 years of age 96 73 171 were 65 and under 75 years of age 92 79 328 75 years of age and over 119 209 CAUSATION OF DEATHS. The main causes of death in Bromley, together with comparative rates per 1,000 population for the last five years were:— 1948. 1949. 1950. 1951. 1952. Cancer 1.8 2.2 1.9 1.98 1.77 Congenital Causes 0.2 0.1 0.12 0.09 0.16 Heart Disease 2.7 3.2 6.31 5.56 6.31 Infectious Diseases 0.01 0.05 0.015 0.062 0.031 Influenza — 0.08 0.03 0.11 — Resp. Diseases (Non-T.B.) 0.9 1.3 0.68 1.27 1.17 Tuberculosis 0.3 0.3 0.26 0.31 0.17 The main deductions to be made from this table are the remarkable reduction of tuberculosis as a cause of death, and the almost constant level of cancer deaths rate. 18 Other causes of deaths. During the year 1952, there were 19 deaths from violence, including 6 suicides, 5 motor vehicle accidents and 8 other accidents. Cancer of the Lung. This shows throughout the country a rise in death rate. Bromley, likewise, shows an increase from .26 per 1,000 population in 1951 to .34 in 1952 the two years when records have been kept. The reason for this is not yet determined—it may be excessive cigarette smoking, or it may be polluted atmosphere, either from factory and domestic smoke, or mechanical transport fumes—it is probably due to the better facilities for diagnosis of modern medical technique—certain carcinogenic factors are known, and their abolition must be one of the problems for future health committees. Details of deaths from Cancer (all forms) during the past ten years are:— Year. Number of Deaths. Rate per 1,000 population. Percentage of Total Deaths recorded for the year. 1943 93 1.8 15.4 1944 122 2.4 18.5 1945 106 2.0 16.1 1946 109 1.8 16.6 1947 119 1.9 16.3 1948 114 1.8 18.1 1949 141 2.2 20.2 1950 122 1.9 16.5 1951 128 1.98 17.4 1952 114 1.77 15.8 MATERNAL MORTALITY. There were no maternal deaths in the Borough during 1952. INFANTILE MORTALITY. 20 infants died during 1952 before reaching their first birthday. Of this number 17 were legitimate and 3 illegitimate. The infant mortality rate for the year is 22.0 per 1,000 live births: 19.5 legitimate infants per 1,000 live legitimate births; 85.7 illegitimate infants per 1,000 live illegitimate births. There were 7 neonatal deaths (under one month of age). The following table shows the number of infant deaths and the rate per 1,000 live births, over the past ten years:— 19 Year. Number of deaths. Rate per 1,000 live births. 1943 25 27.7 1944 32 39.02 1945 25 28.6 1946 31 26.3 1947 25 19.11 1948 21 20.15 1949 16 15.5 1950 19 21.3 1951 11 12.0 1952 20 22.0 The average infant death rate for the past ten years is 23.2 per 1,000 live births. UNEMPLOYMENT. The Manager of the Employment Exchange has kindly supplied the following information with regard to unemployment during 1952:— "The following figures indicate the rise and fall in Unemployment in the area of Bromley Employment Exchange during 1952 as compared with the corresponding period in 1951:— 1952. Men. Women. 1951. Men. Women. 14th Jan. 156 87 15th. Jan. 164 47 21st April 106 82 16th April 87 51 14th July 87 78 16th July 56 46 13 th Oct. 132 115 15th Oct. 52 94 8th Dec. 158 80 10th Dec. 115 65 With regard to unemployment among men the decline in April and rise in October is mainly attributed to seasonal activity in the building and decorative industry. Excluding the building trades, unemployment is mainly confined to the elderly and physically handicapped worker and the December figure includes 41 Registered Disabled Persons. Apart from elderly and disabled men and the building trades, employment opportunities have been good and men did not remain long unemployed. Although unemployment is slightly higher than in 1951, the percentage of unemployment has kept below 2%. Unemployment among women has remained steady throughout the year around a figure of 80, excepting during October when it jumped to 115. A similar movement occurred in October, 1951, and is attributed to the termination of employment in the Catering industry in holiday resorts. Of the women registered as unemployed in December, fourteen of them were Registered Disabled Persons. The increase in the Register for 1952, as compared with 1951, is mainly attributed to the return of married women to the employment field. One interesting feature is the appreciable number of women at present working in districts outside Bromley who have registered at this office for local employment." 20 METEOROLOGICAL OBSERVATIONS. I am indebted to the Borough Engineer for the following information, which has been extracted from the records at the Climatological Station at Church House Gardens:— Total rainfall during 1952: 26.22 inches. Mean maximum daily temperature: 57.38°F. Mean minimum daily temperature: 42.68ºF. Highest maximum temperature: 88°F. (on 1st July). Lowest minimum temperature: 19°F. (on 27th January). Lowest grass temperature recorded: 17ºF. (on 25th Nov. and 6th Dec.) OPEN AIR RECREATIONAL AMENITIES. Commons, Public Recreation Grounds and Gardens. 603 acres of land have been secured or reserved for public recreational purposes, representing 9.2 per cent. of the total acreage of the Borough. Acres. Roods. Poles. Bromley Public Golf Course 56 1 8 Church House Gardens 12 3 20 Elmstead Woods 61 1 36 Golf Course Playing Fields 41 1 5 Hayes Common (including Pickhurst Green) 213 1 32 Hollydale Open Space 6 1 0 Husseywell Open Space 2 1 30 Keston Common 55 1 24 Kings Meadow Recreation Ground 9 1 0 Library Garden 1 2 0 Martins Hill Recreation Ground 12 0 29 Oakley Road Recreation Ground 2 0 0 Pickhurst Green Recreation Ground 12 2 14 Queens Garden Recreation Ground 2 1 4 Queens Mead Recreation Ground 10 3 15 Southborough Open Space 6 0 0 The Knoll Open Space 4 1 39 Turpington Open Space 1 3 10 Whitehall Recreation Ground 17 1 6 Widmore Open Space 3 1 28 Reserved: Hayes (Old) Rectory Grounds 2 0 25 Hillcrest Open Space 0 2 0 New Street Hill Open Space 11 2 8 Norman Park 56 0 0 603 1 13 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. 22 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. NURSING HOMES. (Public Health Act, 1936, Sections 187/195.) One nursing home was first registered during 1952. There are at the present time six nursing homes on the register. Nursing homes are inspected at frequent intervals and there have been no matters which have called for report to the Local Authority. The six homes provide a total of ninety beds for medical and surgical cases. No maternity beds are provided for. The majority of these beds continue to be occupied by the aged sick or aged infirm. Details of the homes are as under:— Address No. of Beds No. of new patients received during 1952 Surgical Medical and Chronic 18, Blyth Road 25 — 42 42, Cambridge Road 8 — 8 17, Edward Road 12 — 40 24, Elmfield Road 10 — — 67, Hayes Road 3 — 2 47/51, Park Avenue 32 — 72 HOSPITAL SERVICES. (a) Bromley Hospital, Cromwell Avenue. Provides a general hospital service with 133 beds. There are two Maternity Units attached to this hospital, one at 118, Widmore Road (22 beds), and the other at 20, Masons Hill (38 beds). (b) Lennard Hospitals, Lennard Road. There are fifty-six beds in use at the Lennard Hospitals for infectious diseases cases, and twenty-four beds for Geriatrics. The number of infectious disease beds can be doubled in an emergency. (c) Chest Clinic. Situated at the rear of the main Bromley Hospital buildings, with entrance from Tiger Lane. All the above are under the control of the Bromley Group Hospital Management Committee whose offices are at Farnborough Hospital, Farnborough, Kent. AMBULANCE SERVICE. The Ambulance Depot is at Masons Hill, Bromley. There are, at the present time, eleven ambulances and four sitting case cars available at this depot. 23 HOME NURSING SERVICE. There are nine full-time Home Nurses operating in the Borough. (1 male and 8 female.) Home Nursing is provided on medical certification only, and is free. A day service only is provided. HEALTH VISITING. The seven Health Visitors engaged on this work in the Borough combine the duties of Health Visitor and School Nurse, fifty per cent. of their time being allocated to each service. In addition to their school work, they are responsible for the Maternity and Child Welfare Centres, Vaccination and Diphtheria Immunisation Clinics, Home Visiting in connection with Child Life Protection, After Care, etc. Full details of Welfare Centres, Clinics, etc., will be found later in this report. MIDWIFERY (Domiciliary). There are four domiciliary midwives engaged in the area. The services of the midwives are engaged direct by the patient, or through the patient's private doctor, and they act either as midwives or maternity nurses. Ante-natal clinics are held on every Monday, and the first, third and fifth Thursday afternoon in the month at the North Clinic, Station Road, and every Wednesday afternoon at the Minor Ailment Treatment Clinic, Hayes School. DAY NURSERIES. At the end of the year there was one Day Nursery provided by the County Council, at Elmfield Road, Bromley. This nursery was closed on 30th April, 1953. LABORATORY SERVICE. There has been no change to report during the past year. All routine medical and Food & Drugs samples are sent to the County Laboratory at Maidstone. Considerable assistance has been rendered during the past year by Dr. Keall and his staff at the Laboratory attached to Bromley Hospital, in dealing with various specimens of an urgent nature which were forwarded to them. The assistance afforded by this section of the hospital is greatly appreciated as it enables more prompt action being taken by the Department than if the specimens were forwarded to Maidstone. 24 The following details are given of the swabs, specimens, etc., sent for examination and report during the year:— Haemolytic Streptococci 268 Diphtheria 2 Faeces 6 Throat Gargle 1 Food Samples, etc. 492 Water Samples 37 Miscellaneous 6 812 PUBLIC MORTUARY. This is situated in South Street, at the rear of the Fire Station. Twenty-three bodies were taken to the mortuary during the year, eighteen of which were received from hospitals. Inquests were held in seven cases. No provision is made for refrigeration storage of bodies kept for post mortem. MEDICAL LOAN DEPOTS. A full range of nursing requisites is available from the undermentioned depots which are run by the British Red Cross Society. Application for loan of such equipment for Bromley residents should be made to either of the following depots:— 34a, Market Square, Bromley. 4, East Street, Bromley. WOMEN'S WELFARE CLINIC. This clinic is held on the second Thursday afternoon of each month, at the North Clinic, Station Road. Patients attending this clinic are referred on medical grounds only, and are seen by appointment. Most of this service has now been transferred to the Maternity units attached to the hospitals. DOMESTIC HELP SERVICE. Demands for this service are still very high, especially for cases of illness in the home and for old people. Applications for this service should be made to the Area Supervisor at the Municipal Offices, Bromley. The following is a summary of the cases assisted in the Bromley area during the year 1952:— 25 Type of Case. Total. Maternity 78 Tuberculosis 17 Aged 136 Others 275 506 Approximately fifty workers were being regularly employed during the year, of which number about two-thirds were working between 30 and 44 hours weekly. VENEREAL DISEASES. The Kent County Council provides treatment at the various centres in the County. There is no centre in Bromley, but if needs be the close proximity of London affords ample and convenient facilities through the various large general hospitals. LOCAL CLINIC SERVICES. Ante-Natal Clinics. North Clinic, Station Road Every Mon. & first, third & fifth Thurs. in month p.m. (New cases should attend Thurs.) Hayes School Clinic, George Lane Wednesdays p.m. Womens' Welfare Clinic. North Clinic, Station Road Second Thursday in every month p.m. Child Welfare Centres. North Clinic, Station Road Wednesday p.m. South Clinic, Princes Plain Tuesday p.m. William Morris Hall, Masons Hill Mon. and Thursday p.m. First Aid Post, Southlands Road Wed. and Friday p.m. Village Hall, Hayes Tuesday p.m. Village Hall, Keston First & third Thurs. in every month p.m. St. Andrews Hall, Burnt Ash Lane Wednesday p.m. Minor Ailment Clinics (Schools). North Clinic, Station Road Monday to Friday a.m. South Clinic, Princes Plain Monday to Friday a.m. Medical Room, Hayes School Monday to Friday a.m. Medical Room, Quernmore School Mon., Wed. and Frid. a.m. Medical Room, Burnt Ash School Mon., Tues. & Thurs. a.m. Medical Room, Aylesbury Rd. School Monday to Friday a.m. Medical Room, Southborough School Monday to Friday a.m. 26 Dental Clinics. North Clinic, Station Road Monday to Friday a.m. & p.m. South Clinic, Princes Plain (By appointment only.) Immunisation. North Clinic, Station Road Thursday11 a.m. South Clinic, Princes Plain Wednesday 11 a.m. Medical Room, Hayes School Wednesday 11 a.m. Medical Room, Burnt Ash School Thursday 11 a.m. Vaccination. North Clinic, Station Road Thursday 11 a.m. South Clinic, Princes Plain Wednesday 11 a.m. Medical Room, Hayes School Wednesday 11 a.m. St. Andrews Hall, Burnt Ash Lane Wednesday 3 p.m. Specialist Clinics. North Clinic, Station Road Ophthalmic— (By appointment only.) Mon., Wed. a.m., Fri. p.m. Orthopædic— 1st & 3rd Fri. every month p.m. South Clinic, Princes Plain Speech—Monday, p.m. (By appointment only.) Lip Reading—Wednesday, 5-6 p.m. Sat., 10 a.m.—12 noon. NATIONAL ASSISTANCE ACT, 1948. Section 47. Although several possible cases were investigated during the year, it was not found necessary to apply to the court for an order for compulsory removal. Section 50. Under this section of the Act, it is the duty of the local authority to arrange for the burial or cremation of the body of any person who has died or been found dead in their area if it appears that no suitable arrangements for the disposal of the body are being made. During the year 1952 it was not necessary for the Council to take any action under this section of the Act. OLD PEOPLE'S HOMES. The following reports on the Homes run by Voluntary Associations and Public Authorities have been received:— "Southwood," Residential Club, Oldfield Road, Bickley. This Club is run by the Women's Voluntary Services, and the Centre Organiser states:— 27 "Southwood Residential Club has given a happy home to forty elderly people during 1952. Three residents were transferred permanently to hospital, one of whom died there shortly afterwards; three residents were transferred to nursing homes, one left the Club to join her son in South Africa, and one left to go and live with a daughter. We were, therefore, able to accept seven new residents, two men and five women. Two residents spent a short time in hospital and returned to the Club, and one fell in her room and broke a femur and was transferred to hospital, then to one of the W.V.S. Nursing Homes for convalescence, and she eventually returned to the Club after an absence of just over four months. The Management Committee have noted with concern the increasing cost of food, fuel, etc., and it has been necessary to raise the fees twice during this year, and they are now £2 14s. Od. per week. This is in spite of the fact that we grow nearly all our own fruit and vegetables. This comes very hard on residents of limited means, who take a pride in having provided for their old age. The Handicrafts section has developed steadily, after a very slow start, and now a great proportion of the women join in and are getting great satisfaction from making things. The men keep busy about the house and garden of 5½ acres, but we are hoping to start some more handicrafts for them. We are more and more convinced that the answer to old age is to enable everyone to feel that they still have some contribution to make to life. The television and billiards continue to be popular, and the entertainments of all sorts, including concert parties, dancing classes, Shakespeare players, film shows, travel talks, musical evenings, etc., all make a great contribution to life. The residents have converted a room in the basement into a music room, having rehabilitated an old piano, and are having great fun singing and playing the piano together." "Merevale," Bickley Park Road. The year 1952 was one of consolidation rather than of progress. Merevale continued to operate successfully, finishing the year with 33 residents (8 male and 25 females, including one married couple) which meant that there were 2 vacancies; since filled. Due no doubt to the increased number of County Council Homes, a noticeable drop occurred in the applications for admission suggesting that the accommodation available for Old People regarded as able bodied is approaching saturation point, 28 although our experience shows that the need for Homes for sick old people is greater than ever. The addition of the Bromley Group to the Orpington and Sevenoaks Hospital Group as a "catchment" area should help to fill the vacancies experienced hitherto. Consideration is being given to the possibility of obtaining patients from a wider field. The home has been the recipient of numerous gifts and the Committee is indeed grateful to all those who have so kindly assisted in one way or another. "Armstrong House," 1, Southlands Grove, Bromley. This Home is run by the Save Our Souls Society, and the following report for the year ended 31st December, 1952, has been received:— "Accommodation. Capacity 28 Weekly average number 27 Admitted during 1952 7 Departures during 1952 (5 residents transferred and 3 died) 8 Present residents: Men 16 Women 12 Average age, 79 years. Source of Supply and Liaison. Vacancies as they arise are still offered to, and generally filled by, the Welfare Officer, Kent County Council, Maidstone. Due to the small number of vacancies, many applications have to be refused each month. General Health. With an average age of 79 it is not surprising that the general health of the residents can only be described as "fair." From many points of view the winter, which started early, has been a very trying one for old people and acute illnesses have not been uncommon. The difficulty of arranging admission of sick residents to Hospital has not been lessened during the year and the strain on the staff called upon to nurse chronically sick old people who require hospital attention has been severe and during times of emergency affects the whole house. Medical Attention. Several residents are in constant need of medical attention and the Doctors who attend to the old people could not have been more helpful. Routine weekly calls are made and emergency visits whenever necessary. 29 Residents are referred to Hospital for specialist examination, a Chiropodist visits the Home regularly and two residents have obtained deaf aids. Recreation, Entertainments and Welfare. The Home continues to receive invitations from many local organisations and individuals for the old people to attend concerts and parties. Film shows and concerts are also given in the Home at regular intervals. Although invitations to attend outside functions are greatly appreciated, the importance of Home entertainment must not be overlooked, as many of the residents are far from mobile and depend more and more upon newspapers, periodicals and the wireless. Religious Worship. Short informal services are held in the Home every Sunday evening and communion service once a month. Staff. Mrs. Grunberg and Mrs. Van Hemelryck continue in charge as Matron and Assistant Matron respectively. They are assisted by one non-resident assistant and a full complement of domestic staff. It is hoped to fill the joint post of resident cook/handyman very shortly. Finance. During the Society's financial year, ended 27th September, 1952, the total cost of maintaining the Home amounted to £3,300 and exceeded income by approximately £300." "Greenhill," 5, Oaklands Road, Bromley. This Home is run by the Brook Lane Medical Mission, and the Secretary reports:— "The Greenhill Home has been full throughout the year 1952. The number of beds available is twenty-two, and seven new cases have been admitted during the year. We have lost three residents by death, and because of increasing infirmity, one or two others have been transferred to Homes where more nursing care can be given than at Greenhill. During the summer months it was possible to arrange holidays for some of the residents, while others preferred to stay with their relatives for a short time. Coach outings were also arranged through Kent, and to the Isle of Sheppey." 30 "The Vane," Denbridge Road, Bickley, and "Town Court," Wells Road, Bickley. The Welfare Department of the London County Council is responsible for the running of these Homes, and the following details have been supplied by the Chief Officer of that Department:— The Vane. Town Court. Residents on 31st December, 1951 29 31 Admissions during 1952 14 12 Discharges during 1952 16 13 Residents on 31st December, 1952 27 30 "Dunoran," Park Farm Road, Bickley. The Bermondsey and Southwark Group Hospital Management Committee is the Authority responsible for this Home, and I am indebted to the Medical Superintendent of the Home for the following information:— "During the year ended 31st December, 1952, eighty-three patients were admitted to Dunoran Home, fifty-three were discharged, and twenty-nine died. The bed complement was thirtyeight, and the average daily number of beds occupied was 36.9. The Home has continued to admit both dying and chronic patients, taking when possible chronic patients of the younger age group. In the summer a number of the permanent patients were sent for two weeks' holiday at the seaside, and beds thus temporarily vacant were used to take bedfast patients from their own homes, giving a respite and an opportunity for a holiday to relatives normally caring for them." "Homefield" and "Elmwood," Southborough Road, Bickley. The Bermondsey Medical Mission are responsible for the above Homes, and I am indebted to the Matron for the following information:— "Homefield" was opened with the help of the King Edward Hospital Fund as a Home for the aged sick in October, 1950, and has thirty-four beds. Some of the patients are able after a short or long stay to return to their own homes, and some get well enough to go on to Old People's Homes, and some finally return to hospital. Since the Home opened in 1950. two hundred patients have been accommodated. They are nursed in small wards of 3 to 9 beds, with a few single rooms, under conditions as home-like as is possible, and mostly get up every day for a short or longer time. Very few are fit to go out even in cars, but kind friends come and entertain them from time to time with music, films, or other 31 informal entertainments, and the W.V.S. shop and the British Red Cross Society Library are much appreciated, and a good deal of occupational therapy is found very useful." "Elmwood" was opened in Decemtber, 1952, as an Old People's Home, next door to "Homefield," so that such patients as were fit to leave "Homefield" but unable to return home, could stay with us in the house next door under freer circumstances. The Home is licensed by the Kent County Council, and takes patients both from Kent and London. It will hold twenty patients when completed, but at present we have only fifteen as some work remains to be done to the house before it is ready for the full number." SECTION C. SANITARY AND ENVIRONMENTAL CIRCUMSTANCES. 34 SECTION C. SANITARY AND ENVIRONMENTAL CIRCUMSTANCES OF THE AREA. WATER. I am indebted to the Clerk, and the Director of Water examination, of the Metropolitan Water Board, for the following information on the supply of water to the Borough during the year 1952:— "No new source of public water supply has been instituted in the Council's area during 1952, and there have been no extensions of trunk mains, but lengths of service mains have been laid within the Borough, largely in the Council's Hayes Place Estate. The supply to the Bromley district during 1952 has been adequate at all times. The higher level of the area is supplied from Shortlands Well and by Thames-derived filtered water from Walton Works; the lower level is supplied from West Wickham and Orpington Wells with additional Thamesderived water during the summer months. All the Thames-derived water is chlorinated before it leaves the works. The well water is also chlorinated, but any residual chlorine is completely removed before the water leaves the works. Bacteriological analyses of all supplies are made at least five times a week, and in the case of the river-derived supply, the water is tested bacteriologically at all stages of purification. All new and repaired mains are disinfected with chlorine before being restored to use and samples of water from them are tested to establish that the quality of the water is up to the standard normally supplied. None of the supplies is plumfoo-solvent. The closest watch is kept for any evidence of deterioration in quality whether physical, chemical, bacteriological or biological and immediate action is taken if the results of analyses are not up to standard. Appended are the average results of the chemical and bacteriological analyses of the various supplies for 1952." 35 Average Results of the Chemical and Bacteriological Examination of the water supply to Bromley during the year 1952. Chemical. (Parts per million unless otherwise stated). Shortlands Well West Wickham Well Orpington Well Thames-derived filtered water (Walton) No. of Samples 4 6 4 1714 Ammoniacal Nitrogen 0.007 0.012 0.004 0.027 Albuminoid Nitrogen 0.025 0.031 0.035 0.093 Oxidised Nitrogen—Nitrate 5.4 6.1 6.9 3.7 Chlorides as Cl. 18.6 15.0 15.4 24.6 Oxygen abs. from Permanganate 3 hrs at 27ºC 0.19 0.15 0.05 1.05 Turbidity in terms of Silica — — — 0.2 Colour, m.m. brown 2 ft. Tube Burgess's Tintometer Nil Nil 2 12 Hardness (Total) 282 268 284 256 Hardness (Permanent) 61 33 43 62 pH Value 7.6 7.3 7.3 7.8 Magnesium 5.8 2.2 2.6 5.5 Silica as Si02 16 14 12 10 Fluorides F. 0.05 0.03 0.03 — Conductivity 450 475 450 475 Bacteriological Results. No. of samples Plate count (Av. per millilitre) Colonies counted on Agar Bact. coli. test Percentage of samples negative in 100 ml. Average number Bact. coli. per 100 ml. 22ºC (3 days) 37ºC (20-24 hrs.) Shortlands Well 273 5.7 0.5 100.0 Nil West Wickham Well 253 — — 99.2 0.030 Orpington Well 253 896.5 35.0 100.0 Nil River Thames water filtered at Walton Works 3.430 - 17.5 99.8 0.005 DRAINAGE AND SEWERAGE. No works of major importance have been carried out during the year. CESSPOOLS. No new premises were erected with cesspool drainage and no alterations to the drainage system of any other properties on cesspool drainage have been carried out. Cesspool emptying is undertaken by the Borough Engineer's Department upon the request of the householders. During the year twenty-one individual cesspools were emptied by the Department. 36 RIVERS, STREAMS AND LAKES. A venturi-flume meter was installed in the vicinity of Martins Road for the purpose of measuring and recording the flow in the River Ravensbourne, and readings commenced during May. The penstock on the Mill Pond at Mill Vale was removed, permitting an unobstructed flow of the river through the sluice. SWIMMING BATHS AND POOLS. No improvements or alterations were made to the Corporation Open Air Swimming Bath during the year. The Sanitary Inspectors made a total of 69 visits of inspection to Swimming Baths and Pools in the Borough and 32 samples of water were taken for examination. The results of the examinations were as follow:— Four samples taken from Corporation Swimming Bath, all satisfactory. Twenty-eight samples taken from privately owned swimming baths and pools, all were found to be satisfactory. Routine colometric tests for checking the efficiency of purification plants were also made. The Chlorine content and pH value is checked by means of a Lovibond Comparator. PUBLIC CLEANSING, REFUSE COLLECTION AND DISPOSAL. The Borough Engineer reports that a further dustless loading vehicle of improved type was added to the fleet. FACTORIES ACTS, 1937 AND 1948. Table XI in the Appendix gives statistical details of the inspections made by the Sanitary Inspectors and nuisances, defects and contraventions found and abated. A total of 321 inspections and re-inspections were made during the year and 110 nuisances and defects were found. There were 105 nuisances and defects remedied during 1952. (This figure includes those which were outstanding from the previous year.) In addition to the above, 53 inspections were made of outworkers' premises, all of which were found to be satisfactory and no nuisances or defects were found. 37 SANITARY INSPECTION OF THE AREA. Full details of the varied duties involved in sanitary inspection of the area as carried out by the Sanitary Inspectors, are contained in Tables X, XI and XII in the Appendix. The following are the aggregate totals under the respective headings:— Total No. of Inspections and Visits. Total No. of Defects and Nuisances found. Housing 4,557 1,137 Infectious Diseases 288 — Food Premises 3,412 148 Factories, Outworkers, etc. 462 154 Sampling Visits 398 — Trade Premises (Various) 946 70 Rodent Control 306 13 Miscellaneous 849 71 Total 11,218 1,593 In addition to the above, there were 1,725 interviews with owners, agents, etc., on site and at the office, in connection with the above work. Notices issued:— Preliminary:— Housing 550 Food Premises 83 Factories, etc. 68 Trade Premises 37 Rodent Control 481 Miscellaneous 79 1,298 Statutory:— Housing Nil Total 1,298 Food Condemnation Certificates issued: 1,687. SMOKE ABATEMENT. Eleven inspections and re-inspections were made by the Inspectors. Two nuisances were found, and at the end of the year four had been remedied. (This includes those carried over from the previous year.) 38 SHOPS ACT, 1950. One hundred and eighty-seven visits were made by the Inspectors. Forty-seven defects and contraventions were found, and fifty-one were remedied by the end of the year (including those carried over from the previous year). PETROLEUM ACTS. Mr. G. R. Woods is the Inspector appointed under the above Acts. Ninety-three licences were issued to store Petroleum Spirits and Petroleum Mixtures, and one for Carbide of Calcium. The total storage capacity licensed during the year was Bulk Storage 117,380 gallons. Can Storage 1,780 gallons. Carbide of Calcium 300 lbs. Can Storage includes Petroleum Mixtures and Thinners. One hundred and ten visits of inspection were made in connection with this work. One contravention was found and this was remedied immediately. A number of the new flame-proof electrically operated pumps have been installed in lieu of the old pattern and the electrical wiring carried out in accordance with the Home Office Regulations. VERMINOUS CONDITIONS AND UNCLEANLINESS. One hundred and fourteen visits to premises by Sanitary Inspectors related to eradication of bugs, dirty conditions and disinfestations. Twenty-six nuisances were found during the year and 26 were abated (including those carried over from previous year). RODENT CONTROL. This work requires vigilant and energetic action to keep the rat population within reasonable limits, and this table shows. I believe, this is being done:— 39 PREVENTION OF DAMAGE BY PESTS ACT, 1949. TYPE OF PROPERTY Local Authority Dwelling Houses Agricultural All other (including business premises) Total (1) (2) (3) (4) (5) 1. Total number of properties in Local Authority's District 8 18,851 29 1,848 20,736 2. Number of properties inspected by the Local Authority during 1952 as a result of (a) notification (b) survey or otherwise (a) — 446 2 111 559 (b) 6 1,656 25 310 1,997 3. Number of properties inspected (see Section 2) which were found to be infested by rats Major 1 — 1 — 2 Minor 1 311 1 71 384 4. Number of properties inspected (see Section 2) which were found to be seriously infested by mice - 45 - 53 98 5. Number of infested properties (see Sections 3 and 4) treated by the Local Authority 2 356 1 125 484 6. Number of notices served under Section 4:(1) Treatment Nil Nil Nil Nil Nil (2) Structural works (i.e. Proofing) Nil Nil Nil Nil Nil 7. Number of cases in which default action was taken by the Local Authority following the issue of a notice under Section 4 Nil Nil Nil Nil Nil 8. Legal proceedings Nil Nil Nil Nil Nil 9. Number of "block" control schemes carried out 8 Business Property 45 Private Property DISEASES OF ANIMALS ACTS. Mr. G. R. Woods, Animals Acts Inspector, reports:— There was a considerable increase in this work during the year. There were two confirmed cases of Anthrax at one farm, one in May and the other in August. The source of infection was not discovered. There has been an increase of Anthrax 40 throughout the Country during the year, and the Ministry of Agriculture and Fisheries have been actively engaged in this matter. The Local Authority is responsible under the Anthrax Order, 1938, for disposing of the affected carcases by burning on the site and thoroughly disinfecting the affected styes, manure, etc. Anthrax is transmissible to humans, and very careful precautions have to be taken by the staff who have to carry out these operations. During the year, one hundred and sixty Statutory Orders were received with regard to Foot and Mouth Infected and Controlled Areas, and in consequence, ninety-eight licences were issued by this Authority. REGISTRIES FOR FEMALE DOMESTIC SERVANTS. It would appear that there is little work for Registry Offices within the area. Observation has been kept on shops displaying advertising boards. Unless these shops are registered with the Local Authority, the exhibition of advertisements for female domestic servants contravenes the Bye-laws. RAG, FLOCK AND OTHER FILLING MATERIALS ACT, 1951 This Act, which is designed to secure the use of clean filling materials in upholstered articles and other articles which are stuffed or lined, or for purposes connected therewith, came into operation on the 1st November, 1951. One licence has been granted by the Authority under this Act. PET ANIMALS ACT, 1951. The above Act, which is designed to regulate the sale of pet animals, came into force on the 1st April, 1952. Licences in respect of seven premises were issued during the year. RETAIL MARKET. The Corporation owns the Retail Market under a Charter of Market Rights (granted 20th July, 1447). The Market is held on Thursday of each week at the Car Park, Station Road. The administrative supervision is under the Health Committee and the Market is controlled by the Market Superintendent. The Market Tolls collected during 1952 amounted to £459 10s. 6d., which is an increase of £175 18s. 9d. on the corresponding figure for 1951. SECTION D. HOUSING. 42 SECTION D. HOUSING. HOUSING INSPECTIONS AND ABATEMENTS. Statistical details of the work carried out by the Sanitary Inspectors during the year 1952, will be found in Tables IX, X and XII in the Appendix. The following extract summarises the work relating to housing:— Inspections Reason for Inspection On Complaint Routine ReInspections Total Inspections Nuisances found For Nuisances 793 93 3,212 4,098 1,082 Overcrowding 75 90 22 187 7 Verminous Conditions 19 11 34 64 20 Dirty Conditions 7 6 22 35 4 Water Supply 7 3 12 22 3 Disinfestation 6 2 7 15 2 Noxious Accumulations 9 2 6 17 — Other Accumulations 11 10 24 45 6 Miscellaneous 5 5 9 19 5 932 222 3,348 4,502 1,129 Nuisances and Defects Abated Drainage 325 Dampness 458 Water Supply 59 General Items 890 This figure includes defects 1,732 outstanding from previous year and abated during 1952. Rehousing. The following information, which has been supplied by the Property Manager, shows the position as at 1st January, 1953 PERMANENT HOUSING: Completed and occupied:— Units. Princes Plain 50 Coppice Estate 532 London Road Flats 78 Longfield Flats 18 Bourne Way Flats 66 Tylney Road Flats 54 Hayes Place Estate (Part) 114 Purchased Properties 32 43 Under construction:— Units Hayes Place Estate (part) 114 Schemes prepared— Tenders awaiting Ministry approval:— Hayes Place Estate (part) 107 Tenders to be invited:— Hayes Place (Old Peoples) 48 Bromley Park 61 Longfield Extension 9 Nichol Lane 6 Havelock Road 8 Scheme to be prepared:— Blyth Road 76 (estimated) TEMPORARY HOUSING: Properties. Units. Occupied. Prefabricated bungalows 325 325 325 Requisitioned properties available for occupation 356 731 731 Half-way houses and camps 8 125 125 689 1,181 1,181 Lettings during 1952. 1. (a) No. of permanent houses occupied during 1952:— Re-let 93 New Properties 155 248 (b) No. of families accommodated in permanent houses during 1952 248 (c) No. of persons accommodated in permanent houses during 1952 989 2. (a) No. of premises requisitioned during 1952 Nil (b) No. of premises de-requisitioned during 1952 19 3. No. of families on waiting list as at 31st December, 1952: — Medical Category 12 General Category 1,679 O.A.P. 157 1,848 In addition to the above, 70 houses were erected by private enterprise during the year 1952. SECTION E. INSPECTION AND SUPERVISION OF FOODS 46 SECTION E. INSPECTION AND SUPERVISION OF FOODS. This service continues to receive the special attention of the Department, and is one of its main functions. The co-operation of the shopkeepers, restaurant owners, etc., and the personnel engaged in the preparation and handling of food has been all that could be desired. No formal action was taken by the Council, during the year 1952, under the Bye-laws adopted under Section 15 of the Food and Drugs Act, 1938. FOOD AND DRUGS ACT, 1938—FOOD SAMPLING. Article Samples taken. Result. Remarks Formal. Informal. Genuine. Adulterated. Almond Paste - 1 1 - Aspirin — 2 1 1 See (a) Baby Moussec — 1 1 — Baking Powder — 1 1 — Blanc Mange Powder — 1 1 — Breakfast Sausage — 1 1 — Butter — 2 2 - Castor Oil — 1 1 — Cheese Spread — 2 2 — Children's Tonic — 1 1 — Christmas Pudding — 2 2 — Coffee — 2 2 — Coffee Extract — 1 1 — Condiment (Non-brewed) — 1 1 — Cooking Fat — 1 1 — Creamed Rice — 1 1 — Culinary Synthetic Essence — 1 1 — Cut Mixed Peel — 1 1 — Diabetic Apricot Jam — 1 1 — Egg Vermicelli — 1 1 — Fish Cakes — 1 1 — Fish Paste — 2 2 — Flour (National Wheat) — 1 1 — Flour (Self Raising) — 1 1 — Fondant — 1 1 — Fruit Cake — 1 1 — Fruitarian Cake (Date & Ginger) - 1 1 - Frying Oil — 1 1 — Garden Fresh Mint — 1 1 — Ginger Ale — 2 2 — Glycerine — 1 1 — Ground Almonds — 1 1 — Horseradish Sauce — 1 1 — Ice Cream (Loose) — 8 8 — Ice Cream (Pre-Packed) — 22 22 — Ice Cream (Choc. Pre-Packed) — 1 1 — 47 Jam (Smooth-Peach) — 1 — 1 See (b) Jam (Victoria Plum) — 1 — 1 See (c) Juice of Real Lemons — 1 1 — Junior Bacca — 1 1 — Lactic Sugar — 1 1 — Lard — 1 1 — Lemonade — 1 1 - Lemonade Crystals — 1 1 - Lemonade Powder (Sweetened) — 1 1 - Liquid Paraffin — 1 1 - Liquid Orange Colouring — 1 1 - Luncheon Meat — 1 — 1 See (d) Lung Tonic — 1 1 - Malted Milk Tablets — 1 1 - Margarine — 2 2 - Marshmatlow Creme — 2 2 - Matti (Tea) — 1 1 - Meat Paste — 2 2 — Meringue Powder — 2 1 1 See (e) Milk (Pasteurised) — 11 11 - Milk (Channel Island Past.) — 6 6 — Milk (South Devon Past.) — 1 1 - Milk (T.T. Pasteurised) — 3 3 - Milk (Tuberculin Tested) — 1 1 - Milk (Yoghourt) — 1 1 - Milk (Sterilised) — 3 3 - Milkream — 1 1 - Minced Beef Loaf — 1 1 - Mincemeat — 2 2 - Nurse Harvey's Mixture — 1 1 - Orange Juice — 2 1 1 See (f) Orange Squash — 2 2 - Oysters (Canned) — 1 1 - Pate Foie — 1 1 - Peanut Butter — 1 1 - Pepper (Ground White) — 2 2 - Pepper Flavoured Compound — 1 1 - Pickles — 1 1 - Pineapple Juice — 2 1 1 See (g) Port-type British Wine — 1 1 - Processed Cheese — 1 1 - Puff Pastry — 1 1 - Rolled Fillets of Anchovies — 1 1 - Saccharin Tablets — 1 1 - Salad Cream — 1 1 - Sardines in Edible Oil — 1 1 - Sausages 5 5 4 6 See (h) (i-vi) Sausage Meat 1 2 — 3 See (j) (i-iii) Shredded Beef Suet - 3 3 — Sherbert Fountain — 1 — 1 See (k) Sherbits — 1 1 — Soft Icing — 1 — 1 See (1) Synthetic Cream — 2 2 — Synthetic Cream Powder — 1 1 — Tapioca (Seed Pearl) — 1 1 — Tea - 1 1 — 48 Table Jelly — 2 2 — Tomato Juice Cocktail — 1 1 — Tomato Ketchup — 2 2 — Tonic Water — 2 2 — Vinegar (Malt) — 5 4 1 See (m) Welsh Rarebit — 1 1 — 6 176 163 19 (a) Aspirin 5.16 grains per tablet. Free Salicylic Acid 0.1%, i.e., twice B.P. Limit. (b) Soluble solids 67.7%. Slight deficiency in soluble solids. Fruit approximately 67%—sulphite none. (c) Soluble solids 65%. Fruit approximately 58%. Free from sulphite. Slightly low in soluble solids. (d) Meat 69%. (e) Potato starch and wheat flour with m.e. cellulose. (Inaccurate label—ingredients in wrong order and wheat flour not Amylum) (f) Vitamin C. 9.3 mg/fl. oz. Not "fortified." (g) Vitamin C. 2.0 mg/fl. oz. Not "fortified." (h) (i) Adulterated. 53% Meat. 18.5% deficient. (ii) Adulterated. 52% Meat. 20% deficient. (iii) Inferior. Meat 58%. Sulphite absent. Deficient 10.8% minimum amount of meat. (iv) Adulterated. Deficient 16.9% minimum amount of meat. (v) Inferior. Deficient 4.6% minimum amount of meat. (vi) Inferior. Meat 58%. Sulphite absent. (j) (i) Meat 61%. (ii) Deficiency of meat below the minimum amount 16.9%. (iii) Meat 60%. Sulphite none. (k) Maize starch (undeclared) total sugar 46.3%. Sod. bicarb 4.6%. Tartaric Acid 4.2%. (1) Fairly rancid taste due to oxidative rancidity. (m) Acetic acid 4.17w/v, Salt 0.91%. The presence of added salt should be declared. BACTERIOLOGICAL EXAMINATIONS. Milk. No. of Samples taken. Description. Satisfactory. Unsatisfactory. 149 Designated Milk 135 14 6 Washed Bottles 6 - 155 141 14 49 Ice Cream. No. of samples taken Description Satis. Unsatis. Methylene Blue Group I. II. III. IV. 15 Ice Cream (loose) 15 — 11 1 1 2 2 „ „ (mix.) 2 — 1 — 1 — 74* „ „ (Pre-packed) 66 — 52 11 2 1 9 „ „ (choc.) 9 — 6 2 1 — 10 Ice Lollies 10 — 9 — 1 — 110 102 — 79 14 6 3 * 8 samples deteriorated whilst in transit—unable to be tested. There is a decrease in the number of itinerant sellers of Ice Cream within the District, and it is noticeable that at least one reputable firm of manufacturers is offering Ice Cream on the streets. All manufacturers conscientiously comply with the Heat Treatment Regulations, and are producing an Ice Cream of good bacteriological quality. The sale of Ice "Lollies" has increased, and it is hoped that a legal standard will eventually be instituted. One hundred and fifty-two premises in the area are registered to sell Ice Cream. Seven of these are registered to manufacture Ice Cream in this district. Grade. No. of samples. 1947 No. of samples. 1952. % % i 13 17.8 79 77.5 ii 18 24.6 14 13.7 iii 17 23.3 6 5.9 iv 25 34.3 3 2.9 73 100.0 102 100.0 Thirty-one samples were submitted for Chemical examination, the lowest fat content was 6.7% and the highest 18.1%. SPECIAL ENQUIRIES Bacteriological investigation into complaints. Twenty-seven samples of the following foodstuffs were submitted for examination:— 50 Blanc Mange Powder. Meat Pie with Stewed Steak. Brawn (Home Made). Milk Powder. Brawn (Pork). Prunes. Bread. Rice. Chocolate Sauce. Rice Pudding. Chocolate Swiss Roll. Sardines in Peanut Oil. Cooked Meat. Sausages (Beef). Cooked Ham. Self Raising Powder. Crude Sugar Cane Molasses. Spray Process Skim Milk Powder. Dressed Crab. Water. Haricot Beans. of these 16 were satisfactory, 3 inferior or unsatisfactory, and 8 were adulterated. UNSOUND FOOD. The amount of unsound food condemned during 1952 again showed an increase. One thousand six hundred and eighty-seven Food Condemnation certificates were issued, affecting in quantity 30 tons 17 cwts. 1 qtr. 24 lbs. of varied articles of food, which was utilised either for manufacturing purposes, animal food, or where this was impracticable, destroyed. The corresponding figures for the year 1951 were, 1,713 certificates, and 21 tons 2 cwts. 2 qtrs. 9 lbs. of food. Article of Food. Approximate weight (lbs.). Animal Food 2,142 Baby Food 14 Biscuits 236½ Blanc Mange Powder 53 Cake and Cake Mixture 2,423¾ Cereals 21,089¾ Cheese 34½ Coffee 5 Cordials 36 Custard Powder 8¾ Dessicated Coconut 15 Eggs (Liquid) 157½ Eggs 13 Fish (Fresh) 1,349 Fish (Canned) 202½ Fish and Meat Paste 5 Flour 1,428 Fruit (Fresh) 20 Fruit (Canned) 2,680¾ Fruit (Dried) 1,537¾ 51 Fruit Juice 94 Gre-solvent 36 Haggis 1,168 Jams and Marmalade 773¾ Jelly 1½ Lemonade Powder 4 Meat (Canned) 6,102½ Meat (Cooked) 83 Meat (Raw) and Bacon 14,074¼ Meat (Horse) 673 Milk (Canned) 420¼ Milk Powder 277 Milk Food 18 Mincemeat 8 Peel 564 Pepper 2 Pickles and Sauces 59¾ Poultry 266¼ Puddings and Pudding Mixtures 1,134¾ Rabbits 132½ Salad Cream 1¼ Salt 1½ Soda 112 Soft Icing 1½ Soups 257¼ Sugar 101 Sweets 75½ Vegetables (Canned) 8,546½ Vegetables (Dehydrated) 693 Vinegar 3¾ Miscellaneous 18½ 69,156 FOOD PREPARING PLACES There are approximately 259 premises within the area issued with a catering licence by the Ministry of Food. This figure includes school and industrial canteens, hospitals, nursing homes, hotels, public restaurants, etc. INSPECTION OF FOOD PREMISES The Sanitary Inspectors made a total of 3,412 visits of inspection to Food Premises during the year 1952. 148 defects were noted. A total of 191 defects were remedied during the year this figure includes those noted in 1951 which were remedied in 1952, 52 FOOD and DRUGS ACTS, 1938 and 1944. Milk and Dairies Regulations, 1949. The Milk (Special Designation) (Raw Milk) Regulations, 1949. The Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949. The following licences were issued by the Local Authority under the above Regulations. Dealers' (Pasteurisers') Licence 1 Dealers' Licences:— "Pasteurised" Milk 15 "Sterilised" Milk 3.1 "Tuberculin Tested" Milk 15 Supplementary Licences:— "Pasteurised" Milk 14 "Sterilised" Milk 16 "Tuberculin Tested" Milk 14 MEAT INSPECTION. Only two of the five existing slaughterhouses in the Borough are used at the present time. Slaughtering is carried out on behalf of local pig-keeping clulbs, etc. No other slaughtering of animals is carried out in the area, centralised slaughtering still being in operation. Annual licences were granted to five slaughtermen under the provisions of the Slaughter of Animals Act, 1933. The following table gives details of the ante- and postmortem inspection of animals made during 1952:— Carcases Inspected and Condemned. Cattle excluding Cows Cows Calves Sheep and Lambs Pigs Number killed — — — — 15 Number inspected — — — — 15 All diseases except tuberculosis: Whole carcases condemned — — — — — Carcases of which some part or organ was condemned - - - — 3 Percentage of the number inspected affected with disease other than tuberculosis - - - - 20.0 53 Tuberculosis only : Whole carcases condemned — — — — — Carcases of which some part or organ was condemned — — — — — Percentage of the number inspected affected with tuberculosis — — — — — It is of interest to compare this table with similar tables in previous years when 3,000 to 6,000 animals were slaughtered and inspected each year. SECTION F. PREVALENCE OF, and CONTROL OVER INFECTIOUS AND OTHER DISEASES. 56 SECTION F. PREVALENCE OF, and CONTROL OVER INFECTIOUS AND OTHER DISEASES. Statistical details of notifiable infectious diseases are shown in Tables V, VI and VII in the Appendix. Seven hundred and eighty-three cases of infectious diseases (excluding tuberculosis) were notified during 1952. There were no epidemics of a serious nature during the year. SMALLPOX. No cases occurred in the area during 1952, although several contacts of cases came under our daily supervision. VACCINATION. The following figures have been furnished toy the County Medical Officer, and show the number of persons who were vaccinated against smallpox during the year 1952. Year of Birth 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 Before 1938 Total Primary Vaccination 316 222 9 6 3 5 6 1 4 1 4 2 3 – 56 638 Re-Vaccination – 1 1 2 6 4 5 7 2 7 4 7 6 3 4 245 304 ACUTE ANTERIOR POLIOMYELITIS. Six notifications of this disease were received during the year. Five of these cases were removed to hospital. Two were paralytic and four non-paralytic. There was one death from this disease. Months during which the cases were notified:— September 4. November 1. December 1. It was apparent that there were many other cases, during these months, who had the prodromal symptoms without reaching a diagnostic stage. SCARLET FEVER. One hundred and twenty-three cases of Scarlet Fever were notified, giving an attack rate of 1.9 per 1,000 population. Fiftyfour of these cases were removed to hospital, the remainder being home nursed. 57 There was an increase of seventy-six cases over the figure for 1951, but the infection continued to be mild in character, so different from the time when it was one of the infectious diseases to be feared. The cases were fairly evenly distributed throughout the area. There were four "return" cases. There were no deaths from this disease recorded in the Borough. DIPHTHERIA. No cases were notified during 1952, nor were there any cases in 1951:— Cases Deaths 1936/40 116 6 1941/45 67 4 1946/50 18 1 DIPHTHERIA IMMUNISATION. During the year 1952, a total of 848 children received Primary Inoculations and 1142 Reinforcing Inoculations. (Figures for 1951 were 956 Primary and 1076 Reinforcing Inoculations.) A total of 10,042 children under the age of fifteen years on 31st December, 1952, had completed a course of immunisation (i.e., at any time since January 1st, 1938). TYPHOID FEVER. No cases were notified during 1952. PUERPERAL PYREXIA. Fifty-four cases were notified. Fifty-two were institutionally treated and two home nursed. This represents an attack rate of 58.3 per 1.000 total births. There were no deaths in the area from this disease during 1952. OPHTHALMIA NEONATORUM. No cases were notified during 1952. PEMPHIGUS NEONATORUM. No cases were notified during the year. 58 MEASLES. Three hundred and eighty-five cases were notified in the Borough during 1952, as against one thousand three hundred and eighty-one during 1951, giving an attack rate of 6.0 per 1,000 total population. Four of these cases were admitted to hospital and the remainder were home nursed, being of mild virulence. Two hundred and ninety of these cases were notified during December. The distribution of the cases was fairly even throughout the Borough. Should measles become of a more virulent type, much general damage to health of the young child can result—at present we merely accept the notifications as there is no staff to carry out home visitation for advice and protection of other young children. WHOOPING COUGH. One hundred and sixty cases were notified, as against four hundred and forty-four during 1951, giving an attack rate of 2.5 per 1,000 total population. Two cases were removed to hospital and the remainder home nursed. There were no deaths in the area from this disease. Whooping cough vaccine is undergoing experimental tests. It may well be, in a year or so, that whooping cough as an epidemic disease will be controlled much as diphtheria has been controlled. TUBERCULOSIS Recordings in the Register for the year ended 31st December, 1952, are as under: Respiratory Other Forms Total number M. F. M. F. cases On Register at 1/1/52 373 319 50 57 799 New cases notified during 1952 36 36 4 2 78 Number of cases coming to knowledge after death 3 1 – – 4 Restored to Register — 1 – – 1 Inward Transfers 20 11 – – 31 432 368 54 59 913 Deletions—deaths, removals, recoveries, etc. 18 19 – 1 38 No. of cases on Register at 31/12/52 414 349 54 58 875 59 Full details of the new cases and mortality during the year 1952 are shown in Table VIII of the Appendix. The number of new cases notified during the year showed an increase of eleven over the corresponding figure for 1951. There were thirty-eight deletions from the Register as against fifty-nine for the previous year. mass x-ray. It was anticipated that a Mass X-Ray Unit would have visited Bromley again during the year 1952, but owing to their heavy commitments this was not found possible. I have commented on this matter in the letter of introduction. food poisoning. Five cases of Food Poisoning were notified during the year. These were all isolated cases. Salmonella Typhi-murium was identified as the agent responsible in two cases ; in the remaining three cases the agent was not identified. OTHER infectious diseases. In addition to the infectious diseases enumerated above, notifications were received as under: Dysentery 5 Erysipelas 7 Meningococcal Infection 1 Pneumonia (all forms) 36 Malaria 1 appendix STATISTICAL TABLES. 62 STATISTICAL TABLES, 1952. TABLE I.—Summary of Statistics, TABLE II.—Causes of Death. TABLE III.—Infant Mortality. TABLE IV.—Analysis of Causes of Infant Deaths. TABLE V.—Notifiable Infectious Diseases—Sex and Age Distribution. TABLE VI.—Notifiable Infectious Diseases—Ward Distribution, Attack and Mortality Rates. TABLE VII.—Notifiable Infectious Diseases—Seasonal Incidence. TABLE VIII.—Tuberculosis—New Cases and Mortality. TABLE IX.—Housing Statistics. TABLE X.—Summary of the work of the Sanitary Inspectors. TABLE XI.—Factories Acts, 1937 and 1948. TABLE XII.—Nuisances, Defects and Contraventions Abated. 63 TABLE I. Summary of Statistics 1952. Population (mid-year 1952, per Registrar General) 64,350 Birth Rate 1.1 Death Rate 11.2 Maternal Mortality Rate Nil Infant Mortality Rate 22.0 Number of Births (live) 908 Number of Stillbirths 18 Number of Deaths 720 Number of Maternal Deaths Nil Number of Infant Deaths (under 1 year) 20 Death Rate of Respiratory Diseases 1.17 ,, „ „ Tuberculosis 0.17 ,, ,, „ Cancer 1.77 „ ,, ,, Zymotic Diseases 0.031 Notifications of Infectious Diseases: Scarlet Fever 123 Diphtheria Nil Poliomyelitis 6 Typhoid Fever Nil Puerperal Pyrexia 54 Pneumonia (all forms) 36 Tuberculosis (New Cases) 78 Number of Deaths from Infectious Diseases 2 „ „ „ „ Diarrhoea (under 2 years) Nil „ „ „ „ Child Birth Nil Number of visits by Sanitary Inspectors 11,218 64 TABLE II. Causes of Death, 1952. 1951 19 5 2 Male Female Total 1. Tuberculosis—Respiratory 18 8 3 11 2. ,, other 2 — — — 3. Syphilitic diseases 6 2 1 3 4. Diphtheria — — — — 5. Whooping Cough — — — — 6. Meningococcal Infections — — — — 7. Acute Poliomyelitis — 1 — 1 8. Measles 1 — — — 9. Other infective and parasitic diseases 3 — 1 1 10. Malignant neoplasm, stomach 21 15 9 24 11. Malignant neoplasm, lung bronchus 22 10 4 14 12. Malignant neoplasm, breast 12 — 11 11 13. Malignant neoplasm, uterus 8 — 3 3 14. Other malignant and lymphatic neoplasms 65 31 31 62 15. Leukaemia, aleukaemia 2 3 1 4 16. Diabetes 6 — 3 3 17. Vascular lesions of nervous system 84 30 72 102 18. Coronary disease, angina 80 56 48 104 19 Hypertension with heart disease 38 6 7 13 20. Other heart disease 133 61 82 143 21. Other circulatory disease 24 19 25 44 22. Influenza 7 — — — 23. Pneumonia 31 11 19 30 24. Bronchitis 40 24 15 39 25. Other diseases of the respiratory system 11 3 3 6 26. Ulcer of stomach and duodenum 13 7 2 9 27. Gastritis, enteritis and diarrhoea 2 — 1 1 28. Nephritis and nephrosis 4 2 3 5 29. Hyperplasia of prostate 8 11 — 11 30. Pregnancy, childbirth, abortion — — — — 31. Congenital malformations 6 4 6 10 32. Other defined and ill-defined diseases 59 21 26 47 33. Motor vehicle accidents 7 3 2 5 34. All other accidents 15 4 4 8 35. Suicide 6 4 2 6 36. Homicide and operations of war 1 — — — All causes 735 336 384 720 65 TABLE III. INFANT MORTALITY, 1952. (Compiled locally from Registrar's Death Returns) CAUSES OF DEATH Under 1 Week 1 and under 2 Weeks 2 and under 3 Weeks 3 and under 4 Weeks Total under 4 Weeks 1 month and under 3 Months 3 months and under 6 Months 6 Months and under 9 Months 9 Months and under 12 Months Total Deaths under 1 year Atelectasis 1 — — — 1 — — — — 1 Malformation — — — — — — — — — — Prematurity 3 — — — 3 — — — — 3 Broncho-Pneumonia — — 1 — 1 3 2 1 — 7 Other Causes 1 1 — — 2 — 4 2 1 9 Totals 5 1 1 — 7 3 6 3 1 20 66 TABLE IV. Analysis of Causes of Infant Deaths 1946-1952. 1946 1947 1948 1949 1950 1951 1952 Total No. of Births (live) 1,176 1,304 1,042 1,030 892 916 908 7,268 Infant Mortality Rate (per 1,000 Live Births) 26.3 19.11 20.15 15.5 21.3 12.0 22.0 19.7 Malformation 3 13 — — — 1 — 17 Prematurity 14 5 6 3 5 3 3 39 Respiratory Diseases 4 5 2 1 4 2 7 25 Marasmus and General Debility — — — — — — — — Infectious Diseases 1 — — 3 — 1 — 5 Gastro Enteritis — — 1 1 — — — 2 Convulsions — — — — — — — — Atelectasis — — — 1 1 1 1 4 Congenital Heart Disease — — — 3 4 — 5 12 Other Causes 9 2 12 4 5 3 4 39 Totals 31 25 21 16 19 11 20 143 67 TABLE V. Notifiable Infectious Diseases, 1952. Sex and Age Distribution Disease Totals Under 1 1-2 3-4 5-9 10-14 15-24 25 and over Age Unknown M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Scarlet Fever 66 57 – – 7 4 9 9 48 37 2 4 – 2 – 1 – – Whooping Cough 71 89 2 2 19 18 14 24 36 41 – – – 1 – 3 – – Poliomyelitis (Paralytic) 1 1 – – – 1 – – – – – – – – 1 – – – (Non Paralytic) 3 1 – – — – – – 2 1 – — 1 – – – – – Measles 206 179 2 2 23 32 51 29 123 109 3 3 1 – 3 3 – 1 Diphtheria – – — — — — – – – – – – — – – – – – 347 327 4 4 49 55 74 62 209 188 5 7 2 3 4 7 – 1 Under 5 5-14 15-44 45-64 65 and over Age Unknown Acute Pneumonia 20 16 3 2 1 2 4 3 9 5 3 4 – – Dysentery 3 2 – – 1 1 2 1 – – – – – – Erysipelas 1 6 – – – – – 1 – 3 1 2 – – Cerebro-Spinal Fever – 1 – – – 1 – – – – – – – – Puerperal Pyrexia – 54 – – – – – 54 – – – – – – Typhoid & Paratyphoid fevers – – – – – – – – – – – – – – Food Poisoning 2 3 – – 1 1 1 – – 1 – 1 – – Ophthalmia Neonatorum – – – – – – – – – – – – – – Tuberculosis— Pulmonary 59 49 3 4 1 4 35 36 17 3 3 2 — — Non-Pulmonary 4 2 2 — 1 1 1 1 – – – – – – Malaria 1 – – – – – – – 1 – – – – – 90 133 8 6 5 10 43 96 27 12 7 9 – – 437 460 68 TABLE VI. Notifiable Diseases, 1952. Ward Distribution, Attack and Mortality Rates. Disease Total WARDS Cases removed to Hospital Attack Rate per 1,000 population No. of Deaths Death Rate per 1,000 population Plaistow Martins Hill Town Sundridge Bickley Bromley Common Keston and Hayes Scarlet Fever 123 8 13 8 14 15 41 24 54 1.91 – – Whooping Cough 160 22 7 – 9 8 46 68 2 2.48 – – Acute Poliomyelitis (Paralytic) 2 1 – – 1 – – – 2 0.03 1 0.02 „ ,, (Non-Paralytic) 4 – 1 — — 1 1 1 3 0 06 – — Measles 385 41 64 38 65 39 107 31 4 5.98 – – Diphtheria – – – – – – – – – – – – Acute Pneumonia 36 6 4 13 3 2 3 5 23 0.56‡ 30 0.47 Dysentery 5 – – – 1 1 2 1 1 0.08 – – Erysipelas 7 – – – 2 1 4 – 2 0.11 – – Cerebro-spinal Fever 1 – – – – – 1 – 1 0.02 – – Puerperal Pyrexia 54 – – 52 – – 2 – 52 58.33§ – – Typhoid & Paratyphoid Fever – – – – – – – – – – – – Tuberculosis (Pulmonary) 108 19 20 9 18 12 15 15 29 1.68 11 0.17 „ (Non-Pulmonary) 6 – 1 — — 1 2 2 5 0.09 – – Food Poisoning 5 1 1 – – – 1 2 2 0. 08 – – Ophthalmia Neonatorum – – – – – – – – – – – – Malaria 1 1 – – – – – – 1 0.02 – – Totals 897 99 111 120 113 80 225 149 181 13.93 42 0.65 † Includes Pneumonia (all forms). § Based on attack rate per 1,000 total births, and not population. 69 TABLE VII Notifiable Infectious Diseases, 1952. Seasonal Incidence. Disease Jan. Feb. Mch. Apl. May Jne. Jly. Aug. Sept. Oct. Nov. Dec. Total Scarlet Fever 6 13 16 9 8 10 9 4 8 14 14 12 123 Diphtheria – – – – – – – – – – – – – Measles 1 1 8 14 12 7 11 20 6 3 12 290 385 Whooping Cough 4 7 9 6 16 7 6 2 4 11 46 42 160 Dysentery- – – 1 – – – – – 2 1 – 1 5 Erysipelas 1 – – 1 1 – 2 2 – – – – 7 Cerebro Spinal Fever – – – – – – 1 – – – – – 1 Pneumonia (all forms) 3 5 6 7 5 1 1 1 1 – 2 4 36 Typhoid & Paratyphoid Fever – – – – – – – – – – – – – Acute Anterior Poliomyelitis – – – – – – – – 4 — 1 1 6 Food Poisoning – – – 1 – 3 – – – – 1 – 5 Puerperal Pyrexia 7 5 7 2 8 8 2 3 4 — 2 6 54 Malaria 1 – – – – – – – – – – – 1 Totals 23 31 47 40 50 36 32 32 29 29 78 356 783 70 TABLE VIII TUBERCULOSIS New Cases and Mortality during the year 1952. Age groups New cases notified or otherwise revealed. (Not including Inward Transfers.)* Deaths. Pulmonary. NonPulmonary. Pulmonary. NonPulmonary. M. F. M. F. M. F. M. F. Under 5 3 3 2 — — — — – 5—14 1 4 1 1 – – – – 15—44 21 26 1 1 2 2 – – 45—64 13 3 – – 6 1 – – 65 and over 1 2 — — 3 1 – – 39 38 4 2 11 4 – – *Inward Transfers 20 11 – – Totals 59 49 4 2 71 TABLE IX Housing Statistics for the Year 1952. Total number of valuation assessments, houses and flats at 31st March, 1952 18,646 1. Inspection of Dwelling-houses during the year:— (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 482 (b) No. of inspections made for the purpose 4,098 (2) (a) No. of dwelling-houses (included under subhead (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 (b) No. of inspections made for the purpose — (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 2 (4) No. 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 550 2 Remedy of Defects during the Year without Service of Formal Notices :— Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 662 Number of dwelling-houses demolished during the year Nil 72 TABLE X Summary of the Work of the Sanitary Inspectors for the year 1952 TYPE OF INSPECTION. On Complaint Routine ReInspec tion Total Visits Nuisances Found Housing 1. Inspection of District Regulations — 55 — 55 8 2. For Nuisances 793 93 3,212 4,098 1,082 3. Overcrowding 75 90 22 187 7 4. Verminous Conditions 19 11 34 64 20 5. Dirty Conditions 7 6 22 35 4 6. Water Supply 7 3 12 22 3 7. Cesspools 1 2 2 5 1 8. Caravans 1 — – 1 1 9. Privy Pails 2 1 1 4 — 10. Houses Let in Lodgings 1 2 6 9 3 11. Disinfestation 6 2 7 15 o 12. Noxious Accumulations 9 2 6 17 — 13. Other Accumulations 11 10 24 45 6 Totals 932 277 3,348 4,557 1,137 Infectious Diseases— 1. Inquiry Visits (Nuisances found recorded in above table) 40 121 36 197 — 2. Disinfection Purposes 13 63 11 87 — 3. Smallpox Inquiries 4 – – 4 – 4. Public Health (Aircraft Regulations) – – – – – Totals 57 184 47 288 — Meat, Milk and Other Food Shops— 1. Butchers 2 880 37 919 9 2. Confectionery — 87 15 102 8 3. Dairies and Cowsheds (excl. Past. Plants) — 93 3 96 2 4. Pasteurising Plants — 63 2 65 1 5. Fish 1 251 13 265 4 6. Fried Fish 1 90 11 102 4 7. Food Hawkers — 23 — 23 — 8. Fruit, Greengrocery 1 113 19 133 7 9. Grocery 3 641 103 747 34 10. Ice Cream Shops — 160 8 168 — 11. Meat Regulations (Special Visits) — 4 — 4 — 12. Milk Examined on Highway — 9 — 9 — 13. Retail Market — 76 — 76 1 14. Slaughterhouses — 21 — 21 — 15. Horseflesh Shops — 172 3 175 — 16. Restaurants 2 132 35 169 25 17. School Canteens 8 63 21 92 13 18. Public Houses 1 38 26 65 11 19. Food Wholesaler — 7 — 7 – 20. Hotels 1 — — 1 – 21. Clean Food Byelaws 1 138 4 143 18 22. Hospital Food Store and Kitchen — 9 — 9 — 23. Merchandise Marks Act — 18 — 18 11 24. Chemist — 2 — 2 — 25. Cinemas — 1 — 1 Totals 21 3,091 300 3,412 148 Factories, Outworkers, etc. 1. (i) Factories in which Sects. 1, 2, 3, 4 and 6 of the Factories Act 1937 are to be enforced by the Local Authority 12 45 35 92 48 (ii) Factories not included in (i) to which Section 7 applies (a) Subject to Local Authority (transfer of Enforcement) Order, 1938 7 97 84 188 55 (b) Others 3 – 3 6 3 Carried Forward 22 142 122 286 106 73 TABLE X (Continued) Type of Inspection On Complaint Routine ReInspec tion Total Visits Nuisances Found Brought Forward — 22 142 122 286 106 Factories, Outworkers, etc. Contd. 2. Other Premises under the Act (excl. outworkers' premises, hotels, Restaurants, etc. 2 30 9 41 23 3. Bakehouses (a) Mech. power 1 33 21 55 10 (b) Non-mech. power 1 10 5 16 13 4. Outworkers' premises — 52 1 53 — 5. Smoke Abatement 2 6 3 11 2 Totals 28 273 161 462 154 Sampling of Food and Drugs— 1. Milk : T.T. Certiaed — 15 — 15 — T.T. Pasteurised 20 20 — Pasteurised — 43 — 43 — Sterilised — 19 — 19 — 2. Schools Milk (Pasteurised) — 9 — 9 — 3. Pasteurising Plant: T.T. Milk — 22 — 22 — Pasteurised — 26 — 26 — Washed Bottle — 2 — 2 — 4. Dried Milk 2 – — 2 — 5. Ice Cream – 90 — 90 — Ice Cream Mix – 2 – 2 — 6. Other Foods 10 102 4 116 — 7. Food Poisoning 3 10 6 19 — 8. Drinking Water 6 1 5 12 — 9. Court Cases l – – 1 – Totals 22 361 15 398 – Trade Premises – Various 1. Under Shops Act 4 137 46 187 47 2. Under Petroleum Acts – 78 32 110 1 3. Registry Offices 1 27 5 33 5 4. Offices (P.H. 1936 Act, Sees. 46 and 91) 3 8 11 22 7 5. Pet Animals Act — 19 5 24 3 6. Diseases of Animals Acts: Movement Licences — 20 — 20 — Foot and Mouth Disease 12 42 — 54 — Swine Fever — 1 – 1 — Fowl Pest — 5 — 5 — Anthrax – 14 4 18 — Other — 12 12 24 1 Interviews — 348 — 348 — 7. Piggeries,Cleansing 4 30 5 39 1 Sanitary Conditions — 7 – 7 1 8. Stables: Cleansing 1 11 7 19 3 Sanitary Conditions 1 2 1 4 — 9. Animals, Keeping of 7 17 6 30 1 10. Poultry Farms — 1 — 1 — Totals Rodent Control— 33 779 134 946 70 1. Trade Premises 5 46 129 180 2 2 Private Premises 57 22 47 126 11 3. Sewers — — — — — Totals 62 68 176 306 13 74 TABLE X. (Continued') TYPE OF INSPECTION On Complaint Routine ReInspec tion Total Visits Nuisances Found Miscellaneous— 1. Schools 5 6 9 20 7 2. Drain Tests: Smoke 10 15 1 26 8 Water 7 49 30 86 13 Colour 9 2 — 11 2 Chemical — — 1 1 – Mirror — — — — — 3. Swimming Baths: Visited — 52 17 69 5 Samples taken — 32 — 32 — Chlorine & Ph. Test — 86 9 95 — 4. Tents, Vans and Sheds 4 71 10 85 3 5. Accumulations (other than dwellings) 4 28 64 96 12 6. Streams and Ponds 4 22 12 38 2 7. Tips 3 7 3 13 3 8. Special Visits 27 138 4 169 7 9. Public Houses—Urinals 1 81 10 92 5 10. Exhumation – 1 — 1 — 11. Pig food bins 2 — 6 8 3 12. Cinemas 1 4 — 5 1 Totals 77 594 176 847 71 Grand Totals 1,232 5,627 4,357 11,216 1,593 75 TABLE XI Factories Acts, 1937 and 1948. I. Inspections for purposes of provisions as to health. Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted (a) Factories in which Sections 1, 2, 3, 4, and 6 are to be enforced by the Local Authorities (8 92 9 – (b) Factories not included in (a) in which Section 7 is enforced by the Local Authority 221 188 7 – (c) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) 139 41 8 – Totals 428 321 24 – II. Cases in which defects were found. Particulars No. of cases in which defects were No. of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness (Sect. 1) 24 21 – – – Overcrowding (Sect. 2) 1 1 — – — Unreasonable temperature (Sect. 3) 1 1 — 1 — Inadequate ventilation (Sect. 4) 3 — — — — Ineffective drainage of floors (Sect. 6) — — — — — Sanitary Conveniences (Sect. 7)— (a) Insufficient 8 8 – 2 – (b) Unsuitable or defective 49 50 — 8 — (c) Not separate for sexes 4 6 — 2 — Other offences against the Act (not including offences relating to Outwork) 20 18 — — — Totals 110 105 — 13 — Outwork: Nil. 76 TABLE XII Nuisances, Defects, Contraventions, etc., Abated or Remedied in 1952 HOUSING Drainage— Premises re-drained and connected to sewer 1 Cesspools abolished 2 Earth closets abolished — Cesspools emptied 2 Privy pails, etc., abolished — Drains relaid or repaired 96 Drains unstopped 117 Inspection chambers provided 11 W.C's. provided (additional or separate) 7 „ buildings reconstructed 3 „ ,, repaired 4 pans renewed 24 „ „ cleansed 1 „ box seats removed 4 Soil vent pipes renewed or repaired 8 Sink/bath waste pipes renewed or repaired 23 Sinks renewed 8 Lavatory basins renewed or repaired 11 Baths „ „ 3 — 325 Dampness- Roofs repaired or renewed 190 R.w.p.'s, guttering, repaired or renewed 103 Vertical Plinth provided 6 Walls rendered 33 Horizontal damp-course provided 4 Solutioning 2 Earth removed from walls 14 Walls repointed 20 Weather-board walls repaired — Sub-floor ventilation provided or improved 16 Dry areas constructed 7 Brickwork repaired 33 Miscellaneous 30 — 458 Water Supply- Drinking water service supplied direct from main 6 Fittings, etc. renewed 26 Separate or additional water supply provided 4 Supply reinstated 1 Flushing cisterns renewed or repaired 19 Storage tanks „ „ „ 1 Boilers „ „ „ 2 59 77 TABLE XII (Continued) General Items- Rooms cleansed 135 W.C. walls cleansed 12 Entrance hall and staircase cleansed 19 Bathroom cleansed 5 Light and ventilation improved 3 Plastering repaired or renewed 265 Floors repaired or renewed 87 Windows, frames, etc. repaired or renewed 90 Sashcords repaired or renewed 40 Putty pointing repaired or renewed 9 Doors repaired or renewed 13 Stoves and grates repaired or renewed 41 Coppers repaired or renewed 3 Handrails repaired or renewed — Stairtreads repaired or renewed 4 Dustbins provided 84 Dirty conditions remedied 3 Overcrowding abated — Chimneys repaired 16 External woodwork repainted 6 Food stores provided — Food stores ventilated 1 Yard paving, etc. renewed 6 Houses disinfested 23 Accumulations removed 22 Fencing 2 Miscellaneous 1 — 890 MEAT, MILK AND OTHER FOOD PREMISES- Yard floors, repaired, etc. 7 Cleansed, lime-washed shops, rooms 40 Lighting/Ventilation improved 7 Drains improved 13 Manure or refuse removed 4 Refuse bins provided 5 Cold store or refrigerator improved 1 Water supply improved 3 Sinks provided 6 Washing facilities improved 31 Sanitary conveniences improved 25 Miscellaneous 49 — 191 FACTORIES, OUTWORKERS, Etc.— Want of Cleanliness (Sect. 1) 21 Overcrowding (Sect. 2) 1 Unreasonable temperature (Sect. 3) 1 Inadequate ventilation (Sect. 4) — Ineffective drainage of floors (Sect. 6) — Sanitary conveniences (Sect. 7): (a) Insufficient 8 (b) Unsuitable or defective 50 (c) Not separate for sexes 6 Other offences 18 Outworkers' premises — Smoke nuisances 4 — 109 78 TABLE XII (Continued) TRADE PREMISES— Shops Act: Ventilation improved 1 Temperature improved — Sanitary conveniences improved 3 Absence of statutory forms 34 Unsatisfactory Washing facilities remedied 2 Meals rest interval contraventions remedied 2 Seats for female workers provided 2 Other offences or defects remedied 7 Petroleum Acts contraventions 1 Registry Office contraventions 5 Offices (P.H. Act, 1936, Sect. 46 and 91) contraventions 4 Pet Animals Act — 61 RODENT CONTROL— Trade premises 46 Private premises 347 Sewers (manholes) 191 Corporation property 584 MISCELLANEOUS— Diseases of Animals Acts: Piggeries—Cleansing 1 Piggeries—Sanitary Conditions — Stables—Cleansing 1 Stables—Sanitary Conditions — Animals, Keeping of 1 Poultry Farms — Schools 7 Drain tests: Smoke — Water 14 Colour — Swimming Baths—visited 3 Tents, Vans and Sheds — 1 Accumulations (other than dwellings) 7 Streams and Ponds 1 Tips 1 Public Houses—Urinals 3 Cinemas 1 41 Grand Total 2,718 NOTICES ISSUED— Preliminary : Housing 550 Food Premises 83 Factories, etc. 68 Trade Premises 37 Rodent Control 481 Miscellaneous 79 1,298 Statutory Nil 1,298 BOROUGH OF BROMLEY COMMITTEE FOR EDUCATION ANNUAL REPORT on the SCHOOL HEALTH SERVICES for 1952 January, 7953 K. E. TAPPER O.B.E., G.M., M B., Ch.B., D.P.H. Medical Officer of Health 80 Members of the Welfare Committee. Alderman M. Stafford Smith, M.B.E. B.A. (Chairman). Alderman Marion Green, J.P. (Vice-Chairman). Councillor P. M. James. Councillor F. G. Austin. Councillor G. H. Russell. Councillor L. C. Winterton, J.P. Rev. F. W. Armstrong, M.A. Mrs. E. R. Baylis. Officers of the Committee. Borough Education Officer: H. T. Smith, M.A. Assistant Education Officer: A. C. Cleveland. Education Welfare Officers: S. J. Mann and L. Saysell. Staff. Medical Officers. Proportion of time allocated to School Health Service. Whole-time. Medical Officer of Health Dr. K. E. Tapper 25% Deputy Medical Officer of Health Dr. H. B. C. Carter-Locke 50 %* Assistant Medical Officers Dr. P. A. Currie 70% Dr. S. A. Laing 44% Part-time. Ophthalmic Surgeon Dr. Eric Lyle. 3 sessions per week. Orthopaedic Surgeon Mr. K. F. Hulbert. 2 sessions per month. Dental Officers. Mr. A. F. King. Whole-time. Mrs. C. McKenzie Lindsay. Whole-time. Clinic Assistants Mrs. E. Brooks. Whole-time. Mrs. D. Harris. Whole-time. Nursing Staff. Mrs. N. M. Taylor. Miss W. G. Hemmings. Miss E. Chenery. Miss K. Owens. 50% Mrs. V. Greig. Miss M. E. Wootton. Mrs. M. Hocking (Temp.) Part-time. Physiotherapist Mr. W. A. Taylor. 6 sessions per week. Orthoptist Miss M. A. Jones. 6 sessions per week. Clerical Staff. Chief Clerk Mr. S. F. Judd. 3/8 Senior Clerk Mr. E. P. J. Wythe. 3/8 Clerk (Clerical Division) Mrs D Cox. 3/4 Clerk (General Division) Mrs. W. J. Foot. 3/4 Clerk (General Division) Mrs. R. C. Tye. 3/4 * Includes duties in connection with Independent Schools, 81 To the Chairman and Members of the Welfare Committee. School Health Service. The School Health report for the year 1952 follows the usual form. It shows that the school child is maintaining a good standard of health and that we have not been faced with any outbreak of a debilitating disease. The problems met with in the early years of the School Health Service, e.g., impetigo, ringworm (scalp), the unclean child and rickets, have very largely disappeared. We can safely say that the nutrition and care of children has improved, an improvement which, while not wholly due to the School Health Service over the past thirty years, can be placed to the effort of enlightened Education Committees. Although the medical inspections at school of routine age groups do not now show, and have not shown over the last decade, the grossly neglected defects so common in the early days of the Service, we still meet with defects of vision, defects affecting nose and throat and minor physical and orthopaedic deformities. The problem "behaviour" child is always before us, but in the main this is not the fault of the child and in most cases the problem is overstressed. The year saw changes in medical staff. The retirements of Drs. Stinson and Orgler and the redistribution of work to two instead of three Assistant Medical Officers has led to economy while maintaining efficiency. The clerical and statistical work of the School Health Service entails close and detailed recording in order to compile the official forms and records. It is a section of the work which is unfortunately increasing. I have again this year included the report of the Advisers of Physical Education for I believe full publicity should be given to this very valuable work in the physical development of the school child. The reports of the specialists, Dr. Lyle and Mr. Hulbert, speak for themselves. Mr. King's report on the School Dental Service shows the line of progress of a service which, during recent years, passed through the doldrums. Dr. Carter-Locke has continued the inspection of eight Independent Schools, a work which is receiving the full support of the parents of children attending these schools and is of proved value to the schools themselves. 82 The School Health Service during 1952 has run smoothly and without difficulty, due to the keen work of the staff, clerical and professional, and to the co-operation and help received from Mr. Smith, the Borough Education Officer, and not least, as a result of the sound direction of the Welfare Committee. K. E. TAPPER. Medical Officer of Health. GENERAL INFORMATION. Numbers on 1951. School Roll. 1952. County Primary Schools 4.501 4,897 County Secondary Schools 1,884 1,897 County Grammar and Technical Schools 1,737 1,764 Total 8,122 8,558 Further Education. Bromley College of Arts. Tweedy Road. Department of Building, Wharton Road. Technical Institute. Bromley Technical Institute, "Springhill," College Road. Clinics. Minor Ailments. North Clinic, Station Road Monday to Friday. a.m. (Doctor in attendance) Thursday. a.m. South Clinic, Princes Plain Monday to Friday. a.m. (Doctor in attendance) Wednesday. a.m. Medical Room, Hayes School Monday to Friday. a.m. (Doctor in attendance) Wednesday. a.m. Medical Room, Quernmore School Mon., Wed. & Fri. a m. Medical Room, Burnt Ash School Mon., Tues. & Thurs. a.m. (Doctor in attendance) Thursday a m. Medical Room, Aylesbury Road School Monday to Friday. a.m. Medical Room, Southborough School Monday to Friday. a.m. Dental. North Clinic, Station Road Monday to Friday. a.m. & p.m. (By appointment only.) South Clinic, Princes Plain (Closed for time being owing to lack of Dental Officers.) Sunlight Clinics. North Clinic, Station Road Tuesday, p.m. & Friday, a.m. South Clinic, Princes Plain Monday & Wednesday. p.m. 83 Specialist Clinics. Ophthalmic. North Clinic, Station Road Monday & Wednesday. a.m. Friday. p.m. (By appointment only.) Orthopaedic. North Clinic, Station Road 1st & 3rd Friday in every month. p.m. (By appointment only.) Speech. South Clinic, Princes Plain Monday p.m. (By appointment only.) Lip Reading. South Clinic, Princes Plain Wednesday 5-6 p.m. Saturday 10 a.m. - 12 noon. The attendances at the minor ailment treatment clinics have decreased considerably during the year, a total of 7,957 attendances being made compared with 11,779 during 1951, and 12,229 in 1950. The main types of ailments treated were:— 1950. 1951. 1952. Ringworm, Body 7 25 6 Scabies 9 — — Impetigo 36 28 8 Other Skin Diseases 397 457 372 Minor Ear Defects 222 240 197 Miscellaneous (e.g., minor injuries, bruises, sores, chilblains, etc.) 2.413 2,277 1,973 The attendance of the doctor at minor ailment clinics has now been reduced to one session a week at each of four clinics, minor ailment treatments being carried out by the School Nurses as need arises, cases requiring medical advice being referred to the General Practitioner or to the clinic doctors at their weekly visits. SCHOOL HYGIENE. There have been no noteworthy improvements during the year. The high standard of cleanliness and hygiene of the Bromley Schools has been maintained. During the year the new Southborough Junior School was completed, provision being made for 520 pupils. The programme for the year 1953 provides for a commencement to be made on the new Bickley and Widmore School, and an additional classroom and lavatory accommodation at St. Joseph's School. The standard of cleanliness at the school canteens continues to foe most satisfactory, and the Sanitary Inspectors made frequent visits of inspection during the year, 84 MEDICAL INSPECTIONS AT SCHOOLS. Three thousand seven hundred and thirty-eight children were examined at schools and clinics during the year, necessitating the holding of 286 medical inspection sessions. (1951 figures were 3,367 children and 259 sessions.) The average attendance at each session was 13.7, compared with 13 for 1951. Two hundred and fifty-three individual pupils were found to require treatment (excluding Dental Diseases and Infestation with Vermin), giving a percentage of 6.8 compared with 9.6 for the year 1951. Information on the general condition of the pupils inspected in the various age groups will be found in Table II—B, at the end of this report. Comparative rates for the past five years are given below 1952. 1951. 1950. 1949. 1948. Category A. (Good) 50.08% 64.42% 68.35% 54.60% 49.25% Category B. (Fair) 48.90% 34.63% 30.17% 43.65% 46.72% Category C. (Poor) 1.02% 0.95% 1.48% 1.74% 4.02% The interpretation of this classification of A, B, C, must not be taken too critically—they are based on an overall opinion on the child. Categories A and B are so closely associated in type that to make comparison with previous years would be unreliable. The attendance of parents at routine medical inspections is still high, and the examinations continue to show a satisfactory standard of health and general physique in the Bromley child. SPECIAL EXAMINATIONS. One thousand eight hundred and ninety-seven cases have come under medical supervision during the past year, necessitating 2,781 medical examinations. (2,438 cases and 4,567 medical examinations during 1951.) Sixty-five cases requiring special investigation were referred for examination at the Municipal Offices. One hundred and seventy-five cases were referred to the various hospitals for other Specialists' advice and treatment. The closest liaison exists between this Department, the hospitals and the General Practitioners, and I am indeed grateful to them for the assistance given. 85 DENTAL SERVICE. Mr. King reports:— "Much progress has been made during the past year. Inspections of the children at school has been stepped up and as a result, a considerable amount of conservative treatment has been carried out. Where parental consent has been forthcoming, practically every child so examined has been restored to dental fitness. In August, owing to retirement, we lost the valuable services of Mr. S. Russell Edey, who attended for three sessions weekly. This depletion of staff was, very fortunately, counteracted by the appointment, in November, of Mrs. Lindsay, a full-time Dental Officer, and I now visualise a vastly improved and more comprehensive service. The Maternity and Child Welfare facilities have continued to operate very satisfactorily. During the year 487 presented themselves for treatment and have received all operative and prosthetic treatment necessary to restore dental health. Conservative and surgical treatment has been given priority, and orthodontic treatment has of necessity been limited as each case takes up a considerable amount of time. When the contemplated re-opening and modernisation of the clinic at Princes Plain is completed it will enable a much better dental service to be given to the Borough, as a clinic will then be situated at each end of the town and the time saved in travelling will be welcomed by both parents and school teachers alike. I look to 1953 with every confidence. To the Radiologists and Staff of Bromley Hospital, I again express my grateful thanks for their very willing co-operation and help during the past year. For details of inspections and treatments, reference should be made to the Statistical tables at the end of the main report." OPHTHALMIC CLINIC. I am indebted to Dr. Eric Lyle for this report:— "I am pleased to be able to report that the work of the School Eye Clinic has gone on steadily and in a happy atmosphere during the year 1952. Three sessions have been held regularly each week on Mondays, Wednesdays and Fridays. Attendance has been good. The work consists mainly of the correction of refractive errors, the treatment of squints and the treatment of minor diseases of 86 the eyes, such as blepharitis, corneal ulcer and defects of the lachrymal passages. Parents have co-operated well over the treatment of squints, which is often a prolonged and difficult piece of work, requiring a great deal of patience on the part of the mothers. Several pieces of worn-out and out-of-date medical apparatus have been able to be replaced this year. The result is that the Clinic is now very well equipped. I should like to conclude by offering my sincere thanks to all those who have helped so untiringly to make the School Eye Clinic run so smoothly. The Health Visitors and School Nurses have played their part valiantly. As usual the Secretarial staff have been most co-operative and most helpful in every way. Only with such assistance is it possible for the Clinic to carry on in the trouble free way in which it does." ORTHOPTIC CLINIC. Over the past year 1,828 treatments have been given. There are no waiting lists for either new cases or treatments. The increase of 242 treatments from the previous year may be accounted for by the extra number of sessions during 1952 and the increase from two and a half hours, to three hours per session. The number of new patients is always far greater than the number discharged, therefore, the extra half-hour per session allows each patient to be seen a little longer—this being particularly beneficial to new cases. Spectacles are being obtained reasonably quickly after they have been prescribed, but the waiting list for squint operations is still a great drawback. Patients are given a course of orthoptics treatment and then, if necessary, put on the waiting list. By the time they are admitted to hospital, they have often deteriorated so much that their condition is the same as when they first attended the orthoptic clinic. In some cases it is essential to keep up continuous treatment while they are on the waiting list, so that there can be no deterioration. This is a gross waste of time and can only be overcome if the waiting list is diminished. EAR, NOSE AND THROAT DEFECTS. During the year 343 children received operative treatment in hospitals for adenoids and chronic tonsillitis, and five for other nose and throat conditions. I have no detailed information as to 87 children receiving treatment for serious diseases of the ear during the year 1952. In addition to the above, 234 children received other forms of treatment at the School Clinics and as Outpatients at the hospitals. ORTHOPÆDIC CLINIC. I am indebted to Mr. K. F. Hulbert, F.R.C.S., (for the following report on this Clinic:— "The Orthopaedic Clinic has continued as before at the Bromley North Clinic, and is now held on the first and third Fridays of every month. There has been some falling off in the number of cases, but the type of case has not materially altered. There are still a lot of cases of poor posture being referred, which really ought not to occur with good physical training at school. As to the other cases, there is the ever present problems of the spastic children, the majority of which cases are not being provided for adequately. Where the child is of sufficient intelligence to be educated there are schools which will take them on, but the child who is sub-normal but not certifiable is not being cared for by either of these institutions and, therefore, we find them on our hands at the school Orthopaedic Clinic. This is the type of case where attention should be given to the education and treatment of these children in large groups. Mr. Taylor has continued as Physiotherapist in charge, and his skill and attention are praiseworthy in every way, and we are all indebted to him for his care and enthusiasm. He has eased some of our problems this year by instructing some of the Physical Training Instructors from the schools so that they can treat some of the older children without their having to miss their education. As far as In-patient treatment is concerned facilities are now available for these patients to be admitted under my care to Sydenham Children's Hospital, thus considerably reducing the distance that they have had to travel previously." PHYSIOTHERAPY AND SUNLIGHT CLINIC. Mr. Taylor reports as follows:— "The work of this clinic during 1952 has been varied and interesting. Remedial exercises classes have been well attended, a total of 2,070 attendances being made, which is a slight increase on the previous year. 88 Among the more interesting have been several cases of Scoliosis. These are treated twice a week, special exercises for the condition are taught. In all cases good progress has been made. The children continue these exercises at home and at school during their physical training period, under the supervision of their physical training teachers. I am very pleased to state that every co-operation is obtained from the schools in these cases. Two fresh Spastic cases have been taken on treatment, both under five years of age. These usually take quite a time to settle down, not understanding what is required of them, but with help from the parents, which is much appreciated and quite essential, they gradually learn what is required. To this purpose the parallel bars, purchased during the year, have assisted greatly. They derive much confidence by holding these bars, which, together with the walking machine, are valuable assets to the Clinic. The sunlight clinic has been extremely busy during the year, a total of 783 treatments having been given. This is quite an appreciable increase on the previous year." SPEECH CLINIC. A Speech Therapy Clinic is held at the South Clinic, Princes Plain, one session a week. At the end of the year there were 63 cases on the waiting list. Of the six cases closed at Bromley during the year, three were closed in view of the improvement made following contact with the clinic; in a fourth case it was found desirable to discontinue attendance in favour of treatment at a Child Guidance Clinic; speech was found to be normal when appointments were offered in a fifth case; in the sixth case the parents did not respond to appointments offered nor to letters written to them. Eight cases were in contact with the clinic at the end of 1952, and will continue to attend the clinic in 1953; one of these is an adult patient for whom special priority was requested in view of the nature of the case and the complications involved. VERMIN AND UNCLEANLINESS INSPECTION. Out of a total of 17,296 routine inspections carried out by the School Nurses, only thirteen children were found to be infested, with a further eighty-eight children showing minor evidence of uncleanliness. The children infested are chronic offenders and as a consequence the routine inspections are being curtailed so that more frequent examinations can be made of the offenders. 89 EXCEPTIONAL AND HANDICAPPED CHILDREN. Twenty-eight attendances were made at the special clinic held at the Municipal Officers for Exceptional and Handicapped Children. There are, at the present time, fifty-three known educationally sub-normal and physically handicapped children in the area. Details of these children are:— Not in School. In residential schools for E.S.N. children 4 6 Attending day schools for E.S.N. children 15 In residential schools for Blind and Partially Sighted children 3 In residential schools for Deaf and Partially Deaf children 3 1 Attending day schools for Deaf and Partially Deaf children 2 In residential premises for Physically Handicapped children 3 3 In residential premises for Delicate children 6 Attending day schools for Delicate children 1 In residential premises for Mal-adjusted children 5 1 There are twenty-six known ineducable children in the area, eleven of this number being in Institutions and fifteen at home. CHILD GUIDANCE. All cases requiring treatment at the Child Guidance Clinics are referred to the local hospital Psychiatric Department. Fifteen cases were referred for treatment during 1952. There has now been established, on a professional basis, a much more closely knit procedure of reporting of cases. MILK IN SCHOOLS. There is no change to report in the arrangements for the provision of milk in schools during the year 1952. The latest return to the Ministry of Education showed that 86.67% of the pupils in attendance at Primary and Secondary Schools received milk on a single day in October. SCHOOL MEALS SERVICE. Despite the continued restrictions on building projects, it is satisfactory to report that the approval of the Ministry of Education was given during the year to the erection of a new Kitchen and Dining Room for 375 meals a day at the Valley County Primary School. Work on the building is in hand and the Canteen should be ready for use at Easter, 1953. The Kitchen and Dining Rooms serving 750 meals a day at Southiborough County Primary School, built in conjunction with the new Junior Department, were completed and taken into use in October. 90 Owing to alterations in the accommodation of the new school at Pickhurst Lane, Hayes, the plans for the Kitchen and Dining Room had to be amended during the year. Provision has now been made to serve 350 meals a day, but it will not be possible for this canteen to be erected until the latter half of 1953. As a result of the Kent Education Committee's decision to reduce the age of admission to Technical Schools from 13 years to 11 years, the provision of a new canteen at the Technical School for Girls has become imperative. Proposals are under consideration for the provision of new accommodation on the school site to serve 600 meals a day. No change has been made during the year in the charge for the mid-day meal which remains at 7d. The number of meals served in schools continues to increase and towards the end of the year the daily average reached 7,062. A return to the Ministry of Education showed that on a single day in October 76.72% of the pupils in attendance at Primary and Secondary Schools received a mid-day meal. EMPLOYMENT OF CHILDREN AND YOUNG PERSONS. Two hundred and sixty-three children were examined by the Assistant School Medical Officers in respect of fitness for employment out of school hours. Fit certificates were issued in all but one case. BROMLEY SCHOOLS' BOOT CLUB. The work of the Bromley Schools' Boot Club progressed satisfactorily during the year 1952. Contributions received from members £630 11s. 11d. Purchases of Footwear £658 10s. 6d. Total number of members, 31st December, 1952 652 Purchases made during the year 627 PROVISION OF CLOTHING. During the year twenty-six applications were received as a result of which thirty-one children of necessitous families were provided with clothing at a total cost of £68 12s. 5d. INFECTIOUS DISEASES IN SCHOOLS. Ninety-two cases of Scarlet Fever in school children were notified during the year, as against 34 for the previous year. Of this number, 56 were home nursed and 36 admitted to hospital. 91 As in previous years, the infection continued to be mild in character and the distribution of the cases was fairly even throughout the area. There were no cases of diphtheria notified in children of school age during 1952. Three cases of Poliomyelitis, all non-paralytic, were notified. Two were admitted to hospital and one was home nursed. There were no deaths from this disease. Three cases of Pneumonia were notified, one child being admitted to hospital. During the year 238 cases of measles and 76 cases of Whooping Cough in children of school age were notified. Four suffering from Measles and six suffering from Whooping Cough were admitted to hospital. The following gives details of the seasonal incidence of the various diseases notified:— Disease Jan. Feb. Mar. Apl. May June July Aug. Sept. Oct. Nov. Dec. Scarlet Fever 5 6 14 8 4 10 7 2 7 11 9 9 Poliomyelitis — — — — — — — — 2 — — 1 Pneumonia — — — 2 — — — 1 — — — — Measles — — 6 9 2 4 7 5 1 — 5 199 Whooping Cough 1 2 3 1 7 3 1 2 2 8 22 24 JUVENILE DELINQUENCY. During the year 86 children and young persons appeared before the Local Court. The types of offences were:— Larceny and attempted Larceny 34 Insulting words and behaviour 1 Road Traffic Act 11 Beyond Control 6 Wilful Damage 9 In need of Care and Protection 7 Breaking and Entering 4 Obstructing passage of footway 9 Playing football in street 5 Inflicting grievous bodily harm 1 Wandering abroad to beg 1 Trespassing on Railway Property 2 Damaging advertisements 2 PHYSICAL EDUCATION, 1952. The following is the report of the Area Advisers of Physical Education:— 92 1. General. Secondary Schools. Reference has been made in the last few years to the growing awareness of the great variety of work possible in Physical Education in Secondary Schools and it is pleasing to note that the schools now provide systematic training in the following major sports:— Hockey, Tennis and Dancing. As a result of the provision of these wider opportunities, the children are leaving school with greater ability to employ their leisure profitably and with a better appreciation of the virtues of our National Games and Sports. During the Easter vacation two Bromley Secondary Girls' Schools demonstrated "Secondary School Gymnastics" at the Annual Conference of the Ling Physical Education Association. Primary Schools. The recent Ministry of Education publication "Moving and Growing" which is Part I of the new Physical Education Syllabus for Primary Schools, has been welcomed by the schools, partly because it shows how well, in five years of free experiment, the teachers have anticipated the new conception of Primary work. It is pleasing to note that several photographs in the book were taken at Bromley Schools; the publication of the final section, Part II, is expected in 1953. 2. Training Courses for Teachers. The following courses, which were well attended, have been organised for the area by the Physical Education Advisers 1. Cricket. Coaching scheme. 32 men. 2. Swimming. Elementary. 24 men and women. 3. Swimming. Advanced. 31 men and women. 4. Modern Dance. Summer: Elementary. 35 men and women. 5. Modern Dance. Autumn: Elementary. 21 men and women. 6. Modern Dance. Autumn: Advanced. 11 men and women. 7. Gymnastics for Secondary Girls. Advanced. 19 women. 8. Primary School P.E. General. 31 men and women. 9. Remedial Work. At Broadstairs. Men and women. 3. Swimming. Provision was made for ten visits to the Baths in the summer term for most schools, with the following attendances:— Schools. No. of classes per week. No. of children per week. Secondary. 52 1,560 (approx.) Primary. 34 1,020 (approx.) 93 The following facilities were used to their fullest extent:— (a) Bromley Open Air Pool. 22 classes, mornings only. (b) Crown (Lane Swimming Bath. 32 classes during school hours. (By kind permission of the Cement (Marketing Company.) (c) Downham Swimming Bath. 29 classes during school hours. (By kind permission of the London County Council.) 4. Schools Sports Associations. (a) Swimming. The growth of the Bromley Schools Swimming Association from thirteen member schools in its first year to seventeen in its second, is indicative of an increased interest in swimming in the schools. The first annual Gala held by the Association, at Downham Baths in July, was very successful. Before about 600 spectators, twenty-four events for Juniors and Seniors were held and six trophies were presented to the successful competitors. These trophies, the first to be presented under the aegis of the new Bromley Schools Swimming Association were the gifts of several kindly and interested citizens of the Borough, and were much appreciated. Prior to the Gala arranged by the Association, several Primary Schools organised their own individual swimming galas. One Bromley boy was selected to represent Division II (Kent and Surrey) in the National Championships held at Bristol, but several took part in the Division's final trials. (b) Athletics—Boys. One of Bromley's Secondary Boys' Schools won the championship of the West Kent Schools Athletic Association and four Bromley boys represented West Kent in the County Championships. (c) Athletics—Girls. West Kent Schools Sports Association. A Bromley school won the Championship and several girls took part in all the major events at the Kent County Schools Sports Association. In a triangular meeting held in the Ladywell area of the London County Council a Bromley school finished second. (d) Boxing. The Secondary Schools again held a triangular contest at the Boys' Grammar School. (e) Football. The County Secondary Schools took part in the competitions organised by the West Kent Association. In all representative teams fielded by the Association there were never less than five Bromley boys. 94 It is pleasing to note that all the Primary Schools in the Borough became affiliated to the West Kent Schools Sports Association and played a full series of friendly matches. (f) Cricket. On account of the shortness of the season the schools prefer not to form a cricket league, but to play friendly matches. One Bromley boy gained a place in the Kent Schools County team and in the London Schools team. (g) Games in Secondary Girls' Schools (Tennis, Rounders, Hockey, Netball). The element of competition usually so marked in Boys' schools does not seem to be so strongly in evidence in Girls' schools. Friendly matches are given preference in every case and it is pleasing to note that, with the exception of Hockey, there is an increase in the number of matches played. The bad weather conditions during the Autumn and Spring Terms appreciably limited the teaching of Hockey. (h) Netball and Shinty. Ten Primary Schools have formed a Primary Schools Association to enable the girls to play friendly matches in these games. 5. Climbing and Agility Apparatus. The Primary Schools greatly appreciate the climbing apparatus which has been supplied during the last three years. There is no doubt that it meets a real need in the children's lives and will be instrumental in improving their physique. Many visitors from local authorities and Training Colleges came to see the apparatus and the work being done upon it. 6. Youth Activities. Economy measures at present permit the formation of only one class of physical recreation for women and one for men. These are held at Aylesbury and Hayesford-Raglan Secondary Schools during the Autumn and Spring terms. English Folk Dance Classes are run under the auspices of the English Folk Dance Society. The Scottish Folk Dance Classes are continuing in a neighbouring area where financial assistance is available. Football. Football pitches have not been so fully booked as in previous years. National Service seems to have affected many of the clubs, some of which have had to close down. 95 Tennis Courts. These have been fully booked and the need for extended facilities is still apparent. Cricket. The second cricket pitch at Oakley field inaugurated last year, has been well used and appreciated. Other pitches have been in full use throughout the summer. Netball. Bookings for Netball matches for Youth Clubs have been steady throughout the good weather. Cycling, Walking and Youth Hostelling offer wonderful opportunities in this area. Organised runs and outings are part of the programme of most of the Clubs during the summer months. 7. Conclusion. The schools are maintaining good progress in Physical Education, although the cessation of supplies of clothing and shoes is necessarily marring the work to some extent, in spite of the efforts of Head Teachers to encourage parents to make full provision of kit for their children. However, judging from the numbers of spectators who attend School Sports and Open Days, there is an increasing parental interest in the physical work of the children. The Advisers wish to record their appreciation of the support of the Borough Education Officer and his staff and of the cooperation of the Heads and Assistant Teachers in the Schools." F. M. BENTLEY, J. LOUGHRAN. Area Advisers of Physical Education. 96 SCHOOL HEALTH SERVICE. STATISTICAL TABLES, 1952. TABLE I.—Medical Inspection of Pupils attending Maintained Primary and Secondary Schools. A. Periodic Medical Inspections. B. Other Inspections. C. Pupils found to require Treatment. TABLE II.—A. Return of Defects found by Medical Inspection in the year 1952. B. Classification of the General Condition of Pupils inspected during the year, in Age Groups. TABLE III.—Group I. Diseases of the Skin. Group II. Eye Diseases, Defective Vision and Squint. Group III Diseases and Defects of Ear, Nose and Throat. Group IV. Orthopaedic and Postural Defects. Group V. Minor Ailments. TABLE IV.—Dental Inspections, Treatment and Orthodontics. TABLE V.—Infestation with Vermin. TABLE VI.—Orthoptic Clinic. TABLE VII.—Handicapped Pupils. TABLE VIII.—Independent Schools. 97 TABLE I. Medical Inspection of Pupils Attending Maintained Primary and Secondary Schools. A. Periodic Medical Inspections. Number of Inspections in the Prescribed Groups:— Entrants 867 Second Age Group 1,493 Third Age Group 401 Total 2,761 Number of other Periodic Inspections 977* Grand Total 3,738 *Children aged 8 years. Children in their 13th year, at County Grammar and Technical Schools. B. Other Inspections. Number of Special Inspections 1,897 Number of Re-Inspections 884 Total 2,781 C. Pupils Found to Require Treatment. Number of Individual Pupils found at Periodic Medical Inspections to require treatment (excluding Dental Diseases and Infestation with Vermin). Group For defective vision (excluding squint) For any of the other conditions recorded in Table II. A. Total individual pupils Entrants 14 50 64 Second Age Group 33 53 86 Third Age Group 15 16 31 Total (prescribed groups) 62 119 181 Other Periodic Inspections 41 31 72 Grand Total 103 150 253 98 TABLE II. A. Return of Defects Found by Medical Inspection. Defect Code No. Defect or Disease Periodic Inspections. Special Inspections. No. of Defects. No of Defects. Requiring treatment Requiring to be kept under observation but not requiring treatment Requiring treatment Requiring to be kept under observation but not requiring treatment (1) (2) (3) (4) (5) 4 Skin 12 6 114 7 5 Eyes— (a) Vision 103 100 82 27 (b) Squint 5 9 5 — (c) Other 8 10 73 12 6 Ears— (a) Hearing 1 9 5 6 (b) Otitis Media 1 - 19 1 (c) Other 2 1 64 1 7 Nose and Throat 30 65 85 47 8 Speech 4 7 8 10 9 Cervical Glands 1 2 8 3 10 Heart and Circulation 2 10 2 26 11 Lungs 8 14 21 20 12 Developmental— (a) Hernia 1 1 1 3 (b) Other 2 46 14 30 13 Orthopaedic— (a) Posture 16 59 18 20 (b) Flat Foot 11 39 31 36 (c) Other 30 30 78 24 14 Nervous System— (a) Epilepsy — 1 24 1 (b) Other 1 7 13 13 15 Psychological— (a) Development 2 5 14 19 (b) Stability — 4 3 4 16 Other 21 103 313 118 Totals 261 528 995 428 B. Classification of the General Condition of Pupils Inspected during the Year in the Age Groups. Age Groups Number of Pupils Inspected A—Good B—Fair C—Poor No. % of Col. 2 No. % of Col. 2 No. %of Col. 2 (1) (2) (3) (4) (5) (6) (7) (8) Entrants 867 472 54.44 386 44.52 9 1.04 Second Age Group 1,493 652 43.67 823 55.12 18 1.21 Third Age Group 401 187 46.63 212 52.87 2 0.50 Other periodic inspections 977 561 57.42 407 41.66 9 0.92 Total 3,738 1,872 50.08 1,828 48.90 38 1.02 99 TABLE III. TREATMENT TABLES. Group I.—Diseases of the Skin. Number of cases treated or under treatment during the year: — By the Authority. Otherwise. Ringworm—(i) Scalp — — (ii) Body 6 — Scabies — — Impetigo 8 — Other Skin Diseases 372 4 Total 386 4 Group II.—Eye Diseases, Defective Vision and Squint. Number of cases dealt with: By the Authority. Otherwise. External and other, excluding errors of refraction and squint 542 No information available. Errors of Refraction (including Squint) 1367 Total 1,909 — Number of pupils for whom spectacles were: (a) Prescribed 680 No information available. (b) Obtained 1,132 Total 1,812 — Group III.—Diseases and Defects of Ear, Nose and Throat. Number of cases treated: By the Authority. Otherwise. Received operative treatment: (a) for diseases of the ear — — (b) for adenoids and chronic tonsillitis - 343 (c) for other nose and throat conditions - 5 Received other forms of treatment 197 37 Total 197 385 100 Group IV.—Orthopædic and Postural Defects. (a) Number treated as in-patients in hospitals 10 (b) Number treated otherwise, e.g., in clinics or out-patient departments By the Authority. 94 (New) 360 (Re-ins) Otherwise. No information available. Group V.—Minor Ailments. Number of cases treated. Miscellaneous minor ailments By the Authority. 1,973 Otherwise. No information available. TABLE IV. Dental Inspection, Treatment and Orthodontics. (1) Number of pupils inspected by the Authority's Dental Officers:— (a) Periodic age groups 1,938 (b) Specials 1,455 Total (1) 3,393 (2) Number found to require treatment 2,552 (3) Number referred for treatment 2,507 (4) Number actually treated 2,107* (5) Attendances made by pupils for treatment 4,819* (6) Half days devoted to: Inspection 16 Treatment 527 Total (6) 543 (7) Fillings: Permanent Teeth 1,266 Temporary Teeth 185 Total (7) 1,451 (8) Number of teeth filled: Permanent Teeth 1,211 Temporary Teeth 178 Total (8) 1,389 101 (9) Extractions: Permanent Teeth 567 Temporary Teeth 3,511 Total (9) 4,078 (10) Administration of general anaesthetics for extraction 1,707 (11) Other operations: Permanent Teeth 1,123* Temporary Teeth 418 Total (11) 1,541 * These figures include orthodontic work. TABLE V. Infestation with Vermin. (i) Total number of examinations in the schools by the school nurses or other authorised persons 17,296 (ii) Total number of pupils on roll of schools visited 6,776 (iii) Total number of individual pupils found to be infested 13* (iv) Number of individual pupils in respect of whom cleansing notices were issued (Section 54 (2), Education Act, 1944) Nil. (v) Number of individual pupils in respect of whom cleansing orders were issued (Section 54 (3), Education Act, 1944) Nil. * In addition 88 children showed minor evidence of infestation. Grammar and Technical Schools. (i) Total number of examinations in the schools by the school nurses or other authorised persons Nil. (ii) Total number of pupils on roll of schools visited Nil. (iii) Total number of individual pupils found to be infested Nil. (iv) Number of individual pupils in respect of whom cleansing notices were issued (Section 54 (2), Education Act, 1944) Nil. (V) Number of individual pupils in respect of whom cleansing orders were issued (Section 54 (3), Education Act, 1944) Nil. 102 TABLE VI. Orthoptic Clinic. Total number of treatments given 1,828 Number of new cases 57 Number of cases on occlusion alone 2 Number of cases found unsuitable 6 Number of cases postponed 303 Number of cases failed to attend 9 Number of cases put down for operation 38 Number of cures, with operation 2 without operation 9 Number of sessions 1952 293 Number of sessions 1951 275 TABLE VII. Year 1952. Handicapped Pupils Requiring Education at Special Schools (other than Hospital Schools) or Boarding in Boarding Homes. 1. Blind 2. Partially Sighted 3. Deaf 4. Partially Deaf 5. Delicate 6. Physically Handicapped 7. Educationally Sub-normal 8. Maladjusted 9. Epileptic T O T A L 1-9 (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) In the calendar year ended 31st Dec., 1952: A. Handicapped Pupils newly placed in Special Schools or Boarding Homes - - - - 1 - 8 - - 9 B. Handicapped Pupils newly ascertained as requiring education at Special Schools or Boarding in Homes - - - - 6 3 11 1 - 21 Number of children reported during the year:— (a) under Section 57 (3) (excluding any returned under (b)) 5 (b) under Section 57 (3) relying on Section 57 (4) Nil. (c) under Section, 57 (5) of the Education Act, 1944. 103 1. Blind 2. Partially Sighted 3. Deaf 4. Partially Deaf 5. Delicate 6. Physically Handicapped 7. Educationally Sub-normal 8. Maladjusted 9. Epileptic T O T A L 1—9 (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) On or about December 1st, 1952: C. Number of Handicapped Pupils from the area: (i) Attending Special Schools as: (a) Day Pupils — — 2 — 1 — 15 — — 18 (b) Boarding Pupils - - - - - - - - - - (ii) Attending Independent Schools under arrangements made made by the Authority - - - - - - - - - - (iii) Boarded in Homes and not already included under (i) or (ii) - - - - - - - - - - Total (C). — — 2 — 1 — 15 — — 18 D. Number of Handicapped Pupils being educated under arrangements made under Section 56 of the Education Act, 1944: (i) in hospitals - - - - - 1 - - - 1 (ii) elsewhere — — 1 — — 3 — — — 4 E. Number of Handicapped pupils from the area requiring places in Special Schools (incl. any such unplaced children who are temporarily receiving home tuition) - - - - - - 4 - - 4 Amount spent on arrangements under Section 56 of the Education Act, 199, for the education of handicapped pupils otherwise than at school, in the financial year ended 31st March, 1952 £153 12s. 7d. 104 TABLE VIII. Independent Schools. Number of Schools visited (including Occupation Centre) 8 Number of Medical Inspection Sessions 33 Number of children examined (various age groups) 274 Number of Re-inspections 37 Nutrition Table. Classification "A" (Good) 173 pupils or 63.14% „ "B" (Fair) 98 pupils or 35.77% „ "C" (Poor) 3 pupils or 1.09% Table of Defects found by Medical Inspection. Defects or Disease. Number of Defects:— requiring treatment. requiring observation. Skin 3 — Eyes, Vision 11 9 Eyes, Squint 5 — Eyes, Other 1 — Ears, Other 3 1 Nose and Throat 13 6 Speech — 1 Heart and Circulation 2 4 Lungs 2 — Developmental, Other 1 1 Orthopædic, Posture 6 — Flat Feet 19 1 Other 9 — Other 2 1 Total 77 24