??? CHI 26 AC 4412 (3) CHISLEHURST CHISLEHURST AND SIDCUP URBAN DISTRICT COUNCIL ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH on the Health of the Urban District and the Work of the Health Department 1954 Printed by Bromley Office Supplies & Printing Co., Ltd. East Street, Bromley CHISLEHURST AND SIDCUP URBAN DISTRICT COUNCIL ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH on the Health of the Urban District and the Work of the Health Department 1954 3 CONTENTS. Page Members of the Public Health Committee 5 Staff 5 Prefatory Letter 6 Section A. Vital and Other Statistics and Social Conditions of the Area. Vital Statistics 10 Population 11 Births 11 Illegitimate Births 11 Stillbirths 11 Deaths 11 Causation of Deaths 12 Maternal Mortality 12 Infantile Mortality 12 Unemployment 13 Open Air Recreational Amenities 13 Morbidity Statistics 15 Seciton B. General Provision of Health Services for the Area. Public Mortuary 18 National Assistance Act, 1948 18 Nursing Homes 18 Laboratory Service 19 Public Conveniences 19 Disinfection 20 Hospital Services 20 County Council Services:— Domiciliary Midwifery 21 Health Visiting 21 Ambulance Service 21 Domestic Help Service 21 Women's Welfare Clinics 21 Home Nursing Service 21 Local Clinic Services 22 Services rendered by Voluntary Agencies:— British Red Cross Society 23 The St. John Ambulance Brigade 23 Chislehurst and Sidcup T.B. Care Committee 24 Women's Voluntary Services 24 Chislehurst and Sidcup Old People's Welfare Committee 24 Section C. Sanitary and Environmental Circumstances of the Area. Water Supply 28 Drainage and Sewerage 31 Rivers and Streams 31 Cesspools 31 Factories Acts, 1937 and 1948 32 Swimming Baths 33 Sanitary Inspection of the Area 33 Smoke Abatement 34 4 Page Section C. Sanitary and Environmental Circumstances—continued. Heating Appliances (Fireguards) Act, 1954 36 Shops Act, 1950 36 Verminous Conditions and Uncleanliness 36 Rag Flock and Other Filling Materials Act, 1951 37 Rodent Control 37 Pet Animals Act, 1951 38 Petroleum (Regulation) Acts, 1928 and 1936 38 Riding Establishments Act, 1939 38 Game Act, 1831 38 Section D. Housing. Housing Inspections 40 Housing Repairs and Rents Act, 1954 41 New Houses 41 Re-housing 41 Moveable Dwellings 42 Section E. Inspection and Supervision of Foods. Food & Drugs Act, 1938. Section 14 46 Food Premises 46 Milk and Dairies Regulations, 1949 47 Inspections 47 Food & Drugs Act, 1938. Food Sampling 47 Food Complaints 48 Bacteriological Examinations 49 Unsound Food 49 Meat Inspection 50 Piggeries 50 Section F. Prevalence of, and Control Over Infectious and Other Diseases. General 52 Smallpox 52 Vaccination 52 Acute Anterior Poliomyelitis 53 Diphtheria 53 Diphtheria Immunisation 53 Typhoid Fever 54 Scarlet Fever 54 Puerperal Pyrexia 54 Ophthalmia Neonatorum 54 Pemphigus Neonatorum 55 Measles 55 Whooping Cough 55 Food Poisoning 55 Dysentery 56 Other Infectious Diseases 56 Tuberculosis 57 Chest Clinic 58 Mass X-ray 58 APPENDIX—STATISTICAL TABLES. Table I.—Summary of Statistics 61 II.—Causes of Death 62 III.—Infant Mortality 63 IV.—Notifiable Infectious Diseases—Sex and Age Distribution 64 V.—Notifiable Infectious Diseases—Seasonal Incidence 65 VI.—Sanitary Inspection of the Area 66 VII.—Tuberculosis Rates 68 PUBLIC HEALTH COMMITTEE. Chairman: Miss B. JAMES, J.P. Vice-Chairman: W. J. SKINNER, Esq. Chairman of the Council. Vice-Chairman of the Council. Mrs. F. J. Daubney. E. J. Reader, Esq. J. R. Fitzgerald, Esq. P. A. Shaw, Esq. M. H. Grimmer, Esq. Mrs. E. V. Wallace. Mrs. S. M. Gunn. E. W. White, Esq. H. A. Miller, Esq. C. E. Wiltshire, Esq. Mrs. R. Moss. STAFF OF THE HEALTH DEPARTMENT as at 31st December, 1954. Medical Officer of Health: K. E. TAPPER, o.b.e., g.m., m.b., ch.b., d.p.h. (Also Medical Officer of Health for the Borough of Bromley, and Orpington Urban District Council.) (Retired 12th January, 1955.) 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. (Also Deputy Medical Officer of Health for the Borough of Bromley, and Orpington Urban District Council.) (Appointed Medical Officer of Health 13th January, 1955.) Chief Sanitary Inspector, Chief Food & Drugs Act Inspector, Inspector under the Petroleum Acts, Shops Act. Rag Flock & Other Filling Materials Act, Pet Animals Act, and Heating Appliances (Fireguards) Act. J. C. KERMODE, c.r.s.i., m.s.i.a. Deputy Chief Sanitary Inspector and Inspector under the Food & Drugs Act, Shops Act, Rag Flock & Other Filling Materials Act, Pet Animals Act, and Heating Appliances (Fireguards) Act. (Vacant) District Sanitary Inspectors, and Inspectors under the Food & Drugs Act, Shops Act, Rag Flock & Other Filling Materials Act, Pet Animals Act, and Heating Appliances (Fireguards) Act. E. C. BERWICK, c.r.s.i., m.s.i.a. J. W. P. HARRIS, c.r.s.i., m.s.i.a. K. W. FINCH, c.r.s.i., a.r.san.i. CLERICAL STAFF. A. F. OUGHTON (Appointed March, 1954). Miss C. DEVONSHIRE. OUTDOOR STAFF. T. BACK (Disinfector, Mortuary Keeper, Drain Clearer and General Handyman.) J. DAVIS (Assistant to Mr. Back.) E. ELLIS (Rodent Operative.) 6 To the Chairman and Members of the Chislehurst and Sidcup Urban District Council. Mr. Chairman, Ladies and Gentlemen, In this, my first report to you, I do not intend to write a lengthy preamble as the year under review was one in which Dr. Tapper was still your Medical Officer of Health. As will be well known the latter retired very early in 1955 after a comparatively short but active period in the service of this authority. During this time his infectious enthusiasm left an impression, the result of which will be felt for years to come. During a year of many changes, I have to record with profound regret the death of Mr. Allen who for so long had served this Council well and faithfully as Chief Sanitary Inspector. Always battling, as he was, against ill health, his stoicism and unfailing cheerfulness must have been an inspiration to many, thereby making his loss all the more keenly felt. To fill the vacancy caused by Mr. Allen's death, his deputy. Mr. Kermode, was promoted and to take the latter's place. Mr. Berwick, one of the district inspectors was appointed. I also have the sad task of recording the death of Mr. Watling during the course of the year, after a number of years of valued clerical work in the department. He was succeeded by Mr. Oughton. From a public health viewpoint, one of the outstanding features of the year was the inauguration of a cesspool emptying service by the Council, and although it would be wrong to pretend that this service has been taken advantage of to the full, there is no doubt an improvement has occurred in the overcoming of this problem and with the full co-operation of all concerned, one looks forward with hope to a gradually increasing response to this service. On the other hand, it should be pointed out that the Council have sewerage schemes under consideration, and it is to be hoped that in the long run it will be possible to do away with the majority of the cesspools. Without going into tiresome details, suffice it to say that the vital statistics are very satisfactory, and barring some entirely unexpected catastrophe should remain so. Details will be found in the body of the report where they can be studied by those who are interested, but I have deliberately refrained from dilating upon them in this letter, as most people seem to find figures frightening, forbidding and formidable! 7 By a process of education and encouragement, the department has kept up its efforts to maintain as high as possible a standard of personal and food hygiene. The results of our efforts to cncourage the clean handling of food must of necessity, be slow in showing themselves, for most of the work is undertaken on a personal basis, but if we can obtain the full support of the trade and the public, benefit is bound to accrue to all concerned in the long run. This must be considered as a combined operation hence the need for obtaining the co-operation of all interested parties. My final remarks will be addressed firstly to the Public Health Committee, whom I should like to thank for their kindness and thoughtfulness to me in the past, and whom I hope to serve to their satisfaction for many years to come, and secondly, to the staff of the department a special word of both thanks and praise for the way they have all contributed towards keeping the flag flying in a year so full of change and difficulty. Truly can it be said that a good job has been well done. I am, Your obedient Servant, JUNE, 1955. H. B. C. CARTER-LOCKE. Medical Officer of Health. SECTION A. VITAL AND OTHER STATISTICS AND SOCIAL CONDITIONS OF THE AREA. 10 SECTION A. VITAL AND OTHER STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area of the Urban District (in acres) 8,957 Registrar General's estimate of total population (mid-year) 1954 85,830 Number of valuation assessments of habitable premises at 31st March, 1955: — (a) Houses 22,087 (b) Flats 2,001 (c) Farmhouses 17 (d) Public Houses, including Beerhouses 27 24,132 Rateable Value (estimated) at 31st March, 1955 £739,293 Product of a Penny Rate for the year ending 31st March, 1955 £2,950 Vital Statistics. Live Births. Total. Male. Female. Legitimate 1,276 674 602 Birth Rate 15.3 (crude) per 1,000 total population. (Adjusted rate for comparison with other areas 14.8.) Illegitimate 41 22 19 1,317 696 621 The area comparability factor calculated by the Registrar General for the purposes of determining rates for comparison with other areas is 0.97. Stillbirths. Total. Male. Female. Legitimate 28 17 11 Stillbirth Rate 0.35 per 1,000 total population and 22.27 per 1,000 (live and still) births. Illegitimate 2 1 1 30 18 12 Deaths. Total. Male. Female. Death Rate 7.9 per 1,000 total population. (Adjusted rate for comparison with other areas 9.6.) 678 364 314 The area comparability factor calculated by the Registrar General for comparison of death rates is 1.22. Deaths from Puerperal Causes. Puerperal Sepsis Nil. Maternal 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. Infant Mortality Rate 18.2 per 1,000 live births. Legitimate 24 14 10 Illegitimate — — — 24 14 10 11 Death Rates of Infants under 1 year of age. All Infants per 1,000 live births 18.2 Legitimate Infants per 1,000 live legitimate births 18.8 Illegitimate Infants per 1,000 live illegitimate births Nil. POPULATION. The estimate of total population, mid-year, 1954, as given by the Registrar General is 85,830, which is an increase of 540 over the figure for the previous year. This gives a density of 9.6 persons to the acre. The natural increase of population (measured by excess of births over deaths) for 1954, was 639. The following figures indicate the increase in population during the last five years:— Year. Estimated Population. 1950 80,040 1951 85,150 1952 85,130 1953 85,290 1954 85,830 BIRTHS. 1.317 live births were registered during the year, giving a Birth Rate of 15.3 per 1.000 total population (adjusted rate for comparison purposes 14.8). Of this number, 696 were males and 621 females. This rate is an increase on that for the previous year, and compares favourably with the rate of 15.2 for England and Wales. Illegitimate Births. There were 41 illegitimate births registered, of which 22 were males, and 19 females, giving an illegitimate birth rate of 30.4 per 1,000 live and still births. Stillbirths. There were 30 stillbirths registered during 1954. giving a rate of 22.27 per 1.000 live and still births. Of this number 18 were males and 12 females. (28 legitimate and 2 illegitimate.) DEATHS. 678 deaths were registered (after adjustment for inward and outward transfers), giving a Death Rate of 7.9 per 1.000 total population (9.6 for comparison purposes). The rate for England and Wales is 11.3. 12 An analysis of the ages at death shows that of the deaths registered:— Male. Female. 24 were under 1 year of age 14 10 1 was 1 and under 5 years of age 1 — 3 were 5 and under 15 years of age 3 — 11 were 15 and under 25 years of age 5 6 40 were 25 and under 45 years of age 21 19 172 were 45 and under 65 years of age 105 67 150 were 65 and under 75 years of age 92 58 277 were 75 years of age and over 123 154 364 314 CAUSATION OF DEATHS. Main causes of death in Chislehurst and Sidcup during the year 1954, together with comparative figures for the last five years, were:— 1950. 1951. 1952. 1953. 1954. Cancer (all sites) 131 132 127 154 149 Respiratory Diseases (not Tuberculosis) 59 89 72 80 73 Heart and Circulatory Diseases 330 361 377 325 320 Tuberculosis 30 30 22 20 14 Infectious Diseases 8 4 4 3 2 Road Traffic Accidents 5 6 4 9 5 Other Violent Causes 12 12 10 7 9 Suicide 7 9 8 13 6 Digestive Diseases 18 18 11 17 14 Other Causes 82 96 104 104 86 682 757 739 732 678 CANCER OF THE LUNG. 1950 31 1951 22 1952 21 1953 38 1954 36 These figures are included for information, but as will be seen, they do not show any very definite tendency and it is hardly necessary to add that the numbers are too small to have any real statistical significance. MATERNAL MORTALITY. There were no maternal deaths in the area during 1954. INFANTILE MORTALITY. The Infant Mortality Rate for the year is 18.2 per 1.000 live births. 24 Infants died during 1954 before reaching their first birthday. 21 died in the first four weeks of life, 20 of which were within the first week. The rate for England and Wales was 25.5 per 1,000 related live births. 13 UNEMPLOYMENT. I am indebted to the Manager of the Local Employment Exchange for the following information in respect of the year 1954:— "There has been a great improvement in the unemployment position during 1954. The registers have dropped considerably. Such unemployment as there has been is due to age—particularly the over 60's—indifferent health and domestic circumstances. There is, generally speaking, plenty of work for the young, fit and able." OPEN AIR RECREATIONAL AMENITIES. Commons. The Chislehurst and St. Paul's Cray Commons have an area of approximately 165 acres and are administered by a Board of Conservators. Public Recreation Grounds, Gardens, etc. Some 392.42 acres of land have been secured or reserved for public recreational purposes within the Urban District. Location. Acreage. Description. Abbeyhill Park 6.84 Part allotments. Belmont Lane Open Space 5.59 Temporary allotments. Beverley Avenue 1.64 Open space. Chalk Wood and Mount Misery 69.21 Open space. Chislehurst Recreation Ground and Whytes Woodland 15.02 Open space with 4 tennis courts, 1 football pitch and 1 cricket pitch and children's playground. Church Lane Recreation Ground 2.25 Open space. Footscray Common .70 Open space. Footscray Recreation Ground 6.80 Open space and part allotments. Hollyoak Wood Park 11.61 Open space and part allotments. King George's Field 11.10 Open space with 3 football pitches, 2 cricket pitches and 2 concrete cricket practice pitches and children's playground. Lamorbey Park:— (1) The Glade 10.63 Open space. (2) Land fronting Burnt Oak Lane 2.00 Open space. (3) Land leased 12.42 Open space. Longlands Recreation Ground 6.00 Open space with 1 football pitch. 14 Location. Acreage. Description. Marlborough Park 6.23 Open space with 1 football pitch and 1 netball pitch. Mottingham Sports Ground 30.00 Open space with 2 tennis courts, 8 football pitches, 6 cricket pitches, 1 hockey pitch and 3 concrete cricket practice pitches (mobile canteen, summer). Mottingham Recreation Ground 5.89 Open space — children's playground. Old Farm Park 11.78 Open space and part allotments. Parish Wood 6.73 Open space. Penhill Park 17.10 Open space with 4 football pitches, 3 grass cricket pitches, 1 concrete cricket pitch and children's playground. River Cray Reservation:— (1) North Cray Place Farm 29.60 Used for agricultural purposes. (2) Footscray Meadows 49.32 Open space and agricultural purposes. St. Paul's Cray Recreation Ground 6.20 Open space with children's playground. Sidcup Place 25.31 Open space with 1 football pitch, 1 cricket pitch, 1 putting green, 4 tennis courts, walled garden, children's playground and cafe. Stable Meadow Sports Ground 17.45 Open space with 2 football pitches and 1 cricket pitch. The Oval 1.66 Open space. Walden Recreation Ground 4.60 Open space with 1 football pitch. Waring Park 13.06 Open space with 4 tennis courts, 2 cricket pitches, 1 putting green, 2 netball pitches and 1 concrete practice pitch and children's playground. Willersley Park 5.59 Open space with 4 tennis courts and children's playground. 392.42 15 MORBIDITY STATISTICS. The following figures, which give some indication of the major trend of sickness in the area during 1954, have been furnished by the Ministry of National Insurance. 1954. Four weeks ending. Total number of certificates received. Weekly Average. 26th January 1,142 285 23rd February 1,087 271 23rd March 931 232 20th April 665 166 18th May 702 175 15th June 577 144 13th July 531 132 10th August 478 119 7th September 510 127 5 th October 702 175 2nd November 829 207 30th November 819 204 28th December 720 180 In conformity with the usual experience it will be noticed that the greatest incidence of illness occurred during the months of January and February, after which there was a steady fall until August, following which another rise occurred. SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. 18 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. PUBLIC MORTUARY. The Public Mortuary is situate at Beaverwood Road, Chislehurst. During the year 106 bodies were taken there. 44 of these were received from hospitals. Inquests were held in 22 cases. NATIONAL ASSISTANCE ACT, 1948. Section 47. This Section of the Act gives powers to the local authority to apply to a court of summary jurisdiction for an order for the compulsory removal of any person suffering from grave chronic disease, or who is aged, infirm or physically incapacitated, and who is living in insanitary conditions and unable to devote to himself and not receiving from other persons proper care and attention, to a suitable hospital or other place in, or within convenient distance of, the area of the local authority, and for his detention and maintenance therein. Before such application is made, however, the Medical Officer of Health must be satisfied after thorough enquiry, that in the interests of any such person or for preventing injury to the health of, or serious nuisance to, other persons it is necessary to remove that person. Several possible cases were investigated during the year, but in no instance was it 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. It was not necessary for the Council to take any action under this heading during the year 1954, although a number of enquiries were received. NURSING HOMES. There are five Nursing Homes on the register at the present time, providing for a total of 72 beds. Three of these beds are for maternity patients and the remainder for medical or surgical cases. The aged sick or aged infirm patients occupy the majority of these beds. Inspection of these Homes was carried out at frequent intervals during the year, and at no time were any contraventions found which required action on the part of the local authority. 19 Details of the Homes are as under:— Number of Beds. Maternity. Other. Total "Fallowfield," Ashfield Lane, Chislehurst — 37 37 "Hadlow," Hadlow Road, Sidcup 3 4 7 "Hatherley," Hatherley Road, Sidcup — 9 9 "Glenthorne," Lower Camden, Chislehurst — 12 12 "Redhill House," Redhill, Chislehurst — 7 7 3 69 72 LABORATORY SERVICE. Routine Food and Drugs samples, and medical specimens, etc., are sent to the County Laboratory at Maidstone. The Public Health Department is responsible for the cleaning of the undermentioned conveniences used by the public:— Public Lavatories (Male & female sections):— Westwood Lane, Blackfen. St. Johns Road, Sidcup. Queens Head P.H., Chislehurst. Adj. Tigers Head P.H., Chislehurst. Public Conveniences in Parks (Female sections only):— Willersley Park, Blackfen. Penhill Park, Blackfen. The Glade, Lamorbey. Waring Park, Sidcup. King George's Field, Sidcup. Longlands Recreation Ground, Sidcup. Recreation Ground, St. Paul's Cray. West Chislehurst Sports Ground, Chislehurst. Recreation Ground, Mottingham. A staff of three whole-time and one part-time cleaners is employed for this work. Owing to the small demand for the washing facilities provided, the stationing of whole-time attendants at the convenience at Westwood Lane was discontinued. The Committee has given further consideration to the establishment of additional facilities in the district and it is hoped that a new convenience will be erected on the L.C.C. Estate at St. Paul's Cray during 1955. It is regretted that acts of wanton damage to several of the conveniences continue to be reported, PUBLIC CONVENIENCES. 20 DISINFECTION. The disinfecting station is situate at the Council Depot. Main Road, Sidcup. Details of the work carried out during 1954 arc follow:— DISINFECTIONS. Premises visited 188 Rooms disinfected 34 Articles disinfected 869 DISINFESTATIONS. Premises visited 42 Rooms disinfested 76 Articles disinfested — DISINFECTIONS. Fumigation Sprayed Steam Disinfected Destroyed Rooms 34 76 — — Mattresses — — 154 13 Pillows — — 403 — Blankets — — 275 — Clothing, bundles of — — 6 — Library Books — 61 — — 34 137 838 13 Disinfection. On the removal of a case of infectious disease to hospital or when a patient isolated at home is declared to be free from infection, the Department has made available its disinfection service. Rooms and their contents are immediately sprayed with formalin and where possible, bedding and clothing are removed for disinfection with steam under pressure. Public Library books which may carry infection are treated to render them safe before return to the Library. Disinfestation. Work of disinfestation is also carried out by the Department, although the need has decreased due to the efficacy of modern insecticides and their ease of application by the general public. Where necessary, rooms are sprayed with a solution containing a quick acting insecticide together with D.D.T. which has a valuable residual action. Bedding is removed for steam disinfection at the same time. Advice on cleanliness and the prevention of reinfestation is given to householders. HOSPITAL SERVICES. Queen Mary's Hospital, Sidcup.—Provides a general hospital service with 350 staffed beds. (Possible 510.) Cray Valley Hospital.—General hospital service with 35 beds, including 10 maternity beds. 21 Sidcup Cottage Hospital.—General hospital service with 15 beds. The above all come within the Sidcup and Swanley Hospital Group of the South East London Region. Grove Park Hospital.—Six blocks of this hospital come within the area of the Urban District. The hospital is within the area of the Lewisham Group of the South East London Region, and the 292 beds in Chislehurst and Sidcup are reserved for the use of tuberculous patients. Venereal Diseases.—Patients are referred to the various hospitals with specialist clinics for dealing with these diseases. Domiciliary Midwifery. Eight Midwives are engaged whole-time in the area. The midwives act either as midwives or maternity nurses, and their services are engaged direct by the patient, or through the patient's private doctor. Health Visiting. Thirteen Health Visitors and School Nurses, and 2 Tuberculosis Health Visitors are engaged in the area. The Health Visitors are responsible for the Maternity and Child Welfare Centres, Diphtheria Immunisation and Vaccination Clinics, etc., and carry out Home visiting in connection with Child Life Protection, After Care, etc. Ambulance Service. The ambulance depot is at Main Road, Sidcup. where 2 ambulances and 4 sitting-case cars are available. Domestic Help Service. The District Organiser's office is at 69, Sidcup Hill. Sidcup. During the year 1954, the following cases received assistance:— Maternity and Expectant Mothers 115 Tuberculosis 33 Aged 251 Other sick 162 Demands for this service are still high, especially for old people and cases of illness in the home. Women's Welfare Clinics. These clinics are held in various parts of the district. Patients are referred on medical grounds only, and are seen by appointment. Home Nursing Service. Twelve Home Nurses are engaged in the area. Home Nursing is provided on medical certification only, and is free. No night service is provided at the present time. 22 LOCAL CLINIC SERVICES. Child Welfare Centres. CHISLEHURST: The Willows, Red Hill FOOTSCRAY: W. Smith Memorial Hall MOTT1NGHAM: Kimmeridge Road NORTH CRAY: Social Club, North Cray Road ST. PAUL'S CRAY: Mickleham Rd. SIDCUP: The Oval, Sherwood Park Avenue ... Congregational Church Hall Ante-Natal Clinics. CHISLEHURST: The Willows, Red Hill MOTT1NGHAM: Kimmeridge Road ST. PAUL'S CRAY: Mickleham Rd. SIDCUP: The Oval, Sherwood Park Avenue .... Congregational Church Hall Tuesday & Thursday p.m. Test Feeds—Tuesday a.m. Tuesday p.m. Monday & Wednesday p.m. 1st, 3rd & 5th Friday p.m. Mon., Wed. & Thurs 2—4 p.m. Tues., Wed. & Fri p.m. Monday & Wednesday p.m. Wednesday p.m Monday & Wednesday a.m. Wednesday 9—12 noon Tuesday & Friday a.m. Wednesday a.m. Thursday p.m. Women's Welfare Clinics. CHISLEHURST: The Willows, Red Hill SIDCUP: The Oval, Sherwood Park Avenue Post-Natal Exercises. MOTTINGHAM: Kimmeridge Road SIDCUP: Days Lane Junior School Hall Ante-Natal Exercises. MOTTINGHAM: Kimmeridge Road ST. PAUL'S CRAY: Mickleham Rd. SIDCUP: The Oval, Sherwood Park Avenue Midwives Clinic. ST. PAUL'S CRAY: Mickleham Rd. Minor Ailments Clinics (Schools). CHISLEHURST: The Willows, Red Hill MOTTINGHAM: Kimmeridge Road SIDCUP: 10, Station Road ST. PAUL'S CRAY: Mickleham Rd. Tuesday (2nd in month) a.m. 1st & 3rd Thursday a.m. Monday 8—9 p.m. Wednesday 7—9 p.m. Thursday 2.30 p.m. Tuesday 2—4 p.m. Thursday 2.30 p.m. Wednesday 2—4 p.m. Mon., Wed., Fri. & Sat 9—10 a.m. Tues., Thurs. & Fri. 9—10 a.m. 2nd & 4th Saturday a.m. Thursday a.m. Mon., Tues., Wed. & Fri. 9—10 a.m. 23 Dental Clinics. CHISLEHURST: The Willows, Red Hill MOTT1NGHAM: Kimmeridge Road SIDCUP: 10, Station Road ST. PAUL'S CRAY: Mickleham Rd. Immunisation and Vaccination. Child Welfare Centres. SIDCUP: 10, Station Road. Asthma Clinic. CHISLEHURST: The Willows, Red Hill Ophthalmic Clinic. CHISLEHURST: The Willows, Red Hill ST. PAUL'S CRAY: Mickleham Rd. Thurs. & Fri. by appointment. Monday all day. Daily By appointment. At all sessions Thursday a.m. Thursday a.m. Monday a.m. By appointment. SERVICES RENDERED BY VOLUNTARY AGENCIES. British Red Cross Society. The Chislehurst and Sidcup Division has six Detachments which operate wholly or partly within the District. The Divisional Office is at Hornbrook House, High Street, Chislehurst. Four medical loan depots are operated in the area, to provide invalid and sick room equipment for local residents. A small charge is normally made for each article. "Beltoft," Hadlow Road, Sidcup Kent County Council, District Office, Sidcup Hill, Sidcup 56, Woodside Avenue, Chislehurst 51, Framlingham Crescent, Mottingham By appointment. During office hours. Mondays 3—4 p.m. Thursdays 3—4 p.m. or by appointment. Wednesdays 6—7 p.m. or by appointment. A club for disabled men and women known as "The Good Samaritan Club" meets at the British Legion Headquarters, Chislehurst, on the second and fourth Friday in each month, at 2.30 p.m. In addition to first aid duties and regular auxiliary nursing in The hospitals of the neighbourhood, invaluable assistance is rendered in home visiting of the sick and aged, diversional therapy for the home bound, auxiliary hospital services, etc. The St. John Ambulance Brigade. The Sidcup Brigade continues to offer personnel trained in first aid for attendances at public gatherings, to accompany children and aged persons and to escort patients undertaking long journeys. 24 Chisiehurst and Sidcup Voluntary Tuberculosis Care Committee. This Committee which has been in existence since 1938, continues to render valuable assistance to tuberculous patients and their families within the district. The Committee's Liaison Officer is available three afternoons each week at the United Services Club, 108. Main Road, Sidcup, when patients or their families can seek help and advice on the many problems which arise during prolonged illness. Approximately 380 cases were assisted during the year and frequent home visits were made. Arrangements were made for free holidays at the seaside for 25 families, thus enabling tired wives and mothers to have a complete rest and to assist patients in making full recovery. All statutory and voluntary bodies in the district co-operate with the Care Committee, and the closest contact exists with the Chest Clinic and with hospitals. Women's Voluntary Services. The W.V.S. carry out good work in the district, especially in connection with the welfare of old people. Wheel chairs are loaned, escorts are provided to assist those attending hospital, domestic help is arranged, shopping, etc., undertaken and clothing supplied to old people at the request of the National Assistance Boards' Officers or other bodies. In special cases, elderly persons are provided with a free holiday at a W.V.S. Holiday Home. CHISLEHURST AND SIDCUP OLD PEOPLE'S WELFARE COMMITTEE. Abstract from Secretary's Annual Report:— While Club-life goes smoothly on from week to week, meaning more and more to the 1,000 elderly people attending the 13 Clubs established throughout the district, the Old People's Welfare Committee has concentrated this year on the problem of housing for the elderly. For many years it has been apparent that one of the greatest difficulties facing old people is that of finding unfurnished accommodation at a reasonable rental—a single room with cooking facilities, where an elderly person or a married couple may live among their own treasured possessions. Advertising for such accommodation proved hopeless ; the only solution appeared to be to buy a large, older type property with a view to conversion. At first, it seemed tha:t such a scheme would involve insuperable financial difficulties ; but with tremendous enthusiasm, faith and 25 energy on the part of the Old People's Welfare Committee, backed by the sympathy of a financial support of some hundreds of donors; followed by the co-operation and practical help of the North West Kent Housing Society, the scheme came to a reality in January, 1955. " Redlac," 49, Station Road, Sidcup. In April. 1954, this property was bought by the North West Kent Housing Society Limited, and put into the hands of a builder, for conversion into ten single-room flatlets, each containing an enclosed kitchen unit, comprising sink. Ascot water heater, shelves, plate rack and cooker, and a separate, ventilated food cupboard. Applications were invited from elderly people in need of such accommodation and finally nine tenants were selected. A housemother was then appointed who would live rent-free in return for light services concerned with the welfare of the other nine tenants. Holiday Scheme. Eastbourne and Bognor were chosen this year for the inexpensive holiday, and about 100 club members availed themselves of the scheme paying £3 10s. Od. per week. SECTION C. SANITARY AND ENVIRONMENTAL CIRCUMSTANCES OF THE AREA. 28 SECTION C. SANITARY AND ENVIRONMENTAL CIRCUMSTANCES OF THE AREA. WATER SUPPLY. A number of samples of water from the mains of the Metropolitan Water Board were taken by the Department. Six were submitted for bacteriological test and seven were analysed to ascertain the chemical constitution. All were found to be satisfactory for drinking purposes. At the end of the year there were 2 dwelling houses with water supplied from one private well. 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 Urban District during the year 1954. " The supply to the district of Chislehurst and Sidcup has been adequate at all times in 1954. although there has been some reduction of pressure due to heavy consumption during certain periods of peak demand in the vicinity of Chislehurst Common. No new source of supply has been instituted. Water is obtained from the following seven wells; Orpington. North Orpington. Shortlands. Eynsford. Bexley. Wilmington and Darenth, together with Thamesderived filtered water via Shortlands pumping station. Bacteriological analysis of samples of water at these various sources of supply are made at least five times a week and consistently satisfactory results have been obtained from samples of water passing into supply. Chemical analyses of the samples are also made at frequent intervals. All supplies are treated with chlorine at the works, but any excess remaining after a period of contact is removed completely or reduced to an amount that will not be perceptible to consumers. Tanks have been installed at all the above well stations to ensure an adequate period of contact of chlorine with the water. There have been no extensions to trunk mains but various lengths of service mains have been laid within the district. All new and repaired mains are disinfected with chlorine before being restored to supply and samples of water from them are analysed to establish that it is up to the normal standard of quality expected in the distribution system. None of supplies is plumbo-solvent. Appended are the results of chemical and bacteriological analyses of the various supplies to Chislehurst and Sidcup during 1954 before and after treatment." 29 Average Results of the Chemical and Bacteriological Examination of the Water Supply to Chislehurst and Sidcup during 1954. Parts per Million (unless otherwise stated). Orpington Well North Orpington Well Shortlands Well Eynsford Well Bexley Well Wilmington Well Darenth Well Thames derived filtered water Number of samples 4 4 4 4 3 8 4 1585 Ammoniacal Nitrogen 0.003 0.004 0.004 0.003 0.007 0.006 0.003 0.021 Albuminoid Nitrogen 0.020 0.019 0.024 0.025 0.025 0.025 0.018 0.092 Oxidised Nitrogen—Nitrite — — — — — — — — Oxidised Nitrogen—Nitrate 6.1 4.6 5.4 3.6 4.8 7.2 5.3 3.9 Chlorides as Cl 15.4 13.8 18.5 14.6 16.0 16.6 15.4 26.7 Oxygen abs. from Permanganate 4 hrs. at 27°C. 0.10 0.08 0.14 0.05 0.13 0.11 0.07 1.20 Turbidity in terms of Silica Nil 0.3 Nil Nil Nil Nil Nil 0.3 Colour, m.m. brown 2 ft. tube, Burgess's Tintometer Nil 2 Nil Nil Nil Nil Nil 12 Hardness (Total) 276 265 287 260 282 290 265 269 Hardness Non-Carbonate 48 41 74 39 53 62 40 70 pH Value 7.1 7.1 7.2 7.2 7.2 7.2 7.1 7.9 Phosphate as P.04 0.08 0.08 0.07 0.06 0.05 0.04 0.07 0.65 Silica as SiO2 14 15 18 14 18 17 11 11 Sulphates as S04 14 8 43 10 24 21 15 50 Magnesium Mg 2.5 2.5 3.9 2.6 3.5 3.4 2.8 5.0 B.O.D. 5 days at 65°F — — — — — — — — Conductivity 400 375 425 400 425 450 425 450 30 BACTERIOLOGICAL RESULTS Orpington Well N. Orpington Well Shortlands Well Eynsford Well Bexley Well Wilmington Well Darenth Well Thames derived filtered water Before Chlorination (Raw Water) Number of samples Plate Count (Average per millilitre) 246 231 504 257 572 477 136 7222 Colonies counted on Agar: 22°C. (3 days) 1478.7 42 0 21 18 4 5.6 51.2 29.8 Nil 37°C. (20-24 hours) 101 0 4.6 0.2 0.1 0.1 0.3 0.8 Nil Bact. coli test: Percentage samples negative in 100 ml. 100 0 22.9 100.0 100.0 100.0 100.0 100.0 62.2 Average number per 100 ml Nil 11 70 Nil. Nil Nil Nil Nil 3.45 After Chlorination (Water passing into Supply) Number of samples 257 235 257 265 306 252 236 3604 Plate Count (Average per millilitre) Colonies counted on Agar: 22°C. (3 days) Nil Nil Nil Nil Nil Nil Nil Nil 37°C. (20-24 hours) 01 Nil Nil Nil Nil Nil Nil 8.8 Bact. coli test: Percentage samples negative in 100 ml. 100.0 100.0 100.0 100.0 100.0 99.6 99.6 99.8 Average number per 100 ml. Nil Nil Nil Nil Nil 0.008 0.008 0.004 31 DRAINAGE AND SEWERAGE. The Engineer and Surveyor has kindly furnished details of work carried out as under:— Extensions to Public Sewers carried out during the year:— Birchwood Avenue. Sidcup—107 yards of 9" foul sewer. Old Maidstone Road, Ruxley Corner—110 yards of 9" foul sewer. Sidcup By-pass Road—120 yards of 9" foul sewer. Dulverton Road, Sidcup—36 yards of 18" storm water relief sewer. Suffolk Road, Footscray—212 yards of 9" storm water sewer. In addition, a total of approximately 818 yards of foul and storm water sewers have been laid in connection with the development of private housing estates. These sewers will eventually be adopted under Section 17 of the Public Health Act. 1936. RIVERS AND STREAMS. No works of major importance have been carried out during the year. Twenty-five inspections were made by the Sanitary Inspectors. CESSPOOLS. Two new buildings with cesspool drainage were erected in 1954, and one with a chemical closet. The owners have each given an undertaking to connect to the sewer when available. Two cesspools were abolished during the year and there are now 473 premises not connected to main drainage as follow:— Lamorbey and Black fen 9 Sidcup and Footscray 22 North Cray 239 St. Paul's Cray 101 Chislehurst and Mottingham 102 473 In a number of cases, two or more premises are drained to one cesspool. The total number of cesspools is 378. During the course of the year the Council inaugurated an emptying service for cesspools. A charge of 7/6 is made for the removal of 600 gallons from houses and 15/- per 600 gallons from other premises. The scheme met with a fair response. Considerable efforts have been made to publicise it and to ensure, as far as possible, its full use. 32 In the eight months during which the service was in operation, 208 cesspools were emptied and approximately 614,000 gallons of sewage disposed of. Some owners continue to use the service provided by a private contractor whilst others undertake their own emptying. Sewers are being laid in Maidstone Road and Leesons Hill, St. Paul's Cray, with a view to the abolition of cesspools in those areas, and further schemes are projected. FACTORIES ACTS, 1937 AND 1948. A total of 350 inspections and re-inspections were made during the year and 35 nuisances and defects were found. Thirty-five nuisances and defects were remedied during 1954. The following is a copy of the return for the year 1954, which has been made to the Minister of Labour and National Service:— 1. 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 27 50 3 - (b) Factories not included in (a) in which Section 7 is enforced by the Local Authority 156 198 12 - (c) Other Premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) 49 102 1 - Total 232 350 16 0 2. Cases in which Defects were found. Number of cases in which defects were Referred Number of cases in which prosecutions were Instituted Found Remedied To H.M. Inspector By H.M. Inspector Want of cleanliness (S.l) 10 13 — 2 — Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) — — — — — Inadequate ventilation (S.4) — — — — — Ineffective drainage of floors (S.6) — — — — — Sanitary Conveniences (S.7):— (a) Insufficient 6 5 — — — (b) Unsuitable or defective 16 13 — 6 — (c) Not separate for sexes 4 5 — 2 — Other offences against the Act (not including offences relating to Outwork — 2 8 — — Total 36 38 8 10 0 OUTWORK: Nil. — — — — — 33 SWIMMING BATHS. There is one small private open air swimming pool in the area, to which the public are admitted in the summer. Two samples of water were taken during 1954, both being satisfactory. SANITARY INSPECTION OF THE AREA. Full details of the work of the Sanitary Inspectors will be found in Table VI in the Appendix. The following is a summary of the totals under the respective headings:— Total number of Inspections and Visits. Housing 4,810 Infectiou Diseases 296 Food Premises, Sapling, Visits, etc. 2,288 Factories, Outworkers, etc. 350 Moveable Dwellings 655 Smoke Abatement and Shops Act Rodent Control 403 1,161 Miscellaneous 537 Total 10,500 Notices issued:— Preliminary: General Sanitary Defects 152 Food Premises 69 Factories, etc 16 Rodent Control 4 241 Statutory: Public Health Act 11 Housing 1 Total 12 Total number of Food Condemnation Certificates issued, 326. 34 SMOKE ABATEMENT. Inspections and observations were made of commercial premises during the year. The owners of one large factory in the area, responsible for the emission of considerable quantities of smoke, have been persuaded to fire their furnaces with oil fuel in place of solid fuel. After the completion of the necessary conversions a substantial improvement was effected. The Council continue to be represented on the Thames-side Advisory Committee for the Abatement of Atmospheric Pollution and in collaboration with other interested Local Authorities organised a petition concerning the nuisance caused by the emission of cement works flue dust. The deposit gauge installed in North Cray records fairly satisfactory progress during the year. The total amount of solids fell continuously from a monthly average of 17.7 tons per sq. mile in the first quarter to 8.16 tons per sq. mile in the third quarter. It rose slightly to 10.63 tons per sq. mile in the last quarter. Detailed figures are given below. A sulphur dioxide gauge will be provided during 1955, thus making available information concerning the more poisonous element of atmospheric pollution. 35 Monthly deposit. Tons per sq. mile. Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Water—in rain 1.00 1.82 1.35 0.54 1.65 3.20 2.64 3.03 1.67 1.43 4.20 1.42 pH value 7.0 7.3 7.5 7.0 6.9 6.3 6.4 6.0 6.2 5.9 5.2 6.20 Total water insoluble matter 9.11 6.45 10.45 6.30 10.07 7.48 3.83 5.04 3.20 2.41 3.47 5.87 Soluble in CS2 0.03 0.08 0.05 0.09 0.08 0.05 0.07 0.14 0.08 0.10 0.10 0.19 Ash 7.25 5.05 8.73 4.92 7.33 5.57 2.51 3.18 2.04 1.81 2.48 4.51 Other combustible matter 1.83 1.32 1.67 1.29 2.66 1.86 1.26 1.72 1.08 0.50 0.89 1.16 Total water soluble matter 8.06 8.34 10.71 6.41 7.55 6.68 4.09 4.36 3.96 2.75 10.60 6.80 Ca 0.89 1.11 2.25 0.91 1.41 0.90 0.34 0.67 0.44 0.23 0.67 0.57 Cl 1.06 1.28 1.17 0.82 0.76 0.74 0.44 0.57 0.52 0.50 2.75 1.96 SO4 3.46 3.07 4.84 2.21 2.88 2.65 1.42 1.52 1.40 0.97 2.14 1.42 Total solids 17.18 14.79 21.16 12.71 17.62 14.16 7.93 9.40 7.16 5.16 14.08 12.67 36 HEATING APPLIANCES (FIREGUARDS) ACT, 1954. This Act became fully effective during the year. Observations have been kept on premises from which gas, electric and oil fires are sold, but no contraventions were found. SHOPS ACT, 1950. There are now 803 shops in the area. They are situated as follow:— Lamorbey and Blackfen 259 Sidcup and Footscray 266 North Cray and St. Paul's Cray 93 Chislehurst and Mottingham 185 Visits and observations under the Act have totalled 238. Visits and observations under the Act have totalled 238. Nine informal notices have been served and a number of other infringements have been dealt with without the service of notices. Offences. Found. Remedied. Notices and records 19 13 Sanitary accommodation 8 7 Closing hours 2 1 Washing facilities 3 3 Light — •— Sunday trading 4 — Other matters 6 3 Number of inspections and observations 238 Number of informal notices served 9 No Closing Orders have been made. Thursday is the Early Closing Day generally observed in the District, but in Chislehurst, part of St. Paul's Cray, and at the Oval, Blackfen shops close early on Wednesdays. VERMINOUS CONDITIONS AND UNCLEANLINESS. Sixteen complaints were received in connection with premises alleged to be verminous or unclean. Forty-two visits of inspection were made but the number of houses found to be infested with bed bug (Cimex Lectularius) amounted to eight only. One of these was a house owned by the Council. The extent to which the problem of infestation by bed bugs has been solved, by the use of modern insecticides, is indicated by the fact that ninety-one premises were found to be infested in 1937. In appropriate cases disinfestation was carried out by the staff of the Department. It is usually possible to persuade tenants to deal with dirty premises although considerable supervision is needed to ensure a permanent remedy. 37 RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951. There are no premises within the district licensed under this Act. RODENT CONTROL. The following is a summary of the work carried out during the year:— TYPE OF PROPERTY Non- Agricultural (1) (2) (3) (4) (5) Local Authority Dwelling Houses (including Council Houses) All other (including Business Premises) Total of Cols. (1) (2) & (3) Agricultural I. Number of properties in Local Authority's District 66 24,088 1,969 26,323 200 II. Number of properties inspected as a result of: (a) Notification 8 40 37 453 — (b) Survey under the Act — 473 53 526 12 (c) Otherwise (e.g., when visited primarily for some other purpose) 3 14 6 23 2 III. Total inspections carried out —including re-inspections — — — 3,449 — IV. Number of properties inspected (in Sect. II) which were found to be infested by: (a) Rats: Major — — — — — Minor 9 502 59 570 — (b) Mice: Major — 6 1 7 — Minor — — — — — V. Number of infested properties (in Sect. IV) treated by the L.A 9 492 54 555 VI. Total treatments carried out including re-treatments. 13 590 94 697 — VII. Number of notices served under Section 4 of the Act: (a) Treatment — 1 — 1 — (b) Structural Work (i.e., Proofing.) — 5 2 7 — VIII. Number of "Block" control schemes carried out — 7 — — — 38 SEWER INFESTATION. Each year one in ten of all manholes within the District are "test baited" to ascertain the extent of infestation in the sewerage system. Lengths of sewer adjacent to manholes found to be affected, together with those known to have been infested in the previous year, are subjected to treatment. The following table indicates the results of the 1954 operation :— SEWERS. Number Manholes treated No. manholes in which " Complete takes" "Partial takes" "No takes' 10% Test 196 23 13 160 1st Maintenance treatment (June) 117 42 25 50 2nd Maintenance treatment (Nov.) 133 22 11 100 PET ANIMALS ACT, 1951. Supervision of premises from which pets are sold has been maintained. Licences to carry on the trade have been issued in respect of six premises, five of these being renewals. PETROLEUM (REGULATION) ACTS, 1928 AND 1936. Mr. J. C. Kermode is now the Inspector appointed under the above Act. Fifty-nine licences to store petroleum were issued during the year. There is a tendency for individual premises to extend their capacity for storage of petroleum spirit consequent upon the increased use of motor vehicles. Opportunity is being taken to instal more modern pumping equipment. The total storage capacity licensed during the year was:— Petroleum Spirit in tanks 109,114 gallons. in cans 100 gallons. Petroleum Mixtures in approved store 5,645 gallons. Calcium Carbide 112 pounds. RIDING ESTABLISHMENTS ACT, 1939. During the year horses and stabling at premises from which horses are hired out for riding were inspected by a Veterinary Surgeon appointed by the Council, who reported conditions to be satisfactory. At the end of December there were two such stables. One closed during the year, but was replaced by other premises under the control of the same owner. GAME ACT, 1831. Three Licences were issued to dealers in Game in respect of the current year. SECTION D. HOUSING. 40 SECTION D. HOUSING. (i) Routine Inspections : Three hundred and seven visits were made to premises in connection with the Housing Act, 1936. The survey under the Housing Repairs and Rents Act, 1954, was commenced in order to obtain information for the return required by the Ministry of Housing and Local Government in 1955. (ii) Clearance Areas: No clearance areas were declared during the period under review. (iii) Individually Unfit Houses : One house was dealt with during the year. (iv) Demolition Orders : No orders were made. (v) Overcrowding: The position so far as is known with regard to statutory overcrowding, as defined in the Housing Act, 1936, is as shown in the following table : — Number of cases—31st December 31st Dec., 1954 Area 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 No. of cases found during the year No. of cases remedied during year Cases at end of year No. of cases No. of persons concerned Aged over 10 Aged under 10 Lamorbey 2 4 6 7 9 6 7 11 9 5 2 2 2 4 — 1 3 20 4 Longlands — — 1 — 1 1 1 — — — — — — — — — — — — Birch wood — — — 1 — — — — — — — — — — — — — — — Frognal — — 1 1 — — 1 1 1 — — — — — 2 1 1 7 3 North Cray 1 1 1 1 1 1 1 3 1 1 — — — — — — — — — St. Paul's Cray 1 I 2 4 5 6 4 5 3 3 2 2 4 4 3 4 3 14 5 Chislehurst Common 1 1 — — — 1 3 6 3 1 1 1 1 — — — — — — Mottingham 2 2 2 4 5 15 6 15 26 17 13 10 10 11 1 7 5 41 5 Totals 7 9 13 18 21 30 24 42 43 27 18 15 17 19 6 13 12 82 17 (vi) Defects : Number of houses inspected for housing defects (Public Health and Housing Acts) 808 Number of houses found not in all respects fit 578 Number of houses made fit without service of formal notices 468 41 Housing Repairs and Rents Act, 1954. This Act came into operation on 30th August. 1954. Applications for Certificates of Disrepair were few and in the four months of 1954, only six were dealt with. Of these one was granted and the other five withdrawn by the tenants concerned. New Houses. There were 182 units erected by private enterprise during the year. Re-Housing. The following information has been supplied by the Housing Manager :— Prior to 1954. During 1954. 1. (a) Number of " permanent " dwellings built by the Local Authority 1,156 69 (b) Number of prefabricated dwellings erected by the Local Authority 275 (c) Number of dwellings (excluding Halfway Houses) under requisition by the Local Authority 203 196 (d) Number of half-way houses and emergency huts 17 17 11. (a) Number of families occupying I (a) 1,156 69 (b) Number of families occupying I (b) 275 275 (c) Number of families occupying 1 (c) 336 321 (d) Number of families occupying 1 (d) 39 46 III. The total number of families re-housed during 1953 in (a), (b) and (c):— (a) 94 (b) 22 (c) 57 173 Note.—The figure of 173 lettings includes 60 transfers from various types of Council controlled properties. IV. Total number of families on waiting list at 1st February, 1955:-— Couples 621 Families requiring 2 bedrooms 722 Families requiring 3 bedrooms 467 Families requiring 3 or more bedrooms 45 Old Age Pensioners and Single Persons 146 2,001 Cases not yet pointed 219 Families in requisitioned premises or huts 332 Cases passed and not yet housed, including refusals of accommodation 52 603 2,604 42 MOVEABLE DWELLINGS. The problems arising from the use of caravans and other moveable dwellings for permanent living accommodation continue to exercise the attention of the Department. A licence is required under the Public Health Act, 1936, and Town Planning permission is also needed in most cases. Close co-operation with the Engineer and Surveyor's Department is maintained in this connection. Licencing under the Public Health Act enables a measure of control to be maintained over these dwellings and failure to obtain same renders the user and owner of the land concerned liable to legal action. It will be seen that there are very few dwellings stationed on most of the sites set out below. most of the sites set out below. Careful watch is maintained on these, and steps are taken to draw the attention of unauthorised users to the legal position. Average number of families Approx. number of persons Whether licenced Chalk Pit, Ruxley 39 130 All but 4 families. Land adjoining Chalk Pit, Ruxley 6 15 No Old Brickfield, Baugh Estate, Footscray 6 19 Yes Twysdens Meadow, Cray Road, Footscray 1 3 Yes Birchwood (adj. Bull Hotel) 3 6 Yes Smallgains Farm, Maidstone Road, Ruxley 2 4 Yes *The Limit, Maidstone Road, Ruxley 1 1 No *Beaverwood Farm, Perry St., Chislehurst 1 1 No *Fairview, Cray Road, Footscray 3 4 No 168, Blackfen Road, Sidcup 1 3 Yes * Walters Cafe, Sidcup By-pass, Ruxley 1 3 No Lower Hockenden Farm, Lower Hockenden 1 2 Yes Corke's Meadow, St. Paul's Cray 112 446 No Conservative Club, Oxford Road, Sidcup 1 3 Yes Sports Ground (Kemnal), Sidcup By-pass 1 1 Yes Mundays Piggery, Trunks Alley, Hockenden 2 5 No Ruxley Manor Farm, Ruxley 1 2 Yes * Ceased to be used during the year. Chalk Pit, Ruxley. This site is used by families of the gipsy type. It is overcrowded and applications for licences from four newcomers during the year were refused. Land adjoining Chalk Pit, Ruxley. Action has been authorised in connection with five families using the "overflow" accommodation to the Chalk Pit. with a view to clearing the site. 43 Buckfield, Baugh Estate, Church Road, Footscray. Six families have been using his land which is owned by the Council. Corke's Meadow, St. Paul's Cray. The site is used by approximately 112 families, mostly of the gipsy type. The ground is being acquired by the London County Council for other purposes. This Council has been in consultation with the Ministry of Housing and Local Government, the Kent County Council and the London County Council, with a view to the site being cleared. The possibility of the Council establishing and controlling another site for the caravans in the St. Paul's Cray area to accommodate those displaced, is being actively considered. SECTION E. INSPECTION AND SUPERVISION OF FOODS. 46 SECTION E. INSPECTION AND SUPERVISION OF FOODS. FOOD AND DRUGS ACT, 1938. SECTION 14. The food premises in the area registered under the above Section are:— No. of Premises Registered. Ice- Cream. Mfr. of Sausages. Cooked Ham. 1. Bakers' shops 2 — — 2. Butchers' shops — 44 — 3. Dairies (all but one are grocers) 11 — — 4. Fishmongers (wet and dried) 1 — — 5. Greengrocers' shops 4 — — 5. Grocers (" a " also included in ice-cream) 34 — 4a 7. Ice cream premises other than those mentioned in 1, 3, 5, 6 and 8, but including confectioners 77 — — 8. Restaurants, cafes 21 — — 150 44 5 Total 199 — FOOD PREMISES. There are some 484 food premises in the area, made up as under:— (1) Bakers 17 (2) Bakers and Bakehouses 16 (3) Butchers 55 (4) Dairies (all but two are Grocers) 17 (5) Fishmongers (wet and dried) 15 (6) Fishmongers (wet, dried and fried) 9 (7) Fishmongers (fried) 4 (8) Greengrocers' shops and stalls 60 (9) Grocers 110 (10) Ice Cream premises, other than those included in (1), (2), (4), (8), (9) and (13), but including confectioners 75 (11) Public Houses and Hotels with catering facilities 9 (12) Public Houses without catering facilities 16 (13) Restaurants, Cafes 36 (14) Works Canteens 8 (15) School Canteens, etc 32 (16) Private Canteens — (17) Confectioners (not included in 10) 5 Total 484 47 MILK AND DAIRIES REGULATIONS, 1949. Seventeen Dairies have been registered under the above Regulations. The following are details of the licences issued by the Local Authority in respect of the year 1954 Pasteurised Dealer's Licences 17 Pasteurised Supplementary Licences 12 Sterilised Dealer's Licences 24 Sterilised Supplementary Licences 12 Tuberculin Tested Dealer's Licences 17 Tuberculin Tested Supplementary Licences 11 INSPECTIONS. A total of 2,288 visits to Food Premises were made by the Sanitary Inspectors during 1954. Three hundred and thirty defects were noted and three hundred and fifty-four remedied. (This figure includes those found in 1953 and abated during 1954.) No formal action was taken by the Council during the year 1954 under the Bye-laws adopted under Section 15 of the Food and Drugs Act, 1938. FOOD SAMPLING—FOOD & DRUGS ACT, 1938. Samples Taken Result Remarks See below ARTICLE Formal Informal Genuine Inferior Adulterated Baking Powder 2 — 2 — — Bread — 1 — 1 — See (a) Butter 3 — 3 — — Cake and Pudding Mixture 2 — 2 — — Cereals 9 — 9 — — Cheese 8 — 6 1 1 See (b) Chicken Cutlets 1 — 1 — — Christmas Pudding 6 — 6 — — Coffee and Coffee Essence 4 — 4 — — Cornflour 1 — 1 — — Cream 3 1 4 — — Custard Powder 2 — 2 — — Crystalised Fruit 5 — 5 — — Dates 1 — 1 — — Drugs 15 — 15 — — Fish Cakes 4 — 4 — — Flavouring Essence 1 — 1 — — Ice Cream — 17 17 — — Jelly 5 — 5 — — Lard 11 — 10 1 — See (c) Lemon Squash 1 — 1 — — Lemonade Powde 2 — 2 — — Lentils 1 — 1 — — Margarine 15 — 13 2 — See (d) Marzipan 3 — 2 1 — See (e) 48 Meat Paste 6 — 6 — — Milk 6 15 21 — — Nuts (Ground) 5 — 5 — — Olive Oil 2 — 2 — — Oranges — 1 1 — — Peel 6 — 6 — — Pepper 2 — 2 — — Pies and Pastries 6 — 5 1 — See (f) Preserves 20 — 20 — — Sardines 2 — 2 — — Sauces 7 — 7 — — Sausage Rolls 2 — — 2 — See (g) Sausages and Sausage Meat 55 — 47 8 — See (h) Soups 5 — 4 1 — See (i) Spices 15 — 14 1 — See (j) Suet (shredded) 2 — 2 — — Sugar 1 2 1 2 — See (k) Sugar Confectionery 10 1 8 3 — See (l) Tea 1 — 1 — — Vinegar 3 — 3 — — 261 38 274 24 1 (a) Contained small piece of coal. Makers warned. (b) Edam Cheese. Fat in original milk 2.9%. Not labelled " made from partially skimmed milk." No legal requirement re labelling. Cream Cheese. Fat in original milk 3.6%. Not a cream cheese. Wrongly labelled. Vendor warned—label changed. (c) Contained small amounts of moisture and tissue. Wholesalers informed. Further sample satisfactory. (d) Two samples deficient in Vitamin A content (98 and 560 I.U's instead of 760 I.U's). Subsequent sample satisfactory. (e) Almond deficient (15%). Makers warned. Further sample revealed increased almond. (f) Meat deficient 19%. Makers warned. Further sample satisfactory. (g) Two samples deficient in meat (9% and 15%). Makers informed. Further samples satisfactory. (h) Seven samples of pork sausages or sausage meat and one of beef sausages—meat content varying from 45% to 62% (below former standards). Makers warned—further samples satisfactory. (i) Chicken soup only 2½% chicken. Stock withdrawn from sale. (j) Chillies extensively attacked by insects. Importers informed. (k) Contained carbonised and caremelised sugar. Manufacturers notified. (l) Butter mixtures. Two samples deficient in butter fat (1.2% and 2.7%). Manufacturers warned. Label changed in one case. Recipe changed in other. French Nougat contained tobacco. Manufacturer successfully prosecuted. FOOD COMPLAINTS. A total of 20 complaints were received in respect of impurities in food, etc. All of these were investigated and the food stuff traced to its source. Where necessary warning letters were sent to shopkeepers or manufacturers, and in two cases successful prosecutions were instituted under the Food and Drugs Act, 1938, 49 BACTERIOLOGICAL EXAMINATIONS. Ice Cream. Nineteen samples were taken for bacteriological examination. No pathogenic organisms were found to be present. No. of samples taken. Description. Satis. Unsatis. Methylene Blue Group. I. II. III. IV. 19 Ice Cream 19 — 16 3 — — 19 19 — 16 3 — — Eighteen samples were submitted for chemical examination, the lowest fat content being 7.5% and the highest 12.5%. UNSOUND FOOD. A total of 3 tons 14 cwts. 3 qrs. 27 lbs. of varied articles of food were condemned during the year, and 326 Food Condemnation Certificates issued. The main items were :— Description. Weight. Item. Condition. tons. cwts. qrs. lbs Bacon Decomposed 1 3 11 Beef ,, 6 1 21 Beef Tumours 20 Beef Bruising 1 3 Beef Kidney Nephritis 7 Biscuits Unsound 15 Butter " 2 Cake Decomposed 24 Cake Mixture Contaminated 17 Canned Cream Containers blown, tured or perforated 4 Canned Fish ” ” ” 3 12 Canned Fruit ” ” ” 19 3 8 Canned Ham ” ” ” 16 Canned Jam ” ” ” 1 1 8 Canned Meat ” ” ” 11 1 24 Canned Meat Pudding ” ” ” 1 8 Canned Milk ” ” ” 6 3 9 Canned Paste ” ” ” 1 Canned Pudding ” ” ” 4 Canned Soup ” ” ” 4 3 14 Canned Syrup ” ” ” 8 Canned Vegetables ” ” ” 8 3 15 Cereals Contaminated 17 Cheese Unsound 2 2 8 Cheese Spread Decomposed 5 Chocolate Spread Unsound 1 Coconut (dessicated) ,, 1 27 Cordial Fermented 3 Cornflour Unsound 9 Cream Decomposed 4 50 Fish " 3 1 22 Fruit (dried) Fermented 1 25 Jam Unsound 2 Jelly " 6 Lard Trimmings Contaminated 2 Mutton Decomposed 1 7 Pork Pneumonia 7 Pork Decomposed 2 20 Pickles Fermented 6 Pudding Container broken 2 Pudding Unsound 10 Sausages Decomposed 1 12 Sweatbreads " 3 3 14 3 27 Unsound food is, whenever possible, sent for treatment to a large local piggery and used for animal food. There was no consignment of food especially examined during the year. MEAT INSPECTION. One small slaughterhouse within the District is licensed but was not used during the year. An application for a licence in connection with another building was refused. Carcases of six freshly slaughtered pigs which had been brought into the District without inspection, were examined. Portions of two of them were found to be unsound. Three persons were granted licences to slaughter under the Slaughter of Animals Act. 1933. PIGGERIES. One hundred and sixty visits of inspection were made to the twenty-six piggeries in the district. Fourteen defects were found and eighteen remedied. SECTION F. PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. 52 SECTION F. PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. Two hundred and ninety-six visits were made to notified cases of infectious disease. Six hundred and sixty cases of infectious disease (excluding tuberculosis) were notified during 1954, as compared with 1,862 in 1953. There was no serious epidemic during the period although a considerable increase in the incidence of measles was noted towards the end of the year. Statistical details of infectious diseases will be found in Tables IV and V in the Appendix. Smallpox. No cases were notified during the year, but three contacts were brought to the notice of the Department and kept under supervision during the requisite period. Although we had another year free from this disease, it is still an ever present potential danger which may arise at any moment— the danger perhaps being greater with the ever increasing speed with which it is possible to travel from one part of the globe to another. Vaccination. The following figures, which have been furnished by the County Medical Officer, show the number of persons in the area who were vaccinated against smallpox during 1954. Year of Birth. Primary Vaccination. Re-vaccination. 1954 495 — 1953 360 — 1952 16 1 1951 8 1 1950 17 3 1949 10 3 1948 8 6 1947 3 5 1946 1 4 1945 3 3 1944 3 2 1943 3 2 1942 2 — 1941 4 1 1940 1 — Before 1940 20 102 954 133 53 Acute Anterior Poliomyelitis. No case of this disease was confirmed during the year. Three cases of suspected poliomyelitis were investigated and three contacts kept under supervision. Diphtheria. One case of diphtheria, the first to be notified since 1949 occurred in the person of an adult, who had not been immunised. Diphtheria Immunisation. The following figures have been furnished by the County Medical Officer, and show the number of children under the age of 15 years on 31st December, 1954, who had completed a course of immunisation at any time before that date (i.e., at any time since 1st January, 1940):— Year of Birth Last complete course of injections (whether primary or booster) 1950 - 1954 1949 or earlier[/$$$] 1940 144 474 1941 161 470 1942 221 433 1943 461 160 1944 928 115 1945 839 29 1946 1,093 64 1947 1,369 23 1948 1,233 46 1949 1,227 49 1950 1,217 — 1951 1,187 — 1952 992 — 1953 968 — 1954 145 — Total 12,185 1,863 The following table shows the number of children resident in the area, who were immunised against diphtheria during the year ended 31st December, 1954 :— Year of Birth Primary Inoculations Re-inforcing Innoculations 1954 145 — 1953 819 — 1952 74 — 1951 25 — 1950 26 59 1949 43 692 1948 56 291 Year of Birth Primary Innoculation Re-inforcing Innoculation 1947 46 245 1946 52 230 1945 33 231 1944 32 277 1943 9 182 1942 2 18 1941 1 7 1940 2 3 Tolal 1,365 2,235 Typhoid Fever. One case of typhoid fever was notified in the person of a young male student. The disease was contracted abroad and prompt measures taken on receipt of notification, prevented any spread of the infection. Scarlet Fever. Ninety-six cases of Scarlet Fever were notified. Forty-eight of these cases were removed to hospital, and the remainder home nursed. This disease continued to be mild in character and the distribution of the cases was fairly even throughout the area. There were no " return cases " nor were any deaths from this disease recorded in the district. The tendency for the severity of this disease to be much diminished in recent years has been commented upon previously, and at the moment there seems no indication that a change for the worse is in any Way likely in the near future. In my own mind I find it difficult to decide whether the organism causing the disease has lost a great deal of its virulence, or whether the generally improved standard of living has built up such a strong generation that the human body is now able to cope with the invader very much more effectively. It may well be, of course, that a combination of these circumstances is responsible, but whatever the cause, the results can only be counted as eminently satisfactory. Puerperal Pyrexia. There were three cases notified, of which one was institutionally treated. No deaths were registered in the area. Ophthalmia Neonatorum. Three cases were notified, all of which made a satisfactory recovery with no impairment of vision. 55 Pemphigus Neonatorum. No cases were reported during the year. Measles. Two hundred and twenty-nine notifications were received during 1954 as against one thousand and ninety-seven for 1953. One of these cases was admitted to hospital and the remainder home nursed. There were no deaths from this disease in the area. What has been said of scarlet fever with regard to its severity might well be repeated in the case of measles, but there the similarity ends. In the case of measles we still get large outbreaks occurring usually in alternate years, that is to say when a large number of non-immune children are congregated at school. In other words, in the year following an epidemic, there are normally too few susceptibles left in the schools to allow of an outbreak, in view of the fact that one attack of measles usually confers a life long immunity. Whooping Cough. Two hundred and twenty-three notifications of this disease were received during 1954 as against four hundred and forty-eight in 1953. Seven of these cases were removed to hospital and the remainder home nursed. No deaths from this disease were recorded in the Urban District. In this case also, we seem to be facing a problem of diminishing severity although it may well be that improved methods of treatment are largely responsible, but here again the improved stamina of the children may be a likely factor in the severity of the disease. The value of immunisation against this illness is still a controversial point and although many doctors and parents are convinced of its efficacy at least in mitigating the effects of the disease, it has not yet received universal approval. Food Poisoning. Seventeen cases of food poisoning or suspected food poisoning were notified by doctors and in all twenty-one persons came under supervision. Detailed investigations were made, which in most cases involved examination of specimens collected from patients and of food alleged to be the cause of the illness. In only five cases was food poisoning actually confirmed, each of these being due to salmonella organisms. Two of these persons were in one family, the other three being isolated cases. The great majority of these illnesses were of short duration and no deaths were reported. 56 A great deal of publicity is being given to-day to the ravages of food poisoning and there is little doubt that most sections of the community are very much alive to its dangers. Unfortunately, it is one of those conditions where the human element enters in to a great extent and some minor deviation from the best practice of food hygiene can have disastrous consequences to a large number of people. It is on account of this fact that our efforts to teach food handlers, and they represent almost the whole population, to handle food cleanly must be unending for it is only by constant reminders that we can hope to maintain or improve the standard. As far as this district is concerned, with only five cases confirmed during the whole of 1954, we cannot complain, but it is as well to remember that there were, in all probability, a much larger number which never came to light. Efforts to build up our defences against this illness are constantly being made by all possible means, but ultimately we are in the hands of those whose task it is to prepare and handle our food, and if we can impress upon them all the importance of their work, we shall have made a great contribution to eradicating another of those diseases which are all too prevalent to-day. Dysentery. Twenty-nine cases of dysentery were notified during the year, the majority of these in the summer months. All were investigated and specimens taken for examination were necessary. This disease, which now appears to have become endemic, is normally of a very mild type and gives rise to more inconvenience than serious ill-health. It is a very fair assumption that the disease is more prevalent than the notified figures would indicate, as owing to its extreme mildness, many sufferers probably never come for medical attention. On the other hand, this very point tends to the spread of the disease and makes its proper control a matter of great difficulty. Only by the exercise of extreme care in personal hygiene can this condition be mastered and it therefore resolves itself into a problem of health education especially once again of those responsible for our food. Other Infectious Diseases. In addition to the above, notifications were received as under:— Acute Encephalitis 1 Erysipelas 6 Pneumonia (all forms) 62 Meningococcal infection 1 There were twenty-eight deaths from pneumonia. 57 Tuberculosis. The following is a summary of the recordings in the Register for the year ended 31st December. 1954 :— [ Respiratory Other Forms Total number of cases M. F. M. F. On Register at 1st January, 1954 664 663 61 61 1,449 New cases notified during 1954 51 25 7 2 85 Number of cases coming to knowledge after death — — — — — Restored to Register 2 1 — — 3 Inward Transfers 26 29 2 2 59 743 718 70 65 1,596 Deletions, deaths, removals, recoveries, etc 41 45 3 — 89 Number of cases on Register at 31st December, 1954 702 673 67 65 1,507 New Cases and Mortality, 1954. Age Groups New cases notified or otherwise revealed. (Not including Inward Transfers)* Pulmonary Non-Pulmonarv Deaths Pulmonary Non-Putmonary M. F. M. F. M. F. M. F. Under 5 1 — — — — — — — 5—14 4 3 3 1 — — — — 15—24 8 6 2 1 — — — — 25—44 22 12 1 — 6 1 — — 45—64 9 4 1 — 4 — — — 65 and over 7 — — — 1 1 — — 51 25 7 2 11 2 — — *Inward Transfers 26 29 2 2 Totals 77 54 9 4 The number of cases notified during the year was eighty-five as against seventy-eight for 1953. There were eighty-nine deletions from the register (eightyseven in 1953). 58 Chest Clinic. I am indebted to Dr. M. Price, Physician in charge, for the following information :— Male. Female. Children. Total Number of new patients referred to the Clinic 283 306 282 871 Number of new patients diagnosed as tuberculous 28 21 5 54 Number of patients included above who attended as Contacts 92 111 184 387 Number of Contacts diagnosed as tuberculous 3 3 1 7 Number of persons vaccinated with B.C.G. 143 children. 8 adults. Number of refills given during the year 5,930 Apart from the day-time Diagnostic and Kehll sessions, a Refill Clinic is held on Tuesday evenings to accommodate those patients who are working. Mass X-Ray. During the course of the year under review, a total of 4,720 individual Mass X-Ray photographs were taken in the district. Of these 1,746 had previously been X-rayed, so approximately 3,000 new volunteers were found. In this large total, only five fresh cases of pulmonary tuberculosis were discovered requiring treatment, and one case is still under investigation. In addition, eight other abnormalities of the lungs were discovered, fifteen cases of heart disease and sixty-seven abnormalities requiring no action. From the above figures, it is very obvious that although the primary object of these visits is to assist in the early detection and prevention of pulmonary tuberculosis, they are also taking a big part in discovering other, often unsuspected, diseases within the chest wall. Once again I should like to stress that this service is worthy of all the support and encouragement that it is within our province to give. APPENDIX. STATISTICAL TABLES. 60 STATISTICAL TABLES, 1954. TABLE I.—Summary of Statistics. TABLE II.—Causes of Death. TABLE III.—Infant Mortality. TABLE IV.—Notifiable Infectious Diseases—Sex and Age Distribution. TABLE V.—Notifiable Infectious Diseases—Seasonal Incidence. TABLE VI.—Sanitary Inspection of the Area. TABLE VII—Tuberculosis Rates. 61 TABLE I. SUMMARY OF STATISTICS, 1954. Population (mid-year 1954, per Registrar General) 85,830 Birth Rate 15.3 Death Rate 7.9 Maternal Mortality Rate (per 1,000 live births) Nil Infant Mortality Rate (per 1,000 live births) 18.2 Number of live Births 1,317 Number of Stillbirths 30 Number of Deaths 678 Number of Maternal Deaths Nil Number of Infant Deaths (under 1 year) 24 Death Rate of Respiratory Diseases (including Influenza but not Tuberculosis 0.84 Death Rate of Tuberculosis 0.16 Death Rate of Cancer (all forms) 1.74 Death Rate of Zymotic Diseases 0.02 Notification of Infectious Diseases: — Scarlet Fever 96 Diphtheria 1 Poliomyelitis (paralytic) Nil (non-paralytic) Nil Typhoid Fever 1 Puerperal Pyrexia 3 Pneumonia (all forms) 62 Tuberculosis (new cases) 85 Number of Deaths from Infectious Diseases 2 Number of Deaths from Diarrhoea (under 2 years of age) Nil Number of Visits by Sanitary Inspectors 10,500 62 TABLE II. CAUSES OF DEATH, 1954. 1952 1953 1954 Total. Total. Male. Female. Total 1. Tuberculosis—Respiratory 17 18 8 4 12 2. Tuberculosis—Other 5 2 1 1 2 3. Syphilitic Diseases 5 2 — 1 1 4. Diphtheria — — — — — 5. Whooping Cough — — — — — 6. Meningococcal Infection 2 1 — — — 7. Acute Poliomyelitis 1 1 — — — 8. Measles — — — — — 9. Other infective and parasitic diseases 1 1 1 1 2 10. Malignant neoplasm, stomach 22 23 6 9 15 11. Malignant neoplasm, lung bronchus 21 38 31 5 36 12. Malignant neoplasm, breast 14 13 — 19 19 13. Malignant neoplasm, uterus 5 5 — 9 9 14. Other malignant and lymphatic neoplasms 65 75 42 28 70 15. Leukaemia, aleukaemia 8 8 4 1 5 16. Diabetes 7 5 — 1 1 17. Vascular lesions of nervous system 103 66 38 41 79 18. Coronary disease, angina 101 99 65 42 107 19. Hypertension with heart disease 16 13 14 8 22 20. Other heart disease 117 96 35 52 87 21. Other circulatory disease 40 51 10 15 25 22. Influenza 2 11 — 1 1 23. Pneumonia 27 32 15 13 28 24. Bronchitis 38 44 29 10 39 25. Other diseases of respiratory system 7 4 2 4 6 26. Ulcer of stomach or duodenum 8 10 7 3 10 27. Gastritis, enteritis and diarrhoea 3 7 3 1 4 28. Nephritis and nephrosis 7 8 2 3 5 29. Hyperplasia of prostate 4 6 6 — 6 30. Pregnancy, childbirth, abortion 2 — — — — 31. Congenital malformation 10 8 5 3 8 32. Other defined and ill-defined diseases 59 56 28 31 59 33. Motor vehicle accidents 4 9 3 2 5 34. All other accidents 10 7 6 3 9 35. Suicide 8 13 3 3 6 36. Homicide and operations of war — — — — — All causes 739 732 364 314 678 63 TABLE III. INFANT MORTALITY, 1954. (Compiled locally from Registrar's Death Returns.) CAUSES OF DEATH Under 1 week 1 week and under 2 weeks 2 weeks and under 3 weeks 3 weeks 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 5 — — — 5 — — — — 5 Malformation 3 — — — 3 — — 1 — 4 Prematurity 7 2 — — 9 — — — — 9 Bronchopneumonia 1 — — — 1 — — 1 — 2 Other causes 3 — — — 3 1 — — 4 TOTALS 19 2 — — 21 — 1 2 — 24 64 TABLE IV. NOTIFIABLE INFECTIOUS DISEASES, 1954. 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 51 45 - 1 2 2 8 13 37 20 3 5 1 2 - 2 - - Whooping Cough 114 109 15 12 21 15 37 24 38 54 3 1 - - - 3 - - Poliomyelitis (Paralytic) - - - - - - - - - - - - - - - - - - Poliomyelitis (Non-Paralytic) - - - - - - - - - - - - - - - - - - Measles 131 98 - 6 17 7 39 28 71 56 3 - - 1 1 - - - Diphtheria - 1 - - - - - - - - - - - - - 1 - - 296 253 15 19 40 24 84 65 146 130 9 6 1 3 i 6 - - Under 5 5—14 15—44 45—64 65 & over Age unknown M. F. M. F. M. F. M. F. M. F. M. F. Acute Pneumonia 37 25 4 2 9 7 10 8 10 3 4 5 - - Dysentery 15 14 6 6 6 4 2 3 1 1 - - - - Erysipelas 4 2 - - - - - - 3 1 1 1 - - Encephalitis 1 - - - 1 - - - - - - - - - Food Poisoning 1 4 - - - - - 1 - 1 1 2 — — Meningococcal Infection - 1 - - - 1 - - - - - - - - Ophthalmia Neonatorum 1 2 1 2 - - - - - - - - - - Puerperal Pyrexia - 3 - - - - - 3 - - - - - - Typhoid Fever 1 - - - 1 - - - - - - - - - Tuberculosis (Pulmonary) 51 25 1 - 4 3 30 18 9 4 7 - - - Tuberculosis (Non-Pulmonary) 7 2 - - 3 1 3 1 1 - - - - - 118 78 12 10 23 16 45 34 24 10 13 8 - - 414 331 65 TABLE V. NOTIFIABLE INFECTIOUS DISEASES, 1954. Seasonal Incidence. Disease Jan. Feb Mar. April May June July Aug. Sep. Oct. Nov. Dec. Total Diphtheria 1 - - - - - - - - - - - 1 Dysentery 1 3 - 3 5 6 2 2 - 1 3 1 29 Encephalitis - - - 1 - - - - - - - - 1 Erysipelas - - 1 - 1 - 1 - 1 - - 2 6 Food Poisoning - - - - - - 1 - 1 1 2 - 5 Measles - - - - - 1 - 3 3 16 78 126 229 Meningococcal Infection - - 1 - - - - - - - - - 1 Ophthalmia Neonatorum - - - - 1 - 1 - - - 1 - 3 Acute Pneumonia 8 - 2 3 5 4 2 10 2 - 12 14 62 Puerperal Pyrexia - - 1 - - - - - - 1 1 - 3 Scarlet Fever 15 15 17 11 5 9 5 3 3 7 4 2 96 Typhoid Fever - - - - - - - - - 1 - - 1 Whooping Cough 13 8 3 23 23 19 19 20 15 12 30 38 223 Totals 38 26 25 43 40 39 31 38 27 39 131 183 660 66 TABLE VI. SANITARY INSPECTION OF THE AREA. 1. Inspections—General. Dwelling Houses (Public Health Acts) 4,503 Dwelling Houses (Housing Acts) 307 Bakers 75 Bakehouses 110 Butchers 136 Butchers and registered sausage manufacturers 157 Works canteens 30 Restaurants and cafes 188 Dairies 66 Fishmongers 191 Greengrocers 185 Grocers 528 Ice cream shops 314 Public Houses 21 Confectioners shops 19 Other food preparing premises 29 Piggeries 160 Slaughterhouses 28 Factories (Sections 1, 2, 3, 4, & 6. Factories Acts) 50 Factories (Section 7) 198 Factories (Section 7 ; other premises) 102 Smoke abatement 165 Premises for rats and mice 1,161 Cases of infectious disease 265 Food poisoning 31 Moveable dwellings 655 Rivers and streams 25 Shops Act matters 238 Schools 6 Public lavatories 222 Unsound food 211 Petroleum Acts 97 Miscellaneous 27 10,500 67 2. Complaints. General Sanitary defects 226 Drainage 307 Keeping of animals 13 Offensive accumulations 69 Verminous premises 16 Water supply 32 Rats 335 Mice 44 Overcrowding 20 Foods 19 Dustbins 12 Smoke 21 Miscellaneous 6 1,120 3. Notices. Two hundred and fifty Informal Notices were served drawing the attention of the owners to the existence of nuisances and requesting abatement. Eleven Statutory Notices were served under the Public Health Act and one under the Housing Act. These were for nuisances, general sanitary defects, etc. In eight cases the matters were remedied by owners and by the Council in default in the remainder. 68 TABLE VII. TUBERCULOSIS IN CHISLEHURST AND SIDCUP. (as corrected by Inward and Outward Transfers.) Year Ending Population of Chislehurst and Sidcup Urban District Notifications Number of Cases on Register Pulm. Non-Pulm. Pulm. Non-Pulm. Total Number of yearly increase Number per 1,000 pop. M. F. M. F. Dec. 1942 60,400 73 12 191 128 54 43 416 19 6.8 1943 60,130 77 15 200 140 51 45 436 20 7.1 1944 57,470 81 6 194 177 51 42 464 28 8.9 1945 59,170 58 13 201 194 56 47 498 34 8.4 1946 67,870 78 15 231 217 61 51 560 62 8.2 1947 70,580 81 3 253 241 58 51 603 43 8.5 1948 72,750 114 5 308 301 60 51 720 117 9.8 1949 73,510 86 9 399 395 64 55 913 193 12.4 1950 80,040 94 5 583 587 73 66 1,309 396 16.3 1951 85,150 89 9 590 602 56 59 1,307 (minus 2) 15.3 1952 85,130 72 6 635 629 59 62 1,385 78 16.3 1953 85,290 75 3 664 663 61 61 1,449 78 15.8 1954 85.830 77 9 702 673 67 65 1,507 68 17.6