C4128 AC4412(3)(H)SLEH4025 CHISLEHURST AND SIDCUP URBAN DISTRICT COUNCIL MEDICAL OFFICER OF HEALTH'S h Annual Report on the HEALTH OF THE URBAN DISTRICT 1956 H. B. C. CARTER-LOCKE, M.B., B.S., M.R.C.S., L.R.C.P., D.P.H. Medical Officer of Health. CHISLEHURST AND SIDCUP URBAN DISTRICT COUNCIL MEDICAL OFFICER OF HEALTH'S Annual Report on the HEALTH OF THE URBAN DISTRICT 1956 H. B. C. CARTER-LOCKE, M.B., B.S., M.R.C.S., L.R.C.P., D.P.H. Medical Officer of Health. 3 CONTENTS. page Members of the Urban District Council 5 Staff 5 Prefatory Letter 7 Section A. Vital and Other Statistics and Social Conditions of the Area. General Statistics 12 Vital Statistics 12 Births 14 Deaths 14 Medical Examinations 15 Morbidity Statistics 15 Open Air Recreational Amenities 16 Population 13 Unemployment 16 Section B. General Provision of Health Services for the Area. Ambulance Service 24 British Red Cross Society 25 Clinics, etc 27 Disinfection 20 Domestic Help Service 24 Domiciliary Midwifery 25 Health Visiting 25 Home Nursing Service 25 Hospital Services 23 Laboratory Service 22 Laundry for the Aged Sick 22 National Assistance Act, 1948 23 Nursing Homes 21 Old People's Welfare Committee 30 Public Conveniences 21 Public Mortuary 23 St. John Ambulance Brigade 26 Tuberculosis Care Committee 26 Women's Voluntary Services 27 Women's Welfare Clinics 25 Section C. Sanitary and Environmental Circumstances of the Area. Agricultural (Safety, Health and Welfare Provisions) Act, 1956 32 Atmospheric Pollution 39 Cesspools 32 Drainage and Sewerage 33 Factories Acts, 1937 and 1948 33 Game Act, 1831 34 Heating Appliances (Fireguards) Act, 1954 34 Pet Animals Act, 1951 34 Petroleum (Regulation) Acts, 1928 and 1936 34 Public Cleansing, Refuse Collection and Disposal 35 Rag Flock and Other Filling Materials Act, 1951 36 4 Riding Establishments Act, 1939 36 Rivers and Streams 36 Rodent Control 36 Sanitary Inspection of the Area 38 Shops Act, 1950 38 Swimming Baths 45 Verminous Conditions and Uncleanliness 45 Water Supply 45 Section D. Housing Housing Inspections 50 Housing Act, 1949 51 Housing Repairs and Rents Act, 1954 51 Moveable Dwellings 52 New Houses 51 Re-housing 51 Slum Clearance 51 Section E. Inspection and Supervision of Foods. Bacteriological Examinations 60 Food & Drugs Act, 1955. Section 16 59 Food & Drugs Act, 1955. Food Sampling 57 Food Complaints 56 Food Hygiene Regulations, 1955 56 Food Premises 60 Inspections 56 Meat Inspection 60 Piggeries 60 Unsound Food 59 Section F. Prevalence of, and Control Over Infectious and Other Diseases Acute Anterior Poliomyelitis 62 Diphtheria and Diphtheria Immunisation 63 Dysentery 63 Food Poisoning 63 General Remarks 62 Measles 64 Meningococcal Infections 64 Other Infectious Diseases 68 Pneumonia 64 Psittacosis 65 Scarlet Fever 65 Smallpox and Vaccination 65 Tuberculosis, Mass X-ray and Chest Clinic 65 Typhoid and Para-Typhoid Fever 67 Whooping Cough 68 STATISTICAL TABLES. Table I.—Summary of Statistics 71 II.—Causes of Death 72 III.—Infant Mortality 73 IV.—Notifiable Infectious Diseases—Sex and Age Distribution 74 V.—Notifiable Infectious Diseases—Seasonal Incidence 75 VI.—Sanitary Inspection of the Area 76 5 MEMBERS OF THE URBAN DISTRICT COUNCIL (as at 31.12.56) Chairman : *F. C. MANSFIELD, Esq., J.P. Vice-Chairman : J. R. CAMPBELL CARTER, Esq. Councillors: P. Andrews. G. F. Barr. Mrs. E. G. Beecher Bryant. D. W. Child, D.C.M. *C. J. Christopher. F. G. Emmerson. F. H. Farmer. E. N. Foinette. W. G. Fuller. *Mrs. S. M. Gunn. *Miss B. H. James, J.P. (Chairman of P.H. Committee) *F. E. Skone James. *G. H. Kirby-Smith. E. V. Mills, J.P., C.A. *Mrs. R. Moss. R. Pope. E. J. Reader. *Miss E. E. Rhodes. R. D. Rowland-Hill. D. W. Ryan. R. A. Sanderson, J.P. J. W. Schuch. F. P. Sellors. R. E. Sims. *W. J. Skinner. (Vice-Chairman of P.H. Com.) *R. Toon. *Mrs. E. V. Wallace. *E. W. White. *C. E. Wiltshire. *R. E. Woods. (* denotes members of the Public Health Committee.) STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health: (Municipal Offices, Bromley, Kent. Tel.: Rav. 4623) H. B. C. CARTER-LOCKE, M.B., B.S., M.R.C.S., L.R.C.P., D.P.H. (Also Medical Officer of Health for the Borough of Bromley, and Orpington Urban District Council.) Deputy Medical Officer of Health: A. J. I. KELYNACK, M.B., B.S., D.P.H. (Also Deputy Medical Officer of Health for the Borough of Bromley, and Orpington Urban District Council.) Chief Public Health 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, M.R.S.H., M.A.P.H.I. (Manor House, The Green, Sidcup. Tel.: Foots Cray 3081) 6 Deputy Chief Public Health Inspector, and Inspector under the Food & Drugs Act, Shops Act, Rag Flock & OtheH Filling Materials Act, Pet Animals Act, and Heating Appliances (Fireguards) Act: E. C. BERWICK, c.r.s.h., m.a.p.h.i. Public Health Inspectors, and Inspectors under the Food & Drugs Act, Rag Flock & Other Filling Materials Act, Pet Animals Act, and Heating Appliances (Fireguards) Act: G. F. DOWNING, c.r.s.h., m.a.p.h.i. K. W. FINCH, a.r.s.h., m.a.p.h.i. (Resigned 24.11.56) J. W. P. HARRIS, c.r.s.h., m.a.p.h.i. CLERICAL STAFF. A. F. OUGHTON. Miss C. DEVONSHIRE. Miss C. BUTLER. (Appointed 20.8.56) OUTDOOR STAFF. T. BACK (Disinfector, Mortuary Keeper, Drain Clearer and General Handyman.) J. DAVIS (Assistant to Disinfector.) A. ELLIS (Rodent Operative) (Died 18.11.56) E. FIFE (Rodent Operative) (Commenced 14.7.56) 7 To the Chairman and Members of the Chislehurst and Sidcup Urban District Council. Mr. Chairman, Ladies and Gentlemen, Amongst those who pick up and read this report will be some who have had experience of a new car and will remember what devoted care and attention was lavished upon it during its early weeks and perhaps months, but as time passed the first flush of enthusiasm gradually died away, leaving the vehicle more and more to its own devices. I cannot help wondering if to some extent we are treating the ageing human organism in somewhat the same way, and bestowing all our benefits on the very young, and then leaving them to look after themselves. There is so much we can teach the young and middle-aged adult about caring for themselves, both at the present and with an eye to the future, and this is my annual opportunity to stress some of the matters which have most struck me during the course of the year. This letter is of course not by any means the only channel of communication between the Public Health department and the Public, for the contact between the Public Health Inspectors and the population at large, is a very close and constant one, and those very valuable and able officers are undoubtedly our most useful Health Educators. Incidentally, this is the first time that in any annual report I have used the designation of "Public Health Inspector," for it was only during the last year that by Act of Parliament, their name was altered from the former sanitary inspector. To my mind the alteration is for the better, giving as it appears to, a much clearer picture of the varied duties undertaken by these officers. I have digressed a little from my theme, but will now revert to dealing with matters of Health Education which appear to me to be of vital importance. In the first place, I feel that no apology is needed for drawing attention once again to the mounting volume of statistical evidence, of an association between tobacco smoking and the incidence of lung cancer. This is no attempt at scare-mongering or dictation to a social custom, but merely a statement of fact of which as many people as possible should be made aware as frequently as possible. This information is given particularly for the benefit of those who may not yet have commenced the smoking habit, for it is they who are likely to derive the most advantage from taking heed of the knowledge so far gained. Another matter to which I feel constrained to refer is the still too prevalent habit of not keeping meat, which has been heated, in a cool atmosphere subsequent to that heating. It is most 8 important that it should be fully realised that meat is an ideal medium on which germs can multiply, and that that multiplication is greatly assisted in a warm atmosphere. I would therefore, enjoin everyone to cool their meat as rapidly as possible by placing it in the coolest place on the premises, followed if possible, by refrigeration at the earliest practicable moment. It is not so long since the problem of under-nutrition was a serious one, but the pendulum has now possibly swung in the opposite direction with results almost as damaging to health. When tuberculosis was rife, poverty and mal-nutrition were also common, but now that these latter evils have been so greatly reduced, another menace has arisen which is taking too big a toll of too great a number of our community, who are often in the prime of their lives. The condition to which I refer is coronary thrombosis, and in this case evidence is accumulating that an excess of fat in the diet is a predisposing cause. In the present state of knowledge, it is therefore prudent to advise that as the years pass and one's physical activities are reduced, so at the same time should one's intake of food especially of fat, be moderated. The trail of misery brought about by accidents in the home is another matter to which I think your attention should be drawn. Although such accidents are, of course not notifiable, they do I understand exceed in number those occurring on the roads and it is indeed sad that the home, which most of us regard as a haven from the more cruel blows of the outside world, should be the scene of so many tragic incidents. There are few, if any of us, not guilty of thoughtlessness and carelessness in this direction, and if a few potential sources of trouble are quoted one hopes that the reader will think of others and take appropriate measures to ensure the maximum safety at home. My mind runs on such things as loose stair carpets, highly polished slippery floors, defective gas or electric fittings, unguarded fires, poor lighting, obstacles on the floor, poisonous substances left within reach of children, and pots and pans on a stove in such a position that they can be upset easily. This list could be multiplied many fold, and in particular where the very young or very old make up part of the household, is it necessary to take precautions against accidents, to which these groups are peculiarly prone. Amongst matters of particular interest and importance occurring during the year, must be mentioned the commencement of the County Council's scheme for vaccination against anterior poliomyelitis. It is as yet too early to attempt to assess the results as the numbers who have completed courses of treatment are too small, but there is every justification for hoping that from small beginnings a campaign will eventually be built up, producing results as satisfactory as the preventive treatment of diphtheria proved to be. 9 I must also refer to the occurrence of two cases of psittacosis during the year. In both cases budgerigars were kept in the households, and, thanks to the co-operation of their owners, it was possible to have the birds examined for infection. In neither case was this infection confirmed in the birds, but that does not necessarily mean that they were not the origin of the trouble. As psittacosis presents itself in the human being as a chest infection, it may well be that it is more prevalent than its somewhat infrequent diagnosis would suggest. The vital statistics are dealt with in full in another part of the report, so a general statement that all in all they must be considered satisfactory, will suffice. In addition, it is gratifying to be able to record that the year was one with a low incidence of notifiable infectious diseases, full details of which can be found under the section devoted to this subject. My final words will be of thanks, first to Mr. Kermode, the Chief Public Health Inspector for his able administration and unfailing efficiency. The rest of the Inspectors and staff in general have all given of their best, and we were sorry to lose the valuable services of Mr. Downing, one of the Public Health Inspectors towards the end of the year. My gratitude is also due to Dr. Kelynack for his willingness and meticulous attention to detail, and to a whole host of professional colleagues, in various branches of medicine, who have given me such helpful co-operation during the year. My very last words of thanks must be addressed to the Chairman and Members of the Public Health Committee, all of whom take such a keen interest in the work of the department, thus encouraging those whose task it is to implement Committee decisions. I am, Your obedient Servant, H. B. C. CARTER-LOCKE, Medical Officer of Health. SECTION A. VITAL AND OTHER STATISTICS AND SOCIAL CONDITIONS OF THE AREA. 12 SECTION A. VITALAND OTHER STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area of the Urban District (in acres) 8,957 Census, 1951 83,850 Registrar General's estimate of total population (mid-year) 1956 87,300 Rateable Value at 1st April, 1956 £1,249,876 Rateable Value at 31st March, 1957 £1,261,396 Rateable Value at 1st April, 1957 £1,196,396 Product of a Penny Rate for year ended 31st March, 1957 £4,950 Number of Valuation assessments as at 31st March, 1956:— Houses and Flats, including Flats over shops 24,449 Farmhouses 93 Shops, including Flats over shops 823 Industrial and Miscellaneous premises 1,057 Crown properties 45 26.467 Mileage of Roads as at 31st March, 1955:— County Roads, Class 1 (including Trunk Roads) 21.42 County Roads, Class 2 4.30 County Roads, Class 3 6.12 District Roads 76.125 Unadopted Roads 9.00 116.965 Vital Statistics. Live Births. Males. Females. Total. Legitimate 635 565 1,200 Illegitimate 17 27 44 652 592 1,244 Birth rate for England and Wales 15.7. Stillbirths. Males. Females. Total. Legitimate 14 16 30 Illegitimate — — — 14 16 30 Stillbirth rate per 1,000 estimated total population 0.34 Stillbirth rate per 1,000 live and still births 23.5 Deaths. Males. 362 Females. 313 Total. 675 Crude death rate per 1,000 estimated total population 7.7. Adjusted death rate for comparative purposes 10.2. (Area comparability factor for deaths is 1.32.) Death rate for England and Wales 11.7. Crude birth rate per 1,000 estimated total population 14.2. Adjusted birth rate for comparative purpose: 13.8. (Area comparability factor for births is 0.97.) 13 Maternal Deaths. Deaths from puerperal sepsis Nil. Deaths from other puerperal causes Nil. Maternal mortality rate per 1,000 (live and still) births Nil. Deaths of Infants under 1 year of age. Males. Females. Total. Legitimate 13 14 27 Illegitimate . 2 1 3 15 15 30 Infant mortality rate per 1,000 live births 24.12 Legitimate infants per 1,000 live legitimate births 22.5 Illegitimate infants per 1,000 live illegitimate births 68.18 Infant mortality rate for England and Wales per 1,000 live births 23.8 Vital Statistics of the Urban District for the past ten years. Year Population No. of Births (live) No. of Deaths No. of No. of Infant Maternal Deaths Deaths Birth Rate (crude) Death Rate (crude) Infant Mortality Rate Maternal Mortality Rate 1947 70,580 1,481 632 44 1 20.9 8.9 29.0 0.6 1948 72,750 1,197 659 20 3 16.4 9.1 16.7 2.5 1949 73,850 1,159 582 22 3 15.8 7.9 19.0 2.6 1950 80,040 1,201 682 28 — 15.0 8.5 23.3 — 1951 85,150 1,372 757 32 4 16.1 8.9 23.3 2.9 1952 85,130 1,282 739 25 2 15.1 8.7 19.5 1.5 1953 85,290 1,291 732 31 — 15.1 8.6 24.0 — 1954 85,830 1,317 678 24 — 15.3 7.9 18.2 — 1955 86,870 1,370 747 34 1 15.8 8.6 24.8 0.72 1956 87,300 1,244 675 30 — 14.2 7.7 24.12 — Statistics for England and Wales, 1956. Birth Rate per 1,000 total population 15.7 Death Rate per 1,000 total population 11.7 Infant Mortality rate per 1,000 live births 23.8 POPULATION. The Registrar General's estimate of the total population of the Urban District, mid-year 1956, was 87,300, which is an increase of 430 over the figure for the previous year. This figure gives a density of 9.8 persons to the acre. The natural increase of population, measured by excess of births over deaths, in 569. It is interesting to note that since 1947, the total increase in population is 19,430. 14 BIRTHS. One thousand, two hundred and forty-four live births were registered during the year, as against one thousand, three hundred and seventy during 1955. The birth rate for the year is 14.2 which is slightly lower than that of the previous year. The adjusted rate for comparison purposes is 13.8. The rate for England and Wales as a whole is 15.7. The illegitimate birth rate was 34.54 per 1,000 live and still births. There were forty-four live illegitimate births registered, seventeen being males and twenty-seven females. Thirty stillbirths were registered, giving a rate of 0.34 per 1,000 total population, and 23.5 per 1,000 live and still births. Fourteen of the stillbirths were males and sixteen females. DEATHS. There were 675 deaths appertaining to the Urban District and registered during the year, giving a death rate of 7.7 per 1,000 total population. The adjusted rate for comparison purposes is 10.2. The rate for England and Wales as a whole is 11.7 Of the deaths registered, 362 were males and 313 females. The following is an analysis of the ages at death:— 30 were under 1 year of age. 5 were 1 and under 5 years of age. 5 were 5 and under 15 years of age. 4 were 15 and under 25 years of age. 27 were 25 and under 45 years of age. 167 were 45 and under 65 years of age. 159 were 65 and under 75 years of age. 278 were 75 years of age and over. 675 Full details of the causes of death will be found in Table 11 in the appendix, but the following information with regard to certain causes of death in the Urban District during the past six years may be of interest:— 1951 1952 1953 1954 1955 1956 Cancer (all sites) 132 127 154 149 157 127 Cancer of Lung, Bronchus 22 21 38 36 44 31 Respiratory Diseases (not Tuberculosis) 89 72 80 73 87 88 Tuberculosis 30 22 20 14 7 11 Digestive Diseases 18 11 17 14 14 11 Heart and Circulatory Diseases 361 377 325 320 353 329 Infectious Diseases 4 4 3 2 2 2 Road Traffic Accidents 6 4 9 5 5 8 Other Violent Causes 12 10 7 9 10 11 Suicide 9 8 13 6 10 3 15 One of the more satisfactory features in these figures is the not inconsiderable fall in the number of deaths attributed to cancer generally, and to cancer of the lung in particular, but it would be wise to say that no false hopes should be raised for the future on the evidence of one year only. Deaths from violence have only dropped by one compared with the previous year, but it is pleasing to see that suicides were at their lowest level for several years past. Deaths from tuberculosis rose a little, last year, but still remain at a very low number. As was forecast in my report last year, a further fall could scarcely be anticipated reasonably. MORBIDITY STATISTICS. A weekly return is received from the Regional Office of the Ministry of National Insurance of the number of certificates for sickness benefit received at the local office. Whilst the area served by this office does not exactly coincide with the urban district boundaries, these figures give a fair indication of the seasonal trend of illness in the area. The year 1956 followed the expected trend, the highest incidence of illness occurring during January and February and then declining to its lowest level in August, before gradually rising again towards the end of the year. Four weeks ending 1956. Number of certificates of incapacity. First. Intermediate. Final. 31st January 1,196 4,173 1,048 28th February 1,474 4,428 1,277 27th March 991 4,218 1,253 24th April 674 3,637 743 22nd May 625 3,487 602 19th June 570 3,505 616 17th July 549 3,416 496 14th August 465 3,152 477 11th September 553 3,018 480 9th October 724 3,346 604 6th November 930 3,399 810 4th December 941 3,662 864 1st January (1957) 667 3,037 637 MEDICAL EXAMINATIONS. Twenty-nine members, or potential members of the staff, were medically examined for superannuation purposes etc. during the year. 16 UNEMPLOYMENT. I am indebted to the Manager of the local employment exchange for the following information with regard to unemployment in the area during 1956:— “The position in Chislehurst and Sidcup during 1956 remained very good. Unemployment among men was very small, and, except for the over 60's and disabled, the periods of unemployment have been short. Unemployment among women has been negligible, and either ill-health or domestic commitments have accounted for practically all of it.” OPEN AIR RECREATIONAL AMENITIES. Location. Acreage. Description. Abbeyhill Park 6.84 Part allotments. Belmont Lane Open Space 5.59 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. Hoblingwell Wood 87.00 Open space, 1 cricket pitch and 2 football pitches. 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. Marlborough Park 6.32 Open space with 1 football pitch and 1 netball pitch. Mottingham Lane 1.00 Children's playground. Mottingham Sports Ground 30.00 Open space with 2 tennis courts, 8 football pitches, 6 cricket pilches, 1 hockey pitch and 3 concrete cricket practice pitches (mobile canteen, summer). 17 Location. Acreage. Description. 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 3 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,cafe and aviary. 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, children's playground and 2 hockey pitches. Willersley Park 5.59 Open space with 4 tennis courts and children's playground. 480.42 The provision of open spaces, where the populace, both young and old, may take recreation, is a necessity, both from the point of view of health and mental well-being. Throughout the district the Council has provided facilities both for those who desire the peace of beautifully laid out parks, and those who wish to take part in games and sports. In the latter connection the appointment of Games Wardens at Marlborough Park and Mottingham Sports Ground have been much appreciated by the children. During the year work has proceeded in connection with the layout of Hoblingwell Wood, St. Paul's Cray, where provision has been made for organised cricket and football. SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. 20 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. DISINFECTION. The disinfecting station is situate in Main Road, and the department carries out the necessary disinfection of premises, etc. after the removal of a person suffering from an infectious complaint, or subsequent to the patient being declared free from infection. Rooms, fixtures, and furnishings are sprayed with formalin, and bedding and clothing are treated by means of steam disinfection. Public Library books which have been exposed to infection are rendered safe and returned to the libraries concerned. Disinfestation. Work in connection with the eradication of vermin in premises is also undertaken by the department. Rooms are treated with a solution containing a quick acting insecticide containing D.D.T. Bedding is subjected to steam treatment in order to destroy eggs, etc. Advice is given to householders to assist them in dealing with the various insect infestations. Details of the work carried out during 1956 are as under :— DISINFECTIONS. Premises visited 788 Rooms disinfected 41 Articles disinfectec 527 D1SINFESTATIONS. Premises visited 22 Rooms disinfested 9 Articles disinfested — Fumigation Sprayed Steam Disinfected Destroyed Rooms 9 41 – – Mattresses – – 75 16 Pillows – – 249 – Blankets – – 145 – Clothing, bundles of – – – 2 Library Books – 37 – 3 9 78 469 21 21 NURSING HOMES. There have been no changes during the year. Details of the six nursing homes in the area registered at 31.12.56 are given below. Number of Beds. Maternity. Other. Total. " Fallowfield," Ashfield Lane, Chislehurst — 38 38 *" Hadlow," Hadlow Road, Sidcup 3 4 7 " Hatherley," Hatherley Road, Sidcup — 9 9 " Glenthorne," Lower Camden, Chislehurst — 12 12 " The Retreat," Lower Camden, Chislehurst — 4 4 " Redhill House," Redhill, Chislehurst — 7 7 3 74 77 (* Closed April, 1957) The homes were inspected at frequent intervals during the year, and at no time were any contraventions found which called for action on the part of the local authority. All but three of the beds are for medical or surgical cases, and the majority of patients are aged sick or aged infirm. PUBLIC CONVENIENCES. 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 one part-time and three whole-time cleaners is employed for this work. Work was commenced on a new public convenience on the L.C.C. estate at St. Paul's Cray, and a further building will be erected in Mottingham, during 1957. 22 Severe frosts in the early part of the year caused considerable damage to water fitments. Steps have been taken in existing conveniences to minimise the effects of future cold weather, and as far as possible, apparatus less liable to damage by frost is being specified for new buildings. Conveniences continue to be damaged by maliciously disposed persons and there has been some success in tracing the culprits. LAUNDRY FOR THE AGED SICK. The scheme for the laundering of bedding from aged and incontinent persons, where it is not possible to use ordinary facilities, was launched in April 1954 and was used in 1956 to a greater extent than in the preceding year. The bedding is collected from the homes of persons concerned, laundered by the Sidcup Hospital Management Committee and returned. During 1956, the service was provided for a total of six aged ladies, in most cases for substantial periods. It has been much appreciated. LABORATORY SERVICE. Medical specimens are sent to the Public Health Laboratory at Maidstone. In cases of urgency specimens are examined at the Bromley Hospital Laboratory, and I am indebted to Dr. Keall and his staff for this assistance. During the course of the year, the following specimens have been submitted for examination :— Food Faeces Vomit Others No. sent No. Positive No. sent No. Positive No. sent No. Positive No. sent No. Positive Bromley Hospital 1 1 60 6 — — — — Maidstone Public Health Laboratory 23 — 328 137 1 — — — Totals 24 1 388 143 1 — — — The number of specimens of fasces sent for examination is greatly in excess of that for the previous year. The increase was largely occasioned by investigations carried out to control dysentery and food poisoning. Through the co-operation of Dr. Randall of Orpington Hospital, copies of numerous reports on similar specimens submitted by local practitioners, were also made available to me. 23 NATIONAL ASSISTANCE ACT, 1948. Section 47. The conditions under which several persons, alleged to be in need of care and attention were living came under investigation during the year. In certain of these cases, it was possible, in collaboration with other interested parties, to effect some amelioration of their unhappy circumstances. In no case was it necessary to apply to the Court for an order for compulsory removal. Section 50. This section of the Act places a duty on 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 have, or are being, made. Expenses incurred by the local authority may be recovered from the estate of the deceased person, or from any person liable to maintain the deceased person, immediately prior to his death. During the year the Council arranged for the burial of four persons under this section of the Act, a greater number than in any previous year. PUBLIC MORTUARY. The public mortuary is situate at Beaverwood Road, Chislehurst, and during the year 136 bodies were taken there. Of this number, 58 were received from hospitals. Inquests were held in 25 cases. These figures show a slight reduction on the previous year, but are greatly in excess of those recorded a few years ago. HOSPITAL SERVICES. Cray Valley Hospital. Provides a general hospital service with the following beds :— Maternity 10 Medical 10 Surgical 10 " Section 4 " 2 " Section 5 " 3 Queen Mary's Hospital. A general hospital service with the following beds :— Male. Female. Children. General Medicine 37 20 — Paediatrics — — 16 Diseases of the Chest 30 30 — Chronic Sick 24 24 — General Surgery 27 19 6 24  Male. Female. Children. Tonsils and Adenoids — — 12 Traumatic and Orthopedic 16 15 — Ophthalmology — — 2 Gynaecology — 16 — 134 124 36 As in other hospitals within the district, voluntary service is rendered by many organisations. The newly formed " Friends of Queen Mary's Hospital" are particularly active and have taken charge of a mobile telephone for the use of patients. Sidcup Cottage Hospital. A General Practitioner hospital with 11 Medical, 1 " Section 4," and 1 " Section 5 " beds. The above hospitals are within the area of the Sidcup Hospital Management Committee of the South East London Region. Grove Park Hospital. There are six blocks of this hospital within the area of the Urban District. 233 of the beds concerned are used for tuberculous patients, whilst the remaining 32 are reserved for non-tuberculous thoracic patients. All 265 beds are fully used. This hospital comes within the area of the Lewisham Group of the South East London Region. Venereal Diseases. Patients are referred to the various hospitals with specialist clinics for dealing with these diseases. None of these clinics are situate within the Urban District. COUNTY COUNCIL SERVICES. Ambulance Service. The district is served by the Ambulance Depot at Bromley, with a sub-depot at Main Road, Sidcup, where ambulances and sitting case cars are available. These vehicles are radio controlled. Domestic Help Service. The District Organiser's office is at 69, Sidcup Hill, Sidcup. The following is a summary of the cases assisted during 1956 :— Maternity (Expectant Mothers) 108 Tuberculosis 17 Aged 374 Others 208 707 25 Family Help Service. This service was brought into operation towards the end of the year, and is provided to deal with the care of children in their own homes when they are temporarily deprived of the care of their mother or a female guardian. Night Attendant Service. The Night Attendant Service is for old people in their own homes, and arrangements include evening service and preparation for sleep, preparation of meals, attention to fires and night service. Domiciliary Midwifery. Eight full-time midwives are engaged in the area. Patients may obtain the services of a midwife on direct application, or through the patient's private doctor. Health Visiting. Twelve Health Visitors and School Nurses, and three Tuberculosis Health Visitors are employed in the Urban District. In addition to their school work, the Health Visitors are responsible for the Maternity and Child Welfare Centres, Immunisation and Vaccination Clinics, Home Visiting, After Care, and give advice on the care of young children, and advice to expectant and nursing mothers. All Health Visitors now undertake Mental Health work. Home Nursing Service. Thirteen Home Nurses are engaged in the area. This service is provided on medical certification only, and is free. No night service is given at the present time. Women's Welfare Clinics. These clinics are held in various parts of the district, and details will be found under the heading " Health Services." Patients must be referred on medical grounds, and are seen by appointment. SERVICES RENDERED BY VOLUNTARY AGENCIES. British Red Cross Society. There are six Detachments in the Chislehurst and Sidcup Division operating wholly or partially in the Urban District. The Divisional office is situated at Hornbrook House, High Street, Chislehurst. 26 The Society is best known for the first aid duties and auxiliary nursing in hospitals undertaken by its members. Assistance is also rendered in home visiting of the sick and aged, diversional therapy for those who are unable to leave their homes, hospital services and escort duties to invalids on long journeys. First aid is rendered to those injured in accidents, from a Road Hut near Ruxley Corner, on the Sidcup By-Pass. This is manned on Sundays and Bank Holidays. There are four medical loan depots established in the area from which invalid and sick room equipment is provided for those needing it, usually at a small charge. The depots are as follow :— " Beltoft," Hadlow Road, Sidcup .... By appointment. Kent County Council, District Office, Sidcup Hill, Sidcup During office hours. 56, Woodside Avenue, Chislehurst By appointment. 51, Framlingham Crescent, Mottingham Wednesdays 6—7 p.m. or by appointment. The " Good Samaritan Club " for disabled men and women meets at the British Legion Headquarters, Chislehurst, on the second and fourth Friday in each month at 2.30 p.m. Petrol rationing made it necessary to reduce these meetings to one per month for a limited period. A successful new venture to aid the disabled was a class for handicrafts held on each Tuesday morning from 10 a.m. to noon at Hornbrook House. The St. John Ambulance Brigade. The Sidcup Brigade of the St. John Ambulance Association continues to be active within the district. Personnel trained in first aid attend at public gatherings and are available to accompany children, aged persons and patients undertaking journeys. A Road Hut is stationed in the Sidcup By-Pass near Main Road, where injured persons may receive first aid treatment. Chislehurst and Sidcup Voluntary Tuberculosis Care Committee. The following report has been supplied by the Liaison Officer :— " The Committee has been very active and help of all kinds has been extended to many families. During the Summer months several families were sent to the South coast for a fortnight's holiday, and this proved to be most beneficial to all members of the respective families despite the poor Summer. In most cases our help has followed the usual pattern—help with fuel during the Winter months, assistance with fares to visit patients, hire purchase debts, clothing, bedding, furniture, etc. Financial help has also 27 been obtained from other organisations such as " S.S.A.F.A.", " W.V.S.", British Legion and the British Red Cross Society, and the closest co-operation has been maintained between all statutory bodies. Many home visits were paid, and the office is open at the United Services Club, 108, Main Road, Sidcup, for all patients or their representatives to call and see the Liaison Officer to discuss their many problems and to obtain whatever help is necessary, any Tuesday, Wednesday or Thursday, between 2 p.m. and 4 p.m. Unfortunately, obtaining employment, especially light employment, still presents a very big problem for this Committee, but, fortunately we have the closest co-operation with many local firms, and whenever possible they will help when a suitable vacancy occurs. Toys were once again distributed at Christmas time via the Chairman of the Council, as well as help in the form of grocery parcels for many patients." Women's Voluntary Service. The service has moved to new headquarters at Craybrook House, Sidcup Hill, and from there is continuing its good work, especially that of ministering to the needs of old people. Wheel chairs are loaned and escorts are provided to assist those attending hospital. Assistance is given in the Outpatients' Department of Queen Mary's Hospital, and a trolley shop is operated at Cray Valley Hospital. Help has been given to the staff of the Mass X-Ray Unit, whilst operating in the district. Domestic help is arranged in suitable cases and personal shopping undertaken. Clothing is supplied to tuberculous patients and other needy persons, at the request of the National Assistance Board's Officers. The distribution of welfare food is also undertaken. HEALTH SERVICES. Ante-Natal Clinics and Child Welfare Centres. CHISLEHURST: The Willows, Red Hill Child Welfare Tuesday & Thursday p.m. Ante-Natal Wednesday p.m. Women's Welfare 2nd Tuesday a.m. Relaxation & Mothercraft Wednesday p.m. FOOTSCRAY: W. Smith Memorial Hall, Church Road Child Welfare Tuesday p.m. 28 MOTTINGHAM: K.C.C. Clinic, Kimmeridge Road Child Welfare Monday & Wednesday p.m. Ante-Natal Monday & Wednesday a.m. Relaxation Class Thursday p.m. NORTH CRAY: Men's Social Club Child Welfare 1st, 3rd & 5th Friday p.m. SIDCUP: Congregational Church Hall, Station Road Child Welfare Monday & Wednesday p.m. Relaxation & Mothercraft Wednesday a.m. First Aid Post, The Oval, Sherwood Park Avenue Child Welfare Tues., Wed. & Fri p.m. Ante-Natal Tuesday & Friday a.m. Women's Welfare 1st & 3rd Thursday a.m. Relaxation & Mothercraft Thursday p.m. ST. PAUL'S CRAY: Health Clinic, Mickleham Road Child Welfare Monday & Thursday p.m. Ante-Natal Wednesday a.m. Parentcraft for Senior Girls Tuesday a.m. Relaxation Classes Tuesday p.m. Asthma Clinic. CHISLEHURST: The Willows, Red Hill Thursday (by appointment)a.m. Dental Clinics. (all Dental Clinics by appointment.) CHISLEHURST: The Willows, Red Hill Mon., Wed. & Thurs (all day) Saturday morning. MOTTINGHAM: Kimmeridge Road Tuesday & Friday (all day) ST. PAUL'S CRAY: Mickleham Rd. Mon., Tues, Thurs. & Fri. (all day) SIDCUP: 10, Station Road Mon., Tues., Wed., Thurs. & Fri (all day) Domestic Help, Family Help and Old People's Service. District Organiser: Miss J. SMITH, 69, Sidcup Hill, Sidcup. Tel. FOOtscray 5521/2. Diphtheria Immunisation and Vaccination. CHISLEHURST: The Willows, Red Hill Immunisation Tuesday & Thursday 2—4 p.m. Vaccination Tuesday & Thursday 2—4 p.m. FOOTSCRAY: W. Smith Memorial Hall, Church Road Immunisation Tuesday 2—4 p.m. Vaccination 1st Tuesday in month 2—4 p.m. MOTTINGHAM: Kimmeridge Road Immunisation Monday & Wednesday 2—4 p.m. Vaccination Wednesday 2—4 p.m. 29 NORTH CRAY: Men's Social Club Immunisation & Vaccination 1st Friday in month 2—4 p.m. ST. PAUL'S CRAY: Mickleham Rd. Immunisation Mon., Wed. & Thurs 2—4 p.m. Vaccination Mon., Wed. & Thurs 2—4 p.m. SIDCUP: First Aid Post, The Oval, Sherwood Park Avenue Immunisation Tues, Wed. & Fri 2—4 p.m. Vaccination Wednesday & Friday 2—4 p.m. All the above sessions are in conjunction with the normal child welfare sessions. SIDCUP: 10, Station Road Immunisation Thursday from 10 a.m. Vaccination Thursday from 10 a.m. These sessions are for diphtheria immunisation and vaccination only. Midwives Clinic. SIDCUP: First Aid Post, The Oval, Sherwood Park Avenue Mon. & Thurs. (alternate weeks) p.m. Minor Ailment Clinics (Schools). CHISLEHURST: The Willows, Red Hill Thursday 9—10 a.m. Saturday 9—12 noon ST. PAUL'S CRAY: Mickleham Rd. Mon., Tues., Wed. & Fri. 9—10 a.m. Saturday 9 a.m.—12 noon SIDCUP: 10, Station Road Thursday 9.30-11.30 a.m. Physiotherapy. ST. PAUL'S CRAY: Mickleham Rd. Monday & Thursday a.m. Child Guidance Clinic. CHISLEHURST: The Willows, Red Hill Monday to Friday a.m. & p.m. (By Appointment) Saturday a.m (By Appointment) Speech Therapv. CHISLEHURST: The Willows, Red Hill Monday a.m. & p.m. (By Appointment) SIDCUP: 71, Sidcup Hill Monday to Friday. (By Appointment) Ophthalmic Clinic. CHISLEHURST: The Willows, Red Hill Monday a.m. (By Appointment) ST. PAUL'S CRAY: Mickleham Rd. Thursday a.m. (By Appointment) Post-Natal—Women's Welfare Clinics. CHISLEHURST: The Willows, Red Hill 2nd Tuesday a.m. SIDCUP: The Oval, Sherwood Park Avenue 1st & 3rd Thursday a.m. 30 District Officer and Assistant District Officer. (Also Duly Authorised Officers under the Lunacy and Mental Treatment Acts.) District Officer: Mr. B. C. WICKENDEN, Office: 69, Sidcup Hill, Sidcup. Tel. FOOtscray 5521/2. Assistant District Officer: Mr. J. N. TIBBALLS, Office: 69, Sidcup Hill, Sidcup. Tel. FOOtscray 5521/2. Occupation Centre: Scads Hill House, Chislehurst Road, Orpington. During School Terms—Monday to Friday 10 a.m.—3.30 p.m. A Home Teacher for the mental defective is also available. Application for this service should be made to the County Medical Officer of Health, County Hall, Maidstone. Home Teacher of the Blind. Miss S. M. Noble, c/o 69, Sidcup Hill, Sidcup. CHISLEHURST AND SIDCUP OLD PEOPLE'S WELFARE COMMITTEE. The following is a brief resume of the work carried out by the Committee— During the year, two new clubs have been opened, one at Mottingham called " The Gay Venture," and one in Chislehurst at Edgebury called the " Happy Wanderers." In May 1956, 104 old people went to Paignton, and 68 to Eastbourne, for two weeks' holiday. Boarding-Out Schemc. This is a further contribution to the solution of the difficult problem of accommodation for elderly people. It is an attempt to find comfortable and kindly homes willing to accept elderly people as paying guests. During the year six old people have been thus accommodated. " Redlac," Station Road, Sidcup. The tenants of "Redlac" have now lived in their flatlet homes for more than two years and appreciate the amenities provided. Visiting. This is a very essential part of work for old people. It is carried out by a visitor's panel who visit the sick and lonely who are house-bound and who cannot participate in club activities. Special visiting of club members who are in hospital is also undertaken. SECTION C. SANITARY AND ENVIRONMENTAL CIRCUMSTANCES OF THE AREA. 32 SECTION C. SANITARY AND ENVIRONMENTAL CIRCUMSTANCES OF THE AREA. AGRICULTURE (SAFETY. HEALTH AND WELFARE PROVISIONS) ACT, 1956. This Act came into operation on the 5th July, 1956, its main object being to make provision for securing the safety, health and welfare of farm workers and avoiding accidents to children arising out of the use of agricultural equipment. CESSPOOLS. Six new cesspools have been installed during the year, 2 of which drain sports pavilions. Forty-five cesspools are known to have been abolished during the year. The majority of these were dealt with subsequent to the laying of short lengths of public sewer and are mainly in Footscray and Sevenoaks Way, St, Paul's Cray. There are now 421 premises not connected to main drainage. Lamorbey and Blackfen 6 Sidcup and Footscray 8 North Cray 242 St. Paul's Cray 80 Chislehurst and Mottingham 85 421 In a number of cases two or more properties are drained to the same cesspool. The total number of cesspools in use in the district is now 320. It is hoped that a further length of sewer will be laid, during 1957, at Birchwood Corner, Hockenden. This will enable several more houses, now drained to cesspools, to connect to main drainage. Consideration is also being given to the construction of the necessary sewerage works so that properties in the North Cray area may be connected to the new sewer, already provided for the Bedens Field Housing Estate. The cesspool emptying service instituted by the Council in 1954, continues to function satisfactorily. A charge of 7/6 per load of 600 gallons is made for removal from private houses and 15/- for the same quantity in respect of business premises. 33 The following figures indicate the use being made of the service :— 1955 1956 Individual cesspools emptied 239 242 (many of these on a number of occasions) Total number of emptyings 748 750 Total number of loads removed 1,664 1,919 This represents a total of 1,151,400 gallons of sewage dealt with. It will be seen that despite a reduction in the number of cesspools in the area, the use made of the service shows a modest increase. This may be due to action taken by the Department to persuade the householders concerned of the necessity for fully utilising the facility provided. DRAINAGE AND SEWERAGE. I am informed by the Engineer and Surveyor that the following new drainage works have been carried out, or adopted, by the Council during the year. 400 yards 6" foul sewer with 8 manholes laid. 147 yards 9" foul sewer with 2 manholes laid. 215 yards 9" surface water sewer with 4 manholes adopted. 60 yards 12" surface water sewer with 1 manhole adopted. FACTORIES ACTS, 1937 AND 1948. Public Health Inspectors have made 358 visits of inspection to factories, with and without mechanical power, and to building sites etc. which are now controlled by these Acts. 18 nuisances or defects were dealt with. The following is a copy of the return supplied to the Ministry of Labour and National Service in respect of the year 1956 :— 1. Inspections for purposes of provisions as to health. Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted (i) Factories in which sections 1. 2, 3, 4 and 6 are to be enforced by the Local Authorities 25 18 2 — (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 158 196 6 — (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) 81 144 1 — Totals 264 358 9 0 34 2. Cases in which Defects were found. Number of eases in which defects were Referred Found Remedied To H.M. By H.M. Inspector Inspector Number of cases in which prosecutions were Instituted Want of cleanliness 3 3 — — — Overcrowding 1 1 — 2 — Unreasonable temperature — — — — — Inadequate ventilation — — — — — Ineffective drainage of floors — — — — — Sanitary Conveniences: (a) Insufficient 1 1 — 1 — (b) Unsuitable or defective 9 8 — 10 — (c) Not separate for sexes 4 — — 3 — Other offences against the Act (not including offences relating to outwork) 2 1 18 15 0 17 0 GAME ACT, 1831. During the year three licences to deal in Game were issued to local firms. HEATING APPLIANCES (FIREGUARDS) ACT, 1954. It was not necessary to take any action in connection with gas, oil or electrical heating apparatus being sold in the district. Observations did not reveal contraventions of the Act, and it would appear that manufacturers are adhering strictly to the requirements laid down, to prevent fire danger to users. PET ANIMALS ACT, 1951. Licences to sell pet animals were issued to proprietors of six premises. Supervision of these shops entailed 29 visits and it was found that the sale of pets was on a comparatively small scale. PETROLEUM (REGULATION) ACTS, 1928 AND 1936. Mr. J. C. Kermode, Chief Public Health Inspector, is the Inspector appointed under the Acts. Petroleum spirit and/or petroleum mixtures are stored at 59 premises, under licence. The total storage capacity is as follows :— Petroleum spirit in tanks 119,720 gallons. Petroleum spirits in cans 160 gallons. Petroleum Mixtures in approved stores 8,197 gallons. Carbide of Calcium 100 pounds. 35 Some of the underground tanks in the district have now been installed for many years and their replacement will become necessary in due course. During the year, at least three tanks were renewed. Regulations controlling more strictly the arrangements for filling tanks from petrol waggons, etc. will be issued in 1957. PUBLIC CLEANSING, REFUSE COLLECTION AND DISPOSAL. I am indebted to the Cleansing, Transport and Salvage Officer, for the following information :— The volume of refuse has again increased with little variation in weight. The tendency is for the refuse to get lighter with the increased use of electricity and other means of heating. This trend does, however, require changes in transport needs, and vehicles of larger capacity, with some degree of packing are necessary if the work is to be kept to schedule. The estimated tonnage of refuse collected amounted to 24,300. In addition another 4,000 tons of refuse was disposed of at the tip in the form of debris, trade refuse, gully contents, street sweepings, grass trimmings, builders' refuse etc. delivered to the site. The amount of kitchen waste collected during the year 1956-57, is in the region of 400 tons. This shows a reduction and has been brought about by the removal of the communal bins from the streets. The system of collection from individual containers in the Lamorbey and Mottingham areas has been continued. There are approximately 3,500 containers in use. The disposal of domestic and trade refuse is carried out at St. Paul's Cray Hill Park and is used to reclaim low lying ground. During the year steps have been taken to complete the filling of a small unfinished portion of the Baugh Estate, Footscray. When this work is completed approximately 14 acres of derelict land will have been reclaimed, and will be a valuable area for providing recreational facilities in the future. Another modern vehicle of special design has been introduced in the past year to enable the work to be carried out more effectively and hygienically. Improved trailers for the reception of salvage have also been put into operation. These are totally enclosed making another valuable contribution to the prevention of litter. The collection and disposal of salvage, including waste paper, has been maintained at a good level. 36 RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951. There are no premises in the district licensed under the Rag Flock Act. RIDING ESTABLISHMENTS ACT, 1939. During the year there were four riding stables open in the district. One of these commenced business in the Autumn, whilst another, where the stables were not altogether satisfactory, closed down. The animals consisting of 36 horses, 31 ponies, and 1 foal, were inspected by the Veterinary Surgeon appointed for the purpose. Seven visits were made and the animals reported to be in good health. The Inspectors paid a further six visits. RIVERS AND STREAMS. The South bank of the River Shuttle, East of Burnt Oak Lane Culvert, was revetted for a distance of twenty yards. The average height of the stone retaining wall is 8'. The usual works of clearance and maintenance have also been carried out by the Engineer and Surveyor's Department. Considerable attention has been given by the Department to the eradication of rats which nest in the banks of the streams. Close watch is kept on the streams for signs of pollution. RODENT CONTROL. A second rodent operative was appointed during the Summer, but a few months later, Mr. A. Ellis, who had served the Council so well for fifteen years, passed away. It will be remembered that infestation was exceptionally high in 1955. It has been at a slightly lower level in 1956, and this may, in part be due to the extra labour available for carrying out treatments promptly, thus preventing the rats from spreading. 37 The following is a summary of the work carried out during the year:— TYPE OF PROPERTY (1) Local Authority (2) Dwellings (including Council Houses) (3) Others Business (inc. L.A. Business) (4) Agricultural (5) Total II. No. of properties inspected as a result of: — (a) Notification (Complaints, etc.) 11 335 55 2 403 (b) Survey under Act (Visits as a result of (a), etc.) 4 500 35 539 (c) Otherwise (e.g., visits primarily for other purpose) — 40 18 — 58 III. Total inspections carried out 150 4,079 494 2 4,725 IV. No. of properties inspected (in Sect. II) found infested: (a) Rats (Major) — — — — — (Minor) 12 617 65 — 694 (b) Mice (Major) — — — — — (Minor) — 22 9 — 31 V. No. of infested properties (in Sect. IV.) treated by L.A. 12 611 63 — 686 VI. Total treatments — including retreatment and those carried out privately to properties .... 30 613 83 1 727 VII No. of notices (verbal or written) under Section 4: (a) Treatment — 3 2 — 5 (b) Structural (e.g., proofing) 1 41 21 — 63 X. No. of " Block " control schemes carried out — 5 1 — 6 SEWER INFESTATION. The usual " test baiting " of all the sewers in the area was carried out in May and was followed by treatments of those portions found to be infested, in June and again in November. The latter treatment was carried out in accordance with revised instructions issued by the Ministry of Agriculture, Fisheries and Food. As expected, it resulted in a considerably larger amount of bait being taken, and it is hoped that this will have resulted in a more efficacious treatment. The results are as follow :— Number Manholes treated No. manholes in which " Complete ' takes" " Partial takes" "No takes" Test bait 211 3 4 204 1st Maintenance treatment (June) 161 25 24 125 2nd Maintenance treatment (Nov.) 148 72 30 65 38 SANITARY INSPECTION OF THE AREA. Full details of the work carried out by the 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 4,639 Infectious Diseases 884 Food Premises, Sampling, Visits, etc 2,151 Factories, Outworkers, etc. 366 Moveable Dwellings 671 Smoke Abatement and Shops Act 655 Rodent Control 1,536 Miscellaneous 523 11,425 Notices issued :— Preliminary: General Sanitary Defects 184 Food Premises 226 Shop Premises 27 Factories, etc 9 Rodent Control 24 470 Statutory: Public Health Act 10 Housing 0 480 Food Condemnation Certificates issued 518 SHOPS ACT, 1950. The number of shops within the meaning of the Act, existing at the 31st December, 1956, was 830. They are situated as follow :— Lamorbey and Blackfen 258 Sidcup and Footscray 277 North Cray and St. Paul's Cray 96 Chislehurst and Mottingham 199 830 39 Certain requirements of the Food Hygiene Regulations 1955 overlap with the welfare provisions of the Shops Act, and it has been possible to deal with both simultaneously. Observations and a few complaints indicate that some shops which open on Sundays and on the afternoon of the early closing day, have been selling goods, not permitted under the Act. The attention of possible offenders has been drawn to the matter and it is being kept under observation. No Closing Orders have been made in the district. The General Closing days vary throughout the area and are as follow :— Wednesday—St. Paul's Cray Estate (except Leith Hill), Chislehurst, The Oval, Lamorbey, Lewis Road, Sidcup. Thursday—Sidcup area, other than above. A few shops open on the usual early closing day and remain closed on Saturday afternoons. Visits and observations total 556. The following infringements of the Act have been dealt with. Offences Found. Remedied. Notices and records 14 13 Hours of work 2 2 Closing Hours including Sunday Trading 22 22 Sanitary accommodation defective or insufficient 7 7 Temperature 5 3 Lighting 1 1 Seats for female assistants 1 1 ATMOSPHERIC POLLUTION. The Clean Air Act was carried through Parliament during the year. Although not all of its provisions are immediately operative, it is hoped that the Act will provide a firm basis for a serious attempt to deal with atmospheric pollution. So far as this district is concerned, the most important function of the Act is that which enables smoke emission from domestic property to be reduced or eliminated by the provision of fireplaces designed to burn smokeless fuel, which is now becoming more readily available. The Local Authority may select particular parts of the district and, with Ministerial sanction, declare them to be " Smoke Control Areas," in which, generally, it will be an offence to produce smoke. In the early part of 1957 the Council decided to confer with neighbouring authorities so that a concerted plan could be discussed. 40 The Council continues to be represented on the Thames-side Joint Committee for the Abatement of Atmospheric Pollution. The main aim of this Committee is to lessen the pollution caused by the cement factories, on and near, the Thames Estuary. The Deposit gauge situated at North Cray indicates that solid matter dropped there is less in quantity than when the gauge was installed in 1953, although a part of this improvement may well be due to variations in weather. During the year a further Deposit gauge and a Sulphur Dioxide gauge were provided in Blackfen. By and large, these instruments give parallel readings to those at North Cray. The total of solids deposited at North Cray averages 13.234 tons per month for the twelve months (as against 14.97 tons in 1955), whilst at Lamorbey (for seven months) it was 11.997 tons per sq. mile per month. The manner in which the amount of deposited solids varies from month to month, can be seen from the accompanying tables and graphs. County Primary Roman Catholic School, Sidcup. Monthly deposit in tons per square mile during 1956. June July Aug. Sept. Oct. Nov. Dec. Water (in rain in inches) 2.95 3.57 4.76 2.21 1.21 0.59 2.36 pH Value 5.30 7.02 7.16 7.28 5.26 5.48 4.02 Total water in soluble matter 7.33 6.97 7.03 4.49 5.29 6.69 4.71 Soluble in CS2 0.09 0.11 0.10 0.05 0.09 0.05 0.09 Ash 5.01 4.87 5.43 3.47 3.72 4.75 3.18 Other combustible matter 2.24 1.99 1.50 0.97 1.48 1.89 1.44 Total water soluble matter 5.03 5.91 8.19 6.38 5.60 5.34 5.03 Ca+ + 0.60 1.21 1.34 1.28 0.77 0.84 0.60 CI' 0.67 1.01 1.21 0.60 0.81 0.81 1.21 SO"4 2.20 2.65 3.15 2.77 2.30 1.99 1.88 Total solids 12.36 12.87 15.22 10.87 10.89 12.02 9.75 Sulphur Dioxide (milligrams of sulphur trioxide collected per day by 100 sq. cms. of Batch A lead peroxide) 0.86 0.70 1.01 2.10 3.52 2.37 41 Footscray County Primary School, Sidcup. Monthly deposit in tons per square mile during 1956. Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Water (in rain in inches) 3.00 0.11 0.97 1.41 0.48 2.92 3.63 3.60 1.98 1.53 0.56 2.26 pH Value 4.88 6.50 7.08 6.60 7.54 5.34 7.16 6.64 7.32 6.10 5.42 4.68 Total water in soluble matter 5.87 5.34 8.21 7.57 7.95 6.71 8.02 7.28. 4.44 5.84 6.24 4.58 Soluble in CSs 0.03 0.09 0.12 0.03 0.11 0.07 0.11 0.12 0.04 0.08 0.07 0.05 Ash 3.71 4.01 6.47 5.82 5.28 4.68 5.67 5.44 3.46 4.41 4.56 3.26 Other combustible matter 2.13 1.24 1.62 1.72 2.56 1.96 2.24 1.71 0.95 1.53 1.60 1.28 Total water soluble matter 6.85 4.90 10.71 7.79 4.80 5.57 7.52 8.86 7.45 6.24 5.37 4.77 Ca + + 1.21 0.77 2.28 1.38 0.94 0.54 1.48 1.48 1.61 1.01 0.81 0.67 CI' 1.75 0.74 0.79 0.79 0.47 0.74 0.94 1.14 0.60 0.84 0.81 1.21 SO"4 3.48 1.44 4.17 3.24 1.60 2.30 2.93 3.26 3.04 2.63 2.02 1.77 Total solids 12.72 10.24 18.91 15.36 12.75 12.28 15.54 16.14 11.89 12.08 11.61 9.34 Sulphur dioxide (milligrams of sulphur trioxide collected per day by 100 sq. cms. of Batch A lead peroxide) 2.05 2.80 1.49 1.30 1.17 1.04 0.64 0.57 0.67 1.60 2.58 1.49 42 43 44 45 SWIMMING BATHS. There are two small open air swimming pools in the area. One is in the grounds of a factory and is used by employees, whilst the other, although privately owned, admits members of the public on a limited scale. Treatment is undertaken to keep the water in a pure condition. Three samples of water were taken from the baths, all proving satisfactory. VERMINOUS CONDITIONS AND UNCLEANLINESS. Fourteen complaints were received in connection with premises alleged to be verminous or filthy and in this connection 22 inspections were made. In only nine cases were insect infestations found, four of them being premises controlled by the Council. Work of disinfestation was carried out by the Department in four cases whilst the others were dealt with by occupiers. A few cases of elderly persons, living in dirty conditions came to the notice of the Department. Often these people live alone and it is sometimes possible to arrange for assistance to be provided by the ancillary County Health Services. WATER SUPPLY. The supply of water to the district is from the mains of the Metropolitan Water Board. The Chairman of the Council became a member of the Board during the year. In two cases only are there premises not connected to the public supply, water being obtained from one private well. A sample from this source proved satisfactory, together with water taken from wells attached to two factories. Routine sampling is carried out by the Board and the results are indicated below. Four samples were also taken by the Department, and submitted for both bacteriological and chemical analysis. All were reported to be satisfactory. Complaints concerning suspected metallic contamination of the supply water, believed to originate from service pipes were investigated, but metal found in the water was not of sufficient quantity to cause any ill effects. 46 1 am indebted to 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 1956:— " The supply to the district of Chislehurst and Sidcup in 1956 was adequate and of high quality. The water was derived from the following sources: Bexley, Orpington, North Orpington, Shortlands, Eynsford, Horton Kirby, Wilmington and Darenth, together with Thames-derived filtered water via Shortlands Pumping Station. There were no extensions of trunk mains in 1956, but 4-inch service mains were laid in various estate roads. Bacteriological analyses of samples of water from 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 regular intervals. The following tables give the results of chemical and bacteriological analyses of the various sources of supply during 1956, before and after treatment. 47 Average Results of the Chemical and Bacteriological Examination of the water supplied to Chislehurst and Sidcup Urban District Council during 1956. Milligrammes per litre (unless otherwise stated). Description of the Sample Bexley New Well North Orpington Well No. 1 Orpington Shortlands No. 1 Shortlands No. 2 Eynsford Bore Hole Eynsford Well Horton Kirby Wilmington No. 1 Wilmington No. 2 Darenth Well Darenth Bore Hole Thamesderived Number of Samples 5 3 3 4 4 1 3 3 4 4 3 3 1598 Ammonia Nitrogen 0.006 0.002 0.003 0.001 0.005 0.000 0.005 0.005 0.012 0.004 0.005 0.007 0.036 Albuminoid Nitrogen 0.022 0.027 0.018 0.024 0.025 0.025 0.023 0.023 0.027 0.026 0.027 0.030 0.086 Oxidised Nitrogen—Nitrite — — — — — — — — — — — — — Oxidised Nitrogen—Nitrate 5.6 4.7 6.2 4.8 5.1 4.0 3.8 4.5 6.6 8.4 5.0 5.5 4.3 Chlorides as Cl. 17 12 15 16 16 15 14 17 22 21 16 16 30 Oxygen abs. from Perman ganate 4 hrs. at 27°C. 0.06 0.06 0.10 0.08 0.06 0.06 0.06 0.06 0.18 0.18 0.06 0.12 1.16 Turbidity in terms of Silica Nil Nil Nil Nil Nil — Nil Nil Nil Nil Nil Nil 0.3 Colour, m.m. brown 2 ft. Tube Burgess's Tintometer Nil Nil Nil Nil Nil — Nil Nil Nil Nil Nil Nil 13 Hardness (Total) 282 262 278 282 282 248 260 256 284 292 262 280 258 Hardness (non-carbonate) 54 42 48 74 72 42 40 42 56 62 38 54 72 pH Value 7.2 7.1 7.1 7.2 7.2 7.3 7.2 7.2 7.1 7.2 7.1 7.2 7.7 Phosphate as PO4 — — — — — — — — — — — — 0.90 Silicate as SiO2 — — — — — — — — — — — — 10 Sulphates as So4 28 8 16 40 40 8 12 20 22 22 14 22 58 B.O.D. 5 days at 20°C. — — — — — — — — — — — — — Electrical Conductivity (gemmhos) 475 450 475 475 500 400 400 425 400 425 425 450 500 48 Average Results of the Bacteriological Examination of the water supplied to Chislehurst and Sidcup Urban District Council during 1956. Parts per million (unless otherwise stated). BACTERIOLOGICAL RESULTS Bexley Well Horton Kirby Well Orpington Well N. Orpington Well Shortlands Wells Eynsford Wells Wilmington Wells Darenth Wells Thames derived filtered water Before Chlorination Number of samples 467 289 251 146 499 278 366 421 7066 Plate Count (Average per millilitre) Colonies counted on Agar: 37°C. (20-24 hours) 0.2 0.7 0.3 4.7 0.01 0.1 0.3 0.02 Bact. coli test: Percentage samples negative in 100 ml. 1000 98.3 99.6 13.7 100.0 100.0 96.5 99.5 61.2 Average number per 100 ml — 0.03 0.02 17.86 — — 0.09 0.01 4.43 After Chlorination (Water passing into Supply) Number of samples 257 243 256 149 255 283 244 255 3736 Plate Count (Average per millilitre) Colonies counted on Agar: 37°C. (20-24 hours) — — — — — — — — 5.0 Bact. coli test: Percentage samples negative in 100 ml. 1000 100.0 100.0 100.0 100.0 100.0 100.0 100.0 99.9 Average number per 100 ml — — — — — — — — 0.002 SECTION D. HOUSING. 50 SECTION D. HOUSING. (i) Routine Inspections: One hundred and forty-eight visits to premises were made in connection with the Housing Acts. (ii) Clearance Areas: No Clearance Areas were declared during the year. (iii) Individually Unfit Houses: One house was closed after agreement with the owner. (iv) Demolition Orders: No orders were made. (v) Overcrowding: The position at the 31st December, 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., 1956 Area 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 No. of cases found during the year No. of cases remedied during year Cases at end of year No. of persons concerned No. of cases Aged over 10 Aged under 10 Lamorbey 6 7 9 6 7 11 9 5 2 2 2 4 3 4 — 1 3 20 3 Longlands 1 — 1 1 1 — — — — —- — — — — — — — — — Birchwood — 1 — — 1 1 — — — — — — — — — — — — — Frognal 1 1 — 1 1 1 — — — — — 1 1 1 - 2 11 10 North Cray 1 1 1 1 1 3 1 1 - — — — — — — — — — — St. Pauls Cray' 2 4 5 6 4 5 3 3 2 2 4 4 3 3 1 2 2 16 8 Chislehurst Common — — — 1 3 6 3 1 1 1 1 — — — — — — — — Mottingham 2 4 5 15 6 15 26 17 13 10 10 11 5 5 — 1 14 27 3 Totals 13 18 21 30 24 42 43 27 18 15 17 19 12 13 2 4 11 74 24 (vi) Defects: Number of houses inspected for housing defects (Public Health and Housing Acts) 1,801 Number of houses found not in all respects fit 865 Number of houses made fit without service of formal notices 818 51 SLUM CLEARANCE. Detailed inspections were carried out in connection with ten houses with a view to representation being made by the Medical Officer of Health early in 1957. An additional house which had been seriously damaged by enemy action but not included in the "five year programme" was closed under Section II of the Housing Act 1936 and Sections 10 (1) and 11 (2) of the Local Government (Miscellaneous Provisions) Act 1953. The tenants did not take advantage of the alternative accommodation offered by the Council. HOUSING ACT, 1949. During the year 34 applications for Improvement urants were received and a similar number approved. The total amount of grants made was £5,198. Six applications were made in respect of conversions, two of which were approved. The total amount of the grant in these cases was £687 10s. CERTIFICATES OF DISREPAIR. Very little use has been made of the appropriate Sections of the Housing Repairs and Rents Act 1954. Only four applications were received during the year of which three were granted. One Certificate issued in 1954 was revoked. New Houses. During the course of the year, 281 new houses were erected in the area including 64 flats. Council Houses. The following information has been supplied by the Housing Manager:— Prior to 1956. During 1956. Houses. Families in occup. Houses. Families in occup. 1. Permanent dwellings built by Local Authority 1,355 1,355 44 1,399 2. Prefabricated dwellings built by Local Authority 275 275 0 275 3. Premises requisitioned by Local Authority 161 253 144 216 4. Halfway Houses 6 31 6 29 5. Temporary Hutments 0 0 0 0 During 1956 there were 90 lettings as follow: — (a) Permanent dwellings 51 families from waiting list. (b) Prefabricated dwellings 9 families from wailing list. (c) Requisitioned premises 2 families from waiting list. 62 52 The figure of 90 lettings includes 28 transfers which have been effected from various types of Council controlled property. During the year 13 families have been admitted to the Halfway Houses. 6. The total number of families on the waiting list as at the 31st January, 1957:— Couples 430 Families requiring two bedrooms 532 Families requiring three bedrooms 340 Families requiring four or more bedrooms 17 Old Age Pensioners and single persons 120 Cases not pointed and those passed for accommodation 103 Families in requisitioned premises 205 1,747 With reference to Item No. 3 it will be noted that a number of properties have been released from requisition during the year. MOVEABLE DWELLINGS. A far as possible strict control is exercised over the stationing of tents, vans and sheds used as dwellings, in the area. Powers are given in Sections 268 and 269 of the Public Health Act 1936, and under Town Planning legislation. In this connection, close liaison is maintained with the Engineer and Surveyor. A number of unlicensed dwellings have been using the grass verges on the Maidstone Road and spare land adjacent to it. The owners in conjunction with the police have taken steps to deal with trespassers, where private land is concerned. These sites are invariably left in a dirty condition. The position at the end of the year is indicated below:— Site Average number of families Approx. number of persons Whether licensed Smallgains Farm 2 4 Yes Ruxley Manor Farm 1 2 Yes Birchwood (adjoining Bull Hotel) 4 8 Yes Lower Hockenden Farm 1 2 Yes 168, Blackfen Road 1 3 Yes Sports Ground (Kemnal) 1 2 Yes Old Brickfield, Baugh Estate 3 11 Yes Twysdens Meadow 3 9 Yes Conservative Club 5 14 3 L., 2 N.L. Old London Road, Ruxley 1 3 No Chalk Pit, Ruxley 48 210 3 1 L„ 17 N.L. Corke's Meadow 109 466 No 53 Chalk Pit, Ruxley. As mentioned in my last Annual Report, it had been decided on grounds of Public Health that no more than 31 families could be permitted to use this restricted site. In spite of this, 17 additional families not possessing a licence were in residence there. The owner of the site has intimated that it is his intention to apply to the Court for an injunction restraining the persons concerned from using the site. Corke's Meadow, St. Paul's Cray. Corke's Meadow is used by some 109 families, none of whom possess licences. The site, which is under private ownership, is required by the London County Council for industrial purposes. As a prelude to any action which it might be decided to take, a number of surveys were carried out during the year, with a view to ascertaining the type of dwelling used by occupants, their mode of life, etc. The position is a very complex one owing to the varying types of structures used as dwellings, and the individual requirements of the families resident. Businesses are carried on, usually of a domestic nature, but in one instance on a large scale. Consultations at various levels have taken place with the London County Council and the Kent County Council. Conferences have been arranged by the Minister of Housing and Local Government with a view to securing an agreed policy as to the best methods to be employed. Towards the end of the year, a considerable volume of Press publicity was given to the general conditions at Corke's Meadow. Every effort is being made to reach a prompt solution to the problem. SECTION E. INSPECTION AND SUPERVISION OF FOODS. 56 SECTION E. INSPECTION AND SUPERVISION OF FOODS. INSPECTIONS. A total of 2,101 visits were paid to premises where food is stored, prepared or from which it is sold. 367 defects were found and in 265 instances, the attention of the persons concerned was called to deficiencies, either verbally or in writing. 209 written intimations were sent in this connection. FOOD HYGIENE REGULATIONS, 1955. These Regulations became fully effective during 1956. The great majority of the 531 premises concerned were visited. This has taken a greater proportion of the Public Health Inspectors' time than any other single item during the year. Much time was devoted to explaining in detail the Regulations, and the reasons for them, to shop keepers and their staffs. It was gratifying to note that the work carried out in the past few years in persuading proprietors to bring their premises up-to-date, had resulted in some provisions of the Regulations having been anticipated. Particularly so was this the case in connection with constant hot water supply and washing facilities. Where premises were found to fall short of the new requirements all possible advice has been given to owners and occupiers to meet their commitments. Certain items in the new Regulations are not sufficiently explicit. Thus, the provisions of sinks for washing equipment is open to doubt in certain cases, whilst differing opinions have been expressed in connection with the covering of benches on which bacon, etc. is cut, and on the precise steps necessary to prevent contamination of open food. So far as possible a high standard is being asked for and it is hoped that the position will be clarified when the Ministry issues the promised Codes of Practice. FOOD COMPLAINTS. A total of 31 complaints were received from purchasers regarding the alleged quality or the presence of impurities, in food. A great deal of detailed work is necessary in each of these cases in order to trace the foodstuff to its original source and to ascertain at which stage the trouble arose. 57 Some of the complaints were unjustified or arose from a misunderstanding on the part of the purchasers. In a number of instances it was possible to give advice to the traders concerned, who readily agreed to take all the steps suggested, in order to prevent similar occurrences. In 17 cases warning letters were issued, either as a routine measure, or on the explicit instructions of the Committee. In two serious cases (a bandage in a loaf and pork sausages sold in a mouldy condition) proceedings were instituted with successful results. A third case concerning a dirty milk bottle was pending at the end of the year. FOOD AND DRUGS ACT, 1955. FOOD SAMPLING ARTICLE Samples Taken Result Remarks See below Formal Informal Genuine Inferior Adulterated Arrowroot I — I — Bakers' Confectionery 2 3 4 1 — See (a) Bread 3 1 2 See (b) & (c) Butter 9 2 11 — — Butter Peanut 1 — 1 — — Cake and Pudding Mixture 12 — 11 1 — See (d) Cereals 9 — 9 — — Cheese Spread 1 — 1 — — Cream 3 — 3 — — Creamed Rice 1 1 2 — — Coffee and Chicory 3 — 3 — — Drugs 9 — 9 — — Faggotts 1 — 1 — — Fish, Tinned or Potted 4 — 3 — 1 See (e) Fish Dressing 1 — I — — Flour 3 — 3 — — Fruit (Dried) 13 — 12 1 — See (f) Fruit Juice 1 — 1 — — Fruit Pudding 1 — 1 — — Glace Cherries 1 — 1 — — Gravy Salt 1 — 1 — — Herbs, Dried 2 — 2 — — Ice Cream — 11 11 — — Ice Lollies — 1 1 — — Instant Icing 1 — 1 — — Jelly 7 — 7 — — Lard and Cooking Fat 3 — 3 — — Lemonade Powder 1 — 1 — — Margarine 6 2 8 — — Marzipan 3 — 3 — — Meat Paste 5 — 5 — — Meat Pies and Puddings 7 — 7 — — 58 Meat (tinned) 6 — 5 1 — See (g) Milk 37 32 5 — See (h), (i),(j).(k) &(1) Milk (Condensed) 1 — 1 — — Milk Chocolate 4 — 4 — — Nuts (Ground) 3 — 3 — — Parsley and Thyme Forcemeat 1 — 1 — — Preserves 16 2 18 — — See (m) Pulses 3 — 3 — — Saccharin 2 — 2 — — Sauces 9 2 11 — — Sausages 6 — 5 1 — See (n) Soft Drink 2 1 3 — — Soup and Soup Powder 3 — 3 — — Spices 12 1 13 — — Suet (Shredded) 4 — 4 — — Sugar 1 — 1 — — Sugar Confectionery 1 — 1 — — Tea 7 1 8 — — Vegetable Salad 1 — 1 — — Vinegar 1 — 1 — — 195 67 249 10 3 (a) Custard tart contained numerous specks and particles of dirt. Baker warned. (b) Sliced bread contained part of dressing. Bakers prosecuted and fined £25 and costs. (c) Bread contained much cereal starch, vegetable fibres and fat and some indeterminate black material. Baker warned. (d) Cake mix contained numerous mites. Stock withdrawn. Further sample satisfactory. (e) Pink salmon described as Red Salmon on label. Consignment exhausted at time of investigation. (f) Figs contained 360 mites to the pound. Stock withdrawn. Further samples satisfactory. (g) Luncheon Meat—Fat 16%, lean 33%. Total meat 49%. Standard of defunct Meat Products Order 80%. Manufacturers informed. (h) Milk bottle containing small particles of dirt. Company warned. (i) Milk bottle containing numerous particles of sandy grit. Company warned. (j) Milk bottle containing small gelatinous foreign body. Company warned. (k) Milk bottle containing deposit of nature of cement. Warning sent to Dairy concerned. (m) Apricot Jam. Fruit approximately 25%. Should not be less than 40%. Further sample satisfactory. (n) Pork sausages contained 60%. Slightly deficient. No legal standard. Manufacturers informed. (1) Milk bottle with coating of very fine black particles and deposit of black angular fragments. Probably coal dust. Referred to Local Authority in whose area bottling took place. 59 UNSOUND FOOD. A total of 5 tons, 3 cwts. 3 qrs. 3 lbs. of food unfit for human consumption was surrendered to Inspectors during the year, as follows:— Item. tons. cwts. qrs. lbs. Cheese 2 14 Canned Fish 1 7 Canned Fruit 9 2 5 Canned Meat 15 2 24 Canned Milk 2 3 26 Canned Vegetables 6 2 26 Fish, fresh 1 2 14 Flour, Confectionery and Cereals 3 7 Meat, cooked 2 15 Meat, fresh 2 3 23 Poultry and Rabbits 1 1 — Vegetables 3 — 1 7 Miscellaneous 1 3 5 3 3 3 Where the items concerned are suitable for the purpose, they are supplied to a local pig keeper and used as animal feeding stuff, following treatment by him. Five hundred and eighteen Food Surrender Certificates were issued. MEAT INSPECTION. No slaughtering was carried out in the district during the year. Routine inspection of meat has been carried out in butchers' shops, etc. FOOD AND DRUGS ACT, 1955—SECTION 16. The food premises in the area, registered under the above Act are:— No. of Premises Registered. IceCream. Mfr. of Sausages. Cooked Ham. Bakers' shops 2 — — Butchers' shops — 44 — Dairies 1 — — Fishmongers (wet and dried) 2 — — Greengrocers' shops 5 — — Grocers 45 — 8 Restaurants and Cafes (for consumption oft the premises) 23 — Others, including confectioners, etc. 83 — — 161 44 8 60 FOOD PREMISES. There are some 514 food premises in the area, made up as under:— *Bakers 17 *Bakers and Bakehouses 13 Butchers 56 *Dairies 4 Fishmongers (wet and dried) 13 Fishmongers (wet, dried and fried) 9 Fishmongers (fried) 3 *Greengrocers' shops and stalls 56 *Grocers 133 Ice Cream premises, other than those marked (*), but including confectioners 72 Public Houses and Hotels with catering facilities 11 Public Houses without catering facilities 20 *Restaurants, Cafes 34 Works Canteens 12 School Canteens, etc. 41 Private Canteens 8 Confectioners (not included under Ice Cream premises) 12 514 Sixteen Dairy premises are registered in the district and 17 persons are registered as Distributors of Milk. The following are details of licences to deal in specially designated milks, issued by the Council, in respect of 1956:— Dealers. Supplementary. Pasteurised 19 14 Sterilised 26 13 Tuberculin Tested Pasteurised 19 12 BACTERIOLOGICAL EXAMINATIONS. Thirty-one samples of designated milk were taken with the following results:— Number passing phosphatase test 31 Number failing passing phosphatase test — Number passing methylene blue test 28 Number giving unsatisfactory methylene blue result 3 Thirty-two samples of milk were submitted for chemical examination and all proved to be satisfactory. ICE CREAM. Ten samples were taken during the year. Eight were placed in Grade I and 2 in Grade II. PIGGERIES. There are 17 piggeries of varying size in the district, one of which has a normal complement of approximately 1,000 pigs. Seventy visits of inspection were made and three defects found were subsequently remedied. SECTION F. PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. 62 SECTION F. PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. General. During the year 1956, notifications of infectious disease, excluding tuberculosis, were very low, only 790 notifications being received as against 1,896 in the previous year. The main reason for the difference was the big drop in the prevalence of measles. Other variations which have occurred during the year include a reduction in the number of cases of acute anterior poliomyelitis, and an increase in whoopinj cough, scarlet fever and dysentery. The overall picture is one of a continued decline in what might almost be called the traditional infectious diseases and this decline is shown not only in lessened numbers but what is even more important, in decreased virulence. The latter point is underlined when it is considered that only 60 cases in all. of the notified illnesses, were treated in hospitals. One of the outstanding features of the year was the introduction, on a small scale, of the County Council's scheme for vaccination against acute anterior poliomyelitis. It is much too early to attempt to judge the efficacy of this new preventive measure but high hopes are held out for the future and research is continuing in methods of preventing a disease which quite naturally produces so much public anxiety. Acute Anterior Poliomyelitis. During the past year five cases were notified and confirmed, as against thirteen confirmed cases in 1955. In addition to these five, two other cases occurred, but these were admitted to hospitals outside the area before diagnosis was made. Of the five cases, of which all were removed to hospital, three were adults (all paralytic) and two children of school age (one paralytic and one non-paralytic). All of these have since made a good recovery. Many other suspected cases were brought to our attention and investigated but these subsequently proved to be other illnesses. No deaths were attributable to this condition. The County Medical Officer informs me that 372 Chislehurst and Sidcup children completed a course of two injections against this disease during the year and that a further 348 received one injection, but these numbers are of course too small to have had any significant influence on the incidence of this illness. 63 Diphtheria and Diphtheria Immunisation. Once again I am thankful to be able to report a complete absence of this disease from our community. The immunisation campaign against this illness appears to have been wonderfully successful in the past, but with the development of immunisation procedures against other diseases, and the publicity given them, it is sincerely to be hoped that no one will forget to have their children immunised against a disease which has not yet been stamped out of the country entirely and could still give rise to a serious epidemic if proper precautions are not taken. The present position with regard to immunisation against this disease is summarised in the following figures which have been furnished by the County Medical Officer. Of the children resident in the area who were born since 1942, a total of 1,235 received primary inoculations and 1,917 received re-inforcing inoculations during 1956. A total of 16,452 children under the age of 15 years have completed a course of immunisation at some time prior to 31st December, 1956. Dysentery. This is a condition which is causing a good deal more trouble than formerly. One hundred and sixty-eight cases were notified during the year as against eighteen last year, but only three were sufficiently severe to need hospital treatment. Generally speaking, the illness is of a mild character and a great number must inevitably never receive any medical attention, this, combined with the fact that in an outbreak there always appear to be a large number of symptomless carriers, makes control by ordinary public health measures extremely difficult as there must always be so many unsuspected sources of infection. An exhortation to hand cleanliness is probably the best single piece of advice than can be given in our efforts to eradicate this very annoying complaint. Food Poisoning. In all, 34 cases of suspected food poisoning were notified, as against 13 in the previous year. After full investigation, only 14 could be confirmed and in most of these cases the organism causing the illness was not detected. A number of patients believed to have food poisoning were found to be suffering from dysentery. In a town of this size it is difficult to believe that this condition was so limited in numbers, despite the increase compared with the previous year, and one would like to think that such was indeed the case, but it would only be self deception not to acknowledge that there must in reality have been many more 64 cases. In point of fact, many probable cases have such shortlived symptoms that they never come to the notice of the medical profession despite the fact that for a few hours the symptoms can be most distressing. ANNUAL RETURN OF FOOD POISONING NOTIFICATIONS—1956. (Corrected) Food Poisoning Notifications (Corrected) Returned to Registrar General: 1st Quarter. 4 2nd Quarter. 5 3rd Quarter. 1 4th Quarter. 4 Total. 14 Outbreaks due to identified Agents: Total outbreaks. 1 Total cases. 3 Outbreaks due to: (a) Chemical poisons. (b) Salmonella organisms. (c) Staphylococci (including Toxin) = 1 Outbreaks of Undiscovered Cause: Total outbreaks. 1 Total cases. 4 Single cases: Agent identified. 4 Unknown cause. 3 Total. 7 Measles. Following a year of heavy incidence, the expected drop in notifications duly occurred, there being only 156 cases brought to our notice as against 1,466 during the previous year. Eight of these cases were admitted to hospital but there were no deaths from this condition in the area during 1956. Meningococcal Infection. One case came to our attention during the year, affecting a child of school age. This patient was removed to hospital and made a good recovery. Pneumonia (all forms). Forty-three cases were notified during 1956, as against 67 in the previous year. There were forty-two deaths from pneumonia—this figure includes people who died in other areas but are normally resident in the Urban District. 65 Psittacosis. Two cases were brought to our attention by the Physician-inCharge of the Chest Clinic, after they had been referred to him by private practitioners. Further reference to this condition has been made in the prefatory letter. Scarlet Fever. Notifications of this disease showed an increase in 1956, 75 cases being notified as against 44 in the previous year. Twenty-four of these were admitted to hospital. The general run of cases is now so mild and uncomplicated that normally very little anxiety is occasioned by this illness. In addition, some cases are so mild and atypical that extreme difficulty may be experienced in arriving at a definite diagnosis and it may well be that cases are occurring which do not receive medical attention, having been considered merely as a slight throat infection. There were no " return cases " and no deaths occurred in the area from this disease during 1956. Smallpox and Vaccination. Another year has passed without any cases of this disease but it is still an ever present potential menace against which our defences must always be kept deployed. The policy of offering re-vaccination annually to all members of the staff of the Public Health Department has been maintained. It is interesting to note that during the year as many as 358 International Certificates of Vaccination have passed through the hands of the department for purposes of authenticating doctors' signatures. I am indebted to the County Medical Officer for the following figures showing the current position with regard to vaccination in the area. A total of 902 residents received primary vaccination and 144 re-vaccination during 1956. Tuberculosis. The following table shows the position with regard to tuberculosis, with comparative figures since 1943 (as corrected by inward and outward transfers). There were eleven deaths from tuberculosis during the year. 66 Tuberculosis, 1956. Year Ended Population 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. 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 58 17.6 1955 86,870 74 1 744 714 65 65 1,588 81 18.3 1956 87,300 83 2 785 756 66 66 1,663 75 19.0 67 Mass X-Ray. The very close liaison between this department and Dr. J. M. Morgan, the Director of the Mass X-Ray Unit of the South Eastern Regional Hospital Board continues, and I am very grateful to him and his staff especially for supplying me with the statistics upon which the following information is based. During the year 5,124 people were x-rayed, of whom 2,132 were men and 2,992 women. Of the grand total 2,201 had previously taken advantage of this service. Of the 75 abnormalities discovered, 36 required no action, and 19 were considered tuberculous. Of this latter group, 10 required treatment, 8 needed occasional supervision only, and 1 refused treatment. The remainder of the 75 consisted of non-tuberculous chest conditions, cardiac abnormalities, and a few previously known tuberculous cases. The total number of people x-rayed is smaller than when the unit previously visited the area (7,115), and every effort should be made to publicise this very valuable service and encourage the people to co-operate if we are to succeed in our aim of the eventual elimination of the scourge of tuberculosis from our midst. 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 255 272 306 833 Number of new patients diagnosed as tuberculous 38 38 5 81 Number of Contacts diagnosed as tuberculous 4 2 1 7 Number of persons vaccinated with B.C.G. 201 children. adults. Number of refills given during the year 2,652 The Evening Refill Clinic continues to be held on Tuesday evenings in addition to the daytime diagnostic and refill sessions. Typhoid and Para-Typhoid Fever. One case of para-typhoid fever was notified during the year and removed to hospital. This case was part of an epidemic which occurred in the area of an adjoining local authority and which was, I understand, due to a carrier in a food premises. The patient visited the adjoining district one week prior to commencing her illness, and partook of food purchased from the food premises where the para-typhoid carrier worked. 68 Whooping Cough. Three hundred and nine notifications were received during the year, as against two hundred and sixty in 1955. Seven of these cases were sufficiently severe to necessitate hospital treatment. No deaths from this disease were recorded in the area. Other Infectious Diseases. In addition to those previously mentioned, notifications were received as under:— Erysipelas 1 Ophthalmia Neonatorum 10 (No impairment of vision in any case.) Puerperal Pyrexia 6 APPENDIX. STATISTICAL TABLES. 70 STATISTICAL TABLES, 1956. 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. 71 TABLE I. SUMMARY OF STATISTICS, 1956. Population (mid-year 1956, per Registrar General) 87,300 Birth Rate (crude) 14.2 Death Rate (crude) 7.7 Maternal Mortality Rate Nil Infant Mortality Rate 24.12 Number of Births (live) 1,244 Number of Stillbirths 30 Number of Deaths 675 Number of Maternal Deaths Nil Number of Deaths from Infectious Diseases 2 Number of Infant Deaths (under 1 year) 30 Death Rates: — Respiratory Diseases (excluding Tuberculosis) 1.01 Tuberculosis 0.13 Cancer (all forms) 1.45 Cancer of the Lung, Bronchus 0.36 Infectious Diseases 0.02 Notification of Infectious Diseases: — Diphtheria Nil Dysentery 168 Erysipelas 1 Food Poisoning 15 Measles 156 Meningococcal Infection 1 Ophthalmia Neonatorum 10 Pneumonia (all forms) 43 Poliomyelitis (paralytic) 4 Poliomyelitis (non-paralytic) 1 Puerperal Pyrexia 6 Scarlet Fever 75 Typhoid and Paratyphoid Fever 1 Whooping Cough .... .... .... .... .... .... .... 309 Number of visits made by Public Health Inspectors .... 11,425 72 TABLE II. CAUSES OF DEATH. 1952 1953 1954 1955 1956 Total Male Female 1. Tuberculosis—Respiratory 17 18 12 7 6 3 9 2. Tuberculosis—Other 5 2 2 — 2 — 2 3. Syphilitic Diseases 5 2 1 — 1 — 1 4. Diphtheria — — — — — — — 5. Whooping Cough — — — — — — — 6. Meningococcal Infection 2 1 — — — — — 7. Acute Poliomyelitis 1 1 — 1 — — — 8. Measles — — — — — — — 9. Other infective and parasitic diseases 1 1 2 1 1 1 2 10. Malignant neoplasm, stomach 22 23 15 20 7 5 12 11. Malignant neoplasm, lung bronchus 21 38 36 44 27 4 31 12. Malignant neoplasm, breast 14 13 19 13 — 20 20 13. Malignant neoplasm, uterus 5 5 9 8 — 1 1 14. Other malignant and lymphatic neoplasms 65 75 70 72 37 26 63 15. Leukaemia, aleukaemia 8 8 5 6 4 1 5 16. Diabetes 7 5 1 4 — 4 4 17. Vascular lesions of nervous system 103 66 79 98 35 45 80 18. Coronary disease, angina 101 99 107 113 80 38 118 19. Hypertension with heart disease 16 13 22 20 3 8 11 20. Other heart disease 117 96 87 80 29 53 82 21. Other circulatory disease 40 51 25 42 18 20 38 22. Influenza 2 11 1 3 — 1 1 23. Pneumonia 27 32 28 37 25 17 42 24. Bronchitis 38 44 39 42 27 13 40 25. Other diseases of respiratory system 7 4 6 8 4 2 6 26. Ulcer of stomach or duodenum 8 10 10 6 5 1 6 27. Gastritis, enteritis and diarrhoea 3 7 4 8 2 3 5 28. Nephritis and nephrosis 7 8 5 8 2 4 6 29. Hyperplasia of prostate 4 6 6 2 5 — 5 30. Pregnancy, childbirth, abortion 2 — — 1 — — — 31. Congenital malformations 10 8 8 10 4 — 4 32. Other defined and ill-defined diseases 59 56 59 68 27 32 59 33. Motor vehicle accidents 4 9 5 5 5 3 8 34. All other accidents 10 7 9 10 5 5 10 35. Suicide 8 13 6 10 1 2 3 36. Homicide and operations of war — — — — — 1 1 All causes 739 732 678 747 362 313 675 73 TABLE III. INFANT MORTALITY, 1956. (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 Malformation — — — — — — — — — — Prematurity 7 — — — 7 — — — — 7 Respiratory Diseases 1 1 — — 2 4 1 — 2 9 Gastro-enteritis — — — — — — — — — — Atelectasis 3 — — — 3 — — — — 3 Congenital Heart Disease — — — — — 1 — — — 1 Other causes 5 — — — 5 1 1 — 3 10 TOTALS 16 1 — — 17 6 2 — 5 30 TABLE IV. NOTIFIABLE INFECTIOUS DISEASES, 1956. Sex and Age Distribution. Disease Totals Under 1 1—2 3—4 5—9 10—14 15—24 25 and over Age unknown Scarlet Fever M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. 41 34 — — 2 1 10 5 20 22 6 4 2 2 1 — — — Whooping Cough 147 162 7 9 40 34 28 40 68 71 4 4 — 2 — 2 — — Poliomyelitis (Paralytic) 2 2 — — — — — — — — — 1 — — 2 1 — — Poliomyelitis (Non-Paralytic) 1 — — — — — — — 1 — — — — — — — — — Measles 82 74 2 3 22 19 25 14 31 35 — 1 2 1 — 1 — — Dysentery 86 82 2 2 20 7 10 11 29 27 10 9 1 8 14 18 — — Meningococcal Infection — 1 — — — — — — — — — 1 — — — — — — Acute Pneumonia 359 355 11 14 84 61 73 70 149 155 20 20 5 13 17 22 — — Under 5 5—14 15—44 45—64 65 & over Age unknown M. F. M. F. M. F. M. F. M. F. M. F. 22 21 3 2 7 1 5 8 5 5 2 5 — — Para-Typhoid Fever — 1 — — — 1 — — — — — — — — Erysipelas — 1 — — — — — — — 1 — — — — Food Poisoning 6 9 — 1 3 2 2 4 1 2 — — — — Puerperal Pyrexia — 6 — — — — — 6 — — — — — — Ophthalmia Neonatorum 5 5 5 5 — — — — — — — — — — 33 43 8 8 10 4 7 18 6 8 •2 5 — — 392 398 74 75 TABLE V. NOTIFIABLE INFECTIOUS DISEASES, 1956. Seasonal Incidence. Disease Jan. Feb Mar. April May June July Aug. Sep. Oct. Nov. Dec. Totals Dysentery — 2 30 13 20 42 13 3 5 — 14 26 168 Erysipelas 1 — — — — — — — — — — — 1 Food Poisoning 4 — — 1 — 4 — 1 — 1 2 2 15 Measles 4 3 8 42 13 22 23 30 7 1 — 3 156 Meningococcal Infection — — — 1 — — — — — — — — 1 Ophthalmia Neonatorum 1 3 1 — — 1 1 1 1 — — 1 10 Paratyphoid Fever — — — — — — — 1 — — — — 1 Pneumonia 3 9 7 4 7 6 1 — 4 1 — 1 43 Poliomyelitis (Paralytic) — — — — — — 2 — — 1 1 — 4 Poliomyelitis (Non-Paralytic) 1 — — — — — — — — — — — 1 Puerperal Pyrexia — — 1 1 — 1 1 — 1 — — 1 6 Scarlet Fever 6 5 14 4 4 6 9 2 4 6 7 8 75 Whooping Cough 31 32 30 31 16 15 6 33 46 14 27 28 309 Totals 51 54 91 97 60 97 56 71 68 24 51 70 790 76 TABLE VI. SANITARY INSPECTION OF THE AREA. 1. Inspections—General. Dwelling Houses (Public Health Act) 4,491 Dwelling Houses (Housing Act) 148 Bakers 108 Bakehouses 89 Butchers 134 Butchers and registered sausage manufacturers 123 Works Canteens 67 Restaurants and Cafes 185 Dairies 34 Fishmongers 165 Greengrocers 230 Grocers 672 Ice Cream Shops 172 Public Houses 29 Confectioners Shops 8 Other Food Preparing Premises 12 Piggeries 70 Slaughterhouses 3 Factories (Sections 1, 2, 3, 4 and 6, Factories Acts) 18 Factories (Section 7, Factories Acts) 196 Factories (Section 7—other premises) 144 Factories (Section 110, Factories Acts)—Outworkers 8 Smoke Abatement 99 Premises—for rats and mice 1,536 Infectious diseases 788 Food Poisoning 96 Moveable Dwellings 671 Rivers and Streams 37 Shops Act 556 Schools 74 Swimming Pool 1 Public Conveniences 278 Unsound Food 123 Stables 6 Petroleum Acts 24 Pet Animals Act 29 Fireguards Act 1 11,425 77 2. Complaints. General Sanitary Defects 270 Drainage 450 Keeping of Animals 7 Offensive Accumulations 86 Verminous premises 14 Water Supply 28 Rats 375 Mice 55 Overcrowding 19 Foods 32 Dustbins 80 Smoke 30 Air Raid Shelters 6 Miscellaneous 31 1,483 3. Notices. Ten Statutory and four hundred and fifty-two Informal Notices were served, drawing the attention of the owners to the existence of nuisances at their properties and requesting abatement. RI/71