AC 4412 (3) CHISLEHUR51 CHI 29 TSDCUP CHISLEHURST AND SIDCUP URBAN DISTRICT COUNCIL MEDICAL OFFICER OF HEALTH'S Annual Report on the HEALTH OF THE URBAN DISTRICT 1957 H. B. C. CARTER-LOCKE, M.B., B.S., M.R.C.S., L.R.C.P., D.P.H. Medical Officer of Health 74195 CHISLEHURST AND SIDCUP URBAN DISTRICT COUNCIL MEDICAL OFFICER OF HEALTH'S Annual Report on the HEALTH OF THE URBAN DISTRICT 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 15 Section B. General Provision of Health Services for the Area. Ambulance Service 25 British Red Cross Society 29 Clinics, etc 26 Disinfection and Disinfestation 20 Domestic Help Service 25 Domiciliary Midwifery 25 Health Visiting 25 Home Nursing Service 26 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 29 Women's Voluntary Service 29 Women's Welfare Clinics 26 Section C. Sanitary and Environmental Circumstances of the Area. Agricultural (Safety, Health and Welfare Provisions) Act, 1956 32 Cesspools 32 Diseases of Animals (Waste Foods) Order, 1957 33 Drainage and Sewerage 33 Factories Acts, 1937 and 1948 33 Game Act, 1831 34 Heating Appliances (Fireguards) Act, 1952 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 Page Riding Establishments Act, 1939 36 Rivers and Streams 36 Rodent Control 37 Sanitary Inspection of the Area 38 Shops Act, 1950 39 Smoke Abatement—Clean Air Act 40 Swimming Baths 45 Verminous Conditions and Uncleanliness 45 Water Supply 45 Section D. Housing. Housing Inspections 50 Housing Act, 1949 51 Moveable Dwellings 54 New Houses 53 Re-housing 53 Rent Act, 1957 52 Slum Clearance 51 Section E. Inspection and Supervision of Foods. Bacteriological Examinations 62 Food & Drugs Act, 1955. Section 16 61 Food & Drugs Act, 1955. Food Sampling 59 Food Complaints 58 Food Hygiene Regulations, 1955 58 Food Premises 62 Inspections 58 Meat Inspection 61 Piggeries 62 Unsound Food 61 Section F. Prevalence of, and Control Over Infectious and Other Diseases. Acute Anterior Poliomyelitis and Vaccination 64 Diphtheria and Diphtheria Immunisation 64 Dysentery 65 Food Poisoning 65 General Remarks 64 Measles 65 Meningococcal Infections 65 Other Infectious Diseases 69 Pneumonia 66 Scarlet Fever 66 Smallpox and Vaccination 66 Tuberculosis, Mass X-ray and Chest Clinic 66 Tuberculosis Care Committee 68 Typhoid and Para-Typhoid Fever 69 Whooping Cough 69 STATISTICAL TABLES. Table I.—Summary of Statistics 73 II.—Causes of Death 74 III.—Infant Mortality 75 IV.—Notifiable Infectious Diseases—Sex and Age Distribution 76 V.-—Notifiable Infectious Diseases—Seasonal Incidence 77 VI.—Sanitary Inspection of the Area 78 5 MEMBERS OF THE URBAN DISTRICT COUNCIL (as at 31.12.57) Chairman : J. R. CAMPBELL CARTER, Esq., J.P. Vice-Chairman : Mrs. S. M. GUNN. Councillors : P. Andrews. Mrs. E. G. Beecher Bryant. R. G. H. Bond. D. W. Child, D.C.M. *C. J. Christopher. *F. G. Emmerson. *D. I. Evans. F. H. Farmer. W. G. Fuller. *A. V. Hatley. *Miss B. H. James, J.P. (Chairman of P.H. Committee) G. H. Kirby-Smith. F. C. Mansfield. E. V. Mills, J.P., C.A. R. Pope. (* denotes members of the H. Quittenden. E. J. Reader. *Miss E. E. Rhodes. D. W. Ryan. R. A. Sanderson, J.P. J. W. Schuch. *F. P. Sellors, C.C. R. E. Sims. *F. E. Skone James. E. G. Smith. *Mrs. G. M. Vander. *Mrs. E. V. Wallace. E. W. White. *C. E. Wiltshire, J.P. *R. E. Woods. (Vice-Chairman of P.H. Com.) 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, Heating Appliances (Fireguards) Act, and Agriculture (Safety, Health and Welfare Provisions) 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, Inspector under the Food and Drugs Act, Shops Act, Rag Flock and Other Filling Materials Act, Pet Animals Act, Heating Appliances (Fireguards) Act, and Agriculture (Safety, Health and Welfare Provisions) Act : E. C. BERWICK, c.r.s.h., m.a.p.h.i. Public Health Inspectors, Inspectors under the Food and Drugs Act, Rag Flock and Other Filling Materials Act, Pet Animals Act, Heating Appliances (Fireguards) Act, and Agriculture (Safety, Health and Welfare Provisions) Act: K. W. FINCH, a.r.s.h., m.a.p.h.i. J. W. P. HARRIS, c.r.s.h., m.a.p.h.i. E. J. WEBBER, c.r.s.h., m.a.p.h.i. (Appointed 7.1.57) CLERICAL STAFF. A. F. OUGHTON. Miss C. DEVONSHIRE. Mrs. M. BUNTON. (Appointed 29.4.57) Miss C. BUTLER. (Resigned 5.4.57) OUTDOOR STAFF. T. BACK (Disinfector. Mortuary Keeper, Drain Clearer and General Handyman.) J. DAVIS (Assistant to Disinfector.) E. FIFE (Rodent Operative) R. C. FAIRHURST. (Rodent Operative) (Appointed 25.2.57) 7 To the Chairman and Members of the Chislehurst and Sidcup Urban District Council. Mr. Chairman, Ladies and Gentlemen, Looking through recent annual reports, I have gained the impression that they have tended to open with a letter full of admonitions and to be rather of the type that begins "unless." In view of this, the time seems ripe to alter one's tactics to emerge from the shadows into the bright sunlight and do a little blessing counting. It is all very well to make a vague general statement of this character, but can it be followed up by some concrete facts to confirm this assertion? In my submission this is so, and I should like to indicate what in my opinion are some of the local features for which we should be truly thankful. Real health is a state of physical and mental well-being attributable to a mass of factors most of which are within our own powers of attaining. The main difficulty is that with so many influences, both hereditary and environmental affecting it, we can only exceptionally expect everything to be operating in our favour at any one time. Matters affecting health materially, include a happy home, full employment, the air we breathe, the water we drink, the food we eat, and many other environmental conditions, all of which taken together as a whole can make or mar our existence. Now let us consider in detail some of our reasons for gratitude. In this connection one notices that our infant mortality rate is well below the average for the whole country, we have a maternal mortality rate of nil, and an adjusted death rate less than that for England and Wales. These are all good healthy signs and indicative of a state of affairs which is eminently satisfactory. The death rate has admittedly risen a little compared with 1956, but is still less than in 1955, and this is surely a cause for congratulation when one considers the magnitude of the influenza outbreak which affected us no less than the rest of the country in the autumn of last year. This outbreak which originated in the East, spread across the world with some speed and was caused by a mutation of a previously known virus. Fortunately it can be said as a generalisation that the resultant disease was mild in character and tended to affect predominantly the younger members of the community who were of course, better equipped to withstand its assault, but the problem of its control remained more or less unsolved. Even should a vaccine with one hundred per cent efficiency be produced there are the difficulties of preparation, distribution and injection of virtually the whole population of the country, and getting it immune before the epidemic strikes. In 8 this connection it must be remembered that before a vaccine can be produced, the responsible organism has to be known and that full immunity could not be attained until some weeks after the first of two spaced injections had been given. It will thus be obvious that there are still many serious obstacles to be overcome before we can hope to control effectively these periodic invasions of the influenza viruses. Whilst on the subject of immunisation procedures, it is gratifying to find that the County Medical Officer is able to report that 3,467 local children were vaccinated against anterior poliomyelitis during the year, a figure which it is anticipated will be considerably exceeded during 1958. As this programme gathers momentum, it is sincerely to be hoped that its beneficial effects will make themselves felt by a greatly reduced incidence of this disease, although in this local authority's area, we were fortunate in only having three non-paralytic cases notified during the whole of 1957. Another feature which is encouraging and to which I should like to draw attention, is the considerable fall in the incidence of dysentery and the figures for food poisoning also show a reduction. Although over 1,400 notifications of measles were received, when one considers that of this number only six had to be admitted to hospital, further words are not needed to stress the generally benign character of this disease. Unemployment in the district has remained an insignificant problem and we are indeed fortunate in having so many open spaces in the district, both factors making for a happy, healthy and contented populace. Still stressing the bright side, I should like to draw attention to the many valuable activities undertaken in this district by various voluntary bodies, and I am especially intrigued by one short cryptic statement in the report of the Chislehurst and Sidcup Old People's Welfare Committee where it says that homes have been found for some twelve persons during the year under their boarding out scheme. This is surely a really practical method of dealing with the problem of the loneliness of, and assistance to elderly persons and is to be commended greatly. Not only can such a scheme ultimately make a great contribution to relieving the difficulties of finding suitable institutional care for those in the later decades of life, but if suitable homes can be found in sufficient numbers there is little doubt the older folk would in the majority of cases much prefer to spend their declining years in surroundings which must inevitably be more homely to them than in any institution however well run. There is one more matter to which reference must be made and that is the succ3ssful clearance of Corke's Meadow during the course of the year. Although other difficulties may still remain to be ironed out, from the point of view of the Public Health 9 Committee, a potentially serious menace to health has been removed and on that score a major triumph has been achieved after years of frustration and disappointment. As I promised at the beginning of this letter. I have endeavoured to keep to the bright side and avoid reference to the less satisfactory features and hope I have succeeded at least in creating the impression that things could be a great deal worse. My thanks are due to Mr. Kermode, the Chief Public Health Inspector, for the great volume of work he has achieved so efficiently during the year, but without the willing and able cooperation of all members of the staff of the Public Health Department, including my deputy, Dr. Kelynack, satisfactory results could not be obtained. During the year we welcomed Mr. Webber on the Inspectoral staff and Mrs. Bunton on the clerical staff, both these officers replacing others who had obtained fresh appointments. I should also like to thank all those organisations and individuals, the latter including the local doctors who once again have been so helpful in so many ways. In conclusion my gratitude goes to the Chairman and Members of the Public Health Committee for their continued enthusiasm for the cause they represent and without whose help so little could be achieved. 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. VITAL AND 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) 1957 87,790 Rateable Value at 1st April, 1957 £1,183,935 Rateable Value at 31st March, 1958 £1,214,889 Product of a Penny Rate for year ended 31st March, 1958 £4,775 Number of Valuation assessments as at 31st March, 1957: — Houses and Flats, including Flats over shops 24,735 Farmhouses 93 Shops, including Flats over shops 823 Industrial and Miscellaneous premises 1,084 Crown properties 42 26,777 Mileage of Roads as at 31st March, 1956: — County Roads, Class 1 (including Trunk Roads) 21.42 County Roads, Class 2 4.30 County Roads, Class 3 6.12 District Roads 78.33 Unadopted Roads 9.00 119.17 Vital Statistics. Live Births. Males. Females. Total. Crude birth rate per 1,000 Legitimate 598 594 1,192 estimated total population Illegitimate 16 19 35 14.0. Adjusted birth rate for com- 614 613 1,227 parative purposes 13.6. (Area comparability factor for births is 0.97.) Birth rate for England and Wales 16.1. Stillbirths. Males. Females. Total. Legitimate 14 9 23 Illegitimate — — — 14 9 23 Stillbirth rate per 1,000 estimated total population 0.26 Stillbirth rate per 1,000 live and still births 18.4 Deaths. Males. Females. Total. Crude death rate per 1,000 365 368 733 estimated total population 8.3. Adjusted death rate for comparative purposes 11.0. (Area comparability factor for deaths is 1.32.) Death rate for England and Wales 11.5. 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 12 8 20 Illegitimate — — — 12 8 20 Infant mortality rate per 1,000 live births 16.3 Legitimate infants per 1,000 live legitimate births 16.8 Illegitimate infants per 1,000 live illegitimate births Nil. Infant mortality rate for England and Wales per 1,000 live births 23.0 Vital Statistics of the Urban District for the past ten years. Year Population No. of Births (live) No. of Deaths No. of Infant Deaths No. of Maternal Deaths Birth Rate (crude) Death Rate (crude) Infant Mortality Rate Maternal Mortality Rate 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 — 1957 87,790 1,227 733 20 — 14.0 8.3 16.3 — Statistics for England and Wales, 1957. Birth Rate per 1,000 total population 16.1 Death Rate per 1,000 total population 11.5 Infant Mortality Rate per 1,000 live births 23.0 POPULATION. The Registrar General's estimate of the total population of the Urban District, mid-year 1957, was 87,790 which is an increase of 490 over the figure for the previous year. This figure gives a density of 98 persons to the acre. The natural increase of population, measured by excess of births over deaths is 494. 14 BIRTHS. One thousand, two hundred and twenty-seven live births were registered during the year, a decrease of seventeen compared with the previous year. The birth rate for the year is 14.0 which is .2 lower than that for 1956. The adjusted rate for comparison purposes is 13.6. The rate for England and Wales as a whole is 16.5. Of the births registered, six hundred and fourteen were males, and six hundred and thirteen females. There were thirty-five illegitimate births. Twenty-three stillbirths were registered, giving a rate of 0.26 per 1,000 total population, and 18.4 per 1,000 live and still births. Fourteen of the stillbirths were males and nine females. The figure for 1957 shows a decrease of seven compared with the year 1956. DEATHS. Seven hundred and thirty-three deaths appertaining to the Urban District were registered during the year, giving a death rate of 8.3 per 1,000 total population. The adjusted rate for comparison purposes is 11.0. The rate for England and Wales as a whole is 11.5. Full details of the causes of death will be found in Table II 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. 1952 1953 1954 1955 1956 1957 Cancer (all sites) 127 154 149 157 127 151 Cancer of the Lung, Bronchus 21 38 36 44 31 34 Respiratory Diseases (not T.B.) 72 80 73 87 88 99 Tuberculosis 22 20 14 7 11 8 Digestive Diseases 11 17 14 14 11 17 Heart and Circulatory Diseases 377 325 320 353 329 348 Infectious Diseases 4 3 2 2 2 — Road Traffic Accidents 4 9 5 5 8 8 Other Violent Causes 10 7 9 10 11 13 Suicide 8 13 6 10 3 2 Deaths from cancer rose appreciably compared with the previous year, including a small increase in the number of deaths from lung cancer. Non-tuberculosis respiratory diseases also exacted an increased toll but such a rise is only to be expected in a year in which influenza was so prevalent. It is very encouraging to note that there were no deaths from the common infectious diseases and that the tuberculosis rate remained low. It is also worth recording that suicides accounted for fewer deaths than in any of the previous five years. 15 MORBIDITY STATISTICS. The following is a summary of the weekly details received from the Ministry of National Insurance during 1957 :— Four weeks ending. Number of certificates of incapacity. First. Intermediate. Final. 22nd January 971 4,004 866 19th February 840 3,627 826 19th March 967 3,664 851 16th April 765 3,427 739 14th May 707 3,264 648 11th June 554 3,144 552 9th July 520 2,939 506 6th August 471 2,655 411 3rd September 529 2,737 435 1st October 1,014 3,004 684 29th October 3,030 4,375 2,371 26th November 1,172 3,876 1,487 31st Dec. (5 weeks) 1,594 3,714 1,349 These figures follow the usual yearly trend with one important and dramatic difference. In an ordinary year the January and February figures show the highest incidence of illness, but in 1957, the last four months were by far the worst and in October, when the influenza epidemic reached its peak, the number of persons incapacitated was quite exceptionally high. UNEMPLOYMENT. I am indebted to the Manager of the local Employment Exchange for the following information with regard to unemployment in the area during 1957 :— "As regards the unemployment position, 1957 has been a good year for the Urban District of Chislehurst and Sidcup, and local firms have maintained a good position. A few new small firms have added to the variety of industry in the area. Unemployment among women has been negligible, in fact there has been a decided shortage of young full-time female labour. Unemployment among men has also been very small." MEDICAL EXAMINATIONS. Thirty-three members, or potential members of the staff were medically examined for Superannuation purposes etc., during the year. 16 OPEN AIR RECREATIONAL AMENITIES. Location. Abbeyhill Park Belmont Lane Open Space Beverley Avenue Chalk Wood and Mount Misery Chislehurst Recreation Ground and Whytes Woodland Church Lane Recreation Ground Footscray Common Footscray Recreation Ground Hoblingwell Wood Hollyoak Wood Park King George's Field Lamorbey Park: — (1) The Glade (2) Land fronting Burnt Oak Lane (3) Land leased Longlands Recreation Ground Marlborough Park Mottingham Lane Mottingham Sports Ground Mottingham Recreation Ground Old Farm Park Parish Wood Penhill Park River Cray Reservation: — (1) North Cray Place Farm Acreage. Description. 6.84 Part allotments. 5.59 1.64 Open space. 69.21 Open space. Open space with 4 tennis 15.02 courts, 1 football pitch and 1 cricket pitch and children's playground. 2.25 Open space. .70 Open space. 6.80 Open space. 87.00 Open space, 1 cricket pitch and 2 football pitches. Games Warden. Children's playground. 11.61 Open space and part allotments. 11.10 Open space with 3 football pitches, 2 cricket pitches and 2 concrete cricket practice pitches and children's playground. 10.63 Open space. 2.00 Open space. 12.42 Open space. 6.00 Open space with I football pitch. Games Warden. 6.32 Open space with 1 football pitch and 1 nelball pitch 1.00 Open space. 30.00 Open space with 2 tennis courts, 8 football pitches, 6 cricket pitches, 1 hockey pitch and 3 concrete cricket practice pitches (mobile canteen, summer) Games Warden. Pulling Green. 5.89 Open space — children's playground. 11.78 Open space and part allotments. 6.73 Open space. 17.10 Open space with 3 football pitches, 3 grass cricket pitches, 1 concrete cricket pitch and children's playground. 29.60 Used for agricultural purposes. 17 Location. Acreage. Description. (2) Footscray Meadows 49.32 Used for 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 Council maintains no less than three-quarters of a square mile of open spaces within the district. Some of these provide quiet, unspoilt ramblage, some are well laid out Parks with the usual amenities, and the rest consist of sports fields. Provision is thus made for all sections of the community and the general health of the populace is thereby benefitted. This area does not include the Commons at Chislehurst and St. Paul's Cray, nor land under the control of the National Trust, which was recently increased by the gift of a tract of woodland originally part of the Hawkwood Estate, Chislehurst. The principal advancement during the year has been connected with improvements at Hoblingwell Woods, St. Paul's Cray, where further provisions have been made for organised games. Games Wardens have been installed at the last mentioned Park, as well as at Marlborough Park and Mottingham Sports Ground. They have been much appreciated by the children in holiday time. SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. 20 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. DISINFECTION AND DISINFESTATION. The Department carries out the necessary disinfection of premises, etc., after the removal of persons suffering from infectious complaints, or subsequent to the patient being declared free from infection. Infected bedding and clothing are subjected to steam under pressure at the disinfecting station situated in Main Road, Sidcup. Rooms, fixtures, and furnishings are sprayed with formalin. 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 as well as D.D.T. Bedding is subjected to steam treatment, in order to destroy eggs, etc. Advice is given to householders and others to assist them in dealing with the various insect infestations. Details of the work carried out during 1957 are as under :— DISINFECTIONS. Premises visited 562 Rooms disinfected 37 Articles disinfected 455 DISINFESTATIONS. Premises visited 7 Rooms disinfested 26 Articles disinfested — Fumigation Sprayed Steam Disinfected Destroyed Rooms 26 37 — — Mattresses — — 77 1 Pillows — — 230 — Blankets — — 71 16 Clothing, bundles of — — 12 3 Library Books — 45 — — 26 82 390 20 21 NURSING HOMES. One Nursing Home was closed during the year. Details of the five homes on the register at 31st December, 1957, are as under:— Number of Beds. Maternity. Other. Total. " Fallowfield, Ashfield Lane, Chislehurst — 38 38 " 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 70 70 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 the beds are for medical or surgical cases, and the majority are occupied by aged sick or aged infirm patients. PUBLIC CONVENIENCES. The Public Health Department is responsible for the cleaning of the undermentioned conveniences used by the public :— Public Lavatories (Male and Female sections): — Westwood Lane, Blackfen. St. Johns Road, Sidcup. Queens Head P.H., Chislehurst. Adj. Tigers Head P.H., Chislehurst. Cotmandene Crescent, St. Paul's Cray. 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. Sidcup Place, Sidcup. A staff of one part-time and three whole-time cleaners is employed for this work. During the year the conveniences at Cotmandene Crescent, St. Paul's Cray, were completed and opened. Considerable damage has since been sustained both to the fabric and fittings of this building, and to a lesser extent at other conveniences. Work was put in hand at the new conveniences at Dorset Road, Mottingham, and it was possible to open these in the early part of 1958. 22 LAUNDRY FOR THE AGED SICK. The service for laundering bedding from aged and incontinent invalids, where it was not possible to use ordinary facilities was inaugurated in April, 1954. Bedding was collected from the homes of persons concerned, laundered by the Sidcup Hospital Management Committee and returned. The service was much appreciated by those who had need to use it. Persons who might otherwise have occupied a hospital bed were enabled to remain in their own homes. During 1957, the service was utilised by four persons for periods varying from twelve to four months. Chislehurst and Sidcup Council was the only authority in Kent to be associated with a scheme of this nature. Unfortunately, the Hospital Management Committee came to the conclusion that it could no longer bear the cost of laundering and the service had to be withdrawn at the beginning of 1958. 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 again 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 11 — 41 — 1 — — — Maidstone Public Health Laboratory — — 73 12 — — — — Orpington Hospital — — 1 — — — — — Totals 11 — 115 12 1 — — — The number of specimens of food and fæces sent for examination shows a large decrease for the year. This is accounted for by a drop in the number of dysentery cases which it was necessary to investigate. 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 the County Authorities and 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 had 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. Although applications were investigated during the year, it was not necessary to arrange for any burial. The necessity for this service should decrease following the extension of Death Grants by the Ministry of Pensions and National Insurance announced early in 1958. PUBLIC MORTUARY. The year has seen a considerable increase in the work attributable to this service. No fewer than 187 bodies were accepted, an increase of 51 over the corresponding figure for 1956. 88 of these bodies were received from hospitals and inquests were held in 37 cases. This work now occupies a considerable proportion of the disinfector's time. Tribute should here be paid to the excellent work of the Chief Disinfector and Mortuary Keeper, Thomas Leonard Back, who fell ill in November. By his untimely death early in 1958, the Department suffered a great loss. During the year, the mortuary premises at Beaverwood were decorated throughout and a telephone installed. 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 24 Queen Mary's Hospital. A general hospital service with the following beds :— Male. Female. Children. General Medicine 39 27 — Paediatrics — — 16 Pleural Effusion 25 15 — Chronic Sick 24 24 — General Surgery 30 27 6 Tonsils and Adenoids — — 12 Traumatic and Orthopaedic 15 15 — Ophthalmology — — 2 Gynaecology — 15 — Ear, Nose and Throat 1 1 — 134 124 36 Regular clinics for outpatients are held in the following branches :—Medical, Gynaecology, Surgical, Ear, Nose and Throat, Fracture, Orthopaedic and Surgical Applicances, Dermatology, Diabetic, Pediatric, Physical Medicine, Neurology, Ophthalmic surgery, Diseases of the Chest and Psychiatry. As in other hospitals within the district, voluntary services are rendered by many organisations. The body named " Friends of Queen Mary's Hospital," are particularly active and are furnishing important amentites, which the hospital staff are unable to provide. 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 nontuberculous 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 is situate within the Urban District. 25 COUNTY COUNCIL SERVICES, Ambulance Service. The district is served by the ambulance depot at Bromley, where at the present time, there are twenty-nine ambulances and twenty sitting case cars available for use. The majority of these vehicles are radio controlled. There is also a sub-depot at Main Road, Sidcup. Domestic Help Service. The District Organiser's office is at 69, Sidcup Hill, Sidcup. The following is a summary of the cases assisted during 1957 :— Maternity (Expectant Mothers) 122 Tuberculosis 12 Aged 422 Others 171 727 Family Help Service. This service is provided to deal with care of children in their own homes when they are temporarily deprived of the care of their mother or a female guardian. Thirty-eight cases were assisted during the year. Night Attendant Service. This 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. 29 cases received assistance in 1957. Domiciliary Midwifery. Eight full-time midwives are employed in the area. Patients may obtain their services 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 Clinics, Immunisation and Vaccination Clinics, Home visiting, Mental Health visiting, etc. 26 Home Nursing Service. Thirteen Home Nurses work in the area. This service is provided on medical certification only and is free. No night service is in operation. 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. HEALTH SERVICES. The following services are provided by the Kent County Council. Ante-Natal Clinics and Child Welfare Centres. CHISLEHURST: The Willows, Red Hill Child Welfare Ante-Natal Women's Welfare Relaxation & Mothercraft FOOTSCRAY: W. Smith Memorial Hall, Church Road Child Welfare MOTTINGHAM: K.C.C. Clinic, Kimmeridge Road Child Welfare Ante-Natal Relaxation Class SIDCUP: Congregational Church Hall, Station Road Child Welfare Relaxation & Mothercraft Ante-Natal First Aid Post, The Oval, Sherwood Park Avenue Child Welfare Ante-Natal Women's Welfare Relaxation & Mothercraft Wren Road Child Welfare ST. PAUL'S CRAY: Health Clinic, Mickleham Road Child Welfare Ante-Natal Parentcraft for Senior Girls Relaxation Classes Mothers Club Rehabilitation Class — Old People Tuesday & Thursday p.m. Wednesday p.m 2nd Tuesday a.m. Wednesday p.m. Tuesday p.m. Monday & Wednesday p.m. Monday & Wednesday a.m. Thursday p.m. Monday & Wednesday p.m. Wednesday a.m. Thursday 1.30—3.30 p.m. Tues., Wed. & Fri p.m. Tuesday & Friday a.m. 1st & 3rd Thursday a.m. Thursday p.m Tuesday p.m. Monday & Thursday p.m. Wednesday a.m. Friday a.m. Tuesday p.m. Wednesday p.m. Wednesday a.m. 27 CHISLEHURST: The Willows, Red Hill Asthma Clinic Dental Clinics. (all Dental Clinics by appointment.) CHISLEHURST: The Willows, Red Hill MOTTINGHAM: Kimmeridge Road ST. PAUL'S CRAY: Mickleham Rd. SIDCUP: 10, Station Road 1st & 3rd Thursday a.m. (By Appointment) Mon., Wed. & Thurs (all day) Saturday morning. Tuesday & Friday (all day) Tuesday & Wednesday (all day) 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 & Vaccination FOOTSCRAY: W. Smith Memorial Hall, Church Road Immunisation Vaccination MOTTINGHAM: Kimmeridge Road Immunisation Vaccination Whooping Cough Immunisation SIDCUP: Congregational Church Hall, Station Road Immunisation and Vaccination St. Andrews Hall, Wren Road Immunisation and Vaccination ST. PAUL'S CRAY: Mickleham Rd. Immunisation and Vaccination SIDCUP: First Aid Post, The Oval, Sherwood Park Avenue Immunisation Vaccination Tuesday & Thursday 2—2.30 p.m. Tuesday 2—4 p.m. 1st Tuesday in month 2—4 p.m. Monday & Wednesday 2—4 p.m. Wednesday 2—4 p.m. Monday & Wednesday 2—4 p.m. Monday & Wednesday 2—4 p.m. Tuesday 2—4 p.m. Monday & Thursday 2—4 p.m. Tues, Wed. & Fri 2—4 p.m. Wednesday & Friday 2—4 p.m. All the above sessions are by appointment only, and are held in conjunction with the Child Welfare Clinics. Midwives Clinic. SIDCUP: First Aid Post, The Oval, Sherwood Park Avenue Minor Ailment Clinics (Schools). CHISLEHURST: The Willows, Red Hill Monday & Thursday 2—3.30 p.m. (alternate weeks) Thursday 9—10 a.m. Saturday 9—10 a.m. 28 ST. PAUL'S CRAY: Mickleham Rd. SIDCUP: 10, Station Road Saturday 9—12 noon Thursday 9.30-11.30 a.m. (Doctor attends 1st, 3rd and 5th Thursdays) Remedial Exercises. ST. PAUL'S CRAY: Mickleham Rd. Child Guidance Clinic. CHISLEHURST: The Willows, Red Hill Speech Therapy. CHISLEHURST: The Willows, Red Hill SIDCUP: 71, Sidcup Hill Ophthalmic Clinic. CHISLEHURST: The Willows, Red Hill ST. PAUL'S CRAY: Mickleham Rd. Monday & Thursday a.m. Monday to Friday a.m. & p.m. (By Appointment) Saturday a.m (By Appointment) Monday a.m. & p.m. (By Appointment) Monday to Friday a.m. & p.m. (By Appointment) Monday a.m. (By Appointment) Thursday a.m (By Appointment) Post-Natal—Women's Welfare Clinics. CHISLEHURST: The Willows, Red Hill SIDCUP: The Oval, Sherwood Park Avenue 2nd Tuesday a.m. 1st & 3rd Thursday a.m 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. TIBBALS, 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 for the Blind. Mrs. S. M. Belsham, c/o 69, Sidcup Hill, Sidcup. 29 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. 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. Sick room equipment can be borrowed at a small charge from the Society's depot at Hornbrook House, High Street, Chislehurst, on Monday to Friday, 9.30 a.m. to 5.30 p.m. and on Saturday, 9.30 a.m. to 1 p.m. A sub-depot is now open at 34, Crescent Road, Sidcup. The "Good Samaritan Club" for disabled men and women meets at the Divisional Headquarters, on the second and fourth Fridays in each month at 2.30 p.m. Handicraft classes for the disabled are also held at Hornbrook House, Chislehurst (Tuesday, 10-11.45 a.m.), and at the Clinic, St. Paul's Cray (Wednesday, 10-12 noon). 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. A new venture for 1958 is the establishment of a Medical Comforts Fund, as a result of which invalids may hire bed-pans, bath chairs, rubber sheeting, etc., at a nominal fee. Women's Voluntary Service. Valuable facilities continue to be placed at the disposal of the public through the Women's Voluntary Service from its offices at Craybrooke House, Sidcup Hill, Sidcup. Wheel chairs are loaned and escorts are provided to assist those attending hospital. Assistance is given in the Out-patient's Department of Queen Mary's Hospital, and a Trolley Shop is operated at Cray Valley Hospital. 30 Domestic help is arranged in suitable cases and personal shopping undertaken. At the request of the National Assistance Board's Officers, clothing is supplied to tuberculous patients and other needy persons. The distribution of welfare food is also undertaken. The service is particularly active in its connection with the Welfare Section for Civil Defence. CHISLEHURST AND SIDCUP OLD PEOPLE'S WELFARE COMMITTEE. The following is a brief resume of the work carried out by the Committee :— The Committee now have twelve clubs meeting weekly which are attended by some seven hundred people. During the year the Friendly Club had to close down as its premises in Kemnal Road were demolished, but through the generosity of the Harland and District Social Club it has been possible to re-open the Club in their admirably equipped club premises in Dulverton Road. " Redlac," Station Road, Sidcup. The original ten tenants still occupy their small flatlet homes. Boarding-Out Scheme. Homes have been found for some twelve persons during the year. Visiting. This is a very essential part of the 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 places on local authorities the duty of securing the provision and maintenance of sanitary accommodation for the use of employees on agricultural holdings. The number of agricultural holdings within the district, which come under the terms of this Act, is limited. Two visits have been paid in this connection and in one instance the provision of a closet was required. CESSPOOLS. Three new cesspools have been installed during the year, all for private dwellings where access to a sewer is not possible. Seven cesspools have been abolished during the year. There are now 400 premises not connected to main drainage. Premises. Cesspools. Lamorbey and Blackfen 6 6 Sidcup and Footscray 7 7 North Cray 224 180 St. Paul's Cray 78 50 Chislehurst and Mottingham 85 73 400 316 In a number of cases two or more properties drain to one cesspool. There are also several premises provided with small sewage disposal plants and a few using chemical or earth closets. The total number of cesspools in use in the district is now 316. During the year, a short length of sewer was constructed at Birchwood Corner, in the extreme eastern part of the district. This discharges to an existing sewer in the Dartford Rural District. Of the 29 houses previously without main drainage 19 had drained to a single large cesspool. All have now been connected to the sewer. Consideration is to be given to the laying of sewers in private streets off Leesons Hill, at a future date. There are, in the district, a number of properties draining to cesspools, although suitable sewers are available. No power at present exists to require owners to carry out the necessary works of connection. 33 DISEASES OF ANIMALS (WASTE FOODS) ORDER, 1957. The work of licencing and controlling plants for boiling waste food was delegated by the Kent County Council during the latter part of the year. This measure is principally designed to prevent disease in animals fed on such swill. There are twelve premises with plant of this nature and twelve visits were paid to them. DRAINAGE AND SEWERAGE. I am informed by the Engineer and Surveyor that new lengths of Foul and Surface water Sewers have been completed by the Council or adopted in private estate development as follow :— Foul Sewers of 6" and 9" diameters, totalling 2,165 yds. Storm Water sewers of 9", 12", 15", 18" and 24" diameters, totalling 3,263 yds. FACTORIES ACTS, 1937 AND 1948. Public Health Inspectors have made 261 visits of inspection to factories, with and without mechanical power, and to building sites, etc. which are now controlled by these Acts. 39 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 1957 :— 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 17 17 — — (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 189 205 7 — (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) 25 39 — — Totals 231 261 7 0 34 2. Cases in which Defects were found. Number of cases in which defects were Referred Number of cases in which prosecutions were Instituted Found Remedied To H.M. Inspector By H.M. Inspector Want of cleanliness 7 3 1 1 — Overcrowding — — — — — Unreasonable temperature — — — — — Inadequate ventilation 5 4 — — — Ineffective drainage of floors — — — — — Sanitary Conveniences: (a) Insufficient 4 1 — 1 — (b) Unsuitable or defective 20 18 1 1 — (c) Not separate for sexes — — — — — Other offences against the Act (not including offences relating to outwork) 3 6 2 — — 39 32 4 3 0 GAME ACT, 1831. During the year four licences to deal in Game were issued to local firms. HEATING APPLIANCES (FIREGUARDS) ACT, 1952. Twenty-nine visits were paid to various shops, etc. where oil, electric, or gas heating apparatus is sold. Observations did not reveal contraventions of the Act, and it would appear that manufacturers are adhering strictly to the requirements laid down, with a view to the prevention of fire danger. PET ANIMALS ACT, 1951. Licences to sell pet animals were issued to proprietors of six premises. Supervision of these shops entailed 21 visits and it was found that the sale of pets was on a comparatively small scale. No contraventions were detected. 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 61 premises, under licence. The total capacity is as follows :— Petroleum spirit in tanks 133,150 gallons. Petroleum spirits in cans 200 gallons. Petroleum mixtures in approved stores 11,380 gallons. Petroleum spirit and Petroleum mixture canned stores 500 gallons. Calcium carbide 100 pounds. 35 The amount of petroleum spirit kept in the district is being increased, mainly due to the provision of additional storage at existing licensed premises. New Regulations controlling more strictly the arrangements for filling tanks from petrol wagons, etc. were made during the year, and the attention of all licence holders was drawn to the new requirements. The Home Office has issued a model code of Principles of construction and licencing conditions for storage of petroleum spirit and mixtures. This Code has been incorporated into the licences issued in respect of all installations and is being enforced. The principal new requirement deals with the testing of ageing underground storage tanks and pipe lines. PUBLIC CLEANSING, REFUSE COLLECTION AND DISPOSAL. I am indebted to the Cleansing, Transport and Salvage Officer, for the following information :— The volume of refuse is still increasing and this is in line with the general trend throughout the country, due in a large measure to the increased use of electricity and oil for heating. This trend demands changes in our transport requirements which means vehicles of larger capacity with some degree of packing in order to maintain schedules. The number of premises cleared was in the region of 27,000 and as some of these buildings, particularly the large ones, use more than one bin, the number of journeys made by the collectors is substantial. It is estimated that 1,500,000 calls were made last year. In addition to dealing with special accumulations from trade premises, arrangements are in force for this service to be provided to individual householders. A charge is made, based on the actual cost of the job plus the usual oncosts. Whilst the volume of work involved is not great it does provide a useful outlet to people who have extra debris or refuse for disposal, and is appreciated. All night burning stoves are obviously used to a large extent and these bring added dangers from fire, owing to hot ashes being placed in the bin. The weight of refuse collected was in the region of 24,600 tons. A further 4,000 tons was received at the tip in the form of trade refuse, gully contents, street sweepings, trimmings from verges, etc. Kitchen waste amounted to 482 tons and is cleared chiefly from individual containers in the Mottingham and Lamorbey areas and certain schools. About 3,000 containers are in use. 36 Disposal of the refuse was carried out at St. Paul's Cray Hill Park, where low lying ground is being reclaimed. Tipping also took place at the Baugh Estate, Footscray. Further vehicles and trailers of improved design, fitted with diesel engines, have been purchased. Salvage including waste paper, has been maintained at a high level in spite of market difficulties. 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. Four establishments from which horses are hired out for the purposes of riding have been kept under observation during the year. One of these closed, but the proprietor opened stables in another part of the area. The animals, consisting of 29 horses and 40 ponies, were inspected by the Veterinary Surgeon appointed for the purpose. Six visits were made and the animals reported to be in good health. The Inspectors paid a further 14 visits. Improvements to stables have been carried out where necessary. RIVERS AND STREAMS. The Engineer and Surveyor informs me that an old brick culvert 66 yards long, through which the Quaggy flows, has been replaced by a precast concrete culvert on a new and improved alignment. Points of entry and outfall were constructed. To preserve stability of the public footpath in Holly Oak Park and the fences of private property adjacent, the course of the River Shuttle has been corrected. For a short length, on the Wyncham Stream, the banks between Old Farm Avenue and Halfway Street, Sidcup, have been revetted to protect adjoining carriageways. 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 and a total of 70 visits have been made to rivers and streams. 37 RODENT CONTROL. A new rodent operative was appointed so that two operatives have been in action throughout the year. This has greatly facilitated the work of eradication, as a result of which the total number of visits for inspection and treatment has risen by 5,791 during the year and treatments carried out show an increase of 395. The following is a summary of the work carried out during the year :— TYPE OF PROPERTY (1) (2) (3) (4) (5) Local Authority Dwellings (including Council Houses) Others Business (inc. L.A. Business) Agricultural Total II. No. of properties inspected as a result of: — (a) Notification (Complaints, etc.) 23 435 84 5 547 (b) Survey under Act (Visits as a result of (a), etc.) 18 873 90 7 988 (c) Otherwise (e.g., visits primarily for other purpose) — 20 14 — 34 III. Total inspections carried out .... 462 9,192 848 14 0,516 IV. No. of properties inspected (in Sect. II) found infested: (a) Rats (Major) 1 12 3 — 16 (Minor) 32 899 99 7 1,037 (b) Mice (Major) — — — — — (Minor) 3 29 16 — 48 V. No. of infested properties (in Sect. IV.) treated by L.A. 37 885 92 7 1,021 VI. Total treatments — including retreatment and those carried out privately to properties 39 954 122 7 1,122 VII. No. of notices (verbal or written) under Section 4: (a) Treatment — — — — — (b) Structural (e.g., proofing) .... 2 15 15 — 32 X. No. of Block " control schemes carried out — 11 1 — 12 SEWER INFESTATION. It has also been possible to devote more attention to infestation in the Council's sewers. This is an important part of rodent control as the sewers may form a reservoir for surface infestation. Information concerning new techniques in the treatment of sewers has become available and there is reason to believe that the work carried out in 1957 will show benefits in the future. 38 The usual test baiting, to determine the extent of infestation by rats in sewers, was carried out in April. Although it appeared to indicate a considerable increase in population, as compared with the corresponding test in 1956, it is believed that the new method used gave a truer indication of the conditions obtaining. This was largely borne out by the results of the maintenance treatments subsequently carried out. The position revealed by the second treatment in October showed little change from that found during the first treatment in May. In consultation with the appropriate officer of the Ministry of Agriculture, Fisheries and Food, it was decided to institute a third or " follow-up " treatment in November, using a different poison. The figure for the final treatment may be regarded as encouraging. Number Manholes treated No. of manholes in which "Complete takes" "Partial takes" "No takes" Test bait 198 27 33 138 1st Maintenance treatment (May) 252 128 9 115 2nd Maintenance treatment (Oct.) 244 106 25 113 3rd Maintenance treatment (Nov.) 232 18 88 106 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 6,093 Infectious Diseases 642 Food Premises, Sampling, etc 2,592 Factories, Outworkers, etc. 264 Moveable Dwellings 720 Smoke Abatement and Shops Act 582 Rodent Control 1,892 Miscellaneous 715 13,500 Written Notices issued :— Preliminary: General Sanitary Defects 217 Food Premises 108 Shop Premises 21 Factories, etc 7 Rodent Control 9 362 39 Statutory: Public Health Act 5 Food Condemnation Certificates issued 575 SHOPS ACT, 1950. The number of shops within the meaning of the Act, existing at the 31st December, 1957, was 846. They are situated as follow :— Lamorbey and Blackfen 259 Sidcup and Footscray 286 North Cray and St. Paul's Cray 97 Chislehurst and Mottingham 204 846 This represents an increase and is due mainly to the opening of shops on the Royal Park Estate and on Sidcup Hill. There is evidence that in a few cases shops permitted to open in the afternoon of the early closing day, or on Sundays, for trade in certain commodities have been selling other articles. Warnings have been issued where necessary. 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 afternoon. The Council decided to use its powers to suspend the general closing hours of shops prior to Christmas, but general observation did not reveal that advantage was taken of this concession. Visits and observations total 500. The following infringements of the Act have been dealt with. Offences Found. Remedied. Notices and records 40 30 Hours of work 5 5 Sanitary accommodation (defective & insufficient) 10 8 Washing accommodation (defective & insufficient) 1 — Ventilation 1 — Temperature 3 3 Lighting 3 3 Sunday trading 6 10 40 SMOKE ABATEMENT—CLEAN AIR ACT Preliminary consideration was given to the establishment of "Smoke Control Areas" and a meeting of neighbouring Authorities was called with a view to deciding whether joint action was called for. It did not appear that such measures were necessary at this stage, although consultation with individual adjacent districts will doubtlessly be desirable, at a later stage. Further sections of the Clean Air Act became operative in January, 1958, but these, mainly relating to the emission of dark smoke, are not likely to affect this district to any great extent. The Council's representatives on the Thames-side Joint Committee for the Abatement of Atmospheric Pollution continue to play an active part in its deliberations. It was decided to ask the Minister of Housing and Local Government for a Public Enquiry into the nuisance caused by the dust from cement works in the Thames-side area. The Deposit Gauges and Sulphur Dioxide Gauges situated at Riverside Road, North Cray, and at Holbeach Gardens, Blackfen, have continued in operation. The two Deposit Gauges, which indicate the amount of the solid polluting matter in the air (largely cement flue dust) show figures which are largely parallel. Both indicate a moderate but continuing improvement when compared with previous years. This may, in part, be due to the weather conditions prevailing in 1957, but may also represent that the electro static precipitators, fitted to the kilns at the Thames-side Cement Works, have been functioning more consistently. The total solids deposited at North Cray are equivalent to 11.522 tons per square mile per month, and at Blackfen the corresponding figure is 11.468 tons. The results obtained from the first complete year, during which the Sulphur Dioxide gauges have been recording, also show little difference between the two stations. Figures from both have dropped slightly ; Sulphur dioxide is a highly irritant component originating from the combustion of coal. It is present in higher concentrations during the winter months. The figure for North Cray, 1.27 milligrams of SO3 per day compared with 1.62 milligrams at Blackfen. The variations from month to month in the analysis of the material collected in the Deposit and Sulphur Dioxide Gauges is given in the following tables and on the graphs. 41 County Primary Roman Catholic School, Sidcup. Monthly deposit in tons per square mile during 1957. Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Water (in rain in inches) 0.96 2.47 0.70 0.20 1.08 0.63 3.45 2.25 2.06 1.58 2.54 1.59 pH Value 5.20 4.86 6.70 6.90 7.64 8.02 7.62 6.55 6.46 5.75 5.73 5.22 Total water in soluble matter 4.53 3.87 5.23 7.32 7.22 7.25 7.27 5.73 4.89 5.08 8.16 3.82 Soluble in CS, 0.12 0.11 0.06 0.06 0.05 0.07 0.11 0.09 0.05 0.14 0.10 0.13 Ash 3.18 2.64 3.96 5.57 5.46 5.32 5.49 4.25 3.50 3.75 6.07 2.68 Other combustible matter 1.22 1.12 1.21 1.69 1.70 1.85 1.68 1.40 1.34 1.19 1.99 1.01 Total water soluble matter 3.59 4.03 7.10 3.89 5.25 5.27 8.19 6.95 5.81 5.03 7.11 5.03 Ca + + 0.40 0.54 1.41 0.81 0.77 0.91 1.34 1.21 0.94 0.81 1.21 0.47 CI' 0.91 0.81 0.62 0.57 0.72 0.50 0.94 0.94 0.81 0.67 2.15 0.97 SO"4 1.15 1.82 2.55 1,55 2.04 1.62 3.24 2.51 1.98 2.25 2.87 1.93 Total solids 8.12 7.90 12.33 11.22 12.47 12.52 15.46 12.68 10.69 10.11 15.27 8.85 Sulphur dioxide (milligrams of sulphur trioxide collected per day by 100 sq. cms. of Batch A lead peroxide) 2.06 1.22 1.85 1.72 1.25 1.19 1.11 0.88 1.03 1.76 2.91 2.46 42 Footscray County Primary School, Sidcup. Monthly deposit in tons per square mile during 1957. Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Water (in rain in inches) 0.98 2.31 0.75 0.31 1.08 0.73 3.27 2.62 2.24 1.46 2.68 1.63 pH Value 5.44 5.22 6.42 6.92 7.70 8.02 7.60 6.82 6.32 5.56 5.98 5.47 Total water in soluble matter 4.11 3.22 3.37 6.74 7.18 7.73 6.30 5.80 5.59 5.06 8.62 3.50 Soluble in CS2 0.05 0.09 0.04 0.10 0.06 0.08 0.12 0.10 0.06 0.11 0.06 0.07 Ash 2.94 2.24 2.54 5.20 5.39 5.85 4.64 4.27 4.13 3.81 6.72 2.45 Other combustible matter 1.12 0.89 0.79 1.44 1.73 1.79 1.55 1.43 1.40 1.14 1.84 0.97 Total water soluble matter 4.40 4.09 4.53 4.87 6.21 6.81 8.39 7.11 5.17 5.30 9.26 4.93 CA++ 0.44 0.54 0.81 0.97 0.94 1.24 1.34 0.94 0.87 0.81 1.48 0.54 CI' 1.01 0.74 0.49 0.50 0.86 0.69 0.94 0.91 0.94 0.64 2.21 1.11 SO"4 1.40 1.80 1.76 1.76 2.39 2.14 3.54 2.71 2.03 2.49 3.46 1.95 Total Solids 8.50 7.31 7.90 11.61 13.38 14.54 14.69 12.91 10.76 10.36 17.88 8.43 Sulphur dioxide (milligrams of sulphur trioxide collected per day by 100 sq. cms. of Batch A lead peroxide) 1.49 2.04 0.94 1.16 0.92 0.96 0.79 1.11 0.84 1.24 2.11 1.68 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. Four visits have been paid to these baths whilst in use and the three samples of water taken all proved satisfactory. VERMINOUS CONDITIONS AND UNCLEANLINESS. Eighteen complaints were received in connection with premises alleged to be verminous or filthy and in this connection 26 inspections were made. In only seven cases were insect infestations found, five 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. One or two 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 some amelioration through the ancillary County Health Services or by voluntary bodies. WATER SUPPLY. The supply of water to the district is from the mains of the Metropolitan Water Board. In two cases only are there premises within the district not connected to the public supply, water being obtained from one private well. A sample from this source proved satisfactory. Two samples of water taken from wells attached to each of two factories were indicative of possible pollution. These were kept under observation and a further 11 samples proved to be satisfactory. Routine sampling is carried out by the Metropolitan Water Board and the results are indicated in the following tables. Eighteen samples were also taken by the Department and submitted for both bacteriological and chemical analysis. All were reported to be satisfactory. Some inconvenience was occasioned to householders residing in a considerable area of Chislehurst during peak periods in the warm spell in June and July. In some instances no water could be drawn from taps supplied direct from the main. This was due to exceptionally heavy demands on the supply and additional pumps have since been installed with a view to preventing any recurrence. 46 Average Results of the Chemical Examination of the water supplied to the Urban District of Chislehurst and Sidcup during 1957. Milligrammes per litre (unless otherwise stated). Description of the Sample Bexley Well Orpington Well North Orping ton Well Shortlands No. 1 Shortlands No. 2 Eynsford Well Eynsford Bore Hole Horton kirby Wilming ton No.1 Wilmington No. 2 Darenth Well Darenth Bore Hole Thamesderived Number of Samples 3 5 4 3 2 4 4 2 4 4 4 4 1882 Ammonia Nitrogen 0.007 0.002 0.002 0.005 0.002 0.001 0.001 0.005 0.002 0.001 0.001 0.006 0.027 Albuminoid Nitrogen 0.018 0.018 0.019 0.026 0.010 0.020 0.019 0.023 0.025 0.030 0.020 0.020 0.074 Oxidised Nitrogen—Nitrite — — — — — — — — — — — — — Oxidised Nitrogen—Nitrate 6.5 5.8 4.4 4.3 4.5 3.2 3.3 4.5 6.2 7.4 4.6 5.0 3.9 Chlorides as Cl 17 15 13 17 18 16 16 17 22 22 16 17 29 Oxygen abs. from Perman ganate 4 hrs. at 27°C. 0.06 0.08 0.08 0.03 0.02 0.10 0.06 0.05 0.14 0.10 0.06 0.11 1.16 Turbidity in terms of Silica Nil Nil Nil Nil Nil 0.2 Nil 0.3 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 Nil 11 Hardness (Total) 304 272 258 275 278 256 250 250 278 286 255 272 260 Hardness (non-carbonate) 66 30 21 54 57 24 24 38 44 49 22 36 56 pH Value 7.1 7.2 7.3 7.2 7.3 7.2 7.3 7.3 7.2 7.2 7.2 7.2 7.9 Phosphate as PO4 — — — — — — — — — — — — 0.90 Silicate as SiO2 - - - - - - - - - - - - 10 B.O.D. 5 days at 20°C. - - - - - - - - - - - - - Electrical Conductivity (gemmhos) 575 525 475 525 525 475 475 475 525 550 500 525 550 47 Description of the Sample Bexley Well Orpington Well North OrpingWell Shortlands No. 1 Shortlands No. 2 Eynsford Well Eynsford Bore Horton Kirby Wilmington No. 1 Wilmington No. 2 Darenth Well Darenth Bore Hole Thames derived Before Chlorination (Raw Water) No. of Samples Plate Counts (Average per ml.] 321 251 215 161 92 231 121 241 236 225 239 209 — Colonies counted on Agar: 37° C. (20-24 hours) 0.2 0.04 1.2 0.04 0.1 0.03 0.02 0.1 0.8 0.1 0.2 1.6 - 22° C. (3 days) 4.3 102.0 53.4 4.9 2.2 15.0 81.0 27.7 57.4 14.5 7.5 14.8 — Coliform test. Percentage samples negative in 100 ml.: Coliform 99.10 94.82 3.26 100.0 100.0 97.40 99.17 96.27 88.98 88.80 94.98 95.69 - E. Coliform 100.0 99.60 26.51 100.0 100.0 99.57 99.17 98.76 99.58 99.56 100.0 99.04 — After Chlorination (Water passing into Supply) Number of Samples 252 256 221 256 256 234 124 246 255 255 255 255 3438 Plate Counts (Average per ml.) Colonies counted on Agar: 37°C. (20-24 hrs.) 0.02 0.03 0.7 0.2 0.2 0.02 0.04 0.2 0.1 0.1 0.4 0.4 6.4 22°C. (3 days) 4.3 16.0 21.2 3.6 3.6 11.3 1.2 27.0 2.8 2.8 5.4 5.4 — Coliform test Percentage samples negative in 100 ml.: Coliform 100.0 100.0 99.10 100.0 100.0 97.44 100.0 99.59 98.82 98.82 100.0 100.0 99.33 E. Coliform 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 99.91 SECTION D. HOUSING. 50 SECTION D. HOUSING. (i) Routine Inspections: Seven hundred and thirty-eight visits to premises were made in connection with the Housing Acts. (ii) Clearance Areas: Two Clearance Areas, comprising eight houses, were declared during the year. (iii) Individually Unfit Houses: Six houses were closed after agreement with the owners concerned, or as a result of a Closing Order. (iv) Demolition Orders: Three further individually unfit houses were made the subject of Demolition Orders. (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., 1957 Area 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 No. of cases found during the year No. of cases remedied during year Cases at end of vear No. of cases No. of persons concerned Aged over 10 | Aged under 10 Lamorbey 7 9 6 7 11 9 5 2 2 2 4 3 4 3 - 1 2 13 3 Longlands - 1 1 1 - - - - - - - - - - - - - - - Birchwood 1 - - 1 1 - - - - - - - - - - - - - - Frognal 1 - - 1 1 1 - - - - - 1 1 2 - 1 1 2 4 North Cray 1 1 1 1 3 1 1 - - - - - - - - - - - St. Paul's Cray 4 5 6 4 5 3 3 2 2 4 4 3 3 2 2 3 1 6 5 Chislehurst Common - - 1 3 6 3 1 1 1 1 - - - - 1 1 - - - Mottingham 4 5 15 6 15 26 17 13 10 10 11 5 5 4 1 - 5 43 2 Totals 18 21 30 24 42 43 27 18 15 17 19 12 13 11 4 6 9 64 14 (vi) Defects: Number of houses inspected for housing defects (Public Health and Housing Acts) 1,589 Number of houses found not in all respects fit 568 Number of houses made fit without service of formal notices 541 51 SLUM CLEARANCE. Procedures designed to set in motion the second year of the Council’s five year programme for slum clearance were instituted. Generally speaking these procedures are lengthy and frequently preclude the possibility of completion in the same year, especially if demolition is involved. 1956 Programme. Hope and Sydney Cottages, Main Road, St. Paul’s Cray, were declared a Clearance Area, and will demolished by the owner. 1-6 Albert Place, Main Road, St. Paul’s Cray, were declared a Clearance Area and negotiations have been instituted with the owner with a view of purchase by the Council. 69 and 71 Halfway Street, Sidcup, were declared to be individually unfit houses and were demolished by the owner. The tenants were rehoused. 1957 Programme. 4,5 and 6 Woods Cottages, Nelson Road, Sidcup, were declared to be individually unfit houses and an undertaking has been accepted from the owner not to re-let. The tenants will be rehoused by the Council. Rose Cottage and Nutley Cottage, High Street, Footscray, were subjected to the same procedure, but re-housing of tenants was not necessary as they were already vacant. 5 Cray Road, Footscray, was represented as being unfit and will be dealt with by closure. 19 and 20 Garden Cottage, Footscray, were scheduled to be included in the 1957 programme. Inspection revealed that works of improvement had been carried out since the original survey in 1953. They have rendered demolition or closure inappropriate, at present, but will be kept under observation. In addition to the programme scheduled for 1957, Nos. 16 and 17 Mill Place, were found to be unfit. The former was subjected to a Demolition Order and the latter to a Closing Order. In both cases tenants were rehoused by the Council. HOUSING ACT, 1949. During the year, 34 applications for Improvement Grants, and a further three for conversions were dealt with. The total amount of the works concerned amounted to £13,677, whilst the sum of grants came to £6,239. 52 Of the Improvement Grants approved, 30 involved the provision of bathrooms, 2 were concerned with the provision of main drainage and a further 2 enabled additional accommodation to be provided. CERTIFICATES OF DISREPAIR. The Rent Act, 1957, became operative as from 6th July, 1957. The first six weeks of this period was mainly concerned with answering enquiries from landlords and tenants who were affected by its provisions. This work was largely undertaken by the Clerk. Applications for Certificates of Disrepair began to be received in September and within six weeks no fewer than 70 were dealt with. The Act requires a tenant to serve on his landlord a schedule of disrepair and it is upon the items contained therein that the contents of a Certificate of Disrepair must be based. The exercise of considerable judgment was necessary to translate the terms used by tenants into technical language, suitable for the Local Authority’s Certificate. In instances where tenants had omitted serious items, or had been precluded from mentioning them, the matters were taken up with the landlord concerned, under the Public Health and Housing Acts. The Act also requires that a notice of intention to grant to a tenant a Certificate of Disrepair, be sent to the landlord after which he is permitted a period of three weeks in which to give an undertaking to carry out work within six months. Such undertakings were in fact given by landlords in the majority of cases and observation reveals that a considerable amount of remedial work is being carried out to houses coming under this part of the Rent Act. The following is a summary of work carried out:— (1) Number of applications for certificates 89 (2) Number of decisions not to issue certificates Nil. (one withdrawn) (3) Number of decisions to issue certificates: (a) in respect of some but not all defects 44 (b) in respect of all defects 44 (4) Number of undertakings given by landlords under paragraph 5 of the First Schedule 65 (5) Number of undertakings refused by Local Authority under proviso to paragraph 5 of the First Schedule Nil. (6) Number of Certificates issued 15 (7) Number of applications for Cancellation of Certificates Nil. 53 New Houses. The following table shows the number of new houses and flats erected during the year:— New Houses. New Flats. Erected by Council 120 130 Erected by Private Developers 155 42 Totals 275 172 447 dwellings. Council Houses. The following information has been supplied by the Housing Manager:— Prior to 1957. During 1957. Houses. Families in occup. Houses. Families in occup. 1. Permanent dwellings built by Local Authority 1,399 1,399 308 1,707 2. Prefabricated dwellings built by Local Authority 275 275 0 255 3. Premises requisitioned by Local Authority 144 216 97 111 4. Halfway Houses 6 29 5 19 During 1957 there were 514 lettings as follow (a) Permanent dwellings 144 families from waiting list. (b) Prefabricated dwellings 13 families from waiting list. 157 The figure of 514 lettings includes the housing of 104 families from Corke's Meadow and 253 transfers which have been effected owing to the housing of these families and from various types of Council controlled property. During the year fourteen families have been admitted to the Halfway Houses. It will be noted that a reduction of twenty is shown in the number of prefabricated dwellings. These have been demolished preparatory to permanent development. The reduction of the total of requisitioned properties and Halfwav Houses indicates the number released durine the vear. 5. The total number of families on the waiting list as at the 31st January, 1958:— Couples 477 Families requiring two bedrooms 575 Families requiring three bedrooms 358 Families requiring four or more bedrooms 20 Old Age Pensioners and single persons 170 Cases not pointed and those passed for accommodation 98 Families in requisitioned premises 107 1,805 54 MOVEABLE DWELLINGS. A considerable demand continues for sites on which to station moveable dwellings, intended for use as long term housing accommodation. With the exception of Chalk Pit, Ruxley, all sites are now of a restricted character and generally speaking, do not give rise to serious public health problems, although a constant watch has to be kept. The position at the end of the year is indicated below:— Site Average number of families Approx. number of persons Whether licensed Smallgain’s Farm 2 4 Yes Ruxley Manor Farm 2 6 Yes Birchwood (adjoining Bull Hotel) 4 11 3 L., 1 N.L Lower Hockenden Farm 1 2 Yes 168, Blackfen Road 1 3 Yes Kemnal Scouts Field, Sidcup 1 2 Yes Old Brickfield, Baugh Estate 2 6 Yes Twysdens Meadow 3 13 Yes Conservative Club, Sidcup 2 6 Yes Old London Road, Ruxley 1 3 No Chalk Pit, Ruxley 42 195 28L., 14 N.L. Oakleigh Park Avenue, Chislehurst 1 2 Yes Chalk Pit, Ruxley. Twenty-eight families were licensed to use moveable dwellings for 1957. A further eight families resided there for most of the year and thirteen other dwellings are known to have been brought into the Pit, for varying shorter periods. Most of these have used the site sporadically in previous years, but at least three families were newcomers. In March, 1957, the Court granted an injunction to the owner of the Pit with regard to 17 unlicensed families. The effect of this was to restrain the person concerned from using the Pit, after a period of two months. Most of these caravan dwellers did in fact leave the Pit, but at a later date habitation there was resumed. The owner has now declared his intention to clear the Pit of all its occupants. Corke’s Meadow, St. Paul’s Cray. The Council set up a special Committee to deal with the problem of the moveable dwellings encampment, which for very many years, gave rise to serious public health problems in and around the Meadow. 55 The Committee decided that the only practicable solution entailed the complete clearance of the site. The establishment of a Council controlled encampment elsewhere in St. Paul's Cray was considered, but rejected. Negotiations were entered into with the Kent County Council, the London County Council, and at certain stages the Minister of Housing and Local Government, without arriving at a satisfactory conclusion. The Committee then recommended that the users of Corke’s Meadow should be offered accommodation on a nearby estate of prefabricated houses and that no provision should be made for those not accepting the offer. The problem was an urgent one, as at no foreseeable phase in the Council's housing programme would conditions be more favourable for the move than in the second half of 1957. The necessary arrangements were made, and between the months of July and November, 1957, virtually all of those on the site were re-housed, 110 families in all. This was an operation of considerable magnitude and complexity. It was carried through jointly with the Clerk and Housing Manager. It involved not only the physical moving of the families’ furnishings often unsuitable for use in a house, but the disposal of their erstwhile homes and a complete re-orientation of their mode of life. Although opposition was voiced by certain residents in streets adjoining the prefabricated housing estate, other bodies lent a hand in providing equipment and assisting in the rehabilitation of the people from Corke’s Meadow. Difficulties have arisen, subsequently, the principal problem being concerned with parking of vehicles used by occupants for their businesses. These are being solved, and it might well be said that Christmas, 1957, which for many children was the first spent under a proper roof, indeed forecast a healthier future. A serious public health problem has been solved. Corke's Meadow is being prepared for use as an industrial estate. SECTION E. INSPECTION AND SUPERVISION OF FOODS. 58 SECTION E. INSPECTION AND SUPERVISION OF FOODS. INSPECTIONS. A total of 2,592 visits were paid to premises where food is stored, or prepared, or from which it is sold. 430 defects were found and in 282 instances the attention of the persons concerned was called to deficiencies, either verbally or in writing. 108 written intimations were sent in this connection. Particular attention has been paid to the enforcement of the Food Hygiene Regulations, 1955, and the year's work has brought much nearer the date on which all premises will comply with structural requirements. It will of course, be necessary to see that the standard is maintained. In all cases where it is known to be necessary, hot and cold water supplies have been provided, so that this facility is now available to staffs at all times and especially after using the toilet. Perhaps the most serious of the problems involving the structure of food premises is that concerned with the shielding of open food from contamination. A recent High Court decision has raised considerable doubts as to the extent of the powers thought to have been available in the Regulations. Much work will always remain to be done in educating the staff of food preparing premises in the clean handling of food, and seeing that they comply with the personal hygiene requirements. Of greatest importance in this connection is the cleanliness of staff in kitchens attached to cafes and canteens. FOOD COMPLAINTS. Twenty-four complaints were received concerning alleged impurities or abnormalities in food. Not all of these were substantiated on investigation. As might be expected most complaints dealt with the more common items of food. Thus, five referred to loaves of bread and four to bottled milk. This is not a high number, having regard to the number of units of these two staple foods sold in the district in the course of a year. In all appropriate instances advice was given with a view to securing the improvement of technique and premises. In eight cases warning letters were sent to the firms responsible and prosecutions were instituted as follow:— Hair curler in milk bottle—fine £10, plus £3 3s. costs. Portion of label in loaf—fined £30, plus £3 3s. costs. Pork sausage sold in mouldy condition—conditional discharge £10 10s. costs. 59 An unusual case related to the finding of a young lizard in a tin of Pineapple imported from Malaya. As a result of representation made by this Council, the authorities in Malaya undertook to amend the Health Regulations there to guard against a repetition. FOOD AND DRUGS ACT, 1955. FOOD SAMPLING A RTICLE Samples Taken Result Remarks See below Formal Informal Genuine Inferior Adulterated Baking Powders 6 - 6 - - Blackcurrant Syrup 1 - 1 - - Bread - 2 1 - 1 See (a) Butter 5 - 5 - - Buttered Confectionery 3 - 3 - - Cake and Pudding Mixture 5 - 5 - - Cereals 20 - 20 - - Chocolate Confectionery 4 - 4 - - Chocolate Drink - 1 1 - - Coffee 2 - 2 - Colouring (Artificial) 1 - 1 - - Cream I 1 1 1 - See (b) Creamed Rice 3 - 3 - - Custard Powder 2 - 2 - - Drugs 4 - 4 - - Flour 1 - 1 - - Fruit (Dried) 21 1 21 1 - See (c) Fruit (Glace) 1 - 1 - - Fruit Juice 2 2 3 1 - See(d) Fruit Pie 1 - 1 - - Gravy Powder 1 - 1 - - Herbs (Mixed) 2 - 2 - - Jelly 6 - 6 - - Ice Cream and Mousse - 18 18 - - Lard 2 - 2 - - Lemonade Powder 3 - 3 - - Margarine 4 - 4 - - Marzipan 1 - 1 - - Meat (tinned) 3 - 3 - - Meat and Fish Paste 6 - 6 - - Meat Pies and Pasties 3 1 3 1 - See (e) Milk (Pasteurised) 1 36 35 2 - See (f) & (g) Milk (Condensed) 1 2 - 3 - See (h), (i) & (j) 60 Nuts (Ground) 4 1 5 — — Peel (Mixed) 3 — 3 — — Plum Pudding 2 — 2 — — Pulses 5 — 4 1 — See (k) Preserves 15 — 15 — — Rennet Essence 1 — 1 — — Rusks 1 — 1 — — Sausages 8 1 8 1 — See (1) Soft Drinks 2 — 2 — — Soup (Dried) 2 — 2 — — Spices 10 — 10 — — Spirits 6 — 6 — — Sugar 1 — 1 — — Sugar Confectionery 10 — 10 — — Synthetic Cream Powder 1 — 1 — — Tea 9 — 9 — — 196 66 250 11 1 (a) Bread contained piece of thick pink paper 1/3” x 2/3” bearing printing. Vendors prosecuted. (b) Double cream in dirty bottle containing non-viable mould spores. Warning letter sent. (c) Figs contained 2,300 mites in the pound. Stock withdrawn. Further samples satisfactory. (d) By comparison with data for genuine lemon juice appeared to consist of 60% lemon juice to 40% water. Two further samples satisfactory. (e) Cornish pasty contained grit and other mineral matter. Investigation carried out at the bakehouse. No further action. (f) Milk contained 0.1% soap. Bottlers warned. (g) Milk deficient by 3.3% minimum amount of fat. Further sample satisfactory. (h) and (i) Full Cream Sweetened Milk thick and contained lumps. Of low commercial quality. Referred to Ministry of Agriculture, Fisheries and Food, who disposed of old stock. (j) Evaporated Milk contained granulated deposits of calcium citrate— a sign of age and low commercial quality. Ministry of Agriculture, Fisheries and Food notified. (k) Dried peas contained 4% peas attacked by maggots. No maggots in sample. Stock withdrawn. Further sample satisfactory. (l) Beef sausages, sulphite 250 p.p.m. not declared. Warning letter sent to Company concerned. Further sample satisfactory. 61 UNSOUND FOOD. A total of 3 tons, 9 cwts. 0 qrs. 20 lbs. of food unfit for human consumption was surrendered to Inspectors during the year, as follow:— Item. tons. cwts. qrs. lbs. Bacon - - 1 26 Canned Fish 1 15 Canned Fruit 1 1 — 1 Canned Jam - - - 2 Canned Meat - 15 2 9 Canned Milk - 5 3 16 Canned Soup - - - 4 Canned Vegetables - 15 2 11 Cheese - - 1 4 Flour - - 1 19 Flour, Confectionery - - 2 3 Fish - 2 1 14 Fruit and Vegetables, Dried - - - 16 Fruit, Fresh - 2 2 20 Meat, Cooked - - 2 4 Meat, Fresh - 1 3 23 Sausages - 1 — 27 Miscellaneous - - - 2 3 9 — 20 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 seventy-five 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 Ac are:— No. of Premises Registered. Icecream. Mfr. of Sausages. Cooked Ham. Bakers’shops 2 — — Butchers’shops 1 44 — Fishmongers (wet and dried) 2 — — Greengrocers’ shops 4 — — Grocers 41 — 5 Restaurants and Cafes (for consumption off the premises) 30 - - Sweet shops, confectioners 75 - — Others 3 - — 158 44 5 62 FOOD PREMISES. There are some 529 food premises in the area, made up as under:— Bakers Bakers and Bakehouses 13 Butchers 57 Dairies 4 Fishmongers (wet and dried) 13 Fishmongers (wet, dried and fried) 9 Fishmongers (fried) 2 Greengrocers' shops and stalls 60 Grocers 136 Ice Cream premises, other than those included in (1), (2), (4), (8), (9) and (13) but including confectioners 76 Public Houses and Hotels with catering facilities 11 Public Houses without catering facilities 21 Restaurants, Cafes 34 Works Canteens 12 School Canteens, etc 43 Private Canteens 8 Confectioners (not included under Ice Cream premises) 12 529 Sixteen Dairy premises are registered in the district and 18 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 1957:— Dealers. Supplementary. Pasteurised 19 14 Sterilised 27 13 Tuberculin Tested Pasteurised 19 13 BACTERIOLOGICAL EXAMINATIONS. Thirty-six samples of designated milk were taken with the following results:— Number passing phosphatase test 36 Number failing passing phosphatase test — Number passing methylene blue test 35 Number giving unsatisfactory methylene blue result — Thirty-seven samples of milk were submitted for chemical examination, thirty-five of which proved satisfactory. Appropriate action was taken in connection with two inferior samples. ICE CREAM. Eighteen samples were taken during the year. Eight were placed in Grade I, seven in Grade II and three in Grade III. PIGGERIES. There are 15 piggeries of varying size in the district, one of which has a normal complement of approximately 1,000 pigs. Eighty-four visits of inspection were made and seven defects found were subsequently remedied. SECTION F. PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. 64 SECTION F. PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. General. Compared with the previous year when only 790 notifications of infectious diseases, excluding tuberculosis were received, the figure of 1,954 for 1957 may appear bad on the surface. Actually the picture portrayed by these figures is deceptive for if we exclude measles, only 506 notifications other than for tuberculosis were received. If measles were to be eliminated from the 1956 figures our total of notifications would have been 634, giving an overall result of 128 notifications less in 1957 than in 1956. Other variations which have occurred during the year include small decreases in the number of cases of scarlet fever and whooping cough, and a big reduction in the incidence of dysentery, which dropped from 168 to 81. The figures for anterior poliomyelitis dropped from five to three, and those of food poisoning from 34 to 23. Generally speaking, the infectious diseases retained their mild characteristics of recent years, of the 1,448 cases of measles notified, only six were removed to hospital. Acute Anterior Poliomyelitis. Only three cases were notified, all of which were non-paralytic, but were all removed to hospital. Vaccination against Poliomyelitis. Vaccination against poliomyelitis was carried out by the County Council during the year, and the County Medical Officer has furnished the following details of the numbers of children resident in the Urban District who received a course of two injections during the year ended 31st December, 1957 :— Year of Birth 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 No. Vaccinated 768 699 683 558 183 130 141 120 80 105 — Grand Total 3,467 Diphtheria and Diphtheria Immunisation. Once again I am pleased to be able to report a complete absence of this disease in the Urban District. The present position with regard to diphtheria immunisation 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 1943, a total of 1,123 received primary inoculations, and 876 reinforcing inoculations during 1957. 65 A total of 12,838 children under the age of fifteen years on 31st December, 1957, have completed a course of immunisation at some time before that date. Dysentery. Quite a considerable fall in the incidence of dysentery was experienced during the year, and this was in conformity with the figures for the country as a whole. Eighty-one cases occurred in the area, as against one hundred and sixty-eight in 1956, and once again most of the cases were of short duration and not responsible for any severe symptoms. Five cases received in-patient hospital treatment. Food Poisoning. Twenty-three notifications were received during the year, as against thirty-four in 1956. None of these cases was of a serious nature, and in spite of exhaustive enquiries entailing the examination of eighty-eight pathological specimens, in no case was the causative agent identified. The following is a copy of the annual return rendered to the Ministry of Health in respect of the year 1957:— Food Poisoning Notifications (Corrected) Returned to Registrar General: 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Total. 7 1 15 — 23 Outbreaks due to identified Agents: Total outbreaks. Total cases. Outbreaks of Undiscovered Cause: Total outbreaks. Total cases. 3 19 Single cases: Agent identified. Unknown cause. Total. — 4 4 Measles. As was to be expected after a year of few notifications, a large increase in the incidence of this disease occurred in 1957. One thousand, four hundred and forty-eight cases being notified as against one hundred and fifty-six in 1956. Only six cases had to be admitted to hospital. This ailment, although so widespread, retained the milder characteristics so noticeable of late, and it would seem that here we are dealing with a condition of lessening importance and that the higher standard of living has dealt a crippling blow to the killing power of this illness. Meningococcal Infections. No cases were notified in the area during 1957. 66 Pneumonia. Forty-five cases were notified during the year, as against forty-three in 1956. There were forty-nine deaths from pneumonia. This figure includes people who are normally resident in the Urban District but who died outside the area. A rise in the incidence of pneumonia is expected in a year in which influenza is epidemic on a large scale. In fact an increased notification rate of 2 compared with the previous year is less than one would have expected in the circumstances. It is more than probable that the explanation is that influenza affected predominantly the younger age groups and tended to miss those age groups which are more likely to be attacked by pneumonia. Scarlet Fever. Notifications of this disease showed a decrease during 1957, fifty-six cases being notified as against seventy-five in 1956. Sixteen of these cases were removed to hospital. There were no " return" cases, and no deaths from this disease in the Urban District in 1957. Smallpox and Vaccination. No cases of this disease occurred in the Urban District during the year. The policy of offering re-vaccination annually to all members of the staff of the Public Health Department has been maintained. During the year, a total of four hundred and ninety-four International Certificates of Vaccination passed through the hands of the department for purposes of authenticating doctors' signatures. The County Medical Officer informs me that a total of one thousand and fifty-seven residents in the area received primary vaccination, and one hundred and seventy-seven re-vaccination during 1957. Tuberculosis. The following table shows the position with regard to tuberculosis, with comparative figures since 1944 (as corrected by inward and outward transfers). There were eight deaths from tuberculosis during the year. The total of new notifications received during the year was fifty-four, as compared with eighty-five in 1956. The considerable reduction in the number shown on the register at the end of the year, is due to the fact that, in conjunction with the Chest Clinic, a survey of those on the register was undertaken and those patients found to have removed from the district without notification, and those who are not now regarded as suffering from tuberculosis have been deleted. 67 Tuberculosis, 1957. Year Ended Population Notifications Number of Cases on Register Number of yearlyincrease Number per 1,000 pop. Pnlm. Non-Pulm. Pulm. Non-Pulm. Total M. F. M. F. Dec. 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 1957 87,790 52 2 675 641 19 32 1,367 (minus 296) 15.6 68 Mass X-Ray. I am indebted to Dr. J. M. Morgan, the Director of the Mass X-Ray Unit of the South Eastern Regional Hospital Board and his staff for supplying me with the statistics upon which the following information is based. During the year 3,118 people were x-rayed, of whom 1,644 were men and 1,474 women. Of the grand total, 2,441 had previously taken advantage of this service. Of the 64 abnormalities discovered, 36 required no action, and 12 were considered tuberculous. Of this latter group, eight were previously known tuberculous cases, and the remaining four required treatment. The remainder of the 64 consisted of nontuberculous chest conditions and cardiac abnormalities. Chest Clinic. I should like to thank Dr. M. Price, Physician in Charge for the following information:— Number of new patients referred to the Clinic 835 Number of new patients diagnosed as tuberculous 45 Number of Refills 1,393 Number of persons vaccinated with B.C.G 206 children. 10 adults. The evening Refill Clinic continues as before, but the number of patients required to attend is steadily decreasing. Chislehurst and Sidcup Voluntary Tuberculosis Care Committee. I am indebted to the Liaison Officer of the above Committee for the following information:— “The Committee has been very active during 1957, and help has been extended whenever possible to many families. Our help follows, in most cases, the usual pattern, help towards fares to visit patients, fuel during the winter months which now costs the Committee almost double what it did in 1955; hire purchase debts, clothing, bedding, furniture, etc. Financial help has also been obtained from other organisations, i.e. SSAFA, British Legion, British Red Cross Society, and clothing from the W.V.S. The closest co-operation is maintained between all Statutory authorities, particularly the National Assistance Board who help in practically every case where help is requested by this Committee. Holidays for 30 families were arranged and great benefit derived from same. Home visits have been paid to many patients. An office is still open on Tuesday, Wednesday and Thursday between 2 p.m. and 4 p.m. at United Services Club, 108, Main Road, Sidcup, for all patients or their representatives to call and see us to discuss their many problems and obtain whatever help is possible. 69 Employment of many of the patients still presents a major problem to this Committee, as most patients are only considered fit for light work, which is very difficult to obtain, especially as labour is now more plentiful—however, local firms still assist when a suitable vacancy occurs. Toys are distributed at Christmas time via the Chairman of the Council, and help is often given from various other sources in the form of grocery vouchers for distribution to patients." Typhoid and Para-Typhoid Fever. One case of para-typhoid fever was notified during the year and removed to hospital. This case first appeared to be an isolated one, but on tracing the movements of the patient during the previous month, it was found that she had twice dined at a certain restaurant. On communication with the Medical Officer of Health of that area, it was learned that other cases throughout the country had also partaken of meals there at about the same time. Whooping Cough. Two hundred and seventy-nine notifications were received, as against three hundred and nine during the previous year. Two of these cases were removed to hospital. Mildness is still the characteristic feature of this disease in most instances and as in the case of measles, I suspect that the general standard of living has quite a lot to do with this happy state of affairs. Other Infectious Diseases. In addition to those previously mentioned, notifications were received as under:— Encephalitis, Infective 1 Encephalitis, Post Infectious 1 Erysipelas 5 Ophthalmia Neonatorum 4 (No impairment of vision in any case.) Puerperal Pyrexia 7 APPENDIX. STATISTICAL TABLES. 72 STATISTICAL TABLES, 1957. TABLE I.—Summary of Statistics. TABLE II.—Causes of Death. TABLE III.—Infant Mortality. TABLE IV.—Notifiable Infectious Diseases—Sex and Age Distribution. TABLE V.—Notifiable Infectious Diseases—Seasonal Incidence. TABLE VI.—Sanitary Inspection of the Area. TABLE I. SUMMARY OF STATISTICS, 1957. Population (mid-year 1957, per Registrar General) 87,790 Birth Rate (crude) 14.0 Death Rate (crude) 8.3 Maternal Mortality Rate Nil Infant Mortality Rate 16.3 Number of Births (live) 1,227 Number of Stillbirths 23 Number of Deaths 733 Number of Maternal Deaths Nil Number of Deaths from Infectious Diseases Nil Number of Infant Deaths (under 1 year) 20 Death Rates: — Respiratory Diseases (excluding Tuberculosis) 1.1 Tuberculosis 0.09 Cancer (all forms) 1.7 Cancer of the Lung, Bronchus 0.4 Infectious Diseases Nil Notification of Infectious Diseases: — Diphtheria Nil Dysentery 81 Erysipelas 5 Encephalitis 2 Food Poisoning 23 Measles 1,448 Meningococcal Infection Nil Ophthalmia Neonatorum 4 Pneumonia (all forms) 45 Poliomyelitis (paralytic) Nil Poliomyelitis (non-paralytic) 3 Puerperal Pyrexia 7 Scarlet Fever 56 Typhoid and Paratyphoid Fever 1 Whooping Cough 279 Number of visits made by Public Health Inspectors 13,500 73 74 TABLE II. CAUSES OF DEATH. 1953 1954 1955 1956 1957 Total Male Female 1. Tuberculosis—Respiratory 18 12 7 9 4 2 6 2. Tuberculosis—Other 2 2 — 2 1 1 2 3. Syphilitic Diseases 2 1 1 1 3 1 4 4. Diphtheria — — — — — — — 5. Whooping Cough — — — — — — — 6. Meningococcal Infection 1 — — — — — — 7. Acute Poliomyelitis 1 — 1 — — — — 8. Measles — — — — — — — 9. Other infective and parasitic diseases 1 2 1 2 — — — 10. Malignant neoplasm, stomach 23 15 20 12 11 8 19 11. Malignant neoplasm, lung bronchus 38 36 44 31 28 6 34 12. Malignant neoplasm, breast 13 19 13 20 — 10 10 13. Malignant neoplasm, uterus 5 9 8 1 — 6 6 14. Other malignant and lymphatic neoplasms 75 70 72 63 36 46 82 15. Leukaemia, aleukaemia 8 5 6 5 2 5 7 16. Diabetes 5 1 4 4 2 2 4 17. Vascular lesions of nervous system 66 79 98 80 23 56 79 18. Coronary disease, angina 99 107 113 118 78 49 127 19. Hypertension with heart disease 13 22 20 11 4 10 14 20. Other heart disease 96 87 80 82 35 56 91 21. Other circulatory disease 51 25 42 38 18 19 37 22. Influenza 11 1 3 1 3 5 8 23. Pneumonia 32 28 37 42 30 19 49 24. Bronchitis 44 39 42 40 23 13 36 25. Other diseases of respiratory system 4 6 8 6 8 6 14 26. Ulcer of stomach or duodenum 10 10 6 6 8 4 12 27. Gastritis, enteritis and diarrhoea 7 4 8 5 1 4 5 28. Nephritis and nephrosis 8 5 8 6 2 1 3 29. Hyperplasia of prostate 6 6 2 5 4 — 4 30. Pregnancy, childbirth, abortion — — 1 — — — — 31. Congenital malformations 8 8 10 4 5 3 8 32. Other defined and ill-defined diseases 56 59 68 59 22 27 49 33. Motor vehicle accidents 9 5 5 8 6 2 8 34. All other accidents 7 9 10 10 7 6 13 35. Suicide 13 6 10 3 1 1 2 All causes 732 678 747 675 365 368 733 75 TABLE III. INFANT MORTALITY, 1957. (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 Prematurity 4 — — — 4 — — — — 4 Respiratory Diseases 2 — 1 — 3 1 1 — — 5 Cerebral Hæmorrhage 2 — — — 2 — — — — 2 Atelectasis 2 — — — 2 — — — — 2 Congenital Heart Disease 2 — — — 2 — — — — 2 Meningitis — — — — — — — 1 — 1 Other causes 1 — — 1 2 — — 2 — 4 TOTALS 13 — 1 1 15 1 1 3 — 20 76 TABLE IV. NOTIFIABLE INFECTIOUS DISEASES, 1957. Sex and Age Distribution. Disease Totals Under 1 1—2 3—4 5—9 10—14 15—24 25 and over Age unknown M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Scarlet Fever 28 28 — 2 1 — 5 5 17 13 3 6 2 2 — — — — Whooping Cough 134 145 9 10 31 27 35 40 54 57 3 4 — 2 2 5 — — Poliomyelitis (Paralytic) — — — — — — — — — — — — — — — — — — Poliomyelitis (Non-Paralytic) 2 1 — — — — — — 1 — — — — — 1 1 — — Measles 746 702 10 9 114 136 181 183 426 359 10 7 3 5 2 3 — — Dysentery 46 35 2 — 3 2 5 2 20 12 8 8 — — 8 11 — — Meningococcal Infection — — — — — — — — — — — — — — — — — — 956 911 21 21 149 165 226 230 518 441 24 25 5 9 13 20 — — Under 5 5—14 15—44 45—64 65 & over Age unknown M. F. M. F. M. F. M. F. M. F. M. F. Acute Pneumonia 23 22 6 4 1 2 6 10 6 6 4 Para-Typhoid Fever — 1 — — — — — 1 — — — — — — Erysipelas 2 3 — — — — — — 2 3 — — — — Food Poisoning 14 9 — — 2 2 3 3 2 1 7 3 — — Puerperal Pyrexia — 7 — — — — — 7 — — — — — — Ophthalmia Neonatorum 2 2 2 2 — — — — — — — — — — Encephalitis 1 1 — — 1 1 — — — — — — — — 42 45 8 6 4 5 9 21 10 10 11 3 — — 998 956 77 TABLE V. NOTIFIABLE INFECTIOUS DISEASES, 1957. Seasonal Incidence. Disease Jan. Feb Mar. April May June July Aug. Sep. Oct. Nov. Dec. Totals Dysentery 15 10 24 18 5 4 3 1 1 — — — 81 Encephalitis — Infective — — — — — — — 1 — — — — 1 Encephalitis — Post Infectious — — — — — — — — — 1 — — 1 Erysipelas — — 1 — 1 1 — 2 — — — — 5 Food Poisoning 5 1 1 — — 1 — 15 — — — — 23 Measles 21 44 184 300 306 351 199 31 4 6 2 — 1,448 Ophthalmia Neonatorum 1 — 2 — — — — 1 — — — — 4 Paratyphoid Fever — 1 — — — — — — — — — — 1 Pneumonia 3 9 3 4 4 4 — — — 12 6 — 45 Poliomyelitis (Non-Paralytic) — — — — — — — 2 1 — — — 3 Puerperal Pyrexia 1 1 1 — 1 — 1 — — 1 — 1 7 Scarlet Fever 12 8 12 4 6 5 1 — 1 2 4 1 56 Whooping Cough 34 28 38 41 24 39 33 12 19 6 1 4 279 Totals 92 102 266 367 347 405 237 65 26 28 13 6 1,954 78 TABLE VI. SANITARY INSPECTION OF THE AREA. 1. Inspections—General. Dwelling Houses (Public Health Act) 5,290 Dwelling Houses (Housing Act) 738 Dwelling Houses (Rent Act) 65 Bakers 122 Bakehouses 110 Butchers 271 Butchers and registered sausage manufacturers 123 Works Canteens 77 Restaurants and Cafes 267 Dairies 30 Fishmongers 217 Greengrocers 282 Grocers 762 Ice Cream Shops 233 Piggeries 84 Public Houses 31 Confectioners Shops 66 Chemists 1 Mineral Water Factory 1 Factories (Sections 1, 2, 3, 4 and 6, Factories Acts) 17 Factories (Section 7, Factories Acts) 205 Factories (Section 7—other premises) 39 Factories (Section 110, Factories Acts)—Outworkers 3 Smoke Abatement 82 Premises—for rats and mice 1,892 Infectious Diseases 562 Food Poisoning 80 Moveable Dwellings 720 Rivers and Streams 70 Shops Act 500 Schools 71 Swimming Pools 4 Public Conveniences 203 Unsound Food 175 Stables 14 Petroleum Acts 43 Fireguards Act 29 Pet Animals Act 21 13,500 79 2. Complaints. General Sanitary Defects 257 Drainage 490 Keeping of Animals 19 Offensive Accumulations 99 Verminous Premises 18 Water Supply 19 Rats 455 Mice 39 Overcrowding 22 Foods 29 Dustbins 150 Smoke 34 Miscellaneous 47 1,678 3. Notices. Five Statutory and three hundred and sixty-two Informal Notices were served, drawing the attention of the owners to the existence of nuisances at their properties and requesting abatement. *