Ac. 4412 (3) CHI 31 CHISLEHURST AND SIDCUP URBAN DISTRICT COUNCIL MEDICAL OFFICER OF HEALTH'S Annual Report on the HEALTH OF THE URBAN DISTRICT, 1959 H. B. C. CARTER-LOCKE, M.B.. B.S., M.R.C.S , L.R.C.P., D.P.H. Medical Officer of Health Telephone : RAVensbourne 4623. Offices: MANOR HOUSE, SIDCUP, KENT. Telephone : FOOtscray 3300 CHISLEHURST AND SIDCUP URBAN DISTRICT COUNCIL MEDICAL OFFICER OF HEALTH'S Annual Report on the HEALTH OF THE URBAN DISTRICT, 1959 H. B. C. CARTER-LOCKE, M.B., B.S., M.R.C.S., L.R.C.P., D.p.H. Medical Officer of Health Telephone : RAVensbourne 4623. Offices: MANOR HOUSE, SIDCUP, KENT. Telephone : FOOtscray 3300 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. 27 Disinfection and Disinfestation 20 District Nursing Service 26 Domestic Help Service 26 Domiciliary Midwifery 26 Health Visiting 26 Hospital Services 24 Laboratory Service 22 National Assistance Act, 1948 23 Nursing Homes 21 Old People's Welfare Committee 31 Public Conveniences 21 Public Mortuary 24 St. John Ambulance Brigade 30 Women's Voluntary Service 30 Women's Welfare Clinics 29 Section C. Sanitary and Environmental Circumstances of the Area. Agriculture (Safety, Health and Welfare Provisions) Act, 1956 34 Cesspools 34 Clean Air Act, 1956 44 Diseases of Animals (Waste Foods) Order, 1957 35 Drainage and Sewerage 35 Factories Acts, 1937 and 1948 35 Game Act, 1831 36 Heating Appliances (Fireguards) Act, 1952 36 Pet Animals Act, 1951 37 Petroleum (Regulation) Acts, 1928 and 1936 37 Public Cleansing, Refuse Collection and Disposal 38 Rag Flock and Other Filling Materials Act, 1951 41 Riding Establishments Act, 1939 41 Rivers and Streams 41 Rodent Control 42 Sanitary Inspection of the Area 43 4 Page Shops Act, 1950 43 Swimming Baths 53 Verminous Conditions and Uncleanliness 53 Water Supply 53 Section D. Housing. Housing Inspections 58 Housing Act, 1949 59 Moveable Dwellings 61 New Houses 60 Re-housing 60 Rent Act, 1957 59 Slum Clearance 59 Section E. Inspection and Supervision of Foods. Bacteriological Examinations 71 Food & Drugs Act, 1955. Section 16 70 Food & Drugs Act, 1955. Food Sampling 66 Food Complaints 64 Food Hygiene Regulations, 1955 64 Food Premises 70 Ice Cream 71 Inspections 64 Meat Inspection 69 Piggeries 71 Unsound Food 69 Section F. Prevalence of, and Control Over Infectious and Other Diseases. Acute Anterior Poliomyelitis and Vaccination 74 Diphtheria and Diphtheria Immunisation 75 Dysentery 75 Food Poisoning 75 General Remarks 74 Measles 77 Meningococcal Infections 77 Other Infectious Diseases 79 Pneumonia 77 Scarlet Fever 77 Smallpox and Vaccination 77 Tuberculosis, Mass X-ray and Chest Clinic 77 Tuberculosis Care Committee 79 Typhoid and Para-Typhoid Fever 79 Whooping Cough 79 STATISTICAL TABLES. Table 1.—Summary of Statistics 83 II.—Causes of Death 84 III.—Infant Mortality 85 IV.—Notifiable Infectious Diseases—Sex and Age Distribution 86 V.—Notifiable Infectious Diseases—Seasonal Incidence 87 VI.—Sanitary Inspection of the Area 88 5 MEMBERS OF THE URBAN DISTRICT COUNCIL (as at 31.12.59) Chairman : J. R. CAMPBELL CARTER, Esq., J.P. Vice-Chairman : Mrs. S. M. GUNN. Councillors : *F. Ambrose. R. Pope. P. Andrews. H. Quittenden. Mrs. E. G. Beecher-Bryant. E. J. Reader. R. G. H. Bond. Miss E. E. Rhodes. *C. J. Christopher. A. Robinson. B. Cotter. D. W. Ryan. *D. I. Evans. R. A. Sanderson, J.P. (Vice-Chairman of P.H. Com.) 3. W. Schuch. F. H. Farmer. G. H. Scobie. W. G. Fuller. *S. L. Silvester. *A. V. Hatley. R. E. Sims. *Miss B. H. James, J.P. W. Steven. (Chairman of P.H. Committee) H. Taylor. *A. H. MacDonald. Mrs. G. M. Vander. F. C. Mansfield. *Mrs. E. V. Wallace. *A. T. J. Marsh. *E. W. White. E. V. Mills, J.P., C.A. (* denotes members of the Public Health Committee.) STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health : (Municipal Buildings, 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 3300) 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. 6 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. CLERICAL STAFF. A. F. OUGHTON. Miss C. DEVONSHIRE. Mrs. I. E. B. BRENNAN. OUTDOOR STAFF. J. CONNER (Disinfector, Mortuary Keeper, Drain Clearer and General Handyman.) J. DAVIS (Assistant to Disinfector.) E. FIFE (Rodent operative) 7 To the Chairman and Members of the Chislehurst and Sidcup Urban District Council. Mr. Chairman, Ladies and Gentlemen, "Everything in the garden is lovely," is a well known expression which can rarely be true literally, for it must be a most exceptional circumstance when any garden is completely free from weeds. The purpose of a letter such as this, is to draw attention to the fact that in most respects, the garden of health is in a satisfactory condition but that there are a few black spots or weeds which are worthy of thought and consideration. One of the outstanding black spots in my opinion is the fact that such a small number of the most recent group available for vaccination against anterior poliomyelitis has offered itself for treatment. This refers to those in the 26—40 age group who rely too much perhaps, on the fact that this disease used to be one primarily affecting children. Now that a high percentage of children have been vaccinated against this disease its attack is more likely to be made on the non-immunes of an older generation. It is not without significance that no cases of poliomyelitis in children were notified in 1959, but that during that year, two very serious adult cases occurred. It seems strange that it apparently needs the death from poliomyelitis of some public personality to bring home the need for self protection against this affliction, and it should be unnecessary for such a tragic event to occur before the public will respond to one's most fervent appeals. It may be that there are those who have their own objections to injections, and therefore one hopes that the work now being undertaken on the subject of an oral vaccine will be brought to a satisfactory conclusion at an early date. Not only could this method if ultimately found to be effective, be much pleasanter and less troublesome for the patient, but would also be very time saving from the point of view of the doctor. Unsatisfactory in the extreme must be considered the fact that deaths from violence numbering 28 reached their highest figure of the past decade. This total was made up of twelve motor vehicle accidents, seven suicides and nine other accidents. These latter figures are surely worthy of further comment and firstly one can only express horror at this needless waste of life bringing sudden and unexpected loss to some innocent and unsuspecting family. Road accidents are being given great publicity and the law is being invoked wherever possible in an effort to reduce the carnage on the roads, but only when there is a change of attitude of mind on the part of all road users, is any permanent and significant reduction in road accidents likely. Turning to the other nine fatal accidents, the fact that most of these would have been preventable had reasonable care been taken, 8 is undeniable, and they should act as a spur to us all to take that little bit of extra care in our comings and goings which can make all the difference between happy security and disastrous tragedies. The seven deaths due to suicide make one think immediately of the Mental Health Act with its very progressive approach to the problems of mental sickness. In future the stress will be laid on community care, and hospital admission which procedure will be simplified greatly, will only be a phase in the course of treatment. Taking a long term view of the problem of Mental Illness, and it certainly is a big problem, one hopes that the Mental Health Act will make a big contribution to the improvement of those needing its help. At this stage it might be appropriate to draw attention to the modern craze for drug taking, especially of the tranquilliser type. That such a state exists is of course, indicative of an unhealthy mental outlook and anything that can be done to combat it is likely to produce an improvement in health. This of course, brings us to the question of the pressure of modern life, for with all the modern labour saving devices life should be easier, but in fact, although we seem to have relieved the pressure on the body, the same cannot be said for the pressure on the mind, and in the solution of this problem lies one of the great hopes for the future of mankind. In this connection, mention should also be made of the problem of alcoholism which is now gradually becoming recognised as a disease and not as an objectionable social habit. There is little doubt that this disease is more rife that is generally realised, but the number of cases where it is a crippling disablement is fortunately limited. The fact that there were 42 deaths from cancer of the lung is one more warning to the hardened smoker, of the apparent association between his or her habit and this disease. In addition to this, the number of deaths from cancer in general reached its highest ever level at 179. As the population increases it is only to be expected that a disease of this nature is likely to claim more victims, but I sometimes wonder whether knowledge of this disease and its treatment is sufficiently wide-spread among the public. The fact that most cases treated at an early stage are curable, is too little known, with the result that people tend to delay treatment from a sense of fear and hopelessness until the disease is in fact incurable. The remaining statistics do not reveal any drastic alterations from the average figures, and do not call for any special consideration, but although it is not one of the vital statistics as usually recorded, reference should be made to the really wonderful summer of 1959, when the hours of sunshine were so high and the rainfall so low. 9 A great deal has been written about the problem of radiation in recent years, and it is very difficult for a person not trained as an atomic physicist to understand all the opinions that have been expressed. However, I have come to the conclusion that so long as man-made radiation is not greatly increased from its present level, the hazards to man are not great, and it must not be forgotten that natural radiation is much greater than that of bomb fall-out. It is also right to draw attention to the fact that diagnostic radiology which is so useful and constructive, is productive of much more radiation than the purely destructive bomb. Mankind has of course, always been exposed to the effects of radiation, but excess can be very damaging and one hopes that the Radio Active Substances Act will make its contribution to keeping radiation within bounds, by taking care of the disposal of radio-active wastes and the registration of all users of radio-active materials. The difficulties of the no longer so young members of the population are frequently being brought to our attention, but it is only right to say that both statutory and voluntary bodies are doing all they possibly can to alleviate the lot of our less fortunate elder citizens. Perhaps some of the difficulties which arise and bring these cases to our notice are due to the pride and independence exhibited by so many of the old folk. They have never expected or asked for assistance all their lives, and they sometimes, rather misguidedly, resent any attempt to help them. This of course can lead to the eventual need for some sort of residential care which is so unwelcome to the patient. It is also a great pity to load hospitals and old people's Homes with cases which could remain at home with community care, for the demand for accommodation for aged sick and aged infirm is still overwhelming. It would be wrong to finish this letter without reference to the Royal Commission on Local Government in the Greater London Area, before which the Council presented its views during 1959. Without wishing to do any thought reading, it is fairly obvious that the Commission's Report when presented, may recommend considerable alterations to the structure of Local Government as it is now, and those changes could affect the Health Committee very materially. Any changes recommended which increased the responsibilities and interests of this Committee would, I am confident, be accepted with alacrity and enthusiasm. It is the custom, and a very pleasant one, to finish by thanking all those who, in their different spheres, have helped in keeping the wheels oiled. Their number includes many doctors outside the Public Health Service, and my deputy Dr. Kelynack, who continues to give such sterling and cheerful service. I must also acknowledge 10 with grateful thanks, my indebtedness to Mr. Kermode the Chief Public Health Inspector, and all the other Inspectors and clerical staff. Last but by no means least, a word of thankfulness to the Chairman and Members of the Public Health Committee who are both so tolerant of, and helpful to, me personally. 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. General Statistics. Area of the Urban District (in acres) 8,957 Area of Parks, Open Spaces, etc. (in acres) 480 Census, 1951 83,850 Registrar General's estimate of total population (mid-year) 1959 89,020 Rateable Value at 1st April, 1959 £1,261,396 Rateable Value at 31st March, 1960 £1,309,618 Product of a Penny Rate for year ended 31st March, 1960 £5,295 Number of Valuation assessments as at 31 st March, 1959:— Houses and Flats 25,646 Houses, Agricultural 94 Houses and Shops (assessed together) 344 Other Shops, etc. 496 Other Commercial Premises 1,239 Industrial Premises 70 Crown Properties 39 27,928 Mileage of Roads as at 31st December, 1959:— County Roads, Class 1 (including Trunk Roads) 21.42 County Roads, Class 2 4.30 County Roads, Class 3 6.12 District Roads 80.33 Unadopted Roads 9.00 121.17 Vital Statistics. Live Births. Males. Females. Total. Legitimate 633 587 1,220 Illegitimate 29 22 51 662 609 1,271 Crude birth rate per 1,000 estimated total population 14.3 Adjusted birth rate for comparison with other areas 13.9 (The area comparability factor for births is 0.97.) Illegitimate live births per cent of total live births 4.0 Birth rate for England and Wales 16.5 Stillbirths. Males. Females. Total. Legitimate 7 14 21 Illegitimate — 2 2 7 16 23 Stillbirth rate per 1,000 total live and still births 17.8 Stillbirth rate per 1,000 estimated total population 0.3 13 Total Births (Live and Still). Males. Females. Total. Legitimate 640 601 1,241 Illegitimate 29 24 53 669 625 1,294 Infant Mortality. Males. Females. Total. Legitimate 13 11 24 Illegitimate 1 — 1 14 11 25 Infant mortality rate per 1,000 live births 19.7 Legitimate infants per 1,000 legitimate live births 19.67 Illegitimate infants per 1,000 illegitimate live births 19.6 Neonatal mortality rate (deaths under 4 weeks per 1,000 total live births) 13.4 Early neonatal mortality rate (deaths under 1 week per 1,000 total live births) 10.2 Perinatal mortality rate (stillbirths and deaths under 1 week combined per 1,000 total live and still births) 27.8 Infant mortality rate for England and Wales 22.0 Maternal Mortality. Maternal deaths (including abortion) Nil. Maternal mortality rate per 1,000 total live and still births Nil. Maternal mortality rate for England and Wales 0.38 Deaths. Males. Females. Total. 389 373 762 Crude death rate per 1,000 estimated total population 8.6 Adjusted death rate for comparison purposes 11.3 (The area comparability factor for deaths is 1.31) Death rate for England and Wales 11.6 POPULATION. The Registrar General's estimate of the total population of the Urban District, mid-year 1959, was 89,020, which was an increase of 480 over the figure for 1958, and was equivalent to a density of 9.94 persons to the acre. 14 The natural increase of population, measured by excess of births over deaths, was 509. It is of interest to note that the population of the Urban District has risen by 8,980 during the past ten years. BIRTHS. The birth rate for 1959 was 14.3 per 1,000 total population, which is a decrease of 0.9 compared with the previous year. The adjusted rate for comparison with other areas is 13.9. The rate of 14.3 is well below that 16.5 for England and Wales as a whole. 1,271 live births were registered in the Urban District during the year, as against 1,342 in 1958. Of this number, 662 were males and 609 females. The illegitimate birth rate was 40.9 per 1,000 live and still births. There were 53 illegitimate births (including 2 stillbirths), 29 being males and 24 females. Of a total of 23 stillbirths registered, 7 were males and 16 females. The stillbirth rate for the year being 17.8 per 1,000 total live and still births, and 0.3 per 1,000 estimated total population. DEATHS. Seven hundred and sixty-two deaths appertaining to the Urban District were registered in 1959, giving a death rate of 8.6 per 1,000 total population. The adjusted rate for use when comparing one area with another is 11.3. The rate for England and Wales as a whole is 11.6. Of the Chislehurst and Sidcup deaths, 389 were males and 373 females. The following is an analysis of the ages at death: Under 1 year of age 25 1 and under 5 years of age 5 5 and under 15 years of age 5 15 and under 25 years of age 7 25 and under 35 years of age 8 35 and under 45 years of age 17 45 and under 55 years of age 76 55 and under 65 years of age 120 65 and under 75 years of age 184 75 years and over 315 762 Full details of the causes of death will be found in Table II in the appendix to this report, but the following table, giving details of certain causes of death in the Urban District during the past ten years, may prove of interest:— 15 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 Cancer of the lung, bronchus 31 22 21 38 36 44 31 34 41 42 Cancer (all sites) 131 132 127 154 149 157 127 151 156 179 Respiratory Diseases (not T.B.) 59 89 72 80 73 87 88 99 96 103 Tuberculosis 30 30 22 20 14 7 11 8 10 6 Heart and Circulatory diseases 330 361 377 325 320 353 329 348 356 367 Infectious Diseases 8 4 4 3 2 2 2 — 1 3 Road Traffic accidents 5 6 4 9 5 5 8 8 8 12 Other violent causes 12 12 10 7 9 10 11 13 13 16 LOCAL SICKNESS. The following is a summary of the weekly details received from the Ministry of Pensions and National Insurance during 1959:— Four weeks ending Number of First Certificates of incapacity received. 27th January 1,155 24th February 2,527 24th March 1,410 21st April 691 19th May 568 16th June 551 14th July 510 11 th August 434 8th September 503 6th October 674 3rd November 771 1st December 969 29th December 739 These figures followed the expected trend, i.e. the highest incidence of illness occurred during the first three months of the year, the lowest level was reached in August, after which it began to rise again. MEDICAL EXAMINATIONS. Twenty-eight members, or potential members of the staff were medically examined during the year. UNEMPLOYMENT. I am indebted to the Manager of the local Employment Exchange for the following information with regard to unemployment in the area during 1959:— "Unemployment during 1959, averaging 250, was less than 1958, and was small in proportion to the population. Local firms have held their own, and a few small firms in varying industries have come to the area." 16 OPEN AIR RECREATIONAL AMENITIES. Location. Acreage. Description. Abbeyhill Park 6.84 Part allotments. Belmont Lane Open Space 5.59 Beverley Avenue 1.64 Open space. Chalk Wood and Mount Misery 69.21 Open space. Chislehurst Recreation Ground and Whytes Woodland 15.02 Open space with 4 tennis courts, 1 football pitch and 1 cricket pitch, children's playground, Aviary. Church Lane Recreation Ground 2.25 Open space. Footscray Common .70 Open space. Footscray Recreation Ground 6.80 Open space. Hoblingwell Wood 87.00 Open space, 2 cricket pitches and 4 football pitches. Games Warden. Children's playground. Hollyoak Wood Park 11.61 Open space and part allotments. King George's Field 11.10 Open space with 3 football pitches, 2 cricket pitches and 2 concrete cricket practice pitches and children's playground. Lamorbey Park:— (1) The Glade 10.63 Open space. (2) Land fronting Burnt Oak Lane 2.00 Open space. (3) Land leased 12.42 Open space. Longlands Recreation Ground 6.00 Open space with 1 football pitch. Marlborough Park 6.32 Open space with 1 football pitch and 1 netball pitch Games Warden. Mottingham Lane 1.00 Open space. Mottingham Sports Ground 30.00 Open space with 2 tennis courts, 8 football pitches, 6 cricket pitches, 1 hockey pitch and 3 concrete cricket practice pitches. Games Warden. Putting Green. Mottingham Recreation Ground 5.89 Open space — children's playground. Old Farm Park 11.78 Open space and part allotments. Parish Wood 6.73 Open space. Penhill Park 17.10 Open space with 4 football pitches, 3 grass cricket pitches, 1 concrete cricket pitch and children's playground. River Cray Reservation:— (1) North Cray Place Farm 29.60 Used for agricultural purposes. 17 Location. Acreage. Description. (2) Footscray Meadows 49.32 Part used for agricultural purposes. Children's playground. 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. Aviary. Willersley Park 5.59 Open space with 4 tennis courts and children's playground. 480.42 Although Chislehurst and Sidcup is urban in character, it is fortunate in possessing a variety of open spaces, as befits a district on the edge of the metropolis. The eastern edge of the area forms a part of the Metropolitan Green belt and on it many fine orchards thrive. Forming a wooded wedge between Chislehurst and St. Paul's Cray, is an extensive area of well cared for Common Land. Near to the London County Council's boundary there are many privately owned games fields which help to preserve the open character of the district. The Council, too, provides and cares for some 480 acres of open space. Here too, we find woodland and games pitches and in addition many well placed parks, gardens and recreation grounds in which the children, old people and the populace generally, may relax. The children are especially catered for by the provision of playground equipment on several sites and the employment of Games Wardens was continued at five of the parks. This facility proved to be very popular. The main constructional works 18 carried out during the year were the levelling and seeding of terraces and the levelling for the car park at Hoblingwell Wood, St. Paul's Cray, and preparatory works for the erection of the Pavilion at Mottingham Sports Ground. On a smaller scale, The Crescent, Main Road, Sidcup, and The Oval, Blackfen, were laid out. 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 is responsible for disinfection of premises, etc. after the removal of persons suffering from infectious complaints, or subsequent to the patient being declared free from infection. This is carried out as a routine measure in cases of certain serious infections and on request in other instances. 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. It is an interesting commentary on the progress of medical science, the advance in health education and on the efficacy of modern insecticides and techniques that the use of these services is on a decreasing scale. Details of the work carried out during 1959 are as under:— DISINFECTIONS. Premises visited 208 Rooms disinfected 24 Articles disinfected 463 DISINFESTATIONS. Premises visited 28 Rooms disinfested 78 Articles disinfested 18 Fumigation Sprayed Steam Disinfected Destroyed Rooms 78 24 — — Mattresses — 8 33 — Pillows — — 229 — Pillow Case — — — 1 Blankets — 4 141 — Clothing, bundles of — — 1 — Library Books 18 34 12 — 96 70 416 1 21 NURSING HOMES. Details of the five Nursing Homes on the Register at 31st December, 1959, 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, but at no time were any contraventions found which called for action on the part of the local authority. The majority of the beds continue to be occupied mainly by aged sick or aged infirm patients. PUBLIC CONVENIENCES. The Public Health Department is responsible for the maintenance and supervision of all Public Conveniences in the area. Its staff cleanse the undermentioned toilets:— 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. Dorset Road, Mottingham. Public Conveniences in Parks (Female sections only):- Willersley Park, Blackfen. Penhill Park, Blackfen. The Glade, Lamorbey. Waring Park, Sidcup (2) 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, SidcuD. A staff of two full-time and one part-time cleaners was employed at the 31st December, 1959. In addition there was one full-time employee who divided her time between cleaning and attending, four part-time attendants and two relief workers. 22 No new public conveniences were opened during 1959. Nevertheless, an extension to provide accommodation for attendants was nearing completion at Cotmandene Crescent, St. Paul's Cray, and plans were well advanced for the construction of a modern building in the Car Park at St. Johns Road, Sidcup, to replace the unsatisfactory structure in use there now. The opening of this will further the policy of installing attendants where necessary. The first convenience to be dealt with was that at Westwood Lane, Sidcup, which has been manned for a substantial part of each day as from April. At manned conveniences hot water washing facilities are available free of charge, including the provision of a paper towel, at all times when open. Whilst personnel are in attendance, a linen towel may be used for a small charge. The provision of hot water for hand washing is most desirable and is particularly helpful to roundsmen and others handling food. Further the presence of attendants on the premises, for substantial periods of the day, has proved an effective, even if not a complete, deterrent to those who would cause damage to the building and its equipment. There has been a notable decrease in the amount of malicious damage suffered not only at Westwood Lane, but at most other conveniences. It was, nevertheless, necessary to expend the sum of £171 18s. Id. on remedying the effects of a recorded number of 91 incidents. The evidence points to school children as being the main perpetrators of this wilful abuse. The Committee after examining the possibility of making no charge (by coin locks) for the use of W.C's decided that at least half the number of these in each section should be "free." LABORATORY SERVICE. In the detection and control of food poisoning, dysentery and the enteric fevers, the Laboratory Service is of great importance. Most medical specimens are sent to the Public Health Laboratory at Maidstone, and the co-operation of Dr. J. H. C. Walker, the Director, is willingly given. 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. Through the courtesy of Dr. Randall of Orpington Hospital, and Dr. Herman of Queen Mary's Hospital, copies and reports on certain specimens submitted by local practitioners are made available to me. 23 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 - - 4 3 - - - - Maidstone Public Health Laboratory 27 — 112 7 — — 1 — Orpington Hospital — - 10 2 — - 1 - Queen Mary's Hospital — — 26 8 — — — — Totals 27 - 152 20 - — 2 - The number of specimens dealt with shows a very substantial increase on the corresponding figure for 1958. NATIONAL ASSISTANCE ACT, 1948. Section 47. Power is given to apply to the Court for an order for the compulsory removal of aged or infirm persons living in insanitary conditions and not able to care for themselves. In all, seven cases of this description came to notice. Full investigations were made and in all but one instance it was possible, in collaboration with other authorities, to alleviate the conditions obtaining. The other case, that of an elderly lady living in a shack, was not amenable to informal procedure and a Magistrate's Order was obtained providing for her removal to a County Establishment. Section 50. This Section of the Act places a duty on the local authority to arrange for the burial or cremation of the body of any person who has died, or been found dead in their area. if it appears that no suitable arrangements for the disposal of the body have, or are being, made. Expenses incurred by the local authority may be recovered from the estate of the deceased person, from any person liable to maintain the deceased person, immediately prior to his death, or from the "Death Grant." During the year, two bodies were caused to be buried under this Section. 24 PUBLIC MORTUARY. A small decrease occurred in the number of bodies received at the Public Mortuary at Chislehurst, but the work of reception, of preparing the bodies for post mortem examination and arranging details of disposal, continue to occupy a considerable proportion of the time of the disinfectors. Refrigerated accommodation for six bodies is provided and this would appear to be just sufficient. The number of bodies received during 1959 was 158 of which 75 came from hospitals in the district. Post mortem examinations were carried out in all cases and inquests were held on 19 bodies. HOSPITAL SERVICES. The following hospitals are within the area of the Sidcup Hospital Management Committee of the South-East London Region. Cray Valley Hospital. Provides a general hospital service with the following beds:— Maternity 10 Medical 10 Surgical 10 "Section 4" 2 "Section 5" 3 Sidcup Cottage Hospital. A General Practitioner hospital with 11 Medical, 1 of Section 4 and 1 Section 5 beds. A Physical Medicine clinic is held once each week. Queen Mary's Hospital. A general hospital service with the following beds:— Male. Female. Children. General Medicine 39 27 — Pædiatrics — — 16 Pleural Effusion 25 15 — Chronic Sick 24 24 — General Surgery 30 27 6 Tonsils and Adenoids — — 12 Traumatic and Orthoædic 15 15 — Ophthalmology — — 2 Gynæcology — 20 — Ear, Nose and Throat 1 1 — 134 129 36 25 Regular Clinics for out-patients are held as follow:— General Medicine, Diseases of the Chest, Dermatology, Physical Medicine, Ear, Nose and Throat, Neurology, General Surgery, Infertility and Birth Control, Pædiatric, Ophthalmic Surgery, Orthopædic and Traumatic Surgery, Psychiatry, Gynæcology, and Orthodontic, the last mentioned being opened during the year. The Control of Infection Committee, on which I am represented, continued to function. Voluntary organisations including the British Red Cross Society, the Women's Voluntary Service and the Friends of the Sidcup Hospitals continue to work for all local hospitals. The Secretary to the Sidcup Hospital Management Committee informs me that plans are being prepared for the new hospital to replace the existing buildings at Queen Mary's. It has been agreed with the Ministry of Health that the beddage will be in the order of 500; that there will be greatly increased provision for chronic sick; that a maternity department and an ophthalmic department which will include a national centre for corneo-plastic work will be provided; and that in addition the new hospital will rank as a major accident centre. Grove Park Hospital. This hospital comes within the purview of the Lewisham Group Hospital Management Committee, and has only five blocks comprising 265 beds which come within the Urban District boundaries. 202 of these are used for tuberculous patients, whilst the other 63 are reserved for non-tuberculous thoracic cases. 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. COUNTY COUNCIL SERVICES. Ambulance Service. The district is served by the ambulance depot at Bromley, where at the present time, there are twenty-seven ambulances and twenty-two sitting case cars available. The majority of these vehicles are radio-controlled. There is also a sub-depot at Main Road, Sidcup. 26 Domestic Help Service. The District Organiser's Office is at 69, Sidcup Hill, Sidcup. The following is a summary of the cases assisted during 1959:— Maternity (Expectant Mothers) 104 Tuberculosis 2 Aged 233 Others 143 482 Family Help Service. This service is provided to deal with the care of children in their own homes when they are temporarily deprived of the care of their mother or a female guardian. Twenty-five cases were assisted during the year. Evening and 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. 27 cases received assistance in 1959. Child Help Service. Assistance under this scheme was given to 3 families in the area during 1959. Domiciliary Midwifery. Eight full-time midwives are employed in the area. Patients may obtain their services on direct application, or through their private doctor. Health Visiting. Twelve Health Visitors and School Nurses and three Tuberculosis Health Visitors are employed in the Urban District. District Nursing Service. Thirteen District Nurses work in the area. This service is provided on medical certification only and is free. No night service is in operation. 27 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. Ante-Natal Clinics and Child Welfare Centres. CHISLEHURST: The Willows, Red Hill Child Welfare Tuesday & Thursday p.m. Ante-Natal Wednesday p.m. Women's Welfare 2nd Tuesday a.m. Relaxation & Mothercraft Wednesday p.m. FOOTSCRAY: W. Smith Memorial Hall, Church Road Child Welfare Tuesday p.m MOTTINGHAM: K.C.C. Clinic, Kimmeridge Road Child Welfare Monday & Wednesday p.m. Ante-Natal Wednesday a.m. Relaxation Class Thursday p.m. SIDCUP: Congregational Church Hall, Station Road Child Welfare Monday & Wednesday p.m. Relaxation & Mothercraft Wednesday a.m. Ante-Natal Thursday 1.30—3.30 p.m First Aid Post, The Oval, Sherwood Park Avenue Child Welfare Tues., Wed. & Fri p.m. Ante-Natal Tuesday & Friday a.m. Women's Welfare 1st Thursday a.m. Relaxation & Mothercraft Thursday p.m. Wren Road Child Welfare Tuesday p.m. ST. PAUL'S CRAY: Health Clinic, Mickleham Road Child Welfare Monday & Thursday p.m. Ante-Natal Wednesday a.m. Parentcraft for Senior Girls Friday a.m. Relaxation Classes Tuesday p.m. Mothers Club Wednesday p.m. Rehabilitation Class — Old People Wednesday a.m. CHISLEHURST: The Willows, Red Hill Asthma Clinic 1st & 3rd Thursday a.m (By Appointment) 28 Dental Clinics. (all Dental Clinics by appointment.) CHISLEHURST: The Willows, Red Hill Mon., Wed. & Thurs. (all day) MOTTINGHAM: Kimmeridge Road Tuesday & Friday (all day) ST. PAUL'S CRAY: Mickleham Rd. Tuesday & Wednesday (all day) SIDCUP: 10, Station Road Mon., Tues., Wed., Thurs. & Fri. (all day) Domestic Help, Family Help and Old People's Service. District Organiser: Miss J. SMITH, 69, Sidcup Hill, Sidcup. Tel. FOOtscray 5521/2. Diphtheria Immunisation and Vaccination. 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 Monday & Thursday 2—3.30 p.m (alternate weeks) Minor Ailment Clinics (Schools). CHISLEHURST: The Willows, Red Hill Thursday 4—5 p.m. ST. PAUL'S CRAY: Mickleham Rd. Monday 4.30—5.30 p.m. SIDCUP: 10, Station Road Thursday 9.30—11.30 a.m. (Doctor attends 1st, 3rd and 5th Thursdays) Remedial Exercises. ST. PAUL'S CRAY: Mickleham Rd. Monday & Thursday a.m. Child Guidance Clinic. CHISLEHURST: The Willows, Red Hill Monday to Friday a.m. & p.m. (By Appointment) Speech Therapy. CHISLEHURST: The Willows, Red Hill Monday a.m. & p.m. (By Appointment) SIDCUP: 71, Sidcup Hill Monday to Friday a.m. & p.m. (By Appointment) Ophthalmic Clinic. CHISLEHURST: The Willows, Red Hill Monday a.m. (By Appointment) ST. PAUL'S CRAY: Mickleham Rd. Thursday a.m. (By Appointment) 29 Post-Natal—Women's Welfare Clinics. CHISLEHURST: The Willows, Red Hill 2nd Tuesday a.m. SIDCUP: The Oval, Sherwood Park Avenue 1st 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 Centres: Scads Hill House, Chislehurst Road, Orpington. During School Terms—Monday to Friday 10 a.m.—3.30 p.m. Montrose Residents Club, Hurst Road, Sidcup. 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. SERVICES RENDERED BY VOLUNTARY AGENCIES. British Red Cross Society. The local Headquarters of the Society is at Hornbrook House, Chislehurst, Mrs. A. Harvey being the Divisional Director and Mrs. E. M. Watling, Divisional Secretary. Nine detachments in the Chislehurst and Sidcup Division continue to operate wholly or partially within the Urban District, and training is undertaken in first aid and nursing, including the training of National Hospital Service Reserve personnel. V.A.D. Members of the Society, apart from attendance at many social and sports meetings, give service to the public by rendering first aid, especially from the Road Hut at Ruxley, on the Sidcup By-Pass, which is manned on Sundays and Bank Holidays. Auxiliary nursing is undertaken at Hospitals and invalids are escorted for long and short journeys. Cadet units for both boys and girls are attached to most detachments and they also assist in this work. In the home assistance is given to the sick and aged and diversional therapy is provided. Personnel also assist at Blood Transfusion Sessions. A Foot Clinic has now been established in Chislehurst for Old Age Pensioners and anyone requiring this service may contact Mrs. Henderson, The Chestnuts, Belton Road, Sidcup. 30 A store of sick room equipment is maintained and can be borrowed for a small charge from Hornbrook House, High Street, Chislehurst, on:— Mondays, Tuesdays, Wednesdays 3 p.m. — 4 p.m. Thursdays 11 a.m. — 12 noon Fridays 12 noon — 1 p.m. Saturdays 9 a.m. — 10 a.m. A sub-depot is also open at 34, Crescent Road, Sidcup, and 245, Beaconsfield Road, Mottingham. The Good Samaritan Club for disabled men and women meets at Hornbrook House on the second and fourth Fridays in each month at 2.30 p.m., and handicraft classes for the members are held at Hornbrook House on Tuesdays from 10—11.45 a.m. and at the Clinic, St. Paul's Cray, on each Wednesday, from 10—12 noon. A club for Deaf-Blind is held on the last Saturday in each month at Hornbrook House. The St. John Ambulance Brigade. The 97th Sidcup Nursing Division functions within the Urban District under the Divisional Superintendent, Mrs. O. Barton, and the Divisional Secretary is Miss H. R. Haley. Personnel with First Aid qualifications attend local cinemas and many other public gatherings. They also attend meetings and outings of the Old Age Pensioners Association and Rest-A-While Club. The Division is now helping the Cheshire Foundation Home in Bromley whenever possible. First Aid is rendered in case of road accidents by members stationed at the road hut on the Sidcup By-Pass in the Longlands area. Through the Division's Medical Comforts Fund, bath chairs, rubber sheeting, etc. may be hired for a nominal fee. Application for these may be made at the Drill Hall, Halfway Street, Sidcup, on Tuesdays at 8—10 p.m. and at other times by telephoning FOOtscray 7444. Women's Voluntary Service. This report has been furnished by the Metropolitan Kent County Organiser: "The W.V.S. Office is at Craybrooke House, Sidcup Hill. Sidcup. and the members are always ready to assist the public in any way they can. 31 General Welfare work—W.V.S. members visit elderly people in their homes, helping them with their shopping or in any other way that is necessary. Wheel chairs are available on loan. A "Sitters in" scheme for minding children is also arranged by the centre. Members help at Blind Clubs at Chislehurst and Sidcup—one afternoon a week at each club. On Tuesday evenings they help at the Blind Club which is run by the Blind—in this case they do escort work and give clerical assistance when required. Hospital work—Assistance is given daily in the out-patient department of Queen Mary's Hospital. Escort of patients, chiefly elderly people, is also undertaken. The Cray Valley Hospital Trolley Shop is still continuing its good work weekly. The W.V.S. now have a Darby and Joan Club with a membership of 56. The Meals on Wheels service has still not materialised, as there are many problems to overcome, but we hope, before the end of 1960, that the service will be a reality." CHISLEHURST AND SIDCUP OLD PEOPLE'S WELFARE COMMITTEE. The following is a brief resume of the work carried out by the Committee:— "Weekly Club meetings continue to be the backbone of the work for older people. Unfortunately, owing to lack of premises, the Albany Park Over 60 Club has been forced to close, but most of its members were able to be absorbed by the Jolly Rogers Club. "Redlac," Station Road, Sidcup. The original nine tenants still live in their flatlet homes. Boarding-Out Scheme. This scheme is now becoming much better known and more widely used. Many placings have been made—some temporary, some permanent. The Committee is always grateful to hear of offers of accommodation and landladies can always be assured of all possible help, both voluntary and statutory." SECTION C. SANITARY AND ENVIRONMENTAL CIRCUMSTANCES OF THE AREA. 34 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. Forty-five visits have been paid to the 29 premises. Sanitary accommodation was found to be insufficient in five cases and other defects were discovered in two instances. These matters received remedy. CESSPOOLS. Four new cesspools have been installed during the year, two of which were for new buildings where access to a sewer is not possible, and two in respect of improvements to existing private dwellings. Ten cesspools have been abolished. There are now 390 premises not connected to main drainage. Premises. Cesspools. Lamorbey and Blackfen 4 4 Sidcup and Footscray 5 5 North Cray 230 185 St. Paul's Cray 71 43 Chislehurst and Mottingham 80 72 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 309. During the year, a short length of sewer was constructed in Sevenoaks Way, providing main drainage to five dwellings previously on cesspools. It is hoped that sewerage works, to be carried out in 1960, in North Cray and in the Leesons Hill area, will effect a substantial decrease in the premises using cesspool drainage. The Council's cesspool emptying service continues to find favour and in spite of a small decrease in the total number of cesspools use of the service is on the increase. Not only are more owners taking advantage of the moderate charges made, but 35 cesspools generally are being emptied more frequently. The total quantity of effluent collected amounted to 1,444,800 gallons. Some difficulty has been experienced in finding suitable disposal points to discharge the contents of the emptying vehicle. Quarters Whole Year Mar. June Sept. Dec. 1959 1958 Individual cesspools emptied 113 152 114 111 211 206 No. of "jobs" including repeats 210 301 217 221 949 857 No. of loads removed 539 745 546 578 2,408 2,088 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 1958. It is principally designed to prevent disease in animals fed on swill. Plants at six premises are licenced and nineteen visits were paid to ensure that operation was satisfactory. DRAINAGE AND SEWERAGE. I am informed by the Engineer and Surveyor that new lengths of sewer have been completed, or adopted in private estate development as follow:— Foul Sewers of 6", 9" and 12" diameters, totalling 250 yds. Surface Water Sewers of 9", 12" and 15" diameters, totalling 386 yds. In addition, the Council completed in repairs and modifications of existing sewers, the replacement of lengths of new pipe:— Foul Sewers 9" diameters, totalling 85 yds. Surface Water Sewers 15" diameters, totalling 17 yds. Schemes have been prepared for Foul Sewers 6", 9" and 12" diameters, totalling 1,800 yds. Surface Water Sewers 9", 12" and 15" diameters, totalling 380 yds. FACTORIES ACTS, 1937 AND 1948. Public Health Inspectors have made 339 visits of inspection to factories, with and without mechancial power, and building sites, etc. which are controlled by these Acts. 37 nuisances or defects were dealt with, some in conjunction with H.M. Inspector of Factories. 36 The following is a copy of the return supplied to the local Inspector of Factories in respect of the year 1959:— 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 22 56 - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 162 236 7 - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) 20 47 2 - Totals 204 339 9 - * It was necessary to serve a statutory notice in one instance. 2. Cases in which Defects were found. Number of casts in which defects were Number of cases in which prosecutions were Instituted Found Remedied To H.M. Inspector By H.M. Inspector Want of cleanliness 4 4 - - - Overcrowding - - - - - Unreasonable temperature - - - - - Inadequate ventilation - - - - - Ineffective drainage of floors - - - - - Sanitary Conveniences: (a) Insufficient 3 4 — — — (b) Unsuitable or defective 26 25 — — — (c) Not separate for sexes - - - - - Other offences against the Act (not including offences relating to outwork) 4 4 — — — 37 37 — — — GAME ACT, 1831. During the year, three 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. 37 No accidents resulting from the use of heaters are known to have occurred in the district. PET ANIMALS ACT, 1951. Licences to sell pet animals were issued to proprietors of six premises. Supervision of these shops entailed eight visits and it was found that the sale of pets was on a 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 above Acts. Petroleum spirit and/or petroleum mixtures are stored at 64 premises, under licence. The total capacity is as follows:— Petroleum spirit in tanks 145,250 gallons. Petroleum mixture in tanks 9,660 gallons. Petroleum spirit in canned and approved stores 220 gallons. Petroleum mixture in canned and approved stores 2,470 gallons. Carbide of calcium 100 lbs. The year has seen great activity in connection with the enforcement of the Petroleum (Regulation) Acts 1928 and 1936. Two separate features have given rise to this position. Ten years ago fresh conditions were laid down governing the construction of petroleum pumps and their associated electrical equipment. All new pumps installed in the interim complied with these requirements and it was stipulated that existing pumps must be adapted or renewed by 1960. A great deal of this work was accomplished during 1959, involving 102 pumps. Following the issue in 1957 by the Home Office of a "Model code of principles of construction and licencing conditions," the annual licences granted by the Council were amended. Holders were given to understand that the clauses dealing with the testing of storage tanks and pipe lines, installed more than 20 years ago, must also be completed during 1959. This testing involved most garage premises, etc., in the district. It consisted of the disconnection of each tank, and the application of a seepage test. At the same time all suction lines were subjected to one or other of the appropriate tests. 87 tanks were dealt with. This work caused licence holders considerable expense and inconvenience, as the installation is of necessity put out of action for a period. Only one tank was found to be defective (at the joint where the pipe line entered it) and was easily repaired. Minor defects were also detected in two or three suction lines. 38 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. Compression of refuse within the vehicle is now an important factor to avoid the uneconomic use of transport. The number of premises cleared was in the region of 29,000 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 1,560,000 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 volume of refuse collected was in the region of 150,000 cubic yards. A further 13,000 cubic yards was received at the tip in the form of trade refuse, gully contents, street sweepings, trimmings from verges, etc. Kitchen waste amounted to 350 tons and was cleared chiefly from individual containers in Mottingham and Lamorbey areas and a number of schools. About 3,000 containers are in use. Disposal of the refuse was carried out at St. Paul's Cray Hill Park, where low lying ground is being reclaimed. 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. The demand for newspaper has improved; cardboard and mixed papers are in keen demand and so are textiles. 39 Trade Refuse. As there appears to be some misunderstanding regarding the clearance of this material, it is perhaps desirable to make the position clear. The removal of Trade Refuse can only be undertaken by the department, providing payment is made in accordance with the scale of charges laid down by the Council in order to comply with the provisions of the Public Health Act, 1936. Charges for Removal of Trade Refuse:— Small quantities—6d. per bin or skep. Large quantities—Charge based on cost involved. Bulk container—£16 per annum for one collection per week. The frequency of collection can be increased provided the extra cost is met by the trader concerned. Bulk Containers used in flats and other premises for storage of domestic refuse are emptied free of charge. The Bulk Container System has many advantages where the volume of refuse to be dealt with is equal to 8 to 14 normal sized bins. The above system was introduced to deal with refuse from flats, hospitals, hotels and other similar places in the district. Some of the main advantages are as follow:— 1. Improved storage. 2. The containers are emptied hydraulically, and the operation is dustless. 3. The containers cannot be interfered with by dogs or cats. Where the volume of refuse is substantial it does away with the need for a large number of bins, which can look untidy and, take up a lot of room. Description of Containers. Containers of up to cubic yards capacity are emptied on site into an SD Refuse Collection vehicle by an extremely simple method which does not involve any additional hydraulic gear or controls. Containers arc removed from chambers or other loading positions (where they stand on side sills) by a simple form of Jack Truck, by which they are lifted about 2" and transported to the rear of the vehicle adjacent to the lifting hooks. The safety catches are lifted and the container pushed against the lifting cradle when the catches are dropped over the container handle, after which no further action by the operator is necessary, the containers are lifted automatically from the truck by the forward tipping action of the body of the vehicle, and as the body lifts the 40 container is tipped through a dustless sealed aperture in the rear door of the body. The refuse from each container has the full available depth of the body into which it can fall, this provides a substantial degree of consolidation of refuse in the vehicle. When the body is again lowered, the container returns to the waiting Jack Truck and is automatically disconnected from the vehicle and can be immediately returned to the loading site. The total time for discharging each container into the vehicle is less than one minute from the arrival of the container on the truck to departure for repositioning on the loading site. Bulk Loading Vehicle. This consists of a modified SD Fore and Aft Tipping Refuse Collector of 16/18 cubic yards capacity, which is fitted with a special rear door carrying the necessary hooks for container attachment and automatic safety locking gear. The upper part of the door carries an aperture through which the mouth of the container enters as the body lifts, this being dust proofed by the use of simple double doors and a ring of rubber flaps. This arrangement forms a fully effective dust screen and seals the entry of the container before refuse commences to fall. The upper portion of the door is hinged and spring loaded, which can be lifted without effort and locked in an open position to present a standard loading rave and fall opening for use when discharging ordinary household bins at normal team loading rate from ground level. Discharge of the loading is by rear tipping, the rear door opening automatically as in the standard Fore and Aft Tipping vehicle. Containers. The containers are of 1 1/4 cubic yards capacity of 16 s.w.g. steel construction stiffened with angle and flat section bands, and carry the lifting bar for attachment to the vehicle. The whole being galvanised after welding. Dimensions, 4' 3" high × 3' diameter. Circular type, or alternatively with flat sides 2' 6" wide to suit narrow dust chambers, and are adapted to stand on concrete sills 24 1/2" to 25" apart × 8 1/2" to 9" high. Prevention of Noise. A new type of bin is now on the market fitted with rubber lid and rubber base. This is an attempt to reduce noise and it is hoped these will find favour with the public. Plastic bins are also coming to the fore, unfortunately they are easily damaged, particularly by hot ashes." 41 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. There are now four establishments from which horses are hired out for the purpose of riding. The animals, consisting of 30 horses and 46 ponies were inspected by the Veterinary Surgeon appointed for the purpose. Four visits were made and the animals were reported to be in good health. The Inspectors paid a further 30 visits. Improvements to stables have been carried out where necessary. RIVERS AND STREAMS. I am informed by the Engineer and Surveyor that apart from the normal maintenance of streams and rivers for which he is responsible, only the normal patrolling has been found necessary. The year was exceptionally dry, and only on one occasion did rainfall exceed 1" in 24 hours compared with five occasions in 1958. This was on 29th July when 1.03 inches fell. On 27th October the amount recorded was 0.94 inches. On the former date some flooding occurred, affecting mainly the highway at two points and in six private gardens. 1959 Rainfall. The rainfall figures for the year were:— January 2.53 ins. July 1.96 ins. February 0.37 ins. August 0.95 ins. March 1.785 ins. September 0.73 ins. April 2.16 ins. October 2.17 ins. May 1.29 ins. November 2.635 ins. June 0.83 ins. December 3.12 ins. Total for 12 months 20.53 ins. Considerable attention has been given by this Department, to the eradication of rats, which nest in the banks of the streams, as it is considered that such settlements can serve as a "reservoir" for vermin, which may then infest adjoining properties. Close watch is kept on the streams for signs of pollution and a total of 89 visits have been made to rivers and streams. 42 RODENT CONTROL. There has been a decrease in the rat population of the district. It is difficult entirely to account for this, but factors which may have brought it about include the flooding in 1958, and better techniques in the destruction of the rodents. The comparative freedom of the sewers from rats may be a condition influencing the decrease in surface infestation. It may also be that the prevalence or otherwise of these vermin, is in part, due to some natural cycle. The future will give a better indication of these trends. In the meantime it has been found possible to dispense with the services of one of the two Rodent Operatives. The following is a summary of the work carried out:— TYPE OF PROPERTY (1) Local Authority (2) Dwellings (including Council Houses) (3) Others Business (inc. L.A. Business) (4) Agricultural (6) Total II. No. of properties inspected as a result of:— (a) Notification (Complaints, etc.) 1 273 22 2 298 (b) Survey under Act (Visits as a result of (a), etc.) 2 380 10 - 392 (c) Otherwise (e.g., visits primarily for other purpose) - 3 - - 3 III. Total inspections carried out 17 267 86 1 371 IV. No. of properties inspected (in Sect. II) found infested: - - - - - (a) Rats (Major) — 9 1 — 10 (Minor) 2 396 16 2 416 (b) Mice (Major) 1 7 9 — 17 (Minor) - - - - - V. No. of infested properties (in Sect. IV.) treated by L.A 3 406 26 3 438 VI. Total treatments — including retreatment and those carried out privately to properties 4 406 26 3 438 VII No. of notices (verbal or written) under Section 4: (a) Treatment — 6 1 — 7 (b) Structural (e.g., proofing) — 11 1 — 12 X. No. of "Block" control schemes carried out - 7 - - 7 SEWER INFESTATION. As mentioned above the very minor infestation of sewers indicates a pleasing position. The test bait carried out in the Spring revealed the presence of rats in only 5% of manholes investigated. Traces of rodents were found in but three manholes during the second of the annual maintenance treatments in October. 43 Particulars of treatments are given below:— Number of Manholes treated No. of manholes in which "Complete takes" "Partial takes" "No takes" Test bait 210 8 2 200 1st Maintenance treatment (April) 34 8 4 22 2nd Maintenance treatment (Oct.) 38 1 2 35 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 5,268 Infectious Diseases 367 Food Premises. Sampling, etc. 4,050 Factories, Outworkers, etc. 339 Moveable Dwellings 489 Smoke Abatement 214 Shops Act 400 Rodent Control 993 Public Conveniences 680 Petroleum Acts 227 Miscellaneous 576 13,603 Written Notices issued:— Preliminary: General Sanitary Defects 146 Food Premises 60 Shop Premises 22 Factories, etc. 9 Rodent Control 13 Clean Air Act Notices 4 Statutory: Public Health Act 3 Factories Act 1937 and 1948 1 SHOPS ACT, 1950. The number of shops within the meaning of the Act, existing at the 31st December, 1959, was 854. They are situated as follow:— Lamorbey and Blackfen 260 Sidcup and Footscray 288 North Cray and St. Paul's Cray 105 Chislehurst and Mottingham201 854 44 Only a few new shops have been opened in the area during the year, but considerable reconstruction is being carried out to individual premises. Where possible shopkeepers are encouraged to incorporate a better standard of amenities for their employees in such premises. In a few cases, shops legally 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) and Mottingham. A few shops open on the usual early closing day and remain closed on Saturday afternoon. Again the Council decided to use its powers to suspend the general closing hours of shops prior to Christmas. Visits and observations total 400. The following infringements of the Act have been dealt with. Offences Found. Remedied. Notices and records 23 24 Sanitary accommodation (defective or insufficient) 32 30 Washing accommodation (defective or insufficient) 6 7 Closing 1 — Temperature 9 9 Sunday trading 17 17 Seats for female assistants 3 3 Light 2 1 CLEAN AIR ACT, 1956. Measurement of Atmospheric Pollution. There are installed within the district five instruments for the measurement of atmospheric pollution. Deposit gauges, for measuring the solid particles in the air, are situated at the Footscray County Primary School, Sidcup (Riverside Road), and at the County Primary Roman Catholic School, Sidcup (Lamorbey). The analysis of the matter collected is of particular value in determining the extent of pollution by cement flue dust. This substance is emitted from the concentration of cement factories situated on the 45 bank of the Thames between Dartford and Gravesend, and to a lesser extent from works on the river Medway. The problem is one of very long standing and the amount of pollution in this district at any time, is influenced by the quantity of cement being produced, the efficiency of the electro-static precipitators installed, and by the weather conditions prevailing. The Council was represented on the Thames-side Joint Committee for the Abatement of Atmospheric Pollution by Mrs. E. V. Wallace and Mr. A. V. Hatley, who played an active part in the representations being made to the Government, with regard to the nuisance created by the dust. Both gauges referred to above, indicated an increase in the total solid matter collected, when compared with the previous year, there being a high total of 19.25 tons to the square mile, during the month of September, at Riverside Road. The average deposit for each month from this gauge was 13.97 tons per square mile, and from that at Lamorbey 13.015 tons per square mile. Also installed at the two sites mentioned above are sulphur dioxide gauges, which indicate the extent of this pollutant gas in the atmosphere, from month to month. Generally speaking the higher readings for sulphur dioxide are obtained in the winter when conditions are conducive to the formation of fog. This is indicated more positively by the volumetric apparatus for the measurement of sulphur dioxide and tarry matter suspended in the air, installed at the Manor House. It gives daily readings and indicates that the early part of 1959 was characterised by persistently foggy conditions, whilst the autumnal months were well below the average in this respect. The Council were also represented on the Standing Conference of Co-operating Bodies in the Investigation of Atmospheric Pollution (by the same two Councillors) and on the London and Home Counties Clean Air Advisory Council (by Mrs. E. V. Wallace and the Chief Public Health Inspector). Smoke Control Areas. The Clean Air Act, 1956, envisages the eventual control of the emission of smoke from all sources, especially the chimneys of domestic premises. Some measure of financial assistance will be available to owners of properties required to adapt existing fireplaces, to enable them to burn smokeless fuel. A decision was taken during the latter part of the year to carry out a staged programme of Smoke Control Areas commencing with the Mottingham South Ward. Footscray County Primary School, Footscray. Monthly deposit in tons per square mile during 1959. Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Water (in rain in inches) 2.01 0.07 1.86 1.66 1.10 0.65 1.80 0.47 0.005 2.12 2.82 3.33 pH Value 4.79 — 6.52 7.26 7.22 7.90 7.14 7.98 — 7.16 5.34 7.33 Total water in soluble matter 6.66 5.88 4.88 4.67 6.73 7.77 7.02 3.94 7.81 5.93 4.05 3.12 Soluble in CS2 0.11 0.04 0.07 0.08 0.09 0.07 0.05 0.06 0.05 0.07 0.10 0.06 Ash 4.29 4.03 3.35 3.50 5.69 3.53 4.76 3.30 6.23 4.17 2.47 2.18 Other combustible matter 2.26 1.81 1.45 1.09 0.95 2.17 2.21 0.58 1.53 1.68 1.48 0.88 Total water soluble matter 8.29 9.98 7.05 7.05 10.64 6.43 6.91 6.11 11.44 8.26 7.92 9.13 Ca + + 0.87 2.18 1.01 1.21 2.15 1.34 1.34 1.21 1.91 0.94 1.07 1.07 CI' 1.41 0.62 1.01 0.81 0.70 0.54 0.67 0.42 0.92 1.31 1.61 1.95 SO"4 2.74 5.26 3.16 3.42 3.74 2.07 2.77 1.77 4.13 2.98 2.49 3.20 Total solids 14.95 15.86 11.92 11.72 17.37 14.20 13.93 10.05 19.25 14.18 11.97 12.25 Sulphur dioxide (milligrams of S.O.3 per day collected by 100 sq. cms. Pb.O2) 3.42 3.39 1.27 1.54 1.23 0.84 0.86 0.80 1.32 1.21 1.46 1.63 46 County Primary Roman Catholic School, Sidcup. Monthly deposit in tons per square mile during 1959. Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Water (in rain in inches) 1.88 0.05 2.04 1.67 1.03 0.51 1.27 0.49 0.015 1.80 2.42 3.31 pH Value 4.77 — 5.37 6.37 7.28 7.95 7.21 7.90 — 7.12 4.88 6.34 Total water in soluble matter 7.11 5.26 4.70 4.72 8.62 8.65 7.01 4.66 8.55 5.96 3.55 2.95 Soluble in CS2 0.17 0.08 0.09 0.11 0.08 0.07 0.05 0.06 0.05 0.09 0.09 0.06 Ash 4.91 3.64 3.29 3.32 6.92 6.51 5.07 3.40 6.79 4.32 2.27 1.98 Other combustible matter 2.03 1.54 1.38 1.29 1.61 2.06 1.89 1.21 1.71 1.55 1.19 0.91 Total water Soluble matter 6.91 7.77 6.41 6.14 9.75 6.23 5.77 6.16 8.12 7.99 6.31 6.78 Ca + + 0.81 1.64 1.34 0.87 2.08 1.34 1.21 1.28 1.41 1.34 0.67 0.67 CI' 1.34 0.65 0.87 0.81 0.65 0.54 0.60 0.44 0.72 1.17 1.54 2.01 SO"4 2.38 4.15 2.57 2.49 3.68 2.11 2.32 2.04 2.90 2.82 1.38 2.49 Total solids 14.03 13.03 11.11 10.86 18.37 14.87 12.87 10.82 16.68 13.95 9.86 9.73 Sulphur dioxide (milligrams of S.O.3 per day collected by 100 sq. cms. Pb.O2) 4.34 3.42 1.88 1.94 1.75 1.16 0.98 1.35 1.49 1.93 2.11 2.08 47 48 49 50 51 52 53 SWIMMING BATHS. There are three swimming pools in the area, to which twelve visits were made. All use mains water. 1. A small privately owned open air bath, available to the public only on a limited scale mainly by appointment for swimming lessons, is used only when the weather is suitable. The water is chlorinated by the addition of chloride of lime and is cleaned manually. In a normal summer season the pool is emptied and refilled three times. Samples have been collected from this bath for many years. Two taken during 1959 were satisfactory. 2. An outdoor pool attached to a factory, used mainly in the evening by the workers there and not open to the public. The bath is fitted with plant, working continually which provides for filtration, aeration and chlorination. A change of water is effected twice in every 24 hours. Two samples taken during the year were satisfactory. 3. An indoor pool situated at a Children's Home, owned by the London County Council, is used by the children there and by those attending other schools in the area. A purification plant is installed providing for chlorination, filtration and heating. Water circulates every eight hours whilst the pool is in use. Copies of reports on six samples taken by the owners, reveal the water to be kept in good condition. VERMINOUS CONDITIONS AND INSECT PESTS. Twenty-two complaints were received alleging the presence of vermin (bed bugs, fleas, etc.) and 59 visits were paid to the premises concerned and to others. In 22 cases insect infestation was found and the necessary treatment, using one of the residual insecticides, was applied. Seven of these treatments were carried out to premises under the control of the Council and a further six prefabricated bungalows were sprayed as a precautionary measure. Weather conditions obtaining during the summer gave rise to exceptionally large numbers of garden insect pests, which can be troublesome when they invade the dwelling. Ants were numerous and no fewer than 141 instances of wasps nests were drawn to the attention of the Department. WATER SUPPLY. The supply of water to the district is from the mains of the Metropolitan Water Board. In one case only are there premises where water is obtained from a private source. Six samples of 54 water taken from three wells in the district all proved to be satisfactory. Five samples were taken by the Department and submitted for bacteriological examination and one for chemical analysis. All were reported to be satisfactory. Complaints were received, towards the end of the very dry summer, of lack of pressure in mains in certain parts of Chislehurst. It was said that this was due to excessive watering of gardens. There were no extensions to the Board's trunk or service mains during the year, but a programme of laying new mains and renewing others, in the areas affected, has just been announced. The following tables show results of samples collected during the year and are provided by the Director of water examination to the Metropolitan Water Board:— 55 Average Results of the Chemical Examination of the water supplied to the Urban District of Chislehurst and Sidcup during 1959. Milligrammes per litre (unless otherwise stated). Description of the Sample Bexley Eynsford Orpington North Orpington Shortlands Wilmington Thames derived No. of Samples 4 8 4 4 13 5 386 Ammonia Nitrogen .008 .009 .010 .014 .009 .012 .030 Albuminoid Nitrogen .031 .026 .020 .027 .024 .026 .074 Oxidised Nitrogen—Nitrite — — — — — - - Oxidised Nitrogen—Nitrate 5.4 4.1 6.9 5.0 5.0 8.5 3.6 Chlorides as Cl. 18 16 16 14 16 22 28 Oxygen abs. from Permanganate 4 hrs. at 27°C. 0.10 Nil 0.02 0.06 0.06 0.08 1.04 Turbidity in terms of Silica Nil Nil Nil Nil Nil Nil 0.4 Colour m.m. brown 2 ft. Tube Burgess's Tintometer Nil Nil Nil Nil Nil Nil 9 Hardness (Total) 298 258 278 262 278 288 254 Hardness (non-carbonate) 60 34 44 30 64 58 56 pH Value 7.2 7.2 7.2 7.2 7.2 7.1 7.8 Phosphate as PO4 — — — — — — 0.90 Silicate as SiO2 — — — — — — 9 Potassium as K 2.0 1.4 1.6 1.7 1.8 2.3 - Sulphate as SO4 — — — — — — 54 Fluoride as F — — — — — — 0.2 Magnesium as Mg — — — — — — 4.0 B.O.D. 5 days at 20°C. — — — — — — - Electrical Conductivity (gemmhos) 575 475 525 475 525 550 525 56 Average Results of the Bacteriological Examination of the water supplied to the Urban District of Chislehurst and Sidcup during 1959. Source of Supply Bexley Eynsford Well Eynsford Borehole Orpington North Orpington Shortlands No. 1 Shortlands No. 2 Shortlands No. 3 Wilmington No. 1 Wilmington No. 2 Thames derived Before Treatment Number of Samples 250 229 175 252 245 65 187 251 137 152 — Agar plate count per ml. 20-24 hours at 37°C. 1.0 0.1 0.1 0.2 2.3 0.1 0.1 0.4 0.7 2.0 - 3 days at 22°C. 4 9 3 3 23 1 2 3 44 95 - Coliform count Percentage samples negative in 100 ml. 99.20 81.22 100 93.25 17.55 100 100 100 75.91 86.18 - Count per 100 ml. — 1.4 — 0.2 20.0 — — — 0.3 0.2 - Escherichia coli count Percentage samples negative in 100 ml. 100 99.13 100 99.60 33.47 100 100 100 95.62 96.05 - Count per 100 ml. — — — — 10.0 — — — — 0.1 - After Treatment Number of Samples 255 258 257 250 257 257 3.344 Agar plate count per ml. 20-24 hours at 37°C. 0.3 0.1 0.1 0.9 0.2 0.1 9.8 3 days at 22°C. 2 25 7 2 1 0.2 — Coliform count Percentage samples negative in 100 ml. 99.32 100 99.22 100 100 99.61 99.46 E. coli count Percentage samples negative in 100 ml. 100 100 99.6 100 100 99.6 99.97 SECTION D. HOUSING. 58 SECTION D. HOUSING. (i) Routine Inspections: Three hundred and twenty-seven visits to premises were made in connection with the Housing Acts. (ii) Clearance Areas: No Clearance Area was declared during the year. (iii) Individually Unfit Houses: Three flats were closed as a result of a Closing Order. (iv) Demolition Orders: A Demolition Order was made in respect of one house. A Demolition Order was substituted for a Closing Order in respect of another house. (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., 1959 Area 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 No. of cases found during the year No. of cases remedied during year Cases at end of year No. of cases No. of persons concerned Aged over 10 Aged under 10 Lamorbey 6 7 11 9 5 2 2 2 4 3 4 3 2 1 1 — 1 6 1 Longlands 1 1 - - - - - - - - - - - - - - - - - Birchwood — 1 1 - - - - - - - - - - - - - - - - Frognal — 1 1 1 - - - - - 1 1 2 1 1 — 1 - - - North Cray 1 1 3 1 1 - - - - - - - - - - - - - - St. Paul's Cray 6 4 5 3 3 2 2 4 4 3 3 2 1 2 2 2 2 5 4 Chislehurst Common 1 3 6 3 1 1 1 1 — — — — — 1 — — 1 2 4 Mottingham 15 6 15 26 17 13 10 10 11 5 5 4 5 2 - 2 - - — Totals 30 24 42 43 27 18 15 17 19 12 13 11 9 7 2 5 4 13 9 (vi) Defects: Number of houses inspected for housing defects (Public Health and Housing Acts) 1,140 Number of houses found not in all respects fit 455 Number of houses made fit without service of formal notices 442 59 SLUM CLEARANCE. The Clearance Area comprising 1—12 School Cottages, declared in 1958, has not yet been vacated, but it is hoped that the tenants will soon be rehoused. During 1959 the following formal action was taken:— Church Cottage, Church Road, Footscray (in the ownership of the Council), was declared unfit and subsequently demolished. Three first-floor flats above shops known as Nos. 7 and 9 Cray Road, Footscray, were closed by agreement with the owner. No. 5 Cray Road, Footscray (closed in 1957), was found to be in a dangerous condition and a Demolition Order was substituted. No. 68 Corbylands Road, Sidcup, found to be unfit and not repairable at a reasonable cost, was closed. HOUSING ACT, 1949. During the year 113 schemes were submitted, of which 72 were approved, including one conversion scheme. Of those approved 13 were in respect of standard grants. Improvements effected were mainly for the provision of bathrooms and hot water systems. The total cost of the works involved amounted to £21,373. RENT ACT, 1957. CERTIFICATES OF DISREPAIR. There has been a very considerable decrease in the number of premises for which Certificates under the Rent Act have been supplied. Eighty-nine were dealt with in the last four months of 1957 when the Act came into force. In the whole of 1958, the corresponding figure was 72, whilst in the current year the number fell to 27. In addition to this last mentioned number, cancellations of Certificates of Disrepair and other statutory documents in connection with previous applications, continued to be dealt with. Number of applications for certificates 27 Number of decisions not to issue certificates Nil. (one application withdrawn) Number of decisions to issue certificates: (a) in respect of some but not all defectns 10 (b) in respect of all defects 13 Number of undertakings given by landlords under paragraph 5 of the First Schedule 18 Number of undertakings refused by Local Authority under proviso to paragraph 5 of the First Schedule — 60 Number of certificates issued 6 Number of applications for cancellation of certificates 22 (including 6 in respect of certificates issued under the Housing Repairs and Rents Act 1954.) Number of objections by tenants to cancellation of certificates 8 (two subsequently withdrawn.) Decisions by Local Authority to cancel in spite of tenants objection Nil. Certificates cancelled by Local Authority 15 Number of applications by landlords or tenants for certificates as to the remedying of works which the landlord has undertaken to remedy 12 Number of such certificates issued 16 New Houses. The following table shows the number of new houses and flats erected during the year:— New Houses. New Flats. Erected by Council 117 12 Erected by Private Developers — 120 by Conversion 48 18 Totals 165 150 315 dwellings. Council Houses. The following information has been supplied by the Housing Manager:— Prior to 1959. During 1959. Houses. Families in occup. Houses (Let) Families in occup. 1. Permanent dwellings built by Local Authority 1,855 1,855 139 1,994 2. Prefabricated dwellings built by Local Authority 251 248 0 209 (3 families occupy two bungalows each) 3. Premises requisitioned by Local Authority 58 56 2 2 4. Halfway Houses 5 18 2 8 During 1959 there were 298 lettings as follow:— (a) Permanent dwellings 106 families from waiting list. (b) Prefabricated dwellings 24 families from waiting list. 130 61 The figures of 298 lettings includes 168 transfers which have been effected from various types of Council controlled property. During the year 14 families have been admitted to the Halfway Houses. 5. The total number of families on the waiting list as at the 31st January, 1960:— Couples 436 Families requiring two bedrooms 552 Families requiring three bedrooms 412 Families requiring four or more bedrooms 26 Old Age Pensioners and single persons 229 1,655 Applicants passed for accommodation 42 Families in requisitioned premises 2 1,699 During the year, 56 properties have been released from requisition and 39 temporary bungalows on the Chalk Pit Estate were demolished in connection with the permanent development now taking place. MOVEABLE DWELLINGS. Existing legislation covering the use of tents, vans and sheds for human occupation has not proved effective. Neither the licensing provision of the Public Health Act, 1936, nor the Town Planning Act gave sufficient powers to secure proper control in certain instances. The Government has now introduced fresh planning legislation which, if passed by Parliament, may provide for control of future sites and the gradual reduction of existing unsuitable encampments. The district has suffered from the effects of this unsatisfactory legislation. In 1957, Corke's Meadow site was eliminated only by the rehousing of all inhabitants, a solution which still leaves residual problems of fitting the caravan dweller into his new environment. In the early part of the war, following bomb damage, some of the dwellers at Corke's Meadow took their caravans to the Chalk Pit at Ruxley. It was not expedient to have them removed at that time, but control was exercised over them, as far as possible, by the issue of licences, under the Public Health Act. In post-war years the number of dwellers has increased and in spite of every effort being made by the Council, and in latter years by the owner, the growth of the site has continued and brought with it a multiplication of unsatisfactory conditions. 62 The matter has been before the Public Health Committee constantly and it was decided to set up a joint sub-Committee to keep the position under review. The number of families in residence in the Pit and on the ground adjoining, at the end of the year, was 37 compared with 27 a year before. The persons living there amounted to 172. Other sites in the district are on a very much smaller scale, the largest containing four families. Most of these caravan dwellers hold an annual licence under the Public Health Act and have Town Planning permission. Others are exempt, but in no instance is nuisance being caused. The position at the end of the year was as follows:— Site Average number of families Approx. number of persons Whether licensed Smallgain's Farm 2 4 Yes Ruxley Manor Farm 1 2 Yes Birchwood (adjoining Bull Hotel) 1 3 Yes Lower Hockenden Farm 2 3 1 L., 1 N.L. Old Brickfield. Baugh Estate 2 5 Yes Twysdens Meadow 3 10 2 L., 1 N.L. Conservative Club, Sidcup 1 2 Yes Greenwood Nursery, Parsonage Lane 1 2 No Oakleigh Park Avenue, Chislehurst 1 2 Yes Hillside Nursery, Maidstone Road 4 14 No Chalk Pit. Ruxley 28 132 No Ground Adj. Chalk Pit, Ruxley 9 40 No Yard R/o White House, Church Road 3 6 No Itinerant caravaners of the gipsy type, are apt to station their dwellings on the verge of the trunk road A.20 or on any spare land in the vicinity. Action to secure their removal is taken, in conjuction with the owners of the land, in instances where the stay is prolonged. SECTION E. INSPECTION AND SUPERVISION OF FOODS. 64 SECTION E. INSPECTION AND SUPERVISION OF FOODS. INSPECTIONS. There are 533 premises in the district at which food is prepared, or where it is stored or from which it is sold. Details of the different categories are given later in this section. Since the Food Hygiene Regulations were issued in 1955, supervision of food premises and the processes carried out in them, has taken an increasing percentage of the Inspectors' time. Thus by 1957, 2,592 visits were made in this connection. A year later the total reached 3,197 and the figure for 1959 amounted to 4,050. The nature of the work accomplished during these visits has changed. In the early days of the Regulations it was necessary to enforce the structural requirements set out, the most important of which was the provision of hot and cold running water, sinks and wash basins. This has now been accomplished, although, from time to time, defects occur and must be remedied. Thus the number of defects dealt with during the year has dropped from just over 500 to 380, necessitating the service of 116 informal notices. The nature of food premises varies from the large school and factory canteen, down to the fruit stall or small sweet shop. These premises must comply with the Regulations, but more important is the necessity for the changing staffs to be fully aware of their obligations under the Regulations, and the reasons why hygienic habits and methods should be strictly adhered to. There has been a welcome tendency to modernise food shops and it is found that excellent equipment, from the food hygiene point of view, is usually installed. By arrangement with the Engineer and Surveyor, all plans of food premises are examined by the Inspectors and usually suggestions for improvements are accepted by the owners. FOOD COMPLAINTS. The majority of food sold in the shops is now produced on a large scale in factories, which may be distant from the consumer. Much of this is prepacked, and greatly facilitates hygienic transport and handling. It does not, however, obviate the necessity for care in preparation, as is indicated by the number of complaints received concerning abnormalities or, the discovery of foreign matter in food. 65 During the year these totalled 52, although on investigation not all were substantiated. As usual the staple commodities of bread (22) and milk (13) were most often brought to notice. The common complaint regarding milk was due to the discovery of foreign matter such as cement, adhering to the glass of the bottle. Such complaints originated due to misuse of the bottle by a previous customer and the failure of the Dairy to notice that the bottle washing plant had failed to remove the matter. Complaints concerning bread and flour confectionery became so numerous that the Committee decided that letters should be addressed to all persons, baking and handling these products, asking for co-operation in preventing such occurrences. This had a salutary effect and although instances have not ceased, they have become less frequent. Amongst the articles found in bread, etc., were oil, grit, metal and wood. There were also a number of instances of loaves being sold in a mouldy condition. Other items of food which were the subject of complaint were: (a) Unpleasant taste of mineral water (tainted by a stopper). (b) Insects in imported cheese and tinned fish. (These matters were subsequently raised with the authorities in the exporting countries). (c) Bitter vegetable marrow. (Due to natural causes). Prosecutions under the Food and Drugs Act were instituted as follow:— Oil and cotton wool in bread—fined £30, plus £5 5s. costs. Lubricating oil in bread—fined £30, plus £5 5s. costs. Mould growth in milk—fined £15, plus £5 5s. costs. Mouse droppings in bread—fined £15, plus £3 3s. costs. Mould growth in bread—fined £40, plus £3 3s. costs. Mould growth in milk—fined £25, plus £10 10s. costs. Mould Growth in meat pie—fined £25, plus £5 5s. costs. Metal in bread—fined £10, plus £10 10s. costs. 66 FOOD AND DRUGS ACT, 1955. FOOD SAMPLING ARTICLE Number Examined Number Unsatisfactory Formal Informal Formal Informal Arrowroot 1 - - - Baking Powder 1 2 — — Bread — 9 — 9 Bun — 1 — 1 Butter 8 — — — Buttered Cheese 1 — — — Cake and Pudding Mixtures 5 1 — — Cereals 14 — — — Cheese Spread 2 1 — 1 Chocolate Sweets — 1 — — Chocolate Tea Cakes 1 — — — Colouring 1 — — — Cream — 7 — — Cream Cake — 1 — 1 Creamed Rice Pudding — 3 — 1 Curry Powder 1 — — — Custard Powder 1 2 — — Drugs 1 7 — — Fish (Tinned) 1 3 — 1 Flour 6 2 — — Fruit (Dried) 14 1 — 1 Glucose 1 — — — Herbs (Mixed) 1 1 — — Ice Cream — 10 — — Ice Lollies — 1 — — Jelly 1 4 — — Lard 7 — — — Margarine 1 — — — Marzipan 3 — — — Meat (Tinned) 3 2 — 1 Meat and Fish Paste 4 — — — Meat Pies 3 2 — — Meat Puddings — 2 — — Milk — 33 — 3 Milk (Condensed) — 1 — — Milk (Dried) — 1 — — Nuts (Ground) 4 — — — Peanut Butter 1 — — — Plum Pudding 1 — — — Peel (Mixed) 1 3 — — Preserves 9 — 1 — Pulses 12 4 1 — Saccharin Tablets — 2 — — Sauces — 3 — — Sausages 7 — 1 — Sausage Rolls 1 — — — Soft Drinks — 2 — 2 67 Soup 3 2 — — Spaghetti (Tinned) — 1 — 1 Spices 1 7 — — Spirits 6 — — — Suet (Shredded) 5 — — — Sugar 3 — — — Tea 8 1 — — Vegetable Marrow — 1 — 1 144 124 3 23 Unsatisfactory Samples, etc. Serial No Article Formal/ Informal Nature of adulteration etc. Observations Q.49 Bread Informal Contained lubricating oil and a small piece of dirty cotton wool. Firm prosecuted and fined £30 with costs. Q.50 Bread do. Contained an ½" length of course thread of either string or sacking. Warning letter sent to baker. New sieve installed. Q.63 Bread do. Contained lubricating oil. Firm prosecuted and fined £30 with costs. R.4 Bread do. Contained foreign material of nature of coal. Warning letter sent to Baking Company. R.12 Bread (Wholemeal) do. Base of loaf was contaminated by bakehouse "char." ditto. R.19 Bread do. Contained charred dough. ditto. R.20 Bread (Wholemeal) do. Contained three Rodent droppings. Baker prosecuted. Fined £15 with £3 3s. costs. S.60 Bread do. Contained needle, but not possible to ascertain whether needle had been baked in loaf. No action. R.42 Bread Roll do. Contained slight traces of "bakery char." Warning letter sent to Baking Company. Q.84 Hot Cross Bun do. Contained three small fragments of stone. ditto. Q.64 Cheese Spread do. Of poor commercial quality. Manufacturers have withdrawn stock and altered method of manufacture. R.61 Chewed Cream Horn Cake do. Nasty taste due to oxidative rancidity of the fat. Matter drawn to attention of baker. R.100 Creamed Rice Milk Pudding do. Contained 10% added water. Manufacturers informed. No legal standard. 68 R.11 Tuna Fish do. Contained green bottle fly which had been subject to a heating process. Representations made to importers and Government of country in which canning took place. Q.36 Currants do. Sugar crystallisation and fermentation — unfit for use. Stock withdrawn from sale. R.80 Stewed Steak (Tinned) do. Meat tainted. Matters drawn to attention of manufacturer. R.3 Milk (Pasteurised) do. Milk contained darkish bodies consisting of milk films permeated by mould hyphæ. Dairy Company prosecuted. Fined £15 with £5 5s. costs. R.91 Milk (Channel Islands) (Pasteurised) do. Mould in milk and film on bottle. Dairy Company prosecuted. Fined £25 and £10 10s. costs. S.12 Milk (Pasteurised) do. Contained small lump of calcoreous matter. Referred to Local Authority in whose area the bottling plant is situated. R.79 Peach Jam Formal Contains 67.8% soluble solids with probable fruit content not more than 35% (low). Further sample satisfactory. R.63 Dried Peas do. 7% of peas showed signs of insect attack. Stock withdrawn from sale. R.18 Sausages, Beef do. Meat content 50% of which 28% was fat. Proportion of fat too high and meat content borderline. There is no legal standard for sausages. Further sample from same source was satisfactory. Q.35 Cream Soda Mineral Water Informal Odour due to sulphuretted hydrogen (H2S). Derived from stopper. Manufacturers now use new type of stopper in more stable material. R.81 Rivella Health Drink do. The description "lactoserum" is neither a dictionary nor a scientific word. Makers have agreed to substitute term "deproteinised whey." Further sample to be taken. S.76 Spaghetti with Tomato Sauce and Cheese do. Contained fly which had been cooked. No action. S.20 Vegetable Marrow do. Intensely bitter. A rare natural habit of the marrow plant. No further fruits from plant sold. 69 UNSOUND FOOD. A total of 4 tons, 11 cwts. 1 qr. 20 lbs. of food unfit for human consumption was surrendered to Inspectors during the year. Details of the various items are given below. Item. tons. cwts. qrs. lbs. Bacon 2 2 10 Butter 2 Cake 8 Canned Fish 1 2 19 Canned Fruit 1 — 3 17 Canned Jam 2 Canned Meat 17 1 15 Canned Milk 2 3 2 Canned Soup 1 20 Canned Syrup 6 Canned Vegetables 19 1 10 Cheese 20 Currants 18 2 27 Dried Fruits 1 2 9 Fish 1 3 25 Margarine 1 3 Meats (cooked) 4 Meats (fresh) 2 2 24 Sausages 2 14 Suet 2 Sweets 5 4 11 1 20 Where the items concerned are suitable for the purpose, they are supplied to a local pig keeper and used as animals feeding stuff, following treatment by him. Seven hundred and fifty-four 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. 70 FOOD AND DRUGS ACT, 1955—SECTION 16. The premises in the area, registered under the above Act, are:— No. of Premises Registered. IceCream. Mfr. of Sausages. Cooked Ham. Bakers' shops 3 1 — Butchers' shops — 46 — Fishmongers (wet and dried) 6 — — Greengrocers' shops 7 — — Grocers 57 1 5 Restaurants and Cafes (for consumption off the premises) 22 - - Sweet shops, confectioners 78 - — Others 3 - — 176 48 5 FOOD PREMISES. There are some 533 food premises in the area, made up as under:— Bakers 17 Bakers and Bakehouses 12 Butchers 56 Dairies 4 Fishmongers (wet and dried) 12 Fishmongers (wet, dried and fried) 9 Fishmongers (fried) 3 Greengrocers' shops and stalls 66 Grocers 134 Ice Cream premises, other than those included in (1), (2), (4), (8), (9) and (13) but including confectioners 78 Public Houses and Hotels with catering facilities 16 Public Houses without catering facilities 15 Restaurants, Cafes 33 Works Canteens 13 School Canteens, etc. 46 Private Canteens 10 Confectioners (not included in 10) 9 533 Fourteen Dairy premises are registered in the district and eighteen 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 1959:— Dealers. Supplementary. Pasteurised 23 15 Sterilised 26 14 Tuberculin Tested Pasteurised 17 14 71 BACTERIOLOGICAL EXAMINATIONS. Twenty-five samples of designated milk were taken with the following results:— Number passing phosphatase test 25 Number failing phosphatase test — Number passing methylene blue test 25 Number giving unsatisfactory methylene blue result — Number passing the turbidity test (sterilised) — Twenty-six samples of milk were submitted for chemical examination, all of which proved satisfactory. ICE CREAM. Ten samples were taken during the year. Eight were placed in Grade I, one in Grade II, and one in Grade III. PIGGERIES. There are eleven piggeries in the district. This indicates a decrease on the year, and is part of a trend against pig keeping on a small scale, noticeable since shortly after the war. Approximately 1,553 pigs are kept, one large piggery accounting for 1,000 animals. 34 visits were paid to these piggeries. SECTION F. PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. 74 SECTION F. PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. General. Of the total notifications received during the year, 1,127 referred to measles, leaving only 264 others, which is an exceptionally low figure. In common with the rest of the country, the incidence of anterior poliomyelitis in a year in which weather conditions might have encouraged its spread, was very low but it is regrettable that both the cases that did occur were serious ones. The complete absence of typhoid and para-typhoid fevers combined with a low incidence of dysentery were matters for congratulation. One is thankful to be able to record another year without a single case of diphtheria being notified, but no excuse is offered for stressing once again the urgent necessity of keeping up the immunisation rate if we are to avoid getting cases which indeed have occurred in the Greater London Area during the past year. Acute Anterior Poliomyelitis and Vaccination. Only two cases of this disease occurred in the area during 1959, as against seven in the previous year. Both of these cases were of the paralytic type and were admitted to hospital. The County Medical Officer has kindly supplied the following information with regard to the number of residents in the Urban District who were vaccinated against poliomyelitis during 1959 :— Year of Birth Given second injections. Given third injections 1959 139 — 1958 984 460 1957 241 661 1956 188 612 1955 167 544 1954 195 624 1953 187 583 1952 209 539 1951 184 564 1950 183 573 1949 193 623 1948 225 702 75 1947 287 818 1946 272 1,000 1945 182 704 1944 239 680 1943 231 382 Before 1943 3,742 1,299 Others 659 289 Total 8,707 11,657 Diphtheria and Diphtheria Immunisation. Once again I am pleased to be able to report a complete absence of this disease in the Urban District during 1959. The County Medical Officer informs me that of the children resident in the area who were born since 1945, a total of 1,126 received primary inoculations and 667 received re-inforcing inoculations during 1959. A total of 17,889 children under the age of fifteen years on 31st December, 1959, have completed a course of immunisation at some time prior to that date. Dysentery. Ten cases were notified as against twelve in the previous year. Food Poisoning. A total of twenty-seven confirmed cases of food poisoning occurred in the area during 1959, as against twelve in the previous year. There were no serious outbreaks of this disease, the majority of the cases reported being isolated ones. The following is a copy of the annual return rendered to the Ministry of Health :— 1. Local Authority: Chislehurst & Sidcup Urban District Council. Year: 1959. 2. (a) Food Poisoning Notifications (Corrected) as returned to Registrar General: 1st Quarter. 7 2nd Quarter. 10 3rd Quarter. 4 4th Quarter. 6 Total. 27 (b) Cases otherwise ascertained : 1st Quarter. 7 2nd Quarter. 3 3rd Quarter. 4th Quarter. 2 Total. 12 (c) Symptomless Excreters: 1st Quarter. 2nd Quarter. 3rd Quarter. 1 4th Quarter. Total. 1 (d) Fatal Cases: Nil. 76 3. Particulars of outbreaks: Agent No. of Outbreaks No. of cases Total No. of cases Family outbreaks Other outbreaks Notified Otherwise ascertained Agent identified (a) Chemical Poisons (type to be stated) Nil (b) Salmonella (type to be stated) Typhi-murium 1 — 2 — 2 Thompson 2 — 5 — 5 Newport — 1 3 1 4 Enteriditis 1 — 1 2 3 (c) Staphylococci (including toxin) 1 — 1 1 2 (d) Cl.botulinum — — — — — (e) Cl.welchii — — — — — (f) Other bacteria (to be named) - — — — — Totals 5 1 12 4 16 Agent not identified 3 2 12 9 21 4. Single Cases: Agent No. of cases No. of cases Notified Otherwise ascertained Agent identified (a) Chemical Poisons (type to be stated) - - Nil (b) Salmonella (type to be stated) Typhi-murium 2 2 Enteriditis 1 — 1 (c) Staphylococci (including toxin) - - - (d) Cl.botulinum — — — (e) Cl.welchii — — — (f) Other bacteria (to be named) — — - Totals 3 — 3 Agent not identified - - - 5. Salmonella Infections, Not Food-Borne: Salmonella (type Outbreaks No. of cases (outbreaks) Single cases Total No. of cases (outbreaks & single cases) Family Other Totals Nil 77 Measles. As was to be expected after a year of low incidence of this disease, notifications rose sharply in 1959, there being 1,127 cases notified as against one hundred and forty-five in 1958. One death from this disease was recorded in the area during the year under review, and ten cases were admitted to Hospital for varying reasons. The outbreak which reached its peak in the spring of the year was once again predominately mild. Meningococcal Infections. Three cases were notified and one of these was admitted to hospital. No deaths were recorded. Pneumonia. Forty-two cases were notified in 1959, as against thirty-nine during 1958. There were fifty-five deaths attributed to pneumonia, but this figure includes people who are normally resident in the Urban District and who died outside the area. Scarlet Fever. Notifications of this disease showed a reduction in 1959, a total of seventy-seven cases being notified as against eighty-nine in 1958. There were no deaths from this disease recorded in the area during the year under review. Thirty-seven cases were admitted to hospital but in the majority of instances this infection is now of an extremely mild nature. Smallpox and Vaccination. No cases of this disease occurred in the district in 1959, but one contact was kept under surveillance for the requisite period during the year. The policy of offering re-vaccination to all members of the staff of the Health Department was maintained. Four hundred and forty International Certificates of Vaccination were dealt with by the Department during the course of the year. The County Medical Officer informs me that a total of 998 residents in the area received primary vaccination and 52 re-vaccination in 1959. Tuberculosis. The following table shows the position with regard to tuberculosis, with comparative figures since 1946 (as corrected by inward and outward transfers). There were six deaths from tuberculosis during the year. 78 TUBERCULOSIS 1959. Year Ended Population Notifications Number of Cases on Register Pulm. Non-Pulm. Pulm. Non-Pulm. Total Number of yearly increase Number per 1,000 pop. M. F. M. F. Dec. 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 1958 88,540 57 2 718 664 19 33 1,434 67 16.2 1959 89,020 37 1 725 640 21 31 1,417 (minus 17) 15.9 79 Mass X-Ray. No mass x-ray survey was undertaken in the area during 1959. Chest Clinic. Dr. M. Price, Physician in Charge of the Chest Clinic, has kindly furnished the following details:— Number of new patients referred to the Clinic 532 Number of new patients diagnosed as tuberculous— Male 16 Female 11 Number of patients included in above who attended as contacts 205 Number of persons vaccinated with B.C.G.— Children 124 Adults 11 Chislehurst and Sidcup Voluntary Tuberculosis Care Committee. I am indebted to the Liaison Officer of the above Committee for the following information:— "The work of the Committee has followed the usual pattern, assisting many families with fuel, hire purchase, clothing, footwear, etc., and for several families, holidays by the sea were provided. We also assist with fares for families to regularly visit their dear ones lying in hospital, thus relieving the monotony of hospital life for the patient, and the anxiety of the families. We obtain the closest liaison with all statutory bodies and we are particularly grateful to the local W.V.S. who always assist if possible. The office at the United Services Club, Main Road, Sidcup, continues to function every Tuesday, Wednesday, and Thursday between 2 p.m. and 4 p.m. and regular home visits are also paid." Typhoid and Para-Typhoid Fever. No cases were notified during the year. Whooping Cough. Notifications of this disease showed an increase during 1959, eighty-eight being received as compared with sixty-nine in the previous year. Three of these cases were admitted to hospital, but no deaths were recorded. The County Medical Officer informs me that 1.169 children resident in the Urban District were immunised against this disease during the year under review. Other Infectious Diseases. In addition to those previously mentioned, notifications were received as under :— Erysipelas 4 cases. Ophthalmia Neonatorum 2 cases. (No impairment of vision in either case) Puerperal Pyrexia 9 cases. APPENDIX. STATISTICAL TABLES. 82 STATISTICAL TABLES, 1959. 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. 83 TABLE I. SUMMARY OF STATISTICS, 1959. Population (mid-year 1959, per Registrar General) 89,020 Birth Rate (crude) 14.3 Death Rate (crude) 8.6 Maternal Mortality Rate Nil Infant Mortality Rate 19.7 Number of Births (live) 1,271 Number of Stillbirths 23 Number of Deaths 762 Number of Maternal Deaths Nil Number of Deaths from Infectious Diseases 3 Number of Infant Deaths (under 1 year) 25 Death Rates:— Respiratory Diseases (excluding Tuberculosis) 1.16 Tuberculosis 0.07 Cancer (all forms) 2.01 Cancer of the Lung, Bronchus 0.47 Infectious Diseases 0.03 Notification of Infectious Diseases:— Diphtheria Nil Dysentery 10 Erysipelas 4 Food Poisoning 27 Measles 1,127 Meningococcal Infections 3 Ophthalmia Neonatorum 2 Pneumonia (all forms) 42 Poliomyelitis (paralytic) 2 Poliomyelitis (non-paralytic) Nil Puerperal Pyrexia 9 Scarlet Fever 77 Typhoid and Para-Typhoid Fever Nil Whooping Cough 88 Number of visits made by Public Health Inspectors 13,603 84 TABLE II. CAUSES OF DEATH. 1955 1956 1957 1953 1959 Total Male Female 1. Tuberculosis—Respiratory 7 9 6 9 5 1 6 2. Tuberculosis—Other — 2 2 1 — — - 3. Syphilitic Diseases — 1 4 — 1 — 1 4. Diphtheria — — — — — — — 5. Whooping Cough - - - - - - - 6. Meningococcal Infections — — — — — — — 7. Acute Poliomyelitis 1 - - - - - - 8. Measles - - - - - 1 1 9. Other infective and parasitic diseases 1 2 — 1 1 1 2 10. Malignant neoplasm, stomach 20 12 19 19 13 13 26 11. Malignant neoplasm, lung bronchus 44 31 34 41 33 9 42 12. Malignant neoplasm, breast 13 20 10 5 — 16 16 13. Malignant neoplasm, uterus 8 1 6 9 — 7 7 14. Other malignant and lymphatic neoplasms 72 63 82 82 44 44 88 15. Leukaemia, aleukaemia 6 5 7 5 2 2 4 16. Diabetes 4 4 4 5 — 1 1 17. Vascular lesions of nervous system 98 80 79 81 27 38 65 18. Coronary disease, angina 113 118 127 127 106 49 155 19. Hypertension with heart disease 20 11 14 19 2 13 15 20. Other heart disease 80 82 91 82 32 59 91 21. Other circulatory disease 42 38 37 47 17 24 41 22. Influenza 3 1 8 4 2 6 8 23. Pneumonia 37 42 49 44 20 35 55 24. Bronchitis 42 40 36 44 30 13 43 25. Other diseases of respiratory system 8 6 14 8 4 1 5 26. Ulcer of stomach or duodenum 6 6 12 5 2 2 4 27. Gastritis, enteritis and diarrhoea 8 5 5 7 — 5 5 28. Nephritis and nephrosis 8 6 3 5 4 4 8 29. Hyperplasia of prostate 2 5 4 2 2 — 2 30. Pregnancy, childbirth, abortion 1 — — — — — — 31. Congenital malformations 10 4 8 5 4 1 5 32. Other defined and ill-defined diseases 68 59 49 70 18 20 38 33. Motor vehicle accidents 5 8 8 8 11 1 12 34. All other accidents 10 10 13 13 5 4 9 35. Suicide 10 3 2 8 4 3 7 36. Homicide and operations of war — 1 - - - - All causes 747 675 733 756 389 373 762 85 TABLE III. INFANT MORTALITY, 1959. (Compiled locally from Registrar's Death Returns.) CAUSES OF DEATH Under 1 week 1 week and under 2 weeks 2 weeks and under 3 weeks 3 weeks and under 4 weeks Total under 4 weeks 1 month and under 3 months 3 months and under 6 months 6 months and under 9 months 9 months and under 12 months Total deaths under 1 year Atelectasis 3 - - - 3 - - - - 3 Congenital Heart Disease - - - - - - - - - - Encephalitis — - — - — — — - 1 1 Prematurity 7 1 — — 8 — — — - 8 Peritonitis - - - - - - 1 - - 1 Respiratory Diseases 1 1 - - 2 2 1 1 1 7 Cerebral Hæmorrhage 1 - - - 1 - - - - 1 Gastro-Enteritis - - - - — — - - 1 1 Other causes 1 2 — — - - - - - 3 TOTALS 13 4 — — 17 2 2 1 3 25 86 TABLE IV. NOTIFIABLE INFECTIOUS DISEASES, 1959. 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 42 35 - - 4 1 8 7 24 22 6 4 - 1 - - - - Whooping Cough 35 53 1 2 10 12 5 15 19 24 - - - - - - - - Poliomyelitis (Paralytic) 1 1 - — - - — — — — — — — — 1 1 — — Measles 578 549 16 11 104 105 140 155 308 268 8 6 — 2 2 2 — — Dysentery 5 5 — — — — 1 — 1 1 1 2 — 1 2 1 — — Meningococcal Infection 2 1 - - - - 1 - 1 - - 1 - - - - - - 663 644 17 13 118 118 155 177 353 315 15 13 — 4 5 4 — — 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 22 20 2 2 3 3 1 5 10 4 6 6 - - Erysipelas 2 2 — - - — 1 2 1 — — — - — Food Poisoning 15 12 9 1 1 2 3 6 2 3 — — — — Ophthalmia Neonatorum 2 — 2 - - - - - - - - - - - Puerperal Pyrexia - 9 — — — — — 2 — 7 — — — — — — — — 41 43 13 3 4 5 5 15 13 14 6 6 — — 704 687 87 TABLE V. NOTIFIABLE INFECTIOUS DISEASES, 1959. Seasonal Incidence. Disease Jan. Feb Mar. April May June July Aug. Sep. Oct. Nov. Dec. Totals Dysentery - - - 1 4 2 - 1 - 1 1 - 10 Erysipelas - - - 1 - - 1 1 1 - - - 4 Food Poisoning - 5 2 2 8 - - 3 1 - 1 5 27 Measles 47 85 312 247 216 163 33 22 1 1 - - 1,127 Meningococcal Infection - 3 - - - - - - - - - - 3 Ophthalmia Neonatorum - - - - - 1 1 - - - - - 2 Acute Pneumonia 4 16 9 3 2 1 1 2 - - - 4 42 Poliomyelitis (Paralytic) - - - - - - - - - 1 - 1 2 Puerperal Pyrexia 1 1 1 1 2 - - 1 1 - 1 - 9 Scarlet Fever 6 1 18 4 6 8 9 3 1 4 8 9 77 Whooping Cough - 1 15 3 11 7 7 13 7 10 7 7 88 Totals 58 112 357 262 249 182 52 46 12 17 18 26 1,391 88 TABLE VI. SANITARY INSPECTION OF THE AREA. 1. Inspections—General. Dwelling Houses (Public Health Act) 4,586 Dwelling Houses (Housing Act) 327 Dwelling Houses (Rent Act) 355 Moveable Dwellings 489 Sampling Visits 168 Unsound Food 248 Meat Inspections 1 Dairies 37 Ice Cream Shops 234 Butchers and registered sausage manufacturers 480 Bakers 202 Bakehouses 126 Restaurants, Cafes and Canteens 425 Chemists 25 Fishmongers 241 Greengrocers 486 Grocers 1,082 Confectioners Shops 176 Vans and Stalls 45 Public Houses, Licensed Premises and Clubs 42 Halls 32 Factories (Section 1, 2, 3, 4 and 6 Factories Acts) 56 Factories (Section 7, Factories Act) 236 Factories (Section 7, other premises) 47 Shops Act 400 Fireguards Act 29 Petroleum Acts 227 Agriculture (Safety, Health and Welfare Provisions) Act 45 Swill Plants 19 Piggeries 34 Riding Establishments and Stables 68 Keeping of Animals 53 Premises—for rats and mice 993 Premises—for other pests 99 Offensive Accumulations 99 Rag Flock Act 1 Pet Animals Act 8 Clean Air Act 214 Public Conveniences 680 Swimming Pools 12 Rivers and Streams 89 Water Supplies 20 Infectious Diseases 208 Food Poisoning 159 13,603 89 2. Complaints. General Sanitary Defects 226 Drainage 498 Keeping of Animals 25 Accumulations and Smells 83 Verminous Premises 22 Water Supply 9 Rats 344 Mice 48 Overcrowding 12 Food 65 Dustbins 35 Smoke 51 Flooding 8 Pests generally 27 Fouling of footpaths 2 Noise 1 1,456 3. Notices. Statutory 4 Informal 141 Food 60 Shops 22 Rats 13 Factories 9 Agriculture (Safety, etc.) Provisions 5 Clean Air Act 4 258