Cou 30 I HEALTH REPORT for 1963 for the COULSDON & PURLEY URBAN DISTRICT by the MEDICAL OFFICER OF HEALTH PRINTED BY RAYNES PARK PRESS LTD., LONDON, S.W.20. Urban District Council of Coulsdon and Purley With the Compli ments of the Medical Officer of Health Public Health Department, 115, Brighton Road, Purley, Surrey. Telephone: UPLands 9277 CONTENTS Page INTRODUCTION 4 Part 1. THE DISTRICT - AREA, POPULATION AND GROWTH 5 Part 2. ASSESSMENT OF THE HEALTH OF THE DISTRICT 6 Vital statistics 6 Infectious diseases and their control 12 Factories Act, 1961 19 Water Supply 21 Public Swimming Baths 22 Sewerage 22 Part 3. PERSONAL HEALTH SERVICES 23 Addresses for reference 28 Part 4. REPORT OF THE CHIEF PUBLIC HEALTH INSPECTOR 30 APPENDICES 55 1 URBAN DISTRICT COUNCIL OF COULSDON AND PURLEY 1963 Public Health Committee. Chairman : Councillor Mrs. D. Pattison, b.a. Vice-Chairman : Miss J. C. Simpson, j.p„ m.a.(Oxon) Councillor Mrs. B. M. Bashford Councillor H. W. Hayden, j.p., „ A. L. Gurl f.b.o.a.(Hons), f.s.m.c., m.r.s.h. „ R. W. Kersey, „ S. E. Littlechild b.sc., a.r.i.c. „ J. S. Smeaton Ex-Officio: Councillor Mrs. E. E. Bray, j.p. (Chairman of the Council) Councillor G. W. Aplin, f.r.i.c.s., m.r.s.h. (Vice-Chairman of the Council) Councillor (Col.) F. N. Charlton, c.b., c.b.e., m.a.(Oxon) (Chairman of the Finance and General Purposes Committee) Councillor D. M. Weightman, m.a. (Oxon) (Chairman of the Local Government Reorganisation Committee) Representatives of the South-Eastern Divisional Health Sub-Committee. Councillor Mrs. B. M. Bashford Councillor Mrs. D. Pattison, b.a. Mrs. N. B. Booth „ J. S. Smeaton R. W. Kersey, b.sc., a.r.i.c. Public Health Department. STAFF: Medical Officer of Health: *J. B. Morwood, m.b., f.r.c.s.i., d.p.h. Deputy Medical Officer of Health: *T. R. Bennett, m.r.c.s., l.r.c.p„ d.p.h. (Left April, 1963) *Gwen R. Tapp, m.b., b.s., d.p.h., d.c.h. (Commenced 8-4-63) Chief Public Health Inspector: W. Haworth, f.a.p.h.i. Deputy Chief Public Health Inspector: W. Rice-Jones, m.a.p.h.i. Additional Public Health Inspectors: E. R. Rogers, m.a.p.h.i. G. H. Bourne, m.a.p.h.i. G. N. Hart, m.a.p.h.i. R. J. Sturgess (Pupil) Assistant to Public Health Inspectors: B. Newland Rodent Operative: H. M. Key Chief Clerk: *D. V. Prothero Clerks: Mrs. L. R. Proctor Mrs. B. F. Alder Miss C. J. Skelton *Mrs. M. Le Hur (* Part-time appointment only to this Council) 3 TO THE CHAIRMAN AND MEMBERS OF THE COULSDON AND PURLEY URBAN DISTRICT COUNCIL Mr. Chairman, Ladies and Gentlemen, I have the honour to submit my Annual Report for the year 1963 which has been prepared in accordance with Ministry of Health Circular 1/64. The health of the District remains good and the vital statistics compare favourably with those of the country as a whole. It is very satisfactory to report that for the third year in succession no case of poliomyelitis occurred. Vaccination has proved very effective and it is to be hoped that this most distressing disease will become as rare as diphtheria, the last case of which occurred in 1958. Tuberculosis still remains a challenge and I have recorded the work the Coulsdon and Purley, Caterham and Warlingham Care Committee have done in the prevention, care and after care of this disease during the past 40 years. The Health Centre for the Elderly at Purley Clinic has proved a great success and a report on this work is given on page 24. In conclusion I should like to thank the Chairman and members of the Public Health Committee for their advice and support throughout the year and the staff of the Department for their keenness and efficiency. I am, Mr. Chairman, Ladies and Gentlemen, Your obedient Servant, J. B. MORWOOD Medical Officer of Health. 4 HEALTH REPORT FOR 1963 PART 1 AREA AND POPULATION The Urban District of Coulsdon and Purley was constituted by an Order of the Local Government Board dated 1st November, 1914, and came into existence on the 7th April, 1915. It has therefore been a separate District for just over 49 years. Situated on the North Downs and for the most part in the Green Belt it is a well favoured residential area. The District has an area of 11,142 acres, these being distributed among the wards as follows:— Coulsdon East 2,870 Coulsdon West 1,248 Kenley 1,261 Purley 669 Sanderstead North. 701 Sanderstead South 1,448 Selsdon and Farleigh 2,075 Woodcote 870 The mid year population was 74,200 in 1963 as compared with 63,770 at the time of the 1951 census. These numbers include persons resident in institutions and schools in the District, the numbers of which at the end of 1963 were as follows:— Cane Hill Hospital 2,086 Netherne Hospital 1,969 Reedham School 190 In December, 1963 there were 21,321 occupied houses, distributed as follows:— Coulsdon East 3,586 Coulsdon West 3,236 Kenley 2,069 Purley 2,832 Sanderstead North 2,659 Sanderstead South 3,188 Selsdon and Farleigh 1,924 Woodcote 1,827 This gives an average of 3.48 persons per occupied house in 1963 or 3.28 if the institutional population is excluded. 5 PART 2 STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (in acres) 11,142 Registrar-General's estimate of population, mid 1963 74,200 Population, Census 1951 63,770 Population, Census 1961 74,738 Number of occupied houses, December, 1963 21,321 Number of occupied houses, 1951 18,071 Number of occupied houses, 1931 9,533 Rateable Value, December, 1963 £3,750,175 Sum represented by a penny rate £15,480 VITAL STATISTICS FOR THE YEAR 1963 M F Live births 1,109 Live-births - Legitimate 568 492 Live birth rate per 1,000 Live-births - Illegitimate 26 23 population 14.9 Corrected 16.2 Illegitimate live births per cent of total live births = 4.4. Still-births 12 Still-births - Legitimate 4 6 Still-birth rate per 1,000 Still-births - Illegitimate 2 live and still-births 10.7 Total live and still-births 1,121 Infant deaths 17 Infant deaths - Legitimate 7 8 Infant deaths - Illegitimate 1 1 Infant mortality rate per 1,000 live births - total 15.3 Infant mortality rate per 1,000 live births - legitimate 14.1 Infant mortality rate per 1,000 live births - illegitimate 40.8 Neo Natal Mortality rate per 1,000 live births (first four weeks) 11.7 Early Neo Natal Mortality Rate per 1,000 live births (first week) 90 Perinatal Mortality Rate per 1,000 live and still-births (still-births and deaths under 1 week combined) 19.6 Maternal deaths (including abortion) - Maternal mortality rate per 1,000 live and still-births M F Deaths 994 415 579 Death rate per 1,000 population 13.3 Corrected 10.3 6 VITAL STATISTICS The following table gives the average population, birth, death, maternal and other important mortality rates for the quinquennial periods 1920-1959 together with the actual figures for 1963. TABLE I Rales per 1,000 population. 19201924. 19251929. 19301934. 19351939. 19401944. 19451949. 19501954. 19551959. 1963 Birth rate 13.5 12.9 11.6 12.8 15.2 15.2 12.0 13.9 14.9 Percentage illegitimate 3.4% 3.7% 2.8% 3.4% 3.9% 3.4% 2.7% 2.6% 4.4% Stillbirth rate — — — 0.43 0.48 0.40 0.24 0.24 0.16 Death rate 7.4 7.0 7.4 8.3 11.4 9.7 12.1 13.7 13.3 Cancer death rate 0.96 1.15 1.35 1.19 1.70 1.75 2.02 2.11 1.9 Tuberculosis death rate (per 100,000 population) 57 36 38 35 48 36 25 14 8 Violence including Suicide 0.44 0.35 0.32 0.46 0.82 0.37 0.46 0.56 0.61 Maternal mortality rate per 1,000 live and still births 2.08 2.66 3.21 2.27 2.10 1.12 1.01 0.58 - Infant mortality rate (per 1,000 registered births) 28 38 32 38 40 26 21 17 15 Neo-natal mortality rate - - - 26 28 19 15 12 11 Estimated population 21,351 28,950 41,616 53,084 49,880 60,610 64,466 67,522 74,200 BIRTHS During the year 1963, 1,109 births were registered as occurring in the District, of which 594 were male and 515 female, compared with 1,035 in 1962. It will be seen by reference to the preceding table that this is equal to an annual birth rate of 14.9 per 1,000 population, as compared with 13.9 in 1962. If this rate is corrected in accordance with the RegistrarGeneral's assessment of the atypical constitution of the population it becomes 16.2 and this is comparable with the birth rate for England and Wales which was 18.2. Illegitimacy.—In 1963, of the births registered 49 were illegitimate (26 males and 23 females), this being 5 more than in the preceding year. Stillbirths.—The number of still-births registered during 1963 was 12 (6 males and 6 females), which is 4 less than last year. The local still-birth rate was 10.7 per thousand live and still births. 7 DEATHS The number of deaths registered during 1963 as belonging to this District was 994 (415 males and 579 females), the same as the previous year. Of this total 259 deaths (73 males and 186 females) occurred in the mental hospitals. The uncorrected death rate was 13.3, but the corrected death rate which allows for the high proportion of deaths occurring in the mental hospitals was 10.3 which compares with the rate of 12.2 for England and Wales. In order that a more accurate comparison can be made, the records in respect of normal residents have been kept separate from those of mental hospital patients and a full list of the causes of deaths and the ages at which they occurred is given in Table III. The principal causes of death during 1963 are shown in the following table:— TABLE II Cause. Number of Deaths General Population Mental Hospitals Vascular lesions of nervous system 111 23 Heart and circulatory diseases 293 76 Pneumonia 34 86 Bronchitis 34 8 Accidents 39 7 Malignant neoplasms other than lung 104 10 Malignant neoplasm, lung 30 — HEART AND CIRCULATORY DISEASE Among the ordinary residents the death rate from heart and circulatory disease was 3.94 compared with an average of 3.52 in the preceding five years. CANCER The number of deaths from malignant neoplasms in the general population was 134. Thirty of these, i.e. 22% were due to cancer of the lung. The considerable increase shown in 1962, i.e. fifty cases of cancer of the lung, 31% of the deaths from malignant neoplasms, has not been maintained and the figures for 1963 correlate closely with those for 1961. It would be premature to make an optimistic interpretation of these figures and the warnings given on the danger of smoking are still reiterated. 8 TABLE III DEATHS OCCURRING DURING THE YEAR 1963 CAUSE OF DEATH Sex Total All Ages Private Residents Hospital Cases Under 4 weeks 4 weeks and under 1 year AGE IN YEARS 1- 5— 15— 25— 35— 45— 55— 65— 75 and over Tuberculosis, respiratory M 5 4 1 - - - - - - - - 1 3 1 F 1 1 - - - - - - - - - - 1 - Syphilitic disease M 1 1 - - - - - - - - - - 1 - F - - - - - - - - - - - - - - Other infective and parasitic diseases M 1 1 - - - - - - - - - 1 - - F 1 1 - - - - - - - - - - - - Malignant neoplasm, stomach M 6 6 - - - - - - - - 1 1 2 2 F 8 7 1 - - - - - - - 1 - 3 4 Malignant neoplasm, lung, bronchus M 25 25 - - - - - - - 1 2 8 9 5 F 5 5 - - - - - - - - 1 1 2 1 Malignant neoplasm, breast M - - - - - - - - - - - - - — F 20 16 4 - - - - - - - 5 5 7 3 Malignant neoplasm, uterus F 3 2 1 - - - - - - 1 - — 1 1 Other malignant and lymphatic neoplasms M 37 36 1 - - 1 - - 3 1 4 10 9 9 F 40 37 3 — — — — 1 — — 8 7 7 17 Leukaemia, aleukaemia M 4 3 1 — — 1 1 — — — 1 — 1 — F 2 2 — - - - - - - - - 1 1 — Diabetes M 2 2 — — — — — — — — 1 — 1 — F 3 2 1 - - - - - - - - - 1 2 Vascular lesions of nervous system M 44 36 8 - - 1 - - - - 3 11 11 18 F 90 75 15 — — — — 1 — — 2 9 23 55 Coronary disease, angina M 105 92 13. - - - - - - 1 9 36 36 23 F 92 79 13 - - - - - - 1 5 7 22 57 Hypertension with heart disease M 4 3 1 - - - - - - - - - - 4 F 13 9 4 - - - - - - - 1 — 1 11 Other heart disease M 31 26 5 - - - - - - 1 2 2 4 22 F 79 51 28 - - - - - - - 1 3 10 65 Other circulatory disease M 18 16 2 - - - - - - - 1 5 3 9 F 27 1/ 10 - - - - - - - - 3 10 14 Influenza M 1 1 — — — — — — — — — 1 — — F 6 3 3 - - - - - - - 1 1 2 2 Pneumonia M 37 17 20 — — — — — — 2 2 3 11 19 F 83 17 66 — — 1 — — — — 2 11 9 60 Bronchitis M 30 25 5 — 1 - - - - - - 6 8 15 F 12 9 3 - - - - - - - 1 1 3 7 Other diseases of respiratory system M 6 6 - - - - - - - - - 2 2 2 F 5 5 — - - - - - - - - 1 — 4 Ulcer of stomach and duodenum M 2 2 - - - - - - - - - - 2 - - F - - - - - - - - - - - - - - Gastritis, enteritis and diarrhoea M 2 2 - - - - - - - - - 1 1 - F 2 1 1 - - - - - - - - - 1 1 Nephritis and nephrosis M 4 4 — — — — — — — 2 — 1 1 — F 1 - 1 - - - - - - - - 1 - - Hyperplasia of prostate M 2 2 - - - - - - - - - - - 2 Congenital malformations M 1 1 — 1 - - - - - - - - - - F 3 3 — 1 1 - - - - - - - - - Other defined and ill-defined diseases M 26 11 15 6 - - - 1 1 - 1 6 6 5 Motor vehicle accidents F 58 32 26 5 2 — 1 — 1 1 7 4 11 26 M 7 7 — — — — — 4 1 — 1 — — 1 F 2 2 - - - - - - - - - 1 1 — All other accidents M 7 6 1 — — — — 1 1 1 — 1 — 3 F 12 7 5 - - - - - - 1 - - 3 8 Suicide M 6 6 - - - - - - - - 2 2 1 1 F 11 10 1 - - - - - - 2 3 5 1 — Homicide and operations of war M 1 1 - - - - - - - 1 - - - - F - - - - - - - - - - - - - - TOTAL ALL CASES M 415 342 73 7 1 3 1 6 6 10 30 100 110 141 F 579 393 186 6 3 1 1 2 1 6 39 61 120 339 9 MATERNAL MORTALITY I am pleased to report that no maternal death occurred during 1963. The maternal mortality rate for England and Wales was 0.28 per 1,000 live and still births. INFANT MORTALITY During 1963 there were 17 deaths among children under one year of age as compared with 16 last year and an average of 17 in the last five years. Two of the deaths were in respect of illegitimate children. The resultant infant mortality rate was 15.3 per 1,000 registered births, compared with an average of 16.2 for the previous five years. The infant mortality rate for England and Wales was 21.1. The 13 babies dying in the first month correspond with a neonatal rate of 11.7 (i.e. deaths in the first month per 1,000 live births) and the average for the past five years was 11.7. The 10 babies dying in the first week correspond with an early neo-natal rate of 9.0. During the year 8 premature babies were notified as being born at home. Fifty-five premature babies were born in institutions and of the latter 6 died within the first 24 hours and 2 within 28 days. 10 TABLE IV INFANT MORTALITY DURING THE YEAR 1963 Cause of Death Under I week. 1-2 weeks. 2-3 weeks. 3-4 weeks. Total under 4 weeks. 4 weeks 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. Rhesus group incompatibility 1 - - - 1 - - - - 1 Congenital malformations — 1 1 — 2 1 — — — 3 Atelectasis 1 — — — 1 — — — — 1 Placental infarction 1 — — — 1 - — — — 1 Prematurity 6 1 — - 7 1 — — — 8 Ante partum haemmorrage 1 — — - 1 — — — — 1 Bronchitis — — — - — 1 1 - — 2 TOTAL 10 2 1 - 13 3 1 - — 17 The following table gives the causes of the 17 infant deaths which occurred during 1963, together with the age at death. 11 INFECTIOUS DISEASES AND THEIR CONTROL The following table indicates the number of cases of infectious diseases notified during 1963, the number admitted to hospital and the number of deaths which occurred. TABLE V Disease. Numbers Notified. Admitted to Hospital. Total Deaths. Scarlet fever 30 — — Acute pneumonia 14 1 — Measles 859 1 — Whooping cough 11 — — Erysipelas 1 1 — Dysentery 21 12 — Food poisoning 1 — — Acute poliomyelitis — — — Puerperal pyrexia 2 — — Diphtheria — — — Paratyphoid B — — — Acute encephalitis — — — Meningococcal infection — — — A further analysis of these cases by ages, wards and the months during which they occurred is given in Tables XVI and XVII in the Appendix and the number of cases of infectious disease notified since 1933 is given in Table XVIII in the Appendix. It will be seen that tuberculosis is omitted from this list of infectious diseases, as it is dealt with separately later. SCARLET FEVER There were 30 cases of scarlet fever, seven more than the number that occurred in 1962. This disease is difficult to control and it is fortunate that in recent years it has become a very much milder disease than it used to be. ACUTE PNEUMONIA During the year 14 cases occurred, one being admitted to hospital. MEASLES 1963 was again an epidemic year for measles: 859 cases occurred compared with 582 in 1962 which was also an epidemic year. One case was admitted to hospital. Immunisation is still not available against this disease although work is progressing on a vaccine and it remains one of the commonest diseases of childhood. 12 WHOOPING COUGH Eleven cases of whooping cough were notified compared with two in 1962 and 30 in 1961. None was admitted to hospital. These comparitively low figures continue the low incidence of this disease since 1956, indicating the value of immunisation and the importance of immunising all young children. The number of children immunised against this disease was 986 and 217 were given reinforcing injections. DYSENTERY Twenty-one cases of dysentery of the mild Sonne type occurred, the majority among patients in a mental hospital. FOOD POISONING Only one case of food poisoning occurred during the year. The organism responsible was Salmonella Dublin. ACUTE POLIOMYELITIS I am pleased to report that no case of poliomyelitis occurred in the District during 1963. The credit for this must go to the Salk vaccine, given by injection. This vaccine, however, has one fault; it does not prevent the carrier state. The Sabin oral vaccine was introduced in February 1962 and has replaced the Salk vaccine. It has the great advantage that it does prevent the carrier state and is being given as a booster dose to children who have previously had the Salk vaccine. Since the inception of the Scheme in 1957, 47,835 persons in the South-Eastern Division of Surrey have been vaccinated against poliomyelitis. PARATYPHOID FEVER No case of paratyphoid fever occurred in the District but a lady resident of Coulsdon and Purley contracted paratyphoid B fever while an in patient in Croydon General Hospital and was transferred to Waddon Hospital where she subsequently died. Another lady resident of this District was sent home from Croydon General Hospital when the first case occurred and she was found to be excreting the organism of paratyphoid B although free from symptoms. She was admitted to Wandle Valley Hospital and after treatment became free from infection. 13 DIPHTHERIA No case of diphtheria occurred during the year but cases are still occurring in the rest of the country. The number of cases in England and Wales was 37 compared with 19 in 1962. It is, therefore, as important as ever that parents should have their children immunised and arrange for reinforcing injections when they are 5 and 10 years old. The number of children immunised against this disease was 1,022 and 1,541 were given reinforcing injections. PUERPERAL PYREXIA Two mild cases occurred. SMALLPOX The necessity for obtaining and maintaining protection against this disease was stressed by the outbreaks that occurred in various parts of the country in 1962 and there has been a welcome increase in the number of vaccinations and revaccinations carried out since then. Towards the end of 1962 it was recommended that primary vaccination should be carried out during the second year, as recent figures suggest that the risk of serious reaction is lowest at this age. Previously it had been the normal practice to vaccinate babies at about 4 or 5 months of age. The number of primary vaccinations carried out was 400 and the number of re-vaccinations was 68. TETANUS Tetanus is not notifiable and its incidence is not known. Cases do occur, however, and there have been several fatal cases in Surrey during recent years including one in Purley in 1959. It is hoped that parents will have their children immunised against this disease as well as the other diseases of childhood. The tetanus prophylactic injection is usually a combined one with whooping cough and diphtheria prophylactics so that no extra injections are necessary. The number of children immunised against this disease was 1,018 and 680 were given reinforcing injections. 14 TUBERCULOSIS The following table presents concisely the position with regard to tuberculosis in the District during 1963 TABLE VI Pulmonary. Nonpulmonary. Total. M. F. M. F. M. F. Number of cases on register 212 138 8 14 220 152 Additions :— New cases notified 8 10 — 1 8 11 Cases removed into district 14 8 — — 14 8 Restored 1 — — — 1 — Total Added to Register 23 18 — 1 23 19 Removals:— Deaths from T.B. 5 1 — — 5 1 Other causes 3 5 — — 3 5 Removed from district 16 11 — — 16 11 Recovered 25 17 — 3 25 20 Reclassification - - - - - - Non T.B. - - - - - - Total Removed from Register 49 34 - 3 49 37 Number of cases on register, 1st January, 1964 186 122 8 12 194 134 The following table shows the age groups in which notifications and deaths occurred:— TABLE VII Age Periods New Cases. Deaths. Pulmonary Nonpulmonary. Pulmonary. Nonpulmonary. M. F. M. F. M. F. M. F. Under 1 year - - - - - - - - 1 and under 5 - - - - - - - - 5 and under 10 - - - - - - - - 10 and under 15 - - - - - - - - 15 and under 20 — 1 — - - - - - 20 and under 25 — — — — — — — — 25 and under 35 2 3 — - — — — — 35 and under 45 — 1 — 1 — 1 — — 45 and under 55 2 2 — — 1 2 — — 55 and under 65 3 — — — 2 — — — 65 and over 1 3 — — 5 3 — - Totals 8 10 — 1 8 6 — — 15 The new cases were distributed amongst the wards as follows TABLE VIII Localisation. Coulsdon East. Coulsdon West. Kenley. Purley. Sanderstead. Selsdon. Woodcote. Pulmonary 5 11 — — 2 — — Nonpulmonary — 1 — — — — — Totals 5 12 — — 2 — — The following table illustrates the trend of this disease since the formation of the District. TABLE IX 19151924 19251934 19351944 19451949 19501954 19551959 1963 Pulmonary— New cases notified 22 29 35 49 43 38 18 *Case rate 115 82 68 81 67 56 24 Deaths 12 13 21 27 16 8 6 *Death rate 65 37 42 44 22 12 8 Non-Pulmonary— New cases notified 3 6 7 8 5 2 1 *Case rate 15 18 15 13 8 3 1 Deaths 3 3 2 2 2 2 — *Death rate 15 8 5 3 4 3 — * (The rates quoted are per 100,000 population). The Council is responsible for rehousing, one of the most important measures in the prevention of this disease, and also for disinfection, but the County Council bears the responsibility for all other preventive measures except the treatment of cases which is that of the Regional Hospital Board. There are several methods of control of tuberculosis and their efficient implementation is important in view of the fact that 18 new cases of pulmonary tuberculosis were notified in 1963, the average for the last five years being 24. Among these methods the following are especially effective: Mass X-ray. This has brought to light early cases which have been treated and rendered non-infectious in a short time. B.C.G. Vaccination of School Children. This protects the vulnerable under 25 years age group. Contacts. Tracing contacts and arranging for treatment of those found to be suffering is important in the prevention of spread of the disease. 16 THE COULSDON AND PURLEY, CATERHAM AND WARLINGHAM CARE COMMITTEE This is the 40th anniversary of the Coulsdon and Purley, Caterham and Warlingham Care Committee. A 40th birthday is quite an occasion and I am marking this by making an assessment of the work the Care Committee has done in its lifetime. The record is impressive. Both the case rate and the death rate of nonpulmonary tuberculosis are a fraction of what they were forty years ago and the death rate from pulmonary tuberculosis is also a fraction of what it then was. The challenge of tuberculosis is still with us, however, because the case rate of pulmonary tuberculosis is still more than half of what it was forty years ago although there has been a tendency for it to fall during the past two or three years. The outlook for tuberculosis patients forty years ago was a very unhappy one. Prolonged stay in sanitoria was the only effective treatment and this gave rise to grave family and social problems which the T.B. Care Committees were formed to deal with. Those were the days before the Welfare State and the work that the Care Committee, the Care Almoner and the Tuberculosis Health Visitors did in alleviating suffering, supporting patients and their families and looking after the welfare of contacts was invaluable in keeping up the morale of patients and relatives and in keeping the disease in check. The Care Committee Officers have given unsparingly their time and consideration to the cases and our thanks are due to them. A major contribution to the fight against non-pulmonary tuberculosis before the War was the introduction of legislation prohibiting the sale of milk from cows suffering from tuberculosis and the general acceptance of pasteurisation of milk. Since the War there has been a continuous improvement in nutrition, housing and the standard of living. The outstanding advance, however, was in the treatment of pulmonary tuberculosis with the introduction of the antibiotic drugs. These have proved an invaluable asset to the Chest Physician. The next advance was in the prevention and control of the disease with the introduction of Mass X-Ray and B.C.G. vaccination and, later on, the B.C.G. vaccination of school children. The result of these measures was that the non-pulmonary death rate fell and the number of cases of pulmonary tuberculosis probably fell also as there must have been a large reservoir of cases of undiagnosed pulmonary tuberculosis during the years before X-Ray examination was readily available for everybody. The number of notified cases, however, did not fall because diagnostic facilities such as Mass X-Ray and the tracing of contacts had improved so greatly that a much greater proportion of all cases in the community were being diagnosed than in previous years. The introduction in 1959 of weekly visits of the mobile X-Ray unit to both 17 Caterham and Purley to which doctors could send any suspect cases and to which members of the public can now go if they so desire has been an important factor in the early detection of pulmonary tuberculosis. During the past two years the Care Committee has taken on other diseases of the chest and this work is increasing. Primarily, however, its work is the care of tuberculosis patients and this work is by no means over. In other words, the phrase 'finished at forty' does not apply to the Coulsdon and Purley, Caterham and Warlingham Care Committee. BACTERIOLOGICAL AND CHEMICAL EXAMINATIONS Almost all the specimens requiring bacteriological examination in the interests of the public health are sent to the Public Health Laboratory, West Park Hospital, Epsom, whilst samples of water requiring chemical analysis and Food and Drug samples are submitted to the Public Analyst. During 1963 reports were received on the following specimens:— Milk, ice cream and water samples 313 Food utensils 315 Nose and throat swabs 13 Faeces 287 Rectal Swabs 858 Miscellaneous foods 132 18 FACTORIES ACT 1961 PART I OF THE ACT 1. Inspections for purposes of provisions as to health (including inspections made by Public Health Inspectors). TABLE X 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 Local Authorities 35 27 - - (ii) Factories not included in (i) in which Section 7 is enforced by the local Authority 165 150 - - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) 19 25 - - Total 219 202 — — 2. Cases in which defects were found. TABLE XI Particulars Number of cases in which defects were found No. of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness (S. 1) — 1 — — — Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) — — - — - Inadequate ventilation (S.4) — — — — — Ineffective drainage of floors (S.6) — — - - — Sanitary conveniences (S.7) (a) Insufficient 2 2 — 1 — (b) Unsuitable or defective 15 11 - — - (c) Not separate for sexes - - - - - Other offences against the Act (Not including offences relating to outwork) - - - - - Totals 17 14 — 1 — 19 FACTORIES ACT 1961 PART VIII OF THE ACT OUTWORK - (Sections 133 and 134) TABLE XII Nature of work Section 110 Section 111 No. of Outworkers in A ug. list required by Section 110(1) (c) No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwhole some premises Notices served Prosecutions Wearing apparel (Making etc. cleaning and washing) 31 - - - - - Household linen 2 — — — — — Umbrellas, etc. 1 — — — — — Carding, etc., of buttons, etc. 7 - - - - - Duster Dolls 13 — — — — — Cosaques, Christmas crackers, Christmas stockings, etc. 2 - - - - - Bootmaker 1 — — - — — Lampshades 1 — — — — — Greetings cards 1 — — — — — Total 59 — — — — — 20 WATER SUPPLY The water supply of the District is provided by The Sutton District Water Company and The East Surrey Water Company from deep wells or borings in the chalk. The water is softened and chlorinated and all houses in the District are provided with a direct supply which was satisfactory in quality and quantity during the year. The natural fluoride content of the water was 0.13 to 0.15 parts per million supplied by both companies. There are no private wells in the District with the exception of the one at Cane Hill Hospital which is used to supplement the public supply. Routine samples of the treated water in public supply were submitted quarterly for bacteriological and chemical examination. In all, 25 samples were taken for bacteriological examination and 8 samples for chemical examination with satisfactory results in each case. No samples of raw water were submitted by the department for bacteriological examination. In addition, both the Water Companies and Local Authorities sharing these public supplies provided the department with copies of reports on the samples taken by them of the treated water in public supply. Fifty-two samples were taken from the supplies of the two Companies and examined for hardness by the department. All of these were satisfactory in that adequate softening had been carried out as required. The private supply at Cane Hill Hospital which is chlorinated is kept under supervision and sampled regularly by the Public Health Department of the London County Council. Copies of reports on the samples taken are submitted to the department for information. RAINFALL The rainfall registered by the automatic rain gauge installed at Alderstead Heath was 28.51 inches in 1963, an increase of 3.10 inches compared with the previous year. (See note against January and February readings). The monthly totals throughout the year were as follows:— inches January 005*† February 0.23 March 4.14 April 3.16 May 2.34 June 1.75 21 July 208 August 3.66 September 2.85 October 2.30 November 5.09 December 0.86 * Gauge inaccessible from 1st to 7th January due to snow drifts. †Snowfall not registered on gauge, therefore the value for snow is not included in the monthly and annual totals. PUBLIC SWIMMING BATHS There are two swimming baths in the District used by the public; one, an open-air pool at Selsdon, is owned privately and although operating primarily in conjunction with a large hotel, is made available to the general public at a charge. The second is a covered bath situated at Reedham School which is used extensively by the Divisional Education Authority for school children. Both baths are filled and replenished as and when necessary from the public supply and provided with the necessary plant for chlorination and filtration. In addition there is a teaching swimming pool at the Keston County Primary School provided for the scholars and this pool is also equipped with the necessary filtration and chlorination plant. During the year 28 samples of the water in these baths were submitted for chemical and bacteriological examination and with the exception of one sample the reports proved satisfactory. Adverse reports are thoroughly investigated and steps taken to effect a remedy. In addition regular tests are carried out by an Inspector to check the chlorine content and the Ph value of the water. SEWERAGE By agreement, sewage from the District drains into the sewerage system of the Croydon Borough Council and the West Kent Main Sewerage Board for treatment. The most serious problem affecting the District under this heading has been the flooding that has occurred for many years at Purley Corner due to the inadequacy of the outfall sewer to Croydon in times of heavy rainfall. This matter has now been resolved by the construction by Croydon Corporation of a new relief sewer from Purley corner to Warham Road. During the year a new section of public sewer was constructed in Brancaster Lane to relieve local flooding and the sewer at Beech Way, Selsdon was extended to Great Farleigh Green to provide main drainage to a group of properties in that area. 22 PART 3 PERSONAL HEALTH SERVICES Since 1948 the local Council has been represented on the S.E. Divisional Health Sub-Committee of the County Health Committee and the corresponding Educational Executive, which bodies have certain specified powers and responsibilities for the Personal Health Services. The Medical Officer of Health for this District and his Deputy, who hold similar positions in the Caterham and Warlingham Urban District, are the officers responsible for the Divisional Health Services which include the following:— Ante Natal Clinic An Ante Natal Clinic is held at 62, Whytecliffe Road, Purley, every Wednesday, 11 a.m. - 12 noon. Home Help Service The activities of this service continue to increase, particularly as there is no comparable agency in this District. Applications for the service of a Home Help should be addressed to the Home Help Organiser, 115 Brighton Road, Purley. In case of emergency the following telephone numbers may be used: UPLands 7014 or 9277, preferably between 9.30 and 10.30 a.m. Home Helps can only be supplied for maternity cases and for other cases genuinely needing their assistance in which ill-health or old-age are involved; the capacity of the Service is limited and priority is given to those in greatest need, the degree of help varying with the physical and social circumstances of the family. Family Planning The local Family Planning Clinic is now held at the Surrey County Council Clinic, Chaldon Road, Caterham-on-the-Hill. Residents needing advice are seen only by appointment and this should be obtained by application to the Divisional Medical Officer at 115 Brighton Road, Purley. Health Visiting The Health Visitors can be contacted through the Divisional Health Visitor between 9.0 and 10 a.m. daily at 115 Brighton Road, Purley, telephone number UPLands 9277. Infant Welfare Clinics The following Infant Welfare Clinics are held regularly from 2-4 p.m. except Purley Clinic which is held from 10 a.m. - 12 noon, and Selsdon and Coulsdon Youth Centre, 9.30 a.m. - 12 noon and 1.30p.m. to 4 p.m.:— Purley Clinic, 62 Whytecliffe Road, Purley Every Tuesday Methodist Church, Brighton Road, Coulsdon Every Thursday. Coulsdon Youth Centre, Chipstead Valley Road, Coulsdon Every Monday. 23 Territorial Army Drill Hall, Marlpit Lane, Old Coulsdon Every Tuesday. Memorial Hall, Godstone Road, Kenley Every Friday. British Legion Hall, Dulverton Road, Selsdon Every Monday. Congregational Church, Sanderstead Road, Sanderstead Every Wednesday. St. Antony's Church, Wentworth Way. Sanderstead Every Thursday. Church Hall, Mitchley Avenue, Purley 2nd and 4th day in each month. Peter Aubertin Hall, Elmore Road, Chipstead 1st and 3rd Friday in each month. Rent Office, Cherry Tree Farm Estate, Sanderstead Every Wednesday. Baptist Church Hall, Reedham Park Avenue, Purley Every Friday. Mothercraft and Relaxation Classes Classes covering these subjects were commenced in Purley at the end of 1953 and the numbers attending have increased very rapidly. Expectant mothers wishing to join these classes should make application to the Divisional Health Visitor at 115 Brighton Road, Purley, who will inform them as soon as a vacancy occurs. School Health Service The basis of this service is the periodical medical and dental inspection of all the children in attendance at the local schools who, in this Division, now number over 15,000 compared with 7,490 in 1946. Some of the defects noted need to be kept under observation and others are referred for treatment by private doctors, hospitals or specialist clinics. Among the clinics organised are the dental, eye, speech, general medical, child guidance and remedial exercise clinics. Special attention is given to handicapped children, some of whom require to be admitted to special schools, e.g. those for the deaf and mentally or physically sub-normal. Health Centre for the Elderly This Centre at Purley Clinic was opened on 4th February, 1963, a letter having previously been sent to the local medical practitioners explaining the aims and objects of this new venture which are simply to help elderly people remain well and active for as long as possible. The Old People's Welfare Committee and W.V.S. were contacted and the object of the scheme was explained to them and their co-operation sought in forming a panel of advisers on local social services and a committee to purchase and sell at cost price various dietary supplements and vitamin preparations. 24 An official of the National Assistance Board paid us a visit and briefed us on retirement pensions, national assistance and supplementary allowances, so that advice could be given and applicants put in touch with the appropriate authorities. In this way we were able to advise on both social and health problems which in practice we have found are closely associated. Regarding the old people themselves we had to make it quite clear that we were not running another social club, and once this point was taken the users of the club were quick to appreciate the help we could give them. The general practitioners on the whole are happy that we are able to hold a watching brief over their patients; we always get the general practitioner's permission for physiotherapy and when we observe that an elderly person is not well or is deteriorating we contact his or her doctor by telephone and he pays a home visit. The co-operation has been excellent. Each new patient has a case sheet recording the usual information, i.e. name, age, address, whether living alone, domestic help, general practitioner's name, Club or Church membership if any. While many patients come as a result of hearing about the Centre at their Over Sixties Club, quite a number are not club minded and are only interested in the medical aspect of the Centre. At the first visit full particulars are entered on the old persons's card including height, weight, temperature, urine and blood pressure and subsequently the weight and blood pressure are recorded at each visit. If glasses are worn and the eyes have not been tested for more than a year, the patient is asked to have a check up to confirm that they are suitable; otherwise their eyes are tested with Snellen's test card and type card. Enquiries into past illnesses and present health are made and the discussion on appetite and diet is thorough as we find this is faulty in many cases, particularly in regard to the protein and Vitamin B containing foods. To overcome this, the voluntary helpers are able to supply the necessary vitamin preparations, high protein and other welfare foods and beverages at cost prices. We get as many free samples as possible, for Old Age Pensioners cannot afford to experiment with new foods which they may dislike. We issue simple diet sheets advising on the foods to select and the foods to reduce in quantity. We feel it is not reasonable to expect old people to make drastic changes in the eating habits of a lifetime so we point out the needs of the older person for the various types of food suggested. A voluntary helper runs the projector while talks are being given on diets and home safety, etc. Where we find there is stiffening of the hands and feet and consequent loss of mobility we ask the general practitioner's permission for the patient to have physiotherapy and this is given in a group by Mrs. Curd our senior physiotherapist. The effects of an improved diet and vitamin supplements and the gentle physiotherapy exercises are very noticeable. At first the 25 old people often look dull and ill — many have not been out of doors for weeks, and they come in using walking sticks, and are so tottery that they have to be helped to get up from the chairs, but after only a few weeks the improvement is quite remarkable. They are very enthusiastic and quite obviously have followed the advice we give them. In a few cases their friends have been so intrigued by the improvement that they have come to try it for themselves. The group physiotherapy is most encouraging; there is quite keen competition among the patients to show each other how well they are getting on. These exercises are designed to teach self help in their own homes and deal with the questions of posture, standing, lifting, turning knobs, taps, etc. The old people cannot be hurried and we do not want to give them the impression that we are too busy to listen as talking over their problems has a great therapeutic value to many of them. The first visit usually takes about half an hour; we find so many social problems that cannot be disassociated from their health condition. This involves quite a lot of contacting of the various social agencies but we cannot speak too highly of the co-operation we have received from all sources. The National Assistance Board visit very promptly when we ask their advice about extra allowances etc., and the general practitioners have visited patients we have referred back to them. In practice we have found that the size of the clinic should be kept small; 20-25 an afternoon are as many as can be coped with, and that is with a good team of voluntaries, two health visitors and a physiotherapist. A Medical Officer does not attend these clinics, the general practitioners being encouraged to regard the health visitors as acting as almoners on their behalf. Welfare Services The staff of the Health Department work in close cooperation with the local representatives of the County Council's Welfare, Children's and Education Departments and such voluntary bodies as the Guild of Social Service, N.S.P.C.C. and Marriage Guidance Council. The Divisional Medical Officer is responsible for co-ordinating the activities of all concerned with "Problem Families" and children neglected in their own homes. In addition to emergency meetings, all current cases are reviewed at quarterly case conferences. NATIONAL ASSISTANCE ACT, 1948, SECTION 47 The powers given under this Section for securing the removal of aged persons living in insanitary conditions were not utilised during 1963. Periodically border-line cases occur in which the Welfare Officers seek advice, but every endeavour is made to find a satisfactory solution without resorting to compulsory powers. 26 THE PHOTOGRAPHS IN THIS REPORT ARE PUBLISHED WITH THE KIND PERMISSION OF THE CROYDON TIMES. SALE OF WELFARE FOODS EYE TESTING THE PHYSIOTHERAPY CLASS A SECTION OF THE HOME SAFETY EXHIBITION (See Report - page 27) NATIONAL ASSISTANCE ACT, 1948, SECTION 50 Under the above section, as from 5th July, 1948, the Council became responsible for the disposal of the remains of any person who dies in the District if suitable arrangements would not otherwise be made. During the year the Council were requested to deal with one case of this type. HEALTH PROPAGANDA Constant attention is given to the opportunities for health education at the Clinics and Centres in the area and during the visits made by the Health Visitors and Public Health Inspectors. In addition each year talks are given by the Officers to various organisations and schools. The material supplied by the Central Council for Health Education and the assistance of the County Council's Health Education Officer prove extremely useful. HOME SAFETY This important work continued throughout the year. I consider that propaganda on the prevention of home accidents should be directed on as broad a front as possible and for this reason the home safety activities are carried out by all members of my staff who have access to the homes of the public. The health visitors who regularly visit all homes in which there are children under 5 years and in some cases school children also, have made it a point to bring out all aspects of home safety in their discussions with parents, and they also distribute leaflets, home safety handbooks, etc., as need arises. All expectant mothers are invited to attend courses of 6 lectures on mothercraft which are very popular and well attended and all these lectures include different aspects of home safety and in addition there is one lecture entirely devoted to it. Health visitors give lectures with films and film strips to Over 60's clubs and other organisations for old people on home safety especially directed towards the type of accidents to which old people are prone. There is also a wide field for propaganda, which is fully exploited, open to the district nurses who visit the homes of the sick of all ages. During the year the staff were also very active in the preparation of visual aids applicable to all age groups on all aspects of home safety, e.g. falls, burns and scalds, cuts, poisoning and electric shock, suffocation and drowning. There is also a considerable amount of time spent on home safety activities by the administrative staff of my department not only in assisting the field staff but also preparing agenda and 27 reports for the Home Safety Committee. All the members of my staff have been very willing to assist voluntary organisations who wish to include prevention of accidents in their training programmes. During December, 1962 and January, 1963 a Home Safety Exhibition was held in the foyer of the Council Offices following which the Exhibition was displayed at the Council Libraries and the Clinics of the County Council. From the various comments received it was obvious that this Exhibition proved very successful. I should like to thank all the members of my staff who have participated in this very important aspect of preventive medicine under the general direction of the Divisional Health Visitor. Addresses for Reference Telephone: Office of the Medical Officer of Health, 115 Brighton Road, Purley UPLands 9277 Public Health Inspectors' Office, 73 Brighton Road, UPLands 6981 Purley UPLands 9644 Ambulances Ambulance Station. 115a Brighton Road, Purley. Sanderstead Fire and Ambulance Station, Limpsfield Road, Sanderstead. Requests should be made to MALden 7733, or in cases of emergency dial 999. Authorised Officer for Mental Health Services Telephone: Mr. D. E. Twivey, 44, Reigate Hill, Reigate Reigate 3357 Blind Welfare Worker Miss E. E. Dudley, County Health Dept., County Telephone: Hall, Kingston-on-Thames KINgston 1050 Children's Officers for the District Miss D. M. Thorpe, Miss I. Keen, Children's Telephone : Department, County Hall. Kingston-upon-ThamesKINgston 1050 Divisional Health and School Health Services Immunisation and Family Planning Telephone: Divisional Medical Officer, 115, Brighton Road, Purley. UPLands 9277 Divisional Education Executive Telephone: 38, Grovelands Road, Purley UPLands 7601 Emergency Units ('Flying Squads') Telephone: Redhill General Hospital, Earlswood Common, Redhill Redhill 3581 St. Helier Hospital, Wrythe Lane, Carshalton ... FAIrlands 4343 Mayday Hospital, Mayday Road, Croydon THOrnton Heath 6999 Hospital Groups Telephone: Croydon General Hospital, London Road, Croydon CROydon 7755 Redhill General Hospital, Earlswood Common, Redhill Redhill 3581 28 School Clinics S.C.C. Clinic, 62, Whytecliffe Road, Purley Tuesdays 9—10 a.m. British Legion Hall, Dulverton Road, Selsdon Mondays 1.30—2.0 p.m. Territorial Army Drill Hall, Old Coulsdon Tuesdays 1.45—2.0 p.m. School Dental Clinics S.C.C. Clinic, 62, Whytecliffe Road, Purley Monday, 9.45a.m. or by appointment. Welfare Officers Telephone: 115a, Brighton Road, Purley UPLands 0776 Mr. E. G. Griffiths (Principal Divisional Welfare Officer) WALlington 9237 Mrs. J. M. Parker, (Divisional Welfare Officer) Caterham 4713 Welfare Homes Telephone: "Chipstead Lodge", Hazelwood Lane, Chipstead Downland 4811 "Santa Tecla", Stanstead Road, Caterham Caterham 2641 Road and Home Safety Committee (Coulsdon and Purley) Telephone: Organiser: Mr. P. E. Arthur, 71, Brighton Road. Purley UPLands 4844 Caterham 4018 Voluntary Bodies Moral Welfare Telephone: Miss Scoones,1 Sunny rise, Caterham Caterham 3728 National Society for the Prevention of Cruelty to Children Inspector R. Channing, 599 Mitcham Road, Croydon THOrnton Heath 4250 Coulsdon and Purley Guild of Social Service Secretary: Miss Honeyman, 105, Brighton Road, Purley UPLands 6800 Coulsdon and Purley Old People's Welfare Association Secretary: Miss D. M. Barnett, 196 Chaldon Way, Coulsdon. Coulsdon and Purley Marriage Guidance Council Secretary: Mrs. H. W. Pritchard, 38, Russell Hill, Purley UPLands 9029 29 PART 4 REPORT OF THE CHIEF PUBLIC HEALTH INSPECTOR 1963 TO THE CHAIRMAN AND MEMBERS OF THE COULSDON AND PURLEY URBAN DISTRICT COUNCIL Mr. Chairman, Ladies and Gentlemen, I have the pleasure to submit herewith a report on the work of the Public Health Inspectors for the year 1963. This will probably be the last report in its present form in view of the reorganisation of local government in the London area, which takes effect as from the 1st April, 1965 and from which date the Urban District as a separate local authority will cease to exist. During my seventeen years service with the Council as Chief Public Health Inspector, it has always been the endeavour of the inspectorate not only to maintain but to improve the environmental standards of the district whenever possible whether it be in the field of housing, food hygiene and control, drainage or sanitary conditions generally. Much of the work is unspectacular and anonymous in character, but the very nature of the duties involved bring the Inspector into very close contact with the personal problems and difficulties of the residents concerned. Personal service as free as possible from officialdom can be very rewarding to officers and public alike and for our part we have had many rewards. Whether we have been entirely successful is open to question but we can at least share in the pleasure, not unmixed with sighs of relief, that the problem of drainage at Purley Corner has, we hope, at last been resolved. Flooding and its attendant after effects at this point has been a serious nuisance and cause for anxiety to the department for many years and business houses in the area will be no less relieved I am sure, that the remedial works have now been completed. In concluding the introduction to the report, I should like to record my appreciation of the support given to me at all times by the Chairman and Members of the Public Health Committee, the friendly co-operation of Dr. J. B. Morwood, Medical Officer of Health and the most willing assistance of all my colleagues in the department. I am, Mr. Chairman, Ladies and Gentlemen, Your obedient Servant, W. HAWORTH, Chief Public Health Inspector. 30 HOUSING The following is a summary of work carried out in respect of the sanitary condition of dwelling houses during the year. 1. Inspection of Dwelling Houses during the year 1963. (i) Total number of houses inspected for housing defects (under Public Health or Housing Acts) 497 (ii) Number of dwelling houses [included under subhead (i) above] which were inspected and recorded under the Housing Consolidated Regulations 1925 and 1932 14 (iii) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 4 (iv) Number of dwelling houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 289 2. Remedy of Defects during the year without service of Formal Notices— Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their officers 209 3. Action under Statutory Powers during the year (a) Proceedings under Sections 9, 10 and 12 of the Housing Act, 1957— (i) Number of dwelling houses in respect of which notices were served requiring repairs Nil (ii) Number of dwelling houses which were rendered fit after service of formal notices (a) By owners Nil (b) By Local Authority in default of Owners Nil (b) Proceedings under the Public Health Acts— (i) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 32 (ii) Number of dwelling houses in which defects were remedied after service of formal notices— (a) By owners 2 (b) By Local Authority in default of Owners 20 31 (c) Proceedings under Sections 17 and 23 of the Housing Act, 1957— (i) Number of dwelling houses in respect of which Demolition Orders were made 1 (ii) Number of dwelling houses demolished in pursuance of Demolition Orders Nil (iii) Number of dwelling houses in respect of which Closing Orders were made 1 (d) Proceedings under Section 18 of the Housing Act, 1957— (i) Number of separate tenements or underground rooms in respect of which Closing Orders were made Nil (ii) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit Nil 4. Housing Act, 1957— Part IV— Overcrowding (a) (i) Number of dwellings overcrowded at the end of the year 1 (ii) Number of families dwelling therein 2 (iii) Number of persons dwelling therein 16 (b) Number of new cases of overcrowding reported during the year 1 (c) (i) Number of cases of overcrowding relieved during the year Nil (ii) Number of persons concerned in such cases Nil (d) Particulars of any case in which dwelling houses in respect of which the Local Authority have taken steps for the abatement of overcrowding have again become overcrowded Nil Number of New Houses erected during the year By the Local Authority 32 By other persons 109 The shortage of suitable alternative accommodation has continued to be the controlling factor in the demolition of outstanding unfit properties. A balance of 17 unfit houses from the original slum clearance programme still remains to be dealt with but at the time of writing this report the majority of the occupants have been rehoused and progress appears to be in sight. During the year official action was taken in respect of four houses included in the current programme. Undertakings not to relet were accepted in the case of two of the properties, a Closing Order was made in respect of a third 32 where it is not yet opportune to deal with the adjoining cottage and a Demolition Order was made on the remaining house. A hut on Riddlesdown in respect of which an Undertaking had been accepted formerly was demolished during the year. The problem of the house in multiple occupation is providing the department with an increasing amount of work. It is quite apparent that the majority of cases found in this district are not of the type, nor do they give rise to the bad conditions which inspired the legislation to deal with the subject, but such laws are not selective and efforts are being made to apply the provisions as reasonably as possible. A further effort has been made to stimulate the interest of owners and occupiers in improvement grants to provide basic amenities in cottage type property. Approximately 135 houses were visited and appropriate communications addressed to the persons concerned, but with only a limited response. The increasing pressure on the building trade in all directions is proving, and will, it is considered, continue to be a major obstacle in the drive to repair and improve the large numbers of houses requiring rehabilitation treatment. It is becoming increasingly difficult, if not impossible, to get builders to submit competitive prices for this kind of work. During the year, Discretionary Improvement Grants were made in respect of five houses where improvement works were carried out to the total value of £2,997.0.0. for which grants to the value of £1,294 were made. This type of grant is, of course, limited in this district to the improvement of sub-standard type cottage property to a degree a little superior to that provided by a Standard Grant. The Council has not, so far, been prepared to extend the scope of this grant aid for the purpose of conversion or enlargement of dwellings. Standard Grants were also made in respect of the provision of Standard amenities in five houses to the total value of £1,396 for which grants to the value of £530 were made. One application for a Certificate of Disrepair was received during the year under the provisions of the Rent Act, 1957. In response to a Notice of Proposal to issue a Certificate of Disrepair, an Undertaking was received from the Landlord to remedy the defects proposed to be included in the Certificate. DRAINAGE During the year approximately 660 lineal yards of soil sewer were constructed by the Council. This included the extension of the sewer in Beech Way, Selsdon, to Great Farleigh Green to provide main drainage facilities for 18 houses and two farmsteads. During the year three houses were connected to main drainage and three cesspools were abolished. 33 The following is a summary of cesspool conversions carried out since 1950— Year Pail Closets (end of year) Cesspools (iend of year) Houses and other premises connected to sewer Cesspools abolished 1950 17 180 19 houses 1 other 15 1951 14 153 30 houses 2 other 28 1952 11 144 10 houses 2 other 13 1953 11 134 10 houses 12 1954 11 136 3 houses 1 other 3 1955 11 117 21 houses 1 other 21 1956 6 106 10 houses 1 other 15 1957 6 101 4 houses 1 other 10 1958 6 94 6 houses 7 1959 6 95 — 1 1960 6 90 3 houses 2 other 7 1961 5 86 5 houses 5 1962 5 82 5 houses 5 1963 5 79 3 houses 3 PUBLIC CLEANSING This service is administered under the direction of the Engineer and Surveyor - Mr. H. M. Collins. A weekly collection of house refuse is in operation and trade refuse is collected concurrently as part of the daily routine in the five collection areas. During the early part of the year the Council commenced the tipping of refuse at Merstham on a joint basis with the Croydon Borough Council. This arrangement has not affected the refuse collection service to any marked degree as the additional travelling time incurred has been largely offset by the use of larger refuse vehicles, thereby lessening the number of journeys to and from the tip site. The operation of the Kenley Destructor has since been restricted to the destruction of unwanted household furniture and miscellaneous articles. 34 Cesspool contents are emptied into the sewer. Charges are made for the removal of trade refuse and for cesspool emptying. The scale of charges for cesspool emptying is now as follows:— (a) Existing cesspools at private properties erected before 1st April, 1958 — 10/- per load for the first 12 loads in any year and thereafter 15/- per load for all additional loads in the same year. (b) Cesspools constructed on or after 1st April, 1958 and before 31st March, 1959 at newly erected properties— a standard charge of 15/- per load. (c) Cesspools constructed on or after 1st April, 1959 at newly erected properties— a standard charge of 25/- per load. (d) Cesspools at commercial premises— 25/- per load. RIVERS AND STREAMS The only water courses in the District are those provided by the intermittent Bourne flows. These present no difficulties apart from occasional rat infestation along the banks. INSPECTION OF THE DISTRICT It is the statutory duty of a Public Health Inspector to inspect and have a thorough knowledge of the sanitary circumstances of his district in order that action can be taken if necessary to abate conditions that give rise to nuisance or are prejudicial to health. The intensive production of livestock for meat and eggs is giving rise to an increasing public health problem in the countryside and an outlying district within the Council's area has been similarly affected from time to time. During the year failure to comply with the provisions of a Nuisance Order by the occupier of a broiler unit compelled the Council to resort to Court proceedings. The Court found the case proved and imposed a daily penalty of £1. per day for the period 7th August to 3rd September, 1963 (inclusive) and ordered the occupier to pay £10.10.0d Costs. Also during the year a building Company was prosecuted for failing to give the Council the required 24 hours notice under Section 41 of the Public Health Act, 1936, of their intention to carry out works to the private drainage system of a property. A fine of £1. was imposed. The Company was also fined £5. for failing properly to support and protect the drain in accordance with Building Byelaw No. 88, and the Council was awarded £15.15.0. Costs. 35 Proceedings were taken against another building firm for failing to give notice under Section 41 of the Public Health Act, 1936. A fine of £3. was imposed and the Council was awarded £5.5.0d. Costs. Camping Sites The Caravan Sites and Control of Development Act, 1960 confers on Local Authorities powers for the control of caravan sites and apart from improved planning powers it provides for a system of site licensing to be administered by district councils. Site licences can only be issued if planning permission has been granted by the Planning Authority. Site operators in possession of planning permission cannot be refused a site licence which will remain valid for the period of planning permission subject to observance of the site licence conditions. In deciding what conditions to attach to a site licence a local authority must have regard to the Model Standards specified by the Minister. Provision is made for appeal against the conditions of a site licence and subject to this proviso penalties may be imposed for failure to comply with licence conditions. The licence in respect of a caravan at Hall & Company's depot was renewed for a further year. Site licences in force during the year were as follows:— Address No. of Caravans Period of Licence Dean Lane Park, Dean Lane, Merstham, 160 3 years from 21.12.60. Hall & Co., Depot, Marlpit Lane. Coulsdon. 1 1 year from 10.12.62. Windmill Farm, Coulsdon Common. 2 5 years from 29.12.60. Caterham Drive, Old Coulsdon. 1 3 years from 8.8.61. Site licence conditions in all cases require a water carriage system of drainage, main water supply and fire precautions. In the case of Dean Lane Park, communal ablution and laundry facilities with a constant supply of hot and cold water are additional requirements. Clean Air There has been no change in the policy of the Council regarding the formation of Smoke Control Areas. The district is not 36 within the "Black Areas" around London as designated by the Ministry of Housing and Local Government and the Minister has indicated in a recent circular that for the present he does not consider it necessary to make any general request for the submission of smoke control programmes by Councils outside the "Black Areas". The Council are participating in a National Survey of Air Pollution by Smoke and Sulphur Dioxide under the auspices of The Warren Spring Laboratory, Department of Scientific and Industrial Research. Stations for the purpose have been set up in the district at 73 Brighton Road, Purley, and Selsdon Library. Apart from a few minor complaints no problem has arisen in connection with smoke nuisance during the year. There is little or no industrial smoke in the district. Hairdressing Establishments Byelaws are now in force in the district which provide for securing the cleanliness of premises and the instruments, towels, equipment and materials used in the premises. During the year 53 visits were made in pursuance of the byelaws. Consumer Protection Act 1961 The provisions of the Heating Appliances (Fireguards) Act, 1952 and Regulations made thereunder have now been incorporated in the Consumer Protection Act, 1961 which empowers the Secretary of State to make Regulations in respect of any goods which he may prescribe, imposing such requirements as he may think expedient, to prevent or reduce risk of death or personal injury. In June, 1962, The Oil Heaters Regulations 1962, which impose requirements as to construction, design and performance of domestic space heaters, which burn paraffin oil and are not designed for use with a flue, came into operation. Mines & Quarries Act, 1954 This Act requires compliance with provisions designed to prevent accidents arising through lack of proper fencing or too easy access. Routine visits are made to quarries in the district as necessary. Schools In co-operation with the Divisional Medical Officer and in the course of milk sampling, schools are visited from time to time. 37 Shops Act As far as possible inspections have been made in respect of the provision and maintenance of sanitary accommodation, washing facilities, heating, lighting and ventilation in shops. The provisions of the Offices, Shops and Railway Premises Act 1963 will, of course, shortly supersede the welfare provisions contained in the Shops Act, 1950. By arrangement with the Engineer & Surveyor, the Department is given an opportunity of examining all plans submitted for the construction of new shops or alteration of existing premises, with a view to obtaining proper compliance with the requirements of the Act. This is generally appreciated by shop developers who are usually very willing to co-operate. The Council is also the Authority responsible for enforcement of the Shops Hours of Closing and Sunday Trading provisions of the Act and routine surveys and inspections are carried out for this purpose. The Home Secretary is at the present time reviewing the need, if any, for further legislation on shop closing hours. Noise Abatement Act 1960 Three complaints of noise nuisance were investigated and observations carried out. Representations were made to the persons concerned with satisfactory results. The Fabrics (Misdescription) Act, 1913 The Fabrics (Misdescription) Regulations 1959 The above mentioned Regulations prescribe standards of noninflammability for textile fabrics to which is attributed the quality of non-inflammability or safety from fire or any degree of that quality. The increased cost of fire resistant textile fabrics has so far restricted the demand for a product which if popularised would, no doubt, make a significant contribution to the cause of home safety. Radioactivity During the year the department was consulted in connection with the disposal of a small stock of radioactive materials from a local Research Establishment. This operation was carried out under the supervision of a Ministry of Housing and Local Government Radiochemical Inspector. 38 Disinfection and Disinfestation Disinfection is carried out when considered necessary following cases of infectious disease and otherwise on request and on payment of a small charge. Bedding and other clothing if possible is disinfected by arrangement with the Wandle Valley Hospital in a steam disinfector at the hospital. Sick rooms and other articles are disinfected by means of formaldehyde gas or spray, and library books are treated in a disinfecting chamber at the offices at 73, Brighton Road, Purley. During 1963 the following disinfections were carried out:— Free of cost Upon Payment Total Loads of bedding, etc. 1 3 4 Houses disinfected 3 - 3 Parcels of clothing - 9 9 Library Books 14 - 14 Disinfestation work is now largely confined to the more common domestic pests such as flies, ants, cockroaches and wasps. The use of proprietary insecticides principally of the liquid variety and having a residual effect, is proving very effective in dealing with all types of insect pests. During the year 111 cases of infestation were dealt with by the department. COMPLAINTS RECEIVED General disrepair and insanitary conditions 28 Defective drainage systems 31 Blocked drainage systems 366 Accumulation of refuse, etc 8 Rats and mice 276 Insect pests, etc. 33 Wasps nests 123 Smoke nuisance 3 Contaminated food 17 Unsound food 19 Miscellaneous 46 Flooding 8 Disinfection 2 Noise Nuisance 3 Total 963 39 VISITS CARRIED OUT AND INTERVIEWS Number of houses visited in respect of improvement and repair 773 Number of reinspections made to above houses in respect of improvement and repair 2,705 Verminous premises 18 Insect pests 65 Water supply 18 Tents, vans and sheds 23 Schools 4 Places of entertainment 4 Licensed premises 79 Storage of refuse 13 Accumulation 114 Piggeries, fowls and other animals 153 Stables 3 Rodent control 3,942 Drainage inspected 1,674 Drainage tested 237 Merchandise Marks Act 20 Passage pavings 1 Betting, Gaming and Lottery 7 Animal boarding establishments 8 Radioactivity 3 Houses in Multiple Occupation 417 Home safety 7 Trade effluent 1 Cesspools 39 Urinals 3 Sewers and street gullies 96 Dairies and milkshops 22 Ice cream premises 7 Meat shops 137 Food preparing premises 609 Other food shops 644 Bakehouses - Power 45 Food inspection - meat 28 Food inspection - other food 77 Factories - Power 105 - Other 16 Workplaces 36 Outworkers 17 Pet Animals Act 7 Shops Act 856 Mines and Quarries Act 5 Clean Air Act 570 Hairdressing Establishments 53 Infectious disease enquiries 273 Infectious disease contacts 206 Food poisoning enquiries 21 Disinfection 29 Disinfestation 189 40 Noise Abatement 33 Swimming baths 145 Sampling - Food and Drugs Act, 1955 121 - Ice Cream 60 - Milk (Bacteriological) 176 - Milk (Bio) 16 - Water 75 - Miscellaneous Food Samples 22 Interviews 2,799 Number of incoming telephone enquiries and personal callers received at the office 2,346 Miscellaneous visits 1,099 NOTICES SERVED Preliminary Notices 793 Statutory Notices 129 WORK CARRIED OUT AND DEFECTS REMEDIED Drainage and Sanitary Fittings:— Drains repaired or reconstructed 85 Blocked drains cleared 360 Disused drains sealed off 22 Soil and vent pipes repaired/renewed 8 inspection chambers provided or repaired 71 Fresh air inlets repaired or renewed 5 Stoppers to interceptors renewed 4 New W.C. pans fixed 18 W.C. cisterns repaired or renewed 12 Cesspools abolished and filled in 3 Cesspools repaired/renewed/enlarged 8 Cesspools cleansed 1 Eaves gutters and rainwater pipes renewed/repaired 43 Lavatory basins renewed or provided 3 Baths renewed or provided 8 Sinks renewed or provided 1 Drainage disconnected from cesspool and connected to sewer 2 Waste pipes renewed or repaired 16 Sink gully curbs and dishings renewed 21 Soakaways reconstructed or provided 11 Miscellaneous 55 General Housing Repairs:— Defective roofs repaired or renewed 27 Chimney stacks repaired or rebuilt 4 External walls repaired 9 Yards paved or paving repaired 5 Steps repaired or renewed 1 External paintwork renewed 3 Dampness in walls remedied 19 Damp-proof courses provided 2 Walls and ceilings repaired 17 41 New ceilings provided 5 Walls of rooms cleansed or redecorated 35 Ceilings of rooms cleansed or redecorated 36 Floors repaired or renewed 7 Internal woodwork cleansed or redecorated 6 Staircases repaired/renewed 3 Additional subfloor vent provided 1 Windows repaired or renewed 29 Doors repaired or renewed 7 Firegrates repaired or renewed 6 Domestic hot water systems repaired or renewed 6 Water service pipes repaired or renewed 28 Walls and ceilings of W.C. compartments repaired 5 Walls and ceilings of W.C. compartments cleansed 3 Floors to W.C. compartments repaired/renewed 2 Portable dustbins provided 9 Miscellaneous 7 Food Stores provided 1 Food Premises:— Premises reconstructed 6 Premises altered and improved structurally 9 Floors repaired/renewed/recovered 25 Walls and ceilings of rooms repaired 17 Walls of rooms cleansed or redecorated 98 Ceilings of rooms cleansed or redecorated 88 Doors repaired or renewed 2 Woodwork cleansed or redecorated 22 Roofs repaired 4 Rainwater pipes/gutters repaired/renewed 2 Yards paved or paving repaired 2 Food stores provided 1 Sinks renewed or new sinks provided 28 Draining boards provided 16 Hot water supply provided for personal ablution purposes 19 Hot water supply provided for cleansing purposes 15 External walls repaired 2 Waste pipes repaired or renewed 5 Towels, soap, nailbrushes supplied 7 First-aid equipment supplied 5 Lockers for clothing provided 1 Equipment cleansed 9 Equipment renewed or repaired 13 New equipment provided 10 Additional lighting provided 4 Additional ventilation provided 5 Sanitary accommodation provided for staff 1 Sanitary accommodation repaired 32 Sanitary accommodation cleansed 37 Staff Rooms provided 2 Lavatory basins provided 26 Miscellaneous 32 Dustbins provided 6 42 Hairdressers:— Rooms cleansed or redecorated 1 W.C.s cleansed 2 Ratproofing:— Work carried out by occupiers of premises after completion of treatment 7 Shops Act :— Additional sanitary accommodation provided and repaired 1 Heating provided 1 Washing facilities provided 1 PREVENTION OF DAMAGE BY PESTS ACT, 1949 RODENT CONTROL The Council employ the services of a rodent operator assisted as necessary by another officer in the department for work under this heading. Compared with 1962 there was a decrease in the number of premises found to be infested by rats and mice. During the year the Department continued to carry out on a contract basis certain disinfestation work at agricultural premises formerly carried out by the Ministry of Agriculture, Fisheries & Food. The Department does not, of course, rely solely on the receipt of complaints as an indication of infestation and routine inspections of dwelling houses, business premises including agricultural holdings, council owned properties and land are carried out from time to time and in conjunction with treatment on adjoining premises. The Ministry of Agriculture, Fisheries and Food continue to take an active interest in rodent control work carried out by local Authorities. Technical advice and instructional service through the regional and divisional pests staff is freely available and meetings of the No. 10, London Workable Area Committee of which this Authority is a member, are held from time to time to discuss with the Ministry's Officers, problems and new developments in connection with rodent control. Your Chief Public Health Inspector is Chairman of this Committee. It is the legal responsibility of the occupier of premises to keep the premises free from infestation by rats and mice, and in view of this the Council has maintained the principle that a small charge should be made in respect of destruction work carried out by the Council at private dwellings. A nominal charge of 5/- is made therefore for this service which is generally appreciated and in respect of which no serious difficulty has been experienced since it was first put into practice in 1951. 43 Work carried out at business premises including agricultural holdings is charged at the full cost which, during 1963 was 14/6d. per hour plus cost of materials. Check baiting was carried out on the sewerage system at points where small infestations had formerly occurred. Sixty-two manholes were test baited and evidence of infestation was found in only ten. The Council has continued to undertake rodent control at local schools for the Surrey County Council on a contract basis. 44 45 RODENT CONTROL The following table is a tabular statement indicating the action taken in 1963. TABLE XIII Type of property Number of properties inspected by the Local Authority as a result of: Number of properties found to be infested by Number of treatments carried out by the Department by arrangement with occupier Number of Notices served under Section 4 Number of inspections made Notifica tion Otherwise Total Rats Mice Rats Mice Treatment Structural works, i.e. proofing Primary and reinspec tions Sewer treatment Total Local Authority 2 4 6 4 2 4 2 — — Dwelling Houses 239 17 256 156 43 149 43 — — Business Premises 35 23 58 31 22 27 22 — — 3.832 110 3.942 Agricultural - 3 3 2 — 2 — — — Total 276 47 323 193 67 182 67 — — THE FOOD HYGIENE (GENERAL) REGULATIONS, 1960 These Regulations provide the Statutory authority to enforce reasonable standards of food hygiene in food premises and in respect of food handlers. Routine visits are made to all food premises with the object of maintaining these standards and reference to the tabular statement of works carried out will give some indication of the matters to which attention is directed. It can be said at this point in time that there is little or no resistance to the demands of the department for the provision of necessary equipment or facilities in food premises in the interests of clean food. Progressive food traders recognise the importance of the subject but staffing difficulties and shortages are factors that to some extent hinder the full implementation of a satisfactory routine. The shopping public is quick to recognise a lapse in standards and during the year 21 complaints received in respect of contaminated or unsound food were fully investigated and warning letters were sent in appropriate cases. In three instances, however, relating to foreign matter in bread. Court proceedings were instituted and fines totalling £45 with 15 guineas costs were imposed. A variety of food samples 132 in number, were submitted for bacteriological examination during the year, including synthetic and fresh cream, cream cakes, minced beef, sausages, frozen meats and vegetables, shrimp croquettes, peeled prawns, meat pudding, meat pie, fish fingers, crab meat, pure monosodium glutanate crystals, herring roes, desiccated coconut, minced chicken in jelly, egg albumen, cracked fresh eggs, etc. The reports on these samples were generally very satisfactory. During the year 63 swabs were taken from 315 items of washed crockery and submitted for bacteriological examination. Advisory work was carried out as and when necessary based on the reports received. Further details of food samples are recorded elsewhere in this report. The register of premises coming within the scope of the Food Hygiene Regulations at present includes the following:— Confectioners 62 Butchers 34 Fishmongers (wet and dry) 13 Fishmongers (fried) 4 Bakers 19 Greengrocers and Fruiterers 38 46 Cafes and Restaurant 35 Grocers 79 Chemists 20 Licensed premises 35 Hospitals, Nursing Homes, Guest Houses Hotels 21 Canteens, Clubs, Halls, etc 53 Schools 45 Twelve shops other than butchers and one baker's premises are registered for the preparation of preserved meat, etc., and all the fish friers' premises are similarly registered in respect of fish frying. Milk. The Milk & Dairies (General) Regulations, 1959. Apart from small quantities bottled on the farms, milk sold in the larger Urban areas is collected in the distant producing areas and transported in bulk to large processing plants situate in the consuming centres where it is pasteurised or sterilised and bottled for sale by a comparatively few large dairy companies. Residents in this district rely in the main on these sources of supply, there being only one registered dairy now operating in the Council's area. General control by the Department is exercised under the above regulations and only pasteurised, tuberculin tested or sterilised milk can be sold in the district as a result of a Special Designations Order made in 1951. A complaint of a dirty milk bottle was passed to the Authority in whose area the milk was bottled. The entries in the register, which has to be kept, were as follows:— Distributors of Milk in the District 18 Premises registered as Dairies 1 Under the Milk (Special Designation) Regulations, 1960, the following licences to sell milk continued in force during the year. Dealer's Pre-packed Licences 14 Dealer's (Pasteuriser's) Licence 1 Dealer's (Tuberculine Tested) Licence 1 47 48 TABLE XIV TESTS REQUIRED BY THE MILK (SPECIAL DESIGNATION) REGULATIONS, 1960 Designation No. Methylene Blue Phosphatase Turbidity Tubercle Bacilli Brucella Satisfactory Unsatisfactory Satisfactory Unsatisfactory Satisfactory Unsatisfactory Satisfactory Unsatisfactory Satisfactory Unsatisfactory Pasteurised 124 124 — 124 — — - — — — T.T. (Raw 32 31 1 failed — — — — 3 — 3 — T.T. (Pasteurised) 15 15 — 15 — — — — — — — Sterilised 7 — — — — 7 — — — — — Total 178 170 1 139 — 7 — 3 — 3 - A total of 178 samples of milk was submitted for bacteriological examination, with the results set out in the following table : — One sample only of T.T. Raw Milk failed the Methylene Blue Test. The results of the phosphatase test reflect the efficiency of modern pasteurisation. Three samples of raw milk were submitted to biological examination for the presence or otherwise of Tubercle Bacilli or Brucella Abortus with satisfactory results. A total of 70 washed bottles was submitted for bacteriological examination with satisfactory results. Ice Cream The Ice Cream (Heat Treatment etc.) Regulations, 1959 One hundred and twenty-five premises are registered for the sale of ice cream within the district and although two premises are also registered for the manufacture of this product, no manufacturing has been carried out for some years. A total of 73 samples of ice cream was examined for bacterial quality by submission to the methylene blue reduction test, and placed in the following provisional grades :— Grade I 70 Grade II 1 Grade III 1 Grade IV 1 These results can be considered very satisfactory. Meat Slaughterhouses Act, 1958 Slaughter of Animals Act, 1958 Public Health (Meat) Regulations 1924-1955 There are now no slaughtering facilities within the area of the Urban District and the Minister of Agriculture, Fisheries and Food has accepted the Council's view that there is no future need for such facilities in the district. Meat inspection is thus restricted to supplies in retail shops which are obtained in the main from the Croydon abattoir and Meat Market and the Smithfield Market. There are 34 butchers' shops in the District, all registered for the preparation or manufacture of sausages or potted, pressed, pickled or preserved meat under the provisions of Section 16 of the Food and Drugs Act, 1955. Unsound Food The following is a list of foodstuffs which after inspection were classified as unfit for human consumption and destroyed at the Council's refuse destructor at Kenley. 49 Food and Drugs Analysis During the year a total of 141 samples of food and drugs including 41 milk samples were purchased for the purpose of analysis by the Public Analyst. Adverse reports were received on 10 samples as follows:— Sample No. Nature of adulteration or irregularity Action taken Formal Sample No. 594 EVAPORATED FRUIT SALAD The ingredients were not specified on the label in the order of the proportion in which they were used, as is required by the Labelling of Food Order, 1953. Representations were made to the Merchants concerned and explanation accepted. Formal Sample No. 609 VEGETABLE MACEDOINE The ingredients of the tin were not specified on the label in the order of the proportions in which they were used. Steps taken to prevent a recurrence. Formal Sample No. 613 PEAS The article was described on the packet as peas and the contents were stated to be: peas, preservative (sulphur dioxide). In fact, the article was a form of dried peas. Label amended. Formal Sample No. 665 MEAT PASTY The filling of this article consisted of two small pieces of meat together with potatoes and a little onion and would be correctly described as a meat and vegetable pasty. A reasonable minimum meat content for such an article would be 12½ per cent. Enquiry revealed misdescription by Shop Assistant. Attention of Vendor directed to the report of the Food Standards Committee on Meat Pies. 50  tons cwts. lbs. Fresh Fruit and Veg 9 8 Sugar, Jams, etc 7 Tinned Goods 2 80 Meat, Bacon, etc 5 15 Fish 2 55 Frozen Foods 2 77 Miscellaneous 55 Total 1 2 73 Fruit Juices 12 pints Sample No. Nature of adulteration or irregularity Action taken Informal Sample No. 687 RAISIN BRAN FLAKES This article was not correctly described as Raisin Bran Flakes. It consisted of wheat and bran flakes mixed with raisins. Product renamed "Raisin Bran" folowed by the description "30% Bran Flakes with Raisins". Formal Sample No. 688 WHEAT FLAKES (Starch reduced) Deficiency of fat content compared with declaration set out on the label. Explanation of Manufacturers accepted. Informal Sample No. 708 LIGHT CHOCOLATE CAKE COVERING This article was not a chocolate cake covering since hardened palm kernel oil had been substituted for cocoa butter which is the only fat present in chocolate apart from the milk fat present in milk chocolate. No list of ingredients was given with this article. Label redesigned. Informal Sample No. 710 CHERRIES FOR COCKTAILS The presence of sulphur dioxide not declared on label. Matter left in abeyance for the time being pending consultations with the Food Standards Committee. Formal Sample No. 736 CHANNEL ISLANDS MILK This sample was reported upon as containing Penicillin equal to 0.03 International Units per ml. This was a sample of Channel Islands Milk obtained from a local dairy and comprising the mixed product of seven producers. Individual samples failed to identify the source and in the circumstances a communication was addressed to each producer directing attention to the findings of the Milk Hygiene Sub-Committee of the Milk and Milk Products Technical Advisory Committee appointed by the Ministry of Agriculture, Fisheries and Food and the recommendations contained therein. Informal Sample No. 740 PINEAPPLE MILK SHAKE SYRUP Sample contained 270 parts per million by weight Sulphur Dioxide. Declaration referred to "Permitted Preservatives only". New label printed. 51 LIST OF SAMPLES TABLE XV A rticle A nalysed Non-Genuine Formal Informal Total Formal Informal Total Ale, Brown 1 - 1 - - - Ale, Mild 2 — 2 — — — Apple Flakes, Instant 1 — 1 — — — Bacon and Mushroom in White Sauce - 1 1 - - - Baked Beans 1 — 1 — — — Batter Mix 1 — 1 — — — Beef Suet, shredded 1 — 1 — — — Bisto Gravy Mix - 1 1 — — — Beer, Bitter 1 - 1 — — — Bitter Lemon - 1 1 — — — Bitter Orange Sweets - 1 1 — — — Blackcurrant Health Drink 1 - 1 — — — Blackcurrant and Liquorice Pellets - 1 1 - - - Blancmange Powder 1 - 1 — — — Bourbon Biscuits - 1 1 — — — Brazil Toffee - 1 1 — — — Brandy 1 - 1 — — — Bread 1 - 1 — — — Bread and Butter - 1 1 — — — Butter 1 - 1 — Butter Sponge Jam Pudding - 1 1 - - - Cake Covering, Light Chocolate - 1 1 - 1 1 Cambridge, Wors 1 - 1 — — — Cherries for Cocktails - 1 1 — 1 1 Cheese Flaps in Tomato Sauce - 1 1 - - - Cheese 1 - 1 — — — Chop Sauce - 1 1 — — — Castor Oil - 1 1 — — — Cheese Wensleydale 1 - 1 — — — Chocolate Cake made with Butter 1 - 1 - - - Chocolate Chip Cookies 1 - 1 — — — Cocktail Onions 1 - 1 — — — Coffee, Fresh 1 - 1 — — — Cottage Cake 1 - 1 — — — Corn Relish - 1 1 — — — Cornish Pasties 1 - 1 — — — Crab Spread with Butter 1 - 1 — — — Crispets - 1 1 — — — Creamed Rice Milk Pud. 1 - 1 — — — Demerara Sugar 1 - 1 — — — Devon Toffee 1 - 1 — — — Doughnuts (Jam) 1 - 1 — — — Dairy Cream - 1 1 — — — Egg Custard Tart 1 - 1 — — — Evaporated Fruit Salad 1 - 1 1 — 1 Evaporated Milk, Full Cream, (Unsweetened) 1 - 1 - - - Flour, Self-Raising - 1 1 — — — Fruit Cake 1 - 1 — — — Total C/fwd. 31 18 49 1 2 3 52 Article Analysed Non-Genuine Formal Informal Total Formal Informal Total Total B/fwd. 31 18 49 1 2 3 Frankfurters 1 - 1 — — — Fish and Chips — 1 1 — — — Fruit Cocktail 1 — 1 — — — Fruit Salad, Choice in heavy syrup 1 - 1 - - — Gravy Salt 1 — 1 - — — Ginger Nuts — 1 1 - — — Garlic Salt 1 — 1 - — — Gin 1 — 1 - — — Ginger (formerly nonalcoholic Ginger Wine) - 1 1 - - - Glucose Almond - 1 1 - — — Ham Sausage 1 — 1 - — — Hamburgers and 4 Veg. with gravy - 1 1 - - - Haslet 1 — 1 - — — Honey 1 — 1 - — — Instant Coffee 1 — 1 - — — Irish Stew — 1 1 - — — Jam, Blackcurrant - 1 1 - — — Jam, Raspberry — 1 1 - — — Jiffi-Jelly, Fruited Orange 1 — 1 - — — Kidneys, Pork Braised 1 — 1 - — — Lemon Pie Filing — 1 1 - — — Lemon Curd Puffs 1 — 1 - — — Lemon Glucose Drink - 1 1 - — — Lemon Juice, Unsweetened 1 — 1 - — — Lard, Pure 1 - 1 - — — Lollipop - 1 1 - — — Liver Sausage 1 — 1 - — — Marmalade, Amber - 1 1 - — — Marmalade, Ginger 1 - 1 - — — Marmalade, Orange Jelly 1 — 1 - — — Meat Balls, Savoury 1 — 1 - — — Mincemeat — 1 1 - — — Mincemeat Steak, Savoury 1 — 1 - — — Milk Choc Wafers 1 — 1 - - — Milk 36 5 41 1 — 1 Milk, Condensed Sweetened Machine Skimmed - 1 1 - - - Meat Pasty 1 — 1 1 — 1 Margarine (10% butter) 1 — 1 - — — Mixed Pastilles 1 - 1 - — — Meringues 2 — 2 - — — Milkie Loaf 1 — 1 - — — Morello Cherry Jam - 1 1 - — — Mustard German 1 — 1 - — — Nuts and Raisins 1 — 1 - — — Pease Pudding 1 — 1 - — — Peppermint Essence — 1 1 - — — Pineapple Jelly 1 — 1 - — — Pineapple Milk Shake Syrup — 1 1 - 1 1 Pizza — 1 1 - — — Popcorn — 1 1 - — — Peas 1 — 1 1 — 1 Processed Peas 1 — 1 - — — Potato Crisps 1 — 1 - — — Total C/fwd. 101 42 143 4 3 7 53 Article Analysed Non-Genuine Formal Informal Total Formal Informal Total Total B/fwd. 101 42 143 4 3 7 Rum 1 - 1 - - - Red Hot Peppers 'Lombardi in Vinegar' - 1 1 - - - Rum Extract, Artificial — 1 1 - - - Raisin Bran Flakes - 1 1 - 1 1 Ravioli, Swiss in Rich Tomato Sauce - 1 1 - - - Rice, Long Grain l - 1 - - - Rose Hip Syrup 1 1 - - - Sardines, Pure in Olive Oil l — 1 - - - Sausages, Beef 2 — 2 - - - Sausages, Pork 2 - 2 - - - Steak and Kidney Pie - 1 1 - - - Stewed Steak 1 - 1 - - - Sherry. Brown 1 - 1 - - - Sherry. Pale Dry 1 - 1 - - - Short Pastry 1 - 1 - - - Smoked Oyster Spread - 1 1 - - - Scones 1 - 1 - - - Scone Mix 1 - 1 - - - Shrimps - 1 1 - - - Short Puff Pastry 1 - 1 - - - Sausage Rolls 1 — 1 - - - Savoroni, Spanish 1 — 1 - - - Soup, Beef Liver — 1 1 - - - Sausage Meat, Pork Pres. 1 - 1 - - - Top Crackers — 1 1 - - - Tea 2 - 2 - - - Tomato Soup, Condensed Cream of - 1 1 - - - Vinegar, Spec. Flav. with Tarragen 1 - 1 - - - Vodka 1 - 1 - - - Vegetable, Veal and Rice — 1 1 - - - Vegetable Macedoine 1 - 1 1 - 1 Vienese Short Bread 1 - 1 - - - Whisky 2 - 2 - - - Wheat Flakes 1 - 1 1 - 1 Yoghurts with Real Fruit Raspberry 1 - 1 — — — Totals 128 54 182 6 4 10 54 55 TABLE XVI CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1963 Disease. At all ages. Number of cases notified. At Ages—Years. Total cases notified in each Ward. Under 1 year. 1 and under 2. 2 and under 3. 3 and under 4. 4 and under 5. 5 and under 10. 10 and under 15. 15 and under 20. 20 and under 35. 35 and under 45. 45 and under 65. 65 and over. Coulsdon East. Coulsdon West. Purley. Kenley. Sanderstead. Selsdon and Farleigh. Woodcote. Diphtheria — - — - - - — - - — - - - — — - - - — - Scarlet fever 30 — — - 3 2 21 3 1 — - - - 8 5 5 - 8 4 — Pneumonia 14 — — - — — 1 — - 3 1 2 7 3 2 3 3 1 1 1 Measles 859 15 64 94 132 142 387 10 4 4 7 — — 195 166 212 48 148 37 53 Whooping cough 11 1 1 1 1 2 5 - - - - - - 4 5 — 1 — — 1 Erysipelas 1 - - - - - - - - - - - 1 - 1 - — — — — Dysentery 21 - - - - - 2 — 1 3 3 7 5 2 13 — — 5 1 — Poliomyelitis — — — — — — - — — — — — — - — — — — — — Encephalitis — — - - - - - - - - - — - - - - - - - — Meningococcal infection - - - - - - - - - - - - - - - - - - - - Puerperal pyrexia 2 - - - - - - - - 2 — — — - 1 — — — 1 — Paratyphoid B — — — — — — — — — — — — — — — — — — — — Food poisoning 1 - - - - - - - - - - 1 - - 1 — — — — — Totals 939 16 65 95 136 146 416 13 6 12 11 10 13 212 194 220 52 162 44 55 56 TABLE XVII THE MONTHLY INCIDENCE OF INFECTIOUS DISEASE, 1963 Disease. Jan. Feb. Mar. April May June July Aug. Sept. Oct. Nov. Dec. Total Diphtheria - - — - - — — - - - - - - Scarlet fever 3 — 5 4 3 - 4 — 3 2 - 6 30 Pneumonia 1 3 2 2 — 1 1 2 — 2 - — 14 Measles 275 244 165 60 13 18 42 34 3 3 - 2 859 Whooping cough — 1 2 — — — 1 — — 4 3 — 11 Erysipelas — — — — — 1 — — — — — 1 Dysentery 6 1 — 1 — 1 — 5 — — 7 — 21 Poliomyelitis — — — — — — — — — — — — — Meningococcal infection — — - — — — — — — — — — — Puerperal pyrexia — — 1 — — — — — — 1 — — 7 Paratyphoid B — — — — — — — — — — — — — Encephalitis - - - - - - - - - - - - — Food poisoning — — — —- — — 1 — — — — — 1 Totals 285 249 175 67 16 21 49 41 6 12 10 8 939 LS TABLE XVIII INFECTIOUS DISEASE NOTIFIED EACH YEAR SINCE 1933 Disease 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 Smallpox - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Scarlet fever 69 119 124 117 62 71 65 61 39 45 184 88 67 93 78 62 138 149 90 80 118 68 46 41 47 49 132 95 43 23 30 Diphtheria 16 24 52 35 8 10 10 25 7 9 7 19 15 8 — — — — — — — — — — — 1 — — — — — Erysipelas 23 17 11 12 14 13 10 17 27 22 5 9 4 8 5 8 4 4 3 — 3 4 4 8 1 4 2 5 — 4 1 Typhoid and paratyphoid fever 5 5 1 3 26 5 1 53 12 3 1 6 4 4 2 2 2 1 11 1 - 1 3 3 - - - 1 1 - - Meningococcal infection: - - 1 1 - - 4 8 6 1 4 2 1 3 1 1 - - - 1 - - - - - 1 - - 1 1 - Puerperal fever — 1 1 1 5 - - - - - - - - - - - - - - - - - - - - - - - - - - Puerperal pyrexia 1 2 1 — 2 5 3 2 — 2 3 1 2 2 1 2 2 2 3 2 3 — 3 2 4 1 1 — 1 2 2 Poliomyelitis — 1 1 — 3 1 1 1 2 3 — — 2 1 11 2 9 10 — 8 9 1 17 7 13 — - 1 — — — Polio-encephalitis - - - - 2 - - - - - - - - 1 - - - - - - - - - - - - - - - - - Acute encaphalitis — — — — — — — — — — 1 — — — — — — — — 1 — 1 — 1 1 1 - — 1 1 — Ophthalmia neonatorum - 1 - 1 1 1 - 1 1 - 1 - 1 - - - - 1 - - - - - - - - - - - — - - Pneumonia 28 20 32 13 30 12 52 19 32 38 27 9 17 16 20 13 5 23 51 21 44 20 31 36 26 22 10 8 17 15 14 Malaria — — — — — — — — — — — — — — — — — 1 — — — — - 2 — - — — — — — Measles 2 11 214 479 275 52 705 41 218 567 600 477 810 170 1319 9 1012 82 1184 103 930 60 884 582 859 Dysentery — — 6 — 1 2 10 85 224 121 21 42 172 82 43 71 14 28 22 48 13 12 98 81 2 35 141 19 42 16 21 Whooping cough 6 1 136 36 55 51 100 31 115 201 42 242 204 196 66 131 64 93 58 41 32 24 30 2 11 Food poisoning 2 6 2 5 2 74 5 8 3 17 15 1 19 1 Tuberculosis :— Pulmonary 44 28 30 27 36 32 31 31 32 43 39 51 44 38 59 48 57 47 60 42 37 31 47 41 45 31 1 26 38 24 14 18 Other forms 10 17 5 3 7 10 12 8 11 7 9 7 3 7 11 13 5 7 4 4 3 7 3 3 2 2 3 2 1 1 Totals 196 235 265 213 197 162 207 323 743 809 632 337 1137 335 564 990 880 998 1260 579 1617 359 1333 408 1386 291 1293 269 1047 680 958 *