AC4412 (3) ORPING TOA ORP 15 ORPINGTON URBAN DISTRICT COUNCIL. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH on the Health of the Urban District and the Work of the Health Department. 1951 Printed by Bromley Office Supplies & Printing Co. Ltd. East Street, Bromley CONTENTS. Page Members of the Health Committee 3 Staff 3 Prefatory Letter 4 Section A. Vital and Other Statistics and Social Conditions of the Area. Vital Statistics 8 Population 9 Births 10 Illegitimate Births 10 Stillbirths 11 Deaths 11 Maternal Mortality 11 Infantile Mortality 12 Unemployment 12 Open Air Recreational Amenities 12 Section B. General Provision of Health Services for the Area. Hospitals 15 Home Nursing Service 15 Health Visiting 15 Domiciliary Midwifery 15 Child Welfare Centres 15 Clinics 16 Ambulance Facilities 16 Laboratory Services 16 Domestic Help Service 17 Day Nurseries 17 Medical Loan Service 17 Meals on Wheels Service 17 Tuberculosis Care Committee 18 St. John Ambulance Brigade 18 Old People's Welfare Committee 18 Old People's Clubs 18 Section C. Sanitary and Environmental Circumstances. Water Supply 20 Drainage and Sewerage 21 Cesspools 21 Swimming Baths 22 Section D. Factories, Workplaces, Outworkers, Etc. Factories, Workplaces and Outworkers 24 Smoke Abatement 24 Shops Act 25 Verminous Conditions and Uncleanliness 25 Rodent Control 26 Section E. Housing. Housing Inspections 28 Rehousing 28 Moveable Dwellings 28 2 Page Section F. Inspection and Supervision of Food. Food Sampling 32 Slaughterhouses 33 Meat Inspection 34 Butchers' Shops 34 Bakehouses 34 Food Complaints 34 Milk 34 Ice Cream 35 Food Preparing Places 36 Unsound Food 36 Section G. Infectious Diseases. Anterior Poliomyelitis 40 Smallpox 40 Vaccination 41 Scarlet Fever 41 Diphtheria 41 Diphtheria Immunisation 41 Measles 42 Whooping Cough 42 Tuberculosis 42 Paratyphoid 43 Food Poisoning 44 Dysentery 45 Section H. Refuse Collection and Disposal. Refuse Collection and Disposal 48 Section J. Health Education 52 APPENDIX—STATISTICAL TABLES. Table I. Summary of Statistics 55 II. Cause of Death 56 III. Sanitary Inspection of the Area 57 IV. Housing Inspection—Defects Remedied 59 V. Infectious Diseases—Notifications and Age Groups 61 VI. Factories Acts 62 VII. Food and Drugs Sampling 64 VIII. Water Supply—Analysis 66 IX. Schedule of Parks and Open Spaces 67 3 PUBLIC HEALTH COMMITTEE as at 31st December, 1951. Chairman : S. J. L. MURRAY-WHITE, Esq. Vice-Chairman: Mrs. B. D. BARHAM. CHAIRMAN OF THE COUNCIL. F. W. BUCK, Esq. C. J. FOREMAN, Esq. Mrs. F. G. GARDNER. B. P. HANCOCK, Esq. J. W. HARRADINE, Esq. W. E. HAWKEN. Esq. VICE-CHAIRMAN OF THE COUNCIL. J R. HENDERSON, Esq. E. W. LANE, Esq. Lt.-Col. T. H. NEWEY. P. H. POWELL, Esq. H. C. VICKERS, Esq. STAFF OF THE HEALTH DEPARTMENT as at 31st December, 1951. Medical Officer of Health. K. E. TAPPER. O.BE, G.M., M.B., Ch.B, D.P.H. Deputy Medical Officer of Health. H. B. C. CARTER-LOCKE, M.B., B.S., M.R.C.S., L.R.C.P , D.P.H. Chief Sanitary Inspector, Cleansing Superintendent and Food and Drugs Inspector. F. C. CROWE, M.R.S.I., M.S.I.A. Deputy Chief Sanitary Inspector, Deputy Cleansing: Superintendent and Deputy Food and Drugs Inspector. W. T. WEEDY, C.R.S.I.. M.S.I.A. District Sanitary Inspectors. K. AUTY, C.R.S.I., M.S.I.A. C. W. BEDDIS, M.S.I.A., F.R.Met.S. T. E. W. OSBORNE, C.R.S.I., R.I P.H. Note—All the Sanitary Inspectors have been appointed as Inspectors under the Shops Act. Clerical Staff. Secretary/Shorthand-Typist : Miss C. COOPER. Clerk/Shorthand-Typist: Miss G. SMITH. Junior Clerk : Miss S. McGOWAN. Outdoor Staff. Disinfector: W. O. PRINCE. Rodent Operative: W. S. MILLS. Assistant Rodent Operative: C. V. POTTER. 4 To the Chairman and Members of the Orpington Urban District Council. Mr. Chairman, Ladies and Gentlemen, • It is once again my pleasant task to report to you a year of consolidation and progress in the Public Health Department, in this the eighteenth edition of the annual report of the Medical Officer of Health. The Public Health Department is now firmly established in permanent office accommodation at the main Council Offices at Crofton Pound Hill. The effect of this change has been to increase the stature of the department in the eyes of the public and it has had a stimulating effect on the staff with regard to their morale and pride of work. The general structure of the report has been maintained upon the lines of the last report and it is hoped that it will prove of interest to the members of the Council. It should be realised that a report such as this, necessitates good team work and I would like to pay tribute to all the members of the staff who have contributed to this effort and, especially to Mr. Weedy who has devoted many arduous hours to the checking and compilation of the many facts contained in it. I would draw your attention to a few of the most interesting features of the year, amongst which must be numbered the census, the visit of the mass radiography unit, the clean food exhibition and film show, the incidence of certain infectious diseases and the vital statistics. The census figures are reported upon fairly comprehensively elsewhere in this report, but it should be stressed that these figures are only preliminary ones and it is hoped that at some future date it will be possible to give a much more detailed statistical analysis of the population distribution. The visit of the mass radiography unit to Orpington was arranged in December, 1951, when a number only just short of two thousand people had chest x-rays. This is a truly preventive service for there is surely no better example in medicine than that of pulmonary tuberculosis of the truth of the old adage that " a stitch in time saves nine." It is indeed to be hoped that in the not too distant future the unit will be able to pay us annual visits with corresponding benefits to the health of the district. The results of the findings at these x-ray examinations have been analysed and detailed figures will be found in the section dealing 5 with tuberculosis. Unless prevention of disease becomes once again an active national policy your hospital beds and doctors' surgeries will be filled with patients lost to the nation's productive effort. Unless the public respond to all efforts of prevention the cost of treatment will continue to be an ever increasing burden. A prominent activity during the year was the clean food exhibition and film show which was a success, thanks to the co-operation of the Council and the food trade. The enthusiasm with which this was greeted was most gratifying and augurs well for the future, for without the co-operation which is so willingly forthcoming in Orpington, all our efforts towards clean food would be very largely nullified and frustrated. Under the heading of health education will be found a full report on this successful venture. The most striking feature concerning the infectious diseases was the very steep rise in the incidence of both measles and whooping cough—measles notifications increasing from two hundred and fifty in 1950 to one thousand six hundred and sixtythree in 1951, and whooping cough rising in the same period from two hundred and ninety-seven to five hundred and fifty. Although these figures look alarming on paper, they are only in conformity with the country as a whole and rather typical of the rise and fall of these diseases over a period of years. There were no deaths from these diseases during 1951. The figures for infantile paralysis shew little change but the notifications of pneumonia rose from forty-four to one hundred and forty-three which is a rise to be expected in a year in which influenza was prevalent. Another disease to show a big rise in notification was dysentery which rose from twenty-nine to ninety-three ; this, again, is comparable with the position in the country generally but, fortunately, the organism responsible in the majority of cases only gives rise to a comparatively mild form of the illness. When one considers the amount of infectious disease still occurring, it may well be that the time is approaching where the Local Authority will have to consider the appointment of an infectious disease nurse or nurses to visit and advise where necessary. None of the Vital Statistics show any significant variation from the previous year, but it is of some interest to note that forty-five per cent, of the total deaths in the district in 1951 6 were due to diseases of the heart and circulatory system in general. This is a high proportion and may possibly be due to the stress and strain of modern life, although it is a subject on which it would be unwise to dogmatize. The increasing age of the population is another factor. Statistical details of cesspool conversions will be found in the body of the report, from which it will be seen that only slow progress is being made. Two staff changes occurred during the course of 1951. Miss McGowan taking the place of Miss Clee as junior clerk and Mr. White's temporary appointment as cesspool survey officer terminating. Earlier in this letter I have referred to the importance of teamwork and I should like specially to thank Mr. Crowe and the rest of the public health department for their unfailing efficiency and cheerfulness. Finally, I would like to express my gratitude to Mr. King and the other Chief Officers of the Council for their help and co-operation and to the members of the Public Health Committee who have supported me so generously throughout what I like to think was a successful year of work. I have the honour to be, Your obedient Servant, June, 1952. K. E. TAPPER, Medical Officer of Health. SECTION A. VITAL AND OTHER STATISTICS AND SOCIAL CONDITIONS OF THE AREA. 8 SECTION A. VITAL AND OTHER STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Summary of Vital and Other Statistics. Area (in acres) 20.842 Registrar General's estimate of total population (midyear), 1951 62,850 No. of Inhabited Houses and Flats, according to the rate books, at the close of the year 18.833 No. of valuation assessments of habitable premises at the close of the year 18,928 Rateable Value (31st December, 1951) £565,071 Product of a Penny Rate for the year ending 31st March, 1952 £2,270 # Live Births. Legitimate Illegitimate Total 905 34 939 Male 465 18 483 Female 440 j 16 456 Birth Rate, 14.9 per 1,000 total population. Stillbirths. Legitimate Illegitimate Total 24 24 Male 17 Female 7 I Stillbirth Rate, 0.38 per 1,000 population. Deaths. Total 654 Male 321 Female 333 1 Death Rate 10.4 per 1.000 total population. Deaths from Puerperal Causes. Pregnancy, childbirth and abortion Nil Deaths of Infants Under 1 Year of Age. Legitimate Illegitimate Total 17 1 – 18 Male 10 1 – 11 Female 7 – – 7 Infant Mortality Rate 19.2 per 1,000 Live Births. Death Rates of Infants Under 1 Year of Age. All Infants per 1,000 live births 19.2 Legitimate Infants per 1.000 live legitimate births 18.1 Illegitimate Infants per 1,000 live illegitimate births 1.06 9 Population. The preliminary report of the Registrar General on the Census of 1951 has recently been published and shows the population of Orpington to be 63,344 at midnight on the 8th April, 1951—an increase over the previous census in 1931 of 37,486 persons, that is 145%. Compared with the neighbouring authorities, the percentage increase shows, 208.7% for Chislehurst and Sidcup (the fourth highest percentage) 34.6% for Bromley, 48.4% for Beckenham and 171.9% for Bexley. This increase in North West Kent's population is largely due to the flow of population from London, especially from those areas which were badly blitzed during the second World War. The percentage increase in the various local authorities' areas is also affected by certain changes of boundaries which have occurred since the census in 1931. It is to be noted that the figures stated in the census are exclusive of those persons absent in the armed forces, mercantile marine and others outside the country on the night of Sunday the 8th April. The population of England and Wales is shown to be 43,744,924 persons, which gives the number of persons per square mile as 750—a density which is higher than any other country in the world. The population of England and Wales has increased by 3,792,547. a percentage increase of 9.5 over the previous census. This increase is largely due to the excess of births over deaths since 1931 and accounts for 3,288,000. Females continue to exceed males by H million. In Orpington there are 29,967 males compared with 33,377 females, but age distribution and other statistical figures are not yet available. The following information which is based on a 1% sample has also been extracted from the report: Housing: conditions. Bromley. Chislehurst & Sidcup. Orpington. Total Households 20,500 24,100 18,500 Households sharing accommodation 3,400 2,000 1,300 Persons living more than 2 persons per room – 1.12% 1.33% Average number of persons per household 3.09 3.34 3.25 Average number of persons per room .66 .75 .70 Households living density— l½-2 persons per room 700 700 300 1-1½ persons per room 2,000 2,700 1.400 Less than 1 17,800 20,600 16,700 10 Households without exclusive use of— Water closet 2,100 1,700 1,000 Fixed bath 5,100 3,600 2,700 Stove and sink 1,700 1,300 900 Age distribution. 1. Persons of over 65 years of age: Bromley Chislehurst and Sidcup Orpington 12% 9% 11% 2. Child population (0-15 years): Bromley Chislehurst and Sidcup Orpington 20% 23% 25% 3. Excess females over males (all ages): Bromley Chislehurst and Sidcup Orpington 6,000 4,200 4,500 4. Single females (all ages): Bromley Chislehurst and Sidcup Orpington 13,800 19,100 14,600 Births. The Birth Rate for 1951 is 14.9 per 1,000 total population. Comparative rates during the past ten years are as follow :— Year Orpington England & Wales 1942 20.6 15.8 1943 21.0 16.5 1944 22.7 17.6 1945 17.8 14.1 1946 20.0 19.1 1947 19.0 20.5 1948 16.3 17.9 1949 16.5 16.7 1950 14.8 15.8 1951 14.9 15.5 The average yearly Birth Rate during the past ten years was 18.36 for Orpington and 17.15 for England and Wales. The Registrar General's returns for the year showed the following registered births, after transferable adjustments had been made :— Live Births—939. Stillbirths—24. Total—963. Illegitimate Births. The illegitimate birth rate (per 1,000 total population) for 1951 is 0.54. 11 Stillbirths. The number of stillbirths registered for the area during 1951 is 24. The stillbirth rate per 1,000 (live and still) births for the year is 24.9, and on a basis per 1,000 population, the rate is 0.38. The following tabulation gives the number of stillbirths and rates per 1,000 (live and still) births for the past ten years :— Year. No. of Stillbirths. Rate per 1,000 (live and still) births. 1942 28 27.5 1943 20 19.1 1944 17 25.6 1945 27 29.4 1946 33 28.2 1947 26 22.9 1948 24 25.0 1949 18 18.1 1950 21 22.2 1951 24 24.9 Deaths. The Death Rate for the year 1951 is 10.4 per 1,000 total population. Of the 654 deaths occurring, 321 were males and 333 females. The following table shows the main causes of death :— 1950 1951 Cancer 114 120 Heart and Circulatory Diseases 342 293 Respiratory Diseases (not Tuberculosis) 66 76 Tuberculosis 11 19 Infectious Diseases 1 0 Influenza 5 10 Road Accidents 9 10 Other Accidents 9 14 Suicide 3 6 Digestive Diseases 5 7 Other Causes 96 99 661 654 Maternal Mortality. There were no maternal deaths in the Urban District during the year. During the last ten years, Maternal Deaths have been as follow :— Year Actual Number of Maternal Deaths. 1942 2 1943 1 1944 2 1945 1 1946 2 1947 3 1948 1 1949 1 1950 1 1951 – 12 Infantile Mortality. The Infant Mortality rate for the year is 19.2 per 1,000 live births. 18 infants died during 1951 before reaching their first birthday :— Died in first four weeks of life 12 Died within first week and twelfth month 6 The Infant Mortality Rate compares favourably with last year's rate which was 24.9. Unemployment. There is no doubt whatever that during years of full employment there is a consequent improvement in the health of the population. I am indebted to the Manager of the Local Employment Exchange for the following information :— " At the beginning of the year the Unemployed Register had been increased by men from the building trades (mainly painters) who were affected by seasonal slackness—otherwise the register consisted generally of older men and those who were limited to light work owing to disabilities. On the Women's side the register contained a number of married women seeking part-time work and others who wanted certain kinds of employment for which there was little demand. It was possible to place a few part-time workers, with local laundries on evening work and also with a large bakery. With the improved weather in April the position changed appreciably and men returned to building and decorating whilst women were employed in local factories and a wide range of other industries. This improvement continued throughout the summer months with a special demand for building workers and women for catering, laundries, domestic service and the retail distributive trades. The last quarter of the year approached with demands steadily continuing for building, food process and hospital labour and the Women's department also enjoyed a busy quarter due to trades preparing for the Christmas season and the year ended with only a comparatively slight increase in the registers. The year viewed as a whole was one of steady demand for the young lit worker, and a number of the ' not so fit' were placed in the lighter kinds of work—the Festival of Britain employing an appreciable number of gatekeepers, porters and similar jobs —for a few months." Open Air Recreational Amenities. I have again inserted in the schedule at the end of the report a list of parks and open spaces. I have done this because this excellent provision by the Local Authority is an important factor in the promotion of health of body and mind of the inhabitants. SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. 14 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. I have again sub-divided the services into services rendered by the Council, services rendered by the Hospital Boards, services rendered by the County Council under Part III of the National Health Service Act, 1946, and Voluntary Services. 1. Public Health Services Rendered by the Council. The major services of the Public Health Department, to which detailed reference is made under Sections C, D, E. F. G and J of this report are as follow :— Enquiries into Complaints and the Abatement of Nuisances. Infectious Diseases (Prevention and Notification). Inspection of Food and Food Premises. Inspection and Examination of Water and Milk Supplies. Inspection of Factories and Shops. Refuse Collection and Disposal. Housing. Inspection of Nursing Homes. Rodent Control. Atmospheric Pollution. Health Education and all matters covered by the general heading of Sanitary and Environmental Services. On the 25th May the department moved into accommodation on the ground floor of the main Council Offices at Crofton Pound Hill and it is a great source of satisfaction to us that we have, at last, a permanent source of administration which is easily accessible to members of the public and from which contact may quickly be made with other departments. I am sure the move has brought about a greatly increased efficiency in our administration. The number of complaints received from residents during the year was two hundred and seventy-three, approximately the same as for 1950 and, once again, it is pleasing to note that it was necessary only in six cases to take recourse to formal action to secure an abatement of the nuisance. In the Appendices is a summary of the work of the Health Department. 15 2. Services Rendered by the Hospital Boards. There are two hospitals situate in the district; Farnborough Hospital with 812 beds, which comes under the Bromley Group Hospital Management Committee, and Orpington Hospital with 983 beds, which is within the Orpington and Sevenoaks Group. 3. Services Rendered by the County Council. Home Nursing Service. There are six Home Nurses operating in the Urban District. Home Nursing is provided on medical certification only, and is a free service. It is a very valuable service especially at a time when there are long waiting lists for hospital admission. Health Visiting. The County Council employ twelve Health Visitors, two School Nurses and one Tuberculosis Health Visitor within the district. Among the duties of the Health Visitors are included attendances at Welfare Centres, and the follow up and arrangement of immunisation against diphtheria and vaccination against smallpox. Their domiciliary visiting and advice has been the keystone upon which the Maternity and Child Welfare Services have been successfully built since 1918. Midwifery (Domiciliary). Three full-time midwives and three others are employed in the area. The services of the midwives are engaged direct by the patient or through the patient's private doctor and the midwives act either as midwives or maternity nurses. Child Welfare Centres. CHELSFIELD Reading Room 1st, 3rd and 5th Tuesday in month—afternoon. CUDHAM and BIGGIN HILL Sports Pavilion, Biggin Hill Thursday—morning and afternoon. DOWNE Gospel Hall 1st and 3rd Wednesday in month—afternoon. FARNBOROUGH Methodist Hall Friday—afternoon. GREEN ST. GREEN Baptist Schoolroom Friday—afternoon. KNOCKHOLT The Institute 2nd and 4th Tuesday in month—afternoon. ORPINGTON Methodist Church Hall Monday and Tuesday —afternoon. CROFTON St. Paul's Church Hall Monday—afternoon. PETTS WOOD Sports Pavilion, Recreation Ground Monday and Thursday —afternoon. ST. MARY CRAY (opened 3/7/51) Temple Congregational Church Hall Tuesday and Wednesday —afternoon. PRATTS BOTTOM (opened Oct. 51) Village Hall 2nd and 4th Thursday— afternoon. 16 Ante-Natal Clinics. CUDHAM and Sports Pavilion, Thursday—morning and BIGGIN HILL Biggin Hill afternoon. GREEN ST. GREEN Baptist Schoolroom Friday—morning. ORPINGTON Methodist Church Hall Monday and Tuesday— afternoon. PETTS WOOD Sports Pavilion, Monday and Thursday— Recreation Ground afternoon. ST. MARY CRAY Temple Congregational Friday — morning and Church Hall afternoon. Women's Welfare Clinics. CUDHAM and Sports Pavilion, 3rd and 5th Wednesday BIGGIN HILL Biggin Hill in month—morning. ORPINGTON Methodist Church Hall Every Thursday in month—morning. ST. MARY CRAY Temple Congregational 3rd Thursday in month— Church Hall afternoon. PETTS WOOD Sports Pavilion, 4th Wednesday — Recreation Ground ing. Minor Ailment Clinics (Schools). The School House. Chislehurst Road, Orpington—Saturday morning. Dental Clinics. The School House, Chislehurst Road, Orpington.—Monday to Friday (all day) and Saturday (morning),- Dental Clinics are also held in the country areas—Farnborough, Cudham, Westerham, Biggin Hill, Downe, Green Street Green, Knockholt, etc. Immunisation and Vaccination. This is carried out at the Child Welfare Centres as listed above and, in addition, at the Sports Pavilion, Recreation Ground, St. Mary Cray, every second and third Thursday and by special appointment at Chislehurst Road School, Orpington, on Tuesday afternoons. Ambulance Service. There is an ambulance depot at Farnborough Hospital where there are eleven ambulances and six sitting case cars. Laboratory Service. Food and drug samples and bacteriological medical samples are examined by the Public Health Laboratory at Maidstone, and details appear later in the report. Farnborough Hospital, with whom there is close co-operation in matters of urgency, provides a full laboratory service. 17 Day Nurseries. At the time of writing, it is the intention of the County Council to cease to provide a Day Nursery Service. During the year under review, there was one Day Nursery in the area at Scad's Hill House, Orpington. Domestic Help Service. The following is a summary of the cases assisted in Orpington during the year :— Types of cases Jan. Feb. Mar. Apl. May June July Aug. Spt. Oct. Nov. Dec. Total Lying-in 11 5 4 4 7 10 9 4 5 1 1 5 66 Expectant Mothers. Ambulant 5 — 4 2 2 — 2 4 — — 1 1 21 Bedridden 2 — — 1 1 — 2 2 4 — 1 — 13 Aged. Ambulant 33 4 6 5 1 4 7 3 2 — 2 3 70 Bedridden 12 5 2 2 3 2 1 2 1 1 5 — 36 Tuberculosis. Ambulant 14 — — 1 1 3 2 3 — 1 — — 25 Bedridden 4 — — 2 — — — 1 1 — — — 8 Other Cases. Ambulant 33 8 3 4 10 6 16 5 6 8 7 8 114 Bedridden 29 7 7 9 2 2 2 3 2 6 5 2 76 143 2S 26 30 27 27 41 27 21 17 22 19 429 No. of Part-Time Domestic Helpers Employed throughout the Year 99 Average Employed each week Diseases of Animals Acts. The County Council have an Officer stationed in Orpington who carries out the functions of this service. 4. Services Rendered by Voluntary Agencies. Meals on Wheels Service. This service is organised and operated entirely by the W.V.S. Since its inception in October, 1950, the number of meals provided steadily increased during 1951 from twenty to thirty per week, the area extending at the same time to include St. Mary Cray, Orpington, Petts Wood, Farnborough, Cudham, Green Street Green and Knockholt. The meals are cooked at The Rookery, every Thursday, and for a charge of one shilling are delivered to old and infirm people. Medical Loan Depots. Applications for the loan of nursing requisites, which are available for Orpington residents, should be made to :— Mrs. M. M. Jones, 39, Willett Way, Petts Wood (Orp. 2083). Mrs. M. Brown, 31, Willett Way, Petts Wood (Orp. 1847). 18 Orpington and District Tuberculosis Care Committee. The St. John Ambulance Brigade. Orpington Old People's Welfare Committee. Old People's Clubs. I reported fairly fully on the services of these voluntary Committees in 1950 and I have nothing useful to add, except that they are doing very valuable work for the health and welfare of the district. The extension of the services to the aged is becoming year by year more necessary, especially as it has been recorded that there are at present 13% of people who are of pensionable age and that, in thirty years time if present tendencies continue, the percentage will be 20. SECTION C. SANITARY AND ENVIRONMENTAL CIRCUMSTANCES. 20 SECTION C. SANITARY AND ENVIRONMENTAL CIRCUMSTANCES. Water Supply. I am indebted to the Director of Water Examination, Metropolitan Water Board, for the following statement and also for the details of analysis of water supplies, which are set out in Appendix VI. " The supply to the district of Orpington has been adequate at all times during 1951 and is derived from seven wells, namely, Orpington, North Orpington, Jewels Wood, Sundridge, Eynsford, Shortlands and Bexley. Bacteriological analyses of these wells are made five times a week and consistently satisfactory results have been obtained. Chemical analyses of well supplies are also made at regular intervals. All supplies are treated with chlorine on the works, but any excess remaining after a period of contact is removed completely or reduced to an amount that will not be perceptible to the consumers. All new and repaired mains are disinfected with chlorine before being restored to supply and samples of water from them are analysed to establish that the water in them is up to the normal standard of water in the distribution system. None of the supplies is plumbo-solvent. We have no information with regard to the proportion of the total number of dwelling houses and population in Orpington which are supplied from the above-mentioned sources. All the houses are supplied directly and not by means of stand pipes." The following information has been supplied by the Clerk to the Metropolitan Water Board :— " The supply to the Orpington district during 1951 was satisfactory as regards quantity. There have been no extensions of trunk mains in the Council's area during the year and no new sources of public water supply have been instituted. Lengths of service mains have been laid in various areas of the Orpington district." There are certain residential areas within the district that are without main piped water supply, no less than one hundred and sixty-three being dependent upon underground tank or well supply. During the year seventeen houses previously devoid of main supply were connected to water mains. 21 Drainage and Sewerage. Main drainage is under the control of the West Kent Main Sewerage Board. During the year improvements were completed to surface water drainage in Shire Lane near Beechlands Estate. Cesspools. Number of cesspools 2,599 Number of cesspools converted to main drainage during year .... 39 Number of houses with Pail Closets converted to cesspool drainage 15 Number of new houses erected with cesspool drainage 11 Number of other premises erected with cesspool drainage 1 Number of loads removed from cesspools on private properties .... 3,394 Number of loads removed from cesspools on requisitioned properties 543 Number of loads removed from cesspools on Council properties .... 485 In the above statistical table it will be noted that the conversion of cesspool drainage to main drainage makes very slow progress, for during the twelve months under review only thirtynine premises were converted against fifty-five of the previous year. Even with this slow progress that is being made, eleven new houses were erected with cesspool drainage. The fact that there are five hundred and twenty-seven cesspools in the sewered area, only one hundred and twenty-nine of which were emptied on application to the Local Authority, indicates that there is much still to be done even in this part of the problem. In the non-sewered area there are one thousand nine hundred and forty-seven cesspools, only five hundred and forty-three of which were emptied on application being made to the Local Authority. The problem is, therefore, three-fold. First to convert to main drainage those cesspools where the main drain is available, secondly to plan with foresight the extension of main sewers into non-sewTered areas and thirdly, the extension of the services for regular emptying of cesspools. I can but repeat what has been said in previous reports, that until this problem is solved and the gross pollution of the subsoil which is daily occurring by seepage is prevented, there remains a potential danger of the contamination of water supplies, especially where such seepage is occurring in fissured chalk formations. Although the Local Authority provide an extensive service for the emptying of cesspools at the request of occupiers, inadequate use is made of it. During the year a record was kept of the frequency in which these emptyings occurred, and the following figures show that, emptying was not adequate to prevent percolation occurring. 22 Number of premises with Cesspools 2,599 Number emptied by the Council during 1951 672 Details regarding the frequency of the emptyings during the 12 months are given below :— Premises Emptied 672 Once 281 Twice 141 3 69 4 48 5 30 6 19 7 15 8 11 9 10 10 5 11 3 12 1 Premises emptied more than twelve times during 1951—39. Swimming: Baths. There is one swimming bath in the district to which the public are admitted. Samples of water were taken periodically throughout the year and all proved to be satisfactory. SECTION D. FACTORIES, OUTWORKERS, SMOKE ABATEMENT, SHOP ACT, RODENT CONTROL AND VERMINOUS CONDITIONS AND UNCLEANLINESS. 24 SECTION D. FACTORIES, OUTWORKERS, SMOKE ABATEMENT, SHOP ACT, RODENT CONTROL AND VERMINOUS CONDITIONS AND UNCLEANLINESS. Factories. A complete survey and inspection of factories was carried out during the year and as a result the 1950 total of one hundred and seventy-nine, was corrected to a figure of one hundred and thirty-eight. Comparatively few of this number are of any size and these are situated mainly in the Cray Valley Area. The survey, which entailed over two hundred inspections, revealed comparatively few defects and, without exception, these were remedied by the close of the year. As with other premises, subject to public health legislation, an up-to-date card index register has been compiled and facts and figures giving an overall picture are readily obtainable therefrom. Table VI in the Appendix gives details of the inspections made and of the cases where defects were found. Outworkers. Twenty-seven lists of Outworkers were received during the year and from these I have extracted a list of the trades involved, together with the number of persons employed. Number of Outworkers Trade. Employed. Clothing 45 Cardboard Box and Carton Making 2 Surgical Appliances 2 Brush Making 4 Leather Goods 2 55 As stated in my last report, when a case of infectious disease is notified at an outworker's home steps are taken to ensure that there is no risk of infection being conveyed by the articles made thereat. Smoke Abatement. Once again the average monthly deposit found in the gauge at St. Mary Cray corresponds very closely with the results of previous years. 25 The comparison is shown below in the equivalent of tons per square mile :— 1949 14.78 1950 15.88 1951 14.09 Compared with industrial areas and others with a greater density of building this is quite a mild pollution but the value of the gauge lies in its ability to indicate fluctuations within our own area. However, I must stress once again that the direction of the wind and the amount of rain affects the results considerably and observations over a number of years will have to be made before we can come to any useful conclusion. In dealing with the few complaints of smoke and grit emission from factory chimneys we have found the managements and directors most anxious to co-operate and it must be said in justice to them that a factor contributing to the nuisance is the poor quality of the fuel received by them. The Council is well represented on the London and Home Counties Smoke Abatement Advisory Council and the Standing Conference of Local Authorities which co-operates with the Department of Scientific and Industrial Research. Shops Act, 1950. The survey referred to in previous reports was completed during the early part of the year. The full co-operation of the shopkeepers was received and in no case was it necessary to resort to statutory action to obtain compliance with the various requirements of the Act. A summary of the work in 1951, shows :— Inspections 305 Neglect in displaying Statutory Forms 107 Inadequate Sanitary Accommodation 3 Inadequate Heating Arrangements 2 Sanitary Accommodation in need of cleansing and repair 5 Inadequate Washing Facilities 2 Insufficient Seating for Female Assistants 1 Contravention of Closing Hours 3 Verminous Conditions and Uncleanliness. The rarity in which these conditions now occur, compared with conditions of thirty years ago, is indicative of the progress made in social services. There are cases, fortunately very few in number, where uncleanliness occurs in uncared for aged persons. In spite of the lack of baths in many homes and in 26 spite of the fact that there are many premises built with facilities for one family and shared by more than one, there is distinctive evidence that our efforts in the past in the education of the public in hygiene and cleanly habits has been successful. The cleansing station was abolished four years ago. Rodent Control. On the 1st April the Council introduced a free service to occupiers of private dwelling houses and this undoubtedly explains the steep rise in the number of notifications received and the consequent increase in the number of treatments as compared with previous years. The following statistics are of the work carried out by the rodent operatives and the District Sanitary Inspectors, following complaints and by routine investigations, and the figures for 1950 are shown to illustrate the effect of the free service at private dwellings. No. of Total No. of Infestations Inspections. Cleared. 1950 1951 1950 1951 Local Authority's Property 168 107 18 11 Dwelling Houses (including Council Houses) 6,881 7,394 185 436 Business Premises 317 193 35 37 In addition, the Council's sewers were test baited early in the year to ascertain the areas of infestation and this was followed up by treatments with poison bait in March and September. SECTION E. HOUSING. 28 SECTION E. HOUSING. The following is a summary of the work of the Inspectors during the year :— Premises inspected 201 Number of visits 1,779 Premises with defects 191 Premises rendered fit by informal action 190 Premises rendered fit by formal action 6 Re-Housing. I am indebted to the Housing Manager for the following statistics of re-housing carried out by the Local Authority :— Prior to During Total as at 1951 1951 Dec. 1951 1. (a) No. of permanent dwellings built by Local Authorities 990 162 1,152 (b) No. of prefabricated dwellings built by Local Authorities 319 — 319 (c) No. of dwellings requisitioned by Local Authorities 234 — 227 2. (a) No. of families occupying 1 (a) — — 1,152* (b) No. of Families occupying 1 (b) — — 319 (c) No. of families occupying 1 (c) — — 328 (* Plus lodgers.) 3. Total No. of families rehoused during 1951: (a) 162. (b) Nil. (c) As before. 4. No. of families with a residential claim on this authority on waiting list at 31.12.1951 in various categories: — (a) Families in urgent need of other accommodation 299 (b) Families whose applications require early consideration 690 (c) Families whose applications are less urgent 282 (d) Families with varying degrees of housing need but with no residential claim on this Authority 729 It is not possible to give any accurate idea of the number of families on the waiting list living in statutory overcrowded conditions, but the families included in Groups 4 (a), 4 (b) and approximately 255 of Group (d) above may all be said to be living in crowded conditions. Moveable Dwellings. This continues to be a problem in Orpington and one that is likely to continue and to exercise the attention both of the Town Planning Committee and the Health Committee. During the year under review, four licences were renewed embracing a total 29 of seventy-four caravans and seventy tents. For the winter months three licences, covering a total of eighteen caravans were also issued. One licence was issued to a person authorising the use of a caravan on an individual site. In all one hundred and thirty-three visits of inspection to the various sites were made by the Sanitary Inspectors. SECTION F. INSPECTION AND SUPERVISION OF FOOD. 32 SECTION F. INSPECTION AND SUPERVISION OF FOOD. During the year food premises were subject to routine and specialised inspection and a total of two thousand three hundred and twenty-one visits were made, as shown in Table III in the Appendix. Nearly four hundred of these visits were made in connection with the Council's Clean Food Byelaws which were brought into operation on the 24th July, 1950. On the whole the premises were found to be satisfactory and where additional facilities were required such as constant hot water, towels and soap, etc., little difficulty was found in persuading the shop-keepers to make the necessary provision. On the other hand the standard of handling food in a cleanly manner and the standard of protection given to it against contamination, with a few notable exceptions, was by no means high. This is a major problem which cannot be dealt with by the visiting district inspector in the limited time that he can afford to spend in each shop and the solution lies in the education of food handlers in the elementary principles of personal and environmental hygiene. In Section J, under the heading of Health Education, it will be seen that an attempt has been made to sustain the interest of food handlers in this important subject, but I cannot help feeling that the real solution lies in the teaching of these principles in the schoolroom. Bad habits formed through ignorance, and practised for ten to twenty years or more are not easily broken but good habits learnt in childhood become automatic. Children leaving school and taking up employment in food premises would automatically apply the safeguards learned in their early teaching and, becoming part of the purchasing public, would be ever demanding the highest standards of their teaching. Food and Drugs Act, 1938. One hundred and ninety-one samples of food and drugs were taken for analysis under the above Act, thirty-seven samples being formal. A further one hundred and fifty-four samples were taken for bacteriological and pathological examination and other special tests. Table VII in the Appendix gives details of these samples submitted for examination. Five samples (all informal) were found to be inferior or adulterated and the following table gives a precis of the Analyst's reports and a brief description of the action taken. 33 Samples. Potted Meat .. Analyst's Report. Meat 70%, Cereal 7.0% —Inferior. Potted Meat Contained 4% Cereal Binder—Inferior. Loaf of Bread Inferior — Contained 0.08% gritty matter, probably sand. Tapioca Adulterated — Processed farina (Potato Starch). Action Taken. Potted meat should contain 100% meat. The Ministry of Food was informed, as the product was imported, and the foreign packers were instructed to provide new labels with the correct description. This sample was taken before the new labels, referred to above, had been affixed and in view of the Ministry's explanation, no fur ther action was taken. The mode of adulteration was not determined in this case. A warning was issued however and there was no recurrence of the complaint. Upon investigation it appeared that an assistant had inadvertantly labelled Farinoca as Tapioca and the mistake had been noticed and remedied within a day or so. No action taken beyond a verbal warning. Reported to the Ministry of Food for any action deemed necessary against foreign manufacturers. Representations were made through the Importers and the Manufacturers finally agreed to conform to the Ministry's standard. Slaughterhouses. The Sanitary Inspectors made fifty-one visits to the nine slaughterhouses which remain on the register of the Local Authority. Fourteen slaughtermen's licences were issued under the Slaughter of Animals Act, 1933. Under present Food Control Regulations, very little slaughtering of animals is carried out locally and the following table is self-explanatory ;— Processed Gruyere Cheese Adulterated — Fat 8.2%. Moisture 55.7% Excessive water (Recommended limit of Food Standards Committee 45%). 34 Carcases Inspected and Condemned. Cattle Sheep excluding Cows Calves and Pigs Cows Lambs Number killed (if known) — — 2 4 89 Number inspected — — 2 2 89 All Diseases except T.B.— Whole carcases condemned — — — — — Carcases of which some part or organ was condemned — — — — 2 Percentage of the number inspected affected with disease other than T.B. — — — — 2.24% Tuberculosis only— Whole carcases condemned — — — — 1 Carcases of which some part or organ was condemned — — — — 1 Percentage of the number inspected affected with T.B — — — — 2.24% Butchers' Shops. One hundred and seventy detailed inspections were made to the forty retail butchers shops in the area. In no case during the year was there any evidence of unsound meat being exposed for sale. Bakehouses. Generally speaking, the standard of the twenty-one premises was good. One hundred and two complete inspections were made and notices issued for cleansing and repairs in eight premises. Food Complaints. The co-operation between the public and the department is excellent and, during the year, thirty instances occurred where the public submitted specimens of food which required action by the Department. Milk. The Food and Drugs (Milk, Dairies and Artificial Cream) Act, 1950, came into force on the 1st January, 1951, and, as a consolidating Act, has proved to be most helpful from the administrative point of view. A dealer's licence for Pasteurising was granted to a dairyman in the Southern Area who had installed a Heat Treatment plant and after a few teething troubles the results have been 35 consistently good. These troubles accounted for the two unsatisfactory samples mentioned below. It was gratifying to receive a letter from the dairyman expressing his appreciation for the help and advice accorded by the various officers of the Department. . The Milk (Special Designations) (Specified Areas) Order, 1951, made under the Act referred to above, came into force in Orpington on the 1st October, 1951, and from that date it became illegal for any person to sell milk without the use of a special designation, viz., Tuberculin Tested, Accredited, Pasteurised or Sterilised. All the retailers in the urban district comply with the requirements of the Order. Eighty-six visits were made to the twelve registered dairies in the Urban District and the following Licences were issued in respect of the sale of milk having a special designation. Tuberculin Tested—Dealers' Licences 12 Supplementary Licences 2 Pasteurised— Dealers' Licences 12 Supplementary Licences 3 Pasteuriser's— Dealers Licence 1 Sterilised— Dealers' Licences 21 Supplementary Licences 2 Fifty-one samples of these milks were sent to the Pathological Laboratory for examination and all but two passed the appropriate tests. Ice Cream. At the end of the year there were one hundred and fourteen premises registered for the sale of Ice Cream. One hundred and sixty-seven visits were paid to these premises and a total of fifty samples were submitted for analysis. The Food Standards (Ice Cream) Order, 1951, which came into operation on the 1st March, 1951, now lays down a standard for the composition of ice cream and the three samples submitted for chemical examination were shown to be satisfactory. In addition to reaching a defined standard of nutrition, all ice cream has to be heat treated in much the same way as pasteurised milk and forty-seven samples were submitted to test the efficiency of this treatment, which is prescribed by The Ice Cream (Heat Treatment, etc.) Regulations, 1947, and Amendments thereto. The Analyst's grading of these samples indicates a very marked improvement over the results of previous years, as shown by the following statistics ; 36 1949 (47 samples taken) Grade I 22 Grade II 13 Grade III 9 Grade IV 3 1951 (47 samples taken) Grade I 36 Grade II 6 Grade III 5 Grade IV 0 In general, Grades I and II are satisfactory while Grades III and IV may indicate some defect in manufacture, storing or handling. Where a Grade III or IV result is received an investigation is made and follow-up samples taken. Restaurant, Hotels and Canteens. In an effort to intensify the focus on safe food, visits to these premises were almost doubled during 1951 and I think the trade is beginning to realise that the early post-war Clean Food campaigns were not just a " flash in the pan." We are encouraged by the fact too that the general public is becoming more food hygiene conscious and is demanding the best that our efforts can produce. Unsound Food. During 1951, a total of one thousand two hundred and fifty Condemnation Certificates were issued, affecting in quantity 3 tons, 12 cwts, 7 lbs. of varied articles of food. No prosecutions were necessary, and the condemned food was utilised either for animal food or, where this was impracticable, destroyed. The co-operation of the traders was in all cases complete. Meat 1,019 tins Vegetables 749 tins Fruit 942 tins Preserves 208 tins Milk 353 tins Fish 499 tins Soup 185 tins Pudding 10 tins Macaroni & Cheese 1 tin Baby Food 13 tins Coffee & Coffee Essence 36 tins Mustard 3 tins Fru Grains 3 tins Crab Paste 10 tins Fruit Juice 4 tins Ham 3 tins Custard Powder 2 tins Cereals 458 packets Flour 23 packets Cake, Pudding & Flour Mixture 116 packets Ground Coffee 4 packets Savourmix 1 packet Dried Fruit 39 packets Dessert Powder 8 packets Dessicated Cocoanut 1 packet Breadcrumbs 1 packet Table Jellies 10 packets Potato Crisps 5 packets Sunnyspread 1 packet Crispbread 28 packets Dessicated Soup 7 packets 1950 (35 samples taken) Grade I 8 Grade II 12 Grade III 12 Grade IV 3 37 Rice Creamola 27 packets Dates 30 packets Milts 2 packets Salt 6 packets Gravy Powder 4 packets Biscuits 1 packet Mayonnaise 12 jars Fish Paste 8 jars Pickles 44 jars Preserves 15 jars Fruit 13 jars Chicken 1 jar French Mustard 3 jars Fruit Sauce 65 bottles Cochineal 2 bottles Bovril 2 bottles Tonic Wine 5 bottles Coffee 10 bottles Vinegar 1 bottle Lemonade Powder 14 bottles Figs 2 boxes Cheese & Cheese Spread 188 boxes Ice Cream Cones 8,700 Cakes 24 Eggs 294 Rabbits 114 Turkeys 3 Chickens 15 Oxtails 17 Tea 3 lbs. Jellied Veal 2 lbs. Dried Milk 14 lbs. Butter 21 lbs. Biscuits 5 lbs. Toffees lbs. Cereal 71 lbs. Cheese 134 lbs. Ham 23 lbs. Bacon 106 lbs. Sausages 33 lbs. Fresh Meat 771 lbs. Flour 172 lbs. Dried Fruit 182 lbs. Prawns 18 lbs. Wet Fish 65 stones SECTION G. INFECTIOUS DISEASES. 40 SECTION G. INFECTIOUS DISEASES. I have shown in Table V in the Appendix a return of the notifications of infectious diseases received during the year, where it will be seen that, in all, two thousand, six hundred and fifty-seven notifications were received of which one thousand six hundred and sixty-three were of measles. Not all of these cases received a home visit from the Sanitary Inspectors, visitation being limited to the more acute attacks of infection and the follow-up of the cases admitted to hospital—which numbered one hundred and thirty-eight. Home enquiries by the Sanitary Inspectors totalled four hundred and six. Broadly speaking, there was no event of serious import during the year, the exception being a controlled outbreak of paratyphoid, upon which I report later. Anterior Poliomyelitis. Sixty-one cases were notified, thirteen of which were admitted to hospital. While these figures tend to imply that the disease was widespread, in effect there was only one acute case, which arose in June and was still in an iron lung at the end of the year. A few of those admitted to hospital showed evidence of partial paralysis which cleared up under treatment and without resulting in permanent paralysis. The balance of the cases were notified as infantile paralysis, but did not reach the development of the paralytic stage. Smallpox. Fortunately there were no cases of smallpox, although the disease did appear elsewhere in the country in its severe form. It is a disease which is not infrequently undiagnosed in the early stages and, because of this, there is not infrequently a spread of the infection before the diagnosis is confirmed. The possibility of a case being smallpox should always be uppermost in the minds of doctors when called to a case where the diagnosis is uncertain. Owing to the ease and speed of modern travel, the importation of smallpox from countries where the disease is endemic is an ever present possibility, and the Health Committee have accepted a plan of action to be exercised in the event of a case of virulent Smallpox arising in Orpington. It is also for this reason that yearly vaccination of Health Department staff is undertaken. 41 Vaccination. I am indebted to the County Medical Officer for the following return of persons vaccinated during 1951 : Age at 31st December, 1951 Under 1 1 to 4 5 to 14 15 or Over Total Number Vaccinated 312 326 109 76 823 Number Rc-vaccinated 10 80 276 366 It will be seen from this that the public are showing a very poor response with the result that there is an ever-increasing proportion of the population who remain unvaccinated. Scarlet Fever. Ninety-four cases were notified, thirty of which were admitted to hospital. Scarlet Fever continues to show itself in a mild form and none of the ninety-four cases showed the acute illness which used to be so common years ago. It is now a disease which can be safely treated at home, the necessity for hospital removal rarely arising. It is only one form of an infection by hemolytic streptococci and it is only when the condition can be diagnosed as scarlet fever that it becomes notifiable. It must, however, not be overlooked that there is no guarantee that scarlet fever will remain in its present mild state. It is the habit of such diseases not only to rise and fall in incidence, but also to rise and fall in severity of infection. There is no real evidence that the population is creating an immunity against this disease. Diphtheria. There have been no cases of diphtheria in Orpington for over two years. Because of its absence, there is a great tendency for the public not to realise that diphtheria must always remain a dangerous possibility. In diphtheria immunisation lies a preventive service which, to be effective, must be maintained at the highest possible level. The following table has been supplied by the County Medical Officer : (a) year of birth 1037 1938 1939 1940 1941 1042 1043 1044 1045 1046 1047 1048 1040 1050 1951 Total 624 712 806 753 763 583 1,076 945 816 812 959 619 614 687 54 10,823 (b) year of birth 1051 1050 1040 1048 1947 1046 1045 f1944 1943 1042 1041 1940 1039 1038 1037 Total Primary Inoculations. 54 616 139 21 15 23 8 7 4 6 2 7 28 13 17 960 Reinforcing Inoculations. — — — 2 53 269 97 62 35 46 31 38 108 100 152 993 42 These two tables show (a) the number of children under the age of fifteen who have been immunised at one time or another and (b) the extent to which immunisation has been carried out during the year 1951. Measles. One thousand six hundred and sixty-three cases of measles were notified during 1951, compared with two hundred and fifty cases in 1950 and one thousand and forty-nine in 1949. The type of infection was mild and there were no deaths. Thirty of the cases were admitted to hospital, mainly because of inadequate facilities for home nursing. The notification figures taken over the three years 1949, 1950 and 1951 demonstrate the well-known fact that measles occurs in two yearly periods with a superimposed wave of five-yearly periods. Whooping Cough. There were five hundred and fifty cases of whooping cough notified, compared with two hundred and ninety-seven in the previous year. Twenty-three of the cases were admitted to hospital. This disease, like measles, was not so severe as in previous years but, nevertheless, remains a disturbing disease of childhoods Immunisation against whooping cough is possible, but it has not yet received the full support of the medical profession. Research is continuing and there is every possibility of approval being given by the Ministry of Health once all dangers of immunisation against the disease have been eliminated. Tuberculosis. The following table has been extracted from the tuberculosis register, where it will be seen that there were eighty-four additions and twenty-three removals : Pulmonary Non-Pulmonary Total Cases M F M F (a) No. of Cases of Tuberculosis on the register at the commencement of year 296 240 65 71 672 (b) No. of cases notified under the Public Health (Tuberculosis) Regulations for the first time during the year 30 21 4 1 56 (c) No. of cases restored to the register during the year (d) Other additions to the register during the year 12 15 1 _ 28 (e) No. of cases removed from the register during the year 15 5 2 1 23 (f) No. of cases remaining on the register at the end of the year 323 271 68 71 733 43 The total number of cases of tuberculosis represents a rate of 11.7 per thousand population, which is a slight increase over the previous year. There were nineteen deaths from tuberculosis. The mass radiography unit made its first visit to Orpington between the 5th and the 11th December, 1951. There was excellent response and, during the one week of their stay, one thousand nine hundred and fifty-four people took advantage of this service. The value of the service cannot be over estimated. It is, in fact, a truly preventive service in that it brings to light evidence of early tuberculosis and so allows treatment to be commenced and every action taken before the disease takes a crippling grip. I am sure that a wider use of mass x-ray would assist the hospitals and prevent high cost of treatment which arises once a person becomes badly affected. As a result of this one week's operation, fourteen cases were discovered to be significant new cases of pulmonary tuberculosis. Statistically, this would indicate that in the population of Orpington there are as many as seven persons per thousand who are potential cases of tuberculosis. Paratyphoid. It was during September that I reported to the Committee on a small outbreak of paratyphoid which occurred in this part of North West Kent. I am, therefore, extracting, from the Chislehurst and Sidcup Annual Report what I have written. " Two cases of paratyphoid ' B ' were notified, one on the 13th July, 1951, and the second on the 17th July, 1951—the date of onset of symptoms in each case being respectively the 7th and 12th July. The delay in notifications was mainly due to the difficulty of diagnosis and to the time taken for bacteriological and seriological verification. It is this delay between onset of illness and the confirmation of the diagnosis that makes any investigation into the source of this disease so difficult. In cases of paratyphoid infection, there is also to be considered the period of incubation which, in some cases, may be as much as two weeks. As a general rule, one can accept that paratyphoid ' B ' is a food infection and not a ' Case to case ' infection. On investigation being made into these two cases, there appeared to be no connection—the one at Sidcup had no relation or contact with the case at St. Paul's Cray. It was only on the occurrence in the same week of a case in the Orpington district that a relationship was found between all three. All three 44 families had purchased cakes from the same baker, and had possibly purchased ' iced lollies' which although obtained from different itinerant dealers, were found to come from a common source. The investigation made into the " iced lolly " source, however, proved negative and we were left with the Baker as the only possible source of infection. It was known that this Bakery covered a very wide area in North West Kent and there was definite evidence in two of the three cases that cream buns had been eaten from this supply. On communicating with the Medical Officer of Health of the area in which this firm is established, it was found that another case had arisen about the same time in his own area—the baker being the same itinerant supplier. Steps were immediately taken by this Medical Officer to investigate and control the source of supply. In the meantime a further case arose in the Orpington district and other cases in Lewisham, Dartford and Dartford Rural Distict and Crayford. Of the fourteen cases which thus came to notice, eleven had the same baker and there was evidence that cream buns had been eaten. There was, therefore, presumptive evidence that the infection lay with the ' cream.' As a result of action taken, there were no further cases. The comparatively small number of cases notified bears little relationship to the number of persons who may have been infected, for it is noteworthy that, in epidemics of Paratyphoid ' B,' cases occur which are not severe enough to call in medical aid and, therefore, escape supervision." Food Poisoning. It is now happily the custom in any doubtful cases for the General Practitioner to notify the Medical Officer of Health of Food Poisoning or suspected Food Poisoning. It is only by the very closest co-operation between the practitioner and the department that control and investigations can be exercised. It is of vital importance that these notifications should be made within twenty-four hours of onset, otherwise we are unable to co-relate the symptoms, the food taken and the movements of the patient. It follows, however, that although twenty-six cases were notified, in only three cases were we able to identify the organisms concerned. Fortunately, there were no real outbreaks, the twenty-six cases being individual patients. The adage that "prevention is better than cure "is truly demonstrated in the question of food poisoning. Hygienic handling of food in all its aspects is the real controlling factor. 45 Dysentery. A widespread epidemic of dysentery occurred throughout the country during the year, mainly of a mild type and mainly due to the presence of salmonella sonne. It is difficult and practically impossible to find the source of this infection as it is principally a case to case infection. Ninety-three cases in all were notified. SECTION H. REFUSE COLLECTION AND DISPOSAL. 48 SECTION H. REFUSE COLLECTION AND DISPOSAL. Mr. Crowe reports :— As far as the collection of household refuse is concerned, 1951 was a very successful year. I have stated before that the first essential for a satisfactory refuse collecting service is regularity of collection. When the teams are paying their weekly visits on the same day and at about the same hour there are practically no complaints. The service has only to be irregular and over the weekly interval, for the office to be inundated with complaints, both verbal and written. During the year the number of complaints received was the fewest since before the war. The regular weekly collection was maintained with only slight disturbance at Easter and Christmas. The collecting teams have been enthusiastic in their endeavours to maintain the weekly collection and the decision of the Public Health Committee, as a result of my special report, to increase the number of collectors and to provide the foreman with a utility van contributed in no small measure to the improved service. At the end of the year the Council owned eleven selfcontained side loading refuse collecting vehicles, one of which is used exclusively for the collection of kitchen waste. Four teams operating a relay system with two vehicles each account for eight of the vehicles, one is engaged on collections from hospitals, schools and specials, and, as stated, one on pig food collection, thus leaving one vehicle in reserve to be brought into service at times of breakdown or repair and overhaul of the vehicles. The total number of workmen engaged on the service including the collection of kitchen waste is forty-one. At the end of the year, of the forty-one men employed, the average age was forty years. Seven were in their twenties, thirteen in their thirties, twelve in their forties and eight in their fifties. The fact that I have been able to engage younger men to fill vacancies when they have occurred has contributed to the improved service. The collectors use skips and where the length of carry is considerable, as it is in this district, there is a saving in time as only one trip to the premises is necessary. If the bin were emptied direct into the vehicle and then returned to its position 49 at the rear of the house the number of bins emptied daily would be greatly reduced. A census of the number of premises visited and the bins emptied was taken in July : Premises Bins Northern Area (weekly collection) .... 15,697 17,184 Southern Area (fortnightly collection) .... 2,559 3,017 The average number of bins emptied by each collector daily is one hundred and eighty. The approximate weight of the refuse collected is fifty tons daily and this is disposed of by means of controlled tipping in a valley at Downe. The refuse is tipped in layers and all surfaces are covered with soil, clinker and ashes. The ashes and clinker which are obtained from two large hospitals in the district have been invaluable in this respect. The layers have to be of a depth so as to allow for consolidation which is obtained by the vehicles backing on the deposited refuse and tipping their loads over the end of the layer. This sealing of the refuse is necessary to prevent rats and flies gaining access and to prevent the emergence of flies which may be hatched from larvae present in the refuse. It also prevents the escape of offensive odours associated with decaying vegetable matter. In addition the sealing of the tip surface assists in retaining the heat which is generated by the bacteriological and chemical action occurring in the body of the refuse and thus helps to speed up the process of decomposition. The temperature inside the tip may rise to 160°F. within the first fourteen days and this is maintained for twenty-four hours or more, consequently there is little likelihood of pathogenic organisms surviving. The return to normal atmospheric temperature takes three months or more. The danger of a fire breaking out due to hot ashes or to spontaneous combustion has to be carefully watched. Pig Food is collected three times each week from street bins and daily from a few food shops and canteens. During the year a total of four hundred and eighty-two tons of pig food was sold to pig keepers for £1,725. The monthly figures for the pig food collections are as follow : 50 Tons. Cwts. Quarters. £ s. d. January 45 17 — 154 15 0 February 36 13 2 123 15 8 March 40 3 2 135 11 11 April 37- 7 2 128 19 0 May 40 7 3 139 6 11 June 38 0 2 140 13 11 July 32 0 2 118 9 11 August 35 6 — 130 12 3 September 41 15 2 154 11 5 October 47 0 3 174 0 10 November 45 8 2 168 1 6 December 42 • 6 2 156 12 1 482 7 2 £1,725 10 5 The Council collected waste paper from 1940 until 1949 when the price dropped drastically and it became difficult to sell. A large stock accumulated which ultimately was almost given away. During 1951 the prices for waste paper were again high and the Council discussed on many occasions the question of reinstituting a waste paper collection and finally it was agreed that a trial scheme be operated from the 31st December, 1951, for a period of three months. SECTION J. HEALTH EDUCATION. 52 SECTION J. HEALTH EDUCATION. A Clean Food Exhibition and Film Show was held in the Civic Hall on Monday, 25th June, 1951. It was attended by members of the staffs of food shops, school and works canteens and food handlers generally. One hundred and thirty-one people were present including the Chairman of the Council, the ViceChairman of the Public Health Committee and several members of the Council. Three films were shown, namely :— "Another Case of Food Poisoning," " The Town Rat " and " Catering." They were very much enjoyed and invoked a good deal of interesting discussion. Items in the exhibition included (1) a "Prevention of Food Poisoning " display set which showed the various ways in which food can become infected and cause food poisoning and also how this can be prevented. (2) a Clean and Contaminated Milk Bottle display which emphasised the care that should be taken to rinse the bottles thoroughly after emptying and to protect them from gross contamination before returning them to the milk roundsman. (3) a Sampling Display unit which showed the types of food and drugs which are sent to the Analyst for routine examination. A brief description of the legal standard of composition was given with each article. (4) a display of Tinned Food which had been condemned for various reasons. The exhibition attracted much attention and the Inspectors had many questions to answer, particularly on the " sampling " display. People generally were surprised to learn of the thoroughness employed in the routine checking of food supplies. The question of giving talks to shop staffs, immediately after closing hours, referred to in my last report, was dealt with in the few cases where the numbers made it a practical proposition, but towards the end of the year preliminary arrangements were made to put another scheme in hand, the object of which is to train one or two suitable members of the staff in each establishment who can be made responsible under the management, for calling attention to bad hygienic practices, etc. I hope to be in a position to comment on the success, or otherwise, of this scheme in my next report. APPENDIX. STATISTICAL TABLES—1951. 54 STATISTICAL TABLES—1951. TABLE I—Summary of Statistics. TABLE II—Cause of Death. TABLE III—Sanitary Inspection—Visits and Defects. TABLE IV—Housing Inspection—Defects Remedied. TABLE V—Infectious Diseases—Notifications and Age Groups. TABLE VI—Factories Acts—Official Return. TABLE VII—Food and Drugs Sampling. TABLE VIII—Water Supply Analysis. TABLE IX—Schedule of Recreation Grounds, etc. 55 TABLE L SUMMARY OF STATISTICS—1951. Population (mid-year, 1951, per Registrar General) 62,850 Birth Rate 14.9 Death Rate 10.4 Maternal Mortality Rate — Infant Mortality Rate 19.2 Number of Births (live) 939 Number of Stillbirths 24 Number of Deaths 654 Number of Maternal Deaths — Number of Infant Deaths (under 1 year) 18 Death Rate of Respiratory Diseases (incl. Influenza but not Tuberculosis 1.36 Death Rate of Tuberculosis 0.3 Death Rate of Cancer 1.91 Death Rate of Zymotic Diseases — Notifications of Infectious Diseases— Scarlet Fever - 94 Diphtheria — Poliomyelitis 61 Typhoid Fever — Puerperal Pyrexia 5 Pneumonia 143 Tuberculosis (new cases) 56 Number of Deaths from Infectious Diseases — Number of Deaths from Diarrhoea (under 2 years) — Number of Visits by Sanitary Inspectors 14,826 56 TABLE II. CAUSE OF DEATH—1951. Male. Female. Total 1. Tuberculosis—Respiratory 13 3 16 2. Tuberculosis—Other 2 1 3 3. Syphilitic deisease — 1 1 4. Diphtheria — — — 5. Whooping Cough — i — — 6. Meningococcal infections — — — 7. Acute Poliomyelitis — — — 8. Measles — — — 9. Other infective and parasitic diseases .... — — — 10. Malignant, neoplasm, stomach 16 11 27 11. Malignant neoplasm, lung, bronchus 19 — — 12. Malignant, neoplasm, breast — 13 13 13. Malignant neoplasm, uterus — 7 7 14. Other malignant and lymphatic neoplasms 24 30 54 15. Leukaemia, Aleukaemia 2 2 4 16. Diabetes — 6 6 17. Vascular lesions of nervous system 19 47 66 18. Coronary disease, angina 55 34 89 19. Hypertension with heart disease 13 7 20 20. Other heart disease 40 54 94 21. Other circulatory disease 12 13 25 22. Influenza 1 9 10 23. Pneumonia 18 23 41 24. Bronchitis 17 18 35 25. Other diseases of respiratory system 4 7 11 26. Ulcer of stomach and duodenum 6 1 7 27. Gastritis, enteritis and diarrhoea — — — 28. Nephritis and nephrosis 2 3 5 29. Hyperplasia of prostate 7 — 7 30. Pregnancy, childbirth, abortion — — — 31. Congenital malformations 4 1 5 32. Other defined and ill-defined diseases 25 34 59 33. Motor vehicle accidents 7 3 10 34. All other accidents 11 3 14 35. Suicide 4 2 6 36. Homicide and operations of war — — — All causes 321 333 654 57 TABLE III. VISITS PAID TO VARIOUS PREMISES TOGETHER WITH DEFECTS AND CONTRAVENTIONS FOUND. Housing Inspection. No. of Inspections No. of Premises at which Defects or Contraventions were found For defects and nuisances 1,779 191 Verminous conditions 16 5 Water supply 82 22 Cesspools 540 313 Common Lodging Houses 13 — Drainage 499 51 (2,929) Infectious Diseases. Inquiry Visits 406 — Food Premises. Dairies 86 — Bakehouses 102 8 Restaurants, Canteens, etc. 250 13 Butchers 170 13 Fishmongers and Poulterers 66 7 Grocers 508 19 Greengrocers and Fruiterers 56 6 Ice-Cream 167 5 Slaughterhouses 51 4 Fried Fish Shops 14 — Hawkers' Carts, Stalls and Street Vendors 40 8 Visits in connection with sampling 211 — Re Clean Food Byelaws 394 — Miscellaneous 206 — (2,321) Factories. Factories with Mech. Power 175 9 Factories without Mech. Power. 16 6 Other premises classified as Factories 11 1 Emission of Smoke and Fumes 66 — (268) Trade Premises. Shops (for Shops Act) 305 116 Piggeries 55 4 Caravan Sites 133 — (493) 58 Miscellaneous. No. of Premises at which Defects or Contraventions were found No. of Inspections Rodent Control— Local Authority's Property 107 11 Dwelling Houses (including Council Houses) 7,394 436 Business Premises 193 37 Swimming Baths 8 — Suspected Food Poisoning 52 — Keeping of Animals 57 5 Offensive Accumulations 74 6 Schools 7 3 Public Conveniences 51 — Theatres and Places of Entertainment 2 1 Unclassified 464 — 14,826 1,300 59 TABLE IV. HOUSING INSPECTION—DEFECTS, ETC., REMEDIED DURING 1951. Drainage. Drains constructed or reconstructed 3 Water closets cleansed 1 Water closets provided 1 Drains repaired 7 W.C. basins provided 3 Drains cleansed 38 W.C. basins renewed 8 Inspection Chamber covers provided 1 W.C. seats repaired or renewed 2 Ventilation improved or repaired 1 Flushing cisterns repaired or renewed 13 Cesspool provided 1 Provided with supply of water 1 Cesspool emptied 13 Cesspools repaired or reconstructed 1 Leaking cesspools abolished & premises connected to sewer 15 New kitchen sinks provided 3 Sink waste pipes renewed or repaired 8 Dampness. Roofs made watertight 73 Rainwater downpipes repaired or renewed 12 Walls made waterproof . 43 Damp proof courses repaired or renewed 6 Flashings repaired or renewed 10 Rainwater gutters repaired or renewed 25 Chimney stacks made waterproof 5 Water Supply. Main supply provided 1 Ball valves repaired or renewed 5 Pipes repaired or renewed 12 Storage tanks repaired or renewed 6 Domestic boilers repaired 7 Taps repaired or renewed 6 General Items. Wall plaster repaired 38 Dustbins provided 28 Ceiling plaster repaired 29 Ventilated food stores provided 1 Floors repaired 20 Rooms cleansed or redecorated 42 Nuisance from animals abated 1 Windows and doors repaired 46 Noxious accumulations removed 8 Glazing repaired 3 Lighting improved 1 Walls re-pointed 1 Staircase repaired 1 Chimney pots renewed 1 Fire surrounds and grates repaired or renewed 15 Doorsteps repaired or renewed 2 Chimney flues cleansed 1 Yard paving and drainage repaired 4 60 NUISANCE ABATED AND DEFECTS REMEDIED FOLLOWING FORMAL ACTION, 1951. Defective & overflowing Defective plasterwork to cesspool l 1 staircase walls 1 Defective roiofs, causing Defective brickwork and dampness 4 cement rendering 2 Defective front entrance Chimney flashing renewed 2 door 1 Defective scullery roof 1 Defective fillets and lead Drains cleared 1 gutterings 4 Provision of airtight covers Defective dripboard over to I.C. 1 window 1 Defective window frames 1 Defective flushing cistern 1 61 TABLE V. CASES OF INFECTIOUS DISEASE NOTIFIED DURING 1951. At all ages Under 1 year 1-2 3-4 5-9 10-14 15-24 25-44 45-64 65 and over Age Unknown Removed to Hospital Total Deaths Scarlet Fever 94 1 6 19 58 7 3 — — — — 30 — Whooping Cough 550 20 132 179 184 9 5 7 4 1 9 23 — Poliomyelitis 61 — 1 6 16 8 11 11 8 — — 13 — Measles 1663 28 277 484 794 44 7 11 4 — 14 30 — Diphtheria — — — — — — — — — — — — — Pneumonia 143 2 6 5 23 1 15 22 33 31 o 15 — Dysentery 93 5 6 13 19 6 8 20 8 2 — 13 — Smallpox — — — — — — — — — — — — — Puerperal Pyrexia 5 — — — — — 2 3 — — 4 — Erysipelas 14 — — — — — 1 0 4 2 1 1 — Malaria — — — — — — — — — — — — — Food Poisoning 26 2 5 1 1 1 1 11 2 2 — 2 — Meningococcal Infection 4 1 — — — — 2 1 — — — 3 1 Paratyphoid 4 — — — 2 — 2 — — — — 4 — Totals 2657 59 433 707 1097 76 57 98 63 38 29 138 1 62 TABLE VI. FACTORIES ACTS 1937 AND 1948. PART I. OF THE ACT. 1. INSPECTIONS FOR PURPOSES OF PROVISIONS AS TO HEALTH. Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 20 16 6 — (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 114 175 9 — (iii) Other premises in which Section 7 is enforced by the Local Authority *(excluding outworkers' premises) 4 11 1 — Total 138 202 16 — * Electrical Stations (Section 103 (1)), Institutions (Section 104), and sites of Building Operations and works of Engineering Construction (Sections 107 and 108). 63 TABLE VI (contd.) 2. CASES IN WHICH DEFECTS WERE FOUND. Particulars Number of Cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness (S. 1) 5 5 — 1 — Overcrowding (S. 2) — — — — — Unreasonable temperature (S. 3) 1 1 — — — Inadequate ventilation (S. 4) 1 1 — — — Ineffective drainage of floors (S. 6) — — — — — Sanitary Conveniences (S. 7)— (a) Insufficient 1 0 — 1 — (6) Unsuitable or defective 15 14 — 2 — (c) Not separate for sexes 1 1 — — — Other offences against the Act (not including offences relating to Outwork) 12 1 11 — — Total 36 25 11 4 — 64 TABLE VII. FOOD AND DRUGS SAMPLING. Articles Formal Samples Informal Samples Apricot Nectar — 1 Aspirin Tablets — 1 Arrowroot — 1 Baking Powder — 8 Bread — 1 Blancmange — 2 Bacon — 2 Butter — 3 Beef Suet — 1 Cakes and Pastries — 3 Cough Syrup — 2 Cornflour — 1 Chutney — 2 Cake Flour Mixture — 2 Christmas Pudding — 1 Cheese — 2 Cheese Gruyere (Processed) — 1 Castor Oil — 1 Camphorated Oil — 1 Chicken Broth — 1 Cooking Fat — 2 Curry Powder — 1 Doughnuts — 1 Dessert Gelatine — 1 Essence: Almond — 2 Coffee and Chicory — 5 Lemon Flavouring — 1 Peppermint — 1 Flour, Self-Raising — 1 Glace Cherries — 1 Glycerine, Lemon and Ipecacuanha Mixture 1 Gee's Linctus — 1 Groats — 1 Horseradish with Vitacream — 1 Ice Cream — 3 Jam: Raspberry — 2 Damson — 2 Strawberry — 1 Apricot — l Lemon Squash — l Meat, Potted — 2 Margarine — 2 Mixed Peel — 1 Milk: New (Fat Content) 37 — Milk Pudding Mixture — 1 Magnesia — 1 Mustard — 4 Mince Pies — 1 65 Articles Forma Samples Informal Samples Mayonnaise — 1 Ointment: Boracic — 1 Boric Acid — 1 Zinc — 3 White Precipitate — 2 Orange Squash — 1 Olive Oil — 1 Paste: Meat — 8 Fish — 10 Powder: Custard — 4 Junket — 1 Gravy — 1 Ice Cream — 1 Daisy — 1 Raising — 1 Pepper: White — 2 Flavoured Compound — 1 Piccalilli — 2 Pickle, Sweet — 2 Potato Crisps — 1 Sauce — 4 Sauce, Fruit — 1 Sandwich Spread — 1 Spaghetti — 1 Semolina — 1 Skin Tablet — 1 Soup: Tomato — 1 Kidney — 1 Dessicated — 1 Onion — 1 Mock Turtle — 1 Salad Cream — 7 Tomato Ketchup — 3 Tapioca — 2 T.C.P. — 1 Vinegar — 3 Total 37 154 SPECIAL SAMPLES OF MILK, ICE CREAM AND WATER Milk (Tuberculin Tested)—Bacteriological Examination 4 Milk (Pasteurised)—Phosphatase Test 39 Milk (Sterilised)—Turbidity Test 8 Ice Cream—Bacteriological and Pathological Examination 47 Ice Cream—Chemical Test 3 Water—Bacteriological Examination 48 Water—Chemical Examination 5 154 GRAND TOTAL 345 66 TABLE VIII. AVERAGE RESULTS OF THE CHEMICAL AND BACTERIOLOGICAL EXAMINATION OF THE WATER SUPPLY TO ORPINGTON FOR THE YEAR 1951. PARTS PER MILLION (unless otherwise stated). Description of the Sample No. of Samples Ammoniacal Nitrogen Albuminold Nitrogen Oxidised Nitrite Nitrogen Nitrate Chlorides as C1 Oxygen abs. from Permanganate 3 hrs. at 80°F. Colour m.m. brown, 2 ft. tube Burgess's Tintometer Hardness (Total) Hardness noncarbon ate pH Value Silica as Sio$ Conductivity Orpington Well 2 0.000 0.016 — 8.5 16.0 0.090 0 292 52 7.3 13 475 North Orpington 2 0.004 0.020 5.3 13.8 0.100 0 269 34 7.4 15 425 Jewels Wood 2 0.004 0.016 — 3.0 10.0 0.190 0 249 27 7.4 12 375 Sundridge 4 0.015 0.027 — 2.8 17.4 0.070 0 219 40 7.5 17 350 Eynsford 4 0.014 0.032 — 4.2 14.3 0.062 2 264 35 7.3 15 425 Shortlands 6 0.005 0.022 — 5.1 16.3 0.050 0 295 77 7.3 17 450 Bexley 6 0.009 0.053 — 5.8 17.3 0.160 0 295 61 7.3 17 450 BACTERIOLOGICAL RESULTS. No. of samples Plate Count (Average per millilitre) Colonies counted on Agar Bact. coli Test Percentage of samples negative in 100 ml. Average number of Bact. coli per 100 ml. 22 C. (3 days) 37 C. (20-24 hrs.) Orpington 249 108.7 9.7 99.6 0.008 North Orpington 250 104.8 5.7 100-0 Nil Jewels Wood 47 2.3 0.6 100.0 Nil Sundridge 255 0.9 0.5 99.6 0.008 Eynsford 352 181.6 42.0 99.2 0.017 Shortlands 256 7.8 0.1 100.0 Nil Bexley 247 2.0 0.5 99.6 0.004 67] TABLE IX. ORPINGTON URBAN DISTRICT COUNCIL. SCHEDULE OF RECREATION GROUNDS, COMMONS, PARKS, OPEN SPACES AND PUBLIC GARDENS FACILITIES, MARCH, 1952. Parks and Recreation Grounds Ward Acreage Sports Fixtures Children's Playground | Football | Rugby | Hockey | Lacrosse [ Cricket f Netball Bowls Hard Courts | Grass Courts Concrete Practice Wicket | Putting Running Track, etc. | Swings | Plank Swings Roundabout 1 Ocean Wave See-Saw Giant Stride Sandpit Paddling Pool Hut Storm Shelter Pavilion BIGGIN HILL Biggin Hill 10.7 2 - 1 — 1 — — 2 — 1 — _ 9 — _ 1 1 _ 1 _ 1 _ Yes CHELSFIELD Chelsfield 2.10 - - - - - - — - - - - — - - — - — - — — — No CUDHAM VILLAGE Cudham 10.39 1 - - - 1 1 — - 1 1 — - 3 1 — 1 — — 1 — — — Yes CUDHAM LANE Green St. Green 6.5 — — — — — — — — — — — — — — — — — — — — — — No DOWNE Downe 0.5 - - - - - - - - - - - 4 - - 1 - - - - - No FARNBOROUGH Farnborough 10.0 2 - 1 - 1 1 . -7 - - 1 - - 6 - 1 1 1 1 1 1 - — Yes GLENTRAMMON Green St. Green 13.5 1 - - - 1 2 - - - 1 - - 8 - - 1 1 - 1 - - - Yes GODDINGTON Goddington South 63 .95 4 3 1 1 3 2 - 2 - 1 - 1 4 - 1 1 - 1 - 1 - Yes GRASSMEADE Goddington North 9 .6 - - - - - - - - - - - - 8 - 1 1 - — - - 1 Yes KNOCKHOLT Knockholt 0.75 - - - - - - - - - - - 3 - - 1 1 1 — - — 1 No PETTS WOOD Crofton North 12.27 1 - 1 - 1 - — 2 - - — — 6 — — 1 1 — — — — — Yes POVEREST Knoll 17.5 2 - — — 1 1 1 4 - 1 1 — 6 — 1 — 1 - 1 — — — Yes PRATTSBOTTOM PLAYGROUND Green St. Green 0 .055 - - - — — - - — - — - — - - — - - - — - — — No ST. MARY CRAY St. Mary Cray North 19 .0 3 - 1 - 1 1 1 2 - 1 - - 4 1 1 1 1 - 1 - 1 1 Yes WILLETT Petts Wood 6.1 - - - - 1 - 1 6 - 1 - - - - - — - - - — - - Yes FARNBOROUGH (Opp. New Inn P.H.) Farnborough 0.134 No PUBLIC GARDENS. BROXBOURNE GARDENS Knoll 0.82 — — — — — — — — — — — — — — — — — — — — — — No RIVERSIDE GARDENS St. Mary Cray North 5.8 — — — — — — — 1 — — — — — — — — — — — — — — No THE PRIORY GARDENS Goddington North 14.03 — — — — — — — — — — — — — — — — — — — — — — No OPEN SPACES. OKEMORE GARDENS St. Mary Cray North 3.15 — — — — — — — — — — — — — — — — — — — — — No WOTTON GREEN St. Mary Cray North 2.25 — — — — — — — — — — — — 4 — - - 2 — - - — - No COMMON LAND. BIGGIN HILL GREEN Biggin Hill 1.47 — — — — — — — — — — — — — — — — — — — — — — — BROOMHILL COMMON Knoll 1.89 — — — — — — — — — — — — — — — — — — — — — — — DARRICK COMMON Crofton South 1.88 — — — — — — — — — — — — — — — — — — — — — — — FARNBOROUGH COMMON Farnborough 16.72 — — — — — — — — — — — — — — — — — — — — — — — GREEN ST. GREEN COMMON Green St. Green 15.6 — — — — — — — — — — — — — — — — — — — — — — — PRATTSBOTTOM COMMON Green St. Green 0.52 — — — — — — — — — — — — — — — — — — — — — — — LEAVES GREEN COMMON Leaves Green 19.55 — — — — — — — — — — — — — — — — — — — — — — — TUGMUTTON GREEN Farnborough 4.39 — — — — — — — — — — — — — — — — — — — — — — — OLD HILL Green St. Green 1.8 — — — — — — — — — — — — — — — — — — — — — — — .