AC 4412(3) ORPIN GTON ORP 17 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. 1953 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. 1953 K. E. TAPPER, O.B.E., G.M., M B., Ch.B., D.P.H Medical Officer of Health. 3 CONTENTS. page Members of the Public Health Committee 5 Staff 5 Prefatory Letter 6 Section A. Vital and Other Statistics and Social Conditions of the Area. Vital Statistics 10 Population Births 11 Illegitimate Births 12 Stillbirths 12 Deaths 12 Causation of Deaths 12 Cancer of the Lung 13 Maternal Mortality 13 Infantile Mortality 13 Unemployment 13 Local Sickness 14 Open-Air Recreational Amenities 14 Section B. General Provision of Health Services for the Area. Public Health Services rendered by the Council 18 National Assistance Act, 1948 18 Nursing Homes 19 Public Mortuary 19 Disinfection 19 Laboratory Service 20 Hospitals 20 Ambulance Service 20 Home Nursing Service 20 Health Visiting 20 Midwifery (Domiciliary) 21 Women's Welfare Clinics 21 Day Nurseries 21 Domestic Help Service 21 Diseases of Animals Acts 21 Medical Loan Depots 21 Meals on Wheels Service 21 List of Local Clinic Services 22 Section C. Sanitary and Environmental Circumstances. Water Supply 26 Drainage and Sewerage 29 Cesspools 29 Swimming Baths 29 Section D. Factories, Outworkers, Smoke Abatement, Shops Act, Rodent Control and Verminous Conditions and Uncleanliness. Factories Acts, 1937 and 1948 32 Outworkers 33 Smoke Abatement 34 Shops Act, 1950 34 Rodent Control 34 Pet Animals Act, 1951 35 Verminous Conditions and Uncleanliness 35 Complaints 35 4 page Section E. Housing. Housing Statistics 38 Clearance Areas, Housing Acts, 1936-1949 38 Re-housing 38 Moveable Dwellings 39 Section F. Inspection and Supervision of Food. Food and Drugs Act, 1938—Food Sampling Clean Food Bye-laws 45 Special Samples—Milk, Ice Cream and Water 45 Ice Cream 45 Food and Drugs Act, 1938—Section 14 46 Food Premises 46 Milk 46 Unsound Food 46 Food Complaints 42 Meat Inspection 47 Restaurants, Hotels and Canteens 48 Butchers' Shops 48 Bakehouses 48 Section G. Prevalence of, and Control over Infectious and other diseases. Smallpox 50 Vaccination 50 Acute Anterior Poliomyelitis 50 Scarlet Fever 51 Diphtheria 51 Diphtheria Immunisation 51 Typhoid Fever 52 Puerperal Pyrexia 52 Ophthalmia Neonatorum 52 Pemphigus Neonatorum 52 Measles 52 Whooping Cough 52 Food Poisoning 53 Other Infectious Diseases 53 Tuberculosis 53 Mass Radiography 54 Section H. Refuse Collection and Disposal. Refuse Collection and Disposal 56 Appendix. Statistical Tables. Table I.—Summary of Statistics 59 „ II.—Causes of Death 60 „ III.—Infant Mortality 61 ,, IV.—Notifiable Infectious Diseases—Sex and Age Distribution 62 „ V.—Notifiable Infectious Diseases—Ward Distribution, Attack and Mortality Rates 63 ,, VI.—Notifiable Infectious Diseases—Seasonal Incidence 64 ,, VII.—Summary of the Work of the Sanitary Inspectors 65 ,, VIII.—Nuisances, Defects and Contraventions Abated 67 5 MEMBERS OF THE PUBLIC HEALTH COMMITTEE. (as at 31st December, 1953). Chairman: Mrs. R. D. BARHAM, j.p. Vice-Chairman: Lt.-Col. T. H. NEWEY, e.d., c.c. Chairman of the Council: Vice-Chairman of the Council: H. T. Cox, Esq., j.p. W. D. Hayne, Esq., t.d. Members: Mrs. J. G. Banks. F. J. H. Hill, Esq. H. L. Blake, Esq. E. W. Lane, Esq. V. P. Gray, Esq. S. J. Murray-White, Esq., t.d. J. W. Harradine, Esq. P. H. Powell, Esq. J. R. Henderson, Esq. P. F. Rogers, Esq., c.b.e. G. A. Smith, Esq. STAFF OF THE PUBLIC HEALTH DEPARTMENT, (as at 31st December, 1953). Medical Officer of Health: K. E. TAPPER, o.B.e., g.M., M.B., ch.B., d.P.H. (Also Medical Officer of Health of the Borough of Bromley, and Chislehurst and Sidcup Urban District Council). 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. (Also Deputy Medical Officer of Health of the Borough of Bromley, and Chislehurst and Sidcup Urban District Council) Chief Sanitary Inspector and Cleansing Superintendent: F. C. CROWE, M.R.s.I., M.s.I.A. Deputy Chief Sanitary Inspector, and Deputy Cleansing Superintendent: 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, T. E. W. OSBORNE, c.R.s.I., R.I.P.H. Note.—All Sanitary Inspectors are Inspectors under the Food and Drugs Act, Shops Act, Rag Flock and Other Filling Materials Act and Pet Animals Act. CLERICAL STAFF: Secretary-Shorthand-Typist:. Miss C. COOPER. Clerk/Shorthand-Typist: Miss G. SMITH Junior Clerk: Miss S. McGOWAN. OUTDOOR STAFF: Pisinfector: W. O. PRINCE. Rodent Operative: W. S. MILLS Assistant Rodent Operative: C. V. POTTER, 6 To the Chairman and Members of the Orpington Urban District Council. Mr. Chairman, Ladies and Gentlemen, In accordance with instructions contained in Ministry of Health Circular 1/1954, I have to submit an Annual Report on the Health of the Urban District during the year 1953. This will be my sixth Annual Report to you and my last. Much that could be written has already been reported in my previous reports, but 1953 should remain memorable in that the policy adopted by the Health Committee in 1949 with reference to the abolition of the large number of cesspools in the area, has now culminated in the promotion of a Private Bill whereby, if and when it becomes an Act, compulsory connection to main drainage will be enforceable where applicable: and also memorable because of the adoption by the Council of large schemes of main drainage extensions to be carried out over a period of the next six years. The way ahead should now be clear. The rapid increase in the population during the past ten years, viz., 17,500 persons, has brought not only its problems, but has enlarged the responsibilities of the Local Authority. The reestablishment of truly Local government, the abolition of government by forms and a return to the more personal and simple approach to Health problems is more than ever needed to-day. The water from the taps is not improved by elaborate and expensive fittings. I have, for purposes of record, extracted from the Registrar General's 1951 Census figures certain fundamental facts which give some indication of the social conditions in Orpington. These figures are also of some importance in indicating the direction which Health Services should take in the future. Orpington. Bromley. Chislehurst and Sidcup. Population under 5 years of age 6% 8.2% 9.9% Population 65 years and over 10.4% 12.6% 8.1% Population living more than 2 persons per loom .86% .93% 1.65% Households sharing dwellings 971 3,472 1,701 Households with no fixed bath 2,243 3,560 2,202 Households with no piped water .. 291 26 161 Households with no water closet .. 441 36 153 The above figures apply to the Census for the year 1951, but I think we can safely say that our figures also apply to the year 1953. In this year of 1953, births exceeded deaths by 293 persons, and, while the Death Rate for the year corresponded with the average Death Rate for the past ten years, viz., 9.8, the Birth Rate is falling. The fall in the Infantile Mortality Rate during the last three decades is remarkable and is common throughout the country, but there still remains an unaffected hard core of neonatal deaths and of stillbirths. Deaths from cardio-vascular diseases are increasing, one hundred and 7 eight of the three hundred and twenty deaths classified under heart and circulatory diseases dying of angina. Nineteen persons died of cancer of the lung and this, too, is a yearly increasing figure. In these two directions alone lies a field of preventive work for Public Health Authorities. If carcino-genic factors exist in polluted atmosphere, then the atmosphere must be made clean. If "stress and strain"is part of the modern way of life and work, then we must learn that periodic rest and relaxation are essentials. It is known that cardiovascular diseases are more common in the "executive" class than among the "skilled" and "unskilled" workers, and it is also known that, in Orpington, out of every 1,000 persons over 18 years of age employed, three hundred and thirty-two are classified as executives, a higher rate per 1,000 than in either Bromley or Chislehurst and Sidcup. It becomes, therefore, of paramount importance, especially in Orpington, that attention should be given to the prevention of the increase in these stress diseases. It may not lie wholly within the power of the Health Committee, but it certainly places responsibility on the General Practitioner. I believe, more and more, that the General Practitioner must now come into the Public Health Services and take an active part in the prevention of illness. I believe that the future Public Health Services will be directed towards such matters as these, for the pattern of service laid down some thirty years ago is overdue for remodelling. With the improvement of the treatment services at home, at work and in hospital, there has developed a tendency to overlook the importance of the Public Health Services in the prevention of disease and in the correction of the conditions that lead to an overload on the hospital beds. I believe it is more important than ever before that the services of the hospital, the General Practitioner, Public Health and of Industrial Medicine, should combine efforts to abate those illnesses that cause so much anxiety and loss of efficiency, and to give more attention to prevention generally. One has only to look at the successes of the Public Health Services in the last thirty years to know what can be done. One has only to read carefully of the work of the Sanitary Inspectors, as recorded in this report, to realise what is being done so well in Orpington. I would commend to the Council the good services of Mr. Crowe and the staff of his department. It has been my pleasure to work with them since 1948 and to take part in their successful endeavours. I would also like to take this opportunity to thank Mr. King and his fellow officers for their help and advice, and, not least, to the Health Committee who have been so patient with my endeavours to advise them in the past six years. I am, Your obedient Servant, K. E. TAPPER, Medical Officer of Health May, 1954. SECTION A. VITAL AND OTHER STATISTICS AND SOCIAL CONDITIONS OF THE AREA. 10 SECTION A. VITAL AND OTHER STATISTICS AND SOCIAL CONDITIONS OF THE AREA. The area of the Urban District is 20,842 acres. Registrar General's estimate of total population (mid-year) 1953 64,480 Number of Inhabited Houses and Flats, according to the rate books, at the close of the year 19,530 Total number of valuation assessments of habitable premises at the close of the year (excluding shops, factories, etc.) 19,964 Rateable Value (31st December, 1953) £598,643 Product of a Penny Rate for the year ending 31st March, 1954 £2,360 VITAL STATISTICS. Live Births. Total Male Female Legitimate 892 445 447 Birth Rate 14.4 per 1,000 total Illegitimate 35 24 11 population. (Adjusted rate for comparison with other areas 14.8). 927 469 458 Stillbirths. Total Male Female Legitimate 17 10 7 Stillbirth Rate 0.26 per 1,000 total Illegitimate — — — population and 18.0 per 1,000 (live and still) births. 17 10 7 Deaths. Total Male Female 634 328 306 Death Rate 9.8 per 1,000 total population (adjusted rate for comparison with other areas 9.8). Deaths from Puerperal Causes. Puerperal Sepsis 2 Maternal Mortality Rate 2.1 per 1,000 (live and still) births. Deaths of Infants under 1 year of age. Total Male Female Infant Mortality Rate 17.2 per 1,000 live births, Legitimate 15 7 8 Illegitimate 1 — 1 16 7 9 11 Death Rates of Infants under 1 year of age. All Infants per 1,000 live births 17.2 Legitimate Infants per 1,000 live legitimate births 16.8 Illegitimate Infants per 1,000 live illegitimate births 28.6 Comparative statistics for the year 1953. Birth rate (per 1,000 population), Death rate . (per 1,000 population). Infant mortality rate (per 1,000 live births). Live Births Still Births Orpington 14.8 0.26 9.8 17.2 England and Wales 15.5 0.35 11.4 26.8* London Administrative County 17.5 0.38 12.5 24.8 *Per 1,000 related live births. POPULATION. The Registrar General's estimate of the total population (civilian and non-civilian) of the Urban District, mid-year 1953, is 64,480, which is an increase of 810 over that for the previous year. This population figure gives a density of 3.09 persons to the acre. The natural increase of population (measured by excess of births over deaths) for the year was 293. The following figures show how the population of the Urban District has increased over the past ten years:— 1944 46,980 1945 49,610 1946 56,640 1947 58,080 1948 58,320 1949 59,500 1950 62,420 1951 62,850 1952 63,670 1953 64,480 BIRTHS. The Birth Rate for 1953 is 14.4 per 1,000 total population, which is a slight decrease on that for the previous year (14.7). There were 927 live births registered during 1953, of which 469 were males and 458 females. Birth rates for the past ten years are as under:— 1944 22.7 1945 17.8 1946 20.0 1947 19.0 1948 16.3 1949 16.5 1950 14.8 1951 14.9 1952 14.7 1953 14.4 12 It should be noted that there is a fall in the Birth Rate, which fact is also applicable to other areas. The average rate for the period 1944-1953, was 17.1. Illegitimate Births. There were 35 illegitimate births registered during the year, giving an illegitimate birth rate of 0.54 per 1,000 total population, and a rate of 3.7 per 1,000 live and still births. Stillbirths. The total number of stillbirths in the area during 1953 was 17, which gives a stillbirth rate of 18.0 per 1,000 live and stillbirths, and a rate of 0.26 per 1,000 total population. DEATHS. The total number of deaths belonging to the Urban District and registered during the year was 634. Of this number, 328 were males and 306 females. The Death Rate for the Urban District for the year is 9.8 per 1,000 total population, and 11.4 for England and Wales. An analysis of the ages at death shows that, of the deaths registered:— Total. Male Female 16 were under 1 year of age 7 9 6 were 1 and under 5 years of age 4 2 3 were 5 and under 15 years of age 2 1 2 were 15 and under 25 years of age 1 1 27 were 25 and under 45 years of age 15 12 127 were 45 and under 65 years of age 78 49 158 were 65 and undei 75 years of age 81 77 295 were 75 years of age and over 140 155 Causation of Deaths. The main causes of death in the Urban District for the past five years were:— Disease. 1949. 1950. Year. 1951. 1952 1953. Cancer 99 114 120 85 108 Heart and Circulatory Diseases 310 342 293 285 320 Respiratory Diseases (not Tuberculosis) 63 66 76 77 81 Tuberculosis 18 11 19 11 10 Infectious Diseases 6 1 — 2 4 Influenza 4 5 10 3 11 Road Accidents 7 9 10 4 5 Other Accidents 10 9 14 6 3 Other Causes 119 104 112 92 92 636 661 654 565 634 13 Cancer of the Lung. During the years 1950/53, sixty-seven persons have died of cancer of the lung. This cause of death has increased in recent years. This may be due to better diagnosis, but the general opinion is that there is an actual increase of the disease throughout the country. No other form of cancer shows a like increase. Investigations as to the reason for this increase are actively proceeding under the direction of the Medical Research Council, and it is too early yet to say whether it is due to excessive smoking or to carcino-genic factors in the atmosphere However, a field for prevention lies open. Maternal Mortality. There were two maternal deaths in the Urban District during 1953, giving a rate of 2.1 per 1,000 live and stillbirths. There have been four maternal deaths in the last five years, compared with nine during the previous five-yearly period. Infantile Mortality. The Infant Mortality rate for the year is 17.2 per 1,000 live births. Sixteen infants died during 1953 before reaching their first birthday. Of this number, fifteen were legitimate and one illegitimate. There were nine neonatal deaths (under one month of age). The fall in the Infant Mortality rate is general throughout the country. UNEMPLOYMENT. There is, no doubt, in my mind that full employment is one of the main factors that make for the health of the public. I am, therefore, indebted to the Manager of the Local Employment Exchange for the following information in respect of the year 1953:— "The year opened with the usual seasonal increase in the numbers unemployed as the house decorating season and the Christmas trade demands returned to the quiet season, but during the early months trade gradually improved and the unemployed register slowly decreased as local factories and building firms steadily engaged workers. Hospitals and the retail trades in addition to private domestic demands accounted for a small but steady reduction in the register. Reviewing the year as a whole, however, there has been less turnover of labour generally, owing to the increased competition for the overseas markets and the tendency for employers to retain workers with skill and experience to maintain output. On the workers' side, there has also been less tendency to change jobs owing to the fact that opportunities have been fewer. 14 The Building Industry has had another good year and the mild weather of the last quarter enabled outdoor work to continue well beyond the normal season in the decorating trade and the year finished with an Unemployed Register smaller than in previous years. The problem of finding suitable employment of a lasting nature for the disabled and the elderly worker is receiving constant attention, and workers in these categories comprise a substantial proportion of the Register, and local bodies are interesting themselves in the First Report of the National Advisory Committee on this subject." LOCAL SICKNESS. A weekly return is received from the Ministry of National Insurance, indicating for the area the first certificates of sickness benefit received at the Local Office. These figures give some indication of the major trend of general sickness in the area, but must not be taken as being exact as the area covered by the Ministry statistics is that of Orpington Postal district and not that covered by the Urban District boundaries. The following information is given in respect of 1953:— Four weeks ending: — Total number of Certificates received. Weekly average. 27th January 1,086 272 24th February 1,674 419 24th March 720 180 21st April 537 134 19th May 443 111 16th June 381 95 14th July 402 101 11th August 322 81 8th September 306 77 6th October 431 108 3rd November 589 147 1st December 543 136 29th December 418 105 OPEN AIR RECREATIONAL AMENITIES. Approximately 273.5 acres of land have been secured for public recreational purposes within the Urban District, as under:— Parks and Recreation Grounds. Ward. Acreage. Biggin Hill Biggin Hill 10.7 Chelsfield Chelsfield 2.10 Cudham Village Cudham 10.39 Cudham Lane Green-Street-Green 6.5 Downe Downe 0.5 Farnborough Farnborough 10.0 Glentrammon Green-Street-Green 13.5 15  Ward. Acreage. Goddington Goddington South 63.95 Grassmeade Goddington North 9.6 Knockholt Knockholt 0.75 Petts Wood Crofton North 12.27 Poverest Knoll 17.5 Prattsbottom Playground Green-Street-Green 0.055 Si. Mary Cray St. Mary Cray 19.0 Willett Petts Wood 6.1 Farnborough (Opp. New Inn P.H.) Farnborough 0.134 Public Gardens. Broxbourne Gardens Knoll 0.82 Riverside Gardens St. Mary Cray 5.8 The Priory Gardens Goddington North 14.03 Open Spaces. Okemore Gardens St. Mary Cray 3.75 Wotlon Green St. Mary Cray 2.25 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-Street-Green Green-Street-Green 15.6 Prattsbottom Green-Street-Green 0.52 Leaves Green Common Leaves Green 19.55 Tugmutton Green Farnborough 4.39 Old Hill Green-Street-Green 1.8 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. 18 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. These services are rendered by four distinct and separate bodies:— (1) The Council through its Public Health Department. (2) Two Hospital Management Committees. (3) Kent County Council under Part III of the National Health Service Act, 1946. (4) Voluntary Agencies. 1. Public Health services rendered by the Council. The major services of the Department, to which detailed reference is made later in this report, are as under:— Atmospheric Pollution. Enquiries into complaints and the abatement of nuisances. Health Education and all matters covered by the general heading of Sanitary and Environmental Services. Housing. Infectious Diseases (Prevention and Notification). Inspection of Food and Food Premises. Inspection and examination of Water and Milk supplies. Inspection of Shops and Factories. Rodent Control. Refuse Collection and Disposal. NATIONAL ASSISTANCE ACT, 1948. Section 47. This Section of the Act gives powers to the local authority to apply to a court of summary jurisdiction for an order for the compulsory removal of any person suffering from chronic disease, or who is aged, infirm or physically incapacitated, and who is living in insanitary conditions and unable to devote to himself and not receiving from other persons proper care and attention, to a suitable hospital or other place in, or within convenient distance of, the area of the local authority, and for his detention and maintenance therein. Before such application is made, however, the Medical Officer of Health must be satisfied, after thorough enquiry, that in the interests of any such person or for preventing injury to the health of, or serious nuisance to, other persons it is necessary to remove that person. Several possible cases were investigated during the year, but in no instance was it necessary to apply to the court for an order for compulsory removal. 19 Section 50. Under this Section of the Act, it is the duty of the local authority to arrange for the burial or cremation of the body of any person who has died or been found dead in their area if it appears that no suitable arrangements for the disposal of the body are being made. It was not necessary for the Council to take any action under this heading during the year 1953. NURSING HOMES. There are no registered nursing homes within the area. PUBLIC MORTUARY. There is no public mortuary in use in the Urban District. Facilities have been given for the use of the mortuary attached to Farnborough Hospital. DISINFECTION The disinfecting station is situate at the Council Offices. Details of the work carried out during 1953 are as under:— Disinfections. Premises visited 140 Rooms disinfected 188 Articles disinfected 654 Disinfestations. Premises visited 8 Rooms disinfested 24 Articles disinfested 20 Articles treated. Articles destroyed. Beds 7 — Mattresses 101 — Bolsters 90 — Pillows 222 — Cushions 3 — Blankets 36 — Sheets 107 5 Eiderdowns Bedspreads Carpets 2 — Chairs — — Miscellaneous 106 — 674 10 In the case of disinfections, rooms and furniture are treated with Formalin vapour and, if necessary, liquid spray. 20 Some articles are steam treated with a pressure of 20 lbs. per square inch. Bedding is steam treated with a pressure of 20 lbs. per square inch. Disinfestation of Premises. Rooms and furniture are sprayed with a proprietary brand of insecticide containing 5 per cent. D.D.T. LABORATORY SERVICE. All routine medical and Food and Drugs samples are forwarded to the County Laboratory at Maidstone. 2. Services rendered by the Hospital Boards. (a) Farnborough Hospital. Provides a general hospital service with 812 beds. This hospital is under the control of the Bromley Group Hospital Management Committee. (b) Orpington Hospital. Provides a general hospital service and has 977 beds (including Part III residential accommodation for County use), and comes within the area of the Orpington and Sevenoaks Group. (c) Chest Clinic. There is no chest clinic within the area, all patients being referred to the Bromley Chest Clinic which is under the control of the Bromley Group Hospital Management Committee. (d) Venereal Diseases. No centre is provided within the Urban District for the treatment of these diseases. Patients are referred to the various hospitals with specialist clinics for dealing with such diseases. 3. Services rendered by the Kent County Council. Ambulance Service. The main ambulance depot covering the Orpington area is situate at 12, Hayes Lane, Bromley, where there are twelve radio controlled ambulances and twelve sitting case cars available for use. Home Nursing Service. Five Home Nurses and four Home Nurse/Midwives operate in the area. Home Nursing is provided on medical certification only, and is free. No night service is provided at the present time. Health Visiting. Eight Health Visitors, two School Nurses, and one Tuberculosis Health Visitor are employed in the area. The Health Visitors are responsible for the Maternity and Child Welfare Centres, Clinics in connection with Vaccination and Diphtheria Immunisation, etc., and carry out home visiting for Child Life Protection, After Care, etc. 21 Midwifery (Domiciliary). Five full-time Midwives and four Home Nurse/Midwives are employed in the area. Their services are engaged direct by the patient, or through the patient's private doctor. They act either as midwives or maternity nurses. Women's Welfare Clinics. These clinics are held in various parts of the district. Patients attending these clinics are referred on medical grounds only and are seen by appointment. Day Nurseries. No Day Nurseries are provided in this area by the County Council, Scads Hill Nursery having been closed in June. 1953. Domestic Help Service. Demands for this service continue to be heavy, especially for cases of illness in the home and for old people. The following is a summary of the cases in the Orpington area who received assistance during 1953:— Maternity (expectant mothers) 80 Tuberculosis 29 Aged 143 Others 188 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. Medical Loan Depots. There is one medical loan depot in the area which is run by the British Red Cross Society, where a full range of nursing requisites is held. Except in cases of hardship, a charge is made of threepence per week, per article. Applications should be made to:— Mrs. M. M. Jones, 39, Willett Way, Petts Wood, Kent. From the number of applications received during 1953, it is evident that good use is made of this very valuable service. Meals on Wheels Service. This is run by the Women's Voluntary Services. These meals are available to all infirm and aged people whose circumstances justify a weekly visit. The meals are cooked at the W.V.S. Headquarters (The Rookery, St. Mary Cray), and delivered every Wednesday to the Chelsfield area, 22 and every Thursday to Orpington, Petts Wood, St. Mary Cray, Knockholt, Cudham, Farnborough and Green-Street-Green districts. Approximately ninety-five old people are now catered for in this way and all express their appreciation of this excellent two-course meal which costs them 1s. only. Orpington and District Tuberculosis Care Committee. The St. John Ambulance Brigade. Orpington Old People's Welfare Committee. Over 60's Club. These four services have been reported upon fully in previous reports, and they are continuing to do very valuable work in the care of the sick and the aged. LOCAL CLINIC SERVICES. 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-Street-Green Baptist School Room 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, Eynsford Close Monday and Thursday— afternoon. St. Mary Cray Temple Congregational Church Hall Tuesday and Wednesday —afternoon. Pratts Bottom Village Hall 2nd and 4th Thursday in month—afternoon. Ante-Natal Clinics. Cudham and Biggin Hill Sports Pavilion, Biggin Hill Every Wednesday in month—morning. Green-Street-Green Baptist School Room Friday—morning. Orpington Methodist Church Hall Tuesday and Friday— morning. Petts Wood Sports Pavilion, Eynsford Close Tuesday—afternoon. St. Mary Cray Temple Congregational Church Hall Friday—morning. 23 Women's Welfare Clinics. Green-Street-Green Baptist School Room 4th Thursday—morning. Orpington Methodist Church Hill 1st Thursday—morning. Minor Ailment Clinics (Schools). The School House, Chislehurst Road Orpington Every Saturday— morning. Dental Clinics. The School House, Chislehurst Road Orpington Monday to Friday—all day. 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 in the month, and by special appointment at Chislehurst Road School, Orpington, on Tuesday afternoons. SECTION C. SANITARY AND ENVIRONMENTAL CIRCUMSTANCES. 26 SECTION C. SANITARY AND ENVIRONMENTAL CIRCUMSTANCES OF THE AREA, Water Supply. There are fifty premises within the area where a main piped water supply is not available. In addition, eighty-three premises at Biggin Hill have not been connected to the main, although a piped water supply is available. These 133 premises are dependent upon underground tank or well supply, as under:— Number of premises with: Stored Rainwater. Wells. Biggin Hill Ward 96 — Cudham 19 — Knockholt 1 — Chelsfield 8 — Green-Street-Green 2 — Downe 3 — Farnborough 1 1 Poverest — 2 130 3 As a result of special survey by the Sanitary Inspectors during the year, ten houses previously devoid of main water were connected to the main supply. I am indebted to the Clerk, and the Director of Water Examination, Metropolitan Water Board, for the following information on the supply of water to the Urban District during the year 1953:— "The supply to the district of Orpington has been adequate at all times during the year and is derived from seven wells, namely: Orpington, North Orpington, Jewels Wood, Sundridge, Eynsford, Shortlands and Bexley. No new source of public water supply has been instituted in the Council's area during the year and there have been no extensions of trunk mains, but lengths of service mains have been laid within the district. Bacteriological analyses of these wells are made five times a week and consistently satisfactory results have been obtained from samples of water passing into supply. Chemical analyses of well supplies are also made at regular intervals. All supplies are treated with chlorine on the works, but any excess 27 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. All the houses are supplied directly and not by means of standpipes. Appended are the results of chemical and bacteriological analyses of the various supplies to Orpington during 1953, including analyses of water before treatment." 28 Results of the Chemical and Bacteriological Examination of the Water Supplied to Orpington Urban District Council during 1953. (Parts per million, unless otherwise stated). Description of Sample. No. of Samples. Ammoniacal Nitrogen Albuminoid Nitrogen Oxidised Nitrogen Nitrate Chlorides as C1. Oxygen abs. from Permanganate 4 hrs. at 27 °C. Turbidity in terms of Silica Colour m.m. brown 2ft. tube Burgess's Tintometer. Hardness (Total) Non-Carbonate Hardness pH Value Magnesium Mg. Silica SiO 2 Sulphates SO 4 Conductivity[/##]] Orpington Well 4 Nil 0.025 6.7 15.4 0.09 Nil Nil 281 47 7.2 3.1 15 15 500 N. Orpington Well 2 0.003 0.028 4.2 13.3 0.02 Nil Nil 259 34 7.3 3.0 15 4 500 Jewels Wood Well 3 Nil 0.018 2.8 9.3 0.10 Nil Nil 241 23 7.3 3.5 11 4 400 Sundridge Well 4 0.013 0.028 2.3 17.3 0.06 Nil Nil 213 48 7.4 3.3 18 28 475 Eynsford Well 3 0.003 0.022 3.4 14.5 0.07 Nil Nil 265 41 7.3 3.2 15 13 425 Shortlands Well 8 0.003 0.022 4.7 15.5 0.12 Nil Nil 283 68 7.2 3.9 16 41 500 Bexley Well 11 0.005 0.021 4.8 16.1 0.06 Nil Nil 284 54 7.3 3.9 18 30 450 Bacteriological Results. Before Chlorination (Raw Water). After Clorination (Water passing into Supply). Bact. coli test Plate count (average per millilitre) Colonies counted on Agar Bact. coli test Percentage samples neg. 100 ml. Average No. per 100 ml. Number of samples. Percentage samples neg. 100 ml. Average No. per 100 ml. 22°C. 37°C. 3 days 20-24 hrs. Orpington Well 249 1825.6 34.4 99.6 0.008 255 100.0 Nil N. Orpington Well 242 33.2 1.7 33.1 18.000 248 100.0 Nil Jewels Wood Well 188 4.4 0.4 96.3 0.053 193 100.0 Nil Sundridge Well 299 8.2 0.2 99.0 0.017 255 100.0 Nil Eynsford Well 265 162.6 0.7 99.6 0.008 272 99.6 0.019 Shortlands Well 493 1.9 0.1 99.8 0.004 253 100.0 Nil Bexley Well 581 0.7 0.2 100.0 Nil 309 100.0 Nil 29 Drainage and Sewerage. The trunk soil sewerage system is under the control of the West Kent Main Sewerage Board. Branch main soil sewers and main surface water sewers have been provided during the year by the Local Authority, as under:— (a) Private Estate Development: 737 lineal yards 9in. soil sewer. 393 „ „ 6in. „ 686 „ „ 9in. surface water sewer. (b) Council Estate Development and Private Street Works: 440 lineal yards 6in. soil sewer. 599 „ „ 6in. surface water sewer. Cesspools. I would refer to my previous Annual Reports, 1948—1952, where this problem in Orpington is discussed. Number of Cesspools at 31st December, 1953:— (1) On line of sewer (332 premises) 283 (2) Not on line of sewer 2,283 2,566 Number of cesspools abolished and main drainage provided during the year 23 Number of houses with pail closets converted to cesspool drainage 4 Number of new houses erected with cesspool drainage 36 Number of loads removed from cesspools on private, requisitioned and Council properties 4,241 There were more houses built with cesspools during the year than there were cesspools abolished. Swimming Baths. There is one swimming bath in the district to which the public are admitted. Three samples of water were taken for examination during the year, all of which were satisfactory. Sixteen visits of inspection were made by the Sanitary Inspectors. . SECTION D. FACTORIES, OUTWORKERS, SMOKE ABATEMENT, SHOPS ACT, RODENT CONTROL AND VERMINOUS CONDITIONS AND UNCLEANLINESS. 32 SECTION D. FACTORIES, OUTWORKERS, SMOKE ABATEMENT, SHOPS ACT, RODENT CONTROL AND VERMINOUS CONDITIONS AND UNCLEANLINESS. Factories Acts, 1937 and 1948. One hundred and fifteen visits were made to the one hundred and twenty-six factories on the Council's register. Compliance with the various health and welfare regulations was found, on the whole, to be good. Eleven defects or contraventions were detected and these were of a minor character only. Details of inspections made and defects found are given below:— 1. Inspections for purposes of provisions as to health. Premises No. on Register Inspections No. of Written Notices Occupiers Prosecuted (a) Factories in which Sections 1, 2, 3, 4 & 6 are to be enforced by the Local Authorities 13 11 - - (b) Factories not included in (a) in which Section 7 is enforced by the Local Authority 107 102 10 (c) Other Premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) 6 2 1 — TOTAL 126 115 11 — 33 2. Cases in which defects were found. No. of cases in which defects were No. of cases in which prosecutions were instituted Referred Found Remedied To H.M. Inspector By H.M. Inspector Want of cleanliness (S.l) — 1 — — — Overcrowding (S.2) — — — — — Unreasonable temp. (S.3) 1 1 — 1 — Inadequate ventilation (S.4) — — — — — Ineffective drainage of floors (S.6) — — — — — Sanitary Conveniences (S.7: (a) Insufficient 2 1 — — — (b) Unsuitable or defective 8 10 — 2 _ (c) Not separate for sexes — — — — — Other offences against the Act (not including offences relating to Outwork) — — 1 — — TOTAL 11 13 1 3 — Outwork: Nil. Outworkers. Twenty-seven lists of Outworkers were received during the year, and the following is a summary of the trades involved, together with the number of persons employed. Trade. Number of Outworkers, employed.[/##] Clothing 47 Cardboard Box and Carton Making 2 Surgical Appliances 2 Leather Goods 2 Bootmakers 2 55 When a case of infectious disease is notified at the home of an outworker, steps are taken to ensure that there is no risk of infection being conveyed by the articles made there. 34 Smoke Abatement. In my report for 1952, it was stated that one factory, where a fairly persistent nuisance had been caused by the emission of black smoke and grit, had ordered the conversion of their sprinkler fired boilers to chain grate stokers. The result of this conversion was awaited with great interest and it is, indeed, gratifying to report that the nuisance from black smoke has been completely abated and the emission of grit considerably reduced. This reduction in the amount of air polluting material is reflected in the figures obtained from the Council's deposit gauge analyses for the year. The comparative figures are shown below in the equivalent of tons per square mile. 1950 .. 15.88 1951 .. 14.09 1952 .. 14.76 1953 .. 12.21 Towards the end of the year the Committee decided to purchase a Lead Peroxide Instrument for determining the average distribution of sulphur dioxide within the district. With the willing co-operation of the United Dairies (London) Limited, this instrument was installed on a flat roof of their premises at Church Road, Orpington, on the first day of the new year. The amount of sulphur dioxide absorbed by the instrument is determined by chemical analysis and it should be possible to make some observations on the findings in the 1954 Annual Report. The Council is still 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 hope that the high standard attained last year would be maintained has been fulfilled. Washing facilities and sanitary accommodation are adequate in most cases and the chief offence appears to be the neglect in displaying Statutory forms of Notice—a very human failing in this "paper" age. A summary of the work carried out in 1953 is given below:— Inspections 92 Neglect in displaying Statutory Forms 17 Contravention of Section of Act dealing with employment of Young Persons 1 Insufficient seating for Female Assistants 1 Rodent Control. The treatment of infestations at dwelling-houses and business premises was maintained at approximately the same level as in the two previous years, but there was a notable falling off in the number of treatments required on the Council's own properties (excluding Council houses which are included as dwelling-houses). 35 Comparative statistics are given below. The large number of inspections, as compared with the number of infestations cleared, is explained by the fact that the rodent operators spend a considerable proportion of their time making house-to-house surveys in their search for rodents and each treatment entails a minimum of six visits to the infested premises. Total Number of Inspections. Number of Infestations Cleared. 1951 1952 1953 1951 1952 1953 Local Authority's Property 107 147 28 11 18 1 Dwelling Houses (including Council houses) 7394 6875 7277 436 493 424 Bussiness premises 193 391 351 37 40 40 . . . SECTION E. HOUSING. 38 SECTION E. HOUSING. Housing Statistics for the year 1953. Total number of valuation assessments, houses and flats, at the close of the year 19,964 1. Inspection of Dwelling-houses during the year:— I. (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) ... 208 (b) Number of inspections made for the purpose 1,364 II. (a) Number of dwelling-houses (included under sub-head (I) above), which were inspected and recorded under the Housing Consolidated Regulations, 1925 ... - (b) Number of inspections made for the purpose - III. Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation - IV. Number of dwelling-houses (exclusive of those referred to under preceding sub-head) found not to be in all respects reasonably fit for human habitation 173 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 159 Clearance Areas. Housing Acts, 1936—1949. During the year, steps were taken to review housing conditions in the urban district and preliminary lists prepared of proposed Clearance Areas. It is anticipated that these properties can be dealt with during the next five years and the tenants rehoused in co-operation with the Housing Department. Re-Housing. I am indebted to the Housing Manager for the following statistics of re-housing carried out by the Local Authority:— Prior to 1953. During 1953. Total as at Dec., 1953. I. (a) Number of permanent dwellings built by Local Authority 1 442 322 1,764 (b) Number of prefabricated dwellings built by Local Authority 319 — 319 (c) Number of dwellings requisitioned by Local Authority 195 — 134 II (a) Number of families occupying 1 (a) — — 1,764 (b) Number of families occupying 1 (b) — — 319 (c) Number of families occupying 1 (c) — — 168 39 III. Total number of families re-housed during 1953:— (a) 322. (b) Nil. (c) Fluctuating. IV. Number of families with a residential claim on this Authority on waiting list at 31st December, 1953, .in various catgeories:— (a) Families in urgent need of other accommodation 217 (b) Families whose applications require early consideration 376 (c) Families whose applications are less urgent 838 (d) Families with varying degrees of housing need but with no residential claim on this Authority 284 It is not possible to give any accurate idea of the number of families on the waiting list living in overcrowded conditions, but all the families in Group 4 (a) and 30 per cent in 4 (b), 10 per cent in 4 (c) and 10 per cent in 4 (d) may be said to be living in crowded conditions. MOVEABLE DWELLINGS. During the year, three licences were renewed embracing a total of seventy-six caravans and fifty tents. For the winter months, three licences, covering a total of twenty caravans, were also issued. In all, ninety visits of inspection to the various sites were made by the Sanitary Inspectors. The matter is now largely dealt with by Town Planning. SECTION F. INSPECTION AND SUPERVISION OF FOOD. 42 SECTION F. INSPECTION AND SUPERVISION OF FOOD. General. This work has been pursued with vigour and there is undoubtedly a considerable all-round improvement in the standard of hygiene as compared with the immediate post-war years, not only in the premises but also in the methods adopted for protecting and handling food. The lectures and film shows given to food handlers and the routine personal discussions with managers and proprietors on the requirements of the Council's Clean Food Byelaws have had a beneficial effect, but I still think the real solution to this problem lies in the teaching of hygienic principles of practice while the child is at school. The hygienic handling of food is the real controlling factor in the prevention of food poisoning and a heavy responsibility is placed on the persons engaged in this work. It is, therefore, only right that they should be given an elementary knowledge of the dangers involved, at an age when their minds are receptive and their personal habits not too rigidly moulded. FOOD AND DRUGS ACT, 1938. Food Sampling. One hundred and ninety-five samples of food and drugs were taken for analysis, forty-four of which were formal. Seventeen samples, all informal, were found to be inferior or adulterated. It is the practice of the department to concentrate as much as possible on the sampling of articles which are manufactured within the Urban District and for which there is a prescribed food standard, the principle being that if this is done in all areas, a comprehensive check is made and the duplication of sampling on a national scale is reduced to a minimum. Details of samples taken, together with information as to the unsatisfactory samples, and action taken, are given below:— Article. Samples taken Formal. Informal. Result AdultGenuine. erated. Inferior Remarks Anchovies, Fillets 1 1 Aspirin Tablets 1 1 Buttercrunch Confectionery 2 — 2 See (a) Butterdrops 1 1 Butterscotch Toffees 3 3 Buttermint Toffees 1 -— 1 See (b) Butterscotch 1 1 Butter Pats 1 1 Baking Powder 4 4 Butter and Cream Toffees 1 1 Bread, Sliced 1 - 1 See (c) 43 Article. Samples taken Genuine Result Adulterated. Inferior Remarks Formal. Informal. Butter Brazils 1 — 1 See (d) Coffee and Chicory Essence 2 2 Cake Mixture 1 1 Cough Syrup, Cherry 1 1 Cocoanut, Sugared 1 1 Custard Powder 1 1 Cheese, Processed 3 3 Cake Confectionery 9 i- 2 Cinnamon and Quinine 1 1 Flour, Self-Raising 1 i Flavouring Essence 1 1 Fish Spread 1 l Gelatine 1 I Gravy Salt 1 l Ginger Wine 1 l Iodine, Tincture of 2 2 Influenza Mixture 1 1 Milk, Dried 3 — 3 See (e) Milk (Fat Content) 39 56 89 4 2 See (f) Milk (Condensed) 1 — 1 See (g) Meat Spread 1 1 Ointment, Zinc 1 1 Ointment, Boric Acid 1 1 Pepper, White 1 1 Paste, Meat 13 13 Paste, Fish 12 12 Pickle 1 1 Quinine, Tincture of 2 2 Sausages, Beef 3 — 3 Sausages, Pork 9 1 1 1 1 See (h) Steak Pie 1 1 Squash, Orange 5 5 Squash, Lemon 1 1 Semolina 1 .1 Shortbread, Mixture 1 1 Sponge Mixture 1 1 Suet, Shredded 3 3 Salad Cream 2 2 Vinegar, Malt 3 3 Welsh Rarebit (Mixture) 1 1 44 151 178 7 10 Details of unsatisfactory samples:— Sample. Analyst's Report. Action Taken. (a) (1) Buttercruch Confectionery (Informal) Inferior, but sample too small for accurate estimation. "Follow-up" sample proved to be inferior also. See below. (a) (2) Buttercruch Confectionery (Informal) Inferior. Butter fat in coating 2.7% should be 4%. Manufacturers stated that this line of confectionery had been withdrawn from production on account of insufficient butter supplies, but were unable to explain deficiency as they had endeavoured to conform with the regulations. 44 Sample. Analyst's Report. Action Taken. (b) Buttermint Toffees (Informal) Inferior. Deficient in butter. Fat 2.1% should be 4%. This case was fully investigated with the Manufacturers—an old and reputable firm—the conclusion being that only half the quantity of butter allocated for a particular "boiling" was added. The Company gave an assurance that there would be closer supervision in the future. (c) Portion of Sliced Bread Loaf (Informal) Inferior. Foreign matter present. Warning given to baker concerned. (d) Butter Brazils (Informal) Adulterated. Coating contained 2.0% fat (including 0.6% butterfat). Butter fat should have been at least 4%. The Manufacturers apologised for the "inadvertent" offence. They explained that they had only recently commenced the manufacture of buttered sweets. Their attention had been drawn to the regulations and they had accordingly changed their labels to read "Butter Flavoured Brazils." Samples of labels now in use were submitted. (e) Dried Milk (3) (Informal) Inferior. Old stock. Not harmful but unsuitable for use in school canteen. These samples were submitted by the Schools Canteen Supervisor. The stocks were withdrawn. (f) Pasteurised Milk (4) (Informal) Adulterated. Extraneous water varied between 4% and 5%. Dairyman given strict warning. Addition of water believed to be due to negligence rather than deliberate intent. Pasteurised Milk Inferior. Deficiency of •3.3% in the minimum amount of milk fat. Strict warning given. Sterilised Milk (Informal) Inferior. Deficiency of 5% in minimum amount of fat. Milk Company at loss to explain the deficiency. A "follow-up" sample proved to be genuine. (g) Condensed Full Cream Milk (Informal) Pronounced rancid taste. Unfit for use. This tin of milk was submitted by a local grocer, following complaints from customers. The remainder of the stock was condemned. (h) (1) Pork Sausages (Informal) Inferior. Meat 60% Sulphite absent. Meat content should have been 65%. The butcher was warned and given advice on the proper mixing of ingredients, 45 Sample. Analyst's Report. Action Taken. (h) (2) Pork Sausages (Informal) Inferior. Labelled to contain 80% meat. Analysis showed 73% only. Warning given to manufacturers. The Public Analyst in reporting upon samples which are not passed as being satisfactory certifies them as either "Adulterated" (i.e. seriously unsatisfactory) or "inferior" (unsatisfactory in less serious or minor ways). Clean Food Byelaws. No formal action was taken by the Local Authority under the Byelaws adopted under Section 15 of the Food and Drugs Act, 1938. Special Samples of Milk, Ice Cream and Water. In addition to the samples taken above, a further one hundred and sixty-eight samples were taken for bacteriological and pathological examination and other special tests, as under:— Milk (Tuberculin Tested)—Bacteriological Examination 1 Milk (Pasteurised)—Phosphatase Test 45 Milk (Sterilised)—Turbidity Test 10 Ice Cream—Bacteriological and Pathological Examination 36 Water—Bacteriological Examination 61 Water—Chemical Examination 15 168 Ice Cream. At the end of the year, there were one hundred and twenty-eight premises registered for the sale of ice cream, but none for the manufacture of this commodity. Ninety inspections were made and conditions were found to be satisfactory. Thirty-six samples were sent for bacteriological and pathological examination. No pathogenic organisms were isolated and the grading of the samples under the Methylene Blue test for cleanliness showed that a high standard is being maintained. The following is an analysis of the results obtained during the past three years:— Year. No. of Samples taken. Grade I. Grade II. RESULT. Grade III. Grade IV. 1951 47 36 6 5 — 1952 41 33 8 — — 1953 36 31 5 — — In general, Grades I and II are satisfactory, whilst Grades III and IV may indicate some defect in manufacture, storing or handling. Should a result in Grade III or IV be received, investigations are made and follow-up samples taken. 46 FOOD AND DRUGS ACT, 1938. SECTION 14. One hundred and forty shops and food premises have been registered under this Section of the Act:— Ice Cream Stores 128 Fish Shops (Fried) 7 Butchers' Shops 4 Fish and Meat Paste Factory 1 140 Food Premises. There are some 467 food premises in the area, made up as under:— Bakers and Confectionery 26 Butchers 40 Chemists 20 Clubs and Hotels 9 Confectionery 54 Dairies 12 Fishmongers (Wet, Dried and Fried) 25 Greengrocery 45 Grocery 92 Hospitals 2 Industrial Canteens 9 Public Houses 46 Restaurants, etc. 56 School Canteens 14 Slaughterhouses 9 Street Vendors 8 467 Milk. Licences were issued in respect of the sale of milk having a special designation, as follow:— Tuberculin Tested Dealer's Licences 12 Supplementary Licences 2 Pasteurised Dealer's Licences 12 Supplementary Licences 2 Pasteuriser's Dealer's Licences 1 Sterilised Dealer's Licences 26 Supplementary Licences 2 One hundred and sixty-six visits were made to the twelve registered dairies in the district and fifty-eight samples were sent to the Public Analyst for the prescribed tests. All but seven samples of Pasteurised Milk were satisfactory, and in these cases subsequent samples satisfied the tests. Unsound Food. During the year 1953, a total of one thousand, one hundred and eighty-eight Food Condemnation Certificates were issued, affecting in quantity approximately four tons of varied articles of food. 47 No prosecutions were necessary and the condemned food was utilised for animal food, or, where this was impracticable, disposed of by deep burial at the Council's Refuse Tip, or burnt. Food Complaints. Eighteen complaints of unsound condition and/or contamination of foodstuff were received from the public during the year, as under:— Bread 5 Biscuits 1 Cheese 1 Cream and Jam Sponge 1 Corned Beef 1 Dried Fruit 1 Mussels 1 Milk 3 Meat, Fresh 1 Milk Powder 1 Pickles 1 Tinned Fruit 1 Where doubt existed as to the nature of the condition, the specimens were sent to the Analyst for his observations and in every case the complaints were dealt with to the ultimate satisfaction of the department and the complainants. The co-operation between the public and the department continues to be excellent. Meat Inspection. A total of fifty-three visits were made by the Sanitary Inspectors to the nine slaughterhouses which remain on the register of the Local Authority. Licences were issued to seventeen slaughtermen under the Slaughter of Animals Act, 1933. The following table gives details of the ante- and post-mortem inspection of animals made during 1953:— Carcases Inspected and Condemned. Cattle excluding Cows. Cows. Calves. Sheep and Lambs. Pigs Number killed — — 1 — 73 Number inspected — — 1 — 73 All diseases except tuberculosis : Whole carcases condemned — — — — 5 Carcases of which some part or organ was condemned — — — — 10 Percentage of the number inspected affected with disease other than tuberculosis — — — — 20.5 Tuberculosis only: Whole carcases condemned — — — — — Carcases of which some part — — — — — or organ was condemned — — — — — Percentage of the number inspected affected with tuberculosis — — — — — 48 Restaurants, Hotels and Canteens. One hundred and eighty-seven visits were made to these premises during the year, and although many of them are unsuitable to be used for this purpose due to insufficient space, a reasonable standard of cleanliness has been maintained. In seven cases defects requiring the attention of the owners were dealt with by informal action. Butchers' Shops. One hundred and seventy-one detailed inspections were made at the forty retail butchers' shops in the area. In no case was there any evidence of unsound meat being exposed for sale. Bakehouses. Generally speaking, the standard of the twenty-one premises was good. Eighty-five inspections were made and notices issued for cleansing and repair in eight premises. SECTION G. PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. 50 SECTION G. PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. A total of 1,559 notifications of infectious diseases were received during the year, as against 1,577 for 1952. Statistical details will be found in the Appendix. There were no epidemics of a serious nature during the year. Smallpox. No cases occurred in the area, although several contacts or suspected contacts of cases came under our supervision. Vaccination. The following figures, which have been supplied by the County Medical Officer, show the number of persons resident in the area, who were vaccinated against smallpox during 1953. Year of Birth. Primary Vaccination. Re-vaccination. 1953 366 — 1952 251 — 1951 15 1 1950 9 2 1949 9 5 1948 8 6 1947 2 11 1946 2 6 1945 4 2 1944 9 3 1943 3 11 1942 3 4 1941 6 3 1940 4 3 1939 5 4 Before 1939 29 146 Total 725 207 One should compare these figures with the number of babies born during a twelve month. Acute Anterior Poliomyelitis. Eleven cases were notified, giving an attack rate of 0.17 per 1,000 population. Six of these were paralytic cases and five non-paralytic. Seven cases were removed to hospital and the remainder were home nursed. There was one death from this disease. It was apparent that there were many other cases during the year who had the prodromal symptoms without reaching a diagnostic state. Present state of the six paralytic cases:— 51 (1) H.P. Admitted to Hospital, 7th June, 1953. Right leg still paralysed and left leg weak. Patient can move around only with the aid of leg appliances. At date of onset, muscles of chest, back and legs were affected, but the former muscles are now normal. General health satisfactory. (2) G.P.A. Admitted to hospital, 17th July, 1953, with paralysis of neck and both legs. Discharged mid-August, 1953. Out-patient until December, 1953. Completely cured—no permanent paralysis. (3) M.H. Admitted to hospital, 15th July, 1953. Discharged mid-September, 1953. Now attending hospital twice a week for treatment and expects to do so for at least another two years or so. Muscles of lower back, right hip and right leg affected, unable to walk farther than 100 yards at a time. Difficulty in maintaining balance and surgical belt worn for support. A wheel chair has been provided by the Red Cross Society. (4) I.M. Admitted to hospital, 18th August, 1953. Died, 20th August, 1953. (5) A.M. Admitted to hospital, 20th August, 1953. Discharged mid-March, 1954. Attending hospital for treatment twice a week. Both legs affected; is unable to walk without leg irons. (6) F.H. Admitted to hospital, 22nd September, 1953. Discharged at the end of April, 1954. Attends hospital for treatment twice a week. Both legs and right arm affected, the latter being under-developed and almost useless. Both legs weak, more especially the left, on which a support is worn. Is only able to walk a little. Scarlet Fever. One hundred and fifty-four cases were notified, giving an attack rate of 2.4 per 1,000 population. Forty-four of these cases were removed to hospital and the remainder home nursed. There were no "return" cases, and no deaths from this disease. Diphtheria. For the fourth year in succession, it is most pleasing to state that no case of Diphtheria was notified during the year. Diphtheria Immunisation. The following figures, which have been furnished by the County Medical Officer, show that a total of eight hundred and thirty-five children received Primary Inoculations and seven hundred and seventeen Reinforcing Inoculations during 1953. (Figures for 1952 were nine hundred and eleven Primary and nine hundred and seventy-five Reinforcing Inoculations). A total of ten thousand, eight hundred and eighty children under the age of fifteen years had completed a course of immunisation at the 31st December, 1953, out of a total of fifteen thousand, two hundred and forty-six children—i.e., 71 per cent. 52 Year of Birth. Last complete course of injections (whether primary or booster) 1949—1953. 1948 or earlier Population 1951 Census 1939 422 384 830 1940 282 475 872 1941 259 510 918 1942 326 265 932 1943 445 241 785 1944 538 233 815 1945 444 396 1,030 1946 622 239 1,080 1947 790 211 1,108 1948 851 — 1,066 1949 734 — 1,382 1950 802 — 1,270 1951 708 — 1,129 1952 631 — 1,073 1953 72 — 956 Total 7,926 2,954 15,246 Typhoid Fever. No cases were notified during 1953. Puerperal Pyrexia. Forty-eight cases were notified. Forty-seven were institutionally treated and one home nursed. This represents an attack rate of 50.8 per 1,000 total births. Ophthalmia Neonatorum. One case was notified. This was treated in hospital and made a satisfactory recovery. There was no impairment of vision. Pemphigus Neonatorum. No cases were notified during the year. Measles. Seven hundred and sixty-one cases were notified, giving an attack rate of 11.8 per 1,000 population. This figure showed a slight decrease compared with that for 1952 (786 cases). Nineteen of these cases were removed to hospital and the remainder home nursed. There was one death from this disease. Whooping Cough. Three hundred and fifty-two notifications of this disease were received during the year, representing an attack rate of 5.5 per 1,000 population. Three cases were admitted to hospital and the remainder home nursed. This figure also showed a slight decrease on the 386 cases notified during 1952. 53 Food Poisoning. Forty-four single cases were notified during 1953., but in only seven cases were we able to identify the responsible organism. The following is a copy of the annual return of food poisoning notifications (corrected) furnished to the Ministry of Health:— (1) First Quarter 10 Second Quarter 17 Third Quarter 16 Fourth Quarter 1 44 (2) Outbreaks due to identified agents:— Total outbreaks Nil. Total cases Nil. (3) Outbreaks of undiscovered cause:— Total outbreaks Nil. Total cases Nil. (4) Single cases:— Agent identified 7 (Salmonella organisms). Unknown cause 37. Unless notification of food poisoning is reported within twentyfour hours of onset, added difficulties arise in tracing the origin of the food infected or the causative organism. Other Infectious Diseases. In addition to the infectious diseases enumerated above, notifications were received as under:— Anthrax 1 Dysentery 23 Erysipelas 6 Malaria 1 Meningococcal Infection 1 Pneumonia (all forms) ... 96 Tuberculosis. Recordings in the Register for the year ended 31st December, 1953, are as under:— Respiratory. Other Forms. Total No. of Cases. M. F. M. F. On Register at 1st January, 1953 349 302 69 69 789 New cases notified during 1953 31 23 — 2 56 Number of cases coming to knowledge after death 1 2 — — 3 Restored to Register 1 — — — 1 Inward Transfers 9 14 1 1 25 391 341 70 72 874 Deletions—deaths, removals, recoveries, etc. 11 21 2 2 36 Number of cases on Register at 31 st December, 1953 330 320 68 70 838 54 The number of new cases notified during the year showed a decrease of two over the corresponding figure for 1952, and this in spite of the increased facilities for diagnosis. There were thirty-six deletions from the Register as against twenty-five for the previous year. New Cases and Mortality, 1953. Age Groups. New cases notified or otherwise revealed. Not including Inward Transfers)*. Deaths. Pulmonary. Non-Pulmonary. Pulmonary. Non-Pulmonary. M. F. M. F. M. F. M. F. Under 5 1 1 — — — — — — 5—14 — — — 1 — — — — 15—44 20 20 — 1 — 5 — — 45—64 10 3 — — 1 1 — 1 65 and over 2 1 — — 3 1 — — 33 25 — 2 4 7 — 1 *Inward Transfers 9 14 1 1 Totals 42 39 1 3 Mass Radiography. The unit attended for public sessions at the Village Hall, High Street, Orpington, from the 14th to the 28th July, 1953, when 4,318 persons attended. Of this total, eighteen were significant new cases of Tuberculosis, which is equivalent to a rate of 4 per 1,000. This is a reduced rate, compared with the previous survey in December, 1951, when 1,954 persons attended and fourteen persons were discovered to have Tuberculosis, a rate of 7 per 1,000. This is a pleasing result and compares with similar reductions in the rate in other local authorities. SECTION H. REFUSE COLLECTION AND DISPOSAL. 56 SECTION H. REFUSE COLLECTION AND DISPOSAL. Mr. Crowe reports:— During the year, regular weekly collections of household refuse (fortnightly in the rural parts of the district) has been maintained with only slight disturbances at Bank Holiday periods. Two new side-loading refuse collecting vehicles were purchased during the year, replacing outworn vehicles. The Council now have a fleet of twelve vehicles of the same make engaged on refuse collection. The number of men (including the foreman) engaged on the work is forty-one. The approximate weight of the refuse collected is fifty tons daily and this is disposed of by means of controlled tipping. The tip at Downe, which was first used in April, 1940, is rapidly reaching the final levels and a report was submitted to the Public Health Committee in the early part of the year regarding another site. At the time of writing this report, the site has not been obtained by agreement and a compulsory purchase order is being applied for. Pig food was collected three times each week from 'communal street bins and daily from a few shops and canteens. During the year, a total of four hundred and ten tons, eight hundredweights of pig food was sold to pig-keepers for £1,787 9s. 2d, APPENDIX. STATISTICAL TABLES. 58 STATISTICAL TABLES, 1953. TABLE I.—Summary of Statistics. TABLE II.—Causes of Death. TABLE III.—Infant Mortality. TABLE IV.—Notifiable Infectious Diseases—Sex and Age Distribution. TABLE V.—Notifiable Infectious Diseases—Ward Distribution, Attack and Mortality Rates. TABLE VI.—Notifiable Infectious Diseases—Seasonal Incidence. TABLE VII.—Summary of the work of the Sanitary Inspectors. TABLE VIII.—Nuisances, Defects and Contraventions Abated. 59 TABLE I. SUMMARY OF STATISTICS, 1953. Population (mid-year 1953, per Registrar General) 64,480 Birth Rate 14.4 Death Rate 9.8 Maternal Mortality Rate 2.1 Infant Mortality Rate 17.2 Number of Births (live) 927 Number of Stillbirths 17 Number of Deaths 634 Number of Maternal Deaths 2 Number of Infant Deaths (under 1 year) 16 Death Rate of Respiratory Diseases (including Influenza but not Tuberculosis) 1.4 Death Rate of Tuberculosis 0.16 Death Rate of Zymotic Diseases 0.06 Notifications of Infectious Diseases:— Scarlet Fever 154 Diphtheria — Poliomyelitis 11 Typhoid Fever — Paratyphoid Fever — Puerperal Pyrexia 48 Pneumonia (all forms) 96 Tuberculosis (new cases) 60 Number of Deaths from Infectious Diseases 4 Number of Deaths from Diarrhoea (under 2 years) 2 Number of Visits by Sanitary Inspectors 13,492 60 TABLE II. CAUSES OF DEATH, 1953. 1951. 1952. 1953. Male. Female. Total 1. Tuberculosis—Respiratory 16 10 2 7 9 2. Tuberculosis—Other 3 1 — 1 1 3. Syphilitic diseases 1 3 1 — 1 4. Diphtheria — — — — — 5. Whooping Cough — — — — — 6. Meningococcal infections — — — — — 7. Acute Poliomyelitis — — 1 — 1 8. Measles — — 1 — 1 9. Other infective and parasitic diseases — 2 1 1 2 10. Malignant neoplasm, stomach 27 17 10 5 15 11. Malignant neoplasm, lung, bronchus 19 9 15 4 19 12. Malignant neoplasm, breast 13 10 — 12 12 13. Malignant neoplasm, uterus 7 2 — 3 3 14. Other malignant and lymphatic neoplasms 54 47 31 28 59 15. Leukaemia, Aleukaemia 4 4 4 2 6 16. Diabetes 6 5 2 2 4 17. Vascular lesions of nervous system 66 66 33 45 78 18. Coronary disease, angina 89 85 71 37 108 19. Hypertension with heart disease 20 16 5 14 19 20. Other heart disease 94 91 30 48 78 21. Other circulatory disease 25 27 22 15 37 22. Influenza 10 3 4 7 11 23. Pneumonia 41 32 21 15 36 24. Bronchitis 35 35 22 14 36 25. Other diseases of respiratory system 11 10 5 4 9 26. Ulcer of stomach or duodenum 7 6 5 2 7 27. Gastritis, enteritis and diarrhoea — 1 — 2 2 28. Nephritis and nephrosis 5 5 1 1 2 29. Hyperplasia of prostate 7 4 2 — 2 30. Pregnancy, childbirth, abortion — — — 2 2 31. Congenital malformations 5 7 4 3 7 32. Other defined and ill-defined diseases 59 54 26 28 54 33. Motor vehicle accidents 10 4 5 — 5 34. All other accidents 14 6 1 2 3 35. Suicide 6 2 3 2 5 36. Homicide and operations of war — 1 — — — All causes 654 565 328 306 634 61 TABLE III. INFANT MORTALITY, 1953. (Compiled locally from Registrar's Death Returns). CAUSES OF DEATH. Under 1 Week- 1 and under 2 Weeks. 2 and under 3 Weeks. 8 and under 4 Weeks. Total under 4 Weeks. 1 month and under 8 Months 3 months and under Months 6 Months and under 9 Months 9 Months and under 12 Months. Total Deaths under 1 year. Atelectasis 3 .. .. .. 3 .. .. .. .. 3 Malformation .. .. .. .. .. .. .. .. .. .. Prematurity 3 .. .. .. 3 .. .. .. .. 3 Broncho-pneumonia 1 .. .. .. 1 .. .. 1 1 3 Other Causes 1 1 .. .. 2 3 1 1 .. 7 Totals 8 1 .. .. 9 3 1 2 1 16 62 TABLE. IV. NOTIFIABLE INFECTIOUS DISEASES, 1953. Sex and Age Distribution. Disease. Totals. Under 1 1—2 3—4 5-9 10—14 15—24 25 and over. Age unknown M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Scarlet Fever 80 74 — — 8 4 10 14 50 50 6 3 4 1 2 2 — — Whooping Cough 173 179 15 11 32 45 63 47 59 63 2 2 2 2 8 — 1 Poliomyelitis (Paralytic) 1 5 — — — — — 3 — 1 — — — — 1 1 — — Poliomyelitis (Non-Paralytic) 2 3 — — — — — — 1 — 1 — 1 1 — — — — Measles 356 405 12 14 80 96 106 113 133 171 8 3 4 — 4 3 9 5 Diphtheria — — — — — — — — — — — — — — — — — — 612 666 27 25 120 145 179 177 243 285 17 8 9 4 9 14 9 6 Under 5 5—14 15—44 45—64 65 and over. Age unknown M. F. M. F. M. F. M. F. M. F. M. F. Acute Pneumonia 44 52 4 6 11 13 11 14 9 10 8 9 1 — Dysentery 9 14 1 5 3 3 2 3 2 1 1 2 — — Erysipelas 2 4 — — — — — 2 1 2 — — 1 — Meningococcal Infection 1 — — — — — — — — — — — 1 — Typhoid and ParaTyphoid Fever — — — — — — — — — — — — — — Food Poisoning 18 26 5 5 2 9 8 7 3 3 — 1 — 1 Ophthalmia Neonatorum — 1 — 1 — — — — — — — — — — Tuberculosis (Pulm.) 33 25 1 1 — — 20 20 10 3 2 1 — — Tuberculosis (NonPulmonary) — 2 — — — 1 — 1 — — — — — — Malaria 1 — — — — — 1 — — — — — — — Puerperal Pyrexia — 48 — — — — — 48 — — — — — — Anthrax 1 — — — — — — — 1 — — — — — 109 172 11 19 16 26 42 95 26 19 11 13 3 1 721 838 63 TABLE V. NOTIFIABLE INFECTIOUS DISEASES, 1953. Ward Distribution. Attack and Mortality Rates. Diseases. WARDS Total Biggin Hill Chelsfield Crofton North Crofton South Cudham Downe Farnborough Goddington North Goddington South Green-Street-Green Knockholt Knoll Leaves Green Petts Wood Poverest St. Mary Cray Cases removed to hospital. Attack rate per 1,000 population. No. of Deaths. Death rate per 1,000 population. Scarlet Fever 154 9 4 15 18 1 — 4 6 30 7 5 11 — 19 9 16 44 2.4 — — Whooping Cough 352 46 14 12 14 3 2 17 41 34 17 — 10 1 7 85 49 3 5.5 — — Acute Poliomyelitis (P) 6 — — — — — — 1 — 1 2 — — — — 2 — 6 0.17 1 0.02 Acute Poliomyelitis (N/P) 5 — — — — — — — 1 — — — — — — 1 3 1 — — Measles 761 100 23 59 80 18 3 39 35 89 71 14 38 12 43 93 44 19 11.8 1 0.02 Diphtheria — — — — — — — — — — — — — — — — — — — — — Acute Pneumonia 96 4 — 10 38 — — 12 1 3 3 — 5 — 4 9 7 17 1.5§ 2 0.03 Dysentery 23 — — — 1 — — 1 5 1 — 1 3 — 1 4 6 3 0.36 — — Erysipelas 6 — 1 1 2 — — — — — — — 1 — — — 1 — 0.09 — — Cerebro Spinal Fever — — — — — — — — — — — — — — — — — — — — — Puerperal Pyrexia 48 — — — — — — 46 — — — — — — 1 1 — 47 50.8* — — Typhoid and Paratyphoid Fever — — — — — — — — — — — — — — — — — — — — — Tuberculosis (Pulmonary) 58 4 4 3 8 — 1 — 3 4 3 1 — 3 3 17 4 27 0.9 11 0.17 Tuberculosis (Non-Pulmonary) 2 — — 1 — — — 1 — — — — — — — — — 1 0.03 1 0.02 Food Poisoning 44 — — — 2 — — 4 9 4 — — — 1 4 8 12 2 0.68 — — Ophthalmia Neonatorum 1 — — — — — — 1 — — — — — — — — — 1 0.02 — — Malaria 1 — — — — — — — — — — — — — — 1 — 1 0.02 — — Anthrax 1 — — — 1 — — — — — — — — — — — — 1 0.02 — — Meningococcal Infection 1 — — — — — — 1 — — — — — — — — — 1 0.02 — — TOTALS 1559 163 46 101 164 22 6 127 101 166 103 21 68 17 82 230 142 174 24.2 16 0.23 *Based on 1,000 total births and not population. §Includes all forms of Pneumonia. 64 TABLE VI. NOTIFIABLE INFECTIOUS DISEASES, 1953. Seasonal Incidence. Disease. Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Total. Scarlet Fever 19 23 31 21 6 15 6 8 3 2 11 9 154 Diphtheria — — — — — — — — — — — — — Measles 436 192 61 44 12 11 3 — 2 — — — 761 Whooping Cough 27 52 86 45 28 22 23 26 23 7 12 1 352 Dysentery 8 2 — — 9 — — — 2 — 2 — 23 Erysipelas 1 2 3 — — — — — — — — — 6 Meningococcal Infection 1 — — — — — — — — — — — 1 Anthrax — — — — — — — — — — — 1 1 Pneumonia (all forms) 14 45 21 6 2 4 1 — 1 — 2 — 96 Typhoid & Paratyphoid Fever — — — — — — — — — — — — — Acute Anterior Poliomyelitis 1 — — — — 2 3 4 1 — — — 11 Food Poisoning 2 3 5 2 9 6 8 3 5 1 — — 44 Puerperal Pyrexia — 5 — 4 1 1 3 3 8 7 4 12 48 Malaria — — — — — — 1 — — — — — 1 Ophthalmia Neonatorum — — — — — — — — — — — 1 1 TOTALS 509 324 207 122 67 61 48 44 45 17 31 24 1499 65 TABLE VII. SUMMARY OF THE WORK OF THE SANITARY INSPECTORS. No. of Inspections. No. of premises at which defects or contraventions were found. Housing Inspection. For defects and nuisances 1,335 94 Verminous conditions 29 8 Water supply 214 4 Cesspools 41 6 Common Lodging Houses 2 — Drainage 322 41 (1,943) (153) Infectious Disease. Inquiry visits 255 — Disinfection 7 — (262) Food Premises. Dairies 166 1 Bakehouses 85 8 Restaurants, hotels, canteens, etc. 187 7 Butchers 171 9 Fishmongers and Poulterers 80 2 Fish Fryers 50 — Grocers 483 — Greengrocers and Fruiterers 46 1 Ice Cream 90 I Slaughterhouses 76 1 Food preparing or manufacturing premises 75 1 Hawkers' carts, stalls and street 100 3 vendors Visits in connection with sampling 322 — Re Clean Food Byelaws 61 — Miscellaneous 463 — (2,455) (34) Factories. Factories with mechanical power 102 10 Factories without mechanical power 11 — Other premises classified as factories 2 1 Emission of smoke and fumes 62 2 (177) (13) Trade Premises. Shops (for Shops Act) 92 19 Piggeries 84 4 Caravan sites 90 2 (266) (25) 66 No. of Inspections. No. of premises at which defects or contraventions were found. Miscellaneous. Rodent Control. Local Authority's Property 28 1 Dwelling Houses (including Council Houses) 7,277 424 Business Premises 351 40 Swimming Baths 16 — Suspected Food Poisoning 37 — Keeping of Animals 33 1 Offensive Accumulations 29 2 Schools 4 — Public Conveniences 63 — Theatres & Places of Entertainment 2 — Rivers, streams, etc. 18 — Unclassified 531 — —(8,389) —(468) 13,492 693 67 TABLE VIII. Nuisances, Defects, Contraventions, etc., Abated or Remedied in 1953. Drainage. Drains constructed or reconstructed 7 Cesspools abolished 1 Sink waste pipes renewed or repaired 5 Drains repaired 9 Drains cleansed 37 Water closets repaired or reconstructed 5 Inspection chambers repaired or renewed 3 Water closets provided 4 Inspection chamber covers provided 4 Water closets cleansed 1 W.C. seats repaired or renewed 1 Cesspools ventilation improved or repaired 2 Flushing systems repaired or renewed 2 Cesspools emptied 4 Dampness. Roofs made watertight 22 Rainwater downpipes repaired or renewed 3 Walls made waterproof 17 Damp-proof courses repaired or renewed 2 Flashings repaired or rerenewed 3 Rainwater gutters repaired or renewed 12 Chimney stacks made watertight 2 Water Supply. Main supply provided 1 Ball valves repaired or renewed 3 Pipes repaired or renewed 2 Storage tanks repaired or renewed 3 Domestic Boilers repaired 3 General Items. Wall plaster repaired 8 Dustbins provided 3 Ceiling plaster repaired 3 Nuisance from animals abated 2 Floors repaired 7 Noxious accumulations removed 3 Windows and doors repaired 12 Glazing renewed 1 Fire surrounds and grates repaired or renewed 6 Chimney flues cleansed 1 Yard paving and drainage repaired 1