41231 L ORP 24 ORPINGTON URBAN DISTRICT COUNCIL MEDICAL OFFICER OF HEALTH'S Annual Report on the HEALTH OF THE URBAN DISTRICT 1960 H. B. C. CARTER-LOCKE, M.B., B.S., M.R.C.S., L.C.R.P., D.P.H. Medical Officer of Health Telephone: RAVensbourne 4623 Offices: COUNCIL OFFICES, ORPINGTON, KENT. Telephone: Orpington 27661 ORPINGTON URBAN DISTRICT COUNCIL MEDICAL OFFICER OF HEALTH'S Annual Report on the HEALTH OF THE URBAN DISTRICT 1960 H. B. C. CARTER-LOCKE, M.B., B.S., M.R.C.S., L.C.R.P., D.P.H. Medical Officer of Health Telephone: RAVensbourne 4623 Offices: COUNCIL OFFICES, ORPINGTON, KENT. Telephone: Orpington 27661 3 CONTENTS Page Members of the Urban District Council 5 Staff 5 Prefatory Letter 6 Section A. Vital and Other Statistics and Social Conditions of the Area. General Statistics 10 Vital Statistics 10 Population 11 Births 11 Deaths 12 Morbidity Statistics 13 Medical Examinations 13 Unemployment 13 Open Air Recreational Amenities 14 Section B. General Provision of Health Services for the Area. Ambulance Service 18 British Red Cross Society—Medical Loan Depot 21 Day Nurseries 18 Diseases of Animals Acts 18 Disinfection 16 District Nursing Service 19 Domestic Help Service 18 Domiciliary Midwifery 18 Health Visiting 19 Hospitals 17 Laboratory Service 17 Local Clinic Services 21 National Assistance Act, 1948 17 Nursing Homes 17 Old People's Welfare Committee 20 Public Mortuary 17 Women's Voluntary Services 19 Section C. Sanitary and Environmental Circumstances of the Area Agriculture (Safety, Health and Welfare Provisions) Act, 1956 24 Atmospheric Pollution—Clean Air Act, 1956 24 Cesspools 24 Complaints 25 Diseases of Animals (Waste Foods) Order, 1957 25 Drainage and Sewerage 26 Factories Acts, 1937 and 1948 26 Heating Appliances (Fireguards) Act, 1952 27 Pet Animals Act, 1951 27 Prevention of Damage by Pests Act, 1949 28 Rag Flock and Other Filling Materials Act, 1951 28 Rivers, Streams and Lakes 28 Sanitary Inspection of the Area 28 Shops Act, 1950 28 Swimming Baths and Pools 29 Verminous Conditions and Uncleanliness 29 Water Supply 29 4 Page Section D. Housing. Clearance Areas 36 Rent Act, 1957 36 Housing Statistics 36 Moveable Dwellings 37 Re-Housing 37 Section E. Inspection and Supervision of Foods. Bakehouses 46 Butchers' Shops 45 Food Complaints 42 Food Hygiene Regulations, 1955 42 Food Premises 44 Food and Drugs Act, 1955—Food Sampling 40 Food and Drugs Act, 1955—Section 16 44 Game Act, 1831 46 General 40 Ice Cream 43 Merchandise Marks Act 46 Milk and Dairies Regulations 45 Restaurants, Hotels and Canteens 45 Slaughterhouses and Slaughtermen 45 Special Samples—Milk, Ice Cream, Water and Egg Products 43 Unsound Food 44 Section F. Prevalence of, and Control Over Infectious and Other Diseases. Acute Anterior Poliomyelitis 48 Poliomyelitis Vaccination 48 Diphtheria and Diphtheria Immunisation 48 Dysentery 49 Food Poisoning 49 General Remarks 48 Measles 49 Meningococcal Infections 49 Other Infectious Diseases 52 Pneumonia 50 Scarlet Fever 50 Smallpox and Vaccination 50 Tuberculosis, Chest Clinic and Mass X-ray 50 Whooping Cough & Whooping Cough Immunisation 52 Section G. Refuse Collection and Disposal. Refuse Collection and Disposal 54 APPENDIX—STATISTICAL TABLES. 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 Public Health Inspectors 65 VIII. Nuisances, Defects and Contraventions abated 67 5 MEMBERS OF THE URBAN DISTRICT COUNCIL (as at 31st December, 1960) * Chairman of the Council: Councillor G. A. SMITH * Vice-Chairman of the Council: Councillor G. G. ROMAIN Councillors *Mrs. J. G. BANKS (Chairman of Public Health Committee) *F. W. LANE *E. H. LUCAS H. L. BLAKE Mrs. C. M. MEDLYCOTT *J. W. BRAY R. L. MUMFORD R. J. BROWN C. H. E. PRATT H. T. COX C. R. RAYNER Mrs. J. C. M. DAISH *Mrs. P. L. ROBERTSON J. DAVIES, C.C. C. S. SAFFERY A. L. FERRIS *D. A. SCOLLICK, A.F.I.C.D. *Mrs. F. G. GARDNER *Mrs. S. M. STEAD P. A. GOLDING, A.R.I.B.A. M. J. A. STEVENS *J. T. HARRIS, F.C.I.P.A. Mrs. J. V. WEBB W. D. HAYNE, T.D. *S. W. WELLS (Vice-Chairman of Public Health Committee) L. F. HENDY, M.B.E. F. S. HOCKEY *B. D. WOODMANSEE *A. B. HOWARD M. G. WORMAN *W. D. KNIGHT (* denotes members of the Public Health Committee.) STAFF OF THE PUBLIC HEALTH DEPARTMENT (as at 31st December, 1960) 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 Medical Officer of Health for the Borough of Bromley, and Chislehurst and Sidcup Urban District.) Deputy Medical Officer of Health A. J. I. KELYNACK, M.B., B.S., D.P.H. (Also Deputy Medical Officer of Health for the Borough of Bromley, and Chislehurst and Sidcup Urban District.) Chief Public Health Inspector and Cleansing Superintendent F. C. CROWE, M.R.S.H., M.A.P.H.I. Council Offices, Orpington, Kent. Telephone: Orpington 27661. Deputy Chief Public Health Inspector and Deputy Cleansing Superintendent W. T. WEEDY, C.R.S.H., M.A.P.H.I. District Public Health Inspectors T. E. W. OSBORNE, C.R.S.H., R.I.P.H. K. J. COPPIN, C.R.S.H., M.A.P.H.I. A. E. ROBINSON, C.R.S.H., M.A.P.H.I. Note.—All Public Health Inspectors are Inspectors under the Food and Drugs Acts, Shops Act, Rag Flock and Other Filling Materials Act, Pet Animals Act, Heating Appliances (Fireguards) Act, and the Agriculture (Safety, Health and Welfare Provisions) Act, 1956. Clerical Staff Secretary: Miss C. COOPER. Shorthand Typist: Mrs. G. BOONE. Clerk: Mrs. S. KNIGHT. Outdoor Staff Disinfector: J. MURRAY. Rodent Operative: W. S. MILLS. Assistant Rodent Operative: C V. POTTER. General Foreman (Refuse): F. HONESS. 6 To the Chairman and Members of the Orpington Urban District Council. Mr. Chairman, Ladies and Gentlemen, "I couldn't care less." Perhaps this may seem an odd way to open a report such as this, but the expression does summarise the attitude of some people to some of the hazards and tribulations of our everyday life. The overall picture of Orpington's health is bright and cheerful, but a careless attitude could lead to trouble, and this risk is not by any means a local one only. One's thoughts turn instinctively to such matters as smoking, immunisation, vaccination, accidents and clean food, and one is immediately conscious of the fact that, although much has been done to publicise these very important public health concerns, yet the attitude towards them has in too many instances been one of inertia rather than urgency. No apology is needed for stressing once again the now well known association between smoking and cancer of the lung, and yet I have a rather hopeless feeling that any appeal however impassioned will once more fall on deaf ears. It is a fact, and one that is recorded with guarded satisfaction, that there was a fall in the number of deaths from this disease during 1960, but one would have to see a steady year-by-year decline in the death rate before any real and and lasting satisfaction could be expressed. This is also the occasion and opportunity to mention a small reduction in the number of deaths from cancer in other parts of the body, a trend which I would also like to see continued in the coming years. Immunisation against diphtheria and vaccination against anterior poliomyelitis are other very important public health measures which if taken seriously, can make a big contribution to the future health of our people. Unfortunately they are too often being neglected, with sad consequences to the affected families. Although diphtheria has been near during the past year, we have fortunately avoided it once again in this district, but immunity from its ravages cannot be expected unless a substantial proportion of our children are immunised against this disease. Because we were lucky enough to avoid anterior poliomyelitis entirely during the year under review, there is no reason for complacency, and everyone under the age of 40, is strongly urged to take advantage, by a course of injections, of the protection offered against this disease. Here again failure to take action in time, will inevitably lead to future unnecessary cases of this disease arising. Frequent reference has been made in previous reports to the unnecessary loss of life due to accidents, and stressing the need to take every reasonable precaution both in the home and on the roads. The mention of accidents should remind us of a hazard which has 7 only arisen in recent years, namely the wrongful use of thin polythene film. This very excellent material can cause suffocation if misused by the very young, from whom it should always be kept, even to the extent of burning after use if it cannot be stored safely away from the reach of young hands. This is a very obvious case of how carelessness can lead to tragedy, and in a similar way thoughtless handling of food can be responsible for outbreaks of food poisoning and the passing on of serious intestinal infections. Every effort is made by the Department to teach food handlers to treat their job as the important one that it undoubtedly is, but one wonders sometimes whether the ordinary domestic standards of hygiene are not, in too many instances, such as to expose the household to quite unnecessary risks. One is disturbed to see that we lost nine of our population by suicide, and this automatically makes one's thoughts turn to the Mental Health Act. This is undoubtedly a very progressive measure, but the full effect of it will it is hoped, be seen in the future when the tendency will be more and more to treat cases within the community rather than in hospital, which will merely be used in certain stages in the treatment when such is necessary. Statistically a year must be considered satisfactory when the birth rate is above the national average, and the death rate and infant mortality rates are below that average. The year was one with a low incidence of infectious disease, and there were no major incidents in this field. Orpington is indeed fortunate in its voluntary services which supplement so extensively the statutory services provided by the local authorities, but with the number of elderly people in the community always on the increase, more and not less help from all possible sources is likely to be the need for the future. One of the problems relative to the world in which we live is that of noise, and I am not referring to any particular sound, but the generally noisy atmosphere with which we are surrounded. This is a very thorny problem, and one which at the moment seems very difficult to solve, particularly as the younger generation seems to find great pleasure in loud sounds, which although music in their ears, would not be so described by the "squarer" members of the community. It would be wrong not to mention the report of the Royal Commission set up to study the local government of the Greater London Area. The recommendations made would have the effect of transferring to a health committee composed of Members of this Council plus Members from an adjoining authority, most of the functions now exercised by a local health authority. At the time of writing, the Government has not revealed its intentions with 8 regard to the Royal Commission's Report, but should they decide to implement its main recommendations, it is obvious that the Health Committee would have to undertake quite a number of additional tasks. When it comes to thanking the many people who help me during the year, I always feel very humble and conscious of the major contributions to the successful running of the Department made by others. My deputy, Dr. Kelynack, is always behind me to give of both his advice and help, and Mr. Crowe, the Chief Public Health Inspector, has added one more successful year to the many he has served so well with this authority. To both these officers I offer my heartfelt thanks, as also I do to all the other members of the Department. I should also like to express my gratitude to all those doctors outside the realm of the Department who help in any way to make my work easier. Finally, very grateful thanks are due to the Chairman and Members of the Public Health Committee for their gracious treatment to myself, and for their keenness and enthusiasm in the work of the Public Health Committee. I am, Your obedient Servant, H. B. C. CARTER-LOCKE, Medical Officer of Health. SECTION A VITAL AND OTHER STATISTICS AND SOCIAL CONDITIONS OF THE AREA 10 SECTION A VITAL AND OTHER STATISTICS AND SOCIAL CONDITIONS OF THE AREA GENERAL STATISTICS Area of the Urban District (in acres) 20,842 Area of Parks, Open Spaces, etc. (in acres) 283.6 Registrar General's estimate of total population (mid-year) 1960 76,020 Rateable value at 31st December, 1960 £1,277,182 Estimated net product of a penny rate, 1960/1961 £5,145 Total number of valuation assessments at 31st December, 1960 24,334 Mileage of Roads as at 31st December, 1960. County Roads (Class I, II and III) 41.35 miles District Roads 106.51 miles Unadopted Roads 27.93 miles Total 175.79 miles VITAL STATISTICS Live Births. Males Females Total Legitimate 703 685 1,388 Illegitimate 28 21 49 731 706 1,437 Crude birth rate per 1,000 estimated total population 18.9 Adjusted birth rate for comparison with other areas (The area comparability factor for births is 0.98) 18.5 Illegitimate live births (per cent. of total live births) 3.47 Birth rate for England and Wales 17.1 Stillbirths. Males Females Total Legitimate 9 12 21 Illegitimate 1 - 1 10 12 22 Stillbirth rate per 1,000 total live and still births 15.1 Stillbirth rate per 1,000 estimated total population 0.3 Total Births (live and still). Males Females Total Legitimate 712 697 1,409 Illegitimate 29 21 50 741 718 1,459 11 Infant Mortality. Males Females Total Legitimate 14 11 25 Illegitimate 1 1 2 15 12 27 Infant mortality rate per 1,000 live births 18.8 Legitimate infant deaths per 1,000 legitimate live births 18.0 Illegitimate infant deaths per 1,000 illegitimate live births 40.8 Neo-natal mortality rate (deaths under 4 weeks per 1,000 total live births) 17.4 Early neo-natal mortality rate (deaths under 1 week per 1,000 total live births) 16.0 Perinatal mortality rate (stillbirths and deaths under 1 week combined per 1,000 total live and still births) 30.8 Infant mortality rate for England and Wales 21.7 Maternal Mortality. Maternal deaths (including abortion) Nil Maternal mortality rate per 1,000 live and still births Nil Maternal mortality rate for England and Wales 0.39 Deaths. Males Females Total 380 332 712 Crude death rate per 1,000 estimated total population 9.4 Adjusted rate for comparison purposes (The area comparability factor for deaths is 1.08) 10.1 Death rate for England and Wales 11.5 Population. The Registrar General's estimate of the total population of the Urban District, mid-year 1960, was 76,020 which is an increase of 1.400 over the figure for the previous year. This population figure gives a density of 3.65 persons to the acre. The natural increase of population measured by excess of births over deaths, was 725. Births. The birth rate for 1960 was 18.9 per 1,000 total population. The adjusted rate for comparison with other areas being 18.5. The rate of 18.9 is .3 higher than that for the previous year, and is well above the figure of 17.1 for England and Wales as a whole. 1,437 live births were registered in the Urban District during the year, as against 1,388 in 1959. Of this number, 731 were males and 706 females. 12 The illegitimate live births amounted to 3.4% of the total live births. There were 50 illegitimate births (including 1 stillbirth), 29 being males and 21 females. The stillbirth rate for the year was 15.1 per 1,000 total live and still births, and 0.3 per 1,000 estimated total population. Of the 22 stillbirths registered 10 were males and 12 females. Deaths. 712 deaths appertaining to the Urban District were registered in 1960, giving a death rate of 9.4 per 1,000 total population. The adjusted rate for use when comparing one area with another is 10.1. The rate for England and Wales as a whole is 11.5. Of the Orpington deaths registered, 380 were males and 332 females. The following is an analysis of the ages at death: Under 1 year of age 27 1 and under 5 years of age 1 5 and under 15 years of age 3 15 and under 25 years of age 7 25 and under 35 years of age 5 35 and under 45 years of age 24 45 and under 55 years of age 45 55 and under 65 years of age 95 65 and under 75 years of age 143 75 years and over 362 712 Full details of the causes of death will be found in Table II in the appendix, but the following table, giving details of certain causes of death in the Urban District during the past ten years may prove of interest: 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 Cancer (all sites) 120 85 108 108 134 131 131 158 172 159 Cancer of the lung, bronchus 19 9 19 25 23 34 33 38 48 33 Heart and Circulatory diseases 293 293 285 320 262 264 284 328 348 321 Respiratory diseases (excluding T.B.) 76 77 81 44 79 135 88 119 107 110 Tuberculosis 19 11 10 5 6 7 4 4 4 3 Infectious Diseases — 2 4 1 2 1 1 3 3 1 Road Accidents 10 4 5 8 6 6 5 10 12 13 Other Accidents 14 6 3 2 8 10 8 10 6 8 13 The changing hazards of present day life are illustrated by the decline in deaths from tuberculosis, the figure this year being the smallest ever to be recorded in the Urban District, and, in contrast, by the increasing importance of road deaths, which reached the highest level of any year for which records are available. Morbidity Statistics. The following is a summary of the weekly details received from the Ministry of Pensions and National Insurance during 1960:— Four weeks ending Number of First Certificates of incapacity received 26th January 987 23rd February 987 29th March 796 26th April 703 24th May 659 21st June 522 12th July 577 9th August 485 6th September 482 4th October 611 1st November 869 29th November 732 27th December 741 Medical Examinations. 110 members, or potential members of the staff were examined medically during the year. Unemployment. I am indebted to the Manager of the local Employment Exchange for the following information with regard to unemployment in the area during 1960:— "The number of unemployed persons has throughout the year 1960 been considerably lower than in 1959, the difference varying, according to the time of year, between 50 and 200 persons. The usual pattern has been followed, i.e. the highest figure in January, gradually decreasing until June, and then slight increases until the end of the year. There as been a steady demand for workers throughout the year, and with local firms increasing their labour force and some new firms coming into the area, there has been little long term unemployment." 14 Open Air Recreational Amenities. Approximately 283.6 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 0.50 Cudham Village Cudham 10.39 Cudham Lane Green-Street-Green 6.5 Downe Downe 3.0 Farnborough Farnborough 10.0 Glentrammon Green-Street-Green 13.5 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 St. 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 10.3 The Priory Gardens Goddington North 14.03 Open Spaces. Okemore Gardens St. Mary Cray 3.75 Wotton 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 Gumping Common Crofton South 4.25 Sparrow Common Petts Wood 0.50 The contribution which the open spaces can make towards the health of the place is, of course, incalculable, and by its provision of a large number of open-air recreational facilities, the Council has made arrangements for both young and old alike. The younger generation are given the opportunity to enjoy their sports and pastimes, and for those who enjoy less active pursuits, every chance is given to take full advantage of the restfulness of a summer evening or week-end. Such amenities for both recreation and relaxation can only have beneficial effects on the population in general. SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. 16 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. PUBLIC HEALTH SERVICES RENDERED BY THE COUNCIL. Major services of the Public Health Department, to which reference is made in later sections of this report are:— Atmospheric Pollution. Enquiries into Complaints, and Abatement of Nuisances. Health Education and all matters covered by the headings of Sanitary and Environmental Services. Housing. Inspection of Food and Food Premises. Inspection and Examination of Water and Milk Supplies. Inspection of Factories and Shops. Infectious Diseases (Prevention and Notification). Rodent Control. Refuse Collection and Disposal. Disinfection. The disinfecting station is situate at the Council Offices and details of the work carried out during 1960 are as under:— Disinfections— Premises visited 52 Rooms disinfected 53 Articles disinfected 573 Disinfestations— Premises visited 20 Rooms disinfested 38 Articles disinfested 124 Articles treated. Articles destroyed. Beds 91 — Mattresses 90 — Pillows 126 — Bolsters 20 — Bedclothes (batches) 58 — Clothing (batches) 57 — Cushions 35 — Hangings 74 — Carpets, etc. 68 — Library Books 78 — 697 - 17 In the case of disinfection, rooms and furniture are treated with Formalin vapour and, if necessary, liquid spray. Some articles are steam treated with a pressure of 20 lbs. per square inch. Bedding is steam treated with a similar pressure. For disinfestation purposes, rooms and furniture are sprayed with a proprietary brand of insecticide containing five per cent D.D.T. Laboratory Service. Routine medical and Food and Drugs samples are forwarded to the Public Health Laboratory at Maidstone, and the following is a summary of the work carried out on behalf of the Council during 1960:— Faeces 297 Food Samples, etc. 261 Water Samples 48 Miscellaneous 8 614 NATIONAL ASSISTANCE ACT, 1948. Section 47. Although several cases were visited and investigated during the year, it was not necessary to apply to the Court for an Order for compulsory removal of any of the persons concerned. Section 50. Under this section of the Act, a duty is placed on the local authority to arrange for the burial or cremation of the body of any person who has died or been found dead in their area, if it appears that no suitable arrangements for the disposal of the body have or are being made. During the year, three bodies were dealt with by the Council under this Section of the Act. Nursing Homes. There are no registered Nursing Homes within the area. Public Mortuary. There is no public mortuary in use in the district. Facilities have been given for the use of the mortuaries attached to Farnborough and Orpington Hospitals. SERVICES RENDERED BY THE HOSPITAL BOARDS. (a) Farnborough Hospital.—Provides a general hospital service with 736 beds. 18 (b) Chest Clinic.—There is no Chest Clinic in the area, all patients being referred to the Clinic at Tiger Lane, Bromley. The above are under the control of the Bromley Group Hospital Management Committee, whose offices are at Farnborough Hospital. (c) Orpington Hospital.—General Hospital with provision for 809 beds, including Part III residential accommodation for County use. This Hospital is controlled by the Orpington and Sevenoaks Group Hospital Management Committee and their offices are at Orpington Hospital. (d) Venereal Diseases.—Patients are referred to the various hospitals with specialist clinics for dealing with these diseases. SERVICES RENDERED BY THE KENT COUNTY COUNCIL. Ambulance Service. The main depot for the area is at 12, Hayes Lane, Bromley. At the present time there are twenty-seven ambulances and twenty-two sitting case cars available for use at this depot, and the majority of these are radio controlled. Day Nurseries. There are no day nurseries in the district. Diseases of Animals Acts. There is an officer stationed at Bexley who carries out the functions of this service. Domiciliary Midwifery. Six full-time Midwives and five Home Nurse Midwives are employed in the Urban District. The services of a Midwife may be obtained on direct application or through the patient's private doctor. Domestic Help Service. The District Organiser's office is at The County Offices, "The Walnuts," High Street, Orpington. The following is a summary of the cases assisted during 1960:— Maternity (Expectant Mothers) 173 Tuberculosis 4 Aged 236 Others 200 613 19 Family Help Service. This service is provided to deal with the care of children in their own homes when they are temporarily deprived of the care of their mother or a female guardian. Twenty-five cases were assisted during 1960. Child Help Service. Assistance under this scheme was given to one family in the area during the year. Night Attendant Service. Ten cases received assistance under this scheme in 1960. District Nursing Service. There are six District Nurses and four District Nurse Midwives employed in the area. No night service is provided. The services of a District Nurse may be obtained on medical certification. Health Visiting. Ten Health Visitors/School Nurses, one full-time School Nurse and one Tuberculosis Health Visitor are employed in the area. In addition to their school work, Health Visitors are responsible for the Maternity and Child Welfare Clinics, Home Visiting, Mental Health Visiting, Immunisation and Vaccination Clinics, etc. SERVICES RENDERED BY VOLUNTARY AGENCIES. The St. John Ambulance Brigade. Over 60's Clubs. The invaluable work carried out by these agencies continued during the year. Women's Voluntary Service. The County Organiser has kindly furnished the following information:— "Meals on Wheels." Orpington W.V.S. members cook the meals at The Rookery, these are delivered three days a week. The total number delivered during 1960 was 7.708. The charge is still only 1s. per head and they received no subsidy from the Local Authority. The van is their own property and is maintained by them through the generosity of various donations and a grant from Alexandra Rose Day. 20 Darby and Joan Clubs—Farnborough Club. The membership at this Club has slightly increased during the year. The car service is even more in demand as the members become more infirm. The members of this Club have been very fortunate in having a number of free Outings during the year. The Rookery Club. This Club has now about the same membership as Farnborough. The W.V.S. helpers at both Clubs continue to take a personal interest in the old people, listening to their problems and frequently escorting them to hospital or to the Doctor when necessary. General Welfare Work. During the year 1960 the appeals for assistance from the Almoners of Orpington and Farnborough Hospitals have been constant. W.V.S. members have been asked to take elderly people to New Cross General Hospital for repairs to deaf aids, also to Convalescent Homes (including one in the Isle of Wight) and to bring them home again. In all, 321 escorts by car have been undertaken. The Trolley Shop continues to give valuable service at Farnborough Hospital. It is the high-light of the week for the old and permanent patients. Orpington and District Old People's Welfare Committee. The Honorary Secretary has kindly furnished the following report:— "The Orpington and District Old People's Welfare Committee exists to promote and assist the general good of all old people in the Urban District of Orpington, by assisting the work of statutory authorities and voluntary organisations engaged in providing facilities for physical and mental recreation, developing physical improvement, furthering health or relieving poverty, distress or sickness. It works in close collaboration with these organisations, and many of them are represented on the Committee. All the 11 Old People's Clubs in the district continue to flourish, and the Committee continues to maintain a visiting service and help many old people from its Benevolent Fund. The need for this work is increasing as the number of old people grows; they live longer nowadays and therefore more of them become frail. In March, 1960, this Committee in conjunction with the British Red Cross Society, opened a chiropody clinic in the Orpington Village Hall for the treatment of old people. This provides for central Orpington a service which had already been established in other parts of the Urban District. The clinic meets a real need, and is fully booked for weeks ahead." 21 British Red Cross Society—Medical Loan Depot. One medical loan depot is in operation in the area, where a full range of nursing requisites is held and articles are available to local residents. A small charge is normally made, but, in necessitous cases, and for most old age pensioners articles are loaned free. The address of this depot is 1, Birchwood Road, Petts Wood, and it is open by appointment. Application should be made to Mrs. Jones of that address—telephone number Orpington 22083. LOCAL CLINIC SERVICES. Child Welfare Centres. Chei.sfield Village Hall 1st, 3rd & 5th Tuesday in month—afternoon. Biggin Hill Sports Pavilion, Biggin Hill Thursday—afternoon. Downe Village Hall 1st & 3rd Friday in month —afternoon. Farnborough Methodist Hall Friday-afternoon. Green-Street-Green Baptist School Room Friday—afternoon. Knockholt The Institute 2nd & 4th Tuesday in month—afternoon. Orpington Methodist Church Hall Monday, Tuesday & Friday—afternoon. „ St. Giles Church Hall, Leamington Avenue Wednesday—afternoon. Crofton St. Paul's Church Hall Monday—afternoon. Petts Wood G.E.A. Hall, Woodhurst Avenue Monday & Thursday— afternoon. St. Mary Cray Temple Congregational Church Hall Tuesday & Wednesday —afternoon. Pratts Bottom Village Hall 2nd & 4th Thursday in month—afternoon. Poverest Coronation Hall, Bridge Road, St. Mary Cray Each Thursday afternoon cudham Eldon Hall, Downe Avenue 1st & 3rd Wednesday in month—afternoon. Ante-Natal Clinics. Green-Street-Green Baptist School Room Friday—morning. Relaxation Class — 2nd 4th Tuesday in month. Orpington Methodist Church Hall Tuesday & Friday— morning. Petts Wood G.E.A. Hall, Woodhurst Avenue 1st, 3rd and 5th Tuesday afternoon, 1-2.30 p.m. Relaxation Class 10 a.m. 12 noon. 22 St. Mary Cray Temple Congregational Church Hall 1st, 3rd & 5th Friday— afternoon, Doctor in attendance. St. Mary Cray Temple Congregational Church Hall 2nd & 4th Friday—afternoon. (Midwives only in attendance.) Ophthalmic Clinic. The School House, Chislehurst Road Orpington Every Monday, all day— By appointment only. Minor Ailment Clinics (Schools). The School House, Chislehurst Road Orpington Every Wednesday—afternoon, 1.45 p.m.- 3 p.m. Dental Clinics. The School House, Chislehurst Road Orpington Monday, Tuesday, Wednesday, Thursday and Friday—all day. Dentist attends full time each day. Dental Clinics are also held in the country areas—Farnborough, Cudham, Westerham, Biggin Hill, Downe, Green-StreetGreen, Knockholt, etc. Immunisation and Vaccination. This is carried out at the Child Welfare Centres listed above. SECTION C. SANITARY AND ENVIRONMENTAL CIRCUMSTANCES OF THE AREA. 24 SECTION C SANITARY AND ENVIRONMENTAL CIRCUMSTANCES OF THE AREA. Agriculture (Safety, Health and Welfare Provisions) Act, 1956. The responsibility of the Health Department under this Act is to ensure that farm workers have suitable and sufficient sanitary accommodation and adequate washing facilities. Atmospheric Pollution. During the year, 430 observations and visits were made by the Public Health Inspectors in connection with the Clean Air Act, 1956, and in 17 cases it was necessary to call attention to infringements. A happy relationship exists between the various factory managements and the Public Health Department and any infringements detected are dealt with on an informal basis. This district is not shown as a black area by the Ministry of Housing and Local Government on their map of the Greater London area. The district, which comprises some 20,000 acres, is well provided with open spaces, parks and recreation grounds and with many factories and private dwellings using oil fuel, the atmosphere is comparatively free from pollution. The Council co-operates with the Fuel Research Station acting under the Department of Scientific and Industrial Research in the measurement of atmospheric pollution. There are two sites in the district at one of which a deposit gauge is positioned for the measurement of solid matter suspended in the atmosphere and at the other a Lead Peroxide Cylinder for the measurement of sulphur dioxide. At monthly intervals, samples are forwarded to the Council's Analyst and reports thereon are submitted to the Fuel Research Station. The Council is represented by the Chairman of the Public Health Committee and the Chief Public Health Inspector on the London and Home Counties Smoke Abatement Advisory Council, the National Smoke Abatement Society, and the Standing Conference of Local Authorities which co-operate with the Department of Scientific and Industrial Research. Cesspools. As forecast in my last Report, the number of drainage connections made to the newly sewered roads in the Biggin Hill area was highly satisfactory, almost 100%. 25 The roads concerned were Aperfield Road, Edward Road, Moselle Road and St. Winifred's Road, involving in all 107 properties. Of these, 103 have been connected leaving only four premises, two of which are over 100 feet from a sewer and two where the road portion of the connection is already completed. The number of cesspools abolished in the roads mentioned, was 100. Elsewhere in the district 81 cesspools were abolished, making a grand total of 181 for the year—a record since this work began some 10 years ago. The following summary shows the position at the end of 1960:— Number of cesspools at 31st December, 1960: (1) On line of sewer 65 (2) Not on line of sewer 2,262 Number of cesspools abolished and main drainage provided during the year 181 Number of houses with pail closets converted to cesspool drainage Number of new houses erected with cesspool drainage 32 Number of loads removed from cesspools:— On private properties 5,809 On requisitioned properties 56 On Council properties 525 6,390 Complaints. During the year, 54 complaints were received from residents, but in no case was it necessary to take formal action to secure abatement of the nuisance. Diseases of Animals (Waste Foods) Order, 1957. The object of this Order is to prevent the spread of Foot and Mouth and other diseases of animals. The Order provides, inter alia, that where persons collect waste foods for feeding to animals or poultry, the foods must first be boiled for one hour in a Plant licensed by the Local authority. Five Boiling Plants were licensed during 1960, making a total of 46 licences issued under this order. 26 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 as under:— Private Estate Development: Foul sewer 9" 698 lineal yards. Foul sewer 6" 501 lineal yards. Surface water 9" 45 lineal yards. Surface water 6" 74 lineal yards Factories Acts, 1937 and 1948. There are 140 factories on the Council's register at the present time. Ninety visits of inspection were made by the Public Health Inspectors and by the end of the year practically all of the 21 defects found had been remedied. The following gives particulars of the work carried out during 1960 1. Inspection for purposes of provisions as to heatlh : Premises No. on Register Number of Inspections Written Notices Occupier s Prosecuted (a) Factories in which Section 1, 2, 3, 4 and 6 are to be enforced by the Local Authorities 8 2 - - (b) Factories not included in (1) in which Section 7 is enforced by the Local Authority 119 63 21 (c) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises)* 13 25 - - 140 90 21 - * Building sites on Estate development. 27 2. Cases in which defects were found : Number Number of cases in which defects were of cases Referred in which Found Remedied to H.M By H.M. prosecuInspector Inspector tions were Instituted Want of cleanliness (S.l) — — — — — Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) — — — — — Inadequate ventilation (S.4) — — — — — Ineffective drainage of floors (S.6) — — — — — Sanitary Conveniences (S.7): (a) Insufficient — — — — — (b) Unsuitable or defective 21 20 — — (c) Not separate for sexes — — — — — Other offences against the Act (not including offences relating to outwork) — — — — — Total 21 20 — — — Outworkers. Twenty-nine lists of Outworkers were received during the year, and the following are details of the trades involved, together with the number of persons employed. Trade No. of outworkers employed Clothing 76 Cardboard boxes 2 Surgical Appliances 2 Brushmaking 1 Lamp shades 3 84 Heating Appliances (Fireguards) Act, 1952. No contraventions were found during the course of the year. Pet Animals Act, 1951. Licences in respect of five premises were granted or renewed during 1960 and 21 visits were made by the Public Health Inspectors. No nuisances or defects were found. The pets sold from these shops consist mainly of birds, fish and tortoises. 28 Prevention of Damage by Pests Act, 1949. The number of inspections and treatments carried out was as follows : Total number Number of of inspections. Infestations cleared. Local Authority's property 49 8 Dwelling houses (including Council houses) 5,398 532 Business premises : 169 31 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 treatment with poison bait in February and September. The degree of infestation was found to be negligible. Rag Flock and Other Filling Materials Act, 1951. This Act is designed to secure the use of clean filling materials in upholstered articles and other articles which are stuffed or lined, or for purposes connected therewith. No contraventions were found under this Act during 1960. Rivers, Streams and Lakes. Since 1950, the Kent Rivers Board has been responsible for the supervision of the two rivers in this area, i.e. the Cray and the Kydbrook. Sanitary Inspection of the Area. No of premises at Total number of which defects or Inspections contravention! were and visits found Housing 3,172 253 Infectious Diseases 684 — Food Premises 1,352 64 Factories (including Smoke Observations, Outworkers) 520 38 Rodent Control (Public Health Inspectors only) 152 135 Trade Premises 563 24 Miscellaneous 765 3 7,208 517 Shops Act, 1950. During the year, 270 inspections of shops were made and the following contraventions were found and subsequently remedied by the shop-keepers : Neglect in displaying Statutory Forms 20 Inadequate Heating 2 Hours of Closing 1 Swimming Baths and Pools. There is only one swimming bath in the district to which the public are admitted, and this is situated at Darrick Wood, Lovibonds Avenue, Orpington. It is owned by the Kent Education Committee, but is operated by Orpington Urban District Council in conjunction with the Committee under a financial arrangement during the summer months, whereby, although it is normally reserved for the use of school children, the general public are admitted at certain times. The charge for admittance is 1/- for adults and 6d. for children. It is an indoor swimming bath covered with white glazed tiles. A new gas chlorination plant was installed during the year to replace the old type and this has proved to be far more effective. The water, supplied by the Metropolitan Water Board, is heated, chlorinated and then filtered continuously, this cycle taking eight hours. Four visits of inspection were made during the year by the District Public Health Inspector and three samples of the water taken for analysis proved to be satisfactory. Verminous Conditions and Uncleanliness. No cases of unclean premises were found during the year, but 20 verminous premises were dealt with by the Department's Disinfector. Water Supply. During the year, three premises were connected to the main water supply, having previously been dependent upon stored rainwater. Of approximately 24,000 dwellings, only 33 are not provided with a main piped water supply. Of these, 21 are situated where a water main is not available in the roads fronting their premises. These are in isolated parts of the district and generally dependent upon rain-water collected from roofs and stored in underground tanks, but three premises obtain their source of supply from a private well. The remaining 12 premises are not connected to a main water supply although it is available in the roads on to which they front. Some of these are a considerable distance from the road, but seven premises are within 80 feet of the Metropolitan Water Board main. Fourteen week-end bungalows are not connected to a main water supply. 29 30 The total number of premises still dependent upon underground tank or well supply is made up as follows : Number of premises with Ward Stored Rainwater Wells Biggin Hill 18 — Chelsfield 2 Cudham 4 — Downe 2 — Farnborough 2 1 Green St. Green 3 — Knockholt 1 — 32 1 The Metropolitan Water Board supplies the mains water for the whole of the district. The Public Health Department obtains samples of this water at monthly intervals from various dwelling houses throughout the district. Fifty-two samples were taken and the Analyst's reports show that they were all satisfactory. The Director of Water Examination, Metropolitan Water Board, has kindly reported on the water supply to the Urban District during the year 1960: — "The supply to the district of Orpington during 1960 was derived from the following seven wells, namely Eynsford, Horton Kirby, Lullingstone, North Orpington, Orpington, Shortlands and Sundridge together with Thames derived filtered water. The following extension of trunk mains has been carried out in the area during 1960:— In Poverest Road, Lovibonds Avenue, Croften Avenue and The Avenue where 12" and 10" mains were laid. None of the water is plumbo-solvent and there have been no specific instances of contamination in the area during 1960. No statistics are available as to the number of dwelling houses supplied by pipes direct to the houses, but the figure required is the total population less those dependent on rain water or private wells. The Board have no accurate information as to standpipes but there are some bungalows in Biggin Hill area that have no water fittings except a standpipe in the front garden. The following tables give the results of the chemical and bacteriological analyses of the various supplies to Orpington during 1960 including bacteriological quality of the well water before treatment." 31 Average Results of the Chemical Examination of the Water supplied to Orpington during the Year 1960. Milligrammes per litre (unless otherwise stated) Description of the Sample No. of Samples Ammonia Nitrogen Albuminoid Nitrogen Oxidised Nitrogen Chlorides as CL Oxygen abs. from Permanganate 4 hrs. at 27°C. Turbidity units Colour, mm. brown 2 ft. Tube Burgess's Tintometer Nitrate Eynsford well 7 0.013 0.020 4.1 16 0.06 Nil Nil Horton Kirby well 6 0.012 0.022 4.5 17 0.04 Nil Nil Lullingstone well 5 0.014 0.023 3.8 15 Nil Nil Nil Orpington well 4 0.015 0.021 6.6 15 0.04 Nil Nil N. Orpington well 4 0.013 0.023 5.0 14 0.04 0.1 Nil Shortlands well 12 0.016 0.026 5.3 18 0.04 Nil Nil Sundridge well 4 0013 0.017 3.0 18 0.04 Nil Nil Thames derived 156 0.038 0.080 4.0 28 1.26 0.3 14 (Southern Group) Description of the Sample Hardness (Total) Hardness (noncarbonate) pH. Value Phosphate as po4 Silicate as SiO2 Sulphate as sO4 Fluoride as F Magnesium as Mg. Surface Active Material as Manoxol Free CO2 Electrical Conductivity (Gemmhos) Eynsford well 258 32 7.3 16 0.2 32 475 Horton Kirby 258 38 7.2 20 0.15 30 475 Lullingstone well 246 30 7.2 14 0.15 29 450 Orpington well 278 42 7.1 16 0.1 38 500 N. Orpington well 266 30 7.1 12 0.1 36 475 Shortlands well 282 64 7.2 44 0.15 31 525 Sundridge well 210 42 7.4 28 0.1 15 400 Thames derived 254 68 7.8 1.00 9 58 0.25 4 0.12 525 (Southern Group) 32 Result of the Bacteriological Examination of the Water supplied to Orpington during the Year 1960. Parts per million (unless otherwise stated) BACTERIOLOGICAL RESULTS Source of supply BEFORE TREATMENT AFTER TREATMENT Number of samples Agar plate count per ml. Coliform count Escherichia coli count Number of samples Agar plate count per ml. Coliform count E. coli count 20-24 hours at 37°C. 3 days at 22°C. Per cent. samples negative in 100 ml. Count per 100 ml. Per cent. samples negative in 100 ml. Count per 100 ml. 20-24 hours at 37°C. 3 days at 22°C Per cent. samples negative in 100 ml. Per cent. samples negative in 100 ml. Eynsford No. 1 well 197 - 74 71.07 1.2 96.95 0.1 256 0.1 12 99.61 100 Eynsford No. 2 well 140 - 3 98.57 - 100 - Horton Kirby No. 1 well 216 0.2 105 92.13 0.7 95.37 0.4 246 0.2 75 99.59 100 Horton Kirby No. 2 well 150 0.3 14 98.67 - 100 - Lullingstone No. 1 well 84 0.1 93 98 81 _ 100 _ 212 0.2 73 99.53 100 Lullingstone No. 2 well 62 0.2 61 100 - 100 - Orpington well 247 0.1 38 88.26 0.2 100 - 253 0.1 8 99-60 100 North Orpington well 226 59.4 437 7.96 134.4 20.35 50.3 229 3.1 10 99.13 99.56 Shortlands No. 1 well 74 0.1 1 100 — 100 — 257 0.1 19 100 100 Shortlands No. 2 well 201 - 1 99.50 0.1 100 - Shortlands No. 3 well 226 1.0 25 99.12 — 100 - Sundridge No. 2 well 203 0.4 10 100 - 100 - 253 0.1 2 100 100 Sundridge No. 4 well 120 0.1 18 100 - 100 - Thames derived — — — — — — - 1,874 8.6 — 99.57 100 (Southern Group) 33 The following extract from the 57th Annual Report of the Metropolitan Water Board for the year ended 31st March, 1960, is reproduced by kind permission of the Clerk to that Authority. "At Farnborough, there are at present two service reservoirs with a combined capacity of 2.925 million gallons. Water is normally received from the Board's North Orpington, Orpington and West Wickham pumping stations and from the Thames Valley via Honor Oak and Shortlands pumping stations, but can also be infused from the higher reservoirs at Knockholt through a 12 inch main. The area supplied by the reservoirs includes the districts of Chislehurst, Crockenhill, Eynsford, Farnborough, Farningham, Hayes, Keston, Orpington, Swanley Junction, Petts Wood, Shirley and West Wickham, and the daily demand now averages over 5 m.g. with a maximum exceeding 9 m.g. On two days in June 1957, both reservoirs were completely empty and occasions arose during the summer of 1959 when the water level was dangerously low. At their meeting in October 1959, the Board decided to construct, at an estimated cost of £125,000, a third service reservoir on land adjoining the existing ones which will have a capacity of 5 million gallons. It will be connected to the others by short lengths of mains and have the same top water level. Work on the site commenced in January, 1960. Water from North Orpington pumping station is pumped into the Farnborough reservoir zone through one 18 inch main, and one 8 inch main. These mains are connected at Orpington pumping station to a single 14 inch main which runs between that station and the reservoirs. The proposals approved by the Board in 1958 for the improvement of the supply to the Kent area included the installation of additional pumping plant at North Orpington pumping station which, in the near future, will enable the maximum output of the station to be raised from 1 m.g.d. to 2 m.g.d. The capacity of the 14 inch main will, as a result be inadequate to enable full use to be made of the reservoirs. It is accordingly intended to lay, at an estimated cost of £37.000 approximately 3,910 yards of 12 inch main to connect the 18 inch main in High Street, Orpington, with the 24 inch inlet/outlet main from the reservoirs. The main will pass through an area in which shortages occurred during the hot weather of June and July 1959, and will be available for improving the supply." SECTION D. HOUSING. 36 SECTION D. HOUSING. Clearance Areas and Individual Unfit Dwellings. In the early part of 1960, the Ministry of Housing and Local Government asked Local Authorities, in view of the progress made in carrying out their existing slum clearance programmes, to consider the next phase of this important work. As far as this Authority is concerned, there remained at the end of the year a small balance of properties to be dealt with in order to complete the current five year programme. Further proposals will be made to the Ministry in 1961 after a final check has been made. It is not anticipated that there will be many properties involved and when these have been dealt with, it may be assumed that the clearance of unfit houses has been completed. Rent Act, 1957. This Act came into force on the 6th July, 1957. The role of the Health Department in the administration of the Act is confined almost entirely to the consideration of applications made by tenants of controlled houses for Certificates of Disrepair. In broad terms, the possession of this Certificate enables a tenant to resist the rent increase permitted by the Act and the granting of a Certificate is justified only where the dwelling is in disrepair by reason of defects which ought reasonably to be remedied "having due regard to the age, character and locality of the dwelling." Only three applications for Certificates were received during 1960, and from a study of the number of applications received since the passing of the Act (given below) I think it is reasonable to assume that in the majority of cases, where the permitted increases in rents have been applied, tenants and landlords have reached agreement on the question of necessary repairs without recourse to the Local Authority. APPLICATIONS RECEIVED 1957 (six months) 1958 1959 1960 59 38 8 3 Housing Statistics for the year 1960. Total number of valuation assessments, houses and flats, at 31st December, 1960 24,334 (1) (a) Total number of dwelling houses inspected for defects (under the Public Health or Housing Acts) 141 (b) Number of inspections made for the purpose 1,239 37 (2) Number of dwelling houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 7 (4) Number of dwelling houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 132 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 112 Number of dwelling houses demolished during the year 7 Moveable Dwellings. During the early part of 1960, four licences were renewed, embracing a total of 111 caravans and 10 tents for the summer months, and 106 visits were made by the District Health Inspectors during the year to the various sites. The Caravan Sites and Control of Development Act, 1960, came into operation on the 29th August, 1960. It has two objects : (1) to control the location of caravan sites, so as to prevent them starting up in the wrong places, while allowing them to develop in suitable places. (2) to improve conditions on sites by requiring good standards of layout, equipment and maintenance. Re-Housing. I am indebted to the Housing and Estates Manager for the following statistics on re-housing carried out by the Local Authority:— Prior to During Tota as at 1960 I960 Dec. 1960 1. (a) Number of permanent dwellings built by Local Authority (excluding 402 old type pre-1939 council houses 2,371 18 2,389 (b) Number of pre-fabricated dwellings built by Local Authority 319 — 314** (c) Number of dwellings requisitioned by Local Authority 2 — 2 2. (a) Number of families occupying 1 (a) 2,389 and lodgers (b) Number of families occupying 1 (b) 314—5 demolished** (c) Number of families occupying 1 (c) 18 38 3. Total number of families re-housed during 1960 in (a) 18 (b) Nil (c) 11 4. Number of families on waiting list at 31st December, 1960, in various categories:— (a) Families in urgent need of other accommodation 101 (b) Families whose applications require early consideration 265 (c) Families whose applications are less urgent 356 722 (d) Families with varying degrees of housing need 370 5. Number of families on waiting list living in overcrowded conditions ; no figures are kept as to the extent of statutory overcrowding, but about 366 of the families included in 4 above are living in crowded conditions. SECTION E. INSPECTION AND SUPERVISION OF FOODS. 40 SECTION E. INSPECTION AND SUPERVISION OF FOODS. General. During the year 1,352 routine and special visits were made to food premises to ensure that the Food Hygiene Regulations of 1955 were being complied with. The new regulations were brought into force on the 1st January 1956, and extended in 1960 to assist in reducing to a minimum the risk of food poisoning by the stricter use of hygienic practices. No serious contraventions were detected but the attention of a number of shopkeepers had to be drawn to the necessity for the redecoration of their premises. However, the hygienic handling of the food itself is the real controlling factor in the prevention of "food poisoning" as this disease is generally caused by germ contamination from the human body, and it is therefore vital that all persons handling open food should be aware of this responsibility and pay attention to strict personal hygiene. In my opinion, the elementary principles of personal hygiene should be taught in all schools at an early age and the present position could be helped considerably by the featuring of Ministry sponsored documentary programmes from time to time through the medium of television. It is pleasing to note that there has been little food and drug adulteration during the year. Food and Drugs Act, 1955. Details of the 220 informal samples of food and drugs taken for analysis are as follow:— Food and Drugs Sampling. Formal Samples taken Result Informal Genuine Inferior Adulterated Bacon - 3 3 - - Baking Powder — 1 1 — — Beechams Powders — 1 1 — - Beef and Kidney Pie — 2 2 — - Bemax — 1 1 — Blackcurrent Vitamin C Drink — 1 1 — - Blancmange Powder — 1 1 — — Butter — 9 9 — — Butter Sweet Confectionery — 3 3 — — Cheese — 1 1 — — Cheese Spread — 1 1 — — Chicken and Lentils — 1 1 — — Citroze — 1 1 — — Cochineal — 1 1 — — Condensed Milk — 1 1 — — 41  Formal Samples taken Result Informal Genuine Inferior Adulterated Cooking Fat — 2 2 — — Cough Mixture — 6 6 — — Creamed Rice Pudding — 1 1 — — Custard Powder — 1 1 — — Currants — 1 1 — — Curry Powder — 1 1 — — Digene — 1 1 — — Doughnuts — 1 1 — — Dripping — 1 1 — — Essence of Rennet — 1 1 — — Fish Paste — 12 12 — — Fynnon Salts — 1 1 — — Gin — 2 2 — — Gravy Browning — 1 1 — — Ice Cream — 1 1 — — Lemon Barley and Glucose Drink 1 1 - - Lemon Juice — 2 2 — — Lemon Squash — 1 1 — — Liquid Paraffin — 1 1 — — Luncheon Meat — 2 2 — — Malt Vinegar — 3 3 — — Margarine — 4 4 — — Mazda Corn Oil — 1 1 — — Meat Paste — 14 14 — — Milk of Magnesia — 1 1 — — Milk Shake — 1 1 — — Milk (Pasteurised) — 36 36 — — Milk (Sterilised) — 31 31 — — Milk (Tuberculin Tested) — 1 1 — — Mincemeat — 1 1 — — Mustard — 1 1 — — Olive Oil — 1 1 — — Orange Squash — 2 2 — — Orange Juice — 1 1 — — Orange Drink — 2 2 — — Pepper — 1 1 — — Pickles — 2 2 — — Pork Pie — 1 1 — — Prunes in Syrup — 1 1 — — Quinine — 3 1 *2 — Raisins — 1 1 — — Rivella — 1 1 — — Salad Cream — 1 1 — — Sauce — 4 4 — — Self-Raising Flour — 4 4 — — Sild in Tomato Sauce — 1 1 — — Sliced Mushrooms in butter — 1 1 — — Soup — 6 6 — — Steak and Kidney Pie — 4 4 — — Steak Pie — 2 2 — — Sulphur Tablets — 1 1 — — Sultanas — 1 1 — — Syrup of Figs — 1 1 — — 42  Formal Samples taken Result Informal Genuine Inferior Adulterated Table Jelly — 1 1 — — Tea — 3 3 — — Tincture of Iodine — 1 1 — — Tomato Ketchup — 3 3 — — Veal and Ham Rissoles — 1 1 — — Vitaminised Iron Tonic — 1 1 — — Vitamin Tablets — 2 2 — — Whisky — 4 4 — — 220 218 *2 — *These two samples of quinine were found to be inferior due to the deficiency of ammonia which presumably had evaporated through the cork. This often happens with old stock and the Pharmacist concerned was asked to prepare his stock in smaller quantities. Food Hygiene Regulations, 1955. There were no prosecutions under the above Regulations during 1960. A total of 960 inspections were made by the District Inspectors during the year. As a result of these inspections, 29 informal notices were served on the proprietors, and by the end of the year the following works had been carried out at various food premises:— Walls and ceilings cleansed 11 Floors cleansed 3 Structural repairs 7 Sanitary accommodation— Repaired 4 Cleansed 2 Hand washing notices affixed 1 Wash hand basins provided 1 Hot Water Supply provided 4 Clothing accommodation provided 1 Dustbin provided for refuse storage 1 Soap, towels and nailbrush provided 3 Impervious work surfaces provided 1 Miscellaneous 6 Food Complaints. Twenty-nine complaints of unsound condition and/or contamination of foodstuffs were received from the public during the year as under. Where the condition of the food could not be determined by visual examination, the article was sent to the Council's Analyst. In each case it was possible to give a satisfactory explanation to the complainant and restitution was made as necessary. 43 Apple Pie 1 Bread 9 Bread Rolls 1 Butter 1 Cake 2 Cheese 1 Cooked Ham 1 Grapefruit 1 Jam 1 Milk 6 Orange Squash 1 Pork Pie 1 Salmon (tinned) 1 Sausages (Beef) 1 28 Special Samples of Milk, Ice Cream, Water. In addition to the samples previously mentioned, a further 147 samples were taken for bacteriological and pathological examination and other special tests as under:— Milk (Tuberculin Tested) Bacteriological Examination 1 Milk (Pasteurised) Phosphatase Test 32 Milk (Sterilised) Turbidity Test 28 Ice Cream—Bacteriological and Pathological Examination 37 Water—Bacteriological Examination 48 Water—Chemical Examination 2 147 Ice Cream. At the end of the year, 184 premises were registered for the storage of, and sale of ice cream, but none for the manufacture of this commodity. Eighty-one inspections were made and conditions were found to be satisfactory. Thirty-seven samples were sent for bacteriological and pathological examination. The following is an analysis of the results obtained during the past three years:— No. of Result Year samples taken Grade I Grade II Grade III Grade IV 1958 33 30 2 1 — 1959 23 20 3 — — 1960 37 29 5 2 1 No pathogenic organisms were found in any of the 37 samples and the bacteriological grading was highly satisfactory. 44 Food Premises. Bakehouses 12 Bakers' Shops 19 Butchers 47 Chemists 21 Clubs and Hotels 7 Confectionery 62 Cooked Meat Shops 1 Dairies 9 Fishmongers (Wet, Dry and Fried) 21 Greengrocery 52 Grocery 87 Hospitals 2 Industrial Canteens 17 Public Houses 43 Restaurants 47 School Canteens 15 Street Vendors 12 474 Food and Drugs Act, 1955—Section 16. Two hundred and thirty-one shops and food premises have been registered under the above Act, as under:— Ice Cream Stores 184 Fish Shops 7 Butchers' Shops 39 Fish and Meat Paste Factory 1 231 Unsound Food. During the year a total of 8 tons, 17 cwts, 1 quarter, 19 lbs. of varied articles of food were condemned and destroyed and 439 Food Condemnation Certificates were issued. 89 lbs. Bacon 5 lbs. Biscuits 16 lbs. Butter 15 lbs. Cereals 49 lbs. Cheese 80 lbs. Chickens 1 lb. Coffee 3 lbs. Cordial 13 lbs. Cream 234 lbs. Fish 56 lbs. Fish (tinned) 41 lbs. Flour 881 lbs. Fruit (tinned) 45 12,091 lbs. Fruit 33 lbs. Fruit (dried) 20 lbs. Kidneys 44 lbs. Liver 1,135 lbs. Meat (tinned) 405 lbs. Meat 66 lbs. Milk (tinned) 3 lbs. Pickles 23 lbs. Poultry 32 lbs. Preserves 240 lbs. Rabbit 36 lbs. Sausages 3 lbs. Sauces 45 lbs. Soups 2 lbs. Suet 319 lbs. Vegetables (tinned) 3,891 lbs. Vegetables Milk and Dairies Regulations. Twelve dairies have been registered under the above Regulations. Details of the licences issued during 1960 are:— Tuberculin Tested Dealer's Licences 12 Supplementary Licences 3 Pasteurised Dealer's Licences 24 Supplementary Licences 4 Sterilised Dealer's Licences 29 Supplementary Licences 3 Thirty-two visits were made to the dairies in the district during 1960. Slaughterhouses and Slaughtermen. No slaughterhouses were licensed during the year, but licences were issued to nine slaughtermen under the Slaughter of Animals Act, 1958. Restaurants, Hotels and Canteens. One hundred and thirty-eight visits were made to these premises during the year. In ten cases defects requiring the attention of the owner were dealt with by informal action. Butchers' Shops. One hundred and forty-four detailed inspections were made of the 47 retail Butchers' shops in the area. The butchers work in close collaboration with the Public Health Department and during the year called upon the services of the District Inspectors in connection with carcase meat suspected of being unsound, as a result of which 405 lbs. of meat was condemned as being unfit for human consumption. In no case was there any evidence of unsound meat being exposed for sale. 46 Bakehouses. Forty-three inspections were made of the 12 premises during the year, and in only two cases were defects found which required the attention of this department. Merchandise Marks Act. Six visits were paid to premises during the year in connection with this Act. No contraventions were detected. Game Act, 1831. Four licences were renewed during the year. SECTION F. PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. 48 SECTION F. PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. General. Four hundred and eighty-four notifications of infectious diseases were received during the year, compared with 1,890 recorded during 1959. The difference in the figures for these two years is mainly accounted for by the decrease in the number of cases of measles which during 1960 amounted to 139 against the 1,570 for 1959. Although many of the cases could not be confirmed bacteriologically, the substantial increase in notifications of dysentery and food poisoning during the year, reinforces the importance of maintaining the highest standards of care in personal hygiene, particularly in the handling of food, if these comparatively minor, though debilitating illnesses are to be avoided. Oh the other hand it is gratifying to be able to record the complete absence in the district during the year, of anterior poliomyelitis. The moral that can be drawn from this, is that since any freedom from this complaint can be largely attributed to the successful scheme of immunisation, individuals neglecting to obtain this immunity are placing themselves seriously at risk. This applies equally to the protection of children against diphtheria, of which there were also no cases during the year. Details of individual diseases will be found in the subsequent paragraphs. Acute Anterior Poliomyelitis and Vaccination. No cases were notified. The County Medical Officer informs me that a total of 4,746 residents in the Urban District received their second injection, and 5,846 their third injection against this disease during the year. Diphtheria and Diphtheria Immunisation. For the 11th consecutive year, I am pleased to be able to report a complete absence of this disease in the Urban District. I understand from the County Medical Officer that a total of 15,816 children resident in the area who were under the age of 15 years on 31st December, 1960, have, at some time before that date, completed a course of immunisation against this disease. 49 Dysentery. Sixty-one cases of dysentery were notified during the year, six being admitted to hospital. This is quite a large increase on the four cases recorded during 1959. Food Poisoning. A total of 74 cases were notified during the year, three being admitted to hospital. Forty-nine were single cases and the remaining 25 occurred during two outbreaks, one at an Old Peoples' Home and the other at a private house, following a family party. Staphylococci were isolated in two cases, CI Welchii in seven, Salmonella Wagenia in two, and Salmonella Heidelberg in three. No deaths from this disease were recorded. The following is a copy of the annual return of Food Poisoning notifications (corrected) forwarded to the Ministry of Health. (1) First Quarter 29 Second Quarter 25 Third Quarter 4 Fourth Quarter 16 74 (2) Cases otherwise ascertained 14 (3) Symptomless Excreters — (4) Fatal cases — (5) Particulars of Outbreaks: No. of cases notified 25 No. of cases otherwise ascertained 14 Agent identified: Staphylococci 2 CI. Welchii 7 (6) Single cases: Agent identified: Salmonella Wagenia 2 Salmonella Heidelberg 3 Unknown 44 (7) Salmonella Infections, not foodborne Nil Measles. One hundred and thirty-nine cases were notified during the year, all being home nursed. No deaths were recorded. Meningococcal Infections. Only one case occurred in the area during 1960, and this was admitted to hospital. 50 Pneumonia. Fourteen cases of pneumonia were notified during 1960, as against 13 in 1959, and all were home-nursed. There were 71 deaths attributed to this disease. This latter figure includes people who are normally resident in the area but who died outside the Urban District. Scarlet Fever. One hundred and twelve cases were notified during the year, six being removed to hospital, and the remainder home nursed. This is only a very slight increase on the 106 cases recorded during 1959. No deaths occurred from this disease during 1960 and there were no "return cases". Smallpox and Vaccination. No cases of smallpox occurred in this area, neither was it necessary to keep any contacts under surveillance during the year. During the year, four hundred and nine International Certificates of Vaccination passed through the hands of the department for purposes of authenticating doctors' signatures. The County Medical Officer informs me that a total of 1,187 residents in the area received primary vaccination and 36 revaccination during the year. (These figures are based on record cards received.) Tuberculosis. The following is a copy of the recordings in the register at 31st December, 1960:— Respiratory. Other Forms. Total No. of cases. M. F. M. F. On register at 1st Jan., 1960 New cases notified during 1960 485 431 64 82 1,062 15 11 - 2 28 Number of cases coming to knowledge after death 2 - - - 2 Restored to register — — — — — Inward Transfers 13 9 1 — 23 515 451 65 84 1,115 Deletions, deaths, removals, recoveries, etc. 117 88 26 25 256 398 363 39 59 859 51 New Cases and Mortality, 1960. 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 - - - - - - - - 5-14 2 - - - - - - - 15-24 2 3 - — 1 - - - 25-44 3 5 — 2 1 1 — — 45-64 6 4 1 1 65 and over 1 - - - 5 1 - - Age unknown — — — — - — — — *Inward Transfers 14 12 — 2 8 2 1 13 9 1 - 27 21 1 2 The number of new cases of tuberculosis notified during the year was 28, and there were three deaths from this disease in 1960. This maintains the low level of new cases noted last year and is a further indication of the progress being made in the control of this disease. Chest Clinic. Dr. D. G. Madigan, Physician in Charge, has kindly furnished the following details:— New cases attending the Chest Clinic for the first time during 1960 Adults. Children. under 15 yrs. of age. M. F. M. F. Pulmonary Tuberculosis 25 19 1 — Non-Pulmonary Tuberculosis 1 1 — - Non-Tuberculosis 67 46 51 58 New contacts examined during 1960 (not included in the above figures):— Non-Tuberculous, 223. Tuberculous, Nil. B.C.G. Vaccination of contacts, 85. Number of patients who completed a course of hospital or sanatorium treatment during 1960, 45. Public Health (Prevention of Tuberculosis) Regulations, 1925. Section 172, Public Health Act, 1936. No action was taken by the Local Authority under these Regulations during 1960. Mass X-ray. No general survey was undertaken in the area during the year under review. 52 Typhoid and Para-Typhoid Fever. No cases were notified during 1960. Whooping Cough. Thirty-nine cases were notified during the year, as against 50 cases recorded in 1959. Only one case was admitted to hospital, the remainder being home nursed. No deaths from this disease were recorded in the area during 1960. The County Medical Officer informs me that 1,396 children resident in the Urban District were immunised against this disease during 1960. Other Infectious Diseases. In addition to those previously mentioned, notifications were received as under:— Erysipelas—3 cases, two of which were admitted to hospital. Puerperal Pyrexia—12 cases (10 were institutionally treated and two home nursed). SECTION G. REFUSE COLLECTION AND DISPOSAL. 54 SECTION G. REFUSE COLLECTION AND DISPOSAL Mr. Crowe reports:— The continued growth of the district with many newly erected premises becoming occupied, creates problems but I am pleased to be able to report that weekly collections of household refuse were maintained throughout the whole of the district with only slight disturbance after Bank Holidays. Every effort is made to collect the refuse from premises in each road on the same day each week and at about the same time. Following the Bank Holidays, particularly Easter and Christman, the work is very heavy. At these times there is a large accumulation of refuse awaiting collection at each of the premises when the men return to work. Every endeavour is made to speed the work of collection in order to revert to the normal day, and this is achieved by the working of overtime. Householders can assist by depositing only dry refuse in their dustbins and keeping the quantity down to a minimum. The method of operating the collection of household refuse is the relay system: Each team of collectors works with two vehicles and drivers, and at the commencement of the day's work, they divide into two collecting teams with a vehicle and driver. The divided teams work in close proximity and when one vehicle proceeds to the refuse tip with its load, the collectors join forces and complete the loading of the remaining vehicle. This principle is adopted throughout the whole day's work with the teams working either with one or two vehicles. Thus there is no waste of collectors' time as with the single vehicle system. Collections are made weekly throughout the whole of the district from some 24,500 premises. A weekly collection of trade refuse is made from 290 shop premises and offices. A vehicle and driver and a collector are engaged on this work for which an annual charge is made. Collections of refuse are made each week from the two large hospitals and also from the numerous schools; vehicles and personnel separate from the regular refuse teams, being engaged on this work. The Council owns a fleet of 16 refuse collecting vehicles, three of which are of the dual-tip rear loading type. It is the Council's policy, as replacements take place, to purchase this type of vehicle which enables the work to be carried out in a more cleanly manner than with vehicles which are loaded from the sides. 55 Forty-seven workmen are employed on the work of collection and disposal. All the refuse is disposed of by means of controlled tipping on low-lying land of poor agricultural value at Budgin's Hill, Pratts Bottom. The refuse is deposited in layer formation, consolidated, covered and sealed in accordance with modern principles of controlled tipping as laid down by the Ministry of Housing and Local Government. The layer formations are arranged so that the final layer merges with the contours of the site. Completed sections are covered with soil, and then sown with grass seed, thus reclaiming the land and enabling it to be used as pasture. Two men are employed at the tip, a Major Tractor Muledozer being used for the levelling process and approximately 19,500 tons of refuse is deposited annually. The cost of collection and disposal compares favourably with districts of comparable size and characteristics. The costing returns of the Ministry of Housing and Local Government published in 1960 show that the net cost per 1,000 population for collection and disposal of house refuse was £558, and the net cost per 1,000 premises for collection and disposal was £1,711. The Abstract of Accounts prepared by the Council's Treasurer for the year ended 31st March, 1960, showed that on a unit basis, the cost of house refuse collection and disposal was £1 18s. 9d. per dwelling per annum. APPENDIX. STATISTICAL TABLES. 58 STATISTICAL TABLES, 1960 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 Public Health Inspectors. TABLE VIII—Nuisances, Defects and Contraventions Abated 59 TABLE I. SUMMARY OF STATISTICS, 1960 Population (mid-year 1960) per Registrar General 76,020 Birth Rate (crude) 18.9 Death Rate .(crude) 9.4 Maternal Mortality Rate Nil Infant Mortality Rate 18.8 Number of Births (live) 1,437 Number of Stillbirths 22 Number of Deaths 712 Number of Maternal Deaths Nil Number of Infant Deaths (under 1 year) 27 Number of Deaths from Infectious Diseases 1 Death Rates:- Respiratory Diseases 1.44 T uberculosis 0.04 Cancer (all forms) 2.09 Cancer of the lung 0.43 Infectious Diseases 0.01 Notifications of Infectious Diseases: Diphtheria Nil Dysentery 61 Erysipelas 3 Food Poisoning 74 Measles 139 Poliomyelitis (paralytic) Nil Poliomyelitis (non-paralytic) Nil Puerperal Pyrexia 12 Pneumonia (all forms) 14 Scarlet Fever 112 Tuberculosis (new cases and including Inward Transfers) 51 Typhoid and Para-typhoid Fever — Whooping Cough 39 Number of visits made by Public Health Inspectors 7,208 60 TABLE II. CAUSES OF DEATH. 1956 1957 1958 1959 1960 Total Male Female 1. Tuberculosis—Respiratory 3 3 3 3 1 1 2 2. Tuberculosis—Other 4 1 1 1 — 1 1 3. Syphilitic Diseases 2 — 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 2 i 1 1 10. Malignant neoplasm, stomach 17 12 24 16 13 16 29 11. Maligant neoplasm, lung bronchus 34 33 38 48 26 7 33 12. Malignant neoplasm, breast 10 16 23 14 — 13 13 13. Malignant neoplasm, uterus 6 2 7 5 — 6 6 14. Other malignant and lymphatic neoplasms 64 68 66 89 40 38 78 15. Leukaemia, Aleukaemia 3 4 6 6 4 2 6 16. Diabetes 3 2 4 3 — 1 1 17. Vascular lesions of nervous system 64 73 75 84 21 27 48 18. Coronary disease, angina 111 96 133 139 88 44 132 19. Hypertension with heart disease 11 16 17 20 1 10 11 20. Other heart disease 50 61 68 73 32 56 88 21. Other circulatory disease 28 38 35 32 21 21 42 22. Influenza 2 4 2 5 — — — 23. Pneumonia 70 52 83 65 39 32 71 24. Bronchitis 50 31 31 36 20 7 27 25. Other diseases of respiratory system 15 5 5 6 9 3 12 26. Ulcer of stomach or duodenum 13 6 7 8 4 3 7 27. Gastritis, enteritis and diarrhoea 4 3 3 2 2 1 3 28. Nephritis and nephrosis 4 7 6 3 — 2 2 29. Hyperplasia of prostate 4 9 6 3 2 — 2 30. Pregnancy, childbirth, abortion — 1 - - - - - 31. Congenital malformations 4 7 9 10 3 4 7 32. Other defined and ill-defined diseases 48 56 60 55 30 28 58 33. Motor vehicle accidents 6 5 10 12 12 1 13 34. All other accidents 10 8 10 6 6 2 8 35. Suicide 5 8 9 3 4 5 9 36. Homicide and operations of war 2 — — 1 1 — 1 All causes 648 628 747 751 380 332 712 61 TABLE III. INFANT MORTALITY, 1960. (Compiled locally from Registrar's Death Returns.) CAUSES OF DEATH Under 1 Week 1 and under 2 Weeks 2 and under 3 Weeks 3 and under 4 Weeks Total under 4 Weeks 1 month and under 3 months 3 months and under 6 months 6 months and under 9 months 9 months and under 12 months Total Deaths under 1 year Atelectasis 2 — — — 2 — — — — 2 Congenital Heart Disease 2 — — — 2 — — — — 2 Prematurity 10 — — — 10 — — — — 10 Respiratory Diseases 1 — — — 1 1 — 1 — 3 Gastro-Enteritis 1 — — — 1 — — — — 1 Cerebral Haemorrhage 3 — — — 3 — — — — 3 Meningitis — — 1 — 1 — — — — 1 Other Causes 5 — — — 5 — — — — 5 Totals 24 - 1 — 25 1 — 1 — 27 62 TABLE IV. NOTIFIABLE INFECTIOUS DISEASES, 1960. 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. Measles 70 69 1 3 14 10 16 19 37 32 1 1 1 2 1 1 Whooping Cough 20 19 1 — 4 3 4 4 10 9 1 — — 1 2 _ — Scarlet Fever 61 51 — — 4 2 15 11 35 33 6 5 — — — _ 1 _ Dysentery 31 30 1 — 4 3 2 1 11 9 3 3 2 3 8 11 _ Poliomyelitis (Paralytic) Poliomyelitis (Non-Paralytic) Meningoccal Infection 1 183 169 3 3 27 18 37 35 93 83 11 9 3 6 8 14 1 1 Under 5 5-14 15-24 25-44 45-64 65 and over Age Unknown M. F. M. F. M. F. M. F. M. F. M. F. M. F. Pneumonia 6 8 1 3 2 2 1 1 - - - 1 - 1 2 - Erysipelas 1 2 — — — 1 — — - - 1 1 - - - Food Poisoning 34 40 8 8 5 6 4 1 9 7 2 4 6 14 - - Puerperal Pyrexia — 12 — — — — — 4 - 8 - - - - - - Ophthalmia Neonatorum 1 — 1 — — — _ — — - - - - - - - Tuberculosis (Pulmonary) 14 12 - — 2 - 2 3 3 5 6 4 1 - - - Tuberculosis (Non-Pulmonary) - 2 - - - - - - - - - - - - - 56 76 10 11 9 9 7 9 12 22 9 10 7 15 2 - 239 245 63 TABLE V. NOTIFIABLE INFECTIOUS DISEASES, 1960. Ward Distribution. Attack and Mortality Rates. Diseases Total WARDS Cases removed to Hospital Attack rate per 1,000 population No. of Deaths Death rate per 1,000 population Biggin Hill Crofton South Crofton North Chelsfield Cudham Downe Farnborough Green-Street-Green Goddington South Goddington North Knockholt Knoll Leaves Green Petts Wood Poverest St. Mary Cray Measles 139 2 22 5 - - 1 52 3 4 15 — 14 — 9 10 2 — 1.82 — — Whooping Cough 39 1 7 2 — - — L — 4 2 2 2 — — 4 13 1 0.51 — — Scarlet Fever 112 1 31 13 — 2 — 10 10 10 8 1 2 — 3 1 20 6 1.47 — — Pneumonia 14 10 — — — — — — — — 1 — — — — — 3 — 0.18* 71 0.93 Dysentery 61 5 3 — — — 8 2 — 2 7 5 6 — 1 8 14 6 0.80 — — Erysipelas 3 — 1 — — — 1 1 — — — — — - — — — 2 004 — — Food Poisoning 74 — 18 — — 6 — 20 2 1 — 16 — — — 8 3 1 0.97 — — Poliomyelitis (Paralytic) — — — — — — — — — — —— — — — — — — — — — — Poliomyelitis (Non.Paralytic) — — — — — — — — — — — — — - —- — — — - - — Puerperal Pyrexia 12 - - - - - - - - - - 4 - - - - 1 10 8.22| — - Tuberculosis (Pulmonary) 26 3 3 — — 1 — 1 2 2 3 — 2 — 2 4 3 13 0.34 2 0.02 Tuberculosis (Non-Pulmonary) 2 - - 1 - - - - - - - - - - - - - 2 0.02 1 001 Ophthalmia Neonatorum 1 — 1 — — — — — — — — — — — — — — — 0.01 — — Meningococcal Infection 1 - - - - - - - - - - - - - - 1 - 1 0.01 - - Totals 484 22 86 21 - 9 10 98 17 2\ 36 24 26 -- 16 36 59 44 6.36 74 0.97 †Based on 1,000 total births and not population. *Includes all forms of Pneumonia. 64 TABLE VI. NOTIFIABLE INFECTIOUS DISEASES, 1960. Seasonal Incidence. Disease Jan. Feb. March Apr. May June July Aug. Sept. Oct. Nov. Dec. Total Measles - 6 6 — 9 12 50 18 - 2 1 35 139 Whooping Cough 7 1 4 2 2 6 1 5 3 8 39 Scarlet Fever 19 36 13 16 9 4 4 — 1 8 2 — 112 Pneumonia 1 1 3 — — 1 1 — — 1 3 3 14 Dysentery 1 16 8 21 2 5 2 2 2 1 — 1 61 Erysipelas 1 2 — — — — — — — — — — 3 Food Poisoing 2 15 12 1 — 24 — 3 1 3 12 1 74 Poliomyelitis (Paralytic) — — — — — — — — — — — — — Poliomyelitis (Non-Paralytic - - - - - - - - - - - - Meningococcal Infection - — — — 1 — — — — — — — — 1 Puerperal Pyrexia 5 1 — — 1 1 — — 2 — 2 — 12 Ophthalmia Neonatorum - - - - - - - 1 - - - - 1 Totals 29 84 43 39 25 49 59 30 7 20 23 48 456 65 TABLE VII SUMMARY OF THE WORK OF THE PUBLIC HEALTH INSPECTORS. No. of Inspections No. of premises at which defects or contraventions were found Housing Inspection. For defects and nuisances 1,239 132 Verminous condftions 8 3 Water supply 154 2 Cesspools 108 3 Common Lodging Houses 4 1 1,643 109 Under Rent Act, 1957 16 3 (3,172) (253) Infectious Diseases. Inquiry Visits 631 — Disinfection 53 — (684) (-) Food Premises. 43 7 Butchers 144 8 Dairies and Milkshops 7 — Fishmongers and Poulterers 16 1 Fish Fryers 14 — Food preparing or manufacturing premises 13 1 Greengrocers 41 6 Grocers 411 21 Ice Cream Premises 81 1 Restaurants, hotels and canteens 138 16 Slaughterhouses 3 — Street Vendors & Hawkers Carts 49 3 Visits in connection with sampling 137 — Miscellaneous 255 — (1,352) (64) Factories. Factories with mechanical power 63 21 Factories without mechanical power 2 — Other premises classified as factories 25 — Emission of smoke, grit, fumes and noise 430 17 (520) (38) Rodent Control. Miscellaneous premises 152 135 (152) (135) 66 Trade Premises. Shops (for Shops Act) 270 23 Piggeries 60 1 Caravan Sites 146 — Hairdressers 59 — Merchandise Marks Act 6 — Pet Animals Act 21 — Rag Flock Act 1 — (563) (24) Miscellaneous. Swimming Baths 4 — Suspected Food Poisoning 54 — Keeping of Animals 13 — Noxious accumulations 4 3 Schools 41 — Public Conveniences 36 — Rivers, streams etc. 2 — (154) (3) Unclassified. 611 — (611) (-) 7,208 517 67 TABLE VIII. NUISANCES, DEFECTS, CONTRAVENTIONS, ETC., ABATED OR REMEDIED IN 1960. Drainage. Drains constructed or Overflowing cesspools emptied 4 reconstructed 1 Leaking cesspools repaired Drains repaired 6 or reconstructed 1 Drains cleansed 44 Sink Waste pipes trapped Inspection chambers repaired renewed or repaired 3 and removed 1 Water closets repaired or Inspection chamber covers reconstructed 1 provided 1 Water closet seats repaired or Ventilation improved or renewed 2 repaired 1 Flushing cisterns repaired or Cesspools provided 1 renewed 4 Dampness. Roofs made watertight 10 Rainwater downpipes repaired Walls made waterproof 6 or renewed 1 Chimney stacks made waterproof 2 Water Supply. Main water supply provided 3 Storage tanks repaired or Pipes repaired or renewed 1 renewed 2 Ball valves repaired or renewed 4 General Items. Wall plaster repaired 5 Ventilation improved 1 Ceiling plaster repaired 3 Fire surrounds and grates Floors repaired 12 repaired or renewed 1 Rooms cleansed or decorated 5 Dustbins provided 4 Windows and doors repaired 2 Noxious accumulation removed 3