AC 4412(3) ORP 25 ORPINGTON URBAN DISTRICT COUNCIL MEDICAL OFFICER OF HEALTH'S ANNUAL REPORT on the Health of the Urban District H. B. C. CARTER-LOCKE, m.b., b.s., m.r.c.s., l.r.c.p., d.p.h. Medical Officer of Health. Telephone: RAVensbourne 4623. Offices: 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 1961 H. B. C. CARTER-LOCKE, m.b., b.s., m.r.c.s., l.r.c.p., d.p.h. Medical Officer of Health. 3 CONTENTS page Members of the Urban District Council 5 Staff 5 Prefatory Letter 7 Section A. Vital and other Statistics and Social Conditions of the Area. General Statistics 12 Vital Statistics 12 Population 13 Births 14 Deaths 16 Morbidity Statistics 18 Medical Examinations 18 Unemployment 18 Open-Air Recreational Amenities . . 19 Section B. General Provision of Health Services for the Area. Ambulance Service 24 British Red Cross Society—Medical Loan Depot 26 Day Nurseries 24 Diseases of Animals Acts 24 Disinfection 22 District Nursing Service 24 Domestic Help Service 24 Domiciliary Midwifery 24 Health Visiting 24 Hospitals 23 Laboratory Service 23 Local Clinic Services 26 National Assistance Act, 1948 23 Nursing Homes 23 Old People's Welfare Committee 25 Public Mortuary . 23 Women's Voluntary Services 25 Section C. Sanitary and Environmental Circumstances of the Area. Agriculture (Safety, Health and Welfare Provisions) Act, 1956 30 Atmospheric Pollution—Clean Air Act, 1956 30 Cesspools 31 Complaints 31 Diseases of Animals (Waste Foods) Order, 1957 31 Drainage and Sewerage 31 Factories Acts, 1937 and 1948 32 Heating Appliances (Fireguards) Act, 1952 33 Pet Animals Act, 1951 33 Prevention of Damage by Pests Act, 1949 33 Rag Flock and Other Filling Materials Act, 1951 33 Rivers, Streams and Lakes 33 Sanitary Inspection of the Area 34 Shops Act, 1950 34 Swimming Baths and' Pools 34 Verminous Conditions and Uncleanliness 34 Water Supply 34 4 Section D. Housing. page Clearance Areas 40 Common Lodging Houses 42 Housing Act, 1961 40 Housing Statistics 41 Moveable Dwellings 41 Re-Housing 42 Rent Act, 1957 40 Section E. Inspection and Supervision of Foods. Bakehouses 51 Butchers' Shops 50 Food Complaints 47 Food Hygiene Regulations, 1955 47 Food Premises 49 Food and Drugs Act, 1955—Food Sampling 44 Food and Drugs Act, 1955—Section 16 49 Game Act, 1831 51 General 44 Ice Cream 48 Merchandise Marks Act 51 Milk and Dairies Regulations 50 Restaurants, Hotels and Canteens 51 Slaughterhouses and Slaughtermen 50 Special Samples—Milk, Ice Cream, Water and Egg Products 48 Unsound Food 49 Sectin F. Prevalence of, and Control over Infectious and other Diseases. Acute Anterior Poliomyelitis and Vaccination 54 Diphtheria and Diphtheria Immunisation 54 Dysentery 55 Food Poisoning 55 General Remarks 54 Measles 56 Meningococcal Infections 56 Other Infectious Diseases 58 Pneumonia 56 Scarlet Fever 56 Smallpox and Vaccination 56 Tuberculosis, Chest Clinic and Mass X-Ray 57 Whooping Cough and Immunisation 58 Section G. Refuse Collection and Disposal. Refuse Collection and Disposal 60 APPENDIX—STATISTICAL TABLES Table I. Summary of Statistics 64 ,, II. Causes of Death 65 „ III. Notifiable Infectious Diseases—Sex and Age Distribution 66 „ IV. Notifiable Infectious Diseases—Ward Distribution, Attack and Mortality Rates 67 „ V. Notifiable Infectious Diseases— Seasonal Incidence 68 ,, VI. Summary of the work of the Public Health Inspectors 69 „ VII. Nuisances, Defects and Contraventions Abated 71 5 MEMBERS OF THE URBAN DISTRICT COUNCIL (as at 31st December, 1961) Chairman of the Council: *Councillor G. G. ROMA1N, J.P. Vice-Chairman of the Council: *Councillor J. DAVIES, C.C Councillors H. L. BLAKE *J. W. BRAY R. J. BROWN H. B. BUDGEN H. T. COX *Mrs. K. S. M. CROSSKEY. M B Ch.B. Mrs. J. C. M. DAISH A. L. FERRIS R. W. FOX *Mrs. F. G. GARDNER P. A. GOLD1NG, A.R.I.B.A. J. T. HARRIS, F.C.I.P.A. *L. F. HENDY. M.B.E. F. S. HOCKEY *A. B. HOWARD, C.C. •F. W. LANE *E. R. LUBBOCK, B.A., A.M.l.Mech.E. Mrs. C. M. MEDLYCOTT *A. A. PARFITT Mrs. C. A. PARKER C. H. E. PRATT C. R. RAYNER *Mrs. P. L. ROBERTSON *D. A. SCOLLICK, A.F.I.C.D *Mrs. S. M. STEAD (Vice-Chairman of Public Health Committee). M. J. A. STEVENS I. C. WALDEN, A.I.Q.S. Mrs. J. V. WEBB *S. W. WELLS (Chairman of Public Health Committee). *B. D. WOODMANSEE. M. G. WORM AN (*denotes members of the Public Health Committee). STAFF OF THE PUBLIC HEALTH DEPARTMENT (as at 31st December, 1961) 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). 6 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.l. 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.l. A. E. ROBINSON, C.R.S.H., M.A.P.H.l. 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. Pupil Public Health Inspector Mr. R. PYMAN. Clerical Staff Secretary: Miss C. COOPER. Shorthand-Typist: Mrs. G. BOONE. Clerk: Mrs. S. KNIGHT. Outdoor Staff Disinfector: E. J. PEPPER. Rodent Operative'. W. S. MILLS. Assistant Rodent Operative: C. V. POTTER. General Foreman (Refuse): F. HONESS. 7 To the Chairman and Members of the Orpington Urban District Council. Mr. Chairman, Ladies and Gentlemen, Any year is bound to have its outstanding events, and the purpose of letter such as this is to draw attention to some of these occurrences in the field of Public Health. Education is a word very much on the lips of people to-day, but if the word Health is put in front of Education, the latter seems to lose its appeal, for there is no doubt that far too many people tend to ignore the facts that they must know only too well. Paramount amongst the failures of Health Education, is the inability to obtain any lasting effective result to the campaign discourage smoking. There were forty-three deaths from lung cancer during the year, and over twenty-five thousand in the country as a whole, 382 deaths from heart and circulatory diseases, and another 90 from respiratory diseases, and it is probable that tobacco Played a material part in a high proportion of these deaths. Although cigarettes are undoubtedly the chief offender, it is perhaps opportune to point out that other forms of smoking are only relatively less danSerous, and also make their contribution to both mortality and morbidity. At the end of the year, Smallpox was imported into the country, but in this case the public attitude was quite the reverse of what it was in the case of smoking, even though there were no local cases, Many people whose chance of getting the disease was extremely remote more or less insisted on being vaccinated, and thereby caused acute ernbarrassment to some general practitioners who were already overloaded with patients suffering from winter ailments. As a result of this episode, one hopes that more attention will be paid in the future to infant vaccination, which although it could not by itself prevent a smallpox outbreak, at least gives some protection later in life and saves the patient from the hazards of primary adult vaccination. While on the subject of protection against disease, it is well to mention once again the importance of keeping a high level of immunity among our child population if we are to continue to keep diphtheria at bay. Similar sentiments can be expressed about anterior poliomyelitis, except that in this case all under the age of 40 are urged to take Advantage of the very simple procedure now available for vaccination against this disease, a procedure which merely involves swallowing the vaccine. With the notable exception of measles, infectious diseases were very much out of the picture, and it is pleasing to be able to report the complete absence of any outbreak of food poisoning, a result one hopes, of the intensive efforts of the Department over the years to 8 instill into all food handlers the vital importance of cleanliness. It is both interesting and encouraging to realise that there were only 30 new cases of tuberculosis notified during the year, and three deaths, and this compares with fifty-six notifications and nineteen deaths in 1951, when the population was only 63,344, compared with the present figure of 80,080. This surely is real progress. A Census was taken during the year 1961, and as yet only a preliminary report has been published, but it is expected that many interesting facts will be brought to light when the more detailed figures are available. The local statistics show that the population has risen once again to its highest ever level, but that there is not a lot of variation in the other figures with the exception of the birth rate, which has now fallen to a level well below the national figure, whereas in 1960 the Orpington figure was well above that for England and Wales. The infant mortality rate has fallen and is well below the national figure, but as only sixteen deaths are involved, a small variation in that figure could of course, make a large percentage difference. There were no maternal deaths and the general death rate remaining at approximately the same level as in the previous year, is well below that for the country as a whole. One of the outstanding events of the year, as far as the Public Health Committee are concerned, was the publication of the Government's intentions with regard to the future of Local Government in the Greater London area. As a result of these decisions, Orpington Council, in conjunction with three other local authorities, would administer almost all the health services, both personal and environmental, and would thus, of course, acquire a number of additional responsibilities. In view of the Government's clear intention, it is interesting to note some words written in a report to another local authority in 1950, by my predecessor, Dr. K. E. Tapper:— "The day must come when local incentive and local interest will require truly local government. With development of new estates, shops, houses, and transport, the boundaries of local authorities are no longer defined, and amalgamation of authorities is a natural sequence—large enough to be financially sound and small enough so that the administrator, the elected representatives and the electorate, are members of a team, and can exercise their functions without reference to forms and form-filling." Once again I have to thank Mr. Crowe, the Chief Public Health Inspector, and the whole staff of the Orpington Public Health Department for their loyalty and devotion to duty. Mr. Crowe has handled his dual task with his customary efficiency, and I am deeply conscious of the fact that being Cleansing Superintendent is no sinecure. I also 9 have great pleasure in thanking Dr. Kelynack, my deputy, for his great and cheerful contribution to the Department's work. Finally, I am extremely grateful to the Chairman and Members of the Public Health Committee, who have been so helpful and courteous to me, and I trust that our combined efforts have made some contribution, however small, to the advancement of the health and well-being of the residents of Orpington. I am, Your obedient Servant, H. B. C. CARTER-LOCKE, Medical Officer of Health. SECTION A VITAL AND OTHER STATISTICS AND SOCIAL CONDITIONS OF THE AREA 12 SECTION A VITAL AND OTHER STATISTICS AND SOCIAL CONDITIONS OF THE AREA GENERAL STATISTICS Area of the Urban District (in acres) 20,842 Area of Parks, Open Spaces, etc. (in acres) 292.28 Registrar General's estimate of total population (mid-year) 1961 80,080 Rateable value at 31st December, 1961 £1,325,827 Estimated net product of a penny rate, 1961/2 £5,480 Total number of valuation assessments at 31st December, 1961 24,733 Mileage of Roads as at 31st December, 1961. County Roads (Class I, 11 and 111) 41.35 miles District Roads 114.62 miles Unadopted Roads 25.36 miles Total 181.33 miles VITAL STATISTICS Live Births. Males Females Total Legitimate 651 621 1272 Illegitimate 15 21 36 666 642 1308 Crude birth rate per 1,000 estimated total population 16.3 Adjusted birth rate for comparison with other areas 15.6 (The area comparability factor for births is 0.96) Illegitimate live births (per cent. of total live births) 2.75 Birth rate for England and Wales 17.4 Stillbirths. Males Females Total Legitimate 8 4 12 Illegitimate 1 — 1 9 4 13 Stillbirth rate per 1,000 live and still births 9.8 Stillbirth rate per 1,000 estimated total population 0.16 Total Births (live and still). Males Females Total Legitimate 659 625 1284 Illegitimate 16 21 37 675 646 1321 13 Infant Mortality. Males Females Total Legitimate 9 7 16 Illegitimate — — — 9 7 16 Infant mortality rate per 1,000 total live births 12.2 Legitimate infant deaths per 1,000 live legitimate births 12.6 Illegitimate infant deaths per 1,000 live illegitimate births Nil Neo-natal mortality rate (deaths under 4 weeks per 1,000 total live births 10.7 Early Neo-natal mortality rate (deaths under 1 week per 1,000 total live births) 9.2 Perinatal mortality rate (still births and deaths under one week combined, per 1,000 total live and still births) 18.9 Infant mortality rate for England and Wales 21.4 Maternal Mortality. Maternal deaths (including abortion) Nil Maternal mortality rate per 1,000 total live and still births Nil Maternal mortality rate for England and Wales 0.33 Deaths. Males Females Total 386 375 761 Crude death rate per 1,000 estimated total population 9.5 Adjusted rate for comparison with other areas . . 10.6 (The area comparability factor for deaths is 1.12) Death rate for England and Wales 12.0 Population. The Registrar General's estimate of the total population of the Urban District, mid-year 1961, was 80,080, which is an increase of 4,060 over the figure for the previous year. This population figure gives a density of 3.85 persons to the acre. The natural increase of population, measured by excess of births over deaths, was 547. The population figure given in the Preliminary Report on the 1961 Census was 80,277, of which number 38,578 were males and 41,699 females. The intercensal increase (1951-1961) was 16,913 persons or 26.7 per cent. increase in population. Details of the changes in population of the Urban District during the past ten years are given below:— Year Population Variation from previous year. 1952 63,670 + 820 1953 64,480 + 810 1954 66,380 + 1,900 1955 68,450 + 2,070 1956 70,410 + 1,960 1957 72,170 + 1,760 1958 73,640 + 1,470 1959 74,620 + 980 1960 76,020 + 1,400 1961 80,080 +4,060 14 The steady and uninterrupted increase in population over the last decade, has, of course, been accompanied by a similar increase in housing. The Preliminary Report on the 1961 Census shows that during these ten years the number of private dwellings in the district has risen from 18,214 to 25,277, an increase of 38.8 per cent. It is interesting to reflect on the increased use of such Council services as refuse collection and disposal, resulting from these substantial changes. Birth. 1,308 live births appertaining to the Urban District were registered during 1961, of which 666 were males and 642 females, and 1,272 legitimate and 36 illegitimate. The crude birth rate for the Urban District was 16.3 per 1,000 total population. The rate for England and Wales as a whole was 17.4. The illegitimate birth rate was 28.0 per 1,000 live and still births. There were 36 illegitimate live births, of which 15 were males and 21 females. Thirteen stillbirths were registered, giving a rate of 0.16 per 1,000 total population, and 9.8 per 1,000 live and stillbirths. Nine of the stillbirths were males and 4 females. The rate for England and Wales was 18.7 per 1,000 total births. Details of the births in the area during the past ten years are given below:— Year. Number of Legitimate. live births. Illegitimate. Total. Number of stillbirths. Total births Legitimate. Illegitimate. Total 1952 901 33 934 16 1 17 951 1953 892 35 927 17 — 17 944 1954 1,026 21 1.047 31 1 32 1,079 1955 1,059 24 1.083 18 1 19 1,102 1956 1,174 45 1,219 20 — 20 1,239 1957 1,285 17 1,302 13 — 13 1,315 1958 1.283 36 1,319 21 3 24 1,343 1959 1,340 48 1,388 20 1 21 1,409 1960 1,388 49 1,437 21 1 22 1,458 1961 1,272 36 1,308 12 1 13 1,321 The above figures show the gradual increase in the number of births during the period up to 1960, followed by a small decline in 1961. 15 Infant Mortality. There were 16 deaths of infants under one year of age in the Urban District during 1961, as compared with 27 in the previous year. The table which follows gives the Orpington mortality rate for legitimate and illegitimate infants, as well as for all infants, and also shows the comparison between the infant mortality rate in the Urban District and that for England and Wales during the past ten years. Year. Legitimate Infanta. Rate per 1,000 live legitimate births. Illegitimate Infanta. Rate per 1,00 live illegitimate births. Ail Infants Rate per Orpington. 1,000 live births. England & Wales. 1952 17.8 30.3 18.2 27.6 1953 16.8 28.6 17.2 26.8 1954 13.6 47.6 14.3 25.5 1955 16.99 41.7 17.5 24.9 1956 21.3 Nil 20.5 23.8 1957 19.5 Nil 19.2 23.0 1958 20.3 27.8 20.5 22.5 1959 13.4 41.7 14.4 22.0 1960 18.0 40.8 18.8 21.7 1961 12.6 Nil 12.2 21.4 Causes of Infant Deaths, 1961. 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. Acute Bronchitis — — — — — 1 — — — 1 Atelectasis 1 — — — 1 — — — — 1 Broncho Pneumonia — — — 1 1 — — — 1 2 Gastro-enteritis — — — — — — — — — — Malformation — — — — — — — — — — Prematurity 7 — — — 7 — — — — 7 Cerebral Haemorrhage 2 _ _ _ 2 _ — _ _ 2 Meningitis — — 1 — 1 — — — — 1 Other causes 2 — — — 2 — — — — 2 12 — 1 1 14 1 — — 1 16 16 Analysis of Causes of Infant Deaths. 1952-1961. 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 Total Number of Births (live) 934 927 1047 1083 1219 1302 1319 1388 1437 1308 11,964 Infant Mortality Rate (per 1,000 live births) 18.2 17.2 14.3 17.5 20.5 19.2 20.5 14.4 18.8 12.2 17.3 Atelectasis — 3 1 3 6 9 3 2 2 1 30 Malformation — — 2 — — — — — — — 2 Gastro-enteritis — — — — — — — 1 1 — 2 Prematurity 9 3 7 4 8 7 6 4 10 7 65 Respiratory Diseases 5 3 3 6 6 3 8 3 3 3 43 Cerebral Haemorrhage — — — — — — 5 1 3 2 11 Meningitis — — — — — 1 — 1 1 1 4 Congenital Heart Disease — — — 1 — 1 3 4 2 11 Other Causes 3 7 2 5 5 4 2 4 5 2 39 Totals 17 16 15 19 25 25 27 20 27 16 207 Maternal Mortality. There were no maternal deaths in the Urban District during 1961. The England and Wales maternal mortality rate for the year was 0.33 per 1,000 (live and still births). Only three maternal deaths have occurred in the Urban District during the ten-year period 1952-1961. Two of these were in 1953 and the other in 1957. Deaths. Seven hundred and sixty-one deaths appertaining to the Urban District were registered during the year, giving a death rate of 9.5 per 1,000 total population. The adjusted rate for use when comparing one area with another is 10.6. The rate for England and Wales as a whole was 12.0. Of the Orpington deaths registered, 386 were males and 375 females. The following statement shows the number of deaths and rates per 1,000 total population for the past ten years:— Year. Number of deaths. Total. Death rate per 1,000 population. Males. Females. 1952 299 266 565 8.9 1953 328 306 634 9.8 1954 262 254 516 7.8 1955 323 301 624 9.1 1956 344 304 648 9.2 1957 333 295 628 8.7 1958 388 359 747 10.1 1959 400 351 751 10.1 1960 380 332 712 9.4 1961 386 375 761 9.5 17 The following is an analysis of the ages at death for the year 1961:— Males. Females. 16 were under one year of age 9 7 4 were one and under 5 years of age 3 1 8 were 5 and under 15 years of age 5 3 11 were 15 and under 25 years of age 10 1 22 were 25 and under 45 years of age 12 10 153 were 45 and under 65 years of age 90 63 167 were 65 and under 75 years of age 99 68 380 were 75 years of age and over 158 222 386 375 18 Morbidity Statistics. The following is a summary of the weekly details received from the Ministry of Pensions and National Insurance during 1961:— Four weeks ending Number of first certificates of incapacity received. 24th January 1,125 21st February 1,887 21st March 902 18th April 650 16th May 650 13th June 599 11th July 565 8th August 490 5th September 476 3rd October 545 31st October 971 28th November 911 26th December 896 The sickness rate followed the usual trend, namely, the highest incidence of illness occurred during the early and late part of the year with the lowest figure being recorded in August. Staff Medical Examinations. One hundred and twenty members, or potential members of the staff were given a medical examination during 1961. One hundred and ten were examined in 1960 and seventy-seven in 1959. Unemployment. I am indebted to the Manager of the local Employment Exchange for the following information with regard to unemployment in the area during 1961:— "For the first seven months of the year the number of persons unemployed was lower than in 1960. The latter part of the year, except for October, showed a slight increase on the previous year. The peak figure was in January, when 210 persons were registered as unemployed, the lowest in May with 151. There has been little long term unemployment except perhaps in the older age groups and the physically handicapped." 19 Open-Air Recreational Amenities. Approximately 292.28 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 Biggin Hill Valley Biggin Hill 0.54 Chelsfield Chelsfield 0.50 Cudham Village Cudham 10.39 Cudham Lane Green-Street-Green 6.5 Downe Downe 3.0 Farnborough Farnborough 10.0 Farnborough (Opp. New Inn P.H.) Farnborough 0.134 Glentrammon Green-Street-Green 13.5 Goddington Goddington South 63.95 Grassmeade Goddington North 9.6 Knockholt Knockholt 0.75 Leamington Avenue Crofton South 4.0 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 Tubbenden Lane Crofton South 4.14 Willett Petts Wood 6.1 Public Gardens. Ward. Acreage. 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 In addition, there are 213 acres of woodland at High Elms Estate, situated between Farnborough, Green-Street-Green and Downe. The value of Orpington's open spaces cannot be over estimated, for they provide rest and relaxation for the older members of the population and facilities for recreational activities for the younger generation, thus making a notable contribution to the general wellbeing of the community. SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. 22 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 1961 are as under:— Disinfections. Premises visited 12 Rooms disinfected 11 Articles disinfected 101 Disinfestations. Premises visited 6 Rooms disinfested 20 Articles disinfested 72 Articles treated. Articles destroyed. Beds 13 1 Mattresses 15 4 Pillows 34 2 Bolsters 5 — Bedclothes (batches) 13 1 Clothing (batches) 8 1 Cushions 25 2 Hangings 16 — Carpets, etc. 12 — Library Books 32 — 173 10 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. 23 Laboratory Service. Routine medical and Food and Drugs samples are forwarded to the Public Health Laboratory at Barming and to the County Analyst's Laboratory at Maidstone, and the following is a summary of the work carried out on behalf of the Council during 1961:— Faeces 82 Food Samples, etc. 276 Water Samples 50 408 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, one body was dealt with by the Council. 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 712 beds. (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 806 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. 24 SERVICES RENDERED BY THE KENT COUNTY COUNCIL. Ambulance Service. The main depot for the area is situate at 12, Hayes Lane, Bromley. At the present time there are 25 ambulances and 24 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 Walnuts," High Street, Orpington. The following is a summary of the cases assisted during 1961: — Maternity (expectant mothers) 163 Tuberculosis 6 Aged 267 Others 219 655 Family Help Service. Nineteen cases were assisted during 1961. Child Help Service. Assistance under this scheme was given to one family during the year. Night Attendant Service. Twelve cases received assistance during 1961. 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 Urban District. 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, etc. 25 SERVICES RENDERED BY VOLUNTARY AGENCIES. The St. John Ambulance Brigade. Over 60's Clubs. These agencies continue to carry out their good work in the area. Women's Voluntary Service. The County Organiser has kindly furnished the following report: " Meals on Wheels". These are delivered three days a week in the area, 7,783 meals were delivered during the year. Darby and Joan Clubs. Farnborough Club—This Club has many frail old people. Twenty-five have to be fetched and taken home every week, which means a lot of extra work for W.V.S. members, but the visit to the Club means so much to the old people that the effort is well worth while. " The Rookery "—This Club continues to flourish. Both Clubs have had some good outings during the year. Escorts. Many escorts have been undertaken by W.V.S. members, and it has recently come to light that one of these members makes a point of keeping in touch with every old person she drives—«ven if this is only on one occasion. Four hundred and twenty such escorts have been undertaken during the year. This work entails journeys to specialists or hospitals in London and visits to the coast to convalescent homes after patients have been in hospital. One escort was undertaken on 27th December to enable a patient who had been in hospital for 18 weeks to be admitted to a Re-habilitation Centre at Farnham Royal, Hants. Farnborough Hospital—An excellent liaison is maintained between the Centre and the hospital, and the Trolley Shop in the Geriatric Ward is very much appreciated. 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 continue to provide a means of regular contact between the many organisations that help old folk in Orpington, and to foster locally a general interest in the care of the elderly. A very welcome feature of the past year is that more schools and youth organisations have given practical aid in meeting the needs of old people in various ways. The Fellowship of Youth, of St. John's Presbyterian Church, deserve special mention for the work they have done in the homes and gardens of the incapacitated. 26 The Committee also provides a liaison between the dozen Old People's Clubs that do so much to relieve the monotony and loneliness of many old people. There is a growing need for more car drivers to provide transport for the aged and infirm. Several individuals have very kindly helped in this way for several years—particularly with transport to and from clubs—and members of the Rotary Club of Orpington have recently formed a rota to take part in this service. Still more helpers are needed. The Committee relieves genuine distress among old people from its Benevolent Fund, within the limits set by the donations which are the only source of income for that Fund. 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 opened by appointment. Application should be made to Mrs. Jones of that address—'telephone number Orpington 22083. LOCAL CLINIC SERVICES. Child Welfare Centres. Chelsfield Biggin Hill Downe Farnborough Green-Street-Green Knockholt Orpington Orpington Crofton Petts Wood St. Mary Cray Pratts Bottom Poverest CUDHAM Village Hall Sports Pavilion. Biggin Hill Village Hall Methodist Hall Baptist School Room . The Institute Methodist Church Hall St. Giles Church Hall. Leamington Avenue St. Paul's Church Hall Methodist Church Hall, Lakeswood Road .. Temple Congregational Church Hall Village Hall Cbronation Hall. Bridge Road, St. Mary Cray Eldon Hall, Downe Avenue 1st, 3rd and 5th Tuesday in month, p.m. Thursday—p.m. and 1st, 3rd and 5th Monday— p.m. 1st and 3rd Friday in month—p.m. Friday—p.m. , Friday—p.m. 2nd and 4th Tuesday in month—p.m. Monday, Tuesday and Friday—p.m. Wednesday—p.m. Monday—p.m. Monday and Thursday— p.m. Tuesday and Wednesday —p.m. 2nd and 4th Thursday in month—p.m. Each Thursday—p.m. 1st and 3rd Wednesday in month—p.m. 27 Ante-Natal Clinics. Green-Street-Green Orpington Petts Wood St. Mary Cray St. Mary Cray Baptist School Room.. Methodist Church Hall Methodist Church Hall Lakeswood Road Temple Congregational Church Hall Temple Congregational Church Hall Friday—a.m. Relaxation Class—2nd and 4th Tuesday in month— a.m. Tuesday and Friday— a.m. 1st, 3rd and 5th Tuesday —p.m. Relaxation Class, 10 a.m.—12 noon—Wednesday. 1st, 3rd and 5th Friday— p.m. Doctor in attendance. 2nd and 4th Friday—p.m (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—p.m. 1.45 p.m.—3 p.m. Dental Clinics. The School House, Chislehurst Road, Orpington Monday, Tuesday, Wednesday, Thursday, Friday all day. Dentist attends full time each day. Dental Clinics are also held in the Country areas, Farnborough, Zudham, Westerham, Biggin Hill, Downe, Green-Street-Green and K.nockholt, etc. Immunisation and Vaccination. This is carried out at the Child Welfare Centres listed above. District Officer. There is a District Officer stationed at County Offices, the Walnuts, High Street, Orpington. Telephone: Orpington 21123. SECTION C. SANITARY AND ENVIRONMENTAL CIRCUMSTANCES OF THE AREA. 30 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. Two hundred and seventy-nine observations and visits were made by the Public Health Inspectors under the Clean Air Act, 1956, during the year. I am pleased to report that there is a happy relationship between the factory managements and the Public Health Department, consequently any infringements which are detected are dealt with on an informal basis. The district, with an acreage of some 20,000 is one of the largest urban districts in the country and is fortunate in having many open spaces, parks and recreation grounds. With many factories and dwelling-houses using smokeless fuels, the atmosphere is comparatively free from smoke pollution. The Ministry of Housing and Local Government prepared a map of the Greater London area and this district is not shown thereon as a black area. 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. 31 Cesspools. During the year, the work of substituting main drainage for cesspools has proceeded smoothly. Forty-three cesspools have been abolished on the line of sewers which were constructed before 1961, and at Leaves Green, where new sewers were being installed in Blackness Lane and Westerham Road, 27 cesspools had been abolished by the end of the year. Also at Allenby Road, Biggin Hill, 8 cesspools were abolished on the line of a new sewer which has not as yet been taken over by the Council. The following summary shows the position at the end of 1961: — Number of cesspools at 31st December, 1961: (1) on line of sewers constructed before 1st January, 1961 37 (2) not on line of sewers 2,270 Number of cesspools abolished and main drainage provided during the year 78 Number of houses with pail closets converted to cesspool drainage 2 Number of new houses erected with cesspool drainage 21 Number of loads removed from cesspools: On private properties 5,815 On Council properties 393 6,208 Complaints. During the year, 34 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. Six Boiling Plants were licensed during 1961, making a total of 52 licences issued under this Order. Drainage and Sewerage. The trunk soil sewerage system is under the controlof 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: Foul sewer 9in. 3.025 lineal yards 6in. 1,041 „ „ Surface Water 12in. 309 „ „ 9in. 983 „ „ 6in. 495 „ „ 32 Factories Acts, 1937 and 1948. There are 149 factories on the Council's register at the present time. Eighty-two visits of inspection were made by the Public Health Inspectors and the three defects found were remedied. The following gives particulars of the work carried out during 1961:— 1. Inspection for purposes of provisions as to health: Premises. Number on Register Inspection; Number Written Notices of Occupiers Prosecuted (a) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by the Local Authority 10 ____ ____ ____ (b) Factories not included in (1) in which Section 7 is enforced by the Local Authority 122 69 ____ ____ (c) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises)* 17 13 ____ 149 82 ____ ____ * Building sites on Estate development. 2. Cases in which defects were found: Found Remedied Number of cases in which defects were Number of cases in which prosecutions were instituted referred to H.M. Inspector by H.M. Inspector 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 2 3 ____ ____ _____ (c) Not separate for sexes ____ ____ ____ ____ ____ Other offences against the Act (not including offences relating to Outwork) ____ ____ ____ ____ ____ Total 2 3 ____ ____ ____ 33 Outworkers. Twenty-two 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 56 Cardboard boxes 2 Leather Goods 1 59 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 1961 and eighteen 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. Prevention of Damage by Pests Act, 1949. The number of inspections and treatments carried out was as follows: — Total number of Inspections. Number of Infestations cleared. Local Authority's property 79 13 Dwelling houses (including Council houses) 5,104 650 Business premises 222 38 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. 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 1961. 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. 34 Sanitary Inspection of the Area. Total number of inspections and visits. No. of premises at which defects or contraventions were found. Housing 2.801 147 Infectious Diseases 212 — Food Premises 1,617 108 Factories (including Smoke 389 3 Observations, Outworkers) Rodent Control (Public Health 254 20 Inspectors only) Trade Premises 824 42 Miscellaneous 674 7 6,771 327 Shops Act, 1950. During the year, five hundred and seven inspections of shops were made and the following contraventions were found and subsequently remedied by the shop-keepers: — Neglect in displaying Statutory Forms 38 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 admission is Is. 6d. for adults, 9d. for children, and 3d. for spectators. It is an indoor swimming bath covered with white glazed tiles. The water, supplied by the Metropolitan Water Board, is heated, chlorinated and then filtered continuously, this cycle taking eight hours. Eight visits of inspection were made during the year by the District Public Health Inspector and five 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 6 verminous premises were dealt with by the Department's Disinfector. Water Supply. During the year, six premises were connected to the main water supply, having previously been dependent upon stored rainwater. Of approximately 24,000 dwellings, only 27 are not provided with a main piped water supply, and of these 19 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 rainwater collected from roofs and stored in underground tanks, but three premises obtain their source of supply from a private well. 35 The remaining 8 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 five premises are within 80 feet of the Metropolitan Water Board main. Fourteen week-end bungalows are not connected to a main water supply. The total number of premises still dependent upon underground tank or well supply is made up as follows: — Ward. Number of premises Stored rainwater. with Wells. Biggin Hill 14 — Chelsfield 2 — Cudham 2 — Downe 2 — Farnborough 2 1 Green-Street-Green 3 — Knockholt 1 — 26 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 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 1961: — "The supply to the district of Orpington during 1961 was derived from the following wells, namely Eynsford, Horton Kirby, Lullingstone, North Orpington, Orpington and Sundridge. A total length of 9,294 yards of supply mains were laid in the Orpington area in 1961. None of the water is plumbo-solvent and there have been no specific instances of contamination in this area during 1961. The following tables give the results of the chemical and bacteriological analyses of the various supplies to Orpington during 1961, including bacteriological quality of the well water before treatment." 36 Average Results of the Chemical Examination of the Water supplied to Orpington during the Year 1961. Milligrammes per litre (unless otherwise stated). Description of the Sample No. of Samples Ammonia Nitrogen Albuminoid Nitrogen Oxidised Nitrogen Chlorides as CI. Oxygen abs. from Permanganate 4 hrs. at 27°C. Turbidity units Nitrite Nitrate Eynsford well 8 0.022 0.031 4.1 16 0.04 Nil Horton Kirby well 8 0.021 0.039 4.8 17 0.08 Nil Lullingstone well 8 0.017 0.032 4.3 14 0.02 0.2 North Orpington well 5 0.017 0.037 4.7 14 0.08 0.1 Orpington well 4 0.018 0.040 6.8 18 0.18 Nil Sundridge well 9 0.020 0.033 3.0 18 0.12 0.1 Description of the Sample Colour, mm. brown 2 ft. Tube Burgess's Tintometer Hardness (Total) Hardness (noncarbonate) PH Value Phosphate as P04 Silicate as SiO2 Free CO2 B.O.D. 5 days at 20°C Electrical Conductivity (micromhos) Eynsford well Nil 270 30 7.2 32 475 Horton Kirby well Nil 260 32 7.2 31 500 Lullingstone well 1 256 24 7.2 30 450 North Orpington well Nil 274 28 7.2 40 500 Orpington well Nil 300 60 7.2 38 550 Sundridge well Nil 210 36 7.4 14 400 37 Result of the Bacteriological Examination of the Water supplied to Orpington during the Year 1961. 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 154 0.2 74 77.27 0.9 92.21 0.3 253 — 4 99.60 100.0 Eynsford No. 2 well 163 __ 4 99.39 — 100.0 — Horton Kirby No. 1 well 211 0 1 28 98.10 0.2 99.05 0.2 245 0 .1 63 100.0 100.0 Horton Kirby No. 2 well 151 01 26 99.34 — 100.0 — Lullingstone No. 1 well 132 01 20 100.0 — 100.0 — 401 0 .1 40 99.50 100 .0 Lullingstone No. 2 well 132 0.7 30 100.0 — 100.0 — North Orpington well 176 2.5 26 22.73 9.6 46.59 3.9 181 0.3 6 100.0 100.0 Orpington well 250 0.2 14 94.00 0.1 100.0 — 255 1.8 22 99.6 99.6 Sundridge No. 1 well 52 0.2 106 100.0 — 100.0 — 225 0.3 149 99.56 100.0 Sundridge No. 2 well 91 0.1 8 100.0 — 100.0 — Sundridge No. 3 well 110 0.3 93 100.0 — 100.0 — Sundridge No. 4 well 135 0.1 82 98.52 — 100.0 — SECTION D. HOUSING. 40 SECTION D. HOUSING. Clearance Areas and Individual Unfit Dwellings. As indicated in my last report, the problem of unfit houses is by no means an acute one in the Orpington district. To complete our programme, we have to deal with approximately thirty-five houses and it is anticipated that, in the majority of cases, we shall apply the procedure under Section 17 of the Housing Act, 1957 (Demolition or Closing Order). A close liaison is maintained with the Housing Department to ensure that our formal action is related to the availability of alternative accommodation for the displaced persons. 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 two applications for Certificates were received during 1961, 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 increase in rent has 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 1961 59 38 8 3 2 Housing Act, 1961. This Act came into force at the end of the year. It extends and amends the principal Act of 1957. From the viewpoint of this department, the most important amendments are those dealing with houses in multiple occupation and the raising of the Rent Increase from 8 per cent, to 12| per cent, for improvements. 41 With regard to the former, it is true that the question of multiple occupation of dwellings is not a problem here as it is in some parts of London and other big cities, but it is reassuring to know that proper standards of management can be insisted upon if occasion arises. The raising of the permitted Rent Increase from 8 per cent to \2i per cent for improvements has been the subject of much speculation. The recognised improvements include such items as bathrooms, hot water supply, wash-hand basins, ventilated food stores and water closets. It is hoped, of course, that more landlords will be induced by this increase to carry out these improvements and so raise the general level of housing accommodation. I propose to comment on the situation next year. Housing Statistics for the year 1961. Total number of valuation assessments, houses and flats, at 31st December, 1961 24,733 (1) (a) Total number of dwelling houses inspected for defects (under the Public Health or Housing Acts) 139 (b) Number of inspections made for the purpose 915 (2) Number of dwelling houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 Nil (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 6 (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 65 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 57 Moveable Dwellings. Sixty-one visits were made to the various caravan sites, of which there are approximately six. Only four of these are of any size and in only one case has a permanent licence been granted. Two shortterm licences were issued to coincide with the unexpired period of planning consent. These will expire at 31st December, 1962. At the sites, this department is concerned with the provision of a pure and wholesome water supply, adequate sanitation, drainage and washing facilities and the proper storage of refuse, and the recommended standards of the Ministry of Housing and Local Government have been adopted in full by the Council and applied as licence conditions to ensure that a good standard of hygiene is maintained. 42 Re-Housing. I am indebted to the Housing and Estates Manager for ihe following statistics on re-housing carried out by the Local Authority: — Prior to 1961 During 1961 Total as at December, 1961. (a) No. of "permanent" dwellings built by Local Authority (excluding 402 old type pre-1939 Council houses) 2,389 63 2,452 (b) No. of pre-fabricated dwellings built by Local Authority 319 314* (c) No. of dwellings requisitioned by Local Authority 2 — 2 2. (a) No. of families occupying 1 (a) 2,452 and lodgers. (b) No. of families occupying 1 (b) 314—5 demolished*. (c) No. of families occupying 1 (c) 22 3. Total number of families re-housed during 1961 in (a) 63 (b) Nil). (c) 39 4. No. of families on waiting list at 31st December, 1961, in various categories : — (a) Families in urgent need of other accommodation 134 (b) Families whose applications require early consideration 272 (c) Families whose applications are less urgent 334 740 (d) Families with varying degrees of housing need . 340 5. No. of families on waiting list living in overcrowded conditions: no figures are kept as to the extent of statutory overcrowding, but about 406 of the families included in 4 above are living in crowded conditions. Common Lodging Houses. There is only one registered common lodging house within the area. SECTION E. INSPECTION AND SUPERVISION OF FOODS. 44 SECTION E. INSPECTION AND SUPERVISION OF FOODS. General. The numerous visits made each year to food premises have for their object the prevention of the illness generally known as " Food Poisoning". As well as ascertaining if the provisions of the Food Hygiene Regulations are being complied with, the opportunity is taken to emphasise with the staff the importance of handling food in a cleanly manner and storing it in a clean, cool place, preferably a refrigerator. No serious contraventions were detected and the general standard of cleanliness was found to be satisfactory. Food and Drugs Act, 1955. Food Sampling. Details of the 235 informal samples of food and drugs taken for analysis are as follow: — Samples taken. Result Description. Formal. Informal. Genuine Inferior. erated. Remarks Alka-Seltzer — 1 1 — — Almond Essence — 1 — 1 — See (a) Almond Oil — 1 1 — — Ammoniated Tincture of Quinine 1 1 — — Apples, Australian — 1 1 — — Apple and Orange Drink — 1 1 — — Aspirins — 2 2 — — Baking Powder — 1 1 — — Beef Sausages — 1 1 — — Beef Suet — 1 1 — — Bicarbonate of Soda — 1 1 — — Blackcurrant Drink — 1 1 — — Boric Acid Ointment — 1 1 — — Bread (Sliced) — 1 — 1 — See (b) Butter — 2 2 — — Butter Sweet Confectionery — 6 6 — — Canned Strawberries — 1 1 — — Catarrh Pastilles — 1 1 — — Cheese — 1 1 — — Cheese Spread — 3 3 — — Chocolate Biscuits—Snack Pack — 1 1 — — Chocolate Spread — 1 1 — — Coffee and Chicory — 2 2 — — Condensed Milk — 5 5 — — Cornflour — 1 1 — — Cough Pastilles — 4 4 — — Cough Syrup — 1 1 — — Currants — 1 1 — — Custard Powder — 2 2 — — Demerara Sugar — 2 2 — — Dessicated Coconut — 1 1 — — 45 Diabetic Marmalade — 1 1 — — Doughnuts — 1 1 — — Epsom Salts — 1 1 — — Evaporated Milk — 1 1 — — Fish Paste — 12 12 — — Gelatine — 1 1 — — Glucose Drink — 1 1 — — Gravy Browning — 1 1 — — Ground Nutmegs — 1 1 — — Honey — 1 1 — — Horlicks — 1 1 — — Influenza Mixture — 1 1 — — Iodized Table Salt — 1 1 — — Jam Roll — 1 1 — — Junket Crystals — 1 1 — — Kruschen Salts — 1 1 — — Lard — — — Lemon Drink — — — Lemon Juice — 1 1 — — Lemonade Powder — 1 1 — — Liquid Paraffin — — — Margarine — 1 1 — — Marmite — 1 1 — — Meat Paste — 12 12 — — Milk in sealed 1 pt. bottle — 1 — 1 — See (c) Milk (Channel Island) — 1 1 — — Milk (Pasteurised) — 33 33 — — Milk (Sterilised) — 27 27 — — Milk (T.T.) — — — Milk Shake — 1 1 — — Milk of Magnesia — 1 1 — — Milo Food Drink — 1 1 — — Mincemeat — 1 1 — — Mustard — 1 1 — — Nurse Harvey's Mixture. . — 1 1 — — Oatmeal — 1 1 — — Olive Oil — 3 3 — — Oranges — 1 1 — — Orange Drink ~ 5 3 2 See (d) & (e) Orange Sponge Pudding and Sauce 1 1 — — Pea Flour 1 1 — — Peanut Butter 1 1 — — Pickle 1 1 — — Pork Luncheon Meat 1 1 — — Pork Pie 1 1 — — Pork Sausages 2 — — Quick Mix Dried Vegetables — — Raisin Beverage 1 ! — — Raising Powder 1 I — — Salmon (tinned) 1 i — — Salad Cream 1 I — — Saveloys 1 I — — Self-Raising Flour 5 — — Soup — — Soup Mixture 1 1 — — Sponge Mixture 1 1 — — Strained Beef Broth 1 1 — — Strained and Homogenised Liver and Vegetables 1 1 — — 46 Steak and Kidney Pudding — 1 1 — — Sugared Almonds — 1 1 — — Sultanas — 1 1 — — Syrup of Figs — 1 1 — — Table Jelly — — — Tapioca — 1 1 — — Tea — — — — — Tinned Ham and Pork — 1 1 — — Tinned Steak and Kidney Pie — 1 1 — — Tinned Mandarin Oranges — 1 1 — — Tomato Ketchup — 4 4 — — Tonic Tablets — 1 1 — — Truefood Cereals — 1 1 — — Turkey (portion of carcase) — 1 — 1 — See (f) Turkish Delight — 1 1 — — 235 229 6 — NATURE OF ADULTERATION. (a) Serial No. 411. Almond Essence. Some deterioration presumably with age. Benzoic acid 0.5%. Not dangerous to health in amounts used. Inferior. REMARKS. No action possible as complainant was unable to remember the name and address of retailer. (b) Serial No. 530. Bread. 2 slices of bread made into jam sandwich. On the bottom and side of the slices of bread were two patches of material similar in character to dirty machine grease. Inferior. A thorough investigation was made at the bakery concerned. Arrangements were made for a more effective inspection of the machinery. (c) Serial No. 529. Milk in sealed pint bottle. Consisted of an unopened one pint bottle of milk. Halfway down the inside of the bottle was a dirty vertical smear about 2 inches long and i inch wide. Below the main smear was a much smaller similar mark. The material consisted of gritty sand and dirt firmly adherent to the inside of the bottle. It was insoluble in milk and unlikely to be harmful to health. Though the colour suggested mould none was detected. Inferior. A full enquiry was made of the dairy company from which it appeared that this particular bottle escaped the vigilance of the Company's Inspector. (d) Serial No. 432. Orange Drink. On the side of bottle and inside was an area of faint dark staining. Microscopically it consisted of mould spores. Some of these innoculated with wort agar failed to grow in 20 days. The spores had, therefore, been killed by the bottle cleansing process. Not dangerous to health. Inferior. The mould spores were not alive and it was obviously one of those cases where the bottle examiners employed by the dairy had overlooked its condition on its travel between the washing and filling machines. 47 (e) SERIAL No. 516. Whole Orange Drink. Soluble solids 8.3, acidity 0.9, potable fruit not more than 7%. Food Standards Committee recommend mini10%. Sulphite 340, Saccharin 420 p.p.m. Inferior. A further sample of this orange drink was submitted to the Analyst and was found to be satisfactory. (f) Serial No. 531. Rooked Turkey. The fat showed signs of incipient rancidity which might be due to the interval Between cooking and receipt. It also had a slight but definite fishy savour, the most likely cause of jyhich would be the food on which 116 bird had been reared. Inferior. The complainant was notified of the result of the analysis, but no further action was taken. Food Hygiene Regulations, 1955. There were no prosecutions under the above Regulations during A total of 1,333 inspections were made by the District Inspectors during the year. As a result of these inspections, 108 informal notices were served the proprietors, and by the end of the year the following works had been carried out at various food premises: — Walls and ceilings cleansed 61 Floors cleansed 3 Structural repairs 2 Sanitary accommodation: Repaired 4 Cleansed 16 Wash-hand basins provided 5 Hot water supply provided 15 Dustbin provided for refuse storage 4 Water heater repaired 3 Accumulation of rubbish removed 2 Soap, towels and nailbrush provided 7 Equipment cleansed 2 Lighting Improved 1 Protective clothing provided 1 Incinerator provided 1 First aid materials provided 2 Food protected from contamination 2 Meat carriers delivery van repaired 1 Storage accommodation cleansed 1 Miscellaneous 3 Complaints Thirty-three 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 possilble to give a satisfactory explanation to the complainant and restitution was made as necessary. 48 Bacon 1 Bread 12 Cakes 1 Cream 1 Custard Pie 1 Cheese Sandwiches 1 Milk 5 Orange Squash 1 Peas (tinned) 1 Pilchards (tinned) 1 Pork Pie 1 Puff Pastry Salmon (tinned) 1 Sausages (Beef) 2 Sausage Rolls Steak and Kidney Pie 1 Turkey 1 33 Special Samples of Milk, Ice Cream, and Water. In addition to the samples previously mentioned, a further 151 samples were taken for bacteriological and pathological examination and other special tests, as under: — Milk (Tuberculin Tested) Bacteriological Examination 2 Milk (Pasteurised) Phosphatase Test 31 Milk (Sterilised) Turbidity Test 26 Milk (Channel Island) 1 Ice Cream—Bacteriological and Pathological Examination 41 Water—Bacteriological Examination 48 Water—Chemical Examination 2 151 Ice Cream. At the end of the year, one hundred and ninety-five premises were registered for the storage of, and sale of ice cream, but none for the manufacture of this commodity. One hundred and two inspections were made and conditions were found to be satisfactory. Forty-one samples were sent for bacteriological and pathological examination. The following is an analysis of the results obtained during the past three years: — Year. No. of samples taken. Grade I. Result. Grade II. Grade III. Grade IV. 1959 23 20 3 1960 37 29 5 2 1 1961 41 25 14 2 No pathogenic organisms were found in any of the 41 samples and the bacteriological grading was satisfactory. 49 Food Premises. Bakehouses 12 Bakers' Shops 20 Butchers 49 Chemists 21 Clubs and Hotels 7 Confectionery 61 Cooked Meat Shops 1 Dairies 9 Fishmongers (Wet, Dried and Fried) 21 Greengrocery 55 Grocery 84 Hospitals 2 Industrial Canteens 18 Public Houses 43 Restaurants 47 School Canteens 15 Street Vendors 12 477 Food and Drugs Act, 1955—Section 16. Two hundred and forty-five shops and food premises have been registered under the above Act, as follow: — Ice Cream Stores 195 Fish Shops 8 Butchers' Shops 41 Fish and Meat Paste Factory 1 245 Unsound Food. During the year a total of 2 tons 15 cwts. 3 quarters 251bs. of varied articles of food were condemned and destroyed, and 488 Food Condemnation Certificates were issued. Bacon 82 lbs. Biscuits 150 lbs. Butter 4 lbs. Cereals 48 lbs. Cheese 52 lbs. Chickens 219 lbs. Coffee 1 lb. Cordial 7 lbs. Cream 3 lbs. Fish 487 lbs. Fish (tinned) 44 lbs. Flour 11 lbs. Fruit (tinned) 1,134 lbs. Fruit 11 lbs. Fruit (Dried) 17 lbs. Liver 44 lbs. Meat (tinned) 954 lbs. Meat 2,210 lbs. Meat Pies 52 lbs. Milk (tinned) 31 lbs. Milk (dried) 1 lb. 50 Pickles 2 lbs. Poultry 65 lbs. Preserves 52 lbs. Rabbits 12 lbs. Sausages 40 lbs. Soups 13 lbs. Sweets 3 lbs. Vegetables (tinned) 411 lbs. Vegetables 109 lbs. Milk and Dairies Regulations. Five dairies have been registered under the above regulations. The new Milk (Special Designation) Regulations, 1960, came into force on the 1st January, 1961. The principal change affecting this department is that dealers' licences issued on that date remain valid for five years instead of one as hitherto and will be renewable for subsequent quinquennial periods. These licences no longer restrict sales to the area of the Licensing Authorities so that supplementary licences are no longer needed. The following licences were issued during 196:— Tuberculin Tested 24 Pasteurised 29 Sterilised 31 Thirty-three visits were made to the dairies in the district during the year. 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 twenty-two visits were made to these premises during the year. In sixteen cases defects requiring the attention of the owner were dealt with by informal action. Butchers' Shops. One hundred and thirty-three detailed inspections were made of the forty-nine 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 2,210 lbs. of meat were condemned as being unfit for human consumption. In no case was there any evidence of unsound meat being exposed for sale. 51 Bakehouses. Forty-four inspections were made of the twelve premises during the year, and in eight cases defects were found which required the attention of the department. Merchandise Marks Act. Fifty-two 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. 54 SECTION F. PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. General. Two thousand and ninety-nine notifications of infectious diseases were received during the year, compared with 484 during 1960. The difference in the figures for these two years is mainly accounted for by the increase in the number of cases of measles which during 1961 amounted-to 1,847, against 139 for 1960. This large fluctuation in cases of measles takes place in alternate years, and tends to dominate the picture in a somewhat misleading way. If measles is ignored, the remaining notifications show a decrease compared with the previous year, the figures then being 252 compared with 345 in 1960. An increase in Whooping Cough was more than offset by the decreased incidence of Scarlet Fever, dysentery and food poisoning. The year was again noteworthy for the complete absence of Anterior Poliomyelitis, and, for the twelfth consecutive year, of diphtheria. There were also no cases of Typhoid or Paratyphoid Fever notified. Acute Anterior Poliomyelitis and Vaccination. No cases were notified. Most of the credit for our continued freedom from this complaint is undoubtedly due to the success of our immunisation scheme, and the following figures with regard to the poliomyelitis vaccination have been supplied by the County Medical Officer:— Priority Group. 2nd injections. 3rd injections. 4th injections. 1957-1961 1,542 1,344 — 1946-1956 384 678 — 1943-1945 53 74 — 1933-1942 416 405 — 1921-1932 1,837 2,509 — Others 50 90 School children under 12 years — — 5,472 Totals 4,282 5,100 5,472 Diphtheria and Diphtheria Immunisation. For the twelfth consecutive year, I am pleased to be able to report a complete absence of this disease in the Urban District. 55 The following table, which has been supplied by the County Medical Officer, shows the diphtheria immunisation figures for 1961, based on the returns submitted to the Ministry of Health: Year of Birth. Primary. Reinforcing. 1961 575 — 1960 681 44 1959 86 84 1958 43 54 1957 51 75 1952-1956 108 931 1947-1951 39 155 Totals 1,583 1,343 Immunisation against diphtheria is still vitally important if our present immunity to the disease is to be maintained. Dysentery. Seven cases of dysentery were notified during the year, one being admitted to hospital. This shows a considerable improvement compared with the previous year, when 61 cases were notified. The disease has been of the very mild Sonne type. No deaths from this disease were recorded. Food Poisoning. A total of twenty-three cases were notified in 1961, one being admitted to hospital. All were single cases. There were no outbreaks of the disease, and the number of notifications was fewer than in 1960, when 74 cases were reported. The absence of outbreaks reflects creditably on the standards of food hygiene and food handling in the district. Salmonella was isolated in one case. No deaths from this disease were recorded. The following is a copy of the annual return forwarded to the Ministry of Health: Notifications (corrected): (1) First Quarter 1 Second Quarter 1 Third Quarter — Fourth Quarter 21 23 (2) Cases otherwise ascertained Nil (3 Symptomless Excreters Nil (4) Fatal Cases Nil (5) Particulars of outbreaks: No. of cases notified Nil No. of cases otherwise ascertained Nil Agent identified: Staphylococci Nil C1. Welchii Nil 56 (6) Single cases: Agent identified: Salmonella 1 Unknown 22 (7) Salmonella infections, not foodborne Nil Measles. One thousand, eight hundred and forty-seven cases were notified during the year, eleven of which were admitted to hospital. No deaths were recorded, and the illness was, generally speaking, mild in character with few complications. Meningococcal Infections. Only one case occurred in the area during 1961, and this was admitted to hospital. Pneumonia. Forty-three cases of pneumonia were notified in 1961, as against fourteen in 1960, two of these cases were admitted to hospital and the remainder home nursed. There were fifty deaths attributed to this disease. This latter figure includes people who are normally resident in the district, but who died outside the Urban District area. Scarlet Fever. Eighteen cases were recorded in 1961, one being removed to hospital and the remainder home nursed. Notifications of this disease dropped sharply when compared with the 112 cases which came to knowledge during 1960. No deaths from this disease were recorded and there were no "return" cases. Smallpox and Vaccination. No cases of smallpox occurred in the area, neither was it necessary to keep any contacts under surveillance during the year. The staff of the Public Health Department are vaccinated against smallpox from year to year, a precaution which was to prove valuable in the investigations during the early part of 1962, following the importation into this country in December, 1961, of cases of smallpox from Pakistan. Persons travelling to certain countries abroad must furnish themselves with International Certificates of Vaccination. These must be stamped in the Department and 457 were dealt with in 1961. The County Medical Officer informs me that a total of 1,101 residents in the Urban District received primary vaccination and 12 re-vaccination during the year. 57 Tuberculosis. The following is a copy of the recordings in the register at 31st December, 1961: — Respiratory Other Forms. Total No. of cases M. F. M. F. On register at 1st January, 1961 161 327 24 30 742 New cases notified during 1961 16 13 1 — 30 No of cases coming to Knowledge after death — — — — — Restored to Register — — — — — Inward Transfers 12 9 — — 21 389 349 25 30 793 Deletions, deaths, removals. recoveries, etc. 36 33 — — 69 353 316 25 30 724 Cases and Mortality, 1961. New cases notified or otherwise revealed. (Not including Inward Transfers*). Groups. Pulmonary. Non-Pulmonary. Deaths. Pulmonary. Non-Pulmonary. M. F. M. F. M. F M. F. Under 5 1 — — — — — — — 5-14 — — — — — — — — 15-24 — 4 — — — — — — 25-44 6 8 — — 1 — — — 45-64 6 1 1 — 4 — — — 65and over 3 — — — 4 — — — Age unknown — — — — — — — — 16 13 1 — 9 — — — *Inward Transfers 12 9 — — 28 22 1 — The number of new cases of tuberculosis notified during the year 30 and there were 3 deaths from this disease in 1961. The number of deaths directly due to the disease has thus remained at the very low level achieved last year. The figures illustrate the present tendency for the illness to affect males somewhat later in life than it does females, the male mortality also being higher in this age group. It has been suggested that this may be. at least in part, associated with smoking habits. 58 Chest Clinic. Dr. D. G. Madigan, Physician in charge, has kindly furnished the following details for the year 1961:— New cases attending the Chest Clinic for the first time:— Adults. Children. M. F. M. F. Pulmonary Tuberculosis 21 20 1 — Non-Pulmonary Tuberculosis 1 1 — — Non-Tuberculous 75 50 30 50 New Contacts examined during 1961 (not included in above figures): Negative: 193 Positive: 1 Number of patients who completed a course of hospital treatment during 1961:32. B.C.G. Vaccination: 131. Public Health (Prevention of Tuberculosis) Regulations, 1925. Section 172, Public Health Act, 1936. No action was taken by the Local Authority under these Regulations in 1961. Mass X-Ray. No general survey was undertaken in the area during the year under review. Typhoid and Paratyphoid Fever. No cases were notified in 1961. Whooping Cough. One hundred and twenty-two cases were notified during the year, as against thirty-nine in 1960. Only one case was admitted to hospital. No deaths from this disease were recorded. The County Medical Officer informs me that a total of 1,369 children, normally resident in the Urban District, were immunised against Whooping Cough in 1961. Other Infectious Diseases. In addition to those previously mentioned, notifications were received as under:— Erysipelas—6 cases, two of which were admitted to hospital. Puerperal Pyrexia—2 cases (both institutionally treated). SECTION G. REFUSE COLLECTION AND DISPOSAL. 60 SECTION G. REFUSE COLLECTION AND DISPOSAL. Mr. Crowe reports:— Regular weekly collections of household refuse were maintained throughout the year with only slight disturbance at Bank Holidays. Following the holidays, particularly Easter and Christmas, the work is very heavy. At these times, large accumulations of refuse await collection at practically all the premises when the men return to work. Every effort is made to speed the work of collection in order to revert to the normal day, and this is achieved by working overtime. The method employed in the collection of household refuse is known as 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 district from some 25,000 premises. A weekly collection of trade refuse is made from 287 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, four 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. Fifty workmen are employed on the work of collection and disposal. 61 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 year 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 Fordson Major Tractor ^uledozer being used for the levelling process and approximately 22,000 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 1961 show that the net cost per 1,000 population for collection and disposal of house refuse was £621, and the net cost per 1,000 premises for collection and disposal was £1,925. The Abstract of Accounts prepared by the Council's Treasurer for the year ended 31st March, 1961, showed that on a unit basis, the cost of house refuse collection and disposal was £1 16s. 3d. per Celling, per annum. APPENDIX. STATISTICAL TABLES. 64 STATISTICAL TABLES, 1961. TABLE I. Summary of Statistics. TABLE II. Causes of Death. TABLE III. Notifiable Infectious Diseases—Sex and Age Distribution. TABLE IV. Notifiable Infectious Diseases—Ward Distribution, Attack and Mortality Rates. TABLE V. Notifiable Infectious Diseases—Seasonal Incidence. TABLE VI. Summary of the work of the Public Health Inspectors. TABLE VII. Nuisances, Defects and Contraventions Abated. TABLE I. SUMMARY OF STATISTICS, 1961. Population (mid-year 1961) per Registrar General 80,080 Birth Rate (crude) 16.3 Death Rate (crude) 9.5 Maternal Mortality Rate Nil Infant Mortality Rate 12.2 Number of Births (live) 1,308 Number of Stillbirths 13 Number of Deaths 761 Number of Maternal Deaths Nil Number of Infant Deaths (under 1 year) 16 Number of Deaths from Infectious Diseases 3 Death Rates:— Respiratory Diseases (excluding Tuberculosis) 1.12 Tuberculosis 0.04 Cancer (all forms) 2.11 Cancer of the lung, bronchus 0.54 Infectious Diseases 0.04 Notifications of Infectious Diseases:— Diphtheria Nil Dysentery 7 Erysipelas 6 Food Poisoning 23 Measles 1,847 Poliomyelitis (paralytic) Nil Poliomyelitis (non-paralytic) Nil Puerperal Pyrexia 2 Pneumonia (all forms) 43 Scarlet Fever 18 Tuberculosis (new cases and including Inward Transfers) 50 Typhoid and Paratyphoid Fever Nil Whooping Cough 122 Number of visits made by Public Health Inspectors 6,771 65 TABLE II. CAUSES OF DEATH. 1957 1958 1959 1960 19 6 1 Total Male Female 1. Tuberculosis—Respiratory 3 3 3 2 3 — 3 2. Tuberculosis—Other 1 1 1 1 — — — 3. Syphilitic Diseases — 3 — 1 1 2 3 4. Diphtheria — — — — — — — 5 Whoolping Cough — — — — — — — 6. Meningococcal Infections — — — — — — — 7. Acute Poliomeylitis — 1 — — — — — 8. Measles 1 — 1 — — — — 9. Other infective and parasitic diseases — 2 2 1 — 3 3 10. Malignant neoplasm, stomach 12 24 16 29 9 5 14 11. Malignant nneoplasm, lung, bronchus 33 38 48 33 34 9 43 12. Malignant neoplasm, breast 16 23 14 13 — 16 16 13. Malignant neoplasm, uterus 7 7 5 6 — 13 13 14. other malignant and lymphatic neoplasms 68 66 89 78 48 35 83 l5 Leukaemia, Aleukaemia 4 6 6 6 5 — 5 16. Diabetes 2 4 3 1 3 5 8 17. Vascular lesions of nervous system 73 75 84 48 28 50 78 18. Coronary disease, angina 96 133 139 132 69 39 108 19. Hypertension with heart disease 16 17 20 11 6 10 16 20. Other heart disease 61 68 73 88 47 86 133 21. Other circulatory disease 38 35 32 42 21 26 47 22. Influenza 4 2 5 — 1 5 6 23. Pneumonia 52 83 65 71 26 24 50 24. Bronchitis 31 31 36 27 23 10 33 25. Other diseases of respiratory system 5 5 6 12 4 3 7 26. Ulcer of stomach or duodenum 6 7 8 7 2 1 3 27. Gastritis, enteritis, diarrhoea. 3 3 2 3 2 1 3 28. Nephritis and Nephrosis 7 6 3 2 — — — 29. Hyperplasia of Prostate 9 6 3 2 7 — 7 30. Pregnancy, childbirth, abortion 1 — — — — — — 31. Congenital malformations 7 9 10 7 4 1 5 32. Other difined and ill-defined diseases 56 60 55 58 23 27 50 33. Motor vehicle accidents 5 10 12 13 10 2 12 34. All other accidents 8 10 6 8 6 — 6 35. Suicide 8 9 3 9 4 2 6 36. Homicide and operations of war — — 1 1 — — — 628 747 751 712 386 375 761 66 TABLE ID. NOTIFIABLE INFECTIOUS DISEASES, 1961. 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 948 899 20 12 180 172 263 262 444 416 22 18 5 5 4 7 10 7 Whooping Cough 66 56 8 5 11 7 18 9 26 32 3 2 — — — — — 1 Scarlet Fever 12 6 — — 1 — 1 — 7 6 3 — — — — — — — Dysentery 5 2 — — — — — 1 2 — — — — — 3 1 — — Poliomyelitis (Paralytic) — — — — — — — — — — — — — — — — — — Poliomyelitis (Non-Paralytic) — — — — — — — — 1 — — — — — — — — — Meningococcal Infection 1 — — — — — — — — — — — — — — — — 1032 963 28 17 192 179 282 272 480 454 28 20 5 5 7 8 10 8 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 22 21 3 2 2 2 1 1 3 4 9 8 4 3 — 1 Erysipelas — 6 — — — — — — — 1 — 3 — 2 — — Food Poisoning 10 13 3 2 2 3 — — 3 7 2 1 — — — — Puerperal Pyrexia — 2 — — — — — — — 2 — — — — — — Ophthalmia Neonatorum — — — — — — — — — — — — — — — — Tuberculosis (Pulmonary) 16 13 1 — — — — 4 6 8 6 1 3 — — — Tuberculosis (Non-Pulmonary) 1 — — — — — — — — — 1 — — — — — 49 55 7 4 4 5 1 5 12 22 18 13 7 5 — 1 1081 1018 67 TABLE IV. NOTIFIABLE INFECTIOUS DISEASES, 1F61. Ward Distribution. Attack and Mortality Rates. Diseases Total WARDS Cases removed to Hospital Attack 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 1847 160 383 106 28 16 3 31 203 241 190 6 99 13 84 136 148 11 — — — Whooping Cough 122 1 17 7 2 6 1 2 1 16 34 1 6 — 2 17 9 1 — — — Scarlet Fever 18 — 6 1 — — — — — — 5 1 2 — 1 1 2 1 — — — Pneumonia 43 14 4 8 — — — 1 5 1 — 1 1 — 4 3 1 2 — — — Dysentery 7 — 3 — — 1 — 1 — — — 1 — — — 1 1 — — — Erysipelas 6 — 2 — — 1 — 2 — 1 — — — — — — — 2 — — — Food Poisoning 23 — 11 — — 7 — — 3 — — 1 _ — 1 — — 1 — — — Poliomyelitis (Paralytic) — — — — — — — — — — — — — — — — — — — — — Poliomyelitis (Non-Paralytic) — — — — — — — — — — — — — — — — — — — — — Puerperal Pyrexia 2 — — — — — — 2 — — — — — — — — — 2 — — — Tuberculosis (Pulmonary) 29 2 6 2 — — 2 1 3 1 4 — 1 — 2 1 4 9 — 9 — Tuberculosis (Non-Pulmonary) 1 — — — — — — — — — 1 — — — — — — 1 — — — Ophthalmia Neonatorum — — — — — — — — — — — — — — — — — — — — — Meningococcal Infection 1 — — 1 — — — — — 1 — — — — — — — 1 — — — Totals 2099 177 432 124 30 31 6 40 215 261 234 11 109 13 94 157 165 32 — 9 — † Based on 1,000 total births and not population. * Includes all forms of Pneumonia. 68 TABLE V. NOTIFIABLE INFECTIOUS DISEASES, 1961. Seasonal Incidence. Disease Jan. Feb. March Apr. May June July Aug. Sept. Oct. Nov. Dec. Total Measles 161 425 649 451 84 52 12 10 1 — 2 — 1847 Whooping Cough 16 17 28 14 13 6 5 7 13 1 1 1 122 Scarlet Fever 2 5 — 2 4 1 — 1 — — — 3 18 Pneumonia 4 18 1 3 2 — — 2 1 — 4 8 43 Dysentery — 2 3 1 — — — 1 — — — — 7 Erysipelas — — 1 2 — — — 1 — — 2 — 6 Poliomyelitis (Paralytic) — — — — — — — — — — — — — Poliomyelitis (Non-Paralytic) — — — — — — — — — — — — — Food Poisoning 1 — — — — 1 — — — 10 8 3 23 Meningococcal Infection — — 1 — — — — — — — — — 1 Puerperal Pyrexia — — — 1 — — — 1 — — — — 2 Ophthalmia Neonatorum — — — — — — — — — — — — — Totals 184 467 683 474 103 60 17 23 15 11 17 15 2069 69 TABLE VI. 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 1,217 65 Verminous conditions 11 6 Water Supply 104 7 Cesspools 106 6 Common Lodging Houses 23 — Drainage 1.325 61 Under Rent Act, 1957 .. 15 2 (2,801) (147) Infectious Diseases. Inquiry Visits 203 — Disinfection 9 — (212) (-) Food Premises Bakehouses 44 8 Bakers' Shops 10 3 Butchers 133 12 Dairies and Milkshops 33 1 Fishmongers and Poulterers .. 20 4 Fish Fryers 19 — Food preparing or manufacturing Premises 9 Greengrocers 91 10 Grocers 484 43 Ice Cream Premises 102 7 Restaurants, Hotels and Canteens 122 16 Street Vendors and Hawkers' Carts 51 4 Visits in connection with sampling 131 — Miscellaneous 368 — (1,617) (108) Factories. Factories with mechanical power 69 2 Factories without mechanical power.. — — Other premises classified as Factories 13 — Emission of smoke, grit, fumes and noise 307 1 (389) (3) Rodent Control. Miscellaneous premises 254 20 (254) (20) 70 Trade Premises. Shops (for Shops Act) 507 38 Piggeries 99 2 Caravan Sites 95 1 Hairdressers 53 1 Merchandise Marks Act 52 — Pet Animals Act 18 — (824) (42) Miscellaneous. Swimming Baths 8 — Suspected Food Poisoning 47 — Keeping of Animals 7 2 Schools 20 — Public Conveniences 38 — Rivers, Streams, etc. 21 — (141 ) (2) Unclassified 533 5 (533) (5) 6,771 327 71 TABLE VII. NUISANCES, DEFECTS, CONTRAVENTIONS, ETC., ABATED OR REMEDIED IN 1961. Drainage. Drains repaired 3 Sink waste pipes trapped, renewed or repaired 2 Drains cleansed 64 Overflowing cesspools emptied 7 Water closets repaired or Cesspools abolished 78 reconstructed 3 Wash basins renewed 1 Water closet seats repaired or renewed 1 Flushing cisterns repaired or renewed 5 Dampness. Roofs made watertight 8 Rainwater downpipes repaired or renewed 2 Walls made waterproof 15 Rainwater gutter repaired or renewed 5 Flashings repaired or renewed 1 Water Supply. Main water supply provided 2 Ball valves repaired or renewed 2 Pipes repaired or renewed 4 Domestic boilers repaired 1 Storage tanks repaired or renewed 3 General Items. Wall plaster repaired 2 Staircase repaired 1 Ceiling plaster repaired 4 Fire surrounds and grates repaired or renewed 1 Floors repaired 3 Rooms cleansed or decorated 57 Yard paving and drainage repaired 1 Windows and doors repaired 5 Glazing repaired 1 Dustbins provided 20 Miscellaneous items 12 Nuisance from animals abated 1