PEN 19 PENGE URBAN DISTRICT COUNCIL. ANNUAL REPORTS of THE MEDICAL OFFICER of HEALTH and tho CHIEF SANITARY INSPECTOR for 1941. Chairman:- Mr.Emery, J.P. Vice-Chairman: - Mr.F.-x. Smith. Acting Vice-chairman - - Mr.G.J.Gully, J.P. PUBLIC HEALTH COMMITTEE Chairman:- Mr.0.E.Prince. Mr.H.A1lder. Mr.F.W.Foreman. Mr.R.C.S.Barnett, J.P. Mr.J.B.Geale, J.P. Mr.G.R.Deal. Mr.H.S.George. Mr.J.F.D.Dixon. Mr.F.P Hodes, J.P. Mr.A.Emery, J.P. Mr.R.H.Jarvis. Captain F.Theobald. Co-opted Members of Maternity and Child r~elf_are Secjt_ion^- Mrs.M.Barson, Mrs,F.Dixon, Mrs.E.Jarvis, Miss Fannie Moore and Mrs.A.Theobald. Representatives on the Joint Maternity Home Committee- Mr.R.C.S.Barnett, J.P., Mr.J.B.Geale, t J.P., Mr.F.P.Hodes, J.P., Dr.F.M.Penny, Mr.O.E.Prince and Mrs".A.Theobald. PUBLIC HEALTH DEPARTMENT ST;-FF. X Medical Officer of Health: R.Filkinson, M.D.(Brux.), M.R.C.S.(Eng.), L.R.C.P.(Lond.J. (on sick leave until he retired 31.3.41.). X Temporary Medical Officer _o_f _Hea_lth: B. E. Hawkins , M.R. C. S. ("Eng. J, ~L. R. C . P .TLond.). Chief Sanitary Inspector: R.T.Pearce, "Cert." S. I.E. B. (Lond. ). Cert.Insp. of Food, S. I.E. B. (Lond.). Sanitary Inspec tor and Shops Act_Ins pector• E. G. Thomas, Cert .R. S. I. Cert.Insp. of Food, R.S.I. Health Visitor: Miss V.M.Evans, S.R.N., S.C.M., H.V's Cert. (Until 7.8.41) Miss D.Nicholson, S.R.N., S.C.M., H.V's Cert. (From 18.8.41). Clerks. X Miss A.C-.liitchel 1. Miss J.M.Garrett. (Temporary). X Part-time Officer. Town Hal 1, Anerley, S„E,20. June, 1942. To the' Chairman and Members of the Urban. District Council of Penge. Mr .'Chairman and Gentlemen, I beg to present, an abridged Annual Report on the health of the district for the year ending the 31st December, 1941. It • is compiled in accordance with Circiilar 2604 (1942) of the Ministry of Health and does not include matters connected with the Civil Defence Services. • On the grounds of National Security, the estimated population of the district is not to be published this year and in consequence the number of births, deaths, etc. are not given, the information being restricted to the publication of birth and other rates. ? , STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (acres.) 77 0 Population (Census, 1931) 27,771 Rateable value £205,436 Sum represented by Id. rate £677 The Manager of the Employment Exchange informs me that there were approximately 51 men and 28 women unemployed in the Penq-e" Urban District at the end of the year, compared with 43 men and 104 women in 1940. The Out-door relief, given during the year amounted to £9,420 of which £464 was to able-bodied unemployed and .their families and the balance to the unemployable from age or other causes. This compares with an amount of £15,481 of which £936 was to able-bodied unemployed and ttieir .families in the year 1940. VITAL .STATISTICS Birth rate per 1,000 of estimated Civilian population, 17.3 Still-birth rate per 1,000 total (live and still) births, 39.7 Crude Death Rate per 1,000 of the estimated Civilian population, 18.4 Deaths from Puerperal causes - Nil. Death Rate of Infants under one year of age:- All infants, per 1,000 live births 70.4 Legitimate infants, per 1,000 legitimate live births 68.3 Illegitimate infants,.per 1,000 illegitimate live births 100.0 Births. The live birth rate per 1,000. civilian population was 17.3, compared with 18.3 for 1940. St ill-births. The" rate per 1,000 total births was 39.7, compared with 21.9 for 1940. 1 Deaths. The crude death rate for the year equalled 18.4 per 1,000 civilian population, compared with 17,8 for 1940. The increase in the Death Rate is due partly to the allocation to this district of the deaths of a number of elderly men in a local institution whose home addresses were not known. The areal comparability factor has not been issued by the Registrar-General and the adjusted death rate cannot be given Assuming that the factor given in 194 0 (0.90) would have been the same for 1941, the adjusted death rate would be 16,5 per 1,000 compared with 16.0 per 1,000 for 1940. Of the total deaths, 58,9% were of persons 65 years of age and over. Cancer. The Cancer Death Rate per 1,000 civilian population was 2,69,compared with 1,87 in 1940, Maternal Mortality. There was no maternal death, but one woman died in consequence of septicaemia following abortion. Infant lie Morta1ity. The Death Rate of infants under one year of age was 70.4 per 1,000 births compared with a rate of 62,1 for 1940, Five deaths occurred amongst infants who had attended the Child Welfare Centre; and 47.6% of the total infant deaths occurred within the first week of life, due in the main to premature birth. Comparative Vital Statistics. The following- table shows the comparative figures for 1941 Rate per 1,000 Civilian • Population. Death rate per 1,000 Civilian" Population. Deaths under 1 year per 1,000 births. LiveBirths StillBirths Penge 17,3 0,71 18.4 70 England and Wales 14,2 0,51 12.9 59 126 County Boroughs and Great Towns including London 14.7 0.58 14.9 71 148 Smaller Towns (resident populations, 25,000 to 50,000 at Census, 1931) 16.4 0,60 13.0 . 56 London 8,9 0.33 16.3 68 GENERAL PROVISION OF HEAE.TH SERVICES FOR THE AREA. Ambulance _Facilities . ""During" the year the Council's motor ambulance responded to 458 calls; 217 for private removals and 241 for accidents and sudden' illness. Maternity and Child Welfare Centre. The" Maternity and Child Welfare Centre was held, as before, at the Council's School Clinic, 17, Oakfield Road, on Tuesday, Wednesday and Friday afternoons, and the Ante-Natal and Post-Natal Clinic on Wednesday mornings. 2. Medical Offioer 's _Cojisul_ta.tions . Infant 1,17 0 Nursing Mothers 265 Ante-Natal 465 Post-Natal 24 1,924. Total attendance of children at the Centre. 4,988 Individual children v/ho attended 617 Average weekly attendance of children 95.9 Total attendance of nursing mothers 977 Individual nursing mothers who attended 181 Average weekly attendance of nursing mothers 18.8 Total attendance of expectant mothers 465 Individual expectant mothers who attended 193 Average weekly attendance of expectant mothers 11.6 Total attendance of post-natal mothers 24 Average weekly attendance of post-natal mothers 0.6 Dried milk and other foods for mothers and children are sold at cost price and during 1941 the receipts totalled M54. HOSPITALS. Arrangements were made early in 1942 for the treatment of cases of Typhus Fever in the Croydon Borough Isolation Hospital. Cases admitted to the County Hospital, Farnborough, Kent, from this district numbered 410 compared with 456 during the year 1940. Maternity Home. During the year 79 Penge cases were admitted to the Penge and Beckenham Joint Maternity Home, Stone Park Avenue, Beckenham. The following table gives the number- of mothers admitted annually for the last five years:- Year Total cases admitted. Penge cases. Beckenham cases. Other cases 1937 319 81 238 _ 1938 333 91 24 2 _ 1939 246 48 198 _ 1940 405 102 303 _ 1941 310 79 228 3 The average period spent in the home during the year by each patient was 14 days. Health Visiting. One Health Visitor and a part-time nurse wore employed and the following shows the number of visits paid:- First visits to infants under one year 295 Subsequent visits to infants under one year 883 Visits to children between the ages of 1 and 5 years 2,307 Visits to expectant mothers 213 Visits to post-natal mothers 25 Visits to tuberculosis cases 267 Visits to foster children 42 Visits re diphtheria immunisation 125 Miscellaneous visits 151 4,308 3 Child Life Protection. Number of foster parents on the Register- (a) at the beginning of the year 6 (b) at the end of the year 3 Number of foster children on the Register (a) at the beginning of the year 6 (b) at the end di the year 5 (c) who died during the year 1 No legal proceedings were taken. Dental Treatment, Where necessary, expectant and nursing mothers and children are referred to the Dental Surgeon for treatment, and during the year this was done in 66 cases. HOUSING. There were no new houses or flats erected or houses converted into flats during the year. 1. Inspection of dwel1inghouses during the year: (1) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 337 (b) Number'of inspections made for the purpose. 370 (2) (a) Number of dwelling houses (included under head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, I92o and 1932 1 (b) Number of inspections made for the purpose. 1 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation,, Nil (4) Number of dwelling ho uses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 308 2. Remedy of Defects without service of formal notices: Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their officers 290 3. Action under Statutory Powers (a) Proceedings under Section 9 of Housing Act, 1936. l (1) Number of dwelling houses in respect of which notices were served requiring repairs l (2) Number of dwellinghousos rendered fit after service of formal notices? (a By Owners (b) By Local Authority in default of Owners 1 (b) Proceedings "under Public Health .Acts, (1) Number of dwellinghouses in respect of which notices were served requiring defects to be .remedied 17 (2) Number of dwellinghouses in which defects were remedied after service of formal notices:- (a) By Owners 16 (b) By Local Authority in default of Owners 1 /j. 4. Housing Act, 1956 - Overcrowding; Number of cases of overcrowding relieved during the 12 year PREVALENCE OF, AND CONTROL OVER, INFECTIOUS ' AND OTHER DISEASES, Diphtheria , Fourteen cases were notified compared' with 7 year, the latter being the lowest number recorded Penge became an Urban District. the previous in one year since Hospital treatment' was provided in all cases and there wore no ''return1' cases. There was one death from diphtheria during the year. Diphtheria Immunisation. . ; A Clinic was opened at the Maternity and Child Welfare Centre on the 17th March, 1941 and held weekly. The following table gives the attendances, etc. up to the end of the year. First inoculations Second inosculations Schick tests Children who received complete course of immunisation Under 5 years. 260 214 63 214 Over 5 years, 7 56 703 339 703 Scarlet Fever. There were 11 cases of Scarlet Fever notified (as against 13 in 1940) and 9 of these were removed to hospital. This was the lowest number of cases recorded in one year. The disease generally was of a mild type and there were no deaths. There were no "return" cases. Typhold Fever. Two Penge residents were removed to Famborough Hospital, Kent, and subsequently notified as suffering from Typhoid Fever. The adjoining district of Beckenham had a few cases at the same time. In all but one of the cases, fresh fruit and salads had been ..purchased from a local greengrocer. Specimens of urine and excreta were obtained from the people employed in the greengrocery business and a young assistant was found to be a carrier of the Typhoid Bacillus He was therefore suspended from work until subsequent tests proved negative and no more cases were reported. An isolated case o: source of infection was Paratyphoid Fever not discovered. was notified but the Disinfection Rooms fumigated 90 Mattresses disinfected 711 Blankets disinfected 2739 Pillows disinfected 1200 Miscellaneous articles disinfected 1005 5. 7-?acteriolop;ical Work. Bacillus found„ Bacillus not found. Total. Diphtheria. County Laboratory. 5 30 35 Diphtheria. Clinical Research Assoc iation. – 4 4 Tuberculosis. Couhty Laboratory. 12 46 58 Typhoid Fever. Government Laboratory. 1 57 58 Paratyphoid Fever, County Laboratory.. 1 1 Haemolytic streptococcus. County Laboratory. – 2 2 Meningococcus. County Laboratory. – 5 5 19 144 163 Four samples of water from dwellinghouses in the district were analysed during the year and in each case the water was satisfactory. A sample of water from a disused well was found "to be not satisfactory. NOTIFIABLE DISEASES (other than Tuberculosis) during the year 1941. Disease Total cases notified. Cases admitted to Hospitals. Total deaths. Scarlet Fever 11 9 – Diphtheria. 14 14 1 Puerperal Pyrexia 3 1 1 Paratyphoid Fever 1 1 – Pneumonia 9 4 15 (all foms) Erysipelas. 3 – – Cerebro-spinal fever. 2 2 1 Measles 237 8 1 Vhooping Cough 102 2 3 Ophthalmia Neonatorum. 1 1 — Acut.e Poliomyelitis 2 1 "— Prevention of Blindness No action was taken under Section 176, Public Health Act, 1936. Tuberculosis. No action was necessary under the Public Health (Prevention of Tuberculosis) Regulations, 1925 or Section 172, Public Health Act, 1936. Total cases admitted Total Primary Cases to Sanatoria and Total notified Hospitals Deaths. Pulmonary.. (Males ) 10 12 6 11 (Females) 11 11 6 Totals 21 23 12 Non-Pulmonary (Males) - 1 11 (Females) 1 2 1 Totals l 2 2 Five deaths from tuberculosis were of cases not notified, four of whom died in hospitals outside the district. 6 New Tuberculosis Cases_ and Mortality during 1941. Age Period X New Cases Deaths Respiratory Nonrespiratory. Respiratory Nonrespafcory M F. M F M F M F 0-1 - - - - - - - — 1-5 - - - - - - - 515 1 1 1 1 - - - - 15 -35 4 4 - - I 1 l 1 25 - 35 3 6 - — 1 1 - - 35 - 4 5 3 2 -~~ - 1 2 - - 45-55 2 1 - - 1 - - 55-65 4 2 - - 2 1 - - 65 and upwards 1 1 - - - 1 - - Totals 18 17 1 1 6 6 1 1 X Cases previously notified in other districts and transferred to Penge and those restored to the Register are included in these figures. There were 1-55 cases of tuberculosis on the register at the end of the year, compared with 175 in. 1940. Pulmonary Non-pulmonary.. Ma 1 e 63 18 81 Female 62 12 74 Total 125 50 155 I am, Mr.Chairman and Gentlemen, Your obedient Servant, B.E.HAWKINS . Temporary Medical Officer of Health. Notifiable Diseases (other than Tuberculosis) during the year 1941. Cases notified. At ages -.Years. Cases admit ted to Isolation Hospitals. At all ages „ Under 1 1 to 2 2 to 3 3 to 4 4 to 5 5 to 10 10 to 15 15 to 20 20 to 35 35 to 45 45 to 65 6 5 and upwards Scarlet Fever 11 1 o 1 1 5 - - 1 - - - 9 Diphtheria 14 - 1 — 4 2 5 2 — _ — — - 14 Puerperal Pyrexia 3 - - - - - - - 1 2 - - - 1 Pneunonia 9 - 1 1 - - 1 1 - - 2 3 – Erysipelas 3 - - - - - — - - - - 2 1 - Cerebro-spinal Fever 2 - - - 1 - 1 - — _ - 2 Measles 237 12 25 20 27 23 124 4 1 1 - - — 1 Yihooping Cough 102 12 12 16 14 12 34 1 -- 1 - - - 2 Acute Poliomyelitis 2 - 1 - - 1 - - - - - – Paratyphoid Fever 1 - - - - - - - - 1 - - - - 1 Ophthalmia Neonatorum 1 1 - - - - - ~ - , - - - – Totals 335 26 . 42 38 45 39 170 7 4 6 "- 4 4 30 Deaths of notified cases - Pneumonia, 2 aged 2-k years and 73 years respectively. whooping Cough, 3 aged years, 2 years and 14 months respectively. Diphtheria, 1 aged 3 years. Town Hall, Anerley, S.F.20. June, 1942 To The Chairman and Members of the Urban District Council of Penge, Mr.Chairman and Gentlemen, I have the honour to place before you the Annual Report of the work of the Sanitary Inspectors (excluding that in connection with Civil Defence) for the year ending the 31st December, 1941. In addition to verbal intimation of defects found in premises, 232 written intimation notices and 17 Statutory Notices were served under the Public Health Act, 1936 and 1 Sanatory Notice under. Housing Act. 1936. Two hundred and fifteen Intimation Notices and 17 Statutory Notices were complied with. The Council did the work required by 9 notices served under Section 24 of the Public Health Act, 1936, respecting 27 premises and one notice served under Section 9, Housing Act, 1936. Legal proceedings were taken for non-compliance with notices served regarding nuisances caused by housing defects, with the following results 1. Orders made to comply with Notice within 4 days and to prohibit a recurrence of the nuisance. Defendant fined £5.0.0. and ordered to pay £5,5,0, costs. 2. Orders made to comply with Notice within 4 days and to prohibit a recurrence of the nuisance. Defendant fined £5.0.0. and ordered to pay £5.5.0. costs. The drainage systems of 50 houses were partially relaid and 54 cleared. The shortage of labour and materials necessitated attention being given only to the more serious items of disrepair in houses. PREMISES OR OCCUPATIONS WHICH CAN CONTROLLED BY BYELA OR REGULATIONS. No, in District. Common Lodging Houses 7 5 Houses Let in Lodgings 50 Dairies 8 Stables Butchers' Shops 23 No . of vis its. 57 60 31 53 199 Notices served. 2 5 3 1 Not ices complied with. 2 5 3 1 SUMMARY OF INSPECTIONS AND JTESITS. The following summary shows "the number "of visits and inspections made'- Inspections through complaints received 297 Infectious diseases,, ... ... .„ ... ... ... 121 Transferable deaths.. ... ... , 90 Overcrowding and measurement of rooms,. ... ... ... 45 Houses let-in-lodgings and Common Lodging Houses... ... 97 Bakehouses ... ... ... ... ... ... ... 40 D airies.. ... ... i.o ... ... ... ... 1 Milkshops ... ... .. . ... ... 34 Meat Shops , .. , . 199 9 „ Milk sampling 22 Pish frying shops 16 Other Pood Shops, Stores and Stalls 281 Urinals 80 Stables 53 Rats and Mice (Destruction) Act 425 Factories 157 Shops Acts 57 Air Raid Shelters 69 Inspections and re-inspections of work in hand 1152 Miscellaneous visits 35 Drain tests 78 Civil Defence Services 370 SUMMARY OF WORK EXTOTED DURING THE YEAR. pater Supply:- '""Water supply re-instated to houses 14 ""ater service pipes repaired 37 Cisterns cleansed, covered or covers repaired 4 Water Closets:- New pans ami "traps fixed 17 Flushing apparatus renewed or repaired 31 Foul pans and traps cleansed 10 Connections of flushing pipes to pans made good Seats and doors, provided or repaired 4 Ventilation provided or improved 1 Flooring or paving repaired 1 Drainage;- Drains tested with smoke, water or colour 78 Drains cleared 54 Houses with drains partially relied 50 Inspection chambers constructed or improved 15 Soil and ventilation pipes fixed or repaired Sinks, lavatory basins and baths provided 3 Waste pipes renewed or provided 6 Waste pipes repaired or trapped Waste pipes cleared 4 Fresh-air-inlets provided or repaired 4 Rainwater pipes disconnected from drain 1 Dampness:- Houses with - Walls re-pointed or rendered 3 Dampness in. ground floor rooms remedied 10 Roof s repaired 47 Gutters repaired or renewed Rain water pipes repaired or renewed 14 Ventilation under floors provided or improved 5 Water service pipes repaired 37 Window sills repaired Cleanliness:- Dirty rooms, etc. cleansed 237 Verminous rooms fumigated 37 Miscellaneous:- Houses with defective floors, joists, etc. repaired 21 Houses with defective plaster repaired 47 Houses with new sash lines provided to windows 5 Houses with window frames, etc. repaired Houses with yards -or forecourts paved or repaired Houses with scullery paving repaired 3 Houses with air bricks renewed 10 Houses with stairs repaired 3 Houses with fireplace jambs and mantels repaired 6 Kitchen stoves repaired or renewed 6 10. Miscellaneous (contd):- Scullery coppers repaired or renewed 2 Other stoves repaired or renewed 6 Doors repaired or renewed 5 New dustbins provided 10 Premises with miscellaneous defects repaired, etc. 11 Overcrowding abated 12 Animals removed 6 Accumulations removed 19 INSPECTION AND SUPERVISION OF F00D. At the end of the year there were 8 premises registered as dairies. In addition, 33 persons were registered to sell milk in sealed containers only. The analysis of 22 informal. samples of milk obtained during the year, all of which were genuine, show the following satisfactory average;- Pat 3.76% Solids, not fats 8.90% The following licenses were issued under the Milk (Special Designations) Orders Dealers' Licenses:- Tuberculin tested milk 2 Pasteurised milk 3 Supplementary Licenses:- Tuberculin tested milk 2 Pasteurised milk 3 The following shows the amount of food surrendered and condemned from shops and stalls:- Beef 3046 lbs. Mutton 17 lbs . Sausages 26 lbs. Sweat breads 185 lbs. Tinned Meat 11 tins. Tinned Milk 11 tins. Tinned Peas 2 tins. Tinned Beans 4 tins. Tinned Paste 2 tins. Bacon 7 lbs. Jam 14 lbs. Cheese 17 lbs. Rabbits 6 02 lbs. Eggs 4619 Total weight 4542 lbs. In addition, various articles of food weighing approximately 3 cwts. 0 qtrs. 4 lbs, were condemned as a result of enemy action. The total weight of all food condemned was 2 tons. 3 cwts. 2 qtrs. 10 lbs. Periodical visits were made to premises and stalls where foods are prepared, stored or exposed for sale and with a few exceptions, these were found to be kept in a satisfactory condition. Adulteration, etc. The Kent County Council's Inspector took 73 samples of various foods during the year and all were found to be genuine. Your Inspectors obtained 22 informal samples of milk, all being genuine. Factories Act, 1957. Visits paid to factories total 157 and in addition to verbal intimations regarding small defects, 3 written notices were served and complied with. Rats and Mice (Destruction) Act, 1919, Complaints were received from various parts of the district and investigated, 425 visits being paid in this connection. Poisons were supplied, traps set and lent and rat runs gassed. Poison baits wore also laid in the sewers from time to time, and when considered necessary, the drains of premises were tested with smoke and any defects found made good. I am, Mr.Chairman and Gentlemen, Your obedient Servant, R. T . PEARCE. Chief Sanitary Inspector, 12.