PEN 20 PENGE URBAN DISTRICT COUNCIL. ANNUAL REPORTS of THE MEDICAL OFFICER OF HEALTH and the CHIEF SANITARY IMS HECTOR for 1942. Chairman:- MrCA.Emery,J.P. Vice-Chairman:- Mr-G.J.Gully,J.P. PUBLIC HEALTH COMMITTEE. Chairman:- Mr00.E.Prince. Mr.H.Allder. Mr .F.W.Foreman. Mr.R.C.S.Barnett, J.P. Mr.J.B.Geale, J.P. Mr.G.R.Deal. Mr.H.E.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 Maternlty and Child Welfare Section:- 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, J.P., Mr.F.P.Hodes, J.P., Dr,W.M.Penny, Mr,O.E,Prince and Mrs.A.Theobald. PUBLIC HEALTH DEPARTMENT. STAFF. x temporary Medical Officer of Health: B. E.Hawkins, M.R. C. S. (Eng.L.R. C. P. (Lond. ). Chief Sanitary Inspector: R.T.Pearce, Cert .3. I.E. B. (Lond. ). Cert.Insp. of Food, S. I.E.B. (Lond.). Sanitary Inspector and Shops Act Inspector: E.G. Thomas, Cert.R. S. I. Cert2Insp. of Food, R.S.I. Health Visitors: Miss D.Nicholson, S.R.N. , S.C.M., H.V's Cert. T.A. Cert. Miss E. P.Eldridge, S.R.N., S.C.M., H.V's Cert. (From 1.6,42.) X Miss A.G.Mitchell. Miss J.M.Garrett. (Temporary). X Part-time Officer. Town Hall, Anerley, S.E.20. July, 1943, 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, 1942. It is compiled in accordance with Circular 2773 (1943) of the Ministry of Health and does not include matters connected with the Civil Defence Services. On the grounds of National Security, the population of the district estimated by the Registrar-General is not to be published this year and in consequence the number of births, deaths, etc.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) 770 Population (Census, 1931) 27,771 Rateable value £205,378 Sum represented by Id. rate. £655 The Manager of the Employment Exchange informs me that there were approximately 21 men and 6 women unemployed in the Penge Urban District at the end of the year, compared with 51 men and 28 women in 1941. The Out-door relief given during the year amounted to £9,405 of which £500 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 £9,420 of which £464 was to able-bodied unemployed and their families in the year 1941. VITAL STATISTICS Birth rate per 1,000 of estimated Civilian population, 20.4 Still-birth rate per 1,000 total (live and still) births, 13.3 Crude Death rate per 1,000 of the estimated Civilian population, 14.5 Deaths from Puerperal causes-: Rate per 1,000 total (live and still) births. Puerperal sepsis Nil Other maternal causes. 2.65 Death Rate of Infants under one year of age:- All infants, per 1,000 live births 53,9 Legitimate infants, per 1,000 legitimate live births 52,1 Illegitimate infants, per 1,000 illegitimate live births76,9 Births. The live birth rate per 1,000 civilian population was 20.4, compared with 17.3 for 1941. Sti11-blrths. The rate per 1,000 total births was 13.3, compared with 39.7 for 1941. 1. Deaths. The orude death rate for the year equalled 14.5 per 1.000 civilian population compared with 19,4 for 1941. Of the total deaths, 58.7 were of persons 65 years of age and over, compared with 58.9 the previous year. Cancers. The Cancer Death Rate per 1,000 civilian population was 2,42 compared with 2,69 in 1941. Maternal Mortality. The rate for The year per 1,000 live and still births was 2.65. The average maternal mortality rates per 1,000 total births for the last ten years are as follows England and Wales 3.15. Penge 2.39. Infantile Mortality. The Death Rate of Infants under one year of age was 53,9 per 1-000 births compared with a rate of 70.4 for 1941., Seven deaths occurred amongst infants who had attended the Child Welfare Centre. Comparative Vital Statistics. The following table shows the comparative figures for 1942. Rate per l,000 Civilian Population Death rate per 1,000 Civilian Population. Deaths under 1 year per 1,000 live births. LiveBirths Still- Births. Penge 20.4 0.27 14.5 54 England and Wales 15.8 0.54 11.6 49 126 County Boroughs and Great Towns including London 17.3 0.66 13.3 59 148 Smaller Towns (resident populations, 25,000 to 50,000 at Census, 1931) 18.4 0.62 12.1 46 London 14.0 0.48 13.9 60 GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. Ambulance Facilities, During the year the Council's motor ambulance responded to 752 calls; 448 for private removals and 304 for accidents and sudden illness. Maternity and Child Welfare Cent re,, 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. The Medical Officer now attends the Clinics on Tuesday and Wednesday afternoons and Wednesday mornings. His attendance at the Tuesday afternoon Clinic commenced on the 4th/ August., 1942 and an additional session of the Ante-Natal and PostNatal Clinic commenced on the 3rd June, 1942. There was a marked increase in the attendances at the Centre during the year, and the figures for 1941 and 1942 are as follows 2. Medical Officer's Consultations. 1941 1942 Infants 1,170 1,379 Nursing Mothers 265 361 Ante-Natal 465 730 Post-Natal 24 1,924 109 2,579 Health Visitors' Consultations. Children 6,394 Weighing of children 5,708 Nursing Mothers 1,616 Expectant Mothers 441 Test feeds 116 Scabies 133 Total attendance of children at the Centre 4,988 6.394 Individual children who attended 617 783 Average weekly attendance of children 95,9 122.9 Total attendance of Nursing Mothers 977 1.616 Individual Nursing Mothers who attended 181 256 Average weekly attendance of Nursing Mothers 18.8 31.0 Total attendance of Expectant Mothers 465 730 Individual Expectant Mothers who attended 193 255 Average weekly attendance of Expectant Mothers 11.6 14.0 Total attendance of Post-Natal Mothers 24 109 Individual Fost-Natal Mothers who attended - 99 Average weekly attendance of Post-Natal Mothers 0.6 2.1 Dried milk and other foods for mothers and children are sold at cost price and during 1942 the receipts totalled £546. Day Nursery. On the 24th August, 1942, a War-time Day Nursery was opened *9 218, Anerley Road, with accommodation for 50 children between the ages of 0 and 5 years. The attendances up to the 31st December, 1942, were as follows:- Total attendances. Average daily attendances. 0-2 years 1659 15 2-5 years 3182 29 Totals 4841 44 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, Parnborough, Kent, from this district number 236 compared with 410 during the year 1941, 'Maternity Home. During the year 119 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 admit ted. Penge cases. Beckenham cases. Other cases. 1938 333 91 242 1939 246 48 198 mm 1940 405 102 303 - 1941 310 79 228 3 1942 570 119 447 4 3. The average period spent in the home during the year by each pal lent was 14,3 days. Maternity cases sent to the County Hospital, Farnborough, Kent* through the Council's Ante-Natal Clinic totalled 26, Health Visiting, One Health Visitor and a part-time nurse were employed up to the 31st May and from then to the end of the year, two Health Visitors, The following shows the number of visits paid:- First visits to infants under one year 369 Subsequent visits to infants under one year 1,471 Visits to children between the ages of 1 and 5 years 2,079 Visits to expectant mothers 383 Visits to Post-Natal mothers 113 Visits to Tuberculosis cases 314 Visits to foster children 61 Visits re Diphtheria Immunisation 153 Visits re Scabies 79 Miscellaneous visits 232 5,247 Child Life Protection. dumber of foster parents on the Register: (a) at the beginning of the year 3 (b) at the end of the year 5 Number of foster children on the Register: (a) at the beginning of the year 5 (b) at the end of the year 6 (c) who died during the year- 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 85 cases. HOUSING. There were no new houses or flats erected or houses Converter into flats during the year, 1, Inspection of dwellinghouses during the year: (1) (a) Total number of dwellinghouses inspected for housing defects (under Public Health or Housing Acts) 468 (b) Number of inspections made for the purpose 502 (2) (a) Number of dwellinghouses (included under subhead (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 Nil (3) Number of dwellinghouses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (4) Number of dwellinghouses (exclusive of those referred to under the preceding sub-head) found not to be in all respeots reasonably fit for human habitation 431 4. 2. Remedy of Defects without service of formal notices: Number of defective dwellinghouses rendered fit in consequence of informal action by the Local Authority or their officers 418 3. Action under Statutory Powers: (a) Proceedings under Section 9 of Housing Act, 1936. Nil (b) Proceedings under Public Health Acts. (1) Number of dwellinghouses in respect of which notices were served requiring defects to be remedied 13 (2) Number of dwellinghouses in which defects were remedied after service of formal notices (a) by Owners 8 (b) by Local Authority in default of Owners 5 4. Housing Act , 1936 - Overcrowding; Number of cases of overcrowding relieved during the year 4 PREVALENCE OP, and CONTROL OVER, INFECTIOUS AND OTHER DISEASES. Diphtheria. Two cases were notified (compared with 14 the previous year), this being the lowest number recorded in one year since Penge became an Urban District. Both were over school age. They received hospital treatment and recovered. There were no "return" cases. Diphtheria Immunisation. A Clinic was opened at the Maternity and Child Welfare Centre on the 17th March, 1941, The following table gives the attendance, etc..during the year 1942. Under 5 years. Over 5 years. First Inoculations 347 304 Second Inoculations 323 220 Schick Tests 235 372 Children who received complete course of Immunisation 323 220 Scarlet Fever. .There were 28 cases of Scarlet Fever notified (as against 11 in 1941) and 23 of these were removed to hospital. The disease generally was of a mild type. There were no deaths and no "return" cases. Scabies. There was an increase in the number of cases of scabies, Pat'ients (other than school children) who attended at the Maternity and Child Welfare Centre for treatment numbered 212 and they received 859 treatments, Information regarding school children will be found in the School Medical Officer's report. 5. Disinfection. Rooms fumigated 99 Mattresses disinfected 449 Blankets disinfected 962 Pillows disinfected 534 Miscellaneous articles disinfected 753 Bacteriological Work. Bacillus found. Bacillus not found. Diphtheria. County Laboratory. - 9 Diphtheria. Clinical Research Association. - 5 Tuberculosis. County Laboratory. 8 *? Haemolytlc County Laboratory, streptococcus. 1 ? On the grounds of economy, copies of the reports on specimens sent to the County Laboratory which prove to be negative are not forwarded to local medical officers of health. Pour samples of water from dwellinghouses in the district were analysed during the year and in each case the water was satisfactory. NOTIFIABLE DISEASES (other than Tuberculosis) during the year 1942. Disease. Total cases notified. Cases admitted to Hospitals. Total deaths. Scarlet Fever 28 23 - Diphtheria 2 2 - Puerperal Pyrexia 1 - - Pneumonia 6 - 11 (all forms) Erysipelas 4 - - Dysentery (Sonne) 1 1 - Measles 110 - - Whooping Cough 12 1 - Ophthalmia Neonatorum 1 - - Prevention of Blindness. No action was taken under Section 176, Public Health Act, 193Q# Tuberculosis. No action was necessary under the Public Health (Prevention of Tuberculosis) Regulations, 1925 or Section 172, Public Health Act, 1936, Total Primary cases notified. Total cases admitted to Sanatoria and Hos pitals. Total Deaths. Pulmonary (Males) 14 14 7 11 (Females) __7 8 _5 Totals 21 22 12 Non-Pulmonary (Males) 4 1 1 (Females ) 3 4 2 Totals 7 5 3 Five of the deaths from tuberculosis were of cases not notified, four of whom died in hospitals outside the district. 6. New Tuberculosis Cases and Mortality during 1942. Age Period X New Cases Deaths Pulmonary . Non Pulmonary. Pulmonary Non Pulmonary M F M F M F M F 0—1 - - - - - - - - 1-5 1 - - 3 - - - 2 5-15 3 1 3 1 - - - - 15-25 4 5 1 - - 2 1 - 25-35 3 4 1 - 1 1 - - 35 - 45 5 3 - 1 3 1 - - 45 — 55 2 2 - 1 - - - - 55 - 65 4 - - - 2 - - - 65 and upwards 1 - 1 - 1 - - - Totals 23 15 6 6 7 5 1 2 X Cases previously notified An other districts and transferred to Penge and those restored to the Register are included in these figures. There were 161 cases of tuberculosis on the register at tha end of the year, compared with 155 in 1941. Male Female Total Pulmonary 67 60 127 Non-pulmonary 21 13 34 88 73 161 I am, Mr.Chairman .and Gentlemen, Your obedient Servant, B.E.HAWKINS. Medical Officer of Health. ?. Notifiable Diseases (other than Tuberculosis) during the year 1942. Cases notified. At ages - Years. Cases admitted 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 zu to 35 Ob to 45 45 to 65 t»t> ana upv?ards Scarlet Fever 28 - - 2 2 7 14 2 - 1 - - - 23 Diphtheria 2 - - - - - - - 1 1 - - - 2 Puerperal Pyrexia 1 - - - - - - - - 1 - - - - Pneumonia 6 1 - - - - - 1 - - 1 1 2 - Erysipelas 4 - - - - - - - - 1 - 3 - - Dysentery (Sonne) 1 - - - - - - - - - - - 1 -• Measles 110 7 13 12 13 15 43 4 2 1 - - - - Whhooping Cough 12 5 - 1 3 1 1 1 - - - - - 1 Ophthalmia Neonatorum 1 1 - - - - - - - - - - - - Totals 165 14 13 15 18 23 58 8 3 5 1 4 3 26 Deaths of notified cases - Pneumonia; 2, aged 65 years and 78 years respectively. Town Hall, Anerley, S.E.20. July, 1943. 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, 1942. In addition to verbal intimation of defects found in premises, 367 written intimation notices and 14 statutory notices we re served under the Public Health Act, 1936. Three hundred and fifty three intimation-notices and 14 statutory notices were complied with. The Council did the work required by 17 notices served under Section 24 of the Public Health Act, 1936, respecting 17 premises and 5 notices served under Section 39 of the Public Health Act, 1936, Legal proceedings were taken for non-compliance with notices served regarding nuisances caused by housing defects, with the following results 1. Order made to comply with Notice within one month and to pay £2.2.0. coets and Court costs. 2. Order made to comply with Notice within 28 days and to pay £1.1.0. costs and Court costs. The owner of a dwellinghouse, who had been convicted by the local Magistrates in November, 1941 for causing a statutory nuisance by removing a door and windows, appealed in May, 1942 in the King's Bench Division before the Lord Chief Justices Court against the conviction. The Appeal Bestrid upheld the decisions of the local Magistrates and awarded costs against the appellant. The drainage systems of 38 houses were partially relaid and 85 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 BE CONTROLLED BY BYE LAWS OR REGULATIONS. No. in District. No. of visits. Notices served. Notices complied with. Common Lodging Houses 3 43 2 2 Houses Let in Lodgings 50 60 9 9 Dairies 9 34 - - stables 22 95 3 3 Butchers' Shops 23 116 1 1 SUMMARY Of INSPECTIONS AND VISITS. The following summary shows the number of visits and inspections made:- Inspections through complaints-received 427 Infectious diseases 64 Transferable deaths 83 Owercrowding and measurement of rooms 23 9. Houses let-in-lodgings and Common Lodging Houses 103 Bakehouses 29 Dairies and milkshops 63 Meat Shops 116 Milk sampling 29 Fish frying shops 15 Other Pood Shops, Stores and Stalls 312 Urinals 69 Stables and piggeries 95 Rats and Mice (Destruction) Act 488 Factories 117 Shops Acts 53 Marine stores 10 Schools 20 Inspections and re-inspections of work in hand 1,487 Miscellaneous visits 133 Drain tests 107 Civil Defence Services 259 SUMMARY OP WORK EXECUTED DURING THE YEAR. Water Supply:- Water supply re-instated to houses 31 Water service pipes repaired 86 Cisterns cleansed, covered or covers repaired 7 Water Closets:- New pans and traps fixed 38 Flushing apparatus renewed or repaired 43 Foul pans and traps cleansed 7 Connections of flushing pipes to pans made good 10 Seats and doors provided or repaired 10 Ventilation provided or improved. 1 Flooring or paving repaired 4 Drainage:- Drains tested with smoke, water or colour 107 Drains cleared. 85 Houses with drains partially relaid 38 Inspection chambers constructed or improved 17 Soil and ventilation pipes fixed or repaired, 11 Sinks, lavatory basins and baths provided 5 Waste pipes renewed or provided, 4 Waste pipes repaired or trapped 13 Waste pipes cleared 9 Fresh-air-inlets provided or repaired 3 Rainwater pipes disconnected from drain 1 Dampness:- Houses with - Walls re-pointed or rendered 7 Dampness in ground floor rooms remedied 18 Roofs repaired 65 Gutters repaired or renewed 24 Rain water pipes repaired or renewed 17 Ventilation under floors provided or improved 3 "later service pipes repaired 36 Window sills repaired 2 Cleanliness Dirty rooms, etc. cleansed 285 Verminous rooms fumigated 47 Miscellaneous:- Houses with defective floors, joists, etc. repaired 35 Houses with defective plaster repaired. 66 Houses with new sash lines provided to windows 7 Houses with window frames, etc. repaired 12 Houses with yards or forecourts paved or repaired 7 10. Miscellaneous (continued):- Houses with scullery paving repaired 4 Houses with air bricks renewed 6 Houses with stairs repaired 7 Houses with fireplace jambs and mantels repaired 5 Kitchen stoves repaired or renewed 5 Scullery coppers repaired or renewed 4 Other stoves repaired or renewed 14 Doors repaired or renewed 10 Ventilation and lighting of rooms improved 3 Chimney stacks repaired 8 New dustbins provided 23 Premises with miscellaneous defects repaired, etc. 21 Overcrowding abated 4 Animals removed 3 Manure receptacles provided 1 Wasps nests destroyed 8 Accumulations removed 13 INSPECTION AND SUPERVISION OF FOOD. At the end of the year there were 9 premises registered as dairies. The analysis of 28 informal samples of milk obtained during the year, all of which were genuine, show the following satisfactory average:- Fat 3.66% Solids, not fats 8.87% 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 78 lbs. Eggs 309 Fish 74 lbs. Sauces 10 bots. Sausages 5 lbs. Cordials 29 bots. Tripe 13 lbs. Pickles 17 bots. Tinned Meat 77 tins. Sugar 123 lbs. Tinned Milk 172 tins. Cereals 62 lbs. Tinned Vegetables 98 tins. Biscuits 5 lbs. Tinned Fruits 89 tins. Margarine 1½lbs. Tinned Fish 42 tins. Lard 1 lb Tinned Soup 2 tins. Butter ¼lb. Jam. 60 lbs. Coffee 67 lbs. Cheese 42 lbs. Chocolate lO½lbs. Rabbits 1046 lbs. Cake 3 lbs. Approximate weight of food condemned:- 1 ton. 0 cwts. 3 qtrs. 13 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. 11. Adulteration, etc. The Kent County Council's Inspector took 102 samples of various foods in this district during the year. Two samples of compound syrup of figs were found to contain camphor, but the facts did not warrant legal proceedings being taken. All other samples were found to be genuine. Your Inspectors obtained 28 informal samples of milk, all being genuine. Factories Act, 1957. Visits paid to factories total 117 and in addition to verbal intimations regarding small defects, 3 written notices were served and complied with. Rats and Mice (Destruction) Act 1019. Complaiints were received from various parts of the district and investigated, 488 visits being made in this connection. Poisons were supplied, traps set and lent and rat runs gassed. Poison baits were 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.