Urban District Council of Chesham Reports of the Medical Officer of Health and of the Chief Public Health Inspector for the year 1971 REPORTS of the MEDICAL OFFICER OF HEALTH and of THE CHIEF PUBLIC HEALTH INSPECTOR for the YEAR 1971 Chairman of the Council: Councillor Mrs. K.L. Harries HEALTH. PLANNING AND ESTATES COMMITTEE Chairman Councillor P.0. Bell, O.B.E.,B.A. Councillor Mrs. K.L. Harries Councillor E.G. Bailey- Councillor A. Boodson Councillor C.F.J. Downs Councillor A.H.J. Baines,M.A.,C.C Councillor W.J. Phelps Councillor K.J. Reynolds Councillor R. Groves Councillor J.V. Standish STAFF Medical Officer of Health B.H. Burne, M.R.C.S., L.R.C.P., D.P.H., M.F.C.M. Other Appointments: The Medical Officer of Health is also Medical Officer of Health for Amersham Rural District Council, and Beaconsfield Urban District Council. Deputy Divisional School Medical Officer, and Departmental Medical Officer. • Deputy Medical Officer of Health Winifred J, Risk, M.B., Ch.B, Chief Public Health Inspector L.D. Saturley, Cert.S.I.B., M.A.P.H.I., F.I.H.M. Other Appointment: Housing Manager to Chesham Urban District Council Deputy Chief Public Health Inspector A.P. Wells, Cert. S.I.B., M.A.P.H.I. Other Appointment: Deputy Housing Manager to Chesham Urban District Council Additional Public Health Inspector A.E. Scott, B.Sc. ,Dip.-.P.H.I.E.B. ,M,A.P.H.I, (Appointed At 10* 71) Assistant Rodent Officer A. Palmer Clerk Mrs. G.W, Hawley Secretary/Administrative Assistant Mrs. L.W. Gillard Copy Typist & Records Clerk Mrs. C.P, King Junior Clerk Miss J. Wilyman Tel: Chesham 2622 Public Health Department, Council Offices, Chesham, Bucks* To; The Chairman and Councillors of the Chesham Urban District Council Dear Members, The year 1971 saw the establishment locally of a multi- disciplinary group meeting regularly and known as the Area Liaison Committee on Drug Abuse. There is a similar Committee at County Headquarters level. As in other fields where society feels threat- ened (for instance the Road Safety Committee), it helps that those with common interests should evolve a common philosophy, exchange what facts and figures that are available and get to know each other personally. Essentially ours is a professional Committee of those working in the field, A pastoral analogy is perhaps not too apposite since part of our vulnerability here we feel to be our position adjacent to ’the great wen1 itself. Whilst not denying the value of the fruits of technological progress in pharmaceutical chemistry some new products have been shown to have drawbacks and plant-based narcotics continue to be of commercial and medical value. Every silver cloud of human advancement turns out to have a black lining unless responsibility is exercised at six levels, (l) personal, (2) professional, (3) social, (4) economic, (3) governmental and (6) international, I do not propose to deal with 4, 5 and 6. (1) It would be most undesirable for the medical patient to eschew drugs completely. There are many who need maintenance therapy of one kind or another? insulin for diabetics being a good example. Many psychiatric patients and others of a suspicious nature do themselves, their relations and their doctors a dis- service through net taking their properly prescribed treatment carefully and consistently. On the other hand there are people who would even consider taking aspirin as a sign of moral weakness and their view should be respected as in certain circumstances, this drug can be dangerous* (2) As medical practitioners we have recently been taking a shrewd look at our prescribing habits- In some areas there have been self-imposed professional limitations on the medical use of some preparations, notably the stimulants such as amphetamine, As with hire-purchase some drugs may encourage people to live beyond their personal limit. This can be more disastrous than living beyond one’s financial limits There are so many different ways of spending one’s personal resources, physical, mental and social quite apart from the more obvious. Again there are many better drugs now available (compared with barbiturates, for instance, there are sedative and hypnotic drugs with a wider safety margin); also more preventive use can be made of the drugs now available, (5) Surely we must take a cool, long look at our society that needs so many ’facilitators’ in order to keep it working smoothly. Think of the thousands of gallons of alcohol, the hundred weights of caffeine in the form of coffee and tea, the lorry-loads of hypnotics and tranquillisers, the shiploads of nicotine which keep us in working order and to be reasonably nice towards each other. Could we not avoid the use of all these by improving the adaption processes which have, evolutionarily speaking, brought us to our present eminence. We are certainly pre-eminent but Desmond Morris is not so far wrong when he refers to part of us at least as belonging to a ’human zoo' We are not well adjusted because we keep changing the situation to which we have to adjust - like spoilt children we want new toys to play with before we have fully- explored the old- Unlicensed use of drugs, and the adjuncts of the drug sub-culture including drug fetishes, false art, bogus music and unintelligible poetry, etc., provide a whole nursery ful of ’mind expanding’ toys for the immature adolescent to play with, Unfortunately, after wasting his time playing he may find out rather too late that he should have been working at growing up, It is not automatic. Maturation is not inevitable except in a vegetative sense, despite what some modern philosophers would have us believe. There is much talk of communication. It is no use being able to communicate if you have nothing to say and any form of communication can only be a means to an end.- My conclusion is that there are no more short cuts to be made which are acceptable on all health grounds, be they medical, psychological or social. Society demands happier people, fewer patients and less crime and on this account alone 1 am reasonably satisfied but standards keep rising. We have had nationally and internationally an epidemic of drug-addiction to the 'hard* drugs. The most recent national figures tend to confirm that this out- break has been contained. On 'soft'* drugs„ society’s attitudes are more ambivalent but I expect this to harden against them. It would seem better to try to moderate the drives and attitudes within our society which make us so vulnerable to drugs of social use. Chief amongst these must be rated the cult of mechanisation. Our bodies do not run like internal combustion engines, as some by their behaviour seem to think, nor do our minds have the detached efficiency of computers. We had better accept ourselves for what we are. Yours sincerely, B.H. BURNE Medical Officer of Health ARRANGEMENT OF REPORTS Page Nos SECTION I - GENERAL AND VITAL STATISTICS 1 - 5 General Statistics Vital Statistics SECTION II - HEALTH SERVICES 6-11 Hospital Services Laboratory Facilities Ambulance Service Midwifery and Home Nursing Service Child Health Clinics Health Visiting Home Help Service Cervical Cytology Family Planning Service Health Centre Medical Comforts Depot Public Health Dentistry SECTION III - NATIONAL ASSISTANCE ACTS 12 - 14 Removal to Suitable Premises of Persons in need of care and attention Burial or Cremation of the Dead Chesham Old People's Welfare Committee (Age Concern) Meal3 Service Homeless Families SECTION IV - PREVALENCE AND CONTROL OF INFECTIOUS DISEASE 15 - 17 Notifications Immunisation and Vaccination Mobile Chest X-ray Service SECTION Inspection of the Area Insect Pests Stray Cats Feral Pigeons Public Health Acts Informal Action Statutory Notices Noise Abatement Clean Air VI - SANITARY CIRCUMSTANCES OF THE AREA 24 - 43 Water Supply Public Swimming Baths Sewerage and Sewage Disposal Refuse Collection and Disposal Slum Clearances The Improvement of Old Houses Grants for the Improvement of Old Houses Improvement of Pre-War Council Houses Housing Repairs Housing in Multiple Occupation Council Housing Caravan Sites Rodent Control Rag Flock Hairdressers and Barbers Welfare of Animals Factories Offices and Shops Page Nos. 18 - 23 I ANNEX Prescribed particulars on the administration of the Factories Act, 1961, Prescribed particulars in the Annua? Report to the Department of Employment and Productivity on the administration of the Offices, Shops and Railway Premises Act, 1963c, 1 SECTION I GENERAL ANN VITAL STATISTICS 1. GENERAL STATISTICS Population, Census 1951 11*433 Population, Census 1961 16,297 Population (estimated mid-year 1971) 20,480 Area (acres of District) 3*489 Number of inhabited dwellings (per Valuation List) 7*014 Rateable Value cf Area (31.12.7l) £1,015*265 Product of Penny Rate 1971/72(probable) £9*752 Comparative Statistics 1934 - 1971 YEAR 1934 1 970 1971 Population 10,240 21,140 20,480 Rateable Value £56,463 £1,003,408 £1,015,265 Product of Penny Rate £212 £9,654 £9*752 Number of inhabited 3,084 6,995 7,014 dwellings 2. * VITAL STATISTICS Live Births Males Legitimate 192 Illegitimate 10 All 202 Live Birth Rates, etc. Live births per 1,000 home population (Crude rate) Area comparability factor Local adjusted rate Ratio of local adjusted rate to national rate Illegitimate live births as percentage of all live births Females Total 201 393 14 24 215 417 Chesham England & Wales 20.4 16.0 .84 1.0 17.1 16.0 c- o o 1.0 * See Page 5 Stillbirths Males Legitimate 3 Illegitimate - Total ' 3 Total Live and Stillbirths Legitimate 195 Illegitimate 10 Total 205 Females Total 1 4 1 4 202 397 14 24 216 421 Stillbirth Rate Chesham England & Wales Stillbirths per 1,000 total live and stillbirths 10 12 Infant Deaths Males Under 1 year of age Legitimate 5 Illegitimate - Total 5 Under 4 weeks of age Legitimate 4 Illegitimate Total 4 Under 1 week of age Legitimate 3 Illegitimate - Total 3 Females Total 4 4 4 4 3 3 9 9 8 8 6 6 Infant Mortality Rates Deaths under 1 year per 1,000 live births Deaths of legitimate infants under 1 year per 1,000 legitimate live births Deaths of illegitimate infants under 1 year per 1,000 illegitimate live births Neonatal mortality rate: deaths under 4 weeks per 1,000 live births Chesham England & Wales 22 18 23 17 nil 24 19 12 Chesham England & Wales Early neonatal mortality rate: deaths under 1 week per 1,000 total live births 14 10 Perinatal mortality rate: still- births and deaths under 1 week combined, per 1,000 total live and still births 24 22 Maternal Mortality (including abortion) Maternal deaths NIL Maternal mortality rate per 1,000 total live and still births NIL Deaths Males Females All ages 87 78 Death rate per 1 ,000 population (crude rate) Death Rate per 1 ,000 population: England & Wales * Local adjusted rate per 1 ,000 population (Area comparability factor 1,20) Ratio of Local adjusted Death Rate to National Death Rate Total 165 8.1 11.6 9.7 .84 * The locally adjusted birth and death rates are those which are obtained when the crude local rates are adjusted to make allowance for the way in which the sex and age distribution of the local population differs from that for England and Wales. The locally adjusted rates are comparable with the crude rates for England and Wales, and the corresponding adjusted rates for any other area. Causes of Death It will be seen from the following table that the principal causes of death were diseases of the heart and circulation (71) which caused approximately 43/^ of the deaths. Deaths from malignant conditions (45) accounted for approximately 27$ of the total and those from pneumonia and bronchitis (16) for approximately 1 0foB Males Females Total 1, Malignant Neoplasm, Oesophagus 2 ?.o Malignant Neoplasm, Stomach 4 3. Malignant Neoplasm, Intestine 1 4o Malignant Neoplasm, Lung, Bronchus 10 5* Malignant Neoplasm, Breast ~ 6. Malignant Neoplasm, Uterus 7* Malignant Neoplasm, Prostate 1 8* Leukaemia 1 9. Other Malignant Neoplasms 7 10, Diabetes Mellitus 1 11 o Mental Disorders - 120 Meningitis 1 13. Other Diseases of Nervous System 1 14. Chronic Rheumatic Heart Disease 1 15. Hypertensive Disease - 16. Ischaemic Heart Disease 28 17. Other Forms of Heart Disease 2 18. Cerebrovascular Disease 5 19. Other Diseases of Circulatory System 3 20. Pneumonia 5 21. Bronchitis and Emphysema 4 22. Other Diseases of Respiratory System - 23. Peptic Ulcer 1 24. Cirrhosis of Liver 1 25. Other Diseases of Digestive System 1 26. Nephritis and Nephrosis 1 27. Hyperplasia of Prostate 1 28. Congenital Anomalies 2 29. Birth Injuiy, Difficult Labour, etc. 1 30. Other Causes of Perinatal Mortality 31. All Other Accidents 2 32. Suicide and Self-Inflicted Injuries - 33. All Other External Causes - 1 2 4 4 1 4 3 i 1 3 2 15 2 9 1 6 1 1 7 2 1 3 2 1 1 2 5 3 14 4 1 1 5 10 2 1 1 1 4 2 43 4 14 4 11 5 1 1 1 8 3 1 3 1 3 4 1 1 Total All Causes 87 78 165 COUNTY OF BUCKINGHAM POPULATIONS, BIRTH AND DEATH RATES FOR THE YEAR 1971 pi Pl o a) -h ft o p O a3 0) O H -P ~ pl cd >r- ft Pl O ft CO ft EH a CM CO LO CO CO CM CO CO 00 tP- VO CO 0C> LO t— 00 VO 00 00 CM C— H- ■'st' ^ K"\ C— cococooooor3-c— co C"- co vo CMCOKMTMAOOMj^tOT-Tf tocoo^M-corovoo^ooo'X) tO 1— T-O H" T— 0-1— c- VQ Os. 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Pi O ft O •H ft O O CD pi ft 03 03 •H 0 rH a P ft o> Pi ft i—1 ft pl !> <d Pl CD Pi ft tio 03 0 CD o Cl> o tcO Pi £ O rH EH pq CD 1—1 O O 1* Pi Pi 0 rH pi ft p •H cd CD rH O 0 B a rH Pl P CD •H •H t=H ft ft o ft « £5 CO EH Ph «<? <d ft ft ft 1* SECTION.., II HEALTH SERVICES 1« HOSPITAL SERVICES The Chesham Urban District is situated within the area of the High Wycombe & District Management Committee of the Oxford Regional Hospital Board. Hospitals available for the District are as follows? Pulmonary Tuberculosis General Infectious Diseases Mental Illness Maternity Cases Berks and Bucks Joint Sanitorium, Peppard Common Chesham Cottage Hospital Stoke Mandeville Hospital, Aylesbury Amersham General Hospital Tindal General Hospital, Aylesbury Royal Buckinghamshire Hospital, Aylesbury Wycombe General Hospital Chalfonts and Gerrards Cross Hospital Isolation Hospital, Stoke Mandeville St, John’s Hospital, Stone The Stone Maternity Home, Chalfont St, Giles Amersham General Hospital 2• LABORATORY FACILITIES Bacteriological laboratory facilities are provided by the Public Health Laboratories situated at Oxford, Luton and Watford, Samples of water for chemical analysis are sent to the Public Analyst for Southwark Borough Council, The Public Analyst for Buckinghamshire is Mr, Eric Voelcker, A.R.C.Sc f P,R,IoC,, Analytical Laboratory, Stuart House, 1 Tudor Street, London, E.C„4. (Telephone No, Fleet Street 9026) 3. AMBULANCE SERVICE This service is provided by the County Council, the Chesham Urban District being covered by the sub-station at Chiltern Road, Amersham (telephone No, Amersham 7154) fTOm 7o00 a,in, - 11,00 p.m. The main station at High Wycombe (telephone No, High Wycombe 21871) provides a 24-hour cover to the whole of the area. Since the Autumn of 1968, the Casualty Department at the Amersham General Hospital (telephone No, Amersham 4411) has opened only during the day. Casualties occurring during the evening, at night or on Sunday, are treated at Wycombe General Hospital where there is a 24-hour service,, 4. MIDWIFERY AND HOME NURSING SERVICE The District is cohered by a number of district nurses and midwives controlled by supervisory staff of the County Health Department. A scheme of attachment with all medical practitioners in the Town is in operation and the close liaison achieved is appreciated by both general practitioners and the nursing staff. The service is provided by the under-mentioned nursess Telephone (also undertakes midwifery for patients of Drs, Widman, Heywood, McMullan and Harley), Attached to Name and Address of Nurse Number Drs. Wise, Middle and Holmes, Fab re Miss Mo Bly, D.N., S.R.N., S,C.M. Shenley Cottage, Ley Hill, (also Health Visitor) Chesham 2838 Miss M.Eo Marston, S.R.N., S.C.M, QoN, 367 Chartridge Lane, Chesham Chesham 2762 Drs. Howe and Hutt MissP.M, Cross, S.R.N. 27 Penn Avenue, Chesham Chesham 4251 Mrs. BoL, Fowler, S.RoN., S.C.M. Q.N, 17a Berkeley Avenue, Chesham Chesham 4191 Drs. Widman, Heywood, Mrs. D.M. Bilbey, S.R.N., McMullan and Harley 28 Loudham Road, Little Chalfont Little Chalfont 4161 (Male Nurse) Mr, Jo Jackson, 3.R.N., Q,N. Chesham 537 Waterside, Chesham 71309 5 o CHILD HEALTH CLINICS Child Health Clinics at which mothers can obtain help and advice in the care of babies and young children and arrange for immunisation are provided as followsz Session MoPo Attends Chesham School Clinic 2*00 p*m* each and Health Centre, Wednesday and Germain Streets, Friday (Tel.No* Chesham 3991) 1st, 2nd, 3rd and 4th Friday each month and 1st and 3rd Wednesday each month Chesham Community Hall, Windsor Road, Pond Park 2nd and 4th Monday at 2.00 p.m. each month Each session * Chartridge Village 1st and 3rd Hall Thursday each month Each session * Although situated in Amersham Rural District, a number of Chesham residents form the clientele* 6c HEALTH VISITING ( A health visiting service is provided by the County Council for health education of the public and personal guidance to families seeking advice* Health visitors for the Chesham District may be contacted either at the School Clinic, Germain Street, Chesham (telephone No. 3991) or at Ivy House, Red Lion Street, Chesham {telephone No* 71952)* They are normally available at these centres Monday to Friday, 9®00 - 10*00 a*m„ and 4-30 - 5*30 p.m. In recent years an attachment scheme has been developed whereby health visitors operating within geographical areas work in liaison with medical practices. Under this arrangement health visitors are working in attachment with, ten general medical practitioners in the three group practices in Chesham* In addition, health visitors maintain liaison with hospital staffs and other medical and social workers* 7* HOME HELP SERVICES This scheme provides for help to be given in the homes of people suffering from chronic or acute illness including old age and pregnancy. The scheme is administered by the Local Organiser operating from the School Clinic, Germain Street, Chesham, This service was administered by the County Medical Officer up to 1st April, 1971, when responsibility was transferred to the Social Services Department, The local organiser’s address remains the same. 8. CERVICAL CYTOLOGY National Health Service Act, 1946, Section 28 A Clinic has been established at Chesham Cottage Hospital and sessions are held on alternate Mondays between 10.00 - 11,00 a.m. Applications for appointments may be made through the County Health Visitors, General Practitioners or at the Public Health Department, 9. FAMILY PLANNING SERVICES I am pleased to be able to report that the Chesham Council in co-operation with the Amersham Council is sponsoring a family planning information service at the Maternity Hospital, Amersham, This is available to the majority of mothers having their babies at the Hospital, A full report on the activities of the local branch of the Family Planning Association is Published as an appendix to my report to the Amersham Rural District Council, 10. PROPOSED HEALTH CENTRE FOR CHESHAM National Health Service Act, 1946, Section 21 Unfortunately in view of the lack of unanimity among the General Practitioners working in the Town, negotiations for the establishment of a Health Centre in Chesham were suspended in 1970, Any future plans would be the responsibility of the new Area Health Authority to be set-up in April, 1974. 11. MEDICAL COMFORTS DEPOT The Medical Comforts Depot situated at the rear of 122 High Street, Chesham, and organised by the Chesham Nursing Division of the St. John’s Ambulance Brigade, has again rendered valuable service not only in this area but throughout the County. Close liaison is maintained with general practitioners, Hospitals Medical Social Workers, Health Visitors, District Nurses and Mid-wives. It is a pleasure to give below the interesting and informative report that has been received from Mrs. Janet Mash, the officer in charge of the Depot. ”1 have much pleasure in presenting my first annual report. The Depot has continued to help the sick and infirm people of Chesham and District with various types of medical aids, and all requests have been met. Invalids helped 948 Maternity Cases 80 Total number of articles lent 2,621 We were very grateful to the many organisations in the Town who have supported the Depot, and together with donations from grateful patients have been responsible for the purchase of some new and modern aids. It will be seen from the Accounts that this year we are carrying forward an increased cash balance. There are many reasons for this, the main one being that during my first year of office I have been reluctant to buy several urgently needed and expensive articles such as Wheelchairs, Ripple beds, Commode Chairs, etc. as I wished first to ascertain that there would be no falling off of support for the Depot with Miss Wheeler's departure, I would assure all those whose support we value so much that their help is very much appreciated and needed to help finance the replace- ment stock and expensive items we need for 1972, A Sale of Work was held in November and raised £232, The hard work of the helpers and the support of the public made the wonderful total possible. This year we purchased 10 new Wheelchairs at an average cost of £50, even so we had difficulty in the Summer to supply chairs on request and waiting lists were sometimes needed. We now have a stock of 160 Wheelchairs of various kinds. Ripple beds are becoming more widely used, a bed and engine costs £36. We bought 3 beds in 1971 and more will be needed in 1972. 29 various kinds ofwaLking aids have been added to our stock and there is an ever increasing demand as more Social Workers and Health Visitors find aged people in need. During the past year we purchased 2 Buggy Chairs, These are a light weight collapsible push chair for handicapped children. The parents are able to open and fold with one hand, leaving the other hand free to control the child. The chairs have been out on loan a number of times and have proved extremely useful, especially for holidays. The County Council Health Department has again supplied us with premises and electricity, and they can be assured that the buildings have been usefully employed, St. John Ambulance Brigade together with 16 Town helpers have maintained the equipment and assisted in the Depot at opening times, my grateful thanks to them all for their dedicated service, I look forward to 1972 and feel sure that the Depot will be able to help all those in need of Medical ComfortsJ 1 2. PUBLIC HEALTH DENTISTRY (a) Visit of Under-Graduate Dental Students A party of approximately 50 fourth year dental students and their tutors visited Chesham on the 9th and 10th of June from the Royal Dental Hospital, Leicester Square. This is the fourth year we have arranged this, and for the second year it extended over two days. Students spent the night at Woodrow High House, Amershara, and a very full programme of talks, discussions and visits took place. I am most grateful to all the participants who contributed to the success of the two day course and only wished we were able to do the same for medical students. (b) National Health Service Act. 1946, Section 28 '(Prevention of Disease)' Fluoridation of Water Supplies During the year no further action was taken by the Council to secure the fluoridation of the water supplied by the Council’s undertaking. The fluoride content of the water supplied by the Council's undertaking is 0.04 parts/million according to the last analysis carried out in March, 1969> S E G T I 0 N __ III NATIONAL ASSISTANCE ACTS, 1948 - 1951 1 , REMOVAL TO SUITABLE PREMISES OF PERSONS IN NEED OF CARE AND ATTENTION National Assistance Act, 1948,, Section 4V Under this Section when persons (a) are suffering from grave chronic disease or, being aged, infirm or physically^ incapacitated, are living in insanitary conditions, and (b) are unable to devote to themselves, and are not receiving from other persons, proper care and attention, the local authority may apply to a magistrate or a court of summary jurisdiction for an Order to remove the person to a suitable place. In general it is felt preferable for persons of good mental state to be persuaded to accept more suitable care voluntarily. Most patients and relatives will accept the combined advice of both general practitioner and medical officer of health and can see the advantages of informal admissions and discharges. Administration of this Section of the Act remained the statutory duty of the District Council after the establishment of the Social Services Department, No formal action under these provisions was necessary during the year. 2* BURIAL OR CREMATION OF THE DEAD National Assistance Act, 1948, Section 50 Under this Section the District Council has the duty to arrange for the burial of any person who has died in their area, if no suitable arrangements for the disposal of the body are being made. No burials were arranged under this Section during the year. 3* CHESHAM AND DISTRICT OLD PEOPLE'S WELFARE COMMITTEE (AGE CONCERN) ~~ The Temperance Hall, leased from the Ohesham Council and opened in January, i962, has continued to be the centre of activity by this Committee, The Hall is open daily between 10.00 a.m, and 4,00 p*m* :°r the use of the elderly people of the Town and a wide range of amenities and services are provided. Full details of these services are given in a booklet published by the Committee and distributed to interested persons throughout the Town* The Committee reported another useful and successful year, due entirely to the support of the many voluntary helpers and workers . All Club activities continue with ever increasing interest by the elderly people in Chesham;; the Wednesday Club is going strongly with outings, entertainments and annual holiday arrangements. The Luncheon Club is carrying on its very necessary service, and Meals-on-Wheels, although there have been problems with recruiting workers, cooked and delivered over 7,000 meals during the past year - 40 meals a day, 4 days a week. Over the Christmas period, 320 Christmas parcels were distributed. Thanks are extended to the donor of the goods and the volunteer deliverers. Chiropody continues to be one of the most widely used services, although the charges have been raised during the past year, the Committee bearing the larger portion of the increase. The elderly ladies of Chesham have hairdressing services at Temperance Hall and there are a great number of regular customers. The Committee is pleased to report that there appeared to be very little real suffering and inconvenience during the electricity strike and subsequent fuel crisis in January, although they had obtained an emergency stock of bagged coal. The Committee would like to thank the local coal merchants for their co-operation during this period. After considerable discussion, the Committee, in line with the National Old People’s Welfare Movement have incorporated the name "Age Concern" into their title. Mrs. L.M« Esseen, the Secretary of the Committee ends her report - "New helpers are always needed and anyone who is interested should call any morning at the Temperance Hall, Church Street, Chesham. 4. MEALS SERVICE In addition to the meals-on-wheels service provided by the Old People's Welfare Committee to elderly persons m their houses and. to the meals provided by the Committee at Temperance Hall, a valuable contribution to this important welfare service is provided by the Wallington Road Luncheon Club, a voluntary organisation using the facilities at the Council's Community Centre. Meals are provided for elderly persons living in the Deansway and Elm Tree Hill area on two days eech week. During 19‘"1 , the Old People's Welfare Committee provided over 7,000 meals, either at recipients' homes or at the Centre, The Wallington Road Luncheon Club provided over 3,00Q meals. Thanks are due to the many voluntary workers who make it possible to maintain these services. 5. HOMELESS FAMILIES Case Conference on Families in Need The Case Conferences of professional workers active in the field of child and family care, which have been held regularly for a number of years, were brought to an end in September, 1971, as a result of the formation of a separate Social Services Department at the County Council. During the period that the Case Conference continued to operate in 1971 five families in Chesham were discussed on twenty occasions. It has been accepted by the Social Services Department that I may call ? ad hoc' meetings of social workers and health workers concerned with families in need. This particularly arises in regard to the special needs of children of school age and pre- school age. Conferences have been held at the Divisional School Health Office, Amersham to which requests for conferences should be addressed. SECTION IV PREVALENCE AND CONTROL OF INFECTIOUS DISEASE 1 . NOTIFICATION OF INFECTIOUS DISEASES The table below gives the cases of infectious disease notified during 1971, together with figures for the two previous years: Disease Cases Notified 1969 1970 1 971 Measles 32 229 10 Sonne Dysentery 102 3 - Pulmonary Tuberculosis - - 3 Non-Pulmonary Tuberculosis 2 1 1 Infective Hepatitis 1 - 3 Scarlet Fever 1 1 - Whooping Cough — 1 4 Food Poisoning No cases of food poisoning were reported during the year. 2. IMMUNISATION AND VACCINATION (a) Smallpox Vaccination Routine vaccination of children against smallpox has been suspended following an advisory circular from the Department of Health. Vaccination is still available, however, on request, especially for those intending to make overseas visits, (b) Ministry of Health Circular 15/67 Distribution of Smallpox Vaccine Under the arrangements described in the circular, a supply of smallpox vaccine is held in the Public Health Department and is available to local general practitioners. During 1971 , 1,057 doses x/ere issued. (c) Diphtheria. Whooping Cough and Tetanus Immunisation The schedule for the use of triple antigens — containing pertussis, diphtheria and tetanus prophylactic - continues to follow the advice of the Standing Advisory Committee to the Ministry on the subject,, The current arrangement is that parents are encouraged to have their children immunised with triple antigens at about four months and again at about six months; a third dose is given at about one year of age, (d) Measles Measles vaccine has continued to be made generally available during the year. This is given early in the second year. The figures for notifications show a considerable drop due to the vaccination programme. (e) Poliomyelitis Oral vaccine is used, given in conjunction with triple vaccine usually. Booster doses are available before starting school or on going abroad. (f) Rubella (Gorman Measles) Following a circular received in 1970 from the Department of Health licensing vaccine for use against Rubella, an immediate programme of vaccination for 13 year old girls was carried out at the beginning of 1971„ The age of vaccination was later reduced to 12 year olds. Vaccination and Immunisation Records The following table gives the numbers of local children rfho were protected against the above diseases: 1970 1971 Diphtheria only — Diphtheria/Tetanus combined Diphtheria/Whooping Cough 5 10 combined aa. — Triple 469 382 Renewals 406 316 Tetanus-Two injection Tetanus-Third injection to complete 22 19 course 50 47 Polio 352 384 Polio-Booster 8 6 Measles 521 394 Rubella No separate figures Figures for Polio and Measles (shown in the table on the previous page) refer to children born between 1968 - 1971. Most vaccinations are now done following appointments arranged by the County Health Authority’s computer, whether or not the general practitioner or medical officer attending the child health clinic gives the vaccination. (g) Tuberculosis B.C.G-. vaccination for children at the age of about 13 years is provided by the School Health Service. In the Amersham and Chesham Division it is pleasing to note that once again there was an excellent response from parents. The B.C.G-. vaccination is preceded by a tuberculin test which indicates whether the individual has in the past been infected with Tuberculosis. Most of these infections are very mild and cause no definite symptoms. The number reacting to this test is a measure of the past exposure of these children to Tuberculosis, 2,3$ of children tested in 1971 were tuberculin positive. The comparable figure in 1961 was 6.5$. Those children who react strongly to this test are referred to the County Chest Physician for further investigation, and usually a chest X-ray. (h) Influenza Vaccine As in previous years, routine? vaccination against Influenza was offered to members of the Council's staff and 29 persons volun- teered. 3. MOBILE CHEST X-RAY SERVICE A letter from the Medical Director of the Mass Radiography Service of the Oxford Regional Board stated that as from 1st January, 1971 Chesham and Amersham would both be omitted from the itinerary of the mobile unit. This was in line with a recommendation of a specialist committee of the Department of Health. I wrote to the Medical Director protesting about the suspension of this service. However, the X-ray services at both Amersham and Chesham hospitals seem to be able to cope with the increased number of referrals. This arrangement appears to extinguish the general public's right to direct access to routine X-ray checks unless specially arranged. 3__ E C T I 0 N JT PUBLIC HEALTH INSPECTIONS 1, INSPECTION OF THE AREA The number and nature of visits made by the Public Health Inspectors during the year is given below? No. of Housing Acts Visits Houses inspected under Housing Acts (except multi-occupied) ... .5 Houses revisited under Housing Acts (except multi-occupied) ., . ,, . «• 9 Multi-occupied houses . . . ... ««<> 2 Visits in connection with applications for Qualification Certificates 46 Visits under Rent Acts 2 Visits in connection with improvement grant applications .. „ .... * * * 166 Compulsory improvement of houses . »< Visits to housing applicants *.„ ,.. 1 Public Health Acts Primary visits to houses re defects . Revisits to houses re defects 0», Nuisances from animals and refuse, etc. Caravan Sites ... ,.. .,« ... .., Water Supplies ... ... ... ... Swimming Pool and Paddling Pool... Sewers, Drains and Cesspools . Drain Tests Sanitary Accommodation ... ... 13 15 49 58 2 49 2 Factories Power Factories ... ... „. 0 ,. 0 Non-Power Factories ... ... . 0 4 Other Premises (e.g. Building Sites) Outworkers Premises ... ... ... Food, and Food Premises Butchers Grocers 00. «0 ... o.. Fishmongers Restaurants, Cafes and Hotels Works and School Canteens ... o © o c o a o o o o o o O O o Q O if © O C © © -a © © a o o o 3 15 34 5 13 2 No, of Visits Food,, and Food Premises (continued) Bakehouses and Confectioners . „. Icecream Premises .... Food Manufacturing Premises ... Licensed Premises ... ., «, Da—ries .,, ,,, ,«, ,,. ooo ., Visits to inspect foodstuffs or take samples ,.. •,, o,o ,,, ... ., Food Vehicles and stalls inspected ., Poultry Processors ... ... ... ., Offices, Shoos and Railway Premises General Inspections ... „ ,. »„. Other Visi '.,s ,., ... .., „, . Investigation of Accidents .. . 2 2 11 6 1 49 15 46 5 3 Rodent and Insect Pest Control (Excludes visits by the Rodent Officer) Rodent Contiol .*. .,. ,.. ... ..o 8 Insect Pests .... ... ... ... 3 Disinfestation for Insect Pests ... 1 Infectious Disease and Food Poisoning Infectious Disease enquiries ... Disinfections carried out ... .. < Food Poisoning enquiries ».c • »< Noise Abatement Visits to premises ... ... ... .»< Observations only ... ... ... Clean Air Visits to Plant or Premises ... Observations only ... ... ... .», Miscellaneous Pet ohops ... ... ... ,, ochools ..o ... ... ., Hairdressers ... ... Interviews ... ... Other miscellaneous visits No access - no one at home 15 3 12 35 14 17 1 1 623 88 67 Complaints Number of complaints made to the Public Health Department (excluding complaints of rats, mice and insects which are dealt with elsewhere in the Report) ... ... ... 126 2, INSECT PESTS Members of the public have continued to seek the help of the Public Health Department in controlling insect pests. Appropriate advice is given on every occasion and where necessary treatments ere carried out by staff of the Department. The most urgent calls for assistance are received from occupiers of premises where wasp nests have been located. In 1971 85 nests were destroyed by the Council's Rodent Officer who carries out this work in addition to his normal duties. This number compares with 106 in 1970 and 71 in 1969* A variety of other insect pests were treated at 28 premises. 3. STRAY CATS The Council's Rodent Officer has on a number of occasions during tne year carried out the trapping of stray cats where these animals were causing a nuisance to residents. 4 cats were trapped and destroyed humanely by a local veterinary surgeon. 4. FERAL PIGEONS The number of feral pigeons frequenting the central area of the Town has steadily increased over the last two years following the trapping operations carried out by a servicing company in 1969* The fouling of the footpaths below buildings on which birds rest has become a most unpleasant hazard to pedestrians. During the year it was arranged that the Council’s Rodent Officer should carry out some trapping operations at convenient sites in the Town. Two traps designed in accordance with advice received from the Ministry of Agriculture were constructed in the Council's workshops. Records show that 29 pigeons were trapped as a result of these operations; however, this comparatively small catch had necessitated over 30 visits to set up bait and inspect traps. This experience has shown that pigeon trapping is a very time consuming operation demanding considerable patience with often little reward. Other methods of pigeon control are not thought suitable for use in the built up area of Chesham, and it seems likely that with the problem still growing consideration will again have to be given to the employment of a specialist servicing contractor. 5. PUBLIC HEALTH ACTS, 1936 & 1961 - ABATEMENT OF NUISANCES BY INFORMAL ACTION As a result of the investigation of complaints and during the course of routine work a wide variety of sanitary defects and nuisances are met and dealt with under the provisions of the Public Health Acts. In the majority of cases remedies are effected following written or verbal requests made by the Public Health Inspectors, without resort to statutory procedure. During 1971, 21 written requests were made with respect to various defects. A table showing the type of matters dealt with follows. Defect No. of Occurrences Dampness in dwellings 10 Defective drainage systems 9 Defective windows 6 Accumulation of refuse 3 Defective plasterwork 3 Defective roofs 2 Defective surface water roof drainage 2 Miscellaneous defects 5 TOTAL 40 6. PUBLIC HEALTH ACTS, 1936 & 1961 - STATUTORY NOTICES If within a reasonable time the informal action described above fails to secure the remedy of sanitary defects or the abate- ment of nuisances, the matters concerned are reported to the Council's Health Committee, which authorises statutory notices to be served. The following is a statement of the Statutory Notices served and complied with during the year. ACT & SECTION NUMBER OF NOTICES Public Health Act, 1936 DETAILS Out- standing on 1.1.71 Served Complied with Out- standing on 31.12.71 Section 93 Dampness & other defects in dwellings 1 2 1 2 Nuisance at unoccu- pied prem ises 1 1 A 7 At the end of the year appropriate enforcement action was being considered in respect of the three outstanding notices,, In two cases Court proceedings were anticipated,, Work Carried Out by the Council It was necessary to utilise the Council's powers on several occasions to clear stoppages in drainage systems common to groups of old houses. Under the Public Health Act, 1936P these systems are “public sewers" which the Council has a duty to "maintain, cleanse and empty", although the costs of any works of repair or renewal are recoverable. The work has been carried out by labour from the Surveyor's Department,, The absence of proper inspection chambers to old drainage systems often makes the work of clearing stoppages a lengthy process„ 7° NOISE ABATEMENT The Noise Abatement Act, I960, empowers local authorities to take action in respect of nuisances caused by noise and vibration. Complaints of noise from nine separate sources were received during the year. All were concerned with noise from commercial or industrial activities in close proximity to residential property. The complaints were investigated by the Public Health Inspectors and all but one were considered to be justified. Informal discussions with the persons responsible secured the abatement of the noise nuisances in three of the cases; in three other instances the noise was the result of temporary operations only and in the circumstances no practicable measures could be adopted to abate the nuisances. In the two remaining cases the nuisances continued after informal approaches had been made to the responsible firms concerned and the Council's Health Committee authorised the service of abatement notices under the Act. In both incidents the noises causing annoyance to residents were heard only intermittently. The noise in the first case arose from the testing of vehicle engines without proper silencing apparatus. In the other case the offending noise was from a ventilating fan used irregularly, which had been installed without any sound reducing fittings. Following the service of the statutory notice the firm engaged in vehicle engine testing completed a sound-proof bay in which to carry out the operation and no further complaints have been received. Complaints about the noisy fan have also ceased. 8. GLEAN AIR The Clean Air Act, 1956 and 1963 make provision for abating the pollution of the air, A total of 8 incidents involving smoke nuisances or emissions of dark smoke were investigated during the year. The emission of dark smoke from factory chimneys were noticed on five occasions and appropriate warnings were issued. Smoke from domestic bonfires were the subject of two complaints? fumes from a faulty diesel engine in temporary use were also complained of. Section 3 of the 1956 Act; requires new industrial furnaces to be as smokeless as practicable0 and local authorities must be notified of new installations. Two notifications of new furnaces were received during the year. In only one case was prior approval of the appliance sought and this was granted after due consideration. The Acts give local authorities control over the height of furnace chimneys. Luring the year, approval to the proposed height of two chimneys was granted. S. E C T I 0 N VI. SANITARY CIRCUMSTANCES OF THE AREA 1 . WATER SUPPLY, (a) Public Water Supplies, Main water in the Chesham Urban District is supplied by the Council's Undertaking and the Undertaking of the Rickmansworth and Uxbridge Valley Water Company and amalgamated companies« This Council’s Undertaking supplies over 80$ of the total dwellings within the District in tnat part which may be conveniently described as the area of the Urban District prior to the extension of boundaries in 1934o During the year under review the Undertakings have supplied main water that has been satisfactory both in regard to quantity and quality,, Treatment and Plumbo-Solvency of Water The main supplies receive no treatment other than chlori- nation and the waters are not liable to have plumbo-solvent action,. Distribution of Main Supplies The following table shows the number of dwellings and estimated population supplied from public water mains? Internal piped supply External supply (Stand- pipes ) No„ of No0 of Estimated Houses Caravans Population . I 6„990 i ca 20,410 6 3 25 Adequate public water supplies were available for all parts of the District in which new dwellings were erected during the year Fluoride Content of Water The fluoride content of both water from the Chesham supply and that of the Rickmansworth and Uxbridge Valley, is .04 p.p.m. or less. Sampling of Public Water Supplies During the year samples have been taken from the piped water supplied by the Chesham Urban District Council and the Rickmansworth and Uxbridge Valley Water Company. Twenty-two samples, thirteen for bacteriological examina- tion and nine for chemical analysis, were submitted to the Public Health Laboratory or the Public Analyst. One sample from the Council's main supply showed slight bacterial contamination but this was considered to be of adventitious origin. All other samples were reported to be of high chemical and bacteriological purity suitable for drinking and domestic purposes. Chemical Analysis The following are copies of the Analyst’s Reports on the examination of samples from four different sources of mains water: Reference No. Sample Collected From Ml 73 13 Elm Tree Hill M75 69 Woodley Hill Ml74 Buckingham Mushrooms Ltd., Lycrome Road M271 241 Great Hivings Water Undertaking Chesham U.D.C. Rickmansworth and Uxbridge Valley Water Company (Amersham Main) Rickmansworth and Uxbridge Valley Water Company (Berkhamsted Main) Rickmansworth and Uxbridge Valley Water Company (Rickmansworth Main) Sample Ref, Ncy Appearance Reaction (pH) Free chlorine Total solids Loss on ignition Chlorine in chlorides Ammoniacal nitrogen Albuminoid nitrogen Nitrate nitrogen Nitrite nitrogen Oxygen absorbed from permanganate (3 hours at 98°F) Hardness, temporary permanent Total Metals - lead, copper, zinc H21 M75 mmm* * iMna Ml 74 M271 all clear and colourless 7o2 7o5 7.2 7.0 par ■is per mill ion nil nil nil nil 240 336 320 365 25 ca 30 20 15 15 15 18 0.007 0,02 0,008 nil nil 0,01 nil nil 3<>2 3.8 3o8 3.0 nil nil nil nil 0,03 0,14 0,11 0,23 265 243 242 277 10 14 27 10 275 257 269 287 not found (b) Private Well Supplies Eighteen dwellings and two business premises in the District are dependent upon a supply of water from wells, these being mostly deep bore wells„ They are known to yield an adequate supply all the year round, and the water is normally of high bacteriological quality. Sampling of the water is carried out from time to time and given below is a table showing the number of samples collected in 1971$. together with the results of examinations carried outs SAMPLING OF WELL WATER SUPPLIES Number of Result of Examination Samples Satisfactory Suspicious Unsatisfactory Bacteriological Examination 24 15 9 Chemical Analysis 3 L 3 - - Eight out of the nine samples with unsatisfactory bacterio- logical results were from two houses in Missenden Road, After receiving information on the problems met by one of the owners, where efforts to trace the source of contamination had failed, the Council’s Health Committee recommended that consideration should be given to the laying of a public water main to serve the houses. It is anticipated that this extension of the mains which will be available to three houses at present on well supplies will be completed in late 1 972 * The other unsatisfactory sample was from a well supply at a factory® The contamination was traced to a dirty storage tank and after cleansing the tank further tests on the water proved satisfactory® (c) Water Supplies to Cressbeds Samples of water were collected from the spring supplying a local cressbed following a report that the water appeared contaminated® Chemical analysis confirmed the evidence of contamination with black carbonaceous particles and light oily matter® Investigations were made into the probable source of contamination and appropriate advice was given to the grower on the precautions to be taken to safeguard supplies of watercress® 2. PUBLIC SWIMMING BATHS The Council’s Open Air Swimming Bath on The Moor operated throughout the summer months and the water heating has proved very beneficial particularly at the beginning and end of the season® Financial provision has been made for the roofing-in of the swimming pool during the year 1972/73* The Bath is filled with water from a well on the site and the filtration and chlorination plant continues to ensure that the water is attractive and safe for bathing at all times® Four samples of water from the bath were examined bacteriologically and all but one were found to be satisfactory® Checks on the chlorinating routine were made following this isolated unsatisfactory result® Paddling Pool - Lowndes Park The pool continues to be popular with small children and is filled with water from the Town’s mains supply® and further chlorinated and renewed at frequent intervals® 3 * SEWERAGE AND SEWAGE DISPOSAL The sewerage of the Town is on a separate system, the foul sewers discharging to the Council’s Sewage Treatment Works in Latimer Road. The reconstructed Sewage Treatment Works is operating very satisfactorily and the final effluent discharged to the River Chess continues to be of nigh standard,, A survey carried out in 1953/54 showed that approximately 450 dwellings were situated in areas not served by a public sewer. This number has since increased with the building of further houses in out-lying parts of the Town, Most of the dwellings drain to either a sealed cesspool or to a septic tank and soakaway into chalk. In June„ 1971 the Department of the Environment finally gave approval to the scheme prepared by the Amersham Rural District Council for main sewerage in the Bexley's, Ley Hillp and Lye Green areas. This scheme will enable a considerable number of dwellings within the District which are at present served by cesspools or septic tanks to be connected to main drainage. Commencement of the scheme is expected in early 1972, Since 1954 sealed cesspools only have been permitted for new dwellings. These must have a capacity of not less than 4^000 gallons, a capacity which is adequate for the average household for at least two months, A typical cesspool in the Chesham district consists of a circular pit-13 feet deep below the level of the inlet, 8 feet in diameter, constructed in 9” brickwork and cement rendered internally with a concrete base and cover. The Council’s machine emptied 442 cesspools during the year, 416 at premises within the District.., the remainder in adjoining areas. 4, REFUSE COLLECTION AND.DISPOSAL Household and some Trade Refuse is collected within the Urban District and disposed of by incineration at 'the Council-s Refuse Destructor, Certain Trade Refuse which cannot be incinerated is taken to a privately-operated tip outside the District, Storage of Household Refuse The paper sack system of refuse storage has been introduced at a number of new Council estates in recent years, 5 * SLUM CLEARANCEs THE,IMPROVEMENT OF OLD HOUSES Individual Unfit Houses During the year Demolition Orders were made on two unfit dwellings within the Districts, in "both cases the occupiers being rehoused by the Council0 Extensive works of repair and improvement were completed at four houses in Vale Road in accordance with undertakings given previously by the owner that the premises would not be used for habitation until rendered fit0 Improvement grants were given towards the cost of the work. As mentioned in the report for 1970„ recent surveys of the District show that there are now under 30 dwellings that are considered suitable only for demolition or closing. Action to deal with these is proceeding and should be completed within the next two years. Compulsory Improvement of Houses Powers for the compulsory improvement of dwellings within an improvement area which were given to Local Authorities under the Housing Aot£1 1964 have been repealed and replaced by new provisions in the Housing Act9 1969» Financial aid may now be given towards the improvement of the environment in general improvement areas but Local Authorities must rely on compulsory purchase powers where owners fail to improve property voluntarily in an improvement area. The powers available to the Local Authority to compel a landlord to install standard amenities on the application of the tenant in the case of a single dwelling have been retained. This power is rarely used by tenants. During the year one cottage was improved following representations from the tenant and in one other case the owner gave an undertaking to carry out the required improvements within a specified period. 6, anAWS FOR THE IMPROVEMENT OF OLD SOUSES The Council has continued to make Discretionary and Standard Grants for the improvement of old houses and the Public Health Department is responsible for the considerable amount of administrative work attached to the operation of these schemes. The Public Health. Inspectors made i66 visits during the year to advise applicants on proposals or to inspect works in progress or completedo New Legislation A thorough, and self-contained code for grant-aided improvement and conversion of houses came into operation or the 25th August9 1969 under the Housing Act9 1969° The new code provides flexibility to deal with a wide range of house conditions9 and a minimum of statutory requirements!* as much as possible is left to the local authority’s judgment. The upper limit for Discretionary Improvement Giants has been increased to £1y000 (£1 ,,200 for conversions) and to £200 for Standard Grants (£450 in the case of higher limit Standard Grants)<> A new type of grant has been introduced to enable grant-aid tc be made towards the provision of amenities in houses in multi-occupationo Improvement grant is now available to cover repairs and replace- ments needed for the purpose of making fully effective other improvements carried out at the same time*, Scope of Grant-Aided Work, The greater discretion allcwed in recent years nas enabled local authorities to make grants available for a much wider range of improvements than was possible when Government restrictions applied, Chesham Council has* for example9 decided that works of central heating may qualify for giant-aid provided such works form part of a comprehensive scheme of improvement. Costs allowed for grant-aid are based on those necessary to achieve the minimum standard of heating which has been adopted for new Council houses. Grant is also allowed on the provision of second water closets and wash-hand basins where a second fitting is necessary to bring the houses up to Parker Morris standards. Other works attracting grant-aid are the prevision of electrical socket outlets up to minimum Parker Morris standards and the enlargement of existing kitchens * or the building of new kitchens where none exists together with the provision of adequate kitchen fitments. These more sophisticated types of improvement together with damp-proofing works by specialists now form a large part of applications submitted for approve]0 It follows that the assess- ment of applications and the calculation of approved expenses is accordingly considerably more exacting than hitherto0 Grant-Aided Improvements in 9"' ' In the year under reviewv a to al of 46 applications for both types of grant were received as against q-2 in the previous year0 Details are given in the tables followings STANDARD GRANTS 0 wne r/0 c c upi e r Other All Appli- cations Standard Standard . 5 point 3 point _ . ... 5 i point 3 point Total Applications Received 7 CO T - 14 Applications Approved 7 WSJ 6 - 13 Applications Pending os C=S) 1 - 1 Applications Refused <23 csa - GO - Applications Withdrawn C2» - - (S3 - Dwellings Improved ■ - -1 10 4 c_o 14 Amount paid in grants £2,836032 Average grant per house £202o?9 Number of amenities provided - fixed bath or shower 11 wash-hand basin 1 2 hot water supply @ 3 points 4 @ 2 points 9 inside water .ioset 12 In the years 1959 to 1971 inclusive, a total of i39 applications for Standard Grants have been received, of which 126 have been approved* ’15 of the schemes have been completed* DISCRETIONARY IMPROVEMENT GRANTS Owner/Occupiers Other Total Applications Received 22 10 32 Applications Approved 20 9 29 Applications Refused - - - Applications Withdrawn 2 1 3 Dwellings Improved 14 8 22 Amount paid in grants £10,939.75 Average grant per house £497.26 Since 1954, 302 applications for Discretionary improvement grants have been received and of these 266 have been approved, 238 of the schemes have been completed. 7, IMPROVEMENT OF PRE-WAR COUNCIL HOUSES In addition to making grants to the owners of private dwellings, the Council are also proceeding with schemes of improve- ment and modernisation of their own property. As far back as 1958, they approved schemes for 471 dwellings out of 529 properties built before 1946, The work is made more difficult due to the wide variety of house types; 46 different layouts for pre-war properties alone. The proposed schemes of improvement provide all the houses with amenities of a standard equivalent to that of post-war properties. Hot water supply is provided by means of a back boiler, independent boiler or immersion heater, according to type, whilst in certain instances, additional improvement is effected by the re-arrangement of sculleries, larders and coal stores, In several of the older types, a considerably improved layout is obtained by demolishing the ground floor bathrooms and W.C. and constructing a new bathroom and W.C. on the first floor by partitioning off a section of a large bedroom, A modern electrical installation, incorporating ring mains with adequate socket outlets, is also provided. The Housing Act, 19699 has extended the definition of "improvement" to include "alteration and enlargement and such other repairs and replacements as are either incidental to some other improvement or needed for the purpose of making the other improve- ment fully effective”« This 'broader definition has enabled the Council to obtain financial assistance on a number of items not previously eligible0 At the present time, there are fourteen basic schemes of improvement, which vary according to the layout and facilities of the original dwellings, With the more liberal provisions of the Housing Act, i969 some of these schemes could be modified to include partial or full central heating, as already introduced in Bois Moor Road and a prototype scheme in Brockhurst Road, These modifications are in course of preparation and will be submitted to the Council in due course, Several house types lend themselves to improvement by means of schemes incorporating modern gas-fired appliances, details of which will be shown to the Housing Committee as they are prepared,, The provision of a warden’s flat and community room in Townfield was completed in August, 1971, but following delay in obtaining approval from the Department of the Environment, it was decided to postpone actual work until after the winter,, The scheme of complete modernisation of the 22 elderly persons flats should be completed during 1972c Of the 529 pre-war properties owned by the Council, 215 have not yet been completed,, During 1971? only 10 dwellings were modernised,. Of these, 9 properties were dealt with by contract and one by direct labour,, These low figures reflect the great difficulty in recruiting suitable maintenance staff and the ever-increasing demands of normal housing maintenance on the Council’s growing stock of properties, together with the marked reluctance of suitable contractors to undertake this type of work,, The wide variety of house types and the fact that the dwellings are occupied are two features which tend to deter private builders from submitting tenders„ 8. HOUSING REPAIRS ■Wi niMl.il »nmwi in ■■ !■■■»» hi»mi,ii»i The Housing Act, i969 as well as encouraging the repair of houses by making grant-aid available for certain works carried out with improvements has introduced a new power to require the repair of houses which are not yet unfit. Up to now the powers in the Housing Act, 1957 have dealt with only the works required to make unfit houses fit for human habitation,, The new power may be used where substantial repairs are needed to bring the house up to a reasonable standard having regard to its age, character and locality. No routine house-to-house inspection of dwelling houses has been carried out during the year,, Where action under the Public Health and Housing Acts was taken to secure repairs, it was in most cases the result of complaints made to the Public Health Department by the occupiers concerned* The number of houses at which repairs were carried out following informal action was 5« Statutory action secured the repair of one dwelling,, Schedules of defects were also sent to the landlords of a number of houses which were subject to applications for qualifi- cation certificates under the procedure described below and resulted in substantial repair works being carried out* No application for certificates of disrepair under the Rent Act, 1968 were received during the year* Rent of Dwellings in g;ood repair and provided with standard amenities Part 3 of the Housing Act, 1969 introduced a new system governing the rents of privately rented dwellings which have been brought up to a satisfactory standard* Controlled tenancies will be converted to regulated tenancies where the qualifying standard is attained, The qualifying conditions are that the dwelling has all the standard amenities for the exclusive use of the occupants, that it is in good repair having regard to its age, character and locality and disregarding internal decorative repair, and that it is otherwise fit for human habitation. The standard amenities ares (a) A fixed bath or shower which must be in a bathroom unless this is not reasonably practicable, (b) A wash-hand basin, (c) A sink, (a) a water closet which must be in, and accessible from within, the dwelling unless this is not reasonably practicable, (e) A hot and cold water supply at the fixed bath or shower, at the wash-hand basin and at the sink* The chief responsibility of local authorities in relation to these new rent provisions is to deal with applications for qualification certificates relating to the state of the dwelling when it is let on a controlled tenancy. There are two types of case: the first is where the dwelling is to be provided with some or all of the standard amenities^ the second is where the dwelling already- had ail the standard amenities at the commencement of the Act0 A booklet explaining the provisions is available in the Department and has been distributed to Landlords and tenants concerned,, The administration of this part of the Act is carried out by the Council's Public Health Inspectors and involves considerable works, including negotiations with landlords and tenantsw the inspection of properties and liaison with the Rent Officer,, Applications for Quailfication Oertifioatea dealt with during 97 - Ao Standard Amenities already provided Applications pending at beginning of year 4 Applications received during year 21 Total 25 Applications approved and Certificates issued Applications refused Applications withdrawn Applications pending at end of year 15 1 2 7 Total 25 B0 Improvement Oases Applications pending at beginning of year 2 Applications received during year 4 Total 6 Qualification Certificates issued 2 Applications refused - Applications withdrawn - Applications provisionally approved or pending at end of year 4 Total 6 Since the introduction of the procedure in 19691> twenty two qualification certificates have been issued,, 9, HOUSES III MULTIPLE OCCUPATION The Housing Acts, 1961 and 1964, strengthened by new provisions in the Housing Act, 1969, have given local authorities extensive powers to control houses which are in multiple-occupation. Suitable and sufficient services and amenities may be required together with provision for means of escape in case of fire. The number of occupants may be limited according to the accommodation or facilities available. Where management standards are bad a code of management may be applied and in extreme cases local authorities may take over the property under control orders0 Once again it is regrettable that due to shortage of staff and pressure of other duties no progress was made in enforcing proper standards in local multi-occupied dwellings. However, with the filling of the vacancy for a Public Health Inspector late in this year, inspections will be resumed in 1972. 10. COUNCIL HOUSING IN QHESHAM During 1971 the Council rehoused 86 families including 29 exchanges. Since 1946 Ghesham Council have provided alternative housing accommodation for 3,006 families, and the following details of the number of new dwellings erected in the post-war period are of interest. Year 1» Temporary Bungalows Houses Flats O.A.P. Bunga- lows & Flatlets Council Totals Houses Erected By Private Enterprise Housing Assocs, 1946/ 1950 35 196 36 - 257 85 - 1951/ 1955 - 233 86 40 359 229 10 1956/ 1960 - 126 129 - 255 1,109 22 1961/ 1965 — 82 32 37 151 842 - 1966/ 1970 — 159 59 - 218 413 - 1971 — — 1 — — 26 - 77 1 ,240 2,704 32 Whilst no houses were completed during the yeai\ progress was made on Stage III of the Trapps Lane housing development and at Batchelors Way® Altogether, 70 Council houses were under construction at the end of the year® Dwellings under private construction at the end cf the year numbered 42„ Housing Needs The waiting list of applicants for Council accommodation which is restricted to persons who reside or work in the Town, numbered 458 in December, 1971c This number compares with 429 in the previous yea.r0 'The 1971 figure includes 90 applications from elderly persons or couples„ 11o CARAVAN SITES Only one licence under the Caravan Sites and Control of Development Act, I960, was in operation during the year* This site was occupied by a single caravan only and the Licence conditions, although based on the model standards, were suitably modified to take account of the temporary nature of the site® 1 2. RODENT CONTROL Prevention of Damage by Pests Act0 1949 Under this Act it is the duty of the local authority to take such steps as may be necessary to secure, as far as practicable, that their district is kept free from rats and mice0 The Council’s duties are carried out by one full-time Rodent Officer working under the supervision of the Public Health Inspectors,, His time is divided between surveys and treatments of all types of premises, including farms0 Surveys are carried out as a result of notification by occupiers or in the course of the general inspection of the District,, The table following shows that 'i 74 premises were inspected as a result of notifications, and that 1 ,034 properties were inspected in the course of routine surveys„ The majority of infestations discovered are treated by the Rodent Officer, only a few occupiers preferring to carry out their own treatments,. During the year the Council decided to abolish charges for treatments at business premises. Treatments at all types of premises are now free of charge, encouraging the co-operation of occupiers to report infestations. No notices under the Act were served during the year* A summary of action taken during the year is given below: PROPERTIES OTHER THAN SEWERS TYPE OP PROPERTY NON- AGRICULTURAL AGRICULTURAL Number of properties in district (l.4.71) 8,408 40 Total number of properties (including nearby premises) inspected following 170 4 notification Number infested by (i) Rats 86 2 (ii) Mice 20 - Total number of properties inspected for rats and/or mice for reasons other than o o 30 notification Number infested by (i) Rats 16 - (ii) Mice 2 - Total number of properties where treatment for rats and/or mice has been completed 1 23 13. RAG FLOCK AND OTHER FILLING MATERIAL ACT, 1961 The purpose of this Act is to ensure that rag flock and other filling materials used in the manufacture of furniture, bedding, soft toys, etc., are of a satisfactory standard of cleanliness. Where such articles are manufactured, the Act provides for registration of the premises. No premises in Chesham are at present registered under the Act, U. BUCKINGHAMSHIRE COUNTY COUNCIL ACT, 1957 Registration of Hairdressers and Barbers Occupiers of 23 premises at which the business of hain dresser or barter is carried on are registered under Section 52 of the Buckinghamshire County Council Act, 1957° Byelaws as to hairdressers and barbers came into operation on the 1st October, :958* Tnese byelaws make provision for securing the cleanliness of premises, of equipment used and of persons working on the premiseso 15 o WELFARE OF ANIMALS In recent years three Acts of Parliament have given local authorities duties in relation to the health and welfare of animals<, These Acts are the Pet Animals Act, 951 .o the Animal Boarding Establishments Act, 1963p and the Riding Establishments Act, 1 964« The two former are administered by the District Council and the latter by the Bucks* County Councils Since March, 1966, Mr„ David Do Unwin, B0Vet0Medo9M0R0C0VoSo, has carried out the inspection of premises and animals under the Acts enforced by the Councils Administrative provisions are dealt with by the Public Health Departments (a) Pet Animals Act„ 1951 This Act regulates the conditions in which pet animals are kept pending sale0 It provides for the licensing of premises from which pet animals are sold and empowers a Local Authority to make conditions regarding the housing and care of the pets0 There are two licenced pet shops and one wholesaler of goldfish and tortoises in the Town0 The conditions attached to the licences have been complied with* (b) Animal Boarding Establ.ishiD.ents Act,, ‘965 This Act provides for a system of licensing and inspection by local authorities of any establishment at which a business of providing accommodation for cats and dogs is carried on* One licence has been in operation during the year in respect of premises accommodating 40 dogs and 30 cats* Satisfactory conditions have been maintained* 16. THE FACTORIES ACT 0 1961 The Council are responsible for enforcing certain provisions of the Factories Act relating to healthy and annexed to this report are tables giving particulars of the visits made to factories by Public Health Inspectors and the cases in which defects were found. Plans of new factories are examined in the Public Health Department and appropriate comments are passed to the architects concerned with a view to ensuring that sanitary conveniences and other provisions as to health meet with the statutory requirements. The principal industries in which local factories are engaged are indicated by the list followings Factories (No Mechanical Power) Descaling fluid 1 Car accessories 1 Factories (With Power) Light engineering 19 Woodware, joinery and sawmills 14 Motor vehicle repairs 14 Printers 10 Brushware 4 Food manufacture and packing 2 Aircraft seats 4 Foundries 2 Injection moulding 2 Boot manufacturers 3 Instrument manufacturers 4 Shoe repairs 1 Furniture 5 Scrap sorting and packing 1 Radio and T,V, repairs 2 Gas and electricity suppliers 2 Tailors 1 Jewellers 1 Other industries 35 126 Outworkers Under Section 133 of the Factories Act, 1961, the occupier of every factory employing outworkers in certain specified classes of work must send to the District Council during the months of February and August of each year a list showing all the outworkers employed by him during the previous six months* A table showing the persons employed as outworkers in the specified trades in Chesham is annexed to the report* 1 7. OFFICESrSHOPS AND RAILWAY PREMISES ACT, 1965 The Act, which came into force during 1964s makes provision for securing the safety,, health and welfare of persons employed to work in offices, shops and certain railway premises* The Council are responsible for enforcing the general provisions of the Act in most of the office and shop premises in the Chesham Urban District* H.M. Inspectors of Factories enforce the general provisions of the Act in railway premises, in fuel storage depots on railway land and in factory offices* In addition, they are responsible for premises owned or occupied by the Crown and those occupied by local authorities* The fire provisions of the Act are, at most premises in the District, enforced by the Buckinghamshire County Council* Administration of the Act The Council's Public Health Inspectors are responsible for administration of the Authority’s functions under the Act, One post of Public Health Inspector was vacant until October and as a result work under the Act was disrupted until the last quarter of the year* Registration of Premises Section 49 of the Act requires occupiers of premises within scope to register them with the appropriate authority* Only six premises were newly registered with the Council during the year* The total number on the register at the end of the year was 211 , an increase of one on the corresponding figure for 1970* Except for the multiple concerns few new employers appear to be aware of their responsibility to register under the Act* Whenever possible steps are, therefore, taken to locate and identify new businesses or changes of occupiers as a matter of priority. Forms of registration are provided and guidance offered on the operation o.f the Act* Inspection of Premises during 1971 During 1971, 46 premises received a general inspection and the total number of visits of all kinds to registered premises (including general inspections) was 54« Operation and General Provisions of the Act During 1971 a total of 25 written notices nqtifying 57 contraventions were sent out to the persons responsible. The most frequently occurring defects related to the cleanliness and safety of floors, the provision of first aid materials, and the failure to supply employees with information about the Act. An analysis of the total contraventions recorded during the year is given below: Analysis of Contraventions of the Act Number of Contraventions Section found and notified to of Act Sub.iect owners or occupiers 4 Cleanliness of rooms and furnishings 5 6 Temperature of workrooms 4 8 Lighting of premises 3 9 Provision and maintenance of sanitary conveniences 2 10 Provision and maintenance of washing facilities 1 16 Safety of floors, passages, and stairs 15 17 Fencing of exposed parts of machinery 5 24 First Aid materials 9 50 Information for Employees 10 Other matters 3 Since 1964 when the Act came into operation 292 informal notices have been served. At the end of 1971 15 notices had not been complied with. All these outstanding notices are of recent service. Accidents Section 43 of the Offices, Shops and Railway Premises Act, 1963 requires occupiers of premises which are subject to the Act to report any accident which causes the death of an employee, or disables an employee from doing his normal work for more than three days. Reports of accidents must be submitted to the Authority on a prescribed form. There were nine accidents notified during the period covered by this report. Pour were the result of falls, three occurred whilst handling goods, and two persons suffered injury cutting meat. Prosecutions No legal proceedings for offences under the Act were instituted by the Council during the year. Prescribed Particulars The appendix to the report contains the following tables, giving the prescribed particulars on the administration of the Act, TABLE A - Registrations and General Inspections TABLE B - Number of visits of all kinds by Inspectors to registered premises. TABLE C TABLE D TABLE E TABLE P Analysis of persons employed in registered premises by workplace. Exemptions Prosecutions Staff S E C T I 0 N VII INSPECTION AND SUPERVISION OF FOOD 1 . MILK Milk and Dairies (General) Regulations, i959 Since 1949s the duties of local authorities have been concerned mainly with the enforcement of provisions relating to the distribution of milk and its handling and treatment at premises other than dairy farms,. The provisions with regard to the infection of milk with diseases communicable to man are also the responsibility of local authoritieso One shopkeeper, intending to sell either 'pasteurised' or 'ultra-heat treated* milk in bottles or cartons, was newly registered as a milk distributor during the year. A total of 11 milk distri- butors and one dairy are registered in the Urban District. One producer/retailer operates from premises in the District, Milk supplies are sampled regularly by Officers of the Bucks. County Council and tested for both compositional and bacteriological quality. Tests to check the cleansing of milk bottles at the local dairy are arranged by the Public Health- Inspectors. During the year 6 washed milk bottles in 1 batch were submitted for bacteriological examination at the Public Health Laboratory. The results were satisfactory. Milk Supplies - Brucella Abortus No action to deal with infected supplies of milk was necessary during the year. 2. ICE-CREAM The Ice-Cream (Heat Treatment etc.) Regulations, 1959 & 1963 The regulations regulate the treatment of ice-cream during manufacture and until sale. No ice-cream is manufactured in the District and the ice-cream sold from the shops is of the pre-packed variety supplied by large firms distributing on a national scale. The vehicles from which ice-cream is sold are also operated by firms whose premises are situated outside the District. No samples of ice-cream were submitted to the Public Health Laboratory for bacteriological examination during 1971. 3. FOOD HYGIENE The Food Hygiene (General) Regulations, 1970 These Regulations came into operation on the 1st March, 1 971 , They consolidated previous regulations and introduced some minor improvements. (a) Food Businesses The table following shows the categories of trade carried on in the food premises in the District subject to these Regulations. Principal Business No. Grocery 33 Greengrocery 8 Butcheis 12 Wet Fish 1 Fish Frying 5 Bakers 3 Sweet Shops 15 Catering 8 Canteens 10 School Meals 11 Manufacturing 2 Licensed Premises 22 Clubs, Halls 8 Warehouses 2 Poultry Dressing 2 Total 142 (b) Inspection of Food Premises The inspection of premises where food is stored, manufactured or sold continues to be an important duty of the Public Health Inspectors. Visits are made to all such premises and those with a record of poor hygiene are given frequent inspections Unfortunately the number of visits that could be made during the year was severely curtailed by a shortage of staff and only 139 visits were made to premises subject to the Regulations, On 18 occasions written notices detailing 74 infringements found were sent to the persons responsible. The matters concerned are summarised below. Regulation Subject of Infringement No? of Cases 7 Dirty equipment 9 9 Pood exposed to contamination 13 16 Defective or dirty sanitary conveniences 2 18 Defective or deficient washing facilities 5 19 Absence of firsI aid materials 3 21 Defective or deficient washing facili- ties for food and equipment 2 22 Inadequate lighting in food rooms 1 23 Inadequate ventilation in food rooms 1 25 Pood rooms dirty or in disrepair 30 - Miscellaneous 8 Total 74 (c) The Food Hygiene (Markets, Stalls & Delivery Vehicles) Regulations, 1966 These Regulations lay down requirements as to food hygiene in respect of markets, stalls and delivery vehicles. Although the Regulations have been in operation for 5 years many persons affected still appear ignorant of their requirements. Whenever possible the opportunity is taken to distribute explanatory leaflets on the Regulations and to otherwise give guidance to those concerned. During September inspections were made of the four food stalls set up at a travelling fair in Chesham, Conditions were generally found to be of a good standard. The attention of one stallholder selling candy-floss had to be drawn to the need to have proper washing facilities available at all times the stall was in operation, A number of minor infringements of the Regulations were also brought to the notice of the stallholders. Visits were also made to a public "fireworks'* event in November when conditions under which food was being sold were examined and found to be satisfactory. (d) Poultry Inspection The provisions of the Pood and Drugs Act, 1955? and the Pood Hygiene (General) Regulations, 1970, apply to premises at which poultry are processed for sale and local authorities are responsibl for seeing that the Act and Regulations are complied with, There are no large poultry processing premises within the District, but processing on a small scale is carried on at two premises,, No inspection of poultry at the premises has been carried out by the Public Health Inspectors, 4• REGISTRATION OF PREMISES USED FOR THE MANUFACTURE, STORAGE OR SALE OF FOOD UNDER SECTION 16 OF THE FOOD AND DRUGS AC£». 1,955. Purpose for which Registered Premises on Register 1970 Added to Register 1 971 Removed from Register 1971 Total on Register 31,12,71 Sale and storage of ice-cream 65 2 **13 54 Manufacture of ice-cream * 2 - 2 * Manufacture of preserved food 25 4 ** c-; 24 Fish Frying 4 1 (as 5 Totals 96 1 7 L 18 85 No ice-cream was manufactured at these premises in 1971. ** All removals from the Register were premises where the relevant business had ceased to operate. 5. SLAUGHTERHOUSES Since September, 1959 no slaughtering has taken place in Chesham. The few local butchers wishing to buy meat "on the hoof" now make use of the slaughtering facilities available in adjoining districts. Slaughter of Animals Act0 1958 The following details are extracted from the Register of Siaughterm m Number of Slaughtermen on 3 s t December, 1970 Applications for Licences during 1971 Applications for Renewals during 1971 Number of Slaughtermen on at 31st Decembers 1971 Register at considered considered Register 2 0 2 2 6 > INSPECTION OF FOOD The Food and Drugs Act, 19559 gives local authorities wide powers to deal with offences in relation to the sale of food. Section 2 of the Act deals with food not of the nature, or substance, or quality demanded. Where there is a danger to health, or where it appears that the offence is local in character, e,g, the sale of mouldy food by a shopkeeper, as the result of poor stock control, the matter is dealt with by this Authority, In certain instances complaints falling under this Section are passed to the Chief Inspector of the Bucksc County Council wnich is the Food and Drugs Authority for this district. The sale or exposure for sale of food unfit for human consumption is covered by Section 8 of the Act, and all cases are handled by this Council’s Public Health Department, 44 complaints relating to food were received during the year. 9 of these were passed to the Chief Inspector of the Bucks, County Council, The remaining 35 cases were investigated by the Council’s Public Health Inspectors, Nearly a third of the complaints investigated were of mould affecting perishable foods such as bread, confectionery and cooked meats, a condition which might well have been avoided if more care had been taken in the handling, storage and stock rotation of the products. Just over a third of the complaints were of foreign matter in food, mostly bread, whilst the remainder were complaints of general unsoundness, Or.e housewife who complained had been surprised to find a piece of glass tubing and a length of rubber in the giblets of a frozen chicken. In view of the thorough inspection arrangements at the processors it was assumed that an employee had deliberately packed the giblets in this condition cut of malice. No legal proceedings were instituted during the year in relation to food complaints, but appropriate warnings and advice was given to the retailers and manufacturers involved. Unsound Food Condemned A considerable amount of unsound food was voluntarily surrendered to the Department by traders during the year, details of which are set out below. Meat at retail shops Tons Cwte- JS i Lbs, 70 ' Cooked meat and meat products an - — Canned Meat - - 50 Fish - - - Other foods including frozen foods 1 15 70 Total 1 17 58 Disposal of Condemned Foodstuffs Condemned foodstuffs are normally destroyed by incineration at the Council’s plant in Latimer Road, Chesham, BoH. BURNE Medical Officer of Health L.D. SATURLEY Chief Public Health Inspector !> O'. 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