E Urban District of Bexley. Annual Report OF THE Medical Officer of Health, For the Year 1925. T. W. HINDS, M.D. (Lond.), Medical Officer of Health. T. W. JENKINS (T.U.), BEXLEYHEATH & ERITH.—J.C. Bexley Urban District Council. Annual Report of the Medical Officer of Health. To the Chairman and Members of the Bexley Urban District Council. Ladies and Gentlemen, I submit herewith my Fifth Annual Report as Medical Officer of Health, being that for the year 1925. Natural and Social Conditions of the Area. Area (in acres), 4,901. Population (Census 1921), 21,475, estimated 1925, 23,210. Number of Inhabited Houses (1921), 4,610. Number of Families or separate occupiers (1921), 5,127. Rateable Value, £117,530. Sum represented by a penny rate, £428. The District, which is divided into Three Wards, is situated in the North-West corner of Kent, about 12 miles from London Bridge. The bulk of the population reside in the Christchurch (Bexley heath) and East Wickham Wards, the St. Mary's Ward (known locally as Old Bexley) being less populated. The height above Sea Level varies from 50 to 200 feet. The subsoil is chiefly gravel, with patches of clay here and there. 1 The air is pure and bracing, and owing to the before mentioned nature of the subsoil, even in wet weather, the natural drainage is such that the water readily disperses. There are only a few small factories within the Area, the inhabitants being chiefly of a residential character. The bulk of the population is either engaged in work in London or in factories in surrounding areas. The chief industries are Market Gardening and Flower Growing (Nurseries), and owing to the absence of pollution of the air by smoke, flowers are grown almost to perfection. There is no occupation that has a prejudicial influence on health. Vital Statistics. In dealing with the Birth Rate and Death Eate, the figures of the Registrar General, as to the estimated population, namely, 23,210, have been the basis upon which the calculations have been made. During the year 419 Births (223 males and 190 females) were registered, representing a birth rate of 18.0 per thousand, compared with 17.9 per thousand for the previous year. The number of births registered during the year 1924 was 413. The rate per thousand for England and Wales was 18.3, and for the 157 Towns of populations between 20,000 and 50,000, 18.3. The figure for Bexley1 is slightly below the average and I submit for the Council's perusal the figures for the last five years:— 1921, Birth Rate, 23.6 per thousand. 1922, „ 21.5 „ 1923, ,, 22.7 „ 1924, „ 17.9 „ 1925, ., 18.0 „ 2 It- will be noticed from these particulars that the Birth Rate is much below that of five years ago. Seventeen Illegitimate Children were registered. Death Rate. The number of deaths from all causes was 251, namely, 136 males and 115 females. This represents a Death Rate of 10.8 against 9.6 for the previous year. The Death Rate over England and Wales was 12.2, and for the 157 Towns, previously mentioned, 11.2. In this instance Bexley compares favourably with the remainder of the Country. The Death Rates for the Area during the last five years are as follows:— 1921 10.8 per thousand. 1922 10.4 1923 10.3 1924 9.6 1925 10.8 Twenty-five Infants failed to reach the age of one year which, on the 419 Births Registered, gives an Infantile Death Rate of 59.6 against 58.1 per thousand for the previous year. The Infantile Death Rate for the year over England and Wales was 75.0 per thousand, and for the 157 Towns, referred to, 74.0 per thousand. Although the Rate for this District is slightly in excess of that of the previous year, it compares very favourably with the average over the whole of the country. Four illegitimate children died before reaching the age of one year. Deaths occurring from Measles Nil. ,, ,, ,, Whooping Cough 2 ,, ,, ,, Diarrhoea 3 ,, ,, ,, Sepsis 2 3 GENERAL PROVISION OF HEALTH SERVICES WITHIN THE AREA. HOSPITALS. The Council's Isolation Hospital, situated in Long Lane, Bexleyheath, has again proved a valuable asset. It consists of three buildings known as follows:— Upper Hospital and Pavilion, which are used for the treatment of Scarlet Fever Patients, and Lower Hospital, used for Diphtheria Patients. These buildings have been in use for a considerable number of years, but with the rapidly growing population it may be found necessary in a few years to provide other or additional accommodation. I shall again refer to the work carried out at this Hospital in my remarks on the Prevalence and Control of Infectious Disease. The Maternity Home, situated in the Broadway, Bexleyheath, is also the property of the Council. It has been open during the whole of the year under the charge of Dr. C. Kinsley Carroll. The accommodation is as follows:—Three Wards, each containing two beds, Labour Ward, and Isolation Ward. In addition to this, there are, of course, the necessary staff quarters. Sixty-six cases were dealt with during the year. Tuberculosis. The Kent County Council are the Tuberculosis Authority and patients suffering from this disease are treated by that body, who provide Hospital Accommodation where they consider the same desirable. The Cottage Hospital, situated in Upton Road, Bexleyheath, is supported entirely by Voluntary Subscriptions. As stated in my previous reports, the area is so close to London that the facilities offered in the Hospitals there are freely taken advantage of by Local Residents. 4 AMBULANCE FACILITIES. Infectious Disease. The Council have continued to hire an Ambulance, from a local jobmaster, for the purpose of removing cases of Infectious Disease. The vehicle is used exclusively for that purpose. The cost for the hire of the same during the year under review, was approximately £30. Non Infectious Cases. The arrangements for removing accident cases or cases of sickness of an urgent character, have been continued with the Dartford Guardians and Sidcup- Urban District Council. Each of these bodies possess a Motor Ambulance and I have experienced no difficulty in obtaining the use of either when occasion has arisen. The cost to the Council for this service for the year was approximately £26.8s. 3d. The Council have given consideration to the question as to the advisability of purchasing a Motor Ambulance, but for the time have resolved to continue the arrangements as stated. Clinics and Treatment Centres. No Maternity and Child Welfare Centre has yet been established within the Area The Kent County Council provide the following services:— Dental Clinics. (School Children). Tuberculosis Dispensaries. At Overy Street, Dartford and Pier Road, Erith. Venereal Clinics, at King Edward's Hospital, Dartford. The following is the Staff of the Health and Maternity and Child Welfare Depts. T. W. Hinds, M.D.fLond.): Medical Officer of Health and Medical Supt., of Isolation Hospital. 5 C. Kinsley Carroll, M.C., L.R.C.P., Medical Supt., Council Maternity Home. E.J. Rayner, Sanitary Inspector and Certified Food Inspector. Jack Gray, Assistant Sanitary Inspector and Certified Food Inspector. E. Sheehan (Miss), Certificated Nurse and C.M.B. Health Visitor. N. Feeley (Miss), C.M.B. and Health Visitor's Certificate, Health Visitor. M. Bentley (Miss), Clerk. PROFESSIONAL NURSING IN THE HOME. A voluntary nursing association functions in each of the three Wards, and each provides a nurse for general nursing in the Home. Funds are provided entirely by voluntary contribution and the work carried out by these nurses is very highly appreciated. The Council do not provide a whole-time nurse for nursing cases of Infectious Disease in the Home, hut will consider any application for the services of such a person and, if it is necessary, will provide a nurse as the need arises. Midwives. The Council do not employ or subsidise midwives. The number of Midwives practising in the Area is 6. 6 LIST OF ADOPTIVE ACTS, ETC., IN FORCE WITHIN THE AREA. Date ariopted. Acts. Private Street Works Act, 1890 January 1899 Infectious Disease Prevention Act April 1891 Public Health (Amendment Act) 1890, Parts 1, 2, 3 and 5 April 1891 Public Health Act (Amendment Act) 1907, Parts 8 and 9 April 1909 Part 2—the whole May 1909 ,, 3—Sections 34 to 49 & Sec. 51 ,, 4 —Section 52 to 60 & Sec. 62-68 „ 5 and 6—the whole ,, 7—Section 95 Bye-Laws. New Streets and Buildings Nov. 1901 Pleasure Ground—Christchurch May 1899 do. St. Mary's Ward June 1904 Nuisance and Cleansing of Privies Nov. 1901 Common Lodging Houses Oct. 1900 Slaughterhouses Oct. 1900 Cleansing of Earth Closets and Cesspools January 1883 Nuisances, Removal of Offensive and Noxious matters Dec. 1907 Hop Pickers and Fruit Pickers Lodgings January 1901 Tents, Vans, Sheds & Similar Structures Aug. 1923 Offensive Trades (Fish frying) Dec. 1923 Regulations. Dairies. Cowsheds and Milkshops - March 1900 7 SANITARY CIRCUMSTANCES OF THE AREA. Water Supply. The Area is supplied with water from the mains of the Metropolitan Water Board. The supply is constant and the quality good. Rivers and Streams. No pollution of Rivers or Streams has come to the knowledge of the Council during the year. Drainage and Sewerage. The larger portion of the sewers within the District are connected with the mains of the West Kent Main Sewerage Board, and the sewage is treated and disposed of by this hody at their outfall works near Joyce Green, Dartford. In two instances in the East Wickham Ward, the sewers are connected to those of the London County Council. The properties thus drained by this method, are the Government Hutments at Lodge Hill and Victoria Cottages, Wickham Lane. The drainage of the latter has been mentioned in previous reports and one is pleased to find that the very unsatisfactory method of dealing with the sewage by cesspools has now been abolished. The Council have continued to abolish cesspools wherever practicable. During the year 12 cesspools were thus dealt with and the drainage from the premises concerned connected with the sewer. Closet Accommodation. With very few exceptions, such as outlying farm premises, the whole of the closets are on the water carriage system. Scavenging. A weekly collection of House Refuse has been made during the whole of the year. Moveable ash-bins have been in use for some years. 8 The work is carried out by Contract under the supervision of the Sanitary Inspector, the refuse being carted on to arable land and ploughed in. It is found to be very useful when worked into heavy land. Apart from any manurial value its mechanical action upon this land is very beneficial. The question of the disposal of the refuse has, as in previous years, been a subject to which some attention has been given. The district is growing rapidly and how long the present means can be utilised depends largely upon building operations. The quantity of London refuse dumped at the Cravford end of the St. Mary's Ward, has been negligible and in the interests of the inhabitants, it is hoped that the practice has been discontinued for good. Such cesspools as remain are cleansed under the supervision of the Surveyor's Department. SANITARY INSPECTION OF THE AREA. A detailed statement of the work carried out under this heading is to be found in the Report of the Sanitary Inspector. PREMISES AND OCCUPATIONS CONTROLLED BY BYE-LAWS. The principal Bve-Laws or Regulations in force are those concerned with (1) Tents, Vans and Sheds, and (2) Fish Frying. 9 The Fruit Pickers' Hilts, within the Area, are gradually ceasing to be used either through a smaller amount of fruit being grown or through the demand for the labour in connection therewith being met locally. The control of caravans, however, is dealt with under these bye-laws and trouble is sometimes experienced in dealing with the same. The bye-laws concerning fish frying have proved to be useful, and visits have been paid to the shops with a view to these being carried out. Schools. The Schools within the Area are supplied with water from the mains of the Metropolitan Water Board. It has been necessary during the year for the Council to press for improved Water Closet Accommodation for the Church of England Schools in the St. Mary's Ward. Trough Closets have been demolished and those of the Wash-down type, with separate flushing apparatus, have been provided. Owing to the delay in the completion of the work the schools were closed for some weeks in the summer months. The senior children during the period of closure were accommodated in the Boys' and Girls' Hall in Bourne Road. The Water Closets now provided are of an efficient type and the conveniences can now be used with more comfort by the children attending these schools. Additional W.C. and urinal accommodation is also needed at the Welling Council Schools. These schools are overcrowded and the Education Committee have been asked to provide improved accommodation. 10 HOUSING. The district is still suffering from lack of Housing Accommodation. It is difficult to estimate the shortage, but I understand that there are some GOO applicants for either the Council Houses on the Welling Estate, which have now been occupied from 3½ to 5 years, or the 100 houses that the Council contemplate building in the Christchurch and St. Mary's Wards. There is every reason to believe that overcrowdingdoes exist and to a large extent, but in the absence of housing accommodation, it is impossible to find a solution to this problem. The Council have had Statutory Notices on the occupiers of one particular premises for the whole of the twelve months covered by this report, but at the end of the year the overcrowding therein had not been abated. As regards fitness of houses I consider Bexley compares very favourably with surrounding areas. Where defects are found they are due chiefly externally to dampness, either through absence or perished damp courses, defective pointing, or defective roofs. With regard to internal defects, such as defective floors, plaster on walls, etc., it is very difficult to say whether this is due to lack of supervision by owners or carelessness on the part of the tenants. Many houses which were originally built for the use of one family are occupied by two or more families and the wear and tear is consequently greater owing to this fact. HOUSING STATISTICS FOR THE YEAR 1925. Number of new houses erected during the year:— a. Total (including nos. given separately under b) 128 11 b. With State assistance under the Housing Acts: i. By Local Authority Nil. ii. By other bodies or persons 82 1. Unfit Dwelling Houses. Inspection—(1) Total number of dwellinghouses inspected for housing defects under Public Health or Housing Acts) 539 2. Number of dwelling-houses which were inspected and recorded under the Housing (Inspection of District) Regulations, 1910, or the Housing Consolidated Regulations, 1925 51 3. Number of dwelling-houses found to be in a state so dangerous of injurious to health as to be unfit for human habitation 1 4. Number of Dwelling-houses (exclusive of those referred to under the preceding subheading) found not to be in all respects reasonably fit for human habitation 280 2. Remedy of defects without service of formal notices. Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 241 3. Action under Statutory Powers. a. Proceedings under section 3 of the Housing Act, 1925:— 1. Number of dwelling-houses in respect of which notices were served requiring repairs 6 2. Number of dwelling-houses which were rendered fit after service of formal notices:— (a) By Owners 5 (b) By Local Authority in default of Owners Nil 12 3. Number of dwelling-houses in respect of which Closing Orders became operative in pursuance of declarations by Owners of intention to close Nil b. Proceedings under Public Health Acts:— 1. Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 18 2. Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By Owners 17 (b) By Local Authority in default of Owners 1 0. Proceedings under Sections 11. 14, and 15, of the Housing Act, 1925:— 1. Number of representations made with a view to the making of Closing Orders — 2. Number of dwelling-houses in respect of which Closing Orders were made — 3. Number of dwelling-houses in respect of which Closing Orders were determined, the dwelling-houses having been rendered fit — 4. Number of dwelling-houses in respect of which Demolition Orders were made — 5. Number of dwelling-houses demolished in pursuance of Demolition Orders — Milk Supply. The greater portion of the milk consumed within the Area is rail-borne. From samples taken throughout the year both by your Sanitary Inspector, and also the Kent County Council Inspector, it would appear that little adulteration has been found. 28 Samples were taken by your Official and all were found to be genuine. Improvement is however still necessary in the standard of cleanliness observed not only by retailers but also by producers. 13 The Cowsheds within the District have been regularly inspected and in one case a new brick shed has been constructed in lieu of an old wooden structure. The new shed is a great improvement on the old one and in its construction due regard has been paid to the model Regulations. The cows in the Local Sheds are inspected periodically by the Council's Veterinary Inspector. No licences have been applied for under the milk (Special Designations) order, 1923. MEAT INSPECTION. Since the Public Health (Meat) Regulation (1924) came into operation, the whole of the meat slaughtered within the Area has been inspected before being offered for sale. This has entailed a great amount of work on the Inspector and his Assistant, much of which has had to be done after Office Hours. The amount of meat condemned, particulars of which appear in the Inspector's Report, shews how necessary these regulations were, in order that the food supply of the Public should be inspected before being offered for consumption. If the standard of inspection at present carried out can be maintained the inhabitants of the District will benefit by a more wholesome supply of meat. The Inspector has not been instructed to carry out Meat Marking under the Regulations. Condemned Meat is disposed of by burning in the Boilers of the Council's Electricity Generating Station, but as it is likely that this station will shortly be closed, owing to the arrangements of a bulk supply of the current from an adjoining authority, the question of disposing of this meat will present some difficulty. Meat inspection is also carried out in shops, stalls and carts, due regard being paid to the question of cleanliness in handling the same. The details as to the number of inspections under this heading will be found in 14 the Inspector's Report. The particulars relating to the number of Registered and Licenced Slaughterhouses are as follows:— In 1920. In Jan. 1925. In Dec. 1925 Registered 8 8 8 Licensed 0 2 2 Total 8 10 10 The inspection of Food Stuffs other than meat has been carried out systematically. The Health Dept. view this branch of their work as one of great importance, and no pains are spared in the, endeavour to procure for the Public a wholesome supply of food. PREVALENCE OF AND CONTROL OVER INFECTIOUS DISEASE. The following table gives a comparative statement of the number of cases of Infections Desease notified during the last five years. 1921 1922 1923 1924 1925 Small Pox — 2 — — — Scarlet Fever 161 163 46 53 63 Diphtheria 47 41 33 14 16 Enteric Fever 1 — 2 Puerperal Fever 1 — — 1 2 Pneumonia — 1 — 4 3 Chicken Pox 40 54 81 — — Erysipelas 4 6 4 9 1 Tuberculosis 32 33 35 29 44 Ophthalmia Neonatorum 4 1 — — — Encephalitis Lethargica 1 — — — 2 Dysentry — 1 — — — Poliomyelitis — — 4 4 — Cerebro Spinal Meningitis — — 1 — — During the five years the Council's Isolation Hospital, situate in Long Lane, Bexleyheath, has been utilised for the treatment of Scarlet Fever and Diphtheria. 15 The Buildings which comprise the Upper Hospital, Lower Hospital and Pavilion, are capable of dealing with 40 cases at once. The Lower Hospital is used chiefly for dealing with diphtheria cases. During that period the number of cases treated in the Hospitals was 523. In the year 1922 an outbreak of Small Pox occurred within the Area, but fortunately, owing to the steps that were taken with the same, the outbreak was confined to 2 cases; one of these proved fatal. At the time these cases occurred 21 persons were vaccinated by myself as Medical Officer of Health. In this connection, I wish again to draw attention to the fact that the percentage of children vaccinated, compared with the number of births registered, is very small. The following particulars relate to the cases of Infectious Disease notified during the year 1925:— Disease Total Cases Notified Cases admitted to Hospital Total Deaths Small Pox — — — Scarlet Fever 63 58 — Diphtheria 16 9 3 Enteric Fever (including Para-Typhoid) 2 — Puerperal Fever 2 — 2 Pneumonia 3 — — Tuberculosis 44 — 22 Erysipelas 1 — — Poliomyelitis — — — Encephalitis Lethargica 2 — 2 Two of the patients suffering from diphtheria died at home, shortly after notification of the cases had been received by myself. Anti Toxin is now used much more in connection with this disease than was the case some years ago. 16 During the year 31 Phials were used by Local Medical Practitioners, and 19 were used by myself as Medical Superintendent of the Council's Isolation Hospital. I still make a practice of having a negative swab, before discharging a patient from Hospital. In addition to the use of Anti Toxin, greater use has also been made of the County Laboratory during recent years. During 1925, 64 swabs from the throat or nose were forwarded for the purpose of examination, and this practice has been very helpful, in that suspected cases that might have been notified as diphtheria and removed to Hospital, have been dealt with in the manner in which they should. Eight of the cases of diphtheria notified were removed to the Council's Isolation Hospital, one to the Dartford Joint Hospital, and seven Isolated at Home. Scarlet Fever. 57 of the cases notified were removed to the Council's Isolation Hospital, one to a Hospital of the Metropolitan Asylums Board, and 5 isolated in their own homes. Diphtheria. The number of cases dealt with in the Long Lane Isolation Hospital was in excess of that of the previous year. The Average length of stay of patients suffering from Scarlet Fever was 44 days and those suffering from diphtheria 21 days. The cost of dealing with the cases at the Hospital compared with that for the year 1924 is as follows 1924 1925 £ £ s. d. Salaries and Wages 412 392 19 0 Provision and Fuel 299 328 10 3 Medical Sundries 16 20 0 5 Disinfectants 28 21 4 6 Furniture and Drapery 58 34 5 8 Repairs, Rates etc 54 69 18 3 Telephone Rental 9 7 18 11 Electricity Supply 16 18 8 5 £892 £893 5 5 17 TUBERCULOSIS. During the year 44 cases were notified and particulars relating to the same are contained in the following Table: Age Periods. New Cases Deaths. Pulmonary Non Pulmonary Pulmonary Non Pulmonary M. F. M. F. M. F. M. F. 0 1 1 5 3 2 10 1 3 2 15 2 4 1 3 20 1 1 1 25 3 4 2 2 35 6 1 4 1 45 6 4 3 2 55 3 65 and upwards Totals 18 14 7 5 13 8 1 The number of cases notified is higher than that of a year ago, and I regard this as being due to the introduction of the Public Health (Tuberculois) Regulations, 1924, 52 specimens of sputum were forwarded from this District, to the County Laboratory for the purpose of Bacteriological examination. The number of specimens forwarded in 1924 was 25. The Kent County Council administer the Tuberculois Scheme for this Area, and apart from the keeping of the Register, the supply of disinfectants, the disinfection of infected premises, and periodical visits by the Health Visitor, your Health Department, have little responsibility in the matter. 459 visits were paid during the year by the Health Visitors to persons suffering from this disease. 18 CANCER. Before closing my remarks with regard to the prevalence and control of Infectious disease, I wish to draw attention to the fact that, in conformity with other parts of the Country, cases of Cancer appear to be on the increase; in fact, the number of deaths, namely 38, occurring from this disease within the Council's Area, during the year was larger than that of any other single disease. Maternity and Child Welfare. The Council have continued to carry on this work as in previous years, 388 Births were notified and notifications of 13 still births were received. No Child Welfare Centre has been established, although at the end of the year this question was under discussion. Ante-natal clinics were opened in two of the Wards, but the attendances have been very disappointing; consequently it has been decided to discontinue the same. I am of opinion, however, that if the Ante-natal Clinics could be run in conjunction with Child Welfare Centres they would be successful. The need for the same can be realised when it is found that during the last three years no less than 40 per cent of the deaths of children under one year of age have been due to some morbid condition of the mother before confinement. It is with a view to reducing this mortality that I am anxious to see the Ante-natal and Child Welfare Clinics established in this District. Home visitation has again been given special attention, and during the year the Health Visitors paid 5,183 visits to the homes of children. As previously, first visits have been made as soon as possible after the tenth day following the birth, and subsequent visits every two months. Additional visits have been paid in such cases as thought desirable or necessary. During the year assistance has been given to necessitous cases in the shape of providing fresh or dried milk as follows:— (1) Children under 3 years. (2) In certain cases children up to 5 years of age. (3) Expectant Mothers. 19 The income and number in family are taken into consideration in determining whether a case needs assistance. Each applicant furnishes the necessary particulars on a form provided by the Council. These particulars are verified, and the forms, after being scrutinsed by myself, are examined by a Sub-Committee of the Maternity and Child Welfare Committee formed for that purpose. New forms are issued every three months to applicants receiving assistance, and the milk books supplied to applicants are examined monthly by the Health Visitor. No order is given to supply milk for a longer period than one month, at the end of which time the circumstances of the applicant are again verified. A large percentage of the cases assisted were un-employed persons. The cost to the Council for this service was approximately £245. Dried milk is supplied from the office at cost price to such cases as are recommended by the Health Visitors. The scheme for granting assistance has now been in operation for some years, but the number of persons assisted during the year 1925 was considerably lower than was the case for the four previous years. The Council's Maternity Home, about which I have previously remarked in this Report, has proved very useful during the year. Ante-natal work is also carried on at this building with good results. This Home has now been established five years. No case of Ophthalmia Neonatorum was notified in the Area during the year. In conclusion, I wish to record my appreciation and thanks to the members of the Staff of the Health and Maternity and Child Welfare Departments for the loyal and efficient manner in which they have rendered their services throughout the year. Yours obediently, THOS. W. HINDS, Medical Officer of Health. 20 SANITARY INSPECTOR'S REPORT. Health Department, Council Offices, Bexleyheath. To the Chairman and Members of the Bexley Urban District Council. Ladies and Gentlemen, I submit herewith my Eleventh Annual Report as Sanitary Inspector to your Council, being for the year 1925. The Report consists, as on former occasions, of a tabulated record of the work carried out. Table No. 1. Number of Complaints received and investigated 282 „ „ Statutory Notices served 22 „ ,, Statutory Notices complied with 20 „ ,, Statutory Notices Outstanding 5 ,, ,, Informal Notices, Letters, etc. 508 ,, „ Informal Notices complied with, including outstanding, 1924 416 ,, „ Informal Notices outstanding 210 Table No. 2. Details of Inspection Work carried out during the year. Number of Inspections Reinspections Houses Inspected Housing Town Planning, etc. Act (all particulars recorded) 51 Houses Inspected (defects only recorded) 481 1391 „ ,, re Infectious disease 98 96 21 Inspections Reinspections Inspections—Factory and Workshops 36 — Outworkers 10 — Schools 62 — Refuse Tips 77 — Van Dwellers 74 — Bakehouses 41 — Slaughterhouses, Meat Shops, etc. 1180 - re Overcrowding 26 — re Offensive Accumulations 28 25 re Keeping of Animals 23 17 Cowsheds and Dairies 57 — Common Lodging House 2 — re Rats 53 28 Drains inspected 466 135 Drains tested (Water, Smoke or Grenade) 84 — Miscellaneous Inspections (including Supervision of Hospital, Refuse Removal and Shops Acts) 1203 - Table No. 3. Improvements effected and defective sanitary conditions remedied. Houses— With Notice Without Notice Provided with sufficient W.C, accommodation 3 41 Provided with sufficient ashplace accommodation 8 87 Houses improved internally— Dirty rooms cleansed 10 208 Walls and Ceilings repaired 5 90 Supply of Drinking Water improved — 4 Dampness in rooms remedied 3 88 Defective Floors repaired 2 18 Ventilation of Rooms improved 2 52 Coppers repaired 1 15 Stoves, Fireplaces, etc., provided or repaired 1 32 22  With Notice Without Notice Houses improved externally— Roofs repaired 5 111 Eaves, Gutters and Down Spouts fixed or repaired 50 Yards paved or repaired — 15 Drainage— Drains cleansed or repaired — 205 New Drains constructed 26 7 Ventilation of drainage system improved 3 17 Inspection chambers built or improved 6 10 Waste pipes provided or improved — G Offensive accumulations removed — 18 Nuisance from animals abated — 12 Overcrowding abated — 20 Tents, Vans and Sheds, nuisances abated — 41 Table No. 4. Infectious Disease— Cases removed to Isolation Hospitals 65 Houses visited, including re-visits 194 Rooms disinfected 165 Notices delivered to Educational Authorities, Royal Factories, etc. 235 Houses at which defective sanitary conditions were found and remedied 8 Table No. 5. Food Inspection. The following are the details of food condemned within the District during the year 1925, as being unfit for human consumption:— Meat 1407 lbs. Fish 28 „ Vegetables 112 ,, It was necessary on one occasion to seize diseased meat which was exposed for sale and the Purveyors in question were convicted and fined £20 and £6 costs. 23 Table /Vo. 6. FACTORY AND WORKSHOP ACT, 1901. 1. Inspection of Factories, Workshops and Workplaces. Premises. Number of:— Inspections. Written Notices Prosecutions 1 2 3 4 Factories (including Factory Laundries) 28 1 Workshops „ Workshop ,, 27 — — Workplaces (other than outworkers premises) 22 — — Total 77 1 — 2. Defects found in Factories, Workshops and Workplaces. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector 1 2 3 4 5 Nuisances under the Public Health Acts— Want of Cleanliness 4 4 ,, ,, Ventilation Overcrowding Want of drainage of floors 1 1 Other nuisances 2 2 Sanitary Accommodation— Insufficient 1 Unsuitable or defective 1 Not separate for sexes Offences under the Factory and Workshops Acts— Illegal occupation of underground bakehouses Other offences Total 9 7 I am, Ladies and Gentlemen, Yours obediently, R. J. RAYNER, Sanitary Inspector.