BRO 13 BROMLEY RURAL DISTRICT COUNCIL. REPORT FOR THE YEAR 1925 on the Sanitary Conditions & Vital Statistics of the RUBAL DISTRICT OF BROMLEY BY THE MEDICAL OFFICER OF HEALTH TOGETHER WITH THE Repobts of the Sanitary Inspectors. TONBRIDGE: TONBRIDGE FREE PRESS, 129 High Street. RURAL DISTRICT COUNCIL OF BROMLEY. Health Report for 1925. Ladies and Gentlemen, I have the honour of submitting my Annual Report for the year 1925, being the third one presented by me as your Medical Officer of Health. The estimated population for the year 1925 is 27,560, as compared with estimated population of 26,800 for 1924, 25,940 for 1923, and an actual population of 26,012 at the 1921 Census. The Birth Rate for the District was 17.0 per thousand of estimated population, as against 18.3 for England and Wales. The corresponding figures for 1924 were 17.6 and 18.8. The standardised Death Rate was 10.2 per thousand of population, as against 12.2 for England and Wales. The corresponding figures for 1924 were 10.8 and 12.2. The Infantile Mortality Rate was 50 per thousand of registered births, as compared with 75 per thousand of registered births for England and Wales. In 1924 the figures were 57 and 75. The year 1924 was a very satisfactory one from the point of view of Infectious Diseases, no epidemic of any consequence arising. I desire to express my hearty thanks to the Council and their Officers for the help and consideration shown me. I should again like to place on record my appreciation of the services rendered by Mr. Dunlop and Mr. Nightingale, and to recognise the valuable work done by Mr. Fisher in connection with meat inspection. I am, Ladies and Gentlemen, Your obedient Servant, P. N. CAVE, Medical Officer of Health. 2 RURAL DISTRICT COUNCIL OF BROMLEY. Public Health Committee. W. A. WARING, Esq., J.P., Chairman MRS. CARTER. MR. C. GEORGE. MRS. SMAIL. „ W. GOSLING. COL. SIR HENRY LENNARD, „ R. J. GRIFFIN. BART, D.L., J.P. „ F. J. HYAM. C. BERENS, Esq., J.P. „ W. O. H. JOYNSON. MR. E. BERENS. „ G. J. MILLER. „ H. BOND. „ B. SIMPSON. „ G. G. FLOYD. „ C. SMITHER. REPRESENTATIVES ON THE BROMLEY AND BECKENHAM JOINT HOSPITAL BOARD. MR. G. G. FLOYD. MR. W. 0. H. JOYNSON. REPRESENTATIVE ON THE WEST KENT MAIN SEWERAGE BOARD. MR. W. 0. H. JOYNSON. STAFF. Medical Officer of Health. P. N. CAVE, M.A., M.D., M.R.C.S., L.R.C.P., D.P.H. Sanitary Inspectors. H. NIGHTINGALE, C.R.S.I., M.S.I.A. A. DUNLOP, C.R.S.I. Meat Inspector. P. J. FISHER. Health Visitor. MISS W. MEADE. 3 REPORT. The Bromley Rural District, which was formed in 1895 from the Bromley Rural Sanitary Authority, lies in the northwestern portion of the County of Kent, and borders on the neighbouring Authorities as follows:— On the North: Bromley Borough, Woolwich Borough, Chislehurst, Sidcup, and Bexley Urban Districts. On the South: Godstone and Sevenoaks Rural Districts. On the East: Sevenoaks and Dartford Rural Districts. On the West: Bromley Borough and Godstone Rural District. The Administrative County of Kent is divided into 18 Municipal Boroughs, 24 Urban Districts, and 23 Rural Districts. Compared with the 23 Rural Districts of Kent, the Bromley Rural District stands second as regards population, the first place being held by the Dartford Rural District, the population of which exceeds that of the Bromley Rural District by 11,000. As regards acreage, this District stands seventeenth amongst the 23 Rural Districts, and consequently its density of population stands high amongst the Kent Rural Districts, being only second to the Dartford Rural District, to which it closely approximates. The Rural District of Bromley consists of 13 parishes, and the total area is 28,839 acres. The largest parish as regards acreage is Cudham with 5,925 acres, and the smallest Mottingham with 642 acres. The parish with the largest population is Orpington with 7,047, and that containing the smallest is North Cray with 755. The acreage and population of the parishes at the 1921 Census is shown in the following Table:— 4 Civil Parishes. Area in Statute Acres. (land and inland water). POPULATION. 1901 1911 1921 Persons. Males. Females. Persons. Males. Females. Chelsfield 3,378 1,522 1,790 885 905 2,108 979 1,129 Cudham 5,925 1,111 1,604 832 772 2,247 1,141 1,106 Downe 1,652 610 649 285 364 791 323 468 Farnborough 1,429 2,262 3,210 1,708 1,502 3,322 1,643 1,679 Hayes 1,282 838 925 369 556 1,010 364 646 Keston 1,487 832 986 440 546 1,029 489 540 Knockholt 1,701 952 943 472 471 908 416 492 Nottingham 642 1,332 1,534 727 807 1,804 892 912 North Cray 1,484 661 655 303 352 755 367 388 Orpington 3,517 4,259 5,036 2,351 2,685 7,047 3,700 3,349 St. Mary Cray 2,028 1,894 1,857 872 985 2,178 1,016 1,162 St. Paul's Cray 1,654 1,207 1,467 676 791 1,512 708 804 West Wickham 2,660 1,328 1,302 610 692 1,301 594 707 TOTALS 28,839 18,808 21,958 10,530 11,428 26,012 12,632 13,380 5 The persons per acre in the Rural Districts of Kent are shown in the subjoined Table, given in order of density of population. Rural District. Persons per Acre. Dartford 1.1 BROMLEY 0.9 Isle of Thanet 0.8 Mailing 0.7 Maidstone 0.5 Milton 0.5 Strood 0.5 Sevenoaks 0.4 Tonbridge 0.4 Blean 0.3 Bridge 0.3 Cranbrook 0.3 Dover 0.3 East Ashford 0.3 Eastry 0.3 Faversham 0.3 Elham 0.2 Hollingbourne 0.2 Hoo 0.2 Sheppy 0.2 Tenterden 0.2 West Ashford 0.2 Roniney Marshes 0.1 The number of families or separate occupiers in the various parishes is shown as \inder:— Parish. Families or Separate Occupiers. 1901. 1911. 1921. Chelsfield 341 428 525 Cudham 234 389 532 Downe 145 164 170 Farnborough 284 508 525 Hayes 195 214 232 Keston 179 235 251 Knockholt 223 244 236 Mottingham 256 316 369 North Cray 147 140 153 Orpington 864 1130 1305 St. Mary Cray 439 457 523 St. Paul's Cray 256 301 334 West Wickham 264 294 292 Totals 3,827 4,820 5,447 6 Comparison between the structurally separate occupied dwellings and the number of private families, together with the exact number of occupied houses in 1923 and 1925, yields the following figures:— Parish. Private Families. Structurally separate dwellings occupied. Number of occupied houses. Number of occupied houses. 1921. 1921. 1923. 1925. Chelsfield 525 485 560 605 Cudham 532 532 600 734 Downe 170 167 180 174 Farnborough 525 512 600 600 Hayes 232 222 230 246 Keston 251 237 274 309 Knockholt 236 233 277 271 Mottingham 369 296 329 327 North Cray 153 149 151 150 Orpington 1305 1243 1369 1513 St. Mary Cray 523 478 468 435 St. Paul's Cray 334 325 253 304 West Wickham 292 281 278 308 Totals 5,447 5,160 5,569 5,976 The local age and condition distribution are:— Area. Average age. Number of married women under 45 per 1000 women of all ages. Number of females per 1000 males. Males. Females. Bromley Rural District 31.0 32.1 212 1059 OCCUPATIONS BY SEX—1921. Males. Females. Total population 12,632 13,380 Aged 0—11 2,781 2,679 Aged 12 and upwards 9,851 10,701 I Fishermen 2 — II Agricultural occupations 2,103 397 III Mining and quarrying occupations 20 — IV Makers of coke, lime, cement, etc. 4 — V Makers of bricks, pottery, glass 14 — VI Workers in chemicals, paints, etc. 17 — VII Metal workers 478 2 VIII Workers in precious metals 6 — IX Electrical apparatus makers, fitters, etc. 76 1 X Makers of watches, etc. 30 — XI Workers in skins, leather goods makers 17 — XII Textile workers 12 12 XIII Makers of textile goods and articles of dress 101 163 7 OCCUPATIONS BY SEX—Continued. Males. Females. XIV Makers of foods, drinks and tobacco 112 8 XV Workers in wood, etc. 267 3 XVI Paper workers, printers, etc. 131 203 XVII Builders, bricklayers, etc. 419 — XVIII Painters and decorators 170 — XIX Workers in other materials 4 3 XX Workers in mixed and undefined articles 34 — XXI Persons in water, gas and electricity supply 33 — XXII Transport workers 904 24 XXIII Commercial and financial tions 782 289 XXIV Public administration and defence 429 69 XXV Professional occupations 277 342 XXVI Persons employed in entertainments, etc. 35 14 XXVII Persons employed in personal service 453 1,791 XXVIII Clerks, draughtsmen, typists, etc. 333 244 XXIX Warehousemen, etc. 104 15 XXX Stationary engine drivers, etc. 66 — XXXI All other occupations 607 26 TOTAL OCCUPIED 8,240 3,566 Unoccupied and Retired 1,611 7,135 TOTAL OCCUPIED AND UNOCCUPIED 9,851 10,701 POPULATION. The estimated population for the year 1925 is 27,560, an increase of 760 over that of 1924. The recent variations in population are shown in the following Table:— 1921 Actual Population. 1922 Estimated Population. 1923 Estimated Population. 1924 Estimated Population. 1925 Estimated Population. 26,012 25,750 25,940 26,800 27,560 VITAL STATISTICS. BIRTHS. During the year 470 Births were registered, of which number 247 were males and 223 were females, as against 472 last year. This is equal to an Annual Birth Rate of 17.0 per thousand of population, as against 17.6 last year. The Birth Rate in England and Wales was 18.3, and for 1924, 18.8. 8 The number of illegitimate births registered was 16, as against 20 last year. The illegitimate birth rate was equal to 3.4 per eent. of total births, as compared with 4.4 last year. DEATHS. The number of deaths registered during the year was 279. This number excludes the deaths which occurred inside but belonged to other districts, but includes those deaths which belonged to this district although occurring outside. Of these deaths, 140 were males and 139 were females. The Death Rate for the year is equal to 10.2 per thousand of population, as against 10.8 last year. The death rates for England and Wales were 12.2 and 12.2 respectively. The diseases claiming the greatest number of deaths were: Cancer, with 44; Bronchitis, with 34; and Heart Disease, with 29. INFANTILE MORTALITY. During the year 24 deaths were registered as occurring in infants under one year of age (17 legitimate and seven illegitimate). This gives an infantile mortality rate of 50 per thousand registered births, as against 57 last year. The illegitimate infantile mortality rate is equal to 437 per thousand illegitimate births. The infantile mortality rate in England and Wales was 75, and for 1924 it was 75. MORTALITY AT DIFFERENT AGES. Children Between One and Five Years.—During the year seven deaths were registered as occurring in children between the ages of one and five. This is equal to an Annual Death Rate of 0.25 per thousand of population, and constitutes 2.5 per cent. of the total number of deaths. Persons of 65 Years and Over.—The number of deaths registered as occurring in persons of 65 years and over was 128. This is equal to an Annual Death Rate of 4.6 per thousand of population, and constitutes 45.8 per cent, of the total number of deaths. CAUSES OF DEATH. The deaths in 1925 included:— Scarlet Fever nil Diphtheria 1 Typhoid Fever 1 Pulmonary Tuberculosis 15 Other Tuberculous Diseases 8 Measles 2 Whooping Cough nil Diarrhoea and Enteritis (under two years) 2 Influenza 7 Pneumonia (all forms) 21 Bronchitis 34 Cancer 44 Puerperal Sepsis nil Other Diseases and Accidents of Pregnancy & Parturition 1 Appendicitis 1 9 ZYMOTIC DEATH RATE. The Zymotic Death Rate is a term commonly applied to the rate of deaths from the seven principal Zymotic complaints, viz., Small Pox, Measles, Scarlet Fever, Diphtheria, Whooping Cough, Fever (which latter term includes Typhus, Typhoid or Enteric, Paratyphoid and Continued Fever), and Diarrhoea. The number of deaths occurring from these complaints during the year was six, giving a Zymotic Death Rate of 0.21 per thousand of population. PULMONARY TUBERCULOSIS. The deaths from Pulmonary Tuberculosis (Consumption or Phthisis) number 15, as against 25 last year. The Death Rate for this year was 0.55 per thousand of population, as against 0.93 last year. OTHER RESPIRATORY DISEASES. Deaths occurring from other respiratory diseases numbered 59, as against 32 last year. This gives a Death Rate of 2.12 per thousand of population, as against 1.20 last year. CANCER. The number of deaths occurring from Cancer (malignant disease) numbered 44, being the same as last year. This gives a Death Rate of 1.61 per thousand of population, as against 1.65 last year. INFLUENZA. Deaths from Influenza numbered seven, as against 20 last year. This gives a Death Rate of 0.25 per thousand of population, as against 0.75 last year. Analysis of Death Rates. All Causes. Zymotic Disease. Pulmonary Tuberculosis Other Respiratory Diseases. Cancer. Influenza. 1925 Number of Deaths. 279 6 15 59 44 7 Rate per 1000 of population. 10.2 0.21 0.55 2.12 1.61 0.25 1924 Number of Deaths. 288 6 25 82 44 20 Rate per 1000 of population. 10.8 0.22 0.93 1.20 1.65 0.75 10 Birth Rate, Death Rate, and Analysis of Mortality during the Year 1925. BIRTHRATE PER 1,000 TOTAL POPULATION ANNUAL DEATH-RATE PER 1,000 POPULATION. RATE PER 1,000 BIRTHS. All Causes. Enteric Fever Small-pox. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Influenza. Violence. Diarrhoea and Enteritis (under Two years.) Total Deaths under One year. England and Wales 18.3 12.2 0.01 0.00 0.13 0.03 0.15 0.07 0.32 0.47 8.4 75 105 County Boroughs and Great Towns, including London 18.8 12.2 0.01 0.00 0.17 0.03 0.18 0.09 0.30 0.43 10.8 79 157 Smaller Towns (1921 adjusted Populations 20,000—50,000) 18.3 11.2 0.01 0.00 0.15 0.02 0.14 0.06 0.31 0.38 7.6 74 London 18.0 11.7 0.01 0.00 0.08 0.02 0.19 0.11 0.23 0.46 10.6 67 Bromley Rural District 17.0 10.2 0.03 0.00 0.07 0.00 0.00 0.03 0.25 0.25 4.2 50 11 INFECTIOUS DISEASE. The year 1925 was again a very satisfactory one from the point of view of incidence of Infectious Disease. The following Tabic shows the number of notifications received during the year, together with the removals to Hospital:— Disease. Total cases notified. Cases-remoed to Hospital. Total Deaths. Scarlet Fever 15 14 - Diphtheria 9 8 1 Enteric Fever 6 5 1 Puerperal Fever 1 - - Erysipelas 3 - - Pneumonia. 10 - 31 Ophthalmia Neonatorum 3 - - Cerebro-spinal Fover 1 1 - Poliomyelitis 1 - - TOTAL 49 28 23 12 The monthly incidence of Infectious Disease is shown in the following Table:— Month. Scarlet Fever. Diphtheria. Enteric Fever. Puerperal Fever. Erysipelas. Pneumonia. Ophthalmia Neonatorum. Cerebrospinal F ever. Poliomyelitis. TOTAL. January — — — — — 1 — — — 1 February 1 1 — — — 1 — — — 3 March — 1 — — — — — — — 1 April 3 — — — — 2 1 — — 6 May 1 — — — 1 — — — — 2 June 1 2 1* — — — — — — 1 July 1 2 1* — — 1 1 — — 6 August — 1 4‡ — — — — 1 — 6 September 1 1 — — — — — — 1 3 October — — — 1 — 2 1 — — 4 November 5 — — — 2 1 — — — 8 December 2 1 — — — 2 — — — 5 TOTALS 15 9 6 1 3 10 3 1 1 49 * Para-typhoid B. tIncluding one Para-typhoid B. 13 The notifiable Infectious Diseases fall into the following groups:— Number of cases. 0-1 1-5 5-10 10-15 15-20 20-35 35-45 45 and over. 49 3 6 9 9 2 7 7 6 Scarlet Fever.—A large decrease in the number of cases of Scarlet Fever notified took place, viz., 15 as against 59 last year. The average number of cases notified during the years 1920-24 was 59. Fourteen cases were removed to the Isolation Hospital. I am glad to state that again this year no deaths were registered as occurring from this complaint. The age periods were:— Number of cases. 0-1 1-5 5-10 10-15 15-20 20-35 35-45 45 and over. 15 — 3 5 4 — 1 2 — The monthly incidence was:— Total number of cases. Jan. Feb. Mar. Aprl. May. June. July. Aug. Sept. Oct. Nov. Dec. 15 — 1 — 3 1 1 1 — 1 — 5 2 Diphtheria.—A decrease also took place in the number of cases of Diphtheria notified, there being nine as against ten last year. The average number of cases per year for the years 1920-24 was 45. Eight cases were removed to the Isolation Hospital. One case proved fatal. The number of swabs examined during the year was 50, of which five proved positive. The age periods were:— Number of cases. 0-1 1-5 5-10 10-15 15-25 25-35 35-45 45 and over. 9 — 2 3 2 — 1 1 — 14 The monthly incidence was:— Total number of cases. Jail. Feb. Mar. Aprl. May. June. July. Aug. Sept. Oct. Nov. Dec. 9 — 1 1 — — 2 2 1 1 — — 1 Enteric Fever.—Six cases of Enteric Fever were notified, as against one last year. Of the six cases, three were Paratyphoid B. Five cases were removed to the Isolation Hospital, and one death was registered during the year. The age periods were:— Number of cases. 0-1 1-5 5-10 10-15 15-25 25-35 35-45 45 and over. 6 - 1 - 1 2 1 1 - Puerperal Fever.—There was one case of Puerperal Fever notified. Erysipelas.—Three cases were notified, as against nine last year. Pneumonia.—Ten cases were notified. The age periods were:— Number of cases. 0-1 1-5 5-10 10-15 15-20 20-35 35-45 45 and  10 — — 1 1 — 2 2 4 The monthly incidence was:— Total number of cases. Jan. Feb. Mar. Aprl. May. June. July. Aug. Sept. Oct. Nov. Dec. 10 1 1 — 2 — — 1 — — 2 1 2 Malaria.—No case was notified. Encephalitis Lethargica.—No notification was received. Cerebro-Spinal Fever.—One case was notified. Ophthalmia Neonatorum.—Three cases were notified. Poliomyelitis.—One case was notified. 15 The following Table shows the number of cases of Infectious Disease notified during the past six years:— 1920 1921 1922 1923 1924 1925 Scarlet Fever 63 39 65 72 59 15 Diphtheria 77 68 51 21 10 9 Enteric Fever 3 1 2 2 1 6 Puerperal Fever 1 — 3 — 1 1 Erysipelas 6 6 7 9 9 3 Pneumonia 4 4 7 2 8 10 Ophthalmia Neonatorum — — — — 1 3 Encephalitis Lethargica 1 1 — — 4 — Malaria — 1 1 1 1 — Cerebro-spinal Fever 2 2 — — 1 1 Poliomyelitis — — — — — 1 Chicken Pox — — 17 18 — — TOTALS 157 122 153 125 95 49 Tuberculosis.—The number of new eases of Tuberculosis notified as occurring during the year was 48, of which 38 were Pulmonary and 10 were other forms of Tuberculosis. Since Tuberculosis became a notifiable disease in February, 1913, the following cases and deaths have occurred in this District:— Year Cases. Deaths. Pulmonary. NonPulmonary. Total. Pulmonary. NonPulmonary. Total. 1913 25 16 41 21 11 32 11 months 1 1914 36 5 41 23 4 27 1915 19 5 24 15 6 21 1916 30 4 34 26 7 33 1917 25 2 27 13 8 21 1918 34 7 41 23 7 30 1919 33 6 39 23 8 31 1920 28 2 30 25 4 29 1921 25 2 27 19 5 24 1922 27 3 30 ... ... ... 1923 10 4 14 18 7 25 1924 29 6 35 25 9 34 1925 38 10 48 15 8 23 16 The Kent County Council carries out through the agency of their Tuberculosis Officers the treatment of Tuberculosis. The nearest Dispensaries for this District are:— 2 Park Road, Bromley—Wednesday, 1.30 p.m. to 3.0 p.m. 73 High Street, Beckenham—Wednesdays, 10.0 a.m. to 11.0 a.m. Dr. Grabham attends both these Dispensaries. Sanatorium and hospital treatment is provided both for insured and non-insured persons when accommodation is available. The following is the number of persons who received treatment during the year:— Number of persons who received sanatorium treatment 18 Number of persons who received dispensary treatment 30 Dispensary supervision only 57 Specimens of sputa from suspected cases of Tuberculosis are examined, and during the year 54 examinations have been made from persons residing in this District. The following Table shows the cases of Tuberculosis notified during the year according to age and sex:— Age Periods. Years New Cases. Deaths. Pulmonary. Non Pulmonary. Pulmonary. NonPulmonary. M F M F M F M F Under 1 year ... ... 1 ... ... ... 1 ... 1 and under 5 ... ... 1 3 ... ... 1 2 5 ,, 10 1 ... 3 ... ... ... 2 1 10 ,, 15 2 ... ... 2 ... ... ... ... 15 ,, 20 1 1 ... ... ... ... ... ... 20 ,, 25 3 4 ... ... 2 1 ... ... 25 ,, 35 6 6 ... ... 2 2 ... ... 35 ,, 45 4 4 ... ... 1 1 1 ... 45 ,, 55 2 2 ... ... ... ... ... ... 55 ,, 65 1 ... ... ... 1 1 ... ... 65 and upwards 1 ... ... ... 2 2 ... ... TOTALS 21 17 5 5 8 7 5 3 17 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1924. The above Regulations came into force on the 1st January, 1925, requiring, inter alia, that a quarterly return should be made to the County Medical Officer of Health of all cases of Tuberculosis, whether pulmonary or non-pulmonary, that were on the register at the end of each quarter. Existing cases in the event of cure, removal from the District, or death are deleted from the register, and the new notifications added on as received. Subjoined arc the figures on the register at the end of each quarter:— PULMONARY. NON-PULMONARY. M. F.. Total. M. F. Total. 31st March 41 42 83 6 3 9 80th June 50 46 90 9 6 15 30th September 53 46 99 9 6 15 31st December 44 44 88 8 7 15 NON-NOTIFIABLE DISEASES. Measles.—Two deaths were registered as occurring from Measles. Whooping Cough.—No deaths occurred during the year from this complaint. Influenza.—During the year seven deaths were registered from Influenza, as against 15 last year. Cancer.—Deaths from cancer numbered 44, of which 19 were males and 25 were females. The death rate from Cancer is 1.61, as against 1.65 last year. The figures in previous years were:— 1907 1908 1909 1910 1911 1912 1913 1914 1923 1924 1925 Number of Deaths. 11 36 19 20 20 28 33 31 37 44 44 Death Rate. 0.54 1.76 0.92 0.96 0.91 1.25 1.45 1.34 1.42 1.65 1.61 18 PREVENTIVE MEASURES.—DISINFECTION. General Remarks.—On the receipt of a notification of Infectious Disease, the case is visited and full particulars obtained. I am always glad to see any doubtful case of Infectious Disease in consultation with the Doctor in charge; and I have pleasure in placing on record the cordial co-operation I have received from the Medical Practitioners in this respect. This is, I feel sure, of great assistance in dealing with the incidence of Infectious Disease. When any outbreaks of Infectious Disease arise in connection with the scholars attending any school, whether a Private School or a Public Elementary or Secondary School, particular attention is given to any possible factors which may be tending to cause the spread of the disease. Convalescent cases after return from hospital are visited, and should circumstances arise rendering it advisable, are kept under further observation. Isolation Hospital.-The District is served by the Bromley and Beckenham Joint Isolation Hospital. This Hospital, administered by the Bromley and Beckenham Joint Hospital Board, serves the Borough of Bromley, the Urban Districts of Beckenham, Chislehurst and Sidcup, and the Rural District of Bromley. Cases are removed in the Board's motor ambulances. At present there are no means available for the steam disinfection of bedding, clothing, etc. Temporary arrangements, however, have now been made with a neighbouring Authority for steam disinfection of infected articles when so required. Disinfection is carried out by means of spraying with formalin and by fumigation with formic aldehyde gas. All disinfection, as well as the actual drain testing, is carried out by the Sanitary Inspectors, no assistance being provided for this purpose. During the year 108 premises were disinfected. LABORATORY WORK. The laboratory work for this area is carried out at either the Kent County Laboratory at Maidstone or at the Clinical Research Association, London. 19 During the year the following specimens have been examined;— Positive. Negative. Total. Swabs for Diphtheria 5 45 50 Widal reactions 1 3 4 Sputa for Tubercle 16 38 54 Milk — — — TOTAL 22 86 108 HEALTH VISITOR. The Council appointed a Health Visitor, who commenced her duties on the 11th May, 1925, and devotes the whole of her time to the services of the Council. During the period of the year for which she has been in the District, she has paid 326 visits, of which 34 were primary and 292 re-visits to cases of Tuberculosis. The following Table shows the number of visits paid in each Parish:— Parish. Primary Visit. Revisits. Chelsfield 3 50 Cudham 6 46 Downe 1 3 Farnborough 4 36 Hayes 1 7 Keston 2 22 Knockholt 3 14 Mottingham 3 7 North Cray 1 2 Orpington 5 72 St. Mary's Cray 3 12 St. Paul's Cray 1 12 West Wickham 1 9 TOTAL 34 292 20 The following Tables show the number of visits paid to cases of pulmonary and non-pulmonary Tuberculosis:— Pulmonary. Visits. Revisits. Total. Males 15 145 160 Females 11 130 141 Children (under 5 years) 1 2 3 TOTAL 27 277 304 Non-Pulmonary. Visits. Revisits. Total. Males — — — Females — — — Children under 5 years Boys 4 9 13 Girls 3 6 9 TOTAL 7 15 22 The cases of non-pulmonary Tuberculosis included: Tuberculoid Ankle, Tuberculosis Meningitis, Tuberculosis Mesenteric Glands, Tuberculosis5 Peritonitis, and Tuberculosa Cervical Glands. Total Visits—Pulmonary and Non-Pulmonary. Visits. Revisits. Total. Males 15 145 160 Females 11 130 141 Children under 5 years Boys 5 11 16 Girls 3 6 9 TOTAL 34 292 326 21 DRAINAGE. The outstanding feature is the urgent need for main drainage in the Parish of West Wickham. The present state of affairs is extremely bad, and is a constant source of anxiety to the public Health Department. The only solution is the construction of the necessary sewers and their connection to the system of the West Kent Main Sewerage Board. The sewering of the Parishes of Hayes and Keston, though not presenting the same degree of urgency, will have to be considered seriously in the near future. Chelsfield.—That part known as New Chelsfield is sewered, the sewage discharging into the West Kent Main sewers. The other part of the Parish, including Chelsfield Village, Prattsbottom, and Maypole, are on cesspool accommodation. Cudham.—There is cesspool accommodation throughout the whole of the Parish, and these are cleansed when necessary by the owners, the sewage being deposited on the land. Downe.—Entirely drained to cesspools, which are cleansed by the owners and deposited on agricultural land. Farnborough.—With the exception of seven houses in isolated parts, all premises are connected to the main drainage. Hayes.—The main drain of Hayes Village deals only with the slop water.in connection with 60 houses, and discharges on to pasture land. About 40 houses in Hayes Road are connected with the West Kent sewer. The other parts of the Parish are connected to cesspools. Keston.—The general system is on cesspool accommodation, with the exception of 24 houses at Keston Park, where the slop water is deposited on small gardens at the rear of houses and nuisances are constantly arising therefrom. In consequence of the water-logged subsoil, it is impossible to provide cesspools, and the only practical remedy is main drainage. The drainage from 40 houses in Lakes Road is conveyed by overflow pipes from cesspools to a Farrar's patent filter tank, the effluent being afterwards treated by trenching on isolated land in the vicinity. Knockholt.—Cesspool accommodation universal. The cleansing is done by the owners when necessary, and contents deposited on agricultural land. Mottingham.—Five houses only (in Elmstead Lane where no sewer exists) have cesspools; the remainder of the houses in this Parish are drained into the sewer. North Cray.—The Council's sewer runs through the village and the drains of houses adjoining are connected up. About 70 outlying houses have cesspools. Orpington.—The West Kent Board's sewer runs through the High Street and the sewers in the district roads merge into 22 it, and the house drains are connected thereto. Houses on the Georgewood Estate, Carnwell Wood Estate, Knoll Estate, and a few houses at Crofton are drained into cesspools. St. Mary Cray.—The West Kent main sewer traverses the main street, and all houses in the Village proper are connected to the sewer. A few scattered houses at Kevington, Hockenden and Birchwood Corner are drained to cesspools. St. Paul's Cray.—The West Kent main sewer runs through the High Street, and houses in this and the adjoining district roads are drained to the sewer. Only a few outlying houses are drained to cesspools. A new Estate known as "Leesons" is being laid out, and for the present the new houses are being drained into cesspools. West Wickham.—Cesspool accommodation universal. The drainage of 40 houses in Pix Park is conveyed by overflow pipes to meadow land and disposed of by irrigation by the owners. The drainage from 11 houses in Grosvenor Road is treated by irrigation on meadow land under an agreement with the Council and owners. The drainage from 1 to 7 Victoria Road, and "The Nest," is conveyed by overflow pipes from cesspools and after filtration is discharged into the "Copse" at the Alders, and in close proximity to the Beck. It will be seen from the above Summary that the closet accommodation of the District consists of water-carriage, privies and earth closets. The number of premises containing each type of sanitary convenience are approximately: Water closets into drainage system, 3,365; water closets into cesspools, 1,970; earth closets or privy middens, 60; and pail closets, 890. There was no conversion of privies, etc., to the watercarriage system during the year. WATER SUPPLY. Chelsfleld.—The supply from the Metropolitan Water Board is generally available throughout, with the exception of the locality known as Well Hill, where the supply is obtained from two well springs by means of service pipe with draw-off tap. The water is of excellent quality, and is used by inhabitants of about 20 houses, some of which are in the adjoining Parish of Shoreham. Cudham.—The Metropolitan Water Board's supply is available throughout the largest area of the Parish, but on the Aperfield Court Estate at Biggin Hill many new houses are entirely dependent upon stored rain water, and the extension of the Board's mains has become necessary. Downe.—The Metropolitan Water Board's supply is generally available throughout the Parish. Farnborough.—A supply is available from the mains of the Metropolitan Water Board. 23 Hayes.—The. Metropolitan Water Board's mains are available throughout the Parish. Keston.—The Metropolitan Water Board's mains supply the Parish. Knockholt.—With the exception of a few bungalows at Knockholt Wood which have rain water storage tanks, a supply is available from the mains of the Metropolitan Water Board. Mottingham.—The whole of the houses in this Parish derive their supply from the Metropolitan Water Board's mains. North Cray.—With the exception of about six houses, which derive their supplies from deep wells, the whole of the houses are supplied by the mains of the Metropolitan Water Board. Orpington.—The Metropolitan Water Board's mains are available for the whole Parish, and practically all houses have a constant supply therefrom. There are 11 houses which derive their drinking water from deep wells, and two houses which are not within reasonable distance of the mains have rain water cistern storage tanks. St. Mary Cray.—A constant supply from the Metropolitan Water Board is available for the whole Parish. About 25 houses derive their drinking water from deep wells, including Messrs. Joynson's factory and eight houses connected therewith. St. Paul's Cray.—The Metropolitan Water Board's main is available for and practically supplies all the houses in the Parish. Messrs. Nash's Paper Factory and one cottage near by are supplied from a deep well. An artesian well is being provided for a new house 200 yards distant from the water main. West Wickham.—The Metropolitan Water Board's mains are available throughout the Parish. HOUSE REFUSE REMOVAL. Chelsfleld.—A fortnightly collection is made under contract with the Council throughout the whole of the Parish. The refuse is deposited on agricultural land. Cudham.—No systematic collection made, the refuse being disposed of by burying in gardens by occupiers. Downe.—No systematic collection made; the occupiers are allowed to dump the refuse on an isolated spot on a farm, free of charge, by an arrangement between the Parish Council and the occupier of farm. This arrangement has so far proved fairly satisfactory. 24 Farnborough.—Weekly collection under contract with the Council, the refuse being deposited on suitable fruit grounds. Hayes.—The Council contract for a weekly collection. The refuse is deposited on agricultural land. Keston.—Fortnightly collection made under contract with the Council, the refuse being disposed of on agricultural land outside the district. Knockholt.—No systematic collection in force, the occupiers burying the refuse in gardens. Mottingham.—The refuse is collected weekly by contract, the refuse being used to fill up a disused clay pit. North Cray.—The house refuse is collected fortnightly by contract. The refuse is deposited on land and subsequently used for agricultural purposes. Orpington.—The house refuse is collected weekly by contract, and dumped on land to be subsequently used for agricultural purposes. St. Mary Cray.—The house refuse is collected weekly by contract. It is deposited on land and covered with earth. St. Paul's Cray.—The house refuse is collected weekly by contract and deposited in a disused brickfield and covered with earth. West Wiekham.—A fortnightly collection is carried out under contract with the Council. The refuse is burnt and afterwards disposed of for manurial purposes. HOUSING CONDITIONS. G-enerally speaking, the standard of houses in the District is fairly good. The defects found consisted mainly of defective roofs, general dampness and dilapidation. These were chiefly due to the lack of management and supervision on the part of the owners; but there are a number of dirty and destructive tenants. Legal overcrowding was not discovered to any serious extent. There still remains, however, a shortage of houses in nearly every Parish, those mainly affected being Mottingham, Orpington, St. Mary Cray, Farnborough, Cudham, Keston, Downe, and West Wiekham. A real necessity for more houses still exists from two points of view; firstly to relieve cases of overcrowding, and secondly to provide alternative accommodation for families living under unsatisfactory surroundings, which cannot be properly and effectively dealt with owing to the present lack of alternative accommodation. The Council are taking all necessary steps to improve these conditions in every way possible. 25 The following Tables, taken from the last Census, have been specially collated and brought together to illustrate the condition of affairs:— TABLE "A." Housing of Private Families, 1921. Percentage of structurally separate dwellings returned as:— Bromley Rural District. Whole County. (a) Private houses 92 91 (b) Maisonettes, flats, tenements, etc. 0 1 (c) Attached to shops, offices, warehouses, etc. 8 8 Rooms per dwelling, 1921 5.35 5.62 Families per dwelling, 1921 1.06 1.10 Persons per family, 1921 4.17 4.09 Persons per family, 1911 4.27 4.24 Rooms per person, 1921 1.21 1.25 Population being more than Two persons to a room, 1921 1,379 47,688 Two persons to a room, 1911 886 35,120 TABLE "B." Private families classified by size of families and according to the number of rooms occupied. Number of Persons in family. Number of private families occupying the following number of rooms. 1 2 3 4 5 6-7 8-9 10 and over. 1 34 51 87 37 22 24 5 2 2 32 106 126 337 218 143 39 10 3 25 71 117 375 302 165 56 30 4 22 41 57 335 323 136 78 38 5 15 19 52 223 214 123 67 37 6 7 5 32 141 186 95 43 25 7 5 2 20 84 100 48 25 27 8 2 1 10 57 60 30 10 20 9 1 1 4 28 36 19 10 19 10 ... ... 2 14 14 7 4 9 11 ... ... ... 2 5 1 ... 9 12 ... ... ... 2 4 3 1 3 13 ... ... ... ... 4 1 1 3 14 ... ... ... ... 1 ... ... 4 15 and over ... ... ... ... ... ... ... 6 26 TABLE "C." Private families classified by density of occupation. Number of persons in families. Total No. Private families percentage. Population in private families. Rooms occupied. Average number of rooms per person. 1 262 4.8 262 925 3.53 2 1,011 18.6 2,022 4,413 2.18 3 1,141 20.9 3,423 5,382 1.57 4 1,030 18.9 4,120 5,202 1.26 5 750 13.8 3,750 3,980 1.06 6 534 9.8 3,204 2,903 0.91 7 311 5.7 2,177 1,749 0.80 8 190 3.5 1,520 1,098 0.72 9 118 2.2 1,062 786 0.74 10 50 0.9 500 366 0.73 11 17 0.3 187 189 1.01 12 13 0.2 156 129 0.83 13 9 0.2 117 114 0.97 14 5 0.1 70 110 1.57 15 and over 6 0.1 110 170 1.55 HOUSING. Number of new houses erected during the year:— (a) Total, including numbers given separately under (b) 296 (b) With State assistance under the Housing Acts: (i) By the Local Authority 34 (ii) By other bodies or persons 6 1.—Unfit Dwelling Houses. Inspection. (1) Total number of houses inspected for housing defects (under Public Health or Housing Acts) 232 (2) Number of dwelling houses which were inspected and recorded under the Housing (Inspection of District) Regulations, 1910, or the Housing Consolidation Regulations, 1925 51 27 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 7 (4) Number of dwelling houses (excluding those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 225 2.—Remedy of Defects Without Service of Formal Notices. Number of defective dwelling houses rendered fit in consequence of the Local Authority or their Officers 160 3.—Action Under Statutory Powers. A.—Proceedings under Section 3 of the Housing Act, 1925:- (1) Number of dwelling houses of which notices were served requiring repairs Nil (2) Number of dwelling houses which were rendered fit after service of formal notice: (a) By owners Nil (b) By Local Authority in default of owners Nil (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 the Public Health Acts:— (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 72 (2) Number of dwelling houses in which defects were remedied after service of formal notice: (a) By owners 65 (b) By Local Authority in default of owners Nil C.—Proceedings under Sections 11, 14 and 15 of Housing Act, 1925: (1) Number of representations made with view to making of a Closing Order 3 (2) Number of dwelling houses in respect of which Closing Orders were made 3 (3) Number of dwelling houses in respect of which Closing Orders were determined, the dwelling house having been rendered fit Nil (4) Number of dwelling houses in which Demolition Orders were made Nil (5) Number of dwelling houses demolished in suance of Demolition Orders Nil 28 MATERNITY AND CHILD WELFARE. Maternity and Child Welfare work in this District is carried out by the Kent County Council. The Health Visitors employed in the District are:— North Cray, St. Mary Cray, and St. Paul's CrayMrs. Reid. Knockholt—Miss Watt. Chelsfield—Nurse Hardy. Remaining Parishes—District Nurses working under the Kent County Nursing Association. Three Maternity and Child Welfare Centres have been established, all of which hold sessions weekly, viz.:— Farnborough, Parish Room.—Sessions held each Friday afternoon at 2.0 p.m. Average attendance, 40. The Medical Officer is Dr. Douse, who attends fortnightly. Cudham, Jail Lane, Biggin Hill.—Voluntary Centre. Sessions held each Tuesday afternoon. Average number of children, 12. St. Mary Cray, The Temple.—Sessions held each Wednesday at 2.0 p.m. The Medical Officer is Dr. Ruth P. Elliott, who attends fortnightly. Average attendance per session, 31. An antenatal clinic under the control of Dr. M. Oldershaw is held on the first and third Wednesdays in each month at this centre. SCHOOLS. The medical inspection of school children is under the supervision of the Kent County Council. There are 20 elementary schools within the District, there being no secondary schools. On no occasion was it found necessary to close a school owing to the prevalence of Infectious Disease amongst the scholars. REGULATED TRADES. Dairies, Cowsheds, and Milk Shops.—There are 53 persons on the register, which is eight more than the previous year. During the year 436 visits of inspection have been paid, and in 58 instances were nuisances discovered, all of which were remedied. Milk (Special Designations) Order.—Three licenses were granted under the above Order; whilst in no case was a licence to a retailer refused or revoked. Slaughterhouses.—There are 21 Slaughterhouses on the register, of which 20 are licensed annually and one is a registered slaughterhouse. 29 During the year 312 visits of inspection have been paid. Defects were found in 49 instances. The following number of Slaughterhouses were in use on the dates mentioned:— In 1920. In January, 1925 In December 1925 Eegistered 1 1 1 Licensed 18 19 20 TOTAL 19 20 21 PUBLIC HEALTH (MEAT) REGULATIONS, 1924. These Regulations came into force on the 1st April, 1925. The duty of carying out the provisions of this Order was met by the Council, after full consideration, by the appointment of a third Sanitary Inspector, holding the Meat Certificate, whose main duty consisted in inspecting animals killed for human consumption, and otherwise supervising and enforcing the due observance of the provisions of the Order. The Council applied to the Ministry of Health and obtained .their permission to Meat Marking. During the period from the 2nd June until the 31st December, 1925, the following number of animals were killed for human food in the Slaughterhouses in the District:— Under Special Under Regular Notices of Slaughter. Notices of Slaughter. Beasts 13 40' Calves 77 25 Sheep 73 143 Pigs 634 1993 Inspections were made of the carcasses of:— Beasts 53 Calves 102 Sheep 216 Pigs 2627 In all, 6,295 pounds of meat were found unfit for human consumption. This comprised:— Beef on account of Tuberculosis 4084 pounds. Veal on account of Tuberculosis 80 „ Beef for other causes 650 „ Mutton for other causes 11 „ Pork on account of Tuberculosis 1245 „ Pork for other causes 225 „ 30 The amount of unsound meat duly found on inspection and condemned, during the comparatively short time that systematic inspection was practised, compared with the extremely small amounts thus dealt with in previous years, proves the great utility of the Meat Regulations now in force, when these are thoroughly carried out. Special attention is directed to the large proportion of Tuberculosis meat, which has thus been prevented from being put on the market. Bakehouses.—There are 23 Bakehouses within the District. All are regularly inspected, 178 visits being paid during the year, and in 37 instances were defects found. SALE OP FOODS AND DRUGS ACTS. The Sale of Poods and Drugs Acts is under the control of the Kent County Council. FACTORY AND WORKSHOP ACT. It will be seen from the subjoined list that there are 24 Factories and 121 Workshops on the register. All the premises are regularly visited and inspected, and due attention has been paid to maintaining them in such a condition as to comply with the requirements of the Act. During the year 221 visits of inspection have been paid, and in 43 instances nuisances or irregularities were discovered. Trade. Numfc ier of Total. Factories. Workshops. Saw Mills 5 — 5 Laundries 4 7 11 Cycle Works 4 16 20 Carriage Makers and Wheelwrights — 6 6 Printing 3 — 3 Carpenters and Builders 1 20 21 Undertakers — 1 1 Shoeing Forges — 15 15 Dressmakers and Tailors — 7 7 Upholsterers — 3 3 Bakeries — 22 22 Paper Mills 2 — 2 Harness Making — 3 3 Bootmaking and Repairing — 18 18 Chaff Cutting and Corn Grinding 2 — 2 Motor Repair Factories 2 — 2 Sculptural Factory 1 — 1 Cab Washing (workplace) — 1 1 Basket Making — 1 1 Gunsmith — 1 1 Total 24 121 145 13 DEFECTS FOUND. Particulars. Found. Remedied Reported to H.M. Inspector. Number of prosecutions. Nuisances under Public Health Acts:— Want of cleanliness 40 40 — — Want of ventilation — — — — Overcrowding — — — — Want of drainage of floors 1 1 — — Sanitary accommodation insufficient — — — — Sanitary accommodation unsuitable or defective 2 2 — — Sanitary accommodation not separate for sexes — — — — Offences under the Factory and Workshops Acts:— — — — — Illegal occupation of underground bakehouse (s. 101) ... — — — — Breach of special sanitary requirements for bakehouses (ss. 97 to 100) — — — — Other offences (including offences relating to outwork) — — — — Total 43 43 — — OUTWORKERS. There are no outworkers in the District. SUMMARY. Total number of factories and workshops 145 Total number of visits paid 221 Number of defects found 43 Number of notices served 43 32 GENERAL. Legal Proceedings.—In the following cases it was found necessary to institute legal proceedings for the abatement of nuisances, etc.:— Particulars. Result. For occupying bungalow without Water Certificate and contravention of Byelaws with respect to New Streets and Buildings Fined £4 and £4 1s. costs. Contravention of Bye-laws with respect to New Streets and Buildings Fined £G and £3 3s. costs. For permitting a nuisance to exist Ordered to pay £3 costs. Ditto. Fined £25 and £6 11s. costs and ordered to abate nuisance. For exposing unsound meat for sale Fined £2 and £1 11s. 6d. costs. Water Courses.—The following water courses are kept under the supervision of your Officers:— The River Cray, which is the largest stream within the District, rises in Orpington and runs through Orpington and the Crays. The Ravensbourne, which rises in Keston, and flows through Keston and Hayes. The Quaggy, a small stream, flows through Mottingham and thence through Woolwich and Lewisham. The Beck rises in West Wickham and runs through West Wickham into the Beckenham Urban District. Ambulance Facilities.—The following are the ambulances available for this District:— For Infectious Cases.—The Bromley and Beckenham Joint Hospital Board provide two motor ambulances for the removal of cases of Infectious Disease to the Isolation Hospital. For General Cases.—No ambulance is at present available for Accident or General Cases. NURSING FACILITIES. Nursing is provided by the local District Nursing Associations, which are affiliated to the Kent County Nursing Association. 33 MIDWIVES ACT. The supervision of Midwives is carried out by the Kent County Council. Thirteen Midwives, all of whom are trained, have given notice of intention to practise within the District. Two Midwives receive subsidies from the Kent County Council. APPENDIX. 1.—GENERAL STATISTICS. Area (acres), 28,840. Population (1925), 27,560. Number of occupied houses (1921) 5,160; (1925) 5,976. Number of families or separate occupiers (1921) 5,447. Rateable Value, £191,434. Sum represented by a Penny Rate, £798. 2.—EXTRACTS FROM VITAL STATISTICS OF THE YEAR. Total. Male. Female. Births, Legitimate 454 238 216 Births, Illegitimate 16 9 7 Birth Rate, 17.0. Deaths, 279. Death Rate, 10.2. Number of women dying in, or in consequence of childbirth:— Prom Sepsis Nil From other causes 1 Deaths of infants under one year of age per 1,000 births: Legitimate 37, illegitimate 437, total 50 Deaths from Measles (all ages) 2 Deaths from Whooping Cough (all ages) Nil Deaths from Diarrhoea (under two years) 2 34 TABLE I. Cases of Infectious Disease notified during the year 1925. Disease. Number of Cases Notified. Cases removed to Hospital. At all Ages. at—ages—years. Under 1 1 to 2 2 to 3 3 to 4 4 to 5 5 to 10 10 to 15 15 to 20 20 to 35 35 to 45 45 to 65 65 and over Scarlet Fever 15 ... ... 1 ... 2 5 4 ... 1 2 ... ... 14 Diphtheria 9 ... ... 1 ... 1 3 2 ... 1 1 ... ... 8 Enteric Fever *6 ... ... ... ... 1 ... 1 2 1 1 ... ... 5 Puerperal Fever 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... Erysipelas 3 ... ... ... ... ... ... ... ... 1 1 1 ... ... Pneumonia 10 ... ... ... ... ... 1 1 ... 2 2 1 3 ... Ophthalmia Neonatorum 3 3 ... ... ... ... ... ... ... ... ... ... ... ... Cerebro-spinal Fever 1 ... ... ... ... ... ... ... ... ... ... 1 ... 1 Poliomyelitis 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... Totals 49 3 ... 2 ... 4 9 9 2 7 7 3 3 28 * Including 3 Para-typhoid "B." 35 TABLE II. Deaths registered during the year 1925. Disease. Males. Female. Total. Enteric Fever ... 1 1 Small Pox ... ... ... Measles 2 ... 2 Scarlet Fever ... ... ... Whooping Cough ... Diphtheria 1 1 Influenza 2 5 7 Encephalitis Lethargica ... ... ... Meningococcal Meningitis ... ... ... Tuberculosis of Respiratory system 8 7 15 Other tuberculous diseases 5 3 8 Cancer, malignant disease 19 25 44 Rheumatic Fever ... ... ... Diabetes ... 2 2 Cerebral haemorrhage, etc. 12 13 25 Heart disease 18 11 29 Arterio Sclerosis 4 3 7 Bronchitis 15 19 34 Pneumonia, all forms 8 13 21 Other respiratory diseases 1 3 4 Ulcer of stomach or duodenum 2 ... 2 Diarrhoea, etc. (under two years) 2 ... 2 Appendicitis and typhilitis 1 ... 1 Cirrhosis of Liver ... ... ... Acute and chronic nephritis 8 1 9 Puerperal sepsis ... ... ... Other diseases and accidents of pregnancy and parturition ... 1 1 Congenital debility, malformation, premature birth 9 5 14 Suicide ... 1 1 Other deaths from violence 4 2 6 Other defined diseases 20 23 43 Total 140 139 279 36 BROMLEY RURAL DISTRICT COUNCIL. No. 2 SANITARY DISTRICT. Sanitary Inspector's Office, Farnborough. April 29th, 1926. To the Chairman and Members of the Bromley Rural District Council. Ladies and Gentlemen, I have the honour to present to you my Report for the year ending December 31st, 1925. Disinfection.—Fifty-three houses, or parts of houses, and articles therein were sprayed and fumigated. Water Supply.—One hundred and twenty-three visits have been paid in connection with new houses, under Section 6 Public Health (Water) Act, 1878. The extension of the Metropolitan Water Board's main is very necessary in the various roads at Biggin Hill, where the occupiers of a large number of bungalow dwellings are still dependent on rain water storage for dietetic purposes, and which is unsatisfactory. Dairies, Cowsheds and Milkshops.—There are 32 Cowsheds, one Dairy and one Milkshop. The register contains the names of 10 Wholesale Producers, 23 Producers and Retailers combined, and one Retailer only; 260 visits were paid during the year, 58 sanitary defects found and 58 remedied. Bakehouses.—There are 13 Bakehouses; 83 visits were paid, 32 defects found and 32 remedied. Slaughterhouses.—There are 10 Slaughterhouses; 86 visits were paid, 43 defects found and 43 remedied. A new Slaughterhouse, for killing pigs only, has been provided at Southwood Farm, Buckhurst Lane, Westerham Hill, occupied by Dr. Rowlands. Insanitary Dwellings.—The total number of Dwelling Houses inspected for housing defects under the Public Health or Housing Acts was 110; one was demolished, and one closed as being unfit for human habitation by respective owners; 108 have been put into a reasonable state of repair, in compliance with notices served upon owners of same. Factory and Workshops Act, 1901.—The register contains the name of six Factories and 66 Workshops, which were periodically inspected, and the various sanitary defects found were remedied on verbal notice to owners, 37 Number of inspections made and nuisances discovered and abated are as follows:— Number of inspections 2,688 Number of nuisances discovered 555 Which arose from the following:— Houses not reasonably fit for habitation 110 Insufficient ash-pits 117 Defective drainage, including W.C.s 167 Animals kept in dirty state 21 Overcrowding 12 Cesspools 128 Number of premises containing each type of sanitary convenience in District (approx.):— W.C.s into drainage system 965 W.C.s into cesspools 1,502 Earth closets or privies 60 Pail closets 476 Fruit Pickers' Huts.—These were cleansed and limewashed before occupation, and the bye-laws generally complied with relative to water supply and closet accommodation; 36 inspections were made during the fruiting season. Removal of House Refuse.—A weekly collection is carried out under contract with the Council in connection with the Parishes of Farnborough and Hayes, and fortnightly in Chelsfield, Keston and West Wickham. The addition of Chelsfield Village was added during the year. Having regard to the large increase of residential houses in Keston and West Wickham, I respectfully suggest that a weekly collection has become necessary. The refuse collected by contractors is generally used for agricultural purposes; no serious complaints were received in connection with "refuse dumps." London Refuse.—During last March a large consignment from Southwark Borough Council was delivered at Knockholt Station for agricultural purposes on land adjoining the main road, Pratts Bottom. Both the main road and the station were littered with the stuff during transit, and nuisance existed. After writing to the owner of the farm, the refuse was ploughed in as soon as possible, and the roads also cleansed. Rats and Mice (Destruction) Act, 1919.—During National Rat Week I made many personal visits to premises in the various parishes, distributing circulars giving simple suggestions and methods to be employed in rat destruction; and a very large number of rats, I understand, were destroyed during the week in question, 38 Legal Proceedings.—On March 23rd Mr. M. A. Hodson, Berries Green Farm, Cudham, was fined £3 for non-compliance with statutory notices to abate cesspool nuisances at premises known as "Cheriton," "Braemar," "Glenhaven," and "Falkirk," Tail Lane, Cudham. One June 26th the same defendant was fined £36 lis. for non-compliance with statutory notices to carry out structural repairs and abate cesspool nuisances in connection with the same property. SUMMARY OF WORK DONE DURING THE YEAR 1925. Number of all kinds of visits paid 2,688 Number of nuisances discovered and abated 555 Number of dwelling houses repaired, cleansed and washed 108 Number of new dustbins provided 117 Visits to bakehouses 83 Visits to dairies, cowsheds and milkshops 260 Visits to slaughterhouses 86 Houses (part of) disinfected and fumigated 53 Visits to new houses re water supply 123 Houses where drains were examined and tested 54 Number of visits to fruit pickers' huts 36 Number of statutory notices served 35 Number of preliminary notices served 199 Number of reports, letters, school notices, etc., written 973 I am, Ladies and Gentlemen, Your obedient servant, A. DUNLOP, Sanitary Inspector. 39 BROMLEY RURAL DISTRICT COUNCIL. No. 1 DISTRICT. Sanitary Inspector's Office, Orpington. March, 1926. To the Chairman and Members of the Bromley Rural District Council. Ladies and Gentlemen, 1 have the honour to present my twenty-fourth yearly Report on Sanitary Work carried out during the year ending December 31st, 1925. Inspections, Nuisances, Etc.—During the year 3,013 inspections were made and 410 nuisances discovered, arising from the following sources:— 122 from defective and dirty houses. 21 from dampness to dwelling houses. 67 from defective drains. 54 from offensive accumulations. 30 from insufficient water closets. 59 from insufficient ash-pits. 6 from overcrowding. 16 from overflowing cesspools. 11 from rat infestation. 19 from defects at bakehouses, slaughterhouses, common lodging houses, workshops, etc. 5 from animals kept in a dirty condition. Disinfection.—Sixty-one houses or parts of houses were sprayed and fumigated; and wards at Cray Valley Hospital were sprayed and fumigated after septic cases. Water Supply.—Visits were paid to 74 new houses in connection with the certificate required under Sec. 6 Public Health (Water) Act, 1878. Samples of water were submitted for analysis from an artesian well and a storage tank at St. Paul's Cray, and both samples were found to be of good organic quality and suitable for drinking purposes. Dairies, Cowsheds and Milkshops.—There are 13 persons on the register as Wholesale Traders and Producers, and 11 as Retail Purveyors. There are six milkshops where milk is sold over the counter. During the year 176 visits were paid to the premises. About 200 cows are kept by the registered cowkeepers. 40 Licenses under the Milk (Special Designations) Order are held by The Express Dairy Coy., Mottingham, and Mr. F. S. Hodsoll, Orpington. One complaint was received alleging that milk was delivered in dirty bottles. 1 made early morning visits for observation on the roundsmen, and although I discovered no instance where dirty bottles were filled on the round, I warned the roundsmen of the consequences if they were caught filling unwashed bottles. A sample of the milk submitted for a bacteriological count proved to be satisfactory. Slaughterhouses.—Two hundred and twenty-six visits were paid to these premises, and during the two months preceding the appointment of a special Officer I inspected 885 carcases under the Meat Regulations. The majority of these carcases were sent to Smithfield Meat Market and re-examined by the Inspectors there. Out of the 885 carcases examined only 218 lbs. of meat were found to be unsound. Food Inspection Generally.—Seven hundred and sixty inspections were recorded as paid to butchers' shops, fish shops, grocers' shops, hawkers' carts, etc.; 84lbs. of fish were surrendered to me and destroyed. Fruit Pickers' Huts.—The temporary shelters occupied by persons engaged in fruit picking were inspected, generally in the evening when the pickers were not at work. In two instances huts were found to be occupied before being cleansed and limewashed, but the matter was immediately attended to when the fruit growers' attention was drawn to it. Common Lodging House.—Forty visits were paid to the common lodging house at Orpington. This place has served one useful purpose during the past year by providing temporary cheap lodging for men working on the new arterial road. No contravention of the bye-laws was discovered. The limewashing was carried out in April and October. Factory and Workshops Act.—There are 18 factories and 55 workshops on the register, and to these 126 visits were made. There are no outworkers in this District. Bakehouses.—There are nine bakehouses in the District; 95 visits were paid to the premises and five nuisances discovered. Defective and Dirty Houses.—General defects were dealt with at 122 houses. One old dilapidated cottage, No. 4 Downcroft Cottages, Orpington, became vacant in the spring, and a Closing Order was made against it. Tents, Vans and Similar Structures Used for Habitation.— Considerable trouble has been experienced by gipsy 41 ments; these undesirable people come in relays. With the assistance of the Police and the School Attendance Officer I have moved one lot on, only to find in a day or so that a fresh batch have arrived. They leave a considerable amount of refuse and filth behind, and arc a pest and terror to the local residents, especially the timid housewife. Unfortunately so far I have not been able to recommend a case for prosecution under the bye-laws. Removal of House Refuse.—The work of collection and disposal of house refuse is carried out by contract, and the contractor is required to empty the dustbins once each fortnight in North Cray Parish, and in the other parishes once each week. The work has been carried out in a satisfactory manner in the Parishes of Mottingham, North Cray, St. Mary Cray, and St. Paul's Cray; but there has been irregularity in the collection at Orpington, which has given cause for a number of complaints. River Cray.—Owing to the continued activity of the springs at Orpington, there has been a good flow of water and the river has been in a satisfactory condition. I have paid a considerable number of visits to different points of the stream for the purpose of detecting any possible pollution or obstruction, and in one instance it was necessary to serve a preliminary notice requiring the removal of stable manure in close proximity to the stream. Rats and Mice (Destruction) Act.—I have made special visits to premises upon information or complaint of rat infestation. Circulars were distributed giving suggestions for rat destruction, and recipes for making baits. Occupiers generally make an effort to keep down the rats, but there are some people who think they are everybody's rats but their own. SUMMARY OF WORK DONE DURING THE YEAR. Total number of inspections made 3,013 Number of nuisances discovered 410 Number of statutory notices served 99 Number of preliminary notices served 201 Number of reports, letters, etc., sent 1,446 Visits to common lodging house 40 Visits to factories and workshops 126 Visits to bakehouses 95 Visits to dairies, cowsheds and milkshops 176 Visits to slaughterhouses 226 Visits to other food shops 760 Houses disinfected and fumigated 61 Institutions disinfected 7 42 Houses generally repaired and cleansed 122 Rooms cleansed after infectious disease 80 Moveable dustbins provided 59 New soil pans and flushing cisterns provided 30 Houses where drains were examined and tested 67 Offensive accumulations removed 54 I have the honour to be, Your obedient servant, H. NIGHTINGALE, M.S.I.A. (Cert. Royal San. Inst.), Sanitary Inspector. 43 1 Seaward Villas, Moorfield Road, Orpington, Kent. March 31st, 1926. To the Chairman and Members of the Bromley Rural District Council. Ladies and Gentlemen, I beg to make my Report for the period June 2nd, 1925, to December 31st, 1925. During the above period I received 381 occasional notices of the intended slaughter of animals (under the provisions of the Public Health. (Meat) Regulations of 1925) intended for human consumption. The number of animals slaughtered and inspected were as follows:— Swine. Calves. Sheep. Beasts. 634 77 73 13 The method of giving occasional notice of intended slaughter by the butchers is either by telephone, on official forms (provided by the Council), or verbally to the Inspector. Regular Notices of Slaughter.—The following number of animals were inspected under the regular notices already received:— Swine. Calves. Sheep. Beasts. 1993 25 143 40 There are seven butchers who slaughter under the regular notices. Total number of animals slaughtered under both occasional and regular notices:—2,998. Meat condemned and destroyed as unfit for human consumption :— Beef on account of Tuberculosis 4084 pounds. Veal on account of Tuberculosis 80 Beef unfit through other causes 650 „ Mutton unfit through other causes 11 „ Pork on account of Tuberculosis 1245 „ Pork unfit through other causes 225 „ Total 6295 Method of Destruction of Unsound Meat.—The method of destruction of unsound or diseased meat is as follows:— I.—Cremation in an incinerator at Mr. E. G. Matthews', Farnborough. 44 II.—Burial in quicklime. III.—Small portions being mutilated and treated with strong carbolic solution (to render same unusable) and burned or buried. Butchers' Shops.—There are 28 butchers' shops in the District, to which 797 visits were paid. Slaughterhouses.—There are 21 slaughterhouses in the District, one being registered and 20 licensed. One slaughterhouse was discontinued to be used and one re-licensed. There were 1,092 visits paid to the above slaughterhouses. The methods of meat inspection are carried out strictly in accordance with the standards laid down by the Ministry of Health in Memorandum 62, Foods. The Public Health (Meat) Regulations, 1925.—The butchers and other persons concerned on the whole carry out the provisions of the above Regulations fairly well, both as regards the giving of notices of slaughter, cleanliness and the prevention of the contamination of meat, etc., by flies and dirt. Contraventions.— (1) One case of unsound meat was reported to the Council, who succeeded in recording a conviction with a fine of £2 and £1 16s. costs. (2) Two warnings were issued by the Clerk to the Council for failure to give the required notices under the Public Health (Meat) Regulations, 1925. Meat Marking.—The marking of carcasses after slaughter by the Inspector (when found fit for human consumption) does not appear to have found favour with the butchers. Those who do favour marking only allow the carcases which are sold locally to be marked, and not those conveyed to the Metropolitan Market. Some who allowed marking in the first case have requested its discontinuance on account of the objections of customers, who appear to be prejudiced unreasonably against meat which is marked, they being under the impression (without examining the meat) that it is foreign. Tuberculosis Regulations, 1925.—I inspected six carcasses of beef and one of veal slaughtered under the above Regulations. and 2,360 lbs. were condemned. This amount is included in the previous total. I am, Ladies and Gentlemen. Yours obediently, P. J. FISHER. Meat and Food Inspector.