CAR 036 Carshalton Urban District. ANNUAL REPORT OF THE Medical Officer of Health, J. WILLIAMSON, m.d., d.p.h. For the Year 1920. 3 CARSHALTON URBAN DISTRICT. Annual Report of the Medical Officer of Health for the Year 1920. (1) Natural and Social Conditions of the District. Population.—The population at the Census 1911 was 11,634 persons, of whom 713 were patients and 262 were officials at the Queen Mary's Hospital, and 74 were patients and 29 were officials at the Beddington Corner Isolation Hospital. The nett population in 1920, which is exclusive of persons in Institutions in the District belonging to other Districts, was estimated by the Registrar-General at 12,901 persons. Physical Features and General Character of the District.— The District is situated upon, and at the foot of, the northern slope of the chalk downs. The whole of the district south of the ponds, including the greater part of the old village (120ft. above sea level), a large residential district which has been recently developed to the south, and Carshalton-on-the-Hill (250ft. above sea level), are on the chalk; the northern part is situated mainly on a bed of river-gravel and sand overlying the.Thanet sand, the Woolwich and Reading beds, and the London clay (100ft. above sea level). The drainage is to the River Wandle, one head of which rises from the ponds in the middle of the town. The District is to a large extent residential, and there are no special industries. The chief factories are an ironworks, skin mills, and one for the manufacture of paper goods, etc. At the Census 1911 the number of persons returned as engaged in occupations was 3,055 males and 1,735 females. Among males, 425 were employed in the building trade and 254 in agriculture, and, among females, 752 were employed in indoor domestic service. Births.—The births registered in the District numbered 263; the births notified were 238, or 91 per cent., and 7 still-births. The nett births belonging to the district numbered 269, of which 258 were legitimate and 11 were illegitimate; 138 were males and 131 were females. . The birth rate for 1920 was 20.9 per 1,000 of the nett population, as against an average rate of 19.6 for the preceding ten years. The rate for England and Wales for 1920 was 25.4. 4 Deaths.—The deaths registered in the District in 1920 numbered 173, of which 57 occurred in the Queen Mary's Hospital, 24 in the Beddington Corner Isolation Hospital, and 4 in the District Hospital; 86 deaths were transferred to other districts, and 21 were transferred from other districts, leaving 108 nett deaths belonging to the District, of which 48 occurred among males and 60 among females. Influenza caused two deaths; Pulmonary Tuberculosis, 9; Cancer, 16; Heart Disease, 15 ; Bronchitis, 8; and Pneumonia, 5. The death rate for 1920 was 8.4 per 1,000 of the population, as agfc-inst an average rate of 10.0 for the preceding ten years. The rate for England and Wales for 1920 was 12.4. Child Mortality.—The deaths of infants under one year of age numbered 12, of which 7 occurred among males, and 5 among females ; 7 of the deaths occurred within a month of birth. All the infants were legitimate. The mortality rate was 45 per 1,000 births, as against an average rate of 70 for the pieceding ten years. The rate for England and Wales for 1920 was 80. Three deaths, of which two were due to Broncho-pneumonia, and one to accident, occurred among children between the ages of one and five years. The following table shows for the District the average annual birth rate, death-rate, infant mortality rate, and number of deaths of children between the ages of one and five years for each of the last nine quin quennial periods and for the year 1920:— Birthrate. Deathrate. Infant mortality. Average Deaths 1—5 years. 1876—1880 34.4 16.6 139 10 1881—1885 29.8 14.7 129 8 1886—1890 27.2 13.1 118 7 1891—1895 29.2 15.3 124 9 1896—1900 27.6 13.4 132 7 1901—1905 24.3 11.7 118 12 1906—1910 25.9 9.5 80 6 1911—1915 20.2 9.3 76 7 1916—1920 17.6 10.7 64 10 1920 20.9 8.4 45 3 Poor Law Relief.—The number of parishioners of Carshalton maintained in the Guardians' Institution in the half-year ended Michaelmas, 1919, were 51, and in the half-year ended Lady Day, 1920, were 57; the parishioners who received out-relief in the same periods were 53 and 60 respectively. The cost of in-maintenance during the year ended Lady Day, 1920, was £1,163, and of out-relief was £415. 5 (2) Sanitary Circumstances of the District. Water Supply.—The water supply of the District is a constant service from the mains of the Sutton District Water Company. The water is obtained from wells in the chalk at Sutton and Woodmansterne, and is softened. A few outlying houses are supplied from private wells. Rivers and Streams.—No instance of pollution came to the notice of the District Council during the year. Drainage and Sewerage.—The District was sewered in 1899, and the outfall works were remodelled in 1911. The high level sewage is treated by continuous flow through the sedimentation tanks of the original scheme, the effluent from which is treated on a specially prepared filtration area, followed by passage over the land. The low level sewage is pumped into tanks in which it undergoes quiescent settlement for two hours, and is then treated by sprinklers ; the effluent passes into a deep tank, the top water of which flows through humus filters. In June Mr. W. J. Dibdin was engaged to make monthly analyses of the effluent, and reported that the results were satisfactory in every instance. The houses are provided with water-closets with flushing apparatus, and the drains are intercepted from the sewers and are ventilated. The drains of 54 houses discharge into cesspools. Closet Accommodation.—The Sanitary Inspector informs me that approximately 2,824 premises are provided with water-closets and 10 with earth-closets, and that there are no privies in the district. Scavenging.—House refuse is collected weekly by the Council's staff, under the supervision of the Surveyor; it is deposited at the Sewage Farm, at a considerable distance from any dwellings. The houses are provided with movable covered ashbins. Sanitary Inspection ok the District.—The Sanitary Inspector makes the following report upon the inspection of premises during the year, of nuisances or defects discovered, of action taken, and the result thereof:— Number of inspections of dwelling-houses 725 „ „ cowsheds, dairies and milk-shops 41 „ „ slaughter-houses 9 „ „ factories and workshops 38 „ „ premises where food is prepared, etc. 79 „ „ schools 8 Number of dwelling-houses at which nuisances were discovered 301 „ other premises „ „ „ „ 20 „ informal notices served 36 „ statutory notices served 197 „ nuisances abated or defects remedied 217 6 Premises and Occupations Controlled by Bye-Laws or Regulations.—The Model Bye-Laws as to Slaughter-houses, Common Lodging Houses, Houses let in lodgings, and Tents, vans and sheds, and the Model Regulations as to cowsheds, dairies and milkshops, are in force in the District. There were three slaughter-houses, and sixteen cowkeepers, dairymen and purveyors of milk on the Registers at the end of the year. There is no Common Lodging-house in the District. The houses which are let in lodgings are mostly of a higher rent than that specified in the bye-laws, but they have been provided with separate sanitary accommodation for each family. There are no offensive trades in the District. Schools.—Each of the four Elementary Schools has a water supply from the public mains, and is provided with water-closets draining to the sewers. Notices are sent to the Head Teachers on the receipt of notifications of infectious disease occurring in a house in which there are children attending school, and the teachers report to me the absence or exclusion of any children on account of infectious or contagious disease. I visit and inspect the children when the schools appear to be the centre of infection. Each school was visited by me during the year. The Stanley Road and Roman Catholic Schools were closed in May on account of the prevalence of measles. (3) Food. (a) Milk Supply.—The Sanitary Inspector paid 41 visits of inspection under the Dairies, Cowsheds, and Milkshops Order, and reports that he found general compliance with the requirements of the Order and Regulations ; one notice was served for want of cleanliness. The Veterinary Inspector makes quarterly examinations of the cows belonging to the registered cowkeepers, and reports that he paid 66 visits and made 275 examinations. He found no cases of tuberculosis, and only one case of other disease. Milk (Mothers and Children) Order, 1919.—Milk for infants and nursing or expectant mothers was provided on the certificate of the Medical Officer of the Maternity and Infant Welfare Centre in 36 instances. In 30 cases one pint was provided daily free of charge, in two cases one quart daily free, and in four cases one quart daily at half the cost. (b) Meat.—The amount of slaughtering in the District is small, and that chiefly at one of the three slaughter-houses. The Sanitary Inspector paid nine visits, as far as possible at the time of slaughtering, and he reports that he found the premises to be kept in compliance within the Regulations. One slaughter-house was entirely rebuilt. There is no public abattoir in the District. No carcases or parts of carcases were condemned for Tuberculosis, and no seizure of butcher's meat was made. 7 The number of slaughter-houses in use in the District at the undermentioned dates was:— In 1914. In January, 1920. In December, 1920. Registered 2 2 2 Licensed 1 1 1 3 3 3 (c) Other Foods.—The Sanitary Inspector paid 15 visits to the bakehouses, and 79 visits to other premises where foods are manufactured, prepared, stored, or exposed for sale. He found the bakehouses to be satisfactory and had no reason to take action; three notices were served with respect to the other premises. He made 22 seizures of unsound food, consisting of the following articles:— Fish 3 cwt. 1 qr. Rabbits 2 boxes. Butter 16½ lb. Evaporated Milk 10 tins. Potatoes 31 lb. Tomatoes 14 lb. (d) Sale of Food and Drugs Acts.—The County Medical Officer of Health informs me that 18 samples of milk, 3 of butter, 2 of margarine, and 14 of other articles were analysed under the Sale of Food and Drugs Acts, that 5 samples of milk were found to be adulterated, and that there were 3 prosecutions. (4) Prevalence of and Control over Infectious Diseases. The following table shows, for each of the notifiable diseases, the number of cases notified, of patients removed to hospital, and of fatal cases, during the year, exclusive of cases in the Queen Mary's Hospital:— Disease Cases notified. Patients removed. Deaths. Scarlet Fever 47 39 — Diphtheria 22 18 — Enteric Fever 3 1 1 Erysipelas 2 — — Pneumonia 6 — 5 Malaria 3 — — Encephalitis Lethargica 1 — 1 Pulmonary Tuberculosis 10 10 9 Other Tuberculosis — — 1 Fifteen cases of Diphtheria and seven cases of Scarlet Fever were notified in the Queen Mary's Hospital; the patients were removed to hospitals of the Metropolitan Asylums Board. 8 Scarlet Fever and Diphtheria.—The following table shows the number of primary cases and total cases of Scarlet Fever and Diphtheria notified in each month :— Month. Scarlet Fever. Diphtheria. Primary Cases. Total Cases. Primary Cases. Total Cases. January 2 2 3 3 February 3 3 1 2 March 2 2 1 1 April 2 2 3 3 May 3 3 1 1 June 5 5 1 2 July 6 6 1 1 August 3 5 — — September 3 4 — — October — 1 4 4 November 1 3 2 2 December 8 11 1 3 The six cases of Scarlet Fever in July occurred among the children attending the Camden Road School, four being in one class; I examined all the children in this class, inspected the other children in the School, and visited absentees at their homes. A girl was removed to the Isolation Hospital on October 8th, 1919, suffering from Scarlet Fever, and returned home on December 14th; she had an operation for mastoid disease in November, but still had discharge from the ear in February; her brother failed with Scarlet Fever on February 4th. A girl was removed to the Hospital on April 4th, suffering from Scarlet Fever, and was discharged on June 14th; her brother and sister failed with Scarlet Fever on August 27th and September 1st, and the first patient was then found to be suffering from rhinitis and was again removed to the Hospital. A girl was removed to the Hospital on July 15th, suffering from Scarlet Fever, and returned home on August 28th; she had no symptoms of illness after her return, but two other inmates of the house failed with Scarlet Fever, and a third with sore throat, between October 11th and November 4th. A boy was removed on September 3rd, suffering from Scarlet Fever, and returned home on October 16th; he had no symptoms after his return, but another child in the house failed with Scarlet Fever on November 17th. A boy was removed on November 15th, suffering from Diphtheria, and returned home on December 13th ; another boy in the house failed with Diphtheria on December 24th. Eleven cases of Scarlet Fever were notified in December. On the occurrence of three cases in a house in December, a boy who had returned home from a boarding-school in another district was found to be peeling from Scarlet Fever. No other source could be discovered among the other seven patients who were notified in that month, except that two of them were living in adjoining houses, 9 Twenty-five specimens were examined for the presence of the diphtheria bacillus, at the expense of the District Council, with seven positive results. The District Council provide Diphtheria antitoxin for patients who are unable to afford it, and 4 phials of 2,000 units each were issued. Enteric Fever.—A boy, aged 4 years, was notified to be suffering from Paratyphoid B. Fever in March. A girl, aged 9 years, failed with Measles on May 24th ; a week later she had symptoms which were thought to be due to Appendicitis, but, on examination of the blood about June 10th, the paratyphoid A. reaction was obtained; she died on June 30th. A woman, aged 49 years, failed with Enteric Fever in November and was removed on December 3rd to the Wandle Valley Isolation Hospital, where she died on January 3rd, 1921. Encephalitis Lethargica.—A fatal case was notified in December ; the patient was convalescent after an attack of Pneumonia five weeks before the symptoms of the disease supervened. Pneumonia.—Two cases of Influenzal Pneumonia, 1 case of Primary Pneumonia, and 3 cases of Broncho-pneumonia were notified. There were three deaths from Broncho-pneumonia, 1 death from Influenzal Pneumonia, and 1 from Lobar Pneumonia in the District, and a woman belonging to Carshalton died of Pneumonia in Epsom Infirmary. The Health Visitor visited the patients who were notified and ascertained that they were receiving appropriate treatment; she also gave advice in several cases in which she found that infants were suffering from Broncho-pneumonia. Malaria.—Three cases of recurrence of Malaria, which had been contracted abroad, were notified. Measles, Whooping Cough and Diarrhcea.—A large number of cases of Measles and 3 cases of Whooping Cough were reported by the School Teachers in April and May. The lists of cases were transmitted to the Health Visitor, who paid 105 visits to cases of Measles and 3 visits to cases of Whooping Cough ; very few of the children suffered from complications, and there were no deaths from either disease. I visited the Schools, two of which were'closed by my advice on account of the prevalence of Measles. There was no death from Diarrhcea or Enteritis. Influenza.—There were 2 deaths from Influenza, in February and March. Tuberculosis.—Pulmonary Tuberculosis caused 9 deaths, representing an annual death-rate of 0.7 per 1,000 of the population, which is equal to the average rate for the preceding ten years. There was one death from Tuberculosis of the Intestines; 3 of the 10 fatal cases had not been notified to me, but 2 of these deaths occurred in Institutions in other districts. A letter was sent to the medical practitioners in the District requesting that cases of Tuberculosis should be promptly notified. 10 Visiting, Disinfection, etc.—Inquiry was made into each notified case of infectious disease with a view to tracing the source of infection and to ascertain that there was no illness among contacts. After the removal, recovery or death of a patient, the room was disinfected and bedding and other articles were removed to the Isolation Hospital and stoved in the Washington Lyons disinfector. The Sanitary Inspector paid 88 visits to houses where infectious disease was reported, and disinfected after each case of acute infectious disease, and in 19 instances after the removal or death of patients suffering from Pulmonary Tuberculosis. The Health Visitor made inquiries into each case of Tuberculosis on notification, paying 24 visits in all. I sent a list of all cases of Tuberculosis which still remained on the Register to the Health Visitor of the Surrey County Council, who visited and reported on the condition of the patients. (5) Maternity and Child Welfare. The two Welfare Centres, at the small Public Hall, and at the Church Schoolroom, Carshalton-on-the-Hill, are open weekly, Dr. Sloan Chesser attending at each centre in alternate weeks for the examination of children, and for the purpose of holding an ante-natal clinic. In April the Ministry of Health gave their sanction to the proposal of the District Council to convert part of the Phoenix Orphanage, which was being purchased for the provision of flats under the housing scheme, into a Clinic, to replace the Centre at the Church Schoolroom, and in September they gave their approval to a loan of £800 for the purpose. The Health Visitor visits infants whose births are notified or registered, in all suitable cases, and continues to visit up to school age. She also attends at the Centres and Clinics, visits expectant mothers, school children for some purposes, and cases of Measles and Tuberculosis. The District Council make an annual contribution of £65 towards the salary of the Nursing Association's Nurse, who takes charge of maternity work, attends the Clinics, acts as deputy for the Health Visitor, and nurses infants and cases of Measles if required. The following table shows the number of attendances at the Centres and Clinics during the year 1920:— Small Public Hall. Church Schoolroom. Attendances of Mothers 1,119 566 Attendances of Children 1,206 820 Attendances at the Ante-natal Clinic 61 27 11 The Health Visitor paid the following visits during the year:— First visits to Infants 242 Subsequent visits to Infants 726 Visits to Children aged 1—5 years 1,454 „ School children 22 Ante-natal Visits 69 Visits to cases of Tuberculosis 24 „ „ Measles 105 „ „ Pneumonia 7 „ „ Ophthalmia 1 „ „ Epidemic Diarrhoea 12 „ „ Whooping Cough 3 „ „ Puerperal Fever 1 The District Council make an annual grant of £50 to the Day Nursery, and Dr. Chesser attends weekly to examine the children. They also contribute £10 to the Carshalton, Beddington and Wallington District Hospital to procure treatment for children who are found to require it, on attendance at the Clinics, and for the administration of anaesthetics in dental cases. No case of Puerperal Fever or of Ophthalmia was notified, but the Health Visitor paid visits to a patient, who was found to be suffering from Puerperal Fever on admission to the London Hospital, and also to an infant who was found to have Ophthalmia on attendance at the Clinic. The homes at which cases of Measles and Whooping Cough had been reported by the School Teachers were visited by the Health Visitor, who distributed leaflets in respect of these diseases and of Diarrhoea; there were no deaths during the year from any of these diseases. (6) Sanitary Administration. (1) Staff.—Mr. C. P. Ingram, A.R.San.I., the Sanitary Inspector, gives his whole time to the duties of the office. (2) Hospital Accommodation.—The Isolation Hospital for the District is the Cuddington Joint Isolation Hospital, which provides accommodation for the Epsom Rural District, and the Carshalton, Leatherhead, and Sutton Urban Districts, and is situated in the parish of Cuddington, in the Epsom Rural District. The population of the District served by the Hospital was 68,648 persons in all at the Census of 1911, and 63,215 persons, exclusive of the patients in public Institutions which belong to other Authorities. The Hospital consists of two Ward Blocks, each containing two wards for 6 and 8 beds respectively (capacity 12,000 and 16,000 cubic feet), a third Ward Block containing two wards for 4 and 6 beds (capacity 8,000 and 12,000 cubic feet), and a fourth Block containing four wards for 3 beds each (capacity 5,500 cubic feet); a Discharging Block containing 2 beds; Administrative Block, Disinfector, Laundry, Mortuary, etc. 12 During the year 39 patients suffering from Scarlet Fever and 18 from Diphtheria were removed to the hospital from houses in Carshalton. One patient, who had been discharged after an attack of Scarlet Fever, was re-admitted owing to a recurrence of symptoms and the infection of two other persons in the house. The Hospital is administered by a Joint Board of representatives of the four constituent Councils. Accommodation for cases of Small Pox is available under the scheme of the Surrey County Council. (a) Adoptive Acts.—The Adoptive Acts in force in the District are:— The Infectious Disease (Prevention) Act, 1890. The Public Health Acts Amendment Act, 1890; and The Public Health Acts Amendment Act, 1907, Parts II. (except Sec. 28), III., IV., V. and VI., and Sec. 95. (4) Bacteriological Examinations.—Examinations for the presence of the diphtheria and tubercle bacillus, and for the Widal test, are made at the Lister Institute of Preventive Medicine, at the expense of the District Council. During the year, 25 examinations were made for the diphtheria bacillus, with 7 positive and 18 negative results. There was no application for examination for the tubercle bacillus. Five specimens were examined for the Widal reaction, with 1 positive and 4 negative results ; one of the specimens was negative to typhoid, but gave a positive paratyphoid A. reaction. (7) Housing. (1) General Housing Conditions in the District.—At the Census of 1911 there were 2,247 inhabited buildings in the District used as dwellings, of which 2,073 were ordinary dwelling-houses, 124 were shops, and 12 were Institutions; and 275 uninhabited, of which 265 were ordinary dwelling-houses. In 1901 there were 1,330 inhabited houses and 98 uninhabited, and in 1891 there were 1,091 inhabited houses and 97 uninhabited. The number of dwelling-houses in 1920 was estimated at 2,820, of which about 1,140 were working-class dwellings. Nearly three-fifths of the houses have been built in the past 30 years, and one-half of them in the past 20 years. In 1919 the District Council adopted a scheme for the erection of 200 houses to meet the shortage of working-class dwellings and to replace cottages of a low standard, and purchased a site of 27 acres at The Culvers, Nightingale Road. The first 11 houses under the scheme were completed in October. In May the Council advertised for tenders for the erection of a second group of 49 houses, but the tenders received were too high for acceptance. The Council then entered into an agreement that H.M. Office of Works should carry out the remainder of the scheme, and in September they received an estimate for the erection of 184 houses, 13 for which the Ministry of Health sanctioned a loan of £185,000. The work was begun in October, and 108 houses were commenced by the end of the year. In September the District Council purchased for £1,200 two houses in William Street which were in course of erection, and they were completed in October. The Council also made an application to the Ministry of Health for sanction to purchase for £800 each four houses which were being erected in Green Wrythe Lane by the Ex-Service Men's Housing and Provident Society, and this was granted in January. In February the plans for the conversion of the Phoenix Orphanage into working-class flats was approved by the London Housing Board, and the price of purchase was agreed. It was proposed that a portion of the building should be used as a Maternity and Infant Welfare Clinic, and the sanction of the Ministry of Health was obtained to a loan of £3,166 in respect of the conversion into flats, and subsequently to a loan of £800 for the establishment of the Clinic ; the purchase was completed and the work was commenced in November. The District Council decided in January to put forward a scheme under Part III. of the Housing of the Working Classes Act, 1890, in respect of Avenue Road, and for the erection of 50 houses in Avenue Road and Stanley Road. A report was received from the District Valuer, and steps were taken to acquire the land compulsorily. The scheme was recommended by the London Housing Board, but the Ministry of Health decided that it was not one which they could approve. The erection of 66 houses at Little Woodcote under the Small Holdings scheme of the Surrey County Council was commenced, and eight of them had been completed at the end of the year. (2) Overcrowding.—At the Census of 1911 there were 39 tenements with more than two occupants per room, with a population of 337 persons, or 3.3 per cent. of the population in private families. Figures obtained in the course of the Survey showed that there were 33 houses with more than two persons per room, with a population of 307 persons. The detailed figures showed comparatively few cases of serious overcrowding. During the year the District Council dealt with four cases, in two of which families were living and sleeping in one room; the conditions could not be remedied owing to want of alternative accommodation. In the other two cases the overcrowding was abated by the use of living-rooms as bedrooms, and in many other instances it was found in the course of inspection that this method was being adopted. (3) Fitness of Houses.—About one-half of the working-class dwellings in the District are of modern construction. Of 1,065 cottages of which particulars were obtained in the Survey, 14 contained two rooms, 27 three rooms, 325 four rooms, 628 five rooms, 14 and 71 six rooms; there were in addition 74 tenements, 7 containing two rooms, 23 three rooms, 26 four rooms, 17 five rooms, and 1 six rooms. A number of the older houses are badly constructed and require constant supervision in order to keep them in a habitable state of repair. The Sanitary Inspector visited 725 houses in the course of the year and secured general repair, cleansing, remedy of dampness and other improvements in a large number of cases. In February I represented that a house in West Street was unfit for human habitation, and a closing order was made; no repairs were executed, and in July the District Council made a demolition order, against which the owner appealed to the Ministry of Health, who directed an inquiry to be held in November, when the owner undertook to submit a specification of the works necessary to make the house fit, and in December the Ministry informed him that the demolition order was justified, but would be quashed provided that the proposed works were carried out within four months, the owner to pay the costs of the appeal. In March, a closing order which had been made against a cottage at The Culvers in the previous year was determined on completion of the repairs. A group of 32 four-storied houses at Carshalton-on-the-Hill which have for a considerable number of years been let in tenements to working-class tenants, each house as a rule accommodating two families, is constantly being brought to the notice of the Council, owing to the continual want of repair. The size of the houses would entail a heavy expense to put them into a complete state of repair, and consequently only the more urgent defects are dealt with. In 1919 the District Council submitted a proposal for purchasing the houses, as part of their housing scheme, and in 1920 they put forward a scheme under Part III. of the Housing of the Working Classes Act, 1890, but were unable to obtain the sanction of the Ministry of Health to either scheme. The houses are provided with separate sanitary accommodation for each tenant. The houses throughout the District are supplied with water from the public mains, and are provided with properly constructed waterclosets and drains connected with the sewers, and with covered movable ashbins ; house refuse is removed weekly by the Council's staff. (4) Unhealthy Areas.—There are no areas such as might be dealt with under Part I. of the Housing Act of 1890. (5) Bye-Laws.—The Model Bye-Laws relating to houses, to houses let in lodgings, and to tents, vans and sheds, are in force in the District. 15 APPENDICES. HOUSING CONDITIONS. Statistics for the year ended 31st December, 1920. 1. General. (1) Estimated population 12,901 (2) General death-rate 8.4 (3) Death-rate from tuberculosis 0.78 (4) Infant mortality , 45 (5) Number of dwelling-houses of all classes 2,820 (6) Number of working-class dwelling-houses 1,140 (7) Number of new working-class houses erected 25 2. Unfit Dwelling-houses. I. Inspection. (1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 725 (2) Number of dwelling-houses which were inspected or recorded under the Housing (Inspection of District) Regulations, 1910 177 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 1 (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 113 II. 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 53 III. Action under Statutory Powers. A. Proceedings under Section 28 of the Housing, Town Planning, etc., Act, 1919. (1) Number of dwelling-houses in respect of which notices we?e served requiring repairs 1 (2) Number of dwelling-houses which were rendered fit— (a) by owners — (b) by Local Authority in default of owners — (3) Number of dwelling-houses in respect of which Closing Orders became operative in pursuance of declarations by owners of intention to close — 16 B. Proceedings under Public Health Acts. (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 194 (2) Number of dwelling-houses in which defects were remedied— (a) by owners 164 (b) by Local Authority in default of owners C. Proceedings under sections 17 and 18 of the Housing, Town Planning, etc., Act, 1909. (1) Number of representations made with a view to the making of Closing Orders 1 (2) Number of dwelling-houses in respect of which Closing Orders were made 1 (3) Number of dwelling-houses in respect of which Closing Orders were determined, the dwelling-houses having been rendered fit 1 (4) Number of dwelling-houses in respect of which Demolition Orders were made 1 (5) Number of dwelling-houses demolished in pursuance of Demolition Orders — 3. Other Matters. (1) Number of houses not complying with the building byelaws erected with consent of Local Authority under section 25 of the Housing, Town Planning, &c., Act, 1919 33 (2) Staff.—Mr. C. P. Ingram gives his whole time to the duties of the office of Sanitary Inspector. Epsom, April, 1921.