library Urban District of CHISLEHURST AND SIDCUP REPORT For the Year 1937 on the Sanitary Conditions and Vital Statistics of the Urban District of Chislehurst and Sidcup by the Medical Officer of Health Together with the REPORTS of the CHIEF SANITARY INSPECTOR Conbridge Tonbridoe Free Press, Ltd., 129 High Street. Tel. 18 CHI 9 Urban District of CHISLEHURST AND SIDCUP REPORT For the Year 1937 on the Sanitary Conditions and Vital Statistics of the Urban District of Chislehurst and Sidcup by the Medical Officer of Health Together with the REPORTS of the CHIEF SANITARY INSPECTOR Conbridge tonbridqe free press, ltd., 129 High Street. Tel. 18 2 URBAN DISTRICT COUNCIL OF CHISLEHURST & SIDCUP HEALTH REPORT FOR 1937. Ladies and Gentlemen, I beg to present my Annual Health Report for the year 1937, this being the fourth one submitted by me as your Medical Officer of Health, but the fifteenth one I have had the pleasure to submit as Medical Officer of Health for the area concerned. The population of the District as estimated at mid-year 1937 by the Regjptrar-General is 58,670, as compared with 54,300 in 1936. The Birth Rate for the year showed an increase, this being 16.9 as compared with 15.8 last year. This compares very favourably with that for England and Wales, which was 14.9 for 1937. A slight rise also took place in the Death Rate, viz. 8.7 as against 8.3 last year. This also compares very favourably with that for England and Wales, in which the Rate was 12.4 for 1937. The Infantile Mortality Rate was equal to 47 per thousand registered births, as compared with 53 last year and 43 in 1935. As previously stated, this Rate is liable to fluctuate from year to year owing to the small numbers involved. The Infantile Mortality Rate for this District can be considered as satisfactory when compared with that for England and Wales, in which the Rate was 58 for 1937, and 59 and 57 in the preceding two years. The year 1937 can be considered a satisfactory one from the point of view of incidence of Infectious Disease, the number of notification certificates received having fallen from 983 in 1936 to 396 in 1937. This, however, is chiefly due to a large decrease in the number of cases of Measles notified during the year. In presenting this Report, I desire to take the opportunity of expressing my appreciation of the help and assistance I have received from the Council and all its Officers. I would specially place on record the loyal and efficient services rendered by Mr. Allen and all the members of the Public Health Department. I am, Ladies and Gentlemen, Your obedient Servant, P. N. CAVE, Medical Officer of Health 3 URBAN DISTRICT COUNCIL OF CHISLEHURST & SIDCUP PUBLIC HEALTH COMMITTEE. Chairman C. E. NORRIS, Esq. G. W. ALLEN, Esq. Mrs. E. M. CRAWFORD. G. A. APPLETON, Esq. W. G. FULLER. Esq. Lt.-Col. W. J. BELL. T. G. GALBRAITH, Esq. A. A. BONE, Esq. E. V. MILLS, Esq. H. F. BRIDEL, Esq. Miss M. K. PILLMAN. E. CHAPMAN, Esq. T. RAMSBOTTOM, Esq. REPRESENTATIVES ON THE WEST KENT JOINT HOSPITAL BOARD. A. A. BONE, Esq. T. G. GALBRAITH, Esq. REPRESENTATIVES ON THE WEST KENT MAIN SEWERAGE BOARD. A. A. BONE, Esq. J. KERFOOT, Esq. T. G. GALBRAITH, Esq. STAFF. Medical Officer of Health: P. N. CAVE, M.A., M.D., D.P.H., M.R.C.S., L.R.C.P. Chief Sanitary Inspector: A. V. B. ALLEN, M.R.S.I., M.R.LP.H.H., M.S.I.A. District Sanitary Inspectors: S. H. G. STEVENS, A.M.I.S.E., A.R.S.I., M.S.I.A. RIOKARD, A.R.S.I., M.S.I.A. LIVESEY, M.R.S.I., M.S.I.A. Health Visitor: MISS W. M. HUMPHRIES. General Clerk: E. AUSTIN. Shorthand-Typist and Infectious Disease Clerk: MISS M. PETCHEY, 4 SECTION A— STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres) 8,950 Registrar-General estimate of population, mid-1937 58,670 Census, 1931 27,063 Number of occupied houses, December, 1937 16,630 Rateable Value, December, 1937 £499,427 Sum represented by a penny rate, December, 1937 £1,930 Vital Statistics. Birth Ratq per 1,000 of estimated resident population. Live births: Total. M. F. Legitimate 971 504 467 Illegitimate 24 9 15 Total 995 513 482 16.9 Rate per 1,000 (live and still) births. Stillbirths 28 17 11 27.3 Death Rate per 1,000 of estimated resident population. Deaths 515 263 252 8.7 Rate per 1,000 total (live and still) births. Deaths from puerperal causes: Puerperal sepsis 1 0.975 Other puerperal causes 6 5.865 Total 7 6.84 Death Rate of Infants under one year of age: All infants per 1,000 live births 47 Legitimate infants per 1,000 legitimate births 46 Illegitimate infants per 1,000 illegitimate live births 83 Deaths from Cancer (all ages) 71 Deaths from Measles (all ages) Nil Deaths from Whooping Cough (all ages) 1 Deaths from Diarrhoea (under two years of age) 5 SECTION B.— GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. Laboratory Facilities: West Kent Joint Isolation Hospital, and Kent County Laboratory, Maidstone. Ambulance Facilities: For Infectious Disease: Four ambulances provided by the West Kent Joint Hospital Board. For general and accident cases: Two ambulances provided by Council. Nursing' Facilities: Local District Nursing Associations. Clinics and Treatment Centres: Maternity and Child Welfare work is carried out by the Kent County Council. Immunising- Clinic (against Diphtheria) held once a week at the Council Offices, 5 Hospitals, Public and Voluntary: Infectious Disease: West Kent Joint Isolation Hospital. General Hospitals (Voluntary) : Sidcup Cottage Hospital and Cray Valley Hospital. Midwifery and Maternity Services: Under the control of the Kent County Council. Institutional Provision for Mothers or Children: Under Kent County Council. Health Visitors: One employed by District Council. Four Health Visitors also employed by County Council. Infant Life Protection (under Part I of Children Act, 1908, as amended by Children and Young Persons Act, 1932): Under control of the Kent County Council. , Orthopaedic Treatment: Under Kent County Council. Nursing- Homes Registration Act, 1927: The Medical Officer of the Local Supervising Authority under this Act is P. N. Cave, M.A., M.D., MLR.C.S., L.R.C.P., D.P.H. Action Taken during the year under this Act, and the arrangements made for the supervision of Maternity and Nursing Homes registered under the Act: Routine inspection by Health Visitor, and inspections by Medical Officer of Health as required. HEALTH REPORT FOR 1937. Area and Population. The Urban District of Chislehurst and Sidcup was constituted under the Kent County Review Order, 1934, and came into existence on the 1st April, 1934. It comprises the former Urban District of Sidcup and the former Urban District of Chislehurst, with the exception of the Pettswood area, south of the old London, Chatham and Dover railway line (now part of the Southern Railway system), which was transferred to the newly constituted Urban District of Orpington. Also included in the Urban District are the old Rural Parishes of Mottingham and North Cray, the greater part of St. Paul's Cray, and a small portion of St. Mary Cray and Ol-pington, all of which previously formed part of the Bromley Rural District. A small portion of the Borough of Bromley on the western boundary of Chislehurst was also transferred to the Chislehurst and Sidcup Urban District. Local Census. A local census of population was taken in the middle of the year 1936, and the figure obtained was 54,859. This compares with the figure of 54,300 as estimated' by the Registrar-General. The District has an area of 8,950 acres, the Rateable Value is £499,427, and the sum represented by a penny sate is £1,930. 6 The following Table shows the acreage, population, etc., for the various Wards:— KENT COUNTY COUNCIL REVIEW OF COUNTY ELECTORAL DIVISIONS. Wards acreage Population Rateable Value (approx.) 1st April, 1935 Local Government Electors, 1934 Census 1931 (Estimated) 1935 (Estimated) LAMORBEY 1,082.2 4,101 18,540 £125,527 9,834 BIRCHWOOD 409.2 4,610 2,104 FROGNAL 741.4 4,627 2,082 LONGLANDS 596.2 7,406 2,606 NORTH CRAY 1,293.6 1,020 501 3,040.4 12,890 17,663 £159,305 7,293 MOTTINGHAM 646.0 3,685 1,334 ST. PAUL'S CRAY 2,374.6 2,301 1,068 THE COMMONS 1,807.2 8,281 3,180 4,827.8 10,072 14,267 £137,086 5,582 Totals 8,950.4 27,063 50,470 £421,918 22,709 Average Population per County Councillor: 16,823.3 7 VITAL STATISTICS. Births. During the year 995 Births were registered as belonging to the District, of which number 513 were males and 482 were females. This is equal to an Annual Birth Rate of 16.9 per thousand of population, as compared with 15.8 last year. The Birth Rate for England and Wales was 14.9 in 1937, and 14.8 in 1936. The number of Births registered as being illegitimate was 24, of which 9 were males and 15 were females. There were also 28 stillbirths, 17 males and 11 females. Deaths. The number of Deaths registered during the year as belonging to this District was 515 (263 males and 252 females), as compared with 455 last year. This number includes those deaths which, although occurring outside belonged to this District, but excludes deaths occurring inside the District but belonging to other districts. The Death Rate for the year was equal to 8.7 per thousand of population, as against 8.3 last year. The Death Rate in England and Wales was 12.4 in 1937, and 12.1 in 1936. The diseases claiming the largest number of deaths were: Heart disease 120, Cancer 71, and Pneumonia 38. The following Table shows the diseases having the greatest influence on the Death Rate for the past four years- Year Heart Disease Cancer Cerebral Haemorrhage Bronchitis Pneumonia Pulmonay Tuberculosis 1984 (9 months) 96 56 14 6 22 22 1935 117 57 28 5 28 16 1936 101 69 14 9 22 26 1937 120 71 20 10 38 29 Infantile Mortality. The number of deaths registered as occurring in infants under one year of age was 47 (23 males and 24 females). Of these, 45 were legitimate and 2 were illegitimate. 8 The Infantile Mortality Rate was equal to 47 per thousand births, as compared with 53 last year. The Infantile Mortality Rate for England and Wales was 58, and for 1936, 59. Deaths at Different Ages. Deaths in Children between One and Five Years.— Eight deaths occurred in children between the ages of one and five years. This is equal to a Death Rate of 0.13 per thousand of population. Deaths in Persons of 65 Years and Over.— The number of deaths registered as occurring in persons of 65 years and over was 240. This is equal to a Death Rate of 4.0 per thousand of population, and comprises 46.6 per cent, of total deaths. Causes of Deaths. The Deaths registered during the year included:— Diphtheria 3 Scarlet Fever 1 Influenza 16 Pulmonary Tuberculosis 29 Other Tuberculous Diseases 1 Cancer 71 Cerebral Hæmorrhage 20 Heart Diseases 120 Bronchitis 10 Pneumonia 38 Appendicitis 1 Nephritis 11 Congenital debility, etc 24 Suicide 7 Accident 6 Vital Statistics— Principal Features. The following Table shows a comparison of the main features in Vital Statistics for the District during the past four years:— Years 1931 1935 1936 1937 Population 44,200 47,692 54,300 58,670 No. of Births registered 671 808 862 995 Birth Bate 16.7 16.9 15.8 16.9 No. of Deaths Registered 347 419 455 515 Death Rate 8.6 8.7 8.3 8.7 Infantile Mortality Rate 46 43 53 47 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.: Smallpox, Measles, Scarlet Fever, Diphtheria, Whooping Cough, Diarrhoea, and "Fever," which later includes Typhus, Typhoid (or Enteric) and Paratyphoid Fevers. During the year 12 deaths occurred from these complaints, the Zymotic Death Rate being 0.20 per thousand of population. Pulmonary Tuberculosis. The deaths occurring from Pulmonary Tuberculosis (Consumption or Phthisis) numbered 29. This is equal to a Death Rate of 0.49 per thousand of population. Other Respiratory Diseases. The deaths from other diseases of the respiratory system numbered 82. This gives a Death Rate of 1.39 per thousand of population. Cancer. The deaths from Cancer (malignant disease) were 71 (42 males and 29 females). The Death Rate from Cancer was therefore 1.21 per thousand of population. Influenza. During the year 16 deaths occurred from Influenza, the Death Rate being 0.27 per thousand of population. Analysis of Death Rates. All causes Seven principal Zymotic complaints Pulmonary Tuberculosis Other respiratory complaints Cancer Influen.a Number of Deaths 515 12 29 82 71 16 Death Rate per 1000 8.7 0.20 0.49 1.39 1.21 0.27 10 A comparison between the Vital Statistics for the District and those for England and Wales is shown by the subjoined Table:— 1934 1935 1936 1937 Chislehurst and Sidcup Urban District England and Wales Chislehurst and Sidcup Urban District England and Wales Chislehurst and Sidcup Urban District England and Wales Chislehurst and Sidcup Urban District England and Wales Birth Rate 16.7 14.8 16.9 14.7 15.8 14.8 16.9 14.9 Death Rate 8.6 11.8 8.7 11.8 8.3 12.1 8.7 12.4 Infantile Mortality Rate 46 59 43 57 53 59 47 58 11 Birth-rates, Death-rates, Analysis of Mortality, Maternal Death-rates, and Case-rates for certain Infectious Diseases in the year 1937:— England and Wales 125 County Boro's. and Great Towns including London 148 Smaller Towns (Resident Populations 25,000 to 50,000, 1931 Census) London Administrative County Chislehurst and Sidcup Urban District Rates per 1,000 Population BIRTHS: Live 14.9 14.9 15.3 13.3 16.9 Still 0.60 0.67 0.64 0.54 0.47 DEATHS: All Causes 12.4 12.5 11.9 12.3 8,7 Typhoid and Paratyphoid Fevers 0.00 0.01 0.00 0.00 0.03 Smallpox ... ... ... ... ... Measles 0.02 O.O3 0.02 0.01 ... Scarlet Fever 0.01 0.01 0.01 0.01 0,01 Whooping Cough 0.04 0.04 0.03 0.06 0.01 Diphtheria 0.07 0.08 0.05 0.05 0.05 Influenza 0.45 0.39 0.42 0 38 0.72 Violence 0.54 0.45 0.42 0.51 5.62 NOTIFICATIONS: Smallpox 000 ... 0.00 ... ... Scarlet Fever 2.33 2.56 2.42 2.09 3.42 Diphtheria 1.49 1.81 1.38 1.93 0.93 Enteric Fever 0.05 0.06 0.04 0.05 0.11 Erysipelas 0.37 0.43 0.34 0.44 0.23 Pneumonia 1.3 1.58 1.20 0.18 0.83 Rates per 1,000 Live Births Deaths under one year of age 58 62 55 60 47 Deaths from Diarrhoea and Enteritis under two years of age 5.8 7.9 3.2 12.0 5.C2 MATERNAL MORTALITY: Puerperal Sepsis 0.97 Not available. 1.00 Others 2.26 6.03 Total 3.23 7.03 Rates per 1,000 Total Births (i.e. Live and Still MATERNAL MORTALITY: Puerperal Sepsis 0.94 Not available. 0.975 Others 2.17 5.865 Total 3.11 6.84 NOTIFICATIONS: Puerperal Fever 13.93 17.59 11.52 4.15 3.91 Puerperal Pyrexia 14.34 6,84 12 INFECTIOUS DISEASE. From the point of view of incidence of Infectious Disease the year 1937 was a fairly satisfactory one, the number of notifications having fallen from 983 in 1936 to 396 in 1937. This is chiefly due to the large decrease in the number of cases of Measles notified. The following Table shows the number of each disease notified during the year:— Scarlet Fever 207 Diphtheria 55 Typhoid Fever 7 Eirsyipelas 14 Puerperal Fever 4 Puerperal Pyrexia 7 Poliomyelitis 4 Cerebro-spinal Fever 1 Ophthalmia Neonatorum 2 Pneumonia 49 Measles 24 Dysentery 22 Reference to Table I. in the Appendix will show:— 1.— Cases notified at various ages. 2.— Total number of cases removed to hospital. 3.— Number of deaths registered. 13 The monthly incidence of Infectious Disease was as follows:— Disease Jan. Feb. Mar. April May Juna July Aug. 8ept. Oct. Not. Dec. TOTAL Scarlet Fever. 20 16 19 14 19 7 30 17 7 16 21 21 207 Diphtheria. 4 1 6 2 2 4 6 1 9 2 7 11 55 Typhoid Fever ... ... 1 ... 2 ... ... 1 ... 1 2 ... 7 Erysipelas. 3 1 1 ... 4 ... 1 ... 1 ... 3 ... 14 Pneumonia 10 3 4 ... 5 2 1 3 1 4 4 12 49 Puerperal Fever ... ... ... 1 ... ... 2 1 ... ... ... ... 4 Puerperal Pyrexia ... ... ... 3 ... ... ... ... ... 1 1 2 7 Ophthalmia Neonatorum ... ... ... 2 ... ... ... ... ... ... ... ... 2 Cerebro-spinal Fever 1 ... ... ... ... ... ... ... ... ... ... ... 1 Polio-myelitis ... ... ... ... ... 1 1 ... 2 ... ... ... 4 Dysentery ... ... ... ... ... ... ... ... ... ... 7 15 22 Measles ... ... 5 1 5 4 1 1 1 1 ... 5 24 TOTALS 38 21 36 23 37 18 42 24 21 25 45 66 396 14 The following Table shows the number of cases of Infectious Disease notified during the past four years:— 1934 6 months 1935 1936 1937 Scarlet Fever 132 193 162 207 Diphtheria 24 60 29 55 Typhoid Fever 2 3 ... 7 Erysipelas 8 22 16 14 Puerperal Fever 1 3 3 4 Puerperal Pyrexia 2 5 7 7 Ophthalmia Neonatorum ... 1 ... 2 Acute Poliomyelitis 1 ... ... 4 Cerebro-spinal Fever ... ... ... 1 Pneumonia 11 30 21 49 Malaria ... 1 ... ... Dysentery ... ... ... 22 Measles ... 38 745 24 TOTALS 181 356 983 396 Smallpox. No case of Smallpox was notified as occurring in this District during the year. Scarlet Fever. An increase in the number of cases of Scarlet Fever notified took place, there being 207 cases notified as compared with 162 last year. One hundred and eighty-nine cases were removed to the Isolation Hospital. One death occurred from Scarlet Fever. The age incidence of the disease was:— 0-5 5-10 10-15 15-20 20 and over 38 98. 37 9 25 15 Diphtheria. The number of cases of Diphtheria notified was 55, as against 29 last year and 60 in 1935. Of these, 54 were removed to the Isolation Hospital. Three deaths were registered as occurring during the vear. The age incidence was:— 0-5 5-10 10-15 15-20 20 & over 11 26 5 2 11 Arrangements have been made by the Council for the examination, free of charge, of swabs from cases, or suspected cases, of Diphtheria, and during the year 370 such examinations have been made. A Clinic for the immunisation of children has been established by the Council. Particulars of this will be found on another page. Typhoid Fever. During the year 7 cases of Typhoid Fever were notified. Two cases were removed to the Isolation Hospital. Unfortunately two deaths were registered from this complaint during the year. Erysipelas. Fourteen cases of Erysipelas were notified, this being two less than last year. Puerperal Fever. Four cases of Puerperal Fever were notified, this being one more than last year. Two cases were removed to hospital. One death was registered during the year. Puerperal Pyrexia. During the year 7 cases of Puerperal Pyrexia were notified, this being the same number as last year. Three cases were removed to hospital. Ophthalmia Neonatorum. Two cases were notified. Acute Poliomyelitis. During the year 4 cases were notified. Two cases were removed to hospital. Cerebro-Spinal Fever. One ease was notified during the year. The patient was removed to the Isolation Hospital. / 16 Pneumonia. During the year 49 cases of Pneumonia were notified, as compared with 21 last year. The number of deaths registered as occurring from Pneumonia (all forms) was 38. Dysentery. In common with other districts an outbreak of Dysentery occurred during the latter months of the year, and in this District 22 cases were notified. Measles. First cases of Measles were made compulsorily notifiable by the Chislehurst and Sidcup Urban (Measles) Regulations, dated the 15th April, 1935, which came into force on the 15th May, 1935. A large decrease in the number of cases notified during the year took place, there being 24 cases as compared with 745 last year. Arrangements are in force for home nursing of Measles, where required, and for the removal to hospital of such cases where the condition of the patient renders it desirable. I am pleased to report that no deaths were registered as occurring from Measles. Tuberculosis. The number of new cases of Tuberculosis notified during the year was 60, viz.:— Males Females Total Pulmonary 25 28 53 Non-Pulmonary 3 4 7 Total 28 32 60 17 The number of new cases notified durine- 1936 was 65. The number of deaths registered as occurring from Tuberculosis during the year was 30, viz.:— Males Females Total Pulmonary 15 14 29 Non-Pulmonary 1 - 1 Totals 16 14 30 The Kent County Council carries out the treatment of cases of Tuberculosis, and during the year the following number of patients from this area have received treatment:— Number of persons receiving sanatorium treatment 58 Number of persons receiving dispensary treatment 11 Dispensary supervision only 373 The following Table shows the number of new cases of Tuberculosis notified during the year, together with the deaths, at various age-periods:— Age Periods. New Cases. Deaths. Pulmonary. NonPulmonary. Pulmonary. NonPulmonary. M F M F M F M F Under 1 year ... ... ... ... ... ... 1 ... 1 and under 5 ... ... 2 1 ... ... ... ... 5 „ 10 ... ... ... ... ... ... ... ... 10 „ 16 ... 3 ... 2 ... 2 ... ... 15 „ 20 2 ... ... ... 2 ... ... ... 20 „ 25 1 3 ... ... 2 2 ... ... 25 „ 35 6 11 1 1 4 3 ... ... 35 „ 45 9 7 ... ... 3 4 ... ... 45 „ 55 5 2 ... ... 1 3 ... ... 55 ,, 65 1 1 ... ... 1 ... ... ... 66 and over 1 1 ... ... 2 ... ... ... TOTALS 25 28 3 4 15 14 1 ... 18 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930. These Regulations, which came into force on the 1st January, 1931, require, inter alia, that a weekly Return of all notified cases shall be sent to the County Medical Officer of Health; also that every Medical Officer of Health shall furnish the County Medical Officer of Health with a quarterly return and a statement showing:— (a) The number of cases of Tuberculosis on his register at the commencement of each quarter; (b) The number of cases notified to him for the first time during the quarter; (c) The number of cases removed from the register in a preceding quarter which have been restored to the register, giving the name and address of each case and the reason for the restoration. (d) The number of cases added to the register during the quarter which have been brought to his knowledge other than by notification; (c) The number of cases removed from his register during the quarter, giving the name of each case and the reason for removal; (f) The number of cases remaining on the register at the end of the quarter. Previously a large part of this statement was required under the Public Health (Tuberculosis) Regulations, 1924. The following Table shows the number of cases on the register at the end of each quarter since the District was constituted:— Quarter ending Pulmonary Non-Pulmonary Total M. F. M. F. 1934 30th June 79 67 34 33 213 30th Sept. 86 72 37 33 228 31st Dec. 63 42 31 19 115 1935 31st Mar. 56 40 28 20 144 30th June 53 39 26 20 138 30th Sept. 49 47 25 19 140 3lst Dec. 55 53 26 19 153 1936 31st Mar 68 62 31 19 180 30th June 76 61 33 18 188 30th Sept. 85 64 36 20 205 31st Dec. 95 68 40 23 226 1937 13st Mar. 101 74 40 25 240 30th June 109 81 39 25 254 30th Sept. 104 85 42 25 256 31st Dec. 109 96 43 25 273 19 PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925. No action was required during the period under review in respect of tuberculous employees in the milk trade. PUBLIC HEALTH ACT, 1925, SECTION 62. There was no need, during 1937, for the Council to take action with a view to securing an Order of the Court for the compulsory removal to hospital of a case of Pulmonary Tuberculosis. DIPHTHERIA ANTI-TOXIN. A supply of Diphtheria Anti-toxin is kept for the use of Doctors practising in the District. This is supplied free on the certificate of the Medical Officer of Health that the circumstances of the case render this desirable. In other cases the cost price is charged. ISOLATION HOSPITAL. For Isolation Hospital purposes this District is served by the West Kent Joint Isolation Hospital. This Hospital is administered by the West Kent Joint Hospital Board, and serves the Boroughs of Bromley and Beckenham, and the Urban Districts of Chislehurst and Sidcup . and Orpington. The Board have provided four motor ambulances for the removal of cases. Cases of Smallpox are also removed to the West Kent Joint Smallpox Hospital, maintained by the West Kent Joint Hospital Board, on a separate site from the ordinary Infectious Diseases Hospital. 20 LABORATORY WORK. The bacteriological work in connection with this District is carried out at the Kent County Laboratory, Maidstone, and during the year the following number of specimens have been examined there:— Positive. Negative. Total. Swabs for Diphtheria 4 36 40 Sputa for Tubercle 52 157 209 Swabs for Haemolytic Streptococci 20 50 70 Faeces (or Sonne bacillus 15 46 61 Blood for Typhoid — 5 5 TOTALS 91 294 385 In addition to the above, emergency swabs arc examined at the West Kent Joint Hospital Board, the number of such Examinations during the year being:— Positive Negative Total Swabs for Diphtheria 27 303 330 Swabs for Haemolytic Streptococci 3 5 8 Totals 30 308 338 DIPHTHERIA IMMUNISATION A Diphtheria Immunisation Clinic has been established by the Cotincil, and sessions have been held at the Council Offices, Sidcuo Place. Sidcun. The following is a statement of the work carried out during the year:— Number of sessions held 47 Number of new cases 168 Number found susceptible 159 Number found not susceptible 9 Number of re-tests 45 Number found not susceptible 44 Number found susceptible (re-immunised) 1 Subsequent attendances 537 Total attendances 750 The Health Visitor paid 27 visits in connection with cases attending the Clinic. 21 DRAINAGE. Practically the whole of the District is drained to the public sewers. Sewage outfall facilities are provided by the West Kent Joint Sewerage Board. During the year the following new sewers were laid:— Approximately 5.15 miles of new sewer. Approximately 3.89 miles of surface water sewer. The approximate number of each type of closet in use at the end of the year was:— Water closets draining into sewers 17,413 Water closets draining into cesspools 319 Elarth closets or privy middens 5 Pail closets 53 SANITARY STATISTICS. No. of Houses connected to the sewei No. of Houses not oonnected to Bewora No. of Houses not provided with a piped water supply No. of wells still in use for purpose of domestic supply 17413 377 23 15 Sanitary Conveniences. W.C.s Pan or Pail Closets Earth Closets Ashpits separate from Midden Privies Cesspools No. of No, of houses into 17413 53 5 ... 255 319 WATER SUPPLY. This District is supplied with water by the mains of the Metropolitan Water Board. With the exception of about 23 premises, which obtain their water from wells, the whole of the District has a main supply. Samples of water from the wells were submitted for bacteriological examination, and found to be satisfactory. Bacteriological examination of samples of water were examined for the Sonne bacilli, and proved negative. HOUSE REFUSE COLLECTION AND DISPOSAL. A weekly collection of house refuse is undertaken by the Council, under the supervision of the Public Health Department. 22 The refuse is deposited in a new tip which has been opened during the year near Swanley Junction. The Council does not undertake the cleansing of cesspools or earth closets. The contents arc disposed of by the occupants on their land, or the work is undertaken by contractors. HOUSING. 1.— Inspection of Dwelling-houses during the Year. (1) (a) Total number of houses inspected for housing defects (under Public Health or Housing Acts) 1,225 (b) Number of inspections made for the purpose 3,737 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 167 (b) Number of inspections made for the purpose 1,540 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 9 (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 144 2.— Remedy of Defects during the Year without service of Formal Notices. Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers 218 3.— Action under Statutory Powers during the Year. (a) Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936: (1) Number of dwelling-houses in respect of which notices were served requiring repairs Nil (2) Number of dwelling-houses which were rendered fit after service of formal notices: (a) By owners Nil (b) By Local Authority in default of owners 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 10 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (a) By owners 10 (b) By Local Authority in default of owners Nil 23 (c) Proceedings under Sections 11 and 13 of the Housing Act, 1936: (1) Number of dwelling-houses in respect of Demolition Orders were made Nil (2) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil (d) Proceedings under Section 12 of the Housing Act, 1936: (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made Nil (2) Number of separate tenements or underground rooms in respect of which dosing Orders were determined, the tenement or room having been rendered fit Nil 4.— Housing Act, 1936, Part IV, Overcrowding. (a) (1) Number of dwelling-houses overcrowded at end of year 23 (2) Number of families dwelling therein 23 (3) Number of persons dwelling therein 208 (b) Number of new cases of overcrowding reported during the year 7 (c) (1) Number of cases of overcrowding relieved during the year 35 (2) Number of persons concerned in such cases 295 (d) Particulars of any cases in which dwelling-houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding Nil Number of new houses erected during the year:— By the Local Authority 10 By other persons 1,200 houses and 122 flats MATERNITY AND CHILD WELFARE. The Maternity and Child Welfare work in this District is carried out by the Kent County Council. Health Visiting is undertaken by Nurses Lyle, Dobson, Bowman, Braminer, Stokes and Rothera. Five Maternity and Child Welfare Centres have been established, as follows:— Chislehurst West: Hornbrook Hall.— Sessions held every Thursday afternoon. The Medical Officer in charge is Dr. Tallent. The average attendance per session is 53. Foots Cray: Memorial Parish Hall.— Sessions held alternate Tuesday afternoons. The Medical Officer in charge is Dr. Geddes. The average attendance per session is 32. 24 Sidcup: Baptist Church Hall, Days Lane.—Sessions are held on each Tuesday, Wednesday and Friday afternoon, Dr. S. S. M. Wood is the Medical Officer in charge, and he attends twice weekly. The average weekly attendance is 319. Sidcup: Congregational Hall, Station Road.— Sessions held each Thursday afternoon. Dr. C. J. M. Geddes is the Medical Officer in charge, and he attends each session. The average attendance is 95. Mottingham: Parish Hall.— Sessions held first, third and fifth Monday in each month. Dr. Power is the Medical Officer in charge. The average attendance per session is 70. An Ante-natal Clinic is held as follows:— Sidcup : Baptist Church Hall, Days Lane.— Sessions held on each Friday morning at 10 p.m. Dr. C. J. M. Geddes is the Medical Officer in charge. HEALTH VISITOR. The Council employs one full-time Health Visitor, who works under the supervision of the Medical Officer of Health. The following is a summary of the visits paid by her during "fee year:— Total number of visits paid 1,759 Visits re Measles 38 German Measles 46 Chicken-pox 116 Whooping Cough 107 Mumps 89 Influenza 14 Tuberculosis: Primary visits 85 Re-visits 609 Infectious disease, cases discharged from hospital 232 Infectious disease, home cases 157 Nursing Homes 25 Ophthalmia Neonatorum 11 Conjunctivitis 7 Impetigo and Scabies 12 Dysentery 92 Immunisation Clinic 27 Hæmolytic streptococci cases 16 Typhoid Fever 7 Swabs 11 Visits to schools 4 Visits re contacts with infectious disease 48 Maternity Homes, etc. 6 25 SCHOOLS. There are fifteen elementary and two secondary schools within the District. Medical Inspection.— The medical inspection of school children is carried out by the Kent County Council. Sanitary Accommodation— Periodical inspection is made of the sanitary accommodation at the schools. Closure of Schools.— No schools have been closed by order of the Local Authority during the year. The following Certificates, however, covering low attendances at school owing to the incidence of Infectious Disease have been issued:— School. Disease. Period. Chislehurst C. of E. Chicken-pox 1 week ended Jan. 15. Infants' Dept. Influenza do. Scarlet Fever 1 week ended July 30. and colds Chislehurst Annunciation Severe colds 1 weok ended Dec. 24. Infants' Dept. Influena and Pneumonia Mottingham Council Influenza and 2 weeks ended Dec. 24. Infants' Dept. colds MIDWIVES. The supervision of Midwives is under the control of the Kent County Council. The following Midwives have given Notice of Intention to Practice in this District:— Alcock, E., 171 Blackfen Road, Sidcup. Crazer, E. H., 57 Canterbury Avenue, Sidcup. Day, M., 16 Ingleby Way, Chislehurst. Esther, E. E., 268 High Road, Mottingham. Evans, E. M., 23 Braundton Avenue, Lamorbey. Gibson, E. M., 22 Chalk Pit Avenue, St. Pauls Cray. Harris, L. E. P., 6 Cornwallis Avenue, New Eltham. Hopkins, EL, 84 Wellington Avenue, Sidcup. Jones, F. M., 3 Berwick Crescent, Days Lane, Sidcup. Nugent, F. M., "M'ottingdene," High Road, Mottingham. Osborn, F. A., Danehurst Nursing Home, Sidcup. Rafferty, M. J.. "Mottingdene," High Road, Mottingham. Smith, E. EL, 117 Longlands Road, Sidcup. NURSING FACILITIES. Nursing facilities for this District are provided by the local Nursing Association. HOSPITALS. The hospitals available for residents of this District are:— For Infectious Cases.— Oases of Infectious Disease are admitted to the West Kent Joint Isolation Hospital. General Cases.— The County Hospital, Farnborough (PuhliAssistance), the Sidcup Cottage Hospital, and the'Cray Valley Hospital (Voluntary). 26 AMBULANCES. For Infectious Disease.— Four motor ambulances have been provided by the West Kent Joint Lsolation Hospital Board for the conveyance of cases of Infectious Disease. For General and Accident Cases.— Two ambulances are provided by the Council for the removal of general and accident cases. NURSING AND MATERNITY HOMES. The powers under the Nursing Homes Registration Act, 1937, have been delegated by the Kent County Council to the District Council. There are eight premises registered in this District, two of which are maternity homes, four are for both maternity and general cases, and two for general cases only. The number of beds provided is 51, viz.: 16 for maternity cases and 35 for other cases. RIVERS AND STREAMS Constant supervision is paid to all watercourses within the District. The principal rivers are the River Quaggy (about 1,170 yards), the Cray (about 5,200 yards), and the Shuttle (about 2,800 yards). During the year a portion of the River Quaggy was cleared of obstruction. LEGAL PROCEEDINGS. In the following case it was found necessary to institute legal proceedings:— Particulars Result No proper supply of water, main supply being out off. (section91, Fined 10s. Od. Public Health Act, 1875) REGULATED TRADES. Dairies and Cowsheds. There are 29 registered premises within the District, this being 6 less than last year. During the year 102 visits were paid, and in 6 instances defects were found. Milk (Special Designations) Order, 1936. The Council granted the following mimber of licences under the above Order during the year:— Tuberculin Tested 5 Ditto, supplemental 4 Pasteurised 15 Ditto, supplemental 27 Milk Supply. During the year 102 visits were paid to the 29 dairies and cowsheds. Thirty-three samples of graded milk were submitted for examination, with the following results:— Satisfactory. Unsatisfactory. Tuberculin Tested 14 1 Pasteurised 13 2 Accredited 3 - Slaughterhouses. There are 5 Slaughterhouses in the District, of which 2 are registered and 3 are licensed. During the year 255 visits were paid, and on 2 occasions defects were found. These have now been remedied. Public Health (Meat) Regulations, 1924. Under the above Regulations, which came into force on the 1st April, 1935, an opportunity is afforded for the inspection of carcases of animals slaughtered for human consumption. The following Table shows the work carried out during the year:— Cattle excluding Cows Cows Calves Sheep and Lambs Pigs Number of animals killed 102 7 35 532 1189 Number of animals inspected 102 7 32 532 1189 ( All diseases except Tuberculosis) Whole carcases condemned ... ... ... ... ... Carcases of which some part or organ was condemned 2 1 ... ... 26 Percentage of the number inspected affected with diseases other than Tuberculosis 1.99 14.3 ... ... 2 Tuberculosis Only Whole carcases condemned 1 ... ... ... 1 Carcases of which some part or organ was condemned 12 ... ... ... 78 Percentage of the number inspected affected with tuberculosis 12.7 ... ... ... 6 28 Bakehouses. There are 19 Bakehouses within the District, to which 34 visits have been paid. Ten defects were found during the year. Piggeries. There are 19 Piggeries within the District, this being the same number as last year. Seventy-three visits were paid, and 9 defects were found and remedied. Other Food Preparing Places. There are 133 other premises m which food is prepared for human consumption. During the year 163 visits were paid, and on 53 occasions defects were found. Common Lodging Houses and Houses Let in Lodgings. There are no Common Lodging Houses nor Houses Let in Lodgings within the District. Fish Friers. There are 11 premises in which fish frying is carried on, and during the year 20 visits were paid. Five defects were found and remedied. Factories and Workshops. There are 107 Factories and Workshops in the District, of which 64 are Factories and 43 are Workshops. In addition there is one Workplace. During the year .114 visits were paid to these premises, and 17 defects were found and later remedied. A detailed list of the Factories and Workshops remaining at the end of the year is found in the following Table:— 29 'aotories. Workshops. Workplaces. Total. Advertisement Manufacturers - 1 - 1 Bakehouses 14 5 — 19 Breeze Block Manufacturers 1 1 - 2 Builders and Decorators 4 7 - 11 Boot Repairers 6 7 - 13 Brake Lining Manufacturers 1 - - 1 Carpenters 1 1 - 2 Carriage Builders 1 - - 1 Cycle Repairers - - 1 1 Electrical Station 1 - - 1 Electrical Engineers 2 - - 2 Grinders 1 - - 1 Hairdressers — 2 - 1 Ladies' Garments — 1 - 1 Laundries 3 2 - 5 Machinist - 1 - 1 Mason - 1 - 1 Metal Workers 1 - - 1 Mineral Water Manufacturers 1 - - 1 Motor Engineers 10 9 - 19 Organ Works 1 - - 1 Paper Mills 1 - - 1 Paint Manufacturers 1 - - 1 Piano Repairers - 1 - 1 Printers 4 - - 4 Radio Manufacturers 2 - - 2 Saw Mills 1 - - 1 Smiths 2 1 - 3 Surgical Instrument Makers - 1 - 1 Surgical Rubber Manufacturers - 1 - 1 Tailor - 1 - 1 Upholsterers 1 2 - 3 Ventilation Engineers 1 - - 1 Window Manufacturer 1 - - 1 Woodcutter 1 - - 1 Totals 64 43 1 108 30 1.— Inspection of Factories, Workshops and Workplaces. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. PREMISES Number of Inspections Written Notices. Occupiers Prosecuted. FACTORIES (Including Factory Laundries) 61 1 ... Workshops (Including Workshop Laundries) 50 ... ... workplaces (Other than Outworkers' premises) 3 ... ... TOTAL 114 1 ... 2.— Defects Found in Factories, Workshops and Workplaces. PARTICULARS. Number of Dufeeta. No. of offences in respect of which prosecutions were instituted Found. Remedied. Referred to H.M. Inspector. (1) 18) (S> (4) (5) Nuisance* under the Public Health Acts Want of cleanliness 7 7 — — Want of ventilation — — - — Overcrowding — — — — Want of drainage of floors — — — — Other nuisances 7 7 — — Sanitary accommodation .insufficient 1 1 — — unsuitable or defective 1 1 — — ^not separate for sexes 1 1 — — Offences under the Factory and Workshop Acts— Illegal occupation of underground bakehouses (s. 101) — — — — Other offences (Excluding offences relating to outwork and offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921) Total 17 17 Nil Nil X Including those specified in Sections 2, 3, 7 and 8 of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts. 31 Summary of Regulated Trades. Number of Premises Visits Paid Defects. Found. Remedied. Dairies | 29 102 6 5 Cowsheds Slaughterhouses: Licensed 3 255 2 2 Registered 2 Bakehouses 19 34 10 8 Piggeries 22 73 9 9 Other food preparing places 133 163 53 48 Factories 64 61 17 17 Workshops 43 50 — - Workplaces 1 3 — — Pish Friers 11 20 5 5 Totals 327 761 102 94 SHOPS. Inspection of shops within the District is carried out in order to enforce the provision of the Shops Acts. In two cases action was found necessary to improve the heating arrangements and in one an additional sanitary convenience was provided. Eight certificates of exemption were granted in exceptional cases. SWIMMING BATHS AND POOLS. There are no public swimming baths in the District. There is one small private swimming pool which is open to the public." Samples of the water taken during the year were found to be satisfactory. SMOKE ABATEMENT. Observations were kept on many occasions with respect to the emission of smoke from a factory at St. Paul's Cray and the owners are considering the installation of new apparatus. Bye-laws with respect to the emission of black smoke were approved by the Council on the 21st October, 1936, and these came into force on the 1st February, 1937. ERADICATION OF BED BUGS. During the year 18 Council houses and 35 other premises were found to be infested with bed bugs. All of these were disinfested. The method employed is to strip the woodwork, seal the premises, and use a sulphurous spray and an insecticide fluid. 32 The furniture, etc., of prospective tenants of Council houses is inspected, and where necessary disinfestation is carried out, the bedding, etc., being steam disinfected. All Council houses are disinfested on vacation of tenants. The work of disinfestation is carried out by the Council's workmen, the owner of the premises doing any structural works. Close observation is kept oij all suspected tenants, and advice and leaflets arc given to occupants of affected premises. MORTUARIES. The following cases were admitted to the Mortuary at Beverwood Road, Chislehurst. during the year:— No. Sex. Age. Cause of Death. 90. F. 54 years. Cerebral haemorrhage. 91. F. 5 years. Accidental— shock following burns. 92. M. 46 years. Misadventure— shock and hæmorrhage from internal injuries. 93. F. 42 years. Heart failure. 94. M. 63 years. Cardiac failure due to coronary atheroma. 95. F. 9 weeks. Lobar pneumonia. 96. M. 24 years. Accidental— frecture base of skull. 97. F. 59 years. Cardiac failure duo to dilation and atheroma of aorta. 98. M. 78 years. Hypostatic pneumonia following fall at homo. 99. F. 62 years. Aortic aneurism. 100. M. 62 years. Cholecystitis myocardial degeneration cardiac failure. 101. F. 8 months. Misadventure— suffocation by bedclothes while asleep in cot. 102. M. 69 years. Myocardial degeneration. 103. M. 59 years. Myocardial degeneration. 104. M. 55 years. Cerebral hæmorrhage. Chronic nephritis. 105. F. 6 years. Intestinal obstruction. 106. F. 18 years. Accidental— fracture base of skull. 107. F. 38 years. Pulmonary embolism. 108. M1. 49 years. Acute pneumonia. Natural causes. 109. M. 61 years. Syncope. Angina pectoris. Myocardial degcration. 110. M. 65 years. Chronic bronchitis. Degeneration heart. Cardiac failure. 111. F. 65 years. Pulmonary oedema (acute) due to myocardial degeneration. 112. M. 51 years. Lysol poisoning. Suicide whilst of unsound mind. 113. M. 28 years. Suicide— coal gas poisoning. 114. M. 57 years. Heart failure. 115. F. 76 years. Pneumonia and cardiac degeneration. 116. M. 56 years. Drowning— suicide whilst of unsound mind. 117. M. 33 years. Fatty degeneration. 118. M. 36 years. Accidental— fracture base of skull. 119. M. 30 years. Aortic stenoeis. 120. M. 67 years. Rupture of left ventricle due to chronic myocarditis. Natural causes. 121. M. 66 years. Myocardial degeneration. Natural causes. 122. F. 75 years. Cerebral hæmorrhage. Arterio sclerosis. 123. F. 3 days. Asphyxiation duo to overlying. 33 ADOPTIVE ACTS, ETC. The following is a list adopted, together with the Acts. The Public Health Acts Amendment Act, 1890, Parts 2 and 3. The Infectious Disease (Prevention) Act, 1890. The Public Health Acts Amendment Act, 1907, Parts 2 to 6 (inclusive) and Part 10 (Section 95). Part 7 (Sections 81 and 86), Parts 8 and 9. Private Street Works Act, 1892 Public Heath Act, 1925. The whole of Parts 2, 3, 4 and 5. Museums and Gymnasiums Act, 1891. Slaughter of Animals Act, 1933, Section 1. Local Government Act, 1894, Section 8 (1) (h) (i). of Acts, etc., whiich have been date of adoption:— Date of Adoption. Adopted 14th January, 1904, and came into force 1st March, 1904. Ditto. Order of the Local Government Board, 24th December, 1909. Order of Secretary of State, 12th November, 1909. Confirmation Order dated 4th August, 1911, made by the Local Government Board declaring each of the following trades, viz. Blood-dryer, Tanner, Leather-dresser, Fat-melter or Fat-extractor, Glue-maker, Size-maker, Gut-scraper, and Fish-fryer, to be an offensive trade. 25th July, 1902. The Sections subject to the consent of the Ministry of Health came into force on the 1st March, 1926. January, 1928. By resolution dated 19th September, 1934, Section 1 of the Act was made to apply to Sheep, Eiwes, Wethers, Rams and Lambs, and came into force on the 1st October, 1934. 17th December, 1923. 34 BYELAWS AND REGULATIONS. Regulations with respect to Allotments. Byelaws with respect to Common Lodging-houses. Byelaws with respect to Slaughterhouses. Byelaws with respect to Whirligigs, Swings, and Firearms in Shooting Galleries. Byelaws with respect to New Streets and Buildings. Byelaws with respect to the Cemeteries. Byelaws with respect to the Mortuary and Drainage of Existing Buildings at Sidcup. Byelaws with respect to the Drainage of Existing Buildings at Chislehurst. Byelaws with respect to Tents, Vans, Sheds, etc. Byelaws with respect to Pleasure Grounds (Waring Park and Longlands Recreation Ground). Byelaws with respect to the Ventilation of Buildings. Byelaws with respect to Nuisances. Regulations with respect to mode of construction and laying out of drains and their connection to the sewer. Byelaws with respect to the Keeping of Swine. Byelaws with respect to decent lodging accommodation of persons engaged in hop-picking and picking of fruit and vegetables. Regulations with respect to the Compudsory notification of Measles (1935). Byelaws relating to Nursing Homes. Smoke Abatement Byelaws (Confirmed by the Minister of Health December, 1936, and to operate from 1st February. 1937). Byelaws with respect to New Streets and Buildings (approved 21st April, 1937, and confirmed by the Minister of Health 16th July, 1937). Allotment Regulations (approved 17th March, 1937, and confirmed by the Minister of Health 6th May, 1937). Amended Regulations (approved 22nd September, 1937, and confirmed by the Minister of Health 18th November, 1937). CO 07 TABLE I.— CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1937. Disease. At all Ages. Number of Cases Notified. Total cases removed to Hospital. Deaths Under 1 year 1 and u rider 2 years 2 and under 3years 3 and under 4 years at ages— years. 20 and under 35 years 35 and under 45 years 45 and under 65 years 65 and over 4 and under 5 years 5 and under 10 years 10 and under 15 years 15 and under 20 years Scarlet Fever 207 1 6 8 11 12 98 37 9 16 5 4 ... 189 1 Diphtheria 55 1 ... 3 5 2 26 5 2 9 1 1 ... 54 3 Typhoid Fever 7 ... ... ... ... ... 1 1 2 ... ... 2 1 6 2 Erysipelas 14 ... ... ... ... ... ... 1 ... 3 1 7 2 ... ... Pneumonia 49 3 1 3 4 2 10 2 ... 3 6 6 9 ... 38 Puerperal Fever 4 ... ... ... ... ... ... ... ... 3 1 ... ... 2 1 Puerperal Pyrexia 7 ... ... ... ... ... ... ... ... 6 1 ... ... 3 ... Ophthalmia Neonatorum 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... Cerebro-spinal Fever 1 ... ... ... 1 ... ... ... ... ... ... ... ... 1 2 Poliomyelitis 4 ... 1 ... ... ... 3 ... ... ... ... ... ... 2 ... Dysentery 22 1 1 2 ... 3 5 4 1 2 2 ... ... ...... Measles 24 ... 3 3 1 4 8 3 1 ... 1 ... ... ... ... Total 396 6 12 19 22 23 151 53 15 42 19 21 12 257 47 36 TABLE II.— DEATHS REGISTERED DURING THE YEAR 1937. Cause of Death Males. Females. Total. Typhoid and paratyphoid fevers ... 2 2 Measles • •• • •• • •• Scarlet Fever 1 ... l Whooping Cough ... 1 l Diphtheria 2 1 3 Influenza 7 9 16 Enoephalitis Lethargica ... ... ... Cerebro-spinal Fever 3 ... 2 Tuberculosis of Respiratory system 15 14 29 Other Tuberculous diseases 1 ... 1 Syphilis ... ... ... General paralyis of the insane, tabes dorsalis ... ... ... Cancer 42 29 71 Diabetes 1 4 5 Cerebral hæemorrhage 11 9 20 Heart disease 51 69 120 Aneurism 1 1 2 Other circulatory diseases 13 22 34 Bronchitis 6 4 10 Pneumonia, all forms 24 14 38 Other respiratory diseases 2 1 3 Peptic Ulcer 4 1 5 Diarrhcea, (under two years) 3 2 5 Appendicitis 1 ... 1 Cirrhosis of the Liver 1 ... 1 Other diseases of the Liver, ... 2 2 Other digestive diseases 5 6 11 Acute and chronio nephritis 9 9 18 Puerperal sepsis ... 1 1 Other puerperal causes ... 6 6 Congenital debility, premature birth, malformations 11 13 24 Senility 4 3 7 Suicide 4 2 6 Other violence 19 8 27 Other defined diseases 24 18 42 Ill-defined or unknown ... 1 1 Total 263 252 515 37 URBAN DISTRICT COUNCIL OF CHISLEHURST & SIDCUP REPORT OF THE CHIEF SANITARY AND SHOPS ACTS INSPECTOR For the Year ended 31st December, 1937. Mr. Chairman, Ladies and Gentlemen, I have the honour of submitting a Report on the Sanitary and Shops Acts inspection carried out in the District during the year ended 31st December, 1937. 1. Inspections— General. A total of 6,431 inspections were made during the year as follow:— 2,197 to dwelling-houses (Public Health Acts) 1,540 do. (Housing Acts) 102 farms, dairies and cowsheds 255 slaughterhouses 73 piggeries 34 bakehouses 20 fish friers 163 other food preparing premises 61 factories 50 workshops 3 workplaces 186 premises for rats and mice 218 cases of infectious diseases 9 rivers and streams 7 vans and sheds 24 pickers' huts 521 smoke abatement 26 water supplies 896 shops 46 various 6,431 Total 2. Complaints. 362 complaints were received and investigated. Where necessary, appropriate action was taken. They were as follow:— 192 re general sanitary defects 10 keeping of animals 31 offensive accumulations 23 verminous premises 38 1 water supply 47 rats 7 overcrowding 1 food 50 various 362 Total 3. Notices. 665 Informal Notices were served, drawing the attentions of property owners and others to the existence of nuisances and requesting abatement. It was found necessary to serve 11 Statutory Notices under the Public Health Acts to secure the abatement of nuisances where Informal Notices had not received compliance. In one instance (absence of a proper water supply) it was found necessary to resort to legal proceedings, in consequence of which a fine of 10s. was imposed. 4. Nuisances Remedied during the year: Sanitary accommodation: (i) Insufficient 4 (ii) Defective 39 Drainage: (i) Reconstructed 5 (ii) Repaired 38 (iii) Cleaned 85 (iv) Provided 5 Cesspools: (i) Cleaned 10 (ii) Reconstructed 2 (iii) Abolished 2 (iv) Provided 2 Baths, lavatory basins and sinks 24 Yard paving 26 Moors 45 Sub-floor ventilators 12 Walls and ceilings redecorated 130 Walls and ceilings repaired 104 Dampness, roofs, walls and rainwater pipes 159 Verminous premises 52 Refuse receptacles 41 Water supplies 14 Keeping of animals 3 Offensive accumulations 8 Fruit pickers' huts 43 Rats 43 Windows 104 Various 66 39 5. Housing. (i) Routine Inspections. 167 premises were inspected under the Housing Consolidated Regulations, 1932, as follow:— Address. No. of Premises. Mill Place, Chislehurst 1 Hawkwood Lane, Chislehurst 3 Queen's Road, Chislehurst 22 Victoria Road, Chislehurst 30 Mottingham Road, Mottingham 9 Dorset Road, Mottingham 33 Portland Road, Mottingham 36 Albert Road, Mottingham 1 Blackfen Road, Sidcup 4 Halfway Street, Sidcup 10 Nelson Place, Sidcup 19 Sussex Road, Sidcup 3 Becks Road, Sidcup Total 6 167 1,540 visits were made to premises in connection with the Housing Acts. (ii) Clearance Areas. On 27th September, 1937, an Inquiry was held into the following Clearance Orders made by the Council, and these Orders have been confirmed by the Minister of Health with the following directions:— No. 4 Order 1-14 (consecutive) Mill Place, Chislehurst. Payment in accordance with Section 42, Housing Act, 1936, to be made in respect of well-maintained houses— Nos. 3, 4, 7, 10, 11 and 12 Mill Place. No. 5 Order ... Cromwell Mews and Nos. 27 and 27a Mill Place, Chislehurst. No. 27 Mill Place to be excluded from Order. No. 27a Mill place to be dealt with under Section 12 of the Housing Act, 1936, by a Closing Order for part of the building. No. 6 Order Trunks Alley. No. 7 Order Nos. 136 to 152 (even numbers) Mottingham Road, Mottingham. (iii) Individually Unfit Houses. The premises known as Church Cottage, Church Road, Foots Cray, were reconditioned in accordance with a Schedule of Works submitted to and approved by the Council, and on satisfactory completion of the works a Certificate of Fitness extending over five years was granted. 40 The premises known as Railway Cottage, Bournewood Siding, St. Mary Cray, in respect of which an Undertaking not to use for human habitation had been given, were found to be demolished in April, 1937. (iv) Overcrowding. is shewn on the following Table:— The position with regard to overcrowding at the end of the year under review July 1936 1st Jan. 1937 31st Dec. 1937 No. of cases Number of Cases No. of persons concerned Cases remedied during year Cases found during year Cases to end of year No. persons concerned Aged over 10 Aged Under 10 Aged over 10 Aged under 10 Lamorbey 12 13 77 28 9 2 6 41 14 Longlands 2 1 7 3 1 — — — — Birchwood — — — — — — — — — Mottingham 8 9 50 11 7 2 4 26 11 Chislehurst Common 11 13 68 18 9 — 4 25 5 Frognal 5 5 38 10 3 3 5 38 15 North Cray 2 2 7 1 1 — 1 4 — St. Pauls Cray 4 8 40 20 5 - 3 17 12 Totals 44 51 287 90 35 7 23 151 57 41 During the year approximately 250 premises were measured in consequence of requests for the "permitted number" from owners of premises. 6. Infectious Disease. 218 visits of enquiry were made to notified cases of infectious disease, mainly cases of diphtheria and scarlet fever. On the removal of a case to the Isolation Hospital, the release from quarantine (home cases) or in other necessary eases, disinfection was immediately carnied out by spraying rooms and their contents with formalin, and the clothing and bedding was steam disinfected at the disinfecting station. Public Library books found in any premises in which infectious or contagious disease occurred were also disinfected by formalin vapour in a special metal chamber. Certain articles have also been destroyed by fire. The disinfections carried out during the year were as follow:— Sprayed. Fumigated. Steam Disinfected Destroyed. Rooms 273 198 — - Mattresses 106 — 266 14 Pillows 249 - 850 24 Bedclothes, Batches of 82 - 194 5 Clothing, Batches of 65 - 168 2 Library Books - 114 - - Cushions 3 — 29 5 Carpets 282 - - 6 Divan — - — 1 Hut 1 — - - Motor-car 1 - - - 7. Vermin. (i) Bed Bugs. During the year 23 complaints were received of infestation of premises by bed bugs. The number of houses and/or their contents found to be infested was 53 (including 18 in the Council's possession). In suitable cases, and on the request of tenant and owner, the disinfestation of the premises and contents were simultaneously carried out by the Department. In all other cases the premises were disinfested by the owners, and the contents by the tenants. In all necessary cases bedding was steam disinfested by the Department. 42 The usual method of disinfestation insisted upon is to strip as much woodwork from walls, etc., as possible, seal the premises and use a sulphurous gas or spray with contact fluid. Close supervision was made of premises which had been disinfested, and tenants were given suitable advice and instruction on methods of prevention and destruction of vermin. (ii) Rats and Mice. 186 visits were made to premises in connection with rat infestation. 47 complaints were received and at 43 premises infestation was remedied. 8. Food Inspections. (i) Meat Inspections. During the year a total of 1,865 animals were killed in slaughterhouses in the District. Of the 1,865 animals slaughtered, 1,862 were examined. The details of killings are as follow:— Beasts. Cows. Calves Sheep and Lambs. Pigs. Animals slaughtered under "lingular Notice" (243 occasions) 98 7 34 524 1,126 Animals slaughtered under "Occasional Notice" (12 occasions) 4 - 1 8 63 Total number examined 102 7 32 532 1,189 Total number not examined - - 3 - - Total number slaughtered 102 7 35 532 1,189 (ii) Food: Diseased or Unsound. Disease. Tons. Weight. lbs. cwts. qrs. Beef: Distomatosis - - - 14 Liver abscess - - - 4 Mammitis - - 1 12 Tuberculosis - 6 2 10 Pork: Cirrhosis - - - 4 Hepatitis - - - 2 Nephritis - - - 1 Pericarditis - - - 5 Pleurisy - - 1 8 Tuberculosis - 7 2 25 Plaice: Unsound - - - 12 - 15 1 13 43 (iii) Slaughterhouses. There are 5 slaughterhouses within the District, situated as under:— Address. Occupier. Registered: High Street, Foots Cray J. S. Tompkins. Royal Parade, Chislehurst Lidstone Ltd. Licensed: High Street, Chislehurst B. Keith. Station Road, Sidcup Fewell & Co. High Street, Sidcup Chalk & Cox Ltd. These premises have been closely inspected on 255 occasions and 2 defects which were found were remedied. (iv) Slaughter of Animals Act, 1933. (a) Slaughtering. In accordance with the provisions of this Act and by reason of the adoption by the Council of Section 2 of the Act, all beasts, sheep and lambs slaughtered in the District have been killed with a mechanically operated instrument. All pigs have been similarly killed. (b) Slaughtermen. In accordance with the requirements of the Slaughter of Animals Act, 1933, six Licences were issued to slaughtermen during the year. (v) Milk and Dairies. There are 29 dairies and cowsheds in the District. These premises have been given special attention and 102 visits were made. Six defects were found, of which five were remedied. During the year 33 samples of Graded milk were taken as follow:— Grade of Milk. Satisfied test. Did not satisfy test. Tuberculin tested 14 1 Pasteurised 13 2 Accredited 3 - 44 (vi) Bakehouses. There are 14 factory bakehouses and 5 workshop bakehouses in the District, to which 34 visits were made. Ten defects were found, eight of which were remedied during the year. (vii) Fish Frying. Fish frying is a declared Offensive Trade within the District. There are 11 premises in which fish frying is carried on, and 20 inspections have been made to these premises. Five defects were found, all of which were remedied. 9. Factories, Workshops and Workplaces. 114 visits were made to the 64 factories, 43 workshops and one workplace in the District, details of which are incorporated in the Annual Report of your Medical Officer of Health in the Home Office Form. 10. Piggeries. There are 22 piggeries in the District, to which 73 visits were made during the year. Nine defects were found and remedied. 11. Cesspools. As far as is known, there are 255 cesspools draining 319 premises in the District. Owners or occupiers of premises make private arrangements for emptying cesspools with a Maidstone firm. The charge made is £1 for the first 1,000 gallons, and 17s. 6d. for each subsequent 1.000 gallons of sewage emptied. During the year the drains of two premises were connected with the Council's sewers and the cesspools abolished. The large majority of the cesspools drain premises not within a reasonable distance of a sewer, and the few that drain premises within this distance were constructed prior to the laying of the sewer. These latter are closely watched, but nuisance therefrom has not arisen and consequent action was unnecessary. 45 12. Smoke Abatement. During the year smoke abatement was effected at St. Pauls Cray by the use of coke instead of coal at a gravel pits engine. Smoke abatement was similarly effected at a laundry by the subsequent use of coke. Further observation was continued on a factory chimney at St. Pauls Cray owing to complaints of emission of grit. The matter is still in hand. 13. Pickers' Huts. There are 6 camps of pickers' huts in the District, of which only 4 have been used during the year and to which 24 inspections were made. In consequence of inspection 42 defects were found and remedied after informal action. 14. Rivers and Streams. Nine inspections were made to rivers and streams in the District. During the year the River Quaggy was cleared of obstruction. 15. Shops Acts. During the year 896 inspections and observations were made of shops, and 196 Informal Notices were served in connection with the Acts. The number of shops situate in the District are as follow:— Ward. Shops. Lamorbey 212 Longlands 75 Birchwood 90 Frognal 108 North Cray 10 St. Pauls Cray 14 Chislehurst Commons 103 Mottingham 37 649 46 (1) Ventilation. In no shop was it found necessary to require improvement to ventilation. (ii) Temperature. In two cases was it found necessary to require additional heating to be provided (iii) Sanitary Conveniences. One Statutory Notice was served requiring the provision of additional sanitary accommodation Eight Certificates of Exemption were granted to occupiers of shops where exceptional circumstances obtained and suitable and sufficient sanitary accommodation was available within reasonable distances (iv) Lighting. No action was found necessary in this respect. (v) Washing Facilities. Six Certificates of Exemption were granted to occupiers of shops where exceptional circumstances obtained and suitable and sufficient washing facilities were available within reasonable distances. (vi) Facilities for Meals. No action was found to be necessary in this respect. (vii) Closing. No Closing Orders have been made for shops in the District, but the days of Early Closing generally observed are: Thursdays— Sidcup High Street; Blackfen; Mottingham. Wednesdays— The Oval, Sidcup; Chislehurst; St. Pauls Cray. (viii) Hours. In 25 instances offences respecting hours of employment were remedied after the attention of the shopkeepers had been drawn thereto. In no case was it found necessary to take formal action. (ix) Records. 163 shops were found not to be keeping, exhibiting, or providing the necessary Notices or Records, and in each case a letter was sent to the shopkeeper. 47 16. House Refuse Collection and Disposal. The section of the Department dealing with this matter was placed under my supervision in August, 1937. At the beginning of the year the refuse was collected from approximately 15,825 premises, and at the end of the year from 17,390 premises. (i) Vehicles. The vehicles in use at the time of writing (January) are as follow:— One 15 cubic yard Thornycroft. Three 12/15 cubic yard Thornycrofts. Two 7 cubic yard Thornycrofts. Two 30 cwt. Morris. One Fordson Tractor with trailers. One 30 cwt. Chevrolet. It is anticipated that a new vehicle will shortly be purchased, and when this machine comes into commission the Chevrolet and the Fordson Tractor will be used for emergency work only. The average length of haul throughout the District from point of disposal is six miles. (ii) Collection. Refuse is collected from all premises once weekly. Collection is also made of trade refuse at a standard charge of 6d. per small bin and 9d. per large bin, and prepaid vouchers were used for this at the latter part of the year. (iv) Disposal. Until December refuse was disposed on land rented by the Council at Ruxley. This tip had been burning for some time and nuisance was caused by the smoke. From 1st December refuse was tipped at a new shoot at a brickworks near Swanley, the site being some distance from dwelling-houses. The brickmakers intend to use the refuse for brickmaking. During the year Tenders were invited for the erection of a Separation and Incineration Plant at Foots Cray, and after full consideration the matter was deferred for consideration at a later date. (v) Clothing. Every man is provided with clean overalls, smock, and with waterproof leggings and leather shoulder pads, 48 (vi) Salvage. Paper, bottles, rags and metals are salvaged. The value of goods salvaged during the year was approximately £444 (vii) Cost of Service The cost of the service for the year ending 31st April, 1937, was £10,969, and it is anticipated that the cost during the financial year ending 31st March, 1938, will be £14,450, as follow:— 1935-6 1936-7 1937-8 1938-9 £ £ £ £ Collection 7,534 9,142 12,600 9,804 Disposal 2,241 1.827 1,850 1,618 9,775 10,969 14,450 11,022 Tonnage (estimated) 11,700 12,132 12,500 12,850 Cost per ton: Collection 12/10 15/- 20/2 14/11 Cost per ton: Disposal 3/11 3/11 2/11 2/2 17. Conclusion. In conclusion I desire to place on record my appreciation of the assistance rendered by all members of the Department. I am, Mr. Chairman, Ladies and Gentlemen. Your obedient Servant, A. V. 13. ALLEN. Chief Sanitary and Shops Acts Inspector '