CRA 12 Az4412(30 CRA/PRD Urban District of Crayford Annual Report OF THE Medical Officer of Health For the Year 1947 BY M. A. G. WARD M.B., Ch.B., D.P.H. The Sparta Press, Crayford. Urban District of Crayford Annual Report OF THE Medical Officer of Health For the Year 1947 BY M. A. G. WARD M.B., Ch.B., D.P.H. The Sparta Press, Crayford. MEMBERS OF HEALTH COMMITTEE. Chairman : Councillor (Mrs.) M. M. Hetherington, C.C. Members : Councillors: W. A. Borrie H. E. Clark (Miss,) V. M. Constant E. G. Costin F. T. Havill Councillors : C. Hetherington N. E. Killick G. T. W. Mooney (Mrs.) D. L. Pyves S.J. Woolley, J.P. Co-opted Members (M. & C.W.): Mrs. E. J. Borrie Mrs. E. Saxby Mrs. L. Woolley Public Health Staff. Medical Officer of Health: M. A. G. Ward, M.B., Ch.B., D.P.H. Appointed 1-7-47. Sanitary Inspectors: R. Milligan, Cert. R. San. I., M.S.I.A. F. C. Weston, A.R.S.I., M.S.I.A., Cert. S.I.B., R.I.P.H. (Hons.) Dip. R.I.P.H. (Hons.). Health Visitors : Miss I. E. Smith, S.R.N., S.C.M., Health Visitors' Cert. Miss W. M. A. Beauchamp, S.R.N., S.C.M., Health Visitors Cert. Appointed G-l-47. Resigned 17-8-47. Mrs. J. Manson, S.R.N., S.C.M., Health Visitors' Cert. Appointed 13-10-47. Day Nurseries : Matron—Shenstone Nursery : Miss M. A. Firth, S.R.N. Scabies Treatrtient: Mrs. L. Wildish, S.R.N. (Part-time). Chief Clerk : Mrs. G. Mitchell. Clerks : Mr. E. T. Shutte, Mrs. E. E. Butler, Miss P. Jennings, Appointed 21-7-48. Clinic Clerk : Miss J. Fletcher, resigned 24-5-47. Mrs. M. Murphy, (Part-time) appointed 23-5-47. Rodent Operator : Mr. W. McCulla. 2 Crayford Urban District Council. To the Chairman and Members of the Urban District Council and Health Committee. Ladies ,and Gentlemen, I have the honour to present my First Annual Report. STATISTIC AND SOCIAL CONDITIONS OF THE AREA. Area (in acres) 2,698.71 Population (Census 1931) 15,896 Population estimated 26,610 Number of inhabited houses 7,448 Rateable Value £158,455 Sum represented by a penny rate £650 Live Births Total M. F. Legitimate 563 306 257 Illegitimate 20 10 10 583 316 267 Birth rate per 1,000 of the estimated resident population 22. General birth rate for England and Wales 20.5. Stillbirths Total M. #] Legitimate 16 7 9 Illegitimate 1 — 1 17 7 10 3 Death rate per 1,000 of the estimated resident population 10.2. General death rate for England and Wales 12. Deaths from puerperal causes.:— Puerperal Sepsis — Other Puerperal causes — Other Maternal causes 1 Death rate of infants under one year of ago :— All infants per 1,000 live births (Crayford) 36 General death rate of infants under 1 year of age for England and Wales 41 Legitimate infants per 1,000 legitimate live births 37.3 Illegitimate infants per 1,000 illegitimate live births 0 Deaths from various causes. Cancer (all ages) 48 Measles (all ages) 0 Whooping Cough (all ages) 0 Diarrhoea (under 2 years of age) 6 4 Rate per 1,000 total (live and still) births 28.3. Total M. F. Deaths 271 147 124 Vital Statistics during 1947 and previous years. Year Population LIVE BIRTHS DEATHS INFANT DEATHS No. C.U.D.C. RATE C.U.D.C. Eng. & W. No. C.U.D.C. RATE C.U.D.C. Eng. & W. No. C.U.D.C. RATE C.U.D.C. Eng. & W. 1939* 25,200 458 18.26 15 194 9.4 12.1 16 35.4 50 1940* 23,770 428 18 14.6 256 13.8 14.3 16 38.9 55 1941* 22,380 347 15.5 14.2 227 10.1 12.9 20 59.7 59 1942 22,840 441 19.3 15.8 193 8.5 11.6 20 45.3 49 1943 22,850 431 18.9 16.5 223 9.8 12.1 18 41.8 49 1944 21,910 507 23.1 17.6 243 11.1 11.6 21 41.4 46 1945 23,030 432 18.8 16.1 170 7.4 11.4 10 23.1 46 1946 25,780 566 22 19.1 249 9.7 11.5 21 37 43 1947 26,610 583 22 20.5 271 10.2 12 21 36 41 * Instructions were issued by the Registrar General for these particular years, giving certain alternative figures for calculation of these statistics. 5 Table showing Summary of Causes of Death registered during the year ended 31st December, 1947. CAUSES OF DEATH. Male Female 1. Typhoid and Paratyphoid Fevers — — 2. Cerebrospinal fever — — 3. Scarlet fever — — 4. Whooping cough — — 5. Diphtheria — — 6. Tuberculosis of respiratory system 8 8 7. Other form of tuberculosis 1 2 8. Syphlitic diseases — — 9. Influenza 2 1 10. Measles — — 11. Acute Poliomyelitis and Polioencephalitis — — 12. Acute Infantile encaphalitis — — 13. Cancer of buccal cavity and oesophagus (M) Uterus (F) 7 5 14. Cancer of stomach and duodenum 8 2 15. Cancer of breast — 2 16. Cancer of all other sites 18 6 17. Diabetes — — 18. Intracranial vascular lesions 9 16 19. Heart disease 41 43 20. Other diseases of circulatory system 2 3 21. Bronchitis 9 5 22. Pneumonia 4 4 23. Other respiratory diseases 1 1 24. Ulcer of stomach or duodenum 2 — 25. Diarrhoea under 2 years 4 2 26. Appendicitis 2 — 27. Other digestive diseases 3 2 28. Nephritis 1 5 29. Puerperal and post-abortive sepsis — — 30. Other maternal causes — 1 31. Premature birth 4 2 32. Congenital malformation, birth injuries, infant disease 2 3 33. Suicide 1 1 34. Road traffic accident 1 — 35. Other violent causes 3 3 36. All other causes 14 7 All causes Total 147 124 Population. As will be seen from the summary of statistics the Registrar General has estimated the population for the mid-year 1947 to be 26,610. This is an increase of 830 over last year's figure. 6 Births. The 583 live births notified is an increase of only 17 compared with last year's figure. The birth rate per 1,000 of the population is 22 the same as last year. The birth rate for England and Wales is 20.5. Deaths. This year we recorded 271 Deaths out of a population of 26.610, representating a Death rate of 10.2 as against 9.7 in 1946. Infant Deaths. During the year 21 infants died before reaching the age of one year. Rate of Infant Deaths under one year, per 1,000 live births is 36 as against 37 last year. That of England and Wales 41. Analyses of the causes of Death of Infants at various ages under one year. Causes of Death as Certified Under 1 week 1 to 2 weeks 2 to 3 weeks 3 to 4 weeks Total under 1 month 1 to 3 months 3 to 6 months 6 to 9 months 9 to 12 months Total under 1 year Asphyxia 1 1 Congenital Heart Disease 1 1 Congenital Morbus Cordis 1 1 1 Erythroblastosis Foetalis 1 1 1 Gastro Enteritis 2 2 1 3 IcterusGraves Neonatorum 1 1 1 Infective Hepatitis 1 Peritonitis 1 1 1 Pneumonia 1 1 2 1 2 5 Prematurity 6 6 6 10 2 1 1 14 2 2 2 1 21 Maternal Mortality. One Death occurred during the year under this heading. 7 MATERNITY AND CHILD WELFARE FACILITIES. Ante-Natal Clinics. One session per week is held at the Council's Antenatal Clinic, at the Town Hall. The Clinic has been re-organised and a new system of record keeping instituted so that records can be sent with patients transferred to other areas. 261 women made 1205 attendances. X-Rays. 10 Expectant Mothers were referred to the County Hospital for X-ray examination. Obstetric Consultant. Abnormalities in connection with Maternity Cases are recommended for examination when necessary, to the Council's Obstetric Consultant at Guy's Hospital. Intant Welfare Clinics. The average attendances are as follows:— Toddlers Clinics. No. of Clinics Attendances Average Crayford 23 263 37.52 Slade Green 24 546 22.75 Barnehurst 22 863 39.22 Infants Clinics. Crayford 46 3199 69.54 Slade Green 22 1438 65.36 Barnehurst 46 3510 76.3 Totals at both Clinics 183 10419 56.93 As will be seen from the above 183 Clinics were held and the attendances were 10,419. This is an increase of 1,025 over the previous year's figures when 185 Clinics were held and the attendances were 9,394. The Crayford Clinic has been redecorated internally, and new matting laid to the concrete floor. 8 The erection of a pram shelter has been under consideration, but it was not possible with existing restrictions to carry the proposed plans to completion. As a temporary measure an open lean-to roof at one end of the building was provided with a concrete ramp so that it could be used as a shelter, but this is unsatisfactory and inadequate, and the permanent scheme should be completed as soon as possible. Adverse comment has been made both by the public and Council regarding the existing Slade Green Clinic premises. Efforts have been made over many months to obtain part use of the unoccupied Children's Nursery building, but nothing has materialised to date owing to complicated negotiations of various bodies concerned in the property. Home Helps. The Council's Home Help Scheme provides the services of women to undertake Domestic duties for confinements cases. Number of cases attended 35. In order to make full use of staff engaged for Home and Domestic Help services it has been found advantageous to combine the two sections of employees thus simplifying the working of the Home Help Service. Staff employed at the end of the year 14 part-time. Maternity Cases. The Council accept financial responsibility for patients recommended to the Kent County Council Hospitals. Admission is restricted to cases where complications are likely to occur or where home conditions are unsuitable for a confinement. Number of cases recommended during the year 97. Day Nursery. Shenstone Nursery accommodates sixty children. I he number of attendances during the year was 11,913. This is an increase of 1,301 on the previous year's figures. 9 At the end of the year there were G9 children on the register and also a long waiting list. A boundry fence has been erected in the grounds making control of the children less arduous. The Nursery has also been redecorated internally. Priority. Priority Dockets for sheets are available for expectant mothers being confined in their own homes. 314 dockets have been issued during the year to 136 women. Care of Premature Infants. Daily visits are paid commencing immediately on discharge from hospital, and in the case of home confinements as soon as the Midwife has left the case, and continue until the child is one month old. Two sets of equipment including Draught-proof Cots, Blankets, Hot Water Bottles, Cot Mattress, Pillows, and Electric Blanket, are available for use in the District. The total number of premature babies notified who were born:— (a) At Home 15. (b) In Hospital 24. (i) The number of those born at home:— (a) Who were nursed entirely at home 15. (b) Who died during the first 24 hours 2. (c) Who survived at the end of one month 13. (ii) The number of those born in Hospital:— (a) Who died during the first 24 hours 3. (b) Who survived at the end of one month 20. Total from 1st January, 1947, to the 31st December, 1947, 39. This figure includes 13 outward transfers. Care of Illegitimate Children. Co-operation exists between the Staff of the Health Department and the Moral Welfare Officer of the Rochester Diocese. The Council have continued to make contribution toward the maintenance of unmarried mothers admitted to the Diocesan Homes. 10 Maternity and Nursing Homes. Of the 600 births, 377 occurred at institutions, of these 198 at the Russell-Stoneham Memorial Hospital and 85 at the Dartford County Hospital. Health Visiting. Visits to children under one year 5,182 Visits to children between one and five years 5,901 Visits to Expectant Mothers 297 Total 11,380 Ophthalmic and Orthopaedic Treatment. Facilities are available for Ophthalmic and Orthopaedic treatment at the Dartford County Hospital. Sixteen children attended for Ophthalmic treatment, and twenty-four children made forty attendances for Orthopaedic treatment. Dental Treatment. Twenty-one children received treatment at the Kent County Council's Clinic, Mayplace Road East, Bexleyheath. CHILD LIFE PROTECTION. Adoption of Children (Regulation) Act, 1939. Foster Children—Section 206—Public Health Act, 1936. Visits to Adopted Children 218. Number of adopted children on the register at the end of the year 53. Number pending adoption 3. Visits to Foster Children 47. Number of children on the register at the end of year 8. The Senior Health Visitor is also the Child Life Protection Officer, and heir work in this connection is greatly appreciated by the new parents. She found no cause for complaint throughout the year. Domestic Help. This assistance is granted to families where there is sickness or infirmity. Number of cases attended 27. Most of the patients were of a chronic type. 11 Nutrition and General Health Education. Supplies of posters and leaflets on health matters have been received from the Central Council of Health Education. Posters have been displayed on the Council's hoardings and leaflets distributed at the Council's Clinics. LABORATORY FACILITIES. The following specimens were sent to the County Laboratory from the District:— Swabs 41 Sputa 58 Others 7 Milk Bacteriological 2 Water, Public Supplies 10 Swimming Bath 2 Ice Cream 2 Total 122 AMBULANCE FACILITIES. Infectious Disease. Cases of Infectious Disease are removed to the Bow Arrow Hospital by the Ambulance in connection with that institution. Non-Infectious Diseases. The Council have an arrangement for the hire of an ambulance for removal of cases to hospital with the Crayford Division of the St. John Ambulance Brigade, Bexley Borough Council, London County Council, Dartford Public Assistance Committee, Sidcup Urban District Council. PUBLIC MORTUARY. The Public Mortuary maintained by the Council is situated to the left of the Town Hall Buildings. Number of times used 12. CONTROL OVER INFECTIOUS DISEASE Diphtheria Immunisation. Continuous propaganda has been carried on as in previous years. The results of the work is reflected in 12 the high percentage of Children immunised, and in the fact that no cases of Diphtheria have occurred in the area since 1942. Children are now immunised at the age of .8 months, receiving two injections of A.P.T. with an interval of four weeks between them. A further injection is given at the age of 5 years. The total number of children immunised during the year is as follows:— Under 5 years of age 588 Over 5 years and under 15 46 634 Children receiving a further injection at the age of 5 years 120 Percentage of Child population considered Immunised at the end of the year:— Under 5 years 78 per cent. Over 5 and under 15 years 89 per cent. Notifiable Diseases (other than Tuberculosis) during the year. Disease Total cases notified Cases admitted to hospital Deaths Small Pox — — — Scarlet Fever 41 11 — Diphtheria — — — Enteric Fever (including Paratyphoid) — — — Puerperal Pyrexia 5 2 — Pneumonia 15 4 — Erysipelas 3 — — Cerebrospinal Meningitis 1 1 — Measles 204 2 — Whooping Cough 82 1 — Ophthalmia Neonatorium — — — Dysentry 1 1 — Scabies 41 — — Poliomyelitis 4 2 — Totals 397 24 — 13 14 Age Groups. Ages, etc. (N.K.-age unknown) Scarlet Fever Diphtheria Whooping Cough Measles (excluding rubella) Ac Poliomyelitis Ac Polioencephalitis M F M F M F M F M F M F Civilians— 0 — — — — 2 7 5 6 — — — — 1 1 1 — — 10 14 25 17 — — — — 3 3 2 — — 11 10 32 26 — — — — 5 14 13 — — 13 14 40 35 1 — — — 10 3 2 — — — — 4 5 1 1 — — 15 — 1 — — — 1 3 4 1 — — — 25 and over — 1 — — — — 1 1 — — — — Age unknown — — — — — — — — — — — — Total Civilians 21 20 — — 36 46 110 94 3 1 — — Non-Civilians— 15 — — — — — — — — — — — — 25 and over (or N.K.) — — — — — — — — — — — — Total Non-Civilians — — — — — — — — — — — — Ages, etc. (N.K.-age unknown) Enteric or Typhoid Fever Paratyphoid Fevers Ac Pneumonia Dysentery Cerebro Spinal Fever Ac encephalitis lethargica Civilians— M F M F M F M F M F M F 0 — — — — 2 — — — — — — — 5 — — — — 1 2 — — — — — — 15 — — — — 2 4 1 — 1 — — — 45 — — — — 3 1 — — — — — — 65 and over — — — — — — — — — — — — Age unknown — — — — — — — — — — — — Total Civilians — — — — 8 7 1 — 1 — — — Non-Civilians— 15 (or N.K.) — — — — — — — — — — — 45 and over — — — — — — — — — — — — Total Non-Civilians — — — — — — — — — — 15 Age Groups Continued. Ages, etc. (N.K.-age unknown) Erysipelas Smallpox Civilians M F M F M F Puerperal pyrexia — 5 Civilians— Ophthalmia neonatorum — — 0 — — — — Scabies 18 23 5 — 1 — — 15 — — — — 45 — 1 — — 65 and over — — — — Age unknown — 1 — — Non-Civilians M F Total Civilians — 3 — — Puerperal pyrexia — — Non-Civilians— — — — — 15 (or N.K.) — — — — 45 and over — — — — Total Non-Civilians — — — — Tuberculosis. Age periods New Cases Deaths Respiratory NonRespiratory Respiratory NonRespiratory M F M F M F M F 0 — — — — — — — — 1 1 — 1 1 — — — — 5 2 1 1 — — — — — 15 5 12 1 — 1 4 — 2 25 2 5 — 1 1 4 — — 35 4 1 — — 2 — 1 — 45 2 2 2 — 3 — — — 55 1 — — — — — — — 65 and upwards 1 — — — 1 — — — Totals 18 21 5 2 8 8 1 2 Tuberculosis Dispensaries. At Overy Street, Dartford and Bexley Road, Erith. Scabies. Two sessions are held per week at the Council's Cleansing Station at the Town Hall. Children and adults receive treatment which consists of bathing and the appliof Benzyl Benzoate. Piatients are instructed regarding the treatment of bedding and personal clothing. Cases notified 41 Cases and contacts treated 96 Venereal Diseases. Under the auspices of the Ministry of Heath and Central Council for Health Education posters were displayed in the area throughout the year. 175 blood specimens for Wasserman testing were taken at the Ante-Natal Clinic, all of which proved negative. Venereal Disease Clinic. At the County Hospital, West Hill, Dartford. 16 Gifts. 123 Layettes have been distributed through the Women's Voluntary Service in addition to tot quilts, woollen clothing and rubber teats. INSPECTION AND SUPERVISION OF FOOD. Milk. Two samples of Pasteurised Milk from the same retailer were submitted for analysis following complaints regarding the keeping quality. Both reports were unsatisfactory. As the Purveyor in question was selling a very small quantity he decided to dispose of his round to one of the larger Companies, and there was no need to proceed further in the matter. One sample of milk sent for bacteriological examination was found to be free from Tuberculosis. Fqllowing complaints regarding faulty cleansing of milk bottles, representations were made to the Ministry of Health and the Dairy Companies concerned urging that greater publicity, by means of broadcasting if rteces, sary, should be given to the matter drawing Public attention to the need for the speedy return of bottles properly rinsed out after use. The following Licences were issued under the Milk (Special Designation) Orders:— Principal Licences:— Pasteurised milk 4. Supplementary Licences:— Pasteurised milk 6. Tuberculin tested milk 6. Milk Powder. Two samples of milk powder used at a school canteen, one of whole powder and one from the residue of powder which had already been made up, were submitted for analysis. Both samples were found to be fit for use. 17 Meat and Other Foods. During the year a total of 4 tons, 5 cwts. 3 qtrs. 20 lbs. of food was found to he unfit for human consumption. Classification is shown below:— Tons Cwts. Qtrs. Lbs. Meat 1 5 3 20 Fish 3 — 18 Fruit 6 3 14 Vegetables 2 — — 8 Miscellaneous 9 3 16 Total 4 5 3 20 The following samples of meat and other foods were submitted for analysis during the year. Cooking Fat. Two samples of cooking fat were submitted for analysis from the Civic Restaurant. Both samples were found to be genuine, and of similar quality. (The query was that while both samples appeared to be the same there was a considerable difference in the price). Corned Beef. One sample of corned beef from a consignment that appeared to be unsound was found to contain 116 parts of tin per million. Although fit for food according to the sample submitted there was an element of doubt about the advisability of selling some of the meat and two boxes were returned to the Meat Depot for observation and further inspection. Ice Cream. Two samples of Ice Cream were submitted for analysis under the Ice Cream (Heat Treatment) Regulations. One from an outside manufacturer was reported as Grade 1 and one from a local manufacturer was reported as Grade 3. 18 Owing to the time limit proviso in sampling technique, difficulty is being experienced in obtaining samples early enough for submission to the County Analyst on the same day. Particulars of samples taken in the Crayford Area during the year ended the 31st December, 1947:– No. of Articles Samples Alasil Tablets 1 Aspirin 1 Baking Powder 1 Biscuits 1 Brandy Flavour Essence 1 Bread and Scone Flour 3 Bronchial Balsam 1 Castor Oil 1 Cheese 3 Cod Liver Oil 1 Coffee 1 Condensed Milk 1 Cooking Fat 3 Cough Cure 2 Custard Powder 1 Daydown Oats 1 Epsom Salts 1 Eucalyptus Oil 1 Extract 2 Fish Paste 2 Gelatine Crystals 1 Gin 1 Glycerine 1 Glycerine and Borax 1 Gravy Browning 2 Green Peas 1 No. of Articles Samples Ground Ginger 1 Honey 1 Ice Cream 3 Jam 2 Lemon Curd 1 Lobster Paste 1 Malt Vinegar 2 Margarine 2 Meat Pie 1 Milk 20 Milk Pudding 1 Non-brewed Vinegar 3 Port 2 Port Type Wine 1 Pudding Mixture 1 Saccharin 1 Spring Salts 1 Stewed Steak 1 Tea 1 Tincture of Iodine 2 Tincture of Quinine 1 Whisky 2 87 All samples genuine with the exception of the following:— Cheese. This was a sample of Processed Cheese, the analysis of which showed that half the fat was other than butter fat. Gin. Contained 10.8 per cent, excess water. 19 The Control of Rodents and other Pests. During the year the following infestations were dealt with:— Rats 235. Crickets 2. Miscellaneous 21. HOUSING STATISTICS. (1) Inspection of Dwelling-Houses. (1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1521 Number of inspections made for that purpose 3160 (2) Number of dwelling-houses (included under sub-heading (1) above which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 30 Number of inspections made for that purpose 253 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 5 (4) Number of dwelling-houses (exclusive of those referred to under the preceding subheading) found not to be in all respects reasonably fit for human habitation 1409 (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 Local Authority or their Officers 1381 (3) Action under Statutory Powers during the year. Statutory Notices under Housing or Public Health Acts 28 1 (3) Number of dwelling-houses in respect of which demolition orders were made 5 Number of dwelling-houses demolished in pursuance of demolition orders — 20 Total number of houses owned by Local Authority 1297 Number of new houses built during the year:— (a) by the Local Authority 227 (b) by other bodies or persons 118 (4). Housing Act, 1936, Part IV.—Overcrowding. Until an official survey is carried out it is difficult to assess the extent of overcrowding and so long as the present acute shortage of houses exists Section 59 must necessarily remain dormant. SANITARY CIRCUMSTANCES OF THE AREA. Water. The supply to the Crayford district is a mixture of water from Bexiley, Crayford, Dartford, Darenth., Deptford, Wansunt and Wilmington wells and River Thames filtered water from Walton works. All the water is chlorinated before it leaves the works. Bacteriological analyses are made five times per week of all supplies and consistently satisfactory results have been obtained. In the case of Bexley, Dartford Darenth,. Deptford, Wansunt and Walton filtered the water is also tested before chlorination, but owing to the conditions of treatment at the other stations this is not possible. All new and repaired mains are chlorinated before being restored to use and samples of water from them are tested bacteriologically. None of the supplies is plumbo-solvent. Samples taken by the Sanitary Inspector from two well supplies were found to be unsatisfactory A repeat sample from one, following certain improvements to the storage tank was found to be satisfactory. In the other case suggested improvements to the structure of the well are being carried out. 21 Water Supply. Extensions to the mains of the Metropolitan Water Board at Housing Schemes No. 14 (Heath Road), 15 and 18 (Thames Road), 16 (Martens Avenue), 17 (Colyers Lane), 19 (Station Road). Drainage and Sewerage. Extensions and connections to the mains of the West Kent Main Sewerage Board at Housing Schemes Nos. 14, 15, 16, 17, 18 and 19. Rivers and Streams. The normal annual maintenance work was carried out on the ditches, water-ways, and rivers, in the district. Closet Accommodation. Approximate number of premises containing each type of sanitary convenience in the district:— W.C's. into drainage system 8375 W.C's. into Cesspools 15 Earth Closets or privy middens 4 Pail Closets 9 Number of premises not connected to public water supplies 2 Public Cleansing. A seven days collection of refuse has been maintained for approximately 6 months mainly as a direct) result of the delivery and operation of new Freighters. Refuse disposal satisfactorily carried out and controlled tipping continued on an improved basis through operating Chaseside shovel on tip covering. Vermin on tip now reduced to minimum through mixing spent acetylene with covering material. Salvage—January to December, 1947—191 tons 14 cwts., value £1,252 (approx.)—(includes paper, bottles, metals and rags). 22 Sanitary Inspection of the Area. No. in district No. of visits in 1947 No. of faults and defects found No. of faults and defects remedied Bakehouses 1 7 0 0 Dairies 3 50 0 0 Other food - preparing places, which are, as such, subject to inspection 39 703 0 0 Nuisances and defects remedied during the year (other than those enumerated in the previous tabulation). Overcrowding 0 Roofs and Rain Water Sanitary Accommodation: Pipes 287 Defective 450 Floors 90 Drainage: Walls and Ceilings 649 (i) Repaired 14 Windows & Ventilation 332 (ii) Cleansed 273 Baths, Lavatory Basins Refuse Receptacles 154 and Sinks 106 Dampness 106 Water Supplies 118 Total number of visits of all kinds paid by Inspectors during the year 6,963 Approximate number of separate premises in area 8,625 Notices served:— Statutory 28 Informal 1,409 Number of houses, etc., disinfected 74 Swimming Pool. Period open from the 17th May, to the 14th September (104 days). Number of bathers 39,352. This figure does not include schools when the Swimming Pool was used outside normal hours. Shops Acts. Visits made during the year 140. 23 Smoke Abatement. Up to the present five installations have converted to oil burning fuel. One factory has had trouble with their installation with the consequent periodical emission of black smoke, but it is hoped that when repairs are effected this trouble will cease. Eradication of the Bed Bug. Particulars of the action taken in 1947, for the eradication of the Bed Bug are as follows:— Number of Infested Disinfested Council Houses 43 43 Other Houses 7 7 Prescribed particulars on the administration of the Factories Act, 1937. 1. Inspections for purposes of provisions as to health (including inspections made by Sanitary Inspectors). Premises (1) Number on Register (2) Number of Inspections (3) Written notices (4) Occupiers prose Cuted (5) (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 12 25 1 0 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 33 93 3 0 (iii) Other Premises in which Section 7 is enforced by Local Authority (excluding outworkers' premises 10 18 1 0 TOTAL 55 136 5 0 24 2. Cases in which Defects were found. Particulars (1) Number of cases in which defects were found Number of cases in which prosecutions were instituted (6) Found (2) Remedied (3) Referred To H.M Inspector (4) By H.M. Inspector (5) Want of cleanliness (S.1) — — — — — Overcrowding (S.2) Unreasonable temperature (S.3) — — — — — Inadeqate ventilation (S, 4) — — — — — Ineffective drainage of floors (S.6) — — — — — Sanitary Conveniences S, 7) — — — — — (a) Insufficient 5 5 0 2 0 (b) Unsuitable or defective 5 5 0 2 0 (c) Not separate for sexes — — — — — Other offences (not including offences relating to Outwork) ... 2 2 0 0 0 TOTAL 12 12 0 4 0 25 (Sections 110 and 111). OUTWORK. Part VIII of the Act. Nature of Work. Section 110 Section 111 No. of out-workers in August list required by Sect. 110 (1) (c). No. of cases of default in sending lists to the Council. No. of prosecutions for failure to supply lists. No. of instances of work in unwholesome premises. Notices Served. Prosecutions. Wearing Apparel. Making, etc. 9 – – – – – Carding, etc. of buttons, etc. 1 – – – – – Total 10 – – – – – I am, Your obedient servant, M. A. G. WARD, Medical Officer of Health. 26