HAMPT 1 E Arban Destrict Council Nil. Annual Report OF THE MEDICAL OFFICER OF HEALTH Year ending December 31st, 1925. THE HAMPTON PRESS, HAMPTON HILL. 1926 Hampton Arban District Council. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH For the Year ending December 31st, 1925. Gentlemen, I have the honour to present my Thirteenth Annual Report on the general health and conditions of the district for the year ending December 31st, 1925. Included in this Report are details of the progress made in the district since the beginning of 1921. NATURAL AND SOCIAL CONDITIONS OF THE DISTRICT. Area.—The Urban District of Hampton includes the ecclesiastical parishes of Hampton with Hampton Court, and Hampton Hill. The total area being 2,044 acres, of which 62 acres are covered with water. The area of Hampton district in Bushy Park being 550 acres. Population.—Census, 1921 10,677. Estimated, 1925 (R.G.) 10,920. Physical Features and General Character of the Area.—Mainly a flat district with gravel subsoil, which is a good natural drainage for the surface soil. Although in the Thames Valley the district stands on comparatively high ground, the level of the Thames water being many feet below ground level of the main district. The land in the western part is mainly used for horticulture, and this forms one of the staple industries of the 4 district. The only large employer of labour is the Metropolitan Water Board, and the main occupations of the working classes are outdoor ones. The River Thames flows along the whole of the southern boundary, a distance of nearly two and a-half miles, but a considerable portion of the frontage is occupied by the works of the Water Board and by private residences. The district is fortunate in the possession of open spaces for recreation, a large portion of Bushy Park being in the area, and there are several small recreation grounds owned and controlled by the Local Council. Number of inhabited houses (1921) 2,038. Number of families or separate occupiers (1921) 2,470. Rateable Value £141,333. Sum represented by a penny rate £466. Social conditions are good, and the chief occupations are market-gardening and nurseries, and Water Works. VITAL STATISTICS, 1925 The total number of births registered in the district was 148, of whom 68 were males, and 80 were females, five being illegitimate. This is equal to a Birth rate of 13.64 per thousand of the estimated population. The rate for England and Wales is 18.3. The rate for London is 18.0. DEATHS AND DEATH RATE. The number of deaths registered as occurring within the district was 136, of whom 10 were non-residents. Returns relating to the deaths of 36 residents who died outside the district were furnished by the Registrar 5 General. After due corrections for non-residents and the inclusion of residents dying outside the district, the net total of deaths of residents is 126—51 males, and 75 females. A tabular statement is appended showing the cause of death, together with the age periods at death, also a table showing the distribution of these deaths between males and females. The Death rate is 11 -54 per thousand. The rate for England and Wales is 12.2 per thousand. The rate for London is 11.7 per thousand. INFANTILE MORTALITY. Twelve deaths of infants under one year of age were recorded; this is equal to a rate of 81.08 per thousand births. The two previous years the rates were 1924, 40.5; and 1923, 19.5 per thousand births. The infantile mortality rate for England and Wales is 75 per thousand births. The two previous years the rates were—1924, 75, and 1923, 69 per thousand births. The rate for London last year was 67 per thousand births. The amount of Poor Law relief paid out in the district of Hampton during the year 1925 was £639 11s. 6d. This of course does not include persons who are sent to the Poor Law Infirmary. During these five years ending December 31st, 1925, there have been no illnesses which need any special comment. 6 TABLE I. DEATHS—MALES AND FEMALES. SEX. At all Ages. Under 1 year. 1 to 2 2 to 3 3 to 4 4 to 5 5 to 10 10 to 15 15 to 20 20 to 35 35 to 45 45 to 65 65 and upwards Total. Males 51 7 0 0 2 0 0 0 1 4 3 9 25 51 Females 75 5 1 1 1 0 1 0 1 4 6 16 39 75 Totals 126 12 1 1 3 0 1 0 2 8 9 25 64 126 TABLE 2. DEATHS FROM NOTIFIABLE DISEASES. DISEASE. At all Ages. Under 1 year. 1 to 2 2 to 3 3 to 4 4 to 5 5 to 10 10 to 15 15 to 20 20 to 35 35 to 45 45 to 65 65 and upwards. Total M F Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... 1 Diphtheria ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... 1 Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pneumonia 3 2 2 ... ... ... ... ... ... 1 ... 1 1 ... 5 Ophthalmia Neoratorum ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... TOTALS 3 4 2 ... ... 1 ... 1 ... 1 ... 1 1 ... 7 7 TABLE 3. CAUSES OF, AND AGES AT DEATH OF RESIDENTS, 1925. CAUSES OF DEATH. At all Ages. Under 1 1 to 2 2 to 3 3 to 4 4 to 5 5 to 10 10 to 15 15 to 20 20 to 35 35 to 45 45 to 65 bo and upwards Total M F Scarlet Fever ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... 1 Whooping Cough ... 2 2 ... 1 1 ... ... ... ... ... ... ... ... 4 Diphtheria ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... 1 Influenza ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... 1 Tuberculosis of tory System ... 4 ... ... ... ... ... ... ... ... 3 1 ... ... 4 Other Tuberculous Diseases 1 1 1 1 ... ... ... ... ... ... ... ... ... ... 2 Cancer, Malignant Disease 6 15 ... ... ... ... ... ... ... ... 1 ... 7 13 21 Diabetes ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 1 Cerebral Haemorrhage 3 6 ... ... ... ... ... ... ... ... ... ... 2 7 9 Heart Disease 7 13 ... ... ... ... ... ... ... ... ... 3 5 12 20 Arterio-Sclerosis 3 1 ... ... ... ... ... ... ... ... ... ... 1 3 4 Bronchitis 4 1 ... ... ... 1 ... ... ... 1 ... ... 1 3 5 Pneumonia, all forms 3 2 2 ... ... ... ... ... ... ... ... 1 1 ... 5 Diarrhoea, under 2 years ... 1 1 ... ... ... ... ... ... ... ... ... ... ... 1 Appendicitis ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... 1 Nephritis 6 ... ... ... ... ... ... ... ... ... ... 2 3 1 6 Congenital Debility, Malformation, and Premature Birth 3 3 6 ... ... ... ... ... ... ... ... ... ... ... 6 Suicide 1 2 ... ... ... ... ... ... ... 2 ... ... 1 1 3 Other deaths from Violence ... 4 ... ... ... ... ... ... ... ... ... 2 1 1 4 Other defined diseases 12 15 ... ... ... ... ... ... ... ... 3 ... 22 22 27 TOTALS 51 75 12 1 1 3 ... 1 ... 2 8 9 25 64 126 8 TABLE 4. NOTIFIABLE DISEASES (other than Tuberculosis), DURING THE YEAR 1925. DISEASE. Total Cases Notified. Cases Admitted to Hospital. Total Deaths. Small Pox ... ... ... Scarlet Fever 32 30 1 Diphtheria 21 20 1 Enteric Fever and Para-Typhoid 2 2 ... Puerperal Fever ... ... ... Pneumonia 13 ... 5 Ophthalmia Neoratorum 1 ... ... Erysipelas 2 1 ... TOTAL 71 53 7 TABLE 4 (a). DISEASE. At all Ages. Under 1 year. 1 to 2 2 to 3 3 to 4 4 to 5 5 to 10 10 to 15 15 to 20 20 to 35 35 to 45 45 to 65 65 and upwards Total. M F Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever 32 ... 1 1 6 2 9 8 1 2 1 1 ... 15 17 Diphtheria 21 ... ... ... 1 1 3 10 2 1 2 ... 1 6 15 Enteric Fever 2 ... ... ... ... ... ... ... 2 ... ... ... ... 1 1 Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pneumonia 13 1 ... ... ... ... ... 1 1 3 2 4 1 7 6 Ophthalmia Neoratorum 1 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 Erysipelas 2 1 ... ... ... ... ... ... ... 1 ... 1 ... 1 1 TOTAL 71 1 1 1 7 3 12 19 6 7 5 6 2 30 41 9 TABLE 5. TUBERCULOSIS. NEW CASES AND MORTALITY DURING 1925. AGE PERIODS. NEW CASES. DEATHS. Pulmonary. NonPulmonary. Pulmonary. NonPulmonary. M F M F M F M F 0 to 1 year ... ... 1 ... ... ... 1 ... 1 to 5 ... ... ... 1 ... ... 1 ... 5 to 10 ... ... ... 1 ... ... ... ... 10 to 15 ... ... ... ... ... ... ... ... 15 to 20 ... ... ... ... ... ... ... ... 20 to 25 ... 2 ... 1 ... ... ... ... 25 to 35 ... 1 ... ... ... 3 ... ... 35 to 45 ... 2 ... ... ... 1 ... ... 45 to 55 ... ... ... ... ... ... ... ... 55 to 65 ... ... ... ... ... ... ... ... 65 and upwards ... ... ... ... ... ... ... ... TOTAL 1 5 1 3 ... 4 2 ... TABLE 6. CASES OF OPHTHALMIA NEORATORUM NOTIFIED DURING 1925. CASES. Vision unimpaired . Vision impaired. Total Blindness Deaths. Notified. Treated. At Home. In Hospital. 1 1 ... 1 ... ... ... 10 GENERAL PROVISIONS OF HEALTH SERVICES IN THE AREA. HOSPITALS : Nursing arrangements and other Institutions available in the district. (1) Tuberculosis.—None. (2) Maternity.—No Maternity Hospital is provided by the Local Authority. (3) Children.—No Children's Hospital is provided by the Local Authority. (4) Fever.—The Local Council have provided an Isolation Hospital, which is situated in the Uxbridge Road, Hampton. This hospital is kept up entirely by the Local Council, and every case possible is admitted here and treated free of charge The details of this hospital are given on a later page. (5) Small Pox.—Small Pox patients from this district would be treated at the hospitals kept for this purpose by the Middlesex Districts Joint Smallpox Board, of which this Council is a member. The Hampton District Council joined this Board during 1925. These Hospitals are situated at South Mimms, Middlesex. (6) Other Hospitals.—The other Hospital in the district is St. Mary's Cottage Hospital, which is situated in the Upper Sunbury Road, Hampton, and is equipped to accommodate 18 patients. This Hospital was built and partially endowed by a local resident, who has mainly supported the Hospital for some years. Voluntary contributions are also accepted. Institutional provisions for unmarried mothers, illegitimate infants and homeless children is provided by the Kingston Board of Guardians, of which this district is within their area. 11 Ambulance Facilities. The Local Council have an ambulance for infectious cases. The local branch of the St. John's Ambulance and Red Cross Society have a motor ambulance, which is always available for the removal of accident and other urgent cases. There is also available a hand-wheeled ambulance belonging to the Police. Clinics and Treatment Centres. An Infant Welfare Centre is provided by the Local Council and is situated in Priory Road, Hampton. It is under the control of a Lady Medical Officer, and is supervised by the Medical Officer of Health. Weekly sessions are held, at which the Health Visitor attends, and she is assisted by a body of Voluntary Workers. The Health Visitor keeps all children under observation until they are five years of age, after which they attend school and so come under the School Clinic, which is held at the Stanley Road School, Teddington, and is provided and staffed by the County Council. There are no Day Nurseries in this district. A Tuberculosis Dispensary is provided by the Middlesex County Council, and is situated at Twickenham and Hounslow, where patients from this district attend for treatment. Sanatorium treatment is also arranged for by the Middlesex County Council. Venereal Diseases are treated at various hospitals as arranged under the scheme of the Middlesex County Council. 12 STAFF OF THE PUBLIC HEALTH DEPARTMENT. Medical Officer of Health and Medical Officer of the Isolation Hospital: ARTHUR DEAKER OWEN, M.R.C S., L.R.C.P., L S.A. (part time). Medical Officer of the Infant Welfare Centre: Dr. ELLEN M. HATTON (part time). Sanitary Inspector: CLIFFORD J. RABBITTS, A. R. San. I. (whole time). Health Visitor: Miss G. E. EAGLE, A.R.San. I. (whole time). Health Visitor's Certificate, Royal Sanitary Institute. Matron of Isolation Hospital : Miss FANNY ROBINSON (whole time). Special Officer: H. J. EDWARDS, M.R C.V.S. Veterinary Inspector of Dairy Cows (part time). Contributions are made to the salaries of the Medical Officer of Health. Medical Officer of the Infant Welfare Centre. Sanitary Inspector. Health Visitor. 13 Professional nursing in the home is carried out in the Hampton portion of the district by the Hampton Nursing Association, and in the Hampton Hill portion of the district by a branch of the local Church. No professional nursing for the home for Infectious Diseases is provided. Midwives. There were four midwives practising in the district, entirely in a private capacity, and they are under the County Medical Officer. CHEMICAL WORK. Bacteriological examinations of suspected materials are undertaken for the Council by the Clinical Research Association. The following specimens were examined and reported on during 1925:— Throat and Nose Swabs 93 Sputum 5 Blood 5 Excreta 1 Total 104 ADOPTIVE ACTS, BYE-LAWS & REGULATIONS IN FORCE IN THE DISTRICT. Private Street Works Act, 1892. Adopted February 14th, 1893. Infectious Diseases (Prevention) Act, 1890. Adopted September 8th, 1891. Public Health Acts (Amendment) Act, 1890. Adopted March 8th, 1892. Public Health Acts (Amendment) Act, 1907. Adopted February 13th, 1911. 14 Bye-laws:— New Streets and Buildings. Prevention of Nuisances and Keeping of Animals. Slaughter Houses. Removal of Offensive Matter. Regulations:— Dairies, Cowsheds and Milkshops. SANITARY ADMINISTRATION. The report of the Sanitary Inspector on work carried out during the year 1925 is appended herewith. Water Supply. Practically every house in the district is supplied direct from the mains of the Metropolitan Water Board. There is a constant supply, which is maintained at a good pressure throughout the year. Rivers and Streams. The River Thames and the Queen's (or Longford) River are each partly within the district. No complaints have been received concerning contamination of either, from any source within the district. Drainage and Sewerage. Nearly the whole of the drainage has been remodelled during recent years, and the present condition is good. The general system of drainage is to lay stoneware drains on cement concrete foundations, with watertight inspection chambers at each change of direction and to intercept the drains from the sewers. All new drainage work is under the constant supervision of the Council's officers; and is tested by water pressure before covering, and by smoke on completion. 15 The district is divided into small compact areas for the purpose of sewerage, each area draining to one centre by gravitation; the sewerage being discharged into a Shone pneumatic ejector, from which it is lifted by compressed air through cast iron mains to the disposal works, which are situated in Hanworth Road, Hampton. As the population of the district is growing very quickly it is considered that the Sewage Disposal Works will have to be enlarged, and plans for these alterations are being prepared accordingly. Closet Accommodation. Water-closets of the wash-down type are in general use throughout the district, each being provided with a proper flushing apparatus. Scavenging and the Disposal of Refuse. Galvanised iron movable dustbins are in general use for the reception of household refuse, and the refuse is collected weekly by the Council's staff, every house being visited at about the same time and day in each week. This important work has been performed very efficiently and very few complaints are received. The method of disposal is by burning in a two-cell front feed Horsfall Refuse Destructor, which is situated at the Sewage Disposal Works. Sanitary Inspection of the Area. The work of inspection of dwelling houses and other premises has been maintained throughout the year by the Sanitary Inspector. Constant visiting and supervision of the necessary works to effect repairs to premises, for the abatement of nuisances or the prevention of disease, has been carried out. A number of preliminary notices were served, but very few statutory notices were served, and not one summons was served throughout the year. 16 The defects found to exist were of the general type, being dirty rooms, choked drains, defective roofs and gutters, rainwater pipes, &c. The full details of the work will be found in the report of the Sanitary Inspector. Smoke Abatement. It was necessary to notify the Metropolitan Water Board on one occasion during 1925, of the nuisance being caused by the smoke from the chimneys of the Water Works. Premises and Occupations which can be controlled by Bye-laws or Regulations. There are four slaughter houses in the district, which are under the constant supervision of the Sanitary Inspector. Thirty-eight factories, workshops, and workplaces are in this area. These are visited about six times a year, the exact number of inspections being 178. There is only one offensive trade carried on in this district, and that is a soap-making works. Only one complaint was received concerning these works, this nuisance being caused owing to alterations being made to part of the boilers, and this lasted only a few hours. Schools. There is one secondary school for boys, and four public elementary schools in the district:—the Council school for boys and girls at Percy Road; the infants' school in Station Road, Hampton; and the Church of England schools for boys and girls, and infants, at Hampton Hill. The Council schools are quite modern and have been built in recent years by the Middlesex County Council; and the erection of a new school at Hampton Hill is contemplated. 17 The schools are supplied with water from the public service, and the sanitary arrangements are quite satisfactory. All schools are visited and inspected, and any defects discovered are promptly remedied. HOUSING. 1. General Housing Conditions in the Area. (1) General housing conditions.—Many families are living in one, two, and three rooms. (2) (a) Extent of shortage or excess of houses.—The shortage of houses may be estimated by the number of applications received for houses which are being erected by the Local Council. After careful deductions are made the total number is 650, of which 250 are non-residents. (2) (b) Measures taken or contemplated to meet any shortage.—The Local Council are building houses at the present time, and will continue to do so for some period. (3) Important changes in the population.—There is no extraordinary increase in the population, but the number of inhabitants is gradually growing, as people are taking up residence in the district as quickly as houses are built. 2. Overcrowding. (1) Extent. — Many cases of overcrowding are known to exist in the district, but few only are bad cases. (2) Causes.—The main cause is the shortage of suitable houses; the most suitable house being the small low-rental type. (3) Measures taken or contemplated for dealing with overcrowding.—A number of houses are at present in course of erection by the Local Council, and as each house is completed it is allotted to a suitable applicant. 18 (4) Principal cases of overcrowding during the year 1925 and action taken.—There were only one or two very bad cases, and these people were allotted a Council house as soon as possible. 3. Fitness of Houses. (1) (a) General standard of housing in the area.—Good. (b) General character of the defects found to exist in unfit houses.—The general defects are : defective roofs, gutters, rain-water pipes, floors and windows, dirty walls and ceilings, dampness caused by other defects, &c. (c) The majority of defects found to exist in this district are due to the owners or agents being reluctant to have small repairs carried out when they first become necessary. (2) General action taken as regards unfit houses. (a) The Public Health Acts.—A preliminary notice of repairs is served on the owner, and in nearly every case this is complied with in a reasonable time. (b) The Housing Acts.—A preliminary notice of repairs is served on the owner, and, if this is not complied with within a reasonable time, instructions are asked for from the Local Sanitary Authority to serve statutory notice under the Housing Acts. (3) During the year 1925 no difficulties were met with in regard to repairing unfit houses under either the Public Health Acts or the Housing Acts. (4) Conditions as to water supply, closet accommodation and refuse disposal are good, but it was found necessary to press many owners of property to provide proper sanitary dustbins. 19 4. Unhealthy Areas. There are a few unhealthy areas in the district— chiefly old cottages, which no doubt will be demolished as soon as the housing question becomes better. 5. Bye-laws. Bye-laws relating to houses, houses let in lodgings, and to tents, vans, sheds, &c. (1) The existing bye-laws are found to be quite satisfactory. (2) At the present it is not contemplated to alter the existing bye-laws. 6. General and Miscellaneous. Advice as to the burning of household refuse is given whenever possible, and in many houses it is being carried out. HOUSING STATISTICS FOR THE YEAR 1925. Number of new houses erected during the year:— (a) Total, including numbers given separately under (b), In course of erection 68 (b) With State assistance under the Housing Acts 6 (1) By the Local Authority 6 (2) By other bodies or persons None 1. Unfit Dwelling Houses. Inspection (1). Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 276 Inspection (2). Number of dwelling houses which were inspected and recorded under the Housing (Inspection of District) Regulations, 1910, or the Housing Consolidated Regulations, 1925 60 Inspection (3). Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation None 20 Inspection (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 38 2. Remedy of Defects without Service of Formal Notices. Number of defective dwelling houses rendered fit in consequence of action taken by the Local Authority or their officers 107 3. Action under Statutory Powers. (a) Proceedings under section 3 of the Housing Acts, 1925. (1) Number of dwelling houses in respect of which notices were served requiring repairs 3 (2) Number of dwelling houses which were rendered fit after service of formal notices :— (a) By owners 3 (b) By Local Authority in default of owners None (3) Number of dwelling houses in respect of which closing orders became operative in pursuance of declarations by owners of intention to close None (b) Proceedings under Public Health Acts:— (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 107 (2) Number of dwelling houses in which defects were remedied after service of formal notices: (a) By owners 3 (b) By Local Authority in default of owners None (c) Proceedings under sections 11, 14, and 15 of the Housing Acts, 1925:- 21 (1) Number of representations made with a view to the making of Closing OrdersNone (2) Number of dwelling houses in respect of which Closing Orders were made None (3) Number of dwelling houses in respect of which Closing Orders were determined, the dwelling houses having been rendered fit None (4) Number of dwelling houses in respect of which Demolition Ordeis were made None (5) Number of dwelling houses demolished in pursuance of demolition ordersNone INSPECTION AND SUPERVISION OF FOOD. (a) Milk Supply. All milk produced or brought into this area is good, clean and wholesome. The only producer has, on an average, 100 cows. These are kept on grass-land in the summer, and in good, clean, well-ventilated sheds in the winter. The piemises are quite up-to-date. The necessary plant and utensils used for dealing with the milk is good, clean, and well looked after. At the premises there is a cold room for the storage of milk. Every attention is given to the producing and supplying of good, clean, wholesome milk. I may add that about 50 per cent, of the milk consumed in this district is obtained from this producer. The rest of the milk supplied in this district is nearly all brought into the district in sealed bottles, ready for delivery to the consumer. (1) Action taken as to tuberculous milk and tuberculous cattle :— The taking of samples, testing of milk, and testing the cattle is carried out by the County Council. A quarterly inspection is made by the Local Council's Veterinary Surgeon for the purpose of detecting any case of tubercular disease of the udder that may exist. 22 (2) Numbers of licenses granted for the sale of milk under special designations, classified as in the Fourth Schedule to the Milk (Special Designations) Order, 1923; types of apparatus licensed for the pasteurisation of milk None (3) Refusal or revocation of registration of retailers or of licenses for graded milk, with reasons for the refusal or revocation None (4) The summarized results of the bacteriological examination of samples of graded and other milk ... None (b) Meat. (1) Meat inspection in this district is carried out by the Sanitary Inspector. All notifications of slaughter are received by him, and he is present at the time of slaughter whenever possible. As most of the slaughtering takes place during different hours of the day it is impossible to be present always, but every effort is made to examine all animals after slaughter, if not at once, during the next few hours. Very little diseased meat was found during the year 1925, details of which will be found in the Sanitary Inspector's Report. All condemned meat and fish is at once taken to the refuse disposal works and disposed of by burning. There is no meat marking under the Public Health (Meat) Regulations, 1924, in this district. (2) The Public Health (Meat) Regulations; 1924, are working quite smoothly in this district. All butchers' shops are fitted with movable glass windows, which are used at the discretion of the butcher, and so far the butchers are quite keen on keeping their meat, &c., free from contamination, and not one has had to be requested to use the windows or other covering when it was necessary. 23 (3) There is no public slaughter house in the district. The number of private slaughter houses in the district is as follows:- In 1920. In January, 1925. In December, 1925. Registered5 5 5 Licensed - - - Total 5 5 5 (c) Other Foods. The Sanitary Inspector has all shops, carts, barrows &c., under constant observation, and many visits are paid to premises where food is kept or prepared. There are five bakehouses in use in the district, and all are in a very satisfactory condition. None are underground. The work of sampling articles of food, etc., under the Sale of Food and Drugs Acts, is carried out by County Council Officers. There has been no cases of food poisoning in the district during the year 1925 FACTORIES AND WORKSHOPS. There were 38 factories and workshops (including workplaces) on the register at the end of the year. One Hundred and Seventy-eight inspections were made to the above premises. The numbsr of defects found to exist was only four, and these were remedied by the owners, a written notice being sent in three instances. These defects were not of any size. The previous table shows the prevalence of the principal Infectious Diseases during the year 1925. Scarlet fever comes first with 32 cases; following closely is Diptheria with 21 cases. There were only five other cases notified during the year, namely, Typhoid and Para Typhoid 2, Erysipelas 2, and Ophthalma Neoratorqm 1, 24 Fifty-three cases out of the above 58 were removed to the Isolation Hospital for treatment. Only two deaths were recorded from infectious disease during the year: Scarlet Fever 1, Diphtheria 1. All rooms are disinfected as soon as possible after the removal of patients suffering from infectious disease. The disinfection is carried out by the Sanitary Inspector with a Formalin gas lamp or a Formalin sprayer. When necessary the bedding and clothing are taken to the Isolation Hospital and disinfected by steam. During the year 45 cases of Whooping Cough were notified to me by the school authorities in the district, and on this account the Infants' School in Station Road was disinfected right through. Only one death was due to Influenza during the year 1925. Ten new cases of Tuberculosis were notified during the year. Of these four were of the non-pulmonary type. Four out of the ten new cases notified during 1925 proved fatal. The same routine of disinfection is carried out with both Cancer and Tuberculosis. By arrangement with the Local Council all medical practitioners in the district take swabs or specimens for pathological or bacteriological examination in all cases suspected of infectious disease. No use has been made of the Schick and Dick tests during the year 1925. No vaccinations have been performed by the Medical Officer of Health under the Public Health (Small-pox prevention) Regulations, 1917. 25 PUBLIC HEALTH (Prevention of Tuberculosis) REGULATIONS, 1925.* No action relating to tuberculous employees in the milk trade was taken under these regulations during the year. PUBLIC HEALTH ACT, 1925 (Section 62). No action was taken by the Local Authority under this Act during the year. The Tuberculosis Dispensary for this district is at Hounslow. It is under the control of the County Council, who arrange for the sanatorium treatment where neessary. I have again to thank Mr. C. J. Rabbitts, the Sanitary Inspector, for his constant help in the department during the year. I am, Gentleman, Your obedient Servant, A. D. OWEN, Medical Officer of Health. Public Offices, Hampton. Jane 1st, 1926. MATERNITY AND CHILD WELFARE. HEALTH VISITOR'S REPORT, 1925. The Maternity and Child Welfare Centre, which is provided by the Local Authority, is under the supervision of the Medical Officer of Health. Sessions are held weekly, when a lady doctor is in attendance. 26 The Lady Health Visitor is a full-time officer, and does a lot of good work in visiting the young children of district The following is a summary of the work carried out during the year 1925:— Number of sessions held during 192547 Number of attendances 1179 Average number of attendances 25 Number on books for the year 150 Number of visits to expectant mothers 24 Number of other visits 2115 Total number of visits 2139 ANTE-NATAL CLINIC. This clinic was provided and furnished by the Local Council. It was opened on June 9th, 1925. The attendances to the end of the year were 41. The number of names on the books at the end of the year was ten. 26a During the last five years several works and improvements have been carried out for the benefit of the inhabitants of the district. No. 1.—Housing. In all 46 houses have been built by the Local Authority. These include houses of different types:—Four bedrooms arid parlour type, three bedrooms and parlour type, and several of the smaller type (two bedrooms and no parlour). Another 29 of the smaller type are in course of construction at the present time, with a further 16 to follow. This will considerably relieve the present position of more than one family per house, but many more houses are needed before * this regrettable situation is overcome. Altogether the number of houses owned by the Local Authority is 66 pre-war houses and 46 post-war houses, making a total of 1x2. No. 2—Swimming Bath. An Open-air Swimming Bath, which is situated in a part of Bushy Park and adjoining High Street, Hampton, is practically the centre of the district. It was built and opened by the Local Council in June, 1922. It is built of concrete, is 120 feet long and 30 feet wide, the depth varying from 3 to 6 feet. During the last year extra dressingbox accommodation was added, and now the dressing-rooms extend to the whole of one side, a double row of boxes three-quarters the length of the other side, and a large room at the end. Shower bath, lavatories, and office for the attendant in charge complete the buildings. No. 3.—Isolation Hospital. During 1924 the Isolation Hospital was extended by the addition of four observation wards, and general offices, quite apart from the other buildings. The administration block was also enlarged accordingly. Previously the hospital was known as a ten-bedded hospital. 26b No. 4.—Mortuary. During 1925 a new, up-to-date Mortuary was built in the same grounds as the Public Offices. The building comprises receiving-room; tank-room, fitted with concrete tank for decomposed bodies such as are taken from the river from time to time. This tank has a glass cover, so that the contents can be seen without removing anything. A viewing room, with a glass partition, also an operating room for holding post-mortem examinations, fitted with revolving operating table, sinks, shelves, instruments, geyser for hot water, and electric light for lighting purposes. Each room is separate, and can only be entered from the open air, as there are no connecting doors inside. No. 5.—Land Acquired. The Local Council have acquired two pieces of land in different parts of the district for Recreation Grounds. One piece has been divided up into Allotment Grounds and Sports Fields; the other piece will be more for Pleasure Grounds and outdoor games, such as tennis and bowling greens. This concludes the improvements carried out during the last five years. The most outstanding necessity at the present time is the need of many more houses of the smaller type, enabling the working classes to meet the expenses of rent, etc.; and until this is done much suffering, inconvenience and poor health is caused through different families, and especially children, being herded together, and thus losing the natural benefits which fresh and clean air provide for all. It is extremely difficult to deal with any case of overcrowding at the present time, but advice is given freely, and sometimes the offending person is requested to abate this nuisance. An Ante-Natal Clinic was opened in this district on June gth, 1925. This Clinic has only been in existence for six months. The average attendances per session was two. 27 ANNUAL REPORT OF THE SANITARY INSPECTOR For the year ended 31st December, 1925. To A. D. Owen, Esq., M.R.C.S., &c., Medical Officer of Health. Sir, I beg to present my Second Annual Report on the work carried out as Sanitary Inspector during the year 1925- Inspections. Complaints received and attended to 41 Premises inspected on complaint 41 Premises inspected re infectious disease 50 Number under periodical inspection60 House-to-house inspections 196 Other inspections 445 Re-inspections 1517 Re-inspections after order or notice 1517 Total inspections and re-inspections 2158 28 Notices. Cautionary or intimation notices issued 251 Notices to supply new dustbins 92 Statutory notices served 3 Summonses issued None Dwelling Houses. Premises repaired or cleansed 45 Premises closed None Roofs repaired 37 Gutters repaired 15 Rain water pipes repaired 16 Ventilation below floors 2 Water pipes repaired 4 Chimney stacks repaired 2 New roofs fixed 1 New gutters fixed 7 New floors fixed 1 Walls damp-proofed with cement 2 Cistern covers provided 1 Taps repaired 4 New gullies fixed 3 Damp courses inserted None Yards paved and repaired 7 Yards drained 7 New cisterns fixed 1 New dustbins provided 92 Refuse removed 2 Animals removed None Cellars cleared (from water) None Staircases cleansed 17 Ball-cocks repaired 11 Sash lines renewed 15 29 Sashes renewed or repaired 8 New cooking ranges fixed 3 Cooking ranges repaired 3 Door sills repaired or renewed 2 Coppers repaired 10 Floors repaired 30 Ceilings repaired 10 Walls repaired 17 Window sills repaired 6 Ceilings renewed 4 Infectious Disease. Rooms disinfected—ordinary infectious disease 52 Rooms disinfected—Tuberculosis 10 Rooms disinfected—Cancer 8 Rooms disinfected—other reasons 3 Schools disinfected after Whooping Cough 1 Rooms stripped and cleansed 73 Articles disinfected or destroyed 875 Patients removed to Hospital (Local) 47 Patients removed to Hospital (L.C.C.) 5 Unsound Food. Two diseased beasts' livers, one set of beasts' lungs and one box of fish were surrendered and destroyed. Schools. Number in district 5 Frequency of inspection Monthly Defects or nuisances remedied 4 Yards and playgrounds repaired 2 Flushing tanks repaired 2 30 Bakehouses. Number in district 5 Number of inspections 60 Frequency of limewashing half-yearly Contravention of regulations None Slaughter Houses. Number in the district 5 Number of inspections 121 Frequency of limewashing Quarterly Contravention of regulations None Defects remedied 1 Yards repaved 1 Dairies, Cowsheds and Milkshops. Number of cowkeepers in the district 1 Number of cowsheds 3 Average number of cows kept 100 Number of dairies and milkshops 4 Frequency of limewashing ay and October. Number of inspections to above premises Contraventions of regulations None Factory and Workshops (including workplaces). Number of workshops on register 38 Number of retail bakehouses in use 5 Number of inspections to factories and workshops 178 Bakehouses limewashed Every six months Works carried out at above premises:— Water closets repaired 1 Premises cleansed 1 Floors or yard repaired 2 31 Drainage. The following is a summary of the various works carried out under this heading:- Drains examined 2 Drains cleared 16 Drains repaired 17 Drains reconstructed 1 Soil or vent pipes repaired 1 Urinals cleansed 5 Urinals repaired 1 Cesspools emptied 1 New water closets fixed 1 Water closets repaired 12 Water supplies repaired 11 New flushing tanks fixed 4 Flushing tanks repaired 15 New sinks fixed 4 Waste pipes repaired 4 Canal Boats Acts and Regulations:- Number of visits to Coal Wharf and Dock 43 Number of cratt seen 156 Number of boats coming under the Regulations 2 Number of contraventions None I am, Sir, Your obedient Servant, CLIFFORD J. RABBITTS, A.R.San. I. Public Offices, Hampton, Middlesex.