HARROW-ON-THE-HILL URBAN DISTRICT COUNCIL Population, Estimated (middle of 1908), 16,132. Birth-rate, 21.4. Death-rate, 6 7 Corrected Death-rate, 71. Houses, 3275; occupied, 3020; unoccupied, 255. Flats, 295; occupied, 247 ; unoccupied, 48. Houses & Flats occupied, 3267 ; unoccupied, 303. Average number of persons per house, 5; per flat, 4. Rateable Value, £127,648. Population 1854, 2,813. Population, 1891 (census), 5,725. Area 1,000 Statute Acres. Population, 1901 (census), 10,220. Area 2,197 Statute Acres. Population, June, 1906 (census), 13,697. INDEX. Page. General Statistics 1 Birth-Rate 3 Death-Rate 3 Deaths at All Ages 4 Deaths in Harrow Hospitals 4 Deaths of Harrow Paupers 4 Deaths of Residents Outside the District 4 Corrected Death-Rate 5 Infantile Death-Rate 5 Infantile Mortality 5 Babies' Health League 6 Health Visitor 6 Early Notification of Births 7 Infectious Diseases 7 Diphtheria 7 Diphtheria and Anti-Toxin 8 Enteric Fever 8 Bacteriological Examination 8 Measles and Whooping Cough 8 Isolation Hospital 8 Consumption 9 Prevention of Consumption 9 Compulsory Notification of Consumption 9 Disinfection of Rooms used by Consumptives 9 County Sanatorium for Consumption 10 Medical Inspection of School Children 10 Cottage Hospital 12 Mount Park District 12 New Houses, Buildings, etc 12 Inhabited Houses 13 Sewage Farms 13 House Numbering 13 Common Lodging Houses 13 Houses Let in Lodgings 14 Housing of the Working Classes 14 Scavenging 14 Factory and Workshop Acts 14 Dairy Farms, etc. 15 Veterinary Inspection of Milch Cows 15 Milk from Outside the District 17 Water Supply 18 Food and Drugs Act 18 Public Urinals 18 Meteorological Observations 18 3 ANNUAL REPORT, 1908. 1, Park Crescent, Portland Place, London, W. January, 30TH 1909. \ To the Chairman and Members of the Harrow Urban District Council. Sirs, I have the honour to present to you my Report for the year ending December, 31st, 1908. The estimated population to the middle of the year was 16,132. BIRTH-RATE. The births of 163 boys and 183 girls were registered during the year, making a total of 346, as compared with 350 in 1907. This gives a birth-rate of 21.4 per thousand, which is a serious decrease compared with that of the previous year, when it was 23.5. This is lower than that of any year in the previous decade. The average for the previous ten years is 227. The birthrate for England and Wales in 1908 was 26.5, and for 142 smaller towns 26. DEATH-RATE. There were 109 deaths registered—59 males and 50 females—the death-rate being 6.7 per thousand, which is slightly more than that of 1907, when it was 6.5 per 1,000. Of these deaths 37 occurred in the March quarter, 17 in the June quarter, 29 in the September quarter, and 25 in the December quarter. There were 34 deaths in the parish of St. Mary, 35 in Roxeth, and 40 in Greenhill. 4 DEATHS AT ALL AGES. The distribution of the 109 deaths according to age is as follows Under 1 year 33 Under 5 years of age 42 Over 1 year and under 5 9 Over 5 and under 15 0 Over 5 years 67 Over 15 and under 25 5 Over 25 and under 65 40 Over 65 22 109 109 DEATHS IN HARROW HOSPITALS. There were ten deaths in the Harrow Cottage Hospital. Of these, four were those of residents in Harrow, in the following parishes:-Two in Roxeth, one in Greenhill, and one in St. Mary's. There were six deaths of patients admitted from outside the district:—Two from Wembley, three from Wealdstone, and one from Watford. In the Isolation Hospital there was one death of a Greenhill resident. DEATHS OF HARROW PAUPERS. Six deaths of Harrow paupers occurred in the Hendon Workhouse, three men and three women. Their ages and the causes of death are as follows:—Heart Disease, 53 years; Phthisis, 59 years; Malignant Disease, 65 years; three from old age, at the ages of 72, 77 and 84. There were 44 paupers belonging to the district in the Hendon Workhouse. I have again to thank Mr. Strachan, your Clerk, for procuring me the above and other information. DEATHS OF RESIDENTS OUTSIDE THE DISTRICT. Five deaths were reported as having occurred in the following Institutions:— Napsbury Asylum.—Phthisis, age 23. Children's Hospital, Great Ormond Street.—Epidemic Diarrhoea, age 9 months, 5 Central London Throat Hospital.—'Suppuration of middle ear, age 6 years. Friedenheim Hospital.—Cancer, age 68. Peckham House Asylum.—Heart disease, age 66. CORRECTED DEATH-RATE. The 11 deaths of residents outside the district, including the deaths of six Harrow paupers in the Hendon Workhouse, added to the 109 deaths registered in Harrow, gives a total of 120. From this number are deducted the deaths of six non-residents in the Harrow Cottage Hospital, giving a nett total of 114, and a corrected death-rate of 7.1 per 1,000. The death-rate for England and Wales was 147, and for 142 of the smaller towns 14.7 When age and sex distribution are taken into account the standard death-rate is 8'22. INFANTILE DEATH-RATE. The Infantile Death-rate for the year was 95 per 1,000 births, or about one-third more than that for 1907, when it was 57. The average for the previous 10 years was 88.4 INFANTILE MORTALITY. This year there is a sad increase in the mortality of infants under one year of age. This increase is chiefly owing to two causes, (1) Premature birth, which caused 15 deaths, or about double the number in 1907, and (2) Diarrhoea and Enteritis, which caused 7 deaths, or 6 more than in 1907. These causes of death, which are largely preventable, deserve the serious consideration, of the Medical profession of Harrow, and of the Babies' Health League. Greater care of expectant mothers before confinement would doubtless prevent a considerable number of premature births, whilst better knowledge of the proper feeding of infants and more scrupulous care in the storage of their food, or, better still, in many cases, a reversion to breast feeding would largely diminish, if not entirely prevent, deaths which ensue upon disorders of the infant's alimentary canal. The rate of infantile mortality in England and Wales was 121, and for 142 smaller towns 124. 6 BABIES' HEALTH LEAGUE. Mrs. Owen, who has done such excellent work as hon. secretary from the commencement of the League, having resigned, Mrs. Taylor, of "Rowney," Mount Park, has recently been appointed hon. secretary. Throughout the year a weekly return of births has been sent to the League. It is desirable that the scope of the work of the League should include every part of the district. There can be no doubt that the visits of the workers to many of the houses on the Bessborougb Estate, St. Kilda's, Roxborough, Headstone, St. Annes and Pinner Roads would have beneficial results. This League has not received from the people of Harrow that financial support which its work deserves and requires. If it is to be carried on successfully, all those interested in the preservation of infant life should contribute generously to this most beneficent Society. If sufficient funds are provided, the work of the League would be greatly facilitated by the appointment of a trained health visitor, whom the voluntary workers could assist. Should private benevolence prove inadequate, the Council may have to consider whether it should not supply what may be lacking to the due performance of this important duty. HEALTH VISITOR. But in any case, in view of the rapid increase of population, the large influx of young people, the high infantile mortality (amounting to 10 per cent, of the births), and a declining birth-rate, I strongly recommend the appointment of a "Health Visitor." Many other sanitary authorities have found it necessary to appoint such visitors to deal with the deplorable infantile mortality and thereby save infant life. Infant life is a most valuable national asset. To do nothing to decrease the present "slaughter of infants" would be discreditable alike to our humanity and our patriotism. We should take warning from what is going on across the English Channel, where our French friends are on the way to racial suicide. They have not sufficient sons and daughters to populate their colonies, but have actually to fill up the ranks of their 7 workers by immigrants from all the neighbouring" nations. We are allowing our vast territories in Canada, Australasia, and South Africa to be peopled by races other than our own, and we are trending towards the point when we shall no longer be a colonising race, and the tie of blood between the mother country and its colonies will no longer exist. EARLY NOTIFICATION OF BIRTHS. I regret that the births of children born in the Town are not registered so early as they ought to be, and this can be seen by reference to the Registrar's lists. I feel it my duty to draw the attention of the parents and guardians of children born in Harrow, to the very serious responsibility which rests upon them in this matter. With earlier notification and registration the Sanitary Authority and the Babies' Health League could take steps to prevent many infantile deaths. I recommend the Council to memorialise the Government to make the registration of a birth compulsory within 36 hours of the event. INFECTIOUS DISEASES. Seventy-seven cases of infectious disease were certified during the year as compared with 53 in 1907, and 32 in 1906. They are as follows:— Scarlet Fever, 49; Diphtheria, 20; Erysipelas, 5; and Enteric, 3. There was one death from Enteric. There were no deaths from Scarlet Fever, Diphtheria, and Puerperal Fever. The following nine deaths occurred from non-notifiable diseases:—One from Whooping Cough, four from Influenza, and four from Enteritis. There was no death from Measles. DIPHTHERIA. Twenty cases of this disease have been certified during the year, as compared with six for each of the last three years. No death from this disease has occurred during the last four years, which happy result I attribute chiefly to the prompt administration of anti-toxin provided by the Council. 8 DIPHTHERIA ANTI-TOXIN. A fresh supply of this valuable remedy has been kept, as usual, at the Council Offices day and night, and also at night at the Sanitary Inspector's house, 28, Devonshire Road, Greenhill. In cases of Diphtheria, if the anti-toxin is injected during the first 24 hours, the prospects of recovery are bright, but every hour that is lost involves an increasing danger. It is, therefore, of vital importance that a supply should always be at hand. On one occasion the anti-toxin was obtained after midnight and immediately injected. ENTERIC FEVER. Three cases were certified during the year, one of which was treated in the Hospital, There was one death. BACTERIOLOGICAL EXAMINATION S. Forty specimens were sent to the Lister Institute for examination during the year (38 Diphtheria and 2 Enteric) and the results were telegiaphed from London. Such examinations are of great value as aids to diagnosis. No case of Diphtheria is discharged from the Hospital until a bacteriological examination has shown that the patient is free from infection. MEASLES AND WHOOPING COUGH. The Council have provided printed directions for the guidance of parents and guardians when members of their families are attacked by Measles and Whooping Cough. They are distributed by Mr. Bone, the Registrar of Births, at the time of registration, and by the school teachers whenever an outbreak is feared. ISOLATION HOSPITAL. Forty-five cases of Scarlet Fever, 17 cases of Diphtheria, and 1 case of Enteric were admitted to the Hospital. There was one death from Enteric, but none from Scarlet Fever or Diphtheria. 9 CONSUMPTION. Eleven deaths ensued on Phthisis, and 2 upon other tuberculous diseases, or 11.5 per cent. of the total mortality In 1907 the percentage was 5; in 1906, 8.6; in ,1905, 7.6; and in 1904, I2.5. PREVENTION OF CONSUMPTION. Five consumptive cases were voluntarily notified during the year. Upon application disinfection is always carried out free of charge, with the result that 13 rooms and 107 articles were disinfected. Disinfectants and cards containing instructions have been distributed when required. During the year disinfection has been carried out after every death, and upon the removal of a patient . It has only been possible to carry this out through the recommendation of the medical attendant. COMPULSORY NOTIFICATION OF CONSUMPTION. Until Consumption and other forms of Tuberculosis have been placed on the list of notifiable diseases, sanitary authorities will not be in a position to act promptly, and the work of "stamping out" cannot be begun in earnest. But when this is done, and adequate provision is made in every county in the kingdom, 50,000 lives should be saved, and half-a-million illnesses prevented every year. DISINFECTION OF ROOMS USED BY CONSUMPTIVES. It ought to be universally known that disinfection of rooms should be systematically conducted whilst they are occupied by consumptives, as well as afterwards. Unless the greatest care is taken to keep such rooms disinfected healthy people are liable to be attacked. I claim the assistance of the people of Harrow in securing this imperative sanitary operation. 10 COUNTY SANATORIUM FOR CONSUMPTION. I deeply regret that I have again to report that the great count of Middlesex has made no progress in the provision of a County Sanatorium for Consumption. There is, however, some prospect of its being done by private co-operation. Every county in England should have one or more of these institutions. They would promptly receive cases in the earlier and curable stages, and thereby not only prevent much suffering and many deaths, but restore a large number of bread-winners to heal th and usefulness, and prevent the spread of this terrible disease. Owing to the present quite inadequate accommodation in sanatoria for consumption, many patients have to wait for several months before they can be admitted, and by this delay opportunities for cure are frequently lost. Humanity is shocked when tens of thousands of lives are quickly lost in such a calamity as a great earthquake even on distant shores, but the National conscience is not yet sufficiently touched by the fact that yearly 50,000 of our own countrymen die from this preventable cause. The national burden owing to disablement of so many bread-winners from consumption would be greatly lightened if adequate provision were made for the prompt treatment and ultimate extinction of the disease. Many voluntary institutions are unable to receive cases owing to inadequate financial support, and this makes it incumbent on sanitary authorities to consider whether they should make financial arrangements with those institutions to induce them to receive cases occurring in their districts. I, therefore, recommend the Council to take this matter into serious consideration. MEDICAL INSPECTION OF SCHOOL CHILDREN. Owing to the courtesy of Dr. Young, Medical Officer of Health for the County, I am able to report as follows:— The district of Harrow forms part of the area which for purposes of public elementary education is under the jurisdiction of the Education Committee of the County Council of Middlesex. For the purpose of carrying out the medical inspection of school children in the public elementary schools. 11 required by the Education (Administrative Provisions) Act 1907, the County Council have appointed two medical inspectors to act under the supervision of the County Medical Officer of Health, and the work of medical inspection commenced when the schools reopened after the Easter holidays, 1908. The work required by the Board of Education during the first year, is the inspection of (a) children newly admitted to school life, and (b) children about to leave school. Before the date upon which the medical inspector has arranged to visit a school, notice is sent to the parents of the children who are due for examination, i.e., who come under either of the above headings, in order that they may avail themselves of the opportunity of being present, and with very few exceptions they have attended at the schools on the day of inspection. In order that they shall be kept waiting for as short a time as possible, the probable time of each child's examination is notified so far as possible. The medical inspection has been very favourably received. In the district of Harrow a total of 363 children have been inspected during 1908, viz:—181 boys and 182 girls, and in all cases where the necessity arose, advice to consult a doctor has been given to the parent, or if the matter was more trivial in character, the parent has been told what course to pursue. In connection with the occurrence of infectious disease amongst scholars, the County Medical Officer communicated with the Medical Officer of Health of the district, asking to be informed by him as to infectious disease, whether notifiable or non-notifiable, occurring amongst children attending the public elementary schools, in order that he might be able to consult at once with him in the matter, and to ensure that the administrative procedure of both the local sanitary authority and the local education authority should be reciprocally helpful. With the same object in view any information obtained by the medical inspectors or the County Medical Officer which would be of value to the local Medical Officer of Health was at once communicated to him with a view to obtaining his assistance. 12 This has already borne fruit. On receipt of information the County Medical Officer of Health has visited the school, examined children, and with the local Medical Officer of Health, inquired into the circumstances and come to a conclusion as to the action which facts have justified. With the development of the work, this co-operation between the officers of the two authorities should prove of much benefit to the public health of the County. COTTAGE HOSPITAL. The Cottage Hospital continues to be of inestimable benefit, not only to the inhabitants of Harrow, but to several of the neighbouring districts. It receives and deserves the most cordial support. MOUNT PARK DISTRICT. The present seems to be an appropriate time for the incorporation of this district with the town of Harrow, to which it naturally belongs. As it becomes more populous the unsatisfactory condition produced by the present state of things will be more accentuated. In previous reports I have dealt with the necessity for this reform, and I would again strongly urge the Council to take steps to bring it about. A rectification of the boundary in other parts of the district is also desirable. At the present there, is one house situated partly in Harrow and partly in the adjoining district. NEW HOUSES, BUILDINGS, Etc. Mr. Percy Bennetts, your Surveyor, reports as follows : The number of Plans approved by the Council was:— New Houses, 261; Shops, 22; Alterations and Additions, 35; Buildings not Dwellings, 14; New Roads, 3. One hundred and fifty-seven houses and 17 shops, with dwellings attached, have been finished and approved. The number of inspections of houses, etc., in course of erection during the year amounted to 3,400, and the number of defects or contraventions of the By-Laws found and remedied was 200. 13 The following private streets have been mrde up under Section 150 of the Public Health Act, 1875, viz:— Drury Road, Lance Road, Colbeck Road, Sumner Road, Butler Road (part 3) and Butler Road (part 4). The following streets have been declared highways repairable by the inhabitants at large, viz:—Greenhill Crescent and Wellesley Road. The Mortuary has been used in 7 cases. I am glad to say that no plans of Flats have been approved by the Council since 1903. Such dwellings would be most undesirable in Harrow. INHABITED HOUSES. The number of houses at the middle of the year was 3,275. Of this number 3,020 were occupied, and 255 were unoccupied. There were 295 fiats. Of this number 247 were occupied, and 48 unoccupied. This gives a total of 3,570 houses and flats, of which 3,267 were occupied and 303 unoccupied. This shows in the town 39 fewer unoccupied dwellings than in 1907, despite an increase of 295 in the number of dwellings. SEWAGE FARMS. The effluents from the Sewage Farms have on the whole been satisfactory. A portion of the new field at Newton has been dug over and about 1,000 loads of ashes mixed with the soil. This should prove helpful in purification of the sewage. HOUSE NUMBERING. Mr. Kramm reports as follows:— During the year the houses in Heath, Merivale, Pinner, Sheepcote, and Butler Roads have been numbered, totalling 405 houses in all. This now makes a total of 1562 houses numbered. These figures show that about half the existing houses are numbered. Instructions have been given for notices to be served on the residents of Sumner, Colbeck, and Lance Roads, with a view to numbering the houses. COMMON LODGING HOUSES. There is one Common Lodging House in the town, which was visited and found in a satisfactory condition. 14 HOUSES LET IN LODGINGS. Three houses have been registered during the year. The owner was called upon to carry out certain sanitary work in order to improve the conditions in these houses. There was a complaint of overcrowding, and the Council called upon the occupier to abate the nuisance and the owner to register these houses as Houses Let in Lodgings. Recent inspections have shown that the improved conditions are maintained. HOUSING OF THE WORKING CLASSES. No action has been taken under the Housing of the Working Classes Act, yet the rents paid by the Working Classes in Harrow bear far too high a proportion to their wages. Married men with large families have serious difficulty in finding adequate housing accommodation, and as our birth-rate is steadily going down, I would recommend the Council to consider whether it is not desirable to provide healthy house room at a moderate cost where there are large families of the Working Classes. By doing so a great obstacle to maintaining and increasing the birth-rate would be removed. SCAVENGING. A weekly collection of refuse has been carried out during the year, and only 8 complaints have been made. A collection of refuse twice a week would greatly conduce to the public health, especially in the more densely populated parts of the district. The provision of a refuse destructor seems desirable in view of the rapid increase of the population. FACTORY & WORKSHOP ACTS. The factories, workshops, workplaces and the outworkers premises have been periodically inspected and with the exception of a few minor sanitary defects they have been found in good condition. It became necessary to again send out a circular letter calling attention to the necessity of the outworker's lists being sent to me in order to obtain complete returns. 15 DAIRY FARMS, Etc. There are 8 Dairy Farms, 10 Milk Shops, 13 Bakehouses (3 underground), 7 Slaughter Houses, 18 Butcher's Shops, 8 Fish Shops, and 7 Laundries. Two underground bakehouses have not been used during the year. All these places have been carefully and regularly inspected, and are now on the whole satisfactory. The sanitary standard of the Dairy Farms has been greatly raised, in some instances by erecting new buildings in place of old ones. VETERINARY INSPECTION OF MILCH COWS. I again draw your attention to the necessity of a Veterinary Surgeon being appointed to make an examination of the milch cows in the District. Some of the dairy farms are inspected by their own Veterinary Surgeon, and it has been ascertained that one or two cows have had to be disposed of and taken to market. In one instance a calf was transferred to a rejected cow, probably for no other purpose than to enhance its value. An accident having occurred to one of the cows at a Dairy Farm, it was found necessary for it to be killed. The carcase was dressed for inspection and found to be affected with tuberculosis. A careful examination was made of the udder and mammary glands, but no trace of tuberculosis was found. The third interim report of the Royal Commission appointed to inquire into the relations of human and bovine tuberculosis has been issued. In the report the Commissioners state:— "Tuberculosis involving the udder is compara"tively common in cows, and in such cases their milk "always contains tubercle bacilli and is therefore "dangerous for human beings consuming it. It was, "however, undecided what is the danger, if any, "attaching to the milk of tuberculous cows in which "the udder presents no evidence of disease. We "therefore took the opportunity of making a number "of observations and experiments bearing on this "point. The experiments were made with the milk "of cows which had contracted the disease in the 16 "natural way. In natural tuberculosis in the cow "cases which show such obvious symptoms of the "disease as emaciation and cough should be con"sidered separately from the cases in which there are "no such signs and in which the disease is to be "recognised during life only by means of the injection "of tuberculin." "None of the cows investigated showed any sign "of disease of the udder during life, and in all, after "slaughtering, the udder was carefully examined for "tuberculous lesions and tubercle bacilli. No tuber"culosis was found except in one case in which one "quarter of the udder showed four small nodules. "These could not possibly have been detected during "life. We found that the milk of the cows obviously "suffering from tuberculosis contained tubercle bacilli "whether the milk was obtained in the ordinary way "or was withdrawn from the teat by means of a "sterilized catheter. The presence of tubercle bacilli "in the milk of cows clinically recognizable as tuber"culous confirms the opinion we expressed in our "second interim report that the milk of such cows "must be considered dangerous for human beings." "The experiments which we have carried out "with regard to the infectivity of the faeces of tuber"culous cows were dictated by knowledge of the fact "that dirt of various kinds from cows and the cow"shed is almost constantly present in milk as it "reaches the consumer. Cows suffering from exten"sive tuberculosis of the lungs must discharge con"siderable numbers of bacilli from the air passages in "the act of coughing and some of the bacilli thus "expelled may find their way into the milk. But our "experiments indicate that the excrement of cows "obviously suffering from tuberculosis of the lungs or "alimentary canal must be regarded as much more "dangerous than the matter discharged from the "mouth or nostrils. We have found that even in the "case of cows with slight tuberculous lesions tubercle "bacilli in small numbers are discharged in the "faeces, while as regards cows clinically tuberculous "our experiments show that the faeces contain large "numbers of living and virulent tubercle bacilli." 17 " The presence of tuberculous cows in company " with healthy cows in the cowshed is therefore dis" tinctly dangerous, as some of the tubercle bacilli "which escape from their bodies in the excrement are "almost certain to find their way into the milk." If Veterinary inspection is made, information would then be immediately obtained of diseased cows, and pressure brought to bear on the cow-keepers as to the proper disposal of the rejected cattle. MILK FROM OUTSIDE THE DISTRICT. A large amount of the milk consumed in Harrow is imported, and its quality and condition should be most carefully investigated. This can only be done by samples being taken at the place of delivery by your Sanitary Inspector and sent to a laboratory for examination. I have, in my reports both annual and special, drawn attention to the evil conditions under which some of this milk is produced, and the insanitary manner in which it is conveyed. This is very serious, as milk is the staple food of infants and invalids, and is also used in one way or another by all members of the community. The London County Council has taken steps to examine the milk brought into London by the London and North-Western Railway Company, the Great Eastern Railway Company, the London and South-Western Railway Company, and the Great Western Railway Company, and after examination at the Lister Institute the result was that 23.9 per cent., or nearly 1 in 4 of the samples were tuberculous. The Council's Veterinary Surgeon visited 19 of the farms from which samples were taken. As a result of this examination 9 cows were at once reported by the Council's Veterinary Surgeon to have tuberculous udders. The owner and manager at once undertook not to send to market in London any more milk from these cows. In what place have they succeeded in disposing of that milk? Seeing that the bulk of our milk supply comes from outside the district, and as there is a great interchange of milk supplied to London, it is quite possible that some of the tuberculous milk has been sent into Harrow. This is a very grave subject, and affords abundant food for thought and stimulus to action. 18 I would urgently recommend that Mr. Kramm, your Sanitary Inspector, be authorised to take samples of milk coming into Harrow, and forward them to the Lister Institute for examination and report. WATER SUPPLY. Analyses of the public water supply (Colne Valley Water Co.), were made twice during the year, and showed that the four samples of water submitted were of a high degree of purity, and that it is a soft water and well fitted for drinking and domestic purposes. FOOD AND DRUGS ACT. Dr. Young, the Medical Officer of Health for the County, has forwarded to me the following particulars of the County Inspector's work in Harrow for 1908 :— Formal samples taken during 12 months (1908) 47. Informal „ „ ,, „ „ 70. Adulterated samples 3. Inferior samples 2. Prosecution 1. Conviction 1. PUBLIC URINALS. I have repeatedly recommended the Council to provide public urinals in Harrow. The increase of resident population, and the large number of visitors to Harrow, render such provision more urgent every day. A great deal of avoidable inconvenience and suffering is caused by the want of such sanitary provision. I would urge the Council to take the matter into their early consideration. METEOROLOGICAL OBSERVATIONS. The rainfall for the year was 27.47 inches, which is 2.10 more than in 1907, when it was 25.37 inches. The average for the previous 10 years was 24.39. The number of days on which .01 or more inches of rain fell was 20 in April and December, 19 in March, 17 in January, 16 in September and October, 15 in February, May and August, and 14 in Jul}' and November. The greatest fall in 24 hours was 1.22 on January 7th. 19" The highest temperatures were 83 in July; 81 in August; 79 in June and September; 78 in October; 76 in May ; and 62 in April. The lowest were 14 in December; 19 in January; 25 in March; 26 in November; 29 in February and April; 32 in October ; and 34 in September. The highest mean temperatures were 71.13 in July; 70.55 in August; 70.33 in June; 67.70 in September; 64.22 in May ; and 60.32 in October. The lowest were 30.35 in January : 33.81 in March ; 34.55 in December; 34.93 in February; 37.10 in April ; and 40.30 in November. I have to thank Mr. Strachan, your Clerk, Mr. Percy Bennetts, your Engineer, and Mr. Kramm, your Sanitary Inspector, for the great assistance they have given me in my work, and their co-operation has always been promptly and cheerfully given. Mr. Kramm, whose work comes more under my notice, has performed his duties with the zeal, skill and discretion which have always characterised it. I remain, Gentlemen, Your obedient servant, JOHN FLETCHER LITTLE, M.B. Cantab., M.R.C.P. Lond., Medical Officer of Health for Harrow... January 30th, 1909. 20 TABLE I. VITAL STATISTICS OF WHOLE DISTRICT DURING 1908 AND PREVIOUS YEARS. Year. Population estimated to Middle of each year. Births Total Deaths Registered in the District Total Deaths in Public Institutions in the District. Deaths of Nonresidents registered in Public Institutions in the District. Deaths of residents registered in Public Institutions beyond the District. Net Deaths at all Ages belonging to the District Number Rate* Under 1 year of Age At all Ages Number Rate per 1,000 Births registered Number Rate* Number Rate* 1898 9,293 195 22.0 20 102.5 109 11.7 17 8 117 12.5 1899 10,077 221 21.9 29 131.0 108 10.7 14 11 119 11.8 1900 10,540 238 22.5 20 84.0 103 9.7 4 6 109 10.3 1901 10,540 238 22.5 29 121.8 90 8.5 6 96 9.1 1902 10,850 251 23.1 17 67.7 88 8.1 3 6 94 8.6 1903 11,337 255 22.4 17 66.6 87 7.6 6 3 2 96 8.4 1904 12,313 277 22.4 30 108.0 104 8.4 6 10 114 9.2 1905 13,000 313 24.0 17 57.6 104 8.0 13 1 19 123 9.3 1906 13,697 327 23.2 29 88.6 115 8.4 3 15 130 9.4 1907 14,860 350 23.5 19 57.0 98 6.5 9 3 13 111 6.9 Averages for years 1898-1907 11,650 266 22.7 88.4 88.4 100 8.7 7 9 110 9.5 1908 16,132 316 21.4 95 95.0 109 6.7 11 6 10 114 7.1 * Rates in columns 4, 8 and 13 calculated pec 1,000 of estimated population. Area of district in acres (exclusive of area coverrd by water), 2,197. At the Census of 1901:—Total population at all ages, 10,220. Number of inhabited houses, 1,893. Average number of persons per house, 5.3. '21 TABLE III. CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1908. Notifiable Disease Cases notified in whole District. Total Cases notified in each locality. No. of Cases removed to Hospital from each locality. At all Ages At Ages—Years. 1 to 5 5 to 15 15 to 25 25 to 65 S. Mary's. Roxeth. Greenhill S. Mary's. Roxeth. Greenhill Diphtheria 20 4 13 2 1 10 8 2 8 8 1 Erysipelas 5 1 4 1 1 3 Scarlet Fever 49 10 35 3 1 16 15 18 14 14 17 Enteric Fever 3 2 1 1 2 1 Totals 77 14 48 8 7 28 24 25 22 22 19 Isolation Hospital, Newton Fields, Harrow. 22 TABLE IV. CAUSES Of, AND AGES AT, DEATH DURING YEAR 1907. Causes of Death Deaths at the subjoined Ages of " Residents " whether occurring in or beyond the District Total deaths whether of " Residents " or " nonResidents " in Public Institutions in the District All Ages Under 1 year 1 and under 5 5 and under 15 15 and under 25 25 and under 65 65 and upwards Measles Whooping-Cough 1 1 Diphtheria (including membranous croup) Enteric Fever 1 1 1 Epidemic Influenza 4 2 1 1 Diarrhoea 5 5 2 Enteritis 4 3 1 Phthisis 13 3 10 Other tubercular diseases 1 1 Cancer,malignant disease 10 1 4 5 1 Bronchitis 2 2 Pneumonia 1 1 Other diseases of respiratory organs 7 3 2 1 1 Premature birth 15 15 Diseases and accidents of parturition 1 1 1 Heart diseases 15 11 4 Accidents 2 1 1 Suicides All other causes 38 7 3 1 1 13 13 6 All causes 120 34 9 1 6 43 27 11 23 TABLE V. INFANTILE MORTALITY DURING THE YEAR 1908. Cause of Death Deaths from stated Causes in Weeks and Months under One Year of Age Total Deaths under One Year Under 1 Week 1-2 Weeks 2-3 Weeks 3-4 Weeks Total under 1 Month. 1-2 Months 2-3 Months 3-4 Months 4-5 Months 6-7 Months 8-9 Months 9-lo Months 10-11 Months. Certified 19 33 Chicken-pox Measles Scarlet Fever Diphtheria : Croup Whooping Cough 1 Diarrhoea, all forms 1 1 2 Enteritis, Mucoenteritis, Gastroenteritis 1 1 1 Gastritis, Gastrointestinal Catarrh Premature Birth 9 3 1 2 Congenital Defects Injury at Birth Want of Breast milk Atrophy, Debility, Marasmus Tuberculous Meningitis Tuberculous Peritonitis : Tabes Mesenterica Other Tuberculous Diseases Meningitis (not Tuberculous) 1 Convulsions Bronchitis Laryngitis Pneumonia Suffocation, overlaying Other Causes 2 2 2 1 1 1 19 33 Births in the year : legitimate 341; illegitimate 5. Deaths from all Causes at all ages 114. Population (estimated to middle of 1908) 16,132. Deaths in the year: legitimate 33 ; illegitimate 0. Note.—Columns in which no death has incurred have been omitted. 24 METEOROLOGICAL OBSERVATIONS TAKEN AT HARROW DURING THE YEAR ENDING DECEMBER 31st, 1908. By J. PEBCY BENNETTS, Engineer and Surveyor. Month Hygrometer Temperature Rainfall Wind Dry Bulb Wet Bulb Max. Min. Earth Total Depth Greatest Fall in 24 Hours. No. of Days on which "01 or more fell Prevailing Wind 1ft. 4ft. Depth Date January Means 34.58 33.84 40.93 30.35 36.55 43.32 .. .. .. .. N.W. Highest 50.00 47.00 53.00 48.00 41.00 46.00 1.88 1.22 7th 17 S.W Lowest 20.00 20.00 31.00 19.00 35.00 42.00 .. .. .. .. S.E. February. Means 39.51 37.89 47.03 34.93 39.31 42.38 .. .. .. .. N.W. Highest 46.00 46.00 52.00 43.00 42.00 43.00 1.55 0.37 17th 15 S.W. Lowest 30.00 29.00 41.00 29.00 37.00 42.00 .. .. .. .. March. Means 39.29 37.68 46.42 33.81 39.68 43.00 .. .. .. .. N.W. Highest 48.00 47.00 58.00 42.00 43.00 43.00 3.14 0.96 25th 19 S.W. Lowest 30.00 30.00 40.00 25.00 38.00 43.00 .. .. .. .. N.E. April. Means 43.53 40.83 51.96 37.10 43.23 44.57 .. .. .. .. N.E. Highest 53.00 50.00 62.00 50.00 46.00 45.00 2.67 0.62 24th 20 N.W. Lowest 32.00 31.00 41.00 29.00 40.00 43.00 ... ... ... ... N.E May-. Means 56.36 53.00 64.22 47.26 52.61 48.09 ... ... ... ... N.W. Highesl 66.00 51.00 76.00 59.00 46.00 45.00 2.11 0.52 2nd 15 S.W. Lowest 52.00 48.00 55.00 38.00 57.00 51.00 ... ... ... ... N.E. June. Means 59.96 55.73 70.33 50.13 58.96 54.20 ... ... ... ... N.E, Highest 73.00 58.00 79.00 59.00 62.00 55.00 1.91 0.95 1st 8 N.W. Lowest 46.00 44.00 59.00 38.00 57.00 52.00 ... ... ... ... S.W. July. Means 62.48 58.19 71.13 54.13 58.19 57.81 ... ... ... ... N.E Highest 72.00 65.00 83.00 63.00 63.00 59.00 3.43 0.84 16th 14 N.W. Lowest 56.00 55.00 62.00 48.00 59.00 56.00 ... ... ... ... S.W. August. Means 62.16 58.26 70.55 53.22 61.93 58.81 ... ... ... ... N.W Highest 70.00 64.00 81.00 58.00 64.00 59.00 3.12 0.69 23rd 15 N.E Lowest 55.00 52.00 60.00 44.00 57.00 58.00 ... ... ... ... S.W. 25 Meteorological Observations (continued). Month Hygrometer Temperature. Rainfall Wind Dry Buib WetBulb Max. Min. Earth Total Depth Greatest Fall in 24 Hours. No. of days on which .01 or more fell. Prevailing Wind 1ft. 4ft. Depth Date September. Means 55.63 53.30 67.70 47.10 55.46 57.00 ... ... ... ... N.W Highest 66.00 63.00 79.00 59.00 58.00 58.00 1.57 0.65 3rd 16 S.W. Lowest 49.00 47.00 54.00 34.00 52.00 56.00 ... ... ... ... October. Means 51.07 50.00 60.32 45.78 53.08 56.01 ... ... ... ... S.E. Highest 62.00 60.00 78.00 54.00 58.00 57.00 2.70 0.76 18th 16 S.W. Lowest 35.00 33.00 44.00 32.00 48.00 50.00 ... ... ... ... N.E. November. Means 41.93 43.63 51.23 40.30 46.63 51.97 ... ... ... ... N.W. Highest 55.00 53.00 56.00 49.00 51.00 54.00 0.90 0.20 20th 14 S.W. Lowest 30.00 29.00 44.00 26.00 43.00 50.00 ... ... ... ... S.E. December. Means 39.03 38.20 43.90 34.35 43.10 48.35 ... ... ... ... S.W. Highest 53.00 53.00 52.00 46.00 47.00 50.00 2.50 0.44 14th 20 S.E. Lowest 18.00 18.00 24.00 14.00 37.00 47.00 ... ... ... ... N.W. 26 FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES AND HOMEWORK. 1.—INSPECTION. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (Including Factory Laundries) 26 Workshops (Including Workshop Laundries) 112 2 Workplaces 108 11 Total 246 13 2.—DEFECTS FOUND. Particulars. Number of Defects. Number of Prosecutions Found. Remedied. Referred to H.M. Inspector. Nuisances under the Public Health Ads:— * Want of Cleanliness Want of Ventilation Overcrowding ... Other Nuisances 30 30 Sanitary accommodation insufficient unsuitable or defective not separate for sexes 3 3 Offences tinder the Factory and Workshop Act Illegal occupation of underground bakehoute (S. 101) Breach of special sanitary requirements for bakehouses (ss. 97 to 100). Other offences Total 33 33 Section 22, Public Health Act, 1890, adopted one w.c., for every 20 workers is insisted upon. [C I] SANITAEY WORK. 1908. Particulars as to Staff employed in Sanitary Department, specify if Inspectors are engaged in any other duties, and if so, what. Inspections. Notices. Dwelling Houses. Houses let in lodgings. Tenement Houses. Common Lodging Houses. Number of Premises Inspected on Complaint. Number of Premises Inspected in connection with Infectious Diseases. Number of Premises under Periodical Inspection. Houses Inspected from Houseto-House. Total Number of Inspections and re-inspections made. Cautionary or Intimation Notices Given. Statutory Orders Issued. Summonses Served. Convictions Obtained. Houses, Premises, &c., Cleansed, Repaired, &c. Closed as Unfit for Habitation. Re-opened after Repairs, Alterations, &c. Demolished. Illegal Underground Dwellings Vacated. Number Registered under Bye-laws. Number of Contraventions. Number Registered under ByeLaws. Number of Inspections made. 100 80 104 6 Ill 59 17 — 23 — — — 1 3 6 1 4 A. B. KRAMM, Inspector. [C I] SANITARY WORK, 1908. Canal Boats used as Dwellings. Movable Dwellings, Caravans, Tents, &c. Bakehouses. Slaughterhouses. Cow-sheds. Dairies and Milk-shops. Unsound Food. Water Supply and Water Service. Wells. Percentage of Houses supplied from Public Water Service. Cisterns. Percentage of Houses supplied or Constant System. Number of Samples obtained for analysis from Public Supply. Number Registered under the Acts. Number of Contraventions of Regulations. Number Observed during the Year. Number of Nuisances therefrom abated. Number Removed from District Number in District. 1 Contraventions of Factory Acts. Number on Register. Number of inspections made and frequency of inspections. Contraventions of Bye-laws. Number on Register. Number of Inspections made and frequency of inspection, Contraventions of Regulations. Number of Milch Cows in District. Number on Register. Number of Inspections made and frequency of inspection. Contraventions of Regulations. (a) Animals seized (b) Articles or Parcels seized. Condemned by Magistrate (a& b) Articles or Parcels surrendered. New Sunk. Cleansed, Repaired, &c. Closed as Polluted. New, Provided. Cleansed, Repaired, Covered, &c. Draw-Taps placed on mains — — — — - 13 - 7 90 - 8 82 — 154 10 10 - - - 3 - - - 100% 2 6 16 100% 4 When killing is in progress. Quarterly. [CIII.] SANITARY WORK, 1908. Drainage and Sewerage of existing Buildings. Disinfection. Dust. Sundry Nuisances Abated. Water Closets. Percentage of Houses Provided with Water Closets. Examined, Tested, Exposed, etc. Unstopped, Repaired, Trapped, etc. Waste Pipes, Rain Water Pipes Disconnected, Repaired, etc. Drains. Cesspools. Percentage of Houses Draining into Sewers. Rooms Disinfected (a) Ordinary infectious diseases, (6) Phthsis. Rooms stripped and cleansed. Articles disinfected or destroyed. (a) Ordinary infectious disease. (b) Phthisis. j New bins provided. | Periodical frequency of dust removal. Number of complaints of nonremoval received. Method of Disposal (a) Destructor, (b) by Tipping, (c) Other, state method. Overcrowding Smoke. Number of Water Closets substituted for Dry Receptacles. Repaired, Supplied with Water, or otherwise Improved. New Soil Pipes or Ventilating Shafts fixed. ] Existing Soil Pipes or Ventilating Shafts repaired. Disconnecting Traps or Chambers Inserted. Reconstructed. Rendered Impervious, Emptied, Cleansed, etc. Abolished, and Drain connected to Sewer. Accumulation of refuse. Foul ditches, ponds, &c., and stagnant water. Foul pigs and other animals. Dampness. Yards repaved or repaired. Other nuisances. 56 99% 104 43 35 20 12 57 18 1 - 99°/o A 143 B 13 10 A 2457 B 107 60 Weekly 8 Tipped on Farm and burnt- 2 1 29 3 4 43 53 56 27 3.—HOME WORK. NATURE OF WORK. OUTWORKERS' LISTS, SECTION 1908. Number of Inspections of Outworkers' premises. OUTWORK IN UNWHOLESOME PREMISES, SECTION 108. Lists received from Employers. Numbers of Addresses of Outworkers received from other Councils. Numbers of Addresses of Outworkers forwarded to other Councils. Instances Notices served Prosecutions. Twice in the year. Once in the year. Lists. Outworkers. Lists. Outworkers. Wearing Apparel— (1) making, &c 2 6 3 3 3 2 18 Total 2 7 3 3 3 2 18 28 4.—REGISTERED WORKSHOPS. Workshops on the Register (S. 131) at the end of 1907. Number. Important classes of workshops, such as workshop bakehouses, may be enumerated here. Dressmakers and Milliners 16 Tailors 7 Laundries 7 Bakehouses 17 Cycle Makers, Carpenters, &c. 8 Workplaces . 7 Total number of workshops on Register 02 Underground Bakehouses (S. 101):— In use at the end of the year 1