HARRO 19 1923. Harrow-on-the-Hill Urban District Council. "Observer" Printing Works, Station Road, Harrow. ANNUAL REPORT of CHARLES E. GODDARD, O.B.E., M.D., MEDICAL OFFICER OF HEALTH. 2 PUBLIC HEALTH DEPARTMENT. STAFF. Charles E. Goddard, O.B.E., M.D. Ethel Mary Brand,L.S.A Cyril F. Mayne, O.B.E., M.A., B.S. Thomas B. Barley, M.R.C.S., L.R.C.P. Florence Goodman, L.D.S., R.C.S. Helen Townsend Francis M. Huxley, M.D., B.Sc, Albert B. Kramm Thomas A. Studley Rose F. Vowles Kate Kindell Margaret Byerley Elizabeth Randall Gertrude Stevenson Mary Pitcairn Emma Musker John Livy Medical Officer of Health (Part-time). Medical Officer to the Maternity and Infant Welfare Clinics (Part-time), Hon. Surgeon Massage Clinic (Part-time). Anaesthetist to Dental Clinic (Part-time). Dentist (Part-time). Masseuse (Part-time). Ante-natal Clinic (Part-time). Sanitary Inspector (Wholetime). Sanitary Inspector's Assistant (Whole-time). Clerk. Maternity Nurse (until Sept.) Health Visitor (Part-time), Supt. Greenhill Baby Clinic. Health Visitor (Part-time), Supt. Roxeth Baby Clinic. Health Visitor (Part-time). Health Visitor (Part-time). Matron Isolation Hospital, Disinfector, Isolation Hospital 3 HARROW-ON-THE-HILL URBAN DISTRICT COUNCIL. Area, 2028 Statute Acres. Population (Registrar General's Estimate), 19,640. Birth Rate 14.7 Death Rate 10.1. Infantile Death Rate 38.0 per 1,000 Births. Total Number of Houses 4,395. Occupied 4,325. Unoccupied 70. Number of families or separate occupiers, 4,518. Average number of persons per house 4-2. Rateable Value of District £173,337. Assessable Value for General District Rate Purposes, £169,536. Sum represented by a penny rate £706. Population 1891 (Census) 5,725. Area 1,000 Statute Acres. Population 1901 (Census) 10,220. Population 1906 (Census) 13,697. Population 1911 (Census) 17,074. Population 1921 (Census) 19,460. Population 1922, 19,440. 5 HARROW - ON - THE - HILL URBAN DISTRICT COUNCIL. Annual Report of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1923. by CHARLESE. GODDARD, O.B.E., M.D. To the Chairman and Members of the Harrow Urban District Council, Gentlemen, I have the honour to present the Annual Report of the General Health Conditions of the Harrow Urban District for the vear 1923, AREA. The area of the district is 2028 acres, so that, with a population of 19,640, there are 9.6 persons to the acre, POPULATION. The population of Harrow at the taking of the Census in 1921 was 19,460. In 1922 it was 19,440. It was estimated that in 1923 to be 19,640 You remember I made special enquiry about these figures and was assured by the Registrar-General that they were arrived at by careful scientific methods, and in any case we are bound to accept them as correct and base our statistics thereon for those years. In 1851 Harrow's population was only 2813. In 1901 it was 10,220. In 1911, 17,074. 6 BIRTH-RATE. During the year there were registered as belonging to Harrow 289 births. Of these 144 were males and 145 females (including one illegitimate male child and tour females). The birth-rate for the district in 1923 was 14.7. In 1922 it was 15.3. The average for the last five years is 14.7, a far different birth-rate from former days, for reasons that are well known. One is only glad to know that the compensation for a low birth-rate is the greater care of the children that are born. DEATH-RATE. One hundred and ninety-nine deaths were registered as having occurred in the Harrow district, or were allotted to Harrow. Of these 85 were males and 114 females. 35 persons (14 males and 21 females) died over the age of 80 years. The average death-rate for the last five years has been 9.2. The death-rate for 1923 was 10.1. In 1922 it was 9.6. Among the chief causes were:— Cancer 35 Tuberculosis 26 Heart Disease 23 Arterio-Sclerosis 12 Cerebral Haemorrhage, etc. 12 Bronchitis 6 Other defined diseases 46 It is not easy to explain the higher mortality, viz., 26, from Tuberculosis, especially as the district adjoining with a similar population has only six for the same year. 34 cases were notified, of which 31 were pulmonary. We know that there is still much overcrowding and that there are still some slum properties In addition to this, no doubt, many affected people come to Harrow as to a health resort There were 35 deaths from Cancer last year, one less than in 1922. In recent reports I have referred to this disease because of its prominence in our death-rate, but there is not much new knowledge to record. All we know at present is that Cancer is curable by operation in the early stage, and also by X-rays and by radium if the growth is purely superficial. We know also from statistics that, over the age of forty, one woman in eight, and one man in fourteen, dies of certified Cancer. 7 The memorandum on the subject issued by the Ministry of Health states that there is no evidence that Cancer is infectious or contagious in the ordinary sense, nor that there are specially infected areas, nor that there is really any hereditary tendency. We must just wait for more evidence, collecting all the information we can, and assist the British Cancer Campaign by gifts of money to further a cause so vital to the health of the whole nation. I would remind you that only a very small sum has been placed in the bank as a result of the subscriptions to the collecting box for Cancer still in the Public Health Department. Arterio-sclerosis, usually a senile change, implies a hard life, and means hardening of the blood vessels. It is recognised much more frequently in death certificates now than formerly as a cause of death. It is often said that we are as old as our arteries, and so it behoves us to live more quietly, free from excess of work or indulgence, especially after fifty years of age. INFANTILE MORTALITY, There were II deaths recorded in 1923 of children under twelve months—5 males and 6 females. One male was illegitimate. The infantile mortality was 38 per 1000 births (it was 527 in 1921,52 in 1920, and 60.6 in 1922). For England and Wales it was 69. This rate of 38 is therefore quite satisfactory if we could keep about this figure annually. At the end of this Report you will find an interesting chart of this mortality drawn up by one of my staff. NOTIFIABLE INFECTIOUS DISEASE. There were 134 cases of infectious disease notified in Harrow during 1923. Of these:— 46 were Chicken-pox. 34 Tuberculosis (31 pulmonary). 20 Scarlet Fever. 13 Measles. 6 Diphtheria. 1 Small-pox. 6 Erysipelas. 3 Pneumonia. 1 Puerperal Septicaemia. 1 Encephalitis Lethargica. 1 Typhoid. 2 Anterior Poliomyelitis. 8 The Case of Small-pox. A contact from a London case of small-pox was kept under observation in Harrow, and vaccinated on the first opportunity, but unfortunately too late to be of any avail, and was notified as suffering from small-pox a few days later. By the invitation of the medical attendant I was able to verify the diagnosis, and at once removed the patient to the small-pox hospital at Yeading. It was through the prompt information received from the Public Health departments of the Metropolitan Borough and the Middlesex County Council that we were able to deal with the case immediately, remove it, and take the necessary action that prevented the further spread of the disease. ISOLATION HOSPITAL. This Hospital will accommodate 30 patients, and during 1923, 17 cases were admitted from the district, 4 cases of Diphtheria, 11 cases of Scarlet Fever, 1 case of Typhoid, and 1 case of Chicken-pox. One case of Scarlet Fever was admitted from the Hendon Rural District, one case of Diphtheria was admitted from a London hotel, and one case of Small-pox was removed to Yeading Isolation Hospital. I am glad to report to you that this little Hospital is kept in good condition. From the letters received during the year 1923, it is evident that the parents of the patients appreciate the efficicncy and kindness of the Matron and her staff. Every care is taken by your Public Health Committee to conduct ihis Hospital with efficiency and economy. LABORATORY WORK. Total number of examinations made for us by the Lister Institute are as follows:—Diphtheria 73, Tuberculosis 3, Other 1. Total numer of examinations made :—77. THE MORTUARY. The Mortuary was used on 14 occasions. The attention of the Council was drawn to the fact that the Mortuary was not sufficiently equipped for the use of the doctors who attended to make post-mortems, and the Public Health Committee consented to the supply ot instruments and what was necessary. It was noted, too, that certain structural alterations would be necessary later, and would be brought to your notice. 9 Whilst referring to the Mortuary, may I be allowed to say that I think that the methods usually pursued in the case of a person dying in a public place leave something to be desired in the matter of refinement. For instance, if a lady of whatever rank in life dies suddenly in the street, at a railway station, or in any public place, the body at once becomes the property of the Coroner, who, rightly, causes it to be conveyed to the nearest mortuary for identification, and not to the home of the deceased, even if well known, or when the medical attendant is able to certify the cause of death. At the mortuary the body is placed on the slab and stripped at once, the clothes being put on one side. This may be appropriate for the unclaimed, but it appears to me that as soon as the Coroner has ascertained that there is no suspicion of foul play or of violence, he might well be permitted to restore the body to the friends, if they so desire, and not allow it to be left, perhaps for days, in a nude condition, in such a place as a mortuary, till an inquest is held. I suggest only that the Coroner be permitted a wide discrimination in the matter of disposal, and that, for a deceased woman, the services of the women police should be utilised. At the same time we all know how necessary it may be to have bodies removed to the mortuary from crowded tenements, especially in cases of infectious disease, or when post-mortem examinations have to be made, but that is a different matter. With regard to post-mortem examinations, the time has surely arrived when Coroners should be empowered to provide and pay for skilled post-mortem assistants to do the actual work of the examination in the presence of the doctor, instead of throwing the whole responsibility for duties so unsuitable and so undesirable on the busy medical practitioner. THE HARROW CLINICS. There can be no doubt that these Clinics continue to be of great service, and are widely appreciated. Dr. Tchaykovsky, Mrs. Laurence-Browne, and Mrs„ Handley, with the Public Health Committee, supervised the work of the Municipal Clinics, which are referred to below in detail. There are other Clinics, which are under the control of the Council of Child Welfare. The accompanying tables show the details of attendances, &c., and the large amount of work that was accomplished in 1923.1 10 INFANT WELFARE REPORT. Dr. Brand reports that: — "The Clinic shows a satisfactory record for the year. The average number of attendances increased. "The enlarged accommodation in the New Hut at Greenhill has been much appreciated by the Mothers. "Cases of diarrhoea noted in the Summer have been few in comparison with those arising in Autumn and early Winter ; the latter often run a less acute course, but leave a more marked effect on the general 'condition of the infants, particularly in the absence of sun as at this period of the year. "We would once again express our thanks to the helpers, voluntary and otherwise, who give such whole-hearted interest to the work," I might add that it is understood that this is not a treatment centre, but a Clinic where the inexperienced mother can obtain information as to the child's progress in health, and receive advice as to the clothing, feeding, and general care of the infant, especially those mothers who have been attended by a midwife. In this Clinic it sometimes happens thai ailments have been discovered that had previously been unnoticed by the parents, in which cases the parents are referred to the usual medical attendant. DENTAL CLINIC. Miss Goodman reports:— "There is very little to report on the Dental Clinic this year, it goes on just the same, except that there are fewer Special Cases owing to another year being included in the ages of the School Inspections. This year all children up to 13 years of age are being inspected at the schools. "Each year shows a great improvement in the teeth, more fillings, and fewer extractions, being necessary, but alas, the parents do not readily consent to fillings, only about 50 per cent. responding, whereas about 95 per cent. attend for extractions. "The nurses render valuable assistance to the Mothers requiring dentures, and the V.A.D. Nurses lighten the work greatly at the Clinic." The tables at the end of the Report show in detail the particulars of attendance and treatment at this Clinic. 11 MASSAGE CLINIC. Miss Townsend reports:— "The number of children who have received treatment during the year is large, especially those under 5 years of age, and the results have been satisfactory. "On the whole, we consider the work of the Clinic during the year to have been successful, but we are much hampered by the fact that attendances frequently cease just when the benefit of the treatment is beginning to be felt. This nonattendance is sometimes temporary, sometimes permanent, but in either event we are seldom notified by the mother, "This entails loss of time, as other appointments cannot be booked at the same time, and is discouraging to the workers. "We suggest that a printed notice be given to each patient on the first appointment, stating that regular attendance is a condition of treatment, and absence must be notified at once." ANTE-NATAL CLINIC. Dr. Huxley reports:— "All patients wishing to engage beds at the Maternity Hostel were examined and passed when suitable for admission. " Treatment was given for the following abnormalties:— Abnormal presentation (breech) 5 Retroflexion uterus 1 Death of foetus 1 Miscarriage 2 Albuminuria 3 Digestive disturbances 19 Varicose veins 10 Haemorrhoids 2 Leumcarrhœa 10 Goitre 1 Tachycardia 1 Ten cases were referred to the dentist." 12 NEEDLEWORK CLINIC. The Needlework Clinic at Greenhill and at Roxeth are still proving a boon to the mothers who attend them. The Clinics are held once a week at each Centre and the garments cut out from approved patterns, the mothers paying for the material, mostly by small instalments. Thanks are due to Miss Stevenson and Mrs. Maude, who give so much time and thought to both these Clinics, and whose work is so much appreciated by the mothers attending. MATERNITY NURSE. The record of Nurse Kindell's work shows that she had attended at 36 cases, and her total number of visits paid amount to 2182, and the fees received from her £20 10s. Nurse Kindell discontinued acting as the Council's Maternity Nurse after the 31st September, 1923. As the public did not avail themselves of the services of this Nurse, the Council, at the recommendation of the Ministry of Health, decided to discontinue her engagement as a whole time Maternity Nurse. Arrangements have been made for her to attend the Ante-Natal Clinic once a week and emergency cases of parturition. Otherwise she is engaged privately as a midwife or with the resident medical practitioners. NURSING. The Harrow District Nursing Fund has a staff of four nurses, who are responsible for the general nursing of the district. They are Nurse Byerley, Nurse Randall, Murse Stevenson and Nurse Pitcairn. The Council continue to make a grant to the District Nursing Fund for the services of the nurses as part-time Health Visitors. On special forms these nurses keep me informed of cases of infectious disease, sore throat, epidemic diarrhoea. etc. Indeed their health work for the district is excellent; so quietly, so. tactfully carried out. May I take this opportunity to refer to the courtesy and ready help afforded to the Health Department by the Hon. Secretary of the Fund, Miss Colbeck, whom I always consult on matters relating to the nursing of the district. 13 MILK GRANTS. The supply of milk to mothers and children has been continued during the year, and the total amount of milk supplied under this scheme was 1507 pints to 16 applicants. At the end of the year two mothers were receiving milk free of cost. All these cases were recommended by the Health Visitors and certified by the Medical Officer at the Clinic. Number of children receiving free grants of milk during the year 4 Number of children receiving milk at reduced price during the year 6 Number of nursing and expectant mothers 6 16 Every case is approved by the Sub-Committee appointed for the purpose, consisting of the Chairman of the Public Health Committee, the Clerk, the Medical Officer of Health and the Sanitary Inspector. THE DAIRIES, COWSHEDS AND M1LKSHOPS. These have all been regularly inspected. You are aware that we visit all the sheds in the early morning every month and report to you their exact condition. I am glad to state that the improved conditions of 1922 have been well maintained. The Certified Milks have a fair sale in the district. There can be no doubt of the comparative purity of these milks, which we are now compelled to have examined regularly at a laboratory to test their purity. When the sales have markedly increased no doubt the cost of these milks will be less, I would strongly urge the use of the Certified Milks for invalids and delicate, susceptible children. One of the cowkeepers was prosecuted for not keeping his premises, utensils, etc., in accordance with the Regulations, and a conviction obtained. 14 BAKEHOUSES AND FOOD POLLUTION. Your sanitary officers have made frequent inspections of the bakehouses of the district, and usually are satisfied with the conditions found, but a few of the bakehouses have given trouble during 1923, and this has arisen chiefly from the fact that nearly all the premises are too small. Eventually larger and better equipped bakeries will be built and displace the smaller ones. The public have a right to demand better conditions, and certainly better methods in distribution. You are aware of the efforts that have been made recently to induce purveyors of food to take still greater care to protect the people's food from pollution, and especially to have bread wrapped by machinery, preferably in sealed, waxed paper We have pointed out the advantages to the consumer and to the baker, and that the custom is almost universal in America, and rapidly becoming so in Canada. One feels, however, that the vendors generally will take no steps in the matter until the British Public seriously demands this precaution, and it behoves all who prefer to eat clean food to request for this service, and not be satisfied till the reform is the common practice of the country. The fact that bread is being wrapped in this manner without extra charge being made to the customer should cause us less hesitation in requiring this precaution. We know that the method is necessary and that it is coming, but what really disgusts one is that the British who have led the way in hygienic matters for a hundred years should lag behind in embracing this very obvious precaution in preventing the unnecessary ingestion of other people's filthy microbes, it may be of consumption, of enteric, of diphtheria, and of many other diseases. WATER SUPPLY. The water supplied to the district is obtained from the Colne Valley Water Company. It is a constant supply, and excellent character. Owing to the war, the Company was not able to cope with the rapid increase of population, and could not establish sufficient plant, with the result that much chalky material got into the system, and has caused many complaints during the past five years. There is little of this trouble now, indeed the latest report of a few days ago by Messrs. Thresh and Beale says:—"This is an excellent water, free from any objectionable bacteria, pure and wholesome, and well-adapted for the purposes of a public supply." Occasionally accidents occur to the mains, but the Company is well able to cope with any difficulty now at short notice. 15 SURVEYOR'S REPORT. I am indebted to your Engineer and Surveyor, Mr. Bennetts, for the following Reports:— "During the year 1923, plans have been approved for 253 houses, 31 combined shops and dwellings, 16 other shops, 42 additions, temporary buildings, &c. 139 houses, 5 combined shops and dwellings, and 5 other shops have been completed and occupied. ''his is a big increase over last year. 780 inspections of buildings in course of erection have been made. Several widenings and public street improvements have been carried out, including Bessborough Road (from the Wesleyan Church to the Ham and Bacon Factory, also from The Avenue to Kingsfield Road), Northolt Road (from Parkfield Road to Eastcote Road), also the carriageway of Northolt Road (from Eastcote Lane to the Boundary), London Road (between Mount Park and Roxeth Hill), High Street (between Church Hill and West Street), Roxborough Road. A newsurface water sewer has been laid off Vaughan Road, and a newsoil sewer a part of Eastcote Lane. Developments of shops have taken place in station Road, near the Coliseum, and in College Road, near Clarendon Road, and in each case the Council have been able to obtain valuable concessions of land for the purpose of future widenings. A comprehensive scheme of Direction Posts on the through traffic roads, carried out daring the vear, has proved very valuable. RECREATION GROUND AND OPEN SPACES. Land at West Harrow to the extent of about 26 acres has been purchased for a new Recreation Ground, and is in course of being laid out for Sports, including also a paddling pool, and a space reserved for children's games. This will be a valuable addition to the Council's Open Spaces, and in view of the proposed development of the land on the South side for building, was acquired just at the right time. Improvements have been carried out on the Recreation Ground, notably 6 hard and 4 additional grass Tennis Courts, and a new Pavilion on the Harrow Recreation Ground and two additional Grass Tennis Courts on the Roxeth Recreation Ground, and the fact that these were constantly being used, and a good revenue obtained, showed that the provision of such was much appreciated. A new full size Bowling Green has been provided at Roxeth Recreation Ground, and it is anticipated that this will prove a boon to residents in that neighbourhood. 16 Spaces at the bottom of Grove Hill, top of Roxborough Road, and in Pinner Road, hitherto unsightly waste spaces, have been planted, making a much improved appearance. The Northolt Road allotments, opposite the Gas Works, hitherto held privately, have been acquired by the Council, thus preserving the area for permanent allotments. SWIMMING HATH. The Open Air Swimming Bath was completed during the year, and opened for the use of the public on Saturday, July 28th, by Mrs. E. W. de W. Bruce. A display of swimming, diving, &c., by experts, on the day was carried out with great success. The use of the bath was beyond expectation, as during the two months about 24,000 tickets were issued. The weather was exceptionally fine, which, of course, made a great difference. On all sides much appreciation has been expressed of the Bath, including several deputations from other districts. The fact that this bath, after consideration of all the Baths in the Country, has been selected for the venue of matches, e.g., British Empire versus United States of America, during the coming year, speaks for itself. A filtration plant, which will keep the water filtered and clean, is to be installed, and this will enhance the value of the bath, and is an excellent thing from the public health point of view. Special arrangements have also been made for the use of the bath by children from various schools, so that they can be taught swimming, which should not only improve them physically, but also prove of service in lessening danger from drowning. LIGHTING. During the year the Harrow and Stanmore Gas Company has been taken over by the Brentford Gas Company. Improvements have been made in the lighting of some of the principal roads by the use of high pressure burners with 4 mantles, and the Council proposes to extend these improvements. The introduction of a lighted "Danger" sign post at the bottom of Peterborough Hill, which can be seen from four ways, as a means of minimising accidents at a dangerous corner, has proved to be very successful, and is being copied in other districts. 17 HOUSING. There is still a very large waiting list of appficants for houses. No additional houses have been erected. It was desired to erect another 18 to complete the Estate, but certain difficulties have prevented this for the present. SEWAGE DISPOSAL. The Sewage Disposal Works have been satisfactory during the year. One complaint was received from the Middlesex County Council that a sample was not up to the usual standard, and it was thought that this was due to a leakage of oil, &c., from the Gas Works, otherwise all tests of effluent, &c., have been reported good. SCAVENGING. Owing to the growth of the district this work has increased. Very few complaints have been received. Consideration is to be given to the advisability of adopting Motor Dust Vans, or a combination of Motor and Horse Vans, so as. to improve the mode of colfection. OFFENSIVE TRADES. There are three Fried Fish Shops in Harrow. They have been regularly inspected. Two complaints were received with regard to one of the Fried Fish Establishments, which were immediately investigated and steps taken by the proprietor to remedy the cause of complaint. During the year a motor car titled up as a travelling fried fish establishment, commenced to fry fish in one part of the district and steps were taken, which resulted in the practice being discontinued. AMBULANCE FACILITIES (a). For infectious diseases. Two ambulances, one for cases of Diptheria and one for Scarlet Fever. (b.) For non-infectious and accident cases. The Council's ambulance is housed at the Fire Station and is driven by the firemen, who are on call at any time of the day or night. 18 The number of cases removed during the year 1923 was 248, the ambulance travelling 2,595½ miles. Of these 248 cases 56 were taken to the Cottage Hospital, 25 Hendon Infirmary, 124 to London Hospitals, and 43 to residences in or about the district. 133 were Harrow cases. 98 were Wembley cases. 17 were Wealdstone cases. HOSPITALS PROVIDED OR SUBSIDISED BY THE LOCAL AUTHORITY OR BY THE COUNTY COUNCIL. 1. Tuberculosis 2. Maternity 3. Children 4. Fever 5. Small-pox 6. Other Clare Hall Sanatorium, South Mimms, Barnet. The Maternity Hospital, 10, College Road, Harrow. Observation Ward, "Holmleigh,"8, College Road, Harrow. Isolation Hospital, Rayner's Lane, South Harrow. The Small-pox Hospital, South Mimms, Barnet. The Cottage Hospital, Roxeth Hill, Harrow. Middlesex County Council. Council of Child Welfare. Council annually subscribe £300. Council of Child Welfare. Harrow on the Hill Urban District Council Middlesex Joint Small pox Hospital Board. Local Committee of Management. SAMPLES TAKEN IN HARROW DURING THE YEAR. Samples taken by the Middlesex County Council are as follows:— article. taken. adulterated. Milk 66 I Milk Separated 1 - Cream 4 - Ale 3 - Baking' Powder 3 - Vinegar 5 - 82 1 19 LIST OF ACTS ADOPTED IN HARROW URBAN DISTRICT. Infectious Disease Prevention Act 1890. Public Health Acts, Amendment Act 1890. Public Health Acts, Amendment Act 1907. BYELAWS IN FORCE. Common Lodging- Houses, Slaughter Houses, Nuisances, Cleansing of Earth Closets, Privies and Ashpits, Removal of House Refuse, Houses Let in Lodgings, Provisions of means of escapes in case of fire, Factories and Workshops, Pleasure Grounds and Open Spaces, Fish Frying, New Streets and Buildings, Dairies, Cowsheds and Milk-shop Regulations. THE GIPSIES (SO CALLED). I want again to draw your attention to the encampment of gipsies constantly in our midst, and to show that their presence is a menace to the public health. Unfortunately the type found in our lanes and fields is a most undesirable one. There is no doubt that these gipsies are a dirty and immoral race, and should be controlled. The good word these people receive in song and fiction is pure moonshine; they are thieves and evil livers; the women go out to sell and beg; the men are for the most, part idle and drunkenHuddled together in their filthy vans we find the children often neglected not so much in the mat,ter of food as in the matter of cleanliness. They are allowed to become verminous, their education we know is neglected, and they must often be witnesses to many gross evils. We found recently several gipsy children in this verminous condition. The National Society for the Prevention of Cruelty to Children prosecuted, and obtained a conviction against the Parents. Last November in a neigbouring district a swab was taken from a gipsy child by a local doctor and found to be positive of Diphtheria. When sought for, the family had fled, but the Sanitary Inspector and the doctor eventually overtook them at Greenford and had the child 20 admitted to the Ealing Isolation Hospital. Here is a concrete case again of infectious disease among these people likely to be propagated to many others. It is very evident that the law is quite insufficient to deal with this class. What is required is the compulsory registration of the van as well a:s of the owner in the same way as the canal boats are registered. We can board canal boats and have little difficulty in controlling their condition and the number of occupants, etc., and report defects found to the authority granting registration. With gipsies there is very little real control. They are here to-day and, on receiving a summons, are off to-morrow. They may be tolerated on some farms on the condition that the property of that particular farm is not damaged, and then again they often change their names. The great evil is, of course, that we are all contributing to the support of a race which is breeding potential criminals in large numbers with no education, no definite trade, and nothing to recommend them as useful and respectable members of society. I recommend that the matter be brought before the notice of all Boroughs and Districts on the outskirts of London and to the Urban District Councils' Association, with a view to co-operation and concerted action to amend the law relating to this class of traveller. A RETROSPECT IN PUBLIC HEALTH. As an old practitioner of forty years' standing and as a Medical Officer of Health of nearly thirty, I have witnessed the following among many other stages of progress in the physical and social well-being of the people, for example:— In my youth, cases of Typhoid Fever were common, even in epidemic form, and were then always attributed, though erroneously, to the poison of sewer gas. At the present time typhoid (enteric) is comparatively rare and when occurring is so skilfully attended and watched that "return" cases are infrequent. Scarlet Fever, except for the throat and ear complications is now a comparatively mild complaint, but formerly it often assumed a virulent or malignant type, wiping out three, four or five children in a large family. The virus has 21 become attenuated, passing through several generations and, of course, better sanitation has had its effect. We still know little of Diphtheria, its origin and the factors that influence its incidence in epidemic form, but its terrors are seldom witnessed now if the anti-toxin is injected at an early date, and in sufficient quantity. Pulmonary Tuberculosis (Consumption) and Tuberculosis generally are gradually becoming less prevalent. By this date all forms of Tuberculosis should have been stamped out, if sufficient money had been expended twenty years ago. The fact is that politicians have been slow, until lately, to recognise that a "nation's health is a nation's wealth." The fact that last year more than a million days were lost, among the workers, on account of sickness alone, is sufficient evidence of the need for an even greater expenditure in the cause of Public Health. What Sir George Newman says is true— Public Health is purchasable and the cost must be paid by Parliament, that is, by the State. One of the most pronounced changes in Public Health in recent years is in the lessening of Rickets, owing to better and more scientific feeding of infants. It is by no means a common experience now, as formerly, to see a markedly typical instance of this disease. Chronic Alcoholism is undoubtedly less than in former days, and drunkenness in our streets is now far from common, but doctors and lawyers and the clergy are still often made aware of the ruin of homes and the misery produced by the excessive use of alcohol. What really surprises one is the fact that quite a large percentage of young men, potential fathers of the race, in these more enlightened days, are still willing to indulge too freely in drink before marriage, and during the child-bearing period of their wives. Fortunately the women usually save the situation, but this is by no means always the case, and in a long experience, in the absence of other Itaint, a doctor knows that the unexpected appearance of insanity, asthma, bronchitis, epilepsy and many nerve and asthenic conditions, in the next and succeeding generations, are directly and solely traceable in this cause. However, in spite of all that can be advanced against the abuse of alcohol there can be no doubt that excess in feeding is responsible for far more invalidism is the form of gastric troubles, and general functional disorders, but even these 22 complaints are becoming less evident because of the better attention to the teeth and a wider knowledge of the best hygienic rules and conditions. I remember in the days of my youth it was a very common procedure, among all ranks of life, but especially in the domestic-class, for young women on being disturbed, distressed or distraught to become hysterical, often to get temporarily out of control. This expression of emotion is now rare, and when occurring, is definitely pathological, calling out for treatment. At an earlier date in the 19th century, this exhibition of feeling was fashionable, if not encouraged, we read in the fiction of that date on almost every page that the heroine wept copiously or swooned away into somebody's arms. All this is now changed, girls are becoming selfreliant, they have nothing to learn from their masculine friends, and whilst there are many signs of lack of stability, they have acquired a very definite idea of working out their own salvation, and certainly have no intention of being exploited by the other sex. There is still much room for greater refinement with both sexes, in the home, in the office, and especially in public places. It seems a pity that the war and consequent levelling of the classes should have banished much of the old-fashioned courtesy that means so much. The influence of the Churches, the Secondary and Elementary Schools, and the efforts of the great business houses in providing Clinics, libraries, rest rooms, cubicles, ball-rooms, athletic clubs, etc., are gradually tending to neutralise the evils of overcrowding and the faulty conditions of the homes, and to produce a race of sturdy independence and of higher intelligence. One would really have little fear for the future of the nation which encourages the work of the Child and Maternity Welfare, Girls' Clubs', Lads' Brigades, Girl Guides, Boy Scouts, and kindred Associations, if concurrently, we could only get the people better housed and constantly employed. There is one thing which is needed for the whole nation and yet is so far unapproached, and is perhaps unattainable, and that is a practical and workable scheme of public supervision of boys and girls between the ages of fourteen and twenty. I mean a local, registered, certified control by paid elected committees with certain statutory powers, duties and rules, a supervision, chiefly advisory, which should take note 23 of the physical and mental condition, recreation and preparation for life's work, and assist or advise in placing out every boy or girl after leaving school whether in a profession, in a trade, on the land, in an office, or to qualify for emigration. It is probable that from lack of such control in the home and out of it, much of the expenditure on Education and Religion if absolutely wasted and too often the health of the young is seriously threatened by the development of evil habits contracted, in these early impressionable years, as the result of bad example. On the whole there is no question but that Public Health administration, through the Ministry, Public Health Committees and Officials is gradually effecting reforms and better conditions throughout the country. We hear for instance on good authority that, chiefly through the influence of the organisation of Maternity and Child Welfare Clinics, a child born to-day will, on the average, live for twelve years longer than its grandfather; we know there is greater temperance in food and drink and we believe that civilisation, in spite of the set-back of the war, is slowly and steadily advancing and that, as a result of better knowledge, the general health of the people will improve but, whilst we feel that, we cannot ignore the fact that there is still much to be done; and when we think of the ravages of Cancer, of influenza and pneumonia, of the prevalence of whooping cough, scarlet fever, measles, chicken pox, diphtheria and numerous other complaints all probably preventable, we feel that we cannot yet be proud of our efforts to exterminate disease and to pass down a clean bill of health to those who follow, but we can, and you as a Public Health Authority certainly do add your quota in your own generation in the best interests of Public Health for the district for which you are responsible. STATISTICS. I desire to draw your attention to the many tables of statistics of our work drawn up with the assistance of my staff, to be found at the end of the Report. They afford valuable information of the work for which the Public Health Committee is responsible. In conclusion I would like to state that I am always glad to express my appreciation of the help rendered by my 24 Public Health staff and more especially are my thanks due to my very able colleague, Mr. Kramm, for his loyal cooperation at all times and may I add how indebted I am to my fellow officials and to every member of the Council for their courtesy and assistance. I am, Gentlemen, Yours obediently, CHARLES E. GODDARD, Medical Officer of Health. Fellow of the Society of Medical Officers of Health. Fellow Royal Institute of Public Health. Fellow Royal Sanitary Institute. TABLE I. VITAL STATISTICS OF THE WHOLE DISTRICT DURING 1923 AND PREVIOUS YEARS. Year Total Birth. Total Deaths registered in the District Transferable deaths Nett deaths belonging to the District. Estimated Population Number Rate Number Rate of Nonresidents registered in the District of Residents not registered in the District Under 1 year of age At all ages Number Rate per 1000 nett Births Number Rate 1919 20,003 277 13.8 142 7.0 10 36 17 61.3 168 8.7 1920 19,967 346 17.3 138 6.9 12 48 18 52.0 174 8.7 1921 19,460 322 16.5 153 7.8 15 48 17 52.7 186 9.5 1922 19,440 297 15.3 197 10.1 10 45 18 60.6 187 9.6 1923 19,640 289 147 199 9.5 14 47 11 38.0 199 10.1 25 26 TABLE II. CAUSES OF AND AGES OF DEATH DURING THE YEAR, 1923. Cause of Death. Deaths at the subjoined agea of " Residents " whether occurring within or without the dist. Total deaths whether Resident or Nonresident in institutions in the District At all ages under 1 1-2 2—5 5—15 15—25 25—45 45-65 65 and over All Causes Certified -and Uncertified 199 11 2 4 9 28 57 88 Diphtheria 2 1 1 1 Influenza 4 1 2 1 Tuberculosis 26 1 2 3 12 7 1 1 Other Tuberculos diseases 2 2 Cancer 35 1 1 21 12 Rheumatic fever 1 1 1 Diabetes 1 1 Cerebral Haemorrage 12 I 3 8 Heart Disease 23 3 6 14 Arterio Sclerosis 12 2 10 Bronchitis 6 1 5 Pneumonia 2 1 1 1 Other Respiratory Diseases 2 1 1 Ulcer of Stomach 1 1 Cirrhosis of Liver 5 1 4 Nephritis 2 1 1 Puerperal Sepsis ■2 2 Congenital debility and Prematurity 6 6 1 Suicide 4 3 1 Other Deaths from Violence 4 2 2 Other Defined Diseases 46 4 1 1 1 1 10 28 2 Causes ill-defined or unknown 1 1 27 TABLE III. INFANT MORTALITY DURING THE YEAR 1923. Causes of Death Nett Deaths fiom stated causes at Various Ages under 1 year oI age. Under 1 Week 1-2 Weeks 2-3 Weeks 3-4 Weeks Total under 1 Month. 1-3 Months 3-6 Months 6-9 Months 9-12 Months Total Deaths under One Year All Certified Causes Uncertified 6 1 7 2 1 1 11 Marasmus 2 Miliary T. B. Meningitis 1 Prematurity 3 1 Convulsions 1 Thrombosis 1 Asphyxia Neonatorum 1 Congenital Cardiac Malformation 1 28 CASES OF NOTIFIABLE DISEASES DURING THE YEAR 1923. Disease. Number of Cases Notified. Total No. removed to Hospital Total Deaths of those notified during 1923. At all ages. Under 1. 1-5. 5-15. 15-25- 25-45. 45-65- 65 and over. Diphtheria 6 2 2 1 1 4§ Scarlet Fever 20 3 11 5 1 12|| Erysipelas 6 2 4 Pulmonary T.B 34 6 10 11 6 1 4 Chicken-pox 46 6 34 4 2 1 Small-pox 1 1 1* Measles 13 1 5 6 1 Pneumonia 3 1 2 Puerperal Septicaemia 1 1 Encephali tis Lethargica 1 1 Typhoid 1 1 1 Anterior Poliomyelitis 2 • 1 1 $ One case from Hendon Rural District. || One case from London Hotel. * Removed to Yeading Isolation Hospital. 29 THE HARROW CLINICS AND TREATMENT CENTRES. Name of Clinic. Address. Nature of Accommodation. When held. By whom provided. Doctor. Harrow Baby Clinic ''Holmleigh,"Col lege Road Hut in rear of " Holmleigh." T u es d a y and Wednesday afternoons Harrow - on - the Hill Urban District Council Dr. Brand. Roxeth Baby Wesley Hall, 1 large hall, 2 Thursday do. Dr. Brand. Clinic Lower Road small rooms noon An t e-na t a 1 Consulting room T uesday Joint Harrow Dr. Huxley. Clinic lege Road waiting room noon Urban District Council and Council of Child Welfare Dental Clinic do. Ground floor of Saturday do. Dr. Bailey, " Holmleigh." Anaesthetist. Miss Goodman, Dentist. Massage do. do. do. Tuesday, Thursday & Saturday do. Miss Townsend, Masseuse. Ear, Nose and Throat do. do. As cases accumulate Council of Child Welfare Dr. Lowry. Clinic Eye Clinic do. do. do. do. Dr. Sheppard. Observ at ion do. First floor of do. do. Dr. Mayne. Ward for " Holmleigh." Ailing Babies Needlework Clinic do. Ground floor Tuesday afternoons Harrow Urban DisCouncil Miss Stevenson. Needlework Clinic Wesley Hall, Lower Road 1large hall Wednesday afternoon do. Mrs. Maude. 30 GREENHILL CLINIC. Summary of Attendance Quarter ending Total. Consultations A. March. June. | Sept. Dec. 1238 320 239 255 424 New Cases (under one year) 21 26 27 31 105 Consultations B. 260 262 213 256 991 New Cases (over one year) 4 5 3 2 14 Weighing only 97 42 54 114 307 Home Visits (under on year) 509 39o 561 363 1823 1st Visits 26 34 42 33 L35 Home visits (over one year) 264 338 221 408 1231 Feeding, Breast New cases. 13 I 2 17 19 61 Bottle 8 10 9 12 39 ,, Mixed — 4 1 1 6 No. of New Cases during Quarter 25 31 30 34 120 Attendance of New Cases 88 104 103 99 394 Attendance of Old Cases 589 432 419 695 2135 Total attendance 677 536 .522 794 2529 No. of Sessions 24 20 17 24 85 Individual attendance 194 181 183 220 778 Cases attended but once 60 31 57 62 2I10 Average attendance per session 28 27 30 33 Needlework Clinic. No of Clinics 11 10 8 12 41 Total attendance 56 63 45 55 219 Average attendance 5 6 5 4.5 31 ROXETH CLINIC. Summary of Attendance. Quarters ending Total March. June. Sept. Dec. Consultations A. 216 147 184 299 846 New cases (under one year) 16 12 28 20 76 Consultations B. 134 126 125 172 557 New cases (over one year) 4 4 5 4 17 Weighing only 95 66 70 193 414 Home visits (under one year) 193 206 262 125 786 First visits 26 32 23 13 94 Home visits (over one year) 52 109 187 175 523 Feeding, Breast new cases 13 10 15 13 5i ,, Bottle 2 2 11 17 32 „ Mixed 1 — 2 1 5 No. of new cases during Quarter 20 14 33 25 92 Attendance of new cases 86 37 101 103 327 Attendance of old cases 359 302 278 459 1398 Total attendance 445 339 379 562 1725 No. of Sessions 12 10 9 12 43 Individual attendance 112 106 116 139 473 Cases attended but once 31 36 29 40 136 Average attendance per session 37 34 42 46 — Needlework Clinic. No. of Clinics 12 11 11 12 46 Total attendance 65 72 61 66 264 Average attendance 5 6.5 5 5.5 32 DENTAL CLINIC. Summary, January to December, 1923. March June Sept. Dec. Total Total No. of SessionsHeld ... 34 36 22 36 128 Mothers & Children under five years— Total No. of Inspection Cases 46 43 32 34 155 Total No. of Filling Attendances 34 25 15 26 100 Total No. of Extraction Attendances 52 43 29 40 164 Total No. of New Denture Cases 8 6 7 9 30 Total No. of Denture Attendances 32 15 12 19 78 M. C. C. Special Cases — Total No. of ( ases Inspected at Clinic 71 51 51 53 226 Total No. of Filling Attendances 27 56 40 53 176 Total No. of Extraction Cases 41 24 28 21 T14 M.C.C. School Inspection Cases— Total No. inspected at Schools 593 672 140 738 2143 Total No. of Filling Attendances at Clinic 53 86 41 79 259 Total No. of Extraction Attendances at Clinic 99 105 89 139 432 Analysis. Total No. of cases attending under 5 years, 84, viz., 63 Harrow, 21 Wealdstone. Total No. of attendances under 5 years. 168, viz., 119 Harrow, 49 Wealdstone. Total No. of Mothers attending, 126, viz., 90 Harrow, 36 Wealdstone. Total No. of attendances (not including Denture attendances), 250, viz., 184 Harrow, 66 Wealdstone. Total No. of School Special cases, 259, attendances made, 517. Total No. of School Inspection cases attending Clinic, 597, attendances made, 691. 30 cases for Dentures, viz., 24 Harrow, and 6 Wealdstone. (Two Harrow cases received Denture grant). 33 MASSAGE CLINIC. Summary January—December, 1923. Quarters No. of Sessions New Cases. Massage Treatment Exercises Inspections by Dr. Mayne. Attendances. Total Attendance. Fees Taken Under 5. Over 5. Under 5. Over 5. March 33 7 10 188 131 — 121 180 301 f, s. d. 7 4 6 June 31 8 5 182 146 12 151 192 343 8 0 6 Sept. 23 5 4 110 83 13 97 103 200 4 I 0 Dec. 34 3 5 187 91 18 164 125 289 5 14 6 Totals 121 23 24 66 7 451 43 533 600 1133 £25 2 6 34 Analysis. Ages 1 year 2 3 4 5 Total 34 cases. No. of cases 14 10 3 5 21 Ages 6 years 7 8 10 11 15 Vdult Total 28 cases. No. of cases 2 8 10 3 3- 1 1 Total No. of New Cases, 47, viz., 23 under 5 years of age, 24 over 5 years of age. Total No. of Cases Attending, 62, viz., 34 under 5 years of age, 28 over 5 years of age. Total No. of Attendances, 1133, viz., 533 under 5 years of age, 600 over 5 years of age' Total No. of Sessions held, 121, average attendance per session, 9. Treatments. 12 Spinal Curvature, 9 Breathing exercises (leferred from Ear, Nose and Throat Clinic), 4 Fractures, 6 Talipes, 2 Muscular Debility, 1 Muscular Athrophy Right Arm, 1 Defective Muscular Development, 6 Flatfoot, 2 Knockknee, 2, Bowleg, 6 Rickets, 5 Pigeon Chest, 1 Drop Foot, 4 Poliomelitis (i.e. Infantile Paralysis), 1 Rheumatism (advisory). Cases have been sent by the School and Clinic Doctors, London Hospitals and Local Medical Practitioners, and during the year Dr. Mayne, the Hon. Surgeon to this Clinic, has paid visits and inspected 43 cases. 35 ANTE-NATAL CLINIC. Summary—January to December, 1923. Quarters. Sessions. New Cases. Attendances. Totals. Harrow. Wealdstone. Harrow. Wealdstone. March 12 29 18 79 77 156 June 11 16 11 74 66 140 September 9 13 13 58 50 108 December 12 29 22 80 64 144 Totals 44 87 64 291 257 548 Analysis. Total Number of New Cases, 151; viz., 87 Harrow, 64 Wealdstone. ,, ,, Cases attending, 197; „ 111 ,, 86 ,, attendances, 548; „ 291 „ 257 „ „ Sessions held, 44; average attendance per session, 12. Average attendance 1922, 10. 38 COUNCIL'S MATERNITY NURSE. Quarters No. of Cases Nursing Visits Health Visits Antenatal Visits Total Visits Fees Received March 12 258 4°4 148 812 1 \i 6 June 8 144 280 132 556 5 15 0 September 16 437 284 93 814 826 36 839 968 373 2182 £20 10 0 SANITARY WORK EXECUTED. Drains inspected or tested 27 Drains unstopped 22 Drains repaired 17 Drains reconstructed 2 Disconnecting and Trap Chambers inserted 7 New soil pipes provided 1 Soil pipes repaired or altered 3 New vent, pipes provided 3 Vent pipes repaired or altered 9 New waste pipes provided 12 Waste pipes repaired, disconnected or trapped 2 New W.C.'s provided 9 W.C.'s repaired 4 New flushing cisterns provided 9 Flushing cisterns repaired 16 New cisterns provided 2 Cisterns cleansed 3 Overflow to cistern disconnected - New draw tap from main provided 2 37 Water service restored 8 New dustbins provided 101 Houses cleansed and repaired 36 Houses overcrowded - Dampness remedied 16 Floors ventilated 8 Roofs repaired 24 Yards paved 13 Yards cleansed 3 Accumulation of refuse removed 19 Ditches cleaned out 3 Pigs and other animals 5 Caravans observed 8 Nuisances therefrom 6 Removed from district 8 Other defects 85 SANITARY INSPECTION OF DISTRICT. Visits to Dairies 42 Visits to Cowsheds 86 Visits to Foodshops 296 Visits to Slaughter houses 28 Visits to Bakehouses 46 Visits to Laundries 22 Visits to Factories and Workshops 186 Inspections under Housing and Town Planning Act 5 Re-Inspeotions under Housing and Town Planning Act 32 Visits to cases of Infectious Disease 256 Rooms disinfected after infectious disease 373 Rooms disinfected after Phthisis 57 38 Articles of clothing;, etc., disinfected after Infectious disease 923 Articles of clothing-, etc., disinfected after Phthisis, and other diseases ... 1623 UNSOUND FOOD DESTROYED. Cod 3 stone. Haddock 5 stone. Bloaters 4 boxes. Kippers 7 boxes. Fruit 1 cwt. HOUSING CONDITIONS. STATISTICS. Year ended 31st December, 1923. 1. GENERAL. to Estimated Population 19640 (2) General death-rate 10.1 (3) Death-rate from Tuberculosis 1.7 (4) Infantile Mortality 38. (5) Number of dwelling houses of all classes 4395 (6) Number of working-class dwelling houses 1688 (7) Number of new working-class houses erected 4 UNFIT DWELLING HOUSES. 1. INSPECTION: (1) Total Number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 278 (2) Number of dwelling houses which were inspected and recorded under the Housing (Inspection of district) Regulations, 1910. 12 39 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil. (4) Number of dwelling houses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation Nil. 2. REMEDY OF DEFECTS WITHOUT SERVICE OF FORMAL NOTICE Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their officers 259 3. ACTION UNDER STATUTORY POWERS (A) Proceedings under Section 28 of the Housing, Town Planning Act, 1919. (1) Number of dwelling houses in respect of which notices were served requiring repairs 5 (2) Number of dwelling houses which were rendered fit :—• (a) by owners 3 (b) by Local Authority in default of owners — (3) Number of dwelling houses in respect of which Closing Orders became operative, in pursuance of declaration by owners of intention to close Nil. (B) Proceedings under Public Health Acts. (1) Number of dwtelling houses in respect of which Notices were served requiring defects to be remedied 278 (2) Number of dwelling houses in which defects were remedied :— (a) by owners 259 (b) by Local Authority in default of owners — 4° (C) Proceedings under Sections 17 and 18 of the Housing, Town Planning, etc.. Act, 1909. (1) Number of representations made with a view to the making of Closing Orders Nil. (2) Number of dwelling houses in respect of which Closing Orders were made (3) Number of dwelling houses in respect of which, Closing Orders were determined, the dwellings having been rendered unfit (4) Number of dwelling houses in respect of which Demolition Orders were made (5) Number of dwelling houses demolished in pursuance of Demolition Orders 3. UNHEALTHY AREAS Areas represented to the local authority w'th a view to Improvement Schemes under (a) Part 1, to Part 2 of the Act of 1890:— (1) Name of Area Nil. (2) Acreage (3) Number of working-class houses in area (4) Number of working-class persons to be displaced 4. Number of houses not complying with the building byelaws erected with consent of Local Authority under Sections 25 of the Housing and Town Planning, etc., Act, 1919 5. Staff engaged on housing work with, briefly, duties of each officer The Sanitary Inspector. 41 FACTORIES, WORKSHOPS, WORKPLACES AND HOMEWOJtiK. 1.—INSPECTION. Including Inspections made by Sanitary Inspector. Number of Premises. Inspections. Written Notices. Prosecutions. Factories (Including Factory Laundries) 90 1 Nil. Workshops Including Workshop Laundries) 120 5 „ Workplaces (Other than Outworkers' premises, included in Part 3 of this Report). 58 6 „ Total 268 12 Nil. 2.—DEFECTS FOUND. Particulars. Number of Defects. Number of Prosecutions, Found. Remedied. Referred to H.M. Inspector. Nuisances under the Public Health Acts:— Want of Cleanliness 4 4 Nil. Nil Want of Ventilation Overcrowding Want of drainage of floors Other Nuisances 5 4 Sanitary accommodation insufficient unsuitable or de fective 3 3 not separate for sexes Offences under the Factory and Workshop Acts :— Illegal occupation of under ground bakehoupe (S. 101) Breach of special sanitary requirements for bakehouses (ss. 97 to 100) Other offences 6 6 Total 18 17 Nil Nil. 42 3.—HOME WORK. NATURE OF WORK. OUTWORKERS' LISTS, SECTION 107. Notices served on Occupiers as to keeping or sending lists. Number of Inspections of Out-workers premises. Outwork in Infected Premises, Section 109-110. Lists received from Employers Numbers of Addresses of Outworkers received from other Councils. Numbers of Addresses of Outworkers forwarded to other Councils. Instances Orders made. Twice in the year. Once in the year. Lists. Outworkers. Lists. Outworkers. Wearing Apparel— (1) making, &c (2) cleaning and washing 5 10 2 4 16 6 10 28 Nil. Nil, Total 5 10 2 4 16 6 10 28 Nil. Nil. 43 4.—REGISTERED WORKSHOPS Workshops on the Register (S. 131) at the end of the year. Number. Important classes of workshops, such as workshop bakehouses, may be enumerated here. Bakehouses (retail) 11 Wheelwrights, etc 3 Harness Makers 1 Motor Repair Shops 7 Milliners and Dressmakers 20 Laundries 6 Cycle Makers 3 Plumbers 1 Tailors 18 Printers 2 Boot Repairing 20 Tinsmith 1 Workshops and Work places 16 Upholsterers 3 Total number of Workshops on Register 112 5.—OTHER MATTERS. Class. Number. Matters notified to H.M. Inspector of Factories :— Failure to affix Abstract of the Factory and Workshop Act (S. 133) Nil. Action taken in matters referred by ('Notified by H.M. Inspector... 3 H.M. Inspectors as remediable under the Public Health Acts, but not under the Factory and Reports (of action taken) sent 3 Workshop Act (s. 5, 1901). to H.M. Inspector. Other Nil. Underground Bakehouses (S. 101) ; — Certified granted during the year 1 In use at the end of the year Nil. 44 METEOROLOGICAL OBSERVATIONS TAKEN AT HARROW DURING THE YEAR ENDING DECEMBER 31st, 1923. By J. PERCY BENNETTS, Engineer and Surveyor. Month Hygrometer. Temperature. Rainfall Dr. Bulb Wet Bulb Max. Miu. Earth Total Depth Greatest • Fall in 24 Hours No. of Days on which .01 or more fel l 1 ft. 4 ft. Depth Date January. Means 38.61 37.74 47.09 34.16 39.38 44.29 ... ... ... ... Highest 49.00 48 00 54.00 46.00 43.00 45.00 1.45 .33 0 14 Lowest 27.00 26.00 42.00 26 00 37'00 43.00 ... ... ... ... February. Means 41.07 40.21 44 28 38.00 41.85 43.89 ... ... ... ... Highest 51 00 51.00 54.00 50.00 46.00 44.00 3.51 .71 7 24 Lowest 29.00 29.00 40.00 26.00 39.00 43.00 ... ... ... ... March Neans 41.80 40.77 50.25 38.64 4.5.93 44.12 ... ... ... ... Highest 54.00 52.011 67.00 49.00 48.00. 45.00 2.35 .76 12 15 Lowest 34.00 33.00 43.00 30.00 40.00 41.00 ... ... ... ... April. Means 45.63 43 26 54.10 37.00 46.43 16.33 ... ... ... ... Highest 54.00 53.00 62.00 49.00 48.00 47.00 2.03 .58 25 12 Lowest 36.00 31.00 46.00 31.00 43.00 45.00 ... ... ... ... May. Means 48.93 42.51 59.84 43.38 fl.96 4.1.03 ... ... ... ... Highest 63.00 57.00 80.00 55.00 56.00 50.00 2.10 .61 28 21 Lowest 40.00 39.00 50 00 32.00 49.00 47 .00 ... ... ... ... June. Means 54.23 51.43 62.36 48.20 54.43 51.50 ... ... ... ... Highest 63.00 61.00 76.00 57.00 59.00 54 00 .38 .10 15 9 Lowest 46.00 44.00 53.00 38 00 51.00 50.00 ... ... ... ... July. Means 63.67 60.58 75.93 58.96 62.29 56.12 ... ... ... ... Highest 77.00 74.00 92.00 68.00 68.00 58.00 3.65 218 9 9 Lowest 55.00 52.00 65.00 48.00 58.00 53.00 ... ... ... ... August. Means 59.13 56.32 71.25 52.80 61.16 59.32 ... ... ... ... Highest 70.00 66.00 87.00 6.2.00 66.0 60.00 1.80 .48 29 10 Lowest 50.00 47.00 58.00 43 00 55.00 58.00 ... ... ... ... 45 Meteorological Observations (continued). Month Hygrometer Temperature. Rainfall Dry Bulb Wet Bulb Max. Min. Earth Total Depth Greatest Fall in 24 Hours. No. of days on which •01 or more fell. 1ft. 4ft. Depth Date September. Means 52.53 50.93 65.83 46.66 55.20 57.60 ... ... ... ... Highest 65.00 64.00 74.00 61.00 59'00 6000 1.54 .35 14 12 Lowest 16.00 44.00 55.00 38.00 52 00 56 00 ... ... ... ... October. Means 50.12 48.80 57 09 44.77 51.03 55.00 ... ... ... ... Highest 62.00 60.00 65.00 55.00 59.00 56.00 5.41 .85 19 21 Lowest 41.00 39.00 52.0O 34.00 47.00 53 00 ... ... ... ... November. Means 35.50 34.53 44.70 30.66 41.43 48.90 ... ... ... ... Highest 55.00 53.00 57.00 40.00 49.00 52.00 1.71 .53 13 11 Lowest 23.00 23.00 31.00 19.00 36.00 43.00 ... ... ... ... December. Means 37.06 36.32 45.09 31.64 37.90 45.09 ... ... ... ... Highest 45.00 44.00 49.00 44.00 41.00 49.00 2.56 .58 26 20 Lowest 25.00 25.00 39.00 24.00 36.00 43.00 ... ... ... ... - HARROW- INFANTILE MOHTftUTY PER lOOO BIRTHS. 18 9 6 - 1923