The Urban District Council of Hayes. Annual Report For the Year ended December 31st, 1925, OF THE . MEDICAL OFFICER OF HEALTH. E. R. Wbscott and Son, Printers, Uxbridgb, Middx. the Urban District Council of Haybs. Annual Report For the Year ended December 31st, 1925, OF THE MEDICAL OFFICER OF HEALTH. THE URBAN DISTRICT COUNCIL OF HAYES. Public Health and Housing Committee, 1925. COUNCILLOR F. H. CONWAY (Chairman). COUNCILLOR A. H. BOOT. „ I. ELLIS. „ R. W. GUNTON. „ J. HOOK. COUNCILLOR R. J. LEACH. „ F. F. OSGOOD. „ A. SIMPSON. „ W. SUTCLIFFE. COUNCILLOR W. W. WESTACOTT. PUBLIC HEALTH DEPARTMENT. Medical Officer of Health : E. S. PHILLIPS, M.R.C.S., L.R.C.P., (Part time). Sanitary Inspector: S. H. FRANKLIN, M.R.San.I., C.M.I. Health Visitor : MISS J. MOCKETT, C.M.B., Registered Nurse. Clerk of the Council : D. C. FIDLER. MR. N. BASTABLE resigned his position as Sanitary Inspector of the Council on August 31st, 1925. 4 Medical Officer's Annual Report. Public Health Department, Town Hall, Hayes, June, 1926. To the Chairman and Members of the Urban District Council of Hayes. Mr. Chairman and Gentlemhn, I have the honour to present the Annual Report upon the Health and Sanitary condition of the Urban District of Hayes for the year ending December 31st, 1925. This report has been compiled according to the Circular No. 648 which was despatched from the Ministry of Health on December 10th, 1925. Natural and Social Conditions of tho Area. 1.—GENERAL STATISTICS. Area (Acres) 3,311 Population (census 1921) 6,303 Population (1925 Registrar-General's figures) 8,859 Present estimated population at 4.7 persons per house 10,189 Number of Inhabited Houses (1921) 1,336 Number of separate occupiers (1921) 1,379 Number of Inhabited houses (1925) 2,168 Rateable Value of the District — Buildings £90,252 10S. 0d. ,, ,, „ Agricultural Land 3,658 10s. 0d. Sum represented by a id. rate 366 0s. 0d. Amount of Poor Law relief: — Relief in money £2,135 12s. 9d. Relief in kind £216 18s. 6d. Total £2,352 11s. 3d. 5 The Urban District of Hayes is situated 11 miles West of London. The district generally is flat, the highest point above Ordnance Datum being 180 feet at Charville Lane and the lowest 82 feet at the Watersplash in North Hyde Road. In the South Ward are a number of large factories which give employment to many thousands of persons ; in the East Ward is situated the Council's principal Housing Estate, while the North and West portions of the district are mainly agricultural. The principal occupations of the inhabitants are in connection with the factories and agriculture. The soil North of the Uxbridge Road is clayey, and south of that Road consists mainly of gravel. 2.—EXTRACT FROM VITAL STATISTICS OF THE YEAR. Births :— Total. M. F. Legitimate 205 102 103 Illegitimate 4 1 3 Birth Rate (R.G.) 23.6 Deaths:— 68 39 29 Death Rate (R.G.) 7.6 Number of Women dying in or in consequence of childbirth Nil. Deaths of Infants under one year of age : — Legitimate, 12; Illegitimate, 1 Total 13 Death Rate per thousand Births 61.7 Deaths from Measles (all ages) Nil. Deaths from Whooping Cough (all ages) 3 Deaths from Diarrhcea (under 2 years) Nil. A climate which has a high humidity and a large rainfall is very beneficial to vegetation, but it acts injuriously on mankind by raising the level of the sub-soil water and thus rendering buildings and their surroundings damp. In misty districts with a large rainfall the prevalent disease is anaemia. Wind is generally beneficial, it removes exhalations of all kinds and promotes complete ventilation of the atmosphere. Soil humidity is associated in many cases with atmospheric humidity, so 6 that the separate effect of each upon health is difficult to trace. Soil humidity has, however, considerable effect in producing consumption, bronchitis and rheumatism, it can also be linked with absence of healthy colour and lack of energy. Again, sub-soil water is an essential condition in the production of the mosquito pest, which is especially harmful if the sub-soil water is stagnant. In reading this I wish the members of the Council to bear in mind its relation to the manner in which storm water is at present dealt with over the area. As long ago as 1913 the attention of the Council was called to the unsatisfactory method of drainage, the area rely ing upon ditches and water courses for the removal of surplus water. In the majority of instances these become silted up and are of no service, becoming excellent breeding places for mosquitoes as instanced in the stagnant pools dotted over the district. At this date in parts of the district a stormwater sewer has been constructed and where it is in existence there is a noticeable absence of the damp surroundings prevalent where it is non-existent. The dampness is a fertile cause of Rheumatism and increases considerably the cases of Tuberculosis of the lungs, of which disease the number of cases notified during the year under review is larger than in any previous year. Unfortunately the district is very flat and the removal of surplus rainwater a problem, but I am emphaticallv of the opinion that an effective system would do much to lessen the sickness of which dampness is a predisposing cause. There were no special noteworthy causes of sickness during the year. Following are the classified causes of the sixty-eight deaths which occurred in the district. As will be seen from the comparative table, the Birth Rate is above and the Death Rate below that of the average for ihe Smaller Towns of England and Wales. Ihe Infantile Mortality Rate again shows a rise, it being 61.7 per thousand births compared with 23.6 in 1923 and 46.7 in 1924. I aken as a whole the Vital Statistics for 1925 compare favourably with those of preceding years. 7 CAUSES OF DEATH DURING 1925. (Civilians only). Males. Females. All causes 39 29 1. Enteric Fever — — 2. Small-pox — — 3. Measles — — 4. Scarlet Fever 1 — 5. Whooping cough 3 — 6. Diphtheria — — 7. Influenza 1 1 8. Encephalitis lethargica — — 9. Meningococcal meningitis — — 10. Tuberculosis of respiratory system 3 — 11. Other tuberculous diseases 1 — 12. Cancer, malignant disease 6 2 13. Rheumatic fever — — 14. Diabetes — — 15. Cerebral haemorrhage, etc. 3 2 16. Heart disease 9 5 17. Arterio-sclerosis — — 18. Bronchitis 4 3 19. Pneumonia (all forms) 1 2 20. Other respiratory diseases — — 21. Ulcers of stomach or duodenum — — 22. Diarrhoea, etc. (under 2 years) — — 23. Appendicitis and typhlitis — 1 24. Cirrhosis of liver — 1 25. Acute and chronic nephritis 1 1 26. Puerperal sepsis — — 27. Other accidents and diseases of pregnancy and parturition — — 28. Congenital debility and malformation, premature birth 3 6 29. Suicide — — 30. Other deaths from violence 2 — 31. Other defined diseases 1 5 32. Causes ill-defined or unknown — — According to the figures furnished by the Registrar-General. 8 The causes and ages at death of the thirteen children who died under one year of age were as follows : — Intra-cranial haemorrhage 1 day Prematurity 2 days Prematurity 2 days Prematurity 5 days Prematurity, Atelactasis 7 days Prematurity 8 days Prematurity, Atelactasis 10 days Prematurity 1 month Acute Bronchitis 1 month Congenital pyloric stenosis 1 month Bronchitis, whooping cough 3 months Whooping cough, convulsions 8 months Endocarditis, marasmus 10 months The various rates compared with those for England and Wales (Smaller Towns) are given in the table below : — Per 1,000 population. Deaths per 1,000 births. Births. Deaths. Diarrhoea under 2 years. Under one year. England and Wales (Smaller Towns) 18.3 11.2 76 74 Hayes 23.6 7.6 — 61.7 General Provision of Health Services in the Area. HOSPITALS. (1) Tuberculosis. Cases are admitted to sanitoria through the Middlesex County Council. (2) Maternity. Nil. (3) Children. Nil. (4) Fever. 9 The Hospital provided for the isolation of cases of infectious disease is under the management of a Joint Hospital Board appointed, by the Urban District Councils of Hayes, Ruislip-Northwood, Uxbridge and Yiewsley, and the Rural District Council of Uxbridge. The Hospital is situated in Kingston Lane, within the Rural District of Uxbridge. Accommodation is provided for 50 Scarlet Fever beds, 20 beds for Diphtheria, and 10 beds for Enteric Fever. (5) Small-Pox. The Small pox Hospital is in the Yeading area of this district and is managed by the Joint Hospital Committee. Provision is made for 45 beds. (6) Other. I he Hayes Cottage Hospital, which is supported by voluntary contributions, is situated in Grange Road and has accommodation for six beds. Arrangements have been made for this accommodation to be increased during the coming year to provide for the ever growing needs of the district. Institutional provision for unmarried mothers, illegitimate children and homeless children.—Nil. AMBULANCE FACILITIES. (a) For Infectious Cases. A motor ambulance is provided by the Joint Hospital Board. (b) For Non-Infectious and Accident Cases. The Council have an arrangement whereby residents in Hayes may use the motor ambulance provided by the Urban District Council of Uxbridge for street accidents and for the removal of non-infectious sick to hospital. Any user in a position to pay must do so. CLINICS AND TREATMENT CENTRES. A Maternity and Child Welfare Centre and School Clinic under the supervision of the Middlesex County Council is held every Tuesday and Friday in the 10 Wesleyan Chapel Room, Station Road. A Maternity and Child Welfare Centre is also held on Tuesday and Thursday afternoons in the Baptist Cliapel Room, High Road. TUBERCULOSIS DISPENSARY. This is provided by the Middlesex County Council at Green Man Passage, Uxbridge Road, Ealing. VENEREAL DISEASES. Arrangements are made by the County Council for the treatment of these diseases at various Hospitals and Centres. PROFESSIONAL NURSING IN THE HOME. (a) General. There is no organization which provides for any general nursing over the district. To meet this need the Council employ a whole time Health Visitor, whose services are available for general nursing of non-infectious sick. (b) For Infectious Diseases. There are no arrangements for the home nursing of cases of Measles, Whooping Cough, etc. MIDWIVES. The District Council does not employ or subsidise any mid wives. 1 he Middlesex County Council is the supervising authority under the Midwives Act. There are two midwives practicing in the district. CHEMICAL WORK. Through the courtesy of Dr. J. Tate, County Medical Officer, I have received the following return of work done during the year by the County Council Inspectors under the Sale of Food and Drugs Acts, in this district. List of Samples purchased in the District of Hayes during the year 1925 : — Article. No. Taken. Adulterated. Milk 41 1 Milk Separated 4 — 11 Butter 2 — Cream 1 — Cinnamon 1 — Cocoa 1 — Sweets 1 — Vinegar 1 — Total 52 1 Your Sanitary Inspector is also appointed Inspector under the Sale of Food and Drugs Acts. Twelve samples of milk were taken by him during the year, of which three were found not to be genuine. PUBLIC HEALTH OFFICERS OF THE LOCAL AUTHORITY. The Staff of the Public Health Department consists of one part time Medical Officer, and one whole time Sanitary Inspector, who is also designated Housing Inspector, Inspector of Canal Boats, Inspector under the Petroleum Acts, and Inspector under the Sale of Food and Drugs Acts. The inspection of Meat and Other Foods is carried out by the Sanitary Inspector, for which work he holds the necessary qualifications. Contributions to the salaries of these two officers are received under the Public Health Acts. The Council employs also one whole time Health Visitor. LIST OF ADOPTIVE ACTS, BYE-LAWS, AND LOCAL REGULATIONS RELATING TO PUBLIC HEALTH, IN FORCE IN THE DISTRICT, WITH DATE OF ADOPTION. Adoptive Acts. Infectious Disease (Prevention) Act, 1890 (April 1904). Public Health Acts Amendment Act, 1890 (April 1904). „ „ „ 1907, Parts 2, 3 & 4 (Feb. 2nd, 1916). Bye-laws and Regulations. (1) Regulations as to Dairies, Cowsheds and Milkshops (March 1st, 1910). (2) Bye-Laws with respect to Nuisances (June 24th, 1915). 12 (3) Bye-Laws with respect to Tents, Vans. Sheds, and similar Structures (April 3rd, 1922). (4) Bye-Laws as to Slaughterhouses (March 17th, 1925). (5) Bye-Laws as to New Streets and Buildings (October 16th, 1925). Sanitary Circumstances of the Area. WATER. The Rickmansworth and Uxbridge Valley Water Company have Parliamentary powers to supply water in the Hayes Urban area. 'Their mains, however, do not embrace the whole of the district, but where the public mains are laid the supply is satisfactory. From the junction of Coldharbour Lane with the main London to Oxford Road, eastward to the boundary of the district the only water supply available is from surface wells. Samples of water taken from these wells at varying periods of the year have repeatedly been certified as unfit for domestic purposes. As stated in my Report for last year the Water Company was approached with a view of providing a proper supply of water in this area, but their considered reply included a desire for the Hayes Council to construct water mains 1,200 yards in extent on each side of the road. At a date when the receipts from the rentals for three consecutive years showed a profit of 10 per cent. the Water Company were prepared to take over the mains. The Council could not of course entertain such a proposal. I consider that the absence of a safe water supply in this part of the district is matter of grave concern. RIVERS AND STREAMS. The River Crane, also known as Yeading Brook, which rises in the direction of Harrow, passes through the district and forms the north-eastern boundary for about 930 yards and the eastern boundary for about two miles. The effluents from the Sewage Disposal Works of Wealdstone, Harrow, and Ruislip are discharged into it, and these effluents form the greater part of the volume of the flow. The stream is always more or less polluted. 13 It is cleansed and maintained by the Middlesex County Council. The Grand Junction Canal Feeder, an artificially constructed water course, crosses the district and is used to convey water from the Company's Reservoir at Ruislip to the Canal to maintain the water level during summer months. The Grand Junction Canal is in the south part of the district, and the Paddington branch of this canal forms the eastern boundary for a distance of about 1,500 yards. There are numerous ditches and small watercourses throughout the district, all of which are more or less polluted and silted up. DRAINAGE AND SEWERAGE. With the exception of eighty houses all other premises in the district are connected to the sewers. The exceptions referred to are houses situated at Yeading, Hayes Gate, Charville Lane, and a number of isolated houses in the west part of the district. The cleansing of cesspools and pail closets is undertaken by the Council. In consequence of the flat nature of the district the whole of the sewage has to be lifted to the Disposal Works and this has necessitated the provision of eight Sewage Ejector Stations. They are adequate for the requirements of the district with the exception of the " Redleaf " Station, where in spite of installation of an auxiliary electrically driven pump, the plant is insufficient to meet all the demands made upon it during winter months, and when the slightest hitch occurs the sewers and house drains around that station become surcharged with sewage matter. I would impress upon the Council the need for pressing forward with the scheme in coure of preparation to provide additional pumping capacity for this part of the district. The sewage is treated at the Disposal Works situated in the south-east of the district near the Southall boundary. The process consists of passing the sewage through Precipitation Tanks, Percolating Filters, and Humus Tanks, the effluent being discharged into the River Crane. No complaints have been received as to the character of the effluent. The average daily flow is about 420,000 gallons. 14 CLOSET ACCOMMODATION. Every house connected with the sewer has a water closet provided with flushing apparatus. Of the eightv premises not connected with the sewer a number have water closets and the remainder pail closets of which, as previously mentioned, the Council undertake the cleansing. SCAVENGING. House Refuse is removed weekly from the whole of the District and disposed of by crude tipping at a spot remote from any dwelling. Portable galvanised iron ashbins are in use throughout the district. SANITARY INSPECTION OF AREA. 1.—COMPLAINTS. During the year one hundred and ten complaints were received with respect to the following matters, viz.:— Choked and defective drains 14 Insanitary or dilapidated condition of houses and premises 25 Defective Water Closets 1 Offensive accumulations 9 Offensive smells 4 Alleged overcrowding 8 Cesspools overflowing 13 Nuisances from Animals improperly kept 5 Smoke Nuisances a Non-removal of House Refuse 6 Defective Dust Bins 7 Verminous condition of premises 3 Insufficient Water supply 8 Defective Eaves, Gutters 1 Miscellaneous 4 Total 110 15 2.—INSPECTION OF DISTRICT. Number of houses and premises inspected (ordinary) 419 Number of houses inspected and particulars recorded (H.T.P. &c., A. 1909 & H.A. 1925) 108 Number of houses and premises re-inspected 617 ,, miscellaneous visits 372 ,, visits to works in progress 344 ,, food inspections 310 „ visits to slaughter-house 359 ,, visits to dairies, cowsheds and milkshops 42 ,, visits to bakehouses 13 „ visits to workshops and workplaces 18 ,, visits to factories 5 ,, visits to homeworkers premises 3 ,, visits re cases of infectious disease 43 „ smoke observations 66 „ drains examined 4 „ tested with water or smoke 3 Total 2,726 3.-NOTICES SERVED. Informal notices 254 Statutory notices under Section 36, Public Health Act, 1875, to provide a sufficient dust receptacle 56 Statutory notices under Section 94, Public Health Act, 1875, to abate nuisance 14 Statutory notices under Section 41, Public Health Act, 1875, or Section 45, Public Health Acts Amendments Act, 1907, to examine and test drains 2 Statutory notices under Section 41, Public Health Act, 1875, to re-lay drains 3 Statutory notices under Section 28, Housing, Town Planning, etc., Act, 1919, or Section 3, Housing Act, 1925, to make premises reasonably fit for human habitation 39 Statutory notices under Section 11, Housing Act, 1925, that a Closing Order had been made 2 Total 370 16 4.-SUMMARY OF SANITARY IMPROVEMENTS CARRIED OUT. DRAINAGE. Number of drains, examined, exposed, etc. 4 Drainage systems re-constructed 2 Additional drains provided 1 Defective drains unstopped, repaired, etc. 27 Manholes built, altered, or repaired 5 New gulleys provided 4 Intercepting traps fixed 2 Ventilating pipes fixed 3 WATER CLOSETS. Additional provided 5 Defective flushing cisterns renewed or repaired 7 Pans cleansed or repaired 12 Urinals re-constructed or repaired 5 Additional provided 1 W.C. apartment repaired, cleansed, etc. 9 GENERAL REPAIRS, ETC. Roofs repaired and made weatherproof 15 Eaves gutters repaired or renewed 10 Damp walls re-pointed or rendered damp-proof 29 Defective brickwork of external walls repaired 22 Defective floors, walls, etc., repaired 19 Defective doors repaired 10 Defective windows repaired or renewed 8 Rooms provided with permanent means of ventilation 3 Rooms cleansed 72 Defective stoves, coppers, etc., repaired 5 Sink waste pipes trapped or repaired 8 Defective water fittings repaired 14 Insufficient water supply increased 22 Defective yard pavings repaired 5 Yards cleansed 14 Offensive accumulations removed 20 Domestic cleansing enforced 19 17 Overcrowding abated 5 Nuisances arising from improper keeping of animals abated 8 New dust bins provided 142 Miscellaneous 17 SMOKE ABATEMENT. Observations are from time to time made as to the emission of black smoke from the chimneys of the various factories, and on four occasions during the year formal notices were served upon firms in the district requiring the abatement of a nuisance arising from this cause. PREMISES AND OCCUPATIONS WHICH CAN BE CONTROLLED BY BYE LAWS OR REGULATIONS. The process of Fish Frying has been declared to be an Offensivs Trade, but no Byelaws regulating the trade have yet been adopted. There are three fish fryers in the district; each has installed modern apparatus and no complaints have been received of any nuisance arising therefrom. There are no Common Lodging Houses in the district or any Underground Rooms used for Sleeping purposes. FACTORIES WORKSHOPS AND WORKPLACES. 1. — Inspection of Factories, Workshops and Workplaces. Premises. number of inspections written notices. occupiers prosecuted. Factories (Including Factory Laundries) 5 Workshops (Including Workshop Laundries) 11 3 Workplaces (Other than Outworkers premises) 7 1 Total 23 4 18 2. — Defects found in Factories, Workshops, and Workplaces. particulars. number of defects. number of offences in respect to which prosecutions were instituted. found. remedied referred to h.m. inspector. Nuisances under the Public Health Acts: Want of cleanliness 3 3 Want of ventilation Overcrowding Want of drainage of floors Other nuisances Sanitary accommodation Insufficient. 1 1 Unsuitable or defective. Not separate for sexes. Total 4 4 LEGAL PROCEEDINGS. Legal proceedings were taken in respect of the following cases. No. Nature of Offence. Result of Proceedings. 1 Failing to comply with a notice served under Section 94 of the Public Health Act, 1875, to abate a nuisance arising from overcrowding Order made to abate nuisance within 14 days. 2 Selling to the prejudice of the purchaser an article of food not of the nature, substance, and quality of the article demanded, i.e., milk to which 7% of water had been added Conviction recorded and defendant ordered to pay £4 4s. costs. 3 Selling to the prejudice of the purchaser an article of food not of the nature, substance, and quality of the article demanded, i.e., separated milk to which had been added 14.2 grains of boracic acid per gallon Conviction recorded and defendant ordered to pay £4 4s. costs. 19 Housing. (i) GENERAL HOUSING CONDITIONS IN THE AREA:— (1) General housing conditions: Satisfactory. (2) —(a) Extent of shortage or excess of houses, and Shortage, 726 of the Ministry's estimate of 2,078 houses have been erected. (b) Measures taken or contemplated to meet any shortage: No houses were erected by the Council during 1925, but preparations are being made whereby it is hoped to erect a further 100 houses during 1926. (3) Information as to any important changes in population during the period under review or anticipated in the future: No important change in population has occurred during the period under review, but in consequence of the large amount of employment afforded by the factories in the district, the number of would-be residents of Hayes is large. (ii) OVERCROWDING: — (1) Extent: The amount of overcrowding in the district is above the normal but is not excessive. (2) Causes: Insufficient housing accommodation. (3) Measures taken or contemplated for dealing with overcrowding; (a) As houses under tle control of the Council become vacant preference is given on re-letting to acute cases of over-crowding. (b) Preparations are being made for the erection of additional houses. (4) Principal cases of overcrowding during the year 1925, and action taken. Legal proceedings were taken during 1925 in one case of over-crowding. Houses were allotted to people from over-crowded areas. (iii) FITNESS OF HOUSES. (1) —(a) General standard of housing in the area ; and Fair. 20 (b) General character of the defects found to exist in unfit houses. Ordinary dilapidations. (c) How far defects are due to the lack of proper management and supervision by owners, or to acts of waste or neglect by tenants. Speaking generally owners are willing to remedy defects when requested to do so by the Sanitary Inspector, but there are a number of instances in which considerable expenditure has been incurred by owners, in consequence of lack of early attention to maintenance repairs. (2) General action taken as regards unfit houses under (a) the Public Health Acts: Notices served For action taken see "Action under Statutory Powers," A. and B. (b) the Housing Acts ; Notices served (3) Difficulties found in remedying unfitness, either under the Public Health Acts or under Section 3 of the Housing Act, 1925; special measures taken, or suggested, including, for example, any special action to secure improved management of property by owners, or better care of property by tenants; the gradual carrying out of repairs according to agreed arrangements; or any special method of dealing with unfit back to back houses, or other types of insanitary property. Difficulties have been experienced owing to the very low rentals obtaining in this district, but where repairs are considered necessary the Sanitary Inspector is always willing to discuss the matters with the owners on the premises. (4) Conditions, so far as they affect housing, as regards water supply, closet accommodation and refuse disposal, together with measures taken during the year in these matters. Satisfactory. 21 (iv) UNHEALTHY AREAS:— Information as to complaints received or representations made, and action taken, in regard to unhealthy areas. Nil. (v) BYELAWS RELATING TO HOUSES, TO HOUSES LET IN LODGINGS, AND TO TENTS, VANS, SHEDS, &c.:— (1) As to working of existing bye- Byelaws have been put into operation laws, and when necessary with satisfactory results. (2) As to need for new byelaws Nil. or revision of existing byelaws. (vi) GENERAL AND MISCELLANEOUS:-Nil. Housing Statistics for the Year 1925. Number of new houses erected during the year:— (a) Total (including numbers given separately under (b) 145 (b) With State assistance under the Housing Acts: (i) By the Local Authority Nil (ii) By other bodies or persons 109 1.-UNFIT DWELLING-HOUSES. Inspection:— (1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 378 (2) Number of dwelling-houses which were inspected and recorded under the Housing (Inspection of District) Regulations, 1910, or the Housing Consolidated Regulations, 1925 108 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 5 22 (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 267 2.—REMEDY OF DEFECTS WITHOUT SERVICE OF FORMAL NOTICES. Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 176 3.—ACTION UNDER STATUTORY POWERS. A. Proceedings under Section 28 of the Mousing, Town Planning, etc., Act, 1919, and Section 3 of the Housing Act, 1925 : (1) Number of dwelling-houses in respect of which notices were served requiring repairs 19 (2) Number of dwelling-houses which were rendered fit after service of informal notices: (a) By owners 9 (b) By Local Authority in default of owners 1 (3) Number of dwelling-houses in respect of which Closing Orders became operative in pursuance of notice by owners of intention to close Nil B. Proceedings under Public Health Acts: (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 47 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (a) By owners 41 (b) By Local Authority in default of owners 3 C. Proceedings under Sections 11, 14 and 15 of the Housing Act, 1925. (1) Number of representations made with a view to the making of Closing Orders 5 (2) Number of dwelling-houses in respect of which Closing Orders were made 3 (3) Number of dwelling-houses in respect of which Closing Orders were determined, the dwelling-houses having been rendered fit Nil 23 (4) Number of dwelling-houses in respect of which Demolition Orders were made Nil (5) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil Inspection and Supervision of Food. (a) MILK SUPPLY.—All the Dairies, Cowsheds and Milkshops in the district were visited at irregular periods during the year to ascertain if they were kept in a clean and satisfactory condition and in accordance with the Regulations. While some improvement has taken place in their general condition, the importance of properly cleansing the cows before milking and the removal of manure from the vicinity of the cowsheds is not yet fully realized by the majority of the Producers of Milk. (i) No inspection of dairy cattle by a Veterinary Inspector for the detection of tuberculous animals is undertaken by the Council. (ii) No milk to which any of the titles specified in the Milk (Special Designations) Order, 1923, is applied, is produced in the district, but such grades of milk are retailed in this area by a producer from a neighbouring district and by one firm of distributors to whom Supplementary Licences have been granted to sell milk to which the special designations "Certified," "Grade A (Tuberculin Tested)," and "Pasteurized" is applied. (iii) No refusal or revocation of registration of retailers has been made. One application to be registered as a Producer and Wholesale Purveyor of Milk was received during the year. One application was also received from a person residing outside the district, and two from persons residing in the district, to be registered as Retail Purveyors of Milk. There are now twenty-two persons registered in accordance with the Milk and Dairies (Amendment) Act, 1922, as follows:— Wholesale Traders or Producers of Milk 7 Retail Purveyors of Milk residing in the district 7 Retail Purveyors of Milk who reside outside the district but retail milk in the district 8 Total 22 24 (iv) No bacteriological examinations of graded or other milk have been made during the year. (b) MEAT.— (i) Meat inspection is carried out by the Sanitary Inspector, who holds the Special Diploma of the Royal Sanitary Institute for the work. He makes frequent visits to the slaughter-houses and has examined the carcases and organs of the majority of the animals slaughtered therein during the year. No system of marking inspected carcases has been adopted. The following is a list of the carcases and organs of diseased animals surrendered by the owners during the periodical visits to the slaughter-houses : Carcase and offal of a cow 448 lbs. Emaciation. Carcases and offal of pig 1,237 1bs. Tuberculosis. Carcase and offal of pig 165 lbs. Jaundice Carcases and offal of pig 235 lbs. Emaciation. Heads of pig 450 lbs. Tuberculosis. Offal of pig 310 lbs. Tuberculosis. Offal of pig 6 lbs. Cirrhosis. Offal of pig 56 lbs. Parasites. Lungs of pig 65 lbs. Pneumonia. Lungs of pig 56 lbs. Congestion. Total 3,028 lbs. (ii) Speaking generally, the Butchers have shown themselves willing to carry out the requirements of the Public Health (Meat) Regulations, 1924, and it has not been found necessary to institute any legal proceedings to enforce compliance therewith. (iii) There is no public slaughter-house in the district; the number of private slaughter-houses are as follows:— In 1920. In January, 1925. In December, 1925. Registered — — — Licenced 5 6 *5 'Total 5 6 5 *Three licenced without limit of time; two subject to an annual licence. 25 (c) OTHER FOODS. — There are three bakehouses in the district, all in a satisfactory condition, and these, together with shops of butchers, fishmongers, fruiterers, and other places where food is prepared, stored or exposed for sale have been frequently inspected. (d) FOOD POISONING.—No. cases of food poisoning have come under my notice. Prevention of, and Control over, Infectious Diseases. NOTIFIABLE DISEASES (OTHER THAN TUBERCULOSIS) DURING THE YEAR. disease. total cases notified. cases admitted to hospital. total deaths. Scarlet Fever 5 5 Nil Diphtheria 7 7 Nil Erysipelas 3 ... Nil  total cases notified. at ages. disease. Under 1 year. 1—2 2—3 3—4 4—5 5—10 10—15 15—20 20—35 35—45 45—65 65 and over. total deaths. Scarlet Fever ... ... ... 1 ... 2 ... ... 1 ... 1 ... Nil Diphtheria ... ... 1 1 1 ... 3 ... ... 1 ... ... Nil Erysipelas ... ... ... ... ... ... ... ... ... ... 3 ... Nil As will be seen from the accompanying tables the total number of cases of infectious disease, other than tuberculosis, notified annually since 1920 show a steady decrease. This decrease is all the more noteworthy when it is considered in conjunction with the rapid increase in the population, which according to the figures supplied by the Registrar-General, has grown from 6,000 inhabitants in 1920 to 8,859 in 1925. 26 I consider that the improved health of the district, as far as notifiable diseases are concerned, is due largely to the very great improvement that has taken place in the housing conditions, owing to the action of the Council in providing so many working-class houses, in closing and demolishing insanitary and worn-out dwellings and in improving generally the sanitary condition of the district. Year. Scarlet F kvkr. Diphtheria. Enteric Fever. Dysentery. Pnfumonia. Erysipei.as. mai.aria. Ophthalmia Neonatorum Pkurpf.kal Fever. Total. Population. 1920 52 11 ... 1 7 3 1 1 ... 76 6,000 1921 50 3 ... ... 4 ... 1 ... 58 6,303 1922 37 11 ... ... ... ... ... ... ... 48 6,777 1923 14 4 1 ... ... ... ... ... 1 20 7,419 1924 18 2 1 ... 3 ... ... ... ... 24 8,238 1925 5 7 ... ... ... 3 ... ... ... 15 8,859 The distribution over the district of cases of Infectious Disease notified during the years 1920 to 1925 is given below:— Year. South Ward. East Ward. West Ward. Total. 1920 33 13 / 30 76 1921 43 7 8 58 1922 22 17 9 48 1923 3 15 9 20 1924 12 10 2 24 1925 6 7 2 15 Total 119 69 53 241 27 Case rate of attack per 1,000 of the population of certain infectious diseases in this district and in England and Wales:— Case rate per 1,000 living Hayes. England & Wales. Small Pox — 0.14 Scarlet Fever 0.56 2.36 Diphtheria 0.78 1.23 Enteric Fever — 0.07 Puerperal Fever — 0.06 Erysipelas 0.36 0.39 Arrangements are made with the Clinical Research Association for the examination, at the expense of the Council, of pathological and bacteriological specimens forwarded to them by local Medical Practitioners. Forty such specimens were sent for examination during the year with the following results:— For Diphtheria 35 specimens 5 positive. For Tuberculosis 4 specimens 2 positive. For Typhoid Fever 2 specimens Both negative. Diphtheria anti-toxin is supplied by the Council free of charge to Medical Practitioners in the District. No use has been made of the tests known as the Schick and Dick tests in Diphtheria and Scarlet Fever respectively, or of the recently developed artificial methods of immunization against these diseases. There have been no " return " cases of Scarlet Fever. No vaccination or re vaccination has been done by me during the year. The cases of non-notifiable diseases occurring in the district were few. Two deaths were recorded as being caused by Influenza. Every house where a case of infectious disease was notified was visited by your Inspector, and full instructions given to the parents as to the necessary precautions to be taken. Disinfectants are freely supplied by the Council, and all infected houses are thoroughly sprayed and disinfected, and if desired bedding is also taken away and disinfected free of expense to the householder. 28 In cases where it has been considered necessary, owners of property have, on the request of the Public Health Department, had the walls and ceilings of infected rooms stripped and cleansed. TUBERCULOSIS. NEW CASES AND MORTALITY DURING 1925. TUBERCULOSIS. NEW CASES. DEATHS. AGE PERIODS. PULMONARY. NON-PULMONARY. PULMONARY. NON-PULMONARY. M. F. M. F. M. F. M. F. 0 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 5 ... ... 1 ... ... ... 1 ... 10 ... ... ... 1 ... ... ... ... 15 ... 1 ... ... ... ... ... ... 20 4 2 ... ... 1 ... ... ... 25 1 1 1 ... ... ... ... ... 35 2 ... ... ... ... ... ... ... 45 2 1 ... ... 3 ... ... ... 55 ... ... ... ... ... ... ... ... 65 and upwards. ... ... ... ... ... ... ... ... Total 9 5 2 1 4 ... 1 ... One of the deaths from Tuberculosis was of a case for which no notification was received. 29 No action has been taken under the Public Health (Prevention of Tuberculosis) Regulations, 1925, relating to tuberculous employees in the milk trade, or under the Public Health Act, 1925, Section 62, for the compulsory removal to hospital of persons saffering from tuberculosis. Appreciation and Thanks. In conclusion I desire to thank you, Mr. Chairman, and the Members of the Council, for the consideration and co-operation so readily extended at all times. To Mr. N. Bastable, your former Sanitary Inspector, and Mr. S. H. Franklin, your present Inspector, I am much indebted for their loyal and efficient work. To your Clerk and Surveyor, Mr. D. C. Fidler, and all the Members of the Staff, I am most grateful for help at all times most ungrudgingly given. I am, Mr. Chairman and Gentlemen, Your obedient servant, E. S. PHILLIPS. Medical Officer of Health.