AC 4413 (1) 1???SB 2Library KIN32 THE HEALTH OF THE ROYAL BOROUGH OF KINGSTON-UPON-THAMES SURREY 1958 THE ANNUAL REPORT of the Medical Officer of Health and the Chief Public Health Inspector PUBLIC HEALTH DEPARTMENT GUILDHALL KINGSTON-UPON-THAMES N& MAY, 1959 THE HEALTH OF THE ROYAL BOROUGH OF KINGSTON-UPON-THAMES SURREY 1958 THE ANNUAL REPORT of the Medical Officer of Health and the Chief Public Health Inspector PUBLIC HEALTH DEPARTMENT GUILDHALL KINGSTON-UPON-THAMES (Telephone No.: KINgston 2121) MAY, 1959 ANNUAL R E P 0 R T. 1958 TABLE OF CONTENTS. Page. Preface 1,2,3. Population 1 Births 1 Deaths 1 Causes of Death 2 Housing and rehousing 2 Clean Air Act 3 "Problem" Families and Social Reclamation 3 Constitution of Public Health Committee 4 Staff of Public Health Department 4 SECTION A. Statistics and Social Conditions„ (l) General Statistics 5 (2) Social Conditions 5,6. (3) Extracts from Vital Statistics of the Year 7 (a) Live Births 8 (b) Still birthS 8 (c) Total Live and Stillbirths 8 (d) Deaths 8 (i)Death Rate 8 (ii) Infant Deaths 8 (iii) Maternal Deaths 8 (e) Maternal Mortality Rate 8 Infant Mortality Rate 1954 - 1958 9 Quinquennial Infant Mortality Rate 9 Causes of Death of Children under 1 year 9 (iv) Deaths from Other Causes 10 Introduction to Tables on Vital Statistics 10 Table I — Extract from Vital Statistics for the years 1954-1958 11 Table II - Comparison of Vital Statistics 1929 — 1958 12 Table III - Causes of Death 13 SECTION B. General Provisions of Health Services. (1) (i) Laboratory Facilities 14 (ii) Hospitals:- (a) Infectious Diseases 14 (b) Smallpox 14 (c) General 14 (2) Health Services provided by other Authorities:- Surrey County Council - Health Department 15,16 Surrey County Council - Education Department 16 Surrey County Council - Welfare Department 17 Surrey County Council - Children's Department 17 Surrey Executive Council 17 (3) National Assistance Act, 1948) 17 National Assistance (Amendment) Act, 1951 ) 17 Page. SECTION C. Sanitary Circumstances. (l) Water Supply 18 (2) Drainage and Sewerage 18 (3) Rivers and Streams 18 (4) Closet Accommodation 18 (5) Public Cleansing 18 (6) Sanitary Inspection of the Area 18,19 (7) Shops 19 (8) Factories Act, 1937 20 (9) Camping Sites 21 (10) Atmospheric Pollution 21,22,23, 24,25. (11) Swimming Baths and Pools 26 (12) Eradication of Bed Bugs 26 (13 Complaints 26 (14) Rodent and Insect Pest Control 26,27. SECTION P. Housing. General 28 Statistical Statement, 1958 29 SECTION E. Inspection and Supervision of Food. (a) Milk Supply 30 (b) Designated Milks 30 (c) Bacteriological Examination of Milk 30 (d) ICe Cream 30 (e) Meat and Other Foods 31 (f) Food Hygiene - Food Hygiene Regulations 1955 32,33,34. Pood and Drugs Act, 1955 34 Tabulated Statement of Samples Submitted to the Public Analyst during 1958 35,36. Merchandise Marks Act, 1926 36 SECTION F. Infectious Diseases. Notifiable Diseases 37 Table IV. Notifiable Diseases during 1958 38 Table V. Comparative Statement of Notifications of certain Infectious Diseases 39 Smallpox 40 Scarlet Fever 40 Diphtheria 40 Poliomyelitis 4l Enteric Fever (Typhoid or Paratyphoid) 4l Dysentery 41 Measles 42 Whooping Cough 42 Ophthalmia Neonatorum 42 Puerperal Pyrexia 42 Pood Poisoning 42 Tuberculosis 43,44. Table VI Notified cases and Deaths from Tuberculosis in 1958 45 1 PREFACE TO THE MAYOR, ALDERMEN AND COUNCILLORS OF THE ROYAL BOROUGH OF KINGSTON-UPON-THAMES. ANNUAL REPORT. 1958. Mr. Mayor, Ladies and Gentlemen, I have the honour to present the Annual Report on the public health and social conditions of the Borough for 1958. The Report is on a similar pattern to that for previous years and follows the general lines indicated by the Minister of Health. The information is given on essential matters affecting the health of the people and the Report is in accordance with Ministry of Health Circular 22/58. I am indebted to Mr. G.C. Smith, Chief Public Health Inspector, with special reference to Sections C - E, and Mr. M.E. Powell, Administrative Officer, for assistance in compiling the Report, Population - The estimated mid 1958 home population given by the Registrar General is 38,800 an estimated increase of 210 persons compared with 1957. It is always necessary to draw attention to the fact that this figure relates to the resident population of the town and is used for the calculation of the statistical data now presented. The actual day population has been estimated to be about 300,000 persons who come to the town for business, education and recreation purposes. This is a special feature of the town which influences the volume of work and responsibility of the Corporation. Infectious Disease - The number of infectious disease notifications received in 1958 was 469, which is 195 less than in 1957, and is accounted for by a reduction in the number of cases of measles and whooping cough. Further progress was made in the active protection of the child population against diphtheria, whooping cough, tetanus, smallpox, tuberculosis and poliomyelitis. It has been a particular satisfaction to receive increasing supplies of poliomyelitis vaccine sufficient to forward a vigorous campaign of vaccination which is undoubtedly bringing us nearer the stage of "high" protection of the whole population. In general the health of the people was very good, and a high standard of hygiene was maintained. Births - The number of live births for 1958 is 536 and compares with 548 for 1957. The crude birth rate is 13.8 per 1,000 population compared with 14.2 for 1957. Deaths - The number of deaths recorded in 1958 is 434 compared with 432 for 1957. This makes a crude death rate of 11.2 which is the same as for 1957. The excess of births over deaths was 102 compared with 11.6 for the previous year. 2 The number of deaths of infants under 1 year of age in 1958 is 8 which gives an Infant Mortality rate per 1,000 live births of 14.9. The corresponding figures for 1557 were 7 infant deaths and an Infant Mortality rate of 12.8. The approximate average rate for the previous five years (1953-57) is 19. There were no maternal deaths (i.e. from pregnancy, childbirth, abortion). These rates are very satisfactory and are not likely to be bettered to any great degree in the future. Causes of Death - The main conditions causing death during 1958 were Heart Disease - 147, Cancer - 91 and Vascular Lesions of the Nervous System - 61. National attention has been drawn in recent years to the general increase in the number of deaths attributable to lung cancer and its possible association with cigarette smoking. The following table shows the relevant figures for the past five years in respect of Kingston residents. The Registrar General couples cancer of the lung with cancer of the bronchus in his abbreviated list of causes of death. 1954 1955 1956 1957 1958 M F M F M F M F M F 16 2 24 4 21 1 10 6 23 2 Total Total Total Total Total Deaths from cancer of the lung and bronchus 18 28 22 16 25 Housing and Rehousing. New houses provided by the Corporation during the year are reported to be 63 flats, all built within the Borough. In addition to this, 12 houses and 28 flats were built by private enterprise, giving a total of 103 new housing units in Kingston. Several families were assisted to be rehoused in new towns and the Corporation quota in respect of rehousing in Primley new town is to commence in 1959• Very few houses remain in the Borough which, by the present legal standard, may be classed as unfit. The next step forward is the improvement of older properties, which are structurally sound, by the provision of modern amenities such as baths, hot water supplies and W.Cs. inside the houses. Outside sanitation can no longer be considered adequate. In touching upon the problem of the housing of old people, consideration should be given to the provision by Local Authorities of a greater proportion of dwellings specially for the aged. It is not likely that private enterprise will enter this field, and it must be borne in mind that year by year the proportion of older people in the population is increasing and that there will be a continuing need for special accommodation. 3 Clean Air Act. Attention is now being given to the clearing of smoke and noxious matters from the air. The Clean Air Act can be implemented in stages until the whole town becomes a "smokeless" area. Every effort is needed to encourage householders to use smokeless fuel for all purposes, and where necessary to have fire places adapted for its use. We are subject to occasional fogs by the river and across the Ham area to Richmond Park. It would seem therefore that such areas should be vigorously tackled to make them smokeless zones so that no more "smogs" may occur in them. It is the "smog" which kills and causes a large amount of illness. Therefore if smoke which causes "smog" is removed immeasurable improvement will take place and reduction in deaths and illness and saving in cleaning will amply compensate for the time and trouble and cost of the work undertaken. "Problem" Families and Social Reclamation. One of the most difficult parts of the work of a Medical Officer of Health these days is to try and rehabilitate socalled problem families. The causes of failure in these families are many and usually a combination of several conditions lead to the degeneration, but unsuitable or inadequate housing is a large contributing factor. It will always be necessary for the Corporation to provide one or two houses for rehousing these large families. Those who have already been granted tenancies are being watched with great interest because already the more adequate accommodation has given the mother a chance to show what she can do and givesher back her confidence and self respect. It has also given the children suitable conditions in which to live and play. Father too can now take a pride in keeping up his decent home. This goes a long way towards preserving the family during the period of the growing up of the children which gives them in turn a better chance to learn to be successful parents in their time. I gladly record my thanks for the support and encouragement to me in my work, to The Worshipful The Mayor, Aldermen and Councillors. I specially record my appreciation of the understanding and help given by the Chairman of the Public Health Committee at all times to the Department. I also acknowledge my gratitude for the hard work and loyal support of the staff of the Public Health Department, and the unfailing co-operation and advice of my fellow Chief Officers. I have the honour to be, Your obedient Servant, J.W. STARKEY. Medical Officer of Health. Public Health Department, Guildhall, Kingston-upon-Thames. (Telephone No. Kingston 2121). 4 1958 ROYAL BOROUGH OF KINGSTON-UPON-THAMES. The Public Health Committee is responsible for the consideration of all questions affecting the health of the inhabitants of the Borough over which the Town Council may have jurisdiction. During the Municipal Year 1958-59 the Public Health Committee was constituted as follows:- Alderman Oldfield (Chairman) Councillor Evans " Knowlden (Vice-Chairman) " Marshall Councillor Judge (Mayor) " Prince " Alexander (Ex-Mayor) " Parker Alderman Lacey " Tapping " McDonald " Lees Councillor Eades " Wells STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health: J.W. STARKEY, M.B., Ch.B. (Edin.), D.P.H. Deputy Medical Officer of Health: (Part-time). W.H. KINSTRIE, M.B. , Ch.B. (Edin.), D.P.H. Chief Public Health Inspector: G.C. SMITH, F.R.S.H., M.A.P.H.I. (a)(b) Senior Additional Public Health Inspector: G. HOLMES, M.A.P.H.I. (resigned 10.3.58) (a) (b)(c) L. BURROWS, M.A.P.H.I.(appointed 1.5.58) (a)(b) Additional Public Health Inspectors: S.W. SIMPSON-SCOTT, M.R.S.H., M.A.P.H.I. (a)(b) M.G. TOMKINS, M.A.P.H.I.(resigned 17.6.58). (a)(b) K. APPLETON, A.R.S.H., M.A.P.H.I.(appointed 1.10.58). (a)(b) Junior Public Health Inspector: (vacant) Chief Clerk: M.E. POWELL, D.P.A. (Lond.) Clerical Staff: MISS C.L. FOISTER. MISS M.W. FILBEE. G. NORTHWOOD. H. SHARP (resigned 30.9.58). A. HYDE (appointed 29.9.58). Assistant Rodent Officer: F.W. STAGG. Rodent Operatives: G.H. LOCKE. F.J. PERRY. Disinfector/Driver: D. WILKINSON. (a) Certificate as Public Health Inspector. (b) Certificate as Meat and Foods Inspector. (c) Certificate as Smoke Inspector. 5 SECTION A STATISTICS AND SOCIAL CONDITIONS 1. General Statistics. Area in Acres 1,390 Total Population (including Service personnel 38,800 Number of inhabited houses (approx.) 11,695 Rateable Value - General Rate (1.4.58) £1,038,783 Sum represented by Penny Rate (Year 1958/59) £4,181 The total number of hereditaments is 14,232 of which 80% are domestic dwellings. There are 2,354 commercial premises in the town being 16% of the total hereditaments. The remaining premises totalling 425 are classified as industrial, entertainment, public utility, educational and miscellaneous. 2. Social Conditions. The Royal and Ancient Borough of Kingston-upon-Thames is a thriving market town situated in the County of Surrey on the bank of the river Thames, and in the Greater London area. The shopping centre provides the main economic function, but there is also an important industrial activity mainly in Aircraft and Engineering. Kingston is also a busy centre for education and recreation, and is to some extent a dormitory town for London business people. An outstanding factor influencing the social conditions is the fact of high employment and the Manager of the local Employment Exchange has kindly provided the following information regarding employment in Kingston and the surrounding districts. "In reviewing the employment situation in the area covered by the Kingston-upon-Thames Employment Exchange over the past year, it is worthy of note that despite the general worsening of the national employment position Kingston has been more fortunate. During 1958 demands for all classes of labour were maintained although in later months there was a decrease in the number of vacancies notified for men in unskilled and semi-skilled occupations. These demands were to a large degree satisfied except in certain categories of skilled engineering. During the year 4,897 men and women were placed in employment locally and 287 in other districts, compared with 4,662 and 283 in 1957. From these figures it will be seen that 239 more men and women were found jobs than during the previous year. In a year during which the word "recession" was increasingly heard this increase in numbers placed in employment is encouraging. We hope that 1959 will provide as many opportunities for placing people in work but at the end of 1958 there were indications that things might be more difficult in the coming year. Amongst these pointers were:- At the end of 1958 there were at the Exchange 170 fewer unfilled jobs available. 6 It is "becoming harder to place people who have poor records of employment or who have no trade or little useful experience at their command. More time and effort has to be spent by employment officers in finding suitable jobs for applicants. The ratio of unfilled vacancies to unemployed workers has fallen during the year from 1.8 to .8. Workers in many cases are now having to travel further afield for employment. Employers' order books are not so full for such long periods ahead as has been the case in recent years. There has been a gradual rise in unemployment during the year. With regard to the unemployment situation, there were at the end of 1958, 515 men and 95 women out of work compared with 380 and 89 respectively at the end of 1957. The figure for December, 1958, represents .68% of the insured population in the Kingston area and despite the increase over the previous year compares very favourably with the national percentage of 2.5. Local unemployment has risen very much more slowly than in the rest of the country. The aircraft industry has been busy throughout the year and the labour force has increased by some 32%. Workers have been brought from beyond daily travelling distance and many of these have qualified for the receipt of travelling and lodging allowances paid by the Ministry of Labour. There has been difficulty in finding accommodation for these transferred workers and the cost of lodgings has averaged about £4. 4. Od per week. In the newer fields of electronics and plastics the area is fortunate in having a variety of these developing industries which during 1958 maintained a high level of employment. Employment in the Distributive Trades during 1958 has been good because Kingston continues to be the major shopping town for this part of Surrey. Efforts to resettle members of H.M. Forces who are retiring both prematurely and normally were intensified. The co-operation of employers in providing employment opportunities for these men and women has been sought in a special appeal made by Lord de Lisle and Dudley in his capacity as Chairman of the London and South-Eastern Resettlement Board. The year 1958 has, on the whole, been quite good for Kingston in so far as employment is concerned, particularly when the picture is looked at as part of the wider national canvas. If the year concluded with a stronger feeling of caution and perhaps some apprehension it is but a reflection of the general economic situation which, it is hoped, may improve during 1959•" 7 3. Extracts from Vital Statistics of the Year. The crude birth and death rates for local areas cannot properly be compared by reason of the fact that the populations on which they are based may be of widely differing sex and age constitutions. Consequently the Registrar General provides a comparability factor for each area. When the crude rate of any area is multiplied by this factor an adjusted rate is produced which can be used to compare with the adjusted rate of any other area, or with the crude rate for England and Wales as a whole (where the comparability factor is unity). The comparability factors for Kingston-upon-Thames are Births 0.96; Deaths 0.92. The birth and death rates in respect of the town are shown overleaf and for the purpose of providing some comparison the rates for England and Wales are also shown. It will be noticed that the rates for Kingston-upon-Thames are lower than for the country as a whole. 8 (a) Live Births - Total Male Female Legitimate 506 244 262 Illegitimate 30 17 13 536 261 275 Live Birth Rate Per 1,000 population 13.8 Adjusted Birth Rate 13.2 England and Wales Live Birth Rate 16.4 Illegitimate Live Births per cent of total Live Births 5.6 (b) Stillbirths - Total Male Female Legitimate 14 8 6 Illegitimate 1 1 - 15 9 6 Rate per 1,000 total Live and Stillbiths 27.2 England and Wales Stillbirth Rate 21.6 (c) Total Live and Stillbirths - Total Male Female Legitimate 520 252 268 Illegitimate 31 18 13 551 270 281 (d) Deaths - Total Male Female 434 228 206 (i)Death Rate per 1,000 population 11.2 Adjusted Death Rate 10.3 England and Wales Death Rate 11.7 (ii) * Infant Deaths Total No. of Deaths 8 Infant Mortality Rate per 1.000 Live Births 14.9 Infant Mortality Rate per 1.000 Live Births:- Legitimate 15.8 Illegitimate Nil Infant Mortality Rate for England and Wales 22.5 ** Neo Natal Mortality Rate per 1,000 Live Births. 9.3 (iii)Matenal Deaths(including abortion) total Nil (e) Maternal Mortality Rate per 1,000 Live and Stillbirths Nil * Under 1 year of age. ** Under 4 weeks of age. 9 The approximate infant mortality rate for 1958 and the rates since 1954 are shown for purposes of comparison. 1954 1955 1956 1957 1958 Kingston-upon-Thames 20 15 24 13 15 England and Wales 25 25 24 23 22 It will be seen from the following figures that since the war ended the Quinquennial Infant Mortality Rate was more than halved by 1950, and has since dropped even further. Period Infant Mortality Rate 1921 - 1925 69 1926 - 1930 56 1931 - 1935 56 1936 - 1940 k6 1941 - 1945 52 1946 - 1950 25 1951 - 1955 21 The following are the numbers in age groups of Kingstonupon-Thames children who died during 1958 before reaching the age of one year, together with the cause of death. Age Total Deaths Acute Bronchitis Broncho Pneumonia Prematurity Bilateral Cerebral Haemorrhage 0 - 24 hours. 4 — — 3 1 24 hrs. - 1 mth. 1 - - 1 - 1 mth. - 1 yr. 3 1 2 - - Totals 8 1 2 4 1 10 (iv) Deaths from Other Causes. No. of Deaths Deaths from Heart Disease 147 Deaths from Cancer 91 Deaths from Vascular Lesions of the Nervous System 6l Deaths from Circulatory Disease other than Heart 32 Deaths from Bronchitis 24 Deaths from Pneumonia 16 Deaths from Influenza 1 The following tables I, II, III summarise certain vital statistics. Table I shows the figures for live "births, stillbirths, and deaths for the years 1954-1958 inclusive. The figures in Table II are the Registrar General's estimates for successive years since 1929. They give the population, number of live births, birth rate per 1,000 population, number of deaths, the death rate per 1,000 population, and also the infant mortality rate per 1,000 live births of Kingston-upon-Thames and England and Wales. The trend of the estimated population figure is to remain just below 4O,OOO. The causes of deaths shown in Table III are in accordance with the 36 headings based on the Abbreviated List of the International Statistical Classification of Diseases, Injuries and Causes of Death. EXTRACT FROM VITAL STATISTICS FOR YEARS 1954-1958 INCLUSIVE. TABLE I. 1954 1955 1956 1957 1958 Total M. F. Total M. F. Total M. F. Total M. F. Total M. F. LIVE BIRTHS Legitimate 498 246 252 491 253 238 508 260 248 509 245 264 506 244 262 Illegitimate 36 22 14 52 23 29 42 21 21 39 17 22 30 _ 17 13 534 268 266 5k3 276 267 550 281 269 548 262 286 536 261 275 Birth rate (R.G.) per 1,000 pop. 13.6 13.9 l4.2 14.2 13.8 STILLBIRTHS Legitimate 13 4 9 8 3 5 10 4 6 8 3 5 14 8 6 Illegitimate 2 1 1 — - - 2 2 - — — — 1 1 — 15 5 10 8 3 5 12 6 6 8 3 5 15 9 6 Rate per 1,000 (live and stillbirths) 29.1 14.5 21.4 14.4 21.2 DEATHS 450 206 2kk k2k 212 212 442 214 228 432 202 230 434 228 206 Death rate (R.G.) per 1,000 pop. 11.5 10.9 11.4 11.2 11.2 11 I 12 COMPARISON OP VITAL STATISTICS 1929 - 1958. TABLE II. Year Estimated Population Live Births Birth Rate per 1,000 Population Deaths Death Rate per 1,000 Population Infantile Mortality Rate per 1,000 live births Kingston upon Thames England and Wales 1929 38760 556 14.3 517 13.4 56 74 1930 38760 553 14.3 423 11.0 43 60 1931 39052 489 12.6 493 12.8 57 66 1932 38250 450 11.8 480 12.5 60 65 1933 38690 470 12.2 464 12.0 59 64 1934 38270 470 12.3 422 11.0 45 59 1935 39030 510 13.0 482 12.3 57 57 1936 39880 573 14.4 502 12.6 52 59 1937 39850 539 13.5 540 13.6 52 58 1938 39790 528 13.2 468 11.8 43 53 1939 39970 533 13.3 450 11.4 28 50 1940 37430 519 13.9 659 17.6 55 55 1941 35970 520 14.5 525 14.6 57 59 1942 36090 551 15.3 491 13.6 63 49 1943 35900 637 17.8 500 13.9 48 49 1944 34780 578 16.6 474 13.6 48 46 1945 35760 593 16.6 505 14.1 43 46 1946 39670 794 20.0 460 11.6 29 43 1947 40780 870 21.3 495 12.1 22 41 1948 40780 722 17.7 455 11.2 23 34 1949 40660 729 17.9 500 12.3 20 32 1950 41950 619 14.8 492 11.7 30 30 1951 39920 574 14.4 556 13.9 24 29 1952 39990 576 14.4 499 12.5 24 27 1953 39940 609 15.3 465 11.6 24 26 1954 39160 534 13.6 450 11.5 20 25 1955 39070 543 13.9 424 10.9 15 25 1956 38790 550 14.2 442 11.4 24 24 1957 38590 548 14.2 432 11.2 13 23 1958 38800 536 13.8 434 11.2 15 22 13 TABLE III Causes of Death Registrar General's Tables 1951 1955 1956 1957 1958 M F M F M F M F M F All Causes 206 244 212 212 214 228 202 230 228 206 Tuberculosis, respiratory 3 6 — 2 — 5 1 2 — Tuberculosis, other 1 — — — — — — 1 1 2 Syphilitic disease - - 1 — 1 — — 2 — — Diphtheria - - - - — — — - — — Whooping cough — — — — — — — — — — Meningococcal infections. — — — — — — — — — — Acute poliomyelitis — — — — — — — — — — Measles - — — — — — — — — — Other infective and parasitic diseases 1 1 1 2 1 1 2 Malignant neoplasm, stomach 2 3 — 6 4 5 3 7 9 5 Malignant neoplasm, lung, bronchus 16 2 24 4 21 1 10 6 23 2 Malignant neoplasm, uterus. — 1 3 — 4 — 5 — 6 Malignant neoplasm,breast — 6 — 5 — 12 — 7 — 5 Other malignant and lymphatic neoplasms 22 20 27 16 19 29 19 19 20 21 Leukaemia, aleukaemia — 1 3 1 1 — — 3 — 1 Diabetes 1 1 — 3 1 2 1 — 3 1 Vascular lesions of the nervous system 21 45 25 46 22 39 24 50 19 42 Coronary disease, angina. 34 28 44 22 43 26 43 25 49 32 Hypertension with heart disease 6 10 1 6 2 7 5 6 9 4 Other heart disease 18 34 12 35 18 26 17 25 20 33 Other circulatory disease 17 20 12 21 8 19 11 15 19 13 Influenza. 1 1 — 2 1 2 — 6 — 1 Pneumonia. 9 14 9 12 9 8 9 11 10 6 Bronchitis 15 9 17 6 16 9 24 12 19 5 Other diseases of respiratory system. 2 7 — — 3 — 4 1 2 6 Ulcer of stomach and duodenum 3 1 3 — 8 1 — — — — Gastritis, enteritis, and diarrhoea — 3 1 3 1 — — 1 — 1. Nephritis and nephrosis 4 2 1 — 2 — 5 2 — — Hyperplasia of prostate 5 - 2 - 4 — 3 — 1 — Pregnancy, childbirth, abortion. — — — 1 — 2 — — — — Congenital malformations 4 1 3 1 3 3 3 3 1 1 Other defined and illdefined diseases 16 21 8 10 17 23 11 15 12 10 Motor vehicle accidents 4 — 2 1 2 — 1 3 4 — All other accidents 3 — 2 5 2 4 2 3 3 5 Suicide 1 5 4 2 2 5 1 2 2 Homicide and operations of war 1 1 — — — — — 1 — — 14 SECTION B GENERAL PROVISIONS OF HEALTH SERVICES 1. (i) Laboratory Facilities. Bacteriological examinations are carried out by Dr. D.S. Murray at the Laboratory, 37, Coombe Road, as part of a pathological service administered by the South West Metropolitan Regional Hospital Board, In addition, the Ministry of Health Public Health Laboratory at Epsom is available for consultations and, if the occasion should arise, for help in the investigation of any important outbreaks of disease. Special thanks are due to Dr. D.S. Murray at Kingston Hospital Laboratory, and Dr. D.M. Stone of the Public Health Laboratory at Epsom for their assistance in dealing with a large number of specimens in connection with sonne dysentery. There are also occasions on which special use is made of the services of the Public Analyst in chemical sampling which may become necessary in the interests of public health. Bacteriological examinations of milk are undertaken by the Public Health Laboratory, Epsom, and samples under the Food and Drugs Acts are submitted to the Public Analyst, Mr. D.D. Moir, at the Analytical Laboratory, Southwark Street, S.E.1. (ii) Hospitals. (a) Infectious Diseases. The South West Metropolitan Regional Hospital Board is responsible for the provision of beds for cases of infectious disease. Patients are admitted directly to Tolworth Isolation Hospital, which is directed by the Physician Superintendent of Kingston Hospital. During the year 68 cases of infectious disease were treated in hospital, but 60 of these had been already notified from Kingston Hospital and related to puerperal pyrexia. To Kingston Hospital 62 "Tolworth Isolation Hospital, Surbiton. 6 (b) Smallpox. Arrangements are in being whereby any case of smallpox or suspected smallpox can be transported by the London County Council Ambulance Service to special isolation. (Telephone Whitehall 2177, or Waterloo 3311). (c) General. The main General Hospital situated in the Borough available for the district is the Kingston Hospital, Wolverton Avenue, Kingston-upon-Thames (Telephone - Kingston 5692). This is a large comprehensive hospital with a full range of general and special departments. It has also busy and highly organised out-patient departments fully supported to meet all surgical, medical, and psychological emergencies. 15 2. Health Services provided by other Authorities. The Medical Officer of Health is the Divisional Medical Officer responsible for the personal health services administered by the Surrey County Council. Surrey County Council - Health Department. The County Council which is the Local Health Authority under the National Health Service Acts 1946, provides the following services in the Borough (a) Ante-natal and Post-Natal Clinics. Health Centre, Grange Road. Wednesday afternoon. (b) Infant Welfare Clinics. Health Centre. (Kingston 7261) Tuesday and Friday afternoons. Queen's Road Clinic, Monday and Thursday 27, Queen's Road. (Kingston 5812) afternoons. (c) Immunisation and Vaccination Clinics. Health Centre. Friday afternoon. Queen's Road Clinic. Friday forenoon. (d) Dental Clinics. Health Centre. Daily. "Keeldar",25, Queen's Road. Daily by (Orthodontic only). ment. (e) Day Nursery. Approved 53-55, Canbury Park Road. dation 46 places. This day nursery admits children aged 0-5 years and a small charge is made for the care of the children. (f) Midwifery Service. Certified midwives are employed for attendance as midwives or maternity nurses at domiciliary confinements. (g) Home Nursing. This is undertaken by nurses of the Queen's Institute of District Nursing® Where nursing equipment is required for use in the home, arrangements have been made for this to be supplied on loan through the British Red Cross Society, at the B.R.C.S., H.Q.p 73, Penrhyn Road,Kingston-upon-Thames, (Kingston 5072). (h) Health Visitors. Health Visitors who also act as school nurses work in the clinics and also do home visiting. Their work is largely educational and socials, and is defined in the Act as "giving advice as to the care of young children^ persons suffering from illness- and expectant and nursing mothers; and as to the Measures necessary to prevent the spread of infection." 16 (i) Home Helps. Home Helps are employed to provide domestic help for households "where such help is required owing to the presence of any person who is ill, lying-in, an expectant mother, mentally defective, aged, or a child not over compulsory school age." A charge is made for this service but in assessing what the charge should be consideration is given to the means of the persons concerned. (j) Prevention of Illness,Care and After-Care. The care and after-care of tuberculous persons is dealt with by the Care Almoner at the Chest Clinic, Queen's Road, Kingston-upon-Thames. Among other things, the County Council scheme provides for the admission of persons, not in need of medical or nursing care, to recuperative holiday homes and for this a charge is made according to the person's circumstances. (k) Mental Health. This service provides for the ascertainment of cases of mental ill-health and mental deficiency, the statutory supervision and guardianship of mental defectives living in the community, and the provision of after-care for persons who have undergone treatment for mental illness. The office of the Mental Welfare (Duly Authorised) Officer for the Borough is at 35, Coombe Road, Kingston-upon-Thames, (Kingston 3302). Surrey County Council - Education Department. The School Health Service is staffed by the County Health Department and provides the following services:- (a) Routine medical inspection of pupil3. (b) Cleanliness surveys of pupils. (c) Dental inspection of pupils. (d) Ascertainment of handicapped pupils in need of special education. (e) Treatment clinics as under:- (i) Minor Ailments. Health Centre. Daily, 9-10 a.m. Queen's Road Clinic. Daily, 9-10 a.m. (ii) Medical Consultation. Health Centre. Monday forenoon. Queen's Road Clinic. Friday afternoon. (iii) Eye Clinic. Health Centre. Thursdays, from 10 a.m. by appointment. (iv) Dental Clinic. (See under Health) Immunisation Clinic. ( Department ) (v) Child Guidance Clinic. Cases referred to clinic at "Roselands", Kingston Road, New Maiden. (vi) Speech Therapy. Health Centre. Mondays and Thursdays by appointment. ] 7 Surrey County Council - Welfare Department. This service is concerned with the welfare of aged, physically and mentally infirm, blind and partially sighted, deaf and dumb, epileptic and crippled persons and the provision of temporary accommodation for persons in urgent need thereofo The address of the Welfare Officer for the Borough is 35, Coombe Road, Kingston-upon-Thames, (Kingston 4402). Surrey County Council - Children's Department. This Department discharges responsibility for the welfare of children who have been deprived of a normal home life. It has important functions in connection with child life protection and adoption and deals with children taken into or committed to the care of the County Council, supervision of foster children, child neglect etc. The Children's Officer for the Borough works from the County Hall, Penrhyn Road, Kingston-upon-Thames. Surrey Executive Council. This body is responsible for the provision under the National Health Service Act of the general practitioner, dental (other than Local Health Authority provision for expectant and nursing mothers, young children), pharmaceutical and supplementary ophthalmic services. The headquarters of the Council is at 187Ewell Road, Surbiton, Surrey, (Elmbridge 5723). 3. National Assistance Act 1948. National Assistance (Amendment) Act. 1951. Under Section hi of the 1948 Act, a Local Authority is empowered to apply to a Court of Summary Jurisdiction, to have removed to suitable premises, persons in need of care and attention. The 1951 Act enables Local Authorities to deal more speedily with very urgent cases by initial removal, for a period not exceeding three weeks. It was not necessary to use these powers in respect of any person resident within the Borough during 1958. There is a close co-operation between the Physician Superintendent of Kingston Hospital, the Welfare Officer, local Doctors, and your Medical Officer of Health. The Superintendent of Kingston Hospital is assisted by Geriatrician and Geriatric Health Visitor and your Medical Officer of Health, in his capacity of Divisional Medical Officer for the North Central Division of the Surrey County Council, acts as co-ordinating officer between all the centrally, locally and voluntarily administered services in the towne Every effort is made (a) to ensure that no old person who is in need of care and attention is unknown to the Health Department, and (b) to maintain regular visiting, domiciliary help, medical attention and etc., to all known geriatric cases. 18 SECTION C. SANITARY CIRCUMSTANCES. 1, WATER SUPPLY. The town's water supply is provided by the Metropolitan Water Board who successfully maintain constant supervision over the purity and adequacy of the supply. Well water is used for industrial purposes at certain factories,but is not used as a domestic supply, all the houses in the town being provided with a main water supply0 2. DRAINAGE AND SEWERAGE. The sewage from the Borough gravitates to the Corporation Pumping Station and is then pumped to the Hogsmill Valley Joint Sewerage Board's Works for treatment. 3o RIVERS AND STREAMS. The River Thames forms the Western Boundary of the Borough and is Tinder the control of the Thames Conservancy Board. The Hogsmill River. a tributary of the Thames, flows through the Borough. The Works of the Hogsmill Valley Joint Sewerage Board have been completed and the plant is now in full operation, These Works receive the sewage from the Boroughs of Epsom & Ewell, Maiden & Coombe, Surbiton and Kingston~upon~Thames and the effluents, together with storm water overflowsp is discharged into the Hogsmill River. In consequence its flow is increased. 4. CLOSET ACCOMMODATION. All closets in connection with dwelling houses in the Borough are on the water carriage system. 5. PUBLIC CLEANSING. The Borough Surveyor is responsible for the collection and disposal of house and trade refuse. Disposal is still carried out by tipping into a worked out gravel pit provided by the haulage contractor. The refuse from this Borough, Surbiton and Maiden is transferred to large capacity road vehicles and transported to the tip by the contractor. The refuse is now weighed on a weighbridge and 36,814 tons of refuse have been sent from this Borough in 1958„ The Corporation's refuse destructor has not operated since 1st March 1951. 6. SANITARY INSPECTION OF THE AREA. The following is a tabulated list of visits and inspections made by the Public Health Inspectors which totalled 8,095 as compared with 10,450 for 1957. The lower figure for the current year is accounted for by the long periods when the staffing of the department was below establishment due to the vacancies. 19 House inspections, defects, etc 429 Drainage439 Factories 81 Outworkers 9 Atmospheric Pollution 164 Dairies, Milk Shops, etc. 178 Restaurants and cafes 276 Other Food Premises 753 Infectious Disease Inquiries 951 Theatres and cinemas 3 Verminous Premises 47 Rodent Control = 43 Shops ACt 176 Schools 22 Housing Act 88 Markets 688 Public Sanitary Conveniences 55 Fireguards 63 Merchandise Marks Act 148 Interviews 46l Miscellaneous 940 6,014 Reinspections and works in progress 2,081 8,095 NOTICES SERVED. Informal. (a) Verbal 53 (b) Written 216 Statutory. (a) Housing Acts 1 (b) Public Health Acts 17 NOTICES COMPLIED WITH. Informal. (a) Verbal 228 (b)Written 8 Statutory. Public Health Acts 8 7. SHOPS. There are 981 shops in the Borough and inspections are made with regard to those provisions of the Shops Act, 1950 which are concerned with sanitary accommodation, washing facilities, heating, lighting and ventilation. Where plans are submitted of new construction or alteration to shop premises, due consideration is given to ensure that the proposals comply with the provisions of the statute. The Public Health Inspectors are also responsible for the administration of the law relating to shop hours, including early closing and Sunday trading. 20 8. FACTORIES ACT. 1937. The following are the particulars required to he furnished to the Ministry of Labour and National Service respecting matters dealt with by the Corporation under Parts I and VIII of the Factories Act. PART I OF THE ACT, 1. INSPECTIONS. Premises No. on Register Number of Inspections Written Notices Prosecutions Factories in which Sec. 1,2,3,4 & 6 are enforced by the Corporation 70 3 — — Factories not included above in which Sec. 7 is enforced by the Corporation 283 67 3 — Other premises excluding Outworkers 13 65 - • 2. CASES IN WHICH DEFECTS WERE FOUND. No. of cases in which defects found Found Remedied Referred No. of Prosecutions To H.M. Inspector By H.M. Inspector Want of Cleanliness 1 3 - - - Overcrowding — — — — — Unreasonable Temperature - — - - - Inadequate Ventilation 1 - - - — Ineffective drainage of floors - - - - - Sanitary Conveniences - (a) Insufficient - - - — - (b) Unsuitable or defective - 2 - - - (c) Not separate for sexes - 2 - - - Others 1 6 — — — 21 PART VIII OF THE ACT, Outwork. The following table gives details of work which is carried on in private dwelling houses, The conditions obtaining have been found to be satisfactory. Nature of Work No. of Outworkers Wearing apparel Making etc. 5 Cardboard Boxes 1 Puses 1 Brass Articles 8 15 9. CAMPING SITES. There are no camping sites within the Borough. A licence was granted for a caravan to be stationed at the rear of one of the stores in the town. The applicants, however, obtained other accommodation and the vehicle was not, in fact, put in position,, 10, ATMOSPHERIC POLLUTION. During the year 20 complaints were received in respect of smoke or grit emission. These complaints, in the main, related to one particular installation. Whilst the plant in this case could be improved, the prime cause for the nuisance was to a large extent due to the inefficient manner in which the plant was operated. Advice was given and demonstrations made by members of the staff in an effort to bring about an improvement. In this part of the country there is a shortage of skilled stokers and at the present time it is obvious that a man with the skill and intelligence to carry out stoking properly can obtain a more lucrative and congenial occupation elsewhere. The difficulty in recruiting skilled staff and the problem of obtaining a regular supply of suitable coal have together been good reasons for the conversion of practically all the industrial plants in the district to oil firing. In the domestic field much could be done to provide adequate supplies of suitable types of smokeless fuel and improvements could also be brought about by the replacement of obsolete and inefficient firegrates with more modem appliances. In many instances the cost of conversion could be recovered in some measure by the consequent saving in fuel consumption. With regard to the recording of atmospheric pollution, instructions were given for the installation of an instrument for the recording of smoke and sulphur dioxide by the volumetric method. The advantage of this instrument over the deposit gauge is that it is possible to obtain daily readings of pollution and to observe more closely the effects of weather conditions on the state of the atmosphere. The instrument which is installed on the roof of the Guildhall was in operation for the whole year. The following table and graph indicate the results obtained. Smoke is expressed in milligrams per .100 cubic metres and the sulphur dioxide in parts per 100 million. 22 23 Month Smoke S02 Monthly Average Highest Value Lowest Value Monthly Average Highest Value Lowest Value January * ll.2 32.6 l.3 5.1 19.0 0.9 February 7.5 22.5 0.9 3.8 10.7 0.4 March 10.l 21.3 2.2 6.2 15.8 1.2 April 7.0 13.4 1.0 4.3 8.1 0.5 May l.7 5.2 0.2 0.9 3.1 0.3 June l.4 6.8 0.4 1.1 3.9 0.1 July 1.7 5.0 0.1 0.9 4.1 0.1 August 1.8 7.1 0.2 0.9 2.3 0.2 September 3.7 9.9 0.4 l.9 6.2 0.1 October 7.9 32.3 l.0 3.8 12.9 0.4 November 18.1 35.1 5.3 lO.l 19.3 1.4 December 14.1 28.7 1.8 7.3 15.9 1.2 * Smoke=30 days S.02=25 days. In addition to the instrument previously referred to, the Corporation maintains two deposit gauges which were located, after consultation with the Department of Scientific and Industrial Research, in Canbury Gardens and Tiffin Girls' School respectively. They are, for the purposes of report, referred to as 'A' and 'B'. The following tables give the results of analysis, together with rainfall and wind readings. The figures are from observations made to show the effect when the prevailing wind was blowing from industrial sources towards the recording stations. With regard to the figure for June in respect of the instrument at Canbury Gardens, this was exceptional and was thought to be due to the dislodgment of a portion of solid matter from the chimney of the Power Station. The high reading for this instrument was essentially local in character and no corresponding increase was recorded in the other gauges in the district. For this reason the figure has not been included in calculating the totals and averages. 2 4 CANBURY GARDENS - Station 'A'. 1958 Deposit in Tons per sq. mile Wind Direction Rainfall in Inches Insoluble Solids Soluble Solids Total Solids No. of Observations No. of times SE-SW January 4.71 3.69 8.40 26 11 1.18 February 8.80 11.92 20.72 24 11 2.24 March 9.82 5.01 14.83 25 6 1.07 April 5.96 3.66 9.62 23 6 1.17 May 12.36 5.82 18.18 25 18 2.25 *June 34.81 92.22 127.53 25 10 4.37 July 10.43 4.20 14.63 26 11 1.61 August 11.01 6.13 17.14 24 18 3.63 September 11.92 11.04 22.96 25 10 4.23 October 9.50 10.74 20.24 26 15 2.65 November 4.03 3.56 7.59 25 8 1.72 December 12.93 7.l8 20.11 26 12 2.64 Totals 101.47 72.95 174.42 – – 28.76 Average 1958 9.22 6.63 15.86 – – 2.40 Average 1957 12.51 6.57 19.08 – – 2.15 * See text. TIFFIN GIRLS' SCHOOL - Station 'B'. 1958 Deposit in Tons per sq. mile Wind Direction Rainfall in Inches Insoluble Solids Soluble Solids Total Solids No. of Observations No. of times SE-SW January 2.76 3.55 6.31 26 11 1.10 February 3.85 10.35 14.20 24 11 l.73 March 4.48 5.11 9.59 25 6 0.98 April 3.25 3.49 6.74 23 6 1.03 May 5.14 4.98 10.12 25 18 2.40 June 4.28 8.50 12.78 25 10 4.83 July 3.12 2.79 5.91 26 11 l.53 August 3.52 3.88 7.40 24 18 3.74 September 4.02 5.81 9.83 25 10 4.07 October 4.48 4.25 8.73 26 15 2.52 November 2.22 3.2 5.34 25 8 1.73 December 8.13 7.94 16.07 26 12 2.56 Totals 49.25 63.77 113.02 – – 28.22 Average 1958 4.10 5.31 9.42 – – 2.35 Average _ 1957 4.34 4.61 8.95 – – 1.70 25 The following additional table, illustrated with a graph, is of interest in showing the trend of atmospheric pollution over the years. Average Monthly Deposit-Total Solids, Tons per Sq. Mile. Year Station A. Canbury Gardens Station B. Tiffin Girls. School 1948 28.38 (7/12) – 1949 20.41 – 1950 22.17 14.98 (6/12) 1951 22.19 12.47 1952 19.12 12.49 1953 17.58 10.32 1954 18.70 10.21 1955 15.85 9.13 (11/12) 1956 19.00 9.95 1957 19.08 8.95 1958 15.86 (11/12) 9.42 28 11. SWIMMING BATHS AND POOLS. (a) Public –The Corporation swimming baths are situate in Denmark Road and comprise two pools, one of which is in use throughout the year whilst the other is used for swimming during the summer months and in the winter season is converted for use as a hall for concerts, dancing, etc. The pools are equipped with pressure filters capable of treating the water of both pools every 3½ hours during bathing periods. In hot weather the filters are working continuously day and night. Chlorination is marginal and the residual quantity is maintained at the deep end of the baths with a maximum of 0.6 parts per million available chlorine. (b) Private–There are no privately owned swimming baths or pools open to the public in the Borough. 12. ERADICATION OP BED BUGS. During the year 21 premises were disinfected. Seven of these were houses under the control of the Corporation. 13. COMPLAINTS. The number of complaints received from the general public during the year was 424 compared with 429 for the previous year. The highest number of complaints recorded was 920 in 1947 and, with the exception of the year 1953. the figures recorded have shown a steady decline. The following is a brief tabulated list of causes for complaints received during 1958:– Sanitary defects 118 Rodents 127 Drains and sanitary arrangements 60 Overcrowding 6 Food 37 Nuisance from Smoke 20 Defective Yards and Paving 3 Insect Pests 19 Accumulations 3 Animals 4 Water 2 Others 25 424 14. RODENT AND INSECT PEST CONTROL. As in previous years, it is pleasing to report that no legal action was required under the provisions of the Prevention of Damage by Pests Act, 1949. This is in itself an indication of the co-operation received from householders and business people. The department maintains, through servicing agreements, a good liaison with the majority of the commercial and industrial interests in the town. This service which is carried out with both efficiency and economy, is greatly appreciated. With regard to domestic properties, many of the infestations are found to be due to accumulations of rubbish in back gardens, spaces between fences and on waste land. There appears to be some difficulty in the disposal of unwanted furniture, perambulators, etc. and the indiscriminate dumping of these and other materials provides harbourage for rodents. 27 During 1958 an initial treatment to the sewers was carried out on manholes which had shown evidence of infestation on previous occasions. This is part of a series of four treatments in which sodium fluoracetate is being used. This rodenticide was first used in Kingston-upon-Thames during 1957 and the results were such that further treatments with this material are considered to be justified. The need for this work is emphasized by the fact that many surface rat infestations are traceable to defective drains, and more rarely to faults in the sewers. During the year 23 defects of drainage systems were traced which had been proved to be the cause of the infestation. Rodent Control – Statistical Statement, 1958. Private Dwellings and Corporation Property. Rats. Mice. Total. No. of complaints received in office 74 20 94 No. of premises inspected as a result 302 NO. of premises found to be infested 136 22 158 No. of separate infestations treated 163 19 182 NO. of visits for treatment and reinspections 915 90 1,005 No. of premises treated by occupier or other agency 1 3 4 No. of poison baits deposited 222 Business and Factory Premises. Rats. Mice. Total. No. of complaints received in office 10 23 33 No. of premises inspected, including those under Service Agreement 179 No. of premises in which slight infestations were found 46 116 1,621 No. of separate infestations treated 42 355 397 No. of visits for treatment and inspections 600 1,776 2,376 No. of premises treated by occupier or other agency 4 1 5 No. of poison baits deposited 2,305 Summary. No. of complaints received 127 No. of premises inspected 481 No. of premises infested 320 No. of visits 3,381 No. of premises treated by occupier or other agency 9 No. of poison baits deposited 2,527 Insect Pest Control. Control and maintenance treatments are carried out by the Department in all types of premises. During the year requests were received to deal with infestations which involved the following insects: Ants, cockroaches, carpet beetles, fruit flies, flour moths, clothes moths, mosquitoes and woodworm. In addition, the Department were asked to identify insects submitted by members of the public and in this connection it is pleasing to acknowledge the assistance afforded by the Ministry of Agriculture, Fisheries and Pood Laboratory at Tolworth. 28 SECTION D, HOUSING. During the year it was possible further to observe the effects of the Rent Act, 1957. Eighty applications were made for Certificates of Disrepair compared with 77 for the six months of the previous year in which the Act was in operation. By the end of 1958 the rate of applications had diminished to such an extent that it is reasonable to assume that the Act is functioning satisfactorily and in the main, landlords were able to meet the tenants' requirements as to repairs. It will be remembered that the function of the Local Authority with regard to the Act is generally one of arbitrator between landlord and tenant and during the twelve months under review this duty has been discharged without difficulty. With regard to statutory action under the provisions of the Housing Act, 1957, Closing Orders were made in respect of NO. 20, Brunswick Road and No. 22, Park Road. The following premises were the subject of Demolition Orders:– No. 1, Avenue Road. NoS. 9, 42 & 44, Cowleaze Road. NO. 74, Fassett Road. NO. 37, Mill Street. A Representation was also made and a Clearance Order declared for an area in Brook Street comprising 5 houses. Steps were taken with a view to the demolition of 3 properties in Bath Passage and 4 houses in Hawks Road all of which are unfit and in the ownership of the Corporation. A Statutory Notice was also served under the provisions of Section 9 for repairs to be carried out at No. 84 Cambridge Grove Road. In accordance with Ministry of Health Circular 28/54, the following information in tabular form, as required by article 31 of the Housing (Consolidated) Regulations is included. l. Number of houses inspected and recorded 6l 2. Number of houses which, on inspection, were considered to be unfit for human habitation 21 (a) Parts of houses which, on inspections, were considered to be unfit for human habitation - 3. Number of houses, the defects of which were remedied in consequence of informal action by the Local Authority or its officers 94 Number of representations made to the Local Authority with a view tog- (a) The serving of notices requiring the execution of works 1 (b) The making of demolition or closing orders (number of houses involved) 21 5o Number of formal notices served requiring the execution of works 15 29 6. Number of houses which were rendered fit after the service of formal notices - 7. Number of demolition or closing orders made 7 8. Number of houses in respect of which an undertaking was accepted under subjection 4 of section 16 of the Housing Act, 1957 - 9. Number of houses demolished 2 Housing – Statistical Statement,1958. The following information is supplied by the Borough Surveyor who indicates that 63 flats were built by the Corporation during the year - all within the Borough. Total number of permanent dwellings erected by the Corporation since March 1924 to 31st December,1958. Houses 1,137 (Inc.876 outside Borough) Flats 904 (lnc.326 outside Borough) Total number of temporary dwellings erected up to 31st December, 1958. Still remaining. Arcon 132 129 Aluminium 70 57 2 year huts 113 12 (in use by Surrey County Council) 315 198 Number of dwellings erected by private enterprise during 1958. Houses 12 Plats 28 40 30 SECTION E. INSPECTION AND SUPERVISION OF FOOD. (a) Milk Supply. All milk supplies in the town are brought in from outside sources, there being no milch herds in the Borough. All known sources of supply are regularly sampled. The quality generally has proved to be satisfactory throughout the year. Under the provisions of the Milk (Special Designations) (Special Areas) Order 1951, the Borough of Kingston-upon-Thames forms part of Specified Area No. l. By the provisions of the 0rder, it is an offence to sell in the Borough milk which is not either Pasteurised, Sterilised or Tuberculin Tested, The sale of raw undesignated milk is therefore entirely prohibited within the Borough. (b) Designated Milks. The following table shows the number and type of licences issued by your Corporation during 1958 under the provisions of the Milk (Special Designations) Regulations0 All the licences were in force at the end of the year. Pasteurised Sterilised Tuberculin Tested To Pasteurise 1 – – To Deal 12 12 6 Supplementary 9 8 9 (c) Bacteriological Examination of Milk. During the year 86 samples of milk, all of which were pasteurlsed, were sent to the Public Health Laboratory at Epsom for examinations. The samples were submitted for the phosphatase and methylene blue testsp which are respectively tests of adequate pasteurisation and satisfactory bacteriological condition. All samples passed the test for which they were submitted. (d) Ice Cream. The number of registered premises in the Borough upon which ice cream may be stored or from which it may be sold is 158. This figure also includes five producers. In addition to these dealers and producers there are other premises, such as restaurants, canteens, cinemas, etc. upon which ice cream is sold. These premises are not required to be registered, By far the greater part of the ice cream sold in the town is obtained from manufacturers whose premises are situate outside the Borougho More them ever the production of ice cream is being confined to the few large manufacturers. 31 The following table shows the results of examinations in respect of 67 samples submitted to the Public Health Laboratory at Epsom during 1958. Owing to the numerous factors governing the hygienic quality of ice cream, undue attention is not paid to the bacteriological results on any single sample. It is significant to note that during the year under review all the samples came within Grades I and II this is considered to be satisfactory; where samples fall within Grades III and IV these are not considered to be so, and appropriate action is taken with the persons concerned so that a satisfactory standard may be achieved. GRADE I II III IV Total Ice Cream 65 2 – – 67 (e) Meat and Other Foods. (i) There are no slaughter houses in the Borough. The supply of meat for the town arrives from Smithfield and through the local wholesale shops. A certain amount of home killed meat also comes from the modern abattoir at Guildford. (ii) Foodstuffs condemned as unfit. The following tabulated statement shows the amounts of various foods which were condemned during the year and the causes for condemnation. The quantities involved are small in comparison with the amount of food which is handled in the town. The list is very much condensed to avoid unnecessary detail. Tabulated list of Condemned Foodstuffs showing causes for condemnation and the Weights, Article of Food Reason for Action. Weight. lbs. lbs. Raw Meat. Bovine Decomposition 1,035½ Ovine „ 80 Porcine „ 91 Total quantity raw meat 1,206½ Raw Fish. Decomposition 210 Poultry, Game etc. „ 152½ Dried Fruit „ 30¾ Canned Goods. Meat and Meat Products 896½ Fruit 1,811 Jam 23 Vegetables Punctured, 146½ Milk Blown. 46 Soup Damaged or 30½ Fish and Fish Paste Decomposition. 17 Others 40¾ 3,011¼ Food in Glass Containers. Confectionery Glass 28 Fish and Fish Paste tion, mouldy 12 Pickles deterioration 7 47 32 Weight. lbs. lbs. Other Pood condemned for Various Reasons. Potatoes 12,635 Fruit 2,018 Chinese Frozen Egg 22 Sausages 70½ Meat 76½ Nuts 56 Cheese 54¼ Miscellaneous 9 14,941¼ Unsound food is made in a condition that recovery is impossible and placed in vehicles for conveyance to a tip. Where this method of disposal would be unsatisfactory, arrangements can be made for incineration at the refuse destructor of the Merton and Morden Urban District Council. Food Hygiene Regulations 1955. During the period under review the supervision of food premises continued satisfactorily. The very high standard which has been achieved is the result of the excellent co-operation which existed between the managements concerned and the Public Health Inspectors. The maintenance of good food handling practice depends on continuous effort. In the catering and food retailing trade there are frequent changes in staff. In such circumstances regular routine visiting by the Public Health Inspectors is essential to ensure the continuance of satisfactory methods of food hygiene. As with other matters with which the Department is concerned, when plans and proposals are submitted for the alteration of existing, or the establishment of new, businesses. it is possible to ensure that the premises will comply with the Regulations in the first instance. This service is appreciated by the proprietors. It was necessary to undertake legal proceedings for contraventions of the Food Hygiene Regulations, 1955 in the case of a bakehouse in the town. In accordance with the request of the Minister of Health, the under-mentioned particulars of the case are included:- Information was laid against the owner in respect of three contraventions of Regulation 6, three of Regulation 8(a) and one of Regulation 16. The defendant pleaded guilty to the contravehtion of Regulations 8(a) and 16 and was fined a total of £20. The other summonses were not proceeded with. Information was laid against an employee at the bakery in respect of contraventions of Regulations 9(d) and (e). A plea of guilty was made on his behalf and a fine of £5. on each summons was imposed. During the year 75 Notices were served under these Regulations and 80 were complied witho The following tabulated statement shows the nature of the Notices served and complied. 33 PART IV. Defects requiring Notices Complied. Sanitary Conveniences. Lack of Wash Your Hands Notices 12 Ik Fittings cleansed or repaired k 7 Lighting Provided 1 1 Walls & Ceilings Cleansed 8 9 Sinks. Renewed or repaired, also draining boards 3 5 Cleansed 1 1 Washing Facilities for Staff. Absence of, defective, or inadequate hand basins 1 7 Absence of hot water 5 8 " " cold water 3 6 " " water heaters or repaired 4 2 Provision of towels, soap and nailbrushes 14 13 Repairs to Food Rooms. Floors cleansed 5 5 Walls and Ceiling cleansed 4 3 Additional Ventilation provided 1 1 Protection of Food against contamination. Smoking 1 1 Food to be kept 18" off ground 1 3 Covers provided for food 5 7 Others 4 3 Uncleanliness. Personal 1 1 Kitchens and equipment 3 8 Food Stores – 4 Preparation Rooms – 2 Delivery Vans 5 6 Refrigerators 5 7 Shops 5 6 Dining Rooms 5 5 Utensils. Unclean and/or replaced 1 2 Others. 15 11 117 148 In accordance with the request of the Minister of Health the following is a tabulated statement of inspections made during the year of the various types of food premises. 34 Food Premises. No. of Premises Visits. Bakehouses and Bakers' Shops 16 43 Dairies and Milk Shops 16 178 Butchers 35 11k Greengrocers and Stalls 80 384 Public Houses 47 45 Fishmongers and Stalls 12 199 Ice Cream premises 149 102 Grocers and general provisions and stalls 130 377 Restaurants and cafes 62 276 Kitchens and canteens (including factory, school and shop) 23 Public Houses (not included in the figure above but at which restaurant services are provided) 11 17 Meat Distribution Depots 5 43 Visits to Food Premises re unsound food 117 586 1,895 FOOD AND DRUGS ACT. 1955. Details of samples submitted to the Public Analyst during the year are set out in the attached tabulated statement. The following are the reports of action taken in respect of samples which were the subject of adverse comment. Casserole Steak - The Analyst reported that this sample contained 70% meat whereas in his opinion a reasonable meat content is 95% In the absence of a legal standard for such food products, the matter was referred to the Ministry of Agriculture, Fisheries and Food and is receiving consideration. Natural Lemon Juice - Included in the label of this sample were the words "Slimming Aid", but the Analyst's views were that it would add a small number of calories to the total intake of food and he was not aware of any reliable scientific experiment which showed that the consumption of lemon juice in the way indicated could have any significant effect as a slimming aid. The manufacturers were notified of these views, but no further action was taken. Pine and Honey Syrup - The name Pine and Honey Syrup' was, in the opinion of the analyst, misleading, as the pine and honey were used as flavouring and had no medicinal purpose whatsoever. When the matter was taken up with the manufacturers, the label was amended to read 'Catarrh Syrup Compound. Steak and Kidney - Analysis revealed that this sample comprised 59% steak 38% heart and 2.5% kidney. Heart is considered to be a foreign ingredient. Legal proceedings were instituted against the vendors concerned and a fine of £20 with 2 guineas costs was imposed. Scone - This was submitted following upon the receipt of a complaint. The scone contained a partially smoked cigarette. Legal proceedings were taken, the baker pleaded guilty and a fine of £10 and one guinea costs was imposed. 35 Pork Pie - It was reported that the article contained a mature mould growth,, In the ensuing legal proceedings, the vendors pleaded guilty to selling a pie which was not of the nature demanded. A fine of £15 and £3.l6.0.costs was imposed. The frequency with which complaints are made concerning the sale of pre-packed perishable articles which are stale suggests that such products should he clearly marked with the date of manufacture. By this means it would be possible for the consumer to check whether or not the article is fresh. On many occasions retailers have been found to be lax in stock rotation methods for such products. Tabulated Statement of Samples Submitted to the Public Analyst during 1958. Commodity No. of Samples Genuine Not Genuine or otherwise irregular Formal Informal Formal Informal Formal Informal Almond Flavoured Essence - 1 - 1 - - Apricots in Syrup - 1 - 1 - - Aspirin - 1 - 1 - - Bicarbonate of Soda - 1 - 1 - - Boracic Powder - 1 - 1 - - Bread Crumbs - 1 - 1 - - Bun Flour - 1 - 1 - - Butter Cheese Spread - 1 - 1 - - Butter Fudge - 1 - 1 - - Casserole Steak - 1 - 1* - - Cheese Spread - 1 - 1 - - Cheese & Tomato Spread - 1 - 1 - - Chico - 1 - 1 - - Cocoa - 1 - 1 - - Cough Sweets - 1 - 1 - - Crab & Lobster Fish Paste - 1 - 1 - - Crab Spread - 1 - 1 - - Custard Powder - 1 - 1 - - Desiccated Soup - 1 - 1 - - Dressed Crab - 1 - 1 - - Essence of Anchovies - 1 - 1 - - Fish Paste (Crab) - 1 - 1 - - Ground Almonds — 1 — 1 — - Honeycake - 1 — 1 - - Horseradish Sauce - 1 — 1 — - Horseradish with imitation cream - 1 - 1 - - Ice Cream - 15 - 15 - — Instant Icing - 2 - - — - Lemon Pie Filling — 1 — 1 — — Loganberry Jam — 1 — 1 — — Luncheon Meat - 1 — 1 — - Malt Vinegar - 1 - 1 - - Meat Paste (Ham & Tongue) - 2 — 2 - - Milk - 38 - 38 — - Milk Gums - 1 - 1 - - Mincemeat — 1 - 1 - - Mix-a=Shake - 1 - 1 - - Mixed Cut Peel - 1 - 1 — — Mixed Fruit - 1 - 1 - - C/Fwd. - 92 - 92 - - 36 Commodity No. of Samples Genuine Not Genuine or otherwise irregular Formal Informal Formal Informal Formal Informal B/Fwd. - 92 - 92 - - Natural Lemon Juice - 1 - - - 1 Orange Squash - 3 - 3 - - Pate-de-foie - 1 - 1 - - Peppermint Cordial - 1 - 1 - - Pilchards - 1 - 1 - - Piping Jelly - 1 - 1 - - Pine & honey Syrup - 1 - - - 1 Pork Pie - 2 - 1 - 1 Pork Sausages - 1 - 1 - - Potted Salmon with Batter — 1 - 1 - - Salmon & Shrimp Paste - 1 - 1 - - Semolina — 1 - 1 - - Steak & Kidney 1 - - - 1 - Steak & Kidney Pudding - 1 - 1 - - Stewed Steak - 1 - 1 — - Stewed Steak with gravy - 1 - 1 - - Strawberry Jelly - 1 - 1 - - Stuffed Pork Roll - 1 — 1 - - Tinned Cream - 1 — 1 - — Tomato Ketchup - 2 — 2 - - White Pepper - 2 - 2 - - 1 117 - 114 1 3 MERCHANDISE MARKS ACT. 1926. Regular and frequent inspections were made during the year with regard to the labelling and display of appropriate notices, in compliance with the Orders made under the above Act in respect of certain foods. From time to time attention was drawn to infringements, particularly in respect of tomatoes and apples, but it was not considered necessary to take any legal enforcement action. 37 SECTION F PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES The following infectious diseases are notifiable to the Medical Officer of Health of the Borough:- Scarlet Fever Whooping Cough Diphtheria (including Membranous Croup) Measles (excluding Rubella) Acute Pneumonia (primary or influenzal) Meningococcal Infection Acute Poliomyelitis - Paralytic " " - Non-paralytic Acute Encephalitis - Infective " " - Post Infectious Dysentery Ophthalmia Neonatorum Puerperal Pyrexia Smallpox Para-typhoid Fevers Enteric or Typhoid Fever (excluding para-typhoid) Food Poisoning Erysipelas Malaria Cholera Plague Typhus Fever Relapsing Fever Tuberculosis Leprosy is notifiable by General Medical Practitioners direct to the Chief Medical Officer of the Ministry of Health. In 1958 a total of 2+69 notifications of infectious disease was received, and these are analysed and commented upon in the following tables and reports. 38 NOTIFIABLE DISEASES DURING 1958 TABLE IV CASES DEATHS Age Groups Age Groups Under 1 year 1-2 2-3 3-4 4-5 5-10 10-15 15-20 20-35 35-45 45-65 65 & over Total cases notified Cases admitted to Hosp. Under 1 year 1-2 2-3 3-4 4-5 5-10 10-15 15-20 20-35 35-b5 45- 65 65 & over Total Diphtheria - - - - - - - - - - - - - - - - - - - - - - - - - - - Scarlet Fever — — 1 - 1 7 1 1 - — - — 11 2 - - - - - - - - - - - - - Measles 2 13 18 18 30 113 5 1 - - - - 200 - - - - - - - - - - - - - - Whooping Cough - 1 2 1 1 4 - - - - - - 9 - - - — — - — — — — — — — — Acute Poliomyelitis: Paralytic - - - - - - - - - - - - - - - - - - - - - - - - - - - Non-paralytic - - - - - - - - - - - - - - - - - - - - - - - - - - - Acute Infective Encephalitis - - - - - - - - - - - - - - - - - - - - - - - - - - - Meningococcal Infection. 1 - - - 1 - - - - - - - 2 2 - - - - - - - - - - - - - Puerperal Pyrexia - - - - - - - 9 43 8 - - 60 60 - - - - - - - - - - - - - Dysentery 3 5 6 5 5 74 21 4 21 11 10 2 167 2 - - - - - - - - - - - - - Food Poisoning - - 1 - - 1 - - 4 1 1 - 8 2 - - - - - - - - - - - - - Pneumonia - - - - - 1 - - - 2 5 2 10 - - - - - - - - - - - 1 15 16 Erysipelas - - - - - - - - - - 1 - 1 - - - - - - - - - - - - - - Opthalmia Neonatorum 1 - - - - - - - - - - - 1 - - - - - - - - - - - - - - Total 7 19 28 24 38 200 27 15 68 22 17 4 469 68 - - - - - - - - - - 1 15 16 39 The following table gives a comparative statement of notifications of certain infectious diseases received during the last thirty years:- TABLE V Year Scarlet Fever Measles Whooping Cough Puerperal Pyrexia Poliomyelitis Acute Infective Encephalitis Diphtheria Ophthalmia Neonatorum Enteric Fever (including Para-typhoid) 1929 74 - - 5 - - 113 3 1 1930 73 not notifiable until 1940 not notifiable until 1940 9 - - 100 2 5 1931 61 14 — - 53 4 1 1932 56 13 2 - 47 — 1 1933 125 10 3 - 30 2 2 1934 40 5 - - 42 3 2 1935 54 8 - - 50 3 2 1936 67 19 - - 27 2 6 1937 51 32 2 - 21 3 1 193S 61 47 2 - 72 2 1 1939 69 - - 66 1 - 19 3 1 1940 45 373 22 63 - - 53 3 3 1941 54 331 271 37 1 - 15 - 7 1942 79 375 99 24 - - 8 3 — 1943 110 287 151 18 1 - 3 - 1 1944 49 33 73 15 1 - 7 2 — 1945 28 407 84 23 1 - 16 2 - 1946 34 283 67 41 2 - 8 1 1 1947 24 219 38 28 5 3 2 1 1 1948 34 197 200 30 3 - - - — 1949 73 483 81 29 7 3 - - — 1950 51 132 41 23 4 — — — - 1951 37 443 222 41 - 1 — — — 1952 29 280 102 84 3 - — — — 1953 21 302 126 80 5 — - — — 1954 16 419 21 96 - 1 — - — 1955 11 170 17 72 10 1 — — — 1956 17 35 58 88 3 - - — - 1957 13 483 55 59 2 1 — — — 1958 11 200 9 60 — — — 1 — 40 Smallpox. There were no cases recorded in Kingston during 1958, but the disease is very prevalent in many parts of the world and constant vigilance is necessary. Particular surveillance has to be maintained over persons arriving from abroad particularly when they have come by air from countries where outbreaks have occurred. The majority of countries now insist upon an International Certificate of Vaccination being produced before travellers are allowed to land. In this connection, a large number of certificates issued by Kingston doctors are officially authenticated in the Public Health Department each year in accordance with regulations. Vaccination is voluntary and every effort is made to maintain a high level of immunity to smallpox in the population by vaccinating the infants during their early months. This is carried out by general practitioners and at the Surrey County Council clinics. Vaccination and re-vaccination is available free for persons of all ages. At present some 60% of Kingston babies are known to be vaccinated during their first year and there is every need to raise this figure to at least 75%* Scarlet Fever. Eleven cases were notified during 1958, 8 of which were of school age. The cases were not serious and there were no deaths. Scarlet fever is a streptococcal infection and is therefore always viewed as potentially dangerous. Modern drugs however prove to be a good weapon, and the illness now usually takes a mild form. Diphtheria. For the eleventh year in succession no cases of diphtheria occurred in Kingston. An intensive campaign is carried out to immunise the school and pre-school population against this disease and this is done under the direction of the Medical Officer of Health at the Surrey County Council clinics, and by the general medical practitioners. Continued freedom from any illness creates a complacency in the minds of the people but this must be combated particularly in regard to diphtheria which is always likely to reappear, and will do so if protective immunisation of children is not kept up to a high level. During 1958, 4,ll6 Kingston children were immunised for the first time or received reinforcing "booster" injections. A figure known as the immunity index, which is shown as a percentage, is computed each year. This relates to the proportion of the child population which is known to have received inoculation during the previous 5 years. The immunity index in Kingston for the 1/4 age group is 78% and the total index for all children under the age of 15 is 63%. The intensive campaign to immunise as many children as possible is being maintained with a special objective to secure the immunisation of 75% of babies before their first birthday, and it is calculated that during 1958 the proportion of Kingston babies immunised before they reached the age of 1 year was 74%. 41 Poliomyelitis. Further progress was made toward the protection of the child population. Supplies of vaccine became plentiful and 2 injections have been offered to every Kingston child up to the age of 15 years. A third reinforcing injection was given some 7 months after the second injection, and expectant mothers who registered for vaccination also received the injection. No cases of poliomyelitis were notified in Kingston during 1958. Enteric Fever (Typhoid or Paratyphoid). There were no cases of typhoid or paratyphoid B notified in Kingston during 1958 and this is the eleventh successive year without notification of enteric fever. Infection that does occur is mostly imported from abroad through contaminated foodstuffs, but polluted water courses and streams can carry the organism and indiscriminate bathing and drinking of contaminated impure water can be dangerous. Dysentery (Sonne). The year was characterised by 2 sharp outbreaks of mild dysentery each centred on a particular school, into each of which the organism, having been introduced, spread rapidly. Action was taken which was successful in preventing the spread of infection to other schools. This laborious process consists of visiting cases, and suspected cases, distribution and collection of specimen containers, and maintaining accurate records of the progress of each patient. A considerable amount of correspondence with parents, schools, and doctors is involved. It is considered that a notable success in containing the outbreaks was achieved by instituting at all schools a rigorous hand washing regimen applicable after the use of the W.C., and before eating. The infant schools were also provided with supplies of disinfectant and disposable paper towels, the disinfectant being used as a hand dip after washing. It is thought that such a hand dip is an indispensable precaution when dysentery is prevalent among children who are too young to be trusted always to wash their hands thoroughly after using the lavatory. The novelty, and the attractive blue colour of the solution seemed to make the idea popular with the children. The first of the 2 outbreaks occurred in February and resulted in 113 cases. The second, smaller, outbreak occurred in July with 50 cases. Altogether during 1958, 167 cases of sonne dysentery were officially notified. Those not associated with the above incidents being sporadic individual cases the appearance of which is becoming a normal occurrence each year. The prevalence of this infection seems to have increased throughout the country during the last few years. The illness is mild but it has a possible serious effect on young babies and debilitated persons. 42 Measles. There were 200 cases of measles notified during 1958 compared with 483 in. 1957. Generally speaking the illness was of a mild type with little by way of complications and all cases were nursed at home. The majority of the illnesses (113) occurred in children in the 5/10 age group, and 81 in younger children. Whooping Cough. During 1958, only 9 cases of whooping cough were notified compared with 55 in 1957, Ophthalmia Neonatorum. One case was notified during 1958, the first that has occurred in Kingston since 1947. The child was born in Kingston hospital of parents resident in Richmond. Puerperal Pyrexia. The maternity block at Kingston hospital serves Kingston and a large surrounding area embracing a population of some 285,000 persons. In spite of closure of one-third of the beds for 6 months for major reconstruction works, 1,700 deliveries took place during 1958 in the hospital, and inevitably some cases of puerperal pyrexia occurred. all of which were notified to the Medical Officer of Health of Kingston in accordance with the regulations which define the illness as a febrile condition occurring in a woman in whom a temperature of 100.4 of or more has occurred within fourteen days after childbirth or miscarriage. During 1958, 60 eases were notified, 18 of which referred to Kingston residents and all of whom were notified from Kingston hospital. These figures compare with 59, 8 and 59 respectively for 1957. An analysis for the years back to 1954 is shown below. Cases 1954 1955 1956 1957 1958 (a) Total notified 96 72 88 59 60 (b) Number included in (a) of (i) Kingston residents 27 17 21 8 18 (ii) Extra district residents 69 55 67 51 42 (c) Number included in (a) notified from Kingston hospital 96 69 88 59 60 (d) Number included in (a) notified by private doctors - 3 - - - (e) Number of cases included in (d) removed to hospital other than those included in (c) - - - - - Food Poisoning, In spite of the very large number of eating places and food shops in Kingston, no cases of food poisoning occurred during 1958 which could be attributable to lack of hygiene in the trade. A total of 8 cases was notified, 5 of which were single unrelated illnesses caused by salmonella organisms, and 3, which constituted a small outbreak in a group of people, all of whom ate tongue which had been left in the tin after opening, and had become infected with staphylococcal organisms. 43 With regard to the single cases, although the causal organisms were isolated there was no indication as to which article of food provided the vehicle of infection. Tuberculosis. In accordance with the national trend the number of new cases of tuberculosis notified continues to fall. In 1958 in Kingston 18 cases were reported, 16 of which referred to the lungs. The corresponding figures for 1957 were 27 and 26, and in no previous year has the total been so low as 18. During the year the South West Regional Hospital Board X-Ray Unit resumed its annual visit to the town, after missing during 1957, and 7,632 people (3,444 males - 4,188 females) were x-rayed. A total of 8 cases (5 males - 3 females) of active pulmonary tuberculosis was discovered and referred for immediate treatment. These figures do not necessarily relate only to Kingston residents. Whilst there is considerable satisfaction to be derived from the steady decline in the number of new cases appearing there are still very many cases, a large proportion of whom are chronic, on the register and receiving treatment and attention at the Chest Clinic. Breakdowns and consequent periods of infectivity are continually possible in these cases and the infection is therefore still within the community. It will be many years before the combined effects of improved living conditions of the population, advances in therapeutic treatment, facility for early detection of tuberculosis by public mass x-ray sessions and B.C.G. vaccination of school children, bring the disease to the point of eradication. The following table shows comparative figures of notified cases and deaths for the years 1949 to 1958 (inclusive):- Year Cases Notified Deaths Respiratory Non-Respiratory Total Respiratory Non-respiratory Total 1949 40 6 46 10 1 11 1950 37 11 48 12 — 12 1951 38 9 47 12 1 13 1952 43 2 45 9 2 11 1953 37 5 42 8 1 9 1954 26 4 30 3 1 4 1955 14 6 20 6 — 6 1956 25 2 27 2 — 2 1957 26 1 27 6 1 7 1958 16 2 18 2 3 5 The efficiency of notification has been good and there is no reason to suspect refusal or neglect to notify. Throughout the year no action became necessary under the Public Health (Prevention of Tuberculosis) Regulations 1925, or Section 172 of the Public Health Act 1936. These regulations relate to the restriction of tuberculosis sufferers from employment in the handling of milk, and the compulsory removal to hospital in certain circumstances of persons suffering from tuberculosis respectively. 44 Considerable help is given to tuberculosis patients and their dependents by the Kingston and District Tuberculosis Care Committee. During 1958, 89 families were helped in the form of grants for extra nourishment, clothing, fuel, removals, bedding, fares, pocket-money, etc., and a total of £1,510 was expended from the funds of the Committee on this work. An analysis of the total notified cases during 1958 in age groups is shown on the next page, and the following graph depicts the numbers of new cases and deaths in respect of respiratory tuberculosis occurring for the past 15 years. 45 NOTIFIED CASES OF, AND DEATHS FROM, TUBERCULOSIS IN 1958. TABLE VI. NEW CASES DEATHS Under 1 year 1-5 5-15 15-25 25-35 35-45 45-55 55-65 65 & over Total Under 1 year 1-5 5-15 15-25 25-35 35-45 45-55 55-65 65 & over Total Tuberculosis (a) Respiratory M - - - - 1 1 1 1 3 7 - - - - - - - 1 1 2 F - - - 1 4 1 2 1 - 9 - - - - - - - - - - Total - - - 1 5 2 3 2 3 16 - - - - - - - 1 1 2 (b) Non-respiratory M - - - - - - - - - - - - - - - - - 1 1 F - 1 - - 1 - - - - 2 - 1 - - 1 - - - - 2 Total - 1 - - 1 - - - - 2 - 1 - - 1 - - - 1 3