MAL 036 THE URBAN DISTRICT OF THE MALDENS & COOMBE ANNUAL REPORT of the Health and Sanitary Conditions for the Year 1923 RASHELL DAVISON, M.D., M.R.C.S.Eng., Fellow of the Royal Institute of Public Health and Society of Medical Officers of Health, Medical Officer of Health HENRY TUNBRIDGE, M.R.S.I., Sanitary Inspector Maldens and Coombe Urban District Council. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH, 1923. Public Health Department, Council Offices, New Malden. January, 1924. Mr. Chairman and Members of the Council, I have the pleasure to lay before you my Twenty-seventh Annual Report on the Health and Sanitary Conditions of the Urban District of the Maidens and Coombe for the year ended December 31st, 1923. The Report is drawn up on lines indicated in circular 451, Ministry of Health, dated 15th December, 1923. The Report is brief, but Annual Reports of a full and detailed character will be required at intervals of not less than five years. (1) GENERAL STATISTICS. Area—3,220 acres. Estimated Population, 1923, 15,366. Estimated Number of Inhabited Houses, 3,647. Rateable Value, £139,474. Assessable Value, £122,312 17s. 6d. Sum represented by a Penny Rate District, £508. Poor, £560. 3 RATES for the half-year ending March 31st, 1924— Wards. General District Rate. Poor Rate. Total. No. 1, Coombe 2 9 2 6 5 3 No. 2, New Maiden 2 5 2 6 4 11 No. 3, Maiden 3 2 10 5 10½ (2) VITAL STATISTICS. The Maidens and Coombe England and Wales Birth Rate per 1,000 living 15.3 19.7 Death Rate per 1,000 living 9.4 11.6 Infantile Mortality per 1,000 Births 33.9 69.0 Diarrhoea Mortality (under 2 years) Per 1,000 Births Nil. 7.7 BIRTHS. During the year there were 236 births, being an increase of 25 on last year's total. This is more satisfactory as for the previous two years decreases were recorded. The Births were distributed as follows:— Males Females No. 1 Ward, Coombe 6 2 No. 2 Ward, New Maiden 107 114 No. 3 Ward, Maiden 3 4 Totals 116 120 Of the total number of births, 11 (3 males and 8 females), or 4.6 per cent, were illegitimate. DEATHS. During the year 145 deaths were registered, being 4 less than during 1922. One hundred and two deaths were registered in the District and 43 in Public Institutions and other Districts. The Death Rate per 1000 remains under 10, and is more than 2 per 1,000 less than that of England and Wales. This may be accounted very satisfactory. The infantile mortality rate, which is less than half that of England and Wales, is also exceedingly satisfactory. The number of women dying in, or in consequence of child-birth, number two, one being from puerperal sepsis and the other from peritonitis following abnormal confinement. Four deaths occurred from whooping cough, but it is satisfactory to note that none occurred from measles or diarrhoea (under 2 years of age). Severe cases of measles are received in Tolworth Infectious Hospital. 4 CAUSES OF DEATH. Whooping cough 4 Meningococcal meningitis 1 Tuberculosis of respiratory system 7 Other Tuberculous diseases 5 Cancer, malignant disease 12 Diabetes 4 Cerebral haemorrhage 5 Heart disease 25 Arterio-sclerosis 12 Bronchitis 9 Pneumonia (all forms) 11 Other respiratory diseases 2 Appendicitis and typhlitis 1 Cirrhosis of liver 1 Acute and chronic nephritis 6 Puerperal sepsis 1 Other accidents and diseases of pregnancy and parturition 1 Congenital debility and malformation, premature birth 4 Suicide 1 Other deaths from violence 3 Other defined diseases 30 Total 145 Wards Districts Kingston & Dist. General Hospital London Hospitals Other Hospitals Other Districts TOTALS No. 1, Coombe 7 1 — — — 8 No. 2, New Malder 91 21 5 6 9 132 No. 3, Maiden 4 1 — — — 5 Totals 102 23 5 6 9 145 INFANTILE MORTALITY. Number of deaths occurring in infants under 1 year of age for the past five years. 1919 18 1920 16 1921 14 1922 7 1923 8 Average for the past 5 years, 12.6 THE MALDENS AND COOMBE URBAN DISTRICT COUNCIL. Table shoving Infantile Mortality Rate per Thousand Births. (a) in England and Wales (b) in The Maidens and Coombe. 1903 to 1923. 5 SUMMARY OF BIRTH, INFANTILE MORTALITY AND DEATH RATES FOR THE PAST FIVE YEARS. Year Births Infantile Mortality Deaths 1919 155 75.60 11.2 1920 186 55.74 7.6 1921 176 54.60 9.9 1922 148 33.10 9.9 1923 153 33.90 9.4 Average for 5 years 163 50.58 9.6 DISTRICT STATISTICAL TABLE. District Area (acres) Estimated Population middle 1923 Estimated Houses Occupied Births Deaths Coombe 1,337 1,316 243 8 8 New Maiden 1,041 13,500 3,288 221 132 Maiden 842 550 116 7 5 Totals 3,220 15,366 3,647 236 145 MORTUARY. Dr. H. M. Taylor, H.M. Coroner for the Division of Surrey, held inquests on twelve bodies as under, being an increase of four over the previous year. District Verdict New Malden Syncope. Auricular fibrillation, Cardiac hypertrophy, aggravated by army service. Natural causes. Cerebral haemorrhage. Chronic nephritis. Coma. Natural causes. Syncope. Aortic aneurism. Natural causes. Syncope. Atheroma of arteries. Enlargement of the heart. Natural causes. Shock. Fracture of the skull. Laceration of brain. Knocked down by motor car. Accidental death. Shock. Fracture of skull and ribs. Suicide whilst of unsound mind. Syncope. Valvular disease of heart. Natural causes. Syncope. Haemorrhage. Pulmonary tuberculosis. Natural causes. Syncope. Acute bronchitis. Fall downstairs. Accidental death. Malden Syncope. Fatty degeneration of the heart. Natural causes. Syncope. Myocardial degeneration of the heart. Natural causes. Coombe Shock. Fracture of skull. Destruction of brain. Knocked down and run over by trailer of motor lorry. Accidental death. 6 RAINFALL Table showing the rainfall in the District during the year 1923, taken at the Sewerage Works,.Kingston Road, New Maiden. January 1.19 inches February 2.81 „ March 2.08 ,, April 1.43 ,, May 2.37 ,, June 0.24 „ July 3.97 ,, August 1.72 „ September 1.15 ,, October 5.18 „ November 1.35 ,, December 2.02 ,, Total 25.51 inches This is an increase of four inches over last year and 14 inches over the drought year of 1921. SCHOOLS. The children attending the various Public Elementary Schools in the District are as follows:— Girls Boys Total Increase or Decrease over 1922. Kingston Vale 19 17 ,, ,, Infants 8 13 57 -6 Malden Parochial 24 83 ,, ,, Infants 6 10 123 -10 New Malden— Lime Grove 175 ,, ,, Infants 85 75 335 -14 Elm Road 214 214 -2 Burlington Road 254 220 474 -56 ,, ,, Infants 97 93 190 -30 Dickerage Lane 152 159 311 -14 ,, Infants 83 78 161 -31 903 962 1,865 Decrease 159 The sanitary condition of the Schools has been satisfactorily maintained. I am glad to be able to record that the paving at the Dickerage Lane Schools has received attention and greatly improved. Very little infectious disease was reported among scholars attending these Schools and one closure only was necessary during the year. (3) NOTIFIABLE DISEASES DURING THE YEAR Diseases Coombe New Malden Old Malden Total Under 1 1-2 2-3 3-4 4-5 AGE 5-10 GROUPS 10-15 15-20 20-35 35-45 45-65 Over 65 Scarlet Fever — 16 — 16 — 1 — 3 3 5 2 1 — 1 — — Diphtheria — 11 — 11 — 1 2 — 1 3 — 1 2 — 1 — Measles 3 19 — 22 1 2 3 3 1 6 5 1 — — — — Erysipelas 1 4 — 5 — — — — — — — — 1 3 1 — Pneumonia — 6 — 6 — — — — — . — — — 1 3 2 — Acute Poliomyelitis — 1 — 1 — — — — — — 1 — — — — — Chicken Pox — 34 — 34 — 1 1 2 2 18 8 — 2 — — — Encephalitis Lethargica — 3 — 3 — — — — — — — 1 — — 2 — Cerebro-spinal-meningitis — 1 — 1 1 — — — — — — — — — — — Totals 4 95 — 99 2 5 6 8 7 32 16 4 6 7 6 — TUBERCULOSIS Age Periods NEW CASES DEATHS Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary Male Female Male Female Male Female Male Female 0 - - - - - - - - 1 - - - - - - - - 5 - - - - - 1 - 10 - - - 1 - - - 1 15 1 - - - - 1 - - 20 - 1 - - 1 1 2 - 25 - - 1 - - - - - 35 2 2 - - 1 1 1 - 45 2 - - - 1 - - - 55 - 1 - - 1 - - - 65 and upwards - - - - - - - - Totals 5 4 1 1 4 3 4 1 OPHTHALMIA NEONATORUM—Nil 7 8 CASES TREATED AT TOLWORTH ISOLATION AND OTHER HOSPITALS. Diseases Tolworth Hospital Westminster Hospital Remarks Scarlet fever 17 — One case was found to be suffering from Chicken pox only. One case removed from M.A.B. South Eastern Hospital to Tolworth at request of parents. Diphtheria 11 — Chicken pox 1 — Cerebro-spinal-meningitis — 1 Do. "carrier'' 1 — Totals 30 1 HEALTH WEEK. In response to a request from the Surrey Branch of the National Council for Combating Venereal Diseases, the Council gave permission for holding one week's intensive campaign in the District to further the objects of this Association. The week was held from January 22nd—28th, and was an unqualified success. Eight meetings were held and were followed by two further meetings for teachers. Mr. Tunbridge, your Sanitary Inspector, undertook the general organisation of the week and was ably assisted by Mrs. Councillor Porter, and it was very gratifying to them and to me that, after the great amount of preliminary work necessary and the natural reticence of the public in matters of this kind, such excellent attendances were recorded. (4) CAUSES OF SICKNESS There have been no causes of sickness and invalidity which have been specially noteworthy during the year. 9 (5) SUMMARY OF NURSING ARRANGEMENTS, HOSPITALS AND OTHER INSTITUTIONS AVAILABLE FOR THE DISTRICT Professional Nursing in the Home. (a) General : Nursing Institute in district has staff of trained nurses available for attending cases in the home (including maternity cases). (b) For Infectious diseases, e.g., Measles, etc. : No permanent ments for nursing these cases, which would have to be dealt with as they arise. Midwives: Employment of, or subsidy to, practising midwives by the Public Health Authority. The District Council does not employ any midwives, or subsidise any midwives. The Midwives' Act is administered by the County Council. Number of midwives practising in the district 7 Clinics and Treatment Centres. Maternity and Child Welfare.—Rear of Congregational Church, Malden Road (provided by County Council). Day Nursery—Rear of Council Offices, Malden Road (provided by District Council). Tuberculosis Dispensary.—Kingston-upon-Thames (provided by County Council). Venereal Diseases.—Arrangements are made by the County Council for the treatment of these diseases, at various Hospitals and Centres. School Clinic.—Surbiton. Hospitals Provided or Subsidised by Local Authority or County Council. (1) Tuberculosis Various by County Council (2) Maternity do. do. (3) Children do. do. (4) Fever Joint Hospital at Tolworth (subsidised by District Council) (5) Small Pox Provided by County Council at Clandon (subsidised by District Council) (6) Other Institutional Provision for Unmarried Mothers, Illegitimate Infants and Homeless Children in the District. Arrangements made by the County Council. Ambulance Facilities. (a) For Infectious Cases Tolworth Motor Ambulance (b) For Non-Infectious and Accident Cases Nil 10 (6) LABORATORY WORK. BACTERIOLOGICAL EXAMINATIONS. Disease Result. Total Positive. Negative. Tuberculosis Sputa 7 39 46 Diphtheria Swabs 3 69 72 Cerebro-spinal Meningitis Swabs Post Nasal 1 3 4 Typhoid Fever Serum - 1 1 Typhoid Fever Faeces - 1 1 Miscellaneous Swabs - 5 5 Totals 11 118 129 The whole of the above examinations were carried out by the Clinical Research Association, London. Diphtheria anti-toxic serum is issued to medical practitioners free of charge. A syringe, with a supply of anti-toxic serum, is placed at four different points of the district for the immediate treatment, day or night, of diphtheria. The Council has authorised the Schick test to be available for any medical practitioner. LIST OF ADOPTIVE ACTS, BYE-LAWS AND LOCAL REGULATIONS RELATING TO PUBLIC HEALTH, IN FORCE IN THE DISTRICT, WITH DATE OF ADOPTION Act Date of Adoption Infectious Disease (Prevention) Act, 1890 June 1908 Housing of the Working Classes Act, 1890 (part III) June 1904 Public Health Acts (Amendment) Act, 1890 (parts I and III) June 1904 Private Street Works Act, 1892 December 1902 Public Health Acts (Amendments) Act, 1907 (parts II, III, IV, V and VI) November 1908 (part X, Secs. 92, 93 and 95) November 1908 (part VII, Secs. 81 (part), 85 and 86) December 1908 (parts VIII and IX) December 1908 Bye-Law Buildings May 1904 New Streets and Buildings (Amending Series) November 1914 New Buildings (Amending Series) December 1919 New Buildings (Amending Series) May 1922 Nuisances October 1908 Tents, Vans, Sheds and similar structures April 1909 Common Lodging Houses October 1908 Drainage of Existing Buildings, etc October 1910 Offensive Trades November 1913 Slaughterhouses April 1909 Regulations Dairies. Cowsheds and Milkshops March 1906 11 MILK. No licence is held to sell certified or Grade 'A' milk in your District. Two were granted early in the year, but the venders discontinued the sale of this class of milk. No bacteriological examination has been made during the year. The milk consumed by the public is only examined under the Sale of Food and Drugs Acts by the County Inspector whose duty it is to see that nothing is added and nothing taken away. It is a test to prevent adulteration and no more. It has been proved beyond doubt that railway borne milk is very often dirty and contains large numbers of bacteria, including Tubercle. 820 gallons of railway borne milk is delivered every day at the railway stations. 16 purveyors of milk have their premises outside the district. Milk such as I have described above is especially dangerous to infants and young children. Indeed, the Minister of Health, in answer to a question by Mrs. Wintringham, stated that the public could not even rely on the hygienic quality of the milk on sale, described as nursery, invalids, or guaranteed. The Medical Officer of Health lor the City of London stated in his Annual Report that of a large number of milk samples examined, one in ten were Tubercular. Sir Robert Firth (a military expert) in his Science and Practice of Hygiene states " It is always advisable to examine a milk sample microscopically. To determine the kinds of bacteria in a milk sample is an almost hopeless task, but an endeavour should be made to detect B. Coli typhoid, diphtheria and tubercle bacteria, which can be done from a cultured specimen. Probably animal inoculation is the only reliable test of virulence." The Veterinary Surgeon reports that he could not detect any signs of tubercle in the cows examined by him in the District. Railway borne milk, not safeguarded by bacteriological examination or supervision at the place of production must be dangerous to children and the public. I draw especial attention to the remarks made by Mr. Tunbridge in his Report. I trust you will take this question into your serious consideration. There is little to report on the administration of the Factory and Workshops Acts, which has proceeded smoothly. Any minor defects which are noted by the Factory Inspector at his periodical inspections are notified and given immediate attention. In conclusion I have again to thank Mr. Tunbridge and the staff for their unanimous and loyal support which has greatly contributed to the satisfactory result of the health of your district during the year, and although crowding conditions still prevail and might easily lead to less satisfactory results the efficiency of the department has been well maintained. I am, Mr. Chairman and Members of the Council, Your obedient servant, RASHELL T. DAVISON, M.D., Medical Officer of Health. 12 (7) SANITARY ADMINISTRATION. ANNUAL REPORT of the SANITARY INSPECTOR, 1923. Public Health Department, Council Offices, New Malden. To The Maidens and Coombe Urban District Council. Mr. Chairman, Ladies and Gentlemen, I have the pleasure of presenting my Fourth Annual Report of work accomplished and matters of interest concerning the Sanitary Department. As in previous years since the War a brief report only is given and is confined to information that varies from year to year. For the purposes of abating nuisances, the following notices have been served under the Public Health Acts 1875-1907 and the Housing Acts 1890-1919. Preliminary. Formal. Notices served 216 35 Complied with 209 35 No action taken 7 — It is again satisfactory to note that the owners of a number of houses have executed sanitary repairs without the service of notice, but on one or two occasions I have had to call builders' attention to the fact that sanitary work had been carried out without giving proper notice to this Department. In framing notices I have always endeavoured to be reasonable to the owner and at the same time to satisfy the tenant. This however is not always successful, especially at those houses where dilapidations exist which appear to be due to the tenant's neglect. In these cases personal interviews with owner and tenant has generally had the effect of obtaining improvements to which both sides have contributed—financially and otherwise. 13 A number of cases of overcrowding has again been met with, but now that the Council houses are all occupied more difficulty is experienced in dealing with these cases. Service of notice to abate overcrowding is almost a hopeless method of dealing with the problem as in practically all cases it simply means the removal of the nuisance to another place to be discovered on subsequent inspection. Whilst admitting that the problem is, comparatively, a much smaller one in this district than in larger towns and cities, it is sufficiently apparent to cause anxiety from the point of view of the health and morals of those persons compelled by force of circumstances to live under these most unsuitable conditions. NUISANCES DEALT WITH AND ABATED DURING THE YEAR Dampness 9 Guttering and downspouts repaired 20 Rooms cleansed and repapered or distempered 134 Ceilings cleansed and limewashed or distempered 117 Ceilings repaired 10 Cooking stoves repaired or renewed 10 Flushing cisterns repaired, regulated 5 Drinking water taps repaired 1 Blocked drains cleared 26 Roofs repaired 18 New glazed sinks fixed 6 New W.C. basins fixed 7 W.C. basins repaired or cleansed 8 Other W.C. nuisances 15 New inspection chambers constructed 3 New manhole covers fixed 5 New galvanised iron dustbins 57 Yards repaved or repaired 26 Scullery floors repaved or repaired 7 Water cisterns repaired 11 Covers provided to water cisterns 8 Want of proper water supply owing to defects in pipes, etc 3 Floors repaired 3 Houses totally re-drained 3 House drains repaired and portions re-laid 7 New vent pipes fixed 1 Coppers repaired 9 Accumulations removed 8 From keeping pigs 3 From keeping other animals 4 Slaughter house nuisances 7 Private road nuisances 1 Urinal nuisances 1 Cesspool nuisances 2 Broken window frames, sashcords, etc. 12 14 Factory and workshops 7 Caravans, tents, etc. 1 Surface water combined drains connected to sewer 1 Miscellaneous 59 This is a slight decrease on last year's total, but in addition to this, the fact that 58 of the Council Houses on the Mount Pleasant Estate were decorated during the year and that numerous repairs to roofs, W.C.'s, cisterns, etc., were also effected under the direct supervision of this department, must be taken into consideration. INFECTIOUS DISEASES Premises where cases of infectious diseases occurred have been visited and in some cases the drains were tested. The principals of the various schools where patients or contacts attended were immediately notified. During the year it was necessary to send 26 notifications in respect of 39 children. Detailed inquiries are made after each of the principal infectious diseases with the object of at once ascertaining the origin and endeavouring to prevent an extension of the disease. The following rooms were disinfected for the undermentioned causes:— Scarlet fever 19 Diphtheria 10 Deaths 6 Tuberculosis 8 Pneumonia 3 Chicken Pox 2 Vermin 3 Schools and Creche 2 . Miscellaneous 1 Total 54 In many cases, and in addition to the above, a bottle of disinfectant is left at the house to enable the occupier to clean down woodwork, floors, chairs and bedsteads. Little good can be done by fumigating a dirty room which is allowed afterwards to remain dirty, and encouragement is given on these occasions, at dirty homes, to effect improvement in this direction. No arrangements exist for disinfecting bedding within the district. Any to be done is sent to Tolworth, who make a charge of 8s. 6d. per load excluding cartage. There are no arrangements within the district for disinfestation. TENTS, VANS, ETC. Considerable trouble was experienced at the beginning of the year with an encampment of tents and vans used for habitation, and vigorous steps had to be undertaken to prevent the nuisance and annoyance occasioned thereby. After a good deal of correspondence and interviews I was successful in getting the field cleared of all the vans, etc. Many of these vans were dirty and caused annoyance to the adjoining occupiers by requests for water, etc. Towards the end of the year a few other vans encamped on the land, but inspections of these have disclosed cleanly conditions and a much more respectable occupant, and I have not therefore had occasion to object to their presence. 15 STABLES, etc. Watch has been kept on the various small stables situated in the District. These of late years have tended to reduce in numbers, giving way to motor garages. There are, however, a number where one, two or three horses are kept in each, and at the commencement of the flybreeding season I circularised these requesting the more frequent removal of manure. If the manure is removed at least twice weekly and disposed of in a satisfactory manner, and the pit and surroundings properly cleaned the breeding out of some millions of flies can undoubtedly be prevented. SLAUGHTERHOUSES AND INSPECTION OF MEAT AND OTHER FOODS There are four slaughterhouses in the district, one registered and three licensed, viz.:— (1) Rear of 1, Park Terrace, Worcester Park (registered). (2) Rear of 27, Malden Road, New Malden. (3) Rear of 54 Coombe Road, New Malden. (4) At Norbiton Common Farm, New Malden. Frequent inspections have insured the premises being kept in as good a condition as their structure and position will permit. The slaughterhouse at the Norbiton Common Farm is very little used indeed, chiefly about Christmas time for the slaughter of pigs. Notice of slaughter is given from this slaughterhouse. The position and structure of the remaining premises are far from good. Some two years ago I had the honour of reading a paper at the Folkestone Congress of the Royal Sanitary Institute and I strongly recommended then that, failing the institution of the abattoir system, notice of intention to slaughter should be made obligatory. I am glad to notice that. regulations are being framed by the Ministry of Health to this effect and also making further regulations regarding the handling and transport of meat. I hope to be able to report next year that these regulations are an established fact. Places where foodstuffs are prepared have been inspected and found to be conducted in a satisfactory manner. Some minor difficulties have been overcome. Careful watch has been made on food supplies so far as time permits. Time, however, will be saved and inspection facilitated if the regulations before-mentioned come into force. It was found unnecessary to have any food condemned by a magistrate, as in each case it was voluntarily surrendered, the owners raising no objection to my decision. FOODSTUFFS DESTROYED 1 carcase of a pig Tuberculosis 6 heads of pigs do. 1 pair beast's lungs do. 1 beast's liver do. 16 Rabbits Decomposition 236 lbs. of Beef Bone taint Internal organs of heifer (excepting kidneys) Slight tuberculosis 16 SALE OF FOOD AND DRUGS ACTS. These Acts are administered by the County Council, and by the courtesy of the County Medical Officer of Health a return of samples analysed during the year is given herewith. I am also appointed and authorised to take samples under these Acts should occasion so demand. Articles Analysed Adulterated or Deteriorated Prosecutions Formal Informal Total Formal Informal Total Prosecutions Convictions Milk 50 - 50 1 - 1 1 - Preserved Cream 2 - 2 - - - - - Butter - 1 1 - - - - - Cocoa 1 - 2 - - - - - Confectionery and Jam - 2 2 - - - - - Other articles 3 7 10 2 - 2 - - Totals 56 11 67 3 - 3 1 - DAIRIES, COWSHEDS AND MILKSHOPS The sanitary condition of the cowsheds has been fairly maintained during the year. The proprietor of one cowshed has sold his stock and the shed is not now used as such. The Milk (Special Designations) Order, 1922, came into force on the 1st January, 1923. This order has the effect of allowing certain milk to be sold under license as "Certified," "Grade A (Tuberculin tested)," "Grade A," and "Pasteurised." Certain strict conditions are laid down to be complied with before the licence is granted, and a sample taken at any time before delivery must not contain more than a certain number of bacteria per cubic centimetre. To obtain this the cows must, necessarily, be free from disease and the milk produced and delivered under strictly hygienic conditions. At the commencement of the year two dairymen in the district sold certified milk, but at the end of the year both had ceased to do so. There is little doubt that the extra charge for milk produced under these conditions prevents the demand to enable it to be sold in any quantity. I am of the opinion that any careful dairy farmer, exercising proper care with the selection and management of his stock and producing his milk in the proper and ordinarily hygienic manner that the trade demands, can always produce milk up to Grade A standard. In other words, all milk should be up to Grade A standard, and with a little extra expense Grade A (Tuberculin tested) should be produced I always accompany the Veterinary Surgeon at his quarterly inspections and also inspect the cowsheds at other intervals. At the end of the year there were 11 cowkeepers and 10 purveyors of milk on the register. There are also 16 purveyors delivering milk in the district who have their businesses in other districts. 17 ACTION TAKEN WITH A VIEW TO SMOKE ABATEMENT Observations have been made of the few factory chimneys in the district, and I have had to issue cautions on one or two occasions regarding the emission of black smoke. It was found, however, on each occasion that the trouble was due to the non-receipt of consignments of proper fuel suitable to the particular furnace. One or two complaints were received, but the difficulties were soon overcome. Occasionally I have had to give verbal warnings regarding bakehouse chimneys. RATS AND MICE (DESTRUCTION) ACT It has not been necessary to take formal action during the year, but on numerous occasions advice has been sought and assistance given Wire cage traps have been lent out to persons making application for same and have accomplished good results. Several people also have obtained the services of professional ratcatchers with like results. CONCLUSION In concluding I have to thank the Committee and my brother Officials for the courtesy and assistance extended to me during the year in carrying out my duties. I am, Mr. Chairman, Ladies and Gentlemen, Your obedient servant, HENRY TUNBRIDGE, Sanitary and Foods Inspector. 18 (8) PUBLIC HEALTH STAFF. Public Health Officers of the Council. RASHELL DAVISON, M.D., M.R.C S. Eng. (part time), Medical Officer of Health, Fellow of the Royal Institute of Public Health, Fellow of the Society of Medical Officers of Health. HENRY TUNBRIDGE, M.R.San.I., M.I.H. (whole time), Sanitary and Foods Inspector, Certificates Royal Sanitary Institute as Sanitary Inspector and Inspector of Meat and other Foods, Certificates for Building Construction and Drawing. W. R. KENNEDY, M.R.C. V.S.Lond (part time). Veterinary Inspector. OLIVER ELLIOTT, Clerk to Public Health Department. Public Health Committee, 1923. Mr. J. E. Bignall, J.P., C.C., Chairman of the Council. Mr. C. Harvey, Vice-Chairman of the Council. Major G. E. White, M.C., Chairman of the Committee. Mrs. J. Marshall, Mrs. L. N. McCondach, Mrs. D. M. Porter, Mr. A. Dicker, Rev. C. P. Fynes-Clinton, Messrs. C. W. Kirk, S. E. Parkes and A. S. Weekes 19 (9) HOUSING. Number of New Houses erected during the year:— (а) Total 140 (b) With State assistance under the Housing Acts 1919 or 1923 (1) by Local Authority Nil (II) by other bodies or persons Nil Advances made by the Council under the Small Dwellings Acquisition Acts, 1899-1923:— To 29th December, 1923 65 Amount of Advances £40,235 1.—UNFIT DWELLING-HOUSES. Inspection. (1) Total number of houses inspected for housing defects (under Public Health or Housing Acts) 273 (2) Number of dwelling-houses which were inspected and recorded under the Housing (Inspection of District) Regulations, 1910 All recorded (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 203 2.—REMEDY OF DEFECTS WITHOUT THE SERVICE OF FORMAL NOTICES. Number of dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers 162 3.—ACTION UNDER STATUTORY POWERS. A. Proceedings under Section 28 of the Housing, Town Planning, &c., Act, 1919. (1) Number of dwelling-houses in respect of which notices were served requiring repairs 13 (2) Number of dwelling-houses which were rendered fit— (a) By Owners 13 (b) By Local Authority in default of owners Nil (3) Number of dwelling-houses in respect of which Closing Orders became operative in pursuance of declarations by owners of intention to close Nil 20 B. Proceedings under the Public Health Acts. (1) Number of houses in respect of which notices were served requiring defects to be remedied 22 (2) Number of dwelling-houses in which defects were remedied— (a) By Owners 22 (b) By Local Authority in default of Owners Nil C. Proceedings under Sections 17 and 18 of the Housing, Town Planning, &c., Act, 1909. (1) Number of representations made with a view of making a Closing Order Nil (2) Number of dwelling-houses in respect of which Closing Orders were made Nil (3) Number of dwelling-houses in respect of which Closing Orders were determined, the dwelling-house having been rendered fit Nil (4) Number of dwelling-houses in respect of which Demolition Orders were made 1 (5) Number of dwelling-houses demolished in pursuance of Demolition Orders 1 Printed at The Coombe Press, New Malden.