LIBRARY ORPINGTON URBAN DISTRICT COUNCIL REPORT For the Year 1937 on the Sanitary Conditions and Vital Statistics of the Urban District of Orpington by the Medical Officer of Health, Together with REPORTS of the SANITARY INSPECTORS Bromley: THE BROMLEY PRINTING CO., BROMLEY, KENT, URBAN DISTRICT COUNCIL OF ORPINGTON. Health Report for 1937. Gentlemen, I beg to present to you my Annual Health Report for the year 1937, this being the fourth one submitted by me as your Medical Officer of Health, but the fifteenth one in respect of the area concerned. The Registrar-General's estimate of population for midyear 1937 is 43,610, which is an increase of 3,710 on the corresponding-figure for mid-year 1936. The year 1937 may be considered to have been a satisfactory one from the point of view of Public Health. A decrease took place in the Birth Rate, this being- 18.0 per thousand of population, as compared with 19.1 last year. This compares very favourably with England and Wales in which the Birth Rate was 14.9 for 1937 and 14.8 in 1936. The Death Rate also showed a decrease, viz., 8.6 as compared with 10.3 last year. The Death Rate in England and Wales was 12.4 in 1937 and 12.1 in 1936. The Infantile Mortality Rate was also less than last year, the Rate for 1937 being 52 per thousand registered births as against 64 last year. The Infantile Mortality Rates for England and Wales were 58 in 1937 and 59 in 1936. The year was a satisfactory one from the point of view of incidence of Infectious Disease, the number of notification certificates received being 260 as against 1,123 last year. This is chiefly due to a very much smaller number of cases of Measles being notified. I again desire to take the opportunity of placing on record my thanks for the help and assistance I have received from the Council and its Officers. In particular I would specially desire to express my appreciation of the services rendered so efficiently and loyally by Mr. Capon, Mr. Crowe, Mr. Weedy, and the Health Visitor, Miss L. Tate. I am, Gentlemen, Your obedient Servant, P. N. CAVE, Medical Officer of Health. 2 URBAN DISTRICT COUNCIL OF ORPINGTON. Public Health Committee. Chairman: A, L. PRIEST, Esq. vice-Chairman: F. J. BELL, Esq. Lt.-Col. K. M. Kirkhope, c.i.e.H. J. Lester, Esq., f.s.a.a. C. L. Bruce, Esq. F. W. Moore, Esq., j.p., f.c.a. A. Carter-Wright, Esq. J.. H. B. Rich, Esq. W. Gosling, Esq. G. R. Rickaud, Esq. J. R. Guthrie, Esq. P. W. H. Twymak, Esq. O. J. R. HowArth, Esq. Representatives on the West Kent Joint Hospital Board: C. L. Bruce, Esq. A. L. Priest, Esq. Representatives on the West Kent Main Sewerage Board: C. L. Bruce, Esq. A. L. Priest, Esq. STAFF: Medical Officer of Health: P. N. Cave, m. a., m. d., d. p. h., m. h. c. s., l. r. c. p. Sanitary Inspectors: J. A. Capon, c.r.s.i., m.s.i.a. F. C. Crowe, c.r.s.i., m.s.i.a. W. T. Weedy, c.r.s.i., m.s.i.a. Health Visitor: Miss L. Tate. 3 SECTION A.—STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres) 20,859 Registrar-General estimate of population, mid-1937 .. 43,610 Do., 1936 39,900 Number of occupied houses, December, 1937 13,635 Rateable Value, December, 1937 £395,129 Sum represented by a penny rate, December, 1937 £1,510 VITAL STATISTICS, Total. M. F. Birth Rate per 1,000 of estimated resident population. Live births Legitimate 755 365 390 Illegitimate 31 20 11 18.0 Total 786 385 401 Rate per 1,000 (live and still) births. Stillbirths 25 13 12 31.8 Death Rate per 1,000 of estimated resident population. Deaths 378 207 171 8.6 Rate per 1.000 total (live and still) births. Deaths from puerperal causes: Puerperal sepsis Nil - Other puerperal causes 1 1.27 Total 1 1.27 Death Rate of Infants under one year of age:— All infants per 1,000 live births 52 Legitimate infants per 1,000 legitimate births 45 Illegitimate infants per 1,000 illegitimate live births 225 Deaths from Cancer (all ages) 50 Deaths from Measles (all ages) Nil Deaths from Whooping Cough (all ages) Nil Deaths from Diarrhoea (under two years of age) 8 4 VITAL STATISTICS. BIRTHS. During the year 786 Births were registered as belonging to the District, of which number 385 were males and 401 were females. This is equal to an Annual Birth Rate of 18.0 per thousand of population, as compared with 19.1 last year. The Birth Rate for England and Wales was 14.9 in 1937 and 14.8 in 1936. The number of Births registered as being illegitimate was 31, of which 20 were males and 11 were females. There were also 25 still-births, 13 males and 12 females. DEATHS. The number of Deaths registered during the year as belonging to this District was 378 (207 males and 171 females), as compared with 413 last year. This number includes those deaths which, although occurring outside, belonged to this District, but excludes deaths, occurring inside the District, but belonging to other districts. The Death Rate for the year was equal to 8.6 per thousand of population, as against 10.3 last year. The Death Rate in England and Wales was 12.4 in 1937 and 12.1 in 1936. The diseases claiming the largest number of deaths were: Heart disease 101, Cancer 50, and Pneumonia 26. The following Table shows the diseases having the greatest influence on the Death Rate for the past four years:— Year Heart Disease Cancer Cerebral Haemorrhage Bronchitis Pneumonia Pulmonary Tuberculosis 1934 (9 months) 46 31 18 2 6 11 .. 1935 108 39 17 5 21 , , - 19 1936 98 61 16 9 31 15 1937 101 50 12 8 26 19 5 INFANTILE MORTALITY. The number of deaths registered as occurring in Infants under one year of age was 41 (25 males and 16 females). Of these 34 were legitimate and 7 were illegitimate. The Infantile Mortality Rate was equal to 52 per thousand births, as compared with 64 last year. The Infantile Mortality Rate for England and Wales was 58 and for 1936, 59. DEATHS AT DIFFERENT AGES. Deaths in Children between One and Five Years.—Fourteen deaths occurred in children between the ages of one and five years. This is equal to a Death Rate of 0.32 per thousand of population. Deaths in Persons of 65 Years and Over.—The number of deaths registered as occurring in persons of 65 years and over was 175. This is equal to a Death Rate of 4.0 per thousand of population, and comprises 45.5 per cent, of total deaths. CAUSES OF DEATHS. The Deaths in 1937 included:— Diphtheria 3 Pneumonia 26 Influenza 8 Bronchitis 8 Pulmonary Tuberculosis 19 Appendicitis 2 Other Tuberculous Nephritis 6 Diseases 2 Congenital Debility, etc. 23 Cancer 50 Suicide 5 Cerebral Haemorrhage 12 Accident 17 Heart Disease 101 VITAL STATISTICS—PRINCIPAL FEATURES. The following Table shows a comparison of the main features in Vital Statistics for the District during the past four years:— 1934 (9 months) 1935 1936 1937 Population 33,420 36,620 39.900 43,610 No. of births registered 430 668 763 786 Birth Rate 17.1 18.2 19.1 18.0 No. of Deaths registered 217 349 413 378 Death Rate 8.6 9.5 10.3 8.6 Infantile Mortality Rate 32 47 64 52 3 Birth-rates, Death-rates, Analysis of Mortality, Maternal Death-rates, and Case-rates for certain Infectious Diseases in the year 1937. England and Wales, London, 125 Great Towns and 148 Smaller Towns. England and Wales 125 County Boroughs and Great Towns including London 148 Smaller Towns (Resident Populations 25,000 to 50,000 at 1931 Census) London Administrative County Orpington Urban District Rates per 1,000 Population Births :— Live 14.9 14.9 15.3 13.3 18.0 Still 0.60 0.67 0.64 0.54 0.57 Deaths:— All causes 12.4 12.5 11.9 12.3 8.6 Typhoid and Paratyphoid fevers 0.00 0.01 0.00 0.00 0.00 Smallpox — — — — — Measles 0.02 0.03 0.02 0.01 0.00 Scarlet Fever 0.01 0.01 0.01 0.01 0.00 Whooping Cough 0.04 0.04 0.03 0.06 0.00 Diphtheria 0.07 0.08 0.05 0.05 0.06 Influenza 0.45 0.39 0.42 0.38 0.18 Violence 0.54 0.45 0.42 0.51 0.50 Notifications:— Smallpox 0.00 0.00 Scarlet Fever 2.33 2.56 2.42 2.09 1.67 Diphtheria 1.49 1.81 1.38 1.93 121 Enteric Fever 0.05 0.06 0.04 0.05 0 09 Erysipelas 0.37 0.43 0.34 0.44 0.43 Pneumonia 1.36 1.58 1.20 1.18 0.61 Rates per 1,000 Live Births Deaths under 1 year of age 58 62 55 60 52 Deaths from Diarrhoea and Enteritis under 2 years of age 5.8 7.9 3.2 12.0 10.17 Maternal Mortality:— Puerperal Sepsis 0.971 Not available Others 2.26 1.27 Total 3.23 1.27 Rates per 1,000 Total Births (i.e. Live and Still) Maternal Mortality:— Puerperal Sepsis 0.941 Not available Others 2.17 1.23 Total 3.11 1.23 Notifications :— Puerperal Fever 13.93 17.59 11.52 14.15 4.93 Puerperal pyrexia 14.34 6.16 7 ZYMOTIC DEATH RATE. The Zymotic Death Kate is a term commonly applied to the rate of deaths from the seven principal zymotic complaints, viz., Small Pox, Measles, Scarlet Fever, Diphtheria, Whooping Cough, Diarrhoea and "Fever," which latter includes Typhus, Typhoid (or Enteric) and Paratyphoid Fevers. During the year 11 deaths occurred from these complaints, the Zymotic Death Kate being 0.25 per thousand of population. PULMONARY TUBERCULOSIS. The deaths occurring from Pulmonary Tuberculosis (Consumption or Phthisis) numbered 19. This is equal to a Death Rate of 0.43 per thousand of population, OTHER RESPIRATORY DISEASES. The deaths from other diseases of the respiratory system numbered 37. This gives a Death Rate of 0.84 per thousand of population. CANCER. The deaths from Cancer (malignant disease) were 50 (22 males and 28 females). The Death Rate from Cancer was, therefore, 1.14 per thousand of population. INFLUENZA. During the year 8 deaths occurred from Influenza, the Death Rate being 0.18 per thousand of population. A comparison between the Vital Statistics of the District and those for England and Wales is shown by the subjoined Table 8  1934 1935 1936 1937 Orpington Urban District England and Wales Orpington urban District England and Wales Orpington Urban District England and Wales Orpington Urban District England and Wales Birth Rate 17.1 14.8 18.2 14.7 19.1 14.8 18.0 14.9 Death Rate 8.6 11.8 9.5 11.7 10.3 12.1 8.6 12.4 Infantile Mortality rate 32 59 47 57 64 59 52 58 ANALYSIS OF DEATH RATES. All Causes Seven Principal Zymotic Complaints Pulmonary Tuberculosis Other Respiratory Complaints Cancer Influenza Number of Deaths 378 11 19 37 50 8 Death Rate per 1000 of population 8.6 0.25 0.43 0.84 1.14 0.18 9 INFECTIOUS DISEASE. From the point of view of incidence of Infections Disease the year 1937 was a fairly satisfactory one, the number of notification certificates received being 260, as compared with 1,123 last year. The details in connection with the work carried out at the Immunisation Clinic will be found on another page. The following Table shows the number of cases notified, together with the number removed to Hospital, and the number of deaths registered :— Disease Number of cases Number Removed to Hospital Deaths. Scarlet Fever 73 56 — Diphtheria 53 47 3 Typhoid Fever 4 2 — Erysipelas 19 — — Pneumonia 27 — 26* Puerperal Fever 4 — 4 Puerperal Pyrexia 5 — 2 Ophthalmia Neonatorum 1 - — Cerebro-spinal Fever 2 1 — Dysentery 2 — — Malaria 1 — — Measles 69 — — TOTALS 260 106 29 *A11 forms. 10 The monthly incidence of Infectious Disease was:— Disease Jan. Feb, Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Total Scarlet Fever 6 16 4 4 3 8 6 4 6 3 5 8 73 Diphtheria 3 4 5 2 ... 3 4 4 3 15 6 4 53 Typhoid Fever ... ... 2 ... ... ... ... ... 2 ... ... ... 4 Erysipelas 1 ... 3 ... 2 3 ... ... 3 1 2 4 19 Pneumonia 6 2. 6 1 3 ... ... ... 3 1 ... 5 27 Puerperal Fever ... ... 1 ... ... 1 ... 1 1 ... ... ... 4 Puerperal Pyrexia 2 1 ... ... ... ... ... ... ... ... 2 ... 5 Ophthalmia Neonatorum ... ... ... ... 1 ... ... ... ... ... ... ... 1 Cerebro-Spinal Fever ... ... ... ... ... ... 1 ... ... ... 1 ... 2 Dysentery ... ... ... ... ... ... ... ... ... 1 1 2 Malaria ... ... 1 ... ... ... ... ... ... ... ... 1 Measles ... ... ... ... 2 2 10 39 2 3 4 7 69 Totals 18 23 22 7 11 17 21 48 20 23 21 29 260 11 The following Table shows the number of cases notified during the past four years:— 1934 (9 months) 1935 1936 1937 Scarlet Fever 86 63 193 73 Diphtheria 46 48 33 53 Enteric Fever — 1 3 4 Erysipelas 31 25 26 19 Puerperal Fever 2 4 3 4 Puerperal Pyrexia 2 7 3 5 Ophthalmia Neonatorum 3 — 1 1 Acute Poliomyelitis 1 — — Pneumonia 15 22 25 27 Cerebro-spinal Meningitis — 2 2 Malaria — — 3 1 Dysentery — — — 2 Measles 104 59 831 69 TOTALS 290 229 1,123 260 SMALL POX. No cases of Small Pox occurred in the district during the year. SCARLET FEVER. There was a large decrease in the number of cases of Scarlet Fever notified, viz., 73 as against 193 last year. The cases were distributed fairly evenly over the year with the exception of February, when 16 cases occurred. Fifty-six cases were removed to the Hospital. No deaths were registered as occurring from Scarlet Fever. 12 The age periods were:— Under 1 1 to 5 5 to 10 10 to 15 15 to 20 over 20 — 16 31 19 2 5 The monthly incidence was:— Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. 6 16 4 4 3 8 6 4 6 3 5 8 DIPHTHERIA. An increase in the number of cases of Diphtheria, there being 53 cases notified as compared with -33 last year and 48 in 1935. Forty-seven cases were removed to the Isolation Hospital. Three deaths were registered as occurring from Diphtheria during the year. The age periods were:— Under 1 1 to 5 5 to 10 10 to 15 15 to 20 over 20 — 10 27 6 3 7 The monthly incidence was:— Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. 3 4 5 2 ... 3 4 4 3 15 6 4 The Immunisation Clinic, which was opened in May, 1929, has been in operation during the year. Details of the work will be found on another page. The number of new cases attending during the year was 437, 13 Arrangements have been made by the Council for the examination, free of charge, of swabs from cases, or suspected cases of Diphtheria, and during the year 89 specimens have been examined. ENTERIC FEVER. Four cases were notified as against three last year. All the cases were Paratyphoid Fever. Two cases were removed to Hospital. No deaths occurred from this disease. PUERPERAL FEVER. Four cases were notified, this being one more than last year. PUERPERAL PYREXIA. During the year five cases were notified as against three last year and seven in 1935. OPHTHALMIA NEONATORUM. One case was notified, this being the same number as last year. CEREBRO SPINAL FEVER. Two cases were notified. DYSENTERY. During the latter months of the year an outbreak of Dysentery occurred in many districts, and two cases were notified in this area, one in November and one in December. PNEUMONIA. Twenty-seven cases of Pneumonia were notified as compared with 25 last year. During the year 26 deaths were registered from Pneumonia (all forms). MEASLES. Measles is a compulsorily notifiable Disease within this District. During the year 69 cases were notified, as compared with 831 cases last year. No cases were removed to the Isolation Hospital. During the year no deaths were registered as occurring from Measles. 14 TUBERCULOSIS. The number of new cases of Tuberculosis notified during the year was 54 as compared with 51 last year. The 54 cases comprised:— Males. Females. TOTAL. Pulmonary 23 11 34 Non-Pulmonary 15 5 20 TOTAL 38 16 54 The number of deaths registered as occurring from Tuberculosis was 21, viz.:— Males. Females. TOTAL. Pulmonary 12 7 19 Non-Pulmonary 1 1 2 TOTAL 13 8 21 The Kent County Council, through the agency of their Tuberculosis Officers, carry out the treatment for cases of Tuberculosis. Sanatorium and dispensary treatment is provided for both insured and uninsured persons, and during the year the following' number of patients have received treatment:— Number who received sanatorium treatment 27 Number who received dispensary treatment 9 Dispensary supervision only 97 The two Dispensaries available for this District are:— 2, Park Road, Bromley.—Wednesdays 1.30 to 3.30 p.m. and Fridays 5 to 6 p.m. Medical Officer in charge: Dr. B. G. Edelston. 1, Westbury Road, Penge.—Wednesdays 5 to 6 p.m. and Fridays 1.30 to 3.30 p.m. Medical Officer in charge: Dr. T. P. Cole. 15 The following Table shows the number of new cases of Tuberculosis notified during the year, together with the deaths at various age periods :— Age Periods. New Cases. Deaths. Pulmonary. non- pulmonary. Pulmonary. NonPulmonary. M. F. M. F. M. F. M. F. Under 1 year • • • ... 1 • • • • • • ... • •• ... 1 and under 5 ... ... 1 1 ... ... ... 1 5 and under 10 1 • •• 2 1 ... ... ... ... 10 and under 15 ... ... 2 ... .... ... ... ... 15 and under 20 1 3 2 ... ... 1 ... ... 20 and under 25 1 1 2 1 2 2 ... ... 25 and under 35 2 3 3 1 4 3 ... ... 35 and under 45 9 2 2 1 5 1 ... ... 45 and under 55 4 2 ... ... ... ... ... ... 55 and under 65 5 ... ... ... 1 ... 1 ... 65 and over ... ... ... ... ... ... ... ... TOTALS 23 11 15 5 12 7 1 1 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930. The above Regulations, which came into force on the 1st January, 1931, require, inter alia, that a Weekly Return of all notified cases of Tuberculosis should be sent to the County Medical Officer of Health: and also that a quarterly statement should be sent by the Medical Officer of Health to the County Medical Officer of Health, showing:— (a) The number of cases on his register at the ment of each quarter; (b) The number of cases notified for the first time during the quarter; (c) The number of cases which have been removed from the register in a preceding quarter, and which have been restored, giving the name and address of each case, and the reason for restoration; 16 (d) The number of cases added to the register which have been brought to his knowledge other than by notification; (e) The number of cases removed from the register, giving the name and address of each case, and the reason for removal; (f) The number of cases remaining on the register at the end of the Quarter. Previously most of these particulars were required under the Public Health Tuberculosis Regulations, 1924, and subjoined are the number on the register at the end of each quarter since the formation of the District:— Pulmonary Non-Pulmonary Totals M. F. M. F. 1934 30th June 62 60 17 25 164 30th Sept. 70 66 16 26 178 31st December 72 65 16 27 180 1935 31st March 73 68 16 27 184 30th June 73 68 16 27 184 30th Sept. 78 73 17 28 196 3lst December 83 72 17 30 202 1936 31st March 83 81 17 33 214 30th June 89 85 19 35 228 30th Sept. 90 84 23 37 234 31st December 95 94 23 39 251 1937 31st March 96 96 25 39 256 30th June 100 101 31 40 272 30th Sept. 105 98 39 41 283 31st December 111 100 38 44 293 17 The number of new cases of Tuberculosis notified together with the number of deaths occurring in the past four years is shown in the following Table:— Year. . Cases notified. Deaths Pulmonary NonPulmonary Pulmonary NonPulmonary 1934 (nine months) 21 5 11 2 1935 35 4 19 3 1936 34 17 15 5 1937 34 20 19 2 PUBLIC HEALTH ACT, 1925, SECTION 62. On no occasion during the year was it necessary for the Council to take steps to secure an Order for the compulsory removal to Hospital of a person suffering from Pulmonary Tuberculosis. PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925. No action was required during the year under the powers conferred by the above Regulations in respect of Tuberculous employees in the milk trade. NON-NOTIFIABLE INFECTIOUS DISEASE. Whooping Cough.— No deaths were registered from Whooping Cough during the year. Influenza.—Eight deaths were registered during the year, as compared with seven last year, DIPHTHERIA IMMUNISATION CLINIC. A Diphtheria Immunisation Clinic was established by the late Bromley Rural District Council, and was first opened on the 24th May, 1929. The purpose of this Clinic is to test the susceptibility, or otherwise, of children to Diphtheria, and to immunise those giving a positive result. 18 The following is a statement of the work carried out during the year:— Number of sessions held 50 Number of attendances 1,702 Number of new cases 437 A similar procedure to that in the previous years has been adhered to, viz.: Each new patient was Schick tested, and the result read the following week. If the result was positive—that is, if the child showed a susceptibility to Diphtheria—he or she then received three injections of an immunising mixture at weekly intervals. (The material used was "Toxoid-Antitoxin Mixture," prepared by Messrs. Burroughs and Wellcome). Three months later the child was asked to attend again, and was then re-tested by the Schick method. Practically every child then gave a negative reaction to the re-test, thus showing the previous susceptibility was no longer present, and that the child could now be regarded as immune. In those few cases which showed a persistent positive reaction after three months, one further injection was given of the Toxoid-Antitoxin, and a further test after one month showed that the reaction was now negative. In no case was there any constitutional disturbance reported by parents as a result of these injections. The number of children tested at various age-groups was:— Age groups. N umber Tested Number of children in each age group. Per cent Positive. M. F. 0—5 93 49 44 82.8 5—10 244 128 116 75.2 10—15 83 45 38 50.6 over 15 17 4 13 29.4 The monthly attendances were:— January 94 February 07 March 96 April 82 May 61 June 151 July 143 19 August 51 September — October 323 November 411 December 223 The number of children attending from each Ward was as follows:— Chelsfield 25 Crofton 124 Cudham 1 Farnborough 7 Godding ton 128 Green-Street-Green 1 Knockholt 19 Knoll 71 St. Mary Cray 55 ISOLATION HOSPITAL. This District is served by the West Kent Joint Isolation Hospital. The Hospital, which is situated at Bromley Common, is administered by the West Kent Joint Hospital Board, and in addition to this District, serves the Boroughs of Bromley and Beckenham, and the Urban District of Chislehurst and Sidcup. In addition to the accommodation provided for the treatment of the ordinary Infectious Diseases, provision has been made for the treatment of cases of Small Pox, on a separate site. During- the year 106 cases from this District were admitted to the Hospital, viz.:— Scarlet Fever 56 Diphtheria 47 Paratyphoid Fever 2 Cerebro-spinal Fever 1 LABORATORY WORK. The bacteriological work in connection with this District is carried out at the Kent County Laboratory at Maidstone. The following number of specimens from this area have been examined during the year;— 20 Positive Negative Total Swabs for Diphtheria 10 79 89 Sputa for Tubercle 27 144 171 Widals for Typhoid — 3 3 Urine and faeces for organisms of the Typhoid group 3 7 10 TOTALS 40 233 273 In addition, the following emergency swabs for diagnostic purposes were examined by Dr. J. Byers, at the Laboratory of the West Kent Joint Isolation Hospital:— Positive Negative Total Swabs for Diphtheria 25 204 229 Swabs for Hæmolytic Streptococci 1 4 5 DRAINAGE. The houses in the main portion of the District are on the water carriage system, most of the houses being connected to the public sewers. Where no sewers are available, most of the houses are drained into cesspools. In addition there are 294 houses with pail closets, and 13 houses with privy middens or earth closets. At the end of the year the number of houses with sanitary conveniences in use were approximately:— Houses with water closets draining into the sewer 10,767 Houses with water closets draining to cesspools 3,005 Houses with earth closets or privy middens13 Houses with pail closets 294 The main drainage for the greater part of Downe was completed during the year Main drainage was also provided at one street in the Farn borough Ward. The preliminary work is well in hand in connection with the provision of main drainage in the greater portion of the Biggin Hill Ward. 21 SANITARY STATISTICS. No. of houses connected to the sewer No. of houses not connected to sewers No. of houses not provided with a piped water supply No. of wells still in use for purpose of domestic supply 10767 3512 393 6 Sanitary Conveniences. W. C' s. Pan or Pail Closets Midden Privies Ashpits separate from Midden Privies Cesspools No. of No. of houses into 13502 294 13 — 2584 3005 WATER SUPPLY. The Metropolitan Water Board's mains supply the greater portion of the District. In some outlying portions, however, water is obtained from deep wells or from rain water collected from the roofs of the houses and stored in tanks. Main supply has been extended during the year to various new estates which have been laid out. The problem of houses not provided with a main water supply, but depending on stored roof-water, is receiving consideration, but is a difficult one, owing to the scattered position of the premises affected. A detailed survey is being undertaken in an endeavour to improve the condition of affairs at present obtaining. The following tabular statement, compiled at the end of the year, gives a rough idea of the present position. Roads in the Biggin Hill Area where no Water Mains are laid, Occupiers of Premises, therefore, having to depend on Stored Rainwater for Domestic Purposes. 6th Dec., 1937. Approx. No. of houses without main water. Alexander Road 12 Allen by Road 18 Aperfield Road 13 Arthur Road (Six have private services from adj. roads) 8 22 6th Dec., 1937. Approx. No. of houses without main water. Beech Road 10 Fairchilds (Main available but not used by Owners) 13 Highfield Road 16 Hill crest Road (About half of road only from Stock Hill has main) 17 King's Road (Two houses have private main from Norheads Lane) 60 Lebanon Gardens (Two supplied from Sutherland Avenue) 9 Lillie Road 1 Melody Road 29 Moselle Road (Four supplied from St. Winifred's Road) 15 Mount Pleasant (Greater part have private services from Polesteeple Hill) 12 Oaklands Lane 11 Rose Hill Road 5 St. Mary's Grove 5 Sunning vale Avenue (South portion) 45 Swievelands Hill 24 The Grove 41 Upper Drive 9 Village Green Avenue 10 Yew Tree Path 4 York Road 1 387 PUBLIC CLEANSING. The whole of the District has a weekly collection of house refuse carried out by direct labour. The refuse is disposed of on the Bradford system. The Council do not undertake the disposal of the contents of earth closets or the collection of trade refuse. A special cesspool emptying tank is available for emptying cesspools, the contents of which are deposited on agricultural land. HOUSING. I. Inspection of Dwelling Houses during the Year:— (1) (a) Total number of houses inspected for housing defects (under Public Health or Housing Acts) 541 (b) Number of inspections made for the purpose 2334 23 (2) (a) Number of dwelling houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 96 (b) Number of inspections made for the purpose 289 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 1 (4) Number of dwelling 1 louses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 171 2. Remedy of Defects during the year without Service of Formal Notices:— Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their Officers167 3. Action under Statutory Powers during the Year:— (a) Proceedings under sections 9, 10 and 16 of the Housing Act, 1936:— (1) Number of dwelling houses in respect of which notices were served requiring repairs — (2) Number of dwelling houses which were rendered fit after service of formal notices :— (a) By owners — (b) By Local Authority in default of owners — (b) Proceedings under the Public Health Acts:— (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 4 (2) Number of dwelling houses in which defects were remedied after service of formal notices:— (a) By owners 4 (b) By Local Authority in default of owners — (c) Proceedings under sections 11 and 13 of the Housing Act, 1936 :— (1) Number of dwelling houses in respect of which Demolition Orders were made 1 (2) Number of dwelling houses demolished in pursuance of Demolition Orders 1 24 (d) Proceeding's under section 12 of the Housing Act, 1936:— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made — (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit — 4. Housing Act, 1936—Part IV.—Overcrowding:— (a) (i) Number of dwelling houses overcrowded at end of year 43 (ii) Number of families dwelling therein 43 (iii) Number of persons dwelling therein 284 (b) Number of new cases of overcrowding reported during the year 6 (c) (i) Number of cases of overcrowding relieved during the year15 (ii) Number of persons concerned in such cases 91½ (d) Particulars of any cases in which dwelling houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding Nil Number of new houses erected during the year:— By the Local Authority Nil By other persons 1173 HEALTH VISITOR. The Council employs one full-time Health Visitor, who works under the supervision of the Medical Officer of Health. She carries out her duties in a very tactful and efficient manner. The following is a summary of the visits paid by her during the year:— 25  Cases Visited Number of Visits Tuberculosis: Primary—Pulmonary 53 53 Non-Pulmonary 23 23 Revisits—Pulmonary 142 325 Non-Pulmonary 56 168 Measles 65 88 Scarlet Fever 20 147 Small Pox and Diphtheria contacts 130 130 Other visits 278 411 TOTAL 767 1345 The visits to cases of Tuberculosis have been as follows Primary Revisits Other Visits P. N.P.T. P. N.P.T. January 5 2 40 17 30 February 5 — 32 18 23 March 6 — 14 12 123 April 3 2 37 16 44 May 4 2 24 12 60 June 2 3 26 13 40 July 7 3 42 16 98 August 6 8 23 17 87 September 3 1 21 15 42 October 3 1 28 14 50 November 5 1 — — 106 December 4 — 38 18 73 TOTALS 53 23 325 168 776 26 MATERNITY AND CHILD WELFARE. The Maternity and Child Welfare work in this area is under the control of the Kent County Council. The Health Visiting is undertaken in the various parts of the District as follows:— St.. Mary Cray.—Miss Dobson. Biggin Hill, Chelsfield, Cudham, Downe, Knockholt, Leaves Green and Green-Street-Green.— Miss Jobson. Goddington, Knoll, Crofton and Farnborough.— Miss Beck-Slinn. The following Maternity and Child Welfare Centres have been established to serve this District:— Chelsfield. Heading room. Sessions held first and third Tuesday in each month. The Medical Officer in charge is Dr. Peacock, and the Nurse in charge, Nurse Jobson. The average attendance is 24. Cudham (Biggin Hill). Big Teapot Pavilion, Main road, Biggin Hill. Sessions held on each Thursday afternoon. The Medical Officer in charge is Dr. M. E. Pease, and Miss Jobson attends this Centre. The average attendance per session is 26. Cudham. Village Hall. Sessions held first and third Friday in the month. The Medical Officer in charge is Dr. Christieson. Nurse Jobson attends this Centre. The average attendance is 8. Downe. Gospel Hall. Sessions held second and fourth Tuesday in each month. Dr. Douse, who attends monthly, is the Medical Officer in charge. Nurse Jobson attends this Centre. The average attendance is 12. Farnborough. Parish Hall. Sessions held every Friday afternoon. The Medical Officer in charge is Dr. Douse, who attends fortnightly. Miss Beck-Slinn attends this Centre. The average attendance is 31. St. Mary Cray. Parish Hall. Sessions held each Tuesday af'ternoon. The Medical Officer in charge is Dr. Grant, and Miss Dobson attends. The average attendance per session is 68. Orpington. Methodist Church Hall, Sevenoaks Eoad. Sessions held each Tuesday. The Medical Officer is Dr. ledger, and she attends weekly. Miss Beck-Slinn attends this Centre. The average attendance is 86. Green-Street-Green. Church Hall, World's End lane. This is a Voluntary Centre. 27 ANTE-NATAL CLINIC. An Ante-natal Clinic has been established at the Methodist Hall, Orpington. Sessions are held on the second Tuesday in each month at 10 a. m. SCHOOLS. There are fourteen elementary Schools within the District. Medical Inspection. The medical inspection of school children is carried out by the Kent County Council. Water Supply. All schools are supplied with water by the mains of the Metropolitan Water Board. Inspection. Inspection is made from time to time of all sanitary accommodation at the schools.. Closure of Schools. It was not found necessary to close any school during the year 011 account of the incidence of Infectious Disease amongst the scholars, nor was any Certificate issued covering low attendances. MIDWIVES. The Supervising Authority under the Midwives Act for this District is the Kent County Council. The following Midwives have given Notice of Intention to practice in this area during the year:— Brier, Y. M., 3, Rosecroft Close, St. Mary Cray. Bellamy, E. B., 10, Hayfield Road, Sullivan's Estate. Bhat, E. M., Orchard Rise, Farnborough. Dagnall, W., 1, Kelvinside, Mount View Road, Orpington. Ellis, V. E., Rose Dene, 2, Main Road, Biggin Hill. Franks, B., 3, Market Parade, Orpington. Grieves, E. E., Delmuir, Westerham Road, Keston. Kerridge, P. M., 26, Vine Road, Green-Street-Green. Lewis, N. E., 26, Vine Road, Green-Street-Green. Mortimer, E. M., Cross Ashes, Bromley Road, Downe. Page, M., Lexington, Sandy Lane, Orpington. Williams, L.. M., The Bungalow, Old London Road, Knockholt. REGULATED TRADES. Dairies and Cowsheds.—There are 67 premises registered as Dairies and Cowsheds in the District. During the year 574 visits of inspection were paid, and in three instances defects were found. All have since been remedied. 28 MILK (SPECIAL DESIGNATION) ORDER, 1936. During' the year the Council granted the following number of licences:— Tuberculin Tested 8 Pasteurised 8 Eight samples of mixed milk were examined for the presence of Tuberculosis, and 29 samples of Graded Milk were submitted for bacteriological examination. SLAUGHTERHOUSES. There are 17 licensed Slaughterhouses within the District, this being the same number as last year. During the year 1,079 visits of inspection were paid. PUBLIC HEALTH (MEAT) REGULATIONS, 1924. The above Regulations came into force on the 1st April, 1925, and under their provisions an opportunity is afforded for the examination of carcases of animals slaughtered for human consumption. The following Table shows the number of animals killed, the number inspected, and the amount of meat destroyed as being unfit for human consumption :— Cattle excluding Cows Cows Calves Sheep and Lambs Pigs Number killed (if known) 150 20 188 604 4825 Number inspected 150 20 158 464 4725 All diseases except Tuberculosis: Whole carcases condemned Nil. Nil. Nil. Nil. 15 Carcases of which some part or organ was condemned 6 Nil. Nil. 3 27 Percentage of the number inspected affected with diseases other than Tuberculosis 4% Nil. Nil. .64% .88% TUBERCULOSIS ONLY. Whole carcases condemned 1 Nil. Nil. Nil. 17 Carcases of which some part or organ was condemned 5 6 Nil. Nil. 135 Percentage of the number inspected affected with tuberculosis 4% 30% Nil. Nil. 5.21% 29 A Meat Marketing Scheme is in force within the District, but advantage is not taken of it by the tradesmen. BAKEHOUSES. There are 20 Bakehouses in the District, this being the same number as last year. During the year 172 visits were paid, and in one instance a defect was found and remedied. PIGGERIES. There are nine Piggeries in the District, this being one more than last year. One hundred and fifty-four visits of inspection were paid, and in no instance was any defect found. OTHER FOOD PREPARING PLACES. There are 235 other premises in which food is prepared for human consumption. During the year 574 visits have been paid to these premises. COMMON LODGING HOUSES AND HOUSES-LET-IN-LODGINGS. There is one Common Lodging House in the District, to which four visits have been paid. There are no Houses-Let-in-Lodgings. FACTORIES AND WORKSHOPS. There are 154 premises within the District, of which 32 are Factories and 122 are Workshops. During the year 138 visits were paid. A detailed list of the Factories and Workshops remaining at the end of the year is shown in the following Table;— 30 Trade. Number of Factories. Workshops. Total. Saw Mills 4 — 4 Laundries 3 7 10 Cycle Works 1 13 14 Carriage Makers and Wheelwright — 2 2 Printing Works 3 — 3 Carpenters and Builders — 25 25 Undertakers — 1 1 Shoeing Forges — 8 8 Dressmakers and Tailors — 8 8 Upholsterers — 3 3 Bakeries — 18 18 Paper Mills 1 — 1 Harness Makers — 1 1 Bootmaking and Repairing — 19 19 Chaff Cutting and Corn Grinding 1 — 1 Motor Repairers 10 5 15 Sculptural Factory 1 — 1 Cab Washing (workplace) — 1 1 Basket Makers — 1 1 Wireless — 3 3 Ballast Works 1 — 1 Breeze Block Makers 2 1 3 Tile Makers 1 — 1 Builders' Merchants (workplaces) — 2 2 Electrical Engineers — 2 2 Plumber — 1 1 Rag Sorter — 1 1 Brick Works 1 — 1 Cooperage 1 — 1 Gas Mask Works 1 — 1 Leather Cloth Works 1 — . 1 Total 32 122 154 One hundred and thirty-eight visits were paid to these premises, but no defects were found. 1.— Inspection of Factories, Workshops and Workplaces. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances Premises. (1) Number of Inspections (2) Written Notices (3) Occupiers prosecuted (4) Factories (Including Factory Laundries) 138 — — Workshops (Including Workshop Laundries) Workplaces (Other than Outworkers' premises) Total 138 — — 31 2.—Defects found in Factories, Workshops and Workplaces. Particulars (1) Number of Defects. Number of offences in respect of which Prosecutions were instituted (5) Found (2) Remedied (3) Referred to H.M. Inspector (4) Nuisances under the Public Health Acts :— Want of cleanliness Nil. Want of ventilation Overcrowding Want of drainage of floors Other nuisances Sanitary accommodation insufficient unsuitable or defective not separate for sexes Offences under the Factory and Workshop Acts:— Illegal occupation of underground bakehouse (s. 101) Other offences (Excluding offences relating to outwork and offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921). Total - — — — *Including those specified in sections 2, 3, 7 and 8 of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts. 32 SUMMARY OF REGULATED TRADES. Number Visits Defects found Detects remedied Dairies 67 574 3 3 Cowsheds Slaughterhouses Licensed 17 1079 — — Registered Bakehouses 20 172 1 1 Piggeries 9 154 — — Other food preparing places 235 574 — — Factories 32 |138 - - Workshops 122 Workplaces 3 Common Lodging Houses 1 4 — — Houses let in Lodgings - - — TOTAL 506 2695 4 4 SHOPS ACTS, 1912—1934. Inspection of the shops in the District is made as time permits. During the year 221 visits were made to shops under the provisions of the Shops Acts, but on no occasion was it found necessary to take formal action in relation to the ventilation, etc., and sanitary accommodation. SWIMMING BATHS AND POOLS. There is one privately owned swimming bath in the District which is open to the public. There is also one private swimming bath owned by the London Boy Scouts' Association. During the year inspections were made, but no action was found necessary. 33 ERADICATION OF BED BUGS. The following work was carried out during the year in connection with the eradication of bed bugs:— Number of Council houses found to be infested 5 Number of other houses found to be infested 7 Number of Council houses disinfested 5 Number of other houses disinfested 6 The disinfestation in the case of Council houses is carried out by the Cimex (Ltd.) system, employing non-poisonous fumigation by gas. In other houses the method adopted is by spraying with one of the recognised insecticides. The premises of all prospective tenants of Council houses are inspected, and where necessary, disinfestation is carried out. The work of disinfestation is carried out by Officers of the Local Authority. Strict supervision is exercised by the responsible official in regard to possible infestations, and every possible advice and assistance is given in connection therewith. WATER COURSES. Constant supervision is paid to all watercourses. The principal stream running through the District is:— The River Cray, which rises in Orpington, and runs through Orpington and the Crays. AMBULANCE FACILITIES. The following ambulances are available for use in this District:— For Infectious Cases.—Four motor ambulances are provided by the West Kent Joint Hospital Board for the conveyance of Infectious Disease cases to the Isolation Hospital.. For Accident and General Cases.—An ambulance is available for the removal of accident and general cases. NURSING FACILITIES. The local District Nursing Associations, which are affiliated to the Kent County Nursing Association, provide nursing facilities in the District. NURSING HOMES REGISTRATION ACT, 1927. The powers under the above Act have been delegated by the Kent County Council to the District Council. At the end of the year there were four Nursing and Maternity Homes, the number of beds available being 19, of which 12 were for maternity cases and seven for other cases. 34 LEGAL PROCEEDINGS. In the following cases it was found necessary to institute legal proceedings:— Particulars Result[/##] A cow keeper was summoned for breaches of sec. 23, sub-sections 2, 3, 4 and 5, of the Milk and Dairies Order, 1926. Convicted, and fined £4 0s. Od. with £2 2s. Od. costs. ADOPTIVE ACTS AND BYE-LAWS. No Acts nor Bye-laws were adopted by the Council during the year. The following general Acts and Bye-laws are in force within this District:— Public Health Acts Amendment Act, 1890.—Sections 16, 17, 18, 19, 20 (i), 21, 24, 25, 26, 27, 28, 32, 33, 35, 38, 39, 40, 42, 43, 44, 45, 46, 47, 48, 49, 81, 85, 87, 89, 90 and 91. Public Health Act, 1925.—Sections 17, 18, 20, 23, 24, 26, 29, 33, 36, 37, 38, 40, 41, 42, 45, 46, 47, 48, 49, 50, 55 (unrepealed provisions). Public Health Act, 1907.—Sections 21, 22, 44 and 51 to 54. Section 1.—Slaughter of Animals Act, 1933, made to apply to sheep, ewes, wethers, rams and lambs as from the 1st September, 1934. Bye-laws. Bye-laws with respect to the management of a mortuary. Bye-laws with respect to new streets and buildings. Bye-laws with respect to Nursing Homes to come into force 1st January, 1937. Bye-laws with respect to Parking Place to take effect from 1st February, 1937. Bye-laws with respect to Slaughterhouses (slaughter of pigs, etc.), made during 1937. Bye-laws with respect to Hop-Pickers' Accommodation, made during 1937. Bye-laws with respect to Pleasure Grounds, made during 1937. co Ov TABLE 1.—CASES OF 1NFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1937. Disease Number of cases notified At ages—years Cases removed to Hospital Deaths At all ages Under 1 year 1 and under 2 2 and under 3 3 and under 4 4 and under 5 5 and under 10 10 and under 15 15 and under 20 20 and under 35 35 and under 45 45 and under 65 65 and over Scarlet Fever 73 — 3 4 5 4 31 19 2 4 1 — — 56 — Diphtheria 53 — — 4 4 2 27 6 3 6 1 — — 47 3 Typhoid Fever 4 — 1 — 1 — ] — — 1 — — — 2 — Erysipelas 19 — — 1 — — 1 — — 3 4 6 4 — Pneumonia 27 — — 1 1 4 — — 2 6 5 5 3 — 26 Puerperal Fever 4 — — — — — — — — 3 1 — — — — Puerperal Pyrexia 5 — — — — — — — 5 — — — — — Ophthalmia Neonatorum 1 1 — - - - - - - - - - - - — Cerebro-Spinal Fever 2 — - — — — — 1 1 — — — — 1 — Dysentery 2 — - — — — — — — 2 — — — — — Malaria 1 — - — — — — — — — — 1 — — — Measles 69 3 - 3 6 3 43 3 1 3 - - - - - TOTALS 260 4 8 13 17 13 103 29 9 33 12 12 7 106 29 36 TABLE II.—DEATHS REGISTERED DURING THE YEAR 1937. Cause of Death Males Females Total Typhoid and paratyphoid fevers - - - Measles — — — Scarlet fever — — — Whooping Cough — — — Diphtheria 1 2 3 Influenza 4 4 8 Encephalitis Lethargica — — — Cerebro-spinal Fever — — — Tuberculosis of the respiratory system 12 7 19 Other Tuberculosis diseases 1 1 2 Syphilis — — — General paralysis of the insane (Tabes Dorsalis.) - - - Cancer 22 28 50 Diabetes 4 3 7 Cerebral haemorrhage 4 8 12 Heart disease 54 47 101 Aneurism — — — Other circulatory diseases 12 7 19 Bronchitis 2 6 8 Pneumonia (all forms) 18 8 26 Other respiratory diseases 3 - 3 Peptic ulcer 1 — 1 Diarrhoea (under 2 years) 4 4 8 Appendicitis 2 — 2 Cirrhosis of the liver — — — Other diseases of the liver 1 1 2 Other digestive diseases Acute and chronic 1 3 4 Nephritis 2 4 6 Puerperal sepsis — — — Other Puerperal causes — 1 1 Congenital debility, premature birth, malformations 17 6 23 Senility 7 7 14 Suicide 3 2 5 Other violence 10 7 17 Other defined diseases 22 15 37 Ill-defined or unknown - - - Total 207 171 378 37 ORPINGTON URBAN DISTRICT COUNCIL. No. I District. Comprising the Wards of Biggin Hill, Cudham, Downe and Leaves Green. GENTLEMEN, I beg' to present my Annual Report for the year ended 31st December, 1937. Nuisances.—Public Health and Housing' Acts. The number of inspections and re-visits made to premises for the detection of nuisances and the abatement thereof was 687, and 99 nuisances were discovered and dealt with at 54 premises. Intimation Notices were served on the owners or occupiers in all cases where Statutory Nuisances existed, and it is pleasing to note that in no instance was it necessary to resort to the service of an Abatement Notice within the meaning of the Act. Complaints.—During the year sixteen complaints were received as to nuisances existing at premises. These were as follows:— Overflowing cesspools and obstructed sewage drains 4 Defective houses 8 Keeping of animals 1 Absence of water supply 3 All complaints were investigated, and where just cause for complaint was found, the defects were duly remedied. Disinfection.—The number of houses disinfected was 10, consisting- of 15 rooms, after the following diseases:— Diphtheria 1 Scarlet Fever 6 Tuberculosis 2 Cancer 1 Temporary Shelters for Fruit and Vegetable Pickers.— These shelters were periodically visited during the summer months, and the requirements of the Byelaws in respect to the occupied shelters, privies, etc., were duly carried out. A few only of the shelters were used for living or sleeping purposes. Factories and Workshops.— A total of 22 visits was made to the workshops in my district. No nuisance was discovered. Rats and Mice Destruction Act.—Prior to the National Rat Week held during the first week in November posters were displayed as in the previous year on various Posting Stations 38 throughout your district, and also exhibited by the various shopkeepers, drawing public attention to the week in question, and asking for special efforts to be made for the destruction of the vermin. A supply of Bulletin No. 30 issued by the Ministry of Agriculture and Fisheries was also available for applicants. Shops Acts.—During the year 160 visits were made to various shop premises in the area, and the register was duly amended from time to time as far as practicable. Warnings were necessary to shopkeepers in some cases, particularly in regard to non-observance of closing hours of certain businesses, and the display of required notices as prescribed by the Acts. Housing Act, 1936, Section 62: Measurement of Houses.— Two temporary Measuring Assistants were engaged solely on this work. Their services were dispensed with in August, by which date, as far as could be ascertained, all rented properties in the district coming within the scope of the Act had been measured, these numbering 3,950. By this measurement survey it has been possible to build up a system of records which should serve a very valuable purpose in the future. By the end of the year the total number of Certificates issued to landlords on application was 1,007, embracing 1,626 properties. INSPECTION AND SUPERVISION OF FOOD. Dairies, Cowsheds and Milkshops.—One Dairy Farm was removed from the Register during 1937 owing to the premises becoming vacant, and one farm changed ownership. The occupier of one farm was licensed by the appropriate authority for the production of Accredited milk. The number of cowsheds in use at the end of the year was 24, the number of Dairies being 15. The number of inspections made to the 15 Farms was 109, and premises, etc., generally were found in good order, the half-yearly cleansing and limewashing being carried out without exception. Action was necessary to obtain the removal of a large accumulation of manure, and the proper cleansing of milking stools at one farm. Eighteen samples of Graded Milk, seven Tuberculin Tested and 11 Accredited were taken from Licensed Farms during the year and submitted, as required, for bacteriological examination, 39 Bakehouses.—Eighteen inspections were made to the two occupied registered bakehouses, and internal cleansing* and limewashing carried out as required. Defects at one premises were remedied as the result of informal action. Food Shops.—To these premises 51 visits were made. No nuisance or unsound food discovered. Slaughter-houses.—One hundred and twenty-seven visits were made to the four occupied slaughter-houses. The premises were generally kept clean and in good order, minor repairs as necessary being carried out from time to time by occupiers. Piggeries.—Pig keeping is carried on to a fairly large extent at four premises in my area, and 109 inspections were carried out. 1 discovered no nuisance. Public Health (Meat) Regulations.—The number of Notices of Slaughter received during the year was 134, the number of pigs slaughtered and examined thereunder being 1,077. A total of 764 1bs of pork was condemned as unfit for food for the following reasons:— Tuberculosis 674 Cirrhosis 90 SUMMARY. Number of visits made to premises under the Public Health, Housing, and other Acts and Regulations, excluding those directly connected with food supply 834 Number of Food Trade Inspections carried out 478 Number of visits made to premises in connection with the removal of house refuse 1801 Number of Intimation Notices served 45 Number of Statutory Notices served — Number of Premises where nuisances discovered 54 Number of Nuisances discovered 99 Nature of nuisances discovered and remedied:— Dirty and defective walls and ceilings 16 Defective roofs and guttering 9 Defective floors and internal paving 4 Defective or obstructed sewage drains 9 Defective W.C.s, sinks, gullies, etc. Overflowing cesspools 7 34 Discharge of sewage on to public highway 1 Offensive accumulation 1 Rising or penetrating dampness of walls 4 Animals so kept as to be a nuisance 9 Absence of water supply 4 Miscellaneous 8 40 HOUSE REFUSE COLLECTION AND DISPOSAL. Since April, 19-30, the work of collection has been carried out by the Council by direct labour with their own vehicles weekly from the Northern portion of the district, prior to which date Contractors were employed. Previous to the formation of the Urban District, there was no collection made by the Council from houses in the Southern portion (viz., Cudham, Downe and Knockholt), but from April, 1934, a collection has been made in the area each fortnight, and the service is much appreciated by residents. The vehicles in use are:—One 10-c. yard capacity self-contained Karrier Freighter, one 7-c.. yard and six 9-c. yard capacity Eagle two-wheeled hydraulic end-tipping trailers, adaptable for either horse or mechanical power haulage. Haulage of full trailers to the dump and the conveyance of empty trailers to collecting teams is carried out by two International Tractors. House-to-house collection by trailers is done by horse haulage, horses and drivers for this work being hired under yearly Contract. The work of collection throughout the year has been carried out regularly, all teams having performed their duties in a very satisfactory manner. The census of houses visited is taken each half-year (April and October), a normal week's work being the basis. The following are the figures ascertained for the year 1937, together with the figures for the corresponding period of the previous year for comparison:— Apl. 1937. Apl. 1936. Oct. 1937. Oct. 1936. Total number of separate premises visited 12,385 11,257 13,412 12,116 Total number of dustbins emptied 12,771 11,681 13,961 12,596 The question of the Council undertaking a special collection of Trade Refuse from the various business premises in the district was still under consideration during the year, but a definite decision in the matter has not yet been arrived at. During 1937 the two International Tractors travelled a distance of 12,708 and 12,772 miles each respectively. The Council purchased during the year a new Karrier Freighter of 10-c. yards to replace the previous Vulcan Freighter which was deemed to be past renovation. The Vulcan was out of commission from the beginning of the year, the Karrier 41 commencing work for the first time on the 14th September, and during this period the machine covered 1,920 miles. It was necessary to hire a lorry or lorries to collect from the area ordinarily covered by the Freighter during the period from the 1st January to the 13th September. During the year 1,801 visits were made by me to various premises in connection with the work of supervision, etc. Disposal.—Disposal of the refuse from the whole of the district in the old gravel pit at Green-Street-Green on the Bradford System lias continued to work satisfactorily, but it is unfortunate to have to record that the pit is rapidly nearing its life for disposal purposes, and the acquisition of land suitable for a new dump is of vital concern. Prior to the formation of the Urban District there was on proper or efficient means adopted for the disposal of the refuse, the same being deposited by the Contractor in disused pits or on agricultural land without treatment or covering of any kind. Complaints regarding insanitary tips and nuisances from flies and rats in the vicinity thereof were then frequent. From the 1st January to the 31st December, 1937, the total number of loads disposed of was approximately 3,897. JETHRO A. CAPON, Cert. R. San. Inst., Cert. S.I. Ex. Bd., M.S.I.A. Chief Sanitary Inspector. Cleansing Superintendent. 42 ORPINGTON URBAN DISTRICT COUNCIL. No. 2 District. Comprising Crofton, Knoll, Farnborough, St. Mary Cray (part) and Goddington (part) Wards. I beg to present my Annual Report for the year ended December, 1987. Inspections, Nuisances, etc.—During the year 2,051 visits of all kinds were made, and 148 nuisances were discovered arising from the following sources:— 65 from generally defective and damp houses. 6 ,, offensive accumulations. 49 ,, defective drainage. 4 ,, insufficient water-closets. 5 ,, insufficient refuse receptacles. 19 ,,overflowing cesspools. Disinfection.—Sixty-two premises or part premises were disinfected after the occurrence of infectious disease, the method adopted being spraying with formaldehyde and fumigation formic- aldehyde gas. Five batches of bedding were steam disinfected. Public Health (Meat) Regulations, 1924.—The carcases and organs examined during the year were as follows:— Beasts 154 Calves 118 Sheep and lambs 248 Pigs 2377 Two tons 1 cwt. 3 qrs. 25 lbs. of meat was condemned as being diseased and unfit for human consumption, and this was destroyed. Arrangements were made with a neighbouring Authority for the destruction of condemned whole carcases and large portions of meat at their destructor. The particulars regarding the condemned meat are as follows:— Beef, 3921bs.—Seven heads and tongues affected with localised tuberculosis. One forequarter tainted. One liver affected with tuberculosis. Four livers affected with flukes. One liver affected with abscess. Pork, 4,29Glbs.—Twenty-six whole carcases and all organs for the following reasons: Thirteen generalised tuberculosis, two dropsy, two jaundice, one nephritis, two acute fever, two pleurisy, three pneumonia, one bruised. 43 Ninety-nine heads affected with localised tuberculosis, seven forequarters affected with pleurisy, one head (abscess), two legs (bruised), 20 plucks or part plucks. Mutton, 131bs.—Three livers affected with flukes. Visits.—Six hundred and eighty visits were paid to the slaughter-houses in connection with the work under the Meat Regulations. Slaughter-houses.—Six hundred and eighty visits were paid to the nine slaughter-houses in my district. The premises are kept in a clean and satisfactory condition. Slaughtermen's Licences.—Fifteen men were licenced under the Slaughter of Animals Act, 1933, to slaughter in my district, and the slaughtering was carried out in a humane manner. Bakehouses.—Ten visits were paid to the bakehouses in my district. The half-yearly limewashing was carried out in each case and the premises are conducted in a clean and satisfactory manner. Foodshops.—One hundred and seventy visits were paid to the various foodshops. The premises are kept in a clean and satisfactory manner. Factories and Workshops.—Fifty-seven visits were paid to these premises. Smoke nuisances were abated at two of these premises upon informal action. Housing.—One dwelling-house was demolished under the provisions of the Housing Act, 1930, the occupants being rehoused in a Council House. Milk and Dairies Orders.—Twenty-three visits were paid to the cowsheds and dairies in my district. Two samples of Mixed Milk were submitted for analysis and these were satisfactory. The premises are conducted and kept in a clean and satisfactory manner. Six Retailers were licenced to sell milk of a special designation under the Milk (Special Designations) Order, 1936, the licences being in respect of:— Tuberculin Tested Milk 5 Pasteurised Milk 6 Piggeries.—Five visits were paid to the piggery in my district and no nuisances were discovered. Rats and Mice (Destruction) Act.—During the year 92 visits were paid to premises in connection with rat infestation, and information and assistance was given to the occupiers with a view to the extermination of the vermin. 44 During the week preceding "Eat Week" inaugurated by the Ministry of Agriculture, posters were displayed throughout my district calling attention to the week and asking for the co-operation of owners and occupiers with a view to the extermination of any infestations. A book on rat extermination, published by the Ministry of Agriculture, was also supplied upon request. Certain Chemists shops in the district made a special window display of poisons. Common Lodging Houses.—Four visits have been paid to the one common lodging house in my district, and the premises were conducted in a satisfactory manner. Fruit Pickers Huts.—During the season visits were paid to the huts in use in my district, and the requirements of the Bye-laws were carried out. Shops Acts.—Ninety-six visits were paid during the year to the shops in my district.. It was necessary to warn shopkeepers regarding infringements of the closing hours and the hours of employment of young persons. SUMMAEY. Number of visits paid during the year 2051 ,, ,, nuisances discovered 148 ,, ,, Informal Notices served 104 ,, ,, Statutory Notices served 2 ,, ,, visits to shops under Shops Acts 96 ,, ,, visits to Cowsheds and Dairies 23 ,, ,, visits to Slaughterhouses 680 ,, ,, lbs. of meat condemned 4701 ,, ,, visits to Foodshops 170 ,, ,, visits to Bakehouses 10 ,, ,, visits to Factories and Workshops 57 ,, ,, premises disinfected 62 ,, ,, batches of bedding steam disinfected 5 WOEK EXECUTED. Dustbins provided 5 Overflowing cesspools emptied 7 Cesspools abolished 12 House drains reconstructed 27 Obstructed drains cleared 19 Defective drains repaired 3 Closet Accommodation repaired 4 Offensive accumulation removed 6 Dampness remedied 10 45 Roofs and guttering repaired 14 Defective floors repaired 5 Walls and ceilings repaired 18 Windows and ventilation repaired 4 Sinks and lavatory basins provided 4 Steps taken to abate Rat Infestation 27 Smoke nuisances abated 0 Miscellaneous 10 F. C. CROWE, M.R. San. I., M.S.I.A. Cert. R. San. I. (Joint Board). Cert. (R.S.I.) Inspector of Meat and other Foods. Sanitary Inspector. 46 ORPINGTON URBAN DISTRICT COUNCIL. No. 3 District. Comprising the Wards of Chelsfield, Green-Street-Green, Knockholt, Goddington (part) and St. Mary Cray (part). I beg to present to you my Annual Report for the year 1937, Inspections, Nuisances, etc.—The total number of visits of all kinds during the year was 2,512. Seventy-eight intimation notices were served in respect of nuisances, and with only two exceptions the remedial work was carried out promptly. In the two cases mentioned, the nuisances were abated after the service of Statutory Notices. The nature of the work carried out is contained in a summary of this report. Disinfection.—The number of premises fumigated after the occurrence of infectious disease was 64. Formic aldehyde gas was used in each case, and two school premises were sprayed with formaldehyde after the occurrence of Scarlet Fever. Ten batches of bedding were steam disinfected. Public Health (Meat) Regulations, 1924.—Two hundred and seventy-two visits were paid to the four slaughter-houses in my district and the carcases and organ of 16 beasts, 40 calves, 1,271 pigs and 216 sheep were examined. 2,0131bs. of meat was condemned as being unfit for human consumption, and this was destroyed. The condemned meat comprised :— Pork.—Two whole carcases and organs, 15 heads, two forequarters and two hindquarters, all affected with Tuberculosis. Two whole carcases and organs affected with Erysipelas and seven livers with Cirrhosis. Beef.—One whole carcase and organs, one head and two forequarters, all affected with Tuberculosis.. The work in each slaughterhouse has been carried out in a satisfactory manner, and the sanitary conditions maintained. Bakehouses.—One hundred and forty-four visits were paid to the six bakehouses in my district. Internal cleansing and whitewashing was carried out as required, and I was satisfied that the premises were being conducted in a hygienic and satisfactory manner. Milk and Dairies Orders.—Four hundred and forty-two visits were paid to the cowsheds and dairies. At one farm the drainage of the floor to the cowshed was found to be ineffective, 47 and the floor was reconstructed in concrete and properly drained. On the whole these premises were maintained in a clean and satisfactory condition with the following' exception:— Legal Proceedings.—It was found necessary to institute proceedings against a cowkeeper for breaches of Section 23, Sub-sections 2, 8, 4 and 5 of the Milk and Dairies Order, 1920. The justices convicted the defendant and imposed fines upon him of £1 in each of the four cases, and also made an Order for £2 2s. Od. costs. Licences to use special designations under the Milk (Special Designations) Order, 1986, were granted to three retail purveyors of milk in my district, these were as follows:— Tuberculin Tested 8 licences; Pasteurised 2 licences. Milk Sampling.—The number of' milk samples taken during the year were as follows:— Mixed milk 4 (As required by the Kent County Council) Accredited 5 Ditto Tuberculin tested 5 (As required by the Ministry of Health) With- the exception of two samples of accredited milk the reports thereon were satisfactory. In the two cases mentioned an investigation was made by the Agricultural Organiser who satisfied himself that certain necessary precautions were not being taken at the farm concerned during the process of milk production. Subsequent samples from these farms proved to be satisfactory. Piggeries.—Periodic visits were made to the four piggeries in my district, and the conditions were found to be satisfactory. Food Shops.—Three hundred and fifty-three visits were paid to the various food shops. No diseased or unwholesome food was found. Methods of storage and handling were examined and found satisfactory. Rats and Mice Destruction Act.—Forty-five visits were made to premises in connection with rat infestation, and information and assistance was given to the occupiers in connection therewith. During the week preceding "National Rat Week'' posters were displayed throughout the district, and special visits were made to certain premises, and a number of vermin accounted for. Shops Acts (1912-1934).—Seventy-four shop premises were visited during the year. In a number of cases it was found necessary to call the attention of shopkeepers to the Statutory closing hours, and the provisions of the Acts relating to the employment of young persons. 48 Factories and Workshops.—Fifty-nine visits were paid to these premises and 110 nuisances were discovered. SUMMARY. Number of visits paid during the year 2512 ,, ,, nuisances discovered 182 ,, ,, preliminary notices served 78 ,, ,, Statutory Notices served 2 ,, ,, visits to Cowsheds and Dairies 442 ,, ,, visits to Foodshops 353 ,, ,, visits to Bakehouses 144 ,, ,, visits to Slaughterhouses 272 ,, ,, lbs. of meat condemned 2013 ,, ,, premises disinfected 64 Batches of bedding steam disinfected 10 Number of Milk samples taken 14 ,, ,, visits to Piggeries 40 ,, ,, visits in connection with rat infestation 45 ,, ,, visits to Factories and Workshops 59 ,, ,, visits in connection with Shop Acts 74 ,, ,, visits in connection with Housing Acts 162 WORK EXECUTED. Dustbins provided 7 Overflowing Cesspools emptied 7 Cesspools abolished 9 Obstructed drains cleared 10 Defective drains repaired 1 Offensive accumulations removed 7 Defective water closet cisterns repaired 1 Defective water supply pipes repaired 1 Dampness remedied 39 Walls and ceilings cleansed and repaired 32 Roofs and gutterings repaired 7 Floors repaired 8 Miscellaneous repairs 18 Verminous rooms disinfested 7 Nuisance from keeping of animals abated 2 Additional water closets provided 3 Additional lavatory basins provided 3 Defective water closet renewed 1 Connections to sewer 9 Nuisances arising from tents, vans and sheds abated 8 Smoke nuisances 2 W, T. WEEDY, Cert. R.S.I. (Joint Board) M.S.I.A. Cert. R.S.I. (Insp. of Meat and other Foods, . ■ • .. -:U^d ■ ■}- ■