AC4349 PAD 20 Metropolitan Borough of Paddington. REPORT ON THE Public Health AND Vital Statistics OF THE BOROUGH OF PADDINGTON FOR THE YEAR 1930. BY GEOFFREY EUGENE OATES, M.D., B.S. (London), M.R.C.P. (London); D.P.H. (Cambridge); Barrister-at-Law, Medical Officer of Health. VAIL & Co., Printers, 170, Farringdon Road, London, E.C.1 Metropolitan Borough of Paddington. REPORT ON THE Public Health AND Vital Statistics OF THE BOROUGH OF PADDINGTON FOR THE YEAR 1930. BY GEOFFREY EUGENE OATES, M.D., B.S. (London), M.R.C.P. (London); D.P.H. (Cambridge); Barrister-at-Law, Medical Officer of Health. VAIL & Co., Printers, 170, Farringdon Road, London, E.C.1 CONTENTS. PAGE Acute Encephalitis Lethargica 19 Acute Influenzal Pneumonia 20 Acute Polio-encephalitis 19 Acute Polio-myelitis 19 Acute Primary Pneumonia 20 Acute Rheumatism 21 Administrative Work 35 Agricultural Produce (Grading and Marking) Act, 1928 49 Annual Cleansing 39 Ante-natal Consultation Centres 29, 31 Anthrax 20 Artificial Cream Act, 1929 50 Bacteriological Work 35 Bakehouses 44 Births 7 ,, Illegitimate 7 ,, in Institutions 8 ,, Notifications 8 ,, Stillbirths 8 Birth-rates 7 Canals, Canal Boats 38 Cancer 20 Cerebro-spinal Fever 19 Chicken-pox 17 Cholera 20 Combined Drainage 36 Common Lodging Houses 39 Compulsory Repairs 39 Compulsory removal of certain persons 51 Condensed Milk Regulations 47 Continued Fever 17 Convalescent Homes 35 "Conversions'' 39 Dairies and Milkshops 46 Day Nurseries 32 Deaths, Causes of 9 „ in Institutions 10 Death-rates 10 Diarrhoea 21 Diphtheria 15 Diphtheria Carrier Clinic 16 ,, Schick Test 16 Disinfection 35 District Inspectors' Work 53 Drainage, Combined 36 ,, House 35 „ Reconstruction Plans 36 Dried Milk Regulations 47 Dysentery 20 Erysipelas 19 Factories and Workshops 43 Food Adulteration 46 ,, Chemical and Bacteriological Examination 47 ,, Destroyed 46 ,, Purveyors 45 ,, Samples Analysed 48 ,, Supervision 45 Fouling of Footways by Dogs 37 German Measles 18 Glanders 20 Health Education 51 ,, Visiting 28 Houses Unfit for Habitation 39 Housing 39 ,, Acquisition of Building Site 39 ,, Paddington Houses Association 40 ,, on L.C.C. Estates 40 Hydrophobia 20 Ice Cream 46 Infant Consultation Centres 29-31 Infantile Mortality 11, 12 ,, ,, in Special Areas 12 PAGE Infectious Diseases, Notification of 14 ,, ,, Prevention of 35, 51 Infective Enteritis 21 Inquests 13 Invalid Children's Aid Association 34 Legal Proceedings 51, 52 L.C.C. Houses 40 Malaria 19 Marriages 6 Maternal Consultations 31 ,, Mortality Investigation 35 Maternity and Child Welfare 28 Maternity Nursing 31 Measles 17 Meat Regulations 45 Merchandise Marks Act, 1926 50 Milk Grants 32 ,, (Special Designations) Order 46 Mortuary 37, 54 Nursing 35 Office Work 54 Ophthalmia Neonatorum 18 Outworkers (Homework) 44 Overcrowding 39 Pigeons, Nuisance from 50 Plague 20 Population 6 Poultry Slaughtering 45 Pneumonia 20 Preservatives, etc., in Food Regulations 17 Puerperal Fever 18 ,, Pyrexia 19 Rag and Bone Dealers 37 Rag Flock Acts 45 Rats and Mice Destruction 50 Relapsing Fever 20 Rent and Mortgage Interest (Restrictions) Acts 40 Rent Books 39 Sale of Food Order, 1921 50 Scarlet Fever 15 Schools and Infectious Disease 35 Sewer Connections 37 Slaughterhouses 45 Smallpox 16 Smoke Control 37 Staff 5, 35 Tenement Houses 39 Trade Nuisances 37, 54 Tuberculosis, Artificial Pneumothorax Treatment 24 ,, Deaths from 22 ,, Dental Treatment 24 ,, Dispensary Treatment 24 ,, Home Visiting 23 „ Notification 22 ,, Regulations, 1921 and 1925 23 ,, Shelters 24 ,, Supply of Beds and Bedding 24 Tuberculosis Care Committee 27 Typhoid Fever 17 Typhus Fever 20 Underground Rooms 39 Unhealthy Areas 39 Vaccination 16 Venereal Diseases Clinic 5 Verminous Conditions 50 Vital Statistics 3, 6 Water Supply 37, 54 Whooping Cough 20 Workshop Supervision 44 TO HIS WORSHIP THE MAYOR, THE ALDERMEN AND COUNCILLORS OF THE METROPOLITAN BOROUGH OF PADDINGTON. Mr. Mayor, Ladies and Gentlemen, I have the honour to present to you my Annual Report for the year 1930 as required by the Statutes and Orders applicable to my office. During the year the health of the Borough continued to be good, the death-rate being substantially lower than that of the previous year, owing to the smaller prevalence of catarrhal and respiratory diseases. The birth-rate was slightly higher than in the previous year. The infantile mortality showed a very welcome fall from 101 per thousand births in 1929 to 78 per thousand births last year. Paddington, however, continues to be amongst the metropolitan boroughs with the highest infantile mortalities. During the year a careful investigation was made by the Maternity and Child Welfare Committee into the causation of infantile mortality. It was considered that such mortality, so far as it is excessive in Paddington, is due to causes which are largely social and do not admit of an immediate remedy. An important step towards securing the improvement of housing conditions in the poorer parts of the Borough was the decision of the Council to subscribe for debenture shares of the Paddington Houses Association, Ltd., up to an amount of £5,000, thereby enabling the Association to extend their activities in the direction of the purchase and re-conditioning of house property. In December, 1930, a survey of the health services of the Borough was made by a Medical Officer of the Ministry of Health. In the absence of any communication from the Ministry it may be presumed that the Ministry are satisfied that a reasonable standard of efficiency and progress in the discharge of public health functions is maintained by the Council. I have again to express my appreciation of the loyal help of the staff of the Public Health Department of the Council and to thank the members of the Public Health, Maternity and Child Welfare, and Special Housing Committees for the support and kind consideration which they have extended to me during the past year. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, F.E. Oates. M.D., M.R.C.P., D.P.H., Medical Officer of Health. Town Hall, Paddington Green, W. 2. June, 1931. SUMMARY OF VITAL STATISTICS 1930. Area of Borough 1,356.1 acres, including waterways 20.0 acres: Population: Census, 1921 144,261 Registrar-General's estimate for year 1929 142,800 Density of population per acre 105 Census 1921: Total number of buildings containing dwellings 17,153 (a) Dwellings occupied by non-private families 435 Population inhabiting the same 12,910 (b) Dwellings occupied by private families 38,320 (Including vacant census night, 938). Population enumerated in occupied dwellings 131,351 (Occupying 141,959 rooms, averaging 108 persons per room, or 0.92 room per person). Marriages 1,663 Total M. F. Live Legitimate 1,923 966 957 Birth-rate 1512* Births Illegitimate 238 120 118 Birth rate 1512 Still Births 72 41 31 Still Birth-rate 32† Deaths 1,805 872 933 Death-rate 12.4* Percentage of total deaths occurring in public institutions53.5 Number of women dying in, or in consequence of childbirth from sepsis 3 ,, other causes 3 Maternal mortality 2.78† Deaths of Infants under 1 year of age 169 Infantile Mortality 78† Legitimate, 72†; Illegitimate, 126† Deaths from Measles (all ages) 21 ,, Whooping Cough (all ages) 4 „ Diarrhoea (under 2 years of age) 29 Pulmonary Tuberculosis 104 Death-rate from Pulmonary Tuberculosis 0.72* Deaths from all forms of Tuberculosis 114 Tuberculosis death-rate 0.79* Rateable Value £1,642,701 Product of a Penny Rate £6,613 * per 1,000 persons. †per 1,000 births. 5 PUBLIC HEALTH OFFICERS (on December 31st, 1930). (W.T. = Whole-time appointments. P.T. = Part-time appointments. See footnote for explanation of figures in parentheses.) Medical Officer of Health, Administrative Tuberculosis Officer, W.T. G. E. Oates, M.D., B.S., M.R.C.P., D.P.H., Barrister-at-Law. Assistant Medical Officers of Health, P.T. (For purposes of the Public Health (Tuberculosis) Regulations). R. S. Walker, M.R.C.P., L.R.C.S.Ed., L.R.F.P.S.Glas., D.P.H., Tuberculosis Officer. Paddington Tuberculosis Dispensary. A. B. Porteous, M.D., D.P.H., Tuberculosis Officer, St. Mary's Hospital Tuberculosis Dispensary. Public Analyst, P.T. Sir William R. Smith, M.D., D.Sc., F.I.C. Public Vaccinators.P.T. S. Denovan Adam, M.R.C.S., L.R.C.P.Lond. (For Borough, excluding Paddington Hospital). W. G. Bendle, F.R.C.S.Ed., M.B., B.S.Durh. (For Paddington Hospital). Vaccination Officer, P.T. W. J. Hughes. District Sanitary Inspectors, W.T. Workshops Inspector and Canal Boats Inspector, W',T. T. Mitchell (1), (3), (4), (5). C. S. Wansbrough (1), (4), (5). G. J. Miners (1), (4). Tenement Housas Inspectors, W.T. V. L. Ronchetti (2), (3), (5). C. Lawrence (1), (3), (4). (5). E. B. Wilde (2), (3), (4), (5), (11). C. G. Heron (2), (3). E. Marshall (2), (5). Meat and Food Inspector, W.T. Health Visitors, W.T. F. J. Pallet (2), (3). D. A. M. Newhall (1), (2), (8), (9). E. A. S. Davies (8). (9). Women Sanitary Inspectors, W.T. L. M. O'Kell (1), (7). I. L. Buckledee (2), (8), (9), (10). (1) Sanitary Inspector's Certificate, Royal Sanitary Institute. (2) „ „ „ Sanitary Inspectors' Examination Board, or Royal Sanitary Institute and Sanitary Inspectors' Examination Joint Board. (3) Meat and other Foods Certificate, Royal Sanitary Institute, or Sanitary Inspectors' Examination Board. (4) Building Construction Certificates. (5) Plumbing Certificates. (6) Diploma, National Health Society. (7) Tuberculosis Certificate, National Health Society. (8) Central Midwives Board Certificate. (9) Nursing Training Certificates. (10) Health Visitor's Diploma, Board of Education. (11) Smoke Inspector's Certificate, Royal Sanitary Institute. CLINICS AND TREATMENT CENTRES. Maternity and Child Welfare. Address. By whom provided. Ante-natal Consultation Centres 232, Harrow Road Paddington School for Mothers St. Mary's Hospital, Cambridge Place St. Mary's Hospital. Infant Consultation Centres ... *232, Harrow Road Paddington School for Mothers. †St. David's Church Hall, St. Mary's Terrace St. John's Mission Room, Sovereign Mews (Closed February, 1931). *Congregational Institute, Third Avenue *St. Simon's Hall, Macroom Road Christ Church Parochial Church House, Queensborough Passage *Two sessions weekly. †Two sessions weekly from February, 1931. Day Nurseries 21, Howley Place Paddington Day Nursery. 66, Lancefield Street Queen's Park Day Nursery. Tuberculosis. Dispensaries 20, Talbot Road Paddington Tuberculosis Dispensary. St. Mary's Hospital, Cambridge Place St. Mary's Hospital. Venereal Diseases. Clinic St. Mary's Hospital, Cambridge Place (Male London County Council. and Female) 6 VITAL STATISTICS. The Metropolitan Borough of Paddington as constituted under the London Government Act, 1899, covers an area of 1,356.1 acres, including 20.0 acres of waterways. It is co-extensive with the Civil Parish and Registration District of the same name. The Borough is divided into nine wards. General Summary of Vital Statistics. Year. Estimated Population. Births. Deaths at All Ages. Deaths under One Year. Registered Locally. Transfers. Nett. Registered Locally. Gross Mortality. Transfers. Nett. Registered Locally. Nett. Out. In. Totals. Rates. Out. In. Totals. Mortality. Number. Mortality Totals. Mortal ity. 1914 142,087 2,708 49 274 2,933 20.64 1,892 13.31 347 350 1,895 13.33 312 115 281 96 1915 131,397 2,506 59 267 2,714 20.65 2,304 17.53 370 352 2,286 17.39 343 137 319 117 1916 t 142,169 2,378 61 372 2,689 18.91 ... ... ... ... ... ... 289 121 253 94 c 136,668 ... ... ... ... ... 1,924 14.72 370 326 1,880 14.38 1917 t 136,561 1,834 77 334 2,091 15.31 ... ... ... ... ... 290 158 273 135 c 122,507 ... ... ... ... ... 1,997 16.30 321 374 2,050 16.73 1918 t 131,673 1,798 118 337 2,017 15.31 ... .... ... ... ... 266 148 235 116 c 117,517 ... ... ... ... ... 1,999 17.01 345 595 2,249 19.13 1919 t 149,941 2,016 154 454 2,316 15.44 ... ... ... ... ... 213 105 212 91 c 143,938 ... ... ... ... ... 1,499 10.41 310 725 1,914 13.29 1920 t 150,128 3,181 251 483 3,413 22.73 ... ... ... ... ... ... 279 87 266 78 c 149,673 ... ... ... ...... 1,667 11.13 370 410 1,707 11.40 1921 145,600 2,653 296 502 2,859 19.63 1,784 12.25 372 346 1,758 12.07 307 115 263 92 1922 145,300 2,557 288 462 2,731 18.79 1,929 13.27 365 324 1,888 12.99 224 88 189 69 1923 146,200 2,410 275 485 2,620 17.92 1,743 11.92 338 317 1,722 11.77 207 86 180 69 1924 146,400 2,343 284 446 2,505 17.11 2,054 14.03 475 341 1,920 13.11 232 99 196 78 1925 147,100 2,206 312 443 2,337 15.88 2,011 13.67 570 339 1,780 12.10 196 88 170 72 1926 146,700 2,131 345 462 2,248 15.32 2,067 14.09 554 344 1,857 12.65 210 98 194 86 1927 142,700 2,064 322 474 2,216 15.53 2,006 14.05 489 419 1,936 13.56 188 91 176 79 1928 145,200 2,074 376 479 2,177 14.99 1,954 13.45 507 446 1,893 13.03 186 89 186 85 1929 142,800 2,058 447 518 2,129 14.90 2,344 16.41 550 417 2,211 15.48 230 111 215 101 1930 142,800 2,216 524 469 2,161 15.12 1,890 13.23 482 397 1,806 12.64 174 78 169 78 "T"=Total; "C"=Civil. POPULATION. As the Registrar-General's estimate of the population of the Borough for the year 1930 will not be available before the end of June, 1931, the estimate for the year 1929, viz.: 142,800 persons, has been used for the purpose of calculating the various rates in this report. The following table shows the estimated population in each Ward of the Borough. The Borough 142,800 Wards— Queen's Park 15,594 North Paddington 72,090 Harrow Road 27,236 Maida Vale 21,876 Town 7,384 Westbourne 23,858 South Paddington 70,710 Church 17,315 Lancaster Gate, West 9,435 Lancaster Gate, East 8,078 Hyde Park 12,024 MARRIAGES. During 1930, 1,663 marriages were solemnized in the Borough, being a rate of 23.3 persons per 1,000 of the population. 7 BIRTHS. The number of births registered in the Borough during 1930 was 2,216. From this total it is necessary to deduct 524 births which occurred to residents of other localities and to add 469 births which occurred to Paddington residents outside the Borough. The corrected total of 2,161 births thus obtained is equal to a rate of 15.12 per 1,000 of the population. Of the 2,161 births, 1,086 were those of males and 1,075 those of females, and of these 120 males and 118 females were illegitimate. The Registrar-General's final figure for the nett number of births is given as 2,156 but this does not materially affect the figure for the birth-rate given above. The following table shows the birth-rate during each of the last six years in England and Wales, in London, in Paddington and in each of the wards of the Borough:— 1930 Birth-rates. No. of Births. Birthrates. 1929 1928 1927 1926 1925 England and Wales 649,430 16.3 16.3 16.7 16.7 17.8 18.3 London 69,449 16.7 15.7 15.9 16.1 17.1 18.0 Paddington 2,161 15.12 14.90 14.99 15.53 15.32 15.88 Wards— Queen's Park 161 10.32 10.26 10.97 11.29 12.48 12.63 Harrow Road 479 17.58 14.94 15.05 15.50 14.44 16.07 Maida Vale 297 13.57 15.22 14.65 16.69 15.84 14.09 Town 99 13.40 16.52 16.78 18.70 17.92 23.54 Church 384 22.12 23.50 22.83 23.11 23.94 Westbourne 472 19.78 17.22 19.25 18.58 18.03 18.14 Lancaster Gate, West 61 5.40 8.05 5.00 6.25 6.29 7.82 Lancaster Gate, East 58 7.18 8.79 7.42 9.04 8.79 9.49 Hyde Park 160 13.30 11.81 12.75 11.56 12.14 11.94 The following table shows the course of the birth-rate in the Borough in the past:— BIRTH-RATES. Paddington. 1881-1885 26.66 1886-1890 24.89 1891-1895 24.44 1896-1900 23.29 1901-1905 22.89 1906-1910 21.14 1911-1915 20.88 1916-1920 17.63 1921-1925 17.86 1926 15.32 1927 15.53 1928 14.99 1929 14.90 1930 15.12 Illegitimate Births.—These were 238 in number, or 1101 per cent. of the total number of births. The proportion of illegitimate births varies remarkably in the different wards as is shown is the table below:— Rate of Illegitimate Births Per 100 Total Births. Ward. Rate. Queen's Park 6.21 Harrow Road 6.42 Maida Vale 13.80 Town 12.12 Church 13.02 Westbourne 9.11 Lancaster Gate, West 19.60 Lancaster Gate, East 22.41 Hyde Park 20.62 8 Stillbirths.—During 1930, 78 stillbirths were registered in the Borough in accordance with the provisions of the Births and Deaths Registration Act, 1926. Of these, 29 occurred to residents of other localities; on the other hand 23 stillbirths occurred outside the Borough to Paddington residents. The nett number for the Borough was therefore 72, a figure equivalent to 3 2 per cent. of the total births recorded. Of the 72 stillbirths, males numbered 41 and females 31, 6 of the males and 3 of the females being illegitimate. Births in Institutions. Local. Legitimate. Illegitimate. Total. Residents. Non-residents. Residents. Non-residents. Residents. Non-residents. Paddington Infirmary (Hospital) 146 34 83 19 229 53 St. Mary's Hospital 116 159 1 1 117 160 Lock Hospital ... 3 24 7 107 10 131 Outlying. (Paddington residents) Legitimate. Illegitimate. Total. Queen Charlotte's Hospital 203 21 224 Other Lying-in Hospitals... 15 7 22 Other Hospitals ... 48 9 57 Public Assistance Committees' Institutions 13 11 24 Notification of Births Acts, 1907 and 1915.—These Acts require the father of a child, if actually residing in the house where a birth takes place at the time of its occurrence, and any person in attendance upon the mother at the time of, or within six hours after, the birth, to give notice in writing of the birth to the Medical Officer of Health of the district in which the child is born, in the manner provided. Notification applies in the case where a child has issued forth from its mother after the expiration of the twenty-eighth week of pregnancy, whether alive or dead. In practice, it is almost always the doctor or midwife who notifies a birth, and not the father of the child. During the year, 2,193 live births were notified to the Medical Officer of Health. There were also 73 stillbirths notified. Of the 2,266 living and stillbirths notified, 46.1 per cent. were notified by medical practitioners, 383 per cent. by midwives, 1.3 per cent. by parents, and 14.3 per cent. by medical students or other persons. A comparison of the Notification Register with the returns supplied by the local Registrars of Births shows that 97.5 per cent. of the live births and 93.6 per cent. of the stillbirths occurring within the Borough were duly notified. It will be seen that only a small proportion of live births are not notified and so escape being brought to the notice of the Medical Officer of Health until they come to be registered within the statutory period of six weeks. In nearly every case of default a cautionary letter was sent to the person responsible, and in no instance did the Maternity and Child Welfare Committee consider it necessary to institute legal proceedings. DEATHS. The number of deaths registered during the year as having taken place in the Borough was 1,890. Of these, 482 were of persons whose residence was not in Paddington, 409 dying in Paddington Institutions and 73 in other places in the Borough. There were also reported to the Registrar-General 397 deaths of Paddington persons whose deaths occurred outside the Borough. This correction gives the nett number of deaths for Paddington as 1,805, making an annual death-rate of 12.64. The Registrar-General's final figure for the nett number of deaths is given as 1,808, but this does not materially affect the figure for the death-rate given above. 9 1930 Selected Causes of Death Arranged in Four-Weekly Periods. Period ended. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Phthisis. Cancer. Influenza. Bronchitis. Pneumonia. Diarrhoea & Enteritis January 25th - - - 5 6 14 2 3 13 2 February 22nd — — — 1 7 24 1 2 19 — March 22nd 4 — 1 2 14 23 2 6 21 2 April 19th 1 — — — 8 20 2 4 14 3 May 17th 3 — 1 2 11 30 — 5 13 2 June 14th 5 — - — 7 19 1 4 8 2 July 12th 3 1 1 — 10 16 — 3 5 4 August 9th 3 — — — 6 20 — 2 4 3 September 6th 1 1 — 1 7 28 — 1 1 2 October 4th — - — 1 6 15 — 1 5 2 November 1st 1 - - - 4 19 2 3 7 5 November 29th — — 1 — 7 27 — 4 11 3 December 31st — — — — 11 21 2 6 7 8 Totals 21 2 4 12 104 276 12 44 128 38 The foregoing table gives the numbers of deaths from the various causes as classified locally. The figures differ somewhat from those supplied by the Registrar-General in the table appearing below. Deaths of Residents of the Borough, 1930, Sex-Age Distribution for Whole Borough. Cause of Death. All Ages. Deaths at Ages. 0— 1— 2— 5— 16— 25— 45— 65— 75— F. M. f. M. f. M. f. M. f. M. f. M. f. M. f. M. f. M. f. M. f. All Causes 1808 872 936 99 70 14 9 14 14 18 15 39 30 78 91 269 232 195 199 146 276 Enteric Fever 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... Smallpox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 21 11 10 5 2 5 3 1 5 ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever 2 2 ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... Whooping Cough 4 4 ... 3 ... ... . . . 1 ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 12 9 3 1 ... 1 ... 4 2 3 1 ... ... ... ... ... ... ... ... ... Influenza 13 7 6 1 ... ... ... ... ... 1 1 ... 1 ... i 2 2 1 1 2 Encephalitis Lethargica 4 2 2 ... ... ... ... ... ... ... ... ... ... ... ... 2 1 ... 1 ... ... Meningococcal Meningitis 3 1 2 1 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... Tuberculosis of Respiratory System 104 61 43 ... ... ... ... ... ... ... 2 8 11 19 21 29 8 4 1 1 ... Other Tuberculous Diseases 10 6 4 2 ... ... ... ... 1 2 ... 1 1 ... 1 1 1 ... ... ... Cancer, Malignant Disease 278 130 148 ... 1 ... ... ... ... ... ... ... ... 7 13 60 67 39 46 24 21 Rheumatic Fever 9 5 4 ... ... ... ... ... ... 1 2 1 2 ... 1 2 ... ... ... ... Diabetes 6 3 3 ... ... ... ... ... ... ... ... 1 1 2 1 ... ... 1 Cerebral Haemorrhage, etc. 46 15 31 ... ... ... ... ... ... ... ... ... ... ... . . . 3 8 7 7 5 16 Heart Disease 409 172 237 ... ... ... ... ... 1 4 ... 3 3 12 45 36 65 68 58 114 Arterio-sclerosis 80 33 47 ... ... ... ... ... ... ... ... 2 10 11 9 12 14 22 Bronchitis 52 23 29 2 6 1 ... ... 2 ... ... 2 ... ... 5 3 5 2 8 16 Pneumonia (all forms) 131 75 56 19 11 3 4 ... 1 ... ... 2 ... 7 1 30 10 10 10 4 19 Other Respiratory Diseases 18 8 10 ... ... ... ... ... 1 ... ... ... 1 1 1 3 3 3 2 1 2 Ulcer of Stomach or Duodenum 18 13 5 ... ... ... ... ... ... ... ... 1 ... 2 1 10 4 Diarrhoea, etc. 35 20 15 15 12 1 1 ... ... ... ... 1 ... ... 1 1 ... 2 ... ... 1 Appendicitis and Typhlitis 12 8 4 ... ... ... ... 1 ... 1 ... ... ... 4 3 1 ... 1 ... 1 Cirrhosis of Liver 14 7 7 ... ... ... ... ... ... ... ... ... ... 1 2 4 4 2 1 ... ... Acute and Chronic Nephritis 83 43 40 ... ... ... ... ... 1 2 ... 2 ... 4 6 15 14 15 13 5 6 Puerperal Sepsis 3 ... 3 ... . . . ... ... ... ... ... ... l ... 2 ... ... ... ... ... Other Accidents and diseases of Pregnancy and Parturition 3 ... 3 ... ... ... ... ... ... ... ... ... l ... 2 ... ... ... ... ... ... Congenital debility and Malformation, Premature Birth 58 32 26 30 24 1 1 ... ... ... ... ... ... 1 1 ... ... ... ... ... ... Suicide 34 20 14 ... ... ... ... ... ... ... ... 2 2 6 2 9 8 3 1 ... 1 Other deaths from Violence 69 39 30 2 2 ... 3 6 1 9 4 6 4 5 5 4 5 4 9 Other defined diseases 276 123 153 18 11 2 ... 3 1 3 5 8 5 12 14 33 43 23 29 21 45 Causes ill-defined or unknown ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 10 The following table shows the deaths and death-rates during each of the last five years in England and Wales, in London, in Paddington and in each of the wards of the Borough:— 1930 Death-rates. No. of Deaths. Deathrates. 1929 1928 1927 1926 1925 England and Wales 455,397 11.4 13.4 11.7 12.3 11.6 12.2 London 51,184 11.4 13.8 11.6 11.9 11.6 11.7 Paddington 1,805 12.64 15.48 13.03 13.56 12.65 12.10 Wards— Queen's Park 180 11.54 11.67 11.22 12.12 12.10 11.39 Harrow Road 323 11.85 14.94 11.88 13.04 12.58 10.80 Maida Vale 287 13.12 14.08 14.56 14.68 14.37 11.84 Town 93 12.59 16.65 11.98 16.94 ll.60 Church 250 14.43 20.61 15.27 15.60 16.92 14.73 Westbourne 334 13.99 17.06 15.45 13.92 12.64 13.99 Lancaster Gate, West 100 10.59 13.56 10.21 9.33 11.04 10.28 Lancaster Gate, East 97 12.00 13.61 10.71 11.39 7.71 9.25 Hyde Park 141 11.72 15.72 11.61 13.64 9.55 10.57 The following table shows the course of the death-rate in the Borough in the past:— DEATH-RATES—PADDINGTON. 1881-1885 16-23 1886-1890 16*19 1891-1895 17-17 1896-1900 15-51 1901-1905 15-33 1906-1910 14-52 1911-1915 14-06 1916-1920 14-62 1921-1925 12-41 1926 12-65 1927 13-56 1928 13-03 1929 15-48 1930 12-64 Deaths in Institutions. 1930. Local. Total Nonresidents. Paddington Infirmary (Hospital) ... 590 23 St. Mary's Hospital ... 276 199 Paddington Green Children's Hospital 49 36 Hospital for Women and Children (Lock Hospital) 10 10 St. Luke's Hospital ... 154 141 1,079 409 Deduct Non-residents 409 670 Outlying. Paddington Residents. Isolation Hospitals of London County Council... 21 Public Assistance Committees' Institutions 60 Lunatic Asylums 60 Voluntary Hospitals (General) 71 Hospitals (Special, including Sanatoria) 86 298 Total Deaths of Paddington residents in institutions ... 968 11 INFANTILE MORTALITY. During the year 1930 there were 2,161 births, and 169 deaths of children under the age of twelve months in the Borough. These figures give an infantile mortality rate (deaths of infants under 12 months to each 1,000 births) of 78. The following table gives the births and the infantile deaths and death-rates for the year 1930 in England and Wales, in London, in the Borough and the various wards of the Borough. The infantile mortality rates for 1925 to 1929 are given for comparison. 1930 Infantile Mortality Rates. No. of Births. No. of Deaths of Children under 1 year. Infantile Mortality Rates. 1929 1928 1927 1926 1925 England and Wales 649,430 38,790 60 74 65 69 70 75 London 69,449 4,191 59 70 67 59 64 67 Paddington 2,161 169 78 101 85 79 86 72 Wards— Queen's Park 161 7 43 44 28 91 45 88 Harrow Road 479 19 39 71 79 49 104 66 Maida Vale 297 29 97 66 82 96 87 50 Town 99 5 50 147 95 130 37 91 Church 384 47 122 164 99 99 108/ Westbourne 472 41 86 126 109 76 86 69 Lancaster Gate, West. 51 5 98 39 83 51 109 50 Lancaster Gate, East 58 6 103 42 82 - 115 52 Hyde Park 160 10 62 98 57 65 53 74 Infantile Mortality Rates, 1896-1930. Period. England and Wales. London. Paddington. 1896-1900 156 162 161 1901-1905 138 139 128 1906-1910 117 114 104 1911-1915 109 110 108 1916-1920 91 92 103 1921-1925 76 70 76 1926 70 64 86 1927 69 59 79 1928 65 67 85 1929 74 70 101 1930 60 59 78 12 Infantile Mortality in Paddington.—1930. * Causes of Death. Under 1 week. 1 to 2 weeks. 2 to 3 weeks. 3 to 4 weeks. Total under 4 weeks. 4 weeks and under 3 months. 3 months and under 6 months. 6 months and under 9 months. 9 months and under 12 months. Total Deaths under 1 year. Rate per 1,000 Births. All Causes 43 4 9 5 61 17 43 25 23 169 78.20 Common Infectious Diseases (6-10, 25:2) - - - - - - - 5 6 11 5.09 Tuberculous Diseases (31-37) — — - — — - 2 - 1 3 1.39 Diarrhœa and Enteritis (113) — — 1 — 1 6 13 2 5 27 12.49 Developmental and Wasting Diseases (159, 160, 161:1, 162:2) 37 3 3 3 46 6 7 - - 59 27.30 Miscellaneous Diseases (Remainder) 6 1 5 2 14 5 21 18 11 69 31.93 Measles (7) — - - - - - - 3 4 7 3.24 Whooping cough (9) — — — — — — — 1 2 3 1.39 Diphtheria (10) — — — — — — — 1 — 1 0.46 Influenza (11) — — — — — — 1 — — 1 0.46 Tuberculosis of nervous system (32) 1 — 1 2 0.93 Tuberculosis of intestines and peritoneum (33) - - - - - - 1 - - 1 0.46 Other tuberculous diseases (31, 3437) - - - - - - - - - - - Syphilis (38) - - 1 - - - 1 0.46 Meningitis (71) - - - - _-_ - - - - - - Convulsions (80) - - 2 - 2 - - - 1 3 1.39 Bronchitis (99) — — 1 1 1 1 3 1 7 3.24 Pneumonia (100, 101) 1 — 1 1 3 2 12 9 3 29 13.42 Other respiratory diseases (98, 102107) - - - - - - - - - - - Inflammation of the stomach (112:1) - - - - - - - - - - - Diarrhoea and Enteritis (113) - — 1 - 1 6 13 2 5 27 12.49 Hernia, intestinal obstruction (118) — — - — — - - 1 — 1 0.46 Congenital malformations (159) 2 1 — 1 4 2 2 — — 8 3.70 Congenital debility and sclerema (160:1) 3 - 1 - 4 3 6 12 5.55 Icterus (160:2) 1 — 1 — 2 — - - — 2 0.93 Premature birth (161:1) 24 2 1 2 29 1 — — — 30 13.88 Injury at birth (161:2) 4 — — 4 - - 4 1.85 Disease of umbilicus (162:1) — — 1 — 1 - - - — 1 0.46 Atelectasis (162:2) 3 — - — 3 — — — — 3 1.39 Suffocation—in bed or not stated how (180 pt.) - - - - - - 2 - - 2 0.93 Other causes 5 1 1 — 7 1 5 5 6 24 11.11 Nett Births in the Year Legitimate 1,923. Illegitimate 238. Nett Deaths in the Year Legitimate Infants 139. Illegitimate Infants 30. Note.—The numbers given in brackets after certain causes of death indicate the numbers of the corresponding headings in the Detailed International List of Causes of Death, 1920. It has been customary in previous annna.1 reports to make a note of infantile mortality in special localities. The following is a summary of the results. Infantile Mortality in Special Areas. Areas 1930 Infantile Mortality. Births. Deaths. 1930 1929 1928 1927 1926 Church Ward— North Wharf 39 3 77 143 148 40 92 Clarendon Street 157 24 153 170 105 138 148 Rest of Ward 188 20 106 165 75 70 67 Westbourne Ward— Alfred Road 95 8 84 152 83 165 107 Rest of Ward 377 33 87 117 117 48 79 Maida Vale Ward— Amberley Road 34 7 206 87 104 178 89 Rest of Ward 263 22 83 62 79 80 86 Totals for 4 Areas 325 42 129 151 105 139 121 Rest of Borough 1,836 127 69 90 81 65 78 13 The subjoined information, comparing the vital statistics for the metropolitan boroughs, has been supplied by Dr. W. Allan Young, Medical Officer of Health for Poplar:— 1930. Cities and Boroughs. Population. Births Annual rate per 1,000 persons living. Death-rate per 1,000 living. Deaths of Infants under one year to 1,000 births. West Districts. Paddington 142,800 15.1 12.6 78 Kensington 176,000 14.6 12.7 69 Hammersmith 136,900 15.9 11.7 64 Fulham 153,700 15.3 10.8 57 Chelsea 62,680 12.7 12.5 40 City of Westminster 125,800 10.5 11.7 59 North Districts. St. Marylebone 102,400 12.1 10.6 62 Hampstead 84,830 11.8 11.6 58 St. Pancras 203,900 15.4 11.9 60 Islington 319,800 17.4 12.1 70 Stoke Newington 50,040 14.6 12.2 54 Hackney 214,400 16.4 11.1 49 Central Districts. Holborn 38,380 10.5 12.7 89 Finsbury 66,860 19.4 13.8 63 City of London 10,700 8.3 12.0 89 East Districts. Shoreditch 99,710 20.1 12.2 65 Bethnal Green 110,500 17.7 11.1 60 Stepney 241,800 17.4 11.2 76 Poplar 160,000 19.1 10.5 55 South Districts. Southwark 178,500 16.8 12.5 57 Bermondsey 113,800 18.1 13.1 63 Lambeth 294,400 15.7 12.0 56 Battersea 161,800 16.4 11.4 54 Wandsworth 355,864 13.1 10.5 55 Camberwell 256,900 14.8 10.9 51 Deptford 111,000 15.9 11.3 61 Greenwich 104,430 15.3 9.9 45 Lewisham 207,900 15.1 9.7 42 Woolwich 141,600 15.5 10.9 42 INQUESTS. During 1930, 128 inquests were held on residents of the Borough, and 101 deaths were registered after the issue of certificates by the Coroner under powers conferred by the Coroners (Amendment) Act, 1926. 14 THE PREVALENCE OF DISEASE. The following diseases are compulsorily notifiable under certain conditions in Paddington : Acute Encephalitis Lethargica. Glanders. Acute Influenzal Pneumonia. Hydrophobia. Acute Polio-encephalitis. Infective Enteritis or Summer Diarrhoea. Acute Polio-myelitis. Malaria. Acute Primary Pneumonia. Measles. Acute Rheumatism. Ophthalmia Neonatorum. Anthrax. Plague. Cerebro-spinal Fever. Puerperal Fever. Chicken-pox. Puerperal Pyrexia. Cholera. Relapsing Fever. Continued Fever. Scarlatina or Scarlet Fever. Diphtheria or Membranous Croup. Smallpox. Dysentery. Tuberculosis. Erysipelas. Typhoid or Enteric Fever. German Measles. Typhus Fever. The following table summarises the cases of notifiable diseases notified in the years 1920 to 1930 Analysis of Notification Certificates (Uncorrected for Errors in Diagnosis). 1920. 1921. 1922. 1923. 1924. 1925. 1926. 1927. 1928. 1929. 1930. Acute Encephalitis Lethargica 2 7 2 3 12 7 4 4 1 5 1 „ Influenzal Pneumonia 45 27 72 33 87 88 76 107 59 135 40 „ Primary Pneumonia 96 105 254 302 369 265 184 183 202 247 168 „ Polio-encephalitis 2 1 — 2 4 3 3 1 1 1 „ Polio-myelitis 3 4 3 1 1 „ Rheumatism — — — — — — — (a) 34 76 62 43 Anthrax — 1 1 — — — 1 1 - - - Cerebro-spinal Fever 1 2 2 1 1 5 5 3 4 6 3 Chicken-pox — — 22 465 395 459 599 461 567 382 516 Continued Fever — — — — — — — 2 10 3 2 Diphtheria 461 442 401 219 278 336 462 367 302 311 366 Dysentery 1 2 — 2 1 — — — — - - Erysipelas 81 83 77 54 69 64 76 90 90 69 74 German Measles 71 83 144 48 458 375 124 78 109 1,163 86 Infective Enteritis or Summer Diarrhœa — — — — — — — (a) 6 20 63 30 Malaria 24 7 5 2 9 1 1 2 3 1 Measles 1356 80 1973 324 2757 879 1738 154 2862 210 1790 Membranous Croup 3 3 — 1 2 1 1 2 4 6 7 Ophthalmia Neonatorum 29 34 15 22 18 23 16 15 24 9 15 Puerperal Fever 15 16 8 5 9 15 14 7 5 4 5 „ Pyrexia — — — — — — (a) 17 34 32 42 37 Scarlet Fever 502 827 529 323 290 264 199 320 519 323 356 Smallpox — — — i — — — — 5 3 3 Tuberculosis—Total 383 335 312 33h 379 400 356 381 321 335 284 Pulmonary 277 244 204 222 242 231 218 212 196 242 196 Other Forms 106 91 108 116 137 169 138 169 125 93 88 Typhoid or Enteric Fever 19 13 8 13 15 18 12 16 25 19 10 (a) First Year of Notification. The following table furnishes an analysis of some of the notifiable diseases according to age, sex and ward of the Borough:— 1930. Notifications. A.—Ward Distribution. Queen's Park. Harrow Road. Maida Vale. Town. Church. Westbourne. Lancaster Gate. Hyde Park. West. East. M. f. M. f. M. f. M. f. M. f. M. f. M. f. M. F. M. F. Diphtheria and Memb. Croup 9 15 31 28 23 38 9 13 42 49 44 45 6 9 2 5 5 Typhoid and Continued Fever — 1 — 2 2 1 — — — 1 — — 1 — 1 2 1 Erysipelas 3 5 2 6 8 6 1 1 1 8 8 15 1 1 — 3 2 3 Ophthalmia Neonatorum — — 2 1 1 1 1 1 4 1 1 1 — — - - - 1 Pneumonia—A. Influenzal 2 — 3 — 3 9 — 2 8 5 2 4 - - - - 2 - „ A. Primary 14 5 15 5 14 11 7 — 21 31 19 18 1 2 1 1 2 1 Puerperal Fever — — — — — 1 — — — 1 — 2 — — — 1 - - „ Pyrexia — — — 6 — 3 — 5 — 10 — 8 2 2 - 1 Scarlet Fever 13 17 29 39 21 20 19 11 36 36 31 45 7 8 3 3 10 8 15 B.—Sex—Age Distribution. Borough. 0— 1— 2— 3— 4— 5— 10— 15— 20— 35— 45— 65— M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F Diphtheria and Memb. Croup 3 3 10 5 19 10 17 12 17 15 71 70 14 26 7 16 10 31 1 10 — 6 - - Typhoid and Continued Fever — — - - - - 1 - - - - - 1 - 1 - - 6 — 1 1 - - 1 Erysipelas 1 1 1 1 1 1 2 - - 2 4 10 4 4 9 18 3 12 Pheumonia- —A. Influenzal 1 — — — — 3 — — 1 2 — 1 3 1 7 3 3 — 5 3 — 7 ,, A. Primary 11 7 14 14 4 9 3 3 3 3 7 11 — 1 6 1 12 4 9 5 19 9 6 7 Scarlet Fever 2 2 5 4 8 11 9 15 14 16 78 64 25 29 8 9 17 27 3 8 - 2 - - SCARLET FEVER. During 1930 there were 356 cases of scarlet fever notified. Of the cases notified 4 were under the age of 1 year, 82 between the ages of 1 and 5 years, 196 between the ages of 5 and 15 years, 61 between the ages of 15 and 35 years, and 13 over the age of 35 years. Of the 356 cases, 324 were removed to Isolation Hospitals. The remaining cases were treated at home, proper facilities being available for isolation and treatment. There were 2 deaths from this disease during the year. The clinical picture of scarlet fever nowadays is totally different from what it was 50 years ago. It was then a dangerous disease with a high case-mortality. It is now a disease of minor importance as compared with measles, diphtheria and whooping cough. 1930 Notifications of Scarlet Fever. Four-Weekly Periods. Period No. 1. Period No. 2. Period No. 3. Period No. 4. Period No. 5. Period No. 6. Period No. 7. Period No. 8. Period No. 9. Period No. 10. Period No. 11. Period No. 12. Period No. 13. Totals. London 1,483 1,443 1,388 1,393 1,240 1,343 1,212 1,149 929 1,103 1,333 1,370 1,098 16,484 Paddington Wards- 24 23 29 27 20 33 27 28 14 25 28 37 41 356 Queen's Park 1 2 5 3 1 2 1 3 4 4 2 2 30 Harrow Road 6 5 2 1 5 2 4 3 6 5 7 14 8 68 Maida Vale 4 l 3 7 1 3 2 1 2 6 4 2 5 41 Town 2 2 3 4 3 1 2 3 4 6 30 Church 2 7 5 5 6 6 5 6 1 4 6 10 9 72 Westbourne 7 3 8 9 3 17 6 3 4 4 2 4 6 76 Lancaster Gate, West - 2 1 1 3 1 2 3 - - - - 2 15 Lancaster Gate, East 1 — — - - 1 1 1 — - 2 - - 6 Hyde Park 1 1 2 1 1 1 2 5 — — — 1 3 18 DIPHTHERIA. (Including Membranous Croup). During 1930 there were 366 cases of diphtheria and 7 of membranous croup notified. Of these there were 6 cases under the age of 1 year, 105 between the ages of 1 and 5 years, 181 between the ages of 5 and 15 years, 64 between the ages of 15 and 35 years and 17 aged 35 years and upwards. Of the 373 cases, 367 were removed to Isolation Hospitals. Six cases were treated at home, proper facilities being available for isolation and treatment. Twelve deaths from this disease occurred during 1930, 8 of the deaths being those of children under the age of 5 years. Comparison with previous years is as follows:— 1919 17 deaths. 1920 25 ,, 1921 22 ,, 1922 25 ,, 1923 14 ,, 1924 14 ,, 1925 11 ,, 1926 21 ,, 1927 11 ,, 1928 7 ,, 1929 9 „ 1930 12 „ 16 Seasonal prevalence.—The following table shows the numbers of cases notified in each fourweekly period during 1930. Notifications of Diphtheria and Membranous Croup. Four-Weekly Periods. Period No. 1. Period No. 2. Period No. 3. Period No. 4. Period No. 6. Period No. 6. Period No. 7. Period No. 8. Period No. 9. Period No. 10. Period No. 11. Period No. 12. Period No. 13. Totals. London 1,311 1,274 1,202 1,150 1,019 875 911 918 736 949 1,120 1,014 824 13,303 Paddington 33 35 40 27 21 15 32 24 12 31 37 31 35 373 Wards— Queen's Park 3 1 3 2 — — 2 — 1 4 2 5 1 24 Harrow Road 6 6 3 5 2 1 7 6 2 8 4 5 4 59 Maida Vale 4 8 8 7 3 2 7 5 - 1 5 4 7 61 Town 2 3 4 5 1 - 1 2 - - 1 1 2 22 Church 7 5 12 5 6 6 8 3 3 4 16 7 9 91 Westbourne 6 11 5 3 7 5 6 7 4 13 8 7 7 89 Lancaster Gate, West 5 1 2 — 1 - - 1 2 1 - 1 1 15 Lancaster Gate, East - - 1 - - 1 - - — - - - - 2 Hyde Park — — 2 1 — 1 - — — 1 1 4 10 Diphtheria Carriers.—There is a clinic for diphtheria carriers held at St. Mary's Hospital, but only a small number of cases attend during the course of a year. These are mostly contacts of acute diphtheria cases sent by medical practitioners for treatment. Anti-Diphtheritic Serum.—This is stocked at the Town Hall and supplied to medical practitioners on request for the use of patients who are too poor to obtain such serum privately. During the year 31 phials of 4,000 units and 38 phials of 500 units were distributed. Schick Test.—During the year this test was applied to 65 children in an Orphanage in the Borough. Twenty-seven children proved to be susceptible and were immunised against diphtheria. SMALLPOX. Four cases of this disease were brought to notice during the year. Of these three were notified, the remaining case being that of a resident of another Borough attending a hospital in Paddington. The prevailing type of smallpox does not exhibit a high degree of infectiousness but inasmuch as between four and five thousand cases of smallpox were reported during the year in other parts of London, mainly the East End, the freedom from smallpox which Paddington enjoyed is very satisfactory. It speaks well for the care and vigilance exercised by the authorities in the boroughs mainly affected. During the year all vaccinations of smallpox contacts were performed by the Public Vaccinator. None were performed by the Medical Officer of Health under the Public Health (Smallpox Prevention) Regulations, 1917. VACCINATION. In pursuance of Section 2 of the Local Government Act, 1929, the functions relating to vaccination were transferred from the local poor law authority to the Borough Council as from the 1st April, 1930. There are two vaccination districts in the Borough, one consisting of the Paddington Hospital, for which the Medical Superintendent, Dr. W. G. Bendle, acts as Public Vaccinator, and the other of the rest of the Borough, the Public Vaccinator being Dr. S. Denovan Adam. The duties of Vaccination Officer are carried out by Mr. W. J. Hughes, who holds a part-time appointment. During the nine months from the 1st April to the end of the year one primary vaccination and 18 re-vaccinations were performed in the Paddington Hospital. In the rest of the Borough 532 infants under one year of age, and 45 persons over that age were successfully vaccinated by the Public Vaccinator, by whom also 59 persons were re-vaccinated who had been successfully vaccinated at some previous time. The latest return available as to the state of vaccination in the Borough is for the year 1929. This shows that 61.3 per cent. of the children whose births were registered during that year were successfully vaccinated, and that 20.7 per cent. were exempted on production of statutory declarations of conscientious objection. Insusceptibility, postponements, removals, deaths, and not traced, accounted for the remaining 18 per cent. In four instances during that year legal proceedings were taken for non-compliance with the provisions of the Vaccination Acts, and the parents fined. 17 CHICKEN-POX. Chicken-pox has been notifiable in Paddington since November 28th, 1922, but the sections of the Public Health (London) Act, 1891, dealing with disinfection, exposure to infection, etc., are not in force as regards this disease. There was an increased prevalence of the disease during the year, the number of cases certified by medical practitioners being 515 and of those reported from other sources 278, making a total of 793 cases. The greatest prevalence occurred during the first four months of the year. Chicken-pox is not usually nursed in an institution, but 23 cases received institutional treatment for various reasons. The District Nursing Association's nurses attended 5 patients, all under 5 years of age. The number of visits paid was 44. In view of the prevalence of smallpox in other parts of London and the resemblance between chicken-pox and smallpox a large number of the cases of chicken-pox reported were visited by the Medical Officer of Health to verify the diagnosis. TYPHOID FEVER AND CONTINUED FEVER. Ten cases of typhoid fever were notified in 1930. In a few cases no doubt, the diagnosis was subsequently revised, but no accurate information is available on this point. Two cases of continued fever were notified. In cases where the diagnosis of typhoid fever cannot be made with certainty but there is a strong likelihood of the disease being present, local doctors are encouraged to obtain early hospital treatment for the patients by notifying them as having continued fever. Of the 12 cases of typhoid fever and continued fever, 11 received hospital treatment. One death occurred from typhoid fever. MEASLES. Measles has been notifiable in the Borough since 1914 under various Orders and Regulations those at present in operation being "The Metropolitan Borough of Paddington (Measles and German Measles) Regulations, 1920." Sections 60-65, 68-70 and 72 of the Public Health (London) Act, 1891, were extended to measles as a dangerous infectious disease throughout the County of London by order made by the London County Council on April 1st, 1903. The effect of this order is to enable local authorities to disinfect after measles and to safeguard the public in several ways against spread of infection. In addition to the cases medically certified a number of cases come to the knowledge of the Department through reports from schools, parents, etc. There were, in 1930, 1,790 cases of measles certified by medical practitioners, and 438 cases reported from other sources, the corresponding figures for 1929 being 210 and 62, and for 1928 2,862 and 571. The number of notified cases is analysed in the adjoining table in 4-weekly periods for the various wards. 1930. Measles. Notified Cases. Four-Weekly Periods. Period No. 1. Period No. 2. Period No. 3 Period No. 4. Period No. 5. Period No. 6. Period No. 7. Period No. 8. Period No. 9. Period No. 10. Period No. 11. Period No. 12. Period No. 13. Totals. Borough 25 99 227 433 486 223 138 57 25 10 9 19 39 1,790 Wards— Queen's Park 3 2 15 60 50 6 3 3 2 - 3 1 2 150 Harrow Road 2 41 44 95 91 36 20 7 5 2 2 12 19 376 Maida Vale 3 7 48 83 81 44 8 4 - 1 4 12 1 295 Town — 3 4 9 18 19 38 7 - 2 1 102 Church 6 6 32 86 113 48 34 18 12 2 1 358 Westbourne 6 19 49 66 87 47 26 11 3 3 3 1 1 322 Lancaster Gate, West 2 7 16 18 15 6 5 3 1 - 1 1 75 Lancaster Gate, East 2 9 10 8 19 9 2 1 - - - - 61 Hyde Park 1 5 9 8 12 8 2 4 1 - — — 1 51 18 Twenty-one deaths were attributed to measles, 7 of which occurred among children under the age of 1 year, 8 among children between the ages of 1 and 2 years, and 6 among children between the ages of 2 and 5 years. The Women Sanitary Inspectors visit cases of measles with few exceptions and arrange, where necessary, for the attendance of the District Nurses. The cases requiring nursing assistance during the year numbered 163 under 5 years of age and 24 over 5 years of age. The number of visits paid by the nurses was 1,519 and 147 to each group respectively. Two hundred and forty-six cases received treatment in hospital. GERMAN MEASLES. This harmless, but infectious disease, is notifiable in Paddington; 86 cases were notified in 1930, as compared with 1,163 in 1929, 109 in 1928, 78 in 1927 and 124 in 1926. Seven patients received treatment in hospital. OPHTHALMIA NEONATORUM. This disease is notifiable in London under section 55 of the Public Health (London) Act, 1891, the London County Council having by resolution in 1911 made this section applicable to the disease. Fifteen notifications relating to cases of purulent eye-discharge of the new-born were received during 1930. The patients numbered 14, one case being notified a second time owing to a relapse after apparent recovery from the disease. Of the 14 patients 11 recovered without any impairment of vision, 1 patient lost the sight of one eye and 2 patients could not be traced after discharge from hospital. As soon as a case of this disease is notified, intensive efforts are made by the Council's staff to ensure that proper treatment is carried out. Daily visits are paid and private or charitable medical treatment is invariably enforced. Where necessary the infant and its mother are removed to a hospital, provision of this accommodation being ample. All necessary nursing attention is given by home visiting on the part of the Paddington and St. Marylebone District Nursing Association. In addition to true purulent discharge some fourteen cases of slight discharge from the eyes of infants reported by midwives to the London County Council were referred to this Department and received attention, no doubt preventing in a few instances the onset of the more severe form of the disease. During 1930, 4 cases were referred to the District Nursing Association, 187 visits being paid. Eight cases of ophthalmia of the new-born were treated in hospitals as in-patients. PUERPERAL FEVER. There were 5 cases of puerperal fever notified during 1929, all of which were removed to or nursed in a hospital. There is no difficulty in obtaining institutional treatment for women suffering from this disease. Cases of puerperal fever referred to the London County Council are concentrated as far as practicable in three institutions, namely, the Eastern Hospital, Homerton, the North-Western Hospital, Hampstead, and the South-Western Hospital, Stockwell, where special wards are set aside for these cases and special medical and nursmg staffs provided. The Council have also provided an obstetric consultant at these three institutions. Paddington mothers go, as a rule, to the North-Western Hospital, Hampstead, which is within easy reach of the Borough. Three women were certified as having died from puerperal fever, one of them not having been formally notified. 19 PUERPERAL PYREXIA. This condition is defined as:— "Any febrile condition (other than a condition which is required to be notified as puerperal fever) occurring in a woman within 21 days after childbirth or miscarriage in which a temperature of 100.4 degrees Fahrenheit, or more, has been sustained during a period of 24 hours or has recurred during that period." The febrile condition referred to in the above definition may be due to any cause, and it may be to some cause quite independent of the puerperal condition. It may, however, be the precursor of the more serious condition known as puerperal fever, and it is with this in view that the numerous conditions comprised under the term puerperal pyrexia are made notifiable. During the year 37 cases of puerperal pyrexia were notified, 31 of which occurred within or were removed to institutions. One case of puerperal pyrexia was nursed by the District Nurses at home, 31 visits being paid. During the year the Council retained the services of Mr. Aleck W. Bourne, F.R.C S. (England), Obstetric Surgeon to Out-patients, St. Mary's Hospital, to act in a consultative capacity, for cases of puerperal fever and puerperal pyrexia. One request for his assistance was made to the Council during the year. ERYSIPELAS. Seventy-four (74) cases were notified, 38 of which occurred within or were removed to hospitals. ACUTE POLIO-MYELITIS. One case of this disease, otherwise known as Infantile Paralysis, was notified and received treatment in hospital. Owing to the serious after-effects, such as deformities, which result from this disease much care is taken to keep in touch with all cases previously notified. Recent experience tends to show that most of the cases notified by doctors receive all the necessary remedial treatment. It is evident that the possibility of preventing the onset of serious deformities is now realised by parents and doctors more than formerly. ACUTE POLIO-ENCEPHALITIS. No case of this disease, somewhat similar in its nature to the last mentioned, was notified. ACUTE ENCEPHALITIS LETHARGICA. One case of this disease was notified and received treatment in hospital. Commonly known as "sleepy sickness," the disease is found to be frequently the forerunner of progressive mental and physical deterioration, occasionally signalised by disorders of conduct. For this reason careful enquiry is made as to the after-history of all cases of this disease which are brought to notice. Four deaths were attributed to "encephalitis lethargica," 3 of persons between the ages of 45 and 65 years, and 1 of a person over the age of 65 years. CEREBRO-SPINAL FEVER. Three cases of this disease were notified in 1930. All were treated in hospital. Two of the three cases proved fatal, as well as another case which had not been notified. MALARIA. One case of this disease was notified. 20 ACUTE PRIMARY PNEUMONIA, ACUTE INFLUENZAL PNEUMONIA. One hundred and sixty-eight (168) cases of acute primary pneumonia were notified in 1930, as compared with 247 in 1929, 202 in 1928, 183 in 1927 and 184 in 1926. Of the 168 cases 91 were nursed in institutions. Forty (40) cases of acute influenzal pneumonia were notified as compared with 135 in 1929, 59 in 1928, 107 in 1927 and 76 in 1926. Of the 40 cases, 15 were nursed in institutions. Sixty-seven (67) cases of pneumonia of all kinds received nursing attention at home under the auspices of the Council scheme for district nursing, 1,263 visits being paid. ANTHRAX, CHOLERA, DYSENTERY GLANDERS, HYDROPHOBIA, PLAGUE, RELAPSING FEVER, TYPHUS FEVER. No cases of these diseases were notified during 1930. WHOOPING-COUGH. This disease is notifiable in only three London boroughs and not in Paddington. Since both the cause of the disease and effective means for treating it are unknown it would not appear that notification could assist very much in checking it. Whooping-cough is very infectious in the catarrhal stage, before the characteristic whoop develops and this adds to the difficulty in dealing with the disease. In 1930, 4 persons died of whooping-cough, all being children under the age of 5 years. The number of deaths in 1929 and 1928 were 71 and 12 respectively. CANCER. The deaths from cancer are growing in number year by year in every part of the country, including Paddington. It is now one of the commonest causes of death. The number of deaths, 278, which occurred in Paddington last year was, however, slightly lower than that recorded in the previous year. Careful analysis of the figures demonstrates that the increase is a real one and is only partly accounted for by increased longevity and consequent proclivity to the disease, and by more accurate diagnosis on the part of doctors. The numbers of deaths for previous years are shown in the list following:— Numbers of Deaths in Paddington. 1930 278 1929 284 1928 260 1927 247 1926 239 1925 230 1924 234 1923 206 1922 191 1921 226 1920 194 1919 170 1918 164 1917 201 1916 205 1906 164 The following table furnishes an analysis of the sites affected in the fatal cases of cancer during the year. Two cases are not included owing to absence of information. 1930. Cancer. Site of Disease. Ages. All Ages. 0- 15- 25- 35- 45- 55- 65- 75- M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. f. Buccal cavity - - — — — _ 1 — 2 - 4 1 3 - 1 - 11 1 Pharynx, oesophagus, stomach, liver and annexa - - - - 1 2 3 2 4 3 11 6 14 12 6 8 39 33 Peritoneum, intestines and rectum - - - - - - 1 3 7 7 4 13 9 7 3 31 23 Female genital organs - - - - - 2 — 3 - 6 - 7 - 12 - 1 - 31 Breast - - _ - — 1 — 1 — 6 — 5 - 6 - 5 - 24 Skin - - - - - - 1 - - - 2 1 1 - - - 4 1 Other or unspecified organs - 1 - 1 - 1 - - 8 7 18 13 8 7 10 4 44 34 - 1 - 1 1 6 6 6 17 29 42 37 39 46 24 21 129 147 21 ACUTE RHEUMATISM. This widely prevalent disease was made notifiable as from the 1st March, 1927, by virtue of the Paddington (Acute Rheumatism) Regulations, 1927. Paddington was the first area in Great Britain to make acute rheumatism notifiable. The above Regulations remained in force for a year and were extended to March 31st, 1930, from which date the disease, under further Regulations, became permanently notifiable in the Borough. During 1930, 43 cases of acute rheumatism were notified. This figure compares with 52 cases in 1929, 76 cases in 1928, and 34 cases for the ten months of the year 1927 during which the disease was notifiable. Acute rheumatism is defined in the Regulations as being the following conditions, occurring separately or together in a child under the age of 16 years:— (1) Rheumatic pains or arthritis, if accompanied by a rise of temperature; (2) Rheumatic chorea; (3) Rheumatic carditis. The Regulations enjoin the medical officer of health to make such enquiries and take such steps as are necessary or desirable for investigating the source of disease, for removing conditions harmful to the patient and arranging for the treatment of the patient. All these enquiries and any necessary action have been delegated to the "Rheumatism Supervisory Centre "which was opened at Paddington Green Children's Hospital on October 9th, 1926. The objects of this voluntary centre are:— (1) To meet the need shown by rheumatic cases for careful supervision during periods of apparent quiescence to prevent the development of heart disease. (2) To supervise rheumatic children when apparently well by periodical examinations, and to instruct the parents to consult their usual doctor or hospital should fresh symptoms of rheumatism develop. Treatment at the Centre itself is only given in urgent cases. (3) To instruct parents in the care of rheumatic children and to make investigations in Paddington into the causation of rheumatism. The Centre is under the personal supervision of one of the Honorary Physicians to the Hospital and there is also a salaried medical officer who devotes her whole time to visiting cases of the disease and making such enquiries as may elucidate the causes thereof. The work of the Centre lies with children who are suffering from rheumatism in any of its forms, whether slight or "acute" as defined in the Regulations. During the year 43 sessions were held, the 188 Paddington children on the register making 366 attendances. Sixty-six new cases from Paddington attended the Centre, but of the 43 notified as "acute rheumatism," only 15 attended, including 3 cases notified from the Children's Hospital. The remaining patients either received treatment in institutions or were under the care of private medical practitioners. INFECTIVE ENTERITIS. This disease is notifiable in some eight other metropolitan boroughs. On May 2nd, 1927, the Council made the disease known as "Infective Enteritis" or "Summer Diarrhœa" notifiable for a period of two years. This Order was made by virtue of the Public Health (London) Act, 1891, and is only applicable to children under the age of five years. It was extended in 1929 for a further period of three years. Thirty cases of the disease were notified during the year. The number of deaths under the age of 5 years was 29 as compared with 37 in the year 1929, 23 in the year 1928 and 16 in the year 1927. In no case was it found necessary to provide for home nursing by the district nurses, all severe cases being treated in institutions. Provision was available in the isolation hospitals of the London County Council but no cases of the disease were removed from Paddington to such institutions. 22 TUBERCULOSIS. Tuberculosis of all kinds is notifiable, and particulars of the number of notification certificates received during the year 1930 are set out in the tables appended hereto. Owing to the fact that a case of tuberculosis may be notified in several boroughs or districts, the number of notification certificates received is only a very imperfect guide to the amount of tuberculosis in the Borough. There is also the consideration that notification is more strictly enforced in some districts than in others. However, recent alterations in procedure tend to make the number of cases on the tuberculosis register serve as a guide to the real prevalence of the disease. One can also take the annual number of deaths as being a measure of prevalence. This is probably the most exact method which can be used at the present time. From pulmonary tuberculosis there were 104 deaths in 1930, and from other tuberculous diseases there were 10 deaths. The number of deaths from tuberculosis of all kinds was 116 in 1928, 128 in 1929 and 114 in 1930. In recent years the numbers of deaths were as follows:— 1919 133 1925 116 1920 146 1926 125 1921 125 1927 118 1922 143 1928 116 1923 127 1929 128 1924 149 1930 114 Public Health (Tuberculosis) Regulations, 1912. Summary of Notifications on Forms A and B received during the year 1930. Tuberculosis of the Lungs. Other Tuberculosis. Male. Female. Total. Male. Female. Total. Primary Notifications— 0— 1 year — - — 2 1 3 1— 5 years — - — 6 7 13 6—10 1 - 1 14 12 26 10—15 — 1 1 3 1 4 15—20 10 7 17 1 4 5 20—25 8 19 27 2 8 10 25—35 25 32 57 2 4 6 35—45 24 14 38 3 1 4 45—55 18 8 26 — 2 2 55—65 15 6 21 — - - 65 years and over 1 1 2 1 — 1 Total 102 88 190 34 40 74 Cases re-notified 91 67 158 15 13 28 Total Notifications on Form A 193 155 348 49 53 102 Primary Notifications by School Medical Officers— 0— 5 years — — — — — - 5—10 — — — 3 2 5 10—15 „ — — — — - Cares re-notified — — — 2 2 4 Total Notifications on Form B 1 — 1 5 4 9 1930. No. of Notifications on Forms C and D. Poor Law Institutions. Sanatoria. c. d. C. d. Pulmonary Tuberculosis— Male 25 32 87 65 Female 12 16 52 57 Non-Pulmonary Tuberculosis— Male 1 3 17 15 Female — 8 16 10 C—Upon admission. D—Upon discharge. 23 Public Health (Tuberculosis) Regulations, 1921. Cases removed from Register:— 1930. By reason of— Death 117 Removal 211 Recovery of patient or variation of diagnosis 62 Total 390 Of the patients who removed from the Borough during 1930, the new addresses were obtainable in 111 instances, and particulars of the cases were transmitted to the medical officers of health of the respective districts. In 1930, 18 cases of patients who had removed into the Borough from other districts were added to the register. The number of cases remaining on the Tuberculosis Register at the close of 1930 was 1,522 as compared with 1,610 at the close of the year 1929. Visits Paid to Homes of Tuberculous Patients. By Council's Women Inspectors 1,463 By Tuberculosis Officers 552 By Dispensary Nurses— 20, Talbot Road 2,949 St. Mary's Hospital 2,231 6,929 Tuberculosis. New Cases and Mortality During 1930. Age Periods. New Cases.* Deaths. Pulmonary. Non-Pulmonary. Pulmonary. Non-Pulmonary. m f. m. f. M. f. m. f. 0 — 2 1 - - 2 1 — — — 7 7 — — — 1 6 — 1 — 18 14 - 2 2 - 10 — — 1 6 2 15 — 10 7 1 4 8 11 1 1 20 — 9 19 2 8 25 — 27 33 2 5 19 21 — 1 35 — 25 14 3 3 45 — 19 8 2 29 8 1 1 55 — 15 6 — — 65 years and upwards 1 1 1 — 5 1 — — Totals 107 89 42 46 61 43 6 4 No notifications were received with regard to 20 persons dying from tuberculosis during the year, this number being equal to 17.5 per cent. of the total tuberculosis deaths recorded. In all cases where it appeared necessary, inquiries were made as to the reason for the absence of notification. Public Health (Prevention of Tuberculosis) Regulations, 1925. By virtue of these regulations persons who are aware that they are suffering from tuberculosis of the respiratory tract may not enter upon any employment or occupation in connection with a dairy which would involve the milking of cows, the treatment of milk or the handling of vessels used for containing milk. Furthermore, if a local authority are satisfied that a person residing in their district who is engaged in any such occupation mentioned above is suffering from tuberculosis of the respiratory tract and is in an infectious state, they may by notice in writing require such person to discontinue his employment or occupation. No use has so far been made of these regulations. 24 Supply of Beds and Bedding.—In certain instances, so that the separate sleeping ot tuberculous patients may be arranged, beds and bedding are supplied on loan by the Council. One set was so supplied during 1930 and 2 sets were returned following the removal of the patients. Shelters.—The Council possesses four shelters, which, on the recommendation of the Tuberculosis Officers, are lent to patients who are able to make use of them. During 1930 no shelters were lent or returned, but one lent prior to 1930 was still being used by a patient. Artificial Pneumothorax Treatment.—By arrangement with Brompton Hospital patients recommended for this treatment are given refills at a cost to the Council of 10s. 6d. per refill. During 1930, 8 patients were referred to the Hospital, the number of refills received by each being respectively 36, 26, 25, 21, 17, 16, 4 and 1. The total cost amounted to £76 13s. Od. Dental Treatment.—Dental treatment for tuberculous persons attending either of the Tuberculosis Dispensaries is provided at 20, Talbot Road, by the Committee of the Paddington Tuberculosis Dispensary, in return for a payment by the Council of the sum of £90 per annum. A Dental Surgeon is in attendence one half-day weekly. Arrangements have also been made for the supply of dentures by the Dispensary Committee. In connection therewith 7 patients were supplied with full dentures, 4 with partial dentures and in 1 case repairs to dentures were effected. Out of a total cost of £45 5s. 0d., grants to the amount of £10 10s. 6d. were made by the Council, the balance being contributed by the patients, approved societies or other agencies. When patients are able to contribute towards the cost of their dentures, arrangements are usually made for payment to be accepted by instalments. Particulars of the dental work done during the year are shown in the subjoined table. Summary of Dental Treatment for the Year 1930. Particulars of Patients. Number of Fillings. Number of Scalings. Extraction Cases. Dentures. No. of Dressings. No. for Advice Denture Visits. No. of New Patients. Without An aesthetic. Local Administration Gas Administration Number of teeth extracted Upper. Lower. Re-models. Repairs. Number of j Attendances. Simple Root. Women 128 1 - 8 — 5 20 77 6 5 — 3 — 27 62 10 Children 127 22 2 1 - 6 46 140 — — — — 1 51 — 29 Men 53 — — 2 6 17 4 3 — — 21 24 9 Total 308 23 2 9 — 12 72 234 10 8 — 3 1 99 86 48 Number of Sessions held = 44. In addition to the dentures supplied at the Talbot Road Dispensary, partial dentures were supplied to two patients receiving treatment in a sanatorium, the cost, amounting to £6 7s. 6d., being borne by the Council. DISPENSARY TREATMENT OF TUBERCULOSIS For administrative purposes the Borough is divided into two dispensary areas, the line of division passing down Inverness Terrace, Porchester Road, Ranelagh Road, Formosa Street to its junction with Shirland Road, and Shirland Road to its junction with Kilburn Park Road. The portion of the Borough to the east of this line is served by the St. Mary's Hospital Dispensary, and the portion to the west of the line by the Paddington Tuberculosis Dispensary. 25 AO Paddington Tuberculosis Dispensary, 20,Talbot Road. This is a voluntary agency supported by voluntary subscriptions and a grant from the Paddington Borough Council usually amounting to £1,288. A full account of the Dispensary and its activities will be found in the annual reports for 1924 and 1925. Artificial sunlight treatment of patients was carried on during the year, but such treatment is not recognised as part of the approved scheme by the Ministry of Health and the London County Council. During 1930, 43 patients received treatment, 929 exposures being given. All that can be said so far of this treatment is that the results are encouraging. New arrangements are now in force for the X-ray examination of patients, through the services of a consulting Radiologist who resides close to the Dispensary. Return Showing the Work of the Dispensary During the Year 1930. Diagnosis. Pulmonary. N on-Pulmonary. Total. Adults. Children. Adults. Children. Adults. Children. M. F. M. F. M. F. M. F. M. F. M. f. A.—New Cases examined during the year (excluding contacts):— (a) Definitely tuberculous 46 37 1 - 6 7 15 16 52 44 16 16 (6) Doubtfully tuberculous -- - - - - - - - 26 36 22 16 (c) Non-tuberculous - - - - - - - - 59 182 133 151 b.—Contacts examined during the year:— (a) Definitely tuberculous 2 6 2 2 - 5 2 (6) Doubtfully tuberculous — — - — — - - - 3 5 8 5 (c) Non-tuberculous — — - — — — — — 45 79 50 40 c.—cases written off the Dispensary Register as (a) Cured 4 9 - - 28 5 30 23 32 14 30 23 (b) Diagnosis not confirmed or non-tuberculous (including cancellation of cases notified in error) - - - - - - - - 133 302 213 212 d.—Number of Persons on Dispensary Register on December 31st:— (a) Diagnosis completed 189 221 3 1 37 75 175 118 226 296 178 119 (b) Diagnosis not completed - - - — — — - — 1 6 2 3 1. Number of persons on Dispensary Register on January 1st 962 2. Number of patients transferred from other areas and of "lost sight of" cases returned 9 3. Number of patients transferred to other areas and cases "lost sight of " 127 4. Died during the year 61 5. Number of observation cases under A (b) and B (b) above in which period of observation exceeded 2 months 18 6. Number of attendances at the Dispensary (including Contacts) 5,451 7. Number of attendances of non-pulmonary cases at Orthopaedic Out-stations for — treatment or supervision 8. Number of attendances, at General Hospitals or other Institutions approved for the purpose, of patients for (а) "Light treatment — (b) Other special forms of treatment 108 9. Number of patients to whom Dental Treatment was given, at or in connection with the Dispensary ... 78 10. Number of consultations with medical practitioners:— (а) At Homes of Applicants 51 (b) Otherwise 195 11. Number of other visits by Tuberculosis Officers to Homes 310 12. Number of visits by Nurses or Health Visitors to Homes for Dispensary purposes 2,949 13. Number of (a) Specimens of sputum, &c„ examined 374 (b) X-ray examinations made in connection with Dispensary work 103 14. Number of Insured Persons on pensary Register on the 31st December 341 15. Number of Insured Persons under Domiciliary Treatment on the 31st December 153 16. Number of reports received during the year in respect of Insured Persons:— (a) Form G.P. 17 14 (b) Form G.P. 36 149 26 St. Mary's Hospital Tuberculosis Dispensary. This dispensary is voluntary and was subsidised by a grant of £1,075 from the Paddington Borough Council during the year 1930 A full account of this dispensary and its activities will be found in the annual reports for 1924 and 1925. Return Showing the Work of the Dispensary During the Year 1930. Diagnosis Pulmonary. Non-Pulmonary. Total. Adults. Children. Adults. Children. Adults. Children. m. f. m. f. m. f. m. f. m. f. m. f. A.—New Cases examined during the year (excluding contacts):— (a) Definitely tuberculous 20 23 1 1 7 3 1 21 30 4 1 (b) Doubtfully tuberculous — — — — — — 7 17 3 6 (c) Non-tuberculous — — — — — — 6 12 7 8 B.—Contacts examined during the year:— (a) Doubtfully tuberculous 1 (b) Non-tuberculous — — — — — — 8 17 22 11 C.—Cases written off the Dispensary Register as (a) Cured — — — — 1 — — 1 (b) Diagnosis not confirmed or non-tuberculous (including cancellation of cases notified in error) 17 47 31 29 D.—Number of Persons on Dispensary Register on December 31st:— (a) Diagnosis completed 76 65 2 4 48 47 47 28 124 112 49 32 (b) Diagnosis not completed 1. Number of persons on Dispensary Register on January 1st 317 2. Number of patients transferred from other areas and of "lost sight of" cases returned 15 3. Number of patients transferred to other areas and cases " lost sight of " ... 53 4. Died during the year 19 5. Number of observation cases under A (6) and B (b) above in which period of observation exceeded 2 months 2 6. Number of attendances at the Dispensary (including Contacts) 3,622 7. Number of attendances of non-pulmonary cases at Orthopaedic Out-stations for treatment or supervision - 8. Number of attendances, at General Hospitals or other Institutions approved for the purpose, of patients for (a) "Light" treatment — (b) Other special forms of treatment 21 9. Number of patients to whom Dental Treatment was given, at or in connection with the Dispensary 5 10. Number of consultations with medical practitioners:— (а) At Homes of Applicants — (b) Otherwise 33 11. Number of other visits by Tuberculosis Officers to Homes 242 12. Number of visits by Nurses or Health Visitors to Homes for Dispensary purposes 2,231 13. Number of (а) Specimens of sputum, &c., examined 115 (b) X-ray examinations made, in connection with Dispensary work 80 14. Number of Insured Persons on pensary Register on the 31st December 152 15. Number of Insured Persons under Domiciliary Treatment on the 31st December 3 16. Number of reports received during the year in respect of Insured Persons:— (а) Form G.P. 17 — (b) Form G.P. 36 27 The Borough Tuberculosis Care Committee. The constitution of the Tuberculosis Care Committee for the year 1930 was as follows:— Representing. Paddington Borough Council British Red Cross Society Charity Organisation Society Insurance Committee Invalid Children's Aid Association London County Council ,, ,, Paddington Tuberculosis Dispensary ,, ,, ,, ,, ,, ,, ,, ,, ,, Paddington and St. Marylebone War Pensions Committee Kensal House School Care Committee ,, ,, ,, Paddington and St. Marylebone District Nursing Association Paddington Board of Guardians Panel Committee St. Mary's Hospital United Services Fund ,, ,, Paddington and St. Marylebone Employment Committee ... Councillor Mrs. R. M. Drury (Vice-Chairman) Councillor Mrs. A. E. Lambert. Dr. G. E. Oates, Medical Officer of Health. Miss L. M. O'Kell, Sanitary Inspector. Miss I. L. Buckledee, Sanitary Inspector. Miss A. V. Edden. Mrs. G. S. Warren. Miss P. Bethell. Miss R. Russen. Miss Liddiard Dr. A. W. Sikes (Divisional Medical Officer). Miss K. Marriott (District Organiser of School Care Committees). Dr. R. S. Walker (Tuberculosis Officer). Nurse C. Griffin. Nurse A. B. Munro. Miss C. Milner. Mr. S. G. Last, J.P. (Chairman). ,, ,, ,, Miss F. Alston. Miss Bennett. Miss H. C. Davidson, Dr. G. de Swietochowski. Dr. A. B. Porteous (Tuberculosis Officer). Sister M. M. Lee. Miss M. M. Barthorp. Mr. J. E. Bennison. Mr. A. E. Goss. The Medical Officer of Health continued to act as Honorary Secretary to the Committee, an allowance of £50 per annum being allocated to certain members of the clerical staff for clerical assistance. The social work of the Tuberculosis Care Committee is ancillary to the work of the Public Health Committees of the Borough Council and London County Council in the sphere of the prevention and treatment of tuberculosis. The principal duties Derformed are: (1) The assessment of patients' contributions, who are receiving institutional treatment at the hands of the London County Council. (2) The co-ordination of the various agencies which can be invoked to assist patients and their dependants. No funds are available in the hands of the Committee for the assistance of patients. The Committee met on 22 occasions during the year, and the attendance of members was well maintained. Two hundred and ninety-four individual cases were considered. Residential treatment was granted by the London County Council to 141 patients, 12 of whom were children under the age of 16 years. In each instance the financial circumstances of the patient were carefully considered by the Care Committee, and a recommendation was forwarded to the County Council as to whether free treatment should be granted or a contribution assessed. Of the 141 patients, 106 received free treatment, the remaining 35 patients, or their parents, paying contributions varying from 2s. to 30s. a week. Payments are collected by the Committee and transmitted monthly to the County Council. During the year a total of £315 16s. 0d. was dealt with in this manner. It not infrequently happens that after a case has been assessed, a revision of the rate of contribution is rendered necessary owing to a change in the circumstances of the family. During 1930, 13 assessments were revised by the County Council on the recommendation of the Care Committee, and in 6 further instances payments of the contributions were excused for various periods. Typical examples of the help rendered by the Committee in connection with the social welfare part of their work have appeared in previous Annual Reports. During 1930, the Committee were able to arrange for assistance in the form of clothing, extra nourishment or monetary grants to be given to a number of patients, or their dependants, by various charitable organisations, including the Charity Organisation Society, the British Red Cross Emergency Fund, and the British Legion and United Services Benevolent Fund. Several patients were helped to find suitable employment, and action was taken on behalf of others with a view to obtaining settlement of difficulties connected with the payment of insurance benefit. 28 MATERNITY AND CHILD WELFARE. Health Visitors. These officers, two in number, work under the control of the Maternity and Child Welfare Committee of the Council. Their duties are:— (1) To visit the homes of all newly-born children where considered necessary. (2) To make enquiries concerning stillbirths and deaths of infants and young children. (3) To visit and give advice to parents in cases of ophthalmia of the new-born, infective enteritis and other important diseases. (4) To investigate all cases of puerperal fever and puerperal pyrexia. The Health Visitors attend several consultations weekly at the Paddington School for Mothers; they also attend alternately once a fortnight at the Infant Consultation Centre at Queen Charlotte's Maternity Hospital. The work performed by the Health Visitors is summarised in the appended tables, which also show how many infants were breast-fed and other interesting information. HEALTH VISITING. Births— First Visits 2,310 Revisits 2,315 4,625 Ante-natal— First visits 556 Revisits 366 922 OTHER VISITS. Puerperal Fever and Puerperal Pyrexia 149 Ophthalmia Neonatorum 360 Diarrhoea 228 Miscellaneous 1,634 2,371 Particulars recorded as to Method of Feeding. Breast. Artificial. Mixed. Total. Number 1,561 84 133 1,778 Percentage 87.8 4.7 7.5 AGES AT FIRST VISIT. Method of Feeding. Breast. Artificial. Mixed. Totals Weeks 0— 22 2 3 27 1— 890 26 22 938 2— 449 12 31 492 3— 101 12 14 127 Months 0— 1,462 52 70 1,584 1— 47 12 11 70 2— 26 9 6 41 3 and upwards 26 11 46 83 DIED BEFORE END OF YEAR: 69. Breast 52 Artificial 12 Mixed 5 CAUSES OF DEATH. Diarrhœal Diseases 11 Whooping Cough 1 Respiratory „ 25 Measles — Atrophy, Debility 4 Premature Birth 6 Congenital Defects 5 Other Causes 17 Institution Deaths 50 (Paddington Hospital 32). 29 Maternity and Child Welfare Centres. These are provided by the Paddington School for Mothers, which is a voluntary society financed by voluntary contributions and by grants from the Paddington Borough Council, and before April 1st, 1930, from the Ministry of Health. The scheme made by the Minister of Health under section 101 (6) of the Local Government Act, 1929, provides for an annual contribution of £2,750 to be made by the Council to the Paddington School for Mothers, as from April 1st, 1930. The following is a brief account of the activities of the Paddington School for Mothers. Headquarters : 232, Harrow Road, W. 2. Established 1910, when the Paddington Health Society was divided into two distinct bodies for dealing with Tuberculosis and Infant Welfare, the latter being the Paddington School for Mothers. The Birth Visiting was performed by the School's qualified Visitors until 1913, when, owing to the great increase in the work, for which only voluntary funds were then available, the Birth Visiting was taken over by the Borough Council, who appointed their first Health Visitor for that purpose. South Centres. 232, Harrow Road, W. 2.—Nine good rooms warmed by gas fires, bathroom and basement. Two Infant Consultations weekly.—Tuesday, 2.30. Medical Officer, Dr. O. Stuart Thompson. Thursday, 2.30. Medical Officer, Dr. J. Thoresby Jones. Area served :—Parts of Church, Harrow Road, Westbourne and Maida Vale Wards. One Maternity Consultation weekly (Ante- and Post-Natal).—Established January, 1918, monthly. March, 1919, weekly. Monday, 10.30 a.m. Medical Officer, Dr. E. Dorothy Fenwick. Area served :—All Paddington. St. David's Welsh Church Hall, St. Mary's Terrace, W. 2.—Large hall, electrically heated, and doctor's room, guarded coal fire. Established November, 1914, at Paddington Wharves' Mission Hall, Church Place, W. 2. Moved to present address, June, 1921 One Infant Consultation weekly.—Wednesday, 2.30. Medical Officer, Dr. Maude Richards Area served :—Church and Town Wards. St. John's Boys' Club, Sovereign Mews, Cambridge Street, W. 2.—Three rooms warmed by gas radiators and guarded coal fire. Established November, 1918. Moved to All Saints' Church House, Norfolk Mews South, London Street, W. 2, April 22nd, 1919 Returned to present address, July 30th, 1926. To be transferred as from February 27th, 1931, to St. David's Welsh Church Hall, St. Mary's Terrace, W.2. One Infant Consultation weekly.—Friday, 2.30. Medical Officer, Dr. J. A. B. Hammond. (deceased December 1st, 1930, temporary appointment made). Area served :—Hyde Park Ward. Christ Church Parish Rooms, Queensborough Passage, Porchester Terrace, W. 2.—Two large rooms and doctor's room, warmed by gas fires, radiators and oil stove Heating by electricity installed autumn, 1930. One Infant Consultation weekly.—Monday, 2.30. Medical Officer. Dr. E. Dorothy Fenwick. Area served.—Lancaster Gate East and West Wards and part of Westbourne Ward. 30 North Centres. Congregational Institute, Third Avenue, Harrow Road, W. 10.—Large double room, doctor's room and sales room, warmed by gas radiators and hot pipes. Established 1911, at Emmanuel Hall, Harrow Road. Moved June, 1916, to St. Peter's Institute, Chippenham Mews. Moved to present address, November, 1916. Two Infant Consultations weekly.—Tuesday, 2.30. Medical Officer Dr. J. A. B. Hammond (deceased December 1st, 1930, temporary appointment made). Friday, 2.30 Medical Officer, Dr. J. Thoresby Jones (resigned as from March 31st, 1930, Dr. S. Denovan Adam appointed as from April 4th, 1930). Area served :—Queen's Park Ward and part of Harrow Road Ward. St. Simon's Parish Hall, Macroom Road, Saltram Crescent, W. 9.—Large hall, doctor's and weighing rooms, warmed by gas radiators and gas fires. Established December 6th, 1920. Two Infant Consultations weekly.—Wednesday, 2.30. Medical Officer, Dr. J. McKail. Thursday, 2.30. Established February 8th, 1921, at the Orphanage of Mercy, Randolph Gardens, Kilburn Park Road, N.W.6. Transferred to present address as from June 27th, 1929. Medical Officer, Dr. Hubert Hodge. Massage Sessions, established March 17th, 1925, are held at 232, Harrow Road on Tuesday and Thursday mornings from 10.0 to 12.30, by Miss Gannon, C.S.M.M.G., for children referred by Medical Officers at all Paddington Centres. These children continue to attend the Centres in order that progress may be noted by the doctors. A second Masseuse, Miss Pinkerton, C.S.M.M.G., was appointed to attend on Tuesday" mornings, as from July 17th, 1928, and on Thursday mornings as from May 23rd, 1929. Sewing Classes (temporarily suspended in February, 1928) were re-opened March 1st, 1929, and are held weekly at 232, Harrow Road, except during the summer months. Dental Arrangements.—Messrs. J. Trude Fripp and F. H. Brinckley Tofts, 281, Harrow Road, treat mothers and children who attend Centres, on special terms. Assistance, when necessary, given from Vest Fund. Lectures.—Lectures are provided from time to time, on Health topics at all Centres. Convalescent and Holiday Homes.—Mothers and children are sent to Convalescent and Holiday Homes on recommendation of Medical Officers at Centres. All arrangements made by School workers, and assistance given when necessary, from the Vest Fund. Vest Fund.—A small Association of ladies connected with the School, knit garments and woollies which are sold to the mothers at low cost at the Centres. The stock is augmented by gifts from friends, and the money realised is spent on dentures, convalescence, etc. Artificial Sunlight Treatment can be procured for cases recommended by doctors at Centres, at St. Mary's Hospital and the Children's Hospital, Paddington Green. Home Visiting. Home visiting is carried on systematically from the time of receiving the Borough Health Visitor's birth card, until the child goes to school. Each Health Visitor has her appointed area. Staff. Until April, 1930, the salaried staff consisted of the Superintendent, Assistant Superintendent, one part-time and four whole-time Visitors. Since then it has consisted of the Superintendent, one-part time and five whole-time Health Visitors, and one part-time clerical assistant. 31 Consultation Centres. Summary of Work for the Year, 1930. Harrow Road. Third Avenue. Macroom Road. St. Mary's Terrace. Sovereign Mews. boro' Passage. Totals. Tues. Thurs. Tues. Fri. Wed. Thurs. Wed. Fri. Mon. Number of Sessions 50 51 50 50 51 49 50 50 47 448 Number of Attendances 2965 3061 2701 2745 2290 2876 2655 1269 2326 22,888 Average Attendance 59.30 60.19 54.02 54.90 44.90 58.69 53.10 25.38 49.48 51.09 Seen by Doctor 821 1053 901 843 717 1211 991 623 1251 8411 Average number seen by Doctor at each Session 16 21 18 17 14 24 20 12 26 19 Ante-Natal and Post-Natal Clinic. Number of Sessions 49 Number of Attendances 821 by 337 expectant or recently confined mothers. Average Attendance per Session 16 75 Number of cases referred by midwives in private practice 66 Home Visiting. Visits to Babies 14,063 Visits to Expectant Mothers 593 Other Visits 8,478 Supply of Dried Milk, Etc., at Consultation Centres. £ s. d. Purchases of Dried Milks, etc. 1,450 10 3 Sales 1,336 4 1 Grants from Borough Council 105 3 0 Queen Charlotte's Maternity Hospital.—During the year 1930, 111 infants of mothers resident in Paddington attended the Infant Consultation Centre. The average number of attendances per infant was about 13. As regards ante-natal consultations, exact figures are not available. During 1930, there were received into the Hospital for confinement 259 women from Paddington. This number is approximately equal to the number of women from Paddington attending the ante-natal department during the year, and the average number of attendances was 6 per patient. With regard to out-patients in 1930, 459 Paddington women were delivered in their own homes by midwives from the hospital; each of these would have attended the ante-natal department about 6 times on the average. St. Mary's Hospital.—There is no Infant Consultation Centre at this Hospital, but Antenatal Consultations are held. There are no figures available as to the number of Paddington mothers who attended such consultations, but the number of Paddington mothers delivered at their own homes during 1930 was 155 and presumably all of these received ante-natal examination and advice. Maternity Nursing.—The arrangement whereby the Paddington and St. Marylebone District Nursing Association provides the services of trained maternity nurses in connection with lying-in cases attended by the students and the Medical Officer of the Extern Midwifery Department of St. Mary's Hospital, continued in operation throughout the year. The results of this arrangement are excellent although it is not possible to adduce any figures in support of this statement. During the year 1930, 155 confinements were attended by the nursing staff, the number of visits being 2,710. These figures compare with similar ones of 113 and 1,846 in the year 1929. The annual grant in aid of this work is now £175. Maternal Consultations.—On two occasions the Council's obstetric consultant was asked to see patients in consultation with private practitioners on account of complications associated with parturition. 32 DAY NURSERIES. At the end of the year 1930, there were two day nurseries in Paddington, situated at No. 66, Lancefield Street, Queen's Park, W.10, and No. 21, Howley Place, W.2. Statistical Summary. Queen's Park. Howley Place. Full days. Saturdays. Full days. Saturdays. Days open 242 48 225 45 Attendances 5,429 273 8,490 729 Average attendance 22 6 38 16 New Children 35 92 Cases of Infectious Disease. Diphtheria - - Scarlet Fever - - Measles 11 18 Whooping Cough - - Chicken-pox - - There were no Closures during the Year on account of infectious disease The Scheme made by the Minister of Health under section 101 (6) of the Local Government Act, 1929, provides for the annual payment as from April 1st, 1930 of contributions from the Council, to the Paddington Day Nursery, £322, and to the Queen's Park Day Nursery, £252. PROVISION OF MILK FOR NECESSITOUS MOTHERS AND CHILDREN Milk is given in the following cases :— (a) Expectant mothers during the last three months of pregnancy. (b) Nursing mothers. (c) Children up to three years, also in exceptional cases children over three and under five years of age when not attending school. Before any case is considered the Medical Officer of Health must be satisfied that the supply is necessary on grounds of health. In the case of an expectant mother the existence and duration of pregnancy must be verified by the signature of a doctor or midwife. The quantity of milk authorised varies with the need of the mother or infant concerned. Usually one pint per day is granted to an expectant mother and to a nursing mother, unless she be nursing twins, when one quart is allowed. The bottle-fed baby, also, normally has the same quantity up to about the sixth month of its age but thereafter this is increased to 1½ or 2 pints per day when the necessity is certified by the medical officer of a Welfare Centre. In cases where dried milk is prescribed one packet (one pound) is considered the equivalent of seven pints of milk. The "Grants" Sub-Committee has latterly made a practice of insisting on the attendance periodically of the infants on grant at one or other of the welfare centres and the issue of at least one medical certificate of necessity every three months. Applications are made at the Public Health Department at any time, when particulars of the circumstances of the family are obtained. Whenever considered necessary wages, etc., are verified from the employer, and other enquiries instituted by the Investigation Officer. Close touch is also maintained with all other sources of assistance. A scale of income is appended which is used for the purpose of determining whether applicants are to be regarded as necessitous, and for guidance in deciding whether milk shall be supplied free or at half price. Where considered necessary, however, the Sub-Committee reserve the right to deviate from such scale. Applications for grants are considered in detail by the full Maternity and Child Welfare Committee sitting as a "Grants" Sub-Committee, meetings being held practically every fortnight. Pending the sitting of the Sub-Committee the Chairman may authorise emergency grants. Grants take one or other of the following forms :— (a) Fresh milk to Expectant or Nursing Mother or a child under 5 years of age (see first paragraph) on an order issued on the dairyman usually supplying the family ; 33 (b) Dried Milk—supplied at the Welfare Centre attended by the infant; and (c) Dinners (cut from joint, two vegetables and "sweet") to expectant or nursing mothers partaken at approved restaurants. The necessary orders are despatched on the evening of the day on which the Sub-Committee sits, one copy to the tradesmen and one to the grantee. On the latter the following conditions are printed:— Milk supplied under this order is to be used only for the mother or child to whom the milk has been granted. It is not to be given to other members of the family. The Medical Officer of Health should be informed at once if there be :— (1) Any change whatever in workplace or income of any member of the family ; (2) Any change of address ; or (3) Any assistance received from the Relieving Officer. During the year the following quantities of milk were issued to necessitous mothers :— Fresh Milk 11,462 quarts. Dried Milk 600 lbs. The approximate cost of milk given in this way was £362 17s. 7d. Income Scale. Free. Half-Price. Number of family. Total Income less Rent. Total Income less Rent 1 15/- 18/— 2 20/- 24/- 3 25/6 27/— 4 30/- 34/- 5 32/6 37/6 6 36/— 42/- 7 40/- 47/6 8 44/- 51/6 9 48/- 55/6 10 52/— 60/- 11 56/- 65/— 12 60/- 70/- The wave of trade depression and consequent unemployment had its natural effect on the work of the Maternity and Child Welfare (Grants) Sub-Committee and the resultant marked increase in the grants during the year may form an excuse for some special comments. The influx of applications, totalling 2,519, for assistance under the Scheme rendered it necessary for the Sub-Committee to meet fortnightly, twenty-five times in all. The following Table forms a comparative statement of the work during the past five years:— 1926. 1927. 1928. 1929. 1930. Total cases dealt with (Figures not kept) 1,300 2,519 Total of new applications 467 371 385 443 652 No. granted 365 271 273 337 575 No. refused or referred to Relieving Officer 102 100 112 106 77 No. of orders for milk 904 776 814 1,015 1,761 No. of orders for dried milk 149 113 149 152 361 No. of orders for dinners 19 6 — — 8 The figures relative to grants of dinners to expectant and nursing mothers may appear somewhat low. During the year under review efforts have been made to urge such applicants to take advantage of the provision of meals, but with little success. In most cases domestic difficulties, such as the necessity of having to provide meals at home for other children, have been advanced, and in others there is undoubtedly shyness at the thought of having to attend a general restaurant, though arrangements are made for the meal to be taken in a room apart from the public. Of the 652 families whose applications were considered, approximately two-thirds were unemployed. Three factors accounted for the remaining one-third " in works," viz., low wages, high rents, and large families. The low wage type of grantee is chiefly the domestic or hotel worker. With wages of anything between 20s. and 40s. per week, plus food, a rent of perhaps 15s. to 20s. a week to meet and a wife and children to maintain, the difficulty can be appreciated. The Sub-Committee has dealt with over 100 such applicants and many will undoubtedly remain in the "chronic group" of grantees. 34 The high rent factor is too well known to call for much comment. A so-called furnished room will rent at from 15s. to 27s. 6d. per week and an unfurnished room (difficult to obtain) will realise 8s. to 16s. weekly (decontrolled), the size of room and the neighbourhood being, of course, accountable for variations. As regards large families the following can be mentioned as extreme instances of necessity for assistance under the scheme:—1 family of ten (housed in one basement room) and 6 families of nine (1 family in one room and 5 families in two rooms each). Whilst making a passing reference to housing, mention can be made of the following further cases coming within the purview of the Scheme during the year:—Four families of 7 persons, four of 6, and ten of 5, all in occupation of one room only. Other recipients of grants included:—Unmarried mothers, 12; Deserted or separated mothers, 10; Widows, 8 (one with 8 children and one with 9); wives of men in the Navy or Army, 4. A noteworthy feature is that the "centre of gravity" of grants has shown a tendency of late years to move towards Westbourne Ward. Many houses in the south-western quarter of that area have gradually developed into one- and two-roomed tenements, with the natural result that there has been a great influx of persons from other parts. In this district one finds mainly the low-paid class of worker previously referred to. This influx has been a prime factor in the increase of grants, for over one-fourth of the families dealt with have been newcomers to the Borough. Visitation of the homes of grantees by the School for Mothers' Visitors regularly, and by the Investigation Officer intermittently, continues. About 3,500 interviews between applicants and the Investigation Officer have taken place during the year, in the homes or the office. Generally speaking the recipients of grants can be trusted to report any change of circumstances, but close touch has to be maintained with a certain class. The Committee's grants usually cover a period of four weeks but discretion is allowed the Officer to divide them into shorter terms if thought desirable. Particulars of Milk Grants during 1930. (1929 figures in brackets). The total number of cases considered by the "Grants" Committee during the year was 2,519 of which 652 represented new applications. These latter were divided up as follows:— Number of Refused or New Applications. Granted. referred to Guardians. Fresh Milk 561 (390) 489 (288) 72 (102) Dried Milk 87 (53) 82 (49) 5 (4) Dinners 4 (—) 4 (—) — (—) 652 (443) 575 (337) 77 (106) Number of Orders for Milk 1,761 At Total Cost 1,730 At Half Cost 31 Number of Quarts at Total Cost 21,594 „ „ „ Half Cost 402 Total Number of Quarts 21,996 £ s. d. Cost of Milk at Total Cost 597 2 6 ,, „ Half Cost 5 8 7 £602 11 1 Number of Orders for Dried Milk 361 At Total Cost 361 At Half Cost — Total Cost of Dried Milk £105 3 0 Number of Orders for Dinners 8 Number of Dinners supplied at Total Cost 107 Total Cost of Dinners £6 6 2 Invalid Children's Aid Association. A grant of £10 in aid of the funds of the local branch of the Invalid Children's Aid Association was made. 35 CONVALESCENCE. Three nursing mothers with their babies were admitted to St. Mary's Convalescent Home, Birchington-on-Sea, for varying periods of convalescence. In one case the Council paid the whole cost, in the other two contributions were made by the head of the family. MATERNAL MORTALITY. During the year six maternal deaths were enquired into by Dr. E. Dorothy Fenwick, the Council's medical investigator, and reports thereon were forwarded to the Maternal Mortality Committee of the Ministry of Health. ADMINISTRATION. GENERAL. Staff of the Department.—Mr. J. W. Webster, Senior Sanitary Inspector, retired from the Council's service on November 9th, and Mr. T. Mitchell was designated Senior Sanitary Inspector as from that date. The vacancy on the inspectorial staff was filled by the appointment of Mr. E. Marshall, who commenced his duties on November 24th. Mr. C. T. Wyatt, who had been engaged in a temporary capacity on the clerical staff of the Department was appointed an officer in the Council's service as from March 26th. Mr. C. H. F. Drake was appointed Junior Clerk as from August 18th. Prevention of Infectious Disease.—Visits of enquiry after notification of infectious disease numbered 6,770. This figure excludes visits in connection with tuberculosis, which are recorded elsewhere in this report. The removals to hospitals and other institutions for various diseases other than tuberculosis numbered 1,211. In connection with the arrangement between the Council and the Paddington and St. Marylebone District Nursing Association, 270 patients (comprising 187 cases of measles, 67 of pneumonia, 12 of whooping-cough, and 4 of ophthalmia neonatorum) were visited in their homes by the nurses of the Association. The visits paid to such patients numbered 3,289. Disinfection.—The rooms disinfected after infectious disease numbered 1,271, including 202 rooms disinfected after tuberculosis. The weight of bedding, etc., removed for disinfection at the Wood Lane Disinfecting Station, under the agreement with the Kensington Borough Council, amounted to nearly 30 tons. Two hundred and forty-one library books were disinfected. Schools.—A total of 4,231 notices relating to cases of infectious disease was despatched to the Head Teachers of the various schools attended by patients or their " contacts," 3,414 of such notices referring to cases of measles, whooping-cough and chicken-pox, and the remainder to cases of diphtheria, scarlet fever and other notifiable diseases. In addition 486 reports were sent to the medical officers of health of other boroughs in connection with cases attending outlying schools. Bacteriological Work.—The Council have an arrangement with the Royal Institute of Public Health, 37, Russell Square, W.C.1, for the bacteriological examination, at the expense of the Council, of specimens sent by medical practitioners of Paddington patients suspected to be suffering from diphtheria or typhoid fever. All specimens are collected at the Town Hall and transmitted to the Institute by special messenger. The results are generally available the next morning, and are telephoned to the medical practitioner concerned. Examinations of sputa from patients suspected to be suffering from tuberculosis of the lungs are undertaken by the Paddington Tuberculosis Dispensary, 20, Talbot Road. The examinations made during 1930 were as follows:— Disease suspected. Number of Examinations. Number. Positive Results. Diphtheria 1,426 194 Tuberculosis 350 52 Typhoid Fever 8 2 House Drainage.—During the year 33 existing drains were tested and found water-tight, 128 defective drains were reconstructed and 8 made sound by special process. 36 Reconstruction Plans.—Three hundred and seven (307) plans were submitted for drainage works in existing buildings. In connection therewith 536 letters were despatched. No summonses were issued for failure to supply plans. Combined Drainage.—Orders were made under Section 74 of the Metropolis Management Act, 1855, with respect to new drainage systems to which the following groups of houses were to be connected:— Palace Houses, Bayswater Road, Nos. 1, 2 and 3. The Memorial Hall, Nos. 45 and 51, Porchester Road, Westbourne Park Chapel, and No. 2, Westbourne Park Villas. New Petrol Filling Station on sites of Nos. 327-329, Harrow Road, and Nos. 22, 24, 26 and 28, Woodfield Road. Garage in St. Petersburgh Mews, at rear of No. 28, Bark Place, and No. 28, Bark Place. Garages, and flats over, in Canterbury Terrace at the rear of No. 145, Maida Vale, and No. 145, Maida Vale. Harrow Road, Nos. 512, 514 and 516. Bayswater Hill, Nos. 7 and 8 (Embassy Hotel). Bayswater Hill, No. 8 and garage adjoining. Poplar Place, Nos. 1, 2, 3 and 4, Queen's Road No. 79 and premises at rear. New building St. Petersburgh Place and Mews on sites of Nos. 10 and 12, St. Petersburgh Place, and the Synagogue, St. Petersburgh Place. Leinster Gardens, Nos. 25, 26, 27 and 28. Leinster Gardens, Nos. 16 and 17. New garage on the north-west side of Sutherland Avenue at the rear, and within the curtilage of the premises No. 115, Maida Vale, and No. 2, Canterbury Terrace. The premises known as the kitchens of the Connaught Club in Seymour Street, and the new building No. 16, Connaught Mews. New business and residential premises, Nos. 73, 75 and 77, Queen's Road. New garage on the south side of Torquay Street, at the rear of Nos. 223-227, Harrow Road and on the sites of premises numbered and known as 11, 13, 15 and 17, Torquay Street. New garages, billiard room and flats on the south side of Westbourne Street Mews, and numbered and known as 15 to 18, Westbourne Street Mews, rear portions of Nos. 8 and 9, Stanhope Terrace, and other premises connected to the existing main drain passing down the centre of Westbourne Street Mews. New garage extension on the east side of Courtnell Street, at the rear and within the curtilage of premises numbered and known as 19, Westmoreland Road, and the garage (adjoining) at the rear and within the curtilage of premises numbered and known as 17, Westmoreland Road. Garages (converted stables) and all other premises in Westbourne Park Mews, drained through one outlet to the sewer in Westbourne Gardens. New offices and residential premises on the sites of Nos. 77, 79, 81 and 83, Harrow Road, No. 1, Albert Street and No. 25, Victoria Street. New residential and business premises on the sites of Nos. 11 to 47 (odd, inclusive), Queen's Road, and the courtyard on the sites of Nos. 49, 51 and 53, Queen's Road. Westbourne Terrace, Nos. 70 and 72. Westbourne Terrace, Nos. 52 and 54. Formosa Street, No. 56 and Annexe. Lancaster Gate, Nos. 1 and la. „ „ Nos. 23 and 24. „ Nos. 87 and 88. New garage premises on the north-west side of Newcastle Place and immediately at the rear of premises numbered and known as 283 to 289 (odd, inclusive), Edgware Road, and having a frontage to Newcastle Place of approximately 170 feet. 37 New shops and residential flats or building on the south-west side of Edgware Road, immediately south of Star Street at its junction with Edgware Road, and numbered and known as 189, 191 and 193, Edgware Road. Cambridge Street, Nos. 58, 59 and 60. Warrington Crescent, Nos. 37 and 39. Two combined systems were reconstructed by the Council during the year. Drainage Bye-laws.—A revised series of bye-laws made by the London County Council came into operation on March 4th, 1930. Revised bye-laws with respect to water-closets, urinals, earth-closets, privies and cesspools came into operation on August 21st, 1930. Sewer Connections.—In 1930, 51 were reconstructed, either partially or wholly, 9 after Orders under Section 85 of the Metropolis Management Act, 1855, and 42 on the application of the owners of the properties concerned. Water Supply—Three certificates under Section 48 of the Public Health (London) Act were issued. The Metropolitan Water Board reported 2 cases of discontinuance of water supply, both in consequence of non-payment of rates. In one instance the premises were found to be used as a dwelling and in the other as a garage. The water supply was restored to the inhabited house within a few days of the disconnection. Mortuary.—Three hundred and forty-one (341) bodies were deposited at the Mortuary, inquests being held on 181 of that number. Bodies deposited pending burial (all noninfectious) number 77. Trade Nuisances.—Twenty-nine complaints were received during the year, those relating to manure numbering 13. Notice was given by the Council under Section 36 (2) of the Public Health (London) Act, 1891, requiring the removal of manure or other refuse matter from mews, stables, etc., twice in every week during the months of May to September. No serious difficulty was found to arise in connection with such periodical removal. Rag and Bone Dealers.—In December, 1930, there were 11 rag and bone dealers in the Borough. Smoke Control.—During 1930, 34 trade premises were kept under observation for the detection of smoke emitted so as to be a nuisance. These premises were watched on 186 occasions, occupying 58f hours. Smoke of all descriptions was noted during 34¼ hours, the duration of "black" smoke being only l¼ hours. Fifteen complaints relating to the emission of smoke were received during the year. One Written Intimation was served together with numerous informal communications. No Statutory Notices were served. FOULING OF PUBLIC FOOTWAYS BY DOGS. The following bye-law was made by the Council on the 29th July, 1924, for the good rule and government of the Borough:— No person being in charge of a dog in any street or public place and having the dog on a lead shall allow or permit such dog to deposit its excrement upon the public footway. Any person offending against this bye-law shall be liable to a penalty not exceeding 40 shillings. This bye-law shall cease to be in force after the first day of August, 1926, unless a bye-law confirming and continuing its provisions has been duly made and come into force before that date. In July, 1926, the bye-law was adopted permanently by the Council. This bye-law is enforced by the Medical Officer of Health and his staff. Active assistance is given by the police, the Home Secretary having intimated in June, 1928, as a result of representations from the Council, that the police had been instructed to report to the Council such offences against the bye-law as come to their notice in the course of their ordinary duties. During 1930 three prosecutions were instituted, resulting in one defendant being fined the sum of seven shillings and sixpence and another being ordered to pay a similar sum as costs. 38 In the remaining case the summons was dismissed. Numerous verbal warnings to offenders were also given. The publicity which has been given to the bye-law has had good effect in causing many dog-owners to be more careful. One minor difficulty in enforcing the bye-law is that an offender cannot be compelled to divulge his identity, and cannot be given in charge as the police do not enforce the bye-law. Notices concerning the bye-law were frequently posted on shingle-bins throughout the Borough. CANAL BOATS ACTS, 1877 and 1884. By virtue of the Local Government Board Regulations of May 17th, 1878, the Paddington Borough Council is one of the Registration Authorities for the Regent's and Grand Junction Canals, now the Grand Union Canal. The Medical Officer of Health is the Examining Officer for the purpose of the Regulations. Mr. C. S. Wansbrough acted as Canal Boats' Inspector during the year. The following report for the year 1930 was made to the Council by the Medical Officer of Health, and was adopted by the Council as their statutory report to the Minister of Health as required by the Canal Boats Act, 1884. Report for 1930.—One hundred and eleven inspections of canal boats and 98 calls and reinspections were made during the year, and the following infringements of the Acts and Regulations were discovered :— Cabins leaky 7 Cabin floors defective 9 Stoves and stove pipes defective 13 Boats without certificates 14 Lettering, marking and numbering illegible 2 Painting of cabins required 11 Seven formal notices were served. On no occasion was admission to a boat refused, and no legal proceedings were necessary in respect of any of the infringements discovered. There was one case of infectious disease notified, viz. :—measles. There were two deaths reported amongst canal boat dwellers. One boat was registered. One hundred and five children of school age were found to be living on the canal boats using the Paddington Basin (50 males, 55 females), a reduction of the number reported last year, due to the tendency of the parents to find homes ashore for their families. The total number of boats in respect of which certificates of registration had been issued at the end of the year was 249, one being a motor-boat. It is practically certain that a number of boats, registered many years ago, have changed ownership, been registered with another authority or been broken up. It is under the circumstances impossible to trace a number of registered boats or to know the exact number of " live " certificates of registration. One of the requisites for an inhabited canal boat is that if ordinarily used for the conveyance of any foul or offensive cargo, it shall contain between the space occupied by such cargo and the interior of any cabin used as a dwelling, two bulkheads of substantial construction, separated by a space not less in any part than four inches, open throughout to the external air. Such space must be furnished with a pump for the removal of any liquid and the bulkhead next to the cargo is to be watertight. It has not hitherto been considered in this Borough that house refuse comes within the scope of the term "foul or offensive" cargo. Steps are now being taken, however, that double bulkheads shall be fitted to all inhabited canal boats conveying house refuse and the owners of such boats are taking all necessary action to comply with this interpretation of the Regulations. During the year, of the 22 inhabited boats known to be conveying house refuse from Paddington Basin, 11 were found to be fitted with double bulkheads. The remaining 11 boats will be refitted as circumstances permit. The annual cleansing at Paddington Basin was carried out during the Easter holidays. About 1,547 tons of mud were removed from the bed of the Basin, in addition to 670 tons which were dredged previously. 39 HOUSING. Conversions.—Section 102 of the Housing Act, 1925, and Section 84 of the Law of Property Act, 1925, empower a County Court to vary the terms of a lease or other instrument so as to enable a house to be converted into tenements, notwithstanding any restrictive covenant there may be to the contrary. Two applications under these Sections were made during the year relative to the conversion into flats of Nos. 23 and 37 Palace Court. Plans continue to be submitted to the Council under the drainage bye-laws, relative to the conversion of premises into tenements. It is probable that a number of other conversions were carried out in which no interference with existing drainage was involved. Such conversions would not come within the purview of the department. Compulsory Repairs.—No notices were served under Section 3 of the Housing Act, 1925, or Section 17 of the Act of 1930, but 489 communications were sent to owners drawing attention to defects liable to be dealt with under these sections. These communications in most instances resulted in the defects being remedied. Unhealthy Areas.—No representations were made to the Council during 1930. Houses Unfit for Habitation.—Following a representation by the Medical Officer of Health the Council made a Closing Order with respect to No. 2, Westbury Road. The Closing Order was determined before the end of the year, the premises having been made fit for habitation. Underground Rooms.—No rooms were dealt with under the Council's Regulations pursuant to Section 18 of the Housing Act, 1925, but action was taken under Section 96 of the Public Health (London) Act 1891 with respect to the illegal occupation of underground rooms at four premises. In one instance proceedings were instituted against the person responsible for the letting. The summons was heard in January, 1931, when the defendant was fined £4. Tenement Houses.—There were no additions to the Register, the total remaining the same as at the close of the previous year, viz., 1,406. The inspections made by the two Special Inspectors numbered 7,055. Particulars of the defects, etc., discovered and remedied will be found on paegs 41 and 42. Overcrowding.—During 1930 nine tenements in registered houses were reported to be overcrowded. In only two instances was it possible to secure the abatement of the overcrowding before the close of the year, the occupants of the remaining seven tenements being unable to find other accommodation. Owing to existing social conditions only extreme cases of overcrowding are dealt with by official action. Annual Cleansing.—The usual practice with regard to the selection of special streets for inspection was followed, a total of 844 houses being inspected during the year. Notices were served for the cleansing and other work which was found to be necessary. Common Lodging Houses.—The customary inspection was made by the Sanitary Inspector of the district of the 5 common lodging houses in Kilburn Lane, prior to the annual licensing by the London County Council. During the year 6 deaths from various causes occurred among the occupants of these houses. Housing Act : Rent Books.—At one house the rent books were found not to contain the required particulars. A cautionary letter was addressed to the owner. Acquisition of a site for building purposes.—On July 22nd, 1930, the Council made an Order for the compulsory acquisition of a site formerly comprising Nos. 61, 63 and 65, Brindley Street, pursuant to Part III. of the Housing Act, 1925 and the Housing Consolidated Regulations, 1925, and application was made to the Minister of Health for confirmation of the Order. The site consists of an area of approximately 2,088 feet super and is suitable for the erection of working-class tenement dwellings. It is intended that the tenements to be provided shall be self-contained flats and shall be used for re-housing families displaced by housing schemes to be undertaken in the Borough. 40 Purchasing and re-conditioning of houses.—The consent of the Minister of Health was obtained to the Council's subscribing during the year ending March 31st, 1931, an amount not exceeding £5,000 in respect of debentures, bearing interest at 2½% per annum, secured by a Trust Deed and issued by a public utility society known as The Paddington Houses Association, Ltd. The money subscribed will be utilised in purchasing, reconditioning and improving working-class houses in the Borough, which will be let in tenements. Rent and Mortgage Interest (Restrictions) Acts, 1920-1925. Seven applications for certificates were made, six of which were granted. HOUSING ON THE LONDON COUNTY COUNCIL ESTATES. The arrangement with the London County Council made in 1924 continues in force whereby the County Council under Part III of the Housing Act, 1890, allocates preferentially to suitable applicants recommended by Borough Councils, 50 per cent. of new accommodation. The quota for Paddington is 15 houses per 1,000 built. The cases are selected on the grounds of overcrowding, unhealthy conditions, urgency and special hardship. The following Table (No. 1) shows the number of applications submitted to the London County Council for accommodation on the different Estates, during the year only, and how they were dealt with. Table No. 1 (Housing). Estate. Submitted. Housed. Waiting. Withdrawn. Refused by L.C.C. Offered, not accepted. Becontree 29 12 12 - 2 3 Downham — — - - - - St. Helier 33 12 11 3 4 3 Watling — - - — — — Wormholt 2 - 2 - — — 64 24 25 3 6 6 In addition to the above figure of 24 housed, 15 families were housed on the different Estates on applications submitted to the London County Council previously to 1930. This figure brings the total number of Paddington applicants housed during the year to 39. The Table refers only to the number of applications submitted to the London County Council: it gives no indication of the number remaining on the "waiting lists," which is over 1,160 for all Estates. (Compare Tables Nos. 1 and 2). Neither does it show the number of Paddington residents who have made application direct to the London County Council, many of whom have been accommodated. During the year 147 new applications were accepted, and over 1,954 interviews were held. The next Table (No. 2) will give some idea of the amount of housing already achieved for Paddington, showing as it does the total number of applications received and how they were dealt with since the inception of the Scheme up to the end of 1929. Table No. 2 (Housing). Estate. Number of Applications Received. Number Housed. Waiting. Withdrawn. Refused by L.C.C. Offered, not accepted. Becontree 367 107 142 54 45 19 Castelnau 28 11 17 - - — Downham 222 102 66 10 12 32 Old Oak Common 38 8 10 4 10 6 Roehampton 45 23 18 2 2 — St. Helier 226 16 175 26 5 4 Tottenham 33 13 11 - 5 4 Watling 620 109 439 41 20 11 Wormholt 563 159 347 43 12 2 2,142 548 1,225 180 111 78 The following Estates on which 425 Paddington residents have obtained accommodation are now completed, the Borough receiving the full quota of houses:—Castelnau, Downham, Old Oak Common, Roehampton, Tottenham, Watling and Wormholt. There is a total of 940 Paddington applicants remaining on the several lists for these Estates awaiting accommodation. 41 The development of the new St. Helier Estate at Morden is proceeding and applications are being forwarded as and when required to the London County Council. In November, 1927 and July, 1928 agreements were completed between the London County Council and the Borough Council whereby provision was made for the housing of 150 families on the Wormholt Estate, Hammersmith, the Borough Council to pay to the London County Council the sum of £7 per annum for a period of 20 years for each house occupied The 150 families are in occupation. During the year 3 vacancies occurred and new tenants were admitted at once from the waiting list. The following analysis of 240 cases of overcrowding remaining on the list after completion of the Watling Estate, and, similarly, 160 cases for the Wormholt Estate, gives some indication of the urgent need for the provision of further housing accommodation for the Borough. Number in family, including Parents. Number of Rooms Occupied. 1. 2. 3. 4. 5. 3 52 - - - - 4 52 40 - — — 5 28 52 15 — — 6 8 47 17 — — 7 2 21 14 — — 8 1 12 12 1 — 9 - 6 6 4 — 10 1 2 3 1 — 11 — 1 1 — — 13 - - - - 1 Defects, Nuisances and Contraventions of Bye-laws (other than items of Dilapidation) Discovered and Remedied in Registered Tenement Houses. 1930 Drain defective 1 „ choked 19 „ not properly ventilated or ventilating pipe defective 17 Manhole cover defective 11 Gully choked 12 Soil pipe defective — Water-closet defective 71 „ choked 18 „ without sufficient flush 11 „ flushing apparatus defective 61 „ foul 8 „ improperly constructed — „ accommodation insufficient 4 „ without door, door defective, or without proper fastenings 92 Rain-water pipe defective 46 „ choked 15 Guttering defective 48 Waste pipe defective 21 „ choked 9 „ untrapped 1 „ not provided or missing — Sink defective or not provided 16 Other drainage defects 2 Cistern defective 2 dirty 26 „ without proper cover or cover defective 22 Dustbin defective 187 „ not provided 2 „ insufficient 27 „ disused and not abolished 1 Paving of yard or area defective 51 „ washhouse defective 28 Premises damp 79 Rooms, etc., dirty (including staircases, washhouses, water-closets, yards, areas, etc.) 3,250 „ verminous 70 „ contents, bedding, etc., dirty 4 „ not provided with a window opening directly to the external air 1 Chimney smoky 45 Food cupboards not provided - Windows defective including cords and fastenings out of repair 828 Roof defective 288 Common staircases out of repair 102 Staircases without sufficient handrail 17 Animals improperly kept — Accumulation of refuse (not offensive) 9 Premises without water or supply insufficient 51 Any other defects, etc. 144 42 Notices Issued. 1930 Written Intimations 722 Statutory Notices 260 Bye-law „ 648 Notices under L.C.C. (G.P.) Acts— Verminous rooms 44 Additional taps 12 Abolition of old dustbins — Provision of cooking ranges — Items of Dilapidation for which Letters were sent to the Owners (Section 3 of the Housing Act, 1925). Wall-plaster broken, bulging, or defective 97 Matchboarding defective 6 Wall-paper loose 5 Skirting defective 5 Doors defective or missing 48 Locks defective 38 Ceiling plaster defective 73 Ceiling paper loose 11 Floors broken or badly worn 66 Stoves defective (including fire tiles burnt away, bars broken or missing, oven plates burnt through, oven doors defective or missing, plates broken or missing) 196 Stove settings defective 9 Flues defective — Hearths defective 30 Chimney-pieces loose or defective (including jambs, frieze, or mantel broken, loose, or missing) 41 Cupboard doors defective or missing and shelves missing 13 Window-sashes defective (including sash or sash-bars broken, rotten or defective, beads missing or defective, putties defective) 111 Window-frames loose or defective (including oak sills worn or rotten) 21 Window-glass broken 250 Copper brickwork defective, furnace pan leaky, furnace door missing or defective, setting defective, flue smoky or defective 92 Steps to front entrance or area defective 25 Railing to area or area steps defective 26 Guard rails to addition roofs defective, broken or rotten 7 Rubbish or refuse in yard, washhouse, vault, area, under-basement, etc. 2 Vault doors missing or defective 30 HOUSING. (Ministry of Health Table.) Number of New Houses erected during the Year. (а) Total— (i) By the Local Authority — (ii) By other Local Authorities — (iii) By other bodies or persons 4 (comprising 15 dwellings) (b) With State assistance under the Housing Acts :— (1) By the Local Authority — (a) For the purpose of Part II of the Act of 1925 — (b) For the purpose of Part III of the Act of 1925 — (c) For other purposes — (ii) By other bodies or persons — I.—Inspection of Dwelling-houses during the Year. (1) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) (2) Number of dwelling-houses which were inspected and recorded under the Housing Consolidated Regulations, 1925— (а) Houses inspected on complaint or after illness 2,084 Inspections made 15,837 (b) Registered tenement houses inspected 844 „ „ 7,055 (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-houses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation — II.—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 officers No record. III.—Action under Statutory Powers during the Year. (A) Proceedings under Section 3 of the Housing Act, 1925— (1) Number of dwelling-houses in respect of which notices were served requiring repairs *489 (2) Number of dwelling-houses which were rendered fit— (а) by owners 416 (approx.) (b) by Local Authority in default of owners — (3) Number of dwelling-houses in respect of which Closing Orders became operative in pursuance of declarations by owners of intention to close — 43 (B) Proceedings under Public Health Acts— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 1,403 (2) Number of dwelling houses in which defects were remedied after service of formal notices— (a) by owners 1,547 (b) by Local Authority in default of owners - (C) Proceedings under Sections 11, 14 and 15 of the Housing Act, 1925— (1) Number of representations made with a view to the making of Closing Orders 1 (2) Number of dwelling-houses in respect of which Closing Orders were made 1 (3) Number of dwelling-houses in respect of which Closing Orders were determined, the dwelling-houses having been rendered fit 1 (4) Number of dwelling-houses in respect of which Demolition Orders were made - (5) Number of dwelling-houses demolished in pursuance of Demolition Orders - *Informal notices. IV.—Number of Houses owned by the Local Authority. Held under the Local Authorities (Assisted Housing Schemes) Regulations, 1919 2 FACTORIES AND WORKSHOPS. 1930. Inspection of Factories, Workshops and Workplaces. Premises. Number of Inspections. Written Notices. Occupiers prosecuted. Factories (including factory laundries) 998 3 - Workshops (including workshop laundries) 1,155 6 — Workplaces (other than outworkers' premises) 689 — — Total 2,842 9 — Defects found in Factories, Workshops and Workplaces. Particulars. Number of Defects. Number of offences in respect to which Prosecutions were instituted. Found Remedied Referred to H.M. Inspector. Nuisances under the Public Health Acts:—* Want of cleanliness 133 133 — - Want of ventilation - - - - Overcrowding 3 3 — — Want of drainage of floors — — — - Other nuisances 11 11 — — Sanitary accommodation insufficient 1 1 - - unsuitable or defective 19 19 - - 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 167 167 — - * Including those specified in sections 2, 3, 7 and 8 of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts. 44 Outwork in Unwholesome Premises, Section 108 Nature of work. Instances. Notices served. Prosecutions. Wearing Apparel— Making, &c. — — — Cleaning and washing — — — Household linen — — — Lace, lace curtains and nets — — - Curtain and furniture hangings — — — Furniture and upholstery — — — Electro-plate — — — File making — — — Brass and brass articles — — — Fur pulling — — — Cables and chains — — — Anchors and grapnels — — — Cart gear — — — Locks, latches and keys — — — Umbrellas, &c. — — - Artificial flowers — — - Nets, other than wire nets — — - Tents — — - Sacks — — - Racquet and tennis balls — — - Paper, etc., boxes, paper bags — — — Brush making — — — Pea picking — — — Feather sorting — — — Carding, &c., of buttons, &c. — — — Stuffed toys — — — Basket making — — — Chocolates and sweetmeats - - - Cosaques, Christmas crackers, Christmas stockings, &c. — — — Textile weaving — — — Total — — — At the end of the year 1929, 1,172 premises were on the Register as compared with 1,165 at the end of the year 1928. During the year 1930, 27 premises were removed from the Register and 67 added, making the total at the end of the year, 1,212. The Department reported the opening of 15 workshops to the Home Office, and received from that Office, notice of 22, 15 of which were already known to the Department. Homework (Outworkers).—Local employers of outworkers sent in 24 lists in February and 23 lists in August. These lists contained 307 names and addresses of which 243 were forwarded to other districts. From other districts 308 addresses within the Borough were received. Supervision.—There were during the year, 2,842 inspections, comprising 998 of factories, 1,155 of workshops and 689 of workplaces. There were 167 nuisances or defects found upon registered premises, 167 of which were remedied during the year, the majority being remedied by verbal request. The defects found comprised:— Want of cleanliness 133 „ ventilation — Overcrowding 3 Sanitary accommodation—insufficient 1 ,, ,, unsuitable or defective 19 „ „ not separate for sexes — Other offences 11 The Home Office forwarded 2 complaints, which comprised:— Overcrowding 3 Sanitary conveniences not separate for sexes — Other offences 17 Bakehouses.—During the year one level bakehouse was opened, the total number on the Register at the end of the year being 60, of which 51 were factory bakehouses. The number of "level" bakehouses was 17 (13 being factories) and of " underground " 43 (38 being factories) 45 The number of persons working in bakehouses was 289, including 4 women and 23 individuals under the age of 18. The bakehouses were inspected on 911 occasions during the year. RAG FLOCK ACTS, 1911 and 1928. The rag flock in use in the Borough appears to be well washed and free from dust. Three samples were taken and were found to comply with the regulations applicable. FOOD SUPERVISION. Slaughterhouses.—There were, at the end of the year 1930, two slaughterhouses within the Borough licensed by the London County Council:— 275, Edgware Road; 249, Maida Vale. There were 306 inspections made during the year. The number of animals slaughtered, so far as is known, was 3,306, comprising 196 bullocks, and 3,110 sheep, being a decrease of 22 bullocks and 44 sheep, as compared with 1929. The following Table shows the number of organs destroyed and the disease with which they were affected. Bullocks. Sheep. Heads. Tongues Lungs. Livers. Mesenteries. Hearts. Spleens. Lungs. Livers. Hearts. Tuberculosis 5 5 12 10 4 1 1 - - - Actinomycosis - - - - - - - - - - Pleurisy - - 5 - - - - 2 - - Abscess 1 1 3 5 - - 1 - - - Distomum Hepaticum - — — 45 — — — — — — Parasitic Invasion - — — — — — — 147 68 — Pneumonia - - - - - - - 6 - - Cyst - — — 1 — 1 - — 6 - Disease not determined - - - - - - - - - 49 6 6 20 61 4 2 2 155 74 49 2 Breasts of Lamb—Pleurisy. Total weight, 1,710 lbs. In addition to the animals slaughtered in the licensed slaughterhouses, a number of pig carcases arrive in the Borough which have not been previously inspected. During 1930 the number of carcases was 152. On examination it was found necessary to destroy— 1 head weighing 9 lbs. affected with tuberculosis. Pieces of pork weighing 25 lbs. bruised. Public Health (Meat) Regulations, 1924.—It was not found necessary to take any legal proceedings under these Regulations during the year. Occasional defaults were dealt with by means of a caution. Poultry Slaughtering.—This business is dealt with by special bye-laws. The only poultry slaughterhouse in the Borough is situated at No. 51, Shirland Road. During the year 60 inspections were made and approximately 8,110 head of poultry were slaughtered. Food Purveyors.—At the end of the year there were some 829 purveyors of food in the Borough, classified as follows:—Butchers 85, Fishmongers 25, Fried Fish 34, Refreshments 120, Greengrocers 89, Milk 115, Margarine 19, General 60, Confectioners 115, Provisions 45, Grocers 112, Ham and Beef 10. 46 In addition to the above premises there are 77 licensed Street Traders selling food within the Borough, namely:—Fruit and Vegetables 48, Ice Cream 13, Light Refreshments 12, Fish 3, Poultry 1. These, with the storage premises of 21 Street Traders licensed by other Boroughs, are under constant supervision. There were 7 premises on which fish curing was performed, this business as well as fish frying, being regulated by special bye-laws. There were also 42 premises on which sausages were made. The number of visits of inspection paid to premises occupied by food purveyors was 2,007. There were 126 shops at which ice-cream was known to be sold, comprising the following kinds of businesses:—Bakers 9, General 13, Milk 12, Confectioners 47, Refreshments 40, Wholesale 3, Newsagent 1, Greengrocer 1. Two hundred and fifty (250) inspections of premises were made. Ice-cream was sold from 25 barrows stored within the Borough and from 35 barrows stored outside the Borough. Section 29 of the London County Council (General Powers) Act, 1928, renders it necessary for the owner or occupier to register with the sanitary authority any premises which are used or proposed to be used for the sale or the manufacture for the purpose of sale of ice-cream or other similar commodity or the storage of ice-cream or other similar commodity intended for sale. At the end of 1930 there were 90 entries in the Register. Registration is not necessary as regards premises which are occupied as factories or workshops or used as hotels, restaurants or clubs. Food Destroyed.—The total weight of food surrendered by tradesmen and dealers for destruction by the Council was 3 tons, 13 cwts., 3 qrs., 9 lbs., comprising the following varieties:—Fish 255 lbs., Fruit and Vegetables 6,034 lbs., Meat 268 lbs., Offal 1,712 lbs. Dairies and Milkshops.—At the end of the year 1929 there were 113 names on the Register. During the year 1930, 4 names were added and 2 removed (premises closed), making a total of 115. Ten of the businesses were transferred to new proprietors. There were 425 inspections made. Sterilised milk in bottles was found to be on sale at 90 premises. Milk (Special Designations) Order, 1923. During the year 66 licences were issued by the Council pursuant to this Order, 15 being for "Certified," 23 for "Grade A (Tuberculin Tested)," and 28 for "Pasteurised" milk. The licences in respect of "Grade A (Tuberculin Tested)" milk included one for a bottling establishment, and those in respect of "Pasteurised" milk, four for pasteurising establishments. The samples taken by the Council's Inspector numbered 17, all of "Certified" milk. Three of the samples were found not to be in compliance with the bacteriological standard appropriate to the kind of milk. The bacteriologist's reports were forwarded to the Ministry of Health. Fifteen churns of "Grade A (Tuberculin Tested)" milk in course of delivery at Paddington Station were found not to be sealed in accordance with the requirements of the Order. The facts were reported to the Ministry of Health. Milk and Dairies Order, 1926. Twelve churns containing skimmed milk were found on arrival at Paddington Station not to be marked in the manner prescribed by Article 30 of this Order. The consigner of the milk was cautioned. Food and Drugs (Adulteration) Act, 1928. Of the 600 samples taken during the year, 18 (3.8 per cent.) were found to be "not of the nature, or not of the substance, or not of the quality demanded by the purchaser." This compares with 3 per cent. in 1929 and 1.8 per cent. in 1928. Forty of the samples were taken on Sundays and Bank Holidays. None of these was adulterated 47 One hundred and twenty-six samples of milk and six samples of separated milk were taken at Paddington Station on delivery by rail. Fifteen of the milk samples were found to be adulterated. Sixteen samples of milk were obtained at Paddington Station at the request of other Boroughs. Sampling of milk supplies to Public Institutions.—There are seven institutions from which samples of milk are taken quarterly and two from which samples are taken half-yearly. Of the 32 samples taken in 1930 all were returned as genuine. PUBLIC HEALTH (PRESERVATIVES, &c., IN FOOD) REGULATIONS, 1925 TO 1927. With few exceptions all samples taken under the Food and Drugs (Adulteration) Act were examined for the presence of preservatives. Two samples of sausages, sold without proper declaration of the presence of preservative were found to contain respectively 82 parts and 99 parts per million of sulphur dioxide, and one sample of strawberry jam was found to contain 67'95 parts per million of sulphur dioxide. The vendors were cautioned. PUBLIC HEALTH (CONDENSED MILK) REGULATIONS, 1923 AND 1927. During the year one sample of full cream unsweetened, four samples of full cream sweetened, and eight samples of skimmed sweetened condensed milk were taken. All were found to comply with the Regulations. PUBLIC HEALTH (DRIED MILK) REGULATIONS, 1923 AND 1027. No samples of dried milk were taken during 1930. CHEMICAL AND BACTERIOLOGICAL EXAMINATION OF FOOD. Analyses for the purposes of the Food and Drugs (Adulteration) Act, 1928, and the various Food Regulations are made by the Public Analyst, Sir William R. Smith, at the Royal Institute of Public Health, 37, Russell Square, W.C.1, where also bacteriological examinations of food are made when required. Bacteriological examinations of samples of milk procured under the provisions of the Milk (Special Designations) Order, 1923, are also made at the Royal Institute of Public Health. During 1930 one sample of sausages was submitted for bacteriological examination following complaint of suspected poisoning. No injurious organisms were found. The results of other samples analysed or bacteriologically examined are recorded elsewhere in this Report under the appropriate headings. Summaries of the results of analyses made by the Public Analyst during the year are given on pages 48 and 49. The results of legal proceedings are summarised on page 52. In connection with the analysis of milk samples, the Public Analyst furnishes the result of his analysis and the following table is of interest. It may be noted that the Ministry of Agriculture standards for presuming milk to be adulterated are 3 per cent. for fat and 8.5 per cent. for non-fatty solids. These standards are generally considered to be rather unfair to the consumer and the deduction to be made from the tables is that the milk sold in Paddington is, generally speaking, of average natural strength. Genuine Milk Samples, 1930. Average Monthly Figure for Percentage. Fat Content and Non-Fatty solids. January 3.61 8.80 February 3.66 8.86 March 3.62 8.81 April 3.49 8.83 May 3.41 8.89 June 3.55 8.89 July 3.41 8.71 August 3.60 8.91 October 3.73 8.83 November 3.75 8.79 December 3.97 8.73 No samples were taken during the month of September. Average for Year. Samples taken at Paddington Station 3.63 8.87 „ „ elsewhere 3.66 8.79 48 Samples Submitted to Public Analyst—1930. Number examined. Number adulterated. Percentage adulterated. Formal. Informal. Formal. Informal. Formal. Informal. Ale - 6 - - - - Ammoniated Tincture of Quinine - 2 — — — — Asparagus - 1 — — — — Baking Powder - 3 — — — — Beans, Tinned - 1 — — — — Boric Ointment - 3 — — — — Brandy - 1 — — — — Brawn - 2 — — — — Bread 3 — — — — — Bread and Butter 2 — — — — — British Wine (Non-Alcoholic) — 1 — — — — Butter — 13 — — — — Calomel Ointment — 1 — — — — Camphorated Oil — 1 — — — — Carbolic Powder — 1 — — — — Cheese — 14 — — — — Chocolate — 3 — — — — Chutney — 1 — — — — Cocoa — 4 — — — — Coffee — 8 — — — — Coffee and Chicory Extract — 1 — — — — Cream — 13 — — — — Cream Buns — 1 — 1 — 100.0 Cream Horns — 1 — — — — Cream Jam Sandwich — 1 — — — — Cream Meringues — 1 — 1 — 100.0 Cream Soda — 1 — — — — Crystallised Fruits — 1 — — — — Crystallised Ginger — 1 — — — — Currants — 3 — — — — Custard Powder — 6 — — — — Dates — 1 — — — — Dried Fruit — 2 — — — — Dripping — 3 — — — — Egg Substitute Powder — 1 — — — — Figs — 1 — — — — „ Tinned — 1 — — — — Fish, Potted — 2 — — — — „ Tinned — 2 — — — — Flour — 3 — — — — Gin 1 4 1 — 20.0 — Ginger Beer — 1 — — — — Ginger in Syrup — 1 — — — — Glycerin — 1 — — — — Grape Fruit, Tinned — 1 — — — — Honey — 4 — — — — Ice Cream — 4 — — — — Jam 1 10 — 1 — 9.09 Lard — 4 — — — — Lemonade Powder — 4 — — — — Lemon Squash — 1 — — — — Lime Juice Cordial — 1 — — — — Luncheon Sausage — 1 — — — — Margarine — 8 — — — — Meat Paste — 4 — — — — Mercury Pills — 1 — — — — Milk 303 — 15 — 4.95 — „ Full Cream Sweetened Condensed — 4 — — — — „ „ „ Unsweetened — 1 — — — — „ Skimmed 2 — — — — — „ „ Sweetened Condensed — 8 — — — — Mincemeat — 3 — — — — Mustard 1 2 — — — — Orange Curd — 1 — — — — Orange Juice — 1 — — — — Orange Quinine Wine — 1 — — — — Orange Wine (Non-Alcoholic) — 1 — — — — Oysters, Canned — 1 — — — — Ox Tongue — 1 — — — — Peas, Tinned — 3 — — — — Peel — 1 — — — — Pepper — 2 — — — — Peptonised Cocoa and Milk — 1 — — — — Pickled Cabbage — 1 — — — — Pickles — 2 — — — — Plums, Tinned — 2 — — — — Raisins — 2 — — — — Rice — 2 — — — — 49 Samples Submitted to Public Analyst—1930—(continued). Number examined. Number adulterated. Percentage adulterated. Formal. Informal. Formal. Informal. Formal. Informal. Sago — 2 — 1 — 50.0 Salmon, Tinned — 1 — — — — Sardines — 2 — — — — Sauce — 2 — — — — Sausages 8 — 2 — 25.0 — Sausages, Preserved 4 — — — — — Saveloy — 2 — — — — Semolina — 2 — — — — Shredded Suit with Flour — 6 — — — — Sherry — 1 — — — — Soup, Tinned — 1 — — — — Spaghetti — 1 — — — — Stout — 5 — — — — Sugar — 2 — — — — Sulphur Ointment — 2 — — — — Sultanas — 3 — — — — Sweets — 2 — — — — Table Jelly — 1 — — — — Tapioca — 2 — — — — Tawny Wine — 1 — — — — Tea — 13 — — — — Tincture of Iodine 2 4 — 1 — 16.66 „ „ Strong — 1 — — — — Tomato Pickle — 2 —— — — — Tomatoes, Tinned — 2 — — — — Treacle — 1 — — — — Turpentine Liniment — 1 — — — — Veal, Ham and Egg Pie — 1 — — — — Vinegar 2 1 — — — — „ Malt — 2 — — — — White Precipitate Ointment — 1 — — — — Zinc Ointment — 2 — — — — 329 271 18 5 5.47 1.84 600 23 3.83 Agricultural Produce (Grading and Marking) Act, 1928. The Council is responsible for enforcing the provisions of this Act and the Medical Officer of Health and the male Sanitary Inspectors have been authorised to act as officers for this purpose. During the year certain articles were added to the list of those which may be graded and marked. At the end of the year regulations were in force applicable to :— Apples and Pears; Beef ; Broccoli; Canned Fruits, Peas and Beans ; Cherries ; Cider; Dressed Poultry; Eggs ; Glasshouse grown Tomatoes and Cucumbers ; Malt Flour and Malt Extract; Potatoes; Strawberries ; Wheat Flour. No premises used by way of trade or for purposes of gain for the cold storage or chemical storage of eggs were registered during the year. Three samples of graded eggs which were procured were found not to comply with the regulations applicable. These defaults were dealt with effectively by the Ministry of Agriculture and Fisheries on the facts being reported. 50 Merchandise Marks Act, 1926. The Council is responsible for executing the provisions of this Act, so far as relates to any goods being foodstuffs to which an Order in Council under the Act applies, and excepting any provisions relating to the importation of goods. The Medical Officer of Health and the Sampling Officer have been authorised to act as officers in this respect. At the end of the year Orders were in force relating to— Honey; Fresh Apples ; Raw Tomatoes; Currants, Sultanas and Raisins ; Eggs in shell and Dried Eggs ; Oat Products. Malt Products. Various samples of the above foodstuffs were obtained. All were found to comply with the requirements of the Act. On three occasions unmarked imported eggs were found on the premises of retailers. The eggs were returned to the wholesale dealers in order that the country of origin should be stamped upon them. Sale of Food Order, 1921. Proceedings were instituted against a butcher for exposing for sale imported meat which did not bear the appropriate labels. The defendant was fined £5 with £5 5s. Od. costs. Artificial Cream Act, 1929. This Act which came into force on May 10th, 1929, is intended to regulate the manufacture and sale of what is commonly known as reconstituted cream, usually prepared by emulsifying butter With dried skimmed milk and water. This substance gives the same analytical results as natural cream and cannot therefore be dealt with under the Food and Drugs (Adulteration) Act, 1928. During the year no premises were registered under the Act for the manufacture or sale of Artificial Cream. LONDON COUNTY COUNCIL (GENERAL POWERS) ACT, 1927, SEC. 52. Nuisance Caused by Pigeons.—The number of complaints received arising from the above cause was eight. Fifty pigeons were trapped and destroyed. It is estimated that there are some 2,000 pigeons at large in the Borough. RATS AND MICE (DESTRUCTION) ACT, 1919. Fifty-six (56) complaints were received. In practically every case the usual procedure was followed of requesting an examination by the Borough Engineer and Surveyor of the sewer connections of the infested house and the two premises immediately adjacent. In several instances defects were found and these received the requisite attention of either the owner or, where only a minor trouble, the Borough Engineer and Surveyor. Eight Notices were served under the Act in respect of rat-infested premises. Rat Week.—This was held from 3rd to 8th November inclusive. The usual circular letter was sent out to principal wharfingers, railway companies, tradesmen, etc., and an intensive campaign in sewers, etc., carried out by the Borough Engineer and Surveyor, who caused 9,397 baits to be laid in 635 different positions, 177 rats eventually being found dead. This number is of course only a small proportion of the number killed. VERMINOUS CONDITIONS. Cleansing of Verminous Persons.—Thirty-three (33) cases were referred by the department to the Kensington Medicinal Baths for treatment under the scheme arranged with the Kensington Borough Council. Cleansing of Verminous Rooms.—Notices under section 10 of the London County Council (General Powers) Act, 1922 were served with respect to 96 premises, the verminous rooms numbering 131. The owners of 61 premises accepted the Council's offer with regard to the spraying of infested rooms with a special vermicidal solution, 104 rooms being so treated at a charge to the owners of 7s. 6d. per room. 51 Section 26 of the London County Council (General Powers) Act, 1928, authorises the cleansing of verminous persons by the exercise of powers granted by a petty sessional court in cases where the verminous person does not consent to being removed to a cleansing station. No use was made of this Section during the year. COMPULSORY REMOVAL OF AGED, INFIRM OR DISEASED PERSONS. By virtue of Section 28 of the London County Council (General Powers) Act, 1928, it is possible in London to remove to a hospital or infirmary, by compulsion and under certain circumstances, aged, infirm, sick or physically incapacitated persons. The circumstances which may enable an order for removal to be obtained are somewhat involved. Unless the person concerned is suffering from disease it is necessary for the premises to be insanitary. It is in all cases necessary as well to prove that the person is not receiving proper attention and that removal is necessary in the interests of the affected person and of other persons. No cases were dealt with under this Section during the year. HEALTH EDUCATION. A subscription of £3 3s. Od. was paid to the Central Council for Health Education, a body which concerns itself with rendering assistance to local authorities in the organisation of health education work. LEGAL PROCEEDINGS—1930. The results of the Summonses taken out during the year are summarised in the following tables:— Premises. Offence. Fines. Costs. PUBLIC HEALTH (LONDON) ACT, 1891. £ s. d. Section 4. 2, Alfred Road Gully in front area choked Order made - 145, Church Street Roof defective Work done Summons withdrawn — 47, Clarendon Street Washhouse paving, flooring of ground floor back room, and chimney or stove of basement front room defective. Work done l 1 0 34, Craven Road Drain defective and untrapped Work done l 1 0 30, Delamere Terrace Guttering, rainwater pipe and waste pipe defective. Order made l 1 0 21, Netley Street Basement back room damp, rainwater pipe defective Order made — 8, Tavistock Crescent Failure to comply with Magistrate's Order requiring certain cleansing and repairing works to be carried out at these premises. £5 - 25, Waverley Road Main roof defective Work done Summons withdrawn Bye-laws. 17, Andover Place Water-closet without a proper flush of water £1 0 10 6 4, Brindley Street Annual cleansing not carried out Work done Summons withdrawn — 19, Clarendon Street Annual cleansing not carried out; dust receptacle defective. Work done l 1 0 47, „ „ Annual cleansing not carried out; window cords broken in basement back room. Work done Summonses withdrawn — 34, Elgin Terrace Flushing cistern to water-closet defective Work done l 1 0 112, Elgin Avenue Executing sanitary work without giving notice — 0 10 6 „ „ „ Failing to join the soil pipe with the drain in a proper manner. Summons withdrawn — 122, Lancefield Street Improperly connecting new waste-pipe to soil pipe, and failing to give notice of intention to carry out work. Alterations made to meet requirements of Bye-laws. Summonses withdrawn 2 2 0 21, Netley Street Defective window cords in basement back and first floor rooms. 10s. — „ „ „ Window glass broken in first floor front room 10s. 1 1 0 „ „ „ Seat of upper water-closet defective Work done Summons withdrawn — 240, Portsdown Road Improperly fixing new bath, lavatory basin and watercloset, and failing to give notice of intention to carry out the work. £4 3 3 0 52 LEGAL PROCEEDINGS—1930, (continued.) Food and Drugs (Adulteration) Act, 1928. Offence. Fines. Costs. £ s. d. £ s. d. Separated Milk.—20.8 per cent. of added water 2 0 0 5 5 0 „ „ 26.6 „ „ 2 0 0 „ „ 24.5 „ „ 2 0 0 Milk 15.3 „ „ „ Summons dismissed under Probation of Offenders Act. 5 5 0 Milk 26.12 „ „ 7 0 0 8 8 0 „ 27.77 „ „ „ 7 0 0 „ 30.24 „ „ 7 0 0 „ 25.3 „ „ „ 7 0 0 „ 39.65 „ „ „ 7 0 0 „ 29.77 „ „ „ 7 0 0 Milk 8.71 „ „ „ 2 0 0 5 5 0 „ 15.65 „ „ „ 2 0 0 „ 16.94 „ — „ 15.65 „ „ „ — „ 12.82 „ „ „ — „ 9.29 „ „ „ — „ 9.53 „ „ „ — „ 12.00„ „ „ — Gin 17.11 per cent. excess water Summons dismissed under Probation of Offenders Act. 3 3 0 Sale of Food Order, 1921. Offence. Fines. Costs. £ s. d. £ s. d. Exposing for sale by retail imported meat without causing such meat to bear the appropriate labels. 5 0 0 5 5 0 on first summons, remaining summonses marked "withdrawn." 53 Report of the Work of the District Inspectors, 1930. Inspection of Dwelling Houses. Sanitary Works completed in Dwelling Houses. To Regulate Keeping of Animals. Drainage, &c. Water Supply. Dust Receptacles. Miscellaneous. YEARS. Number of Complaints received. "House-to-House." On Complaint or after Illness. Cellar Dwellings. Re-Inspection of all kinds. Entire Reconstruction. Drains Relaid, Trapped or Ventilated. Drains Repaired and made Sound. Waste Pipes Disconnected. New Waste Pipes Provided. Rain-water Pipes Disconnected. W.C.'s, New Provided, Repaired, &c. Soil Pipes, New Provided. Soil Pipes Repaired. Soil Pipes Ventilated. Services Separated. Supplies Reinstated. Cisterns, New Provided. Cisterns, Cleansed, Repaired, &c. New Provided. Repaired, &c. Drains Cleared, Flushed, &c. Houses or Rooms Cleansed, Whitewashed, &c. Cases of Overcrowding Abated. Cellar Dwellings Closed. Yards and Areas Paved and Drained. Roofs Repaired. Manure Receptacles Reconstructed, &c. Accumulations Removed. Improperly kept, Removed. 1925 1,044 49 2,373 - 12,232 38 88 46 60 1008 41 495 103 31 34 2 9 27 46 128 6 87 517 2 - 19 145 — 41 5 1926 1,194 — 2,531 — 13,815 40 123 56 149 1394 35 702 155 70 72 5 6 25 62 169 21 94 793 6 3 75 195 3 28 17 1927 1,043 — 2,443 - 11,573 20 62 23 10 838 18 357 76 30 29 1 1 1 24 140 3 74 278 1 — 7 137 6 29 1 1928 1,086 — 2,453 - 13,254 32 109 15 25 1269 3 481 119 66 27 — 4 — 31 148 8 85 349 2 — 27 199 6 30 — 1929 1,196 6 2,390 - 10,055 27 70 15 6 1485 1 546 116 49 16 3 46 2 13 151 2 91 288 — — 12 115 2 28 1 1930 1,076 - 2,084 1 13,753 22 106 36 38 1551 2 638 104 46 23 1 3 - 55 142 2 62 517 - 3 22 252 - 25 1 54 1930. Prevention of Infectious Disease. All Diseases, Enquiries by— District Inspectors 1,891 Women Inspectors and Health Visitors 6,342 Tuberculosis—Included in above— Women Inspectors 1,463 Patients removed to Hospital—All Diseases (excluding Tuberculosis) 1,211 Rooms disinfected after— Tuberculosis 202 Other Diseases 1,069 Weight of Bedding, etc., disinfected (tons) 30 School Notices issued— Measles, Whooping Cough, Chicken-pox 3,414 Other Diseases 817 Bacteriological Examinations for— Diphtheria 1,426 Typhoid Fever 8 Tuberculosis 350 Sanitary Work—Cutting-off of Water Supplies. Notices received 2 Referring to Inhabited Premises 1 Empty „ — Other „ 1 Reasons for—Rates unpaid 2 Defective fittings — Mortuary. Bodies deposited, total 341 „ „ for inquests 181 „ „ pending burial, infectious — „ ,, „ ,, other 77 P.M. examinations made 134 Trade Nuisances. Offensive Smells—Complaints 16 Accumulations of Manure 13 Smoke— Complaints 15 „ Premises watched 34 „ ,, „ Hours of observation 58¾ „ Duration of smoke (hours), including 34½ „ „ black smoke 1½ Office (Clerical) Work. Letters received 4,713 „ despatched 5,530 Entries in Postage Book 11,997 Certificates dealt with relating to Infectious Disease (including Tuberculosis) 4,835 Notices sent re above 8,074 Entries in Birth Register 2,305 Complaints received 1,425 Plans dealt with 307 New openings in Journals 299 Disinfection Orders 1,322 Notices to abate nuisances, etc. 892