PENGE URBAN DISTRICT. ANNUAL REPORT of the Medical Officer of Health Robert Wilkinson (M.D.Brux.). together with THE ANNUAL REPORT of the Chief Sanitary Inspector Richard T. Pearce (M.S.I.A.). 1936 Urban District Council of Penge. Chairman: Mr. F. W. Foreman, J.P. Vice-Chairman: Mr. G. L. Wells. PUBLIC HEALTH COMMITTEE. Chairman: Mr. D. E. Jones. Mr. R. C. S. Barnett. Mr. E. Hodges. „ J. F. D. Dixon. „ J. T. W. Huckin. ,, F. W. Foreman, J.P. „ J. Smith. „ J. B. Geale, J.P. „ F. Theobald. „ F. P. Hodes, J.P. „ G. L. Wells. Co-opted Members of Maternity and Child Welfare Section : Mrs. M. Barson, Mrs. F. Dixon, Mrs. L. Hodges, Mrs. E. Jarvis and Miss Fannie Moore. Representatives on the Joint Maternity Home Committee : Mr. R. C. S. Barnett, Mr. J. B. Geale, J.P., Mr. F. P. Hodes, J.P., Mr. D. E. Jones, Mr. F. Theobald and Mr. G. L. Wells. PUBLIC HEALTH DEPARTMENT. STAFF. †Medical Officer of Health and Medical Officer to the Maternity and Child Welfare Centre : R. Wilkinson, M.D. (Brux.), M.R.C.S. (Eng.), L.R.C.P.(Lond.) Chief Sanitary Inspector : R. T. Pearce, Cert. S.I.E.B. (Lond.). Cert. Insp. of Food, S.I.E.B. (Lond.) Sanitary Inspector and Shops Acts Inspector : E. G. Thomas, Cert. R.S.I. Cert. Insp. of Food, R.S.I. Health Visitor: Miss E. M. Dell, Cert. C.M.B. Trained Nurse. Clerks: R. W. Rixson. †Miss A. G. Mitchell. † Part-time Officer. ANNUAL REPORT of the Medical Officer of Health for the Penge Urban District in the COUNTY OF KENT for the Year ending December 31st, 1936 Town Hall, Anerley, S.E. 20. April, 1937. To the Chairman and Members of the Urban District Council of Penge. Mr. Chairman and Gentlemen, I beg to present my Twenty-eighth Annual Report on the Health of the District for the year ending the 31st December, 1936. It is compiled in accordance with Circular 1,561 (1936) of the Ministry of Health. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (acres) 770 Population (Census, 1931) 27,771 Population (Estimated middle of 1936, R.G.) 25,810 Number of inhabited dwellings (Census, 1931) 5,235 Number of separately rated inhabited dwellings (end of 1936) according to rate books (approximate) 6,287 Number of private families (Census, 1931) 7,595 Total dwellings occupied and vacant (Census, 1931) 5,368 Miscellaneous habitations and institutions housing non-private families (Census, 1931) 62 Rateable value £201,907 Sum represented by Id. rate £786 6 The District is situated on the slope of a hill, its highest point being 370 feet above sea level, and the lowest, 95 feet above sea level. The Crystal Palace and greater part of the grounds, occupying approximately 127 acres, are within the district, and provide a much needed "lung." About 20 acres of the grounds are open to the public. The District is mainly residential, the chief industries being button-making, laundry work, dyeing and cleaning, printing and knitted dress making. A large number of the residents are engaged in business in London and a number are employed in the building and allied trades. The density of population per acre is 33.5, this being the highest in the County of Kent. The Manager of the Employment Exchange informs me that there were 818 men and 96 women unemployed in the Penge Urban District at the end of the year. The Out-door Relief given during the year amounted to £18,303 Is. 10d., of which £7,468 7s. 2d. was to able-bodied unemployed and their families, and the balance to the unemployable from age or other causes. This compares with an amount of £19,984 14s. 7d., of which £7,173 lis. Id. was to able-bodied unemployed and their families, in the year 1935. VITAL STATISTICS. Total Male Female Live- Legitimate 416 211 205 Births Illegitimate 17 5 12 Birth rate per 1,000, of estimated resident population, 16.7 7 Total Male Female Still- Legitimate 13 10 3 Births Illegitimate 2 1 1 Still-birth rate, per 1,000 total (live and still) births, 33.4 Deaths 307 153 154 Crude Death Rate per 1,000 of the estimated resident population, 11 -8. Adjusted Death Rate per 1,000 of the estimated resident population, 10-9. Deaths from puerperal causes : Nil. Deaths of Infants under one year of age:— Legitimate, 18. Illegitimate, 3. Total, 21. Death Rate of Infants under one year of age: All Infants, per 1,000 live births 48.4 Legitimate Infants, per 1,000 legitimate live births 43.2 Illegitimate Infants, per 1,000 illegitimate live births 176.4 Deaths from Measles (all ages) 4 „ Whooping Cough (all ages) 2 „ „ Diarrhoea (under two years of age) 2 Births. The live births registered during the year numbered 433, of which 216 were males and 217 females. This gives a birth rate of 16.7 per 1,000, compared with 14.9 for 1935. 8 Still-Births. The number of still-births registered was 15, of which 11 were males and 4 females. Notification of Births Act. Of the live births occurring in the district, 84 were notified by Medical Practitioners, 222 by Midwives, and 1 by a Parent. Six notifications of still-births were received, 3 being from Medical Practitioners and 3 from Midwives. Thirteen births were not notified. Deaths. The number of deaths registered in the Urban District of Penge during the year was 186. Forty-seven of these were transferable to other districts; but 168 deaths of Penge Parishioners occurring in public institutions, etc., outside the District were transferred to Penge. The corrected number of deaths was therefore 307, equal to a crude death rate of 11-8 per 1,000. The factor for adjusting the death rate for the district, given by the Registrar-General, is 0-92. This comparability factor makes the Adjusted Death Rate 10-9 per 1,000, compared with a rate of 11-7 per 1,000 for 1935. Of the 307 deaths during the year, 169, or 55-0 per cent, were of persons over 65 years of age. Seventy-four were of persons between the ages of 75 and 85 years and 31 were of persons over 85 years of age. Misadventure and accidents accounted for 12 deaths, compared with 12 the previous year, and 18 in 1934. 9 Maternal Mortality. No women died in, or as a consequence of, childbirth. Puerperal Sepsis Other Causes Total. England and Wales :— per 1,000 live births 1.40 2.41 3.81 Penge Nil Nil Nil England and Wales :— per 1,000 total births 1.34 2.31 3.65 Penge Nil Nil Nil The average maternal mortality rates per 1,000 live births for the last ten years (1927 to 1936 inclusive), are as follow :— England and Wales 4.23 Penge 3.61 Infantile Mortality. The number of deaths under one year of age was 21, corresponding to a rate of 48.4 per 1,000 births, compared with the rates of 69.4 for 1935, and 76.1 for 1934. Nine infants died under the age of one week from unavoidable causes. 10 Of the 21 deaths, 6 were from Premature Birth, 2 from Whooping Cough, 2 from Enteritis and 6 from Pneumonia. Nine deaths occurred amongst infants who had attended the Child Welfare Centre. Comparative Vital Statistics. Rate per 1,000 Population Death rate per 1,000 population Deaths under one year per 1,000 births Live. births Stillbirths Penge 16.7 0.58 10.9 48 England and Wales 14.8 0.61 12.1 59 122 County Boroughs and Great Towns including London 14.9 0.67 12.3 63 143 Smaller Towns (resident populations, 25,000 to 50,000 at Census, 1931) 150 0.64 11.5 55 London 13.6 0.53 12.5 66 11 Public Mortuary. One inquest was held in Penge during the year 1936 as follows:— Verdict. Males. Females. Total. Suicide 1 — 1 In addition, 8 post-mortem examinations were made, the Coroner certifying the cause of death in these cases without holding an inquest. Causes of Sickness. Measles was prevalent during the early part of the year. Unemployment of parents is a contributing, though indirect, factor in malnutrition and consequent sickness, especially in young children. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. Laboratory Facilities. No developments or changes took place during the year. Ambulance Facilities. The Council's motor ambulance, which is housed at the Fire Station, Croydon Road, is available at any time, day or night. 12 Cases of accident and sudden illness in the street are attended free of charge, and other cases removed as wished, according to a fixed scale. During the year the Council's motor ambulance responded to 653 calls : 353 for private removals and 300 for accidents. There is a co-ordination scheme between the ambulance services of Penge, Beckenham and Bromley, which works satisfactorily. Nursing at Home. There are no changes or developments to report under this heading. Clinics and Treatment Centres. The Maternity and Child Welfare Centre, provided by the Council, is held, as before, at the Council's School Clinic, 17, Oakfield Road, on Tuesday and Wednesday afternoons, and the Medical Officer of Health, who is the Medical Officer for the Centre, attends on Wednesday afternoons for consultations. He is also available for special consultations at the Town Hall. In addition, a special Ante-Natal Clinic, attended by the Medical Officer of Health, is held fortnightly. Medical Officer's Consultations. Infants 2,295 Nursing Mothers 506 Ante-Natal 793 3,594 13 Total attendance of children at the Centre 5,910 Individual children who attended 680 Average weekly attendance of children 115.8 Total attendance of nursing mothers 1,313 Individual nursing mothers who attended 219 Average weekly attendance of nursing mothers 25.7 Total attendance of expectant mothers 812 Individual expectant mothers who attended 199 Average weekly attendance of expectant mothers 15.3 During the year 468 urinary analyses were made. The Health Visitor, assisted by ladies who very kindly volunteer their services, and a nurse from the Maternity Home, manage the weighing, record cards, and distribution of food and drugs. Dried milk is supplied at cost price to mothers and children attending the Centre, and, in necessitous cases, fresh and dried milk are provided free. The following amounts were expended in supplying milk gratis to 50 expectant mothers and 161 nursing mothers and infants during the year :— Dried milk : £309 14s. Id. ; Fresh milk : £11 3s. 9d. Malt Extract and Cod Liver Oil, Virol, Ovaltine, Lactagol, etc., are also supplied free or at cost price. The cash receipts for Dried Milk sold were £272 14s. 3½d. 14 There is no doubt whatever that the provision of free milk, etc., to necessitous mothers and infants continues to be the main cause in keeping down the rate of Infantile Mortality. Where necessary, expectant mothers and infants are referred to the Dental Surgeon for treatment, and during the year this was done in 61 cases. Dentures are not provided. School Clinic. The School Clinic, provided by the Penge Council, is held in specially adapted premises at 17, Oakfield Road, Penge. The accommodation is as mentioned in previous reports. Further particulars appear in the School Medical Officer's Annual Report. Tuberculosis Dispensary. Penge patients were treated at the Kent County Council Tuberculosis Dispensary, 1, Westbury Road, Penge, on Wednesdays and Fridays. Treatment Centres for Venereal Disease. Patients are treated at the several London hospitals and the Croydon General Hospital. Orthopaedic Clinic. Cases are sent to Croydon General Hospital. 15 HOSPITALS. Infectious Diseases. Cases are removed to Waddon Isolation Hospital, Croydon, as before, under an agreement with the County Borough of Croydon, when adequate isolation cannot be obtained at home. The Hospital Authorities provide any beds that may be required, and the number of diseases that can be treated concurrently is six, viz.: Diphtheria, Scarlet Fever, Enteric or Typhoid Fever, Cerebro-Spinal Fever, Puerperal Fever and Encephalitis Lethargica. Smallpox. Negotiations are still taking place regarding new arrangements for the hospital treatment of cases of smallpox. In the meantime Penge cases will be accepted, as before, at the Surrey Smallpox Hospital, Clandon. Tuberculosis. The majority of the cases are admitted into Sanatoria through the Kent County Council. Children. There is no hospital in this district. Patients are usually sent to the following hospitals :— The South Eastern Hospital for Children, Sydenham. The Evelina Hospital for Children, London, S.E. The Hospital for Sick Children, Great Ormond Street, London, W.C. 2. 16 Orthopaedic. Cases are sent to the Croydon General Hospital, those from the Infant Welfare Centre and Elementary Schools being paid for by the Council. Other Hospitals. There are no hospitals in this district. Cases are usually sent to the Beckenham Hospital, Norwood Cottage Hospital and Croydon General Hospital, all being within easy reach. These are all voluntary Hospitals. Cases admitted to the County Hospital, Farnborough, Kent, from this District, numbered 320. A number of Penge patients are also treated at various London general hospitals. Extensive use has been made of the facilities offered by the South Eastern Hospital for Children, Sydenham, also by the Croydon General Hospital. Midwifery and Maternity Services. During the year, notifications of births occurring in the District were received from 12 mid wives. District Midwives are employed by the Beckenham and Penge Joint Maternity Home to attend patients in their own homes. 17 A consulting obstetrician is available for complicated maternity cases occurring in the District and in the Joint Maternity Home. Maternity Home. The Penge and Beckenham Joint Maternity Home, Croydon Road, Beckenham, with accommodation for 14 beds, is managed by a Joint Committee appointed annually by the Penge Urban District Council and the Beckenham Borough Council, and receives a grant from the Ministry of Health. The facilities provided are intended for those who have not sufficient accommodation, or are unable to pay for, adequate attention in their own homes. Necessitous cases, after due enquiry by the Committee, are granted free admission to the Home. The following table gives the numbers of mothers admitted annually for the last five years :— Year Total cases admitted Penge Cases Beckenham Cases Out-District Cases 1932 333 93 236 4 1933 324 97 227 — 1934 347 93 254 — 1935 323 97 226 — 1936 339 98 241 — 18 The average period spent in the Home during the year by each patient was 14-47 days. Patients can be attended at the Home by their own Doctors if they wish. Those who desire it, can be attended in their own home by a qualified midwife from the Maternity Home. She is assisted by a probationer nurse. During the year, 81 Penge cases were attended by the visiting Midwives. I am still getting many applications for admission into the Joint Maternity Home too late for acceptance, it being usually necessary for at least six months' notice to be given by applicants. The Authorities are still considering the provision of a new Maternity Home. Maternal Mortality. The Assistant County Medical Officer enquires into maternal deaths in this area. Enquiries into cases of Puerperal fever and Puerperal pyrexia are made by myself and the Health Visitor. Institutional Provisioh for Mothers or Children. Maternity patients whose home conditions are unsuitable for a confinement, and those suffering from abnormal antenatal conditions, are admitted into the Penge and Beckenham Joint Maternity Home. 19 Health Visiting. One Health Visitor is employed, and the following shows the number of visits paid by her :— First visits to infants under one year 417 Subsequent visits to infants under one year 1,212 Visits to children between the ages of one and five years 1,790 First visits to expectant mothers 153 Subsequent visits to expectant mothers 144 Visits to Tuberculosis cases 336 Visits under the Children Act 46 Miscellaneous visits 70 4,168 Infant Life Protection. The Health Visitor is the Inspector appointed under Part One of the Children Act, and she paid 46 visits to the homes of foster-children. Foster-parents are required to have the children in their care examined by a doctor once every three months, and in the majority of cases these examinations are made by the Medical Officer of Health at the Infant Welfare Centre. The standard of health of the children has been good. Number of foster-parents on the Register :— (a) at the beginning of the year 13 (b) at the end of the year 10 20 Number of children on the register:— (a) at the beginning of the year 14 (b) at the end of the year 10 (c) who died during the year — No legal proceedings were taken. Orthopaedic Treatment. Cases are seen at the Infant Welfare Centre and at the School Clinic, and, when necessary, referred to the Croydon General Hospital, where treatment is provided at the cost of the Council. Suitable cases are sent to St. Nicholas' and St. Martin's Orthopaedic Hospital, Pyrford, Surrey, for in-patient treatment. In necessitous cases hospital treatment and surgical appliances are provided by the Council free of charge. Maternity and Nursing Homes. The Nursing Homes Registration Act, 1927, is administered by the Kent County Council. SANITARY CIRCUMSTANCES OF THE AREA. Water. All the houses in the district are supplied with a constant service of water by the Metropolitan Water Board, the majority of the premises being directly connected with the rising main. Four drinking water cisterns were cleansed and covered, and at 7 houses water was supplied direct from the rising main. 21 Drainage and Sewerage. All the premises in the district are connected to the public sewers. The sewage of Penge goes through the Metropolitan Borough of Lewisham into the London County Council system of sewers, and a part of the surface water into a local stream, which is culverted in certain parts. Rivers and Streams. There are no rivers in the District. There is a stream forming part of the boundary between Penge and Beckenham, portions of which are culverted. It was necessary for cleansing to be carried out periodically. During the year the Penge and Beckenham Councils commenced the culverting of another portion of the stream between Avenue Road and Pelham Road, and the work was completed early in 1937. The culverting of the remaining portion of the stream is desirable. Closet Accommodation. The whole of the premises—approximately 5,635—in the area, are provided with water-closets connected to the main drainage system. Public Cleansing. The house refuse is collected throughout the District by a Contractor, once every week. The refuse is removed in closed vehicles by the Contractor to a controlled shoot situated in another district. The total cost of collection, removal and disposal of house refuse during the year amounted to £6,298. There are no cesspools or privies within the District. 22 Sanitary Inspection of the Area; and Shops. These subjects are dealt with in the Report of the Chief Sanitary Inspector. Smoke Abatement. Smoke nuisances were found at two factories and abated after informal action. Swimming Baths and Pools. There are none in the area. Schools. The School Medical Officer, the Medical Inspectors and the Head Teachers are notified of cases of infectious diseases that occur in the homes of children attending school. Attendance from infected houses is prohibited for certain periods. Eradication of Bed Bugs. Bed bugs were found in four Council houses and 61 other houses, all of which were disinfected. The methods employed for freeing houses of bed bugs are to require the stripping of paper from the walls and the loosening of woodwork in the rooms. The Council's workman then sprays the room with an insecticide and burns sulphur candles therein, the openings in the rooms being sealed. When considered necessary, the bedding is removed and steam disinfected. 23 HOUSING. Number of new houses erected during the year 4 In addition, 9 houses were converted into 25 selfcontained flats, and 5 houses containing 10 selfcontained maisonettes were erected. 1.—Inspection of Dwelling houses daring the year : (i) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 553 (b) Number of inspections made for the purpose 620 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 33 (b) Number of Inspections made for the purpose 33 (2a) Number of dwelling-houses inspected in connection with dustbin accommodation only 58 (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-head) found not to be in all respects reasonably fit for human habitation 505 24 (4a) Number of dwelling-houses found with defective dustbins only 58 2.—Remedy of Defects without service of formal notices. Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers 462 Number of dwelling-houses provided with new dustbins only in consequence of informal action by the Local Authority or their Officers 56 3.—Action under Statutory Powers. A.—Proceedings under sections 17,18 and 23 of the Housing Act, 1930 (1) Number of dwelling-houses in respect of which notices were served requiring repairs 1 (2) Number of dwelling houses which were rendered fit after service of formal notices:— (a) By Owners — (b) By Local Authority in default of Owners 1 B.—Proceedings under Public Health Acts. (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 43 25 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (а) By Owners 30 (b) By Local Authority in default of Owners 13 (2a) Number of dwelling-houses supplied with dustbins after service of formal notices: (a) By Owners 2 (b) By Local Authority in default of Owners — C.—Proceedings under sections 19 and 21 of the Housing Act, 1930 — D.—Proceedings under section 20 of the Housing Act, 1930 — 4.—Housing Act, 1935—Overcrowding. (a) (i) Number of dwellings overcrowded at the end of the year 83 (ii) Number of families dwelling therein 83 (iii) Number of persons dwelling therein— Over 10 years 385 Under 10 years 134 26 (b) Number of new cases of overcrowding reported during the year 161 (c) (i) Number of cases of overcrowding relieved during the year 78 (ii) Number of persons concerned in such cases- Over 10 years Under 10 years 330 118 (d) Particulars of any cases in which dwellinghouses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding Nil (e) Any other particulars with respect to overcrowding conditions upon which the Medical Officer of Health may consider it desirable to report:— As required by the Act, a survey of the working class houses and tenements of the district was made during the latter part of 1935 and the early part of 1936, and the following particulars were obtained:— Structurally separate dwelling-houses and flats visited 3,334 No. of tenants and sub-tenants therein 5,005 Families overcrowded 158 27 Population of overcrowded families:— 1. As married couples 294 2. Other adult males 209 3. Other adult females 190 4. Males under 10 years of age 126 5. Females under 10 years of age 130 949 A table giving full details is to be found at the end of my report. Under the Act, persons over 10 years of age are counted as one person, and those over one year and under 10 years of age as half a person. Infants under one year are not counted. It was found that 95 structurally separate houses and flats containing 582 rooms, and 235 tenements containing 692 rooms were empty. Ten cases of overcrowding were found in the houses and flats owned by the Council, four of which were relieved during the year. INSPECTION AND SUPERVISION OF FOOD. These subjects are dealt with in the Chief Sanitary Inspector's Report. 28 PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. General. Schick and Dick tests and artificial methods of immunization against diphtheria and scarlet fever have not been used. Patients suffering from measles and whooping cough are not admitted to the isolation hospital. Diphtheria. Eighteen cases were notified (compared with 42 the previous year), three of them being nasal. Two of the cases occurred in a Local Residential School, and four whilst the patients were inmates of a London hospital. Hospital treatment was provided in each case and there were no "return" cases. There were two deaths from diphtheria during the year, one of which occurred in a London hospital. The latter case was not notified until after death had taken place. Supply of Antitoxin. Anti-diphtheritic serum was used for the treatment of only one case, vials being supplied containing 16,000 units. The early administration of antitoxin to all cases of diphtheria is, of course, of vital importance. A supply of antitoxin is always kept at the Public Health Department and at three chemists' shops, and is available for the use of Medical Practitioners upon request. In cases of emergency, antitoxin can be obtained day or night, from the Council's Fire Station, Croydon Road, Penge. 29 Scarlet Fever. There were 29 cases of Scarlet Fever notified (the lowest number since 1924) as against 61 in 1935, and 25 of these were removed to hospital. Three of the cases occurred in a Local Residential School, and two families had two or more cases. The disease generally was of a mild type. There were no "return" cases. When adequate isolation and nursing can be obtained, cases are nursed at home. This was done in four instances. Puerperal Pyrexia. One case was notified, and made a satisfactory recovery. An arrangement exists with a local nurse for the home nursing of cases when required. Non-Notifiable Diseases. Measles and whooping cough were prevalent during the early part of the year. Influenza was moderately prevalent, but was not of a severe type. The following cases were notified to me from the local Elementary Schools :—Measles, 201; Mumps, 2; Whooping Cough, 43 ; Chicken-pox, 11; Tonsillitis, 1; and Influenza, 4. Disinfection. In addition to the usual disinfection of rooms, bedding and clothing after cases of Scarlet Fever, Diphtheria, etc., disinfection has been carried out at 39 premises after cases of Tuberculosis and 10 of Cancer. 30 Where vermin are discovered, disinfection of rooms, and, if necessary, bedding and clothing, is carried out. This was done in 65 cases. The following list shows the number of rooms fumigated and of beds and other articles steam disinfected during the year Rooms fumigated 262 Mattresses disinfected 163 Blankets disinfected 365 Pillows disinfected 397 Miscellaneous articles disinfected 1,119 Library books fumigated 137 Bacteriological Work. Bacillus found Bacillus not found Total Diphtheria. County Laboratory 2 37 39 Diphtheria. Clinical Research Association 7 56 63 Tuberculosis. County Laboratory 31 92 123 Typhoid Fever. County Laboratory — 2 2 Puerperal Fever. Clinical Research Association — 1 1 40 188 228 31 Notifiable Diseases (other than Tuberculosis) during the Year, 1936. Disease Total Cases notified Cases admitted to Hospital. Total Deaths Scarlet Fever 29 25 — Diphtheria 18 18 2 Puerperal Pyrexia 1 — — Pneumonia 8 1 19 (all forms) Erysipelas 12 1 — Cancer. This disease was the certified cause of death in 37 cases (males 18, and females 19). The organs affected were: Gastrointestinal Tract, 15; Breast, 7; Bladder, 6; Respiratory Organs, 2; Kidneys, 2; and other sites, 5. The Cancer Death Rate per 1,000 population was 1.43, compared with 1.96 in 1935. The rate for England and Wales was 1 .62. Prevention of Blindness. One infant received treatment for suppurative ophthalmia and made a good recovery. 32 Tuberculosis. No action was necessary under the Public Health (Prevention of Tuberculosis) Regulations, 1925, or under Section 62, Public Health Act, 1925. Total Primary Cases notified Total Cases admitted to Sanatoria and Hospitals Total Deaths Pulmonary (Males) 6 ,, (Females) 14 9 19 12 3 Totals 20 28 15 Non-Pulmonary (Males) 2 „ „ (Females) 2 3 4 1 Totals 4 7 1 Thirteen of the 15 deaths from pulmonary tuberculosis were of cases notified in this district. Of the non-notified cases who died, one had resided in this district for a few weeks only and had been notified whilst residing in an adjoining district; and in the other the disease was found after a post-mortem examination. The one death from another form of tuberculosis occurred in a hospital outside the district and had not been notified. Cases of tuberculosis are periodically visited and disinfection is carried out as occasion requires. 33 During the year 123 specimens of sputum were sent to the Kent County Laboratory, Maidstone, to be examined for tubercle bacillus; 31 of these were positive. New Tuberculosis Cases and Mortality during 1936. *New Cases. Deaths. Age Periods. Pulmonary NonPulmonary Pulmonary NonPulmonary M F M F M F M F 0—1 1 — — — 1 — — — 1— 5 1 — — — — — — — 5—15 2 — 1 1 — 1 — — 15—25 1 3 2 2 3 — — 1 25—35 2 5 — — 2 — — — 35—45 3 3 1 1 1 1 — — 45—55 — 2 1 — 1 — — — 55—65 — 3 — — 3 1 — — 65 and upwards 2 2 — — 1 — — — Totals 12 18 5 4 12 3 — 1 *In addition to primary notifications, all other new cases coming to the knowledge of the Medical Officer of Health are included in these figures, such as cases which have been previously notified to other districts and transferred to Penge, and patients who died from tuberculosis and were not notified previous to death. 34 There were 157 cases of tuberculosis on the register at the end of the year as follows:— Male Female Total Pulmonary 54 63 117 Non-Pulmonary 23 17 40 77 80 157 I have again to express my thanks to the Chairman and Members of the Public Health and Maternity and Child Welfare Committee for their cordial support during the year, and also to the staff of the Public Health Department for their co-operation. It gives me much pleasure again to register my cordial appreciation of the devoted work of the lady voluntary helpers at the Maternity and Child Welfare Centre. I am, Mr. Chairman and Gentlemen, Your obedient Servant, ROBERT WILKINSON, Medical Officer of Health. Causes of Death in Penge Urban District, 1936. Registrar-General's Figures. Causes of Death. Males Females All Causes 153 154 1 Typhoid and paratyphoid fevers • • • • • • 2 Measles 3 1 3 Scarlet fever • • • • • • 4 Whooping cough 1 1 5 Diphtheria 1 1 6 Influenza • • • 1 7 Encephalitis lethargica • • • • • • 8 Cerebro-spinal fever • • • • • • 9 Respiratory tuberculosis 12 3 10 Other tuberculosis ... 1 11 Syphilis • • • • • • 12 General paralysis of the insane, etc • • • 1 13 Cancer 18 19 14 Diabetes 1 1 15 Cerebral haemorrhage 1 7 16 Heart disease 37 47 17 Aneurysm 2 ... 18 Other circulatory diseases 7 7 19 Bronchitis 10 6 20 Pneumonia (all forms) 12 7 21 Other respiratory diseases 2 4 22 Peptic ulcer 6 2 23 Diarrhoea, etc. (under 2 years) 2 • • • 24 Appendicitis 1 2 25 Cirrhosis of liver • • • • • • 26 Other liver diseases 1 ... 27 Other digestive diseases ... 4 28 Nephritis 4 1 29 Puerperal sepsis 30 Other puerperal causes ... 31 Congenital causes, etc. 6 3 32 Senility 6 17 33 Suicide 1 1 34 Other violence 6 4 35 Other defined causes 13 13 36 Ill-defined causes ... ... Special causes (included in No. 35 above) Small-pox ... • • • Poliomyelitis ... • • • Polioencephalitis ... ... Deaths of Infants under 1 year Total 13 8 Legitimate 10 8 Illegitimate 3 ... Live Births Total 216 217 Legitimate 211 205 Illegitimate 5 12 Still births Total 11 4 Legitimate 10 3 Illegitimate 1 1 Population (estimated middle of 1936 R.G.) 25,810 Infant Mortality, 1936. Nett deaths from stated causes at various Ages under One Year. Causes of Death. Under 1 week. 1-2 weeks. 2-3 weeks. 3-4 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. All Causes Certified 9 — — — 9 — 3 6 3 21 Uncertified 1 Small-pox ... ... ... ... ... ... ... ... ... ... 2 Chicken-pox ... ... ... ... ... ... ... ... ... ... 3 Measles ... ... ... ... ... ... ... ... 1 1 4 Scarlet Fever ... ... ... ... ... ... ... ... ... ... 5 Whooping Cough ... ... ... ... ... ... ... 2 ... 2 6 Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... 7 Erysipelas ... ... ... ... ... ... ... ... ... ... 8 Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... 9 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... 10 Other Tuberculous diseases ... ... ... ... ... ... ... ... ... ... 11 Meningitis ... ... ... ... ... ... ... ... ... ... 12 Convulsions ... ... ... ... ... ... ... ... ... ... 13 Laryngitis ... ... ... ... ... ... ... ... ... ... 14 Bronchitis ... ... ... ... ... ... ... ... 1 l 15 Pneumonia (all forms) 1 ... ... ... 1 ... 1 3 1 6 16 Influenza ... ... ... ... ... ... ... ... ... ... 17 Diarrhoea ... ... ... ... ... ... ... ... ... ... 18 Enteritis ... ... ... ... ... ... 2 ... ... 2 19 Gastritis ... ... ... ... ... ... ... ... ... ... 20 Syphilis ... ... ... ... ... ... ... ... ... ... 21 Rickets ... ... ... ... ... ... ... ... ... ... 22 Suffocation, overlying ... ... ... ... ... ... ... ... ... ... 23 Injury at Birth 1 ... ... ... 1 ... ... ... ... 1 24 Congenital Malformations ... ... ... ... ... ... ... ... ... ... 25 Premature Birth 6 ... ... ... 6 ... ... ... ... 6 26 Atrophy, Debility, Marasmus ... ... ... ... ... ... ... ... ... ... 27 Other causes 1 ... ... ... 1 ... ... 1 ... 2 Totals 9 — — — 9 — 3 6 3 21 Nett live Births registered during the calendar year:— Legitimate 416 Illegitimate 17 433 Nett Deaths registered during the calendar vear:— Legitimate infants 18 Illegitimate „ 3 21 BIRTH-RATES, DEATH-RATES, AND ANALYSIS OF MORTALITY IN THE YEAR, 1936. Rate per 1,000 Total Population. Annual Death-rate per 1,000 Population. Rate per 1,000 Live Births Live Births. Still-births. All Causes. Typhoid Fevers. Small-pox. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Influenza. Violence. Diarrhoea and Enteritis (under two years). Total Deaths under one year. Penge U.D. 16.7 0.58 10.9 — — 0.15 — 0.07 0.07 0.03 0.46 4.6 48 England and Wales 14.8 0.61 12.1 0.01 — 0.07 0.01 0.05 0.07 0.14 0.52 5.9 59 122 County Boroughs and Great Towns including London ... 14.9 0.67 12.3 0.01 — 0.09 0.01 0.06 0.08 0.14 0.45 8.2 63 143 Smaller Towns (Resident Populations, 25,000 to 50,000 at Census, 1931) 15.0 0.64 11.5 0.00 — 0.04 0.01 0.04 0.05 0.15 0.39 3.4 55 London 13.6 0.53 12.5 0.01 — 0.14 0.01 0.06 0.05 0.14 0.52 14.4 66 Notifiable Diseases (other than Tuberculosis) during the Year 1936. Notifiable Disease. CASES NOTIFIED. At ages—Years. Cases admitted isolat'n hospital At all ages. Under 1 1 to 2 2 to 3 3 to 4 4 to 5 5 to 10 10 to 15 15 to 20 20 to 35 35 to 45 45 to 65 65 & upwards. Scarlet Fever 29 ... 1 ... 6 3 11 3 1 4 ... ... ... 25 Diphtheria 18 2 • • • ... 1 1 12 1 ... ... 1 ... 18 Puerperal Pyrexia 1 ... ... ... ... ... ... ... 1 ... ... ... ... Pneumonia 8 1 1 ... ... ... 1 ... ... 2 ... 2 1 ... Erysipelas 12 ... ... ... 1 ... ... ... ... 3 2 5 1 ... Totals 68 3 2 ... 8 4 24 4 1 10 2 8 2 43 Deaths of notified cases—Diphtheria, 1 case, aged 6 years. Inspection of Factories, Workshops and Workplaces, 1936 Premises. Number of Inspections. Written Notices. Occupiers Prosecuted. Factories Including Factory Laundries 48 4 ... Workshops Including Workshop Laundries 15 ... ... Workplaces Other than Outworkers' premises 25 ... ... Total 88 4 ... Defects found in Factories, Workshops and Workplaces. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Ref'rr'd to H.M. Insp't'r Nuisances under the Public Health Acts:—* Want of cleanliness 1 1 ... • • • Want of ventilation ... ... ... • • • Overcrowding ... ... ... • • • Want of drainage of floors ... ... ... Other nuisances 10 10 ... • • • Sanitary accommodation:— ... ... ... ... Insufficient 1 1 ... • • • Unsuitable or defective 1 1 ... • • • Not separate for sexes ... ... ... • • • Offences under the Factory and Workshop Acts:— ... ... ... ... Illegal occupation of underground bakehouse ... ... ... ... 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). ... ... ... ... Totals 13 13 ... • •• *Including those specified in sections 2, 3, 7 and 8 of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts. OVERCROWDING SURVEY-REPORT. Number • of "Persons" in Family Number of Families containing the Number of Persons in the first column occupying Dwellings with the permitted Number shown at the head of this Column. FAMILIES Overcrowded (A) Uncrowded (B) Total (c) 1 1½ 2 2½ 3 3½ 4 4½ 5 5½ 6 6½ 7 7½ 8 8½ 9 9½ 10 11 11½ 12 13 13½ 14½ 16 16½ 17½ 19 20½ 1 20 251 57 141 33 — 76 2 15 — 64 1 — 2 20 — 1 4 — — — — — — — — — — — — — 687 687 1½ — — 2 2 4 — 2 — — — 1 — 1 — — — — — 1 — — — — — — — — — — — — 13 13 2 1 14 35 236 82 1 329 11 49 4 329 2 7 16 148 1 2 56 — 19 — — 9 — 2 — — — — — 15 1,338 1,353 2½ — — 1 12 55 2 146 — 29 — 93 — 4 5 26 — — 19 — 5 — — 2 — 1 — — — — — I 399 400 3 — — 2 — 70 3 179 19 48 3 278 2 5 13 165 1 2 104 — 26 1 1 12 1 2 2 — — 1 1 2 939 941 3½ — — 1 — 23 — 59 8 23 4 71 2 2 6 50 — — 1 — 6 — — 2 — — — — — — — 24 234 258 4 — — — 1 17 1 22 — 56 3 143 7 6 10 121 — 4 95 1 27 1 1 9 1 4 — 1 1 — — 19 513 532 4½ — — — — 4 — — 4 18 — 43 1 — 4 37 1 — 25 1 4 — — 2 — — — — — — — 4 140 144 5 — — — — 4 — 1 8 26 — 62 — 3 7 79 2 1 50 — 15 — — 8 1 3 1 — — — — 13 258 271 5½ — — — — 3 — — 5 12 — 16 1 1 3 22 2 — 19 1 3 — 1 2 20 71 91 6 — — — — 1 — — 7 11 1 3 3 1 12 33 — 1 38 — 12 1 1 9 — 2 1 — — — — 20 117 137 6½ — — — — 4 — — — 8 1 — 1 3 4 13 2 — 7 — 4 — — 2 — 2 — — — — — 13 38 51 7 — — — — — — — — 3 — — 3 1 7 18 — — 13 — 4 — — 5 — 2 2 — — — 1 6 53 59 7½ — — — — — — — — 2 — — 3 2 — 5 — 1 7 — — — — 1 — — — — — — — 7 14 21 8 — — — — — — — — 1 — — 1 — — 5 — 1 7 — — 1 — 1 — — — — — — — 2 15 17 8½ — — — — — — — — — — — — — 3 — 1 1 4 2 — — — 2 — — — — — — — 3 10 13 9 — — — — — — — — — — 1 — — 1 1 — — 1 — — — — 1 — — 1 — — — — 3 3 6 9½ — — — — — — — 1 1 1 — — — — — — — — — — — — — — — — — — — — 3 — 3 10 — — — — — — — — — — — — — — — — — — — — — — 1 — — — — — — — — 1 1 10½ — — — — — — — — — — — — 1 — — — — — — 1 — — 1 — — — — — — — 1 2 3 11 — — — — — — — — — — — — — 1 — — — — — — — — — — — — — — — — 1 — 1 11½ — — — — — — — — — — — — — — — — — — — — — — — — 1 — — — — — — 1 1 12 — — — — — — — — — — — — — — — — — — — — 1 — 1 — — — — — — — 1 1 2 Dwellings (a) Uncrowded 20 251 94 391 244 6 813 44 264 14 1103 20 34 89 742 10 14 450 6 126 4 4 70 3 19 7 1 1 1 2 — 4,847 4,847 (b) Overcrowded 1 14 4 1 56 1 1 21 38 3 1 7 3 5 1 — — — — — 1 — — — — — — — — — 158 — 158 (c) Total 21 265 98 392 300 7 814 65 302 17 1104 27 37 94 743 10 14 450 6 126 5 4 70 3 19 7 1 1 1 2 158 4,847 5,005 Overcrowding Cases are shown below the stepped diagonal line. ANNUAL REPORT of the Chief Sanitary Inspector for the Penge Urban District in the COUNTY OF KENT for the Year ending December 31st, 1936 Town Hall, Anerley, S.E. 20. April, 1937. To the Chairman and Members of the Urban District Council of Penge. Mr. Chairman and Gentlemen, I have the honour to place before you the Annual Report on the work of the Sanitary Inspectors for the year ended the 31st December, 1936. Four hundred and seventy-seven written intimation notices and 56 Statutory Notices were served under the Public Health and Housing Acts. In addition, notices were served for the periodical cleansing of the following:—Bakehouses and Common Lodging Houses (semi-annual) ; and Slaughter Houses (quarterly). Four hundred and twenty-one Intimation Notices and 30 Statutory Notices were complied with. In default of the Owners, the Council did the works required by 19 notices served under section 41, etc., of the Public Health Act, 1875, and one notice under section 17 of the Housing Act, 1930. Difficulty was experienced in 14 cases regarding repairs, and the necessary works were effected only after summonses had been served or threatened. 44 Legal proceedings were taken for non-compliance with notices served under sections 91-94 of the Public Health Act, 1875, regarding nuisances caused by general housing defects, with the following results:— 1. Order made to comply with Notice within 4 days. Defendant ordered to pay £2 2s. 0d. costs and Court Costs. 2. Order made to comply with Notice within 7 days. Defendant ordered to pay £1 1s. 0d. costs. 3. 4 and 5. Summonses withdrawn on payment of £3 18s. 0d. costs and Notices being complied with before hearing of the cases. 6. Order made to comply with Notice within 10 days. Defendant ordered to pay £5 0s. 0d. costs. 7. Order made to comply with Notice within 5 days. Defendant fined £1 0s. 0d. and ordered to pay £2 2s. 0d costs. The orders of the Court were complied with in each case. An official representation was made to the Council under section 19, Housing Act, 1930, that a dwelling house was unfit for human habitation and could not be rendered fit at a reasonable expense. After consultation with the Owners' representative, the Council accepted an undertaking that the house would be vacated and certain repairs carried out, and that the house would not be used for human habitation. 45 The drainage system of 7 houses were entirely reconstructed, the drains of 48 houses partially relaid, and 66 cleared. Work in connection with the overcrowding survey and the measurement of rooms required by the Housing Act, 1935, took up a great deal of your Inspectors' time during the year. Premises or Occupations which can be Controlled by Byelaws or Regulations. No. in District. No. of Visits. Notices served. Notices complied with. Slaughter Houses 2 325 — — Common Lodging Houses 5 31 7 7 Houses Let in Lodgings 54 80 12 12 Dairies 11 44 2 2 Stables 32 70 5 5 F ried F ish Shops 8 20 2 2 Butchers' Shops 31 64 4 4 Housing Consolidated Regulations, 1925. During the year, 33 houses in various roads were inspected, the drains tested and particulars recorded, in accordance with these Regulations. Notices requiring defects to be remedied were served in 31 instances. 46 SUMMARY OF INSPECTIONS AND VISITS. The following summary shows the number of visits and inspections made:— Inspections through complaints received 437 Inspections re defective dustbins 42 Inspections under the Housing Consolidated Regulations, 1925 33 Visits re cases of infectious diseases 115 Visits re transferable deaths 82 Visits re overcrowding survey and measurement of rooms 512 Houses Let-in-Lodgings and Common Lodging Houses 111 Slaughterhouses 325 Bakehouses 43 Dairies 44 Milkshops 37 Meat shops 64 Fish shops 28 Ice cream shops 15 Other food shops, stores and stalls 172 Urinals 33 Stables 70 Visits under Rats and Mice (Destruction) Act 83 Factories, Workshops and Workplaces 88 Visits under Shops Acts 304 Smoke observations 40 Inspections and re-inspections of work in hand and various visits 2,168 Drain tests 138 47 SUMMARY OF WORK EXECUTED DURING THE YEAR. Water Supply: Water supply re-instated to houses 11 Water service pipes repaired 30 Draw-off taps provided on the rising main 7 Cisterns cleansed, covered or covers repaired 4 Water Closets: New pans and traps fixed 42 Flushing apparatus renewed or repaired 32 Foul pans and traps cleansed 13 Connections of flushing pipes to pans made good 10 Seats and doors provided or repaired 25 Ventilation provided or improved 7 Flooring or paving repaired 4 Drainage: Drains tested with smoke, water or colour 138 Drains cleared 66 Houses provided with new drains 7 Houses with drains partially relaid 48 Inspection chambers constructed or improved 11 Interceptors provided 2 Soil and ventilation pipes fixed or repaired 20 Sinks, lavatory basins and baths provided 32 Sinks repaired 4 Waste pipes renewed or provided 31 Waste pipes repaired or trapped 16 Waste pipes cleared 18 Fresh-air-inlets provided or repaired 10 Grids provided to gullies 3 48 Dampness: Houses with:— Walls repointed or rendered 21 Dampness in ground floor rooms remedied 51 Roofs repaired 136 Gutters repaired or renewed 61 Rainwater pipes repaired or renewed 32 Ventilation under floors provided or improved 17 Water service pipes repaired 30 Cleanliness: Dirty rooms, etc., cleansed or whitewashed 661 Verminous rooms fumigated 156 Miscellaneous: Houses with defective floors, joists, etc., repaired 38 Houses with defective plaster repaired 98 Houses with new sash lines provided to windows 30 Houses with window frames, etc., repaired 33 Houses with yards or forecourts paved or repaired 29 Houses with scullery paving repaired 7 Houses with air bricks renewed 12 Houses with window sills repaired 10 Houses with fireplace jambs and mantels repaired 11 Houses with stairs repaired 15 Ventilation and light of rooms provided or improved 8 Kitchen stoves repaired or renewed 21 Scullery coppers repaired or renewed 14 Other stoves repaired or renewed 46 New dustbins provided 95 Premises with miscellaneous defects repaired, etc. 46 Overcrowding abated 78 Animals removed 2 Manure pits repaired 2 Accumulations removed 22 Smoke nuisances abated 2 49 INSPECTION AND SUPERVISION OF FOOD. Milk Supply. At the end of the year there were 11 premises registered as dairies. Periodical inspections have been made and in two instances defects were discovered. These were remedied after informal action. In addition, 47 persons are registered to sell milk in sealed containers only. Fifteen dairymen, with dairies outside the district, who sell milk in Penge, are also registered. There are no cowsheds in the district. The analyses of 72 informal samples obtained during the year show the following average:— Fat 3.39% Solids not fat 8.66% The following licenses were issued under the Milk (Special Designations) Order, 1923:— Dealers Licenses:— Certified 1 Grade A (Tuberculin Tested) milk 5 Pasteurised milk 10 Supplementary Licenses:— Certified milk 3 Grade A (Tuberculin Tested) milk 2 Grade A (Pasteurised) milk 1 Grade A milk 1 Pasteurised milk 1 50 Meat. Most of the meat sold in the district is obtained from the London Meat Market. Visits are paid to meat purveyors' premises from time to time, and attention drawn to the requirements of the Public Health (Meat) Regulations. Four intimation notices were served requiring defects in butchers' premises to be remedied. The notices were complied with. Slaughterhouses. Registered 2 These have been regularly limewashed and inspected. The total number of visits to the slaughterhouses was 325. The number of animals slaughtered in the district during the year is as follows:— Cattle (other than cows) 16 Cows 5 Calves 254 Sheep 1,468 Pigs 78 1,821 With the exception of a few sheep all the carcases were examined. 51 The following were surrendered and condemned at the slaughterhouses:— Cows: 1 set of lungs Tuberculosis. Calves: 1 Pluck Tuberculosis. 2 Kidneys „ 2 sets of lungs „ 1 Mesentery „ 1 set of lungs Abscesses. Pigs: 1 Head and tongue Tuberculosis. 2 Plucks Inflammation. 1 set of lungs „ 9 Livers Cirrhosis. Sheep: 2 Carcases and offal Emaciation. 20 Livers Parasitical. 1 Pluck „ 2 Kidneys Nephritis. 2 sets of lungs Parasitical. 4 „ „ Abscesses. cwts. qrts. lbs. Total weight of tuberculous meat — — 27 Total weight of diseased nontuberculous meat 1 — 25 Total 1 1 24 52 Other Foods. There are 16 bakehouses in the district, 2 being underground. These have been periodically inspected and cleansed. Four informal notices to remedy defects were served and complied with. In addition to visits to the slaughterhouses, 403 visits were made to premises and stalls where foods are prepared, stored or exposed for sale, and, with a few exceptions, these were found to be kept in a satisfactory condition. The following list shows the amount of food which was surrendered and then condemned from shops and stalls, and afterwards destroyed:— Condensed milk 672 tins Broccoli 59 lbs. Mackerel 42 lbs. Periwinkles 21 galls. Pork pie 1 Total weight : 6 cwts., 1 qrt. 13 lbs. Adulteration, etc. The Kent County Council administers the Food and Drugs (Adulteration) Act in this District. 53 The Clerk to the Kent County Council has kindly furnished the following statement of the 62 samples taken:— 39 New milk 3 Butter 1 Coffee 1 Dried fruit 2 Flour 2 Ground ginger 1 Lard. 1 Margarine. 1 Condensed milk 2 Olive oil 1 Rice 1 Sausages 2 Sugar 1 Pepper 1 Tapioca 1 Tea 1 Vinegar 1 Cooked meats All samples were found to be genuine. In addition, 72 informal samples of new milk were purchased by your inspectors and submitted for analysis. Of these 61 samples were reported genuine and 11 slightly below standard. Subsequent samples in the latter cases proved to be genuine. One formal sample was obtained and reported to be genuine. Chemical and Bacteriological Examination of Food. Informal samples of milk are analysed by an analytical chemist in London, and formal samples by the Public Analyst for Kent. Facilities are available at the Kent County Laboratory and the Clinical Research Association for the bacteriological examination of food. 54 Factories and Workshops. There are 106 factories and workshops on the register, in the great majority of which very few people are employed. Four notices were served respecting cleansing, defective sanitary accommodation, etc., and complied with. Rats and Mice (Destruction) Act, 1919. Complaints were received from various parts of the district and investigated, 83 visits being paid in this connection. Poisons were supplied, traps set and lent, and rat runs gassed. Poison baits were also laid in the sewers from time to time. When considered necessary, the drains of premises were tested with smoke. Shops Acts. The Shops Act, 1934, which came into force on the 30th December, 1934, imposes upon Sanitary Authorities the duty of enforcing the requirements of the Act relating to the ventilation, temperature and lighting of shops, and the provision of sanitary accommodation and washing facilities for the use of persons employed in or about shops. The shops inspected in this connection during the year numbered 115, and it was not necessary to serve any notice. Exemption certificates were issued:— (1) Sanitary conveniences 1 (2) Washing facilities 1 55 Mr. E. G. Thomas, the Shops Acts Inspector, reports as follows on the administration of the Shops Acts on matters other than the above:— Individual premises visited 268 Total number of visits 304 Premises where assistants were employed 50 Premises where young persons were employed 27 Minor contraventions (official forms and records not posted or incorrect) 38 Shops not closed on weekly half-holiday 2 Shops where young persons were found to be employed in excess of prescribed hours 2 Customers served after prescribed hours 13 Warnings given respecting contraventions 17 Evening patrols 35 A survey of shops in this district under the Shops Act, 1934, was completed during the year. Hairdressers' and Barbers' Shops (Sunday Closing) Act, 1930. Visits paid on Sundays 96 No contraventions were found. 56 I desire to express thanks to the Chairman and Members of the Public Health Committee for their ready consideration and support, and to the staff for their painstaking work. I am, Mr. Chairman and Gentlemen, Your obedient Servant, R. T. PEARCE, Chief Sanitary Inspector.