PEN 25 PENGE URBAN DISTRICT. Annual Report of the Medical officer of health together with THE ANNUAL REPORT Medical officer of health 1947 Penge Urban District Council. Chairman : Councillor G. H. E. Duffield, J.P. Vice-Chairman : Councillor O. E. Prince. PUBLIC HEALTH AND MATERNITY AND CHILD WELFARE COMMITTEE. Chairman : Councillor G. H. E. Duffield, J.P. Councillor H. Allder, J.P. Councillor A. E. Dubery. Councillor H. Chapman. Councillor A. Emery. Councillor T. H. J. Child. Councillor F. J. Goatcher. Councillor E. A. Martin Clark. Councillor R. H. Jarvis. Councillor G. R. Deal. Councillor O. E. Prince. Co-opted Members : Mrs. O. A. Dubery, Mrs. F. J. Goatcher, Mrs. H. V. Howell, Mrs. E. Jarvis, and Miss Fannie Moore. REPRESENTATIVES ON THE JOINT MATERNITY HOSPITAL COMMITTEE. Councillors H. Allder, J.P., G. H. E. Duffield, J.P., F. J. Goatcher, and O. E. Prince ; and Dr. W. M. Penny and Mrs. E. Jarvis (Co-opted Members). PUBLIC HEALTH DEPARTMENT. STAFF : * Temporary Medical Officer of Health : B. E. Hawkins, 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 Act Inspector : E. G. Thomas, Cert. R.S.I. Cert. Insp. of Food, R.S.I. Health Visitors and School Nurses : Miss D. Nicholson, S.R.N., S.C.M., H.V's Cert., T.A. Cert. (Senior). Miss E. P. Eldridge, S.R.N., S.C.M., H.V's. Cert. Miss M. M. Goldsmith, S.R.N., S.C.M., H.V's. Cert. (from 16/6/47) Miss M. Lewis, S.R.N., H.V's. Cert. (from 8/10/47) Miss E. M. Martin, S.R.N., S.C.M., H.V's. Cert. (Resigned 28/3/47). Mrs. H. E. Dowdell, S.R.N., S.C.M., H.V's. Cert. (Resigned 19/8/47). Clerks : *Miss A. G. Mitchell (Full-time 1/4/47). Mrs. J. M. Maundrell. C. W. Briggs (in Army from 4/12/47). Mrs. M. K. Wood (Temporary from 1/12/47). *Part-time Officer. 1 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1947. Town Hall, Anerley Road, S.E. 20. June, 1948. To the Chairman and Members of the Urban District Council of Penge. Mr. Chairman and Gentlemen, I beg to present an Annual Report on the health of the district for the year ending the 31st December, 1947. It is compiled in accordance with Circular 170 (1947) of the Ministry of Health. Before giving the detailed statistics I would like to draw attention to several features in this Report which can be regarded with satisfaction. The Birth Rate is again high and there have been no maternal deaths during the year, and the Stillbirth Rate compares favourably with the rest of the Country. The Death Rate for infants under one year is very little higher than last year, which was the lowest recorded in Penge since it became an Urban District. The Maternity and Child Welfare Clinic sessions continued to be attended in increasing numbers, except for Ante-Natal cases which showed the expected decline. The restricted Clinic accommodation continued to cause difficulty in dealing expeditiously with the numbers attending. The Maternity Hospital and Farnborough Hospital were able to cope with all maternity cases which required to be admitted for their confinements. The Day Nursery continued to serve a very real need in the area and there was almost always a short waiting list of children requiring admission. During the year, there was an outbreak of Poliomyelitis throughout the Country, four cases occurring in Penge, but fortunately, these were of a mild type and none proved fatal. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (acres) 770 Population (Census 1931) 27,771 Civilian Population mid-year 1947 (estimated by Registrar-General) 24,410 Rateable Value 1st October, 1947 £195,797 Sum represented by 1d. rate £787 The Manager of the Employment Exchange informed me that there were considerably fewer than 100 persons unemployed in the Penge Urban District at the end of the year, which was slightly better than in 1946. The Out-door relief given to the unemployable from age or other causes during the year amounted to £10,703. This compares with an amount of £11,200, of which £12 was to able-bodied unemployed and their families, in the year 1946. 2 VITAL STATISTICS. Birth Rate per 1,000 of estimated Civilian population, 27.65. Stillbirth Rate per 1,000 total (live and still) births, 16.03. Crude Death Rate per 1,000 of the estimated Civilian population, 12.86. Deaths from Puerperal Causes:—Rate per 1,000 total (live and still births): Nil. Death Rate of Infants under One Year of Age:— All infants, per 1,000 live births 32.59 Legitimate infants, per 1,000 legitimate live births 32.76 Illegitimate infants, per 1,000 illegitimate live births 29.41 Births. The live births registered during the year numbered 675. This gives a live birth rate of 27.65 per 1,000 Civilian Population, compared with 25.80 for 1946. Stillbirths. The number of stillbirths registered was 11, equal to a rate of 16.03 per 1,000 total births, compared with 32.62 for 1946, a very satisfactory decrease. Deaths. The deaths registered during the year totalled 314, equal to a crude death rate for the year of 12.86 per 1,000 civilian population, compared with 13.01 for 1946. Deaths among the inmates of an Institution for elderly men numbered 22. It should be noted that a large proportion of the deaths were of elderly people and of the total deaths, 202 or 64.3 % were of persons 65 years of age and over, compared with 68.8% the previous year. Those dying at 75 years of age and over accounted for 38.2% of the total deaths. Cancer. The Cancer death rate per 1,000 civilian population was 1.55 compared with 2.22 in 1946. Maternal Mortality. There were no maternal deaths during the year, compared with one death in 1946. It is pleasing to record that in the past three years, only one maternal death occurred in connection with 1,738 births. Infantile Mortality. The number of deaths under one year of age was 22, corresponding to a rate of 32.59 per 1,000 births, compared with a rate of 32.04 for 1946, which was the lowest rate recorded in Penge. Of the 22 deaths, 9 died before reaching the age of one week from unavoidable causes. 3 Comparative Vital Statistics. The following table shows the comparative figures for 1947. Rate per 1,000 Civilian Population Death Rate per 1,000 Civilian Population Deaths under 1 year per 1,000 live Births Live Births Still Births Penge Urban District 27.6 0.45 12.8 32 England and Wales *20.5 *0.50 *12.0 41 126 County Boroughs and Great Towns including London 23.3 0.62 13.0 47 148 Smaller Towns (resident populations, 25,000 to 50,000 at Census, 1931) 22.2 0.54 11.9 36 London Administrative County 22.7 0.49 12.8 37 *Rates per 1,000 total population. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. Ambulance Facilities. A motor ambulance service for non-infectious and accident cases is operated jointly by the Penge and Beckenham Councils and co-operation is maintained with neighbouring authorities. The service responded to 712 calls from the Penge district during the year and is working satisfactorily. Infectious cases are removed by the motor ambulance from the Isolation Hospital. Maternity and Child Welfare Centre. The Maternity and Child Welfare Centre was held at the School Clinic, 17, Oakfield Road, on Tuesday, Wednesday and Friday afternoons and the Ante-Natal and Post-Natal Clinic on Tuesday mornings and two Monday afternoons in every four weeks. There was again a marked increase in the attendances at the Centre during the year. Clinic Accommodation. The accommodation at the Clinic has again proved inadequate, but plans for alternative accommodation have been prepared. Difficulty in acquiring a site has so far prevented any improvement being made during the year. In view of the increasing numbers attending the various Clinics, and the probable necessity of increasing the number of the Staff to deal with the work, further accommodation is becoming a very pressing need, Medical Officer's Consultations. 1946 1947 Infants 1,691 2,163 Nursing Mothers 466 532 Ante-Natal 1,530 1,251 Post-Natal 174 204 3,861 4,150 Health Visitors' Consultations. Children 8,852 11,046 Weighing of Children 8,421 10,649 Nursing Mothers 2,981 3,802 Expectant Mothers 1,124 932 Test feeds 227 241 Scabies 37 8 Miscellaneous 208 97 Total attendance of Children at the Centre 8,852 11,046 Individual Children who attended 1,147 1,309 Average weekly attendance of Children 171.3 212.4 Total attendance of Nursing Mothers 2,981 3,802 Individual Nursing Mothers who attended 331 404 Average weekly attendance of Nursing Mothers 57.7 73.1 Total attendance of Expectant Mothers 1,530 1,251 Individual Expectant Mothers who attended 449 368 Average weekly attendance of Expectant Mothers 29.4 24.0 Total attendance of Post-Natal Mothers 174 204 Individual Post-Natal Mothers who attended 149 165 Average weekly attendance of Post-Natal Mothers 3.3 3.9 Dried Milk and other foods for mothers and children are sold at cost price, and during 1947 the receipts totalled £1,382 16s. 7d. Day Nursery. Accommodation is provided at 214, Anerley Road, for 20 children 0—2 years and 25 children between 2—5 years. The attendances were as follows :— Tolal A verage A verage daily 0—2 2—5 attendances daily attendance years years attendance (excl. Sats.) Opened 303 days 3,197 6,478 9,675 31.93 36.84 The highest daily attendance (excluding Saturdays) was 45 and the lowest 25. The Saturday attendances were well below the average for the other days of the week. The highest average monthly attendance (excluding Saturdays) was 39.90 in December and the lowest 33.80 in August. During January, the occurrence of Measles among the children resulted in decreased attendances. Sessions for the routine medical inspection of the children were held once every four weeks, 4 5 Maternity Hospital. During the year, 280 Penge cases were admitted to the Penge and Beckenham Joint Maternity Hospital, Stone Park Avenue, Beckenham. The following table gives the number of mothers admitted annually for the last five years:— Year Total Cases admitted Penge Cases Beckenham Cases Other Cases 1943 571 118 453 — 1944 373 84 277 12 1945 561 142 419 — 1946 882 241 641 — 1947 982 280 702 — The average period spent in the Hospital during the year by each patient was 10.99 days. Maternity cases sent to the County Hospital, Farnborough, Kent, totalled 66. Midwifery Service. The Kent County Council provides and administers a domiciliary midwifery service in the district. Health Visiting. Four Health Visitors and School Nurses were employed and the following shows the number of visits paid by them in connection with maternity and child welfare and tuberculosis. First visits to infants under one year 660 Subsequent visits to infants under one year 1,587 Children between the ages of 1 and 5 years 2,490 Expectant Mothers 334 Post-Natal Mothers 300 Tuberculosis cases 244 Foster children 64 Diphtheria Immunisation 249 Scabies 4 Measles 12 Whooping Cough 10 Home and Domestic Helps 207 Still-births 7 Miscellaneous visits 123 6,291 Child Life Protection. Number of foster parents on the Register (a) at the beginning of the year 5 (b) at the end of the year 7 Number of foster children on the Register: (a) at the beginning of the year 5 (b) at the end of the year 7 (c) who died during the year - No legal proceedings were taken. Dental Treatment. Where necessary, expectant and nursing mothers and children are referred to the Dental Surgeon for treatment and during the year, this was done in 125 cases, compared with 120 cases in 1946. Care of Illegitimate Children. The Council is co-operating in the arrangements adopted by the Kent County Council for the care of unmarried mothers and their children, and a grant towards the cost of their maintenance was made in one case. Care of Premature Infants. Steps have been taken to implement the suggestions contained in Circular 20/44 of the Ministry of Health. Arrangements have been made for Penge babies born outside the Joint Maternity Hospital to be admitted thereto when requiring institutional care. During the year, 11 premature infants were born in the district. Born at home 9 Nursed entirely at home 7 Died during first 24 hours 1 Alive at end of one month 8 Born in Maternity Home 2 Died during first 24 hours 2 Alive at end of one month— Home and Domestic Helps. Part-time Home Helps are employed in connection with maternity cases and during the year their services were provided in 29 cases, compared with 28 cases during 1946. Domestic Helps were provided in 12 cases on account of illness in the families concerned, compared with two cases during the previous year, 6 7 HOUSING. During the year, the Local Authority erected 16 houses and converted 17 houses into 55 self-contained flats. Private builders erected 3 houses and 10 maisonettes and converted 4 houses into 8 self-contained flats. 1. Inspection of Dwellinghouses during the Year:— (1) (a) Total number of dwellings inspected for housing defects (under Public Health or Housing Acts) 1,300 (b) Number of inspections made for the purpose 1,360 (2) (a) Number of dwellinghouses (included in sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 — (3) Number of dwellinghouses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 1,270 2. Remedy of defects without service of formal notices:— Number of defective dwellinghouses rendered fairly fit in consequence of informal action by the Local Authority or their officers 1,215 3. Action under Statutory Powers:— (a) Proceedings under Section 9 of Housing Act, 1936 .. Nil (b) Proceedings under Public Health Acts— (1) Number of dwellinghouses in respect of which notices were served requiring defects to be remedied 55 (2) Number of dwelling houses in which defects were remedied after service of formal notices:— (a) by Owners 46 (b) by Local Authority in default of Owners 9 4. Housing Act, 1936—Overcrowding. Although progress has been made with conversion of large houses into flats, there still remains a large amount of overcrowding in the district. The Housing Manager reports that 130 families living in overcrowded and unsatisfactory conditions were rehoused during the year. Water Supply. All the houses in the district are provided with a constant service of water by the Metropolitan Water Board, the water being examined bacteriologically daily by the Board. In addition, the County Pathologist reports that the samples of water submitted to him quarterly were good, Bacillus coli being absent in 100 c.c's. The majority of the premises are directly connected to the rising main. Nineteen storage cisterns were renewed, cleansed or covered and in two cases drinking water was supplied direct from the rising main. 8 PREVALENCE OF, AND CONTROL OYER, INFECTIOUS AND OTHER DISEASES. Diphtheria. Six cases were notified compared with 8 in 1946 and all received hospital treatment. Four of the cases had not been immunised. There were no " return " cases and no deaths. Diphtheria Immunisation. The following table gives the attendances, etc.,'during the year 1947. Under 5 Over 5 years years Totals First inoculations 412 '16 428 Second inoculations 371 17 388 Schick tests 118 27 145 Children who received complete course of Immunisation 371 17 388 Pve-inoculations at 5 years of age — 38 38 Diphtheria Immunisation in relation to Child Population. Number of children who had completed a full course of Immunisation at any time up to 31st December, 1947. Age at 31/12/1947 i.e. born in year Under 1 1947 1 1946 2 1945 3 1944 4 1943 5 to 9 1938— 1942 10 to 14 1933— 1937 Total under 15 Number Immunised 29 281 219 235 169 829 621 2,383 Estimated mid-year population, 1947 2,370 3,070 5,440 Scarlet Fever. There were 20 cases of Scarlet Fever notified (as against 15 in 1946) and 14 were removed to Hospital. The disease generally was of a mild type. There were no deaths and no " return " cases. Scabies and Verminous Heads. The directions contained in the Ministry of Health Circular 2831 were carried out. Patients and contacts (other than school children) who attended at the Maternity and Child Welfare Centre for treatment for Scabies numbered 28 and received 77 treatments ; and 35 school children received 97 treatments. Persons affected with head lice totalled 47 (of whom 42 were school children) and they received 96 treatments. Disinfection. Verminous rooms disinfested 128 Rooms fumigated 71 Mattresses disinfected 250 Blankets disinfected 321 Pillows disinfected 144 Miscellaneous articles disinfected 239 9 Bacteriological Work. Bacillus Bacillus found not found Diphtheria. Clinical Research Association 1 5 Tuberculosis. County Laboratory 21 ? On the grounds of economy, copies of the reports on specimens sent to the County Laboratory by private medical practitioners which prove to be negative are not forwarded to local Medical Officers of Health. NOTIFIABLE DISEASES (other than Tuberculosis) during the Year 1947. Total Cases Cases admitted Total Disease notified to Hospitals Deaths Scarlet Fever 20 14 — Diphtheria 6 6 — Pneumonia 8 1 15 (all forms) Ophthalmia Neonatorum 1 — — Erysipelas 6 1 — Measles 151 1 — Whooping Cough 72 — — Puerperal Pyrexia 1 1 — Poliomyelitis 4 4 — Cerebro-spinal Fever 1 1 — Prevention of Blindness. No action was taken under Section 176, Public Health Act, 1936. Tuberculosis. No action was necessary under the Public Health (Prevention of Tuberculosis) Regulations, 1925, or Section 172, Public Health Act, 1936. Total Total Cases Primary admitted to Total cases Sanatoria and Deaths notified Hospitals Pulmonary (Males) 19 17 8 „ (Females) 12 11 9 Totals 31 28 17 Non-Pulmonary (Males) 4 3 — „ (Females) 4 4 1 Totals 8 7 1 Five of the 18 deaths from Tuberculosis were of cases not notified, three of whom died in Hospitals outside the district. 10 New Tuberculosis Cases and Mortality during 1947. Age Period *New Cases Deaths Pulmonary NonPulmonary Pulmonary NonPulmonary m f m f m f m f 0—1 — — — — — — — — 1—5 — 1 1 — — — — — 5—15 2 2 2 1 — — 1 — 15—25 11 9 1 1 — 4 — — 25—35 7 2 — 1 2 4 — — 35—45 2 3 1 — 2 1 — — 45—55 4 1 — 1 — — — — 55—65 3 — — — 3 — — — 65 and upwards — — — — 1 — — — Totals 29 18 5 4 8 9 1 — *Cases previously notified in other districts and transferred to Penge and those restored to the Register are included in these figures. There were 197 cases of tuberculosis on the Register at the end of the year, compared with 181 in 1946. Male Female Total Pulmonary 74 85 159 Non-Pulmonary 19 19 38 93 104 197 My thanks are due 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 ready cooperation. It gives me pleasure again to register my cordial appreciation of the work of the Lady voluntary helpers at the Maternity and Child Welfare Centre. 1 am, Mr. Chairman and Gentlemen, Your obedient Servant. B. E. HAWKINS, Medical Officer of Health. 11 Notifiable Diseases (other than Tuberculosis) during the Year 1947. Cases Notified at ages—years Casesadmitted to Isolation Hospitals 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 and upw'ds Poliomyelitis 4 — 1 — 1 — 2 — — — — — — 4 Cerebro-spinal fever 1 1 — — — — — — — — — — — — Diphtheria 6 — — — — — 4 1 — 1 — — — 6 Scarlet fever 20 — — 2 — 4 6 3 2 1 1 — 1 14 Pneumonia 8 — — — — — 1 — — — 1 5 1 — Erysipelas 6 — — — — — — — — 1 1 1 3 — Measles 151 8 21 18 33 19 45 4 1 2 — — — — Whooping Cough 72 7 10 9 13 9 19 1 — 1 3 — — — Puerperal Pyrexia 1 — — — — — — — — — — — — — Ophthalmia Neonatorum 1 1 — — — — — — — — — — — — Totals 270 17 32 29 47 32 77 9 3 7 6 6 5 24 Deaths of notified cases :—Nil. BIRTH-RATES, DEATH-RATES AND ANALYSIS OF MORTALITY IN THE YEAR 1947. Rate per 1,000 Civilian Population Annual Death Rate per 1,000 Civilian Population Rate per 1,000 Live Births Live Births Still Births All Causes Typhoid Fever J Small-pox Measles Scarlet Fever Whooping Cough Diphtheria Influenza Diarrhoea and Enteritis {under two years) Total Deaths under one year Penge U.D.C. 27.6 0.45 12.8 — — — — — — 0.04 4.4 32 England and Wales *20.5 *0.50 *12.0 0.00 0.00 0.01 0.00 0.02 0.01 0.09 5.8 41 126 County Boroughs and Great Towns including London 23.3 0.62 13.0 0.00 0.00 0.02 0.00 0.03 0.01 0.09 8.0 47 148 Smaller Towns (Resident Populations, 25,000 to 50,000 at Census 1931) 22.2 0.54 11.9 0.00 0.00 0.02 0.00 0.02 0.01 0.08 3.7 36 London 22.7 0.49 12.8 0.00 — 0.01 0.00 0.02 0.01 0.08 4.8 37 *Rate per 1,000 total population. A dash (—) signifies that there were no deaths. 12 PART I, FACTORIES ACT, 1937. 1. Inspections for purposes of provisions as to health. Premises Number on Register Number of Inspections Written Notices Occupiers prosecuted (I) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 32 35 10 (II) Factories not included in (1) in which Section 7 is enforced by the Local Authority 71 54 21 — (III) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 1 1 — — Total 104 90 31 — 2. Cases in which Defects were found. Particulars. Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness (S. 1) 7 1 — 4 — Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) — — — — — Inadequate ventilation (S.4) — — — — — Ineffective drainage of floors (S.6) — — — — — Sanitary conveniences (S.7) (a) insufficient 2 2 — — — (b) unsuitable or defective 12 12 — 8 — (c) not separate for sexes 1 1 — 1 — Other offences (not including offences relating to Outwork) 22 22 — — — Total 44 44 — 13 — PART VIII, FACTORIES ACT, 1937—OUTWORK. In the August list required by Section 110, three outworkers employed in making wearing apparel were notified. There were no defaults or prosecutions. There were no instances of work in unwholesome premises (Section 111). 13 CAUSES OF DEATHS IN PENCE URBAN DISTRICT, 1947. Registrar-General's Figures. causes of death. males females All Causes 162 152 1. Typhoid and paratyphoid fevers — — 2. Cerebro-spinal fever — — 3. Scarlet fever — — 4. Whooping cough — — 5. Diphtheria — — 6. Tuberculosis of respiratory system 8 9 7. Other forms of tuberculosis — 1 8. Syphilitic diseases 2 — 9. Influenza — 1 10. Measles — — 11. Acute poliomyelitis and polioencephalitis — — 12. Acute infective encephalitis — — 13. Cancer of buccal cavity and Oesophagus (m), Uterus (f) 3 2 14. Cancer of stomach and duodenum 4 4 15. Cancer of breast 1 2 16. Cancer of all other sites 13 9 17. Diabetes — 1 18. Intra-cranial vascular lesions 14 23 19. Heart disease 48 51 20. Other diseases of circulatory system 4 8 21. Bronchitis 16 5 22. Pneumonia 10 5 23. Other respiratory diseases — 1 24. Ulcer of stomach or duodenum 5 — 25. Diarrhoea under 2 years 3 .. — 26. Appendicitis 1 1 27. Other digestive causes — 2 28. Nephritis 3 3 29. Puerperal and post-abortion sepsis — — 30. Other maternal causes — — 31. Premature birth — 3 32. Congenital malformation, birth injuries, infantile disease 5 3 33. Suicide 1 — 34. Road traffic accidents 2 .. — 35. Other violent causes 5 4 36. All other causes 14 14 Deaths of Infants under 1 year Total 13 9 Legitimate 13 8 Illegitimate — 1 Live Births Total 323 352 Legitimate 305 336 Illegitimate 18 16 Stillbirths Total 7 4 Legitimate 6 4 Illegitimate I .. — Civilian population (estimated middle of 1947 R.G.) 24,410 14 ANNUAL REPORT OF THE CHIEF SANITARY INSPECTOR for the Year 1947. Town Hall, Anerley Road, S.E. 20. June, 1948. 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 of the work of the Sanitary Inspectors for the year ending the 31st December, 1947. There was again a large increase in the number of complaints received regarding defects and nuisances in houses. The severe wintry weather in the early part of the year accounted for many burst pipes, cracked cisterns and sanitary fittings and should serve as a warning for the need of more adequate protection from frost of these items. The continued restrictions imposed in the granting of Licences for repair and maintenance work and the shortages of various materials and fittings have caused a certain amount of delay in remedying even some of the most serious nuisances. In order to expedite the granting of building licences, many owners of property, particularly those of the owner-occupier class, lodged complaints regarding the condition of their houses, a thing unheard of before the War. The requirements of Notices served have, of necessity, been restricted to the more serious defects. A great deal of work is still necessary to bring many houses in the district up to a reasonable standard of fitness. A large amount of repair work has, however, been done during the year as will be seen on reference to the list of work executed. There are unsatisfactory owners as well as unsatisfactory tenants, and I regret that it was found necessary to take legal proceedings on many occasions regarding statutory nuisances caused by housing defects. 15 The following is a summary of these cases:— Case No. Result. 1. Nuisance Order made to do work in 56 days and pay £1 9s. 6d. costs. 2. (a) Nuisance Order made to do work in 28 days and pay £1 9s. 6d. costs. (b) Non-compliance with Nuisance Order. Fined £2 Os. Od. and £1 9s. 6d. costs. 3 & 4. Nuisance Orders made to do work in 28 days and pay £2 8s. 6d. costs. 5. (a) Nuisance Order made to do work in 42 days and pay Court costs. (b) Non-compliance with Nuisance Order. Fined £3 Os. Od. and £1 9s. 6d. costs. The Council did work in default. 6. (a) Nuisance Order made to do work in 42 days and pay Court costs. (b) Non-compliance with Nuisance Order. Fined £5 Os. Od. and £1 9s. 6d. costs. (c) Owner appealed against conviction to West Kent Quarter Sessions on 13th February, 1948, when appeal was dismissed and he was ordered to pay £21 Os. Od. costs. The Council did work in default. 7. Nuisance Order made to do work in 42 days and pay Court costs. 8. Summons withdrawn on payment of Court costs, the work having been done before the adjourned hearing of case. 9. Nuisance Order made to do work in 28 days and pay £1 9s. 6d. costs. 10. Nuisance Order made to do work in 56 days and pay £1 9s. 6d. costs. 11. Nuisance Order made to do work in 14 days. Fined £5 Os. Od. and £1 9s. 6d. costs. Nuisance Order not obeyed and Council did work in default. 12. Nuisance Order made to do work in 21 days. Fined £2 Os. Od. and £1 9s. 6d. costs. 13. Nuisance Order made to do work in 42 days and pay £1 9s. 6d. costs. 14. 15 & 16. Hearing adjourned until 6th January, 1948. In addition to verbal intimation of defects found in premises, 1,110 written informal notices and 59 statutory notices were served under the Public Health Act, 1936. One thousand and fifty-one intimation notices and 51 statutory notices were complied with. The Local Authority carried out, in default of the owners, the works required by two statutory notices served under Section 39, three under Section 75 and three under Section 93 of the Public Health Act, 1936. The Council also did the work required by 6 notices served under Section 24 of the Public Health Act, 1936, respecting defective public sewers at 10 premises. The drainage systems of 43 premises were partially relaid and 81 cleared of obstructions. The year was a very busy one for your Inspectors and it was not possible to give the desired attention to all the matters coming within the scope of a Sanitary Inspector's multifarious duties. At the end of the year, it was decided to appoint an additional Inspector. 16 Premises or Occupations which can be controlled by Byelaws or Regulations. No. in district No. of visits Notices served Notices complied with Common Lodging Houses 3 12 - - Houses Let-in-Lodgings 40 67 18 18 Dairies 5 30 1 1 Stables 17 20 2 2 Butchers' Shops 21 89 2 2 SUMMARY OF INSPECTIONS AND VISITS. The following summary shows the number of visits and inspections made:— Inspections through complaints received 1,220 Infectious diseases 70 Transferable deaths 105 Overcrowding and measurement of rooms 23 Houses let-in-lodgings and Common lodging houses 79 Bakehouses 25 Dairies and milkshops 30 Meat shops 89 Fish frying shops 15 Other food shops, stores and stalls 429 Urinals 38 Stables 20 Rats and Mice (Destruction) Act 221 Factories 90 Shops Acts inspections and patrols 168 Schools 17 Inspections and re-inspections of work in hand 2,267 Miscellaneous visits 205 Drain tests 78 SUMMARY OF WORK EXECUTED DURING THE YEAR. Water Supply:— Water supply re-instated to houses 30 Water service pipes repaired 108 Cisterns cleansed, covered or covers repaired New storage cisterns provided 12 Provided direct from rising main 2 Water Closets:— New pans and traps fixed 202 Flushing apparatus renewed or repaired 98 Foul pans and traps cleansed 12 Connections of flushing pipes to pans made good 23 Seats and doors provided or repaired 25 Ventilation provided or improved 7 Walls repaired 5 Flooring or paving repaired 7 Artificial lighting provided 4 17 Drainage:— Drains tested with smoke, water or colour 78 Drains cleared 81 Houses with drains partially relaid 43 Inspection chambers constructed or improved 19 Soil and ventilation pipes fixed or repaired 29 Sinks, lavatory basins and baths provided 26 Sink fillets repaired 11 Waste pipes renewed or provided 15 Waste pipes repaired or trapped 38 Waste pipes cleared 20 Fresh-air-inlets provided or repaired 11 Rainwater pipe disconnected from drain 1 Dampness, Houses with :— Walls re-pointed or rendered 23 Dampness in ground floor rooms remedied 59 Roofs repaired 245 Gutters repaired or renewed 55 Rainwater pipes repaired or renewed 53 Ventilation under floors provided or improved 15 Water service pipes repaired 108 Window sills repaired 12 Cleanliness:— Dirty rooms, etc., cleansed 557 Verminous rooms fumigated 128 Miscellaneous:— Houses with defective floors, joists, etc., repaired 120 Houses with defective plaster repaired 201 Houses with new sash lines provided to windows 20 Houses with window frames, etc., repaired 57 Houses with yards or forecourts paved or repaired 22 Houses with scullery paving repaired 6 Houses with chimneys repaired 44 Houses with air bricks renewed 11 Houses with stairs repaired 11 Houses with front and back steps repaired 21 Houses with fireplace jambs and mantels repaired 14 Houses with brickwork repaired 400 Kitchen stoves repaired or renewed 17 Scullery coppers repaired or renewed 3 Other stoves repaired or renewed 47 Doors repaired or renewed 34 Ventilation and lighting of rooms improved 5 New dustbins provided 45 Premises with miscellaneous defects repaired, etc. 49 Animals removed ' 9 Wasps nests destroyed 2 Accumulations removed 28 Smoke nuisances abated 2 18 INSPECTION AND SUPERVISION OF FOOD. Complaints were received regarding dirty milk bottles, slimy deposits in two bottles of lemonade, and the presence in a bun of part of a beetle. Explanations were obtained from the Firms concerned and in each case, the Public Health Committee directed that a warning letter be sent. The practice of some people in returning milk bottles to dairymen in an unwashed and sometimes very foul condition cannot be too strongly condemned. There are no manufacturers of ice-cream in the district. Eight samples were submitted for bacteriological examination and the following is the grading of the samples :—Grade 1—2; Grade 2—2; Grade 3—3; and Grade 4—1; Pathogenic organisms were not found in any of the samples. Periodical visits were made to premises and stalls where foods are prepared, stored or exposed for sale. Defects found at 29 food premises were remedied. The amount of food surrendered and condemned as unfit for human food after examination by your Inspectors was 10 tons, 5 cwts., 2 qtrs., 3 lbs., a large proportion of which was at a Food Manufacturing Factory. The items condemned were as follows:— Bacon 9,637 lbs. Meat and fish pastes 2 jars Beef 2,487 lbs. Meat pies 8 Bottled Apples 2 bots. Milk l½pts. Bread 1,448 lbs. Mutton 19 lbs. Butter 2 ¼ lbs. Oatmeal 32 lbs. Butter beans 113 lbs. Pickles 13 bots. Cake mixtures 25 pkts. Rabbits 60 lbs. Cheese 31 lbs. Sauces 11 bots. Chickens 161 lbs. Sausages 7 lbs. Coffee essence 4 bots. Shellfish 117 lbs. Cooked meat 6 lbs. Sugar 43 ½ lbs. Cordials 4 bots. Sugar confectionery 5 'lbs. Dates .. 182 lbs. Syrup 1 tin Dried eggs 5 pkts. Tea 3 bs. Dried fruit 51½ lbs. Tinned fish 67 tins Fish 2,646 lbs. Tinned fruit 62 tins Flour 1,622 lbs. Tinned meat 656 tins Hare 7 lbs. Tinned meat pudding 2 tins Honey lib. Tinned meat and vegetables 18 tins Jam 208 lbs. Tinned milk 314tins Lemon curd 1 jar Tinned soup 4 tins Liquid egg 28 lbs. Tinned vegetables 122 tins Marmalade 58 lbs. Vinegar 4 bots. Maws 265 lbs. Condemnation certificates totalled 381, compared with 304 in 1946, 19 The following Licences were issued under the Milk (Special Designations) Orders:— Dealers' Licences:— Tuberculin tested milk 1 Pasteurised milk 3 Supplementary Licences:— Tuberculin tested milk 5 Pasteurised milk 6 Adulteration, etc. The Kent County Council's Inspector took 177 samples of various foods in this district, of which 171 were found to be genuine. One sample of whisky was adulterated with 18.9% of added water and proceedings resulted in the Licencee being fined £10 0s. Od. with £10 10s. Od. costs. Two samples of gin contained 30.8% and 31.2% excess water. The Manager of the licensed premises was prosecuted and convicted for wilfully obstructing the Sampling Officer in the course of his duties and was fined £5 0s. Od and £5 5s. Od. costs. One sample of milk was 7.3% deficient in fat. The dairyman was convicted and fined £2 0s. Od. and £1 1s. Od. costs. Two samples of liqueur ginger were found to contain only 88.6% and 88.2% respectively of the alcoholic strength claimed. The manufacturer was cautioned. Factories Act, 1937. Visits paid to factories totalled 90 and in addition to verbal intimations regarding small defects, 31 written notices were served and complied with. These dealt mainly with minor defects. Rats and Mice (Destruction) Act, 1919, and Infestation Order S.R.O. 1943. Complaints received from various parts of the district and investigated numbered 221. When considered necessary, the drains of premises were tested with smoke and any defects found made good. The foul-water sewers were treated on two occasions during May and November /December pre-bait and poisoned bait being laid in the manholes and side entrances. In May, 255 manholes were baited and pre-bait takes recorded in 137. The figures for November /December were 270 manholes baited and pre-bait takes recorded in 129. It is estimated that 1,619 rats were killed in consequence of these treatments. The Special Scheme for the systematic inspection of all premises in the district in connection with rodent infestation commenced in September, 1946, and continued during the year until completion at the end of June. During 1947. Full Scheme. Premises surveyed 1,122 6,164 Premises reported infested with rats 118 60 Premises treated for rats 168 602 Premises where rat poison bait taken 126 473 Premises re-treated 146 488 Estimated number of rats poisoned 2,790 6,188 Number of rats trapped 7 247 Premises treated for mice 33 149 20 It was necessary to treat some premises on several occasions and the total treatments for the destruction of rats carried out under the Scheme numbered 1,425. There is no doubt that the Scheme, combined with the sewer treatments proved worthwhile. During the last six months of the year, 147 premises were treated and it is estimated that 598 rats were killed. Shops Acts, 1912 to 1938. Mr. E. G. Thomas, Sanitary Inspector and Shops Act Inspector, reports as follows:— Number of shops visited 86 Number of visits made 101 Number of evening patrols carried out 39 Number of Sunday patrols carried out 28 Number of shops where sanitary accommodation insufficient, Notices served under Section 10, Shops Act, 1934, and complied with 4 Number of shops where washing accommodation insufficient, Notices served under Section 10, Shops Act, 1934, and complied with 1 Number of shops where Young Persons employed 8 Number of shops where official forms relating to staff not posted up on the premises 42 Number of " mixed shops " where poster relating to Sunday trading not exhibited under Shops (Sunday Trading Restriction) Act, 1936 5 Number of " mixed shops " where poster relating to trading on the early closing day not exhibited (Shops Act, 1912) Offences. Shops Act, 1912. Number of shops open after 1 p.m. on the early closing day 1 Shops (Hours of ClosinG) Act, 1928. Number of shops open after the official closing hour Shops (Sunday Trading Restriction) Act, 1936. Number of shops open contrary to the provisions of the Act 4 Shop-keepers have been sent warning letters in respect of contraventions of the Shops Acts. My thanks are due to the Chairman and Members of the Public Health Committee for their ready consideration and support and to the Staff for their painstaking work during another very busy year. I am, Mr. Chairman and Gentlemen, Your obedient Servant, R. T. PEARCE, Chief Sanitary Inspector.