AC 4412 (3) PENGE PEN 29 PENGE URBAN DISTRICT Annual Report of the Medical Officer of Health together with THE ANNUAL REPORT Chief Sanitary Inspector 1951 Penge Urban District Council. Chairman: Councillor J. W. Croxon, J.P. Vice-Chairman: Councillor E. A. Martin-Clark. PUBLIC HEALTH COMMITTEE, 1951. Chairman: Councillor H. M. Bowles. Vice-Chairman: Councillor Mrs. D. L. Lockwood. Councillor H. A. Burns Councillor W. J. Kees. (Resigned Nov., 1951). Councillor E. A. Martin-Clark. Councillor J. J. Coleman. Councillor E. A. Rogers. Councillor A. K. Cooke. Councillor A. Savage. Councillor A. Emery, J.P. Councillor P. White. Councillor F. J. Goatcher. PUBLIC HEALTH DEPARTMENT. STAFF: *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.). Deputy Chief Sanitary Inspector and Shops Act Inspector: E. G. Thomas, Cert. R.S.I. Cert. Insp. of Food, R.S.I. Sanitary Inspector: H. J. Bishop, Cert. R.S.I, and S.I.E. Joint Board Cert. Insp. of Food, R.S.I. Clerks: Mrs. A. L. Sheppard. C. W. Briggs. *Part-time Officer. 3 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1951. Town Hall, Anerley Road, S.E.20. June, 1952. To the Chairman and Members of the Urban District Council of Penge. Mr. Chairman and Gentlemen, I beg to present an Annual Report for the year ended 31st December, 1951, which has been compiled in accordance with Circular No. 42/51 of the Ministry of Health. The Vital Statistics for the year continue to compare favourably with other parts of the country. Again it is noticeable that a high proportion of the deaths occurring in the district were those of persons of 65 years of age and over. This large number of elderly people continues to present many problems in providing for their care and welfare, and it is gratifying to record the large amount of help given to them by various voluntary organisations, especially in the provision of meals in their own homes. There is, however, a number of elderly people living alone in one or two rooms who, while not in a strict sense hospital cases, are unfit for the ordinary old people's homes and it is cases such as these which present the biggest problem in providing for their care. The difficulty arises from the fact that there is no provision for this type of case and that the responsibility for the care of the aged is divided between the County Council and the Hospital Board. The result is that these border line cases are refused admission to the institutions of either of these authorities and remain at home in gradually deteriorating conditions until they are so bad that they either reach hospital or die in their own homes under circumstances which are to be deplored. The value of diphtheria immunisation has been proved by the fact that for the fourth year in succession no case of diphtheria was notified in Penge. In order to maintain this record, however, it is absolutely necessary for parents to ensure that their children are immunised before reaching the age of one year and for the children to receive reinforcing inoculations prior to entry into school life and subsequently during that period. Although the number of cases of diphtheria throughout the country has shown a marked decline since the start of the immunisation campaign in 1941, it is still possible for an outbreak to occur in any district. Any relaxation of immunisation precautions is therefore likely to be followed by an increase in the number of cases of diphtheria. The figures of Tuberculosis do not provide such a satisfactory picture since once again there is a rise in the number of new cases notified during the year. This increase may be partly accounted for by earlier diagnosis as a result of mass radiography and medical examinations prior to entry to the services, but it seems certain that other factors must play their part in causing this increase. Of these overcrowding and unsuitable living quarters due to the housing shortage 4 are undoubtedly contributory causes. On the other side of the picture it is gratifying to note that as a result of the newer methods of treatment the death rate from tuberculosis shows a slight decline. Much, however, remains to be done in investigating the causes of and preventing this increase which, rising year by year, has resulted in the number of cases on the tuberculosis register showing an 85% increase on those of 1938. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (acres) 770 Population (Census 1931) 27,771 Population (Census 1951—provisional figure) 25,009 Home Population, Mid-Year 1951 (estimated by Registrar-General) 25,370 Rateable Value, 1st October, 1951 £202,382 Sum represented by 1d. rate £821 The district, immediately adjoining the Counties of London and Surrey, 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 density of population per acre is 32.9, this being the highest in the County of Kent. The remains of the Crystal Palace and the greater part of the grounds occupying approximately 127 acres, are within the district and provide a much needed "lung" for the area. The district is mainly residential although there is an amount of industrial work in the district, the chief industries being engineering, button making, printing and laundry work. The Manager of the Employment Exchange for the area informs me that there were less than one per cent of the working population unemployed at the end of the year. VITAL STATISTICS. Crude Live Birth Rate per 1,000 of estimated Home population 20.85 Adjusted Live Birth Rate per 1,000 of estimated Home population 20.22 Stillbirth Rate per 1,000 of estimated Home population 0.61 Stillbirth Rate per 1,000 total (live and still) births 29.35 Crude Death Rate per 1,000 of estimated Home population 11.58 Adjusted Death Rate per 1,000 of estimated Home population 10.53 Maternal Mortality 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 24.57 Legitimate infants per 1,000 legitimate live births 26.36 Illegitimate infants per 1,000 illegitimate live births Nil 5 Births. The live births registered during the year numbered 529. This gives a crude live birth rate of 20.85 per 1,000 Home population, compared with 22.05 for 1950. The area comparability factor calculated by the Registrar-General for the purpose of securing comparability between local birth rates is 0.97. This makes the Adjusted Birth Rate 20.22, compared with 21.60 in 1950. Stillbirths. The number of stillbirths registered was 16, equal to a rate of 29.35 per 1,000 total births, compared with 26.31 for 1950. Deaths. The deaths registered totalled 294, equal to a crude death rate for the year of 11.58 per 1,000 Home population, compared with 11.36 for 1950. The area comparability factor calculated by the Registrar-General for the purpose of securing comparability between local death rates is 0.91. This makes the Adjusted Death rate 10.53 compared with 10.45 for 1950. Deaths among the inmates of an Institution for elderly men numbered 10. It should be noted that a large proportion of the deaths were of elderly people, and of the total deaths 208 or 70.7 % were of persons 65 years of age and over, compared with 72.0 % the previous year. Those dying at 75 years of age and over accounted for 41.8 % of the total deaths compared with 45.8% in 1950. Cancer. The cancer death rate per 1,000 home population was 1.93 compared with 1.66 in 1950 and 2.01 in 1949. Tuberculosis. The death rate per 1,000 home population was 0.39 as against 0.43 in 1950. Maternal Mortality. There was no maternal death during the year. The maternal mortality rate for England and Wales was 0.79 per 1,000 total (live and still) births, compared with 0.86 in 1950. Infantile Mortality. The number of deaths under one year of age was 13, corresponding to a rate of 24.57 per 1,000 births compared with a rate of 25,22 for 1950. Ten of the 13 infants died under the age of one week. 6 Comparative Vital Statistics. The following table shows the comparative figures for 1951:— Rate per 1,000 Home Population Death Rate per 1,000 Home Population Deaths under 1 year per 1,000 live Births Live Births Still Births Penge Urban District 20.2 0.61 10.5 24.5 England and Wales 15.5 0.36 12.5 29.6 126 County Boroughs and Great Towns including London 17.3 0.45 13.4 33.9 148 Smaller Towns (resident populations, 25,000 to 50,000 at Census, 1931) 16.7 0.38 12.5 27.6 London Administrative County 17.8 0.37 13.1 26.4 SANITARY CIRCUMSTANCES OF THE AREA. Water Supply. The water supply of the area has been satisfactory both in quality and quantity, all the houses in the district being 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. The majority of the premises are directly connected to the rising main. Eight storage cisterns were renewed, cleansed or covered. Drainage and Sewerage. All the premises in the district are connected to the public sewers, the sewerage of Penge going through the Metropolitan Borough of Lewisham into the London County Council's sewers, and part of the surface water into a local stream which is culverted. No important additions to existing works of sewerage have been made during the year. Rivers and Streams. There are no rivers in the district. There is a stream forming part of the boundary between Penge and Beckenham, the whole of which is culverted. Closet Accommodation. The whole of the premises in the area are provided with waterclosets connected to the main drainage system. Public Cleansing. House refuse was collected throughout the district once every week by the Council's refuse collection service using modern vehicles and the refuse taken for disposal to the Beckenham destructor. Trade refuse is also dealt with and there is a regular collection of pig food from bins placed in the various roads. There are no cesspools in the district. Sanitary Inspection of the Area. This subject is dealt with under the heading of Housing and in the Report of the Chief Sanitary Inspector. 7 HOUSING. The erection of 77 flats by the local authority was completed during the year. Private builders erected 4 dwellinghouses and 6 maisonettes and converted one house into four flats and one outbuilding into a dwelling. 1. Inspection of Dwellinghouses during the Year:— (1) (a) Total number of dwellinghouses inspected for housing defects (under Public Health or Housing Acts) 861 (b) Number of inspections made for the purpose 910 (2) (a) Number of dwellinghouses (included in subhead (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 4 (b) Number of inspections made for the purpose 5 (3) Number of dwellinghouses found not to be in all respects reasonably fit for human habitation 815 2. Remedy of Defects without Service of Formal Notices: Number of defective dwellinghouses rendered fit in consequence of informal action by the Local Authority or their officers 733 3. Action under Statutory Powers. (a) Formal notices served under Section 9 of the Housing Act, 1936 2 In both cases the defects were remedied by the Local Authority in default of the owners. (b) Proceedings under Section 11 of the Housing Act, 1936 — One house was demolished. (c) Proceedings under Section 12 of the Housing Act, 1936 2 Qno houac waa demoliahGdl (d) Proceedings under Public Health Acts:— (1) Number of dwellinghouses in respect of which notices were served requiring defects to be remedied 78 (2) Number of dwellinghouses in which defects were remedied after service of formal notices:— (a) by Owners 77 (b) by Local Authority in default of Owners 1 4. Housing Act, 1936—Overcrowding. Although progress has again been made in the erection of houses, maisonettes and flats, there still remains an amount of overcrowding in the district. The Housing Manager reports that 122 families living in overcrowded or unsatisfactory conditions were rehoused during the year. 8 PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. Diphtheria. For the fourth year in succession no cases of Diphtheria occurred in the district. Diphtheria Immunisation. The following is a return of the number of children resident in the district who were immunised against diphtheria during the year:— Children born 1947-1951 Children born 1937-1946 Totals Primary inoculations 407 85 492 Reinforcing 36 574 610 Penge children under the age of 15 years on 31st December, 1951, who had completed a course of immunisation at any time before that date were as follows:— Aged 0-4 years inclusive 1,588 ,, 5-14 3,, ,, 197 These figures show a continued steady increase in the number of children immunised. Smallpox. No case was notified. A contact of cases notified elsewhere was kept under observation for the requisite period. The following shows the number of Penge residents who were vaccinated against smallpox during the year. Age at 31/12/51. Under 1 1 to 4 5 to 14. 15 or over Total. Vaccinated 209 171 59 27 466 Re-vaccinated - 8 16 98 122 Scarlet Fever. There were 43 cases of Scarlet Fever notified (as against 15 in 1950) and 29 were removed to hospital. Six cases occurred in two families residing in the same house. The disease generally was of a mild type. There were no deaths and no "return" cases. 9 Dysentery. Of the five cases notified, four were inmates of an institution. The primary case at the institution was admitted there when suffering from diarrhoea and no doubt infected the other inmates. The other case, a child of 2 years, undoubtedly contracted the disease whilst staying in another district, where he was in contact with other cases. Poliomyelitis. No case occurred during the year. Measles. Most of the 468 cases were notified between January and March, 171 being in March. Whooping Cough. Cases were notified throughout the year and totalled 107, compared with 204 cases in 1950. Disinfection. Verminous rooms disinfested 87 Rooms fumigated 67 Mattresses disinfected 104 Blankets disinfected 205 Pillows disinfected 175 Miscellaneous articles disinfected 656 NOTIFIABLE DISEASES (Other than Tuberculosis) during the year 1951. Disease Total Cases notified Cases admitted to Hospitals Total Deaths Scarlet Fever 43 29 — Pneumonia 10 2 14 (all forms) Erysipelas 7 — — Measles 468 4 — Whooping Cough 107 4 1 Dysentery 5 4 - 10 Tuberculosis. No action was necessary under the Public Health (Prevention of Tuberculosis) Regulations, 1925, or Section 172, Public Health Act, 1936. Total Primary cases notified Total Cases admitted to Sanatoria and Hospitals Total Deaths Pulmonary (Males) 32 34 7 „ (Females) 18 20 3 Totals 50 54 10 Non-Pulmonary (Males) - - - (Females) 2 1 — Totals 2 1 — Five of the ten deaths from Tuberculosis were of cases not notified. NEW TUBERCULOSIS CASES AND MORTALITY DURING 1951. Age Period *New Cases Deaths Pulmonary NonPulmonary Pulmonary NonPulmonary m f m f m f m f 0—1 - - - - - - - - 1—5 2 2 — 1 — — - — 5—15 2 2 - - - - - - 15—25 12 13 - - - - - - 25—35 8 8 - - - - - - 35—45 1 1 — 1 — 1 — — 45—55 13 — — — 1 — — — 55—65 7 — — — 4 — — — 65 and upwards 3 — — — 2 2 - —— Totals 48 26 — 2 7 3 — — *Cases previously notified in other districts and transferred to Penge and those restored to the Register are included in these figures. 11 There were 296 cases of tuberculosis on the Register at the end of the year, compared with 270 in 1950. Male Female Total Pulmonary 139 122 261 Non-Pulmonary 15 20 35 154 142 296 NATIONAL ASSISTANCE ACT, 1948. Legal action was taken in one case for the admission of an elderly woman to hospital, after endeavours to obtain her admission had proved fruitless. The Group Hospital Management Committee were legally represented and opposed the application. The Justices decided, in view of the shortage of beds in the Group area to refuse the application, although they expressed the view that the person concerned should be in an institution. On other occasions difficulty was experienced in obtaining admission to institutions of aged persons suffering from chronic illness and in need of care and attention. Until sufficient institutional accommodation and staff are provided for the chronic aged sick, particularly those living alone, the proper care of these elderly people will remain a serious problem. Under Section 50 of the Act, it is the duty of the local authority to arrange for the burial or cremation of the body of any person who has died in their area if it appears that no suitable arrangements for the disposal of the body have or are being made. During the year four bodies were dealt with by the Council under these provisions. FOOD. Regular inspections of food shops, restaurants and stores have again been made and instruction given in hygienic food preparation and handling, particular stress being paid to the importance of personal hygiene. There is no doubt that the hygienic storage and handling of food has shown improvement. As will be seen in the Chief Sanitary Inspector's Report, a considerable amount of food has been surrendered by the food traders and their applications for examinations to be made of foodstuffs of which they are doubtful as to the fitness helps to safeguard the purity of the food supply. 12 A large amount of meat and bacon is sent from food stores in other districts to a local food factory for manufacturing purposes and requires careful examination and trimming before being used. This entails frequent visits being made. No animals were slaughtered in the district. Food Poisoning. No cases of food poisoning were notified during the year and no deaths from enteritis and diarrhoea were recorded. A set of posters illustrating the causes of and advice on how to prevent food poisoning was exhibited in a prominent position in the Public Library. MORTUARY. During the year improvements were made to the Council's mortuary, including the provision of a refrigerating chamber to accommodate two bodies. My thanks are due to the Chairman and Members of the Public Health Committee for their cordial support during the year, and also to the staff of the Public Health Department for their ready co-operation. I am, Mr. Chairman and Gentlemen, Your obedient Servant, B. E. HAWKINS, Medical Officer of Health. 13 Notifiable Diseases (other than Tuberculosis) during the Year 1951. Cases Notified at ages—years Cases admitted 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 upwds Scarlet fever 43 1 1 2 6 4 25 2 1 1 - - - 29 Dysentery 5 — 1 — — — — - — — - - 4 4 Pneumonia 10 1 1 — 1 2 — - - 1 - 1 3 - Erysipelas 7 — — — — -— — - 1 1 5 — - - Measles 468 26 94 67 110 97 64 5 1 3 1 — - 4 Whooping Cough 107 13 27 23 15 15 10 1 1 — 1 1 - 4 Totals 640 41 124 92 132 118 99 8 4 6 . 7 2 7 41 Deaths of notified cases:—1 Pneumonia, aged 82 years. Whooping Cough 1, aged l½ years BIRTH-RATES, DEATH-RATES AND ANALYSIS OF MORTALITY IN THE YEAR 1951. Rate per 1,000 Home Population Annual Death Rate per 1,000 Home Population Rate per 1,000 Live Births Live Births Still Births All Causes Typhoid Fever Small-pox Acute Poliomyelitis & Polioencephalitis Tuberculosis Whooping Cough Diphtheria Influenza Pneumonia Diarrhoea and Enteritis (under two years) Total Deaths under one year Penge U.D. 20.2 0.61 10.5 - — — 0.39 0.03 — 0.27 0.55 - 24.5 England and Wales 15.5 0.36 12.5 0.00 0.00 0.00 0.31 0.01 0.00 0.38 0.61 1.4 29.6 126 County Boroughs and Great Towns including London 17.3 0.45 13,4 0.00 0.00 0.01 0.37 0.01 0.00 0.36 0.65 1,6 33.9 148 Smaller Towns (Resident Populations, 25,000 to 50,000 at Census 1931) 16.7 0.38 12.5 0.00 0.00 0.01 0.31 0.01 .. 0.00 0.38 0.63 1.0 27.6 London Administrative County 17.8 0.37 13.1 — - 0.00 0.38 . 0.01 0.00 0.23 0.61 0.7 26.4 A (—) signifies that there were no deaths. 14 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 25 40 4 - (II) Factories not included in (1) in which Section 7 is enforced by the Local Authority 90 136 10 - (III) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 10 18 1 - Total 125 194 15 — 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.l) 5 5 - 2 - Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) — — - — — Inadequate ventilation (S.4) — —- — — — Ineffective drainage of floors (S.6) - - - - - Sanitary conveniences (S.7) (a) insufficient 1 1 — 1 — (b) unsuitable or defective 7 7 — 3 — (c) not separate for sexes - — — — — Other offences (not including offences relating to Outwork) 11 11 — — — Total 24 24 — 6 — PART VIII, FACTORIES ACT, 1937—OUTWORKERS. In the August list required by Section 110, five 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). 15 CAUSES OF DEATH IN PENGE URBAN DISTRICT, 1951. Registrar-General's Figures. causes of death males females All Causes 141 153 1. Tuberculosis, respiratory 7 3 2. Tuberculosis, other — — 3. Syphilitic disease — — 4. Diphtheria — — 5. Whooping Cough — 1 6. Meningococcal Infections — — 7. Acute poliomyelitis — — 8. Measles — — 9. Other infective and parasitic diseases — 1 10. Malignant neoplasm, stomach 2 2 11. Malignant neoplasm, lung, bronchus 8 1 12. Malignant neoplasm, breast - 6 13. Malignant neoplasm, uterus - 2 14. Other malignant and lymphatic neoplasms 17 11 15. Leukaemia, aleukaemia - — 16. Diabetes - 2 17. Vascular lesions of nervous system 9 23 18. Coronary disease, angina 14 5 19. Hypetension with heart disease 7 9 20. Other heart disease 22 28 21. Other circulatory disease 5 9 22. Influenza 2 5 23. Pneumonia 7 7 24. Bronchitis 12 6 25. Other diseases of respiratory system 2 1 26. Ulcer of stomach and duodenum 2 - 27. Gastritis, enteritis and diarrhoea - - 28. Nephritis and nephrosis 2 2 29. Hyperplasia of prostate 3 - 30. Pregnancy, childbirth, abortion — - 31. Congenital malformations 2 3 32. Other defined and ill-defined diseases 12 25 33. Motor vehicle accidents 2 - 34. All other accidents - 1 35. Suicide 4 - 36. Homicide and operations of war — - Deaths of infants under 1 year Total 7 6 Legitimate 7 6 Illegitimate — — Live Births Total 262 267 Legitimate 243 250 Illegitimate 19 17 Stillbirths Total 7 9 Legitimate 6 9 Illegitimate 1 — Home population (estimated middle of1951 R.G.) 25,370 16 ANNUAL REPORT OF THE CHIEF SANITARY INSPECTOR for the year 1951. Town Hall, Anerley Road, S.E.20. June, 1952. To the Chairman and Members of the Urban District Council of Penqe. Mr. Chairman and Gentlemen, I have the honour to place before you my twenty-fourth Annual Report on the work of the Sanitary Inspectors for the year ended 31st December, 1951. It is becoming increasingly difficult for owners of property to maintain their houses in a reasonable state of repair. The very high cost of work and the fact that rentals (excluding rates) remain the same as in 1939, result in the neglect of property. A consequence of this is that the tenants call upon the sanitary inspectors for action to be taken to improve the conditions in which they live. This is reflected in the number of complaints received, which totalled 959 during 1951, the great majority being concerned with housing defects. A large amount of repair work has been done following action taken by your Inspectors, as will be seen on reference to the list of work executed. It is only after every endeavour has been made informally to have notices complied with that statutory action is taken. In some cases delay is still being experienced in getting repairs executed owing to prolonged negotiations between owners and the War Damage Commission. It was found necessary to institute legal proceedings against several owners in order to abate nuisances caused by housing defects and the following is a summary of those cases heard during the year :— Case No. Result 1. Non-compliance with Nuisance Order made by Justices. Fined £3 0s. 0d. Council did work in default. 2. Continued non-compliance with Nuisance Order. Fined £3. 0. 0. (a) Continued non-compliance with Nuisance Order. Fined £3 0s. 0. and 10s. 6d. costs. 3. Nuisance Order-made-to 4o work in 56 days -and pay 9s. 6d, Court costs, 4. Continued non-compliance with Nuisance Order. Work completed before hearing of case. Summons withdrawn on payment of 4s. 0d. Court costs. 5. Continued non-compliance, with Nuisance Order. Fined £5 0s. 0d. and £1 1s. 0. costs. 17 Case No. Result. 6, 7 and 8. Nuisance Orders made to do work in 56 days and pay a total of £2 2s. 0d. costs and £1 8s. 6d. Court costs. 9 and 10. Nuisance Orders made to do work in 14 days and pay a total of £1 1s. 0d. costs and Court costs. 11. Nuisance Order made to do work in eight weeks and to pay 11s. 6d. Court costs. An appeal against this decision by way of case stated was made to the Queen's Bench Division of the High Court of Justices, when the Appeal was dismissed with costs against the Appellant. 12. Nuisance Order made to do work in 28 days and to pay 8s. 6d. Court costs. 13. Case adjourned sine die, the work having been commenced prior to date of hearing. In addition to verbal intimation of defects in premises, 745 written informal notices and 89 statutory notices were served under the Public Health Act, 1936, and two statutory notices under Section 9, Housing Act, 1936. Six hundred and fifty-six intimation notices and 88 statutory notices were complied with. The Local Authority, in default of the owners, had carried out the works required by one statutory notice served under Section 94 of the Public Health Act, 1936, and two notices served under Section 9 of the Housing Act, 1936. The Council also did the work required by 19 notices served under Section 24 of the Public Health Act, 1936, respecting defective public sewers (previously known as combined drains) at 34 premises. One house was demolished during the year following the making of a Demolition Order under Section 11 of the Housing Act, 1936, the previous year. A Closing Order was made under Section 12 of the Housing Act, 1936, respecting one underground room which could not be made fit for human habitation at a reasonable cost. A Closing Order was also made regarding a basement room which could not be made to comply with the byelaws relating to Underground Rooms. No applications were received under the Rent Restriction Acts for certificates that houses were not in a reasonable state of repair. The drainage systems of 57 premises were wholly or partially relaid and 89 cleared of obstructions. There was a diminution in the number of premises found to be infested with vermin, but it was necessary to disinfest 87 rooms as against 124 rooms in 1950. Five licences to deal in game were issued during the year. 18 SUMMARY OF INSPECTIONS AND VISITS. The following summary shows the number of visits and inspections made:— Inspections through complaints received 959 Housing Act 41 Overcrowding and measurement of rooms 30 Infectious diseases 222 Houses-let-in-Lodgings and Common Lodging Houses 105 Bakehouses 92 Dairies 112 Meat shops 205 Fish frying shops 42 Ice cream shops 117 Cafes and restaurants 187 Food factories 206 Other food shops, stores and stalls 583 Public conveniences 49 Stables 45 Rats and Mice 207 Factories 194 Outworkers 25 Schools 15 Smoke observations 26 Drain tests 248 Keeping of Animals 25 Food and water sampling 213 Movable dwellings 26 Rag Flock Act 26 Transferable Deaths 120 Revisits and inspections of work in hand 3,837 Miscellaneous visits 202 Shops Acts inspections and patrols 462 SUMMARY OF WORK EXECUTED DURING THE YEAR. Water Supply:— Water supply reinstated to houses 5 Water service pipes repaired 40 Cisterns cleansed, covered or covers repaired 8 Water Closets:— New pans and traps fixed 24 Flushing apparatus renewed or repaired 28 Foul pans and traps cleansed 7 Connections of flushing pipes to pans made good 13 Seats and doors provided or repaired 21 Ventilation provided or improved 2 Walls repaired 3 Flooring or paving repaired 6 Artificial lighting provided 2 Labelled 1 19 Drainage:— Drains tested with smoke, water or colour 248 Drains cleared 89 Houses redrained 1 Houses with drains partially relaid 56 Inspection chambers constructed or improved 21 Soil and ventilation pipes fixed or repaired 6 Sinks, lavatory basins and baths provided 9 Sink fillets repaired 4 Waste pipes renewed or provided 8 Waste pipes repaired or trapped 17 Waste pipes cleared 6 Fresh-air-inlets provided or repaired 4 Dampness—Houses with:— Walls repointed or rendered 30 Dampness in ground floor rooms remedied 47 Roofs repaired 211 Gutters repaired or renewed 64 Rainwater pipes repaired or renewed 39 Ventilation under floors provided or improved 7 Water service pipes repaired 40 Window sills repaired 34 Cleanliness:— Dirty rooms etc. cleansed 556 Verminous rooms disinfested 87 Miscellaneous:— Houses with defective floors, joists, etc. repaired 84 Houses with defective plaster repaired 167 Houses with new sashlines provided to windows 43 Houses with window frames, etc. repaired 48 Houses with yard or forecourts paved or repaired 8 Houses with scullery paving repaired 6 Houses with chimneys repaired 37 Houses with air bricks renewed 11 Houses with stairs repaired 12 Houses with front and back steps repaired 17 Houses with fireplace jambs and mantels repaired 11 Houses with brickwork repaired 28 Kitchen stoves repaired or renewed 14 Scullery coppers repaired or renewed 4 Other stoves repaired or renewed 63 Hearths renewed or repaired 5 Doors and frames repaired or renewed 17 Ventilation and lighting of rooms improved 15 New dustbins provided 77 Premises with miscellaneous defects repaired, etc. 23 Animals removed 2 Accumulations removed 16 Smoke nuisances abated 1 20 INSPECTION AND SUPERVISION OF FOOD. The supervision of premises and stalls where foods are prepared, stored or exposed for sale has been regularly carried out, 1,555 visits being made in this connection. In a few cases warnings were given relating to contraventions of the byelaws made under Section 15, Food & Drugs Act, 1938, but in no case was it found necessary to take statutory action. Various improvements have been made in food shops particularly in regard to the hygienic storage and display of meat products, and the provision of a constant supply of hot water. Your sanitary inspectors continued to give advice to occupiers of food premises on matters relating to food and general hygiene and found them willing to co-operate. Communications were send to the occupiers of 19 food premises regarding defects found, and in each case the work was carried out after informal action. Proceedings were taken under Sections 9 and 10, Food & Drugs Act, 1938, against a confectionery firm for selling a bun containing straw and sacking fibres. The Justices imposed a fine of £5 0s. 0d. The amount of food surrendered and condemned as unfit for human consumption after examination by your inspectors was 7 tons, 7 cwt., 3 qrs., 22 lbs. The foods condemned were as follows:— Bacon 8,780 lbs. Beef 590 „ Confectionery 73 „ Cornflour 10 „ Chitterlings 207 „ Cheese 24 „ Dried fruits 30 „ Dried vegetables 15 „ Fish 675 „ Jam and Marmalade 19 „ Lard 18 „ Margarine 15 „ Mutton 51 „ Pork 3,106 „ Rabbit 2 „ Sausages 2 „ Spaghetti 14 „ Suet 7 „ Sugar 8 „ „ confectionery 19 „ Vermicelli 20 „ Barley Flakes 33 pkts. Flour mixtures 178 „ French Mustard 8 bots. Gravy cubes and powders 186 pkts. Health salts 6 „ Salad cream 27 bots. Sauce 6 „ Soft drinks 1 Soups 7 pkts. Tinned Fish 11 tins „ Fruit 83 „ „ Meat 500 „ „ Meat & Vegetables 2 „ „ Milk 80 „ „ Soup 20 „ „ Spaghetti 7 „ „ Vegetables 136 „ Condemnation certificates totalled 315, compared with 377 in 1950. The co-operation of the food traders in bringing to the notice of the department the existence of suspected unsound food has been maintained. 21 Milk Supply. There are no cowsheds or pasteurising plants in the district. All milk sold in the district is special designated milk in sealed containers. Milk (Special Designations) Orders. The following licences were issued:— Dealers' Licences : Tuberculin tested milk 5 Pasteurised milk 7 Sterilised milk 10 Supplementary Licences: Tuberculin tested milk 6 Pasteurised milk 6 Sterilised milk 5 Milk Sampling. Samples of milk submitted to chemical analysis totalled 77 (of which 3 were below the standard for fat content) and gave the following averages:— Fat—3.41 % (standard 3.0%). Solids not fat—8.84% (standard 8.5%). Fifty-three samples of pasteurised milk and twelve samples of tuberculin tested (pasteurised) milk were submitted to the Methylene Blue and Phosphatase tests and they all satisfied the tests. Nine samples of sterilised milk were examined and satisfied the Turbidity test. Ice-Cream. There are no manufacturers in the district, but a number of premises are registered for the sale of ice-cream, the shopkeepers obtaining their supplies from well-known manufacturers. Fifty-two samples of ice-cream were taken and submitted to the Methylene Blue test with the following satisfactory results:— Grade 1—41; Grade 2—11. These figures show an improvement on the previous year and in all cases temperatures of the ice-cream did not exceed 28° F. Six samples were submitted to analysis for fat content and found to be satisfactory, the results ranging from 8.2% to 10.8%. Slaughterhouses. No animals were slaughtered in the district. 22 Bakehouses. Defects found in one bakehouse were remedied after informal action. Adulteration. The Kent County Sampling Officers took 110 samples of various foods and drugs in this district. Included in the total were 30 samples of milk, 18 drugs and 10 of spirits. One sample of pineapple jelly, one of jelly crystals and one of marzipan were found to be of inferior quality, and the manufacturers of these articles were notified accordingly. One sample of sal volatile was reported to be adulterated and another to be of inferior quality. In both of these cases further samples were unobtainable the stocks having been disposed of. Your Inspectors obtained 76 informal samples of milk, the Analyst reporting 73 samples to be genuine and three samples of sterilised milk from the same source deficient in fat. A formal sample and informal samples subsequently taken in the latter case proved to be genuine. FACTORIES ACT, 1937. Visits paid to factories totalled 194 and in addition to verbal intimations regarding small defects, 15 written notices were served and complied with. These dealt mainly with defective sanitary conveniences and want of cleanliness. PREVENTION OF DAMAGE BY PESTS ACT, 1949. Complaints numbering 280 were received from all parts of the district and investigated. In only one case was a major infestation discovered, and this is no doubt due to the employment of a rodent operative during recent years. Rats are prolific breeders, and constant action against them is necessary. In several cases defective drains and sewers were the cause of rat infestation and the keeping of animals contributed to the number of infestations. When considered necessary the drains of premises were tested with smoke and colour and all defects found made good. The foul-water sewers were treated during June and December, pre-bait and poisoned bait being laid in the manholes and side entrances. In June 321 manholes were baited and pre-bait takes recorded in 105. The figures for December were 324 manholes baited and pre-bait takes recorded in 89. These results show an improvement on the previous year. 23 One full-time rodent operative is employed and the following is a summary of the work carried out by him at premises in the district:— Inspections and re-inspections made 2,886 Premises treated for rats 358 Premises where rat poison bait taken 335 Premises re-treated for rats 290 Estimated number of rats poisoned 1,231 Number of rats trapped 14 Premises treated for mice 133 Premises re-treated for mice 92 It was necessary to treat some premises on three or more occasions and the total treatments for the destruction of rodents numbered 873. Legal proceedings were taken under Section 3 of the Act against a firm of butchers for failing to give notice in writing to the Council that rats were living in or resorting to their premises in substantial numbers. The Justices imposed the maximum fine of £5 0s. 0d. RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951. This Act, and Regulations made thereunder, came into force on the 1st November. The object of the Act is to secure the use of clean filling materials in upholstered articles and other articles which are stuffed or lined. Four premises were registered in connection therewith. MOVABLE DWELLINGS. For the period of the Festival of Britain from May to September, a camping and caravan site of nearly 3 acres in the Crystal Palace Grounds, was managed by and under the joint auspices of the Camping and Caravan Clubs of Great Britain and Ireland. Suites of waterclosets and lavatory basins in an existing brick building were put in order and suitable arrangements made for the collection of refuse, etc. Periodical inspections were made of the camp and apart from a few minor matters, which were attended to immediately attention was drawn to them, no cause for complaint arose during the existence of the camp. SHOPS ACT, 1950. Mr. E. G. Thomas, Deputy Chief Sanitary Inspector and Shops Act Inspector, reports as follows:— Number of visits made 373 Number of evening patrols carried out 60 Number of Sunday patrols carried out 29 Number of shops where Young Persons employed 17 Number of shops where official forms relating to staff not posted up on premises 26 Number of "mixed shops" where poster relating to Sunday trading not exhibited 6 24 Offences:— Number of shops open after evening closing hour 1 Letters of warning were sent to shopkeepers with reference to contravention of the Act relative to the non-exhibition of forms relating to "mixed shops" when open for Sunday trading, and for failing to post up official forms regarding employment of shop assistants. A warning was given to the shopkeeper who contravened the provisions relative to evening closing hours. I should like to express my thanks to the Chairman and Members of the Public Health Committee for their courtesy and assistance and to the Staff for their great help and efficient service during the year. I am, Mr. Chairman and Gentlemen, Your obedient Servant, R. T. PEARCE, M.S.I.A. Chief Sanitary Inspector.