RICH 20 AC 4413(1) RICHMOND BOROUGH OF RICHMOND (SURREY) ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH 1951 RICHMOND: J, H. BROAD AND CO., LTD., PRINTERS, 8, KING STREET. BOROUGH OF RICHMOND (SURREY) ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH 1951 CONTENTS. Page. List of Staff 2 Preface 3 SECTION A—STATISTICS AND SOCIAL CONDITIONS. Social Conditions 8 Births 8 Deaths 8 Maternal Mortality 9 Infant Mortality 9 Premature Infants 10 Comparative Statistics 11 SECTION C—SANITARY CIRCUMSTANCES. Water Supply 12 Sanitary Inspection 14 Sanitary Defects 17 Noticcs Served 20 Complaints Received 21 Food Inspection 22 Food Premises 23 Byelaws 23 Richmond Clean Food Traders' Guild 23 Petroleum Acts 24 Disinfection and Disinfestation 24 Rodent Control 24 Smoke Abatement 25 Rag, Flock and Other Filling Materials Act, 1951 25 SECTION D—HOUSING. Housing 26 Council's Housing Programme 28 SECTION E—INSPECTION AND SUPERVISION OF FOOD. Sale of Food and Drugs 30 The Food and Drugs (Milk & Dairies) Act, 1944 31 Ice Cream 32 SECTION F—PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. Notification of Infectious Diseases 33 Admission to Infectious Diseases Hospitals 33 Laboratory Facilities 33 Food Poisoning 34 Diphtheria Immunisation 34 Vaccination Against Smallpox 35 Verminous Conditions—Scabies and Head Lice 36 Tuberculosis 38 1 Public Health Department, Parkshot, Richmond. August, 1952. To the Mayor, Aldermen and Councillors of the Borough of Richmond (Surrey). Ladies and Gentlemen, I have the honour to present the Annual Report of the Medical Officer of Health for the year 1951 upon the Sanitary Circumstances, Sanitary Administration and Vital Statistics of the Borough. The form of the report is in accordance with the requirements of the Ministry of Health and special reference is made to certain subjects at the Minister's request. I wish to express my thanks to all members of the Council for their appreciation and encouragement during a particularly full year and once again to record my gratitude to all members of the Staff of the Public Health Department for their unfailing loyalty and support. I am, Ladies and Gentlemen, Your obedient servant, ERIC PEREIRA, Medical Officer of Health. 2 LIST OF STAFF. Medical Officer of Health: ERIC PEREIRA, M.B., B.S., D.P.H. Chief Sanitary Inspector: BERNARD AISTHORPE, M.R.San.I. Senior Additional Sanitary Inspector: GEORGE C. SMITH, M.S.IA., M.R.San.I. Additional Sanitary Inspectors: CHARLES S. SMEATON, M.R.San.I. KENNETH H. HALSTEAD, M.S.IA., A.R.San.I. Clerks: MISS J. BLACK (Senior Clerk). MRS. F. G. SMITH. MISS M. WILTSHIRE. Rodent Officer: THOMAS R. SMITH. Rodent Operator: RONALD EVANS (from 14/8/51). Drain Tester and Disinfector: J. DAVIS. 3 BOROUGH OF RICHMOND. Report of the Medical Officer of Health for the year 1951. PREFACE. In accordance with Ministry of Health Circular 42/51, the Annual Report has been prepared on the lines of that for 1950. On this occasion the report has been divided into two parts—a preface covering points of special interest and an appendix which is mainly statistical. Staff. The Department was fully staffed throughout the year. It was, however, found that the organization for the control of rats and mice was more extensive than had been anticipated. Mr. T. R. Smith, Rodent Officer, had commenced duty in April 1950 and Mr. R. Evans was appointed to the staff as Rodent Operator in August 1951. Population. The Registrar General's estimate of the population was 41,940 which is slightly less than his estimate for the previous year. The exact figure resulting from the Census is not yet available. Births. During the year 648 births were recorded—(338 males and 310 females). This figure may be compared with 641 births in 1950 and 851 in 1947. The number of illegitimate births was 43 which is the same as for the previous year. The proportion of births taking place in hospitals or nursing homes has reached 78%. Unsatisfactory housing plays a considerable part in reducing the number of domiciliary confinements but in addition a large number of women desire admission to hospital for a variety of other reasons. There were 23 premature births belonging to this district. Nineteen of these survived for over 28 days and 4 died within 7 days of birth. Health Visitors are notified early of the occurence of a premature birth and every possible form of assistance is given to the mother. 4 Deaths. The total number of deaths occuring amongst residents was 568 (278 males and 290 females). This gives a corrected death rate of 10.93 per thousand of the population which compares favourably with the country as a whole. There were 11 infant deaths which gave the lowest infant mortality rate ever recorded. However, too much significance should not be paid to this since the numbers are small for statistical purposes. Each of the 11 infant deaths was carefully investigated with a view to ascertaining what preventative measures could help to reduce the incidence in future. There were no maternal deaths during the year. NATIONAL ASSISTANCE ACTS, 1948 and 1951. Removal to suitable premises of persons in need of care and attention. The amending Act of 1951 makes it possible for the Local Authority (or the Medical Officer of Health if so authorized) to apply to a Court of Summary Jurisdiction or to a Justice for an order for the removal of a person to suitable premises. Application can be made without giving to the person the period of seven days clear notice when it is certified by the Medical Officer of Health and a registered medical practitioner that it is necessary in the interests of that person to remove him without delay. Action under these Acts was contemplated on a number of occasions but in each case the solution was finally found in other ways. There is a considerable number of old persons living in the district alone and uncared for, so that the problem is continually recurring. The difficulty is not so much to find suitable available accommodation but to persuade the old people that removal is in their interests. My experience is that once they have been persuaded to enter a home or hospital they settle down quickly and rarely wish to return to the squalor of their former accommodation. The policy generally is to help them as much as possible in their own homes and only to resort to the powers given under the National 5 Assistance Acts when every other means has failed and there is danger to the life or health of the individual or those living in the same house. Water Supplies. Drinking water is from local wells and from the Metropolitan Water Board. Action taken to ensure the purity of these supplies is set out in the Appendix. Sanitary Inspections of the District. The report of the Chief Sanitary Inspector is included in the Appendix to this Report. It shows that a great deal of work has been done connected with complaints made by members of the public, inspections of properties made under the Housing, Public Health and Factories Acts, etc. The Sanitary Inspectors are concerned with anything which may affect the public health and thus their duties are varied and often of a technical nature. The policy generally is to obtain improvements by co-operation and persuasion, and to avoid, as far as possible, resort to the use of legal powers. Throughout this year only 68 Statutory Notices were served and it was only necessary to take legal proceedings in one instance. Food Premises. The campaign to obtain high standards of hygiene and sanitation in all food premises has continued successfully. Details of improvements obtained are shown in the Appendix. Generally, the food traders are anxious to co-operate and will carry out any reasonable improvement demanded. There are certain older properties with rather cramped and poorly lighted accommodation which cannot be further improved without major structural alterations. In these cases good management results in satisfactory conditions. It should be comforting for the public to know that conditions in tood premises are improving all the time, and are probably as good as anywhere in the country. 6 Housing. This remains a major problem. The building programme cannot compete with the demand and there remains very little available land for this purpose. Many properties have nearly reached the end of their useful life and in normal times would be scheduled for demolition. As things are today, these houses are kept weatherproof and in such state of repair that they provide useful dwellings. It is unfortunate that such low standards of housing must now be accepted; but how much pleasanter it must be to occupy a separate dwelling than live in overcrowded conditions with the inevitable family quarrels and resulting mental ill-health. The time for Slum clearance has not yet arrived, and there is no doubt that these conditions must be tolerated for a number of years to come. Prevalence of, and control over, infectious, and other diseases. There was an epidemic of measles and a rather high incidence of whooping cough. However, these compared favourably with other parts of the country and there were no deaths. Only 10 cases of measles and four cases of whooping cough were severe enough to require admission to hospital. Two cases of poliomyelitis occurred—both were adults. A man aged 21 was left with some weakness of the left leg, but otherwise made a good recovery. A woman aged 27 made a complete recovery without any paraylsis. Both cases were treated at the South Middlesex Fever Hospital. The incidence of scarlet fever was high, the notification rate being 2.08 per thousand population compared with a rate of 1.11 for the country as a whole. The reason for this is not clear since the cases were fairly evenly distributed over the district without significant concentration in any particular school or locality. The prevailing type of scarlet fever is mild and undiagnosed cases may well play their part in its spread. Home isolation of cases is permitted and, in fact, encouraged, wherever facilities are reasonably satisfactory. 7 Nine cases only of food poisoning were notified. These were isolated cases infected in their own homes and, in most cases, caused by the faulty storage of food. This is a good record when one takes into account the very large numbers of meals served daily in public restaurants. The diphtheria immunization campaign was continued; every thing possible being done to persuade parents to have their children protected. The percentage of children immunized is very high in this district. Not a single case of diphtheria was notified during this year. Vaccination against smallpox has been undertaken by private doctors and at the local clinics since the National Health Service Act came into operation. Approximately, 64% of our babies were vaccinated under these arrangements. Although this figure cannot be considered satisfactory it is much higher than in most other parts of the country. The number of notifications of tuberculosis increased from 42 to 61 but the death rate decreased from 0.47 to 0.38 per thousand population. Too much significance should not be placed on these figures which are comparatively small. Good facilities exist for the diagnosis, treatment and after care of patients, and facilities for admisions to hospital or sanatorium are improving. 8 APPENDIX. SECTION A—SUMMARY OF STATISTICS AND SOCIAL CONDITIONS. Area in acres 4,234 Population (Census 1931) 37,791 Population (estimated 1951) 41,940 Number of inhabited houses (estimated) 11,235 Rateable value £631,141 Sum represented by a Penny Rate £2,508 BIRTHS. Birth-Rate per 1,000 of estimated resident population 15.5 Total number of births (live and still) 648 Analysis:— M. F. Total. Live Births: Legitimate 309 277 586 Illegitimate 18 25 43 Still Births: Legitimate 10 7 17 Illegitimate 1 1 2 Still-Birth Rate per 1,000 total births 29.0 Environment of Births:— Proportion taking place in the Borough 27% Proportion taking place outside the Borough 73% Proportion taking place in Institutions 78% Proportion taking place in dwelling houses 22% Proportion notified by midwives alone 29% Proportion notified by doctors or parents 71% DEATHS. Death-Rate per 1,000 of estimated resident population 13.5 (Corrected) 10.93 Total number of deaths from all causes 568 Analysis:— M. F. Total. All causes 278 290 568 Cancer 44 47 91 Diphtheria — — — Measles — — — Whooping Cough — — — Diarrhoea (under two years) 1 — 1 9 Maternal Mortality Rate per 1,000 total births 0.00 Total number of maternal deaths 0 Infant Mortality (Deaths under one year of age). Infant Mortality Rate for all infants per 1,000 live births 17.5 Rate for legitimate infants per 1,000 legitimate live births 18.7 Rate for illegitimate infants per 1,000 illegitimate live births — Total number of infant deaths in the Borough 11 Analysis:— M. F. Total. Legitimate 6 5 11 Illegitimate — — — Environment of Infant Deaths:— Number occurring in the Borough 4 Number occurring outside the Borough 7 Number occurring in Institutions 8 Number occurring in dwelling houses 3 Causes of Death under 1 year of age. Cause 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 1. Pneumonia ... ... ... ... ... 2 1 ... ... 3 2. Congenital Debility and Malformation including Premature Birth 3 ... 1 ... 4 ... ... ... 1 5 3. Enteritis ... ... ... ... ... ... ... ... ... ... 4. Birth Injury 3 ... ... ... 3 ... ... ... ... 3 5. Other defined diseases ... ... ... ... ... ... ... ... ... ... 6. Asphyxia (Accidental Death) ... ... ... ... ... ... ... ... ... ... 7. Accidental Death ... ... ... ... ... ... ... ... ... ... 6 ... 1 ... 7 2 1 ... l 11 10 PREMATURE INFANTS Number born Number nursed Number born alive but dying within Number surviving for over 28 days 24 hours 7 days 28 days Richmond Children bom in the Borough: (a) At Home 6 6 1 — — 5 (b) In Nursing Homes — — — — — — (o) In Hospitals — — — — — — Richmond Children born outside the Borough: (a) In Nursing Homes 1 1 1 — — — (b) In Hospitals 16 16 2 — — 14 Children born in Richmond, mother normally residing elsewhere: (a) In Nursing Homes — — — — — — (b) In Hospitals — — — — — — ILLEGITIMATE BIRTHS 1944 1945 1946 1947 1948 1949 1950 1951 No. of illegitimate live births 62 62 51 54 38 40 43 43 No. of illegitimate deaths under 1 year 3 4 5 2 0 1 2 0 Illegitimate death rate 48 65 98 36 0 25 46 0 11 COMPARATIVE STATISTICS—1951. England and Wales 126 County Boroughs and Great Towns including London. 148 Smaller Towns (Resident populations 25,000— 50,000 at 1931 Census I.ondon Administrative County- Richmond Richmond *Rates per 1,000 Home Population. Actual Nos. Births— Live Births 15.5 17.3 16.7 17.8 14.9 629 Still Births 0.36 0.45 0.38 0.37 0.5 19 Deaths— All Causes 12.5 13.4 12.5 13.1 13.5 560 corrected 10.93 Typhoid and Paratyphoid 0.00 0.00 0.00 – – 0 Whooping Cough 0.01 0.01 0.01 0.01 – 0 Diphtheria 0.00 0.00 0.00 0.00 – 0 Tuberculosis 0 31 0.37 0.31 0.38 0.38 16 Influenza 0.38 0.36 0.38 0.23 0.21 9 Smallpox 0.00 0.00 0.00 – – 0 Acute Poliomyelitis (including Polioencephalitis) 0.00 0.01 0.01 0.00 – 0 Pneumonia 0.61 0.65 0.63 0.61 0.52 22 Notifications (corrected) Typhoid Fever 0.00 0.00 0.00 0.01 – 0 Paratyphoid Fever 0.02 0.03 0.02 0.01 – 0 Meningicoccal Infection 0.03 0.04 0.03 0.03 – 0 Soarlet Fever 1.11 1.20 1.20 1.10 2.08 87 Whooping Cough 3.87 3.62 4.00 3.11 2.67 112 Diphtheria 0.02 0.02 0.03 0.01 – 0 Erysipelas 0.14 0.15 0.12 0.15 0.21 9 Smallpox 0.00 0.00 0.00 – – 0 Measles 14.07 13.93 14.82 14.64 13.01 546 Pneumonia 0.99 1.04 0.96 0.72 0.12 5 Acute Poliomyelitis (including Polioencephalitis) Paralytic 0.03 0.03 0.03 0.02 0.02 1 Non Paralytic 0.02 0.02 0.03 0.02 0.02 1 Food Poisoning 0.13 0.16 0.08 0.23 0.21 9 Rates per 1,000 Live Births. Deaths— All causes under 1 year of age 29.6 (a) 33.9 27.6 26.4 17.5 11 Enteritis and Diarrhœa under 2 years of age 1.4 1.6 1.0 0.7 1.6 1 Rates per 1,000 Total (Live and Still) Firths. Noticaitons (corrected)— Puerperal Fever and Pyrexia 10.66 13.77 8.08 14.90 4.63 3 Maernal Mortality— Sepsis of Pregnancy childbirth and puerperium 0.10 Abortion with toxaemia 0.00 Other toxaemias of pregnancy and puerperium 0.24 Haemorrhage of pregnancy and childbirth 0.13 Abortion without mention of sepsis or toxaemia 0.05 Abortion with sepsis 0.09 Other complications of pregnancy, childbirth and puerperuim 0.18 (a) Rates per 1,000 related live births. 12 SECTION C—SANITARY CIRCUMSTANCES. Water Supply. Richmond has two separate sources of drinking water:— (a) From local wells. (b) From the Metropolitan Water Board. The origin and method of treatment of these supplies have been fully reported in previous years and remain unchanged. Both supplies are treated by chlorination: and very close observation of the purity of the water is maintained by frequent examinations of the water samples. During the year the following samples were taken for examination:— (a) Richmond Water Supply. Untreated water 260 samples Treated water 372 samples For chemical analysis 20 samples Every sample of treated water passing into public supply was of the highest standard of bacterial purity. Chemical analysis of samples showed that the organic quality of the water maintained a high and satisfactory standard. (b) Metropolitan Water Board Supply. Samples examined bacteriologically 766 Samples examined chemically 250 The results of these examinations indicated that a very high standard of chemical and bacteriological purity was maintained throughout the year. In addition to these two supplies of drinking water there is a supply of raw river water which is delivered to Kew Gardens, allotments and to the gardens of a proportion of the residences in Richmond. The water is chlorinated as a precautionary measure but is not fit for drinking. 13 The following figures show the daily average consumption from the three sources:— 1950/51 1951/52 AH Richmond Wells 752,307 galls. 841,881 galls. Metropolitan Water Board 912,529 galls. 832,973 galls. Raw River Water 182,548 galls. 205,161 galls. The drinking water supplies in the district are not plumbo solvent. Water fit for human consumption is made available by piped supply to every dwelling house in the Borough. 14 SANITARY INSPECTION. For the following particulars I am indebted to the Chief Sanitary Inspector, who submitted his Report in accordance with the Sanitary Officers (Outside London) Regulations, 1935. Inspections during 1951. Houses visited and particulars recorded (Housing Act) 4 Houses visited (Public Health Acts) 1038 Revisits to houses and other premises 1908 Visits paid in connection with:— Overcrowding 92 Vermin 134 Disinfestation 178 Enquiries into Infectious Diseases 107 Corporation Dwellings 1 Routine inspections in connection with:— Factories (mechanical) 21 Factories (non-mechanical) 22 Work-places 2 Bakehouses 30 Butchers' Shops 96 Fishmongers' and Poulterers 18 Other registered food stores 84 Dairies and Milk Shops 69 ■« C Ice-cream premises 135 Restaurants and Tea Shops 161 Fried Fish Shops 5 Stables 6 Rag and Bone, Dealers 3 Piggeries 15 Public Houses 33 Public Sanitary Conveniences 1 Shops Acts 23 Theatres, Cinemas l Greengrocers' and Fruiterers 35 Rats and Mice (Visits to Properties) 3157 15 Rats and Mice (Visits re sewer treatments) 2135 Smoke Observations 26 Schools—Elementary and Secondary 17 Tents, Vans and Sheds 6 Water Supply 262 Drainage 666 Milk Sampling (Pasteurised) 79 Unsound Food 154 Petroleum Acts 94 Rent Restrictions Acts 1 Interviews 443 Celluloid and Cinematograph Film Act — Massage Establishments 3 Rag Flock Act 7 Miscellaneous Visits 1258 12,530 Drains and Sewerage Systems Tested. Hydraulic tests 24 Smoke tests 33 Chemical tests 21 Examinations 31 Factories Act, 1937. At the end of the year there were 165 factories on the register (140 mechanical and 25 non-mechanical) carrying on the following trades:— Mechanical. NonMechanical. Artificial wreathes, etc 1 — Bakeries 10 — Boat Repairs 1 1 Boot-making and Repairing 10 2 Box-making 1 — Building 8 5 Butchers 2 — 16 Clothing 4 1 Dressmaking 5 5 Electrical Instruments 4 — Engineering 13 — Furniture and Upholstery 3 4 Furriers — 2 Gas Storage 1 — Glue-making 1 — Jewellery Repairs 1 2 Joiners 4 — Laundering and Cleaning 5 — Leather Craft 2 — Milk Pasteurising 2 — Motor Vehicle repairing 24 — Photography (Printing and Developing) 2 — Printing 6 — Sausage-making 3 — Saw Mills 2 — Tailoring 1 2 Undertaking 1 — Welding 2 — Wheelwright and Coach Building 5 — Wig-making — 1 Miscellaneous Trades 16 140 25 127 visits of inspection were made to the premises outlined above and the following defective conditions were remedied:— Want of cleanliness to Factory walls, etc. 1 Inadequate ventilation of Factories 2 Ineffective drainage of Factory floors 1 Insufficient Sanitary Accommodation 1 Unsuitable or defective conditions in Sanitary accommodation 4 1? Miscellaneous items 25 Sanitary accommodation not separate for sexes 1 35 In the main the Factories visited were found to be in good condition, the defects found being mainly minor in character. Shops Acts, 1950. Shops on the Register 793 Visits made 23 The above figure does not include the number of visits paid to food shops which, when visited, are covered for all provisions of the various Acts. SANITARY DEFECTS REPORTED. Water Supply: Defective or foul storage tanks 3 Defective fittings (notified to Water Engineer) 1 W.C.'s and Urinals: Defective pans 32 Foul pans 6 Defective woodwork around pans 2 Defective seats 11 Absence of water supply 11 Defective flushing apparatus 17 Defective flush-pipe connections 13 Defective walls, floors or roofs 38 Defective doors and windows 18 Want of light and ventilation 11 Insufficient closet accommodation 6 Defective walls and channels of urinals 1 Insanitary urinals cleansed 1 Defective brickwork (repaired or re-built) 10 Closets not separate for sexes 1 Unsuitable or defective urinals 1 18 Soil-Pipes: Defective or insufficient soil-pipes and vent shafts 16 Want of, or defective ventilation shafts 3 Rainwater pipe acting as ventilation shafts 37 Defective Fresh air inlets 8 Drains: Defective drains 36 Defective sewers 12 Want of additional house drains 3 Choked or foul drains or gullies 28 Defective or insufficient gullies 10 Defective grating, dishing or curbing 5 Absence of, or defective, interceptor 17 Defective manholes 7 Defective manhole covers and frames 2 Sub-soil drains required 3 Dustbins: Defective receptacles 13 Paving: Defective paving of yards, forecourts, etc. 14 Sinks: Defective or insanitary sink 23 Want of sink 3 Insanitary wall-surface around sink 5 Waste-Pipes: Insanitary W.P.'s or shafts 3 Defective waste-pipes 36 Untrapped or unventilated waste-pipes 5 Dampness: Defective roofs 134 Defective gutters or spouting 75 Want of damp-proof course 11 19 Defective external brickwork 42 Defective pointing of door and window reveals 22 Damp and insanitary site under floor 4 Floor cavity unventilated 2 Defective wall or floor ventilators 8 General Defects: Verminous rooms 12 Verminous bedding 7 Dirty floors, woodwork, etc. 4 Accumulations of offensive matter 12 Defective plastering (No. of rooms) 258 Dirty walls and ceilings (No. of rooms) 193 Dirty walls and ceilings of staircases and passages 78 Defective floors 57 Defective doors and windows 41 Defective doors and window fastenings 40 Defective furnace or brickwork of copper 1 Defective sashcords 70 Defective window sills 79 Windows not made to open 29 Inadequate lighting and ventilation 9 Defective firegrates and kitchen ranges 42 Defective chimney pots, etc. 35 Smoke nuisances 2 Defective coppers 2 Dilapidated Outbuildings 1 Defective staircases 9 Miscellaneous defects 273 2024 At the end of the year, 1612 of the defects discovered had been abated, the work of remedying 207 was in hand, and the balance of 205 were still outstanding. In order to see that these defects were being properly remedied 1,908 visits were paid to the various premises. 20 NOTICES SERVED TO REMEDY DEFECTS AND ABATE NUISANCES. Informal Action. Preliminary intimations 318 Verbal intimations 107 Interviews 443 Statutory Action. Act and Section. Notices Authorised. Notices Served. Public Health Act, 1936. Section 24 (Drainage) 6 6 Section 39 (Drainage) 18 18 Section 40 (Soil Pipe) 1 1 Section 45 (Defective Closets) 3 3 Section 75 (Dustbins) 1 1 Section 89 (Sanitary Conveniences) 1 1 Section 92/93 (Nuisances) 33 33 Housing Act, 1936. Section 9 (Insanitary Dwelling) 4 4 Food and Drugs Act, 1938. Section 13 (Food Preparing Room) 1 1 In the main the work called for by Statutory notices was carried out by the owners but in one case it became necessary for the Local Authority to carry out work in default under Section 9 of the Housing Act, 1936 at a cost of £30/0/0. PROSECUTIONS. It became necessary to take proceedings against an occupier of premises who failed to comply with statutory notices to abate nuisances. The prosecution was in respect of three summonses and the hearing was at the Petty Sessions Court, Richmond, on the 5th July. The defendant was convicted on all three summonses and fined £1/10/0 with £1/1/0 costs in each case. 21 The Court also granted an abatement order for the work required by the notices to be abated within a specified period. COMPLAINTS. The number of complaints received from the 1st January to 31st December, 1951 was 789 which is a considerable decrease over the same period in 1950. The complaints received have been classified as follows:— Defective firegrates 6 Defective sinks 6 Defective drains and gullies 46 Leaking pipes 18 Defective windows 7 Defective Walls and ceilings 16 Offensive manholes 3 Lack of water supply 10 Defective W.C's. 35 Defective roofs and gutters 27 Dampness 58 Dry rot 1 Defective stoves 1 Defective stairs and steps 2 Accumulation of rubbish 1 Defective dustbins 11 Unsound food 27 Nuisance from rats and mice 261 Nuisance from animals 2 Nuisance from smoke 5 Nuisance from vermin, ants, etc. 24 General Defects 214 Wasps Nests 6 Overcrowding 2 789 Prompt investigation was made and suitable action was taken to remedy the complaints. 22 FOOD INSPECTION. The following foodstuffs, found to be unfit for human consumption, were surrendered by the owners and either salvaged for animal food or destroyed. Articles Tons Cwts. Qrs. lbs. Chicken — — 2 6 Cheese — — 1 5 Confectionery (Flour) — — 1 22 Confectionery (Sugar) — — 1 6 Egg (Dried)' — — 2 0 Fats — — — 13 Fish (Wet and Dried) — 2 1 2 Fruit (Dried) — — 3 19 Fruit (Pulp) — — — 20 Meat — 4 0 11 Meat and Fish Pastes or Essences — — — 14 Rabbits — 1 1 27 Sausages — — 1 22 Tinned Goods (all classes) 1 12 1 2 Tripe — — 2 24 Other Foodstuffs — — 1 13 2 5 0 10 INSPECTIONS OF FOOD PREMISES. Inspection of Food Premises has been steadily maintained throughout the year, a total of 676 visits being made. As a result of such visits the following improvements have been carried out:— Cleansing, repair and redecoration 33 premises Additional Sanitary accommodation 5 Improvement of existing Sanitary accommodation 11 Hot Water supply installed 12 Washing (staff) facilities improved 8 Ventilation of rooms improved 9 Major alterations to Food preparing rooms 6 Drainage improvements 22 In one case it was necessary to serve Statutory Notice under the provisions of Section 13 of the Food and Drugs Act, 1938 for improvement of the premises. 23 Much time has been spent over the last few years in effecting improvement of premises which were below standard and it is pleasing to note that this work is nearing completion and that future inspection will be mainly to see that the standards acheived are maintained. BYELAWS AS TO THE HANDLING, WRAPPING AND DELIVERY OF FOOD AND SALE OF FOOD IN THE OPEN AIR. Byelaws for this purpose came into force on the 24th July, 1950 since when they have been very much in the minds of Inspectors when visiting food premises. Attention of proprietors has been drawn to infringements of the byelaws and advice and suggestions for improvements of methods given in many cases in an endeavour to help management and staff to acheive the byelaws standards.. Evidence of the value of this work is coming to the fore in many ways. Most particularly in the signs of greater care which is being taken to prevent contamination of displayed foods. Mobile Canteens and Ice-cream vehicles receive regular inspection to see they are observing the byelaws requirement. RICHMOND CLEAN FOOD TRADERS' GUILD. The Advisory Committee of the Guild held meetings throughout the year. In an effort to give further publicity a meeting was held in April to which all Food traders were invited. The evening's programme included the showing of suitable films, short talks by the Chairman and members of the Advisory Committee, the Medical Officer of Health and Chief Sanitary Inspector and a small exhibit of methods of Clean Food handling, etc. The response by Food traders was disappointing, few only, making further enquiries as to the objects and usefulness of the Guild. At the end of the year membership stood at 53 which while being increase of 20 over the previous year only a percentage of 13.98 for the whole district. 24 There are many premises in the district which are in excellent condition but the proprietors have not yet intimated they are willing to join the Guild. petroleum (consolidation) act 1928 and regulations made thereunder. 49 premises within the Borough are licensed to store a total of 68,583 gallons of Petrol, Petroleum Mixtures and Cellulose solutions and they have received regular inspection to ensure that the various regulations have been observed. In all a total of 94 visits were made to the various installations. Two new licenses were approved and the licence fees amounted to £34 10s. Od. Only minor infringements of the Regulations were found. DISINFECTION OF PREMISES. Reason. Houses. Rooms. Bedding, etc. Infectious Fevers 60 62 288 Tuberculosis 20 26 141 Vermin 18 27 11 Other Diseases 28 20 185 Costs recovered throughout the year £19 4s. 7d. Solutions of D.D.T. in Kerosene are used for dealing with infestations by bedbugs and are usually applied in spray form to the walls, ceilings and woodwork of the infested rooms. It is becoming a rare occurence to give more than one course of treatment to eradicate bedbugs. D.D.T. powders prove very effective in dealing with ants and cockroaches and much practical help and advice has been extended to householders who have found their premises infested with these pests. PREVENTION OF DAMAGE BY PESTS ACT, 1949. The rodent section of the staff have done much useful work during the year in eradicating rats and mice from premises and foul sewers. 25 A total of 3157 visits were made to Dwellings and Business premises throughout the year. 261 complaints of infestation by rats or mice were received from occupiers of premises, and inspection and investigation revealed rat infestation at 171 premises, and mice infestations at 45 premises. By the end of the year infestations had been cleared at 205 of these premises. Treatments of the foul sewers were carried out on two occasions, a total of 2135 visits being made for this purpose in connection with inspection, baiting, poisoning and checking of results. In all 607 manholes were dealt with and of this number 197 were found to be infested and were baited and poisoned. The takes of poison baits in the infested manholes were good and the results obtained at both sewer treatments were very satisfactory. smoke abatement. Richmond, being residential in character, has few large works or Factories and has little trouble with smoke nuisances from industrial chimneys. Five complaints of a minor character were received during the year and 26 observations for excess smoke were made. Interviews with managers and advice to stokers, in those cases where the complaints were justified, resulted in improved conditions. Rag flock and other filling materials act, 1951. This Act came into force on the 1st November, 1951 and briefly its provisions call for the registration of all premises in which Rag Flock or other filling materials, as defined in Section 33 of the Act (i.e.: Kapok; Woollenfelt; Cotton flock, etc.) are used, in the manufacture of bedding, toys, babycarriages and other articles of upholstery. A general survey of all premises, to which it was thought the Act would apply, was made but in only one case was registration necessary. The Act also calls for the licensing of premises where Rag Flock is (a) Manufactured; (b) Stored for distribution to registered premises but no premises coming within this definition are situated within the Borough. 26 SECTION D—HOUSING. Housing Statistics for the year 1951. 1. Number of dwellings owned by the Local Authority:— Number of Houses 1269 Number of Flats 297 Total 1566 2. Unfit Houses. (I) Inspection of Dwelling Houses during the Year:— (i) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 1042 (b) Number of inspections made for the purpose 2950 (ii) (a) Number of dwelling houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 4 (b) Number of re-inspections made under the Regulations 13 (iii) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil. (iv) Number of dwelling houses (exclusive of those referred to under the preceding subheading) found not to be in all respects reasonably fit for human habitation 366 (II) Remedy of Defects during the Year without service of formal notices:— Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their officers (including cases outstanding from the previous year) 327 27 (III). Action under Statutory Powers during the Year:— A. Proceedings under sections 9, 10, and 16 of the Housing Act, 1936:— (i) Number of dwelling houses in respect of which notices were served requiring repairs 4 (ii) Number of dwelling houses which were rendered fit after service of formal notices:— (a) By owners 2 (b) By Local Authority in default of owners 1 B. Proceedings under the Public Health Acts:— (i) Number of dwelling houses in respect of which notices were served, requiring defects to be remedied 63 (ii) Number of dwelling houses in which defects were remedied after service of formal notices:— (a) By owners 54 (b) By Local Authority in default of owners - C. Proceedings under sections 11 and 13 of the Housing Act, 1936:— (i) Number of dwelling houses in respect of which Demolition Orders were made Nil. (ii) Number of dwelling houses demolished in pursuance of Demolition Orders Nil. D. Proceedings under section 12 of the Housing Act. 1936:— (i) Number of separate tenements or underground rooms in respect of which Closing Orders were made Nil. (ii) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit 1 28 3. Overcrowding. Overcrowding is still considerable throughout the Borough. The points scheme of House allocation usually covers the worst of these cases and their overcrowded conditions are relieved as and when houses are available. 4. Council Houses. Total number of houses erected post-war to 31st December, 1951 Temporary bungalows 179 Permanent houses 286 Permanent flats 135 421 Total number included in above, erected in 1951 Permanent Houses Permanent Flats 44 37 Total number of requisitioned premises up to December 31st., 1951 122 (providing 241 family units) Total number of families rehoused in 1951 128 Total number of families still on Waiting list at December 31st., 1951 1695 At the present time there are 36 flats nearing completion on the Cedar Nursery Site, and work has already commenced on the Sandy Lane Site, which will ultimately provide 193 dwellings, including 16 flats for aged persons. As to the future, it is proposed to erect, on three separate sites, seventeen one-bedroom flats for aged persons. Moveable Dwellings. An owner of land within the Borough, holds a licence, renewable annually, permitting him to stand two caravans on the land. Satisfactory provision is made for the disposal of household refuse, use of sanitary conveniences and main water supply. Frequent inspections of this site were made during the year. 29 Withdrawal of Closing Orders. A closing order was made by the Richmond Borough Council, prohibiting the use of rooms over a garage for human habitation, on the 21/11/38. In early 1951 works of alteration, to this garage and the rooms over, were carried out and the rooms were incorporated within a new dwelling. The work carried out was substantial in character, made the rooms fit for habitation and enabled the Council to withdraw the Closing Order. Rent & Mortgage (Interest Restrictions) Act, 1920-1939. One application, for a certificate to enable the tenant of a dwelling house to suspend payment of the increase of rent on the grounds of the premises being not in a reasonable state of repair, was made. On inspection, the application was found to be justified and the Council agreed to the issue of the necessary certificate. 30 SECTION E—INSPECTION AND SUPERVISION OF FOOD. SALE OF FOOD AND DRUGS. Particulars of samples taken in the Borough of Richmond by Surrey County Council during the year ended 31st December, 1951. Analysed Adulterated or Irregular Prosecutions Convictions Articles Formal Informal Total Formal Informal Total FOOD: Milk 29 13 42 1 - 1 Blackcurrant Juice 1 1 Cherries glace 1 1 Cream 3 3 Fish Paste 1 1 Ground Almonds 1 1 Ground Rice 1 1 Ice Cream 5 7 1 1 2 1 1 Macaroni 1 1 Meat, cooked and prepared 1 1 Pepper 1 1 Sago 1 1 Salt iodised 1 1 Sausage meat 2 — Sausages 6 — Tapioca 1 1 Vinegar 1 1 Wine 1 1 DRUGS: Cough mixture 1 1 Totals 42 32 74 2 1 3 1 1 31 THE FOOD AND DRUGS (MILK AND DAIRIES) ACT, 1944. The above Act which amends the Food and Drugs Act, 1938 in relation to milk and dairies, came into operation on the 1st October, 1949. Various regulations were made under the Act and came into operation on the same date. The general effect was that all dairy farms became the direct responsibility of the Ministry of Agriculture and Fisheries. Premises in which milk is pasteurised or sterilised must be licenced by the Food and Drugs Authority, which in the case of Richmond is the Surrey County Council. In all other cases, Dairies or Dealers in Designated Milk are under the control of Richmond Council in respect of licencing, inspection and control. No. of licences granted authorising dealers to store and sell Designated Milk:— Pasteurised Milk 18 Tuberculin Tested Milk 19 Sterilised Milk 19 Supplementary licences were granted authorising dealers to retail milk in the Borough from premises situated outside as follows:— Pasteurised Milk 7 Tuberculin Tested Milk 7 Sterilised Milk 7 All premises in the district were inspected after receipt of the application for a licence and principal licences were verified with the appropriate Local Authorities. No licences were refused. Under the Regulations the Local Authority may continue to take samples from any dealer:— No. of samples of pasteurised milk taken 93 No. found to be satisfactory 92 No. of samples of raw milk examined biologically for tne presence of tubercle bacilli 5 No. of samples found satisfactory 5 The District Medical Officer of Health retains the power to take appropriate action to prevent the spread of disease by infected milk. 32 ICE CREAM. Premises manufacturing or storing or selling Ice Cream have been kept under supervision throughout the year; the total number of visits paid in this respect being 135. A total of 96 samples were submitted to the Bacteriologist for examination and of this number 71 fell within Grades I and II and were considered satisfactory and 25 fell within Grades III and IV and were considered to be unsatisfactory. It must be remembered that the greater number of samples are taken from premises which have been found to produce unsatisfactory samples in the past; whereas those dealers who invariably produce good results are only sampled occasionally. The figures given therefore do not give a true picture of conditions throughout the Borough Generally the standard is high and in all cases the Ice Cream (Heat Treatment) Regulations, 1947 are complied with in every respect. In all cases of unsatisfactory samples the premises were carefully inspected and methods of manufacture were investigated. The Manufacturers and retailers were found to be very co-operative in their efforts to improve conditions and were always willing to accept help and advice. 33 SECTION F—PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. (Civilians only). Diseases. Total Cases Notified. Cases Admitted to Hospitals. Total Deaths. Scarlet Fever 87 40 ... Puerperal Pyrexia 3 2 ... Pneumonia 5 ... 22 Erysipelas 9 3 ... Measles 546 10 ... Whooping Cough 112 5 ... Poliomyelitis Paralytic 1 1 ... Poliomyelitis Non Paratytic 1 1 ... Polioencephalitis ... ... ... Cerebro Spinal Meningitis ... ... ... Smallpox ... ... ... Dysentery 9 5 ... Total 773 67 22 During the year 113 cases of suspected infectious disease were admitted to hospital. Of these 86 were accommodated in the South Middlesex Fever Hospital. This is a higher proportion than was reported for the previous year and I consider that this Borough is fortunate in retaining the facilities of this excellent hospital. The remaining 27 cases for whom beds were not available in the South Middlesex Hospital were admitted to Tolworth Isolation Hospital or to Isolation Hospitals in the L.C.C. area. laboratory work General practitioners send specimens for examination to the laboratory of the Royal Hospital, Richmond. In addition the following laboratory facilities are available to the Public Health Department:— CENTRAL PUBLIC HEALTH LABORATORY, COLINDALE AVENUE, N.W.9. For advice, special immunising agents and special investigations. MINISTRY OF HEALTH, PUBLIC HEALTH LABORATORY, EPSOM. 34 For examination of samples of milk, ice cream and water and for advice and field investigations in cases of epidemics. THE COUNTIES PUBLIC HEALTH LABORATORIES, 66, VICTORIA STREET, S.W.1. For examination of water samples and advice on the control of water supply. FOOD POISONING. Total number of outbreaks Nil. Number of cases notified 9 Number of deaths Nil. In 3 cases the organism responsible was found to be Salmonella Typhimurium. In the remaining cases no specific organisms or other agents were isolated. Various foods were suspected of having caused these infections but in no case was it possible to prove this bacteriologically. In some cases none of the suspected food was available for examination and in others specific organisms were not isolated. There is little doubt that faulty storage of the remains of unused meat, made-up dishes, etc., caused the majority of the non-specific cases. diphtheria immunisation. Number of children immunised for the first time during the year 1951:— (a) Pre-school children (under 5 years) 384 (b) Between 5 and 15 years 219 Total 603 Grand Total of Children in the Borough who have received immunising treatment by the end of the year:— (a) Under 5 years 2262 (b) Between 5 and 15 years 4178 Number of Children given re-inforcing doses during 1951 1019 35 At the 31st December the percentages of children who had been immunised were as follows:— (a) Under 5 years 67.6% (b) Between 5 and 15 years 95.2% From these figures it will be seen that the Diphtheria Immunisation Scheme has been actively conducted during the year. The number of children immunised for the first time was 603 compared with 801 in 1950. In addition the policy of giving single-reinforcing doses at appropriate intervals during a child's school life has been continued. . The materials used are, for children under 10, Alum Precepitated Toxoid and for children over 10 Toxoid Anti-Toxin Floccules. T.A.F. is used for all reinforcing doses and is given subcutaneously. vaccination against smallpox. 1. Welfare Centres. Number of Vaccination sessions held at Welfare Centres in the Borough during 1951 and number of vaccinations carried out at these sessions was as follows:— No. Vaccinated. No. of Sessions. Children. Adults. Windham Road, Richmond 51 286 33 Back Lane, Ham. 21 61 — Totals 347 33 Grand Total 380 2. Private Doctors. Number of Richmond residents who were vaccinated by private doctors was as follows:— Children. Adults. Totals 182 253 Grand Total 435 36 3. Analysis of vaccinations at Welfare Centres and Private Doctors Surgeries. Children. Adults. Primary Vaccination 468 69 Re-vaccination 61 217 Totals 529 286 Grand Total 815 4. Figures showing the percentage of children under 1 year vaccinated during 1951. No. Vaccinated. Net Births 1950. % Vaccinated. 391 612 63.9 These figures cannot be considered really satisfactory since nothing less than 100% vaccination of the babies is required to impart a really useful protection to the community. However, the figure is considerably higher than in most other parts of the country and has increased compared to previous years. VERMINOUS CONDITIONS. YEAR 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 Scabies 34 128 241 431 274 377 66 12 11 7 2 Head Lice 204 205 181 188 308 239 78 141 129 98 Figures in the above table are school children treated for verminous conditions at the School Clinic, Windham Road and Back Lane, Ham. The incidence of scabies is now at a very low level and is no longer a problem in the district. The 98 cases of louse infestation are school children who are well known to the School Nurses. They are cleansed under supervision and parents are given full instructions on how to prevent a recurrence. However, this advice is frequently 37 disregarded and the children are found re-infested, particularly after the school holidays. Inspections in the schools are regularly carried out and materials used for the treatment are efficient. In spite of this I fear that it will be a long time before the incidence falls much below the present level. 38 TUBERCULOSIS. The position in Richmond for the year 1951 may be summarised as follows:— NOTIFICATIONS: Respiratory Tuberculosis. Sixty-one cases of respiratory tuberculosis were notified, viz:— 29 males and 32 females. The corresponding figure for 1950 was 42. Non-Respiratory Tuberculosis. Seven new cases of non-respiratory tuberculosis were notified during the year and there were two deaths from this cause. Seven such cases have been notified during 1950. TUBERCULOSIS REGISTER. After all additions and deletions had been taken into account, the number of cases of tuberculosis remaining upon the Register at the close of the year was as under:— Pulmonary. NonPulmonary. Males 171 22 Females 119 21 Total 290 43 Corresponding figures for 1950 305 45 PREVENTION OF TUBERCULOSIS. Under the Public Health (Prevention of Tuberculosis) Regulations 1925, powers are given to prohibit any person suffering from respiratory tuberculosis from entering upon employment involving the handling of milk. Under the Public Health Act 1936 (Section 172) powers are given to cause the removal and detention of any tubercular patient 39 where proper precautions are not being taken and the circumstances are such as could constitute a danger to others. During the year 1951 it was not found necessary to take action under either of the above enactments. TUBERCULOSIS. New Cases Deaths Age Periods Respiratory NonRespiratory Respiratory NonRespiratory M F M F M F M F 0 ... ... ... ... ... ... ... ... 1 ... ... 1 1 ... ... ... ... 5 2 3 2 ... ... ... ... ... 15 3 8 1 ... ... ... ... 25 7 11 2 ... 2 1 1 ... 35 8 3 ... ... 2 2 ... ... 45 4 6 ... ... 2 ... ... ... 55 1 ... ... ... 4 ... ... ... 65 and upwards 4 1 ... ... 3 2 1 ... Totals 29 32 6 2 13 5 2 ... AFTER CARE. The Barnes and Richmond Tuberculosis Care Committee continued to play a most important part in the Surrey County Council Scheme for the "care and after-care" of tuberculous patients. The aim of the Committee is to supplement official help for the Patient and his family, according to his individual needs, and so lessen 1 e anxieties which hinder recovery.