4413 (1) Library RICH 31 ??? BOROUGH OF RICHMOND (SURREY) ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH 1962 borough of richmond (SURREY) ANNUAL REPORT OF THE medical officer of health 1962 J. H. BROAD & Co. Ltd., Printers, 8, King Street, Richmond, Surrey 3 STAFF OF THE PUBLIC HEALTH DEPARTMENT. Medical Officer of Health: ERIC PEREIRA, M.B., B.S., D.P.H. Deputy Medical Officer of Health: C. J. RADWAY, M.A., B.M., B.Ch., D.P.H. Chief Public Health Inspector: EDWARD S. HERBERT, M.A.P.H.I. Senior Additional Public Health Inspector: HENRY DOUGLAS WILLIAMS, M.A.P.H.I. Additional Public Health Inspectors: JOHN WILLIAM REAVLEY, M.A.P.H.I., A.R.S.H. JOHN B. FACER. (Left: 17.6.62). ROGER WALTER SHEPPARD, M.A.P.H.I., A.R.S.H. (Commenced: 3.9.62). Technical Assistant: WILLIAM J. HAUTING. Chief Clerk: MRS. FLORENCE G. SMITH. Clerks: MISS MARGARET M. DENNEHY. MISS EILEEN M. LANE. Rodent Officer: THOMAS R. SMITH. Rodent Operator: RONALD EVANS. Disinfector and Driver: JOHN BENNETT. ALBERT CLEGG. (Left: 22.6.62). (Commenced: 23.7.62). 4 Public Health Department, Municipal Offices, Parkshot, Richmond. July, 1963. To the Mayor, Aldermen and Councillors of The Borough of Richmond (Surrey). Mr. Mayor, Ladies and Gentlemen, I have the honour to present the Annual Report of the Medical Officer of Health for the year 1962 upon the Sanitary Circumstances, Sanitary Administration and Vital Statistics of the Borough. The form of the Report is in accordance with the instructions of the Minister of Health, and special reference is made to certain subjects at the Minister's request. Apart from the outbreak of mild dysentery at two primary schools, the incidence of notifiable infectious diseases has been very low during the year, and the small number of admissions to infectious disease hospitals is noteworthy. I am indebted to Mr. E. S. Herbert, Chief Public Health Inspector, for his report on the sanitary circumstances of the area, and to Miss E. Lane for compiling the tables of Vital Statistics and preparing the report for the printers. I wish to express my thanks to all members of the Council for their support throughout the year, and to record my gratitude to every member of the staff of the Public Health Department for their loyalty and co-operation. I am, Ladies and Gentlemen, Your obedient Servant, ERIC PEREIRA, Medical Officer of Health. 5 BOROUGH OF RICHMOND (SURREY). PREFACE. SECTION A. —SUMMARY OF STATISTICS AND SOCIAL CONDITIONS. Staff. Mr. J. B. Facer, District Public Health Inspector, resigned his appointment in June, 1962 and was replaced by Mr. R. W. Sheppard in September. Population. The Registrar General's estimate of the population was 40,680. This may be compared with his estimate of 40,700 for the previous year and the Census 1961 figure of 41,002. Births. During the year 640 births were recorded (345 males and 295 females) compared with 670 in 1961. There were 37 premature live births and of these, 34 survived. Deaths. The total number of deaths occurring amongst residents was 607 (273 males, and 334 females) compared with 626 in 1961. The death rate when corrected to allow for the high proportion of elderly residents is 10.4 per thousand population which compares favourably with other towns in the country. The Infant Mortality, Neo-natal Mortality and Still birth rates, we at a very low level; and although the number of illegitimate births rose to 54 there was not a single death. There were only 4 infant deaths and of these one was due to a birth accident and the other three to prematurity. It is interesting to note that nearly 29% of the births took place at home compared with 25% in previous years. 6 SECTION B.—GENERAL PROVISION OF HEALTH SERVICES IN THE AREA. These are mainly provided by the Surrey County Council, the South West Metropolitan Regional Hospital Board, and the Executive Council for the County. In order to make the report complete these are briefly described below. (a) Services Provided by the Surrey County Council. These are organized on a Divisional basis, the Northern Division comprising the Boroughs of Richmond and Barnes. The Medical Officer of Health for Richmond is also the Divisional Medical Officer and this arrangement assists co-ordination of the personal health services and environmental health. Administrative, Infant Welfare, and School Medical functions are carried out from the following Centres:— Divisional Health Offices and Welfare Centre, Kings Road, Richmond. Welfare Centre, Windham Road, Richmond. Welfare Centre, Back Lane, Ham. Health Visitors are employed and, according to the District in which they work they are based at one or other of the above centres. District Nurses and Midwives are provided and they work under the direct supervision of the general practitioners. Moral Welfare or the care of unmarried mothers and illegitimate children is undertaken by an officer based at the Divisional Health Office. A Home Help Service provides for domestic help in the home in cases of home confinement or illness. The service is under the management of the Home Help Supervisor who is based at the Divisional Health Office. An Ambulance Service is provided from the station in Kings Road, Richmond which operates under the control station in Maiden. The service is supported by the ambulance of the local division of the St. John Ambulance Brigade. A Day Nursery for the care of children up to the age of five years is located in Parkshot, Richmond. 7 (b) Services Provided by the Regional Hospital Board. Hospitals. The Royal Hospital and Kingston Hospital provide general treatment both for in-patients and out-patients. In addition, hospitals in London and Middlesex are frequently used by Richmond residents. Patients suffering from infectious diseases are admitted to the South Middlesex Hospital, Mogden Lane, except in the few instances when no beds are available. In these cases, patients are admitted to Tolworth Isolation Hospital or to a hospital in the London area. Psychiatric Services. The Medical Staff of Banstead Hospital hold Out-patient Clinics on Tuesday and Friday afternoons at the Royal Hospital for patients living in Richmond and Barnes. Laboratory Facilities. The laboratory of the Royal Hospital is available for the examination of specimens sent in by general practitioners. The Ministry of Health, Public Health Laboratory, Epsom, is available for the examination of samples of milk, ice-cream, and water and of any pathological specimens. In addition, the staff is always available to assist the Medical Officer of Health in field investigations in the case of epidemics or outbreaks of food poisoning. The Central Public Health Laboratory, Colindale, N.W.9, is available for advice, special immunising agents and special investigations. The Counties Public Health Laboratories, Victoria Street, S.W.I are used for the examination of water samples and for advice in the control of purity of the water supply. Mortuary. This is provided and maintained by Richmond Borough Council on a site close to the Petty Sessions Court. It is well equipped with two post-mortem examination tables. All such examinations required within the boroughs of Richmond and Barnes are carried out here and Barnes Borough Council make an annual payment for this service. 8 Nursing Homes. The following private Nursing Home is registered by the Surrey County Council:— Tyneham House Nursing Home, 108, Church Road. (c) Services Provided by the Surrey Executive Council. Under Part IV of the National Health Service Act, 1946, the Surrey Executive Council has the responsibility of providing General Medical and Dental Services, Pharmaceutical Services, and Supplementary Ophthalmic Services. More than twenty doctors living within the Borough have undertaken to provide General Medical Services. Many of these have also undertaken to provide Maternity Medical Services. A list of doctors taking part is available at the Main Post Office, Public Library and Public Health Department. The offices of the Council are situated at 187, Ewell Road, Surbiton Care of the Aged and the Chronic Sick. The local scheme for the care of the aged and the chronic sick is largely unchanged. The general Health Visitors continue to supervise those who are frail or in need of assistance while the geriatric Health Visitor supervises those who are on the Waiting List for admission to hospital. Other than in times of epidemic the waiting period for admission to a hospital or a home is not unduly long, and a desperate case is invariably admitted without delay. The Home Helps and District Nurses continue to play an important part in the care of elderly patients in their homes and the voluntary services do most valuable work by such services as "Meals on Wheels", Old Peoples' Clubs, etc. Laundry Service. A laundry service for incontinent patients is provided which considerably reduces the burden on relatives and makes it possible for them to nurse at home a patient who would otherwise have to be admitted to hospital. The service is confined exclusively to incontinent patients and articles laundered are limited to sheets and draw sheets. This Service is provided twice weekly throughout the year. Soiled sheets are collected on Tuesdays and Fridays and at the same time 9 an appropriate number of laundered sheets is delivered to the house. A charge of sixpence per sheet is made which is covered by a supplementary allowance for those in receipt of National Assistance. The charge has not been known to cause hardship. The service continues to be of great benefit to those who use it, and similar arrangements are now being made in other parts of Surrey. Number of new patients 42 Admitted to hospital 14 Died 17 Service discontinued 7 Number of patients using Service at 31.12.62 8 Number of sheets laundered and issued 1,797 NATIONAL ASSISTANCE ACT, 1948—SECTION 47. In many cases old people create their own difficulties by refusing to leave their homes when they can only be properly cared for in hospital or other suitable accommodation. A satisfactory solution is generally arrived at without resort to compulsion. Under the National Assistance Act, 1948 and the Amendment Act, 1951 the Medical Officer of Health can apply to the Court or to a Magistrate for a compulsory Removal Order which has the effect of placing and detaining the patient in hospital or home. An old man living in a Council flat had been under supervision for a considerable period. He was provided with the services of a Home Help but in spite of this he neglected himself and had to be cleansed on a number of occasions by a relative or the District Nurse. There is no doubt that he would have been better cared for in a Home for Old People, but he refused this with such vehemence that it was decided to let him remain in his own home for as long as possible. In January his health began to deteriorate rapidly, and since he now refused to agree to admission to hospital, application was made to a Magistrate and a Removal Order was granted under the National Assistance (Amendment) Act, 1951. This old man was removed to hospital where he settled quite happily, hut died some weeks later. 10 SECTION F.—PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. (Civilians only). NOTIFIABLE DISEASES. The table in Section F sets out the number of cases of infectious diseases notified during 1962. Measles. Following the epidemic of the previous year, only 55 cases were notified. Of these only two were severe enough to require admission to hospital. Dysentery. In the autumn an outbreak of mild dysentery due to Shigella sonnei occurred at the Vineyard Infants School and later at St. Elizabeth's R.C. Primary School. Both of these outbreaks were complicated by the simultaneous occurrence of cases of "winter vomiting" which is an illness of sudden onset and short duration presumed to be due to an unidentified virus. A great deal of the time of the Health Inspectors was taken up in attempting to control these outbreaks. Cases, and close contacts of primary school age and under were excluded from school; contacts of secondary school age were allowed to continue. It is interesting that only two primary schools were affected in this way. One school is quite modern with excellent sanitary facilities, the other had its sanitary facilities modernized only a few years ago. Although a few cases occurred at some of the secondary schools, there was no spread of the disease. It is pleasing to note that although three cases occurred at the Parkshot Day Nursery, the vigilance of the staff prevented any transmission to the other babies and young children attending. Paratyphoid Fever. A woman aged 24 was infected with Salmonella paratyphi B. She had travelled to various parts of the country and it was not possible to trace the source of infection. Five close contacts were investigated but all were negative and no further cases occurred. 11 Food Poisoning. Only two isolated cases were notified. One was due to Salmonella nashua and was contracted in Greece; the other was due to Salmonella typhimurium and the source of this infection was not ascertained. IMMUNIZATION. The Schemes for immunizing children against diphtheria, whooping cough, tetanus, and poliomyelitis continued as in previous years, and the response from parents was very good indeed. Reference to Section F will show how these schemes are progressing. Smallpox. By January a number of confirmed cases of smallpox had been imported from Pakistan and this led to a considerably increased demand for vaccination and re-vaccination. All travellers to the Continent of Europe were required to have an Internationtal Certificate showing recent vaccination and special facilities were provided to cover the need. Since that time the Minister of Health has advised that primary vaccination in infancy is a valuable protective measure, but that the safest time for that to be done is in the second year of life. This policy has since been adopted. Poliomyelitis. During the year Oral vaccine became available which had been manufactured and tested in this country. It has since almost completely replaced the Salk-type vaccine which is given by injection. It is readily accepted by infants and children and the great majority of parents have complete confidence in its safety and efficacy. It has the advantage of causing no unpleasant reactions and it gives some protection so rapidly that it is a useful preventive procedure to give a single dose to all contacts of a case of the disease. Tetanus. It has become routine now for all infants to be protected by a "Triple" Antigen which gives protection against Diphtheria, whooping Cough and Tetanus. In addition, parents of older children readily accepting immunization against tetanus. The chief 12 age is that if an immunized child suffers an injury that could lead to tetanus infection, it is sufficient to give a booster dose of tetanus antigen instead of anti-tetanic serum which, at times, causes dangerous reactions. Tuberculosis. As in previous years all children aged 13 years were offered B.C.G. vaccination. The object is to provide artificial immunity to the disease during the adolescent period when children are susceptible and can be seriously affected. During 1962 a total of 474 boys and girls were inoculated with B.C.G. Mass Radiography Service. The Regional Hospital Board set up a Mobile X-Ray Unit at the Bus Station behind the Odeon Cinema on every Thursday from 5.30 to 6.30 p.m. The Unit is primarily for the conveniece of the local general practitioners who can refer their patients without any prior appointment, and who receive a written report within two or three days of the examination. The service is much appreciated by the doctors, and is also a convenience to the patients who are saved both travelling and waiting time. Prospective employees of the Council who are unable to provide proof of recent chest X-Ray are referred, and the reports are of considerable assistance in enabling a decision to be made as to whether or not they are suitable for inclusion in the Superannuation or Sick Pay Schemes. The Unit is also available for use by the general public. 13 THE REPORT OF THE CHIEF PUBLIC HEALTH INSPECTOR, Mr. E. S. HERBERT, IS CONTAINED IN THE FOLLOWING SECTIONS C, D and E. SECTION C.—SANITARY CIRCUMSTANCES OF THE AREA. 1. Water Supply. The drinking water supply in Richmond is served partly from local wells and partly from the Metropolitan Water Board, and the origin, purity and treatment of these supplies has been fully reported in the past. Water from the five local wells is pumped to the low level reservoir at Petersham Pumping Station, and thence to the high level reservoir in Richmond Park; from here it is distributed by gravity to a proportion of the residents and, in particular, to those living in and around Richmond Hill. Formerly the water was treated only by chlorination, but during 1962 apparatus was installed to enable treatment by "superchlorination and dechlorination" to be carried out. The advantage of this process is that a dose of chlorine large enough to deal with any possible conlamination can be added to the water at its entry to the Petersham Reservoir and, after a suitable contact period excess chlorine is destroyed by the addition of an appropriate amount of sulphur dioxide. This procedure gives an even greater measure of safety, and in addition, by preventing fluctuations in the level of residual chlorine reduces to a minimum the chances of the water tasting unpleasant. During the year a connection was made with the Metropolitan Water Board's mains so that, in an emergency, the Board's water can replace entirely the supply from the local wells. Frequent sampling ensures that the purity of the water supply is maintained, and throughout the year the sample results have shown a high standard of bacteriological and chemical fitness. The drinking water supplies in the district are not plumb-solvent and every dwelling house in the Borough has a piped supply of water fit for human consumption. The determination of radioactivity in the well water supplies of the Borough was first carried out in 1959 when samples from each of the five wells proved to be satisfactory. The examination has been 14 repeated annually and further samples were taken in the past year which continued to show entirely satisfactory results. A river water supply is piped to Kew Gardens, allotments and to many domestic gardens; the water is chlorinated as a precautionary measure but it is not fit for drinking. Table 17 gives information on the consumption of water in the Borough and on the samples taken. 2. Swimming Pools. There is only one public swimming pool in the Borough which is the public baths establishment owned by the Council. The pool is 100 feet by 32 feet with a capacity of 96,000 gallons, the water supply being from local wells and the Metropolitan Water Board. The water is filtered by Candy pressure filters, giving a turnover of approximately six hours, and sterilization is achieved by chlorine gas treatment. Daily recordings are made of available and residual chlorine in the water, the pH value, and the shallow and deep-end temperatures. In addition, bacteriological samples of the water are taken each month, and all during the year, have proved satisfactory. 3. Sewerage and Sewage Disposal. The Borough is sewered on a partially separate system, with the drainage from roads discharging directly into the river through surface water sewers. The soil sewers drain to the purification works of the Richmond Main Sewerage Board, which receives sewage from the Boroughs of Richmond and Barnes. The works are adequate for the area, and all sewage arrives there by gravity, the sewage from Ham being pumped through a rising main to join the main flow at Buccleuch Gardens. 4. Public Health Inspections. The wide range of public health inspections is shown in Table 18 and once again it proved possible during the year to increase the number of visits to food premises. The occurrence of a Sonne dysentery outbreak added considerably to the number of infectious disease enquiries. The number of complaints received in 1962 (Table 20) shows a marked decrease of 97 compared with 1961. Fewer complaints were made about rats and mice and there were fewer complaints about housing defects. It is interesting to note that, for the first time, a 15 significant number of complaints were received about noise, and undoubtedly the number will rise in the years ahead as public opinion reacts to this social evil. Every effort is made to ensure that each complaint is investigated within twenty-four hours of its receipt. Table 19 indicates the number of informal and statutory notices served for the repair of premises and the abatement of nuisances; in two instances legal proceedings were taken against owners of dwelling-houses for failure to carry out repairs. In one case the owner was fined £5 (and one guinea costs) at the first hearing for failing to comply with a Nuisance Order made under the Public Health Act, 1936, and at a second hearing the Court imposed a daily fine of £1 for the sixty days in which the Order had been outstanding. The imposition of the fine of £60 was quickly followed by the completion of the works of repair which the Court had required. In the second case, an owner was fined £4 for failing to carry out drainage repairs. 5. Disinfection and Disinfestation. There has been no increase in the treatment of premises after cases of infectious disease or of bed-bug infestation. The fumigation of clothing before being sent abroad is carried out to assist members of the public to satisfy Post Office regulations, and a small charge is made for the treatment. A summary of the work done is contained in Table 21. 6. Atmospheric Pollution. (a) Smoke Control Areas. The third Smoke Control Order covering approximately 382 acres in the Petersham and Richmond Hill area was confirmed by the Minister of Housing and Local Government on 25th January, 1962, and came into operation on 1st October, 1962. Included in this area are 1,663 private dwellings, 214 Council houses and 112 other premises. The fourth Smoke Control Order was made by the Council on 17th July, 1962 and was confirmed on 15th October, 1962. This order covers an area of 122 acres, extending north from The Vineyard to Twickenham Road and includes 1,035 private dwellings, 33 Council houses and 485 other properties. The Order is expected to come into operation on 1st October, 1963. (b) Complaints of Smoke Emission. The number of complaints received has remained low and they have referred to bonfires in 16 gardens and on building sites rather than to industrial chimneys. The few complaints made of smoke emission from factory chimneys were properly investigated and the advice given generally resulted in the desired improvement. No legal proceedings were taken in the year for any contravention of the Clean Air Act. 7. Diseases of Animals Act, 1950. Outbreaks of foot and mouth disease were much lower in the country in 1962 when only 5 outbreaks were confirmed (compared to 103 in the previous year). Richmond was not included in an infected area and no case of the disease occurred in the Borough. 8. Petroleum Spirit Storage. Forty-seven premises are licensed to store petrol and petroleum mixtures totalling 85,940 gallons. The licence conditions provide that storage tanks be tested in the 20th, 25th and 30th year after installation and thereafter in every second year. Thirty-five tanks were tested and found satisfactory. During the year petroleum spirit storage was discontinued at three premises and petroleum mixtures storage at one premises. New licences were granted for the storage of petroleum mixtures at two premises. 9. Caravan Sites. The Caravan Sites and Control of Development Act, 1960 came into operation during the year. The Act gives local authorities effective powers for controlling sites so that they may be properly equipped and conducted and permitted only in acceptable places. There is, in the Borough, only one licensed site which accommodates three caravans. 10. Shops Act, 1950. A number of enquiries are dealt with each year about general closing hours and Sunday trading and the advice given is usually acted upon with confidence. The co-operation of shopkeepers in dealing with the complexities of the Act has never been lacking, and for this reason it is regrettable to report that legal proceedings were necessary in one case last year for persistent contraventions of the Sunday trading law. Fines amounting to £23 with five guineas' costs were inmposed. 17 SECTION D.—HOUSING. 1. Unfit Houses. The demolition of unfit houses in Garden Road was completed early in the year, and in June the Council made a Clearance Order in respect of Nos. 4-10 (consecutive) Wellington Place. One Closing Order made in 1937 was determined in respect of a basement dwelling (45, Queen's Road) and undertakings to carry out repairs at two basement dwellings (31, Evelyn Road and 84, Church Road) were accepted and the premises were made fit for human habitation. An undertaking as to repairs was also accepted in the case of a house (7, Kew Foot Road), and the necessary works were in progress at the end of the year. 2. Council Houses. Number of dwellings owned by the Local Authority as at 31st December, 1962: Number of houses 1,398 Number of flats 641 Total 2,039 Total number of houses erected post-war, 31st December, 1962 Temporary bungalows 179 Permanent Houses 498 Permanent Flats 468 966 1,145 Since 1956 a total of 78 prefabricated bungalows have been demolished and one taken over for use as a dental clinic by the Surrey County Council 79 Total 1,066 Housing Waiting List. Total number of families on Waiting List as at 31st Dec., 1962 541 Applications from Aged Persons as at 31st Dec., 1962 291 Total number of families rehoused in 1962 17 Miscellaneous allocations 12 29 18 Building Schemes. By December, 1962, 13 one-bedroomed bungalows in Thompson Avenue, known as "The Haven" were occupied. Current Building Programme. The redevelopment of the Ham Close site (192 dwellings) is now in progress and when completed will comprise: 48 Bed-sittingrooms. 60 One Bedroomed flats. 63 Two Bedroomed flats. 21 Three Bedroomed flats. 192 Total. SECTION E.—INSPECTION AND SUPERVISION OF FOOD. 1. Unsound Food Complaints. Twenty-three complaints alleging that food had been sold to the dissatisfaction of the customer were received during the year. The investigations which followed showed that in nearly half the cases the complaint referred to mould growths or souring due to the failure of the food trader to turn over stock in a proper manner. There is growing evidence of the advantage to the retailer if a system of visualaid coding is adopted for deliveries of prepacked perishable goods; the retailer can then easily determine the date of delivery and is in no doubt as to the day when the "shelf-life" of the article has expired, so that such foods can be withdrawn from sale and destroyed. Two of the complaints resulted in legal proceedings being taken against the retailers and in each case a fine of £20 with two guineas' costs was imposed. 2. Food Premises. There has been an improving standard of hygiene in food shops in the Borough over a number of years, and in many premises now the proprietor is choosing to reconstruct and re-equip food rooms rather than patch and repair them as was the practice in the immediate post-war years. 19 Table 29 shows the broad headings under which food premises were improved in the past year. In general, excellent co-operation has been maintained with proprietors of food businesses, and in only two cases were legal proceedings necessary where premises failed to conform to the standards laid down in the Food Hygiene (General) Regulations, 1960. In one case fines totalling £175 with 35 guineas' costs were imposed against a butcher and in the second case a fine of £6 with three guineas' costs was imposed against a greengrocer. Proceedings were also taken against two employees in the same greengrocer's shop for smoking when handling open food and each was fined £1 with two guineas' costs. 3. Food Sampling. One hundred and tewnty-six samples were procured during the year of which 21 were shown to be irregular. The Public Analyst (D. D. Moir, Esq., M.Sc., F.R.I.C.) has at all times given most helpful advice and his continued interest has contributed in great measure to the usefulness of this branch of public health work. As in past years most of the irregular samples failed to satisfy the Labelling of Food Order either in the description of the product or in the list of ingredients, but in all cases it proved possible to reach agreement with the manufacturers or importers to remedy the irregularity revealed by sampling. Ice-Cream. There is only one ice-cream manufacturer in the Borough; the process involves the heat-treatment of the product to a temperature of not less than 160°F for 10 minutes, and not the high-temperatureshort-time method (175°F for 15 seconds), which is also permitted by the Ice-Cream (Heat Treatment) Regulations. One hundred and twenty premises are registered for the sale and storage of ice-cream, and during the year 44 samples were submitted to the Public Health Laboratory for examination, of which 42 were satisfactory (Grades I and II) and 2 were unsatisfactory (Grades III and IV). Unsatisfactory samples received thorough investigation, and in both instances there was evidence that the low grading was due to a failure to keep sterile the water in which the server was kept. The proprietors, in each case, were advised on the use of sterilising agents and subsequent samples proved satisfactory. 20 5. Other Foods. Twenty-two other samples were examined bacteriologically; these samples included meat products, ice cream server waters, frozen egg, parsley and swabs from the surface of food tables. One sample of ice-cream server water proved to be unsatisfactory and after suitable advice had been given the results showed a very satisfactory standard. 6. Milk—Licensing and Sampling. Under the provisions of the Food and Drugs Act, 1955, and Regulations made thereunder, Dairy Farms have become the direct responsibility of the Ministry of Agriculture and Fisheries; the premises on which milk is pasteurised or sterilised are licensed by the Food and Drugs Authority and in all other cases, Dairies or Dealers in Designated milk come under the complete control of the Local Authority in respect of licensing, inspection and control. There is one dairy farm within the Borough under the control of the Ministry. Details of sampling are included in Table 30. BOROUGH OF RICHMOND (SURREY) APPENDIX TO THE ANNUAL REPORT OF THE medical officer of health 1962 25 Table i. statistical summary —1962. SECTION a. — summary of statistics and social conditions. Area in acres 4,234 Population (Census 1961) 41,002 Population (Estimated 1962) 40,680 Number of inhabited houses (estimated) at 1.4.63 12,500 Rateable value at 1.4.63 £2,550,291 Sum represented by a Penny Rate, 1963/64 £10,147 BIRTHS. Birth Rate per 1,000 of estimated resident population . 15.7 (Corrected) . 14.9 Total number of births (live and still) 640 Analysis:— M f Total Live Births Legitimate 311 266 577 Illegitimate 28 26 54 Still Births Legitimate 6 3 9 Illegitimate - - - Still Birth Rate per 1,000 total births 14.1 Environment of Births:— Proportion taking place in Institutions (428) 71.10 Proportion taking place in dwelling houses (174) 28.90 DEATHS. Total number of deaths from all causes 607 Death rate per thousand estimated resident population 14.9 (Corrected) 10.4 The principal causes of deaths:— Malignant Neoplasms 107 Heart disease 197 302 Vascular lesions of Nervous System 66 Other circulatory diseases 39 Pneumonia 41 84 Bronchitis 39 Other respiratory diseases 4 Malignant Neoplasms were responsible for 107 deaths or 17.6% of total deaths. 26 Diseases of the Heart and Circulation caused 302 deaths or 49.7% of total deaths. Diseases of the Respiratory System caused 84 deaths or 13.8% of total deaths. TABLE 2. — ANALYSIS OF DEATHS RELATING TO RICHMOND FOR THE YEAR 1962. Causes of Deaths. Male. Female. Total. Tuberculosis, respiratory 1 - 1 Tuberculosis, other 1 - 1 Syphilitic Disease 1 - 1 Meningococcal Infections - - - Measles - — - Malignant neoplasm, stomach 6 4 10 Malignant neoplasm, lung bronchus 17 4 21 Malignant neoplasm, breast - 15 15 Malignant neoplasm, uterus — 8 8 Other malignant and lymphatic neoplasms 27 26 53 Leukaemia, Aleukaemia 2 2 4 Diabetes 1 3 4 Vascular lesions of nervous system 29 37 66 Coronary disease, angina 72 47 119 Hypertension with heart disease 2 2 4 Other heart disease 19 55 74 Other circulatory diseases 14 25 39 Influenza 1 1 2 Pneumonia 12 29 41 Bronchitis 26 13 39 Other diseases of respiratory system 3 1 4 Ulcer of stomach and duodenum 2 3 5 Gastritis, enteritis and diarrhoea - 1 1 Nephritis and nephrosis - 2 2 Hyperplasia of prostate 2 - 2 Congenital malformations — - - Other defined and ill defined diseases 18 40 58 Motor vehicle accidents 5 2 7 All other accidents 6 12 18 Suicide 6 2 8 273 334 607 TABLE 3. MATERNAL MORTALITY — 1962. The provisional numbers of deaths and death rates per 1,000 total live and still births are:— England and Wales. Number Rate Maternal causes, excluding abortion 243 0.28 Due to abortion 57 0.07 Total maternal mortality 300 0.35 27 Richmond. Maternal causes, excluding abortion Nil Due to abortion Nil Total maternal mortality Nil TABLE 4. INFANT MORTALITY. (Deaths under one year of Age). Infant Mortality Rate for all infants per 1,000 live births 6.3 Rate for legitimate infants per 1,000 legitimate live births 6.9 Rate for illegitimate infants per 1,000 illegitimate live births Nil Total number of infant deaths in the Borough 4 Analysis:— M F Total Legitimate 2 2 4 Illegitimate - - - Environment of Infant Deaths:— Number occurring in the Borough 1 Number occurring outside the Borough 3 Number occurring in Institutions 3 Causes of Death under 1 year of age. Cause of Death Under 1 week 1-2 weeks 2-3 weeks 3-4 weeks over 4 weeks Total 1. Birth Accident 1 - - - - 1 2. Prematurity 3 - — — — 3 4 - — — — 4 Neonatal Mortality Rate: (Deaths under 4 weeks per 1,000 total live births) 6.3 Early Neo-natal Mortality Rate: (Deaths under 1 week per 1,000 total live births) 6.3 Perinatal Mortality Rate: (Stillbirths and deaths under 1 week combined per 1,000 total live and stillbirths) 20.3 18 TABLE 5. ILLEGITIMATE BIRTHS. 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 No. of illegitimate births 34 33 31 40 30 40 36 46 45 54 No. of illegitimate deaths under 1 year 1 2 0 3 1 0 1 1 2 0 Illegitimate death rate 29 60 0 75 33 0 27 21 44 0 TABLE 6. COMPARATIVE STATISTICS — 1962. Rate per 1,000 Population LIVE BIRTHS Rate per 1,000 (Total Live & Still) | STILLBIRTHS Rate per 1,000 Population DEATHS (All Ages) Rate per 1,000 Related Live Births DEATHS (Under One Year) Neonatal Mortality (Under 4 weeks) (Live Births). England & Wales 18.0 18.1 11.9 21.4 15.1 Richmond 14.9 (Corrected) 14.1 10.4 (Corrected) 6.3 6.3 29 PREMATURE TABLE 7. PREMATURE LIVE BIRTHS — 1962. STILLBIRTHS. Weight Born in Hospital Born and Nursed at Home Born in Hospital Born at Home Born In Nursing Home Total Died within 24 hours of birth Died 2nd-28th day Survived 28 days Total Died within 24 hours of birth Died 2nd-28th day Survived 28 days 3lbs. 4oz. orless 3 - 1 2 — - - - 1 — — Over 3lb. 4oz. to 4lb. 60z 1 - - 1 1 - - 1 2 1 — Over 4lb, 60z. to 4lb. 15oz 8 - 1 7 — - - — — — — Over 4lb. 15oz. to 51b. 80z 13 1 - 12 11 — - 11 — — — TOTALS 25 1 2 22 12 - - 12 3 1 — Note : Born at home and transferred to Hospital on or before 28th day - Born in Nursing Home and nursed entirely there 1 Born in Nursing Home and transferred to hospital on or before 28th day — 30 SECTION F. — PREVALENCE OF, AND CONTROL OVER. INFECTIOUS AND OTHER DISEASES. (Civilians only). TABLE 8. NOTIFIABLE INFECTIOUS DISEASES. Diseases. Total Cases Notified. Cases admitted to Hospital. Total Deaths. Pueperal Pyrexia - - - Erysipelas 1 1 — Scarlet Fever 9 1 — Pneumonia 3 2 — Measles ... 55 3 — Whooping Cough 1 — — Food Poisoning ... 2 - — Opthalmia-Neonatorum ... 1 - — Dysentery 46 - — Paratyphoid 1 1 119 8 Nil TABLE 9. FOOD POISONING. Total number of outbreaks Nil Number of cases notified 2 Number of deaths Nil TABLE 10. DIPHTHERIA IMMUNISATION. Number of children immunised for the first time during the year 1962:— (a) Pre-school children (under 5 years) 599 (b) Between 5 and 15 years 31 630 Grand Total of children in the Borough who have received immunising treatment by the end of the year:— (a) Under 5 years 2,340 (b) Between 5 and 15 years 5,061 Number of children given re-inforcing doses during 1962 598 31 State of Immunity. No attempt is made to give the percentage of children immunized, because of the extreme difficulty of ascertaining the true population of any particular age group and the considerable annual transfer of children into and out of the Boroughs. As a check the immunological state of 401 entrants to County Schools during the autumn term was carefully examined with the following results:— Percentage immunized IN Richmond or Barnes 67.83% Percentage immunized OUTSIDE Richmond or Barnes 29.43 % Total immunized at entry to school 97.26% Total not immunized 2.24% No information 0.5% 97.26% of children entering school were shown to be immunized against diphtheria. The percentage immunized against whooping cough would be almost as high, and shortly the same high state of immunity to tetanus will apply since the "Triple" Antigen is now in general use. TABLE 11. POLIOMYELITIS VACCINATION. Northern Division — Surrey County Council. 1st January — 31st December, 1962. PRIMARY COURSE. Age Group. Number of persons who have received Salk Vaccine Oral Vaccine One injection only Two injections One dose only Two doses only Three doses (1) (2) (3) (4) (5) (a) Children born in 1962 2 6 42 125 102 (b) Children born in 1961 113 170 319 481 (c) Children and young persons born in the years 1943-1960 83 113 127 197 (d) Young persons born in years 1933-1942 3 73 27 44 80 (e) Others 4 174 80 125 174 (f) Total 9 449 432 740 1,034 32 REINFORCING DOSES. (a) Number of persons given third injection of Salk Vaccine 999 (b) Number of persons given fourth injection of Salk Vaccine 39 (c) Number of persons given a reinforcing dose of Oral Vaccine after: (i) Two Salk doses 700 (ii) Three Salk doses 786 Total number of doses: 5,188 Number of record cards submitted by General Practitioners during the year Primary Courses Reinforcing doses Salk or Oral Salk (first & second injections) Oral (three doses) 312 254 940 TABLE 12. VACCINATION AGAINST SMALLPOX 1962. 1. Analysis of Vaccinations at Welfare Centres and Private Doctors' Surgeries: Children. Primary Vaccination. 773 Re-vaccination 421 Total 1,194 In addition 291 vaccinated, 687 re-vaccinated — over 15 years of age. 2. Figures showing the percentage of children under 1 year vaccinated during 1962: No- Vaccinated. Estimated mid-year Population under 1 year. % Vaccinated. 310 566 54.38 TABLE 13. IMMUNIZATION AGAINST TETANUS. During the year 937 children were given courses of inoculations against Tetanus at the parents' request. In addition 218 children were given a re-inforcing dose to maintain their immunity. 33 TETANUS IMMUNIZATION. AGE at date of final injection 0—4 years 5—14 years Total Number of children who have completed a primary course of three injections whether single or combined during the year ended 31st December, 1962 619 318 937 Number of children who received a reinforcing dose 148 70 218 TABLE 14. WHOOPING COUGH IMMUNIZATION. Number of children who have completed a primary course of 3 injections during the year ended 31st December, 1962 564 TUBERCULOSIS. Vaccination Against Tuberculosis. During 1962 a total of 474 boys and girls were inoculated with B.C.G. in the Northern Division (Richmond and Barnes). NOTIFICATIONS: Respiratory Tuberculosis. Thirty-three cases of respiratory tuberculosis were notified during the year, viz:— 25 males and 8 females. The corresponding figure for 1961 was 33. Non-Respiratory Tuberculosis. Three new cases of non-respiratory tuberculosis were notified during the year and there were no deaths from this cause. One case was notified in 1961. 34 TABLE 15. 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 110 3 Females 53 9 163 12 Corresponding figures for 1961 150 15 TABLE 16. ANALYSIS OF CASES AND DEATHS FOR 1962. Age Periods New Cases Deaths Respiratory NonRespiratory Respiratory Non' Respiratory M F M F M F M F 0— 4 - - - - - - - — 5—14 — — 1 - — - — — 15—24 — — — — — - — — 25—44 7 2 - 2 — - — — 45—64 12 4 — - — - — — 65 and upwards 6 2 - - 2 1 - - Totals 25 8 1 2 2 1 — — 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 where proper precautions are not being taken and the circumstances are such as could constitute a danger to others. 35 MASS RADIOGRAPHY SERVICE. General Practitioners' Service. Men Women Total Number of patients referred 329 315 644 Cases of Pulmonary Tuberculosis 4 Nil 4 Cases of Lung Cancer 8 Nil 8 Public Mass Radiography Service 1401 2071 3472 Cases of Pulmonary Tuberculosis 4 3 7 Cases of Lung Cancer . Nil Nil Nil Employees of Richmond Borough Council referred by Medical Officer of Health— 35. 36 Section c—sanitary circumstances. table 17. water supply. (a) The following figures show the daily average consumption of water in the district:— 1961 1962 All Richmond Wells 798,616 galls. 740,907 galls. Metropolitan Water Board 1,098,414 galls. 1,169,183 galls. Raw River Water 275,797 galls. 257,011 galls. (b) During the year the following samples were taken for examination:— (i) Richmond Water Supply: Untreated water 326 samples. Treated water 177 „ For chemical analysis 25 „ (ii) Metropolitan Water Board Supply: Bacteriological examination 1,121 „ Chemical examination 52 „ (iii) Raw River Water 48 „ (c) Swimming Water samples 26 „ table 18. public health inspections. Houses inspected 274 Revisits to houses and other premises 684 Houses visited for Certificates of Disrepair 6 Visits paid in connection with:— Permitted number for dwellings - Vermin 69 Enquiries into Infectious Diseases and Disinfection 1,015 Routine inspections in connection with:— Factories (mechanical) 90 Factories (non-mechanical) 12 Outworkers 21 Bakehouses 38 Butchers' Shops 120 Confectioners (Flour) 39 Confectioners (Sugar) 66 Dairies and Milk Shops 12 Fishmongers and Poulterers 29 Fried Fish Shops 8 37 Greengrocers and Fruiterers 102 Grocers 202 Ice-cream premises 90 Public Houses 112 Restaurants and Tea Shops 380 Food and Drugs Act Sampling 94 Milk Sampling (Designated Milk) 70 Ice-cream Sampling 46 Unsound Food 74 Caravans 6 Clean Air Act — Inspection and Observations 793 Diseases of Animals Act 2 Drainage 834 Interviews 495 Heating Appliances (Fireguard) Act 3 Massage Establishments 3 Merchandise Marks Act 14 Noise Abatement 53 Pet Animals Act, 1951 10 Petroleum Act, 1928 181 Piggeries 2 Rag Flock Act 5 Rats and Mice (Visits to Properties) 3,818 Rats and Mice (Visits re sewer treatments) 675 Schools — Elementary and Secondary 14 Shops Act, 1950 196 Theatres and Cinemas 2 Water Supply 376 Miscellaneous Visits 1,487 12,622 TABLE 19. SERVICE OF NOTICES. (1) Informal action by letter or verbal intimation 481 (2) Statutory action by notice: (a) under the Public Health Act, 1936 — (i) Section 39 (drainage) 11 (ii) Section 92/93 (nuisances) 9 (iii) Section 89 (sanitary conveniences) 8 (b) under the Clean Air Act, 1956 — Section 12 (firegrate adaptations) 103 38 TABLE 20. COMPLAINTS. The complaints received have been classified as follows:— Disrepair of premises:— Dampness 19 Drainage 100 General defects 104 Nuisance from refuse 20 Nuisance from smoke or fumes 45 Nuisance from insects, animals, etc. 27 Rodent infestations 194 Unsound food 23 Miscellaneous nuisances 27 Noise nuisance 10 Pigeons 2 571 TABLE 21. DISINFECTION AND DISINFESTATION. A summary of the treatment of premises, bedding, clothing and other articles is given below:— Houses. Rooms. Bedding, etc- Infectious Fevers 1 1 1 Tuberculosis 3 3 3 Vermin 18 68 204 Other Diseases 3 4 161 Costs recovered throughout the year: £40 18s. 10d. TABLE 22. FACTORY INSPECTIONS. 1. Inspections. Premises. Number on Written Register. Inspections. Notices. Prosecutions. Factories (non-power) 14 12 Nil Nil Factories (power) 158 90 16 Nil Building Sites and Institutions 17 17 Nil Nil 39 2. Defects. Particulars. Found. Remedied. Referred by H.M. Inspector Want of Cleanliness 2 2 Nil Sanitary Conveniences. (a) Unsuitable 17 17 1 (b) Insufficient 3 3 1 3. Outworkers. Nature of Work Number of Outworkers. Number of Unwholesome Premises. Wearing apparel (making) 21 Nil. Brass and brass articles 4 Nil. Lampshades 1 Nil. Artificial flowers 8 Nil. Brushes 3 Nil. Legal Proceedings — no prosecutions were taken in 1962. TABLE 23. RODENT CONTROL. The rodent control staff have continued to do much useful work in eradicating rats and mice from premises. Number of complaints received 201 Number of infestations found 185 Number of infestations cleared 180 The treatment of foul sewers was carried out in May and November using the anti-coagulent, Sewarin P. and damp Sausage Rusk, and baiting was concentrated in specific areas known to be persistently infested with rats. May. November. Manholes test-baited 30 Nil. Manholes above found infested Nil. Nil. Manholes poison-baited 73 50 Manholes infested 25 20 Number of visits 425 250 40 SECTION D — HOUSING. TABLE 24. Housing Statistics for 1962. 1. Number of dwellings owned by the Local Authority:— Number of houses 1,398 Number of Flats 641 Total 2,039 2. Unfit Houses. (a) Dwelling houses inspected 274 (b) Total number of visits made 964 (c) Clearance Areas represented to Council Nil. (d) Dwellings included in (c) above Nil. (e) Compulsory Purchase Orders made by Council Nil. (f) Dwellings demolished after Clearance Orders made 1 (g) Dwellings represented for Demolition or Closing Orders 3 (h) Undertakings received that dwellings be not used for human habitation Nil. (i) Closing Orders made (a) in respect of whole of building Nil. (b) in respect of part of building Nil (j) Dwellings demolished in pursuance of Demolition Order Nil. (k) Undertakings received to repair dwellings 3 (1) Closing Orders determined on part of a building being made fit 1 (m) Undertakings cancelled on part of a building being made fit 2 (n) Dwellings in respect of which formal notices were served requiring defects to be remedied 14 (o) Dwellings in which defects were remedied after service of formal notices 13 (P) Dwellings in respect of which informal notices were served requiring defects to be remedied 189 (q) Dwellings in which defects were remedied after service of informal notices 171 41 TABLE 25. RENT ACT, 1957. The Rent Act, 1957, came into operation on the 6th July, 1957, and repealed the Housing Repairs and Rent Act, 1954. The 1957 Act permits the rents of controlled houses to be in creased within specified limits, and lays down a procedure to enable the tenant and landlord to reach agreement on works of repair which should be carried out to the property. Should agreement not be possible, the tenant may apply to the local authority for a Certificate of Disrepair which, if granted, stops the rent increase. The landlord has the opportunity, however, of giving an undertaking to carry out the repairs within 6 months, and if such an undertaking is accepted by the local authority, the rent increase continues to be payable. The following tables show the action taken since the Act came into force:— PART 1. — Applications for Certificates of Disrepair. 1957-1960 1961 1962 Number of applications 119 Nil 2 Number of decisions not to issue certificates 5 Nil Nil Number of decisions to issue certificates:— (a) in respect of some but not all defects 80 Nil 2 (b) in respect of all defects 34 Nil Nil Number of undertakings given by landlords 82 Nil 2 Number of undertakings refused by Local Authority 1 Nil Nil Number of certificates issued 32 1 Nil PART 2.— Applications for Cancellation of Certificates. 1957-1960 1961 1962 Applications by landlords to Local Authority for cancellation of certificates 15 1 Nil Objections by tenants to cancellation of certificates 4 1 Nil Decisions by Local Authority to cancel in spite of tenants' objection 3 Nil Nil Certificates cancelled by Local Authority 14 Nil Nil 42 SECTION E.—INSPECTION AND SUPERVISION OF FOOD. TABLE 26. INSPECTION OF FOOD. The following foodstuffs, found to be unfit for human consumption, were voluntarily surrendered and destroyed. cwts. qrs. lbs. ozs. Fresh Foods (all classes) 1 2 17 8 Tinned Meats, vegetables 8 3 15 9½ Tinned Fruits 3 2 14 8½ Animal Foods 1 23 8 14 2 15 2 TABLE 27. FOOD SAMPLING. The following table shows the results of examinations made of samples procured during the year. Articles. Number Analysed Number Irregular Formal Informal Tota1 Formal Informal Total Bread - 2 2 - - - Butter - 1 1 - - — Cereals and Cakes - 14 14 - 3 3 Cheese - 3 3 - 1 1 Cream and Cream Products - 7 7 - 1 1 Fish and Fish Products - 3 3 - 1 1 Fried Bumble Bees - 1 1 - 1 1 Fruit (Tinned) - 12 12 - 1 1 Ice Cream — 7 7 - 1 1 Jams and Marmalade — 2 2 - — — Jelly — 3 3 — — — Malt - 2 2 - — — Meat and Meat Products — 2 2 - — — Medicinal Preparations — 18 18 — 2 2 Milk and Milk Products — 5 5 — 2 2 Pickles and Sauces — 6 6 - — — Roasted Caterpillers — 1 1 — 1 1 Soup — 2 2 — — — Sweets — 16 16 — — — Syrup - 1 1 — — ; - Vegetables - 12 12 — 5 5 Vegetable Juice - 1 1 — - 1 Vegetable Oil — 4 4 — 1 I Vintage Cider - 1 1 — 1 1 Totals — 126 126 — 21 21 43 The irregular samples are referred to below:— (a) in this group are those samples reported to be irregular because the label did not specify the ingredients of the product as required by the Labelling of Food Order, 1953; in every case correspondence with the retailer and the manufacturer or importer resulted in an undertaking being given that the labelling of unsold stocks and of future consignments would be correctly amended: Sample 11: Sardines. „ 21: Fried Bumble-bees. „ 22: Roasted Caterpillars. „ 43: Stuffed Aubergines. ,, 45: Mushrooms. „ 64: Dairy Nut Crunch. „ 88: Red Cabbage. „ 112: Cucumbers in Vinegar. (b) a further group of samples proved to be irregular because the description of the product was misleading or because the product was not of the standard prescribed by statute; in these cases undertakings were given that the correct description would be used in future or that the statutory standard would be complied with: Sample 3: Steak Pie— description changed to Meat Pie. Sample 10: Corolac— description altered so as not to include a reference to "cream". Sample 23: Cream Powder— marketing of product discontinued. Sample 24: Cheese Spread with Caviar— description changed to Cheese Spread with Mock Caviar. Sample 35: Birchermuesli— undertaking given to omit claim that product is non-fattening. Sample 99: Chocolate Cream Pie— description changed to Chocolate Whip Pie. Sample 105: Pick-Ups— description changed to Cocktail Sausages. Sample 122: Sunflower Oil— lacking in vitamin E. and withdrawn from sale. Sample 124: Hot Roll Mix— marketing of product discontinued. Sample 126: Paprikaschoten— description changed to Red Pep' pers. 44 (c) A small group of samples were reported as irregular, but no action was taken by the Council because of the absence of a statutory standard to which the manufacturer's attention could be drawn: Samples 33 and 49: Cress. Sample 109: Cultured Butter Milk Drink. TABLE 28. CLASSIFICATION OF FOOD PREMISES. No. of Premises. No. of Visits Bakehouses 9 38 Butchers (including 27 premises registered for manufacture of preserved food) 30 120 Confectioners (flour) 17 39 Confectioners (sugar) 47 66 Dairies (registered under Milk and Dairies Regulations) 3 12 Fishmongers 13 37 Greengrocers 38 102 Grocers (including 3 premises registered for manufacture of preserved food) 63 202 Ice-cream premises (manufacture) 1 90 Ice-cream premises (sale and storage) 120 Licensed premises 82 112 Restaurants, cafes, etc. 80 380 503 1,198 45 TABLE 29. IMPROVEMENTS IN FOOD PREMISES. As the result of inspections made the following improvements were carried out:— 1. Food rooms reconstructed 13 premises 2. Food rooms repaired, cleansed or redecorated 184 " 3. Food storage improved 13 " 4. Food preparation equipment improved 121" 5. Ventilation and lighting improved 72 " 6. Staff washing facilities improved 48 " 7. Staff clothing accommodation provided 24 " 8. First aid boxes provided 7 " 9. Constant hot water supply installed 60 " 10. New sinks provided 23 " 11. Existing sanitary accommodation improved 43 " 12. Drainage improved, repaired or altered 20 " 13. Refuse accumulations removed 18 " 14. Refuse receptacles provided 11 " 15. Other improvements or repairs carried out 179 " 46 table 30. milk licensing. The following licences have been granted by the Council authorising dealers to store and sell Designated milks:— Pasteurised Milk 26 Tuberculin Tested Milk 19 Sterilised Milk 22 All premises are inspected before licences are granted, and principal licences are verified with the appropriate local authorities before licences are issued. No licences were refused. Under the regulations the Local Authority continued to take samples from dealers and during the year under review the following were taken:— Pasteurised Milk 32 samples Number found unsatisfactory Nil Tuberculin Tested (Pasteurised) Milk 30 „ Number found unsatisfactory Nil Sterilised Milk 13 „ Number found unsatisfactory Nil Raw Milk examined biologically for the presence of Tubercle bacilli 6 „ Number found unsatisfactory Nil The District Medical Officer of Health retains the power to take appropriate action to prevent the spread of disease by infected milk.