SIDI E URBAN DISTRICT COUNCIL OF SIDCUP. Health Report of the Sidcup Urban District for the Year 1925 by the Medical Officer of Health together with the Report of the Sanitary Inspector Health Report of the Sidcup Urban District For the Year 1925 by the Medical Officer of Health, Together with the Report of the Sanitary Inspector. Tonbribge. Printed by Tonbridge Free Press Ltd., 129 High Street, 2 Urban District Council of Sidcup. HEALTH REPORT FOR 1925. Madam and Gentlemen, I have the honour of submitting my Annual Report for the year 1925, being the third one presented by me as your Medical Officer of Health. The estimated population of the District for 1925 is 9,271, as compared with estimated populations of 8,924 and 8,833 for the years 1924 and 1923; and an actual population of 8,920 at the Census in 1921. The birth rate for the District was 13.4 per thousand of estimated population, as against 18.3 per thousand for England and Wales. The birth rate in 1924 was 12.9, as compared with 18.8 per thousand for England and Wales. The corrected death rate was 10.9 per thousand of population, as against 12.2 per thousand for England and Wales. The death rate in 1924 was 9.7, as compared with 12.2 per thousand for England and Wales. The Infantile Mortality Rate was 64 per thousand of registered births, as compared with 75 per thousand registered births for England and Wales. The Infantile Mortality Rate in 1924 was 8, as compared with 75 for England and Wales. The year 1925 was again a most satisfactory one from the point of view of Infectious Disease, no epidemic of any consequence arising. I desire to express my hearty thanks to the Council and their Officers for the help and consideration shown me. I should like to place on record my appreciation of the services rendered by Mr. Farnham and Mr. Allen. I am, Madam and Gentlemen, Your obedient Servant, P. N. CAVE, Medical Officer of Health. 3 Urban District Council or Sidcup. PUBLIC HEALTH COMMITTEE. Mr. H. H. Austwick (Chairman) Mr. R. Ellison, j.p. Mr. W. Pool Mr. T. G. Galbraith Mr. Williamson Mr. J. F. Parker Mr. Winn Mr. T. J. Robins Representative on the Bromley and Beckenham Joint Hospital Board: Mr. R Ellison, j.p. Representative on the West Kent Main Sewerage Board: Mr. R. Ellison, j.p. STAFF. Medical Officer of Health: P. N. Cave, m.a., m.d., d.p.h., m.r.c.s., l.r.c.p. Surveyor and Sanitary Inspector: W.A. Farnham, a.m i.c.e i., f.s.i., a.m.i.m.e., m.inst.m. and cy.e. m.r.s.i. Assistant Sanitary Inspector: A. V. Allen, a.r.s.i., m.i.h. 4 HEALTH REPORT. AREA AND POPULATION. The Urban District of Sidcup was constituted in 1902, the District previously being contained within the Rural District of Bromley. The change in name from "Foots Cray" to "Sidcup" became operative from 1921. The area of the District is 2,043 acres. The number of inhabited houses within the District is 1,970, and the Rateable Value is £72,962. A penny rate represents £285. The population at the time of the Census in 1921 was 8,920, and for 1925 it is estimated at 9,271, as compared with an estimated population for 1924 of 8,924. The following Table shows the occupation by sex of residents of the District at the time of the Census of 1921:— Males. Females. Agricultural occupations 274 36 Mining and quarrying occupations 1 1 Workers in chemicals, paints, etc. 14 1 Makers of coke, lime, cement, etc. 2 - Metal workers 225 1 Workers in precious metals 2 — Electrical apparatus makers, fitters, etc. 19 — Makers of watches, etc. 21 — Workers in skins, leather goods makers 15 2 Textile workers 10 3 Makers of textile goods and articles of dress 33 52 Makers of foods, drinks and tobacco 25 4 Workers in wood, etc. 83 1 Paper makers, printers, etc. 48 17 Builders, bricklayers, etc. 121 — Painters and decorators 60 2 Workers in other materials 6 — Workers in mixed and undefined materials 10 1 Persons in gas, writer and electricity supply 1 — Transport workers 185 9 Commercial and financial occupations 423 115 Public administration and defence 128 57 Professional occupations 147 123 Persons employed in entertainments, etc. 22 6 Persons employed in personal service 66 675 5  Males. Females. Clerks, draughtsmen, typists, etc. 281 179 Warehousemen, etc. 37 4 Stationary engine drivers, etc. 6 — All other occupations 116 8 Total occupied 2381 1297 Unoccupied and retired 567 2741 Total Occupied and Unoccupied 2948 4038 VITAL STATISTICS. BIRTHS. During the year 125 births were registered as belonging to the District, of which number 69 were males and 56 were females. The Birth Rate for the year was 13.4 per thousand of population, as against 12.9 last year. The rates for England and Wales were 18.3 and 18.8 respectively. The number of births registered as being illegitimate was 7, giving an Illegitimate Birth Rate of 5.6 per cent. The rate last year was 8.5. DEATHS. The number of deaths registered was 101 (43 males and 58 females). This number includes persons who have died outside but belong to the District, but excludes those who have died within the District but belong to other districts. The Death Rate for the year was 10.9 per thousand of population, as against 9.7 last year. The Death Rates for England and Wales were 12.2 and 12.2 respectively. The four diseases accounting for the largest number of deaths were Heart Disease 12, Bronchitis and Cancer 11 each, and Cerebral Haemorrhage 7. During the year 1924, the diseases claiming the largest mortality were Heart Disease 12, Cancer 11, and Cerebral Haemorrhage 7. INFANTILE MORTALITY. During the year eight deaths occurred in infants under one year of age. The Infantile Mortality Rate was 64 per thousand of registered births, as against 8 last year. The Infantile Mortality Rates for England and Wales were 75 and 75 respectively. 6 DEATHS OF CHILDREN BETWEEN ONE AND FIVE YEARS. The number of deaths occurring in children between the ages of one and five years was 2, as compared with 3 in 1924. This is equal to a rate of 1.9 per cent. of total deaths, as compared with 3.4 per cent. in 1924. DEATHS IN PERSONS OF 65 YEARS AND OVER. During the year 50 deaths occurred in persons of 65 years and upwards, as compared with 37 in 1924, giving a percentage rate of 49.5 per total deaths, as compared with 42.5 per cent, in 1924. CAUSES OF DEATH. The deaths in 1925 included:— Scarlet Fever Nil Diphtheria Nil Typhoid Fever Nil Pulmonary Tuberculosis 6 Other Tuberculous diseases 1 Measles Nil Whooping Cough Nil Diarrhoea and Enteritis (under 2 years of age) Nil Influenza 4 Pneumonia 6 Bronchitis 11 Heart Disease 12 Cancer 11 Puerperal sepsis Nil Other accidents and diseases of pregnancy and parturition Nil Appendicitis 1 ZYMOTIC DEATH RATE. The Zymotic Death Rate is a term commonly applied to the rates of deaths from the seven principal zymotic complaints:- Small Pox, Measles, Scarlet Fever, Diphtheria, Whooping Cough, Diarrhoea and "Fever," which latter includes Typhus, Typhoid (or Enteric) and Paratyphoid Fevers. No deaths occurred from these complaints during the year. In 1924, 4 deaths were registered, giving a Zymotic Death Rate of 0.4 per thousand of population. 7 PULMONARY TUBERCULOSIS. The deaths occurring from Pulmonary Tuberculosis (Consumption or Phthisis) numbered 6. This is equal to a Death Rate of 0.6 per thousand of population. OTHER RESPIRATORY DISEASES. The deaths occurring from diseases of the respiratory system numbered 18, giving a Death Rate of 1.9 per thousand of population. CANCER. The deaths from Cancer (malignant disease) were 11 (4 males, 7 females), the Death Rate from Cancer being 1.1 per thousand of population. INFLUENZA. During the year 4 deaths occurred from Influenza, giving a Death Rate of 0.4 per thousand of population. ANALYSIS OF DEATH RATES. (Per thousand of population.) Year All Causes. Zymotic disease. Pulmonary Tuberculosis Other Respiratory diseases Cancer Influenza 1925 10.9 0.0 0.6 1.9 1.1 0.4 1924 9.7 0.4 0.5 1.2 1.3 0.1 Table X.—Birth-rate, Death-rate and Analysis of Mortality during the Year 1925. (Provisional figures. The rates for England and Wales have been calculated on a population estimated to the middle of 1925, while those for the towns have been calculated on populations estimated to the middle of 1924. The mortality rates refer to the whole population as regards England and Wales, but only to civilians as regards London and the groups of towns.) BIRTHRATE PER 1,000 TOTAL POPULATION ANNUAL DEATH-RATE PER 1,000 POPULATION. RATE PER 1,000 BIRTHS. PERCENTAGE OF TOTAL DEATHS. All Causes. Enteric Fever Small-pox. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Influenza. Violence. Diarrhœa . and Enteritis (under Two years.) Total Deaths under One year. Causes of Death certified by Registered Medical Practitioners Inquest Cases Uncertified Causes of Death. England and Wales 183 12.2 0.01 0.00 0.13 0.03 0.15 0.07 0.32 0.47 8.4 75 92.1 6.9 1.0 105 County Boroughs and Great Towns, including London 18.8 12.2 0.01 0.00 0.17 0.03 0.18 0.09 0.30 0.43 10.8 79 92.1 7.3 0.6 157 Smaller Towns (1921 adjusted Populations 20,000—50,000) 18.3 11.2 0.01 0.00 0.15 0.02 0.14 0.06 0.31 0.38 7.6 74 93.0 5.9 1.1 London 18.0 11.7 0.01 0.00 0.08 0.02 0.19 0.11 0.23 0.46 10.6 67 91.1 8.9 0.0 Sidcup Urban District 13.4 10.9 0.00 0.00 0.00 0.00 0.00 0.00 0.4 0.2 0.00 64 — — — 9 INFECTIOUS DISEASE. The year 1925 has again been a very satisfactory one from the point of view of incidence of Infectious Disease. As in 1924, no serious outbreak of any form of Infectious Disease occurred. During the year 28 Certificates of Notifications of Infectious Disease were received, which comprised:— Scarlet Fever 5 Diphtheria 4 Enteric Fever Nil Puerperal Fever 1 Erysipelas 2 Pneumonia 13 Ophthalmia Neonatorum Nil Encephalitis Lethargica 2 Acute Poliomyelitis Nil Cerebro-spinal Fever 1 Malaria Nil Reference to Table I. in the Appendix will show:— 1. Cases notified at ages. 2. Total cases removed to Hospital. 3. Deaths. The following Table shows the number of cases of Infectious Disease notified during the past six years:— 1925 1924 1923 1922 1921 1920 Scarlet Fever 5 12 4 7 25 36 Diphtheria 4 1 5 7 69 50 Enteric Fever — 2 2 2 — — Puerperal Fever 1 — — — — — Erysipelas 2 3 2 2 6 1 Pneumonia 13 16 2 — — 4 Ophthalmia Neonatorum — — 2 — 1 2 Encephalitis Lethargica 2 2 — 1 1 — Acute Poliomyelitis — 1 — — — — Cerebro-spinal Fever 1 — — — — 1 Malaria - - - - - 4 Total 28 37 17 19 102 98 SCARLET FEVER. A decrease took place in the number of cases of Scarlet Fever notified, viz., 5 as against 12 last year. Four cases were removed to the Isolation Hospital. The monthly incidence of Scarlet Fever was:— Jan Feb. Mar. April May June July Aug Sept. Oct. Nov. Dec. 10 The age incidence was:— Under 1 year 1-2 2-3 3-4 4-5 5-10 10-15 15-25 25-35 35-45 45-65 65 and over — — — — — 2 3 — — — — DIPHTHERIA. Four cases of Diphtheria were notified as occurring during the year. All the cases were removed to the Isolation Hospital. The monthly incidence of Diphtheria was:— Jan. Feb. Mar. April May June July Aug. Sept. Oct. Nov. Dec. The age incidence was:— Under 1 year 1-2 2-3 3-4 4-5 5-10 10.15 15-25 25-35 35-45 45-65 and over - 1 - - - 2 - - 1 - - - The number of swabs sent from cases and suspected cases during the year numbered 35, of which 5 were positive and 30 were negative. ENTERIC FEVER. No cases of Enteric Fever were notified, as against 2 in the previous year. PUERPERAL FEVER. One case of Puerperal Fever was notified. This is the first case notified since 1919. OPHTHALMIA NEONATORUM. There were no cases of Ophthalmia Neonatorum notified. ERYSIPELAS. Two cases were notified, as against three last year. PNEUMONIA. Thirteen cases of Pneumonia were notified. The monthly incidence of this complaint was:— Jan. Feb. Mar. April May June July Aug. Sept. Oct. Nov. Deo. — 3 2 2 — 2 — — — — 1 3 The age incidence was:— Under 1 year 1-2 2-3 3-1 4-5 5-10 10-15 15-S5 25-35 35-15 4E-65 65 and over — — — 1 — 11 3 1 2 2 2 ENCEPHALITIS LETHARGICA. Two cases of Encephalitis Lethargica were notified, viz., a male, aged 4 years in May, and a female, aged 64 years in July. 11 ACUTE POLIOMYELITIS. No case of Poliomyelitis was notified. In 1924 one ease occurred. MALARIA. No case of Malaria has been notified since 1920. CEREBRO SPINAL FEVER. One case of Cerebro-spinal Fever was notified, as occurring in a female aged 12 years. The last notified case occurred in 1920. TUBERCULOSIS. During the year 9 new eases of Tuberculosis were notified, of which 6 (4 males and 2 females) were Pulmonary, and 3 (2 males and 1 female) were non-pulmonary Tuberculosis. The following Table shows the number of eases notified, together with the deaths registered at age periods:— Age Periods. Years. New Cases. Deaths. Pulmonary. Non Pulmonary. Pulmonary. NonPulmonary. M F M F M F M F Under 1 year ... ... ... ... ... ... ... 1 1 to 5 ... ... ... ... ... ... ... ... 5 to 10 ... 1 ... ... ... 1 ... ... 10 to 15 ... ... 1 ... ... ... ... ... 15 to 20 2 ... ... ... ... 1 ... ... 20 to 25 ... ... ... ... ... 1 ... ... 25 to 35 1 ... ... ... ... 1 ... ... 35 to 45 ... 1 ... ... 2 ... ... ... 45 to 55 1 ... 1 ... ... ... ... ... 55 to 65 ... ... ... ... ... ... ... ... 65 and over ... ... ... ... ... ... ... ... TOTALS 4 2 2 1 2 4 ... 1 12 The death rate from Tuberculosis was equal to 0.7 per thousand of population. Hospital and Sanatorium Treatment are provided for by the Kent County Council. During the year 6 patients received sanatorium treatment, 9 received Dispensary treatment and 27 received Dispensary supervision. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1924. The above Regulations came into force on the 1st January, 1925, requiring, inter alia, that a quarterly return should be made to the County Medical Officer of Health of all cases of Tuberculosis, whether pulmonary or non-pulmonary, that were on the register at the end of each quarter. Existing cases, in the event of cure, removal from the District or death, are deleted from the register and the new notifications added on as received. The extra work entailed in order to obtain the information required was allotted by the Council to Mr. Allen, who has carried out the work most efficiently and satisfactorily. Subjoined are the figures on the register at the end of each quarter:— PULMONARY. NONPULMONARY. TOTAL. M. F. Total. M. F. Total. March 31st 4 9 13 5 1 6 19 Jupe 30th 4 9 13 4 2 6 19 September 30th 6 8 14 5 2 7 21 December 31st 7 8 15 5 2 7 22 NON-NOTIFIABLE DISEASES. Measles.—No deaths were registered as occurring from Measles. Whooping Cough.—There were no deaths from this complaint. Diarrhoea and Enteritis (under two years of age).—No deaths were registered during the year. Influenza.—Four deaths occurred from Influenza. This gives a Death Rate of 0.4 per thousand of population. 13 OTHER DISEASES. Cancer.—The deaths from Cancer numbered 11, of which four were males and seven were females. This gives a Death Rate of 1.1 per thousand of population. There were 12 deaths in 1924. Heart Disease.—There were 12 deaths from Heart Diseases, giving a Death Rate per thousand of population of 1.3. PREVENTIVE MEASURES. On the receipt of a notification of Infectious Disease, the case is visited and full particulars obtained. I am always glad to see any doubtful case of Infectious Disease in consultation with the Doctor in charge; and I have pleasure in placing on record the cordial co-operation I have received from all medical practitioners in this respect. This is, I feel sure, of great assistance in dealing with the incidence of Infectious Disease. Where any outbreak of Infectious Disease arises in Connection with the scholars attending any school, whether a private school or a public elementary or secondary school, particular attention is given to any possible factors which may be tending to cause the spread of the disease. Post convalescent cases after return from Hospital are visited, and should circumstances arise rendering it advisable, are kept under further observation. Diphtheria Anti-toxin.—A supply of Diphtheria Anti-toxin is kept for the use of Doctors practising in the District. This is supplied free of charge on the certificate of the Medical Officer of Health that the circumstances of the case render this desirable. In other cases the cost price is charged. Isolation Hospital.—The District is served by the Bromley and Beckenham Joint Isolation Hospital. This Hospital, administered by the Bromley and Beckenham Joint Hospital Board, serves the Borough of Bromley, the Urban Districts of Beckenham, Chislehurst and Sidcup, and the Rural District of Bromley. Cases are removed by the Board's motor ambulances. Disinfection.—The Council have a fully equipped Thresh's Disinfecting Apparatus available for the disinfection of bedding, clothing, etc., and in addition, rooms are fumigated and sprayed after cases of Infectious Disease; and also after cases of non-notifiable disease at the request of a medical practitioner. 14 Recently, disinfection has been carried out after fatal cases of cancer, when so desired. Laboratory Work.— The bacteriological work for this District is carried out at the Kent County Laboratory. The following shows the number of examinations made and the results obtained:— Total. Positive. Negative. Swabs for Diphtheria 35 5 30 Sputa for Tubercle 16 1 15 Widals for Typhoid Fever 2 - 9 Totals 53 6 47 DRAINAGE. The whole of the developed area is sewered by the sewers of the Local Authority which connect with the outfall sewers of the West Kent Main Sewerage Board. The undeveloped part is mainly agricultural with the exception of an area known as the Queenswood Estate, Blackfen, consisting of about 40 houses, which are drained into Septic Tanks. The sewerage of this area must be dealt with in the near future, and I understand it will receive consideration following the completion of the Town Planning Scheme now in hand. WATER SUPPLY. The mains of the Metropolitan Water Board are available for the whole of the District. A chemical analysis of the water yields the following figures:— Parts per 100,000. Ammoniacal Nitrogen .0001 Albuminoid Nitrogen .0015 Oxidised Nitrogen 0.65 Oxygen absorbed from Permanganate .0060 Chlorides expressed as Chlorine 1.42 Hardness (Total) 27.3 Hardness (Permanent) 5.4 HOUSING. The overcrowding in the District is mainly of the type which could be termed "moral" in contradistinction to the overcrowding which is remedial under the Public Health or Housing Acts. From observations, the following may be suggested the reasons for this state of affairs:— 15 1. (a) The influx of munition workers during the late War who were employed at Woolwich and Dartford, and have since remained in residence here, (b) The removal here of persons from the more overcrowded parts of inner London. 2. The absence since 1914 of the erection of houses for those unable to purchase them; and the natural increase of families from that date. 3. The inability of those families with young children to find or afford the necessary accommodation. Some twelve months ago the Council submitted to the Ministry of Health a Scheme for the erection of 50 houses with sufficient land for the erection of 50 more, should they be found necessary. The latter scheme was dropped owing to various difficulties, whilst the former scheme has been now sanctioned in respect of 12 houses, for which roads and sewers are under course of construction and the work of building will commence about the end of February, 1926. The general standard of houses within the District is that suitable for the middle classes, and it is estimated that not more than 20 per cent, are those suitable for the lower classes. The usual standard of defects found are those of fair wear and tear, it generally being found that tenants are mindful of their premises, and the landlords willing to accede to representations. Unsatisfactory conditions still obtain on the Queenswood Estate. Inspection of the site still shows that numerous huts, sheds and the like are being used by persons for the purpose of habitation, more or less permanent. These fall roughly into three categories:— (a) Those occupied.as temporary premises whilst a proper bungalow is being built in accordance with plans duly deposited and approved. (b) Those huts which, although having every appearance of being occupied, are locked up and empty when inspected. Curtains at the windows, the presence of chimneys and other indications point to the probability that these are occupied nightly or for week-ends. (c) Those huts occupied by persons who profess to be about to build bungalows, but who show no indication of commencing to do so, and who further do not appear to be in a financial position to undertake the work. 16 The above state of affairs is most undesirable, particularly as there are a number of houses in the near vicinity built in every way in accordance with the Council's Bye-laws. Further the absence of drainage and the careless use of earth closets constitute a very real risk of the spread of disease such as Typhoid and Epidemic Diarrhoea. Another factor also must not be lost sight of, namely the possibility of a similar state of affairs coming into being in other parts of the District. HOUSING STATISTICS FOR THE YEAR 1925. Number of new houses erected during the year:— (a) Total (including numbers given separately under (b) 46 (b) With State assistance under the Housing Acts:— (i) By the Local Authority Nil (ii) By other bodies or persons 8 1. Unfit Dwelling Houses. Inspection. Total number of houses inspected for housing defects (under Public Health or Housing Acts) 134 (2) Number of dwelling houses which were inspected and recorded under the Housing (Inspection of District) Regulations, 1910, or the Housing Consolidation Regulations, 1925 31 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (4) Number of dwelling houses (excluding those referred to under the preceding sub-headings found not to be in all respects reasonably fit for human habitation 27 2. Remedy of Defects without Service of Formal Notices. Number of defective dwelling houses rendered fit in consequence of the Local Authority or their Officers 121 3. Action under Statutory Powers. A. Proceedings under Section 3 of the Housing Act, 1925. (1) Number of dwelling houses of which notices were served requiring repairs 3 17 (2) Number of dwelling houses which were rendered fit after service of formal notice:— (a) By owners 3 (b) By Local Authority in default of owners Nil (3) Number of dwelling houses in respect of which Closing Orders became operative in pursuance of declarations by owners of intention to close Nil B. Proceedings under the Public Health Acts. (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 7 (2) Number of dwelling houses in which defects were remedied after service of formal notices:— (a) By owners 7 (b) By Local Authority in default of owners Nil C. Proceedings under Sections 11, 14, and 15 of Housing Act, 1925. (1) Number of representations made with view to making of a Closing Order Nil (2) Number of dwelling houses in respect of which Closing Orders were made Nil (3) Number of dwelling houses in respect of which Closing Orders were determined, the dwelling house having been rendered fit Nil (4) Number of dwelling houses in which Demolition Orders were made Nil (5) Number of dwelling houses demolished in pursuance of Demolition Orders Nil MATERNITY AND CHILD WELFARE. The Maternity and Child Welfare work in this District is carried out by the Kent County Council. The Health Visitor in this area is Nurse Staines. An Infant Welfare Centre is held each Thursday afternoon at the Congregational Church Hall. 18 SCHOOLS. There are four Elementary Schools within the District. The Kent County Council carries out the Medical inspection of School children. During the year investigations into complaints regarding the sanitary condition of the trough closets and of the ditch running at the boundary of Birkbeck C. of E. Schools were made. These matters were brought to the notice of the School Managers, who are now endeavouring to raise the necessary funds for the piping of the ditch and for the provision of flush down closets in place of the existing trough closets. On no occasion was it found necessary to close a School in consequence of the prevalence of Infectious Disease amongst the scholars. REGULATED TRADES. DAIRIES, COWSHEDS AND MILKSHOPS. There are 13 premises registered under the Dairies, Cowsheds and Milkshops Order and Milk and Dairies (Amendment) Act, of which three are Dairies, three are Cowsheds and seven are Milkshops. During the year 35 visits of inspection were paid, and in only one instance was a defect discovered. SLAUGHTERHOUSES. There are four licensed Slaughterhouses within the District, to which 41 visits of inspection have been paid during the year. No meat has been condemned, but a small quantity was voluntarily surrendered. The number of Slaughterhouses in use on the undermentioned dates were:— In 1920. In January, 1925. In December, 1925. Licensed 4 4 4 Registered - - - PUBLIC HEALTH (MEAT) REGULATIONS, 1924. These Regulations came into force on the 1st April, 1925. The duty of carrying out the provisions of the Order was undertaken by the Medical Officer of Health and the Assistant Sanitary Inspector. 19 During the period from the 1st April to the 31st December, 1925, the following number of animals were killed for human food in the slaughterhouses in the District:— Oxen 1, Calves 1, Sheep and Lambs 12, Swine 22. During the year only a small quantity of meat was found to be unfit for human consumption, this being voluntarily surrendered. BAKEHOUSES. There are five Bakehouses in this District (being one less than last year), to which 11 visits have been paid. In two instances defects were found, both of which were remedied. PIGGERIES. There are two Piggeries, to which three visits of inspection have been paid. SALE OF FOOD AND DRUGS ACTS. This work is carried out by the Kent County Council. FACTORY AND WORKSHOP ACT. It will be seen from the subjoined list that there are 11 Factories and 24 Workshops within the District. All these have been periodically visited, and due attention has been paid to maintaining them in such a condition as to comply with the requirements of the Act. During the year 64 visits of inspection have been paid, and in only one instance nuisances or irregularities have been founded. All the detects were remedied. Trade. Number of Total. Factories. Workshops. Boot Repairers 2 2 4 Builders, Decorators 1 1 2 Grindery 1 - 1 Laundries 2 4 6 Motor Engineers, etc. 2 5 7 Mason - 1 1 Machinist - 1 1 Printers 1 - 1 Sauce Manufacturers - 1 1 Saw Mills 2 - 2 Tailors, Dressmakers - 7 7 Upholsterers — 2 2 11 24 35 20 DEFECTS FOUND. Particulars Found Remedied Reported to H.M. Inspector Number of prose cutions Nuisances under Public Health Acts:— Want of cleanliness 1 1 - — Want of ventilation - - - - Overcrowding - - - - Want of drainage of floors - - - - Other nuisances 3 3 - — Snnitary accommodation insufficient 1 1 - - Sanitary accommodation unsuitable or defective 1 - - - Sanitary accommodation not separate for sexes - - - - Offences under the Factory and Workshops Acts:— Illegal occupations of underground bakehouses (s. 101) - - - - Breach of special sanitary requirements for bakehouses (ss. 97 to 100) - - - - Other offences (including offences relating to outwork) - - - - Total 6 5 - - OUTWORKERS. There are two outworkers residing in the District. SUMMARY. Total number of factories and workshops 35 Total number of visits paid 64 Number of defects found 6 Number of notices served 1 GENERAL. Water Courses.—All water courses within the District are under constant supervision. The Rivers Cray and Shuttle run through the District, and are the only streams of any consequence. 21 HOSPITAL FACILITIES. Cases of Infectious Disease are dealt with by the Bromley and Beckenham Joint Hospital Board at their Isolation Hospital. The Sidcup Cottage Hospital serves the needs of the District for a General Hospital. The accommodation available is ten beds, consisting of four for males, four for females and two private beds. AMBULANCE FACILITIES. Infectious Cases.—Two ambulances are provided by the Joint Hospital Board for the removal of cases of Infectious Disease. Accident and General Cases.—When necessary, an ambulance is available for the removal of accident and general cases. NURSING FACILITIES. The Sidcup and District Nursing Association provide facilities for the area. The Nurse is Mrs. Staines, residing at 19 Lincoln Road. HOUSE REFUSE DISPOSAL. A weekly collection of house refuse is made under the supervision of the Surveyor. During the year complaints were received in respect of the House Refuse Shoot at Crescent Farm, Sidcup, which had been in use for some years. Two other Shoots were obtained, but complaints being again received in respect of these, the Owners excluded us from continuing depositing there. The Shoot at Foot's Cray which is at present being used is the cause of further complaints, but as this Shoot will only last some six months, it will be necessary for the Council to again consider the question of House Refuse disposal, MIDWIVES ACT. The supervision of Midwives is carried out by the Kent County Council. Two trained Midwives have given notice to practise in this District. LEGAL PROCEEDINGS. On one occasion legal proceedings were instituted in respect of the use of an unauthorised hut for a dwelling, but defendant satisfied the Court that she had ceased occupation after receipt of notice. 22 ADOPTIVE ACTS, Etc. The following is a list of Acts, etc., which have been adopted, together with the date of adoption. Acts:— The Public Health Acts Amendment Act, 1890 (Parts 2 and 3). Adopted 14 January, and came into force 1st March, 1904. The Infectious Disease (Prevention) Act, 1890. Ditto. The Public Health Acts Amendment Act, 1907, Parts 2 to 6 (inclusive), Part 10 (Section 95). Order of the Local Government Board, 24th December, 1909. Part 7 (Sections 81 and 86), Parts 8 and 9. Order of Secretary of State, 12th November, 1909. Private Street Works Act., 1892 25th July, 1902. Acts Adopted:— Public Health Act, 1925. The whole of Parts 2, 3 4 and 5 with the exception of Section 44, Part 3, and with the sanction of the Ministry of Health to Sections 21 and 22, Part 2. The Sections subject to the consent of the Ministry came into force on the 1st March, 1926. Bye-laws and Regulations:— Regulations with respect to Allotments. Bye-laws with respect to Common Lodging Houses. Regulations with respect to Dairies, Cowsheds and Milk- shops. Bye-laws with respect to Slaughterhouses. Bye-laws as to Whirligigs and Swings, Firearms in Shooting Galleries, etc. Adopted 18th July, and allowed by the Local Government Board on the 6th September, 1906. Bye-laws with respect to New. Streets and Buildings. Adopted 21st February, and allowed by L.G.B. on 2nd April, 1906. 23 Rye-laws with respect to the Mortuary, Cemetery and the drainage of existing buildings. Adopted 15th November, 1911, and allowed by theL.G.B. on 11th January, 1912. Bye-laws:— Bye-laws in respect of Tents, Vans, Sheds, etc. Adopted 20th November, 1925, and allowed by Ministry of Health on 20th January, 1926. New Streets and Buildings Bye-laws. Revised on 20th November, 1925, and allowed by Ministry of Health on 31st December, 1925. APPENDIX. 1.—GENERAL STATISTICS. Area (acres) 2,043. Population (1925) 9,271. Number of inhabited houses (1921) 1,752, (1925) 1,970. Number of families or separate occupiers (1921) 1.910. Rateable value, £72.962. Sum represented by a penny rate, £285. 2.—EXTRACTS FROM VITAL STATISTICS OF THE YEAR. Total M. F. Births Legitimate 118 64 54 Birth Rate 13.4 Illegitimate 7 5 2 Deaths 101 Death Rate 10.9 Number of women dying in, or in consequence of childbirth From sepsis Nil From other causes Nil Deaths of infants under one year of age per 1,000 births:— Legitimate 64 Illegitimate Nil Total 64 Deaths from Measles (all ages) Nil Deaths from Whooping Cough (all ages) Nil Deaths from Diarrhœa (under 2 years of age) Nil 24 Table I.—Cases of Infectious Disease notified during the Year 1925. Disease. Total Number of Cases. Cases removed to Hospital. Total Deaths. At all Ages. at—ages—years. Under 1 1 to 2 2 to 3 3 to 4 4 to 5 5 to 10 10 to 15 15 to 25 35 to 35 35 to 45 45 to 65 65 and over Scarlet Fever 5 ... ... ... ... ... 2 3 ... ... ... ... ... 4 ... Diphtheria 4 ... 1 ... ... ... 2 ... ... 1 ... ... ... 4 ... Erysipelas 2 ... ... ... ... ... ... ... ... ... ... ... 2 ... ... Pneumonia 13 ... ... ... 1 ... 1 1 3 1 2 2 2 ... 6 Encephalitis Lethargica 2 ... ... ... ... 1 ... ... ... ... ... 1 ... ... 1 Cerebro-spinal Meningitis 1 ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... Puerperal Fever 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... Totals 28 ... 1 ... 1 1 5 5 4 2 2 3 4 9 7 Table II.—Infectious Disease Notification Certificates received during the Years 1904 1905 1906 1S07 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 Cerebrospinal Meningitis ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... 1 ... ... ... ... 1 Diptheria 7 11 7 8 1 9 2 17 5 18 33 7 23 124 31 34 49 25 7 5 1 4 Encephalitis Lethargica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 2 2 Enteric Fever 1 ... ... ... ... ... ... 2 ... 1 ... ... ... ... 1 ... ... ... 2 2 2 ... Erysipelas 2 6 3 1 3 2 4 3 3 4 1 3 6 4 7 5 1 6 4 2 3 2 Malaria ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... 164 148 33 203 ... ... ... ... ... ... Opthalmia Neonatorum ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 2 1 ... 2 ... ... Pneumonia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 4 ... ... 2 16 13 Poliomyelitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... Puerperal Fever 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... 1 Scarlet Fever 2 12 7 25 10 61 17 16 14 30 27 5 6 2 4 22 36 69 7 4 12 5 Tuberculosis: Pulmonary M ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 4 9 3 4 2 ... 4 4 F ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 2 3 8 3 3 4 3 2 NonPulmonary M ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 1 1 ... ... 2 F ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 1 2 ... 1 1 1 Totals 13 29 17 34 14 72 25 38 22 53 61 16 199 278 85 290 109 112 26 22 45 37 26 Table III. Causes of Deaths in Sidcup Urban District during the Year 1925. Cause of Death. Male. Female. Total. Enteric Fever Small Pox Measles Scarlet Fever Whooping Cough Diphtheria Influenza 1 3 4 Encephalitis Lethargica 1 1 Meningococcal Meningitis Tuberoulosis of respiratory system 2 4 6 Other tuberculous diseases 1 1 Cancer, malignant diseases 4 7 11 Rheumatic Fever 1 1 Diabetes 3 3 Cerebral hæmorrhage, etc. 4 3 7 Heart disease 7 5 12 Arterio Sclerosis 3 2 5 Bronchitis 4 7 11 Pneumonia, all forms 4 2 6 Other respiratory diseases 1 1 Ulcer of stomach or duodenum 1 1 Diarrhoea, etc. (under two years) Appendicitis and typhilitis 1 1 Cirrhosis of Liver 1 1 Acute and chronic nephritis 1 2 3 Puerperal sepsis Other diseases and accidents of. pregnancy and parturition ... ... ... Congenital debility, malformation, premature birth 1 1 2 Suicide Other deaths from violence 1 1 2 Other defined diseases 8 14 22 Causes ill-defined or unknown Totals 43 58 101 27 Sidcup Urban District Council. SANITARY INSPECTOR'S REPORT, 1925. Madam and Gentlemen, I have the honour of submitting my Annual Report on the work of the Department for the year 1925. General. The number of visits paid, 629, are analysed as follows:— 402 to dwellinghouses. , 63 to butcher shops anil slaughterhouses. 11 to bakehouses. 35 to dairies, cowsheds and milkshops. 64 to factories and workshops. 54 to special premises—piggeries, stables, etc. 100 to cases of infectious disease. Total 629 To secure the abatement of nuisances it was found necessary to serve 104 Informal Notices and 10 Statutory Notices. Two hundred and sixteen premises were visited, of which 134 were dwelling houses, 35 factories and workshops, and 27 special premises (slaughterhouses, stables, etc.). Complaints. There were 45 complaints received and investigated, which were as follows:— No. investigated. No. abated. Re noxious accumulations 11 11 „ overcrowding 2 2 „ keeping of animals 2 2 „ sanitary accommodation 4 4 „ drainage 4 4 „ dustbins 1 1 Various 21 21 28 Housing Consolidating Regulations, 1925. Thirty-one premises in Days Lane and Corbylands Road were inspected under the above Regulations, and in 27 houses defects were observed, which the Owners, after intimation, remedied. I would here like to draw attention to the fact that during these inspections it has been found that some of the tenants were quite unconcerned as to the hygienic condition of their premises and were served with Notices. I am accordingly keeping these premises under observation. Increase of Rents, Etc., Acts. During the year under review two applications for Certificates were received and the Council granted the requisite Certificate under the Acts in each case. Infectious Diseases. Notified cases of infectious disease arc visited and at the termination of the disease the infected room and contents are sprayed with formalin and the bedding disinfected in your Thresh Disinfector with steam. One hundred visits were paid to cases of infectious disease, which includes a figure of 86 to tuberculous cases. The Tuberculosis Regidations, which came into operation at the commencement of the year, necessitates quarterly visits to each , of these cases. The disinfection data for the year is:— Rooms disinfected 16 Batches of clothing disinfcctcd 21 Bedding steam disinfected 16 Offensive Trades. There are no Offensive Trades, as defined in the Public Health Act, established in the District. Food Preparation. Food, and its preparation, has again been the subject of legislation during the year, being dealt with in the Meat Regulations, 1925, and in Sections of the Public Health Act, 1925. Thus more frequent visits and closer attention has to be given to premises at which food is prepared or offered for sale. 20 The inspections were as follows:— No. in District No. of Visits No. of defects found No. of defects remedied Bakehouses 5 11 2 2 Dairies 3 35 1 1 Cowsheds 3 Milkshops 7 Slaughterhouses 4 41 ... ... Other food preparing places 1 7 ... ... Total 23 94 3 3 The four Slaughterhouses are licensed biennially. During the year one pair of sheep lungs and liver were voluntarily surrendered. Factories, Workshops and Workplaces. All registered premises were visited. The following inspections were paid:— Number of Premises Inspections Written Notices. Prosecutions. Factories (Including Factory Laundries) 11 11 1 ... Workshops (Including Workshop Laundries) 24 53 ... ... Workplaces (Other than Outworker premises) ... ... ... ... Total 35 64 1 ... 30 Defects Found. PARTICULARS. Number of Defects. Prosecutions. Found. Remedied. Referred to H.M. Inspector. Nuisances under the Public Health Acts (including those specified in Sections 2, 3, 7 and 8 of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts): — Want of cleanliness 1 1 — — Want of ventilation — — — - Overcrowding - — — — Want of drainage of floors — — — — Other nuisances 3 3 — — Sanitary accommodation insufficient 1 - — - unsuitable or defective 1 1 — - not separate for sexes — — — Offences under the Factory and Workshop Acts— Illegal occupation of underground bakehouses (s. 101) — — — — Other offences — — — — Total 6 5 — — 31 Disposal of House Refuse. This matter has caused some difficulty during the year. Complaints were received in respect of the House Refuse Shoot at Crescent Farm, Sideup, at which it had been shot for many years. As a result of this the Shoot was discontinued, but it was only with some difficulty that we found two other but not so convenient shoots. After a short use of these shoots complaints again compelled the Owners to exclude us from depositing there. The Shoot next used, and which is still in our use, is at Foots Cray. It has also been the subject of complaints, and it is estimated to last for only six months, when it will again become imperative for the Council to consider the question of disposal of collected house refuse. Town Planning. During the year the Council decided to proceed with a Town Planning Scheme for the whole of the Urban District, and although this matter is not one of sanitary administration it has many relative aspects, especially in regard to its accompanying sanitary provisions. Improvements Effected. Coppers repaired 9 Dairies cleansed 2 Dampness remedied in premises 33 Drinking water cisterns cleaned 11 Dustbins provided 23 Floors repaired 12 Gutters repaired or renewed 14 Noxious accumulations removed 8 Paving to premises repaired or provided 7 Rain water pipes renewed 10 Roofs repaired 19 Rooms cleansed or repaired—Bedrooms 85 Larders 8 Living Rooms 61 Sculleries 38 Sink waste pipes repaired or renewed 1 Stables cleaned 5 Ventilation to rooms provided 6 Water closets cleaned 24 Water closet pans renewed 2 Water closet flushing cisterns adjusted or repaired 10 32 During the past year Mr. A. V. B. Allen, my Sanitary and Clerical Assistant, has qualified by examination of the Royal Sanitary Institute for the duties of a Sanitary Inspector, and, as a further qualification by securing the Diploma of the Institute of Hygiene, and whilst before so doing he possessed a good practical experience of the duties, such qualifications will undoubtedly improve his status when deputising for me in that capacity. I feel that it is only by mentioning this fact (•hat I can pay tribute to the loyal service your District lias secured at his hands. (Signed) WM. AUGUSTUS FARNHAM, Sanitary Inspector.