Sout 1 SOUTH ALL-NORWOOD Urban District Council. Annual Report OF THE Medical Officer of Health FOR THE YEAR 1933. 68656 Southall=Aorwood Urban District Council ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the year 1933. Wood gates & Sons Ltd., Printers, South Acton, W.3. Public Health Department Manor House, southall. June, 1933. To the Chairman and Members of the Southall-Norwood Urban District Council. Mr. Chairman and Gentlemen, For the Fifth year in succession, it becomes my duty to present the Annual Report on the health and sanitary circumstances of this district. By comparison over a number of years with 118 great towns and cities and 132 smaller towns with populations between 25,000 and 50,000 Southall shows a record consistently good in the matter of the general health of its people and an excellent standard of sanitation. The Report is framed according to the instructions issued by the Ministry of Health. It is therefore necessarily mainly statistical. The population of the Council's area, as estimated by the Registrar-General to mid-1933 is 44,780, an increase of 3,250. The following table is appended for the sake of completeness, showing the progressive growth since 1883 :— 3 TABLE SHOWING GROWTH OF POPULATION. Year Population No of Houses 1883 4,164 - - 1891 5,188 1,021 Census. 1901 9,953 1,920 „ 1911 26,323 5,058 „ 1921 30,287 5.405 „ 1922 30,287 5,518 Registrar-General's Estimate. 1923 31,360 5,620 „ 1924 31,800 5,758 „ 1925 32,220 5,843 „ 1926 32,870 6,074 „ 1927 33,480 6,493 „ 1928 35,340 6,838 „ 1929 35,370 7,190 „ 1930 37,560 8,101 „ 1931 38.932 9,300 Census. 1932 41,530 10,000 (approx.) Registrar-General's 1933 44.780 11,000 „ Estimate. The Birth rate is 15.74 per 1,000 population (17.10 in 1932). The Death rate is 8.64 per 1,000 population (8.1 in 1932). The infant Mortality Rate is 43.9 per 1,000 (48.3 in 1932). The total number of infant deaths under 1 year was 31. It is noted that half of these were due to congenital defects and malformations either in the mother or the child. It is safe to affirm that some of these mothers should not have had any children at all. While the Maternal Mortality rate for England and Wales in 1933 was approximately 4 per 1,000 births, that of Southall averaged over 10 per 1,000 (See Table IX, page 14) It must be pointed out that this figure is misleading without the added explanation that actually there were no maternal deaths in Southall itself. These deaths all occurred in institutions outside the area and with two exceptions in women who had previously arranged to be confined away. In the portion of the Report dealing with the Sanitary Circumstances, it will be seen that special attention is being paid to the matters of dust, dust contamination of food and 4 to refuse disposal. Also to the milk and water supplies. In reference to these latter, systematic inspections are strictly carried out. No dairy premises from which milk issues to the public (excepting only distributors of bottled milk) are sanctioned unless an approved type of steam boiler or other sterilisation plant is installed. It is the intention of the Minister to tighten up the regulations in respect to milk certification. No sample can be considerered satisfactory unless the certificate guarantees that the contents of the bottle as delivered are tubercle free. The public can be assured that we have a very live Sanitary Inspector who is devoting a large portion of his time to the important question of the milk supply. A word as to the Sanatorium. The fact that it was not to have a place in the County Scheme (Report to the County Council dated 30th April, 1931), should not, in my view, deter the Council from making at least one essential addition by the provision of an observation block wherein, in these days of mixed and doubtful infections, cases can be watched before it is decided whether to admit or discharge them. It is much more economical to do this than to have in a large ward full of children a case that from its very nature should never have been admitted. It will add to the value of the sanatorium which will continue to be of great service to Southall for many years to come. As I have previously pointed out—"The Medical Officers of Health of the various areas in the County are of opinion that these small institutions serve a very real local need and should be retained." Concluding I desire to thank the Council for the courtesy and consideration extended to me during my five years of office and especially for the official letter of commendation they were good enough to send me through the Clerk. In my public capacity as Medical Officer of Health and my private capacity as a general practitioner I had to steer a strict and rigid course of impartiality and to be extremely tactful, 5 and I think I can affirm with confidence that throughout the whole of this time my relations with my fellow practi tioners have been most cordial. As to Dr. Smithard—Southall's first full-time Medical Officer of Health, who took up his position at the beginning of April—I think you have in him an able Officer who will serve you loyally. He has met with a cordial reception from the profession and I feel sure the Council will accord to him every facility and assistance he may require to bring his department to a grade of high efficiency. I had an excellent staff to work with. It is scarcely necessary for me again to say with what pleasure I worked with them and how greatly I valued the help and services that, without exception, they invariably and whole-heartedly gave me. I am, Gentlemen, Your obedient servant, CHARLES W. SECCOMBE. Medical Officer of Health (Temp.). 6 SOUTHALL-NORWOOD URBAN DISTRICT COUNCIL. For the Year 1933. THE PUBLIC HEALTH COMMITTEE. Members of the Council :— F. Webster, Esq., (Chairman). C. P. Abbott, Esq. C. F. Collins, Esq., j.p. (Chairman of the Council). H. R. CurTis, Esq. R. F. Fryars, Esq., f.i.s.a. G. Creesey, Esq. E. J. Emerson, Esq. W. Garrod, Esq., j.p. E. B. Hamblin, Esq. John Hill, Esq. J. H. Holmes, Esq. J. Mogg, Esq. G. Reed, Esq. W. R. A. Olive, Esq. J. A. Saxon, Esq. N. H. Stewart, Esq. Major A. T. S. White. F. Ashbourne, Esq. MATERNITY AND CHILD WELFARE COMMITTEE. Members of the Council:— G. Reed, Esq. (Chairman). F. Ashbourne, Esq. E. J. Emerson, Esq. W. Garrod, Esq., j.p. J. Hill, Esq. R. F. Fryars, Esq., to October, 1933. H. R. Curtis, Esq., from October, 1933. J. H. Holmes, Esq. J. A. Saxon, Esq. 7 Maternity and Child Welfare Committee—continued. Co-opted Members :— Mrs. F. M. Gibbs. Mrs. L. Harrison Mrs. E. Knights. Mrs. Parslow. STAFF. Medical Officer of Health (Temp.) :— *C. W. Seccombe, M.R.C.S. (Eng.) L.R.C.P. (Lond) Public Health Department. Chief Sanitary Inspector :— *T. A. Drew, Diploma, R.S.T., M.R.H.S., (Resigned July, 1033). *Ivor A. Stephenson, Cert. R.S.I., C.M.I. (Appointed July, 1933). Assistant Sanitary Inspectors :— J. W. Cronk, Cert., R.S.I. C. G. Rothwell, M.R.San.I., M.S.I.A. Health Visitor for Infectious Diseases :— *Miss E. L. Perrett, Fully trained Nurse, S.R.N. 8 Maternity and Child Welfare Department. Ante-Natal Medical Officer—Part time. *Iris M. Gaddum, M.B., B.Ch., M.R.C.P., M.R.C.S. Infant Clinics—Medical Officers—Part time : *A. E. Beryl Harding, B.A., M.B., B.Ch., M.R.C.P. *A. S. Hall-Craggs, M.R.C.S. (Eng.), L.R.C.P. (Lond.). Health Visitors :— *Miss E. S. Boyd, C.M.B., S.R.N. *Miss B. M. Stanbridge, H.V.Cert., R.S.I., S.R.N. Clerks :— *Mrs. K. M. Masterman. Miss P. Ashton. *Contribution made to salary by Ministry of Health or County Council. STATISTICAL AND SOCIAL CONDITIONS OF THE AREA. Area (acres) : Land, 2,525 ; Water, 50. Population—Registrar-General's estimate 44,780 Number of inhabited houses according to Rate Book approx. 11,000 Rateable value £338,376 Sum represented by a Penny Rate £1,242 VITAL STATISTICS. Total. Male. Female. Live Births—Legitimate 685 371 314 Illegitimate 20 8 12 Stillbirths 29 14 15 Deaths 387 209 178 Birth Rate per 1,000 of Population 15.74 Stillbirth Rate per 1,000 (live and stillbirths) births 395 Death Rate per 1,000 of the Population 8.64 Deaths from diseases and accidents of pregnancy and childbirth— From Sepsis 6 From Other Puerperal Causes 2 Death Rate of infants under one year of age— All Infants per 1,000 live births 43.9 Legitimate Infants per 1,000 legitimate live births 39.4 Illegitimate Infants per 1,000 illegitimate live births 200 Deaths from Measles (all ages) 1 Deaths from Whooping Cough (all ages) 2 Deaths from Diarrhoea under 2 years. 7 10 TABLE OF CAUSES OF DEATHS, 1933. Male. Female Causes of Death. All Causes 209 178 1. Typhoid and Paratyphoid Fever 1 — 2. Measles — 1 3. Scarlet Fever — 1 4. Whooping Cough 1 1 5. Diphtheria .— 1 6. Influenza 12 5 7. Encephalitis Lethargica — — 8. Cerebro-Spinal Fever — 1 9. Tuberculosis—Respiratory 18 19 10. Other Tuberculous Diseases 4 3 11. Syphilis 1 — 12. General Paralysis of the Insane - 1 13. Cancer, Malignant Disease 23 28 14. Diabetes 1 1 15. Cerebral Haemorrhage, etc 8 4 16. Heart Disease 32 35 17. Aneurysm 3 1 18. Other Circulatory Diseases 3 6 19. Bronchitis 16 5 20. Pneumonia (all forms) 9 4 21. Other Respiratory Diseases 2 2 22. Peptic Ulcer 2 2 23. Diarrhoea, etc. (under 2 years) 4 3 24. Appendicitis 9 2 25. Cirrhosis of Liver - — 26. Other Diseases of Liver - 2 27. Other Digestive Diseases 6 4 28. Acute and Chronic Nephritis 8 8 29. Puerperal Sepsis . 6 30. Other Puerperal Causes — 2 31. Congenital Debility. Malformation, Premature Birth, &c 13 3 32. Senility 4 6 33. Suicide 4 1 34. Other Violence 13 8 35. Other Defined Diseases 19 12 11 Table o! Causes of Deaths, 1933—continued. Causes of Death. Males. Females. 36. Causes ill-defined or unknown — — Special Causes (included in No. 35 above) Smallpox - - Poliomyelitis — — Polioencephalitis - - Total Deaths 387 INFANT MORTALITY DURING 1933. Whole District. The total number of deaths under 1 year of age was 31. Rate per 1,000 births, 43.9. The rate in England and Wales was 64, for London 59, and for the 132 smaller towns, 56 per 1,000. Sixteen of the 31 deaths were due to congenital defects and prematurity. Thirteen of these lived less than one week. Nett deaths from stated causes at various ages under one year of age. Causes of Death Under 1 week. 1-2 weeks. 2-3 weeks. J 3-4 weeks. Total under 4 weeks. 1-3 months. 3-6 months. 6-9 months. 9-12 months. Total deaths under 1 year. Certified 13 — — 2 15 4 6 3 3 31 Prematurity, Congenital, Malformation, &c., &c. 13 - - - 13 3 1 - - 17 Enteritis & Diarrhoea - - - - - - 4 2 1 7 Mastoiditis - — — — - - 1 — — 1 Whooping Cough — — — 1 1 — — — — 1 Pneumonia — — — — - 1 - - 2 3 Bronchitis - - - 1 1 - - 1 - 2 13 — — 2 15 4 6 3 3 31 Nett Births Legitimate, 685. Illegitimate, 20. Nett Deaths Legitimate infants, 27 Illegitimate infants, 4 12 DEATHS AND DEATH-RATE. Whole District. Total 387 (Males, 209) ; (Females, 178). Rate 8.64 per 1,000. The total number of deaths registered of persons dying within the district at all ages and from all causes was 184 (males 95, females 89). For statistical purposes it is necessary to add to this figure the deaths of persons from your district who died in the Hillingdon County Hospital, the various London Hospitals and Middlesex County Asylums. These " outside " deaths were 203 in number (males 114, females 89). The total number of deaths, therefore, belonging to the district is 387, and the death-rate 8.64 per 1,000. The deaths in Hanwell Asylum were 217 (males 104, females 113). Deaths North and South-Wards. On the North side the deaths registered in the district were 92 (males 48, females 44). The "outside " deaths numbered 113 (males 58, females 55). Total deaths belonging to this side, 205. On the South side, the deaths registered in the district were 92 (males, 47, females 45). The " outside" deaths were 90 (males 56 females 34). Total deaths belonging to this side are 182). For the purpose of comparison the following table is shown giving the birth and death-rates and the rates of infantile mortality in England and Wales during the year 1933, the figures being provisional: 13 14 Table IX BIRTH RATES, DEATH RATES and ANALYSIS) England and Wales, 118 County Boroughs OP MORTALITY in the YEAR 1933. and Great Towns ; and 132 smaller towns. (Provisional figures. The rates for England and Wales have been calculated on a population estimated to the middle of 1933. But those for the Towns have been calculated on populations estimated to the middle of 1932.) Rate per 1,000 Total Population Annual Death-Rate per 1,000 Population Rate per 1,000 Births Percentage of Total Deaths All Causes. Typhoid and Paratyphoid Fevers. Small-pox. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Influenza. Violence. Diarrhoea, and Enteritis (under 2 years). Total Deaths under 1 year. Certified by Registered Medical Practitioners. Inquest Cases. Certified by Coroner after P.M. No. Inquest Uncertified Caus3s of Death. Live Births Still Births England and Wales 14.4 0.62 12.3 0.01 0.00 0.05 0.02 0.05 0.06 0.57 0.54 7.1 64 90.9 6.3 1.9 0.9 118 County Boroughs and Great Towns, including London 14.4 0.67 12.2 0.00 0.00 0.06 0.02 0.06 0.08 0.55 0.49 9.4 67 91.0 6.0 2.5 0.5 132 Smaller Towns (Estimated Resident Populations, 25,00050,000 at Census 1931) 14.5 0.63 11.0 0.00 0.00 0.04 0.02 0.04 0.04 0.53 0.44 4.9 56 91.7 5.8 1.5 1.0 London 13.2 0.45 12.2 0.00 0.00 0.02 0.02 0.08 0.08 0.51 0.58 11.6 59 88.3 6.3 5.4 0.0 Southall-Norwood 15.74 0.64 8.64 0.02 0.00 0.02 0.02 0.04 0.02 0.37 0.58 9.92 43 88.9 8.5 2.1 0.5 Puerperal sepsis, other. Total. The maternal mortality rates for England and Wales are as follows Per 1,000 live births 1.79 2.63 4.42 Per 1,000 total births 1.71 2.52 4.23 The meternal mortality rates for Southall are as follows Per 1,000 live births 8.51 2.83 11.34 BIRTHS AND BIRTH-RATE. The total number of births belonging to the District was 705; the number registered in our books, however, was 477. The illegitimate births were 20, and there were 29 still-births. The birth-rate per 1,000 population is 15.74. MONTHLY REGISTRATION OF BIRTHS. North Side. South Side. Totals. M. F. M. F. January 17 9 11 7 44 February 13 12 10 6 41 March 7 8 5 8 28 April 19 17 17 15 68 May 18 12 21 19 70 June 13 6 11 7 37 July 11 4 5 10 30 August 11 7 17 9 44 September 7 6 9 10 32 October 7 12 3 6 28 November 12 6 13 8 39 December 4 5 5 2 16 Totals 139 104 127 107 477 243 234 477 15 PHYSICAL FEATURES AND GENERAL CHARACTER OF THE DISTRICT. The Urban District of Southall-Norwood is situated on the main road from London to Oxford, 9} miles from Marble Arch, 5½ miles south-east of Uxbridge, and 4 miles north-west of Brentford, the County Town. The area of the District is 2,575 statute acres—2,525 acres of land and 50 acres of water. The soil is gravel, with occasional outcrops of brick earth. The length of the District from north to south is 2 miles 4 furlongs 86 yards, and the breadth from Bull's Bridge to the Sewage Disposal Works 3 miles 0 furlongs 203 yards, the narrowest parts being at the extreme northern end of the District, which is 2 furlongs 210 yards. The highest point above Trinity high-water mark is on the Southall Station Bridge, which is 115.5 feet, and the lowest point at the Sewage Disposal Works, which is 21.5 feet above such level. The total length of public roads is about 26.75 miles. The average weekly rainfall is 0.36 inches. The total rainfall for the year was 25.2 inches. This information is by courtesy of J. B. Thomson, Esq., the Engineer and Surveyor. The Council control the following open spaces Norwood Green 8 acres Recreation Ground (South all Green) 18 ,, Southall Park 26 ,, Manor House Grounds about) 2 „ For administrative purposes the District is divided into East and West Wards, but for our statistical purposes the District is divided into North and South sides, the Railway being the dividing line. The majority of the houses in the District are occupied by good-class working people, chiefly engaged in the local 16 factories and workshops. These comprise food, jam and chemical works, enginering, hosiery, paint, dye and wood works and laundries, &c. There are no trades carried on which are scheduled as offensive trades. INFECTIOUS DISEASE. Prevalence of, and control over, Infectious Disease. Scarlet Fever. The number of notifications received during the year was 226 as compared with 180 for the previous year. Infection was mainly due to contacts. It has not always been easy to trace a contact from one case to another. Of these 226 cases 212 were admitted to Hospital and 14 were nursed at Home. In reference to the case that died, this had previously had a suspicious throat. It became affected with paralysis and was a late case on admission. Diphtheria. There were 23 cases of diphtheria as compared with 25 for last year. Of these 22 were removed to our own Isolation Hospital. The remaining case which was nursed at home died. There was 1 death from Diphtheria. Smallpox. During the year 2 direct (or actual) contacts with cases of smallpox were notified to this Department. Each one was visited by me on several occasions and kept under observation. Nothing further developed. 17 18 NOTIFIABLE DISEASES DURING THE YEAR (other than Tuberculosis.) Diseases. Ages. Total Cases Notified. Cases Admitted to Hospital Deaths. Under 1 year 1 to 2 2 to 3 3 to 4 4 to 5 5 to 10 10 to 15 15 to 25 25 to 35 35 to 45 45 to 65 65 and over Scarlet Fever - 8 11 14 22 94 38 20 15 2 2 - 226 212 1 Diphtheria 1 1 — 2 — 7 3 5 2 2 — — 23 22 1 Enteric Fever (Para-Typhoid " B ") — — — — — — — — 2 — — — 2 2 1 Erysipelas — — — — — — 1 5 1 13 3 25 8* — Pneumonia 1 1 — - 1 6 1 3 9 12 20 8 62 9* 13 Cerebro-Spinal Meningitis — — — — 1 — 1 — — — — — 2 1* 1 Ophthalmia Neonatorum 2 - - - - - - - - - - - 2 — — Dysentery — — — — — — — — 3 4 1 — 8 — — Chicken-pox 1 6 6 5 4 60 18 3 3 — — — 106 — — Puerperal Pyrexia — — — — — — — 3 4 3 — — 10 10* — Small-pox - - - - — - - - - - - - - - - *To London Hospitals or Institutions outside the District. 19 The Table hereunder gives the number of Infectious Diseases that were notified from the various Institutions and Hospitals (other than Sanatoria) during 1933. Scarlet Fever. Diphtheria. Pneumonia. Dysentery. Erysipelas. Chickenpox. Puerperal Pyrexia. Cerebro S. Meng. Ophth. Neon. Para Typhoid. Pulmonary T.B. Non-pul. T.B. Total. Brompton Hospital - — — - - - - - - - 6 — 6 Central London Throat Hos. - 1 - - - - - - - - - - 1 City of London Maternity Hos. - - - - - - 1 - - - - - 1 Hanwell Mental Hos. - — 17 7 2 - - - - - 1 - 27 Hillingclon County Hos. - 1 9 - 1 1 1 1 - 1 6 2 23 Hounslow Hospital - - - - - - - - - - - 1 1 King Edwards Hos. 1 - - - - - - - - - - - 1 M.P.IfNursing Home. - - - - - - - - - - 1 — 1 Paddington Green Children's Hospital - 1 - - - - - - - - - 2 3 Princess Louise Hos. - - - - - - - - - - - 1 1 Queen Charlotte's Hos. - - - - - - 3 - - - - - 3 St. George's Hospital - - - - - - - - - - 3 — 3 St. Thomas's Hos - - - - - - - - - - - 1 1 West London Hos - - - - 1 - - - - - - 1 2 West Middlesex Hos. - - - - - - - - - - 1 - 1 University College Hos. - 1 - - - - - - - - 1 — 2 Totals 1 4 26 7 4 1 5 1 - 1 19 8 77 NOTIFICATIONS CLASSIFIED IN LOCALITIES FOR 1933. Diseases. Total for District North Side South Side. Admitted to Hospital Total Deaths. Scarlet Fever 226 153 73 212 1 Diphtheria 23 10 13 22 1 Para Typhoid B. 2 1 1 2 1 Pneumonia 62 20 42 9* 13 Dysentery 8 — 8 — — Erysipelas 25 11 14 8* — Puerperal Pyrexia 10 5 5 10* 3 Ophthalmia Neonatorum 2 1 1 — — Chicken-pox l06 50 56 — — Tuberculosis (all forms) 66 33 33 — 44 Cerebro Spinal Fever 2 1 1 1* 1 Small-pox — — — — — 532 285 247 264 64 *To London Hospitals or Institutions outside the District. The eight cases of dysentery occurred in the Hanwell Mental Hospital. Cases of Infectious Diseases have occurred during the year among school children as follows:— School. S.F. Diphtheria. Beaconsfield Road 27 1 Clifton Road 11 2 County 1 — Featherstone Road 13 1 North Road 16 — Tudor Road 27 1 St. Anselm's 1 — Western Road 14 1 20 School. S.F. Diphtheria Crosby House 1 — Allenby Road 4 1 Miss Puttee's, Villiers Road 2 — Miss Abdo's, Portland Road 1 — Gumley House Isleworth 1 — 119 7 Case rate of certain infectious diseases compared with England and Wales:— Rate per 1,000 Living Disease. Local. England and Wales. Small-pox 0.00 0.02 Scarlet Fever 5.04 3.21 Diphtheria 0.51 1.18 Enteric Fever (Para-Typhoid "B") 0.04 0.04 Erysipelas 0.55 0.45 Puerperal Fever (Per 1000 total births) 0.00 3.5 Puerperal Pyrexia (per 1000 total births) 13.4 9.6 ZYMOTIC DISEASE VISITS. (Miss Perrett). During the year, the Nurse paid 1893 visits with reference to cases of infectious disease. Included in this number were 31 visits to cases of measles, (8 to children under 5 years of age and 23 to children over 5 years). Two-hundred and forty-one swabs were taken and 29 anti-toxins given. The total number of children examined by the nurse in the schools was 3110. 21 The following children were excluded from schools for the reasons given:— Various 16 Measles contacts 45 Sore Throat 36 Rhinitis 6 Desquamating 4 Chickenpox contacts 40 Scarlet Fever contacts 196 Diphtheria contacts 17 Total 360 ARTICLES DISINFECTED DURING 1933. Number of Rooms Disinfected 426 Beds 294 Blankets 651 Bolsters 209 Books 98 Covers 156 Eiderdowns 125 Pillows 479 Quilts 47 Sheets 508 Wearing Apparel 157 Total Number of Articles Disinfected 3,150 22 The following articles were destroyed— Beds 11 Covers 1 Bolsters 2 Blankets 7 Pillows 19 Sheets 15 Wearing Apparel 17 Sundries — Total Number of Articles Destroyed 72 ISOLATION HOSPITAL. There were 235 patients admitted during the year. Of these 212 were sent in as Scarlet Fever and 22 as Diphtheria. The following table gives the numbers admitted an discharged each month:— Number Admitted Number Discharged Deaths Scarlet Fever Diphtheria. Scarlet Fever Diphtheria Scarlet Fever. Diphtheria. January 20 — 17 — 1 — February 21 2 19 1 — — March 19 2 26 3 — — April 26 — 19 2 — — May 9 2 22 — — — June 11 3 19 2 — — July 15 5 13 4 — — August 12 3 15 5 — — September 20 — 12 1 — — October 21 2 15 1 — — November 17 1 19 3 — — December 21 2 21 2 — — Total 212 22 217 24 1 — 23 METHODS OF DISINFECTION. Infectious Disease. As to Rooms—The procedure adopted in disinfecting rooms is as follows:— in all cases the room occupied by the patient is sealed and fumigated with Formalin, etc. As to Articles of Clothing.—The clothing, bedding, curtains, and all infected articles which can be removed are taken to be disinfected in the Thresh's apparatus at the Hospital. Verminous Persons and their Belongings. No centre or arrangements for the cleansing of verminous persons or their belongings have been established, and the need for such has not made itself apparent during the year. VACCINATION. Total number of successful Vaccination Certificates received during the year was 228. Total number of Exemptions, 306. 24 Expenditure during the Year:— I am indebted to Mr. H. J. Potter, the Accountant Clerk, for the following particulars of expenditure in connection with our Fever Hospital, for the year ended 31st March, 1934 :— £ s. d. Salaries and Wages 1,441 3 11 Loan Charges 11 16 0 Provisions 652 4 4 Furnishing and Equipment 90 18 5 Rates, Insurances, etc. 229 0 1 Establishment and other expenditure 747 7 8 Materials from Stores 421 17 6 Nurses Accomodation 491 0 11 Total £4,085 8 10 PREVENTION OF BLINDNESS. No action has been taken under Section 66 of the Public Health Amendment Act, 1925, by this Authority, for the prevention of blindness or for the treatment of persons suffering from any disease or injury to the eyes. Several persons are, however, receiving assistance from organisations who care for the blind. OPHTHALMIA NEONATORUM. Cases. Notified. Treated Vision Unimpaired Vision Impaired Total Blindness Deaths. At Home. In Hospital 2 2 — 2 — — — TUBERCULOSIS. Pulmonary Tuberculosis. The number of new cases notified during the year was 57. Twenty-two of these were notified from Institutions (Sanatoria, 2; County Council Hospitals, 7; General Hospitals, 12 ; Mental Hospitals, 1; T.B. Dispensary, Nil). Other forms of Tuberculosis. The number of new cases notified during the year was 9. Deaths from Tuberculosis. Tuberculosis of the Respiratory System, 37; other Forms, 7. 25 The following table shows new cases notified and deaths in 1933:— TUBERCULOSIS NEW CASES AND AGES AT DEATH. New Cases. Deaths. Age Periods. Pulmonary NonPulmonary Pulmonary NonPulmonary. M F. M. F. M. F. M. F. 0-1 _ _ 1 1-5 — 2 1 — — 1 — 5-10 — — 1 — — — 10-15 1 1 1 — 1 15-20 5 8 _ _ _ 2 — — 20-25 3 9 1 1 3 7 — 25-35 4 6 1 — 4 3 — 1 35-45 6 5 — — 4 3 — — 45-55 7 1 — 1 4 1 2 1 1 2 65 and upwards 1 1 — — 1 1 — — Total 26 31 5 4 18 19 4 3 The Table hereunder gives the number of Primary Notifications (Form " A ") of Tuberculosis that were notified from the various Sanatoria and Hospitals during 1933. Hospital. Pulmonary Non-Pulmonary Male. Female. Male. Female. Brompton Hospital 1 5 — — West Middlesex Hospital — 1 — — St. Georges Hospital 1 2 — — Hanwell Mental Hospital 1 — — — Harefield Sanatorium — 1 — — Hillingdon County Hospital 3 3 1 1 Princess Louise Hospital — — — 1 University College Hospital 1 — — — St. Thomas's Hospital — — 1 — West London Hospital, W.6 — — 1 — M.P. Nursing Home 1 — — — Hounslow Hospital — 1 — — Paddington Green Childrens Hospital — — 2 — Clare Hall Sanatorium 1 — — — Total 9 13 5 2 26 ORTHOPAEDIC TREATMENT. There are no special arrangements for the prevention, treatment and after-care of crippling conditions. Any such cases that come before our notice are referred to the patient's own doctor or to the Orthopaedic Hospital. PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925. Action under these Regulations has not been necessary during the year. PUBLIC HEALTH ACT, 1925, SECTION 62 It has not been necessary to take action under this Section during the year. GENERAL PROVISION OF HEALTH SERVICES IN THE AREA. NURSING IN THE HOME. Nature of the Arrangements in the Area. General. The local Nursing Association provides two Nurses, one on each side of the district, for the home nursing of cases of ordinary sickness and accidents, but manifestly more are needed for our rapidly increasing population. Infectious Disease (Measles). The Health Visitor for Zymotic diseases acts as Nurse in cases of Measles outbreaks. 27 FIRST AID DRESSING STATION AND MEDICAL COMFORTS DEPOT. These departments of public service, organised and started by the St. John Ambulance Brigade, were opened in June 1928. Most efficient work has been done, the men of the 55th Division, No.1 District, being detailed for rotation duty. The Medical Comforts Depot, in charge of Nursing Sisters (55th Division Nursing), is open daily from 7.30 to 8.30 p.m. for the issue of all nursing requisites for the sick, on presentation of a voucher signed by a District Nurse, a Certified Midwife, or a Medical Practitioner. A small charge is made for loan of articles and such money is used towards replacements. Two of the Nursing Sisters have been or regular duty assisting at the Child Welfare Centre on two afternoons per week, and their services are much appreciated. The work of the Men's Brigade and of the Nursing Division is not confined to the Station. All local sports meetings and public events are attended, and members are also detailed for duty on all important occasions in London and district, such as Royal Tournaments, Processions, the Cup Final, the Boat Race, etc. The service is honorary. Each member of the Division has to pass a re-examination every year after a course of lectures. The continued interest of the Council in this work is hereby gratefully acknowledged. MIDWIVES. There are 11 Midwives practicing in the district, 2 on the South side and 9 on the North. One of those on the 28 North side only attends to patients in the Nursing Home which she controls. The inspection of Midwives is under the supervision of the County Council. No Midwife is employed or subsidised by this Council MATERNITY AND NURSING HOMES. The Middlesex County Council is the local super vising Authority under the Acts relating to the registration of Maternity and other nursing homes. There are two private nursing homes in the district. POOR LAW MEDICAL RELIEF. The Relieving Officer issued 167 Medical Orders during 1933. Some of these cases also received out-relief or institutional treatment. MATERNAL MORTALITY. Puerperal Fever and Puerperal Pyrexia. During the year ten cases of Puerperal Pyrexia were notified and treated at Hospitals of the London County Council Three of the cases were fatal. There were five maternal deaths of Southall residents confined and treated elsewhere. Maternal deaths and cases of Puerperal Fever and Puerperal Pyrexia are investigated by the Medical Officer of Health, and there is an arrangement whereby the Council has empowered the Medical Officer of Health to call in specialists where, after consultation with the practitioner concerned, it is deemed necessary. Institutional Provision for Unmarried Mothers, Illegitimate Infants and Homeless Children in the District. None. 29 LABORATORY WORK. There has been no change in the arrangements for laboratory work since the last report. The Council provides Anti-toxin free for cases of Diphtheria and a nurse to inject it if desired. The diagnosis of Diphtheritic-croup and Diphtheria is often doubtful for a time, meanwhile no harm can come from a dose of Antitoxin. The importance of the early treatment of diphtheria by anti-toxin cannot be too strongly stressed. The patient's prospect of recovery is thereby greatly enhanced and there is definitely less liability to nerve and heart complications. When the Nurse is on holiday, practitioners are requested to take their own swabs. The Ministry of Health has sanctioned the supply of anti-tetanic serum by the Council to local practitioners. Anti-diphtheric and anti-tetanic serum can always be obtained at the Health Department or directly from the Medical Officer of Health. Diphtheria carriers before leaving the Sanatorium are tested out for virulence. The Council affords facilities to all medical men practising in the district for the examination of pathological specimens and the work is carried out very satisfactorily bv the Lister Institute of Preventive Medicine The following are the figures for the year:— Positive. Negative. Swabs for Diphtheria. &c. 50 460 Sputa for Tubercle 28 124 Blood 2 6 Widal reaction 1 — Urine 3 1 Swabs for Puerperal Pvrexia 6 3 Swabs for Cereobro-spinal Meningitis — 6 90 600 Total 690 This includes a Diphtheria carrier who was tested out for virulence. 30 ADOPTIVE ACTS IN FORCE IN THE DISTRICT. No Local Acts, bye laws, &c., came into force during the year. The following list gives those at present in operation: *(1) Infectious Diseases (Notification) Act, 1889. *(2) Infectious Disease (Prevention) Act, 1890. *(3) Public Health Acts Amendment Act, 1890. *(4) Housing of the Working Classes Act, 1890 (excepting Part IV of this Act). *(5) Public Libraries Act, 1892 and 1893. *(6) Public Heal h Acts Amendment Act, 1907, as to Parts II, III and IV (except Sections 61 and 66), V. VI, VIII, IX and X. (7) Small Dwellings Acquisition Act, 1899-1923. *(8) Public Health Act, 1925 (Parts II, III, IV and V). (9) Maternity and Child Welfare Act, 1918. (10) Local Government and Other Officer's Superannuation Act, 1922. The Bye-laws of this Authority, recently revised, are based on the Model Bye-laws of the Local Government Board and relate to— *(1) Cleansing of Earth Privies, Ashpits and Cesspools. *(2) For the Prevention of nuisances arising from snow, filth, dust, ashes and rubbish, and for the prevention of the keeping of animals on any premises so as to be injurious to health. (P.H.A., 1875, S. 44.). *(3) Common Lodging-houses. (P.H.A., 1875, S.80). (4) New Streets and Buildings. (P.H.A., 1875, S. 157, and P.H.A.A.A., 1890, S. 23). *(5) Slaughterhouses. (P.H.A., 1875, S. 169, and T.I.C.A., 1847, S. 128). 31 *(6) Houses Let in Lodgings. (P.H.A., 1875, S.90). *(7) Removal of Offensive Matter or House Refuse. (P.H.A.A.A., 1890, S. 26). *(8) Keeping of Anmals. (P.H.A., 1875, S.44). (9) Public Baths and Wash-houses. (B. and W.H.A., 1846-82). (10) Open Spaces and Pleasure Grounds. (P.H.A., 1875, S. 164). *(11) Tents, Vans, Sheds, etc. (H.W.C.A., 1885, S. 9 (2) ). Regulations Made by Local Authority in Force in District. (1) Allotments. (A.A. 1887, S. 6). ''These are administered wholly or partly by the Public Health Committee. The unstarred are administered by other Committees of the Council. HOSPITALS. There are no Hospitals in the district other than our own Isolation Hospital for fever cases and the Hanwell Mental Hospital which is governed by the London County Council. Plans have already been prepared for the building of a small General Hospital in Southall, to consist of 18 beds, with a view to enlarging, as funds permit. This Hospital will be situated at The Green, Southall. It will contain an X-Ray installation. The foundation stone will be laid by Lord Wakefield on 19th June, 1934. The Infectious Disease Hospital consists of 60 beds and 7 cots disposed in 6 wards and one isolation ward. There is one discharge block. It is designed for cases of scarlet fever and diphtheria only. The staff of the hospital is as follows:— Medical Superintendent, Matron, Sister, Staff-Nurse, four assistant nurses, two wardmaids, cook, housemaid, laundress, porter-ambulance driver and one gardener. 32 On account of the number of mixed infections and the difficulty in not being always able to determine the exact nature of the case from the initial rash, it seems to me that an observation ward could and should be available attached to the hospital. This could be procured at no great expense. AMBULANCE FACILITIES. For Infectious Cases. A Morris motor ambulance, especially constructed for the Council, is in use for conveying infectious patients to Hospital. For Non-infectious and Accident Gases:— Two properly equipped motor ambulances under the charge of the Chief Officer of the Fire Brigade, are provided by the Council for the use of residents to remove nonnfectious and accident cases to Hospital. Very prompt and efficient service has been rendered. Table of Year's Working of Motor Ambulances. Ordinary cases removed to Hospital 18 Accidents 255 Out of District Cases — Total 1373 Miles travelled 15,291 Cash received £18 1 1 Total expenditure £418 14 1 The 55th Division of the St. Johns Ambulance Brigade is now equipped with a motor ambulance. With the large number of doctors practising in this area, it seems extraordinary that so many cases of street accidents need be taken to other areas for treatment. 33 CLINICS AND TREATMENT CENTRES. Clinic and Treatment Centres. situation. services Provided. day and time. by whom Provided Ante-Natal Clinic Manor House, Southall Medical Supervision Tuesday 10 a.m. Thursday, 10 a.m. Southall-Norwood U.D.C. Infant Welfare Clinic 1. Manor House. Southall 2. Branch Library Supervision of Mothers and Children under 5 years Ditto. 1. Monday and Wednesday 2 p.m. Wednesday, 10 a.m. 2. Thursday, 2p.m. Southall-Norwood U.D.C. M. & C. W. Dental Clinic. Featherstone Road Schools, Southall. Dental Inspection and Treatment of Nursing and expectant mothers and children under 5 years. As required. Southall-Norwood U.D.C. by arrangement with the County Education Authority School Clinics Do. Medical Inspection and treatment of School Children. Daily at 10 Middlesex County Council. Treatment Centres for V.D. Various London Hospitals Examination and treatment. Daily, 7.30 a.m to 7.30. p.m. Middlesex County Council. Tuberculosis Dispensary Green Man Passage Ealing, W.13. Dispensary Treatment and supervision. Monday, 1.30 p.m. Tues., Wed. & Fri. 10 a.m. Middlesex County Council. (Revised to date of Publication). Maternity and Child Welfare Centre. Sessions held by Dr. A. E. B. Harding at the Manor House. Clinic Hours—during 1933 Thursday, 2 p.m. to 4 p.m. Wednesday, 10 a.m. to 12 noon (new cases). Monday, 2 p.m. to 4 p.m. Attendances at Clinic— Seen by Doctor Infants 2663 Children 887 Weighing only— Infants 765 Children 610 4,925 New Cases (Wednesday mornings)— Infants 237 Children 88 Sessions held by Dr. A. S. Hall-Craggs at the Branch Library. Clinic Hours during 1933:— Thursday, 2 p.m. to 4 p.m. Attendances at Clinic:— Seen by Doctor Infants 1032 Children 410 Weighing only Infants 685 Children 375 2502 35 New Cases included in foregoing:— Infants 113 Children 48 161 Summary of Infant Welfare Work for Year 1933. Miss Boyd. Miss Stanbridge. No. of Births Notified 417 272 No. of Births un-notified 21 26 No. of Stillbirths notified 8 6 No. of Illegitimate Births notified 11 9 Visits to Infants: 1st visits 228 229 Re-visits 159 361 Visits to children: 1st visits 57 42 Re-visits 576 978 Visits to Expectant Mothers 168 120 Miscellaneous visits (Unsatisfactory cases] 171 131 Removals 145 97 No access 160 94 Total Visits 1564 2052 Grand Total 3616 36 The attendance of children at the Clinics during the past 5 years have been as follows:— 1929 5,459 attendances 1930 5,890 ,, 1931 5,794 ,, 1932 7,105 ,, 1933 7,427 ,, GRANTS OF MILK. Milk is supplied free or at a reduced rate to expectant mothers (during the last 3 months of pregnancy), to nursing mothers, and to children under 3 years of age. There were 1006 applications granted during the year : Cows Milk Cows Milk Dried Milk Dried Milk Free. at 50% cost. Free. at 50% cost 822 11 173 — ANTE-NATAL CLINIC. The number of patients seen at the Ante-Natal Clinic during the year was 264, and the total number of attendances were 1046. The figures for the last five years are given below :— Year. No. of Patients. Total attendances. 1929 186 464 1930 182 449 1931 260 788 1932 289 893 1933 264 1046 DENTAL TREATMENT. By arrangement between this Council and the County Education Authority, expectant and nursing mothers, and children under 5 years attending the Infant Welfare Centre, are enabled to have Dental treatment and advice. Below are the details of the year's working:— Expectant and Nursing Mothers:— Number sent for inspection 10 Number inspected 7 Number receiving treatment 10 Number of completed dentures — Numcer of Repairs to Dentures 6 Number of Fillings 7 Total number of attendances and re-attendances to dentist 45 37 Number of Extractions under local anaesthetic 12 Number of Extractions under gas anaesthetic 49 Children under 5 Years:— Number sent for inspection 42 Number receiving treatment 38 Number of extractions under local anesathetic 25 Number of extractions under gas anaesthetic 63 Number of fillings 33 Total number of attendances and re-attendances to dentist 44 CHILDREN ACT, 1908. Under the Local Government Act, 1929, the functions of Part 1 of the Children's Act, formerly discharged by the Poor Law Authorities, were transferred to this Council on 1st April, 1930, and Miss Boyd, one of the Health Visitors, was appointed the Infant Life Protection Officer. Below are the particulars of the year's working:— 1.—Notification. (1) Number of Foster Parents on Register:- (a) At the beginning of the year 32 (b) At the end of the year 37 (2) Number of Children on Register:— (a) At the beginning of the year 46 (b) At the end of the year 70 (c) Number who died during the year (in Hospital) 3 (d) Number on whom inquests were held during the year — 2.— Visiting:— (1) Number of children received by foster parents during the year 121 38 (2) Number of nursed children:— (a) Removed during the year 64 (b) Adopted 33 (3) Total number of visits made during the year 180 3. Number of cases in which proceedings were taken during the year — Note.—By a recent decision of the Council, all foster children on arrival are subject to a medical examination by the Medical Officer of Health. SANITARY CIRCUMSTANCES OF THE AREA. Water Supply. There is an adequate supply of water supplied by the South West Surbuban Water Co., and the Metropolitan Water Board to practically every house in the district. No houses are supplied by means of wells. During the year, samples were taken from the mains of the company's supplying the district, and the result of two of the analyses are given below:— "A" Company. Chemical. Parts per 100,00 Total solids dried at 100 deg C. 30.20 Total solids ignited 27.76 Chlorine 2.27 Nitric acid 0.7 Nitrous Acid Nil. Oxygen absorbed 0.031 Free ammonia 0.0031 Albuminoid Ammonia 0.0067 39 Bacteriological. No. of micro-organisms developing on Gelatin (aerobically) at 68 clegs F (3 days) averaged 788 per c.c. No. of micro-organisms developing on Agar (aerobically) at 98 degs F (48 hours) averaged 12 per c.c. Bacillus coli (typical) absent from 100 c.c of sample. Coliform organisms—None. Other organisms—Baccillus welchii absent from 100 c.c. " B " Company. Chemical. Parts per 100,000 Total solids dried at 120 degs C. 36.40 Combined chlorine 2.80 equivalent to NaCl 4.62 Nitric nitrogen 0.45 Nitrous nitrogen Nil. Ammonical nitrogan 0.0006 Albuminoid nitrogen 0.0026 Oxygen absorbed in 4 hours at 27 degs F. 0.065 Lead or copper Nil Temporary hardness (equivalent to CaCo3) 2.38 Permanent hardness 5.3 Total hardness 2.91 Bacteriological. Average No. of organisms producing visible colonies on gelatine, incubated at 20.22 degs (for 3 days—17 per c.c. Average No. of organisms producing visible colonies on agar plates, incubated at 37.5 deg C for 2 days—15 per c.c. 40 B. Coli—Not found in 100 c.c. Streptococci—Not found in 30 c.c. B. Enteriditis Sporogenes—Not found in 100 c.c. Drainage and Sewerage. Excepting in positions of the district not fully developed the whole of the houses are supplied with water closets and are drained to the sewerage system. Public Cleansing. Practically the whole of the district is scavenged directly by the Council. House refuse is collected in low-loading covered mechanical vehicles and transported to an incinerator which deals adequately with the work. During the year a total of 6862 loads of refuse were removed from the houses in the district. Schools. A thorough inspection of all the public schools has been made and they are found to be well cared for. Smoke Abatement. Smoke observations were made on chimneys during the year and no serious infringements were noted. In a few cases the cause of the nuisance was the improper stoking of the furnaces and the advice given to the stokers was effectual in causing an abatement. Housing. Compared with most districts, there is no serious housing problem in Southall. There are undoubtedly many instances of families living under adverse circumstances associated with overcrowding and many instances of extortionate rents being charged for very inadequate accommodation. 41 The main demand is for small houses at the lowest possible rent which the workers with small incomes can afford to pay. There are no so-called "slums" in Southall. There exists, however, houses which are unfit for human habitation, but these are comparatively small in number and occur in widely separated areas, and those areas are small in number, and are being dealt with. The Council has completed a contract for 201 houses which are practically ready for occupation. Slum Clearance. The Committee have under discussion the question of slum clearance, and have scheduled 4 Clearance and 2 improvement areas, together with 5 individual unfit houses. This matter was still under consideration at the end of the year. Inspection and Supervision of Food Milk Supply. There are only 2 cowkeepers on the register as producers of milk. At the end of the year there were on the register 34 purveyors of milk, and during the year 5 purveyors of milk were registered with respect to premises occupied for other purposes to retail milk in sealed receptacles only and 2 new purveyors of milk were registered who had purchased premises from others who were on the register. One new dairy was registered during the year. 42 Milk (Special Designations) Order. 1923. Under this Order, 18 licences were granted during the year, four for the sale of Certified milk, ten for Grade A (tuberculin tested) milk, three for Pasteurised milk, and one for Grade A Pasteurised milk. Thirty-six samples of ordinary unclassified milk were examined for general bacterial count; of these 21 were found to contain over 50,000 bacteria per c.c., the maximum being 1,000,000 per c.c. The attention of the vendors was drawn to the large bacterial count and advice was given in all instances to exercise more care in the sterilisation of milk utensils. During the year considerable attention has been given to improving the methods of cleansing and sterilising milk bottles and utensils. Apparently it is not generally recognised by dairymen that by Article 21 of the Milk & Dairies Order, the use of steam or boiling water for the scalding of all milk vessels is imperative. Boiling water means water at the temperature at which it boils—212 degs F. or in practice, 210 degs F., and does not mean, as is often mistakenly thought, water from which watery vapour, (sometimes erroneously called steam) arises. To get boiling water for the purposes of dairying, the cheapest and most practicable way is by means of a steam boiler. The cleansing of bottles in which milk is delivered is a matter which often receives insufficient attention. A milk bottle is included under the article quoted and therefore should be cleansed by means of steam or boiling water, yet milk bottles which are subjected in the homes to varied uses are apt to be imperfectly dealt with by the dairyman. Exposure of milk bottles and utensils to steam is essential alike for the protection of the public and from a commercial point of view, because when the bottles and milk receptacles are sterilised, the milk keeps better and the dairyman gets the resulting approbation of the public and so greater custom. 43 During the year, special attention has been paid to the question of the installation of steam raising boilers and the provision of proper sterilising cabinets for bottles, and the dairymen are rapidly falling into line with this requirement. A survey of the milk supply was undertaken with interesting results, which are here recorded:— Total population : 48,000. Average consumption of milk per person per day :.4 of a pint. Total quantity of milk consumed per day: 19,200 pints. The amount of milk consumed per person per day in Southall is slightly higher than the estimated average for the whole country, which is .3 of a pint. Meat and Other Foods. There were no infringements of the Public Health (Meat) Regulations. No meat is sold from stalls in the district. There are two registered slaughterhouses and one licensed slaughterhouse in the district. During the year,, 17 cattle, 17 calves, 37 sheep and 566 pigs were slaughtered in these slaughterhouses and all meat was inspected. There is no public abattoir in the district. In connection with the inspection of meat and other foods the following were found to be diseased or unsound, and were voluntarily surrendered for destruction:— tons. cwts. qrts. lbs. Meat, including rabbits and offal 1 6 — 1 Fish — 11 2 27 Fruit — 1 1 20 Marzipan — 2 0 0 44 Food and Drugs Adulteration Act. Ill discussing the question of the food supply, the following figures were kindly supplied by Richard Robinson, Esq., the Chief Officer of the Public Control Department of the County Council, showing the number of samples taken during the year by his Officers :— Article. No. of .samples. Adulterated. Milk 119 — Hake 7 1 Lemon Soles 3 - Minced Beef 1 - Sausages 2 — 132 1 45 The following table shows the number of samples taken by the officers of your Public Health Department :— Article. No. of samples. Remarks Milk 510 Including 42 samples for bacteriological examination. Sausages 8 Satisfactory Butter 4 ,, Faggots 1 ,, Sweets 1 ,, Minced Meat 1 ,, Prawn Paste 1 ,, Flour 1 ,, Marzipan 2 ,, Tinned strawberries 1 ,, Meat Paste 2 ,, Water 8 ,, 549 PETROLEUM ACTS, 1821-1928, AND ORDERS THEREUNDER. The Acts provide for the safe keeping of petroleum and carbide of calcium. During the year 40 applications were received for the renewal of petrol licences for similar quantities as hitherto, and two applications for licences to store an increased quantity and one for a decreased quantity. In each instance the applications were granted, subject to the Regulations being strictly observed. In addition, 1 new application was received to store petrol. Three applications were received for the renewal of licences to store carbide of calcium. These applications were granted subject to the regulations being strictly observed. All the licensed premises have been regularly inspected, and no infringement of the terms of the licences was recorded. The number of licences in force at end of 1933 within the district was 50 for petroleum and 3 for carbide of calcium, and the number of gallons covered by the licences was 288,690 gallons, and 6 cwt. 3 qrs. of carbide of calcium. A perpetual licence was granted to the British Petroleum Company in 1919, to store 3,000 gallons of petroleum spirit at a store on a site known as " The Crescent." This licence was issued by the Secretary of State, Home Office, and is not renewable. CELLULOID AND CINEMATOGRAPH FILMS ACT, 1922. There is only one Licence issued by this Council, the business being for the purpose of stripping and making celluloid solution from Cinematograph Films. These premises are periodically inspected during the year. 46 CANAL BOATS. During the year 148 visits, including 24 ineffectual visits due to no boats plying at the time, were paid to the Canal and 90 boats were inspected. The general conditions of the boats and their occupants were satisfactory. One infringement was found. but by the end of the year no certificate of it being rectified had been received. There were no complaint notes issued by other Authorities, and no cases of Infectious Disease were notified upon any of the boats. It has therefore not been necessary to detain any vessel for the purpose of cleansing and disinfection. Inspection of the boats is often made by an Inspector from other districts just prior to the visit for inspection by the Local Inspector. This causes overlapping. REPORT ON THE ADMINISTRATION OF THE FACTORY AND WORKSHOP ACT, 1901. in connection with. FACTORIES, WORKSHOPS AND WORKPLACES. 1.—Inspection of Factories, Workshops and Workplaces. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. N umber ot Inspections. Written Notices. Occupiers prosecuted. (1) (2) (3) (4) Factories (Including Factory Laundries) 458 12 - Workshops (Including Workshop Laundries 84 2 — Workplaces (Other than Outworkers' premises) Total 542 14 47 2.—Defects found in Factories, Workshops and Workplaces. Particulars. Number of Defects. Number of offences in respect to which Prosecutions were instituted. Found. Remedied Referred to H.M. Inspector. (1) (2) (3) (4) (5) Nuisances under the Public Health Acts :—* Want of cleanliness 7 7 — — Want of ventilation — — — — Overcrowding — — — — Want of drainage of floors — — — — Other nuisances 7 7 — — Sanitary accommodation: insufficient — — — — ' unsuitable or defective 1 1 — — not separate for sexes 1 1 — — Offences under the Factory and Workshop Acts :— Illegal occupation of underground bakehouse (s. 101) - - - - Other offences (Excluding offences relating to outwork and offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921). - - - - Total 16 16 — — *Including those specified in sections 2, 3, 7 and 8 of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts. 48 SANITARY INSPECTION OF DISTRICT. The total number of inspections made to premises in connection with the work of your Health Department (including re-visits and visits to food shops) was 8,594. Houseto-house inspections, supervision and testing of drainage and sanitary fittings, taking of samples of milk, and other foods, inspection of canal boats, lodging-houses, dairies, cowsheds, milkshops, storage of petroleum, workshops, slaughterhouses, bake-houses and all premises where food is deposited, prepared or exposed for sale, have each received attention. The following table shows the number and nature such inspections :—- No. of Notices served : Preliminary 456 Statutory 60 Total 516 Visits to premises on Complaints 482 Houses Inspected—House-to-house 671 No. of Inspections and Re-inspections of Houses and Premises, etc. 4,408 Miscellaneous 368 Slaughterhouses 145 Factories, Workshops, Workplaces and Outworkers 542 Visits to Canal for Boat Inspections 148 Infectious Disease 141 Petroleum and Carbide Stores 70 Food Sampling 135 Food Shops, Dairies, Bake-houses, Fried Fish Shops, &c. &c. 1059 Smoke Observations 34 Ditches 81 Shops' Acts 38 Piggeries 71 Tents, Vans & Sheds, &c 43 Deposits & Accumulations of Refuse 149 Schools 9 Total Number of Inspections 8594 49 Total number of defects or nuisances found during the year 1,331 Total number of defects or nuisances abated during the year 1,268 The following table shows the number and nature of complaints received during the year :— Choked Drains 54 Dampness 18 Nuisance caused by the keeping of Animals and Fowls, etc. 8 Defective Dustbins or absence thereof and non-removal of House Refuse 76 Offensive Smells from various causes 35 Defective Roofs, Gutters, R.W.P.'s 9 Dirty Condition of House 17 Defective Condition of House 30 Accumulation of Refuse, etc. 31 Defective Sanitary Fittings 18 Miscellaneous 74 From H.M. Inspector of Factories 1 Total number of Complaints received 371 PREMISES AND OCCUPATION WHICH CAN BE CONTROLLED BY BYE-LAWS. Van Dwellers. There are still 2 occupied caravans in Havelock Road, Southall. This matter the Council has in hand. There are also 2 occupied caravans in the Pleasure Ground of Mr. Beach, Regina Road. These latter are provided with Lavatory Accommodation and have water supply off the main. 50 Offensive Trades. There is none in this district. Underground Sleeping Rooms. There are no underground sleeping rooms within the meaning of the Act. Houses Let in Lodgings. There are no lodging houses within this district, OTHER SANITARY CONDITIONS. M ortuary. The Mortuary is situated in the Cemetery Ground, Havelock Road, It remains antiquated and out of date. The Council have under consideration the provision of a new building in a more convenient position. 51 HOUSING STATISTICS FOR THE YEAR 1933. 1. Unfit Dwelling-houses. Inspection of Dwelling Houses During the Year— (1) (a) Total number of dwelling houses spected for housing defects (under Public Health or Housing Acts) 1,579 (b) Number of inspections made for the purpose 2,592 (2) (a) Number of Dwelling-houses, included under sub-head (1) above, which were inspected and recorded under the Hous- ing Consolidated Regulations, 1925 671 (b) Number of Inspections made for this purpose 1,335 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unlit for human habitation without reconstruction0 — (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 578 2. Remedy of Defects without Service of Formal Notices— Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers 315 3. Action under Statutory Powers— (A) Proceedings under Section 17, 18 & 23 of the Housing Act, 1930. (1) Number of dwelling-houses in respect of which notices were served requiring repairs 25 52 (2) Number of dwelling-houses which were rendered fit after service of formal notices— (a) By Owners 25 (b) By Local Authority in default of owners — (B) Proceedings under Public Health Acts— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 27 (2) Number of dwelling-houses in which defects were remedied after service of formal notices— (a) By owners 25 (b) By Local Authority in default of owners — (C) Proceedings under Sections 19, and 21 of the Housing Act, 1930— (1) Number of Dwelling-houses in respect of which Demolition Orders were made (2) Number of dwelling-houses demolished in pursuance of Demolition Orders — (D) Proceedings under Section 20 of the Housing Act, 1930: (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made — (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit — 53 (E) Proceedings under Section 3 of the Housing Act, 1925:— (1) Number of Dwelling-houses in respect of which notices were served requiring repairs — (2) Number of Dwelling-houses which were rendered fit after service of formal notices : (a) By Owners — (b) By Local Authority in default of Owners— (3) Number of Dwelling-houses in respect of which Closing Orders became operative in pursuance of declarations by owners of intention to close — (F) Proceedings under Sections 11, 14 and 15 of the Housing Act, 1925 : (1) Number of Dwelling-houses in respect of which Closing Orders became operative — (2) Number of Dwelling-houses in respect of which Closing Orders were determined, dwelling-houses having been rendered fit — (3) Number of Dwelling-houses in respect of which Demolition Orders became operative — (4) Number of Dwelling-houses demolished in pursuance of Demolition Orders — 54 INDEX. Acts, Adoptive in Force 31 Ambulance Facilities 33 Ante-Natal Clinic 37 Area 10, 16 Articles Disinfected 22 Births and Birth Rate 10, 14, 15 Blindness, Prevention of 25 Bye-Laws in Force 31, 32 Canal Boats 47 Caravan Dwellers 50 Causes of Death 11,12 Celluloid and Cinematograph Films Act 46 Clinics 34, 35, 36, 37 Committees 7, 8 Cowkeepers 42 Deaths and Death Rates 10, 11, 12, 13, 14 Dental Treatment 37, 38 Diphtheria 17, 18,19 Disinfection 22, 24 Drainage and Sewerage 41 Factories, Workshops and Workplaces 47, 48 Food, Examination of 44, 45 Food, Unsound 44 Foster Children 38 Grants of Milk 37 Health Services, General Provision of 27 Health Visitors' Reports 36 Hospitals 32 Houses Let in Lodgings 51 Houses—Number Inhabited 10 Housing Conditions 41 Housing Statistics 52, 53, 54 55 Infant Mortality 10, 12 Infant Welfare Centre 35 Infectious Diseases 17,18,19, 20, 21, 22, 23, 24 25,26 Infant Life Protection 38 Inspections by Sanitary Inspectors 49 Inspection and Supervision of Food 42, 45, 46,47 Isolation Hospital 23,24 Laboratory Facilities and Work 30 Maternal Mortality 10, 29 Maternity and Child Welfare Committee 7, 8 Maternity Cases—Accommodation 29 Medical Relief 29 Midwives 28 Milk 42, 43, 44 Mortuary 51 Nursing in the Home 27 Notifiable Diseases 17 to 26 Offensive Trades 51 Ophthalmia Neonatorum 25 Orthopaedic Treatment 27 Petroleum Acts 46 Physical Features of District 16 Population 10 Premises and Occupations which can be Controlled by Bye-Laws 50 Public Health Committee 7 Puerperal Fever and Pyrexia 29 Rateable Value 10 Refuse Collection 41 Saint John's Ambulance Service 28 Samples taken 45 Sanatoria 26 56 Sanitary Circumstances 39 Scarlet Fever 17, 18, 19 Schools 41 Sewerage and Drainage 41 Slaughterhouses 44 Small-Pox 17 Smoke Abatement 41 Staff 8, 9 Statistics—General and Vital 10 Still Births 10 Swabs, Examination of 30 Tents, Vans, Sheds, etc. 50 Tuberculosis 25, 26, 27 Unsound Food 44 Vaccination 24 Venereal Disease Clinics, &c. 34 Verminous Persons 24 Vital Statistics 10 Water Supply 39 Workshops 47, 48 57 «