Sur 10 The Urban District Council Of SURBITON. ANNUAL REPORT For the Year ended December 31st, 1925 of the MEDICAL OFFICER OF HEALTH and THE SANITARY INSPECTOR. Philpott & Co. (Surbiton), Ltd., Brighton Road, Surbiton.—22235. The Urban District Council of SURBITON. ANNUAL REPORT For the Year ended December 31st, 1925 of the MEDICAL OFFICER OF HEALTH and THE SANITARY INSPECTOR. The Urban District Council or Surbiton. PUBLIC HEALTH COMMITTEE. Councillor W. Sanger, C.B. (Chairman). Councillor J. B. Ryland (Vice.Chairman). Councillor Miss M. Edwards. „ Bailey. „ Dumper. „ Durbin. „ Ferguson. „ Glover. Councillor Hawkey. „ Mence. „ Page. „ Ray. „ Reynolds. „ Wilkins. PUBLIC HEALTH DEPARTMENT. Medical Officer of Health: * N. Hood Linzee, M.R.C.S., L.R.C.P., D.P.H. (jpart time). Sanitary Inspector. *W. Nesfield, A. R. San. Inst. Assistant Sanitary Inspector: S. H. Franklin, M. R. San. Inst., C.M.I. Veterinary Surgeon: Alfred C. Wild, M.R C.V.S. (part time) Clerk: H. J. Eldridge, Cert. R. San. Inst. Clerk to the Council: C. Edgar Shelly. *Contribution to salary made from Exchequer. 5 Medical Officer's Annual Report. Public Health Department, Council Offices, Ewell Road, Surbiton. August, 1926. To the Chairman and Members of the Urban District Council of Surbiton. Ladies and Gentlemen, I have the honour to submit to you my Fourth Annual Report upon the Health and Sanitary condition of the district for the year ending December 31st, 1925. This Report is compiled on the lines set out in Circular No. 648 from the Ministry of Health dated December 10th, 1925, and is on this occasion a a quinquennial Survey Report, this being the first of its series. The health of the district according to the Death Rate seems to be better than in the previous year; Death Rate 10.6 as compared with 11.8 per thousand. The Death Rate for the 157 smaller towns in England and Wales was 11.2 per thousand. 6 The Infant Mortality Rate is 325 per thousand births, and, compared with the previous year, which was 82 per thousand births, is very satisfactory, and is the lowest in the last five years save for the year 1923. The Infant Mortality Rate for England and Wales is 74 per thousand births. A.s regards the Birth Rate, there is a steady decline, being 15.3 per thousand. The Birth Kate for England and Wales is 18.3. There seems to be a gentle decline in the number of cases of Diphtheria and Scarlet Fever. The number of cases of Pneumonia on the other hand has increased. In this Survey Report I am required to make a statement on the progress made during the last five years in this district. In glancing through the statistics one can see that considerable satisfaction as regards the public health of the district is apparent. Particulars of the number of houses inspected and other work carried out by the Sanitary Inspector are set out in his Report wbich is appended. The inspection of the district in my opinion is carried out very satisfactorily, in spite of the increased amount of work in the Office in keeping the books and records, typing out necessary notices, etc. In July, 1925, the Council purchased an up.to. date Motor Ambulance, details of which will be found in a subsequent paragraph. 7 The erection of houses, with regard to which full information is given further on in this Report, proceeds well above the normal. An up.to.date X.Rays Apparatus was installed at the Surbiton Hospital during 1925, which has proved a great benefit to the people in the district. I should like to point out the necessity of providing a larger or more convenient Hospital. The site of the present Hospital was purchased in 1881, and the building, which was opened in April, 1883, fully equipped for 16 beds, has since been added to from time to time, and naturally has several drawbacks. Very good work has been accomplished in the Hospital, but in view of the rapid increase in population, the matter of re.building should be urgently considered. I have to thank Mr. Nesfield, your Sanitary Inspector, and the Officers of the Public Health Department, for their assistance. I am, Ladies and Gentlemen, Your obedient Servant, N. H. LINZEE. Medical Officer of Health. NATURAL AND SOCIAL CONDITIONS OF THE DISTRICT. Area (acres) 3,046 Population (1921 Census) 19,547 Population (1925 Registrar.General's figures) 20,020 8 Physical Features and General Character of the District. Area of District.—This is officially given as being 3,046 acres, or as 3,031 exclusive of water. The shape is practically a square with a long protruding tongue stretching between Cbessington and Claygate, and consists of the Civil Parishes of Surbiton, Tolworth and Hook. Boundaries.—On the North by the Borough of Kingston.upon.Thames, on the North.West by the River Thames, which has a length within the district of 940 yards and includes within our area the Island known as Ravens Eyot, on the West and partly South.West by the territory of the Urban District Authority of Esher and The Dittons, on the East by the Hogg's Mill River, otherwise locally known as the Maiden River, and by the Maidens and Coombe Urban District, and from South.East to South.West by the Epsom Rural District. Physical Features.—The area of the district is roughly divided into Northern and Southern parts by the Southern Railway which runs in a deep cutting through the entire district from North.East to South.West, and by the rising ground known as Surbiton Hill, towards which on the Northern aspect the ground slopes upward from the level of the Rivers Thames and Hogg's Mill, forming a ridge which extends from Minniedale and the parts known as Clay Hill (now re.christened Villier's Avenue) overlooking Kingston, to just outside the boundary 9 at Cock Crow Hill within the Parish of Long Ditton. The highest part of this ridge within our area is 118.6 feet. Geology.—The greater part of the district is of the Tertiary period embracing the Eocene strata of London Clay. In the portion nearer the river there are post.tertiary deposits of gravel and sand, described in the geological survey as "Valley Brick Earth." This extends from the line of the river up to the railway and then stretches down the Clare. mont Road to the Kingston Boundary Fossils have been discovered occasionally, but not in any quantity. In the clay there have been found round stones or boulders with iron stained crystals and deposits of crystalline gypsum Number of Inhabited Houses. At the 1921 Census the number of completed buldings in the district containing dwellings was 4,112. Twenty.three of these buildings were occupied by " non.private families." The remaining 4,089 buildings contained 4,255 structurally separate dwellings, 155 of which were vacant (chiefly owing to the temporary absence of the occupiers) when the Census was taken. The remaining 4,100 structurally separate dwellings were occupied by 4,767 private families or separate occupiers 10 Rateable Value. The Rateable Value and the sum represented by a Penny Rate during the past five years was as under:— Year ended 31st December. Rateable Value. Sum represented by a Penny Rate. £ s. d. £ s d. 1921 184,986 0 0 682 5 9 1922 190,516 0 0 690 15 7 1923 191,917 0 0 710 17 0 1924 197,947 0 0 726 14 8 1925 200,806 10 0 760 17 0 Social Conditions. The district is entirely a residential one. It is situate on the banks of the River Thames, but with a considerable portion of it on hill ground at a height of from 100 to 120 feet above ordnance datum. A very large proportion of the adult male residents here are engaged in business in London, for access to which the facilities offered by the Southern Railway are not surpassed in the case of any similar extra metropolitan district. The tramways also provide a good service, more especially for transit to Kingston and the townships on the other side of the river, besides communications with Richmond and Bushey Parks and Hampton Court. There are no factories or works employing 11 many hands, with the exception of the pumping stations of the Metropolitan Water Board, and of the workers engaged at these, the majority are locally resident within the district, the balance living over the border in Long Ditton. There are three large open, pleasantly situated Recreation Grounds, where cricket, bowls, hockey, football, tennis, etc., are played, and where flower, horse and other shows from time to time take place, all under the control of a Committee of the Council. Originating solely as a residential suburb of London consequent on the South.Western main line running through it, Surbiton has ever since remained of that character, and under the guardianship of successive enlightened and progressive Commissioners and Councillors has, not unsuccessfully, led the way in the matter of sanitary observances, under which I include drainage, water and milk supplies, the construction and maintenance of its roads and paths, the treatment of its infectious sick, and especially in the housing of the working classes. A lead has always been given in these important matters, and we have always endeavoured to keep in the forefront of progress, and moreover, thanks to careful administration, these benefits have been obtained and maintained at a cost that bears a most favourable comparison with any first class neighbourhood of a similar character. Situate in a delightful position on the banks of the Thames and in the immediate neigbourhood of the Royal Parks and a charming surrounding district, 12 these added sanitary conditions mentioned above, combine to provide Surbiton with attractions so far in excess of most other places that it has always been and—given a continuance of policy on similar lines— should always be a most popular and populous place. It deserves to be classed as a "health resort" if there is any meaning in such a term, inasmuch as it is a place where good health can be obtained, perpetuated and enjoyed, especially suitable for children and for old people, and in direct contra distinction to that other and baser use of the term which signifies "health resort" to mean a place to which people, out of health, resort in order to be restored to health. Maintaining its character from its inception on the making of the L. & S. W. Railway, Surbiton is de facto a residential neighbourhood with no dominating factories or works. The trade is mainly that which exists for the needs of the residents, a very large proportion of whom travel to and from London daily. Chief Occupations. The following particulars as to the chief occupations of Surbiton residents are extracted from the Census Report for 1921 :— MALES OVER 12. Total occupied 5,635 Agricultural occupations 427 Mining and Quarrying occupations 1 Makers of Coke, Lime, Cement, etc 3 Makers of Bricks, Pottery, Glass 29 13 Workers in Chemicals, Paints, etc 10 Metal Workers 405 Workers in Precious Metals 9 Electrical Apparatus Makers, Fitters, etc 76 Makers of Watches, etc 17 Workers in Skins; Leather Goods Makers 9 Textile Workers 6 Makers of Textile Goods and Articles of Dress 132 Makers of Foods, Drinks and Tobacco 69 Workers in Wood, etc 228 Paper Workers; Printers etc 94 Builders, Bricklayers, etc 230 Painters and Decorators 199 Workers in other Materials 12 Workers in Mixed and Undefined Materials 59 Persons in Gas, Water, Electricity Supply 34 Transport Workers 555 Commercial and Financial Occupations 948 Public Administration and Defence 306 Professional Occupations 397 Persons Employed in Entertainments, etc 27 Persons Employed in Personal Service 222 Clerks, Draughtsmen, Typists, etc 580 Warehousemen, etc 63 Stationary Engine Drivers, etc 85 All other occupations 403 FEMALES OVER 12. Total occupied 3,275 Agricultural occupations 16 Metal Workers 8 Electrical Apparatus Makers, Fitters, etc 2 Makers of Watches, etc 2 Workers in Skins; Leather Goods Makers 2 Textile Workers 13 Makers of Textile Goods and Articles of Dress 185 Makers of Foods, Drinks and Tobacco 18 Workers in Wood, etc 12 14 Paper Workers; Printers, etc 35 Painters and Decorators 2 Workers in Mixed and Undefined Materials 6 Transport Workers 31 Commercial and Financial Occupations 261 Public Administration and Defence 90 Professional Occupations 282 Persons Employed in Entertainments, etc 17 Persons Employed in Personal Service 1,875 Clerks, Draughtsmen, Typists, etc 395 Warehousemen, etc 10 All other occupations 13 It does not appear that any particular occupation has had a prejudicial effect on the public health. Extracts From Vital Statistics of the Year 1925. Births:— Total M. F. Legitimate 298 140 158 Illegitimate 9 4 5 Birth Rate (R.G.) 15.3. Deaths 214 95 119 Death Rate (R.G.) 10.6. 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 32.5. Legitimate, 8; Illegitimate, 2 ; Total 10. Deaths from Measles (all ages) 1 Deaths from Whooping Cough (all ages) 1 Deaths from Diarrhoea (under 2 years of age) 1 15 Causes of Death During 1925. (Civilians only). Male. Female. All causes 95 119 1. Enteric Fever — — 2. Small.pox — — 3. Measles — 1 4. Scarlet Fever — — 5. Whooping Cough — 1 6. Diphtheria — — 7. Influenza 3 5 8. Encephalitis Lethargica — 2 9. Meningococcal Meningitis — — 10. Tuberculosis of Respiratory System 9 2 11. Other Tuberculous Diseases 1 2 12. Cancer, malignant disease 17 20 13. Rheumatic Fever — — 14. Diabetes — — 15. Cerebral Haemorrhage &c 4 2 16. Heart Disease 13 18 17. Arterio.Sclerosis 8 15 18. Bronchitis 5 7 19. Pneumonia (all forms) 3 14 20. Other Respiratory Diseases 2 1 21. Ulcer of Stomach or Duodenum 3 1 22. Diarrhoea, &c. (under 2 years) 1 — 23. Appendicitis and Typhlitis 1 — 24. Cirrhosis of Liver 1 — 25. Acute and Chronic Nephritis 3 2 26. Puerperal Sepsis — — 27. Other accidents and diseases of pregnancy and parturition — — 28. Congenital Debility and Malformation, premature birth 2 3 29. Suicide 3 — 30. Other deaths from violence 5 1 31. Other defined diseases 11 22 32. Causes, ill.defined or unknown — — According to figures furnished by the Registrar.General. 16 The various rates compared with those for England and Wales (Smaller Towns) are given in the table below:— Per 1,000 Living. Per 1,000 Births. Births. Deaths. Diarrhoea under 2 years. Under 1 year. England and Wales (Smaller Towns) ... 18.3 11.2 76 74. Surbiton 15.3 10.6 3.2 32.5 Infantile Mortality. The causes and ages at death of the ten children who died under the age of one year were as follows:— Infective Enteritis 7 days. Broncho Pneumonia 6 months. Premature Birth 3 days. Asphyxia. Want of attention at birth Newly-born. Infantile Debility. Congenital Malformation 2 months. Whooping Cough. Bronchitis 3 months. Prematurity 15 days. Premature Birth. Marasmus 27 days. Prematurity 1 day. Intersusception. Operation. Shock 4 months. Population. The population of Surbiton at the time of the 1921 Census was 19,547. The following table shows the Registrar General s estimate of the population and the number of new 17 houses erected in the district during the past five years:— year. Estimated Population. Number of New Houses Erected. 1921 19,330 61 1922 19,520 25 1923 19,670 55 1924 19,660 134 1925 20,020 219 In spite of the very satisfactory progress in building and the conversion of a number of the larger houses in the district into flats, the Registrar General's estimate of the population has only been increased by 690 from 1921 to 1925, and his figures would appear not to represent the true population of the district In 1924, when 134 new houses were erected, the estimated population was actually decreased by 10, and in 1925, when a further 219 houses were built, it was only increased by 360. GENERAL PROVISION OF HEALTH SERVICES IN THE AREA. Hospitals. 1. Tuberculosis. Cases are admitted into sanatoria through the Surrey County Council, 2, Maternity—Nil. 18 3. Children—Nil. 4. Fever. The Hospital provided for the isolation of cases of infectious diseases is under the management of a joint hospital board appointed by the Urban District Councils of Surbiton, Maiden, Esher and the Dittons, and Ham. The Hospital is situated in this district. 5. Small-pox. The Small-pox Hospital, situated at Clandon, is controlled by the Surrey County Council, and is subsidised by the District Council. 6. Other. The Surbiton Hospital, which is supported by voluntary contributions. Institutional provision for the unmarried mothers, illegitimate children and homeless children.—Nil. Ambulance Facilities. (a) For Infectious Cases.—A motor ambulance is provided by the Joint Hospital Board. (b) For Non.Infectious and Accident Cases.— In July last the Council abolished the old hand ambulance, and purchased a 20/25 H.P Austin Special Ambulance Chassis, and had erected thereon an ambulance body to take two stretcher cases, and four sitting cases, fitted with 19 electric light, lavatory basin, heating, and all necessary first.aid appliances. Arrangements have been made for it to be available at any time, night or day, in cases of accident or sudden illness in the street. The Ambulance is also available for the removal of private cases at any time upon the production of a medical certificate and evidence of accommodation having been arranged at the Hospital, etc., to which the patient is to be taken, and upon payment of the prescribed fee. Clinics and Treatment Centres.—Combined Maternity and Child Welfare Centre and School Clinic (provided by Surrey County Council), Ewell Road, Surbiton. Tuberculosis Dispensary (provided by Surrey County Council), Grove Crescent, Kingston.on. Thames. Venereal Diseases.—Arrangements are made by the County Council for the treatment of these diseases at various Hospitals and Centres. Professional Nursing in The Home. (a) General. The St. Mark's, Surbiton, and St. Mary's, Ditton, Nursing Association, which is affiliated with Queen Victoria's Jubilee Nurses Association, has a trained nurse who is available for attending 20 cases of sickness (other than maternity cases) in the home, within a radius of two miles of the Surbiton Post Office. In each of the Ecclesiastical Parishes of Christ Church and St. Matthew's a parish nurse is provided by the Church Authorities for home nursing. There are also three private nursing associations, whose nurses are available for home nursing on payment of the prescribed fee. (b) Infectious Disease. There are no arrangements for the home nursing of cases of Measles and Whooping Cough. Midwives.—The District Council does not employ or subsidise any midwives. The Surrey County Council is the supervising authority under the Midwives Act. There are three midwives practising in the District. List of Adoptive Acts, Bye.Laws, and Local Regulations Relating to Public Health, in Force in ths District, with Date of Adoption. Local or Adoptive Acts. The Surbiton Improvement Act, 1855. Infectious Disease (Prevention) Act, 1890 (March 10th, 1891). 21 Public Health Acts Amendment Act, 1890 (March 10th, 1891). Private Street Works Act, 1892 (March 13th, 1893). Public Health Acts Amendment Act, 1907 (part of) (September 27th, 1909). Surbiton Urban District Council Act, 1910. Public Health Act, 1925 (part of) (December 14th, 1925). Bye-Laws and Regulations. (1) Bye-Laws with respect to Nuisances (March 20th, 1880). (2) Bye-Laws with respect to Tents, Vans, Sheds and Similar Structures (October 10th, 1898). (3) Bye-Laws as to New Streets and Buildings (April 18th, 1898). (4) Regulations as to Dairies, Cowsheds and Milkshops (July 10th, 1899). (5) Bye-Laws as to Drainage of Buildings (July 14th, 1902). (6) Bye-Laws as to New Buildings (June 15th, 1905 and April 16th, 1907). (7) Bye-Laws as to Registries for Female Domestic Servants (September 29th, 1910). (8) Bye-Laws as to Means of Escape in Case of Fire in certain Factories and Workshops (January 28th, 1913). (9) Regulations as to Underground Rooms habitually used as Sleeping Places (August 29th, 1916). (10) Bye-Laws with respect to the Cemetery (April 25th, 1917 and July 29th, 1924.) (11) Bye-Laws with respect to Sanitary Conveniences at the Victoria Recreation Ground, the Alexandra Recreation Ground and King Edward VII Recreation Ground (May 27th, 1921) (12) Bye-Laws for the Regulation of Offensive Trades (May 25th, 1925). (13) Bye-Laws as to Slaughter Houses (October 6th, 1925). 22 SANITARY CIRCUMSTANCES OF THE AREA. Water Supply. The water supply throughout the district is that furnished by the Metropolitan Water Board, is of excellent character, and the supply to all houses is constant and has been since about 1913. Rivers and Streams. The North+-Western boundary of Surbiton is the centre of the River Thames. This portion of the river is below the intakes of the Metropolitan Water Board, and is under the control of the Thames Conservancy. The Hogsmill River also flows through the district, and practically forms its boundary on the eastern side. In 1925 Royal assent was given to a Bill promoted by the Surrey County Council, in which were inserted clauses for the protection of this stream with regard to obstruction and purity. It receives the effluent from the Sewage Disposal Works of the Epsom Urban District and from the Ewell Works of the Epsom Rural District before it reaches this district. In places the river takes a very winding course, and was considerably obstructed by dead trees and want of attention to the banks, but it is hoped that under the clauses of the Act referred to, a considerable improvement will take place. No complaints have been received with respect to the purity of the water, and no nuisance appears to arise from this cause. 23 Drainage and Sewerage. With the exception of a small sparsely populated outlying portion of the district adjoining that of the Epsom Rural District, the whole of the district is drained by means of pipe sewers, the surface water from houses erected during the present century and from the whole of the streets being taken into separate surface water sewers. All new streets are provided with duplicate sewers when constructed. The Sewage Disposal Works were constructed in 1912, and have been working efficiently since that date, no complaints having been received from the Thames Conservancy with regard to the purity of the effluent discharged from the Works. The average dry weather flow at the Works is 850,000 gallons per day, and the Works are amply sufficient to deal with a further increase up to a million gallons with the exception of the possibility of installing additional filter beds. Closet Accommodation. Every house is provided with a water closet, mostly, if not all, with proper flushing arrangements. Scavenging. Section 36 of the Public Health Act, 1875, is enforced in the district. It empowers the Council to insist upon each house being provided with a portable galvanized iron dust bin where no suitable ashpit exists, or where they are unsuitably placed or beyond repair. 24 Most of the houses in the district are now provided with covered ashbins, most of which are moveable. A weekly collection is made of house refuse, which is removed by means of mechanically propelled vehicles (electric and petrol) to the Sewage Disposal Works, in connection with which there is a Refuse Destructor. Heat arising therefrom is used for the production of steam for driving pumps and other engines at the Sewage Works. There are no privies or cesspools within the district other than those at Worcester Park and Tolworth Court Farm, which are not within the sewer area, and these are cleansed by the occupiers. No cesspools are emptied by the Council. Sanitary Inspection of the Area. This is fully dealt with in the report of the Chief Sanitary Inspector, which is attached hereto Smoke Abatement. There are practically no factories in the district, and it has not been necessary for the Local Authority to take any action with a view to the abatement of nuisance from smoke. Housing. General housing conditions in the district are fairly satisfactory. There is, of course, a shortage of houses but it is 25 difficult to estimate with accuracy the extent of such shortage. A large number of bouses are sub-let without being actually overcrowded. Many of these sub-tenants would be only too willing to have houses of their own, but the high rents forbid them taking advantage of the recently built houses. One hundred and six houses have been erected by the Council, and a further fifty were in course of erection at the end of 1925. A number of the larger old-fashioned houses in the district have been converted into fiats. Building by private enterprise is also proceeding in a very pleasing manner. Considerable development has been taking place, more particularly in regard to Westfield Lodge Estate, where over 100 houses have been erected, the Regent Farm Estate where new roads are being laid out with necessary sewers, etc., with provison for the erection of between 500 and 600 houses, similarly at the Egmont Estate where possibly about the same number of houses will be erected. The surplus land on the Surbiton Hill Housing Site has been acquired by a builder who has erected 75 subsidy houses on this Estate, the development being in accordance with the Council's original plans, making now a total number of 131 houses on this Estate. The following table shows the number of new houses erected in the district during the past five years:— The following table shows the number of new houses erected in the district during the past live years:— 26  By the Local Authority. By Private Enterprise. TOTAL. 1921 50 11 61 1922 — 25 25 1923 6 49 55 1924 — 134 134 1925 — 219 219 Total 56 438 494 Only four cases of overcrowding were discovered during the year. One was abated after a verbal notice had been given, one after the service of an informal notice, one after the service of a formal notice, and the other after the issue of a summons which was thereupon withdrawn upon payment of costs. The general standard of houses in the district is good. The principal defects found upon inspection are ordinary dilapidations, and generally speaking, owners are willing to remedy same when requested to do so by the Sanitary Inspector. If the owners fail to comply with the verbal notice given or preliminary notice served, a report is made to the Public Health Committee, who authorise the service of a statutory notice under the Housing Act, 1925, or the Public Health Act, 1875. If these notices are not complied with, the Council either do the work themselves and recover the cost from the owner, or take proceedings before the Magistrates as the case may require. 27 No complaints have been received and no representations made in regard to Unhealthy Areas. INSPECTION AND SUPERVISION OF FOOD. Milk Supply. The milk supply is very satisfactory. Milk is now beginning to be delivered in sealed bottles. The cowsheds, besides being inspected by the Medical Officer of Health and the Sanitary Inspector, are also visited by the Council's Veterinary Inspector. Other Foods. All premises where food is prepared, stored or exposed for sale are visited periodically and steps taken to ensure that the premises are kept in proper sanitary order and condition. Sale of Food and Drugs Acts. The Sale of Food and Drugs Acts in this District are administered by an Inspector acting under the direction of the Surrey County Council, and the County Medical Officer of Health has kindly furnished the following particulars for 1925:- ARTICLES. ANALYSED. ADULTERATED OR DETERIORATED. PROSECUTIONS. CONVICTIONS. Formal Informal Total Formal Informal Total Milk 5.2 — 52 4 — 4 — — Cream 2 1 3 — 1 1 — — Preserved Cream 3 — 3 — — — — — Butter — 3 3 — — — — — Margarine — 1 1 — — — — — Lard — 1 1 — — — — — Coffee — 1 1 — — — — — Cocoa — 1 1 — — — — — Other Articles — 1 1 — 1 1 — — Total 57 9 66 4 2 6 — — 28 PREVALENCE OF AND CONTROL OVER INFECTIOUS DISEASES. The table on the opposite page shows the number of cases of the various notifiable diseases which have occurred in the district during the past five years. Scarlet Fever and Diphtheria show a steady decrease, the maximum number of cases occurring in 1922. During 1925 two "return" cases of Scarlet Fever were reported. Diphtheria anti-toxin is supplied free of charge to Medical Practitioners requiring it for cases within the district. It is kept in stock at the Council Offices, and is available at any time. There is an increased number of cases of Pneumonia notified, as, previous to the last three years, General Practitioners were rather lax in notifying these cases. Nine cases of Encephalitis Lethargica were notified during the period under review, but two of these notifications were subsequently withdrawn, the diagnosis not having been confirmed. No cases of Malaria, Dysentery or Trench Fever were notified. All " return " and " carrier " cases are inspected by the Medical Officer of Health, and special arrangements made for dealing with same. 29 NOTIFICATION OF INFECTIOUS DISEASES DURING THE PAST FIVE YEARS. Year. Diphtheria. Scarlet Fever. Enteric Fever. Puerperal Fever. Pneumonia. Erysipelas. Encephalitis Lethargica Cerebrospinal Meningitis Ophthalmia Neonatorum. Acute Poliomyelitis. 1921 (a) 6 (b) 58 3 1 5 1 1 — 1 — 1922 (a) 38 (a) 84 (a) 1 — 8 2 — — 2 — 1923 (a) 16 (c) 32 3 — 14 4 — — 4 2 1924 (c) 7 (d) 38 1 2 48 2 (b) 4 1 2 — 1925 (d) 11 (a) 34 (a) 1 — 46 3 4 1 1 — Total 78 246 9 3 121 13 9 2 10 2 (a) Diagnosis not confirmed in one case. (b) Diagnosis not confirmed in two cases. (c) Diagnosis not confirmed in three cases. (d) Diagnosis not confirmed in four cases. 30 Pathological and Bacteriological examinations are made for the Council by the Clinical Research Association. During 1925 the following examinations were carried out:— Disease Suspected. Nature of Specimen. Result. TOTAL. Positive. Negative. Diphtheria Swabs 3 40 43 Tuberculosis Sputum 1 11 12 Tuberculosis Milk — 2 2 Gonorrhea Pus — 2 2 Typhoid Blood — l 1 Total 4 56 60 The Schick and Dick tests for Diphtheria and Scarlet Fever have not been adopted, as the Schools are under the control of the Surrey County Council. No primary vaccinations or re-vaccinations were performed by the Medical Officer of Health under the Public Health (Smallpox Prevention) Regulations, 1917. The death rates from Influenza and Cancer have been as follows:— 1921. 1922. 1923. 1924. 1925. Influenza 0.41 0.66 0.10 0.35 0.39 Cancer 1.75 1.94 1.62 1.67 1.84 31 There has been no occurrence of cases of Anthrax or Rabies. % Infectious and verminous bedding, clothing, etc., is disinfected by steam. Infectious rooms are sprayed with Formalin. No facilities have been provided for cleansing verminous persons. NOTIFIABLE DISEASES (OTHER THAN TUBERCULOSIS) DURING THE YEAR 1925. Disease. Total Cases Notified. Cases admitted to Hospital. Total Deaths. Diphtheria 11 11 — Scarlet Fever 34 31 — Enteric Fever 1 1 — Pneumonia 46 6 17 Erysipelas 3 2 — Encephalitis Lethargica 4 2 2 Ophthalmia Neonatorum 1 — — Cerebro-Spinal Meningitis 1 1 1 The number of cases of Tuberculosis is on the increase, but this is accounted for by the fact that previously cases were not always notified. 32 TOTAL CASES NOTIFIED DURING 1925. TOTAL DEATHS. at ages. at ages Under 1 Year. 1-2 2-3 3-4 4-5 5-10 10-15 15-20 20-35 35-45 45-65 65 and over Under 1 Year 1-2 2-3 3-4 4-5 5-10 10-15 15-20 20-35 35-45 45-65 65 and over Diphtheria — — — — (a) 1 (a) 2 4 2 (a) 1 (a) 1 — — — — — — — — — — — — — — Scarlet Fever — — — 2 3 12 7 4 4 (a) 1 1 — — — — — — — — — — — — — Enteric Fever — — — — — — — — — (a) 1 — — — — — — — — — — — — — — Pneumonia 2 1 1 — — 7 2 — 7 2 11 13 1 — 1 — — — — 1 — — 3 11 Erysipelas — — — — — 1 — — — — 2 — — — — — — — — — — — — — Encephalitis Lethargica — — — — — — — 1 1 1 — 1 — — — — — — — — 1 — 1 — OphthalmiaNeonatorum 1 — — — — — — — — — — — — — — — — — — — — — — — Cerebro-Spinal Meningitis — — — — — — — 1 — — — — — — — — — — — 1 — — — — (a) Diagnosis not confirmed in one case. (b) Diagnosis not confirmed in two cases. 33 TUBERCULOSIS. Age-Periods. NEW CASES. DEATHS. Pulmonary. NonPulmonary. Pulmonary. NonPulmonary. M. F. M. F. M. F. M. F. Under 1 year 1— 5 1 1 5—10 2 10—15 1 2 1 1 15-20 1 2 1 20-25 4 4 1 1 25-35 5 4 1 2 35-45 4 2 1 45—55 2 1 55-65 2 1 1 2 65 and upwards 1 Totals 19 10 7 2 9 2 1 2 Of the total number of deaths from Tuberculosis 57% were of cases for which no notifications had been received. MATERNITY AND CHILD WELFARE. Ophthalmia Neonatorum. Cases. Vision unimpaired. Vision Impaired. Total Blindness. Deaths. Notified. Treated. At Home. In Hospital. 1 1 Nil. — — — Nil. 34 Maternity and Child Welfare work in the district is under the control of the Surrey County Council, who appoint the Medical Officers and Health Visitors. The District Council appoints a number of voluntary helpers, who render valuable assistance with this work. A statistical report is supplied to the District Council by the County Medical Officer of Health every three months. In 1925 a temporary Shelter for Perambulators was erected at the Child Welfare Centre and School Clinic, but, having regard to the large numbers attending, the accommodation generally is now quite inadequate, and it is essential that the existing building should be enlarged or more commodious premises provided. FACTORIES, WORKSHOPS, WORKPLACES AND HOMEWORK. 1.—INSPECTION. Including Inspections made by Sanitary Inspectors. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (Including Factory Laundries) 12 1 ... Workshops (Including Workshop Laundries) 52 8 ... Workplaces (Other than Outworkers' premises included in Part 3 of this Report) 3 ... ... Total 67 9 ... 35 2.—DEFECTS FOUND. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. Nuisances under the Public Health Acts :—* Want of Cleanliness 1 ... ... ... Want of Ventilation 1 1 ... ... Overcrowding ... ... ... ... Want of drainage of floors ... ... ... ... Other Nuisances 1 1 ... ... Sanitary accommodation Insufficient 3 1 ... ... Unsuitable or defective 6 6 ... ... Not separate for sexes ... ... ... ... Offences under the Factory and Workshop Acts: — Illegal occupation of underground bakehouse (S. 101) ... ... ... ... Breach of special sanitary requirements for bakehouses (SS. 97 to 100) 1 1 ... ... Other offences (excluding offences relating to outwork which are included in Part 3 of this Report) ... ... ... ... Total 13 10 ... ... *Including those specified in Sections 2, 3, 7 and 8, of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts. 36 3.—HOME WORK. NATURE OF WORK. OUTWORKERS LISTS, SECTION 107. Number of Inspections of Outworkers premises OUTWORK IN UNWHOLESOME PREMISES, SEC. 108. Lists received from Employers. Notices served on Occu. piers as to keeping or sending lists. Prosecutions. In stances Notices served Prosecutions Sending twice in the year. Sending once in the year. Failing to keep or permit inspection of lists. Failing to send lists. Lists. Outworkers. Lists. Outworkers. Contract'rs Workmen. Contract'rs Workmen. Wearing Apparel— (1) Making, &c. 10 6 14 ... ... ... ... ... ... 20 ... ... ... (2) Cleaning and washing ... ... ... ... ... ... ... ... ... ... ... ... ... Total 10 6 14 ... ... ... ... ... ... 20 ... ... ... 37 4 —REGISTERED WORKSHOPS. Workshops on the Register (S. 131) at the end of the Year. Number. Bakehouses 13 Laundries 15 Tailors 13 Bootmakers 9 Dressmakers 13 Milliners 6 Sundry Other Trades 59 Total number of Workshops on Register 128 5.—OTHER MATTERS. Class. Number. Matters notified to H.M. Inspector of Factories :— Failure to affix Abstract of the Factory and Workshop Act (8. 133, 1901) 2 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5,1901). ) Notified by H.M. Inspector 3 Reports (of action taken) sent to H.M. Inspector. 3 Other — Underground Bakehouses (s. 101), in use at the end of the year 1 Certificates granted during the year — In use at the end of the year — 38 Sanitary Inspector's Annual Report. To the Chairman and Members of the Urban District Council of Surbiton. Ladies and Gentlemen, I have the honour to present to you my Thirtieth Annual Report for the year ending December 31st, 1925. COMPLAINTS. During the year, one hundred and eighty-nine complaints were received with respect to the following matters, viz:- Defective condition of house drains 15 Insanitary or dilapidated condition of houses and premises 46 Nuisance from dampness in walls and floors 12 Water in basement rooms 2 Defective water closets 11 Insanitary condition of Public House urinals 1 Defective sink and other waste pipes 2 Defective roofs 14 Defective eaves gutters and rainwater pipes 7 Defective or dangerous ceilings 3 Defective floors 1 Insanitary condition of yards 4 39 Water supply to dwelling-houses disconnected 17 Polluted water supply 1 Burst water pipes causing dampness 1 Workshops not properly ventilated 1 Houses infested with rats 4 Houses Dot provided with sufficient receptacles for house refuse 6 Non-removal of house refuse 5 Pigsties in an insanitary condition 1 Nuisance from animals improperly kept 9 Offensive accumulations of manure, etc. 9 Offensive smells from various causes 11 Alleged overcrowding 4 Miscellaneous 2 Total 189 Each complaint was immediately investigated, and, where a nuisance was found to exist, steps were at once taken to obtain the abatement thereof. The complaints with respect to the non-removal of house refuse were referred to the Surveyor, as the supervision of the removal of house refuse is carried out by his Department, and the complaints that houses were infested with rats were referred to the Surrey County Council's Rats Destruction Officer, as the Rats and Mice (Destruction) Act, 1919, is administered by the County Council, 40 INSPECTION OF DISTRICT. Inspection of the district has been carried out during the year, both systematically and at certain intervals as occasion required, in order to comply with the General Orders of the Ministry of Health, the Public Health Acts, the Housing Regulations, etc., and all necessary steps have been taken to secure the abatement of anv nuisances which were J found to exist. In all, 4,463 visits to houses and premises have been made during the year ; these include houses from which complaints of a nuisance have been received and in which cases of infectious disease have occurred; also houses inspected under the Housing Regulations, visits to works in progress, inspection of Bakehouses, Dairies, Cowsheds, Milkshops, Slaughter Houses, Workshops, Food Inspections, etc. The following table shows the number and nature of such inspections:— Number of houses and premises inspected (ordinarily) 551 ,, houses inspected and particulars recorded (Housing Acts) 49 ,, houses and premises re-inspected 1,056 „ miscellaneous visits 328 „ visits to works in progress 1,412 „ visits to slaughterhouses 44 „ visits to dairies, cowsheds, and milkshops 118 „ visits to bakehouses 52 „ visits to schools 22 41 „ visits to workshops 52 „ visits to factories 12 „ visits to workplaces 3 „ visits to homeworkers' premises 20 „ visits re cases of infectious disease 204 „ visits to fried fish shops 1 „ food inspections 539 Total 4,463 TESTING OF DRAINS AND SANITARY FITTINGS. Drainage systems exposed for examination under Section 41 of the Public Health Act, 1875 2 Drains, soil pipes, &c., tested with smoke crair 41 Drains tested with water 82 Drains tested with chemical 1 NOTICES SERVED. As a result of these inspections, 667 notices were served during- the year, of which the following is a summary :— Informal notices 2.3 Statutory notices under Section 36, Public Health Act. 1875, to provide a sufficient dust receptacle 248 Statutory notices under Section 94, Public Health Act, 1875, to abate nuisance 18 Statutory notices under Section 28, Housing. Town Planning, &c., Act, 1919, and Section 3, Housing Act, 1925, to make premises reasonably fit for human habitation 76 42 Statutory notices under Section 22, Public Health Acts Amendment Act, 1890, to provide building where persons are employed with sufficient and suitable accommodation in the way of Sanitary Conveniences 1 Statutory notices under Section 41, Public Health Act, 1875, or Section 45, Public Health Acts Amendment Act, 1907, to examine and test drains 2 Statutory notices under Section 41, Public Health Act, 1875, to re-lay drains 19 Statutory notices under Section 47, Public Health Acts Amendment Act, 1890, to abate nuisance caused by sink waste pipe discharging into stream 1 Statutory notices under Section 25, Public Health Acts Amendment Act, 1907, to pave yards 14 Statutory notices under Bye-Laws to abate nuisance from pigsties in an insanitary condition 1 Certificates issued under Section 2 (2), Increase of Rent and Mortgage Interest (Restrictions) Act, 1920, certifying that premises are not in a reasonable state of repair 4 Total 667 In most cases the notices were readily complied with. In three instances, however, it was necessary to institute summary proceeding's before the Magistrates to enforce compliance with the Acts in force in the district or with notices served, or to recover the cost of carrying out work in default. 43 The following table contains particulars of such proceedings:— No. Nature of Offence. Result of Proceedings. l. Exposing for sale a rib of beef which was unsound and unfit for the food of man, contrary to the provisions of the Public Health Act, 1875. Summons was withdrawn on payment of costs in consequence of the death of Defendants' Manager prior to the hearing. 2. To recover the sum of £4 3s. 0d., together with 5% interest, balance of expenses incurred in carrying out repairs to a house in default of the owner complying with a notice served under Section 28 of the Housing, Town Planning, etc., Act, 1919. Summons was withdrawn. Amount claimed, together with costs, having been paid previous to the hearing. 3. Failing to comply with a notice served under Section 94 of the Public Health Act, 1875, to abate a nuisance arising from overcrowding. Summons was withdrawn on payment of costs, as nuisance had been abated. DETAILS OF SANITARY IMPROVEMENTS EFFECTED DURING THE YEAR. House Drainage. During the year the drains belonging to two houses were opened up for examination in accordance with the provisions of Section 41 of the Public Health Act, 1875, and were found to be in a defective condition. Detailed reports of their condition were made to the Public Health Committee, and instructions were given for notices to be served upon the owners and occupiers of the premises specifying the work necessary to remedy the defects found. 44 The drains and sanitary fittings belonging to seven houses have been entirely re-constructed on modern lines during the year, at three houses the drains have been partly re-constructed, one house has been provided with a sufficient drain, twenty-five houses have been provided with additional drains, and at forty houses defective drains have been repaired, cleansed etc. Twenty-nine additional manholes have been built on line of existing drains, five defective manholes have been repaired, and one manhole has been provided with a new iron cover Three new intercepting traps have been fixed, and new stoppers fixed in the raking arms belonging to six intercepting traps. Sixty-six defective stoneware, brick, or iron bell traps have been removed and replaced with properly trapped iron or glazed stoneware gullies. All new drainage work is tested on completion, the water or air test being applied to the drains and the air or smoke test to the soil and ventilating pipes. A block plan showing the new system of drainage or alterations to existing systems of drainage is also prepared, and, together with particulars of the work done and tests applied, is filed for future reference. Soil Pipes. Two defective light iron soil pipes have been removed and replaced with strong cast iron pipes having molten lead caulked joints. 45 Five defective soil pipes have been repaired. Six additional soil pipes have been provided. One defective soil pipe inside the house has been abolished, and a new soil pipe fixed outside. Ventilating Pipes. Three defective ventilating pipes have been removed and replaced with coated cast iron pipes having molten lead caulked joints. Seventeen defective ventilating pipes have been repaired. Two additional ventilating pipes have been provided. Fifteen new mica flap fresh air inlet valves have been fixed. Thirteen defective mica flap fresh air inlet valves have been repaired. Water Closets. One dilapidated water closet has been pulled down and re-built. Three premises have been provided with a sufficient water closet. Thirty additional water closets have been provided where the existing accommodation was insufficient. Eight water closet roofs have been repaired and made weatherproof. Four external walls belonging to water closets have been rendered or repaired. 46 Eleven defective water closet walls have been rendered internally with Portland cement or repaired. Eight defective water closet ceilings have been repaired or renewed. Six water closets have been provided with ceilings. Two defective water closet floors have been paved with concrete or repaired. Sixteen water closet doors have been repaired or renewed. Three water closets have been lighted and ventilated. Fifty-four new pans have been fixed. Thirty-four dirty or defective pans have been cleansed or repaired. Three pans have been provided with an antisyphonage pipe. Thirty-eight new flushing cisterns have been fixed. Twenty-four defective flushing cisterns have been repaired. One water closet has been provided with a separate flushing cistern. The water supply has been re-instated to four flushing cisterns. Urinals. One Public House urinal has been cleansed and repaired. One defective urinal sparge pipe has been repaired. One new flushing cistern has been provided to a urinal. 47 Sinks, Baths, etc. Twenty-three defective sinks or lavatory basins have been abolished and new glazed stoneware sinks, etc., fixed. Fifty additional sinks, baths or lavatory basins have been provided. Seventy-seven new trapped waste pipes have been provided to sinks, baths, lavatory basins, etc. Ten defective sink, bath or lavatory basin waste pipes have been repaired. Fourteen sink, bath or lavatory basin waste pipes have been trapped or disconnected from the drain. Rain Water Pipes, Gutters, etc. One rain water pipe has been disconnected from the drain and arranged to discharge into a trapped gully. Forty-three defective rain water pipes have been repaired or renewed. Sixteen roofs have been provided with eaves gutters and rain water pipes, where none previously existed. Twenty-seven defective eaves gutters have been repaired or renewed. Water Supply. The water of the district is supplied by the Metropolitan Water Board. The supply is constant, and many of the houses now draw their drinking water direct from the main instead of from a storage cistern. 48 No complaints have been received during the year that the supply was insufficient or unsatisfactory. Seventeen notifications were received from the Metropolitan Water Board that the supply had been withdrawn from dwelling houses owing to the water rate not having been paid or where the supply pipes had been found to be defective and the owners had neglected or refused to carry out the necessary repairs. All such houses were at once visited, and the necessary steps taken to secure the immediate reinstatement of the supply. During the year eleven storage cisterns in dwelling houses were abolished and the water fittings connected direct to the main. At twenty-one houses, where the storage cisterns were necessary owing to the houses being fitted with a hot water supply, the taps supplying the drinking water were disconnected from the storage cistern and connected direct to the main. Two dirty storage cisterns have been cleansed, and five defective water pipes or fittings have been repaired. Dampness. Forty-nine defective roofs, causing dampness inside dwelling houses, have been made weatherproof. Eleven houses have had the space under the floors concreted to prevent dampness. At ten houses air bricks have been fixed in the outside walls to provide sufficient ventilation under the floors. 49 Nine houses have been provided with a proper damp course. At three houses the joints of the brickwork to the external walls have been raked out and repointed in cement to prevent dampness. Six damp external walls of dwelling" houses have been rendered with Portland cement. At twenty-eight dwelling houses damp walls have been treated with damp-proof solution Two fowl-houses which were causing dampness in adjoining houses have been removed. General Repairs. Seventy-four defective house walls have been repaired. Thirty-seven defective house ceilings have been repaired or renewed. Three rooms have been provided with a ceiling. Sixty-one defective or dangerous house floors have been repaired or renewed. Ninety-nine defective windows have been repaired or renewed. Thirty defective window cills have been repaired or renewed. Ten fixed windows have been made to open. One room, the lighting of which was insufficient, has had an additional window provided. Eighty-three broken sash cords have been renewed. 50 Thirty-four defective stoves, ranges or coppers have been repaired or renewed. Thirty-eight defective doors have been repaired or renewed. Ten rooms have been provided with permanent means of ventilation. Three staircases have been provided with a handrail. Two houses have been painted externally. Four hundred and fifty-one dirty or infectious rooms have been cleansed and decorated. At two houses defective brickwork belonging to external walls has been repaired. Paving of Yards. Section 25 of the Public Health Acts Amendment Act, 1907, provides that if any yard in connection with and exclusively belonging to a dwelling house is not so formed, flagged, asphalted or paved, or shall not be provided with such works on, above or below the surface of the yard to allow of the effectual drainage by safe and suitable means to a proper outfall, the Local Authority may require the owner of the dwelling house to execute all such works as are necessary for the effectual drainage of the subsoil or surface of the yard to a proper outfall. Where this Section has been enforced, great improvement has been effected in the condition of the yard and general surroundings, tending to greater cleanliness and to the prevention of 51 ness and the accumulation of stagnant pools of water about the dwelling house. As a result of notices served, paving has been laid down in the yards, and, where necessary, the side passages and forecourts, of twenty dwelling houses. At seven houses the yard paving has been repaired. Dust Receptacles. Generally speaking all the houses in the district are now provided either with portable galvanized iron dust bins or ashpits constructed in accordance with the Council's Byelaws. The Surveyor's Department, under whose direction the removal of house refuse is carried out, supply the Public Health Department periodically with a list of houses not provided with suitable receptacles for the storage of house refuse or where the existing ones are worn out or in a dilapidated state of repair. They are then inspected by one of the Sanitary Inspectors, and the result of this inspection is reported to the Public Health Committee, who give instructions for a statutory notice to be served upon the owner requiring him to provide a suitable galvanized iron dust bin within seven davs. If this notice is not complied with, a letter is sent drawing the owner's attention to this fact, and if the dust bin is not provided, the Council provide one and charge him with the cost. 52 Most of the notices served are complied with within seven days of their being served. During the past five years it has only been necessary on twenty-two occasions for the Council to provide dust bins in default of the owners complying" with the notices served. As requested by the Ministry of Health, I append a list shewing the number of houses provided with portable galvanized iron dust bins during the past five years : — 1921 19-22 1923 1924 1925 Total 207 156 314 300 236 1,213 Overcrowding. During- the year four houses were discovered to be so overcrowded as to constitute a nuisance dangerous to the health of the inmates. In one instance the nuisance was abated after a verbal notice had been given, and one on the service of an informal notice. The other two cases had to be reported to the Council, and formal notices served. In one of these cases a summons was issued, but was withdrawn on payment of costs as the nuisance had been abated previous to the hearing. Two cases of overcrowding brought forward from the previous year were also abated during the year. In one of these cases a Magistrates Order had been made for the nuisance to be abated, and in the other case a statutory notice had been served. 53 Miscellaneous. Two nuisances arising from animals being kept in an insanitary condition have been abated. Fifteen offensive accumulations have been removed. Nine dirty yards have been cleansed. One sink waste pipe which discharged into a stream, causing the same to be polluted, has been connected with the drain. One pigsty has been re-constructed, paved and drained. HOUSING STATISTICS FOR THE YEAR 1925. Number of new houses erected during the year :— (a) Total 219 (b) With State assistance under the Housing Acts:— (i.) By the Local Authority Nil (ii.) By other bodies or persons 91 1 Unfit Dwelling Houses. Inspection. (1) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 560 (2) Number of dwelling houses which were inspected and recorded under the Housing (Inspection of District) Regulations, 1910, or the Housing Consolidated Regulations, 1925 49 54 (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 (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 443 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 216 3. Action under Statutory Powers. A.—Proceedings under Section 28 of the Housing, Town Planning, etc., Act, 1919, and Section 3 of the Housing Act, 1925. (1) Number of dwelling houses in respect of which notices were served requiring repairs 34 (2) Number of dwelling houses which were rendered fit:— (a) by owners 13 (b) by Local Authority in default of owners ... 2 (3) Number of dwelling houses in respect of which Closing Orders became operative in pursuance of declaration by owners of intention to close Nil B.—Proceedings under Public Health Acts. (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 221 55 (2) Number of dwelling houses in which defects were remedied after service of formal notices: — (a) by owners 225 (b) by Local Authority in default of owners ... Nil C.—Proceedings under Sections 11, 14 & 15 of the Housing Act, 1925. (1) Number of representations made with a view to the making of Closing Orders 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 houses having been rendered fit Nil (4) Number of dwelling houses in respect of which Demolition Orders were made Nil (5) Number of dwelling houses demolished in pursuance of Demolition Orders Nil INCREASE OF RENT AND MORTGAGE INTEREST (RESTRICTIONS) ACT, 1920. Four applications were received during the year from tenants for certificates under Sub section 2 of Section 2 of the Increase of Kent and Mortgage Interest (Restrictions) Act, 1920, that the house was not in a reasonable state of repair. After making a careful inspection of the premises, a certificate was granted in each case, and the owner's attention called to the defects found. In three instances the necessary repairs were carried out by the owners, and in the fourth case the work was in progress at the end of the year. 56 FACTORY AND WORKSHOP ACT, 1901 The total number of workshops now on the .Register, including bakehouses, is 128. The businesses carried on at the respective premises are as follows :— Bakehouses 13 Dressmakers 13 Bootmakers 9 Laundries 15 Tailors 13 Milliners ... 6 Other Trades 59 Total ... 128 Visits from time to time have been paid, and as a result the following nuisances have been dealt with :— Sufficient W.C's. provided 1 Additional W.C's. provided 2 New W.C. pans fixed 2 New flushing cisterns fixed 2 Flushing cisterns repaired 3 W.C. pans cleansed or repaired 3 W.C. roofs repaired 1 W.C. external walls repaired 1 W.C's. cleansed 1 W.C. doors repaired or renewed 1 W.C. windows repaired or renewed 1 Water supply re-instated or provided to W.C's. 1 Additional lavatory basins provided 1 New waste pipes provided 1 Permanent means of ventilation provided in workshops 1 57 BAKEHOUSES. There are 13 bakehouses in use in the district, one of which is situated underground. They have been visited at least twice during the year, and found to be kept in a satisfactory condition. SLAUGHTER HOUSES. The number of private slaughterhouses in use in the district at the dates mentioned hereunder was as follows:— Type of Slaughter House. In 1920. In January, 1926. In December 1925. Registered 3 3 3 Licensed 1 1 2 Total 4 4 5 They have all been regularly inspected and generally found to be well kept. On the 13th day of July, 192-5, the Council adopted new Bye-laws with respect to Slaughter Houses. These Bye-laws provide (inter alia) that, with the exception of duly licensed members of the Jewish faith "a person shall not in a slaughter house proceed to slaughter any animal until the same shall have been effectually stunned, and such stunning shall be effected with a mechanically operated instrument suitable and sufficient for the the purpose." 58 The "Greener" Humane Killer is now used in all the slaughter houses for the purpose of stunning all animals slaughtered. DAIRIES, COWSHEDS AND MILKSHOPS. Three applications to be registered as Wholesale Traders were received during the year. Four applications were also received from persons residing outside the district and three from persons residing in the district, to be registered as Retail Purveyors of Milk. There are now 44 persons registered in accordance with the Milk and Dairies (Amendment) Act, 1922, as follows :— Wholesale Traders or Producers of Milk 11 Eetail Purveyors of Milk residing in the district 16 Retail Purveyors of Milk who reside outside the district but retail milk in the district 17 Total 44 All the Dairies, Cowsheds and Milkshops were visited twice during the year and at irregular periods to ascertain if they were kept in a clean and satisfactory condition and in accordance witb the Regulations. At two farms the cows were found to be in a dirty condition, but were immediately cleansed on the owners attention being called to their condition. The average number of milch cows kept by the persons registered is 288, all of which are periodically 59 examined by the Council's Veterinary Inspector to ensure that they are free from any disease likely to affect the milk. One cow was found to be suffering from Tuberculosis and was removed from the sheds and subsequently slaughtered. Three Dealer's Licences to sell Certified Milk were granted under the Milk (Special Designations) Order, 1923. In accordance with instructions received from the Ministry of Sealth, four samples of Certified Milk were taken from local Dairymen, and sent to the Clinical Research Association for Bacteriological Examination. The following is a summary of the Bacteriologists' reports:— No. of Sample. Temperature on arrival at Laboratory. Number of Bacteria per 1 cubic centimetre. Presence of Bacillus Coli. in 48 hours and 3 days. 1. 14° Centigrade 8,566 Negative 2. 16° Centigrade 30,030 Negative 3. 15° Centigrade 3,966 Negative 4. 12° Centigrade 7,866 Negative The Milk (Special Designations) Order, 1923, stipulates that there shall not be more than 30,000 Bacteria per cubic centimetre, and that no Bacillus 60 Coli. shall be present in one tenth of a cubic centimetre. FOOD INSPECTION. The Public Health (Meat) Regulations, which came into operation on April 1st, 1925, contain a number of new provisions for the more adequate supervision of food premises, one of the most important being that which requires notice to be given to the Local Authority before an animal is slaughtered for sale for human consumption. I might mention, however, that this practice has been carried out by the occupiers of the Licensed Slaughter Houses in the district for some years prior to the issue of these Regulations, as the Council only granted a Licence on condition that the Licensee agreed to give notice of the day and time on which slaughtering took place and to retain the carcase of any animal slaughtered until it had been inspected by Officers of the Public Health Department. One butcher has given formal notice that he will slaughter on fixed days and at fixed times, while the other butchers give notice each time they intend to slaughter. Arrangements have been made for the inspection of all animals slaughtered in the district at the time of or as soon as possible after slaughter. Frequent visits have been made to butchers' 61 shops, and also to other shops, etc., where food is prepared or exposed for sale. No meat is sold in the district from stalls or vehicles. The following foodstuffs found to be unfit for human food were surrendered by the owners, and subsequently destroyed: — Offal of calf 91b. 7 oz8. Tuberculosis. Carcases and offal of pigs 670 „ 4 „ Tuberculosis. Heads of pigs 19 „ 6 „ Tuberculosis. Heads and plucks of pigs 129 „ 9 „ Tuberculosis. Livers of pigs 26 „ 7 „ Cirrhosis. Livers of pigs 9 „ 14 „ Coccidiosis. Livers of pigs 8 „ 9 „ Echinococcus Veterinorum. Liver of pig 1 .. - " Abscesses. Offal of pigs 122 „ 4 „ Congestion. Offal of pigs 35 „ 6 " Tuberculosis. Offal of pigs 26 „ 2 „ Pneumonia. Offal of pigs 19 „ 15 „ Strongylus Paradoxicus. Offal of pigs 12 „ 8 „ Inflammation. Offal of pigs 2 „ 5 " Mitral Regurgitation. Offal of pig 2 „ >> Abscesses. Livers of sheep 11 3 „ Fluke. Livers of sheep 4 „ 15 „ EchinococCus Veterinorum. Livers of sheep 4 „ 11 „ Cirrhosis. Offal of sheep 34 „ 2 „ Strongylus Rilfescens. Offal of sheep 6 „ 14 „ Congestion. Offal of sheep 3 „ 5 „ Cysticercus Tenuicollis. Offal of sheep 2 6 „ Strongylus Filaria. Offal of sheep 1 2 " Pneumonia. Fish 28 „ -" Putrefaction. Total, 1,191 lbs. 5ozs. 62 DISINFECTION. During the year disinfection has been carried out at 73 premises in which the following cases of infectious disease have occuired :— Scarlet Fever 37 Diphtheria 10 Typhoid Fever 1 Pulmonary Tuberculosis 27 Cerebro-Spinal Meningitis I Erysipelas 1 Encephalitis Lethargica 3 Pneumonia 3 Disinfection was also carried out at 8 premises after deaths from non-notiliable diseases, on the occupiers of the houses in which the deaths occurred agreeing to pay the expense The Public Elementary Schools were, as usual, disinfected as arranged with the Managers and the Surrey County Education Committee, the walls, floors and ceilings being sprayed with Formaldehyde during the Easter, Summer and Christmas vacations. The following articles of bedding, wearing apparel, etc , were removed to the Tolworth Isolation Hospital for steam disinfection under the superintendence of the Hospital staff :— Beds 64 Bed valances 10 Blankets 336 Blinds 6 Bolsters 76 63 Carpets 58 Counterpanes 35 Curtains 150 Cushions 51 Mattresses 120 Mattress Covers 67 Palliasses 9 Pillows 242 Pillow Cases 18 Quilts 67 Rugs 76 Sheets 9 Toilet covers 7 Towels 1 Wearing apparel 526 Miscellaneous 118 Total ... 2,046 I am, Mr. Chairman, Ladies and Gentlemen, Yours obediently, W. NESFIELD, a.r.san. i., Chief Sanitary Inspector. PHILPOTT & Co., (Surbiton), Ltd., Printers, 40-42, BRIGHTON ROAD, SURBITON.