??? ??? The Urban District Council OF SURBITON ANNUAL REPORTS OF THE MEDICAL OFFICER OF HEALTH AND SANITARY INSPECTOR FOR THE YEAR 1934 Printed by J. B. Blackmore & Co. Ltd., 85, High Street, Merton, S.W.19 The Urban District Council OF SURBITON ANNUAL REPORTS OF THE MEDICAL OFFICER OF HEALTH AND SANITARY INSPECTOR FOR THE YEAR 1934 The Urban District Council of Surbiton PUBLIC HEALTH COMMITTEE. Councillor W. Sanger (Chairman). Councillor Mrs. A. Woodgate (Vice-Chairman). Councillor Mrs. Cudbird Councillor Leach „ Ames „ Penwill „ Bridge „ Potter „ Dommett „ Harry Reynolds „ Durbin „ Roberts Councillor Sayer. PUBLIC HEALTH DEPARTMENT. PERSONNEL. Medical Officer of Health: #N. Hood Linzee, M.R.C.S., L.R.C.P., D.P.H. (part time). Sanitary Inspector: •Geoffrey McClelland, C.R.S.I., M.S.I.A., C.M.I. Additional Sanitary Inspectors: *J. R. Glover, C.M.I., *C. Wilson, C.M.I., Cert. R.S.I. & S.I.E.J.B. Cert. R.S.I. Senior Clerk: E. D. Elms. Junior Clerk: J. L. Willoughby. Disinfector, etc.: W. A. Hutchins. * Contributions to salary made from Exchequer. 5 Annual Report of The Medical Officer of Health for 1934 Public Health Department, Council Offices, Surbiton. June, 1935. To the Chairman and Members of the Urban District Council of Surbiton Ladies and Gentlemen, I have the pleasure of presenting to you my 13th Annual Report, dealing with all matters appertaining to the health and sanitary condition of the Urban District of Surbiton. As laid down by the Ministry of Health Circular 1417, this report is an Ordinary Report and not a Survey Report. The development of the District is still maintained, and the population for mid-year 1934 was 38,050, an increase of 2,910 on the previous year. The number of inhabited houses has gone up from 9,866 to 11,068, the development taking place in the outlying areas of the District. This year a factor for comparing the death rate of Surbiton with that of any place in England and Wales has been given by the Registrar General. 6 This factor is called the Comparability Factor, viz.:—0.98. The Birth Rate is 16.08 per 1,000 population, an increase of 1.68, which compares very favourably with that for England and Wales, viz.:—14.8. The 612 births for the year ending 1934 is the largest that has occurred, showing an increase of 104 over 1933. The Crude Death Rate is 9.33 per 1,000 population and the Corrected Death Rate is 9.14 per 1,000; that for England and Wales is 11.8. The total deaths are 355, so there is a natural increment of 257. The Infantile Mortality Rate, that is, the number of deaths of Infants under 1 year of age, is very satisfactory. For the past year, it was 27.78 per 1,000 live births, the lowest on record for Surbiton, with 41.83 for 1933, while the figure for England and Wales was 59. This satisfactory figure reflects great credit on the Infant and Child Welfare Clinic and those who are connected with it and I feel that Surbiton should be proud of possessing such encouraging rates. The Maternal Mortality Rate per 1,000 total births is 6.31, an unfortunate rise above 1933 of 2.49. The cause for the increase is difficult to state definitely. An increase in this rate is general throughout England and Wales. The incidence of Infectious Disease remains about the same with the exception of Diphtheria. A slight epidemic of this disease occurred with 3 deaths. 7 During the year I made official representation under Part I of tlie Housing Act, 1930, in respect of 10 Clearance Areas comprising 74 houses. An Inquiry was held in October into the above by H. McGregor-Wood, Esq., A.R.I.B.A. The result of the Inquiry was not made known within the year. With regard to unsound meat in the district, there has been a considerable drop in the amount surrendered and destroyed. The decrease amounts to something like 600 lbs. The condition of the Cowsheds and Dairies is satisfactory. The results of the analysis of milk will be seen in a later section and the necessity for taking an increased number of samples of milk should be pointed out. The most notable acquisition to the district in the way of entertainment was the provision of an open air Swimming pool situated in Raebum Avenue, Tolworth—a most central position. It was commenced in June, 1933, and finished in April, 1934, being opened in the following May. The dimensions are 165 feet long by 90 feet wide, and the depth is graded from 3 to 9 feet. The original accommodation was 125 changing cubicles and 500 lockers, but this was increased soon after the opening day by the provision of communal rooms, and a further 196 lockers were installed. Owing to the fortunate climatic conditions, the bath was well patronised during the season, having an approximate attendance of 173,000. Samples were taken on three occasions during both rush and quiescent periods and these were satisfactory. 8 I wish to offer my appreciative thanks to the Chairman and Members of the Public Health Committee for their help and co-operation. My thanks are due to Mr. McClelland, your Sanitary Inspector, and the other members of my Staff. I am, Ladies and Gentlemen, Your obedient Servant, N. H. LINZEE, Medical Officer of Health. 9 PHYSICAL FEATURES AND GENERAL CHARACTERISTICS OF THE DISTRICT. Area of District.—This is officially given as 4,711 acres. The shape is practically a square with a long protruding tongue, and consists of the Civil Parishes of Surbiton, Tolworth, Hook and Chessington. 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 Eslier, on the East by the Hogsmill River, otherwise locally known as the Maiden River, and by the Maidens and Coombe Urban District, and on the South-East by the Epsom Urban District, and on the South by the Leatherhead Urban 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 district from North-East to SoutliWest, 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 Hogsmill, 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 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 10 Earth." This extends from the line of the river up to the railway and then stretches down the Claremont 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. In the Chessington portion of the District the soil is entirely London Clay, undulating considerably. SOCIAL CONDITIONS. The district is 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 residents here are engaged in business in London, for access to which the facilities offered by the Southern Railway by both steam and electric trains, and by bus services, are not surpassed in the case of any similar extra metropolitan district. There is also an efficient and adequate service of buses and trolley tramways connecting with most of the adjoining districts. There are a few factories and workshops, and of the workers engaged at these the majority are resident within the district. Surbiton is a residential neighbourhood, and 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. The added area of Chessington is rural in character and the majority of its residents are engaged in agricultural pursuits. 11 STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres) 4,711 Resident Population (Census 1931) 29,396 Registrar General's estimate mid-year 1934 38,050 Number of inhabited houses (end of 1934) according to the rate books 11,068 Number of families or separate occupiers (1931) census 8,116 Rateable Value £430,427 Sum represented by a penny rate £1.630 EXTRACTS FROM VITAL STATISTICS OF THE YEAR. (Based on population of 38,050). Live Births:— Total. M. F. Legitimate 592 319 273 Illegitimate 20 9 11 Birth rate per 1,000 of the estimated resident population 16.08 Still Births:— Legitimate 21 14 7 Illegitimate — — — Rate per 1,000 total (live and still births) births 33.17 Deaths 355 189 166 Crude death rate per 1.000 of the estimated resident population 9.33 Adjusted death rate (comparability Factor 0.98) 9.14 Percentage of total deaths occuring in Public Institutions 41.69 Deaths from puerperal causes:— Deaths. Rate per 1000 total Births (live & still) No. 29 Puerperal Sepsis l 1.58 No. 30 Other puerperal causes 3 4.74 Total 4 6.32 12 Deaths from diseases and accidents of pregnancy and childbirth :—from sepsis, one ; from other causes, three. Death rate of Infants under one year of age :— All infants per 1,000 live births 27.78 Legitimate infants per 1,000 legitimate live births 27.03 Illegitimate infants per 1,000 illegitimate live births 50.00 Deaths from Measles (all ages) 1 Deaths from Whooping Cough (all ages) — Deaths from Diarrhoea (under 2 years of age) 2 The natural increment in the population for 1934 is 257. Still Births.—The rate per 1,000 population is 0.55, which is below that for England and Wales (Smaller Towns), namely 0.67. The maternal mortality rate per 1,000 live births is 6.53. The maternal mortality rate per 1,000 total births is 6.31. From the above particular attention must be called to the very low Infantile Mortality Rate and its sub-divisions, legitimate and illegitimate. It points out what good care is taken of the mothers and babies in Surbiton and that any increase in expenditure in this service is fully justified. I feel appreciation should be extended to all connected with the Infant Welfare Clinics. There was one death due to Measles, and it is to be hoped that in the future, when the extension to the Tolworth Isolation Hospital is completed, institutional treatment may be given to the more advanced cases of Measles and Pertussis. 18 The Maternal Mortality Rate has unfortunately almost doubled itself. Of the four cases, all were treated in institutions. Three were associated with toxaemia due to pregnancy, two of which had to have therapeutic termination of pregnancy, and the third developed coma from eclampsia within an hour of parturition. The fourth was due to broncho pneumonia and nephritis. It is absolutely essential for pregnant women to have skilled advice and to have periodical examinations, especially of the urine, as any abnormality discovered would iead to proper and early treatment. CAUSES OF DEATH DURING 1934. (Civilians only). ] Male. Female. All causes 189 166 1. Typhoid and Paratyphoid Fevers — — 2. Measles — 1 3. Scarlet Fever — 1 4. Whooping Cough — — 5. Diphtheria 1 2 6. Influenza 4 1 7. Encephalitis Lethargica 1 — 8. Cerebro-spinal Fever — — 9. Tuberculosis of Respiratory System 16 6 10. Other Tuberculous Diseases 1 1 11. Syphilis 1 1 12. General paralysis of the insane, tabes dorsalis 2 13. Cancer, malignant disease 20 13 14. Diabetes 5 — 15. Cerebral Haemorrhage, etc. 5 5 16. Heart Disease 42 44 17. Aneurysm — — 18. Other Circulatory Diseases 9 13 14  Male. Female. 19. Bronchitis 6 4 20. Pneumonia (all forms) 11 17 21. Other Respiratory Diseases 1 2 22. Peptic Ulcer 2 1 23. Diarrhoea, etc. (under 2 years) 2 — 24. Appendicitis 2 — 25. Cirrhosis of Liver 1 3 26. Other Diseases of Liver, etc. — 3 27. Other Digestive Diseases 4 3 28. Acute and Chronic Nephritis 7 2 29. Puerperal Sepsis — 1 30. Other Puerperal causes — 3 31. Congenital Debility, Premature Birth, Malformations, etc 6 8 32. Senility 8 9 33. Suicide 2 3 34. Other violence 13 4 35. Other defined diseases 17 15 36. Causes ill-defined or unknown – During the year 355 deaths were registered, being a decrease of 3 on the previous year. 227 deaths occurred in the district, 125 deaths in Public Institutions outside the district, and 23 deaths in other premises outside the district. The outstanding increase in the causes of death is that accounted for by Heart Disease and a very considerable fall in death due to Influenza. There were two deaths of infants under two years due to Diarrhoea. Death Rate for Surbiton is 9.14. Death Rate for England and Wales is 11.3, 15 The causes and ages at death of the children who died under the age of 1 year were as follows:— Gastro-enteritis 6 months. Marasmus 3 months. Marasmus 1 month. Oedema lungs, Congenital Heart Disease 1 week. Congenital Heart Disease 45 minutes. Marasmus, Oedema of lungs, Bronchitis 5 months. Infective Enteritis 5 months. Marasmus 3 months. Anencephalus & Spina Bifida 1 hour. Gastro-enteritis 2 months. Cardiac muscle failure, Bronchopneumonia 4 months. Premature 9 hours. Toxaemia from maternal eclampsia 5 minutes. Asphyxia, due to convulsion reflex of central origin 3 months. Enteritis 3 months. Intracranial injury 1 day. Asphyxia, Medullary compression, Oper- ation for meningocele 3 months. Hydrocephalus There were 17 deaths of children under one year of age, which is a decrease of 4 compared with the number for the previous year. Of the infant deaths, 11 occurred in Hospitals or Public Institutions outside the district of Surbiton. One of these deaths occurred at 5 minutes, one at 1 hour, one at 9 hours, one at 1 day, one at 1 month, one at 2 months, four at 3 months and one at 6 months. 16 The infantile mortality rate is 27.78 and the infantile mortality rate for England and Wales (Smaller Towns) is 53. Ward. No. of deaths. No. of Births. In fantile  Berrylands 2 49 40.8 Chessington — 23 Nil. Hook & Southborough 1 43 23.2 Seething Wells 3 23 130.4 St. Mark's 1 54 18.5 Surbiton Hill 1 39 25.6 Tolworth East 3 84 35.7 Tolworth West 3 71 42.2 Tolworth South 3 58 51.7 INFANT MORTALITY RATE. SURBITON ENGLAND & WALES (Smaller Towns) 1929 49.3 69.0 1980 56.3 55.0 1981 45.78 62.0 1982 60.46 58.0 1988 41.88 56.0 1934 27.78 58.0 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) 15.0 11.8 8.6 53.0 Surbiton 16.08 9.14 8.27 27.78 From the above table one can look back with satisfaction as the figures are very much better in each case than those of the other Smaller Towns in England and Wales, 17 NOTIFIABLE DISEASES DURING THE YEAR. Disease. Total Cases Notified. Cases admitted to Hospital. Total Deaths. Diphtheria 49 48 8 Scarlet Fever 87 78 1 Enteric Fever 2 2 — PneumoDia 40 6 28 Erysipelas 7 2 — Encephalitis Lethargica — — 1 Ophthalmia Neonatorum 5 — — Puerperal Fever 8 1 1 Cerebro-Spinal Meningitis — — — Puerperal Pyrexia 10 6 — Smallpox — — — Scarlet Fever heads the list of Infectious Diseases followed by Diphtheria. Pneumonia shows a slight decrease but gives a larger percentage of deaths than last year. OPHTHALMIA NEONATORUM. Cases. Vision Unimpaired Vision Impaired Total Blindness. Deaths. Notified. Treated. At Home [n .Hospital 5 5 — 6 — — — There is a definite increase in the above. None of these cases, however, were due to the micrococcus intracellulars, and there was no case with impaired vision. 18 NOTIFICATION OF INFECTIOUS DISEASES DURING THE YEARS 1925 to 1934. 1925 1926 1927 1928 1929 1930 1931 1982 1938 1934 Diphtheria 11 27 29 28 31 40 14 12 7 49 Scarlet Fever... 84 38 35 82 82 89 48 40 85 87 Enteric Fever... 1 1 — 8 2 — 2 —' 1 2 Puerperal Fever — 1 — 1 1 1 — 1 2 8 Puerperal Pyrexia — — 2 6 4 6 2 7 2 10 Pneumonia 46 50 67 25 46 64 64 68 54 40 Erysipelas 3 8 5 5 3 9 2 6 12 7 Encephalitis Lethargica 4 1 3 1 – – _ Cerebro-spinal Meningitis 1 1 2 Ophthalmia Neonatorum 1 4 1 1 1 1 3 2 2 5 Acute Poliomyelitis — — — — — — — — — — Malaria — – – – – – – – 1 1 Total 101 129 141 154 173 209 130 186 166 204 19 TOTAL CASES NOTIFIED 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 1 — — 3 3 31a 5 2a 9b 2a — — — — — — 1 2 — — — — — — Soarlet Fever 1 — 1 4 6 44b 21 6a 6a 2 1 — — — — — 1 — — — — — — — Enteric Fever — — — — — 1 — — — — 1 — — — — — — — — — — — — — Pneumonia — 2 2 1 — 2 — — 7 3 9 14 — 1 1 1 — 1 — 1 2 5 7 9 Erysipelas — — — 1 1 — — 1 — 2 2 — — — — — — — — — — — — Encephalitis Lethargica — — — — — — — — — — — — — — — — — — — — — — — — Ophthalmia Neonatorum 5 — — — — — — — — — — — — — — — — — — — — — — — Puerperal Fever — — — — — — — — 3 — — — — — — — — — — — 1 — — — Other Puerperal Causes — — — — — — — — — — — — — — — — — — — — 3 — — — Polyomyelitis — — — — — — — — — — — — — — — — — — — — — — — — Puerperal Pyrexia — — — — — — — 1 8 1 — — — — — — — — — — — — — — Measles — — — — 1 4 — — — — — — — — — — — — — — — — — — Malaria — — — — — — — — 1 — — — — — — — — — — — — — — — a—Diagnosis not confirmed in one case b— ,, ,, ,, ,, two cases 20 TUBERCULOSIS Age-Periods. NEW CASES. DEATHS. Pulmonary NonPulmonary Pulmonary NonPulmonary M. F. M. F. M. F. M. F. Under 1 year — — — — — — — — 1—5 — — 2 — — — 1 — 6—10 — — 2 1 — — — — 10—15 1 — — 1 — — — — 15—20 1 — 1 1 — — — — 20—25 4 5 — 1 — 1 — — 25—85 9 11 — 1 3 1 — — 36—46 8 3 — 1 1 1 — — 45—55 3 2 — — 1 1 — — 66—65 — 1 1 — — — 1 — 65 and upwards — — — — — — — — Totals 26 22 6 6 6 4 2 — Of the sixty cases tabulated above eighteen are cases transferred from other districts. Of the total number of deaths from Tuberculosis there were two of patients who had not been notified. There was an increase over last year of ten new Pulmonary cases of Tuberculosis, while new Non-Pulmonary cases were the same as last year. The deaths from Tuberculosis all forms show a decrease of ten. 21 Of the total new cases 25 are resident in new houses and 35 in old. At the commencement of the year there were 116 cases of Tuberculosis ou the register and at the close of the year the figure was 123. During the year 53 cases were removed from the register owing to recovery, leaving the district or death, and 60 new cases were added to the register. Of the 60 new cases it is interesting to note that only 38 of these were new eases first notified in this district and that 18 were cases of persons coming to reside in the area. TUBERCULOSIS—Table showing total Cases. 22 PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS 1925. It was not necessary to take any action under these Regulations during the year. PUBLIC HEALTH ACT, 1925, SECTION 62. No action was taken under this section. Case rate of attack per 1,000 of the population of certain infectious diseases in this district and in England and Wales. Disease. Case rate per 1,000 living. Surbiton. England and Wales. Small-pox — 0.004 Scarlet Fever 2.29 3.76 Diphtheria 1.29 1.70 Enteric Fever 0.05 0.03 Puerperal Fever 0.08 0.06 Puerperal Pyrexia 0.26 0.15 Erysipelas 0.18 0.51 PREVALENCE OF AND CONTROL OVER INFECTIOUS DISEASE. There have been no cases of Small-pox in the area, with tho result that the risks to contacts were less than in recent years. Occasionally ships arrive in our ports which have had cases of Small-pox on board, and the contacts, if any, in Surbiton are kept under observation. Scarlet Fever. The number of cases of the above remain almost as in the previous year, viz.: 87, and were evenly distributed throughout the district, the majority were mild cases and nine were able to be nursed at home under proper care. There were six return cases. 23 Ward. No. of Cases Treated in Hospital. Treated at Home. Deaths. Berrylands 14 11 3 — Chessington 3 3 — — Hook & Southborough 10 9 1 1 Seething Wells 3 2 1 — St. Mark's 5 4 1 — Surbiton Hill 13 12 1 — Tolworth East 7 6 1 — Tolworth West 18 18 — — Tolworth South 14 13 1 — Diphtheria. It w ill be noted that there is a large increase in the number of cases of Diphtheria. The total number of cases notified was 49, of which 48 were removed to Hospital and 3 deaths occurred. This is the largest number of cases of Diphtheria which has occurred in the Urban District during the past 10 years and the average number of cases occurring annually from 1925 to 1934 inclusive has been 24.8. This particular outbreak occurred near the end of August and spread rapidly through one class of school children. It was found to originate from a carrier who was not suffering from the disease but who had infected his wife who had passed the infection on to school children relatives and thus into the class of school children. The cases were of an extremely virulent type and the first death occurred at home prior to notification. The succeeding 2 deaths occurred in the Isolation Hospital. The spread of the disease was effectively checked by the end of September since when there have been no unusual number of cases. The Council approved of the Schick Test and Immunisation but eventually declined to go further, as they thought that the County Council should be asked to undertake it, as they are the School Authority. 24 DIPHTHERIA. 1934. Ward. No. of Cases. Treated in Hospital. Treated at Home. Deaths. Berrylands 3 3 — — Chessington 3 2 1 — Hook & Southborough — — — — Seething Wells 2 2 — — St. Mark's 4 4 — — Surbitou Hill 8 8 — — Tolworth East 3 3 — 1 Tolworth West 18 18 — 1 Tolworth South 8 8 — 1 25 Pneumonia. There was an acutal drop in the incidence of Pneumonia but the number of deaths that occurred were more in proportion. Ward. No. of Cases. Treated in Hospital. Treated at Home. Deaths. Berrylands 2 — 2 — Chessington 1 — 1 — Hook & Southborough 4 — 4 — Seething Wells 5 2 3 — St. Mark's 8 2 6 — Surbiton Hill 5 — 5 — Tolworth East 5 1 4 — Tolworth West 10 1 9 — Tolworth South — — — — Enteric Fever. Two cases occurred of Typhoid Fever; both were of the mild type. The origin of the infection was not clearly known. Ward. No. of Cases. Treated in Hospital. Treated at Home. Deaths. Berrylands — — — — Chessington — — — — Hook & Southborough — — — — Seething Wells — — — — St. Mark's — — — — Surbiton Hill 1* 1 — — Tolworth East — — — — Tolworth West 1† 1 — — Tolworth South — — — — * Typhoid. † Paratyphoid B. Encephalitis Lethargica. No cases were notified. Tuberculosis. Under the Public Health Tuberculosis Regulations a register of all notifications is kept and 26 weekly returns of cases are sent to the County Medical Officer. The continual movement of cases from one district to another requires constant supervision so that particulars can be brought up-to-date and represent a true record. At the end of this year the following was the number of persons shewn to be suffering from the disease and living within the district. Pul. Non. Pul. Males 42 16 Females 49 16 Total 91 32 Measles. There was the usual bi-enniel epidemic of measles during the early part of the year up to J ulv. The number of cases which were notified by the Head Teachers of Schools was 279. There was only one death, however. All cases except 5 were treated at home. German Measles ran concurrently with that of Measles and 49 cases were reported. GENERAL PROVISION OF HEALTH SERVICES IN THE AREA. Hospitals. 1. 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 and Esher. At present there is accommodation for 40 patients, viz.:—Scarlet Fever 24, Diphtheria 16. 27 Owing to the rapid development of the constituent areas, the Joint Board have acquired land for an extension of this Hospital. The alterations are well in hand and will accommodate 30 beds, making a total of 70. The Hospital is situated in this district. By arrangement between the Joint Hospital Board and Esher Urban District Council, Molesey Isolation Hospital is available for the purpose of providing additional accommodation for infectious disease cases when necessary. The accommodation provides for eighteen patients:—Scarlet Fever 12, Diphtheria 6. 2. Small-pox. The Small-pox Hospital, situated at Clandon, is controlled by the Surrey County Council, and is subsidised by the District Council. 3. Tuberculosis. Cases are admitted into sanatoria at Milford through the Surrey County Council. 4. Maternity. Provision is made for these cases at the Kingston & District Hospital and at homes controlled by the Surrey County Council. 5. Children. Provision is also made for these cases at the Kingston & District Hospital. 6. Other. The Surbiton Hospital, which is supported by voluntary contributions. 28 A new and more commodious site has been acquired and funds are being raised for the erection and equipment of a new hospital to provide increased accommodation. Institutional provision for unmarried mothers, illegitimate children and homeless children—Nil. Institutional provision for the care of Mental Defectives.—Surrey County Council Homes at Ottershaw and Bletchingley, and Hospitals at Netherne and Brookwood. Ambulance Facilities. (a) For Infectious Cases.—A motor ambulance is provided by the Joint Hospital Board. (b) For Non-Infectious and Accident Cases.— A motor ambulance is provided by the Council which is available at any time night or day in cases of accident or suddeh illness in the street, irrespective of boundaries. The ambulance is also available, within certain limits, 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), South Place, Surbiton. Tuberculosis Dispensary (provided by Surrey County Council), South Place, Surbiton. Sessions twice weekly or oftener if required. Venereal Diseases.—Arrangements are made by the County Council for the treatment of these diseases at various Hospitals and Centres. 29 Professional Nursing in the Home. (a) General. The Surbiton and District Nursing Association, which is affiliated to the Queen's Institute of District Nursing, has four trained nurses and one maternity nurse available for attending cases of sickness in the home, within the Urban District of Surbiton. In the Ecclesiastical Parish of Christ Church a parish nurse is provided by the Church Authorities for home nursing. (b) Infectious Disease. There are 110 arrangements for the home nursing of cases of Measles and Whooping Cough. It is my opinion that provision should be made in the Isolation Hospital for the admission of complicated cases of Measles and Whooping Cough, and it is understood that when the new portion of the Isolation Hospital is completed, provision will be made for cases of this type to be admitted. 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 seven midwives practising in the District. LABORATORY WORK. Pathological and Bacteriological examinations are made for the Council by the Clinical Research Association. 30 During the year the following examinations were carried out:— Disease Suspected. Nature of Specimen. Result. TOTAL Positive. Negative. Diphtheria Swabs 15 171 186 Tuberculosis Sputum 9 66 76 Tuberculosis Blood — — — Tuberculosis Swab — — — Typhoid Blood 1 1 2 B. Coli U rine 1 — 1 Total 26 238 264 Diphtheria antitoxin 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. Out of 186 diphtheria swabs sent by the general medical practitioners for examination, only 15 proved to be positive. List of Adoptive Acts, Bye-Laws, and Local Regulations Relating to Public Health, in Force in the District, with Date of Adoption. Local or Adoptive Acts. The Surbiton Improvement Act, 1855. Infectious Disease (Prevention) Act, 3890 (March 10th. 1891). 31 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 Common Lodging Houses (March 20th, 1880). (3) Bye-Laws with respect to Tents, Vans, Sheds and Similar Structures (October 10th, 1898). (4) Bye-Laws as to Means of Escape in Case of Fire in certain Factories and Workshops (January 2nd, 1913). (5) Regulations as to Underground Rooms habitually used as Sleeping Places (August 10th, 1916). (6) Bye-Laws for the Regulation of Offensive Trades (May 25th, 1925). (7) Bye-Laws as to Slaughter Houses (July 13th, 1925). (8) Bye-Laws as to New Streets and Buildings (May 26th, 1927 and October 15th, 1928). (9) Bye-Laws as to Emission of Smoke (March 23rd, 1929). (10) Bye-Laws with respect to Houses let in Lodgings (March 30th. 1932). 32 The provisions of the above Acts, Bye-laws and Regulations are rigidly enforced throughout the district. There are a number of Bye-Laws and Regulations operating for a limited period within the added portions of the district only, these Bye-Laws, etc., having been made by the Epsom Rural District Council, Maiden & Coombe Urban District Council, or the Kingston Borough Council. Several of the series are duplicated owing to the operation of the Surrey Review Order, 1933, and the Council are now revising the majority of them. SANITARY CIRCUMSTANCES OF THE AREA WATER SUPPLY. The water supply throughout the District is furnished by the Metropolitan Water Board. It has been of excellent quality. The supply to all houses is constant. No samples have been taken for analysis. (This applies to Surbiton Council). No information of samples taken have been supplied by the Metropolitan Water Board. DRAINAGE AND SEWERAGE. New sewers have been laid in the added area of Chessington, and many houses have been drained and connected thereto. There are only eight houses in the district which cannot be connected to the sewers. SCAVENGING. Section 36 of the Public Health Act, 1875, is enforced in this district. It empowers the Council 33 to insist upon each house being provided with a portable galvanised iron dust bin where no suitable ashpit exists, or where they are unsuitably placed or beyond repair. Most of the houses in the district are now provided with covered ashbins, most of which are movable. A weekly collection is made of house refuse by means of nine trailers and three tractors. The trailers are horse-drawn from house to house and then, when full, taken to the destructor by tractor. The method of disposal is by incineration. The steam produced therefrom is used for pumping and other power in connection with the Sewage Disposal Works. CLOSET ACCOMMODATION. The whole of the closets in the original Urban District of Surbiton were by March 1933 011 the water carriage system. By 1933 in the added Parish of Chessington there was very little house drainage existing and most of the properties had been put 011 the water carriage system by the end of 1934. SANITARY INSPECTION OF AREA. This is fully dealt with in the report of the Sanitary Inspector, which is attached hereto. SALE OF POOD AND DRUGS ACTS. The Sale of Food and Drugs Acts in this district fire administered by an Inspector acting under the direction of the Surrey County Council, who has 34 kindly furnished the following particulars for 1934:— ARTICLES. ANALYSED. ADULTERATED OR DETERIORATED. PROSECUTIONS. CONVICTIONS. Formal Informal Total Formal Informal Total Milk 37 — 37 2 — 2 — — Cream 3 — 3 — — — — — Meat 4 — 4 — — — — — Pneserved Sausages 1 — 1 — — — — — Coffee Essence — 2 2 — — — — — Coffee Extract — 1 1 — — — — — Sausages 1 — 1 — — — — — Ginger Wine — 3 3 — — — — — Malt Vinegar 1 — 1 — — — — — Artificial Vinegar 1 — 1 — — — — — Cake — 2 2 — — — — — Lemon Squash Breakfast — 1 1 — — — — — Chocolate — 1 1 — — — — — Total 48 10 68 2 — 2 — — MILK SUPPLY. There is one producer of "Certified" milk in the District. This grade of milk is brought principally from outside the District and supplied to six retailers all of whom hold licences. Three samples were taken, two of which did not conform to the standard for "Certified" milk as laid down by the Ministry of Health. There is one producer of Grade "A" (Tuberculin Tested) milk in the District and this grade is supplied to six retailers under licence. No samples were taken. 35 There are seven dealers in the District who hold licences for Pasteurised milk. Only one sample was taken which was satisfactory. Thirteen samples of Ordinary milk were taken during the year under review, six of which showed a bacterial count of over 400,000 per cubic centimetre. The remainder varied from 17,000 to 191,000 per cubic centimetre. Nine had Bacillus Coli present in 48 hours and 3 days, the others being negative. The presence of Streptococci and Tuberculosis were not detected in any of the 17 samples. The following is a summary of the Bacteriolo gists's report:— No. of Sample Temperature on arrival at Laboratory Number of Bacteria per 1 cubic oentimetre Presence of Bacillus Coli in 48 hours and 3 days 1 CERTIFIED MILK Positive 19.0° Centigrade 5,666 2 19.0° „ 2,566 „ 3 14.0° „ 916 Negative GRADE A (TUBERCULIN TESTED) MILK Nil PASTEURISED MILK 1 20.0° Centigrade 125,500 Negative 1 ORDINARY MILK Positive 16.0° Centigrade 93,666 2 16.0° „ 67,333 „ 3 16.0° „ 775,000 „ 4 16.0° „ 775,000 Negative 5 16.0° „ 163,333 Positive 6 16.0° „ 191,333 „ 7 16.0° „ 470,000 „ 8 17.0° „ 98,000 Negative 9 17.0° „ 3,100,000 Positive 10 17.0° „ 17,333 Negative 11 20.0° „ 59,666 „ 12 20.0° „ 3,800,000 Positive 13 20.0° „ 10,800,000 „ RAG FLOCK ACT, 1911 and 1928. There are no premises in the District in which Rag Flock is manufactured or sold. 36 FACTORIES, WORKSHOPS, WORKPLACES AND HOMEWORK. 1.—INSPECTION. Including Inspections made by Sanitary Inspectors. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (Including Factory Laundries) 17 — — Workshops (Including Workshop Laundries) 39 1 — Workplaces (Other than Outworkere' premises included in Part 3 of this Report) — — — Total 56 1 — 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 29 29 — — Want of Ventilation — — — — Overcrowding — — — — Want of drainage floors — — — — Other Nuisances — — — — Sanitary accommodation Insufficient — — — — Unsuitable or defective 2 2 — — Not separate for sexes — — — — Offences under the Factory and Workshop Acts:— Illegal occupation of underground bakehouse (S. 101) — — — — Other Offences:— Excluding offences u» der the sections mentioned in the ScheSule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order 1921 — — — — Total 31 31 — — * Including those specified in Sections 2, 3, 7 and 8, of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts. 37 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 Occupiers as to keeping or sending lists. Prosecutions. Sending twice in the Sending once in the year. year. Failing to keep or permit inspection of lists. Failing to send lists. Instances Notices served Prosecution Lists. Outworkers. Lists. Outworkers. Contractus Workmen. Contractus Workmen. Wearing Apparel— (1) Making, &c. 2 — 6 — — — 2 — — 2 — — — (2) Cleaning and washing — — — — — — — — — — — — — Lampshade Painting — — — — — — — — — — — — — Total 2 — 6 — — — 2 — — 2 — — — 38 4.—REGISTERED WORKSHOPS. Workshops on the Register (S. 131) at the end of the year. Number Bakehouses 14 Laundries 7 Tailors 11 Bootmakers 14 Dressmakers 10 Milliners 6 Sundry Other Trades 81 Total Number of Workshops on Register 143 5.—OTHER MATTERS. Class. Number Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (S. 133, 1901) — 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 — Reports (of action taken) sent to H.M. Inspector — 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 1 39 Annual Report of Sanitary Inspector To the Chairman and Members of the Urban District Council of Surbiton Ladies and Gentlemen, I have the honour to present the Annual Report on the work of your Sanitary Inspectors for the year 1934. This report is compiled in accordance with the directions contained in a Memorandum from the Ministry of Health and as required by Article XIX (15) of the Sanitary Officers Order, 1926. COMPLAINTS. During the year four-hundred and ninety-one complaints were received with respect to the ing matters, viz.:— Defective condition of house drains 59 Insanitary or dilapidated condition of houses and premises 90 Verminous rooms 10 Nuisances from dampness in walls and floors 5 Defective water closets 34 Defective sink waste pipes, etc. 18 Defective roofs 21 Defective eaves gutters and rainwater pipes 3 Defective stoves and ranges 40 Water supply to dwelling houses disconnected 23 Smoke nuisance 2 Caravans 1 Overcrowding 2 Underground rooms 2 Houses infested with rats 31 40 Houses not provided with sufficient receptacles for house refuse 24 Nuisances from animals improperly kept 4 Offensive accumulation of manure, etc. 13 Offensive smells from various causes 10 Flooding of premises 4 Defective water fittings 57 Miscellaneous 38 INSPECTION OF DISTRICT. Number of houses and premises inspected (ordinarily) 983 „ houses inspected and particulars recorded (Housing Act) 217 „ houses and premises re-inspected 2156 „ miscellaneous visits 783 „ visits to works in progress 1192 „ visits to slaughterhouses 26 „ visits to dairies, cowsheds and milkshops 78 „ visits to bakehouses 31 „ visits to schools 16 „ visits to workshops 12 „ visits to workplaces – „ visits to factories 13 „ visits to homeworkers' premises 2 „ visits re cases of infectious disease 208 „ food inspections 509 „ visits to Council's Housing Estates 835 „ visits to fried fish shops 4 TESTING OF DRAINS AND SANITARY FITTINGS. Drainage systems exposed for examination under Section 41 of the Public Health Act, 1875 22 Drains, soil pipes, etc., tested with smoke or air 39 Drains tested with water 48 Drains tested with chemical 31 41 NOTICES SERVED. Informal notices 193 Statutory notices under Section 36 of the Public Health Act, 1875, to provide a sufficient dust receptacle 31 Statutory notices under Section 36 of the Public Health Act, 1875, to provide a sufficient water closet 16 Statutory notices under Section 41 of the Public Health Act, 1875, or Section 45 Public Health Acts Amendment Act, 1907, to examine and test drains 14 Statutory notices under Section 41 of the Public Health Act, 1875, to relay drains 50 Statutory notices under Section 73 of the Public Health Act, 1875, to discontinue using basement separately as a dwelling 4 Statutory notices under Section 94 of the Public Health Act, 1875, to abate nuisance 24 Statutory notices under Section 25 of the Public Health Acts Amendment Atct, 1907, to pave yards 18 Statutory notices under Section 19 (Sub-Section 1) Housing Act, 1930, of Time and Place 19 Statutory notices under Section 127, Housing Act, 1925, to enter and survey premises 239 Statutory notices under Section 17, Housing Act, 1930, to make premises reasonably fit for human habitation 146 Statutory notices under Section 42, Housing Act, 1930, to require information re ownership of premises 205 Statutory notices under Section 19 Housing Act, 1930 —Demolition Orders 63 Statutory notices under Byelaws (Houses let in Lodgings) 4 42 Statutory notices Milk and Dairies (Amendment) Act, 1922—removal from register 1 Statutory notices under Section 23 of the Public Health Act, 1875, to provide a covered drain 18 Statutory notices under Section 62 of the Public Health Act, 1875, to obtain a supply of water 2 Statutory notices under Section 49 of the Public Health Acts Amendment Act, 1907, to provide sinks 8 Statutory notices under Section 20 of the Public Health Act, 1925, to pave common passage 3 Statutory notices under Bye-Laws (Stables) 6 Statutory notices under Part I of the Housing Act, 1930 —Clearance Orders 10 Statutory notices under Part 1 of the Housing Act, 1930—Notice of making Clearance Orders 33 Total 1,007 DETAILS OF SANITARY IMPROVEMENTS EFFECTED DURING THE YEAR. Drainage. Defective drains repaired, cleansed, etc. 116 Drainage systems re-constructed 79 Drainage systems partly re-constructed 14 Additional drains provided 5 Water Closets. Additional provided 57 W.C.'s cleansed or repaired 149 New pans fixed 182 Flushing cisterns repaired or renewed 54 Lighted or ventilated 2 43 Sinks, Baths, Etc. New fixed 77 Waste Pipes, Etc. Repaired 18 New provided 44 Disconnected or trapped 38 Water Supply. Draw off taps disconnected 13 Water re-instated or laid on 23 Service pipes and cisterns repaired, etc. 115 Paving. Yards paved 98 Yard paving repaired 12 Dust Receptacles. Provided 62 Dampness. Roofs repaired 70 Eaves gutters or rain water pipes repaired and renewed 39 Damp courses fixed 9 Site of house concreted 7 Ventilated under floors provided 32 External walls pointed and rendered 33 House walls treated with solution 12 General Repairs. Windows provided, repaired or renewed 422 House floors repaired or renewed 72 Doors repaired or renewed 132 Ranges and coppers repaired or renewed 178 44 Rooms ventilated 9 Internal Walls and Ceilings repaired 138 Rooms cleansed 262 External and internal painting 118 Handrails provided 8 Overcrowding abated 9 Animals removed 1 Accumulations removed 6 Miscellaneous 83 Cesspools abolished 13 Pail closets abolished 24 HOUSING. Number of new houses erected during the year:— (a) Total (including numbers given separately under (6) 1204 (i) By the Local Authority Nil (ii) By other Local Authorities Nil (iii) By other bodies or persons 1204 There were no houses erected with State assistance by the Local Authority or any other bodies or persons for the purpose of Part II or Part III of the Act of 1925. 1. Inspection of Dwelling Houses during the year:— (1) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 954 Number of inspections made 954 (2) Number of dwelling houses (included under subheading (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 217 45 Number of inspections made 217 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 83 (4) Number of d'welling houses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 709 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 512 3. Action under Statutory Powers during the year:— A.—Proceedings under Sections 17, 18 and 23 of the Housing Act, 1930:— (1) Number of dwelling houses in respect of which notices were served requiring repairs 69 (2) Number of dwelling houses which were rendered fit after service of formal notices:— (a) by owners 57 (b) by Local Authority in default of owners 2 B.—Proceedings under Public Health Acts:— (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 58 (2) Number of dwelling houses in which defects were remedied after service of formal notices:— (а) by owners 64 (б) by Local Authority in default of owners 4 46 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 14 (2) Number of dwelling houses demolished in pursuance of Demolition Orders 2 (3) Number of dwelling houses in respect of which notices of Time and Place at which the question of making a Demolition Order will be considered —Section 19 (1) 10 (4) NuJmber of undertakings to carry out works accepted – (5) Number of houses rendered fit 5 (6) Undertakings cancelled—the works having been carried out 5 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 Nil (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit Nil E.—Proceedings under Part I of the Housing Act, 1930 In May, 1934, your Medical Officer of Health made official representation as provided in section 51 of the Act of ten clearance areas comprising seventy-four houses. The position with respect to these areas is indicated in the table overleaf:— Clearance Area No. No. of Houses Comprising Date of Representation (sec. 51) Date of Advertisement Inquiry Held 1 11 15/35, Maple Road (odd Nos.) 29th May, 1934 11th August, 1934 16th October, 1934 2 12 1/12, Ivy Place 29th May, 1934 11th August, 1934 16th October. 1934 3 3 78, 79 and 80, Portsmouth Road 29th May. 1934 11th August, 1934 16th October, 1934 4 5 4/8, Grove Footpath 29th May, 1934 11th August, 1934 16th October, 1934 5 4 1/4. Jennetts Cottages, Surbiton Hill Road 29th May, 1934 11th August, 1934 16th October, 1934 6 3 1/3, Stone Cottages, Leatherhead Road 29th May, 1934 11th August, 1934 16th October, 1934 7 5 23/31, Gladstone Road (odd Nos.) 29th May. 1934 11th August, 1934 16th October, 1934 8 24 1/12, Spring Cottages, St. Leonards Road, and 1/12, St. Leonards Square, St. Leonards Road 29th May. 1934 11th August, 1934 16th October, 1934 9 2 291 and 293, Ewell Road 29th May, 1934 11th August, 1934 16th October, 1934 10 5 2/6, Hobill Place 29th May, 1934 11th August, 1934 16th October, 1934 In January, 1935, confirmation was received in respect of areas Nos. 1, 3, 4, 5, 6, 7, 9 and 10, and an Undertaking was accepted for No. 2. 47 48 FACTORY AND WORKSHOP ACT, 1901. The total number of workshops now on the Register, including bakehouses, is 143. The businesses carried on at the respective premises are given in the report of your Medical Officer of Health. Visits from time to time have been paid and as a result the following nuisances have been dealt with:— W.C.'s walls repaired 1 W.C.'s ceilings repaired 1 Rooms cleansed 1 This shows a marked decrease in the number of nuisances discovered, and is probably the result of the closing of several old establishments and erection during recent years of a number of larger factories and workshops on modern lines. SLAUGHTERHOUSES. There are three slaughterhouses in the district, all of which are registered. They have been regularly inspected, and generally found to be well kept. BAKEHOUSES. There are 16 Bakehouses in use in the District, one of which is underground. They have been visited at least twice during the year, and found to be kept in a satisfactory condition. DAIRIES, COWSHEDS AND MILKSHOPS. During the year two persons have discontinued carrying on the trade of Retail Purveyors of Milk, 49 and two have discontinued carrying on the trade of wholesale producers and they have been struck off the Register. Four applications were received from persons residing in the District to be registered as Retail Purveyors of Milk, and one application was received for registration as a wholesale producer. There are now fifty-five persons registered in accordance with the Milk and Dairies (Amendment) Act, 1922, as follows:— Wholesale Traders or Producers of Milk 14 Retail Purveyors of Milk residing in the District 30 Retail Purveyors of Milk who reside outside the District but retail in the District 11 Total 55 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 with the Milk and Dairies Order, 1926. Six Dealers' Licences to sell Certified Milk, seven to sell Pasteurised Milk, six to sell Grade A (Tuberculin Tested) Milk, two to sell Grade A Milk, one to sell Grade A Pasteurised, and one Supplementary Licence to sell Grade A (Tuberculin Tested) Milk were granted under the Milk (Special Designations) Order, 1923. In accordance with instructions received from the Ministry of Health, three samples of Certified Milk, and one of Pasteurised Milk were taken from the local Dairymen and sent to the Clinical Research Association for Bacteriological Examination. 50 The Milk (Special Designations) Order, 1923, stipulates that " Certified " Milk shall not contain more than 30,000 Bacteria per cubic centimetre, and that no Bacillus Coli shall be present in one tenth of a cubic centimetre, also that in Grade "A" (Tuberculin Tested) Milk there shall not be more than 200,000 Bacteria per cubic centimetre and that no Bacillus Coli shall be present in one hundredth of a cubic centimetre. Pasteurised milk must not contain more than 100,000 bacteria per cubic centimetre. It will be observed that the standard of Ordinary milk as represented by the thirteen samples taken appears to be far below that obtaining in 1933. I am confident that the results shown do not indicate the standard throughout the year, as the bad samples, which were taken during extremely hot weather, nearly all related to one source of supply, and that recurred until the source of contamination was discovered. Neglect was found to be (i) careless production at a farm and (ii) dilapidated churns improperly sterilized. Very careful and constant inspection continued throughout the year and there was no recurrence of the trouble. FOOD INSPECTION. Regular visits have been paid to the slaughterhouses in the district for the purpose of inspecting the carcases of animals at the time of, or immediately after slaughter. 181 beasts were inspected, 1,111 pigs, 931 sheep, and 353 lambs, giving a total of 2,576 animals. Of this total 88 animals were affected with disease in some part, representing 3.4%. 51 Visits have also been made to the shops &c., where food is prepared or exposed for sale. The following foodstuffs found to be unfit for human food were surrendered by the owners, and subsequently destroyed lbs. ozs Lungs of beast (1) 14 0 Tuberculosis. Lungs of beast (1) 5 12 Abscess. Liver of beast (3 portions) 22 0 Flukes. Liver of beast (portion) 2 0 Abscess. Liver of beast (2 portions) 4 0 Cirrhosis. Liver and thin skirt of beast(l) 15 0 Bacilliary Necrosis. Liver and spleen of calf (1) 7 0 Tuberculosis. Lungs of calf (1) 2 0 Congestion. Lungs of calf (1) 4 0 Tuberculosis. Carcase and offal of pig (1) 208 0 Generalised Tuberculosis. Liver of pig (5) 23 8 Cirrhosis. Liver of pig (14) 54 0 Milk spot. Liver of pig (1) 4 0 Tuberculosis. Liver of pig (1) 5 0 Congestion. Head of pig (17) 215 9 Tuberculosis. Pluck of pig (1) 11 0 Tuberculosis. Pluick of pig (1) 5 8 Congestion. Lungs of pig (22) 48 0 Congestion. Mesentery of pig (3) 5 8 Tuberculosis. Heart of pig (3) 1 8 Pericarditis. Kidney of pig (1) 0 8 Nephritis. Lungs of sheep (5) 8 8 Congestion. Lungs of sheep (8) 17 8 Strongylus Rufescens. Liver of sheep (2) 3 0 Necrosis. Pickled beef (pieces) 40 0 Decomposition. 726 12 52 CHEMICAL AND BACTERIOLOGICAL EXAMINATION OF FOOD. Arrangements are made for this work to be carried out at the Laboratories of the Clinical Research Association, York Buildings, Adelphi, W.C.2. DISINFECTION. During the year disinfection has been carried out at 148 premises in which the following cases of infectious diseases have occurred:— Scarlet Fever 81 Diphtheria 45 Tuberculosis 14 Pneumonia 1 Puerperal Pyrexia 5 Typhoid Fever 1 Disinfection was also carried out at seventeen premises after cases of non-notifiable diseases on the occupiers of the houses in which the cases occurred agreeing to pay the expense. Seventeen premises were disinfected, and otherwise treated to abate infestation by vermin. The Public Elementary Schools were disinfected as arranged with the Managers and Surrey Education Committee; the walls, floors, and ceilings being sprayed with formaldehyde during the Easter vacation. School disinfection at Mid-Summer and Christmas was discontinued on the grounds of economy. 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:— 53 Beds 1 Blankets 330 Bolsters 33 Carpets 2 Counterpanes 80 Curtains 2 Cushions 10 Mattresses 104 Mattress Covers 5 Pillows 177 Pillow Cases 227 Quilts 36 Rugs 9 Sheets 260 Toilet Covers 13 Wearing Apparel 268 Miscellaneous 300 Towels 24 1,881 LEGAL PROCEEDINGS. (1) Legal proceedings were taken in respect of a serious case of overcrowding and the Magistrates made an Order to abate the nuisance within one month. (2) In co-operation with the National Society for the Prevention of Cruelty to Children three children were removed from a dwelling-house in the district to a hospital for medical care and attention, and the occupier was subsequently prosecuted and committed to prison for one month. MORTUARY. The mortuary situate in Alpha Road is well equipped and maintained. During the year sixteen bodies have been received, sixteen post mortems carried out, and sixteen inquests held. 64 GENERAL. An examination of the number of inspections made, the number of statutory notices served and the amount of work done in compliance with such notices indicates the continued good relations existing between property owners in the district and the Council. It is noteworthy that out of five hundred and sixty demands made by the Council by way of statutory notice it was only found necessary to execute work in default in two instances. The work of improving the sanitary condition of the properties in the added area has proceeded steadily, and during the year thirty-seven defective cesspools or pail closets have been abolished and the premises drained and connected to the Public Sewer. The number of drainage systems completely reconstructed reached the high figure of seventy-nine, which is almost double that of 1933, and the high standard of the work has been fully maintained. During the year the Metropolitan Water Board drafted new Bye-Laws for the purpose of preventing waste, misuse or contamination of water, and representations were made to the Board with a view to the amendment of certain clauses. The objections raised by your Officers were well received by the Board and certain amendments were made. The standard of production and handling of milk continues to improve despite the fact that during the year there was a period when some very bad samples of milk were obtained. One producer in the added area was removed from the register and the farm demolished. Inspections have been made for a long period of the milk arriving in the district by rail in the 55 early morning with a view to preventing the use of bad churns such as were detected during the Summer, and I am pleased to report that the whole of the old churns have been taken out of use. Appreciation should be expressed to the Officials of the Surrey County Council as I am convinced that much of our progress on farms and in connection with the public milk supply is due to their activity. Slaughter of Animals Act, 1933:—A copy of this Act was supplied to each slaughterman and butcher who employs slaughtermen in the district, and there are now ten persons holding licences to act as slaughtermen, the licences were made operative for three years. The Council resolved that section I of the Act should apply to sheep, ewes, wethers, rams, and lambs. Council Housing Estates:—Owing to the continued dry weather serious settlement took place beneath three houses and special underpinning work was placed in the hands of your Architect, and has proved effective. The whole of the Council's houses were painted externally by direct labour in addition to the usual interior decorative work. During the year the Council acquired flats numbered 1-22, Howard Road and houses 17-20, Alpha Road in which properties overcrowding had existed for some considerable time. Several families have been moved into larger Council Houses, and in others, arrangements have heen made to prevent overcrowding. 66 The staff have responded in a willing and efficient manner to the calls of a very busy year and I sincerely thank them. In conclusion may I thank your Medical Officer of Health for his support and the Officers of other Departments for their close co-operation and assistance. I am, Ladies and Gentlemen, Your obedient servant, GEOFFREY McCLELLAND, Sanitary Inspector.