AC 444B ??? The Urban District Council OF SURBITON ANNUAL REPORTS OF THE MEDICAL OFFICER OF HEALTH AND SANITARY INSPECTOR FOR THE YEAR 1935. Printed by J. B. Blackmore & Co. Ltd., 85, High Street, ..Torton, S.W.19 The Urban District Council OF SURBITON ANNUAL REPORTS OF THE MEDICAL OFFICER OF HEALTH AND SANITARY INSPECTOR FOR THE YEAR 1935. The Urban District Council of Surbiton PUBLIC HEALTH COMMITTEE. Councillor Mrs. A. Woodgate. (Chairman). Councillor E. B. Ames (Vice-Chairman). Councillor Mrs. Cudbird Councillor Potter „ Bridge „ Rampton „ Dommett „ H. Reynolds „ Diirbin „ Rix „ Leach „ Roberts ,, Penwill ,, Sanger 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. Deputy Sanitary Inspector : *C. Wilson, C.M.I., C.R.S.I. Additional Sanitary Inspectors : *J. R. Glover, C.M.I.. Cert. R.S.I. & S.I.E.J.P.. (Resigned 30th April, 1935). *H. J. Eldridge, C.M.I., C.R.S.I. (Appointed 11th June, 1935). S. W. Simpson-Scott, C.R.S.I. & S.I.E.J.B., C.M.I. (Appointed 1st May, 1935 to 8th June, 1935, temporary). Senior Clerk : E. D. Elms. Clerk : J. L. wlllougliby. Junior Clerk : W. F. Acres (Appointed 25th Nov., 1935). Disinfector, etc. : W. A. Hutchins. * Contributions to salary made from Exchequer. 5 Annual Report of The Medical Officer of Health for 1935 Public Health Department, Council Offices, Surbiton. June, 1936. To the Chairman and Members of the Urban District Council of Surbiton Ladies and Gentlemen, I have the honour to submit to you my 14th Annual Report on the work of the Public Health Department for the past year ending December, 1935. In it are various matters appertaining to the health and sanitary condition of the Urban District of Surbiton. The Report for 1935 is an Ordinary Report set out on the lines suggested in Circular 1492 of the Ministry of Health. Development of the District still continues; practically the whole of Tolworth is now built on, and instead of being a suburb of Surbiton, it is in fact a town in itself, with well lighted streets, new open spaces and a Cinema, the latter being a much desired amenity. 6 The population given by the Registrar General mid-year 1935 was 40,020, being an increase on the previous year of 1,970, and on this figure all the various data for statistics are calculated. The estimated population at end of 1935 was 42,500. The increase in the number of inhabited houses is from 11,068 to 12,007, this increase occurring mainly in the outlying districts. There has been a very marked tendency for the building of flats in place of the older houses which have been pulled down. The Birth Rate for 1935 is 17.46 per thousand of the estimated population, an increase of 1.38 per thousand. The Death Rate for 1935 is 9.49, a slight increase of 0.35 per thousand. The Infantile Mortality Rate is 37.19 per thousand live births, an increase over last year of 9.41 per thousand live births. This rate is a very creditable one as compared with England and Wales, in spite of the increase over last year. The incidence of Infectious Disease showed a definite drop in respect of all diseases except Dysentery, Erysipelas and Malaria. Early in the year the Council considered my report on the Schick Test and Diphtheria Immunisation. The provision of facilities for this purpose was agreed to in principle and it was resolved that the scheme be provided for in the next year's estimates. 7 The result of the Inquiry held in October 1934 by H. McGregor Wood, Esq., A.R.I.B.A., following my official Representation under Part I of the Housing Act, 1930, in respect of 10 clearance areas comprising 74 houses was that the Ministry of Health confirmed the Orders in respect of Areas Nos. 1, 3, 4, 5, 6, 7, 9 and 10; and an undertaking was accepted in respect of Area No. 2. The Order for Area No. 8 was not confirmed. The attraction of the Surbiton Lagoon is still great, in spite of the none too favourable weather conditions last year, and the samples taken of the water were satisfactory. During the year 17 persons were examined by the Medical Officer for entrance into the Superannuation Scheme and 2 for posts outside that Scheme. Seven persons were examined for the purposes of the Superannuation Scheme by outside doctors and none for other posts. I have to thank Mr. McClelland, your Chief Sanitary Inspector, and the remainder of the Staff, for their valuable help during the year. I am, Ladies and Gentlemen, Your obedient Servant, N. H. LINZEE, Medical Officer of Health. 8 PHYSICAL FEATURES AND GENERAL CHARACTERISTICS OP 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 Esher, 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 SouthWest, 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 9 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 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 when compared with 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 has been a slight increase in the number of factories in the District. The addition of these factories, however, cannot be said to exert any particular influence upon the health of the workers. Of the workers engaged at the factories and workshops the majority are resident within the District. 10 The amount of unemployment in the Urban District is small. At the end of 1935 the number unemployed was 150 males and 50 females, according to approximate figures supplied by the Kingston Labour Exchange. 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. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres) 4,711 Resident Population (Census 1931) 29,396 Registrar General's estimate mid-year 1935 40,020 Estimated Population 31st December, 1935 42,500 Number of inhabited houses (end of 1935) according to the rate books 12,007 Number of families or separate occupiers (1931 census) 8,116 Rateable Value £457,574 Sum represented by a penny rate £1,774 EXTRACTS FROM VITAL STATISTICS OF THE YEAR. (Based on population of 40,020). Live Births:— Total. M. F. Legitimate 682 365 317 Illegitimate 17 9 8 Birth rate per 1,000 of the estimated resident population 17.46 Still Births:— Legitimate 18 8 10 Illegitimate 2 — 2 Rate per 1,000 total (live and still) births 27.81 Deaths 388 178 210 11 Crude death rate per 1,000 of the estimated resident population 9.69 Adjusted death rate (comparability Factor 0.98) 9.49 Percentage of total deaths occurring in Public Institutions 39.69 Deaths from puerperal causes :— Deaths. Rate per 1,000 total Births (live & still). No. 29 Puerperal Sepsis 1 1.39 No. 30 Other puerperal causes — Total 1 1.39 Death rate of Infants under one year of age :— All infants per 1,000 live births 37.19 Legitimate infants per 1,000 legitimate live births 35.19 Illegitimate infants per 1,000 illegitimate live births 117.64 Deaths from Measles (all ages) — Deaths from Whooping Cough (all ages) — Deaths from Diarrhoea (under 2 years of age) 5 The natural increment in the population for 1935 is 311. Still Births.—The rate per 1,000 population is 0.49, which is below that for England and Wales (Smaller Towns), namely 0.64. The maternal mortality rate per 1;000 live births is 1.43. The maternal mortality rate per 1,000 total births is 1.39. 12 Births. The statistics supplied by the Registrar General show that during 1935 the total number of registered live births belonging to Surbiton amounted to 699 (374 males, 325 females). Birth Rate 17.46. There were 17 illegitimate births (9 male, 8 female), this number representing 2.43% of the total births. In addition there were 20 still births representing 2.78% of the total births (live and still). Out of the total 699 live births there was only one death of a mother, thus giving a very low rate, which is a great improvement on the figure for last year. Year. No. of Births. No. of Maternal Deaths. 1931 481 l 1932 535 3 1933 502 2 1934 612 4 1935 699 1 13 TABLE SHOWING BIRTH RATE, DEATH RATE AND ANALYSIS OF MORTALITY FOR THE YEAR 1935. (PROVISIONAL FIGURES). Kate per 1,000 total population Annual death rate per 1,000 population Rate per 1,000 Live Births Live Births Still Births All causes Enteric Fever Smallpox Measles Searlet Fever Whooping Cough Diphtheria Influenza Violence Diarrhoea Enteritis under 2 years Total deaths under 1 year England & Wales 14.7 0.62 11.7 0.00 — 0.03 0.01 0.04 0.08 0.18 0.52 5.7 57.00 121 County Boroughs A Great Towns including London 14.8 0.68 11.8 0.00 0.04 0.01 0.04 0.09 0.16 0.45 7.9 62.00 140 Smaller Towns— resident populations 25,000 to 50,000 at 1931 census 14.8 0.64 11.2 0.00 0.03 0.01 0.03 0.07 0.17 0.41 3.8 55.00 London Administrative County 13.3 0.52 11.4 0.00 0.00 0.01 0.04 0.06 0.11 0.51 11.2 58.00 Surbiton— estimated population 40,020 17.46 0.49 9.49 0.04 — 0.02 — 0.04 0.22 0.69 7.13 37.19 14 CAUSES OF DEATH DURING 1935. (Civilians only). Male. Female. All causes 178 210 1. Typhoid and Paratyphoid Fevers 1 1 2. Measles — — 3. Scarlet Fever — 1 4. Whooping Cough — — 5. Diphtheria 1 1 6. Influenza 4 5 7. Encephalitis Lethargica — — 8. Cerebro-spinal Fever — — 9. Tuberculosis of Respiratory System 10 7 10. Other Tuberculous Diseases 2 1 11. Syphilis 1 1 12. General paralysis of the insane, tabes dorsalis 2 13. Cancer, malignant disease 24 39 14. Diabetes 1 5 15. Cerebal Hemorrhage, etc. 7 12 16. Heart Disease 38 52 17. Aneurysm 1 1 18. Other Circulatory Diseases 8 14 19. Bronchitis 3 4 20. Pneumonia (all forms) 7 10 21. Other Respiratory Diseases 3 — 22. Peptic Ulcer 1 3 23. Diarrhoea, etc. (under 2 years) 3 2 24. Appendicitis 2 1 25. Cirrhosis of Liver 1 — 26. Other Diseases of Liver, etc. — 1 27. Other Digestive Diseases 1 5 28. Acute and Chronic Nephritis 4 3 29. Puerperal Sepsis — 1 30. Other Puerperal causes — — 31. Congenital Debility, Premature Birth, Malformations, etc 10 7 32. Senility 6 8 15 33. Suicide 4 2 34. Other violence 14 8 35. Other defined diseases 19 15 36. Causes ill-defined or unknown — — During the year 388 deaths were registered, being an increase of 33 on the previous year. 245 deaths occurred in the district, 132 deaths in Public Institutions outside the district, and 11 deaths in other premises outside the district. The crude death rate of 9.69 for this District is strictly speaking not comparable with the figure for England and Wales. In order to provide for this the Registrar General introduced a comparability factor which for Surbiton is 0.98, giving an adjusted death rate of 9.49. From the foregoing table it will be seen that the principal causes of death, apart from zymotic diseases, are as follows:— Cancer 63 Heart Disease 90 133 Cerebral Haemorrhage 19 Aneurysm 2 Other Circulatory Diseases 22 Pneumonia 17 27 Bronchitis 7 Other Respiratory Diseases 3 Influenza 9 Tuberculosis (Respiratory) 17 Cancer. Cancer (Malignant Disease) was responsible for 63 deaths or 16.2% of the total number recorded. The following table gives the percentage figure since 1925:— 16 DEATHS FROM CANCER. Year. Total Deaths. Cancer Deaths. Percentage of Total Deaths. 1925. 214 37 17.2 1926. 234 25 10.6 1927. 264 32 12.1 1928. 261 46 17.6 1929. 319 51 15.9 1930. 288 43 14.9 1931. 341 50 14.6 1932. 324 40 12.3 1933. 358 46 12.8 1934. 355 33 9.2 1935. 388 63 16.2 Diseases of the Heart and Circulation. Ninety deaths were due to heart disease. In addition there were 19 deaths from cerebral haemorrhage, 2 from aneurysm and 22 from other circulatory diseases. These 133 deaths occurring from diseases of the heart and circulation represent 34.2% of the total recorded deaths. Year. Total Deaths. Deaths from diseases of heart and Circulation. Percentage of Total Deaths. 1925. 214 60 28 1926. 234 76 32.4 1927. 264 80 30.3 1928. 261 78 29.8 1929. 319 94 29.4 1930. 288 91 31.5 1931. 341 102 29.9 1932. 324 103 31.7 1933. 358 113 31.5 1934. 355 118 33.2 1935. 388 133 34.2 17 Bronchitis, Pneumonia and Other Respiratory Diseases. There were 27 deaths under this group representing 6.9% of the total recorded deaths. Year. Total Deaths. Deaths from Pneumonia, Bronchitis or other Respiratory diseases. Percentage of Total Deaths. 1925. 214 32 14.9 1926. 234 33 14.1 1927. 264 29 10.9 1928. 261 33 12.6 1929. 319 39 12.2 1930. 288 34 11.8 1931. 341 41 12.0 1932. 324 36 11.1 1933. 358 41 11.4 1934. 355 41 11.5 1935. 388 27 6.9 INFANT MORTALITY. The causes and ages at death of the children who died under the age of 1 year were as follows:— Tubercular Meningitis — Broncho Pneumonia 11 months. Acute Enteritis 10 months. Streptococcal Meningitis and Cerebral Hemorrhage 1 month. Prematurity 18 hours. Congenital Hypertrophic Pyloric Stenosis 1 month. Prematurity (Twin) 1 week. Prematurity (Twin) 3 days. Broncho Pneumonia—Congenital Pyloric Stenosis—Operation 2 months. Cerebral Hemorrhage—Childbirth 4 days. Broncho Pneumonia 2 weeks. Defective Vitality — Premature Twin Birth 2 days. 18 Prematurity 18 hours. Enteritis 3 months. Cardiac Failure — Enteritis — Diarrhoea (Summer Infantile) 2 months. Heart Failure — Imperfect Development 7 hours. Cerebral Haemorrhage—Prematurity 5 days. Heart Failure — Asthma — Premature Birth 1 week. Asphyxia due to inattention at birth Newly born. Congenital Heart Disease 3 days. Marasmus—Congenital amentia 1 month. Pulmonary Atelectasis 1 day. Malnutrition—Prematurity 1 month. Syncope from Cholaemia due to Congenital Atresia of the common bile duct 1 week. Convulsions due to Enteritis aggravated by markedly enlarged Thymus Gland 3 months. Broncho Pneumonia—Spina Bifida 1 week. Prematurity 15 hours. There were 26 deaths of children under 1 year of age which is an increase of 9 compared with the number for the previous year. Of the infant deaths, 12 occurred in Hospitals or Public Institutions outside the district of Surbiton. One of these deaths occurred at 15 hours, two at 18 hours, one at 3 days, two at 1 week, three at 1 month, one at 2 months, one at 3 months, and one at 10 months. The Infantile Mortality Rate is 37.19 and the Infantile Mortality Rate for England & Wales (Smaller Towns) is 55.0. 19 INFANT MORTALITY IN WARDS. Ward. No of deaths. No. of Births. Infantile Rate. Berrylands 2 52 38.4 Chessington 2 46 43.4 Hook & Southborough 3 45 66.6 Seething Wells 2 23 86.9 St. Mark's 1 90 11.1 Surbiton Hill 1 35 28.5 Tolworth East 2 114 17.5 Tolworth West 5 63 79.3 Tolworth South 8 66 121.2 The above table does not take account of transferable births occurring outside district. INFANT MORTALITY RATE. SURBITON ENGLAND & WALES (Smaller Towns) 19:29 49.3 69.0 1930 56.3 55.0 1931 45.78 62.0 1982 50.46 58.0 1933 41.88 56.0 1934 27.78 53.0 1935 37.19 55.0 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) 14.8 11.2 8.8 55.0 Surbiton 17.46 9.49 7.15 87.19 20 21 22 PREVALENCE OF AND CONTROL OVER INFECTIOUS DISEASE. No one part of Surbiton was subject to any severe epidemic. It is to be expected that the more populous parts of Tolworth with the greater number of children would show more cases of infectious disease. However, on the whole, the number of infectious disease cases in the district is considerably reduced, as can be seen from the table on page '24. Case rate of attack per 1,000 of the population of certain infectious diseases in this district and in England and Wales (Smaller Towns). Disease. Case rate per 1,000 living:. Surbiton. England and Wales. (Smaller Towns). Small-pox — — Scarlet Fever 1.94 2.75 Diphtheria 0.54 1.34 Enteric Fever 0.02 0.06 Erysipelas 0.29 0.37 Disease. Case rate per 1.000 total births. Surbiton. England and Wales. (Smaller Towns). Puerperal Fever 4.17 2.76 Puerperal Pyrexia 4.17 8.25 23 NOTIFIABLE DISEASES DURING THE YEAR. Disease. Total Cases Notified. Cases admitted to Hospital. Total Deaths. • Diphtheria 22 21 2 Scarlet Fever 78 74 1 Enteric Fever 1 1 2 Pneumonia 30 9 17 Erysipelas 12 1 — Encephalitis Lethargica — — — Ophthalmia Neonatorum 1 1 — Puerperal Fever 8 2 1 Cerebro-Spinal Meningitis — — — Puerperal Pyrexia 8 1 — Smallpox — — — Malaria 1 1 — Dysentery 4 — — *Including in-ward transferable deaths occurring outside the district which are not included in total cases notified. 24 NOTIFICATION OF INFECTIOUS DISEASES DURING THE YEARS 1925 to 1935. 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 Diphtheria 11 27 29 28 31 40 14 12 7 49 22 Scarlet Fever 34 38 35 82 82 89 43 40 85 87 78 Enteric Fever 1 1 — 3 2 — 2 — 1 2 1 Puerperal Fever — 1 — 1 1 1 — 1 2 3 3 Puerperal Pyrexia — — 2 6 4 5 2 7 2 10 3 Pneumonia 46 50 67 25 46 64 64 68 54 40 30 Erysipelas 8 8 5 5 3 9 2 6 12 7 12 Encephalitis Lethargica 4 1 3 1 — — — — Cerebro-spinal Meningitis 1 — 1 2 — — Ophthalmia Neonatorum 1 4 1 1 1 1 3 2 2 5 1 Acute Poliomyelitis — — — — — — — — — — — Dysentery — — — — — — — — — — 4 Malaria — — — — — — — — 1 1 1 Total 101 129 141 154 173 209 130 136 166 204 155 25 TOTAL CASES NOTIFIED TOTAL DEATHS AT AGES AT AGE8 | Under 1 I Year | 1-2 2—3 j 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 2b 1 3a 9 4a — — 1 — — — — - — 1 1 — — — — — Scarlet Fever — — 3 4 3a 40b 6 4b 11a 2 1 — — — — — — — — — — — — — Enteric Fever — — — — — — — — — 1 — — — — — — — — — — 1 — 1 — Pneumonia — 4 — — 1 1 — — 9 4 7 4 1 — — 1 — 1 — — — 1 7 6 Erysipelas — — — — — — — 1 1 1 6 3 — — — — — — — — — — — — Encephalitis Lethargica — — — — — — — — — — — — — — — — — — — — — — — — Ophthalmia Neonatorum 1 — — — — — — — — — — — — — — — — — — — — — — — Puerperal Fever — — — — — — — — — — — — — — — — — — — — — — — — Other Puerperal Causes — — — — — — — — — — — — — — — — — — — — — — — — Polyomyelitis — — — — — — — — — — — — — — — — — — — — — — — — Puerperal Pyrexia -— — — — — — — — 3 — — — — — — — — — — — — — — — Measles — — — — — — — — — — — — — — — — — — — — — — — — Malaria — — — — — — — — — — 1 — — — — — — — — — — — — — Dysentery — — 1 — — 2 — — 1 — — — — — — — — — — — — — — — a—Diagnosis not confirmed in one case b— ,, ,, ,, ,, two cases NOTE:—Total deaths include transferable deaths occurring outside the district which are not included in the total cases notified 26 Scarlet Fever. The total number of cases of Scarlet Fever was 78, of which 74 were admitted to Hospital and 4 were nursed at home. These cases were visited by the Medical Officer and in each case all necessary isolation and other precautions were taken. There was one death which occurred in the Tolworth Isolation Hospital. Ward. No. of Cases. Treated in Hospital. Treated at Home. Deaths. Berrylands 7 7 — — Chessington 5 5 — — Hook & Southborough 5 5 — — Seething Wells — — — — St. Mark's 5 3 2 — Surbiton Hill 5 4 1 — Tolworth East 12 12 — — Tolworth West 18 18 — — Tolworth South 21 20 1 1 It will be noticed that Tolworth has the greatest number of cases which is accounted for by its being the more populous area with the largest number of children Two cases which were already in the Isolation Hospital suffering from Scarlet Fever contracted Diphtheria. In each case the probable source of infection was a nurse who was herself suffering from Diphtheria. Diphtheria. The incidence of Diphtheria in the district showed a remarkable drop, there being only 22 cases aeainst 49 for the previous year, with only 2 deaths. It will be seen from the table below that Tolworth West Ward had the greatest number. 27 Ward. No. of Cases. Treated in Hospital. Treated at Home. Deaths Berrylands 3 3 — — Chessington 2 2 — — Hook & Southborough — — — — Seething Wells — — — — St. Mark's — — — — Surbiton Hill 3 3 — — Tolworth East 2 2 — — Tolworth West 9 8 1 2 Tolworth South 3 3 — — Pneumonia. As with the other notifiable infectious diseases, Pneumonia showed a decline from 40 to 30 cases for the year. Pneumonia is now being regarded as a disease which requires institutional treatment. Nine cases were sent to Hospital during the year. The number of deaths from Pneumonia is still high and here again the Tolworth district presents most cases. Ward. No. of Cases. Treated in Hospital. Treated at Home. Berrylands 1 — 1 Chessington 3 — 3 Hook & Southborough 4 l 3 Seething Wells — — — St. Mark's 3 — 3 Surbiton Hill 5 2 3 Tolworth East 2 1 1 Tolworth West 8 5 3 Tolworth South 4 — 4 Enteric Fever. There was 1 case of Enteric Fever, the cause of which could not be ascertained. 28 Two Surbiton residents contracted Enteric Fever whilst outside the District. Both died in Hospital, one in London and the other at Wallasey. Ward. No. of Cases. Treated in Hospital. Treated at Home. Berrylands — — — Chessington — — — Hook & Southborough 1* 1 — Seething Wells — — — St. Mark's — — — Surbiton Hill — — — Tolworth East — — — Tolworth West — — — Tolworth South — — — * Typhoid. Encephalitis Lethargica. No cases were notified. Tuberculosis. Under the Public Health Tuberculosis Regulations a register of all notifications is kept and 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 48 23 Females 48 13 Total 96 36 29 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. TUBERCULOSIS Ape-Periods. NEW CASES. DEATHS. Pulmonary NonPulmonary Pulmonary NonPulmonary M. F. M. F. M. F. M. F. Under 1 year — — — 1 — — — 1 1—5 — — 3 — — — l — 6—10 1 — 2 — — — I — 10—15 — — 1 — — — — — 15—20 8 4 — 1 1 — — — 20—25 2 1 2 — — — I — 25—35 10 7 1 1 2 4 — — 36—45 4 3 — 1 2 2 I 1 45—55 2 — — — 1 — — — 55—65 3 — — — 2 — — — 65 and upwards — — 1 — — — — — Totals 25 15 10 4 8 6 4 2 Of the fifty-four cases tabulated above fourteen are cases transferred from other districts. 30 Of the total number of deaths from Tuberculosis there were two of patients who had not been notified. There was a decrease compared with last year of eight new Pulmonary cases of Tuberculosis, while new Non-Pulmonary cases show an increase of two over last year. The deaths from Tuberculosis all forms show an increase of nine. Of the total new cases 29 are resident in new houses and 25 in old. At the commencement of the year there were 123 cases of Tuberculosis on the register and at the close of the year the figure was 132. During the year 45 cases were removed from the register owing to recovery, leaving the district or death, and 54 new cases were added to the register. Of the 54 new cases it is interesting to note that 40 of these were new cases first notified in this district and that 14 were cases of persons coming to reside in the area. 31 TUBERCULOSIS—NEW CASES. Year. Resident in New .Houses. Resident in Old Houses. 1933. 17 33 1934. 25 35 1935. 29 25 There was a tendency for a definite increase in the number of tuberculosis cases which can be traced from 1933. The precise cause for the rise is not definite. There is a close co-operation between the Surbiton Public Health Department and the Health Department of the Surrey County Council. 32 An inspection of the home conditions of persons suffering from Tuberculosis is carried out either by the Public Health Department or the Tuberculosis Department of the Surrey County Council, with a view to improving the conditions and to mitigate the risk of infection to other members of the household concerned. The Surrey County Council makes all arrangements for the provision of sanatorium and hospital treatment. Measles. Measles is not a notifiable infectious disease in Surbiton and no accurate records of the number of cases are kept. The Head masters and mistresses notify the cases occurring in the Schools. The Tolwortli Isolation Hospital now, takes in complicated cases of measles. OPHTHALMIA NEONATORUM. Cases. Vision Unimpaired Vision Impaired Total Blindness. Deaths. Notified. Treated. At Home In .Hospital 1 – 1 1 — — — There was a drop from five cases in 1934 to one last year, and the vision of this one case was unimpaired. Ophthalmia Neonatorum is a purulent discharge from the eyes within twenty-one days of birth. 33 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. On the 27th July, 1935, the extensions to the Hospital were opened by Alderman J. Chuter Ede, D.L., J.P., the Chairman of the Surrey County Council. These extensions comprised 10 cubicle beds and 20 pavilion beds with the necessary additions to the administrative buildings and nurses' home. This cubicle block is claimed to be the most advanced cubicle block in England. Each cubicle is so designed that the maximum of light and air is obtained; there is perfect observation and yet a maximum of privacy. Attached to the new cubicle block is an operating theatre, completely equipped. The pavilion block too is light and airy, clean in design and easy to administer. Since the above extensions two further new pavilion blocks have been completed of 20 beds each, bringing the total accommodation of the Hospital to 110 beds. 2. Small-pox. 34 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 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. 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 Bletcliingley, and Hospitals at Netlierne and Brookwood. Ambulance Facilities. (a) For Infectious Cases.—A motor ambulance is provided by the Joint Hospital Board. 35 (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 sudden 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. 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 a superintendent nurse, three general nurses, one maternity and general nurse, and one maternity nurse available for attending cases 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. 36 (b) Infectious Disease. There are no arrangements for the home nursing cases of Measles and Whooping Cough. Provision is made in the Isolation Hospital for the admission of complicated 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 seven midwives practising in the District. LABORATORY WORK. Pathological and Bacteriological examinations are made for the Council by the Clinical Research Association. During the year the following examinations were carried out:— Disease Suspected. Nature of Specimen. Result. TOTAL Positive. Negative. Diphtheria Swabs 9 177 186 Tuberculosis Sputum 7 74 81 Tuberculosis Blood — — — Tuberculosis Swab — — — Typhoid Blood 1 6 6 B. Coli. Urine — — — Dysentery Faeces 1 — 1 Total 18 256 274 37 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. Every package of antitoxin bears the date of preparation and a date (2½ years later) until which time the contents will be of full unit value. Stocks are arranged to ensure that the antitoxin is distributed well within the time limit specified. Out of 186 diphtheria swabs sent by the general medical practitioners for examination, only 9 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, 1890 (By resolution of 26th January, 1891). 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). 38 Bye-Laws and Regulations. (1) Bye-Laws with respect to Nuisances (March 28th, 1935). (2) Bye-Laws with respect to Tents, Vans, Sheds and Similar Structures (November 8th, 1935). (3) Bye-Laws as to Means of Escape in Case of Fire in certain Factories and Workshops (March 28th, 1935). (4) Regulations as to Underground Rooms habitually used as Sleeping Places (March 28th, 1935). (5) Bye-Laws for the Regulation of Offensive Trades (May 25th, 1925). (6) Bye-Laws as to Slaughter Houses (October 6th, 1925). (7) Bye-Laws as to New Streets and Buildings (July 26th, 1927 and October 15th, 1928). (8) Bye-Laws as to Emission of Smoke (May 7th, 1929). (9) Bye-Laws with respect to Houses let in Lodgings (March 30th, 1932). SANITARY CIRCUMSTANCES OF THE AREA. WATER SUPPLY. The water supply throughout the District is furnished by the Metropolitan Water Board and is a constant supply of excellent quality. No samples have been taken for analysis by the Surbiton Council during the year. DRAINAGE AND SEWERAGE. Further new sewers have been laid in the added district of Chessington and many houses have been drained and connected thereto. 89 There are only eight houses in the District which cannot be connected to the sewers but in each case adequate cesspool drainage exists. PUBLIC CLEANSING. Removal and Disposal of House Refuse. The collection of house refuse is carried out by a system of trailers and tractor- A completely new plant was purchased by the Council this year and commenced operations on the 12th August, 1935. There are six specially constructed two-wheeled pneumatically tyred trailers with detachable horse shafts. The horse shafts are fitted with small rubber tyred wheels so that the full weight of the trailer is borne on the wheels and no part bearing on the horse. These trailers are drawn by horses from house to house during the collection of house refuse and when full the shafts are removed and the trailers taken to the Destructor by a petrol-driven tractor. The system is so arranged that the tractor leaves an empty trailer behind for the dustmen to fill when taking away the full trailer. The whole of the refuse is taken to the Destructor and there burnt, the resultant clinker is used for road making and foundations to footpaths. The steam raised by burning the refuse is used for driving powerful pumping machinery and other apparatus at the Sewage Disposal Works. Street Cleansing. A completely new system of street cleansing was also put into operation on the 12th August, 1935. Each sweeper is allotted a beat and provided with a specially constructed hand truck supporting two bins into which he places the street sweepings. 40 A tractor and trailer identical with that used for the removal of house refuse, visits each sweeper in turn and collects the sweepings from his binsBeing of the same pattern as that used for the removal of house refuse, the plant is interchangeable. Street gullies are regularly emptied and flushed by means of a mechanical gully emptier. CLOSET ACCOMMODATION. The whole of the closets in the original Surbiton Urban District are on the water carriage system and most of the properties in the added parish of Chessington have now been put on the water carriage system. SANITARY INSPECTION OF AREA. This is fully dealt with in the report of the Sanitary Inspector, which is attached hereto. 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, who has kindly furnished the following particulars for 1935:— ARTICLES. ANALYSED. ADULTERATED OR DETERIORATED. SNOIi ¬noasoad 'SNOIX ¬OLVMOO Formal Informal Total Formal Informal Total Milk 36 4 40 1 — 1 — — Cream 2 — 2 — — — — — Meat 1 — 1 — — — — — Lard 1 — 1 — — — — — Whiskey 2 — 2 — — — — — Drugs — 2 2 — — — — — Total 42 6 48 1 — 1 — — 41 SWIMMING BATHS AND POOLS. Publicly owned Baths. Surbiton Lagoon, situated in Raeburn Avenue, Surbiton, is an open air pool 165 ft. long and 90 ft. wide with a depth of 3 to 9 ft. The accommodation consists of 125 changing cubicles, 696 lockers and communal changing rooms. The water is treated by continuous pressure sand filtration, sterilization by injection of chlorine and oxygenation over an ornamental cascade. Periodic samples of the water are taken and the plant adjusted accordingly. Privately owned Pools open to the Public. Ace of Spades Swimming Pool, Kingston ByPass Road is an open air pool 40 ft. by 20 ft. with a depth of 4 ft. to 7 ft. 6 ins. The accommodation comprises 96 cubicles with 288 lockers. The water is treated by means of a Candy chlorine filtration plant. 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 nine retailers all of whom hold licences. Eleven samples were taken, one of which did not conform to the standard for "Certified" milk as laid down by the Ministry of Health. 42 Copies of these reports are forwarded by the Laboratory direct to the Ministry of Health and any necessary action is taken by that department. There is one producer of Grade "A" (Tuberculin Tested) milk in the District and this grade is supplied to nine retailers under licence. No samples were taken. There are ten dealers in the District who hold licences for Pasteurised milk. No samples were taken. Six samples of Ordinary milk were taken during the year under review. The presence of Streptococci and Tuberculosis were not detected in any of the 17 samples. The following is a summary of the Bacteriologists's reports:— No. of Sample Temperature on arrival No. of Bacteria per 1 c.c. Presence of Bacillus Ooli in 48 hours and 3 days CERTIFIED MILK 1 13° C 3,800 Negative 2 13° C 2,700 Negative 3 13° C 2,500 Negative 4 19° C 820 Negative 5 20° C 2,500 Negative 6 20° C li020 Negative 7 18° C 77.500 Positive 8 18° C 7,800 Negative 9 21° C 1,750 Negative 10 15° C 2,560 Negative 11 15° C 2,500 Negative ORDINARY MILK 1 15° C 27,000 Negative 2 15° C 3,550 Negative 3 15° C 19,900 Negative 4 15° C 18,860 Negative 5 15° C 6,960 Negative 6 15° C 56,330 Negative BAG FLOCK ACT, 1911 and 1928. There are no premises in the District in which Rag Flock is manufactured or sold. 43 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 4 — Workshops (Including Workshop Laundries) 25 3 — Workplaces (Other than Outworkers' premises included in Part 3 of this Report) 1 — — Total 43 7 — 2.—DEFECTS FOUND. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. Nuisancex under the Public Health Acts:—* Want of Cleanliness 1 1 – – Want of Ventilation – – Overcrowding Want of drainage floors Other Nuisances 6 6 Sanitary accommodation Insufficient – – – – Unsuitable or defective 8 8 Not separate for sexes – Offences under the Factory and Workshop Acts:—Illegal occupation of underground bakehouse (S. 101) – – – – Other Offences: — Excluding offences under the sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order 1921 – – – – Total 15 15 — — * Including those specified in Sections 2, 3, 7 and 8, of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts. 44 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. Instances Notices served Prosecution 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. Contractus Workmen. Wearing Apparel— (1) Making, &c. 4 2 _ _ _ 4 _ 4 __ (2) Cleaning and washing _ _ _ _ _ _ _ _ _ _ _ _ _ Lampshade Painting _ _ _ _ _ _ _ _ _ _ _ _ _ Total 4 — 2 — _ _ 4 — — 4 — — — 45 4.—REGISTERED WORKSHOPS. Workshops on the Register tS. 131) at the end of the year. Number Bakehouses 16 Laundries 7 Tailors 10 Bootmakers 12 Dressmakers 1 Milliners 5 Sundry Other Trades 79 Total Number of Workshops on Register 141 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 46 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 1935. 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 (Outside London) Regulations, 1935. COMPLAINTS. During the year seven-hundred and forty-seven complaints were received with respect to the ing matters, viz.:— Defective condition of house drains 44 Insanitary or dilapidated condition of houses and premises 145 Verminous rooms 18 Nuisances from dampness in walls and floors 16 Defective water closets 58 Defective sink waste pipes, etc 11 Defective roofs 65 Defective eaves gutters and rainwater pipes 15 Defective stoves and ranges 78 Water supply to dwelling houses disconnected 9 Smoke nuisance 7 Caravans — Overcrowding 1 Underground rooms 4 47 Houses infested with rats 5 Houses not provided with sufficient receptacles for house refuse 86 Nuisances from animals improperly kept 7 Offensive accumulation of manure, etc. 12 Offensive smells from various causes 15 Flooding of premises 3 Defective water fittings 112 Miscellaneous 35 Cesspools 1 INSPECTION OF DISTRICT. Number of houses and premises inspected (ordinarily) 617 „ houses inspected and particulars recorded (Housing Act) 89 „ houses and premises re-inspected 976 „ miscellaneous visits 895 „ visits to works in progress 2532 „ visits to slaughterhouses 16 „ visits to dairies, cowsheds and milkshops 43 „ visits to bakehouses 23 „ visits to schools 7 „ visits to workshops 5 „ visits to workplaces 1 „ visits to factories 14 „ visits to homeworkers' premises 4 „ visits re cases of infectious disease 129 „ food inspections 402 „ visits to Council's Housing Estates 1368 „ visits to fried fish shops 2 „ visits under Shops Acts 15 „ visits under Petroleum Acts 8 TESTING OF DRAINS AND SANITARY FITTINGS. Drainage systems exposed for examination under Section 41 of the Public Health Act, 1875 12 Drains, soil pipes, etc., tested with smoke or air 33 Drains tested with water 80 Drains tested with chemical — 48 NOTICES SERVED. Informal notices 102 Statutory notices under Section 36 of the Public Health Act, 1875, to provide a sufficient dust receptacle 43 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 6 Statutory notices under Section 22, Public Health Acts Amendment Act, 1890, to provide sufficient and suitable accommodation in the way of sanitary conveniences for factories 6 Statutory notices under Section 94 of the Public Health Act, 1875, to abate nuisance 37 Statutory notices under Section 19 (Sub-Section 1) Housing Act, 1930, of Time and Place 28 Statutory notices under Section 127, Housing Act, 1925, to enter and survey premises 118 Statutory notices under Section 17, Housing Act, 1930, to make premises reasonably fit for human habitation 98 Statutory notices under Section 42, Housing Act, 1930, to require information re ownership of premises 119 Statutory notices under Section 19, Housing Act, 1930 —Demolition Orders 25 Statutory notices under Byelaws (Houses let in Lodgings) 2 Statutory notices. Notices to quit building after Clearance Order has become operative 34 Statutory notices. Notices to occupier of Demolition Order which has become operative 11 Statutory notices under section 18 of the Housing Act, 1925—basements 15 49 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, 18(75, to obtain a supply of water 2 Statutory notices under Section 20 of the Public Health Act, 1925, to pave common yard 6 Statutory notices under Bye-Laws (Stables) 2 Total 688 DETAILS OF SANITARY IMPROVEMENTS EFFECTED DURING THE YEAR. Drainage. Defective drains repaired, cleansed, etc. 106 Drainage systems re-constructed 21 Drainage systems partly re-constructed 18 Additional drains provided 4 Water Closets. Additional provided 6 W.C.'s cleansed or repaired 51 New pans fixed 97 Flushing cisterns repaired or renewed 71 Lighted or ventilated 17 Sinks, Baths, Etc. New fixed 236 Waste Pipes, Etc. Repaired 22 New provided 144 Disconnected or trapped 74 50 Water Supply. Draw off taps disconnected 7 Water re-instated or laid on 2 Service pipes and cisterns repaired, etc. 142 Paving. Yards paved 54 Yard paving repaired 18 Dust Receptacles. Provided 80 Dampness. Roofs repaired 135 Eaves gutters or rain water pipes repaired and renewed 40 Damp courses fixed 31 Site of house concreted 20 Ventilation under floors provided 22 External walls pointed and rendered 93 House walls treated with solution 37 General Repairs. Windows made to open 46 Windows provided, repaired or renewed 296 House floors repaired or renewed 92 Doors repaired or renewed 191 Ranges and coppers repaired or renewed 242 Food stores provided or ventilated 16 Rooms ventilated 21 Internal Walls and Ceilings repaired 62 Rooms cleansed 1099 External and internal painting 7 Handrails provided 25 Overcrowding abated 2 Animals removed 5 Accumulations removed 18 Miscellaneous 103 Cesspools abolished 1 51 Pail closets abolished 1 Earth closets abolished 1 Urinals abolished 1 Urinals provided 1 HOUSING. Number of new houses erected during the year:— (a) Total (including numbers given separately under (b)) 939 (i) By the Local Authority 56 (ii) By other Local Authorities Nil (iii) By other bodies or persons 883 (b) With state assistance under the Housing Acts:— (i) By the Local Authority— (a) For the purpose of Part II of the Act of 1925 Nil (b) For the purpose of Part III of the Act of 1925 Nil (c) For the purpose of Part I of the Act of 1930 56 (d) For other purposes Nil (ii) By other bodies or persons Nil 1. Inspection of Dwelling Houses during the year:— (1) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 745 Number of inspections made for the purpose 745 (2) Number of dwelling houses (included under subheading (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 89 Number of inspections made for the purpose 89 52 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 16 (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 518 2. Remedy of defects during the year without service of Formal Notices:— Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their officers 365 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 48 (2) Number of dwelling houses which were rendered fit after service of formal notices:— (a.) by owners 55 (6) by Local Authority in default of owners — B.—Proceedings under Public Health Acts:— (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 47 (2) Number of dwelling houses in which defects were remedied after service of formal notices:— (a) by owners 32 (b) by Local Authority in default of owners 2 53 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 9 (2) Number of dwelling houses demolished in pursuance of Demolition Orders 12 (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) 17 (4) Number of undertakings to carry out works accepted 4 (5) Number of houses rendered fit 4 (6) Undertakings cancelled—the works having been carried out 3 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, official representation was made 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 Confirmation Order Persons re-housed Result 1 11 15/35, Maple Road (odd Nos.) 29th January, 1935 17 Demolished 2 12 1 /12, Ivy Place Undertaking accepted — Work carried out in accordance with Undertaking 3 3 78, 79 and 80, Portsmouth Road 4th Februarv. 1935 9 Demolished 4 5 5 4 4/8, Grave Footpath 1/4, Jennetts Cottages, Surbiton Hill Road 29th Januarv, 1935 29th January, 1935 14 8 Demolished Demolished 0 3 1/3. Stone Cottages, Leatherhead Road 4th February, 1935 7 7 5 23/31, Gladstone Road (odd Nos.) 29th January, 1935 18 Demolished 8 24 1/12, Spring Cottages, St. Leonards Road, and 1/12, St. Leonards Square, St. Leonards Road 9 2 291 and 293, Ewell Road 29th January, 1935 3 Demolished 10 5 2/6, Hobill Place 29th Januarv, 1935 11 Or 55 HOUSING—SUMMARY OF POSITION AT 31st DECEMBER, 1935. Houses in Clearance Areas in respect of which action was not completed by 31st December, 1934 75 Houses (excluding Clearance Areas) in respect of which action was not completed by 31st December, 1934 63 Houses found during- the year not to be in all respects reasonably fit 518 Houses found during the year to be unfit 16 Total 672 Houses rendered fit informally 365 Houses rendered fit after procedure under section 17 of the Housing Act, 1930 55 Houses rendered fit after procedure under Public Health Acts 34 Houses rendered fit after undertaking to carry out works (sec. 19 Housing Act, 1930) 4 Houses demolished (sec. 19 •Housing Act, 1930) 12 Houses dealt with in Clearance Areas:— Excluded from area by Ministry 1 Not confirmed — subsequently rendered fit 24 Demolished 12 — 37 Houses in Clearance Areas in respect of which action was not completed by 31st December, 1935 38 Houses (excluding Clearance Areas) in respect of which action was not completed by 31st December, 1935 127 Total 672 56 HOUSING—POSITION AT DECEMBER 31st, 1935, ON LINES OF FORM 256A. Houses dealt with in :— CLEARANCE AREAS. Demolished :— Per September, 1935 Return 12 No addition. — 12 12 Made fit :— Per September, 1935 Return 24 No addition. — 24 Closed, etc 0 Excluded from Order and no action necessary :— Per September, 1935 Return 1 No addition. — 1 37 T otals. UNDER PART II. Demolished :— Per September, 1935 Return 7 Hill Rest, Chessington Road 1 1, 2, 3, Fair Oak Cottages ... 3 5, 6, The Retreat 2 Fox & Hounds Cottage, near Fox & Hounds P.H. 1 The Cottage, Leatherhead Road 1 Ivy Cottage, Leatherhead Road 1 16 28 Made fit :— Per September Return 13 White Cottage 1 14 38 30 67 Action not completed by 31st December, 1925 :— 36, St. Mark's Hill 1 1/6, Lambs Cottages, Alpha Road 6 1/2, Phipps Cottages, Clayton Road 2 " Anderson's Cottage," Chalky Lane 1 3, Grove Footpath 1 Rushet Cottage, Leatherhead Road 1 13, South Place 1 46a, Claremont Road1 24, Grove Road 1 26, Cadogan Road 1 5a, Berrylands 1 1, 2, 3, Berry Lodge, Manor Drive 3 — 20 In Clearance Areas as per September Return 38 — 58 Total 125 57 FACTORY A2TC) WORKSHOP ACT, 1901. The total number of workshops now on the Register, including bakehouses, is 141. 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 :— WATER CLOSETS. W.C. cleansed or repaired 5 New pans fixed 1 Lighted or ventilated 2 WASTE PIPES. New provided 1 GENERAL REPAIRS. Floors repaired or renewed 2 Rooms cleansed 1 Accumulations removed 2 Smoke nuisances abated 1 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 18 Bakehouses in use in the District, one of which is underground. They have been visited regularly during the year, and found to be kept in a satisfactory condition. 58 DAIRIES, COWSHEDS AND MILKSHOPS. During the year six persons have discontinued carrying on the trade of Retail Purveyors of Milk, and one has discontinued carrying on the trade of wholesale producer and they have been struck off the register. Two applications were received from persons residing in the District to be registered as Retail Purveyors of Milk. There are now fifty persons registered in accordance with the Milk and Dairies (Amendment) Act, 1922, as follows :— Wholesale Traders or Producers of Milk ... ... 13 Retail Purveyors of Milk residing in the District 30 Retail Purveyors of Milk who reside outside the District but retail in the District ... ... 7 Total 50 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 iu accordance with the Milk and Dairies Order, 1926. Nine Dealers' Licences to sell Certified Milk, ten to sell Pasteurised Milk, nine to sell Grade A (Tuberculin Tested) Milk, one to sell Grade A Milk, three 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, eleven samples of Certified Milk were taken from the local Dairymen and sent to the Clinical Research Association for Bacteriological Examination. 59 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. 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. 233 beasts were inspected, 889 pigs, 715 sheep, and 179 lambs, giving a total of 2,016 animals. Of this total 119 animals were affected with disease in some part, representing 5-9%. Visits have also been made to the shops, restaurants, &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. Carcase and offal of beast (1) 612 0 Generalised Tuberculosis. Liver of beast (1) 1 8, Multiple Abscesses. Lungs of beasts (2) 16 0 Tuberculosis. Head and tongue of beast (1) 25 0 Tuberculosis. Head, tongue and offal of beast (1) 84 0 Tuberculosis. Head, tongue, mesentery, lungs and one forequarter of beef 163 0 Tuberculosis. 60 lbs. OZS Liver of ealf (1) 4 0 Abscess. Lungs of calf (1) 12 Congestion. Pluck of calf (1) 7 0 Tuberculosis. Carcases and offal of pigs (4) 535 0 Generalised Tuberculosis. Portion of carcase and pluck of pig (1) 110 0 Tubercidous Pleurisy. Short forequarters and offal of pig (1) 48 0 Tuberculosis. Heads of pigs (20) 222 0 Tuberculosis. Head and lungs of pig (1) 16 0 Tuberculosis. Head, tongue and mesentery of pig 10 0 Tuberculosis. Head, tongue and offal of pigs (2) 27 0 Tuberculosis. Head and offal of pigs (3) 66 0 Tuberculosis. Head and pluck of pig (1) 19 0 Tuberculosis. Heart of pig (1) 6 Pericarditis. Kidneys of pigs (2) 2 8 Cysts. Livers of pigs (3) 11 0 Cirrhosis. Livers of pigs (2) 7 8 Milk Spot. Lungs of pigs (46) 63 12 Congestion. Lungs of pig (1) 1 8 Tuberculosis. Mesenteries of pigs (7) 8 8 Tuberculosis. Offal of pig (1) 10 0 Tuberculosis. Plucks of pigs (7) 34 0 Tuberculosis. Plucks of pigs (2) 10 0 Necrosis. Liver of sheep (1) 3 0 Abscess. Liver of sheep (1) 4 0 Distomatosis. Lungs of sheep (1) 1 0 Strongylus Rufescens. Liver of lamb (1) 2 0 Abscess. Pieces of beef 63 0 Bone taint. Golden cutlets (Haddock) 8 0 Decomposition. TOTAL 2 196 6 SCHOOLS. The Church of England School at Chessington was completely re-drained during the year. The cesspool and trough closets were abolished and the new drainage connected to the public sewer. Modern washdown closets were installed. 61 SMOKE ABATEMENT. Informal action was taken during the year in respect of a nuisance from smoke at one premises in the area. No further action was necessary. 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 135 premises in which the following cases of infectious diseases have occurred:— Scarlet Fever 77 Diphtheria 22 Tuberculosis 11 Pneumonia 2 Puerperal Pyrexia 1 Puerperal Fever 1 Typhoid Fever 2 Erysipelas 1 Chicken Pox 1 Disinfection was also carried out at three premises where other diseases had occurred and at eleven premises after cases of non-notifiable diseases on the occupiers of the houses in which the cases occurred agreeing to pay the expense. Three premises were disinfected, and otherwise treated to abate infestation by vermin. 62 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 holidays. 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 1 Blankets 348 Bolsters 27 Carpets 7 Counterpanes 96 Curtains 1 Cushions 8 Mattresses 108 Mattress Covers 26 Pillows 154 Pillow Cases 103 Quilts 10 Rugs 21 Sheets 197 Toilet Covers 3 "Wearing Apparel 370 Miscellaneous 111 Towels 55 Eiderdowns 6 Palliasses 1 1,653 No. of rooms disinfected 170 LEGAL PROCEEDINGS. Legal proceedings were taken in an attempt to abate overcrowding in five caravans on wheels. Two of the cases were adjourned and three were dismissed as there was no legal standard applicable. 63 MORTUARY. The mortuary situate in Alpha Road is well equipped and maintained. During the year fortytwo bodies have been received, thirty-seven post mortems carried out, and forty inquests held. The use of the Mortuary has been more than double that in 1934- GENERAL. During the year 82 houses were completed in Addison Gardens and Lower Marsh Lane to re-house persons displaced from Clearance Areas and other unfit dwellings. Sixty have now been occupied and the tenants express great appreciation of the design and convenience of their new homes. A most successful Health Week and Exhibition was held in the Assembly Rooms in October and was opened by Sir Edward T. Campbell, M.P., J.P., Private Parliamentary Secretary to the Minister of Health. The lectures, dancing, cookery and other displays, talks, films, games, addresses and other demonstrations were well attended by the public, and daily parties of school children were conducted round the exhibition and given educational talks by the Sanitary Inspectors. An official Health Week Magazine was compiled giving details of the exhibition and containing articles by Councillors, Officials and well known experts. A copy was delivered to each house in the district and a few copies are still available at my office- 64 To my staff I extend thanks for tlieir loyal, cheerful, and capable assistance, and in conclusion may I recognise the support given me by your Medical Officer of Health. I am, Ladies and Gentlemen, Your obedient Servant, GEOFFREY McCLELLAND, Sanitary Inspector.