AC 441 3(1) Mr. MOUNTNEY, IIa SUR 8 BOROUGH OF SURBITON ANNUAL REPORTS OF THE medical officer of health chief sanitary inspector for the year 1937 Printed by J.R.B. Blackmore & Co. Ltd., 85, Merton High Street, S.W.19. BOROUGH OF SURBITON ANNUAL REPORTS of the MEDICAL OFFICER OF HEALTH AND CHIEF SANITARY INSPECTOR For the Year 19 3 7 Borough of Surbiton. PUBLIC HEALTH COMMITTEE. Alderman Mrs. A. Woodgate (Chairman). Councillor J. Penwill (Vice-Chairman). Alderman Durbin Councillor Leach ,, Reynolds ,, McDermott Councillor Ames ,, Reynolds ,, Mrs. Cudbird ,, Warwick ,, Heath With the Mayor (Alderman Rampton), the Deputy Mayor (Alderman Sanger) and Alderman Bridge, ex-officio. PUBLIC HEALTH DEPARTMENT PERSONNEL. Medical Officer of Health : *Neville H. Linzee, M.R.C.S., L.R.C.P., D.P.H. Chief Sanitary Inspector : (†*Geoffrey McClelland, M.S.I.A., M.R.San.I., C.A.G.S. Additional Sanitary Inspectors : †*Cyril Wilson, Cert.R.S.I., M.S.I.A. †*H. J. Eldridge, Cert.R.S.L, M.S.I.A. †*S. W. Simpson-Scott, Cert.S.I.B., M.S.I.A., A.R.San.I. (Resigned 29th August, 1937). †*N. F. Cripps, Cert.S.I.B., M.S.I.A., A.R.San.I. (Resigned 22nd August, 1937). Senior Clerk: E. D. Elms. Clerks: J. L. Willoughby, Cert.S.I.B., A.S.I.A. (resigned 19th September, 1937). R. W. Turner. W. F. Acres. P. E. Whittox (appointed 27th September, 1937). Disinfector: W. A. Hutchins (resigned 5th August, 1937). A. C. Ball (appointed 30th July, 1937). * Contributions to salary made from Exchequer, † Certificate of the Royal Sanitary Institute as Inspector of Meat and Other Foods. 5 Annual Report of The Medical Officer of Health for 1937. Public Health Department. 2, Shalston Villas, Surbiton. June, 1938. To the Mayor, Aldermen and Councillors of the Borough of Surbiton. Ladies and Gentlemen, I have pleasure in submitting my Sixteenth Annual Report dealing with all matters appertaining to the health of the people residing in the Borough of Surbiton. The reason for the delay in publishing the Report is that the official figures sent by the Registrar General did not reach me intil nearly the end of May, and, until these figures are received, accurate statistical details cannot be given. As in previous years, the increase in the population still continues, and many new houses are being erected within the Borough. According to the Registrar General's returns, the population of Surbiton for mid-year 1937 is 44,830—an increase 6 of 2,220 on the previous mid-year figure; this is, however, a decrease on the figure for 1936. The increase in the number of inhabitated houses is 717, which also shows a small decrease when compared with the figure for 1936. During the year, 643 new houses were erected and 215 new flats. At the end of 1936, there were seventeen cases of overcrowding outstanding, and during 1937, seven new cases were reported. Of these, fifteen cases were relieved during the year. A Health Campaign was organised in the latter part of the year in conjunction with the Central Council for Health Education and the Surrey County Council. The programme arranged for a series of "Health Days" on which lectures, demonstrations and cinema displays were to be held. Apart from the first Day, the undertaking was not successful, and after the third Day, the remainder of the programme was cancelled owing to lack of public support. Two Acts of major importance came into force during the year. The Housing Act, 1936, came into operation on the 1st January, 1937, and whilst the Act does not include any new legislative requirements, it repeals and re-enacts in a consolidated form, the Housing Acts of 1925, 1930 and 1935. The Public Health Act, 1936, took effect as from the 1st October, 1937. The Act repeals the majority of the provisions of the Public Health Acts, 1875 to 1925, re-enacts them in a consolidated form and also makes additional provisions. 7 Since 1936, a very considerable amount of work has been thrust upon the Department due to the organisation of the Medical Services and the training of personnel of the Decontamination Section of the Surbiton Air Raid Precautions Scheme. There have been several changes in the personnel of the Department during the year under review. In August, two Sanitary Inspectors, Mr. SimpsonScott and Mr. Cripps resigned, and Mr. Willoughby, a clerk, resigned in September. In conclusion, I should like to thank Mr. McClelland the Chief Sanitary Inspector, the other Sanitary Inspectors, and the clerical staff, for their loyal and conscientious service throughout the year. I am, Ladies and Gentlemen, Your obedient Servant, NEVILLE H. LINZEE, Medical Officer of Health. 8 PHYSICAL FEATURES AND GENERAL CHARACTERISTICS OF THE DISTRICT. Area of District.— This is officially given as 4,709 acres, 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 Urban District of Esher, on the East by the Hogsmill River, otherwise locally known as the Maiden River, and by the Borough of Maiden and Coombe, and on the South-East by the Epsom Urban District, and on the South by the Leatherhead Urban District. Physical Features.—The Southern Railway runs in a deep cutting through the Northern portion of the district from North-East to South-West. 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, forms a ridge which extends from Minniedale and the parts known as Clay Hill (now rechristened Villiers 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. In the Southern portion of the district Winey Hill reaches a height of 241 feet and Telegraph Hill 300 feet. 9 Geology.— The greater part of the district is of the Tertiary period embracing the Eocene strata of London Clay. In the portion nearer the river there are post-tertiary deposits of gravel and sand, described in the geological survey as "Valley Brick Earth." This extends from the line of the river up to the railway and then stretches down the Claremont Road to the Kingston Boundary. Eossils 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. On the NorthWest it is bounded by the River Thames, but a considerable portion of it is on hill ground at a height of from 100 to 300 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 the L.P.T.B. 'bus services, are not surpassed when compared with any similar extra metropolitan district. The new line of the Southern Railway through Tolworth. Hook and Chessington has made good progress during the year under review, and when it is completed, the congestion on the trolley 'buses at Surbiton Station should be greatly alleviated. 10 The new Surbiton Station was completed during the year. The building is of modern design and constructed of reinforced concrete. There is also an efficient and adequate service of 'buses and trolley tramways connecting with most of the adjoining districts, except for the Berrylands Estate, which does not seem to be adequately serviced. 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. The amount of unemployment in the Borough is small and is for the most part seasonal. The added area of Chessington may still be said to be rural in character, but this is rapidly changing as building development progresses in this part of the Borough. STATISTICS. Area (in acres) 4,709 Resident Population (Census 1931) 29,396 Registrar General's estimate mid-year 1937 44,830 Estimated Population 31st December, 1937 47,000 Number of inhabited houses (end of 1937) according to the rate books 13,488 Number of families or separate occupiers (1931 census) 8,116 Rateable Value £512,154 Sum represented by a penny rate £1,930 11 EXTRACTS FROM VITAL STATISTICS OF THE YEAR. (Based on population of 44,830). Live Births:— Total. M. F. Legitimate 746 389 357 Illegitimate 39 19 20 Birth rate per 1,000 of the estimated resident population 17.51 Still Births:— Legitimate 31 19 12 Illegitimate 2 1 1 Rate per 1,000 total (live and still) births 40.34 Deaths 449 229 220 Crude death rate per 1,000 of the estimated resident population 10.01 Adjusted death rate (comparability factor 0.98) 9.81 Percentage of total deaths occurring in Public Institutions and Nursing Homes 66.81 Deaths from puerperal causes:— Deaths. Rate per 1,000 total Births (live & still). No. 29 Puerperal Sepsis – – No. 30 Other puerperal causes – – Total – – Death rate of infants under one year of age:— All infants per 1,000 live births 42.04 Legitimate infants per 1,000 legitimate live births 41.55 Illegitimate infants per 1.000 illegitimate live births 51.28 Deaths from Cancer (all ages) 79 Deaths from Measles (all ages) – Deaths from Whooping Cough (all ages) 1 Deaths from Diarrhoea (under 2 years of age) 3 The natural increment in the population for 1937 is 336 12 Still Births.— The rate per 1,000 population is 0.73. That for England and Wales (Smaller Towns), is 0.64. There were no maternal deaths. The total number of cases of Puerperal Pyrexia and Septicaemia was 5. No deaths occurred. Of' these, two cases were removed to hospital and three were nursed at home. Births.—The statistics supplied by the Registrar General show that during 1937 the total number of registered live births belonging to Surbiton amounted to 785 (408 male, 377 females). Birth Rate 17.51. There were 39 illegitimate births (19 male, 20 females), this number representing 4.97 per cent. of the total births. This shows an increase of 12 over last year. In addition there were 33 still births, representing 4.03 per cent,of the total births (live and still). Out of the total 785 live births there were no deaths of mothers. No. of Births. No. of Maternal Deaths. 1932 535 3 1933 502 2 1934 612 4 1935 699 1 1936 727 2 1937 785 – There were 785 births registered for Surbiton. 634 births occurred in the District, of which 105 were outward transfers. There were 245 inward transferable births which occurred outside the Borough. 13 TABLE SHOWING BIRTH RATE. DEATH RATE AND ANALYSIS OF MORTALITY FOR THE YEAR, 1937. (PROVISIONAL FIGURES). Rate per 1,000 total population Annual death rate per 1,000 population. Rate per 1,??? Live Births. Live Births Still Births All causes Enteric Fever Smallpox Measles Scarlet Fever Whooping Cough Diphtheria Influenza Violence Diarrhœa Enteritis under 2 years Total deaths under 1 year England & Wales 14.9 0.60 12.4 0.00 – 0.02 0.01 0.04 0.07 0.45 0.54 5.8 58.0 125 County Boroughs & Great Towns including London 14.9 0.67 12.5 0.01 – 0.03 0.01 0.04 0.08 0.39 0.45 7.9 62.0 148 Smaller Townsresident populations 25,000 to 50,000 at 1931 census 15.3 0.64 11.9 0.00 – 0.02 0.01 0.03 0.05 0.42 0.42 3.2 55.0 London Administrative County 13.3 0.54 12.3 0.00 – 0.01 0.01 0.06 0.05 0.38 0.51 12.0 60.0 Surbiton— estimated population 44,830 17.51 0.73 9.81 – – – – 0.02 0.02 0.40 0.49 3.82 42.04 14 From the foregoing tables the various statistical rates of Surbiton, when compared with those of similar towns, show a very gratifying result. With the exception of deaths due to (1) Influenza; (2) Violence; and (3) Diarrhœa and Enteritis under 2 years, the figures for Surbiton are well below those for England and Wales. CAUSES OF DEATH DURING 1937. (Civilians only). Male Female All causes 229 220 1 Typhoid and Paratyphoid Fevers – – 2 Measles – – 3 Scarlet Fever – – 4 Whooping Cough 1 – 5 Diphtheria 1 – 6 Influenza 10 8 7 Encephalitis Lethargica 1 1 8 Cerebro-Spinal Fever – 1 9 Tuberculosis of Inspiratory System 9 3 10 Other Tuberculosis Diseases 2 1 11 Syphilis – – 12 General paralysis of the insane, tabes dorsalis – – 13 Cancer, malignant disease 33 46 14 Diabetes 4 4 15 Cerebral Hæmorrhage, etc. 8 14 16 Heart Disease 57 56 17 Aneurysm – – 18 Other Circulatory Diseases 13 15 19 Bronchitis 7 4 20 Pneumonia (all forms) 16 11 21 Other Respiratory Diseases 1 1 22 Peptic Ulcer 3 2 23 Diarrhœa, etc. (under 2 years) 2 1 15 Male Female 24 Appendicitis 2 3 25 Cirrhosis of Liver 1 – 26 Other Diseases of Liver, etc. 2 2 27 Other Digestive Diseases 2 2 28 Acute and Chronic Nephritis 8 7 29 Puerperal Sepsis – – 30 Other Puerperal causes – – 31 Congenital Debility, Premature Birth, Malformations, etc. 7 10 32 Senility 2 5 33 Suicide 3 2 34 Other violence 15 7 35 Other defined diseases 19 14 36 Causes ill-defined or unknown – – The total number of deaths for 1937 was 449, sixty-two more than in 1936. Out of this number 290 occurred in the Borough, 134 in Public Institutions outside and 25 in other places outside the Borough. Total Deaths. Year. In Borough. In Public Inst, outside. other Places outside. 1936 216—56% 146—38% 25—6% 1937 290—65% 134—30% 25—5% The crude death rate of 10.01 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 9.81. 16 From the foregoing table it will be seen that the principal causes of death, apart from zymoticdiseases, are as follows:— Cancer 79 Heart Disease 113 163 Cerebral Hæmiorrhage 22 Aneurysm – Other Circulatory Diseases 28 Pneumonia 27 40 Bronchitis 11 Other Respiratory Diseases 2 Influenza 18 Tuberculosis (Respiratory) 12 Cancer. Cancer (Malignant Disease) was responsible for 79 deaths or 17.59 per cent. of the total number recorded. The following table gives the percentage figure since 1927:— Deaths from Cancer. Year. Total Deaths. Cancer Deaths Percentage of Total Deaths. 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 1936 387 56 14.4 1937 449 79 17.59 17 Diseases of the Heart and Circulation. One hundred and thirteen deaths were due to heart disease. In addition there were 22 deaths from cerebral haemorrhage, and 28 from other circulatory diseases. These 163 deaths occurring from diseases of the heart and circulation represent 36.3 per cent. of the total recorded deaths. Year. Total Deaths. Deaths from diseases of heart and Circulation. Percentage of Total Deaths. 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 1936 387 121 31.2 1937 449 163 36.3 Bronchitis, Pneumonia and Other Respiratory Diseases. There were 40 deaths under this group representing 8.9 the total recorded deaths. Total Deaths. Deaths from Pneumonia, Bronchitis or other Respiratory diseases. Percentage of Total Deaths. 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 1936 387 39 10.07 1937 449 40 8.9 18 On reviewing the causes of death from the above tables there have been great increases in the number of deaths due to Cancer and to the Circulatory Diseases. In the latter the increase is due to the number of deaths from Heart Disease. INFANT MORTALITY. The causes and ages at death of the children who died under the age of 1 year were as follows:— Intracranial Haemorrhage 6 days. Sudden Heart Failure—Congenital Heart Disease 1 day. Cardiac Failure—Acute Gastro-Enteritis— Acute Bronchitis 3 months. Prematurity 1 hour. Broncho Pneumonia 8 months. Gastro-Enteritis—Hypopyrexia 3 weeks. Respiratory Failure—Prematurity 5 minutes. Heart Failure—Prematurity (6 months) 2 hours. Acute Bronchitis 2 months. Cardiac Failure—Gastro-Enteritis— Diarrhoea 4 months. Septic Meningitis—Spina Bifida 1 week. Heart Failure—Broncho Pneumonia 8 months. Cardiac Failure—Immaturity of Development—Inanition due to Toxicity 1 hour. Intracranial Haemorrhage—Injury at Birth (non-instrumental) 30 minutes. Heart Failure—Congenital Heart Disease 2 days. Intracranial Haemorrhage—Rupture of Len- torium in the Course of Birth 19 hours. Patent Foramen Ovale—Prematurity 2 days. Cardiac Debility and Heart Failure—Acute Bronchitis 2 months. Cardiac Failure—Atelectasis 13 hours. Pneumonia—Influenza—Otitis Media 5 months. Broncho Pneumonia — Prematurity (7 months) 3 months. Meningitis—Spina Bifida 1 week. 19 Broncho Pneumonia 5 months. Tuberculous Meningitis 10 months. Broncho Pneumonia—Whooping Cough 1 month. Atelectasis—Prematurity 16 hours. Spina Bifida—Broncho Pneumonia 3 weeks. Meningo-coccal Meningitis 5 months. Ac. Supperative Sinusitis 3 weeks. Prematurity 1 hour. Erythroblastosis 1 week. Infantile Diarrhœa 7 months. Ac. Meningitis 1 month. There were 33 deaths of children under 1 year of age which is an increase of 5 compared with the number for the previous year. Of the infant deaths, 12 occurred in Hospital or Public Institutions outside the district of Surbiton. The ages at death were as follows:—1 hour, 16 hours, 1 week (2), 3 weeks (2), 1 month (2), 5 months (2), 7 months and 10 months. The Infantile Mortality Rate is 42.04, and the Infantile Mortality Rate for England and Wales (Smaller towns) is 55.0. Infant Mortality Rate. SURBITON England and Wales (Smaller Towns) 1930 56.3 55.0 1931 45.73 62.0 1932 50.46 58.0 1933 41.83 56.0 1934 27.78 53.0 1935 37.19 55.0 1936 38.51 55.0 1937 42.04 55.0 20 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. Diarrhœa under 2 years. Under 1 year. England and Wales (Smaller Towns) 15.3 11.9 3.2 55.0 Surbiton 17.51 9.81 3.82 42.04 PREVALENCE OF AND CONTROL OVER INFECTIOUS DISEASE. 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. England and Wales Surbiton (Smaller Towns) Small-pox — 0.00 Scarlet Fever 1.83 2.42 Diphtheria 0.60 1.38 Enteric Fever 0.02 0.04 Erysipelas 0.29 0.34 Disease. Case rate per 1,000 total births. England and Wales Surbiton (Smaller Towns) Puerperal Pyrexia 6.37 11.52 Puerperal Fever) In June and July of 1937, an outbreak of Diphtheria occurred in a Private School in Lower Surbiton. 21 There were fifteen cases notified, but no deaths occurred. All the cases were removed to the Isolation Hospital and the school premises disinfected on several occasions. On investigation, a carrier was found in one of the Teaching Staff who had recently been appointed as a mistress to the Junior Boys. Suitable isolations were made and the school was closed for the rest of the term. Notifiable Diseases during the Year. Disease. Total Cases Notified Cases admitted to Hospital. Total Deaths. Diphtheria 27 26 1 Scarlet Fever 82 74 — Enteric Fever 1 1 — Pneumonia 39 11 27 Erysipelas 13 8 — Encephalitis Lethargica 1 — 2 Ophthalmia Neonatorum 1 1 — Puerperal Fever — — — Cerebro-Spinal Fever 1 1 1 Puerperal Pyrexia 5 2 — Smallpox — — — Malaria — — — Dysentery — — — Acute Poliomyelitis 1 1 — * Including inward transferable deaths occurring outside the district which are not included in total cases notified. 22 Analysis of Patients Admitted to the Tolworth Isolation Hospital for the Year Ended 31st December, 1937. Population. Diphtheria. Scarlet Fever. Typhoid. Measles Other Diseases. Total. Surbiton 44,830 25 75 — 3 27 130 Maiden 37,270 29 31 1 2 21 84 Esher 41,450 26 75 1 13 18 133 Paying Patients (admitted from outside of the Constituent Districts) 37 76 — 7 29 149 117 257 2 25 95 496 23 Notification of Infectious Diseases during the Years 1927 to 1937. 1927 1928 1929 1980 1981 1982 1988 1984 1985 1936 1937 Diphtheria 29 28 31 40 14 12 7 49 22 10 27 Scarlet Fever 35 82 82 89 43 40 85 87 78 90 82 Enteric Fever — 3 2 — 2 — 1 2 1 2 1 Puerperal Fever — 1 1 1 — 1 2 3 3 2 — Puerperal Pyrexia 2 6 4 5 2 7 2 10 3 2 5 Pneumonia 67 25 46 64 64 68 54 40 30 51 39 Erysipelas 5 5 3 9 2 6 12 7 12 9 13 Encephalitis Lethargica 1 3 1 — — — — — — — 1 Cerebrospinal Fever 1 — 2 — — — — — — — 1 Ophthalmia Neonatorum 1 1 1 1 3 2 2 5 1 1 1 Acute Poliomyelitis — — — — — — — — — 1 1 Dysentery — — — — — — — — 4 1 — Malaria — — — — — — 1 1 1 — — Total 141 154 173 209 130 136 166 204 155 169 171 24 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 1 — 1 9 7 3 5 — — — — 1 — — — — — — — — — — Scarlet Fever — 2 3 6 7 35 5 9 12 2 1 — — — — — — — — — — — — — Enteric Fever — — — — — — — 1 — — — — — — — — — — — — — — — — Pneumonia 2 1 2 — 1 5 — 1 4 3 9 11 4 — 1 — — 1 — — — 1 8 12 Erysipelas — — — — — — — 1 — 2 7 3 — — — — — — — — — — — — Encephalitis Lethargica — — — — — — — — — — 1 — — — — — — — 1 — — — 1 — Cerebro-Spinal Fever 1 — — — — — — — — — — — 1 — — — — — — — — — — — Ophthalmia Neonatorum 1 — — — — — — — — — — — — — — — — — — — — — — — Puerperal Fever — — — — — — — — — — — — — — — — — — — — — — — — Other Puerperal Causes — — — — — — — — — — — — — — — — — — — — — — — — Polyomyelitia — — — — — — — — 1 — — — — — — — — — — — — — — — Puerperal Pyrexia — — — — — — — — 3 2 — — — — — — — — — — — — — — Measles — — — — — — — — — — — — — — — — — — — — — — — — Malaria — — — — — — — — — — — — — — — — — — — — — — — — Dysentery — — — — — — — — — — — — — — — — — — —— — — — * NOTE:—Total deaths include transferable deaths occurring outside the district which are not included in the total cases notified. 25 Scarlet Fever. Ward. No. of Cases. Treated in Hospital. Treated at Home. Deaths Berrylands 10 7 3 — Chessington 5 5 — — Hook and Sout 111 «jlough 9 9 — — Seething Wells 5 5 — — St. Mark's 7 6 1 — Surbiton Hill 8 7 1 — Tolworth East 7 7 — — Tolworth West 16 14 2 — Tolworth South 15 14 1 — Eiglity-two cases of Scarlet Fever were notified in the Borough of which 74 were sent to Isolation Hospital and 8 nursed at home. The eight nursed at home were properly isolated and all necessary precautions taken to the satisfaction of the Medical Officer of Health. No deaths from this disease occurred. Diphtheria. Ward. No. of Cases. Treated in Hospital. Treated at Home. Deaths. Berrylands 1 1 — — Chessington — — — — Hook and Southborough — — — — Seething Wells 14 13 1 1 St. Mark's 6 6 — — Surbiton Hill 3 3 — — Tolworth East — — — — Tolworth West 1 1 — — Tolworth South 2 2 — — The increase in the number of cases of Diphtheria is due to the fact that there was a small outbreak in a private school in the Seething Wells ward. Monthly Table of Diphtheria Incidence. Diphtheria antitoxin is supplied free of charge to medical practitioners requiring it for cases within the district. It is kept in stock at 2, Shalston Villas, and at the Council Offices, and is available at any time. 26 27 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 211 diphtheria swabs sent by the general medical practitioners for examination, only 15 proved to be positive. Schick Testing and Immunisation. Schick testing and the immunisation of positive reactors has been carried on throughout the year under review at sessions held twice a week. One session is held at the Surrey Comity Council Clinic, South Place, on Tuesday afternoons at 2.30 p.m. and one at a School on Friday mornings at 10.30. Immunisation consists of three 1 cc. doses at weekly intervals of T.A.M. Prophylactic; a final Schick test is carried out 3 to 6 months after the final immunising dose. There were 456 children treated during the year as indicated below:— Treatments. Completed. Incompleted. Children treated at Schools 186 57 Children treated at Clinic 121 92 307 149 28 in addition, there were 49 children whose treatment was not proceeded with or discontinued owing to parents' desire, illness or leaving the district. Where treatment is commenced in Surbiton and the child removes to another district, arrangements are made with the Medical Officer of Health of that district for the completion of the treatment. Of the total number treated, only one child showed any ill-effects—the arm became inflamed which caused a certain amount of pyrexia. I visited the child on one or two occasions but could not ascertain the reason, and no other children treated at that particular session showed any indisposition. The child showed no ill-effects after further injections. No cases of diphtheria were notified amongst children who had been immunised. Pneumonia. Ward. No. of Cases. Treated in Hospital. Treated at Home. Deaths Berrylands 9 4 5 3 Chessington 6 — 6 2 Hook and Southborougli 3 1 2 1 Seething Wells 3 1 2 — St. Mark's 5 — 5 3 Surbiton Hill 4 1 3 2 Tolworth East 2 1 1 1 Tolworth West 2 2 — 1 Tolworth South 5 1 4 1 29 Enteric Fever. One case of Paratyphoid B occurred in the Tolworth East ward and was removed to St. Thomas' Hospital. The patient recovered. Encephalitis Lethargica. One case of Encephalitis Lethargica was notified in the Berrylands ward; this patient subsequently died. There was also one death of a nonnotified case. A 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 70 28 Females 45 16 Total 115 44 30 Public Health (Prevention of Tuberculosis) Regulations, 1925. It was not necessary to take any action under these Regulations during the year. Public Health Act, 1936, Section 172. No action was taken under this section. TUBERCULOSIS. Age Periods. NEW CASES. DEATHS. Pulmonary. NonPulmonary. Pulmonary. NonPulmonary. M. F. M. F. M. F. M. F. Under 1 year — — — — — — — — 1— — — 1 — — — — — 5— — — 7 1 — — 1 — 15— 10 7 1 4 3 — — 25— 6 7 2 1 1 2 2 — 35— 4 8 1 — 1 3 — — 45— 4 — 1 — 3 1 — — 55— — — — 1 — — — — 65 and upwards 1 — — 1 — — — — Totals 25 17 13 8 8 6 3 — Of the sixty-three new cases tabulated above eighteen are cases transferred from other districts. Of the total number of deaths from Tuberculosis there were three of patients who had not been notified. There was a decrease compared with last year of four new Pulmonary cases of Tuberculosis, while new Non-Pulmonary cases show an increase of eleven over last year. 31 The deaths from Tuberculosis, all forms, show a decrease of one. Of I lie total new cases 29 are resident in new houses and 34 in old. At the commencement of the year there were 141 cases of Tuberculosis on the register and at the close of the year the figure was 159. During the year 8 cases were removed from the register owing to recovery, and 39 left the district or died. Sixtythree new cases were added to the register. Of the 63 new cases it is interesting to note that 41 of these were new eases first notified in this district. Graph showing number of cases of Tuberculosis on the Register, 1927-1937:— 32 Tuberculosis—/Vew Cases. Year. Resident in New Houses. Resident in Old Houses. 1933 17 33 1934 25 35 1935 29 25 1936 29 27 1937 29 34 There was a tendency for a definite increase in the number of tuberculosis cases which can be traced from 1933. The rise is undoubtedly due to the increase in population. There is a close co-operation between the Surbiton Public Health Department and the Health Department of the Surrey County Council, the County Coimcil making all arrangements for the provision of sanatorium and hospital treatment. The County Medical Officer of Health periodically sends Health Visitors' reports to this Department on the Home Conditions of Tuberculosis patients, and where necessary, visits are made to ascertain if overcrowding exists, and if patients could beneficially be removed to Council Houses. 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 Tolworth Isolation Hospital takes in complicated cases of measles. Three such cases were admitted from Surbiton during the year. 33 Ophthalmia Neonatorum. Notified. Cases. Vision Unimpaired Vision Impaired. Total Blindness. Deaths. Treated. At Home. In Hospital. 1 - 1 1 - - — Ophthalmia Neonatorum is a purulent discharge from the eyes within twenty-one days of birth. All notifications of Ophthalmia Neonatorum are now sent direct to the Surrey County Council by the local general practitioners, as the County Council are the authority for Maternity and Child Welfare in this district. Puerperal Pyrexia and Puerperal Fever. Five cases of Puerperal Pyrexia were notified during the year, two being removed to hospital and the others nursed at home. No deaths occurred. The Public Health Act, 1936, which came into force 011 the 1st October, 1937, incurred an alteration in the notification of Puerperal Fever. Puerperal Fever is now omitted from the definition of notifiable disease, and the obligation to notify cases of Puerperal Pyrexia now includes the obligation to notify conditions previously notifiable as Puerperal Fever as Puerperal Pyrexia. 34 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 Borough Councils of Surbiton and Maiden and the Urban District Council of Esher. The total accommodation of the Hospital is 110 beds. 2. Small-pox. The Small-pox Hospital, situated at Clandon, is controlled by the Surrey County Council, and is subsidised by the Borough Council. 3. Tuberculosis. Cases are admitted into sanatoria through the Surrey County Council. 4. Maternity. Provision is made for these cases at Surbiton Hospital, the Kingston and District Hospital and at homes controlled by the Surrey County Council. 5. Children. Provision is made for these cases at the Surbiton Hospital and the Kingston and District Hospital. 6. Other. The Surbiton Hospital which is supported by voluntary contributions. 35 Institutional provision for unmarried mothers, illegitimate children and homeless children—Nil, but provision is made for the admission of such cases into the Kingston and District Hospital. Institutional provision for the care of Mental Defectives.—Surrey County Council Homes at Ottershaw and Bletchingley, and Hospitals at Net heme 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 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. As I mentioned in my Report last year, I am of opinion that it would be advisable to consider the provision of a second ambulance. 36 Clinics and Treatment Centres. Combined Maternity and Child Welfare Centre and School Clinic (provided by Surrey County Council), Sontb 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 Borough 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. Provision is made in the Isolation Hospital for the admission of complicated cases of Measles and Whooping Cough. 37 Midwives. The Corporation does not employ or subsidise any midwives. The Surrey County Council is the supervising authority under the Midwives Act. There are ten midwives practising in the District, excluding those employed at Surbiton Hospital. Laboratory Facilities. Pathological and Bacteriological examinations are made for the Corporation by the Clinical Research Association. During the year the following examinations were carried out:— Disease Suspected. Nature of Specimen. Result. TOTAL. Positive. Negative. Diphtheria Swabbings 15 190 211 Tuberculosis Sputum 10 80 90 Tuberculosis Spinal Fluid — 1 1 Typhoid Fever Blood — 2 9 Typhoid Fever Fseces - 1 1 Total 25 289 314 38 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 (part of). (By resolutions of 26th January, 1891, and 13th June, 1910). Private Street Works Act, 1892. (13th March, 1893, and 13th June, 1910). Public Health Acts Amendment Act, 1907 (part of). (27th September, 1909). Surbiton Urban District Council Act, 1910. Public Health Act, 1925 (part of). (14th December, 1925). Bye-Laws and Regulations. (1) Bye-Laws with respect to Nuisances (28th March, 1935). (2) Bye-Laws with respect to Tents, Vans, Sheds and Similar Structures (8th November, 1935). (3) Bye-Laws as to means of Escape in Case of Fire in certain Factories and Workshops (28th March, 1935). (4) Regulations as to Underground Rooms habitually used as Sleeping Places (28th March, 1935). (5) Bye-Laws for the Regulation of Offensive Trades (25th May, 1925. (6) Bye-Laws as to Slaughter-houses (6th October, 1925). (7) Bye-Laws as to New Streets and Buildings (18th January, 1937). (8) Bye-Law as to Emission of Smoke (7th May. 1929). (9) Bye-Laws with respect to Houses let in Lodgings (30th March, 1932). 39 SANITARY CIRCUMSTANCES OF THE AREA. Water Supply. The water supply through 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 this Department during the year bnt the Metropolitan Water Board have supplied me with a report as follows:— During 1937, (the bacteriological standard of water going into supply did not fall below 100%, and every sample showed Bact. coli absent from 100 ml. with an average colony count of 2.2 per ml. The average chemical figures are as follows:— Parts per 100,000. Ammoniacal nitrogen .01,56 Albuminoid nitrogen .0071 Oxidised nitrogen .20 Chlorides expressed as Cl. 2.01 Oxygen abs. from permanganate .101 Turbidity .04 Colour 26 Total hardness 20.2 Permanent hardness 5.7 pH value 7.7 Phosphate as P.04 .015 Silica as Si.02 .64 Drainage and Sewerage. There have been no important extensions to sewerage during the year. With regard to sewage disposal, important extensions to the works at Surbiton and Ruxley are proposed and at the time of writing, applications for loan have been made to the Ministry of Health. The sewage works at Ruxley is situated in the Epsom Urban District; but it also serves the parish of Chessington. 40 Public Cleansing. The collection of house refuse is carried out on the tractor-trailer system and refuse disposal is by incineration. There have been no important alterations in this service during the year. 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 been put on the water carriage system. Sanitary Inspection of Area. This is fully dealt with in the report of the Chief 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 1937: Articles. Analysed. adulterated or deteriorated. PROSECUTIONS CONVICTIONS Forma Informal Total Formal Informal Total Milk 37 3 40 1 — 1 — Meat 3 — 3 – – – – – Jam 1 3 4 – – – – – Other articles — 2 2 – — — — — Total 41 8 49 1 — 1 — — 41 Swimming Baths and Pools. Publicly-owned Baths. Surbiton Lagoon, situated in Raeburn Avenue. Surbiton, is an open air pool 165ft long and 90ft. wide with a depth of 3 to 9ft. 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 by the Borough Engineer and Surveyor and the plant adjusted accordingly. Four samples were also taken by the Public Health Department at peak periods. One sample, taken in the month of July, was not quite up to the standard required for swimming bath purposes, but I understand, that at the time, the Baths Superintendent was trying out a new method of sterilization and chlorination. A further sample was taken one week later, which proved to be more satisfactory. Two other samples taken during the year were satisfactory. Privately-owned Pools open to the Public. Ace of Spades Swimming Pool, Kingston By-Pass Road, is an open air pool 40ft. by 20ft. with a depth of 4ft. to 7ft. 6ins. The water is treated by means of a Candy chlorine filtration plant. No samples were taken by the Public Health Department during the year. 42 Milk Supply. The following is a summary of the Bacteriologist's reports on samples taken during the year:— Pasteurised Milk. No. Temperature on arrival. No. of Bacteria per ml. Presence of Bacillus Coli. in 48 hours and 3 days. Result of Animal inoculation experiment for Tubercle Bacilli. 1 19° C. 1,890 Negative Negative 2 19° C. 8.600 Negative Negative 3 19° C. 65,500 Positive Negative 4 * 9,130 Negative Negative 5 * 43.500 Positive Negative * No temperature given. 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) 36 3 — Workshops (Including Workshop Laundries) 30 – – Workplaces (Other than Outworkers' premises included in Part 3 of this Report) 6 1 – Total 72 4 — 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 4 4 – – Want of Ventilation – – – – Overcrowding – – – – Want of drainage of floors – – – – Other Nuisances 7 7 – – Sanitary accommodation:— Insufficient 2 1 – – 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 under the sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order 1921 – – – – Total 15 14 — — * 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. OUTWORK IN UNWHOLESOME PREMISES. SEC. 108 Lists received from Employers. Notices served on Occupiers as to keeping or sending lists. Prosecutions. Number of Inspections of Outworkers premises Instances Notices served Prosecutions Sending twice in the year. Sending once in the year. Failing to keep or permit inspection of lists. Failing to send lists. Lists Outworkers. Lists Outworkers. Contract' rs Workmen. Contract' rs Workmen. Wearing Apparel— (1) Making, &c. 4 ... 2 ... ... ... 4 ... ... 7 ... ... ... (2) Cleaning and Washing ... ... ... ... ... ... ... ... ... ... ... ... ... Lampshade Painting ... ... ... ... ... ... ... ... ... ... ... ... ... Total 4 ... 2 ... ... ... 4 ... ... 7 ... ... 45 4.—Registered Workshops. Workshops on the Register (S. 131) at the end of the Year. Number. Bakehouses 15 Laundries 7 Tailors 10 Bootmakers 13 Dressmakers 13 Milliners 6 Sundry Other Trades 76 Total number of Workshops on Register 140 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 re- ferred 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. 1 Other – Underground Bakehouses (8. 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 the Chief Sanitary Inspector To the Mayor, Aldermen and Councillors of the Borough of Surbiton. I have the honour to present the Annual Report on the work of your Sanitary Inspectors for the year 1937. This report is compiled in accordance with the directions contained in a Memorandum from the Ministry of Health and as required by Article 27 (18) of the Sanitary Officers (Outside London) Regulations, 1935. COMPLAINTS. During the year 894 complaints were received with respect to the following matters, viz.:— Defective condition of house drains 57 Insanitary or dilapidated condition of houses and premises 220 Vermin 22 Nuisances from dampness in walls and floors 26 Defective or insufficient closet accommodation 65 Defective sink waste pipes, etc. 29 Defective roofs 46 Defective eaves gutters and rainwater pipes 21 Water supply to dwelling houses disconnected 17 Smoke nuisances 10 Caravans 2 Overcrowding 12 Houses infested with rats 27 47 Houses not provided with sufficient receptacles for house refuse 54 Nuisances from animals improperly kept 5 Offensive accumulations of manure, etc. 25 Offensive smells from various causes 27 Flooding of premises 14 Defective water fittings 150 Condition of water-courses 5 Shops Acts infringements 3 Unwholesome food 3 Miscellaneous 54 894 INSPECTION OF DISTRICT. Number of dwelling houses inspected for Housing defects (under Public Health and Housing Acts) 530 Number of Council House inspections 530 Number of Council House re-inspections 1,099 Number of premises inspected for other than Housing defects 1,780 Premises re-inspected (including Housing) 1,936 Works in progress (including Housing) 1,420 Miscellaneous visits 563 Total inspections 7,858 Included in the above are the following classified visits:— Visits to slaughterhouses 178 Visits to premises where food is exposed for sale 49 Visits to Houses-let-in-lodgings 6 48 Visits re Milk & Dairies Order to: — Cowsheds 34 Dairies 7 Milkshops 50 Visits to bakehouses 24 Visits to fish friers' premises 4 Visits to factories 31 Visits to workshops 11 Visits to workplaces 6 Visits to outworkers' premises 7 Visits to schools 25 Visits to caravans 4 Cases of infectious disease investigated 135 Disinfections supervised 72 Smoke observations made 5 Shops Acts inspections 104 Visits re overcrowding 677 Visits to urinals and public conveniences 6 Visits re withdrawal of water supply 17 Visits re street gullies, sewers, highways 18 Matters referred to other departments 37 Interviews with owners, tradesmen, etc. 214 Verminous premises disingested (Council Houses) 12 Verminous premises disinfested (Private Houses) 21 Visits to Council House applicants 13 Special visits 77 In addition to the above, 173 interviews with owners, builders, occupiers of shops, etc., took place in the Office. 49 TESTING OF DRAINS AND SANITARY FITTINGS. Drainage systems exposed for examination under Section 41 of the Public Health Act, 1875 2 Drains, soil pipes, etc., tested with smoke, air or chemicals 37 Drains tested with water 74 NOTICES SERVED. Informal Notices 278 Statutory Notices under Section 36 of the Public Health Act, 1875, to provide a sufficient dust receptacle 16 Statutory Notices under Section 36 of the Public Health Act, 1875, to provide a sufficient water closet 2 Statutory Notices under Section 41 of the Public Health Act, 1875, to relax drains 7 Statutory Notices under Section 94 of the Public Health Act, 1875, to abate nuisance 40 Statutory Notices under Section 12 of the Housing Act, 1936, of Time and Place 4 Statutory Notices under Section 12 of the Housing Act, 1936,—Closing Orders 3 Statutory Notices under Section 157 of the Housing Act, 1936, to enter and survey premises 150 Statutory Notices under Section 157 (d) of the Housing Act, 1936, to measure premises 247 Statutory Notices under Section 9 of the Housing Act, 1936, to make premises reasonably fit for human habitation 228 Statutory Notices under Section 168 of the Housing Act, 1936, to require information re ownership of premises 114 Statutory Notices under Byelaws (Houses-let-in-lodgings) to execute works 8 Statutory Notices under Section 23 of the Public Health Act, 1875, to provide a covered drain 4 Statutory Notices under Section 25, Public Health Acts, Amendment Act, 1907, and Section 20, Public Health Act. 1925, to pave common passage 58 50 Statutory Notices under Section '22, Public Health Acts. Amendment Act, 1890, to provide suitable and sufficient sanitary conveniences (office) 2 Statutory Notices under Section 107, Public Health Act, 1936, of consent to Establishment of an Offensive Trade 1 Statutory Notices under Section 89 of the Public Health Act, 1936, to provide and maintain sanitary conveniences for use of persons frequenting a public-house 2 Statutory Notices under Section 10 (2) of the Housing Act, 1936, of intention to do works in default 17 Statutory Notices under Section 49 of the Public Health Act, 1875. to remove accumulation 2 Statutory Notices under Section 66 (3) of the Housing Act, 1936, requiring statement of persons sleeping in a house 1 1,184 DETAILS OF SANITARY IMPROVEMENTS EFFECTED DURING THE YEAR. Drainage. Defective drains repaired, cleansed, etc. 231 Drainage systems re-constructed 11 Drainage systems partly re-constructed 16 Additional drains provided 30 Water Closets. Additional provided 32 W.C.'s cleansed or repaired 94 New pans fixed 46 Flushing cisterns repaired or renewed 88 Lighted or ventilated 12 Sinks, Baths, etc. New fixed 128 51 Waste Pipes, etc. Repaired 61 New provided 119 Disconnected or trapped 37 Water Supply. Draw off taps disconnected 11 Water re-instated or laid on 6 Service pipes and cisterns repaired, etc. 235 Paving. Yards paved 31 Yard paving repaired 64 Dust Receptacles. Provided 197 Manure receptacles provided 1 Dampness. Roofs repaired 225 Eaves gutters or rain water pipes repaired and renewed 175 Damp courses fixed 39 Site of house concreted 26 Ventilation under floors provided 31 External walls pointed and rendered 139 House walls treated with solution 23 General Repairs. Windows made to open 54 Windows provided, repaired or renewed 491 House floors repaired or renewed 125 Doors repaired or renewed 480 Ranges and coppers repaired or renewed 225 Rooms ventilated 15 Internal walls and ceilings repaired 464 Rooms cleansed 1,140 External and internal painting 152 Handrails provided 23 52 Obstructive buildings removed 5 Smoke nuisances abated 4 Animals removed 3 Accumulations removed 15 Miscellaneous 175 Cesspools abolished 4 Pail closets abolished — Food stores provided or ventilated 38 Chimney stacks repaired 16 Staircases renewed or repaired 9 Staircases lighted 17 Ponds sprayed for mosquitos 6 Houses fumigated for moths 4 Houses disinfested of vermin 33 HOUSING. Number of new houses erected during the year: (a) Total (including numbers given separately under (6)) 858 (i) By the Local Authority Nil (ii) By other Local Authorities Nil (iii) By other bodies or persons— Flats 215 Houses 643 (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 1 of the Act of 1930 Nil (d) For other purposes Nil (ii) By other bodies or persons Nil 53 1. Inspection of Dwelling Houses during the year: (1) Total Number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 530 Number of inspections made for the purpose 530 (2) Number of dwelling houses (included under subheading (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 115 Number of inspections made for the purpose 115 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 2 (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 508 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 436 3. Action under Statutory Powers during the year: A.—Proceedings under Sections 9, 10, and 16 of the Housing Act, 1936:— (1) Number of dwelling houses in respect of which notices were served requiring repairs 105 (2) Number of dwelling houses which were rendered fit after service of formal notices:— (a) by Owners 136 (b) by Local Authority in default of owners 7 54 13.—Proceedings under Public Health Acts:— (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 31 (2) Number of dwelling houses in which defects were remedied after service of formal notices:— (a) by Owners 31 (b) by Local Authority in default of owners Nil C.—Proceedings under Sections 11 and 13 of the Housing Act, 1936:— (1) Number of dwelling houses in respect of which Demolition Orders were made Nil (2) Number of dwelling houses demolished in pursuance of Demolition Orders 1 (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 consideredSection 12 Nil (4) Number of undertakings to carry out works accepted Nil (5) Number of houses rendered fit 2 (6) Undertakings cancelled—the works having been carried out Nil D.—Proceedings under Section 12 of the Housing Act, 1936:— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made 1 (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 55 (3) Number of separate tenements closed on undertaking 1 (4) Number of separate tenements rendered fit. on undertaking 1 4. Housing Act, 1936—Overcrowding:— (a) (i) Number of dwellings overcrowded at the end of the year 17 (ii) Number of families dwelling therein 17 (iii) Number of persons dwelling therein 140 (b) Number of new cases of overcrowding reported during the year 7 (c) (i) Number of eases of overcrowding relieved ing the year 15 (ii) Number of persons concerned in such cases 131 (d) Particulars of any cases in which dwelling houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding Nil (e) Any other particulars with respect to overcrowding conditions upon which the Medical Officer of Health may consider it desirable to report Nil 5. Proceedings under Part I, Housing Act, 1930:— During 1036, Clearance Order No. 11 was made in respect of twenty dwellings belonging to the Council. At 31st December, 1937, 18 of these dwellings had been demolished. The position with respect to the Council's Five Year programme is indicated in the table which follows:— 56 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 22 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 February, 1935 9 Demolished 4 5 4/8, Grove Footpath 29th January, 1935 18 Demolished 5 4 1/4, Jennetts Cottages, Surbiton Hill Road 29th January. 1935 12 Demolished 6 3 1/3, Stone Cottages, Leatherhead Road 4th February, 1935 9 Demolished 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 Not confirmed Made fit 9 2 291 and 293, Ewell Road 29th January, 1935 4 Demolished 10 5 2/6, Hobill Place 29th January, 1935 13 Demolished 11 20 3/22, Howard Road Council property 55 Action not completed 57 Housing—Position at December 31st, 1937. On Lines of Form 256a. Houses dealt with in:— CLEARANCE AREAS. Demolished:— Up to 31st Dec., 1936 38 3, 4, 5, 7, 8, 9, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21 and 22, Howard Road 18 — 56 Made Fit:— Up to 31st Dec., 1936 36 — 36 Closed, etc.:— 0 — 0 Excluded from Order and no action necessary:— Up to 31st Dec., 1936 1 — 1 93 UNDER PART II. Demolished:— Totals. Up to 31st Dec., 1936 36 "Roma," Green Lane 1 37 93 Made Fit:— Up to 31st Dec., 1936 19 25/26, Cottage Grove 2 157a, Ewell Road 1 21 57 Closed, etc.:— Up to 31st Dec., 1936 13 56, Ewell Road 1 14 14 1 72 165 Action not completed by 31st Dec., 1937:— 6 and 10, Howard Road 2 — 58 Housing—Summary of Position at 31st December, 1937. Houses in Clearance Areas in respect of which action was not completed by 31st December, 1936 20 Houses (excluding Clearance Areas) in respect of which action was not completed by 31st December, 1936 178 Houses found during the year not to be in all respects reasonably fit 508 Houses found during the year to be unfit 2 Total 708 Houses rendered fit informally 436 Houses rendered fit after procedure under section 9 of the Housing Act, 1936... 143 Houses rendered fit after procedure under Public Health Acts 31 Houses rendered fit after undertaking to carry out works (sec. 11 Housing Act, 1936) 2 Houses demolished (sec. 11 Housing Act, 1936) 1 Tenements or underground rooms closed (sec. 12) Housing Act, 1936 1 Tenements or underground rooms rendered fit on undertaking 1 Houses dealt with in Clearance Areas:— Demolished 18 — 18 Houses in Clearance Areas in respect of which action was not completed by 31st December, 1937 2 Houses (excluding Clearance Areas) in respect of which action was not completed by 31st December, 1937 73 Total 708 59 FACTORY AND WORKSHOP ACT, 1901. The total number of workshops now on the Register, including bakehouses, is 140. 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. Insufficient 1 Unsuitable or defective 2 Other Nuisances Want of cleanliness 4 Smoke nuisances abated 1 Miscellaneous defects 6 The year 1937 was an eventful one in the history of Factory and Workshop legislation. In July the Factories Act, 1937, was passed and comes into operation on the 1st July, 1938. It is a consolidating and amending measure, completely replacing the Factory and Workshop Act. 1901, and consolidates the provisions of sections of at least ten other statutes. It contains many new provisions, abolishes the old distinction between factory and workshop, and between a textile and non-textile factory, and greatly reduces the permissible working hours laid down in previous Acts both for women and young persons. 60 Its provisions are lengthy and complicated, covering a wide variety of operations and applying both to large and small undertakings. Before the coming into operation of this Act, it will be necessary for your Sanitary Inspectors to give assistance, help and guidance to occupiers of factories in order that they will not offend against the law when the new Act is in force in July of next year. This work of assimilating the provisions of the new law and advising occupiers of factories has progressed satisfactorily. BAKEHOUSES. There are 15 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. 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. Slaughter of Animals Act, 1933. Three licences to act as a slaughterman, subject to the provisions of the Act, were granted during the year. The number of licences in force at the end of the year was seven. 61 DAIRIES, COWSHEDS AND MILKSHOPS. During the year six persons have discontinued carrying on the trade of Retail Purveyors of Milk, and two have discontinued carrying on the trade of wholesale producer, and they have been struck off the register. Seven applications were received from persons residing in the district to be registered as Retail Purveyors of Milk. There are now fifty-one persons registered in accordance with the Milk and Dairies (Amendment) Act, 1922, as follows:— Wholesale Traders or Producers of Milk 10 Retail Purveyors of Milk residing in the district 34 Retail Purveyors of milk who reside outside the district but retail in the district 7 Total 51 The Dairies, Cowsheds and Milkshops were visited during the year at irregular periods and found to be kept in a clean and satisfactory condition, in accordance with the Milk and Dairies Order, 1926. Fifteen Dealers' Licences to sell " Pasteurised " Milk, five to sell " Tuberculin Tested " Milk, three to sell " Tuberculin Tested Pasteurised " and one Supplementary Licence to sell "Tuberculin Tested" Milk, were granted under the Milk (Special Designations) Order, 1936. 02 The Milk (Special Designations) Order, 1936, prescribes that " Tuberculin Tested " milk, if raw, must, until the 31st December, 1936, be so produced that a sample taken at any time before delivery to the consumer shall not contain more than 200,000 bacteria per millilitre; after that date it must satisfy a prescribed methylene blue reduction test for cleanliness. At all dates it must contain no coliform bacillus in one hundredth of a millilitre if pasteurised, it must be described as " Tuberculin Tested Milk (Pasteurised)" and must not contain more than 30,000 bacteria per millilitre. If it is bottled on the farm the word " (Certified)" may be added to its description. The conditions for " Accredited" milk are similar to those prescribed in the Order of 1923 for " Grade A " milk. It is raw milk from cows which have passed a veterinary examination; it may be bottled on the farm or elsewhere. It must satisfy the same bacteriological tests as are prescribed for raw " Tuberculin Tested " milk. " Pasteurised " milk is milk which has been retained at a temperature of 145°F to 150°F for at least thirty minutes and immediately cooled to not more than 55°F; and does not contain more than 100,000 bacteria per millilitre. 63 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. Forty-one beasts were inspected, 43 calves, 414 pigs, 155 sheep and 53 lambs, giving a total of 706 animals. Of this total 80 animals were affected with disease in some part, representing 11.33 per cent. (last year's figure: 7.46 per cent.). Visits have also been made to the shops, restaurants, etc., where food is prepared or exposed for sale. The number of animals slaughtered in the Borough continues to decrease but inspection of all animals killed and all meat exposed for sale in the shops has been most thorough. It is worthy of note that although the number of animals slaughtered within the Borough during the past eleven years has steadily declined, there has been no marked decrease in the sale of homekilled meat. " National marked " meat appears to be steadily increasing in popularity, and this remark applies to other goods bearing the " National mark." The following foodstuffs found to be unfit for human food were surrendered by the owners, and subsequently destroyed:— 64  lbs. ozs. Lungs of beasts (3) 18 0 Tuberculosis. Liver of beast (1) 11 0 Abscess. Portions of beasts' livers (2) 9 0 Cirrhosis. Heads and tongues of beasts (2) 44 0 Tuberculosis. Mesentery of beast (1) 7 0 Tuberculosis. Portion of skirt of beast (1) 1 0 Peritonitis. Kidney and surrounding fat of beast (1) 1 8 Oedematous. Portions of beasts' livers (2) 7 0 Fluke Lungs of calf (1) 4 0 Tuberculosis. Pluck and melt of calf (1) 7 0 Tuberculosis. Mesentery of calf (1) 4 0 Tuberculosis. Livers of pigs (8) 29 8 Milk spot. Livers of pigs (3) 11 0 Cirrhosis. Livers of pig (1) 3 0 Tuberculosis. Heads and tongues of pigs (9) 83 0 Tuberculosis. Heads, tongues and mesenteries of pigs (2) 25 0 Tuberculosis. Heads of pigs (3) 24 0 Tuberculosis. Head and pluck of pig (1) 52 0 Tuberculosis. Heads and mesenteries of pigs (4) 46 0 Tuberculosis. Lungs of pigs (3) 4 12 Pleurisy. Lung and heart of pig (1) 4 0 Pericarditis. Lung and heart of pig (1) 3 0 Pneumonia and pericarditis. Lung and heart of pig (1) 3 0 Pleurisy and pericarditis. Lungs of pig (1) 1 0 Congestion. Lungs, heart and liver of pig (1) 6 0 Pleurisy, pericarditis and cirrhosis. Hearts of pigs (3) 2 4 Pericarditis. Heart of pig (1) 2 12 Pleurisy and pericarditis. Pluck of pig (1) 2 0 Pleurisy. Mesenteries of pigs (17) 24 8 Tuberculosis. Kidney of pig (1) 3 Hydronephrosis. Lungs of sheep (1) 1 0 Strongvlus Rufescens. Liver of sheep (1) 1 8 Cirrhotic fluke. Mussels (half bag) Decomposition. Total 442 15 65 Carcases Inspected and Condemned. Cattle excluding cows. Cows. Calves. Sheep and Lambs. Pigs. Number Killed 41 — 43 208 414 Number Inspected 41 — 43 208 414 All diseases except Tuberculosis— Whole carcases condemned — — Carcases of which some part or organ was condemned 7 — — 2 25 Percentage of the number inspected affected with disease other than Tuberculosis 17% — — 0.96% 6.04% Tuberculosis only— Whole carcases condemned — — — — — Carcases of which some part or organ was condemned 6 — 3 — 37 Percentage of the number inspected affected with Tuberculosis 14.6% — 7% — 8.94% 66 SCHOOLS. The public elementary and private schools have been visited from time to time and the sanitary accommodation and water supply was found to be satisfactory. 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. SMOKE ABATEMENT. Informal action was taken during the year in respect of a nuisance from smoke at four premises in the area. The nuisances were abated and no further action was necessary. SHOPS ACTS, 1912-1936. In May I prepared a special report upon the provisions of the various Acts relating to shops within the Borough, and in particular upon the provisions of the Shops (Sunday Trading Restriction) Act, 1936, which came into force on the 1st July, 1937. 67 Following the usual procedure with new legislation, much time has been spent during the year in advising shopkeepers as to their responsibilities and assisting them to gain a proper understanding of the provisions of the various Acts affecting them. In view of the great interest shown by the Shop-keepers and the lack of precedent to many new requirements it is obvious that Members of the Corporation will have many matters to consider with respect to shops during the forthcoming year. The following is a list of the Acts to be administered:— Shops. Act, 1912. Shops Act, 1913. Shops (Hours of Closing) Act, 1928. Shops Act, 1934. Retail Meat Dealers' Shops (Sunday Closing) Act, 1936. Shops Act. 1936. Shops (Sunday Trading Restriction) Act, 1936. The Acts contain important provisions regulating the hours of shop assistants under 18 years of age and for the health and comfort of shop assistants generally. 68 Each shop will require to be visited at least once in each year for the following purposes:— (i) Sufficiency of snnitary accommodation. (ii) Sufficiency of washing facilities. (iii) Sufficiency of lighting. (iv) Sufficiency of ventilation. (v) Sufficiency of heating. (vi) Facilities for meals for shop assistants. (vii) Provision of seats for females. (viii) Exhibition of proper notices. (ix) Inspection of records, particularly respecting young persons. (x) Personal interviews with shop assistants re hours of work, meal intervals, half-holiday, overtime and compensatory holidays. Special visits become necessary to secure general compliance with provisions relating to half-dav closing, evening closing, Sunday closing, Bank Holidays, employment of newspaper boys and girls and employment of other young persons, control of wholesale shops, street traders, places of amusement, etc. During this year several applications were received for partial exemption orders (under the Sunday Trading Act), but these were declined. Additional watercloset accommodation was secured in one premises, and the ventilation and temperature was attended to in several shops as the result of informal action. 69 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 103 premises in which the following cases of infectious diseases have occurred:— Scarlet Fever 71 Diphtheria 22 Tuberculosis 5 Scabies 1 Erysipelas 1 Cancer — Pneumonia — Typhoid Fever 1 Puerperal Pyrexia 1 Encephalitis Lethargica 1 103 Disinfection was also carried out at six premises after cases of non-notifiable diseases on the occupiers of the houses in which the cases occurred agreeing to pay the expense. Library books from infected households were disinfected by fumigation. The books from the Public Library treated in this way numbered 142 and 10 books were destroyed. 70 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 3 Blankets 186 Bolsters 60 Carpets 3 Counterpanes 105 Curtains 2 Cushions 21 Mattresses 186 Mattress Covers 83 Palliasses 2 Pillows 283 Pillow cases 232 Quilts 41 Rugs 56 Sheets 224 Toilet covers 26 Towels 128 Wearing apparel 527 Miscellaneous 238 Books 94 2,500 No. of rooms disinfected 243 ERADICATION OF BED BUGS. 1.— Number of Council Houses Other Houses Found to be infested Disinfested Pound to be infested Disinfested 12 12 21 21 71 2—Methods employed for disinfestation. Council Houses. Other Houses (a) Fumigation with Sulphur — 11 (b) Fumigation with proprietary fumigating blocks 2 2 (c) Spraying with proprietary insecticide 10 5 (d) Fumigation with Cyanide — 3 12 21 3.—To ensure that the belongings of tenants are free from vermin before removal to Council Houses, an inspection is made by a Sanitary Inspector before removal. Where bed bugs are found, the furniture and other belongings are treated by spraying with insecticide and the bedding by steam disinfection or, with the tenant's consent, the bedding is destroyed. I.—The work of disinfestation was carried out by the local authority for Council Houses found to be infested, except in one instance, where the tenant did the work. Disinfestation at the other houses was carried out by the owners in sixteen cases, and the remaining five by the tenants. 5.—The measures taken by way of supervision or education of tenants to prevent infestation or reinfestation after cleansing, are as follows:— 72 At the time of cleansing the co-operation of the tenant is sought and information is given to him by the Sanitary Inspector as to the measures necessary to prevent re-infestation. Supervision is obtained by periodic re-inspection after cleansing. LEGAL PROCEEDINGS. Proceedings were taken against the owner of a house, upon the basement of which a Closing Order under Section 20, Housing Act, 1930, was in operation, for permitting the basement to be used for human habitation in contravention of the Closing Order. The defendant was fined 5/-. Proceedings were also taken against the owner of a plot of land for failing to comply with a notice served under Section 94, Public Health Act, 1875, to properly drain and cleanse the land. The defendant was ordered to execute the works within 14 days and to pay 10/6 costs. MORTUARY. During the year, thirty-seven bodies were received into the mortuary, thirty-two post mortem examinations carried out, and twenty-five inquests held. Use of the mortuary block increases annually. Most post mortem examinations are now conducted by the Surrey County Pathologist. 73 GENERAL. In the early part of 1937 a re-survey was made under the Overcrowding Act, and each month review cases are visited in order that the Committee may know the exact extent of overcrowding in the Borough month by month. A site has been secured in Clayton Road for the erection of houses to receive overcrowded families, and on this site also will be erected a number of houses for ordinary letting, particularly to accommodate childless couples at present occupying Council Houses. There have been no cases of deliberate overcrowding since the " appointed day," but many hundreds of property owners have had to be communicated with in order to get the correct entries in the rent books. During the year, certificates giving the Permitted number of occupants under the overcrowding provisions of the Housing Act were issued in respect of 689 dwellings. Two Sanitary Inspectors, Messrs. Cripps and Scott, and one clerk, Mr. Willoughby, left the Corporation's employ during the year. Mr. Scott's place was not filled as he was more especially appointed to assist in the Housing Overcrowding Survey. Unfortunately these posts were not filled until late in the year, and the Department was very short of staff for four months. The maintenance of the Council's Houses has proceeded in a routine manner. 74 An investigation into the financial status of persons occupying Council Houses was very thoroughly proceeded with by the Housing Committee, and much work fell upon this Department in consequence. A new phase of local government work has devolved upon this Department (as with others) during the year by reason of the Air Raid Precautions Act, and a most successful Air Raid Precautions Exhibition was held for eight days in September. Later I was given facilities to attend the Falfield Civilian Anti-Gas School, and express my thanks for the opportunity of receiving a wonderful course of instruction. The rapid development of the Borough keeps all members of the Department very fully engaged, and once again it is my pleasure to record my grateful thanks to all members of the staff for the keen interest shown in their duties, and the good spirit which prevails in the Department. I am also grateful to the Medical Officer of Health, the Town Clerk, and Officials engaged in other Departments for their helpful co-operation at all times. T am. Ladies and Gentlemen, Your obedient Servant, GEOFFREY McCLELLAND, Chief Sanitary Inspector.