SuR 11 LIBRARY BOROUGH OF SURBITON ANNUAL REPORTS OF THE MEDICAL OFFICER OF HEALTH AND CHIEF SANITARY INSPECTOR For the Year 1940. BOROUGH OF SURBITON ANNUAL REPORTS OF THE MEDICAL OFFICER OF HEALTH AND CHIEF SANITARY INSPECTOR For the Year 1940. Printed by Philpott & Co., (Surbiton) Ltd., 40/42 Brighton Road, Surbiton. Borough of Surbiton PUBLIC HEALTH COMMITTEE Alderman Mrs. A. Woodgate, J.P. (Chairman). Councillor J. PEnwill (Vice-Chair man). Alderman Reynolds. Councillor Scott. „ Sanger. „ Dommett. Councillor Mrs. Cudbird. „ Rhodes. Leach. ,, Young. „ McDermott. „ Miles. With the Mayor (Councillor Ames, J.P.), the Deputy Mayor (Alderman Rampton) and Alderman Bridge, ex-officio. PUBLIC HEALTH DEPARTMENT PERSONNEL Medical Officer of Health : Nevii,le 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., A.R.P.S. Deputy Chief Sanitary Inspector: †*H. J. Eldridge, M.S.I.A., L.A.G.C. (In H.M. Forces till 9.12.40.) Additional Sanitary Inspectors : †*G. H. Cockell, M.S.I.A., M.R.San.I. (In H.M. Forces.) ††*H. Handscomh, M.S.I.A., A.R.San.I. (In H.M. Forces.) Temporary Additional Sanitary Inspectors: *†W. M. Davis, A.R.San.I. (Appointed 22.1.40.) *J. E. Saundkks, Cert.S.l.B. (Appointed 14.10.40.) Chief Clerk: E. D. Elms. (In II.M. Forces front 21.10.40.) Clerks: W. F. Acrks. (In H.M. Forces.) P. E. Whitton. (In H.M. Forces.) Miss V. Ckyer. Mortuan Attendant and General Assistant: A. C. Ball. *Contributions made to salary from Exchequer. †Certificate of Royal Sanitary Institute as Inspector of Meat and other Foods. †Royal Sanitary Institute Smoke Certificate. Annual Report of The Medical Officer of Health for 1940 Public Health Department, 2, Shalston Villas. SuRBITON. October, 1941. To the Mayor, Aldermen and Councillors of the Borough of Surbiton. Ladies and Gentlemen, I am submitting my nineteenth Annual Report dealing with the very important health conditions of Surbiton during 1940. You may remember that the question was raised last year as to why the Annual Report of the Medical Officer of Health was so late in appearing before the Council. I stated that the delay was due to the fact that the Registrar-General's figures were late in reaching this Office, and as a result of this the statistics could not be compiled. However, this year these figures have come to hand at an earlier date and I am, therefore, able to submit to you the complete Report. For the purpose of comparison the statistics are based upon the Registrar-General's figures and also upon Public Health Department Records. 5 STATISTICS. Area ( in acres) 4,709 Resident Population (Census 1931) 29,396 Estimated Population 28th December, 1930:— National Registration Office's figure 48,418 * Registrar-General's figure 50,440 Number of habitable houses ( middle of 1940) according to rate books 16,035 * Number of families or separate occupiers (1931 Census) 8,116 Rateable Value £577,181 Sum represented by a penny rate £2,156 EXTRACTS FROM VITAL STATISTICS OF THE YEAR. (Based on National Registration Office population figure of 48,418, and on Public Health Department records.) Live Births:— Total M. F. Legitimate 620 332 288 Illegifimate 12 5 7 Birth rate per 1,000 of the estimated resident population 13.05 Deaths:— 544 257 287 Crude death rate per 1,000 of the estimated. resident population 11.23 Percentage of total deaths occurring in Public Institutions and Nursing Homes 44.47 Death rate of infants under one year of age:— • All infants per 1,000 live births 44.31 Legitimate infants per 1,000 legitimate live births 32.25 (Based on Registrar-General's Population figure of 50,440 and on statistics supplied by Registrar-General.) Live Births:— Total M. F. Legitimate 751 396 355 Illegitimate 30 15 15 Birth rate per 1,000 of the estimated resident population 15.48 Still Births:— Legitimate 14 7 7 Illegitimate 1 1 — Rate per 1,000 total (live and still) births 18.84 Total M. F. Deaths 544 257 287 Crude death rate per 1,00() of the estimated resident population 10.78 Adjusted death rate (comparability factor 1.07) 11.53 CAUSES OF DEATH DURING 1940. M. F. All causes 257 287 Typhoid and Paratyphoid Fevers Cerebro-spinal Fever 1 1 Scarlet Fever • Whooping Cough Diphtheria — 1 Tuberculosis of Respiratory System 18 5 Other forms of Tuberculosis 1 2 Syphilitic Diseases 4 Influenza 4 4 Measles Acute poliomyelitis and polio-encephalitis Acute infantile encephalitis Cancer of b. cav. and cesoph. (M.) Uterus (F.) 2 4 Cancer of stomach and duodenum 9 8 Cancer of breast — 6 Cancer of all other sites 27 28 Diabetes 1 1 lntra-cran. vascular lesions 14 30 Heart Disease 65 73 Other diseases of circulatory system 8 9 Bronchitis 12 13 Pneumonia 12 20 Other respiratory diseases 4 1 Ulcer of stomach or duodenum 4 5 Diarrhoea (under 2 years) 1 Appendicitis 2 ()ther Digestive Diseases 4 7 Nephritis ' ^ Puerperal and post-abort. Sepsis Other maternal causes — 1 Premature Birth 6 4 Congenital malformations, birth injuries, infantile diseases 3 6 Suicide --1 3 Road traffic accidents 9 2 Other violent causes 12 21 All other causes 22 22 7 INFANT MORTALITY. There were 28 deaths of children under 1 year of age, which is a decrease of 9 compared with the number for the previous year. Twenty were legitimate and 8 illegitimate. Of the infant deaths, 13 occurred in hospitals or public institutions outside the district of Surbiton. The ages at death were as follows:— One at 1 hour, 10 hours, 12 hours, 14 hours, 2 days, 3 days, 20 days, 3 weeks, 1 month, 10 months and 12 months; two at 4 days, 2 weeks, 3 months, 7 months; three at 1 day, 1 week, and 9 months. The causes and ages at death of the children were as follows:— Convulsions, Epilepsy 3 months Atelectasis Neonatorum 4 days Broncho pneumonia 9 months Prematurity 1 day Toxaemia, Necrosis of Mandible 3 weeks Icterus Gravis Neonatorum 1 weekPrematurity (5 months) 14 hours Prematurity 20 days Prematurity 1 week Broncho-pneumonia, Marasmus I month Exhaustion, Pneumococcic Meningitis 9 months Inanition. Spina Bifida 2 days Broncho-pneumonia, prematurity 1 week Gastro-enteritis, double cesphageal stricture 9 months Exhaustion, Vomiting, Cerebro-spinal Meningitis 9 months Prematurity 10 hours Prematurity 1 hour Prematurity 4 days Intestinal Obstruction 3 days Prematurity 1 day Prematurity 1 day Hydrocephalus 7 months Marasmus 10 months Broncho-pneumonia 2 weeks Broncho-pneumonia, gastro-enteritis 2 weeks Tuberc. meningitis 12 months Prematurity 12 hours Peritonitis, Bilateral mastoiditis 3 months 8 Infant Mortality Rate. SURBITON England & Walks (Smaller Towns) 1930 56. 3 55 .0 1931 45. 73 620. 1932 50. 46 58.0 1933 41. 83 56.0 1934 27.78 53.0 1935 37.19 55.0 1930 38. 51 55.0 1937 42.04 55.0 1938 31.14 51.0 1939 50. 98 40.0 1940 33. 85 54.0 PREVALENCE OF AND CONTROL OVER INFECTIOUS DISEASE. The Clerk to the Tolworth Joint Hospital District Board has kindly supplied me with the following figures for 1940:— Analysis of Patients Admitted to the Tolworth Isolation Hospital for the Year Ended 31st December, 1940. Diphtheria Scarlet Fever Other Diseases Total Surbiton 11 56 89 156 Maiden and Coombe 10 46 59 115 Esher 12 49 100 161 Paying patients (admitted from outside of the Constituent Districts) 34 16 86 136 67 167 334 568 9 Notification of Infectious Diseases during the Years 1930 to 1940. 1930 1931 1932 1933| 1934 1935 1936 1937 1938 1939 1940 Diphthetia 40 14 12 7 49 22 10 27 6 5 9 Scurlet Fever 89 43 40 85 87 78 90 82 80 24 60 Enteric Fever — 2 - 1 2 1 2 1 — 3 — Puerperal Pyrexia 5 2 7 2 10 3 2 5 8 10 6 Pneumonia 64 64 68 54 40 30 51 39 33 37 45 Erysipelas 9 2 6 12 7 12 9 13 9 6 10 Encephalitis Lethargica — - - — - — - 1 - — - Cerebro-Spinal Fever - - - - - - - 1 - - 17 Ophthalmia Neonatorum 1 3 2 2 5 1 1 1 3 — 4 Acute Poliomyelitis — - - - — - 1 1 1 - — Dysentery — - — — 4 1 — - — Malaria — — - 1 1 1 — — - - - Measles - - - - - - - - - 1 839 Whooping Cough - - - - - - - - - 4 6 Chicken.Pox - - - - - - - - - - 6 Paratyphoid - - - - - - - - - - 1 Total 208 130 135 164 201 152 167 171 141 90 1003 10 TOTAL CASES NOTIFIED TOTAL DEATHS AT AGES AT AGES Under 1 Year 1-2 2-3 3-4 4-5 5-10 10-15 j 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 4 - - - - - - - - 1 - - - - - - Scarlet Fever — — 3 4 11 24 8 5 5 - - - - - - - - - - - - - - - Enteric Fever - - - - - - - - - - - - - - - - - - - - - - - — Pneumonia 2 3 2 2 5 — 1 — 4 5 13 8 2 - - - - - - - 1 — 5 24 Erysipelas — - - - - - - - 1 — 6 3 - - - - - - - - - - — — Encephalitis Lethargica - - - - - - - - - - - - - - - - - - - - - - - — Cerebro-Spinal Fever 1 1 - - 2 — 3 8 1 1 - 1 — — — — — 1 — — — — Ophthalmia Neonatorum 4 - - - - - - - - - - - - - - - - - - - - - - — Poliomyelitis - - - - - - - - - - - - - - - - - - - - - - — — Puerperal Pyrexia — — — — — — — 4 2 — — — — — — — — - — — Malaria - - - - - - - - - - - - - - - - - - - - - - - — Dysentery - - - - - - - - - - - - - - - - - - - - - - -- — Measles 7 36 60 49 121 416 42 52 46 3 7 - - - - - - - - - - - - — Whooping Cough — 2 • - - - - - - - - - - - - - - - - - - - - — Paratyphoid - - - - - - - - - - - - - - - - - - - - - - - Chicken-Pox - - - - - - - - - - - - - - - - - - - - - - - - NOTE:—Total deaths include transferable deaths occurring outside the district which are not included in the total cases notified. 11 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 the year 208 persons were shown to be suffering from the disease and living within the district:— Pul Non-Pul Males 79 34 Females 73 22 Total 152 56 TUBERCULOSIS Age-Periods NEW CASES DEATHS Pulmonary XonPulmonary Pulmonary NonPulmonary M. F. M. F. M. F. M F. Under 1 year — — — — 1— — — 1 — — 1 — 5— — — 2 — — — — 15— 4 13 1 1 1 — — — 25— 11 9 1 4 2 4 1 — 35— 5 5 1 — 5 1 — — 45— 5 1 — - 1 1 — — 55— 3 3 — — 4 1 — 1 65 and upwards 2 - — — 3 — — — Totals 30 31 4 7 16 7 2 1 Of the seventy-two new cases tabulated above, 17 cases are transferred from other districts. 12 Of the total number of deaths from Tuberculosis there were two patients who had not been notified. The table shows an increase compared with last year of 11 new pulmonary cases of Tuberculosis and the new Non-Pulmonary cases show a decrease of 8. The deaths show an increase of 13. At the commencement of the year there were 202 cases of Tuberculosis on the register and at the end of the year this figure had increased to 208. During the year four cases were notified as recovered from the disease, 33 patients left the district and there were 27 deaths. Of the 72 new cases it is interesting to note that 50 of these were cases first notified in this district. 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—New Cases. Year Resident in New Houses Resident in Old Houses 1935 29 25 1936 29 27 1937 29 34 1938 38 22 1939 20 45 1940 26 24 13 Ward Cases added to Register Cases on Register 31st Dec. 1940 Primary Notifications Transfers, etc. 1938 1989 1940 1938 1939 1940 Berrylands 7 4 7 2 3 1 31 Chessington 2 5 10 4 11 7 33 Hook and Southborough 3 4 5 - 5 1 18 Seething Wells 4 2 6 2 — 2 14 St. Marks 3 3 3 2 3 4 11 Surbiton Hill 1 3 3 3 2 — 16 Tolworth East 5 6 3 2 3 1 24 Tolworth Wes 7 1 5 - 1 — 28 Tolworth South 9 5 8 3 4 1 33 TOTALS 42 33 50 18 32 17 208 DIPHTHERIA IMMUNISATION. Two hundred and five children were treated during the year as follows:— Treatments Completed. Incompleted. Children treated at Clinic 182 17 Children treated at Schools 5 1 187 18 The division into children of school age and those under is:— Treatments Completed. Incompleted. Children of school age 141 15 Children under school age 46 3 187 18 14 GENERAL PROVISION OF HEALTH SERVICES IN THE AREA. The general provision of health services in the area, including ambulances, clinics, treatment centres, hospitals and other facilities, remain as in previous years. Laboratory Facilities. Pathological and Bacteriological examinations are made for the Corporation by the Clinical Research Association and Victoria Hospital, Kingston. During the year the following examinations were carried out:— Disease Suspected Nature of Specimen Result TOTAL Positive Negative Diphtheria Swabbings 6 103 100 Tuberculous Sputum 14 73 87 Typhoid-Dysentery Fœoes 2 2 Cerebro-spinal Fever Spinal fluid 3 3 ditto Swabbings 2 23 25 Total 22 204 226 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. I am supplied with monthly reports by the Board giving details of their chemical and bacteriological examinations. Drainage and Sewerage. Extensive schemes have been prepared for soil and surface water drainage in the Borough, and would in the ordinary course of events be in hand. The schemes, however, have been deferred owing to the outbreak of hostilities. 15 Swimming Baths and Pools. Publicly-owned Baths. Surbiton Lagoon, situated in Raeburn Avenue, Surbiton, is an open air pool 165 feet long and 90 feet wide with a depth of 3 to 9 feet. The water is treated by continuous pressure sand filtration, sterilisation 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. In addition, check samples are taken by the Public Health Department. Privately-owned Pools open to the Public. Ace of Spades Swimming Pool. Kingston ByPass Road, is an open-air pool 40 feet by 20 feet with a depth of 4 feet to 7 feet 6 inches. The water is treated by means of a Candy chlorine filtration plant. The pool was not open this year. 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, Padies and Gentlemen, Your obedient Servant, NEVILPE H.PINZEE, Medical Officer of Health. 16 ANNUAL REPORT OF THE CHIEF SANITARY INSPECTOR To the Mayor, Aldermen and Councillors of the Borough of Surbiton. Ladies and Gentlemen, I have the honour to present the Annual Report on the work of your Sanitary Inspectors for the year 1940. This report is compiled in accordance with the directions in Ministry of Health Circular No. 2067 and is therefore to be regarded as an interim report. COMPLAINTS. During the year 411 complaints were received and dealt with. This does not include complaints from Council house tenants. INSPECTION OF DISTRICT. Number of dwelling houses inspected for Housing defects (under Public Health and Housing Acts) 206 Number of Council House inspections 1,032 Number of Council House re-inspections 1,137 Number of premises inspected for other than Housing defects 355 Number of premises other than houses inspected 523 Premises re-inspected (including Housing) 679 Works in progress (including Housing) 158 Miscellaneous visits 1,919 6,009 Included in the above are the following classified visits:— Visits to slaughterhouses 42 Visits to premises where food is exposed for sale ... 228 Visits to cowsheds, dairies, milkshops and milk vehicles 65 Visits to bakehouses 25 Visits to fish fryers' premises 11 Visits to factories 58 Visits to outworkers' premises 10 17 Visits to schools 17 Visits re cases of infectious disease (including tuberculosis) 230 Smoke observations made 3 Shops Acts inspections 74 Visits re overcrowding 20 Visits to urinals and public conveniences 35 Interviews with owners, tradesmen, etc. 169 Visits re Food and Drugs Act 127 Visits to Council House applicants 6 Miscellaneous visits 72 TESTING OF DRAINS AND SANITARY FITTINGS. Drains, soil pipes, etc., tested with smoke, air or chemicals 2 Drains tested with water 4 NOTICES SERVED. 197 informal and 21 statutory notices were served. DETAILS OF SANITARY IMPROVEMENTS EFFECTED DURING THE YEAR. Council Houses Privatelyowned Premises Drains repaired, cleansed, etc. 23 103 Drains re-constructed — 7 Additional W.C.'s provided — 4 W.C.'s repaired or cleansed 55 37 New sinks or baths fixed 2 15 Wastepipes repaired or renewed 29 18 Water pipes and cisterns repaired, etc. 135 28 Yard paving repaired or renewed — 8 Dust receptacles provided 32 27 Dampness remedied 94 32 Rooms cleansed 198 82 Internal walls and ceilings repaired 140 64 Windows repaired or renewed 90 50 General house repairs 63 32 Accumulations removed — 36 Houses disinfested of bugs 4 14 Food premises cleansed — 6 Gates and fences repaired or renewed 104 — External painting 48 — Stoves and coppers repaired or renewed 77 10 Miscellaneous 46 70 18 Number of new houses erected during the year: — (a) Total (including numbers given separately under (b)) 93 (i) By the Local Authority Nil (ii) By other Local Authorities Nil (iii) By other bodies or persons—Houses 93 (b) With State assistance under the Housing Acts:— (i) By the Local Authority— (a) For the purpose of Part 11 of the Act of 1925 Nil (b) For the purpose of Part 111 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 1. Inspection of Dwelling Houses during the year (excluding Council Houses):— (11 (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 206 (b) Number of inspections made for the purpose 206 (2| (a) Number of dwelling houses (included under sub-heading (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 5 (b) Number of inspections made for (he purpose 5 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (4) Number of dwelling houses (exclusive of those referred to under the preceding subheading) found not to be in all respects reasonably fit for human habitation 173 2. Remedy of defects during the year without service of Formal Notices (excluding Council Houses):— Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their officers 111 19 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 1 (2) Number of dwelling houses which were rendered tit after service of formal notices (a) By owners Nil (b) By Local Authority in default of owners Nil B. Proceedings under Public Health Acts :— (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied Nil (2) Number of dwelling houses in which defects were remedied after service of formal notices:— (a) By owners Nil (b) By Local Authority in default of owners Nil FACTORIES. There are 190 factories (including 15 hakehouses) on the register. 58 visits were made, and as a result the following contraventions have been dealt with:— Sanitary Conveniences. Insufficient Defective or dirty 4 Other Defects. Dirty premises 4 Means of escape in case of tire 6 There were seven outworkers on the register at the end of the year. SLAUGHTERHOUSES. There were three registered slaughterhouses in use at the commencement of the year. In two cases it was considered that the premises were not suitable for use for the purpose in question, and the Corporation refused to grant a licence in respect of these premises. In one case the occupier appealed to the Magistrates, but the decision of the Corporation was upheld. 20 In the case of the third slaughterhouse, as these premises are but rarely used, the question of the granting of a licence was left in abeyance for the duration of the war. DAIRIES, COWSHEDS AND MILKSHOPS. There are now 54 persons registered in accordance with the Milk and Dairies (Amendment) Act, 1922. 24 licences were issued under the Milk (Special Designations) Order, 1936. FOOD INSPECTION. In consequence of war-time centralised slaughtering, the number of animals slaughtered in the district was considerably less than in normal times. Carcases and offal of 208 animals were inspected, of which number six were affected with disease in some part. Frequent visits were made to food shops of various kinds to ensure that no foodstuffs which were unfit for human food were exposed for sale or deposited therein. The total quantity of food condemned as unfit for human consumption and surrendered by the owners was 1308 lbs. 15 ozs. There was a noticeably marked deterioration in the methods of handling and transporting food. It is realised that traders are working under difficult conditions consequent upon the war. but every effort has been made to impress upon them the importance of maintaining the standard of cleanliness which prevailed in pre-war days. FOOD AND DRUGS ACT. The following is a summary of samples taken during the year:— 21 ARTICLES ANALYSED ADULTERATED OR BELOW STANDARD PROSECUTIONS CONVICTIONS Formal In. formal Total Formal In formal Total Milk 49 6 55 5 — 5 — — Shredded Beef Suet 11 — 11 3 — 3 — Coffee 3 — 3 - — — — — Tea 2 — 2 — — — — — Raisin Wine 1 — 1 — — — — — Orange Juice 1 — 1 - - - - - Olive Oil 1 — 1 — — — — — Butter 3 — 3 1 — 1 — — Sausages — 3 5 — — — — — Cornflour 2 — 2 — — — — — Oats 1 — 1 — — — — — Rice 1 — 1 - — — — — Dried Eggs 1 — 1 1 — 1 — — Vermicelli 1 — 1 1 — - - - Total 77 11 88 11 - 11 - — No prosecutions were undertaken as the eleven cases of adulteration or low standard were not of a serious nature. Warning was given in these cases. DISINFECTION. During the year disinfection was carried out at 47 premises following cases of infectious disease and at 25 other premises on payment. Ninety-one Library books were disinfected and 50 destroyed. 22 BED BUGS. Disinfestation was carried out at 18 premises by the following methods:— Council Houses Other Houses Spraying with Vermicine 4 5 Fumigation with Cyanide — 2 „ „ Cimex — 1 „ „ Sulphur — 3 Use of paraffin, etc. — 3 PUBLIC MORTUARY. During the year 51 bodies were received into the mortuary, 50 post-mortem examinations carried out, and 28 inquests held. This does not include deaths from war operations. SHOPS ACTS. 74 visits were made to shops in connection with Shops Acts, and eight infringements were rectified. No prosecutions were instituted. GENERAL. The year under review was fraught with difficulties, and the normal activities of the Department were considerably affected. The less important routine work had to be abandoned as the whole of the male staff were called to the, Forces, and I was left with only one Clerk out of the original Staff. Great difficulty was experienced in securing two temporary Sanitary Inspectors, one of whom was appointed in January and the other in October. Nevertheless, all essential work was dealt with, but not with that promptitude which has in the past been the pride of the Department. The severe enemy activity in the latter part of the year called for the utmost effort from every member of the staff by day and night, and I am pleased to record that all difficulties were overcome. 23 New duties in connection with Food Treatment, War Damage, Rehousing and Billeting, have had to take precedence over the normal work of Sanitary and Housing inspection, but matters essential to the safeguarding of Public Health have never been neglected. The foregoing report is merely a summary of matters normally reported year by year. Detailed records of other duties performed, and works done, will appear in a more comprehensive report when the war is over. I am, Ladies and Gentlemen, Your obedient Servant, GEOFFREY McCLELLAND, Chief Sanitary Inspector.