SUR 28 AC 4413(1) BOROUGH OF SURBITON ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH AND CHIEF PUBLIC HEALTH INSPECTOR for the year 1958 Public Health Department, 2 Shalston Villas, SURBITON. BOROUGH OF SURBITON ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH AND CHIEF PUBLIC HEALTH INSPECTOR for the year 1958 Public Health Department, 2 Shalston Villas, SURBITON. BOROUGH OF SURBITON ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH AND CHIEF PUBLIC HEALTH INSPECTOR FOR THE YEAR 1 9 5 8. Item:- CONTENTS Page: Public Health Committee 1 Personnel of Department Introduction by Medical Officer of Health 2, 3, 4. General Statistics 5 Social Conditions 5 Vital Statistics 6 Population 7 Births 8 Ages at death 8 Causes of death 9 Infant mortality 10 Infant mortality rate 10 Infectious diseases 11,12,13 Diphtheria 13 Diphtheria immunisation 13,14,15. Smallpox 15 Dysentery 16, 17 Poliomyelitis 17 Pood Poisoning 18 Laboratory facilities 19 Exclusion from school 19 Tuberculosis 20, 21,22. Medical examinations Welfare of old people 23 Co-ordination of Health and other social services 23 Nursing in the Home 24 Ante-natal Clinic 24 Home help service 24 Water supply 25 Rivers and streams 25 Swimming baths 25 Refuse collection and disposal 25 Factories 26,27 28. Complaints 29 Visits made by Inspectors 29, 30 Testing of drains 30 Notices served, licences and certificates issued 30, 31 Housing 31,32,33 Sanitary improvements effected 33,34 Improvement Grants 34, 35, 36 Rent Act, 1957 37 Food Inspection 38 Food Hygiene 38, 39 Food & Drugs 40,41,42,43,44. Milk Supply 44, 45 Ice Cream 45, 46 Glean Air Act 46 Moveable dwellings 46 Dustbins 47 Disinfection 47,48 Disinfestation 48 Public Mortuary 48 National Assistance Act, 1948 49 Shops Act, 1950 49 Heating Appliances(Fireguards) Act,1952 50 Pet Animals Act, 1951 50 Rats and Mice Destruction • ... BOROUGH OF SURBITON PUBLIC HEALTH COMMITTEE Alderman A.C. Healey, M.Sc., Ph.D., F.R.I.C., (Chairman) Councillor C.G.L. Du Cann (Vice-Chairman) Alderman G.W. Dew Councillor Mrs. I.E. Desforges Alderman A.G. Leach Councillor H.J. Halford Alderman Mrs. A. Woodgate, J.P. Councillor W.S. Mutimer Councillor P.P. Alexander Councillor H.A. Sabelli, C.B.E. Councillor Mrs. D.T. Butler Councillor C.G. White, O.B.E. With the Mayor (Councillor J. Harrison, J.P.,) and the Chairman of the Finance Committee (Alderman K. Bidmead, B.A.,) ex officio. PUBLIC HEALTH DEPARTMENT - PERSONNEL Medical Officer of Health - J.W. STARKEY, M.B., Ch.B. (Edin.), D.P.H. Deputy Medical Officer of Health W.H. KINSTRIE, M.B., Ch.B. (Edin.), D.P.H. Chief Public Health Inspector s / – H.J. ELDRIDGE, M.R.S.H. ,M.A.P.H.I. Deputy Chief Public Health Inspector x * / - R.E. HAINES, M.A.P.H.I. Additional Public Health Inspectors. x * / ø – W.H. GRAY, M.A.P.H.I., D.R.I.P.H.H. x / - F.H.A. BURTON, M.R.S.H. Public Analyst (part-time) D.D. MOIR, M.Sc., F.R.I.C. Chief Clerk; E.D. ELMS Rodent Officer; E.C. REEVE Clerks; - Miss V. CRYER Mrs. J.F. DEAKINS A.G. BABBAGE (also Assistant to Inspectors). Miss S. HALLS (Resigned 13.9.58) R. LONG (Commenced 15.9.58 - Transferred to Town Clerk's Department 17.12.58.) I.D. REID (Commenced 29.12.58) Disinfector and Mortuary Attendant. A.C. BALL. - Contributions made to salary by County Council. s Sanitary Inspector's Certificate (Royal Santary Institute) x Sanitary Inspector's Certificate (R.S.I. and S.I.E.J. Board) * Smoke Inspector's Certificate (R.S.I.) ø Certificate in Sanitary Science as applied to Buildings and Public Works (R.S.I.) / Certificate as Inspector of Meat and Other Foods (R.S.I.) 1. INTRODUCTION BY THE MEDICAL OFFICER OF HEALTH. Telephone No: Elmbridge 6441-8. Ext.25. PUBLIC HEALTH DEPARTMENT, 2, SHALSTON VILLAS, SURBITON. June 1959. To the Mayor, Aldermen and Councillors of the Borough of Surbiton. Annual Report 1958. Mr. Mayor, Ladies and Gentlemen, I have the honour to present the Annual Report on the Public Health and Social conditions of the Borough for 1958. The Report is compiled in accordance with Ministry of Health Circular No. 22/58. and follows a similar pattern to that for 1957. The health of the people has been good, and steady progress has been made throughout the year in projects towards prevention of disease and safeguarding food supplies. Population; The home population as given by the RegistrarGeneral is 63,550, an increase of 440 on the figures for 1957. This compares most favourably with an increase of 500 in 1956 and continues the trend of recent years. Infectious Diseases; The number of infectious disease notifications received in 1958 was 450 compared with 1,160 for 1957. This was not a heavy Measles year and the number of dysentery cases was much less than the previous year. I must once again make special reference to the freedom from diphtheria in the Borough since 1946, which is unquestionably due to the efforts of the general medical practitioners, clinics, and all engaged in this work, and shows what a vital and worthwhile work diphtheria immunisation is. Vaccination against Poliomyelitis: The progressive campaign to immunise the population against poliomyelitis was carried forward by the introduction of additional priority groups and the importation of supplies of American and Canadian vaccine to supplement the increasing flow of vaccine from British manufacturers. A good response from the people to the invitation to be vaccinated was forthcoming but much more has to be done before it can be considered that the population is protected. No new cases of poliomyelitis were notified in Surbiton during the year. 2. Births; The number of live births for 1958 is 867 and compares with 777 for 1957. The birth rate is 13.64 per 1,000 of the population compared with 12.31 for the previous year. Deaths: The number of deaths recorded in 1958 is 641 compared with 553 for 1957. This gives a death rate of 10.08 per thousand of the population compared with 8.76 for 1957. The number of deaths of infants under one year in 1958 is 14 giving an Infant Mortality Rate of 16.14 compared with a rate of 11.58 for 1957. The causes of death of these infants will be seen on page 10. Causes of Death: The main causes of death during 1958 were:- Heart 231 Cancer 141 Vascular lesions of Nervous System 87 National attention has been drawn in recent years to the general increase in the number of deaths attributable to lung cancer and its connexion with cigarette smoking. The following table shows the relevant figures for the past six years in respect of Surbiton residents. The RegistrarGeneral couples cancer of the lung with cancer of the bronchus in his abbreviated list of causes of death. 1953 1954 1955 1956 1957 1958 Deaths from cancer of the lung and bronchus. M F M F M F M F M F M F 18 4 19 5 21 2 24 6 19 4 26 3 TOTAL 22 24 23 30 23 29 3. . . Housing: The change in character of the new houses being built which was noted last year still continues. Large family houses are being demolished and replaced by blocks of so-called maisonettes and garages. More specialised housing particularly suited to the needs of aged persons is required and towards this end are to be welcomed 28 special flatlets for the aged with a further programme of 60 more under construction. Private enterprise is reported to have built 280 dwellings in the year which compares with 295 in 1957. Staff: Details of the staff are set out on page one. There has been no change during the year other than a Junior Clerk. I record my thanks to the Chairman and Members of the Public Health Committee for their encouragement and active support of the work of the Public Health Department, and to Mr. Elaridge, the Chief Public Health Inspector, and his Inspectors; and Mr. Elms and clerical staff of the department, and to Dr. W.H. Kinstrie, Deputy Medical Officer of Health. I have the honour to be Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, J.W. STARKEY, Medical Officer of Health. 4. GENERAL STATISTICS Area of Borough (in acres) 4,709 Population (June 1958) 63,550 Resident population (Census 1951) 60,875 Estimated number of separate habitable dwellings (houses and flats) in the Borough at 31st March, 1959 19,638 Number of new houses erected during the years- (a) By local authority 25 (b) By other local authorities Nil (c) By private enterprise 280 (d) Rebuilt following destruction by enemy action Nil (e) Housing units provided by conversion, private enterprise 50 Rateable value at 31st December, 1958 £1,115,858 Sum represented by a penny rate £4,450 SOCIAL CONDITIONS Surbiton is an attractive well favoured residential town with many recreation grounds and open spaces. It flanks the river and is close to Epsom Downs, two Royal Parks and Hampton Court Palace. Its population is healthy and enjoys many physical and social amenities. It is mainly a dormitory town but many of the people are engaged in local industry which comprises a variety of trades in small modern factories. It is a good shopping centre and well supplied with communications by road and rail. 5. VITAL STATISTICS Based on Registrar General's population figure of 63,550 and on adjusted statistics supplied by the Registrar General. LIVE BIRTHS: Male Female TOTAL Legitimate 433 (385) 394 (362) 827 (747) Illegitimate 26 (13) 14 (17) 40 (30) Birth rate per 1,000 of the estimated resident population 13.64 (12.31) Adjusted birth rate (comparability factor 1.00) ..... . 13.64 (12.31) England and vales 16.4 (16.1) STILL BIRTHS; Legitimate 5 (7) 10 (10) 15 (17) Illegitimate 1 (–) – (1) 1 (1) Rate per 1,000 (live and still) births 18.12 (23.16) TOTAL LIVE & STILL BIRTHS: Male Female England & Wales(Still births 465 _ 418 883 21.6 (22.4) INFANT DEATHS: Infant mortality rate per 1,000 live births - total 16.14 (11.58) England & Wales 22.5 (23.0) Infant mortality rate per 1,000 live births - legitimate 16.92 – Infant mortality rate per 1,000 live births - illegitimate – – Neo natal mortality rate (first four weeks) per 1,000 live births 12.68 – Illegitimate live births per cent of total live births 4.61 – Maternal deaths(including abortion) Nil – Maternal mortality rate per 1,000 live and still-births Nil – DEATHS: Male Female 641 ( 553) 325 (264) 316 (289) Crude death rate per 1,000 of the estimated resident population 10.08 (8.76) Adjusted death rate (comparability factor 1.08). 10.88 (9.37) England & Wales (all causes) 11.7 (11.5) NOTE; The figures in parenthesis are those for 1957. 6. POPULATION (a) The following table shows the estimated mid-year Population figure for the last ten years 1949 60,110 1950 61,230 1951 61,090 1952 61,590 1953 62,230 1954 63,320 1955 62,570 1956 62,610 1957 63,110 1958 63,550 (b) Census Figures. 1901 15,017 1911 17,717 1921 20,149 1931 30,178 1951 60,875 (c) 1951 Census - Ages (quinary) Sex Distribution:- Male Female Persons ALL AGES 28,501 32,374 60,875 0-4 2,446 2,409 4,855 5-9 2,312 2,213 4,525 10-14 1,935 1,805 3,740 15-19 1,535 1,738 3,273 20-24 1,568 1,863 3,431 25-29 1,886 2,147 4,033 30-34 2,078 2,380 4,458 35-39 2,569 2,851 5,420 40-44 2,704 2,825 5,529 45-49 2,377 2,593 4,970 50-54 2,013 2,239 4,252 55-59 1,509 1,834 3,343 60-64 1,270 1,530 2,800 65-69 920 1,355 2,275 70-74 649 1,095 1,744 75-79 450 814 1,264 80-84 187 446 633 85-89 71 185 256 90-94 20 46 66 95 and over 2 6 8 7. BIRTHS The following table shows the number of live births and the birth rate over the past ten years. Year Number of Births Birth Rate Birth Rate for England and Wales. 1949 892 14.83 16.7 1950 836 13.65 15.8 1951 841 13.76 15.5 : 1952 814 13.21 15.3 1953 856 13.73 15.5 1954 816 12.88 14.1 1955 760 12.14 15.0 1956 761 12.15 15.7 1957 777 12.31 16.1 1958 867 13.64 16.4 1 AGES AT DEATH DURING 1958 The deaths occurred at the following ages:- Age Group Male Female Under 1 year 10 4 1-4 1 - 5-14 – 2 15 - 24 7 2 25 - 34 8 1 35 - 44 7 5 45 - 54 34 20 55 - 64 58 40 65 - 74 91 59 75 and over 109 183 Total 325 316 8. CAUSES OF DEATH DURING 1958 Male Female  All causes 325 316 Tuberculosis, respiratory 5 2 Syphilitic disease 1 1 Other infective and parasitic diseases – 1 Malignant neoplasm, stomach 6 7 Malignant neoplasm, lung, bronchus 26 3 Malignant neoplasm, breast – 13 Malignant neoplasm, uterus – 5 Other malignant and lymphatic neoplasms 43 38 Leukaemia, aleukaemia 2 1 Diabetes 2 3 Vascular lesions of nervous system 30 57 Coronary disease, angina 71 42 Hypertension with heart disease 8 9 Other heart disease 32 34 Other circulatory disease 14 21 Influenza 1 1 Pneumonia 15 25 Bronchitis 20 5 Other diseases of respiratory system 5 3 Ulcer of stomach and duodenum 3 2 Gastritis, enteritis and diarrhoea 1 2 Nephritis and nephrosis 2 2 Hyperplasia of prostate 4 – Congenital malformation 4 2 Other defined and ill-defined diseases 16 18 Motor vehicle accidents 3 6 All other accidents 5 6 Suicide 6 7 9. INFANT MORTALITY There were fourteen deaths of children under one year of age. It will be noted all but five died in the first hours of life; one died at one week and four died within five months. The causes and ages at death were as follows:— Hydrocephalus 2 weeks Asphyxia following inhalation of regurgitated stomach contents 5 months Acute cor pulmonale 5 months Multiple congenital abnormalities 5 hours Atelectasis; prematurity 10 hours Cerebral haemorrhage 30 minutes Erythroblastosis foetalis 6 hours Duodenal atresia; prematurity 1 week Cerebral haemorrhage 9 hours Acute pneumococcal meningitis 4 months Prematurity 19 hours Prematurity 2 hours Hydropsfoetalis 50 minutes INFANT MORTALITY RATE The following table shows the death rate of infants under one year of age per 1,000 live births. Year Deaths under 1 year Surbiton England and Wales (Smaller Towns) 1949 21 23.54 30.0 1950 22 26.31 29.4 1951 17 20.21 27.6 1952 15 18.42 27.6 1953 18 21.02 24.3 1954 9 11.02 25.0 : 1955 17 22.36 24.9 1956 12 15.76 23.8 1957 9 11.58 23.0 1958 14 16.14 22.5 10. INFECTIOUS DISEASES The table shows the incidence of infectious diseases during the past ten years. NOTIFICATIONS 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 Diphtheria - - - - - - - - - - Scarlet Fever 95 87 53 76 84 45 38 48 23 23 Typhoid Fever - - - - - - 1 - - Paratyphoid Fevers - 1 - - 9 - 1 2 - Puerperal Pyrexia - 1 4 4 3 1 1 2 2 1 Pneumonia 15 11 19 12 34 14 19 18 32 6 Erysipelas 2 5 2 5 6 4 3 4 3 2 Poliomyelitis 5 8 2 2 3 2 8 1 6 - Encephalitis 1 - - - - - - 1 - - Meningococcal Infection - 1 6 4 1 2 2 2 2 - Ophthalmia Neonatorum - - - - 2 - - - - - Dysentery - 140 62 - 10 12 25 289 202 28 Malaria - - - - - - 1 - - - Food Poisoning 8 9 11 11 11 5 4 13 9 20 Measles 601 342 1,069 538 790 114 998 228 838 362 Whooping Cough 102 176 163 204 139 41 70 78 41 8 TOTALS 829 780 1,392 856 1,083 249 1,169 686 1160 450 The list of compulsorily notifiable diseases by General Medical Practitioners in the Borough is as follows:- Cholera Diphtheria Dysentery Encephalitis (Acute) Enteric (Typhoid or Paratyphoid) Fever Plague Pneumonia, Acute Primary Pneumonia, Acute Influenzal Poliomyelitis (Acute) Puerperal Pyrexia Relapsing Fever Erysipelas Malaria Measles Membranous Croup Meningococcal Infection Ophthalmia Neonatorum Scarlatina or Scarlet Fever Smallpox Tuberculosis Typhus Whooping Cough Food Poisoning (or suspected Food Poisoning) Leprosy (specially) 11. AGE GROUPS OF NOTIFIED CASES OF INFECTIOUS DISEASES Disease Under 1 1 - 2 3-4 5 - 9 10 - 14 15 - 24 25 - 44 45 - 64 55 and over Age unknown TOTAL Scarlet Fever - 6 15 1 1 - - - - 23 Enteric or Typhoid Fever - - - - - - - - - - - Paratyphoid Fever - - - - - - - - - - - Puerperal Pyrexia - - - - - 1 - - - 1 Pneumonia 1 - - - - 1 2 2 - - 6 Erysipelas - - - - - - - 2 - - 2 Poliomyelitis - - - - - - - - - - — Encephalitis - - - - - - - - - - - Meningococcal Infection - - - - - - - - - - - Dysentery - 2 4 8 3 2 5 - - 4 28 Food Poisoning 2 - 4 3 6 1 2 2 - - 20 Measles 4 47 98 191 11 4 1 1 - 5 362 Whooping Cough - 3 2 3 - - - - - - 8 AGE GROUPS OF NOTIFIED DEATHS FROM INFECTIOUS DISEASES Disease Under 1 1-2 3-4 5 - 9 10 - 14 15 - 24 25 - 44 45 - 64 65 and over Age unknown TOTAL Pneumonia - - - - - - - 3 37 - 40 NOTE; Total deaths include transferable deaths occurring outside the district which are not included in the total cases notified. 12. INFECTIOUS DISEASES. Sickness benefit, contacts or carriers of infectious disease. Under the National Insurance Act, 1946, sickness benefit will, in certain circumstances, be payable to persons who are deemed to be incapable of work through being contacts or carriers, although not actually ill themselves. Only exceptionally is it necessary to require contacts or carriers of infectious disease to stay away from work, and then only in the case of more serious infections. The Medical Officer of Health may issue a certificate where there is a special risk saying such a person should absent himself from his employment for a time; and it is in such circumstances that the right to draw sickness benefit is occasioned. Benefit will only be paid on the production of a certificate by a Medical Officer of Health that the person is under medical observation by reason of being a carrier of infectious disease, or has been in contact with a case of infectious disease (as the case may be) in circumstances which make it advisable to exclude him from work. This Act applies particularly to food handlers, e.g. persons employed in cafes, canteens and restaurants. During the year two such certificates were issued. DIPHTHERIA. The Borough has now been free from cases of diphtheria since 1946, and if parents will continue to take advantage of the immunisation service offered, there is no reason why the disease should not be entirely stamped out. The responsibility for providing this service rests with the County Council by virtue of section 26 of the National Health Service Act, 1946, and the Medical Officer of Health, who is also the Divisional Medical Officer for the County Council, organises the service within the Borough. Clerical work on immunisation is conducted in the Public Health Department on behalf of the County Council for which 35% of a clerk's salary is reimbursed. Arrangements also exist with general medical practitioners to carry out diphtheria and whooping cough immunisation. A doctor taking part is expected to send records to the Authority of the immunisation carried out in the course of his general medical service; the Authority provides the record cards and pays a fee to the doctor for each completed record card received. Doctors are able to collect prophylactic material from the Public Health Department or from the Central Public Health Laboratory at Colindale. Diphtheria Immunisation Clinics are held at:- Gosbury Hill Clinic 1, Gosbury Hill, Hook. Telephone; Elmbridge 5737. South Place Clinic, Ewell Road, Surbiton. Telephones: Elmbridge 4897. Friday mornings at 11 o'clock. Monday mornings at 11 o'clock. lor Diphtheria immunisation may be carried out by patient's own Doctor, as described above). 13. DIPHTHERIA IMMUNISATION The number of immunisations carried out during the year was as follows:- Age Group Primary Immunisations during 1958. Reinforcement doses during 1958. Age under 1 year * 575 - Age 1 year 134 132 Age 2 years Age 3 years Age 4 years Age 5-9 years 90 1,030 Age 10 - 14 years *This figure includes children born in 1957 but still under 1 year when immunised in 1958. The following table sets out the number of children immunised in each of the last five years:- Year Primary Immunisations Reinforcements. 1954 746 284 1955 737 132 1956 741 298 1957 691 1,399 1958 799 1,162 14. The number of immunisations carried out between 1st January, 1944 and 31st December, 1958, is shown below:- Under 1 1958 1-4 1954-1957 5-9 1949-1953 10-14 1944-1948 Under 15 Total. A. Number of children whose last course (primary or booster) was completed in the period 19541958. 213 2,510 2,454 1,789 6,966 B. Number of children whose last course (primary or booster) was completed in the period 1953 or earlier. - - 1,808 2,761 4,569 C. Estimated mid-year child population. 850 3,115 8,627 12,591 Immunity index 100 A/C. 25.05 80.57 49.18 55.32 Notes The Immunity Index is the number of children immunised (primary or booster) during the last five years (total of item A.) expressed as a percentage of the total estimated mid-year child population (total of item C.) This represents an improvement on the figures for 1957 and reflects the value of the work done in 1958. Continued special efforts must be maintained to raise the total figures of immunised persons up to about 75 or 80% of the total population. SMALLPOX Whilst this disease only appears in this country at rare intervals it is still prevalent in many parts of the world and its introduction here is an ever-present threat. Its seriousness is such that the simple precaution of vaccination ought not to be neglected even though it is no longer compulsory to vaccinate infants. Patients of all ages can be vaccinated by their own doctors, whilst children are also dealt with at the Clinics under the control of the Surrey County Council. Calf-lymph for vaccination is obtainable from the Central Public Health Laboratory at Colindale. 15. The number of persons who were vaccinated or re-vaccinated during 1958 was:- Age Groups Under 1 1 2-4 5-14 15 or over. Total Vaccinations 633 22 19 16 54 744 Re-vaccinations - 1 8 28 240 277 Calculations show that by the end of 1958 some 73% of children born between 1st July, 1957 and 30th June, 1958, have been vaccinated. This is a very satisfactory figure. SONNE DYSENTERY The following table shows the number of cases occurring during the past nine years since first recognition of this disease in Surbiton:- 1950 140 1951 62 1952 - 1953 10 1954 12 1955 25 1956 289 1957 202 1958 28 Personal hygiene is of the utmost importance in prevention of spread, especially the washing of hands after use of water-closets and before eating. W.C.s should be kept scrupulously clean, seats, chain-pulls and door handles in particular being frequently washed with disinfectant. Schools are naturally associated with the dissemination of the illness, but without doubt it also spreads rapidly through households once introduced. It is therefore regarded as a "family" illness necessitating checking of all contacts. This is readily done in the laboratory by examination of faeces, but the task of controlling an outbreak is a major operation calling for close co-operation between laboratory, medical practitioners, teachers, parents and Public Health Department staff. No person who has been a confirmed case (child or adult) is regarded as reasonably free from liability to spread infection until three consecutive negative specimens have been forthcoming. There is much evidence of reversion after two negatives and even of this occurring more than once with the same patient. 16. Sonne Dysentery is a highly infectious disease which can he fatal in very young children, and because of the rapidity with which it spreads it is necessary to move quickly in applying control measures when a case occurs if a large outbreak is to be prevented. The greatest chance of success comes when no time is lost in recognising the condition and notifying it to the Public Health Department so that preventive action can be initiated without delay. POLIOMYELITIS. It is a great pleasure to record that for the first time since 1949 no case of poliomyelitis was notified in the Borough. Figures since 1949 are given below:- Year No. of cases. Deaths. 1949 6 2 1950 8 1 1951 1 - 1952 2 1 1953 3 - 1954 2 - 1955 8 - 1956 1 - 1957 6 - 1958 — - Arrangements are made whereby doctors may collect anti-poliomyelitis vaccine from the Public Health Department, and this facility is very much appreciated and used. At the end of the year good progress had been made towards the protection by vaccination of the priority groups for which vaccine had been issued by the Ministry of Health. These groups were, and are, at the time of writing - (a) Children and young persons born on or after 1st January, 1933 providing that in the case of babies they have reached the age of six months; (b) Expectant mothers. Vaccination consists of one simple initial injection given into the arm followed approximately four weeks later by a second, and after a period of seven months by a third. 17. FOOD POISONING There were no outbreaks of food poisoning and no deaths from this cause. In twenty confirmed cases notified by general practitioners the causative organisms were identified as shown below;- S. Aureus 5 cases. S. Enteritidis 1 case. S. Infantis 1 case. P. Morgani 1 case. S. Newport 1 case. S. Typhi-murium 11 cases. Although every effort is made to trace the source of infection, it is for several reasons very difficult to do so in these sporadic cases. The investigation of an "outbreak" is an entirely different proposition and is in many ways much easier. Of the twenty cases referred to above nine were the only members of their household affected. In family groups there were one of three persons, one of four persons and two of two persons. One of the isolated cases was a child attending a London school and concerned in an outbreak arising from the mid-day meal. Two more of the isolated cases were almost certainly infected whilst away on holiday. One mother and her baby derived their infection from a raw egg. In the remaining cases no source of infection could be traced. The ages of the twenty persons were as follows:- Adults 4 16 years 1 14 years 2 12 years 1 11 years 3 10 years 1 7 years 1 6 years 2 3 years 3 Babies 2 20 18. LABORATORY FACILITIES Extensive use is made of the facilities provided by the Public Health Laboratory Service (directed by the Medical Research Council for the Ministry of Health); and opportunity is taken to gratefully acknowledge the co-operation of Doctor D.M. Stone and her staff at the Epsom Laboratory to which our specimens are taken. Apart from samples of water, milk, ice-cream and other food (details of which are given under other headings) the undermentioned specimens were collected by the Inspectors in the course of investigating cases of dysentery, typhoid, food poisoning, etc. and taken to the Laboratorys:- Year Faeces Suspected Food. 1951 694 2 1952 183 15 1953 129 12 1954 263 8 1955 306 10 1956 3,704 6 1957 2,256 24 1958 610 13 EXCLUSION FROM SCHOOL Eightyfour certificates were issued excluding and re-admitting school cases and contacts of infectious diseases. 19. TUBERCULOSIS At the end of the year 349 persons were shown to be suffering from tuberculosis and living within the district: Sex Pulmonary Non-Pulmonary Males 195 13 Females 121 20 Age Periods NEW CASES DEATHS Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary M F M F M F M F Under 1 - - - - - - - - 1-4 - - - - - - - - 5 - 14 - - - 1 - - - - 15 - 24 7 5 - 1 - - - - 25 - 34 10 12 - 1 1 - - - 35 - 44 10 8 1 - - 1 - - 45 - 54 10 1 - - 2 - - — 55 - 64 3 1 - - 4 - - - 65 and over 3 1 - - 5 2 — - Of the 75 new cases tabulated above 38 were transferred from other districts. At the commencement of the year there were 390 cases of tuberculosis on the register and at the end of the year this figure had decreased to 349. During the year 54 were notified as recovered from the disease, 45 left the district, there were 15 deaths and 2 were found to be non-tubercular. It is pleasing to record that 349 persons remaining on the Tuberculosis Register at the end of the year is the lowest for the last ten years. 20. Cases added to Register. Ward Primary Notifications Transfers, etc, Cases on Register 31st Dec. 1958 1956 1957 1958 1956 1957 1958 Berrylands 3 2 6 5 5 7 32 Chessington 13 5 7 8 4 4 79 Hook & Southborough 4 4 4 9 5 8 65 Seething Wells 5 - 3 10 3 2 19 St. Mark's 3 3 3 6 6 7 39 Surbiton Hill 5 2 2 6 8 11 26 Tolworth East 4 - 1 1 3 3 27 Tolworth West 5 4 3 1 4 1 24 Tolworth South 4 3 2 - 4 1 38 Totals 46 23 31 46 42 44 349 The table below shows the number of cases on the register at the end of the year for the past ten years. Ward 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 Berrylands 47 41 37 43 50 45 43 32 25 32 Chessington 62 59 56 74 80 89 77 89 86 79 Hook & Southborough 68 80 74 95 85 74 87 79 75 65 Seething Wells 34 24 26 23 20 21 22 28 24 19 St. Mark's 38 34 41 46 48 54 46 47 50 39 Surbiton Hill 42 26 39 29 30 30 29 27 28 26 Tolworth East 56 39 42 48 50 45 41 35 32 27 Tolworth West 27 36 37 35 41 38 32 33 30 24 Tolworth South 50 49 46 41 48 50 56 43 40 38 Totals 424 388 398 434 452 446 433 413 390 349 21. 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. Mass Radiography The Mass X-ray Unit visited the Borough twice during the year. On the first occasion it came to Chessington during the 27th to 31st January, and 1,165 people were examined. The second survey was carried out at the Co-operative Hall, Broadway, Tolworth, from 5th to 19th February, when 2,309 people were examined. Patients may be seen at the Chest Clinic for the area which is at 27, Queen's Road, Kingston Hill. Telephone No. Kingston 6251. The times of the clinics are as followss:- Mondays at 9.30 a.m. Tuesdays at 9.30 a.m. and 2 p.m. Wednesdays at 2 p.m. Thursdays at 9.30 a.m. and 2 p.m. Fridays at 9.30 a.m. Kingston and District Tuberculosis Care Committee. This is a local voluntary Committee which raises funds and dispenses them to aid tuberculous families. It works with the Surrey County Council official services and is formed from representatives of the four District Councils in the North Central Division together with other interested persons. During the year 1958 an amount of £1,468 was spent on giving help to eightynine families of which twentyseven were Surbiton families. MEDICAL EXAMINATIONS During the year 73 persons were medically examined for the Council in connection with staff entering the Superannuation Fund or Sick Pay Scheme, or about to go on pension, as follows:- Superannuation Fund. Sick Pay Scheme Special Examinations 29 39 5 22. WELFARE OF OLD PEOPLE There is in the Borough much voluntary activity devoted to this cause. The work is co-ordinated through the Surbiton Old People's Welfare Committee, a voluntary body representative of most walks of life and presided over by His Worship the Mayor. The Committee received a considerable stimulous to its efforts during the year by the leasing to it by the Borough Council of a large house which, after extensive works of repair and re-decoration, was opened in September as a Centre for old people, including club rooms, recreation rooms, handicraft room, chiropody clinic, canteen, office, etc. The acquisition of this property should enable the Committee to expand its activities which cover such things as chiropody service, weekly clubs, daily centre, seaside holidays, distribution of Christmas gifts and visiting of the house-bound. A meals on wheels service is operated by the Surbiton Division of the British Red Cross Society, and the Council makes a generous contribution towards the cost involved. The number of subsidised mid-day meals distributed during the year was 4,463. The Borough Council has provided twenty-eight special flatlets for aged people, and a further sixty such dwellings are under construction. CO-ORDINATION OF HEALTH AND OTHER SOCIAL SERVICES. In 1957 a committee of the Council was formed to consider and report upon methods of co-operation between the Town Council and other bodies concerned with the health and other social services within the Borough, to assist if required in the co-ordination of such work, and to examine ways of encouraging recruitment of more voluntary workers. The need for such work was indicated by the consideration of the Housing Committee of the previously published report of the Working Party of the Surrey County Council on the Prevention of Break-up of Families. The work of the Committee will take considerable time and is divided among three sub-committees which met during the year (i) Youth Sub-Committee, (ii) Marriage Guidance and Problem Families Sub-Committee, (iii) Health and Welfare Services. It is hoped that when the many voluntary social bodies working in the town know that the Town Council is actively interested in co-ordinating social welfare, they may more readily give information on their activities to the Corporation so that others may learn and assist. By this means all available effort may be concentrated and directed where need is greatest. It is hoped also that the official workers when confronted with an emergency case which they cannot immediately resolve may call on voluntary workers to render special emergency help which otherwise might not have been forthcoming. 23. NURSING IN THE HOME (District Nursing) The Headquarters of the District Nursing Association is at 21-23, Upper Brighton Road (Telephone No. Elmbridge 3027) where application should be made for the services of a district nurse or midwife. Such applications have to be supported by the family doctor under whose direction all home nursing is given. The District Nursing Services are administered by the Surrey County Council through the Divisional Medical Officer who is also Medical Officer of Health for Surbiton. ANTE-NATAL CLINICS The ante-natal clinic can serve as the focal point of all activities relating to the expectant and nursing mother. The health visitor from the ante-natal clinic follows up the case in its own home for the purpose of advising and helping the expectant mother in all matters relating to pregnancy. Mothers are also encouraged to attend these clinics after their confinement to make sure that full health and normality is restored. This service is additional to and designed to supplement that which an expectant mother is entitled to receive from a general practitioner and midwife. HOME HELP SERVICE. Persons desiring to avail themselves of this service should apply, supporting their application with a medical certificate, to the Divisional Medical Officer, The Health Centre, Grange Road, Kingston-on-Thames, who will arrange for the Divisional Home Help Supervisor to visit and investigate the application. 24. WATER SUPPLY The whole of the water supply for the Borough comes from the Metropolitan Water Board and is satisfactory both as regards quantity and quality. All premises have a direct mains supply and there are no wells in use. Monthly reports are supplied by the Board giving details of their chemical and bacteriological examinations. Six bacteriological samples were taken by the Department and all were satisfactory. This dependable first class water supply is a tremendous factor in maintaining the good health of the people of Surbiton. RIVERS AND STREAMS. For many years the Hogsmill River which forms the Borough boundary for some two miles on the eastern side has been grossly polluted by effluent from the Epsom sewage disposal works. Now sewage from that district is conveyed to the new disposal works belonging to the Hogsmill Valley Joint Sewerage Board by a new trunk sewer which passes through Surbiton, and the river is again clean. SWIMMING BATHS Publicly owned bath. Surbiton Lagoon, situated in Raeburn Avenue, is an open air pool 165 feet long and 90 feet wide, with a depth of three to nine feet. There is also a paddling pool for small children. The water is treated by continuous pressure sand filtration, sterilisation by breakpoint chlorination and oxygenation over an ornamental cascade. Periodical samples of water are taken by the Borough Engineer and the plant adjusted as necessary. In addition fourteen samples were taken by the Public Health Department for chemical and bacteriological examination all of which proved to be satisfactory. School bath. One private school has a small swimming bath which is used only by scholars and staff. Sterilisation is by hand dosing with chlorine coupled with frequent changes of water. Six samples were taken by the Department to ensure adequate chlorination and fitness for bathing. REFUSE COLLECTION AND DISPOSAL. Refuse and salvage collection is under the control of the Borough Engineer. The collection was maintained at seven day intervals except when interfered with by holidays and sickness. The refuse is transported to a central loading depot in the Royal Borough of Kingston-upon-Thames, transferred to large haulage wagons and then moved under contract for disposal into privately owned pits. 25. FACTORIES ACTS, 1937 and 1948. The total number of factories on the register at the end of the year was 265 (231 mechanical, 26 non-mechanical, and 8 works of building construction). Exactly five hundred visits were made to these premises and work was carried out to remedy contraventions found as under:- Particulars: No. of cases in which defects found and remedied; Want of cleanliness 1 Insufficient sanitary conveniences. 12 Defective, dirty or inadequately lighted sanitary conveniences. 50 Other offences, etc. 8 26. FACTORIES ACTS, 1937 and 1948 (cont.) Ten certificates were issued under section 34 of the Factories Act, 1937, that the factories to which they related were provided with such means of escape in case of fire for the persons employed therein as may be reasonably required in the circumstances. There were 64 outworkers on the register at the end of the year. Sixteen visits were made but no infringements found. 1. INSPECTIONS for purposes of provisions as to health (including inspections made by the Public Health Inspectors.) Premises. Numbers on Register. Inspections Written Notices Occupiers Prosecuted. (i) Factories in which Sections 1,2, 3,4 and 6 are to be enforced by Local Authorities. 26 32 - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority. 231 411 12 - (iii)Other premises under the Act (excluding outworkers' premises). 8 57 3 - Total 265 500 15 - 27. factories acts ,1937 and 198 (cont.) 2. Cases in which DEFECTS were found- Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred to H.M. Inspector By H.M. Inspector. Want of cleanliness (S.1 ) 1 1 - - - Overcrowding(S.2) - - - - - Unreasonable Temperature(S.3) - - - - - Inadequate Ventilation (S.4) — — — — — Ineffective drainage of floors(S.6) — — — — — —Sanitary conveniences ( S.7) (a) insufficient 12 12 - - - ("b) Unsuitable or defective 50 50 - 2 - (c) Not separate for sexes - - - - - Other offences against the Act(not including offences relating to Outwork) 8 . 8 1 1 - TOTAL: 71 71 1 3 - 3. Outwork (Sections 110 and 111) Nature of Work Number of outworkers in August list required by section 110(1)(c) Number of cases of default in sending lists to the Council. Number of prosecutions for failure to supply lists. Number of instances of work in unwholesome premises Notices served. Prosecutions. Wearing apparel (Making etc. cleaning and washing). 25 - - - - - Umbrellas, etc. 1 — - - - - Lampshades 38 - - - - - TOTAL 64 - - - - - 28. COMPLAINTS. During the year 1,251 complaints were received with regard to the undermentioned matters, were duly investigated, and any necessary action taken. Choked and defective drains 372 Insanitary and dilapidated condition of premises 37 Dampness 25 Defective or insufficient W.C. accommodation 12 Defective water pipes or fittings 6 Insufficient or defective refuse bins 6 Offensive smells from various causes 28 Offensive accumulations 3 Nuisances from animals improperly kept 1 Unwholesome food 16 Infestation with bugs or fleas 10 Infestation with other insect pests 44 Infestation with rats or mice 611 Smoke nuisances 12 Flooding 29 Miscellaneous 39 TOTAL:- 1,251 The number of complaints received in the Department during the previous ten years was:- 1957 1,230 1952 1,093 1956 1,210 1951 1,059 1955 1,157 1950 1,083 1954 905 1949 1,007 1953 1,037 1948 986 VISITS MADE BY INSPECTORS. Number of dwelling houses inspected for housing defects (under Public Health and Housing Acts) 247 Number of dwelling houses visited for purposes other than housing defects 1,532 Number of visits to premises other than houses 2,245 Premises re-inspected 1,549 Visits to works in progress 665 Visits re. rats and mice 6,721 Visits re. Rent Act 354 Visits re. Civil Defence 85 Miscellaneous visits 707 14,108 29 VISITS MADE BY INSPECTORS (Cont.) Included in the aforementioned are the following classified visits To food premises and vehicles 570 " cowsheds 15 " dairies and milkshops 37 " milk vehicles 53 " ice cream premises and vehicles 151 " bakehouses 37 " butchers' shops 168 " fish friers' premises 14 " factories 463 " workplaces 8 " outworkers' premises 16 " schools 129 " caravans 90 " council houses 47 11 piggeries 7 Re. cases of infectious disease (including dysentery, tuberculosis and food poisoning) 1,037 " overcrowding or possible overcrowding 23 " Shops Act 123 " Rag Flock Act 2 " Pet Animals Act " Heating Appliances (Fireguards) Act 11 " Clean Air Act 50 Smoke observations made 17 Interviews with owners, tradesmen, etc. 208 Samples of swimming bath water taken 23 Samples of drinking water taken 6 Visits re. Aged People 59 TESTING OF DRAINS AND SANITARY FITTINGS. Drains tested with water 77 Drains tested by other methods 19 Drains examined under section 48, Public Health Act, 1936 Nil NOTICES SERVED, LICENCES AND CERTIFICATES ISSUED. Informal and verbal notices 363 Statutory notices under section 287, Public Health Act, 1936, to enter premises 1 Statutory notices under section 75, Public Health Act, 1936, to provide sufficient dust receptacles 1 Statutory notices under section 93, Public Health Act, 1936, to abate nuisances 8 Statutory notices under section 277, Public Health Act, 1936, requiring information as to ownership of premises 11 Statutory notices under section 159, Housing Act, 1957, to enter premises 45 Statutory notices under section 170, Housing Act, 1957, requiring information as to ownership of premises 5 30. NOTICES SERVED. LICENCES AND CERTIFICATES ISSUED (Cont.) Statutory notices under sections 16 & 17, Housing Act, 1957 - Notice of Time and Place for consideration of condition of House liable to be made subject of Demolition or Closing Order 6 Statutory notice under section 17 (1) Housing Act, 1957 - Closing Order in lieu of Demolition Order in respect of a house 1 Licences to station and use moveable dwellings (section 269, Public Health Act, 1936) 39 Licences under the Pet Animals Act, 1951 3 Statutory notices under Rent Act, 1957 - Notices by Local Authority to Landlord of Proposal to issue a Certificate of Disrepair (Form J.) 57 Certificate of Disrepair under Rent Act, 1957 (Form L) 32 Statutory notices under Rent Act, 1957, - Notice by Local Authority to Tenant of Proposal to cancel a Certificate of Disrepair (Form N.) 16 Statutory notices under Rent Act, 1957 Cancellation of a Certificate of Disrepair 13 Statutory notices under Rent Act, 1957 Certificate as to the Remedying of Defects specified in a Landlord's Undertaking to remedy Defects (Form P) 19 Statutory notices under Rent Act, 1957 - Notice of decision by Local Authority to refuse to cancel a Certificate of Disrepair 2 TOTAL 622 HOUSING 1. Inspection of dwelling houses during the year (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 247 (b) Number of dwelling houses (included under sub-heading (a) above) which were inspected and recorded under the Housing Consolidated Regulations 1925 and 1932 61 (c) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 2 (d) Number of dwelling houses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit 175 31. HOUSING (Cont.) 2. Remedy of defects without service of Formal Notices:- Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their officers - (including some from previous years) 200 3. Action under Statutory Powers A. Proceedings under sections 9, 10 and 16 of the Housing Act, 1957:- (i) Number of dwelling houses in respect of which notices were served requiring repairs. Nil (ii) Number of dwelling houses which were rendered fit after service of formal notices:- (a) by owners (from previous year) Nil (b) by Local Authority in default of owners Nil B. Proceedings under Public Health Acts (i) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 5 (ii) Number of dwelling houses in which defects were remedied after service of formal notices (a) by owners (including some from previous year) 8 (b) by Local Authority in default of owners. Nil C. Proceedings under section 17 (1) of the Housing Act, 1957. (i) Number of dwelling houses in respect of which Closing Orders in lieu of Demolition Orders were made 1 (ii) Number of dwelling houses demolished in pursuance of Demolition Orders. Nil D. Proceedings under Sections 18 and 27 of the Housing Act, 1957:- (i) Number of parts of buildings or underground rooms in respect of which Closing Orders complied with by vacation of premises Nil (ii) Number of such premises in respect of which Closing Orders were determined, the premises having been rendered fit Nil 32. HOUSING (Cont.) 4. Legal Proceedings. It was necessary in one case to apply to the Magistrates to secure compliance with an abatement notice under Section 93, Public Health Act, 1936, requiring repairs to a dwelling house. The Magistrates made an Order requiring the owner to abate the nuisance within twenty-eight days and the owner duly complied. DETAILS OF SANITARY IMPROVEMENTS ETC. EFFECTED DURING THE YEAR. Drainage. Choked drains and sewers cleared 298 Defective drains repaired 36 Drainage systems completely relaid 3 Drainage systems partly relaid 11 Additional drains provided 16 Cesspools abolished 5 Water Closets, etc. Additional provided 14 Cleansed and repaired 62 New pans fixed 11 Lighted, Ventilated or Screened 19 Flushing cisterns repaired or renewed 15 Chemical closet abolished 1 Sinks. Baths, etc. New fixed 33 Waste Pipes, etc. Repaired 11 New provided 13 Disconnected or trapped 2 Water Supply Water re-instated 1 Service pipes and cisterns repaired, etc. 6 Paving Yard paving repaired or relaid 6 Dust Receptacles. New dustbins provided 20 Dampness Roofs repaired 59 Gutters and rainwater pipes repaired or renewed 48 Ventilation provided under floors 1 External walls pointed or rendered 11 Walls treated with damp resisting material 42 Site concrete provided 2 Damp course fixed 7 33. DETAILS OF SANITARY IMPROVEMENTS ETC. EFFECTED DURING THE YEAR (Cont.) General. Windows repaired or renewed 153 Doors repaired or renewed 19 Floors repaired or renewed 28 Stoves and coppers repaired or renewed 21 Internal walls and ceilings repaired 51 Rooms ventilated 7 Staircases repaired or provided with handrails 3 Chimney stacks and pots repaired or renewed 25 Statutory entries made in rent books 8 Overcrowding abated 4 Accumulations removed or covered 8 Nuisances from animals abated 1 Shops Act infringements corrected 4 Heating Appliances (Fireguards)Act infringements corrected 1 Food stores constructed or ventilated 2 Dangerous walls removed or made safe 3 External painting 3 Ditch cleansed 1 Open areas provided 4 Dangerous fences repaired 2 Nuisance from fumes abated 1 Rooms cleansed and redecorated 30 Miscellaneous 35 NOTES: (i) Further details will be found under headings "Food Premises", "Factories", etc. (ii) No works carried out as a result of action under the Rent Act are included above. IMPROVEMENT GRANTS. The Council continued to operate this scheme in cases (a) where new housing accommodation would be provided by the conversion of an existing building, (b) where additional accommodation was to be provided by adding rooms, and (c) where it was intended to improve the sanitary arrangements and/or the system of water heating. Seventeen applications for grants were received during the year. Fifteen were recommended by the Council but one owner did not take up the grant. Two applications were rejected. The amounts granted together with works approved are detailed below:- Serial No. Amount Granted: Approved works: £ s d 89 100 - - i Provision of bathroom, internal W.C., hot water system and ventilated larder. 34. IMPROVEMENT GRANTS.(Cont.) Serial No. Amount Granted: Approved Works: £. s. d. 90 100 - - Conversion of small "back "bedroom into "bathroom, alteration of W.C. so that it may "be approached from inside the house; provision of hot water system and ventilated larder. 92 81 . 12. 8. Provision of "bathroom,hot water system and indoor W.C. 93 100 — - Provision of "bathroom, hot water system, food cupboard and covered approach to W.C. 95 100 - - Conversion of storage building into a bathroom, provision of hot water system, ventilated food cupboard, and covered approach to W.C. 96 100 — — Provision of bathroom, inside W.C., ventilated larder and hot water system. 97 100 - - Provision of new kitchen, and bathroom/WC. on the ground floor so that the existing bathroom/W.C. on the first floor could be used as a third bedroom. 98 100 - - Building a single storey extension to form a bathroom, separate internal W.C., provision of hot water system, and new larder. 99 100 — — Conversion of a back bedroom into a bathroom/W.C. and provision of hot water system. 100 364 — — Conversion of house into two separate self-contained flats. 35. IMPROVEMENT GRANTS.(Cont.) Serial No. Amount Granted: Approved Works. £ s d 101 100 — — Provision of bathroom/WC. new larder, and hot water system. 102 100 — — Provision of bathroom/WC. and hot water system. 103 98 7 11 Conversion of storeroom into bathroom/WC. and provision of hot water system. 104 100 — — Conversion of coal store/ outside W.C. to a bathroom and internal W.C. Provision of hot water system and a ventilated food cupboard. The figures for previous years were:- Year: Applications received: Grants approved: Not taken up: 1957 15 13 — 1956 14 9 1 1955 19 12 3 1954 21 15 3 1953 7 6 3 1952 5 3 1 1951 3 3 1 1950 4 4 — 36. RENT ACT, 1957. This Act and its accompanying regulations came into operation on 6th July, 1957. The Council delegated to the Public Health Committee its powers relating to Certificates of Disrepair, and this materially helps in dealing with applications in the expeditious manner which is so important in common fairness to the parties concerned. The position up to the end of the year is shown in the following summary:- Year 1958 Period 6th July to 31st Dec. 1957. (l) No. of applications for Certificates of Disrepair(Form I) 56 61 (2) No. of decisions not to issue Certificates. 1 3 (3) No. of decisions to issue Certificates- (a)in respect of some but not all defects listed by tenants 36 40 (b)in respect of all defects listed 13 12 (4) No. of undertakings to remedy defects given by landlords under paragraph 5 of the First Schedule (Form K.). 34 27 (5) No. of such undertakings refused by Council Nil Nil (6) No. of notices of proposal to issue a Certificate of Disrepair served (Form J.) 57 52 (7) No. of Certificates of Disrepair issued (Form L.) 32 10 (8) No, of applications by tenants under consideration at the end of the year (Form I) 1 6 (9) Applications by landlords to Local Authority for cancellation of certificates (Form M.) 16 Nil (10) Objections by tenants to cancellation of certificates 9 Nil (11) Decisions by Local Authority to cancel in spite of tenants' objections 2 Nil (12) Certificates cancelled by Local Authority 13 Nil (13) Refusals to cancel Certificates of Disrepair 2 Nil (14) Certificates as to remedying of defects specified in landlord's undertaking (Form P.) 19 Nil Dealing with applications by tenants and landlords has brought its problems, but despite the complications involved, it can be said that there have been no serious troubles and, so far, no appeals in which the Council has "been concerned. There can he no doubt that a great deal of repair and redecoration of houses has taken place as a result of this Act-much of it without recourse to the Council. 37. FOOD INSPECTION. Foodstuffs of all descriptions are constantly under inspection to see that they are fit for human consumption. During the year a variety of foods which were not fit were surrendered by the owners and destroyed by burning or salvaged for animal feeding.. The total weight of such goods was:- 15 cwts: 2 qrs: 16 lbs: 6 ozs. There is no slaughterhouse in use in the Borough, consequently no meat inspection is carried out except in butchers' shops. Twenty-three samples of various kinds of food were taken for bacteriological examination as a routine measure to check on fitness for food. FOOD HYGIENE. Forty-three premises are registered tinder section 16 of the Food & Drugs Act, 1955, for the preparation or manufacture of sausages, or potted, pressed, pickled or preserved food intended for sale, and ten premises for the preparation of preserved food intended for sale for human consumption (being the preparation of fish by any process of cooking). 1,030 visits were made to these premises and to shops, canteens, restaurants, public houses, food handling businesses, and vehicles to ensure the maintenance of a proper standard of hygiene and to examine food intended for sale. The following works were carried out to meet the requirements of the Food & Drugs Act, byelaws and other legislation:- Protection of food from contamination 12 Hot water supply provided for washing 14 Sinks and basins provided 8 Waste pipes repaired or renewed 3 Floors repaired or renewed 2 New draining beard and walls tiled 2 Reconstruction of kitchen 1 Service pipes and cisterns repaired etc. 1 Internal walls and ceilings repaired 6 Rooms ventilated 1 Food rooms cleansed 35 W.Cs. cleansed or repaired 9 New pans fixed 3 W.Cs. lighted or ventilated 1 Drains cleansed, repaired or renewed 7 Drains partly re-laid 1 Dust receptacles provided 12 Refuse storage improved 1 Accumulations removed 5 Paving repaired 2 Name and address displayed on vehicle 2 Miscellaneous 19 38. FOOD HYGIENE (Cont.) Whilst the standard of hygiene has been maintained at a reasonably satisfactory level, it is a subject which calls for constant attention by the Inspectors. No prosecutions were taken during the year. Reference was made in last year's report to street trading and delivery of unwrapped foods from vehicles. No real improvement has been observed, and there seems little likelihood of a change for the better until either the public take a different view of such things or new legislation is introduced to make enforcement action possible. There is no doubt that the street trader has a great attraction for a lot of people particularly as his wares are invariably cheaper than current shop prices, and the question of hygiene is completely disregarded by those who patronise such traders. Delivery of unwrapped bread by roundsmen cannot be regarded as a hygienic operation, but the public still expect the service and do not seem interested in how it is effected. During the year the Council gave consideration to the problem of dogs in food premises and decided to issue to traders small official notices suitable for display on windows or doors worded as follows:- "In the interest of hygiene you are requested not to bring your dog into premises in which food is sold". All food traders were sent copies of this notice and invited to display it, and whilst a large number welcomed it and were pleased to make use of it, there were a number who felt unable to take such a step for fear of losing customers. This difficulty had been expected and there would seem to be no way of overcoming it except to make it an offence for dogs to be brought into food premises by customers. 39. FOOD & DRUGS. The following is a summary of samples taken during the year for analysis "by the Public Analyst:- Sample Nos. Articles Analysed Total Contraventions Formal Informal Formal Informal Total 1966 Vitamin K Tablets — 1 1 1967 Creamed Rice) Milk pudding) — 4 4 1970 2055 2065 1968 Glucose powder with Vitamin D. — 1 1 1969 Sterilised cream — 1 1 1971 Ground white pepper — 1 1 1972 Chop sauce — 1 1 1973 Dried mixed herbs — 1 1 1974 Chopped prime chicken — 1 1 — 1 1 2072 Chopped chicken — 1 1 — 1 1 1975 Cough pastilles — 1 1 1976 Liquid apples — 1 1 1977 Milk 11 \ 2 13 1978 1982/4 2012/5 2017 2030/2 1979/80 Pork sausages 3 3 6 2002 2033 2049 2051 1981 Beef sausages 2 4 6 2 — 2 2048 2050 2052/4 2016 Preserved Beef chipolatas 1 — 1 1985 Coffee and chicory essence 1 — 1 1986 Pilchards in tomato — 1 1 1987 College Pudding — 1 1 1988 Lemon juice — 1 1 1989 Peppermint — 1 1 : 1990 Ohewing gum — 1 1 1991 Frankfurters — 1 1 1992 Vitaminised iron tonic tablets — 1 i 1 1993 Wizard bag (confectionery) — 1 1 2066 fruit flavoured drages (confectionery) — 1 1 1994 Honeycomb mould jelly — 1 1 i 1995 Sherbet — 1 1 1996 Baking Powder — 1 1 1997 Anadin tablets — 1 1 1998 Buttered cheese spread — 1 1 1999 Table jelly — 1 1 2000 Love hearts (confectionery) — 1 1 Carried forward 18 39 57 2 2 40. FOOD & DRUGS (CONT.) Sample. Nos. Articles Analysed Total Contraventions Formal Informal Formal Informal Total Brought forward 18 39 57 2 2 4 2001 Cream of celery soup — 1 1 2003 Yeast tablets — 1 1 2004 Oranges — 1 1 2005 Dried fruit mixture (washed) — 1 1 2006 P.R.Tablets — 1 1 2007 Clear chicken soup — 1 1 2008 Ravioli in tomato sauce — 1 1 2009 Meringue powder — 1 1 — 1 1 2010 Liver and bacon paste — 1 1 2011 Indian curried mutton — 1 1 2018 Sweet matches — 1 1 2019 Sal volatile — 1 1 2020 Juno junipah — 1 1 2021 2058/61 Sardines in oil — 5 5 — 2 2 2062 Brisling in olive oil — 1 1 2022 Powdered gelatine — 1 1 2023 Breadcrumbs — 1 1 2024 Oranges — 1 1 2025 Skimmed condensed milk — 1 1 2026 Pork luncheon meat — 1 1 — 1 1 2027 2083 Butter — 2 2 2028 Pish cakes — 1 1 2029 Ice cream — 1 1 2034 Baked beans with pork sausages — 1 1 2035 2079 Double Devon cream — 2 2 2088-9 Double cream — 2 2 2036 French coffee — 1 1 2037 Jelly crystals — 1 1 2038 Tea — 1 1 2039 Cider vinegar — 1 1 2040 Sausage rolls — 1 1 2041 Orange drink — 1 1 2042 Plain chocolate for diabetics — 1 1 2043 Diabetic pastilles — 1 1 2044 Strained cream fish — 1 1 2045 Fruit dessert — 1 1 2046 Strained apples — 1 1 2047 Strained tomato soup — 1 1 2056 Tinned peaches & pears — 1 1 2057 Cake fruit mixture — 1 1 2063 Figs — 1 1 2064 Ground almonds — 1 1 2067 Marzipan — 1 1 2080 Marzipan substitute — 1 1 2068 Steak and kidney pie — 1 1 2069 Piccalilli — 1 1 2070 Sparkling Orange — 1 1 2071 Scotch broth — 1 1 2073 Plain Flour — 1 1 2074 Marmalade — 1 1 2075 Frozen fresh peas — 1 1 2076 Lemons — 1 1 Carried forward: 18 98 116 2 6 8 M. FOOD & DRUGS (Cont.) Sample Nos. Articles Analysed Total Contraventions Formal Informal Formal Informal Total Brought forward: 18 98 116 2 6 8 2077 Evaporated fullcream milk — 1 1 2078 Chewing gum — 1 1 2081 Cochineal — 1 1 2082 Tomato sauce — 1 1 2084 Cameron Syrup — 1 1 2085 Single cream — 1 1 2086 Sterilised cream — 1 1 2087 Currants — 1 1 TOTALS: 18 106 124 2 6 8 The Analyst's report and details of action taken on contravening samples were as follows:- 1974 (informal) Chicken, chopped. Contained only 80% of chicken meat instead of a reasonable minimum of 95%. The manufacturers explained that their attention had been drawn to this description and for some months they had used new labels bearing the name "Chopped Chicken in Jelly". The sample was no doubt taken from an old supply of this article. The explanation was accepted by the Council. 2009 (informal) Meringue Powder. Misdescription of an ingredient. This article is stated to contain milk solids as an ingredient, but it contained only about 1½% of skimmed milk powder. Manufacturers stated that the matter had already been brought to their notice and revised wording was being used on new packets which would be brought into use. 1981 (formal) Sausage, beef. Contained an added preservative, namely sulphur dioxide amounting to 200 parts per million by weight. These sausages were made by a local butcher and enquiries revealed that he did not add preservative directly but there was some already in the seasoning which he used. He was given a warning and undertook in future to exhibit a proper notice in his shop indicating that his sausages contained preservative. 42. FOOD & DRUGS (Cont.) 2026 (informal) Pork Luncheon Meat Contained only 57% of meat instead of a reasonable minimum of 90 per cent. Matter taken up with importers who stated that they themselves were dissatisfied with the article and were no longer handling it and had, in fact, not done so since October,1956. They were surprised that any of this luncheon meat was available for sale at this late date and it was obviously old stock. 2021 (informal) Sardines in Oil. Contained 1.5% of salt, the presence of which was not specified on the label as required by the Labelling of Food Order,1953. Matter taken up with importers who agreed that in future the cans would bear the words "Added Salt". 2072 (informal Chopped Chicken. Contained only 87% chicken meat instead of a reasonable minimum of 95%. Matter taken up with the manufacturers, and at the time of the preparation of this report the correspondence is still proceeding. 2060 (informal) Sardines in Olive Oil. Contained 1.0% of salt which was not declared on the label as is required by the Labelling of Food Order, 1953. Matter taken up with the importers who undertook to amend wording on cans as soon as present stocks exhausted. Contained only of meat instead of a reasonable minimum of 50%. When purchased the sausages bore a label indicating that the meat content was 35 to 40%. The Council decided to take no further action. FOOD & DRUGS ACT, 1955. Foreign bodies in food. During the year a number of complaints about food containing foreign substances were received in the Department and the following were considered by the Public Health Committee and dealt with as indicated:- (i) Mould in steak and kidney pie: A resident complained about the condition of a steak and kidney pie purchased at a local shop. The observations of the company concerned were considered and the Council decided that a warning letter be sent to the retailer. (ii) Mould on sausages: A resident complained about the condition of some skinless beef sausages purchased at a local shop. The observations of the shopkeeper were considered and the Council decided to send a warning letter to the shopkeeper. 43. FOOD AND DRUGS ACT, 1955. (Cont) Foreign bodies in food (Cont.) (iii)Mould in Eccles cakes: A resident complained about the condition of two Eccles cakes purchased at a local shop. The observations of the Bakery Manager of the firm concerned were considered by the Council who decided that a warning letter be sent in this case. (iv) Wasp in Rusk. A resident had complained about a dead wasp found in a rusk purchased at a local shop. The observations of the manufacturers were submitted for consideration of the Council who decided that a warning letter be sent to the manufacturers. MILK SUPPLY. (i) At the end of the year there were forty-one entries on the register as follows:- Distributors of milk with premises in the Borough 24 Distributors of milk with premises outside the Borough but retailing in the Borough 9 Premises registered (used as Dairies) 8 (ii) Milk (Special Designation) (Raw Milk) Regulations 1949 - 1954. Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations,1949-1953. Dealers' licences to sell designated milk were granted as follows:- Pasteurised milk 19 " " (supplementary) 9 Tuberculin Tested milk 17 " " (supplementary) 8 Sterilised milk 18 " " (supplementary) 9 (iii) Ninety-six samples of milk were taken during the year and submitted to the following tests:- Turbidity Test T.B. Biological Test Methylene Blue Test Phosphatase Test Pasteurised — — 51 51 T.T. Pasteurised — — 16 16 Sterilised 8 — — — Tuberculin Tested — — 3 — T.T. Raw Milk — 12 — — Raw T.T. (C.I.)Milk — 6 — — The phosphatase test indicates that pasteurisation has 44. MILK SUPPLY (Cont.) (iii)Cont. been properly carried out; the methylene blue test is used to determine cleanliness and keeping quality; the turbidity test is a check on sterilisation and the T.B. test is for the purpose of detecting tubercle bacilli. The samples for T.B. test were taken at farms in the Borough. All samples conformed to the required standard. Dirty milk bottles: (i) A local resident complained about the dirty condition of two milk bottles delivered to her house. The observations of the suppliers were submitted, and the Council decided that a strong warning letter be sent to them. (ii) A complaint was made by a local resident concerning the dirty condition of a milk bottle delivered to his house- and the Council decided in this case to institute proceedings against the distributor. The case was heard in 1959, but it is convenient to record here that the distributors were fined £5. and the Council awarded £3.3.0. costs. ICE CREAM. (i) Registration: 173 premises are registered by the Corporation under Section 16, Pood & Drugs Act, 1955, as under:- For manufacture, storage and sale 8 For manufacture, storage and sale but manufacture to be limited to iced lollies 13 For storage and sale but not manufacture 152 (ii) Samples: 68 samples were taken, details being as follows:- Ice Cream. Grade 1. 63 98.44% 100% Grade 2. 1 1.56% Grade 3. Nil Grade 4. Nil 64 Iced Lollies Grade 1 4 100% 68 45. ICE CREAM (Cont.) (ii) Samples (cont.) The Public Health Laboratory Service advises that owing to the numerous factors governing the hygienic quality of ice-cream it is unwise to pay too much attention to the "bacteriological results on any single sample. Judgment should be based rather on a series of samples. It is suggested that over a six monthly period, 50% of a vendor's samples should fall into Grade 1, 80% into Grades 1 or 2, not more than 20% into Grade 3, and none into Grade 4. The results above show that a very high standard of hygienic quality is being maintained both by manufacturers and retailers. There are now no manufacturers of ice cream within the Borough. CLEAN AIR ACT, 1956. The greater part of this Act which is "an Act to make provision for abating the pollution of the air" came into force on 31st December, 1956, and the remaining sections on 1st June, 1 958. There are already a number of explanatory memoranda, orders and regulations to supplement the Act which together make a formidable contribution to the duties of local authorities and their officers. A number of the provisions are new and some even revolutionary. In a district such as ours where atmospheric pollution is not of a serious nature it calls for much earnest consideration before tendering advice to the Council upon some of the procedure prescribed, particularly the establishment of smoke control areas which would involve heavy expenditure of public monies. The year under review was therefore used as a period in which the situation was studied and assessed. It became apparent that the supplies of smokeless fuels were quite inadequate to meet the normal voluntary demand therefor; it was indeed something of a surprise to find that so many householders had already become "wedded" to the premium smokeless fuels and were annoyed that they could not obtain them throughout the winter. The use of coke on open fireplaces appeared to be negligible and the quality of such fuel which could be obtained was not generally suitable for such fireplaces. The review of the position continued into the Spring of 1959 when a comprehensive report was submitted to the Council, and this, together with results accruing therefrom, will be commented upon in next year's annual report. 46. MOVEABLE POLLINGS. Thirty-nine licences to station and use moveable dwellings (caravans) were granted during the year. The local Sports Club which holds the lease of the Riverhill Estate was granted permission to increase the number of caravans from 24 to 36, subject to the additional 12 being taken from offending sites in the Borough or elsewhere in Surrey. This condition was imposed by the County Council under Planning powers in furtherance of its policy to reduce the number of permanent caravan dwellers in the County. Most of the standings on the extended site were occupied by the end of the year and applicants for the remaining site were being considered. Of the 39 licences issued 35 were in respect of the Riverhill site and 1+ for caravans stationed on odd sites throughout the Borough. The unlicensed site referred to in previous reports, having been compulsory acquired by the Council for housing purposes, was closed during the year. DUSTBINS. Twenty dustbins were provided as a result of statutory and informal notices served. The ambiguity of the Public Health Act which provides that the local authority may require either the owner or occupier of any building to provide a dustbin still gives rise to difficulties necessitating a judicial decision by the Council in all disputed cases. The one case so decided by the Council was accepted by the parties concerned and was not the subject of an appeal to the Magistrates. DISINFECTION. (a) During the year disinfection was carried out at forty-three premises in which the following diseases occurred:- Poliomyelitis (suspected) 9 Tuberculosis 12 Scarlet Fever 5 Chicken Pox 1 Whooping Cough 1 Miscellaneous 15 Disinfection was also carried out at twenty premises on request, the occupier in each case paying the cost. 47. DISINFECTION (CONT.) (b) The total number of articles disinfected by steam at the Tolworth Hospital, or destroyed was:- Disinfected Destroyed. Blankets 32 — Bolsters 3 3 Mattresses 9 6 Mattress covers 2 1 Pillows 46 9 Pillow cases 15 — Sheets 16 3 Wearing apparel 45 8 Counterpanes 7 2 Miscellaneous 14 5 189 37 (c) No. of rooms disinfected 81 No. of library books disinfected 40 DISINFESTATION. (a) Bed Bugs, etc. Council Houses Other Houses Found to be infested Disinfested Found to be infested Disinfested Bugs 2 2 4 4 Fleas — — 2 2 Lice — — 2 2 Method employed for disinfestation:- Spraying with insecticide 10 (b) School Canteens. At the request of the Surrey County Council thirteen school canteens were sprayed with insecticide to prevent flies and other insect pests, the County Council paying the cost of the work. (c) General. Advice is frequently sought from the Department in the identification and measures for eradication of insect pests of various kinds. For the convenience of the public a small stock of insecticides and sprayers is held in the Department, and these articles are sold at cost price when required. This service seems to be very much appreciated. PUBLIC MORTUARY. During the year 79 bodies were received into the mortuary for post-mortem examination. 48. NATIONAL ASSISTANCE ACT.1948. It was not necessary to make any burial arrangements as provided by Section 50 of the Act. It was not necessary to make use of the powers of Section 47 for compulsory removal to suitable premises of sick or aged persons in need of care and attention. SHOPS ACT, 1950. One hundred and twenty-three visits were made in the administration of this Act, and four infringements corrected. "Shop" for the purposes of this Act is a very comprehensive term and includes any premises where any retail trade or business is carried on. The number of such premises in the Borough at the end of 1958 was:- Antique dealers and secondhand furniture 10 Bakers 19 Boots and shoes 35 Builders and Decorators supplies 25 Butchers 38 Cafes and Restaurants 38 Chemists 23 Confectioners, newsagents and tobacconists 94 Cycles, radio and television 25 Dairies 8 Drapers and Ladies'Outfitters 48 Electrical supplies 10 Fishmongers and Fried Fish Shops 16 General Stores 12 Greengrocers, Fruiterers, and Florists 50 Grocers and Provision Merchants 83 Hairdressers 47 Hardware, Ironmongery and Timber 20 Licensed Premises 50 Motor and Cycle Dealers and Engineers 26 Tailors and Outfitters 22 Upholsterers and House Furnishers 12 Watchmakers and Jewellers 9 Miscellaneous 72 792 The present unsatisfactory state of the law with regard to shops is to be deplored. The 1950 Act is merely a consolidation of legislation passed between 1912 and 1938 and is to a large degree outmoded. Further, there have been many decisions given by the Courts which have rendered much of the Act virtually incomprehensible and consequently inoperable. It seems most desirable for the sake of traders, public and local authorities, as well as for Inspectors trying to carry out their duties in a state of confusion, that the situation should be straightened out at an early date. 49. THE HEATING APPLIANCES (FIREGUARDS) ACT,1952. This Act which prohibits the sale,o.r letting, of certain heating appliances without an effective fireguard, together with Regulations made by the Secretary of State, became operative during 1 954. Eleven visits were made to premises in the Borough and one warning given where such an appliance was not satisfactory. The offending appliance was withdrawn from sale. THE PET ANIMALS ACT, 1951. This Act is designed "to regulate the sale of pet animals". Three premises were licensed during the year. Eleven inspections were made but no infringements of the licence conditions found. RATS AND MICE DESTRUCTION. The Ministry of Agriculture, Fisheries and Food continued its grant-aid of 50 per cent of the irrecoverable expenditure incurred by the Council in carrying out its functions under the Prevention of Damage by Pests Act, 1949. The Act places upon the occupiers or, in certain circumstances the owners, of land (including buildings) the responsibility for the destruction of rats and mice thereon and for keeping the land free from such pests. It is the duty of the Council to carry out inspections to see that this is done, and to secure so far as practicable that their district is kept free from rats and mice. Where necessary they may serve upon owners or occupiers notices requiring them to take steps for this purpose and penalties are laid down for failure to comply with such notices. The policy of the Council is, however, to give such assistance as is possible to the occupiers of private dwelling houses. For that purpose they permit their own small rodent control staff, who are primarily engaged to deal with Corporation property (including sewers) to give advice and practical help where appropriate, without charge, subject to the signing of the "Request for Treatment" form. The Council is under no legal obligation to do this and does not undertake to provide a service for the destruction of vermin, but does allow its staff to help so far as time permits. Many requests are received and are responded to as quickly as possible, and in the order received as far as practicable, but at times it is as long as a week before complaints can be dealt with. 50. RATS AND MICE DESTRUCTION (Cont.) Every effort is made to give householders the „best possible service with the staff available. Grant-aid is not available in respect of expenditure incurred on treatment at commercial and industrial properties and the full cost of the work has therefore to be recovered from the occupiers of such premises or, in certain circumstances, the owners. Forty-eight business or industrial premises, schools, etc. were treated by the Council's staff on payment of the cost involved by the occupiers or owners concerned. The figures which follow indicate the extent of the v/ork carried out during the year. It seems that the rodent population is being kept down to as low a level as is likely to be achieved until new techniques are evolved and perhaps new poisons introduced. During April/May the 16th maintenance treatment of the Corporation's sewer system was carried out, in October the Tenth annual test baiting of the sewer system v/as completed and this was followed up with the 17th maintenance treatment in December. ANNUAL TEST BAITING; No. of Manholes baited. Takes of bait Percentage of takes Initial 1947/8 384 64 16.666 Second 1948 160 13 8.125 Third 1949 229 8 3.493 Fourth 1950 250 9 3.600 Fifth 1951 200 11 5.500 Sixth 1952 201 7 3.487 Seventh 1953 179 7 3.91 Eighth 1956 162 10 6.173 Ninth 1957 167 7 4.191 Tenth 1958 156 10 6.41 51 . VISITS Private Dwellings Business Premises Agricultural Property Corporation Property Sewers Totals Total No. of visits (a) SURVEYS. Re. complaints 555 54 2 10 — 621 Under Prevention of Damage by Pests Act, 1949. 473 54 1 22 — 550 1028 108 3 32 1171 No access (re complaint) 117 2 — — — 119 No access (re Pests Act) 62 — — — — 62 Miscellaneous 79 5 — 3 — 87 268 (b) TREATMENTS 1439 No. of visits 3977 473 — 237 — 4687 4687 No. of properties treated 499 48 — 21 — No. of somploted treatments 597 57 — 31 — (c) SEVERS. 16th Maintenance treatment) (28 manholes poisou baited) 259 259 17th Maintenance treatment) 49 manholes poison baited) 321 121 580 Annual Test baiting Treatment of seweis in conjunction with surface infestations. 7 7 7 (d) OTHER VISITS. 11 6,724 2. SURVEYS REVI.II.). Premises infesteu. with rats 537 40 2 27 606 Premises infested with mice 43 15 — 2 60 Premises not infested 448 1028 53 108 1 3 5 22 505 1171 52 The following is a summary of the several treatments carried out since disinfestation of Sewers coinmonced in 1948;- Date Description No. of Manholes Pre-baited. Takes of Pre-bait No. of Manholes Poison baited. Takes of Poison bait. April 1948 1 at Initial treatment 218 77 77 31 July 1948 2nd „ „ 77 14 10 8 February 1 949 1st Maintenance treatment 80 49 49 18 July 1949 2nd „ „ 71 20 24 7 March 1950 3rd „ „ 58 41 41 21 July 1950 4th „ „ 41 20 22 13 Februar.v 1 951 5 th „ „ 57 17 17 15 August 1951 Otll „ „ 35 14 14 6 February 1 952 7 th „ „ 69 36 36 15 July 1952 8 th „ „ 58 14 14 4 February 1 953 9 th „ „ 54 13 13 8 February 1 954 10th 47 1 6 16 8 August 1 954 11th „ „ 16 7 7 5 December 1955 12th „ „ 21 18 18 14 December 1956 13th „ „ 61 52 52 38 May 1957 14tn „ „ 49 15 13 8 May 1 957 14th „ „ — — 4+ 2 November 1957 15th „ „ 36 13 13 9 November 1 957 15 th „ „ — — 18 + 9 April/May 1958 16th „ — — 28+ 3 December 1 958 17th „ „ — — 49+ 26 Direct poisoning with Warfarin. 53- JR1/68