YIE 2 E INTELL. LIBRARY Yiewsley Urban District Council. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH, FOR THE YEAR 1925. Uxbridge: Wescott and Son, Printers. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH, 1925. To the Chairman and Members of the Yiewsley Urban District Council. Gentlemen, I beg to submit to you my Fifth Annual Report as your Medical Officer of Health. GENERAL STATISTICS. The area of the District is 899 acres. The population (estimated by the Registrar-General) for the middle of 1925 is 5,599. Number of inhabited houses (1925) 1,203. Number of families or separate occupiers, 1,500. Rateable value £37,715. Sum represented by a penny rate £111. PHYSI0CAL FEATURES. The District is flat and low lying, with clay and gravel subsoil The Grand Junction Canal runs through the District. The Rivers Colne and Frays pass through the District. WATER. The district is supplied by the Rickmansworth Valley Water Company, the water being pure and wholesome. It is hard but not above the average for drinking purposes. The Stockley area 4 of the Urban District is supplied from shallow wells. There have been no complaints as to the quality of the water during the year. FOOD. (a) Milk Supply. Some of the milk is supplied by local farms, the remainder from farms outside the district. The milk is generally of good quality and no complaints have been received. The cleanliness of cows, premises, and utensils is most important. Milk (Mothers and Children) Order, 1919. Doctors and Midwives have been authorised to recommend the supply of milk to suitable cases. (b) Meat. There is no public abattoir, but the private slaughter-houses and facilities for inspecting meat at the time of slaughter are satisfactory. During the year the Public Health Meat Regulations have come into force, and the following carcases have been destroyed as unfit for food. 1 Cow's Liver, Hydatid 1 Liver. tuberculosis 1 Pig's Head, tubercular 3 Lungs, tuberculosis 3 Pigs' Carcases, tubercular 1 Heart, diseased 1 Pig's Carcase, over driven 2 Pigs' Carcases, swine fever (c) Other Foods. In regard to the sanitary condition of premises where food is manufactured, stored, etc., no defects were discovered. Adequate power exists for dealing with sanitary conditions in premises where foods are stored or exposed for sale. SOCIAL CONDITIONS. The population which is steadily increasing is composed of young persons working in Factories and on Railways in the neighbourhood. 5 EXTRACTS FROM VITAL STATISTICS OF THE YEAR. Births. There is a slight decrease in the birth-rate in the Yiewsley area. Birth Rate (R.G.) 22'86 per thousand. Birth Rate per 1,000 England and Wales 18'3. Males. Females. Total Births 128 79 49 Legitimate 76 49 Illegitimate 3 — Deaths. Total, 53; males, 29; females, 24. Death rate (R.G.) 9'46 per 1,000. Death rate for England and Wales, 12.2. Number of women dying in, or in consequence of childbirth : From Sepsis, nil. From other causes, nil. Deaths of Infants under 1 year of age: Total 11; males, 8; females, 3. Illegitimate, male 1; female 1. Deaths from Measles (all ages) nil. Deaths from Whooping Cough (all ages): Males, 4; female 1. Deaths from Diarrhoea, under 2 years of age: Male, 1; female, 1. The Death rate in Babies is remarkably low. Causes of Death. Male Female Whooping Cough 4 1 Influenza 2 1 Meningoocal Meningitis 1 — Tuberculosis of Respiratory System 3 1 Other Tuberculous diseases 1 I Cancer, Malignant disease 2 2 Cerebral Haemorrhage I — Heart disease — 5 Bronchitis 2 2 Pneumonia (all forms) 2 2 Other Respiratory diseases — 1 Ulcer of Stomach or Duodenum — 1 Diarrhoea (under 2 years) 1 1 Congenital Debility and Malformation, Premature Birth 4 — Suicide 1 — Other Defined Causes 5 6 29 24 Deaths of Infants under 1 year: Total 8 3 Illegitimate 1 1 6 NOTIFIABLE DISEASES DURING THE YEAR. Disease. Cases notified in the district. Cases admitted to Hospital. Cerebro Spinal Meningitis 1 1 Diphtheria 6 6 Small Pox — — Scarlet Fever 6 6 Enteric Fever (including Para-Typhoid) — — Puerperal Fever — — Pneumonia — — Erysipelas — — Tuberculosis— Male 5 — Female 1 — TUBERCULOSIS. NEW CASES. Age Period. Pulmonary Non-Pulmonary Male Female Male Female 0 l 1 5 1 7 8 10 12 15 20 23 1 1 25 35 1 38 44 1 45 55 61 65 and upwards to 70 4 1 1 Ophthalmia Leonotorium. There was one notified. Causes of Sickness. German Measles, Influenza, Tuberculosis and Whooping Cough. 7 SUMMARY OF NURSING ARRANGEMENTS. Hospital and other Institutions available for the District. Professional Nursing in the Home. (a) General. District Nurse Collins. (b) For Infectious Diseases, Nil. Midwives. During 1924 three Midwives notified the County Council of their intention to practice in Yiewsley, viz., Nurse Treadwell, a wholetime Midwife employed by the County Council. Nurse Montgomery, one of the County Council health visitors and School Nurses who acts as "relief" Midwife when necessary. Mrs. Fox engaged in Private Practice as a Midwife. Maternity and Child Welfare. This work is carried out by the County Council. A ''Welfare" Centre is held weekly at the Wesleyan Chapel Room ; it is under the charge of Lt.-Col. H. L. W. Norrington, one of the Assistant Medical Officers of the County Council. Mothers attend at the Centre with their infants and children under five years of age, to receive advice in the upbringing of the Children. Visits are made to the homes by the Health Visitors, in order to instruct and assist the mothers in carrying out the Doctor's advice. Dried Milk and similar articles are supplied at the Centre at cost price or less in suitable cases. The provision of dental treatment for nursing and expectant mothers is in force. ATTENDANCES AT MATERNITY AND CHILD WELFARE CENTRE. Number of Sessions held. Total No. of attendances. New Cases. Old Cases. Mothers. Babies under 1 year. Children l to 5. Mothers. Babies under 1 year. Children 1 to 5. A. B. C. A. B. C. 48 5,336 8 5 65 106 48 4 16 1,974 1,472 1,638 8 A.—Expectant Mothers. B.—Expectant Mothers who are also attending with babies or children under 5 years. C.— Mothers who are attending with babies or children under 5 years. Highest attendance 263 Lowest attendance 20 Average attendance (Mothers) 43 Average attendance (Children) 68 HOME VISITS BY HEALTH VISITOR. First Visits. Re-Visits, Expectant Mothers. Babies under 1 year. Children 1 to 5. Expectant Mothers. Babies under 1 year. Children 1 to 5. No of Homes visited. 93 187 24 182 1556 1771 2593 During 1925 a session was held each Tuesday afternoon except on public holidays. Schools. The Local Education Authority for the district is the Middlesex Education Committee. There are three Public Elementary Schools in the district, in all of which the water supply and sanitation are satisfactory, and the accommodation for the scholars is adequate. Information as to the absence of children from school on account of infectious or suspected infectious disease is supplied to the Medical Officer of Health by the School Teachers, in order that the necessary inquiries may be made and suitable action taken. Medical Inspection and Dental Inspection of children attending the schools are carried out by the Assistant Medical Officers and Dental Officers of the County Council. A Clinic is provided at Providence Road Council School, Yiewsley, for the treatment of minor ailments in school children. Dental and Opthalmia treatment also are provided, and for those purposes children are referred to special Clinics held at the Whitehall Council School, Oxbridge. 9 Tuberculosis. Under the scheme of the County Council for dealing with Tuberculosis provision is made for— (a) The Diagnosis, Supervision, and Treatment of Patients as Out Patients at the County Council's Tuberculosis Dispensaries. (b) The Treatment as In Patients of suitable cases at Residential Institutions. The facilities provided are available to residents in all parts of the County suffering from any form of the disease. Dr. Atkinson, one of the County Council Tuberculosis Medical Officers, attends weekly at the Tuberculosis Dispensary, 156, High Street, Uxbridge. Pulmonary Tuberculosis. With very few exceptions all parents in need of Institutional Treatment are accommodated at the following Institutions. Number of Beds. Type of Case. Adults Children. M. F. Middlesex County Council Sanatorium, Harefield 129 129 64 Sanatorium and 8 observation (children) Middlesex County Council Dispensary, Bell Road, Hounslow 9 7 Observation Middlesex County Council Hospital, Twickenham Road, Isleworth 40 Hospital Clare Hall, South Minns 120 66 Late Sanatorium and Hospital Surgical Tuberculosis. The County Council has six beds for Children reserved for its use at the Victoria House, Margate. In all other cases application for admission is made to one or other of the existing institutions approved by the Ministry of Health, for the treatment of Surgical Tuberculosis. In every case Institutional Treatment is provided on the basis of the payment of a suitable contribution by the patient or relatives if the means of the family justify this. 10 Full enquiry is made into the financial circumstances of each patient recommended for admission to an Institution and the amount of contribution to be asked for, decided by the Health Sub-Committee or Chairman. Hospitals provided or subsidised by the Local Authority or by the County Council. Disease. Hospitals available for the District. Supported by Situation. Nature of the present Accom'd'n. Fever Isolation Hosp. Hillingdon Small Pox Isolation Hosp. Yeading Other Diseases Cottage Hosp. Uxbridge There is no institutional provision for unmarried mothers, illegitimate infants, and homeless children in the district. Pathological specimens may be sent to a Laboratory for examination by any Medical Man in the district. The cost of these examinations is borne by the Council. Ambulance Facilities. (a) For infectious cases : Supplied by the Joint Isolation Hospital at Hillingdon. (b) For non-infectious and accident cases : One Ambulance available at Uxbridge on payment. This was used three times. A Mortuary has been built and fully equipped for the holding of Coroner's Court and for Post Mortem operations. It was used on 4 occasions. SANITARY ADMINISTRATION. List of Byelaws and Adoptive Acts in force in the District. New Byelaws with respect to new streets and buildings and nuisances have been approved by M. of H., and are now in operation. Private Street Works Act, 1892. Public Health Acts Amendment Act, 1890, Part 3. Public Health Acts Amendment Act, 1907, Part 4. 11 Infectious Diseases Prevention Act, 1890. Section 50 of part 3 P.H.A.A. Act, 1907. PUBLIC HEALTH STAFF. The Public Health Staff consists of a Surveyor, who also acts as Sanitary Inspector and a part-time Medical Officer of Health. SUMMARY ANNUAL SANITARY REPORT. Enquiries into Infectious Diseases 43 Patients removed to Hospital 43 Rooms disinfected after Infectious Disease 43 Complaints re Gipsies investigated 5 New Drains Tested 16 Petrol Stores Inspected 9 Inspections and re-inspections of new buildings in course of erection 70 House Inspections and re-inspections 237 Dumps Inspected and re-inspected 16 Dairies, etc., Inspections 25 Fried Fish Shops 24 Choked Drains cleared 5 New Dust-bins provided 10 Dampness of Walls remedied 71 Defective Grates repaired 39 Defective Windows repaired 30 Defective Chimneys repaired 8 Defective Doors repaired 12 Defective Floors and Skirting repaired 38 Defective Ceilings repaired 26 Defective Coppers repaired 7 New Sinks procured 4 Roofs repaired 18 Yard Paving relaid 13 Sink Channellings repaired 8 Pointing to Walls renewed 5 Dirty Walls cleaned 85 12 Dirty Ceilings cleaned 55 Rooms ventilated 5 Down-pipes from Roofs repaired or renewed 10 Roof Guttering repaired 11 New W.C. Pansprovided 5 Defective Fireplaces repaired 39 Defective Sashcords to Windows replaced 20 Defective Hot-water Tanks repaired — Old Drains repaired — Privies Converted to Earth Closets 9 Ventilation Shafts repaired 2 Sink Waste Pipes renewed 9 New Cesspools provided 2 Old Cesspools abolished 2 New Wells due 2 Defective Pointing to walls 42 Stair Cases repaired 2 New Covers to Inspection Chambers 1 New Window provided 1 W.C. Seats repaired 5 Foul Ditches cleansed 2 New Roof Guttering provided 18 Housing. Number of New Houses erected during the year 14 Number of New Houses as part of Municipal Scheme Nil During the year the Council have received sanction for the erection of a further 52 houses under the Housing Act, 1923, and Housing Financial Provisions Act, 1924, the work on which is now proceeding. Unfit Dwelling Houses. Number of Houses inspected under housing (Inspection of District) Regulations, 1910 Nil Number of Houses found to be unfit for human habitation Nil Number of Houses found not to be in all respects reasonably fit for human habitation 31 13 Remedy of Defects Without Service of Formal Notice. Number of Houses rendered lit in consequence of informal action 22 Action Under Statutory Powers. Proceedings undeh 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:— (a) By Owners. Nil (b) By Local Authority in default of Owners Nil Proceedings under Section 28 of the Housing and Town Planning Act. (1) Number of dwelling houses in respect of which notices were served requiring repairs 6 (2) Number of dwelling houses rendered fit:— (a) By Owners 6 (b) By Local Authority in default of Owners Nil (3) Number of dwelling houses in respect of which Closing Orders became operative in pursuance of declaration by owners of intention to close Nil Proceedings under Section 17 and 18, Housing and Town Planning Act, 1909. (1) Number of representations made with a view to the making of Closing Orders 11 (2) Number of dwelling houses in respect of which Closing Orders were made Nil (3) Number of dwelling houses in respect of which Closing Orders were determined, the dwelling houses having been rendered fit Nil 14 (4) Number of dwelling houses in respect of which Demolition Orders were made Nil (5) Number of dwelling houses demolished in suance of Demolition Order Nil Dampness. This is dealt with as it arises in course of house-to-house inspection of the District. DUMPS. The Sanitary Inspector and I have made many inspections, and although there is room for improvement I feel sure that the owners now realise their responsibility in the matter and are endeavouring to carry out the Bye-laws. It is very desirable that all dumping should cease, as there is no doubt that it is a source of serious discomfort to the neighbourhood. DRAINAGE AND SEWERAGE. The effluent from the Sewers is treated at the Cowley Sewage Farm by broad irrigation after filtration treatment in Coke beds. This Sewage Farm is governed by a Joint Drainage Committee, as it receives Sewage from the Urban District of Yiewsley and part of the Rural District of Uxbridge. CLOSET ACCOMMODATION. Practically all closets are connected to the main sewers excepting Little Britain and Stockley and the New Garden City Estate, which have cesspools; these are emptied in accordance with the Bye-laws and as far as practical with a Vacuum Cesspool Plant. HOUSE REFUSE COLLECTION. This is done weekly by the Council. Bake Houses. There are five in the area, and these are inspected regularly. There were 110 contraventions of the Factory Act reported during the year. 15 Slaughter Houses. There are five. These are kept clean and satisfactory. Cow Sheds. There is one Cowkeeper in the district. Dairies and Milkshops. There has been no defects. Premises and Occupations Controlled by Bye-Laws or Regulations. These comprise— One offensive trade, viz.:— That of tallow melting and fat boiling. Factories and Workshops. The following is a list of the factories and workshops in the District. 3 Engineering Works. 3 Cycle Shops. 6 Plumbers. 2 Foundries. 6 Boot Repairers. 1 Engraver and Metal Worker. 1 Upholsterer. 1 Photographic Works. 2 Canal Boat Works. 1 Tallow Factory. 1 Smith 5 Bakehouses. 1 Wheelwright. Admiralty Engineering Lab., West 3 Milliners. Drayton. These have been inspected during the year and notices received from the Inspector of Factories were dealt with. HOUSING. 1. General Housing conditions in the District. 1. The Council's Housing Scheme is finished and the whole of the 258 houses occupied., e.g., 134 A Type, 16 Flats, 104 B Type and 4 C Type. During the year the Council have obtained permission to add to their Housing Scheme a further 100 houses, 52 of which are in 16 course of erection, viz., 24 A Type, 28 B. Type. This will complete the scheme, as at present planned. . 2. Extent of Shortage of Houses. At present a considerable shortage exists. 2. Overcrowding. 1. Extent. The overcrowding cf bed rooms is frequent and many cottages are occupied by more than one family. In addition to the above a few houses have been erected by private enterprise. 3. Fitness of Houses. 1. (a) The General Standard of Houses is low. (b) The character of the existing defects consists of a general deterioration in the structural conditions of the older cottages and of excessive dampness. 2. Conditions so far as they affect housing as regards water supply, closet accommodation and refuse disposal. The Water supply is good, closet accommodation generally adequate, and refuse disposal does not adversely affect the housing question. 4. Unhealthy Areas. No complaints were received nor representations made under Parts 1 and 2 of the Housing Act of 1890. I am, gentlemen, Yours obediently, JOHN EVANS, Medical Officer of Health.