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20 mothers saw the medical officer and sometimes brought other children ; in 2 cases arrangements were made for the former at a maternity hospital. In this connection it would be advisable to arrange for a dental clinic for expectant mothers, and no doubt letters could be obtained admitting such cases to a dental hospital. A very successful Baby Show was held at the Ranelagh Club by kind permission of the Club Committee. TUBERCULOSIS. 98 Visits were paid to patients' homes, and contacts advised to attend the dispensary. Extra rations were also obtained for these patients. 20 Child Welfare. MEASLES. 534 Home visits were made during the spring epidemic, advice given and nursing help obtained, and beds provided at the Hospital. Deaths 15, including 2 outside the district. INFLUENZA. 66 Visits were made to the homes, and some nursing undertaken.
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With Influenza and Measles it should be mentioned that during epidemics extra nursing help is required, otherwise the ordinary work must be neglected. In recent years the extra help has been unobtainable owing to the shortage of nurses. SCHOOL AND CLINIC WORK. A good deal of the Health Visitors' time is spent at the various clinics, viz : Eye, Teeth, Medical and Attendance, some 200 visits were made. In Mortlake also 268 visits were paid to the schools and over 10,000 children examined for cleanliness ; 88 were excluded and 14 parents were prosecuted. 80 Visits were also made at the Tuberculosis Dispensary. SUGGESTIONS FOR HOME HELPS, 1. Women of good character and approved by the L.A. 2. Should have 3 months' training at a school for mothers, or at least a certificate of having attended a course of lectures on Home Nursing. 3.
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Instruction to include needlework, cooking, temperature taking, laundry, domestic economy and hygiene, and the elementary principles of sociology. 4. A register of such applicants to be kept by the L.A. 5. L.G.B. will refund half the salaries of approved and registered " Helps." The Child Welfare Committee has been reconstituted according to L.G.B. suggestion, and now contains 8 members of the Council and 4 ladies representing various women's organisations. The Day Nursery continues to do good work in the district by taking care of children whose mothers go out to work, Their Child Welfare. 21 second annual report can be obtained on application to the Hon. Secretary, Afon House, High Street, Mortlake, S.W. 14. POODS, ETC. MILK (MOTHERS' AND CHILDREN) ORDER, 1918.
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As I was appointed to administer the provisions laid down in this order, I have to report that during 1918, 33 nursing or' expectant mothers were secured an adequate supply of cow's milk and that a part of the cost was borne by the Council, in each case according to its needs. Extra Rations for Expectant Mothers have been given to such mothers as have attended the Antenatal Clinic. This order applies to meat or butter coupons. SPECIAL RATIONS FOR INVALIDS. As a Member of the Food Committee I give an opiniou on these applications as to their suitability for extra rations. TUBERCULOSIS. RATIONS. As Tuberculosis officer I have filled up many of these forms securing extra milk, fats and meats for dispensary patients. Those in hospital are also provided for liberally.
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With regard to the Margarine, about which there is some prejudice, 102 parts of Margarine are equivalent in food value to 100 parts of butter. DRIED MILK FOR INFANTS. Dried milk is extensively used at the Child Welfare Centre and found to be most satisfactory, and is infinitely safer than cow's milk as ordinarily sold in towns. There is not the danger of Diarrhoea, especially during the warmer months. The full-cream variety is always used. Scurvy and Rickets are not seen to result, but as an extra precaution the vitamines missing from fresh healthy cow's milk are supplied in the form of Virol and fruit juice. Cows' Milk will be tolerably safe when we are sure of: β€” 1. Clean Shippons, cows, and farm hands. 2. Sterilised covered Milk Pails. 22 Sanitary Administration. 3.
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No handling of the milk at the farm beyond transfer from sterilised pail to sterilised churn. 4. Rapid transit from farm to town in clean cool vans. 5. Distribution of milk to consumer in sterilised vessels, with as little handling as possible. Farmers do not understand sterilisation; this can only be done by steam jets. They only strain the milk with the result that, owing to the strainer getting foul, strained milk is 40 times worse than unstrained milk and sours more quickly. We are selling dried milk to the people generally, when, owing to deficiency in the local retail supply, they are going short ; there being no priority scheme in this district at present. The National Food Kitchen has proved a very successful undertaking. The Central Kitchen in Mortlake, and the 6 depots in the district, have been on the whole well-served, and must have effected considerable economy of food and fuel in the homes.
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The quality of the food is excellent, and the cooking also. All classes of the community have availed themselves of the advantages supplied by the Kitchen. SANITARY ADMINISTRATION. The water supply is that of the Metropolitan Water Board and continues to be of a high standard of purity. Sewerage is conducted on the water-carriage system with separate pipes for storm water. The sewage is dealt with at the works of the Barnes and Richmond Joint Station on the boundary of the Urban District and a clean effluent discharged into the Thames. This has been gone into in detail in a previous report. It is hoped that the street scavenging and dust-bin refuse will shortly be conveyed by motor vehicles to the Council's Destructor. The question of destruction of refuse versus salvage is now engaging the attention of the Council. All places where food is stored, prepared or sold, have been visited by the Inspectors who report more fully elsewhere.
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Structural and sanitary defects found on house inspection have Hospital Administration. 23 been attended to by the landlords and repaired as far as the limited labour resources are available. Under the House and Town Planning Act one basement dwelling was condemned as unfit for habitation, and others are black-listed. Should a case of Smallpox occur, it would be removed to the Guildford, Godalming and Woking Joint Hospital Boards' Hospital at Whitmoor, Surrey. HOSPITAL ADMINISTRATION. The hospital contains 58 beds, including shelters for Tuberculosis cases, and is open to receive cases of Scarlet Fever, Diphtheria, Enteric Fever, Measles, Cerebro-Spinal Fever, Meningitis, Infective Diarrhoea, Tuberculosis of lungs, and Post-Influenzal pneumonia.
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Considerable difficulty has been experienced in keeping the hospital going, owing to incomplete and inadequate nursing and domestic staffs, neither of which has been up to strength the whole year. The best women and nurses have been claimed by the War Office, and the tinge of romance about war nursing is a source of attraction to some. Apart from Tuberculosis the demand on the hospital beds has not been heavy, though the additional nursing of Pneumonia cases was a great strain on the staff. The coming year promises better in regard to the nursing staff. The garden has been made to yield considerable produce for the hospital. A considerable sum of money will have to be spent this year (1919) on repairs and decorations to the hospital as there are several years' dilapidations to make good, and reserve stock to make up. This is the result of keeping expenses down during the war, an effort not fully appreciated by those who do not administer. 24 Hospital Administration.
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The work done includes:β€” TUBERCULOSIS. Admissions 94 Carried over from 1917 11 Total 105 cases. Of these 17 cases improved and went home. 12 remained in the same condition and went home. 10 got worse and went home at own request. 19 sufficiently improved to be recommended for further treatment in a Sanatorium. 26 died. 3 were re-admitted, and the balance remain in the hospital. The Local Cases included in the above numbers are :β€” Mortlake 12 Improved 8 Died 4 Barnes 4 Improved 2 Died 2 DIPHTHERIA Five cases carried over from 1917. Admitted 28 cases (6 from one School) Died 3, including one case brought in dying. SCARLET FEVER. 13 cases carried over from 1917. Admitted 25 cases. Died 1, " Return Case " 1. "
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Septic Throats "β€”Admitted either as Diphtheria or Scarlet Fever. 5 cases. 1 Death. MEASLES. Admitted 6 cases (4 from one school). No deaths. CEREBROSPINAL FEVER. 1 case admitted, recovered 25 Hospital Administration. ENTERIC FEVER. 1 case carried over from 1917, recovered. INFLUENZAL PNEUMONIA. Admitted 12 cases. Died 4. 2 of the cases were "expectant mothers"; in one case the infant was born prematurely and survived, after attention at the Dav Nurserv. LABORATORY. The number of bacteriological examinations made at the Council's laboratory during the year are set out below. Result. Diphtheria. Typhoid Fever. Pulmonary Tuber- " culosis. Other Diseases. Totals.
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Positive 30 β€” 29 2 61 Negative 75 β€” 96 2 173 Totals 105 β€” 125 4 234 STEAM DISINFECTOR. The number of articles disinfected at the hospital, in the steam disinfector during the year are set out below. Heavy lots 76 Light lots 50 Bedding destroyed 10 lots MORTUARY. The number of post mortem examinations and inquests made in the Council's Mortuary are set out below. Inquests 28. Residents 15 Males 10 Non-residents 13 Females 18 Verdicts. Natural Causes 9 Accidental 8 Found Drowned 6 Insane 3 Misadventure 1 Malnutrition 1 28 26 Hospital Administration. TUBERCULOSIS DISPENSARY. The Dispensary is situated in South Worple Way, just within the Hospital ground, but approached from the road.
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It is open twice weekly for sessions of two hours. Since its inception nearly 1,000 cases have been registered as attending for an opinion or diagnosis. During 1918, 130 new cases were registered many of whom were not found tuberculous. The attendances made by old and new patients during the year were :β€” Insured persons 458 Non-insured 214 Dependants 319 Total 991 The dispensary serves the double purpose of a clearing house and a treatment centre, and cases are subdivided as follows:β€” (a) No lung trouble evident. (b) Cases for observation. (c) Cases for treatment while continuing at work. (d) Cases for hospital. (e) Cases for sanatorium. (f) Cases for opinion to recruiting and pensions authorities. (g) Cases for treatment elsewhere. REPORT OP THE SANITARY INSPECTOR FOR 1918.
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1614 house to house inspections have been made, as compared with 1302 in 1917, and 4018 various other visits, as compared with 2007. 172 preliminary notices dealing with 244 nuisances were served during the year 1918, and 11 statutory notices. Landlords have been as leniently dealt with as possible during the past year, owing to the lack of labour, and notices only served where actually necessary. The Bakehouses have been well kept. The number of Factories in the District, 25; the number of Workshops, 109 : the Sanitary Administration. 27 number of Bakehouses, 24; and Domestic Workshops, 12. They are all in a satisfactory condition. Very few cases of notifiable cases of infectious disease have occurred in Hampton Square, but from its confined space, want of circulation of air and low ceiling rooms make it an unhealthy area.
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If 20 houses in the middle of the Square could be swept away, it would vastly improve the conditions. West Road is in constant need of supervision from the slackness of the Owner doing the necessary work, and from the dislike of soap and water of some of the tenants. In Barnes a block of flats in Stanton Road requires constant attention, the Landlord does little or nothing without compulsion, and consequently the houses are more or less in a dirty state, partly also the fault of the tenants. Flats are not desirable dwellings for the poorer class ; in a house of their own many can be educated up to cleanliness. Beyond the fact that St. Ann's Passage containing 20 houses, should be cleared away, and a half-dozen in Railway side, there is nothing special to call attention to. FOOD INSPECTIONS. Very careful inspections of Butchers' and Fishmongers' premises have, from time to time, been made by the Assistant Inspector.
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Seven cases of fish and five lots of butchers' meat, bacon and poultry of various weights were condemned as unfit for human food. A butcher in Sheen Lane, Mortlake, was prosecuted for having bad meat in his safe, and fined Β£20. 28 Sanitary Administration. Table showing number, and number of visits made. Factories and Workshops. BARNES MORTLAKE. TOTALS. No. Visits. No. Visits. No. Visits. A.β€”FACTORIESβ€” Brewery ... ... 1 1 1 1 Electric Light Works ... ... 1 1 1 1 Printers 1 2 1 2 2 4 Wheelwright ... ... 1 2 1 2 Motor Works 2 4 1 2 3 6 Engineering Works 1 1 1 1 2 2 Anglo-Belgian Manufac.
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Co ... ... 1 2 1 2 Beverley Works Munition "5 10 ... ... 5 10 Miralite, L.T.D. . 1 2 1 2 Goggle Manufac 1 1 . . 1 1 Aircraft Co . . 3 3 3 3 MantleWorks . . 1 3 1 3 Flour Store . . 1 2 1 2 Chocolate manufac 1 2 . . 1 2 Metropolitan Foundry 1 1 . . 1 1 STEAM AND ELECTRIC LAUNDRIES β€” Over 40 employees 1 2 1 2 B.
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β€”WORKSHOPSβ€” Tailors 4 4 7 7 11 11 Dressmakers 8 8 11 11 19 19 Shoemakers 6 6 21 21 27 27 Cycle Works 1 1 8 8 9 9 Saddlers 1 1 I 1 2 2 Smiths 2 2 2 2 4 4 Umbrella Makers . . 2 2 2 2 Upholsterers . . 1 1 1 1 Watch Makers 2 2 2 2 4 4 Metal Worker 1 1 . . 1 1 Uudertaker 1 1 . 1 1 Aeronautical Works 1 2 .
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1 2 Outworkers 12 12 14 14 26 26 HAND LAUNDRIES β€” Under 40 employees 3 6 2 4 5 10 BAKEHOUSESβ€” 3 6 9 18 12 24 C.β€”DOMESTIC WORKSHOPS Laundries 8 16 8 16 16 32 Dressmakers 6 6 6 6 12 12 D.β€”WORKPLACES - Stable Yards 4 8 6 12 10 20 Restaurants 8 16 11 22 19 38 Totals 84 121 124 168 208 289 29 School Notes. Table showing the general work done by the Public Health Department during 1918. Nature of Work Done. No. No.
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of House to House Inspections 1614 ,, Various other visits 4018 ,, Defects Notified 274 ,, Houses cleansed 60 ,, ,, ,, after Infectious Disease 16 ,, Disinfections performed 159 ,, Drains unstopped 10 β€ž ,, repaired 7 ,, Defective closet pans and traps 8 ,, ,, dust receptacles 33 ,, Flushing tanks repaired 21 ,, Cisterns cleansed and covered 24 ,, Offensive accumulations removed 3 ,, Roofs and eaves'gutterings repaired 40 ,, Dampness remedied 15 ,, Mica valves made good 7 ,, Bakehouse inspections 24 ,, Dairy and Milkshops inspections 32 ,, Licensed slaughter house inspections 56 ,, Factory and Workshops inspections 207 ,, Visits to Infectious Disease 192 ,, Complaints received 66 ,, Statutory Notices served 11 ,, Summonses to abate Nuisances 1 ,, Premises licensed for storage of Petroleum 16 SCHOOL NOTES, 1918.
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ATTENDANCE CLINIC. (Held twice weekly.) 884 attendances were made by children referred by the teachers or the attendance officer. Letters from Mr Chambers (the attendance officer) referred to 266 absentees, of whom 196 were given certificates, and are included in the total of 884. 70 children did not present themselves at the clinic, suggesting that the warning from the attendance officer, to obtain a medical certificate or attend school, had the desired effect of attaining the second objective. GENERAL TREATMENT CLINIC. Held once weekly. A small fee is payable by the parents, 30 School Notes. The diseases treated were ringworm, deafness, external eye diseases and other skin diseases. First Term 37 cases with 136 attendances. Second Term 48 cases with 260 attendances. Third Term 38 cases with 199 attendances. Total 123 cases with 595 attendances.
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Clinics are also held periodically for treatment of vision and teeth. MEDICAL INSPECTION. The routine inspection of the three age groups has gone on without interruption right through the war The re-examination of those children found defective has not been so fully conducted having consideration for the understaffed and overworked teachers This is to a large extent the work of the care committees, and thanks to their energies a large number of children have been treated for general ailments, defects of teeth and vision, enlarged tonsils, adenoids, etc.I do not agree with those who maintain that the nutrition of school children has not suffered during the war. In this district I think it has been slightly lowered. In the provinces it may be different, but I believe that the huge floating population of London has deprived the suburbs of foodstuffs.
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Eggs, milk and fruit have been scarce and very dear, the coarse bread is only nourishing when properly digested, and has been, in cases of weak digestion, unsuitable. Then again the nervous tension of the parents has been reflected upon the children in some cases. With regard to dental caries, there is ample work in this district for a whole time dentist. The dental treatment of certain age groups only, takes too long to cover the ground and many children leave school without an opportunity of getting treatment. With regard to the commoner ailments of children, I should like to see cards issued containing a brief description of the disease, the danger of neglect, and hints on simple treatment. Such cards mean much more than the note usually given to obtain treatment. School Notes. 31 Cards should be issued for the Vision, Teeth, Ear Discharge, Scabies, Ringworm, Impetigo and Malnutrition.
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(Measles, Whooping Cough and the verminous conditions, are already dealt with by leaflets). The general care and tidiness of the children has not been up to the standard usual in this district and is probably explained correctly by the fact that the mothers are much less at home owing to war conditions; and to the increased cost of clothing. It is also desirable that caretakers should be taught how to clean schools on some dustless system, either by vacuum cleaners or by the use of a dust allayer. A cleansing station has been erected in the Council's Depot for the convenience of soldiers on leave, its uses might be extended to school children suffering from Itch or verminous conditions.
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Notifications received from Head Teachers concerning children absent on account of infectious or contagious disease (sufferers and contacts) comprise the following :β€” Influenza 545 Measles 241 Mumps 207 Whooping Cough 100 Chicken Pox 42 Ringworm 21 Scabies 8 Diphtheria 4 Scarlet Fever 3 Other Diseases 4 Coughs and Colds 50 The school attendance has been greatly diminished this year owing to the prevalence of Measles in the spring term and to out. breaks of Influenza in the summer and winter terms. SCHOOL CLOSURE has been necessary on five occasions and was practically general in the schools in the district during the Influenza outbreaks in July and October. Individual schools were closed in January, February and March for infectious diseases. 3 2 School Notes.
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During the year, 973 (including 18 "special") school children were medically inspected and, of these, 372 were recommended for medical, dental or ocular treatment, some of the defects were : β€” 1. Malnutrition, 114 ; i e., below standard. 2. Uncleanliness, Head, 103; Body, 128; (chiefly want of soap and water). 3. Defective Vision, 53. 4. Defective Hearing, 26, including 5 of ear disease. 5. Enlarged Tonsils, 65, not all requiring operation. Enlarged Adenoids, 15, β€ž β€ž β€ž ,, 6. Organic Heart Disease, 8. 7. AnΓ¦mia, 21. 8. Pretubercular, 16. 9. Teeth (4 or more decayed), 155. 10.
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Skin Diseases, 36. Number of children who received medical, dental, ocular, or surgical treatment :β€” Special Inspection EYES. July 1917 to July 1918, 196 examined and 156 supplied with glasses. Special Inspection TEETH. July 1917 to July 1918, 742 recommended, 250 attended clinic. 375 refused treatment. 34 attended privately, the others failed to keep appointments. General Medical Inspection. 372 recommended and 156 treated. Children moving from one district to another or even from one school to another, come without their medical schedules very often and their previous medical record is thereby lost. Some system which will not break down should be in vogue so that when a child leaves one school for another the schedule accompanies him. MEASLES. Surprise has often been expressed by magistrates hearing school cases, that children are allowed to attend school when there is Measles in the house.
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The practice usually adopted is to exclude (a) the sufferers, (b) the contacts attending Infant schools, (c) older School Notes. 33 children if they have not had Measles. In other words children over 7 years who have had measles may attend school even though there is Measles in the house. My own view is, either let all contacts attend school, or all stay at home. Under trained supervision the former expedient should not be attended with more risk than the latter. MENTAL DEFICIENCY ACT. As Medical Inspector under the Act, 1 have examined 4 mentally defective children and recommended them for special schools or institutional treatment. In this connection the Surrey Voluntary Association for the care and supervision of the mental defective, does useful work. The Secretary is Councillor H. A. Pike, 52 St. Leonards Road, Mortlake. SANITARY.
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The schools have been inspected by the Sanitary Inspector and various small defects found and remedied. Some of the defects are architectural and permanent. In some cases the closets were not kept clean. In one school the heating apparatus was found defective and remedied. At Mortlake Council School and at East Sheen Council School part of the playground is often under water and requires asphalting and draining in each case. / APPENDEX TO ANNUAL REPORT. REGISTRAR GENERAL'S FIGURES FOR 1918. Civilian Populationβ€” For Birth Rate 35279 β€ž Death Rate 31486 Births (actually registered in the District) 438 Deaths 404 Infantile Deaths under 1 year 40 Aged Persons' Deaths 135 Deaths in Public Institutions 88 Birth Rate for Barnes 12.09 Death Rate for Barnes 12.4 Infantile Death Rate for Barnes 91.03 Death Rate for England and Wales 17.6
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BARN 54. Urban District Council of Barnes. Annual Report of the Medical Officer of Health on the Sanitary Conditions of the District during the Year 1919. Barnes, S.W.: R. W. SIMPSON & CO., LTD., PRINTERS, 15 HIGH STREET 1920. CONTENTS. PAGE Rateable Value, etc. 4 Scheme of the Public Health Department 2 Vital Statistics 28 General Features of the District 7 Analysis of Infantile Mortality 8 Hospitals 10 Drainage, Water, Scavenging 11 Schools 13 Contagious Diseases 12 Isolation Hospital 14 Tuberculosis 15 Bacteriology 16 Infectious Diseases 17 Housing 18 Child Welfare Centre 20 Health Visitors' Work 21 Staffs 22 Food and Drugs 23 Inspector's Report 23 Tables 28-31 Appendix 33 Statistical Memoranda for 1919.
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Rateable Valueβ€” Β£ s. d. Agricultural Land 1,678 0 0 Other Hereditaments 285,291 0 0 Total Β£286,969 0 0 Assessable Value Β£265,126 15 0 Barnes. Mortlake. Rates, year to March, 1920β€” s. d. s. d. Poor 4 8 4 3 General 5 0 5 0 9 8 9 3 Id. in the Β£ General District Rate produces Β£1,070. Population for Birth Rate 37,193 β€ž ,, Death Rate 35,704 Birth Rate 13.7 per 1,000 of population Death Rate 9.5 β€ž β€ž β€ž Infant Mortality 89.6 per 1,000 births Total Deaths 351 Total Births 513 Table Shewing the Various Sections of the District's Public Health Administration eithek Directly or Indirectly (through the County) under the Medical Officer of Health.
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MEDICAL OFFICER OF HEALTH. Health Department. Isolation Hospital. (Nursing and Domestic Staffs) Tuberculosis Dispensary. (With Nurse) Child Welfare Centre. (Two Nurses and Voluntary Workers) Bacteriological. School Medical Officer. (With two Nurses and Voluntary Helpers) Refkrer. Inspector of Nuisances Assistant Sanitary Inspector Assistant Sanitary Inspector Disinfector Public Mortuary Boiler House and Laundry Garden Beds for Advanced Cases (Isolation Hospital) Sale of Foods, etc. Milk Orders Laboratory at Isolation Hospital School Inspector School Attendance Clinic School Treatment Clinic Ana-sthetist to School Dentist Local War Pensions Committee Petroleum Licenses Executive Officer under "Rat Order" Nuisances Factory and Workshops Infectious Diseases Housing Insanitary Property Nuisances Foods Shops Act Insanitary Property Nuisances Clerical Housing Infectious Diseases ANNUAL REPORT. To the Chairman and Members of the Urban District Council of Barnes.
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Gentlemen, The year 1919 has been uneventful as regards Infectious Diseases. A few cases of Influenza, the remains of the 1918 epidemic, occurred, some of which being complicated by pneumonia, were treated at the Isolation Hospital. Scarlet Fever was rather more than twice as prevalent as it was in the previous two years; was part of a Metropolitan epidemic; was mild and caused no deaths. Diphtheria has not manifested itself to any extent in the District except for outbreaks in private schools, one at the end of 1918 and the other in 1919. Measles has not been severe during the year, but I have advised the Public Health Committee to keep the notification of the disease in force in the District, as it has proved a helpful measure in the past. Unfamiliar diseases have arisen as a result of soldiers returning from abroad, such as Malaria, Dysentery, Trench Fever.
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These are dealt with according to the instructions sent us from the Ministry of Health. Clinics for the treatment of Venereal Diseases are available at Hammersmith and Richmond for residents in the District. A powerful propaganda film ("The End of the Road") has been shown to selected audiences, and should, I think, with certain reservations, be shown to the public. There has been no Enteric Fever in the District beyond two imported cases ; and one case of para-typhoid fever. 6 General. Cases of mal-nutrition among School Children noticeable during the War are improving, though there is still a lack of nourishing fats, sugar and milk, which must have an adverse influence on the quickly growing child. Cancerβ€”There were 39 deaths from this disease, including 15 males, and 24 females, giving a mortality rate of 1.09 per 1,000, compared with 1.07 in 1918.
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Consumptionβ€”44 cases were notified in 1919, against 58 in 1918, and 54 in 1917. Infantile Mortalityβ€”Ante-natal causes accounted for 22 deaths out of a total of 46 infants under 1 year of age, The Population was estimated by the R.G. as 37,193 for calculating Birth Rate, and 35,704 for Death Rate figures, compared with 36,223 and 32,495, in 1917 and 1918. The Birth Rate for 1919 is 13.7, and is steadily increasing, compared with 12 in 1918, and 13.2 in 1917. The Death Hate.β€”'The residential death is 8.4, but the nett deaths belonging to the District give a rate of 9.5, compared with 12.4 in 1918, and 10.9 in 1917.
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The Natural Increase (births minus deaths) is 162, compared with 34 in 1918 and 125 in 1917. The Infantile Mortality Rate works out at 89.6 for every 1,000 births, compared with 91 in 1918. See Table III. at end of this Report, where it will be noticed that 23 of the deaths were due to Ante-natal conditions and largely non-preventable; one was due to suffocation, and under "other causes" are included those found drowned or dead, without any trace of identity. This subject has been dealt with more fully later on (see page 8). With regard to Cancer, the mortality rate has risen slightly. Deaths among males include 3 over 40 years, 3 over 50 years, 5 over 60 years, and 4 over 70 years.
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Among females, 3 were over 30 years, 4 over 40 years, 2 over 50 years, 8 over 60 years, and 7 over 70 years. 7 General. PHYSICAL FEATURES AND GENERAL CHARACTER OF THE DISTRICT. The Urban District of Barnes extends from Hammersmith Bridge to the Richmond Boundary at Manor Grove, and Upper Richmond Road, East Sheen. It covers 1,583 acres, and is 3i miles long by 1J miles broad. The Urban District includes the Ranelagh Club, reservoirs of the Metropolitan Water Board at Barnes Elms and Lonsdale Road, 600 acres of Richmond Park, 126 acres of Barnes Common, 52 acres of East Sheen Common, and 15 acres of Palewell Common. There are some 50 acres in use as Allotments, including 6 acres of Barnes Common. The District is situated in the N.W.
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corner of Surrey, and is within the Metropolitan Police and the London Postal area. Contiguous to the District are parts of Putney, Roehampton, Richmond, and the River Thames. The District lies on gravel over London clay, and rises gradually towards the Park to 64 feet above sea level. The Atmosphere is humid, especially along the river valley and in the more wooded parts of the District, severe cold is seldom experienced, the effects of heavy rains quickly disappear except in the waterlogged area drained (sic) by the Beverley Brook. The Industries of the District are (a) Brewing; (b) Driving, Conducting and Repairing Omnibuses (London General); (c) Motor Engineering; (d) Chocolate Manufacturing; (e) Market Gardening; (f) Building.
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The Census population of 1901 was 17,900, that of 1911 was 30,377 The pre-war population was 34,745, and the estimated present population 37,193; the number of dwelling-houses is 7737, but the separate tenements are computed to be 8,000. Table I. at the end of the Report, sets out the estimated population over the past five years. 8 Vital Statistics. STATISTICS FOR 1919. Birth Rate 1 Death Rate Infantile Mortality per 1,000 births Eng. and Wales 18.5 13.8 89 96 great towns 19.1 13.9 93 148 smaller towns 18.4 12.7 90 London 18.6 13.6 85 Barnes 13.7 9.5 89.6 Although these figures might be improved with advantage, we compare favourably with the rest of the country.
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ANALYSIS OP INFANTILE DEATHS. Pertussis 2 deaths Preventable. Tuberculous Meningitii 1 β€ž Non-preventable (at present). Miliary Tuberculosis 1 β€ž Non-preventable (at present). Bronchitis 3 β€ž Preventable. Broncho-pneumonia 3 β€ž β€ž Pneumonia 3 β€ž β€ž Enteritis 3 β€ž β€ž Congenital Syphilis 1 β€ž Non-preventable (at present). Suffocation (overlaid) 1 β€ž Accidental. Convulsions (ill-defined) 1 β€ž ? * Premature Birth 14 β€ž Non-preventable (ante-natal causes). Atrophy, Debility and Marasmus 3 β€ž Ante-natal causes. Congenital Malformations 3 β€ž Non-preventable. Congenital Tumour 1 ,, β€ž Hydrocephalus 1 β€ž β€ž Syncope (ill-defined) 1 ,, ?
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Body found in Dustbin 1 ,, Unascertainable. ,, β€ž River 2 β€ž Drowning. β€ž β€ž Box 1 β€ž Violence. 46 * Twins 2. 9 Vital Statistics. Infants dying in Institutions number 9, including 4 illegitimate. While the mortality of legitmate infants is 89.6 for every 1,000 births, that for illegitmate infants reaches the appalling rate of 461 per 1,000 births. Nothing can show more plainly the fate of the "not wanted" child. 5 deaths were due to Accident or Violence. Congenital Malformations account for 5 deaths. Syphilis and Tuberculosis account for 3 deaths. 17 deaths were accounted for by Ante-natal conditions on the part of the mother. Two of the deaths, viz., Convulsions and Syncope, are so illdefined as to be impossible to classify.
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So that only 14 deaths can be really classed as preventable, and coming within the scope of the work of the Health Visitors. 1 have gone into this infantile mortality in detail, because I am disappointed at the high rate of mortality. However, we cannot control deaths in Institutions, nor deaths from violence, nor those arising from malformations. What we must aim at is by advice to the expectant mother to do our best towards keeping her in good health, and helping her to go to her full term of pregnancy. Many infant deaths are the result of prevailing social conditions, such as worry, overcrowding, too short intervals between pregnancies, women working in an advanced state of pregnancy, and recreation taken without due regard to health and exercise. We have tried to secure the co operation of the Midwives in the District in regard to Ante-natal work, but have failed. The reason is not difficult to find.
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The Midwife's first business is her income and the size of her clientele, which she has no desire to lose, nor to share her responsibilities for such with another body. If the Midwives' income was made secure by the Local Authority, and a certain number of beds set aside in the District for her cases by the Local Authority, then she would probably join the Ante-natal Campaign. I am convinced that the only way to do Ante-natal 10 Sanitary Circumstances of the District. work thoroughly is by professional co operation rather than by voluntary help. POOR LAW RELIEF DURING 1919. 147 orders were issued for Medical Attendance. 78 orders were issued for admission to Workhouse and Infirmary. 26 deaths occurred among Barnes and Mortlake cases in the Workhouse Infirmary. Hospitals serving this District include:β€” The Royal Hospital, Richmond. The Putney Hospital, Putney Common. The West London Hospital, Hammersmith.
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The Isleworth Infirmary (through the Richmond Board of Guardians). The Richmond Infirmary, used by the War Office at present, will eventually revert to its original purpose, and release the Brentford Guardians of their responsibilities so far as Richmond and this District are concerned. The Isolation Hospital in Mortlake provides for the Isolation of Infectious Diseases for the Urban District, and contains 50 Beds for Scarlet Fever, Diphtheria, Enteric Fever, and Tuberculosis, the County making use of some of the beds for the latter disease. WATER. The Water Supply is that of the Metropolitan Water Board. It is constant, sufficient, and of good quality. Its plumbo-solvent action is negligible. The raw Thames water is stored to allow of sedimentation, and then filtered. It is quite likely that Chlorine will plav an important part in the purification of future water supplies.
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The system of storing drinking water in cisterns in houses is not to be encouraged, and wherever possible we get Taps off the rising Main supplied to houses. SEWERAGE AND DRAINAGE. The Water-carriage System prevails throughout the District with separate channels for storm water. The Sewage is treated at 11 Sanitary Cirbumstances or the District. the Richmond and Barnes Joint Sewage Worksβ€”the effluent discharged into the Thames and the sludge barged away. The Pumping Machinery at the Works can deal with 50 million gallons of water daily; a good deal of the rain water goes direct to the river by a special system of drains, but most of the roof water enters the sewers. The sewage is treated with chemicals, sedimented, filtered and then discharged after aeration, three to four million gallons being thus treated in the 24 hours. The residue or sludge is filtered under pressure and pressed into slabs 2Β£in.
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thick, and amounting to 7,000 tons of pressed cake annually, which is barged away and sold for agricultural purposes. I only know of three cesspools and one pail closet in the District, and these are only allowed because of the difference in level between drains and sewers. SCAVENGING. For collection of House Refuse the prevailing system is one of movable sanitary bins, which are emptied once weekly, and the contents cremated in the Council's Destructor. The resulting clinker is used for making pavement slabs in normal times. There are several fixed receptacles for refuse still in use, which tend to become untidy and leaky unless properly rendered inside and out with cement. These fixed receptacles are being gradually replaced by movable ones as opportunities arise. SCHOOLS.
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The Public Elementary Schools, with the exception of Mortlake Council Schools, East Sheen Council Schools, Lonsdale Road Council Schools, and Westfield's Boys' School, are old buildings, and do not conform architecturally to modern ideas. The sanitary arrangements are satisfactory. The Caretakers would have more control Of the dust, if Dust Allayers were used on the floors and Vacuum Cleaners run over the walls, cupboards, and hangings. There is an urgent need for a good Secondary School in this District. No Schools were closed for infectious disease during the year. 12 Sanitary Circumstances of the District. Contagious skin diseases have been prevalent. The Private Schools in the District have been systematically visited and various sanitary defects remedied.
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Medical inspection of the children should, in my opinion, be undertaken with regard to these private school children, on the same lines as that obtaining in the Public Elementary Schools; and powers granted in that direction would, I think, be of great benefit to the welfare of the children, whether day scholars or boarders. VERMINOUS AND OTHER CONTAGIOUS AFFECTIONS. It is generally agreed that during the War, home life has been altered and children neglected as far as cleanliness is concerned The mothers are often out all day, and the children get out of hand in more ways than one. The bulk of the subjects of these dirty conditions, including itch, scab and ringworm, are children of school age, and are treated by the School Authorities; it is also to some extent a Public Health question in view of recent research work. I do not see for the moment how more can be done in this District.
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The School nurses follow out the routine laid down by the Surrey Education Committee, but cannot be expected to do the actual cleansing where the mother fails. Itch, scab, and ringworm, are largely treated at the School Clinic. Itch is treated specially (when the cases will go) at the Council's Disinfecting Station with good results. The Surrey Education Committee have not recognised the necessity for a Cleansing Station for verminous children, so that *Section 122 of the Children's Act is not applicable in this respect. If the station were more used, dirty heads and bodies could be cleansed there after a trial had been given* at the child's home by his parents. Overcrowding, infected bedding, dirty hair brushes, etc., are the chief causes of failure at home.
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In this connection it is of interest to note that the earliest recorded occurrence in Britain of the bug is an account of its appearance in 1583 amongst some ladies of noble birth at Mortlake (see "Public Health Journal," January, 1920). * Plans are maturing between the C.C., and the U.D.C., for the cleans ing of children at the Council's Station in Mortlake. 13 Sanitary Circumstances of the District. SCHOOL NOTES. Children Inspected during 1919:β€” Infants. Boys 137 Girls 138 Eight Years Old. Boys 176 Girls 168 Twelve Years Old. Boys 152 Girls 142 Leavers. Boys 19 Girls 30 Specials. Boys 12 Girls 14 Re-examinations. Boys 172 Girls 181 Total Inspections, 1321. Recommended for Treatment, 346. Cases Treated at School Clinic, 130; including 74 new cases during the year.
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Attendances made at Attendance Clinic, 833. School population, 3580. Three mentally defective and two physically defective children were examined and recommended for special institutions or schools. ISOLATION HOSPITAL. There were carried over from 1918 eight cases of Diphtheria, three cases of Scarlet Fever, one case of Pneumonia, and 15 cases of Tuberculosis, 14 Infectious Diseases. The admissions were:β€” Diphtheria, 33. Laryngitis, 1; Septic Tonsillitis, 2; Follicular Tonsillitis, 1; Septicaemia, 1; sent in as Diphtheria. Pertussis, 3. Febricula, 2; 1 sent in as Scarlet Fever and 1 as Influenza. Scarlet Fever 62. Enteric Fever, 1. Erysipelas, 1.
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Post-Influenzal Pneumonia, 9. Post-lnfluenzal Bronchitis, 1; Post-Influenzal Pleurisy, 1; sent in as Pneumonia. Tuberculosis of the Lungs, 76. Total Admissions, 194. Deaths, 24 of Tuberculosisβ€”resident, 6, non-resident, 18; 1 of Diphtheria; 3 of Pneumonia. The high mortality from Tuberculosis is solely due to the advanced stage of the disease on admission. The Nursing and Domestic arrangements and duties have been satisfactorily carried out under the direction of the Matron (Miss Pearson). Those responsible for the Garden, Laundry, Disinfector, Ambulance, Mortuary, and Coroner's Court have carried out their duties satisfactorily. The Ward Blocks and other Buildings have been repaired and painted inside and out. A New Boiler has been re-instated in the Laundry.
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A Covered Way has been built on the north side of the Tuberculosis Block to afford extra protection from the weather to the patients. For Statistics, see Table 4 at the end of this Report. The Coroner's Court and Public Mortuary are situated in the grounds of the Isolation Hospital, and are the property of the District Council. The Hospital Porter acts as Mortuary Attendant. 15 Infectious Diseases. The number of Inquests held during 1919, was 33, including 17 residents, 12 non-residents, and 4 unknown. The verdicts returned were:β€” Natural causes 11 Accidental 7 Suicide 5 Found drowned 5 Murder 1 Unascertainable 4 33 TUBERCULOSIS DISPENSARY (Opened in 1911). Two Sessions of two hours each weekly are held. Total cases examined since 1911= 1,060; new cases examined in 1919 numbered 112.
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A monthly return is made to the County of old and new cases, whether insured, non-insured, or dependants, and whether recommended for Hospital, Sanatorium, or other treatment. Tuberculin is given to certain cases, and palliative medicaments, malt and oil, etc., to those requiring them. Cases referred by the Ministry of Pensions are also seen at the Dispensary, also delicate School Children referred by School Medical Officer. After going over eight years' records of children of school-age treated at the Tuberculosis Dispensary, I have come to the conclusion that out of every 1,000 School Children, six may be stated to show definite signs of Pulmonary Tuberculosis. Fuller details of this Special Report I hope to publish at an early date. Tuberculosis (pulmonary):β€” Year. Notifications. Deaths. Rate per 1,000.
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1915 60 29 .8 1916 55 35 1.09 1917 54 27 .8 1918 58 26 .8 1919 44 26 .7 It will be seen that the death rate from Pulmonary Tuberculosis is decreasing in this district. 16 Infectious Diseases. TUBERCULOSIS. Summary of work done in 1919:β€” 44 cases were notified 26 resident cases died, including 7 who died outside the District. 538 attendances were made by insured persons at the Dispensary. 223 β€ž β€ž β€ž non-insured β€ž β€ž β€ž 247 β€ž β€ž β€ž dependants β€ž β€ž β€ž 18 residents received ward or shelter treatment, 11 of whom were insured workers. 6 local cases died in Hospital. 112 new cases attended the Dispensary. 12 resident, and 43 county patients were discharged from Hospital, mostly improved. 76 cases were admitted to Hospital, including 18 residents.
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34 cases were sent from the Dispensary to either Sanatorium or Hospital, depending on the stage of the disease. 20 cases were sent out of Hospital either to Sanatorium or Dispensary, obviously improved. 261 visits were paid to patients at their homes by the Tuberculosis Nurse. 24 of the 76 cases admitted to Hospital, died in Hospital, all being in an advanced stage of Tuberculosis. BACTERIOLOGICAL WORK for 1919. Specimens examined at the Council's Laboratory at the Isolation Hospital by the M.O.H. Bacteriological Examinations. Result. Diphtheria Typhoid Fever. Pulmuuary Tuberculosis. Other Diseases. Totals. Positive 41 1 34 1 77 Negative 147 1 77 15 240 Totals 188 2 111 16 317 17 Infectious Diseases. INFECTIOUS DISEASES.
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Influenza.β€”67 cases of post-influenzal pneumonia were notified, with 24 deaths. In 1918, there were 88 deaths from influenza, including 54 of post-influenzal pneumonia. Measles and Rubella.β€”There was no epidemic in 1919, 84 cases only of measles, and 75 cases of rubella, were notified. I have recommended the Council to keep these diseases notifiable in this District.* Scarlet Fever.β€”88 notifications were received with no deaths resulting, compared with 32 cases in 1918 with no deaths, and 37 in 1917 with no deaths. Diphtheria.β€”42 cases were notified as such with 4 deaths, including one only in Hospital. Whooping Cough accounted for two deaths, both in children under 1 year. This disease was not prevalent to any extent.
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Infantile DiarrhΕ“a.β€”There were 5 deaths only from infantile diarrhoea, and the disease was not prevalent during last summer.f Enteric Fever.β€”Three cases were notified with one death (at home), an imported case. Typhus.β€”Nil. Small Pox.β€”Nil. Polio-myelitis. β€” None. Cerebro-spinal Fever.β€”Two cases were notified as such, and both died at home. The disease was not confirmed bacteriologically, "contacts" showed negative results. Malaria.β€”18 cases were notified, all amongst returned soldiers. There were no deaths. Malarial Sites have been pointed out to the Council, and treatment of the same advised. Trench Fever.β€”Three cases have been notified, but no lice found on or about the patients. Dysentery.β€”One case has been notified in a returned soldier. Encephalitis Lethargica.β€”Two cases have been notified with one death (at home).
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This disease has often been called " sleeping sickness" in the press, but is quite different from that disease. * Since approved by Ministry of Health. † Children up to 2 years of age in this case. 18 Housing. Puerperal Fever.β€”Two cases were notified with 1 death. Ophthalmia Neonatorum.β€”Three cases were notified and treated until well, with no resulting damage to the eyes. For deaths from all causes, see Table 3 at end of this Report. Also see Table 2 for the list of Infectious Diseases notified during the year. HOUSING. The pre-war population of the District was 34,745, and the present population is estimated at 37,193, and no new houses have been built, hence there is overcrowding and sub-letting. The number of dwelling-houses in the District is 7,737, of which 1,599 are of the working class type.
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There are 448 houses, intended for one family only, which are now occupied (without having been specially adapted) by two or more families. 300 new houses are required to meet the demand. 22 are required to replace those structurally unfit. 62 are required to replace those becoming unfit. Only two Closing Orders have been made for obvious reasons. It is intended to erect 42 houses during 1920, 100 more by 1922, 100 more by 1923, and 58 more by 1924. The Housing Committee are making use of the new powers conferred by the 1919 Housing Act, and a large amount of repairing work is in hand. Bye-Laws are in course of preparation to assist the Council in the proper conversion of houses, originally intended for one family, into flats for two or more families.
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There are no Common Lodging-houses in the District, but some of the houses in Stanton Road are such in fact, if not in name, and will have to be dealt with under the new Bye-Laws. Special Reports have been made by your Medical Officer on certain old property in the Mortlake High Street and in parts of Sheen Lane, with a view to scheduling the same for consideration in the near future. Hampton Square has been reported upon owing to the prevalence of Tuberculosis therein, and the congestion of the 19 Housing. houses. A plan was submitted showing that by the demolition of six houses much more air space could be obtained. West Road was dealt with more on account of general untidiness, due to litter and want of proper ash bins. Stanton Road and Beechcroft Road were reported upon as examples of houses turned into flats without proper sanitary equipment, such as a self-contained flat should contain.
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It must be borne in mind that unless the regeneration of slum areas goes hand in hand with Town Planning and new Building Schemes, there is no hope whatever of getting a result even approximately approaching Garden City Schemes. Many of the Council's Schemes are maturing, or about to mature, and it is hoped that the gross cases of overcrowding occasionally coming to our notice will soon cease to exist. It is very remarkable that Infectious Diseases have not been more prevalent than they are, since the two great factors, overcrowding and lowered resistance, have been and are still with us. It is, however, more than probable that the evil results have manifested themselves in a more subtle way in the shape of premature births, marasmus, bronchitis, and pneumonia.
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In my opinion, the rules laid down for cubic space in living and sleeping apartments and schools are antiquated, and hold that a growing child requires as much fresh air as an adult, and that every one should breathe 3,000 cubic feet of pure air per hour, or 1,000 cubic feet thoroughly changed three times in the hour. Accessory Means of Ventilation (simple and inexpensive) should obtain in every habitation by day and night. Special Housing Work in 1919 comprises the following:β€” HOUSING ACT, 1909. Complaints were received from householders re structural defects in seven cases. Under Section 17 of the same Act, 80 dwelling-houses were inspected, 28 of these were considered unfit for human habitation. None of these were rendered fit, but are awaiting Closing Orders when more houses are available. 20 Child Welfare. HOUSING ACT, 1919. SECTION 28. 34 Orders for repairs were issued.
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None of these were done by the Local Authority; no houses were voluntarily closed, and only one Closing Order was made. MOTHER AND CHILD WELFARE CENTRE. 21 Ante-natal Cases attended during the year, and made 49 subsequent attendances. 135 new Babies attended under one year of age, and made 1,546 subsequent attendances, while 42 new Children over one year of age attended, with 773 subsequent attendances. The Centre was opened on 98 occasions, and the average attendance at each Session was 25. There was no Baby Show in 1919, but a Garden Party was arranged for the mothers and children, followed by an al fresco concert. Twelve Certificates of Merit were awarded to mothers of the twelve best attended babies in the two Districts. In connection with Baby Week, a Lantern Lecture was given by the Medical Officer, and an address by Dr. Barbara Tchaykovsky.
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A great deal of Food (Infant) has been sold at the Centre, and, with the increasing numbers on the register, voluntary help has been accepted, so as to release the Health Visitors for their more professional work. The present accommodation can only be considered temporary, for in several ways it is unsatisfactory. Since the Milk (Mothers and Children) Orders of 1918 and 1919 have been in force, 103 families have been assisted in the purchase of cow's milk, where the case has, after enquiry, been found to be a necessitous one. INSTITUTIONAL ARANGEMENTS FOR MOTHERS AND CHILDREN. It is very desirable that a Maternity Home should be provided nearer home than in London, for the reception of women whose Child Welfare. 21 home circumstances are unfavourable to the confinement taking place there. A Hostel for Deserted or Unmarried Mothers with their babies has been opened at Epsom, and provides 10 beds for Surrey women.
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The Surrey C.C. have also made arrangements for the admission of mothers with children under five years into Convalescent Homes at Bexhill and St. Leonard's, upon the recommendation of Medical Officers of Child Welfare Centres. With regard to Dental Treatment for Expectant Mothers, 1 have drawn up a scheme after conference with the local dentists which might extend to the children of school age. The scheme, however, still awaits confirmation by the County.* Home Helps.β€”Advertisements were issued for women, for the work, but met with no response. The Barnes and Mortlake Day Nursery receives by the day the children of mothers who have to go out to work. HEALTH VISITORS. There are two Health Visitors, one for Barnes and one for Mortlake. An account of their work for the year is summarised below:β€” barnes. mortlake. School Visits for Inspection for Cleanliness 242 281 No. of children Inspected 13,619 13,972 No.
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of children excluded for Uncleanliness 135 90 No. of attendances at the various Clinics 76 146 β€ž ,, at Child Welfare Centre 77 75 β€ž Infant visits at their Homes 738 933 β€ž Visits re Infectious Diseases 53 102 β€ž ,. β€ž Tuberculosis 260 1 ,, Attendances at Tuberculosis Dispensary 92 5 β€ž Other Visits 143 175 ,, Babies' attendances at C. W. Centre 610 952 β€ž Mothers' β€ž β€ž β€ž 1,126 1,396 β€ž Older children's ,, ,, 372 506 * This scheme has been accepted by the County. 22 Child Welfare. PUBLIC HEALTH AND HOSPITAL STAFFS. The Public Health Department has an Inspector of Nuisances and two qualified Assistant Sanitary Inspectors, while a Junior Clerk is about to be added. Food Sampling is done by the County Authorities.
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The Shops Act is administered by one Assistant Inspector, who reports on the Shops Act and the Public Markets to the Finance and General Purposes Committee. Work done under the Housing Act of 1919 is reported to the Housing Committee; the work under the other Housing Acts is reported to the Public Health Committee. The two Health Visitors, who are fully qualified nurses, work the Notification of Births Act, do Tuberculosis visitation, and work under the County as regards Maternity and Child Welfare work and School work. The Maternity and Child Welfare Centre was initiated by the Urban District Council in 1914, and taken over by the County in 1917. Tuberculosis Dispensary and Ward Treatment were also initiated by the U.D. Council, the first in 1911, and the second in 1913, and taken over by the County in 1914. The Midwives Act is administered by the County.
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The Hospital Staff consists of a matron, a sister, 7 nurses 7 domestics, and porter and portress, with gardener, boiler attendant, handy man and assistant gardener. Two of these men are partially disabled ; but the work could be done by three ablebodied men. Child Welfare. 23 SALE OF FOOD AND DRUGS ACT. Barnes Urban District.β€”Samples Analysed, 1919. Aiticle. Number of Samples. Number Genuine. Adulterated. Proceedings Taken. Convictions. Fines & Costs.
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Β£ s. d. Milk 109 98 11 6 3 31 11 6 Coffee 2 2 β€” β€” β€” β€” Mustard 1 1 β€” β€” – β€” Raisin Wine 1 β€” 1 β€” β€” β€” Salad Oil 1 1 β€” – β€” β€” Dripping 1 1 β€” β€” β€” β€” Totals 115 103 12 6 3 Β£31 11 6 K. A. Houghton, County Inspector. Kingston-on-Thames. 17/2/20. VACCINATION. From the Vaccination Officer's Return, I note that only 50 per cent, of the infants are getting protection from small-pox by vaccination.
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REPORT OF INSPECTOR OF NUISANCES 130 Inspections have been made under the Housing Regulations, also 3,002 House to House Inspections, as compared with 1,614 in 1918, and 5,768 various other visits as compared with 4,018, 195 Preliminary Notices dealing with 441 Nuisances were served during the year 1919, and 34 Statutory Notices. The number of Factories in the District is 35 ; the number of Workshops, 90 > number of Bakehouses, 14 ; and Domestic Workshops, 37. The Dairies and Milkshops have received special attention, and on the whole are well kept. 24 Sanitary Administration. BUTCHERS, FISHMONGERS, COOKED MEAT AND PROVISION SHOPS.
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These premises are kept under constant supervision, the result being when any of these tradesmen receive a consignment of goods, and he has a doubt as to the same being fit for food, he invariably calls on the Inspector to decide. The following are results: Food surrendered and disposed of during 1919 as follows:β€”Beel, 131 stone; Heart, Liver, Spleen, &c., 59 lbs. ; Mutton, 4 stone ; Apples, 1A bushels; Rabbits, 2 dozen ; Eggs, 10 dozen ; Potatoes, 12 cwt.: Pork, 8 stone; and 2 boxes of Kippers. There is one licensed Slaughter House in the District, which is kept scrupulously clean. THE RATCATCHER Employed by the Council has accounted for 3,500 rats during the months of June to December. They appear to be prevalent all over the District.
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The banks of the river harbour a large quantity, and they have found foodstuffs in the various Allotments. The brown rat is the sp'ecies frequenting the District, and the fact of its harbouring fleas, which are the actual propagators of plague, makes it an actual danger. Continual complaints of a Smoke Nuisance from a Factory in St. Leonards Road were received during the past year. The chimney has now been heightened by 9 feet, and there has been no further complaint. Sanitary Administration. 2f Table Showing the General Work Done by the Public Health Department During 1919. Nature of Work Done. No. No.
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of House to House Inspections 3002 ,, Inspections made under the Housing Regulations 130 ,, Various other visits 576s ,, Defects Notified 441 β€ž Houses cleansed 84 ,, ,, ., after Infectious Disease 41 ,, Disinfections performed 276 β€ž Drains unstopped 27 ,, ,, repaired 7 ,, Defective closet pans and traps 9 ,, ,, dust receptacles 189 ,, Flushing tanks repaired 26 ,, Offensive accumulations removed 8 ,, Roofs and eaves'gutterings repaired 32 ,, Dampness remedied 14 ,, Mica valves made good 9 ,, Bakehouse inspections 56 ,, Dairy and Milkshops inspections 57 ,, Licensed slaughter-house inspections 71 ,, Factory and Workshops inspections 210 ,, Visits to Infectious Disease 183 ,, Complaints received 98 ,, Statutory Notices served 35 ,, Premises licensed for storage of Petroleum 19 26 Sanitary Administration. Table Showing Number, and Number of Visits Made.
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Factories and Workshops, 1919. BARNES MORTLAKE TOTALS No. Visits No Visits No. Visits Aβ€”FACTORIESβ€” Brewery ... ... 1 1 1 1 Electric Light Works ... ... i 1 1 1 Printers 1 3 1 2 ... 5 Wheelwright ... 1 2 1 2 Motor Works 1 2 ... ... 1 2 Engineering Works 1 2 6 12 ... 14 Mantle Works ... 1 3 1 3 Beverley Engineering 3 6 ... ... ... 6 Anglo-Belgian ... ... 1 2 1 2 Miralite, Ltd.
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... ... 1 3 1 3 Chocolate Works 1 5 ... ... 1 5 Automatic Film Printers 1 2 ... ... 1 2 Golf Club Maker ... ... 1 1 1 1 Flour Stores ... ... 1 2 1 2 Tennis Rackets 1 4 ... ... 1 4 STEAM AND ELECTRIC LAUNDRIESβ€” Over 40 employees 1 3 ... ... 1 3 B. -WORKSHOPS- Tailors 3 6 5 8 8 14 Dressmakers 7 14 6 12 13 26 Shoemakers 7 7 19 19 26 26 Cycle Works 1 2 2 5 3 7 Saddlers 1 1 1 1 2 2 Smiths 1 2 1 2 2 4 Umbrella Makers . .
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2 2 2 2 Upholsterers 1 1 1 1 2 2 Watch Makers l 1 2 2 3 3 Metal Worker I 2 1 1 1 2 Jacobs Oil Works I 3 1 . 1 3 Outworkers 13 26 12 24 25 50 Motor Works 2 5 4 7 6 12 Engineering Works . . 2 6 2 6 HAND LAUNDRIESβ€” Under 40 employees 3 9 4 12 7 21 BAKEHOUSESβ€” 4 16 10 40 14 56 C.
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-DOMESTIC WORKSHOPS Laundries 9 27 12 36 21 63 Dressmakers 7 14 9 18 16 32 D β€”WORKPLACES - Stable Yards S 10 8 16 13 26 Restaurants 8 16 11 22 19 38 Totals 85 189 126 262 211 451 Sanitary Administration. 27 BEDDING DISINFECTED from January 1st to December 31st, 1919. Mattresses. Beds. Blankets. Pillows. Bolsters. Sheets Cushions. Quilts. 127 70 268 218 103 151 36 43 CONCLUSION.
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I trust that this Report has in a concise manner represented the work done by the Public Health Authority during the year; a year in many respects unique in that the State and the people are still suffering from the grievous wounds of a devastating War, as shown by the very unstable equilibrium of minds, morals and material evident everywhere. My Staffs in this Department and at the Hospital have done good work with the least possible friction, and I think are to be congratulated on their results. That work of the Department, which is controlled by the Surrey County Council, has proceeded amicably ; at the same time one would welcome the time when the Urban District of Barnes became the Local Education Authority. I am, Gentlemen, Your obedient Servant, B. C. STEVENS. February 20th, 1920. P.S.β€”At the request of the Ministry of Health, the Council's Housing Scheme has been added to this Report in a detachable form for filing and reference by the Ministry. B.C.S.
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28 TABLE I. Vital Statistics of whole District during 1919 and previous Years. Name of Districtβ€”Barnes Urban. Year Population estimated to middle of each \ ear. Births. Totai. Deaths Registered in the District. Transferable Deaths. Nkit dkaths iiki.oxgimi to the District. Uncorrected Number. Nett. .Number. Rate. Of nonresidents registered in the District. Of residents not registered in the District. Under 1 year of ane At all ages. Number. Rate. Number. Kale per 1.000 nett birlhs Number. Rate 1 2 3 4 5 6 7 8 9 10 11 12 13 1913. 33,386 718 736 22.07 294 8.8 29 85 62 84.2 350 10.5 1914.
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34,745 734 754 21.7 276 7.9 28 88 48 63.1 336 9.6 1915. 33,516 636 656 19.5 287 8.2 38 93 55 83.8 380 11.3 *1916. 34,773 570 570 17.0 256 7.3 37 118 38 62.4 337 10.5 31,960 *1917. 36,223 481 481 13.2 264 8.2 31 123 33 68.6 356 10.9 32,495 *1918.
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36,223 438 438 12.0 368 11.3 41 108 40 91 404 12.4 32,495 '1919 37,193 475 513 13.7 299 8.4 36 88 46 89.6 351 9.5 35,704 *Higher Figure.β€”Birth Rate population. Lower Figure.β€”Death Rate population (civilian onh). 29 TABLE II. Cases of Infectious Disease notified vluring the year 1919. XouyiKD DISEASE No. Barnes Mortlake. No. Removed to Hospital. Deaths Deaths in Hospital.
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Scarlet Fever 88 24 64 63 Diphtheria 42 29 29 38 4 I Cerebro-spinal Fever 2 1 1 β€” 2 β€” Erysipelas 13 6 6 1 β€” β€” Puerperal Fever 2 1 1 β€” 1 β€” Enteric Fever 1 2 1 1 β€” Encephalitis Leth 2 β€” 2 β€” 1 Pulmonary Tuberculosis 44 17 27 76* 44* 6t 18t Other Tuberculosis 12 3 9 β€” 2 β€” Dysentery 1 β€” 1 β€” β€” β€” Malaria 18 4 14 β€” β€” β€” Trench Fever 3 1 2 β€” β€” β€” Ophthalmia Neonatorum 3 2 1 β€” β€” β€” Influ.
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Pneumonia 67 25 42 13 26 j 3 Measles 84 43 41 β€” - β€” Rubella 75 11 64 β€” β€” β€” - Pulmonary Tuberculosis.β€”Admissions to Hospital include 18 local and 58 Surrey County Council patients. fDeaths from Pulmonary Tuberculosis 44, Residents 26, County Patients 18. JDeaths in Hospital 24, Residents 6, County Patients 18. Isolation Hospitalβ€”South Worple Way, Mortlake. S.W. Tuberculosis Dispensary, Hospital Block and Sheltersβ€”South Worple Way, Mortlake, 29 Co o TABLE III. Causes of, and Ages at, Death during the year 1919. Causes of Death. Nett Deaths at the subjoined ages of " Residents " whether occurring within or without the District. Total Deaths whether of Residents or Nonresidents in Institutions in the Disirict. All Ages Under 1 year.
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1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65.
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65 and upward Certified Cases 351 Enteric Fever 1 β€” β€” β€” β€” β€” 1 β€” β€” β€” Small-pox β€” β€” β€” β€” β€” β€” β€” β€” β€” β€” Measles - β€” β€” β€” β€” β€” β€” β€” β€” β€” Scarlet Fever β€” β€” β€” β€” β€” β€” β€” β€” β€” β€” Whooping Cough 2 2 β€” β€” β€” β€” β€” β€” β€” β€” Diphtheria and Croup 4 - - 2 2 β€” - β€” β€” 1 Influenza 24 β€” β€” β€” 2 1 9 9 3 β€” Erysipelas Phthisis (Pulmonary β€” β€” β€” β€” β€” β€” β€” β€” β€” β€” Tuberculosis) 26 β€” β€” β€” 1 8 9 5 3 24 Tuberculous Meningitis 1 1 β€” β€” β€” β€” β€” β€” β€” β€” Other tuberculous dise'ses 3 1 β€” β€” β€” β€” 1 β€” 1 β€” Cancer, malignant disease 39 β€” β€” β€” β€” β€” 5 16 18 β€” Rheumatic
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Fever 2 β€” β€” β€” β€” 2 β€” β€” β€” β€” Meningitis 2 β€” β€” 1 1 β€” β€” β€” β€” β€” Organic Heart Disease 35 ~ β€” β€” 3 2 6 10 14 β€” Bronchitis 27 3 1 β€” β€” β€” 2 5 16 β€” pneumonia (all forms) 23 6 1 1 2 β€” 2 2 9 3 Other diseases of Respiratory organs 8 β€” β€” β€” β€” β€” 2 3 3 β€” Diarrhoea and Enteritis 5 3 1 β€” β€” β€” β€” β€” 1 β€” Appendicitisand Typhlitis β€” β€” β€” β€” β€” β€” β€” β€” β€” β€” Cirrhosis of Liver 3 β€” β€” β€” β€” β€” 1 2 β€” β€” Alcoholism Nephritis and Bright's Disease 4 β€” β€” β€” β€” β€” 3 β€” β€” Puerperal fever 1 β€” β€” β€” β€” β€” 1 β€” β€” β€” Other accidents and diseases of Pregnancy and Parturition β€” β€”
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β€” β€” β€” Congenital Debility and Malformation, including Premature Birth 22 22 β€” β€” β€” β€” β€” 2 Violent Deaths,excluding Suicide 15 3 β€” β€” β€” 4 2 5 1 β€” Suicide 2 β€” β€” β€” β€” β€” 1 1 β€” β€” Other defined diseases 101 4 β€” β€” 3 1 4 25 64 β€” Diseases ill-defined or unknown 1 1 β€” β€” β€” β€” β€” β€” β€” β€” Totals 351 46 3 4 14 18 47 86 133 30 Special Causes (included above)β€”Cerebro spinal Fever 2, Polio-myelitis 1 (notified in 1918). 31 APPENDIX. HOUSING. SURVEY OF DISTRICT.
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Under Section I. of the Housing and Town Planning, etc., Act, 1919, a Survey of the district is to be made of the housing requirements, and the Committee have received from the Ministry of Health a form setting out the particulars required. The following statement shows the particulars asked for, and the answers settled by the Committee :β€” SURVEY OF HOUSING NEEDS-BARNES URBAN DISTRICT. Section I.β€”Prevailing conditions affecting Shortage of Houses. Industries. 1. Particulars as to the staple industries of the district: β€” (a) Brewing; (b) Driving, Conducting, and Repairing Omnibuses (London General); (c) Motor Engineering ; (d) Chocolate Manufacturing 2. Particulars of any anticipated industrial development: β€” Brewing : Motor Engineering. 3. Particulars of any considerable reduction which may be anticipated in the number of persons employed in any industry in the district:β€”Nil. Population. 4.
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Pre-war population (1914) 34;745 5. Average annual increase of population for the five years before the war 850 34 Appendix. Population. 6. Estimated present population (1919) 37,193 7. Anticipated increase or decrease of working-class population due to industrial changes nil Existing Housing Accommodation. 8. Number of dwelling-houses in the district 7,737 9. Number of working-class houses of the types given in the reply to question 15 1,599 10. Average number of working-class houses built annually during the five years before the war 6 11. Number of working-class houses built between January 1st, 1915, and December 31, 1918 44 (R.V. Β£16) 12.
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Number of empty buildings which might be (a) made suitable, by repairs or alterations, for housing the working classes ; or (b) converted into flats (a) 2 for the working classes (b) 6 Overcrowding. 13. Tenements with more than two pants per room:β€” Number of tenements 4 Total number of occupiers 42 14. Number of houses intended for one family only which are now occupied (without having been specially adapted) by two or more families 448 Appendix. 35 Rents. 15. Particulars of prevailing rents of the various types of working-class houses in the district:β€” Type of House. Weekly Rent.
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(Π°) Houses with living-room, scullery and two bedrooms 6/- (Π±) Living-room, scullery and three bedrooms β€” (c) Parlour, living room, scullery and two bedrooms 6/6 to 13/- (d) Parlour, living-room, scullery and three bedrooms 7/- to 14'(e) Parlour, living-room, scullery and four bedrooms none (/) Tenements in block buildings none (g) Other working-class dwellings (specifying) Living-room, scullery and one bedroom 10/- Section II.β€”Estimate of Housing Needs. 1. Working-class houses required during the next three years to:β€” No. of Houses. (a) Meet the unsatisfied demand for houses (taking account of growth of population, overcrowding, etc.)
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300 (b) Re-house persons to be displaced by the clearance of unhealthy areas nil (c) Replace other dwellings which are unfit for human habitation and cannot be see made fit 22 note 1 (d) Replace obstructive or other buildings (now inhabited and not included under heading (c) which should be demolished nil 36 Appendix. No. of Houses. (e) Replace other houses which, although they cannot at present be regarded as unfit for human habitation, fall defin- ^ see itely below a reasonable standard ... 62 I note 1 (/) Meet anticipated deficiencies, e.g., arising from new industrial development... Total 384 2.
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Deduct:β€” (a) Working-class houses which it is anticipated will be set free during the next three years as the result of any probable decrease in the population nil (b) Working-class houses likely to be built during the next three years by persons other than the Local Authority Total 100 Net estimate of number of houses required 284 Note I. Based on the old standard, but if the standard is adopted that no house is Ht for habitation unless a bath is provided, then the number would be from 1,500 to 2,000. Details of figures given in reply to question 2 (b):β€” Name. Place or Parish. No. of Houses. Public utility societies none Housing trusts β€” β€” none Industrial undertakings Watney, Combe, Mortlake 100 or business firms ... Reid & Co , Ltd.
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Private persons β€” β€” none Total (which should agree with reply to question 2 (b)) 100 Section 111.β€”Areas which are being, or may have to be, dealt with as unhealthy under Part 1. or Part 11. of the Act of 1890:β€” Nil. Section IV Insanitary houses (other than houses in unhealthy areas of which particulars are given in Section 111.). Appendix. 37 Prevailing Conditions. (1) How many inhabited houses are there in the district which are not and cannot be made fit for human habitation? 22 (2) Number of persons inhabitating these houses 60 (3) How many houses are already subject to (a) Closing Orders? 2 (b) Demolition Orders? 0 (4) How many houses are seriously defective but can be made habitable? 13 Proposed Action.
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(5) What immediate action is contemplated by the Local Authority with regard to (a) Houses which are not and cannot be made fit for human habitation ? So soon as the present demand for houses is less serious the District Council's Housing Committee will proceed by Closing Orders under the Housing Acts. (b) Houses which are seriously defective but can be made habitable ? So soon as the present demand for houses is less serious the District Council's Housing Committee will proceed by either (a) Closing Orders, or (b) by notice under Section 28 of the 1919 Housing Act. (6) Within what time is it contemplated that conditions will be such as to warrant the demolition of the houses which are not and cannot be made fit for human habitation ? Three years. Section V Map. A map of the district, coloured as directed below, should be forwarded with this completed form. Neutral Tint.β€”Any considerable areas which, although in fair sanitary condition, nevertheless for one reason or 3& Appendix.
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another fall definitely below the ultimate standard at which it is reasonable to aim, or contain a large proportion of houses which fall below such standard. Hampton Square. The Ministry also require that a scheme of the Housing Needs should be submitted with the above-mentioned particulars. After careful consideration the Committee resolved to adopt the following scheme, and directed the Clerk to forward same to the Ministry. Section VI.β€”Scheme of the Barnes Urban District Council for the provision of new houses under Section I. of the Housing, Town Planning, &c., Act, 1919. The Scheme should include any proposals which have already been submitted for approval as assisted schemes. 1.
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Approximate number of new houses to be provided:β€” (a) Houses with living room, scullery, and two bedroomsβ€” (b) Living room, scullery, and three bedrooms 200 (c) Parlour, living room, scullery, and two bedroomsβ€” (d) Parlour, living room, scullery, and three bedrooms 70 (e) Parlour, living room, scullery, and four bedrooms 30 (f) Block dwellings. (Number:β€” ) Number of separate tenements β€” ig) Other dwellings (specifying type):β€” Total number of houses and separate tenements 300 2. Approximate number of existing empty houses to be acquired and:β€” (i) made suitable for housing the working classes (ii) converted into flats for the working classes y-None Approximate number of families to be housed under (i) and (ii) 3. Approximate acreage of land to be acquired 21 4.
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Average number of houses per acre 12 Appendix. 39 5. Approximate localities in which land is to be acquired:β€” Barnes Urban District. 6. Time within which it is proposed that the scheme (or if the scheme is to be carried out by instalments, each part of scheme) is to be carried into effect:β€” Part of Scheme. Approximate date for completion. Note 2. (a) 42 Houses. 1 year from this date (b) 100 2 years from this date. (c) 100 3 ,, ,, (d) 58 4 ,, ,, 300 Note 2. A scheme for part (a) has already been submitted. 7. Particulars of any measure necessary, as part of the scheme, for the preservation of existing erections of architectural, historic or artistic interest, or for the preservation of natural amenities of the locality:β€” Nil. 8.
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Any other provisions (including provisions for joint action with any other Local Authority):β€” Nil. 9. Is it anticipated that the scheme may subsequently require to be amended ? If so, any relevant considerations should be stated. The above scheme was adopted by the Housing Committee of the Urban District Council of Barnes at a meeting held on the 23rd day of Octhber, 1919. WM. THOS. GOODALE, Clerk. GEO. W. P. BATES, Chairman, 23rd October, 1919,