ACTON AC 439 ACT 50 Borough of Acton ANNUAL REPORT OF THE Medical Officer of Health TOGETHER WITH THE Report on the Medical Inspection of Schools FOR THE YEAR 1947 , ■ Borough of Acton ANNUAL REPORT of the Medical Officer of Health together with the Report on the Medical Inspection of Schools FOR THE YEAR 1947 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1947. Public Health Department, Town Hall, Acton, W.3. To the Mayor, Aldermen and Councillors of the Borough of Acton. Ladies and Gentlemen, I beg to submit the Annual Report of the health of the Borough of Acton for the year 1947, together with the report of the School Health Service. This year marks an epoch in the Health Service of this country, for, with the National Health Service Act becoming law on the Appointed Day, July 5th, 1948, there will be a great transition of services to another authority. The transferred services, having been controlled by Acton, will now be controlled by the Middlesex County Council. It is to early yet to describe the new method of administration, but in due course the Middlesex County Council will formulate its requirements. Briefly, the Ambulance Service, the Maternity and Child Welfare Service, and Home and Domestic Help Service will be administered by the Middlesex County Council. It is, of course, of interest to know that since 1877, Acton has had a series of Medical Officers of Health who have built up the health services, and perusal of their Annual Reports is of great interest and could well be a subject of a report in itself at a later date. But let me draw your attention by comparing some statements of the past. The infant mortality rate in 1897 was 198.3 per 1,000; in 1946 it was 27.9. This low rate for 1946 is something of which to be proud, but in 1947 infant mortality rate rose to 33,8. 4 The 1897 death rate was 15.9 and in 1947 was 10.5; the 1897 birth rate was 30.7, and in 1947 was 20.08. These figures justify the work which has been done. I would draw your attention to the contents of the Annual Report itself for your own deliberations, but I would say that there is a field for research in many matters, but unfortunately the staff is not large enough to carry out any work of this character. For instance, the large number of early deaths due to prematurity, congenital defects and stillbirths. Of the deaths due to prematurity and stillbirth, I am of opinion that each should be throughly investigated and the cause ascertained and advice given in the future to the parents. At present it is a case of doing the best at the time. The position cannot be improved until more beds are available to carry out such an intensive investigation. During the year, Dr. Madeley resigned to take up a post with the Islington Borough Council, and the work was carried on by means of part-time medical officers. Dr. Heller was appointed to the vacancy and the Council are considering the appointment of an Assistant Medical Officer. It was found necessary to appoint three additional Sanitary Inspectors but these posts have not yet been filled because of the unsettled state brought about by so many local authorities offering higher grades of the National Charter than this Council regarded as appropriate. The Avenue Road Clinic consists of two houses, and one looks forward to the time when a new Health Clinic will be erected to cope with the work. In 1939 plans were prepared for a new clinic but building was not carried out during the period 1939-1945. The Maternity and Child Welfare Committee has rented Palmerston Road Mission Hall for clinic purposes, and the Ministry of Health have approved the plan, and it is hoped to use the building early in 1948. I would like to thank all members of the Health Department and School Health Service for their loyal co-operation during the year. In particular I wish to place on record my appreciation of the outstanding service rendered to the Borough by Dr. E. J. Madeley who has worked in the department for 12 years as Deputy Medical Officer, and for 3 years of this period had carried out my duties during my absence on war service. Your obedient servant, G. E. B. PAYNE. 5 STAFF. George E. B. Payne, m.d., b.s., m.r.c.s., l.r.c.p., d.p.h., Medical Officer of Health and School Medical Officer. Margaret Heller, m.d., Vienna, l.r.c.p., m.r.c.s. Edinburgh, Deputy Medical Officer of Health and Deputy School Medical Officer. P. H. Slater, l.d.s. School Dentist. H. Barnett, l.d.s., r.c.s., School Dentist. J. J. Matthews, m.r.san.i., Cert. of Royal Sanitary Institute, holds Meat and Smoke Certificates; Chief Sanitary Inspector (Inspector under Diseases of Animals Acts, Rag Flock Act, and Fabrics Misdescription Act). M. Dowie, m.r.san.i. Cert, of Royal Sanitary Institute, holds Meat Certificate; Deputy Chief Sanitary Inspector. G. W. Burdon Cert, of Royal Sanitaiy Institute, holds Meat Certificate; Sanitary Inspector. C. Codrington, Cert, of Royal Sanitary Institute, holds Meat Certificate; Temporary Sanitaiy Inspector. W. G. Collam, Cert, of Royal Sanitary Institute, holds Meat Certificate, Sanitary Inspector. A. H. G. Johnson, m.r.san.i., Cert. of Royal Sanitary Institute, holds Meat Certificate; Meat Inspector. D. G. Paterson, m.r.san.i., Cert. of Royal Sanitary Institute, holds Meat Certificate, Sanitaiy Inspector. E. G. Wren, Cert. of Royal Sanitaiy Institute; Sanitary Inspector. Mrs. D. M. Lewis, s.R.n., Pt. I. c.m.b., Cert. of Royal Sanitary Institute; Health Visitor and School Nurse. Miss W. L. Orfeur, s.r.n., Certificate of Royal Sanitary Institute, s.c.m., Health Visitor and School Nurse. Miss M. Percival, s.r.n., Certificate of Royal Sanitary Institute, s.c.m., Health Visitor and School Nurse. Miss L. S. Pickering, s.r.n., Certificate of Royal Sanitary Institute, s.c.m., Health Visitor and School Nurse. 6 Miss D. B. Sfringall, s.r.n., Pt. i c.m.b., Cert, of Royal Sanitary Institute, Health Visitor and School Nurse. Mrs. E. Walsh, s.r.n., Cert, of Royal Sanitary Institute, s.c.m., Health Visitor and School Nurse. Miss A. J. Woosnam, s.r.n., s.c.m., Health Visitor and School Nurse. Mrs. M. Ford, s.r.n., s.c.m., Clinic Nurse. A. S. M. Pratt, Barrister at Law, Chief Clerk. Miss M. F. Willy Senior Clerk. Miss J. Dobbs Senior Clerk—Sanitary Section. Miss K. M. Beer Clerk Typist. Miss L. G. Bevan, Clerk Typist. Miss F. Dougall, Clerk Typist. Mrs. A. R. Ferguson Clerk Typist. Miss G. M. Gundersen Clerk Typist. Miss M. J. Pearce Clerk Typist. Mrs. E. Underwood Accounts and Stores Clerk. Miss E. Woods Clerk Typist. Mrs. H. Flood Matron, Bollo Bridge Road Day Nursery. Mrs. B. E. Bone Matron, Horn Lane Day Nursery. Mrs. E. J. Hainstock Matron, Friars Place Lane Day Nursery. Mrs. M. Berry Matron, "Longcot" Day Nursery. SECTION A. General Statistics. Area 2,317 acres. Population Census, 1931 70,510 Population, Registrar General's Estimate, 1947 67,920 Rateable Value at 31.12.47 £894,290 Sum represented by the product of a penny rate at 1.4.47 .£3,525 General Rate in the £ 17/- 7 VITAL STATISTICS. (Comparable figures for 1946 given in brackets). Live Births: total males females Legitimate 1287 (1205) (585 (629) 602 (576) Illegitimate 77 (83) 42 (43) 35 (40) Totals 1364 (1288) 727 (672) 637 (616) Birth rate per 1,000 estimated population is 20.08 (19.76). Still Births: total males females Legitimate 31 (21) 15 (13) 17 (8) Illegitimate 1 (2) 1 (2) — (—) Totals 32 (23) 16 (15) 17 (8) Deaths: 720 (720). Death Rate per 1,000 inhabitants 10.5 (11.05). Deaths from Puerperal Causes (Registrar General's short list for England & Wales, Headings 29 and 30): Rate per 1,000 Deaths. Live & Still Births. No. 29. Puerperal Sepsis — (—) — (—) No. 30. Other Puerperal Causes — (—) — (—) Death Rate of Infants under 1 year of age: All infants per 1,000 live births (E. & W.—41) 33.8 (27.9) Legitimate infants per 1,000 live births 34.1 (27.4) Illegitimate infants per 1,000 live births 51.6 (34.09) Deaths. Deaths from Cancer (all ages) 114 (125) Deaths from Measles (all ages) — (1) Deaths from Whooping Cough (all ages) — (—) Deaths from Diphtheria (all ages) — (—) Deaths from Diarrhoea (under 2 years of age) 6 (8) Death rate from Diarrhoea (under 2 years of age) 2.2 (4.4) 8 AGES AT DEATH AND WARD DISTRIBUTION OF DEATHS IN 1947. Causes of Death Total Under 1 year 1—2 2—5 5—15 15—25 25—45 45—65 65 + Ward Distribution. N.E. N.W. S.E. s.w. Bronchitis 51 2 — — — — — 13 36 18 10 13 10 Cerebro-spinal meningitis 2 — — — — — 1 — 1 2 — — — Cancer 114 — —: 7 40 67 40 25 22 27 Cerebral Haemorrhage & Thrombosis 64 — — — — — — 12 52 17 23 11 13 Circulatory Disease 131 1 — — — — 4 32 94 43 41 19 28 Cirrhosis of the Liver — — — — — — — — — — — — — Congenital Deformity 29 29 — — — — — — — 16 5 — 8 Diphtheria — — — — — — — — — — — — — Diabetes 5 — — — — — — 1 4 2 1 — 2 Digestive Tract Disease 8 1 — — — — — 3 4 3 — 2 3 Gastro-Enteritis 6 5 1 — — — — — — 3 — — 3 Gall Bladder — — — — — — — — — — — — — Heart Disease 73 — — 1 — — 4 20 48 25 20 9 19 Influenza 1 — — — — — — — 1 — — — 1 Liver Disease 1 — — — — — — — — — — — 1 Leukaemia and Anaemia 10 2 1 1 — — 1 1 4 1 2 4 3 Measles — — — — — — — — — — — — — Meningitis (not C.S.M. or T.B.) 2 — 1 — — 1 — — — — 2 — — Nervous Disease 7 — 1 — — 1 1 2 2 1 3 — 3 Carried forward 504 39 4 2 — 2 18 124 314 171 132 80 121 9 AGES AT DEATH AND WARD DISTRIBUTION OF DEATHS IN 1947. -contd. Causes of Death Total Under 1 year 1—2 2—5 5—15 15—25 25—45 45—65 65 + Ward Distribution. N.E. N.W. S.E. S.W. Brought forward 504 39 4 2 — 2 18 124 314 171 132 80 121 Nephritis 13 — — 1 — 1 1 3 7 7 2 1 3 Parturition Disease — — — — — — — — — — — — Puerperal Pyrexia — — — — — — —— — — — — — — Peptic Ulcer 12 — — — — — — 4 8 2 4 1 5 Pneumonia 4-2 — 2 — — — 12 25 13 10 9 10 Prostatic Enlargement 5 — — — — — — — 5 4 — 1 — Pulmonary Tuberculosis 34 — 1 — — 6 11 13 3 11 14 2 7 Respiratory Disease 25 5 — — — — 7 4 9 12 2 5 6 Rheumatism 1 — — — — — — — 1 — 1 — — Sarcoma 4 — — — — — — —2 2 — 3 1 — Scarlet Fever — — — — — — — — — — — — — Senility 48 — — — — — — —— 48 16 12 10 10 Suicide 2 — — — — — — 1 1 — 1 1 — T.B. (other than Pulmonary) 7 1 1 1 — 2 2 — — 3 — 1 3 Undefined Disease 2 1 — — — — 1 — — — — 2 — Violent Deaths 20 — — 2 1 2 8 3 4 7 8 4 1 Whooping Cough 1 — 1 — — — — — — — — — — TOTALS 720 50 7 8 1 13 48 166 427 247 189 118 166 10 Cause of Death in Children under one year—1947. 30 Males. 20 Females. Under 1 wk. 1—2 wks. 2—3 wks. 3—4 wks. Total under ! 1 month. 1—3 mths. 3—6 mths. 6—9 mths. 9—12 mths. Total 1—12 months. Atelactasis 2 — — — 2 — — — — — Asphyxia 2 — — — 2 — 1 — — 1 Bronchitis — — i — 1 — — — — 1 Circulatory Disease — — — — — — — — 1 I Congenital Defects 7 — — — 7 — — — — — Digestive Tract Disease 1 — — — 1 — — — — — Gastro Enteritis — — — — — 2 1 2 — 5 Intercranial Haemorrhage & Thrombosis 1 — — — 1 — — — — — Leukaemia and Anaemia 2 — — — 2 — — — — — Marasmus — — — — — — — 1 — 1 Pneumonia — — — — — — 2 — 1 3 Prematurity 15 2 1 1 19 1 — — — 1 T.B. Meningitis — — — — — — — 1 — 1 Undefined Disease (neglect at birth) 1 — — — 1 — — — — — Total 31 2 2 1 36 4 4 4 2 14 62% died during the first week of life. 72% died during the first month of life. Percentage of Deaths under one year. Percentage of total deaths under 45. 6.9% 17.6% Comparative figures of Infant Mortality in last seven years. Acton. England & Wales. 1941 47.8 59 1942 71.2 49 1943 62.4 49 1944 42.8 46 1945 40.4 46 1946 27.9 46 1947 33.8 41 11 Maternal Mortality. There were no maternal deaths during the year. Inquests. Asphyxia 12 Other respiratory conditions 1 Associated with Birth 1 Cancer 3 Peptic Ulcer 1 Accidents on the roads and at home 15 Poisoning due to drugs 2 Electrocution 1 Beach Mine 1 Hanging 1 Total 38 Post Mortems without Inquest. Respiratory Causes 16 Circulatory Causes 52 Peptic Ulcer 4 Senility 4 Septicaemia 2 Cancer 2 Concussion 2 Secretory System—Kidneys 3 Bilestone 1 Total 86 SECTION B. General Provision of Health Services in the Area. Laboratory Facilities. The Ministry of Health Emergency Medical Service, Section 6, provides a Pathological Service at the King Edward Memorial Hospital Laboratory at Ealing. 12 Having this laboratory so close to Acton is a great asset as not only can our specimens for diphtheria, tuberculosis, etc., be dealt with readily, but also samples of milk can be taken for the methylene blue test and phosphatase test. Specimens for Chemical Test are sent elsewhere. Ambulance Facilities. During the year, the Health Committee decided that the twenty-four hour shift system should be discontinued and an eighthour shift system inaugurated. This change involved the appointment of an officer-in-charge, three shift leaders and ten men acting as Ambulance Driver/Attendants. Three ambulances are maintained and there is a system of mutual aid for neighbouring boroughs. During the year, the three ambulances travelled a total of 10,008 miles. 1,691 calls were dealt within the following categories:- Street Accidents 470 Works Accidents 168 Home Accidents 90 Other Accidents 16 Removals in 24 hrs 71 Maternity 256 Private Removals 611 Malicious Calls 9 Of these calls, 383 were carried out as follows for the neighbouring authorities named Brentford & Chiswick 15 Ealing 201 L.C.C. 3 Willesden 31 Wembley 2 Cent. Middx. Hosp 131 Total 383 Assistance was asked for from other authorities on only five occasions, i.e., one from Brentford and Chiswick, two from Ealing, and two from Willesden Councils. 13 The premature-baby outfit, which is maintained for day and night emergency use by the ambulance was called for in one case during the year. No ambulance for infectious disease was maintained by the Town Council, all removals being carried out by ambulances from South Middlesex and Richmond Joint Fever Hospital, Twickenham. Nursing in the Home. The same facilities exist as in previous years. The number of sick persons under care was 508 necessitating 15,832 visits. As a matter of interest, this service was commenced in 1900, and has been continuous to the present time. Hospital Provision. The Acton Voluntary Hospital treats both surgical and medical cases, as does the Central Middlesex County Hospital, which is maintained by the Middlesex County Council. In common with other districts, Acton feels the effect of the shortage of beds, both for acute and chronic sick. It is Realized that the hospital authorities are doing as highly efficient a job as possible, but the shortage of beds due to the lack of personnel to maintain the wards is very apparent as is shown by the number of persons who come to the Health Department for advice. Institutional care for aged persons is a major requirement, but again the shortage of personnel to maintain wards is the cause of a long waiting list. Maternity and Child Welfare. The same four Centres operated in 1947 as Infant Welfare Clinics: (1) The School Clinic, Avenue Road (Three Health Visitors' districts served by this Centre). (2) Steele Road Mission Hall, Acton Green. (3) John Perryn School. (4) St. Gabriel's Church Hall, Noel Road. It is intended to open Palmerston Road Mission Hall as a Clinic for Welfare and Maternity purposes. The plans have been approved and the building will be in use early in 1948. 14 As in the previous year, two weekly sessions were held for each Health Visitor's district, one with a doctor in attendance, and one without, with the exception of the shared clinic at Avenue Road where three of the Health Visitors and their districts share the two sessions and a doctor is in attendance at each. Average weekly attendances (last year's figures in brackets): - Central district 90.2 (70,5) South East 81.3 (66.5) South West 70 (68.6) North East 75.3 (67.8) North West 60.5 (71.5) West district 77.7 (53.2) Attached is a Table showing the attendances at all Clinics and the visits paid by the Health Visitors to the homes. The numbers of mothers and children seen and treated at the Ophthalmic and Dental Clinics are given in the School Medical Report. Health Visiting. Number of visits paid during the year by all Health Visitors working in this area: To expectant mothers First visits 451 Total visits 570 To children under one year of age First visits 1269 Total visits 3915 To children between the ages of one and five years Total visits 3374 Infant Welfare Centres. Total number of children who first attended the Centres during the year, and who, on the date of their first attendance were : Under one year of age 1168 Between the ages of one and five 55 15 Total number of children under 5 years of age who attended at the Centres during the year and who, at the end of the year were:— Under one year of, age 1022 Over one year 1990 Total number of attendances at Centres, during the year:— By children under one year of age 18421 By children between one and five years 5240 A total of 839 Toddlers attended the Welfare Centres during 1947 for a yearly examination. Midwifery Service. Domiciliary Midwifery was performed as in previous years by the Midwives of Queen Charlotte's Hospital. During 1947, 398 women were recommended for admission to Central Middlesex County Hospital for their confinements and of these 350 were accepted. , A fourth Ante-Natal clinic was opened at the beginning of, the year, but by the late Autumn pressure on the sessions was again so heavy that a fifth session was started in December, 1947. Number of new cases attending Clinics during year 1091 Total number of attendances made 5294 Average number attending weekly (4 clinics) 101 The following Table gives the stage of pregnancy at which the new cases reported for examination:— 1st month 77 6th month 47 2nd month 334 7th month 39 3rd month 293 8th month 6 4th month 161 9th month 4 5th month 100 1091 16 The arrangements made by women for their confinements are tabulated below:— % Confined in Central Middlesex County Hospital 83.2 Confined in Queen Charlotte's Hospital 13.8 Confined in other Hospitals 4.85 Confined in Nursing Homes 7.3 Confined at home (Queen Charlotte's Midwives attending) 39.8 Evacuated to Emergency Maternity Hostels Private Doctors and Midwives 1.05 Post Natal Clinics. The majority of women had their post-natal examination at the hospital where they were confined, those confined at home being examined at Queen Charlotte's Hospital. 23 women attended our clinic for their examination. Birth Control Clinics. As in previous years, arrangements for this purpose with the North Kensington Women's Welfare were continued, 8 patients being sent there for advice in 1947. Sterility Clinic. During the year, 3 patients were referred to this clinic at North Kensington Women's Welfare. Exercises Class for Mothers. The classes for expectant mothers were again a feature of the ante-natal work, although a slight decrease was noted in the numbers attending, the total for 1947 being 140 as against 160 for 1946. The total number of attendances was 1149 as compared with 1212 for 1946. Food Sales. During the year, the Maternity and Child Welfare Centres' supplied the following quantities of, milk foods:— For Sale 21,039 packages. Free 257 packages. 17 Home Help Scheme. At the end of the year there were 3 full time Home Helps. The following Table shows the number of cases booked and those actually attended:— Number of Cases booked 122 (88 last year). Number of Cases attended 97 (68 ,, ,, ). Number of Cases cancelled 25 (25 ,, ,, ). Domestic Help Scheme. By the end of the year there was a staff of 11 full time and 2 part time Domestic Helps. 120 cases were attended as against 88 for the previous year. Day Nurseries. The routine of the Day Nurseries was maintained during 1947, along the same lines as in previous years. Apart from some minor staff changes, the position at December, 1947 was very much the same as had characterised 1946. The same four Nurseries were in being, namely, Bollo Bridge Road, Horn Lane, Friars Place Lane, Longcot, the accommodation at these being as follows:— Under 2 Over 2 Total Bollo Bridge Road 17 18 35 Horn Lane 25 35 60 Friars Place Lane 20 25 45 'Longcot' Newton Grove 19 25 44 The numbers on the registers at 31st December, 1947, were as follows:— Bollo Bridge Road 35 Horn Lane 63 Friars Place Lane 47 'Longcot' 47 Analysis of the numbers on the waiting list shows age distribution of those awaiting admission. The demand for nursery accommodation is. greater than at the end of the previous year and the problem of providing further accommodation is a pressing one. 18 The following were the numbers on the waiting list:— Under 2 Over 2 Total Bollo Bridge Road 67 58 125 Horn Lane 68 88 156 Friars Place Lane 29 69 98 'Longcot'—Acton children 23 66 186 Chiswick ,, 22 75 209 356 565 As far as is possible, children are admitted in strict order of their position on the waiting list, but account also has to be taken of cases of special need and these are often given an over-riding priority. The average daily attendances were: Under 2 Over 2 Total Bollo Bridge Road 11.4 15.8 27.2 Horn Lane 19.9 31.5 51.4 Friars Place Lane 9.9 28.7 38.6 'Longcot' 13.4 24.7 38.1 But for an outbreak of Measles, these figures would probably have been higher, as the tendency has been for a more regular and constant attendance since the introduction of the system of collecting the weekly fee in advance. Infectious Disease. During the year, 873 notifications of infectious disease were received. Measles, caused 514 of, these notifications, respiratory tuberculosis 108, pertussis 87, scarlet fever 55, pneumonia 45. There is little to comment upon concerning the above cases, but during the year a large epidemic of poliomyelitis developed throughout Great Britain. Of this disease, ten cases were notified, but five more cases which occurred in Acton were not notified, having been admitted to hospital. Of these fifteen cases, four cases were confirmed as anterior poliomyelitis with paralysis, four were unconfirmed and seven were considered abortive cases. Precautions were taken as recommended by the Minister of Health, and all contacts followed up. Ten cases of diphtheria were notified, five being confirmed and no case occurring in a child known to have been immunized,. The 19 ages were, respectively, 20, 22, 31, 12 and 6 years old. Of the unconfirmed cases admitted to hospital, the ages were 4 years, 13 years, 13 years 28 years and eleven months respectively. Diphtheria Immunisation. Immunisation was carried out along the lines indicated in previous reports. Advertisements were placed monthly in the local paper, giving times and places of, inoculation clinics, and posters were displayed in prominent places. In addition to this, the following routine was practised: (1) A notice was sent to the parent of each 6 months' old child. (2) All Infant Welfare attenders were approached. (3) All children admitted to Day Nurseries were offered protection. (4) Health Visitors combed their districts for children who did not attend Welfares, and urged their protection. (5) Head Teachers gaveforms of consent to new school entrants. (6) Prior to school medical inspections, questionnaires were sent to each parent asking, inter alia, whether the child had been inoculated. If the answer were in the negative a form of consent was. sent to the parent. All immunised cases are followed up and, at the end of three years, each child is offered a boost dose. At the age of 11 years or over, this is preceded by a Schick test. All children under 5 who have not had the disease, are inoculated against Whooping Cough at the same time as they l are inoculated against Diphtheria, i.e., they have three doses, of protective material at monthly intervals. 52.5% of the population under 5 years of age is now protected, and 71% of the population aged 5 to 14. Diphtheria Immunisations, 1947. Total number of under 5's inoculated 754 Total number of over 5's inoculated 160 Re-inoculations after 3 years' 797 Schick tests after 3 years—negative 223 positive 47 Primary Schick tests —negative 50 positive 51 20 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1947. Notifiable Disease. Cases notified in whole District. At Ages—Years. Ward Distribution. At all Ages Under 1 1 . to 2 3 to 4 5 to 9 10 to 14 15 to 24 25 to 44 45 to 64 Over 64 North Eiast North West South East South West Scarlet Fever 55 — 5 12 25 8 2 3 — — 6 22 6 21 Diphtheria 10 — 1 — 2 3 1 3 — — 1 6 — 3 Pneumonia 45 — 1 8 2 4 4 10 12 4 7 18 3 17 Erysipelas 9 — — — — — \— 2 4 3 3 2 2 2 Puerperal Pyrexia 2 — — — — — 1 1 — — 1 1 — — Dysentery 3 — — — — — — 2 — 1 1 2 — — Tuberculosis (resp.) 106 — 2 1 4 4 33 47 14 3 26 47 14 21 Tuberculosis (non-resp.) '24 2 4 2 1 1 3 6 4 1 4 10 6 4 Measles 514 23 122 165 184 13 6 1 — — 92 173 88 161 Whooping Cough 87 10 13 28 34 1 1 — — — 19 45 3 20 Ophthalmia Neonatorum 1 1 — — — — — — — — — 1 — — Meningitis 7 — 2 2 — — 1 — — 2 5 2 — — Typhoid — — — — — — — — — — — — — — Poliomyelitis 15 — 1 5 7 2 — — — — 3 9 — 3 Food Poisoning 3 — — — — — •— — 2 1 1 2 — — TOTALS 883 36 151 223 259 36 54 76 36 15 169 340 122 252 21 Tuberculosis. Particulars of new cases and of deaths from the disease during 1947 are given below: 108 new cases of Pulmonary Tuberculosis and 24 cases of NonPulmonary Tuberculosis occurred during the year. There were 34 deaths from Pulmonary, and 7 deaths from Non-Pulmonary Tuberculosis during the year. The following Table gives the age incidence of new cases of the disease in 1947, and of deaths from the same cause. 22 TUBERCULOSIS Age Periods NEW CASES DEATHS Respiratory Non-Respiratory Respiratory Non-Respiratory Male Female Male Female Male Female Male Female 0 — — — — 2 — — 1 — 1 — 1 2 4 2 1 —— 1 1 5 — 3 5 1 1 — — — — 15 — 16 17 3 — — 6 1 1 25 — 17 15 1 1 4 4 — 1 35 — 11 4 3 1 3 — — 1 45 — 7 1 3 — 4 2 — — 55 — 6 — 1 — 5 2 — —— 65 upwards 3 — 1 — 3 — — — 64 44 17 7 20 14 3 4 23 Amended Table of Statement of particulars appearing on the Register of Cases of Tuberculosis for 1946. Pulmonary NonPulmonary Total (a) Number of cases of T.B. on the Register at the commencement of the year 388 males 64 males 831 302 females 77 females (b) Number of cases notified for the first time during the year 56 males 10 males 106 29 females 11 females (c) Number of cases previously removed from the Register which have been restored thereto during the year — males — males 1 1 female — females (d) Number of cases added to the Register other than by notification 12 males — males 19 4 females 3 females (e) Number of cases removed from the Register during the year 46 males 1 male 78 22 females 9 females (f) Number of cases remaining on the Register at the end of the year 410 males 73 males 879 314 females 82 females Statement of particulars appearing on the Register of Cases of Tuberculosis for the year ending 1947. Pulmonary NonPulmonary Total (a) Number of cases of T.B. on the Register at the commencement of the year 410 males 73 males 879 314 females 82 females (b) Number of cases notified for the first time during the year 51 males 15 males 108 35 females 7 females 24 (c) Number of cases previously removed from the Register which have been restored thereto during the year — males — mal3s — — females — females (d) Number of cases added to the Register other than by notification 11 males 2 males 23 10 females —females (e) Number of cases removed from the Register during the year 34 males 3 males 63 23 females 3 females (f) Number of cases remaining on the Register at the end of the year 438 males 87 males 947 336 females 86 females Scabies and Verminous Conditions. As in previous years, cases suffering from the above conditions have been referred to the Kensington Medicinal Baths for cleansing treatment. The number of cases and the number of families is again smaller than last year. SCABIES RETURN, 1947. Month. Total N.E. N.W. S.E. S.W.. F.W Families January 13 2 5 — 6 1 8 February 15 2 3 1 9 — 7 March 10 4 2 3 1 — 8 April 5 4 — — 1 —— 3 May 5 1 4 — — 1 4 June 4 2 2 — — — 3 July 2 2 — — — — 2 August 3 — 2 — 1 — 3 September 15 5 10 — — — 5 October 9 8 — — 1 — 4 November 10 1 9 — — 1 6 December 9 2 1 — 6 1 5 Totals 100 33 38 4 25 4 58 100 25 NUMBER OF PERSONS TREATED FOR BODY LICE, 1947. Month. Total N.E. N.VV. S.E. s.w F.W Families February 1 1 — — — — 1 December 1 1 — — — — 1 Totals 2 2 — — — —— 2 NUMBER OF PERSONS TREATED FOR DIRTY HEADS, 1947. Month. Total N.E. N.W. S.E. s.w F.VV . Families January 3 1 — — 2 — 3 February 1 1 — — — — 1 March —— — — — — — — April 9 4 1 —— 4 — 5 May 1 — 1 — — — 1 June 4 — 1 1 2 — 4 July — — — — — — — August 3 — a — 1 1 2 September 3 1 l — l 2 3 October 6 3 3 — — 6 6 November 3 — 1 — 2 — 3 December 1 — 1 — — 1 1 Totals 34 10 11 1 12 10 29 34 Premature Infants. Total number notified — 80. Born at Home 20 Born in Hospital 60 Nursed entirely at Home Died in 24 hours. Survived 1 month Died in 24 hours. Died between 1 day and 1 month. Survived 1 month. 20 1 18 7 7 46 Care of Illegitimate Children. During 1047, three mothers were sent to the Hostel under arrangements made with the County Council. 26 HOUSING. Since the Annual Report of 1946 some progress in Housing has been made, more particularly on The Vale site where some blocks are nearing completion. The following summary sets out the position at the close of 1947: Temporary Prefabricated Houses. Completed and Occupied 119 Under construction 131 250 New Permanent Dwellings. (a) Within the Borough: Contracts let or under construction, 31.12.47 The Vale 318 Bromley Lodge 18 336 Schemes in preparation: Horn Lane 24 Ramillies Road 30 Oakley Avenue 18 Park Road North 12 Oldfield Estate. 58 Bollo Bridge Road 38 Creswick Road 12 Avenue Crescent 12 Uxbridge Road 8 Glendun Road 30 Southfield Road 20 262 27 (b) Outside the Borough : Completed and occupied at 31.12.47 Northolt Junction 6 Under construction Northolt Junction 20 Schemes in preparation Northolt Junction 140 Ruislip Gardens 225 Hart Grove 12 412 1,260 In addition it is hoped that new dwellings will be erected and made available to the Acton Council by the Hemel Hempstead Development Corporation, and as a result of the joint development of land on the western boundary of Ealing. Rebuilt War-destroyed Dwellings. (a) By the Council— Completed and occupied 31.12.47 Council houses. 8 Private dwellings 8 Under construction 30 40 (b) Under private licence. Completed and occupied 31.12.47 55 Under construction 136 191 237 Houses found to be overcrowded as a result of Health Inspections by Sanitary Inspectors or Health Visitors are referred to the Housing Department with appropriate recommendation for action. 28 FOOD AND DRUGS ACT, 1938. The Middlesex County Council are the sampling authority in this area, and the Chief Officer of. the Public. Control Department has supplied the figures appended below of samples taken during the year:— Article Taken Adulterated Milk 119 — Milk, sterilised 3 — Milk, homogenised 2 — Ammoniated tincture of quinine 1 — Castor Oil 1 — Cooked Meats 2 — Fish Paste 2 — Gin 11 2 Imitation Black Walnut Flavour 1 — Iron Tonic Tablets 2 1 Lemon Cheese 1 —v Meat Pies 2 — Meat Savouries 1 — Rum 2 1 Sausages 4 — Sausages, cooked 15 —— Sausage Meat 8 — Sulphur Ointment 1 — Whale Meat Sausages 1 — Whisky 9 2 188 6 One sample of Gin, one of Rum and two of Whisky contained 10%, 6.9%, 9.2% and 10% of added water, respectively, for which proceedings were instituted resulting in fines and costs amounting to £43. 10s. 0d. One informal sample of Gin was found not to be normal Gin but appeared to be contaminated with Witch Hazel. Efforts to secure an official sample similarly contaminated have, so far, been unsuccessful. An informal sample of Iron Tonic Tablets was 38.7% deficient in ferrous iron but a subsequent official sample was genuine. 20 SECTION C. SANITARY CIRCUMSTANCES OF THE AREA. Water Supply. The Borough is supplied with water by the Metropolitan Water Board. The whole of the population is supplied from the public water mains direct to each house and the supply has been satisfactory. In addition to the public supply, there are three deep wells in the district, two at factory premises, and one at the Public Baths. Samples of water from these wells have been taken from time to time and on submission to bacteriological and chemical examinations, have proved satisfactory. Drainage and Sewerage. All the dwelling houses are provided with water closets and are connected to the sewerage system which discharges, by an arrangement with the L.C.C., into the London sewers. Stormwater is filtered and emptied into the Thames. Public Cleansing. The amount of house refuse collected by the Council in 1947 was 15,639 tons and trade refuse collected amounted to 846 tons. A total weight of, 11,838 tons was destroyed by the destructor and 4,647 tons was removed to controlled shoots. In addition to the foregoing, 2,080 tons of Salvage was sold. Rodent Control. The Borough has been maintained free from major infestation by rats, due largely to the continued service of maintenance at business premises following baiting, trapping, poisoning, and gassing operations where new infestations occurred, with the co-operation of occupiers of such premises. All complaints from dwelling house occupiers received immediate attention, and the District Sanitary Inspectors carried out complete investigations where they observed evidence of infestation of the slightest degree. The work of investigation destruction and maintenance, has involved a total of, 1,519 visits by the Council's Rodent Operatives, 1,124 to business premises and 395 to dwellings, in addition to inspections, by the Sanitary Inspectors as noted elsewhere. 30 Inspection of Factories. There are 628 premises within the borough in connection with which the Sanitary Inspectors make inspection from time to time to ascertain that the provisions of the Factories Act, 1937, and the Sanitary Accommodation Regulations are complied with. In addition to this routine work, hygiene of canteens etc., has received attention, and advice as to the fitness of food for human consumption given as necessary. Sanitary Inspection of the Area. The following, table includes the tabular statement by the Chief Sanitary Inspector under article 27 (18) of the Sanitary Officers (Outside London) Regulations. 1935. Tabulated Statement of Inspections and Details of Work carried out by Sanitary Inspectors. Number of Inspections made and Action taken: Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 4,108 (1) Dealt with by service of Informal Notice 2,333 (2) Dealt with by service of Statutory Notice under Section 9 Housing Act, 1936. 670 (3) Dealt with by service of Statutory Notice under Public Health Acts. 246 (4) No defects found 61 Premises (other than defective dwelling houses,) inspected for nuisances and miscellaneous defects. 2,725 (1) Dealt with by service of informal notice 84 (2) Dealt with by service of Statutory Notice under Public Health, etc. 4 Reinspections subsequent to service of Notice 15,120 Inspections after notification of Infectious Disease. 159 Premises inspected under Rats and Mice (Destruction) Act, 1919, and Infestation Order, 1943 516 Details of work carried out. Work of maintaining dwellings in accordance with the Manual of Housing issued by the Ministry of Health, through the service 31 of intimation and statutory notices upon the owners, has, resulted in the maximum number of houses and flats etc., being kept fit for human habitation. The following table indicates the extensive and varied nature of the defects and dilapidations which have been made good ing inspection by the Sanitary Inspectors. Sanitary dustbins provided 474 Yards paved or yard paving required 52 Insanitary forecourts remedied 5 Defective drains repaired or reconstructed 168 Defective soil pipes and ventilating shafts, repaired or renewed 45 Defective fresh air inlets repaired or renewed 9 Defective gullies removed and replaced by new 32 Rainwater downpipes disconnected from drain . 3 Dishing and curb to gullies repaired and new gratings fixed 65 Defective W.C. pans and traps removed and replaced by new 166 Defective W.C. flushing apparatus repaired or new fixed 175 Defective W.C. seats repaired or new fixed 109 Defective flush pipe connections repaired 56 Insanitary sinks removed or new fixed 89 Sink waste pipes repaired or trapped 137 Insanitary wall surface over sinks remedied 61 Ventilated food cupboards provided 27 Drinking water cisterns cleansed 18 Defective covers to drinking water cisterns repaired or new fixed 32 Insanitary sites beneath floors concreted 24 Spaces beneath floors ventilated 63 Dampness in walls from defective damp proof course remedied 500 Dampness from defective roof, rainwater gutterings, etc., remedied 3,397 Defective plastering repaired (number of rooms) 2,722 Rooms where dirty walls and ceilings have been cleansed and redecorated 3,273 Defective floors repaired 550 Defective or dangerous stairs repaired 113 Defective doors and windows repaired 2,398 Defective kitchen ranges and firegrates repaired 780 Defective washing coppers repaired 54 32 Coal cupboards provided or repaired 21 Accumulations of offensive matter removed 45 Drains unstopped and cleansed 138 Drains tested, exposed for examination, etc 378 Smoke observations taken 31 Smoke nuisances abated on service of notice — Miscellaneous nuisances abated 418 Notifications of, waste of water sent to Metropolitan Water Board 194 New W.C. apartments 2 Rent Restriction Act. Certificate granted to an occupier 1 Premises under Periodical Inspection. Factories and Workshops 628 Piggeries 2. Rag Dealers 2 Mews 4 Public House Urinals 31 Hairdressers 43 School Buildings:— Grammar 1; Elementary and Secondary 11; Technical 2 ; Special (M.D.) 1; Private 2 Total 17 Butchers' Shops 37 Fish Shops 38 Fish and Chip Shops 17 Greengrocers' Shops 89 Premises where food is manufactured or prepared 43 Grocery and Provision Shops 136 Dairies 13 Bakehouses 26 Slaughter Houses 2 Restaurants, Cafes, etc, . 354 Premises where ice-cream is manufactured 15 Food Inspection. The amount of Unsound Food surrendered and disposed of by way of salvage, for animal feeding, chemical manure, or by destruction, was lower than in the previous year. The number of cans of Meat, Fish, Fruit and Vegetables, etc., was 22,855; of which amount, much was sent by the Ministry of Food into Food Factories 33 within the Borough for manufacturing purposes under the surveillance of the Council's Sanitary Inspectors. Twenty-three complaints as to food unfit for human consumption were recorded and submitted for consideration to the Public Health Committee ; in three cases the Council prosecuted the persons responsible for contravention of the Food and Drugs Act, 1938, and in each case the defendants were fined and costs were awarded to the Council. Milk. Regular inspection of the 13 dairies within the Borough have shown them to be maintained in a hygienic condition. The Pasteurising and Bottling depot in Bollo Lane has continued processing to capacity, with no cause for complaint. Of 153 samples of milk taken during the year, only three were unsatisfactory—one failing in the Methylene Blue test, and two failing in the Phosphatase test. Water. Samples of water totalling 35 taken from various sources in the Borough were submitted to bacteriological and chemical examinations in 27 and 8 cases respectively, and all results indicated satisfactory supplies. Ice Cream. With the coming into force of the Ice Cream (Heat Treatment) Regulations 1946, a number of Ic.e Cream manufacturers in the Borough immediately ordered new plant and machinery, in order that their processing should be in conformity with the regulations as early as possible. In only two cases has the complete plant been delivered, and generally there has been a difficulty of obtaining coolers and thermometers. Some small manufacturers have adopted the "cold mix " process, and others have decided to purchase manufactured Ice Cream wholesale. It may be said that the effect of the regulations and the prescribed laboratory examinations of samples has led to a product with an improved bacteriological standard. Of 63 samples taken during the year, 22 gave indications that there were deficiencies in the operation of the plant, or carelessness in handling the product, close inspection of the premises and plant and follow-up sampling resulted in a quick return to a satisfactory standard in the defaulting cases. 34 Diseases of Animals. During the early Summer, Fowl Pest became prevalent in the country generally, and 3 cases were confirmed within the Borough. Precautions as to disinfection of premises and slaughter of poultry were taken and thus the spread of the disease prevented. On one occasion only Acton was included in "an infected area" Order on account of Foot and Mouth Disease, and 114 licences authorising the movement of animals were granted. Slaughterhouses. The Slaughterhouses, in Atlas Road and Hanbury Road have been in commission throughout the year, and the carcase and offal of every animal slaughtered have been examined as to their fitness for human food. The demand for horseflesh for human food is sustained, there being a further increase in the number of horses slaughtered during the year as compared with 1946. The incidence of Tuberculosis in Pigs is a little higher than in previous years as will be noted from the figures below. No case of Tuberculosis in Horses was noted during the year. TOTAL NUMBER OF ALL CARCASES INSPECTED DURING 1947. WITH DETAILS OF SURRENDERS ON ACCOUNT OF DISEASE. Pigs. Horses. (1) Number killed 50,851 6,121 (2) Number inspected 50,851 6,121 (3) All diseases except T.B. Whole carcases condemned 28 8 Carcases of which some part or organ was condemned 1,529 641 Percentage of number inspected affected with disease other than T.B. 3.08% 10.62% (4) T.B. only:— Whole carcases condemned 51 Carcases of which some part or organ was condemned 1,658 Percentage of number inspected affected with T.B. 3.38% (5) Total weight of meat and offal surrendered :— Pigs—17 tons, 17 cwt. 2 qrs. 27 lbs. Horses—7 tons, 1 qr. 231bs. 35 NUMBER OF PIGS* CARCASES INSPECTED DURI NG 1947 WITH ANALYSIS OF SURRENDERS ON ACCOUNT OF DISEASE. Date PARTS CONDEMNED. Wt. of Mesenteries, Stomachs & Intestines Pigs Slaughtered Carcases Heads Collars Fore Qtrs. Hind Qtrs. Legs Skins Hocks Pieces of of Pork Plucks (Lungs, Livers, Hearts) January 3847 4 48 — — — 24 — 1 22 lbs. 97 - February 4891 3 60 1 — — 22 2 — 4 lbs. 115 310 lbs. March 3315 3 72 — — — 12 2 — 43 lbs. 112 960 lbs. April 5482 3 114 — — — 5 2 3 2 lbs. 149 520 lbs. May 3968 7 57 — — — 4 2 — — 114 790 lbs. June 5206 16 102 — — — 19 12 — 17 lbs 188 770 lbs. July 5854 8 138 — — — 51 3 1 21 lbs. 190 590 lbs. August 3849 4 86 — — — 49 15 — 22 lbs. 125 710 lbs. September 4107 8 94 — 1 — . 69 2 — 81 lbs. 161 770 lbs. October 4004 9 119 — — — 55 — — 173 lbs. 175 750 lbs. November 2773 8 65 — — — 59 4 — 111 lbs. 144 940 lbs. December 3555 6 91 — — — 39 2 1 17 lbs. 165 620 lbs. Total 50851 79 1246 1 1 — 408 46 6 511 lbs. 1735 9200 lbs. 36 FACTORIES ACT, 1937. PART I OF THE ACT. 1.—INSPECTIONS for purposes of provisions as to health (including inspections made by Sanitary Inspectors). Premises Number on Register Number of Inspections Number of Written Notices Occupiers Prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 42 14 1 — (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 582 374 17 — (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 4 — — — TOTAL 628 388 18 — 2—CASES IN WHICH DEFECTS WERE FOUND. Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred to H.M. Inspector Referred by H.M. Inspector Want of cleanliness (S.l) 2 1 1 Overcrowding (S.2) — 1 — — — Ineffective drainage of floors (S..6) 1 Sanitary Conveniences (S.7) — (a) Insufficient (b) Unsuitable or 3 5 — l — defective 9 10 — 7 — TOTAL 14 18 — 9 — PART VIII OF THE ACT. OUTWORK— (Section 110). No. of out-workers in August list required by Sect. 110 (1) (c) — Wearing apparel—Making, etc 10 Artificial flowers 1 Brush making 1 Textile weaving 5 TOTAL 17 37 ANNUAL REPORT of the SCHOOL MEDICAL OFFICER FOR THE YEAR 1947. To the Chairman and Members of the School Health Committee. Ladies and Gentlemen, I beg to submit the following report upon the School Health Service for the year 1947. All Clinics were open throughout the year and figures are given in the report. Most of the work has still been carried out in the Clinic at 45 Avenue Road, in its inadequate and out of date premises. The figures of attendances at the Minor Ailment Clinic are on the increase—in 1946, the number being 5,023, and in 1947 the number was 6,079. There has also been an increase in the attendances at the Eye and Speech Therapy Clinics. The number of children at the Special School has doubled from 21 in 1946 to 40 in 1947, this increase was mainly due to 12 children being sent from Ealing. The visits of the School Nurses paid to the homes has shown a considerable increase, from 559 in 1946 to 861 in 1947. Infectious Diseases among school children have decreased, the number of cases of scarlet fever in 1946 was 56 and in 1947 dropped to 34, whilst the number of cases of diphtheria fell from 12 to 2. During the year, the number on the school roll was 7,123. Immunisation sessions were held continuously once a week during the year and a good attendance was maintained. As a matter of routine, every child is examined twice a term by the Health Visitor or School Nurse. Verminous children are 38 excluded from school for 48 hours and are then seen at the Clinic. If fit, they are re-admitted to school. If still verminous, the parent is warned and advice given as to the best methods of cleansing. If the parent desires, arrangements are made for the child to be cleansed at the Medicinal Baths, North Kensington. Before ending this report, one must thank all the staff of the School Health Service for their co-operation and loyal support throughout the year. Your obedient servant, GEORGE E. B. PAYNE. SCHOOL MEALS AND MILK. Number of meals supplied—1947 601,689 Number of free meals supplied 47,024 Ordinary Schools 46,323 Special Schools 701 Average number of children supplied daily with milk during 1947 6.016 INFECTIOUS DISEASES. Scarlet Fever. 34 cases were reported during 1947 in the school population the distribution being; as follows:— Acton Wells 1 Beaumont Park 3 Berrymede 7 Central 1 Derwentwater 3 John Perryn 3 Priory 3 Rothschild 3 Southfield 2 Special School 1 West Acton 2 Other Schools 3 39 Diphtheria. 2 cases were reported during 1947 in the school population, the distribution being as follows:— John Perryn 1 Priory 1 Percentages of Children Inoculated in School. Acton Wells Secondary 71.31 Acton Wells Primary 74.34 Berrymede Boys' 69.71 Berrymede Girls' 64.46 Berrymede Infants' 58.33 Acton Central Secondary 75.17 Derwentwater Junior 78.06 Derwentwater Infants' 75.81 John Perryn Upper 81.92 John Perryn Lower 83.03 Priory Boys' Secondary 64.31 Priory Girls' Secondary 71.34 Priory Infants' 73.87 Rothschild Junior 76.92 Rothschild Infants' 73.88 Southfield Junior 81.02 Southfield Infants' 85.05 St. Mary's R.C., Turnham Green 71.34 West Acton 79.41 40 INOCULATIONS, 1947. School. Trt. commenced 1940. Primary Schick. Completed 1947. Doses. 1947 Doses. Schick tested after 3 years. " Boost" Dose. Pos. Neg. 2nd. 3rd. 1st. 2nd. 3rd. Pos. Neg, 1st. 2nd. Acton Wells Secondary — — — 2 3 3 2 2 8 — — Acton Wells Primary 3 1 2 6 5 4 3 2 35 1 Berrymede Boys' 4 2 — 2 6 4 4 1 3 21 2 Berrymede Girls' 5 3 4 4 6 5 4 1 12 21 3 Berrymede Infants' — 2 2 3 4 1 — — — 20 3 Central — 2 — 2 3 3 3 3 21 — — Derwentwater Juniors 9 8 — 4 16 15 13 7 25 82 8 Derwentwater Infants' 1 — — 2 6 6 6 — — 83 6 John Perryn Upper 1 1 1 3 6 5 4 4 21 10 1 John Perryn Lower 1 — — 4 11 10 10 2 5 71 — Priory Secondary Boys' 6 — 1 2 23 19 13 7 28 2 — Priory Secondary Girls' 9 21 3 5 2L 19 17 11 63 — — Priory Infants' — — — — 5 4 4 — — 41 3 Rothschild Juniors 2 3 2 3 4 4 2 1 2 30 6 Rothschild Infants' — — — — 6 3 3 — 1 50 4 Southfield Juniors 3 2 1 7 4 3 3 1 8 26 2 Southfield Infants' — 1 — — 7 5 3 — — 53 2 St. Mary's R.C. 6 3 — 3 13 10 8 — 6 21 — West Acton — — — 2 3 3 2 1 — 28 6 Other Schools 1 2 1 2 6 6 3 3 18 49 — TOTALS 51 50 16 52 158 133 108 47 223 643 47 41 DISTRIBUTION OF SCABIES, 1947. Acton Wells. Westfield Road Baths Treatment. 1 child Acorn Gardens ,, ,, 5 children Berrymede. Hanbury Road Baths Treatment. 2 children Park Road North ,, ,, 1 child Junction Road ,, ,, 8 children Stanley Road ,, ,, 1 child Strafford Road ,, ,, 1 child Berrymede Gardens ,, ,, 1 child Mill Hill Terrace ,, ,, 1 child Newton Avenue ,, ,, 1 child Bollo Bridge Road ,, ,, 2 children Bollo Lane ,, ,, 2 children Derwentwater. Steyne Road Baths Treatment. 1 child Essex Road ,, ,, 2 children Shaa Road ,, ,, 1 child Alfred Road ,, ,, 1 child John Perryn. Perryn Road Baths Treatment. 1 child Churchfield Road East ,, ,, 1 child Priory. Bollo Lane Baths Treatment. 1 child Hanbury Road ,, ,, 1 child Osborne Road ,, ,, 1 child Stanley Gardens ,, ,, 1 child Newton Avenue II 1 I 1 child Acton Lane ,, ,, 1 child Rothschild. Fairlawn Grove Baths Treatment. 1 child Cunnington Street „ 1 child Central. Wales Farm Road Baths Treatment. 1 child Steyne Road „ 1 child Chiswick County. Steyne Road Baths Treatment. 1 child St. Stephens. Valetta Road Baths Treatment. 1 child 42 EAR AND NOSE CLINIC. Ear Treatment only. Number attending with Otorrhoea 36 ,, ,, ,, Mastoid swelling 1 ,, ,, ,, Earache 25 ,, ,, ,, Wax 49 ,, ,, ,, other Ear diseases — — ,, referred, but did not attend 4 115 REPORT OF THE SCHOOL OCULIST. The attendances have been much more satisfactory during the past year. In all 400 children from Primary and Secondary Schools were examined of, whom 334 were prescribed glasses. 33 children Nose Treatment. Nasal and post-nasal catarrh. Number cured 95 ,, improved 42 ,, complicated by other conditions 1 ,, referred to Hospital 3 ,, who did not report for examination after treatment 11 ,, referred,, but did not attend 10 who failed to complete treatment 25 193 Nose and Ear Treatment simultaneously. Cases suffering from Otorrhoea and post-nasal Catarrh. Number cured 7 ,, who ceased to attend 5 irregular in attendance (not seen after treatment) 1 ,, referred to Hospital 1 . 14 Number of children sent for Audiometric examination 3] 43 from the Infant Welfare Clinics were seen and of these, 20 were ordered glasses. Three children were referred to a myope school. One child was referred for a squint operation and one child for orthoptic treatment. Much more use could be made of orthoptic treatment if there were facilities for training either at the Clinic or in neighbouring hospitals. At present the nearest training, centre is at one of the London hospitals, and few mothers have the time to take their children weekly as. is required. V. E. Brander. SCHOOL DENTAL REPORT FOR 1947. Not much useful comparison with the previous year's figures can be made because, owing to Mrs. Behr's absence and resignation, we were this year reduced to one Dental Officer for an even longer period—over 4 months. Although, however, the number of treatment sessions was less, actually more patients, were treated. This was partly due to the fact that the number of extractions was greater, a smaller number of gas sessions being missed, and partly because a larger proportion of temporary teeth were treated with Silver Nitrate. This latter course was adopted because it was felt that, with the continual shortage of staff and premises,, while not wishing to reduce the time spent on the conservation of permanent teeth more than absolutely necessary, treatment with Silver Nitrate was better than discouraging and neglecting the large numbers requiring and desiring conservation of the temporary dentition. The acceptance rate for school children is 83.1%. This sharp rise on the 65.9% of the previous year is gratifying, but may be due partly to more cases, being brought over from that year. This also applies to Mothers in the M. & C.W. section, the acceptance rate for whom stands at 82.96% and for infants at 90.84%. In the latter section, however, figures for all treatment have increased. Thirteen school children were referred to the specialist Dental Officer for treatment and 87 to the orthodontic clinic. The most useful function of this report must be to stress, the urgent necessity of solving the problem of space so that the services of existing staff may be used to better advantage, and the appointment of at least one more Dental Officer so that Acton may have a more adequate dental service and that we may approach nearer to fulfilling the requirements, of the Ministry of Health. (Signed) P. H. Slater. 44 Dental Report. Maternity and Child Welfare, 1947. Number Mothers Examined 227 ,, Mothers Referred 223 ,, Children Examined 142 ,, Children Referred 131 ,, Mothers Treated 185 ,, Children Treated 119 ,, Attendances— Mothers 940 Children 178 Permanent Teeth— Fillings 494 Extractions 571 Temporary Teeth— Fillings 122 Extractions 45 Anaesthetics— General 148 Local 50 Dressings— Mothers 168 Children 30 Scale and Polish— Mothers 131 Children — Number Other Operations— Mothers 154 Children 176 Number Dental Plates Supplied 80 SPEECH THERAPY REPORT, 1947. During the earlier part of the year, three sessions weekly were held at the Priory School. From September onwards, after the appointment of an Assistant Speech Therapist by Middlesex County Council, it was possible to double the sessions on Wednesdays. In addition to the regular treatment of individual cases, time is allotted for preliminary interviews with diagnosis; for giving advice to parents; for reviewing cases where no defect was noted at the first interview and for following up cases which have been discharged. Also, seven school departments have been visited. A total of 79 appointments for parents were made; 56 attended. 23 failed first appointments but only 4 failed to attend subsequently. 45 50 children have received regular treatment either for long or short periods. Of these:— 9 have been discharged cured. 2 left school. 12 were irregular in attendance. Of the 27 who require a further period of treatment: 9 are making very good progress. 16 are making satisfactory progress. 1 very little progress. 1 has attended only for a very short time. There are now 5 on the waiting list and one awaiting a preliminary interview. Eileen Richnell. SPECIAL SCHOOL. The School for the educationally retarded was open for the whole of 1947, and at the end of the year 40 children were on the roll. During the year 23 new cases were admitted. EXCEPTIONAL CHILDREN. Defect. In Hospital. Residential Special or O.A. School. Ordinary Elementary School. Day Special School. At Home. Toal. Tuberculosis 4 5 8 — 2 19 Congenital Heart — — 8 1 2 11 Delicate — 1 7 — — 8 Asthma 3 8 — — 11 Rheumatism 3 1 10 — 1 15 Crippled 1 3 6 — 1 11 Epilepsy — 1 5 — 1 7 Cretinism — — 1 — — 1 Partially Deaf and Deaf & Dumb — 3 1 3 — 7 Blind and Partially Blind — 3 3 — — 6 Imbeciles — 2 — — 11 13 Maladjusted — 7 — — — 7 8 29 57 4 18 116 46 VISITS PAID BY SCHOOL NURSES. The following are the number of home visits paid by the Nurses during the year. The visits have been divided into school distribution. Acton Wells 94 Berrymede 122 Central 3 Derwentwater . 104 John Perryn 60 Priory 62 Rothschild 161 St. Mary's Roman Catholic 14 Southfield 64 Special 5 West Acton 114 Other Schools 58 Total 861 MEDICAL INSPECTION RETURNS. TABLE I. A. Periodic Medical Inspections. Number of Inspections in the prescribed Groups . Entrants ... 957 Second Age Group ... 848 Third Age Group ... 549 Total 2,354 Number of other Periodic Inspections ... 233 Grand Total 2,587 B.—Other Inspections. Number of Special Inspections 68 I Number of Re-Inspections 1,314 I Total 1,382 J C.—Pupils found to Require Treatment. Number of Individual Pupils found at Periodic Medical Inspection to require treatment (excluding Dental Diseases and Infestation with Vermin). 47 NOTES.—(1) Pupils found at Periodic Medical Inspection to require treatment for a defect should not be excluded from this return by reason of the fact that, they are already under treatment for that defect. (2) No individual pupil should be recorded more than once in any column of this Table, and therefore the total in column (4) will not necessarily be the same as the sum of columns (2) and (3). Group. For defective vision (excluding squint). For any of the other conditions recorded in Table 11.a. Total individual pupils. 1 (2) (3) (4) Entrants 35 74 97 Second Age Group 72 37 101 Third Age Group 64 12 48 Total (prescribed groups) 171 123 246 Other Periodic Inspections 27 2 29 Grand Total 198 125 275 NOTES ON TABLE I. (a) The return refers to a complete calendar year. (b) The age groups subjected to periodic Medical Inspection are those prescribed by Regulation 40 (2) (a), (b) and (c) of the Handicapped Pupils and School Health Service Regulations, 1945. Those subject to periodic Medical Inspection under 49 (2) (d) should be included as "other periodic Inspections." The age group or groups inspected under Regulation 49 (2) (d) should be specified in the body of the School Medical Officer's Report. Regulation 49 (2) reads as follows : " Subject as in these Regulations provided, the arrangements as to the medical inspection of pupils shall be such that— (a) every pupil who is admitted for the first time to a maintained school shall be inspected as soon as possible after the date of his admission ; (b) every pupil attending a maintained Primary School shall be inspected during the last years of his attendance at such a school ; (c) every pupil attending a maintained Secondary School shall be inspected during the last year of his attendance at such a school ; (d) every pupil attending a maintained school or County College shall be inspected on such other occasions as the Minister may from time to time direct or the Authority with the approval of the Minister may determine." 48 TABLE II. A. Return of Defects found by Medical Inspection in the Year ended 31st December, 1947. NOTE.—All defects noted at medical inspection as requiring treatment should be included in this return, whether or not this treatment was begun before the date of the inspection. Defect Code No. Defect or Disease Periodic Inspections No. of defects Spccial Inspections No. of defects Requiring treatment Requiring to be kept under observation but not requiring treatment Requiring treatment Requiring to be kept under observation but not requiring treatment (1) (2) (3) (4) (5) 4 Skin 8 6 3 1 5 Eyes—a. Vision 198 73 17 — b. Squint 11 — — — c. Other 1 — — — 6 Ears—a. Hearing 2 3 2 5 b. Otitis Media 4 1 — 1 c. Other 2 — — — 7 Nose or Throat 59 20 10 1 8 Speech 8 — — — 9 Cervical glands 1 1 — — 10 Heart and Circulation 1 35 — — 11 Lungs 1 52 — 2 12 Developmental— a. Hernia 1 1 — — b. Other — 1 — — 13 Orthopaedic— a. Posture 9 14 — — b. Flat foot 3 4 — — c. Other 4 8 — — 14 Nervous system— a. Epilepsy — 1 — — b. Other — 2 — 1 15 Psychological— a. Development 1 1 — 3 b. Stability 7 10 — 3 16 Other 2 74 — 4 49 B. Classification of the General Condition of Pupils Inspected during the year in the Age Groups (See Note (b) on Table 1). Age Groups Number of Pupils inspected A. (Good) B. (Fair) c. (Poor) No. % of col. 2 No. % of col. 2 No. % of col. 2 (1) (3) (4) (5) (6) (7) (8) Entrants 957 391 40.85 512 53.51 54 5.64 Second Age Group 848. 222 26.18 535 63.09 91 10.73 Third Age Group 549 197 35.89 320 58.28 32 5.83 Other Periodic Inspections 233 75 32.19 150 64.38 8 3.43 Total 2587 885 34.21 1517 58.63 185 7.15 TABLE III. TREATMENT TABLES. NOTES (a) The Table should deal with all defects during the year, however they were brought to the Authority's notice, i.e., whether by periodic inspection, special inspection or otherwise, during the year in question or previously. (b) Owing to the difficulty of distinguishing between cases treated under the Authority's schemes and those treated otherwise, the treatment tables (excluding dental) should include all cases known to the Authority to have received treatment, whether at their own clinics or elsewhere. 50 Group I. : MINOR AILMENTS (excluding Uncleanliness, for which see Table V). Number of defects treated, or under treatmen t during the year. (a) Skin. Ringworm Scalp: (1) X-Ray treatment (if none, indicate by dash) 2 (2) Other treatment 9 Ringworm—Body 5 Scabies 41 Impetigo 72 Other Skin Diseases 197 Eye Disease. (External and other, but excluding errors of refraction, squint and other cases admitted to hospital) 190 Ear Defects. (Treatment for serious diseases of the ear—e.g., operative treatment in hospital—should not be recorded here but in the body of the School Medical Officer's Report) 135 Miscellaneous. (e.g., minor injuries, bruises, sores, chilblains, etc.) 1684 Total 2335 (b) Total number of attendances at Authority's minor ailments clinics 6079 Group II.—Defective Vision and Squint (excluding Eye Disease treated as Minor Ailments—Group I). No. of defects dealt with Errors of Refraction (including equint) (Operations for squint should be recorded separately in the body of the School Medical Officer's Report) 400 Other defect or disease of the eyes (excluding those recorded in Group I) 3 Total 403 No. of Pupils for whom spectacles were (a) Prescribed 334 (b) Obtained 302 51 Group III. Treatment of Defects of Nose and Throat. Total number treated Received operative treatment— (a) for adenoids and chronic tonsillitis 35 (b) for other nose and throat conditions — Received other forms of treatment 297 Total 242 Group IV.—Orthopaedic and Postural Defects. (a) No. treated as in-patients in hospitals or hospital schools 6 (b) No. treated otherwise, e.g., in clinics or out-patient departments 32 Group V. Child Guidance Treatment and Speech Therapy. No. of pupils treated—. (a) under Child Guidance arrangements 17 (b) under Speech Therapy arrangements 37 Table IV.—Dental Inspection and Treatment. (1) Number of pupils inspected by the Authority's Dental Officers— (a) Periodic age groups 2756 (b) Specials 1072 (c) Total (Periodic and Specials) 3828 (2) Number found to require treatment 2765 (3) Number actually treated 2298 (4) Attendances made by pupils for treatment 463G (5) Half-days devoted to : (a) Inspection 26 (b) Treatment 600 Total (a) and (b) 626 (6) Fillings : Permanent Teeth 2144 Temporary Teeth 807 Total 2951 52 (7) Extractions : Permanent Teeth 370 Temporary Teeth 2061 Total 2431 (8) Administration of general anaesthetics for extraction 1184 (9) Other Operations : (a) Permanent Teeth 981 (b) Temporary Teeth 788 Total (a) and (b) 1769 TABLE V.—Infestation with Vermin. (i) Total number of examinations in the schools by school nurses or other authorized persons 18855 (ii) Total number of individual pupils found to be infested 617 (iii) Number of individual pupils in respect of whom cleansing notices were issued (Section 54 (2), Education Act, 1944) — (iv) Number of individual pupils in respect of whom cleanisng orders were issued (Section 54 (3), Education Act, 1944) 53 AVERAGE HEIGHTS AND WEIGHTS- ENTRANTS. School. BOYS. Total No. Seen. 2 YEARS 3 YEARS 4 YEARS 5 YEARS 6 YEARS 7 YEARS No. seen H. ins. W. lbs. No. seen H. ins. W. lbs. No. seen H. ins. W. lbs. No. seen H. ins. W. lbs. No. seen H. ins. W. lbs. No. seen H. ins. W. lbs. Acton Wells 22 2 41. 37.75 16 43.73 42.67 2 48.87 52 2 48.75 47.37 Berrymede 61 9 39.08 37.69 32 40.69 40.34 13 42.5 40.86 4 45.43 48.5 3 44.08 42 Beaumont Park 34 12 38.41 35.06 6 40.7 39.04 13 44.07 41.96 1 43 40.5 2 48.75 50.25 Derwentwater 96 10 41.67 41.12 71 42.89 42.75 11 46.27 49.02 4 47.25 49.81 John Perryn 65 21 39.14 37.48 19 41.65 41.27 18 44 44.26 4 45.56 46.75 3 50.66 55.08 Priory 74 2 33 26.25 7 38.14 34.89 31 41.41 38.97 28 45 12.77 3 44.66 42 3 47 54.83 Roman Catholic 12 5 43.2 43.5 4 47.06 52.37 3 49.25 59.41 Rothschild 55 20 38.51 35.86 21 40.23 37.64 13 13.36 42.26 1 43.5 48 Southfield 74 21 41.4 39.57 47 43.39 42.26 6 46.1 46.95 1 49 51.25 West Acton 21 3 42.75 39.33 14 43.66 44.69 3 46.41 47.33 1 48 48.25 514 2 33 26.25 69 38.72 36.35 145 41.12 39.61 238 13.31 12.54 38 46.03 48.02 22 47.9 51.36 GIRLS. Acton Wells 11 1 42 36 7 42.75 40.35 3 45.41 47.41 Berrymede 50 5 37.75 34.45 23 40.57 38.27 14 43.01 13.28 7 45.1 45..78 1 47.75 55 Beaumont Park 22 6 39.08 34.79 7 41.57 38.32 4 43.81 41.43 2 44.5 44.5 3 49.16 53.25 Derwentwater 91 6 41.95 43.2 74 44.93 42.3 8 44.31 44.78 3 48 51.83 John Perryn 51 14 38.98 35.73 22 40.45 37.67 11 14.95 43.88 1 47.5 50 3 48.33 51.91 Priory 65 2 34.25 34 6 36.91 31.08 15 41.71 39.11 34 43.9 41.78 7 44.96 47.53 1 50 57.75 Roman Catholic 17 8 44.28 45.25 5 46.15 46.3 4 47.62 50.81 Rothschild 44 11 38.02 34.86 19 40.04 36.85 13 42.98 42.09 1 44.5 43.5 Southfield 68 16 42.15 39.29 44 43.42 42.16 5 46.9 46.3 3 49.25 52.33 West Acton 23 3 42.83 41.25 12 44.47 41.35 7 46.39 46.21 1 47.5 46.25 442 2 31.25 34 42 38.3 34.55 112 41.04 38.5 221 1 43.43 42.3 46 45.48 46.12 19 48.42 52.11 54 AVERAGE HEIGHTS AND WEIGHTS—SECOND AGE GROUP. School. BOYS. Total No. Seen. 8 Yrs. 9 Yrs. 10 Yrs. 11 Yrs. No. seen. Ht.. ins. Wt. lbs. No. seen. Ht.. ins. Wt. lbs. No. seen. Ht. ins. Wt. lbs. No. seen. Ht. ins. Wt. lbs. Acton Wells 34 2 52.37 62.5 2 52.62 65.75 2 57 78.25 28 57.17 80.01 Berrymede 114 8 49.06 56.31 8 51.59 62.19 30 54.51 70.67 68 54.54 73.1 Derwentwater 114 31 50.39 59.37 7 53.21 66.64 39 54.66 70.41 37 56.05 74.19 John Perryn 37 1 55 74 2 52.87 59.75 4 56.87 74.56 30 56.84 79.38 Priory 6 6 55.25 81.29 Rothschild 40 8 54.31 73.25 32 55.74 75.24 Roman Catholic 23 2 51.12 59.5 2 53 65.5 3 56.16 82.16 16 57.28 80.95 Southfield 58 5 52.2 64.8 3 58.33 57.16 11 55.22 75.7 39 54.71 75..73 426 49 50.56 59.85 24 53.21 63.22 97 54.84 72.02 256 55.68 75.99 GIRLS Acton Wells 35 1 53.75 63.5 1 54 69.25 1 51.5 64 32 55.43 71 71 Beaumont Park 52 3 51.58 57.83 1 50.5 56 17 55.85 76.89 31 56.45 76.86 Berrymede 129 1 53.5 70.5 2 52.25 63 51 55.08 73.09 75 55.59 76.34 Derwentwater 101 16 49.39 52.09 7 53.17 67.68 49 54.68 69.55 29 56.04 74.67 John Perryn 46 3 51.16 61.58 10 53.85 69.2 33 55.5 75.43 Roman Catholic. 23 1 48.5 53.5 5 52.2 63.2 1 52.25 71.25 16 56.39 78.5 Southfield 57 5 49.85 57 2 51.25 63.12 8 53.81 70.31 42 54.85 73.83 443 30 50.11 55.47 18 52.48 64.84 137 54.82 71.77 258 55.64 75.25 55 AVERAGE HEIGHTS AND WEIGHTS-THIRD AGE GROUP. School., BOYS. Total No. Seen. 12 YEARS. 13 YEARS. 14 YEARS. 15 YEARS. 16 YEARS. No. seen Ht. ins. Wt. lbs. No seen Ht. ins. Wt. lbs. No seen Ht. ins. Wt. lbs. No seen Ht. ins. Wt. lbs. No. seen Ht. ins. Wt. lbs. Acton Wells 9 9 61.55 100.44 Central 26 13 60.73 99.48 1 66.5 135 10 66.57 124.2 2 68.75 116.5 John Perryn 27 2 til 91.12 14 59.19 90.05 11 61.47 98.45 Priory 127 18 57.36 83.72 63 59.75 92.94 44 62.22 103.84 2 62.62 99.37 Turnham Gn. R.C. 9 7 59.21 94.32 2 63.37 101.37 198 27 58.11 87.24 99 60.07 94.07 58 62.19 103.27 12 65.91 120.06 2 68.75 116.5 GIRLS Acton Wells 5 5 60.3 93.4 Central 29 14 61.57 102.03 10 62.9 114.5 5 64.6 123.7 John Perryn 19 1 54 11 61.47 105.81 7 62.71 110.78 Priory 129 24 58.31 86.24 60 61.08 97.64 45 61.28 102.07 Turnham Gn. R.C. 5 2 57.25 86 3 59.83 117. 16) 187 27 58.07 85.32 90 61.16 99.08 55 61.38 104 1 10 62.9 114.5 5 64.6 123.7 . 439(1) ACT 51 Acton Borough of Acton ANNUAL REPORT OF THE Medical Officer of Health TOGETHER WITH THE Report on the Medical Inspection of Schools FOR THE YEAR 1948