Ac 44 11 (1) BARK 57 THE HEALTH OF BARKING 1963 BARK 57 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR BARKING FOR THE YEAR 1963 Printed in the Town Clerk's Department Barking Borough Council CONTENTS Pages 1. MEMBERSHIP OF COMMITTEES 1-2 2. STAFF 3-5 3. PREFACE 6 4. GENERAL PUBLIC HEALTH 7-23 5. PERSONAL HEALTH SERVICES 24-36 6. SCHOOL HEALTH SERVICE 37-50 7. REPORT OF THE CHIEF PUBLIC HEALTH INSPECTOR 51-83 PUBLIC HEALTH COMMITTEE as at December 1963 Chairman-Alderman Mrs. JULIA H. ENGWELL Vice-Chairman-Councillor Mrs.J. CALLAN Alderman Mrs. A.M. MARTIN Councillor Mrs. D.M. JONES Mr. Alderman J.R. SWEETLAND, C.C. Mr. Councillor E.R. McKEE Councillor Mrs. M. BREDO, C.A. Mr. Councillor R.W. MUGE Mr. Councillor H.J. CLEAVER Mr. Councillor C.A. POOL Councillor Mrs. D.M. GLENNY, Councillor Mrs. M. PRESTON, C.C. M.B.E., C.C. Mr. Councillor S.C. SIVELL Councillor Mrs. C.S.M. GODFREY, J.P. Mr. Councillor LEONARD WRIGHT, J.P. Mr. Councillor H.E. HAMSHERE, J.P. BARKING COMMITTEE FOR EDUCATION as at 31st December, 1963 Chairman-Mr. Alderman G.J.G. BEANE, J.P. Vice-Chairman-Councillor Mrs. D.M. JONES Representaticve Members:- Mr. Alderman A.E. BALL, J.P. Councillor Mrs. C.S.M. GODFREY, J.P. Alderman Mrs. M. BALL, C.A. Mr. Councillor A. GRAY Alderman Mrs. J.H. ENGWELL Mr. Councillor I. GREENHOUSE, J.P. C.C. Alderman Mrs. A.M. MARTIN Mr. Alderman J.R SWEETLAND C.C. Mr. Councillor L..E. HENSTOCK, J.P. Mr. Alderman W.G. WERMERLING Mr. Councillor H.J. HILLS Councillor Mrs. M BREDO.C.A. Councillor Mrs. M. PRESTON, C.C. Mr. Councillor J.A. BUTLER J.P. Mr. Councillor S.C. SIVELL, J.P. Councillor Mrs. J. CALLAN Mr. Councillor J.WARD Councillor Mrs. D.M. GLENNY, M.B.E., C.C. Co-opted Members:- Rev. T. HALL Mr. A.E. GREEN Rev. L. HESTON Mr. P. GRIMES Rev. Prebenda.y J.D.WAKELING Mr. F.H. KING E. BATEMAN Mr. A. STONE 1 Nominated Members:- Mr. County Alderman K.E.B. GLENNY, Mrs. E G LAW O.B.E., J.P. BARKING HEALTH AREA SUB-COMMITTEE of the Essex County Health Committee as at December 1963 Chairman-Alderman Mrs. JULIA H. ENGWELL Vice-Chairman-Councillor Mrs. J. CALLAN Barking Borough Council Representatives:- Alderman Mrs. A.M. MARTIN Councillor Mrs. D.M. JONES Mr. Alderman J.R. SWEETLAND, C.C. Mr. Councillor E.R. McKEE Councillor Mrs. M. BREDO, C.A. Mr. Councillor R.W. Muge Mr. Councillor H.J. CLEAVER Mr. Councillor C.A. POOL Counciller Mrs. C.S.M. GODFREY, J.P. Councillor Mrs. M. PRESTON, C.C. Mr. Councillor H.E. HAMSHERE, J.P. Mr. Councillor S.C. SIVELL Mr. Councillor LEONARD WRIGHT, J.P. Essex County Council Representatives:Alderman Mrs. M. BALL, C.A. Mr. County Alderman K.E.B. GLENNY, O.B.E., J.P. Mr. County Councillor A.C. BERRY County Councillor Mrs. S.M. BOVILL County Councillor Mrs. D.M. GLEEN County Councillor Mrs. L. FALLAIZE M.B.E. County Councillor Mrs. M. SMITH The Executive Council for Essex Representative:- Mr. F.A. WORTLEY The Essex Local Medical Committee Representative:Dr. M. LEWIS The Hospital Management Committee Representative:Mrs. D.L. BELCHAMBER Voluntary Organisations' Representatives:- Mrs. M.E. DALLEY Mr. P. CLAYDON Mrs. G.M. GRAFFY Miss M. NOEL 2 STAFF 1963 Medical Officer of Health, Area Medical Officer and Divisional School Medical Officer MARGARET I. ADAMSON, M.B., B.Ch., D.P.H. Deputy Medical Officer of Health, School Medical Officer Assistant County Medical Officer J.J. SLOME, M.R.C.S., L.R.C.P., M.B., B.S., D.Obst., R.C.O.G., D.C.H., D.P.H., D.I.H. School Medical Officers and Assistant County Medical Officers:- Dr. VIOLET SPILLER, M.D., M.R.C.S., L.R.C.P., D.P.H. Dr. EILEEN E.V. MARTIN, M.B., B.Ch. Dr. E. KLEIN, L.R.C.P.& S. Dr. D. BURGESS, M.D. General Practitioner Medical Officers Dr. S.K. ROY Dr. M. LEVELLE Dr. M. LEWIS Dr. S. FRANKS Area Dental Officer:- Mr. J.K. WHITELAW (Commenced Duty 1.11.63) Dental Officers Mr. P. CHAUDHURY Mr. J. WHITELAW (To 31.10.63) Mrs. B. HINTON Mr. H. NYMAN (Sessional) (Sessional) Miss F. PLAWES (Sessional) Superintendent Health Visitor:Miss G.L. BENFIELD Health Visitors/School Nurses etc:- Miss. S. BERGSTROM Miss E.G. PARRY Miss C,M. BROWNING Mrs. R.L. ROBERTSON Miss A. CATTLE Mrs. A.M. SMALL (Part-time) (Resigned 13.10.63) Miss M.T. DOWD Miss E.M. SCHROPFER (Tuberculosis Visitor) Miss L.A. GOODACRE Miss D.G. GORDON-WILSON Mrs. L. CORRI (Part-time Tuberculosis Visitor) Mrs. M KALU 3 STAFF 1963-Continued Ante Natal Clinic Sister:Miss R. WILLIS Dental Surgery Assistants Miss P. HELLON Mrs. K.McKENZIE (Commenced Duty (Commenced Duty 12.8.63) 24,6,63) Mrs. I.A. ROURKE Miss P. CHANDLER (Resigned 17.7.63) In addition 16 part-time Nurses are employed for the staffing of the various Clinic services Chief Clerk:Mr. G.H. RUFF Senior Administrative Assistant:Mr. B.S. WEAVER Administrative Assistants:- Mrs. E.M. BARTHOLOMEW (School Health Service) Miss H. BEARTON (Handicapped Pupils and Special Children) Mr. S. Deeks (Supplies and Maintenance) Mr. A. LONGMUIR (Prevention of Illness: Care and After-Care) Non-Medical Supervisor of Midwives:Miss E. O'CONNOR District Midwives:Mrs. I.M. BRONNICK Miss A. CUNNINGHAM Matron of Day Nursery:- Miss F.B. NASON Senior Dental Technician:Mr. J. CONSTABLE Domestic Help Organiser:Mrs. L. EVERITT Speech Therapists:Miss J. KING (Commenced Duty 1.4.63) Mrs. S. GIRLING (Part-time)(Resigned 3.7.63) Chief Chiropodist:Mr. H. LEAVESLEY Driver/Handyman Mr. W. HARRIS (Commenced Duty 28.10.63) 4 STAFF 1963 - Continued Occupational Therapist:Miss Z. MERCER REGIONAL HOSPITAL BOARD STAFF Consultant Ophthalmologist Dr. R.F. JAMIESON Consultant Obstetricians:Mr. B.G. SPIERS, F.R.C.S. Miss J. LAMBERT, F.R.C.S. Consultant Paediatrician:Dr. T. SAVAGE Consultant Ear, Nose and Throat Surgeon:Miss M. MASON, F.R.C.S. Consultant Dermatologist:Dr. P.M. DEVILLE Consultant Orthopaedic Surgeon:Mr. B. WHITCHURCH-HOWELL, F.R.C.S. Superintendent Physiotherapist:' Mr. T. HYND Orthoptist:Miss M. LEWIS 5 TOWN HALL, BARKING, ESSEX. December 1964. To the Mayor, Aldermen and Councillors of the Borough of Barking. Mr. Mayor, Ladies and Gentlemen, In presenting my Annual Report for 1963 I wish to express my appreciation to the Members of the Council for their kindness and consideration throughout the year. In addition I should like to place on record my appreciation of the support given to me by my colleagues during the year under review. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, Medical Officer of Health 6 GENERAL PUBLIC HEALTH SHORTAGE OF HOSPITAL ACCOMMODATION The rebuilding and extension of Barking Hospital is now in progress, and the contractors started operations on the site on 19th November 1963. To commemorate the occasion, a "Turf-cutting ceremony" on November 22nd, attended by many representatives from Barking and the surrounding County of Essex, was performed by Sir. Graham Rowlandson who, to my mind, typified the function of a Hospital- "to help those handicapped in any way to regain their strength and learn to function as normally as possible". It was a very moving ceremony, the one thought in many minds at that moment being the wish to hasten on the day when the new Barking Hospital would open its doors and welcome the patients for whom it will be specially equipped. HEALTH EDUCATION Steady progress has been made in group talks in quite a variety of health topics. The demand for talks, however, is likely to exceed the supply, not of subject matter, but of personnel who are suitably qualified to give the talks. I reported last year the serious interest taken by the older girls of the Junior Training Centre in the talks/demonstrations given to them in "Nursing sick people in their own homes" and in 1963 this proved very successful. Their interest developed into retained knowledge with a good practical standard in carrying out the simple nursing procedures which were included in their training. The British Red Cross Society Junior Nursing Manual was used for this training and the good picture drawings which it contains helped the girls considerably. In June they took the British Red Cross Society Junior Nursing Part I Examination and six out of eight girls received certificates. They are now keenly practising these new skills with the great desire to obtain the Part 2 Certificate. I understand it is the first attempt in this kind of training for mentally handicapped girls in the whole of the County. A British Red Cross Society Link Group has been formed in the School and the girls who have been enrolled as members are busy making dresses for the deprived little children in the Aden Protectorate. The talks on Health subjects to classes of girls at Eastbury Secondary Modern School has now become a part of their curriculum. This school has also commenced "after school hours" training for the Duke of Edinburgh Award Scheme for interested boys and girls. Mothercraft and Good Grooming are now firm fixtures on Wednesday afternoons for two members of the health visiting staff. I think the success of this project has promoted bigger and better plans for next year. A Dental Health Exhibition was held at Eastbury Secondary Modern School for one week during the Autumn Term and proved a stimulating topic for discussion for the children and teaching staff. The two classes of girls who had received Health Talks assembled a Health Exhibition themselves with a little assistance from the County Health Education Officer. This was viewed by the whole school and has in no small measure promoted a greater interest in health matters among the boys and girls. Many requests have been received by clubs and organisations for talks. The Barking Women's Co-operative Guild asked for one talk on Home Nursing or First Aid and this extended to three afternoon sessions. This is a typical example of the interest in health matters which is growing in the town. Topics range from: 1. First Aid, Nursing and Mothercraft-these are firm favourites and a good introduction to talks on Home Safety which is now included as a matter of course. 2. The National Health Service and freguently requests are made for a health visitor to talk about her field of work. .3. Nutrition-may sound a dull title but always proves to be of great interest and in these modern days of "snack meals" a very necessaries topic particularly for young mothers. 4. Sex education-is now being requested with more frequency by adult groups which I think shows that parents are beginning to be actively concerned in this aspect of their children's well-being. 5. Mental Health-is another subject which is becoming increasing popular. I have mentioned only a few of the titles of talks requested and no doubt many more will be added to the list as the work progresses. This will mean an expansion of staff with a Health Education Organiser responsible for the overall planning and the training and assisting of staff in methods of teaching, plus a technician to assemble and prepare visual aids and equipment. In fact there should be a Health Education section of the Public Health Department, and this may materialise at a later date. The film "To Janet a Son" was shown in the Assembly Hall in the late Autumn. It proved to be an enormous attraction and some latecomers had to be turned away as the hall was packed. The discussion afterwards, when young "would be" mothers and fathers were invited to ask questions, supplied a fitting end to the evening. 8 HEALTH EDUCATION -Talks etc. given Type of Audience Subject No. of Talks given. In duty Hours After duty Hours Prospectlve Married Couples Preparation for Marriage 15 Junior Training Centre Home Nursing 28 Senior School Girls Health and Hygiene 29 „ „ „ Duke of Edinburgh Award 25 British Red Cross Nursing and Welfare 27 B.R.C. Cadets Nursing and Mothercraft 11 Church of England Ed. Group National Health Service 1 Cons. Women's Assoc. Prevention of Illness 1 Old Age Pensioners Club National Health Service 1 St. John's Ambulance Brigade National Health Service 1 Mayesbrook Womens Club Role of the Health Visitor 1 Girls Life Brigade Home Safety 1 Pupils Faircross Special School Mothercraft 13 Barking Wormen Co-op Guild First-aid Nursing 3 Central Hall Methosidt Womens Club Sex Education 1 Home Helps First aid and Nursing 3 Student Nurses Rush Green Hosp. Social aspects of disease 5 Junior Accident Prevention Council First-aid in the Home 1 Pupil District Nurses Social aspects of disease 3 Prospective Parents Childbirth Film Schoolchildren & Parents Dental Health Exhibition. „ „ „ Home Safety and Health „ Expectant Mothers Relaxation and Mothercraft 214 Young Mothers' Club Health and Child Care 4 During the year 1963, a Discussion Group for mothers was commenced at Thames View Clinic. The venture has proved interesting and worthwhile, and now an Eenthusiastic bunch of young mothers eagerly await the monthly meeting. Discussions have been held on matters of mental and physical health and topics are arranged to take in all aspects of family life. 9 The informal discussions give the mothers an opportunity to air their queries and problems, and go away with greater knowledge and confidence to cope with their children. HOME SAFETY One of the most difficult aspects in the field of Health Education is the promotion of Safety in the Home - it is not easy to persuade housewives and husbands that their homes may not be as safe as the think. Every year more people die as a result of accidents at home than on the road, and our hospitals are kept very busy dealing with both serious and minor injuries caused by falls, burns, cuts and accidental poisoning. It is deplorable that some people 'don't'or 'won't' understand the necessity of using fireguards, particularly where the safety of old people is concerned. Old folk 'feel the cold' more than when they were younger and often remove the fireguard to obtain more benefit from the heat of the fire and in this way danger of accidental burning is aggravated. With this in mind, the Health Visitors and the Home Safety Officer have taken every opportunity to talk to people at home and in organisations on the need for constant care at home, especially where there are elderly folk or young children, and a regular programme of press advertising has been carried out to supplement such talks. Groups of girls in senior schools and in local organisations are studying Home Safety as part of their efforts for the Duke of Edinburgh's awards, and the Council's domestic helps have made a special study of the problems, especially those concerning the elder and infirm. Competitions on Home Safety have been organised among senior schoolchildren, and booklets and other items have been distributed through all women's organisations throughout the Borough. Posters have been displayed at large factories and literature given out at various out-door events during the year. NATIONAL ASSISTANCE ACT, 1948 I am pleased to report that for the third consecutive year it not necessary to take formal action to secure the removal of any persons from their own homes because they could no longer care for themselves. WELFARE SERVICE I am indebted to the County Welfare Officer for the following information:- Residential accommodation for aged persons continues to be developed to meet the increasing demand and a newly purpose-built Home accommodating 61 persons is now fully occupied. 10 Welfare services for blind and other cases of handicapped persons are available in many ways; these include home visitation by specialized field workers, tuition in handicrafts (and braille for the blind), recreational and holiday facilities and, especially for the handicapped person, the supply of home aids, gadgets and hoists. In addition the Welfare Committee gives financial assistance towards the cost of structural alterations designed to help the handicapped person in overcoming his disability. There is an occupational centre at Barking specially for specially for physically handicapped persons, and this is proving a great asset to those able to attend, of whom 47 live in the Borough. The table (on page 12) indicates the extent to which the various services provided by the County Council under the provisions of the National Assistance Act, 1948, have been afforded to persons having residence in the Borough of Barking during 1963. PUBLIC HEALTH ACT, 1961-SECTION 41 It was not necessary to take action under this Section of the Act during the year. The Section provides for compensatory payments to Persons excluded from work at the request of the Medical Officer of Health in the interests of public health. MATTERS OF LIFE AND DEATH Population The estimated population of Barking at each mid-year for the past decade, notified by the Registrar General is given below. 1954 76,580 1955 75,990 1956 75,560 1957 75,070 1958 74,850 1959 74,980 1960 74,920 196172,290 1962 72,440 1963 72,070 Births. During 1963 there were registered 1,028 live births showing a decrease of 9 from the live births in the previous year. With regard to the stillbirth figure of 24, this shows an increase over Previous year,s figure of 17. 11 12 COUNTY COUNCIL OF ESSEX- WELFARE COMMITTEE RESIDENTIAL AND WELFARE SERVICES-1963 (National Assistance Act 1948) 1. Number of Barking residents in accommodation provided under Section 21 (1)(a) of National Assistance Act 1948. 2. Number admitted to residential accommodation during 1963. 3. Number admitted to temporary accommodation under Section (1)(a) of National Assistance Act 1948. 4. Blind Persons, etc. 5. Other classes of Handicapped Persons Registered. Registered Number employed in: Blind Partially Sighted Defective Sheltered Workshops Home Workers Scheme Open Industry Male Female Total Male Female Women Children 132 51 11 1 1 10 236 22 42 64 5 7 4 10 194 Live Births:- Males Females Total Legitimate 461 515 976 Illegitimate 32 20 52 Totals 493 535 1,028 Still-Births:- Legitimate 6 15 21 Illegitimate 1 2 3 Totals 7 17 24 Total live and still-births 500 552 1,052 Birth rate per 1,000 of Estimated Population-14.26 Birthrate adjusted by Comparability Factor of 1.05=14.97 Still-birth rate per 1,000 (live and still) births-22.81 I am glad to say that the proportion of illegitimate live births as decreased from 5.4% in 1962 to 5.06% this year. Though the number of illegitimate births for 1963 is less than during 1962, the problem of the care of the unmarried mother is one the greatest importance. The increasing evidence of earlier physical maturity, without the corresponding development of mental ability, is an established fact and there is no "cast-iron" method coping with the situation. The loosening of family ties and in some cases almost the olition the 'family unit' has also had a retrograde effect. Internal Mortality I am happy to report there is no record of a maternal death in Loss of Infant Life It is regrettable that during 1963 both our loss of life from infant deaths and also from stillbirths increased. This is particularly disappointing as last year our number of infant deaths was so low comtred the national average. 13 1962 1963 Barking England & Wales Barking England & Wales Infant death rate 4.82 21.6 29.18 20.9 Stillbirth rate 16.13 18.1 22.81 17.3 During the first three months of 1963, we had the worst climatic conditions since the century began, and as a result, at both ends of the life span, deaths increased. The stock of coal was severely depleted in the area, and heating by electricity and gas was reduce owing to the phenomenal demands on the plants installed. Infants by their helplessness and rapid loss of heat, and the old folk by their comparative inactivity suffered most. It was an arctic winter that no one wishes to see repeated. The following table shows the loss of infant life during the last sixteen years. 14 15 Year No. of Live Births N o . of Still Births No. of Infant Deaths StillBirth Rate Infant Death Rate Deaths in firs t 7 Days of Life Peri-Natal Mortality Rate Quinquennial Infant Death Rate 1948 1461 29 30 19.46 20.53 13 28.18 30.2 (1944-48) 1949 1 328 24 33 17.75 24.8 17 30.32 29.5 ( 1945-49) 1950 1189 26 32 2 1.39 27.0 18 35.91 27.6 (1946-50) 1951 1162 20 18 16.9 15.49 10 25.38 24.4 (1947-51) 1952 1108 32 24 28.7 21.66 14 40.35 21.9 (1948-52) 1953 1090 33 27 29.39 24.77 20 47.19 22.8 (1949-53) 1954 998 29 20 28.24 20.04 16 43.8 1 21.8 (1950-54) 1955 980 30 24 29.7 24.49 19 48.51 21.2 (1951-55) 1956 919 23 18 24.42 19.59 12 37.15 22.2 (1952-56) 1957 916 18 17 19.27 18.55 14 33.19 21.6 (1953-57) 1958 9 17 23 17 24.47 18.54 10 28.72 20.3 (1954-58) 1959 969 15 28 15.24 28.95 22 37.6 22.1 (1955-59) 1960 996 20 18 19.68 18.07 9 28.54 20.8 (1956-60) 1961 925 26 16 27.34 17.3 13 41.01 20.3 (1957-61) 1962 1037 17 5 16.13 4.82 2 18.03 17.3 (1958-62) 1963 1028 24 30 22.81 29.18 15 37.07 19.7 (1959-63) The following tables show the causes of infant deaths:INFANTILE MORTALITY - 1963 Cause of Death Age at Death Under 1 mth. 1-3 mths. 4-6 mths. 7-9 mths. 10-12 mths. Total under 1 yr. Pneumonia - 4 - 3 - 7 Prematurity 7 - - - - 7 Congenital Malformations 4 2 - - 1 7 Atelectasis (Deficient expansion of lungs) 3 - - - - 3 Bronchitis - 1 - - - 1 Vascular Lesion of Nervous System - 1 - - - 1 Heart Disease 1 - - - - 1 Enteritis - - 1 - - 1 Ruptured Colon 1 - - - - 1 Birth Injury 1 - - - - 1 Totals 17 8 1 3 1 30 Five infants died at home and twenty-five in hospital. Four of the home deaths and eight of the hospital deaths occurred during the very cold weather of early 1963. NEO-NATAL MORTALITY - 1963 (Deaths during the first 28 days of life) Cause of Death Age at Death 0-7 days 8-14 days 15-21 days 22-28 days Total Prematurlty 7 - - - 7 Congenital Malformations 4 - - - 4 A telecta sis (Deficient expansion of lungs) 3 - - - 3 Heart Disease - 1 - - 1 Birth Injury 1 - - - 1 Ruptured Colon - 1 - - 1 Totals 15 2 - - 17 The Neo-Natal death rate was 16.54 per 1,000 live births. 16 Other mortality rates which may be of interest are:- Perinatal Mortality Rate (Stillbirths plus deaths under 1 week) 37.07 per 1 ,000 live and still births Legitimate infant death rate 28.69 per 1,000 legitimate live births. Illegitimate infant death rate 38.46 per 1,000 illegitimate live births. CONGENITAL ABNORMALITIES The Ministry of Health is now paying much more attention to the occurrence of any congenital abnormalities, both in live children and those vho are stillborn. By means of post-mortem examinations, a surprising number of internal congenital abnormalities have been brought to light and a great stimulus has been given to research into this problem. It may e that post-mortem examinations will become a routine "ocedure in all cases of early infant deaths. DEATHS The causes of death in 1963 are as follows: Disease-s of the Heart and Circulatory System 248 Cancer end other Malignant Diseases 167 Pneumonia, Bronchitis and other Respiratory Diseases 109 (excluding T.B.) Diseas of the Brain and Nervous System 90 Other Causes 40 Accider , Poisonings, Violence 38 Infant deaths and congenital malformations 33 Diseases of the Stomach and Digestive System 12 Tuberculosis and other Infectious Diseases 7 Diabetes 6 Pregnancy, Childbirth and Abortion - Total 750 Crude death rate per 1,000 estimated population 10.41 Adjusted death rate (comparability factor 1.23) = 12.80 Of the 167 deaths froni malignant diseases, 54 were attributed to cancer of the lung and 48 of the 54 were men. 17 Cancer A more detailed analysis follows of the deaths from malignant diseases, which appears to suggest that men are much more vulnerable than women, particularly with regard to cancer of the lung. DEATHS FROM MALIGNANT DISEASES - 1963 MALE Site of Disease Age at Death Under 15 yrs. 15-24 yrs. 25-44 yrs. 45-64 yrs. 65-74 yrs. 7 5 yrs. & over Totol Lung/Bronchus - - 3 27 15 3 48 Stornach - - - 3 7 3 13 Blood - 1 - - 1 - 2 Prostate - - - - 1 2 3 Breast - - - 1 - - 1 Other 1 1 1 10 15 7 35 Total 1 2 4 41 39 15 102 FEMALE Site of Disease Age at Death Under 15 yrs. 15-24 yrs. 25-44 yrs. 45-64 yrs. 65-74 yrs. 75 yrs. & over Total Breast - - 1 10 3 2 16 Lung/Bronchus - - 1 4 1 - 6 Stomach - - - 4 3 4 11 U teru s - - - 2 1 1 4 Blood - - 1 1 - - 2 Other 1 - - 9 13 2 25 Total 1 - 3 30 21 9 64 18 INFECTIOUS DISEASES The following notifications were received during the year:- Measles 861 Tuberculosis: Respiratory 27) Non-Respiratory 4) 31 Whooping Cough 70 Scarlet Fever 45 Pneumonia 19 Puerperal Pyrexia 5 Food Poisoning - Dysentery 20 Meningoccal Infection - Scabies 1 Erysipelas 3 Ophthalmia Neonatorum 1 It is pleasing to note that not one single case of poliomyelitis was notified for the fourth consecutive year. 1963 proved to be c "Measles" year with a figure of 861 notifications compared with 135 the previous year. Fortunately, however, except in a 'ew isolated cases the disease was comparatively mild. CARE OF THE AGED The increasing proportion of the aged in Barking is becoming more and more of a problem. Hospital accommodation and accommodation with partial care is still hopelessly inadequate, and although in this area we are fortunate in having two all-day centres, plus a large number of clubs which are open at least two afternoons a week, there is a lot more Quiring to be done. Mayesbrook, the Home for 62 elderly persons, continues to cope odequately for its residents, by the provision of such is not the answer for everyone. We must endeavour to increase and supplement the do miciliary services and keep as many people in their own homes as we can - the extension of the Home Help Service, the introduction of the Good Neighbours service in the days of the future, even o'putting to bed1 service for the old folk, complete with a hot night drink if necessary. As always, it is the difficulty of recruitment of able folk to do it. Why not recruit a few men of moderate age to 3this for their own sex? There may be many men (65-70) who would "•happy to help their older brethren. 19 ESTABLISHMENTS FOR MASSAGE AND SPECIAL TREATMENT Licences were issued during the year in respect of four establishments which are governed by the Borough's bye-laws. In accordance with our requirements a hot water supply is available in each surgery. LAUNDRY SERVICE The laundry service of the chronic sick and elderly has continued to help 54 senior citizens, and in the service 13,135 articles have been collected, laundered and returned. During 1963 we were fortunate in acquiring a Minibus and driver who now does the laundry service transport, delivers and collects sick room equipment and medical supplies and has proved! an invaluable help in the smooth running of the Public Health Department. PATHOLOGICAL SERVICES Close co-operation continues with the Pathologic^! Department of the Barking Hospital, under the capable administrc on of I Dr. J.Caiman. I Blood-groups and Rhesus Type of all expectant jthers attenB ing Upn ey Clinic continued to be determined during 1963, and alsdB the haemoglobin content estimated as soon as the patient was accepted for a bed. Similar tests are carried out for all domiciliaryH confinement cases. At pre-determined intervals further haemoglobin estimations I were performed, thereby revealing at an early stage any patient in need of special treatment and advice for anaemia. Further investigations were performed on those of Rhesusnegative Type in order to detect the presence of Rhesus Antibodies and we have received valuable assistance from the Blood Transfusion Centre of the Regional Board in confirmation and more detailed examination of our findings. In earlier years it has been usual to perform a ingle Kahn Test on each patient, but in 1963 the Wassermann Test was substituted and the Kahn Test employed as a second test, thereby considerably improving the service offered. No material difference existed between the Laboratory service offered to the patient booked for hospital confinement and the mother who preferred to remain at home, except that in the latter 20 case all preliminary arrangements were made either by the patient's own doctor or the staff at Barking Public Health Department BARKING CHEST CLINIC During 1963, the work of Dr. J.T.Paterson and has staff has been considerably increased by the extra x-rays requiring to be taken in connection with the Ministry of Education Research project, and I do lank them most sincerely for their help Statistics relating to the notification of cases are given below:- Respiratory Meninges & C.N.S. Other Total Transfers into the area Total M. F. M. F. M. F. 1955 37 25 1 - 2 3 68 30 98 1956 31 15 1 - 2 1 50 32 82 1957 22 6 - - 4 3 35 22 57 1958 20 14 - - 2 2 38 28 66 1959 20 17 - 1 1 2 41 38 79 1960 27 14 - - 1 2 44 29 73 1961 17 15 1 1 2 2 38 22 62 1962 24 7 1 - 1 4 37 22 59 1963 17 10 - - 4 - 31 31 62 notified cases moved to other districts during the year. Dr. T. Paterson, the Chest Physician, and his staff have helped is considerably with the diagnosis of chest complaints, and their infailing kindness and consideration to their patients has helped considerably when difficult decisions have had to be made. 21 Examination of Contacts Adults Children Totals New Old New Old 1955 278 417 203 683 1581 1956 215 527 185 814 1741 1957 200 690 114 922 1926 1958 101 691 95 807 1694 1959 228 705 82 798 1813 1960 79 672 99 810 1 660 1961 110 680 113 809 1712 1962 88 683 89 741 1601 1963 93 656 84 886 1719 At the end of 1963 there were 557 cases of tuberculosis on the register involving 483 households, which is a slight decrease on the previous year. The nursing attendance at the clinic sessions and the home visiting is done by two members of your nursing star. 2343 home visits were made during the year. MASS MINIATURE RADIOGRAPHY I A Mass Radiography Unit visited Barking in February/March 1963 and I give below statistics in relation thereto: LOCATION MALE FEMALE TOTAL Lawes Chemicals Ltd. 180 19 199 Impalco Foils Ltd. 386 114 500 The Volunteer 834 380 1,214 Faircross Bus Garage 287 235 522 South East Essex Technical College 479 151 630 East Street, Magistrates Court 1,344 1,457 2,801 Fanshawe Tavern 322 365 687 British Eastlight Ltd. 46 245 291 Thames View Estate 117 262 379 Thames Plywood Ltd. 207 102 309 Magnavox Electronics 293 433 726 Sherwoods Paints 102 62 164 Poultons Ltd. 43 40 83 TOTAL NUMBER X-RAYED 4,640 3,865 8,505 22 Mass Miniature Radiography (Contd.) GROUPS ATTENDING MALE FEMALE TOTAL General Practitioner Referrals 148 88 236 General Public 2,138 1,987 4,125 Organised Groups 2,354 1,790 4,144 PULMONARY TUBERCULOSIS Requiring immediate treatment 2 2 4 Requiring close clinic supervision 3 1 4 Requiring occasional clinic supervision 1 4 5 Presumed healed, no further action required 6 17 23 AMONG OTHER ABNORMALITIES DISCOVERED WERE:- Bronchial Carcinoma 2 1 3 Congenital abnormalities of heart & vessels - 1 1 Acquired abnormalities of heart & vessels 10 5 15 Neurofibroma - 1 1 Lipoma - 1 1 Substernal thyroid - 1 1 Pulmonary fibrosis - Non T.B. 10 8 18 Emphysema 1 - 1 Pneumonia 4 2 6 Bronchiectasis 2 - 2 Honeycomb lung 1 - 1 Pneumoconiosis 1 - 1 Pleural thickening or calcification non T.B. 6 7 13 Abnormalities of the diaphragm & oesophagus 4 1 5 Pneumatocele 1 - 1 Congenital abnormalities of the bony & soft issues 4 - 4 Acquired abnormalities of the bony thorax & soft tissues 2 1 3 Did not attend for further investigation 2 2 4 23 PERSONAL HEALTH SERVICES This section deals with those services which come under the control of the Barking Health Area Sub-Committee of the Health Committee of the Essex County Council. CLINIC PREMISES In connection with the future Capital Building Programme the following projects have been included:- Woodward Clinic During 1963, 18 years after the end of the Second World War, the War Damage Claim for Woodward Clinic, was agreed, and arrangements put in hand for the demolition of this clinic and its rebuilding on the same site. Thanks to the kindness of the Education Department, the majority of our services were transferred to Dawson Infants' School, while the Dental Service for this area was accommodated in the second Dental Surgery at Porters Avenue Clinic. It is anticipated that the whole operation will take about 12 months, and here I would like to thank the Headmistress and staff of Dawson School for their kindness in making us welcome, and their forbearance in putting up with a lot of noise and disturbance of their routine life. Upney Clinic With the demolition of Upney Clinic (a one time First Aid Post) as a first step in the rebuilding of Barking Hospital, our clinic services were transferred on 8th November to a pre-constructed building situated near the Barking Hospital Administrative Block and Nurses Home. This building, though nicely designed, is much too small for the "traffic" it is called on to cope with. The number of women attending an ante-natal session may be as many as 100, and the seating accommodation, so essential and advisable for the expectant mother, is completely inadequate. Proposed Blake Avenue Day Nursery (to replace Gale St. Nursery) Our Borough Architect was commissioned to draw up the plans for the Blake Avenue Day Nursery (50 places) in conjunction with a small housing development, and the thought and planning which is going into the construction of this nursery should make it a moadel of its kind. 24 Central Clinic This extension project is still in the future but I hope not too long delayed as with the intensified development of houses and flats in the vicinity, adequate clinic facilities are essential. CARE OF MOTHERS AND YOUNG CHILDREN maternity Service Ante-Natal Care. This was given as follows:- Clinics 629 Hospitals (excluding Barking Hospital) 133 General Practitioners 278 Total 1,040 Confinements. During the year 1,043 mothers were confined, giving birth to 1,052 infants (including 9 sets of twins), These were born as follows:- Barking Hospital 629 Other Hospitals 136 At Home 285 At Private Nursing Homes 2 Total 1,052 In three instances patients failed to seek ante-natal care; in one the expected baby was illegitimate and in the other two the others ignored their condition. However, all three babies survived. Post-natal care. 489 Barking mothers attended the Post-Natal Clinic, making a total of 581 attendances. In addition 278 mothers were under the care of their family doctors and 133 were under the care of hospitals outside the district. Infant Welfare Attendances at Infant Welfare Clinics 1962 and 1963 Number of children born in year 1962 1963 Who attended 938 949 Total number of children who attended 2,806 3,361 Total attendances 22,161 20,132 From the above it will be noted that a larger number of children visited the clinics, but made an average of fewer attendances. 25 Distribution of Welfare Foods The following table shows the welfare foods distributed during 1962 and 1963:- 1962 196.3 National Dried Milk 18,946 18,148 tins Cod Liver Oil 1,360 1,199 bottles Vitamin Tablets (A &D) 1,652 2,027 packets Orange Juice 13,098 15,131 bottles In addition, during 1963, 31,003 packets of proprietary brands of milk foods, etc. were sold at clinics. Play Therapy At my request, the Barking Health Area Sub-Committee agreed to the inauguration of play therapy sessions in clinics. Owing to the lack of accommodation at Central Clinic, play therapy sessions were commenced on two mornings a week in Northbury Infants' School in November, 1963, and we are indebted to the Education Department for their co-operation in this respect, Play therapy in the hands of trained Nursery Nurses helps to alleviate emotional disturbance and help the child towards adjustment. So far these seem to be a great success, enjoyed by the children and appreciated by their parents, who welcome such help from those so highly trained in the care and development of the preschool child. At the end of the year there were nine children between the age of two and four years in attendance. Gale Street Nursery This Nursery continues to be a training school for nursery nurse During 1963 we had seven girls in training, four of whom sat the examination and 3 of whom passed. The table below shows the attendances at Gale Street Day Nursery during 1963:- 26  Number on Register Average daily attendances January 53 37.9 February 46 33.2 March 47 23.8 April 52 40.0 May 54 43.6 June 54 43.2 July 50 39.3 August 57 38.6 September 53 41.7 October 50 42.1 November 48 36.0 December 46 34.6 Nursery and Child Minders' Regulation Act There are no registered child minders in the Borough. Women's Welfare Clinic. Special sessions staffed by a medical officer and nurse trained contraceptive techniques are held for women who are referred for medical reasons. During the year 271 patients made 601 attendances. Prior to October, 1963, these sessions were held in Upney When other services were transferred to the prefabricated building clinic was decentralised to Central, Woodward, Porters venue and Thames View Clinics. This decentralisation has been great success and is much appreciated by the patients. During Testing Depending upon the availability of staff, babies are now screened six months in the clinics or in their homes if necessary, and 5-year as are screened at school entry medical inspection by the "Danavox" click-check audiometer. This has contributed to the earlier and more accurate detection of deafness. During 1963 six Midwives were employed in the Barking area. Twenty-one pupils did their district training and a total of 282 women are confined, which represents 30% of the births occurring in the Banking Hospital is a Part II Training Hospital for midwifery. Your Medical Officer of Health is approved by the Central Mid-wives Board to give the requisite public health lectures at the Banking Hospital. Arrangements are made on request for a midwife to attend 27 natal sessions at General Practitioner Obstetrician's surgeries, thus enabling doctor and midwife to work as a team in the patients' interest. I am only too happy to encourage this co-operation and am gladd to see an increasing number of requests for the services of a midwife for this purpose. Supervision of Midiwives Miss E. O'Connor, Superintendent of the Lady Rayleigh Training Home, has continued to undertake the non- medical supervision of midwives. Health Visiting In 1963 the health visiting staff was reduced by one and a replacement has not yet been found, in spite of repeated advertising in the nursing journals in which there are about one hundred health visitors posts advertised weekly. Only 600 health visitors are lined each year throughout the country, which falls far short of the demand. It is significant that only one of our staff of twelve (which includes the Superintendent Health Visitor, nine health visitors and two tuberculosis visitors) is under 30 years of age an that during the next few years four of your Health Visiting staff will reach the age of retirement. It has become necessary to reorganise the work of health visitors so that they can give as much of their time as possible to home visiting. Health visitors now work from their clinics instead of the Town Hall, this has saved a considerable amount of traveling time. It is hoped that when some of the staff pass the driving test and receive car allowances, they will decrease still further the time spent in travelling around their districts. (Inclement weather is also a great time waster and this could be largely obviated by health visitors using cars. 'Selective' home visits have become the rule rather than the exception, that is to say more visits are paid to families with Problem than to families who are assumed do not have them or who can such difficulties. If there were more staff perhaps, this method could be used in a more reasonable manner and with a better standard of selection. In Essex a workable population case-load for a health visitors is assessed to be 4,000. In Barking the population case-load is 8,000 per health visitor. Although a health visitor does not hold records for every member of the population on her area, a nigh proportion of households are visited during the year. In an assessment made of the number of visits recorded during one month of the year, it was 28 and that on average a health visitor made twenty visits a day or 10 lisits for a half day spent in home visiting. One third of the health visitors' time is spent in home visiting, the rest of her time is spent in advising and teaching in Child welfare Clinics, Ante-natal Clinics, Mothercraft Classes, School Nursing and in clerical work. The keeping of records and report writing is a vital part of the work. This leaves very little time indeed for Group Health Education talks. Home visits are recorded for statistical purposes as follows: 1. To children under 5 years. This group are the basic home visiting population. 2. Persons aged 65 years or over. This caseload is rapidly increasing. 3. Others - in which all other persons visited are included. It is the latter group which holds the greatest number of problems for it may include mentally disordered persons, patients discharged from hospital, expectant mothers, the physically handicapped, and these visits may be made because of failure to attend a hospital appointment, or failure to register the birth of a baby; or perhaps to assess the need of a recuperative holiday in relation to the patient's is ability, or even to visit an aged person whose condition may be Nursing anxiety a distant friend. The visits themselves are frequently requested by a general practitioner, a hospital Almoner, a councillor, or even a relative or the patients themselves. Home visits of this nature are often difficult and require all the gentle art of persuasion which is the keynote of the work in which are health visitors are regarded as Specialists. The visits may be lengthy for the interviews entail: - ( a) assessment of need. (b) advice re maintenance of health and prevention of illness and accidents. (c) arrangements for supportive services (d) advice to relatives relating to care of the patient. (e) follow up visits after discharge from hospital treatment or prior to hospital admission. To Sum Up the activities of the health visitors is to list in long retail the many facts of support, advice and teaching which are done peoples' own homes, in the clinics, in the schools and often in the 29 streets, for it is common to see a health visitor stopped by her mothers not only to pass the time of day but to ask for advice. During 1963 we have again received nursing students from various training centres for observation visits. The Superintendent Health Visitor has continued to give lectures to Student Nurses at Rush Green Hospital and to the Student District Nurses/Midwives from the Lady Rayleigh Training Home. The part time state registered nurses employed in clinic duties continue to assist the doctors and health visitors in carrying out preventative treatment in all our clinics and a few help with school nursing duties. Their work contributes largely to the many services which are conducted from our Welfare Centres. Home Nursing This service, together with approximately half of the domicili midwifery service, is still administered from the County Training Home at Leytonstone. During 1963 an increasing proportion of acute medical cases were cared for in their own homes. This reflects the scarcity of hospital beds. Many of these cases are helped considerably by having tempo use of our sickroom equipment. Vaccination and Immunisation Details of persons protected under the County Council's Schem for vaccination and immunisation are given below: SMALLPOX Primary Re-Vaccination Total Family Doctors 1 15 99 214 Clinics 216 16 232 Total 331 115 446 30 POLIOMYELITIS VACCINATION (Booster Doses Shown in Brackets) Salk Vaccine Sabin Vaccine Total (By Injection) (By mouth) Family Doctors 14 (45) 329 (261) 343 (306) Clinics 2 (13) 833 (743) 835 (756) Total 16 (58) 1162 (1004) 1178(1062) DIPHTHERIA Primary Boosters Total Children Family Doctors 239 75 314 Clinics 587 878 1465 Totals 826 953 1779 WHOOPING COUGH Primary Boosters Total Children Family Doctors 242 54 296 Clinics 510 314 824 Totals 752 368 1120 31 TETANUS Primary Boosters Total Children Family Doctors 282 108 390 Clinics 606 348 954 Tota1s 888 456 1344 PREVENTION OF ILLNESS, CARE AND AFTER-CARE Chiropody Service Our Chiropody Service is greatly appreciated, particularly by the old folk, and during the year 11,585 attendances were made. We are very fortunate in having the services of a domiciliary chiropodist who gives treatment in the patient's own home, and also visits Mayes brook Old People's Home to help the patients there to avoid foot troubles. Chiropody treatment of school children is also done and 342 treatments were given. Parents are encouraged to try to influence their children in their choice of shoes and socks which do not harm the feet, but this appears to be a losing battle! Our Public Health staff continue, however, to try to promote the wearing of sensible shoes. The following warning, given by the Society of Chiropodists should be of interest to all parents: "Don't let children wear stretchnylon socks". It is suggested that whereas these may be useful convenient for adults, so far as young folk are concerned" "reaction being equal and opposite, as the foot stretches the sock, so the sock,compresses the foot, especially the toes". It is a well-known fact in medical and interested circles the socks and stockings that are too short are even more dangerous. than shoes because the fact of the comparative softness of the former makes the damage they do less immediately noticeable. During the latter part of 1963, we started a "detection of diabetes" project among the housebound who were eligible for domiciliary chiropody. I am confident that by this means, some undetected cases of diabetes may come to light. 32 Domiciliary Occupational Therapy - Tuberculous Patinets Miss Z.Mercer, our Occupational Therapist, is still with us and has a stimulating effect on all patients with whom she comes in contact. In addition to her normal duties she also visits the Physically Handicapped Club held at Eastbury House and her efforts there are very much appreciated. I am indebted to her for the following report: - The very severe weather during the early part of the year affected the number of visits during the year. There are four patients on the Register, all of whom have completed some good work. One Patient aged seventy five years has won prizes for weaving in the local exhibitions and the Dagenham Town Show, while mother man gained prizes with his basketry. Work was sold at the Town Show and subsequently at Sales of Work. The Occupational Therapist visits only part of one day per week in each of the areas, which does tend to limit the possibilities of Domiciliary Occupational Therapy. I Patients are referred from the Chest Clinic by the Chest physician, who is always available for consultation and to give advice when requested. First Visits - Re-visits 111 Ineffective Visits - Other Visits 7 Visits to Clinic 5 Total Visits 123 No. of Visits to Patients 111 New Patients - No. on Register 4 Rick room Equipment Loan Scheme Nearly 1,400 articles have been loaned during the year and 1,271 were on loan at the year end. The standard of equipment available is steadily improving. Wheelchairs of the standard type are being replaced by lighter and easy folding types which can be easily stored in small flats, upstairs and put in the boot of a car. The demand for' Wheelchairs would be even higher, but for the fact that so often the only person available to wheel the patient is the spouse, who is not a great deal fitter physically than the patient. Bed pans are now made in a plastic material which is easy 33 to sterilise. Rubber sheeting is giving way to plastic sheeting and disposable incontinence pads are being used in increasing quantities . The management of heavy patients in the home still constitutes a problem. Self-lift poles are available to those patients who, to some ex tent, can help themselves. In other cases hydraulic hoists are a great aid to the home nurse and the patients' relatives who can manage to manipulate them, although they take up a great deal of space which can be ill-afforded in a small home. Domestic Help Service The Domestic Help Service has continued to give valuable service in 878 cases and the following table shows the help give to the various categories of case during 1963:- Category No. of cases helped Hours of Service Aged 693 103,845 Maternity 33 1,167 Chronic Sick 131 20,867 (under 65 yrs.) Other 21 993 (under 65 yrs.) 878 126,872 Recruitment and selection of suitable personnel has been good and whilst it is true to say the "woman power" has be en adequately and satisfactorily deployed, it is still difficult to afford complete coverage of "case load" during peak periods of holiday and sickness amongst the staff. At the close of the year 130 Domestic Helps were employed. To meet the "special needs" of certain cases. three women have been employed in a temporary capacity and one wonders if this can be looked upon as a "Good Neighbours Scheme" potential. The area Domestic Help Organiser has made 1,180 home visits, primarily of initial investigation, but having regard to the other time-absorbing aspects of her work, routine visiting lags far behind the desired standards and there is much to be said for the ment of an Assistant Organiser, or case worker in this vastly increasing field. The first of a series of local training courses was launched on 31st October, covering 8 sessions of 2 hours per week, at which 12 Domestic Helps attended. The talks and demonstrations wereI supplemented by film strips on the following subjects:- Home Safety, First Aid, Home Nursing, Social Services, Nutrition, Budgeting and Housecraft. This course was valuable, informative and aroused much interest amongst the Domestic Helps. It is hoped to develop and further the training of Domestic Helps in 1964. A "lighter side of life" for Domestic Helps has also developed during the past year. Two socials, a theatre outing and the first Annual Dinner and Dance have been held. These functions were well attended and have become quite an "attraction" and do much to minister "espirit de corps". Right Attendance Service Allied to the Domestic Heip Service, is the Night Attendance srvice, which provides attendants to sit in at night with sick, Alderly persons being nursed at home. This service has been asked for in 25 cases and assistance has been provided in 18 cases. In the other cases, due to the very lecture and dei e of illness, requests were cancelled prior to vision and consequence a lot of "ground work" was done to to avail. The recru ment and/or maintenance of staff in this field is Doctor, due to th casual, spasmodic and short-term nature of most during 1963, 3,114 hours of attendance were provided. Three Nig t Attendants were employed at the end of the year. Foluntary Associations As during evious years, the many Voluntary Associations in Barking have done their 'bit'. Barking House - the holiday 'home from home' provided by the Barking Physically Handicapped Association, has permited many Plsabled folk to benefit from the invigorating air of Clacton. The "Happy-Go-Lucky" bungalow at Holland-on-Sea has also Provided simile facilities for those mentally handicapped and, with he near-by fQrn Jnd their beach hut on the sands, both parents and children can relax and enjoy a seaside holiday. Barking Junior Training Centre-Rippleside During 1963 the staff of this centre have introduced many more ocial activities into the curriculum of the children. This included, swimming, physical training, and netball matches with other centres. my talks have been given to the "senior girls" by various people, 35 experts in their own professions, and visits have been arranged to places of interest. There were 80 children on the roll of the Centre at the end of 1963. 36 I SCHOOL HEALTH SERVICE 1963 REPORT ON THE HEALTH OF THE SCHOOL CHILDREN OF BARKING The information in this Section is given in my capacity as Divisional School Medical Officer of the ssex County Council. wish to express my thanks here to Members of the Council and to all my colleagues in the Education and School Health Services for their help ad co-operation during the year. 37 MEDICAL INSPECTION AND TREATMENT The statistical return at the end of this report shows the classification of defects found and the treatment thereof. Minor Ailment Clinics The attendances during the year at these clinics are as follows CASES TREATED AT MINOR AILMENT CENTRES EYES: (External and other - excluding errors of refraction and squint) 245 EARS, NOSE AND THROAT DEFECTS: (other than operative) 283 SKIN: Ringworm (scalp) - „ (body) 2 Scabies 5 Impetigo 34 0ther 1,701 Other minor ailments (e.g. minor injuries, bruises, sores, chilblains, etc.) 891 Total attendances 12,188 Speech Therapy Our full-time Speech Therapist who resigned in January 1963 was not replaced until April, and the post of part-time Speech Therapist has been vacant since July, 1963. During the year, 1,406 attendances for treatment of speech defects were made at the Central Clinics, or during weekly visits 1 to other centres. 158 children attended either regularly for treatment or less frequently for observation. At present, regular visits are made to two Infant Schools, to Gale Street Day Nursery, and four sessions are held each week at Faircross Special School, as well as sessions at the Central Clinic. It is hoped that a weekly visit to Thames View Clinic may be managed early in 1964. These visits have probed to be of great help since the therapist can now meet both parent ano I teacher to discuss problems and can be sure of regular attendance from the children. Unfortunately, since Mrs. Girling left, Woodward Clinic has been without a therapist, but it has been very gratifying to note the number of parents who are sufficiently concerned about their children's defective speech, and who are willing to bring them to the Central Clinic for treatment and advice, rather than wait for an appointment in their own area. 38 Speech therapy students have continued to make observation visits to the clinic throughout the year, to observe the treatment of children attending the clinic. They have been most helpful and interested in the treatment and gradual improvement of the children. DENTAL SERVICES During 1963 our dental services are gradually being increased, More dental health education is'being carried out in the schools and Clinics and both parents and children are becoming dentally conscious, Dental inspections have been trebled since the previous year and we are now using a recall system by vAich school children on our Register a re sent six-monthly inspection appointments. We are grativiewed it hat about 50% of the parents do appreciate this service. I should ike to see this periodic dental inspection extended beyond the school-leaving age. This might be possible if we can restart our Public Dental Service, which last operated in 1956. A dental Exhibition was held in Eastbury School in October, to which children in Schools in the vicinity were invited. The Dental Laboratory, despite the fact that they are one senior Dental Technician short, are working at full pressure. It is interesting to note that 513 Orthodontic appliances were supplied to the 22 County Clinics and 107 to the Barking Clinics in 1963. The Laboratory also covers all other types of mechanical dental work. SCHOOL NURSING The Health Visitors as school nurses find their work involves them more and more in the daily life of the schools, for it is necessary not the prevent ion of illness and physical defects and the mainbeenanace of good health standards continue to remain at the present five level. Fortunately, most ailments can be detected and treated Morly so it is seldom necessary for children to have long absences whom school. It has been noted for some years that fewer parents attend their children's medical inspections at school and because of this health visitors increase in the number of home visits re- discribed after school inspections. Regular hygiene inspections made by health visitors in the schools still remain a necessity and although head infestation is Electrively small, it would not do to relax vigilance particularly with are present trend of longer hair styles of both boys and girls. Most these found today are more in the nature of accidents than the result of neglect.Parents and children alike can be assured that the 39 nurses will advise and help anyone in need if they would attend the clinics , for after all "prevention is better than cure". PROTECTION AGAINST TUBERCULOSIS 1. B.C.G. Vaccination Our B.C.G. vaccination scheme continued during 1963 and the gratifying total of 706 tests undertaken by your doctors illustrates the co- operation of parents in what is one of the major preventive measures against tuberculosis. The Chest Physician and his staff at the Barking Hospital have assisted us in all doubtful cases and their co-operation has been invaluable. The statistics regarding this service are as follows:- Number to whom offered 838 Number tuberculin tested after parents' consent had been received 706 Positive result 73 Negative result 633 2. Tuberculin Testing Survey In addition to our routine B.C.G. programme already mention^ we agreed to take part in a Special Survey by the Ministry of Education, whereby children bom in 1952, 1953 and 1954 will (with parents' consent) have an annual skin test. The scheme is intended to give results over the next five years which will enable the Ministry to decide upon the best age for B.C.G. Vaccination an-, in order to increase the number of children in this Survey, one further age group will be added in 1964. Statistical information relating to the Survey is as follows:* Born 1952 Born 1953 Born 195^ No. to whom offered 997 96 1 917 No. accepted 715(71.7%) 717 (74.6%) 627 (68.4%) No. tested 6 17 593 509 Results: Negative 551 (89.3%) 535 (90.2%) 465 (91.4%) Positive 66 (10.7%) 58 (9.8%) 44 (8,6%) 40 The "negatives" will undergo a similar test next year, whilst he "positives" were referred to the Chest Clinic for routine x-ray. Though no cases of active tuberculosis were found among these positive reactors, it was somewhat alarming to find so many of these children reported as "bronchitis - a sad result of our variable climatic conditions. Note: The discrepancy in number accepted and number tested due:- (a) to exemptions where child was already under the Chest Clinic. (b) to absentees. (c) to removals from the district after acceptance but before tests were undertaken. Tuberculosis "Follow-Up" As the result of a school child requiring hospital treatment for Tuberculosis it was decided to offer a check-up to the staff and children at that particular school. The staff accepted the offer of examination at the Chest Clinic, and 133 parents (out of a possible 137) agreed to their child having skin test. fortunately, the results of the tests were completely satisfactory. FOOT INFECTIONS During the summer there was a marked increase in the incidence Athlete's Foot and Plnntnr Warts amonast school children. Intensive foot inspections were therefore carried out in all Senior and Junior Schools - with the following results:- SENIORS JUNIORS Total number of initial Inspections: 4,658 3,600 Number found to require treatment for:- (a) Athlete's Foot 1,754 (37.6%) 573 (15.9%) (b)Plantar Warts 309 (6.6%) 148 (4.1%), children with Plantar Warts were referred to the Hospital Skin clinic for treatment, and a second treatment session was instituted iscope with the numbers. Those with AthletefeFoot were supplied with ointment and powder, together with a leaflet giving instructions treatment. 41 Following the initial inspection at least two - and sometimes as many as three - further inspections were carried out for the purpose of re-examining those children found to have a foot infect) and to cover absentees, but it was disappointing that despite trea: ment and advice (and after 22,000 _re-inspections) there were still some500 known cases of Athlete's Foot, representing a large reservoir of infection. I would again like to express my grateful thanks to Head Tear and their staffs for their ready co-operation in these inspections, for exercising what supervision they could to ensure that children carried out prescribed treatment - unfortunately supervision could not be extended into the home. I would also like to thank those parents who did co-operates well by s upervising the home treatment. TYPHOID FEVER Owing to an outbreak of typhoid in Zermatt, Switzerland, at the end of March, arrangements for school children to visit a neighbour Canton were cancelled. It is advisable that all children going abroad ir chool Parties be protected against this disease. SPECIALIST SERVICES Eye Clinics Dr. R.F.Jamieson, M.B., Ch.B., D.O.M.S., continues to attend Central, Porters Avenue and Woodward Clinics. A: intments are made as far as possible to suit patients and parents. Cases dealth with were as follows:- External and other diseases (excluding errors of refraction and squint) 57 Errors of refraction (including squint) 1,051 Total 1,108 The number of pupils for whom spectacles w re prescribed was 618. Miss Lewis, Orthoptist (whose sanctum is at present in upper Clinic) , treated 132 schoolchildren during 1963. Paediatric Clinic Dr. T. Savage, Consultant Paediatrician, continued to hold fortnightly sessions at Upney Clinic during 1963. From the following 42 Table it will be noted that the majority of children seen by him are under school age:- New Cases Reexaminations Total Attendances School children 18 31 49 Under school age 155 246 401 Totals 173 277 450 Turesis Clinic For the second year, a regular enuresis session has been held theUpney Clinic at two weekly intervals; the Deputy Medical officer of Health acting as Clinical Assistant to the Consultant pediatrician. Although i has not been possible to verify the efficiency of the buzzer meth od" (due to shortage of health visitors), there is no doubt that it is n important remedy for a very unpleasant symptom. Every patient discharged from the clinic as "cured" (i.e. no cubresis for 6-8 weeks) is told to return should the enuresis re-occur. during the last year, only 3 children did return for another period fifth the buzzer (having been labelled "cured" during the previous Statistics the year are as follows:- Attendcnces New patients 41 Old " 30 Total 71 Appointments not kept (new and old patients) 58 Buzzers issued (for 3 months) 39 (i.e. all new patients less 2, who were too young) Buzzers issued for second period of 3 months 5 The most significant observation one can make is that very few childredn return to the clinic, because of a recurrence of enuresis. was a great many of the patients are aged 12 years or less one would inspect a large proportion to return if the need arose. The large number of failed appointments was due to the fact 43 that many patients did not attend the clinic until 2 or 3 appointments had been made. Although most of these were for return of the buzzer, an opportunity was lost to personally question the patient. Ear, Nose and Throat Clinics Miss M.Mason, F.R.C.S., continues as the Consultant Ear, Nose and Throat Specialist. Figures for treatment are:- Operative treatment (cases):- (a) For diseases of the ear None (b) For adenoids and chronic tonsillitis 92 (c) For other nose and throat conditions 24 Other forms of treatment (cases) 157 Child Guidance I wish to thank Miss C.Helen Watt, Educational Psychologist, Ilford Child Guidance Clinic, for the following report on "The School psychological Service in Barking":- "During the year we held, at the Child Guidance Clinic, a series of discussions for teachers on the subject of emotionally disturbed children. The meetings were open to Ilford and Barking teachers. In order to focus the discussion on the practical situation which faces the teacher we gave as the title for our discussions "The problem of dealing with emotionally disturbed children in class teaching". Although we started by discussing the classroom situation tion, the discussions tended to develop in such a way that people stated their views, in a rather theoretical and generalised fashion, about the causes of emotional disturbance and we got rather far from the classroom situation. In all the discussions, the parents were mentioned as impor- tant in connection with the children's problems and because of the interest in this, we invited the psychiatric social workers to attend the last meeting to describe the aims of their work with parents. As the group varied in composition at each meeting, different people attending each time and only a few coming to all or most meetings, we really had to start the discussion afresh each time for there was little chance to achieve continuity of discussion. We hope to hold further such meetings in the future. We have learnt from the meetings we have already had that we need to be more specific in our subjects for discussion and we may example ask people to present for discussion more detailed accounts of 44 Priblems arising with individual children. It was a great joy to see a second remedial class open in the through in September at Monteagle Junior School. The class started with a small nucleus of children and is gradually building up to a maximum of 16 children. It already has an atmosphere of its own and provides a relaxed and happy, but stimulating environment for the children and is an invaluable addition to the special educational facilities in the borough, The other long-established remedial class Roding Junior School is also, of course, still doing most valuable work. Now that we have two classes, the problem that some children could not attend a remedial class because of a difficult journey from some is eased considerably and some children from the Monteagle plass are picked up by the school coach which brings the Thames new estate children to the school. Ideally, I think all children, accept those within walking distance, should be provided with transport to these special classes on a school coach. This would event some children being penalised because their parents are unfilling or unable to make the effort to escort them to and from a school which involves a bus journey. In some instances this is the only reason given by parents for refusal to accept their child's attendance at a remedial class. The survey of reading difficulty in the Secondary Schools which has mentioned i last year's annual report has now been completed the additional figures confirm the conclusion drawn last year not there is a need for remedial classes for Secondary School childen who have failed to learn to read but who have the intellidance & to make good progress in such a class. The number who need these facilities s small but these few are in great need of more intensive remei 1 teaching. They also need to be relieved from the situation, unavc iable while they remain in ordinary classes at recomandary School level where most of the children read fluently and there they are set written work in a number of subjects; English, history geography etc., where, because of their reading difficulty, they are quite unable to cope with the spelling involved in putting in writing their imaginative ideas or the facts they have learnt. untill they have :stered the basic tools of reading and spelling they merely waste their time and become increasingly frustrated in lessons where the work demands a standard of literacy they have not let achieved. It would be of much more help to them and would rein Quicker progress if they were taught temporarily, until they mastered these basic skills, in classes where all the written work set was at the same level as their reading. The written work could then be geared to keep pace with their reading, so that they could use a gradually increasing vocabulary in their written work, they increased their reading vocabulary. In a small group they 45 would also have more opportunity to learn to read words from their written work by asking how to spell new words they wanted to use in writing. There could, in this way, be a two-way process in whid the child's reading practice helps his written work and his written work helps his reading, as of course happens with the normal Infan school child who learns to read at the expected time. In a small special class, individual work can be set so that each child can go at his own pace and the needs of children with different degrees of reading difficulty can be met. I am hopeful that it may be possible, in the future, to provide some special classes of this kind for secondary school children. This seems to me the most urgent need as far as increasing the local special educational facilities is concerned." New Cases tested individually 54 New Cases tested by group test in connection with reading survey 27 Follow ups for schools 56 Follow ups for Clinic 42 Remedial education cases 11 Children referred to C.G.C. 9 Orthopaedic Clinic Mr.Whitchurch Howell, F.R.C.S., Consultant Orthopaedic Surgeon, continued to visit this clinic at Barking Hospital, and reports that the work of the clinic has run smoothly during the year mainly on account of the excellent accommodation and good staff teamwork. There is still a serious shortage of Physiotherapeutists, and until their salaries are increased to a considerable extent there is no encouragement for anyone to take up this worth-while occpation. Mr. T.Hynd the Superintendent Physiotherapist does a wonderful job almost unaided. The Statistics for 1963 are as follows; Consultant Cases Adults 250 Children 71 Treatments 11,269 In-Patients 26 46 Skin Clinic Dr. P.M.Deville, Consultant Dermatologist continues to attend once a fortnight for the treatment of various skin conditions. In addition one of our assistant medical officers acts as his clinical assistant and deals with cases of athletes foot and warts. On account of the large numbers of children being referred for the treatment by school medical officers it was decided to increase the number of subsidiary skin sessions held to two per week, with effect from 21st October 1963. HANDICAPPED PUPILS A summery is given below of the ascertainment and placement of handicapped pupils during the year:- Category No. of pupils ascertained during 1963 No. of pupils admitted to Special Schools during year Total No. of pupils in Special Schools as at 31.12.63 Day Residential Day Residential Deaf - - - 4 2 Partially deaf 1 - - 1 Blind - - - - 2 Partially sighted - - - 2 - EPileptic - - - - - Delicate 2 2 1 9 4 Physically Handicapped 2 3 - 18 1 Educationally Sub-Normal 8 11 1 55 3 Maladjusted 1 - 2 - 9 Speech - - - — - Dual defect (E.S.N. & P.H.) - - - 2 - Totals 14 16 4 91 21 FAIRCROSS SCHOOL At the end of 1963 there was a total of 162 children attending Faircross School. This school is divided into three sections - Open their, Physically Handicapped and Educationally Sub-Normal, and are children are admitted from Dagenham, East Ham, Ilford, South Essex and Romford, as well as from Barking. The following table bows the distribution :- 47 Open-Air Physically Educations (Delicate) Handicapped Sub-Normit- Barking 10 19 55 Dagenham 12 - 1 East Ham 8 5 - Word 1 1 38 Romford 7 - 3 South Essex - 1 The Physically Handicapped and Open-Air Sections are taught together in one part of the school and the Educationally Sub-Normal in a different part. E.S.N. Section During the year 5 children left the E.S.N. Section on ceasing to be of compulsory school age (3 Barking, 2 Ilford) all of whom were recommended as requiring care or guidance after leaving school. Three children (2 Barking, 1 Ilford) were found to be unsuitable for education at School and recommended for action in accordance with Section 57 of the Education Act 1944. Two children (1 Barking, 1 Ilford) returned to ordinary schools and two Romford children transferred to the Havering Grange E.S.NB School. Open Air Section During the year 11 children (2 Barking, 9 out-of-district) were no longer considered to require special educational treatment - one aged 15 - was allowed to leave school but the others returned to ordinary schools. 10 children (6 Barking, 4 East Ham) left school on reaching the age of 16 years. In addition, 3 out-of-district children were transferred to Residential Special Schools and 2 Barking children were transferred to the Educationally Sub-Normal Section. CONVALESCENCE During 1963, mainly in the summer months, 66 children were afforded a recuperative holiday on medical advice! 48 SCHOOL HEALTH STATISTICS FOR THE YEAR 1963 Total (All Schools) 1.MEDICAL INSPECTION OF PUPILS (a) PERIODIC Number of children examined at school:- (1) Entrants 1,135 (ii) Second age group 1,048 (iii) Third age group 1,443 (iv) Others 217 Total 3,843 Number of defects found requiring treatment 1,319 Number of defects found requiring observation 674 Number of individual pupils found to require treatment 1,206 Nutritional classification of pupils examined:- Entrants 2nd Age Group 3rd Age Group Others Satlsfactory 1,128 1,048 1,4 4 3 214 3,833 Unsatisfactory 7 - - 3 10 (a) SPECIAL Number of children specially examined (lncluding medical examinations for Schoc Camps, Boxing and Part-time employment) 12,753 Numbe of defects found requiring treatment 7,321 Number of defects found requiring observation 67 (c) re-inspection Number of children re-inspected 7,622 2.Treatment of children Total a.tendances at Specialists' Clinics:- (i) Ear, Nose and Throat 369 (ii) Ophthalmic 2,057 (iii) Orthopaedic 49 (iv) Paediatric 49 (v) Skin 837 (b) Total attendances at Treatment Cllnics:- (i) Minor Ailment 12,188 (ii) Chiropody 342 (iii)orthopaedic 387 (iv) Orthoptic 1,435 (v) Speech Therapy 1,256 (vi) Skin Therapy 1,256 2,751 Number of children who received operative treatment for tonsils and adenoids 92 3. home visiting Total number of visits made by School Nurses 712 49  Total (All Schools 4. HYGIENE INSPECTIONS (i) Number of examinations of pupils in school 17,895 (ii) Number of pupils found unclean 105 5. DENTAL INSPECTION AND TREATMENT (i) Number of pupils inspected in school 3,191 (ii) Number of pupils Inspected at Clinics 1,139 Total 4,330 (iii) Number found to require treatment 2,969 (iv) Attendances for treatment 7,874 (v) Number of fillings: Permanent Teeth 2,897 Temporary Teeth 1,166 (vi) Number of teeth filled: Permanent Teeth 2,447 Temporary Teeth 942 (vii) Number of teeth extracted: Permanent Teeth 231 Temporary Teeth 1,011 (viii) Number of general anaesthetics administered for extractions 490 (ix) Other operations: Permanent Teeth 4,615 Temporary Teeth 2,549 (x) Number of treatments (Included in (ix) above carried out by Oral Hygienist - 50 ANNUAL REPORT OF THE CHIEF PUBLIC HEALTH INSPECTOR FOR THE YEAR 1963 Section 1 STAFF Section 2 G EN E R AL ADM IN ISTR AT ION Section 3 HOUSING Section 4 FOOD SUPPLIES Section 5 ATMOSPHERIC POLLUTION Section 6 PEST INFESTATION CONTROL Section 7 FACTORIES AND WORKPLACES Section 8 MISCELLANEOUS Section 9 STATISTICS 51 Section 1 - STAFF Chief Public Health Inspector & Re-Housing Officer E.G. TWEEDY, M.R.S.H., M.A.P.H.I. Deputy Chief Public Health Inspector E.A. ELLIS, M.A.P.H.I. Inspectorate Staff M.R. WILLIAMS, M.A.P.H.I. T.W. GLEW, M.A.P.H.I. S.A. LEMMON, M.A.P.H.I. (from 1.1.63) W.J. BATCHELER, M.A.P.H.I. (until 28.10.63) N.J. BURTON, M.A.P.H.I. D. ROBERTS (Student until 26.8.63) K.P. HUNT (Student from 16.12.63) Chief Clerk F.H. MORGAN Clerical Staff MISS N.M. TOMS MRS. G.M. SANGER Rodent Operative W.J. TERRY 52 Section 2 - GENERAL ADMINISTRATION The statistics relating to the inspections of various types of remises and the results of the inspections are to be found in Tables 1,2,3, and 4. 1. Service of Notices During the year 2,633 preliminary notices were served calling the attention of persons responsible to the need to carry out repairs in houses or to take action necessary to comply with the various regulations administered by the Council. In 156 cases where the preliminary notices were not complied with the Council authorised the service of formal notices calling for action within a specified period. It was not necessary to have recourse to legal action to secure compliance with any formal notice. I In certain cases involving the repair of sanitary accommodation and drains the Local Authority are empowered to carry out work if the person re. onsible fails to do so. This was done in 9 cases. 2. Houses in Multiple Occupation I An important addition to the work carried out by the public Pilth inspec rs is that in connection with houses in multiple Pupdtion. A a result of undesirable practices in various parts of the country gi ag rise to overcrowding and lack of essential facilities whic in turn gave rise to appalling sanitary conditions, regulation wc ntroduced in an effort to provide some measure of control. The legis, tion became operative in November 1961 but whilst gave general powers to local authorities to reguire certain faciliin houses ccupied by members of more than one family, no definite standc is were laid down so that each authority has had turbitrarily to fix such standards as it considers reasonable. Your officers have had consultations with officers of other ocal authorities in Essex and have reached agreement in relation to the following matters:- Overcrowding; Natural and artificial lighting; Ventilation; Wtater supply; Personal washing facilities; Drainage and sanitary conveniences; Facilities for the storage, preparation and cooking of food and disposal of waste water; Installations for space heating. During 196J 118 inspections of 36 houses in multiple occupation care carried out and 11 notices were served on owners to carry out 53 work to ensure compliance with the accepted standards. Work in this field is often rendered difficult because the inspected has to deal with people who have little or no knowledge of English and whose social background is very much different from that of this country. A further complication is the fact that the occupants of the house change frequently. It can be said that frequent visits often carried out outside normal working hours, and constant vigil have averted the worst evils associated with multiple lettings and in fact that those in Barking may be considered of a reasonable standard. An occupant of one house in which eight people lived was discovered to be suffering from pulmonary tuberculosis and it was considered desirable to submit the other occupants to x ray examination. With some difficulty owing to differing working hours the examinations were carried out one evening, transport to and from the hospital being provided by the public health inspectors. 3. Caravans 25 caravans belonging to travelling showmen were given permission by the owners of land adjoining the By Pass to park there for the winter 1962/63. The site was quite unsuitable for the purpose having no water supply, no means of disposal for waste water, no proper roads, no sanitary accommodation and no fire prevention equipment. Neither had planning permission been sought to use the land for the purpose. In addition vans were parked much too close together for safety. As members of the Showmen's Guild the caravan dwellers were exempt from the provisions relating to the licensing of land for caravan sites. It would be reasonable to expect however that any organisation enjoying such a privilege would take steps to ensure that its members are aware of their responsibility not to occupy a site in such a way as to make it a health hazard, a fire hazard, and aesthetically distasteful. As a result of interventions by the Council the site was vacated in March 1963 and has not been re-occupied since. 4. Water Supply to Dwellings During the very severe weather at the beginning of the year many dwellings were without an internal supply of water owing to burst or frozen pipes. There were over two hundred bursts in Council houses alone, apart from many in privately owned property. Many householders had to rely on supplies from a stand-pipe tank vehicle operated by the South Essex Waterworks Company. 54 Mattresses and bedding which were soaked when burst pipes awed were collected and dried at the public baths and returned to are owners. Improvement Grants (a) Standard Grants. As the availability of these grants become more widely known an increase in the number of applications results, this type of grant is usually applicable to the installation of an internal w.c., a bath, wash-basin and hot water supply in an existing com generally a small bedroom. 42 grants of this type were made curing the year. (b) Discretionary Grants. This type of grant is made when the work to be done entails more than the installation of the amenities mentioned above. In a number of cases no suitable room exists and has to be built, usually as an extension of the ground floor. 4 grants of this type were made during the year. The work carried out in connection with both types of grant is in table 5. Local Land Charges Details of any notices or orders likely to give rise to expenditure any property are given on receipt of a request for an official earch. This was done in respect of 701 properties during the year. in addition particulars as to properties were supplied in 84 ises in which mortgages were being arranged under the Housing Act 49 in respect of the purchases of dwellings for occupation by the chaser. Section 3 - HOUSING ACTS Clearance Areas The Council's scheme for the redevelopment of the Gascoigne progressec rapidly during the year. on the 29th January a Public Enquiry was held to consider lections to the proposed compulsory purchase of 238 properties in Clearance Area known as Gascoigno Road (Area No.2). Objections Received on behalf of 136 premises and there were 153 claims payments under section 60 of the Housing Act 1957. The following extract from the official representation outlines case Presented for the Council. 55 (a) Repair The brickwork in the majority of houses is soft and and porous. Pointing in many instances is bad. The external and internal joinery is ill-fitting, warned, worn, badly secured and in some cases decayed. Many of the wooden floors are defective i.e. springy, uneven and dropped in the bedrooms and living rooms. Front and rear entrance gates, boundary walls and fencing is generally dilapidated and in many cases entirely missing. (b) Stability Main walls are out of plumb and bulged in some instances. Several flank walls have tie-rods at first floor level. Many dwellings show signs of settlement in the bedroom walls with cracks of varying width. Joinery of light construction is ill fitting due to late settlement. Wood floors also have settled and floor joists dropped in a number of houses. | (c) Dampness Most houses in the area show evidence of rising and/or penetrating dampness in the walls at all levels. In some cases damp-proofing has been adopted in an endeavour to keep the affected rooms in a reasonable condition for comfort. Where the houses are constructed in long terraces the rainwater pipes are generally insufficient in number to deal adequately with excessive rainfall. There is frequent need for remedial action to be taken to keep the gutters in reasonably sound condition. In all cases front rain-water pipes discharge over the public pavement. Underfloor ventilation is inadequate in the majority of the houses but in some cases additional air bricks have been provided to prevent the recurrence of dry rot in the timbers. (d) Natural Lighting and Ventilation In the majority of houses there is no natural lighting to the staircases. 56 There is generally inadequate natural lighting in ground floor back rooms, sculleries and w.c. apartments. In most of the houses the ventilation to the staircases and w.c. apartments is insufficient. (e) Drainage and Sanitary Conveniences The system is old and not laid in accordance with modern principles. In many cases the w.c. fitments are obsolescent and unsatisfactory. At only 15 houses has a bath been installed in a separate room; there are 22 houses with a bath in the scullery and 1 with a bath in a temporary shed. Of these, 10 baths only are provided with adequate hot water supply thereto. In other cases improvised means of heating water and plumbing have been arranged, whilst in 15 instances there is neither hot nor cold water laid on to the bath. (f)Facilities for the Storage, Preparation and Cooking of Food. Of the 238 properties, only 27 are provided with ventilated food stores. Many of these 27 larders are damp and unuseable. The sculleries used for food preparation are generally small, dark and damp; in many cases the floors are below the level of the adjoining yard. The Order was confirmed by the Minister on the 9th October, 1963 and he was also satisfied that the acquisition of the added and was necessary to provide an area satisfactory for redevelopment, During the year under review the clearance programme took another step forward when the Council declared as unfit dwellings Premises Families Gascoigne Road (Area No.3) 152 161 Table 6 shows the action taken to deal with unfit houses since 1955 Act 1957 sixteen application for Certificates of Disrepair were received during the year. but in only three cases were Certificates issued. 57 This was because the owners concerned gave undertakings that the defects specified in the applications would be dealt with. Details of the work done under the Rent Act 1957 are given in Table 8. Section 4 - FOOD SUPPLIES (a) Food Premises. The regular routine inspections of all types of food premises was maintained, a total of 2,426 visits being made for this purpose. In 133 cases it was found necessary to server written notice concerning contraventions of the Food Hygiene (General) Regulations. In most cases the necessary action was taken by the occupier of the premises without the necessity for legal action by the Council, but in four cases legal action was take In two instances legal proceedings were taken against persons employed in a food room for smoking. One was working in a bakehouse and one was a grocer. In each case a fine of £5. 0. 0. was imposed with £1. 0. 0. costs. The third case involved a vehicle used for the sale of ice Cretan The floor of the vehicle was in such a dirty condition that it was possible to pick up dirt between finger and thumb. The spare wheel was carried inside the vehicle below the ice cream making machine No hot water was available on the vehicle. The owners of the vehicle were fined £5. 0. 0. on each of two counts plus £3. 0.0. case The remaining case concerned a cafe in which parts of the floor were encrusted with dirt. Cooking utensils and food containers were found to be dirty and the rear yard was littered with empty food tins and had been fouled by dogs. A sanitary convenience had no notice displayed in it requesting users to wash their hands. After a number of verbal warnings and a written notice had brought about no improvement the proprietor of the cafe was prose cuted and fined £5.0.0. on each of five counts plus £5. 5. 0. costs. Not only is it necessary for proper facilities to be provided and a high standard of cleanliness to be maintained, but the technique of bulk cooking also plays an important part in preparing safe meals. This was demonstrated in an outbreak of food poisoning affected eighteen employees of a local factory who had all eaten food in the factory canteen. In this instance meat was stewed the day before it was intended to be consumed and allowed to cool slowly. The Food Hygiene Regulations lay down that such should be cooled to a temperature below 50°F under hygiene conations, as quickly as possible and kept at that temperature until required. 58 The catering contractors of the canteen concerned took steps to ensure that the requirements of the Regulations would be rigorously observed in the future. (b) Unfit and Unsound Food. The list in Table 10 sets out details of the fourteen occasions when a complaint was made by a number of the public concerning food which was either unsound or which contained foreign matter. In twelve instances the Council Issued a warning to the persons concerned that a repetition of the occurrence would lead to legal proceedings being taken. The other cases were the subject of prosecution and convictions were obtained in each case. (c) Ice Cream. Tables 12, 13 and 14 give details of the Itemises registered for the sale or manufacture of ice cream and the results of bacteriological and chemical analysis of samples. As a result of the number of samples classified in provisional Bade 4 after bacteriological examination, the Public Health Committee received at its February meeting a special report on the subject. It was pointed out that whilst a manufacturer can be prosecuted selling ice cream which does not conform to the standards laid down regarding fat and milk solids content, there is no legal standard for the bacteriological purity of ice cream and therefore no penalty for the sale of a product which is unsatisfactory bacteriologically. In many cases the ice cream sampled was made outside the borough and representations could only be made to the Authority it hose area the ice cream was manufactured. In the case of soft ice cream sold from a van it may be that an dverse bacteriological report is due to inadequate cleansing of the but is cannot be checked at the time because it is possible to examine soft ice cream machines without dismantling On the Committee's instructions letters were sent to the inster of Health and the Minister of Agriculture, Fisheries and requesting that consideration be given to the following:- (i) The registration of itinerant ice cream vendors and vehicles; (ii) The application of sanctions (e.g. withdrawal of registration) against vendors where ice cream repeatedly falls below the bacteriological standard set. (d) Milk Supplies. Table No. 17 gives details of the samples of milk submitted for bacteriological examination and the results. It is 59 gratifying to record that every sample was found to be satisfactory. (e) Food Sampling. Routine sampling of food for chemical analysis was carried on throughout the year and 202 samples were taken for this purpose. Table 18 gives particulars of the samples taken and Table 19 gives details of those which were found to be unsatisfactory. (f) Cooked Meat Products. A number of samples of cooked meats including brawn, veals, luncheon meat and corned beef were submitted for bacteriological examination. The results of the first ten examinations showed that three were definitely unsatisfactory and three could be described as not entirely satisfactory, whilst the remainder were satisfactory. After the matter had been taken up with the retailers concerned of the six unsatisfactory samples, further samples were examined and with one exception were found to be acceptable. The exception was a sample of brawn manufactured outside the Borough. A subsequent sample was taken as the brawn was delivered to the shop. This was also unsatisfactory indicating that the contamination was arising in the process of manufacture. The matter was discussed with officers of the local Authority in whose district the brawn was manufactured, who visited the factory. Improvements in the procress were effected and check samples have proved to be satisfactory. Although samples of cooked meats with high bacteriological counts are reported as being unsatisfactory no formal action can be taken against manufacturers or retailers because no legal standard exists. A great deal of good is done by drawing the attention food handlers to the need for special care in the handling and storage of cooked meats. It is felt however that in the case of a very high bacterial count there should be some formal power to prohibit sale of similar food from the same manufacturer or retailer unti action has been taken to improve the bacteriological condition Section 5 - ATMOSPHERIC POLLUTION - CLEAN I AIR ACT 1956 (a) Domestic Smoke Control. In accordance with the Council plan to control domestic smoke throughout the Borough by 1965,the further Smoke Control Orders were made during the year. The following table shows the situation at the end of 1963 60 Co-operation by the public continues to be good, but in seventeen cases it was necessary to remind householders living in the first three areas that the emission of smoke from unauthorised is an offence. (b) Industrial Smoke. Nine notifications of intention to install new furnaces were received, of these seven were oil fired, one gas fired, and the other was a conversion from hand firing to a chain grate stoker. There is a marked tendency for new installations to be fired which should reduce smoke emission to a minimum. Obsecrations continue to be made on chimneys from large Mistrial boilers. Two hundred and eighteen such observations were made during he year and there were eleven contraventions of the Smoke (Permitted Periods) Regulations, 1958. In most of these casess warning letters were sent to the firms concerned. (c) Measurement of Pollution. The two volumetric filters at eastbury House and Rosslyn Road School have been working thought the year, with the exception of the month of September when the apparatus at Eastbury House was out of commission. These fiIters meas ure the smoke and sulphur dioxide in the atmosphere and the results are shown in Graphs Nos.1 and 2. The average conception of smoke shows a seven per cent reduction compared with 1962, the pollution from sulphur dioxide shows a reduction of 21%. this latter figure is due to the high figure for 1962, owing to the usurious fog in December of that year. (d) Co-operation with other Authorities. The Council are Presented at the Standing Conference of Co-operating Bodies for atmospheric pollution which meets under the auspices of the Depart- of Scientific and Industrial Research. The Conference coordinates the activities of all authorities and organisations carrying out atmospheric pollution measurements. Council representatives continue to take part in discussions whit neighbouring authorities in connection with the administration the Clean Air Act. The discussions are mainly concerning Smoke area No. Date of Operation No. of Dwellings Dwellings concerted for burning smokeless fuel 1 1st January 1962 4,558 2,650 2 1st November 1962 1,864 1,315 3 1st November 1962 2,365 1,100 4 1st November 1963 1,728 1,210 5 1st November 1963 2,949 1,160 6 1st November 1964 1,421 Awaiting confirmation 7 1st November 1964 1,569 Awaiting confirmation 8 1st November 1964 2,446 Awaiting confirmation Control Areas and the problems that arise in connection with them. Supplies of smokeless fuels and extensions of the grant scheme have been fully investigated and have been the subject of correspondence with the Ministry of Housing and Local Government. The problem of diesel fumes from motor vehicles has also received attention. (e) Recent Legislation. During the year two important circulars concerning atmospheric pollution were issued by the Ministry of Housing and Local Government. The first was issued in May 1963 and dealt with chimney heights elaborating the existing provisions in this connection under the Clean Air Act 1956. In this Circular guidance is given to local authorities in determining the heights of new chimneys to prevent, so far as practicable, smoke, grit, dust and gases emitted therefrom from becoming prejudicial to health and a nuisance. In December 1963 Circular 69/63 was issued, which could have far reaching effects on future Smoke Control Areas. It informed local authorities that in some areas solid smokeless fuel for open fires may not be in sufficient supply in the future if open fires continue to be installed in quantity. The suggested alternatives to open fires are:- (a) Closed stoves or open grates with under floor draught, both of which are capable of burning hard coke, of which there will be adequate supplies. (b) Gas fires. (c) Electric storage heaters. Section 6 - PEST INFESTATION CONTROL (a) Rodent Control. Baiting was again carried out with Sodium Fluoracetate (1080) to control the rat population in the sewers and the regular treatment of industrial premises maintained an effective control of surface infestations. A free service was provided to householders whose premises showed signs of infestation. It is rare to find domestic premises infested with rats. The most common rodent found in houses is the small field mouse. (b) Mosquito Infestation Control. Residents on the Thames View Estate were again troubled by mosquitoes, midges and gnats. Species identified by the Natural History Museum were Culex pipen a type of mosquito not known to carry disease, and Chironomos, an irritating but non- biting midge. 62 Insecticidal spray was used to deal with adult insects and an effort was made to deal with breeding places by filling depressions containing water although in a wet season this latter task could over very extensive. (c) Fly Control. The spraying unit was used again during the to spray with residual insecticide sites which were likely be attractive to flies of all types. This included areas of vacant and the yards of food shops. (d) Verminous Premises. During the year twenty four domestic raises were found to be verminous and all were successfully realt with by using insecticidal spray. Section 7 - FACTORIES AND WORKPLACES Tables 20, 21 and 22 give details of the routine inspections of dories and workplaces made during the year to ensure that dequate sanitary accommodation is available and that hygienic conditions are maintained. A variety of activities are carried on in their homes by people as outworkers which include the making of undergarments, rousers, shirts. ties, cardboard boxes, decorations and Christmas ckers. All the houses are visited regularly to ensure that the work is done a hygienic surroundings. Section 8 - MISCELLANEOUS (a) Supply of Dustbins. The number of premises where dustbins supplied ad maintained by the Corporation under Section 75(2) the Public Health Act, 1936 totalled six thousand one hundred six at the end of 1963. Two hundred and fifty eight dustbins supplied under this scheme during the year. A further sixty dustbins were supplied to dwellings not in the above scheme, Payment of five shillings per year for eight years. The number of premises in the complementary hire purchase now totals one thousand two hundred and ninety three. fifteen further premises have been issued with metal dustbins on a basis at four shillings per year. The total number of privately premises supplied by the Corporation with standard metal is now seven thousand four hundred and fourteen. A proposal to replace all existing metal bins with paper sacks adopted by the Council during the year and the issue of paper and stands commenced on the 30th September 1963. At the the year seven thousand four hundred and thirty two premises been equipped accordingly. 63 (b) Offensive Trades. Throughout the year there have been nine visits to the offensive trade premises in the Borough. Type of Trade No. of Premises No. of visits 1 Oil Boilers 1 3 Gut Scrapers and Fat Melters 1 6 Soap Boilers (not operating) 2 - (c) The Diseases of Animals (Waste Foods) Order 1957. Five licences authorising the operation of plant and equipment for the boiling of waste foods are held by pig breeders in the district. Twenty seven visits were made to the premises concerned, one contravention being observed. This was rectified on service of a preliminary notice. (d) Pet Animals Act, 1951. During the year eighteen inspections were made of the eight licensed premises in the Borough. All were found to be satisfactory. (e) Swimming Baths and Swimming Pool. I am indebted to the Borough Engineer who has supplied me with the following comparative figures:- 1960 1961 1962 1963 East Street Baths Total bathers 113,277 146,121 121,621 141,821 Park Swimming Pool Total bathers 114,895 101,429 62,189 76,335 Slipper Baths Total bathers 32,466 32,282 31,172 31,792 Samples of swimming bath water were taken during the year as follows:- East Street Bath 12 Barking Park Swimming Pool 4 South East Essex Technical College 11 All samples were found to be of a high standard of bacterial purity. (f) Water Supply (i) Domestic Water. Each month samples from the main supplies were obtained for bacteriological examination and twice during the year for chemical analysis. All were reported to be satisfactory. The mains water in the area is supplied by the Sou: Essex Water Works Company. (ii) Industrial Water. There have been six samples of water abtained from deep wells in use at three factories and submitted to bacteriological examination. Samples of water from both mains supply and deep wells were bund to be of a high standard of bacteriological purity. 65 66 Section 9 - STATISTICS Table No. 1 SUMMARY Total Inspections 16,523 Complaints received and investigated 2,036 Preliminary notices served 2,633 Statutory notices served 156 Notices outstanding at December 31st 75 Table No.2 ANALYSIS OF INSPECTION WORK PERFORMED BY THE DISTRICT PUBLIC HEALTH INSPECTORS Housing 6,147 Houses in Multiple Occupation 118 Slum Clearance 222 Factories and Workplaces 906 Outworkers premises 585 Shops 546 Food premises 2,238 Street Traders 85 672 Rats, Mice and other pests Drains 103 4,107 Smoke Control and Clean Air Act Tents, Vans and Sheds 58 Schools 128 Piggeries 27 Stables 13 Public Conveniences 41 Petroleum Acts 20 Improvement Grants pre-war Council dwellings 468 Miscellaneous Visits 39 16,523 Table No.3 PREMISES AT WHICH REMEDIAL WORKS WERE EFFECTET Dwelling Houses 1,301 Premises used for preparation and sale of food 77 Shops - not including food premises 14 Factories and Workplaces 72 67 Table No.4 DEFECTS FOUND AND DEALT WITH UNDER THE PUBLIC HEALTH ACT 1936 Roofs and flashings 495 Gutters 358 Rainwater pipes 63 Sinks 22 Baths and sink waste pipes 54 Choked drains 254 Defective drains 20 Inspection covers 7 Ventilation and soil pipes 10 Gully dishing 27 Gully traps 5 Flushing arrangements 205 W.C. Structures 4 W.C. Seats 13 W.C. Pans 57 Yard paving 29 Chimney pots and stacks 37 Damp walls 90 External walls 35 Underfloor ventilation 19 Window cills 39 Window and door reveals 13 Window frames 99 Sashcords 86 Stairtreads 5 Doors and frames 43 Door cills 4 Floors 44 Weatherboards 1 Stoves 18 Walls and ceilings 92 Water supplies 127 Dustbins and chutes 368 Verminous rooms 24 Accumulation of rubbish 103 Animals, birds and insects 87 2,957 68 Table No.6 CLEARANCE AREAS SUMMARY OF POST-WAR ACTION UNDER SECTION 154 OF THE HOUSING ACT 1936 AND SECTION 157 OF THE HOUSING ACT 1957 Area Dale of Repres. Act Sec. Type of Order No. of Houses Population Enquiry Dale Confirmation Dale Confirmed Houses No. of Houses Demolished Date of Demolition CREEKMOUTH AREA. NOB.2-50 5.10.55 1936 154 C.O. 46 157 - 25.2.56 - 46 Apr. 1956 - July 1957 WEST BANK, Nos. 1-5 consecutively 10.11.55 1936 154 C.O. 5 21 - - - 5 Nov. 1956 - Sep. 1957 ROD1NG VILLA. London Rood 9. 2.56 1936 154 C.O. 1 4 - - - 1 Nov. 1956 AXE STREET. No.71 6. 7.56 1936 154 C.O. 1 1 - - - 1 June 1956 HIGHBRIDGE ROAD. No.36 6. 7.56 1936 154 C.O. 1 2 - - - 1 June 1956 THE COTTAGE. LONGBRIDGE ROAD 6. 7.56 1936 154 C.O. I 4 - - - 1 April i957 HOCKLEY COTTAGES. Nos.1-8 cons. 2.11.56 1936 154 C.O. 8 33 - 16.11.57 - 8 July 1957 - Oct. 1957 OXFORD STREET. Nos..M5. even 29.11.56 1936 154 C.P.O. 8 15 - 23. 5.57 - 8 July 1957 - Oct. 1957 CHURCH ROAD. No.3 9. 1.57 1936 154 C.P.O. 1 5 - 14. 5.59 - 1 March 1957 CCVERDALE ROAD. Area No.l 9. 1.57 1936 154 C.P.O. 6 17 - - - 6 June 1957 - Oct. 1957 Nos. 18-26, even - - ST. MARGAPETS ROAD. No.66 9. 1.57 1936 154 - l 2 - - - AXE STREET. Nos.67.69.73 7. 2.57 1936 154 Closed 3 14 - - - 3 May 1957 AXE STREET. No.77 7. 2.57 1936 154 Closed 1 4 - - - 1 July 1957 ABBEY ROAD. Area No.6 7. 3.57 1936 154 C.P.O. 5 11 3. 2.59 26. 6.59 - 5 Nov. 1959 - May 1960 Nos. 137-145. odd BROADWAY, Area No. 1 - Nos.46-50, even 7. 3.57 1936 154 C.P.O. 3 7 • 2. 6.58 - 3 Sep. 1958 - Dec. 1958 HART STREET. Nos.38-56. even 7. 3.57 1936 154 C.P.O. 10 33 - 2. 6.58 - 10 Sep. 1958 - Dec. 1958 WESTBURY ROAD. Area No.l 7. 3.57 1936 154 C.P.O. 10 27 • 26. 3.58 - 10 Dec. 1957- Nov. 1958 137/147 Ripple Road, odd 2. 4, 6 Westbury Road CHURCH ROAD Area: 4. 4.57 1936 154 C.P.O. 84 286 9.12.58 14. 5.59 - 84 Oct. 1957 - Oct. 1960 Nos.5-15 Church Road, 6-42 Church Road; 34-5C Tanner Street: 1/3 & 2-8 Wakerlng Place; 68-136 & 99-115 Wakenng Road LINTON ROAD. Area No.l: 1-25.29-43. 2-22. 25-32 Kings Road 4. 4.57 1936 154 C.P.O. 152 442 9.12.58 14. 5.59 - 152 Oct. 1957 - May 1960 4-50 Queens Road, even 69-87 Linton Road and 43-67; 2-34 William Street 45-61 and 34-56 Kings Road 66-116 Linton Read 1-A Garden Place, consec. 69 Area Date of Repres. Act Sec. Type of Order So. of Houses Population Enquiry Date Confirmation Date Confirmed Houses No. of Houses Demolished Date of Demolition HIGHBRIDGE ROAD. Nos.30,32. 34, 36 & 40. even 8. 7.57 1936 154 C.O. 5 16 - 20. 8.57 - 5 Aug. 1957 - Sept. 1957 NORTH STREET. Nos.104-106 even 3.10.57 19361937 157 C.O. 2 8 - - - 2 Nov. 1957 NORTH STREET. No.7 Area, Nos. 112-140 even 31.10.57 1957 157 C.P.O. 15 85 - - - 15 Apr. 1959 - Oct. 1959 NORTH STREET. Area No.8 28.11.S7 1957 157 C.O. 3 10 - . - 3 Jan. 1958 - Feb. 1958 LINSDELL ROAD. Area No.l 28.11.57 1957 157 C.O. 4 17 - - - 4 Jan. 1958 - May 1958 ST. PAUL'S. Area No.3 28.11.57 1957 157 - 11 35 - - - 11 Feb. 1958 - Oct. 1958 THAMES ROAD. Area Ncr.l 28.11.57 1957 157 - 75 306 - - - 75 Nov. 1957 - Dec. 1959 THAMES ROAD. Area No.2 28.11.57 1957 157 - 9 32 - - - 9 Nov. 1958 - Sep. 1959 ELDRED ROAD. Area No.3 7. 2.58 1957 157 C.O. 4 21 - 28.10.58 - 4 Mar. 1958 - Feb. 1959 GAS YARD. No.2 5.12.58 1957 157 C.O. 1 2 - - - 1 Oct. 1958 ST. PAUL'S. Area No.4 5.12.58 1957 157 C.P.O. 15 65 30.7.59 16.11.59 - 15 Apr. 1959 - Nov. 1960 GASCOIGNE Road No.l 6. 2.59 1957 157 C.P.O. 222 624 6. 2.59 17. 3.61 - 222 Jan.1962 - July 1963 NORTH STREET. Area No.9 6. 3.59 1957 157 C.P.O. 14 53 26. 1.60 20. 5.60 - 14 ELDRED ROAD. Area No.4 12.10.59 1957 157 C.O. 7 14 - 20. 7.60 - 7 April 1961 WAKERING ROAD. Area No.l 9.11.59 1957 157 C.P.O. 25 55 - 7.12.61 - 25 March 1961 - Sept. 1963 KING EDWARD ROAD. 1 21 odd 5.12.60 1957 137 C.P.O. 11 35 - 11.11.61 - 11 Feb.1962 - July 1963 CAMSRIDGE ROAD. 2.4.12 & 14 3. 2.61 1957 16 Unfit 4 15 - - - 4 March 1961 -June 1962 CAMBRIDGE ROAD. 22 7. 4.61 1957 16 Unfit 1 3 - - - 1 April 1962 ABBEY ROAD. Area No.7 132-164 Abbey Road 6.11.61 1957 157 C.O. 18 51 - 7. 6.62 - 7 July - Dec. 1963 ST. ANN'S ROAD, Nos.95-99 12. 2.62 1957 157 C.O. 3 13 - 8. 3.62 - 3 Jan. - Fe b. 1962 ST. MARY'S ROAD. Nos.9S-101 9. 4.62 1957 157 Unfit 4 12 - - - - RIPPLESIDE, No.l 9. 4.62 1957 157 C.O. 6 18 - - - 6 April 1963 - July 1963 1. CREEKMOUTH 9. 4.62 1957 16 Unfit 1 6 - - - 1 June 1962 GASCOIGNE ROAD. No.2 9. 4.62 1957 157 C.P.O. 238 668 29.1.63 9.10.63 - - GASCOIGNE ROAD No.3 9. 9.63 1957 157 C.P.O. 152 403 - - - - C.O. • Clearance Order C.P.O. • Compulsory Purchase Order 70 Table No.5 IMPROVEMENT GRANTS No. of Premises Grants Value Standcrd Grants 42 £4,905.01 Discretionary Grants 14 £3,723.81 Table No.7 PROVISION OF HOUSING ACCOMMODATION Dwellings Provide New Council Accommodation 1963 Linton Road/Church Road (remainder) 147 Bevan Avenue (aged persons (remainder) 26 Southwold Drive/Hepworth Court development 76 249 New Dwellings completed since end of 1945 Barking Council 4,192 Private Owners 80 London County Council 121 4,393 War Destroyed (Rebuilt) Barking Council 63 Private Owners (including London County Council) 331 394 Temporary Bungalows (still in occupation December 1963) Barking Council 88 London County Council 291 379 Registered Housing Applicants January 1963 - Waiting List 1, 918 December 1963 - Waiting List 1,951 71 Table No.8 RENT ACT 1957 The following gives details of action during the year: - Applications for Certificate of Disrepair 16 Undertaking received after a "Notice of Intention to serve a Certificate of Disrepair" 15 Certificates of Disrepair issued 3 Cancellation of Certificate of Disrepair (after work completed to the satisfaction of tenant) 2 Table No.9 INSPECTION OF FOOD PREMISES During the year the following inspections were made and notices served:- Number of visits made to these premises 2,426 Number of defective or dirty walls, ceilings and floors - 46 Number of notices to repair or provide hot water fittings 10 Number of notices to repair counters, tables and cupboards 14 Number of notices to repair drains and yard paving 12 Number of notices to provide sinks and wash-hand basins 6 Number of notices to repair or renew defective sanitary fitments 7 Number of notices to provide soap, nail brushes and towels 2 Table No. 10 FOOD PROSECUTIONS AND COMPLAINTS Nature of Complaint Action Taken Black Deposit in Whole Orange Drink Warning letter to bottlers. Mouldy Party Pie Committee interviewed Manufacturer and retailer. Mouldy Pork Sausage Warning letter to manufacturer and retailer. Fly larvae in Bacon Rashers Warning letter to retailer. Metal in Butter Warning letter to packers. Foreign matter in Sausage Roll Warning letter to manufacturer. Mouldy steak & kidney pies Warning letter to manufacturer and retailer. Dark streaks in loaf of bread Warning letter to manufacturer. Label in Fruit Bun Warning letter to manufacturer. Thread in Loaf Warning letter to manufacturer. Rubber Band in Milk Bottle Warning letter to bottler. Mouse excreta in Almond Slice Legal proceedings against shopkeeper. Absolute discharge £5. 5. 0. costs. Matchstick in Roll Warning letter. Matchbox in Fruit Cake Legal proceedings against manufacturer. Absolute discharge. £IO. 10.0 costs. Table No. 11 CONDEMNED FOOD Baby Food 3 tins Beans 130 tins Biscuits 101 pkts Cereal 330 pkts Cheese 25 pkts Cheese ½ lb Chicken 1 tin Cider 1 tin Coco-Cola 4 tins Coffee 2 jars Corned Beef 949 tins Cream 34 tins 72 73 Currants 13 lbs Fish - Fresh 122 lbs Fish - Tinned 55 tins Flour 69 lbs Fruit - Dried 33 pkts Fruit Juice 22 tins Fruit - Tinned 721 tins Fruit Pudding 12 tins Gherkins 1 jar Jam 16 jars Marmalade 23 jars Meat - Fresh 498 lbs Meat - Tinned 242 tins Milk - Tinned 203 tins Onions 24 pkts Onions - Pickled 1 jar Peas 63 tins Pease Pudding 15 tins Ravioli 1 tin Riblets 1 pkt Rice 53 tins Rusks 7 pkts Sage & Onion 15 lbs Soup 47 tins Spaghetti 3 tins Sponge Pudding 1 tin Steak & Kidney Pies 28 Steak & Kidney Pudding 1 Sugar 257 lbs Syrup 6 tins Tapioca 1 pkt Tea 2 lbs Tomatoes 309 tins Tomato Juice 25 tins Vegetables 17 tins 74 Table No.12 REGISTRATION OF PREMISES USED FOR THE MANUFACTURE OF SAUSAGES, PRESERVATION OF FOOD, MANUFACTURE AND SALE OF ICE CREAM Trade Number of applications received during 1963 Number of applications refused during 1963 Total number of premises on Register 1963 Manufacturers of Ice Cream - - 2 Retailers of Ice Cream 11 - 191 Manufacturers of Sausages 1 1 37 Fish Frying and Preserving - - 21 Ham Boilers - - 11 Table No. 1 3 BACTERIOLOGICAL EXAMINATION OF ICE CREAM METHYLENE BLUE PROVISIONAL GRADINGS Total No. of Samples Grade 1 (Provisional) Grade 2 (Provisional) Grade 3 (Provisional) Grade 4 (Provisional)[/##] 66 52 9 4 1 Table No.14 CHEMICAL ANALYSIS FAT CONTENT Total No. of Samples 0% - 5% 5% - 10% 10% - 15%[/##] 2 - 1 1 75 Table No.15 LOLLIES - LEAD CONTENT Total No. of Samples Satisfactory Unsatisfactory 24 24 - Table No. 16 LOLLIES - BACTERIOLOGICAL EXAMINATION Total No. of Samples Satisfactory Unsatisfactory 20 20 - Table No.17 EXAMINATION OF MILK Dasigation of Milk Total Samples Submitted Methylene Blue Test Phosphatase Test Turbidity Test Passed Failed Passed Failed Passed Failed Pasteurised 38 38 - 38 - - - Tuberculin Tested (Pasteurised) 27 27 - 27 - - - Sterilised 8 - - - - 8 - 76 Table No. 18 SAMPLES TAKEN Almond Slice 1 Fruit Salad Anchovy Fillets 1 Gherkins Apples 1 Gin Apple Flakes 1 Ginger Cordial Apple Pie 1 Ground Almonds Apricot Jam 2 Ground Ginger Beefburgers 1 Haddock Beef Croquettes 1 Halibut Oil Capsules Beef Dripping 1 Ham Beef Sausages 10 Hamburger Beef <S Tomato Steakettes 1 Honey Beetroot 1 Ice Cream Black Pudding 1 Krakoyska Sausage Brandy 1 Lamb Bread 3 Lard Breakfast Sausage 3 Layer Cake Bronchial Balsaam 1 Lemonade Bubble Gum 1 Lemon Glucose Butter 2 Lemon Juice Cheese 1 Liver Sausage Cherry Cake 1 Luncheon Sausage Chicken 1 Madeira Cake Chicken Noodle Soup 1 Margarine Chocolate Drink 1 Milk Chocolate Mousse 1 Minced Beef Chop Sauce 1 Mincemeat Cinnamon 1 Minced Steak Coconut Dessicated 1 Mock Chicken Roll Coconut Macaroon 1 Mouth Ulcer Tablets Cod 1 Mussels Coffee 1 Mushroom Soup Cooking Oil 1 Neovit Corned Beef 1 Nuritabs Cornish Pasty 1 Nut Oil Crab Spread 2 Onions Cream 1 Orange Cordial Dairy Cream Eclair 1 Peas Dripping 1 Pears Eccles Cake 1 Piccalilli Evaporated Milk 1 Pilchards Fish Cakes 4 Polish Schinken Formalin Tablets 2 Polony Frankfurters 2 Porkburgers Samples Taken (Contd.) Pork Pie 2 Steak & Kidney Pudding 1 Pork Sausages 22 Stewed Steak 3 Pork Sausage Meat 2 Strawberries 1 Pork Sausage Boll 2 Strawberry Jam 1 Potted Beef 1 Sucron 1 Raisin Cordial 1 Tea 2 Raspberry Jelly 1 Teewurst 1 Raspberry Milk Shake 1 Tomatoes 2 Raspberry Pie Filling 1 Tomato Ketchup 1 Ruqenwelder 1 Tonic Water 1 Gum 1 Tuna Fish 1 Rusks 1 Vanilla Flavour 1 Salami 3 Veal & Ham Savouries 1 Salad Cream 1 Vinegar 2 Salmon 1 Violet Colour 1 Saveloy 4 Whisky 2 seak & Kidney Pie 1 77 78 Table No.19 FOOD SAMPLES REPORTED NOT TO BE GENUINE Sample No. Food Adulteration or Labelling Offence Action Token 5459 Pork Chipolatas Meat content on border line and fat content slightly excessive . Letter to manufacturer. 5466 Dehydrated Peas Should have been described as "Dehydrated Peas" and not as "Peas" on wrapper. Letter to manufacturer. Label has been re-worded. 5467 Stewed Steak 31% deficient in meat. Wrongly labelled on display in shop. Vendor warned. 5481 Loaf of Bread Contained foreign matter in the form of burnt bread. Matter drawn to the attention of the manufacturer. 5483 Pork Sausages 9% deficient in meat. Warning letter to Manufacturer. 5494 Almond Slice Contained rodent excreta Legal proceedings. 5527 Bread Contained streaks of dark greyish foreign matter due to presence of traces of metallic iron. Warning letter to manufacturer. 5547 Pork Sausage Meat 9% deficient in meat Warning given to manufacturer. 5554 Pork Sausage Rolls Contained patches of greenish mould. Warning letter to manufacturer. 5572 Hamburger Meat content low for a hamburger. (Meat 66%) Manufacturer advised. 5590 Pork Sausage 7% deficient in meat. Manufacturer advised. 5595 Crab Spread Contained blackish fragment of fish or crab tissue. Manufacturer advised. 5615 Teething Rusk Contained greyish foreign matter. Manufacturer advised. 5603 Formalin Tablets Contained excessive Formaldehyde. Manufacturer advised. Sections 1-6 of the Factories Act 1937 are administered by the Local Authority only in relation to factories in which mechanical power is not used. The Sections deal with cleanliness, overcrowding, temperature, ventilation, lighting and drainage of Mrs. Section 7 of the Factories Act 1937 relating to the provision of sannitary accommodation is administered by the Local Authority in relation to all factories. 79 Table No.20 FACTORIES AND WORKPLACES inspections for purposes of provisions as to health and cleanliness. Premises Sections enforced by local Authority Number on Register Number of Inspections Notices 1. Factories Sections 1-6 Factories Act 1937 26 27 1 2. Factories (not included in 1) Section 7, Factories Act 277 626 58 3. Other premises Section 7 Factories Act 9 2 - 4. Offices and Workplaces Public Health Act 1936 72 148 1 Totals 384 803 60 Table No.21 IMPROVEMENTS EFFECTED AT FACTORIES CASES IN WHICH DEFECTS WERE FOUND. Particulars Found Remedied Want of cleanliness (S. 1) 14 2 Overcrowding (S.2) - - Unreasonable temperature (S.3) - - Inadequate ventilation (S.4) 3 1 Drainage of floors (S.6) - - Sanitary conveniences (S.7) (a) Insufficient 10 9 (b) Unsuitable and defective 59 49 (c) Not separate for sexes - 1 Other offences against the Act (not outwork) 18 7 104 69 Table No.22 OUTWORKERS. Number of outworkers in list required by Section 110(c) | 177 Nature of work carried out:- Artificial flowers 2 Making of wearing apparel 126 Boxes etc. 5 Lamp Shades 1 Cosaques, Christmas Crackers and Stockings etc. 43 Number of visits to outworkers 585 Number of unwholesome premises - Number of notices served - Number of prosecutions - 80 81 Table No.23 RATS AND MICE. 1. Local Authority TYPE OF PROPERTY (Non Agricultural) 4. Totals of cols. 1, 2, and 3. 2. Dwelling Houses (inc. Council Houses) 3. All other (inc. Business Premises) 1. Number of properties in Local Authority's District. (Notes 1 & 2) 42 22,746 3,039 25,827 2. Number of properties inspected as a result of:- (a) Notification 7 187 35 229 (b) Survey under the Act - - - - (c) Otherwise (e.g. when visited for some other purpose) - - - - 3. Total inspections carried out including reinspections (to be completed only if figures are readily available) - - - - 4. Number of properties in Sec.2. which were found to be infested by:- (a) Hats Major Minor 3 85 15 103 (b) Mice Major Minor 4 102 20 126 Number of infested Propertles (in Sec.4) treated by the L.A. (figures should not exceed those in Sect.4) 7 187 35 229 82 GRAPH NO. 1 SMOKE POLLUTION 1963 Monthly average of daily readings from volumetric filter apparatus site at Eastbury House and South - East Essex Technical School Rosslyn Road 83 GRAPH NO.2 SULPHUR DIOXIDE POLLUTION 1963 Monthly average of daily readings from volumetric filter apparatus sited at Eastbury House and South - East Essex Technical School, Rosslyn Road