Ac4413(,) BARNES BARN 13 LIBRARY BOROUGH OF BARNES Annual Report OF THE Medical officer of health For the Year 1945 BOROUGH OF BARNES THE Annual Report OF THE Medical Officer of Health FOR THE YEAR 1945 W. F. Twining McMath, M.D.. B.CH., B.A.O.,Belf.. M.R.C.P.Lond.. L.M., D.P.H. Medical Officer of Health. BOROUGH OF BARNES. STAFF OF THE PUBLIC HEALTH DEPARTMENT. Medical Officer of Health. W. F. Twining McMath, M.D., B.Ch., B.A.O.,Belf., M.R.C.P.Lond., L.M., D.P.H. Assistant Medical Officer of Health. Appointment Vacant. Chief Sanitary Inspector. C. S. Perchard, Cert.R.San.Inst., Cert. Meat and Food Insp. Additional Sanitary Inspectors. G. G. Gardiner *A. A. Brown Cert.San.Insp., Cert. Meat and Food Insp. W. L. Leach Temporary Sanitary Inspector. J. G. Plant, Cert.San.Insp, Cert. Meat and Food Insp. Health Visitors. Miss M. Parnell, S.R.N., S.C.M., Cert. Health Visitor. Miss J. McNish, S.C.M., Cert. Gen. and Fever Trained Nurse. Miss O. L. Wilson, S.R.N., S.C.M., Cert. Health Visitor. Social Welfare Worker (Joint appointment with Borough of Richmond). Miss H. Oliver. Chief Clerk. . R. E. Forrest. Assistant Clerks. Vacancies (2). *G. E. Tydeman. Temporary Clerks. Miss L. M. Fairclough. Miss K. P. Morcom. Miss J. Campbell. Mrs. M. Gazzard. Miss P. A. Healey. *D. Rundle. Matron of the Infectious Diseases Hospital (Temporary Appointment). Mrs. C. Dyer, S.R.N., R.F.N. Matrons, War-Time Day Nurseries. 47 Castelnau, Barnes—- Miss M. J. Farrer, S.R.C.N. 2 and 4 Sheen Gate Gardens—Miss D. Callund. * (Serving with H.M. Force). 3 Public Health Department, 117, Mortlake High Street, S.W.14. To the Mayor, Aldermen and Councillors of the Borough of Barnes. Mr. Mayor, Ladies and Gentlemen, I have the honour to present my Annual Report on the health of the Borough during the year 1945. This being my last report as your Medical Officer of Health I would like to recall that since June, 1940, when I took up office, the work of the department has not only increased in amount, but has extended in several directions. This is quite apart from the strenuous efforts, under most exhausting circumstances, during the war when all members of the staff were severely tried. Although the war is over, the work of the department has not returned to pre-war level, but, on the contrary, has grown considerably and is indeed likely to increase. The housing of the people remains one of the major problems, additional work has already resulted from the new Education Act, and it is probable that further additions to the scope of the activities of the department may be expected as a result of the new National Health Service Act. Before taking leave of you I wish to record my appreciation of the support afforded me by members of the Council and Officers of the Corporation ; and to the staff of the Public Health Department in particular, for their continued co-operation and devotion to duty. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, W. F. TWINING McMATH, August, 1946. Medical Officer of Health. 4 BOROUGH OF BARNES. REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1945. PREFACE. In accordance with the Ministry of Health Circular 28/46 the Annual Report for 1945 has been prepared on the same lines as the one for 1944. Accordingly, the Report is in two parts, a preface in which I refer to items of special interest and an appendix in which is given the statistics relating to the health of the district. OFFICES. Owing to the termination of the European war and the terms of the lease, it was necessary for the department to vacate the premises at 394, Upper Richmond Road, on the 6th December, 1945. As a result, lacking suitable premises to house the department as a whole, the General Public Health and Maternity and Child Welfare Sections of the department were transferred to 117, Mortlake High Street, and the Sanitary Inspector's and Housing Sections to part of the old Council House. This arrangement is intended to continue until the erection of the new temporary council offices at Hampton Square, when the Public Health Department will once again be housed together in a section of its own. STAFF. Dr. Merton Harrison, Assistant Medical Officer of Health, having resigned his appointment, left the services of the Corporation on the 19th January, 1945, on being called to the forces. It is with much regret I have to record the death, on the 20th February, 1945, of Mr. E. Kilner, temporary Sanitary Inspector in the department since December, 1940. Mr. J. G. Plant, who had been previously employed in a similar capacity in the department, returned again as temporary Sanitary Inspector on the 23rd July, 1945. Upon the 11th July, Mr. G. K. Shilleto, while still serving with H.M. Forces, resigned his appointment as a clerk on the permanent staff. Miss P. A. Healey commenced duties as temporary junior clerk on the 5th February. 5 Mrs. P. Manger, temporary Matron at the Infectious Diseases Hospital, having resigned her appointment, ceased duties on the 7th October, 1945. Mrs. C. Dyer was appointed temporary Matron, commencing duties on the 1st October, for the interim period pending the appointment of a Matron on the permanent staff. Mrs. C. Dyer had previously resigned her position as Matron at the Sheen Wartime Day Nursery, finishing duties on the 7th August, Miss D. Callund, Deputy Matron at the Nursery, being promoted on the 14th September, to succeed her. Mrs. M. Heard, Matron of the Castelnau Day Nursery, resigned her appointment and left on the 8th November. She was succeeded by Miss M. Farrar who commenced duties on the 26th November. SANITARY INSPECTION OF DISTRICT. The remarks contained in my Annual Reports for 1943 and 1944 as to the effect upon property of bombing and gunfire, and the consequent demands upon the services of the sanitary inspectors, have proved correct. The position is aggravated by the shortage in supply of materials and labour, causing many more visits by the inspectors, to see that repairs are carried out, than would normally be the case. It can be expected that these conditions will prevail for some considerable time. WATER SUPPLY. The water supply of the area has been satisfactory both in quality and in quantity. Bacteriological examinations of the water have not been made as these are carried out by the Metropolitan Water Board. There has been no evidence of either plumbo-solvency or of any form of contamination. The whole of the dwellings in the Borough are supplied from public water mains direct to house. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASES. Particulars of the incidence and distribution of the cases of infectious disease notified during the year 1945 are set out in Tables 23-26 in the Appendix, in which the number of cases removed to hospital and the number of deaths in the district from these diseases are also given. The incidence of infectious diseases in the Borough during the year have been low, measles being the only disease showing an appreciable increase. The number of cases of measles notified during the year was 358. The disease was prevalent throughout the whole of the country and was not confined to Barnes and was apparently following the normal three to four years cycle, reaching its peak in 1945. It is even more significant this year than last that there has been a great shift of the incidence of diphtheria to the higher age groups. 6 Of the 12 cases notified, eight were over 15 years of age, six of these being over 20 years of age. This change is no doubt resultant upon the pressing of the Corporation's scheme for immunisation of children, particularly infants, against diphtheria. Those adults who contracted the disease were severely affected. DIPHTHERIA IMMUNISATION. The routine propaganda to encourage parents to have their children immunised against diphtheria continued throughout the year. The Government's Special Annual Publicity Campaign was again carried out locally. Slides giving details of the facilities were shown in the two picture houses and appropriate press advertisements appeared in the local newspaper as part of this publicity. It is worth comment that the number of children receiving complete courses of immunising injections during 1945 was 609 as compared with 380 during the previous year. In the case of one child contracting diphtheria, injections for immunisation had been given at the Borough clinic. The child had not attended for a post-schick test. PROTECTION AGAINST WHOOPING COUGH. The Council's scheme for the free inoculation of children against whooping cough continues in operation. The number of children attending the Council's clinic for protection against whooping cough during 1945 was more than double the number attending during the previous year. This increase may in part be accounted for by the fact that during this year the anti-gen used was changed to alum-precipitated whooping cough vaccine which required only two injections and which could, in fact, be given at the same time, if necessary, as the diphtheria prophylactic used. TYPHUS SCHEME. As a result of the disbandment of the Civil Defence Services the premises in Mullins Path which had been a cleansing section of the first aid post, were no longer available for use as an emergency cleansing station for disinfestation of typhus contacts under the Council scheme for dealing with Typhus Fever. It was, therefore, necessary, for the Council to take over these premises, together with clothing and other equipment purchased from Civil Defence stock, for the purpose. In connection with the scheme a 10-h.p. 10-cwt. "Fordson" zinc-lined van has been purchased for the conveyance of infested clothing, etc. When not in use for this it will serve as a general utility van for the Public Health Department. 7 DOMESTIC HELP SCHEME. During the year the Council instituted a Domestic Help scheme to assist in the care of the aged and infirm persons and any cases of illness where domestic assistance in the home is necessary. This service should not be confused with the Home Help scheme, which has been provided for maternity and child welfare reasons, mainly to supply domestic help where a confinement takes place at home. CLEANSING STATION. The Barnes Cleansing Station continued to serve a necessary purpose throughout the year. Incidence of infestation decreased by about 28% as compared with the previous year. There has been no alteration in the arrangements to combat infestation which were enumerated in detail in my Annual Report for 1944. In no case during the year was it found necessary to take statutory action. BOROUGH ACCIDENT AND GENERAL PURPOSES AMBULANCE SERVICE. On the 30th June the Borough Accident and General Purposes Ambulance was transferred to the Council House, Mortlake High Street. Details of the number of journeys made and the types of cases dealt with are given in Table 19. MATERNITY AND CHILD WELFARE. On the 26th November, 1945 the infant welfare and ante-natal clinics for the Mortlake Parish were once again able to return to the pre-war building—the Health Centre, North Worple Way, Mortlake— which had been specially built for the purpose in 1939, but which, upon the outbreak of war, had been requisitioned for civil defence purposes. The number of births allocated to the Borough, after allowing for inward and outward transfers, is 537 compared with 594 in the previous year, giving birth rates of 15.5 and 18.0 per 1,000 population respectively. The figures for 1945 show a decided decrease in the birth rate, partially accounted for, no doubt, by the return of evacuees to the Borough, thus increasing the population upon which the rates are based. It is interesting to note that of the 537 births, 59 were illegitimate, approximately 11%. In 1945, as in previous years, the death rate for infants under one year of age was low in the Barnes Borough compared with the country as a whole, which is a very satisfactory state of affairs. As a result of Ministry of Health Circular 20 /44 upon the care of premature infants, every possible measure has been taken to ensure 8 the proper care of such infants, who may be so adversely affected by loss of heat and moisture. Among various arrangements made for this care are:— (i) The provision of the following equipment:— 1 treasure cot, complete with linen and blankets; 1 thermometer; 1 pair of scales with basket; 2 hot water bottles; 2 premature feeding bottles; 1 mucus extractor; a heated carrier for transporting a premature baby to hospital. (it) The service of the Home Help where necessary and available. As reported in my last year's Annual Report, included in the staff of the department is a Social Welfare Worker specially appointed to undertake work in connection with the care of illegitimate children and unmarried mothers—this officer is jointly employed by the Boroughs of Richmond and Barnes, dividing her time equally between the two areas. Details of the work carried out in the Borough of Barnes by this member of the staff is summarised in Table 36. It will be appreciated that much of the work in connection with this aspect of public health, as indeed in much of the work of the Public Health Department, is advisory and cannot be statistically recorded. The object in the administration of this work has been, as far as possible, to keep the baby with the mother or grandparents where the circumstances are such that this is both desirable and practicable. It is pleasing, therefore, to relate that during the year, out of 71 infants dealt with, 63, that is 89%, have remained with either the mother or relatives. It is to be noted that home and hostel accommodation provided by voluntary bodies has proved adqeuate for the needs of the Borough. The homes used have been situated in Kingston, Croydon, Clapham, Finchley, Highgate, Grayshott and Brighton areas. The standards maintained in the homes have been satisfactory. BOROUGH OF BARNES APPENDIX TO THE annual report OF THE Medical off icer of health 1 945. 10 STATISTICS AND TABLES BOROUGH OF BARNES. VITAL STATISTICS. The following statistical information relating to the Borough has been completed on receipt of the Local and National Statistics issued by the Registrar-General in connection with Population, Birth-rate, Death-rates, Maternal Mortality, Infantile Mortality, and Incidence of Notifiable Infectious Diseases. TABLE 1.—STATISTICAL SUMMARY, 1945. Births :— Birth-rate (per 1,000 of population) 15.5 Live Births:— Total. M. F. Legitimate 478 235 243 Illegitimate 59 31 28 Total 537 266 271 Still Birth-rate (per 1,000 total births) 25.4 Stilll Births (Legit.12; Illgit.2) Total. M. F. 14 7 7 Deaths:— Death-rate, all causes (per 1,000 of population) Deaths (all causes) Total. M. F. 470 217 253 Death-rate from Cancer (per 1,000 of population), 87 deaths 2-5 Death-rate from Zymotic Diseases (per 1,000 of population) 009 Deaths from Diphtheria (all ages) 1 ,, ,, Diarrhoea (under two years of age) 2 Death-rate from Maternal Causes (per 1,000 total births) 3.63 Deaths from Puerperal Sepsis 1 „ ,, Other Puerperal causes 1 Death-rate of infants under one year (per 1,000 live births) 35.4 Death-rate for 1 Legitimate infants (18 deaths) 37.7 1 Illegitimate infants (1 death) 16.9 11 Table 2.—Vital Statistics of the Borough of Barnes during 1945 and previous 5 Years Year. Registered Births Total Deaths Registered in the District. Transferabu Deaths Nett Deaths belonging to the District. Uncorrected Number. Nett. Number. Rate. Of nonresidents registered in the District. Of residents registered outside the District. Under 1 year of age. At all ages. Number. Hate per 1,000 nett births. Number. Rate. Number Rate 1 2 3 1 5 6 7 8 9 10 11 12 1940 285 361 10.3 301 7.6 23 276 12 35.2 554 13 .9 1941 248 360 11.0 215 6.9 14 248 22 74.5 449 14.4 1942 382 473 14.5 221 6.8 17 270 23 48.6 474 14.5 1943 487 607 18.0 210 6.2 15 270 20 32.9 465 13.8 1944 415 594 18.0 260 7.9 18 352 26 43.8 458 13.9 1945 408 537 15.5 245 8.1 22 257 19 35.4 470 13.6 12 Table 3.—Birth-rate, Death-rate, and Analysis of Mortality during the Year 1945, with corresponding rates for england and wales, 126 great towns, 148 smaller towns, and for the County of London for comparison. Birthrate pek 1,000 Total Population. Annual Death-rate per 1,000 Population. Death rate per 1 000 Births. Maternal Mortality Rate per 1,000 Total Births All Causes. Typhoid & Paratyphoid Scarlet Fever. Whooping Cough. Diphtheria. Influenza. Small-pox Measles. Diarrhoea and Enteritis (under 2 years;. Total Deaths under One Year All Causes. Puerperal Infection. Other Causes. England and Wales 126 County Boroughs and Great Towns, including London 161 11.4 0.00 0.00 0.02 0.02 0.08 - 0.02 5.6 46 1.79 0.49 1. 30 19.1 13.5 o.oo o.oo 0.02 0.02 0.07 - 0.02 7.8 54 Not avail able 148 Smaller Towns (Estimated Resident Populations 25,000 to 50,000 at Census, 1931) 19.2 12.3 0.00 0.00 0.01 0.02 0.07 0 0.02 4.5 43 London 15.7 13.8 0.00 o.oo 0.02 0.01 0.07 - 0.01 7.6 53 Barnes Borough 15.5 13.6 - - - 0.03 0.09 - - 3.7 35 3.63 1.81 1.81 13 Table 4.—Causes of Death during the Year 1945. s of Death (Registrar-General's short list of causes). Total Deaths Male Female 1 Typhoid and Paratyphoid fevers - - - 2 Cerebro-spinal fever 1 - 1 3 Scarlet Fever - - - 4 Whooping Cough - - - 5 Diphtheria 1 1 - 6 Tuberculosis of respiratory system 15 11 4 7 Other forms of tuberculosis 4 3 1 8 Syphilitic diseases 2 2 - 9 Influenza 3 - 3 10 Measles - - - 11 Acute poliomyelitis and polioencephalitis - - - 12 Acute infectious encephalitis 1 - 1 13 Cancer of buccal cavity and oesoph. (m); uterus (f) 6 2 4 14 „ stomach and duodenum 13 9 4 15 „ breast 10 - 10 16 „ all other sites 58 29 29 17 Diabetes 4 - 4 18 Intra-cranial vascular lesions 64 29 35 19 Heart Disease 100 51 49 20 Other diseases of circulatory system 27 12 15 21 Bronchitis 18 9 9 22 Pneumonia 24 10 14 23 Other respiratory diseases 8 6 2 24 Ulceration of stomach or duodenum 3 3 - 25 Diarrhoea under 2 years 2 2 - 26 Appendicitis 1 - 1 27 Other digestive diseases 13 3 10 28 Nephritis 8 4 4 29 Puerperal and post-abortive sepsis 1 - 1 30 Other maternal causes 1 - 1 31 Premature birth 2 - 2 32 Congenital malformations, birth injury, infantile diseases 13 5 8 33 Suicide 4 4 - 34 Road traffic accidents 6 1 5 35 Other violent causes 8 5 3 36 All other causes 49 16 33 All Causes 470 217 253 14 Table 5.—Infant Mortality during the Year 1945. Causes of death, at various ages, of infants under one year. Cause of Death Under 1 Week. 1-2 Weeks. 2-3 Weeks 3-4 Weeks. Total under 4 w'ks J-3 Months. 3-6 Months. 6-9 Months. 9-12 Months. Total under 1 Year Deaths in the Borough Deaths outside the Borough. Deaths in Institu'ns Premature Birth 1 l ... .. 2 .. ... .. ... 2 1 1 1 Congenital Malformations 4 ... 1 ... 5 l ... ... ... 6 1 5 4 Atelectasis 3 ... ... ... 3 l ... ... ... 4 1 3 3 Diarrhoea and Enteritis ... ... ... ... ... 1 1 ... ... 2 ... 2 2 Bronchitis ... ... ... ... ... l ... ... ... 1 1 ... ... Broncho-pneumonia ... ... ... ... ... ... 1 ... 1 2 1 1 ... Intussusception ... ... ... ... ... ... l ... ... 1 ... 1 1 Violence 1 ... ... ... 1 ... ... ... ... 1 1 ... ... All causes 9 l 1 ... 11 4 3 ... 1 19 6 13 11 Infectious Diseases Mortality. The death-rate for 1945 from each of the seven principal epidemic diseases (zymotic diseases) are given separately in Table 6, and in Table 7, the zymotic death-rate for the five years, 1940 to 1944, are contrasted with the rate for 1945. In each of these Tables the death-rates for London and for England and Wales are shown for comparison. Table 6.—Epidemic Diseases: Death-rate per 1,000 of the Population, 1945. Disease. Barnes. London. England and Wales. Small-pox - - - Typhoid & Paratyphoid - 0.00 0.00 Measles - 0.01 0.02 Scarlet Fever - 0.00 0.00 Whooping Cough - 0.02 0.02 Diphtheria 0.03 o.o1 0.02 Diarrhoea (under 2 years) 0.06 0.18 o.1o Zymotic Death Rate 0.09 0.22 0.16 Table 7.—Zymotic Death-rate for 1945, contrasted with the Rates for the previous Five Years. Year. Barnes. London. England and Wales. 1940 0.06 0.09 0.17 1941 0.13 016. 0.23 1942 0.06 0.17 0.16 1943 0.06 0.23 0.17 1944 0.18 0.2 0.14 1945 0.09 0.22 0.16 15 Table 8.—Measles : Death-Rate per 1,000 of Population. Year. Barnes. London. England & Wales. 1941 - 0.02 0.03 1942 0.06 0.01 0.01 1943 - 0.02 0.02 1944 - o.oo 0.01 1945 - 0.01 0.02 Average Rate 0.01 0.01 0.02 1941-1945 Table 9.—Whooping Cough : Death-Rate per 1,000 of the Populat.on. Year. Barnes. London. England & Wales. 1941 0.03 0.04 0.06 1942 0.03 0.04 0.02 1943 - 0.03 0.03 1944 - 0.04 0.03 1945 - 0.02 0.02 Average Rate 1941-1945 0.01 0.03 0.03 HOUSING. Table 10.—HOUSING STATISTICS FOR THE YEAR 1945. 1. • Number of Dwellings Owned by the Local Authority:— Number of houses 241 Total 448 ,, ,, flats 207 2. Unfit Houses. (1) Inspection of Dwelling Houses during the Year:— (i) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 2805 (b) Number of inspections made for the purpose 4155 16 (ii) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 Nil (b) Number of re-inspections made under the Regulations Nil (iii) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 3 ( i.) Number of dwelling-houses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 448 (II) Remedy of Defects during the Year without service of formal notices:— Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 430 (III) Action under Statutory Powers during the Year:— No proceedings were taken under any of the following Statutory Powers during the year:— (a)—Sec. 9, 11, 10 and 16, Housing Act, 1936—(Repair of dwelling-houses). (b)—Sec. 13, Housing Act, 1936—(Demolition Order). (c)—Sec. 12, Housing Act, 1936—(Closing Order, underground rooms). 3. Overcrowding. As stated in my Annual Report for 1944 the question of persons living under overcrowded or other unsatisfactory conditions in the Borough is one that must receive attention in the near future, but until the housing problem as a whole has become less pressing little of practical value can be done to remedy the bad general housing conditions which are known to exist. 17 SANITARY CIRCUMSTANCES OF THE AREA. Table 11.—Showing the Number and Nature of the Inspections made by the sanitary inspectors during 1945, the number of Notices Served in Respect of Defects found in the Course of Inspection, and the Number of Notices complied with. Nature of Inspections. Number of Premises on Register. Number of Visits of Inspection and Reinspection Action taken in respect of defective conditions Informal Notices. Statutory Notices. Number issued. Complied with. Number issued. Complied with. Dairies 3 12 - - - - Milkshops 14 26 - - - - Butchers' Shops 30 40 - - - - Fishmongers and Poulterers 14 33 - - - - Greengrocers 37 32 - - - - Fried Fish Shops 4 6 - - - - Restaurants 32 30 1 1 - - Other food premises 37 55 - - - - Slaughterhouses 1 12 - - - - Bakehouses 10 10 1 1 - - Factories:— Mechanical 120 64 - - 1 1 Non-mechanic'l 38 33 1 1 - - Air Raid Shelters 113 101 - - - - Home-workers 19 9 - - - - Schools Public Halls 18 16 1 1 - - and Cinemas Piggeries and 5 5 - - - - Stable Yards Public 38 80 1 1 - - veniences 40 34 4 4 - - Total 573 Dwelling-houses (including houses let in lodgings) No. of Premises Visited. (1) House - toHouse Inspection - (2) Inspected on complaint 1219 4256 1448 430 8 7 (3) Inspected in course of other work:— 1586 (a) Housing work, etc (b) For infectious diseases 101 Totals 2906 4854 464 446 9 8 18 Table 12.—Factories. No. of Premises on Register. Inspection. Number Written Notices Served. Factories with mechanical power 120 64 8 Factories without mechanical power 38 33 1 Total 158 97 9 Contraventions:— Discovered. Remedied. Want of cleanliness 6 6 San. Accom.—Unsuitable/Defective 10 10 Total 16 16 Matters referred to H.M. Inspector of Factories Nil Notifications received from H.M. Inspector of Factories 2 Legal proceedings:— No legal proceedings were necessary during 1945. Table 13.—Home Workers. Work undertaken. No. on Register. Fancy Needlework .. 3 Dressmaking .. 9 Tailoring .. 3 Boot Repairing .. 2 Curtain Making .. 2 Total 19 INSPECTION AND SUPERVISION OF FOOD. Table 14.—Dairies and Milkshops. Number of purveyors of milk:— Dairies situated within Borough 3 Milkshops (not dairies) within Borough 14 Purveyors of milk from outside Borough 4 Total 21 Designated milk is sold from:— (a) Premises within Borough 12 (6) „ outside „ 4 16 19 FOOD AND DRUGS ACT, 1938. A summary of the samples taken under the above Act during the year is given in the following Table. In no instance was it necessary to institute Court proceedings. Table 15.—Return of Samples Analysed during the Year ending 31st December, 1945. Articles ANALYSED. BELOW standard. Prosecutions Convictions Formal Informal Total Formal Informal Total Milk 71 — 71 1 — 1 — — Sweetened Condensed Milk - 1 1 - 1 1 - - Other Foods. Baking Powder 2 1 3 - — — — — Barley—Flaked 1 — 1 - - - - - Beef Extract - 1 1 - - - - - Cake Flour — 2 2 - - - - - Chocolate Spread — 1 1 - - - - - Coffee 1 1 2 - - - - - Curry — 2 2 - - - - - Gelatine 2 1 3 - - - - - Honey 1 — 1 - - - - - J am 2 — 2 - - - - - Nutmeg—Ground — 1 1 - — — — — Oatmeal — 1 1 - - - - - Saccharin Tablets — 2 2 - - - - - Sage and Onion Stuffing - 1 1 - - - - - Sausages—Pork 1 — 1 - - - - - Soya Cream — 1 1 - 1 1 — — Strawaberry Essence - 1 1 - - - - - Veal and Ham Pie 1 - 1 - - - - - Vinegar 3 — 3 2 — 2 — — Drugs. Bicarbonate of Soda — 1 1 - - - - - Blackcurrant and Ipecacuanha Cough Syrup - 1 1 - - - - - Borax—Powdered — 1 1 — — — — — Boracic Acid Crystals — 1 1 - - - - - Boracic and Cocaine Eye Lotion - 1 1 - 1 1 - - Camphorated Oil — 1 1 - - - - - Chemical Food — 1 1 - - - - - Galloways Ointment — 1 1 - - - - - Glauber Salts — 2 2 — 2 2 — — Glycerine — 3 3 - - - - - Iodine—Tincture 1 — 1 - - - - - Petroleum Jelly — 1 1 - - - - - Seidlitz Powders — 1 1 - - - - - Vitamin Tablets — 1 1 - - - - - ,, Tonic — 1 1 — 1 1 — — Totals 86 34 120 3 6 9 — — Note.—It was not found necessary to institute proceedings in respect of the samples found to be below standard. The discrepancies were of 20 a minor character and the informal action taken resulted in satisfactory measure being taken to comply with the required standards. The Public Analyst reports that, in classifying the samples as genuine or otherwise, all relevant Regulations and Orders under the Defence Regulations, as well as the Regulations made under the Food and Drugs Act, 1938, have been taken into account. Several of the discrepancies found related to labelling of articles required by recent legislation. Table 16.—Slaughterhouses. Private. Public. Total. No. of licensed slaughterhouses 1 — 1 No. of notices received of intention to slaughter during the year 13 — 13 No. of animals slaughtered Swine 35 35 Cattle — — — Sheep — — — Total 35 — 35 Table 17.—Unsound Food. In no instance was it found necessary to seize unsound food on any premises. The following articles were voluntarily surrendered and destroyed as being unfit for human consumption :— Meat :— Fruit:— Beef lbs. 7 Dried Fruit lbs. 764 Pork lbs. 36 Canned Fruit tins 1 Ham lbs. 5 Bacon lbs. 18 Other Foods:— Sheep's Kidneys lbs. 11 Sausages lbs. 12 Butter lbs. 8 Tinned Meat tins 116 Cheese lbs. 90 Tinned Meat and Vegetables tins 38 Eggs—Dried pkt. 1 „ „ lbs. 3 Meat Pies—Steak No. 41 Flour lbs. 224 Rabbits lbs. 15 Batter Flour lbs. 140 Jam tins. 3 Vegetables:— „ jars 1 Canned Vegetables tins 89 Marmalade tins. 32 Fish Milk tins 74 Cod lbs. 178 Pepper lbs. 50 Haddock lbs. 56 Soup tins 3 Mackerel box 1 „ pkts. 12 Canned Fish tins 213 Sweets lbs. 63 21 GENERAL PROVISION OF HEALTH SERVICES IN THE AREA. Table 18.—Domestic Help Scheme. Illness Chronic Invalidity Aged & Infirm Miscellan. Reasons Total Sudden Em'cy Serious Tub. Number of applications received since commencement of scheme (25th March, 1945) 7 3 3 3 16 3 35 Number of such cases attended during 1945 6 2 3 1 15 — 27 Not Attended Application withdrawn—other arrangements made 1 1 - - 1 1 4 Domestic help not available - - - - - - - Not within scope of scheme — — - 2 — 2 2 Totals 1 1 - 2 1 3 8 Table 19.—Borough Accident and General Purposes Ambulance Service. Number of Cases Mileage Accidents 219 1049 Removals after accident 42 249 Maternity 234 2516 Other purposes 660 5435 Totals . . 1155 9249 Table 20.—Cleansinc and Disinfestation of Verminous Persons. Treated at Borough Cleansing Station. For Verminous Head For Verminous Body For Scabies Totals No. of Persons Attendances No, of Persons Attendances No, of Persons Attendances No. of Persons Attendances Children under school-age - - - - 32 44 32 44 Schoolchildren 31 31 1 1 74 114 106 146 Adults 4 7 — — 121 174 125 181 Totals 35 38 1 1 227 332 263 371 22 Table 21—Infected and Infested Rooms and Articles (dealt with by the council). Premises disinfected 101 Rooms disinfected 104 Lots of bedding disinfected 148 ,, „ destroyed 2 „ „ disinfested 5 Council houses disinfested by liquid insecticides 1 Other houses disinfested (hydrogen cyanide 1, by liquid insecticides 9) 10 Table 22.—Rats and Mice Destruction. Number of complaints received 208 Visits to (a) Enclosed premises 1105 (b) Open spaces 130 Number of occasions on which (a) Poison bait was laid 267 (b) Gas was used 1 23 PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASES. Incidence of Notifiable Infectious Diseases. Comparison between the incidence of certain of the notifiable infectious diseases in Barnes, and in London and England and Wales, is shown below:— Table 23.—Infectious Diseases: Incidence per 1,000 of the Population in 1945. Disease. Barnes. London. England and Wales. Typhoid Fever - 0.01 0.01 Paratyphoid Fever — 0.00 0.01 Cerebro-spinal Fever — 0.06 0.05 Scarlet Fever 1.04 1.57 1.89 Whooping Cough 2.05 1.25 1.64 Diphtheria 0.35 0.31 0.46 Erysipelas 0.09 0.31 0.25 Small-pox — 0.00 0.00 Measles 10.33 9.03 11.67 Pneumonia 0.58 0.78 0.87 Table 24.—Notifiable Infectious Diseases, 1945. Diseases. Total Cases Notified. Ages, in years. Parish Removed to Hospital. Total Deaths of Residents, † Under 1 year l to 2. 2 to 3. 3 to 4. 4 to 5. 5 to 10 10 to 15. 15 to 20 20 to 25. 25 to 35 35 to 45. 45 to 65. 65 and over. Barnes Mortlake. Diphtheria 12 — 1 — — - 1 2 2 1 3 l 1 - 6 6 12 1 Scarlet Fever 36 — 3 2 5 4 12 4 1 — 1 3 1 — 16 20 34 - Measles 358 15 43 40 34 37 156 16 8 1 4 2 2 — 122 236 25 - Dysentery 9 2 - - - 1 - — — - 1 2 2 1 1 8 4 - Pul. Tuberculosis 39 — 1 — 1 — 1 1 7 7 6 9 4 2 16 23 42 15 Non-Pul. Tuberculosis 6 — — — — — 1 — — 1 2 2 — — 2 4 7 4 Pneumonia 20 1 1 — — — 3 1 1 — 1 2 6 4 14 6 4 24 Erysipelas 3 — - - - - - 1 - - - - 2 — 1 2 1 — Ophthalmia neonator'm 1 1 - - - - - - - - - - - - — 1 1 — Whooping Cough 71 6 10 11 8 9 26 - - - - - - - 10 61 3 — Puerperal Pyrexia 3 — — — — - - - 1 2 — — — 1 2 3 1 All Diseases 558 25 59 53 48 51 200 25 19 11 21 21 18 7 189 369 136 45 †The deaths recorded in this column are the total corrected number of deaths assignable to the District, and are not necessarily deaths of persons recorded as notified during the year. 24 Table 25.—Notifiable Infectious Diseases, 1935 to 1945. Year. 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 Diphtheria 31 4 3 1 4 5 13 6 3 15 12 Scarlet Fever 77 56 84 52 36 39 21 34 184 50 36 Typhoid Fever — 3 2 1 — 1 — — 2 - — Paratyphoid Fever 1 — 1 1 1 1 1 — 1 — — Puerperal Fever — 2 — * * • • * * • • „ Pyrexia 3 1 1 4 3 2 1 4 1 — 3 Erysipelas 16 11 12 6 10 4 5 6 5 10 3 Continued Fever — — — — — — — — — — — Relapsing Fever - - - - - - - - - - - Typhus Fever - - - - - - - - - - - Small-pox - - - - - - - - - - - Cholera — — — — — — — — — — — Plague — — — — — — — — — — Tuberculosis, P. 21 39 28 25 35 32 39 42 43 50 39 Non-P. 8 5 10 8 3 4 4 7 7 1 6 Cerebro-spinal Fever - - - 2 1 5 4 3 2 - - Poliomyelitis — — 2 1 — - - 1 - - - Ophthalmia Neonatorum 1 1 1 1 - 2 1 - 1 1 1 Measles 7 517 101 387 8 79 63 712 111 68 358 Rubella 5 29 9 439 22 * * * * * * Encephalitis Lethargica - - - - - - - - - - - Polioencephalitis - - - - - - - - - - — Malaria - - - - - - - - 1 — — Dysentery — — — 1 — — 1 1 2 1 9 Pneumonia 13 21 34 18 14 14 21 16 20 18 20 Anthrax - - - - - - - - - - - Whooping Cough —(Not Notifiable)— 5 2 151 73 82 108 71 * No longer notifiable. Table 26.—Showing the Notifications of Infectious Diseases Received during 1945 arranged in Four-Weekly Periods. Fourweekly period ending Diphtheria. Scarlet Fever. Measles. Whooping Cough Pneumonia Etysipelas Dysentery. Ophthalmia Neonatorum. Puerperal Pyrexia Jan. 27 - 2 41 26 5 1 1 - 1 Feb. 24 2 2 41 19 5 - — 1 — Mar. 24 — 2 84 11 1 1 — — - April 21 1 2 65 3 3 — — — — May 19 3 3 77 - - - - - — June 16 2 — 29 1 1 — 4 — — July 14 1 4 12 2 1 1 — — 1 Aug. 11 — — 4 — 1 — 1 — — Sept. 8 — 6 1 1 — — 2 — — Oct. 6 2 2 — — — — — — 1 Nov. 3 — 3 1 — — — 1 — — Dec. 1 — 5 3 3 1 — — — — Dec. 29 1 5 — 5 2 — — — — Totals 12 36 358 71 20 3 9 8 3 25 Table 27.—Diphtheria Immunisation Clinic. The Following Table Shows the Position on 31st December, 1945, in Respect of the 823 Children who Attended the Clinic during 1945. Position on 31 Dec., 1945 1. TOTAL CASES dealt with during 1945 658 (A) Continued in Attendance:— 589 (a) Post-Schick Negative (Certificate) 380 (b) Completed injections, awaiting Post-Schick test 179* (c) Receiving injections at end of year 30 (B) Discontinued Attendance:— 69 (a) Completed injections — failed to attend for PostSchick test.. 45* (b) Did not complete injections 17 (c) Left district—completed injections—no Post-Schick test 5* (d) Left district before completion of injections 2 2. CHILDREN attending for Re-Schick Test two years after immunisation:— 165 (a) Re-Schick test negative—immunisation confirmed .. 154 (b) Re-Schick test positive—further injections given 2 (c) Attended for Re-Schick test—did not attend for reading 9 TOTAL CHILDREN attending Clinic during year 823 Children invited but did not attend 19 Note.—In addition to the 380 children in respect of whom certificates were given, 229* additional children completed courses of immunising injections during the year, making in all 609 children immunised during the year. Table 28.—Clinic for Inoculation against Whooping Cough. Position on 11 Dec., 1945 Number of children attending:— (a) Completed course of injections 391 (b) Receiving injections at end of year 30 (c) Discontinued injections—left district 1 —ceased attending 32 Total attending clinic during year 454 Children invited but did not attend 11 26 Table 29.—Schools. Number in Borough Number of scholars who suffered from:— Scarlet Fever Diphtheria County Primary Schools:— 7 Railway Street—Infants 1 — Lowther—J. Mixed and Infants 2 — East Sheen—J. M. and Infants 5 — Mortlake—J. M. and Infants 2 — Mortlake C. of E.—Mixed 2 — „ „ „ —Infants — 1 „ R.C.—J. M. and Infants — — County Secondary Schools:— 4 B a r n e s—Boys — — „ —Girls 1 — Mortlake—Boys — — „ —Girls — — County School :— 1 East Sheen and Richmond Boys — 1 Private Schools 6 1 1 Total 18 14 3 TUBERCULOSIS. Notification Register. The Register of Notifications has been kept revised in accordance with the requirements of the Public Health (Tuberculosis) Regulations, 1930. The number of cases added to or removed from the Register during the year and the number remaining on the Register on December 31st, 1945 are as under:— Table 30.—Tuberculosis Notification Register. Form of Disease. On Register, 1st Ian., 1945 Cases Added. Removed from Register Remaining on Register 31st Dec., 1945 Primary Notif ns Otherwise. Restored Total NonTub. Cured Left District Dead Total Pulmonary 236 39 19 2 60 — 2 22 16 40 256 Non-Pulm'y 56 6 3 — 9 1 1 4 4 10 55 All Forms 292 45 22 2 69 1 3 26 20 50 311 27 Table 31.—Tuberculosis: New Cases and Mortality, 1945. Age-Periods. New Cases.* Deaths. Pulmonary. NonPulmonary. Pulmonary. NonPulmonary. Male Fem'le Male Fem'le Male Fem'le Male Fem'le 0-1 years - - - - - - - - 1-5 „ 2 - - - - - - - 5-10 „ 1 — 1 — — — 1 — 10-15 „ 1 — — 1 — — — 1 15-20 „ 5 2 — — — 1 — — 20-25 „ 7 6 1 1 — — — — 25-35 „ 6 6 — 1 3 1 — — 35-45 „ 5 8 1 2 2 1 — — 45-55 „ 2 3 — — 2 — 1 — 55-65 „ 2 — — — 2 1 — — 65 „ and over 1 1 — 1 2 — 1 — All ages 32 26 3 6 11 4 3 1 * In addition to primary notifications, all other new cases coming to the knowledge of the Medical Officer of Health are included in these figures. Incidence-rate—Pulmonary All froms 1.29 Non-pulmonary 0.17 Death-rate -Pulmonary Non pulmonary 0 43 0.12 All froms 0.55 Table 32.—Tuberculosis: Institutional Treatment. Admissions during 1945 were as under:— Form of Disease. Surrey County Council Other Sanatoria General Hospitals Totals. Sanatoria Hospitals Pulmonary 8 9 13 20 50 Non-Pulmonary 2 - — 5 7 Totals 10 9 13 25 57 Number of patients admitted : Pulmonary 42 Non-pulmonary 7 28 INFECTIOUS DISEASES HOSPITAL. Table 33.—Admissions and Deaths. Residents Nonresidents Noncivilians. TOTALS. Admitted. t- Died. Admit ted. Died. Admit ted. Died. Admit ted. Died. Diphtheria 8 1 — — 2 — 10 1 Diphtheria and Scarlet Fever 1 - - - - - 1 — Diphtheria carrier Sent in as ' Diphtheria 1 - - - - - 1 - Vincent's Angina 2 - - - - - 2 — Tonsillitis 7 — — — 1 — 8 — Quinsy — — — — 1 — 1 — Influenza 1 - - - - - 1 — Bronchitis 1 - - - - - 1 — Tumour of tonsil 1 - - - - - 1 — Non-specific enteritis 1 - - - - - 1 — No appreciable disease 1 - - - - - 1 — Scarlet Fever 34 - - - - - 34 — Measles Sent in as 1 - - - - - 1 — Rubella Scarlet Fever 2 - - - - - 2 — Scarlet Fever and Chickenpox 2 - - - - - 2 — Measles 17 — 1 — 1 — 19 — Measles and Broncho-pneumonia 3 - - - - - 3 — Rubella - — - — 1 — 1 — Urticaria Sent in as Measles 1 - - - - - 1 - Conjunctivitis 1 - - - - - 1 — Rubella — — - — 1 — 1 — Whooping Cough 2 - - - - - 2 — Whooping Cough and Bronchopneumonia 1 - - - - - 1 - Chickenpox 1 - - - - - 1 — Erysipelas 1 - - - - - 1 — Influenzal Pneumonia 1 - - - - - 1 — Broncho-pneumonia 3 - - - - - 3 - Bronchitis Sent in as Pneumonia 3 - - - - - 3 — Enteritis 1 — 1 — — — 2 — Dysentery Sonne 4 — - — 3 — 7 — Enteritis 3 - - - - - 3 — Non-specific Ulcerative Colitis Sent in as Dysentery 1 - - - 2 - 3 - Suspected Poliomyelitis 1 - - - - - 1 — Tubercular Meningitis Sent as in Cerebrospinal Meningitis 1 1 1 — — — 1 1 Influenzal Meningitis 1 1 - — — — 1 1 Acidosis 1 - - - - - 1 — Laryngitis, Catarrhal 1 - - - - - 1 — Tonsillitis Sent in as Mumps — — - — 1 — 1 — No appreciable disease 1 - - - - - 1 — Totals 112 3 2 — 13 127 3 General. During 1945, 12 patients suffering from diphtheria were treated in the hospital. The incidence was once again considerably more marked among adolescents and adults than among children and the older persons who contracted the disease were severely affected. 29 Deaths. (i) Diphtheria—laryngeal—aged one year nine months—tracheotomy performed—died two days after admission. (ii) Tubercular Meningitis—aged five years—admitted as cerebrospinal meningitis—died three days after admission. (iii) Influenzal Meningitis—aged one year eight months—admitted as cerebro-spinal meningitis—died 25 days after admission—diagnosis confirmed bacteriologically. Cross Infection. A child admitted with scarlet fever was at the time of admission incubating chickenpox and gave rise to one secondary case in the ward. Complications. (1) Diphtheria. (3) Measles. Squint, 6. Broncho-pneumonia, 6. Palatal paresis, 3. Rhinorrhoea, 2. Cardiac arrythmia, 2. Double otorrhoea, 1. Septic burns, 1. (2) Scarlet Fever. (4) Whooping Cough. Otorrhoea, 1. Broncho-pneumonia, 1. Double otorrhoea, 1. (5) Pneumonia. Secondary attack, 1. Asthma, 1. Table 34.—Laboratory Facilities. Specimens examined during the year were as follows :— Sputa for detection of tubercle bacilli 32 Swabs „ „ „ diphtheria bacilli 257 Rectal Swabs for pathogenic organisms 53 Cerebro-spinal fluid 6 Blood (Widal) 12 Total 360 30 MATERNITY AND CHILD WELFARE. Table 35.—Home-Visiting. A summary of the work performed by the three Health Visitors during the year is given below :— Visits to expectant mothers 497 First visits to newly-born infants 810 Revisits to infants under 1 year 2,487 Visits to children aged 1 to 5 years 2,912 Still-birth inquiries 7 Special visits to cases of measles 430 „ „ „ „ „ whooping cough 107 „ „ „ „ pneumonia 22 Visits to foster children 45 Visits in connection with infectious diseases other than those above specified 363 Total visits 7,660 Table 36.—Social Welfare Worker. Care of Unmarried Mothers and their Children. Number of cases brought to the notice of the department during the year :— through local authority records, clinics, health visitors 53 by nursing homes, hospitals, police, clergy, etc. 16 by mothers themselves 2 Total 71 Number of cases visited for the first time during the year 67 „ „ home-visits and revisits to all known cases . . 609 ,, „ visits to employers, relatives, institutions, hostels, etc. in connection with cases 341 Number of mothers:— (a) admitted to:— ante-natal or post-natal homes 14 long-stay training homes 1 short-stay shelters 3 special homes for confinements 3 (6) for whom:— residential employment was found 12 non-residential employment was found 2 housing accommodation was found 2 arrangements were made for return to native land 1 31 Number of mothers concerned who were, at the end of the year living with child without child Total as married 17 — 17 in own homes with husbands (extra-marital) — 4 4 with parents or relatives 21 1 22 at homes of employers (residential employment) .. 14 — 14 in lodgings 8 3 11 in institutions or hostels 3 — 3 Affiliations:— Number obtained through court procedure 4 „ arranged voluntarily 6 „ of mothers who refused to make application 4 Number of children for whom arrangements were made:— for adoption 4 for admission to homes, institutions or residential nurseries 4 to remain with mothers, or relatives (89%) 63 Table 37.—Notification of Births. (a) Registered in Borough:— Live Births. Still Births. Totals. Number of births registered during 1945 as occurring in the Borough 401 6 407 Number of such births not notified in accordance with the Public Health Act, 1936, Part VII 1 - 1 (b) Notified. Number of births, live and still, notified during the year— Residents. Outward Transfers. Total by medical practitioners 3 1 4 by midwives 235 160 395 by other persons — — — Total notified 238 161 399 Number of still-births notified during the year 2 2 4 Percentage of still-births to total births occurring in the Borough 0.8 1.2 1.0 (c) Premature Infants. Number of births notified during the year as occurring in the Borough where the baby weighed less than 5i lbs. at birth :— Place of birth. Number Notified Nursed entirely at place of birth Transferred to Hospital Who died during first 24 hours Who survived one month At home - - - - - At private mat. home 3 3 — 1 2 Totals 3 3 - 1 2 32 Table 38.—Institutional Confinements. In institutions within the Borough .. 169 In registered maternity homes 169 In institutions outside the Borough 285 In general hospitals 25 In maternity hospitals 83 In Public Health County hospitals 120 In Public Assistance institutions 38 In maternity homes 19 Total 454 Number of above institutional confinements through the Borough Ante-natal Clinic 130 MATERNITY AND CHILD WELFARE CENTRES. Table 39.—Ante-Natal Clinic. Year 1944 Year 1945 Total number of expectant mothers attending Borough ante-natal Clinic during the year 369 372 Number of new cases attending for first time and included in total number 274 322 Number of attendances made by all mothers 1,123 1,104 Percentage of expectant mothers of total notified births attending Borough Clinic 65.3 80.7 Table 40.—Infant-Welfare Clinics.—Attendances. Year 1944. Year 1945. New Cases:— Infants under 1 year 466 404 Children 1 to 5 years 59 90 Total 525 494 Number of Children attending during the year:— Infants under 1 year 708 738 Children 1 to 5 years 482 538 Total 1,190 1,276 Number of attendances made by:— Infants under 1 year 5,064 6,139 Children 1 to 5 years 2,599 3,484 Total 7,663 9,623 Mothers 7,109 8,885 Number of consultations with Medical Officer 2,710 2,959 Average attendance per week: Infants under 1 year 99.8 120.4 Children 1 to 5 years 52.1 68.3 Total, all children 151.9 188.7 Number of children attending Centre for first time during the year: Percentage of total births assigned to the Borough represented by this figure 78.5 75.2 Table 41.—Home Help Service. Confinements Other Maternity reasons Conditions other than Maternity Totals Application outstanding from 1944 1 - - 1 Applications received during 1945 22 13 5 40 Cases attended during 1945 13 11 4 28 Cases booked but not yet attended 3 — — 3 Cases booked but not attended— mother admitted to hospital in emergency 3 — — 3 Applications received but cases not attended because:— (a) Home Helps already booked and not available 2 1 1 4 (b) Applicants withdrew applications 2 1 — 3 Table 42.—Child Life Protection. The following is a summary of the cases on the Register during 1945:— Foster-mothers on the Register at the beginning of the year 4 „ „ added to the Register 6 „ „ removed from the Register, having ceased to have care of children 4 „ „ on the Register at the end of 1945 6 Foster-children on the Register at the beginning of the year 5 „ „ in respect of whom Notice of Reception was received 5 „ „removed from the Register during the year:— returned to care of parents 3 „ „ on the Register at the end of 1945 7 Number of visits of inspection made by Health Visitors during the year 45 33 Table 43.—War Time Day Nurseries. BARNES NURSERY MORTLAKE NURSERY BOTH NURSERIES Age-groups 0—1 1—2 2—5 Total 0—1 1—2 2—5 Total 0—1 1—2 2—5 Total Places available in Nursery 5 15 25 45 5 15 30 50 10 30 55 95 Children in attendance 31st December, 1944 5 11 16 32 1 10 17 28 6 21 33 60 Children admitted during 1945 11 18 40 69 8 19 37 64 19 37 77 133 Total children attending 16 29 56 101 9 29 54 92 25 58 110 193 „ ceased attending 5 10 38 53 3 6 33 42 8 16 71 95 Still in attendance 31 Dec., 1945 4 14 30 48 2 11 37 50 6 25 67 98 (* The final figures have been adjusted to show age-grouping at end of year.) 1944 1945 1944 1945 1944 1945 Total attendances made by children 8,301 11,105 8,564 10,011 16,865 21,116 Average daily attendance 28 37 28 33 55 70 34 35 Table 44.—Adoption of Children. Number of Notices of Reception received during 1944 still on Register at 1st January, 1945 5 Number of Notices of Reception received during 1945 6 Number of children adopted during year 8 „ „ removed from Register for other reasons — Number of children still on Register awaiting adoption at 31st December, 1945 3 Table 45.—Voluntary Associations. (1) Nursing Associations. Barnes District Nursing Association Mortlake , District Nursing Association Totals Home-visits in connection with maternity and child welfare - - - „ „ to cases of pneumonia 33 92 125 „ ,, ,, ,, —influenza 24 — 24 „ „ to other general and surgical cases 6,578 15,662 22,240 6,635 15,754 22,389 (2) Barnes and Mortlake Day Nursery. Accommodation for children under 5 years 26 Number of attendances—Whole-day 4,122 Half-day 537 R W. Simpson & Co., Ltd., Printers, 70, Sheen Road, Richmond, and Barnes High street.