LIBRARY CAM 35 M E T R 0 P 0 L I T A N B O R O U G H OF C A M B E R W E L L ANNUAL(ABRIDGED) REPORT OF THE MEDICAL OFFICER OF HEALTH H.W.BARNES, M.B. , B.Ch., D.P .H. for the year 1 9 4 6 CAM 35 Public Health Department, Town Hall, Camberwell, S. E. 5. September 1947. The Worshipful the Mayor, Aldermen and Councillors of the Metropolitan Borough of Camberwell. Mr. Mayor, Aldermen and Councillors, I have pleasure in presenting my Annual Report for 1946 which has been prepared In accordance with the directions of Ministry of circular No.13/47 dated 13th March 1947. It is gratifying to record that the health of the inhabitants of the Borough continued to be satisfactory. The Registrar-General's estimate of the civilian population, viz., 164,380, showed an increase of nearly 29 ,000 over the figure for the previous year. There was also a further Increase in the birth rate which, was 23.4 as compared with 19.5 in 1945, while the death rate dropped from 14.5 to 13.5. The maternal mortality rate also showed, a decrease, the figure being 1.2 for 1946 as compared with 2.2 for the previous year. The infantile mortalit rate, however, rose slightly from 34 to 38 infant deaths per 1,000 live births. Deaths from pulmonary tuberculosis numbered 89 - 29 less than in 1945, and the mortality figure from all forms of tuberculosis was 99 - a drop of 27. The number of notifications of infectious diseases received during the year was 2732 as compared with 2363 in 1945, the greatest Increases being recorded in the incidence of measles and whooping cough which were respectively 113 and 291 more than during the preceding year. Notifications of cases of scabies, however, numbered 182 fewer than in Unremitting efforts to secure the immunisation of as many young children as possible against diphtheria were continued during the year. A reflection of the propaganda activities of the Council in this direction appears in the table on page 4 which shows that 557 more persons were immunised against this disease during 1946 than in the preceding 12 months. In addition, a considerable number of "booster" injections were given to persons who had previously been immunised. As a result of the rising birth rate, the Infant Welfare Centre Service was called upon to deal with an increasing number of attendances particularly of children under the age of 1 year. The total attendances at all Centres numbered 47,115 which was 11,481 or 32% higher than the figure for 1945. Similar increases occurred in other sections of the Maternity and Child Welfare Service; the figures for the provision of Home Helps, Domiciliary Nursing, Minor Ailments Treatment and the issue to expectant mothers of priority dockets for sheets all having risen considerably above those for 1945. In the early part of the year the Council decided, in view of the strong demand for women in industry, to continue the War-time Day Nursery Service as a post-war feature of the Maternity and Child Welfare Scheme. At the same time consideration was given to the terms of the Joint Circular from the Ministers of Health and Education issued at the end of 1945, particularly the suggestions for implementing the Service by the provision of schemes of registered daily guardians, evening "sitters-in", and the establishment of afternoon creches at Maternity and Child Welfare Centres. Past failures to recruit a sufficient number of suitable persons to act as foster mothers did not encourage the belief that the response to an appeal for persons to enrol as daily minders would justify a scheme for this analogous service, nor was it considered practicable to arrange for a scheme of "sitters-in" or for the use of Infant Welfare Centres as afternoon creches; consequently the Council decided against promoting any of these proposed supplementary services. On the other hand, a close scrutiny of all applications for admission to the Nurseries was undertaken, and a scheme was adopted which provided for a proportionate allocation of places to cases falling within four priority categories as follows:- 1. Mothers employed in industries vital to production. 2. Widows, unmarried mothers and separated wives. 3. Insufficient Income. 4. Mothers who for some good reason were incapable of undertaking the full care of their children. The application of this Scheme deprived some children of a place and let others in. It made no difference, however, to the length of the waiting list for admission to the Nurseries, but the Scheme has ensured an equitable distribution of the vacancies to applicants most in need of the Service. At the end of the year a propaganda campaign was conducted to ? suitable women to undertake Home and Domestic Help duties and to bring to the notice of the public the provision of these Schemes. posters were displayed throughout the Borough menbers of the Public Health Committee addressed gatherings of women at Church Institutes, Women's Guilds etc., in various parts of the Borough, The Council also authorised payment to persons undertaking casual employment as home or Domestic Helps of a retaining fee of 5/- per 1st available for, but not actually engaged in such duties. These activities assisted in building up a team of workers for vices which has enabled the Council to meet demands for help in the home during the confinement of the mother and in specified cases of illness of members of thhe family. In March of the year under roview County Council's Mass Miniature Radiography Unit was made available at the South-Eastern L.C.C.Hospital for about three months for the examination of clerical and industrial workers in the Borough, and it was requested that arrangements be made for the examination of approximately 3,000 persons. The total number of persons who availed themselves of the offer was 2816 - 1506 men and 1310 women. The results of the examinations showed that 21-8 men ( .53%) and 13 women - were found to be probably suffering from tuberculosis were referred to their own medical practitioners. The sanitary administration of the Borough continued to maintain a satisfactory level, although some difficulty was experienced by landlords and builders in readily obtaining suitable and sufficient materials. A return of work of the Council's Sanitary Inspectors appears on page 8. Finally, I wish to take the opportunity of once again recording my appreciation of the support and consideration which I have received from the Members of the Council, and expressing my thanks to the staff of the Public health Department for the loyal assistance which they have given me at all times. Your obedient Servant, H. W. BARNES. MEDICAL OFFICER OF HEALTH. SUMMARY OF STATISTICS FOR THE YEAR 1946. Area of the Borough in acres 4,480 Registrar General's estimate of civilian population 164,380 Number of live births 3,848 Birth rate 23.4 Number of deaths 2,218 Death rate 13.5 Infantile Mortality - Deaths under 1 year 148 Infantile deaths per 1,000 births (live) 38 Maternal mortality - Deaths of women from diseases or accidents associated with childbirth 5 Maternal death rate (per 1,000 total births) 1.2 Deaths from phthisis 89 Phthisis death rate 0.5 Deaths from all forms of tuberculosis 99 Tuberculosis death rate. 0.6 DEATHS, CAUSES OF, AND AGES AT, DURING THE YEAR 1946. Case of Death Sex All ages 0- 1- 5- 15- 45- 65- All causes M F 1203 1015 80 68 7 12 10 11 93 92 332 194 681 638 Typhoid and paratyphoid fevers M - - - - - - - F - - - - - - Cerebro-spinal fever - M 1 - 1 - - - - F 3 - 3 - - - Scarlet fever - M - - - - - - - F 1 - - 1 - - - Whooping Cough M - - - - - - - F 6 5 1 - - - - Diphtheria M - - - - - - - F 1 - Tuberculosis of respiratory system 1 - - - - M 57 2 - 1 23 21 10 F 32 - - - 22 7 3 - Other forms of tuberculosis M 2 - 1 1 - - F - 1 2 2 1 8 2 Syphilitic diseases M 17 - - 9 7 - 1 9 2 Influenza F - - - 4 3 6 - M - - - 2 4 - F 11 1 - 1 - 9 Measles M - - - - - - - 1 Acute Polio-myelitis and polio-encephalitis F 2 - - - - 3 - M - - - - - - F - - - - - - - Ac: inf: enceph: 1 - - 1 - M - - 1 - Cancer of buc: cav: & oesoph:(M) uterus (F) F - - - - 1 M - - 17 22 - 1 4 - - F 13 - 1 4 8 Cancer of stomach & duodenum M 28 - - - 6 20 2 F 19 - - 3 16 - Cancer of breast - M - - - - - - - F 36 - - 12 20 4 Cancer of all other sites - 150 7 64 79 M - - - - 54 F 96 - 9 33 Diabetes - M 6 - 1 2 3 - - F 6 - - - 1 - 5 Intracranial vascular lesions M - 87 - - 2 30 55 F 115 - - - - 30 85 DEATHS, CAUSES OF, AND AGES AT, DURING THE YEAR 1946. Causes of Death Sex All ages 0- 1- 5- 15- 45- 65- M 319 - Heart disease - 10 68 241 - F 292 1 237 Other Dis: of circ: system - - 16 38 - - - 16 M 41 - 25 - - - Bronchitis F 47 1 5 41 6 - 1 M 125 5 34 79 Pneumonia F 53 1 - - 2 6 44 M 3 70 15 - 4 12 36 13 F 57 2 - 5 5 32 Other resp: diseases M 15 - - 7 - - 8 5 1 F - 2 2 Ulcer of stomach or duodenum - - M 20 - 9 - - 3 8 F 8 - - 1 3 4 - Diarrhoea under 2 years M 4 1 5 - - - - F 7 - - - Appendicitis 7 - - - - 1 M 2 - - 1 1 - 1 - Other digestive diseases F 5 2 1 - - M 29 - 2 13 14 F 1 Nephritis 24 - 1 3 13 6 M 27 - - - 6 11 10 F - Puer: and post-abort: sepsis 12 - - 5 3 4 - F 2 - - - 2 - Other maternal causes F - - - 3 - - 3 20 Fremature birth M - - - - - 20 17 17 - - - - F - M 29 26 - - 2 - 1 Can: Mal: birth inj: infant dis: 13 - - - F 12 - 1 M - - 3 Suicide 5 - 2 - F 5 - - - 1 3 1 Read traffic acc: M 14 - - 4 1 6 3 0 ther violent causes F 3 - 1 - - 1 1 6 M 26 3 2 2 3 10 All other causes F 26 5 2 - 1 1 17 M 79 4 13 12 49 - 1 F 76 4 - 4 9 19 40 INFECTIOUS AND OTHER DISEASES. NOTIFICATIONS. The number of notifications (2732) during the year was made up as follows:- Diphtheria and Croup 64 Scarlet fever 156 Measles 1232 Whooping Cough 431 Enteric fever & Paratyphoid 1 Pneumonia (Acute Influenzal 33 (Acute Primary 124 Erysipelas 49 Cerebro-Spinal Meningitis 18 Malaria 12 Dysentery 22 Ophthalmia Neonatorum 13 Puerperal fever 11 Puerperal Pyrexia 30 Scabies 534 Poliomyelitis 1 Typhoid 1 Total. 2732 In eighty-eight (88) instances it was found that the patient was not suffering from the disease notified. -2- SCABIES & VERMIN. There was a further decrease of over 1000 in the number of attendances at the Council's Cleansing Station for treatment for Scabies during the year; the number of attendances for the treatment of verminous conditions, however, was slightly higher than in the previous year. These cases continued to engage the attention of the Sanitary Inspectors and Health Visitors who paid follow-up visits to the homes of the persons treated. Small tooth combs and Lethane Hair Oil were issued at the Council's Infant Welfare Centres during the year. DISINFECTING STATION - RETURN OF WORK. Notified Infectious Diseases Other Diseases Miscellaneous Vermin Total All Cases. Rooms disinfected 695 63 22 952 1,732 Lets of bedding disinfected 45 230 301 423 999 Total visits 1,130 88 942 678 2,838 Number of articles disinfected by steam 3,590 " " " " " formalin 826 " " books disinfected 178 Beds and mattresses destroyed 136 Miscellaneous goods destroyed 210 T. C. qr. lb. Weight of unsound foods condemned 33 1 1 14¾ " " old and verminous furniture etc., destroyed 2 13 1 " " dead animals destroyed 1 2 " " hospital dressings destroyed 5 4 1 14 CLEANSING STATION. Number of attendances Persons cleansed Scabies Vermin Males Females Males Females Adults 648 714 33 10 1,122 Children 1,432 575 1,614 3. NUMBER OF BACTERIOLOGICAL EXAMINATION PERFORMED 1946. Swabs for diphtheria 925 Sputa for tubercle 1164 Milks 51 Ice Creams 11 Faeces for Dysentery 34 " " Ova of parasites 2 " " Food Poisoning 1 Blood (Typhold group) 6 Bath waters 7 Miscellaneous specimens 48 Total 2,249 RETURN OF WORK 0F THE VACCINATION OFFICER 1946. No. of names received In birth lists 4,189 Certificates of Successful Vaccination received 2,530 " " Postponement received 30 " " Insusceptibility received 9 Statutory Declarations of Objection received 899 IMMUNITSATION AGAINST DIPHTHERIA. The campaign for diphtheria prevention was continued throughout the year by sending birthday cards to children on reaching their first birthday, by the display of posters and distribution of leaflets, and by personal appeals by Health Visitors and Sanitary Inspectors urging parents to take advantage of the facilities provided by the Council for immunisation against diphtheria. A further increase was recorded in the number of persons immunised during 1946. Summary of persons immunised 1946. 1. At Borough Council Clinics etc. 0 - 5 yrs. 5 - 15 yrs. Total. 1,542 1,524 18 136 2. At L.C.C. Schools and Clinics. 785 921 1 86 87 3. Under Private Practitioners Scheme. 1,746 804 2,550 Totals. Four notifications were received during the year of the occurrence of diphtheria in children who had completed a full course of immunisation treatment, but in no case was the attack severe and all the patients recovered. Only one death from this disease occurred during the year and in this case the child had not been immunised. The following table shows the number of children in the Borough who had completed a full course of immunisation treatment at any time up to 31st December 1946, together with the estimated mid-1946 child population. Age at 31.12.46. Under 1 1 2 3 4 5 - 9 10 - 14 Total under 15 1304 1090 1288 4680 16,136 23 1027 6724 No. immunised. Estimated population mid-1946. 13,440 19,830 33,270 4. MATERNITY AND CHILD WELFARE. Infant Welfare centres - Clinic Attendances etc. 1946 Attendances of Children (i) Under 1 year 35,481 (ii) Between 1 & 5 years 9,645 Miscellaneous attendances 1,989 Total attendances 47,115 Analysis of Attendances - Doctors' Consultations 11,746 Seen by health visitor 30,830 Health Visitors - Record of Visits, 1946. No. of Births reported in the area 3,452 Visits to Expectant Mothers 1,513 " " Post-natal Mothers 3,473 " " Children - (i) Urder or 1 year 8,890 (ii) Between 1 & 5 years 11,435 Total 20,325 Miscellaneous Visits 3,917 Total Visits 29,228 PREMATURE BIRTHS. The number of premature births notified during the year was 215, of which 167 survived the first month of life. Special attention was paid to these cases by the Council's Health Visitors. Detailed particulars culars of these cases appear in the following table. No. of premature "babies notified during 1946 who weighed 5½ lbs or less at birth:- (i) Born at home 51 (ii) Born. In hospital 164% No. of those born at home:- (i) who were nursed entirely at home 45 (ii) who died during the first 24 hours 2 (iii) who survived at the end of one month 45 No. of those born in hospital:- (i) who died during the first 24 hours 29 (ii) who survived at the end. of one month 122 *In one instance it was not possible to "follow up" to ascertain whether or not the child survived. CHILD LIFE PROTECTION. The supervision of foster mothers and children is undertaken by the Municipal Health Visitors. Visits to foster mothers and children 158 Foster mothers under supervision at the end of 1946 14 Foster children under supervision at the end of 1946 21 CARE OF ILLEGITIMATE CHILDREN. Close co-operation continued between the Public Health Department and the Moral Welfare Worker of the Southwark Diocesan Association for Moral Welfare in all matters relating to the care of the illegitimate child and its mother. Information of all notified births of illegitimate children were forwarded to the Moral Welfare Worker. Guaranteed payments to foster mothers undertaking the care of illegitimate children were made under this Scheme during the year, and at the end of the year seven foster mothers wore receiving payment in respect of eight Children, contributions towards the cost of this service being recovered by the Council from the natural mother in each case. ANCILLARY SERVICES. In 135 instances the services of a Home help were provided for mothers, either before, during or after confinement. In three instances the services of a Domestic help were provided in homes were there was sickness. Sixteen expectant or nursing mothers were provided with dental treatment. Priority dockets were issued to 935 expectant mothers to enable them to purchase sheets for their confinements. The District Nursing Associations paid a total of 4010 visits to 379 approved cases under Council's Domiciliary Nursing Scheme. A total of 195 patients benefitted under the Council's Treatment of Minor Ailments Scheme. Ten children were sent to convalescent homes during the year through the agency of the Invalid Children's Aid Association. FOOD AND DRUGS. FORMAL AND INFORMAL SAMPLES SUBMITTED FOR ANALYSIS - YEAR ENDED 31.12.46. Number examined Number adulterated etc. Percentage of adulteration. Formal Informal Formal Informal 658 Total Formal Informal Total 1159 11 13 24 2.19 1.97 501 COMPOSITION OF MILK SAMPLES. Four hundred and eighty-three formal and eight informal samples of milk were taken during the year. Four formal samples were found not to conform with requirements. MILK ADULTERATION. Four formal samples were reported against, all being found to contain extraneous water. The percentage of adulteration was 0.81. THE MILK (SPECIAL DESIGNATIONS) ORDER, 1936. The following table shows the number of licences issued under these Regulations during 1946. Accredited Tuberculin Tested Pasteurised Producers - 1 - Dealers 18 - 44 Supplementary 13 - 15 Totals. 31 1 59 The following samples of Designated Milk were submitted for bacteriologicalical examination, Phosphatase and Methylene Blue Tests with satisfactory results:- Bacteriological examination Phosphatase Test Methylene Blue Test Pasteurised 36 36 30 Tuberculin Tested Pasteurised 6 6 6 Sterilised - 8 8 Heat treated - 1 1 Totals 42 45 51 EXAMINATION OF MILK FOR THE PRESENCE OF TUBERCLE BACILLI. Five samples of raw milk were examined by means of the animal test for the presence of tubercle bacillus, with negative results. MERCHANDISE MARKS ACT. No infringements of the Merchandise Marks Act were recorded during the year or of the various orders under the Agricultural Produce (Grading and Marking) Act, 1928. BAKEHOUSES The number of bakehouses on the register at the end of the year was 66 overground and 24 underground. PARTICULARS OF INSPECTION & SUPERVISION OF FOOD 1946. No. of Registered Food Prem ises. Manufacturers of ice cream 31 Storage & sale of ice cream 243 Manufacture of sausages 151 Fish Curers 38 Preparation or manufacture of pot tod or prosorvod meat or fish 299 Fish Fryers 59 Eating houses 247 Miscellaneous food factories & wholesale warehouses 40 Dairies & milkshops 291 RETURN OF WORK 1946. Street markets inspections 2129 Food Places - inspections Bakehouses 162 Fish Curers' premises 100 Fried Fish shops 102 Ice cream premises 521 Restaurants a eating houses 211 Milkshops 276 Slaughterhouses 22 Carcases inspected 47 " condemned with organs 7 Organs Inspected 218 " condemned 33 Other food premises 3750 Inspections of food surrendered 765 Food condemnation certificates issued 2305 No. food premises repaired 229 Shops Act inspections 561 Food Poisoning investigations 26 Inspections not defined 790 Intimations served 281 Statutory Notices served 62 Re-inspections 883 Food Control Inquiries 647 Complaints received 92 Complaints found to be justified 73 Inspections of foodstuffs for export 1 PARTICULARS OF UNSOUND FOOD CONDEMNED. Meat tons cwt qrs lbs 2 18 3 8½ 20½ Fish 14 1 - Canned & Miscellaneous foods Total 29 8 13¾ - 33 1 1 14¾ SANITARY INSPECTION. No. of complaints received 7489 Inspections under the Shops Act, 1954 563 " " the Pharmacy & Poisons Act, 1933 127 " of Milkshops 276 Factories Act, 1937 - No. of inspections of factories 295 " " " " Outworkers' Premises 38 Intimations served Nil No. of Intimations, P.H. (London) Act, 1936 5088 " " Statutory Notices 1811 " " Re-inspections (all enactments) 16189 Total number of visits 25618 WATER SUPPLY. No complaints were made to the Public Health Department as to the purity of the water supply provided by the Metropolitan Water Board. All houses in Camberwell receive their water supply from this source. RODENT CONTROL SCHEME. The organisation which was set up during the War to deal with rat infestations was extended during the year following the issue of Ministry of Food Circular N.S.12 which sought to secure an intensification of effort by local authorities in the destruction of rats during the 1946/7 fiscal year. The effect of this decision was to increase the existing operational staff for surface treatment from 15 to a minimum of 21 persons. A brief outline of the work carried out under this Scheme during 1946 appears in the sub-joined table. No. of complaints received 875 No. of Baits laid 112,409 No. of Investigators' visits 34,901 No. of Operators' visits 35,473 Rodent Officer's Surveys & Inspections 327 TUBERCULOSIS PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930. NEW CASES during 1946. Four hundred and thirty-six fresh cases of Tuberculosis came to the notice of the Dispensary during the year. Three hundred and thirty-six of these cases were primary notification, 80 inward transfers, 3 posthumous notifications and 17 non-notified deaths obtained from the local Registrars' and the Registrar-General's returns. The distribution of the primary cases, in age groups, distinguishing respiratory and non-respiratory forms is set out in the following table. Age periods Fresh Cases Respiratory Non-respiratory Total M F M F 0 - 1 1 - - - 1 1 - 5 6 5 3 1 15 5 - 15 18 10 1 6 35 15 - 45 120 99 4 6 229 45 - 65 36 14 - - 50 65 - - 5 1 129 - 6 Totals 186 8 13 336 MORTALITY during 1946. There were 99 deaths from all forms of Tuberculosis (after correction for inward and outward transfers) equal to a death rate of O.6O per 1000 of population (0.93 per 1000 in 1945). Of these 89 were respiratory cases and 10 nonrespiratory cases. The age groups in which these deaths occurred appear in the sub-joined table. Age periods Deaths Respiratory Non-respiratory Total M F M F 0 - 1 2 - - - 2 1 - 5 - - - 1 1 5 - 15 1 - 1 2 4 15 - 45 23 22 2 48 1 45 - 65 21 7 - 2 30 65 - 10 3 - 1 14 57 Totals 32 2 8 99 11 The total number of cases on the Notification Registe at the end of the year was 1,960, i.e., 1,632 respiratory and 328 non-respiratory. The ratio Of non-notified deaths to the total number of deaths was 1 to 5.8. WORK OF TEH TUBERCULOSIS DISPENSARY DURING 1946. Diagnosis Non-Pulmonary Pulmonary Total Grand Total Adults Children Adults Children Children Adults M F M F M F M F M F M F A- New Cases examined during the year (excluding contacts):- 112 6 3 7 2 - 115 82 75 6 (a) Definitely Tuberculous 3 206 1 (b) Diagnosis not completed - - - - - - - - 81 33 33 70 217 (c) Non-tuberculous - - - - - - - - 440 550 103 125 1218 B- Contacts examined during the year:- I I I I — 22 9 19 1 60 22 (a) Definitely tuberculous - - 19 7 2 10 9 (b) Diagnosis not completed - - - - - - - 9 23 69 - 18 19 (c) Non-tuberculous - - - - - - - 140 216 84 94 534 - C- Cases written off the Dispensary Register as:- 3 6 1 - 50 1 4 (a) Recovered 19 16 1 4 25 20 (b) Non-tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous). - - - - - - - 214 1944 836 243 - 651 D- Number of cases on Dispensary Register on December 31st:- 4 i 87 75 673 605 81 126 118 39 62 1740 754 (a) Definitely tuberculous 723 137 (b) Diagnosis not completed - - - - - - 79 104 51 286 - - 52 1. Number of cases on Dispensary Register on January 1st 1946, 1794 2. Number of cases transferred from other areas and cases returned after discharged under Head 3. in previous years 107 3. Number of eases transferred to other areas, cases not desirous of further assistance under the scheme and cases "lost sight of". 119 4. Cases written off during the year as dead (all causes). 66 5. Number of attendances at tho Dispensary (including contacts). 7448 6. Number of consultations with Medical Practitioners: (a) Personal 73 ( b ) Other 1868 7, Number of visits by Tuberculosis Officers to homes (including personal consultations). 8. Number of visits by Nurses or Health Visitors to homos for Dispensary purposes. 6217 9. Number of: - (a) Specimens of sputum etc examined 1108 (b) No. found to bo positive 100 (c) X-ray examinations made in connection with Dispensary work 4441 110. Number of cases ''recovered" restored to Dispensary Register and included in A (a) and A(b) above 11. Number of "T.B.plus" eases on Dispensary Register at December 31st, 1946. 278 ARTIFICIAL PNEUMOTHORAX TREATMENT. A total of 2,350 refill treatments were given to Cambprwell patients as compared with 2,163 in 1945. One patient received Finsen Light treatment and seven patients dental treatment. Extra diet was given to 80 patients and 48 pocket flasks were supplied. X-RAY. Every new case of "contact'' attending the Dispensary during 1946 received X-ray examination. TUBERCULOSIS ALLOWANCES. Memo 266/T. The Government Scheme of monetary payments to patients suffering from pulmonary tuberculosis receiving approved treatment, and their dependants, which commenced in June 1943, continued to work smoothly. Particulars of the cases dealt with under the Scheme during 1946 appear in the sub-joined table. 1. Number of applications considered 187 2. Number of applications found to be eligible 171 3. Number found to be ineligible but became entitled to an allowance at a later date 2 4. Number of applications approved and subsequently lapsed as a result of altered circumstances - 92 HANDICRAFT CLASS. The members of the class continued their high standard of work, and a ready market for the articles made by then was found. The Friday afternoon class continued throughout the year and there wore 50 sessions; the average attendance was 10 members. CHRISTMAS SEAL SALE. The receipts were £636. 7. 5½d., and the expenses £65. 4. 7d. , the balance of £571. 2.10½d. being disbursed in the provision of bedding and other comforts for tuberculous patients. 12.