Ac 4411 (3) CHIG27 Chigwell Urban District Council ANNUAL REPORT of the Medical Officer of Health including the Report of the Chief Public Health Inspector for the year ending DECEMBER 31st, 1963 CHIGWELL URBAN DISTRICT COUNCIL With the compliments of Dr. H.Franks Medical Officer of health COUNCIL OFFICE S. OLD STATION ROAD. CHIGWELL URBAN DISTRICT COUNCIL Chairman of the Council: Councillor C.T. Davie, J. P. Vice-chairman of the Council: Councillor N.D. Crafford„ PUBLIC HEALTH COMMITTEE. Chairman: Councillor E.G. Perry. Members: Councillor N.T.H, Croucher. D. F. Ellis. J. Fisher. C.K. Hempstead. W.S. North. Mrs. L.M. Scott. H. Worby. The Chairman and Vice-Chairman of the Council, ex-cfficio. PUBLIC HEALTH STAFF: Medical Officer of Health (Part-time) : H. FRANKS, M.B.,BoS.,D.P.,H.,B.Hy. (Tel: Loughton 3871). Deputy Medical Officer of Health (Part-time): B. FRASER. BEATSON, M.R.C.S.,L.R.C.P.,D.P.H.,D.T.M., & H. (Tel: Brentwood 990). Chief Public Health Inspector and Petroleum Inspector: R. ROPER, F.R.S.H.,M.A.P.H.I. (a) (b) (c) (d). (Tel: Loughton 3871) . Deputy Chief Public Health Inspector: J. A. ORRELL, M.A.P.H.I. (a) (b) (c) (Till 30.11.63). Public Health Inspectors: T.E.R. JONES, M.A.P.H.I. (a) (b) . R.P. STEVENS, (a) (b) . J. GALLIMORE, (a) (b) (c) . Student Public Health Inspector: M.F. LEE. Chief Clerk: MISS J. WARRINER. Clerks: MISS S. CLARK. MRS. L. PITT (From 1.1,63 - 22.9.63). MRS. S. PETERS (From 1.10.63). (a) Royal Society of Health and Sanitary Inspectors' Examination Joint Board Certificate. (b) Royal Society of Health Certificate as Inspector of Meat and Other Foods, (c) Royal Society of Health Smoke Inspectors' Certificate. (d) Royal Society of Health Sanitary Science Certificate. 2 To the Chairman and Members of the Chigwell Urban District Council. THE CHAIRMAN, LADIES AND GENTLEMEN, I have pleasure in presenting the Annual Report of the Medical Officer of Health for the year 1963, which includes the report of the Chief Public Health Inspector. VITAL STATISTICS. Although the standardised birth rate at 13.7 per thousand of the population is higher than last year, it is still considerably below the average figure for England and Wales, which is provisionally given by the Registrar General as 18.2. There have been more illegitimate births (6.1% compared with 4.3% of total live births), but less stillbirths (10 compared with 17). The infant mortality rate at 21 per thousand live births is the same as the average rate for England and Wales; for the second year in succession there have been no maternal deaths from childbirth or abortion. The standardised death rate at 11.2 per thousand of the population was a little less than the comparable figure for the whole of England and Wales, which was 12.2. There were more deaths than usual from bronchitis and pneumonia - attributable no doubt to the exceptionally hard winter: 54 out of the total of 80 deaths from these causes were of persons aged 75 or over. CONTROL OF INFECTIOUS DISEASE. This continues on the whole to be satisfactory, despite an increase in the number of measles notifications, and of cases of dysentery. All cases were mild, only 4 measles and 2 dysentery requiring admission to hospital. The increase in notified tuberculosis was due to the visit of the Mass Radiography Unit during the year, which brought to light 13 cases which perhaps otherwise would not have been notified during the current period, if at all. The Unit also revealed 24 other abnormalities, full details of which, together with the attendances, are given elsewhere in this report. SECTION 47, NATIONAL ASSISTANCE ACT, 1948, AND RATIONAL ASSISTANCE (AMENDMENT) ACT. 1951. 9 persons in possible need of care and attention were investigated during the year, 5 cases were subsequently removed to hospital, including 1 outstanding from last year; 1 was removed to an Old People's Hostel, and the remainder were kept under observation at home by the appropriate Department. The Meals-on-Wheels service assisted where necessary and was much appreciated. 3 /RE-HOUSING RE-HOUSING PRIORITY ON. MEDICAL GROUNDS. 110 requests for priority for re-housing on medical grounds were referred to me for assessment, usually supported by a doctor's written certificate. Each case was fully investigated and my recommendations were as follows:- Diseases or Condition Total Applicants Priority Recommended Priority Not Recommended Asthma, bronchitis, catarrhal diseases etc. 20 7 13 Blood pressure 4 2 2 Heart disease 14 10 4 Nervous disease (anxiety states, neurasthenia, neurosis etc.) 31 8 23 Rheumatism 9 2 7 Tuberculosis 3 2 1 Other diseases 4 - 4 Other conditions 24 3 21 Condition not specified 1 - 1 110 34 76 Figures for 1959 were 103 45 58 " " 1960 " 123 40 83 " " 1961 " 80 41 39 " " 1962 " 86 34 52 The 76 applicants not recommended for medical priority include (1) Illness not aggravated by housing conditions; (2) Temporary indispositions; (3) Those pleading the discomforts of overcrowding and structural defects (i.e. grounds other then medical) ; (4) Repeated requests already assessed. FLUORIDATION OF WATER. SUPPLIES. Following the Minister of Health's notification of his willingness to approve arrangements with Water Undertakers for the addition of fluoride to water supplies which are deficient in it naturally, the Council informed the Essex County Council, the Metropolitan Water Board and the Central Council for Health Education that Chigwell Urban District Council is in favour of controlled fluoridation. /The 4 The water supplied by the Board to the District naturally contains about 0.3 parts per million of fluoride, which is well below the optimum of 1 part per million recommended for the maximum protection against dental decay among the population. Because of the large number of Authorities involved in the area supplied by the Metropolitan Water Board it will inevitably take some considerable time before universal agreement can be obtained to the addition of fluoride to the local supply, and technical difficulties overcome. In the meantime, much can be done to improve the condition of children's teeth by discouraging nibbling between meals - especially of sticky sweets and starches - and regular use of the toothbrush at bedtime. W.V.S. WINGED FELLOWSHIP, GRANGE FARM, CHICWELL. At the request of the W.V.S., the Medical Officer of Health assisted with professional advice, particularly on the suitability of applicants for admission to the Centre. I would like to pay tribute to the excellent work being done by W.V.S. and many other volunteers in providing these holidays for severely handicapped persons with great benefit to them and to their families. 412 holidays were given during year, most of them at the request of the London County Council, other Local Health and Welfare Authorities, Hospitals and various voluntary organisations. The following is a list of some of the disabilities involved Hemiplegia 61 Paraplegia 9 Amputees 20 Amputees (double) 10 Rheumatoid Arthritis 56 Osteo " 35 Arthritis 42 133 Osteomyelitis 4 Muscular Dystrophy 10 Multiple Sclerosis 54 Poliomyelitis 10 Spastics 20 Parkinsons 10 Freidrichs Ataxia 8 Spondylitis 3 /In 5 In conclusion, I would again like to record my appreciation to the Chairman and Members of the Public Health Committee for their help and co-operation during the year, and to the staff of the Department for their continued enthusiasm and loyalty. For the statistical information which the Area Health and Divisional Education Departments of the County Council have provided for this report, grateful acknowledgements are also made. H. FRANKS, M.B., B.S., B.Hy., D.P.H. Medical Officer of Health. May, 1964. 6 STATISTICS AND SOCIAL CONDITIONS OF THE AREA, Area (in acres) (14 sq. miles approx.) 8,972 Civilian population (mid 1963) 62,240 Number of inhabited houses (1.4.63) 18,121 Rateable value (1.4.63) £2,903,689 Sum represented by penny rate 1963/64 £11,850(re-estimated) The rate in the pound for 1963/64 8/10d. VITAL STATISTICS: Live Births: Number 762 Rate per 1000 population (standardised) 13.7 Illegitimate Live Births (per cent of total live births) 6.1 Stillbirths: Number 10 Rate per 1000 total live and still births 13.0 Total Live and Still Births 772 Infant Deaths (deaths under one year) 16 Infant Mortality rates - Total infant deaths per 1000 total live births 21.0 Legitimate infant deaths per 1000 legitimate live births 18.2 Illegitimate infant deaths per 1000 illegitimate live births 63.9 Neo-natal Mortality Rate (deaths under 4 weeks per 1000 total live births) 18.4 Early Neo-natal Mortality Rate (deaths under one week per 1000 total live births) 14.4 Perinatal Mortality Rate (stillbirths and deaths under one week combined per 1000 total live and stillbirths) 27.2 Maternal Mortality (including abortion): Number of deaths 0 Rate per 1000 total live and still births 0 Death Rate (all causes) per 1000 of population (standardised) 11.2 /CAUSES 7 CAUSES OF DEATH AS GIVEN BY THE REGISTRAR GENERAL FOR THE YEAR 1963 Male Female Total Tuberculosis, respiratory 4 0 4 " , other 0 0 0 Syphilitic disease 1 0 1 Diphtheria 0 0 0 Whooping cough 0 0 0 Meningococcal infections 0 0 0 Acute Poliomyelitis 0 0 0 Measles 0 0 0 Other infective and parasitic diseases 0 1 1 Malignant Neoplasm, stomach 7 6 13 " " , lung bronchus 24 5 29 " " , breast 0 13 13 " " , uterus 0 2 2 Other malignant and lymphatic neoplasms 24 25 49 Leukaemia, aleukaemia 1 0 1 Diabetes 2 1 3 Vascular lesions of nervous system 21 40 61 Coronary disease, angina 46 47 93 Hypertension with heart disease 2 6 8 Other heart disease 16 19 35 Other circulatory disease 11 11 22 Influenza 1 2 3 Pneumonia 30 14 44 Bronchitis 21 15 36 Other diseases of the respiratory system 4 2 6 Ulcer of stomach and duodenum 2 0 2 Gastritis, enteritis and diarrhoea 4 1 5 Nephritis and Nephrosis 0 0 0 Hyperplasia of prostate 2 0 2 Pregnancy, childbirth, abortion 0 0 0 Congenital malformations 4 3 7 Other defined and ill-defined diseases 21 25 46 Motor vehicle accidents 2 2 4 All other accidents 3 3 6 Suicides 5 0 5 Homicides and operations of war 0 1 1 258 244 502 8 PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. No, of Cases. Admission to Hospitals. Deaths Acute Primary Pneumonia 6 - - Dysentery 51 2 - Erysipelas 3 1 - Food Poisoning 6 1 - Measles 679 4 - Meningococcal Infection 1 1 - Scarlet Fever 35 2 - Tuberculosis, Respiratory 28 7 4 Other 2 1 - Whooping Cough 58 3 - 869 22 4 DIPHTHERIA: There were no cases during the year. The free immunisation of children by general practitioners and at clinics has been maintained. TUBERCULOSIS: 30 new cases of tuberculosis were notified among residents in the District during the year with the following distribution:- Respiratory Non-Respiratory L.C.C. Debden Estate 9 1 Old Loughton 6 1 L.C.C. Hainault Estate 1 - Chigwell (excl. L„C.C. Estate) 4 - Buckhurst Hill 8 - 28 2 /Tuberculosis 9 Tuberculosis case finding among school entrants: The results obtained in the District are as follows;- Number to whom offered 747 Number tested and percentage 530 (70.9) Positive reactors - Known contacts: 10 Newly found reactors: 6 Total: 16 The new reactors were referred to the Chest Physicians for investigation. Where necessary, members of the child's family and other contacts were called for examination, but in no instance was anything of serious significance discovered. MASS RADIOGRAPHY. The Unit visited this District during the year with the following results:- LOUGHTON AND BUCKHURST HILL. LOCATION MALE FEMALE TOTAL[ Church Hill 197 162 359 Brown's Limited 282 367 649 The Broadway, Debden 283 407 690 Hilger & Watts Limited 406 118 524 Buckhurst Hill Station 187 232 419 TOTAL NUMBER X-RAYED 1,355 1,286 2,641 Requiring further investigation 20 9 29 GROUPS ATTENDING Referred by General Practitioner 7 5 12 General Public 894 1,124 2,018 Organised Groups 449 157 606 Contacts 5 - 5 TOTAL 1,355 1,286 2,641 /PULMONARY 10 PULMONARY TUBERCULOSIS MALE FEMALE TOTAL Requiring immediate treatment 2 1 3 Requiring occasional clinic supervision (1 pk3) 1 4 Presumed healed - no further action required 1 ( pk1) 2 GROUPS IN WHICH SIGNIFICANT PULMONARY TUBERCULOSIS WAS DISCOVERED Requiring immediate treatment - General Public 1 1 2 Organised Groups 1 - 1 P.K. = Previously Known, 1 AMONG OTHER ABNORMALITIES DISCOVERED WERE - Acquired abnormalities of the heart and vessels - 1 1 Lymphosarcoma i 1 - Enlarged mediastinal and bronchial glands 1 - 1 Benign tumour 1 - 1 Bronchiectasis 1 1 2 Pulmonary fibrosis - non tuberculous 3 - 3 Pleural thickening or calcification - non T.B., 1 - 1 Abnormalities of the diaphragm - 1 1 Abnormalities of the bony thorax and soft tissues - congenital 2 - 2 Abnormalities of the bony thorax and soft tissues - acquired 2 - 2 Did not attend for repeat miniature film 1 1 Not yet classified - 1 1 /MANFORD 11 CHIGWELL. MANFORD WAY MALE FEMALE TOTAL General Public - total number X-rayed 240 301 541 Requiring further investigation 7 4 11 PULMONARY TUBERCULOSIS y Presumed healed - no further action required 2 2 4 AMONG OTHER ABNORMALITIES DISCOVERED WERE - Acquired abnormalities of the heart and vessels 3 1 4 Pulmonary fibrosis - non tuberculous 1 - 1 Emphysema - 1 1 Abnormalities of the bony thorax and soft tissues - acquired 1 - 1 VACCINATION AND UMMUNISATION SCHEMES: 1. B.C.G. Vaccination of school children: This scheme for the 13/14 year age groups shows a decrease from 74.3% to 69.1% in the acceptance rate. The table below shows the results for the Chigwell Urban District:- Number of school children to whom B.C.G. vaccination was offered: 1,165 Number accepted: 810 (69.1%) Number given skin test and percentage: 766 (65.7%) Number who gave positive reaction to skin test: 57 Number who received B.C„G.: 666 Referrals to the Chest Clinic of pupils who gave a positive reaction continued, but there were no significant findings. /2. 12 2, Smallpox; 170 primary vaccinations were performed and 225 persons were re-vaccinated during the year. 5. Diphtheria: 446 completed a course of diphtheria immunisation during the year. 209 re-inforcing injections were also administered. 4. Whooping Cough; 511 children completed a course of immunisation against whooping cough. 5. Poliomyelitis: 1,132 children completed a course of immunisation against poliomyelitis. Young persons (20 - 30 years) 99 Adults (30 - 40 years) 237 Third injections (Salk or oral) 544 Fourth " ( " " '' ) 718 13 GENERAL PROVISION OF HEALTH SERVICES IN THE DISTRICT. PUBLIC HEALTH OFFICERS OF THE LOCAL AUTHORITY: The County Council Services of the District are administered as follows:- 1. Health: Dr.F.G. Brown, Area Medical Officer 2. School Health: Dr. F.G. Brown, Divisional School Medical Officer. Municipal Offices, High Road, Woodford, E.18. Tel: Buckhurst 9222. 3. Welfare: Mr. R.N. Weston, Area Welfare Officer, Crown Buildings, Crows Road, Epping. Tel: Epping 3253/4. LABORATORY FACILITIES: The Central Ministry of Health Laboratory at Colindale, and the Branch Laboratories at St„ Margaret's Hospital, Epping and at Chelmsford and Essex Hospital, Chelmsford, according to requirements. Water, milk, ice-cream and other foods are also on occasion examined at the Counties Public Health Laboratory, Thresh House, Verulam Streets, Gray's Inn Road, London, W.C.I. All milk and other food samples taken under the Food and Drugs Act, are sent for analysis to the Public Analyst, J.H. Hamence, Esq.,Ph.D., M.Sc.,F,RJ,C., 20 Eastcheap, London, E.C.3. AMBULANCE FACILITIES: The transport of the sick and injured and maternity cases, is provided free by the Essex County Council under the provisions of the National Health Service Act. In case of accident or emergency, (including maternity cases), an ambulance may be called by dialling 999 on the telephone, where automatic, or lifting the receiver and asking the operator for that number in other areas - or, of course, by directly contacting the ambulance station, Knighton Lane, Buckhurst Hill. Non-emergency calls are only accepted from responsible officers of the health service, e.g. doctors, nurses and midwives. Hospital services are provided by the North - East Metropolitan Regional Hospital Board at the Forest Hospital, Buckhurst Hill, and at hospitals in neighbouring districts. 14 /HEALTH HEALTH CENTRES: The County Council has four Health Centres serving the District, as follows:- BUCKHURST HILL: Essex County Council Clinic, Buckhurst Way. Tel: Buckhurst 5180. CHIGWELL: Essex County Health Services Clinic, Manford Way. Tel: Hainault 3143. LOUGHTON: Essex County Health Services Clinic, Loughton Hall. Tel: Loughton 5221. Essex County Health Services Clinic, The Drive. Tel: Loughton 5776. At each of these centres there are clinic sessions for expectant mothers, infant welfare, school children etc., and details of these may be had on application to the centre. Each centre has two or more health visitors or school nurses who call upon mothers in their own homes in addition to giving advice at the centres. In addition to the above, infant welfare centres are also held at the following:- CHIGWELL: St. Winifred's Hall, Manor Road. The Manse, Chigwell Row. LOUGHTON; Roding Road Church Hall. SCHOOL HEALTH SERVICE: The following extracts from the Annual Report of the Divisional School Medical Officer are of interest:- "Treatment of Enuresis by the use of Alarm Apparatus continued to reach a good standard of success when measured in terms of the dry nights achieved during the loan period of the Alarm, The scheme of testing the hearing of new entrants to Infant Schools did not reveal any major defect. /The 15 The response to both the B.C.G. Vaccination and Tuberculosis Case Finding schemes maintain a satisfactory level and is to some extent encouraging in that the lesser prevalence of Tuberculosis is not causing apathy towards the echemes. The staffing position in the School Dental Service remained unaltered and the provision of a satisfactory service in all districts continued. The position of the service provided in the Chigwell Urban District at 31st December, 1963, is as follows:- Buckhurst Way Clinic 2 sessions per week. Manford Way Clinic 4 " " " Loughton Hall Clinic 19 " " " Cleanliness Surveys. Routine surveys were again carried out at the start of the Spring and Autumn terms. Discovery of infestation occurred in 35 cases (0.18%) out of the total of 19,829 pupils inspected and none of these required any further action as the parents cleansed the children satisfactorily by following the advice of the School Nurse. In addition to the routine survey, observation was kept on those pupils whose previous history indicates the keeping of a close watch desirable. It has not been necessary to send a pupil to be cleansed since 1960. Specialist Services. There has been no change in the Ophthalmic, Orthoptic, Orthopaedic and Physiotherapy services provided by the North East Metropolitan Regional Hospital Board at Clinics in this Division. Speech Therapy. A summary of the work carried out in the Chigwell Urban District is shown below:- Number of centres: 3 " " clinical sessions held: 388 '' " individual children treated: 147 " '' visits to schools and homes (i) for treatment (ii) " consultation /Number 16 Number of attendances at clinic 1,901 " discharged - (a) cured: 38 (b) unsuccessful: 5 " failed to continue treatment: 16 " refused treatment: 2 " under treatment as at 31.12.63: 86 " on waiting list as at " Special Schools (Residential); (a) Chigwell High View School: This residential school for educationally sub-normal boys had 116 on roll at the end of the year, ages ranging from 11 to 16 years. 15 pupils were specially examined during the year regarding the provision of community care by the Mental Welfare Department after leaving school, this action being determined as necessary in only 8 cases. There has been no change in the system of giving every pupil a routine School Medical Inspection during the year. (b) Nazeing Park School: A residential school for maladjusted children catering for boys and girls in the 7-11 year age group who are kept under observation by a Consultant Psychiatrist. A School Medical Officer visits the school regularly and each pupil is given a routine medical inspection during the year. Child Guidance Service. Referral of children remains as previously, i.e. to Walthamstow Child Guidance Centre except for those residing in Epping Urban and Rural districts, who attend Harlow Child Guidance Centre. Educational Psychologist referrals continued to be mainly on account of slow progress at school and in the majority of cases the children proved to be of dull intelligence, although some came within the E.S.N, range. A number of pupils were taken on for individual coaching in reading. " 17 /HOME HOME NURSES: BUCKHURST HILL: Mrs. J. Turner, 55 Walnut Way (Buckhurst 7689). Mr, H. Jestice, 11 Rous Road (Buckhurst 7249). Mrs. W. Jestice, 11 Rous Road (Buckhurst 7249) . CHIGWELL: Mrs. G,M. Lee, 64 The Lowe (Hainault 3110). Miss J, Skoyles, 9 Coppice Path (Hainault 2108) . LOUGHTON: Mrs. A. Chad (part-time), 2 Sedley Rise (Loughton 2546). Miss M. Hoather, 46 The Crescent (Loughton 4815). Mrs. A.P. Archer, 29 Rochford Avenue (Loughton 2777). Mrs. O.M. Forrest, 12a Chequers Road (Loughton 7591). Mrs. E. Hennah,(part-time) , 26 Audley Court (Loughton 2864) . MIDWIVES: BUCKHURST HILL: Mrs. N, Warwicker, 40 Chestnut Avenue (Buckhurst 6371). CHIGWELL: Miss J. Skoyles, 9 Coppice Path (Hainault 2108). Mrs. G.M. Lee, 64 The Lowe (Hainault 3110). LOUGHTOM: Miss M. Sibthorpe, 82 Goldings Road (Loughton 1879). Mrs. S. Campe, 100 Borders Lane (Loughton 4644). Mrs. U. Jelbert, 31 Rochford Avenue (Loughton 5878). HOME HELP ORGANISER: Mrs, D.A. Taylor, Municipal Offices, High Road, Woodford, E.18 (Buckhurst 9222). Summary of Attendances and Visits. Number of attendances ats- Child Welfare Centres 11,413 Ante-natal and Post-natal Clinics 1,609 Women's Welfare Clinics 152 Number of visits made by:- Health Visitors and School Nurses 3,638 Revisits 6,887 Home Nurses 22,198 Midwives (Confinements) 231 /CHEST 18 CHEST CLINICS: The District is served by the following clinics. Patients and contacts are seen by appointment only. EPPING: Chest Clinic, St. Margaret's Hospital, Epping. (Epping 2224). ILFORD: Chest Clinic, 130 Cranbrook Road, Ilford. (Valentine 3067). WOODFORD: Chest Clinic, Harts Hospital, High Road, Woodford Green. (Buckhurst 7244) . The Forest Area Care Association for Diseases of the Chest continues to assist cases awaiting admission to sanatoria in various ways and arranges also for the admission of child contacts to convalescent homes. It concerns itself als6 with the after-care of patients by assistance in obtaining materials for occupational therapy, and whenever possible, suitable employment for those fit to work. The Hon. Secretary is Mrs. Hands, 52 Dacre Gardens, Chigwell. (Silverthorn 5767). There are special health visitors for tuberculosis who can be contacted at the Chest Clinics. ESTABLISHMENTS FOR MASSAGE OR SPECIAL TREATMENT: The following establishments are licensed under the Essex County Council Act, 1933:- LOUGHTON: Mr. A.C. Hallard, 4 Algers Road. Messrs M.L. & R. Harris Ltd., 21 The Broadway. Mr. C.J. Quinlan, 56 Station Road. These premises have been inspected and are being conducted in a satisfactory manner. FOOT CLINICS: Chiropody treatment at Essex County Council Health Services Clinics is available for certain priority groups, and appointments should be made through the Area Medical Officer, Municipal Offices, High Road, Woodford, E.18. 19 /VOLUNTARY VOLUNTARY ORGANISATIONS: BRITISH RED CROSS SOCIETY: Hon. Secretary: Miss H. Sewell, 17 High Road, Loughton. (Loughton 1238) . CITIZENS' ADVICE BUREAU: Community Centre, Manford Way, Chigwell. Mondays: 2.30 p.m. - 4 p.m. Wednesdays: 7.30 p.m. - 9 p.m. Crown Buildings, Crows Road, Epping (Epping 2722). Monday - Friday: 2 - 4 p.m. NATIONAL SPASTICS SOCIETY: Hon. Secretary: Mrs. D. Latham, 22 The Meadway, Buckhurst Hill. WOMEN'S VOLUNTARY SERVICE (including Meals-on-Wheels): Centre Organiser: Mrs. P. Buckland, Lincoln Hall, Loughton. (Loughton 7228). LOUGHTON & DISTRICT MARRIAGE GUIDANCE COUNCIL: Hon. Secretary: Mr. J.A. Liddie, 9 Russell Road, Buckhurst Hill. (Buckhurst 5273) . 20 ANNUAL REPORT of the CHIEF PUBLIC HEALTH INSPECTOR FOR 1963. To the Chairman and Members of the Chigwell Urban District Council. MR. CHAIRMAN, LADIES AND GENTLEMEN, I have pleasure in presenting my Annual Report for the year 1963. The information on rivers and streams, sewerage and public cleansing, was supplied by Mr. R.J, Edwards, A.M.I.C.E., M„I.Mun.E., Engineer and Surveyor, and the report on riding establishments by Mr. H.E. Bywater, M.R, C.V.S., F.R.S.H. To both these gentlemen I give my sincere thanks for their assistance and co-operation throughout the year. I also express my appreciation to Dr. J.H. Hamence, Ph.D., M.Sc., F R.I.C., Public Analyst, and his staff for the valuable assistance rendered in matters of food complaints and samples. R. ROPER, F,R.S.H., M.A.P.H.I. Chief Public Health Inspector. June, 1964. 21 SANITARY CIRCUMSTANCES OF THE AREA. 1. WATER SUPPLY. There are 18,121 dwelling houses in the area with an estimated population of 62,240. Of these, one house is supplied with water from a deep well. It is a satisfactory supply both as regards quality and quantity and it is not plumbo-solvent. The remainder are supplied with water from the Metropolitan Water Board mains, which, apart from several complaints regarding suspended matter due to mains repairs, has been satisfactory in quantity and quality and is not plumbo-solvent. The house mentioned in my last report as having an unsatisfactory shallow well supply has been closed and the occupants transferred to a house with a piped water supply. 2. SWIMMING POOLS. Routine visits have been made to the 6 swimming pools in the area to carry out Chlorine tests and to ensure that the pools are maintained in a satisfactory condition. 15 samples of water were sent for bacteriological examination. Of these 12 were satisfactory and 3 unsatisfactory. Chlorination of the water in the pools from which the latter results were obtained, was improved and satisfactory results were then obtained. 3. RIVERS AND STREAMS. The River Roding flows through the centre of the District dividing the Ward of Chigwell on the south-east from those of Buckhurst Hill and Loughton on the north-west side. There are no buildings at present liable to floods in the river area within this District which is under the jurisdiction of the Essex River Board. Some flooding of fields in the valley occurs during the exceptionally heavy winter rains. 4. DRAINAGE AND SEWERAGE. The soil drainage from the greater part of the District gravitates to the main disposal works at Luxborough Lane which were inproved in 1938, extended after the war and are now nearing the end of a further stage of improvement, although the constant increase in the number of dwellings in the District is making yet further work inevitable and, as a result, final effluent and storm water treatment lagoons are soon to be constructed and further percolating filters are to be provided. A smaller part of the District drains to the Millers Lane Sewage Disposal Works and the Council has decided to make improvements there also. /The 22 The completion of improvements at both Works is expected to result in a higher standard of purity in the effluent to be discharged to the River Roding. As regards sewerage, the Council is faced not only with the increasing foul flows from the new development and flooding but also with some ageing and unsatisfactory sewers which contribute to the flooding difficulties as referred to below. Present proposals envisage new sewerage in both the north and south parts of Loughton and in Buckhurst Hill. A small area of Buckhurst Hill drains into the sewers of Wanstead and Woodford, thence via Chingford and to the East Middlesex Scheme. Most of the Hainault Estate drains to the sewers of Dagenham District and the Works of that Authority, using sewers in Ilford en route. There are four outlying pumping stations lighting the flow from low lying areas up to the main gravity sewers. The four stations include the new one at Roding Road and the newly enlarged one at Bradwell Road. Generally, there is a separate system of drainage in the District except in the older parts where combined sewers still exist. These combined sewers have caused flooding at various points in the District and schemes are to be prepared for new surface water sewers to rem???e part of the flow from the combined sewers and the Sewage Works. 5. SANITARY ACCOMODATION AND CESSPOOLS There are 76 dwellings in the area with sanitary accommodation not connected to the main drainage system. These vary from septic tank systems in large houses, cesspools, chemical closets and earth closets. The chemical closets are mainly used in connection with caravan sites and the earth closets are usually of temporary use only at building sites. The camping ground at Chigwell has been connected to the main drainage system during the year. 6. PUBLIC CLEANSING. Domestic refuse is being collected once weekly throughout the District by the Council's vehicles and labour. A fleet of seven compressing type refuse collection vehicles is constantly employed, supplemented by further vehicles for special collections, including a service of removing bulky articles (e.g. mattresses, bedsteads etc.) on request from householders. This free service cannot be stressed too much as it is provided to combat the other alternative of tipping old mattresses, etc. into ditches or on to forest land. Trade refuse also is collected, a charge related to actual cost being made only for refuse, the character of which is clearly not domestic. /Refuse 23 Refuse is at present disposed of by controlled tipping at a new site leased to the Council for this purpose. The refuse is covered with spoil, hardcore or other innocuous filling leaving, during tipping, only a very small surface of refuse uncovered. Measures are taken against flies and vermin as necessary from time to time. This tip will be filled during the next few years. Further and more long term arrangements for refuse disposal will have to be made. Salvage of paper and rags continues to produce sales during the year but the paper market continues not to be good. Nevertheless, the Council has modernised the paper salvage arrangements in the form of a new salvage building and new baling plant at the Depot at Rectory Lane, Loughton. Road gullies in County and District roads are emptied (and re-sealed with clean water) by machine regularly during the year by contract. As the Council took over County roads in April, 1963, there has been a great increase in the number of gullies to be done. 7. SANITARY INSPECTION OF THE AREA, The following statistics show the work of the Public Health Inspectors during the years:- (a) 1,313 complaints were received and dealt with. (b) Summary of complaints: Food 56 Sewage 17 Polluted ditches, watercourses and ponds 4 Flooding 22 Defective or blocked drains 292 " water closets 39 " water supply pipes 39 Dampness 31 Defective roofs and gutters 12 Accumulations of refuse 24 Defective dust bins 10 Insanitary conditions 9 Vermin 3 Rodents 394 Wasps 173 Other insect infestations 52 Smoke 28 Smells 33 Noises 10 Animals and birds 6 Miscellaneous housing defects 29 Miscellaneous 35 24 (c) (c) Summary of visits and inspections General Sanitation Moveable dwellings 119 Swimming pools 43 Drainage 1,346 Ponds, ditches etc 57 Public conveniences 32 Stables 20 Piggeries 7 Refuse 128 Rodents 2,786 Pests 447 Verminous premises 35 Infectious diseases 179 Atmospheric pollution 155 Smell complaints 78 Water supply 45 Noise complaints 26 Schools 4 Miscellaneous 353 5,860 Housing 2,726 Food Control 981 Factories and Shops Acts 1,595 Other Acts and duties 386 Total visits and inspections 11,548 (d) Summary of notices served and complied with. Served Compiled Public Health Acts: Statutory Notices 22 1 6 Informal " 158 150 Housing Acts Statutory " - 1 Food & Drugs Act Informal " 51 48 /8. 25 8. INFECTIOUS DISEASES AND FOOD POISONING. 179 enquiries and revisits were made during the year regarding notifications of the following infectious diseases; Scarlet Fever 35 Food Poisoning 6 Sonne Dysentery 51 Where necessary, specimens were taken and submitted for examination to St Margaret's Hospital Pathological Department, or the County Laboratory. 9. RODENT CONTROL. 469 inspections of private, business and other properties, were made throughout the year, and on the 405 occasions when infestation by either rats or mice was found, the treatment was carried out by the Local Authority". 10. WASP AND OTHER INSECT NUISANCES. Many enquiries are received by the Department for advice concerning infestations by ants, woodworm, cockroaches, flies, larder beetles and silver fish, in each case a visit is made and advice given on the most suitable method to eradicate. During the year the Council instituted a charge of 5/-d., for treatment of wasps nests, 173 complaints were received and dealt with. 11. CARAVAN SITES. There are 10 licensed sites in the area, a reduction of 7 during the year. Visits are made to ensure compliance with the Caravan Sites and Control of Development Act, 1961. The standard of maintenance at these sites is satisfactory. 12. AIR POLLUTION. Observations made throughout the year show that there is no serious air pollution. The installation of any new industrial furnace requires to be notified to the Council and in this way a check is kept at the outset as to whether the new plant operates within the requirements of the Clean Air Act, 1956. The apparatus used for the recording of smoke and sulphur dioxide levels in the atmosphere continues to show a low figure as day by day recordings are made in the Department. One matter which does cause some concern is the unnecessary preponderance of bonfires which, from time to time, are lit in the District. 26 /The The smoke nuisance from such bonfires can, on occasions, be considerable and visits by inspectors are made to gain the co-operation of the householders to dispose of their rubbish by means of the Council's refuse collection service rather than by burning it in their own back gardens. 13. RIDING ESTABLISHMENTS ACT, 1939. The Riding Establishments in the area have been inspected by Mr. HUE. Bywater, who reports as follows:- "I have pleasure in submitting my report of the inspections carried out, at varying times, during each quarter of the year ended 31st December, 1963. The high rentals often demanded, and the limited number of premises available, tends to make the conduct of a riding school a somewhat precarious business which is often undertaken merely because a person likes to be with horses rather than for any great financial gain. It is not surprising, therefore, that frequent changes in premises and ownership or management are fairly common. During the year under review the land occupied by the Nightingale Riding School at Buckhurst Hill was developed for other purposes and the school transferred to the Epping New Road. The Riding School at Chase lane conducted by Mrs. Taylor, who took over from Mr. W.M Scanes, ceased to operate due, apparently, to financial difficulties. Shortly afterwards the stabling was occupied by the Chigwell Riding School, the premises of which, in Hainault Road, had been closed under Town Planning. The buildings at Hainault Road were far from satisfactory and although the stabling at Chase Lane cannot be considered by any means ideal, it is an improvement on those vacated at Hainault Road. I found no evidence, however, that the animals actually suffered due to the defective buildings. The Braeside stables in Connaught Avenue have recently been taken over from Mrs, Cooper by Mr. Carvalho who is attending to the general maintenance of the stables, which had been somewhat neglected, although basically they appear to be of sound construction. Below is a list of the premises regularly visited, the owner or person in charge and the average number of horses:- Braeside Stables, Connaught Avenue. Loughton. Mr. Carvalho, 74 Avondale Drive, Loughton. 2 horses plus 3 at livery. Forest Riding School, near Roebuck Hotel. Buckhurst Hill. Miss de Berry, lives adjoining. 5 horses plus 1 at livery. 27 /Nightingale Nightingale Riding School, Albany Stud Farm, Epping New Road, Buckhurst Hill. Mr. T. Robinson, 74 Field Road, Forest Gate, E.7. 10 horses plus 17 at livery. Chase Riding School, Chase Lane, Chigwell Row, Mrs. Taylor. 7 horses plus 9 at livery. Chigwell Riding School, Chase Lane, Chigwell Row. Mr. C. Wood, 33 Fontayne Avenue, Chigwell. 7 horses plus 9 at livery. (Formerly at Hainault Road, Chigwell). Riding School, Limes Farm, Manor Road, Chigwell. Mrs. Barnett, 23 Harewood Drive, Ilford. 13 horses plus 8 at livery. (Livery - horses privately owned but housed and boarded etc. by riding school management). (Signed) H,E. BYWATER, M.R.C.V.S., F.R.S.H." 28 HOUSING STATISTICS 1963. 1, REDEVELOPMENT, 30 houses were demolished during the year and redevelopment of the cleared sites with permanent housing commenced. 2. NEW HOUSES. 247 new dwellings were erected during the year. By the Chigwell Urban District Council 52 By private builders 195 3. INSPECTION OF DWELLING HOUSES. 1. (a) Total number of dwelling houses inspected for housing defects (under Public Health and Housing Acts) 237 (b) Number of visits made for the purpose 994 2. Number of dwelling houses (included in subhead (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 30 3. Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 9 4. Number of dwelling houses (exclusive of those referred to under the preceding subhead) found not to be in all respects reasonably fit for human habitation 158 4. SUMMARY OF HOUSING VISITS AND INSPECTIONS. Public Health Act 720 Housing Act 274 Overcrowding 17 Rent Act 12 Improvement Grants 53 Searches and S.D.A.A. 1,526 Miscellaneous 124 2,726 /5. 29 5 RENT ACT, 1957. 2 applications were received for Certificates of Disrepair, in both cases no certificates were issued as undertakings from the owners were accepted. 6. REMEDY OF DEFECTS WITHOUT SERVICE OF FORMAL NOTICES: Defects to dwelling houses remedied by informal action 150 7. ACTION UNDER STATUTORY POWERS: (a) Proceedings under Sections 9, 10, 12 and 16 of Housing Act, 1957: (1) Number of dwelling houses in respect of which notices were served requiring repairs Nil (2) Number of dwelling houses which were rendered fit after service of Formal Notice Nil (b) Proceedings under Public Health Acts: (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 22 (2) Number of dwelling houses in which defects were remedied after service of Formal Notices by:- (a) Owners 16 (b) Local Authority in default of owners Nil (c) Proceedings under Section 16, 17, 34 and 42 of Housing Act, 1957: (1) Number of dwelling houses in respect of which Demolition Orders were made 9 (2) Number of dwelling houses demolished in pursuance of formal action 13 (d) Number of houses or parts of houses closed under: (1) Section 17 of the Housing Act, 1957 Nil (2) Section 18 of the Housing Act, 1957 Nil (e) Informal Action: Number of dwelling houses demolished as a result of informal action 5 30 FOOD CONTROL. 1. FOOD ESTABLISHMENTS AND VENDORS. Type Number of Premises Inspections Cafes, restaurants, canteens etc. 54 110 Butchers 33 84 Fishmongers and friers 11 23 Ice cream 98 25 Bakehouses 7 46 Dairies 3 9 Licensed premises 47 43 Grocers 61 231 Greengrocers 32 Bakers' shops 19 Confectioners 53 Inspection under Merchandise Marks Act 4 Visits in connection with food sampling 147 Inspection of food hawkers 23 " " " transport vehicles 9 Other visits 227 Total inspections made in connection with food control 981 2. FOOD HYGIENE (GENERAL) REGULATIONS, 1960. Premises where food is manufactured, stored, or sold, are periodically visited to ensure the compliance with the Regulations. The standard in the District is good and no major infringements were found. In 51 cases letters were sent to proprietors calling attention to minor contraventions and in 48 instances have been complied with. During the year, 1 lock-up cafe has been rebuilt and provided with main drainage and sanitary accommodation for the staff. 3. REGISTRATION OF FOOD PREMISES UNDER SECTION 16, FOOD AND DRUGS ACT. 1955. Ice cream manufacturers 1 " " vendors 98 Butchers (sausage manufacturers) 32 4. REGISTRATION OF DAIRIES UNDER MILK AND DAIRIES REGULATIONS, 1959. Milk Distribution Depots 3 Milkshops 23 31 /5. 5. UNSOUND FOOD. Foodstuffs as listed below were examined during the year and found to be unfit for human consumption. The food was condenned and disposed of by burial at the Council's refuse tip:- Meat 391 lbs. Bread 70 loaves Turkeys 36 " Vegetables 48 lbs. Fish 316 " Miscellaneous groceries 13 " Bacon 940 " Tinned meat 79 " Offal 31 " " vegetables 27 " . Eggs 30 doz. " fruit 53 " Sugar 630 lbs. " fish 2 " Margarine 300 " Frozen Foods: Meat 50 " Butter 476 " Vegetables 111 " Lard 651 " Fish 112 " Cheese 236 " Ice Cream 95 cartons Flour 1,008 " Cream 48 " " (confectionery) 30 " Pies 60 Cereals 467 packets 6. FOOD SAMPLES. (a) Chemical Analysis: 143 samples of foodstuffs were submitted to the Public Analyst for examination, who reported on these samples, as follows:- Submitted Unsatisfactory Angelica 1 — Apple sauce 1 — Aspirin 1 — Baby food 1 — Beef curry with rice 1 — Beef, potted 2 — Beef steak pudding 1 — Beef suet 1 — Blackberries, tinned 1 1 Broad beans 1 — Butter 5 — Cake decorations, edible 1 — +Gasserole steak 1 1 Cheese spread with mushrooms 1 — Cheese spread 1 — Chicken stock tablets 1 — Chocolate cake dressing 1 — Cinnamon 1 — Condiment, non-brewed 1 — 24 2 32 /c/f  Submitted Unsatisfactory Brought forward 24 2 Coconut, dessicated 1 — Coffee 1 — Coffee and chicory essence 1 — Crab spread 1 — Crab spread with butter 1 — Cream 3 — Cream, dairy 1 — Cream, imitation 1 — Easi peas 1 — Essence of rennet 1 — Flour, self-raising 1 — Gelatine 1 — Ginger, ground 1 — Gravy powder, Bisto 1 — Gravy improver 1 — Horseradish, creamed 1 — Horseradish, relish 1 — +Ice lolly 2 1 Ice, ready-mix 1 — Jam 6 — Jelly 3 — Jelly crystals (unsweetened) 1 — Kelp powder 1 — Lard 1 — Lemon glucose drink (Sunfresh) 1 1 Lemon juice 1 — Lemonade powder 1 — Liver, bacon and sausages 1 — Macaroni cheese 1 — Marmalade 1 — Margarine 3 — Mashed potato, instant 1 — Marzipan 1 — Milk 11 — Milk, Channel Island 1 — Milk, evaporated 2 — Milk shake 1 — Minced meat 4 2 Mint leaves 1 — Olive oil 2 — Onions, pickled 1 — Orange drink 1 — Paraffin, liquid 1 — Paste 1 — Peas, garden 3 — Peas, processed 1 — 99 6 33 /c/f  Submitted Unsatisfactory Brought forward 99 6 Pease pudding 1 — Pork meat roll, chopped 1 — Potato crisp with salt 1 — Puff pastry 1 — Raspberry preserve 1 — Ravioli in tomato sauce 1 — Rice, creamed 1 — Saccharin tablets 1 — Sage and onion stuffing 1 — Savoury ducks 1 — Sausages, beef 1 — Sausages, pork 2 1 Soda, bicarbonate 1 — Soup 2 1 Spice, mixed pickling 1 — Stewed steak 2 — Sweets 10 1 Syrup of camphor 1 — Tea 4 — Toffee apple mix 1 — Tomato flavour soup 1 — +Turkey croquettes 1 4 Vegetable juices 1 — Vienna sausages in brine 1 — Vinegar 1 — Vinegar, malt 1 — +White loaf, foreign substance 1 1 White pepper 1 — Yoghurt, fruit 1 1 143 15 + Food complaints. (b) Bacteriological Examination: Cheese 1 Satisfactory Ice cream 5 Grade I Milk 6 Satisfactory Water 1 " /7. 34 7. FOOD COMPLAINTS. 29 complaints regarding the quality, nature and substance of food were received during 1963, as follows:- Beef 1 Lamb 1 Bread 4 Lemon glucose drink 1 Cheese 2 Meat pie 1 Corned beef 1 Milk 4 Cream 2 Nut brittle 1 Fish 1 Pudding (for baby) 1 Flour 1 Sausages 2 Gooseberries 1 Stewed steak 1 Ham 1 Turkey Croquette 1 Ice lolly 1 Walnut cake 1 These complaints were all investigated and in 3 cases formal action was taken. Legal proceedings were instituted in the following cases:- Contraventions Result of Proceedings: Mould growth on bread Fine £10.0.0d. Costs £ 3.3.0d. " " " " Fine £ 5.0.0d. Costs £ 3.3.0d. Finger plaster embedded in turkey croquette Fine £10.0.0d. Costs £ 5.5.0d. 35 FACTORIES ACT, 1961. 1. INSPECTION for purposes of provisions as to health (including inspections made by Public Health Inspectors) . Premises Number on Register Number of Inspections Written notices Occupiers prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 11 15 — — (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 95 50 3 — (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 25 118 3 — Total 131 183 6 — 36 /2. FACTORIES ACT, 1961. 2. CASES IN WHICH DEFECTS WERE FOUND. Particulars Number of cases in which defects were found. Number of cases in which prosecutions were instituted. Found Remedied Referred to H.M. Inspector Referred by H.M. Inspector Want of cleanliness (S.1) 2 2 — — — Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) — — — — — Inadequate ventilation (S.4) — — — — — Ineffective drainage of floors (S.6) — — — — — Sanitary Conveniences (S.7) (a) Insufficient — — — — — (b) Unsuitable or defective — — — — — (c) Not separate for sexes — — — — — Other offences against the Act (not including offences relating to Outwork) 1 1 — — — Total 3 3 — — — 3. OUTWORKERS. 185 visits were paid to the Outworkers in the District. 37 APPENDIX. RAINFALL IN INCHES FOR. YEAR 1963. Metropolitan Water Board Chigwell U. D. C. High Beech Buckhurst Hill Luxborough S.D. Works. Loughton Depot. January 1.20 0.93 0.88 0.85 February 0.76 0.59 0.62 0.68 March 2.70 2.29 1.77 2.63 April 2.16 1.88 1.65 2.01 May 2.04 2.03 2.29 2.27 June 2.70 2.54 1.17 2.71 July 1.85 1.61 3.24 1.23 August 3.02 2.84 2.30 3.58 September 2.36 2.16 2.69 2.92 October 1.69 1.46 1.22 1.66 November 4.19 4.26 4.27 4.27 December 0.77 0.68 0.90 0.63 25.44 23.27 23.00 25.44 AVERAGE RAINFALL FOR THE LAST FIVE YEARS. 1959 18.54 1960 30.94 1961 25.49 1962 22.83 1963 24.28 The Highest point in the district is 372 O.D. and the lowest 44 O.D. 38