DAG 29 BOROUGH OF DAGENHAM ANNUAL REPORT of the Medical Officer of Health for the year 1955 J. ADRIAN GILLET, M.B., CH.B., D.P.H. BOROUGH OF DAGENHAM ANNUAL REPORT of the Medical Officer of Health for the year 1955 J. ADRIAN GILLET, m.b., ch.b., d.p.h. To the Mayor, Aldermen and Councillors of the Borough of Dagenham. Mr. Mayor, Ladies and Gentlemen, I have pleasure in submitting the report on the health service in the Borough of Dagenham during 1955. Most of the work reported upon was done during the time when Dr. Robinson was acting as Medical Officer of Health and Area Medical Officer. As far as future development of the services is concerned, it should be borne in mind that the days of striking results achieved in the field of preventive medicine by administrative action on the part of Health Departments are rapidly coming to an end, and that what people are prepared to do for themselves is gaining in importance. Teaching people what to do and how to do it in order to achieve a state of positive health must be our future endeavour. This involves the use of posters, leaflets, film shows and film strips, talks, discussion groups, etc., and the message must be put over by members of all sections of the Department including Health Visitors, Domestic Helps, Public Health Inspectors, School Nurses, Doctors and Midwives. Much has already been done, but I hope to be able to report further progress in this important field at the end of 1956. I would like to thank the Chairman and Members of the Committees concerned with administration of the services covered by this report and to express my gratitude also to all members of the staff for so readily giving me their assistance as well as their loyalty. J. ADRIAN GILLET, Medical Officer of Health. Public Health Department, Civic Centre, Dagenham. 3 MEMBERS OF THE COUNCIL (31st December, 1955) Mayor: Alderman C. PRENDERGAST, J.P. Deputy Mayor: Councillor A. S. HADDOCK AIdermen: W. E. BELLAMY F. BROWN, E.C.C. G. H. A. CROUCH F. GRINDROD, J.P. A W. KEMPSON D. O'DWYER Councillors: R. BLACKBURN E. H. BOWDLER G. A. BROOKER F. G. BYRNE D. A. L. G. DODD M. EALES J. P. HOLLIDGE. J.P., E.C.C. B. L. HOLLINGSWORTH, B.Sc., Ph.D., A.R.I.C. H. P. LARKING J. F. MOULTRIE. F.A.I. W. G. NOYCE W. A. PARISH A. E. PRENDERGAST (Mrs.) B. M. ROADKNIGHT (Mrs.) L. S. SNELLING (Mrs.) A. R. THOMAS (Mrs.). E.C.C. F. G. THOMAS L. W. TODD S. J. C. WARR M. WARREN (Mrs.) PUBLIC HEALTH COMMITTEE Councillor (Mrs.) A. E. PRENDERGAST, Chairman Councillor M. EALES. Vice-Chairman His Worship the Mayor (Alderman C. PRENDERGAST. J.P.) The Deputy Mayor (Councillor A. S. HADDOCK) Alderman D. O'DWYER Councillor (Mrs.) B. M. ROADKNIGHT Councillor S. J. C. WARR Councillor (Mrs.) M. WARREN 4 DAGENHAM HEALTH AREA SUB-COMMITTEE Councillor (Mrs.) A. E. PRENDERGAST. Chairman Councillor (Mrs.) A. R. THOMAS, Vice-Chairman Members: — Borough Council The Mayor: Alderman C. PRENDERGAST, J.P. The Deputy Mayor: Councillor A. S. HADDOCK Alderman A. W. KEMPSON Alderman D. O'DWYER Councillor E. H. BOWDLER Councillor D. A. L. G. DODD Councillor M. EALES Councillor W. A. PARISH Councillor (Mrs.) B. M. ROADKNIGHT Councillor (Mrs.) A. R. THOMAS Councillor (Mrs.) M. WARREN Councillor H. P. LARKING Councillor W. G. NOYCE Councillor S. J. C. WARR County Council Alderman K. E. B. GLENNY. O.B.E.. J.P. Councillor A. C. BERRY Councillor (Mrs.) S. M. BOVILL Councillor E. R. D. DeROUGEMONT Councillor L. F. SAUNDERS Councillor W. A. SIBLEY Councillor (Mrs.) A. F. WARR Hospital Management Committee Councillor (Mrs.) A. R. THOMAS (Vice-Chairman) Executive Council for Essex Mrs. A. M. BURRELL Local Medical Committee for Essex . Dr. W. J. SMITHER. D.P.H., D.I.H. Voluntary Organisations Mrs. S. M. HOXLEY. Miss N. L. ODELL, Miss A. TOLD and Mr. J. WALSH 5 OFFICERS OF THE PUBLIC HEALTH SERVICES (as at 30.9.56) Officers employed by the Essex County Council are indicated thus " (C) " Full-Time Staff : Medical Officer of Health : J. ADRIAN GILLET, M.B.. Ch.B., D.P.H. Deputy Medical Officer of Health : HELEN MAIR, M.B., Ch.B.. D.P.H. (C) Assistant Medical Officers: CATHERINE F1TZPATR1CK, M.B., B.Ch. (C) FANNIE HIRST, M.B., Ch.B.. D.P.H. (C) EDMUND PERC1VAL JAMES, M.R.C.S., L.R.C.P., L.M.S.S.A., D.(Obst.) R.C.O.G. (C) W1LHELM1NA C. MAGUIRE, L.R.C.P., L.R.C.S.I. (C) MADELINE WEIZMANN, M.R.C.S., L.R.C.P. (C) Public Health Inspector : L. E. PRIOR (1, 2) Public Health Inspectors : J. W. ALLAM (1, 2) F. W. S. FOX (1, 2, 3, 4) G. DOVEY (1) A J. JAMES (1) Superintendent Health Visitor : (C) F. COLLINS (5, 6, 7, 10) Health Visitors: (C) H. M. BEVERIDGE (5, 6, 7) P. G. COLLYER (5, 7, 8, 12) L. DUNBAR (5, 6. 7) J. R. FRANCE (5, 6. 7) I. A. GARRARD (5, 16) A. K. GIBSON (5, 6, 7) D. HICKEY (5, 6, 7) D. B. RUDD (5, 6, 7) L. SALTER (5, 6, 7) K. F. SAMMON (5, 6, 7) D. E. SMITH (5, 7, 8, 15) D. B. STEWART (5, 6, 7) E. VALENTINE (5, 6, 7, 15) R. E. WALKER (5, 6, 7, 15. 16) 6 Senior Midwife: (C) E. M. BEDFORD (5, 6) Mid wives: (C) M. GOODBUN (5, 6) H. MITSON (5, 6) M. M. RICHARDS (6) M. M. ROBSON (6, 13) M. ROCK (6) M. TEATHER (5, 6) Clerical Staff : Chief Clerk : (C) F. W. KNIGHT (1, 2) Trainee Sanitary Inspector : J. POWELL Clerks: E ADAMS (C) I. M. BISHOP (C) M. A. BRIDESON (C) A. M. BROWN (C) N. E. CLOKE (C) D. B. ELLMORE (C) L. M. FREESTONE (C) G. K. HARRIS S. B. LEADER (C) L. A MANNING (C) F. H. MARTIN (18) (C) L. A. MOORE (C) E. NEPORT (C) I. PAGE (C) K. RICHARDS (C) G. SHANNON (C) D. TYLER (C) M. A. WATTS (C) Dav Nurseries: (C) Goresbrook Nursery, Dagenham Avenue. Dagenham. Chadwell Heath Nursery. Ashton Gardens. Chadwell Heath. Kingsley Hall Nursery. Parsloes Avenue. Dagenham. MATRON: E. MADDISON (15) DEPUTY: K. GRAHAM (9) MATRON: I. MUSGRAVE (9) DEPUTY: P. COFFEE (17) WARDEN: D. HOWES Domestic Help Organiser: (C) G. HICKINBOTHAM Chiropodists: (C) N. FREEMAN M. KELLY (14) 7 Part-Time Staff Demist: A. S. ROBERTS, L.D.S.. R.C.S.(Edin.) Public Analyst: J. HUBERT HAMMENCE. Ph.D.. M.Sc., F.R.I.C. Occupational Therapist: ZELDA E. MERCER (New Zealand Diploma of Occupational Therapy) Chiropodist: C. K. BOWER (15) Certificate of Royal Sanitary Institute 1 Meat Inspector's Certificate 2 Sanitary Science as applied to Building and Public Works Certificate 3 Smoke Inspector's Certificate 4 General Trained Nurse 5 State Certified Midwife 6 New Health Visitor's Certificate 1 Midwifery, Part I 8 State Enrolled Assistant Nurse 9 Ex. Queen's Nurse 10 State Certified Mental Certificate 11 Neurological Certificate 12 Registered Mental Nurse 13 Member of Society of Chiropodists 14 State Registered Fever Nurse 15 Tuberculosis Certificate 16 Certificate of National Nursery Examination Board 17 Diploma in Public Administration 18 8 STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (in acres) 6,556 Registrar-General's estimate of resident population, 1955 115,600 Number of inhabited houses (end of 1955) according to Rate Books 30,269 Rateable value (December 31st, 1955) £713,853 Sum represented by a penny rate (approximate 1955-6) £2,927 Extracts from Vital Statistics for the Year. Live Births :— Total Male Female Legitimate 1,448 726 722 Birth rate per 1,000 of the estimated resident population, 12.98. Illegitimate 53 28 25 Stillbirths:— Legitimate 34 20 14 Rate per 1,000 total (live and still) births, 23.42. Illegitimate 2 2 — Deaths 796 421 375 Death rate per 1,000 of the estimated resident population, 6.88. Deaths from pregnancy, childbirth, abortion :— Deaths Rate per 1.000 total (live and still) births. Nil Nil Death rate of infants under one year of age :— All infants per 1,000 live births 29.31 Legitimate infants per 1,000 legitimate live births 28.31 Illegitimate infants per 1,000 illegitimate live births 56.60 Deaths from Cancer (all ages) 189 ,, ,, Measles (all ages) Nil ,, Whooping Cough (all ages) Nil ,, Gastritis, Enteritis and Diarrhoea (all ages) 5 9 Births. 1,501 live births were registered during the year, there being 754 males and 747 females. There is a decrease of total births from 1,672 in 1954 to 1,501. The corrected birth rate per thousand population was 11.81 compared with 15.0 for England and Wales. The illegitimate birth rate continues to be very low, being only 3.53 per cent. of total live births. The rate of illegitimate stillbirths is 5.55 per cent. of total stillbirths. Death Rate. Total deaths in district 675 Outward transfers 243 Inward transfers 364 Deaths of residents 796 Of the 243 deaths of non-residents occurring in the district, 220 took place at Rush Green Hospital. Of the 364 deaths of local residents taking place outside this area, most occurred in institutions. Of these 217 occurred at Oldchurch Hospital; 20 at King George Hospital; 19 at the London Hospital and Annexe; seven at the Ilford Isolation Hospital; seven at Harold Wood Hospital; six at St. Joseph's Hospice and five at the Victoria Hospital, Romford. The crude death rate of 6.88 when corrected becomes 11.28 and compares with 11.7 for England and Wales. A table giving the causes of death, and the age periods at which they occurred, is given at the end of the report. 10 11 Table showing Birth-rate, Death-rate and Analysis of Mortality during the year 1955 Provisional Figures Rate per 1,000 total Population Annual Death-rate per 1,000 Population Rate per 1,000 Live Births Live Births Still Births All Causes Tuberculosis Whooping Cough Influenza Total Deaths (under one year) England and Wales 15.0 0.35 11.7 0.15 0.00 0.03 24.9 Dagenham (Corrected) 11.81 0.28 11.28 0.07 0.00 0.02 29.31 GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA Infant Welfare Centres CENTRE Sessions Held Times Sessions Held Average Attendances Average New Cases The Clinic, Ashton Gardens, Chadwell Heath. Weekly Weekly Thursday, a.m. Thursday, p.m. 47 38 1 2 Becontree Clinic, Becontree Avenue, Dagenham. Weekly Weekly Weekly Monday, p.m. Tuesday, a.m. Tuesday, p.m. 34 22 44 2 1 2 The Leys Clinic, Ballards Road, Dagenham. Weekly Weekly Thursday, a.m. Thursday, p.m. 21 24 1 2 Rush Green Clinic, 179, Dagenham Road, Rush Green. (2nd, 4th & 5th in month) Weekly Friday, a.m. Friday, p.m. 13 28 1 1 The Clinic, Ford Road, Dagenham. Weekly Weekly T uesday, a.m. Tuesday, p.m. 40 39 3 2 The Clinic, Manford Way, Hainault. Weekly Monday, p.m. 20 1 London City Mission Hall, Dagenham Road, Dagenham. Weekly Weekly Weekly Wednesday, p.m. Thursday, a.m. Thursday, p.m. 31 21 37 1 1 2 15/17, Thompson Road, Dagenham. Weekly Weekly Wednesday, p.m. Friday a.m. 30 15 2 1 12 Ante-Natal Clinics CENTRE Sessions Held Times Sessions Held Average Attendances Average New Cases The Clinic, Ashton Gardens, Chadwell Heath. Weekly Wednesday, p.m. 8 I The Clinic, Becontree Avenue, Dagenham. Weekly. Weekly Weekly (Discontinued after 18.6.55) Tuesday, p.m. Wednesday, a.m. Friday, p.m. 11 9 3 2 1 1 The Leys Clinic, Ballards Road, Dagenham. Weekly Wednesday, a.m. 13 2 Rush Green Clinic, 179, Dagenham Road, Rush Green. (1st & 3rd in month) Friday, a.m. 9 2 York House. Frizlands Lane, Dagenham. Weekly Weekly Weekly Weekly Tuesday, a.m. Wednesday, p.m. Thursday, a.m. Thursday, p.m. 17 17 12 12 3 2 1 2 The Clinic, Ford Road, Dagenham. Weekly Weekly Monday, a.m. Monday, p.m. 12 15 2 2 The Clinic, Manford Way, Hainault. Weekly Monday, a.m. 5 1 13 SANITARY INSPECTION OF THE DISTRICT Report of the Public Health Inspectors. (a) Nature and number of visits :— Overcrowding and Housing Conditions 1,256 Nuisances under Public Health Acts— Dwelling-houses 4,304 Other Premises 929 Bakehouses 68 Milkshops and dairies 72 Foodshops, stalls and itinerant vendors 2,418 Gates and canteens 615 Infectious disease enquiries 854 Visits to foster-mothers' premises 98 Number of complaints investigated 874 Outworkers' premises 151 Workplaces and offices 39 Rag Flock, etc. 31 Tents, vans and sheds 231 Stables 12 Pet Shops 40 Hairdressers' and barbers' premises 117 Shops Act 330 Ice Cream premises and vehicles 297 Houses disinfested 10 Other visits 130 (b) Notices served :— Complied with :— Statutory 146 125 Informal 811 841 14 PREVENTION OF DAMAGE BY PESTS ACT, 1949 Local Authority Dwelling Houses All other (including Business Premises) Total Agricultural No. of properties 24 30,345 1,926 32,295 6 No. of properties inspected as a result of: (a) Notification 7 134 73 214 (b) Survey under the Act 1 250 51 302 — (c) Otherwise 8 1,307 980 2,295 3 Total inspections carried out 238 6,769 3,769 10,776 12 No. of properties inspected and found to be infested by:— Major (a) Rats Minor – – – – – 4 74 23 101 — Major (b) Mice Minor — — — — — 4 78 55 137 — No. of infested properties treated by Local Authority 8 152 78 238 Total treatments carried out—including retreatments 14 169 101 284 No. of notices served under Section 4 of the Act:— (a) Treatment – – – – – (b) Structural Work — — — — — No. of cases in which default action was taken following issue of notice under Section 4 – – – – – Legal Proceedings — — — — — No. of "Block" control schemes carried out — — — — — 15 Water The water supply is satisfactory in quality and quantity. During the year two chemical and two bacteriological samples were taken from the Company's mains in this Borough; all were satisfactory. The water is not liable to have plumbo-solvent properties and no action was called for in respect of any form of contamination. Approximately .029 per cent. of the inhabited houses and .016 per cent. of the population of the Borough take their water from standpipes. During the year the mains laid in the Borough were afollows :— Lengths of Mains Yards Diameter 16 12" 996 6" 1,482 4" 771 3" 500 supplies were afforded to houses during the year. The Chief Engineer of the South Essex Waterworks Company has furnished me with the following report " Bacteriological and chemical examinations are made of the raw river water, of the water in its various stages of treatment and of the water going into supply and of both raw and chlorinated water from the Company's wells. "Analyses are also made of samples obtained from consumers' taps in the various parts of the Company's district and all proved to be satisfactory. " Over 3,900 chemical, bacteriological and biological examinations have been made during the year. "All water going into supply was wholesome." 16 HOUSING ACTS Slum Clearance The Council propose to deal with 58 properties during the five-year period. In this year two clearance areas, each containing two houses were represented. Certificates of Disrepair The 1954 Act allows the landlord a limited increase in the rent of certain houses it the house is in good repair and is reasonably suitable for occupation. The tenant can apply to the local authority for a certificate that the house is not in good repair and/or not reasonably suitable for occupation. During 1955, six applications were received from tenants and all were granted; of these, two certificates were revoked after the landlord had carried out the repairs. Statutory notices were served to enforce certain of the items of disrepair included on some of the certificates. Since August 1954 (the commencement of this Act) 13 certificates have been issued, one refused and six revoked. Improvement Grants During the year preliminary enquiries were made in respect of 19 houses. Nine applications were considered by the Council. All were refused. In one case the work which could be approved for grant did not reach the required minimum of £ 100; in another case the " improvement " was not considered to be eligible for grant; in the remaining cases the properties were situate in an area the Council propose to develope within 15 years. Tents, Vans and Sheds A licence was issued under the Public Health Act 1936, Section 269, authorising a person who was building a bungalow to occupy a caravan on the site for a period of six months. The van was vacated before the expiration of this period. Complaints are continually being received in respect of gypsies who pull their vans onto any open land available, usually building sites in course of, or awaiting development. With the co-operation of the police an endeavour is made to move off the vans as soon as possible. 17 National Assistance Act, 1948 Section 47. Several cases of elderly persons who were unable to look after themselves and were without proper care and attention were brought to the notice of the department. In all cases the voluntary agreement of the person was eventually obtained and removal arranged through the County Welfare Department. Section 50. The only corpse to be buried under the provisions of this section was that of a male, 60 years of age. Laundry Service for the Incontinent Aged This service, inaugurated in December 1953, and operated under the provisions of the Public Health Act, 1936, Section 84, continues to meet a real need in the home at a time when help is urgently required. Soiled articles are collected, and laundered articles returned each Monday, Wednesday and Friday. The frequency of the collection and delivery is of the utmost importance as the resources of the home in respect of bedding, clothes, etc., are inevitably stretched to capacity. The service has worked well; there has been little, if any, abuse and the co-operation of the laundry staff at the Barking Hospital, especially at holiday periods, has been excellent. From the commencement of the service to the end of the year covered by this report 70 cases have received assistance. During this year 27 cases have died, 12 have been removed to hospital or no longer require the services and seven were still participating at the end of the year. The number of articles laundered during the year was 7,473. Atmospheric Pollution Systematic observations continue to be made of the chimneys of industrial premises in the Borough. In no case was statutory action necessary. For many years the Council have maintained an observation station in the vicinity of Valence House for the measurement of Atmospheric Pollution. At the Civic Centre, measurements are made of the daily average concentration of smoke, suspended impurity and sulphur dioxide in the atmosphere. With the assistance of the Meteorological Office, Fuel Research Station, and the National Smoke Abatement Society an exhibition dealing with atmospheric pollution was arranged at the Dagenham Town Show held for two days in August. The exhibition proved to be of great interest and, we trust, profit to many people. 18 Rag Flock and Other Filling Materials Act, 1951 There are two premises in occupation which have been registered under Section 2 of the Act. One licence for the manufacture and one licence for the storage of rag flock have been issued. Samples are regularly taken at the three factories in the Borough where filling materials are manufactured. Forty informal samples were taken during the year. The details are as follows:— Material Satisfactory Not Satisfactory Rag Flock 9 — Cotton Felt 8 — Kapok 4 — K011k mixed with cotton 5 — Woollen Mixture Felt 4 — Coir Fibre 5 — Grey Fibre 1 — Sisal 3 — Washed Felt 1 — Pet Animals Act, 1951 Six licences authorising the keeping of pet shops have been renewed. The conditions attached to the licences are those approved by the Association of Municipal Corporations. Premises are regularly inspected and no serious breach of the conditions has arisen. 19 FACTORIES ACTS, 1937 &. 1948 Inspections. Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted Factories without mechanical power 17 21 — Factories with mechanical power 160 242 5 — Other premises under the Act (including works of building and engineering construction but not including out - workers' premises) ... 26 40 5 — TOTAL 203 303 10 — Defects Found. No. of defects No. of Prosecutions instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness 1 1 Overcrowding — — — — — Unreasonable temperature — — — — — Inadequate ventilation — — — — — Ineffective drainage of floors — — — — — Sanitary Conveniences:— Insufficient 4 4 — 1 — Unsuitable or defective 9 8 — 1 — Not separate for sexes — — — — Other Offences 1 1 1 — — TOTAL 15 14 1 2 — Outwork No. of out-workers in August list 105 Nature of work Making, etc., wearing apparel. 20 FOOD AND DRUGS ACT, 1938 Analyses Article Number Examined Number Adulterated, etc. Formal Informal Formal Informal Almonds 1 — Bread 2 — 2 Bread and Butter 7 — 1 — Brislings in Tomato Sauce — 1 — — Butter — 1 — — Celery Salt — 1 — — Cereals — 2 — 2 Coconut — 1 — — Confectionery 2 6 — — Cordials — 3 — 1 Crab, Dressed — 1 — — Cream — 3 — 1 Dessert Sweet — 4 — — Herbs, Dried — 2 — — Ice Cream — 11 — — Ice Lollies — 7 — — Jams, etc. — 2 — — Lard — 2 — 1 Marzipan — 1 — — Medicinal Samples — 18 — — Milk 48 2 4 2 Milk, Evaporated 1 1 — — Non-brewed Condiment 1 — — — Oil, Frying — 1 — — Paste — 3 — Pepper — 5 — — Pudding Mixture — 1 — — Salmon, Potted — 1 — — Sauce — I — — Sausages 25 — 1 — Soups — 1 — — Spices — 1 — — Sponge Mixture — 1 — — Spreads, Various — 2 — — Tea — 2 — — Vinegar — 1 — — Wines and Spirit — 11 3 21 INSPECTION AND SUPERVISION OF FOOD Clean Food Campaign The numbers and types of food premises in the Borough are as follows:— 6 Bakehouses 23 Bakers and Confectioners 60 Butchers 140 Cafes and Canteens 28 Fishmongers 51 Fruiterers and Greengrocers 116 Grocers 20 Licensed Premises 11 Off-licensed Premises 90 Sweets, etc. All food premises are regularly inspected and during the year 3,342 visits were paid. In addition to numerous requests and suggestions during these routine visits, 31 informal notices were served upon owners or occupiers. In addition 144 inspections of itinerant vendors were carried out; much of this work is done at the weekends. The number of premises registered under Section 14, apart from those in respect of ice cream, is as follows:— Out of a total of 60 butchers' premises 37 are registered for the preparation or manufacture of sausages or potted, pressed, pickled or preserved food. To these 738 visits were paid. In addition two grocery premises are registered for this purpose. Out of a total of 28 fish shops 22 are registered for fish frying. To these 415 visits were paid. Lectures have been given to members of local organisations. 22 Milk Under the provisions of the Milk and Dairies Regulations, 1949, eight premises are registered as dairies and 71 persons with premises in the Borough are registered as distributors. 72 visits were paid to these premises. During the year 59 samples of milk were submitted for bacteriological examination; all were satisfactory. The Chairman of the Public Health Committee (Councillor Mrs. A. E. Prendergast) was appointed during the year as a local authority representative on the Milk Sub-Committee of the Essex County Agricultural Executive Committee. Ice Cream The total number of premises in the Borough registered under the provisions of Section 14 of the Food and Drugs Act, 1938, is 155; of this number two are registered for the manufacture of ice cream. 271 visits were paid to these premises. During the year two applications for the storage and sale of ice cream were granted. In all cases the provision on the premises of running hot water is required. The majority of itinerant vendors of ice cream (mostly operating box tricycles) are selling only wrapped products. The few selling loose ice cream are required to have enclosed vehicles and carry suitable washing facilities. Even under these conditions this is an undesirable method of selling ice cream. 26 inspections in connection with itinerant vendors were carried out. Bacteriological Sampling. During the year 41 samples of ice cream were submitted for examination; they were graded as follows:— Grade I Grade II Grade III Grade IV Total 29 8 2 2 41 In addition 25 samples of ice lollies were submitted for examination; seven were unsatisfactory. In all cases the lollies were manufactured outside the Borough and the local authorities concerned were notified. Ten samples were taken of the ice cream manufactured in the Borough (at the two registered premises) with the following results:— Grade I Grade II Grade III Grade IV Total 8 2 — — 10 23 Unsound Food Complaints continue to be received in respect of food containing foreign substances or otherwise alleged to be unfit for human consumption. In two instances (cigarette end in a loaf of bread and foreign material in a bottle of school milk) legal proceedings were taken and a fine of £5 was imposed in each case. The normal method of disposing of unsound food is to use the incinerator at the Council's Refuse Disposal Works. Occasionally when there is a quantity of meat, it is disposed of under supervision through the Council's waste food service; the meat is previously cut up and dyed. Registration of Food Hawkers Essex County Council Act, 1952 — Section 103 During the year five persons were registered as food hawkers and three premises for food storage. Food Poisoning Outbreaks Seventeen cases of food poisoning were notified during the year. The causative organism was not identified in the two outbreaks, which consisted of four cases. In the 13 single cases the causative organism was identified in three cases. 24 Adulterated Samples, etc. Serial No. Article Formal or Informal Nature of Adulteration or Irregularity Observations 43A Egg Flip Informal 1 4% deficient in proof spirit. Further sample obtained. 44A Cocktail Informal 1 % deficient in proof spirit. Further sample was satisfactory. 45A Patent Groats Informal Contained mass of insect web, a living maggot and four dead flour moths. "Out of condition". Manufacturerand vendor warned. 46A Milk Informal Milk had a slightly reddish colour and contained fragments of coloured metallic foil. Legal proceedings. Fine £5. 59A Cream Informal Contained thin film of dried milk on inside of bottle. Vendors warned. 60A Egg Flip Informal Contained 0.7% less proof spirit than the minimum 30% stated on label. Manufacturers warned. 61A Bread Informal Had an objectionable appearance due to the presence of foreign matter resembling a mass of worms. Consisted of discoloured dough. No insect material. Unsuitable for human consumption. Vendors warned. 63A Bread Informal Had brown markings on three of the slices due to the presence of burnt dough. Manufacturers informed. Adulterated Samples, etc.—continued Serial No. Article Formal or Informal Nature of Adulteration or Irregularity Observations 64A Milk Informal Contained foreign matter in the form of milk skin covered with mould growth and a metal cap with a hole in it. Vendors warned. 65A Orange Juice Informal Contained foreign matter on sides and bottom of bottle found to be mould growth. Vendors warned. 89A Lard Informal Slightly rancid. No longer suitable for human consumption. Vendors warned. 90A Corn Flakes Informal Contained a soft blackish mass of foreign matter consisting of dirty mineral oil contaminated with tin. Manufacturers warned. 2175 Milk (purchased in cafe). Formal 8% deficient in fat. Vendors warned. 2177 Milk (purchased in cafe). Formal 22% deficient in fat. Vendors warned. 2195 Beef Sausages Formal Contained 1,000 parts per million ofSulphur Dioxide being approximately 2\ times the maximum permitted amount. Manufacturers warned. 2256 Milk (purchased in cafe). Formal 5% added water. Legal proceedings. Fine 40/-. 2260 Milk (purchased in cafe). Formal 3 % added water. Vendors warned. 2261 Bread and Butter Formal Fat consisted not of butter but of margarine. Legal proceedings. Fine 40/-. 26 PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES NOTIFIABLE DISEASES (Other than Tuberculosis) Under 1 year 1—2 3—4 5—9 10—14 15—24 25 and over Total Scarlet Fever 1 8 12 68 10 3 2 104 Whooping Cough 24 37 61 90 5 — — 217 Acute Poliomyelitis:— Paralytic 1 2 2 3 1 2 — 11 Non-paralytic — — 2 3 — I — 6 Measles 103 570 703 1277 25 5 7 2690 Diphtheria — — — — — — — — Under 5 years 5—14 15—44 45—64 65 and over Total Pneumonia:— Acute Primary 4 8 12 16 4 44 Acute Influenzal — — 1 4 — 5 Dysentery 9 15 3 2 — 29 Encephalitis. AcuteP:- Infective — — — — — — Post-Infectious — — — — — — Enteric — — — — — — Paratyphoid — 1 — — — I Erysipelas — 1 3 12 — 16 Meningococcal Infection 3 1 1 — — 5 Food Poisoning — 7 9 1 — 17 Puerperal Pyrexia — — 2 — — 2 Ophthalmia Neonatorum 3 — — — 3 Pemphigus — — — — — — Malaria (Foreign Origin) — 1 1 Smallpox 27  Notified Admitted to Isolation Hospital, Rush Green Admitted to other Isolation Hospitals Admitted to other Hospitals Registered Deaths Diphtheria — — — — — Dysentery 29 6 2 1 — Encephalitis, Acute — — — — — Enteric Fever — — — — — Erysipelas 16 3 1 -— — Food Poisoning 17 — 3 1 — Malaria 1 1 — — — Measles 2,690 25 13 2 — Meningococcal Infection 5 5 — — — Ophthalmia Neonatorum 3 — — — — Paratyphoid Fever 1 — 1 — — Pemphigus — — — -«=- — Puerperal Pyrexia 2 2 — — — Pneumonia:— Acute Influenzal 5 — — 3 — Acute Primary 44 1 2 1 — Poliomyelitis, 10 Paralytic 11 1 — — Non-Paralytic 6 6 — — — Scarlet Fever 104 4 7 — — Smallpox — — — — Whooping Cough 217 3 4 — — DIPHTHERIA IMMUNISATION The following is a summary of the work carried out during the year:— (in years) at final injection Children immunised Children who Without preliminary received a testing boosting dose Under 1 322 1—4 264 6 5—9 74 408 10 — 14 3 251 Total 663 665 Immunisation by General Practitioners. (in years) at final injection Children immunised Without preliminary testing Children who received a boosting dose Under 1 163 — 1 — 4 160 7 5—9 21 130 10 — 14 3 48 Total 347 185 WHOOPING COUGH IMMUNISATION The number of children who received protective doses against Whooping Cough was 577, the majority of these being under the age of four years. 29 VACCINATION CARRIED OUT BY GENERAL PRACTITIONERS Vaccinated. Age at date of vaccination Under 1 209 1 — 4 60 5 — 14 35 15 or over 76 Total 380 Re-Vaccinated. Age at date of re-vaccination Under 1 — 1 — 4 5 5 — 14 10 15 or over 96 Total 111 VACCINATION CARRIED OUT BY LOCAL HEALTH AUTHORITY STAFF Vaccinated. Age at date of vaccination Under 1 220 1—4 54 5 — 14 13 15 or over 2 Total 289 Re-Vaccinated. Age at date of re-vaccination Under 1 — 1 — 4 1 5—14 1 15 or over 19 Total 21 TUBERCULOSIS New Cases Deaths Primary Notifications Brought to notice other than by Form A Pulmonary NonPul monary Pulmonary NonPul monary Pulmonary NonPul monary M F M F M F M F M F M F Under 1 — — — — — — — — — — — — 1— 1 1 — — — — — — — — — 5— 4 — — — — — — — — — 10— — 2 1 — — 2 — — — — — 15— 7 6 1 1 2 — — — — — — 20— 4 4 1 2 4 9 — 1 — — — — 25— 4 5 1 2 12 15 1 — — 3 — — 35— 3 1 — 1 2 5 — — — — — 45— 3 1 1 — 5 — — 1 2 — — — 55— 8 — — — 1 1 — — 4 I I — 65—and upwards 4 — — 1 — — — 3 — 1 — 29 24 5 7 27 32 2 2 9 4 2 — Register. Pulmonary Non-Pulmonary Male Female Male Female No. on register 1st January, 1954 527 424 73 75 During the year: New notifications 29 24 5 7 New cases brought to notice by Registrars' Deaths Returns 2 — Deaths 9 4 2 — Transfers into area 25 32 2 2 Transfers out of area 21 39 3 5 Removed from register as " Recovered " 10 13 2 1 No. on register 31st December, 1955 543 424 73 78 MATERNITY AND CHILD WELFARE Ophthalmia Neonatorum Three cases of this disease were notified, all made complete recoveries. There were 27 cases in which a medical aid notice was sent by a midwife to a medical practitioner on account of some eye condition occurring in a newly-born infant. 30 Maternal Mortality There were no maternal deaths assigned to this district during the year under review. Work of Health Visitors The following table shows the number of visits paid by the Health Visitors during the year:— (a) To expectant mothers First visits 222 Total visits 484 (b) To children under 1 year of age First visits 1,641 Total visits 4,742 (c) To children between the ages of 1 and 5 years Total visits 10,748 (d) Ineffective visits Total visits 4,002 (e) Other visits Total visits 1,139 Grand Total 21,115 Domiciliary Midwifery Service The following is a summary of the reasons for sending for medical and by midwives:— Perineal Tear 64 Discharging Eyes 27 Rise of Temperature 18 Prolonged Labour 10 Malpresentation 10 Post-Partum Haemorrhage 9 Unsatisfactory Condition of Infant 8 Abnormality of Child 7 Painful Leg 6 Adherent Placenta 4 Premature Labour 4 Ante-Partum Haemorrhage 3 Cyanosed Attack 3 Pernicious Vomiting 3 Other Causes 54 225 31 Notices summoning medical aid 225 For (a) Mothers 169 For (b) Infants 56 Notifications that they had been associated with the undermentioned conditions were received from domiciliary midwives:— Substitution of artificial feeding 37 Liable to be sources of infection Stillbirths 3 Deaths of Mother or Child 3 Laying out dead body 1 Below is a table setting forth in statistical form the work of the County Midwives, Midwives residing at York House Training Home and Salvation Army Midwives for the year 19.55 :— County Midwives Midwives Residing at York House Training Home Salvation Army Midwives Births Attended: As Midwife 172 218 47 As Maternity Nurse 121 24 6 Miscarriages Attended (included in above) 2 15 7 Visits Paid: As Midwife 4,840 6,363 1,424 As Maternity Nurse 2,173 184 143 Ante-Natal 2,592 1,563 346 Ante-Natal Clinics Attended 510 220 35 Gas and Air Administered: As Midwife ... 90 129 36 As Maternity Nurse 71 11 6 Dental Treatment The following particulars relate to dental treatment provided for mothers and young children:— Expectant or nursing mothers Children under five years of age Number of patients examined 137 183 Number of patients needing treatment 125 138 Attendances for treatment 390 207 Number of patients who have completed treatment 71 119 Number of Extractions 443 122 Number of Fillings 56 247 Number of Anaesthetics administered: (a) local 178 87 (b) general — — Number of Scalings or scaling and gum treatment 7 Number of Silver Nitrate treatment — — Number of Dressings — 1 Number of X-ray examinations 2 3 Number of Dentures provided : (a) full 13 — (b) partial 15 — Day Nurseries There are three Nurseries in the Borough, accommodating 164 children in all. Staff : Matrons 2 Deputy Matrons 2 Wardens 3 Nursery Trained Nurses 5 Nursery Assistants 10 Nursery Students 7 Total 29 33 Total Attendances at Nurseries for 1955: Goresbrook Nursery Under 2 years of age 3,189 Over 2 ,, ,, ,, 4,767 Chadwell Heath Nursery . Under 2 ,, ,, ,, 2,933 Over 2 ,, ,, ,, 7,681 Kingsley Hall Nursery Over 2 ,, ,, ,, 4,756 Total 23,326 Premature Infants Live premature births occurring in the area:— 3 4 lb oz. or less 3 5 lb. oz. —4 6 lb.oz. 4 7 lb. oz. —4 15 lb.oz. 5 0 lb. oz. —5 8 lb.oz Total No. Surviv ing One Week Born alive at home and nursed entirely at home 1 — — 19 20 19 Born alive at home and transferred to hospital 1 1 1 2 5 3 Born alive in a private nursing home and nursed entirelv there ... — — — — — — Born alive in a private nursing home and transferred to hospital — — — — — — Born in hospital 9 11 13 33 66 55 Relaxation Classes The following were the attendances at the relaxation classes during the year:— The Becontree Clinic 270 Chadwell Heath Clinic 223 Leys Clinic 382 York House Clinic 444 Total 1,319 DOMESTIC HELP SERVICE During the past year the Domestic Help continued to increase, the figures below show details of all homes assisted by the Service. The Care of the Aged: This gives the Service most of the work, and also presents most of the problems—but every effort is made to alleviate the difficulties of the daily round. Maternity: Full-time Domestic Helps continue to look after the mother and family during the confinement, ante-natal and post-natal periods. Cases are also helped when the mother is away in hospital, the care of the children being left entirely to the Domestic Helps. Mental Sickness: During the year there have been cases of this type which have greatly benefited with a Domestic Help in the background to give the extra confidence required in such cases. Tuberculosis: Domestic Helps have proved invaluable in these cases needing the required bed rest, regular food and general care. Recruitment: Great care is given to select a good type of Help who will prove to be a helpful member of the community. Domestic Help Statistics — Year 1955 Number of Full-time Helps 2 Number of Part-time Helps 62 Organiser's visits 1383 Cases Helped During Year: Maternity 74 Acute Sick 69 Tuberculosis 20 Chronic Aged 285 Chronic Others 87 Aged Not Sick 8 Others (children not over comp. school age) 5 Total 548 35