C 439 (1) B. EAL 55 The Health of Ealing in the year 1964 EAL 55 The Health of Ealing in the year 1964 BEING THE ANNUAL REPORT OF THE Medical Officer of Health I. H. SEPPELT, M.A., M.B., B.Chir., D.P.H., Medical Officer of Health Town Hall Annexe, Ealing, W.5 Telephone: Ealing 3456 INDEX Section 1 INFECTIOUS DISEASES 6 Section 2 ENVIRONMENTAL HEALTH OF THE BOROUGH 10 Section 3 PUBLIC HEALTH INSPECTION 25 Section 4 OLD PEOPLE'S WELFARE 40 Section 5 GENERAL 45 Section 6 STATISTICAL TABLES 47 Section 7 APPENDIX : REPORT ON SCHOOL HEALTH SERVICE 54 Supplement FOR GENERAL INFORMATION 61 PUBLIC HEALTH COMMITTEE Chairman—Councillor R. R. Clay Vice-Chairman—Councillor J. T. Bartlett Alderman Mrs. D. Gundry, j.p. Councillor J. T. C. Hancock Alderman Mrs. E. M. Stephens, m.a. Councillor H. R. Hayselden Councillor J. J. Allsopp Councillor Mrs. N. R. Law Councillor J. F. Barlow Councillor A. W. Morbey Councillor E. R. Bennett Councillor P. W. Parke Councillor C. G. J. Emmins Councillor A. W. Surry Councillor C. L. Gardner Councillor Mrs. D. I. Williams STAFF OF THE PUBLIC HEALTH DEPARTMENT I. H. Seppelt, m.a., m.b., b.chir., d.p.h. Medical Officer of Health I. O. Taylor, m.a., m.r.c.s., l.r.c.p., d.p.h. Deputy Medical Officer of Health A. E. Pooley Chief Public Health Inspector A. C. Bamping Deputy Chief Public Health Inspector E. H. Evans Public Health Inspector C. W. Baxter „ „ „ E. W. Budd „ „ „ G. O. Axon „ „ „ N. V. Saunders „ „ „ L. E. Bowskill „ „ „ J. A. Crisp „ „ „ J. P. Goss „ „ „ D. Newth „ „ „ M. Aldridge „ „ „ A. S. M. Pratt, Barrister-at-Law Chief Administrative Assistant (Part-time) Miss D. E. McKenzie Secretary to Medical Officer of Health D. E. Storr Senior Clerk D. R. A. Smith Clerk R. S. Leggatt „ „ „ Mrs. S. Milstead „ „ „ M. Sansom „ „ „ Mrs. M. G. Byford Clerk and Shorthand Typist Mrs. D. Barker Clerk and Typist Miss C. Stevens Shorthand Typist D. Vosper Trainee Public Health Inspector G. Fish „ „ „ A. Franklin „ „ „ R. S. Cox Assistant Rodent Officer R. Lazzolo Rodent Operative F. Bedley „ „ „ L. B. Radford Driver/Disinfector E. Sheldrick „ „ „ 4 18th August, 1965 Mr. Mayor, Aldermen and Councillors, The last report of the Medical Officer of Health of a Borough such as Ealing must inevitably contain a note of regret. I do not think it is an over-statement that in the public health field Ealing has been amongst the leaders, both in the quality of its service and in its willingness to pioneer new projects. I am confident that these past achievements will form a sound foundation for the health department of the London Borough and will exert an influence for a long time to come. Any regret is tempered by the realization of the opportunities that re-organization will present to local health services. I trust full advantage will be taken of them. In conclusion I would like to record my thanks to the past and present members of the Public Health Committee, and to the staff of the Public Health Department. I do this not as a formality but to express my sincere appreciation for the help I have received. Your obedient servant, I H. SEPPELT, Medical Officer of Health. 5 SECTION 1 INFECTIOUS DISEASES CONTROL The diseases notifiable under the Public Health Act, 1936 are smallpox, cholera, diphtheria, membranous croup, erysipelas, scarlet fever, typhus, typhoid, enteric and relapsing fever. The Minister of Health has also made regulations under this Act whereby the following diseases are notifiable: plague, poliomyelitis, tuberculosis, puerperal pyrexia, ophthalmia neonatorum, malaria, dysentery, acute primary pneumonia, acute influenzal pneumonia, measles, whooping cough, acute encephalitis and meningococcal infection. Food poisoining is notifiable under the provisions of the Food and Drugs Act of 1955. Under the Milk and Dairies (General) Regulations, 1959, the occupier of premises used in the milk trade must notify the Medical Officer of Health if staff are suffering from or have been in contact with any of the diseases enumerated above. In addition to these diseases the occupier of such premises has the same obligations in respect of gastro-enteritis. The Public Health (Infectious Diseases) Amendment Regulations, 1960, provide for the notification of anthrax. The problem posed by many of these conditions in the past is now much reduced. Smallpox and diphtheria, for example, have become a rarity, largely due to immunization, whilst scarlet fever, although still very prevalent, in the type of disease now encountered bears no relation in severity to that experienced in the early part of this century. Tuberculosis has yielded to the attack of improved living conditions and chemotherapy, leaving only a hard core of cases, whilst poliomyelitis, although still able to cripple, has shown a steady decline since the introduction of immunization in 1957. Less satisfactory has been the decline in those conditions caused by faulty food hygiene and it is hoped that continued campaigning for improved standards of food hygiene will result in the near future in a reduction of gastro-enteritis of all types. In contrast to the reduction in the incidence and severity of many diseases, the great increase in international travel and its speed has produced problems of its own. This is particularly so in Ealing, where holidaymakers and immigrants often spend their first few days after entering the country through London Airport. In the event of their being contacts of an infectious disease this entails a considerable amount of work in tracing them, surveillance and finally clearing them of infection. Although this is time consuming work it is an essential protective measure. 6 DIPHTHERIA There were no cases to report. DYSENTERY There was a reduction in notifications from 199 in 1963 to 139 last year. ERYSIPELAS Seven cases were notified. FOOD POISONING Six individual cases were notified. The causative organism in four of these was the staphylococcus, in one case salmonella typhimurium, and in the other case the organism was not identified. There was a large outbreak of food poisoning which originated at the West London Shooting Grounds, Northolt, in April of this year. The Clay Pigeon Shooting Association held their Annual Competition at this venue on Friday and Saturday, 24th/25th April. Approximately 350 people attended, of which some 200 were competitors. These people stayed at various hotels in London and elsewhere. Catering during the Competiton was carried out by a firm from Cheltenham who brought their staff, equipment and food with them on the Thursday and Friday before the meeting. Items of food served included — fresh salmon, cold turkey, chicken, beef, ham, pork, salads, sausage rolls, trifle, cream, cakes, coffee, tea, and ice cream. From the late afternoon onwards reports were received of persons who had attended the meeting being taken ill with vomiting and later, diarrhoea. Searching enquiries were made as to the food eaten and it appeared that the article at fault may have been the salmon. The Medical Officer of Health of Cheltenham Borough Council was contacted and investigations were made there. It was not possible to examine remains of the food provided at the meeting but examination of a similar salmon remaining in the hands of the caterers revealed that it was contaminated by staphylococcus pyogenes. Some 12 people were reported as having food poisoning and seven were admitted to hospital. It is likely that a large number of people were affected but not notified as cases of food poisoning. MALARIA There were no cases. MEASLES Measles is still a troublesome illness which occurs in alternate years in large numbers. 1964 was a year of expected low incidence and there were only 354 cases compared with 2,072 in 1963. 7 MENINGOCCAL INFECTION No notifications were received. OPHTHALMIA NEONATORUM No cases reported. TYPHOID FEVER There were no cases reported during the year. PNEUMONIA 43 cases were notified as compared with 97 in 1963. POLIOMYELITIS There were no cases reported during the year. PUERPERAL PYREXIA There were 47 notifications—all but two patients were in hospital. SCARLET FEVER Although this disease is not now as severe as it has been in the past, and is much more amenable to treatment and less liable to complications, it does still have importance in regard to milk. It is the custom in the Borough to exclude for a period of one week milk handling contacts of those who are notified as having the disease. During the year 51 notifications were received. SMALLPOX There were no cases during the year. Some 12 people arrived by air from declared smallpox endemic areas. Similarly another 17 people arrived by sea in this country. All these persons were visited by Public Health Inspectors. TUBERCULOSIS There were 47 pulmonary notifications—31 male and 16 female, and 5 nonpulmonary notifications—2 male and 3 female. In 1963 there had been 89 pulmonary notifications—61 male and 28 female and 11 non-pulmonary notifications—5 male and 6 female. WHOOPING COUGH There were 80 notifications. 8 IMMUNIZATION Immunization is provided in clinics and by general practitioners in the area against the following diseases: Diphtheria Whooping Cough Tetanus Poliomyelitis Smallpox In addition immunization against tuberculosis is offered to 13-year-old school children, details of which are included in the report on the School Health Service. The schedule of immunization used in Ealing clinics is:— Age Vaccine Interval 3 months Triple antigen (Diphtheria Whooping Cough Tetanus) Four weeks or more 4 months Triple antigen Four weeks or more 5 months Triple antigen Four weeks or more 6 months Vaccination against smallpox Four weeks or more 7 months Poliomyelitis—Oral Four weeks or more 8 months Poliomyelitis—Oral Four weeks or more 9 months Poliomyelitis—Oral 16 months Triple antigen School Entry Diphtheria and tetanus booster SECTION 2 ENVIRONMENTAL HEALTH OF THE BOROUGH WATER There are three sources of supply in the Borough. The Northolt North, Northolt South, Greenford North, Greenford Central and Greenford South Wards, most of Perivale Ward and part of Hanger Hill Ward are supplied by the Rickmansworth and Uxbridge Valley Water Company with the exception of four roads (in part) in the Perivale Ward and one road (in part) in the Hanger Hill Ward which are served by the Colne Valley Water Company. The remainder of the Borough is supplied by the Metropolitan Water Board. These supplies are not subject to plumbo-solvent action and have been satisfactory both in quantity and quality. Water from public mains is supplied to 54,943 dwellings with an estimated population of 182,620. Twelve samples were taken from supplies derived from wells at five factories in the Borough. In these factories water is obtained from deep borings ranging in depth from 300 to 600 feet. Of these 12 samples, 11 were found to be of satisfactory quality. The remaining sample was of doubtful quality owing to the presence of a small count of non-faecal coliform organisms, but this sample was taken late in the year and was being further investigated early in 1965. The 12 samples of water taken from supplies provided by the Metropolitan Water Board were from seven premises from which complaints had been received or where the quality of water supplied from storage tanks was under suspicion. Two of these samples were unsatisfactory owing to the presence of coliform organisms of the nonfaecal type. In one case a defective service pipe was renewed and in the other case a storage tank was thoroughly cleansed and covered and repeat samples taken later were found to be satisfactory. Water Samples 1964 Samples Satisfactory Doubtful Unsatisfactory Wells Supply 12 11 1 — M.W.B. Supply 12 10 — 2 Total 24 21 1 2 DRAINAGE AND SEWERAGE The soil sewerage from the Borough is all eventually treated at the West Middlesex Drainage Works at Mogden. Surface water in most parts of the district is drained in a separate system and is discharged largely to the River Brent and to other water courses. There are still 21 premises not connected to the Council's sewers, but these premises are mostly situated in those small areas of the Borough not yet served by main sewers. 10 PREVENTION OF POLLUTION OF THE RIVER BRENT The Brent enters the Borough at the boundary with Wembley and Willesden and leaves the Borough at its boundary with Brentford, thus dividing the Borough of Ealing into two parts. Responsibility for the prevention of pollution of the river is shared between the Middlesex County Council who are responsible for the river itself, and the Borough Council who are charged with the duty of preventing contamination by surface water sewer outfalls which discharge along its banks. The river flows through other industrial areas of Middlesex before entering Ealing and occasional negotiations with other local authorities to ensure that no major pollution occurs upstream, together with action by the Department to deal with internal sources of pollution, all help to ensure that reasonable conditions are maintained within the district. During 1964 there were no reports of major pollution upstream as in previous years, but local observations involving 65 inspections were made in an attempt to trace and deal with unsatisfactory discharges from certain surface water outfalls. Details of work carried out during the year are as follows:— No. of inspections 65 No. of samples taken by: County Engineer 4 (a) Satisfactory 2 (b) Unsatisfactory 2 No. of drainage defects remedied: (a) In factories 1 (b) In houses 3 (c) In shops 1 The sources of pollution can be analysed as follows: Sinks and handbasins and baths 4 W.Cs. 2 Industrial Wastes 1 Soil sewers and drains 2 ATMOSPHERIC POLLUTION Smoke Control Areas It is satisfactory to report that progress has continued in implementing the Council's Clean Air programme which will ensure that the whole of the Borough is covered by Smoke Control Orders by 1974. During 1964, three further Smoke Control Orders were made by the Council in respect of Areas Nos. 18, 19 and 20, covering 535 acres and affecting 3,410 dwellings and 138 other buildings. Of these three Orders No. 18 was confirmed by the Minister of Housing and Local Government and will come into operation on 1st July, 1965. Orders Nos. 19 and 20 were submitted to the Minister but were still awaiting confirmation at the end of the year. The proposed dates of operation for these Orders are 1st August and 1st October, 1965, respectively. 11 Smoke Control Orders Nos. 16 and 17 which were made by the Council in 1963 were confirmed by the Minister and came into operation on 1st September and 1st November, 1964. Survey work on areas Nos. 21 and 22 had been commenced before the end of the year and preliminary arrangements were also in hand for dealing with area No. 23. The following map and tables give details of the progress of the Council's programme by the end of 1964:— Progress of Smoke Control Programme No. of Smoke Control Orders Acres No. of dwellings involved Other buildings involved Total premises covered Private Local Authority In operation 17 3,389 17,245* 4,552 818 22,615 Confirmed, but not yet in operation 1 202 1,195 — 48 1,243 Awaiting confirmation 2 333 1,846 369 90 2,305 Totals 20 3,924 20,286 4,921 956 26,163 *Includes 1,682 L.C.C. properties. Borough of Ealing—Smoke Control Areas (coloured yellow) Smoke Control Order: Date of Operation: No. 1 1st July, 1960 No. 2 1st October, 1960 No. 3 1st July, 1961 No. 4 1st September, 1961 No. 5 1st November, 1961 No. 6 1st June, 1962 No. 7 1st September, 1962 No. 8 1st November, 1962 No. 9 15th November, 1962 No. 10 1st July, 1963 No. 11 1st July, 1963 No. 12 1st September, 1963 No. 13 1st November, 1963 No. 14 1st July, 1964 No. 15 1st August, 1964 No. 16 1st September, 1964 No. 17 1st November, 1964 No. 18 Made and confirmed in 1964, but to come into operation on 1st July, 1965. Nos. 19 and 20 Made in 1964 but awaiting confirmation by Minister of Housing and Local Government. Nos. 21 and 22 Surveys in progress. No. 23 Next for survey. 12 Smoke Control Orders in operation in adjoining districts (coloured red) A. Urban District of Hayes and Harlington. B. Borough of Harrow. C. Borough of Acton. Proposed Smoke Control Areas in adjoining districts (coloured green) B. Borough of Harrow. C. Borough of Acton. D. Borough of Willesden. E. Borough of Brentford and Chiswick. F. Borough of Southall. G. Borough of Wembley. Mobile Exhibition—Solid Smokeless Fuels Federation Mobile exhibition vehicles operated and staffed by the Solid Smokeless Fuels Federation visited proposed smoke control areas in the Borough on two occasions during the year. In June a vehicle spent two days in the area of Greenford to be covered by the No. 18 Smoke Control Order and three days in the area of Hanwell to be covered by the No. 19 Smoke Control Order, and was visited by 599 local residents at five separate locations in these areas. During the second visit in October the vehicle spent a week in the proposed Nos. 20 and 21 smoke control areas, at six separate locations, with a total of 1,596 visitors. There is no doubt that a much greater interest is being shown in the economics and efficiency of modern methods of home heating and this is reflected in the increasing numbers of householders who now take advantage of the visits of these mobile exhibition units. The staff of the Federation were available to give advice and assistance to all who were interested in appliances and fuels and on the operation of the Clean Air Act as it was likely to affect the residents in the areas concerned. Further arrangements were being made towards the end of the year for similar exhibition vehicles to visit future smoke control areas likely to be made by the London Borough of Ealing after 1st April, 1965. The Council is indebted to the Federation for their continued help and support in arranging these visits and for all the advice given. Publicity for Clean Air Programme Confirmation of the Nos. 16, 17 and 18 Smoke Control Orders by the Minister of Housing and Local Government was followed by a distribution of approximately 5,000 letters to householders and others in the areas concerned giving them full details of the effects of the Orders and of grants available for the conversion of heating appliances. This information was given in addition to that provided by means of personal visits by the Public Health Inspectors during the initial survey of properties and the distribution of pamphlets and leaflets in the early stages and as the result of enquiries and applications for grant assistance. Talks to various women's organisations were continued during the year and a portable display unit illustrating the range of available solid smokeless fuels and appliances was made available by the Solid Smokeless Fuels Federation in the entrance to the offices of the Public Health Department. 13 West Middlesex Clean Air Co-ordinating Committee During 1964 the Committee included representatives from eight local authorities in the West Middlesex area—Acton, Brentford and Chiswick, Ealing, Feltham, Hayes and Harlington, Heston and Isleworth, Ruislip-Northwood, and Southall, thus covering a continuous area of more than 40,000 acres with a total population of 655,000. The full Committee met on three occasions during the year when useful information on the progress of the smoke control programmes of each of the eight constituent authorities was exchanged and discussed. It was reported that at the end of 1964 there were 69 Smoke Control Orders in operation in the area covering 14,178 acres with 70,832 dwellings and 3,460 other buildings. Twelve further Orders were either confirmed but not in operation, or awaiting confirmation. At the three meetings of the Committee consideration was given to a wide variety of subjects, including smokeless fuel usage in smoke control areas, and the changes in availability of fuels, the revised grant arrangements recommended by the Minister in Circular 69/63, fixing costs for appliances, and the forthcoming London Government reorganisation. One meeting was attended by representatives of the North Thames Gas Board who explained the technological changes which were taking place in gas production, which included complete gasification of coal, the use of imported liquid methane from the Sahara and the use of oil refinery waste products. It was stated that the gas industry had no alternative but to adopt these new methods in order to maintain a competitive position and carry out its statutory duty of producing gas at the lowest possible price. It was considered that changes which were already taking place in fuel usage would, for several years to come, keep the supply and demand for coke, in balance. At this meeting several models of modern gas room heaters were available for inspection. At another meeting members were addressed by representatives of the Southern Electricity Board who explained the limitations and advantages of thermal storage heaters and compared running costs with other types of fuels. It was said that supplies of electricity at off-peak times were assured and that the cheap tariff for off-peak electricity would be maintained. A number of storage heaters suitable for installation with grant aid in smoke control areas was on display at the meeting. The last meeting to be held during the year was attended by members and officers of the Barnes and Hammersmith Borough Councils as representatives of the InterBorough Smoke Control Liaison Committee, with a view to seeking the views of the new London Boroughs represented on the two committees about the formation of a new body to cover the whole area. In addition to the full meetings of the Committee, the technical officers met on two occasions to consider fixing costs for appliances, but came to the conclusion that the varying demands on fixers' services in each area made it impossible to arrive at a standard schedule of prices capable of being applied by all constituent authorities. Visits to the mechanised fuel distribution depot recently opened at Neasden by Messrs. Charringtons, and to the National Coal Board's House Warming Centre at Edgware were made by members of the Committee during the year. 14 The Ealing representatives on this Committee were:— Councillor J. T. C. Hancock (Chairman). Councillor A. W. Morbey. Chief Public Health Inspector. Supply of Fuels in Smoke Control Areas No difficulties affecting the supply of smokeless fuels were experienced during the year, although in one or two isolated instances householders were short of supplies caused by delivery delays and lack of sufficient foresight in placing orders with their fuel merchants. Enquiries of the main distributors serving the Borough revealed that the period between receipt of orders and delivery varied from 7 to 21 days and none reported any shortage of supplies from production sources. Grant arrangements The new grant arrangements referred to in last year's annual report, and authorised by the Minister of Housing and Local Government in his Circular No. 69/63, made it possible for grants to be paid for providing a much wider range of approved appliances, including openable stoves, under-floor draught fires and fixed gas, electric storage and oil heaters, to replace firegrates of unapproved types. In this Circular the Minister informed local authorities that grants for the installation of improved open grates would only continue to be payable when they were informed that supplies of open grate fuel would be available for proposed new areas. Otherwise grants would be payable for replacing such grates by other types of appliances. Approaches to the fuel producers and distributors listed in the Circular were made before any reports on proposed new areas were submitted to the Council and no unfavourable replies were received. It was, therefore, not necessary to discontinue the payment of grant for the installation of improved open grates and the demand for these remained fairly high in all areas. The wider range of appliances now grant aided resulted in a very marked increase in the number of grant applications and this was particularly so in the No. 17 Smoke Control Area where the original estimate was exceeded for the first time. Electricity Supplies In Circular 69/63 the Minister advised that the use of direct electric space heaters added to the difficulties being experienced by the electricity supply industry in meeting peak loads in cold weather and asked local authorities to discourage their use. Grants for the installation of approved types of fixed electric fires using direct electric current were therefore restricted to the cost of providing ordinary improved open fires, or a sum of £14 whichever was the lesser amount. The demand for such appliances with grant assistance was fortunately small, as most householders appeared to appreciate the risks involved in relying on electricity for heating purposes in very cold weather. In December, 1964, the Minister issued Circular No. 60/64 in which he designated all electrically operated space heating appliances as a class of appliance which was generally unsuitable for installation in England and Wales as tending, by reason of its consumption of electricity at times when it is generally used, to impose undue strain on the fuel resources available. The designation did not apply to electric storage heaters using off-peak electricity. The effect of this Circular was to prohibit any further grant payments for direct acting electric heaters. The Minister is to keep the position under review in the light of changes in the fuel supply position. 15 New furnaces Notifications of intention to install new boilers increased during 1964 and 111 notifications were received regarding new boilers in domestic, commercial and industrial premises. In conjunction with control of chimney height under Section 10, Clean Air Act, 1956, satisfactory dispersal of flue gases can be ensured. It is unfortunate, however, that no control exists under the Clean Air Act where it is proposed to install a new boiler connecting with an existing chimney which, whilst providing adequate draught for combustion, may be of inadequate height to disperse flue gases satisfactorily. Prior Approval No formal applications for prior approval were received but consultation with architects, consulting engineers and their clients has continued. Many improvements have been incorporated in new proposals as a result of this process. Heights of Chimneys Building Byelaw applications showing the proposed construction of new chimneys also increased in number during 1964. Twenty-two applications were considered, of which 15 required modification before being approved by the Council under Section 10 of the Clean Air Act. In addition to the deficiency pointed out under the heading New Furnaces, control of chimneys is weak in other respects. Domestic, office and shop chimneys are exempt under Section 10 and any premises not subject to Building Byelaw control are also free from control. These matters have been remarked on in previous Reports and also by other authorities, but as yet there appears no sign of amending legislation. Contraventions of Smoke Control Orders Several contraventions were observed during the year, but these were largely due to misunderstandings on the part of householders concerned, and were quickly remedied as soon as attention was drawn to the requirements of the Orders. In the case of one persistent offender, however, a successful prosecution for a contravention of the No. 9 Smoke Control Order resulted in the imposition of a fine of £5. AMENDMENTS TO THE CLEAN AIR ACT, 1956 Amendments to the Clean Air Act, 1956, came into force on the 16th August, 1964, under Section 95 of the Housing Act, 1964. These were as follows:— New dwellings. Eligibility for grant under the 1956 Act was extended to dwellings built or produced by conversion after 5th July, 1956, and before 16th August, 1964. This was to allow grant aided conversion of firegrates installed during this period in areas where open grate smokeless fuels were no longer readily available. Designation of appliances. Local Authorities or the Minister of Housing and Local Government were given power to refuse grant on certain types of appliances in smoke control areas where the appropriate fuel was not available. Such action by local authorities depended upon replies received from fuel and power producers and distributors as a result of the consultations described in Circular 69/63. The 16 effect of designation was that the installation of an appliance of a designated class ceases to attract grant although owners and occupiers remained at liberty to install a designated appliance at their own expense. The Minister later designated direct acting electric space heaters as described in the previous paragraph on electricity supplies. Approval of expenditure—special cases. Local Authorities were given discretionary powers to approve retrospectively for grant purposes, expenditure which an owner or occupier incurred without the local authority's prior approval, after confirmation of an Order by the Minister. Approval would also be given for work carried out after the date of the making of an Order by a local authority, provided the Order was later confirmed. These amendments only applied to expenditure incurred after 16th August, 1964, and were intended to assist in hard or deserving individual cases where there had been genuine misunderstanding or where there were other special considerations. Discretionary grants. The Minister was enabled to make an Exchequer contribution towards local authorities expenses on any discretionary grants made after 16th August, 1964, in excess of the normal seven-tenths of reasonably necessary expenditure on adaptations. The Minister asked for estimates of such additional grants to be supplied separately when Smoke Control Orders are submitted for confirmation. Grant on means of ignition. Grant was made available for providing a gas poker or electric igniter without the previous condition that other works must be involved. Measurement of Atmospheric Pollution During 1964, the Council maintained standard deposit gauges and lead dioxide candles at Birkbeck Avenue, Greenford, and at Longfield Depot at the rear of the Town Hall, and these gave information of local value and served to indicate the level of pollution in the immediate areas concerned. The deposit bowls and candles were changed monthly and the results determined by a private analyst. In addition, there were three sets of equipment which provided daily measurements of smoke and sulphur dioxide by the volumetric system. These were located at the Town Hall, at Eliots Green Grammar School, Northolt, and at Walpole Grammar School, Ealing. The results obtained from these instruments were submitted to the Warren Spring Laboratory of the Department of Scientific and Industrial Research and formed part of the national survey of air pollution. The Council is indebted to the Headmasters of Eliots Green and Walpole Grammar Schools for the facilities provided and for their help and interest in recording the daily readings. The tables and graphs in the following pages give details of the monthly results from the deposit gauges and lead dioxide candles, and the average monthly results obtained from the daily readings from the three sets of volumetric apparatus. Dark Smoke from Industrial Premises The adoptive Section 47 of the Middlesex County Council Act, 1961, was brought into force in the Borough, by special resolution of the Council, and took effect as from 1st September, 1962. This Section prohibits the emission of dark smoke from any 17 industrial premises in the district and provides penalties for contraventions. The Section does not apply to smoke emitted from any chimney of a building or from a chimney to which Section 1 of the Clean Air Act, 1956, applies, nor to dark smoke accidentally or inadvertently emitted if all practicable steps have been taken to prevent or minimise the emission of such smoke, nor to premises controlled under the Alkali, etc., Works Regulations Act, 1906. With these exceptions, the Section proves most useful in dealing with conditions which arise especially in smoke control areas, from the burning of large quantities of waste material in the open, and closes a serious loophole in the provisions of the Clean Air Act. Several occasions arose where the attention of possible offenders was drawn to the Section, but no formal action was necessary. This Section is much stronger in its effect than Section 16 of the Clean Air Act 1956, which makes it necessary for the local authority to prove that a nuisance is being caused to the inhabitants of the neighbourhood, where smoke, other than that dealt with in other Sections of the Act, is produced. Deposit Gauges and Lead Dioxide Instruments (Monthly Analysis) 1964 Deposited matter expressed as tons per square mile per month Sulphur compounds by lead dioxide method expressed as milligrams SO3/day collected by 100 sq. cm of Batch A Pbo2 Birkbeck Avenue Longfield Depot Birkbeck Avenue Longfield Depot Jan. 19.34 17.14 1.9 4.1 Feb. 20.71 29.61 1.8 4.0 March 17.87 20.94 1.9 3.8 April 19.14 21.71 1.0 2.5 May 20.88 21.10 0.6 1.7 June 10.44 19.25 1.2 2.0 July 8.57 24.85 0.4 1.2 August 1.30 14.71 0.5 1.0 Sept. 8.34 12.91 Not available 1.4 Oct. 17.31 15.91 0.9 2.1 Nov. 25.21 16.47 1.5 2.8 Dec. 25.01 15.71 1.4 3.1 Average for year 16.18 19.19 1.2 2.5 18 The photograph on this graph and those on the following two pages are published by permission of the Director of Warren Spring Laboratory of the Department of Scientific and Industrial Research and are "Crown Copyright". Average Monthly Concentrations of Smoke and Sulphur Dioxide (Daily Volumetric Instruments) 1964 Smoke in Microgrammes per cubic metre Sulphur Dioxide in Microgrammes per cubic metre Town Hall Eliots Green School Walpole Grammar School Town Hall Eliots Green School Walpole Grammar School Jan. 214.4 182.3 240.8 398.5 367.2 455.5 Feb. 169.0 179.8 219.9 366.5 260.7 333.8 March 103.8 116.5 154.3 258.6 272.5 338.6 April 60.9 29.6 26.9 213.6 98.7 90.6 May 31.0 28.1 27.1 156.6 96.1 114.1 June 29.8 28.3 31.2 104.5 84.2 104.1 July 25.9 19.1 20.7 136.9 66.6 77.9 August 29.3 * * 101.4 * * Sept. 42.9 30.5 16.3 154.5 79.7 52.3 Oct. 97.1 106.0 105.0 261.0 209.0 227.0 Nov. 99.3 74.6 90.7 256.5 151.7 156.3 Dec. 150.0 178.5 140.3 277.1 304.0 293.8 Average for year 87.9 88.5 97.6 223.8 . 180.9 204.0 *School holidays. FOOD HYGIENE The Clean Food policy of the Ealing Council, which has developed from an energetic approach to the problem of hygiene in the food industry commenced in 1949, was pursued vigorously in 1964. Regular inspection of food premises involving about 2,300 visits by Public Health Inspectors was linked with a continuation of talks to food handlers, school leavers and women's organisations. It is most satisfactory to note that the persuasive methods adopted to secure improvements in food premises were successful and due mainly to the co-operation given by the trade generally. In only one case was it necessary to resort to legal proceedings for persistent and serious contraventions of the Food Hygiene Regulations. During 1964, 39 lectures were given to food handlers and 234 received Certificates of Attendance upon completing the course. In addition 14 talks on food hygiene were given by the Public Health Inspectors to approximately 560 school-leavers at the Grammar and Secondary Modern Schools in the Borough, and three lectures were given to women's organisations. Since the inception of the Food Hygiene Scheme in 1949, 636 lectures have been given and 2,861 food traders and food handlers have completed the courses which have been arranged and all have been supplied with certificates of attendance. In 19 addition there have been 322 talks to school leavers at the Grammar and Secondary Modern Schools and in the 14 years since this part of the scheme was commenced approximately 12,650 children have attended; a total of 60 talks has also been given to various women's organisations, the total attendance being approximately 2,000. On six occasions during the year circular letters were sent to food traders and these dealt mainly with advice concerning supplies of corned beef and personal hygiene at the time of the Aberdeen typhoid outbreak. A further letter was sent later in the year with an appeal to traders dealing with bacon, cooked meats and meat pies to adopt a coding system of their own and to ensure a proper rotation of stocks of these goods in their shops. The letter also gave specific examples of how such a coding system could be used and was commented upon favourably by several major suppliers and manufacturers of these foods. There is no doubt that as a result of the Aberdeen outbreak the general public became more active in protesting about articles of food when sold out of condition or when containing foreign bodies and many more complaints of this nature were dealt with than in other recent years. Food Hygiene Certificates The current holders of these 59 certificates are:— School Meals Service 25 school kitchens. Staff Canteens Aladdin Industries Ltd., Western Avenue, Greenford. Bentall's Ltd., The Broadway, W.5. Hoover Ltd., Bideford Avenue, Perivale. Hoover Ltd., Wadsworth Road, Perivale. Metal Box Co. Ltd., Wadsworth Road, Perivale. Optrex Limited, Wadsworth Road, Perivale. A. Sanderson & Sons, Horsenden Lane, Perivale. Taylor Woodrow Ltd., Ruislip Road, Northolt. Taylor Woodrow Services Ltd., Western Avenue, W.5. F. H. Rowse Ltd., Broadway, W.13. Food Factories Quality Foods Ltd., Park Avenue, N.W.10.—Confectionery. Quality Foods Ltd., Park Avenue, N.W.10.—Synthetic Cream Restaurants Bentall's Ltd., The Broadway, W.5. F. H. Rowse Ltd., Broadway, W.13. Confectioner Joy Day, 5 Bond Street, W.5. Provision Merchants J. Sainsbury Ltd., 1/4 High Street, W.5. J. Sainsbury Ltd., 51 The Broadway, W.5 J. Sainsbury Ltd., 87 Broadway, W.13. 20 Multiple Store Marks & Spencer Ltd., 92/94 Broadway, W.13. Grocers Champion Tea Co., 366/8 Windmill Road, W.5. H. Cradock Ltd., 52/3 Manor Road, W.13. United Dairies (London) Ltd., 7 shops. Williams Bros. Ltd., 24 Broadway, Greenford. Butchers R. Mathews Ltd., 165 Boston Road, W.7. G. A. Scott & Son, 2 Eastmead Avenue, Greenford. L. Shaw, 6 Station Parade, Ealing Road, Northolt. Sutton & Sons, 34 Haven Green, W.5. Sutton & Sons, 1 Station Parade, Uxbridge Road, W.5. 2,289 inspections of food premises were made and 885 repairs and improvements were carried out. The film-strip on food hygiene made by the Council in 1954 is still in demand, a further 12 copies having been sold during the year, bringing the total number of copies so far sold to 173. During the year the Clean Food Booklet was again widely distributed amongst food traders. This booklet gives an account of the principles of food hygiene for all those concerned with food, but particularly shop keepers, school leavers, restaurant workers and housewives and those who handle food at home. It also gives information to food traders regarding the Council's food hygiene lectures and describes the conditions under which Food Hygiene Certificates are issued. This booklet has been of considerable assistance in the Clean Food Campaign. HOUSING ACTS Clearance Area Programme The Council's programme which was drawn up in 1956 includes proposals to deal with approximately 120 premises to which another 31 properties have been added as a result of more recent inspections. Action in earlier years resulted in the clearance or compulsory purchase of a large number of these houses but at the end of 1964. 38 premises included in these proposals were still occupied or remained to be dealt with formally or privately. The following progress was made during the year towards achieving the Council's objective of ensuring that unfit houses which are not capable of being rendered fit for human habitation should not again be used for such purposes:— 1-23 Adelaide Cottages, Hanwell, W.7. At the end of the year only eight of these 23 cottages were still occupied. The Council entered into an agreement with the owners during 1964 to rehouse the existing tenants by the autumn of 1965 and very satisfactory progress towards this end had already been made in 1964. 21 7, 8, 9 and 10 Church Place, These properties were purchased by the Council in 1963 Ealing, W.5. and the two remaining tenants were rehoused in this year. Arrangements are being made for the cottages to be demolished and the site redeveloped. 2-6 Farm Cottages, These premises were purchased by a statutory under- Hanger Lane, W.5. taker and some assistance towards rehousing was vided by the Council. All five properties were vacant at the end of the year and will soon be demolished. 18-26 (even numbers) A Closing Order in respect of the top floor accommo- Church Road, dation at 24 Church Road was made by the Council in Hanwell, W.7. October and the tenant rehoused by the Council. An official representation was submitted to the Council in October, when these properties were declared to be a Clearance Area ("The 18-26 (even inclusive) Church Road, W.7, Clearance Area"). The Council decided to make a Compulsory Purchase Order if negotiations to purchase the lands by agreement were unsuccessful. Individual Unfit Houses or Parts of Houses 22a, 24a, 26a and 30a Closing Orders in respect of the living accommodation South Ealing Road, W.5. behind and over shops at these premises were made by the Council. One family was rehoused and arrangements were being made at the end of the year to offer alternative accommodation to the remaining three families. 144 Uxbridge Road, A Closing Order in respect of the rooms over a shop Hanwell, W.7. was made during the year and the tenants rehoused. 24 Church Road, A Closing Order in respect of the top floor rooms at Hanwell, W.7. this house was made, and the occupants rehoused. Houses Demolished Moat Villa, Ealing Road, These premises were demolished in 1964 as a result of Northolt. Demolition Orders made in previous years. 5 and 7 Church Lane, W.5. Regulations for Underground Rooms 16 Eaton Rise, An undertaking to make the basement accommodation Ealing, W.5. fit for human habitation accepted in 1963, was mined on satisfactory completion of works. 92 Boston Road, W.7. Closing Orders in respect of the basement accommo94 Boston Road, W.7. dation at these addresses were made during the year, 19 South Ealing Road, W.5. and all tenants were rehoused. 44a Windsor Road, W.5. 45 Rosebank Road, W.7. 75 Mattock Lane, W.13. 14 Argyle Road, W.13. 46a Windsor Road, W.5. An undertaking not to relet the basement accommodation was accepted, but no specification of works had been agreed by the end of the year. The family in occupation was rehoused by the Council. 22 Houses in Multiple Occupation—Housing Act, 1961 The inspection of houses in this form of use continued in 1964 after a start had been made late in 1963. By a re-organisation of duties among the inspectors it was arranged that the Deputy Chief Inspector would be responsible for this work in addition to his other duties with such assistance as could be made available from time to time. On this basis known cases and complaints could be investigated. The procedure followed previously was continued and close co-operation was maintained with the Town Planning and Housing Sections of the Borough Surveyor's Department. For a short period an inspector was available to carry out door to door survey work and two roads in West Ealing were selected for survey, as it was thought that multiple occupation was on the increase in this neighbourhood. Eighty-seven houses were inspected and four were found to be in typical multiple occupation, the remainder being in various forms of occupation not requiring action under the Housing Acts. As the result of action taken by the Department the houses in multiple occupation were either sold or reverted to acceptable forms of occupation. This type of activity undoubtedly enables the problem to be properly assessed and the necessary action to be taken. The routine investigation of known cases and complaints resulted in 95 inspections. Ten preliminary notices were served requiring the execution of works under Sections 15 and 16 of the Act. In several cases owners were advised on the future use of their properties so as to avoid overcrowding and the need for additonal facilities. In other cases conditions were remedied without need of notices being served. In one case the owner's reaction to the receipt of informal notices was to give all his tenants notice to quit and to offer the property for sale. In order to ensure that the essential requirements were met formal notices were served and a Management Order made to ensure that even should the premises change hands the Council would still be in a position to enforce satisfactory conditions. Considerable improvement in the living conditions was obtained and the premises are still subject to the Management Order which will only be revoked when the conditions making it necessary no longer exist. BATHS AND SWIMMING POOLS The Council's baths in Longfield Avenue contain four indoor swimming pools. The water is drawn from the mains of the Metropolitan Water Board and is completely circulated in all four pools every four hours. The treatment plant provides for flocculation and alum and soda ash prior to filtration, combined with continuous marginal chlorination of the water as it is drawn from the pools and on its return. The Baths Manager makes tests at frequent intervals each day to ensure that a satisfactory level of residual chlorine is maintained. In addition 75 samples were taken by the Department during the year and sent for bacteriological examination, and all were found to be entirely satisfactory. A private swimming pool operated by a local industrial firm in Greenford was sampled on four occasions during the year and results were satisfactory. PUBLIC HEALTH ACT, 1961—DESTRUCTION OF PIGEONS Section 74 of this Act gives local authorities power to deal with nuisances caused by the congregation of pigeons and certain other birds in built-up areas. The arrangement whereby the Council exercised these powers by employing a specialist firm to 23 deal with such infestations of pigeons in various areas in the Borough, and which was commenced in 1962 was continued in 1964. A new contract for 12 months was entered into in April. A total of 2,371 pigeons was destroyed during the year, and the work resulted in a very marked improvement in many sites in the Borough where previous infestations had been heavy and had caused serious nuisance and inconvenience from roosting and fouling. Particular attention was given to a number of railway bridges, notably those in the Perivale and West Twyford areas. The methods used were mainly trapping and shooting with the occasional use of repellents, and all the work was carried out in accordance with the Protection of Birds Act, 1954, and to the satisfaction of the Royal Society for the Prevention of Cruelty to Animals and the local police. The use of narcotics was excluded. PUBLIC MORTUARY As there is no Public Mortuary in this Borough, existing arrangements continued with the Acton Borough Council for the use of the mortuary at Acton. The number of bodies taken there was 312 and post-mortem examinations were carried out in all cases. Similar arrangements were also continued with the Uxbridge Borough Council for the use of their mortuary and 96 bodies were dealt with at Uxbridge and postmortem examinations made. 24 SECTION 3 PUBLIC HEALTH INSPECTION THE WORK OF THE PUBLIC HEALTH INSPECTORS IN 1964 A report to the Medical Officer of Health by the Chief Public Health Inspector giving details of the work of the Public Health Inspectors during the year is as follows:— PUBLIC HEALTH ACT, 1936 Inspections Premises inspected on complaint 2,232 Nuisances observed 206 Infectious disease visits 469 House to house inspections 16 Smoke observations 107 Houses without water supply 86 Tents, caravans and sheds 115 Pet Animals Act, 1951 39 Cinemas and Music and Dancing Licences 60 Shops Act 2 Animal Boarding Establishments Act 13 Chiropodists and Special Treatment 18 Schools 19 Public Health Laundry Service 102 Licensing Act (W.C. accommodation) 63 Noise Abatement 67 Brent Pollution 65 Rent Act, 1957 79 Other inspections and visits 2,132 Reinspections 4,160 Informal notices (inc. verbal) 531 Letters sent 9,871 Statutory Notices served 797 CLEAN AIR ACT, 1956 Inspections and visits in connection with Smoke Control Areas 6,277 FOOD AND DRUGS ACT, 1955 Food Hygiene (General) Regulations, 1960 and 1962 Milk and Dairies (General) Regulations, 1959 Complaints received 476 Food Inspections 209 Inspections of Food Premises 2,289 Contraventions found 500 25 Informal notices given 480 Proceedings before Magistrates 14 Samples of ice cream and ice lollies taken 104 Samples of synthetic cream taken 33 Samples of other foods taken 18 Samples of tea taken 380 Samples of domestic water taken 24 Samples of swimming bath water taken 79 Legal Proceedings Food and Drugs Act, 1955 During 1964, 11 successful prosecutions for the sale of food articles which were not of the nature, substance or quality demanded by the purhcaser were taken under this Act Fines Costs £ s. d. £ s. d. (a) Sale of canned food containing glass 5 0 0 3 3 0 (b) Sale of bread containing wound dressing 10 0 0 3 3 0 (c) Sale of bread containing tobacco 25 0 0 3 3 0 (d) Sale of bread containing metal 10 0 0 5 5 0 (e) Sale of sausages found to be mouldy 15 0 0 5 0 0 (f) Sale of pie containing rubber 10 0 0 5 0 0 (g) Sale of steak pie found to be mouldy 15 0 0 5 5 0 (h) Sale of ham found to be flyblown 20 0 0 10 0 0 (i) Sale of swiss roll found to be mouldy 15 0 0 — (j) Sale of pork pie found to be mouldy 25 0 0 5 5 0 (k) Sale of cooked chicken found to be unsound 10 0 0 5 5 0 Food Hygiene (General) Regulations, 1960 In one case proceedings were instituted under these Regulations with the following result:— Restaurant proprietor convicted on six summonses relating to contraventions of the Regulations and fined a total of £24 (£4 on each summons) with £5 5s. Od. costs. One summons was dismissed. Milk and Dairies (General) Regulations, 1959 In two cases proceedings were instituted under these Regulations with the following results:— (a) Dirty milk bottle— Dairy company found guilty and fined £20 with £6 6s. Od. costs. (b) Dirty milk bottle— Dairy company found guilty and fined £25 with £6 6s. Od. costs. 26 List of Food Premises in the Borough of Ealing Bakehouses 18 Bakers' shops 47 Butchers 114 Cafes and Restaurants 161 Canteens—factory 93 Canteens—school 34 Confectioners 236 Dairies and Milk Sellers 116 Fish Fryers 22 Fishmongers 31 Greengrocers 134 Grocers 266 Hotels and Licensed Clubs 53 Ice Cream Manufacturers 3 Public Houses 62 Premises registered for the preparation or manufacture of sausages or potted, pressed, pickled or preserved food 113 Premises registered for the sale of ice cream 386 Milk Supply There are 76 registered distributors of milk in the Borough. During the year 112 samples of milk were taken in the Borough of Ealing by officers of the County Council. Ice Cream There are 386 premises in the Borough registered for the sale of ice cream. There are only three registered premises in the Borough manufacturing ice cream, and all are equipped in accordance with the Ice Cream (Heat Treatment) Regulations, 1959. A total of 104 samples was taken during the year and submitted for bacteriological examination. The results were as follows:— Commodity Samples Grade 1 2 3 4 Ice Cream— (Local Manufacturers) 63 52 10 — 1 Ice Cream— (Other Manufacturers) 29 9 3 5 12 Ice Lollies— (Local Manufacturers) 11 — — — — Ice Lollies— (Other Manufacturers) 1 — — — — 104 61 13 5 13 27 The one local sample placed in Grade 4 was followed by an inspection of the factory and plant, and a repeat sample proved to be satisfactory. The 12 samples of ice cream in Grade 4 taken from products manufactured outside the Borough, were followed up with the firms concerned, and subsequent samples proved to be satisfactory. The 12 samples of ice lollies were reported upon satisfactorily, but were not placed in the grades used for ice cream. Synthetic Cream A total of 33 samples of synthetic cream was taken during the year and all were from local manufacturers. In all cases reports from the laboratory indicated that the samples were of excellent or satisfactory quality. Inspection of Meat and Other Foods The following foodstuffs were condemned by the Publich Health Inspectors as unfit for human consumption and were surrendered for destruction:— lbs. Bacon 51 Beef 1,198 Cheese 18 Chopped Pork 3 Corned Beef 15 Dried Fruit 610 Edible Fats 3 Fresh Fruit 900 Flour 114 Ham 38 Lamb 232 Nuts 374 Pork 59 Poultry 310 Preserves 9 Prunes 31 Salmon 27 Sausages 11 Steak 751 Sugar 4,032 Tongue 28 Veal 17 Vegetables 9,708 Tea 38,059 Foodstuffs not calculated by weight: Assorted tins, packets, jars, bottles, articles, barrels 9,135 IMPORTED FOOD REGULATIONS—EXAMINATION OF TEA The examination and sampling of tea taken over from H.M. Customs & Excise in 1959 continued during 1964. Imports of teas from all parts of the world arrive at a 28 large tea blending and packing factory in Greenford and come direct from the London docks without inspection on landing. This places on the Council the responsibility of ensuring that these teas are fit for human consumption in accordance with the provisions of the Food & Drugs Act, 1955, and the Public Health (Imported Food) Regulations, 1937. During the year a total of 380 samples which were representative of all consignments received at the factory were taken by the District Public Health Inspector. Experience over the last few years has shown that greater attention must be paid to teas from certain areas, and sampling is therefore selective. Of these 380 samples, 28 were found to be of doubtful quality after initial tests had been carried out locally and were referred to the Council's analyst for more detailed examination and report. He found that 18 samples were from consignments considered to be unfit for use for human consumption, mainly on account of the presence of excessive amounts of metallic dust. Of these 18 samples, two were found to be completely unfit for use and the two cases concerned were disposed of for other purposes. The remaining 16 samples were from 465 cases of tea which were blended with other good teas under supervision so that they did not form more than 5 % of the final blend. Samples of the resultant product were taken in all cases and found to be satisfactory. The samples taken during the year were from a total stock of 50,841 cases received at the factory direct from the docks. The amount of tea found to be unfit for use or requiring to be blended under special arrangements was therefore 0.91 % of the total consignments. Other Food Samples Eighteen other food samples were submitted for laboratory examination following complaints and all were found to be satisfactory. These samples included cooked fresh meat, cooked meat products, gravy and soups, fish fingers, custard, ice-cream, cooked vegetables, batter pudding, animal foods (examined for risk of crossinfection). SUMMARY OF WORK DONE AND IMPROVEMENTS CARRIED OUT AT FOOD PREMISES Clothing accommodation provided or improved 17 Equipment improved or cleansed 98 First Aid equipment provided or improved 40 Floors repaired and floor coverings improved 56 Food storage accommodation improved 24 Hot water provided or restored 32 Hygiene Notices provided 67 Lighting and ventilation improved 25 Protective clothing provided or improved 8 Refrigeration installed or improved 22 Refuse bins provided or renewed 50 Refuse removed 45 Sinks provided or renewed 24 Tables and working surfaces made impervious 32 Walls and ceilings repaired or cleansed 209 29 Washing facilities provided or improved 29 Water closets cleansed, repaired or lighted 47 Water supply provided or improved 11 Other defects remedied 49 MIDDLESEX COUNTY COUNCIL ACT, 1950, SECTION 11 Under this Section, three persons were registered (and 12 deleted) during the year for the sale of food from carts, barrows, other vehicles, etc., bringing the total number on the Register at 31st December, 1964 to 25. HOUSING STATISTICS 1. Inspection of dwelling-houses during the year: (1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1,522 (2) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Act, 1957 51 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 41 (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 748 2. Remedy of defects during the year without service of formal notices: Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 661 A—Proceedings under Sections 9, 10 and 12 of the Housing Act, 1957 (1) Number of dwelling-houses in respect of which notices were served requiring repairs 1 (2) Number of dwelling-houses which were rendered fit after service of formal notices: (a) by Owners — (b) by Local Authority in default of owners — B—Proceedings under Public Health Act: (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 58 (2) Number of dwelling-houses in which defects were remedied after service of formal notice: (a) by Owners 54 (b) by Local Authority in default of owner 3 C—Proceedings under Sections 16, 23 and 24 of the Housing Act, 1957 (1) Number of dwelling-houses in respect of which Demolition Orders were made — (2) Number of dwelling-houses demolished in pursuance of Demolition Orders 3 30 (3) Number of houses concerning which action has been taken by the Local Authority under Section 16, and in respect of which Owners have given an undertaking that they will not be used for human habitation 1 D—Proceedings under Sections 17, 18 and 27 of the Housing Act, 1957 (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made 13 (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit 1 CARAVAN SITES AND CONTROL OF DEVELOPMENT ACT, 1960 MIDDLESEX COUNTY COUNCIL ACT, 1944 A site licence for the use of a caravan at a sports ground in Northolt was renewed in December for a further period of twelve months. A new gipsy warden was appointed in March and during the year he succeeded in blocking off most of the Council and privately owned sites in the Borough on which caravanners were apt to park. This action forced the caravans on to lay-bys and service roads and roadside verges which could not be blocked except by proper fencing. The Hayes and Harlington Urban District Council continued to share the cost and services of the warden and the arrangement worked satisfactorily. In considering what action could be taken to solve the problem of itinerant caravan dwellers, officers from the Town Clerk's Department and the Public Health Department made visits to two caravan sites provided by Hertfordshire County Council and Eton Rural District Council. As a result of a report submitted to the Public Health Committee jointly by the Town Clerk and myself, members of the Committee visited the Eton Rural District Council site at Mansion Lane, Iver. The question of the provision of a similar site in this area was referred to the Caravan Trespassers Committee who at a meeting in December resolved to request the Council of the London Borough of Ealing to consider the provision of a site in consultation with neighbouring boroughs. The Committee was of the opinion that there was no suitable site available in the existing Borough of Ealing. Although the strenuous efforts of the warden did much to prevent any caravans parking for long periods in any one place, it has become apparent that there is a hard core of families who are loath to move out of the district, and even if they do so temporarily they always return. These are people who consider themselves as locals, and whose children in many cases are employed in the area. The warden was able to deal with those caravan dwellers who were merely passing through the borough or who stayed for two or three days only, but the problem of the dozen or so families who consider themselves as almost permanent inhabitants of the district is practically insoluble by the methods now used. OFFICES, SHOPS AND RAILWAY PREMISES ACT, 1963 This Act, which received the Royal Assent in 1963, was brought into force in 1964 by various Orders made by the Minister of Labour, and for the first time, sets standards for the health, welfare and safety of employees in shops, offices and railway 31 premises. Section 49 of the Act came into force on 1st May, 1964, and required employers in premises to which the Act applies to register their premises by the 31st July, 1964. In spite of considerable publicity given to these requirements in the press and by official announcements on radio and television it was felt that the response might still be inadequate. A preliminary survey of the Borough was therefore carried out by the Public Health Inspectors in April and May. This survey provided information as to the location of all premises in the Borough and for which the Council was the enforcing authority. At the same time an explanatory letter and a copy of the registration form (O.S.R.I) was left at each premises in order to encourage early registration. As a result of this survey, some 60 per cent of the forms delivered were completed and returned by 1st August, 1964. A Technical Assistant was appointed in August and his first duties were to visit those premises from which registration forms had not been received. Almost half the number of premises which had not been registered were found to be occupied by self-employed persons or were premises in which the total number of hours worked weekly by part-time employees was less than 21, and registration was therefore not required. The general inspection of premises was commenced towards the end of August and where contraventions were found letters were sent to those responsible for complying with the requirements of the Act and of the various Regulations which applied, giving details of action required to bring the premises up to standard. In the latter part of the year during which the appropriate part of the Act was in force, 17 accidents were reported. Fortunately most of these accidents were not serious, but one concerned a 17-year-old youth working in a grocery store, who severed the index finger of his right hand whilst cleaning the blade of a food slicing machine. The Council decided to institute proceedings in this case and the hearing is to take place early in 1965. Co-operation with H.M. Inspector of Factories during the year ensured that a proper assessment was made in all cases where the line of demarcation between the responsibilities of the local authority and of the Factory Inspectorate was difficult to define. Only two firms applied for exemption certificates under the various Sections of the Act. Of these, one applied for exemption from the provisions relating to temperature but this was later withdrawn. The other firm applied for exemption from the provisions relating to space, temperature, sanitary conveniences and running water for washing purposes. The application in respect of temperature was refused by the Council and the remaining applications were considered to be unnecessary. No appeal was made. Certain specified statistics, together with a more detailed report on the operation of this Act in the Borough was submitted to the Minister of Labour at the end of the year in accordance with the Annual Reports made under the Act. The statistical details in this report are as follows:— 32 Table A. Registrations and General Inspections Class of Premises No. of premises registered during year Total No. registered at end of year No. of general inspections Offices 473 473 68 Retail shops 1,135 1,133 227 Wholesale shops, warehouses 48 48 48 Catering establishments open to public, canteens 89 87 16 Fuel storage depots — — — Totals 1,745 1,741 359 Table B. Number of visits of all kinds by Inspectors to registered premises—2,370. Table C. Analysis of persons employed in registered premises by workplace. Class of workplace Number of persons employed Offices 7,170 Retail shops 6,884 Wholesale departments, warehouses 623 Catering establishments open to public 749 Canteens 93 Fuel storage depots — Total 15,419 Total Males 6,788 Total Females 8,631 Table D. Exemptions. One application for exemption from the provisions of Section 6 relating to temperature in a retail shop was refused during the year. Table E. Prosecutions. There were no prosecutions instituted during the year for which the hearings had been completed by 31st December 1964. Table F. Inspectors. No. of inspectors appointed under Section 52 (1) or (5) of the Act : Public Health Inspectors (Part-time) 12 Technical Assistant (Full-time) 1 No. of other staff employed for most of their time on work in connection with the Act 1 33 RADIOACTIVE SUBSTANCES ACT, 1960 This Act concerns itself with the control of the keeping and use of radioactive materials and the accumulation and disposal of wastes. As from the appointed day, which had been fixed as 1st December, 1963, persons who keep or use radioactive material are, unless specifically exempted, required to register with the Minister of Housing and Local Government and to obtain authorisation from him for its accumulation or disposal. During 1964 notifications were received from the Minister that he had granted Certificates of Registration under Section 1 of the Act in respect of three premises in the Borough of Ealing. In all cases, enquiries were made by the District Public Health Inspectors to provide information about methods of control and safety measures. Although the Council has no responsibility in this matter it was felt that some details should be available locally. PET ANIMALS ACT, 1951 Licences in respect of 13 premises were renewed by the Council during the year, and one new licence was issued. Routine visits were made by the Public Health Inspectors to these premises on 39 occasions during the year. ANIMAL BOARDING ESTABLISHMENTS ACT, 1963 Licences in respect of three premises were renewed by the Council during the year. COMMON LODGING HOUSES There are no common lodging houses in the Borough. RENT ACT, 1957 Part I—Applications for Certificates of Disrepair (1) Number of applications for certificates 11 (2) Number of decisions not to issue certificates — (3) Number of decisions to issue certificates: (a) in respect of some but not all defects 4 (b) in respect of all defects 7 (4) Number of undertakings given by landlords under paragraph 5 of the First Schedule 9 (5) Number of undertakings refused by Local Authority under proviso to paragraph 5 of the First Schedule — (6) Number of Certificates issued 2 34 (Reproduced by kind permission of "The Nursing Times".) An elderly tenant enlists the aid of the Public Health Inspector in securing essential repairs. Part II—Applications for Cancellations of Certificates (7) Applications by landlord to Local Authority for cancellation of certificates 4 (8) Objections by tenants to cancellation of certificates 1 (9) Decisions by Local Authority to cancel in spite of tenants' objection — (10) Certificates cancelled by Local Authority 3 NEW DWELLINGS, 1964 Completion figures for the 12 months period ending 31st December, 1964, were:— Bed/sitting room flats 74 Flats (1 bedroom) 68 Flats (2 bedroom) 95 Three bedroom maisonettes 108 FACTORIES ACT, 1961 Part I of the Act 1. Inspections for the purposes of provisions as to health (including inspections made by the 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 Authority 6 7 1 — (ii) Factories not included in (i) in which Section 7 is enforced by Local Authority 416 203 20 — (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) — — — — Total 422 210 21 — 35 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 By H.M. Inspector Want of cleanliness 9 7 — — — Overcrowding — — — — — Unreasonable temperature — — — — — Inadequate ventilation — — — — — Ineffective drainage of floors 1 1 — — — Sanitary Conveniences: (a) Insufficient 1 1 — 1 — (b) Unsuitable or defective 8 9 — 2 — (c) Not separate for sexes — — — — — Other offences against the Act (not including offences relating to outworkers) 4 6 — — — Total 23 24 — 3 — 36 Part VIII of the Act Outwork (Sections 133 and 134) Nature of Work Section 133 Section 134 No. of out-workers in August list required by Sect. 133 (1) (c) No. of instances of work in unwholesome premises Wearing apparel: Making, etc. 142 — Artificial Flowers 3 — Feather sorting — — Paper bags 5 — Carding, etc., of buttons, etc. 16 — Stuffed toys 13 — Cosaques, Christmas stockings, etc 100 — Lampshades 2 — Brass and brass articles 2 — Woodwork 1 — Jewellery 28 — Total 312 — During the year 266 inspections of Outworkers' premises were carried out by the Public Health Inspectors. PREVENTION OF DAMAGE BY PESTS ACT, 1949 The following is a summary of the work carried out by the Rodent Operatives acting under the supervision of the Chief Public Health Inspector. Complaints 845 Premises inspected 989 Premises found to be infested with: 1. Rats 825 2. Mice 161 Re-visits to infested premises 3,530 Fees received for treatment 946 1. Od. RODENT CONTROL IN SEWERS The system of rodent control in sewers recommended by the Ministry of Agriculture, Fisheries and Food, with the use of fluoracetamide as a direct poison bait was again in operation in the Borough during 1964. In the areas selected for treatment 37 during the year, 426 manholes were baited in March and again in June and September. As only one visit was made on each of the three occasions to the manholes treated, it was not possible to assess the effectiveness of the fluoracetamide, but experience and test baiting in previous years has shown that the results obtained are extremely good. The practice adopted in 1963 of carrying out a limited sewer maintenance treatment in the immediate area of multiple surface infestations, was also continued. NOISE NUISANCES Certain powers for dealing with noise nuisances contained in the Middlesex County Council Act of 1944, have been strengthened by those of the Noise Abatement Act of 1960, which provide that noise or vibration which is a nuisance shall be a statutory nuisance for the purposes of the Public Health Act, 1936. The Act of 1960 also limits the hours during which a loudspeaker may be used in a street and prohibits its use altogether for certain purposes. No proceedings under this Act were necessary during the year, but 21 complaints about noises of various kinds were dealt with by the District Public Health Inspectors. These complaints concerned Youth Clubs, factory machinery, building operations and neighbours, and were all investigated in detail by the Inspectors. Informal action was taken to bring about improvements in many cases, although some complaints were found to be unjustified. A simple noise measuring device has proved useful in determining whether or not a particular level of noise could be regarded as a nuisance within the meaning of the Public Health Act, 1936. RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951 Seven premises in the Borough were registered under the Act and in only three of these premises is work within the scope of the Act being carried on. In all cases only materials carrying the Certificate of the British Standards Institution are used. DISINFECTION AND DISINFESTATION Number of houses where disinfestation was carried out 99 Number of houses disinfested of vermin 34 Number of articles disinfected by formalin spray 912 Number of articles voluntarily destroyed 35 The arrangement made with the Hammersmith Metropolitan Borough Council in 1952, whereby articles to be disinfected by steam are dealt with at the Scotts Road Depot, W.12, was continued during the year. SUMMARY OF SANITARY DEFECTS REMEDIED AS A RESULT OF NOTICES SERVED AND LETTERS WRITTEN Animals—nuisances abated 14 Baths provided or renewed 9 Caravans—nuisances abated 11 Damp-proof courses inserted in walls 10 Dampness—other forms remedied 112 38 Drains—cleared and cleansed 332 Drains reconstructed 31 Drains repaired or improved 132 Drains—new soil and ventilation pipes provided 32 Dustbins provided 109 Firegrates—repaired or renewed 37 Floors—sub-floor ventilation provided or improved 18 Floors—repaired or renewed 57 Food cupboards provided, ventilated or improved 17 Gutters and downpipes repaired or renewed 149 Land fenced 12 Lighting (natural and artificial) provided or improved 26 Refuse accumulations removed 144 Roofs repaired 166 Sinks and wash-hand-basins repaired or renewed 30 Sink and other waste pipes repaired or renewed 29 Staircases repaired 16 Ventilation improved 11 Walls and ceilings repaired 125 Walls and ceilings cleansed or redecorated 43 Water supply reinstated 86 Water supply—service pipes and fittings repaired or renewed 38 Water supply—draw taps fixed to main supply 10 Water supply—hot water service provided or repaired 25 Water closets—repaired, reconstructed or improved 69 Water closets—additional accommodation provided 11 Windows and doors repaired 166 Yards paved or repaired 28 Other defects remedied or nuisances abated 169 39 SECTION 4 OLD PEOPLE'S WELFARE OLD PEOPLE'S LIAISON COMMITTEE This Committee is representative of the Council and those voluntary organisations receiving grants from the Borough Council under the National Assistance Act and the Local Government Act. The Committee meets annually for the purpose of coordinating the running of the services of these organisations for the year. The voluntary associations are able to bring to the notice of the Council any difficulties they have encountered during the year, any proposals they may have for extending their services during the coming year, and a statement of their future financial requirements. These recommendations are then referred to the Public Health Committee. Members of the Committee for 1964 were:— Councillor R. R. Clay (Chairman) Councillor Allsopp Councillor Barlow Councillor Bartlett Councillor Emmins Councillor Hayselden and the following representative of organisations:— Mrs. D. M. Collins, British Red Cross Society. Mrs. E. M. Doughty, British Red Cross Society. Mr. B. Turrell, Ealing Committee for the Employment and Recreation of Elderly Citizens. Mrs. M. Hill, Ealing Committee for the Employment and Recreation of Elderly Citizens. Mr. F. W. Tomlin, Greenford Philanthropic Society. Mr. L. Ward, Greenford Philanthropic Society. Miss E. Tippetts, Women's Voluntary Service. Mrs. H. W. Corey, Women's Voluntary Service. Mrs. B. Webster, Ealing Elderly Persons Welfare Association. Councillor K. Reeves, Ealing Elderly Persons Welfare Association. WORK CENTRES The Borough's three Work Centres are administered by the Ealing Committee for the Employment and Recreation of Elderly Citizens. They have continued to provide daily employment for a number of men and women of retirement age. The centres are at:— Territorial Drill Hall, Churchfield Road, West Ealing. Methodist Church Hall, Ruislip Road, Greenford. Northolt Memorial Hall, Ealing Road, Northolt. The number of persons employed total 105 West Ealing 40 Greenford 35 Northolt 30 40 (Reproduced by kind permission of "The Nursing Times".) Elderly people suitably employed at a Work Centre. (Reproduced by kind permission of "The Nursing Times".) Hot meals being prepared for delivery to the elderly through the Meals on Wheels Service. The work available is varied and includes the following:— packing soap, repairing industrial gloves, folding and glueing hospital folders, assembling and packing ball point pens, circulars and mailing of all kinds, stapling for printing industry, packing wire binders for catalogues. Although the work at the Centre has to be subsidised, some 11s. 7d. was recovered for every £1 paid in wages. This compares with last year's figure of 11s. 5d. The wage paid to the workers was increased during the year from 1s. to 1s. 3d. an hour. The plans mentioned in last year's annual report for the erection of a prefabricated timber building in Ravenor Park to replace a room at the Methodist Church Hall were rejected by the Minister of Housing and Local Government on the grounds that he could not allow park land to be used for other purposes. Plans for an alternative site are therefore being considered. As in the previous year each centre held a Christmas party—occasions which were much appreciated by the old people. The Ealing Work Centres were again well represented at the Employment Fellowship Annual General Meeting. A display stand designed in the Public Health Department was exhibited and attended by the Organiser of the Borough's Work Centres. This appeared to be well received and a large number of enquiries were dealt with. MEALS ON WHEELS SERVICE The Meals on Wheels Service in the Borough is supplied jointly by The British Red Cross Society and the Women's Voluntary Service. During the year the number of meals distributed was as follows:— British Red Cross Society 16,200 Women's Voluntary Service 10,264 Total number of meals 26,464 B.R.C.S. W.V.S. Normal number of meals served per week 315 295 Normal number given 2 meals per week 37 35 Normal number given 3 meals per week 40 Normal number given 4 meals per week 33 — Normal number given 5 meals per week34 21 This valuable service has continued to be a vital component in the overall care of elderly persons in their own homes. At least one good meal a day goes a long way towards preventing the deterioration which owing to their physical or mental disability follows the failure to cook adequately on their own behalf. EALING DAY TREATMENT CENTRE During the past year the Ealing Day Treatment Centre has provided the care and treatment required to rehabilitate the elderly disabled referred to it. Patients attend on a daily basis from 9.0 a.m. to 5.30 p.m. and those who are unable to make their own way to the Centre are transported by ambulance. Patients are accepted only on 41 the recommendation of their own general practitioner and referrals should be made to the Honorary Medical Adviser, Town Hall Annexe, W.5. The treatments offered are wide in range and include physiotherapy, occupational therapy and chiropody. Hearing tests are carried out as a routine and those patients with marked hearing loss are examined by an ear, nose and throat specialist with a view to supplying them with a hearing-aid if necessary. Similarly there are eye inspections by an ophthalmologist. The services of the nursing staff are available for injections, dressings and baths, or any other treatments requested by the general practitioner. It is our endeavour to maintain a happy, friendly and informal atmosphere. Many of the old persons referred to the Centre have been living alone for an appreciable time and have forgotten how to mix with their fellow beings. It is possible to raise the morale of these persons and to rehabilitate them socially. Ensuing mental benefits are often accompanied by a physical improvement greater than might be expected from the result of physical treatment alone. Occasional social activities outside the Centre are welcomed by the patients and during 1964 some 35 patients were taken to Brighton for a day. They expressed their appreciation of this outing. As in previous years the Centre has continued to attract interest in the medical world. Recently visits have been arranged for parties from China and Nigeria. These visitors have generally expressed a keen interest and a desire for similar facilities in their own areas. During the year 105 patients were admitted, which is slightly less than the previous year and the same number as the year before that. Considering the main disability, that which brought the patient to the Centre, the illnesses may be classified as follows:— Arthritis and allied complaints 23 Neurological diseases (including hemiplegia 24, Parkinson's disease 5, and disseminated sclerosis 4) 34 Diseases of the cardiovascular system 21 Diseases of the respiratory system 2 No major ailment or senility only 12 Others 13 Total number 105 These diagnoses follow the pattern that we have been led to expect from previous years. The average age of the patients remains at 75 years. The districts from which patients attended were as follows:— Hanwell, 27 Ealing, W.13 25 Ealing, W.5 19 Greenford 17 Northolt 15 Perivale 2 42 (Reproduced by Kind permission of "The Nursing Times".) Visits from the home nurse help to maintain the patient's progress achieved while attending the Day Treatment Centre. The procedure is watched with interest by a student nurse from Barbados. When patients are discharged from the Centre it is our aim to ensure, as far as possible, that they return to an environment which offers them more support than it did before their admission. In this respect many of the services supplied or sponsored by the Borough Council are of the greatest value. The Meals-on-Wheels service, for example, and the Home Help Service are often essential elements in preventing the deterioration which might otherwise follow discharge from the Centre. There is still a shortage of visitors to visit discharged patients in their homes and to report back on those who appear to be in need of further treatment. Some form of follow-up centre would appear to be necessary and it is hoped that progress towards this can be made in the coming year. The members of the Committee of the Ealing Day Treatment Centre Association for 1964 were:— Councillor R. R. Clay (Chairman) Councillor J. T. Bartlett (Vice-Chairman) Alderman Mrs. D. Gundry, J.P. Councillor J. F. Barlow Councillor E. R. Bennett Councillor Mrs. D. I. Williams Dr. Barbara Bailey Dr. C. A. Osborn Dr. F. H. Scoones Mrs. D. M. Collins—British Red Cross Society Vacancy—St. John Ambulance Brigade Miss E. Tippetts—Women's Voluntary Service NATIONAL ASSISTANCE ACT, 1948 Section 47 This section provides powers for the compulsory removal to hospital or other place of persons who:— (a) are suffering from grave chronic disease or, being aged, infirm or physically incapacitated are living in insanitary conditions, and (b) are unable to devote to themselves, and are not receiving from other persons, proper care and attention. Once again it was not necessary to take action under this section during the past year. Many old people were visited following reports received from General Practitioners, Home Helps, Health Visitors, etc. Where an old person is unwilling to enter a hospital or home voluntarily it has often been found possible to give sufficient support through the good offices of the Home Help Section, the Meals-on-Wheels service and the Home Nursing service. This enables the person's home to be brought up to a reasonably satisfactory state of hygiene and comfort. Many of the old people visited would undoubtedly receive more adequate care in an Old Person's Home, but one is naturally reluctant to use compulsory powers of removal in any but extreme cases. A great deal, however, can be done by persuasion and explanation. 43 HOLIDAYS FOR OLD PEOPLE Holidays for the elderly are arranged by the Women's Voluntary Service and the Greenford Philanthropic Society, supported by grants from the Borough Council. This valuable service provides both mental and physical recreation for those who would otherwise be unable to have a holiday. During the year the Women's Voluntary Service took 240 people to Bexhill-on-Sea, and the Greenford Philanthropic Society 50 to Ramsgate. Once again many old people have expressed to the organisers their appreciation of this facility. SOILED LINEN CLEANSING SERVICE This service provides for the collection and washing of soiled linen from households where an incontinent person is being cared for. The service is provided by the Public Health Department in co-operation with the Baths Laundry Service. Applications for this service should be made to the Medical Officer of Health. Laundry is collected and delivered on Mondays and Thursdays and there is no charge to the applicant. I should like to acknowledge the continued help given by the Catholic Women's Guild in repairing worn linen and clothing. The table below shows the use made of this service during the past six years. 1959 1960 1961 1962 1963 1964 No. of new cases dealt with during the year 67 83 69 86 92 72 No. of cases remaining at end of year 39 42 34 41 38 42 No. of cases that died 31 48 30 42 30 31 No. of cases removed to hospital 41 30 22 31 32 27 No. of cases where other ments were made 3 – 16 3 33 10 Total number of articles dealt with 59,004 48,847 34,727 38,211 32,968 27,399 Total number of collections 4,822 2,954 3,058 3,041 2,899 2,993 Average number of articles per collection 12.2 16.5 11.0 12.6 11.37 9.1 44 SECTION 5 GENERAL ESTABLISHMENTS FOR MASSAGE AND SPECIAL TREATMENT There are at present the following establishments in the Borough:— Chiropody only Chiropody and Special Treatment Massage only Physiotherapy only Osteopathic 8 10 1 2 1 In accordance with the provisions of the Professions Supplementary to Medicine Act, 1960, a register is kept of all those suitably qualified for this work and allows them to use the title "State Registered". This ensures that these medical auxiliaries have the requisite training and status. NATIONAL ASSISTANCE ACT, 1948 Section 50—Burial of the Dead During the year five burials were carried out. In three instances the total cost was recovered and in one, part of the cost. The remaining one had to be written off as irrecoverable. REGISTRATION OF NURSING HOMES All Nursing Homes in the Borough must be registered with the Council under the provisions of the Nursing Homes Act, 1963. The Conduct of Nursing Homes Regulations, 1963, made under the Act lay down standards of facilities and services which can be enforced by the Council. Qualified nursing staff must be provided both by day and by night in sufficient numbers. Accommodation for patients must be of a high standard in regard to cleanlinesss, state of repair, equipment and facilities for treatment. The number of persons for which a Nursing Home is registered may not be exceeded without permission of the Borough Council. The number of Homes in the Borough now registered by the Council is eight, with a total of 271 beds. The following is a list of Nursing Homes in the Borough:— Alexian Brothers Nursing Home, Twyford Abbey, Twyford Abbey Road, N.W.10. Carlton Nursing Home, 1 Carlton Road, Ealing, W.5. The Lady Margaret Nursing Home, 87 Mattock Lane, W.5. Methuen Nursing Home, 13 Gunnersbury Avenue, W.5. Old Court Nursing Home, 19 Montpelier Road, Ealing, W.5. St. Anthony's Nursing Home, 40 Mount Park Road, W.5. St. David's Home, Castlebar Hill, Ealing, W.5. Servite House, Queens Walk, Ealing, W.5. 45 MEDICAL EXAMINATIONS In order to ensure that staff appointed to work for the Council in any capacity are fit to perform their specific duties efficiently, it is necessary for medical examinations to be carried out. These fall into two main categories. Those who seek permanent appointments in administrative, technical and clerical posts are examined at the time of appointment, and those who are admissible to the Sickness Pay Scheme of the National Joint Industrial Council for Local Authorities non-trading services are examined after 6 months service. The latter scheme enables some employees to be accepted with reservations as to conditions for which sickness pay is granted when otherwise they would fail the examination. The following examinations were carried out during the year:— Administrative, Technical and Clerical staff 65 Sickness Pay Scheme (Servants) 146 211 The Sickness Pay Scheme examinations may be further classified as follows:— Passed without Passed with No. examined reservation reservations 146 114 32 The conditions for which reservations were made were:— High Blood Pressure 4 Hernia 3 Hernia and Varicose Veins 1 Mental Illness 1 Tuberculosis 2 Diabetes 3 Varicose Veins 3 Bladder Disease 1 Cardio-vascular disease 1 Neurosis 1 Peptic Ulcer 1 Bronchitis 2 Acromegaly 1 Duodenal Ulcer 3 Asthma 1 Shoulder Injury 1 Filaria 1 Renal Calculus 1 Diverticulitis 1 46 SECTION 6 STATISTICAL TABLES SUMMARY OF STATISTICS Area (in acres) 8,781 Population (Census, 1961) 183,151 Population (estimated middle of 1964) 182,620 Rateable Value, 1st April, 1964 £12,375,355 Net Product of a Penny Rate, 1964/65 (Est.) £51,400 Live Births:— Legitimate Males 1,443 Females 1,410 Total Illegitimate Males 131 Females 100 Total 231 Birth-Rate per 1,000 of Estimated Population 16.8 Illegitimate Live Births (per cent of total live births) 75% Still-Births:— Males 9 Females 24 Total Rate per 1,000 total Births (Live and Still Births) 14 Deaths:— Males 1,059 Females 950 Total 2,009 Death-Rate for 1,000 of Estimated Population 11-0 Deaths of Infants under one year of age:— Legitimate Males 28 Females 20 Total 48 Illegitimate Males... 5 Females 1 Total 6 Death-Rates of Infants under one year of age:— All Infants per 1,000 Live Births 17.5 Legitimate Infants per 1,000 Legitimate Live Births 16.8 Illegitimate Infants per 1,000 Illegitimate Live Births 25.5 Neo-natal Mortality Rate (deaths under four weeks per 1,000 total live births) 13.2 Early Neo-natal Mortality Rate (deaths under one week per 1,000 total live births) 12.6 Perinatal Mortality Rate (still-births and deaths under one week combined per 1,000 total live and still births) 26 Maternal Mortality (including Abortion) Rate per 1,000 Live and Still Births Nil 47 48 Cases of Infectious and Other Notifiable Diseases notified in the Borough Disease 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 Smallpox – – – – – – – – – – – – Diphtheria – 1 – – – – – – 1 – – – Scarlet Fever 238 287 108 159 95 232 269 117 67 98 76 51 Enteric Fever (including Paratyphoid) 3 5 7 1 – – 1 1 2 1 – Puerperal Pyrexia 61 54 44 71 77 67 37 63 44 49 57 47 Pneumonia: Primary 157 152 135 113 72 94 97 30 37 45 68 29 Influenzal 74 52 56 48 99 57 57 16 33 24 29 14 Acute Poliomyelitis 13 5 61 46 2 2 2 – 1 – Meningococcal Infection – 6 3 2 2 3 2 2 1 1 1 – Malaria 3 1 1 – – 1 – – 1 – – – Dysentery 132 225 149 193 252 244 194 261 127 90 199 139 Erysipelas 18 18 12 12 13 19 9 17 6 7 6 7 Tuberculosis: Pulmonary 205 132 119 134 113 97 109 89 93 70 89 47 Non-Pulmonary 20 17 24 13 16 8 10 18 10 6 11 5 Ophthalmia Neonatorum – 2 2 2 5 6 3 3 2 1 – – Measles 2,558 132 2,422 726 1,854 975 1,928 50 3,250 286 2,072 354 Whooping Cough 491 116 156 67 131 85 90 258 51 19 93 80 Food Poisoning 31 78 36 26 20 18 39 20 15 7 11 7 Totals 4,004 1,284 3,335 1,612 2,752 1,908 2,844 945 3,741 705 2,714 780 The number of cases of infectious disease originally notified sometimes varies due to changes of diagnosis and the following table is therefore given to show the final numbers after correction. Disease Disease Smallpox — Malaria – Diphtheria — Dysentery 139 Scarlet Fever 51 Erysipelas 7 Enteric Fever (including Paratyphoid) — Tuberculosis: Pulmonary 47 Puerperal Pyrexia 47 Non-pulmonary 5 Pneumonia: Ophthalmia neonatorum — Primary 29 Measles 354 Influenzal 14 Whooping Cough 80 Acute Poliomyelitis — Total 779 Food Poisoning 6 Meningococcal Infection — 49 50 Infectious and Other Notifiable Diseases Classified in Age Groups Scarlet Fever Whooping Cough Poliomyelitis Measles Diphtheria Dysentery Meningococcal Infection Paralytic Non-Paralytic M F F M F M F M F M F M F M F M Numbers originally notified 23 28 30 50 — — — — 178 176 — — 59 80 — — FINAL number after correction: Under 1 year — — 3 5 — — — — 3 10 — — 1 4 — — 1— 1 — 1 3 — — — — 19 13 — — 2 1 — — 2— — 2 5 8 — — — — 20 27 — — 4 4 — — 3— 2 2 5 5 — — — — 24 29 — — — 2 — — 4— 4 2 4 6 — — — — 28 24 — — 1 2 — — 5—9 12 18 11 13 — — — — 83 73 — — 3 5 — — 10—14 3 2 1 5 — — — — — — — — 2 3 — — 15—24 1 2 — 3 — — — — — — — — 18 18 — — 25 and over — — — 2 — — — — 1 — — — 28 41 — — Age unknown — — — — — — — — — — — — — — — — Total 23 28 30 50 — — — — 178 176 — — 59 80 — —  Pneumonia Smallpox Acute Encephalitis Enteric or Typhoid Fever Paratyphoid Fevers Erysipelas Food Poisoning Infective PostInfectious M F M F M F M F M F M F M F M F Number originally notified FINAL numbers after correction: 19 24 – – – – – – – – – – 4 3 1 7 Under 5 years 4 4 – – – – – – – – – – – – – 2 5—14 2 4 – – – – – – – – – – – – – 1 15—44 4 8 – – – – – – – – – – 1 2 1 2 45—64 6 4 – – – – – – – – – – 3 1 – – 65 and over 3 4 – – – – – – – – – – – – – – Age unknown – – – – – – – – – – – – – – – Total 19 24 – – – – – – – – – – 4 3 1 5 Tuberculosis Other Notifiable Diseases Respiratory Meningitis & C.N.S. Other Original Other M F M F M F M F M F Numbers originally notified 31 16 – – 2 3 Puerperal Pyrexia FINAL numbers after correction: – 47 – 47 Under 5 years – – – – – – 5—14 – – – – – 1 Ophth. Neonatorum 15—24 3 3 – – – 1 – – – – 25—44 13 7 – – 1 1 45—64 13 3 – – 1 – Malaria 65 and over 2 3 – – – – – – – – Anthrax Total 31 16 – – 2 3 – – – – 51 52 TUBERCULOSIS Age Periods NEW CASES Pulmonary Non-Pulmonary 1959 1960 1961 1962 1963 1964 1959 1960 1961 1962 1963 1964 M F M F M F M F M F M F M F M F M F M F M F M F Under 5 1 2 – – 3 2 1 – 2 1 – – – – – – – – – – – – – – 5—14 4 – – 3 3 1 1 1 2 2 – – – – 1 – – – – – – – – 1 15—24 10 10 9 5 10 9 6 3 4 6 3 3 1 1 – 2 2 1 – — 1 1 – 1 25—44 24 11 13 22 17 6 14 13 20 9 13 7 – 1 2 8 2 2 – 1 3 2 1 1 45—64 31 4 21 6 24 8 19 5 24 5 13 3 3 – 3 2 1 2 – 2 1 2 1 – Over 65 3 5 5 3 8 2 5 2 9 5 2 3 1 3 — — – – – 3 – 1 – – Total 73 32 48 39 65 28 46 24 61 28 31 16 5 5 6 12 5 5 – 6 5 6 2 3 DEATHS Age Periods Pulmonary Non-Pulmonary 1959 1960 1961 1962 1963 1964 1959 1960 1961 1962 1963 1964 M F M F M F M F M F M F M F M F M F M F M F M F Under 5 – – – – – – – – – – – – – – – – – – – – – – – – 5—14 – – – – – – – – – – – – – – – – – – – – – – – 1 15—24 – – – – – – – – – – – – – – – – – – – – – – – 1 25—44 – – 2 – – 1 – – – 2 1 – – – – – – – – – – – 1 1 45—64 1 2 3 1 2 2 4 1 4 1 3 – – – 1 – – – – 1 – – 1 – Over 65 1 1 3 1 2 — 2 1 6 – – – – 1 – – – – – – 1 – – – Total 2 3 8 2 4 3 6 2 10 3 4 – – 1 1 – – – – 1 1 – 2 3 DEATHS Causes of Deaths, 1964 Cause of Death Deaths, 1964 Total Deaths 1963 Male Female Total Tuberculosis, Respiratory 4 – 4 13 Tuberculosis, Other – – – – Syphilitic Disease 1 – 1 – Diphtheria – – – – Whooping Cough – – – – Meningococcal Infections – – – – Acute Poliomyelitis – – – – Measles – – – – Other Infective and Parasitic Diseases 2 2 4 8 Malignant Neoplasm, Stomach 38 15 53 45 „ „ Lung, Bronchus 87 13 100 125 Breast – 40 40 42 Uterus – 9 9 20 Other Malignant Lymphatic Neoplasms 99 114 213 193 Leukaemia, Aleukaemia 8 5 13 16 Diabetes 4 7 11 13 Vascular Lesions of Nervous System 105 146 251 297 Coronary Disease, Angina 266 163 429 470 Hypertension with Heart Disease 16 20 36 31 Other Heart Diseases 87 123 210 278 Other Circulatory Disease 38 57 95 100 Influenza 1 – 1 5 Pneumonia 77 67 144 176 Bronchitis 80 35 115 150 Other Diseases of Respiratory System 7 4 11 25 Ulcer of Stomach and Duodenum 5 7 12 6 Gastritis, Enteritis and Diarrhoea 2 10 12 10 Nephritis and Nephrosis 4 – 4 10 Hyperplasia of Prostate 10 – 10 4 Pregnancy, Childbirth, Abortion – – – – Congenital Malformations 8 6 14 20 Other Defined and Ill-defined Diseases 63 76 139 149 Motor Vehicle Accidents 22 10 32 26 All other Accidents 11 13 24 38 Suicide 14 7 21 28 Homicides and Operations of War – 1 1 1 Totals 1,059 950 2009 2,300 53 SECTION 7 SCHOOL HEALTH SERVICE The School Health Service, in close co-operation with the Education Department, was able to meet all the statutory requirements of this service. Most of our handicapped pupils can be placed in special schools in reasonable time. The child with two or more handicapping conditions continues to present problems of education. As a temporary measure, home tuition is a short-term solution, but the long-term solution occasions many difficulties. The following statistical tables and brief reports of the specialised service reflect no great change in the pattern of recent years. ROUTINE MEDICAL INSPECTIONS Numbers Examined 1962 1963 1964 First age group 2,071 2,438 2,531 Second age group 1,989 2,017 1,823 Third age group 3,246 1,965 2,316 Total 7,306 6,420 6,670 Classification of General Condition Satisfactory 6,660 Unsatisfactory 10 Defects requiring Treatment found at Routine Medical Inspection 1962 1963 1964 Skin Diseases 445 478 468 Defective Vision 699 686 680 Squint 36 43 56 Defects of Hearing 135 97 172 Middle Ear Diseases 10 12 9 Nose and Throat Diseases 127 148 224 Speech Defects 45 51 58 Enlarged Glands 5 – 3 Heart—Circulation conditions 24 12 26 Lung Diseases 38 46 40 Hernia 2 11 11 Postural Defects 18 30 15 Orthopaedic Foot Defects 113 126 102 Epilepsy 2 1 1 MINOR AILMENT CLINICS Total attendances 499 54 HANDICAPPED CHILDREN The following table sets out in their various categories the number of handicapped pupils as at 31st December, 1964. In Special Day Schools In Special Residential Schools In maintained Primary and Secondary Schools Not at School Total M F M F M F M F M F Blind Pupils – – 3 4 – – 1 1 4 5 Partially-sighted Pupils 4 6 – 1 – – – – 4 7 Deaf Pupils 2 1 1 2 – – – – 3 3 Partially-deaf Pupils 11 3 1 1 3 – – 1 15 5 Educationally sub-normal Pupils 61 40 8 9 12 5 2 2 83 56 Epileptic Pupils – – – 1 – – – – – 1 Maladjusted Pupils 33 12 62 17 13 4 1 1 109 34 Physically Handicapped Pupils 11 10 4 3 5 1 1 2 21 16 Pupils with Speech Defects – – – – 9 1 – – 9 1 Delicate Pupils 15 3 7 7 5 3 2 – 29 13 Pupils with Multiple Defects – – – – – – – – – – Total 137 75 86 45 47 14 7 7 277 141 EDUCATION ACT, 1944 Section 57 Cases dealt with under Section 57, Education Act, 1944 5 INFESTATION WITH VERMIN Number Examined 15,231 Number Infested 49 B.C.G. VACCINATION Details of school children offered protection against tuberculosis by B.C.G. vaccination through the approved arrangements under Section 28 of the National Health Service Act, 1946, during the year ended 31st December, 1964, are as follows:— 1. Number of children whose parents consented to participate 1,598 2. Number of those who were tested and found to be (a) Negative 1,499 (b) Positive 65 3. Number of those who were given B.C.G. vaccination 1,498 SPEECH THERAPY The Speech Therapy Department has managed to meet its commitments satisfactorily during the past year in spite of a continuing shortage of staff. To achieve this position it has been necessary to discontinue the service at those clinics where the number of patients was small and this has meant that these patients have had to travel some distance in order to receive treatment. Nevertheless, regular sessions are 55 still held at all the main clinics and treatment where indicated may be started from about the age of 3½ years old. The Speech Class at Brentside Infants School caters for up to 10 pupils with speech defects of such a degree that they are thought to be unable to communicate sufficiently to benefit from attendance at an ordinary class. The small number of pupils in the class is, of course, a great advantage in giving these children the individual attention that they require. A Speech Therapist visits the class weekly in order to give individual speech therapy to the children in addition to discussion and liaison with the class teacher. During the year 10 children were admitted, and four discharged. The figures for the year are as follows:— Number on roll at 1st January, 1964 225 New cases during the year 107 Number discharged 76 Number on roll at 31st December, 1964 256 Number of attendances at Speech Therapy Clinics . 2,548 The types of speech defect treated follow the established pattern:— 1. Dyslalia—omission or substitution of consonants 151 2. Developmental aphasia—delayed or absent speech 58 3. Stammering 35 4. Dysarthria—physical defects of the speech organs 6 5. Aphasia associated with mental subnormality 5 6. Dysphonia 1 ASTHMA CLINIC The Asthma Clinic under the supervision of one of the School Medical Officers continues to provide a valuable service. A Physiotherapist with a particular interest in breathing exercises carries out small group treatment in suitable cases. This form of treatment, although time-consuming, is very beneficial and older children are encouraged to continue exercises in their own homes. During the year there were 132 attendances at the clinic, 40 of these being first attenders. FOOT HEALTH This report last year described the making of a health educational film by Dr. Catharine Hollman on children's feet. Called "52 Small Bones", the film has proved popular with many authorities. The film was submitted to the British Medical Association Film Competition for 1964 and it is gratifying to report that it has received a Gold Award. 1964 saw a resurgence of national interest in the Foot Health of Children, due mainly to a wide press cover of two meetings. The first, in April, was the British Medical Association's Annual Clinical Meeting at Northampton. This being the centre of the shoe industry, it was decided to include a session on the Prevention of Foot Deformities, in which Dr. Hollman was invited to participate. Later in the year, in November, the British Medical Association called a conference entitled "The Health of Children's Feet" at which shoe manufacturers, shoe retailers, parents, medical profession, consumer council, etc., were well represented. Dr. Hollman spoke again at this meeting, particularly on the findings of the Ealing Foot Health Scheme 56 and showed her film. Four recommendations were adopted at the end of this meeting for submission to the Department of Education and Science. They were:— 1. A school foot care service should be established; this service to include regular inspection of children's feet and footwear. 2. There should be control of footwear in school, this footwear to be of approved design. 3. All approved footwear to be free of purchase tax. 4. That the Government be requested to increase its efforts of health education in this connection. Ealing has, of course, provided a school foot care service for many years and indeed has led the way in this respect. It is almost certain that schemes similar to ours will be adopted throughout the rest of the country in the future. The routine work of this department during the year is as follows:— Children inspected 9,761 Referrals to Doctor 129 Referrals to Chiropodist 78 Verrucae 86 Defective shoes 3,295 Everted ankles 94 Hallux Valgus 2,470 Tinea 137 % of children inspected 1.3 •8 •8 34.0 •8 25.0 1.4 ORTHOPAEDIC CLINIC Mr. J. A. Cholmeley, the Orthopaedic Consultant reports:— During the year attendances were as follows:— Pre-School Children New Cases Re-examinations Total Attendance 1963 1964 1963 1964 1963 1964 82 96 178 174 260 270 School Children New Cases Re-examinations Total Attendance 1963 1964 1963 1964 1963 1964 75 93 235 267 310 360 EAR, NOSE AND THROAT SERVICE Mr. R. Savege, Consultant Otologist, reports:— "The figures for the year show an increase in the number of cases in each category, but this does not indicate, I think, an increase in E.N.T. defects, and is probably the result of an increased school population." 57 The statistical report is as follows:— 1962 1963 1964 Number of new cases 141 120 180 Number of re-inspections 319 237 344 Total attendances 460 357 540 Medical Treatment advised 199 114 242 Surgical Treatment advised 77 67 109 Audiometry Report 1962 1963 1964 Number of schools visited 57 48 39 Number of children tested 6,242 5,090 5,921 Number of children with hearing loss 183 156 175 Number referred to E.N.T. Specialist 84 59 61 OPHTHALMIC SERVICE Mr. G. Freeman-Heal, Consultant Ophthalmologist, reports:— "The total number of cases seen was 1,017 (1963-925) of which 335 (1963-230) were new cases and 682 (1963-695) were re-inspections. The number of pairs of glasses prescribed was 556 (1963-529)." Abnormal Eye Conditions other than Errors of Refraction were as follows:— Congenital Abnormalities New Cases Old Cases Squint 46 151 Congenital Nystagmus 1 2 Ptosis — 1 Cataract 1 1 Absence of punctum — 1 Occlusion of nasal duct 2 - Defective extra-ocular muscles 1 1 Abnormalities due to Infection Blepharitis 3 - Chronic conjunctivitis 2 - Meibomian Cyst 1 - Hordeolum 1 - Retinitis (Toxoplasmosis) — 1 Abnormalities due to Trauma Cataract 1 - Optic Atrophy 1 - Neoplasms Glioma Retinae 1 - Abnormalities of Unknown Etiology Macular Degeneration - 1 58 EALING CHILD GUIDANCE CENTRE Dr. Portia Holman, Consultant Psychiatrist, reports:— "The number of patients referred to the Child Guidance Ciinic in 1964 was considerably in excess of those treated; for various reasons the complete diagnostic procedure is not followed in all cases. The psychiatrists saw 283 cases during 1964 and 112 new cases were taken on for treatment or remedial teaching. During the year eight children were admitted to Aston School." REPORT ON THE SCHOOL DENTAL SERVICE IN EALING Mr. L. Mandeville, the Area Dental Officer, reports:— "The School Dental Service has had a year of increasing demand and the dental staff has been more settled than for some time past. The pattern of demand in each clinic catchment area tends to change with changing staff and the school dental officer has to build and maintain his 'practice' in much the same way as any other dental practitioner. With a considerable choice of private dental surgeons available in much of the Area it is a tribute to our staff that so many parents feel their children get treatment with especial understanding of their dental problems and needs at the School Clinic. There is an urgent need for increased facilities at Cherington House Clinic, where the dental suite is quite inadequate in size and design. There is a seemingly evergrowing demand for treatment at this clinic and the dental surgeon is hard-pressed to meet it. Unfortunately there is no quick and easy solution to this problem as rebuilding of the dental unit can only be undertaken when considering the redevelopment of the clinic as a whole. It is growing increasingly difficult to recruit dental surgery assistants of the right calibre. These ladies are essential to the smooth and efficient running of the dental surgeries and they have considerable responsibilities. Even though we co-operate with the Chiswick Polytechnic in providing practical surgery experience for the pupil surgery assistants attending the full-time course there, none of them has elected to work for us on qualification. The opportunities of private practice seem to be a greater attraction. This is a problem that is becoming acute in the whole London area and it is likely that steps will have to be taken to improve the conditions of service in order to recruit staff of the right type. With the changes in London local government that are upon us this is especially a time to look ahead. We have now two new clinics where facilities have been provided for the employment of dental auxiliaries. This experiment provides for the two-year training of female students at the New Cross Hospital. They are trained in the simpler dental procedures for children after qualification work in local authority clinics under the supervision of a qualified dental surgeon. Neighbouring Areas have found that these auxiliaries have a valuable part to play in the treatment of young children and in dental health education. During the year the dental staff participated in two field surveys into particular aspects of dental health. The first was a survey of the dental state of children of schoolleaving age in the County of Middlesex, and the second, which was carried out in part by health visitors and clinic nurses as well as dental staff, was a Ministry of Health survey of children of 3-3½ years in which the dental state and use of various vitamin supplements were investigated. Results of neither survey have been published at the time of writing, but it can be stressed that research of this nature is essential 59 if the dental services as a whole are to be evaluated and future needs as to dental treatment and dental health education properly assessed. Increase in dental staff alone will never catch up with the growing demand and need for modern dental treatment. Dental Health Education of parents and children is likely to become a major part of our activities and school medical as well as dental staff will be drawn into this." Attendances Completing Treatment Fillings Permanent Teeth Fillings Temporary Teeth Extractions Permanent Teeth Extractions Temporary Teeth Orthodontic Treatment New Cases 15,785 6,128 9,174 4,998 626 1,952 251 MEDICAL EXAMINATION OF TEACHERS Number of Teachers examined as to fitness for appointments 81 60 SUPPLEMENT—FOR GENERAL INFORMATION HEALTH SERVICES PROVIDED BY THE LOCAL HEALTH AUTHORITY The Local Health Authority Services, which were provided by the Middlesex County Council during 1964, are now as detailed below. MATERNITY AND CHILD WELFARE Ante-Natal Clinics Regular sessions for expectant mothers are held at the health clinics by doctors and mid wives. Arrangements are made for blood testing, chest X-rays and for distribution of iron and vitamins. Mothers are also given the opportunity of attending ante-natal exercises and mothercraft classes. During the year 2,197 expectant mothers attended clinics in Ealing. Child Welfare Clinics Advice to mothers on the care of their children is given at Health Clinics by doctors and health visitors. There are seven medical officers and 24 health visitors engaged in this work in Ealing. Children are weighed at each attendance and a careful watch kept on all aspects of their progress. Welfare and other foods are distributed. In addition to the clinic work, home visiting by health visitors forms a useful link with the clinics. During the year 8,041 children attended clinics in Ealing. Ante-Natal Clinics (By Appointment) Ealing Address Abbey Parade, North Circular Road, Ealing, W.5 Brentside, Westcott Crescent, Hanwell, W.7 Cherington House, Cherington Road, Hanwell, W.7 Greenford Green, Wadham Gardens, Greenford Islip Manor, Eastcote Lane, Northolt Laurel House, Windmill Road, Ealing, W.5 Mattock Lane, 13 Mattock Lane, Ealing, W.5 Northolt Grange, Edward Road, Northolt Perivale, Horsenden Lane, Greenford Ravenor Park, Oldfield Lane, Greenford Times Monday afternoons Wednesday mornings Monday mornings Monday mornings Wednesday mornings Thursday mornings Monday & Thursday mornings Friday afternoons Wednesday mornings Thursday mornings Acton Avenue Road, 43/47 Avenue Road, Acton, W.3 Cloister Road, Acton, W.3 Pierrepoint Road, 3 Pierrepoint Road, Acton, W.3 Trinity Way, Acton, W.3 Wednesday afternoons Friday mornings Wednesday mornings Tuesday afternoons 61 Southall Jubilee Gardens, Southall King Street, 13 King Street, Southall Northcote, Northcote Avenue, Southall Friday mornings Tuesday mornings Tuesday mornings Child Welfare Clinics Ealing Address Abbey Parade, North Circular Road, Ealing, W.5 . Brentside, Westcott Crescent, Hanwell, W.7 Cherington House, Cherington Road, Hanwell, W.7. Greenford Green, Wadham Gardens, Greenford Islip Manor, Eastcote Lane, Northolt Northolt Grange, Edward Road, Northolt Laurel House, Windmill Road, Ealing, W.5 Mattock Lane, 13 Mattock Lane, Ealing, W.5 Perivale, Horsenden Lane, Greenford Ravenor Park, Oldfield Lane, Greenford Acton Avenue Road, 43/47 Avenue Road, Acton, W.3 Cloister Road, Acton, W.3 Pierrepoint Road, 3 Pierrepoint Road, Acton, W.3 Steele Road, Acton, W.4 Trinity Way, Acton, W.3 Southall Jubilee Gardens, Southall King Street, 13 King Street, Southall Northcote, Northcote Avenue, Southall HOME NURSING SERVICE There are 20 full-time Home Nurses and eight part-time Home Nurses in Ealing, including two male nurses. During the year 64,252 visits were made to 2,493 patients. Times Tuesday & Friday 2-4 p.m. Wednesday 2-4 p.m. Monday, Tuesday & Thursday 2-4 p.m. Tuesday, Wednesday & Friday 2-4 p.m. Monday & Thursday 2-4 p.m. Tuesday 2-4 p.m. Friday 10-12 a.m. Monday & Thursday 2-4 p.m. Monday, Wednesday & Friday 2-4 p.m. Monday & Thursday 2-4 p.m. Monday, Tuesday, Wednesday & Friday 2-4 p.m. Monday & Thursday 2-4 p.m. Tuesday & Friday 2-4 p.m. Tuesday, Wednesday, Thursday & Friday 2-4 p.m. Monday & Thursday 2-4 p.m. Monday & Thursday 2-4 p.m. Tuesday & Thursday 2-4 p.m. Tuesday & Friday 2-4 p.m. Monday & Friday 2-4 p.m. 62 The object of the service is to supply nursing care for those whose illness can be as well treated at home as in hospital. An increasing amount of the work is concerned with the elderly in helping to keep them in the community. 1964 saw a major advance in injection technique. All syringes used by Home Nurses in Ealing were of the disposable type. These are sterilized by Gamma radiation and are used once. The only exception is for patients such as diabetics who have a personal syringe for their treatment. Day and night nursing assistance is now available for patients with terminal carcinoma through the Marie Curie Foundation who will also provide grants for extra nourishment, etc. These services have been greatly appreciated. The services of a home nurse are available at the request of the patient's medical practitioner or hospital medical officer. Application should be made to the Health Department, Town Hall Annexe, Ealing, W.5. DOMICILIARY MIDWIFERY SERVICE There is a staff of 14 Midwives in Ealing. There were 666 home confinements in Ealing in 1964, compared with 708 in 1963. The number of pupil midwives who received district training during the year was 17. Patients suitable for home confinement are those who, it is expected, will have an uncomplicated delivery and whose home circumstances are satisfactory. Because of the extra demand for maternity hospital beds an extra domiciliary midwife has been appointed to nurse midwifery patients who can be discharged from hospital 48 hours after delivery. These patients are very carefully selected and are discharged only if both mother and baby are fit. The inception of this scheme in 1962 was received with some misgiving, the impression being that patients would be asked to leave hospital before they were fit to do so. Experience has proved it to be a very popular idea and mothers participating say they consider they are getting "the best of two worlds". They are particularly pleased to get home if they have other young children. Wherever possible the midwife who visited the patient during the antenatal period will be the midwife who attends the patient when she comes home on the 2nd day. A heated portable incubator, with facilities for the administration of oxygen, is available to transport premature infants from home to hospital. The incubator is kept at the Boston Road Ambulance Station from where it can be sent to any part of the Borough where it is required. Applications for the services of a midwife should be made through a Maternity and Child Welfare Clinic. HOME HELP SERVICE The Home Help Service provides domestic help in time of illness. All normal household duties, including shopping, cooking, washing, cleaning, and looking after children are undertaken. There is an equivalent of 155 full-time home helps in Ealing. At the end of the year there were over 1,000 cases receiving help. The order of priority 1962 67 1963 151 1964 306 63 is acute sick, maternity cases, tuberculosis and chronic sick and aged. Nevertheless, over 75% of those helped were old people. Payment is based on the patient's resources and ranges from no charge to 4s. 9d. per hour. The object of the service is to supplement assistance available from relatives, etc., and to tide patients over in emergency rather than supply permanent domestic help. During the year the night service was continued. Attendance is from 11 p.m. to 7 a.m. and the duties of the helper consist of sitting with and giving general care to the patient. This has proved most valuable. Applications for the services of either a day or night home help should be made, accompanied by a medical certificate, to the Medical Officer of Health, Town Hall Annexe, Ealing, W.5. Family Help Scheme This service is designed to deal with three categories of cases. (1) The family help takes the place of the mother in her absence, assumes responsibility for the home, the children and the finances and resides at the home. (2) The family help takes the place of the mother in her absence, assumes responsibility for the home, the children and the finances in the day time only, but is non-resident. The father or other relative takes over at night. (3) The family help is employed for some part of the day to assist and advise the mother who, although resident with her family, requires to be taught how to manage her household affairs and to budget sensibly. The total number of cases dealt with during the year was 2 and this has been made up as follows: In category (1) Nil In category (2) Nil In category (3) 2 A charge is made on a weekly basis according to the applicant's income and expenditure. Applications for the service should be made to the Children's Officer, 26 Castlebar Road, W.5. Good Neighbour Scheme This service is to help cases that require attention outside the normal Home Help hours of duty. The Home Help who acts as a good neighbour attends a patient without fixed times so that assistance is given when needed. The Good Neighbour is paid according to the time involved up to a maximum of £2 a week the full charge to the patient being the same amount paid to the Good Neighbour but this can be reduced if the patient is unable to meet the full sum. At the moment we have seven Good Neighbours. It will be appreciated that it is not a job which is taken on lightly, implying as it does considerable responsibility for the patient. It also means that the Good Neighbour commits herself to being available during evenings and nights. The scheme has proved most helpful in cases where a suitable Good Neighbour who lives nearby has been prepared to undertake this work. 64 DAY NURSERIES There are two Day Nurseries in Ealing for the care of children under five years of age. One nursery is situated in Culmington Road, and has accommodation for 40 children. The other nursery is in Greenford and has accommodation for 50 children. Both the Day Nurseries are recognised training centres, and girls of 16 are accepted for a two years' training for the National Nursery Examination Board's Diploma. Admission of children is restricted to:— (i) Those whose mothers have of necessity to go out to work because they are the sole supporters, e.g. if they are widowed, divorced, separated or unmarried. (ii) Where the home conditions are unsatisfactory. (iii) Admission is arranged to include children who are physically handicapped, particularly those who are deaf or partially deaf, maladjusted, or partially sighted. Similarly, children whose parents are deaf or dumb and who would therefore lack the normal talking environment in the home, are admitted. In all these instances there is no charge to the parents. The nurseries are open from 7.30 a.m. to 6 p.m. A charge is made for this service on a sliding scale based on the parents' income. All applications for admission to a Day Nursery should be made to the Medical Officer of Health, Town Hall Annexe, Ealing, W.5. CHIROPODY The County Council operated a Chiropody Service under Section 28 of the National Health Service Act in conjunction with the British Red Cross Society. The standard charge for this service is 8s. per treatment. This is reduced for Old Age Pensioners to 4s. per treatment, irrespective of income. Charges are waived altogether where the joint income of an elderly couple is less than £8 per week, or for a single person less than £5 per week. No charges are made to handicapped persons or nursing or expectant mothers (for this purpose, a nursing mother is classified as such for a period of one year following the birth of her child). Treatment given during the year was as follows:— British Red Cross Society County Council Total number of new patients 45 362 Total number of treatments 2,700 3,580 Number of patients receiving domiciliary treatment 180 99 Number of domiciliary treatments 1,080 576 Expectant and nursing mothers — 11 Physically handicapped persons — 9 The service is provided at most of the Local Authority clinics, and some community centres; in addition visits are made to old people's homes. Where necessary ambulance transport can be provided. 65 Treatment is given in the following places:— Clinics Avenue Road, 43/47 Avenue Road, Acton, W.3. Brentside, Westcott Crescent, Hanwell, W.7. Cherington House, Cherington Road, Hanwell, W.7. Cloister Road, Acton, W.3. Greenford Green, Wadham Gardens, Greenford. Islip Manor, Eastcote Lane, Northolt. Laurel House, Windmill Road, Ealing, W.5. Mattock Lane, 13 Mattock Lane, Ealing, W.5. Northcote, Northcote Avenue, Southall. Perivale, Horsenden Lane, Greenford. Ravenor Park, Oldfield Lane, Greenford. Trinity Way, Acton, W.3. Community Centres Northolt—Manor House, Church Road, Northolt, Greenford. Northfields—71 Northcroft Road, Ealing, W.13. Surgeries 120 Uxbridge Road, Hanwell, W.7. Private Surgeries at which the British 234 Northfield Avenue, Ealing, W.13. Red Cross conduct some sessions 129a Greenford Avenue, Hanwell, W.7. under the Middlesex scheme. Old People's Homes Northolt House, Haydock Avenue, Northolt. Kolbe House, Hanger Lane, Ealing, W.5. Servite House, Queens Walk, Ealing, W.5. St. Mary's Almshouses, Church Gardens, Ealing, W.5. Torkington House, Creswick Road, Acton, W.3. Ealing Day Treatment Centre Green Lane, Hanwell, W.7. 66