Library EAS 31 COUNTY BOROUGH OF EAST HAM ANNUAL REPORT of the Medical Officer of Health For the Years 1953 and 1954 JOHN S. COLEMAN, m.b., b.s. (lond.) m.r.c.s. (eng.) l.r.c.p. (lond.), d.p.h. (eng.) Medical Officer of Health & Principal School Medical Officer. COUNTY BOROUGH OF EAST HAM ANNUAL REPORT of the Medical Officer of Health For the Years 1953 and 1954 JOHN S. COLEMAN, m.b., b.s. (i.ond.) m.r.c.s. (eng.) l.r.c.p. (lond.), d.p.h. (eng.) Medical Officer of Health & Principal School Medical Officer. PRINCIPAL CONTENTS SECTIONS:- Constitution of Council Public Health Staff Introduction Statistical and Social Conditions of Area General Provision of Health Services Infectious Diseases National Health Service Act, 1946:- Sec. 22 Care of Mothers and Young Children . Sec. 23 Midwifery Services Sec. 24 Health Visiting Services Sec. 25 Home Nursing Services Sec. 26 Vaccination and Immunisation Sec. 27 Ambulance Services Sec. 28 Prevention of Illness, Care and After-Care Sec. 28 & 51 Mental Health Services Sec. 29 Home Help Services Sanitary Section and Hous Inspection and Supervision of Food PAGES 3 5 9 12 25 28 45 58 62 63 65 67 71 75 81 83 88 3 EAST HAM CORPORATION COUNCIL (shewing Chairmen and Vice-Chairmen of Health, M. & C.W., Mental Health and Education Committee) THE MAYOR: Mr. Alderman Leslie Alfred Victor Bennett, J.P. (1953/4) Mr. Councillor Frank Herbert Howard, J.P. (1954/5) THE DEPUTY MAYOR: Mr. Councillor Francis William French (1953/4) (10) Mr. Councillor Charles Frederick Chapman (1954/5) ALDERMEN: Mr. William Henry Whittock Beecham Mr. Charles William Brading, J.P., C.R.P. Mr. Charles William Dixon Mr. John Albert Hart, J.P. (8) Mr. Walter Edwin Hurford Mr. Herbert Percy Jackson, J.P. (9) Mrs. Winifred May Knight Mr. Alfred Prior, J.P. Mr. Ernest Albert Wood, J.P. COUNCILLORS: Mrs. Agnes Ann Bradshaw Mr. Frederick George Bryce Clayton Mrs. Ruby Lilian Collett Mrs. Amy Beatrice Cowlan (1953/4) (5) Mrs. Daisy May Davey Mr. Edwin John Davey (4) Mrs. Elsie Mary Devenay Mr. William Doran Mr. Frederick Robert Easter (1954/5) (1) (7) Mr. Sidney Arnold Elson Mr. Charles Edward Ellett (1954/5) Mr. Terence James Albert Green Mr. Leonard Lewis Griffiths Mr. William Hogarth (2) Mr. Arthur Henry Richard Huggett Mr. Reginald Arthur James (1954/5) Mr. Thomas Alfred Jenklnson Mr. John Alfred Kemp Mr. George Charles Lay (1953/4) Mr. George Edward Marshall (1953/4) Mr. Arthur Richard Miller Mr. Arthur George Murrell Oakes Mr. John Henry Pagett Mr. Reuben Frederick Ricketts Mr. Albert Cyril Smith Miss Florence Louise Stevens (1953/4) Mrs. Lily Sutton Mr. Joseph Charles Taylor (3) (6) Mr. Norman Roy Thomas Mrs. Dorothea Minnie Wood Mr. Thomas Henry Wood (1954/5) 4 Co-opted members of the Health, M. & C.W., Mental Health and Education Committees;- Dr. O. Thomas Mr. N. Glickman Health Mrs. A.E. Hayes (1954/5) Mrs. D.M. Hill Mrs. I.F. MacDonald (1953/4) Mrs. M. Page Alderman Mrs. D, Parsons, J,P. (1953/4) Mrs. A.A. Woodman, M.B.E. Maternity and Child Welfare Mr. S.C. Foreman Mrs. E. Gadd (1954/5) Mr. W. Harman (1953/4) Mr. H.F. McNeil Mental Health Rev. v. Hurley Mrs. M.E„ Bennett Mr. C. Ellett Mr. J. Huxtable (1954/5) Mr. J. Hugg (1954/5) Mr. F.J. Phillips (1953/4) Mr. H.J. Pitt Dr. L.G. Whitehead, Ph.D., B.Sc. (1953/4) Mr. L.S.J. Witter, B.Sc. Education (1) Chairman, Health Committee (1953/4 & 1954/5) (2) Vice-Chalrman, Health Committee (1953/4) (3) " " " " (1954/5) (4) Chairman, Maternity & Child Welfare Sub-Committee (1953/4) (5) " " " " (1954/5) (6) Chairman, Mental Health Sub-Committee (1953/4) (7) " " " " (1954/5) (8) Chairman, Education Committee (1953/4) (9) " " " (1954/5) (10) Vice-Chairman, Education Committee (1953/4 & 1954/5) 5 PUBLIC HEALTH OFFICERS OF THE AUTHORITY A. Medical - whole-time. J.S. COLEMAN, M.B., B.S., M.R.C.S., L.R.C.P., D.P.H., Medical Officer of Health and Principal School Medical Officer. † A.W. HAY, M.B., B.S., D.P.H., Deputy Medical Officer of Health and Deputy Principal School Medical Officer * D.E. CULLINGTON, M.A., M.B., Ch.B., M.R.C.S., L.R.C.P., D.P.H., Deputy Medical Officer of Health and Deputy Principal School Medical Officer. J. TWELLY REES, M.R.C.S., L.R.C.P., Assistant Medical Officer † GEORGETTE CROSBY, M.R.C.S., L.R.C.P., Assistant Medical Officer STELLA MARGARET BERYL PERRY, M.B., Ch.B., D.P.H., Assistant Medical Officer FREDA GASKELL, M.R.C.S., L.R.C.P., Assistant Medical Officer ø GERALDINE O'CALLAGHAN, M.B., Ch.B., B.A.O., D.P.H., Assistant Medical Off leer. * JOHN JOSEPH DUFFY, M.B„, Ch.B., D.P.H., Assistant Medical Officer † MARY BRIDGET GALVIN, M.B., Ch.B., B.A.O.(Dublin), Assistant Medical Off leer Medical - part-time. R. SAVEGE, M.B., Ch.B., F.R.C.S. (Edin.)., Aural Surgeon. H. BEVAN JONES, M.R.C.S., L.R.C.P., D.P.M.Eng. Psychiatrist. R.A. MORRIS, M.R.C.S., L.R.C.P., D.O.M.S., Ophthalmic Surgeon. Miss E. HUBAND, M.A., M.R.C.S., L.R.C.P., D.P.M., Psychiatrist, Mrs. A. MARSDEN, M.B., Ch.B., D.A. Anaesthetist. K.W. LEON, M.R.C.S., L.R.C.P. Anaesthetist. † H.S.A. HENRY, M.B., B.Ch., D.L.O., E.N.T. Registrar. B. Dental Surgeons Allan ROSS, M.R.C.S., L.R.C.P. B.D.S., L.D.S., R.C.S., Senior Dental Officer Ire SCHACHTER, M.D. (Vienna). Alan Spinner O'SHAUGHNESSY, B.D.S., L.D.S. † Rodney Seymour GLICKMAN, L.D.S., R.C.S. (Part-time) C. Sanitary and Food Inspectors:- D.G. TONKIN, M.S.I.A., Chief Sanitary Inspector, Food and Shops Act Inspector. L. PINGUEY, M.S.I.A., M.R.S.I. L.W. COLE, M.S.I.A., A.R.S.I. † A. COOK R. DAW, M.S.I.A. † J.A. FISH, M.S.I.A., A.R.S.I. A.J. GOFFIN, M.S.I.A. † B.S. HARRAWAY † J.I. MILES, M.S.I.A. E.W. PATRICK F.W. REEVE, M.S.I.A. * J.H. RILEY, M.S.I.A. A.S. WHITE, M.S.I.A. * H.F. WILLIAMS, M.S.I.A., M.R.S.I. Shops Act Inspector:T. GILBERT 6 D. Nursing Staff:- Superintendent Nursing Officer:- * B.M.A. Newman-Pilkington, S.R.N., S.C.M. H.V.'s Cert. (R.S.I.) † M. SHIRLAW, S.R.N., S.C.M. H.V.'s Cert. Q.N. Superintendent Health VI si tor:- B.L. MARYON, S.R.N., S.C.M., H.V.'s Cert. (R.S.I.) Unified Nursing Service (Health Visitors and School Nurses):- M. PRESTON, S.R.N., S.C.M., H.V.'s Cert. (R.S.I.) * M.K. PRESSEY, S.R.N., S.C.M., H.V.'s Cert. (R.S.I.) B. WALTERS, S.R.N., S.C.M., H.V.'s Cert. M. OOLDEN, S.R.N., S.C.M., H.V.'s Cert. * P. CULLIS, S.R.N., S.C.M., H.V.'s Cert. S. GOLDEN, S.R.N., C.M.B. (Part 1), H.V.'s Cert (R.S.I.) * M.J. PYE, S.R.N., C.M.B. (Part 1), H.V.'s Cert. (R.S.I.) V. WILDBORE, S.R.N., S.C.M., H.V.'s Cert. S.P. BURROWS, S.R.N., C.M.B. (Part 1), H.V.'s Cert. E.M. PHILLIPS, S.R.N., S.C.M., H.V's Cert. * E.M. ABRAHAM, S.R.N., S.C.M., H.V.'s Cert. A. CARTER, S.R.N., C.M.B. (Part 1), H.V.'s Cert. K.M. BOLT, S.R.N,, C.M.B. (Part 1), H.V.'s Cert † J.W. DOUGLAS, S.R.N., C.M.B. (Part 1), H.V.'s Cert. * W.J. HUNTING, S.R.N., S.C.M., H.V.'S Cert. G. KAVANAGH, S.R.N., S.C.M., H.V.'S Cert. † W.V. TALBOT, S.R.N., S.C.M., H.V's Cert. * F. KEVILL, S.R.N., C.M.B. (Part 1), H.V.'s Cert. † N.M. LEMAITRE, S.R.N., R.F.N., S.C.M., H.V.'s Cert. * C.C. PLANT, S.R.N., S.C.M., H.V.'s Cert. † V.I. MACDONALD, S.R.N., S.C.M., H.V.'s Cert. V.R. PRUDDEN, S.R.N., S.C.M., H.V.'s Cert. † J.H. THOMAS, S.R.N., C.M.B. (Part 1), H.V.'s Cert. J. WATT, S.R.N., C.M.B. (Part 1), H.V.'s Cert. † J.C. WURR, S.R.N., C.M.B. (Part 1), H.V.'s Cert. C.G. CASE, R.F.N., A.R.S.I. Dental Nurses:- C.M. STRACHAN. M. LOBSENZER. F.E. HUNT. Physiotherapists and Light Sisters:- E.B. BROOME, S.R.N., C.S.M., L.E.T., M.S.R. E.F.M. BOSS, S.R.N., M.S.R., C.S.P. Tuberculosis Nurses:- F.M. ROGERS, S.R.N., R.A. (Cert) H.O. FORD, S.R.N., T.A. (Cert.) S.T. ROBERTS, S.R.N., S.C.M. * A.C. COUTTS, S.R.N. † I. BOYDE, S.R.N. * D.N. CHILTON, S.R.N., T.A. (Cert.) † H. ROWLEY, S.R.N. 7 Municipal Midwives:- M. LAW, S.C.M. E. LLOYD-OWEN, S.C.M. M.A. SULLIVAN, S.R.N., S.C.M. L.E. STEVENS, S.C.M. † H.N. KNOPP, S.C.M. E. Mental Health:- Duly Authorised Officers:- W.R. ELLEDGE J.R. WICKENS. Mrs. M.A. PEARCE. R.C. HOAD. J.C. HILLIER. F. Other Staffs- * A.H. BLEADEN, Supervising Officer, M.D. Training Centre. † I. ALLOT, '' '' '' '' '' W.L. NARBOROUGH, Dispenser. † M.G. LEGG, Assistant Supervisor, M.D. Training Centre. † A.W. LYWOOD, Assistant Supervisor, M.D. Training Centre. D.L. DOBSON '' '' '' " " * I. ALLOTT, '' '' '' '' '' *† J.G. CHAMBERS, Guide and Assistant (Temporary) M.D. Training Centre F.U. LYNCH H.H.L. WEBBER, Care and After-Care Assistant. G.M. KNIGHT, Home Help Organiser. † L.E. MILLER, Assistant to Home Help Organiser. C. HAYWARD, Oral Hyglenlst. †A.K.G. FINCH, Officer-in-Charge, Ambulance Service. G. Child Guidance Mrs. J.F. STEVENS, M.A., Educational Psychologist. † Miss M.E. CROSS, B.A. Educational Psychologist Mrs. M. MILLS, Psychiatric Social Worker † Mrs. A.J. THOMPSON, Psychiatric Social Worker Miss E. DAUNTON, B.A., Child Therapist. † Mrs. P. COHEN, B.A., Child Therapist (Part-time) H. Speech Therapy:- * Miss P.N. GLOVER, L.C.S.T., Speech Therapist † Miss J.R. VOKINS, L.C.S.T., Speech Therapist I. Clerical Staff:- Chief Administrative Assistant - H.J. HORSNELL * Senior Clerk, B.E.R. HARTLEY, A.C.I.S. Male Clerks E.J. STEADMAN (Petitions Officer) C.J. HAYES B.G. BOAR B.J. CURLING R.C. THOROGOOD J.F.J. THOMAS (Senior Clerk from 24.4.54) T.J. BIRD S.C. MANISIER and Temporary Clerks 8 Shorthand Typists:- D. GORDON, Senior D.G. WHEAL D.G. LIGHTLEY E.R.A. CRIBB V.G. NUNN * P.J. TOWNRCW † E.R. GOODRUM and Temporary Staff Female Clerks:- J. MACKINTOSH F.M. CLARK E. BRYAN E.G. DODDEMEADE S. DORAN E.J. TAYLOR and Temporary Staff † Commenced during years 1953 & 1954 * Terminated during years 1953 & 1954 ø Deceased during year 1953 NOTE:- Following review of the departmental establishment Miss A.K. Finch previously temporary Officer in Charge, Ambulance Service, was confirmed In that appointment. 9 COUNTY BOROUGH OF EAST HAM Public Health Department, Town Hall Annexe, East Ham, E.6. TO: THE WORSHIPFUL THE MAYOR, THE ALDERMEN AND COUNCILLORS OF THE COUNTY BOROUGH OF EAST HAM. Mr. Mayor, Ladles and Gentlemen, I have the honour to present the annual report for the years 1953 and 1954, for it is felt by so doing a more synoptic review will be obtained than by fragmenting my observations in separate reports. The Registrar General's estimate of the population at the 30th June, 1953, stood at 119,000, a decline of 1,000 during the year, and at 117,700 on 30th June, 1954, a further decline of 1,300. In 1953 a fractional advance in the birth rate (to 12.8) was to be seen still well below the general birth rate for England & Wales of 15.5. In 1954 a further slight fall in the birth rate from 12.7 to 12.2 brings us to the lowest birth rate in the borough ever recorded, as study of the records in my. possession, which date back to 1879, amply exemplifies. Attention is drawn again to a significant rise in the Infant mortality rate from 22.9 to 28t5 in 1953. Of the 46 infants who died In the first year of life, 30 succumbed within one month of birth, 14 of them from prematurity. In 1954 the Infant mortality rate fell again to 19.6 and of the 30 deaths 27 died in the first month, of prematurity. I believe the continuance of active work well Into the last trimester of pregnancy, plays some part in the relatively high Incidence of prematurity and should be combated by all possible means. Little Is accomplished by a woman who by her toll in the last months of carrying earns enough to acquire a chromium plated baby carriage, only to find that her efforts and anxieties have precipitated the onset of labour and her premature issue if alive, must weigh in the balance for many wearying days before it can be determined that he may survive. But for women who cease work between the twenty-eighth and the thirtysecond week it is difficult to see why continuance of employment up to this time could be a contributory cause of onset of premature labour. However, it may well be that in these women who go to work to relieve financial stress in the home, there is a resurgence of emotional stress and domestic tension which was the besetting problem in the first instance before earning capacity was lost by the advance of pregnancy. This may well engender fresh psychological stresses and strains which can result in premature labour. I would mark also the change to be noted in the physique and physical well-being of the child population of the borough. Twenty years ago, hardly an infant welfare clinic session was completed without the presentation by harassed mothers of babes with florid rickets, malnutrition, impetigo or scabies. These conditions could be regarded as a barometric index to ignorance and poverty. To-day it would be difficult to read the scale at all, for with the enlightenment in infant nurture carried over the threshold 10 of even the meanest habitation In the borough by the Health Visitor In her dally round, Infants receive the care and nurture which Is their birthright. East Ham always has been to the fore In education of the community In health matters, and our health visitors have extended their efforts to cover advice to diabetics of all ages In the management of diet and Insulin rigime, and have also taken an Increasing part In the supervision of old people In their homes, many of whom require advice and help of various kinds. The health visitors have also built up a useful system of surveillance of children who may prove to be Ineducable when the time comes for school entry at the age of five years. They keep careful records of the milestones of development In these children, and bring mother and child to me for consultation at appropriate Intervals. In this way the parents become adjusted to the mental retardation and other physical and social shortcomings of their child, and overcome the dreadful urge to reject him which many of them experience. Parents who have had this health visitor contact during the early years will accept at the proper time the decision that the child Is ineducable, a decision which provokes bitter hostility, affront and resentment in those who have nurtured their child with unseeing eyes and shut minds, burdened with a load of secret guilt and anxieties. But education does not stop here. Each year doctors from many parts of the civilised world come to East Ham to view our health and social services, and take back to their own lands the lessons they have learned. This Council in their wisdom affords these men and women every facility for study and observation, and we must ensure that what they see and learn is of the highest standard and will bear the closest scrutiny. This borough leads also In the close co-operation that exists between the general practitioners and local authority services. In the maternity field, the local general practitioners are given the help they need to keep their patients for domiciliary confinement or ante-natal supervision and yet have available for them all the clinic and ancillary services. G.P.'s who conduct paediatric clinics in their own surgeries Eire given the help of a health visitor for the area, and close-working harmony of the family doctor and the Duly Authorised Officers team ensures the welfare of the mentally sick and mental defectives. With the aid of our District Nursing Service and the Health Visitors, the G.P. also plays an Increasing role in the care of old people In their own homes, and with the shortage of beds for the chronic sick this work is Invaluable In an area where one person in eight or nine Is over the age of 65. In fact, the local doctors take a lively interest in the solution of many medico-social problems in collaboration with the Health Department, so that we may say an attempt has been made to break down the artificial barriers between preventive and curative medicine, and it Is hoped that the goal of the practice of medicine as one Indivisible art is in sight. There is another field in which the Council's enlightened and humanitarian policies play a big part, and that Is in the employment and rehabilitation of disabled persons. It Is notoriously difficult to place persons In suitable employment who are healed of tuberculosis or mental breakdown or suffer physical Incapacity of congenital or accidental origin. Many such workers find congenial employment in the wide range of local authority services, and can continue to live full and useful lives. Put one of the great outstanding problems Is in connection with 'Food Poisoning', a wholly preventable condition which calls for continuous education In personal, domestic and community hygiene at all levels. The loss of working hours for adults and schooling for children is utterly indefensible in the light of the preventabllity of the Illness, not to mention the physical distress experienced by those attacked. 11 Curative and epidemiological methods may be good and successful in prevention of spread of an outbreak, but our efforts are applied too late, for most Infections are the result of breakdown In individual domestic or factory hygiene or faulty technique in food processing or handling. Education and constant vigilance will prevent both types of error and breakdown, and money and effort expended in furthering the spread of knowledge of food hygiene will be well spent. Clean counters, clean canteens, clean crockery and clean carriage of foods, will go a long way towards achieving our preventive aims if practised by all of us when occasion demands. In the pages that follow will be found details of the services administered by the Health Committee whose Chairman and Members have been my most fervent critics and most ardent supporters during the years covered by this report. I am grateful to them for their perpetual stimulus to action In the Interests of the health of the people of East Ham. I wish again to thank all those who have assisted me in the preparation of this report, especially the Chief Administrative Assistant to the department who has also given me considerable and Invaluable help over the long months when I was without a Deputy Medical Officer of Health. I have the honour to be, Mr. Mayor, Ladles and Gentlemen, Your obedient Servant, J. S. COLEMAN. Medical Officer of Health and Principal School Medical Officer 12 STATISTICAL AND SOCIAL CONDITIONS OF THE AREA SOCIAL. 1953 1954 Area (in statute acres) land and water 3,324 3,324 Population. Census - April 1951 120,873 120,873 Estimated civilian population - Mid-Year 119,000 117,700 Number of inhabited houses (end of year according to rate books) (including tenements and shops)* 34,148 34,715 Rateable value at 31st December £781,384 £786,942 Sum represented by a penny rate for the year £3,172 £3,192 * Excludes factories, cinemas, government properties, corporation properties (offices and works), utility undertakings and other miscellaneous heriditaments not actually occupied as dwellings. EXTRACTS FROM VITAL STATISTICS. 1953 1954 'M. F. T. M. F. T. Live Births (Legitimate 779 765 1,544 798 686 1,484 (Illegitimate 28 34 62 20 22 42 Still Births (Legitimate 19 10 29 13 11 24 (Illegitimate 1 — 1 1 1 2 Deaths 569 525 1,094 605 538 1,143 Deaths from Puerperal causes:- Rate per 1,000 Total (Live and Still) Deaths Births 1953 1954 1953 1954 Puerperal Sepsis — — — — Other Maternal Causes 7 1 4.27 0.64 Totals 7 1 4.27 0.64 1953 1954 Deaths of infants under one year of age:- All Infants per 1,000 live births 28.5 19.6 Legitimate Infants per 1,000 legitimate live births 29.1 18.2 Illegitimate Infants per 1,000 illegitimate live births 16.1 71.4 Deaths from Cancer (all ages) 212 220 13 STILL BIRTHS The numbers of still births registered and the rates per 1,000 total (live and still) births are shown In the following table, together with comfortable figures for the preceding three years: 1950 1951 1952 1953 1954 No. of still births Rate per 1,000 total births 46 25.5 35 19.8 30 18.3 30 18.3 28 18.0 The still birth mortality rates for England and Wales and East Ham are shewn In the following table j- TABLE 1 Still births per 1,000 population 1950 1951 1952 1953 1954 Englartd and Wales 0.37 0.36 0.35 0.35 0.36 East Ham 0.37 0.29 0.25 0.25 0.23 BIRTHS Details for 1953 and 1954 with comparative figures for 1952 are shown below 1952 1953 1954 Number of live births registered 1,609 1,606 1,526 Birth rate per 1,000 population 13.4 13.5 12.9 Area comparability factor 0.95 0.95 0.95 Corrected birth rate 12.7 12.8 12.2 Birth rate for England and Wales 15.3 15.5 15.2 DEATHS Details of deaths of residents In 1953 and 1954 with comparative figures for 1952 are shown below j- 1952 1953 1954 Number of deaths notified 1,330 1,094 1,143 Death rate per 1,000 population 11.0 9.2 9.7 Area comparability factor 1.04 1.05 1.05 Corrected death rate 11.4 9.7 10.2 Death rate for England and Wales 11.3 11.4 11.3 Number of deaths occurring In institutions 632 460 608 (47.5%) (42*) (53.2*) Number of deaths occurring outside the borough 568 361 524 Number of non-residents dying in the borough 66 62 59 Due to an error In the classification of Langthorne Hospital In the course of a review by the Registrar General the deaths of East Ham residents in that hospital were not accredited to this area. This has been corrected for 1954 and succeeding years, but local records shown that 79 males and 88 females died in Langthorne Hospital during 1953. These figures should be added to those above to show the actual deaths of residents during the year. 14 The number of deaths in the various age groups was as follows:- 1953 1954 M F T M F T Under 1 year 26 20 46 16 14 30 1-4 years 2 2 4 3 3 6 5-14 years 1 2 3 3 2 5 15-24 years 3 2 5 3 4 7 25 - 34 years 11 12 23 9 5 14 35 - 44 years 18 24 42 22 15 37 45 - 54 years 61 33 94 64 30 94 55 - 64 years 127 64 191 104 54 158 65 - 74 years 179 145 324 192 149 341 75 - 84 years 113 159 272 150 185 335 85-94 years 27 59 86 36 74 110 95 years and over 1 3 4 3 3 6 Totals 569 525 1,094 605 538 1,143 INFANTILE MORTALITY The following tabulation shows details of deaths of infants under one year, comparative figures for England and Wales and for the year 1952 als.) being quoted : 1952 1953 1954 Number of deaths of Infants under one year of age 37 46 30 Iafant mortality rate (par 1,000 live births) 22.9 28.5 19.6 Rate for England and Wales 27.6 26.8 25.5 Number of deaths of illegitimate infants under one year of age 1 1 3 Mortality rate (per 1,000 illegitimate live births) 19.6 16.1 71.4 NE0--NATAL MORTALITY The number of deaths of children under the age of one month and the causes of such deaths were as follows :- 1952 1953 1954 Number of children dying under the age of one month 28 30 27 Neo-Natal mortality rate (per 1,000 live births) 17.4 18.6 17.6 Cause of death Number of deaths 1952 1953 1954 Atalectasis 7 — — Pneumonia — 1 1 Premature Birth 12 14 17 Congenital Malformation, Birth Injury, etc. 4 10 5 Other causes _5 5 _4 Total 28 30 27 MATERNAL MORTALITY The deaths from maternal causes were 7 In 1953 and 1 In 1954 giving maternal mortality rates per 1,000 live and still births of 4.27 and 0.64 respectively. 15 POPULATION The Registrar General's estimates of the population at 30th June each year were :- 1953 - 119,000 1954 - 117,700 The corresponding figure for 1952 was 120,000 Hie various rates per 1,000 population quoted In this report are based on the above estimates. The decline in population can be attributed broadly to three main causes;- (1) The steady fall in the birth rate since 1946 and the steady rise in the number of old people so that the actual reproductive group of the population is reduced In number. (2) The policy of the Council to decant fractions of the population to 'out County' housing estates. (3) Workers leaving the borough to live nearer their jobs or to purchase houses in other areas, plus a steady trickle of emigrants to Canada, Australasia and South Africa. Most of the emigrants are between 25 and h5 years of age, that is at the height of reproductive potential. 16 17 18 TABLE 2. - BIRTH RATE, DEATH RATE AND ANALYSIS OF MORTALITY, 1953. Rate per 1,000 Population Annual Death Rates per 1,000 Population Rate per 1,000 Live Births Live Births Still Births All Causes typho1d and ParaTyphoid Fevers Acute Poliomyelitis & Polioencephalitis Pneumonia Whooping Cough Diphtheria Influenza Smallpox Tuberculosis Total Deaths under one year Deaths from Dfcrrhoea and Enteritis (under 2 years) England and Wales 15.5 0.35 11.4 0.00 0.01 0.55 0.01 0.00 0.16 0.00 0.20 26.8 1.1 160 County Boroughs and Great Towns, Including London 17.0 0.43 12.2 0.00 0.01 0.59 0.01 0.00 0.15 0.00 0.24 30.8 1.3 160 Smaller Towns (resident populations 25,000 to 50.000 at Census, 1951). 15.7 0.34 11.3 — 0.01 0.52 0.00 0.00 0.17 0.00 0.19 24.3 0.9 London - Administrative County 17.5 0.38 12.5 — 0.01 0.64 0.00 — 0.15 — 0.24 24.8 1.1 EAST HAM 12.8 0.25 9.7 — — 0.54 — — 0.12 — 0.18 28.5 — A dash (—) signifies there were no deaths 19 TABLE 3. - BIRTH RATE, DEATH RATE AND ANALYSIS OF MORTALITY, 1954 Rate per 1,000 Population Rate per 1,000 Total (Live and Still) Births Annual Death Rates per 1,000 Population Rate per 1,000 Live Births Live Births Still Births All Causes Malignant Neoplasm Lung and Bronchus Acute Poliomyelitis Pneumonia Whooping Cough Diphtheria Influenza Coronary Disease, Angina Pectoris Tuberculosis (All Forms) Deaths of Infants under one year England and Wales 15.2 23.5 11.3 0.37 0.00 0.41 0.00 0.00 0.04 1.51 0.18 25.5 Great Towns 15.2 23.3 11.1 0.43 0.00 0.45 0.00 0.00 0.03 1.52 0.20 25.2 Smaller Towns 14.9 24.0 11.3 0.34 0.00 0.41 0.00 0.00 0.04 1.52 0.18 26.6 London - Administrative County .. 15.2 19.8 10.7 0.54 0.00 0.48 0.00 —- 0„ 02 1.50 0.20 20.7 EAST HAM 12.2 18.0 10.2 0.49 — 0.43 — —- 0.02 1.74 0.10 19.6 A dash (-) signifies there were no deaths 20 TABLE 4 - INFANT DEATHS UNDER ONE YEAR OF AGE, 1953 Cause of Death Total deaths AGE AND SEX. Total under 1 year Under 1 week 1-2 weeks 2-3 weeks 3-4 weeks 1-3 months 3-6 months 6-9 months 9-12 months M F N F H F M F M F M F M F M F M F Pneumonia 6 — — — — — — 1 — 1 — 1 3 — — — — 3 3 Premature Births 9 7 2 — — — — — — — — — — — — — — 7 2 Congenitial Malformations, Birth Injury, Infantile Diseases 17 7 7 — — — — 1 — — — — 2 — — — — 8 9 Other Causes 14 — 2 — — — 2 — — 1 — 3 — 3 1 1 1 8 6 TOTALS 46 14 11 — — — 2 2 — 2 — 4 5 3 1 1 1 26 20 21 TABLE 5 - CAUSES OF DEATH IN AGE GROUPS 1953, AND TOTAL DEATHS FOR THE YEARS 1950 - 1953 Deaths at different periods of life of residents (Including non-clvlllans) whether occurring within or without the district Total Deaths for the Years All Ages Under 1 Year 1-4 Years 5 - 14 Years 15 -24 Years 25 - 44 Years 45 - 64 Years 65 - 74 Years 75 Years and Over Total deaths In Institutions M F M F M F M F M F M F M F M F M F M F 1953 1952 1951 1950 1. Tuberculosis, respiratory 12 6 — — — — — — — — — 2 9 1 3 3 — — 7 3 18 26 29 33 2. Tuberculosis, other forms 1 2 — 1 1 — — — — — — 1 — — — — — — 1 2 3 2 7 3 3. Syphilitic Disease 3 1 — — — — — — — — — 2 — 1 — — 1 2 — 4 8 10 13 4. Diphtheria — — — — — — — — — — — — — — — — — — — — — — — — 5. Whooping Cough — — — — — — — — — — — — — — — — — — — — — — 1 2 6. Meningococcal Infections 1 — 1 — — — — — — — — — — — — — — — 1 — 1 — — — 7. Acute Poliomyelitis — — — — — — — — — — — — — — — — — — — — — — — 1 8. Measles — — — — — — — — — — — — — — — — — — — — — — — — 9. Other Infective and Parasitic Diseases 1 1 — — — — — — — — — 1 1 — — — — — 1 1 2 2 — 1 10. Malignant Neoplasm, Stomach 20 l5 — — — — — — — — 1 3 7 4 11 b 1 3 12 5 35 49 58 37 11. Malignant Neoplasm, Lung, Bronchus 41 6 — — — — — — — — 1 — 24 4 14 2 2 — 23 3 47 54 50 47 12. Malignant Neoplasm, Breast — 21 — — — — — — — — — 2 — 10 — 4 — 5 — 6 21 23 21 24 13. Malignant Neoplasm, Uterus — 9 — — — — — — — — — 1 — 3 — 4 — 1 — 4 9 6 16 11 14. Other Malignant & Lymphatic Neoplasms 60 40 — — 1 1 1 — l — 4 2 22 11 18 lb 13 11 35 20 100 117 126 120 15. Leukaemia, Aleukeamla 2 2 — — — — — — — — l — 1 2 — — — — 1 2 4 10 12 9 16. Diabetes 2 4 — — — — — — — — — — — 2 — 2 2 — 1 — 6 12 12 8 17. Vascular Lesions of the Nervous System 40 73 — — — — — — — — l 2 8 16 14 22 17 33 18 24 113 161 140 174 18. Coronary Disease, Angina 107 64 — — — — — — — — 3 — 40 7 4o 31 24 26 32 13 171 177 154 144 19. Hypertension with Heart Disease 8 14 — — — — — — — — — 1 2 1 4 6 2 6 2 3 22 35 71 48 20. Other Heart Disease 54 77 — — — — — — — — 4 3 10 8 10 10 30 56 13 19 .131 201 233 261 21. Other Circulatory Disease 22 28 — — — — — — — — — — 4 3 8 8 10 17 7 10 50 54 b3 39 22. Influenza 4 11 — — — — — — — — — 1 l 3 2 1 1 6 1 15 3 27 8 23. Pneumonia 34 31 3 3 — — — — — — — — 10 3 12 8 9 17 22 15 65 77 71 49 24. Bronchitis 56 42 2 — — — — — — —1 — 18 3 21 14 14 25 13 5 98 109 120 82 25. Other Diseases of Respiratory System 5 3 — 1 — — — — — — — — 1 1 1 1 3 — 3 1 8 15 11 15 26. Ulcer of Stomach and Duodenum 7 8 — — — — — — — — — — 7 4 2 — 2 4 6 6 15 10 21 16 27. Gastritis, Enteritis and Diarrhoea 6 4 k 1 — — — — — — — — 1 — — 1 1 2 2 2 10 5 2 6 28. Nephritis and Nephrosis 4 4 — — — — — — — — 1 2 3 1 — — — 1 3 2 8 18 10 17 29. Hyperplasia of Prostate b — — — — — — — — — — — — — 3 — 2 — 4 — 5 7 lb 4 30. Pregnancy, Childbirth, Abortion — 7 — — — — — — — — 7 — — — — — — — 7 7 2 1 l 31. Congenital Malformations 4 9 3 6 — 1 — — — 2 — — 1 — — — — — 4 9 13 9 14 10 32. Other Defined and 111 Defined Diseases 35 32 13 8 — — — 2 — — 3 4 7 7 10 6 2 5 27 29 67 93 104 90 33. Motor Vehicle Accidents 14 1 — — — — — l — 4 — b 1 1 — 3 — 9 1 15 14 ll 3 34. All Other Accidents ll 6 — — — — — — l — 3 — 3 2 1 2 3 2 5 5 17 18 24 16 35. Suicide 9 4 — — — — — — — — 2 4 b — 2 — — — 7 1 13 11 8 11 36. Homicide and Operations of War 1 — — — — — — — — — — — — — 1 — — — — — 1 — 1 1 TOTALS b69 b2b 26 20 2 2 1 2 3 2 29 36 188 97 179 14b 141 221 261 199 L,094 1*530 1,433 1,304 22 TABLE 6 - CAUSES OF DEATH IN AGE GROUPS 1954, AND TOTAL DEATHS FOR THE YEARS 1950-1954 Deaths at different periods of life of residents (including non-civilians) whether occurring within or without the district Total deaths in Institutions Total deaths for the years All Ages Under 1 Year 1-4 Years 5-14 Years 15-24 Years 25 - 44 Years 45-64 Years 65 - 74 Years 75 Years and over M F M F M F M F M F M F M F M F M F M F L954 1953 1952 1951 1950 1. Tuberculosis, respiratory 7 5 — — 1 — — — — 1 1 1 1 1 4 2 — — 5 2 12 18 26 29 33 2. Tuberculosis, other forms — — — — — — — — — — — — — — — — — — — — — 3 2 7 3 3. Syphilitic Disease — — — — — — — — — — — — — — — — — — — — — 4 8 10 13 4. Diphtheria — — — — — — — — — — — — — — — — — — — — — — — — — 5. Whooping Cough — — — — — — — — — — — — — — — — — — —— — — 1 2 6. Meningococcal Infections 1 — — — 1 — — — — — — — — — — — — — 1 — 1 l — — — 7. Acute Poliomyelitis — — — — —— — —— — —— — — — — — — — — — — — — 2 — 1 8. Measles — — — — — — — — — — — — — — — — — — — — — — — — — 9. Other Infective and Parasitic Diseases 1 — — — — — — — — — — 1 — — — — — — — 1 2 2 — 1 10. Malignant Neoplasm, Stomach 24 13 — — — — — — — — 1 1 9 3 8 6 6 3 16 6 37 35 49 58 37 11. Malignant Neoplasm, Lung, Bronchus 43 13 — — — — — — — — 4 1 27 2 9 8 3 2 22 6 56 47 54 50 47 12. Malignant Neoplasm, Breast — 21 — — — — — — — — — — — 9 — 5 — 7 — 10 21 21 23 21 24 13. Malignant Neoplasm, Uterus — — — — — — — — — — — 1 — 3 — — — — — 2 4 9 6 16 11 14. Other Malignant & Lymphatic Neoplasms 60 42 — — — — 1 — — — 5 3 19 9 24 16 11 14 37 26 102 100 117 126 120 15. LeuKaemia, Aleukaemia 3 3 — — — — 1 1 1 — — 1 1 1 — — — — 3 3 6 4 10 12 9 16. Diabetes 2 6 — — — — — — — — 1 — — 1 — 2 1 3 1 4 8 6 12 12 8 17. Vascular Lesions of the Nervous System 52 84 — — — — — — — — — — 12 13 23 26 17 45 39 41 136 113 161 140 174 18. Coronary Disease, Angina 125 71 — — — — — — — — 2 1 36 12 46 30 41 28 49 20 196 171 177 154 144 19. Hypertension with Heart Disease 13 13 — — — — — — — — — 4 2 3 3 6 8 5 6 26 22 35 71 48 20, Other Heart Disease 58 100 — — — — — — — 2 1 2 7 8 13 15 37 73 28 40 158 131 201 233 261 21. Other Circulatory Disease 25 35 — — — — — — — — 4 — 3 2 13 10 5 23 15 1/ 60 50 54 53 39 22. Influenza 2 1 — — — — — — — — — — — — 1 — 1 1 2 — 3 15 3 27 8 23. Pneumonia 24 25 1 1 — 1 — — — — — — 4 — 6 6 13 17 18 17 49 65 77 71 49 24. Bronchitis 56 21 — — — — — — — — — — 16 3 19 1 21 17 21 7 77 98 109 120 82 25. Other Diseases of Respiratory System 6 2 — — — — — 1 — — — — 2 1 2 — 2 — 5 — 8 8 15 11 15 26. Ulcer of Stomach and Duodenum 13 6 — — — — — — — — 1 — 5 1 4 3 3 2 11 4 19 15 10 21 16 27. Gastritis, Enteritis and Diarrhoea 2 3 — — — — — — — — — — — — l 2 1 1 — l 5 10 5 2 6 28. Nephritis and Nephrosis 5 3 — — — — — — — — 2 1 — 1 l 1 2 — 5 3 8 8 18 10 17 29. Hyperplasia of Prostate 12 — — — — — — — — — — — 3 — 2 — 7 — 8 — 12 5 7 15 4 30. Pregnancy, Childbirth, Abortion — 1 — — — — — — — — 1 — — — — — — — 1 1 7 2 1 1 31. Congenital Malformations 8 2 6 I — 1 — — — — — — 2 — — — — — 7 2 10 13 9 14 10 32. Other Defined and 111 Defined Diseases 36 52 9 12 — 1 — — — 1 2 4 8 10 7 11 10 13 31 41 88 67 93 104 90 33. Motor Vehicle Accidents 8 2 — — — — 1 — 1 — 2 — 3 1 1 1 — — 7 2 10 15 14 11 3 34. All Other Accidents 10 4 — — 1 — — — — — 4 — 1 — 2 — 2 4 4 2 14 17 18 24 16 35. Suicide 9 6 — — — — — — 1 — 1 3 4 2 3 1 — — 2 2 15 13 11 8 11 36. Homicide and Operations of War — — — — — — — — — — — — — — — — — — — — — 1 — 1 1 TOTALS 605 538 16 Ik 3 3 3 2 3 4 31 20 168 85 192 149 189 261 343 265 1,343 1,094 1,330 1,433 1,304 23 TABLE 7 - INFANT DEATHS UNDER ONE YEAR OF AGE, 19514 Cause of Death AGE AND SEX Total Under 1 week 1-2 weeks 2-3 weeks 3 - 4 weeks 1-3 months 3-6 months 6-9 months 9-12 months M F M F M F M F M F M F M F M F M F Pneumonia — — — — — 1 — — 1 — — — — — — — 1 1 Congenital Malformation 2 1 1 — — — 1 — — — 2 — — — — — 6 1 Premature Births 7 10 — — — — — — — — — — — — — — 7 10 Other Causes 2 2 — — — — — — — — — — — — — — 2 2 TOTALS 11 13 1 — — 1 1 — 1 — 2 — — — — — 16 14 24 Reference to the Table which dissects the cause of death in age groups, shews that Cancer in its various forms (Nos. 10, 11, 12, 13, 14 and 15) is responsible for 216 deaths in 1953, and 226 deaths in 1954. In 1950 the total was 248, in 1951 it was 283, and 259 in 1952, so that this "Killer" disease is declining somewhat in importance in total destructive power. Yet throughout the years under review cancer of the lung holds a high place with about 50 deaths each year, and shows little tendency to decline, in spite of early diagnosis undoubtedly available now far more readily than in former years, and the application of radical surgery in attempts at early extirpation of the disease. One great educative measure, however, could be pressed home in the schools and by wise parents. No smoking should be the unvarying and unswerving rule for all scholars and all adolescents. The habit acquired young, usually in the boy as a result of wanting to feel big like Daddy, and in the girl of wishing to appear sophisticated, is not easily shed in adult life, and the adolescent who Is supported in resistance to the acquisition of this dirty, useless, extravagant habit, is much more likely to remain a non-smoker throughout life, and greatly lessen the chance of developing lung cancer in middle life. There should be a reorientation in the way smoking is viewed to-day. This habit should be classed among the drug addictions and rank with alcoholism, cocainism, morphinism, and hashishism, as an insidious social evil. Deaths from all causes related to Cardio-vascular disease. 1954—576 1953—487 1952—628 1951—631 1950—666 On the other hand,reference to the above figures of disease of the heart and circulation, indicate a suddenly marked decline In "killing" capacity, so that in 1953 141 fewer persons succumbed in this way. It is difficult to account for this sudden fall in deaths from cardiovascular causes, except perhaps to hazard a guess that domestic, community, and national tensions have lessened a little which might account for greater peace of mind and sense of security and diminished worry in a great body of people, especially the workers, which reflect themselves in lessened mortality from cardlo-vascular catastrophes. Or possibly the full Impact of legislation has transferred a good deal of individual responsibility on to the State and relieved many persons of anxiety they were ill constituted to support. I can hardly credit the belief held in certain quarters that some change in diet (e.g. less fat consumption) has effected this reduction in mortality, for fats, meat, butter, eggs and milk, although all increased in price, show little tendency to be consumed in any less quantities than in preceding years, in fact it is possible the reverse is more likely to be true. When all this is said, diseases of the heart and circulation and cancer remain the Captains of the Men of Death, and account for upwards of 700 deaths each year. The old aphorism that a man is as old as his arteries, still hold good, and it seems we are gradually evolving a race of men whose arteries are the better able to withstand the rigours of modern living. 25 GENERAL PROVISION OF HEALTH SERVICES. MIDWIVES ACTS 1902 - 1953 1953 1954 Number of Midwives who notified their intention to practise in East Ham during the year 25 24 Number of above who also notified intention to practise as maternity nurse 9 12 Employment of midwives - Plaistow Maternity Hospital and District Nurses Home 6 6 Silvertown and North Woolwich District Nursing Association 2 2 East Ham Memorial Hospital 11 9 East Ham Corporation 5 + 6 Private practice 1 1 +Includes the non-medical supervisor of midwives PLAISTOW MATERNITY HOSPITAL AND DISTRICT NURSES HOME Summary of cases attended:— 1953 1954 Domiciliary Midwifery 90 41 Maternity Nursing 18 7 SILVERTOWN AND NORTH WOOLWICH DISTRICT NURSING ASSOCIATION Summary of cases attended:— 1953 1954 Domiciliary Midwifery 4 3 Maternity Nursing 2 1 MUNICIPAL MIDWIVES Summary of cases attended:- 1953 1954 Domiciliary Midwifery 172 261 Maternity Nursing 13 11 CLINICS AM) TREATMENT CENTRES With the exception of North Woolwich these are all provided by the Council. The clinics at Roman Manor are held in the Community Centre, by permission of the Education Committee. The sessions at the Centres (as on 31/12/54) were as follows:- 26 TABLE 8-CLINICS AND TREATMENT CENTRES Situation Purpose used Sessions Town Hall Annexe General Clinic (Minor Aliment cases) Immunization Clinic Monday, Wednesday and Saturday 9.30 a.m. Tuesday 2 p.m. Friday 2 p.m. Infant Welfare Clinic Monday, Thursday and Friday 2 p.m. Physiotherapy Clinic Eye Clinic Continuous Monday and Thursday 2 p.m., Tuesday and Friday 9.30 a.m. Toddlers' Clinic Tuesday 10 a.m. and Wednesday 2p.m. Ear Clinic Ante-Natal Clinic (and Post-Natal) Wednesday and Friday 2 p.m. Monday 9 a.m., Tuesday 2 p.m. Thursday 10 a.m. and Friday 10 a.m. Dental Clinic Daily by appointment Church Road, Manor Park General Clinic (Minor Ailment. Cases) Tuesday and Friday 9.30 a.m. Immunization Clinic Thursday 10 a.m. Infant Welfare Clinic Monday, Wednesday and Thursday 2.p.m. Physiotherapy Clinic Monday, Tuesday, Thursday and Friday 9.30 a.m. and Wednesday 2 p.m. Toddlers' Clinic Friday 2 p.m. Ante-fetal Clinic (and Post-Natal) Monday 9 a.m., Tuesday 2 p.m. Wednesday 9.30 a.m. (double session). Dental Clinic Dally by appointment. North WoolwichFernhill Street Baths General Clinic (Minor Aliment cases) Maternity & Child Welfare Clinic ) ) ) Tuesday 9.30 a.m. ) ) Shrewsbury Road School, Forest Gate Child Guidance Clinic Psychiatrist Present: Tuesday a.m. and p.m. Thursday a.m. and p.m. Speech Therapy 0Ante~Natal Clinic (and Post-Natal) Continuous. Friday 9.30 a.m. Infant Welfare and Toddlers Clinic Friday 2.0 p.m. Roman Manor Maternity & Child Welfare Clinic Wednesday 10 a.m. General Clinic (Minor Ailment Cases) Thursday 10 a.m. +By arrangement with L.C.C. [???]Commenced 10.7.53. 27 VENEREAL DISEASES The following statistics have been abstracted from copies of form V„D.(R), which have been received from the Hospitals named and total figures for 1952 and 1951 are also shewn:- Patients Dealt With for the First Time During the Year 1953 1954 Syphilis Gonorrhoea Other Conditions Total Syphilis Gonorrhoea Other Conditions Total Whitechapel Clinic, London Hospital 4 15 118 137 5 14 111 130 St. Thomas' Hospital - — 1 1 - 1 6 7 Albert Dock Hospital 2 2 26 30 - 2 34 36 Queen Mary's Hospital, E.15 4 2 34 40 2 2 32 36 Totals 10 19 179 208 7 19 183 209 Totals for 1952 14 29 139 182 Totals for 1951 6 25 132 163 ALDERSBROOK HOMES AND SCATTERED HOMES,, The pattern of the Children's Homes is crystallising gradually into the shape designed by the Children's Committee. As far as possible, problem children or short-term stay individuals or siblings are admitted to the reception unit at 80 Aldrsbrook Road. Their placements in the Nursery or Scattered Homes is made if it becomes obvious longer care will be necessary. In general, however, as many children as possible are boarded out with foster parents. The care of the children from the medical point of view has presented no special problems and Dr. Galvin has visited the Nursery and Homes regularly and as required. With appropriate reliefs she has been on call, so that a doctor is always available for the attendance on children and staff In cases of acute illness. The statistics for the years 1953 to 1954 are appended:— 1953 1954 1. Average number in homes throughout the year 324 203 2. No. chargeable to East Ham on 1st January 129 137 3. No. chargeable to East Ham on 31st December 141 129 4. Average weekly admissions 14 6 5. Average weekly discharges 16 8 It will be seen that the overall number of children is greatly reduced as is also the demand for this type of care. 28 INFECTIOUS DISEASES. The quarterly returns to the Registrar-General were as follows:— Qtr. ending 31/3/53 Qtr. ending 30/6/53 Qtr. ending 30/9/53 Qtr. ending 31/12/53 Total Scarlet Fever 90 60 34 61 245 Whooping Cough 66 248 196 44 554 +Acute Poliomyelitis — 1 6 — 7 Measles 726 210 20 4 960 Diphtheria — — — — — Pneumonia 41 15 4 10 70 Dysentery 256 25 4 — 285 Acute Encephalitis — 1 — — 1 Paratyphoid Fever — — l — 1 Erysipelas 2 7 3 3 15 Meningococcal Infection — 1 — — 1 Food Poisoning — — 4 3 7 Puerperal Pyrexia 2 2 — 6 10 Malaria (contracted abroad) — 1 — — 1 + Of the 7 cases finally diagnosed as Acute Poliomyelitis 4 were paralytic and 3 non-paralytic. Qtr. ending 31/3/54 Qtr. ending 30/6/54 Qtr. ending 30/9/54 Qtr. ending 31/12/54 Total Scarlet Fever 68 46 26 32 172 Whooping Cough 37 24 22 34 117 +Acute Poliomyelitis — 1 2 — 3 Measles 4 4 5 17 30 Diphtheria — — — 1 1 Pneumonia 20 9 6 10 45 Dysentery 9 12 6 14 41 Erysipelas 4 4 4 2 14 Meningococcal Infection l — — 2 3 Food Poisoning 3 2 — 3 8 Puerperal Pyrexia 1 — — 2 3 +Of the 3 cases finally diagnosed as Acute Poliomyelitis 2 were paralytic and one was non-paralytic. No deaths from the seven principal zymotic diseases (Smallpox, Whooping Cough, Measles, Diphtheria, Diarrhoea, Scarlet Fever and Enteric Fever) were reported during the two years under review, and no cases of smallpox were notified. Poliomyelitis. It will be seen that for both 1953 and 1954 Poliomyelitis was fortunately no serious problem in our borough, with 7 and 3 confirmed cases respectively. Measles and Whooping Cough assumed minor epidemic proportions in 1953, and it is hoped that with the steady increase in the number of requests for immunisation against Whooping Cough this distressing infection of young children will soon cease to be the menace to health and development which it now undoubtedly is. Parents are reminded that the prophylactic injections against Whooping Cough are advantageously combined with those for Diphtheria, but of course with the majority of children immunisation against Whooping Cough can be carried out successfully at any time. 29 Dysentery shewed a high number of notifications in 1953 and one suspects the actual number of infected individuals was probably much higher than the 285 recorded,, Transient illness and diarrhoea is often made light of by more spartan sufferers, and the danger here lies in the spread by faulty personal hygiene, to a circle of contacts very difficult to control. The sufferer laid low, who takes to his bed, is not the real problem, for he will receive proper investigation and treatment and be surrounded by an adequate hygienic barrier. But our more stole infected individual will rarely seek treatment and if he must continue at his work, then it behoves him to redouble his efforts at impeccable personal hygiene. No person who works with children or in a canteen, restaurant, food factory, or food shop, should go to work with the now very well known dysenteric symptoms unless and until seen and advised by a doctor. The numbers of new oases of tuberculosis notified during the two years under review were as follows :- Pulmonary— 1953 1954 Males 64 74 Females 62 126 53 127 Non-Pulmonary Males 6 3 Females 6 9 12 12 Totals .. 138 139 Details of these notifications are set out in Tables 11 and 12. The significant Increase in the number of notifications of Pulmonary and Non-Pulmonary Tuberculosis (23 or 11.2 per cent increase over 1952) shews that the attack rate of this scourge Is not yet greatly altered although the cure rate and death rate are both substantially Improved by modern methods of therapy, surgery and nursing. The lesson to be drawn from these figures is that in our borough we must not relax our vigilance in searching out every possible infected individual and surrounding him by a zone of hygiene, until he ceases to spit or discharge the live germs of tuberculosis. Every adult, which for this purpose must include all young persons who have ceased attendance at school, should make it a personal duty to undergo chest examination annually by the Mass Radiography Unit in the area. Not only could this be considered a personal effort in community hygiene, but also there are other good reasons for the annual screening. Such conditions as early cancer of the lung or unsuspected cardio vascular disease might be uncovered, and treatment promptly applied may well prolong life for many years. 30 TABLE 9 - PREVALENCE OF, AND CONTROL OYER, INFECTIOUS DISEASE. Notified Cases for Year ended 31/12/53. DISEASE Cases notified in whole district Ward Distribution of Cases No. of Cases removed to Hospital Total Deaths At all ages - years Manor Park Little Liford Woodgrange Plashet Kensington Castle Central Wall End Greatfield South At all ages Under 1 1 to 4 5 to 9 10 to 14 15 to 24 25 to 34 35 to 44 45 to 64 65 and up Scarlet Fever 245 - 62 159 19 3 - 2 - - 32 25 11 21 27 25 19 23 19 43 119 - Diphtheria - - - - - - - - - - - - - - - - - - - - - - Erysipelas 15 - 1 - - 1 l 3 3 6 - 1 2 1 2 - 2 3 2 2 3 - Puerperal Pyrexia 10 - - - - 3 6 1 - - - 2 1 5 - - 1 - 1 - 9 - Acute Encephalitis 1 - - 1 - - - - - - - - - - 1 - - - - - 1 - Paratyphoid Fever 1 - - - - 1 - - - - 1 - - - - - - - - - 1 - Pneumonia 70 1 4 3 2 3 6 6 23 22 2 9 6 8 7 4 3 11 11 9 21 65 Acute Poliomyelitis 7 - 1 1 1 1 2 - - - 1 - - - 1 - 1 1 1 2 7 - Meningococcal Infection 1 1 - - - - - - - - - - - - - - - - - 1 1 1 Malaria 1 - - - - 1 - - - - - - - - - - 1 - - - 1 - Dysentery 285 5 38 167 39 6 14 4 8 4 80 85 29 5 41 - 11 20 6 8 3 - Food Poisoning 7 - - 1 2 - 2 1 - 1 6 - - - - - 1 - - - 5 - Measles 960 54 538 365 16 6 - 1 - - 100 192 69 60 6k 63 61 125 57 169 12 - Whooping Cough 554 47 238 257 7 - 5 - - - 68 74 27 49 41 50 38 84 45 98 10 - 31 TABLE 10 - PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASE. Notified Cases for Tear ended 31/12/54 DISEASE Cases notified in whole district Ward Distribution of Cases No. of Cases removed to Hospital Total Deaths At all Ages - Years Manor Park Little Liford Woodgrange Plashet Kensington Castle Central Wall End Greatfleld South At all ages Under 1 1 to 4 5 to 9 10 to 14 15 to 24 25 to 34 35 to 44 45 to 64 65 and up Scarlet Fever 172 - 47 113 9 1 1 1 - - 18 18 13 8 16 16 11 19 28 25 65 - Diphtheria 1 - - - - - - - - - - - - - - - - - - - 1 - Erysipelas 14 - - 2 - - 1 l 6 4 1 2 1 - 2 - 1 2 1 4 2 - Puerperal Pyrexia 3 - - - - 1 2 - - - - 2 - - 1 - - - - - 1 - Pneumonia 45 1 3 3 1 2 4 3 19 10 3 5 7 5 4 3 3 6 3 6 16 49 Acute Poliomyelitis 3 - 1 - 1 1 - - - - 1 - - - - - - 2 - - 3 1 Meningococcal Infection 3 2 1 - - - - - - - - - - - - - 1 1 1 3 1 Dysentery 41 1 11 12 2 1 9 1 4 - 6 9 4 - l 6 8 3 2 2 5 - Food Poisoning 8 1 - - 1 4 1 - l - 3 - l - - 2 - 1 - 1 3 - Measles 30 16 13 - 1 - - - - - 5 9 l 1 l 2 - 6 3 2 4 - Whooping Cough 117 9 45 58 - - ' 4 l - 17 15 9 2 18 6 10 34 - 6 3 - 32 The hospitals to which the patients suffering from infectious diseases were admitted are named below Name of Hospital No, of cases admitted 1953 1954 Plalstow Hospital, Samson Street, E.13 106 63 Ilford Isolation Hospital, Chadwell Heath 30 13 Eastern Fever Hospital, Homerton, E.9 16 8 Chingford Isolation Hospital, E.4 4 - Rush Green Hospital, Romford 1 - Whipps Cross Hospital, Leyr,onstone, E.ll 19 8 Queen Elizabeth Hospital, E.l 2 - St. Mary's Hospital for Women & Children, E.13 - 1 South Lodge Hospital, N.21 1 - Wanstead Hospital, E.ll 1 - East Ham Memorial Hospital, E.7 7 1 Western Hospital, Fulham, S.W.6. - 1 St. Clements Hospital, Bow, E.3 - 1 Royal Free Hospital, W.C.1 1 - St. Andrew's Hospital, Devons Road, Bow, E.3 - 1 St. Ann's General Hospital, St. Ann's Road, N.15 5 5 Totals 193 102 I would like to record the willing co-operation afforded me at all times by the staffs of the Plaistow Hospital and ilford Isolation Hospital, in the ready acceptance of cases of infectious illness, and the invaluable help given me in the diagnosis of obscure conditions. Cases summaries on discharge have been the invariable rule and on occasion [???]discussion with the senior medical staffs has elucidated difficult points in pathogenesis and epidemiology. 33 TABLE 11 - PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1952 SUMMARY OF NOTIFICATIONS DURING THE PERIOD FROM 1ST JANUARY, 1953 TO THE 31ST DECEMBER, 1953 Age Periods Formal Notifications Number of Primary Notifications of new cases of tuberculosis 0- 1- 2- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- Total (all ages) Respiratory, Males - 1 3 1 - 9 4 9 5 15 12 4 1 64 Respiratory, Females 1 - 2 4 2 3 14 20 10 3 2 1 - 62 Non-Respiratory, Males - - - 1 1 - - - 2 1 1 - - 6 Non-Respiratory, Females - 1 2 1 - - - 1 - 1 - - - 6 PART 11. - NEW CASES OF TUBERCULOSIS COMING TO THE KNOWLEDGE OF THE MEDICAL OFFICER OF HEALTH DURING THE YEAR, OTHERWISE THAN BY FORMAL NOTIFICATION. Source of Information Number of cases in age Groups 0- 1- 2- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- Total Death Returns from Local Registrars Respiratory M - - - - - - - - - - - - 1 1(A) F - - - - - - ~ - - 1 - 1 - 2(B) Non-Respiratory M - - - - - - - - - - - - - -(-C) F - - - - - - - - - - - - - -(D) Death Returns from Registrar-General (Transferable deaths) Respiratory M - - - - - - - - - - 3 - - 3(A) F - - - - - - - - - - 1 - - 1(B) Non-Respiratory M - - - - - - - - - - - - - -(C) F - - - - - - - - - - - - - - (D) posthumous Notifications Respiratory M - - 1 - - - - - - - - 1 - 2(A) F - - - - - - - - - - - - - - (B) Non-Respiratory M - - - - - - - - - - - - - - (c) F - - - - - - - - - - - - - - (D) Totals (A) 6 (B) 3 (C) - (D) - 34 6TABLE 12 - PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1952. SUMMARY OF NOTIFICATIONS DURING THE PERIOD FROM 1ST JANUARY, 1954 TO THE 31ST DECEMBER, 1954 Age Periods Formal Notifications Number of Primary Notifications of new cases of tuberculosis 0- 1- 2- 5r 10- 15- 20- 25- 35- 45- 55- 65- 75- Total (all ages) Respiratory, Males - - 1 - 2 8 3 10 11 17 13 8 1 74 Respiratory, Females - - - 3 1 6 12 13 9 4 4 l - 53 Non-Respiratory, Males - - - - - 2 - - 1 - - - - 3 Non-Respiratory, Females - - - 1 - 2 4 1 1 - - - - 9 PART II. - NEW CASES OF TUBERCULOSIS COMING TO THE KNOWLEDGE OF THE MEDICAL OFFICER OF HEALTH DURING THE YEAR, OTHERWISE THAN BY FORMAL NOTIFICATION Source of Information Number of cases in age Groups 0- 1- 2- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- Total Death Returns from Local Registrars Respiratory M - - - - - - - - - - - - - - (A) F - - - - - - - 1 - - - - - 1 (B) Non-Respiratory M - - - - - - - - - - - - - - (C) F - - - - - - - - - - - - - - (D) Death Returns from Registrar-General (Transferable deaths) Respiratory M - - - - - - - - - - - - - - (A) F 1 - 1 (B) Non-Respiratory M - - - - - - - - - - - - - - (C) F - - - - - - - - - - - - - - (D) Posthumous Notifications Respiratory M - - 1 - - - - - - - - - - 1 (A) F - - - - - - - 1 - - 1 - - 2 (B) Non-Respiratory M - - - - - - - - - - - - - - (C) F - - - - - - - - - - - - - - (D) Totals (A) 1 (B) 4 (C) - (D) - 35 TABLE 13-TOTAL CASES OF NOTIFIABLE DISEASES, 1930 - 1954 DISEASE 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 Small Pox 70 51 13 1 1 - - - - - - - - - - - - - - - - - - - - Scarlet Fever 484 245 779 701 979 411 359 387 287 196 77 68 210 271 132 153 193 179 222 289 270 203 343 245 172 Diphtheria 473 196 157 180 379 254 134 149 141 91 47 45 49 59 33 31 19 46 14 2 1 - 1 - 1 Enteric or Typhoid Fever 3 8 7 5 - 2 2 13 15 8 10 3 - 4 - - - - 1 - 3 - 1 - - Paratyphoid Fever - - - - - - - - - - - - - - - - - - - - l 1 1 1 - Erysipelas 63 54 55 69 74 55 59 53 71 41 33 23 37 28 18 14 25 23 21 24 21 19 16 15 14 Puerperal Fever 9 10 4 4 7 12 7 5+ + + + + + + + + + + + + + + + + + Puerperal Pyrexia 14 6 23 10 11 14 7 7 18 16 8 6 15 8 8 2 8 5 4 2 3 2 7 10 3 Meningococcal Meningitis 3 8 5 1 3 3 - 2 3 3 11 5 12 4 3 1 8 1 5 6 1 1 4 1 3 Encephalitis Lethargica - - - 1 1 1 - 1 1 - - - - - - - - - - - - - - - - Ophthalmia Neonatorum 6 6 6 9 5 5 6 7 9 7 3 4 1 1 4 2 1 2 - 4 2 1 1 - - Acute Poliomyelitis - 1 7 2 5 13 2 4 - 2 1 - - - - 1 - 7 8 13 10 7 10 7 3 Acute Polio Encephalitis - - 3 2 1 - - - - - - - - - - - - 1 - - - - - 1 - Dysentery - - - - 1 - - 3 18 - - - - 6 5 7 5 2 - 1 10 321 3 285 41 Malaria - - 1 1‡ - - - - - - - - - - - 1‡ 3a - - - - - - lb - Measles Not Notifiable 3 36 460 1,091 971 258 1,498 815 964 1,559 1,098 988 2,198 1,883 960 30 Whooping Cough Not Notifiable - 19 262 227 241 293 67 258 430 578 498 1,027 625 361 554 117 Food Poisoning Not Notifiable 4 5 23 8 7 8 Pneumonia 59 75 77 148 100 88 101 111 85 59 42 33 37 72 50 55 97 143 111 88 41 58 61 70 45 Tuberculosis- Pulmonary 165 197 185 164 174 184 186 188 149 157 130 139 164 200 156 205 194 211 211 148 142 117 101 126 127 Non-Pulmonary 38 49 47 35 33 37 31 39 20 24 30 22 22 23 15 16 9 26 20 11 14 16 14 12 12 Totals 1,387 906 1,369 1,333 1,774 1,079 894 969 817 607 447 1,070 3,865 1,834 975 2,053 1,635 2,040 2,754 2,188 2,538 3,592 2,315 2,295 575 +Notifiable as Puerperal Pyrexia as from 1/10/37. †Notifiable as Puerperal Pyrexia a 1 Induced for therapeutic purposes: 2 Contracted abroad, b Contracted abroad ‡1 Induced in an Institution 36 CANCER. 1953 1954 Total deaths 212 220 Male deaths 121 127 Female deaths 91 93 TABLE 14-CANCER DEATHS 1953-LOCATION OF THE DISEASE Parts of Body Affected Ages Under 15 15-24 25-34 35-44 45-54 55-64 65-74 75 and upwards Total Sex M F M F M F M F M F M F M F M F M F Buccal Cavity and Pharynx - - - - - - - - 1 - - - - 1 3 1 4 2 Digestive Organs and Peritoneum - - - - 1 1 2 2 9 2 4 8 20 13 6 11 42 37 Lungs, Bronchus - - - - - - 1 - 9 2 15 2 14 2 2 - 41 6 Other Respiratory Organs - - - - - - 1 - 2. - - - - - - - 3 - Uterus - - - - - - - 1 - 2 - 1 - 4 - 1 - 9 Other Female Genital Organs - - - - - - - - - 1 - 1 - 2 - 1 - 5 Breast - - - - - - - 2 - 4 - 6 - 3 - 6 - 21 Male Genital Organs - - - - - - 1 - - - - - 1 - - - 2 - Urinary Organs - - - - - - - - 1 - 3 - 5 - 5 - 14 - Skin - - - - - - - - - - - - - - - - - - Brain and other parts of Nervous System 2 1 - - - - - 1 1 1 2 - - - - - 5 3 Other or Unspecified Organs - - 1 - - - - 1 - - 6 2 3 4 - 1 10 8 TOTALS 2 1 1 - 1 1 5 7 23 12 30 20 43 29 16 21 121 91 37 TABLE 15-CANCER DEATHS 1954-LOCATION OF THE DISEASE Parts of Body Affected Ages Under 15 15-24 25-34 35-44 45-54 55-64 65-74 75 and upwards Total Sex M F M F M F M F M F M F M F M F M F Buccal Cavity and Pharynx - - - - - - 1 - 1 - 2 1 - - 1 - 5 1 Digestive Organs and Peritoneum - - - - 1 - - 1 6 1 9 5 12 9 8 9 36 25 Lungs, Bronchus - - - - - - 4 1 7 1 20 1 9 8 3 2 43 13 Other Respiratory Organs - - - - - - - - - - - - - - - - - - Uterus - - - - - - - 1 - 2 - 1 - - - - - 4 Other Female Genital Organs - - - - - - - 1 - - - - - - - 1 - 2 Breast - - - - - - - - - 2 - 7 - 5 - 7 - 21 Male Genital Organs - - - - - - - - - - - - - - 1 - 1 - Urinary Organs - - - - - - - - 1 1 3 - 12 - 4 - 20 1 Skin - - - - - - - 1 - - - - - - - - - 1 Brain and other parts of Nervous System 1 - - - - - 1 - 1 - - - - - - - 3 - Other or Unspecified Organs - - - - 1 - 1 1 3 1 2 3 8 13 4 7 19 25 TOTALS 1 - - - 2 - 7 6 19 8 36 18 41 35 21 26 127 93 38 NATIONAL ASSISTANCE ACT, 191*8 - SECTION 47. The above section of the National Assistance Act, 1948, deals with the removal to suitable premises of persons in need of care and attention. I am informed by the Chief Officer of Welfare Services it has not been found necessary for action to be taken under this section during the years 1953 and 1954. WATER SUPPLY. (i) The water supply of the Borough in its several parts has been satisfactory both in quality and quantity. (ii) All houses in the area have water services laid on from the Metropolitan Water Board's mains. No bacteriological or chemical analyses were made by this Authority on the raw water going into supply. (iii) The water supply of this district from the Metropolitan Water Board does not give rise to plumbo-solvent action. (iv) There were no contamination areas. MEAT AND OTHER FOODS No slaughterhouse was in use in the Borough during the years. Details of the work carried out in the inspection of premises, stalls and vehicles used for the storage, preparation and sale of food, including ice-cream, are included in the report of the Chief Sanitary Inspector. FOOD POISONING. In accordance with Ministry of Health Circular 46/49, the following Information was supplied:— (1) Food Poisoning Notifications (Corrected) Return to RegistrarGeneral:- 1953 1954 1st Quarter - 3 2nd Charter - 2 3rd Quarter 3 — 4th Quarter 3 3 Totals 7 8 (2) Outbreaks due to identified Agents:- (a) 1953- Salmonella Typhi-murium 1 (4 cases) Salmonella Muenchen 1 (3 cases) (b) 1954- Salmonella Muenchen 1 (3 cases) (3) There were no outbreaks of undiscovered cause during the two years. (4) Single cases:- 1953 1954 Agent identified 1 5 Unknown cause - - Totals 1 5 39 CLEAN FOOD CAMPAIGN. Reference was made in the 1951 report to the formation of a Food Hygiene Guild in the borough. At the first annual general meeting of the Food Hygiene Guild on 18th February, 1953, the Advisory Committee submitted a report on the work of the Guild since its inception. The constitution, administration and objects were set out in detail, and (a) The promotion of improvement in hygienic manufacture, handling and distribution of all foodstuffs; (b) The encouragement of the observance of all statutory standards of food hygiene; (c) The application of codes of practice to be drawn up and agreed by the Guild; (d) The co-operation of the public by means of appropriate methods of publicity in the maintenance of a suitable standard of food hygiene; were the main alms of the Guild. Membership of the Guild was possible for employers and employees alike, all applications being considered by the Advisory Committee, together with the report of the Hon. Executive Officer. Certificates of membership were granted to sixty-seven applicants, and provisional membership to a further one hundred and fifty-nine applicants. These groups of traders and employers are deemed to have achieved a sufficiently high standard of hygiene and cleanliness in the conduct of their shop premises, having regard to the requirements of the Food & Drugs Act, 1936, and the Bye Laws of the East Ham Council made thereunder. Sanctions and regulations for the maintenance of standards were also agreed. The second annual general meeting was held on 25th November, 195*4, and variations in the constitution to widen representation were agreed. Codes of practice for employees, which have been adopted, were set cut in detail and it was noted that 171 employers and 88 employees had become full members since the inception of the Guild. From 1st to 5th March, 1954, a Clean Food Exhibition was held in the Minor Hall, and many local traders co-operated in making the exhibition a success. 40 FACTORIES ACTS, 1937 and 1948 In accordance with the Factories Act, 1937, and at the request, of the Minister of Labour and National Service, the following information is included in this report. (See Tables 16 and 17). TABLE 16 FACTORIES ACTS, 1937 AND 1948. YEAR 1953 PART I OF THE ACT 1.-INSPECTIONS for purposes of provisions as to health (including inspections made by Sanitary Inspectors) Premises Number on Register Number of Inspections Written notices Occupiers prosecuted (1) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 51 42 2 - (11) Factories not included in (1) in which Section 7 is enforced by the Local Authority 354 342 20 - (111) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 1 1 - Total 406 385 22 - 2. - CASES IN WHICH DEFECTS WERE FOUND (If defects are discovered at the premises on two, three or more separate occasions they should be reckoned as two, three or more "cases") 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 (S.l) 7 2 1 1 - Overcrowding (S.2) - - - - - Unreasonable temperature (S.3) - - - - - Inadequate ventilation (S.4) - - - - - Ineffective drainage of floors (S.6) - - - - - Sanitary Conveniences (S.7) (a) insufficient (b) unsuitable or defective (c) not separate for sexes - ~ - - - 46 12 - - - - - - - - Other offences against the Act (not including offences relating to Outwork) 6 - - - - Total 59 14 1 1 - PART VIII OF THE ACT OUTWORK (Sections 110 and 111) Nature of Work Section 110 Section 111 No. of out-workers in August List required by Sect. 110(l)(c) No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwholesome premises Notices served Prosecutions Wearing Apparel (Making etc.) 189 - - - - - Shopping bags 3 - - - - Metal Caps 21 - - - - - Christmas crackers, cosaques, Christmas stockings, etc. 94 - - - - - Umbrellas, etc. 1 - - - - - Total 308 - - - - - 41 TABLE 17 FACTORIES ACTS, 1937 AND 1948. YEAR 1954 PART I OF THE ACT I.-INSPECTIONS for purposes of provisions as to health (Including inspections made by Sanitary Inspectors) Premises Number on Register Number of Inspections Written notices Occupiers prosecuted (1) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 45 46 1 - (11) Factories not included in (1) in which Section 7 is enforced by the Local Authority 333 412 20 - (111) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 1 1 - - Total 379 459 21 - 2.-CASES IN WHICH DEFECTS WERE FOUND (If defects are discovered at the premises on two, three or more separate occasions they should be reckoned as two, three or more "cases") 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 (S.l) 12 2 - - - Overcrowding (S.2) - - - - - Unreasonable temperature (S.3) - - - - - Inadequate ventilation (S.4) 2 2 - 1 - Ineffective drainage of floors (S.6) - - - - - Sanitary Conveniences (S.7) (a) insufficient 2 1 - 1 - (b) unsuitable or defective 40 15 - - - (c) not separate for sexes - - - - - Other offences against the Act (not including offences relating to Outwork) 3 2 - - - Total 59 22 - 2 - PART VIII OF THE ACT OUTWORK (Sections 110 and 111) Nature of Work Section 110 Section 111 No. of out-workers in August list required by Sect. 110(1)(c) No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwholesome premises Notices served Prosecutions Wearing Apparel (Making etc.) 206 - - - - - Umbrellas, etc 3 - - - - - Metal Caps 20 - - - - - Christmas crackers, cosaques, Christmas stockings, etc. 61 - - - - - Total 290 - - - - - 42 INCIDENCE OF BLINDNESS Information had been requested as to the incidence of blindness, epilepsy and spasticity in the area, and Mr. H.W. Seward, Chief Officer of Welfare Services has kindly provided the following information on these handicapped persons TABLE 18 REGISTERED BLIND AND PARTIALLY-SIGHTED AT 31ST DECEMBER, 1953 Categories AGE GROUPS 0-1 2-4 5-10 11-15 16-20 . 21-30 .31-39 40-49 50-59 60-64 ,65-69 70+ Total Blind M - - 3 - - 6 6 15 19 12 10 54 125 F - 1 1 1 1 4 3 8 20 9 16 90 154 Totals - 1 4 1 1 10 9 23 39 21 26 144 279 0-1 2-4 5-15 16-20 21-49 50-64 65+ PartiallySighted M - 3 2 1 5 2 10 23 F - - 2 - 2 2 22 28 Totals - 3 4 1 7 4 32 51 Table 19 NO. OFFORMSB.D.8 RECEIVED DURING YEAR ENDED 31ST DECEMBER, 195. Categories AGE GROUPS 0-1 2-4 5-10 11-15 16-20 21-30 31-39 40-49 50-59 60-64 65-69 70+ Total Blind M - - 1 - - - - 1 - - - 12 14 F - 1 - - - - - 1 - 3 4 16 25 Totals - 1 1 - - - - 2 - 3 4 28 39 0-1 2-4 5-15 16-20 21-49 50-64 65+ PartiallySighted M - 2 2 - 2 - 5 11 F - - 1 - 1 - 9 11 Totals - 2 3 - 3 - 14 22 43 TABLE 20 ANALYSIS OF DISEASES ETC. Disease or Cause of Blindness No. of cases notified Ho. of cases shown as Requiring Treatment Male Female Male Female Cataract Primary 5 8 2 1 Senile Macular Degeneration 6 4 2 - Detachment of Retina 1 1 - - Local Infection of Coats of Eye - 1 - - Glaucoma Primary 2 3 - 1 Vitreous Haemorrhage Opacities - 1 - - Arteriosclerotic Retinopathy - 1 - - Retrolental Opacity - 1 - - Myopic Error - 1 - - Herpes Ophthalmia Defects - 1 - 1 Congenital Defects - 2 - - Diabetic Retinopathy - 1 - - Hypermetropla Astigmatism 1 - - - Excised 1 - - - Hypermative Cataract - 1 - - Diabetes 1 1 1 Macular & Choroidal Degeneration - 1 - 1 Cerebal Vascular Lesion - 1 - - Macular Haemorrhage - 1 - - Arterio Sclerosis — 1 - - Congenital Glaucoma 1 - - - The above figures record the main causes of eye defects, and where these differ in respect of each eye both causes have been included. Of the 39 cases of blindness certified during the year, 7 were advised by the Ophthalmologist to have treatment, either surgical or medical. in two instances the person was undergoing hospital treatment at the time, and in the other five cases a letter was given to the patient by the examining Ophthalmologist and an appointment made for hospital treatment, by the Home Teacher. 44 TABLE 21 ANALYSIS OF AGES AT NOTIFICATION OF CASES ON REGISTER AT 31.12.53 Disease (Blind) Age at Notification as Blind or Partially-Sighted 0-1 2-4 5-10 11-15 16-20 21-30 31-39 40-49 50-59 60-64 65-69 70+ Total Cataract 1 3 5 5 50 64 Glaucoma 1 1 1 3 2 24 32 Retrolental *Opacities 1 1 Totals 1 1 1 l 4 8 7 74 97 (PartiallySighted) 0-1 2-4 5-15 16-20 21-49 50-54 65+ Cataract 1 1 23 25 Glaucoma 2 2 Retrolental Fibroplasia Nil Totals 1 1 25 27 *Per Form B.D.8. 45 TABLE 22 No. OF PERSONS KNOWN TO BE AFFECTED BY EPILEPSY & CEREBRAL PALSY DISEASE Age Groups 15-24 25-44 45-64 65-74 75+ Total Epileptics M 3 8 9 — — 20 F 2 3 9 2 — 16 Cerebral Palsy M — — — — — Nil F — — — — — Nil Facilities available to Epileptics and Spastics Handicrafts An Occupational Centre is established for all classes of handicapped persons. Assistance is given in disposing of saleable goods. A mid-day meal is provided at low cost and transport is available where necessary. Recreational Regular evening socials or concerts are held, together with occasional outings. Holidays in the Council's Hostels for the Aged are arranged when vacancies exist. Employment Interviews arranged with Disablement Resettlement Officer for placement in industry, training etc., under Education Act, 1944 etc. Accommodation Assistance in obtaining Part. III Accommodation, Epileptic Colonies etc. Liaison with British Epileptic Association. General Visitation by Welfare Officers - personal problems, instruction in handicrafts - liaison with voluntary organisations and voluntary workers. No. attending, or who have attended Occupational Centre 7 " in Part III Accommodation, Colonies etc. 6 " employed in open Industry 4 " " " sheltered workshops 2 NATIONAL HEALTH SERVICE ACT, 1946 SECTIONS 22, 23, 24, 25, 26, 27, 28, 29 and 51. Full details of the Council's proposals approved by the Minister of Health, as indicated in my report for 1948, have been published in booklet form and are available for reference. SECTION 22 - CARE OF MOTHERS AND YOUNG CHILDREN DENTAL CARE. Dr. Allan Ross, the Senior Dental Officer, submits the following reports on the dental treatment provided for expectant and nursing mothers and pre-school children in 1953 and 1954 1953 "It was yet another difficult year, but ended on a more optimistic note. The statistics are similar to those for the previous year. 46 The number of denture capes remains high compared with that prevailing before the imposition of charges for dentures provided under the General Dental Services. The X-ray unit was used in more causes than in the previous year, but it is still used mainly for school children. During the year a new clinic was erected and the dental accommodation thus made available will make it possible to increase the establishment by one dental officer, the present establishment being for three dental officers and one oral hygienist. With four dentists, pre-school children will be able to receive more routine conservative treatment. These young children are a great problem as their parents do find it extremely difficult to obtain treatment from private practitioners. In January, the two full-time dental officers commenced extra evening sessions, primarily to compensate for the continued absence of a third dentist. It was soon found that a very high proportion of mothers much prefer to attend for treatment in the evenings." 1954 "Until the end of the year, there was every prospect of four full-time dental officers working in the Dental Clinics as the establishment had been raised to that figure earlier in the year. Unfortunately the resignation of one dental officer and the certain resignation of another dental officer early in 1955, coupled with the very poor response to numerous advertisements, made the whole position extremely gloomy. There was every prospect of the Senior Dental Officer being the only full-time denial officer for at least the early part of 1955. The continuation of dental treatment for pre-school children in the Clinic is essential as it is just this age group which has great difficulty in obtaining treatment elsewhere. The provision of free dentures is much appreciated by expectant and nursing mothers, and a large number of dentures was, in fact, provided during the year. These services result in an ever heavier burden being borne by the depleted staff. The Oral Hygienist was unfortunately on sick leave for a considerable part of the year." TABLE 23 NUMBERS PROVIDED WITH DENTAL CARE, 1953 Examined Needing treatment Treated Made dentally fit Expectant & Nursing Mothers 337 323 332 121 Children under five 570 534 480 365 47 TABLE 24 FORMS OF DENTAL TREATMENT PROVIDED, 1953 Extrac tions Anaesthetics Fillings Scalings or scaling and gum treatment S ilver Nitrate treatment Dressings Radiographs Dentures provided Local General Complete Partial Expectant) & Nursing) Mothers) 542 239 66 438 252 4 95 28 17 61 Children) under five) 786 34 385 146 14 77 122 3 - 1 TABLE 25 NUMBERS PROVIDED WITH DENTAL CARE, 1954 Examined Needing treatment Treated Made dentally fit Expectant & Nursing Mothers 290 282 296 68 Children under five 542 503 445 358 TABLE 26 FORMS OF DENTAL TREATMENT PROVIDED, 1954 Extrac tions General Anaesthetics Fillings Scalings or scaling and gum treatment Silver Nitrate treatment Crowns or Inlays Radiographs Dentures provided Full upper or lower Partial upper , or lower Expectant) & Nursing) Mothers) 400 84 269 40 2 1 22 28 106 Children) under five) 734 401 94 4 21 - 1 - - PUBLIC HEALTH ACT 1936 - SECTION 203 The following tabulation shows the number of births notified each year, as adjusted by transferred notifications:— (a) Live Births: 1953 1954 (1) Domiciliary 295 331 (11) Institutional 1,362 1,175 48 (b) Still births: 1953 1954 (i) Domiciliary 3 - (ii) Institutional 27 27 (c) Totals (i) Domiciliary 298 331 (ii) Institutional 1,389 1,202 Grand Totals 1,687 1,533 Number of premature infants notified during the years (including transferred notifications) where the mothers normally reside in the area. 1953 1934 (i) Born at home 8 17 (ii) Born in hospital or nursing home 81 67 49 TABLE 27 Weight at birth PREMATURE LIVE BIRTHS 1953 PREMATURE STILL-BIRTHS 1953 Born in Hospital Born at home and nursed entirely at home Born at home and transferred to hospital on or before 28th day Born in hospital Born at home Born in nursing home Total Died within 24 hrs. of birth Survived 28 days Total Died within 24 hrs. of birth Survived 28 days Total Died within 24 hrs. of birth Survived 28 days (a) 3 lb. 4 oz. or less (1,500 gms. or less) 7 4 2 - - - - - - 11 1 - (b) Over 3 lb 4 oz. up to and Including 4 lb. 6 oz. (1,500 - 2,000 gms.) 14 - 14 1 - - 2 - 1 5 - - (c) Over 4 lb. 6 oz. Up to and including 4 lb. 15 oz. (2,000 - 2,250 gms.) 20 - 18 2 - 2 - - - - - -- (d) Over 4 lb 15 oz. up to and Including 5 lb. 8 oz. (2,250 - 2,500 gms.) 40 3 37 3 - 3 - - - - 1 - Totals 81 7 71 6 - 5 2 - 1 16 2 - 50 TABLE 28 PREMATURE INFANTS, 195b Weight at birth PREMATURE LIVE BIRTHS PREMATURE STILL-BIRTHS Born in Hospital † Born at home and nursed entirely at home Born at home and transferred to hospital on or before 28th day Born in nursing home and nursed entirely there Born in nursing home and transferred to hospital on or before 28th day Born in hospital Born at home Born in nursing home Total Died within 24 hrs. of birth Survived 28 days Total Died within 24 hrs. of birth Survived 28 days Total Died within 24 hrs. of birth Survived 28 days Total Died within 24 hrs. of birth Survived 28 days Total Died within 24 hrs. of birth Survived 28 days (a) 3 lb. 4 oz. or less (1,500 gms. or less) 14 8 5 1 1 — — — — — — — — — — 4 — — (b) Over 3 lb. 4 oz. up to and including 4lb.6 oz. (1,500-2,000 gms.) 12 1 9 — — — 2 — 2 — — — — — — 2 — — (c) Over 4 lb. 6 oz. up to and including 4 lb. 15 oz. (2,000-2,250 gms.) 12 — 12 1 — 1 2 — 2 — — — — — — 3 — — (d) Over 4lb. 15oz. up to and Including 5 lb. 8 oz. (2,250-2,500 gms.) 29 1 28 9 — 9 2 — 2 — — — — — — 1 — — Totals 67 10 54 11 1 10 6 — 6 — — — — — — 10 —- — †The group under this heading will include cases which may be born in one hospital and transferred to another 51 TABLE 29 ANTE-NATAL AND POST-NATAL CLINICS, 1953 No. of clinics provided at end of year (whether held at Child Welfare Centres or other premises) No. of sessions held at end of year per month at clinics No. of women In attendance Total No. of attendances made during the year No. of women who attended during the year No. of new cases included in previous column i.e. for A.N. clinics women who had not previously attended any clinic during current, pregnancy and for P.N. clinics women who had not previously attended any P.N. clinic after last confinement Medical Officers Sessions Midwives Sessions * Medical officers Sessions Midwives Sessions Local Health Authority Clinics Ante-natal clinics 4 43 — 1,615 l„134 7,776 — Post-natal clinics — — — 388† 382† 426† — Clinic belonging to other L.H.A.+ Ante-natal clinics 1 4 — 20 11 76 — Post-natal clinics —" — — 5† 5† 6+ — * i.e. Sessions where no Medical Officer is Present + By arrangements with L.C.C. at Fernhill treet Baths, North Woolwich, E.16. † Post-natal patients seen at ante-natal clinics and these numbers are not Included In the ante-natal figures. Note:- An additional clinic operating one session per week was opened at the Shrewsbury Road School on 10th July 1953 No ante-natal or post-natal examinations were carried out by General Practitioners at the mother's home or the practloner's surgery under arrangements made with the Local Health Authority. 52 TABLE 30 No. of clinics provided at end of year (whether held at Child Welfare Centres or other premises) No. of sessions held at end of year per month at clinics No. of women in attendance Total No. of attendances made during the year No. of women who attended during the year No. of new cases included in previous column I.e. for A.N. clinics women who had not previously attended any clinic during current pregnancy and for P.N. clinics women who had not previously attended any P.N. clinic after last confinement Medical Officers Sessions Mldwives Sessions * Medical Otfices Sessions Midwives Sessions Local Health Authority Clinics Ante-natal clinics 4 44 — 1,490 943 6,954 — Post-natal clinics — — — 387† 385† † 407 — Clinic belonging to other L.H.A. Ante-natal clinics 1 4 — 24 18 84 — Post-natal clinics — — — 3† 3† † 3 — * i.e. Sessions where no Medical Officer is present. + By arrangements with L.C.C. at Fernhlll Street Baths, North Woolwich, E.16. † Post-natal patients seen at ante-natal clinics and these numbers are not included in the ante-natal figures Note:- No clinics were discontinued or new premises opened during the year. No ante-natal or post-natal examinations were carried out by General Practitioners at the mother's home or the practitioner's surgery under arrangements made with the Local Health Authority. 53 TABLE 31 CHILD WELFARE CENTRES, 1953 Number of centres provided at end of year Number of Child Welfare Sessions now held per month at centres Number of children who first attended a centre during the year, and who at their first attendance were under 1 year of age Number of children who attended during the year and who were born In: Total Number of children who attended during the year Number of attendances during the year made by children who at the date of attendance were: Total attendances during the year 1953 1952 1951-48 Under 1 year 1 but under 2 2 but under 5 Local Health Authority Centres 4 47 1,302 1,153 827 458 2,438 15,091 2,146 1,899 19,136 Centre belonging to other L.H.A.† 1 4 57 34 24 19 77 471 43 19 533 † By arrangement with L.C.C. at Fernhill Street, Baths, North Woolwich, E.16. Note:- An additional clinic operating one session per week was opened at the Shrewsbury Road School on 10th July 1953 5k TABLE 32 CHILD WELFARE CENTRES, 195k Number of centres provided at end of year Number of Child WeIfare Sessions now held per month at centres Number of children who first attended a centre during the year, and who at their first attendance were under 1 year of age Number of children who attended during the year and who were born in: Total Number of children who attended during the year Number of attendances during the year made by children who at the date of attendance were: Total attendances during the year 1954 1953 1952-49 Under 1 year 1 but under 2 2 but under 5 Local Health Authority Centres 4 44 1,261 1,124 911 419 2,454 14,540 2,214 1,708 18,462 Centre belonging to other L.H.A. † 1 4 21 18 28 23 69 280 76 41 397 f By arrangement with L.C.C. at Fernhill Street Baths, North Woolwich, E.16. Notes- No clinics were discontinued or new premises opened during the year 55 MATERNITY AND CHILD WELFARE CLINICS The work. Is now distributed between four ellnics of the local health authority, and for the extreme south of the borough the Fernhill Street Baths clinic premises are still used. A new centre was opened on 10th July, 1953 in the old Shrewsbury Road School, the better to serve that large centre of population In the north-west area, which ultimately will be covered by the clinic it is proposed to erect on the Durban House site. These school premises have many disadvantages. They are difficult to keep warm, have no proper disrobing arrangements and Inadequate toilet facilities. But in spite of this, the advantage to the mothers of not having to trek long distances (possibly with one or two other infants to take along) appears to outweigh all other considerations, and the clinic Is well attended. Nevertheless we look forward to the day when this large section of our population will be better served in the matter of clinic premises. There had been a falling off in the number of expectant mothers attending our ante-natal clinics. The reasons for this are:- 1. General drop In the birth rate. 2. Reduction in population especially that fraction of virile young persons who have been rehoused in the Council's out-county schemes. 3. Greater share in this work by both general practitioners and the maternity hospitals in the area. It is quite usual for the maternity hospitals to see a proportion of the cases to be delivered in their wards. Where this does not entail a long or awkward journey by the expectant mothers the position is quite logical, but where a long, tedious journey Is involved, in many instances the arrangement for ante-natal supervision could well be reviewed with advantage. DAY NURSERIES TABLE 33 Year Number at No. of approved places No. of children on the register at the end of the year Average daily 31st December 0-2 years 2-5 years 0-2 years 2-5 years 0-2 years 2-5 years 1953 2 60 89 20 55 19.1 54.1 1954 2 60 89 17 63 12.7 52.9 There are no Nurseries In the borough provided by Voluntary Organisations, all nurseries being operated by the authority. No new Nurseries were opened, but on 2nd April 1953 the Roman Road and School Road Nurseries were closed, the children being transferred to one of the two remaining nurseries. 56 The nurseries are open from Monday to Friday each week, with the exception of Public Holidays, and the total attendances during 1953/1954 were as follows:- Nursery Total attendances Average dally attendance 1953 1954 1953 1954 Roman Road (1.1.53 - 2.4.53) 501 - 7.6 - School Road (1.1.53 - 2.4.53) 1,244 - 18.8 - St. Stephen's Road 9,689 33.2 37.8 Wall End/Caledon Road 7,084 33.1 27.8 Total 18,664 16,773 The overall need for day nursery provision in selected oases is still manifest In 1953, but the great reduction in attendance at the School Road and Roman Road Nurseries would appear to indicate that these centres could be closed in the Interests of economy and the children diverted to the St. Stephen's Road and Wall End Nurseries which at the present time have a greater daily use. This policy, in fact, was adopted by the Council, and in 1953 all the remaining children were concentrated In the two central nurseries, transport being employed morning and evening to ensure that no hardship devolved on mothers in bringing and taking home their children. It will, however, be seen from the attendance figures for 1954 that there is a steady decline in the need for this service. Higher wages, full employment, greater social security, and better housing, all may play a part in the reduction of the community need for children's day nursery accommodation. ALDERSBROOK MATERNITY HOSPITAL. STATISTICS 1953 1954 Number of beds on 31st December 20 20 " " midwives employed 7 5 " " patients confined during the period (a) midwifery 457 329 (b) maternity nursing 457 329 " " midwives qualified to administer gas and air analgesia 6 5 " " sets of apparatus of gas and air analgesia in use 2 2 " " patients to whom gas and air analgesia was administered by midwives during the period (a) when acting as a midwife 448 318 (b) " " " " maternity nurse 448 318 " " patients to whom pethidine was administered by midwives during period (a) when acting as midwife 374 194 (b) when acting as maternity nurse - 374 194 " " occasions, medical aid sought by midwives under section 14(1) of the Midwives Act, 1951 18 37 " " infant deaths during the year 1 2 " " premature infants born during the year 18 6 " " still births during the year - 1 57 This Unit still plays an Important part in the arrangements for hospital delivery of mothers who live in East Ham. A doctor attends dally and as required, and close liaison with the staff of Forest Gate Hospital ensures that all difficulties and emergencies are promptly and adequately covered. By selection and greater ante-natal supervision an attempt is made to avoid admitting women to this Unit who may need obstetric Interference for one or other of the foreseeable complications of child-birth. Up to a point this has worked fairly well, but where emergencies have arisen It was often found advisable to transfer the parturient mother to Forest Gate Hospital, The drop in admissions is noted, and goes hand in hand with the decline in the birth rate, the more careful selection of cases as already Indicated, and the Increase In domiciliary confinements with the steady Improvement In the housing position of many families. It is obvious that falling bed occupancy will result in a concomitant rise in the cost per bed, and eventually the unit must be uneconomical to maintain. Nevertheless, so great are the advantages of this obstetric unit to the mothers of East Ham, that no financial considerations should be taken Into account In seeking its closure until and unless full alternative accommodation can be provided for hospital delivery within easy reach of all parts of our borough. ILLEGITIMATE CHILDREN (Circular 2866) The Council do not employ a social worker for the purpose of the above Circular. These duties are undertaken by the Superintendent Health Visitor and her staff and close co-operation is maintained with the Children's Officer. CARE OF UNMARRIED MOTHERS During the years 1953 and 1954 the Council was responsible for the maintenance of 4 and 2 unmarried mothers respectively, in homes of the Chelmsford Diocesan-Moral Welfare Association. NURSERY AND CHILD-MINDERS REGULATION ACT, 1948 There were no dally minders provided by the Council and there were no premises or dally minders registered under the above Act during the years under review. The Authority are not paying any fees to daily minders under section 22 of the National Health Service Act, 1946. REGISTRATION OF NURSING HOMES Under Sections 187 to 194 of the Public Health Act, 1936, there were no homes registered during the years 1953 and 1954, and there were no homes on the register at the end of either year. SECTION 23 - MIDWIFERY SERVICE Domiciliary confinement still shares a most important aspect of the maternity services of East Ham. In 1953, 300 women were confined in their own homes, and In 1954, 324. 58 The number of Council midwlves was increased from four to five in 1954, in order to deal with the additional deliveries which fell to this service by the closure of the Plaistow Maternity Hospital District Home in Burges Road. So that, in practice, the Council's midwlves undertake all the domiciliary midwifery in the borough, excluding that small portion south of the Royal Docks served by the midwoves of the Silvertown & North Woolwich District Nursing Association. This valuable asset to the social life of the borough receives considerable support from the local general practitioners who should play an increasing part in domiciliary midwifery. With the return to better housing conditions for a fraction of the public who were denied good domestic living conditions by the destruction caused by enemy bombing, there is little reason to swell the number of women referred to hospital for confinement. Having a baby is a natural event which should take place in a natural environment,, the home. The highly artificial surroundings of the hospital necessary for their specific function, are not conducive to good beginnings in infant nurture, and It is an undoubted fact that many problems spring from the awkward transition from hospital regime to home conditions, with the concomitant lack of progressive orderly usage and habit which may have suited mother and child (or the doctors and nurses) well In hospital, but are not so well adapted to the home environment. The Regional Hospital Boards are well acquainted with these problems and have urged on hospitals and general practitioners the necessity for reserving hospital confinement for those cases where the need - social, medical or obstetric - Is clear. Under all other circumstances the general practitioners are earnestly adjured to assist the Medical Officer of Health to ensure that babies are born at home and given the best chance of uninterrupted nurture in infancy. TABLE 34 MIDWIVES ACTS, 1902 - 1951 Number of midwlves practising in the area at 31st December Domiciliary Midwlves Midwlves in Institutions Total 1953 1954 1953 1954 1955 1954 Midwlves employed by the Council Midwlves employed by Voluntary Organisations - 4 5 – – 4 5 (a) Under arrangements made with the L.H.A. in pursuance of Section 23 of the N.H.S. Act 2 2 – – 2 2 (b) Otherwise (including hospitals not transferred to the Minister under the N.H.S. Act) – – – – – – Midwives employed by Hospital Management Committees or Boards of Governors under the N.H.S. Act 2 – 7+ 6+ 9 6 Midwlves in private practice 1 – – – 1 – Totals 9 7 7 6 16 13 59 Notes;- Figures for Aldersbrook Maternity Hospital have not been Included In the above table. These mldwlves are employed at East Ham Memorial Hospital. The 2 mldwlves In (a) above carried out part-time Midwifery service In the North Woolwich area and were employed by the Sllvertown and North Woolwich District Nursing Association. The 2 domiciliary mldwlves employed by the Hospital Management Committee were from the Plalstow Maternity Hospital and District Nurses Home, (local branch - Burges Road). TABLE 35 Number of Deliveries attended by Midwives in the area during the year 1953 Domiciliary Cases Cases in East. Ham Memorial Hospital Docta* not booted Doctor booted Totals Doctor present at time of delivery of child Doctor not present at time of delivery of child Doctor present at time of delivery of child (either the booked Doctor or another) Doctor not present at time of delivery of child (a) Mldwies employed by the Authority 6 161 7 11 185 – (b) Mldwives employed by Voluntary Organlsatlons:- (1) Under arrangements with the Local Health Authority in pursuance of Section 23 of the National Health Service Act, 1946 2 4 — — 6 — (ii) Otherwise (Including Hospitals not transferred to the Minister under the National Health Service Act) — — — — — — (c) Midwives employed by Hospital Management Committees or Boards of Governors under the National Health Service AC 2 90 16 — 108 365 (d) Midwives in Private Practice (Including Midwives employed In Nursing Homes) — 1 — — 1 - Totals 10 256 23 11 300 365 60 TABLE 36 Number of Deliveries attended by Midwives in the area during the year 1954 Domiciliary Cases Cases In East Ham Memorial Hospital Doctor not booked Doctor booted. Totals Doctor present at time of delivery of child Doctor not present at time of delivery of child Doctor present at time of delivery of child (either the booked Doctor or another) Doctor not present at time of delivery of child (a) Midwives employed by the Authority — 57 11 204 272 — (b) Midwives employed by Voluntary Organisations:(1) Under arrangements with the Local Health Authority In pursuance of Section 23 of the National Health Service Act, 19i+6 — 3 1 — 4 — (11) Otherwise (Including Hospitals not transferred to the Minister under the National Health Service Act) — — — — — — (c) Midwives employed by Hospital Management Committees or Boards of Governors under the National Health Service Act — 41 7 — 48 307 (d) Midwives in Private Practice (Including Midwives employed in Nursing Homes) — — — — — — Totals — 101 19 204 324 307 1953 1954 Number of cases delivered in institutions but attended by domiciliary midwlves on discharge from institutions and before the fourteenth day 7 2 Breast Feeding Number of domiciliary cases in which the Infant was wholly breast fed at the fourteenth day 256 257 61 Number of cases In which medical aid was summoned by a midwife under section 14(1) of the Midwlves Act, 1951 1953 1954 (a) for domiciliary cases - (1) where the medical practitioner had arranged to provide the patient with maternity medical services under the N.H.S. Act 25 35 (11) others 81 47 Total 106 82 (b) for cases in East Ham Memorial Hospital 102 115 DOMICILIARY MIDWIVES TABLE 37 GAS AM) AIR ANALGESIA AND ADMINISTRATION OF PETHIDINE Domiciliary Midwives employed directly by Council Domiciliary Midwlves employed under Sec.23 by voluntary organisations as agents of Council Domiciliary Midwives employed under Sec.23 by hospital authorities as agents of Council Domiciliary Midwives in private practice Total. 1953 1954 1953 1954 1953 195k 1953 1954 1953 1954 NO. of Domiciliary mldwives practising In the area at 31st December who were qualified to administer gas and air analgesia in accordance with the requirements of the Central Mldwives Board 4 5 2 2 2 — 1 — 9 7 No. of sets of apparatus in use by domiciliary midwlves 4 5 2 2 2 — — — 8 7 No. of cases In which gas and air was administered by domiciliary midwlves during the period:- (a) when acting as a midwife 108 169 2 2 88 24 — - 198 193 (b) when acting as a maternity nurse 6 9 2 - 18 3 - - 26 12 No. of cases in which Pethidine was administered by domicilliary midwives during the period:- (a) when acting as midwife 113 167 - - 9 8 - - 122 177 (b) when acting as maternity nurse 7 7 - - 1 3 - - 8 10 62 INSTITUTIONAL MIDWIVES The numbers of midwives employed by East Ham Memorial Hospital, and qualified at 31st December to administer gas and air analgesia were as follows 1953 - 6 1954 - 5 The figures for 1953 and 1954 shew an overall decline in the use of gas and air analgesia, but a considerable accession in the employ of pethidine. This may be due partly to the smaller number of domiciliary confinements, but I have reason to believe the instruction in relaxation, and attendance at ante-natal exercise classes, also play a part in the lessened need for gas and air analgesia in the various stages of labour. The relaxation and ante-natal exercise classes are open to all women at the discretion of the medical staff, and general practitioners are reminded their patients too have free access to these clinics. SECTION 24 - HEALTH VISITING SERVICE All Health Visiting Services are provided by the Authority. There are no agency arrangements with voluntary organisations TABLE 38 HEALTH VISITORS - STATISTICS Year Number of children under 5 years of age visited during year Expectant Mothers Children under 1 year of age Children age 1 and under 2 years Children age 2 but under 5 years Other cases Total number of families or households visited by Health Visitors Number of attendances per month by Health Visitors at Clinic Sessions First visits Total visits First visits Total visits Total visits Total visits Total visits 1953 8,892 1,256 1,504 1,716 8,644 5,760 6,445 2,925 10,917 221 1954 7,709 1,291 1,624 1,568 9,033 5,229 8,075 2,319 18,584 275 There has been a tremendous increase in the true 'health visiting1 work of these tireless medico-social workers. I have asked many difficult tasks of them, Including the investigation of problem families, follow-up of troublesome hospital cases, and enquiries for research of several kinds in which the health department was taking part. Our highly trained health visitors under their able and alert Superintendent Health Visitor, have risen to the task and spared no effort to make their observations, record their findings, and give advice and help where needed In the numerous ways indicated in the annual report for 1952. They have effected good relationships and co-operation with the family doctor and the hospitals, and have thus widened their front of approach to the family. 63 They have allied themselves to all those who care for the comfort and well-being of our Increasing population of old people, and in this are doing excellent work. They keep what amounts almost to a continuous census of the defective and physically handicapped children of pre-school age, and in this way greatly ease the task of care, ascertainment and placement of these unfortunate young ones. And at all times both in the clinic and the home, they spread the doctrines of prophylaxis and better health. Some of them find time to attend courses of social studies so that they can fit themselves the better to accomplish the many tasks of education and research for which their wide training prepares them. The families of the borough owe them a great debt which is in part repaid by the visible results of their work in the fine children of East Ham, happier, healthier and physically the superior of their counterparts of a generation ago. SECTION 25 "HOME NURSING The Home Nursing Service has proved to be one of the corner stones of social medicine. In fact, without their invaluable aid the family doctor would find his burden of work too onerous, and many an old person would receive infrequent scant attention but for their humanitarian ministrations. The details of the work are clearly set out in the dissected schedules, and the reduction in the total number of visits in 1953 and 1954, compared with the figure for 1952, should not be construed as a lessening in the volume of work. Fewer routine visits are paid to chronic sick and old people who do not need actual nursing care, leaving more time to devote to the host of aged and Infirm who require skilled nursing, and the acute and sub-acute sick being nursed at home. 'Charnwood' is used largely for the residential staff and is the focus of administration. mere is some difficulty in finding a suitable resident assistant superintendent who would ensure the comfort and well-being of the nurses at all times, and see to it that a comfortable home is indeed provided for this hard-working section of the nursing community. The nurses are encouraged to attend refresher courses in subjects allied to their work, and lectures and demonstrations are arranged locally to keep alive their clinical Interest and keep them abreast of current medical and nursing problems. 64 TABLE 39 HOME NURSING - STATISTICS Year Medical Surgical Infectious Diseases Tuberculosis Maternal Complications Others Totals Number of Patients who were 65 or over at the time of the first Visit during the year Number of Children who were under 5 at the time of the first visit during the year Number of Patients who had more than 24 visits during the year Number of cases attended by Home Nurses during the year 1953 2,590 315 27 125 47 - 3,104 1,179 183 485 1954 2,307 128 21 88 45 173 2,762 1,301 48 152 Number of visits paid by Home Nurses during the year 1953 46,493 7,290 141 4,394 335 - 58,653 31,450 990 38,925 1954 48,952 1,780 118 2,445 266 297 53,858 31,099 199 8,283 All home nursing services are provided by voluntary organisations acting as agents of the Council in accordance with arrangements made under Section 25 of the Act. The Council do not directly employ home nurses for this service. 65 SECTiON 26 - VACCiNATiON AND iMMUNiSATiON Small Pox Vaccination the vaccinal state of the burgesses remains lamentably low and this in spite of repeated exhortations in my annual reports, in the press, by leaflet, posters and lectures. Hardly a year passes without small local epidemics of virulent small pox in various parts of the British Isles. it must be remembered that this disease can be introduced into this country by sea, through members of the crew or passengers, or in the cargo, by air travellers - a very dangerous source - or occasionally by members of the armed forcesc Rapid land communications in this country make it very difficult to control the movements of infected individuals or their contacts, which adds to the menace of sporadic introduction of small pox into an unvacclnated community. This borough stands at a most vulnerable point in the long unprotected frontier against small pox invasion. Our large docks, although well protected by an organized Port Health Authority, yet may well be the portal of entry at any moment of virulent small pox. The implications might be serious indeed for the unprotected community in East Ham. Even one death from this disease would reflect discredit on the lackadaisical response to repeated advice and exhortation. Ask your family doctor to vaccinate you and your children now - before it is too late. TABLE 40 DiPHTHERiA iMMUNiSATiON No. of children who completed a full course of primary immunisation (including temporary residents) Total number of children who were given a secondary or re~lnforclng injection (i.e. subsequent to complete full course) Age at date of final injection Under 5 5-14 Total Six months ending 30/6/53 600 56 656 155 " " " 31/12/53 532 36 568 101 Totals 1,132 92 1,224 256 Six months ending 30/6/54 714 57 771 222 " " " 31/12/54 639 32 671 138 Totals 1,353 89 1,442 360 66 TABLE 41 Number of children, who, at 31st December in each year had completed a course of Immunisation at any time before that date Age at 31st December Under 1 year 1-4 . years 5-9 . years 10 - 14 years Totals Number Immunised 1953 188 4,649 7,932 4,996 17,765 Estimated Mid-year Child Population 1953 9,400 16,500 25,900 Number Immunised 1954 349 4,376 8,230 5,489 18,444 Estimated Mid-Year Child Population 1954 1,560 6,340 17,500 25,400 TABLE 42 SMALL POX VACCINATION Year .No. of persons vaccinated or re-vacclnated Total Age at date of vaccination Under 1 1 - 4 5-14 15 or over 1953 No. vaccinated 369 41 13 47 470 No. re-vacclnated 5 2 14 117 138 Totals 374 43 27 164 608 No. vaccinated 344 46 24 51 465 No. re-vacclnated 1 2 4 113 120 Totals 345 48 28 164 585 All vaccinations were carried out by general practitioners. There were no cases specially reported during the period under review of (a) Generalised vaccinia (b) Post-vacclnal encephalomyelitis (c) Death from complications of vaccination other than (a) and (b) 67 SECTiON 27" AMBULANCE SERViCE The new Ambulance Station in Wellington Road, mentioned in my Report for 1952, was opened by the Worshipful the Mayor, Alderman L.A.V. Bennett, J.P. on 19th December, 1953, the transfer of vehicles and staff having taken place on the previous day. The building was designed in the Architects' Section of the Borough Engineer's Department, the main contractors being Messrs. Soar & Co. Ltd., and the following description of the Station was given in the programme of the official opening. "The new Ambulance Station comprises a garage, administration block and facilities for the repair and washing down of vehicles. The garage, which accommodates 14 vehicles arranged in tandem,is provided with folding sliding doors to the main frontage on Wellington Road and at the rear, allowing vehicles to enter by a side entrance and face the main exit without reversing. The main roof to the garage is of light-weight construction with a high thermal insulation value and is supported on tubular steel trussed beams, thus providing minimum but adequate air space and giving high efficiency to the background heating in the garage. Warmed air is introduced by means of overhead unit heaters which operate by means of an electric fan driving air through a hot water coll. Electric points are also fitted in the floor to provide facilities for radiator heaters or other electrical equipment. The adjoining administrative and staff quarters accommodate 30 personnel, the ground floor comprising telephone and message room, superintendent's office, stores and recreation room. On the first floor there are separate rest rooms for both men and women, together with a kitchen and dining room. Adequate sanitary accommodation is provided throughout the premises. The building is heated by means of an accelerated low pressure system with a separate domestic hot water supply, the whole of the installation being situated in the basement where a small drying room is provided. At the rear of the main building there is a service yard with covered accommodation for wash-down for two vehicles, a repair bay with inspection pit and stores. A cycle store is also provided." When one looks back at the appalling conditions in the old Station under which the ambulance crews worked, one marvels at the fortitude and loyalty of these men and women truly dedicated to a service. The Ambulance Service is a vital integer in the network of services covered by the National Health Service Act. Without it the hospital services could not function, and the working classes would lose a means of transport for the sick which they have never been able to afford in the past. it is a paramount necessity therefore to preserve this essential service at its highest pitch of efficiency, and the public and the hospitals are asked to assist me in the attainment of this object by avoidance of the use of ambulances of any kind when adequate alternative transport is available. Abuse of the service may spell disaster to unfortunate persons involved in serious accidents or overcome by acute illness. Properly used the Ambulance Service is one of the greatest boons to the community. 68 TABLE 43 AMBULANCE SERVICE. STATISTICS FOR YEAR ENDING 31ST MARCH 1954 AMBULANCE SERVICE Cars from Council's Transport pool and by Private Hire Transport by Rail Grand Total Ambulances Sitting Case Vehicles (over 4 Passenger Seats) Total - All Vehicles 1. No. of Operational Vehicles on 31st March 5 + 5 10 2. No. of such Vehicles fitted with Wireless - - - 3. No. of Patients carrled:(a) Accident or Emergency 1,050 80 1,130 - - 1,130 (b) Others (c) Total (a & b) 15,094 24,830 39,924 61 9 39,994 16,144 24,910 41,054 61 9 41,124 4. No. of Journeys by Vehicles:- 6,700 5,226 11,926 5. Total Mileage 73,986 99,477 173,463 2,513 278 176,254 6. No. of Operational Staff on 31st March - - 30 † Includes 4 Dual Purpose Vehicles, to carry 8 Sitting Cases or 1 Stretcher Case and 4 Sitting Cases 69 TABLE 44 AMBULANCE SERVICE. STATISTICS FOR YEAR ENDING 31ST MARCH 1955 AMBULANCE SERVICE Cars from Council's Transport pool and by Private Hire Transport by Rail Grand Total Ambulances (2 /4 Stretcher) Dual Purpose Vehicles (One Stretcher) Sitting Case Vehicles Total - All Vehicles 1. No. of Operational Vehicles on 31st March 5 4 1 10 2. No. of such Vehicles fitted with Wireless - - - - 3. No. of Patients carrled:(a) Accident or Emergency 1,012 77 3 1,092 - - 1,092 (b) Others 15,880 24,544 5,123 45,547 56 19 45,622 (c) Total (a & b) 16,892 214,621 5,126 46,639 56 19 46,714 4. Total Mileage 74,024 75,814 28,113 177,951 3,012 1,185 182,148 5. No. of Operational Staff on 31st March - - - 29 - - - 70 TABLE 45 COST OF SERVICE Period Ambulance Service Cars from Transport pool etc. Transport By Rail Total £ £ £ £ Tear ending 31st March 1951 19,057 463 3 19,523 Year ending 31st March 1952 19,522 677 7 20,206 Year ending 31st March 1953 22,094 219 3 22,316 Year ending 31st March 1954 24,279 144 3 24,426 Year ending 31st March 1955 27,482 185 9 27,676 TABLE 46 UNIT COSTS AMBULANCE SERVICE YEAR ENDING 31st MARCH, 1954 Ambulance Service Cars from Transport Pool etc. All Services £ s. d. £ s. d. £ s. d. Cost per Vehicle mile 2. 10. 1. 2. 2. 9. Cost per Patient 11. 10. 2. 7. 3. 11. 11. Cost per Journey 2. 0. 9. Cost per 1,000 Population 204. 0. 0. 1. 6. 0. 205. 5. 0. No. of Patients carried per 1,000 population 345 0.5 346 No. of Journeys per 1,000 Population 100 Average Number of Miles per Patient carried 4.2 41.2 4.3 71 TABLE 47 UNIT COSTS - AMBULANCE SERVICE YEAR ENDING 31ST MARCH, 1955 Ambulance Service Cars from Transport Pool etc. All Services Cost per Vehicle mile £ s. d. £ s. d. £ s. d. 3. 1. 1. 2. 3. 1. Cost per Patient 11. 10. 3. 6. 1. 11. 10. Cost per 1,000 Population 233. 10. 0. 1. 11. 5. 235. 2. 10. No, of Patients carried per 1,000 Population 396 0.5 397 Average Mileage per Patient 3.77 54 4 SECTION 28 - PREVENTION OF ILLNESS, CARE AND AFTER CARE Loan Cupboards The scheme for the loan of articles to aid In the domiciliary nursing of the sick remains as detailed in my report for 1950 Details of the items loaned are shown in the following table. 72 TABLE 48 Article No. of occasions items loaned Total Cupboard at Town Hall Annexe East Chest Ham Clinic Church Rd. Clinic 1953 1954 1953 1954 1953 1954 1953 1954 Air bed rings (adults 9 107 4 - 4 12 17 119 Bed Blocks - 2 - - - - - 2 Bed Boards - 1 - - - - - 1 Bed cradles 1 11 - - 1 - 2 11 Bed pans 38 112 2 1 6 11 46 124 Bed rests 26 92 1 1 4 6 31 99 Blankets 6 3 - - - - 6 3 Commodes 2 4 - - - - 2 4 Crutches 5 5 - - - - 5 5 Dunlopillo Mattresses - 1 - - - - - 1 Dunlopillo Rings 11 3 - 1 - - 11 4 Feeding Cups - 10 - 1 - - - ll Hot Water Bottles - 2 - 1 1 - 4 Hospital Bedsteads 1 - - - - - 1 - Mattresses 5 3 - - - - 5 3 Pillows 1 3 - - - - 1 3 Pillow Slips 5 4 - - - - 5 4 Rubber Sheets 16 71 - - - 6 16 77 Sand Bags - 1 - - - - - 1 Sheets 6 5 - - - - 6 5 Sputum mugs - - 2 - - - 2 - Steam Kettles 2 - - - - - 2 - Urinals „ 11 35 1 - 2 6 14 41 Walking Sticks 1 1 - - - - l 1 Water beds - 2 - - - - - 2 Wheel Chairs 49 36 - - - - 49 36 Totals 195 514 10 5 17 42 222 561 NOTE With the exception of garden shelters stored in sections on other Council premises, all large articles (owing to storage space) are kept at the Town Hall Annexe In addition, from the premature baby outfit cupboard the following articles were Issued No. of occasions 1953 1954 Premature baby outfits 3 1 Scales and weights 48 32 TUBERCULOSIS 1953 1954 No. of attendances at East Ham Chest Clinic 27,521 27,458 No. of visits to homes of patients by Tuberculosis Visitors 4,489 4,307 No. of attendances per month by Tuberculosis Visitors at Clinic Session 105 105 73 1953 1954 No. of notified cases on clinic register on:- 1st January: Adults 945 1,244 1,027 1,236 Children 299 209 31st December: Adults 942 1,234 1,045 1,252 Children 292 207 No. of patients under observation on:- 1st January: Adults 692 1,123 1,193 1,752 Children 431 559 31st December: Adults 1,181 1,739 1,454 2,113 Children 558 659 There is no change in the procedure outlined on page 53 of my report for 1949 in respect of the provision of free extra nourishment (milk and food) and free convalescent treatment to tuberculous patients. Numbers of occasions on which free extra nourishment was provided :- 1953 1954 Milk 527 613 Food 35 91 Total 562 704 During the year the Authority accepted responsibility for the provision of rehabilitation for male tuberculous patients In British Legion Village Settlements as shown :- (a) papworth Village Settlement, Cambridge 1953 - One patient for 12 months and one for 3 days 1954 - One patient for 42 weeks and 6 days (b) British Legion Village, Preston Hall, Maidstone, Kent. 1953 - One patient for 8 months and one for 4 months 1954 - One patient for 17 weeks and 1+ days (c) Enham - Alamein Village Settlement, Andover, Hants 1953 - One patient for 12 months and one for 2 months 1954 - Nil The following statistics relate to the work of the part-time occupational therapist 1953 1954 (a) Number of sessions at the Chest Clinic 101 102 (b) Number of sessions worked in visiting patients and giving instruction in their homes 99 105 (c) Number of attendances at Chest Clinic Classes by patients 761 955 (d) Number of visits by therapist to patients' homes 655 589 MASS RADIOGRAPHY The Mass Radiography Unit (no. 6B) again visited East Ham and conducted a public survey from 25th January to 28th February 1954. The Unit was accommodated In the Minor Hall of the Town Hall and a total of 10,095 persons attended for examination. 74 TABLE 49 CONVALESCENT HOME TREATMENT PERIOD OF TREATMENT - 1953 Age Groups Sex Up to 1 week 1-2 weeks 2-3 weeks 3-4 weeks 4-5 weeks 5-6 weeks over 6 weeks Total Under 5 years M - - 5 - 2 - - 7 F - 2 2 1 - - - 5 School children M - 10 24 4 1 - 1 40 F - 18 17 5 - - — 40 Adults M 1 16 19 - - - 1 37 F 1 20 55 3 - 1 - 80 Totals a 66 122 13 3 1 2 209 TABLE 50 The recommendations for this form of treatment were submitted by:- Referred by Children 0-5 School Children Adults Total General Practitioners 4 22 76 102 Hospitals 4 8 27 39 East Ham Chest Clinic - 11 13 24 School Health Service - 36 - 36 M. & C.W. Section 4 - - 4 Child Guidance Clinic - 3 1 4 Totals 12 80 117 209 TABLE 51 CONVALESCENT HOME TREATMENT PERIOD OF TREATMENT - 1954 Age Groups Sex Up to 1 week 1-2 weeks 2-3 weeks 3-4 weeks 4-5 weeks 5-6 weeks over 6 weeks Total Under 5 years M — — — 5 - - - 5 F — - 1 1 - — - 2 School children M - 3 14 22 6 1 6 52 F 2 - 13 11 2 3 1 32 Adults M 1 - 9 24 2 1 - 37 F 2 2 33 60 2 — — 99 Totals 5 5 70 123 12 5 7 227 75 TABLE 52 The recommendations for this form of treatment were submitted by:- Referred by Children 0-5 School Children Adults Total General Practitioners 12 34 124 170 Hospitals 4 3 20 27 East Ham Chest Clinic 2 6 10 18 School Health Service - 43 - 43 M. & C.W. Section 8 - 3 11 Child Guidance Clinic 1 4 1 6 Totals 27 90 158 275 For comparison the numbers of children and adults receiving this form of treatment in previous years are appended 1949 1950 1951 1952 1953 1954 Children 0-5 years 86 47 20 24 12 27 Schoolchildren 326 180 112 79 80 90 Adults 49 52 82 111 117 158 PARK VIEW THERAPEUTIC CLUB This Club continues to thrive by the efforts of the club members supported by Mr. Steadman and the Duly Authorised Officers. Recommendation for membership still is made by the hospital psychiatrists, and in general it is felt the men and women who attend derive a good deal of pleasure from the warm feeling of companionship which permeates the gatherings, and gradually confidence is built up in themselves and in their power to face the ordinary day to day contacts with other members of the community. The Chairman and other members of the Health Committee and the Mayor all have visited the Club from time to time and these occasions have always been warmly appreciated. The average membership of the Club In 1953 and 1954 was 40. SECTIONS 28 AND 51. The plans for the provision of a second occupation centre for mental defectives remain as detailed on page 54 of the report for 1949. The Committee had viewed with deep concern the growing difficulties of coping with the 30 odd defectives of mixed sex and age grouping in the rather restricted quarters available at the Katherine Road Labour Hall Occupation Centre. Representations were made to the landlords of the premises and the renting of additional accommodation was agreed. It has now become possible, with the aid of more staff, to accept up to 50 defectives daily, and in fact since 21st September, 1953, 50 persons were received dally for training, recreation and supervision. 76 The staff now consists of - One Supervisor Three Assistant Supervisors One Guide and Assistant who are able for some periods to segregate and group the defectives Into smaller units for instruction. A sale of work. is held regularly, an annual outing for the defectives is arranged, and a very good Christmas show and party is given in which the defectives themselves perform a Nativity play and sing, presents from the Christmas tree are given to each child, usually by the Chairman of the Health Committee, assisted by the staff of the Mental Health department and interested friends of the Occupation Centre. An annual holiday also is arranged under the auspices of the National Association for Mental Health, for both males and females, and in general much is done to mitigate the burden imposed on family life by a defective in its midst. 77 TABLE 53 PARTICULARS OF MENTAL DEFECTIVES REPORTED 1953 1954 Males Females Total Males Females] Total Particulars of cases reported during the years:- (1) Ascertainment- (a) Cases reported by Local Education Authorities (Section 57, Education Act, 1944)- (i) Under Section 57(3) 1 1 2 3 4 7 (ii) Under Section 57 (5):- On leaving special schools 1 - 1 1 l 2 On leaving ordinary schools - - - - - — (b) Other ascertained defectives reported and found to be "Subject to be dealt with" 2 1 3 1 - 1 Total ascertained defectives found to be "Subject to be dealt with" during the year 4 2 6 5 5 10 (c) Other reported cases ascertained who are not at present "Subject to be dealt with" - 1 1 1 — 1 (d) Cases reported but not confirmed as defectives by 31st December and thus excluded from (a), (b) or (c) 2 - 2 2 - 2 Total No. of cases reported during the year 6 3 9 8 5 13 (2) Disposal of cases reported during the year:- (a) Ascertained defectives found to be "Subject to be dealt with" - (i) Admitted to Hospitals etc. 2 - 2 2 - 2 (ii) Placed under guardianship - - - - - - (ill) Taken to "places of safety" - - - - - - (iv) Placed under statutory supervision 2 2 4 3 5 8 Total ascertained defectives found to be "Subject to be dealt with" 4 2 6 5 5 10 (b) Cases not at present "Subject to be dealt with"- (i) Placed under voluntary supervision - 1 1 1 - 1 (ii) Action unnecessary - - - - - - Total cases not at present "Subject to be dealt with" - 1 1 1 - 1 No. of cases in institutions, under community care including voluntary supervision or in "places of safety" on 1st January who have ceased to be under any of these forms of care:- (a) Ceased to be under care l - 1 2 1 3 (b) Died, removed from area, or lost sight of 8 3 11 10 5 15 Of the total No. of defectives known to the L.H.A. (a) No. who have given birth to children while unmarried - - - - - - (b) No. who have married - 3 3 - 2 2 During the two years under review, no guardianship orders were discharged with the approval of the Board of Control in accordance with Cirfular 177/48 (Ministry of Health) 78 TABLE 54 MENTAL DEFICIENCY ACTS, 1913 - 1938 PARTICULARS OF MENTAL DEFECTIVES 1953 1954 Males Females Total Males Females Total 1. No. of ascertained mental defectives found "Subject to be dealt with":- (a) In institutions (Including cases on licence therefrom) (Under 16 years of age 12 9 21 11 7 18 (Aged 16 years and over ( 86 94 180 87 90 177 (b) +Under guardianship (including cases on licence therefrom) (Under 16 years of age - - - - - - (Aged 16 years and over 5 5 10 4 5 9 (c) In "places of safety" - - - 1 - 1 (d) Under statutory supervision (excluding cases on licence) (Under 16 years of age 19 12 31 16 15 31 (Aged 16 years and over ( ( 82 70 152 86 73 159 Total ascertained cases found to be "subject to be dealt with" 204 190 394 205 190 395 No. of cases Included in (b) to (d) above awaiting removal to an institution 5 2 7 2 1 3 2. No. of mental defectives not at present "subject to be dealt with" but over whom some form of voluntary supervision is maintained:- Under 16 years of age - - - — - - Aged 16 years and over 26 27 53 21 26 47 Total number of mental defectives (1) plus (2) 230 217 447 226 216 442 3. No. of mental defectives receiving training:- (a) In day training centres (Under 16 years of age 14 11 25 13 14 27 (Aged 16 years and over 17 12 29 15 10 25 (b) At home - - - - - - Total 31 23 54 28 24 52 + No defectives under guardianship were dealt with during the two years under the provisions of section 8 or 9. 79 GUARDIANSHIP CASES 1953 1954 No. on register on 1st January 11 10 No. admitted to Institutions 1 - No. of Orders discharged by the Board of Control - 1 No. on register on 31st December 10 9 No. resident outside East Ham and visited by members of the Mental Health Sub-Committee 6 5 No. resident in East Ham and visited by the Medical Officer of Health 4 4 OCCUPATION CENTRE The numbers of defectives on the register of the Occupation Centre on 31st December of each year was as follows:- 1953 1954 Males 24 26 Females 22 24 Total 46 50 SESSIONS AND ATTENDANCES TABLE 55 1953 Morning Afternoon Period 1st January to 20th September 1953. No. of Sessions 152 152 Males Females Males Females Total Attendances 2,658 1,837 2,658 2,035 Average Attendance per Session 17.5 12.1 17.5 13.3 Period 21st September - 31st December 1953 No. of Sessions 65 65 Total Attendances 1,395 1,163 1,395 1,185 Average Attendance per Session 21.5 17.9 21.5 18.2 Total Attendances during the Year: Males, 8106; Females, 6220 Grand Total 14,326 TABLE 56 1954 Morning Afternoon No. of sessions held during the year 221 221 Males Females Males Females Total attendances 5,102 3,978 5,050 4,013 Average Attendance per Session 23.08 18.0 22.85 18.15 Total attendances; males 10,152, females 7,991, Total 18,143 80 TABLE 57 MENTAL PATIENTS - LUNACY AND MENTAL TREATMENT ACTS Type of patient Number on register on 1st January Admissions to institutions during the year Discharges from institutions during the year Deaths in lnstltuduring the year Number on register on 31st December 1953 1954 1953 1954 1953 1954 1953 1954 1953 1954 Certified Males 158 158 31 37 22 16 10 10 157 169 Females 212 203 54 41 50 29 12 15 204 200 Total 370 361 85 78 72 45 22 25 361 369 Temporary Males 1 1 1 3 1 3 - - 1 1 Females - — 2 6 2 3 - — — 3 Total 1 1 3 9 3 6 - - 1 4 Voluntary Males 66 69 68 66 60 59 4 7 70 69 Females 54 69 94 73 73 74 7 4 68 64 Total 120 138 162 139 133 133 11 11 138 133 Grand Totals 491 500 250 226 208 184 33 36 500 506 Number of patients released on trial 1953 1954 Males 8 18 Females 11 27 Total 19 45 Number of patients returned from trial 1953 1954 Males 1 - Females 1 7 Total 2 7 Disposition of Mental Patients 1953 1954 Runwell Hospital Other Hospitals Runwell Hospital Other Hospitals In patients on 1st January 476 15 484 16 Admissions during the year 234 16 214 12 Discharges during the year 196 12 177 7 1 40 — In patients on 31st December 482 18 492 21 81 TABLE 58 DULY AUTHORISED OFFICERS DETAILS OF VISITS, ETC. YEAR Mental Deficiency Acts 1913 - 38 Lunacy and Mental Treatment Acts Grand Total of visits and attendances Guardianship Statutory Supervision Friendly Care Home reports for patients detained in institutions Occupation Centre Total visits or attendances Patients reported to be In need of treatment After- Care Park View Therapeutic Social Club Total visits or attendances 1953 43 1,522 121 161 128 1,975 1,488 937 78 2,503 4,478 1954 21 1,475 183 131 110 1,920 1,584 972 91 2,647 4,567 This service has won high praise from the public, local doctors and hospitals for the efficiency, courtesy and humanity with which our officers conduct the various and difficult tasks which fall to their lot both with mental sufferers and defectives. The records kept in the department are invaluable in assessing individual states; to the Court on occasion and to the Psychiatrist in diagnosis and treatment. Liaison with the Health Visitor service has widened further. The effectiveness of the aid given to problem families and numbers of old persons, especially those who suffer episodes of mental disorientation due mostly to vascular disturbances of the brain and general senile decrepitude. The Duly Authorised Officers also vouchsafe a helping hand to the staff of the Mental Health Occupation Centre on outings, sale of work days, shows and parties, and their presence on such occasions is a great encouragement to the parents that the welfare and safety of their unfortunate children is amply guarded. Mention has already been made of the contribution to the Park View Therapeutic Club generously afforded by the Duly Authorised Officers, and their assistance in the supervision of a number of our defectives under Order is most invaluable. The Mental Health Service, although less spectacular in its workaday habit, is yet, to my mind, one of the most beneficient of measures which falls to the lot of the Health Committee to carry out under the requirements of the National Health Service Act. SECTION 29 - HOME HELP SERVICE There has been little change in the work or administration of this valuable ancillary service. The old people continue to attract the greatest effort from our Home Helps, and all the indications point to a time not far off when more organized effort on a broader base may be needed to cope adequately with the increasing needs of our rapidly expanding group of aged persons. 82 The hours worked by the helps (including sickness, holidays and travelling time) were as follows:- Period No. of hours Period No. of hours 4 weeks ending 1.2.53 9,312¾ 4 weeks endlng 31.1.54 9,964¼ 4 " " 1.3.53 9,550¾ 4 " " 28.2.54 9,962 4 " " 29.3.53 9,765¾ 5 " " 4.4.54 12,691¼ 4 " " 26.4.53 9,142¾ 4 " " 2.5.54 9,375¼ 5 " " 31.5.53 11,356¼ 4 " " 30.5.54 10,188 4 " " 28.6.53 8,740¼ 4 " " 27.6.54 9,282½ 5 " " 2.8.53 11,097¼ 5 " " 1.8.54 11,317 4 " " 30.8.53 9,486 4 " " 29.8.54 9,866 5 " " 4.10.53 11,517 5 " " 3.10.54 11,656½ 4 " " 1.11.53 9,609¾ 4 " " 31.10.54 10,005¾ 4 " " 29.11.53 9,732 4 " " 28.11.54 10,471¼ 5 " " 3. 1.54 11,896¾ 5 " " 2. 1.55 12,151¾ 121,207¼ 126,931½ The establishment provided for the employment of 60 full time home helps, i.e. a maximum of 2,640 hours per week (60 x 44). The average number of hours worked per week was 2,331 in 1953 and 2,441 in 1954. TABLE 59 HOME HELP SERVICE TABULATION OF CASES Illness or other reason for provision of help Period of Service Provided Under 1 week 1-2 weeks 2-3 weeks 3-4 weeks 1-3 months 3-6 months 6-9 months 9 -12 months Totals 53 54 53 54 53 54 53 54 53 54 53 54 53 54 53 54 53 54 Maternity 1 1 29 35 3 - - - - - - - - - - - 35 36 Tuberculosis - 1 - 3 1 5 - - 10 4 4 7 7 5 7 14 29 39 Cancer 3 - 1 - 2 2 1 1 3 8 4 6 4 - 6 11 24 28 Old Age 19 10 7 15 13 8 13 9 87 100 80 94 67 60 368 435 654 731 Other Sickness 9 5 4 6 6 5 12 8 27 20 18 26 19 12 39 24 134 106 Totals 32 17 41 59 25 20 26 18 129 132 106 133 97 77 420 434 876 940 The number of helps employed on 31st December was as follows:- 1953 1954 (a) Permanent Full-time helps 2 2 (b) Registered casual helps 99 106 (c) Casual helps on probation prior to registration 20 13 Total 121 121 During the years under review, the Organiser and her Assistant made the following numbers of visits to the homes of applicants for the service :- 1953 1954 Primary visits to new applicants for the service 562 577 Visits to applicants already in receipt of the service 2,010 2,385 Totals 2,572 2,962 83 SANITARY SECTION 1953 This section of the report relating to sanitary circumstances, housing, food inspection and general routine work of the Section has been completed by the Chief Sanitary Inspector, Mr. D.G. Tonkin M.S.I,A. The staff position with regard to Inspectors showed an improvement on the preceding years. Mr. Miles commenced in March to fill one vacancy and Mr. Fish was appointed in July to take up the additional post on establishment necessitated by the increasing volume of work in the Section. Mr. Riley terminated his services with the Corporation in December. During the year the Report of the Working Party on the Recruitment, Training and Qualification of Sanitary Inspectors was published, but the recommendations in the Report had not received Parliamentary or official approval by the year end. Mr. A. Lightly, mortuary attendant, retired owing to ill-health in January after many years of valuable service to the Corporation. There were no areas of unfit houses declared during the year, but the Minister after Public Enquiries, approved the Orders made in 1952 in respect of houses in Greenhill Grove and flats in Colston Road. The investigation of accommodation occupied by applicants for Council houses continued, and over 3,600 visits were made in connection therewith. Food and food premises occupy an ever increasing amount of the Inspectors' time. In particular much attention was given to smaller type of premises and many improvements effected thereon. This work, though not spectacular in itself is nevertheless of extreme Importance in ensuring that wholesome food is served to the public. The Food Hygiene Guild made steady progress, and the aim has been to register only those premises which reach a high standard of hygiene rather than to award certificates indiscriminately, though of course every encouragement is given to retailers to qualify. It was not necessary to prosecute any shop-keeper for occupying dirty or unwholesome food premises, though quite a number had to be persistently "persuaded" to carry out improvements. The number of complaints received at the office showed an upward trend over the previous year (2638 - 2749) and consequently the number of notices served also rose from 2836 to 3151, of which 831 were statutory notices, against 593. ANNUAL REPORT, 1953 (A) Inspections 1953 The number of inspections of all classes 32,994 (1 ) Housing Under Public Health Act 6,415 Re-Inspections 14,076 Housing Act 1936 3,642 84 (ii) Sanitary Circumstances 1953 Yards and Passages 68 Drainage and Sanitary Accommodation 1,740 Drainage Tests 190 Caravans 12 Offensive fumes 74 Miscellaneous 790 power and Non-Power Factories 432 Places of Public Entertainments 304 Workplaces and outworkers 860 (iii) Food Supply Milk and dairy premises 136 Ice cream premises 422 Food premises general and unsound food 2,235 Bakehouses 86 Samplings, visits 537 Slaughterhouse 2 (iv) Infectious Diseases, visits 365 (v) Food poisoning visits 54 (vi) Diseases of Animals Act visits 76 poultry Regulations visits 10 (vii) Pet Animals Act visits 40 (viii) Smoke nuisances and observations 430 (B) Notices The number of notices during the year totalled 3,151 of which 831 were statutory notices. The number of notices compiled with in the same period was 2,698, of which 661 were statutory notices. Complaints made to the Department with regard to sanitary circumstances, disrepair, infestations, obstructed drains, etc., totalled 2,747. (C) Rodent Control The number of complaints received in respect of rat and mice infestation totalled 278. The Rodent Operator made 2,690 visits, and it is estimated that 872 rats were destroyed. No major infestations were discovered, and practically all the complaints of rat infestation were traced to defective drainage. It is usual for the department to carry out the repair of the drains by agreement with and at the expense of the owners of the respective premises, though in a few instances defects in the road sewerage were discovered and the Borough Engineer promptly arranged for the necessary repair. (D) Disinfection and Disinfestation It was found necessary or desirable to carry out this work at 339 premises during the year. 211 after cases of infectious disease had been reported, 121 in respect of bug infestation and 208 for other causes e.g. beetles. insects and "smelly" premises. The steam disinfector for disinfecting bedding was used on 86 days during the year. It is pleasing to note the continued decrease in the number of bug infested premises (144 - 133 - 121) though conversely wood beetle damage to timbers in houses appears to show a marked increase over the pre-war incidence. 85 (E) Drainage Complaints of choked or defective drains totalled 632, again a slight decrease on the previous year (648). In 190 cases it was necessary to carry out technical tests on the drains. Undoubtedly the service provided by the Council in clearing without charge main drain blockages saves much time and worry if not illness even if the odd few are inclined to take undue advantage of the service. (f) Fertilisers and Feeding gtuffs Act 1926 10 samples were taken during the year as follows: - Balancer Meal (4) Copra Meal Weaning Meal National Growmore Meat and Bone Meal Fertiliser Expeller Coconut cake Weaning Meal. In 6 instances the Analyst reported slight discrepancies in the vendors statutory statements, but in three of these the discrepancy was not to the prejudice of the purchaser. The attention of the vendor or manufacturer was called to the results of the analyses in the other cases. (G) Rag Flock and Other Filling Materials Act 1951 This Act now brings 13 materials within its orbit as against only rag flock in the previous Act. There were eight premises registered for the use of specified materials during the year, and 1 was licensed for the storage of material. 6 samples were submitted to the Prescribed Analyst as follows:- Rag Flock 5: Coir Fibre 1. One sample of rag flock just failed to satisfy the requirements with regard to soluble impurities but satisfied the other tests and the manufacturer was cautioned. (H) Pet Animals Act 22 premises were licensed to keep a pet shop, and inspections of the premises were carried out to ensure that the conditions of the licence issued by the Council were observed. In one instance it was found advisable to seek the advice of the curator of reptiles at the London Zoo on the question of cruelty to tortoises. (I) Factories, Workplaces and Outworkers There was a large increase in the number of inspections this year, 1292 against 300 in the previous year, and the Factory Register was brought up to date. Conditions generally were satisfactory although in a number of instances it was found necessary to draw the attention of occupiers to minor defects. Outworkers as prescribed by the Act remained at a comparatively low number, but the need for a revision of the list is evident when it is found that people preparing articles ancillary to the food trade are not included. 86 (J) Mosquito Control As usual, a few complaints from persons resident near streams were received and remedial action taken. In addition routine preventive spraying was carried out where infestation was thought likely to occur. (K) Places of Public Entertainment Sanitary and hygiene conditions in these premises continued to receive attention. (L) Rent and Mortgage Interest Restrictions Acts 1920-1939 There were 26 applications for Certificates as to state of repair and 14 Certificates were issued. In the remaining cases the necessary work was carried out before the matter had been reported to the Council. (M) Legal Proceedings Legal proceedings were instituted in the following Instances :- Public Health Act 1936 Section 94 Landlords falling to comply with Statutory Notices served 39 Food & Drugs Act 1938 Section 3 4 HOUSING STATISTICS I, Inspection of dwelling houses during the year 1953 (1) (a) Total number of dwelling houses inspected for defects (under Public Health Act or Housing Act) 10,422 (b) Number of inspections made for the purpose 24,498 (2) (a) Number of dwelling houses (included under heading (1) above) which were inspected and recorded under the Housing Consolidation Regulations 1925 (b) Number of inspections made for the purpose (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation — (4) Number of dwelling houses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation – II, Remedy of defects during the year without service of Formal Notice Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their Officers 2,037 III. Action under Statutory Powers during the year (A) Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936:- (1) Number of dwelling houses in respect of which Notices were served requiring repairs – 87 1953 (2) Numbers of dwelling houses which were rendered fit after service of formal notices :- (i) By owners – (ii) By Local Authority In default of owners - (B) Proceedings under Public Health Acts (1) Number of dwelling houses in respect of which Notices were served requiring defects to be remedied 831 (2) Number of dwelling houses in which defects were remedied after service of formal notices:- (i) By owners 661 (ii) By Local Authority in default of owners – (C) Proceedings under Sections 11 and 13 of the Housing Act, 1936 (1) Number of dwelling houses in respect of which demolition orders were made – (2) Number of dwelling houses demolished in pursuance of Demolition Orders - (D) Proceedings under Section 12 of the Housing Act, (1) Number of separate tenements of which Closing Orders were made - (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit – IV. Visits in connection with housing circumstances of applicants for rehousing 3,601 REHOUSING STATISTICS Position at 31st December. 1953 the following statistics have been supplied by the Council's Chief Housing Officer, Mr. J.E. Austin, M.B.E. 1. Accommodation made available – family units (i) By repair of war damage 6,233 (ii) By requisitioned premises 1,245 (iii) By new housing (including 520 cost-of-works rebuilds and 22 additional units under the Housing Act, 1949) 2,553 10,031 This figure includes 3,307 houses classified Cb (War Damage) and rebuilt by Local Authority - 2. Families rehoused since August 1945 4,920 3. Cases of over-crowding under Housing Act, 1936 abated by rehousing since August 1945 (included in 2) 1,139 4. Total of current applications for rehousing 8,807 88 5. New housing:- Dwellings projected Under Construction Completed Temporary 883 + - 883 + Permanent 2,701 543 1,120 Cost of Works rebuilds 537 + 5 520 Housing Act, 1949 and Private licences (new houses) 34 4 30 4,155 552 2,553 + 51 Bungalows deleted from total of 934 - removed for permanent houses. + After adjustment by Primary Education plan. INSPECTION AND SUPERVISION OF FOOD (a) Milk Supply - The number of milk distributors registered at the close of the year was 153, and the number of dairies 11. The following licences were issued to use special designations prescribed in the Milk (Special Designation) Regulations 1949-50 Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations :_ Pasteurised: Dealer's Licence 101 Supplementary Licence 10 Dealer's (Pasteuriser's Licence) 2 Pasteurised (Tuberculin Tested) 1 Sterilised: Dealer's Licence 133 Supplementary Licence 11 Dealer's (Steriliser's)Licence 1 Milk (Special Designation) Regulations (Raw Milk): Tuberculin Tested: Dealer's Licence 24 Supplementary Licence 10 There were 92 samples submitted for chemical analysis i,e, fat content etc., all of which were satisfactory. (b) Meat and Other Foods (i) Meat Inspection There were nearly 90 butchers premises in the town during the year and generally they were very well maintained. The Inspectors were frequently called in by the trade to examine meat for unsoundness or disease and 5,286 lbs of meat and 22 chickens weighing 90 lbs. were certified as unfit for human consumption. The transport of meat is still unsatisfactory in many cases, and the attention of the responsible authority was called where necessary to unhygienic practices during the transport and delivery of meatstuffs. (ii) Other Foods The Sanitary Inspectors are called upon to examine a great variety of foodstuffs and during the year the following comnodlties were certified as unfit for human consumption. 89 554 tine of milk 209 " "fish 3,091 " " fruit 651 " " meat (2653 lbs) 434 " " vegetables 1,249 " " other footstuffs 6,188 tins 8 lbs of cheese 693 lbs " fish 70 lbs " fruit 5,286 lbs " meat 1 lb " butter 23 lbs " soya flour 6,259 lbs " confectionery 118 lbs " biscuits 12,458 lbs 27 jars of cream 11 steak pies (iii) Food Premises The visits to food premises comprised 2,879 and 537 further visits were made in connection with sampling. These figures again show a large increase on the previous year, and are indicative of the attention that is being paid in this town at any rate to the public's food supply. The two large dairy establishments in East Ham continue to be satisfactory. (c) Slaughterhouses The one licensed slaughterhouse in the Borough was not in operation during the year. (d) Bacteriological Sampling During the year the following samples were submitted for examination t~ Milk: 94. Ice Cream: 41. Bath Water; 6. Drinking Water: 2. Fish Pie: 1. School Dinner, main and sweet: 2. making a total of 146 samples. The Ice creams were graded as follows Grade I: 20, Grade II: 5, Grade III; 13, Grade IV: 3. One sample of milk (Pasteurised) did not satisfy the Methylene Blue Test. One sample of bath water was considered as of a very inferior organic quality, but subsequent samples proved satisfactory. The school dinner was sampled as a result of complaint of alleged food poisoning at a school canteen, but on examination was found to be satisfactory All other samples were satisfactory. (e) Ice Cream 22 premises remain on the Register for the manufacture of ice-cream, and these receive frequent attention from the Department. There were 22 new applications for the registration of premises for the sale of ice-cream during the year and at the end of the year 276 premises remained on the register for the sale of ice-cream. Six samples of ice-cream submitted for bacteriological examination were regarded as unsatisfactory and appropriate action was taken at the place of manufacture to ensure improved standards. 90 SAMPLING FOOD AMD DRUGS ACT Food and Drugs Sampling During the year 313 samples were submitted to the Public Analyst. Details as follows TABLE 60 Number of Samples Percentage of samples adulterated Examined Found adulterated or below standard Cheese 1 - - Confectionery 12 2 17 Jam 10 - - Milk 92 - - Sausage 54 4 7.4 Vinegar 5 - - Wines and Spirits 19 - - Drugs 11 - - Other Articles 109 7 6.4 Totals 313 13 - Included in "other articles" are six samples submitted to this Department by members of the public as being unfit, for human consumption. Samples as follows •- 7112: Glass in pork pie 7125: Suspected rodent excrete in bread. 7046: Rat excrete in bread 7126: Suspected unsound flour 7197: Foreign body in ½ pint bottle of milk 7287: Tinned shoulder of ham. Details of unsatisfactory samples overleaf 91 Details of samples not satisfactory Number Informal or formal Article Adulteration or Deficiency Action taken 7016 Formal Pork Sausage Deficient in meat to extent of 20% Prosecution 7045 Formal " " Deficient in meat to extent of 18% Prosecution 7046 Bread Rodent excreta Prosecution 7089 Inf. Beef Sausage Contained sulphur dioxide preservative to extent of 100 parts per million. Letter of Caution 7112 Pork Pie Small fragment of glass in surface of meat filling. Few very minute fragments in test of pie. Total weight 0.044 grams. Prosecution 7162 Formal Soya Flour Contained considerable free acid, and rancid, Unfit for edible purposes. Stock withdrawn from sale. 7163 Inf. Beef Sausage Meat Contained an excessive amount of sulphur dioxide. 110 parts per million. Letter of Caution 7188 Inf. Oatmeal This sample consisted not of oatmeal, but of Barley meal. " 7197 ½ pint of milk House fly attached to a small portion of coagulated milk protein. (Bottle opened when received at office) 7238 Inf. Sherbert Should be an effervescing preparation, as this sample had no ef f ervescent. properties Caution and stock withdrawn 7239 Inf. Shebert (as 7238) it was mis-described as sherbert. 7287 Inf. Tinned shoulder ham. Not completely sterile No evidence of metallic contamination. The oil taint of contents sufficiently pronounced for them to be objectionable to many persons. Stock returned from Canteen, 7256 Inf. Shredded Suet 1.2 % deficient in fat. 81.8% 83% Caution 7316 Inf. Pork Sausage Meat Deficient in meat to extent of 15% 7083 Inf. Pork Sausage Small amount of sulphur Dioxide Caution 92 Prosecutions re food Legal proceedings were instituted as under:- (i) Selling pork sausages deficient in meat content - Conditional discharge 12 months - Costs awarded against Vendor. (ii) Selling bread containing foreign body - rodent excreta Fined £10. (iii) Selling pork sausages deficient in meat content - Warrantor fined £5 and costs. (iv) Selling a meat pie containing foreign body, to wit glass Fined £10 and costs. LEGISLATION 1. The following Acts of Parliament directly affecting the work of the Section were passed during 1953:— Local Government (Miscellaneous Provisions) Act 1953 Slaughter of Animals (Pigs) Act 1953 Merchandise Marks Act 1953. 2. In addition no less than 35 Statutory Instruments concerned with inter alia, Food, Diseases of Animals (excluding Swine Fever and Foot and Mouth Disease Orders) Housing, Drugs, Poisons, Explosives, were made and affected the work of the Section. SHOPS ACT ADMINISTRATION (Mr. D.G. Tonkin, Chief Inspector, Mr. T. Gilbert, Mr. L. Pinguey, - Inspectors). SHOPS ACT. 1950 The Home Office published a memorandum during the year under the title "Suggested Provisions for amending Shops Legislation". The memorandum followed the Report of the Gowers Committee and sought to remove certain ambiguities and anomalies in existing legislation which in many instances by its indetermination proves very difficult to administer effectively. However, although discussion proceeded, the law stood still. Statistics for 1953 Number of shops in borough subject to Act 2,066 Number of shops in borough open1,973 Number of shops in borough closed 93 Number of assistants employed Males 1,240 Females 1,964 Young persons - males 88 " " females 139 3,431 Visits re Shops Register 1,698 Visits re arrangements for health and comfort and records of shop assistants 871 Visits and observations - closing hours 1,055 Visits re holiday closing 367 Change of occupier 92 Change of occupier and trade 78 Change of trade only 5 175 93 Change from retail to other use 10 Change from other use to retail 5 In addition to the number of shops in the borough subject to the Act there are: laundries 26 Dyers and Cleaners 33 Denture repairs 2 It was necessary to caution shopkeepers (52 occasions) for serving customers after the 'closing hours'. It was further necessary to caution numerous shopkeepers for falling to display the prescribed notices after the closing hours on the 'early closing day' and Sundays. One shop manager was cautioned for falling to give the shop assistants their half-holiday and for falling to keep the necessary records. Heating of Shops Attention was given to this matter and as a result of representations made to managements a number of additional heating appliances were Installed. Sunday Trading - Members of Jewish Faith One application received during the year for registration to trade on Sunday (Section 53) was granted. Total shops registered s 6. PHARMACY AM) POISONS ACT No. of persons in local authority's list entitled to sell Poisons under Part II 1/8 Renewals 158 New Registrations 21 (Including 9 new registrations due to change of occupier). Cancelled 7 EXPLOSIVES ACT No. of Registered Premises 143 Renewals 115 New Registrations 28 (including 13 new registrations due to change of occupier). Cancelled 16 HEATING APPLIANCES (FIREGUARDS) ACT. 1952 This Act and Regulations made thereunder came into operation on 1st October, and prohibits the sale or letting for hire of certain heating appliances without an approved fireguard. Appliances manufactured in Great Britain before the 1st October were exempted until 1st October, 1954. During the period under review, premises stocking heating appliances were visited and information and advice given with regard to the operation of the Act. 94 SANITARY SECTION 1954 This section of the Report relating to sanitary circumstances, housing, food Inspection and general routine work, of the Section has been completed by the Chief Sanitary Inspector, Mr. D.G. Tonkin, M.S.I.A. Legislation affecting the work of the Sanitary Inspectors continues to multiply and with the higher standards demanded. In particular in relation to housing and food supply, the Section has been fully occupied throughout the year. There has been a general shortage of technical staff to carry out the manifold duties of a Sanitary Inspector and it is a matter for regret that the Report of the Working Party on the Recruitment, Training and Qualifications of Sanitary Insepctorshas not yet been officially accepted nor its recommendation carried into effect. The staff position in East Ham has been somewhat fluid as the following information shows. Mr. Patrick commenced duty in March, but Mr. Williams left in April and in his stead Mr. Cook commenced duty in May. In August, Mr. Goffin resigned and Mr. Harraway was appointed in November. These frequent changes amongst the inspectorate have a very unsettling influence on the work of the Department, but by the end of the year the staff was up to establishment. There were no slum clearance representations made during the year but preliminary surveys were carried out with a view to future programming of areas. A Closing Order under the terms of the Housing Act, 1936 and Local Government (Miscellaneous Provisions) Act 1953, was made in respect of one house at North Woolwich. The work in connection with applications for Council houses shows little abatement and well over 3,000 investigations of existing housing accommodation were made. An increasing public awareness of the dangers present in the comsumption of dirty, contaminated or diseased food is most gratifying, and the Inspectors have continued their endeavours to effect improvements in the supply and handling of foodstuffs. Very many people bring samples of foods to the office for examination and opinion. The Food Hygiene Guild continued to function and details are given in the body of the report. With the end of meat rationing the Minister of Food directed Local Authorities to ensure that sufficient slaughterhouse facilities were available to serve the needs of their districts and after consideration, the Council granted licences in respect of three slaughterhouses as against six existing post-war. Killing of animals in these slaughterhouses commenced in July and every animal killed is examined by an Inspector before being released for sale for human consumption. The public appear to be well aware of the service provided by the Department as is shown by the fact that no less than 3,591 complaints of all types were received at the office. Furthermore many local organisations continued to request the attendance of Inspectors at their meetings, to address them on such subjects as housing, food Inspection and atmospheric pollution. It is a regrettable fact that no new legislation dealing with pollution of the atmosphere has been Introduced though the matter was being officially "investigated". The "Beaver" Committee submitted its final report at the end of the year, and this incorporated many unique recommendations which it Is earnestly hoped will eventually reach the Statute Book. 95 ANNUAL REPORT, 1954 (A) Inspections The number of inspections of all classes 30,631 (i) Housing Under Public Health Act 5,924 Re-lnspectlons 11,742 Housing Act, 1936 3,152 (ii) Sanitary Circumstances Yards, passages and stables 77 Drainage and sanitary accommodation 1,907 Drainage tests 186 Caravans 145 Offensive fumes 220 Miscellaneous 534 Factories 487 Work places and out-workers 1,232 Places of public entertainment 369 (iii) Food Supply Slaughterhouses 361 Milk and dairy premises 195 Ice cream premises 431 Food premises, general and unsound food 2,373 Bakehouses 104 Sampling, visits 514 (iv) Infectious Diseases Visits 69 (v) Food Poisoning Visits 19 (vi) Diseases of Animals Acts Visits 36 (vii) Pet Animals Act. Visits 35 (viii) Smoke nuisances and observations 519 (B) Notices There were 1,721 Preliminary Notices served during the year and 1,404 such notices were complied with. It was necessary, in addition, to serve 734 Statutory Notices after report to Committee and 577 Statutory Notices were compiled with. Although there were less notices served as compared with the previous year, the total number of complaints received showed a large increase, 3,591 as against 2,747, but It has been possible to satisfy many of the complainants without recourse to formal action. 96 (C) Rodent Control Complaints in respect of rat and mice infestation totalled 322 as compared with 278 in the previous year, but it is not thought that the increase indicates a worsening of the position, but rather that the public are eager to avail themselves of the service provided. Practically all the rat infestations were again found to be due to defective drainage. The rodent operative made 2,006 visits and it is estimated killed 577 rats. In addition the Inspectors advise in all cases of mice or beetle infestation. (D) Dlslnfestation and Disinfection Work under this heading was carried out at 374 premises during the year, in respect of infectious diseases, bugs and dirty premises and chronic beetle infestation. The steam dlsinfector was used on 110 days for clothing and bedding, and approximately 900 library books used in houses where infectious disease or other malignant illness had occurred, were disinfected. In addition all articles returned from the "loan cupboard" were sterilised or disinfected. (E) Drainage Although the public continued to make good use of the drain cleaning service provided, the number of complaints received showed a marked decrease (632 - 373). Many of the complaints however lead to the discovery of defective drains often necessitating prolonged investigation and testing of the systems. In the vast majority of cases where defects are discovered and are the responsibility of tow or more owners, the work is carried out by agreement by the Corporation's contractors and the cost apportioned between the owners. This ensures a fair Job being carried out and undoubtedly affects a saving in costs for the owners. (F) Mosquito Control Owing to the amount of building that has taken place on lands previously favourable to mosquito breeding, few complaints were received, but preventive spraying of ditches was carried out in the early season, and remedial measures taken later where necessary. (G) Pet Animals Act. 1951 There were 21 premises on the register at the end of the year. All complied with the conditions of licence, though in one instance readjustment of the stock was carried out to prevent nuisances arising. (H) Fertilisers and Feeding Stuffs Act, 1926 13 samples were taken during the year as follows : Layers Poultry Mash Laying Meal Cod Liver Oil Condiment Sulphate of Ammonia (3) Bone Meal (4) Expelled Coconut Cake Expelled Palm Kerne.1 Cake Chick Meal All samples were satisfactory. (I) Rag Flock and Other Fillings Materials Act, 1951 7 samples were taken for analysis during the year as follows ; 97 Rag Flock (4) Coir Fibre Linta Felt (2) One sample of Linta felt failed to satisfy the cleanliness requirements. True trash content 12,158 - Maximum being 7.5%. The manufacturers were warned. In the light of experience gained since the 1951 Act brought 12 extra materials under control, the standards of some materials were amended by new Regulations. There were 7 premises registered for the use of materials during the year but the one licence for storage lapsed. (J) Smoke Abatement In the absence of firm legislation with adequate penalties for offenders, this phase of the Sanitary Insepctors work presents many difficulties. A Smoke Abatement Sub-Committee appointed by the Council considered local problems. There are probably 3 - 4 major trouble spots in the Borough and much inspection time was spent checking smoke and grit emissions, interviewing managements and stoking operatives. Consultation with the engineer in charge at the Products Works, North Thames Gas Board was arranged and Inspection of the new retorts and furnaces then being Installed was carried out. The work of complete reorganisation here will undoubtedly take some long time. Actually East Ham suffers probably more from pollution emanating outside Its boundaries than that caused within, e.g. power station, gas works, shipping and industry on the South Bank of the Thames. More forceful legislation should lead to more uniformity of action by local authorities. A public meeting and small exhibition organised by the Committee In March unfortunately attracted little public response. (K) Factories. Workplaces, Outworkers. The number of factories, power and non-power, shows a slight decrease from the previous year (333 - 354 and 46 - 52). A total of 459 visits were paid to these premises. Liaison was maintained with H.M. Factory Inspector and minor infringements of the Act or Orders were satisfactorily dealt with. (L) Sampling The following table shows the number of samples of all types taken for analysis or examination during the year : - Chemical Food & Drugs Act 322 Bacteriological - Food 123 Water - drinking and bath 6 Fertilisers 7 Feeding Stuffs 6 Rag Flock & filling materials 7 Total 471 (M) Places of Public Entertainment In addition to visits paid in connection with regulations governing music, singing, dancing and cinematograph licences, attention was given to the public health aspect of these premises and some improvements in heating, ventilation and toilet facilities were effected. 96 (N) Diseases of Animals Act. 1950 Numerous Orders are made under the authority of this Act many of them dealing with Imported animals or fodder, and It Is frequently necessary to visit the Docks In connection therewith. Foot and Mouth Disease and Swine Fever Orders affecting the town were In operation during part of the year and movement licences were Issued where necessary. HOUSING STATISTICS I. Inspection of dwelling houses during the year. 1. (A) Total number of dwelling houses Inspected for defects (Under Public Health or Housing Acts) 9,145 (B) Number of Inspections made for the purpose 20,887 2. (A) Number of dwelling houses Included under sub-head (1) above which were Inspected and recorded under the Housing Consolidation Regulations, 1925 - (B) Number of Inspections made for the purpose - 3. Number of premises found to be In a state so dangerous or Injurious to health as to be unfit for human habitation 1 4. Number of dwelling houses (exclusive of those referred to under preceding sub-head) found not be In all respects reasonably fit for human habitation 2,995 II. Remedy of defects during the year without service of formal notices. Number of dwelling houses rendered fit in consequence of Informal action by Local Authority or Officers 1,404 III. Action under Statutory Powers during the year (A) Proceedings under Sections 9, 10 & 16 of the Housing Act, 1936 - (1) No. of dwelling houses In respect of which notices were served requiring repairs - (2) Number of dwelling houses which were rendered fit after service of formal notices: (1) by owners - (11) by Local Authority In default of owners (B) Proceedings under Public Health Acts: (1) Number of dwelling houses In respect of which Notices were served requiring defects to be remedied 734 (2) Number of dwelling houses In which defects were remedied after service of formal notices: (1) by owners 577 (11) by Local Authority In default of owners (C) Proceedings under Sections 11 & 13 of the Housing Act, 1936: (1) Number of dwelling houses in respect of which Demolition Orders were made - (2) Number of dwelling houses demolished In pursuance of Demolition Orders - 99 (D) Proceedings under Section 12 of the Housing Act, 1936: (1) Number of separate tenements or under-ground rooms In respect of which Closing Orders were made - (2) Number of separate tenements or under-ground rooms In respect of which Closing Orders were determined, the tenement or room having been rendered fit - IV. Visits In connection with housing circumstances of applicants for re-housing 3,140 HOUSING REPAIRS AND RENTS ACT 1954 This Act came Into operation on the 30th August 1954. It extends the powers of Local Authorities with regard to slum clearance, It enables them to purchase slum houses and maintain them In a suitable standard pending demolition, and provides for Increases of rents of houses subject to safeguards as to the state of repair of such houses. It was anticipated that there would be wholesale demands for Increased rents with consequential large numbers of applications from tenants for Certificates of Disrepair. Such did not prove to be the case, and at 31st December the position was as follows Applications by tenants for Certificates of Disrepair 64 Granted 49 Pending (later granted) 14 Refused 1 Applications by Landlords for Certificates of Revocation claiming all necessary work done 10 Granted 3 Pending (later granted) 7 RENT AND MORTGAGE INTEREST RESTRICTIONS ACTS 1920 - 1939 The procedure under these Acts is still applied to controlled houses where no application for increased rent has been made, and enables tenants to withhold and retain the 40% increase on the "standard" rent until the work set out in the Certificate as to State of Repair has been carried out, 10 applications for Certificates were received and 6 Certificates were issued. In the remaining cases the work was carried out by the landlords before the matters could be formally reported to the local authority. RE-HOUSING STATISTICS The following information has been supplied by the Council's Chief Housing Officer, Mr. J.E. Austin, M.B.E. position at 31st December 1954 1, Accommodation made available - family units (i) By repair of war damage 6,233 (ii) By Requisitioned premises 1,212 (iii) By new housing (Including 520 cost-of-works rebuilds and 22 additional units under the Housing Act, 1949) 2,879 10,324 This flgure includes 3,307 houses classified Cb (War Damage.) and rebuilt by Local Authority. 100 2. Families rehoused since August, 1945 5,435 3. Cases of over-crowding under Housing Act, 1936 abated by rehousing since August 1945 (Included in 2) 1,271 4. Total of current applications for rehousing 9,087 5. New Housing Dwellings Projected Under construction Completed Temporary 883 + - 883 + Permanent 3,106 651 1,429 Cost of Works rebuilds 544 ø 6 532 Housing Act, 1949 and Private licences (new houses) 35 - 35 4,568 657 2,879 + 51 Bungalows deleted from total of 934 - removed for permanent houses, ø After adjustment by Primary Education plan. LEGAL PROCEEDINGS It was necessary to prosecute landlords in 57 instances for noncompliance with notices served. In one case an Order of the Court was obtained and a fine of £2 imposed. In the remainder, the work was carried out and the proceedings subsequently withdrawn. INSPECTION AMD SUPERVISION OF FOOD SUPPLIES AND PREMISES This work continues to take up an increasing amount of the Inspectors' time. Most food traders were co-operative in their efforts to assure the service of a safe food. The Food Hygiene Guild did much to focus attention on this matter and at the end of the year there were 178 employer members, and as the Guild Council rightly insisted on a very high standard of practice before granting certificates of membership, the figure can be considered quite satisfactory. Late in the year membership was made available to employees and 88 were approved for membership. Undoubtedly the highlight of the Guild's year was the Clean Food Exhibition held in the Minor Hall from 1st to 5th March. A display of modern and ancient equipment, samples of diseased and contaminated foodstuffs, laboratory equipment, food Insects, Model Dairy plants, photographs and charts and film shows, thoroughly interested over 4,000 people who attended despite inclement weather during the week. In addition organised parties of school children attended each session. The Food and Drugs (Amendment) Act 1954 was passed during the year. The Act considerably enlarges the scope of the 1938 Act and gives extensive powers to the Minister to make Regulations governing all phases of food production and sale. The Act was not in operation at the end of the year. (a) Milk Supply The number of milk distributors registered at the close of the year was 149 and the number of dairies 2. The following licences were Issued to use special designations prescribed In the Milk (Special Designation) Regulations 1949-54: Pasteurised Milk: Dealer's Licence 104 Supplementary Licence 10 Dealer's (Pasteuriser's) Licence 2 Dealer's Licence, Pasteurised (Tuberculin Tested 5 Supplementary Licence, Pasteurised (Tuberculin Tested) 1 101 Sterilised Milk; Dealer's Licence 146 Supplementary Licence 11 Dealer's (Steriliser's) Licence 1 Tuberculin Tested Milk: Dealer's Licence 23 Supplementary Licence 9 Eighty-eight samples of milk were submitted for chemical analysis i.e. fat content etc., all of which were satisfactory. Ninety-six samples were submitted for bacteriological sampling. Five were not entirely satisfactory and minor faults were traced in the plant of a local dairy which were later remedied. One tin of cream was found to be not bacterlologlcally satisfactory. The bulk suppliers were notified and the remainder withdrawn from sale. (b) Meat Inspection From the 1st July three private slaughterhouses were licensed to operate, and the following table shows the number of animals killed and examined; Cattle Calves Sheep and Lambs Pigs Total 802 97 2,625 186 3,710 There were 89 butchers shops In the town and frequent inspection of premises and stock was made. Altogether 2,545 lbs. of meat was certified as being unfit for human consumption. The Slaughterhouses Act 1954, which brought up to date provisions relating to slaughterhouses, and the Slaughter of Animals (Amendment) Act 1954 contained provisions relating to slaughter of horses, licensing of slaughtermen and types of Instrument used. Following the Government's avowed long term policy of "moderate concentration" the Conference of South West Essex Authorities re the provision of a regional public abattoir was re-convened. Information regarding the needs of the Area served was discussed, but by the end of the year no definite proposals were formulated. The Slaughter of Animals (Pigs) Act 1953 providing for the humane slaughter of pigs in places other than slaughterhouses and knackers yards came into operation on the 1st July 1954, and the Slaughter of Animals (Amendment) Act 1954 which Implemented certain recommendations of the Committee of Enquiry Into the Slaughter of Horses and further amended enactments relating to the slaughter of animals and licensing of slaughtermen was operative from 1st October 1954. (c) Ice Cream 22 premises were on the register for the manufacture of ice cream and 287 premises, Including 17 new applications were registered for the sale of ice cream. Particularly during the summer months when they are mostly operating, the former receive constant visits of inspection. 24 samples of Ice cream were submitted for bacteriological examination with the following results ; Grade I - 17: Grade II - 6: Grade III - 1: Grade IV - Nil. 102 (d) Other Foods A great variety of foodstuffs was examined during the year as the following table of food certified as unfit for human consumption shows Tinned fruit 1184 tins " milk 254 " " meat 447 " " fish 3334 " + " other goods 1257 " Total 6476 " + including large consignments of tinned salmon released from government stores for use in manufactured fish products. Fish 434 lbs. Meat 2545 " Confectionery 15 " Biscuits 50 " Cheese 27 " Suet 18 " Potatoes 3360 " Total 6449 " Eggs 14½ dozen popcorn 1376 packets Pea steeping tablets 12,000 Food & Drugs Sampling During the year 322 samples were submitted to the Public Analyst. Details as follows Number of Samples Percentage of samples adulterated Examined Found adulterated or below standard Butter 3 - - Margarine 7 - - Lard & cooking fat 7 — - Cheese 2 - — Confectionery 11 - - Jam k - - Milk 88 - - Sausage 41 2 5 Vinegar 7 - - Wines & Spirits 27 — - Drugs 22 - - Other articles 103 3 3 Totals 322 5 - Included in "other articles" are three samples submitted to this Department by members of the public, as follows :- 7339s Suspected rodent excreta in bread 7524: Suspected rodent excreta in bread (was discoloured dough) 7562s Foreign body (part of Insect) in bread. 103 Details of samples not satisfactory No. Informal or formal Article Adulteration or deficiency Action taken 7339 Inf. Bread Contained rodent excreta Prosecution Fined £8 plus £2 costs 7366 Inf. Pork Sausage Deficient In meat to extent of 9% Caution 7394 Inf. Beef Sausage Contained preservative 150 parts per million. Use not declared by Vendor Caution 7562 Inf. Bread Contained foreign body consisting of part of insect nature of flour moth. Caution 7519 Inf. Orange Drink. Label misleading. Should be more precise. Stock withdrawn. New labels Issued. 7543 Inf. Orange Drink ditto ditto 7606 Inf. Marzipan Contained only 18.5% of ground almonds. Should contain 25%. False & misleading. Caution to Manufacturer and Vendor SHOPS ACT etc. ADMINISTRATION (Mr. D.G. Tonkin+ Chief Inspector Mr. T. Gilbert+ Mr. L. Pinguey, Inspectors +Member Institute of Shops Acts Administration) No new legislation to amend ambiguous provisions of the Shops Act was passed during the year, nor were other provisions of the "Cowers Committee" dealing with Health Welfare, and Safety In non-industrial premises and the hours of employment of juveniles, Implemented during the year, although the final Report was submitted in March 1949. However, despite frustrations encountered in this little publicised feature of the Council's responsibilities, many improvements In the heating and ventilation of shops and sanitary facilities, and conditions of employment of assistants, have been accomplished. Much useful Information was given by the Department in connection with the Town Planning Public Enquiry. Statistics 1954: Shops Act 1950 Number of shops in Borough subject to the Act 1,960 Number of shops in Borough closed 75 Total 2,035 Other premises 79 It is interesting to note there are 90 different types of shops in the Borough plus 7 Cinemas and 1 Variety House. 104 Number of shops visited 1,812 there were 875 visits to premises In connection with the 'health and comfort' provisions of the Act, and 48 premises were found to be unsatisfactory. Visits regarding records required to be kept were 873 and In 94 cases the records were found to be not properly kept. 933 shops were visited after closing hours and 368 visits were made during holiday closing times. Though the great majority of shop-keepers are co-operative In the matter of closing hours, It was necessary to Issue verbal cautions in 61 cases and to write warning letters in 22 Instances. One persistent offender was summoned and fined £1 for failing to display notices as required In multi-trade shops. Number of shop assistants employed - Males 1,153 Females 1,813 Young persons M. 81 " " F. 147 3,194 It was noted during the year that in 115 Instances there was a change of occupier; in 44 cases the occupier and the trade changed and In 5 Instances the occupier changed the trade. Arising from requests received from the majority of the persons concerned the Council made Orders during the year in respect of the trades of Monumental Masons and Motor Car Dealers exempting those trades from the half-day closing provisions of the Act. there were 6 shops registered in respect of Sunday Trading by Members of the Jewish faith. Pharmacy and Poisons Act 1933 Number of persons listed to retail Part II poisons 174 (Renewals - 162: New applications - 16. Under both headings - 4). There were 237 visits made primarily in connection with storage of poisons. Explosives Act 1875 Number of premises registered 166; (Renewals 123: New applications 45; Under both headings 2). The type of explosives with which the department Is generally concerned consists of fireworks. The Council have been much concerned of recent years with regard to the indiscriminate handling and explosion of fireworks, particularly by young children. Around the beginning of November 64 special observations were kept on registered premises and 4 summonses were Issued for selling to persons "apparently" under the age of 13 years (vide the Act). In 3 cases fines of £1 were imposed and in the other case the Bench dismissed the case and awarded £l,ls,0d, costs as they were of opinion that the boy concerned could have passed for 13 (although in fact he was 10 years of age). The question of making bye-laws with regard to the period of sale of fire works was being Investigated and the co-operation of the Police regarding the explosion of fireworks was sought and obtained. 105 Heating Appliances (Fireguards) Act 1952 This Act camp into full operation on the 1st October 1954 and 37 visits of inspection were made. The necessary equipment for testing fireguards was obtained and advice and assistance were given during the period under review.