EAS 32 ??? COUNTY BOROUGH OF EAST HAM ANNUAL REPORT OF THE Medical Officer of Health For the Year 1955 JOHN S. COLEMAN, M.B., B.S. (LOND.) M.R.C.S. L.R.C.P. D.P.H. (ENG.) Medical Officer of Health & Principal School Medical Officer. PRINCIPAL CONTENTS SECTIONS:- PAGES Constitution of Council 3 Public Health Staff 5 Introduction 6 Statistical and Social Conditions of Area 9 Infectious Diseases 18 National Health Service Act, 1946:- Sec. 22 Care of Mothers and Young Children 27 Sec. 23 Midwifery Services 34 Sec. 24 Health Visiting Services 37 Sec. 25 Home Nursing Services 38 Sec. 26 Vaccination and Immunisation 39 Sec. 27 Ambulance Services 41 Sec. 28 Prevention of Illness, Care and After-Care 42 Sec. 28 & 51 Mental Health Services 46 Sec. 29 Home Help Services 50 Sanitary Section and Housing 52 Inspection and Supervision of Food 55 3 EAST HAM CORPORATION COUNCIL (shewing Chairmen and Vice-Chairmen of Health, M. & C.W. Mental Health and Education Committees). THE MAYOR: Mr Alderman William Henry Whittock Beecham, J.P. THE DEPUTY MAYOR: Mr. Frederick George Pryer Clayton. ALDERMEN:: Mr, Leslie Alfred Victor Bennett. Mr. Charles William Brading, J P., C.R.P. Mr, Charles William Dixon. Mr John Albert Hart. J.P. Mr, Prank Herbert Howard. (1) Mr. Walter Edwin Hurford. Mr. Herbert Percy Jackson J. P. Mrs. Winifred May Knight. Mr. Alfred Prior J.P. COUNCILLORS (4) Mr. Charles Frederick Chapman. Mrs. Ruby Lilian Collett. (3) Mrs. Daisy May Davey. Mr. Edwin John Davey. Mrs. Elsie Mary Devenay. Mr. William Doran. Mr. Frederick Robert William Easter. Mr. Charles Edward Ellett. Mr. Sidney Arnold Elson. Mr. Francis William French. Mr. Terence James Albert Green. Mr. Leonard Lewis Griffiths. Mr. Stanley John Hobbs. (2) Mr. William Hogarth. Mr Reginald Arthur James. Mr, Thomas Alfred Jenkinson. Mr Walter Christopher Johnson Mr John Alfred Kemp. Mr. Albert Richard Miller. Mr. Arthur George Murrell Oakes. Mr. John Henry Pagett. Mr.0 Reuben Frederick Ricketts. Mr. Albert Cyril Smith. Miss. Florence Louise Stevens. Mrs. Lily Sutton. Mr. Joseph Charles Taylor. (5) Mr. Norman Roy Thomas. Mrs. Dorothea Minnie Wood. Mr. Thomas Henry Wood. Co-opted members of the Health, M. & C. W., Mental Health and Education Committees:- Dr. O. Thomas Mr. H. Phillips Health Mrs. A. A. Bradshaw Mrs. A. E. Hayes Mrs. D. M Hill. Maternity and Child Welfare Mr S. C. Foreman Mrs. E. Gadd. Mr. H. F. McNeil Mental Health 4 Mrs. M. E. Bennett, J.P. Rev. V. Hurley Mr. J. Huxtable Mr. H. Lugg Mr. H. J. Pitt Mr L. S. J. Witter, B.Sc. Dr J. L. Forrest B. Sc. Education (1) Chairman, Health Committee and Mental Health Sub-Committee (2) Vice-Chairman, Health Committee (3) Chairman Maternity & Child Welfare Sub-Committee (4) Chairman Education Committee (5) Vice-Chairman Education Committee 5 STAFF Medical Officer of Health and Principal School Medical OfficerJ.S. COLEMAN. M. B., B.S., M.R.C.S., L.R.C.P., D.P.H., Deputy Medical Officer of Health and Deputy Principal School Medical Officer- A. W. HAY, M. B., B. S., D.P.H., (to 31st May, 1955) J. DRUMMOND, M. B., Ch B., D.P.H., (from 12th December, 1955) Assistant Medical Officers- G. CROSBY, M.R.C.S., L.R.C.P. M. B. GALVIN, M, B., Ch B., B.A.O. (Dublin) F. GASKELL, M.R.C.S., L R.C.P. S.M.B, PERRY M B. , Ch. B., D P.H. J.T. REES M.R.C.S., L.R.C.P. Principal School Dental Officer- ALLAN ROSS, M.R.C.S., L.R.C.P., B.D.S. Chief Sanitary Inspector and Food and Shops Act Inspector D.G, TONKIN, M.S.I.A. Superintendent Nursing Officer and Non-Medical Supervisor of Midwives M. SHIRLAW, S.R.N., S.C.M., H. V s Cert., Q. N. Superintendent Health Visitor- B.L, MARYON, S.R.N., S.C.M., H.V' s Cert (R.S.I.)., Senior Tuberculosis Visitor - F.M, ROGERS, S.R.N., T.A, Cert. Chief Administrative Assistant - H.J. HORSNELL 6 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, Ladies and Gentlemen I have the honour to present the Annual Report on the health of the borough for the year 1955 and at once to remark that apart from Measles this has been a year singularly free from epidemics. The Registrar General's estimate of the population at the 30th June 1955 stands at 116,100 pointing a further decline of 1 600 in the year which in line with the borough's population trend for the past five years follows the Council's policy to achieve an optimum population and must be coupled with the steady decline in birth rate and total births since 1951 Infant Mortality. Thirtyfive infants succumbed in their first year of life giving an infant mortality rate of 24.2 per 1,000 live births a worsening of last year's figures of 19.6. Of the 35 deaths, 25 occurred within one month of birth and of this perinatal mortality, prematurity with 18 deaths claimed the major share. There is little doubt a considerable proportion of perinatal deaths through prematurity were associated with toxaemia of pregnancy in the mothers and here we have a problem as yet little nearer to solution than was the position ten years ago. Those medical men and women concerned with ante-natal care know of the scruples of most women in regard to their weight and figures and are well aware of the work on weight control in the gestation period as one of our chief precautionary measures against the fulmination of toxaemia of pregnancy. Yet they find it unaccountably difficult to persuade a pregnant woman that all her gain in weight is not due to the developing foetus and to regulate her weight increase will not harm her unborn child but in fact enhance its chances of normality at birth and subsequent survival. I do not believe expectant mothers are imbued with the theory and practice of weight control in the last six months of pregnancy I think it just as important for a pregnant woman to carry her weight chart in her handbag as her Rhesus Factor and Blood Grouping card but I see very few women who attend our clinics who know how many pounds they have gained in weight in the preceding four weeks and I believe this would be so in many areas where ante natal care is diffused between the three major contestants for obstetric tutelage in the Health Service arena It would appear to me the Hospital services are submerged in the welter of treatment the General Practitioner services top heavy with general care and diagnosis of diseases and only the Local Authority services are properly placed and orientated to give fully the ante-natal care all expectant mothers should have for the gestation period is a time for learning when receptivity is at its greatest and the teacher need not strain after rapprochement with her pupil. Cancer To turn now to the problems of cancer of the lung and cancer generally which vex us at the present time. I have compiled the following table from the general statistics which all can study. It would appear - 1. That death from cancer is on the increase in our borough in spite of a falling population 2 In regard to cancer of the lung there is a steady increase in the number of deaths each year but whereas deaths in men remain about the same there is a steady increase in the number of women who succumb "from cancer of the lung each year In fact although the numbers mercifully are small there has been a fourfold increase in death from cancer of the lung in women in the past three years. 7 3. Deaths from cancer of the breast and of the womb both show no increase; so that it is in cancer of the lung in women that the heaviest toll of life is extracted 4. With cancer of the digestive organs the picture is much brighter as for both sexes there is a significant drop in mortality over the past three years. No thinking person can fail to see that the change in social habits of women relating to the increase in lung cancer is that of smoking, Women increasingly have adopted the practice of heavy cigarette smoking during the past twenty years. It is known that the 'latent period' for cancer of the lung is a long one (15 to 30 years) so that it is just what one would expect, a gradual increase in the "end products' of twenty years heavy smoking in women, i. e. twenty years of chronic irritation of the lung; and unhappily the end product of this type of chronic irritation may be cancer of the lung I know the futility of trying to teach adults in this borough the wisdom of cutting down or stopping completely the smoking habit; one has to face the hostility of a certain section of the medical profession; the dogged opposition of many men who hold dear the right to self-murder, and the frivolous antagonism of countless women who for half a century have belligerently clamoured for the privileges and vices, vested in men only, since Raleigh s time in the reign of the first Elizabeth, I believe this venture into health education may succeed when begun in the schools with the eleven plus scholars, but even here I am not too sanguine of success for how can thinking children be instructed to refrain from doing something, practised with such fervour and zest by their elders, including their teachers of both sexes. An observation on Deaths from Cancer in East Ham 1953 1954 1955 Population of East Ham 119,000 117,700 116, 100 Total deaths from all forms of cancer 212 220 246 Deaths from Cancer of the Lung, in both sexes 47 56 66 Deaths from Cancer of the Lungs, in WOMEN ONLY 6 13 23 Deaths from Cancer of the Breast 21 21 23 Deaths from Cancer of the Womb (uterus) 9 4 4 Deaths from Cancer of the Digestive Organs in WOMEN ONLY 37 25 12 Deaths from Cancer of the Digestive Organs in MEN ONLY 42 36 17 Research. The Council have always readily agreed to the Health Department taking part in fields of research sponsored by accredited representatives of various scientific bodies The work usually entails additional effort on the part of different groups of staff, but I have found the interest and enthusiasm engendered more than offsets the hours and effort so generously given. Both the Council and health staff should be proud to have been given the opportunity to take part in scientific investigations designed to elucidate difficult problems in morbidity and mortality, and in the end to better the lot of mankind. I can look back over twenty years of work in the public health service of East Ham, and remark on the improvement in housing hygiene school and clinic accommodation and the development of the personal health services But I am not so sure that I see a comparable increase in happiness either among the staff of the Council or in the people they serve 8 I often wonder whether the child sitting on the doorstep with a penny whistle, filling his soul with self made music whilst comforting the howling dog beside him, was not more satisfied and contented than his modern omnipotent counterpart garbed and gunned up like television s Davy Crockett, riding a chromium plated tricycle or expensive Mobo horse and dissipating his energies in comet like rushes and frantic whoopings And similarly the adult who delights in being transported a hundred miles not on a phantasy propelled magic carpet but in a petrol pulsating motor car merely for the infantile delight of experiencing movement without effort In a way I welcome the problem of traffic congestion because it may solve this aspect of man's retardation in mental growth without the tragic end that overtook Icarus For who knows but that the cerebral commotion which may be a part of rapid transport (airmen were not grounded for nothing during the war is not a contributory cause of the mental breakdown so common and so distressing a feature of adolescence and middle life and so glibly attributed to the strain of living to-day. I do not believe that indeed we live longer in the twentieth century I believe merely that we take much longer dying. I greatly deprecate the streets of East Ham cluttered up by the shrouded and tethered hulks of a thousand cars To me they symbolize the spirit of their owners tied and imprisioned in a mechanical contraption when they should be free to seek out a thousand adventures into literature music art and just, quiet observation and contemplation The motor car designed to ease the burden of mankind has come to dominate him like a death breathing Moloch demanding even the sacrifice of children both in the slaughter on our roads and in the falling birth rate which has never before been so low in the story of our borough. I would wish to thank all the members of the public health staff who have worked together as a happy team to maintain at a high level the health services offered to the people I am grateful, in particular, to my Deputy„ Dr. Drummond for his assiduous and valuable help and to Mr Horsnell, the Chief Administrative Assistant, far his vigilance and erudition in departmental administration and generous help in the preparation of my annual reports I welcome the opportunity to thank Mr Alderman Hurford the Chairman of the Health Committee for his helpful and constructive criticism of our work and his continued support throughout the year He has guided the Health Committee through their deliberations in a most statesmanlike manner made possible only by a deep knowledge of the minutiae of public health administration as applied to the need of the community 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 9 STATISTICAL AND SOCIAL CONDITIONS OP THE AREA SOCIAL Area (in statute acres) land and water 3,324 Population, Census-April 1951 120,873 Estimated civilian population-Mid. 1955 116,100 Number of inhabited houses (end of 1955 according to rate books) (including tenements and shops) 31,910/ Rateable value at 31st December, 1955 £ 790,509 Sum represented by a penny rate for the year 1955/6 £ 3, 267 / Excludes factories, cinemas government properties, corporation properties (offices and works), utility undertakings and other miscellaneous herlditaments not actually occupied as dwellings. EXTRACTS FROM VITAL STATISTICS, Males Females Total Live Births Legitimate 699 682 1,381 Live Births Illegitimate 32 28 60 Totals 731 710 1,441 Still Births Legitimate 25 13 38 Illegitimate 2 1 3 Totals 27 14 41 Birth Rate per 1,000 population 12.4 Still Birth Rate per 1,000 population. 0.35 Still Birth Rate per 1,000 Total (Live and Still) Births 27.6 Deaths Males 628 Females 530 Total 1,158 Death Rate per 1,000 population 9.9 Deaths from Cancer (all ages) 246 Deaths from Puerperal causes:- Rate per 1,000 Total (Live and Still) Deaths Births Puerperal Sepsis - - Other Maternal Causes 1 0.67 Total 1 0.67 Death Rates of infants under one year of age:- All infants per 1,000 live births 24.2 Legitimate infants per 1,000 legitimate live births 24.6 Illegitimate infants per 1,000 illigitimate live births 16.6 10 POPULATION The Registrar-General's estimate of the population at the 30th June 1955, was 116,100 as compared with 117,700 for the previous year. The rates per 1,000 of the population mentioned in this report are based on this estimate. PUBLIC HEALTH ACT 1936-SECTION 203 Number of births notified during the period 1/1/55 to 31/12/55, as adjusted by transferred notifications (a) Live births:- (b) Still births:- (c) Totals (1) Domiciliary 330 (i) Domiciliary 2 (i) Domiciliary 332 (ii) Institutional 1,134 (ii) Institutional 34 (ii) Institutional 1,168 The number of live births assigned to the area was 1,441 equivalent to a birth rate of 12.4 per 1,000 population. The Registrar General has computed an Area Comparability Factor to facilitate comparison of the birth rates in the various Local Authority Areas and the factor for East Ham is 0.95. The corrected birth rate is therefore 12 4 x 0.95 11. 8. This corrected rate is used in all comparison tables in this report. A comparison of the statistics for the period since 1951 is appended:- 1951 1952 1953 1954 1955 No. of Births (East Ham) 1,732 1,609 1,606 1,526 1,441 Birth rate (East Ham) 13.6 12.7 12.8 12.2 11.8 Birth rate (England & Wales) 15.5 15.3 15.3 15.2 15.0 STILL BIRTHS The number of still births was 41 compared with 28 for the previous year. The rate per 1,000 total (live and still) births is 27.6 the figure for 1954 being 18. 0. The still birth mortality rates for England and Wales and East Ham are shewn in the following table:- TABLE 1 Still births per 1,000 population 1951 1952 1953 1954 1955 England and Wales 0.36 0.35 0.35 0.36 0.33 East Ham 0.29 0.25 0.25 0.23 0.35 The rates for East Ham per 1,000 total (live and still) births for the past five years are indicated below:- 1951 1952 1953 1954 1955 No of still births 35 30 30 28 41 Rate per 1,000 total births 19 8 18. 3 18.3 18.0 27.6 DEATHS The number of residents dying within or without the district was 1,158 as compared with 1,143 in 1954 The death rate per 1,000 population is 9. 9, that for 1954 being 9.7 The Registrar-General has again supplied an area comparability factor and that for East Ham is 1.05. The corrected death rate is therefore the crude death rate (9.9) multiplied by 1.05 10. 4. 11 For the period 1951-1955 the death rates for England and Wales and East Ham are compared:- 1951 1952 1953 1954 1955 England and Wales 12.5 11.3 11.4 11.3 11.7 East Ham 12.2 11.4 9.7 10.2 10.4 The numbers of deaths in the various age groups were as follows:- Under 1 year 1-4 years 5-14 years 15-24 years 25-34 years M F M F M F M F M F 19 16 5 - 51 93 67 35-44 years 45-54 years 55-64 years 65-74 years 75-84 years M F M F M F M F M F 18 24 56 50 106 72 189 126 176 167 85-94 years 95 years and over M F M F 38 56 1 8 Of the total of 1,158 deaths 626 (54%) took place in institutions and 548 (47.3%) occurred outside the Borough The number of non-residents dying within the Borough was 88. Details of the numbers of deaths by causes and age groups are set out in table 3. There was one death in 1955 from maternal cause the Maternal Mortality rate per 1,000 live and still births being 0.67. INFANTILE MORTALITY. Deaths of infants under one year numbered 35-equivalent to an infant mortality rate of 24.2 per 1,000 live births,, the rate for the previous year being 19.6 The rate for England and Wales for 1955 was 24. 9. The number of deaths of illegitimate children under one year of age was 1 out of a total of 60 illegitimate live births, giving a mortality rate of 24.6 per 1,000 illegitimate live births as compared with a figure of 71. 4 for the year 1954. The infantile mortality rates since 1951 are as follows :- 1951 1952 1953 1954 1955 England and Wales 29,6 27.6 26.8 25.5 24.9 East Ham 18.4 22.9 28.5 19.6 24.2 Illegitimate births and mortality rates for the Borough since 1951 are tabulated below:- 1951 1952 1953 1954 1955 No of illegitimate births 60 51 62 42 60 Mortality rate per 1,000 illegitimate live births 62 1 9.6 16.1 71.4 24.6 NEO-NATAL MORTALITY. The deaths of children under the age of four weeks totalled 25, equal to a neo-natal mortality rate of 17.3 per 1,000 live births. 12 These rates from 1951-1955 are shown below:- 1951 1952 1953 1954 1955 13.8 17.4 17.4 17.6 17.3 The causes of death of these children were:- Atelectasis 4 Congenital Malformation 1 Premature Birth 18 Other Causes 2 Total 25 Comment has been made already in the foreword on this serious matter Steps are being taken by co ordinate action on the part of hospitals, general practitioners and local authorities to ensure a bed will always be available in hospital for the reception of cases of toxaemia of pregnancy and hæmorrhage which together are responsible for most premature births. Furthermore our medical and nursing staffs will redouble their efforts to supervise the health and well being of our expectant mothers especially in relation to diet and weight control In this way it is hoped to reduce the number of cases of toxaemia of pregnancy that terminate in premature labour or labour at term with the issue of a dead foetus In 1955 246 deaths 21 2% of the total number were attributable to cancer The numbers of such deaths and the death rates from cancer per 1,000 population for the last five years are appended:- 1951 1952 1953 1954 1955 Number of cancer deaths 271 249 212 220 246 Rates per 1,000 population 2.2 2.1 1.8 1.9 2.1 Details of the deaths in 1955 are set out in table 5 and reference is also made to this matter in the foreword and attention is drawn especially to the table on page 7 entitled "An Observation on Deaths from Cancer in East Ham". 13 TABLE 2. - BIRTH RATE DEATH RATE AND ANALYSIS OF MORTALITY, 1955 Live Birth rates per 1,000 population Still Birth rates per 1,000 total (live and still) births Annual Death Rates per 1,000 Population Total Deaths under one year (rate per 1,000 Live Births) All Causes Malignant Neoplasm Lung and Bronchus Acute Poliomyelitis & Polioencephalitis Pneumonia Whooping Cough Diptheria Influenza Coronary disease and Angina Pectoris Tuberculosis (all forms) England and Wales 15. 0 23.2 11.7 0.39 0.01 0.49 0.00 0.00 0.07 1.59 0.15 24.9 160 County Boroughs and Great Towns Including London 14.9 23.2 11.6 0.45 0.01 0.53 0.00 0. 00 0. 06 1.60 0.17 25.1 160 Smaller Towns (resident populations 25,000 to 50,000 at Census. 1951) 14.9 23.3 11.6 0.37 0.00 0.45 0.00 0.00 0.07 1.60 0.13 25.2 London-Administrative County 15.1 20. 2 11.5 0.57 0.01 0.63 0.00 0.00 0.05 1.57 0.17 23.2 EAST HAM 11.8 27.6 10.4 0.57 - 0.53 - - 0.05 1.51 0.12 24.2 14 TABLE 3.-CAUSES OF DEATH IN AGE GROUPS 1955. 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 above 1955 1954 1953 1952 1951 M F M F M F M F M F M F M F M F M F M F 1. Tuberculosis respiratory 11 2 - - - - - - 1 - - 1 6 - 4 - - 1 7 2 13 12 18 26 29 2. Tuberculosis other forms 1 - - - - - - - 1 - - - - - - - - - 1 - 1 - 3 2 7 3. Syphilitic Disease 7 - - - - - - - - - - - 2 - 3 - 2 - 4 - 7 - 4 8 10 4. Diphtheria - - - - - - - - - - - - - - - - - - - - - - - - - 5. Whooping Cough - - - - - - - - - - - - - - - - - - - - - - - - 1 6. Meningococcal Infections - - - - - - - - - - - - - - - - - - - - - 1 1 - - 7. Acute Poliomyelitis - - - - - - - - - - - - - - - - - - - - - - - 2 - 8. Measles 1 - - - 1 - - - - - - - - - - - - - 1 - 1 - - - - 9. Other Infective and Parasitic Diseases 1 2 - 1 - - - - - - - 1 - - 1 - - - 1 2 3 1 2 2 - 10. Malignant Neoplasm Stomach 16 12 - - - - - - - - - - 7 5 6 5 3 2 12 5 28 37 35 49 58 11. Malignant Neoplasm Lung Bronchus 49 17 - - - - - - - - 2 2 23 6 22 4 2 5 27 11 66 56 47 54 50 12. Malignant Neoplasm Breast - 23 - - - - - - - - - 5 - 12 - 3 - 3 - 12 23 21 21 23 21 13. Malignant Neoplasm Uterus - 4 - - - - - - - - - 1 - 2 - - - 1 - 3 4 4 9 6 16 14. Other Malignant & Lymphatic Neoplasms 76 43 - - - - 2 - 1 - 5 5 19 19 18 9 31 10 49 25 119 102 100 117 126 •. n 15 Leukaemia, Aleukaemia 3 3 - - - - 1 - - 1 1 - - 1 1 1 - - 2 2 6 6 4 10 12 16. Diabetes 1 7 - - - - - - - - 1 - - 2 - 2 - 3 1 3 8 8 0 12 12 17. Vascular Lesions of the Nervous System 47 72 - - - - - - - - - 1 7 12 15 26 25 33 21 39 119 136 113 161 140 18. Coronary Disease Angina 119 57 - - 1 - - - - - 5 - 40 11 39 21 34 25 46 18 176 196 173 177 154 19. Hypertension with Heart Disease 10 23 - - - - - - - - - - 3 1 3 7 4 15 5 7 33 26 22 35 71 20. Other Heart Disease 54 98 - - - - 1 - - 1 - 2 10 15 13 17 30 63 26 53 152 158 131 201 233 21. Other Circulatory Disease 27 25 - - - - - - - - 2 1 4 3 8 8 13 13 14 18 52 60 50 54 53 22. Influenza 3 3 - 1 - - - - 1 - - - - - - - 2 2 3 1 6 3 15 3 27 23. Pneumonia 36 26 - - 1 - 1 - - - 1 - 4 3 10 5 19 18 28 13 62 49 65 77 71 24. Bronchitis 55 29 2 1 1 - - - - - - - 14 7 22 6 16 15 26 6 84 77 98 109 120 25. Other D iseases of Respiratory System 10 3 - - - - - - - - 2 - 4 3 3 - 1 - 6 1 13 8 8 15 11 26. Ulcer of Stomach and Duodenum 12 1 - - - - - - - - 1 - 3 - 3 - 5 1 10 1 13 19 15 10 21 27. Gastritis Enteritis and Diarrhoea 2 3 2 1 - - - - - - - - - - - - - 2 2 - 5 5 10 5 2 28. Nephritis and Nephrosis 7 5 - - - - - - - - 1 2 3 2 1 - 2 1 4 2 12 8 8 18 10 29. Hyperplasia of Prostate 10 - - - - - - - - - - - - - 3 - 7 - 7 - 10 12 5 7 15 30. Pregnancy Childbirth Abortion - 1 - - - - - - - - - 1 - - - - - - - 1 1 1 7 2 1 31. Congenital Malformations 4 2 2 - - - - 1 1 - - - 1 1 - - - - 3 1 6 10 13 9 14 32. Other Defined and I11 Defined Diseases 44 56 13 12 1 - - - - 1 1 9 8 14 9 8 12 12 36 37 100 88 67 93 104 33. Motor Vehicle Accidents 10 3 - - - - - - 3 - - - 1 1 1 2 5 - 7 2 13 10 15 14 11 34. All Other Accidents 7 6 - - - - - - 1 - - - 1 - 4 - 1 6 4 4 13 14 17 18 24 35. Suicide 5 4 - - - - - - - - 2 - 2 2 - 2 1 - 3 1 9 15 13 11 8 36. Homicide and Operations of War - - - - - - - - - - - - - - - - - - - - - - 1 - 1 Totals 628 330 19 16 5 - 5 1 9 3 24 31 162 122 189 126 215 231 356 270 1158 1143 1094 1330 1433 15 TABLE 4.-INFANT DEATHS UNDER ONE YEAR OP AGE, 1955 Cause of Death 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 M F M F M F M F M F M F M F M F Bronchitis - - - - - - - - - - 1 1 - - 1 - 2 1 Atalectasis 2 2 - - - - - - - - - - - - - - 2 2 Congenital Malformation 1 - - - - - - - 1 - - 1 - - - - 2 1 Premature Birth 8 9 - - 1 - - - - - - - - - - - 9 9 Other Causes 1 - - - - - 1 - - 1 1 1 1 1 - - 4 3 TOTALS 12 11 - - 1 - 1 - 1 1 2 3 1 1 1 19 16 TABLE 5.- CANCER DEATHS LOCATION OP 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 - - - - - - - 2 - 3 1 - 2 7 1 13 4 Digestive Organs and Peritoneum - - - - - - - - 3 3 5 2 6 5 3 2 17 12 Lungs Bronchus - - - - - 1 2 1 7 4 16 2 22 4 2 5 49 17 Other Repiratory Organs - - - - - - - - - - - - - - - - - - Uterus - - - - - - - 1 - 1 - 1 - - - 1 - 4 Other Female Genital Organs - - - - - - - 2 - 2 - 4 - 1 - - - 9 Breast - - - - - 2 - 3 - 8 - 4 - 3 - 3 - 23 Male Genital Organs - - - - - - - - - - 1 - 3 - 5 - 9 - Urinary Organs - - - - - - - - - - 1 2 2 2 4 3 7 7 Leukaemia and Aleukaemia 1 - - 1 1 - - - - - - 1 1 1 - - 3 3 Brain and other parts of Nervous System - - - - 1 1 - 1 - 2 1 1 1 - - - 3 5 Other or Unspecified Organs 1 - 1 - 2 - 2 1 5 6 5 1 11 4 16 6 43 18 TOTALS 3 - 1 1 4 4 4 9 17 26 32 19 46 22 37 21 144 102 16 BIRTH AND DEATH RATES PER 1,000 POPULATION) 1879 - 1955 The high rate in 1941 was due to deaths resulting from enemy action. 17 INFANTILE MORTALITY RATES PER 1,000 LIVE BIRTHS 1939-1955 18 INFECTIOUS DISEASES The quarterly returns to the Registrar-General were as follows:- Qtr ending Qtr. ending Qtr ending Qtr ending Total 31/3/55 30/6/55 30/9/55 31/12/55 Scarlet Fever 11 11 5 5 32 Whooping Cough 42 93 65 8 208 / Acute Poliomyelitis - - 15 9 24 Measles 1316 895 29 - 2240 Diphtheria 1 - - - 1 Pneumonia 29 11 4 16 60 Dysentery 8 1 - 2 11 Typhoid Fever - - - - - Paratyphoid Fever - - - - - E]rysipelas 4 1 3 3 11 Meningococcal Infection - - - 2 2 Food Poisoning 1 1 3 2 1 Puerperal Pyrexia 8 - 1 - 9 Ophthalmia Neonatorum - - 1 - 1 Tuberculosis-Respiratory 24 29 26 31 110 Tuberculosis-Meninges & C.N.S. - - 1 - 1 Tuberculosis-Other 1 - 2 1 4 / Of the 24 cases of Acute Poliomyelitis 12 were paralytic and 12 non paralytic. Eight of the notifications of Puerperal Pyrexia were in respect of in patients of East Ham Memorial Hospital The remaining case occurred following domiciliary confinement. In the one case of Ophthalmia Neonatorum treatment was successful and the child's vision was not impaired. There were no deaths from the seven principal Zymotic diseases (Smallpox Whooping Cough Measles Diphtheria Diarrhoea Scarlet Fever and Enteric Fever.) Details of the Notifications of tuberculosis are set out in table 7. TUBERCULOSIS It is pleasing to note that there has been a 14% reduction in notifications of new cases of pulmonary tuberculosis (127 in 1954 and 109 in 1955). Non pulmonary tuberculosis has followed the downward trend with a 42% reduction in notifications. So it would appear that for the first time we are well set on the road to banishment of this disease from our community For with reduction in mortality therapeutic advances, preventive measures and diminution of the attack rate of both pulmonary and non pulmonary varieties of tuberculosis the way seems clear to achieve this desirable end 19 TABLE 6.-PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASE Notified Cases for Year ended 31/12/55 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 Ilford 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 27 - 11 13 3 - - - - - 1 6 2 1 3 5 2 2 2 10 11 - Diphtheria 1 - - 1 - - - - - - 1 - - - - - - - - - 1 - Erysipelas 11 - 1 - - - - 1 5 4 2 2 3 - - 2 - - - 2 2 - Puerperal Pyrexia 9 - - - - 3 4 2 - - - 2 - 2 1 - - 1 1 2 7 - Paratyphoid Fever 1 - - - - - - - 1 - - - 1 - - - - - - - - - Pneumonia 60 3 3 2 2 3 5 8 24 10 - 13 3 5 12 3 3 8 7 6 11 - Acute Poliomyelitis 23 - 8 8 5 1 1 - - - 1 3 4 4 1 1 1 3 2 3 23 - Meningococcal Infection 2 - 1 - - - - 1 - - - - - - - - 2 - - - 2 - Ophthalmia Neonatorum 1 1 - - - - - - - - - - - - - 1 - - - - - - Dysentery 11 - 4 3 2 1 - - - 1 1 - - 1 1 1 7 - - - 4 - Food Poisoning 7 - 1 1 - 1 - 1 2 1 - 2 - - 1 - - 1 1 2 5 - Measles 2,388 57 966 1352 9 4 - - - - 251 309 171 250 215 152 226 306 187 321 22 - Whooping Cough 208 19 78 101 3 1 3 2 - 1 34 33 18 19 11 19 22 18 7 27 4 - 20 The hospitals to which the patients suffering from infectious diseases were admitted are named below:- Name of Hospital No. of cases admitted Plaistow Hospital, Samson Street, E. 13 40 Ilford Isolation Hospital Chadwell Heath 17 Eastern Fever Hospital, Homerton E.9 9 Coppetts Wood Hospital, N.10 1 Rush Green Hospital, Romford 4 Whipps Cross Hospital, Leytonstone, E.11 1 Queen Elizabeth Hospital, E.l 1 Queen Marys Hospital for the East End, E.15 1 St. George-in-the-East Hospital, E.1 1 East Ham Memorial Hospital, E.7 10 St. Andrew's Hospital, Devons Road, Bow,, E.3 2 St. Ann's General Hospital, St. Ann s Road. N.15 5 Total 92 21 TABLE 7.-PUBLIC HEALTH ( TUBERCULOSIS; REGULATIONS, 1952 SUMMARY OF NOTIFICATIONS DURING THE PERIOD FROM 1ST JANUARY, 1956 TO THE 31ST DECEMBER, 1955 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 - - - 3 - 3 8 6 8 17 12 13 - 70 Respiratory, Females - - 1 - 2 5 10 9 6 3 2 1 - 39 Non-Respiratory, Males - - 1 - - 1 - - - - - - - 2 Non-Respiratory, Females - 1 - - - - 1 1 2 - - - - 5 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 - - - - - - - - - - - - - (B) Non Respiratory M - - - - - - - - - - - - - - (C) F - - - - - - - - - - - - - - (D) Death Returns from Registrar General (Transferable deaths) Respiratory M - - - - - - - - - - - - - - (A) F - - - - - - - - - - - - - - (B) Non Respiratory M - - - - - - - - - - - - - - (C) IF - - - - - - - - - - - - - - (D) Posthumous Notifications Respiratory M - - - - - 1 - - - - - - - 1 (A) F - - - - - - - - - - - - - - (B) Non Respiratory M - - - - - - - - - - - - - - (C) F - - - - - - - - - - - - - - (D) Totals (A) 1 (B) - (C) - (D) - 22 TABLE 8.-TOTAL CASES OF NOTIFIABLE DISEASES, 1931-1955 DISEASE 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 Small Pox 51 13 1 1 - - - - - - - Scarlet Fever 245 779 701 979 411 359 387 287 196 77 68 210 Diphtheria 196 157 180 379 254 134 149 141 91 47 45 49 Enteric or Typhoid Fever 8 7 5 - 2 2 13 15 8 10 3 - Paratyphoid Fever - - - - - - - - - - - - Erysipelas 54 55 69 74 55 59 53 71 41 33 23 37 Puerperal Fever 10 4 4 7 12 7 5+ / / / / / Puerperal Pyrexia 6 23 10 11 14 7 7 18 16 8 6 15 Meningococcal Infection 8 5 1 3 3 - 2 3 3 11 5 12 Encephalitis Lethargica - - 1 1 1 - 1 1 - - - - Ophthalmia Neonatorum 6 6 9 5 5 6 7 9 7 3 4 1 Acute Poliomyelitis 1 7 2 5 13 2 4 - 2 1 - - Acute Polio Encephalitis - 3 2 1 - - - - - - - - Dysentery - - - 1 - - 3 18 - - - - Malaria - 1 ‡1 - - - - - - - - - Measles Not Notifiable 3 36 460 1,091 Whooping Cough Not Notifiable - 19 262 227 Food Poisoning Not Notifiable Pneumonia 75 77 148 100 88 101 111 85 59 42 33 37 Tuberculosis Pulmonary 197 185 164 174 184 186 188 149 157 130 139 164 Non-Pulmonary 49 47 35 33 37 31 39 20 24 30 22 22 Totals 906 1,369 1,333 1,774 1,079 894 969 817 607 447 1,070 1,865 + Notifiable as Puerperal Pyrexia as from 1/10/37 / Notifiable as Puerperal Pyrexia ‡ 1 Induced in an Institution 23 TABLE 8.-TOTAL CASES OP NOTIFIABLE DISEASES 1931-1955 continued. DISEASE 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 Small Pox - - - - - - - - - - - - - Scarlet Fever 271 132 153 193 179 222 289 270 203 343 245 172 32 Diphtheria 59 33 31 19 46 14 2 1 - 1 - 1 1 Enteric or Typhoid Fever 4 - - - - 1 - 3 - 1 - - - Paratyphoid Fever - - - - - - - 1 1 1 1 - - Erysipelas 28 18 14 25 23 21 24 21 19 16 15 14 11 Puerperal Fever / / / / / / / / / / / / / Puerperal Pyrexia 8 8 2 8 5 4 2 3 2 7 10 3 9 Meningococcal Infection 4 3 1 8 1 5 6 1 1 4 1 3 2 Encephalitis Lethergica - - - - - - - - - - - - - Ophthalmia Neonatorum 1 4 2 1 2 - 4 2 1 1 - - 1 Acute Poliomyelitis - - 1 - 7 8 13 10 7 10 7 3 24 Acute Polio Encephalitis - - - - 1 - - - - - 1 - - Dysentery 6 5 7 5 2 - 1 10 321 3 285 41 11 Malaria - - ‡1 3a - - - - - - lb - - Measles 971 258 1,498 815 964 1,559 1,098 988 2,198 1,883 960 30 2,240 Whooping Cough 241 293 67 258 430 578 498 1,027 625 361 554 117 208 Food Poisoning Not Notifiable 4 5 23 8 7 8 7 Pneumonia 72 50 55 97 143 111 88 41 58 61 70 45 60 Tuberculosis Pulmonary 200 156 205 194 211 211 148 142 117 101 126 127 110 Non-Pulmonary 23 15 16 9 26 20 11 14 16 14 12 12 5 Totals 1,834 975 2,053 1,635 2,040 2,754 2,188 2,538 3,592 2,815 2,295 576 2,721 / ,Notifiable as Puerperal Pyrexia ‡ 1 Induced in an Institution (a) l Induced for therapeutic purposes; 2 contracted abroad (b) Contracted abroad 24 VENEREAL DISEASES The following statistics have been abstracted from copies of form V.D. (R) (1952), which have been received from the Hospitals named and total figures for 1954 and 1953 are also shewn:- Patients dealt with for the first time during 1955 Syphilis Gonorrhoea Other Conditions Total Albert Dock Hospital E. 16 - 3 35 38 Queen Mary's Hospital, E. 15 4 5 29 38 St. Thomas' Hospital, S E. 1 - - 2 2 Whitechapel Clinic, E. 1 1 18 128 147 Totals 5 26 194 225 Totals for 1953 10 19 170 209 Totals for 1954 7 19 183 209 ALDERSBROOK NURSERY AND SCATTERED HOMES The statistics for the year 1955 are appended:- East Ham Other Authorities Total 1 Average number in homes throughout the year 120 29 149 2 No chargeable to East Ham on 1/1/55 132 - - 3 No chargeable to East Ham on 31/12/55 96 - - 4 Average weekly admissions 4 1 5 5, Average weekly discharges 5 2 7 Since the dispersal of the Aldersbrook Homes, the medical services for the reception unit at 80 Aldersbrook Road the residual residential nursery in the Aldersbrook grounds, and the scattered homes, have been provided by the Health Department. All the medical needs are covered by rota duties and this close liaison with the Children's Department has proved of great value to the children who have come into care. NATIONAL ASSISTANCE ACT, 1948 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. It has not been found necessary for action to be taken under this section during the year. 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. POOD POISONING. In accordance with Ministry of Health Circular 46/49 the following information was supplied:- (1) Pood Poisoning Notifications (Corrected) Return to Registrar- General:- 1st Quarter 1 2nd Quarter 2 3rd Quarter 3 4th Quarter 2 Total 8 25 (2) There were no outbreaks during the year due to identified agents (3) There were no outbreaks of undiscovered cause during the year. (4) Single cases Agent identified;- a) Salmonella Typhimurium 7 b) Salmonella Group C 1 Total 8 CLEAN POOD CAMPAIGN There is little doubt that the impact of the clean food campaign on shopkeepers and food handling establishments has resulted in an all round improvement in standards of hygiene The public are losing that apathy and indifference which, in the past, enabled some food vendors to carry on their business in inadequate premises with sub- standard equipment and little effort at hygiene practice at all It is anticipated that under the Pood & Drugs (Amendment) Act 1954 and the Food and Drugs Act,, 1955 new Food Hygiene Regulations which will come into force on 1st January 1956 will so widen the powers of the Council that the Food Hygiene Guild will no longer need to function, FACTORIES ACTS 1937 AND 1948 Details of the work carried out under the above Acts will be found set out in Table 9 TABLE 9 FACTORIES ACTS, 1937 AND 3 948 PART I OF THE ACT 1, - INSPECTIONS for the purposes of provisions as to health (including inspections made by Sanitary Inspectors: Premises Number on Register Number of Inspections Written notices Occupiers prosecuted (i) Factories in which Sections 1,2, 3 4 and 6 are to be enforced by Local Authorities 42 58 - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 300 449 11 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers premises) 1 1 - - Totals 343 508 11 - 26 2. - CASES IN WHICH DEFECTS WERE POUND (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 Pound Remedied Referred To H. M. Inspector By H M Inspector Want of cleanliness (S I) 26 26 - 1 - Overcrowding (S 2) - - - - - Unreasonable temperature (S,3) 1 - - 1 - Inadequate ventilation (& 4) - - - - - Ineffective drainage of floors (S 6) - - - - - Sanitary Conveniences (S 7 (a) insufficient 1 - - - - (b) unsuitable or defective 27 27 - 4 - (c) not separate for sexes - - - - - Other offences against the Act (not including offences relating to Outwork) 2 1 - - - Totals 57 54 - 6 - PART VIII OP 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) NOo of cases of default in sending lists to the Council No. of prosecu tions for failure to supply lists NOa of Instances of work in unwholesome premises Notices served Prosecutions Wearing Apparel (Making etc) 240 - - - - - Umbrellas etc 3 - - - - - Assembly of Metal caps 21 - - - - - Christmas crackers cosaques Christmas stockings etc. 76 - - - - - Totals , 340 - = - - - 27 NATIONAL HEALTH SERVICE ACT, 1946 SECTIONS 22. 23, 24, 25 26, 27„ 28, 29 and 51 Pull 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 report on the dental treatment provided for expectant and nursing mothers and pre school children in 1955< As was envisaged in the report for 1954 the beginning of 1955 was gloomy indeed. One dental officer had resigned towards the end of 1954 and the remaining assistant dental officer resigned early in 1955 The Senior Dental Officer was left to cope with the situation entirely alone apart from some rather intermittent and not altogether satisfactory part time help There had been a full turn of the circle as this was the situation for most of 1951, viz one fulltime officer with some part time help The fact that there had apparently been a large increase in the number of dentists working in local authority clinics made the position of this Borough difficult to understand After numerous advertisements at the normal Whitley scales had met with no response the starting salary was increased considerably and the services of two dentists were obtained There is not the slightest doubt that if a realistic view had not been taken by this Authority the Senior Dental Officer would have been the only full-time dentist for nearly the whole year At the end of the year the outlook was considerably brighter as there were three full-time dentists with one vacancy on the establishment still to be filled The dental treatment of expectant and nursing mothers is gradually becoming less of a problem due to a falling birth rate The treatment of children under five cannot be organised on sound lines until there is a much bigger dental staff Kbny patients are keen to obtain conservative treatment but in spite of intensive propaganda from numerous sources it is found that their ideas on oral hygiene are still disappointingly vague* TABLE 10 NUMBERS PROVIDED WITH DENTAL CARE, 1955 Examined Needing treatment Treated Made dentally fit . Expectant & Nursing Mothers 209 201 194 109 Children under five 386 365 291 245 TABLE 11 FORMS OF DENTAL TREATMENT PROVIDED 1955 Ex trac tions General Anaesthetics Fillings Scalings and gum treatment Silver Nitrate treatment Crowns or inlays Radio graphs Dentures provided Full upper or lower Parttial upper or lower Expectant & Nursing Mothers 418 67 143 10 5 - 8 34 37 Children under five 525 273 70 44 - 2 1 3 28 PREMATURE BIRTHS Number of live premature infants notified during the year (including transferred notifications) whose mothers normally reside in the area: - (1) born at home 17 (2) born in hospital or nursing home 77 Total premature births for the past three years:- 1953 1954 1955 89 84 94 The percentage increase in the number of premature births over last year is significant as an index to the persistence of the two problems of toxaemia of pregnancy and antepartum haemorrhage Reference has already been made to the desirability of a concentrated attack on these two persistent and apparently ineluctable causes of infant mortality. Of course we must continue with our measures which ensure the greatest chance of survival of premature infants but should ever have before us the real solution those ante natal practices yet to be determined which will deal with the primary causes of prematurity 29 TABLE 12 Weight at Birth PREMATURE LIVE BIRTHS PREMATURE STILL'-BIRTHS Born in Hospital f 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 be fo re 28 th day Born in hospital Born at home Born in nursing home Total Died within 24 hrs. of birth Sur vived 28 days Total Died within 24 hrs. of birth Sur vived 28 lays Total Died within 24 hrs. of birth Sur vived 28 days Total Died within 24 hrs. of birth Sur vivec 28 days Total Died within 2 4 hrs.of birth Sur- vived 28 days (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (ID (12) (13) (14) (15) (16) (17) (18) (19) (a) 3 lb, 4 oz. or less (1, 5000 gms or less) 19 6 9 1 - - 2 1 - - - - - - - 9 - - (b) Over 3 lb. 4 oz up to and including 4 lb. 6 oz. (1,500 -2,000 gms ) 12 - 12 1 - 1 1 - 1 - - - - - - 3 - - (c) Over 4 lb, 6 oz, up to and including 4 lb. 15 oz. (2.000 2.350 gms.) 12 2 9 4 - 4 - - - - - - - - - 1 1 - (d) Over 4 lb. 15 oz, up to and including 5 lb. 8 oz. (2. 250 - 2 500 gms.) 34 - 134 8 - 8 - - - - - - - - - 5 - - Totals \ 77 8 64 14 - 13 3 1 1 - - - - - - 18 1 - † The group under this heading will include cases which may be born in one hospital and transferred to another. 30 TABLE 13 ANTE NATAL AND POST NATAL CLINICS 1955 No of clinics provided at end of year (whether held at Child Weifare Centres or other premises) No. of sessions held at end of year per month at clinics in eluded in col (2) No, of women in attendance Total No of attendances made i by women included in col (4)during t he year No of womer who attended during the year No. of new cases incLuded in col (4) i. e, f<5r A N. clinics women who had not previously attended any clinic during current pregnancy & for P N clinics women who had not previously attended any P N clinic after last confinement (1) (2) (3) (4) (5) (6) Local Health Authority Clinics Ante natal clinics 4 44 1 316 953 5, 703 Post natal clinics 275/ 271/ 316/ Clinic belonging to other L H A Ante natal clinics 1 4 18 11 63 Post-natal clinics 1/ 1/ 1/ + By arrangements with L C C at Fernhill 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 No clinics were discontinued or new premises opened during the year No ante natal or pest 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 Whilst mothers booked for domiciliary confinement are examined at ante natal clinics by the midwife with whom they are booked a medical officer who is examining mothers booked for hospital also is at the clinic and is readily available for consultation should the midwife consider this necessary There are at present 8 such sessions by midwives each month. 31 TABLE 14 CHILD WELFARE CENTRES 1955 Number of centres provided at end of year Number of Child Welfare sessions now held per month at centres in col (2) Number of children who first attended a centre of this Local Health Authority 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 1955 1954 1953-50 Under 1 year 1 but under 2 2 but under 5 (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) Local Health Authority Centres 4 48 1.151 1,037 826 442 2,305 12,698 2,148. 1,411 16.257 Centre belonging to other L.H A / 1 4 23 22 13 12 47 233 45 41 319 / By arrangement with L C. C at Pernhill Street Baths North Woolwich, E. 16, No clinics were discontinued or new premises opened during the year. 32 Work in these clinics still forms the hub of the health visitor's activities in the community It is true that expanding effort in the directions of care of the aged problem families diabetic schemes and an increasing interest in mental health divert her from her primary maternity and child welfare functions It is inevitable that medico social problems in epidemiology and school hygiene will daily occupy considerable portions of her working hours Yet time must be devoted to the basic problems of mother and child care, subjects vital to the growth and happiness of the community. The health visitor who neglects ante-natal care has missed the zenithal opportunity for health education and to neglect child welfare in the first year of life is to fight a continuous rearguard action in the struggle to thrive between a sickly infant and carewarn mother,, in a domestic atmosphere of tension and anxiety, DAY NURSERIES 1955 TABLE 15 Number at 31/12/55 No, of approved places No of children on the register at the end of the year. Average daily attendance during the year 0-2 years 2-5 years 0-2 years 2 5 years 0-2 years 2-5 years One 25 54 11 57 4.7 38.0 The Day Nursery at Wall End Road E 6 was closed on 23rd April 1955 leaving only one Nursery that at St Stephens Road E.6 open The figures quoted above relate to this latter nursery only those in respect of the Wall End Nursery being appended - Period 1st January 23rd April,, 1955. Number of approved places under 2 15 2 - 5 45 Number of children on register on 23. 4. 55 under 2 7 2 - 5 23 Average daily attendance for the period under 2 7.6 2 - 5 20. 1 The nurseries are open from Monday to Friday each week with the exceptions of Public Holidays, and the total attendances during 1955 were as follows Nursery Total attendances Average daily attendance St, Stephen s Road 10 „ 927 42.7 Wall End/Caledon Road (1,1. 55 - 23 4,55) 2, 141 27.7 Total 13. 068 There are no Nurseries in the borough provided by Voluntary Organisations, all nurseries being operated by the authority The policy of closing the day nursery at Wall End Road was adopted by the Council when it became obvious that with full employment and high wages fewer households need rely on local authority support, and a greater number of families by their own efforts were able to provide complete daily care for their snail children Nevertheless day nursery provision had to be continued for some 60 or 70 children who could not otherwise be cared for during the day And to ensure that no mother endured hardship in bringing her child to the nursery transport has been provided in the morning and evening for every child resident at a distance from the nursery. 33 ILLEGITIMATE CHILDREN (Circular 2866) The Council do not employ a social worker for the purposes of the above Circular. These duties are undertaken by the Superintendent Health Visitor, and close cooperationsis maintained with the Children's Officer. CARE OF UNMARRIED MOTHERS During the year under review it was not found necessary for the Council to accept responsibility for the maintenance of any unmarried mother in a mother and baby home. NURSERY AND CHILD MINDERS REGULATION ACT 1948. There were no daily minders provided by the Council during the year and there were no premises or daily minders registered under the above Act at 31/12/55, The Authority do not pay 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 year 1955 and there were no homes on the register at the end of the year, ALDERSBROOK MATERNITY HOSPITAL This unit closed on 30th June 1955 Statistics for the period 1st January to 30th June are appended Number of beds 20 " " midwives employed on 30/6/55 5 " patients confined during the period 1/1/55 to 30/6/55 - (a) Midwifery 117 ) 117 (b) maternity nursing ) " " midwives qualified on 30/6/55 to administer gas and air analgesia 5 " " sets of apparatus of gas and air analgesia in use on 30/6/55 2 " " patients to whom gas and air analgesia was administered by midwives during the period 1/1/55 to 30/6/55 :- (a) when acting as midwife 112 ) 112 (b) " " maternity nurse ) " " patients to whom pethidine was administered by midwives during period 1/1/55 to 30/6/55 (a) when acting as midwife 67 ) 67 (b) " " " maternity nurse - ) " " occasions medical aid sought by midwives under section 14(1) of the Midwives Act 1951 .. 18 " " infant deaths - " " premature infants born 4 " " still births 2 This hospital was opened on 19,10 46 to meet the pressing needs for maternity beds for our burgesses A glance at the chart on page 16 will show that 1946 was the peak year for new births and never again in the eleven years to follow was the birth rate to equal that post-war figure of 22 per 1,000 population The hospital was fashioned out of the wartime gas decontamination unit together with some rooms of the old Children's Homes and provided 20 beds and two labour wards and a training nursery and rest room for nursing mothers. During the nine years of active live 3,576 mothers were confined there and 3,693 babies delivered Still births numbered 22 and infant deaths 25 so that it can readily be seen the standard of midwifery practised must have been very high and great credit reflects on the matron midwives and staff who ministered go ably to those East Ham mothers confined in this hospital 34 With the falling birth rate and decline in population of East Ham the Regional Hospital Board in reviewing the whole of the provisions for hospital confinement in the area decided that there were sufficient beds for all purposes without the inclusion of the 20 at Aldersbrook It was decided therefore after consultation with the Council who had protested vigorously to close the Unit and to offer beds in Forest Gate Hospital and East Ham Memorial Hospital to East Ham Mothers who sought hospital confinement. SECTION 23 MIDWIFERY SERVICE TABLE 16 MIDWIVES ACTS, 1902 1951 Number of midwives practising in the area at 31st December, 1955 Domiciliary Midwives Midwives in Institutions Total 1 Midwives employed by the Council 5 - 5 2 Midwives employed by Voluntary Organisations (a) Under arrangements made with the L H A in pursuance of Section 23 of the NHS Act - - - (b) Otherwise (including hospitals not transferred to the Minister under the N.H.S Act) - - - 3 Midwives employed by Hospital Management Committees or Boards of Governors under the N.H.S Act - 5+ 5 4 Midwives in private practice - - - Totals 5 5 10 † These midwives are employed at East Ham Memorial Hospital 35 TABLE 17 NUMBER OF DELIVERIES ATTENIED BY MIDWIVES IN THE AREA DURING THE YEAR Domiciliary Cases Cases in Institutions Doctor not booked Doctor booked 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 Totals 1 Midwives employed by the Authority 4 217 6 96 323 - 2 Midwives employed by Voluntary Organisations (a) Under arrangements with the Local Health Authority in pursuance of Section 2? of the National Health Service Act 1946 - 1 2 2 5 - (b) Otherwise (including Hospitals not transferred to the Minister under the National Health Service Act) - - - - - - 3 Midwives employed by Hospital Management Committees or Boards of Governors under the National Health Service Act - - - - = 395 4 Midwives in Private Practice (including Midwives employed in Nursing Homes - - - - - - Totals 4 218 8 98 328 395 It will be noted that although no midwives are shown in section 2(a) of table 16 a total of 5 deliveries is shown under this section of table 17 These deliveries were attended by midwives of the Silvertown and North Woolwich District Nursing Association which terminated its agency agreement with the Authority and ceased to function on 1st November 1955 Since that date the Council's own midwives have attended mothers in the area formerly covered by the Association 36 DOMICILIARY MID WIVES TABLE 18 GAS AND AIR ANALGESIA AND ADMINISTRATION OF PETHIDINE Number of domiciliary midwives practising in the area at end of year who were qualified to administer "inhalational analgesics in accordance with the requirements of the Central Midwives Board Number of sets of apparatus for the administration of inhalational analgesics in use at end of year Number of cases in which inhalational analgesics were administered by midwives in domiciliary practice during the year: - Number of cases in which pethidine was administered by midwives in domiciliary practice during the year; - When doctor was present at time of delivery of child When doctor was not present at time of delivery of child When doctor was present at time of delivery of child When doctor was not present at time of delivery of child Gas and air Trilene" Gas and air Trilene" Gas and air Trilene" 1, Domiciliary Midwives employed directly by the Local Health Authority 5 6 - 8 - 208 - 5 198 2 Domiciliary Midwives employed under Section 23 by voluntary organisations as agents of Local Health Authority (See footnote to table 17 - - - 1 - 2 - - - 3. Domiciliary Midwives employed under Section 23 by hospital authorities as agents of Local Health Authority - - - - - - - - - 4 Domiciliary Midwives in private practice or employed by organisations not acting as agents of Local Health Authority - - - - - - «= - - Totals 5 6 - 9 - 210 - 5 198 37 INSTITUTIONAL MIDWIVES Pour midwives employed at the East Ham Memorial Hospital at the end of the year were qualified in accordance with the requirements of the Central Midwives Board to administer inhalational analgesics Number of cases in which medical aid was summoned during the year under Section 14(1) of the Midwives Act 1951, by a midwife (a) for domiciliary cases (i) where the medical practitioner had arranged to provide the patient with maternity medical services under the N B S Act 24 (ii) others 38 Total 62 (b) for cases in Institutions 165+ + East Ham Memorial Hospital On 1 11„55 the Silvertown & North Woolwich District Nursing Association closed their district nurses home and their work for the East Ham community adjacent to the Royal Docks came to an end These nurses gave both a general nursing and a domiciliary midwifery service to dockland residents and over the years won golden opinions for themselves from the people they served and the general practitioners in the area Henceforth the work will be fragmented The district nursing will be supplied by the Woolwich & Plumstead District Nursing Association and the domiciliary midwifery will be carried out by our own domiciliary midwives as an extension of their sphere of action to cover the whole borough SECTION 24 HEALTH VISITING SERVICE TABLE 19 HEALTH VISITORS STATISTICS 1955 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 nomber of families or households visited by Health Visitors Number of attendances by health visitors at L H A. Clinics during the year First visits Total visits First visits Total visits Total visits Total visits Total visits 8, 403 1.019 1. 294 1, 470 7, 252 4, 411 5, 905 5, 288 19, 709 3, 001 All Health Visiting Services are provided by the Authority There are no agency arrangements with voluntary organisations One aspect of the Health Visitor's work which should be brought to the notice of the public is the seeming lack of co operation between housewife and Health Visitor. Of 41,650 visits to the home 17,500 calls proved abortive and it appears in some instances mothers meke little effort to welcome the Health Visitor or to anticipate her visit When one considers the call is often made at the request of some responsible member of the household concerned one is a little alarmed at the lack of courtesy and consideration shewn to a Visitor who is offering help and advice often of a specialized kind 38 I would appeal to all mothers to open their doors more readily to the Health Visitor who in the realms of family welfare and infant nurture, has much of inestimable value to impart. SECTION 25. - HOME NURSING, TABLE 20 HOME NURSING - STATISTICS 1955, Medical Surgical Infectious Diseases Tuberculosis Maternal Complications Others Totals Patients included in (2)-(7) who were 65 or over at the time of the first visit during the year Children included in (2)-(7) who were under 5 at the time of the first visit during the year Patients included in (2)-(7) who have had more than 24 visits during the year (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) Number of cases attended by Home Nurses during the year : - 2,409 142 18 82 34 306 2,991 825 110 282 Number of visits paid by Home Nurses during the year : - 54,661 3.035 106 3,846 293 2,863 64,804 26 009 679 26,511 The above work is done for the Council by two voluntary District Nursing Associations; - The East Ham District Nursing Association which deals with that area of East Ham North of the Royal Docks and The Woolwich and Plumstead District Nursing Association which provides for cases occuring in the small area of East Ham South of the Docks. As indicated earlier in the report the Silvertown and North Woolwich District Nursing Association ceased to function in this area and by arrangement the nurses of the Woolwich and Plumstead District Nursing Association overed the area from the 1st November, 1955. We are indebted to the Silvertown nurses for the fine work they have done over the years, often under considerable difficulty and always with kindness efficiency and humanity. 39 SECTION 26 VACCINATION AND IMMUNISATION DIPHTHERIA IMMUNISATION TABLE 21 Immunisation carried out by Age at date of final injection or of reinforcihg injection as appropriate Total Under 1 year 1 4 years 5-14 years Number of children who completed a full course of primary immunisation during the year General Practitioners 308 201 84 593 Local Health Authority 468 127 57 652 Totals 776 328 141 1,245 Number of children who received a secondary or reinforcing injection during the year General Practitioners 1 62 219 282 Local Health Authority - 371 156 527 Totals 1 433 375 809 TABLE 22 Number of children who at the end of the year had completed a course of immunisation at any time between 1st January 1941 and 31st December 1955 Age on 31 12, 55 i e born in year(s) Under 1 year 1955 1-4 years 1951-1954 5-9 years 1946-1950 10-14 years 1941-1945 Total under 15 years A Number of children who completed a course of immunisation (primary or booster, in the period 1951 - 1955 230 4,217 4. 298 1,141 9,886 B Number of children who completed a course of immunisation (primary or booster in the period 1941 1950 - - 4 356 4,683 9,039 C Estimated mid-year child population 1,440 6,160 17, 000 24,600 D Immunity index i.e. percentage of children immunised in the past five years (???) 15, 9 68, 4 32 0 40.1 40 TABLE 23 SMALLPOX VACCINATION No of persons vaccinated or re-vaccinated during 1955 Totals Age at date of vaccination Under 1 year 1 year 2 4 years 5-14 years Over 14 years No vaccinated 396 (344) 57 ( 30) 24 (16) 23 (24) 84 (51) 584 (465) No re-vaccinated. 11 (1) 1 (2) 7 (-) 12 (4) 98(113) 129 (120) Totals 407 (345) 58 (32) 31 (16) 35 (28) 182(164) 713 (585) The figures in brackets are those for 1954. 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 vaccinal encephalomyelitis (c) Death from complications of vaccination other than (a) and (b). It would be remiss if mention were not made here of the imperative need which exists in this Borough for the highest vaccinal state possible among our people The danger of small pox is a constant menace in our area which embraces the Royal Docks into which come ocean going ships from all parts of the world including many regions in which small pox is known to be endemic It is almost criminal folly to neglect a precaution which is life saving, in view of the epidemics which are introduced into this country by air and sea traffic and which unfailingly extract their toll of lives in the unvaccinated It is the personal and communal duty of every man to see that all members of his household are vaccinated against small pox. SECTION 27 AMBULANCE SERVICE This service continues to maintain the high standard of medico-social service set at its inception which it gives to the community Apart from urgent calls to accidents and injuries the service virtually is at the behest of the general practitioner and the hospital medical officer Liason with and control by my department ensures that no abuses creep in and vehicles and staff are constantly employed usefully and economically. It is now possible to shape the policy regarding the best types of vehicles to employ, in relation to the future composition of the ambulance fleet The personnel also combine within themselves the dual function of working the service and forming the cadre of highly trained staff for the Civil Defence Ambulance and Casualty Collecting Service A work of praise is due to them for their loyalty and devotion to the Ambulance Service, and their generous sacrifice of many leisure hours in training and study to reach the highest pitch of efficiency in Civil Defence work The community have responded well to recruitment appeals from this branch of the Civil Defence Service and in fact the Ambulance and Casualty Collecting Service may be rated as one of the most efficient and best trained components of the Service The Ambulance Officer Miss Finch the Chief Administrative Assistant Mr. Horsnell and the Senior Administrative Assistant Mr Thomas are largely responsible by their combined personal energy and enthusiasm for this excellent response by the public. 41 The question of equipping the fleet of ambulances with ' radio" was investigated from all aspects In deciding not to adopt this method of inter communication cognizance was taken of the fact that our vehicles were employed largely in the built-up London area in which telephone communication is always readily available and had never failed us In addition the initial cost of installation was high and that of subsequent maintenance not inconsiderable Should the need become imperative for "radio" contact and control the question can be reviewed again. TABLE 24 AMBULANCE SERVICE STATISTICS FOR YEAR ENDING 31ST MARCH, 1956 AMBULANCE SERVICE Transport by Rail Grand Total Ambulances Dual Purpose (1 stretcher) Vehicles 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 carried - (a) Accident or Emergency 1.042 83 1,125 - lt 125 (b) Others 17,026 26 578 43,604 15 43, 619 (c) Total (a& b) 18 068 26,661 44.729 15 44 744 4 Total Mileage 72, 010 103. 900 175,910 1, 905 177,815 5 No of Operational Staff on 31st March - - 30 - - TABLE 25 COST OF SERVICE Period Ambulance Service £ Cars from Transport Pool etc, £ Transport By Rail £ Total £ Year ending 3lst 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 Year ending 31st March 1956 29, 987 198 15 30 200 42 TABLE 26 UNIT COSTS AMBULANCE SERVICE YEAR ENDING 31ST MARCH, 1956 Ambulance Service only All Services including Hire Cars and Rail £ s. d. £ s. d. Cost per Vehicle mile 3. 4, - Cost per Patient 13, 5. 13. 6. Cost per 1,000 Population 258. 0. 0. 260 0. 0. No, of Patients carried per 1,000 Population 385 385 During the past years various changes have been made in the form of annual costing return required by the Ministry for this service, and these changes are reflected in the detail shown in my various reports. SECTION 28. - PREVENTION OP ILLNESS CARE AND AFTER CAFE, 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 except that cupboards are now maintained only at the Town Hall Annexe and at Church Road Clinic. Details of the items loaned during the year are shown in the following table;- TABLE 27, Article No. of occasions items loaned Total Cupboard at Town Hall Annexe Church Road Clinic Bed Blocks 6 - 6 Bed Cradles 16 2 18 Bed Pans, E. I 181 20 201 Bed Pans, Rubber 8 - 8 Bed Rests 134 5 139 Bed Rings, Air 164 8 172 Bed Rings Dunlopillo 4 - 4 Blankets 3 - 3 Commodes 4 - 4 Crutches 4 - 4 Douche Cans 1 - 1 Feeding Cups 10 - 10 Hospital Bedsteads 4 - 4 Mattresses 5 - 5 Mattressesp Dunlopillo 1 - 1 Pillows 2 - 2 Pillow Slips 2 - 2 Rubber Sheets 45 7 52 Sheets 3 - 3 Sand Bags 1 - 1 Sputum Mugs 4 - 4 Steam Kettles 1 - 1 Urinals (Male) 60 7 67 Urinals (Female, 6 2 8 Walking Sticks 1 - 1 Water Beds 3 - 3 Wheel Chairs 42 - 42 Totals 715 51 766 43 NOTE With the exception of garden shelters stored in sections on other Council premises all large articles kept at the Town Hall Annexe In addition the following articles were loaned from the premature baby outfit cupboard No of occasions Premature baby outfits 3 Scales and weights 43 TUBERCULOSIS No of attendances at East Ham Chest Clinic 28, 355 No of visits to homes of patients by Tuberculosis Visitors 4,636 No of notified cases on clinic register on 1.1 55 Adults l 045 1 252 Children 207 31 12 55 Adults 1,092 1, 278 children 186 No of patients under observation on 1.1.55 Adults 1, 454 2, 113 Children 659 31 12 55 Adults 1, 861 2,633 Children 772 Total number of attendances by Tuberculosis Visitors at Chest Clinic Sessions during the year 1,312 No of occasions on which free extra nourishment was supplied Milk 721 Total 847 Pood 126 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 With, the inception of the loan cupboard scheme bedding for the use of tuberculous patients is now loaned from these cupboards and assistance towards the purchase of such bedding is given Clothing for tuberculous patients is now provided by the National Assistance Board and it has not been necessary for the Authority to assist in such cases The Authority was not asked during the year to accept financial responsibility for the maintenance of tuberculous patients receiving rehabilitation in the British Legion Village Settlements B C G Vaccination continued to be offered to contacts of tuberculosis cases and during the year 172 persons were vaccinated at the Chest Clinic under the Authority s Contact Scheme It was found necessary to provide alternative accommodation for the Occupational Therapy Classes for the tuberculous and by arrangement with the Civil Defence Committee these Classes were transferred to Civil Defence premises at 243 High Street North E 12 on 24th January 1955 The new premises are more commodious than those previously enjoyed and it has been possible to expand this valuable aspect of our after care work. Details of the sessions worked by the part time therapist and of the attendances etc during 1955 are quoted below No of sessions at Chest Clinic and 243 High Street North 97 No of attendance by patients at these sessions 1,537 No of sessions for home visits by Therapist , 102 No of visits to patients homes 647 44 MASS RADIOGRAPHY The Mass Radiography Unit (No 6B) again visited East Ham and conducted a public survey from 6th September to 10th October 1955, The Unit was accommodated in the Minor Hall of the Town Hall and a total of 10, 121 persons attended for examination. The following is an extract from the report by the Units Medical Director, Dr. Lawless, on this survey Males Females Total "No of attendances for Miniature X-ray, 4.532 5, 589 10,121 No, recalled for Large Film examination 181 153 334 No showing some abnormality 192 140 332 Percentage showing some abnormality 4, 23 2. 50 3. 28 Failed to attend for Large Film examination 6 - 6 Tuberculous lesions Active tuberculosis 9 9 18 Inactive tuberculosis 47 37 84 Other abnormalities revealed. Abnormalities of bony thorax 29 23 52 Bacterial virus infection of lungs 1 1 2 Bronchiectasis 4 4 8 Emphysema 8 1 9 Pulmonary fibrosis (Non-T B ) 20 6 26 Pneumoconiosis 1 - 1 Bronchial carcinomata 2 - 2 Benign tumour of lungs 1 2 3 Pleural thickening 40 21 61 Abnormalities of the diaphragm 2 5 7 Congenital cardio-vascular lesions 1 - 1 Acquired cardio-vascular lesions 12 24 36 Miscellaneous 15 7 22 Totals 192 140 332 From the above tables it will be seen that of the total of 10,121 persons examined 102 showed evidence of pulmonary tuberculosis: 18 of this number were found to have active disease at the time of examination i.e. 9 males and 9 females The combined rate for active tuberculosis discovered was 1. 78 per 1,000 examinees The rate for males was 1. 98 and for females 1. 61 These figures compare favourably with our findings in other areas," TABLE 28 CONVALESCENT HOME TREATMENT PERIOD OF TREATMENT 1955 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 - - 1 5 1 - - 7 F - - 2 5 - - - 7 School) children ) M - - 16 7 12 1 1 37 F - - 10 16 14 - 3 43 Adults M 1 - 21 32 1 - - 55 F 2 5 45 66 2 - - 120 Totals 3 5 95 131 30 1 4 269 45 TABLE 29 The recommendations for this form of treatment were submitted by:- Referred by Children 0 - 5 School Children Adults Total General Practitioners 7 25 136 168 Hospitals - - 23 23 East Ham Chest Clinic 1 8 14 23 School Health Service 41 - 41 M & C W Section 5 - - 5 Child Guidance Clinic 1 6 2 9 Totals 14 80 175 269 For comparison the numbers of children and adults receiving this form of treatment in previous years are appended 1952 1953 1954 1955 Children 0-5 years 24 12 27 14 Schoolchildren 79 80 90 80 Adults 111 117 158 175 PARK VIEW THERAPEUTIC CLUB The purpose of this club has already been adumbrated in previous reports It suffices here to say referral of members is still practised by the Runwell Hospital medical staff and the constitution and conduct of the club remains unaltered The Mayor the Chairman and the Health Committee and other interested Councillors all give their generous support and the staff of the mental health department are unstinting in their devotion to this difficult and time consuming social work It must be emphasized' the members themselves run the club and the canalization of of their energies along social lines is in itself therapeutic in the long and difficult process of rehabilitation within the community Mr Steadman the petitions officer in the mental health department undoubtedly has a flair for cementing the rather loose knit structure of the club and his energy geniality and gentle personality combine to strengthen and support the members in their social efforts He is ably backed up by all the Duly Authorised Officers whose zeal and sense of vocation is often commented on both by the persons and families they help and the general practitioners who value their services most highly in the manifold problems of dealing with mental illness 46 SECTIONS 28 and 51 TABLE 30 PARTICULARS OF MENTAL DEFECTIVES REPORTED DURING 1955 Males Females Total Particulars of cases reported during the year 1955 - (1) Ascertainment: (a) Cases reported by Local Education Authorities (Section 57 Education Act, 1944) (i) Under Section 57(3) 3 2 5 (ii) Under Section 57(5) - On leaving special schools 2 3 5 On leaving ordinary schools - - - (b) Other ascertained defectives reported during 1955 and found to be " Subject to be dealt with'9 3 3 6 Total ascertained defectives found to be Subject to be dealt with" during the year 8 8 16 (c) Other reported cases ascertained during 1955 who are not at present Subject to be dealt with 2 . 2 (d) Cases reported but not confirmed as defectives by 31st December and thus excluded from (a) (b) or (c) 4 2 6 Total No of cases reported during the year 14 10 24 (2) Disposal of cases reported during the year (a) Ascertained defectives found to be Subject to be dealt with (i) Admitted to hospitals 3 2 5 (ii) Placed under guardianship - - - (iii) Taken to 'places of safety' - - - (iv) Placed under statutory supervision 5 6 11 Total ascertained defectives found to be Subject to be dealt with" 8 8 16 (b) cases not at present ' Subject to be dealt with- (i) Placed under voluntary supervision 2 - 2 (ii) Action unnecessary • - - Total cases not at present Subject to be dealt with 2 - 2 47 TABLE 31 MENTAL DEFICIENCY ACT 1913 - 1938 PARTICULARS OF MENTAL DEFECTIVES AS ON 31/12/55 Males Females Total 1 No of ascertained mental defectives found Subject to be dealt with" (a) In hospitals (in eluding cases on licence therefrom^ (Under 16 years of age 18 5 23 (Aged 16 years and over 88 86 174 (b †Under guardianship (including cases on licence therefrom) (Under 16 years of age .Aged 16 years and over 3 5 8 (c) In places of safety - - (d) Under statutory supervision (excluding cases on licence) (Under 16 years of age 16 18 34 Aged 16 years and over 80 70 150 Total ascertained cases found to be Subject to be dealt with 205 184 389 No of cases included in M F T (b) to (d) above awaiting removal to an institution 1 1 2 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 Total number of mental defectives(l) plus (2) 231 211 442 3 No of mental defectives receiving training (a) In day training centres (Under 16 years of age 13 14 27 (Aged 16 years and over 14 11 25 (b) At home * - - Total 27 25 52 "f"No defectives under guardianship were dealt with during the year under the provisions of section 8 or 9 During the year temporary care in South Ockendon Hospital was arranged for 2 male and 2 femaie defectives Ministry of Health Circular 5/52}. 48 All guardianship cases are supervised either directly or indirectly by the Authority, No on register on 1/1/55 9 No admitted to institutions .. - No of orders discharged by Board of Control 1 No. on register on 31/12/55 .. 8 +- No. visited by membe rs of Mental Health Committee 4 / No visited by Medical Officer of Health 4 + Outside area / Inside area The number of mental defectives on the register of the Occupation Centre on 31/12/55, was 51 '25 males 26 females). With the exception of one male, who attended mornings only, all defectives attended the centre for the whole day TABLE 32 MENTAL DEFECTIVE OCCUPATION CENTRE SESSIONS AND ATTENDANCES 1955 Morning Afternoon No of sessions held during the year 220 220 Male Female Male Female Total attendances 4,772 4, 290 4,601 4,290 21, 69 19, 5 20.91 19.0 Total attendances males 9,373 females 8,580 total 17,953 Eight defectives attended the Welfare Services Occupation Centre for the handicapped during 1955 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 expanded centre in Katherine Road continues to function under the handicap of the Mental Health Committee not being the sole users of the premises After each daily session all the work finished and unfinished must be packed up and safely locked away together with all mobile equipment and small items of apparatus for parts of the premises are then used for other purposes by different sections of the community This factor also militates against the employ of small looms and work benches,, etc which are more static and could not be stored each late afternoon when the centre closes. So the type of instruction given is necessarily curtailed to that which can be imparted only with the aid of small mobile apparatus, This rather stultifies the efforts of the staff with the older and more capable boys and girls who could be taught simple mechanical trade processes which might even prove lucrative in the end and give a greater measure of satisfaction and sense of achievement -to the patients In spite of this the occupation centre serves a useful purpose in the instruction of the defectives who come daily to it and in the relief afforded to many a family who could not cope with the situation of the defective always with them 49 MENTAL PATIENTS LUNACY AND MENTAL TREATMENT ACTS Type of patient Number on register on 1/1/55 Admissions to institutions during the year 1955 Discharges from institutions during the year 1955 Deaths in institutions during the year 1955 Number on register on 31/12/55 Certified - Males 169 37 29 3 174 Females 200 41 33 15 193 Totals 369 78 62 18 367 Temporary Males 1 9 5 3 2 Females 3 3 1 1 4 Totals 4 12 6 4 6 Voluntary 69 61 64 7 58 Females 64 89 76 6 71 Totals 133 149 140 13 129 Grand Totals 506 239 208 35 502 No, of patients released on trial during 1955 - 17 males, 31 females Total 48. No, of patients returned from trial during 1955 2 males, 9 females, Total 11 The majority of these patients were treated in Runwell Hospital as the following figures demonstrate s - Runwell Hospital Other Mental Hospitals No, of East Ham patients on 1/1/55 484 22 Admissions during the year 236 3 Discharges during the year 206 2 Deaths during the year 33 2 No of East Ham patients on 31/12/55 481 21 TABLE 34 DULY AUTHORISED OFFICERS DETAILS OF VISITS, ETC, 1955 Ment&l Deficiency Acts 1913 - 38 Lunacy ai Treatmei id Mental it Acts Grand Total of visits and attend ances Guardianship Statutory Supervision Friendly Care Home reports for patients detained in instituions Occupation Centre Total visits or attendances Patients reported to be in need of treatment After-Care 1 Park View Thera peutic Social Club Total visits or attendances No. of visits and attendances 31 1,429* 112 143 102 1,817 1,655 874 76 2,605 4,422 50 In my report for 1954 I sketched briefly the activites of the Duly Authorised Officer Here I would stress just one aspect of their work namely their relationship to the general practitioner I have heard it said that in many areas the Duly Authorised Officer has in practice usurped the function of the doctor in diagnosis Nothing could be wider of the mark The Duly Authorised Officer has been in the position to be able to observe the behaviour note the language record the conduct of the mentally sick person under a variety of circumstances usually over fairly long or intermittent periods. He places all his recorded observations at the disposal of the doctor when the latter is called in either by the relatives or by himself on occasion. It is fairly obvious, the family doctor with his multifarious distractions of the daily rounds and surgeries, cannot devote such long periods to clinical observation at the bedside or elsewhere. So the Duly Authorised Officer acts as his eyes and ears, and records his factual observations which are set before the doctor for the latter's interpretation and subsequent initiation of action. The Duly Authorised Officer then sets in train those necessary formalities which simplify for the doctor, family and patient, transport to a mental hospital or elsewhere. The general practitioner well knows the Duly Authorised Officer is indeed his valuable henchman and ally, and not the dragooning tyrannical figure he is occasionally held up to be. SECTION 29 HOME HELP SERVICE TABLE 35 HOME HELP SERVICE TABULATION OF CASES, 1955 Illness or other cause for which help provided period of Service Provided 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 Maternity 2 39 5 - - - - - 46 Tuberculosis - 2 - 2 10 9 4 24 51 Cancer - 4 - 1 14 8 5 19 51 Old Age 11 10 8 10 83 84 87 480 773 Other Sickness 5 6 12 3 28 27 9 53 143 Totals 18 61 25 16 135 128 105 576 1,064 The approved establishment is 70 full time helps or their equivalent in part time help and on 31st December 1955 the staff employed comprised:- Pull Time Permanent Helps 2 Registered Casual Helps 124 Casual Helps on probation prior to Registration 7 Total 133 The hours worked by these helps are detailed below:- Period No of Hours 4 weeks ending 9, 1.55 9,919½ 4 " " 27,2.55 9, 888¾ 4 " " 27,3.55 10, 514½ 5 " " 1,5.55 11,548½ 4 " " 29,5.5 5 10, 780¾ 4 " " 26,6.55 10, 290¼ 5 " " 31,7.55 13,155 4 " " 28,8.55 9,070¼ 4 " " 25,9.55 10,521 5 " " 30,10.55 14,554¾ 4 " " 27,11.55 11,815½ 5 " " 1,1.56 12,995 135,053¾ 51 The approved establishment for this service on 1st January was 60 full time helps or their equivalent in part time helps, i„e„ a maximum of 2,640 hours per week (60 x 44) With the approval of the Minister the establishment was increased to 70 full time helps or their equivalent in part time helps thus permitting a maximum use of 3,080 hours per week (70 × 44). provision was made for an average use of 2,530 hours per week from 1st January to 31st March and 2,750 hours per week from 1st April to 31st December, The average number of hours worked per week during the year was 2,597. In the year under review the Organiser and her assistant; made the following visits:- Organiser Assistant Organiser Total Primary visits for initial investigation of a request for help 553 86 639 Subsequent visits to cases already in receipt of help 438 1.611 2,049 Totals 991 1,697 2,688 The salient feature in reporting on this most valuable of the social services is the steady expansion of the service exempified in the following figures of average hours worked per week 1953 - 2,331 hours per week 1954 - 2,441 " " " 1955 - 2,597 " " " Careful study of the Organiser's records and assessment of need in each household shows clearly that the hours of service given to individual cases is the bare minimum actually available to carry out basic chores and provide a hot meal when necessary To devote more time to individual persons would deprive others of the very hours needed for the basic necessities of decency required by any person to continue to live with any degree of human dignity As is already well known the whole problem is exacerbated by the steady increase in the number of old persons in the community coupled to the increasing unwillingness of children to care for and cherish their ageing parents We still find that neighbours will often have more humanity and charity in their hearts than children who are apparently indoctrinated that the state (i, e local authority, will provide the care and nourishment to sustain life This may well be so but the local authority cannot supply the comfort and companionship which banishes the dread loneliness of many of these old folk I know many a home help who devotes much of her leisure time to bring a little companionship and warmth into some of these empty lives No words of praise are too extravagent for these generous thoughts and actions and East Ham can justly be proud of this fine body of socially minded women guided and encouraged by the Home Help Organiser. 52 SANITARY SECTION 1955 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.T.A. The new Food & Drugs Amendment Act, which was passed during the previous year did not come into operation until the 1st January 1956 when it was immediately repealed by the Food and Drugs Act 1955, which also came into operation on the same date. The Housing Repairs and Rents Act 1954 was responsible for a large amount of extra work in the department, much of the Inspectors time being taken up with advising tenants or discussing with landlords items of disrepair which might reasonably be included in Certificates of Disrepair. Details are given elsewhere in the Report There were no slum clearance areas declared during the year but housing work generally continued to take up the bulk of the Inspectors' time It was found in ever increasing numbers, that houses which had received the benefit of extensive war damage repairs were now showing defects, and were the source of much discussion before necessary repairs were effected. The staff position was more static during the year, Mr. E. W. Patrick left the service of the Corporation in July and Mr. W. J. Batchelor commenced duty in December. A welcome addition to the staff was made by the appointment of a full-time student Inspector, Mr. R.K. Raymond filled the position as from the end of October. Various changes were made in the clerical staff. The public continued to make good use of the services provided by the department. In addition to the 3,438 complaints received, a large number of people sought advice with regard to rents, repairs, food and pests. ANNUAL REPORT, 1955 (A) Inspections: The number of inspection of all classes 30,077 (i) Housing Public Health Act 6,975 Re-inspections 10,791 Housing Act, 1936 2,168 Smoke nuisance - observations 342 (ii) Sanitary Circumstances Yards and passages 115 Drainage and sanitary accommodation 2,243 Drainage tests 195 Caravans 372 Offensive fumes 489 Miscellaneous 637 Factories (excluding bakehouses) 628 Workplaces and outworkers 712 Places of public entertainment 399 (iii5 Food Supply Milk and Dairy premises 255 Ice cream premises 422 Food premises general and unsound food 1,729 Cafes and restaurants 249 Bakehouses 118 Itinerant food vendors and stalls 40 Sampling 592 Slaughterhouses 451 (iv) Diseases of Animals Acts Visits 53 (v) Pet Animals Act 36 (vi) Infectious Diseases 55 (vii) Food Poisoning Visits 11 53 (B) Notices The number of notices served during the year total led 2.255 of which 748 were statutory notices The number of notices complied within the same period was 1,625. including 541 statutory notices Complaints made to the Department with regard to sanitary circumstances,, disrepair infestations, obstructed drains etc. , totalled 2,498 (C) Rodent Control The number of complaints received in respect of rat and mice infestation totalled 311, and 593 premises were inspected in detail The rodent operative made 2,102 visits. The complaints were approximately the same as last year (322). Treatment of the sewers continued to be carried out by the sewer gang and undoubtedly the continuance of this practice materially reduces the rat population in the sewers as is indicated by the fact that although practically all surface infestations are eventually traced to faulty drains a major infestation is now a rare occurrence (D) Disinfection and Disinfestation 550 premises were treated as appropriate in respect of infectious disease, bugs and dirty premises and where circumstances warranted help was given by the department for beetle infestation The steam disinfector was in operation on 90 days for disinfection of clothing and bedding. Nearly 1,000 library books were disinfected before return to the libraries from householdswhere infectious disease etc., had occurred. Similarly all articles returned to the Health Department 'loan cupboard by ailing or disabled persons were sterilised or disinfected (E) Drainage The number of complaints of choked or defective drains received during the year totalled 629 This number approximates the previous year (632) which had shown a marked increase The drain clearing service provided by the Corporation is much appreciated by the public and serves the additional useful function of enabling us to trace defective drains at an early stage Most of the repair work is carried out by the Corporation contractors under the direction of the Inspectorate by agreement with the owners of the properties concerned (F) fertilisers and Feeding Stuffs Act, 1926 Twelve samples were taken during the year as follows Bone Meal (2) Meat and Bone Meal Sulphate of Potash(3) Bone Manure (2) National Growmore Sulphate of Ammonia Seemeel Layers Meal No serious breach of the Act was discovered With the fall off in the number of allotments being worked in the borough, there has been a consequent reduction in the amount of fertilisers retailed and the number of shops serving them. (G) Rag Flock and Other Filling Material Act, 1951 Seven samples were taken for analysis during the year as follows Rag Flock (3) Feathers (1) Cotton Felt (1) Algerian Fibre (1) Coir Fibre (1) One sample of Feathers failed to meet the requirements of the Act in respect of total impurities Total impurities shown as a result of tests showed an average of 2. 2%, the permitted maximum being 2.0% The vendor and manufacturer were cautioned. There were seven premises on the register for use of specified materials,, at the end of the year (H) Pet Animals Act 1951 There were 19 premises on the register licensed to keep a pet shop Inspections of the premises were carried out to ensure that the conditions of licence issued by the Council were observed All complied with the Conditions of licence and no complaints wen received (I) Factories, Workplaces, Outworker The number of factories, power and non power again shows a slight decrease from the previous year (300-333. 42-46 This of course is a natural corollary of replanning of the town and in some cases the use of erstwhile industrial sites and premises for housing purposes 54 Nevertheless an increased total of 508 inspections was made of these premises, and it was necessary to serve 11 routine notices in respect of premiss where defects were found. The defects comprised want of cleanliness unreasonable temperature, insufficient and unsuitable or defective sanitary conveniences Liaison was maintained with H. M. Inspector of Factories and all the infringements of the Act were remedied, There were also 340 Outworkers on the Register The persons concerned dealt' in the vast majority of cases with wearing apparel-214, assembling Christmas crackers etc., -76. All these premises were visited to ensure that the work was carried out under suitable conditions. (J) Mosquito Control Complaints with regard to mosquito infestation have reduced materially in the last few years, but the practice of spraying ditches and other likely breeding places as a precautionary measure, was continued (K) Places of Public Entertainment These premises continued to receive attention Generally it is found that managements and owners of such premises are only too willing to co-operate with the department in ensuring that the Regulations with regard to Public Health standards are maintained. (L) Smoke Abatement The position with regard to legislation concerning atmospheric pollution remained as heretofore Parliament not yet having got down to the business of accepting the recommendation of the Beaver Report. Nevertheless much attention was given to the problem by the local staff, and every opportunity was taken to impress upon factory managements the necessity of putting their house in order before compulsory powers were brought to bear on them. In some cases improvements were made. (M) Sampling The following table shows the number of samples of all types taken for analysis or examination during the year:- Chemical Food & Drugs Act 324 Bacteriological Food 131 Water - drinking and bath 8 Fertilisers & Feeding Stuffs 12 Rag Flock & Other Filling Materials 7 Total 482 (N) Diseases of Animals Act Foot and Mouth disease and swine fever and fowl pest are constantly breaking out in some part or other of the country and as three slaughterhouses were working in the town it was necessary to follow closely the numerous Orders made by the Ministry respecting the movement of livestock. Licenses as necessary were issued by the department, and as usual visits of inspection were paid to the Docks in connection with the importation or exportation of animals and certain foodstuffs. 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) 9,198 (B) Number of inspections made for the purpose 19,989 2. (A) Number of dwelling houses (included under sub 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 preceding sub-heading) found not to be in all respects reasonably fit for human habitation 2,014 55 II. Remedy of defects during the year without service of formal notices:- Number of defective dwelling houses rendered fit in consequence of informal action by the local authority or their Officers. 1,084 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 - (2) Number 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 Act (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 748 (2) Number of dwelling houses in which defects were remedied after service of formal notices (i) By owners 541 (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 1936: (1) Number of separate tenements or underground rooms in respect 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 roam having been rendered fit - IV. Visits in connection with housing circumstances of applicants for rehousing 2,168 Legal Proceedings. It was necessary to prosecute landlords in 47 instances for failure to comply with statutory abatement notices. In all cases work was carried out before the actual hearing of the case and the summons withdrawn on payment of costs. HOUSING REPAIRS AND RENTS ACT, i954 Particulars of applications made and Certificates issued under above-mentioned Act: Applications by tenants for Certificates of Disrepair 92 Certificates of Disrepair granted 101 Applications pending - Certificates later granted 1 Applications refused 1 Applications by landlords for Certificates of Revocation 85 Certificates of Revocation granted 82 Applications pending - Certificates later granted 9 Applications refused 1 INSPECTION AND SUPERVISION OP POOD SUPPLIES AND PREMISES A great deal of attention was given to these premises The public awareness of the dangers arising from unsatisfactory food premises and the consequent contamination of food supplies continued to increase, and undoubtedly the work of the Food Hygiene Guild had a most beneficial effect not only upon the traders who qualified for membership but upon others who endeavoured to reach the higher standard set down by the Guild Council as a necessary qualification for membership. 56 It was not practicable to hold another Clean Food Exhibition this year, but enquiries were constantly being received in regard to some aspect of the Exhibition held in the previous year, showing a much appreciated desire on the part of the little food traders to ensure that their premises were satisfactory before the anticipated Food Hygiene Regulations come into force. (a) Milk Supply The number of milk distributors registered at the close of the year was 172, an increase of 23, and the two-large dairies London Co-operative Society Limited and Mortlocks Modern Dairies Limited, continued to function satisfactorily. The following licences were issued to use special designations prescribed in the Milk (Special Designation) Regulations 1949-1954. Pasteurised Milk: Dealer's licence 108 Supplementary licence 12 Dealer's (Pasteuriser's) Licence 2 Dealer's licence pasteurised (Tuberculin Tested) 3 Supplementary licence, Pasteurised (Tuberculin Tested) 2 Sterilised Milk: Dealers licence 164 Supplementary licence 13 Dealers (Steriliser's) Licence 1 Tuberculin Tested Milk: Dealer s license 21 Supplementary licence 10 One hundred and nine samples of milk were submitted for chemical analysis i.e. fat content etc., all of which were satisfactory and 91 samples were submitted for bacteriological examination. All these samples were also satisfactory. One sample of dried milk was reported upon as being unsatisfactory but it was not possible to trace the cause of the complaint precisely, although there were good grounds for believing that the contamination occurred in the purchaser's home. (b) Meat Inspection The three licensed slaughterhouses in the Borough continued to operate and the following table shows the number of animals killed and examined. Cattle Calves Sheep Pige Total 789 6 4,593 1,921 7,309 There were 88 butchers shops in the town and these premises were also inspected with regard to general hygienic conditions and stock carried. Altogether 5,113¼ 1bs of meat was certified as being unfit for human consumption. No further action was taken with regard to the establishment of a regional public abattoir The corporation continued to be members of the Conference of South West Essex Authorities but the report on the recommendations of the Herbert Committee on the siting of slaughterhouses was received only at the end of the year and the Government did not then announce their attitude towards the recommendations of the Committee. It is pleasing to report that as a result of recent legislation all animals killed for human food must be slaughtered humanely. (c) Ice Cream Twenty-two premises remained on the register for the manufacture of ice cream 275 premises were registered for the sale of ice cream. A dequate inspection of the places of manufacture was carried out and 35 samples of ice cream were submitted for bacteriological examination, with the following results: Grade I-18: Grade II- 14: Grade III- 2: Grade IV- 1: Unsatisfactory samples- 2, Follow up samples were taken where the first sample proved to be entirely unsatisfactory. 57 (d) Other Foods There were 119 premises registered for the preparation or manufacture of preserved food. These premises include such premises as sausage manufacturers and fish fryers. Arising out of the examination of a large variety of foodstuffs the following items were certified as unfit for human consumption. Tinned meat and other products 431 tins " fruit 804 " " fish 107 " " milk 279 " " vegetables 194 " Tinned or packeted other goods 357 " or packets Eggs 20 Total 2,192 Pood other than tinned or packeted Meat 3,501 lbs. Fish 854 " (plus 4 boxes herring melts " " " Boneless kippers) Fruit 269 " Cheese 42 " Bacon 14 " Butter 1½ " Semolina 5 " Pie 6 " Total weight 4,692½ lbs. Pood and Drugs Sampling During the year 324 samples were submitted to the Public Analyst. Details as follows:- Butter 8 Cheese 1 Confectionery 12 Jam 5 Lard 5 Margarine 2 Milk 109 Sausage 44 Vinegar 7 Wines and Spirits 11 Drugs 6 Other articles 114 Total 324 Ten unsatisfactory samples represented a percentage of 3,1%. Details of samples not satisfactory Number Informal or formal Article Adulteration or Deficiency 7758 Informal Dried Milk Contained coloured paper. 7783 Informal Piccalilli Foreign body - caterpillar. 7883 Informal Saveloys Contained preservative 100 parts per million Use not permitted. 7884 Informal Beef Sausage Meat Contained preservative 140 parts per mill. Use not declared. 7911 Informal Saveloys Contained preservative 110 parts per million. Use not permitted. 7918 Informal Meat Rissoles Contained preservative 80 parts per million. Use not permitted. 7925 Informal Butter Contained portions of ant of foreign species. 7929 Informal Tizer Very slight trace of paraffin. 7935 Informal Pork Sausage Meat content 55% only. 7961 Informal Pork Sausage Meat content 62%. 58 It was not possible to obtain satisfactory evidence with regard to the caterpillar in the piccalilli, and cautions were issued in all the cases. SHOPS ACT etc. ADMINISTRATION (Mr. D. G. Tonkin* Chief Inspector Mr. T. Gilbert* Mr, L. Pinguey, Inspectors *Member Institute of Shops Act Administration ) The position with regard to legislation affecting shops,, in particular with regard to closing hours, remained as heretofore, and no further positive action was taken by the Government in respect of the recommendation of the Gowers Report. Adequate attention however, was given to the conditions under which shop assistants worked, and where it was found that such conditions were unsatisfactory, advice was given to the occupier or owner of the shop in regard to such matters, and invariably improvements were effected, although in some cases not without much discussion with the persons concerned. Administration of the Shops Act is at most times a difficult procedure, and thanks are due to those members of the trading community who afforded co-operation to the department. Statistics 1955: Shops Art 1950 Number of shops in Borough subject to the Act 1,957 Number of shops in Borough closed 79 Total 2,036 Other premises 53 Number of shops visited 1, 595 There were 769 visits to premises in connection with the health and comfort provisions of the Act, and 62 premises were found to be unsatisfactory. Visits regarding records required to be kept were 781 and in 144 cases the records were found to be not properly kept. 1,090 shops were visited after closing hours and 518 visits were made during holiday closing time. Though the great majority of shop-keepers are co-operative in the matter of closing hours, it was necessary to issue verbal cautions in 105 cases and to write warning letters in 28 instances. Legal proceedings Six summonses were issued against four persistent offenders during the year: 1 (a) Sunday Trading - serving non-exempted goods Fined £2. (b) Weekly half-holiday Dismissed 2 (a) Local Closing Order (Grocery) serving grocery after 7 p. m. Pined £1 (b) Local Closing Order (Breads serving bread after 7 p.m. Fined £l 3 Sunday Trading serving non-exempted goods Fined £2 4 Evening closing hours - serving tobacco after 8 p m Fined £1 The following table gives the number of shop assistants employed in the Borough: Males 1, 280 Females 1, 990 Young persons M. 91 " " F. 153 Total 3,514 This shows an increase of over 300 persons employed in shops during the year. It was noted during the year that in 154 instances there was a change of occupier; in 59 cases the occupier and the trade changed and in 3 instances the occupier changed the trade. There were 7 shops registered in respect of Sunday Trading by Members of the Jewish faith and there were 4 Kosher butchers operating. Pharmacy and Poisons Act 1953 Numbers of persons listed to retail Part II poisons 165 (Renewals - 152;New applications - 13). There were 184 visits made primarily in connection with storage of poisons. Seven of the new applications were due to change of occupier. 59 Explosives Act 1875 Number of premises registered 170: (Renewals 148: New Applications 22: including 8 due to change of occupier). The type of explosives with which the department is generally concerned consists of fireworks. As in previous years there were complaints of juveniles or young persons exploding fireworks in the public highway. This of course is a matter for Police action, and liaison between the three Police Stations in the district and the department is In operation during the early part of November. The Inspector carried out 238 special observations in the vicinity of registered premises round about this time, and in addition 168 visits of inspection to premises were made with regard to the storage of explosives. The question of making bye laws with regard to the period of sale of fireworks was receiving attention in other quarters but during the year no new legislation was enacted in this respect. Heating Appliances (Fireguards) Act 2952 671 observations and visits were carried out. A number of appliances, mostly secondhand, were found to be not in all respects satisfactory having regard to the regulations made under the Act. These were withdrawn from sale hy the retailer. In one case however, it was found that a new fire "recently placed on the market did not conform to the requirements of the regulations and as a result of communication with the manufacturers thereof, appropriate adjustments were made. Domestic Servants Registry There is one person in the Borough carrying on the business of a Domestic Servants Registry. Inspection of the records a t the Registry was made to ensure that the placing of persons, all of whom were foreign, was carried out in an orthodox manner. Minor Excise Licences During the year the Council placed responsibility for enforcement in respect of licences required to be taken out under this heading, upon the Shops Department. The following premises were affected: Pawnbrokers 4 Refreshment Houses 33 Money lenders 5 Hawkers 3 Checks were made of the Licences issued and the persons carrying on the business.