EAS 35 COUNTY BOROUGH OF EAST HAM ANNUAL REPORT of the Medical Officer of Health For the Years 1958 and 1959 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. COUNTY BOROUGH OF EAST HAM ANNUAL REPORT of the Medical Officer of Health For the Years 1958 and 1959 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. 1 PRINCIPAL CONTENTS SECTIONS PAGES Constitution of Council 2 public Health Staff 4 Introduction 5 Statistical and Social Conditions of Area 7 Infectious Diseases 17 General provision of Health Services 24 National Health Service Act, 1946:- Sec. 22 Care of Mothers and Young Children 27 Sec. 23 Midwifery Services 33 Sec. 24 Health Visiting Services 37 Sec. 25 Home Nursing Services 39 Sec. 26 Vaccination and Immunisation 40 Sec. 27 Ambulance Services 43 Sec. 28 Prevention of Illness, Care and After-Care 45 Sec. 28 & 51 Mental Health Services 49 Sec. 29 Home Help Services 54 Sanitary Section and Housing 56 Inspection and Supervision of Food 59 2 EAST HAM CORPORATION COUNCIL (shewing Chairmen and Vice-chairmen of Health, M. & C.W., Mental Health and Education Committees). THE MAYOR: Mr. Councillor Arthur George Murrell cak.es, J.P. (1958/59) (3) Councillor Mrs. Lily Sutton, J.P. (1959/60) THE DEPUTY MAYOR: (6) Alderman Mrs. Winifred May Knight, (1958/59) Mr. Councillor Frederick George Pryer Clayton (1959/60) ALDERMEN: Mr. Leslie Alfred Yictor Bennett. Mr. Charles William Dixon Mr. Sidney Arnold Elson Mr. John Albert Hart, j.p. Mr. Frank Herbert Howard (1)(/+) Mr. Walter Edwin Hurford Mr. Herbert Percy Jackson (2) Mr. John Alfred Kemp Mr. Alfred Prior, J.P. COUNCILLORS: Mr. William John Batterham Mr. Robert Cecil Beadle (7) Mr. Charles Frederick Chapman Mrs. Ruby Lilian Collett Mrs. Daisy May Davey Mr. Edwin John Davey (5) Mrs. Elsie Mary Devenay Mr. William Doran Mr. Frederick Robert William Easter Mr. Charles Edward Ellett Mr. Roy Evans Mr. Henry John Fisher Mr. William James Foster Mr. Frances William French (1958/59) Mr. Leonard Lewis Griffiths Mr. Stanley John Hobbs Mr. Thomas Alfred Jenkinson Mr. Walter Christopher Johnson Mrs. May Matilda Lawes (1959/60) Mr. Harold Francis Lugg Mr. Stanley Henry Mail Mr. Reuben Frederick Ricketts Mr. Leonard Walter Rolfe Mr. Albert Cyril Smith Miss Florence Louisa Stevens, M.B.E. (1959/60 Mr. Joseph Charles Taylor Mrs. Dorothea Minnie wood (1958/59) Mr. Thomas Henry Wood Mr. Albert William Hyman Co-opted members of the M. & C.W., Mental Health and Education Committees ;- Mrs. A.A. Bradshaw Mrs. S. Halter (1958/59) Mrs. L. Willis Mrs. B. Margetts (1959/60) Maternity and Child Welfare 3 Mr. S.C. Foreman (1958/59) Mrs. E. Gadd Mr. H.F. McNeil Mrs. F. Gerdes (1959/60) Mental Health Mrs. M.E. Bennett, J.P. Very Rev. Canon V. Hurley Mr. H.J. Pitt Mr„ L.S.J. Witter, B„Sc. Mr. R.A. Horsley Mrs. M.M. Lawes (1958/59) Dr. H.S. Allen Mr. A. Dowling (1959/60) Education (1) Chairman, Health Committee & Mental Health Sub-Committee (1958/59) (2) " „ „ (1959/60) (3) Vice-Chairman, Health Committee (1958/59) (4) " " on (1959/60) (5) Chairman, Maternity & Child Welfare Sub-Committee (6) Chairman, Education Committee (7) Vice-Chairman, Education Committee 4 STAFF Medical Officer of Health and Principal School Medical Officer J.S. COLEMAN, M.B., B.S., M.R.C.S., L.R0C.P., D.P.H. Deputy Medical Officer of Health and Deputy Principal School Medical Officer J. DRUMMOND, M.B., Ch.B., D.P.H. (to 31.3.59) W.H. ALLEN, M.B., B.Sc., B.Ch., D.C.H., D.P.H. (From 6.7-59) Assistant. Medical Officers - L.J. BAILEY, M.B., Ch.B, (From 18.8.58) 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„C0S., L.R.C.P. J.T. REES, M.R.C.S., L.R.C.P. A. WILKES, M.B., B.S., D.P.H. (To 6.7.58) Principal School Dental Officer - ALLAN ROSS, M.R.C.S., L.R.C.P., B.D.S. (To 30.5.59) J. LUSZTIG-MARTINE, M.D., L.D.S. (From 1.10.59) Chief Public Health Inspector and Food and Shops Act Inspector D.G. TONKIN, M.P.H.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. (To 29.3.59) Superintendent Health Visitor B. Lt 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 5 COUNTY BOROUGH OF EAST HAM Tel;- GRAngewood 11*30 Public Health Department, Town Hall Annexe, tost 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 my report for the two years 1958 and 1959 and again to remark on the rise in the birthrate to 13„6 with 3,025 live births, over the period, to offset somewhat the continued decline in the population from 112,700 in 1957 to 109,900 in 1959. It should be remembered that in their post-war deliberations concerning the future development of the borough the population figure of around 109,000 was considered by the Council, the optimum to be attained possibly in about 20 years. In the light of events this forecast of our population trend has indeed proved fairly accurate. Infant Mortality Of the 43 Infants who succumbed in the perinatal period, death was attributable to prematurity in 24 Instances, in the two years under review. It would appear that in spite of a high level of ante-natal care and the best accouchement that can be provided locally, little progress has been made In preventing both the annual loss of young life and the considerable suffering and anxiety to the mothers concerned* Cancer of The Lung This preventable disease has again proved to be one of the "Captains of the Men of Death." 1959 has proved a peak year for deaths from Cancer of the Lung with 69 cases, an increase of 12 over the 1958 figure. In each year 7 recorded deaths were women. Disease of the Heart and Arteries This group of diseases accounts for the greatest single cause of deaths. Hereditary factors probably play some part in the genesis of cardio-vascular disorders, but excessive consumption of animal fats and overweight In middle life appear also to have some bearing on the causation. Generally speaking weight control, moderation in smoking and alcoholic consumption and continued physical activity in middle life contribute towards longevity, whilst overweight, overindulgence in alcohol and tobacco and the sedentary or lethargic habit tends towards cardio vascular breakdown and early death. Diseases of the Lung Deaths from tuberculosis of the lung in the years under review have declined to single figures, but bronchitis and pneumonia have taken over the "killer1' role with cancer, in lung diseases, and here again smoking and vitiation of the atmosphere appear to play a considerable predisposing part. The Old People The problems of old age continue to loom large. Whilst mobile and semi-active, elderly persons living alone, or married couples, manage often with the help of the local authority Home Help Service to |retain their independence and maintain a reasonable standard of cleanliness, eomfort and nutrition. But when sickness or decrepitude overtakes one or both of the old people, as often as not an acute problem erupts. Little real difficulty need be encountered to find a hospital bed for the 'acute case'. But when chronic Illness or decrepitude determines hospital placement, the way is not so easy. In this area there appear to be no beds for 'chronic sick persons' in our hospitals, and the majority of such elderly sick and infirm must be dealt with In their own homes, by relatives and friends and the local authority medico-social services with medical supervision by the general practitioner. 6 The district nursing service Is hard pressed to cope with the number and weight of "nursings" they are asked to undertake, and can offer no solution to the problem of "night care" which many of these persons need, and when Incontinence further complicates the picture the conditions at times In some of these households deteriorate considerably. The need for night 'sitters in1 becomes increasingly apparent and a laundry service for the incontinent a social necessity in any enlightened community. Much supportive work is done by the Health Visitors with the elderly sick and infirm, to procure appropriate services, advise with diet and regimen, and alleviate loneliness. But the combined efforts of the family, friends, neighbours and the social services often are not enough, and the support of hospital beds for those cases which prove too much for combined community effort should be readily available. Health Education A beginning has been made with selected groups of school children with talks on care of the teeth, care of the feet and smoking. Films have been used to emphasize certain points and to provoke discussion and questions. I have conducted these talks myself in order to ascertain at first hand, the value of such approach to the subjects and whether organized follow up by assistant medical officers, dental surgeons and health visitors was indicated. It would appear that systemised Health Education in relation to care of teeth, the feet and general hygiene should be undertaken, and In relation to the smoking habit, the complete co-operation of the parents and the teachers must be ensured to prevent the establishment of the habit in both boys and girls before the age of lit is reached. A survey carried out in a sample of our schools has established that the Impact of smoking on the social behaviour of our school children has already left Its Impress in both sexes In many Instances between the ages of 10 and 1/+ years. General Health Considerations A perusal of the statistics of birth rate, death rate and analysis of mortality as set out in tabular form in the body of the report, amply demonstrates that East Ham remains a reasonably good area in which to reside. Great strides have been made in housing all sections of the community both within the borough and in participation in out-county schemes and medico-social services and educational facilities of high quality are readily available to the burgesses. I welcome this opportunity to convey to the Chairmen and the members of the Health Committees in the years under review my thanks for their support and encouragement in carrying out the many tasks involved in the maintenance of the 'public health1 and for their helpful and constructive criticism. And to include In this expression of gratitude, my deputy, Dr. Allen, the Chief Administrative Assistant, Mr. Horsnell and all the members of the professional and clerical staff who have worked together as a coherent happy team. I have the honour to remain Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, J. S. COLEMAN Medical Officer of Health and Principal School Medical Officer. 7 STATISTICAL AND SOCIAL CONDITIONS OF THE AREA SOCIAL 1958 1959 Area (in statute acres) land and water 3,324 3,324 Population, Census - April 1951 . 120,873 120,873 Estimated civilian population - Mid. year 110,900 109,900 Number of inhabited houses (end of year according to rate books) (including tenements and shops but excluding factories, cinemas, government properties corporation properties (offices and works), utility undertakings and other miscellaneous hereditaments not actually occupied as dwellings) 32,056 32,109 Rateable value at 31st December, £1,386,298 £1,468,335 Sum represented by a penny rate for the year 1 £5,645 £5,805 EXTRACTS FROM VITAL STATISTICS 1958 1959 M F T M F T Live Births Legitimate 740 681 1,421 766 684 1,450 Illegitimate 39 40 79 47 28 75 Totals 779 721 1,500 813 712 1,525 Still Births Legitimate 16 10 26 17 8 25 Illegitimate 2 1 3 - 1 1 Totals 18 11 29 17 9 26 Birth Rate per 1,000 population. 13.5 13.8 Still Birth Rate per 1,000 population 0.26 0.23 Still Birth Rate per 1,000 Total (Live and Still) Birthsx18.9 16.7 Deaths Males 613 629 Females 521 543 Total 1,134 1,172 Death Rate per 1,000 population 10.2 10.5 Deaths from Cancer (all ages) 232 238 Rate per 1,000 total Deaths (Live and Still) Births Deaths from puerperal Causes 1958 1959 1 958 1 959 Puerperal Sepsis Other Maternal Causes - 2 - 1.28 Total - 2 1.28 Death Rates of infants under one year of age j- 1958 1959 All infants per 1,000 live births 18.0 19.6 Legitimate Infants per 1,000 legitimate live births 18.3 19.3 Illegitimate infants per 1,000 Illegitimate live births 12.7 26.6 8 POPULATION The Registrar General's estimates of the population at 30th June each year were 1958 - 110,900 1959 - 109,900 The corresponding figure for 1957 was 112,700 The various rates per 1,000 population quoted in this report are based on the above estimates. PUBLIC HEALTH ACT 1936 - SECTION 203 The following tabulation shows the number of births notified each year, as adjusted by transferred notifications:- 1958 1959 (a) Live Births; (i) Domiciliary 300 290 (11) Institutional 1,199 1,237 (b) Still Births; (i) Domiciliary 3 2 (11) Institutional 28 20 (c) Totals (1) Domiciliary 303 292 (11) Institutional 1,227 1,257 Grand Totals 1,530 1,549 Number of premature infants notified during the years (Including transferred notifications) where the mothers normally reside in the area. 1958 1959 (1) Born at home 9 7 (li) Born In hospital or nursing home 80 83 Totals 89 90 The number of births assigned to the area and birth rates for the years under review, with comparative figures for previous years are shown in the following tabulation: 1955 1956 1957 1958 1959 Number of live births 1,441 1,393 1,447 1,500 1,525 Birth rate per 1,000 population 12.4 12.1 12.8 13.5 13.8 Area comparability factor 0.95 0.97 0.98 0.98 0.99 Corrected birth rate 11.8 11.7 12.5 13.2 13.6 Birth rate for England and Wales 15.0 15.6 16.1 16.4 16.5 STILL BIRTHS The numbers of still births registered and the rates per 1,000 total (live and still) births are shown in the following table, together with comparable figures for the preceding three years: 1955 1 956 1 957 1 958 1 959 No. of still births 1*1 33 42 29 26 Rate per 1,000 total births 27.6 23.1 28.2 18.9 16.7 The still birth mortality rates for England and Wales and East Ham are shewn In the following table:- TABLE 1 England and Wales East Ham Still births per 1,000 population 1955 1956 1957 1958 1959 0.33 0.36 0.37 0.36 0.35 0.35 0.28 0.37 0.26 0.23 9 DEATHS Details of deaths of residents in 1958 and 1959 with comparative figures are shown below 1955 1956 1957 1958 1959 Number of deaths notified 1,158 1,180 1,246 1,134 1,172 Death rate per 1,000 population 9.9 10.3 11.0 10.2 10.5 Area comparability factor 1.05 1.12 1.11 1.09 1.08 Corrected death rate 10.4 11.5 12.2 11.1 11.3 Death rate for England and Wales 11.7 11.7 12.2 11.7 11.6 Number of deaths occurring In institutions 626 (5 4%) 650 (55%) 710 (56.9%) 643 (56.7%) 678 (57.8%) Number of deaths occurring outside the borough 548 583 626 583 626 Number of non-residents dying In the borough 88 73 91 71 73 INFANTILE MORTALITY The following tabulation shows details of deaths of infants under one year, comparative figures for England and Wales and for the years 1955 to 1957 being quoted: 1955 1956 1957 1958 1959 Number of deaths of Infants under one year of age 35 32 22 27 30 Infant mortality rate (per 1,000 live births) 24.2 22.9 15.2 18.0 19.6 Rate for England and Wales 24.9 23.8 23.1 22.6 22.2 Number of deaths of Illegitimate infants under one year of age 1 2 Nil 1 2 Mortality rate (per 1,000 illegitimate live births) 24.6 41.6 - 18,3 26.6 NEO-NATAL MORTALITY The number of deaths of children under the age of four weeks and the causes of such deaths were as follows j- 1955 1 956 1957 1 958 1 959 Number of children dying under the age of four weeks 25 15 15 19 24 Neo-Natal mortality rate (per 1,000 live births) .. 17.3 10.7 10.3 12.6 15.7 Cause of death Number of deaths 1958 1 959 Atelectasis 2 2 Premature Birth 10 lit Congenital Malformation, Birth Injury, etc 5 6 Other causes 2 2 Total 19 24 MATERNAL MORTALITY There were no deaths from maternal causes in 1958 and two such deaths in 1959 giving a maternal mortality rate per 1,000 live and still births of 1.28. 10 TABLE 2 - BIRTH RATE, DEATH RATE AND ANALYSIS OF MORTALITY, 1958 AND 1959 Year Live Births per 1,000 Population Still Births per 1a000 Total (Live and Still Births) Annual Death Rates per 1,000 Population All Causes Malignant Neoplasm Lung and Bronchus Acute Poliomyelitis Pneumonia Whooping Cough Diphtheria Influenza Coronary Disease, Angina pectoris Tuberculosis (All Forms) Deaths of Infants under one year (Rate per 1,000 Live Births) England and Wale 1958 16.4 21.6 11.7 0.44 0.00 0.54 0.00 0.00 0.05 186 0.10 22.6 1959 16.5 20.9 11.6 0.46 0.00 0.60 0.00 – 0.17 1.87 0.08 22.2 London - Administrative County .. 1958 16.7 20.2 11.8 0.64 0.00 0.70 0.00 0.00 0.05 1.84 0.13 22.6 1959 17.3 19.3 11.9 0.64 0.00 0.82 0.00 – 0.18 1.89 0.11 22.3 EAST HAM. 1958 13.2 18.9 11.1 0.51 – 0.64 – – 0.03 1.90 0.05 18.0 1959 13.6 16.7 11.3 0.62 – 0.55 – –– 0.20 1.90 0.07 19.6 A dash (-) signifies there were no deaths 11 TABLE 3 – CAUSES OF DEATH IN AGE GROUPS 1958 AND TOTAL DEATHS FOR THE YEARS 1954 – 58 Reference No. Cause of Death Number of Deaths of Residents (including non-civilians) whether occurring within or without the district Total deaths in Institutions Total deaths for the years Reference No  All Ages Under 1 Year 1 - 4 Years 5-14 Years 15-24 Years 25-44 Years 45-64 Years 65-74 Years 75 Years and over 1958 1957 1956 1955 1954 M F M F M F M F M F M F M F M F M F M F 1. Tuberculosis, respiratory 5 – – – – – – – – – 1 – 3 – 1 – – – 3 – 5 20 12 13 12 1 2. Tuberculosis, other forms – 1 – – – – – – – – – 1 – – – – – – 1 1 – 1 1 – 2 3. Syphilitic Disease 2 2 – – – – – – – – – – 1 – 1 2 – – 1 2 4 1 4 7 – 3 4. Diphtheria – – – – – – – – – – – – – – – – – – – – – – – – 4 5. Whooping Cough – – – – – – – – – – – – – – – – – – – – – – – – 5 6. Meningococcal Infections 1 – – – 1 – – – – – – – – – - – – – – – 1 – 2 – 1 6 7. Acute Poliomyelitis – – – – – – – – – – – – – – – – – – – – – – – – 7 8. Measles – – – – – – – – – – – – – – – – – – – – – – 1 – 8 9. Other Infective and Parasitic Diseases – 1 – – – – – – – – – – – 1 – – – – 1 1 – 1 3 1 9 10. Malignant Neoplasm, Stomach 14 12 – – – – – – – – – – 6 7 5 2 3 3 8 4 26 40 42 28 37 10 11. Malignant Neoplasm, Lung Bronchus 50 7 – – – – – – – – 1 – 29 6 15 1 5 – 23 4 57 63 52 66 56 11 12, Malignant Neoplasm, Breast – 24 – – – – – – – – – 3 – 5 - 8 – 8 – 14 24 19 30 23l 21 12 13. Malignant, Neoplasm, Uterus – 12 – – – – – – – – – 2 – 5 - 2 – 3 – 10 12 5 11 4 4 13 14. Other Malignant & lymphatic Neoplasms 58 49 – – – – – – – – 3 2 17 24 10 16 28 7 42 32 107 130 110 119 102 14 15. Leukaemia, Aleukaemia 3 3 – – – – – – – – – 1 3 1 - 1 – – 3 3 6 6 10 6 6 15 16. Diabetes 3 4 – – – – – – – – – – – – 1 2 2 2 2 2 7 4 9 8 8 16 17. Vascular Lesions of the Nervous System 68 88 – – – – – – – – 1 1 14 11 23 31 30 45 41 47 156 136 123 119 136 17 18. Coronary Disease Angina 130 81 – – – – – – – – 3 1 53 8 41 22 33 50 57 26 211 232 167 176 196 18 19. Hypertension with Heart Disease 10 13 – – – – – – – – – – 1 1 3 5 6 7 7 5 23 22 28 33 26 19 20. Other Heart Disease 64 80 – – – – – – – – 1 1 7 7 21 15 35 57 40 39 144 182 192 152 158 20 21. Other Circulatory Disease 21 26 – – – – – – – – 1 1 6 4 5 6 9 15 16 14 47 44 51 52 60 21 22. Influenza 1 2 – – – – – – – – – – – – 1 – – 2 – – 3 17 2 6 3 22 23. Pneumonia 31 41 2 1 1 – – 1 1 – – – 7 3 2 4 18 32 24 32 72 87 63 62 49 23 24. Bronchitis 62 13 – – – – – – – – 1 – 17 2 24 2 20 9 22 6 75 72 94 84 77 24 25. Other Diseases of Respiratory System 8 3 – – – – – – – – – – 2 – 3 1 3 2 5 3 11 10 14 13 8 25 26. Ulcer of Stomach and Duodenum 6 2 – – – – – – – – – – 3 – 2 1 1 1 6 2 8 9 9 13 19 26 27. Gastritis, Enteritis and Diarrhoea – 7 – – – – – – – – – 1 – 1 – – – 5 – 3 7 9 9 5 5 27 28. Nephritis and Nephrosis 4 4 – – – – – – – – 2 – – – 2 1 – 3 4 1 8 13 11 12 8 28 29 o Hyperplasia of Prostate 9 – – – – – – – – – – – – – 1 – 8 – 7 – 9 4 11 10 12 29 30. Pregnancy, Childbirth, Abortion – – – – – – – – – – – – – – – – – – – – – 1 – 1 1 30 31. Congenital Malformations 4 3 2 3 – – – – – – 1 – 1 – – – – – 3 3 7 6 13 6 10 31 32. Other Defined and Ill Defined Diseases 40 25 13 4 1 – – – 1 1 1 1 6 4 9 8 9 7 37 20 65 71 85 100 88 32 33. Motor Vehicle Accidents 6 3 – – – – – – 2 – – – 2 1 – – 2 2 5 2 9 15 6 13 10 33 34. All Other Accidents 7 8 – – – – – – 1 – 1 1 3 2 – – 2 5 1 5 15 19 11 13 14 34 35. Suicide .. 5 6 – – – – – – – – – 1 5 3 – 2 – – – 3 11 9 7 9 15 35 36. Homicide and Operations of War 1 1 1 1 – – – – – – – – – – – – – – 1 1 2 – -– – – 36 TOTALS 613 521 18 9 3 – – 1 5 1 17 17 186 96 170 132 214 265 358 285 1134 1246 1180 1158 1143 12 TABLE 4 - CAUSES OF DEATH IN AGE GROUPS 1959 AND TOTAL DEATHS FOR THE YEARS 1955 – 59 Reference No. Cause of Death Number of Deaths of Residents (including non-civilians) whether occurring within or without the District Total Deaths in Institutions Total Deaths for the Years Reference No. All Ages Under 1 Yr. 1–4 Yrs. 5-14 Yrs. 15-24 Yrs. 25-44 Yrs. 45-64 Yrs. 65-74 Yrs. 75 Yrs & over M F M F M F M F M F M F M F M F M F M F 1959 1958 1957 1956 1955 1. Tuberculosis, respiratory 8 – – – – – – – – – 1 – 4 – 1 – 2 – 7 – 8 5 20 12 13 1. 2. Tuberculosis, other forms – – – – – – – – – – – – – – – – – – – – – 1 – 1 1 2. 3 J Syphilitic Disease 1 – – – – – – – – – – – 1 – – – – – 1 – 1 4 1 4 7 3. 4. Diphtheria – – – – – – – – – – – – – – – – – – – – – – – – – 4. 5. Whooping Cough – – – – – – – – – – – – – – – – – – – – – – – – – 5. 6. Meningococcal Infections 1 – – – 1 – – – – – – – – – – – – – 1 – 1 1 – 2 – 6. 7 Acute pollymyelitis – – – – – – – – – – – – – – – – – – – – – – – – – 7. 8. Measles – – – – – – – – – – – – – – – – – – – – – – – – 1 8. 9. Other Infective and Parasitic Diseases 1 2 – – – – – 1 – – – – 1 – – – – 1 1 2 3 1 – 1 3 9. 10. Malignant Neoplasm, Stomach 21 10 – – – – – – – – – – 7 2 8 1 6 7 13 6 31 26 40 42 23 10. 11. Malignant Neoplasm, Lung, Bronchus 62 7 – – – – – – – – 2 – 32 2 22 5 6 – 30 3 69 57 63 52 66 11. 12. Malignant Neoplasm, Breast – 20 – – – – – – – – – 1 – 11 – 4 – 4 – 13 20 24 19 30 23 12. 13. Malignant Neoplasm, Uterus – 9 – – – – – – – – – 1 – 5 – 1 – 2 – 5 9 12 5 11 4 13. 14. Other Malignant & Lymphatic Neoplasms 53 49 – – 1 – – – – – 4 3 20 16 12 13 16 17 32 35 102 107 130 110 119 14. 15. Leukaemia, Aleukaemia 2 5 – – – – – – – 1 1 – – 2 1 – – 2 1 5 7 6 6 10 6 15. 16. Diabetes 5 7 – – – – – – – – 1 – 1 2 1 1 2 4 3 5 12 7 4 9 8 16. 17. Vascular Lesions of the Nervous System 46 93 – – – – – – – – – – 7 14 16 25 23 54 28 59 139 156 136 123 119 17. l8. Coronary Disease Angina 135 74 – – – – – – – – 3 1 68 7 32 27 32 39 60 25 209 211 232 167 176 18. 19. Hypertension with Heart Disease 6 10 – – – – – – – – – – 2 – 2 2 2 8 2 3 16 23 22 28 33 19. 20. Other Heart Disease 74 95 – – – – – – – – 1 – 13 14 13 11 47 70 50 54 169 144 182 192 152 20. 21. Other Circulatory Disease 21 22 – – – – – – – – – 1 8 3 5 5 8 13 7 14 43 47 44 51 52 21. 22. Influenza 11 11 1 – – – – – 1 – – – 5 2 3 4 1 5 4 2 22 3 17 2 6 22. 23. Pneumonia 34 27 – 1 – 1 – – – – – – 7 4 7 3 20 18 23 17 61 72 87 63 62 23. 24. Bronchitis 51 27 – – – – – – – – – – 19 7 15 7 17 13 24 9 78 75 72 94 84 24. 25. Other Diseases of Respiratory System 12 2 – – – – – – – – – – 7 – 5 1 – 1 10 1 14 11 10 14 13 25. 26. Ulcer of Stomach and Duodenum 12 3 – – – – – – – – – – 5 1 4 2 3 – 12 2 15 8 9 9 13 26. 27. Gastritis, Enteritis and Diarrhoea 1 – – – – – – – – – – – – – – – 1 – 1 – 1 7 9 9 5 27. 28. Nephritis and Nephrosis 5 3 – – – – – – – – – – 1 1 2 1 2 1 3 – 8 8 13 11 12 28. 29. Hyperplasia of Prostate 2 – – – – – – – – – – – – – 1 – 1 2 – 2 9 4 11 10 29. 30. Pregnancy, Childbirth, Abortion – 2 – – – – – – – 1 – 1 – – – – – – – 2 2 – 1 – 1 30. 31. 32. Congenital Malformations 8 2 6 2 – – – – – – – – 1 – 1 – – – 7 2 10 7 6 11 6 31. Other Defined and Ill Defined Diseases 33 45 11 9 – 1 – 1 – – 2 2 8 6 6 9 6 17 27 39 78 65 71 85 100 32. 33. Motor Vehicle Accidents 8 6 – – – 1 – – 3 – 1 – 3 3 1 2 – – 6 3 14 9 15 6 13 33. 34. All Other Accidents 13 7 – – – – – – – – 2 – 4 – 1 3 6 4 11 5 20 15 19 11 13 34. 35. Suicide 3 5 – – – – – – – – – – 2 2 1 2 – 1 1 – 8 11 9 7 9 35. 36. Homicide and Operations of War – – – – – – – – – – – – – – – – – – – – – 2 – – – 36. TOTALS 629 543 18 12 2 3 – 2 4 2 18 10 226 104 160 129 201 281 367 311 1172 1134 1246 1180 1158 13 TABLE 5 ~ INFANT DEATHS UNDER ONE YEAR OF AGE, 1958 & 1959 Cause of Death Total deaths AGE AND SEX Total under 1 year Under 1 week 1 - 2 weeks 2-3 weeks 3–4 weeks 1– 3 months 3-6 months 6-9 months 9-12 months M F M F M F M F M F M F M F M F M F Pneumonia 1958 3 – – – – – – – – 1 – – – – – 1 1 2 1 1959 1 – – – – – – – – – – – 1 – – – – – 1 Premature Births 1958 10 6 2 1 – 1 – – – – – – – – – – – 8 2 1959 14 8 6 – – – – – – – – – – – – – – 8 6 Congenital Malformations, Birth Injury, Infantile Diseases 1958 5 2 3 – – – – – – – – – – – – – – 2 3 1959 8 2 2 1 – 1 – – – – – 1 – – – – – 6 2 Other Causes 1958 9 5 1 – – – – – – 1 1 – 1 – – – – 6 3 1959 7 2 2 – – – – – – – – – 1 2 – – – 4 3 TOTALS 1958 27 13 6 1 – 1 – – – 2 1 – 1 – – 1 1 18 9 1959 30 12 10 1 – 1 – – – 1 – 1 2 2 – – – 18 12 14 CANCER 1958 1 959 Total deaths 232 238 Male deaths 125 138 Female deaths 107 100 TABLE 6–CANCER DEATHS 1958 AND 1959 - LOCATION OF THE DISEASE Parts of Body Affected Year Under 15 15-24 25-34 35-44 45-54 55-64 65-74 75 and upwards Total M F M F M F M F M F M F M F M F M F Buccal Cavity and Pharynx 1958 – – – – – – – – – – – 2 3 – 2 – 5 2 1959 – – – – – – – – 1 2 1 1 – 2 2 1 4 6 Digestive Organs and Peritoneum 1958 – – – – – – – – – 3 7 9 5 9 7 7 19 28 1959 – – – – – – 1 – 6 5 8 4 15 7 10 18 40 34 Lungs, Bronchus 1958 – – – – – – 1 – 12 1 17 5 15 1 5 – 50 7 1959 – – – – 1 – 1 – 11 – 21 2 22 5 6 – 62 7 Other Respiratory Organs 1958 – – – – – – – – – – – – – – – – – – 1959 – – – – – – – – – – – – – – – – – – Uterus 1958 – – – – – – – 2 – 2 – 3 – 2 – 3 – 12 1959 – – – – – – – 1 – 1 – 4 – 1 – 2 – 9 Other Female Genital Organs 1958 – – – – – – – – – – – – – – – – – – 1959 – – – – – – – – – – – 1 – 1 – 2 – 4 Breast 1958 – – – – – – – 3 – 2 – 3 – 8 – 8 – 24 1959 - - - - - - - 1 - 6 - 5 - 4 - 4 - 20 Male Genital Organs 1958 – – – – – – – – – – – – – – – – – – 1959 – – – – – – – – – – – – 1 – 2 – 3 – Urinary Organs 1958 – – – – – – – – – – 3 – 3 1 7 – 13 1 1959 – – – – – – – – 2 – 1 1 3 1 4 2 10 4 Leukaemia and Aleukaemla 1958 – – – – – – – 1 1 – 2 1 – 1 – – 3 3 1959 – – – 1 – – 1 – – – - 2 1 – – 2 2 5 Brain and other parts of Nervous System 1958 – – – – 1 – 1 – – – 2 – – – – – 4 – 1959 1 – – – – – 3 1 4 1 1 1 – 1 – – 9 4 Other or Unspecified Organs 1958 – – – – – – 1 2 4 2 7 15 4 8 15 3 31 30 1959 – – – – – – – 2 3 1 - 1 1 2 4 1 8 7 TOTALS .. 1958 – – – – 1 – 3 8 17 10 38 38 30 30 36 21 125 107 1959 1 – – 1 1 – 6 5 27 16 32 22 43 24 28 32 138 100 15 BIRTH AND DEATH RATES (PER 1,000 POPULATION) 1891 -1959 FIRTH RATE DEATH RATE 16 Infatile Mortality Rates(Per 1,000 LIve Births) 1943-1959 England and Wales East Ham 17 INFECTIOUS DISEASES The quarterly returns to the Registrar-General were as follows %- TABLE 7 DISEASE QUARTER ENDING 31.3.58 QUARTER ENDING 30.6.58 QUARTER ENDING 30.9.58. QUARTER ENDING 31.12.58 TOTAL 1958 QUARTER ENDING 31.3.59 QUARTER ENDING 30.6.59 QUARTER ENDING 30.9.59 QUARTER ENDING 31.12.59 TOTAL 1959 Scarlet Fever 29 35 40 47 151 39 15 34 58 146 Whooping Cough 1 12 8 8 29 11 7 1 6 25 + Acute poliomyelitis – 1 1 2 4 – 1 2 – 3 Measles 6 22 129 162 319 1,449 472 39 1 1,961 Diphtheria – – – – – – – – – – Pneumonia 22 6 4 9 41 30 6 3 3 42 Dysentery 16 21 – 76 113 1 20 2 1 24 Typhoid Fever – – – – – – – – – – Paratyphoid Fever – – – – – – – – – – Erysipelas 3 1 2 2 8 4 1 2 5 12 Meningococcal Infection – – 1 –~ 1 1 – – – 1 Food Poisoning 10 46 35 6 97 – 2 11 4 17 puerperal Pyrexia 1 1 – – 2 1 – – – 1 Ophthalmia Neonatorum – – – – – – – – – – Tuberculosis - Respiratory 33 28 21 19 101 20 20 30 19 89 Tuberculosis - Meninges & C.N.S. – – 1 – 1 – – – – – Tuberculosis - Other 1 4 4 – 9 4 1 3 1 9 + The division of the poliomyelitis cases between Paralytic and Non-Paralytic was ; 1958 1 959 Paralytic 2 1 Non-Paralytic 2 2 There were no deaths from the seven principal Zymotic diseases (Smallpox, Whooping Cough, Measless Diphtheria, Diarrhoea,, Scarlet Fever and Enteric Fever.) Details of the Notifications of tuberculosis are set out in Table 10. 18 TABLE 8 - PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASE. Notified Cases for Years ended 31.12.58 and 31.12.59. DISEASE YEAR 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 Wood grange Plashet Kensington Castle Central Wall End Great field 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 1958 151 – 43 84 20 3 1 – – – 28 14 5 8 9 18 6 17 21 25 35 – 1959 1 46 1 35 90 17 2 1 – – – 12 13 7 18 4 12 10 23 11 36 31 – Diphtheria 1958 – – – – – – – – – – – – – – – – – – – – – – 1959 – – – – – – – – – – – – – – – – – – – – – – Erysipelas 1958 8 – – – – – – 1 6 1 – 3 – – 1 – 2 1 – 1 – – 1959 12 – – – – – 1 2 6 3 – 3 – 1 1 2 – 3 – 2 3 – puerperal Pyrexia 1958 2 – – – – 1 1 – – – – – – 1 – – – 1 – – 1 – 1959 1 – – – – – 1 – – – – 1 – – – – – – – – – – Ophthalmia Neonatorum 1958 – – – – – – – – – – – – – – – – – – – – – 1959 – – – – – – – – – – – – – – – – – – – – – – Paratyphoid Fever 1958 – – – – – – – – – – – – – – – – – – – – – – 1959 – – – – – – – – – – – – – – – – – – – – Pneumonia 1958 41 2 4 2 1 4 3 7 10 8 1 14 7 2 7 – 3 1 3 3 6 72+ 1959 42 4 1 2 3 2 2 8 13 7 5 8 1 6 5 2 1 8 2 4 1 61 + Acute Poliomyelitis 1958 4 – 1 2 - 1 – – – – – 1 – 1 – – 2 – – – 4 – 1959 3 – – – 2 – 1 – – – 1 1 1 – – – – – – – 3 –- Meningococcal Infection 1958 1 1 – – – – – – – – – – – – – – – – – 1 1 1 1959 2 - 1 1 - - - - - - 1 - - - - - - – 1 – 2 1 Dysentery 1958 113 6 44 14 10 13 16 2 6 2 8 2 2 57 10 5 8 7 7 7 6 – 1959 24 - 3 14 2 - 2 3 - - - 1 - 1 - - - – 21 1 2 – Food Poisoning 1958 97 2 10 16 6 10 7 4 18 24 2 1 - 82 4 - 1 2 2 3 84 – 1959 22 - 1 - 4 6 1 2 7 1 1 - 1 16 4 - - – – – 17 – Measles 1958 319 9 140 167 1 1 - - 1 - 51 24 19 10 11 25 41 88 20 30 2 – 1959 1961 60 881 980 31 7 2 - - - 184 265 119 194 104 125 146 232 149 443 24 – Whooping Cough 1958 29 2 16 10 1 - - - - _ 3 4 3 2 3 - 1 2 1 10 – – 1959 25 4 12 7 2 - - - - - 4 2 1 2 4 2 1 1 5 3 3 – + Total deaths from all forms of pneumonia. 19 The hospitals to which the patients suffering from infectious diseases were admitted are named below:– Name of Hospital No. of cases admitted 1958 1959 plalstow Hospital, Samson Street, E.13 45 61 Ilford Isolation Hospital, Chadwell Heath 9 3 Eastern Fever Hospital, Homerton, E.9. 4 3 Rush Green Hospital,, Romford 1 – The Hospital for Sick Children,, W.C.1. -– 1 East Ham Memorial Hospital,, E.7. 79 14 St. Ann's General Hospital, St. Ann's Road, N.15. 1 4 139 86 No difficulty is ever experienced In obtaining admission to hospital for a case of infectious disease. We are grateful to the hospital staffs for their ready co-operation in this matter, and for the excellent reports sent to this department concerning the progress and condition on discharge of each patient. 8 TABLE 9 – TOTAL CASES OF NOTIFIABLE DISEASES, 1935–1959 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 Smallpox – – – – – – – – – – – – – – – – – – – – – – – – – Scarlet Fever 411 359 387 187 196 77 68 210 271 132 153 193 179 222 289 270 203 343 245 172 32 27 145 151 146 Diphtheria 254 134 149 141 91 47 45 49 59 33 31 19 46 14 2 1 – 1 – 1 1 – – – – Enteric or Typhoid Fever 2 2 13 15 8 10 3 – 4 – – – – 1 – 3 – 1 – – – – – – – Paratyphoid Fever – – – – – – – – – – – – – – – 1 1 1 1 – – 4 1 – – Erysipelas 55 59 53 71 41 33 23 37 28 18 14 25 23 21 24 21 19 16 15 14 11 14 13 8 12 Puerperal Fever 12 7 5+ † † † † † † † † † † † † † † † † † † † † † † Puerperal Pyrexia 14 7 7 18 16 8 6 15 8 8 2 8 5 4 2 3 2 7 10 3 9 6 4 2 1 Meningococcal Infection 3 – 2 3 3 11 5 12 4 3 1 8 1 5 6 1 1 4 1 3 2 1 3 1 1 Encephalitis Lethargica 1 – 1 1 – – – – – – – – – – – – – – – – – – – – – Ophthalmia Neonatorum 5 6 7 9 7 3 4 1 1 4 2 1 2 – 4 2 1 1 – – 1 3 – – – Acute Poliomyelitis 13 2 4 – 2 1 – – – – 1 – 7 8 13 10 7 10 7 3 24 4 15 4 3 Acute Polio Encephalitis – – – – – – – – – – – – 1 – – – – – 1 – – – – – – Dysentery – – 3 18 – – – – 6 5 7 5 2 – 1 10 321 3 285 41 11 45 167 113 24 Malaria – – – – – – – – – – 1‡ 3a – – – – – – 1b – – – – – – Measles NOT NOTIFIABLE 3 36 460 1091 971 258 1498 815 964 1559 1098 988 2198 1883 960 30 2240 316 807 319 1961 Whooping Cough NOT NOTIFIABLE – 19 262 227 241 293 67 258 430 578 498 1027 625 361 554 117 208 168 116 29 25 Food Poisoning NOT NOTIFIABLE 4 5 23 8 7 8 7 41 13 97 17 Pneumonia 88 101 111 85 59 42 33 37 72 50 55 97 143 111 88 41 58 61 70 45 60 54 75 41 42 Tuberculosis Pulmonary 184 186 188 149 157 130 139 164 200 156 205 194 211 211 148 142 117 101 126 127 110 118 99 100 89 Non-pulmonary 37 31 39 20 24 30 22 22 23 15 16 9 26 20 11 14 16 14 12 12 5 8 10 9 9 Totals 1079 894 969 817 607 447 1070 1865 1834 975 2053 1635 2040 2754 2188 2538 3592 2815 2295 575 2721 809 1468 874 2330 + Notifiable as Puerperal Pyrexia as from 1/10/37. † Notifiable as Puerperal Pyrexia a 1 Induced for therapeutic purposes, 2 Contracted abroad, b Contracted abroad ‡ 1 Induced in an Institution. 21 TABLE 10 - PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1952 SUMMARY OF NOTIFICATIONS DURING THE PERIOD FROM 1ST JANUARY, 1 958 TO THE 31ST DECEMBER, 1959 Formal Notifications Age Periods 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 1958 1 2 – 2 – 2 4 8 11 12 11 3 2 58 1959 – – 2 – – 4 4 6 9 9 11 7 2 54 Respiratory, Females .. 1958 – – 3 2 3 2 7 12 4 4 4 1 – 42 1959 – 1 1 1 1 2 9 6 5 6 2 – 1 35 No n-Resp i ratory, Males 1958 – – 1 1 – – – 1 1 – – – 1 5 1959 – – – – 1 – – 1 – – – – – 2 Non-Respiratory, Females 1958 – – – – 1 – 1 1 1 – – – – 4 1959 – – – 1 – – – 1 – 2 – 1 1 6 The following new cases of Tuberculosis were extracted from the Death Returns from the Registrar General's (Transferable Deaths) for the years 1958 and 1959. RESPIRATORY TUBERCULOSIS TABLE 11 YEAR SEX Number of cases in age Groups o- 1- 2- 5- 10- ,5- 20– 25- 35- 45- 55- 65– 75- Total 1958 FEMALE – – – – – – – – – – – 1 – 1 1959 MALE – – – – – – – – 1 1 1 – 1 4 From time to time I have drawn attention to the decline ir mortality from pulmonary tuberculosis due to a combination of medical and environmental circumstances. In 1952, 26 persons died from this disease of the lungs In 1959, only 8 succumbed in this way. It is more pleasing even to record the decline in the incidence of new cases of pulmonary tuberculosis,, for each new notification indicates a potential source of infection to an ever widening circle of contacts. Reference to the appended table Indicates the gradual decline in the incidence of new cases (i.e„ a steady fall in the attack rate) between the years 1954/59. It is more important now, than ever before, to discover the "new case" before he has had a chance to disseminate the disease, and here the alert general practitioner, the local authority clinic and school medical officers, the chest clinic ana the local Mass Radiograph Unit all share a heavy responsibility. Notifications of cases_of Pulmonary Tuberculosis (from all sources) 1954-1959 1954 127 1955 110 1956 120 1957 108 1958 101 1959 93 22 FOOD POISONING In accordance with Ministry of Health Circular 46/49, the following information was supplied:- (1) (a) Food Poisoning Notifications (Corrected) Return to Registrar-General:- 1958 1959 1st Quarter 10 5 2nd Quarter 46 2 3rd Quarter 35 11 4th Quarter 6 4 Total 97 22 (b) Cases Otherwise Ascertained Nil Nil (c) Symptomless Excreters Nil Nil (d) Fatal Cases Nil Nil (2) Particulars of Outbreaks TABLE 12 YEAR Number of Outbreaks Number of Cases Total no. of Cases Family Outbreaks Other Outbreaks Notified Otherwise Ascertained Agent Identified as "CLOSTRIDIUM WELCHII" 1958 - 3 33 - 33 ,, ,, 1959 - 2 15 - 15 Agent Not Identified 1958 - - - - - 1959 - - - - - (3) Single Cases The various organisms Identified in each case as the cause of illness were:- 1958 1959 Salmonella Typhi-Murium 53 3 Salmonella Derby 10 - E. Coli Type 0.119 1 - Staphylococci (including Toxin) - 3 Salmonella Blockley - 1 64 7 It would be as well to recapitulate here the time honoured advice given to housewives and all who participate in the handling, preparation, packing, selling and storing of food. There are two basic principles in prevention of food poisoning, (i) To maintain a high standard of personal hygiene. (ii) To take precautions against the contamination of food during processing or storage. Protect food and utensils from contamination by flies or refuse. Wash food containers thoroughly. Foods, particularly meats and groceries, if not eaten immediately after preparation, must be refrigerated. 23 VENEREAL DISEASES The following statistics have been abstracted from copies of form V.D.{R), which have been received from the Hospitals named and total figures for 1956 and 1957 are also shown:- Patients Dealt With for the First Time During the Year 1958 1959 Syphilis Gonorrhoea Other Conditions Total Syphilis Gonorrhoea Other Conditions Total Whltechapel Clinic, London Hospital 4 22 71 97 4 25 99 128 St. Thomas' Hospital - - 2 2 - - 1 1 Albert Dock. Hospital - 8 25 33 - 2 23 25 Queen Mary's Hospital, E.15 1 3 33 37 2 5 24 31 Totals 5 33 131 169 6 32 147 185 Totals for 1956 4 26 191 221 Totals for 1957 4 28 163 195 CHILDREN'S ACT-NURSERY AND SCATTERED HOMES The statistics for the two years are appended:- 1958 1959 1. Average number in homes throughout the year 78 60.6 2. No. chargeable to East Ham on 1st January 79 63 3. No. chargeable to East Ham on 31st December 58 51 k. Average weekly admissions 3.21 2.4 5. Average weekly discharges 3.76 2.8 The medical officers of the Public Health Department continue to give a comprehensive medical service to the children in the residential nursery at Brading Crescent and the scattered homes in Woodford, East Ham and Ilford. A rota of medical duties is prepared to cover working days, night calls and weekends. TABLE 13 PUBLIC MORTUARY-STATISTICS AUTHORITY YEAR 5 938 YEAR 1959 No. of Bodies Received No. of Autopsies Performed No. of Bodies Received No. of Autopsies Performed EAST HAM 126 126 163 162 BARKING 31 30 37 36 DAGENHAM 43 45 30 30 ILFORD 24 24 7 7 WEST HAM - - 1 1 TOTALS 224 225 238 236 24 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 years 1958 and 1959. 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, REGISTRATION OF NURSING HOMES Under Sections 187 to 194 of the Public Health Act, 1936, there were no homes registered during the years 1958 and 1959, and there were no homes on the register at the end of either year. FACTORIES ACTS, 1937 and 1948 In accordance with the Factories Act, 1937, and at the request of the Minister of Labour and National Service, the following information is included in this report. TABLE 14 FACTORIES ACTS, 1937 TO 1959 YEARS 1958 & 1959 PART I OF THE ACT 1. - INSPECTIONS for purposes of provisions as to health (including inspections made by Public Health Inspectors) Number on Register Number of Inspections Written notices Occupiers prosecuted 1958 1959 1958 1959 1958 1959 1958 1959 (i) Factories in which sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 42 45 17 18 - - - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 286 279 149 185 4 6 - - (ii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 1 1 - - - - - - Total 329 325 166 203 4 6 - - 25 2. - CASES IN WHICH DEFECTS WERE FOUND (If defects are discovered at the premises on two, three or more separate occasions they are considered as two, three or more "cases") PARTICULARS Number of cases in which defects were found Number of cases in which prosecutions were Instituted Found Remedied Referred To HrM. Inspector BY H.M. Inspector 1958 1959 1958 1959 1958 1959 1958 1959 1958 1959 Want of cleanliness (S.1) 22 24 7 10 - - - 2 - - Overcrowding (S.2) - - - - - - - - - - Unreasonable temperature (S.3) 1 - - - - - - - - - Inadequate ventilation (S.4) - - - - - - - - - - Ineffective drainage of floors (S.6) - - - - - - - - Sanitary Conveniences (S.7) (a) insufficient 1 1 - - - - - - - - (b) unsuitable or defective 14 15 8 7 - - - 2 - - (c) not separate for sexes - - - - - - - - Other offences against the Act (not including offences relating to Outwork) 2 - - - 1 - - - - - Total 40 40 15 17 1 - - 4 - - PART VIII OF THE ACT OUTWORK (Sections 110 and 111) Nature of Work. Section 110 Section 111 No. of out-workers in August List required by Sect. 110(1) (c) No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply list. No. of Instances of work in unwholesome premises Notices served Prosecutions 1958 1959 1958 1959 1958 11959 1958 1959 1958 1959 1958 1959 Wearing Apparel (Making etc.) 171 211 - - - - - - - - - - Umbrellas, etc. 1 - - - - - - - - - - - Paper Containers 7 - - - - - - - - - - - Total 179 211 - - - - - - - - - - 26 PUBLIC SWIMMING BATHS The only public swimming baths in the area are those owned and operated by the Authority. There are two swimming baths and slipper bath and vapour bath suites housed in a building adjacent to the Town Hall. The major bath is 120 ft. long and 40 ft. wide; the minor bath 75 ft. long and 30 ft. wide. The water used for filling is drawn from the Metropolitan Water Board's mains. Treatment of the water is by pressure sand filters and chlorination, the "turn over" period being approximately four hours. Normal water temperature is 74 Fahrenheit. Samples of water from the baths were submitted for analysis as follows Major Bath - 21.5.59 Minor Bath - 21.5.59 and 1 6.11.59 The analyst's reports indicated that the water was suitable for bathing purposes at all times. 27 NATIONAL HEALTH SERVICE ACT, 1946 SECTIONS 22, 23, 24, 25, 26, 27, 28, 29 and 51. Full details of the Council's proposals approved by the Minister of Health, as indicated in my report for 1948, have been published in booklet form and are available for reference. SECTION 22 - CARE OF MOTHERS AND YOUNG CHILDREN DENTAL CARE Dr. Allan Ross, Principal Dental Officer submits the following report on the denial treatment provided for expectant and nursing mothers' and pre-school children in 1958. "For most of the year this Authority was lucky enough to have a full establishment of dental officers. Unfortunately, towards the end of the year one dentist resigned,, and there was every prospect of further resignations in 1959. Dentistry in Local Authorities does not now offer a career comparable with other branches of the profession and therefore the continuation of the Clinics will depend Increasingly upon part-time dentists. The statistical pattern of work done is similar to the previous year, and no special comment is Indicated." Dr. J. Lusztlg Martine, Principal Dental Officer submits the following report on the dental care of expectant and nursing mothers and pre-school children in 1959. "Comparison with previous reports demonstrates little change, and a large proportion of expectant mothers and young children continue to receive treatment in local authority clinics under the special provisions of the National Health Service Act. I have noted that the dental state among East Ham school children is above the national average, apart from a few very neglected "mouths." I would suggest that as the number of dentists employed in the service is below establishment, the work could be speeded up and therefore increased by the introduction of a new kind of dental instrument - high speed air-rotor drills. It would appear the recruitment of dentists remains as limited as before and increasingly I am becoming convinced, that the problem of dental preservation in East Ham may ultimately be solved by the fluoridation of drinking water as practised in some other parts of the world." TABLE 15 NUMBERS PROVIDED WITH DENTAL CARE Examined Needing treatment Treated Made dentally fit Expectant & Nursing Mothers 1958 209 207 205 135 1959 173 165 138 89 Children under five 1958 319 306 300 271 1959 279 260 234 192 28 TABLE 16 FORMS OF DENTAL TREATMENT PROVIDED Extrac tions General Anaesthetics Fi11ings Scalings or scaling and gum treatment Silver Nitrate treatment Radiographs Dentures provided Complete Partial Expectant & Nursing Mothers 1958 370 63 164 32 6 21 25 27 1959 272 49 70 - 1 20 10 16 Children under five 1958 350 195 160 7 109 3 - - 1959 262 156 69 - 73 - - - PREMATURE BIRTHS Number of premature infants notified during the years (including transferred notifications) where the mothers normally reside in the area. 1958 1959 (i) Born at home 9 7 (ii) Born in hospital or nursing home 80 83 Totals 89 90 29 TABLE 17 Height at Birth PREMATURE LIVE BIRTHS PREMATURE STILL-BIRTHS Born in Hospital+ Born at home and nursed entirely at home Born at home and transferred to hospital on or before 28th day Born in nursing home and nursed entirely there Born in nursing home and transferred to hospital on or before 28th day Born in hospital Born at home Born in nursing home Total Died within 24 hrs.of birth Survived 28 days Totoal Died within 24 hrs. of birth Survived 28 days Total Died within 24 hrs.of birtth Survived 28 days Total Died wit hi n 24 hrs. of birth Survived 26 days Total Died within 24 hrs.of birth Survived 28 days (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) (a) 3 lb, 4 oz. or less (1,500 gms. or less) 1958 11 3 3 - - - - - - - - - - - - 5 - - 1959 12 10 - - - - - - - - - - - - - 3 - - (b) Over 3 lb. 4 oz. up to and including 4 lb. 6 oz. (1,500-2,000 gms.) 1958 14 4 8 - - - 2 - 2 - - - - - - 9 1 - 1959 10 2 7 - - - - - - - - - - - - 1 - - (c) Over 4 lb. 6 oz. up to and including 4 lb. 15 oz. (2,000-2,250 gms.) 1958 18 1 17 - - - 1 - 1 - - - - - - - - - 1959 13 1 11 1 - 1 1 - 1 - - - - - - 2 - - (d) Over 4 lb. 15 oz. up to and including 5 lb. 8 oz. (2,250-2,500 gms.) 1958 37 - 37 5 - 5 1 - 1 - - - - - - 1 2 - 1959 48 - 48 5 - 5 - - - - - - - - - 2 - - Totals 1958 80 8 65 5 - 5 4 - 4 - - - - - - 15 3 - 1959 83 13 66 6 - 6 1 - 1 - - - - - - 8 - - + The group under this heading will include cases which may be born in one hospital and transferred to another 30 TABLE 18 ANTE-NATAL AND POST-NATAL CLINICS No. of clinics provided at end of year (whether held at Child Welfare Centres or other premises) No. of Sessions held per month at clinics included in col. (2) No. of women in attendance Total No. of attendances made by women included in col.(4) during the year No. of women who attended during the year No. of new cases included in col.(4) i.e. for 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) 1958 1959 1958 1959 1958 1959 1958 1959 1958 1959 Local Health Authority Clinics Ante-natal clinics 4 4 36 36 1200 1123 920 910 4676 4084 Post-natal clinics 4 - - - - 131 135 131 124 141 168 Clinic belonging to other L.H.A.+ Ante-natal clinics 1 1 4 4 18 13 14 10 82 37 Post-natal clinics † - - - - 3 1 2 1 3 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 open during the year No ante-natal or post-natal examinations were carried out by General Practitioners at the mother's home or the practitioner's surgery under arrangements made with the Local Health Authority 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. TABLE 19 CHILD WELFARE CENTRES,, 1958 Number of centres provided at end of year Number of Child Welfare Sessions held per month at centres Number of children who first attended a centre during the year, and who at their first attendance were under 1 year of age Number of children who attended during the year and who were born in: Total Number of chlldren 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 1958 1957 1956-53 Under 1 year 1 but under 2 2 but under 5 Local Health Authority Centres 4 44 1,232 1,065 821 315 2,201 11,471 1,763 1,405 14,639 Centre belonging to other L.H„A. f 1 4 20 20 15 11 16 255 36 20 311 † By arrangement with L.C.C. at Fernhill Street Baths, North Woolwich, E.16 No clinics were discontinued or new premises opened during the year 32 TABLE 20 CHILD WELFARE CENTRES, 1959 Number of centres provided at end of year Number of Child Welfare Sessions held per month at centres Number of children who first attended a centre during the year, and who at their first attendance were under 1 year of age Number of children who attended during the year and who were born in: Total Number of chl ldren 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 1959 1958 1957-54 Under 1 year 1 but under 2 2 but under 5 Local Health Authority Centres 4 44 1,262 1,140 844 284 2,268 12,858 1,925 1,381 16,164 Centre belonging to other L.H.A. † 1 4 21 19 15 12 46 270 34 27 331 † By arrangement with L.C.C. at Fernhill Street Baths, North Woolwich, E.16. Note:- No clinics were discontinued or new premises opened during the year. 33 DAY NURSERY TABLE 21 Year Number at 31st December No. of approved places No. of children on the register at the end of the year Average dally attendance during the year 0-2 years 2-5 years 0-2 years 2-5 years 0-2 years 2-5 years 1958 1 27 47 16 40 13.0 38.3 1959 1 27 47 20 46 15.0 39.5 There are no Nurseries in the borough provided by voluntary Organisations, the one nursery being operated by the authority. NURSERY AND CHILD-MINDERS REGULATION ACT, 1948. There were no daily minders provided Dy the Council during the years and there were no premises or daily minders registered under the above Act at 31st December ineach year. The Authority do not pay any fees to daily minders under section 22 of the National Health Service Act, 1946. CARE OF UNMARRIED MOTHERS The Authority does not provide a Mother and Baby Home, but, where necessary patients are admitted to homes maintained by voluntary Moral Welfare Associations or by other Local Health Authorities. During 1958 the Council accepted financial responsibility for the maintenance of one unmarried mother and for two unmarried mothers in 1959. These mothers were cared for in recognised mother and baby homes, the period of care varying from 2 weeks to 9 weeks. 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 co-operation is maintained with the Children's Officer and the Chief Education Officer. SECTION 23- MIDWIFERY SERVICE Our domiciliary midwives have acquitted themselves very well in the past 5 years, and won golden opinions both from the mothers they delivered and the doctors practising midwifery in East Ham. The table appended indicates the self reliance and competence of the local authority midwives, but it is possible that an increasing number of general practitioner obstetricians would in the future desire to play a more active role in childbirth. It should be remembered that in addition to the care to their patients, two of our midwives are actively engaged in the supervision and training of midwifery pupils on the district. 34 Domiciliary Deliveries in East Ham Year Delivered at home Doctor booked Doctor present at birth 1955 1956 1957 1958 1959 328 292 277 303 292 102 76 107 99 100 6 16 13 9 16 MIDWIVES ACTS, 1902-1951 Number of midwives practising in the area at 31st December Domiciliary Midwives Midwives in Institutions Total 1958 1959 1958 1959 1958 1959 Midwlves employed by the Council 4 4 - - 4 4 Midwives employed by Voluntary Organisations- (a) Under arrangements made with the L.H.A. in pursuance of Section 23 of the N.H.S. Act - - - - - - (b) Otherwise (including hospitals not transferred to the Minister under the N.H.S. Act. - - - - - - Midwives employed by Hospital Management Committees or Boards of Governors under the N.H.S. Act - - 7 ~+ 7 " + Midwives in private practice - - - - - Totals 4 4 7 - 11 4 + The Maternity Ward at East Ham Memorial Hospital was closed temporarily on 1.4.59 35 TABLE 23 NUMBER OF DELIVERIES ATTENDED BY MIDWIVES IN THE AREA DURING THE YEAR Domiciliary Cases Cases in Institutions Doctor not booked Doctor booked Totals Doctor present at time of delivery of child Doctor not present at time of delivery of child Doctor present at time of delivery of child (either the booked Doctor or another) Doctor not present at time of delivery of child 1. Midwives employed by the Authority 1958 1959 1958 1959 1958 1959 1958 1959 1958 1959 1958 1959 4 1 200 191 9 16 90 84 303 292 - - 2. Midwives employed by Voluntary Organisations (a) Under arrangements with the Local Health Authority in pursuance of Section 23 of the National Health Service Act, 1946 - - - - - - - - - - - - (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 .. - - - - - - - - - - 365 92+ 4. Midwives in Private Practice (Including Midwives employed in Nursing Homes) - - - - - - - - - - - - Totals 4 1 200 191 9 16 90 84 303 292 365 92+ + East Ham Memorial Hospital closed their Maternity Ward on 1.4.59 36 TABLE 24 DOMICILIARY MIDWIVES-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 1958 4 5 - 4 - 213 - 8 152 1959 4 4 - 14 - 189 - 12 116 2. Domiciliary Midwives employed under Section 23 by voluntary organisations as agents of Local Health Authority 1958 - - - - - - - - - 1959 - - - - - - - - - 3. Domiciliary Midwives employed under Section 23 by hospital authorities as agents of Local Health Authority 1958 - - - - - - - - - 1959 - - - - - - - - - 4. Domiciliary Midwives in private practice or employed by organisations not acting as agents of Local Health Authority 1958 - - - - - - - - - 1959 - - - - - - - - - Totals 1958 4 5 - 4 - 213 - 8 152 1959 4 4 - 14 - 189 - 12 116 37 INSTITUTIONAL MIDWIVES The numbers of mldwives employed by East Ham Memorial Hospital, and qualified at 31st December to administer gas and air analgesia were as follows 1958-Seven 1959-Nil (Maternity Ward closed temporarily on 1.4.59) Number of cases in which medical aid was summoned by a midwife under section 14(1) of the Midwives Act, 1951:- 1958 1959 (a) for domiciliary cases- (1) where the medical practitioner had arranged to provide the patient with maternity medical services under the N.H.S. Act 27 10 (ii) others 41 41 Total 68 51 (b) for cases in East Ham Memorial Hospital 156 27 Number of cases delivered in institutions but attended by domiciliary mldwives on discharge from institutions and before the fourteenth day 62 24 Breast Feeding Number of domiciliary cases in which the infant was wholly breast fed at the fourteenth day 203 170 SECTION 24-HEALTH VISITING SERVICE All Health Visiting Services are provided by the Authority. There are no agency arrangements with voluntary organisations. The total visits made in 1958 and 1959 were 28,082 and 30,414 respectively. TABLE 25 HEALTH VISITORS - STATISTICS Year Number of children under 5 years of age visited during year Expectant Mothers Children under 1 year of age Children age 1 and under 2 years Children age 2 but under 5 years Other Cases Total number of families or households visited by Health Visitors Number of attendances by Health Visitors at Clinic Sessions First Visits Total Visits First Visits Total Visits Total Visits Total Visits Total Visits Effective Visits 1958 5,232 1,263 1,813 1,467 6,970 4,083 5,226 3,729 16,161 2,387 1959 5,510 1,199 1,942 1,578 6,093 4,307 6,620 4,977 18,637 2,723 No Access Visits 1958 560 1,389 1,325 1,668 1,319 1959 544 1,623 1,082 1,893 1,353 A "No Access" or ineffective visit is one in which the Health Visitor did not make contact with the individual to be visited or a responsible representative of that individual. 38 In my reports for 1956/57 I sketched briefly the future trends in the service and the necessity for some reorientation of the health visitors' work. in order not to overload her community effort. In particular her work in the Mental Health field requires patient and time consuming observation, interrogation and instruction with both mother (or parent) and the child. Co-operation with the Mental Health Department and discussion with the family doctor and the clinic medical officer are usually necessary in each case to obtain a comprehensive picture and ensure the best advice is given. With old people the health visitor exercises a most invaluable advisory and supportive function, maintaining contact with the hospital or general practitioner, other medico-social services of the authority and alleviating loneliness. She is often the first to detect senile or pathological mental change, initiating action most appropriate to the best Interests of the persons and menage concerned. But it is the problem family that makes the greatest demands on the time and resourcefulness of the Health Visitor. Access to such homes is notoriously difficult, accurate Information as to income budgeting and domestic circumstances only elicited almost with surgical dexterity and time seems to have little importance here. And the Health Visitor must be ever vigilant not to get too involved emotionally in the endless disputes between the parents and relatives and neighbours of her clients. Indeed it can rightly be said the "problem family" is the most exhausting and least rewarding of all the tasks the Health Visitor is asked to deal with. In this corner she will get more buffets than bouquets but must carry on with equanimity and calm determination not to be side-tracked from her chosen vocation. 39 TABLE 26 HOME NURSING - STATISTICS Year TYPE OF CASE Number of Patients who were 65 or over at the time of the f irst visit during the year Number of Children who were under 5 at the time of the first visit during the year Number of Patients who had more than 24 visits during the year Medical Surgical Infectious Diseases Tuberculosis Maternal Complications Others Totals Number of cases attended by Home Nurses during the year 1958 1 ,493 182 5 46 4 386 2,116 778 48 370 1959 1,367 141 3 57 9 144 1,721 602 26 393 Number of visits paid by Home Nurses during the year 1958 45,652 3,833 23 1,818 39 3,802 55,167 36,817 195 39,503 1959 48,240 5,054 13 3,540 56 340 57,243 37,276 172 40,133 For the period 1st January 1958 to 31st March 1959 all home nursing services were provided by voluntary organisations acting as agents of the Council in accordance with agreements made under Section 25 of the Act. From the 1st April 1959 the staff employed by the East Ham District Nursing Association were transferred to the Health Department of the Authority and the administration of the service functioned from the Town Hall Annexe, in respect of the area of East Ham, North of the Royal Docks. The Woolwich & Plumstead District Nursing Association continued to provide for cases occurring in the small area of East Ham, South of the Docks 40 SECTION 26-VACCINATION AND IMMUNISATION DIPHTHERIA IMMUNISATION TABLE 27 Immunisation carried out by Age at date of final injection or of reinforcing 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 1958 1959 1958 1959 1958 1959 1958 1959 486 512 203 224 30 22 719 758 Local Health Authority 265 223 168 153 31 30 464 406 Totals 751 735 371 377 61 52 1183 1164 Number of children who received a secondary or reinforcing injection during the year General Practitioners 5 4 39 60 161 87 205 151 Local Health Authority - - 503 483 132 102 635 585 Totals 5 4 542 543 293 189 840 736 TABLE 28 Number of children who at the end of the year had completed a course of immunisation at any time in the preceding 15 years. Age at 31st December of year under review Under 1 year 1-4 years 5-9 years 10-14 years Total under 15 years A Number of children who completed a course of immunisation (primary or booster) in the last five years. 1958 227 3,993 4,288 1,755 10,263 1959 209 3,687 4,645 1,830 10,371 B Number of children who completed a course of immunisation (primary or booster) in the ten years preceding A above 1958 - - 2,590 6,867 9,457 1959 - - 2,125 6,740 8,865 C Estimated mid-year child population 1958 1,480 5,520 15,500 22,500 1959 1,470 5,430 14,900 21,800 D Immunity index i.e. percentage of children immunised in the past five years A/c x 100/1 1958 15.3 72.3 39.0 45.6 1959 14.2 67.5 43.5 47.6 41 TABLE 29 WHOOPING COUGH IMMUNISATION Immunisation carried out by Age at date of final injection 0 - 4 years 5-14 years Total 1958 1959 1958 1959 1958 1959 Number of children who completed a full course of Primary Immunisation during the year. General Practitioners 598 845 10 18 599 863 Local Health Authority 478 410 11 5 489 415 1,067 1,255 21 23 1,088 1,278 TABLE 30 SMALLPOX VACCINATION Number of persons vaccinated or re-vaccinated Totals Age at date of vaccination Under 1 year 1 year 2-4 years 5-14 years Over 14 years Number vaccinated 1958 551 80 57 63 72 823 1959 532 50 30 24 65 701 Number re-vaccinated 1958 4 1 5 5 95 110 1959 4 - 4 9 88 105 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 vaccinations other than (a) and (b) One must continue to applaud the efforts of the general practitioners to raise up the vaccinal state of the community. 42 TABLE 31 POLIOMYELITIS VACCINATION STATISTICS Class Number vaccinated with two injections during the year By General Practitioners In Authority Clinics Total 1958 1959 1958 1959 1958 1959 Children born in years 1943-58 2,991 3,685 2,856 3,942 5,847 7,627 Young Persons born in the years 1933 -42 192 1,592 269 3,957 461 5,549 Expectant Mothers 92 200 55 87 147 287 General Practitioners and their families 22 15 - - 22 15 Ambulance Staff and their families 8 - 13 - 21 - Hospital Staff, Medical Students and families 10 34 5 13 15 47 3,315 5,526 3,198 7,999 6,513 13,525 At the 31st December 1958, 177 persons had received their 3rd injections. At the 31st December 1959, 11,580 persons had received their 3rd injections. The statistics reflect the result of implementing the Ministry of Health Circulars 16/57 and 20/58 which extended the offer of vaccination to other groups of the community and provided for a third injection to be given to those persons who had already received two injections. 43 SECTION 27 " AMBULANCE SERVICE TABLE 32 Statistics for years ending 31.3.59 and 31.3.60 AMBULANCE SERVICE Transport by rail Grand Total Ambulances Dual Purpose (1 stretcher) vehicles Sitting case Vehicles Total - All Vehicles No. of Operational vehicles on 31st March 1958/9 6 4 1 11 11 1959/60 6 6 1 13 13 No. of such vehicles fitted with wireless 1958/9 - - - - - 1959/60 - - - - - TOTAL MILEAGE 1958/9 83,124 86,588 169,712 169,712 1959/60 76,620 97,957 174,577 174,577 No. of Patients carried: Stretcher Patients Sitting Patients Total (a) Accident or Emergency 1958/9 1,040 72 1,112 - 1,112 1959/60 1,245 70 1,315 1,315 (b) Others 1958/9 20,144 23,775 43,919 14 43,933 1959/60 18,581 25,925 44,506 15 44,521 TOTALS (a) & (b) 1958/9 21,184 23,847 45,031 14 45,045 1959/60 19,826 25,995 45,821 15 45,836 No. of Operational Staff on 31st March 1958/9 30 30 1959/60 30 30 TABLE 33 COST OF SERVICE Period Ambulance Service £ Cars from Transport Pool etc. £ Transport By Rail £ Total £ 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 Year ending 31st March 1957 32,192 95 17 32,304 Year ending 31st March 1958 35,253 69 7 35,329 Year ending 31st March 1959 37,228 172 8 37,408 Year ending 31st March 1960 37,932 102 14 38,048 44 TABLE 34 UNIT COSTS-AMBULANCE SERVICE Ambulance Service only Year ending 31.3.59 Year ending 31.3.60 Cost per Vehicle mile 4/5 4/4 Cost per Patient 16/6 16/7 Cost per 1,000 Population £336. 0. 0. £346. 4. 1. No. of Patients carried per 1,000 Population 406 417 Average mileage per patient 3.8 3.8 Work in the Ambulance Service has crystallised along two well defined lines. 1. An emergency service for the transport of acutely sick and accident cases to hospital, and 2. A "taxi" service for the attendance at hospital for treatment of a wide variety of conditions, and inter-hospital transfer. The transport involved in group 2 makes such extensive demands on the ambulance service, that great difficulty is experienced at certain times of the day (and particularly certain days of the week) to ensure a "manned" vehicle is available always to answer an emergency call. It is true that "mutual support" arrangements exist with West Ham and Essex, but the Ambulance Services of both these authorities are often in a similar predicament when we call on their aid. It is probable an additional ambulance and crew would prove the most satisfactory solution to this problem. Constant vigilance is essential also to ensure abuse of this hospital taxi' service does not arise. It is observed that a number of persons who are transported to hospital for various types of treatment, are well able to use public transport for personal pleasure and shopping. The hospital staffs and the general practitioner are exhorted to assist us to obviate such misuse of an expensive ambulance service, by more careful assessment of the true capabilities and real needs of their patients before asking for this "priority" service. Nevertheless, high praise is due to Miss Finch, the Officer-in-Charge and all her staff for their devotion to a most exacting task in maintaining an efficient round the clock service to the people in East Ham. 45 SECTION 28 - PREVENTION OF ILLNESS, CARE AND AFTER CARE Loan Cupboards The scheme for the loan of articles to aid in the domiciliary nursing of the sick, was centralised in May 1958. The loan cupboard at Church Road Clinic was closed on 31.5.58 and all issues from this date were made from the Town Hall Annexe. Details of the items loaned during the year are shewn in the following table. TABLE 35 No. of occasions items loaned 1958 1959 Bed Blocks 10 22 Bed Boards 1 1 Bed Cradles 36 38 Bed Pans 333 317 Bed Rests 214 183 Bed Rings, Air 234 158 Bed Rings, Dunlopillo 2 1 Commodes 25 54 Crutches 14 6 Douche Cans 2 4 Feeding Cups 10 15 Hospital Bedsteads 3 3 Hot Water Bottles 1 2 Hoist (Patient Lift) 1 1 Lifting Pole and Chain 1 1 Mattresses 2 1 Mattresses, Dunlopillo 1 2 Pillows 1 2 Pillow Slips 1 2 Rubber Sheets 290 268 Sputum Mugs 15 13 Steam Kettles 1 2 Urinals 144 150 Walking Sticks 3 ^ 5 Water Beds 1 - Wheelchairs 60 82 Totals 1,406 1,333 NOTE - With the exception of garden shelters stored in sections on other Council premises all articles kept at the Town Hall Annexe. In addition the following articles were loaned from the premature baby outfit cupboard No. of occasions 1958 1959 Premature baby outfits 1 Nil Scales and weights 24 7 TUBERCULOSIS 1958 1959 No. of attendances at East Ham Chest Clinic 24,059 22,000 No. of visits to homes of patients by Tuberculosis Visitors 4,122 3,575 No. of attendances per month by Tuberculosis Visitors at Clinic Session 1,199 1,290 46 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 tuberculosis patients. Number of occasions on which free extra nourishment was provided:- 1958 1959 Milk 612 547 Food 89 54 Total 701 601 The following statistics relate to the work of the part-time occupational therapist:- 1958 1959 (a) Number of sessions at the therapy centre 95 96 (b) Number of attendances at Classes by patients 1,227 905 (c) Number of sessions worked in visiting patients and giving instruction in their homes 93 98 (d) Number of visits by therapist to patients' homes 488 478 TABLE 36 B.C.G. VACCINATION-STATISTICS Number Skin Tested Number found Negative Number Vaccinated or re-vaccinated 1958 1959 1958 1959 1958 1959 A Contacts of active cases of Tuberculosis 241 299 145 188 169 215 B Schoolchildren 307 + 534 260 + 390 273 345+ (i) Initial examination (ii) Re-examination of children vaccinated 325 - - - - - + This figure includes numbers of schoolchildren 14 years and over. In accordance with the Ministry's advice, the practice of conducting a "conversion test" after vaccination ceased in 1959. TUBERCULOSIS VACCINES CLINICAL TRIAL A contribution on this subject was made by Dr. T.M. Pollock in my report for 1956/57. In a paper presented to the Annual Conference of The British Tuberculosis Association (Bristol, June 29th 1956) by Dr. Pollock, P. D'Arcy Hart and Ian Sutherland entitled "Clinical Assessment of the First Results of the Medical Research Council's Trial of Tuberculosis Vaccines in Adolescents in Great Britain" several illuminating statements appear under the heading "Practical Outcome". "Widespread vaccination at this age should make a worthwhile contribution to a decline in the incidence of tuberculosis in adolescents aged 13 to 17 years. If protection should last for more than four years, as seems likely, the decline in tuberculosis in young adults in this country may also be hastened." "In association with this general decline of tuberculosis in adolescence, widespread vaccination of schoolchildren in Britain is likely to produce a selective reduction im miliary tuberculosis and meningitis - Indeed, the preliminary findings encourage the hope that in future these two types of tuberculosis will occur very infrequently in adolescents and young adults. 47 "Turning to the findings among the participants in the trial who were found to be tuberculin positive at the first examination, and who were thus Ineligible for vaccination, more than 6 per 1000 had previously unsuspected lesions at this examination, in the majority of cases demonstrable by a miniature chest radiograph. In Britain schoolchildren are usually regarded as an unprofitable group for mass radiograph, because the prevalence of disease among them is relatively low, but it seems from these findings that if the chest x-ray examinations were concentrated upon those tuberculin positive they would be worthwhile. Such x-ray examinations of children found to be positive might thus be a valuable adjunct to the present routine scheme for 13-year-olds in Britain; this procedure had already been adopted by at least one large local authority. "The contribution made to the incidence of tuberculosis by the tuberculin positive group did not cease with the discovery of the 6 per 1,000 cases present initially. Tuberculosis has continued to develop in this group throughout the period of observation. Indeed, the highest morbidity in any group was noted among those who were the most highly sensitive at the outset: among those with reactions of 15 m.m. or more to 3 T.U. the annual incidence was nearly 3 per 1,000. "There are two main ways in which the continuing incidence in this highly tuberculin sensitive and vulnerable group of schoolchildren might be reduced, or its effects ameliorated. The first is by subsequent x-ray supervision. This would mean following up only a relatively small proportion of the total skin-tested. There is also a suggestion from the preliminary results that the period of greatest danger in this highly tuberculin sensitive group may not extend beyond two or three years after leaving school, so that routine x-ray re-examination might be limited to this period. Even this may sound unmanageable because of the large numbers involved, but with the reduction of tuberculous infection In childhood these numbers might soon be less than at present. Even at its most effective, however, a scheme of this nature serves only to detect tuberculosis, not to prevent it. "The second way in which the continuing incidence of tuberculosis in this highly tuberculin sensitive group might be reduced is to vaccinate at an earlier age before natural tuberculin sensitivity has developed. Thus the age might be reduced too early in school life; a more comprehensive approach would be to vaccinate in infancy. Infant vaccination should not merely prevent meningitis in early childhood but might also reduce other cases of tuberculosis notified before and after leaving school. There are, however, certain considerations which suggest caution in introducing mass vaccination in infancy in Britain at the present time. "First, there is the duration of protection afforded by vaccination. The evidence from the trial so far is that it continues at least up to four years, while in the clinical trial of BCG among American Indians by Aronson and his colleagues the protection did not show signs of waning until after ten years, though the conditions in which that investigation was undertaken were admittedly very different from those in this country. Hence, on present knowledge, if the vaccine were to be given in Infancy tuberculin testing and re-vaccination in adolescence would have to be envisaged. In other words, vaccination in infancy would have to be additional to, and could not replace, the present scheme in adolescence. "Secondly, there is the loss of the tuberculin test for epidemiological and diagnostic purposes. These uses of the test are likely to become increasingly important as tuberculosis declines. "Thirdly, there is a natural reluctance to add yet another immunisation procedure to those already advised in infancy, unless the need is very obvious, In 1954, in England and Wales, about 2,000 cases of tuberculosis occurred before the age of 5 years. Among these were 212 cases of meningitis. The provisional figures for 1955 show a reduction from those figures to 1,600 and 155 respectively. We have, therefore, to consider carefully whether these totals, coupled with the decline in incidence, warrant the introduction of a vaccination scheme for over half a million infants each year. We must however, appreciate that the numbers of cases notified in early childhood do not give a comprehensive account of the dangers of tuberculous infection at that time, since tuberculous infection in early life may give rise to some of the cases of tuberculosis notified in later life. There is, therefore, clearly room for varying opinions about the advisability of introducing vaccination for all Infants in Britain as a new policy." 48 TABLE 37 CONVALESCENT HOME TREATMENT-PERIOD OF TREATMENT Age Groups Year 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 Five Years 1958 M - 2 2 - - - - 4 F - - 2 - 1 - - 3 1959 M - - 2 - - - - 2 F - - - 4 - - - b School Children 1958 M - - 10 9 2 2 - 23 F - - 5 10 5 - 2 22 1959 M - - 5 9 3 1 - 18 F - - 9 17 2 - - 28 Adults 1958 M 1 - 23 26 - - 1 51 F - - 65 41 1 - - 107 1959 M 1 1 25 30 - - - 57 F 4 3 70 55 1 - - 133 Totals 1958 1 2 107 86 9 2 3 210 1959 5 4 111 115 6 1 - 242 TABLE 38 The recommendations for this treatment were submitted by:- Referred by Children 0-5 School Children Adults Total 1958 1959 1958 1959 1958 1959 1958 ] General Practitioners 2 4 5 16 123 149 130 169 Hospitals - - 3 1 14 10 17 11 East Ham Chest Clinic 1 - 5 6 18 28 24 34 School Health Service - - 29 22 - - 29 22 M. & C.W. Section 4 2 - - 2 3 6 5 Child Guidance Centre - - 3 1 1 - 4 1 Totals 7 6 45 46 158 190 210 242 For comparison the numbers of children and adults receiving this form of treatment in previous years are appended:- 1955 1956 1957 1958 1959 Children 0-5 years 14 15 7 7 6 Schoolchildren 80 74 53 45 46 Adults 175 192 185 158 190 49 PARK VIEW THERAPEUTIC CLUB This club continues to function under the watchful eye of the staff of the Mental Health Section. Social occasions, dances, theatre outings, whist drives and gramophone sessions are arranged and the number attending continues round about twenty-five each meeting. Mr. Steadman the main prop to this small community whose individual members strive so hard to win back a place in the world, retired on 6th October 1958 after ten years' service to the Health Department. He was a man of sterling quality, full of compassion and humility and in his going, the mental sufferers of East Ham have lost a stalwart friend and the Mental Health Department a loyal colleague. Everyone will wish him well in his much earned retirement from Local Authority service. SECTIONS 28 AND 51-MENTAL HEALTH SERVICE In the two years under review the Duly Authorised Officers have won golden opinions for themselves and for the Mental Health Service of East Ham. They have stood as bulwarks of support to those families in which breakdown threatened. They have served as models of co-operative effort in their liaison with the general practitioners and the hospitals and the other Public Health services. They have not spared themselves in affording assistance to the Mental Health Occupation Centre when needed-in helping the staff during difficult periods and staff sickness - accompanying the patients on outings and annual holidays and materially assisting on 'open day'. Their knowledge of the difficulties and ramifications of family life in those households in which defectives or mental sufferers reside in unrivalled and their meticulous records of the greatest assistance to me in my work with this section of the community. Few boroughs to my knowledge have so personal and humanitarian a Mental Welfare service and it would be invidious to select any of the officers by name for special mention. They have worked as a splendid team and I am sure they will be glad to know of the thanks of the community, the Health Committee and the doctors, in appreciation of their untiring effort. The new legislation foreshadowed by the Mental Health Act 1959 may have a considerable effect on the work of these officers but we can rest assured they will carry out the greater community effort required of them with patience, zeal and enthusiasm. 50 TABLE 39 PARTICULARS OF MENTAL DEFECTIVE REPORTED 1958 1959 Males Females Total Males Females Total Particulars of cases reported during the year:- (1) Ascertainment - (a) Cases reported by Local Education Authorities (Section 57, Education Act, 1944) - (1) Under Section 57(3) 3 2 5 1 - 1 (ii) Under Section 57(5):- On leaving special schools 4 4 8 1 7 8 On leaving ordinary schools - - - - - - (b) Other ascertained defectives reported and found to be "Subject to be dealt with" - 1 1 1 1 2 Total ascertained defectives found to be "Subject to be dealt with" during the year 7 7 14 3 8 11 (c) Other reported cases ascertained who are not at present "Subject to be dealt with" 1 - 1 - - - (d) Cases reported but not confirmed as defectives by 31st December and thus excluded from (a), (b) or (c) 1 2 3 4 2 6 Total no. of cases reported during the year 9 9 18 7 10 17 (2) Disposal of cases reported during the year (a) Ascertained defectives found to be "Subject to be dealt with" - (i) Admitted to Hospitals etc. 2 2 4 1 2 3 (ii) Placed under guardianship - - - - - - (iii) Taken to "places of safety" - - - - - - (iv) placed under statutory supervision 5 5 10 2 6 8 Total ascertained defectives found to be "Subject to be dealt with" 7 7 14 3 8 11 (b) Cases not at present "Subject to be dealt with" - (1) Placed under voluntary supervision 1 - 1 - - - (11) Action unnecessary - - - - - - Total cases not at present "Subject to be dealt with" 1 - 1 - - - 51 TABLE 40 MENTAL DEFICIENCY ACTS, 1913-1938 PARTICULARS OF MENTAL DEFECTIVES AS ON 31st DECEMBER EACH YEAR 1958 1959 Males Females Total Males Females Total 1. NO. of ascertained mental defectives found "Subject to be dealt with":- (a) In hospitals, etc. (including cases on licence therefrom) (Under 16 years of age 17 11 28 17 7 24 (Aged 16 years and over ( 89 88 177 87 90 177 (b) +Under guardianship (including cases on licence therefrom) (Under 16 years of age - - - - - - (Aged 16 years and over ( - 2 2 - 3 3 (c) In "places of safety" - - - - - - (d) Under statutory supervision (excluding cases on licence) (Under 16 years of age 12 15 27 11 12 23 (Aged 16 years and over ( ( 83 69 152 83 76 159 Total ascertained cases found to be "subject to be dealt with" 201 185 386 198 188 386 No. of cases included in (b) to (d) above awaiting removal to an institution - - - 2 1 3 2. No. of mental defectives not at present "subject to be dealt with" but over whom some form of voluntary supervision is maintained Under 16 years of age - - - - - - Age 16 years and over 21 16 37 21 15 36 Total number of mental defectives (1) plus (2) 222 201 423 219 203 422 3.. No. of mental defectives receiving training (a) In day training centres (Under 16 years of age 10 13 23 7 11 18 (Aged 16 years and over 19 15 34 20 18 38 (b) At home - - - - - - Total 29 28 57 27 29 56 + No defectives under guardianship were dealt with during the two years under the provisions of section 8 or 9. 52 GUARDIANSHIP CASES 1958 1959 No. of register on 1st January 6 2 No. admitted to institutions - - No. of Orders discharged by the Board of Control 4 - No. on register on 31st December 2 3 No. resident outside East Ham and visited by members of the Mental Health Sub-Committee 2 2 No. resident in East Ham and visited by the Medical Officer of Health - - OCCUPATION CENTRE The numbers of defectives on the register of the Occupation Centre on 31st December of each year was as follows:- 1958 1959 Males 29 27 Females 28 29 Total 57 56 TABLE 41 OCCUPATION CENTRE-SESSIONS AND ATTENDANCES Morning Afternoon Total Number of Register: 1958-Males 29 28 57 Females 28 28 56 1959-Males 27 26 53 Females 29 29 58 Number of Sessions held during the year 1958 217 217 434 1959 216 216 432 Total Attendances:- 1958-Males 5,421 5,204 10,625 Females 4,370 4,370 8,740 Total 9,791 9,574 19,365 1959-Males 5,484 5,280 10,764 Females 4,939 4,939 5.878 Total 10,423 10,219 20,642 Average attendance per session:- 1958-Males 24.98 23.98 ) 44.66 Females 20.18 20.18 ) 1959-Males 25.39 24.45 ) 47.78 Females 22.86 22.86 ) 53 TABLE 42 MENTAL PATIENTS-LUNACY AND MENTAL TREATMENT ACTS Type of Patient Number on register on 1st January Admissions to Hospitals during the year Discharges from Hospitals during the year Deaths in hospitals during the year Number on register on 31st December 1958 1959 1958 1959 1958 1959 1958 1959 1958 1959 Certified-Males 138 129 14 18 18 21 5 6 129 120 Females 179 171 47 32 48 39 7 15 171 149 Total 317 300 61 50 66 60 12 21 300 269 Temporary-Males - - 2 2 1 - 1 1 - 1 Females 4 4 4 7 4 4 - 4 4 3 Total 4 4 6 9 5 4 1 5 4 4 Voluntary-Males 86 96 117 91 102 89 5 4 96 94 Females 80 97 138 140 115 135 6 6 97 96 Total 166 193 255 231 217 224 11 10 193 190 Grand Totals 487 497 322 290 288 288 24 36 497 463 Number of patients admitted to observation wards 1958 1959 Males 17 22 Females 18 18 Total 35 40 Number of patients released on trial 1958 1959 Males 8 9 Females 32 21 Total 40 30 Number of patients returned from trial 1958 1959 Males 2 2 Females 9 4 Total 11 6 Disposition of Mental Patients 1958 1959 Runwell Hospital Other Hospitals Runwell Hospital Other Hospitals In patients on 1st January 475 12 484 13 Admissions during the year 319 3 286 4 Discharges during the year 286 2 285 3 Deaths during the year 24 - 35 1 In patients on 31st December 484 13 450 13 54 TABLE 43 DULY AUTHORISED OFFICERS DETAILS OF VISITS, ETC. No. of visits and/or attendances Mental Deficiency Acts 1913-38 1958 1959 4 - Guardianship Statutory Supervision 1260 1231 Friendly Care 103 78 Home reports for patients detained in Institutions 74 65 Occupation Centre 126 143 Total visits or attendances 1567 1517 Lunacy and Mental Treatment Acts Patients reported to be in need of treatment 1520 1615 After-Care 953 974 Park View Therapeutic Social Club 72 79 Total visits or attendances 2545 2668 Grand Totals 4112 4185 SECTION 29-HOME HELP SERVICE In my reports for 1956/57 I referred to the sterling community work of the Home Help Service in laudatory phrases. In the two years under review their average hours of service rendered to the public each week has risen to well over 3000 hours, and the quality of the service if anything has been refined to meet the peculiar needs of old people and others threatened by breakdown without this humanitarian medicosocial support afforded by an enlightened council through their Home Help Service. HOME HELP SERVICE TABULATION OF CASES TABLE 44 Illness or other cause for which help provided Total 1958 1959 Maternity 37 42 Tuberculosis 43 34 Cancer 64 62 Old Age 921 1,026 Other Sickness 172 147 1,237 1,311 55 The approved establishment is 80 full time helps or their equivalent in part time help and on 31st December of each year the staff employed comprised 1958 1959 Full Time Permanent Helps Nil Nil Registered Casual Helps 143 136 Casual Helps on probation prior to Registration 14 17 Total 157 153 Provision was made for an average use of 3250 hours per week in the financial year 1958/9 and 3,300 hours per week in 1959/60. The total hours of service given and the average hours worked per week were as follows Year Total hours worked Average per week + 1958 170,504 3,217 † 1959 165,135 3,176 The salient feature in reporting on this most valuable of the social services is the steadyexpansion of the service exemplified in the following figures of average hours worked per week. 1955 - 2,597 hours per week 1956 - 2,744 ,, ,, ,, 1957 - 2,958 ,, ,, ,, + 1958 - 3,217 ,, ,, ,, † 1959 - 3,176 ,, ,, ,, + The figures reflect the result of 53 working weeks. † In this year there was a total sickness period of 10,090 hours. Of this total approximately 1/3 could not be covered by relief workers and this in turn is reflected in the reduction of the total hours worked for the year. During the years under review, the Organiser and her Assistant made the following numbers of visits to the homes of applicants for the service 1958 1959 Primary visits to new applicants for the service 553 542 Visits to applicants already in receipt of the service 2,464 2,266 Totals 3,017 2,808 56 SANITARY SECTION 1958/59 This section of the report relating to sanitary circumstances, housing, food inspection, clean air and general routine work of the section has been completed by the Chief Public Health Inspector, Mr. D.G. Tonkin, M.P.H.I.A. The staff position was once more very disturbing, two Inspectors resigned in April, 1958 and one in September 1959, and at the end of the period they had not been replaced. This threw a very heavy strain on the remaining staff as legislation of recent years has tended to throw more responsibilities on to the department. The public continue to look upon the office as a place where they may unburden themselves of a multifarious number of complaints but are undoubtedly appreciative of the services rendered them. The section was also used considerably by students from technical colleges or Inspectors from abroad seeking to broaden their outlook in sanitation or hygiene matters. The section of the East Ham Corporation Act dealing with noise and vibration has proved very useful though some complainants are proned to over emphasize the alleged nuisance. In 1958, the Florence Road Clearance Area comprising 46 houses was reported upon, and in 1959 the Crescent Road Area of 58 houses was similarly reported, and after Public Enquiries to consider objections, the Minister confirmed the Orders. There still remains a vast amount of slum clearance to be carried out, and it is to be hoped that the staffing position will improve. One house was made the subject of a Closing Order and it is indicative of the housing position that up to one dozen persons have since called at the office with a request that they be allowed to carry out some repairs to the house that they might rent it for their own occupation. ANNUAL REPORT, 1958 (A) Inspections The number of inspections of all classes 22,622 (i) Housing Public Health Act 5,199 Re-inspections 6,643 Housing Act, 1936 2,172 Rent Act, 1957 1,439 Clean Air Act 55 Smoke nuisances-observations 105 (ii) Sanitary Circumstances Yards and passages 57 Drainage and sanitary accommodation 1,909 Drainage tests 197 Caravans 61 Offensive smells 4 Miscellaneous 844 Factories (excluding bakehouses) 212 Workplaces and Outworkers 197 Places of public Entertainment 332 (iii) Food Supply Milk and Dairy premises 72 Ice cream premises 204 Food premises, general and unsound food 1,195 Cafes and restaurants 167 Bakehouses 40 Itinerant Food vendors and stalls 398 Sampling 552 Slaughterhouses 195 (iv) Diseases of Animals Act Visits 85 (v) pet Animals Act Visits 17 57 (vi) Infectious Diseases Visits 228 (vii) Food Poisoning Visits 43 (B) Notices There were 1,494 preliminary notices served during the year and 1,040 such notices were complied with. In addition 577 Statutory notices were served and 525 were complied with. The number of complaints received during the year totalled 2,311. (C) Rodent Control The number of complaints received in respect of rat and mouse infestation totalled 362 and 393 premises were inspected in detail. The rodent operative made 1,797 visits. (D) Disinfection and Disinfestation 460 premises were treated as appropriate in respect of infectious disease, bugs, fleas, flies and ants, and where circumstances warranted help was given by the department because of beetle infestation. The steam disinfector was in operation on 96 days for disinfection of clothing and bedding. 800 library books were disinfected before return to the libraries from households where 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 589, as compared with 607 during the previous year. Most of the repair work is carried out by the Corporation contractors under the direction of the Inspectorate and by agreement with the owners of the properties concerned. (F) Fertilisers and Feeding Stuffs Act, 1926 Three samples submitted during the year. Bone meal (2) Meat and bone meal (1 ) The sample (F.F.S.189) Meat and Bone meal was unsatisfactory, Phosphate Acid 1.75 per cent below stated amount. (0) Rag Flock and Other Filling Materials Act, 1951 Seven samples were taken for analysis during the year as follows: Washed flock loose Coir fibre New Layered fibre Black flock Llnter felt Rag flock New cotton mill puff (H) Mosquito Control The usual spraying of ditches and other areas of stagnant water was carried out, and advice given to numerous householders regarding the treatment of water containers kept for horticultural purposes. (1) Pet Animals Act 1951 There were 19 premises on the register, licensed to keep a pet shop. Inspections were carried out to ensure that the conditions of licence issued by the Council were observed. No serious complaints regarding these premises were made. (J) Smoke Abatement The Clean Air Act became fully operative on the 1st June, 1958 and much propaganda work was carried out by the inspectorate at factories, homes and by addressing meetings, as a forerunner to the implementation of the Act by the establishment of smoke control areas. The North Thames Gas Board 58 began stockpiling large dumps of coke which in turn became the subject of complaints by householders in the area by reason of dust dispersal. A visit to the area was made by members of the Health Committee and after consultation with the Engineer an improvement was effected. (K) Factories, Workplaces and Outworkers These premises received routine visits and out of 329 premises on the register there were 40 cases in which defects were found. These were usually want of cleanliness or defective sanitary conveniences, but In one case an unreasonable temperature was maintained. It was necessary to serve only 4 written notices. (L) Places of Public Entertainment Regular inspections were maintained at such premises, and where conditions were found to be unsatisfactory a verbal intimation to the persons responsible usually had the desired effect. (M) Sampling The following table shows the number of samples of all types taken for analysis or examination for the year: Chemi cal Food & Drugs Act 308 Bacteriological-Food 149 Water - drinking or bath 5 Fertilisers 3 Feeding stuffs - Rag flock & other filling materials 7 472 (N) Diseases of Animals Act 85 visits were made in connection with various Orders made under this Act. Legal proceedings were instituted against a person for bringing a cat off a ship and out of the Docks. A fine of S3 was imposed. New Orders were made requiring slaughterers of poultry to keep a record of birds slaughtered, and prohibiting the holding of poultry exhibitions without licence by the Local Authority. (0) Rent Act Inspections in connection with this Act continued to take up much of the Inspectors' time. There were 362 applications for certificates of disrepair, and each of these may entail several visits as landlords or tenants make further applications for certificates as to the carrying out of work. The advice given by the Inspectors to tenants is undoubtedly very much appreciated. 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) 7»599 Under Rent Act 1,439 Total 9,038 (B) Number of inspections made for the purpose 15,681 2. Number of dwelling houses found not to be in all respects reasonably fit for human habitation 1,893 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: 1,040 III. Action under Statutory Powers during the Year: (A) Proceedings under Public Health Act: (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 577 59 (2) Number of dwelling houses in which defects were remedied by owners after service of formal notices 525 (B) Proceedings under Sections 17 and 22 of the Housing Act 1957: (1) Number of dwelling houses in respect of which Closing Orders were made 1 IV. Visits in connection with housing circumstances of applicants for rehousing 2,172 LEGAL PROCEEDINGS Legal proceedings were taken during the year as follows: East Ham Corporation Act, Section 86 (1) Caravan Fine £2 Shops Act, Section 47 & 50 (Sunday Trading) Section 47 ,, £1 Section 50 Dismissed + Shops Act, Section 1 & 13 (Early Closing) Section 1Fine £1 Section 13 Withdrawn Shops Act, Section 1 & Bakers Closing Order Fine 30/- Shops Act, Section 47 & 50 (Sunday Trading) Section 47 ,, 30/- Section 50 Withdrawn Shops Act, Grocers Closing Order Fine £6 Importation Dogs & Cats Order 1928, Diseases of Animals Act ,, £3 Food & Drugs Act, 1955, Food Hygiene Regulations 29(c) " £10 Food & Drugs Act, 1955, Food Hygiene Regulations 29(d) " £10 Shops Act, Section 47 (Sunday trading) ,, £2 Shops Act, Section 47 (Sunday trading) ,, £2.10s. Shops Act, Section hi (Sunday trading) ,, £2 Shops Act, Bakers Closing Order Early Closing ,, £1 Shops Act, Section 6 (b) Adjourned Sine Die + An appeal to the Queen's Bench Division of the High Court was made in this case, regarding exhibition of notices in a 'mixed' shop, and the Magistrates decision was upheld. RENT ACT 1 957 Particulars of applications was made and Certificates issued under the Rent Act, 1957. (1) Number of applications for certificates of disrepair 362 (2) Number of decisions not to issue certificates 2 (3) Number of decisions to issue certificates- 377 (a) in respect of some but not all defects 31 (b) in respect of all defects 346 (h) Number of undertakings given by landlords under para. 5 of the First Schedule 210 (5) Number of undertakings refused by Local Authority under proviso to para. 5 of the First Schedule (6) Number of Certificates issued 169 (7) Applications by landlords to Local Authority for cancellation of certificates 55 (8) Objections by tenants to cancellation of certificates 13 (9) Decisions by Local Authority to cancel in spite of tenants' objection 5 (10) Certificates cancelled by Local Authority 22 INSPECTION AND SUPERVISION OF FOOD SUPPLIES AND PREMISES Food premises are always a matter of great concern to the department. With a depleted staff it was not possible to maintain the supervision that would have been desirable but generally conditions were satisfactory. One meat trader was prosecuted and fined for having a dirty vehicle and equipment. Particular attention is paid to stalls and these are visited regularly at week-ends to ensure that a high standard of hygiene is observed. As a result of a report by the Public Analyst that spraying of apples imported from the Lebanon caused arsenical and lead contamination, immediate visits were made to all fruiterers in the district and where such apples were for sale they were immediately withdrawn. (a) Milk Supply The number of milk distributors registered at the close of the year was 172. 60 The following licences were issued to use special designations prescribed in the Milk (Special Designation) Regulations 1949-54: Pasteurised Milk Dealer's licence 99 Supplementary licence 10 Dealer's (Pasteurised) Licence 2 Dealer's licence, Pasteurised (Tuberculin Tested) 4 Sterilised Milk Dealer's licence 148 Supplementary licence 11 Dealer's (Steriliser's) Licence 1 Tuberculin Tested Milk Dealer's licence 20 Supplementary licences 10 1. One hundred and one samples of milk were submitted for chemical analysis i.e. fat content etc., Two samples were found to be unsatisfactory as follows:- No. 8696 Complaint of chalky taste - found to be deficient in milk fat at least 46 per cent. No. 8841 Mould growth-No b.Coli. 2. Ninety-seven samples of milk were submitted for bacteriological examination during the year. Three tests were void due to shade temperatures rising above 65 degrees. A.2848 One sample from Monega Junior School-Complaint of discolouration - Due to Green Algae - obvious fault in cleansing and Inspection of the bottle. All other samples satisfactory. (b) Ice Cream Fifty samples of ice cream were submitted for bacteriological examination during the year, the results were as follows: 2 wrapped ice cream-reduction in b.Coli desirable 9 loose ice cream-reduction in b.Coli desirable 1 " " "-contained organisms of excreta origin in small numbers. 1 " " "-contained excessive bacteria. The grading of the samples was as follows:- Grade I-36: Grade II-8; Grade III-5: Grade IV-1. Follow-up samples were taken where the first sample proved to be unsatisfactory. Twenty premises remained on the register for the manufacture of ice cream and 306 premises were registered for the sale of ice-cream, including 15 new registrations. (c) Meat Inspection Two licensed slaughterhouses in the Borough continued to operate and the following table shows the number of animals killed and examined:- Cattle Calves Sheep Pigs Total 767 - 293 350 1,410 There were 3,190 lbs of meat certified as being unfit for human consumption, and 2,769 lbs. condemned at retail butchers' shops making a total of 5,959 lbs. The number of butchers shops in the town was 85 which includes three continental and four Kosher butchers. There were seven Slaughterers licences issued. (d) Other Foods There were 111 premises registered for the preparation or manufacture of preserved food, at the end of the year. These include such premises as sausage manufacturers and fish fryers. There was one new registration. 61 Arising from the examination of a large variety of foodstuffs, the following items were certified as unfit for human consumption. Tinned fruit 647 tins " milk 392 " " meat 327 n (1,870 lbs.) " fish 57 " Other Tinned and Packeted goods 758 " or packets Total 2,181 Food other than tinned or packeted- Meat 2,769 lbs Fish 98 lbs Cheese 77 lbs Lard 29 lbs Rice 52 lbs Butter beans 112 lbs Rabbits 36 1bs Total 3,173 lbs (e) The following samples were also submitted for bacteriological examination Mussels One sample - Satisfactory Jellied eels One sample - Satisfactory Hater Two samples drinking water-Satisfactory Three samples bath water-Bacteriological standard should be higher in two cases. Food and Drugs Sampling During the year 308 samples were submitted to the Public Analyst. Details are as follows Examined Adulterated or below standard Butter 5 1 Cheese 3 - Confectionery 3 - Jam 1 - Milk 101 1 Sausage 36 2 Vinegar 6 - Wines & spirits 24 2 Drugs 13 - Other articles 116 2 Total .. 308 8 62 Details of samples not satisfactory Number Formal or Informal Article Adulteration or Deficiency 8693vvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvv Informal Minced Steak Contained sulphur dioxide. Use not permitted 8695 " Apples Contaminated with lead arsen. 8696 " Milk (pint) Deficient in milk fat, at least 46% 8753 " Beef sausage Sulphur dioxide 280 parts- 8774 " " " " " 240 " 8799 " " " " " 190 " 8836 " Pork sausage " " 100 " 8865 " Beef " " " 70 " 8873 " Pork " " " 270 " 8874 " " " " " 200 " 8880 " " " meat " " 210 " 8884 " " " " " 180 " 8823 " " " Meat 61% Should contain at least 65% 8875 " " " Sulphur D. 560 per million in excess maximum permissable. 8897 " Butter containing insect Contained ground beetle 8902 " Chicken Noodle Soup 0.7% lean chicken meat. Poor proportion 8962 " Whisky 65% proof spirit 8963 " Whisky 64.7% proof spirit 8792 " Bread - complaint Black pellets were charred dough SHOPS ACT etc. ADMINISTRATION Mr. D.G. Tonkin / Chief Inspector, Mr. T,G. Gilbert †, Mr. L. Pinguey, Inspectors (†Member, Institute of Shops Act Administration) SHOPS ACT, 1950 Despite much agitation in the press and through various organisations there was no amending shops legislation during the period. With the growth of multiple shops trading in many different localities the matter of enforcing rules and orders does at times become very complicated. Despite this, however, the vast majority of shopkeepers in East Ham are very willing to comply with directions, and a good relationship is maintained with the local Chamber of Trade. The Act as it now is deals not only with closing hours of shops, and many benefits have been obtained for assistants in the matters of heating, and ventilation, sanitary accommodation, "time off" and hours of employment of juveniles. Complaints are often received from shopkeepers regarding mobile shops, but under a recent ruling of the High Court they do not fall within the provisions of the Act relating to closing hours. Statistics 1958 No. of shops in borough subject to Act - Open 1,900 Closed 101 2,001 Dyers/Cleaners35 Laundries 28 2,064 63 7 Shops demolished during the year. 2 New shops 4 Shops converted into private dwellings and 2 Retail shops to other business. Changes during the year were as follows Change of occupier 95 Change of occupier and trade 76 Change of trade 5 176 No. of shops visited 1,635 No. of inspections - Health and Comfort 592 No. of shops insufficient/unsatisfactory 89 No. of inspection-records 608 No. of shops - Unsatisfactory 200 Visits re closing hours 2,259 Cautions 123 Warning letters 36 Prosecutions 13 Visits re other matters 244 Visits re holiday closing 548 Assistants employed; Male 1,080 Female 1,725 Young Persons - Male 114 Young Persons - Female 163 Total: 3,082 Ten shops are registered in respect of Sunday Trading by members of the Jewish faith, including four Kosher butchers. Pharmacy & Poisons Act Visits re storage 142 New applications 11 Renewals 135 Cancellations 11 Total premises registered 145 Explosives Act Visits re storage 150 New applications 20 Renewals 142 Cancellations 20 Total premises registered 161 Heating Appliances (fireguards) Act, 1952 1,246 visits and observations were made regarding new and second-hand heating appliances exposed for sale. A number of shopkeepers were cautioned regarding defective or unsuitable heaters, - mainly second-hand - exposed for sale. Minor Excise Licences 97 visits were made during the year, for the most part in connection with Refreshment House Act registrations. Domestic Servants Records were inspected at the one registry in the Borough. 64 ANNUAL REPORT, 1959 (A) Inspections The number of inspections of all classes 20,832 (i) Housing Public Health Act 5.326 Re-inspections 4,797 Housing Act, 1936 1,944 Smoke Nuisances-observations 138 Rent Act 1957 1,159 Clean Air Act 68 (ii) Sanitary Circumstances Yards and passages 85 Drainage and sanitary accommodation 2,277 Drainage tests 329 Caravans 28 Offensive fumes 3 Miscellaneous 547 Factories (excluding bakehouses) 258 Workplaces and outworkers 512 Places of public entertainment 444 (iii) Food Supply Milk and Dairy premises 98 Ice cream premises 210 Food premises, general and unsound food 1,090 Cafes and restaurants 171 Bakehouses 30 Itinerant food vendors and stalls 347 Sampling 530 Slaughterhouses 125 (iv) Diseases of Animals Act Visits 29 (v) Pet Animals Act 13 (vi) Infectious Diseases 277 (vli) Food Poisoning 7 (viii) Clean Air Act. 1956 68 (B) Notices There were 1,161 preliminary notices served during the year 758 of which were complied with. In addition 397 statutory notices were served and 349 of these were complied with. Complaints made to the Department with regard to sanitary circumstances, disrepair, infestations, obstructed drains etc., totalled 2,312. (C) Rodent Control Complaints received in respect of rat and mouse infestation numbered 341. 428 premises were inspected. The rodent operative made 1950 visits. (D) Disinfection and Disinfestation 537 premises were treated in respect of infectious diseases, bugs and dirty conditions, also because of beetle infestation. Clothing and bedding was disinfected by the steam disinfector which was used on 97 days. 776 library books from households where infectious disease etc., had occurred were disinfected before return to the libraries. Sterilisation or disinfection of all articles returned to the Health Department "loan cupboard" after use by ailing or disabled persons, was carried out. 65 (E) Drainage There were 536 complaints received during the year of choked or defective drains, as compared with 589 the previous year. The majority of the repair work is still carried out by the Corporation contractors, under the direction of the Inspectorate, and by agreement with the owners of the properties concerned. (F) Fertilisers and Feeding Stuffs Act, 1926 Eleven samples were taken during the year, as follows Hen Battery & Deep Litter (2) Layers Pellets V.N. Fattening Meal Expeller Coconut Cake Expeller Palm Kernel Cake Bone Meal (2) John Innes Base Fertiliser Sulphate of Potash Growers Mash All samples proved satisfactory. (G) Rag Flock and Other Filling Materials Act, 1951 Five samples were taken for analysis during the year as follows Rag Flock (3) Grey Black Fibre Linter Felt All samples proved satisfactory. (H) Pet Animals Act 1951 There were 17 licensed pet shop premises on the register. Inspections of these premises were carried out to ensure that the conditions of licence issued by the Council were observed. All conditions were compiled with and no complaints were received. (I) Factories, Workplaces, Outworkers The usual routine visits were paid to these premises and conditions were generally satisfactory. More attention was paid to building sites in the Borough and the sanitary facilities provided for workers thereat. There was found to be a decline in the number of outworkers actually carrying on work, though the persons concerned continued to be registered with their employers. Statistics are provided in an early part of the report. (J) Mosquito Control Though the usual preventive measures were taken in the early part of the year at the known sources of breeding, persistent complaints were received from residents in the area of the L.C.C. main sewer bank during September. Liaison between this department and the L.C.C. engineering staff has been maintained for some time and at our request cutting and firing of the long grass on the banks of the sewer was carried out. Nevertheless complaints continued to be made and frequent investigations and spraying was carried out. It was not until the winter months that it was learned that one of the sewers had been temporarily blanked off leaving an accumulation of stagnant water with the result that mosquitoes were able to breed there and gain egress through the perforated grids at the top of the sewer. Arrangements were made for this department to be notified of similar work in future. (K) Places of Public Entertainment Conditions regarding sanitary facilities, heating and ventilation were generally satisfactory but frequent inspection at the larger establishments is necessary to ensure that sanitary conveniences in particular are maintained in a satisfactory state particularly during times of popular productions. (L) Smoke Abatement A preliminary programme showing the numbers of houses etc. proposed to be included in smoke control areas in the following years was submitted to the Ministry, but unfortunately it was not possible to make a start in the implementation of this programme. Particular attention was paid to the very few factories which are guilty of emitting black smoke and adjustments in plant were made leading to gradual improvement. Householders continue to seek the advice of the department with regard to the installation of smokeless fires. The Local Authority objected to an Order made by the Minister which exempted 66 certain fireplaces from the control provisions of the Clean Air Act, but the Minister over-ruled these objections. The Chairman and Chief Public Health Inspector attended the Diamond Jubilee Conference in London of the Clean Air Society, previously the Smoke Abatement Society. (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 340 Bacteriological-Food 113 Water - drinking or bath 7 Fertilisers & Feeding Stuffs 11 Rag Flock & Other Filling Materials 5 Total 476 (N) Diseases of Animals Act (a) Slaughtering Following upon the Slaughterhouse Act, 1958, the Minister made Regulations concerning hygiene and prevention of cruelty in slaughterhouses. The Regulations came into force on 1st January 1959, and detailed inspections of the slaughterhouses in the Borough were made and the owners informed of the work required to be carried out to comply with the Regulations. (b) Other There was a welcome drop in the number of Orders made under the Diseases of Animals Act affecting premises in this district but it is still necessary to be informed of all outbreaks of contagious diseases to ensure that all precautions are observed. (0) Rent Act The large number of visits (1159) made in connection with this Act gives an indication of the impact it has had upon tenants. In addition to the practical work a vast amount of filing, entering and referencing is necessary to deal with the numerous forms (over 20) which may be used for various applications or certificates. The Health Committee have appointed a special sub-committee to deal with applications. HOUSING STATISTICS I. 1. (A) Total number of dwelling houses inspected for defects (Under Public Health or Housing Acts) 8,706 (B) Number of inspections made for the purpose 13,503 2. 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 1,584 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 758 III. Action under Statutory Powers during the year Proceedings under public Health Act (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 397 (2) Number of dwelling houses in which defects were remedied by owners after service of formal notices 349 IV. Visits in connection with housing circumstances of applicants for rehousing .. 1,944 V. Legal Proceedings It was not found necessary to prosecute landlords for failure to comply with notices served, as advantage was taken of Section 60 of the East Ham Corporation Act which authorises the Corporation to carry out the work in default where notices are served under that section in respect of defective premises (roofs, gutters &c.) In other cases tenants applied for certificates of disrepair under the Rent Act, and loss of revenue by landlords usually persuaded them to carry out the repairs. 67 RENT ACT 1957 Particulars of applications made and Certificates issued under the Rent Act, 1957. (1) Number of applications for certificates of disrepair 109 (2) Number of decisions not to Issue certificates (3) Number of decisions to issue certificates: 140 (a) in respect of some but not all defects 17 (b) in respect of all defects 123 (4) Number of undertakings given by landlords under paragraph 5 of the First Schedule 116 (5) Number of undertakings refused by Local Authority under proviso to paragraph 5 of the First Schedule (6) Number of Certificates issued 36 (7) Applications by landlords to Local Authority for cancellation of certificates 33 (8) Objections by tenants to cancellation of certificates 5 (9) Decisions by Local Authority to cancel in spite of tenant's objection 1 (10) Certificates cancelled by Local Authority 54 INSPECTION AND SUPERVISION OF FOOD SUPPLIES AND PREMISES As will be seen from the statistical Information given earlier, 2,601 visits were paid to food premises. Although the standards of hygiene in food establishments generally Is steadily improving it is still necessary to maintain constant vigilance at the inferior premises. It had been found on many occasions, where owing to the depletion of staff regular visits were not paid the occupier or employees were much too prone to slip back, to haphazard methods. However, we were able to have improvements carried out at many premises. As usual inspections were carried out at week-ends of the mobile or stall food places where shell-fish or jellied eels are sold and consumed. (A) Milk Supply The number of milk distributors registered at the close of the year was 173. The following licences were issued to use special designations prescribed in the Milk (Special Designation) Regulations 1949-1954 : Pasteurised Milk: Dealer's licence 100 Supplementary licence 10 Dealer's (pasteurlseris) Licence 2 Dealer's licence (Pasteurised and Tuberculin tested) 4 Sterilised Milk; Dealer's licence 149 Supplementary licence 11 Dealer's (Steriliser's) Licence 1 Tuberculin Tested Milk: Dealer's licence 21 Supplementary licence 10 One hundred samples of milk were submitted for chemical analysis i.e. fat content etc., all of which were satisfactory. 76 samples were submitted for bacteriological examination; tests in two samples were void due to shade temperature rising above 65 degrees F. All other samples were satisfactory. (B) Meat Inspection There are two licensed slaughterhouses in the Borough and the following table shows the number of animals killed and examined; Cattle 649 Calves - Sheep 881 Pigs 219 Total 1,749 There were 84 butchers shops in the town and these premises were inspected with regard to general hygienic conditions and stock carried. The quantity of meat certified as being unfit for human consumption was 3,776 lbs. 68 (C) Ice Cream There were 309 premises registered for the sale of ice cream including 10 new registrations. There were twenty premises registered for the manufacture of ice-cream. There were thirty-five samples of ice cream submitted for bacteriological examination during the year four of which were unsatisfactory. Follow-up samples were taken where the first sample proved to be unsatisfactory. The grading of the samples was as follows:- Grade I - 27; Grade II - 3; Grade III - 2; Grade IV - 3. (D) Other Foods There were 112 premises on the register at the end of the year for the preparation or manufacture of prescribed food. One new registration was made this year. Upon examination of a large variety of foodstuffs, the following items were certified as unfit for human consumption; Tinned meat 298 tins " fruit 303 " " milk. 30 " " fish 99 " Other tinned or packeted goods 457 " or packets Total 1,187 Food other than tinned or packeted Meat 592 lbs Fish 90 " Cheese 86 " Rabbits 21½ " (3) Chickens 56 « (16) Total 845½ lbs (E) Food and Drugs Sampling There were 340 samples submitted to the Public Analyst during the year. Details are as follows:- Examined Adulterated or Below Standard Cheese 3 - Confectionery 9 - Jam 5 1 Lard 1 - Milk 100 - Sausage 47 - Vinegar 6 - Wines & Spirits 13 - Drugs 28 - Other Articles 128 7 Total 340 8 69 Details of samples not satisfactory Number Informal or Formal Article Adulteration or Deficiency 8971 Informal Minced beef Contained preservative 1500 parts per million. Use not permitted 9009 Informal Minced steak Contained preservative 1500 parts per million. Use not permitted. 8974 Informal Sausage meat Contained preservative 150 parts per million. Use not declared. 8975 Informal Pork sausage Contained preservative 300 parts per million. Use not declared. 8987 Informal Pork sausage Contained preservative 70 parts per million. Use not declared. 9067 Informal Beef sausage Contained preservative 200 parts per million. Use not declared. 111 Informal Pork sausage Contained preservative. No declaration. 112 Informal Pork sausage Contained preservative. No declaration. 115 Informal Beef sausage Contained preservative. No declaration. 124 Informal Pork sausage Contained preservative. No declaration. 125 Informal Pork sausage Contained preservative. No declaration. 8989 Informal Bread (wholemeal) Contained rodent excreta. 9014 Informal Strawberry jam Contained honey bee. Condition suggests It found its way into jam after cooking stage. 9068 Informal Bread Contained rat excreta. 9 Informal Marzipan Ground almonds 17%. Deficient by 8%. 12 Informal Bun ring Contained brush fibre. 67 Informal Hamburgers Meat 40%. Insufficient to justify term hamburger. 141 Informal Enriched rice Vit. 'B' Niacin and Iron not stated. 147 Informal Hamburgers Meat 39% - Deficient. Legal Proceedings Legal proceedings were instituted under Food & Drugs Act, Public Health (Preservation in food) Regulations, 1925, in one case where minced beef contained preservative. The offender was fined £10. (F) Hairdressers There were three new registrations during the year and two cancellations, making a total of 94 on the register. There bye-laws made by the Corporation under the East Ham Corporation Act, 1957, came into operation on 1st September, 1958, and much time was spent checking establishments to see that the requirements of the bye-laws with regard to premises and equipment were fulfilled. Here again, the 'good' establishments conformed readily, but the occupiers of premises below the 'good' category need a deal of persuasion that all that is asked for is, in fact, necessary. (G) Caravans The East Ham Corporation Act prohibits the parking of vans for human occupation on any site within the Borough without the prior approval of the Local Authority, but this prohibition does not apply to bona-fide members of the Showmen's Guild and at the end of the travelling season a large number of caravans and lorries were parked on vacant land on the By-Pass Road. Enforcement notices under town planning legislation were served by the Town Clerk, to which the principal of the colony 70 objected, but by the time his appeal was heard by the Ministry Inspector and the decision made known, the vans were 'on the road' again. During the time they did occupy the site the occupiers kept it in a clean and sanitary condition, and arrangements were made for the disposal of soil and sewage and the provision of a mains water supply. The site has been approved by the Minister as winter quarters for these fairground folk, and regular inspections were carried out there. SHOPS ACT, 1 950 Statistics 1959 NO. of shops in the borough subject to the Act - Open 1,896 " " " " " " " - closed 108 2,04 Dyers/Cleaners 33 Laundries 27 6 Shops demolished during the year 9 New shops erected during the year 6 Shops converted into private dwellings. Changes during the year as follows Change of occupier 132 Change of occupier and trade 59 Change of trade 2 Total 193 No. of shops visited for inspection 1,466 No. of inspections-Health & Comfort 489 No. found Insufficient or Unsatisfactory 80 No. of inspections-Records 343 No. found Unsatisfactory 185 No. of visits re. closing hours 2,509 No. of Cautions 104 No. of visits re. other matters 248 No. of visits re. Holiday closing 404 Assistants employed: Male- including part time 1,173 Female - " " " 2,135 Young persons-Male 148 Young person-Female 229 Total 3,685 Ten shops are registered under Section 53 of the Shops Act by members of the Jewish faith. Pharmacy & Poisons Act Visits re. storage 156 New applications 14 Renewals 128 Cancelled 22 Total premises registered 137 Explosives Act Visits regarding storage 185 New applications 32 Renewals 138 Cancelled 20 Total premises registered 167 It was: necessary to warn shopkeepers against the sale of fireworks to children apparently under the age of 13 and local police stations were supplied with lists of registered premises. 71 Heating Appliances (Fireguards) Act 1952 1,172 visits and observations were made regarding heating appliances exposed for sale. Minor Excise Licences 101 visits were made during the year in connection with Refreshment House Licences. Hawkers Observations were kept throughout borough during the year. Domestic Servants Records were inspected at the one registry in the Borough.