HAV 6 London Borough of Havering ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH For the Year 1970 INDEX Page INTRODUCTION 1 PREFACE 1 COMMITTEE MEMBERS 6 STAFF OF HEALTH & WELFARE DEPARTMENT 7 GENERAL STATISTICS 13 INFECTIOUS DISEASES 17 Tuberculosis 19 Medical arrangements for long stay immigrants 20 Smallpox contacts 21 Venereal diseases 22 Immunisation & Vaccination 23 PERSONAL HEALTH SERVICES 24 MATERNITY SERVICES 24 Ante-Natal Care 24 Mothercraft and Relaxation Classes 24 Midwifery 24 Dental Treatment for Expectant & Nursing Mothers 25 Unmarried Mothers 25 Family Planning 26 Cervical Cytology 26 Premature Births 26 CHILD HEALTH SERVICES 26 Congenital Malformations 26 Phenylketonuria 28 Handicapped Pre-School Children 28 Clinics 28 Clinic Doctors 28 Health Visitors and Clinic Nurses 29 Speech Therapy 30 Day Nurseries 30 Nurseries and Child Minders 31 HOME NURSING 31 Sick Room Equipment 33 Incontinent Laundry Service 34 i Page Recuperative Holidays 34 Nursing Homes 34 SCHOOL HEALTH SERVICE 35 Medical Inspections 35 Screening Tests 37 Cleanliness Inspections 37 Specialist Services 37 Child Guidance Clinic 38 Dental Clinics 38 School Clinic Sessions 38 Handicapped Pupils 39 REPORT OF THE CHIEF DENTAL OFFICER 41 Staff 41 School Dental Inspections 41 Treatment 41 Equipment 42 Dental Health Education 42 Post Graduate Refresher Courses 43 Priority Dental Service 43 HEALTH EDUCATION 48 DOMESTIC HELP SERVICE 49 Home Help Service 49 Night Attendant Service 49 Good Neighbour Service 50 CHIROPODY SERVICE 51 OCCUPATIONAL HEALTH SERVICE 53 SOCIAL SERVICES 54 SERVICES FOR HANDICAPPED PERSONS 54 (i) Physically Handicapped 54 Number on Register 55 Adaptations to Homes 56 Purpose-Built Dwellings 56 Adaptations to Houses for Home Dialysis Machines 56 Occupation Centre for the Physically Handicapped 56 ii Page Holidays 56 Residential Care for the Physically Handicapped 57 Special Aids 57 (ii) Blind and Partially Sighted 58 (a) Blind 58 Number on Register 58 Employment 58 Handicraft Classes 59 Holidays 59 Residential Accommodation 59 (b) Partially Sighted 60 (iii) Deaf and Hard of Hearing 60 Number on Register 61 Social Clubs 61 Social Work 61 Occupational Facilities 61 (iv) Mentally Handicapped 61 Number of Patients under care of Authority 65 The Belford Centre 66 The Havering Centre 66 The Special Care Unit 66 Residential Care 66 Holidays 66 SERVICES FOR THE ELDERLY 62 Luncheon Centres 62 Meals-on-Wheels 62 Day Centres 62 Elderly People's Workshop 62 Entertainments 62 Holidays 62 Outings 63 Special Housing for the Elderly 63 Residential Accommodation 63 Old People's Clubs 64 iii Page MENTAL HEALTH SERVICE 64 Case Work 64 Hospital Admissions 64 Hostel Accommodation 64 Day Centre 65 HOMELESS FAMILIES 66 Reception Centre 67 ENVIRONMENTAL HEALTH 68 STAFF 68 FOOD HYGIENE 69 Food & Drugs Administration 69 Bacteriological Milk Sampling 70 Brucella Abortis 71 Ice Cream Sampling 71 Other Food Sampling 71 Imported Food Regulations, 1968 72 Soft Drinks (Amendment) Regulations, 1970 72 Labelling of Food Regulations, 1970 72 Essex County Council Act, 1952—Section 103 73 Poultry Processing Plants 73 Pharmacy & Poisons Act, 1933 73 Milk Distributors 74 Milk (Special Designation) Regulations, 1963 74 Night Cafes 74 Late Night Refreshment Houses Act, 1969 74 Game Act, 1831 75 Food & Drugs Act, 1955—Section 16 75 Food Hygiene (General) Regulations, 1960 75 Unsound Food 76 Slaughter of Animals Act, 1958 76 Meat Inspection—Meat Inspection Regulations, 77 1 Diseases of Animals Act, 1950 79 SANITARY CIRCUMSTANCES 79 Enforcement Proceedings 81 Refuse Disposal 81 Radioactive Substances Act, 1960 82 iv Page Rivers, Streams & Watercourses 82 Water Supply 83 Rainfall 84 Sewerage & Sewage Disposal 85 Streets made up and taken over 86 Gypsy Caravan Site 86 HOUSING SERVICES 88 New Houses 88 Local Authority Housing Accommodation 89 Housing Priority on Medical Grounds 89 Improvement Grants 89 Qualification Certificates 91 Certificates of Disrepair 91 Housing Act, 1957—Sections 17 & 18 91 Building Control 92 Land Charges Act, 1925 92 Clean Air Act, 1956 92 Investigation of Atmospheric Pollution 92 Chimney Heights 93 Conversion to Natural Gas 93 SHOPS ACTS 94 OFFICES, SHOPS & RAILWAY PREMISES ACT, 1963 96 Registration and General Inspections 96 Summary of Infringements 97 Accidents—Analysed by Workplace 98 Analysis of Reported Accidents 98 Notification of Accidents 99 Consumer Protection Act, 1961 99 Prosecutions 101 MISCELLANEOUS 102 Noise Abatement 102 Civic Amenities Act, 1967 102 Rag Flock & other Filling Materials Act, 1951 102 Pet Animals Act, 1951 102 Riding Establishments Act, 1964 102 Animal Boarding Establishments Act, 1963 103 v Page Performing Animals (Regulation) Act 1925 103 Paddling Pools 103 Swimming Pools 103 Establishments for Massage or Special Treatment 103 Employment Agencies 104 Theatrical Employees Registration Acts 1925-1928 104 Scrap Metal Dealers Act 104 Hairdressers and Barbers 104 Cemeteries 104 Crematorium 105 Mortuary 105 Common Lodging Houses 105 Disinfection & Disinfestation 105 Pest Control 105 Factories Act, 1961 106 vi Telephone: Hornchurch 52555 Health Department. Billet Lane, Hornchurch. To: The Mayor, Aldermen and Councillors of the London Borough of Havering. Mr. Mayor, Ladies and Gentlemen, I present my report on the work of the health and welfare department of the Borough for the year 1970. Re-organisations and Reports: This report covers the last year of the combined health and welfare department of the Council. The new social services department takes over responsibility for the welfare, mental health, home help, day nurseries and ex-Children's Department services on April 1st 1971, while the control of infectious diseases community maternity, and health visiting, nursing, child and school health, and the various environmental health services continues in the separate health department. In 1974 there will be still further changes as a result of unification of the National Health Service, with the personal health services joining up with general practice and hospital services, leaving the environmental services with local government. All these changes, with many details still to be decided, are having a depressing effect upon morale, and causing very serious recruitment problems. The prevention of disease, relief of disability, control of the environment and provision of community medical and nursing services are too important to be allowed to languish in uncertainty. Further detailed reports and discussions are promised, and although these may confirm what has frequently been stated, that community and preventive medicine will receive greater emphasis in the future than in the past, uncertainties and anxieties will persist until the future pattern is clarified. Health of the Borough in 1970: For the fourth year in succession no woman died in 1 birth or in association with pregnancy. The infant mortality rate was below the average for the rest of the country for the second year in succession, although sudden unexplained deaths in the first year of life still give cause for concern. An investigation into the epidemiology of infant deaths between the ages of one month and twelve months, covering the three years 1967 to 1969 was undertaken during 1970 and a report published. The largest single cause of deaths in adults was again disease of the heart and blood vessels. The best way for an individual to avoid these conditions is to be a non-smoker, keep slim, and take regular exercise. The next greatest cause of death was lung cancer and bronchitis; also closely associated with the smoking of cigarettes. Our community would be fitter, healthier and longer lived if larger numbers could be persuaded to give up smoking. The only other way for this toll of illness and death to be reduced would be the development of a safe cigarette; and there is not the slightest sign of this happening. National figures show that increasing numbers of men are giving up smoking, particularly the professional and managerial groups, but the number of women smokers continues to increase. The cigarette advertisers are aware of these findings and currently seem to be concentrating their publicity on young women. This must be countered. Apart from all other harm the damage caused by cigarette smoking to the unborn child is now well documented and must be made more widely known. Immunisation and Vaccination: Over 90% of infants received their primary protection against diphtheria, poliomyelitis and tetanus; whooping cough protection levels were nearly as high; but less than 50% of young children were immunised against measles. Measles causes a lot of misery and carries a definite risk of serious complications. If protection rates of 75% of the susceptible population of children could be achieved the disease would be eradicated. Immunisation against rubella (German measles) was introduced during the year. This is available to girls between the ages 2 of 11 and 14 with the intention of preventing the damage to the unborn child which can result if a pregnant woman sustains the disease. By the end of the year seven hundred girls had been immunised, mainly at sessions held in their schools. I would like to express my thanks to the Head Teachers who have been most helpful in making arrangements for these and other immunisation sessions. Maternity Services: Eighty-five per cent of the year's births took place in hospital. The steady rise in the proportion of hospital births has been made possible by a sizeable increase in the number of beds available, and by early discharge home of the majority of mothers and children into the care of the domiciliary midwife. The development of general practitioner maternity units, where mothers are attended by the family doctor and the domiciliary midwife, at Rush Green and Harold Wood hospitals has also helped to change the pattern of work of the community midwife, and made close integration of her work with that of the hospital and general practitioner even more essential. The total number of midwives required for community work is steadily declining and it may be that increased opportunities will develop for the employment of part-time midwives, dealing only with ante and post natal care. District Nursing: By contrast the demand for general nursing of patients in their own homes continued to rapidly increase. As district nurses' work becomes more closely linked to general medical practice, either by attachment or liaison, the amount of "acute" or short term nursing increases in addition to the "chronic" or long term nursing of elderly or permanently disabled people. Another factor leading to the increased demand is the pressure to discharge patients from hospital as soon as possible after admission so that others on the waiting list can be dealt with. As 1970 went on it became quite clear that current numbers of staff could not deal with the demand and that an increase in the number of nurses was essential. HANDICAPPED CHILDREN: 1970 showed an upsurge in national interest and conscience with respect to the handicapped, with a continuation of the welcome change from hiding away the disabled to helping them 3 to take their full part in society. The impending absorption of schools for the mentally handicapped into Education Departments, to form another type of special school, is to be welcomed as part of this process, but it is also hoped that these schools will continue to receive the special attention they deserve. Current preventive procedures such as Guthrie screening, rubella immunisation, improvements in childbirth, the decline of infectious diseases, will cause some reduction in the numbers of persons born with a handicap, but it is extremely unlikely that total prevention will ever be possible. Those individuals who happen by chance to be born with or develop a handicap must be fully recognised and accepted as just as much a part of our community as any non-handicapped person. Health Education: Despite shortage of staff and other resources the total amount of health education in our schools was greater than ever before. A dental hygiene programme organised during the year was especially successful, as everyone of the 85 primary schools in the Borough, and nearly all nurseries and playgroups took part. Lists of the health education material available from my department were re-circulated to schools and the films, slides, flannelgraphs, etc. were in very full use throughout the year. Pollution: The body of the report details the regular checks on the environments, including water, air, food, housing, etc. for pollutants of all types, and the investigation of many complaints; all of which are a routine part of the protection of the health of the community. The enormous upsurge in public interest in this matter is very much to be welcomed, as the vigilance of an informed population is required, as well as the work of the professionals, who have tended to be denigrated and ignored in the past. Next Year: The tasks of the coming year are firstly to maintain the co-ordination of health with social services over the time of change, secondly to develop current and new ways of protecting the health of the community, and thirdly to prepare for unification 4 with the other branches of the health service under the new Area Health Boards. With the continued interest and support of my Committee and Council these aims can be achieved, and the resulting services co-ordinated throughout the field of statutory and voluntary service. On these developments depends the further evolution of a healthy and happy community. My thanks are due to the Chairman and Members of the Social Services Committee, to all members of the Council, to my colleagues in other departments for their co-operation, and to the staff of the Health and Welfare Department for their support throughout the year. I am, Mr. Mayor, Ladies and Gentlemen, F. GROARKE. Medical Officer of Health. 5 SOCIAL SERVICES COMMITTEE as at 31st December, 1970 His Worship the Mayor Alderman A.T.James, J.P. (ex-officio) Chairman Councillor F.J. Orrin Vice-Chairman Councillor Mrs. J. Frost Alderman J.F.Moultrie, J.P. (ex-officio) Councillor G.W. Bunch Councillor N.J. Miles Councillor F.A.J. Morley Councillor Mrs. A.L. Sharp Councillor C.J. Sherman Councillor J.A. Smith Councillor M.J. Ward Councillor R.J. Whiting Councillor Mrs. W.L. Whittingham 6 HEALTH AND WELFARE DEPARTMENT STAFF as at December, 1970 Medical Officer of Health F.L. GROARKE, M.B., L.M., D.C.H., D.P.H. Deputy Medical Officer of Health F.W. MURPHY, M.B., Ch.B., D.P.H., D.T.M. & H. Principal Medical Officer PAMELA AIHIE, M.B., B.S., M.R.C.S., L.R.C.P., D.P.H. Departmental Medical Officers JULIE C. ALLARDICE, M.B., Ch.B. H.C. GUPTA, M.B., B.S., D.P.H. L.J. MARSHALL, M.B., B.S., L.M.S.S.A. INDU NAGPAUL, M.B., B.S. NERGESH SURTI, M.B., B.S., D.C.H. JEAN M. WARE, M.B., B.S. MAIR E. WILLIAMS, M.R.C.S., L.R.C.P. Chief Dental Officer E.B. HODGSON, B.D.S., D.D.P.H. Dental Officers K.N.A. JOHNSON, L.D.S., R.C.S. Mrs. O. SAUNDERS, D.D.S. R.F. SAWLE, B.D.S. K. WRIGHT. L.D.S., R.C.S., B.D.S. 2 SESSIONAL DENTAL OFFICERS 7 FULL-TIME DENTAL SURGERY ASSISTANTS 2 PART-TIME DENTAL SURGERY ASSISTANTS Administrative Officer J.F.J. THOMAS, MR. S.H. Deputy Administrative Officer E.W. GOWERS, A.R.S.H. 7 Principal Administrative Assistants J.E. BLAY L.A. CROFT P. HANSEN E.E. LAMB Environmental Health Welfare and Mental Health Management Personal Health 17 Administrative Assistants 53 F/T Clerical Assistants and 2 F/T Telephonists 1 P/T Telephonist 11 P/T Clerical Assistants 6 F/T Shorthand/Audio Typists 1 P/T Shorthand/Audio Typist Chief Public Health Inspector M.F. RANDALL, M.R.S.H., M.A.P.H.I. Deputy Chief Public Health Inspector W. HODSON, F.R.S.H., M.A.P.H.I. 3 Senior Public Health Inspectors 11 Public Health Inspectors 2 Meat Inspectors 1 Senior and 2 Shops & Offices Inspectors 3 Student Public Health Inspectors 3 Pest Control Officers/General Assistants Chief Nursing Officer MISS G.P. THORNHILL, S.R.N., S.C.M., H.V. Superintendent Health Visitor MISS A. CATTLE, S.R.N., S.C.M., H.V. 3 Group Advisor Health Visitors 18 F/T Health Visitors 9 P/T Health Visitors 1 F/T Tuberculosis Visitor 1 P/T Tuberculosis Visitor 2 F/T Clinic Nurses and 17 P/T Clinic Nurses 4 Student Health Visitors 4 Day Nursery Matrons 4 Day Nursery Deputy Matrons 4 Day Nursery Wardens 21 Nursery Nurses and Assistants 11 Student Nursery Nurses 8 Non-Medical Supervisor of Midwives and Superintendent of Home Nurses MISS D.D.K. MARTIN, S.R.N., S.C.M. 24 F/T Midwives 3 P/T Midwives 31 F/T District Nurses and 1 District Nurse/Midwife 5 P/T District Nurses 3 F/T Nursing Auxiliaries Senior Domestic Help Organiser MRS. B. BIGNELL 4 Domestic Help Organisers 381 P/T Domestic Helps Chief Chiropodist L. BOLLAND, M.Ch.S., S.R.Ch. 8 Senior Chiropodists 4 Sessional Chiropodists Senior Speech Therapist MRS. K. HILTON, L.C.S.T. 2 Speech Therapists 1 Sessional Speech Therapist Principal Welfare Officer MISSK.M. WELLS, A.I.M.S.W. Deputy Principal Welfare Officer MISS E.M. TURNER-SMITH, A.I.M.S.W. Senior Psychiatric Social Worker J. COOKE, A.A.P.S.W. Senior Mental Welfare Officer F.G. DEAR 9 Senior Social Welfare Officers MRS. E.M. DICK, Dip. A.S.S. MISS M. GOWER, A.I.M.S.W. 4 Mental Welfare Officers 13 F/T Social Workers, 3 P/T Social Workers 2 Welfare Assistants 3 Trainee Social Workers 1 Organiser, Workshop for the Elderly Child Guidance Clinic 1 Psychiatric Social Worker 2 Trainee Psychiatric Social Workers Old People's Homes 5 Superintendents 5 Matrons 1 Assistant Superintendent 5 Assistant Matrons 80 Attendants 64 Kitchen, Domestic & Gardening Staff Luncheon Centres for the Elderly 9 Supervisors 13 Kitchen Assistants, etc. 1 P/T Handyman Mawney Pensioners Day Centre 1 Warden and 2 Deputy Wardens Havering Adult Training Centre 1 Supervisor 4 Senior Assistant Instructors 8 Assistant Instructors 2 Temporary Assistant Instructors 1 Driver/ Assistant 1 Clerical Assistant 7 Kitchen, Cleaning and Caretaking staff 4 Coach Guides 10 Belford Junior Training Centre 1 Supervisor 1 Senior Teacher 6 Assistant Supervisors/Supervisor Teachers 1 Temporary Assistant Supervisor 2 Trainees 1 P/T Clerical Assistant 1 Welfare Assistant 6 Kitchen, Cleaning and Caretaking staff 3 Coach Guides Special Care Unit 1 Supervisor 1 Assistant Supervisor 2 General Duty Assistants 1 P/T General Duty Assistants 1 Female Driver/Assistant 1 P/T Driver 3 Coach Guides 1 P/T Cleaner and 1 P/T Meal Attendant Faringdon Centre for the Physically Handicapped 1 Supervisor 1 Assistant Supervisor 4 Senior Instructors 1 Clerical Assistant 2 Motor Drivers 1 Kitchen Assistant and 1 Cleaner Harold Wood Hall Day Centre for the Mentally III 1 Supervisor 1 Driver/Assistant Instructor 1 Meal Assistant Westmarsh Lodge Hostel for Mentally Handicapped 1 Resident Warden 1 Deputy Resident Warden 1 Resident Assistant Warden 3 Non-Resident Assistant Wardens 8 Kitchen and Domestic staff 11 Collier Lodge Hostel for Persons Recovering from Mental Illness 1 Resident Warden 1 Resident Assistant Warden 1 Temporary Resident Assistant Warden 1 Non-Resident Assistant Warden 7 Kitchen and Domestic staff Health Centre, Clinics and Billet Lane Offices 48 Caretaking, Cleaning and Kitchen staff Public and Agricultural Analysts J. HUBERT HAMENCE, PHD. M.Sc., F.R.I.C. P.S. HALL, B.Sc., F.R.I.C. REGIONAL HOSPITAL BOARD STAFF Consultant Psychiatrist J.E. VINCENZI, M.R.C.S., L.R.C.P., D.P.M. Chest Physicians E. STEEL, M.D., M.R.C.P. E. WOOLF, M.R.C.S., L.R.C.P. (Harold Hill Area) OPHTHALMOLOGISTS P. DAS GUPTA, M.B., B.S. P. LANCER, M.R.C.S., L.R.C.P., M.B., B.S. D.J.F. NICOL, M.B., B.S., D.O. 12 GENERAL STATISTICS Area in Acres 29,650 Population (Registrar-General's Estimate for Mid 1970 252,130 Number of dwellings as at 31.12.70 80,853 Rateable value as at 31.12.70 £13,018,322 Estimated product of a Penny Rate £52,350 Although the natural increase in population (3,738 births less 2,126 deaths) gives a net figure of 1,612, the Registrar General's estimate of 252,130 shows a decrease of 730 compared with 1969. Thus Havering is one of the 30 London Boroughs whose population decreased. In fact, the remaining two Boroughs (Croydon and Sutton) only showed an increase of 50 persons each and the population of the Greater London area fell by 91,130. The birth rate now 14.2 per thousand of the population, continued the slight but steady decline shown each year since 1965. Extracts from Vital Stati stics for the Year (Figures for 1969 are given in parenthesis) Live Births Male Female Total Legitimate 1858 1689 3547 (3691) Illegitimate 104 87 191 (207) Total 1962 1776 3738 (3898) Birth Rate per 1000 population 13.6 (14.2) Illegitimate live births (percentage of total live births) (5.1%) (5.3%) Still Births Legitimate 10 15 25 (46) Illegitimate 3 1 4 (2) Total 13 16 29 (48) Total live and still births 3767 (4125) Still birth rate (per 1000 live and still births) 7.7 (12.2). 13  Male Female Total Infant Deaths (under 1 year) Legitimate 30 28 58 (63) Illegitimate 3 - 3 (1) Total 33 28 61 (64) Infant Mortality Rates— Total infant deaths per 1000 total live births 16.3 (16.4) Legitimate infants per 1000 legitimate live births 16.4 (17.3) Illegitimate infants per 1000 illegitimate live births 15.7 (4.8) Neo Natal Mortality Rate (Deaths under 4 weeks of age per 1000 live births) 10.7 (10.5) Early Neo Natal Mortality Rate (Deaths under one week of age per 1000 8.5 (10.0) total live births) Perinatal Mortality Rate (Still births and deaths under one week of age combined per 1000 live and still births) 16.2 (22.0) Maternal Mortality (including abortion) Number of deaths 0 (0) Rate per 1000 live and still births — (—) Deaths Male Female Total 1121 1005 2126 (2186) Death rate per 1000 population 11.2 (11.5) Comparison of the above rates with those of England and Wales is shown on the following table:- Havering England & Wales Outer London Greater London Birth Rate 13.6 16.0 14.3 14.1 Illegitimate Live Births (percentage of total live births) 5.1 8.0 8.3 11.3 Still Birth Rate 7.7 13.0 11.9 12.0 Infant Mortality rate 16.3 18.0 16.3 17.8 Neo Natal Mortality rate 10.7 12.0 11.6 12.3 Early Neo Natal Mortality rate 8.5 11.0 10.0 10.7 Perinatal Mortality rate 16.2 23.0 21.8 22.6 Maternal Mortality rate 0.0 0.18 0. 12 0.17 Death Rate 11.2 11.7 11.1 11.4 14 CAUSES OF DEATH AT DIFFERENT PERIODS OF LIFE DURING 1970 CAUSE OF DEATH ALL AGES under weeks 4 weeks &. under 1 year AGE IN YEARS Total Male Female 1-4 5-14 15-24 25-34 35-44 4 5-54 55-64 fi5-74 75 & over Cholera - - - - - - - - - - - - - - Typhoid Fever - - - - - - - - - - - - - - Bacillary Dysentery and Amoebiasis - - - - - - - - - - - - - - Enteritis and other Diarrhoeal Diseases 4 3 1 2 1 1 - - - - - - - - Tuberculosis of Respiratory system 2 2 - - - - - - - - - - 2 - Other Tuberculosis Incl. late effects - - - - - - - - - - - - - - Plague - - - - - - - - - - - - - - Diphtheria - - - - - - - - - - - - - - Whooping Cough - - - - - - - - - - - - - - Streptoccal Sore Throat & Scarlet Fever - - - - - - - - - - - - - - Meningococcal Infection - - - - - - - - - - - - - - Acute Poliomyelitis - - - - - - - - - - - - - - Smallpox - - - - - - - - - - - - - - Measles - - - - - - - - - - - - - - Typhus and other Rickettaioses - - - - - - - - - - - - - - Malaria - - - - - - - - - - - - - - Syphilis and its Sequelae - - - - - - - - - - - - - - Other Infective and Parssltic Diseases 3 3 - - - - - - - - - 1 1 1 Malignant Neoplasm, Buccal Cavity, etc. 5 3 2 - - - - - - - - - 2 3 Malignant Neoplasm, Oesophagus 11 7 4 - - - - - - - 2 5 2 2 Malignant Neoplasm, Stomach 57 36 21 - - - - - - 1 4 15 18 19 Malignant Neoplasm, Intestine 77 33 44 - - - - 1 1 2 7 16 15 35 Malignant Neoplasm, Larynx 4 3 1 - - - - - - - 1 1 1 1 Malignant Neoplasm, Lung, Bronchus 130 111 19 - - - - - - 1 12 38 47 32 Malignant Neoplasm, Breast 43 2 42 - - - - - 5 13 9 12 4 Malignant Neoplasm, Uterus 7 - 7 - - - - - - - 3 2 2 - Malignant Neoplasm, Prostate 16 16 - - - - - - - - 1 1 5 9 Leukemia 13 10 3 - - - - 2 1 - 2 - 5 3 Other Malignant Neoplasms 149 75 74 - - 1 3 2 4 7 24 39 36 33 Benign and unspecified Neoplasms 10 5 5 - - - - - - - - 4 3 2 Diabetes Mellitus 17 9 8 - - - - - - - 1 1 4 11 Avitaminosea and other Nutritional Deficiency - - - - - - - - - - - - - v Other Endocrine, etc. diseases 4 1 3 - - - 2 - - - - 1 - 1 Anaemias 8 2 6 - - - - - - - - - - - 15 CAUSES OF DEATH AT DIFFERENT PERIODS OF LIFE DURING 1970 Contd. Other diseases of blood, etc. 12 - 2 - - - - - 1 - - - 1 - Mental disorders 16 5 11 - - - 1 - - - - - 1 14 Meningitis 1 1 - - 1 - - - - - - - - - Multiple Sclerosis 1 - 1 - - - - - - - - - 1 - Other diseases of Nervous system, etc. 35 20 15 - - 1 - 5 1 2 1 2 7 16 Active Rheumatic Fever - - - - - - - - - - - - - - Chronic Rheumatic Heart Disease 36 14 22 - - - - - - 1 8 6 8 13 Hypertensive Disease 35 14 11 - - - - - - - 2 7 4 12 Ischaemic Heart Disease 494 308 186 - - - - - 2 12 47 99 158 186 Other forms of Heart Disease 62 25 37 - 1 - - - 1 - 1 7 9 43 Cerebrovascular Disease 254 94 160 - - - - - 1 10 30 71 142 Other Diseases of Circulatory system 93 35 48 - - - - - - 1 2 9 18 53 Influenza 17 11 6 - - - - - - - 2 4 6 5 Pneumonia 190 83 107 1 7 - - 1 — 2 3 12 45 119 Bronchitis and Emphysema 107 79 28 - 2 - - - - - 8 23 32 42 Asthma 4 1 3 - - - - 1 - - 2 - 1 - Other Diseases of Respiratory System 11 8 3 - 4 - - - - - 1 - 3 3 Peptic Ulcer 13 6 7 1 - - - - - - - - 5 7 Appendicitis - - - - - - - - - - - - - - Intestinal Obstruction and Hemia 4 2 2 1 - - - - - - - - - 3 Cirrhosis of Liver 2 - 2 - - - - - - - - - 1 1 Other Diseases of Digestic system 24 8 16 - - 1 1 1 1 - 1 4 6 9 Nephritis and Nephrosis 6 4 2 - - - - - - - - 4 1 1 Hyperplasia of Prostate 1 1 - - - - - - - - - - - 1 Other Diseases, Genito-Urinary system 14 5 9 - - - - - 1 - - - 5 8 Diseases of Skin, Subcutaneous Tissue 1 - 1 - - - - - - - - - - 1 Diseases of Musculo-Skeletal system 16 8 8 - - - - - - - ~ 4 3 8 Abortion - - - - - - - - - - - - - - Other complications of pregnancy - - - - - - - - - - - - - - Childbirth and Puerperium. Delivery without mention of complication - - - - - - - - - - - - - - Congenital Anomalies 25 13 12 11 5 1 - 1 1 1 2 1 1 1 Birth Injury, Difficult Labour, etc. 21 12 9 21 - - - - - - - - - - Other causes of Perinatal mortality 3 - 3 3 - - - - - - - - - - Symptoms and Ill-defined Conditions 9 2 7 - - - - - - - - - 1 8 Motor Vehicle Accidents 25 16 9 - - - 1 12 1 3 - 3 2 3 All other Accidents 45 18 27 - - 2 1 1 4 1 3 5 7 21 Suicide and Self-inflicted Injuries 18 7 11 - - - - 1 2 4 4 3 4 - All other External Causes 1 1 - - - - - - - - - 1 - - TOTAL. ALL CAUSES 2126 1121 1005 40 21 7 9 28 22 45 167 359 558 870 16 INFECTIOUS DISEASES The following table shows the number of cases of infectious diseases which were notified during the year- Disease Male Female Total Measles 502 475 977 Dysentery 27(8) 25(10) 52 (18) Scarlet Fever 47 54 101 Whooping Cough 58 83 141 Infective Jaundice 28 19 47 Tuberculosis: Respiratory 15 10 25 Tuberculosis: Other 4 1 5 Acute Meningitis 2 3 5 Acute Encephalitis (Post Infectious) 3 — 3 Acute Encephalitis (Infectious) 1 1 2 Food Poisoning 104(12) 131(27) 235(39) Figure's in () are confirmed cases of food poisoning and dysentery It is once again very pleasing to record the fact that there were no cases of Poliomyelitis, Anthrax, Cholera, Diphtheria, Leptospirosis, Malaria, Ophthalmia Neonatorum, Paratyphoid Fever, Plague, Relapsing Fever, Smallpox, Tetanus, Typhoid or Yellow Fever notified during the year, although there was the usual crop of holiday-makers and travellers returning from countries in which certain of these diseases were endemic and who required surveillance or investigation. There was a slight increase (28) in the number of cases of measles notified, and it might well be that the steady programme of vaccination against this disease has created a levelling out in the number of cases. A total of 977 this year and 94 7 for the previous year compare very favourably with 5,361 in 1961 and 4,239 in 1965. There was an increase of 113 cases of whooping cough— from 28 to 141, but here again this total of 141 must be read against figures in the region of 600 per annum in pre-immunisation days. 17 The only other notable increase was in the number of food poisoning notifications. These rose from 185 to 235, although in only 18 and 39 respectively of these cases was the diagnosis confirmed bacteriologically. The number of cases of scarlet fever notified dropped from 136 in 1969to 101 this year, but in view of the dubiety that exists in the medical profession about whether or not this disease in its present form should remain notifiable, this drop might well be due to lack of notifications, rather than an actual decline in the number of cases. Infective Jaundice notifications dropped by 25 — from 72 to 47. The incidence of infectious disease is decreasing due to a combination of factors, such as immunisation and vaccination programmes, increasing awareness by the public of preventive measures, better standards of housing and hygiene, national and international measures to control the spread from outbreaks and vigilance on the part of doctors who have at their disposal increasingly better facilities for the investigation and treatment of suspected and confirmed cases. The following table shows the number of specimens submitted to the Department of Pathology at Oldchurch Hospital, and once again my thanks are due to Dr. E. Atkinson, Consultant Pathologist, and his staff for their co-operation and assistance in the control of infection within the Borough. Specimens Submitted to the Pathology Department at Oldchurch Hospital Taken from Total No. of persons swabbed Total No. of swabs taken Negative Positive Shig. Sonne i Salmonella Shig. Boydii E.Coli 055 Food Handlers 47 86 78 - *8 - - Non- Food Handlers 309 383 336 13 *32 1 1 Non Food Handlers *Salmonella typhimurium 4) " bredeney 1) " emek 1) " banana 4) " tennessee 1) *Salmonella enteriditis 3) derby 1) " reading 2) " panama 15) 32 Food Handlers *Salmonella banana 1) typhimurium 2) panama 5) 8 18 A table giving the age groups of notified new cases of tuberculosis is given below. T uberculosis Age Group Male Female Respiratory Others Respiratory Others 2-14 - 1 - - 15 - 19 l - 2 - 20 - 24 - - - - 25 - 34 l - 1 - 35 - 44 2 - 2 - 45 - 54 5 1 3 - 55 - 64 2 1 1 1 65 - 74 2 1 - - 75 and over 2 - - - Age unknown - - 1 - Total 15 4 10 1 These figures show an increase of 8 respiratory cases on the previous year (25 against 17) and a decrease of two nonrespiratory cases. Although there is a slight increase this year there has been progressive decline in the number of cases notified in the last decade and it must be assumed that the programme of B.C.G. vaccination is now showing its worth. Mass Radiography During the year M.R.U. 6B provided chest X-ray facilities for the Borough by holding a regular session at the Health & Welfare Department in Billet Lane, Hornchurch, every Monday from 10.00 a.m. to 2.00 p.m. 19 In addition Mass Radiography Unit 6B of the North East Metropolitan Regional Hospital Board revisited the Borough during the year to carry out a survey which had been held every two years. The number of persons examined by the Unit at the various sessions were as follows:- Public sessions on two year Survey visit 10,271 Industrial Visits 9,120 Regular weekly sessions in Billet Lane 3,887 Total: 23,278 Information was received from Dr. Shoulman, Medical Director of the Unit, that owing to the reduction of the Mass Radiography Service, Unit 6B will be closed in 1971. Care of the Tuberculous Aftercare assistance for patients suffering from tuberculosis and contacts of cases continues to be provided by the Havering Tuberculosis Care Association who are provided with a grant for this purpose by the Council. Milk for Tuberculous Patients: One pint of milk per day is provided free of charge to patients suffering from tuberculosis when recommended by the Chest Physician. During the year 15 new patients were recommended, and a total of 85 received milk during the year. This compares with a figure of 86 patients who received milk in 1969. Medical Arrangements for Long Stay Immigrants During the year advice notes were received from various Port Health Authorities in respect of 129 immigrants who were stated to be proceeding to addresses in the Borough-an increase of 52 on the previous year. In 102 cases successful contact was made and appropriate advice given on health matters. Of the remaining 27 the majority were coming to work in one of the five local hospitals in the Borough, or were either not known or failed to arrive at the address given. 20 At the beginning of the year the Department of Health & Social Security hand-out card, printed in eight languages—Spanish, English, Italian, French, Hindi, Urdu, Bengali and Punjabi — which was issued to immigrants at the port of entry and of which supplies were made available to local authorities for distribution to any missed persons, was replaced by a Home Office leaflet produced in English, Gujerati, Hindi, Urdu, Bengali and Punjabi. This new leaflet is now of a general nature and is called "Introduction to Britain". In addition to explaining Health Services, it gives advice on such matters as housing, education, employment, entry of dependants, exchange control, elections, income tax and climate. The countries where passports were issued were as follows:- Common wealth Caribbean — 50 India — 33 Pakistan — 0 Other Asian — 18 African — 14 Other — 8 Non-Common wealth European — 6 Other — 0 Total -129 Smallpox Contacts Eleven passengers who had arrived in this country from overseas and whose destination was an address in this Borough were referred to the Department during the year for surveillance. These passengers had arrived at airports/ports in this country from areas where smallpox was said to be endemic and did not hold valid certificates of vaccination against smallpox. Seven of these were infants and vaccinafion was contra-indicated because of their age, or other health reason. 21 Venereal Diseases Returns received from the Treatment Centre at Oldchurch Hospital showed that new attendances again increased over the previous year as follows:- Venereal Diseases Total Male Female 1970 1969 1970 1969 1970 1969 (a) Syphilis 11 10 8 7 3 3 (b) Gonorrhoea 143 119 99 93 44 26 (c) Other conditions 1296 1001 834 686 462 315 TOTAL: 1450 1130 941 786 509 341 The above figures include persons attending the Centre who reside in other areas. Subtracting non-Havering residents and adding returns relating to Havering residents received from other Treatment Centres, the statistics for Havering are as follows:- 1970 1969 (a) Syphilis 10 6 (b) Gonorrhoea 79 60 (c) Other conditions 750 595 Total: 839 662 During the last five years the number of persons attending the Oldchurch Treatment Centre has doubled. In these permissive days it is probable that promiscuity has increased considerably but the attendances could also partly be due to more publicity being given to the need for a check up if risks have been taken and to the readiness of the modern generation to discuss and seek advice more readily over these matters. This is probably borne out by the fact that 347 persons who presumably had been been at risk, attended for check up but were found to require no treatment within the Centre. Whilst the number of patients has doubled in the five year period the incidence of syphilis and gonorrhoea has not increased to the same extent. In 1966 13.7% of those attending were found to be suffering from either syphilis or gonorrhoea compared with 11.8% in 1970. 22 Immunisation & Vaccination Details of the new schedule of vaccination and immunisation introduced in 1969 were included in my last Annual Report. Under this revised schedule, immunisation does not commence until the child has attained six months of age and this postpones the date by which the child is fully protected. It is, therefore, necessary to refer to children born in 1968 to obtain appropriate vaccination rates. These are as follows with the national rates given for comparative purposes:- Percentage of Children born in 1968 and vaccinated by 31.12.70 Whooping Cough Diphtheria Poliomyelitis Tetanus Measles Havering 88 93 93 93 48 England 79 81 79 Not available Not available 49% of children under 2 years of age had been vaccinated against Smallpox at 31.12.70. This compares with an equivalent figure of 35 for England. 23 PERSONAL HEALTH SERVICES SECTION No major changes occurred in the Personal Health Services section of the department during the year. The arrangement mentioned in my last report for a team of social workers and child care officers to be accommodated at the Health Centre, Harold Hill, were finalised early in 1970, enabling both health and social workers covering this part of the Borough to work in close coordination. MATERNITY SERVICES: Ante-Natal Care: The statistics relatingto this Authority's ante-natal clinics are given below. Both the number of sessions and the number of women attending continued to decline, mainly due to the higher proportion of mothers receiving ante-natal care from hospitals arid their General Practitioners and to some extent the decrease in the birth rate. Ante-natal and Post-natal Clinics Number of women attending Clinics Ante-natal Post-natal Total 747 8 756 Number of sessions Doctor Midwife Total 29 731 760 Mothercraft and Relaxation Classes: These classes continued to be well attended, 770 mothers booked for hospital confinement attending as against 776 in 1969. The number of mothers booked for home confinement however fell from 78 to 21, and this is accounted for by the fact that in the main only those women expecting their first baby attend the classes, and these are priority for hospital confinement. Midwifery: At December 1970 24 full-time and three part-time midwives were in post, a reduction of one compared with the same date in 1969. 24 In the past two or three years there have been considerable changes in the provision of maternity beds in hospitals. As reported last year, the opening of the new maternity unit at Rush Green Hospital in 1968 was followed by the opening of general practitioner unit at the same hospital in 1969. 1970 saw the opening of the maternity unit at Harold Wood Hospital, and subsequently a general practitioner unit at that hospital. The situation with regard to maternity beds has, therefore, greatly improved, and Havering mothers no loneer have to seek beds in hospitals some distancefrom the Borough. The percentage of hospital births again increased, the figure for 1970 being 85.0, an increase of 6.5 over the previous year. Domiciliary confinements decreased from 850 in 1969 to 558 in 1970. The number of patients delivered in hospital and discharged before the 10th day increased from 2,315 to 3,115, and included in the figure of 3,115 were 1,048 patients discharged to the care of domiciliary midwives within 48 hours of confinement. In 1969 the number of patients discharged within 48 hours was 1,516. The domiciliary midwife is thus attending fewer and fewer confinements at home, but is now able to undertake deliveries in the general practitioner units. This enables a mother to have her confinement under the best conditions with help nearby in case of emergency, yet attended by the same midwife, who would have attended her if the confinement had taken place at home. During the year 18 pupil midwives undertook their thirteen weeks' district training on attachment to domiciliary midwives. In addition, during the course of the year 24 students undertaking obstetric training at Rush Green Hospital spent a day with a domiciliary midwife, accompanying her on her visits, and also attending a general practitioner's ante-natal clinic. Dental Treatment for Expectant and Nursing Mothers: Details of the service provided for expectant and nursing mothers are included in the report of the Chief Dental Officer on page 42. Unmarried Mothers: 44 unmarried mothers received help from the outdoor worker of the Chelmsford Diocesan Moral Welfare Association during the year, and of these 19 were admitted to Mother and Baby Homes. 25 Family Planning: Details of the family planning services provided by the Council at four clinics within the Borough, and the family planning service at the clinic in Romford were set out in my report for 1969. The service was extended during the year, by the Family Planning Association, establishing a weekly evening clinic at this Council's South Hornchurch Clinic. Cervical Cytology: This service is provided at six clinics, and also by hospital out-patient departments, family doctors and the Family Planning Association doctors. The total number of smears taken from residents of Havering was approximately 8,000, and of these 2,217 were taken at the Local Authority clinics. Premature Births: 237 premature births were notified during the year which compares with 243 in the previous year, and both figures represent 6.2% of the total notified live births in their respective years. CHILD HEALTH SERVICES Congenital Malformations: Details of congenital malformations observed at birth are required to be reported by the midwife on the notice giving notification of the birth. Particulars of each are forwarded to the Registrar General who has an early warning system to notify Medical Officers of Health of any untoward rise in the number of notifications. During 1970, 89 babies were reported as suffering from congenital malformations, 103 different conditions being observed as set out in the following table:- 26 CLINIC SERVICES - 1970 MAIN CLINICS GENERAL CLINIC SERVICES SCHOOL HEALTH SERVICES Midwives Clinic Antenatal Relaxation Classes Family Planning Cervical Cytology Child Health Immunisation and Vaccination Chiropody Dental Medical Consultation and minor ailments Speech Therapy Ophthalmic Orthoptic Orthopaedic Physiotherapy Collier Row Clinic Hulse Avenue Clinic √ √ √ √ √ √ √ √ Cranham Clinic Avon Road, Cranham √ √ √ √ √ √ √ √ √ √ Elm Park Clinic Abbs Cross Lane, Elm Park √ √ √ √ √ √ √ √ √ √ √ √ Harold Wood Clinic Gubbins Lane, Harold Wood √ √ √ √ √ √ √ √ √ √ √ √ Harold Hill Health Centre Gooshays Drive, Harold Hill √ √ √ √ √ √ √ √ √ Hornchurch Clinic Westland Avenue, Hornchurch √ √ √ √ √ √ √ √ √ √ √ Rainham Clinic Upminster Road, Rainham √ √ √ √ √ √ √ √ √ Romford Clinic Marks Road, Romford √ √ √ √ √ √ √ √ √ √ √ √ South Hornchurch Clinic South End Road, Rainham √ √ √ √ √ √ √ √ √ √ √ √ √ Upminster Clinic St.Mary's Lane,Upminster √ √ √ √ √ √ √ √ √ √ √ √ SUB-CLINICS Hilldene School Clinic Grange Road. Romford √ Heat on Way Congregational Church Chaucer Road, Romford √ √ Mardyke Social Centre Lowen Road, Rainham √ √ Congregational Church Nelmes Road, Hornchurch √ √ Park Lane Social Centre Park Lane, Hornchurch √ √ √ St. Augustine' s Church Birkbeck Road, Rush Green √ √ St.Michael's Church Main Road. Gidea Park √ √ Tweed Way Hall Tweed Way, Rise Park √ √ 27 Malformation Diagnostic Group No. reported 0 Central Nervous System 18 1 Eye and Ear 5 2 Alimentary System 13 3 Heart and Circulatory System 2 4 Respiratory System 0 5 Urino-genital system 9 6 Limbs 40 7 Other Musculo-Skeletal 4 8 Other Systems 5 9 Other Malformations 7 TOTAL:103 Phenylketonuria: The Githrie test introduced in 1969 for screening blood to detect this rare metabolic disease continued during 1970, the laboratory service being provided for this test by the Neonatal Screening Service of the Hospital for Sick Children. The test is taken on the 6th day of life. Handicapped Pre-School Children At the end of 1970, 225 handicapped pre-school children were under regular supervision by doctors, health visitors, educational psychologists, with a view to the provision of special help where necessary and assessment for the usual appropriate education Clinics:- The various services provided at the main clinics and subclinics in the Borough are charted overleaf. Clinic Doctors: Difficulties in recruitment of doctors were experienced during the year, with the result that we were generally one or two short of our establishment of eight doctors. 28 Health Visitors and Clinic Nurses The shortage of qualified health visiting staff continued during 1970. This necessitated the acceptance of a health visiting service which did not reach the standards the health visitors themselves would like to achieve. Although health visitors continue to be general advisers to families on personal health, emphasis has been placed on work in connection with the well being of the young, the elderly and the handicapped in the community. Particular attention has been paid to screening for early detection of mental and physical handicap, and the assessment of the growth and development of children throughout infancy and school life. Clinic nurses have continued to carry out duties requiring the services of trained nurses, but not necessarily the health visitors' specialised skills. This has ensured economical use of personnel. Three student health visitors successfully completed their training in the Autumn, and four were sponsored by the Borough and commenced training in September, 1970. Staff in post, where appropriate, were sent on refresher courses and opportunities were taken to send staff on short inservice and post certificate courses, study days, etc. Staff meetings are arranged regularly for health visitors and clinic nurses at which discussion and dissemination of information are incorporated. Senior staff have continued to take part as lecturers in inservice and full-time training of other groups. Good liaison and co-operation between health visitors, family doctors and social workers has been maintained. Senior health visitors have continued to make regular weekly liaison visits to Oldchurch, Harold Wood and St. George's Hospitals. This is still proving a most valuable link between the hospitals and the community services. Health visitors have undertaken as much health education as possible. More could have been done in the schools if the 29 health visiting staff could have been larger. There is a greater demand from the schools than can be met, but other demands on the health visitor's time, limit her activity in this important field. Speech Therapy There was no improvement in the staffing situation during the year and only two and a half posts from an establishment of 5 are filled. 367 children were newly referred and 214 of the more urgent cases commenced treatment. A total of 7055 treatments were carried out. At the end of the year 192 children were receiving speech therapy and a further 367 were being kept under observation. 156 children were waiting for treatment to be commenced. Day Nurseries: The four day nurseries which provide for the care of 190 children up to the age of five years had a continued average daily attendance of 159 compared with 160.3 in 1969. The demand on accommodation for children requiring admission on priority grounds continues as before, and at the end of the year 60 such priority children were waiting admission. The figures relating to the individual nurseries are given in the following table:- DAY NURSERY ATTENDANCES AND WAITING LIST Nurseries Places Average daily attendance over the year Waiting List at 31.12.70 Priority Non-Priority Elm Park 50 45.6 22 28 Romford 40 29.4 15 14 Collier Row 50 44.4 15 28 Rush Green 50 39.5 8 15 TOTAL: 190 158.9 60 85 Nurseries and Child Minders Regulation Act 1948: Premises registered during the year increased by four. Included in these premises is one provided by a factory giving 30 all day care of 24 children, two other premises providing all day care for 30 children, and 49 premises providing sessional care for 1719 children. The number of persons registered increased from 91 to 127 during the year, the number of children provided for by these persons increasing to 412. HOME NURSING: The present home nursing establishment for the Borough is equivalent to 38 full-time nurses (8 male) together with three nursing auxiliaries. The following table shows the total number of persons nursed at home and the number of nursing visits made:- HOME NURSING 1970 1969 Number of persons nursed — Under 5 years of age 22 44 Ages 5 — 64 732 753 Age 65 and over 1767 1748 Total number of persons nursed 2521 2545 Number of nursing visits made during the year 88085 82794 It will be noted that the total number of nursing visits increased by 5,291 compared with the previous year. The staff was increased during the year by three part-time nurses and a third full-time nursing auxiliary, whose duties are to undertake the bathing of patients in their home, was also appointed. The service was supplemented by a number of part-time voluntary Red Cross nurses, whose interest and assistance was appreciated. A review of the service undertaken during the year revealed that the home nursing service had absorbed as much work as is possible and that there were aspects of the service which were not being undertaken adequately. The ratio of nurse to population in Havering during the year was 1 to 6,500, whereas the Queen's Institute of District Nursing recommend a ratio of at least 1 to 5,000. Many authorities find 31 from experience that a ratio of one nurse to4,000 or even to 3,500 population is necessary. Within these ratios there should be a certain number of state enrolled nurses and in addition a number of ancillary staff who work in a supporting role to S.R.N, and S.E.N. By the appointment of ancillary staff the trained nurses are able to delegate work and thereby give priority to certain fields of activity. The trend towards nurse attachment schemes has been encouraged by the Department of Health and Social Security, and meetings were held with representatives of the National Health Service Executive Council and with the Local Medical Committee with a view to extending attachment schemes. At present four nurses are fully attached to general medical practitioner groups within the Borough and it is hoped to hasten progress in this direction during 1971when the anticipated increase in the establishment may make this possible. 32 Sick Room Equipment Details of the various items issued on loan free of charge to patients being nursed at home are as follows Article Quantity Air Rings 73 Back Rests 288 Bed Cradles 169 Bed Pans 214 Bed Pans (Rubber) 10 Bedsteads 27 Bed Tables 28 Commodes 457 Crutches 28 prs. Draw Sheets 150 Feeding Cups 45 Fireguards 8 Foam Rings 224 Fracture Boards 24 Hoists 23 Mattresses 41 Pillow Covers 9 Plastic Sheets 327 Pole and Chain Pulleys 29 Rubber Sheets - Sani-Cushions 2 Sputum Mugs 6 Female Urinals 14 Male Urinals 165 Walking Aids — Quads 18 Walking Aids — Tripods 31 Walking Frames 157 Walking Sticks 170 Wheelchairs 327 TOTAL 3064 Disposable sheets and interliners, and plastic pants are also issued free of charge for incontent patients being nursed at home. During 1970 74,300 sheets, 28,800 interliners and 519 pairs of plastic pants were issued. 33 Incontinent Laundry Service The laundry service provided by the Department collected a total of 14,319 articles from the homes of incontent patients for laundering at St. George's Hospital. Collection and delivery of the articles continues to be undertaken twice weekly. Recuperative Holidays 71 recommendations for recuperative holidays were received from general practitioners and hospitals during the year. 58 were sent to various private convalescent homes, the normal period being two weeks, and the remaining 13 did not avail themselves of the facilities offered. Nursing Homes Two private nursing homes are registered in the Borough, both of which are regularly inspected by the staff of the Health and Welfare Department. These homes provide a total of 41 beds for acute and chronic sick patients. 34 SCHOOL HEALTH SERVICE 1970 School Population:- 85 Primary School 26,437 pupils 24 Secondary School (inc. Grammar Schools) 16,402 pupils 2 Technical Schools 1,504 pupils 3 Schools for E.S.N, pupils 388 pupils TOTAL 114 schools 44,731 pupils In September 1970 Newtons Junior School was opened and Chase Cross Secondary Boys' and Girls' Schools were merged to form a single co-educational school. Medical Inspections 8164 children were given a full examination by School Medical Officers at periodic medical inspections during the year. This included examination of all new entrants to infant schools. Junior school pupils are examined on a selective basis and only those considered likely to need medical attention are given a full examination. Selection is made by the School Doctor after examination of previous medical records and information provided by parents, teachers, health visitors and school nurses. The selection procedure was also extended to further secondary leaver examinations and will eventually be adopted for the whole of this age group. 2935 pupils were found not to warrant a full medical examination following the selection procedure. As a result of the periodic medical inspections 1299pupils (15.9%) were found to have 1562 conditions requiring treatment. A further 3903 conditions detected were kept under observation. Arrangements were made for children to be referred for investigation or treatment, as necessary, in consultation with their family doctors. Defects found at periodic medical inspections included the following:- 35 Condition No. of defects found requiring:- Treatment Observation Defective vision 536 654 Squint 58 76 Defective hearing 59 306 Nose & Throat conditions 108 474 Lung conditions 24 146 Speech defects 48 105 Developmental abnormalities 100 296 Skin diseases 124 289 Psychological conditions 82 425 Orthopaedic defects 225 478 In addition to Periodic Medical Inspections, the School Doctors see a number of children by special arrangement, sometimes as a follow up of previous examinations and sometimes at the special request of parent, teacher or school nurse. 2406 follow up examinations were carried out and 1381 special examinations arranged. As a result of the special examinations 1125 conditions were found to require treatment and a further 740 kept under observation, including the following:- Condition No. ot defects found requiring:- Treatment Observation Skin conditions 551 19 Defective vision 107 161 Hearing defects 57 118 Nose & Throat conditions 22 34 Speech defects 20 4 Orthopaedic defects 65 54 Psychological conditions 101 123 36 Screening Tests Vision and hearing screening tests by school nurses are included as part of the periodic medical inspections and additional tests are carried out at about 7 to 8 years of age. Any child failing the screening test is referred to the school doctor for further investigation. The number of routine screening tests carried out during the year was as follows:- The number of routine screening tests carried out during the year was as follows:- Vision Hearing Infants 7473 7321 Juniors 9472 7102 Secondary 3053 1520 Special Schools 314 336 TOTAL 20312 16279 Cleanliness Inspections 18218 routine cleanliness inspections were carried out by the school nurses during the year. 109 cases of infestation were found but none of these was sufficiently serious to require a cleansing notice to be issued to the parent. Specialist Services The following specialist consultation and treatment services for school children are provided at the Council's clinics by arrangement with the North East Metropolitan Regional Hospital Board a) Ophthalmic Ophthalmic specialist sessions are held at 8 of the Council's clinics. During the year 3483 pupils attended, including 931 new referrals. 1031 prescriptions for glasses were issued. b) Orthoptic Orthoptic treatment sessions, providing non-surgical treatment of squint, are normally held at 2 of the Council's clinics. One orthoptist resigned at theend of February, however, and the service was restricted until December, when a replacement was appointed. 68 pupils were referred to the orthoptist and 276 treatments were carried out. 37 c) Orthopaedic Orthopaedic Specialist sessions are held at 4 of the Council's clinics. 228 pupils made 593 attendances at these sessions during the year, including 120 new referrals. d) Physiotherapy Physiotherapy is provided at 5 of the clinics, in conjunction with the orthopaedic sessions. 657 children made 1948 attendances for treatment, including 278 new referrals. Child Guidance Clinic 783 children attended the Child Guidance Clinic during the year, including 317 new referrals. At the end of the year 599 cases were under treatment and 51 were awaiting their first appointment. Dental Clinics Dental treatment is provided at 9 of the Council's clinics. 16086 children were inspected by the School Dental Officers in school and 5007 received treatment at the dental clinics. 13304 attendances were made for treatment. The report of the Chief Dental Officer appears on page 47. School Clinic Sessions Medical consultation sessions for school children are held regularly at each of the Council's clinics and at the School Clinic at Hilldene Junior School. Treatment of minor ailments is also available at these sessions. 3690 medical consultations were carried out, including 38 Attendances for treatment were as follows:- No. of Interviews Psychiatrist 2344 Psychiatric Social Worker 2312 Educational Psychologist 741 2406 follow up examinations resulting from previous special or routine medical inspections. 8214 additional attendances were dealt with by the nursing staff. Conditions treated included the following:- Skin diseases 1740 Eye diseases 97 Diseases and defects of 169 the ear, nose & throat Miscellaneous minor 441 conditions Handicapped Pupils The following schools and special units for handicapped pupils are provided by the Council:- Corbets Tey School for educationally subnormal pupils Dycorts School Haverin g Grange School'' '' '' '' Nursery Class for pre-school maladjusted children; Mead Infants School Unit for Partially Hearing Pupils; Hacton Junior School. Other children handicapped by physical disabilities, vision or hearing defects, etc. are placed a† special schools provided by neighbouring authorities or, in appropriate cases, at residential schools. Maladjusted pupils, and those suffering from epilepsy who cannot be educated satisfactorily at an ordinary school, usually attend residential schools. The peripatetic service for hearing impaired children was resumed in January 1970 when Miss J.M. John was appointed to fill one of the vacant posts of Advisory Teacher of the Partially Hearing. 119children were ascertained as handicapped pupils during the year and 133 admissions to special schools were arranged. The following table gives particulars of handicapped pupils at the end of the year:- 39 The following table gives particulars of handicapped pupils at the end of the year:- Category Total number of pupils ascertained as handicapped at end of year Number of pupils newly ascertained during the year Number of pupils admitted to special schools during the year Total number of Pupils attending special schools at end of year Day Residential Blind 4 - — — 4 Partially sighted 11 1 3 8 1 Deaf 16 1 1 14 2 Partially hearing 38 5 5 35 3 Physically Handicapped 46 6 7 32 9 Delicate 25 8 6 14 8 Maladjusted 31 10 6 - 21 Educationally Subnormal 428 87 105 387 12 Epileptic 4 - - - 4 Speech defects - - - - - Total 603 118 133 490 64 40 REPORT OF CHIEF DENTAL OFFICER 1. Staff At the end of the year only 4.5 dental staff were in post, which left 5.5 vacancies on the establishment, which could not be filled. It is disappointing that this staffing position has persisted since the formation of the Borough due to recruitment difficulties. In view of staffing difficulties a full comprehensive school inspection and treatment service for all pupils in maintained schools cannot be achieved. 2. School Dental Inspections The accompanying graph shows that the number of children receiving a dental inspection at school during the year rose to over 16,000, the highest number ever reached in this way. A further 3,800 received a first inspection at clinics, giving a coverage of forty-six per cent of the school population. Of those found to require treatment, seventy-one per cent were recorded as commencing a course of treatment at clinics, a notably high acceptance rate. Great importance is attached to the regularity of these inspections at schools, as in this way dental disease can be reduced and the dentist able to deal with trouble when it is relatively simple. Every effort is made to this end, while bringing new schools into the scheme as conditions permit. The appointment of a full-time dentist to the Elm Park clinic during the year enabled primary schools in that area to be inspected for the first time in almost four years. Treatment Evidence of the increasing standard of dental care is seen in the fact that the ratio of permanent teeth filled to each extracted has risen steadily so that in 1970 more than eleven teeth were filled for every tooth extracted. In 1965 the ratio was eight to one. Similarly for deciduous teeth the ratio reached 2.3 to 1 as against 1.7 to 1 five years ago. Orthodontics This important aspect of dental treatment for children shows a very satisfactory expansion, with 101 cases being successfully completed during the year. 63 new cases commenced and only six cases requiring to be discontinued for various 41 reasons. This low discontinued rate of only six per cent compares very favourably with that found nationally. 4. Equipment The outdated dental unit in the Health Centre was replaced during the year by a modern unit incorporating the latest improvements to increase efficiency and at the same time look less intimidating for the child patient. The last few years have seen tremendous change in the design and lay-out of dental equipment and constant appraisal is required to determine the type most suitable for the needs of children's dentistry. 5. Dental Health Education During the year it was decided to direct a dental health education programme towards the youngest and possibly one of the most impressionable age-groups, the new entrants to primary schools. A letter was sent to all Head Teachers of primary schools asking if they would like a dental health programme arranged for their new entrant classes. One hundred per cent acceptance was assured by the replies received and the project commenced in October. A member of the Health Education Section gave a short talk and demonstration on oral hygiene, interspersed with the showing of two films. The twenty minute programme ended with each child being given a dental hygiene kitconsisting of a beaker, toothbrush and toothpaste, together with a letter to parents from the Chief Dental Officer. By the end of the term, fifty-two schools had been visited and some 4,000 dental hygiene kits distributed. The visits proved to be popular with the children and the teaching staff, who on each occasion were encouraged to followup this introductory session and maintain an interest in their pupils' dental health. It was encouraging to find that the programme stimulated requests from several schools for additional showings of the films to older classes. If this early introduction to good oral hygiene habits can be continued among school beginners it is hoped that the benefit will ultimately be improved dental health in the school population as a whole. 42 6. Post-Graduate Refresher Courses It was possible to arrange for a different member of staff to attend two post-graduate courses for public dental officers during the year — one in Oxford on "Anaesthesia and Planning in Children's Dentistry", and the other in London on "Preventive Dentistry". Both were of two days duration and the reports brought back from these courses proved of considerable value and interest to the rest of the dental staff. In July, the writer was successful in obtaining the Diploma in Dental Public Health, an additional qualification instituted two years ago by the Royal College of Surgeons of England. The course leading to the examination is designed to promote and increase knowledge of community dentistry. Priority Dental Service The dental service for the under fives and expectant and nursing mothers has continued to expand and all the figures compare favourably with the national average. Of the 905 children under five years of age who were given a first inspection during the year, some forty-two per cent required treatment. An attempt to bring dental health education to this important group, in addition to that given at clinics, was made by arranging visits to playgroups in the area by a member of the Health Education Section and a dental surgery assistant. A demonstration was given based on the Oral Hygiene Service boy and girl pictures as shown before the early afternoon T V. programme for children and a short film shown. Twenty-two playgroups were visited during the year and over 1,000 children of pre-school age and many mothers who attended with them were reached in this way. 43 44 The full annual statistics for the Dental Service are given in the following tables:- TABLE Dental Inspections & Treatment of School Children Inspections (a) First inspection at school. Number of Pupils 16,086 (b) First inspection at clinic. Number of Pupils 3,812 Number of (a) 4 (b) found to require treatment 7,162 Number of (a) 4 (b) offered treatment 6,479 (c) Pupils re-inspected at school or clinic 1,297 Number of (c) found to require treatment 734 Attendance and Treatment Ages 5 to 9 Ages 10 to 14 Ages Total 15 & over First Visit 3,047 1,697 263 5,007 Subsequent Visits 4,425 3,274 598 8,297 Total Visits 7,472 4,971 861 13,304 Additional courses of treatment commenced 421 146 28 595 Fillings in permanent teeth 2,374 3,542 854 6,770 Fillings in deciduous teeth 5,500 504 - 6,004 Permanent teeth filled 1,964 2,976 792 5,732 Deciduous teeth filled 4,880 460 - 5,340 Permanent teeth extracted 65 348 88 501 Deciduous teeth extracted 1,935 633 - 2,568 General anaesthetics 547 154 11 712 Emergencies 579 194 27 800 Number of Pupils X-rayed 532 Prophylaxis 797 Teeth otherwise conserved 1,041 Number of teeth root filled 119 Inlays 1 Crowns 28 Courses of treatment completed 3,419 45 Orthodontics New cases commenced during year 63 Cases completed during year 101 Cases discontinued during year 6 Number of removable appliances fitted 103 Number of fixed appliances fitted 5 Pupils referred to Hospital Consultant 30 Dentures 5 to 9 10 to 14 15 & over Pupils supplied with full - - - Nil denture Pupils supplied with other dentures (first time) 1 2 3 Total - 1 2 3 Sessions Number of treatment sessions 2,077 Number of inspection sessions 124 TABLE Dental Service for Expectant and Nursing Mothers and Children under 5 years Children 0-4 (incl.) Expectant & Nursing Mothers First Visit 518 68 Subsequent Visits 483 98 Total Visits 1001 166 Number of Additional Courses of Treatment other than the First Course commenced during year 42 2 Treatment provided during the year Number of fillings 778 111 Teeth filled 686 110 Teeth extracted 136 42 General Anaesthetics given 58 4 Emergency visits by patients 44 15 Patients X-rayed 5 23 Patients Treated by Scaling and/or removal of stains from the teeth (Prophylaxis) 105 43 Teeth otherwise conserved 164 - Teeth root filled - 4 Crowns - 1 Number of courses of treatment completed during the year 225 47 46 TABLE Dentures Expectant and Nursing Mothers Patients supplied with full denture (First time) - Patients supplied with other dentures 3 Inspections Children 0—4 (incl.) Expectant and Nursing Mothers Number of Patients given first inspections during year A. 905 D.79 Number of Patients in A and B.379 E.67 D above whorequire treatment Number of Patients in B and E above who were offered treatment C.359 F.66 Number of Dental Officer Sessions devoted to Maternity and Child Welfare patients — For Treatment 159 47 HEALTH EDUCATION Talks on health subjects were given to many organisations in the Borough by members of the staff of the Department including Medical Officers, Health Visitors, Chiropodists, Public Health Inspectors, Social Workers and Health Education staff. The Health Visitors also gave series of talks in various schools when requested. The Health Education staff undertook a programme throughout the nursery schools and play groups, and also the infants' schools on dental hygiene. The programme for the infants' schools included the showing of two films, a demonstration of the correct method of cleaning teeth, all emphasizing the necessity to clean teeth after breakfast and last thing at night. Each child was given a dental hygiene kit consisting of a toothbrush, toothpaste and beaker with a letter to the parents from the Chief Dental Officer. A rhyme was stamped on the beaker reminding the children to clean their teeth after breakfast and last thing at night. This programme was designed to get children into the habit of cleaning their teeth regularly at an early age in the hope that having started they would continue.This project was well received and in fact every infants' and primary school in the Borough replied to the circular outlining the scheme, so that all schools were included.lt is nowthe intention to undertake this programme for the 5 year old pupils each year. Another project undertaken in schools by the Health Education staff was connected with the care of the feet. This was mainly for girls in junior schools and here again the programme was well received. Health Education material such as films, film slides, flannel graphs, etc. were also made available to all schools, youth clubs and other establishments upon request for use in connection with Health Education and allied subjects by teachers. Over 400 such items were loaned during the year and the total number of adults, school children and pre-school children who were present at talks, film shows, etc. given by staff of this Department throughout the year was over 14,000. 48 HOME HELP SERVICE There has been no change in the arrangements for the supervision of the Home Help Service which were set out in my Report for 1969. The four Home Help Organisers assess the need for the service and allocate the services of the 400 parttime helps accordingly. The co-ordination of the service within these four areas and the allied Night Attendant and Good Neighbour services are undertaken by the Senior Home Help Organiser. In-service training for groups of home helps arranged at the Havering Technical College has now been functioning regularly for a number of years. Statistics relating to the service are as follows:- Home Help Service 1970 1969 Requests for help from new cases during the year 1118 1097 Cases not eligible for assistance or not requiring services 315 335 New cases helped during the year 798 759 Persons being helped at the end of the year 2037 1791 Total number of persons helped during the year 2982 2673 Total number of hours of help provided during the year 307988 305184 The equivalent figures for the previous year are shown for comparison and it will be noted that the number of cases helped and the hours of help given were slightly higher in 1970. Night Attendant Service Only three patients were assisted by this service during the year, the total number of hours involved being 144. The demand on the service fluctuates from year toyear and, of course, a number of requests for such assistance are dealt with by the Marie Curie Memorial Fund which provides a night attendance service for patients suffering from carcinoma. During the year 36 patients were provided with night attendants by this Fund, the total number of hours being 3,056. In addition, four patients were given extra nourishment grants by the Fund, and two were admitted to Marie Curie Homes. This voluntary organisation receives a grant of £350 from Havering Council. 49 Good Neighbour Service This service, ancillary to the Home Help Service, continues to arrange for neighbours to provide assistance to patients living nearby. Limitations in the availability of the service arise where no-one living nearby is available to give attention to the patient at various times during the day. During the year 11 patients were provided with help under the scheme, and at the end of the year 10 patients were receiving assistance from good neighbours. 50 CHIROPODY SERVICE The Chief Chiropodist, Mr. L.A.Bolland, reports as follows:- Statistics relating to the service are as follows:- New Cases No. of Persons Treatec Clinic Attendance Domiciliary Treatment Treatment at Welfare Est. Pre-school children 7 7 14 - - School children 88 157 263 147 - Expectant mothers 9 10 13 - - Aged 1147 5754 21188 10613 1906 Physically Handicapped 22 48 169 183 - Others 32 63 255 12 - TOTALS 1305 6039 21902 1 10955 1906 The service suffered this year by the resignation of two part-time staff and the sudden death of one of our full-time members. This meant a loss each week of some 22 working sessions affecting mainly domiciliary visiting in Harold Hill, Central Romford and Rainham and it was only possible to attend to the Blind and Diabetic. In other parts of the Borough the domiciliary visiting is also causing some concern as it is not possible in many cases to visit more frequently than 10 — 12 weeks, which for certain patients is not satisfactory. Arrangements have been made for the commencement of a regular chiropody service at the Faringdon Centre for the Physically Handicapped. A hydraulic chair has been obtained in order obviate the necessity for the patient climbing the step which is necessary on the normal type of patient's chair as used in the clinics. As many of these patients are already on the domiciliary visiting list, their treatment at the Centre should lessen the case load for visiting chiropodists. As mentioned in my report for 1969, the new Ring Road has given difficulty to many who attend the Romford Clinic and now some patients find the entry step of the new one-man buses higher than the double-deckers and difficult to board. At present 51 there are usually both types of buses serving the clinics, but it is presumed in the future, as the new types are used mainly on the routes, some patients will be unable to get to the clinics. The whole service is now working at its limit and thought must be given in the future to extending the service either by opening extra chiropody clinics or by making the existing ones larger so that more than one chiropodist can work at the same time. 52 OCCUPATIONAL HEALTH SERVICE Details of this scheme, which provides medical screening of all prospective employees of the Council, were given in my annual report for 1969. The scheme also covers investigation of any medical matter affecting individual employees or groups of employees. Entrants to the teaching profession and candidates for admissions to teacher training colleges are also examined in accordance with the requirements laid down by the Department of Education and Science. An additional duty undertaken by this service at the commencement of 1970 was medical examination ofcouncil employees for heavy goods vehicle driving licences. Statistics relating to this service are as follows Occupational Health Service Number of questionnaires scrutinised 1876 Number selected for full examination 81 Number found unfit for employment 8 Number recommended for further review 10 Medical examinations for other authorities 12 Number of full medical examinations of teachers and prospective pupil teachers (carried out according to national requirements outside the Council scheme) 310 Number of persons screened by .chest X-ray 899 (i.e. duties in contact with children) Number of persons screened for intestinal pathogens 561 (i.e. duties concerned with preparation of food) Number of special medical examinations 120 Medical examinations for heavy goods vehicle 43 driving licences 53 SOCIAL SERVICES The effect of legislation arising from the Seebohm Report was felt in the Social Services Section with staff uncertain as to how they would be affected in the forthcoming changes. Therefore, during 1970, the pattern of social work showed little change from that set out in my previous report. The arrangement of the Social Workers in area teams became firmly established, and the number of staff involved in social work—19 full-time, 3 part-time, with 3 trainee social workers and 2 welfare assistants — showed a decrease of two, due to vacancies arising which had not been filled by the end of the year. SERVICES FOR HANDICAPPED PERSONS I. Physically Handicapped The names of 249 persons were added to the register of the physically handicapped during the year compared with 91 in 1970 and 161 in 1969. Details of those on the register are given in the following table:- Register of Physically Handicapped Persons Handicap No. of Persons on Register at 31.12.70 No. of persons whose names were added to the register during year ended 31.12.70 Deaf with Speech 36 8 Deaf without Speech 56 2 Hard of Hearing 33 1 General Classes of the Physically Handicapped 1192 238 TOTAL 1317 249 The age groups of persons on the register, together with an analysis of those in the general classes are set out in the table on the next page. The total number, 1317, shows an increase of 146 over the previous year, the largest increases being those registered under Arthritis and Rheumatism (increase of 79) and organic nervous diseases (increase of 45). 54 Handicaps and Ages of Persons on Registers of Physically Handicapped 31st December. 1970 Handicap under 16 16-29 30-49 50-64 65+ Total Deaf with Speech 2 9 13 2 10 36 Deaf without Speech 2 12 22 16 4 56 Hard of Hearing 1 5 2 3 22 33 General Classes (1) Amputation - - 4 15 20 39 (2) Arthritis or Rheumatism - 4 20 88 343 455 (3) Congenital Malformation or Deformity 3 1 2 2 1 9 (4) Diseases of Digestive and genito-urinary systems, of the heart or circulatory system (other than Tuberculosis of the skin) - 6 6 39 109 160 (5) Injuries of the head, face, neck, thorax, abdomen, pel\ or trunk. Injuries or disease (other than Tuberculosis) o: the upper and lower limbs and of the spine. /is ?s 10 15 18 30 60 133 (6) Organic nervous diseases epilepsy, disseminated sclerosis, poliomyelitis, hemiplegia, sciatica, etc. 13 56 95 100 89 353 (7) Neurosis, psychosis, and other nervous and mental diseases not included in 6 1 2 2 5 6 16 (8) Tuberculosis (Respiratory) - 1 1 1 3 (9) Tuberculosis (Non-respirat ory) - 1 1 - 3 5 (10) Diseases and injuries not specified above 4 - 2 8 5 19 TOTALS 36 Ill 188 309 673 1317 55 Adaptations to Homes 68 adaptations were carried out at the homes of physically handicapped persons during the year. Many of these consisted of handrails in toilets, bathrooms, staircases, etc., fitting of ramps and widening of doors for wheelchairs, etc., but in some instances fairly large adaptations were provided to meet a particular need. Purpose-Built Dwellings By the beginning of 1970 the number of purpose built dwellings designed by the Borough Council for physically handicapped persons had increased to ten, and one further dwelling was completed during the year. Three further dwellings were in the final planning stage at the end of the year. Adaptations to Houses for Home Dialysis Machines Five home dialysis machines had been installed in houses in the Borough prior to 1970, and four further patients had been referred to this department. Of the four, two had had machines installed with financial assistance from the Council, and one without assistance. The fourth patient died before arrangements were put in hand. One further patient was referred during the year and arrangements in this case were still being finalised at the end of 1970. Close co-operation is required in all cases between the hospital dialysis unit, the Borough Architect and the officers in the health and welfare department as alterations necessary can, in some instances, be extensive. Occupation Centre for the Physically Handicapped The Faringdon Occupational Centre continued to function to the full capacity of 60 places throughout the year. Patients transported by the special ambulance vehicle attend twice weekly whilst others with their own transport attend daily. The number of persons on the register was approximately 180 throughout the year. Holidays A total of 131 physically handicapped persons were provided with holidays during 1970. The majority were catered for at Bognor (47) or Caister (27), the remainder being arranged through various voluntary organisations, or in some instances, aided by the Council financially when they had made private arrangements. 56 Residential Care for the Physically Handicapped At the end of the year 16 physically handicapped persons were accommodated in residential accommodation provided by the Council, and in addition, 21 others were resident in accommodation provided by voluntary organisations, the Council being financially responsible for the cost of maintenance. Special Aids The following special aids were issued on loan by the department to assist physically handicapped persons in their own homes Special Aids Issued on Loan from January to December, 1970 Articles Quantity Helping Hands 53 Bath Boards 112 Bath Mats 230 Bath Rails 142 Bath Seats 164 Long Handled Brush & Pans - Thick Handled Knife, Fork, Spoon 4 sets Jacobs Ladders 3 Lazy Tongs 9 Geriatric Chairs 8 Nelson Knives 5 Plate Surrounds 1 Sock Puller-on 2 Stocking Aids 21 Suction Egg Cups 4 Tilting Teapot Stands - Ext. Toilet Seats 44 Toilet Surrounds 34 Trolleys 8 Wall Can Openers 2 Incontinent Laundry Service:- 1970 14,319 articles were laundered. 57 2. Blind and Partially Sighted (a) Blind The number of resident blind persons in the Borough is given in the following table:- No. of Registered Blind Persons Sex AGE GROUPS Total 0-1 2-4 5-15 16-20 21-49 50-64 65 + M - 4 5 1 32 16 83 141 F - - 3 - 17 24 179 223 Total - 4 8 1 49 40 262 364 Additions to the register of blind persons during the year numbered 50 as compared with 37 in the previous year. The ages of these persons were as follows:- Ages of Persons Added to Blind Register in 1970 Sex AGE GROUPS Total 0-1 2-4 5-15 16-20 21-49 50-64 65† M - 2 - - 2 3 17 24 F - - - 1 2 23 26 Total - 2 - - 3 5 40 50 Employment 27 blind persons were in employment at the end of the year, 2 being in special workshops, 4 in home workers schemes and 21 in open employment and their various occupations were as follows:- Occupation of Blind Persons in Employment Proprietors, Managers & Executive Workers 2 Typists, Shorthand Typists, Secretaries 6 Telephone Operators 3 Working Proprietors, Shop Managers 1 Animal husbandry (including poultry keeping) 1 Machine Operators (Engineering) 1 58 Occupation of Blind Persons in Employment (cont'd.) Machine Operators, Minders (other than Engineering) 2 Basket Makers 1 Boot & Shoe Repairers 1 Piano Tuners 2 Labourers 2 Domestic/Canteen Workers, Caretakers, etc. 4 27 Handicraft Classes 3 Handiwork classes are run by Social Welfare Officers who also give braille/moon lessons and handicraft instruction to blind persons in their own homes. In addition the Social Welfare Officers visit the blind to give advice and guidance on a variety of matters and assist them in obtaining free wireless sets, white walking sticks, etc., and also provide help when necessary in connection with claims for Supplementary Benefit, financial assistance with holidays, etc. Holidays Twelve blind persons were provided with holidays in 1970 under the Council scheme. These holidays were arranged individually through voluntary associations for the blind. Residential Accommodation The details of blind persons in residential accommodation as at 31st December, 1970 are as follows:- Blind Persons in Residential Accommodation M F Homes provided under Section 12 (la) of the Health Service and Public Health Act 1968 10 27 Residential Homes other than above - - In Hospitals for mentally ill - 4 In Hospitals for mentally handicapped 3 1 Other Hospitals 4 10 Total 17 42 59 (b) Partially Sighted At the end of the year 145 persons were registered as partially sighted, an increase of 20 compared with the equivalent figure for 1969. The age groups of those on the register are given in the following table:- Number of Partially Sighted Persons on Register as at 31.12.70 Sex AGE GROUPS Total 0-1 2-4 5-15 16-20 21-49 50-64 65 † M - - 9 3 14 9 22 57 F - - 6 3 10 11 58 88 Total - - 15 6 24 20 80 145 Details of those newly registered as partially sighted during the year are as follows:- Persons Newly Registered as Partially Sighted during the year Sex AGE GROUPS Total 0-1 2-4 5-15 16-20 21-49 50-64 65 † M - - - - - 1 3 4 F - - - - - - 3 3 Total - - - - - 1 6 7 Included amongst those removed from the Register were seven persons admitted to the Blind Register, 44 out of 125 persons on the Register were near or prospectively blind. Ten of those were in employment as were 20 other partially sighted persons who were substantially handicapped in obtaining or keeping employment. 3. Peaf and Hard of Hearing A total of 125 deaf or hard of hearing persons were on the register of handicapped persons at the end of the year. Details of these are as follows:- 60 Age Under 16 16- 29 30-49 50-64 65 86 over Total Deaf with speech 2 9 13 2 10 36 Deaf without speech 2 12 22 16 4 56 Hard of Hearing 1 5 2 3 22 33 Total 5 26 37 21 36 125 Social Clubs There are two Social Clubs, one for the deaf and one for the hard of hearing. Both meet weekly and financial assistance is given by the Council as and when necessary. Social Work The Social Welfare Officers' principal work with the deaf is concerned with helping those who may be isolated from the community due to their handicap or help with problems that may arise in the family. So far as the hard of hearing are concerned, the Social Worker helps them to acknowledge then increasing loss of hearing and to accept the use of amplification by hearing aids issued on medical grounds Another important aspect of the Social Workers' duties is concerned with helping the family to understand the difficulties involved with loss of hearing so that they can adjust to the problems involved. Occupational Facilities The Social Worker is also concerned with endeavouring to see thaLthe deaf and hard of hearing avail themselves where possible of the facilities provided for the aged and physically handicapped and liaises with the Old People's Workshop and the Faringdon Centre for the physically handicapped with regard to the placement and subsequent supervision of deaf and hard of hearing persons in these Centres. 4. Mentally Handicapped The number of persons under the care of this Authority at the end of 1970 was as shown in the table on page 61 SERVICES FOR THE ELDERLY Luncheon Centres A total of 180,992 meals were served at the 9 luncheon centres for the elderly, functioning on week-days in various parts of the Borough. Meals-on-Wheels 30,596 meals were served to old people in their own homes, the distribution being undertaken by members of the W.R.V.S. in Romford and by the Havering Old People's Welfare Association in the remainder of the Borough. Day Centres The Council's day centres for the elderly at Mawney Road, Romford, functioned throughout the year. Plans were completed and building work was hearing completion on a second Council day centre in Rainham expected to open early in 1971. In addition, the Havering Old People's Welfare Association's day centre "H.O.P.W.A. House" provided a wide range of social activities for elderly people from many parts of the Borough. Elderly People's Workshop The workshop situated at the rear of the Town Hall, Romford, which has now been functioning for nearly 10 years, continued to provide light employment for 32 elderly persons in two shifts. Entertainments During the year tickets for 24 different operatic, dramatic or variety shows were made available for old people, and coaches were hired by the Council for those attending. The total number of elderly persons who attended the 24 performances was 4,747. Holidays Holidays for the elderly were provided as in previous years by booking the Rogerson Hall Holiday Camp near Lowestoft for a period of seven weeks, which provided accommodation 62 for just over 2,000 persons, and in addition, accommodation for a further 400was booked at Ramsgate invarious private hotels. The charge made to those taking part was £3.12s.0d. inclusive of transport, and a total of 2,460 persons availed themselves of the facilities. Outings For those unable to go on one of the holidays mentioned in the preceding paragraph, day coach outings were arranged. A total of 1,097 elderly persons were conveyed to the seaside by coach and provided with a lunch and tea at a restaurant for an inclusive charge of 7s. 6d. each. Special Housing for the Elderly A further 128 purpose-built dwellings for the elderly were completed during 1970, thus increasing the total number of such dwellings to 742. Two warden controlled complexes were among the completed, so that there are now eleven such complexes comprising a total of 346 flats. In addition tothe above provided by the HaveringCouncil, the Greater London Council have over 300 old persons' dwellings in the Harold Hill Estate. Residential Accommodation Five residential homes for the elderly maintained by the Council provide a total of 381 places. One ot these homes "The Willows" is shared with the London Boroughs ot Barking, Redbridge and Waltham Forest, and therefore the total number of places available for Havering residents is approximately 300. Although there is a considerable waiting list for admission arrangements were made to admit short stay residents during holiday periods whilst the family was on holiday. The addresses of the homes are as follows:- The Grange, Faringdon Avenue, Harold Hill. 61 places Hillside, North Hill Drive, Harold Hill. 63 " The Manor, Upper Brentwood Road, GideaPk. 51 " Ravenscourt, Station Lane, I'ornchurch. 48 " The Willows, Suttons Lane, Hornchurch. 158 " 63 Old People's Clubs Financial assistance was given to old people's clubs where necessary by the Council, all applications being considered by a panel appointed for this purpose. There are 36 old people's clubs, most of which meet on one or two afternoons each week, with an average membership of 100. These clubs are additional to the Day Centres provided by the Council, by the Hornchurch Old People's Welfare Association and the Romford War Memorial Club. MENTAL HEALTH SERVICE Case Work Six members of the social work staff undertake duties under the Mental Health Act, and are thus engaged not only on social work with patients suffering from mental illness, but also on statutory duties in connection with admissions to psychiatric hospitals. This latter duty necessitates one of these officers being available at all times on a stand-by duty rota. In addition to social work with patients in their homes, in hospitals and at hostels, close liaison is maintained with staff in the hospitals and hostels, and their social workers also attend regularly various group meetings and clubs held weekly, in addition to after care sessions and case conferences. Hospital Admissions During 1970 the following admissions to psychiatric hospitals were dealt with, by the six officers mentioned in the last paragraph:- Mental Health Act 1959 Section 25 4 Section 26 — Section 29 112 Section 60 2 Informal Admissions 31 Total 149 Hostel Accommodation Collier Lodge, a purpose built residential hostel offering short stav accommodation for the mentally ill, had an average of 20 patients resident throughout the year. The majority of those accommodated follow a full-time occupation, and with 64 assistance from psychiatric, social work and residential staff, are able gradually to rejoin society after a stay in the hostel. A group home for four ex-residents from the hostel was opened during the year. This was a house made available by the Council, and four residents (three male and one female) at Collier Lodge who had no other home took up residence,sharing expenses and the domestic duties involved in running the home. Day Centre In October 1970, staff were appointed to undertake the preparatory work required to open a Day Centre for patients recovering from mental illness, and the first patients were admitted in the following January. Number of Patients under the care of the Authority as at 3 1.1 2.70 Ment ally 111 Elderly Men tally Infirm Psychopathic Subnormal Severely Subnormal Total GRAND TOTAL under 16 164 under 16 164 unde 16 164 under 16 16+ Attending day training Centre 'Workshop - - - - -8 141 19 7 99 148 247 Awaiting entry thereto - - - - 7 - 9 - 16 - 16 Receiving Awaiting home training - - - - - - - - - - - Resident in Local Authority Home/H; tels - 15 - - - 7 - - - 22 22 Awaiting admission thereto - - - - 5 - 4 1 9 1 10 Resident at Local Authority expense in other residential Home/hostels 2 1 - - 2 5 4 3 8 9 17 Resident at Local Authority expense by boarding out in private household - - - - - - - - - - - Receiving home visits - 250 - 6 15 103 10 34 25 393 418 TOTALS 2 260 - 6 109 256 46 4 5 157 57 3 730 65 The Belford Centre This Junior Training Centre provides places for 72 subnormal children, and was fully occupied throughout the year. The Havering Centre This new Adult Training Centre providing places for 200 mentally handicapped men and women opened on 2nd March, 1970, and replaced the Belford Adult Centre whose accommodation was limited to 146. The new building, providing spacious workshops, a training flat, a recreation hall and a dining hall, was erected at a total cost of approximately £180,000. Special Cafe Unit The Special Care Unit, opened at Collier Row in 1969, continued to functior. there throughout the year as plans for its transfer to the former Belford Adult Centre were delayed pending the necessary work of adaptation being carried out. Accommodation for 30 persons is provided at the Unit which was fully occupied throughout the year. Residential Care Residential accommodation for 30 mentally handicapped men is provided at Westmarsh Lodge. This hostel has continued to function to full capacity throughout the year, the majority of those resident attending the adjacent Adult Training Centre. Holidays 84 persons attending the Adult Training Centre were provided with a holiday of one week at Rogerson Hall Holiday Camp near Lowestoft, and a further 25 had a week's holiday at Ramsgate. 44 holidays of one week's duration at Ramsgate were also arranged for children attending the Junior Training Centre. HOMELESS FAMILIES Close co-ordination continued between the Health and Welfare, Children's and Housing Departments in ensuring that information regarding family problems which might lead to possible homelessness was referred to social workers, so that effective preventive care could be initiated. 66 Reception Centre 24 families were admitted to the Department's reception centre during the year. This is approximately equal to the average of the last three years. The reception centre provides accommodation for six families in self-contained flats in two converted houses. The reception and re-housing schemes administered jointly between the Health and Welfare and Housing Departments, deals only with families with children who have no other accommodation. 67 ENVIRONMENTAL HEALTH SERVICES The retirement of Mr. S. Whitfield, Divisional Public Health Inspector, at the end of 1969 was followed by the retirement of Mr. H.C. Boswell, Associate Chief Public Health Inspector at the beginning of March, 1970. A new structure for the Public Health Inspectorate was established on 1st March, 1970 with the appointment of the remaining Divisional Public Health Inspector as Deputy Chief Public Health Inspector and of three of the District Public Health Inspectors as Senior Public Health Inspectors. A third pupil Public Health Inspector was appointed in the latter part of the year, bringing the establishment for students up to strength. However, one of these students qualified and at the end of the year had obtained an appointment with another London Borough, officially leaving this Authority on 3rd J anuary, 1971. At the end of November a third Pest Officer/General Assistant was appointed and the necessary transport provided by the Council for his use. Ch 31st December, 1970 the Environmental Health Inspectorate consisted of:- 1 Chief Public Health Inspector 1 Deputy Chief Public Health Inspector 3 Senior Public Health Inspectors 1 Senior Shops & Offices Inspector 1 Food Inspector 10 District Public Health Inspectors 2 Shops & Offices Inspectors 2 Authorised Meat Inspectors 3 Pest Control Officers/General Assistants 3 Pupil Public Health Inspectors 68 FOOD HYGIENE Food & Drug Administration A total of 555 samples (53 formal, 502 informal) were taken during the year and examined by the Public Analyst. One formal sample of Channel Island Pasteurised Milk contained 0.07 international units of penicillin antibiotics. Following thorough investigation of the case a warning letter was sent to the producer concerned. A formal sample of herb tea had excessive sand and a formal sample of tonic water did not contain quinine. In both these cases warnings were sent to the manufacturers concerned after full consideration had been given to the facts of each case. Six informal samples had faulty labelling and the manufacturers were informed and the necessary remedial action taken. Included in the above figures are 48 food complaints which were referred to the Public Analyst. 161 other food complaints were dealt with without reference to the Analyst. 13 prosecutions were taken, resulting in fines totalling £260 being imposed and costs amounting to £89.40 being awarded to the Council. Details of these cases appear below:- Complaint Result of Proceedings Wire in bread £20 fine £6 costs Insect larvae in figs £20 fine £5 costs " " peppermint cream £20 fine £5 costs Paper in bread £10 fine £5 costs Mouldy sandwich £10 fine £2 costs Steak contaminated by mice £25 fine £5 costs Wood in bread £10 fine £8 costs Biscuit containing Elastoplast £25 fine £9.70 costs Mouldy beef suet £20 fine £10 costs Mouldy meat pie £20 fine £6 costs Mouldy blackcurrant tarts £30 fine £8 costs Mouldy party pies £25 fine £5 costs Wood louse in chicken and ham dinner £25 fine £14.70 costs 69 Food & Drug Administration (cont'd.) The commodities involved in the 209 food complaints were as follows:- Bread 38 Fruit (Fresh) 5 Beverages 4 Fruit (Dried) 1 Butter 4 Fruit (Canned) 7 Baby Foods 2 Fresh Fish 5 Cereals 8 Frozen Foods 1 Cheese 2 Ice Cream 4 Canned Meats 14 Jam 3 Cooked Meats and Milk 25 Meat Products 29 Cooking Fat 1 Milk Powder 1 Cream 1 Pickles & Sauces 5 Dehydrated Packet Food 1 Vegetables 9 Eggs 1 Shellfish 2 Flour Confectionery 16 Sweets 5 Fresh Meat 12 Sandwiches 2 Yogurt 1 The number of food complaints received was higher this year than last year, in fact, the highest number in any year since the Borough was formed. I think that this is due to the ever increasing public interest in food hygiene. Bread complaints due to mould were also more numerous this year due to the long spell of warm, humid weather. Bacteriological Milk Sampling A total of 212 milk samples were taken during the year and submitted for bacteriological examination with results as follows:- Pasteurised—169 149 passed the methylene blue test, 16 failed and 4 were void. All passed the phosphatase test. Sterilised—16 All satisfied the turbity test. Ultra Heat Treated—27 All satisfied the U.H.T. test. Included in the above totals were 46 samples from vending machines; 39 satisfied the methylene blue test and seven failed. 70 All satisfied the phosphatase test. Failures are due to ineffective stock rotation and the suppliers concerned were informed. Brucella Abortis The Department of Health & Social Security Circular 1/71 requests information regarding the number of samples of raw milk examined for brucella abortis, the number of positive samples found and the action taken in respect of positive samples. I have to report that no samples of raw milk have been the subject of examination in this regard as all supplies of milk retailed in this Borough are heat treated. Ice Cream Sampling - Bacteriological Examination During the year 330 samples of ice cream were submitted for bacteriological examination, with results as shown:- Mobile Shop Trade Soft Other Soft Other Total 1 22 67 4 142 235 2 9 12 - 24 45 3 5 6 2 16 29 4 10 2 1 8 21 46 87 7 190 330 Nine lollies were submitted for bacteriological examination and all proved satisfactory. 14 ice creams and nine lollies were also submitted to the Public Analyst and all were satisfactory. Other Food Sampling Bacteriological examination of other food products were carried out during the year in respect of the undermentioned commodities:- Cream 42 Cream Cakes 63 Cooked Meats 89 Rolls 81 Pies 21 Sausages 18 Meat Products 25 Shell Fish 10 Other Fish 6 71 Generally the results were satisfactory. Some of the samples of fresh cream were not entirely satisfactory. No report has so far been received with regard to the Working Party on hygiene and production of fresh cream. It will be recalled that a survey and sampling programme was carried out in 1969. It was hoped that there would have been a bacteriological standard introduced by this time. Imported Food Regulations. 1968 Last year's report mentioned the fact that under the above mentioned Regulations it is now permissible for appropriately sealed food containers to be examined at the place of destination and not at the port of entry. During the year notification was received of the arrival in the Borough of 95 such containers all of which were the subject of inspection before being released for sale. This traffic in the main consists of meat and groceries consigned to meat depots and grocery warehouses of which there are several in the Borough. Soft Drinks (Amendment) Regulations, 1970 These amending Regulations extend by one year, ending with 31st December. 1971. the period during which the words "permitted artificial sweetener'' may appear in place of the word "saccharin'' on a label or container of anv soft drink which contains a permitted artificial sweetener and which is sold, consigned or delivered for human consumption. Labelling of Food Regulations, 1970 Stricter and wider controls over the labelling and advertisement of food and over the claims made for certain foods will come into force on 1st January. 1973 under new Regulations laid before Parliament on 25th March by the Minister of Agriculture. Fisheries and Food acting jointly with the Secretary of State for Social Services. The new Regulations represent a major step forward in consumer protection. They will require food labels to be clearer and more informative, so that consumers will have a better idea of what it is that thev are buying. Strict controls are placed on the claims that can be made forcertain foods, for example, claims relating to slimming, to the presence in foods of vitamins and minerals and to the tonic or medicinal 72 properties of foods. The Regulations lay down the information that has to be given on the label or in an advertisement when such claims are made. The Regulations comprise the final stage of the first major review since 1953 of the law relating to the labelling of food. They are largely based on two Reports by the Food Standards Committee on Food Labelling and on Claims and Misleading Descriptions. The Regulations will revoke the Labelling of Food Regulations, 1967, which have not yet come fully into force, and supersede the provisions of the Labelling of Food Order, 1953, as amended. Essex County Council Act, 1952—Section 103 During the year under review three new applications for registration as hawkers of food were granted. Poultry Processing Plants Department of Health & Social Security Circular 1/71 requested information in connection with poultry inspection. There are no poultry processing premises within the Borough. Pharmacy & Poisons Act, 1933 During the year seven names and seven premises were added to the list kept by the Department in pursuance of Section 21 of the Act, the applicants thereby becoming entitled, subject to the provisions of the Act and the Poisons Rules, 1970, to sell poisons included in Part 11 of the Poisons List. Ninenames and thirteen premises were removed from the list. At the end of the year the list contained the names of 90 persons (or firms) involving some 150 premises. No formal action was required during the year in respect of any infringements of this legislation. On 8th July, 1970 the Poisons ListOrder, 1970(S.I. No.797) and the Poisons Rules, 1970 (S.I. No. 798) came into operation. The former made changes to the Poisons List and the latter revoked and reproduced with amendments the Poisons (No. 2) Rules, 1968. 73 Milk Distributors During the year the number of registered milk producers reduced from 9 to 6 and the number of dairy premises from 19 to 10. 177 shopkeepers are, however, registered for the sale of milk from their premises, plus six milk vending machines sited outside shop premises. Milk (Special Designation) Regulations. 1963. as Amended. The number of licences granted by the Council during the year, together with the total number valid until 31st December,1970 are shown in the following table. All these licences will be subject to renewal for the new 5 year licensing period 1st January, 1971 to 31st December, 1975. Designation Licences issued Total No in during 1970 force until 31.12.70 Pasteurised Milk 2 177 Sterilised Milk 1 139 Ultra Heat Treated Milk Nil 54 Greater London Council (General Powers) Act. 1968-Part VII— Night Cafes Two applications for registration as night cafes were received during the year. Che of these was in respect of a change of occupier of one of the three applicants outstanding at the end of the previous year and has, therefore, to go through a rather lengthy administrative procedure. Of the other two 1969 applications one was refused and the other—which was the subject of extensive structural alterations to the premises—should achieve finality early in 1971. The remaining 1970 application should also be resolved early in 1971. These registrations are in respect of premises which it is proposed to keep open later than 11.0 p.m. Late Night Refreshment Houses Act, 196 9 This Act, which came into force on 1st January, 1970, consolidates the Refreshment Houses Acts, 1860—1967 and makes certain corrections and improvements to the law relating to refreshment houses. Basically it can be said that this Act now applies nationally most of the very comprehensive conditions required for night cafes under Part VIII of the Greater London Council (General Powers) Act, 1968 and which, of course, only 74 applies to the Greater London area, and then only to those London Boroughs adopting this part of the Act. Eleven licences were issued during the year covering the period from 1st April. 1970 to 31st March. 1971, all requiring that the refreshment houses should not be opened, or kept open for public refreshment, resort and entertainment at any time between eleven o'clock at night and five o'clock in the morning. Occupiers of premises who want to keep open later than 11.0 p.m. must, of course, comply with and be registered under Part VIII of the G.L.C. (General Powers)Act, 1968 as night cafes. Game Act, 1831 Two licences authorising the applicants - both local shopkeepers—to buy and sell game were renewed during the year and two other licences lapsed. These licences cover the period 1st July. 1970 to 31st June. 1971. Food & Drugs Act, 1955-Section 16 During the year four applications for registration of premises for the manufacture of sausages or potted, pressed, pickled or preserved food intended for sale and 14 applications for registration of premises for the storage and sale of ice creams were approved. Food Hygiene (General) Regulations. 1960 The number of food premises subject to these Regulations grouped in categories of trade carried on in them are shown in the following table:- Category (of trade) Number of premises Bakehouses 11 Butchers 128 Cafes & Restaurants 85 Confectioners (flour, etc.) 57 „ (sugar) 197 Fish Shops 44 Grocers 224 Greengrocers 107 Ice Cream Manufacturers 3 Clubs (On Licence) 13 Clubs (Private) 60 75 Category (of trade) Number of premises (cont'd.) Public Houses 74 School Canteens 94 Staff Canteens 96 Off Licences 69 96 notices were served under these Regulations during the year—an increase of 24 on the previous year. No statutory action was required in respect of these notices. Unsound Food During the year the following amounts of food were voluntarily surrendered to the Public Health Inspectors as being unfit for human consumption and appropriate certificates issued to the shopkeepers and/or wholesalers concerned. Meat condemned in the course of meat inspection at the slaughterhouses is shown separately under the heading "Carcases inspected and condemned". Commodity Weight (in lbs.) Meat (Wholesale) 9166 Meat (Retail) 3736 Meat (Tinned) 2935 Fish (Tinned) 360 Fish (Raw) 1769 Offal 543 Poultry 787 Sausages 78 Tinned Fruit 4309 Other Tinned Fruit 2359 Miscellaneous Foodstuffs 2369 Butter 702 TOTAL 29113 Frozen Packets 24230 items Slaughter of Animals Act. 1958 59 licences to slaughter animals were issued during the year, 9 of which authorised the licensees to slaughter horses— by Greener's "Bell" gun—in this Borough only, the killing of horses being a regular practice at one slaughterhouse. 76 24 of the licences were for ritual slaughter—21 Jews and 3 Mohammedans. With the exceptions of two journeymen all the licencees are employed in slaughterhouses in the Borough. Meat Inspection—Meat Inspection Regulations. 1963 The new agreed hours of slaughter came into operation on 1st January, 1970, thus enabling slaughtering to take place at three of our four licensed slaughterhouses from 7.00 a.m. to 6.00 p.m. Mondays to Fridays and from 7.00 a.m. to 2.00 p.m. on Saturdays and Sundays. The fourth slaughterhouse is a very small one at the rear of a family butcher's shop killing only for their own retail trade—this killing taking place during normal hours and not being the subject of an Order controlling the hours of slaughter. In two in stances the owners of the slaughterhouses renewed their offensive trade consents for the year—gut scraping and fat rendering. During the year one slaughterhouse ceased to operate, the occupier moving to a new purpose-built slaughterhouse in a neighbouring district. Despite the increased hours of slaughter the latter fact is obviously the cause of the drop in our overall figures of the number of animals killed from 116,100 in 1969 to 90,992 — a decrease of 25,108. The charge for this service remains the same, Cattle and horses—2 6d. each (12½)p) Calves and pigs—9d." (4p) Sheep and goats—6d." (2½p) The total income from this service during the year was £3,877.12.0d. (£3,877.60). During the year Local Authority organisations made representations to the Ministry of Agriculture, Fisheries & Food and the Department of Health and Social Security that the maximum charges permitted under these Regulations should be increased. It is felt that an increase of 50% would be more commensurate with the expenditure involved in the administration of this service. 77 78 CARCASES INSPECTED AND CONDEMNED The following table shows the post mortem infection of animals during the year 1970 at the four slaughterhouses in the Borough:— Cattle Calves Sheep and Lambs Pigs Horses Goats Total Number Killed 14,090 1,849 61,837 13, 134 65 17 90,992 Number Inspected 14,090 1,849 61,837 13,134 65 17 90,992 All Diseases except Tuberculosis and Cysticercosis Whole Carcase condemned 96 2 196 37 2 - 333 Carcases of which some part or organ was condemned 7,090 80 12,086 1,025 11 - 20,292 Percentage of number affected 51.00% 4.43% 19.86% 7.32% 20.00% - 22.66% Tuberculosis Only: Whole Carcases Condemned — - — — - _ - Carcases of which some parts or organs were condemned 1 - 100 - - 101 Percentage of number affected 0.007% - — 0.76% _ _ 0.11% Cysticercosis Only Carcases of which some part or organs were condemned. 5 - - - - - 5 Carcases submitted to treatment by refrigeration - — — — - - Generalised and totally condemned - - - - - - - Total Meat condemned: 65 tons: 12 cwt: 57 lbs Diseases of Animals Act, 1950 The Regulation of Movement of Swine Order, 1959 continued in force throughout the whole of the year under review, and a considerable number of Movement Licences were received and the necessary investigation made in respect of the movement of swine to destinations within the Borough—slaughterhouses and/or piggeries. No licences were required to be issued by the Department, however, in connection with the movement of swine from within the Borough to destinations elsewhere. During September Fowl Pest became prevalent in the southern part of England and the Borough was eventually included as part of an infected area, which had the effect of imposing restrictions on the movement of poultry and required the issue of appropriate licences where necessary. Four of our poultry farms were also declared by the Ministry of Agriculture, Fisheries and Food to be infected places and appropriate methods were adopted to deal with these local outbreaks. Restrictions in these four instances were withdrawn before the end of the year. 15 licences to operate boiling plants at local piggeries remained in force at the end of the year—a decrease of one on 1969. SANITARY CIRCUMSTANCES This year's pattern of work varied considerably from the previous year. The cancellation of the proposed Havering (No.6) Smoke Control Area reduced considerably the number of visits under the Clean Air Act, but the number of applications for Qualification Certificates gained momentum during the year, with the resultant vast increase of inspections under the heading 'Housing Acts'. Overall there was a slight increase in the number of visits mainly reflected under the headings 'Public Health Acts', 'Food and Drugs Acts', 'Prevention of Damage by Pests Act' (a third third Pest Control Officer/General Assistant commenced work at the end of November) and 'Consumer Protection'. 79 A summary of the 34,018 inspections is as follows:- Clean Air Act 2,819 Public Health Acts 7,501 Food & Drugs Acts 5,758 Prevention of Damage by Pests Act 4,218 Offices, Shops & Railway Premises Act 2,114 Shops Acts 2,154 Infectious Diseases 950 Housing Acts 2,654 Sampling 1,679 Factories Act 325 Noise Abatement 366 Diseases of Animals Act 110 Miscellaneous 1,362 Slaughterhouses & Meat Inspection 1,569 (not including the inspections of 2 Authorised Meat Inspectors based permanently at slaughterhouses) Consumer Protection 439 Total 34,018 As a result of these inspections 627 informal notices were served and in 161 cases further action was necessary, with the service of Statutory Notices—details as follows:- Number of Notices Served: Informal: Statutory: Public Health Acts 210 160 Food & Drugs Acts 96 — Offices, Shops & Railway Premisses Act 221 - Shops Acts 88 - Factories Acts 8 — Housing Acts 1 — Landlord & Tenant Act 1 — Prevention of Damage by Pests Act 2 1 Total 627 161 80 Enforcement Proceedings One prosecution was taken during the year in respect of the non-compliance with Statutory Notice served under Section 93 of the Public Health Act, 1936. The defendant was fined £20 and the Council awarded £10 costs. Twelve Court cases were taken under the Offices, Shops and Railway Premises Act, 1963 (resulting in total fines of £48 and costs of £13); 13 under the Food &. Drugs Act, 1955 (fines totalling £70, costs £89.40); 5 under the Shops Act, 1950 (fines £11, costs £8); 2 under the Consumer Protection Act, 1961 (fines £15, costs £23.75); 1 under the Noise Abatement Act, 1960 (fine £5, costs £2) and 4 under the Civic Amenities Act, 1967(fines £70, costs £11)—all these cases being reported in more detail elsewhere in this report under their appropriate headings. Refuse Disposal Refuse disposal arrangements for this Borough became the responsibility of the Greater London Council (Department of Public Health Engineering) on 1st April, 1965. Household and shop refuse, street sweepings, gully detritus and waste material, is delivered direct by the Council's collection vehicles to landfill sites at either Baldwins Farm, Upminster or Little Belhus, South Ockendon. Both tips are owned and operated by private contractors. Trade refuse can be taken by tradesmen to the G.L.C. transfer station at Frizlands Lane, Dagenham, where a charge is made, depending on weight or capacity. A civic amenity site is operated by the G.L.C. at Gerpins Lane, Upminster where Havering residents may deliver most types of waste materials emanating from private dwellings, including garden refuse, but not old cars or large quantities of car parts. Should any resident wish to dispose of an old car, it may be taken to the G.L.C. depot at Frizlands Lane, Dagenham, during any working day, including Saturday morning, where it will be accepted free of charge, subject to the signing of a surrender form and , if possible, the vehicle log book. 81 Poisonous and toxic materials, in reasonable quantities, can normally be disposed of through the G.L.C. Any request for disposal is passed to the Scientific Branch at County Hall who inspect and analyse the material and advise the method of disposal. No charge is made for this service, but usually the materials would have to be taken to a contractor who specialises in this type of disposal and appropriate charges made by him. Radioactive Substances Act. I960 Mention was made in last year's report of the four premises in the Borough where radioactive materials are stored and/or used, and of the large commercial undertaking which installed a radioactive lightning conductor. During the year review copies of three further certificates of registration were received from the Ministry of Housing and Local Government—one under Section 1 of the Act in respect of a large industrial undertaking; the second under Section 3 of the Act in respect of mobile radioactive apparatus which is normally stored when not in use at premises in the Borough, and the third authorising the disposal and accumulation of radioactive waste on the Company's disposal site. Rivers, Streams & Watercourses I am indebted to the Essex River Authority for the following in formation "A survey of the River Ingrebourne in September showed the water to be clean, although reflecting the high proportion of sewage effluentsarising from theNags HeadLane sewage disposal works of Brentwood Urban District Council. The performance of this works has been satisfactory throughout the year and it has kept the high standards imposed by the River Authority consistently. The River Beam was also surveyed during the year, and it was found to be clean, although some minor sources of pollution, which are being rectified, were found. The intensity of radioactivity and the numbers of bacteria of sewage origin were checked at key points along both rivers regularly throughout the year, and they were found to be at a low, safe level at all times." 82 Water Supply The South Essex Water Works Co. who supply the whole of the Borough amalgamated with the Southend Waterworks Co. on 1st July, 1970 under the terms of the Essex Water Order, 1970, and the joint company is now known as the Essex Water Company. At the end of the year arrangements were proceeding for the transfer on 1st April, 1971 of the other water undertakings concerned in the Essex Water Order, namely those of the Maldon Corporation, the Bumham-on-Crouch and With am Urban District Councils and the Chelmsford & Maldon Rural District Councils. A decision from the Secretary of State for the Environment is awaited in connection with the further Order which has been deposited for the transfer of the water undertaking of the Chelmsford Corporation. The water supply of the whole of the Borough has been satisfactory in quality and quantity. No action has been necessary in respect of any form of contamination. The number of dwelling houses supplied as at 31st December, 1970 was 85,610—an increase of 3,530 on last year—and the population as obtained from the Registrar General was 252,130. I am not aware of any dwellings being supplied with water from standpipes. The Essex Water Company did not make frequent fluorine determinations during the year, but on the basis of past results the fluorine content of the supplies is 0.25 p.p.m. 51 samples were taken by the Department from the main supply during the year, of which 40 were submitted for chemical and 11 for bacteriological examination. In each case a satisfactory report was received. 83 RAINFALL The following table shows the amount of rainfall recorded at four stations in the Borough during the year:- HORNCHURCH RAINHAM ROMFORD UPMINSTER Amount in nillimetres No. of days in which rain fell Amount in millimetres No. of days in which rain fell Amount in millimetres No. of day s in which rain fell Amount in millimetres No. of days in which rain fell January 70.0 25 57.8 23 68.2 24 70.9 25 February 57.7 19 40.5 15 52.0 19 57.1 22 March 55.6 15 39.4 14 53.7 15 53.6 18 April 55.7 20 53.5 21 57.9 23 52.6 22 May 15.6 8 19.5 11 17.1 9 17.8 13 June 38.9 7 16.2 6 26.7 6 20.8 7 . July 45.8 15 45.1 15 41.0 15 42.2 16 August 52.6 12 76.9 11 46.1 11 43.9 13 September 57.3 9 50.6 8 45.5 10 50.3 11 October 16.0 8 15.1 7 14.9 7 16.8 9 November 143.3 18 126.6 19 151.3 18 135.6 21 December 47.8 15 41.9 12 45.2 14 46.7 15 Total 650.3 171 583.1 162 619.6 171 608.3 192 Sewerage & Sewage Disposal The Greater London Council Department of Public Health Engineering state that no extensions or improvements to the existing plant at Riverside Treatment Works were carried out during the year, but the plant continued to operate to a satisfactory standard. The Eastern Outfall Works, now known as Bury Farm Works, continued to produce a high quality effluent throughout the year. The present arrangements for domestic sewage disposal are adequate, although modifications to the domestic plant will be started in February, 1971 to enable this plant to cope with increasing loads. As a result of experimental work carried out during 1969 a biological plant for the treatment of trade sewage is now being designed. Complaints from the public regarding an intermittent smell attributed to the works were received during the course of the year. Investigation has indicated that a trade effluent discharged to the domestic sewer is reacting with domestic sewage to produce the offending smell. Action has been taken to prevent this trade effluent from being discharged to the domestic sewer. The following schedule gives details of new sewers laid in sewerage improvements in the Borough. Foul sewers—Works completed Barton Avenue Pumping Station—renewal. "The Drill" connection between foul sewers (9" dia.) 15 yds. Work to commence soon Barnstaple Road relief. Rom Valley Sewer—Stage II at High Street and parts of Stage III between the Market Place and Junction Road. N.B. Commencement of Cranham foul sewerage removal of surface water connections has been delayed due to staff changes. 85 Surface Water—Works Completed Sewers Douglas Road—relaying (12"/9" dia.) 260 yds. Osborne Road (18"/15"/12"/9" dia.) 775 yds. and 170 yds. 9" dia. foul sewer. Erith Crescent (24"/18"/15"/12" dia.) 720 yds. Front Lane (inc. Clyde Crescent) (24" 15"/12"/9" dia.) 200 yds. Stirling Close—renew outfall (15" dia.) 50 yds. Spey Way (Clyde Way relief) (9" dia.) 75 yds. Carter Drive—renew outfall (15" dia.) 60 yds. Clydesdale Road — relaying (9" dia.) 60 yds. Ockendon Road—near Fen Lane (12" dia.) 125 yds. Elm Park (Airfield) relief—stage 1 (45" dia.)330yds. Work to commence soon Sheila Road sewer N.B. Commencement of London Road S.W. sewer has been delayed due to staff changes and the Ravensbourne stream awaits statutory clearances. The programme for 1971/2 includes Rush Green Road S.W. sewer Wantz Stream improvement Ravensbourne Stream improvement stage II Suttons Avenue S.W. sewer Streets Made up and Taken over The following are the streets made up and taken over by the Council during 1970:- Cul-de-sac off Front Lane serving Nos. 341 to 355 60 feet Service Road off New Road (A. 13) 878 ft. 6 in. Extension of Stanhope Road 223 ft. Turpin Avenue 2638 ft. Total 3799 ft. 6 in. Gypsy Caravan Site To comply with the Caravan Sites Act, 1968 a permanent site for gypsies established at South Park, Dennises Lane, Upminster, was opened in November with standings for 16 cara- 86 vans, including that of the resident Warden appointed to supervise the security and cleanliness of the site. Main water supply and drainage are provided with individual washing and W.C. facilities. To provide for short stay residents a deposit is payable in addition to a weekly rent. The deposit is refundable subject to the standing being left in a satisfactory condition on a resident leaving the site. No undue problems have arisen regarding the lettings of these standings, although each application is, of course, subject to careful scrutiny. With regard to South Park Caravan Site it is annoying to think that with the cost of providing this park—being in the region of £40,000—the Council's request to the former Minister of Housing and Local Government that Havering should be designated as an area to which Section 10 of the Caravan Sites Act, 1968 should apply was turned down. It is hoped, however, that further consideration will be given to this request during 1971. It is also ironic to think that with expenditure of the order of that mentioned above the overall problem of the itinerant traveller will still present a potential public health hazard, as unless the Secretary of State for the Environment confirms the Borough as a designated area there would appear to be no legal control over any itinerant camping on the roadside, waste land or other sites, and whilst the Council may take action to move them on it still raises the question—a national as well as local one of what to do with these people who do not ave the desire to establish themselves in any particular district and who, because of their method of living, are loath to raise the deposit necessary to obtain the right to rent a site on such a park as that provided by this Council. At present plots on South Park are rented to those travellers who can afford the £40 deposit required to secure the contract and agree to pay the weekly rent of £2.75 occupation charge. 87 HOUSING SERVICES Number of New Dwellings Erected During the Year By the Local Authority 353 (529) By other Local Authorities 48 (121) By other bodies or persons 504 (530) The previous year's figures are given in brackets The Borough Architect has very kindly supplied the following information in connection with the 353 dwelling units which were completed by the Council and handed over to the Housing Manager for occupation during the 1970 calendar year. Included in this total are 9 (nine) disabled persons' dwellings, each with a suitably designed garage immediately adjoining:- "Phase II of the Council's Heaton Avenue Estate, off Straight Road, Romford was completed in January when the 2nd block of 57 flats was handed over by the builders to the Housing Manager. Phase III, a small scheme of five three-bedroomed houses, is expected to start on site in February, 1971. The three housing estates at Newtons Corner, Elmhurst Drive and Hamilton Drive, all provided within a joint programme organised by the North Group of the London Housing Consortium, were all successfully completed by July. Most of the work was completed on a small group of eight dwellings off North Road, Havering-atte-Bower. Only the four bungalows for elderly people remain to be handed over in January, 1971. The particular interest in this scheme was due to its position near the centre of the villase and the special efforts made to ensure that the houses and bungalows would add to, and fit in with, the village scene. The Council's policy of providing accommodation for elderly people with a Warden to keep a friendly eyeon them, was continued during 1970 by the completion of two such Villa Blocks. The first to be completed, at Elmhurst Drive, made dwellings available for a total 42elderly people, together with the Warden's two-bedroomed flat and a two-bedroomed bungalow for a disabled person. The 88 second, at Guys field Drive, provided accommodation for 56 old people, plus the Warden's flat. Four O.P. dwellings remain to be completed in January, 1971. Both schemes include communal amenities such as a lounge with small kitchen to encourage the occupants to mix socially, a laundry and a Visitor's Bedroom for those visitors needing to stay overnight or for a few days in cases of emergency." Local Authority Housing Accommodation The Housing Manager informs me that the 353 new dwellings completed during the year included two Warden controlled complex —Lime Court and Will Perrin Court—providing 65 flats for O.A.P.s and 61 one-bedroomed flats in Hamilton Drive, Newtons Corner and Squirrels Heath Road being primarily for pensioners. Twelve pensioners were rehoused following nomination by the Health and Welfare Department, most of them being provided with warden controlled flats. Nineteen families were rehoused from hostel accommodation at 42/44 Brentwood Road. 26 homeless families were rehoused, including two families whose premises had been badly damaged by fire. At the end of the year the housing waiting list included 2,821 applications on the main list, 279on the supplementary list, and 418 on the engaged couples list. The total number of properties under management at 31st December, 1970 was 11,701, together with 2,124 lock-up garages and 1,371 hard standings. Housing Priority on Medical Grounds 353 applications for medical priority in connection with rehousing were received during the year, 216 were in respect of registrations on the waiting list and 137 were from existing tenants requesting transfer to alternative accommodation. Housing Act, 1969 (Part I)—House Improvements Details of applications for improvement grants under section 89 1 of the Housing Act, 1969, received during the year 1970 are given in the following table:- (A) Standard Owner Occupiers Standard Tenanted Standard 5 point 3 point 5 point 3 point 1. Number of Applications Received 213 - 12 - Approved 135 - 10 - Refused 8 - - - 2. Number of dwellings improved 122 - - - 3. Amount paid in grants £15,930. 5. Od. 4. Average grant per house £130.11. 6d. 5a. Number of amenities provided (a) Fixed bath/shower 66 (b) Wash hand basin 80 (c) Hot water supply (to any fittings) 100 (d) Water closet within dwelling 87 (e) A sink 9 5b. Number of bathrooms added 23 (B) Improvement Owner/Occupiers Tenanted 1. Number of Applications Received 73 3 2. ” ” ” Approved 33 1 3. ” ” ” Refused 13 2 4. Number of dwellings improved 40 - 5. Amount paid in grants £15,716. 1. 6d. 6. Average grant per house £392. 18. Od. 90 The above mentioned applications necessitated some 343 visits by members of the Public Health Inspectorate, each visit requiring full liaison with members of the Building Inspectorate. Housing Act, 1969 (Part III) - Qualification Certificates The following table gives details of the number of applications for qualification certificates received during the year in respect of the rent of dwellings in good repair and provided with standard amenities, together with the action taken thereon:- Sn. 45—Qualification Certificates (a) applications: received - 934 (b) granted - 138 (c) refused - Nil (d) appeals (i) allowed - Nil (ii) disallowed - Nil Sn. 46—Certificates of Provisional Approval (a) applications: received - 24 (b) granted - 11 (c) refused - 3 Sn. 54 Number of County Court Orders made empowering landlords to enter and carry out works. - Nil Rent Act, 1957 (Rent Act, 1968)-Certificates of Disrepair Nine applications for the issue of Certificates of Disrepair were received during the year. Undertakings were received from landlords in seven cases in accordance with Paragraph 5 of the First Schedule to the Act, and in the other two cases no further action was taken as the necessary repairs had been put in hand. Housing Act, 1957—Sections 17 & 18 During the year the Council made one Demolition Order and three Closing Orders following representations by the Department. Three of these properties were occupied and necessitated the rehousing of three families totalling six persons. 91 Building Control Liaison with the Borough Engineer & Surveyor and the Borough Planning Officer continued during the year in connection with the scrutiny and study of plans which had a "Public Health" aspect. In all some 350 plans were referred to us during the year and our observations and recommendations made to the Borough Engineer & Surveyor or the Borough Planning Officer so that our proposals could be included in amended plans where necessary before approval and/or consent was given. Land Charges Act, 1925 The procedures regarding land charges enquiries as outlined in lastyear's report remain the same, the necessary liaison being maintained with the Town Clerk's Department in respect of the 6,975 searches which were made during the year 1970. Clean Air Act, 1956-Smoke Control Areas In the early part of the year a further 22 properties had been adapted in Havering (No. 5) Smoke Control Area, making a total of 642 out of the 729 applications approved. The Havering (No. 6) Smoke Control Area which had originally been phased for 1970 was deferred. Due to the anticipated shortage of solid smokeless fuel during the winter of 1970/71 the Council asked for authority from the Minister of Housing and Local Government to suspend four Smoke Control Orders. The necessary approval was forthcoming and the fourOrders were lifted for the period 1st November, 1970 to 31st March, 1971. This enabled householders to burn bituminous coal in these four areas. This decision necessitated circulars being delivered to some 15,000 dwellings in addition to the publication of formal notices in local newspapers and notifying all fuel merchants and and other interested bodies and persons. Investigation of Atmospheric Pollution The seven sites in the Borough containing instruments for the daily measurement of smoke and sulphur dioxide in the atmosphere were all continued during the year. These instruments operate in accordance with the national scheme controlled by 92 Warren Spring Laboratory. The Council maintained representation on the National Society for Clean Air and the Standing Conference of Co-operative Bodies for the Investigation of Atmospheric Pollution. Chimney Heights—Clean Air Act, 1968, Section 6 Thirteen applications for approval to chimney heights were received during the year-an increase of three on the previous year. In four cases alterations to heights were required, the other nine being satisfactory. Conversion to Natural Gas North Thames Gas have very kindly supplied further information to that mentioned in last year's report, in their programme of conversion to natural gas within the Borough:- "During the period under review operations by our Conversion Unit No. 8 based at Kavanaghs Road, Brentwood were extended to include conversion of more than 200,000 gas appliances in about 70,000 premises within Havering. The work involved mainly a variety of appliances in use in domestic dwellings in widely varying circumstances, special attention being necessary in dealing with many elderly, sick and disabled people. In moving progressively, sectorby sector through thearea, factories, schools churches, hospitals, etc., and many commercial premises have required detailed attention to special equipment where essential services had to be maintained during the change-over. Conversion of the majority of domestic appliances has taken the form of a straight exchange of components, i.e. burners, thermostat, pilots, etc., and in replacing the working parts of most appliances from the operational point of view a converted area is to all intents one populated entirely by new or modified appliances. We know that for various reasons, some appliances may require further attention and we make special arrangements to deal with requests for service after conversion. To enable customers to obtain service easily, a Mobile Report Centre is stationed in each sector for three weeks after conversion. Customers are advised by letter of the exact location. 93 A prepaid post card addressed to the local service centre is also provided to each customer who can of course telephone their usual service centre if the matter is urgent. Special teams of Post Conversion fitters are employed by the Conversion Units to deal with requests for service and Home Service Advisers are on call to assist the elderly or disabled in particular. I feel that I must express my appreciation of the valued help and co-operation of the staff of Schools, Hospitals and Council Officials during conversion of premises with which they have been concerned and in particular my most sincere thanks to Officials of the Police for the most commendable way that they have helped in situations involving a mobile labour force using scores of vehicles." SHOPS ACTS The Shops Acts 1950—65 deal with the closing hours of shops and permitted transactions during specified hours; makes provision for meal and rest intervals, weekly half-holidays, holidays in lieu of Sunday employment of all employees within scope of the Acts and also controls the working hours of young persons. Similarly the Young Persons (Employment) Acts, 1938—64 regulate the employment of young persons in certain other occupations, other than in shops, such as operating cinematograph apparatus, attendance on persons resorting to a public swimming bath, operating a mechanically propelled lift or hoist and certain other circumstances. The rationalisation of the Sunday trading laws still have not made the 'Statute Books'. There are anomolies in the main Act, necessary years ago, which have become outdated by social conditions prevailing today. A fourth attempt to sort out the basic problems has successfully passed through the House of Lords and now awaits its appearance in the House of Commons. During the year a series of complaints were received regarding employment conditions of young persons at a petrol filling station. The complaints were not without foundation and enquiries involved exceptional out of hours working by the Inspectors, both in the evenings and at weekends. 94 Altogether the cost to the Council of this one enquiry was calculated as in excess of £200. The firm concerned are due to answer numerous summonses early in the new year. With the completion of additional phases of the Romford Central Shopping Centre, more occupiers are taking advantageof the local Orders permitting six-day trading on a range of goods outside those normally exempted. During the year a further Order was granted allowing the sale of footwear on the 'early closing day'. Generally the observance of the Shops Acts has been satisfactory apart from the notable exception above, although it was considered necessary to prosecute on three other occasions. The majority of contraventions found were of a minor nature and soon remedied with usually only one follow-up visit required. Summary of Contraventions Early Closing Day Failing to exhibit an early closing day notice 25 Failing to close for the "serving of customers" 3 Failing to observe the Regulations 4 Evening Closing Hours Failing to close for the "serving of customers" 2 Sunday Trading Failing to close for the "serving of customers" 6 Failing to observe the Regulations 8 Conditions of Employment F ailing to exhibit notice specifying the day of Assistants' weekly half-holiday 59 Failing to allow Assistants a weekly half-holiday 9 Failing to allow intervals for meals and rest 165 Failing to exhibit the Abstract of Act and to keep records of hours worked by young persons 60 Failing to give young persons at least eleven hours consecutive rest to include 10 p.m. and 6 a.m. 27 Exceeding maximum permitted hours of employment of a young person 4 Failing to keep a record of Sunday employment 6 Failing to allow holidays in lieu of Sunday employment 2 95 Offices, Shops & Railway Premises Act, 1963 With each successive year this Act has been in operation the Inspectors report a greater awareness among employers and employees in the requirements of the Act, resulting in higher standards of compliance. Although the number of premises on the register remains static from year to year (1969—2,024; 1970—2,005) it is surprising that the turnover in pimises covered by the Act is as high as 8%, there being 168 new occupiers registered during 1970. An interesting point to note is that while the number of premises from the previousyear is comparable, the number of staff employed has increased by 1385, over 50% of these being male employees. At the end of the year 14,758 persons were employed in the 2,005 premises registered. Registration and General Inspections (1) Class of Premises (2) Number of Premises Registered during the year (3) Total Number of Registered Premises at the end of the year. (4) Number of Registered Premises receiving a General Inspection during the year. Offices 57 548 91 Retail Shops 80 1272 530 Wholesale Shops, Warehouses 7 42 12 Catering Establishments open to public, Canteens 16 137 69 Fuel Storage Depots - 6 - TOTAL 160 2005 702 Visits by Inspectors to Registered Premises TOTAL 1973 96 Summary of Infringements Section Details Number 4 Cleanliness 32 5 Overcrowding - 6 (1) Temperature 4 6 (2) Thermometers 71 7 Ventilation 7 8 Lighting 6 9 Sanitary Conveniences (insufficient or lacked proper maintenance) 43 10 Washing Facilities (insufficient or lacked provision of running hot water) 33 11 Drinking Water 2 12 Clothing Accommodation 7 13/14 Sitting Facilities - 15 Eating Facilities 2 16 (1) Floors, Passages and Stairs 40 16 (2) Handrails and guarding of open sides 28 17 Fencing Machinery 18 20 Hoists and Lifts 3 22 Dangerous conditions and practices 10 24 First Aid Provisions 104 27 Interference with equipment 1 48 Failing to report accident 2 49 Failing to register 85 50 Abstracts 128 97 Accidents - Analysed by Workplace Workplace Number Report 6 Total Number Investigated Prosecutions Offices 3 2 - Retail Shops 74 66 - Wholesale shops, - - warehouses 2 2 - Catering establishments - - - open to public, canteens 4 4 — Fuel storage depots - - - 83 74 - Analysis of Reported Accidents Offices Retail Shops Wholesale warehouses Catering establishments open to public canteens Fuel storage depots Machinery l 2 - - - Transport - 2 - - - Falls of persons - 21 2 l - Stepping on or striking against object or person l 10 - - - Handling goods - 14 - l - Struck by falling object - 7 - l - Fires and explosions - 3 — - — Electricity - — — — — Use of hand tools l 10 - - - Not otherwise specified — 5 — 1 — TOTAL 3 74 2 4 - Comparison 1969 5 69 6 6 - 98 Notification of Accidents Employers are required to notify the "appropriate authority" of accidents occuring within the premises. In 1970 83 accidents were reported to this Authority as compared with 86 in 1969 and 88 in 1968. Notification by nationwide employers and small combines is reasonably satisfactory although there is room for improvement where company policy requires the accident notification to be directed via head office, rather than direct by the branch to the local authority, which causes delay before an investigation can be commenced should it be necessary. Individual occupiers whose incidence of accidents are low are often unaware of their responsibility to notify and such accidents only come to light when a visit is made to the premises. Although no accidents reported were fatal, one which could well have been was an explosion in a gas cooker range in a restaurant kitchen. When the hot plate was lit an explosion occurred severe enough to blow open the oven door. The unfortunate employee who lit the hot plate was standing directly in front of the oven and was badly injured. From investigation it appears that the pilot light in the oven had gone out some time after being lit at 8.30 a.m. and 9.00 a.m. when the hot plate was ignited. Following recommendations the firm had flame failure valves fitted to the oven pilot light which prevent gas enteringthe oven until the pilot is alight. As.a result of this accident a survey of catering establishments was carried out and advice given where necessary. The number of accidents on steps and ladders among female staff has decreased, probably due to the change in fashions from the stiletto to the now popular block heel. Consumer Protection Act, 1961 This Act gives the Secretary of State power to make regulations on safety requirements and construction of certain goods likely to cause death or personal injury. Regulations made 99 already cover oil heaters, electric fires, nightdresses, stands for carrycots and toys (cellulose and lead paint content). Routine visits were made during the year to both shops and market stalls where such goods are likely to be sold. Imported toy pianos and piano/xylophones gave cause for concern when it was found they had both celluloid keys (highly inflammable) and an excessive lead paint content likely to cause brain damage or even death if consumed in sufficient quantity by young children. Co-operation by the local press highlighted the problem and for a while the Borough was completely free of this menace. However, they began to reappear as Christmas shopping began. One case came before the local magistrates with three others due for hearing in the new year. The one case heard was dismissed, the magistrates accepting the defendants plea that he had taken all reasonable steps to ensure the toy was safe. This meant that someone else along the line from manufacturer to retailer was at fault and at that time there was no 'passing over' clause in the Act allowing the real culprit to be brought to trial. This omission has now been remedied. In view of the high cost of Analyst fees in the case of piano/xylophones as much as £25 per toy, Inspectors have to be reasonably certain toys are suspect as the only way to recover expenses is by a successful prosecution. Liaison with neighbouring authorities to save duplication of sampling has kept such expenditure to a minimum. The Electrical (Colour Code) Regulations came into operation during the year which means British made appliances have the same colour wiring in the flex as thirteen other European countries. The new colours are Brown—live; Blue—negative; and Green/Yellow—earth. Shopkeepers and the trade are allowed a suitable time to dispose of old stocks. To educate the public each appliance will for the next seven years have an explanatory notice attached to the flex 100 advising on wiring connections to the plug. Prosecutions Act Section Offence Result 1. Offices, Shops & Railway Premises Act 1963 6(1) Temperature Dismissed 2. Shops Act 1950 17 Assistants halfholiday notice £1 fine 22(3) Sunday Records £2 fine 23 (3) Holiday in lieu of Sunday £2 fine 3. Offices, Shops & Railway Premises Act 1963 24 First Aid £5 fine 10(1) Washing facilities running supply of hot or warm water £5 fine 50 Abstract of Act £5 fine 4. „ Shops Act 1950 6(4) Thermometer £3 fine 24 First Aid £3 fine 9(2) Ventilation of toilet £3 fine 17 Assistants halfholiday notice £1 fine 5. Offices, Shops & Railway Premises Act 1963 17 (l)(a) Unguarded Machinery £5 fine (b) „„ £5 fine (c) „„ £2 fine (d) „„ £2 fine 16(1) Obstructed passage £10 fine 6- Shops Act 1950 Consumer Protection Act 1961 47 Sale of non-exempted goods on Sunday £3 fine 2 Unsafe Toy Dismissed 7. 2 Unsafe Oil heater £15 fine 101 MISCELLANEOUS Noise Abatement Fifty five complaints were investigated during the year —an overall increase of 17 on 1969. Fifteen referred to industrial premises, 24 commercial, 13 domestic and three were in respect of noisy ice cream chimes. One ice cream vendor was prosecuted under Section 2 of the Noise Abatement Act, 1960 for operating a loud speaker to play musical chimes before noon. A fine of £5 was imposed and costs of £2 awarded the Council. In all other instances informal action was sufficient to effect a reduction in noise levels. Observation continued to be kept during the "season" on the speedway racing activities at "Brooklands", but the noise level was never sufficient to take any formal action despite numerous complaints from residents living close to the speedway. However, it is understood that private action is being taken by a local resident. Civic Amenities Act, 1967 Four prosecutions were taken by the Council during the year under Section 19 of the Civic Amenities Act, 1967. Two were in respect of the dumping of rubbish and two in regard to abandoning motor vehicles. Fines totalling £70 were imposed and costs totalling £11 awarded the Council. Rag Flock & Other Filling Materials Act, 1951 Routine inspections continued to be made to the three registered premises in the Borough and two samples were submitted to the Prescribed Analyst for examination. In each case a satisfactory report was received. Pet Animals Act, 1951 Twenty eight licences to keep a Pet Shop were renewed for the year and one new licence was issued during the year. Five of these licences were in respect of stalls in Romford Market. At the end of the year this figure was reduced by three, the businesses in question closing down. A fee of £2 is payable for eaqh of these licences. Riding Establishments Act, 1964 Nine licences to keep Riding Establishments were issued for the year 1970 (8 renewals, 1 new establishment), but at the 102 end of the year two of these became livery stables and did not therefore, come within the scope of this Act. The fee for each of these annual licences is £10. The Riding Establishments Act, 1970 was passed during 1970 and comes into operation on 1st January, 1971. This contains several important new conditions, including adequate insurance and also amends the Act of 1964. Animal Boarding Establishments Act. 1963 The nine annual licences authorising persons to keep an Animal Boarding Establishment(cats and dogs) were all renewed during the year, the fee for each licence being £2. The total boarding capacity authorised is 539 dogs and 203 cats. Performing Animals (Regulation) Act, 1925 There are no current registrations under this Act. Paddling Pools Ten samples were taken from the Council's paddling pools during the year and all were satisfactory. Swimming Pools A total of 31 bacteriological and 31 chemical samples were taken from the three public swimming pools during the year, and in each case a satisfactory report was received. The total number of school swimming pools is now 15. Regular sampling is carried out and 60 bacteriological samples and 61 chemical samples were taken during theyear. All samples were generally satisfactory. Establishments for Massage or Special Treatment Eighteen licences authorising persons to carry on an Establishment for Massage or Special Treatment were renewed for the period 1st April, 1970 to 31st March, 1971. These licences (annual fee £1.05) were in respect of 15 chiropodists, 1 physiotherapist and two beauticians. One chiropodist, however, retired at the end of the year and the practice closed down. 103 Essex County Council Act, 1933-Part V-Employment Agencies Twenty seven licences to carry on Employment Agencies were issued during the year—an increase of three on the previous year. A fee of £2.10 is payable in respect of new licences and £1.05 for a renewal. Theatrical Employees Registration Acts, 1925—1928 Three new registrations were effected during the year and appropriate copies of the entries in our register passed to the Home Office. Three partnerships ceased to function during the year, making a total of 16 registrations at the end of the year. Scrap Metal Dealers Act, 1964 Thirteen new registrations were made in the Register of Scrap Metal Dealers during the year, these registrations being for a period of three years. Two registrations which expired during 1970 were not renewed and at the end of the year there were 38 entries which were still extant. Hairdressers and Barbers Four certificates of registration were issued during the year in respect of new businesses as hairdressers (barbers) and 11 registrations were made where there had been a change of ownership. Six businesses closed down during the year, making a total of 161 registrations at the end of 1970. Cemeteries The Council operate four cemeteries, all sited within the Borough, the number of burials taking place during the year being as follows:- Cemetery Adults Stillborn Children Romford 495 19 Hornchurch 77 3 Rainham 106 4 Upminster 159 — Total 837 26 Crematorium The total number of cremations carried out during 1970 at 104 the South Essex Crematorium, Ockendon Road, Corbets Tey, Upminster, was 2,598 which included 1,223 from Havering. The figures for 1969 were 2,476 and 1,203. The Crematorium Joint-Committee (Havering & Thurrock) have developed a further 1½ acres of land north west of the present Garden of Remembrance, which it is anticipated will accommodate the disposition of cremated remains for many years to come. Mortuary 280 bodies were received at the mortuary at Oldchurch Hospital during 1970 for which the Council pay the Hospital Management Committee the sum of £2 in respect of each body received into the mortuary. The Hospital Management Committee provide all the necessary labour, services and equipment required for post mortems. Common Lodging Houses There are no common lodging houses in the Borough. Disinfection & Disinfestation The arrangement whereby the Council take advantage of the disinfecting and cleansing services provided by the London Borough of Hackney continued during the year. Six families, totalling 26 persons who were either verminous or suffering from scabies, together with their clothing and bedding were dealt with during the year. These families and their effects are transported to Hackney in one of the Departmental vans which carries special insurance cover for this activity. Pest Control The Council appointed a third Pest Control Officer/ General Assistant at the end of November and provided the necessary transport and equipment for his use. On conclusion of the necessary training this Officer will be able to assist in the extension of our Pest Control Services, particularly those which were previously undertaken by the Ministry of Agriculture, Fisheries & Food, such as extermination of foxes, narcotizing of pigeons, etc., etc. 105 The other two Pest Control Officers are licensed by the Ministry of Agriculture, Fisheries & Food in accordance with Section 10 of the Protection of Birds Act,1954, to use stupefying bait for killing or taking wild birds. This enables these officers to undertake operations against feral pigeons and during the year some nine large scale treatments were carried out, in two instances with the co-operation of British Railways. The baiting of the Council's sewers is dealt with by the staff of the Borough Engineer & Surveyor, who in the main use contractors for this purpose. The following is an extract from the Annual Report on Rats and Mice for the year ending 31st December. 1970 which is sent to the Ministry of Agriculture, Fisheries & Food on Form I.R. 31 under authority of the Prevention of Damage by Pests Act, 1949:- NonAgricultural Premises Agricultural Premises 1. Total number of properties (including nearby premises) inspected following notification 4,500 - Number infested by: (a) Rats 3,303 - (b) Mice 1,197 - 2. Total number of properties inspected for rats and/or mice for reasons other than notification 5,758 232 (a) Rats 19 4 (b) Mice 6 2 Factories Act, 1961 The following prescribed particulars - which are required by Section 153 (1) of the Factories Act, 1961 - are requested by the Secretary of State for Employment with respect to matters under Parts 1 and VIII of the Act which are administered by the Council:- 106 Premises (1) Number on Register (2) Number of Inspections (3) Written Notices (4) Occupiers Prosecuted (5) i) Factories in which Sections 1,2,3,4 & 6 are to be enforced by Local Authorities 38 31 1 - ii) Factories not included in (1) in which section 7 is enforced by the Local Authority 605 255 7 - iii) Other premises in which section 7 is enforced by the Local Authority (excluding out-workers premises) 28 39 - Total 671 325 8 - Particulars (1) Number of cases in which defects were found Number of cases in which prosecutions were instituted (6) Found Re (2) 'medied (3) Referred ToH Inspe (4) M [ByH.M ctorlns pector (5) Want of cleanliness (S. 1 ) 8 4 - 1 - Overcrowding (S. 2) — — — — — Unreasonable temperature (S.3) - - — - - Inadequate ventilation (S.4) - — - - - Ineffective drainage of floors (S 6) - - - - - Sanitary Conveniences (S.7) - - - - - (a) Insufficient 1 1 — 1 — (b) Unsuitable or defective 16 7 - 15 - (c) Not separate for sexes 1 1 — 1 — Other offences against the Ac (not including offences relating to Outwork) 1 1 — — — Total 27 1 4 - 18 - Outwork—Sections 133 and 134 Nature of Work Number of Outworkers in August list Wearing apparel — making, etc. 4 107