HAV 7 I London Borough of Havering ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH For the Year 1971 INDEX Page INTRODUCTION 1 HOUSING & HEALTH SERVICES COMMITTEE 4 STAFF 5 GENERAL STATISTICS 8 INFECTIOUS & OTHER NOTIFIABLE DISEASES 13 Tuberculosis 14 Care of the Tuberculosis 15 Milk for Tuberculosis Patients 15 Medical arrangements for Long Stay Immigrants 16 Smallpox Contacts 16 Venereal Diseases 17 Immunisation & Vaccination 18 B.C.G. 20 PERSONAL HEALTH SERVICES 21 Maternity Services 21 Antenatal Care 22 Mothercraft & Relaxation Classes 22 Midwifery 22 Family Planning 23 Cervical Cytology 24 Premature Births 24 CHILD HEALTH SERVICES 24 Congenital Malformations 24 Phenylketonuria 25 Handicapped Pre-School Children 25 Clinics 26 Clinic Doctors 27 Health Visitors & Clinic Nurses 27 Speech Therapy 28 Home Nursing 28 Sickroom Equipment 29 Incontinent Laundry Service 30 Nursing Homes 30 SCHOOL HEALTH SERVICE 31 Periodic Medical Inspections 31 (i) Page Special Medical Inspections 32 Screening Tests 33 Cleanliness Inspections 34 Provision of Milk in Schools 34 Specialist Services 35 Child Guidance 35 Speech Therapy 36 School Dental Services 36 School Clinics 36 Handicapped Pupils 37 REPORT OF THE CHIEF DENTAL OFFICER 39 Staff 39 Fluoridation 40 Dental Health Education 40 Premises 41 Training 41 Priority Dental Service 41 Inspections 42 Attendance & Treatment 42 Orthodontics 43 Dentures 43 Sessions 43 Dental Service for Expectant & Nursing Mothers and Children under 5 years 43 Dentures 44 Inspections 44 HEALTH EDUCATION 45 Home Safety 46 CHIROPODY SERVICE 48 MENTAL HEALTH 50 OCCUPATIONAL HEALTH SERVICE 51 ENVIRONMENTAL HEALTH 52 Food & Drug Administration 53 Bacteriological Milk Sampling 55 Brucella Abortis 55 Ice Cream Sampling 1971 — Bacteriological Examination 55 (ii) Page Other Food Sampling 56 Pesticide Residues in Foodstuffs 57 Imported Food Regulations 1968 57 Essex County Council Act 1950 — Section 103 57 Poultry Processing Premises 57 Pharmacy & Poisons Act 1933 58 Milk Distributors 58 Milk (Special Designation) Regulations 1963, as amended 58 Greater London Council (General Powers) Act 1968, Part VIII Night Cafes 59 Late Night Refreshment Houses Act 1969 59 Game Act 1831 59 Food & Drugs Act 1955 — Section 16 59 Food Hygiene (General) Regulations 1970 60 Slaughter of Animals Act 1958 60 Slaughterhouses and Meat Inspection 60 Diseases of Animals Act 1950 61 Condemned Foods 1971 61 Carcases Inspected and Condemned 62 Meat Inspection — Meat Inspection (Amendment) Regulations 1971 63 SANITARY CIRCUMSTANCES 63 Enforcement Proceedings 64 Refuse Collection 64 Street Cleansing 65 Refuse Disposal 65 Radioactive Substances Act 1960 65 Rivers, Streams and Watercourses 66 Water Supply 66 Reorganisation of Water and Sewage Services 67 Rainfall 70 London. Weather Centre 1971 (Rainfall & Sunshine) 71 " (Temperature) 72 Sewerages Sewage Disposal 73 Streets made up and taken over 75 (iii) Page HOUSING SERVICES 76 New Dwellings 76 L.A. Housing Accommodation 76 South Park Caravan Site (Gypsies) 76 Priority on Medical Grounds 77 Land Charges 77 Building Control 77 Improvement Grants 77 Qualification Certificates 78 Certificates of Disrepair 79 Closing Orders 79 CLEAN AIR 79 Clean Air Act 1956 — Smoke Control Areas 79 Investigation of Atmospheric Pollution 79 Chimney Heights 80 MISCELLANEOUS 81 Noise Abatement 81 Disinfection & Disinfestation 81 Pest Control 81 Civic Amenities Act 82 Hairdressers & Barbers 82 Cemeteries 82 Crematorium 83 Mortuary 83 Common Lodging Houses 83 Rag Flock & Other Filling Materials Act 83 Pet Animals Act 84 Riding Establishments Act 84 Animal Boarding Establishment 84 Performing Animals 84 Paddling Pools 84 Swimming Pools 84 Establishments for Massage or Special Treatment 85 Employment Agencies 85 and 100 Theatrical Employees 85 Scrap Metal Dealers 85 (iv) Page Factories Act 1961 85 SHOPS & OFFICES LEGISLATION 89 Shops Acts 1950/65 89 Offices Shops & Railway Premises Act 1963 94 Consumer Protection Acts 1961/71 98 Gaming Act 102 (v) Telephone: ROMFORD 66999 Health Department, Mercury House, Mercury Gardens, Romford, RM1 3DS. To: The Mayor, Aldermen and Councillors of the London Borough of Havering Mr. Mayor, Ladies & Gentlemen, I present my report on the work of. the health department of the Borough for the year 1971. The beginning of the year saw the separation of the social from the health aspects of the local authorities services for the community with the formation in April 1971 of the Social Services department. The services with a predominant health constituent remained with the health department, whilst those in which the social aspect predominated passed to the social services department. There were inevitably services which passed to the social services department in which the health aspect remained vitally important and liaison on such services is essential, and as medical advisor it is hoped that close links will be maintained. At the more local level liaison was assisted by the adoption towards the end of 1971 of the Mayston Structure of nursing management with the establishment of three multi-disciplinary area nursing officers responsible under the Chief Nursing Officer for all the nursing services in their particular area of the borough and it is at this level that it is hoped that liaisonwith area social work teams will be most fruitful. In May 1971 the Consultative Document on the Reorganisation of the National Health Services was produced outlining the proposals for the setting up of Regional and Area Health Authoritites in 1974. This served to emphasise the need for close co-operative and liaison links to be set up with all local authority departments which once established can be maintained through and after the the period of change when the present local authority health functions, apart from Public Health Inspectorate, will pass into the National Health Service. Another significant change occurred in 1971 with the 1 ation of the Education (Handicapped Children) Act, 1970, after which no child could be deemed as unsuitable for education in school and all children whatever their degree of handicap should attend a school suitable for their needs. In practical terms in this borough the junior training centre and special care unit became a new school under the name of Ravensbourne School signifying a new approach to these children. These children now come within the scope of the School Health Service and in common with children who are attending special schools, close medical observation is maintained to ensure that each child is not prevented by medical reasons from reaching their maximum potential. Once a handicap has been detected these children are followed up closely with developmental assessments and with the help of the hospital paediatric and the school psychological services. Regular case meetings are held in all areas, when the needs of the child are reviewed both as part of the family, and so that advice can be given as to the best educational placement on reachingschool age. The child is followed up through all the stages of its school life, ending with a final assessment of the handicapped school leaver, including consultation with the Youth Employment Officer and Social Services department, should the degree of the final handicap warrant this and through to placement of the handicapped young person. To obtain the full benefits of this diagnosis and assessment process it is essential that the detection of the handicap is made at a very early stage. It became increasingly apparent however, that there was a need to concentrate these very specialised and limited resources to the children in most need. It is also important to educate mothers on the normal progress and development to be expected from their baby so that early deviations from the normal could be referred at an early stage for comprehensive developmental examinations to be carried out. By this means the time of clinic doctors can be concentrated on those babies who were already exhibiting a possible handicap or because of the birth or family history required special observation. Close observation of these babies' development is also made by the health visitor in the home. Arrangements for this improvement in the early detection of handicap were finalised towards the end of 1971 ready for implementation in 1972. From this review of the situation it can be seen that the child health service is a complete service to a child 2 from birth to school leaving age linking with employment, and primarily needs the continuity of care which is at present being provided. In the latter part of 1971 a re-assessment and re-appraisal of present and future policies of all the other aspects of the health department work was begun. It became apparent that now was the optimum time for making firm foundations for community health especially in the preventive field and to work for their expansion so that the services for Havering are well developed before they become absorbed into the National Health Service and have to compete for resources with the curative services. It is hoped that with this optimistic outlook that the present staff, with your hfelp, will tackle future problems energetically. Recruitment is proving to be difficult in these uncertain times which make expansion of services difficult but positive plans should prevent depletion of our already committed staff. The final part of 1971 was concerned with preparation for the proposed move of office accommodation to Romford, and although this may prove disrupting for a short time, the close proximity with the other local authority departments will lead in time to even closer co-operation than that which is enjoyed at the present time. My thanks are due to the Chairman and the members of the Housing and Health Services Committee and the Council and to the staff of the Department and to the wide range of professional colleagues and voluntary workers whose co-operation and goodwill is so important in the efficient provision of services to the public. I am, Mr. Mayor, Ladies and Gentlemen, F. GROARKE, Medical Officer of Health. 3 HOUSING & HEALTH SERVICES COMMITTEE as at 31st December 1971 His Worship the Mayor Councillor F.J. Coffin, J.P. (ex officio) Chairman Alderman W.F. Cole Vice-Chairmen Councillor F.G. Carrick Councillor H.D.M. Rivers Alderman M.J. Ward (ex officio) Alderman S.A. Legg Councillor A.T. James Councillor C.J. Kemp Councillor R.W.E. Manning Councillor G.W. Saunders Councillor W.F. Topp Councillor T.W. Ward Councillor R.J. Whiting Councillor J.E.D. Whysall Dr. R.G. Troup 4 HEALTH DEPARTMENT STAFF as at 31st December, 1971 Medical Officer of Health F.L. GROARKE, M.B., L.M., D.C.H., D.P.H., M.F.C.M. Deputy Medical Officer of Health PAMELA AIHIE, M.B., B.S., M.R.C.S., L.R.C.P., D.P.H., M.F.C.M. Secretary to Medical Officer of Health Mrs. S.J. WOODS Departmental Medical Officers JULIE C. ALLARDICE, M.B., Ch. B. H.C. GUPTA, M.B., B.S., D.P.H. SYLVIA INGLIS, M.B., B.S. (Part-time) L.J. MARSHALL, M.B., B.S., L.M.S.S.A. INDU NAGPAUL, M.B., B.S. NERGESH R. SURTI, M.B., B.S., D.C.H., D.P.H. PADMATOLANEY, M.B., B.S. MAIR E. WILLIAMS, M.R.C.S., L.R.C.P. Chief Chiropodist L.A. BOLLAND, M.Ch.S., S.R.Ch. 9 Senior Chiropodists 4 Sessional Chiropodists Senior Speech Therapist MRS. K. HILTON, L.C.S.T. 3 Speech Therapists 1 Sessional Speech Therapist Administrative Officer E.W. GOWERS Principal Administrative Assistants (Environmental Health) J.E. BLAY 5 E. LAMB (Personal Health) MRS. B. MATHER (Management) 9 Administrative Assistants 21 F/T Clerical Assistants 3 P/T Clerical Assistants 12 F/T Clinic Clerks 6 P/T Clinic Clerks Chief Nursing Officer MISS G.P. THORNHILL, S.R.N., S.C.M., H.V. Area Nursing Officers MISS A. CATTLE, S.R.N., S.C.M., H.V. MISS D.D.K, MARTIN, S.R.N., S.C.M. MRS. M. SMITH, S.R.N., S.C.M., H.V. Nursing Officers (Midwifery) MRS. P. EDWARDES, S.R.N., S.C.M. MRS. M. ROSE, S.R.N., S.C.M. MRS. T.M. SIU, S.R.N., S.C.M. 16 F/T Midwives 4 P/T Midwives Nursing Officers (District Nurses) MRS. E. SMART, S.R.N., D.T. MISS J. CAREY, S.R.N., D.T. MR. H.A. FOX, S.R.N., D.T. 29 F/T District Nurses 5 P/T District Nurses 1 District Nurse/Midwife 3 State Enrolled Nurses 6 Nursing Auxiliaries Nursing Officers (Health Visitors) MISS P.F. CULL IS, S.R.N., S.C.M., H.V. MRS. A. COWELL, S.R.N., H.V. MISS M. DIXON, N.N.E.B., B.T.A., S.R.N., H.V. 19 F/T Health Visitors 8 P/T Health Visitors Nursing Officers (Health Visitors) (cont'd.) 1 F/T Tuberculosis Visitor 3 F/T Clinic Nurses 17 P/T Clinic Nurses 3 Student Health Visitors Chief Dental Officer E. B HODGSON, B.D.S., D.D.P.H. 4 F/T Dental Officers 3 P/T Dental Officers 7 F/T Dental Surgery Assistants 2 P/T Dental Surgery Assistants Chief Public Health Inspector M.F.G. 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. Senior Public Health Inspectors O. WHITWORTH, M.A.P.H.I. P.W. EDWARDS, M.A.P.H.I. G. HOBSON, M.A.P.H.I. 10 Public Health Inspectors 2 Meat Inspectors 3 Pupil Public Health Inspectors 3 Pest Control Officers Senior Shops and Offices Inspector S. TITTERTON, D.S.A.A., F.I.S.A,.A., A.M.R.S.H. 2 Shops and Offices Inspectors 7 GENERAL STATISTICS Area- in Acres 29,650 Population (Registrar-General's Estimate for Mid 1971) 246,710 Number of dwellings as at 31.12.71 81,703 Rateable value as at 31.12.71 £13,315,430 Estimated product of a lp Rate £128,160 The Registrar-General's estimate of the midyear population of the Borough for 1971 shows a decrease of 5,420 compared with 1970. In 1965, the estimate was 250,430 and the figure has consistently increased each year to reach the 1970 estimate of 252,130. Movement of population away from the London area, which has been considerable in recent years, renders accurate estimates of population very difficult. The 1971 mid-year estimate, being based on the provisional figures from the census taken earlier in the year has resulted in a more accurate estimate. The effect on statistics resulting from a 5,420 fall in the population is noticeable in both the birth rate and the death rate, which are included in the tables below. The number of births increased by 99, and this higher number would have increased the birth rate by approximately 0.4 per 1,000 population, but due to the lower population figure, the rate increased by 0.8. Similarly, deaths were 58 fewer in 1971 compared with 1970, and the rate would have dropped from 11.2 to 10.9. Here the alteration in the mid-year estimate resulted in the death rate remaining at 11.2 per 1,000 population. These rates quoted are after adjustment of the crude rates byv the Area comparability factors of 0.92 for births and 1.33 for deaths. Extracts from Vital Statistics for the Year (Figures for 1970 are given in parenthesis) Live Births Male Female T ot al Legitimate . 1926 1721 3647 (3547) Illegitimate 104 86 190 (191) Tot al 2030 1807 3837 (3738) Birth Rate per 1,000 population 14.4 (13.6) Illegitimate live births (percentage of total live births) 5.0% (5.1%) 8 Still Births Male Female Total Legitimate 25 19 44 ( 25) Illegitimate — — — (4) Total 25 19 44 (29) Total live and still births 3881 (3767) Still birth rate (per 1,000 live and still births) 11.3 (7.7) Infant Deaths (under 1 year) Male Female Total Legitimate 31 21 52 (58) 11 legitimate 2 2 4 (3) Total 33 23 56 (61) Infant Mortality Rates — Total infant deaths per 1,000 total live births 14.6 (16.3) Legitimate infants per 1,000 illegitimate live births 14.3 (16.4) Illegitimate infants per 1,000 illegitimate live births 21.1 (15.7) Neo Natal Mortality Rate (Deaths under 4 weeks of age per 1,000 live births) 9.9 (10.7) Early Neo Natal Mortality Rate (Deaths under one week of age per 1,000 total live births) 8.9 (8.5) Perinatal Mortality Rate (Still births and deaths under one week of age combined per 1,000 live and still births) 20.1 (16.2) Maternal Mortality (including abortion) Number of deaths 0 (0) Rate per 1,000 live and still births — (-) Male Female Total Deaths 1096 972 2068 (2126) Death rate per 1,000 population 11.2 (11.2) Comparison of the above rates with those of England and Wales is shown on the following table:— 9  Havering England & Wales Outer London Greater London Birth Rate 14.4 16.0 15.3 15.2 Illegitimate Live Births (percentage of total live births) 5.0 8.4 8.6 11.5 Still Birth Rate 11.3 12.5 11.9 11.7 Infant Mortality rate 14.6 17.5 16.4 17.4 Neo Natal Mortality rate 9.9 11.6 10.9 11.6 Early Neo Natal Mortality rate 8.9 9.9 9.1 9.7 Perinatal Mortality rate 20.1 22.3 20.9 21.3 Maternal Mortality rate 0.0 0.17 0.10 0.12 Death Rate 11.2 11.6 11.0 11.5 10 11 Cause of Death ALL AGES Under 4 week s 4 weeks & under 1 year AGE IN YEARS Total Male Female 1-4 5-14 15-24 2S-34 35-44 45-54 5 5-6 4 65-74 75 & over Cholera - - - - - - . - - - - - - - - Typhoid Fever - - - - - - - - - - - - - - Bacillary Dysentery and Amoebiasis - - - - - - - - - - _ - - - Enteritis and other Diarrhoeal Diseases - - - - - - - - - _ _ - - - Tuberculosis of Respiratory system - - - - - - - - - - - - - - Other Tuberculosis incl. late effects 3 2 - - - - - - - 1 1 - 1 Plague - - - - - - - - - - - - - Diphtheria - - - - - - _ - - - - - - Whooping Cough - - - - - - - - - - - - - - Streptococcal Sore Throat At Scarlet Fever - - - - - - - - - - - - - - Meningococcal Infection - - - - - - - - - - - - - - Acute Poliomyelitis - - - - - - - - - - - - - - Smallpox - - - - - - - - - - - - - Measles - - - - - - - - - - - - - Typhus and other Rickettsioses - - - - - - - - - - - - - - M alaria - - - - - - - - - - - - - - Syphilis and its Sequelae - - - - - - - - - - - 1 - - Other Infective and Parasitic Diseases 4 2 2 - - - 1 - - - 1 2 - Malignant Neoplasm, Buccal Cavity, etc. 9 4 5 - - - - - - 2 5 3 Malignant Neoplasm, Oesophagus 12 7 5 - - - - - - 3 - 6 4 3 Malignant Neoplasm, Stomach 39 21 18 - - - - - 1 1 5 10 13 24 13 Malignant Neoplasm, Intestine 61 29 32 - - - - - - - - 1 2 13 Malignant Neoplasm, Larynx 3 3 - - - - - - - - - - 48 - Malignant Neoplasm, Lung, Bronchus 129 106 23 - - - - - 3 13 43 19 11 Malignant Neoplasm, Breast 54 1 53 - - - - - - 1 11 1 2 Malignant Neoplasm, Uterus 10 - 10 - - - - - 1 1 2 1 1 11 Malignant Neoplasm, Prostate IS 15 - - - - 1 - - - 2 3 6 6 Leukemia 20 12 8 1 1 1 10 26 35 36 41 Other Malignant Neoplasms 154 75 79 - - 1 1 1 3 1 2 1 - Benign and unspecified Neoplasms 4 2 2 - - - - - - 1 1 2 7 9 Diabetes Mellitus 20 9 11 - - - - - - - - - - 1 Avitaminoses and other Nutritional Deficiency 1 - 1 - - - - - - - - - 2 3 Other Endocrine, etc. diseases 6 4 2 - - - - - - - - - 1 2 Anaemias 3 1 2 - - - - - - - - - - - 12 Other diseases of blood, etc. _ _ _ _ _ _ _ _ _ _ _ _ _ _ Mental disorders 5 _ 5 _ _ _ _ _ _ _ _ _ 3 2 Meningitis 3 2 1 1 _ _ _ _ _ _ _ 1 _ 1 Multiple Sclerosis 6 4 2 _ _ _ _ _ 1 2 _ 2 _ _ Other diseases of Nervous System, etc. 30 14 16 _ 1 _ 2 _ 1 2 3 4 5 .12 Active Rheumatic Fever _ _ _ _ _ _ _ _ _ _ _ _ _ _ Chronic Rheumatic Heart Disease 19 4 15 _ _ _ _ _ _ 1 2 5 3 8 Hypertensive Disease 21 7 14 _ _ _ _ _ _ _ 2 3 6 10 Ischaemic Heart Disease 534 327 207 _ _ _ _ _ 1 12 46 98 164 213 Other forms of Heart Disease 56 23 33 _ _ _ _ _ _ _ 2 5 9 40 Cerebrovascular Disease 289 122 167 _ _ _ _ 2 1 2 13 33 61 177 Other Diseases of Circulatory system 72 45 27 _ 1 _ _ _ _ _ 8 7 13 43 Influenza 2 _ 2 _ _ _ _ _ _ _ _ _ _ 2 Pneumonia 155 63 92 _ 2 _ _ _ _ _ 2 11 26 1 14 Bronchitis and Emphysema 117 92 25 _ 2 _ _ _ _ 3 17 31 64 Asthma 2 1 1 _ _ _ _ _ 1 _ 1 _ _ Other Diseases of Respiratory System 19 12 7 _ 5 1 _ _ 1 _ 1 1 1 9 Peptic Ulcer 7 3 4 _ _ _ _ _ _ _ _ 1 3 3 Appendicitis _ _ _ _ _ _ _ _ _ _ _ _ _ _ Intestinal Obstruction and Hernia 3 1 2 _ 1 _ _ _ _ 1 _ _ 1 _ Cirrhosis of Liver 1 _ 1 _ _ _ _ _ _ _ _ _ _ _ Other Diseases of Digestive system 17 4 13 _ _ _ _ _ _ 1 _ 2 9 1 Nephritis and Nephrosis 15 6 9 _ _ 1 _ _ 1 _ 3 5 5 Hyperplasia of Prostate 5 5 _ _ _ _ _ _ _ _ _ _ 5 Other Diseases, Genito_Urinary System 14 2 12 _ _ _ _ _ _ _ _ 2 1 11 Diseases of Skin, Subcutaneous Tissue 2 1 1 _ _ _ _ _ _ _ _ _ 1 1 Diseases of Musculo_Skeletal System 26 12 14 _ _ _ _ _ _ _ 3 2 6 15 Abortion _ _ _ _ _ _ _ _ _ _ _ _ _ _ Other complications of pregnancy _ _ _ _ _ _ _ _ _ _ _ _ _ _ Childbirth and Puerperium, Delivery _ _ _ _ _ _ _ _ _ _ _ _ _ _ without mention of complication _ _ _ _ _ _ _ _ _ _ _ _ _ Congenital Anomalies 17 9 8 6 5 1 _ 1 _ 1 2 . _ _ 1 Birth Injury, Difficult Labour, etc. 20 12 8 20 _ _ _ _ _ _ _ _ _ _ Other causes of Perinatal mortality 11 5 6 11 _ _ _ _ _ _ _ _ _ _ Symptoms and Ill_defined Conditions 7 1 6 _ _ _ _ _ _ _ _ _ _ 7 Motor Vehicle Accidents 18 14 4 _ _ _ 4 5 1 _ 4 1 1 2 All other Accidents 24 11 13 _ _ 3 _ 2 2 1 4 1 _ 11 Suicide and Self_Inflicted Injuries 3 1 2 _ _ _ _ 1 _ _ 1 _ 1 _ All other External Causes 1 _ 1 _ _ _ _ _ _ _ _ 1 _ _ TOTAL ALL CAUSES 2,068 1,096 972 38 18 7 9 14 14 45 170 326 521 906 INFECTIOUS AND OTHER NOTIFIABLE DISEASES The following table shows the number of cases of infectious and other notifiable diseases which were notified during theyear: — Diseases Male Female Total Measles 286 294 580 Dysentery 3 (3) 2 (2) 5 (5) Scarlet Fever 52 65 117 Whooping Cough 41 50 91 Infective Jaundice 26 20 46 Tuberculosis: Respiratory 11 4 15 Tuberculosis: Other — 3 3 AcuteMeningitis 5 2 7 Acute Encephalitis (Post Infectious) 1 1 2 Acute Encephalitis (Infectious) 3 1 4 Food Poisoning 105 (6) 106 (3) 211 (9) Figures in () are confirmed cases offood poisoning and dysentery Note: Five cases of food poisoning were brought to our attention other than by formal notification and in each case pathological investigation was successful in.finding the causative organism. Two males and three females were involved. No cases of Poliomyelitis, Anthrax, Cholera, Diphtheria, Leptospirosis, Malaria, Ophthalmia Neonatorum, Paratyphoid Fever, Plague, Relapsing Fever, Smallpox, Tetanus, Typhoid Fever, Typhus or Yellow Fever were notified during the year. Surveillance was, however, necessary in many cases where holiday-makers and travellers returned to this country from areas where some of these diseases were endemic. Our annual review of leprosy patients revealed that the two notified cases had been reclassified as "arrested and cured" and their names were deleted from the central leprosy register maintained by the Department of Health and Social Security. The only disease which showed a marked increase was scarlet fever which produced an additional 16 notifications on the previous year's figure. There was a considerable decrease in 13 the number of cases of measles notified namely 397 and this obviously reflects the steady programme of vaccination which continued unabated throughout the year. Whooping cough showed a decline of 50 cases, dysentery reduced by 47 notifications and a reduction of 13 confirmed cases — in fact the number of 5 confirmed cases is the lowest for a considerable number of years. Food poisoning notifications also reduced by 24, the confirmed cases being 30 less than 1970. The following table shows the number of specimens submitted to the Department of Pathology at Oldchurch Hospital, Romford, and once again my thanks are due to Dr. E. Atkinson, Consultant Pathologist and his staff for their co-operation and assistance in this connection : — Specimens submitted to the Pathology Department — Oldchurch Hospital Taken from Total No. of persons swabbed Total No. of swabs taken Negativ e Positive Shig Sonnei * Salmonella E. Coli 0126 Food handlers 58 71 68 — *3 (1 c ase) — N on-food handlers 217 253 235 2 (2 c ases) *12 (7 cases) 1 * Salmonella Okatie ,, Panama ,, Typhimurium ,, Enteriditis 3 7 Non-food 1 handlers 1 12 *Salmonella Typhimurium 3 T uberculosi s A table giving details of newcases of Tuberculosis notified during the year is given below. The respiratory cases show a reduction of 10 on the previous year and it would appear that the programme of BCG vaccination is now proving itself. The nonrespiratory cases reduced from 5 in 1970 to 3 in 1971 thus making an overall reduction of 12 cases of Tuberculosis on the previous year's figures. 14 Age Group MALE FEMALE Respiratory Others Respiratory Others Under 1 year - - - - 1 year 1 - - - 2 — 4 years - - - - 5—9 years - - - - 10 — 14 years 1 - - - 15 — 19 years - - - - 20 — 24 years 2 - - - 25 — 34 years 1 - 1 1 35 — 44 years 1 - 1 2 45 — 54 years 2 - - - 55 — 64 years 2 - 1 - 65 — 74 years 1 - 1 - 75 & over - - - - Age unknown - - - - TOTAL 11 - 4 3 Care of the Tuberculous : After care assistance for patients suffering from Tuberculosis, and for contacts of such patients, continues to be provided by the Havering Tuberculosis Care Association. The Havering Council provide the Association with an annual grant for this purpose, and the secretarial work of the Association is undertaken by the staff of the Health Department. Dr. S. Steel and Dr. E. Woolf, the Chest Physicians, act as medical advisers to the Association, and those members of the nursing staff of the Health Department involved in tuberculosis visiting also serve on the Committee of the Association, providing helpful information on those patients in need of assistance. Milk for Tuberculous Patients : One pint of milk per day is provided free of charge by the Council to patients sufferingfrom tuberculosis where recommended 15 by the Chest Physician. Five new patients were recommended for a grant of milk during the year and the total number of patients who received milk during the year was 72. This was a reduction of 14 compared with the previous year. Medical arrangements for long stay immigrants During the year information was received from various Port Health Authorities in respect of 89 long stay immigrants who were stated to be proceeding to addresses in this Borough. This is a decrease of 40 on the previous year. In 57 cases, successful contact was made and appropriate advice given on health matters, of the remainder 29 were coming to this country to work in one of the five local hospitals and in these cases no contact is made with them as their place of domicile is under the control of the Regional Hospital Board. The countries where the passports of these long stay immigrants were issued were as follows: — Commonwealth Caribbean 35 India 7 Pakistan 10 Other Asian 24 African 3 Other 3 N on-Commonwealth European 4 Other 3 TOTAL 89 Smallpox Contacts Only three 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. 16 These three were cases where vaccination was contra-indicated because of their age, or other health reason. 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 1971 1970 1971 1970 1971 1970 (a) Syphilis 10 11 7 8 3 3 (b) Gonorrhoea 179 143 134 99 45 44 (c) Other conditions 1638 1296 1036 834 602 462 TOTAL 1827 1450 1177 941 650 509 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:— 1971 1970 (a) Syphilis (b) Gonorrhoea (c) Other conditions 4 109 959 10 79 750 TOTAL 1097 839 Last year I mentioned that the number of persons attending the Oldchurch Treatment Centre had doubled in the preceding five years. The increase in numbers between 1970 and 1971 is 26%, and the 1971 total of 1,827 is more than double the equivalent figure of 879 in 1968. From the figures relating to Havering residents, an even greater increase can be seen. The total number of persons from Havering attending the Oldchurch Hospital Treatment Centre and various treatment centres in London rose from 438 in 1968 to 1,097 in 1971, an increase of 150% in three years. 17 This indicates either that more people who had been at risk had overcome their inhibitions against seeking treatment and advice, or just that more people had been at risk and that the percentage of those who sought advice remained unchanged. The number of cases of syphilis continued to decline gradually in line with national statistics but the number of patients from Havering found to be suffering from gonorrhoea increased over the previous year by almost 40%, and the 1971 figure of 109 is just double the 54 diagnosed in 1968. Such increases in attendances must pose grave problems to those concerned with the diagnosis and treatment of venereal diseases, unless appropriate increases in staff and facilities are available. To continue to deal with increases of this order without an equivalent increase in manpower can only lead to a gradual deterioration in the standards that can be maintained at the treatment centres. Immunisation & Vaccination During the Summer of 1971 a recommendation was received from the Ministry of Health stating that the world wide control of smallpox had now reached such a stage that routine vaccination against smallpox in childhood was no longer necessary. This represents a further step forward in the World Health Organisation's campaign for the eradication of smallpox. Smallpox vaccination is still necessary before travelling to countries where the disease is endemic and for all public health personnel who play an important part in the diagnosis and control of any case that is likely to occur in this country. 1971 saw the continuation of a campaign started in 1970 for the immunisation of all girls aged between 11 and 14 years against german measles (rubella). German measles is a mild disease so that eradication is unnecessary, the main complication occurs if this disease is contracted during early pregnancy when deformity of the unborn child may result. Throughout the year immunisation has been offered to two year age groups so that from 1972 it will be offered to the 11 year old girls. Fortunately due to good public awareness, the acceptance rate for this immunisation has been very good indeed. The present schedule of immunisation is as follows:— 18 Approximate Age Immunisation During first year of life Diphtheria / Whooping Cough / Tetanus (three injections) together with Poliomyelitis vaccine (three doses by mouth). During second year of life Measles vaccination. 4—5 years (pre-school booster) Diphtheria/Tetanus booster, Poliomyelitis booster. 11 years Rubella (german measles) immunisation (girls only). 13 years B.C.G. vaccination losis). 15 —19 years Tetanus and Poliomyelitis boosters. The percentage of children born in 1969 immunised by 31.12.71 Whooping Cough 80% Diphtheria 87% Poliomyelitis 90.4% Tetanus 88.0% Measles 64.4% These figures show a fall in immunisation rates for whooping cough, diphtheria, tetanus and poliomyelitis of about 5% on those of last year for 1968 births to about the national average. 1969 was, however, the first year for the implementation of the new immunisation schedule which affords greater protection for the children but does necessitate a gap of six months between the second and the third injections and requires greater vigilance by all our staff to ensure each child completes their course of immunisation. I am pleased to say that the figures so far for children born in 1970 show an encouraging rise so that by next year I hope to be able to report a return to our previous excellent record. 19 The immunisation rate for measles shows a very encouraging rise from 46% to 64% with a resultant decrease of measles in the community from 977 in 1970 to 580 in 1971 due to the continued advice and education by all our staff, especially health visitors. B.C.G. The immunisation of school children during their second year at secondary school continued throughout the year, and a total of 3,886 children were skin tested and 3,204 were vaccinated against tuberculosis. This is a fairly good acceptance rate, but the need for this vital immunisation before going out into the adult world is not always appreciated by the children and their parents. The incidence of tuberculosis over the years has decreased very much but until the disease is completely eradicated, the need for immunisation is still vital. PERSONAL HEALTH SERVICES The personal health services continued through the difficult time of implementation of the Seebohm proposals in increasing strength. The needs for extended services in all fields were highlighted and much progress was made in both reappraisal and implementation of these services. Close liaison was maintained with the newly formed Social Services department and after initial difficulties definite pathways of contact are being established. This was aided in the summer of 1971 by the establishment of the Mayston structure of the nursing services, with appointment of three multi-disciplinary area nursing officers covering the N.E., N.W. and South areas of the Borough. Accommodation for these area nursing officers was difficult to find in the existing clinics but it is hoped to decentralise them in the near future. With a view to 1974 and the proposed unification of the Health Services liaison with general practitioners and hospital services has continued ingrowing intensity with increased attachment of local authority health staff to general practitioners and liaison visits by health visitors and doctors to local hospitals especially in the paediatric and geriatric fields. It is only with the growing awareness of other medical disciplines of the true nature of the role played by the community health services that preventive medicine will come to take its true role alongside curative medicine whilst still maintaining the close links with other local authority departments in the role of medical advisor. Maternity Services The Rush Green and Harold Wood Maternity Units have continued throughout the year but due to many factors, the general practitioner unit at Rush Green Hospital has been incorporated into the consultant maternity unit and this arrangement appears to be functioning well. Maternity Liaison Committees at both Harold Wood and Rush Green Hospitals have continued and enables close links to be made between the hospital and local authority maternity services. 21 Antenatal Care Statistics relating to this Authority's antenatal and postnatal clinics are given below:— Number of women attending clinics Antenatal Post-natal TOTAL 1143 14 1157 Number of sessions Doctor Midwife TOTAL 42 1120 1162 These figures show an increase on previous years mainly in midwife sessions. This is accounted for by the increasing midwife attachment to general practitioners and the inclusions of the figures for the midwives attendance at general practitioner antenatal sessions. Mothercraft and Relaxation Classes These classes continue to be well attended and provide an essential service to the mothers to be in this Borough. The figures show a rise in attendance both by mothers booked for home and hospital confinements as is shown in the following table:— Booked for hospital confinement Booked for home confinement TOTAL Number of women attending 796 65 861 Midwifery At December 1971 19 full-time and 4 part-time midwives were in post, showing a continued reduction in posts since 1970. The position with regard to the availability of maternity beds in the maternity units within Havering continues to be very good and, in fact, Harold Wood Maternity Unit was working below capacity for part of the year. 22 The domiciliary midwives continued attending their mothers in the Rush Green General Practitioner Unit and commenced attending their own patients in Harold Wood General Practitioner Maternity Unit in October 1971. The percentage of hospital births for 1971 was 89.3%, an increase of 4.3% over 1970. The number of domiciliary confinements decreased from 558 in 1970 to 414 in 1971. The number of patients delivered in hospital but discharged before the tenth day into care of the domiciliary midwife increased from 3,115 to 3,249, added to which 187 babies were delivered by the domiciliary midwives in the hospital general practitioner units. This shows the continued trend for the domiciliary midwife to conduct less deliveries in the patient's home but to go with the mother into the hospital general practitioner unit, deliver her baby and return to care for the mother and child in their own home shortly afterwards. This ensures the availability of the best conditions for the delivery but with the continuity of care which is so essential. During the year 20 pupil midwives completed their second part district training under the direction of approved teaching midwives. In addition 24 students undertaking obstetric training at Rush Green Hospital spent a day with a domiciliary midwife accompanying her on her visits and attending a general practitioner antenatal clinic. Family Planning The family planning services within the Borough were further extended during 1971. The service provided by the Council was increased to five clinics within the Borough and the Family Planning Agency Scheme No.5 was implemented which entitled Havering residents to free consultation, advice and supplies when family planning was required for medical reasons, and free consultations in non-medical cases. The F.P.A. continued to provide a full family planning service in their Romford premises provided for their use by Havering Council and the additional evening clinic in South Hornchurch has become after an initial slack period quite a busy session. 23 Cervical Cytology This service continued a gradual expansion in 1971, when the service was available in seven of the Council's clinics with further plans to extend this to all clinics. The number of smears taken during 1971 was 2,522 of which 5 cases required referral for hospital investigation but in a further 688 cases minor conditions were detected which either required treatment by their general practitioner or a repeat smear. 1971 was the start of the local recall of women who were first tested when the Scheme first started in Havering in 1966 — approximately 1,400 repeat smears were taken. The National Recall system is due to start next year. During 1971 the hospitals were working under extreme pressure and were unable to accept any increase in the number of smears examined and for a time they were forced to cut back on some of the cytological services they had offered previously. The service to Havering clinics was maintained and improvements in the laboratory staffing position are hoped for in the near future. Premature Births 207 premature births were notified during the year which compares with 237 in the previous year, which represents 5.3% of the total live births, which marks a reduction on the percentage of the previous two years of 6.2%. A special care baby unit was opened in Harold Wood Maternity Hospital under the care of Dr. Nauth Misir so that the premature and other delicate new born babies receive immediate care, in addition to the facilities already provided by the special baby care unit at Rush Green Hospital. CHILD HEALTH SERVICES Congenital Malformations Details of congenital malformations observed at birth are required to be reported by the midwife on the notice giving the 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 1971 90 babies were reported as suffering from congenital malformations, 111 different conditions being observed as set out in the following table:— 24 Diagnostic Group Number 0 Central Nervous System 19 1 Eye and Ear 3 2 Alimentary System 14 3 Heat and Circulatory System 5 4 Respiratory System — 5 Urino-genital System 13 6 Limbs 38 7 Other Musculo-Skeletal 1 8 Other Systems 10 9 Other Malformations 8 Phenylketonuria The Guthrie test for detection of this rare metabolic disease in new born babies which untreated can lead to severe mental handicap continued in 1971, the laboratory service being provided for this test by the Neo-natal Screening Service of the Hospital for Sick Children. Equivocal results have a repeat test and one baby was discovered suffering from this disease and immediate hospital investigation and treatment were instituted and I am pleased to say that to date normal progress and development has been maintained. Handicapped Pre-School Children At the end of 1971, 246 handicapped pre-school children were under regular supervision by doctors, health visitors and educational psychologists with a view to the provision of special help when necessary and assessment for the most appropriate educational placement. Clinics The various services provided at the main clinics and subclinics are as charted. A new sub-clinic in Hacton Social Centre was started at the beginning of the year, providing a Child Health Clinic which is much more convenient for the mothers of the area. CLINIC SERVICES - 1971 MAIN CLINICS Collier Row Clinic Hulse Avenue, Collier Row 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 V V V V V V V V Cranham Clinic Avon Road, Cranham V V V V V V V V V V Elm Park Clinic Abbs Cross Lane, Elm Park V V V V V V V V V V V V Harold Wood Clinic Gubbins Lane, Harold Wood V V V V V V V V V V V V Harold Hill Health Centre Gooshays Drive, Harold Hill V V V V V V V V V V Hornchurch Clinic Westland Avenue, Hornchurch V V V V V V V V V V V Rainham Clinic Upminster Road, Rainham V V V V V V V V V Romford Clinic Marks Road, Romford V V V V V V V V V V V V South Hornchurch Clinic South End Road, Rainham V V V V V V V V V V V V V Upminster Clinic St. Mary's Lane, Upminster V V V V V V V V V V V V SUB-CLINICS Hilldene School Clinic Grange Road, Romford V He at on Way Congregational Church Chaucer Road, Romford V V Mardyke Social Centre, Lowen Road, Rainham V V Congregational Church Nelmes Road, Hornchurch V V Park Lane Social Centre Park Lane, Hornchurch V V V St. Augustine's Church Birkbeck Road, Rush Green V V St. Michael's Church Main Road, Gidea Park V V Tweed Way Hall Tweed Way, Rise Park V V Hacton Social Centre Hacton Lane, Hornchurch V 26 Clinic Doctors The establishment of doctors which was one short at the commencement of the year was further depleted by the move of Dr. Ware out of the area, a loss which was deeply felt by the staff and all who benefitted from her advice. The rest of the year saw a new doctor joining us and the return in a part-time capacity of a doctor who had previously been on the staff so that by the end of the year we were nearly at full establishment of eight doctors. During the months of June and July Dr. I. Nagpaul was given leave by the Council to go to India to help with the medical relief of the refugees from the war in East Pakistan. Health Visitors and Clinic Nurses The shortage of qualified health visiting staff continued in 1971 and although working under this great handicap the services were maintained to a very high standard. As well as the work with mothers and children increasing, health visitors are involved with the visiting of the elderly assisted in this by the clinic nurses. A total of 1,462 Child Health Clinics were held in the year, giving advice and guidance to mothers and children, increasingly the emphasis in these clinics has been to enlarge on the developmental testing of babies especially with regard to the early detection and assessment of handicap. The number of cases visited in the home by health visitors numbered 19,054. Every child born in the year (3,995) was visited at least once and 16,616 children in the pre-school age group were visited, added to which 1,023 elderly people were visited, as well as other visits often at the special request of hospital or family doctors. This invaluable work is carried out under extreme pressure but at all times they are persons turned to for help and can always be relied upon both by staff and public alike. Clinic nurses continue to provide invaluable support by undertaking school nursing, immunisation sessions and some visiting work. 27 Four student health visitors completed their training in 1971, all were successful and were appointed to the health visiting staff. Three further students commenced their training in October 1971. A considerable number of students, research workers, etc., were accommodated in the section and conducted on observation visits by members of the staff in all grades. 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. 378 children were newly referred and 198 of the more urgent cases commenced treatment. At the end of the year 153 children were receiving speech therapy and a further 380 were being kept under observation. 181 children were waiting for treatment to be commenced. Home Nursing The home nursing establishment for 1971 has not much increased but more nursing auxiliaries and State Enrolled Nurses have been employed, which to some extent enables the district nurse to delegate work and give priority to activities which need full nursing skills. Home Nursing 1971 1970 Number of persons nursed — Under 5 years of age 15 22 Ages 5 — 64 695 732 Age 65 and over 1740 1767 Total number of persons nursed 2450 2521 Number of nursing visits made during the year 96649 88085 28 Attachment of nursing staff to general practitioners has continued and at the present time twelve practices in the area have district nurse attachment. This involves S.R.N. nurses in all cases but some S.E.N. nurses and nursing auxiliaries are involved under their direction. Sickroom Equipment Details of the various items issued on loan free of charge to patients being nursed at home are as follows :— Articles Issued Number Air Rings 77 Back Rests 269 Bed Cradles 147 Bed Pans 247 Bed Pans (Rubber) 4 Bedsteads 41 Bed Tables 32 Commodes 470 Crutches 40 prs. Drawsheets 39 Feeding Cups 38 Fireguards 9 Foam Rings 201 Fracture Boards 31 Hoists 20 Mattresses 46 Pillows 1 Pillow Covers (Plastic) 1 Plastic Sheets 308 Pole and Chain Pulleys 32 Rubber Sheets 1 Sani-cushions — Sputum Mugs 9 Urinals (Female) 12 Urinals (Male) 154 Walking Aids (Quads.) 31 Walking Aids (Tripods) 36 Walking Frames 167 Walking Sticks 158 Wheelchairs 323 TOTAL 2944 29 Disposable sheets, interliners and plastic pants are also issued free of charge for incontinent patients being nursed at home. During 1971,72,856 sheets, 49,234 interliners and 688 pairs of plastic pants were issued. Incontinent Laundry Service The laundry service provided by the Department collected' a total of 16,157 articles from the homes of incontinent patients for laundering at St. George's Hospital. Collection and delivery of the articles continues to be undertaken twice weekly. Nursing Homes Two private nursing homes are registered in the Borough, both of which are regularly inspected by the staff of the Health Department. These homes provide a total of 46 beds for acute and chronic sick patients. 30 SCHOOL HEALTH SERVICE 1971 April 1971 saw the opening of St. Alban's R.C. Primary School at South Homchurch and Ravensbourne School, Harold Hill, which is a special school for subnormal children and those with multiple handicaps. This school was formed by the amalgamation of the former Belford Junior Training Centre and Special Care Unit, which had previously been administered by the Borough's Health and Welfare Department. In September the new Coopers 81 Coborn School was opened at Upminster and Mitchell Infants' School on the Hornchurch airfield estate. At the same time Broadford Junior and Infant Schools were merged to form a single primary school. The school population at the endoftheyear was as follows: — 86 Primary schools 26,726 pupils 25 Secondary schools (inc. grammar schools) 17,208 2 Technical schools 1,520 " 3 Schools for ESN pupils 391 " 1 School for Subnormal pupils 112 " TOTAL 117 schools 45,957 pupils Periodic Medical Inspections All new entrants to infant schools are given a full medical examination which also provides an opportunity for the school doctor to discuss any health problems with the parent and offer advice about immunisation etc. Pupils in the final year at Junior school are given screening tests of vision and hearing by the school nurse, and specially selected children are examined by the School doctor. Selection of these children is made by the doctor after examination of previous medical records and information provided by parents, teachers, health visitors and school nurses. A similar selection procedure used for the medical inspection of secondary school children approaching compulsory school leaving age was extended to all secondary schools from September 1971. 31 The most important periodic medical inspection is the first examination after entering school at 5 years of age. More undetected and untreated conditions are found at this age than at later inspections and there is also a much higher parental attendance. The adoption of selective inspections of junior and secondary pupils has enabled the school doctors to devote more time to these important infant examinations and to concentrate on those junior and secondary pupils most in need of medical attention. 6,228 pupils were examined by the school medical officers at periodic inspections during the year and a further 3,590 were considered not to warrant a full medical inspection as a result of the selection procedure. The number of pupils seen at periodic medical inspections whose general physical condition was considered unsatisfactory totalled only 3, representing approximately 0.05% of the total examined. A further 986 pupils were found to have defects requiring treatment or investigation and a number of others had conditions which although not requiring immediate attention, needed to be kept under observation. Defects found at periodic medical inspections included the following:— Condition Requiring Treatment Requiring Observation Defective Vision 290 606 Squint 65 90 Defective Hearing 65 414 Nose and throat conditions 117 412 Lung conditions 35 167 Speech disorders 64 127 Developmental abnormalities 90 257 Skin diseases 110 184 Psychological conditions 51 392 Orthopaedic defects 142 366 Special Medical Inspections Apart from the periodic medical inspections, facilities exist for any pupil to be examined by a school medical officer at any time at the special request of the parent, teacher or other person 32 concerned with the child's welfare. These examinations are usually carried out at the regular school clinic sessions held at each of the Council's clinics. Follow-up examinations resulting from previous periodic or special inspections are also arranged as required. 1,170 special medical examinations and 2,762 follow-up examinations were arranged during the year. These do not include the special medical inspections necessitated by the Education (Milk) Act 1971, which are mentioned later in this report. Defects found at special medical inspections included the following:— Condition Requiring Treatment Requiring Observation Defective Vision 64 150 Defective Hearing 83 166 Nose and Throat conditions 14 58 Speech disorders 16 12 Developmental abnormalities 12 81 Skin diseases 137 26 Psychological conditions 35 144 Orthopaedic defects 50 61 Screening Tests The number of routine screening tests of vision and hearing carried out by school nurses was as follows:— Vision Tests Hearing Tests Infants 7,562 7,015 Juniors 14,047 9,620 Secondary 4,836 1,830 Special School pupils 384 295 Totals 26,829 18,760 Any child failing a screening test is referred to the School doctor with a view to further investigation. Colour vision is also tested during the last year in the Junior school and pupils found to have defective colour vision are given advice. This condition 33 is not susceptible to treatment but it is important that pupils should be aware of any colour vision defect in order to avoid planning a career in which normal colour vision would be required. Cleanliness inspections School nurses carried out 30,557 cleanliness inspections and 269 pupils were found to be infected. None of these cases was sufficiently serious towarrantacleansing notice being issued. Provision of Milk in Schools Under the Education (Milk) Act 1971 the Authority's power to supply free milk to pupils over the age of seven years was withdrawn after the end of the Summer term, except for pupils attending special schools or others (aged 7 to 12 years) where a school medical officer certifies that the pupils health requires that he should be provided with milk at school. This legislation received Royal Assent during the school summer holiday and took effect from 1st September 1971, with the result that no preparation could be made to identify needy children before commencement of the Autumn term. At the beginning of the term arrangements were made for the sale of milk to those pupils whose parents were willing to pay for it and two letters were sent by the Chief Education Officer to parents of all children in the relevant age group explaining the effect of the Act and inviting applications for free school milk on health grounds in appropriate cases. At the same time all head teachers, school doctors, family doctors, social workers, health visitors and school nurses were asked to notify any child whose health might be adversely effected by withdrawal of free school milk. These enquiries resulted in approximately 1700 applications for free school milk which had to be dealt with as a matter of urgency and could not be allowed to hinder the normal work of the school health service. This created considerable pressures on the staff of the department and, in view of the need to avoid delay in supplying free milk to needy children, sanction was obtained to employ additional temporary medical and clerical staff and for overtime payment to the part-time school nurses assisting with the necessary medical inspections. 34 By the end of the year 1,693 applications had been dealt with and 649 certificates issued recommending the supply of free school milk. Speciali st services Specialist consultation and treatment services for school pupils are provided at the Council's clinics by arrangement with the North-East Metropolitan Regional Hospital Board, as follows:— (a) Ophthalmic Ophthalmic specialist sessions are held at 8 of the Council's clinics. 3,265 pupils made 5,135 attendances during the year, including 832 new referrals. 980 prescriptions for glasses were issued. (b) Orthoptic An orthoptist attends two of the Council's clinics to provide non-surgical treatment to children suffering from squint (referred by the ophthalmic specialists). 134 pupils were referred to the orthoptist and 450 treatments carried out. (c) Orthopaedic Orthopaedic specialist sessions are held at four of the Council's clinics. 191 pupils made 517 attendances, including 73 new referrals. (d) Physiotherapy Physiotherapy is provided at 5 clinics, in conjunction with the orthopaedic sessions. 596 pupils made 1,864 attendances for treatment, including 234 new referrals. Child Guidance In July 1971 Dr. J. Vincenzi resigned from the post of Medical Director of Raphael House Centre for Educational and Family Problems to take up a similar full-time post at Chelmsford. Dr. Vincenzi had been associated with the Centre since its opening in 1956 (then known as the Romford Child Guidance Clinic). Two part-time consultant psychiatrists having left in 35 November 1970 and February 1971, the Centre was without any psychiatric advisers until October 1971 when the assistance of a part-time consultant was obtained for four sessions each week. Dr. J.L. Swift was eventually appointed to fill the vacant post of Medical Director, but did not take up his appointment until 1st J anuary 1972. 781 children, including 182 new cases, attended for Child Guidance during the year as follows:— No. of interviews Psychiatrist 1,079 Psychiatric Social Worker 1,764 Educational Psychologist 656 333 cases were under treatment at the end of the year. Speech Therapy No additional speech therapists were recruited during the year and it remained necessary to restrict treatment to the more urgent cases. 378 children were newly referred for speech therapy and 198 commenced treatment during the year. At the end of the year 153 children were receiving treatment and 380 were being kept under observation. 181 children were waiting for speech therapy tobe commented. School Dental Services Dental treatment facilities are provided at 9 of the Council's clinics. 16,881 children received a routine dental inspection at school and 5,095 made a total of 13,889 attendances at the dental clinics for treatment. The report of the Chief Dental Officer appears on page 39. School Clinics Special sessions for school pupils are held regularly at each of the Council's clinics, including the School Clinic at 36 Hilldene Junior School, providing facilities for medical consultation and treatment of minor conditions. The total attendances at these sessions amounted to 12,940, including 3,828 consultations with the school doctors and 9,112 treatments or interviews with school nurses. Conditions treated included:— Skin diseases 2,381 Eye diseases 107 Diseases and defects of the ear, nose and throat 219 Miscellaneous minor conditions 462 Handicapped Pupils In accordance with the provisions of the Education (Handicapped Children) Act 1970, the former Belford Junior Training Centre and Special Care Unit were transferred to the local education authority from the local health authority on 1st April 1971. These two units, which provided training facilities for mentally subnormal children and those handicapped by multiple disabilities were united to form a new school known as Ravensboume School. This increased the number of special schools for handicapped children in the Borough to four; the full list of special schools and units being as follows:— Corbets Tey School Dycorts School (E.S.N. pupils) Havering Grange School Ravensboume School (subnormal and multiple handicaps). Nursery class for pre-school maladjusted children — Mead Infants' School. Unit for Partially Hearing Pupils — Hacton Junior School. 37 Category Total number of pupils ascertained as handicapped at end of y ear 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 13 2 2 9 2 Deaf 17 3 2 13 3 Partially hearing 36 2 2 32 3 Physically handicapped 22 1 1 15 6 Delicate 21 5 5 12 7 Maladjusted 24 5 5 - 22 Educationally subnormal 580 81 61 505 20 Epileptic 4 - - - 4 Speech defects 1 1 - - Total 722 100 78 586 71 REPORT OF THE CHIEF DENTAL OFFICER Staff There was one addition to the full-time staff during the year and this brought the full-time equivalent to 5.6, an improvement on the previous year. With an increasing school population, the number of school children per dental officer is now over 8,000, a figure which compares unfavourably with the Metropolitan regional average. This low staffing ratio has meant that inspections at school have risen by only a small amount during the year to 16,881 from 16.086 in 1970. If those children inspected for the first time at a clinic are included the number rises to 20,790 given a first inspection during the year. The following table gives particulars of inspections compared with the previous year. 1970 1971 School population 43,599 45,957 First inspections 19,898 20,790 Found to require treatment 7,162 7,204 Offered treatment 6,479 6,827 Treated 5,007 5,095 Owing to the shortage of staff, no inspections were carried out in schools served by the Harold Hill or Romford clinic and not until the very end of the year was an inspection possible in the Collier Row catchment area. In the first two areas no regular programme of inspections has ever been possible. During the year the Borough received an official visit from Mr. C. Howard, one of the dental staff of the Department of Health and Social Security and of Education and Science. In the official letter which followed this visit, mention was made of the fact that the overall staffingsituation remained well below the national average and even more substantially below the regional average. In an effort to reverse this trend and stimulate recruitment, proposals were made for introducing a graded staff structure with the creation of senior posts carrying additional responsibilities. The report incorporating these proposals received approval by the appropriate Committee before the end of the year for implementation at the commencement of the next financial year. 39 On the credit side, the official letter noted with satisfaction that the output of work at treatment sessions has increased by 48% since 1969 and is now above the national average. A figure that would be of greater interest if it were possible to obtain would be the amount of treatment prevented by the efforts of dentists and dental health educators. Astatement made in the first of these dental reports for Havering in 1965 that "prevention must be the key-word of the Local Authority dental service" is as relevant now as ever. Fluoridation The subject of fluoridation of the public water supply is one that has been included in almost every annual report since the inception of the Borough. In all these years no progress has been made towards achieving implementation of what is generally recognised as a safe and well-proven public health measure which would substantially reduce the prevalence of dental decay. The matter was again considered by the Council during the year as a result of a request from the National Health Service Executive Council for North East London. As a result of a full report of the facts placed before them, the Housing and Health Services Committee recommended that the Council should declare themselves in favour of the principle of the addition of fluoride to the local public water supply. When the subject came before Council for consideration, the principle was rejected without discussion. For the writer of this report, this was a particularly disheartening decision. With a known shortage of dentists, and an increasing child population, surely serious consideration should be accorded to a sound and proven preventive measure. Any amount of dental health promotion and local preventive treatments pale into insignificance when compared to the benefits that adjustment of the fluoride content of the water from its present level of .25 parts per million to 1 part per million would bring in a few years' time to the child population of the Borough. Dental Health Education The programme of dental health education introduced last year for new entrants to Primary schools continued in 1971 and again all Primary schools in the Borough indicated a wish to be included In addition to the showing of a film and demonstration, each child who had started school in the past year received a free dental 40 hygiene kit consisting of a beaker, toothbrush and toothpaste, together with a letter to the parents from the Chief Dental Officer. The teaching staff at each school were encouraged to follow-up this session by introducing dental health projects into the classroom during the year. In this way it is hoped to maintain the early enthusiasm generated by these visits. Efforts made by the dental staff during their school visits to discourage the practice of allowing children to bring sweetstuffs into school have met with some degree of success from headteachers. It is evident from school inspections that where there is a restriction imposed by the school then this is reflected in a better standard of dental health among its pupils. In addition, a valuable contribution to dental health continues to be made by health visitors and ancillary staff in their visits to schools and homes and at classes held in clinics. Premises The Departmental official letter drew attention to the substandard facilities at the Rainham and Romford clinics, and it is encouraging to report that plans for improving the accommodation at Rainham clinic have been included in the Capital Building Programme for 1974/5. Training In October a member of the full-time staff commenced the course in London for the Diploma in Dental Public Health, and the training and knowledge received should prove of great value to the dental service in the future. Mr. Wright continued as lecturer for the Dental Surgery Assistants evening courses held at the Havering Technical College. As a result of this local facility which began in 1966, all but two of the dental surgery assistants currently employed by the Borough have now obtained the National Certificate of Dental Surgery Assistants. This necessary training enables them to contribute their full share in the satisfactory running of the dental service. Priority Dental Service The service provided for the under fives received commendation in the official letter from the Government Departments. It was described as "in all respects above average and deserves every encouragement". The number of pre-school children inspected and treated has increased each year and it is pleasing to record a 41 further increase for the year under review:- 1971 1970 Number of courses of treatment completed during year. 346 225 Sessions devoted to treatment 189 159 The full annual statistics for the Dental Service are given in the following tables. TABLE DENTAL INSPECTIONS & TREATMENT INSPECTIONS (a) First inspection at school. Number of Pupils 16,881 (b) First inspection at clinic. 3,909 Number of (a) — (b) found to require treatment 7,204 Number of (a) — (b) offered treatment 6,827 (c) Pupils re-inspected at school or clinic 1,402 Number of (c) found to require treatment 705 ATTENDANCE AND TREATMENT Ages Ages Ages Total 5 to 9 10 to 14 15 — First Visit 3,069 1,738 288 5,095 Subsequent visits 4,766 3,419 609 8,794 Total visits 7,835 5,157 89713,889 Additional courses of treatment commenced 484 198 25 707 Fillings in permanent teeth 2,288 4,207 876 7,371 Fillings in deciduous teeth 5,580 483 - 6,063 Permanent teeth filled 1,827 3,511 793 6,131 Deciduous teeth filled 5,039 427 — 5,466 Permanent teeth extracted 51 311 54 416 Deciduous teeth extracted 1,705 555 — 2,260 General anaesthetics 438 122 6 566 Emergencies 623 205 19 747 Number of pupils X-rayed 778 Prophylaxis 1,405 Teeth otherwise conserved 886 Number of teeth root filled 150 Inlays _ Crowns 53 Courses of treatment completed 4,136 42 ORTHODONTICS New cases commenced during year 85 Cases completed during year 72 Cases discontinued during year 8 Number of removable appliances fitted 118 Number of fixed appliances fitted — Pupils referred to Hospital Consultant 17 DENTURES 5 to 9 10 to 14 15 & Over Pupils supplied with full denture — Pupils supplied with other denturees (first time ) 3 4 1 8 Total 3 4 1 8 SESSIONS (1971) Number of treatment sessions 2,144 Number of inspection sessions 136 TABLE DENTAL SERVICE FOR EXPECTANT & NURSING MOTHERS AND CHILDREN UNDER 5 YEARS Children 0-4 (incl.) Expectant & Nursing Mother First Visit 527 85 Subsequent Visits 679 133 Total Visits 1206 218 Number of Additional Courses of Treatment other than the First Course commenced during year 76 4 Treatment provided during the year — Number of fillings 1041 145 Teeth filled 897 153 Teeth extracted 139 52 General Anaesthetics given 64 — Emergency visits by patients 66 10 Patients X-rayed 13 35 Patients treated by scaling and/or removal of stains from the teeth (Phrophylaxis) 231 36 Teeth otherwise conserved 131 - Teeth root filled — 3 Crowns — 6 Number of courses of treatment completed during the year 346 61 43 DENTURES Children 0-4 (incl.) Expectant & Nursing Mothers Patients supplied with full denture (First Time) — 2 Patients supplied with other dentures 1 10 INSPECTIONS Number of Patients given First Inspections during year 890 86 Number of Patients who required Treatment 380 64 Number of Patients who were offered Treatment 357 63 Number of Dental Officer Sessions devoted to Maternity and Child Welfare Patients For Treatment 189 HEALTH EDUCATION Co-operation between schools and the Health Education Section increased considerably during the year. The number of talks and film shows given by the Section was greater than in the previous year as was the number of requests. from schools and other organisations for talks and/or film shows to be given by the Health Education Staff, Public Health Inspectors, Nursing Officers and Staff, or for the loan of films, film slides or other materials. The Health Education Section undertook three main programmes in the schools during the year:- 1. DENTAL CARE: Visits were paid to all infants' schools to give a film show and demonstration on how and when to clean the teeth, etc., with a dental hygiene kit given to each child. 2. FOOT CARE: Girls in junior schools were given a talk and shown the film "The Five" on the correct choice of shoes, etc. 3. SMOKING: Following the publication of the report of the Royal College of Physicians "Smoking and Health Now", a circular was sent to all schools drawing attention to the recommendation that staff should not smoke in those parts of the school to which children had access. Posters were offered to all Junior and Senior Schools, and a programme of two films and a talk on the dangers of smoking was offered to Secondary Schools for all pupils and to Junior Schools for pupils in their final year at Junior School. The response from Head Teachers was exceedingly good, and it is proposed to make the programme available each year in future to all Junior Schools so that pupils are warned of the dangers at a time when many children are beginning to have the occasional cigarette, but before it becomes a habit. It is, of course, exceedingly difficult to assess whether health education is obtaining any effective results. Probably statistics over a period of time could be used to indicate the value of health propoganda, but there may be other factors which might affect people's smoking habits, etc. Certainly many adult confirmed smokers continue to smoke although fully aware of the risks they run, and do not wish to listen, being fairly convinced, or hopeful "that it can't happen to them". Therefore, it seems that the best long term prospect is to tackle the subject of smoking at an early age, and whilst it will be years before statistics can measure the 45 - success, the immediate effect (whether lasting or not) can be judged by the following letter which is one of many received from pupils in various schools:"Dear Mr. Gowers, We all found your talk most interesting. One of our members of staff has given up smoking for three weeks now. I think it has given us time to think before we do start smoking. We found the film most interesting to all of us. Yours sincerely, Lorraine Dewing" Apart from these regular programmes, the Health Education Section has given talks, including film shows, to local organisations on a wide variety of subjects and has arranged series of other talks and film shows in schools for senior pupils. Nursing Officers, Health Visitors and Public Health Inspectors have co-operated with the Health Education Staff in these programmes. The Chief Public Health Inspector and other members of his staff have organised a series of lectures and courses on food hygiene for employees in the food trades, and In-service Training has also been undertaken on a regularbasis for various sections of the staff. Health Visitors, in the normal course of their duties, also undertake Health Education on a person to person basis both at the clinics and in the course of their visits. Similarly, Public Health Inspectors and other members of the staff whose duties bring them into contact with members of the public, have the opportunity of giving advice to individuals on matters concerned with health and hygiene. Home Safety: Many organisations and schools have also requested talks and film shows on Home Safety. Under the auspices of the Havering Home Safety Panel, the Home Safety Quiz was again organised with teams from secondary schools in the Borough competing for the Teskey Trophy. This year an innovation was made in that the final included a practical course where the teams had to demonstrate how they would deal with persons injured in a simulated home accident. The 1971 finalists were Romford County High School for Girls and Harrowfield School, with the former winning 46 the Trophy after a close contest before a large and appreciative audience, who were able to fully enjoy the proceedings thanks to the co-operation of Mr. Bond, Visual Aids Officer, of the Education Department who provided amplification equipment, and buzzers for the contestants. Thanks are also due to Mrs. Laver of the Education Department who arranged the incident and questions for the practical section of the final. I should also like to record my thanks to Miss E. Thompson of the Social Services Department for undertaking the organisation of the Quiz and for all the work she has carried out in connection with Home Safety including attending meetings of the Greater London Home Safety Council. Thanks are also recorded to the members of the Home Safety Advisory Panel under their Chairman, Miss A.I. Walker, for their continued interest in this important subject. Whilst fatalities for home accidents have been slightly reduced, they are still far too high, and only constant care in the home, particularly where the very young or the very old are concerned, can bring an improvement. This constant care can only be obtained by constant vigilance by those who have the opportunity to point out hazards and make suggestions for their removal, and by constant propoganda to educate everyone in the need for home safety. 47 CHIROPODY SERVICE The Chief Chiropodist, Mr. L.A. Bolland, reports as follows:Statistics for 1971 New Cases No. of Persons treate Clinic Attend ances Domicillary treatments Welfare Establishments Pre-Schoolchildren 15 18 54 — — Schoolchildren 57 86 216 9 - Expectant mothers 7 9 9 1 - Aged 1045 5715 18,822 8090 1564 Physically handicapp ied67 190 507 524 64 Others 14 30 72 36 1 Total 1205 6048 19,680 8660 1629 It will be seen from the attached Table of Statistics that the numbers treated this year are considerably less than in 1970, but the number of sessions worked during the year was also less — 5671 as against 6347 in 1970. Further I would also point out that the difference in the number of Physically Handicapped treated is due partly to the fact that now the Mentally Handicapped seen at the Centre in Spilsby Road are included in that group instead of with the schoolchildren as in previous years. Illness amongst the staff has affected considerably the smooth working of the Service. Two members were on Sick Leave for periods of one month and another member resigned after being in in hospital for some weeks. It is now impossible to arrange relief for absent staff with the result that a considerable back log of work is built up. This is worse in the domiciliary visiting service where there is a period of waiting between treatments of up to 10 — 12 weeks, and it is now no longer possible to find appointments for the urgent or priority cases such as Diabetics. This state is far from satisfactory from either the patient's or the Chiropodist's point of view a {id indeed the fact that certain patients have to wait so long in between attention is the cause of some worry on the part of the chiropodist. The visits to the Training Centre in Spilsby Road and the Handicapped Persons Centre in Farringdon Avenue have proved their 48 worth, but unfortunately, not as many visits as would be liked can be made, in the case of the Training Centre, only priority cases can now be seen. At present only some 6,000 patients are receiving treatment, yet there are approximately 22,000 persons within the Borough entitled, by reason of their age to receive chiropodial attention and it is only to be expected that with the increase of the fieldworkers of the Social Service many more will be referred for treatment which will lead to a complete breakdown of the service unless the number of chiropodists is increased or some form of priority groups instituted to lessen the numbers receiving attention. 49 MENTAL HEALTH: The Mental Health Services of the Council were transferred to the Social Services Department in April, 1971, when the present Health and Welfare Department and Children's Department were formed into a separate Health Department and Social Services Department. Reports on patients discharged from hospital after treatment for mental illness continued to be forwarded under confidential cover to the Medical Officer of Health, and 214 such reports were received between April and December. Relevant information contained in the reports was made available to Social Workers as required. 50 OCCUPATIONAL HEALTH SERVICE: This scheme provides medical screening of all prospective employees of the Council. The scheme also covers investigation of any medical matter affecting individual employees or groups of employees, and medical examination of Council employees in connection with heavy goods vehicle driving licence. Entrants to the teaching profession and candidates for admission to teacher training colleges are also examined in accordance with the requirements laid down by the Department of Education and Science. Statistics relating to this service are as follows:- OCCUPATIONAL HEALTH SERVICE Number of questionnaires scrutinised 2036 Number selected for full examination 56 Number found unfit for employment 9 Number recommended for further review 4 Medical examinations for other authorities 16 Number of full medical examinations of teachers and prospective pupil teachers (carried out according to national requirements outside the Council scheme) 335 Number of persons screened by chest X-ray (i.e. duties in contact with children) 1130 Number refeued to Chest Clinic 5 Number found have pulmonary tuberculosis 3 Number of persons screened for intestinal pathogens (i.e. duties concerned with preparation of food) 582 Number of special medical examinations 129 Medical examinations for heavy goods vehicle driving licences (1 unfit to hold licence) 34 51 ENVIRONMENTAL HEALTH STAFF POSITION The new structure for the Public Health Inspectorate referred to in last year's report was getting nicely under way during 1971 when a Senior Public Health Inspector and a District Public Health Inspector were both stricken with serious illness (mid-year) and had not returned to duty at the end of the year. Another District Public Health Inspector was also admitted to hospital for an operation during this period, so these features — coupled with the resignation of a District Public Health Inspector in the middle of November — caused a serious setback to the routine work of the Section. A Shops and Offices Inspector also resigned at the end of February and his replacement commenced duties at the end of June, 1971. The vacancy which existed at the beginning of the year for a Student Public Health Inspector was filled in August in time for this Student to start his first year's training at Tottenham Technical College (a 3 year course). The appointment in November of the previous year of a third Pest Officer/General Assistant has proved to be an important factor in the improved pest service which we have now been able to provide to the public. On 31st December 1971 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 9 District Public Health Inspectors (one vacancy) 2 Shops & Offices Inspectors 2 Authorised Meat Inspectors 3 Pest Control Officers/General Assistants 3 Pupil Public Health Inspectors 52 Food & Drug Administration A total of 471 samples (43 formal and 428 informal) were taken during the year and examined by the Public Analyst. One formal sample of milk was found to be deficient in milk fat and after investigations a warning letter was sent to the Dairy concerned. A formal sample of a health food was found to be deficient in the stated amount of phosphorous. Proceedings were taken against the Manufacturers and the case was adjourned to enable the third portion of the sample to be examined by the Government Chemist. At the adjourned hearing the Manufacturers were found guilty and fined £40 with costs of £41.20p. Ten informal samples had faulty labelling and the Manufacturers were informed and the necessary remedial action taken. One informal sample of sausages was found to have slightly more than the permitted amount of preservative and the Manufacturer was warned. One informal sample of steak and kidney pie was found to be poor in the amount of kidney. The manufacturer was informed and steps were taken to increase the amount of kidney to a satisfactory level. Included in the above figures are 55 food complaints which were referred to the Public Analyst. 216 other food complaints were dealt with without reference to the Public Analyst. 18 prosecutions (apart from the one referred to above) were taken during the year and fines totalling £425 were imposed. Costs awarded to the Council amounted to £136.17p. 53 Details of these cases appear overleaf: Complaint Result of Legal Proceedings Fine Costs Mouldy Cake £25 £5 Dehydrated Chicken Pate £25 £5 Fly in cake £10 £2.25 Metal nut in loaf £10 £2.25 Mouldy saveloys £20 £12.72 Mouldy meat pie £25 £5 Fly in tin of jam £20 £9.75 Mouldy Cornish Pasty £25 £5 Fly in cake £5 £5 Insect in loaf £10 £14.75 Insect in Baby Food £25 £14.75 Mouldy Tart £75 £5 Mouldy Chocolate "Domino" £25 £5 Insects in cereal £30 £7 Metal in Ham Loaf £25 £10 Mouldy Fruit Pie £20 £5 Cockroach in sweet and sour pork £20 £17.70 Decomposing bacon £30 £5 The Commodities involved in the 271 food complaints were as follows:— 54 Baby Food 7 Beverages 11 Biscuits 2 Bread 42 Butter 3 Cereals 12 Cheese 7 Cream 2 Eggs 1 Fish(canned) 6 Fish (fresh) 3 FishCakes 1 Flour confectionery 31 Frozen Foods 2 Fruit (canned) 5 Fruit (dried) 3 Fruit (fresh) 1 Ice Lolly 1 Jam 4 Margarine 2 Meat (canned) 12 Meat (fresh) 9 Meat products & cooked meat 37 Milk 24 Milk powder 2 Nuts 1 Pickles & Sauces 3 Pizza 2 Poultry 4 Salad Cream 1 Salt 1 Sandwich Spread 1 Soup (canned) 2 Sugar 1 Sweets 5 Tea 1 Vegetables 11 Yoghurt 8 The number of food complaints received this year was the highest in any year since the Borough was formed. This is due, no doubt, to the publicity given to the problems of coding wrapped foodstuffs and to the prevention of the sale of food which has gone beyond the recognised shelf life. This leads the Consumer to complain direct to the Local Authority instead of attempting to settle the matter by going to the vendor. Many of the complaints were due to inefficient stock rotation and it does seem that legislation will eventually be brought in to deal with date codings which can be readily determined by both Consumer and Vendor. Bacteriological Milk Sampling A total of 207 milk samples were taken during the year and submitted for bacteriological examination with results as follows. Pasteurised — 156 (146 passed the methylene blue test — 10 failed for various minor reasons.) (All passed the phosphatase test.) Sterilised — 16 All satisfied the turbidity test. Ultra heat treated — 35 All satisfied the UHT test. Included in the above were 36 samples from vending machines. 34 satisfied the methylene blue test and 2 failed. All satisfied the phosphatase test. 22 samples were also sent to the Public Analyst all being satisfactory except one which was very slightly deficient in milk fat. Brucella Abortis No samples of raw milk have been taken in this Borough as all supplies of milk retailed are heat treated. Ice Cream SamDline 1971 - Bacteriological examination 55 During the year 305 samples of ice cream were submitted for bacteriological examination with results as follows. Grade MOBILE SHOP Total Soft Other Soft Other 1 26 41 13 118 198 2 4 7 4 22 37 3 13 8 1 27 49 4 4 4 6 7 21 47 60 24 174 305 The above results indicate that the general standard is satisfactory although constant vigilance must be obtained. 11 lollies were submitted for bacteriological examination and all were satisfactory. 14 ice creams and 7 lollies were also submitted to the Public Analyst and 5 of the samples of ice cream were found to contain non-milk fat and the vendors were informed and action taken with regard to the necessary labelling requirements. Other Food Sampling Bacteriological examination of other food products were carried out during the year in respect of the undermentioned commodities: Cream 43 Raw meats 8 Cream cakes 54 Shellfish 6 Cooked Meats 77 Fruit juices 7 Meat Products 15 Tomatoes 1 Sausages 17 Baby food 1 Rolls & pies 22 Frozen fish 1 Generally the results were satisfactory although fresh cream samples again left much to be desired. A report has been issued by the Working Party on the survey carried out in 1969 but it would seem that at present there is no prospect of legislation to enforce a bacteriological standard for cream. The Report states although cream frequently has a high bacteriological content pathogenic bacteria are rarely present and very few food poisoning incidents have been traced to fresh cream. 56 Pesticide Residues in Foodstuffs and Water One sample of water from the main supply was taken during the year which proved to be genuine and free from pesticide residues. The national interim report for the second year's results (1968) was published during the year, the results showing no evidence of any gross contamination of food and none of the results obtained was considered to warrant any action being taken. Analytical tests were made on samples obtained by Local Authorities — of which Havering was one — throughout England and Wales at random from food shops. Staple, home-produced and imported foods tested included meat, dairy products, bread, fruit and vegetables, eggs, coffee and cocoa. No sample of baby foods was found with residues in excess of the recommended limits. As in the first year, nationally, lard proved to be the most contaminated food, DDT and related compounds being largely responsible for the contamination which was of minor order and no further action was necessary. Neither pork joints nor sausages were found to be affected to the same degree. A further 12 month period (third year) for analysis of pesticide residues will be carried out in 1972. Imported Food Regulations 1968 During the year notification was received of the arrival in the Borough of 89 sealed food 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 wholesale meat depots and grocery warehouses of which there are several in the Borough. Essex County Council Act 1950 — Section 103 During the year under review 2 new applications for registration as hawkers of food were granted. Poultry Processing Premises Department of Health and Social Security Circular 1/72 57 requests information concerning poultry inspection. There are no Poultry Processing Premises within the Borough. Pharmacy and Poisons Act, 1933 During the year 9 names and 9 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 to sell poisons included in Part II of the Poisons List. 8 names and 16 premises were removed from the list during the year. At the end of the year the list contained the names of 90 persons (or firms) involving some 143 premises. No formal action was required during the year in respect of any infringements of this legislation although one sample was taken and submitted to the Public Analyst for examination. A satisfactory report was received. On 21st June 1971 the Poisons Rules 1971 (S.I. No. 726) and the Poisons List Order 1971 (S.I.No. 725) came into.operation. The former made changes to the Poisons Rules, 1970, and the latter amended the Poisons List Order, 1970. Milk Distributors During the year the number of registered milk distributors increased from 6 to 7 but the number of dairy premises remained at 10. 174 shopkeepers are, however, registered for the sale of milk from their premises, plus 4 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 authorising the use of special designation in relation to milk sold by the licenceesis shown in the following table. These licences are quinquennial and expire on the 31st December 1975. Designation Licences issued Pasteurised Milk 159 Sterilised Milk 144 Ultra Heat Treated Milk 56 58 Greater London Council (General Powers) Act, 1968 Part VIII Night Cafes The 2 applications for registration as night cafes which were outstanding at the end of the previous year were both issued in 1971. 2 other applications were received during the year, one of which was eventually withdrawn and the other was in abeyance pending the completion of alterations to the premises. These registrations are in respect of premises which it is proposed to keep open later than 11 p.m. and which are not subject to control by a Justices on-licence for the sale of intoxicating liquor. This legislation laid down comprehensive conditions for night cafes in the Greater London area, most of these conditions being eventually incorporated and applied nationally under the terms of the Late Night Refreshment Houses Act 1969. Late Night Refreshment Houses Act 1969 The Late Night Refreshment Houses (Variation of Duty) Order 1970 (S.I. 1970/1358) which came into operation at 1st January 1971 increased the duty payable on a Refreshment House licence from £1.05 to £6. This increase obviously resulted in a reduction of the number of licences issued during the year from 11 to 6. These licences cover the period from 1st April 1971 to 31st March 1972 and require that the premises should not be opened at any time between 11 o'clock at night and 5 o'clock in the morning. Occupiers of premises who want to keep open after 11 p.m. must comply with and be registered under Part VIII of the Greater London Council (General Powers) Act 1968 as night cafes. Game Act 1831 4 licences authorising the applicants — all local shopkeepers to buy and sell game were issued during the year. These licences cover the period 1st July 1971 to 31st June 1972. Food and Drugs Act 1955 — Section 16 During the year 3 applications for registration of premises for the manufacture of sausages or potted, pressed, pickled or preserved food intended for sale and 22 applications for registra- 59 uon of premises for the storage and sale of ice cream were approved. Food Hygiene (General) Regulations, 1970 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 116 Cafes & Restaurants 101 Confectioners (flour, etc.) 59 Confectioners (sugar) 193 Fish Shops 45 Grocers 235 Greengrocers 111 Ice Cream Manufacturers 3 Clubs (On Licence) 15 Clubs (Private) . 63 Public Houses 74 School Canteens 100 Staff Canteens 97 Off Licences 67 42 notices were served under these Regulations during the year — a decrease of 54 on the previous year. No further statutory action was required in respect of these notices. Slaughter of Animals Act 1958 52 licences to slaughter animals were issued during the year (a decrease of 7 on the previous year), 7 of which authorised the licensees to slaughter horses, this being a regular practice at one of our slaughterhouses. 23 of the licences were for ritual slaughter — 21 Jews and 2 Mohammedans. With the exception of one journeyman all the licensees are employed in slaughterhouses in this Borough. Slaughterhouses and Meat Inspection 3 slaughterhouse licences were issued during the year. In 60 two instances the owners also being granted offensive trade consents viz. gut scraping and fat rendering. Therewas no change during the year in connection with the agreed hours of slaughter i.e. from 7 a.m. to 6 p.m. Mondays to Fridays and from 7 a. m. to 2 p.m. on Saturdays and Sundays, in two instances, the third slaughterhouse being a very small one at the rear of a 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. 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. The Fowl Pest restrictions on the movement of poultry which was in force in this Borough at the turn of the year was withdrawn on the 8th March 1971 in respect of East Anglia which included the London Borough of Havering. 13 licences to operate boiling plants at local piggeries remained in force at the end of the year—a decrease of 2 on 1970. Condemned Foods 1971 Commodity Weight (in lbs.) Meat (Wholesale) 4673 Meat (Retail) 10707 Meat (Tinned) 1989 Fish (Tinned) 296 Fish (Raw) 1316 Offal 2061 Poultry 441 Sausages 418 Tinned Fruit 5948 Other Tinned Food 3469 Cont'd, over 61 Condemned Foods 1971 (cont'd.) Commodity Weight (in lbs.) Miscellaneous Food Stuffs 1244 Butter 703 33265 Frozen packets 23770 items During the year, the above amounts of food were surrendered and condemned as unfit for human consumption. All food condemned as unfit for human consumption is collected by the Council, taken to the refuse tip or destructor and destroyed. Carcases Inspected and Condemned The following table shows the post mortem inspection of animals during the year 1971 at the three slaughterhouses in the Borough:- Cattle Calves Sheep and Lambs Pigs Horses Goats TOTAL Number Killed 11.419 1,139 54,747 1,574 23 27 68,929 Number Inspected 11.419 1,139 54,747 1,574 23 27 68,929 All Diseases except Tuberculosis and Cysticercosis Whole Carcase condemned 42 3 143 1 3 — 192 Carcases of which some parts or organs were condemned 5,947 49 11,910 194 4 18,104 Percentage of number affected 52.44% 4.56% 20.18% 12.45% 30.43% - 26.39% Tuberculosis Only Whole carcases condemned - _ _ _ - - - Carcases of which some parts or organs were condemned - _ _ 5 _ _ 5 Percentage of number affected Cysticercosis Only - — — 0.31% - - 0.007% Carcases of which some part or organs were condemned 3 _ _ _ _ - 3 Carcases submitted to treatment by refrigeration _ _ _ _ _ _ _ Generalised and totally condemned - - - - - - - Total Meat condemned: 49 tons : 12 cwt : 97 lbs. Meat Inspection — Meat Inspection (Amendment) Regulations 1971 Mention was made in last year's report regarding the inadequacy of the charges permitted under the meat inspection regulations 1963 and I am pleased to report that on 16th August 1971 amended regulations came into operation which had the effect of raising the maximum rates which local authorities may charge in meat inspection from 13p to 18p for a horse or adult bovine carcase; from 4p to 5p for a calf or pig carcase; and from 3p to 4p for a sheep, lamb or goat carcase. The Council agreed to the implementation of these new maximum charges as from the 1st October 1971. The total income from this meat inspection service during the year was £3,250.18. SANITARY CIRCUMSTANCES This year's pattern of work followed very much that of the previous year, the cancellation of the proposed Havering (No.6) Smoke Control Area being deferred for a further year. There was, however, a considerable increase in the number of applications for Qualification Certificates under the Housing Act 1969 which it is anticipated will continue to grow with the additional publicity now being given to this particular piece of legislation. A summary of the 34,629 inspections is as follows:— Clean Air Act 2,430 Public Health Acts 7,219 Food & Drugs Acts 5,654 Prevention of Damage by Pests Act 5,726 Offices, Shops & Railway Premises Act 1,449 Shops Acts 1,931 Infectious Diseases 814 Housing Acts 4,001 Sampling 1,309 Factories Act 271 Noise Abatement 434 Diseases of Animals Act 66 Miscellaneous 1,499 Slaughterhouses & Meat Inspection 1,173 (not including the inspections of 2 Authorised Meat Inspectors based permanently at slaughterhouses) Consumer Protection 653 TOTAL 34,629 63 As a result of these inspections 453 informal notices were served and in 142 cases further action was necessary, with the service of Statutory Notices — details as follows:- Number of Notices Served: Informal: Statutory Public Health Acts 224 136 Food & Drugs Acts 42 - Offices, Shops 81 Railway Premises Act 100 - Shops Acts 69 - F actories Acts 5 - Housing Acts 5 - Prevention of Damage by Pests Act 6 6 Animal Boarding Establishments 1 — Clean Air Act 1 - 453 142 Enforcement Proceedings No legal proceedings were necessary in respect of Statutory Notices served under the Public Health and/or Housing Acts. 18 court cases were taken under the Food and Drugs Act 1955 resulting in total fines of £425 and costs of £136.17; 74 under the Shops Act 1950 (fines £163: costs £96); 9 under the Noise Abatement Act 1960 (fines £36: costs £22); 7 under the Civic Amenities Act 1967 (fines £48: costs £20.60); 5 under the Consumer Protection Act 1961 (fines £30: costs £11.60); and 4 under the Offices, Shops and Railway Premises Act 1963 (fines £100: costs £23). All these cases are reported in more detail elsewhere in this Report under their appropriate headings. Refuse Collection The Cleansing and Transport Section is part of the Controller of Works Division. The administrative headquarters of this Division is situated, at present, at Bretons Farm, Rainham Road, Rainham. Approximately 100,000 dustbins are emptied each week by 110 collectors using 30 vehicles of the most up-to-date rear loading compression type. In addition approximately 250 special collections are made each week for bulky household items. Some materials, such as builders' rubbish, garden refuse, rubble and fencing are not collected, but such items can be taken by residents' own private transport to the disposal site in Gerpins Lane. 64 This site, and all other refuse disposal operations, are now controlled by the Greater London Council. Street Cleansing This work of clearing over 300 miles of roads is carried out by 21 teams each normally consisting of two sweepers and an electrical truck operator and 40 street orderlies equipped with hand barrows. Four suction type sweeper collecting machines are employed on carriageways, although increases in parked vehicles makes the use of these machines less effective. A Work Study has now been completed in the Street Cleansing Section, and it is hoped that the implementation of this Report will lead to an improved service throughout the Borough. Refuse Disposal The refuse disposal arrangements for this Borough which became the responsibility of the Greater London Council (Department of Public Health Engineering) on the 1st April 1965 remains the same as outlined in last year's report. Havering refuse is dealt with by the Borough's own collection vehicles and taken to Little Belhus, Ockendon, a contractor's tip and to Moor Hall landfill site, Romford Road, Aveley, a G.L.C. tip. Both of these tips being situated in the Urban District of Thurrock. Radioactive Substances Act, I960 2 of the 8 firms in the Borough holding certificates of registration and/or authorisations from the Department of the Environment under various sections of the Radioactive Substances Act, 1960, had their old certificates/authorisations revoked during the year and new certificates/authorisations issued. In addition a copy of the Certificate of Registration under Section 1 of the Act which had been issued to a large multiple store was received. This related to eleven luminous signs, each of which is radioactive material solely because it incorporates, in a sealed capsule mounted within a hermetically sealed plastic container (so constructed as to withstand normal usage without breaking) a gas which contains no radionuclide other than, and not more than, 15 curies of tritium. 65 Rivers, Streams and Watercourses I am indebted to the Essex River Authority for the following information:— "In May 1971, a routine survey of the River In grebourne showed it to be clean throughout its length. The quality of the river flow below the Nags Head Lane Sewage Disposal Works of the Brentwood Urban District Council showed some improvement over recent years. During the year some structural damage to the tertiary sand filtration system at this works occurred but alternative methods of treatment of the effluent were available and no deterioration of effluent quality resulted. The Beam River was surveyed in September and was found to be clean in the upper and middle reaches. Below the confluence of the river with the Wantz Stream at Dagenham the water quality showed some pollution resulting from urban surface water run-off and discharges of trade effluent. These matters are being investigated by the River Authority and the London Borough of Barking but a considerable time may elapse before all the discharges can be traced and dealt with. The intensity of radioactivity and the numbers of bacteria of sewage origin were checked at key points on both rivers regularly throughout the year and were found to be at a low and safe level for surface waters. The River Authority has been in consultation with industrialists in the Ferry Lane area of Rain ham to seek reduction of pollution of minor streams. The most important of these is a discharge of high ammoniac nitrogen content from a chemical and metallurgical works and this is expected to cease in early 1972." Water Supply I am indebted to Mr. P. Gordon Spencer, B.Eng., C.Eng., F.I.C.E., F.I.W.E., M.I.Struct.E., M.ASCE., F.G.S., M.B.I.M., Director, General Manager and Engineer-in-Chief of the Essex Water Company for the following information regarding the water supply to the Borough:— The water supply of the whole of your area has been satisfactory in quality and quantity. 66 No action has been necessary in respect of any form of contamination. The number of dwelling houses supplied as at 31st December last was 85,640 and the population as obtained from the Registrar General was 246,710. We are unable to state the number of houses supplied by stand pipe, but the total is quite insignificant. We do not make frequent fluorine determinations but on the basis of past results, the fluorine content of the supplies is put at 0.25 p.p.m. The Essex Water Company was formed by the amalgamation of the Southend Waterworks with the South Essex Waterworks Company when the latter Company changed its name in 1970, and on 1st April 1971, the Essex Water Company had transferred to it the undertakings of the Chelmsford Borough Council, Chelmsford Rural District Council, With am and Burn ham on Crouch Urban District Councils. The present proposals of the Government envisage Regional Water Authorities responsible for water supply, river management and sewage treatment. Under these proposals however, the water companies will continue as agents for the appropriate Regional Water Authority. The full implications of the Government's proposals are still being awaited." 42 samples were taken by the Health Department from the main supply during the year of which 21 were submitted for chemical and 21 for bacteriological examination. In each case a satisfactory report was received. 11 of the above mentioned chemical samples were examined with special reference to the possibility of lead contamination. The results indicated that all these eleven samples were free from lead. Re-Organisation of Water and Sewage Services The Department of the Environment have issued a Circular (92/71) and an explanatory memorandum regarding the re-organisation of water and sewage services. 67 These documents stated that the long-term prospects for water supply in this country, and for maintaining and improving the quality of our rivers give rise to serious concern. The Department of the Environment have reached the conclusion that the way in which responsibilities for managing water are distributed at present imposes a handicap which can no longer be accepted and that a comprehensive reshaping of the machinery is called for. The responsibility in this field at present is fragmented between more than 1,400 different bodies and the Government, therefore, intend to create 10 Regional Water Authorities including one for Wales which will be able to deal with water services as a whole, literally from the source to the tap. The Regional Water Authorities' functions will include the prevention and control of polluting discharges to rivers and estuaries; treatment of water for public use; and dealing with sewage. At the same time they will have a duty to ensure the full development for amenity and recreation of our rivers, canals and wherever appropriate, reservoirs. The Government aim to bring new structure into operation on the 1st April 1974, at the same time as the new local authorities outside Greater London. These new Regional Water Authorities will replace the 25 existing river authorities and Water Boards and will perform their water conservation, water quality control, water supply, navigation and recreational functions, and will take over the water supply and sewage disposal functions at present performed by numerous local Authorities. They will be responsible for controlling the admission of trade effluent to public sewers, but local authorities will be left with their local sewerage functions, i.e. conveyance of sewage into the main sewers. The Government intend that statutory water companies (of which the Essex Water Company is one) should continue in existence, operating as agents of the Regional Water Authority. The British Waterways Board, which administers almost 2,000 miles of canals and river navigations, is to be wound up, 68 69 and its responsibilities transferred to the Regional Water Authorities, so that the inland waterways can be more closely integrated into the system of river management. The London Borough of Havering will become part of the area of Regional Water Authority No.6, which not only includes the whole of the Greater London area but also parts of Essex and Kent, Hampshire, Wiltshire, Gloucestershire, Buckinghamshire, Hertfordshire and virtually the whole of Surrey, Berkshire and Oxfordshire. Regional Water Authority No.6 will also assume the pollution control functions at present exercised by the Port of London and the Greater London Council. 70 RAINFALL The following table shows the amount of rainfall recorded at four stations in the Borough during the year:- HORN CHURCH RAIN HAM ROMFORD UPMIN STER Amount in millimetres No. of days in which rain fell Amount in millimetres No. of days in which rain fell Amount in millimetres No. of days in which rain fell Amount in millimetres No. of days in which rain fell JANUARY 63.1 19 55.7 17 64.2 23 53.1 22 FEBRUARY 10.5 9 8.4 7 11.5 8 7.5 7 MARCH 45.5 20 43.8 14 42.2 19 37.6 18 APRIL 37.0 11 35.1 9 37.2 8 34.0 10 MAY 65.9 12 75.7 13 62.9 12 58.8 11 JUNE 105.0 13 95.8 12 95.6 16 98.8 17 JULY 20.3 6 20.0 9 21.9 9 29.2 8 AUGUST 69.9 21 73.1 20 68.0 20 66.0 20 SEPTEMBER 13.2 6 7.8 5 12.4 6 10.3 5 OCTOBER 42.6 10 37.1 8 48.8 8 33.0 10 NOVEMBER 49.8 17 47.2 12 53.8 17 50.7 18 DECEMBER 25.4 13 16.48 9 19.7 10 15.9 11 TOTAL 548.2 157 516.23 135 538.0 156 494.9 157 71 LONDON WEATHER CENTRE 1971 (RAINFALL & SUNSHINE) Details of rainfall at the London Weather Centre are given in the following table for comparison with local figures. This table also includes details of sunshine:— Month RAINFALL SUNSHINE Total m.m. Percentage of Average Wettest Day No. of dry days Total hours Percentage of Average Sunniest Day Date m.m. Date hours January 53.5 137 23 9.75 16 44 93 24,29 5.7 February 11.0 37 15 2.75 21 79 136 22 88 March 33.5 101 15 13.25 20 107 94 30 10.3 April 35.7 76 24 10.25 23 112 89 28 12.2 May 54.0 155 25 18.50 21 237 122 3 14.0 June 106.2 190 10,14 24.75 16 165 81 1 14.6 July 18.75 38 27 10.00 25 221 117 15 14.1 August 90.75 161 5 49.50 14 146 82 17 13.4 September 16.2 28 27 11.50 25 168 110 12 11.5 October 48.7 84 13 22.5 23 155 139 7 10.0 November 57.2 110 28 17.5 18 107 185 10 8.2 December 13.7 24 19 5.25 22 32 71 28 5.6 Year 553.0 96 Aug 5 49.50 244 1573 107 Jun 1 14.6 A dry day is defined as one with less than 0.25 mm (.01 inch) of rain during the 24 hours. 72 LONDON WEATHER CENTRE 1971 Month TEMPERATURE Nights with Air Frost Mean Difference from Average Mean Max. Difference from Average Mean Min. Difference from Average Highest Day Max. Lowest Night Min. °C °F °C °F °C °F °C °F °C °F °C °F Date °C °F Date °C °F Jan 6.4 43.5 +1.8 +3.2 8.3 47.0 +1.9 +3.5 4.5 40.1 +1.7 +3.1 10 15.2 59.4 3 -2.2 28.0 5 Feb 6.9 44.5 +1.1 +2.0 9.5 49.1 +1.6 +2.8 4.4 40.0 +0.6 +1.2 24 13.8 56.8 16 -0.1 31.8 1 Mar 6.7 44.1 -0.7 - 1.3 9.7 49.4 -0.7 -1.3 3.8 38.8 -0.8 -1.4 30 14.3 57.7 7 -2.8 27.0 4 Apl 9.1 48.5 -0.9 -1.5 12.3 54.1 -1.0 -1.8 6.0 42.8 -0.6 -1.0 22 21.4 70.5 27 2.5 36.5 0 May 13.9 57.0 +0.8 +1.5 18.1 64.6 +1.3 +2.4 9.6 49.2 +0.1 +0.1 11 24.1 75.4 1 3.6 38.5 0 Jun 14.5 58.1 -1.8 -3.2 17.8 64.1 -2.5 -4.04 11.1 52.1 -1.3 -2.2 24 24.4 75.9 15 7.4 45.3 0 Jul 19.3 66.7 +1.6 +2.9 23.5 74.3 +2.2 +4.0 15.0 59.0 +0.9 +1.7 11 31.0 87.8 18 10.4 50.7 0 Aug 17.7 63.9 +0.3 +0.6 20.8 69.4 -0.1 -0.3 14.6 58.3 +0.8 +1.4 19 27.2 81.0 8 11.3 52.3 0 Sept 16.5 61.7 +0.7 +1.3 20.6 69.0 +1.5 +2.7 12.4 54.4 -0.1 -0.1 5 23.4 74.1 16 9.7 49.5 0 Oct 13.9 57.0 +1.3 +2.4 17.2 63.0 +1.9 +3.5 10.6 51.0 +0.7 +1.2 2 24.2 75.6 14,15 5.3 41.5 0 Nov 8.1 46.6 -0.2 -0.4 10.8 51.4 +0.4 +0.7 5.5 41.8 -0.8 -1.5 2 17.9 64.2 20 0.3 32.5 0 Dec 8.3 46. 9 +2.4 +4.3 9.9 49.9 +2.1 +3.9 6.6 43.9 +2.6 +4.7 21 15.4 59.7 29 1.1 34.0 0 Year* 11.8 53.2 +0.6 +1.0 14.9 58.8 +0.7 +1.3 8.7 47.6 +0.4 +0.6 July 11 31.0 87.8 Mar 7 -2.8 27.0 10 *Provisional Sewerage & Sewage Disposal I am indebted to the Borough Engineer & Surveyor for supplying the following details of new sewers laid and improvements effected during the year. Foul Sewers The following works have been completed Barnstaple Road relief (9"dia.) 110 metres Ardleigh Green Road (to Haynes Road) — renewal (9") 90 metres Rom Valley Sewer II—III — High Street to Junction Road (33'/18' 15") 820 metres. Upminster Road North — extension to White Post Corner (9") 525 metres. Work is in progress on Cranham Foul Sewerage — removal of surface water connections. The Programme for 1972/73 includes Corbets Tey Foul Sewer. Surface Water Sewers The following have been completed Mawney Road/White Hart Lane — new outfall (6") 55 metres. Derby Avenue — new outfall (24") 70 metres. Ardleigh Green Road/Haynes Road (15"/12"/9") 250 metres. Rush Green Road/Dagenham Road (36"/27'/18") 1040 metres. Wantz Stream piping (jointly with London Borough of Barking) (54"/48"/42"/36") 870 metres. Mawney Road (north) including new outfall (30"/27"/21"/18") 580 metres. Sheila Road/Highfield Road (36"/33"/27"/21"/18") 815metres. Heron Way — stream culverting (6'9" x 3'0") 55 metres. Work is due to commence soon on Ayloffs Walk/Brookside renewal Suttons Avenue improvement London Road/Waterloo Road Heath Park improvement Airfield/Suttons Lane — new outfall Ravens bourne Stream Improvement II (awaiting C.P.O.) 73 The programme for 1972/3 includes Elm Park (St. Nicholas Avenue) — relief sewer. Several small schemes, subject to rate estimate approval. Nearly 4,000 calls were received by the Department during the year, mostly by telephone, concerning obstructed sewers (combined drains) which are cleansed by the Council free of charge. Follow-up visits are undertaken by the Inspectorate if and when further obstructions are reported to the same sewer within a limited period of time. From these visits 180 notices to either repair or renew any defective sewers were served and the necessary works effected. The Director of Public Health Engineering, Greater London Council has very kindly supplied the following information:— "Modifications to the domestic plant at Riverside Sewage Treatment Works started in February 1971, were completed in November 1971 but, due to several reasons, the plant has not yet been operated in its modified form. However, it did continue 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 satisfactory. However, further extensions may be required if various applications for the discharge of trade effluents to the domestic sewers now being considered, are granted. Design work for a biological plant to treat trade waste is now complete and trial borings on these works are now being carried out. However, no firm date for the commencement of the new plant has yet been set. The incidence of smells which led to complaints from the public during the early part of the year, ceased when the trade effluent discharge which was giving rise to the offending smell was no longer discharged to the domestic sewer." 74 Streets Made Up and Taken Over The following are the streets made up and adopted by the Council during 1971. Name of Street Length Grasmere Road 133 yds. Limerick Gardens 143 yds. Gerard Gardens 160 yds. Hurst lands Close 70 yds. High Elms 100 yds. Ores ton Road 165 yds. Warwick Road 288 yds. Little Aston Road 45 yds. Hay lake Gardens 143 yds. Philan Way 138 yds. Tyrells Close 76 yds. Venette Road 110 yds. Baillie Close 113 yds. Red bury Close 33 yds. Crammerville Walk 195 yds. Magnum Close 120 yds. Norway Walk 116 yds. Laburnham Close 60 yds. Jordan Way 186 yds. Gernon Close 37 yds. Penn Gardens 166 yds. Taylor Close 66 yds. Quartles Close 26 yds. Defoe Way 106 yds. Udall Gardens 413 yds. Charlotte Gardens 240 yds. Navarre Gardens 156 yds. Fentiman Way 150 yds. Woodside Close 288 yds. Lodge Court 213 yds. 75 HOUSING Number of New Dwellings Erected During the Year By the Local Authority — 176 (353) By other Local Authorities — 72 (48) By other bodies or persons — 886 (504) The previous year's figures are given in brackets. Local Authority Housing Accommodation The Housing Manager informs me that of the 176 new dwellings completed during the year all but 19 were flats or bungalows built specifically for retired pensioners. Also included in the total were two dwellings built especially for disabled persons. Four further warden controlled complexes were completed — Will Perrin Court, South Horn church; Bamber House, South Horn church; Lombard Court, Romford, and Snow don Court, Gidea Park. There are now 16 wardens responsible for some 600 elderly persons. On the 1st April 1971 the Greater London Council transferred some 2,650 of their local dwellings to this Council under the terms of the London Government Act 1963. The majority of these were on the Harold Hill estate including a group of Pensioners' bungalows under the supervision of a warden who was included in the transfer and is now in this Council's employ. South Park Caravan Site for gypsies is under the management of the Housing Department and has been the subject of numerous visits by representatives of other local authorities with similar proposals. This site was first used as a temporary standing as from April 1968 but, in December 1970 after a redevelopment programme had been carried out, the site was officially opened as a gypsy site with 16 hard standings, each hard standing having its own outhouse which is fitted with a w.c., shower and sink. The weekly inclusive rent of a standing on this site is £2.75p, there being no other charges for any other services provided. A £5 deposit — reduced from £40 — is required from each resident and this deposit is held against damages or rent arrears that may be outstanding on the residents leaving the site. A warden is employed for 35 hours per week and he is given a rent-free 76 standing for his caravan. An office is provided for the warden to carry out his duties together with a telephone. At the end of the year the Council had approved a scheme for the provision of a hot water supply to each standing. This will consist of a calor gas water heater, water service pipes from the heater to the sink and shower in the individual outhouse, together with necessary pipework and connection to the resident's own bottle of gas. It is anticipated that these facilities will be provided early in the new year. The total number of properties under management at the 31st December 1971 was 14,370 together with 2,546 lock-up garages and 1,409 hard standings for vehicles. At the end of the year the housing waiting list included 2,159 applications on the main list, 313 on the supplementary list and 687 on the engaged couples list. Housing Priority on Medical Grounds 399 applications for medical priority in connection with rehousing were received during the year, 233 being in respect of registrations on the waiting list and 166 from existing tenants requesting transfer to alternative accommodation. Land Charges Act 1925 The procedures regarding land charges enquiries remain as outlined in my annual report for the year 1969, the necessary liaison being maintained with the Town Clerk's Department in respect of the 7,174 searches which were made during the year 1971. Building Control Co-operation with the Borough Engineer & Surveyor and the Borough Planning Officer continued throughout the year and in all some 333 plans were referred to the department for scrutiny and observations. This enables the developer to incorporate our suggestions when actual building commences. Housing Act 1969 (Part 1) House Improvements Details of applications for improvement grants received during the year 1971 under Section I of the Housing Act 1969 are given in the following table:— 77 (A) Standard Owner/Occ upiers Tenanted Standard Standard 5 point 3 point 5 point 3 point 1. Number of Applications Received 231 - 21 - 2. ,, ,, ,,Approved 111 - 17 - 3. Number of dwellings improved 140 - - - 4. Amount paid in grants £17,299.00 5. Average grant per house £ 126.27 6. Number of amenities provided (a) Fixed bath/shower 61 (b) Wash hand basin 91 (C) Hot water supply (to any fittings) 103 (d) Water closet within dwelling 102 (e) A sink 5 7. Number of bathrooms added 30 (B) Discretionary Owner/Occupiers Tenanted 1. Number of Applications Received 71 1 2. ,, ,, ,,Approved 51 5 3. Number of dwellings improved 65 - 4 . Amount paid in grants £25,915.00 5. Average grant per house £498 37 The above-mentioned applications necessitated some 601 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: — Sn. 45 — Qualification Certificates (a) applications: received — 665 (b) granted — 358 (c) refused — 4 (d) appeals: (i) allowed — Nil (ii) disallowed — Nil 78 Sn. 46 — Certificates of Provisional Approval (a) applications : received - 47 (b) granted — 32 (c) refused - 1 Sn. 54 Number of County Court Orders made empowering landlords to enter and carry out works - Nil Rent Act 1968 — Certificates of Disrepair 5 applications for the issue of Certificates of Disrepair were received during the year. Undertakings were received from landlords in 4 cases in accordance with Paragraph 5 of the Ninth Schedule to the Act, and in the other cases a certificate of disrepair was issued to the tenant failing the receipt from the landlord of an undertaking to carry out the repairs listed. Housing Act 1957-Sections 17&18 During the year the Council made three Closing Orders following representations by the Department. Two of these properties were occupied and necessitated the rehousing of two families totalling 3 persons. CLEAN AIR Clean Air Act 1956 — Smoke Control Areas The Havering (No.6) Smoke Control Area which was deferred in 1970 was deferred for a further year, although the Council agreed to make the necessary Order and go ahead with this Smoke Control Area in 1972. The 4 areas which had been suspended for a period of 5 months during the winter of 1970/71 became operative again on the 1st April 1971. 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 Warren Spring Laboratory. 79 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 11 applications for approval to chimney heights were received during the year — a decrease of two on the previous year. In one case alterations to height was required, the other 10 being satisfactory as proposed. 80 MISCELLANEOUS Noise Abatement 66 complaints were investigated during the year, an increase of 11 on 1970. 13 referred to commercial premises, 12 domestic, 6 industrial, 4 construction, demolition, etc., 11 noisy ice cream chimes and 20 miscellaneous. 9 ice cream vendors were prosecuted under Section 2 of the Noise Abatement Act 1960 for operating musical chimes during the prohibited periods. Fines of £36 were imposed and costs amounting to £22 were awarded to the Council. In all other instances informal action was sufficient to effect a reduction in noise levels. Mention was made in last year's report to the speedway activities at "Brook lands". A High Court action by a complainant resulted in the granting of an injunction against the Romford Football Club and Speedway promoters from allowing speedway racing at "Brook lands" thereby causing nuisance by noise to the complainant. Racing consequently ceased at the end of the 1971 season. Disinfection & Disinfestation The arrangement whereby the Council take advantage of the disinfecting and cleansing services provided by the London Borough of Hackney continued during part of the year, during which time 3 families totalling 8 persons together with their clothing and bedding were dealt with. In addition 7 lots of bedding were taken to the cleansing station for disinfection in connection with the treatment of scabies. Towards the end of the year arrangements were made for the treatment of persons who were suffering from scabiestogether with their clothing and bedding—to be carried out by the Health Visitor if possible. Pest Control Two of our three 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 81 to undertake operations against feral pigeons and once again particular reference was given to certain British Railways' property. The rodent 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 1971 which is sent to the Ministry of Agriculture, Fisheries & Food on Form 1.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. 4,026 - Number infested by : (a) Rats 2,727 - (b) Mice 1,299 - 2. Total number of properties inspected for rats and/or mice for reasons other than notification. 5,476 219 Civic Amenities Act 1967 7 prosecutions were taken by the Council during the year under Section 19 of the Civic Amenities Act 1967. All were in respect of the illegal dumping of rubbish. Fines totalling £48 v/ere imposed and costs totalling £20.60 awarded the Council. Hairdressers and Barbers 2 certificates of registration were issued during the year in respect of new businesses as hairdressers (barbers) and 9 registrations were made concerning change of ownership. The total number of registrations at the end of 1971 was 163. Cemeteries The Council operate 4 cemeteries all sited within the Borough, the number of interments — including the interment of cremated remains — taking place during the year was as follows : 82 Cemetery Adults Stillborn Children Romford 417 29 Horn church 81 6 Rain ham 84 2 Upminster 164 4 746 41 During the year 5 interments were carried out under the provisions of Section 50 of the National Assistance Act 1948. Crematorium The number of cremations carried out during 1971 at the South Essex Crematorium, Ockendon Road, Corbets Tey, Up minster was 2,806, an increase of 208 on the previous year. These included 1,190 from the Borough, the corresponding figures for 1970 being 2,598 and 1,223. A new scale of fees will come into operation on the 1st January 1972. Mortuary The Council does not provide or maintain a public mortuary. Use, however, is made of the facilities provided by the Romford Group Hospital Management Committee at Oldchurch Hospital, Romford, at an agreed cost of £3 per body from the 1st January 1971 — previously £2. The Hospital Management Committee provide all the necessary labour services and equipment required for post mortems. 268 bodies were received during the year. From the Council's point of view this is an ideal arrangement, it being essential that facilities for the storage of bodies should be of a high standard and sited close to the Hospital Laboratory Service premises. Common Lodging Houses There are no common lodging houses in the Borough. Rag Flock & Other Filling Materials Act 1951 Routine inspections continued to be made of the 2 registered premises in the Borough and 3 samples were submitted to the Prescribed Analyst for examination. In each case a satisfactory report was received. 83 Pet Animals Act 1951 26 licences to keep a pet shop were renewed during the year—a reduction of 2 on the previous year — and one new licence was issued. 3 of these licences were in respect of sale stalls in Romford Market. A fee of £2 is payable for each of these licences. Riding Establishments Act 1970 8 licences to keep riding establishments were issued during the year 1971 (7 renewals, one new establishment) this being a reduction of 1 on the previous year. The fee for this annual licence is £10. This new Act which came into force on the 1st January 1971 repealed the whole of the Riding Establishments Act 1964 and contained several new conditions concerning compulsory insurance and provision for Local Authorities to issue provisional licences for any licencees whose qualifications did not come up to the standards prescribed in the Act. Animal Boarding Establishments Act 1963 The 9 licences authorising persons to keep an Animal Boarding Establishment (Cats and Dogs) were all renewed during the year. The fee for each licence is £2. The total boarding capacity authorised is 542 dogs and 217 cats. Performing Animals (Regulations) Act 1925 There are no current registrations under this Act. Paddling Pools Six samples were taken from the Council's Paddling Pools during the year and all were satisfactory. Swimming Pools A total of 32 bacteriological and 32 chemical samples were taken from the 3 public swimming pools during the year and in each case a satisfactory report was received. 84 The total number of school swimming pools is now 16, an increase of one on the previous year. Regular sampling is carried out and 54 bacteriological samples and 53 chemical samples were taken during the year. All samples were satisfactory. Establishments for Massage or Special Treatment 17 licences authorising persons to carry on an Establishment for Massage or special treatment under the terms of the Essex County Council Act 1933 were renewed for the period 1st April 1971 to 31st March 1972 being one less than last year. These licences (annual fee £1.05) were in respect of 14 chiropodists, 1 physiotherapist and 2 beauticians. Essex County Council Act 1933 — Part V — Employment Agencies 31 licences to carry on Employment Agencies were issued during the year, an increase of 4 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 No new registrations were effected during the year, the total number of registrations being 16. Scrap Metal Dealers Act 1964 2 new registrations were made in the register of Scrap Metal Dealers during the year, these registrations being for a period of 3 years. 3 registrations which expired during 1971 were renewed and 13 others which expired during 1971 were not renewed, leaving the total number of entries in the register at 25. 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 I and VIII of the Act which are administered by the Council: — 85 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. 36 20 1 - ii) Factories not included in (1) in which section 7 is enforced by the Local Authority 609 206 4 - iii) Other premises in which section 7 is enforced by the Local Authority (excluding out-workers' premises) 31 43 - - Total 676 269 5 - 86 87 Particulars (1) Number of cases in which defects were found Number of cases in which prosecutions were instituted (6) Found (2) Remedied (3) Referred To H.M. Inspector (4) By H.M. Inspector (5) Want of cleanliness (S.1) 6 4 - 6 _ Overcrowding (S.2) - - - - - Unreasonable temperature (S.3) - - - - - Inadequate ventilation (S.4) 3 1 - 3 - Ineffective drainage of floors (S.6) - - - - - Sanitary Conveniences (S.7) (a) Insufficient 2 1 - 2 — (b) Unsuitable or defective 1 - - 1 - (c) Not separate for sexes 1 - - 1 - Other offences against the Act (Not including offences relating to Outwork) - - - - - Total 13 6 - 13 - Outwork - Sections 133 and 134 Nature of Work Number of Outworkers in August list Baby nursery furniture manufacture 15 88 SHOPS AND OFFICES LEGISLATION Within the Department's Inspectorate are three Shops & Offices Inspectors which includes a Senior Inspector. The Section is responsible for the enforcement of the following legislation:- Shops Acts 1950 — 65 Young Persons (Employment) Acts 1938 — 64 Offices, Shops & Railway Premises Act 1963 (in part) Ancillary duties include:- Consumer Protection Act 1961 Gaming Act 1968 Essex County Council Act 1933 (Employment Agencies) In February one of the Inspectorate left to take up a similar appointment with the City of London. In June a replacement was appointed and at present he is receiving comprehensive training with a view to securing early qualification. THE SHOPS ACTS 1950 - 1965 The Shops Acts control the opening hours of shops, both on weekdays and Sundays, and also seek to ensure that staff receive certain basic entitlements such as meal breaks, rest periods, weekly half holidays, time off for Sunday employment, as well as to control the maximum hours of employment of young persons under the age of eighteen. ABOLISH OR IGNORE? During the year the Shops Acts have received a great deal of publicity. First Mr. Evelyn King, M P. sought to abolish closing hours completely, a move which failed. Secondly many saw fit to challenge the restrictive Sunday arrangements of the Act only to find that the Courts were adamant that the law was there to be enforced. Today's problem is that fines laid down years ago no longer act as a deterrent and many have found it profitable to engage in illegal Sunday trading. 89 SUNDAY TRADING The trend to illegal Sunday trading has greatly increased over the past year within the Borough. Enforcement is a long and tedious process and the Authority's three Inspectors have been involved in more than the normal amount of Sunday duty. It is realised that it is impossible to devote adequate time to this problem so enforcement in the first instance has been directed at areas of specific complaint and cases of blatant advertising. Although 153 visits were made in connection with Sunday trading it was only possible to bring two offenders before the Courts. EARLY CLOSING Shops unless otherwise exempted by the Act or by the local Orders must close their premises at 1.00 p.m. on one weekday. In Havering there are a great many trades which are locally exempted and have the right to trade for six days. In the larger departmental stores it has been confusing to the public to find that they can buy some goods and not others. Ladies' wear which is permitted and menswear which is not. New shopkeepers to the Town are often unaware of the complexity of these local Orders and do not take advantage of the advisory service given by the Inspectors. It was unfortunate that one menswear retailer was prosecuted for not observing half day closing. Since this action was taken the Authority have received a request for an exemption Order to cover this trade and a poll of those traders affected will be taken to ascertain whether it is a majority wish that an Order be made. Of 1,074 visits to premises relating to Early Closing 129 infringements were found. EVENING CLOSING While the general closing hours for the majority of shops is 8.00 p.m. only a majority take advantage of staying open late, and then usually only for one evening per week. Surveys were carried out during the year of selected areas and of 34 visits recorded it was necessary to issue cautions in two instances. 90 EMPLOYMENT CONDITIONS This year's figures show improvement over the previous year. From 668 enquiries 135 infringements were noted compared to the 330 infringements found in 1970. The Inspectors though, are not complacent, as according to the type of premises inspected, a far greater number of infringements are found in some occupations compared to others. In 1970 enquiries in depth into the working conditions of employees at one petrol station accounted for nearly one third of all enquiries. Had adequate time and man power been available to extend this type of enquiry to more such premises no doubt similar conditions would have come to light. It is an accepted fact that where shifts are worked at petrol stations it is rare for employees to receive their proper rest and meal periods. From a practical point, to prove an offence of failing to allow an employee a lunch hour, requires two Inspectors keeping the premises and employee under constant observation for a minimum period of three hours plus supporting evidence to show the employee was employed for a minimum period of six hours. The penalty for a first offence of this type is only £1, so it is only in cases where there is evidence of general noncompliance that time has to be found to conduct enquiries in depth to secure a conviction of some magnitude. In the instance indicated in 1970 it was estimated that the cost to the Local Authority of bringing the employer to court was in excess of £200 of which only £70 was recovered in costs. One incident investigated was of young girls only being allowed a 20 minute lunch break on a Saturday. Complaint to the Company was to no avail and legal proceedings was the only answer. As it happened the firm were forced into bankruptcy days before the hearing. SUMMARY The standard of enforcement within the Borough is high and it is disturbing to note that in many other areas Authorities do not discharge their Statutory duties with the same air of responsibility as Havering. 91 TABLE OF ENQUIRIES Early Closing 1074 Evening Closing 34 Sunday Trading 153 Employment of Young Persons 152 Conditions of Employment 429 Sunday Employment 87 Other 2 1931 TABLE OF INFRINGEMENTS Early Closing Day Failing to exhibit an early closing day notice 85 Failing to close for the 'serving of customers' 29 Failing to observe the Regulations 15 Evening Closing Hours Failing to close for the 'serving of customers' 2 Sunday Trading Failing to close for the 'serving of customers' 11 Failing to observe the Regulations 18 Conditions of Employment Failing to exhibit notice specifying the day of Assistants' weekly half holiday 57 Failing to allow assistants a weekly half holiday 14 Failing to allow intervals for meals and rest 12 Failing to exhibit the Abstract of the Act and to keep records of hours worked by young persons 40 Failing to give young persons at least eleven hours consecutive rest to include 10 p.m. and 6 a.m. Nil Exceeding maximum permitted hours of employment of a young person Nil Failing to keep a record of Sunday Employment 17 Failing to allow holidays in lieu of Sunday employment 5 92 Table of Prosecutions No. Section Offence Result 1 47 Sale of non-exempted goods on Sunday (1 case) £3 fine 2 17 Assistants in half holiday notice (2 cases) £1 fine on each 17 No half holiday allowed (7 cases) £1 fine on each 19 Meal breaks & rest periods (32 cases) No evidence offered 22 Sunday Records (3 cases) £3 fine on each 22 Holiday in lieu of Sunday (1 case) £3 fine 24 Young person. Exceeding maximum hours (4 cases) £5 fine on each 31 Night employment of young persons (8 cases) £5 fine on each 32 Young persons. Record of hours (6 cases) £3 fine on each 3 22 Sunday records (1 case) £5 fine 4 47 Sale of non-exempted goods on Sunday (2 cases) £5 fine on each 5 1 Open on the Early Closing Day (1 case) £1 fine 1 No early closing day notice (1 case)£l fine 17 Assistants' half holiday notice (1 case) £1 fine 17 No half holiday allowed (1 case) £1 fine 6 19 Meal breaks and rest intervals (2 cases) £1 fine on each 93 Offices, Shops & Railway Premises Act, 1963 This Act is designed to set and enforce a standard of safety, health and welfare in non-industrial workplaces. Premises registered under the Act are inspected, some by the Shops & Offices Inspectors and some by the Public Health Inspectors. Visits and General Inspections are noticeably less compared with 1970, the reason for this being the accumulated effect of two Public Health Inspectors suffering lengthy serious illnesses, and the departure of one of the Shops Inspectors who was subsequently replaced by a trainee Inspector. The standard of compliance has improved over the years, and in general employers are very co-operative. Registration and General Inspections (1) (2) (3) (4) Class of Premises No. of Premises Registered during the year Total No. of Regis tered Premises at end of year No. of Registered Premises receiving a General Inspection during the year Offices 25 542 15 Retail Shops 68 1228 299 Wholesale Shops, Warehouses 1 41 7 Catering Establishments open to public, Canteens 8 137 66 Fuel Storage Depots - 6 - TOTAL 102 1954 387 Visits by Inspectors to Registered Premises TOTAL 1469 94 Accidents - Analysed by Workplace Workplace No Reported Total No Investigated Prosecutions Offices 3 2 - Retail Shops 57 46 - Wholesale Shops, Warehouses 9 8 - Catering Establishments open to public, canteens 21 16 - Fuel Storage Depots - - - 90 72 - 95 Analysis of Reported Accidents Offices Retail Shops Wholesale warehouses Catering establishments open to publiccanteens Fuel storage depots Machinery - 2 - 1 - Transport 2 3 - - Falls of persons 1 17 1 8 - Stepping on or striking against object or person 1 10 — — — Handling goods 1 12 4 6 - Struck by falling object - 7 - 1 - Fires and explosions - 1 - 1 - Electricity - - - - - Use of hand tools - 5 - 2 - Not otherwise specified - 1 1 2 - TOTAL 3 57 9 21 - Comparison 1970 3 74 2 4 - Notification of Accidents Employers are required to notify the "appropriate authority" of accidents occurring within the premises. In 1971, 90 accidents were reported to this Authority compared with 83 in 1970. This slight increase in notification was no doubt brought about by the distribution of 2000 circular letters, a repeat of 1967, to employers and management of their legal obligations and the importance of the exercise. Once again "falls" top the list of the causes of accidents. A fall is no longer a 'joke' at least to the individual having the fall. Whilst none of the accidents reported was fatal, some of the injuries sustained have caused the injured person to be away from work, in some cases weeks and even months. There was a case of serious burns involving a young woman who became ignited whilst sitting in front of an open fire. Previous to to the incident she had served a customer with petrol and had accidentally spilt some on her clothing (trousers). 'Open' fires should on no account be in an area where petrol is stored, used or sold, not even in an office where this accident actually occurred. During the past seven years accident prevention work done by the inspectorate under the Act and the remedies of structural defects, equipment, appliances, etc., does not appear to have reduced the accident rate as a whole. There has, however, been a significant decrease in the number of accidents concerning the meat slicing machines. The provision of a guard to the knife, coupled with the awareness of the operator that he or she is working at a dangerous machine and training given has been instrumental in obtaining the improvement. Accidents at work are a serious and costly national problem, not only in human suffering but causing a financial burden of some magnitude. The Government has appointed a Committee on safety and health at work to report on the problem and to suggest ways and means to combat it. Of the 90 accidents reported, 25 concerned men, 42 women, 13 boys and 10 girls. 96 Summary of Infringements Section Details Number 4 Cleanliness 5 5 Overcrowding 1 6(1) Temperature 4 6(4) Thermometers 26 7 Ventilation 8 8 Lighting 8 9 Sanitary Conveniences (insufficient or lacked proper maintenance) 15 10 Washing facilities (insufficient or lacked provision of running hot water) 9 11 Drinking Water - 12 Clothing Accommodation 7 13/14 Sitting Facilities 2 15 Eating Facilities 1 16(1) Floors, Passages and Stairs 10 16(2) Handrails and guarding of open sides 10 17 Fencing Machinery 7 20 Hoists and Lifts 4 22 Dangerous conditions and practices 2 24 First Aid Provisions 39 27 Interference with Equipment 97 Summary of Infringements (cont'd.) Section Details Number 48 Failing to Report Accident 1 49 Failing to Register 55 50 Abstracts 48 53 Obstructing Inspector - Table of Prosecutions No. Section Offence Result 1 16 passages obstructed £20 fine 2 6(4) thermometer not provided £20 fine 24 first aid box not provided £20 fine 3 16 stairs and passages obstructed £40 fine 4 16 passages obstructed £60 fine 5 4 cleanliness of walls £10 fine 16 defective floor £10 fine Consumer Protection Acts 1961 — I 971 The Consumer Protection Act 1961 gives power to the Secretary of State to make regulations giverning the safety requirements, and construction of certain goods. The 1971 Act came into force in April, and this extends the scope of regulations such that if a retailer is found to be selling goods which contravene the regulations, and this is due to the act or default of his supplier, then proceedings may now be taken against the supplier as well as, or instead of, the retailer. In addition, the new Act has altered the defence provisions of the 1961 Act. 98 A defendant will now have to show that he took all reasonable precautions and exercised all due diligence to avoid the commission of the offence with which he is charged. Existing regulations cover oil heaters, electric fires, nightdresses, carry cot stands, and toys. The Electrical Colour Code Regulations came into full operation in April, making it an offence for a trader to have in his possession for sale any electrical appliance not using the international colour code on the wiring, and not having an explanatory notice attached to the flex. An introductory leaflet was sent to all known electrical dealers in the Borough, informing them of this new regulation. During the year fourteen toys were submitted to the Public Analyst. Of these four contained excessive quantities of lead in the paint. A case of particular note involved the British manufactured "Top Ten Xylophone". Four of the six colours on this toy contained lead above the legal limit, one colour being sixty six times the limit. Investigations led to the return of some 40,000 of the xylophones to the manufacturer. The nationwide publicity surrounding this case has resulted in a neighbouring London Borough instituting legal proceedings against the manufacturer who was fined a total of £200 with £15 costs. Thirty three offences under the Electrical Colour Code Regulations were investigated, and one offence involving an oil heater was passed to another London Borough for action. The new legislation, and public interest in the subject has necessitated an increase in time allocated to Consumer Protection The number of inspections made during 1971 was an increase of 67% over the previous year. Table of Prosecutions Regulation Offence Result No. 1 The Oil Heaters (Regulations) Unsafe £15 fine and 1962 - 1966 £20.75 costs No. 2 The Toys (Safety) Regulations Lead content Dismissed 1967 excessive No. 3 ,, ,, ,, 99 Table of Prosecutions (cont'd.) Regulation Offence Result No. 4 The Toys (Safety) Regulations Lead content £10 fine and 1967 excessive £5 costs No. 5 ,, ,, £20 fine and £6.60 costs ESSEX COUNTY COUNCIL ACT Employment Agencies The growth of employment agencies over the past few years has been phenomenal. The service offered by agencies has at times been severely criticised as 'obtaining money under false pretences'. At present a working party representative of the London Boroughs is studying various problems connected with employment through agencies and a report is expected soon. Are agencies necessary? This can only be answered by those who avail themselves of the services offered and judging by the expansion in the agency field the answer must be yes. Certainly there have been no complaints of any nature during the year concerning any aspect of agency business in Havering. There are two types of placement that agencies deal with, permanent and temporary. Controlling legislation at present only requires licensing in respect of permanent placings. While the great majority of agency work is temporary placements they seek a licence so that in the event of a temporary employee accepting a permanent position with the employer to whom she has been loaned, the agency can then claim the appropriate placement fee. Why do employers engage agencies to find them staff rather than do it themselves? Convenience is the prime consideration and possibly cost second. To advertise in the press, select a shortlist, hold interviews and notification to both successful and unsuccessful applicants all takes time. At the end of it all the person appointed will have to work notice with the present employer. 100 By contacting an agency the grade of employee can be selected from records and appropriate personnel, introduced within a matter of a day or two, all ready to commence duties. The introduction fee payable is related to earnings with usually a guarantee refund if the employee leaves within a number of weeks. The employer is responsible for satisfying himself as to qualification and references of the person introduced. Temporary staff are employed by the Agency, who pay their wages, S.E.T. and other statutory requirements. The hirer merely pays the agency an agreed fee according to the number of hours worked. All applications for agency licences are carefully vetted and premises intended for use inspected. Annual reinspection as well as spot checks during the year are also made. At the end of 1971 thirty-one agencies operated under licence issued by the Local Authority. 101 GAMING ACT, 1968 Amusements with Prizes It is an increasing trend in cafes and public houses to provide for customers, amusement machines which give prizes. The Gaming Board saw fit to include these machines within the scope of legislation, which although one 'gambles' on them, is gaming in one of its less socially destructive forms. Prizes are paid in the form of tokens exchangeable for goods supplied over the counter and not for cash. There are no known cases of housewives losing the week's housekeeping or becoming addicted to these machines, as has often been the case with their more lucrative big brothers, the one armed bandits, which offer jackpots of as much as £40. Even so control is considered necessary and while the Police look after public houses, the Local Authority's Shops Inspectors inspect cafes and restaurants and recommend the issueof licences where considered suitable. Points considered include access by schoolchildren, seating capacity of the premises and positioning of the machines. In premises where schoolchildren are likely to frequent the panel of Councillors who form the Licensing Committee insist on a notice prohibiting use by persons under sixteen years of age. Machines are only intended for use by diners and not the takeaway trade, as in the case of a fish restaurant. At the end of the year 30 premises held licences issued by the Local Authority. 102