Hornc 13 Hornchurch Urban District Council INTERIM REPORT OF THE MEDICAL OFFICER OF HEALTH For the Year 1945 W. & W. Ltd., Romford. Hornchurch Urban District Council INTERIM REPORT OF THE MEDICAL OFFICER OF HEALTH For the Year 1945 2 MEMBERS OF THE COUNCIL. Councillor A. C. Salinger, J.P., Chairman. Councillor A. J. Twigger, Vice-Chairman. Councillor Mrs. E. M. Field. (2) ,, Mrs. A. J. E. King. (1) ,, Mrs. R J. Reynolds. ,, Mrs. P. Suerring. (2) ,, Mrs. C. M. Stevens. ,, Mrs. H. S. E. Williams. (1) ,, 0. P. W. Ashdown. (1) 0. S. Biggs. (1) W. G. Bunch. (1) (2) & (3) E. W. J. W. Bush. (2) ,, F. J. E. Hecker. ,, A. C. Holmes. ,, H. Holock. (1) ,, A. S'. Hulkes. W. H. F. Maunder. (1) ,, A. W. Pettit. (1) H. H. Wake, J.P. w. h. f. webb. (1) ,, T. f. wllloughby, J.P. (1) Member of the Public Health and Ambulance Committee. (2) Member of the Romford Joint Hospital Board. (3) Chairman of the Public Health and Ambulance Committee. 3 OFFICERS OF THE PUBLIC HEALTH DEPARTMENT. Medical Officer of Health: Alfred Ball, M.D., B.S. (Lond.), M'.R.C.S. (Eng.), L.R.C.P (Lond.), D.P.H. (R.C.P.S.) Lond. Deputy Medical Officer of Health: P. X. O'Dwyer, M.B., B.Ch., B.A.O., D.P.H. Sanitary Inspectors: L. Ager, San. Insp. Cert. R.S.I. Cert. Insp. of Meat and Other Foods. A. Y. J. Hutchings, San. Insp. Cert. R.S.I, and S.I. Joint Board. Cert. Insp. of Meat and Other Foods. *E. Ellerington, San. Insp. Cert. R.S.I, and S.I. Joint Board. Cert. Inspector of Meat and Other Foods. tM. F. Or. Randall, San. Insp. Cert. R.S.I, and S.l. Joint Board. Cert. Inspector of Meat and Other Foods. tL. W. Cole, San. Insp. Cert. R.S.I, and S.I. Joint Board. Cert Inspector of Meat and Other Foods. •(Resigned 24.3.45.) t(Commenced duties 13.11.45.) + (Commenced duties 27.12.45). Clerk: *J. Blay. S. Dance (Temp.). * On War Service. 4 COUNCIL OFFICES, HORNCHURCH. 30th September, 1946. To the Chairman and Members of the Hornchurch Urban District Council. Mr. Chairman, Ladies and Gentlemen, I beg herewith to present an Interim Report on the work of the Public Health Department for the year 1945, written with reference to Ministry of Health Circular letter No. 28/46 dated 11th February, 1946. The report is in the abbreviated war-time form in accordance with the Minister's suggestion, but it is hoped that future reports will not be subject to the same restrictions on their size. The health of the District was again maintained during the year under review, the only exceptional feature being a marked increase in the incidence of measles as compared with the previous year. The year 1945 witnessed the end of hostilities in Europe and the Far East and it was soon evident that the problems of the peace were such as to tax the resources of the community to a greater degree than had been generally realised, if the accumulated unsatisfied demands of the war years were to be met with a minimum of delay, since prolonged delay could only lead to a sense of frustration on the part of the individual citizens. At the end of the year Dr. Alfred Ball relinquished his duties as Medical Officer of Health for the District, thus bringing to a close a long and meritorious career in the public service of the area extending over '25 years. Dr. Ball had experienced indifferent health for some time and it was this that finally compelled his retirement on 31st December, 1945. Many tributes have been pnid to Dr. Ball both publicly and privately and it was obvious from these that he commanded a very deep and sincere respect from 5 the community whose growth he had watched and whose interest he had served in more than one post with quiet and undemonstrative efficiency. My own association with Dr. Ball began informally during the first years of the late war and officially in 1942, when I was appointed Deputy Medical Officer of Health.for the District. During this comparatively short, and for me very happy, association I learned the reason for the high esteem in which he was held. It lay in his own sincerity and the complete absence of all selfish aims in any course which he pursued. This selflessness, and a courtesy of manner rare in the affairs of man at the present time, were characteristic and completely unaffected, springing as they did from that inherent and indefinable quality which distinguishes the "natural gentleman" of whatever station in life. It only remains for me to express my own personal good wishes and those of every member of the Health Department who was associated with him, for Dr. Ball's future happiness, and to assure him that for those of us who worked with him the Council's motto, "A GOOD NAME ENDURETH," is more than a phrase. May both he and Mrs. Ball long enjoy their leisure in the years ahead. PATRICK X. O'DWYER, M.B., B.Ch., B.A.O., D.P.H., Acting Medical Officer of Health. 6 SECTION A. STATISTICS AND SOCIAL CONDITIONS OP THE AREA. Area in acres (land and inland water) 19,768 Estimate of the resident population (mid-vear) 1945 84,430 Number of inhabited houses (Sept., 1945) according to Rate Books 26,757 Rateable Value (September, 1945) £670,706 Sum represented by a Penny Rate (September, 1945) £2,780 Social Conditions. The character and industries of the District remain largely unaltered as compared with 1944. Vital Statistics. Extracts from the Vital Statistics of the year. Number of births registered in the District (767 males, 786 females) 1,553 Birth rate per 1,000 estimated population 18.4 Number of deaths registered in the District:— Residents 560 Non-residents 104 Number of deaths of residents occurring outside the District 385 Total number (adjusted for inward and outward transfers) 841 Death rate per 1,000 estimated population 9.9 Puerperal Deaths :— (a) from sepsis 0 (b) from other causes 3 7 Deaths of infants under one year of age 64 Infant Mortality Rate (per 1,00 births) 41.2 Deaths from Male Female Cancer 62 71 Diabetes 1 2 Diarrhoea 4 3 Influenza 4 4 Pneumonia 27 20 Measles 1 1 Whooping Cough 0 0 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. Bacteriological Laboratory. The County Laboratory established by the Essex County Council at Oldchurch Hospital has continued to serve the needs of the District and is available for any medical practitioners who desire to have a bacteriological report on the specimens which they send. Ambulance Service. There is no change in the ambulance service for the civilian population described in last year's report which includes the mutual assistance scheme with neighbouring authorities. The ambulance which is stationed at Harrow Lodge Depot is under the supervision of the Surveyor. Nursing in the Home. The three nursing associations, viz., the Hornchurch Nursing Association, the Upminster and Cranham Association and the Rainham Association have continued their beneficient work. 8 Maternity and Child Welfare. The County Council which is the Authority has maintained Clinics at the following centres :— (i) Berther Road, (ii) Elm Park. (iii) Malvern Road. (iv) Athelstan Road, Harold Wood. (v) Rainham. (vi) Upminster. Hospital Services. During the year 117 persons notified to be suffering from infections diseases and 37 observation cases needing hospital treatment were admitted to the Joint Isolation Hospital at Rush Green. The average weekly number of patients from this District in the Isolation Hospital was 11. Supply of Insulin for Diabetics. Reference was made in the Annual Report for the year 1943 to Circular '2734 dated 4th January, 1943, in which the Minister of Health drew the attention of local authorities to the desirability of providing insulin for certain classes of persons for whom a public provision is necessary. These include old age pensioners, women engaged in household duties, and other dependants who are not eligible for medical benefit under the national health insurance acts. In compliance with this letter the Council have exercised the power given to them by consent or approval of the Ministry under section 177 of the Public Health Act, 1936, to supply insulin for persons suffering from diabetes among the poorer inhabitants of the District. During the year 28 women were supplied with this remedy, and of these 23 received free supplies and five at reduced cost in accordance with the Council's scale. The majority of these persons were elderly women. Every person applying for a grant was required to furnish a medical prescription stating the variety and amount of insulin to be used. Water. The water supply of the area and of its several parts has been satisfactory both in quality and in quantity. A piped supply of water is laid on to almost the whole of the houses in the District, though private wells are still in use as domestic supplies in some of the outlying areas. 9 Approximately 0.7 per cent, of the inhabited houses, and 0.7 per cent, of the population of the Urban District obtain their water from standpipes. In response to my enquiry the Engineer of the South Essex Waterworks Company has kindly supplied the following information :— "The water supply of the whole of the District has been satisfactory in quality and quantity. Bacteriological and chemical examinations are made of the raw water, of the water in its various stages of treatment and of the water going into supply. A total of about 3,300 chemical, bacteriological and biological examinations have been made and all water going into supply was wholesome. In addition, analyses have also been made of samples obtained from consumers taps in the various parts of the District, and all proved to be satisfactory. The water supply is not plumbo-solvent. No action has been necessary in respect to any form of contamination. The number of dwelling houses supplied as at 31st December, 1945. was 26,851 and the population in September, 1945 as obtained from the Food Office was 85,467. Rats and Mice (Destruction) Act, 1919. Infestation Order, 1943. The Council is the Local Authority for the purposes of this Act, the powers having been delegated by the County Council. The Infestation Order, 1943, lays an obligation on the Local Authority to take the necessary action to cause the destruction of rats and mice in the District. Under the Rats and Mice Destruction Act it is the duty of occupiers of land to take steps to destroy these pests. During the year under review no major infestation was found but minor infestations have been dealt with. All complaints by the public of the occurrence of rats are enquired into by the Sanitary Inspectors, who after investigation on the site give advice to the occupiers of the land or premises on the appropriate methods to be used to eradicate the rodents. 10 SECTION C. Sanitary Officers' Regulations. The Sanitary Inspectors have carried out their ordinary duties as far as possible and until the cessation of hostilities undertook work of a similar character for which they are qualified by reason of their training. This work included visiting public and private air-raid shelters; civil defence depots; inspecting foodstuffs damaged in air-raids. One Sanitary Inspector also carries out inspections of the carcases of animals slaughtered for food at the Regional Slaughterhouse in Romford. SECTION D. HOUSING. During the year 11 houses were completed by private builders and housing certificates were issued. No houses were built by the Council. SECTION E. CONTROLLED TRADES. Milk Production. There are 17 dairy farms in the District, which include 10 farms licensed by the County Council for the production of Accredited Milk and 1 farm for the production of Tuberculin Tested Milk. Inspections of these farms are carried out by the Sanitary Inspectors, and suitable advice given on the production of clean milk and the general hygiene of the premises. Meat. There are 4 slaughterhouses in the district licensed nr-W Section 57 of the Food and Drugs Act, but none is in regular use for slaughtering animals, this being prohibited during the war, by the Livestock (Restriction on Slaughtering) Order, 1940. 11 SECTION F. PREVALENCE OF AND CONTROL OVER INFECTIOUS DISEASE. During the year there was a decrease in the notifications of infectious disease with the exception of Measles which showed a marked increase, 1,196 cases being notified as compared with 154 during the previous year. The Scarlet Fever notifications numbered 121 as against 194 in 1944, and the Whooping Cough notifications decreased from 229 to 38. There were no cases of Smallpox, Typhoid Fever or Encephalitis. In the following table are shown the number of notifications received and the number of cases removed to hospital. Disease. Notified Total Number of Cases Admitted to Hospital. Smallpox 0 0 Scarlet Fever 121 51 Diphtheria 8 8 Cerebro-spinal Fever 6 6 Poliomyelitis 2 2 Puerperal Pyrexia 15 11 Erysipelas 11 2 Pneumonia 79 20 Measles 1,196 5 Whooping Cough 38 0 Ophthalmia Neonatorum 2 1 Dysentery 5 4 Diphtheria Immunisation. Immunisation against Diphtheria was carried on during the year. The Ministry of Health, by advertisements in the national and local press, by their display of advertisements, by the distribution of literature through the schools and child welfare centres, and by cinema notices, continued to bring to the notice of the public the importance of having their children immunised, especially at the age of one year. Mothers were also advised by the Health Visitors and Sanitary Inspectors of the facilities provided by the Council for this to be done. Appointments were sent to those parents who signified their wish for their children to be immunised and special sessions were held at five centres in the District for this purpose. 12 During the year 1,327 children completed the course which consists of two injections of A.P.T. with an interval of four weeks. The immunising substance used is supplied free by the Ministry of Health through the laboratory at Epping. The value of this work is shown by the continued low incidence of Diphtheria of which 8 cases were notified. No death from Diphtheria occurred in this District during the year. Infective Hepatitis. The total number of cases of Infective Hepatitis received during the year was 52, referring to 43 civilians and 9 persons in the armed forces. The following are the age groups of the 43 civilians :— Years. Males. Females. 1-2 1 - 3-4 - 1 5-9 3 5 10 - 14 1 2 15 - 24 6 6 25 - 34 3 4 35 - 44 2 1 45 - 54 4 2 55 - 64 1 - 65 and upwards - 1 Totals 21 22 Tuberculosis. During the year, 148 new cases of Tuberculosis were added to the register. These included 126 cases in which the respiratory organs were affected, and 22 cases in which the infection was in some other part of the body. This is 9 more than last year. There were 52 deaths from this disease, being 11 more than last year . Non-Notifiable Diseases of Childhood. During the year, the cases of non-notifiable infectious disease occurring among school children have been reported by head teachers as follows:—Chickenpox 10, Mumps 74, Scabies 3, Rubella 1, Impetigo 6, Ringworm 1. This is a considerable decrease on the numbers reported during the previous year. '