Ac 4411(5) IILibrary HORNC 31 Hornchurch Urban District Council ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH (James Gorman, M.B., Ch.B,, D.P.H., F.R.S.H.) For the Year 1963 Hornchurch Urban District Council ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH For the Year 1963 Public Health Department, James Gorman, Council Offices, M.B., Ch.B. D.P.H., F.r.s.h. Billet Lane, HORNCHURCH. Medical Officer of Health Essex Telephone: Hornchurch 52555 2 TABLE OF CONTENTS page Members of the Council (as at 31.12.63) 3. SECTION A—Statistics and Social Conditions of the Area 7. SECTION B—General Provision of Health Services for the Area 11. SECTION C—Sanitary Circumstances of the Area 17. SECTION D—Housing 27. SECTION E—Inspection and Supervision of Food and Food Premises 29. SECTION F—Prevalence of, and control over. Infectious and Other Notifiable Diseases 39. SECTION G—Factories Act, 1961 43. Index 44. 3 MEMBERS OF THE COUNCIL (as at 31.12.63) Councillor L. W. Carrol, J. P. Chairman (1) Councillor S. A. Legg, C.C., Vice-Chairman. (1) Councillor Mrs. E. H. Dean. Mrs. J. L. C. Moore. (1) Mrs. M. M. Rudlin. (1) M. Ansell. A. G. C. Davis. T. S. C. Dix. (1) D. W. Edwards. F. W. H. Embleton (1) E. M. Foye. A. C. Good, J.P. L. B. Harris. K. T. Hay. S. G. Heath-Coleman. W. Hec.arty. (1) H. Holock. A. T. James. M. P. V. Leigh, J.P. A. A. Livingstone. (1) N. J. Miles. (1) and (3) H. F. Moss. G. W. Phillips. D. A. Poole. F. J. Powell (1) and (2) N. E. Richards. H. J. S. Turner. A. J. Twigger. (1) C. A. Welch, J.P. W. A. West. (1) (1) Member of Public Health Committee. (2) Chairman of Public Health Committee. (3) Vice-Chairman of Public Health Committee. 4 OFFICERS OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health: James Gorman, M B., Ch.B., D.P.H., F.R.S.H. Deputy Medical Officer of Health: (Part-time) P. X. O'Dwyer, M.B., B.Ch., B.A.O., D.P.H. Chief Public Health Inspector: M. F. G. Randall, M.A.P.H.I. (1) and (2) Deputy Chief Public Health Inspector: E. Oliver, M.A.P.H.I., (1), (2) and (3) (Resigned 10.2.63) S. Whitfield, M.A.P.H.I., (1) and (2) (Appointed 11.2.63) Public Health Inspectors: L. G. Bowyer, M.A.P.H.I., (1) and (2) (Commenced 16.12.63) B. T. A. Cuthbert, (1) and (2) (Resigned 10.11.63). E. J. Day, M.A.P.H.I., (1) (2) and (3). W. R. M. Gray, (1) (2) and (3). A. V. J. Hutchings, M.A.P.H.I., (1) and (2). R. E. Ingleby, M.A.P.H.I., (1) (2) and (3). M. A. Jackson, M.A.P.H.I., (1) and (2). R. K. Raymond, M.A.P.H.I., (1) and (2) (Commenced 1.3.63). F. W. Reeve, M.A.P.H.I., (1) and (2). G. H. Smith, M.A.P.H.I., (1) (2) and (3). Chief Clerk: J. E. Blay. Clerical Staff: Miss E. Thompson. Miss W. A. Hepburn. Miss L. A. Patterson. Mrs. M. Behn. Miss G. C. Taylor (Commenced 13.5.63). Rodent Operative and General Assistant: W. T. Blanchard. Public Analysts: J. Hubert Hamence, M.Sc., Ph.D.. F.R.I.C. P. S. Hall, B.Sc., F.R.I.C. (1) Public Health Inspectors' Certificate of the Royal Society of Health and Public Health Inspectors' Joint Board. (2) Certificate of the Royal Society of Health as Inspector of Meat and Other Foods. (3) Certificate of the Royal Society of Health as Smoke Inspector. 5 Telephone: Public Health Department, Hornchurch 52555. Council Offices, Billet Lane, HORNCHURCH, Essex. 27th May, 1964 To the Chairman and Members of the Hornchurch Urban District Council. Mr. Chairman, Ladies and Gentlemen, I beg to present my report on the health of the district for the year 1963. This report is drawn up in accordance with the provisions of Ministry of Health Circular 1 /64. Population. The figure has risen from 132,400 (mid-year 1962) to 133,380 (mid-year 1963) continuing the steady upward trend of recent years. The 1961 Census figure was 131,014. Vital Statistics. There was a slight increase in the actual number of births, namely 96, giving a five birth rate per 1,000 population of 16.93. This is lower than last year's figure of 17.15 and is accounted for by the fact that the Area Comparability Factor reduced from 0.93 to 0.89. The national figure is 18.2. The percentage of illegitimate five births rose from 2.7 to 3.5, the national figure being 6.9. The actual number of illegitimate births was 90 as against 68 last year. There were no illegitimate infant deaths. The number of stillbirths was 41 (40 legitimate, 1 illegitimate) as against 30 last year, giving an increased rate per 1,000 total five and stillbirths of 15.88 (12.13 last year). The provisional national figure is 17.3. The number of infant deaths dropped from 49 to 35, giving a reduced infant mortality rate of 13.78 (20.05 last year), the national figure being 20.9 There were two maternal deaths this year as against one last year, increasing the maternal mortality rate per 1,000 total live and stillbirths from 0.40 to 0.77. The number of deaths for the year increased by 32 which, coupled with an increase in the Area Comparability Factor from 1.22 to 1.25, shows an increased death rate per 1,000 population of 11.72 as against 11.22 previously. The national figure is 12.2. Infectious Diseases. There was no unusual incidence of any specific infectious or other notifiable disease during the year. 6 Clean Air. A Ministry of Housing and Local Government Circular 69/63 was received towards the end of the year and has potentially important implications concerning grants. It would be idle to discuss this matter in detail since the proposals outlined will depend upon legislation not yet passed but Smoke Control may well in the future be a much more costly, albeit a none-the-less necessary, part of public health activity. London Borough 15. Discussion on a number of items concerning, for example, transfer of premises and the like took place as a result of the formation of an ad hoc Committee representing Hornchurch and Romford. Housing. The number of houses provided during the year by private builders showed a considerable increase but only 13 units of accommodation were completed during the year by the Council. The year has, nevertheless, been one of great activity, the Council having under construction over 400 units of accommodation which includes the multi-storey flat development at South Hornchurch, the old people's dwellings at Cranham and the redevelopment of the prefabricated bungalow site at Fyfield Road, South Hornchurch. In addition, modernisation of certain of the Council's existing properties has continued on an extensive scale. Acknowledgments. My best thanks are due to my fellow Council officials in other Departments, and especially to Dr. O'Dwyer, Mr. Randall and Mr. Blay in my own Department. I am, Your obedient servant, James Gorman, M B., Ch.B., D.P.H., F.R.S.H. Medical Officer of Health. 7 SECTION A STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area in acres (including half of tidal basin) 20,308 Registrar-General's estimate of Home Population (midyear 1963) 133,380 Number of inhabited houses according to rate books (December 1963) 41,201 Rateable Value (December 1963) £6,095,760 Sum represented by a Penny Rate (December 1963) £25,020 Extracts from Vital Statistics for the Year. Live Births: Number 2,539 (1,312 males. 1,227 females) Rate per 1,000 population 16.93 Illegitimate Live Births (per cent of total live births) 3.5 Stillbirths: Number 41 (23 males, 18 females) Rate per 1,000 total live and stillbirths 15.88 Total Live and Stillbirths 2,580 Infant Deaths (deaths under 1 year) 35 (21 males, 14 females) Infant Mortality Rates: Total infant deaths per 1,000 total live births 13.78 Legitimate infant deaths per 1,000 legitimate live births 14.29 Illegitimate infant deaths per 1,000 illegitimate live births Nil Neo-natal Mortality Rate (deaths under 4 weeks per 1,000 total live births) 11.02 Early Neo-natal Mortality Rate (deaths under 1 week per total live births) 7.87 Perinatal Mortality Rate (stillbirths and deaths under 1 week combined per 1,000 total live and stillbirths 23.64 Maternal Mortality (including abortion): Number of deaths 2 Rate per 1,000 total live and stillbirths 0.77 Deaths: Number 1,252 (656 males, 596 females) Rate per 1,000 population 11.72 8 DEATH RATE—COMPARISON WITH PREVIOUS YEARS. 1948 8.2 1956 10.5 1949 10.6* 1957 10.4 1950 10.4 1958 10.2 1951 10.3 1959 10.9 1952 10.4 1960 11.0 1953 13.1 1961 10.5 1954 12.1 1962 11.2 1955 11.6 1963 11.7 *Area Comparability Factor returned. The Area Comparability Factor for deaths this year altered from 1.22 to 1.25 and for births from 0.93 to 0.89. BIRTH RATE—COMPARISON WITH PREVIOUS YEARS. 1948 17.2 1956 16.7 1949 16.0 1957 17.1 1950 13.6* 1958 18.5 1951 14.1 1959 18.1 1952 13.8 1960 18.3 1953 14.8 1961 17.0 1954 14.7 1962 17.1 1955 15.4 1963 16.9 *Area Comparability Factor returned. The Area Comparability Factor might very generally be translated as one which being applied to certain local figures makes them suitable for general comparisons. 9 GENERAL MORTALITY—MAIN CAUSES 1953-1963 Causes of Death 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 Tuberculosis (all forms) 21 11 4 5 3 9 5 10 4 7 7 Cancer 211 234 210 253 248 236 247 235 206 223 239 Infectious diseases 3 1 2 0 2 0 2 0 1 1 0 Cardio-vascular disease 602 590 591 682 679 592 560 548 565 637 631 Influenza 14 1 2 7 8 6 12 0 5 10 7 Pneumonia 52 41 49 53 65 58 57 39 56 73 82 Bronchitis 85 54 65 95 79 76 61 65 76 88 113 Other respiratory diseases 10 8 10 7 9 13 14 8 10 3 10 Gastro intestinal diseases 28 13 10 14 10 15 13 13 13 8 13 Motor vehicle accidents 11 10 12 8 10 15 9 19 22 10 11 All other accidents 10 18 18 20 18 15 8 18 13 16 7 Suicide 7 11 11 9 14 8 12 9 10 3 13 There was a slight decrease in cardio-vascular disease from 637 to 631 although this remained by far the largest cause of death. Cancer deaths rose from 223 to 239. Tuberculosis deaths remained at 7. The largest increase was in Bronchitis which jumped from 88 to 113, in fact the "respiratory block" of Pneumonia, Bronchitis and Other respiratory diseases showed an overall increase of 41. The rather severe winter could have been responsible for this increase. In the Registrar-General's abridged list of causes of death (given overleaf) the age break-down has been extended to:- All ages; under 4 weeks; 4 weeks and under 1 year; 1-4; 5-14; 15-24; 25-34; 35-44; 45-54; 55-64; 65-74; 75 and over. 10 REGISTRAR-GENERAL'S ABRIDGED LIST OF CAUSES OF DEATH IN CERTAIN AGE GROUPS (Corrected for Inward and Outward Transfers) CAUSES OF DEATH ALL AGES AGE GROUPS Under 4 weeks 4 weeks and under 1 year 1—4 5—14 15—24 25—34 35—44 45—54 55—64 65—74 75 and upwards Total Male Female M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. 1. Tuberculosis, Respiratory 7 6 1 - - - - - - - - - - 1 - - - - - 2 - 2 - 1 1 2. Tuberculosis, Other - - - - - - - - - - - - - - - - - - - - - - - - - 3. Syphilitic disease - — — - - - - - - - - - - - - - - - - - - - - - - 4. Diphtheria - - - - - - - - - - - - - - - - - - - - - - - - - 5. Whooping cough - - - - - - - - - - - - - - - - - - - - - - - - - 6. Meningococcal infections — — — - - - - - - - - - - - - - - - - - - - - - - 7. Acute poliomyelitis - - - - - - - - - - - - - - - - - - - - - - - - - 8. Measles - - - - - - - - - - - - - - - - - - - - - - - - - 9. Other infective and parasitic diseases 2 2 - - - - - - - - - - - - - - - - - 2 - - - - 10. Malignant neoplasm, stomach 34 17 17 - - - - - - - - - - - - - 1 2 2 2 1 7 4 6 9 11. Malignant neoplasm, lung, bronchus 61 50 11 - - - - - - - - - - - - -- 1 10 - 15 5 19 3 6 2 12. Malignan: neoplasm, breast 28 - 28 - - - - - - - - - - - - - 1 - 1 - 9 - 9 - 8 13. Malignant neoplasm, uterus 8 - 8 - - - - - - - - - - - - - - - 1 - 1 - 3 - 3 14. Other malignant and lymphatic neoplasms 108 62 46 - - 1 - - - 1 - - 1 3 — 2 2 7 8 13 12 15 10 20 13 15. Leukaemia,Aleukaemia 3 - 3 - - - - - 1 - 1 - - - 1 - - - - - - - - - - 16. Diabetes 8 5 3 - - - - - - - - - - 1 - - - - - - - 3 1 1 2 17. Vascular Lesions of nervous system 181 85 96 - - - - - - - - - - - - 1 - - 5 13 10 19 24 52 57 18. Coronary Disease, angina 230 161 69 - - - - - - - - - - 3 - 4 - 21 3 46 13 43 23 44 30 19. Hypertension with heart disease 35 13 22 - - - - - - - - - - - - - - - - 1 - 4 5 8 17 20. Other heart disease 139 44 95 - - - - - - - - - - - - 2 1 - 2 4 8 7 9 31 75 21.Other Circulatory diseases 46 24 22 - - - - - - - - - - - - - - 1 1 3 3 10 5 10 13 22. Influenza 7 - 7 - - - - - - - - - 1 - - - - - - - -- - -- - 6 23. Pneumonia 82 35 47 1 - - 1 - 1 - - - - - - - - 2 1 2 2 7 5 23 37 24. Bronchitis 113 71 42 1 - 1 1 1 1 — — — — — — — — 2 1 12 5 24 6 30 28 25. Other diseases of respiratory system 10 8 2 - - — — - — - — — — — — 1 - - - 1 - 3 - 3 2 26. Ulcer of stomachand duodenum 9 5 4 - - - - - - - - - - - - - - 1 - 1 - 3 2 - 2 27. Gastritis, enteritis and diarrhoea 4 2 2 - - - - - - - - - - 1 - - - - - 1 - - - - 2 28. Nephritis and nephrosis 6 4 2 — — — — — — — — — — - — — — 2 — - — 1 1 1 1 29. Hyperplasia of prostate 5 5 — — — — — — — — — — — — — — — — — — — 3 — 2 — 30. Pregnancy, childbirth, abortion 2 — 2 - - - - - 1 - - - 1 - - - 1 - - - - - - - - 31. Congenital malformations 16 11 5 5 4 1 1 1 - 2 - 1 - - - - - - - - - 1 - - - 32. Other defined and ill-defined diseases 77 33 44 11 6 - 1 1 - - 1 1 1 - 1 1 3 1 2 4 6 6 8 8 15 33. Motor Vehicle accidents 11 6 5 - - - - - - 1 - - 1 1 - 1 - - 1 2 2 - - 1 1 34. All other accidents 7 3 4 - - - - - - - - 1 - - - - - 1 - - - 1 4 - - 35. Suicide 13 6 7 - - - - - - - - 2 1 1 1 - - - 2 2 2 1 1 - - 36. Homicide and operations of war - - - - - - - - - - - - - - - - - - - - - - - - - TOTAL 1,252 656 596 18 10 3 4 3 3 4 2 5 6 11 3 12 10 50 30 124 81 179 123 247 324 11 SECTION B GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. Staffing. Mr. E. Oliver, Deputy Chief Public Health Inspector, resigned on the 10th February 1963 and the vacancy was filled by the promotion of Mr. S. Whitfield. The vacancy thus created in the establishment of Public Health Inspectors was filled by the appointment of Mr. R. K. Raymond. Mr. B. Cuthbert resigned on the 10th November 1963 and this vacancy was filled by the appointment of Mr. L. G. Bowyer. Miss G. C. Taylor, shorthand-typist, commenced duties in a temporary capacity on the 13th May 1963 due to the prolonged illness of Miss W. A. Hepburn. Medical Examinations—Staff. Staff arrangements remain as last year During the year arrangements were made for the examination of 206 (280) employees or prospective employees—102 (85) permanent and 104 (195) temporary. The 1962 figures are given in brackets. Hospital Plan. A Sub-Committee was formed to consider the Hospital Plan as it affected Harold Wood and St. George's Hospital. St. George's Hospital is of considerable interest since it provides for a number of the geriatric cases from Hornchurch—as well as elsewhere—which demand Hospital care. Its future is obviously going to show an extension of these activities. Harold Wood Hospital which is of course one of the major Hospitals of the area, is planned to extend most comprehensively commencing in the near future. The views of the Secretary to the Romford Hospital Group (which controls St. George's) were made available to the Committee at a meeting which he kindly attended. A very close co-operation is maintained with the Brentwood Hospital Management Committee through their Secretary. That Committee —of which I am a Member—has through the Secretary, Mr. Daniels, been at pains to keep this Council fully informed of its proposals. Public Relations. Talks on subjects of Public Health importance were given to various local Organisations in the area by members of my staff. Clean Air in view of its progress in this district possibly took pride of place as a subject for discussion. 12 Smoking and health in view of its importance and topicality also provided a subject of more than passing interest. A mobile unit sponsored by the Central Council for Health Education attended this district from the 25th to the 29th March. It was staffed by two qualified lecturers and in co-operation with Dr. Pearce, the Divisional School Medical Officer, attended a representative number of Hornchurch schools. The programme of this unit was also greatly facilitated by arrangements made through Mr. Glyn Richards, the Public Relations Officer. Although it is difficult to evaluate the success attending a venture of this kind, I think that good grounds exist for believing it to have been successful. 1 consider also that the lecturers appointed by the Central Council for Health Education were exceedingly competent in the carrying out of what was after all quite a difficult and somewhat unusual task. My thanks are once again due to Mr. Glyn Richards for his assistance in giving the fullest publicity to items of a Public Health nature British Council for the Rehabilitation of the Disabled. I attended a three day course in Cardiff under the auspices of this Council, and found the course exceedingly rewarding. Laboratory Facilities. The arrangements remain the same as last year. Dr. E. A. Atkinson, Oldchurch Hospital, Romford, kindly deal; with a variety of other bacteriological and occasionally pathological material, whilst the laboratories at both Rush Green and Harold Wood Hospitals respond willingly to any calls made upon them. Ambulance Service. The arrangements remain the same as last year. Maternity and Child Welfare. The Essex County Council maintained clinics at the following centres throughout the year:- (i) Abbs Cross Lane, Hornchurch. (ii) Athelstan Road, Harold Wood. (iii) Avon Road, Upminster. (iv) Hornchurch Road, Hornchurch. (v) Nelmes Road, Hornchurch. (vi) St. Mary's Lane, Upminster. (vii) South End Road, South Hornchurch. (viii) Suttons Hostel, Suttons Lane, Hornchurch. (ix) Upminster Road, Rainham. (x) Westland Avenue, Hornchurch. Nursing Homes. The two registered Nursing Homes in the district are supervised by the County Council. 13 Midwives and Home Nurses. There are 12 midwives and 4 home nurse/midwives in the district who are appointed by the Essex County Council and are available to act in the capacity of midwife and of maternity nurse under the supervision of a registered medical practitioner. In addition to the home nurse/midwives there are 6 home nurses working in the district. Day Nursery. A Day Nursery is established within the district at Diban Avenue, Elm Park. It provides accommodation for 50 children up to five years of age. Domestic Help Service. A domestic help service is in operation and is administered for the Essex County Health Services by the Area Medical Officer, 34 Cresthill Avenue, Grays. Domestic help can be supplied for a period of two weeks in the case of a home confinement, but as there is a great demand for this service, it is essential to apply as early as possible. Where there is illness approval may be given, upon receipt of a medical certificate, for a Help to attend. Domestic Helps are paid by the County Council, but the person assisted is required to contribute towards the cost according to his, or her, means. An assessment form must, therefore, be completed if it is desired to claim reduction in the charge, otherwise the full standard charge, which is at present 4/- an hour, will be payable. Care of the Aged. One female of 62 was given Hospital care through a Court Order made under Section 47, National Assistance Act, 1948 (as amended). It cannot be too strongly emphasised that it does not give anyone any pleasure to have to apply to the Court for an Order of this kind. The very few occasions on which it has been found necessary to take this course as against the period during which this Act has been in force amply demonstrates how carefully each case is investigated before a decision to take the ultimate step of applying for a Court Order is decided upon. The independence of an individual is never one to be tampered with unless no other practical course is available. It is a matter for the most extreme regret that occasionally—but inevitably— circumstances come to such a pass that no alternative reasonable course of action but an application for institutional care is open to me. Meals on Wheels. I am indebted to Mr. L. F. de Warr. Chairman of the Old People's Welfare Association for the following information:- "The Service has uperated six days per week throughout 1963. in- 14 cluding all Bank Holidays, without a single lost day. The total number of meals delivered was 7,205. The St. George's Hospital kitchen has continued to supply the meals at a cost of 2/3d. each, and the quality of the meal has been consistently at a high level. The recipients have been well pleased with the meal and the price they are asked to pay (1/-). At the 31st December, 1963, there were 32 drivers and 40 assistants in the Service which owes much to them and. particularly, to Mr. L. J. Taylor who devotes a great many hours towards organising the work. As reported last year, the Urban District has been divided into three delivery areas so that each area has two deliveries per week. The daily average of meals delivered during the year was 23. The Organiser states that, working with one van. 28/30 meals could be delivered each day in just over three hours and there does not appear to be a need for a second van if each recipient is to be limited to the present two meals per week. However, if we delivered three meals weekly, a second van would be in use for 50 per cent of the service time — for four meals weekly, 75 per cent of the time. Mr. Taylor is confident that the extra drivers and assistants could be found to operate the second vehicle. I cannot help thinking that the elderly person who has need of this service must be in need of more than two hot meals during a week. Unfortunately, there is no recognised standard throughout the country. Many districts are still without a Meals on Wheels service, but where a service does exist it generally caters for more than two meals a week. In Romford, the W.V.S. delivers to two areas, each with two deliveries a week. However. Walthamstow deliver five meals weekly. Barking, Dagenham and Ilford deliver four weekly, and Chigwell, Chingford. Leyton. Wanstead and West Ham three meals per week. Plans are now being laid for the administration of the future Borough of Havering, and I feel that the old people of the Borough who benefit from the service should receive, at least, three or four meals each week. For this we would depend on the Local Authority giving approval to doubled expenditure, and I am certain that your views on the subject would be welcomed by all concerned. The Hospital is unable to provide the extra meals that an increased service would demand, but we anticipate that the kitchen to be included in the Old People's Centre would be able to cater for the extra deliveries. It is hoped that the Centre will be completed early in 1965. The Association is very appreciative of the assistance given by the Council to date, both financially and physically. When it was found that the expenses were exceeding the grant, the Council promptlv increased the grant. At the same time, the van has always been ready for our use apart from the short period when an alternative vehicle was provided with a driver whilst the regular van was under repair. I know that you share our opinion that the delivery of Meals to certain old people in their homes is of vital importance, and, whilst there exists a spirit of co-operation amongst all concerned, the service will continue to operate with the maximum degree of efficiency." 15 Laundry Service for the Incontinent — Section 84, Public Health Act, 1936. Advantage is taken of the above Section legally to provide this type of service. Increasing use is made of it (a fuller note was made in my 1960 report) and it is invaluable to the relatively few but deserving families who benefit by its operation. Since the service was commenced the number of cases partaking was 77. The number of garments treated during the year was 6,891 and the cost of the service was approximately £428. County Welfare Services. Mr. Walter E. Boyce, County Welfare Officer, has kindly supplied the following statistical information in relation to the County Welfare Services in the Urban District during the year 1963:- (1) Residential Accommodation under Section 21 of the National Assistance Act, 1948. No. of Hornchurch residents in care on night of 31st December, 1963:- (a) In County Council Homes 128 (b) In Out-County & Non-County Establishments 30 During 1963, 137 applications received for Part III accommodation, resulting in 31 admissions. (2) Accommodation for Homeless Families. There were 51 applications for Temporary Accommodation during 1963, resulting in 10 adults and 27 children being admitted. On 31st December, 1963, 6 women and 19 children remained in care. (3) Welfare Services for the Blind and Physically Handicapped. No. of persons registered at 31st December, 1963:- (a) Blind persons 140 (b) Partially sighted 43 (c) Defective sighted 17 Of these, 1 blind person participated in the Home Workers' Scheme, and 10 blind and 10 partially sighted persons had been placed in employment. No. of physically handicapped persons on the register at 31st December. 1963 205 Home Safety. The Home Safety Sub-Committee continued very actively during the year and close liaison was maintained with all the statutory authorities 16 including the Area Health Office—through the Superintendent Health Visitor—the Divisional Education Office, the County Fire Brigade, the North Thames Gas Board and the Eastern Electricity Board. Home Safety featured prominently in the local Carnival, a decorated float being entered in the procession and a most successful exhibition being staged at the Carnival Fete. The latter was very popular and it was apparent that the different hazards depicted struck a homely note. Amongst the several campaigns conducted during the year were "Buying and Selling for Safety" (stressing the need for purchasing duly approved and tested domestic appliances) and a concentrated Firework Campaign which was directed at schoolchildren and shopkeepers. It is difficult to assess the success of any campaign, failure might be indicated by an increase in accident statistics, but a decrease in these statistics may be assumed to be due to a gradual build-up in awareness of the dangers involved. 1963 also saw the extension of Home Safety into youth organisations through the Duke of Edinburgh's Award Scheme. The Sub-Committee was called upon to provide examiners for both the 1st and 2nd levels of the "Safety in the Home" Course and in one instance to organise and arrange the syllabus and Course. It would be appropriate at this stage to thank all the members of the Sub-Committee representing voluntary organisations for their support not only in this connection but in all the activities of the Sub-Committee. Opportunity was taken during the year of building up a permanent home safety display unit which can be displayed in the Public Health Department and transported and shown at outside exhibitions. In addition to the foregoing, 10.000 leaflets and 5,000 Calendars were purchased and distributed; 700 posters displayed, and special advertisements inserted in the programmes of local functions. In all, the dissemination of home safety propaganda continued steadily and comprehensively throughout the year to all parts of the Urban District. 17 SECTION C SANITARY CIRCUMSTANCES OF THE AREA Water Supplies. Main'. 12 samples were taken by my Department during the year from the main supply. 5 were submitted for chemical and bacteriological examination and 7 for bacteriological examination only. In each case a satisfactory report was received. Well: Few now remain in the district. Mr. P. Gordon Spencer, General Manager and Chief Engineer, South Essex Waterworks Company, has kindly supplied the following particulars concerning the main supply for the district:- "The water supply of the whole of your area 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 over 3,967 chemical, bacteriological and biological examinations have been made and all water going into supply was wholesome. In addition, samples were examined for radioactivity. Analyses have also been made of samples obtained from consumers' taps in the various parts of the Company's district, including that of your Council, and all proved to be satisfactory. The water is not plumbo-solvent. No action has been ncessary in respect to any form of contamination. The number of dwelling houses supplied as at the 31st December last was 42,233 and the population as at the 30th June, 1963 as obtained from the Registrar General was 133,380. We are unable to state the number of houses supplied by standpipes, but the total is quite insignificant." Rainfall. The Engineer and Surveyor has kindly informed me of the rainfall figures for the year which relate to "Langtons". The 1962 figures are given in parenthesis. Amount of Rainfall in inches Number of days in which rain fell January 0.16(2.34) 4(17) February 0.17(0.46) 4(7) March 1.99(1.25) 19(9) April 1.72(1.53) 15(14) May 1.87(1.27) 13(16) June 2.52(0.17) 11(3) July 1.31(1.48) 10(10) 18 August 2.29(1.39) 20(8) September 2.22(1.89) 11(12) October 1.64(1.14) 10(8) November 3.29(1.23) 19(15) December 0.42(1.84) 10(7) 19.50(15.99) 146(126) Radioactive Waste. After satisfactory assurances from the Ministry of Housing and Local Government had been obtained, a quantity of contaminated glassware was buried under supervision in a Local Tip. The level of radioactivity was, of course, innocuous under the approved conditions of tipping. Fluoridation of Water Supplies. On the information available to the Council on the 16th April. 1963, the Council declared themselves as in favour of the principle of raising the fluoride content of the local water supply to one part per million. This does not of course mean that the local water is having fluoride added to it or even that it will have fluoride added to it. The recommendation in that regard rests largely at the moment with the Essex County Council as the local Health Authority and ultimately the decision would, of course, have to be taken by the undertaking supplying the water. Clean Air. No. 5 Smoke Control Area commenced on the 1st August, 1963. Details are appended below. No. 6 Smoke Control Area, with the following boundaries, was submitted to the Public Health Committee in September. These two areas form part of our progressive scheme for making the atmosphere free from smoke. No area is approved lightly since at the least this operation is probably going to cause a certain amount of inconvenience to a large number of people. It has. however, been reasonably established that the ultimate benefits of a Clean Air programme are not likely to be neglected. No. 5 Area Privately owned houses 4,107 Houses — Council 179 Shops 238 Factories 65 Offices 35 Churches 4 Old People's Hostels 2 Schools 2 Clinic 1 Theatre 1 19 Day Nursery 1 Public Houses 5 Social Clubs 3 Police Station 1 The area is bounded by:- The District Railway Line from the Beam River to the centre of Upminster Road and thence by Upminster Road and High Street to the Ravensboume River, and extending along the Ravensbourne River to the Beam River and via the Beam River to the District Railway Line, where it crosses the Beam River. This area covers approximately 550 acres. No. 6 Area Number of private houses 6,468 Number of H.U.D.C, houses 402 Shops 258 Factories 56 Workshops 9 Offices 30 Social Centres and Halls 8 Schools 9 Garages 8 Churches 7 Public Libraries 2 Public Houses 7 Clinics 2 Fire Station 1 Council Offices 1 General Post Office 1 Cinema 1 Telephone Exchange 1 Council Depot 1 L.C.C. Children's Home 1 Swimming Pool 1 The area is bounded by:- A line beginning from the junction of the District Railway Line on the western boundary of the Urban District proceeding northwards along that boundary to the junction of Brentwood Road, proceeding eastwards along the centre of Brentwood Road to the junction of the Romford to Upminster railway line, proceeding south east along the said railway line to a junction where it crosses the River Ingrebourne, south along the River Ingrebourne to the junction with the District 20 Railway Line, then south west along the line to where it crosses Upminster Road, proceeding north west along the centre of Upminster Road, High Street and Hornchurch Road to a junction with the River Ravensbourne, then south west along the River Ravensbourne through Harrow Lodge Park to the centre of Upper Rainham Road, then south west along Upper Rainham Road to the District Railway Line then in a westerly direction to the western boundary. This area covers approximately 1,063 acres. Whilst it is pleasing to think of—and literally to observe—the effect of our local Smoke Control areas, it is somewhat frustrating when residents in control areas look out and observe smoke being emitted — possibly from near and far — under conditions clearly not reflecting control. If, therefore, Clean Air is to become a potent factor in the health of our country it can only be as the result of integrated, planned progress over the widest possible area. Special Processes. Liaison with the Alkali Inspector—Mr. H. Brigg, B.Sc., A.R.I.C., A.R.C.S., — is excellent and of course common problems do from time to time arise. Atmospheric Pollution Investigation. Our present programme comprises smoke filters at:- (1) Public Health Department, Billet Lane. (2) Ayloffs County Primary School, Southend Road. (Removed at end of October and being transferred to the Elm Park Assembly Hall). (3) Whybridge County Primary School, Blacksmith's Lane. (4) Bush Elms Secondary School. Hyland Way, and volumetric S02 apparatus at:- (1) Public Health Department. (2) Whybridge County Primary School. (3) Bush Elms Secondary School. Clean Air Act, 1956, Section 3. 12 notices of installations or applications for prior approval were submitted to the Council during the year. A total of 47 have now been registered. Clean Air Act, 1956, Section 12. Some 463 notices (38 in No. 4 area and 425 in No. 5) were served during the year. These were necessary by the very great accumulation of claims for grant relating to Nos. 4 and 5 Smoke Control Areas and revived in such volume and in such close proximity to the operative date as to render — under all the circumstances - the securing of complete action before the operative date, impossible. The Ministry of Housing and Local Government gave their consent under Section 222 (1) of the Local Government Act. 1933, to adaptations at a house in No. 4 area after the operative date. 21 General Information Meetings of the National Society for Clean Air and its South East Division, the Conference of Co-operating Bodies for the Investigation of Atmospheric Pollution and the London and Home Counties Clean Air Advisory Council are attended as a routine. Sewerage and Sewage Disposal. Bretons Works. Owing to the conditions under which these works have through the demands upon them been forced to operate, many inhabitants—largely in the immediate area of the sewage works—are caused to live in conditions which from time to time cause the most serious possible inconvenience to them. It is easy to believe that visitors to the houses involved are practically precluded at the worst periods of the smell from the Works, and likewise an open window in a house is likely to be regarded with apprehension rather than pleasure. My views on this intolerable situation have been made known previously and I cannot think that there is any further action 1 can take or advice which I can proffer which is likely to secure a solution to the problem either more lasting or more speedily than steps which are already being taken. This may well—and understandably—be cold comfort to the inhabitants affected, but it remains an unfortunate fact. Nags Head Lane Works. The effluent from the Brentwood Council Works at Nags Head Lane comes almost immediately into this district through the medium of the River Ingrebourne. It is said that works currently being carried out at the Brentwood Works will ensure a satisfactory effluent. I must still emphasise that I think a clear distinction falls to be drawn between what is a satisfactory effluent and what is a clean water. Having said that T trust, therefore, that the improvement in the Nags Head Works effluent speedily becomes a reality. I am indebted to the Engineer and Surveyor for the following information:- Soil Sewers. Parsonage Road Pumping Station has been completed and the emptying of cesspools is being discontinued in Parsonage Road, Allen Road. Glebe Road and Farm Road. Queens Park Road (Harold Wood) relief soil sewer improvement in conjunction with the surface water sewer improvement is under construction. Central Area — new soil sewer in conjunction with the surface water sewer improvement and Hacton Lane/Little Gaynes Lane soil sewer improvement will commence shortly. Regional Sewerage Scheme. Tenders are being obtained for the various works at Riverside Sewage Disposal Works and the scheme for the trunk sewers has been submitted to the Ministry of Housing and Local Government for approval. 22 Surface Water Sewers. The following works have been completed:- St. Mary's Lane (Upminster and Cranham) approx. 2-½ miles in length. Lower Mardyke Farm outfall (21 in. dia./18in. dia.) approx. 380 yards. Bridge Avenue relief (15in. dia./12in. dia./9in. dia.) approx. 170 yards. The following works are under construct ion:- Harold Wood (Queens Park Road) (including soil sewer). Improvement of the Ravensbourne Stream (Stage 1). Parkstone Avenue/Ernest Road improvement. Ditchworks at Strathmore Gardens/Gordon Avenue. Works will commence shortly on:- Hornchurch Road (Roneo) relief (Stage 1). Central Area Stage 1 (and soil sewer). Meadowside — ditch improvement. Manor Crescent new outfall. Park Drive/Cranston Park Avenue — relief Nelmes Crescent/Sylvan Avenue — relief. Athelstan Road/Squirrels Heath Road improvement. Works proposed for 1964/65:Central Area sewers — further stages. Wingletye Lane relief (Rayburn Road). Claremont Gardens — relief. Derby Avenue — new outfall. Woodlands Avenue — culvert and sewer improvement. Ash Lane — new sewer in lieu of ditch. Streets Made Up and Taken Over. The Engineer and Surveyor has supplied the following list of streets made up and taken over during the year ended 31st December, 1963:- yards Private Streets: Briscoe Road 832 Farm Road (part) 49 Lake Avenue 760 Parsonage Road (part) 71 St. Albans Avenue 287 Suttons Avenue (part) 134 Limerick Gardens 158 MacLennan Avenue 206 Hood Road 416 Fairholme Gardens 262 Total Length 3,175 23 yards Estate Roads: Arlington Gardens 342 Langham Court 57 Poynings Way 86 Sackville Crescent (part) 431 St. John's Close 66 Saxon Close 102 Cumberland Avenue (part) 123 Ken way 190 Kenway Close 65 Ken way Walk (part) 27 Total Length 1,489 Swimming Pools. 13 samples were taken and have been uniformly satisfactory. Paddling Pools. 14 samples were taken from the Council's 5 paddling pools during the months of June, July and August. The samples were in general satisfactory. Disinfection and Disinfestation. No change in our arrangements has taken place during the year. Rodent Control. During the year the Rodent Operative paid some 314 visits to deal with infestations. 1,188 routine or revisits were also made. The premises visited comprised 229 dwellings and 85 business premises or factories. Attendance at meetings of No. 3 Essex Workable Area Committee is normally made by the Chief Public Health Inspector so that a wider picture of County progress and procedure is available. Establishments for Massage or Special Treatment. The Essex County Council granted licences to 11 persons during the year authorising them to carry on establishments for massage or special treatment. 16 visits were made to these premises. Public Health Inspection of the District. SUMMARY OF PUBLIC HEALTH INSPECTORS' WORK DURING 1963. Inspection of Food and Premises (visits paid): Bakehouses 54 Butchers' shops 116 Cafes 88 Confectioners 107 24 Dairies 5 Fish shops 31 Food complaints 77 Greengrocers' shops 180 Grocers' shops 348 Ice cream vendors' and manufacturers' premises 67 Mobile shops (hawkers) 13 Public houses 23 Sampling 476 School canteens 64 Slaughterhouses 1,587 Staff Canteens 15 Miscellaneous Visits 56 Housing (visits paid): Overcrowding, etc. enquiries 308 Improvement grants 310 Sanitation 59 Structural defects 316 Water supply and pipes 109 Miscellaneous housing visits 135 Re-inspections 936 General Sanitary Circumstances (visits paid): Atmospheric Pollution 586 Camping and fairgrounds, vans, etc. 42 Conveniences 6 Drainage and sewerage 677 Dustbins 46 Farms 2 Stables, piggeries, animals, birds, etc. 35 Nuisances 335 Paddling pool samples 14 Refuse tips 80 Pest Control 141 Swimming Pool samples 13 Water samples (main supply) 18 River sample 1 Rivers, streams, ponds, etc. 32 Miscellaneous visits 179 Re-inspections 696 Factories and Outworkers: Number of visits paid 219 Shops Act: Number of inspections 457 Smoke Control Areas: Number of visits paid 7,894 25 Miscellaneous (visits paid): Animal Boarding Establishments Act 9 Diseases of Animals (Waste Food) Order 19 Heating Appliances (Fireguards) Act 15 Pet Animals Act 16 Rag Flock and Other Filling Materials Act 2 Riding Establishments Act 1 Massage Establishments 6 Infectious Disease: Number of visits paid (including contacts) 482 Number of notices served: Informal 639 Statutory 129 The main headings under which work was done may be noted as follows: Smoke Control Areas 7,894 Inspection of Food and Premises 3,307 General Sanitation 2,902 Housing 2,173 Infectious Diseases 482 Shops Act Inspections 457 Factories and Outworkers 219 Public Health Inspectors' Work. The number of visits paid was reasonably comparable with those of the previous year. The Smoke Control Area visits showed a substantial diminution largely due to the timing of the Area planned. The housing visits on the other hand showed a considerable increase. Shops Act, 1950. The number of shops on the register at the end of the year was 1,217. 92 notices were served during the year regarding contraventions of the Act. Heating Appliances (Fireguards) Act, 1952 and Regulations, 1953. During the year 15 visits were paid in this connection. 36 appliances were tested (involving 49 tests) and all were found to be satisfactory. Old Metal Dealers (Hornchurch) Order, 1956. At the end of the year 15 persons had registered as Dealers in Old Metal. Noise Abatement Act, 1960. One notice was served during the year in this connection, Pet Animals Act, 1951. 16 visits were paid to the 9 Pet Shops in the District. 2 notices were served during the year relevant to the display of the 26 name and address of person having key of shop, provision of thermometers, provision of dustbins, removal of refuse and cleansing and tidying of yard. Rag Flock and Other Filling Materials Act, 1951. One address in the district is registered pursuant to the provisions of Section 2 of this Act. 2 samples were taken during the year and satisfactory reports were received. Riding Establishments Act, 1939. Mr. R. L. Wylie, M.R.C.V.S., and Mr. R. H. M. Coulton. M.R.C.V.S., are the officially appointed Veterinary Surgeons for the purposes of the Act. Quarterly reports are given on the three riding establishments in the district. Diseases of Animals (Waste Food) Order, 1957. All the licences, including those formerly issued by the Ministry of Agriculture, Fisheries and Food, are now issued by this Council. Routine supervision is maintained over the processes and premises involved. A total of 18 licences were in force at the end of the year. Agriculture (Safety, Health and Welfare Provisions) Act, 1956. Two visits were made to farms in connection with the provision, maintenance and cleanliness of sanitary conveniences. No formal action was taken. 27 SECTION D HOUSING Number of New Houses erected during the year: (i) By the Local Authority 13 (100) (ii) By other Local Authorities Nil (Nil) (iii) By other bodies or persons 487 (391) The previous year's figures are given in brackets. Number of Closing Orders made 3 1 & 3, Mashiters Cottages, New Road. The Post Office, North Ockendon (part). Number of Houses voluntarily demolished 8 20 & 22, High Street. 42, High Street (Old Police Station). 58, 60 & 62, High Street. 27 & 29, North Street. Number of Demolition Orders made 6 1, 2, 3, 4, 5, & 6, Woodfine Cottages, Hacton Lane. Number of Houses demolished follow representations 25 136, 138, 140 & 142, Ardleieh Green Road. 378, 380, 382, 384, 386. 388, 390 & 392, Brentwood Road. 46, 48, 50, 52, 54 & 56, High Street. 5, 6, 7, 8, 9, 10 & 11, The Avenue. Undertaking accepted to carry out work 1 2, Mashiters Cottages. Unfit Houses. It will be seen that an increased number of houses were closed or demolished either through voluntary or formal action. Certain houses will always from time to time descend to a stage at which formal action is necessary and it can never be said with complete truth that a district is without sub-standard houses. In Hornchurch, however, houses of this order comprise a relatively very small number. Rent Act, 1957—Certificates of Disrepair. The following is the Return under the Rent Act, 1957. made to the Ministry of Housing and Local Government covering the period 1st .January to 31st December. 1963:- Part 1—Applications for Certificates of Disrepair: (1) Number of applications for certificates 12(15) (2) Number of decisions not to issue certificates 0 (0) (3) Number of decisions to issue certificates: (a) in respect of some but not all defects 8 (6) (b) in respect of all defects 4 (9) (4) Number of undertakings given by landlords under paragraph 5 of the First Schedule 6 (8) (5) Number of undertakings refused 0 (0) (6) Number of certificates issued 6 (5) 28 Part II—Applications for Cancellation of Certificates: (7) Applications by landlords for cancellation of certificates 4 (3) (8) Objections by tenants to cancellation of certificates 0 (1) (9) Decision to cancel in spite of tenants objections 0 (0) (10) Certificates cancelled by Local Authority 4 (2) The previous year's figures are given in brackets. Improvement Grants. My advice has been submitted to the Council in 102 instances during the year. Re-Housing—Medical Aspects. My advice has been sought during the year on some 161 applications respecting which medical recommendations for priority had been submitted by hospitals or private practitioners. Caravans. This problem has not yet been solved so far as concerns the Lake Avenue site. The number of other occasions on which we are troubled is, however, relatively small and has up to now been amenable to a reasonable degree of control. Where caravans have dwelt in our district they have—always excepting the Lake Avenue site—done so only on a temporary and probably short basis. Land Charges Enquiries. During the year 4,247 land charges enquiries were referred to the Department regarding the question of outstanding sanitary notices and or certificates or disrepair. Information is also given as to whether or not a particular property is in a smoke control area. This is one of the routine unpublicised but time-consuming occupations of the Department. Common Lodging Houses. There are no registered common lodging houses in the district. 29 SECTION E. INSPECTION AND SUPERVISION OF FOOD AND FOOD PREMISES Food and Drugs Administration. In the following statistics the figures for the previous year are given in brackets. 314 (309) samples were taken during the year of which 304 (304) were found to be genuine (List A) and 10 (5) to be sub-standard (List B). 8 (13) food complaints were referred to the Public Analysts (List C) and 19 (27) food complaints were dealt with informally (List D). The accompanying lists (A and B) indicate the wide variety of food and drugs actually sampled. I would express my indebtedness to the Public Analysts, Dr. J. Hubert Hamence, M.Sc., Ph.D., F.R.I.C., and Mr. Philip Sidney Hall, B.Sc., F.R.I.C., for their helpful and ready advice in the many difficulties which necessarily crop up in this highly specialised branch of our work. 30 LIST A SAMPLES SUBMITTED TO PUBLIC ANALYSTS AND FOUND TO BE GENUINE Article No. Article No. Ale, Pale 1 Creamed rice milk pudding 1 Almonds, ground 1 Crisps 1 Apple Sauce 1 Curry powder 1 Barbecue spice 1 Currv in a hurry 1 Beef with butter (potted) 1 Dairy cream bun 1 Beef with dumplings 1 Flour (self-raising) 1 Bemax 1 Frizets 1 Blackcurrant Vitamin C Fruit curry sauce 1 drink 2 Fruit (mixed dried) 1 Blancmange powder 1 Fruit pie 1 Bloater spread 1 Fruit salad 1 Butter 3 Ginger 1 Butter (brandy flavour) 1 Glace cherries 1 Butter crisps 2 Golden Orange drink 1 Butter shortcake 1 Grapefruit 1 Buttered ginger 1 Herbs (mixed dried sweet) 1 Button mushrooms 1 Homebread mix 1 Cakelet 1 Honey 1 Cake mix 1 Hot dog 1 Cannelloni 1 Ice cream 41 Cheese spread 3 Ice lollies 18 Cheese spread with crab 1 Jam 4 Cherry pie filling 1 Jelly 2 Chicken curry with rice 1 Lancashire rarebit 2 Chippies 1 Lemonade shandy 1 Chopped pork and ham 1 Lemon cheese 1 Clotted cream 1 Lemon crowns mix 1 Cloves 1 Lemon squash 1 Cider and vinegar 1 Lolly mix 1 Coconut desiccated 1 Macaroni 1 Coffee and chicory 1 Margarine 2 Coffee cup 1 Marzipan (almond) 1 Coffee—instant 1 Marzipan (golden) 1 Condensed milk 1 Milk 26 Condiment, non brewed 1 Milk (Channel Islands) 8 Cooking fat 1 Milk (evaporated) 1 Cooking oil 1 Minced beef pie 1 Corn oil 1 Mincemeat 1 Corned beef 1 Mincemeat pie 1 Corned beef hash 1 Mix-a-shake 1 Cornflake crumbs 1 Mixed spice (ground) 1 Cornflour 1 Mushrooms in brine 1 Crab spread with butter 2 Mushroom ketchup 1 Cranberry sauce 1 Mutton curry 1 Cream 2 Oil (cooking) 1 31 Article No. Article No. Parsley sauce 1 Yorkshire pudding mixture 1 Paprika 1 Yorkshire relish 1 Pate-de-foie 1 Cherry brandy 1 Pepper (ground white) 1 Brandy 1 Peardrax 1 Gin 1 Potato instant mashed 1 Rum 1 Pineapple 1 Sherry 1 Potted salmon with butter 1 Whisky 1 Raisin bran flakes 1 Ammoniate tincture quinine B.P.C. 1 Raspberries 1 Ready Brek 1 Black cherry linctus (child’s) 1 Rice (ground) 1 Rice pudding 1 Bisurated magnesia 1 Rice (Baby) 1 Bronchial mixture 1 Sage and onion stuffing 1 Cough balsam 1 Salad cream 1 Cough drops 1 Salmon 3 Cough syrup 3 Sardines 2 Camphorated oil 1 Sausages—beef 7 D.D.D. balm 1 Sausages—pork 10 Dequadin tablets l Savoury tangs 1 Fumox 1 Smoked rainbow trout 1 Tron tonic tablets 2 Snow cake mixture 1 Kompo l Sponge mix (sweetened) 1 Glycerin, honey and oil of lemon l Soup 2 Soy sauce 1 Meggezones 1 Steak and kidney pie 3 Meloids 1 Strawberries 1 Mentholated balsam l Suet 1 Menthol and wintergreen cream with mustard 1 Sweets 5 Tea 3 Nerve and restorative tonic 1 Tomatoes 3 Oil of wintergreen l Tomato ketchup 1 Panaleve tablets l Tomato puree 1 Paxedin tablets l Turkey supreme 1 Pernivit tablets (for chilblains 1 Veal curry 1 Vegetable juice 1 Senna laxative pastilles l Vegetables mixed 1 Smokers cough pastilles 1 Vegetable oil 1 Speedy cough mixture 1 Velveeta 1 Stomach powder l Vinegar malt 2 Tonic syrup for nerves 1 Vita wheat 1 Sulphur tablets 1 304 32 LIST B SAMPLES SUBMITTED TO PUBLIC ANALYSTS AND FOUND TO BE ADULTERATED OR UNDER STANDARD, etc. Sample No. ARTICLE (General description) Nature of Adulteration or Irregularity Action taken Inf.2772 Cake Mix. The fatty constituent contained butylated hydroxy toluene 50 parts per million. Matter taken up with Importer's Agent. Labelling amended Stated on label as "freshness preserver" instead of its specific name. Inf.2833 Pie Crust Mix. The fatty constituent contained butylated hydroxy toluene 45 parts per million. Matter taken up with Importer's Agent. Labelling amended. Stated on label as "freshness preserver" instead of its specific name. Inf.2834 Frosting mix (white). The fatty constituent contained butylated hydroxy toluene 33 parts per million. Matter taken up with Importer's Agent. Labelling amended. Stated on label as "freshness preserver" instead of its specific name. Inf.2841 Veal Sorrento. Meat content low. No further action in view of absence of legal standard for this type of article. Inf.2850 Baby Cream. Lanolin stated correctly as 3 per cent on the tube but incorrectly as 0.3 per cent on the carton. No further action obviously due to printing error. Manufacturer to amend label. Inf.2906 Lotion for external Use. No statement of ingredients given as required by the Pharmacy and Medicines Act. Referred matter to the Pharmaceutical Society of Great Britain. Labelling amended. Inf.2929 Pork chipolata sausages. Meat content a little on the low side. (62 per cent.) Formal follow-up sample taken—satisfactory. 33 Inf.2945 Stewed Steak in gravy. Meat content low. (66 per cent.) Letter to the Ministry of Agriculture, Fisheries and Food regarding the necessity for a standard for this type of product. Inf.2954 Cheese sauce. Ingredients given in wrong order on the label. Importers informed. New product with amended label to be issued early in 1964. F.1493 Beef Sausages. Meat content low (47 per cent.) Further sample taken. (January, 1964). LIST C FOOD COMPLAINTS REFERRED TO PUBLIC ANALYSTS. Sample No. ARTICLE (General description) Nature of Adulteration or Irregularity Action Taken Cpt.2864 Milk bottle. Contained traces of atmospheric dust and mould growth. Warning letter to Dairy. Cpt.2919 Milk bottle. Contained a house fly. Warning letter to Dairy. Cpt.2941 Dried haricot beans. Contaminated with a phenolic disinfectant. Matter taken up with Wholesaler. Cpt.2963 Raspberries in Syrup. Contained six ants, also a permitted colouring matter which was not declared. Warning letter to Importers. Cpt.3003 Milk bottle Contained minute particles of rusty iron filings. Warning letter to Dairy. Cpt.3019 Corned Beef. Contained small clots of dried blood. Informed Importers. Cpt.2896 Aspirin. Thought to have caused sickness. Found to be genuine. No action required. Cpt.2811 Grapefruit (tinned). Number of small white spots in the syrup and attached to grapefruit. Due to "naringin" a natural constituent of grapefruit. No action required. 34 LIST D FOOD COMPLAINTS WHERE ANALYSIS WAS NOT REQUIRED Complaint Action Taken Swiss roll and a fig roll each alleged to have contained a sewing machine needle. Careful enquiries made but it was impossible to determine how or where the needles gained access. Breakfast cereal alleged to have contained a piece of metal. Manufacturer informed but no further action taken as evidence was inconclusive. Steak and Kidney pie containing foreign matter. Foreign matter consisted of a piece of meat with hair attached. Manufacturer prosecuted. Fined £10. Toffee apple containing a fly. Warning letter to Manufacturer. Loaf with hole through crust. No further action, loaf not unfit in any way. Frozen lamb chop alleged to have contained sawdust. Manufacturer informed but it would appear that dust could have been bone dust from use of mechanical saw. No further action. Slice of chopped ham with small piece of mouldy corned beef adhering to it. Vendor informed and shop inspected. No further action — evidence inconclusive. Cakes alleged to be mouldy. Not mouldy but some staleness. Vendor informed and reminded re stock rotation. Loaf alleged to be dirty. Not dirt but badly mixed piece of dough. Bakery informed. Loaf containing foreign matter (brown streaks). Bakery informed. Due to insufficient mixing of the malt extract and caramel mixture which is added to this type of loaf for flavour and colour. No further action required. Chocolate cake affected with mould. Vendor and Manufacturer informed but no further action taken in view of time lag between purchase and receipt of complaint. Malt loaf containing a nail. Warning letter to Bakery. Milk bottle containing paint. Warning letter to Dairy. Tin of processed peas containing a piece of metal. Warning letter to Manufacturers. 35 Corned beef alleged to have caused stomach pains. Sent to Oldchurch Hospital Pathological Laboratory. No pathogenic organism found. No further action. Sausages affected with mould. Vendor prosecuted. Fined £5. Loaf with dent in crust (alleged rodent infestation). No evidence to support complaint. Probably caused when loaf was taken out of baking tin. No further action. Corned beef alleged to be mouldy when opened. Importers informed. Some tins of this consignment had a weakness in the score strip which seals the tins. Arrangements made to withdraw all this particular batch and special attention to be paid to other stocks from the Packers concerned. Bread pudding alleged to have contained a nail. Warning letter to Catering Firm concerned. Food Premises. The number of food pre.nises in the district may be classified as follows (where more than one trade is carried on at any premises then an entry is made in respect of each trade). The varying types remain remarkably constant as the figures (last year in brackets) show:— Bakehouses 14 (22) Butchers 74 (74) Cafes 55 (53) Confectioners (bread, cakes, etc.) 39 (38) Confectioners (sweets, etc.) 125 (125) Fish Shops 26 (26) Grocers 169 (171) Greengrocers 101 (102) Ice Cream Vendors 320 (312) Ice Cream Manufacturers 4 (4) Food Hygiene Regulations, 1955. Some 183 notices were served as against 100 last year. Essex County Council Act, 1952—Section 105. Notification under Section 105 of the Essex County Council Act. 1952, still assists us to give prior advice to intending traders. Unsound Food. During the year the following foods were voluntarily surrendered to the Public Health Inspectors as being unfit for human consumption:- 36 Tons Cwts. Lbs. Ozs. Meat — 11 82 8 Fish — 2 42 0 Poultry — — 14 0 Tinned Meat — 16 53 0 Tinned Fish — — 26 7 Tinned Milk - 2 8 11 Tinned Food 1 6 28 0 Miscellaneous Groceries — 1 31 0 Ice Cream — 1 26 0 Total 3 1 87 10 Carcases Inspected and Condemned. The following tabular statement regarding the post-mortem inspection of animals at the two slaughterhouses is drawn up in accordance with the Appendix to Ministry of Health Circular 17/55 (last year's figures in brackets) Cattle (excluding cows) Cows Calves Sheep and Lambs Pigs Goats Number killed 2,333 1,392 1,264 24,552 12,358 63 Number inspected 2,333 1,392 1,264 24,552 12,358 63 (3,014) (1,837) (3,313) (21,777) (11,392) (83) All diseases except Tuberculosis and Cysticercosis: Whole carcases condemned - 7 6 50 17 3 Carcases of which some part or organ was condemned 472 623 16 3,612 1,889 6 Percentage of number affected 20.2 45.3 1.7 14.9 15.4 14.3 Tuberculosis only: Whole carcases condemned — 1 — — 1 — Carcases of which some part or organ was condemned 5 4 - 1 333 - Percentage of number affected 0.2 0.4 — 0.004 2.7 — Cysticercosis only: Carcases of which some part or organ was condemned 35 7 - - - - Carcases submitted to treat ment by refrigeration 8 - - - - - Generalised and totally condemned - 2 - - - - Lectures on Food Hygiene. An advanced course in Food Hygiene commenced in January at the Ardleigh House Centre for Further Education. Although it was sponsored by the Education Authority the lectures were in fact arranged by my Department. The attendance averaged approximately 25 which under winter conditions—and especially last winter- must be accounted very satisfactory. Attenders at the course were subsequently able to apply for membership by examination as Associate Members of the Royal Institute of Public Health and Hygiene. 37 Food Hygiene. Food Hygiene posters were delivered or posted to all cafes, public houses and factory canteens at the beginning of the Summer. Slaughterhouses Act, 1958. Two slaughterhouse licences were issued during the year. Meat Iaspection Regulatioas, 1963. These included authority to make a charge for the service. The charges were of the order of:Cattle —2/6d. Calves— 9d. Sheep — 6d. Goats — 6d. Pigs — 9d. It is in some ways regrettable that it was not found possible to deal with the thorny problem restricting slaughtering to certain hours. There are, of course, two sides to this question, the Local Authority one being that it is becoming more and more difficult to reconcile so much after normal hours and weekend work, with the reasonable desires of the Public Health Inspectors. Swine Fever. Routine meat inspection established circumstances which enabled the Ministry of Agriculture, Fisheries and Food to ascertain and deal with an outbreak of this condition in the district. This is fortunately a somewhat unusual but nevertheless an illuminating commentary on the value of our routine meat inspection at the source, i.e. in the slaughterhouse. Slaughter of Animals Act, 1958. 25 slaughterman's licences were issued during the year (18 Jewish). Ice Cream. During the year 25 applications for registration as vendors and 7 applications for registration of premises for the storage and sale of ice cream were granted. At the end of the year 4 persons and premises were registered for manufacture and 320 for the storage and/or sale of ice cream. 79 samples were taken during the year. 72 proved satisfactory. In addition 59 samples were taken under the Food and Drugs Act for examination by the Public Analysts. The quality of the ice cream sold locally remains in general of a highly satisfactory order. Preserved Food Manufacturers. Section 90 of the Hornchurch Urban District Council Act, 1936. requires registration of preserved food manufacturers and premises. At the end of the year 76 persons and 97 premises were registered for the manufacture, preparation or storage of preserved meat. Regular supervision is maintained over them. 38 Essex County Council Act, 1952, Section 103. This section which deals with the registration of hawkers of food and their premises came into force on 1st April, 1953, and at the end of the year under review 81 persons and 16 premises had been registered. Milk Distributors. There are 8 milk distributors with 12 registered premises in the district. There are also 13 firms registered as milk distributors in Hornchurch whose premises are registered in other districts. In addition, 61 shopkeepers are registered for the sale of bottled milk only. Milk (Special Designation) Regulations, 1960. The number of dealers' (pre-packed milk) licences in force at the end of the year was as follows:- Pasteurised 81 Sterilised 85 Tuberculin Tested 66 Milk Sampling. The 70 samples of milk taken from dairies, shops and in the street;during the course of delivery to customers throughout the year were submitted to the Laboratories for testing. In all cases satisfactory reports were received. In addition 34 samples were submitted to the Public Analysts. Three of these samples were also examined for the presence of antibiotics with negative results. Two of the samples were from large dairies (pasteurised bulk supplies) and the remaining one from a producer/retailer in a neighbouring area who retailed raw tuberculin tested milk in the District from an automatic vending machine. This supply is no longer available as this automatic vending machine has been removed. Liaison with other Authorities. Our excellent liaison with the London County Council in respect of the Hornchurch Children's Homes and the Brentwood Group Hospital Management Committee in respect of Harold Wood Hospital regarding the testing of their milk supplies (noted in last year's report) continues. School Canteens. Our liaison with the Divisional Education Committee is now of a most satisfactory order and my thanks are due to the Divisional Education Officer. Mr. D. H. Wilcockson. B.A.. M.Ed., for doing so much to achieve this. Shellfish. Samples of cockles, prawns, scampi, shrimps and winkles were sent for examination during the year with satisfactory results. 39 SECTION F. PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER NOTIFIABLE DISEASES. Infectious and Other Notifiable Diseases, 1963. Disease Total cases notified No. of cases hospitalised Dysentery 25 4 Erysipelas 7 1 Food Poisoning 13 0 Infective Hepatitis 4 0 Measles 1,674 3 Ophthalmia Neonatorum 2 0 Paratyphoid Fever 1 1 Pneumonia 3 1 Puerperal Pyrexia 2 0 Scarlet Fever 74 1 Whooping Cough 135 17 International Certificates of Vaccination or Inoculation. 784 certificates were stamped during the year. The number for the previous year was 3,756. Immunisation and Vaccination Statistics. I am indebted to Dr. R. D. Pearce, Area Medical Officer, for the following information concerning immunisation and vaccination statistics applicable to the Urban District for the year 1963:- Triple, Diphtherial Whooping Cough/Tetanus Immunisation: Completed primary immunisations 2,381 Boost injections 855 Diphtheria/Tetanus Immunisation: Completed primary immunisations 252 Boost injections 365 Diphtheria Immunisation: Completed primary immunisations 28 Boost injections 890 Whooping Cough Immunisation: Completed primary immunisations 36 Boost injections 1 Tetanus Immunisation: Completed primary immunisations 1,208 Boost injections 764 Poliomyelitis Vaccination (Salk): Completed 2 primary injections 299 Boost injections 450 Fourth injections 221 Poliomyelitis Vaccination (Oral): Completed three doses 2,558 40 Third boosting dose 836 Fourth boosting dose 2,032 Smallpox Vaccination: Primary vaccinations 826 Re-vaccinations 389 B.C.G. Vaccinations (School Children of 13 years plus): Number vaccinated 853 Infective Hepatitis 4 cases were notified during the year as against 26 last year. Tuberculosis Respiratory: The number of new notifications decreased from 39 to 24. Non-Respiratory: The notifications remained at 4. The site of infection and age of the non-respiratory cases were as under:Jaw Male 19 Cervical glands Female 44 Skin Female 21 Peritoneum Female 23 Inward Transfers: These totalled 21 as against 20 last year. Deaths: There were 7 this year as compared with seven last year. Cases on Register: The number of cases of tuberculosis on the register at the end of the year was as follows:Respiratory: Males 534 Females 435 Non-Respiratory: Males 37 Females 29 Romford Chest Clinic. Noted below is some information from the Consultant Chest Physician:- "The end of 1963 saw the retirement of Dr. Sidney Thompson as Physician-in-Charge of the Romford Chest Clinic and his replacement by Dr. Stanley Steel. Dr. Thompson has spent 22 years' work in the chest services of this area and I am sure that all his patients who have known his sympathy and kindness, as well as the benefit of his professional skill, would want to express every good wish to him in his retirement. Apart from the continued work in the prevention and treatment of tuberculosis in the combined areas of Romford Borough and Hornchurch Urban District, the Romford Chest Clinic has been dealing with an increasing number of non-tuberculous medical problems related to the chest, and it is expected that this trend will continue. At present there are approximately 1,500 notified cases of tuberculosis in the area, but it is probable that this figure will show a steady decline as the notifications of new cases continue to get fewer in number." 41 CASES OF AND DEATHS FROM TUBERCULOSIS, 1963 age groups new cases inward transfers total no. of cases added to register deaths total deaths respiratory nonrespiratory respiratory nonrespiratory respiratory nonrespiratory M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Under 5 years - - - - - - - - - - - - - - - - 5-14 years - - - - - - - - - - - - - - - - 15-24 years 5 1 1 2 1 3 — 1 7 7 - - - - - - 25-44 years 4 4 — 1 4 6 — — 8 11 1 — — — 1 — 45-64 years 6 3 — — 3 2 — — 9 5 2 — — — 2 — 65 and over 1 - - - - 1 - — 1 1 3 1 — — 3 1 Totals 16 8 1 3 8 12 — 1 25 24 6 1 - — 6 1 42 INTERVAL BETWEEN NOTIFICATION AND DEATH OF FATAL CASES OF TUBERCULOSIS, 1953-1963 YEAR Within one month From 1-3 months From 3-6 months From 6-12 months From 1-2 years From 2-3 years From 3-4 years From 4 years and upwards Not Notified TOTAL 1953 2 — 1 1 1 2 2 8 4 21 1954 — — — 1 2 — — 5 3 11 1955 1 — — — — — 1 1 1 4 1956 1 — — — — — — 3 1 5 1957 — — — 1 — — — 1 1 3 1958 1 1 — — 1 — — 1 5 9 1959 — — — - 1 1 — 2 1 5 1960 2 — — — — — — 5 3 10 1961 — — - 1 — 1 — 1 1 4 1962 — — — - — 1 — 2 4 7 1963 — 1 1 — — — — 3 2 7 43 SECTION G. FACTORIES ACT, 1961 Prescribed particulars on the administration of the Factories Act, 1961. PART I OF THE ACT. 1. Inspections for purposes of Provisions as to Health. Premises No. on Register No. of Inspections No. of written notices No. of occupiers prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by L.A.’s. 36 21 3 - (ii) Factories not included in (i) in which Sec. 7 is enforced by the L.A. 323 145 16 - (iii) Other premises in which Sec. 7 is enforced by the L.A. 12 20 1 — Total 371 186 20 — 2. Cases in which Defects were Found. Particulars Found Remedied Referred Prosecutions To H.M. Inspector By H.M. Inspector Want of cleanliness (Sec. 1) 1 — — — — Overcrowding (Sec. 2) — — — — — Unreasonable temperature (Section 3) - - - Inadequate ventilation tion 4) - - - - - Ineffective drainage of floors (Section 6) - - - - - Sanitary Conveniences (Section 7) (a) Insufficient 6 1 — - - (b) Unsuitable or Defective 11 4 — 3 - (c) Not separate for sexes — — — — - Other offences against the Act. 2 1 8 — — Total 20 6 8 3 - 44 PART VIII OF THE ACT. OUTWORK—Sections 133 and 134 No. of Outworkers Nature of Work in August list Wearing apparel—Making, etc. 113 No instances of work in unwholesome premises. 45 INDEX PAGE Acknowledgments 6 Acreage 7 Accommodation for Homeless Families 15 Adoption of Private Streets 22, 23 Alkali Inspector 20 Aged, Care of 13,15 Agriculture (Safety, Health & Welfare Provisions) Act, 1956 26 Amalgamation 6 Ambulance Service 12 Animal Boarding Establishments 24 Atmospheric Pollution 20 B.C.G. Vaccination 40 Births 7 Birth Rates 7 —Area Comparability Factor 8 —Comparative 8 —Illegitimate 7 Blind & Physically Handicapped 15 Bretons Farm Sewage Works 21 Canteens, School 38 Caravans 28 Certificates of Disrepair 27,28 Child Welfare 12 Clean Air Act, 1956 6,18,19,20,21 —Grants 6 Clinics, Child Welfare 12 Contents, Table of 2 County Welfare Services 15 Day Nursery 13 Deaths 7,9 —Age Groups 10 —Causes of 10 —Infantile 7 —Main Causes 9 —Maternal 7 Death Rates 7 —Area Comparability Factor 8 —Comparative 8 —Early Neonatal 7 —Infant 7 —Neonatal 7 —Perinatal 7 46 PAGE Diphtheria Immunisation 39 Disabled, Rehabilitation of 12 Diseases of Animals (Waste Food) Order, 1957 24, 26 Disinfection 23 Disinfestation 23 Domestic Help Service 13 Drainage and Sewerage 21 Essex County Council Act, 1952 — Section 103 38 Section 105 35 Establishments for Massage or Special Treatment 23, 25 Factories Acts, 1937 to 1959 24,43 —Defects 43 —Inspections 24,43 —Outwork 24,44 —Prescribed Particulars 43 Fireguards 25 Farms 26 Fluoridation 18 Food — Complaints 33,34,35 Hawkers 38 Hygiene 37 Inspection of 23,29 Meat Inspection 36 Premises 23,35 Preserved 37 Unsound 36 Food and Drugs Act, 1955 29 —Administration 29 —Food Hygiene Regulations, 1955 35 —Public Analysts 4,29 —Sampling 29,30,31,32,33 General Mortality—Main Causes 9 General Sanitary Circumstances 17,24 Greater London 6 Heating Appliances (Fireguards) Act, 1952 and Regulations 1953 25 Home Nurses and Midwives 13 Home Safety 15, 16 Homeless Families 15 Hornchurch Urban District Council Act, 1936, Section 90 37 Hospital Plan 11 47 PAGE Houses — Inspection of 24 Number erected 27 Number inhabited 7 Housing 6,27 —Caravans 28 —Certificates of Disrepair 27, 28 —Closure and Demolition 27 —Common Lodging Houses 28 —Improvement Grants 28 —Rehousing (medical aspects) 28 —Visits paid 24 Ice Cream 37 —Registration 37 —Sampling 37 Immunisation and Vaccination Statistics 39, 40 Improvement Grants 28 Infectious and Other Notifiable Diseases 5, 39 —Hospitalisation 39 —Notifications 39 —Visits paid 25 Infective Hepatitis 40 Informal Notices Served 25 International Certificates of Inoculation/Vaccination 39 Laboratory Facilities 12 Land Charges Enquiries 28 Laundry Service 15 London Borough 15 6 Maternity and Child Welfare 12 Meals on Wheels 13, 14 Meat Inspection 37 —Carcases Inspected and Condemned 36 Medical Examinations 11 Members of the Council 3 Members of the Public Health Committee 3 Metal Dealers 25 Midwives and Home Nurses 13 Milk — Distributors 38 Sampling 38 Special Designations 38 Nags Head Lane Sewage Works 21 48 PAGE National Assistance Act. 1948 13,15 —Section 47 13 —Section 21 15 New Streets 22, 23 Noise Abatement Act, 1960 25 Notices Served 25 Nursing Homes 12 Officers of the Public Health Department 4 Old Metal Dealers 25 Outworkers 24 Paddling Pools 23 Penny Rate Product 7 Pet Animals Act, 1951 25 Physically Handicapped and Blind 15 Poliomyelitis Vaccination 39, 40 Population 5,7 Preface 5 Preserved Food Manufacturers 37 Propaganda 11,12 Public Analysts 4,29 Public Health — Inspection 23,24,25 Inspectors 4,25 Public Relations 11,12 Radioactivity 18 Rag Flock and Other Filling Materials Act, 1951 25,26 Rainfall 17 Rateable Value 7 Regional Sewerage Scheme 21 Rent Act, 1957 — Certificates of Disrepair 27,28 Residential Accommodation 15 Riding Establishments Act, 1939 25,26 River Ingrebourne 21 Rodent Control 23 School Canteens 38 Sewage Works 21 Sewerage and Sewage Disposal 21 Shellfish 38 Shops Act, 1950 24,25 49 PAGE Slaughter of Animals Act, 1958 37 Slaughterhouses 36 Smallpox Vaccination 40 Smoke Control Areas 6,18,19,20,21,24 Soil Sewers 21 Staff 4 —Medical Examinations 11 Staffing 11 Statutory Notices Served 25 Stillbirths 7 —Rates 7 Streets Made Up and Taken Over 22, 23 Summary of Public Health Inspector's Work 23, 24, 25 Surface Water Sewers 22 Swimming Pool 23 Swine Fever 37 Table of Contents 2 Tetanus Immunisation 39 Tuberculosis 40 —B.C.G. Vaccination 40 —Incidence and Mortality 41 —Notification/Mortality Interval 42 —Chest Clinic 40 Vaccination Statistics 39, 40 Vital Statistics 5,7 Water — Fluoridation 18 Sampling 17 Supplies 17 Well 17 Welfare Services 15 Whooping Cough Immunisation 39