LIBRARY BOROUGH OF HORNSEY ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1945 r. p. garrow, m.d., d.p.h. HEALTH COMMITTEE (as at 31st December, 1945) Councillor J. L. R. Webb, (Chairman), 11, Wilmer Way.N.14. The Mayor, Alderman W. V. Vall, J. P., Kilton Lodge, Rcwben Close, Totteridge. Alderman F. N. Bailey, 40, oukfield Court, Haslemere Road.N.8. " Mrs. C. M. Cave, 10, Wood Vale.N.10. " S. G. Goulding, Woodlands, Cranley Gardens.N.10. " Mrs. M. N. Hill, 16, Bishopswood Road .N. 6. " J. W. Rowlands, J.P., 25, Cliolmeley Park.N.6. " L. J. Valette, 80, Tottenham Lane .N.8. " C. \V_nkley, 72, Y/o&dside Avenue.N. 10. Councillor Miss 0. R. Anderson, 12, Mountview Road.N.4. " H. G. Ash, 5, Topsfield Parade.N.8. " Mrs. R. A. Bryan, 49, North View Road.N.8. " J. P. Clarkson, 60, Groat Forth Road.N.6. " Mrs. K. C. Clegg, 28, Stormont Road.N.6. " Mrs. K. M. Crump, 84, Wood Vale.N.10. " J. Edwards, 102, Turnpike Lane.N.8. " Miss E. C. McCullough, 20, Prince's Avenue.N. 10. " F. Wilders, 12, Woodberry Crescent.N. 10. " A. J. Young, Woodend, 48, Great North Road.N.6. 1 STAFF OF PUBLIC HEALTH DEPARTMENT (as at 31st December, 1945) Medical Officer of Health, and School Medical Officer Deputy Medical Officer of Health and Assistant Medical Officer of Schools and Maternity and Child Welfare Centres Assistant Medical Officer of Health, Assistant Medical Officer of Schools and Maternity and Child Welfare Centres "Dentist (M. & C. W. Dental Scheme) Senior Sanitary Inspector, Petroleum Inspector, Shops Acts Inspector, Young Persons Act Inspector, Factory Act Inspector, Food Decontamination Officer Sanitary Inspectors and Shops Acts Inspectors, Young persons Act Inspectors, Factory Act Inspectors R. P. Garrow, M.D., D.P.H. Marian Lones, B.Sc. , M.B., B.S., M ,.R. C. S., L.R. C.P. , D.P.H. Margaret Robinson, M.B., Ch.B. , D.T.M. & H. H. A. Creeke, L.D.S. J. H. Jesse, M.S. I. A., Cert. R.San.I., Cert. Insp. of Meat and Foods, A.R.P.S. J. D. Chance, M.S.I.A., Cert. R.San.I., Cert. Insp. of Meat and Foods. E. Handy, M.S. I. A., Cert. R.San.I., Cert. Insp. of Meat and Foods, Cert. San. Science. R. Downes, M.S. I. A., Cert. R.San.I., J. Calderbank, M.S. I.A., M.R.San.I., Cert. R.San.I. & S.I.E. Joint Board, Cert. Insp. of Meat and Foods. 2 Chief Clerk Assistant Clerks Health Visitors Midwives Rodent Operator Disinfectors and Mortuary Attendants Medical Services Motor Driver. W. J. Wilson, M.S.I.A., Cert. 2.San.I., Cert. Insp. of Meat and Foods. N. Smith, Cert. R.San.I. E. Cheesman W. A. Simons (On Active Service) T. Hadley (On Active Service) Miss E. A. Smith Miss S. P. Funn Miss M. Chestoman Miss D. M. Sellman Miss M. Humphreys Mr. L. Wells Miss H. Croak Miss A. Godden, H.V.Cert., S.R.N. , S. C.M. Mrs. L. Hatton, H.V. Cert., S.R.N., S.C.M. (Part-time Health Visiter and School Nurse) Miss E. Whimster, H.V. Cert., S.R.N., S.C.M. Miss W. Molhuish, H.V. Cert., S. R.N. , S.C.M. Miss E. N. Gibbon, H.V. Cert., S.R.N., S.C.M. Miss M. Andrews, S. C. M. Miss L. Hughes, S.C.M. Miss A. C. Matthews, S.C.M. Mis R. (Tones, S.C.M. Mrs. M. Jamison, S.C.M. (Parttime) E. Mead W. H. Lewis P. Hall P. Martin (On Active Scrvice) R. Wood 3 ''Veterinary Inspector under Diseases of Animal Acts F. G. Buxton, M.R.C.V.S. 15, Jackson's Lane.N.6. NOTE - Officers in respect of whom Salary contribution is made under the Public Health Acts or by Exchequer Grants. "Part-time officers. 4 To the Mayor, Aldermen and Councillors of the Borough of Horns ey. Mr. Mayor, Ladies and Gentle men, I have the honour to submit my Annual Report on the Public Health for the year ending 31st December,, 1945. The "birth rate 17.6 and the death rate 13.25 are both a little down from the previous year (19.08 and 14.94). The infant mortality is the same as in 1944, namely 38 per thousand live births. Having regard to the age-distribution of the population of the Borough with its undue proportion in the older age groups, there is nothing unusual about these figures - nothing about which to be unduly elated or depressed. The infant mortality should be lower and the mortality amongst illegitimate infants is a social and moral problem of groat complexity which has not responded to the general measures for the improvement of infant hygiene and nutrition. The unmarried mother and her child have all the maternity and child welfare services at their disposal and, indeed, have special attention and help from Medical Officers, Health Visitors, welfare Workers and other municipal and voluntary agencies. In spite of those sources of help, the illegitimate child is so often unwanted that the balance is heavily loaded against its survival. The two big problems which are engaging the attention of the Council in circumstances of exceptional difficulties are A) Environmental. More houses and better housing. B) Personal. Better preventive health services. A) Housing. The return of men and women from the Services and of families from evacuation has brought the population nearly to its pre-war level. As a result of enemy action there were, at the end of 1945, still well over 1,000 houses or self-contained flats demolished or so damaged as to be un-inhabitable. This number is being steadily reduced by repair, but about 700 to 800 houses have been either completely demolished or so badly damaged as to require demolition. The acute shortage of housing accommodation created in this way has resulted in serious overcrowding in many houses. Before the war the housing position was good in that all groups of old houses unfit for habitation had been demolished and their occupants rehoused and overcrowding- was minimal. At the end of 1939- the number of dwellings overcrowded was 25 the number of families dwelling therein was 27 the number of persons dwelling therein was 165 5 The position is vastly different to-dry but cannot be presented in figures because the Sanitary Inspectors are not keeping records of overcrowding as was done continuously in accordance with the requirements of the Housing Act, 1936. We know from the Officers of the Department - Sanitary Inspectors, Health Visitors, School Nurses, Midlives - that overcrowding is serious and becoming more so. We also know that there are some 5,800 applicants for house accommodation. In addition to this unhappy position is the fact that restrictions in the use of materials and labour to Carry out necessary maintenance repairs is resulting in a lower standard of cleanliness and sanitation of existing accommodation. B) Personal Preventive Health Services. The National Health Service Bill which is likely to become "The National Health Service Act, 1946", is concerned chiefly with the provision of a complete Hospital Service under Regional Boards and a Medical Practitioner and Specialist Service for every citizen in his own home or at proposed "Health Centres". It would be a contribution to accurate thinking if these were referred to as "Hospital and Medical Services" and the phrase "Personal Preventive Health Services" confined to the work which the present Local Authorities have built up since 1900 for mothers and children under the age of five, and since 1907 for school children under Maternity and Child Welfare and Education Committees respectively. The Personal Preventive Health Services arc carried out at the Council's four Maternity and Child Welfare Centres, at the School Clinic, in the School, at the Maternity Home, at five Day Nurseries and in the homes of the people by Sanitary Inspectors, Health Visitors, School Nurses and Midwives. The work of the Council's whole-time and part-time Medical Officers and Specialists deals chiefly with healthy people and the aim is to maintain their health and so enable them to achieve full mental and physical development, and, incidentally, to relieve the burden on the "Hospital and Medical Services". Future Developments in Personal Preventive Health Services. A summary of the further developments in providing better health services approved by the Council and writing only for the necessary sanctions to the use of materials, labour and staff, are- 1) Extension of the Town Hall Centre.N.8. with a view specially to the provision of a better ante-nata1 service. 2) Completion of the conversion of Burgoyne Hall.N.4. 3) A new Centre in Highgate to replace the Centre at Church Road.N.6. 4) A new Centre at Fortis Green.N.l0. The conversion of the Electricity Showrooms has been completed and was opened on 29th April, 1946. It is hoped that the Electricity undertaking may soon be in a position to offer more accommodation in this building. 6 5) A new Centre to serve Stroud Green and Finsbury Park. The work of converting a blitzed shop and residential "building to provide a Centre on the ground floor and flats above, has begun at the corner of Stroud Green Road end Terne Road.N.4. 6) Provision of a new Centre for Central Hornsey. So far no suitable building or site has been found. 7) Extension of the Maternity Home. The building of a new wing to provide twelve additional beds with two labour wards and all necessary ancillary accommodation is nearing completion and, it is hoped, will be fully occupied before the end cf 1946. 8) Extension of the School Clinic.N.8. by the provision of a temporary building alongside to accommodate the Orthopaedic Department. 9) Provision of a Dental Clinic cither at Coldfall or at Burgoyne Hall to accommodate a third whole-time Dentist. 10) The anointment of extra Health Visitors and other personnel to staff these extensions. 11) Provision of a Day Nursery to serve the Highgate district. . I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, R. P. GAROW, Medical Officer of Health. 7 STATISTICS FOE 1945 (Section A) SOCIAL AMD ECONOMIC STATISTICS Area (acres) 2,873 " (square miles) 4.49 Population (Census 1931) 95,524 Do., Registrar-General's estimate, 1945 78,660 Number of separately-assessed inhabited promises (end of 1945), according to Rate Books 23,775 Rateable value (General Rate) at 31st December £1,055,467 Product of a penny rate £4,175 LIVE BIRTHS M. F. Total Legitimate 654 626 1,280 Illegitimate 64 48 112 718 674 1,392 Birth Rate - 17.60 (per 1,000 population) STILL-BIRTHS M. F. Total Legitimate 18 IS 34 Illegitimate 1 1 2 19 17 35 Still-Birth Rate - 25.21 (per 1,000 total live end still-births) DEATHS Males 496 Females 546 1,042 Death Rate - 13.25 (per 1,000 population) INFANT DEATHS (under 1 year of age) ] M. F. Total Legitimate 19 18 37 Illegitimate 12 4 16 31 22 53 DEATH RATE OF PLANTS UNDER 1 YEAR OF AGE All infants per 1,000 live births 38.07 Legitimate infants per 1,000 legitimate live births 28.90 Illegitimate infants per 1,000 illegitimate live births 142.86 8 • MATERNAL MORTALITY Rate per 1,000 total (live and still) Deaths births Puerperal and post-abortive sepsis 1 0.7 Other mater all causes • 1 0.7 Total 2 1.4 DEATHS FROM SPECIAL CAUSES Deaths from Cancer (all ages) 181 Deaths from Measles (all ages) 1 Deaths from Whooping Cough (all ages) 0 Deaths from Diarrhoea (under 2 years of age) 9 -9- GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA (Section B) The normal hospital, clinic, laboratory and nursing services were all maintained as in pre-war years. AMBULANCE SERVICE As from the 30th Jane, 1945, the Ambulance Service ceased to operate as part of the Civil Defence Services and Hornsey joined with Finchley, Wood Green and Friern Barnet to provide a Joint Ambulance service to cover the four districts. The ambulances are based at a depot at The Health Centre, Oak Lane, East Finchley. The following Harnsey calls were made on the Joint Ambulance Service from the time of its -inception until the end of the year - Accident calls 162 Other removals 951 1,113 SANITARY CIRCUMSTANCES OF THE AREA (Section C) WATER SUPPLY The water supply for Hornsey is provided by the Metropolitan Water Board. During 1945 the supply has been satisfactory in quality and quantity. Supplies were afforded by standpipe in various parts of the Borough owing to burst mains on a total of 19½ days. Hornsey is supplied from two sources - (a) Water from the New River, treated at the Board's filtration works at Stoke Newington, and (b) River Thames water stored in Littleton reservoir and treated at the Board's filtration works at Kempton Park. Water is pumped from these works into service reservoirs at Crouch Hill. Samples of water are collected on five days in every week at each stage of the purification process and tests include physical, chemical and microbiological examination. The water supplied to this area is not plumbo-solvent. Easu.lts of Bacteriological Teste. No. of samples Colony Count on Agar at 37° C. % of Sample s negative 100 ml. Bact. coli per 100 ml. Kempton Park 563 9.1 90.95 0.018 Stoke Newinton 252 6.0 99.21 0.016 SANITARY INSPECTION The following statement of the work of the Sanitary Inspectors has been prepared by Mr. J. H. Jesse, Chief Sanitary Inspector - Complaints 2,496 Re-inspections 4,271 Information from builder 279 Special Inspections 593 Drainage 525 Water tests applied (new drains) 32 Smoke and Chemical tests (old drains) 82 Verminous conditions 110 Memorandum from 3orough Engineer & Surveyor 5 Overcrowding surveys 6 Surveys (Permitted Number) 2 Re-surveys (Permitted Number) 3 Notifiable Infectious Diseases 285 Scabies 47 Small-pox Contacts 40 Public Health (Aircraft) Regulations, 1938 70 Sunday Trading Inspections 273 Shops Acts 11 Butchers' shops 12 Slaughter-houses 5 Dairies and Milkshops 20 Grocers' shops 27 Bakehouses 8 Fish shops ^ Restaurant kitchens 6 Greengrocers' shops 9 Ice Cream 1 Other food shops 11 Food inspections 236 Milk Examinations 2 Offices inspected 27 Factories 22 Outworkers 2 Conveniences 3 Passages 9 Music and Dancing Licences 6 Cinemas Petroleum Stores 124 3 River pollution 540 Rats & Mice (Destruction) Act, 1919 Salvage Sites 10 Survey of Unoccupied Houses 925 Landlord & Tenant (War Damage) Amendment Act, 1941 90 Air Raid Shelters 51 Fuel and Lighting Orders 20 Control of Building Operations Orders 3,670 14,935 11 NOTICES The Notices served during the year are as follows:- Under the - Public Health and Housing Acts Housing Bye laws Verbal Preliminary Statutory 372 1,092 78 15 1 372 1,107 79 SUMMARY OF SANITARY IMPROVEMENTS CARRIED OUT DRAINAGE Number of houses and promises redrained 5 Repairs or amendments to existing drains 50 Drains or gullies unstopped or cleansed 115 Manholes provided 17 Manholes repaired 34 Intercepting traps fixed 3 New gulley traps fixed 42 New soil pipes and ventilating shafts fixed 22 Soil pipes and ventilating shafts repaired 37 WATER-CLOSETS AND SANITARY FITTINGS New water-closet buildings 1 New water-closet basins fixed 74 Water-closets unstopped, cleansed or repaired 45 New sinks provided 20 Now lavatory basins provided 12 Waste-pipes trapped, repaired or unstopped 77 Waste-pipes diverted into proper drain 5 Baths provided or made usable 5 MISCELLANEOUS Roofs repaired 206 Eaves guttering renewed, cleansed or repaired 95 Rain-water pipes provided, repaired 55 Damp walls remedied 47 Damp-proof courses inserted 11 Paving of yards repaired 13 Rooms cleansed, distempered or papered 19 Premises disinfested of vermin 123 Drinking-water cisterns repaired, cleansed and covered 36 Water supply pipes repaired 41 Water supply (additional) provided 12 Windows end skylights provided or made usable 16 Sub-floor ventilation 56 Floors repaired 120 Walls and ceilings repaired 94 Windowsills repaired 9 Sashcords and fittings repaired 18 Sanitary dustbins provided 49 Accumulations of manure and refused removed 10 Shoves, ranges and coppers repaired or renewed 65 Food stores provided 48 Sundry items 12 * BYELAWS RELATING TO HOUSES INTENDED OR USED FOR OCCUPATION BY THE WORKING CLASSES AND LET IN LODGINGS OR OCCUPIED BY MEMBERS OF MORE THAN ONE FAMILY One house has been dealt with under these Byelaws during the year and the following work carried out - Byelaw 4 (b) Water supply 1 3 (h) Handrail 1 SHOPS ACTS The following are the particulars of action taken during the year under the provision of the Shops Act. 1934, relating to ventilation and temperature or shops and to sanitary conveniences - < , Complied Notices With Temperature 1 1 HOUSING STATISTICS (Section D) The housing statistics of the year as required by the Ministry of Health are set out below - 1. Inspection of Dwelling-houses during the Year- (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1,664 (b) Number of inspections made for the purpose 3,148 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 (b) Number of inspections made for the purpose (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation (4) Number of dwelling-houses (exclusive of those referred to under the prc-ceding sub-head) found not to bo in all respects reasonably fit for human habitation 627 2. Remedy of Defects during the Year without service of formal Notices:- Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers 369 13 5. Action under Statutory Powers during the Year;- A - Proceeding's under Sections 17, 18 and 25 of the Housing Act, 1930:- (1) Number of dwelling-houses in respect of which notices were served requiring repairs 7 (2) Number of dwelling-houses which were rendered fit after service of formal notices:- (a) by owners (b) by local authority in default of owners B - Proceedings under public Health Acts:- (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 71 (2) Number of dwelling-houses in which defects were remedied after service of formal notices;- (a) by owners 13 (b) by local authority in default of owners C - Proceedings under .Sections 19 and 21 of the Housing Act, 1950:- (1) Number of dwelling-houses in respect of which Demolition Orders were made — (2) Number of dwelling-houses demilished in pursuance of Demolition Orders D - Proceedings under Section 20 of the Housing Act, 1930:- (1) Number of separate tenements or underground rooms in respect of which Closing Orders wore made * (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit 4. Housing Act, 1956. Overcrowding:- (a) (i) Number of dwellings overcrowded at the end of the year 34 (ii) Number of families dwelling therein 41 (iii) Number of persons dwelling therein 239 (b) Number of new cases of overcrowding reported during the year 4 (c) (i) Number of cases overcrowding relieved during the year 2 (ii) Number of persons concerned in such cases 25 14 INSPECTION AND SUPERVISION OF FOOD (Section 5) lbs. ozs. lbs. ozs. Tinned Meat 327 9 Lard 6 0 Tinned Fish 400 12 Cheese 10 4 Tinned Milk 579 5 Bacon 78 8 Tinned Vegetables 438 11 Mincemeat 8 0 Tinned Fruit 48 8 Jam 295 0 Tinned Soup 17 6 Marmalade 53 0 Dried Vegetables 346 12 Golden Syrup 4 0 Dried Milk 1,075 13 Breakfast Cereals 34 8 Dried Egg 3 14 Broad 62 0 Dried Fruit 351 8 Cakes 204 0 Fresh Meat 829 14 Biscuits 20 0 Fresh Fish 3,073 0 Sweets 77 10 Fresh Vegetables 11,301 0 Cake & Pudding Mixtures 79 8 Fresh Fruit 570 0 Custard Powder 2 Smoked Fish 28 0 Baking Powder 6 Frozen Fish 98 0 Pepper 3 8 Cooked Meats 28 8 Salt 11 8 Poultry 52 2 Mustard 18 0 Flour 123 0 Pickles 14 6 Soya Flour 143 0 Soup Powder 6 8 Oatmeal 22 0 Meat Paste . 3 Rice 24 8 Stuffing 2 Semolina 55 8 Ginger 4 0 Pearl Barley 50 8 Soda Bicarbonate 10 Rolled Oats 16 0 Powdered Gelatine 7 0 Macaroni 12 0 Spaghetti 31 0 Tea 54 4 Cocoa 8 8 Sugar 61 0 Chocolate 2 10 Butter 9 6 Margarine 162 0 Eggs 1,092 Rabbits 40 2 Horses were slaughtered 13¼ 1bs. of meat were condemned including lungs RODENT CONTROL On the 1st February, 1944, the Middlesex County Council delegated its powers and duties under the Rats and Mice (Destruction) Act, 1919, to this Council. The investigation of complaints, of rat and nice infestation at private and business premises is carried out by the Sanitary Inspectors. The disinfesation of the premises either by gassing, poisoning, or trapping, is carried out by the Rodent Operator. 15 During the twelve months ending 31st December, 1945, the following work was carried out under the Act:- Visits by the Sanitary Inspectors 540 Visits by the Rodent Operator 2,635 Promises disinfested for rats 132 Premises disinfested for nice 53 Promises rat-proofed 15 No evidence of infestation 128 Disinfestation in hand - rats 10 Disinfestation in hand - mice 3 Estimates submitted 61 CLEANSING AND DISINFECTING STATION Male adults are treated at the Cleansing Station attached to the Central Depot in High Street, Hornsey. Women and children are dealt with at the Cleansing Station close by the School Clinic at the rear of the Town Hall, Disinfection of clothing is carried out by agreement with the Finchley, Hornsey, Wood Green and Friern Barnet Joint Hospital Committee at the Isolation Hospital, Muswell Hill. All these arrangements are working satisfactorily and assist the staffs of the Public Health, Maternity and Child Welfare School Medical Departments in combating head lice and improving the general standard of cleanliness. Legal action has "been taken in one case in 1945 which resulted in treatment being administered under the Scabies order, 1941. The following cases wore treated at the Cleansing Station at the rear of the Town Halls:- (1) Number of women over 15 years treated for Scabies 214 (2) Number of children aged 5-15 years treated for Scabies 374 (3) Number of children aged 0-5 years treated for Scabies. 118 (4) Number of women over 15 years treated for verminous heads 4 (5) Number of children 5-15 years treated for verminous heads 22 (6) Number of children 0-5 years treated for verminous heads 4 44 men were treated for Scabies at the Central Depot. INFECTIOUS DISEASES (Section F) DIPHTHERIA IMMUNISATION The following are the numbers of children immunised during 1945:- Under 5 years of age 1,034 Over 5 years of age 71 Total 1,105 16 INFECTIOUS DISEASES NOTIFIED Scarlet Fever 120 Diphtheria 12 Pneumonia 41 Erysipelas 15 Puerperal pyrexia 15 Ophthalmia neonatorum 8 Cerebro-spinal Meningitis 5 Dysentery 25 Measles 414 Whooping Cough 79 Para-typhoid Fever 3 Polio-myelitis 1 758 Admitted to Joint Isolation Hospital 156 Admitted to other hospitals 32 Nursed at home 550 738 17 VACCINATION The public Vaccinators information that they performed vaccination of persons in the Borough during 1945, as follows:- Dr. E. Buckler 252 Dr. R. Mackay 514 PREVENTION OF BLINDNESS (PUBLIC HEALTH ACT, 1925, SECTION 66) 3 cases of ophthalmia neonatorum were notified, both of which were nursed at home. Cases Vision unimpaired Vision impaired Total blind ness Deaths Rem. from dist. No tified Treated At home In hospital or nursing home 8 4 4 6 0 0 0 0 TUBERCULOSIS PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS No occasion has arisen in the coursc of the year to put these powers into action. The total number of cases on the Tuberculosis Register at the end of 1945 was 1,165, viz., pulmonery 920, non-pulmonery 245, an increase of 89 on the total for last year. NORTUARY One hundred and four bodies were received at the mortuary. DISEASES OF ANIMALS ACTS Mr. P. G. Buxton, the Veterinary Inspector, has kindly supplied me with details of his work in the Borough under the Diseases of Animals Acts and Orders during 1945 as follows Total number of Licences issued under the Contagious Diseases of Animals Acts 0 Inspections made under the Contagius Diseases of Animals Acts (Pigs 137) No action was necessary under the Tuberculosis Order, 1925, -18- -19- INFANTILE DEATHS 1945 Int. List No. Sex Under 1 day 1 day & under 1 week 1 wk. 2 wks. 3 wks. Total under 4 wks. 1-2 mns. 3-5 mns. 6-8 mns. 9-11 mns. Total under 1 year 35 Measles F • • • • • • • • 1 • 1 81 Meningitis (Non-Meningoc) M • • . . • • . . 1 • 1 89B Dis. of tlic Mastoid Antrum M • • • • . . . 1 . • 1 107 Broncho Pneumonic. M . • . . 1 1 1 . 1 3 " " " F • • • • • . 3 1 . • 109 Pneumonia (Unspec.) F • . • • • • 1 • • • 1 119A Enteritis & Diarrhoea M • • • • • • 2 3 2 7 " " " F • . . • • • . 2 • • 2 1223 Intussusception F • • • • • • • • . 1 1 157B Spina Bifida & Meningocele M 1 1 • . • 2 . . • • 2 " " " F 1 2 • • 1 4 • • • . 4 157E Ccngen. Pyloric Stenosis M » • • • • • 1 . • ' • 1 157H Cystic Disease of Kidney M • • 1 1 . • 1 • . . . 1 157IC Gastro-Intestinal M • 1 • • . 1 • . . . 1 159 Premature Birth M 4 1 1 • • 6 . . . . 6 " " F 2 1 • 1 • 4 . • . . 4 160A Injury at Birth F 1 • • • • 1 . • . . 1 161A " Asphyxia during or after Birth " " " " M 2 • . 1 • 3 . . . . 3 Atelectasis F . 1 • • . 1 • • . • 1 161D Melaena Neonatorum M . 1 • • . 1 • • • • 1 161EI Hoemolytic Dis. of the Newborn M • • 2 • . 2 . • . 2 178 Accidental Absorption of Poisonous Gas F • • • • . • • • 1 • 1 182 Accidental Mechanical Suffoc. M • • • • . . • 1 . . 1 " " " " F • • • • . 2 . . . 2 195D Other Unspecified Accidents M • • • • • * • • 1 . 1 M 7 4 4 1 1 17 4 5 5 . 31 F 4 4 • 1 1 10 6 3 2 1 22 ' . BOROUGH OF H 0 R N S E Y ANNUAL REPORT ON MATERNITY AND CHILD WELFARE SERVICES 19 4 5 MATERNITY & CHILD WELFARE COMMITTEE (as at 31st December, 1945) Alderman Mrs. C. M. Cave, (Chairman), 10, Food. Vale.N.10. The Mayor, Alderman W. V. Wall, J.P., Kilton Lodge, Rowben Close, Totteridge. Alderman F. N. Bailey, 40, Oakfield Court, Haslemere Road.N.8. " S. G. Goulding, Woodlands, Cranley Gardens.N.10. " Mrs. M. N. Hill, 16, Bishopswood Road.N.6. " J. W. Rowlands, J.P., 25, Cholmeley Park.N.6. " L. J. Valette, 30 Tottenham Lane.N.8. Councillor H. G. Ash, 5, Topsfield Parade.N.8. " Mrs. R. A. Bryan, 49, North View Road,N.8. " M. W. Burns, 7, Womersley Read.N.8. " Mrs, N. C. Clegg, 28, Stormont Road.N.6. " Mrs. K. M. Crump, 84, Wood Vale.N.10. " J. Edwards, 102, Turnpike Lene.N.8. " Miss E. C. McCullough, 20, Prince's Avenue.N.10. " N. Muldoon, 22, Beech Drive,N.2. " G. F. N. Norman, 12, V/oodberry Crescent.N. 10. " G. W. F. Pallett, 28, Fordington Road.N.6. " J. L. R. Webb, 11, Wilmer Way.N.14. " A. J. Young, Woodend, 48, Great North Road.N.6» Co-opted Members Mrs. G. Bradfield, 80, Etheldene Avenue.N.10. Lady F.O.Dixon, 2, Woodside Avenue.N.6. Mrs. M. King, 45, Wood Vale.N.10. Mrs, E. Jones, 256, Albert Road.N. 22. Miss B. I. Smith, 43, Weston Park.N.8. Mrs. M. A. Vautier, 20, Dorchester Court.N.10. -20- PUBLIC HE.iJ.TH, ACT, 1956 (Sec. 203) NOTIFICATION OF BIRTHS All live births and still-births of seven months and over mast "be notified to the Medical Officer of Health within 36 hoars, in addition to "being registered within a period of six weeks after birth. SUMMARY OF BIRTHS NOTIFIED, 1945 Male Female Total Live births 767 763 1,530 Still-births 16 15 31 783 778 1,561 The births were notified By doctors 9 " Borough Hidwives 315 " Alexandra Maternity Home 268 " Other Midwives 20 " Hospitals 656 " Others 276 Not notified (information extracted from Registrar's Returns) Live births 17 Still-births — 1,561 Of this number there were Live births Still-births Occurring in the Borough and transferred to other districts 210 1 Belonging to Hornsey and occurring in Hospitals, etc., outside the district 653 16 The 1,350 nett number of notified births belonging to Hornsey were divided among the districts of the Centres, as follows:- Live births Still births Total Town Hall Centre 579 12 591 Burgoyne Road Centre 275 9 284 Church Road Centre 228 7 235 Coldfall Centre 238 2 240 1,320 30 1,350 21 Births notified by Borough Midlives:- Miss Andrews 108 Miss Hughes 67 Miss Matthews 79 Miss Jones 25 Miss Buckeridge 33 Miss Fenwick-Tame 3 315 ALEXANDRA. MATERNITY HOME The following statistics relate to the work of the Maternity Home daring 1945. 2) Number of maternity beds in the Institution (exclusive of isolation and labour beds) at 31st December, 1945 19 2a) number of beds, if any, included under item 2 which have been reserved for expectant mothers in need of hospital treatment 2 3) Number of maternity cases admitted during the year 286 3a) Number of women treated during the year in the ante-natal beds shown against item 2a (these women should he included also against item 3) 15 3d) Average duration of stay of expectant mothers in the ante-natal beds shown against item 2a 6 days 4) Average duration of stay of cases in the lying-in wards 14 days 5) †Number of cases delivered by - (a) Midwives 238 (b) Doctors 33 6) Number of cases in which medical assistance was sought by a midwife in emergency 44 7) Number of cases admitted after delivery (these cases should he included in item 3) 1 8) Number of cases notified as- (a) ""puerperal fever 1 (b) //puerperal pyrexia 9) Number of cases of pemphigus neonatorum 10) (a) Number of infants who have at any time received a supplementary or complementary feed while in the Institution (excluding those given during the first three or four days while breast feeding is being established) 30 -22- (b) Number of infants wholly breast-fed on leaving the Institution 234 11) Number of cases notified as ophthalmia neonatorum - 12) Number of maternal deaths — 13) (a) Number of still-births 5 (b) Cause in each case, and results of post-mortem examination (if obtainable) 1) Macerated 2) Macerated 3) A.P.N. Prematurity 4) Extended breech in primigravida 5) Prolonged labour - early rupture of membrane 14) (a) Number of infant deaths within 10 days of birth 2 (b) Cause of death in each case, and results of post-mortem examination (if obtainable) 1) Prematurity 2) Congenital abnormality i.e. complete absence of nose ± Based on the actual number of days each patient stayed. † Students' cases should be included under (a) unless they were delivered by a doctor. ""In London Only. //i.e., rise of temperature to 100.4° P. for 24 hours, or its recurrence within that period. HOME HELPS SERVICE The undermentioned report on the work of the Home Helps Service has been supplied by the Organiser, Mrs. H. Inward. Number of Maternity & Child Welfare cases 147 Number of Domestic cases 128 Total number of cases served (increase on 1944 total of 91) 275 Full fee Part fee Free cases Number of Maternity & Child Welfare cases paying 8 135 4 Number of Domestic cases paying 89 28 11 Total persons prying 97 163 15 Number of Helps employed at 1st January, 194 5 2 Number of Helps resigned during the year 23 Number of Helps engaged during the year 29 Number of Helps employed at 51st December, 1945 15 Total number of visits made by Helps 4,273 2 5 CHILD LIFE PROTECTION PUBLIC HEALTH ACT, 1956 (Secs. 206-220) Regular visits arc paid by the Health. Visitors to the homes of fostermothers in their respective areas, and foster-mothers are encouraged to bring the children to the Centres for periodical medical examination. The number of requests for foster-mothers is much in excess of the number available and requests arc often received from Societies and Authorities outside the Borough. A. register of foster-mothers and foster-children is kept by the Medical Officer of Health and at each Centre. The following is a summary of the Register:- Town Hall Burgoyne Hall CENTRE Church Road Coldfall Tatal No. of foster-mothers on register: At the beginning of 1945 12 3 1 2 18 " " end " " 12 5 1 2 20 No. of foster-children on register: At the beginning of 1945 24 8 2 4 38 " " end " " 22 11 1 2 36 Died during the year 6 — — — 6 On whom inquests were held during the year 1 — — — 1 Visits to foster-children: First visits 26 24 5 — 55 Total visits 203 158 19 19 399 No proceedings were taken during the year. MATERNITY AND CHILD WELFARE DENTAL SCHEME The following is a report on the work carried out during the year by the Dental Surgeons in connection with the Maternity & Child Welfare Dental Scheme for children under five years of age:- Inspections 171 Old cases 46 Nov; cases 125 Attendances 443 Finished cases 129 Teeth extracted 102 Teeth filled 423 General anaesthetics 54 Local anaesthetics 1 Other treatments (silver nitrate dressings, scalings, gum treatments, etc.) 424 24 The following work was carried out in connection with, the Dental Scheme for expectant mothers, by the Dental Surgeon, Mr. Creeke. Attendances 705 New cases 152 Examinations 176 Extractions (133 under local anaesthetic, 538 under gas) 671 General anaesthetics 5 Fillings 234 Dressings 118 Scalings 38 Attendances for dentures 160 Dentures provided - Upper and lower 28Single dentures 10 Dentures repaired 2 Finished cases 85 X-ray 1 MATERNITY STATISTICS ANTE-NATAL, NATAL AND POST-NATAL RECORD OF WORK OF MUNICIPAL, MIDWIVES, 1945 Midwife Confinements attended Ante-natal Clinics attended Ante-natal visits Postnatal visits Miss Andrews 113 45 393 1,444 Miss Hughes 78 86 244 1,250 Miss Matthews 81 45 214 1,150 Miss Jones 18 17 119 192 Miss Buckeridge 33 41 190 622 Mrs. Jamison — — 915 25 CENTRES Totals Town Hall Burgoyne Hall Church Road Coldfall Number of Children's sessions held 227 134 151 82 594 "ante-natal sessions held 149 55 54 49 307 No. of indiv. mths. seen by Doctor:- Ante-natal New cases 540 199 257 133 1,129 „ „ Old cases 1,750 677 663 524 3,614 Post-natal New cases 112 74 83 3 272 „ „ Old cases 21 3 1 53 78 2,423 953 1,004 713 5,093 Tot. att. of mths. 3,322 1,137 1,112 970 6,541 No. of babies att. Cens. 1st time:- Under 1 year 632 302 440 191 1,565 1-3 years 103 30 222 30 385 3-5 years 26 15 29 6 76 No, of indiv. babies on Cen. reg. at end of 1945 1,704 742 577 360 3,383 Babies seen by Dr. 4,414 2,294 854 500 8,062 Atts. of babies at medical cons. 12,833 5,793 1,099 575 20,300 Tot. atts. of babies at Centres:- Under 1 year 8,265 4, 092 2,529 1,787 16,673 1-3 years 3,977 1,470 972 346 6,765 3-5 years 576 231 193 31 1,031 Ref. own priv. drs. 5 15 34 46 100 Ref. to hosps. 60 31 39 31 161 Grand Totals 1st Tot 1st Tot 1st Tot 1st Tot 1st Tot vst vst vst vst vst vst vst vst vet vst Vsts. paid by Nurses To exp. mothers 129 213 50 70 44 110 35 46 258 439 To infs. und. l year 556 1,428 177 330 254 945 201 340 1,188 3,043 To chil. agd 1-5 yr 59 2,504 88 517 169 644 15 435 331 4,100 Total visits 744 4,145 315 917 467 1,699 251 621 1,777 7,582 CHILD LIFE PROTECTION Vets. pd. to Foster Children 26 203 24 158 5 19 - 19 55 399 26 WAR-TIME DAY NURSERIES The following are some particulars relating to the War-time Day Nurseries in the Borough:- Name Address and Telephone No. Number of Children accd. Date of Opening Matren Ladywell • 27, Church Lane, N.8. Mountview 8938 74 6/4/1942 Miss Stewart Queen's Lodge 40/42, Great North Road.N.6. Mountview 5339 80 27/6/1942 Miss Harper Red Gables 113, Crouch Hill, N.8. Mountview 7553 46: 20/7/1942 Mrs. Ryder Vincent House 68/70, Hampden Road,N.8. Mountview 9077 56 22/3/1943 Miss Rigg Clemence House 24, Queen's Ave. N. 10. Tudor 6730 50 24/1/1944 Mrs. Bawcomb Stonecroft 100, Priory Road, N.8. Mountview 7050 60 13/8/1945 Miss Brindle 27 BOROUGH OP HORHSEY ANNUAL REPORT OF THE SCHOOL MEDICAL OFFICER FOR 1945 R. P. GARROW, M.D., D.P.H. HORNSEY EDUCATION COMMITTEE List of Members, 31st December, 1945 Alderman Wm. J. Grimshaw, J.P., (Chairman), 25, Sheldon Avenue.N.6. Councillor M.W.Burns, (Vice-Chairman), 7, Womersley Road.N.8. The Mayor, Alderman W. V. Wall, J.P., Kilton Lodge, Rowben Close, Totteridge. Members of the Town Council:Alderman Mrs. C. M. Cave, 10, Wood Vale. N. 10. " F. E. Dale, 10, Etheldene Avenue. N. 10. " J. W. Rowlands, J.P., 25, Cholmeley Park. N.6 . " L. J. Valette, 80, Tottenham Lane. N.8. Councillor E. C. Castle, 32, Cholmeley Lodge, Highgate Hill.N.6. " Mrs. D.A.E. Cox, 98, Inderwick Road.N.8. " Mrs. K. M. Crump, 84, Wood Vale.N. 10. " D. V. Johnson, 54, Coolhurst Road.W.8. " W. E. Lark, 27, Avenue Road. N.8. " Miss E.C.McCullough, 20, Princes Avenue.N. 10. " IT. Muldoon, 22, Beech Drive.IT.2. " C. MacPhee, 76, Upper Tollington park.N.4. " R. F. T. Nottage, 16, Reds ton Road.N. 8. " G.W.F. Pallett, 28, Fordington Road.N.6. " Mrs. G. M. Roid, 60A, Shepherd's Hill.N.6. " F. Wilders, 12, Woodberry Crescent.N.10. " A. J. Young, "Wocdend", 48, Great North Road. N.6. Co-opted Members Miss J. C. Bolton, 20, Grand Avenue. N. 10. Rev. W.F.P.Chadwick, M.A., The Vicarage, Crescent Road. N.8. Rev. E.S. Duval, M.A., The Rectory, Hornsey.N.8. 28 Mrs. D. A. MacPh.ee, 76, Upper Tollington Park.N.4. Mr. J. W. Palmer, 30, Crescent Road.N.8. Rev. N. Turner-Smith, Park Chapel, Crouch End.N.8. Appointed Members County-Alderman F. Messer, 1.76, Wightman Road.N.8. County-Councillor W. H. Evans, 50, Clifton Road, Alexandra Park.N.22. Borough Education Officer R. E. Brettle, M. A., D. Phil, 29 STAFF OF SCHOOL MEDICAL SERVICES (December, 1945) School Medical Officer R. P. Garrow, M.D., D.P.H. Deputy School Medical Officer Marian Lones, B.Sc., M.B., B.S., M.B.C. S., L.R.C.P., D.P.H., D.O.M.S. Assistant School Medical Officer Margaret Robinson, M.B., Ch.B., D.T.M. & H. Jasmine Taylor, M.B., B. Ch., B.A.O., D.P.H. Dentists ... Winifred M. Hunt, L.D.S. Dorothy Young, L.D.S. Oculist Dr. Marian Lones Aurist F. P. M. Clarke, B.A., B.Sc., L.R.C.P., L.R.F.P.S. (Glas). Orthopaedic Surgeon J. A. Cholmeley, M.B., F.R.C.S. (Eng.) (Resident Medical Superintendent, Royal National Orthopaedic Hospital, Country Branch, Stanmore). Masseuse Mrs,. Yorke (Royal National Orthopaedic Hospital). Orthoptist Miss p. Montague-Smith Speech Thernpist Miss Dorey Educational Psychologist Miss M. Kent Nurses L. M. Oliver L. Hatton C. Martin Dental Attendants L. Bird J. Hughes Clerk H. M. Cavalier Assistant Clerk J. Porter 30 To the Chairman and Members of the Homsey Education Committee. Mr, Chairman, Ladies and Gentlemen, I have the honour to submit my Annual Report on the work of the Scho.l Medical Service for the year ending 31st December, 1945. The 31st March. 1945, marks the end of arrangements under the Education Act, 1921, and on 1st April, 1945, the Education Act, 1944, came into operation. So far as the Scho 1 Medical Services are concerned the work has been carried on in all its branches by the same staff. Scope of the Work. The medical service available to all children attending primary and secondary and grammar schools in the Borough includes- 1) Periodical Medical Inspection (ages 5, 8, 11 and 14 years):Medical inspection is carried out at entrance, age 8, age 11 and on leaving school. This periodical medical inspection which takes place in all the schools at morning and afternoon sessions, by previous arrangement with the Head Teachers, consists of a complete survey of each child. The School Nurse weighs and measures the child and tests vision in each eye. She also records the previous medical history of the child and its present state of cleanliness. The School Medical Officer examines the whole child - hands, feet, limbs, skin, hair, eyes, ears, nose, throat, teeth, heart, lungs, nutrition, posture and physique, noting anything that is abnormal. The parents get previous notice of this examination so that they are able to attend and ask any questions or raise any point in the health and physical or mental development of the child. The Head Teacher is also present (except when shortage of staff compels or to be otherwise engaged). Periodical medical inspection is, therefore, in my view, an important occasion on which Doctor, Head Teacher, School Nurse and Parent enter into consultation in the interests of the child. Views differ as to the value of periodical medical inspection. If done in a routine, humdrum, donkey-fashion, I agree that it is useless. If done by a team who arc keenly int rested in the development of normal children, it is a health scrvice of the highest importance with unique opportunities for influencing for good the wellbeing of the children not only in their school years, but also in later life. 2) Periodical Dental Inspection and Treatment:- Dental inspection of all the school children should be carried out every year. The present staff of two Dentists (who also undertake the treatment of children under 5 years of age) is not sufficient, and approval has already been given to the appointment of a third whole—time Dentist. A new Dental Clinic 31 in one of the outlying parts of the Borough will be required for this third Dental Officer. Nevertheless a s???eady improvement in the dental state of the children is taking place and the position over a period of 17 years has quite changed. In 1929 three part-time Dentists working 10 sessions per week extracted 5,574 teeth, mostly under general anaesthetics, which were administered to 1,690 children. In the same year they did 2,390 fillings. In 1930 a whole-time Dentist was appointed who worked 11 sessions weekly. She was assisted in 1938 by a half-time Dentist working 6 sessions weekly. From 1942 two whole-time Dentists have been employed. Extractions fell and fillings rose until in 1938 for the first time the latter exceeded the former. Subsequent progress was interrupted by the war and the evacuation of children, but, in spite of these conditions, conservative dental work has continued to exceed extractions. Ninety per cent of the extractions in 1945 were of temporary teeth and seventy per cent of the fillings were in permanent teeth. The importance to health, hygiene and good appearand and happiness of the development of a sound dental scheme for children cannot be exagger ted. More boys and girls are leaving school each year with sound sets of teeth. Better nutrition helps in maintaining sound teeth and sound teeth lead to better nutrition - a propitious circle of great importance in the establishment and maintenance of good health and physique. 3) Periodical Inspections by the School Nurses:- Inspection for cleanliness and the condition of boots and clothing is carried out by the School Nurses as early as possible in every school term and repeated as necessary to assist in maintaining a high standard of personal cleanliness. 4) Schemes of Treatment:- A complete scheme of treatment is available for all school children, Primary and Secondary, at the School Clinic and the Centres comprising:- (a) Treatment of Minor Ailments by School Nurses. (b) Medical Consultations as required or asked for by parents or teachers. (c) Dental Treatment. (d) Ophthalmic, including refraction, squint, diseases of the eyes or eyelids, orthoptic training. (e) Treatment of conditions of the Ear, Nose and Throat. (f) Orthopaedic Treatment. (g) Speech Therapy, including the treatment of stammering and defects of art culation. (h) Psychological Investigations and treatment of difficult children. 32 Immediate needs of tho School Medical Service. 1) Orthopaedic 2) Dental The School Clinic built in 1932, has been adequate to the needs of the service for sixteen years but extensions and developments of the work in the last year or too in orthoptics, speech-therapy and dentistry have rendered it too small to-day. Approval has been given to the building of an Orthopaedic Department adjacent to the Clinic and to the equipment of a Dental Clinic in an outlying part of the Borough. When these are provided and staffed, the service available will meet present needs. I have the honour to he, Ladies and Gentlemen, Your obedient servant, R. P. GARROW, School Medical Officer. 33 MINISTRY OF EDUCATION: Medical Inspection and Treatment Returns Year ended 31st December, 1945. BOROUGH OF HORNSEY TABLE I Medical Inspections of Pupils attending Maintained Primary and Secondary Schools. A. Routine Medical Inspections. 1. Number of Inspections. Entrants 2nd ago Group 3rd age Group Total Primary 1,117 1,345 374 2,834 Secondary - 1st January - 31st March 29 141 42 212 1st April - 51st December 205 153 72 430 2. Number of Other Routine Inspections (in Primary Schools) 13 Grand Total 3,489 B. Other Inspections. Number of Special Inspections and Re-inspections 1,888 TABLE II Classification of the Nutrition of Pupils Inspected during the year in the Routine Age Groups (Primary Schools only) Number of Pupils Inspected A B C D (???llent) (Normal) (Slightly subnormal) (Bad) 2,847 1,433 1,394 20 Nil (50.3%) (48.9%) (0.7%) TABLE III Group 1. Treatment of Minor Ailments (excluding uncleanliness). Total number treated 9,531 Group 2. Treatment of Defective Vision and Squint. Errors of Refraction 447 Other defects 14 461 34 Number of pupils for whom spectacles were (a) Proscribed 273 (b) Obtained 222 Group Z. Treatment of Defects of Nose and Throat. Received operative treatment Nil Received other forms of treatment 342 Total treated 342 TABLE IV Dental Inspection and Treatment 1. Number of pupils inspected by Dentist - (a) Routine age groups 3,878 (b) Specials Total 875 4,753 2, Number found to require treatment 4,036 3. Number treated 2,754 4, Attendances for treatment 4,500 5. Half-days devoted to - Inspections 47 Treatment 615 Total 662 6. Fillings - Permanent teeth 4,130 Temporary teeth 592 Total 4,722 7. Extractions - Permanent teeth 307 Temporary teeth 2,745 Total 3,052 8, Administrations of general anaesthetics for extractions 872 9. Other operations - Permanent teeth Temporary teeth 321 3,622 To tal 3,943 TABIE V Verminous Conditions 1. Average number of School Nurses visits 33 2, Total number of examinations of pupils by School Nurses 18,202 3. Number of individual pupils found unclean 86 35 TABLE VI Totally Blind and Totally Doaf Pupils NOT at present being Educated in a Special School At Primary or Secondary School At an Institution other than a Special School At no School or Institution Totally Blind Nil Nil 1 Totally Deaf Nil Nil Nil TABLE VII School Medical and Dental Staff Proportion of Time School Health Service Public Health School Medical Officer - E. P. Garrow 15/40 25/40 Assistant School Medical Officers - Marion. Lones 6/11 5/11 Margaret Robinson 2/11 9/11 Senior Dental Officer - Miss W. M. Hunt Both whole-time Other Dental Officers - Miss D. Young School Nursing Staff School Nurses (whole-time) 3 Dental Attendants „ 2 r -Uu- SCHOOL MEDICAL SERVICE ANNUAL REPORT - AURAL CLINIC, 1945. by Doctor F. P. M. Clarke, The usual weekly Session of the Ear, Hose and Throat Clinic has been carried on during 1945 as in previous years (including the war years). There was some disorganisation in the matter of attendances during the first half of the year, due to the V.1 and V.2 bombings which were heavy in this area. A number of children were evacuated and the attendances due on appointments were frequently interrupted by the raids, notwithstanding this, the total number of children who attended the Clinic and continued afterwards for the required treatment compares favourably with the numbers in previous (pre-war) normal years. The weekly Session of the Aural Clinic is held every Saturday morning and the required treatment is carried out on two Sessions a week at three convenient Centres in the Borough. This arrangement assures a much hotter attendance than if the treatment was carried out at one Centre only. It is convenient for the children and also for the schools and saves a good deal of school time. A certain number of the treatments which require special apparatus and special knowledge in their application, such as Zinc Ionisation, Proetz Displacement, Tonsil Suction, etc., are always done at the Chief "Treatment Clinic" at the Town Hall Centre. The treatments usually carried out at the auxiliary Centres are, diastolisation or intra-nasal massage for rhinitis and catarrh, suction treatment for acute otorrhoea, tonsil painting and the instillation of nasal antiseptic drops, etc. An increasing number of pre—school children is now being seen at the Clinic, including infants and welfare centre children. This inclusion of children (and infants) of the pro-school age group in the schema for ear, nose and throat examination and treatment is a very important raid desirable advance in the cause of preventive medicine. Many conditions such as rhinitis, acute otitis, deafness, nasal obstructions, etc. occur at this ago v/hich, if taken in time, can be quickly and satisfactorily resolved, but if overlooked or neglected c, n become chronic and present a much more difficult problem by the time the child reaches his school inspection age. During the last three years we have found aural suction a most valuable method in the complete and rapid cure of the great majority of cases of acute otorrhoea (running oars). The treatment is carried out at the Clinic daily by means of the Fowler ear suction tube and most cases heal up within a week or ten days. This method is used in conjunction with the instillation of a 10% solution of Albucid (Schering) into the ear once a day. The French (Gautier) method of intra-nasal massage, with the special Gautier diastolisation bougies which has proved so successful in previous years, has been largely employed for such conditions as "catarrh", rhinitis, nasal obstructions of non-organic origin, mouth breathing etc. The results have been very satisfactory. 37 The number of children, seen now at the Clinic with chronic otorrhoea is very small - only seventeen c ses in all were seen during the year. This is in marked contrast to the findings of some years age when the great majority of ear cases then seen at a clinic were suffering from chronic otorrhoca. Two factors have in the main been responsible for this welcome improvement, 1) early detection and treatment of acute otorrhoea and nasal conditions predisposing to car suppuration, and 2) treatment of chronic otorrhoea by the Friel method of zinc ionisation. The subject of the treatment of "enlarged tonsils" is one that always engages attention. It is still a subject of debate - "Tonsils: In or Out?" We adopt a conservative' line towards removal. Hypertrophy, "enlargement" (unless gross) in itself is not a clinical indication for removal. We have treated a large number of children during the last six years by onservative methods, such as tonsil suction with suitable antiseptic, tonsil painting with attention to any nasal defects present, especially sinusitis and we are satisfied that this procedure is preferable to "hit or miss" method of mass removal, A certain number of children have had tonsillectomy performed before they attended the Clinic, privately, and we have found amongst many of these the most intractable cases of sinusitis. The condition of sinusitis in children is one that demands special attention. It is much commoner than is supposed and sinusitis can be present without showing much, if any, "external" signs. This can be easily demonstrated by the us of Proetz sinus "displacement". We find the "displacement" method of the greatest value in sinus infections and during the ye r we have been using in displacement a 10% solution of Albucid (Schering) after the usual ephedrine. The results arc remarkably good, A summary of the statistics of the Ear, Nose and Throat work is appended:- Total number of children seen at the Aural Clinic during 1945 360 School children 253 Pre-school children 76 Ear casus - School - acute 38 chronic 17 Pre-school - chronic 25 Hose and throat cases - School 167 Pre-school 51 Miscellaneous cases 31 Number of cases treated by - Ionisation 14 Diastolisation 106 Proetz Displacement 20 Tonsil (conservative) 50 38 ANNUAL REPORT OF THE ORGANISERS OF PPIYSICliL EDUCATION FOE THE ELIDED 31st MARCH, 1946. The year under review should be regarded as having been a year of planning for the future rather than one of specific achievement. The reliefs brought about by the end of hostilities were not reflected in improved conditions in the schools from any point of view. In fact many of the difficulties wore increased. During the war years there was a marked deterioration in all the conditions and facilities required for Physical Education. Frequent staff changes together with a fluctuating school population inevitably resulted in a general lowering of the standard of work in the schools. From the date of the first evacuation there was little stability in tilings pertaining to physical education. The drop in the intake of new staff, in addition to young men entering the forces, deprived the Authority of the services of many able teachers, and, one by one, the facilities provided for physical Education suffered. The Organisers would like to place on record however, that there was the utmost co-operation in the schools in endeavouring to overcome the difficulties experienced. The Heads were most accommodating in regard to time-table and staffing arrangements, and the teachers were persistent in their efforts to maintain a reasonable standard of efficiency. In particular, the older teachers, untrained in modern methods of physical education, are to be congratulated on their efforts. Equipment. In some cases successful efforts were made to improvise footwear, clothing and apparatus. The importance to the child of being properly clad for physical activities cannot be over-emphasised. A1though it will doubtless be some time before all children will have shorts and vests, for physical training it is encouraging to note that supplies of rubber shoes are increasing. The Organisers appreciate the Committee's recent purchase of 2,000 pairs of plimsolls. Good use is bein, made of some of the black-out material by converting it into shorts. The ucahcers aro to bo commended for undertaking this additional work. Although the annual allocation of new apparatus was small some items were more generously distributed this year. The chief need is in respect of all types of balls particularly in the Primary Departments. Swimming. The Organisers have always boen concerned that large numbers of school children in the Borough could not be offered facilities for learning to swim. Upon the cessation of hostilities, plans were made which it was hoped would eventually result in swimming being regarded as a class subject for all who were physically fit. In the first place, as a now venture, arrangements wore made for swimming to be continued throughout the winter, and the response from schools was regarded as being most encouraging for the first season. 39 In order to ensure that every child should be given the opportunity of learning to swim during school life, it was envisaged . that the present inadequate facilities in the Borough would demand a scheme limiting instruction to certain age groups. The appointment of a Swimming teacher, together with transport facilities to and from the schools, were necessary for the fall implementation o.f the Scheme. The Committee authorised this now venture, and it is hoped that good results will he quickly observed. The need for an additional instruction Bath in the Borough is urgent. It is still necessary to secure extra accommodation at Finchley, Islington and Wood Green as in the past. The scheme as outlined ill only develop swimming in Hornsey in a very limited degree until another bath is available. Playing Fields. The Organisers are pleased to report that there has been a resumption of Organised games at the playing fields on a pre-war scale. Requests for allocation of times were made by Youth Organisations and Grammar Schols in addition to Modern and Primary schools, it was not possible to meet the demands. This situation will persist until additional playing field acreage is secured. The wear and tear upon the fields is too great and it is feared that the grass will deteriorate rapidly, particularly in view of the limited attention the fields have rec ived during the war years. Under present conditions some fields are used more than others. The prevision of transport to and from schools would lead to more even use in addition to enabling Heads to plan their time-tables more economically. At present there are approximately 30 acres in Hornsey available to the schools. It must be pointed out that this does not permit of organised games lessons for all school children for whom provision should be made, A survey of the Borough shows that additional playing fields space cannot be acquired and it may be necessary to consider the purchase or hire of additional grounds outside the Borough, or even outside the County areas as in the cases of Stationers and Hornsey County Playing Fields. This suggestion mi.ht apply particularly to grounds for the use of Youth Organisations, and thus relieve pressure on the school grounds. Greater stress should bo laid on the training in hygiene and general health matters in connection with the games lesson. The Organisers, therefore, would strongly urge that, as so, n s conditions permit, consideration should be given to the provision of suitable changing and washing accommodation on all fields. Improved storage facilities for both games apparatus and groundsmen's equipment should also be planned. Sport3 Meetings. In reviewing the war period the Organisers wish to congratulate the schools upon their tenacity and courage in the matter of Sports Meetings. Not only have they continued their annur.l meetings throughout a difficult period, but they have also accepted and developed a new Athletics Scheme which is already ensuring a better all—round training for a greater proportion of children. This has been achieved in spite of a shortage of experienced staff. Inter-School Matches. There has been a resumption of inter-school matches, and it is hoped that 40 experience in matches will help to raise the general standard of play. Teachers' Courses. Preliminary arrangements were made to hold a two-day Course in Physical Education for all teachers in the Borough. It was a matter of great disappointment that permission to close the schools for two days was not granted by the County Authority. Consequently plans for the Course were abandoned. The chief aim of the Course was to give all teachers an opportunity to observe progression in the various aspects of physical education from infant to secondary work. The Course was designed for propaganda purposes and to serve as a general stimulus to all teachers. Specialist courses in particular branches would have followed. The disappointment upon the cancellation of the Course was particularly felt by Heads who realised the need for such stimulus. Staffing, Organisers would urge that when future appointments to Secondary Modern Schools are mc.de, consideration should be given to the need for Specialist Teachers of Physical Education in these schools. The Organisers welcome the men demobilised from the Forces and look forward to the return of the remainder in 1946. Recreative Work. It is encouraging to note that there has been an increase in the number of evening classes during the season, although in some cases they have not been consistently well attended. There will doubtless be a marked improvement in recreative work as conditions in general become more settled and when an additional number of qualified leaders are available, J. B. MOH. FLORENCE E. BIRKBY. Organisers of Physical Education. 41