LIBRARY . HoR 38 BOROUGH OF HORNSEY ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for 1946 R. P. GARROW, m.d., d.p.h. HEALTH COMMITTEE (as st 31st December, 1946) Councillor J. L. R. Webb (Chairman) The Mayor, Aldermen L. J. Valette, J.P. Alderman F. H. Bailey ,, S. G. Goulding ,, Miss E. C. McCullough ,, J. W. Rowlands, J. P. ,, J. W. Shipp ,, W. V. Wall, J.P., ,, C. Winkley Councillor Miss O. R. Anderson ,, L. W. Anderson ,, M. W. Burns ,, J. P. Clarkson ,, Mrs. N. C. Clegg ,, W.J. M. Croslsnd ,, N. Muldoon ,, G. W. F. Psllett ,, Mrs. G. M. Reid ,, Mrs. R. A. Smythe 1 STAFF OF PUBLIC HEALTH DEPARTMENT (as at 31st December, l946) Medical Officer of Health and School Medical Officer Deputy Medical Officer of Health and Assistant School Medical Officer Assistant Medical Officer of Health and Assistant School Medical Officer Assistant Medical Officer of Health and Assistant School Medical Officer Veterinary Inspector Senior Sanitary Inspector, Petroleum Inspector, Shops Acts Inspector Sanitary Inspectors and Shops Acts 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., D.O.M.S. Margaret Robinson, M.B., Ch.B., D.T.M. & H„ J. A. Montgomery, M.D. F. G. Buxton, M.R.C.V.S. J. H. Jesse, M.S.I.A., Cert. R.San.I., Cert.Insp. of Meat & Foods J. D. Chance, M.S.I.A., Cert. R.San.I., Cert. Insp. of Meet and Foods. E. Hundy, M.S.I.A., Cernt. R.San.I., Cent. Insp. of Meat and Foods, Cert. San. Science . R. Downes, M. S. I.A., Cent. R. San.I. J. Calderbank, M.S.I.A., M.K.San.I., Cent. R.San.I. & S.I.E. Joint Board, Cent. Insp. of Meat and Foods. W. J. Wilson, M.S.I.A., Cert. R.San.I., Cent. Insp. of Meat and Foods. II. Smith, U.S. I.A., Cent. R.San.I., Cent. Insp. of Meat and Foods. 2 L Chief Clerk E. Cheesman Assistant Clerks W. A. Simons T. Hadley (On Military Service Miss E. A. Smith Miss S. P. Nunn Miss M. Chesterman Miss D. M. Sellman Miss M. Humphreys Miss M. S. Arnell Rodent Operator E. Mead Disinfectors and Mortuary W. H. Lewis Attendants P. F. Hall Medical Services Motor Driver P. Martin To the Mayor, Aldermen and Councillors of the Borough of Hornsey. Mr. Mayor, Ladies and Gentlemen, I have the honour to submit my Annuel Report on the Health Services of the Borough for the year ending 31st December, 1946. The vital statistics arc the best ever experienced in the Borough. Deaths numbered 1,112 giving a death rate of 11.95 per 1,000 of population compared with - 13.25 in 1945 14.c4 in 1944 14.48 in 1943 14.13 in 1942 13.95 in 1941 15.16 in 1940 11.16 in 1939 11.26 in 1938 The death rate has thus returned l most to its pre-war level. The live births numbered 2,008 which is the largest number born in one year, and the infent mortality rate was the lowest ever recorded, namely, 26.89 per 1,000 live births as gainst 27.25, the previous lowest figure in 1939. Two materna1 deaths give a maternal mortality rate under 1. For the fifth year in succession there has been no death from Diphtheria and the number of deaths from all the infectious diseases together has been negligible, namely, 0.085 per 1,000 of population. The deaths from Tuberculosis in -1.1 its forms totalled 42 which is the lowest ever recorded in one year. These figures compere favourably with those of countries and cities often quoted as models in matters of health administration, e.g. Oslo, Holland, New Zeal nd and certain cities of Canada and America. They do not reflect the awful plight in which this country is believed to be in by the outside world and by a section of its own population. They do reflect the high standard of nutrition rnd health and happiness in the 23,334 homes which accommodate the population - standards which arc also apparent in the Council's Welfare Centres, Day Nurseries, Schools and Maternity Home. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, R. P. GARROW, / Medical Officer of Health. 4 STATISTICS FOR 1946 SOCIAL AND ECONOMIC STATISTICS Area (acres) 2,872 " (square miles) 4.49 Population (Census 1931) ' 95,524 Do., Registrar-General's estimate, 1946 93,050 Number of separately-assessed inhabited premises (end of 1946), according to Rate Bocks 23,334 Rateable value (General Rote) at 31st December, 1946 £1,070,117 Product of a penny rate £4,280 LIVE BIRTHS M. F. Total Legitimate 997 889 1,886 Illegitimate 65 57 122 1,062 946 2,008 Birth Rate - 21.58 (ner 1,000 population) STILL -BIRTHS M. F. Total Legitimate 24 19 43 Illegitimate 3 3 24 22 46 Still-Birth Rate - 22.4 (per 1,000 total live and still-births) DELATHS Males 510 Fema1es 602 1.112 Death Rote - 11.95 (per 1,000 population) INFANT DEATHS (under 1 year of age) M. F. Total Legitimate 29 19 48 Illegitimate 4 2 6 33 21 54 DEATH RATE OF INFANTS UNDER 1 YEAR OF AGE All infants per 1,000 live births 26.89 Legitimate infants per 1,000 legitimate live births 85.4 Illegitimate infants per 1,000 illegitimate live births 49.2 5 MATERNAL MORTALITY Hate per 1,000 total (live and still) Deaths births Puerperal and cost-abortive sepsis 1 0.48 Other maternal causes. 1 0.48 2 DEATHS FROM SPECIAL CAUSES Deaths from Cancer (all ages) 209 Deaths from Measles (all ages) 1 Deaths from Whooping Cough (all ages) 0 Deaths from Diarrhoea (under 2 years of age) 6 STATISTICS FOR COUNTRY AS A WHOLE England & Weles 126 C.B's. & Great Towns including Lender. 140 Smaller Towns Resident Pop. 25,000 - 50.000 London Adm. County *Live births 19.1 22.2 21.3 21.5 *Still births 0.53 0.67 0.59 0.54 *Deaths (all causes) 11.5 12.7 11.7 12.7 Ø Deaths under 1 year 43 .0 46.0 37.0 41.0 *Rate per 1,000 Cnvilian Population ØRate per 1,000 live births GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA HOSPITAL SERVICE Genera1 hospitals Persons requiring in-patient or out-palient treatment at general hospitals have available the services provided by the North Middlesex County Hospital, which is maintained by the Middlesex County Council and of numerous voluntary hospitals situated in London. Infectious diseases. Admitted to the Hornsey Finchley, Wood Green and Friern Barnet Joint Isolation Hospital, Muswell Hill.N.10. Cases of puerperal pyrexia and ophthalmia neonatorum are admitted to Isolation Hospitals maintained by the London County Council where specialist treatment is available. Tuberculosis. Cases admitted mainly to hospitals and sanatoria maintained by the Middlesex County Council. A number of persons are also admitted to hospitals and sanatoria maintained by voluntary organisations. Maternity. Mothers have the choice of the Alexancra Maternity Home provided by the Council, the Maternity Wing of the North Middlesex County Hospital, numerous voluntary hospitals in London or of private nursing homes. LABORATORY SERVICES as from the 28th January pathological specimens which were formerly examined at the Laboratory situated in the Joint Isolation Hospital,. were forwarded for examination to the Central Public Health Laboratory at Hendon which was established by the Medical Research Council on behalf of the Ministry of Health. The assistsnce of the technical staff attached to the Laboratory is also available in connection with outbreaks of infectious diseases 7 at Day Nurseries and this assistance is of extreme value in controlling the spread of infection. Details of specimens examined at the Central Public Health Laboratory are as follows:— Throat & Nose Swabs Diphtheria bacilli 4 Haemolytic streptococci 124 Vincents angina. 15 Negative 211 354 Faeces Shigella 56 Salmonella --- Protozoa 1 Negative 366 423 Sputum Tuberculosis smear 5 Other organisms 4 Negative 56 65 Pertussis Cough plates --- Postnasal swabs 7 Negative 173 180 Milk Water --- Miscellaneous 26 26 1,048 « 8 AMBULANCE SERVICE Infectious Diseases . Cases of infectious disease are convoyed from their homes to the Joint Isolation Hospital by the London County Council Ambulance Service, an arrangament which has given complete satisfaction for many years. General. Medical, surgical and accident cases re conveyed by the Joint Ambulance Service (Hornsey, Finchley, Wood Green and Friern Barnet) with Headquarters at O k L no off the Great North Road at East Finchley. As speed is an important factor in the removal of casualties, a report is made to the Health Committee each month of the time taker between the. c 1 for the ambulance and its arrival at the seenc of the accident. The very sma11 average time occupied on these journeys is a testimony to the alertness and efficiency of this Service. I desire also to acknowledge the skill nd care with which the ambulance personnel handle their patients and minister to their comfort until they arrive at hospita1. The following cases were removed in Hornsey by the Joint Ambulence Service:- Accidents - 290 Other cases - 2.060 2,350 SANITARY CIRCUMSTANCES OF THE WATER SUPPLY The water supply for Hornsey is provided by the Metropolitan Water Board. During 1946 the supply has been satisfactory in quality and quantity. 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 Themes 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. All new and repaired mains are chlorinated before being restored to use and samples of water from them are tested bacteriologicallv to ensure efficient disinfection. Result s of Boctcriclogical Tests No. of samples Colony Count On Ager at 37° % of Semples negative 100 nil Bact. coli per 100 ml. River Themes (Kempton Park) 819 17.4 99.0 .016 Hew River (Stoke Newington) 318 8.6 98.1 .031 10 i SANITARY INSPECTIONS The following statement of the work of the Sanitary Inspectors has been prepared by Mr. J. H. Jesse, Chief Sanitary Inspector. Complaints 2,761 Re-inspections 5,345 Information from Builder 466 Special Inspections 565 Drainage 235 Water Tests applied (new drains) 37 Smoke and Chemical Tests (old drains) 52 Tests applied on payment of a prescribed fee 1 Verminous conditions 67 Overcrowding surveys 23 Overcrowding re-inspections 1 Surveys (Permitted Number) 2 Re-surveys (Permitted Number) 11 Memorandum from Borough Engineer & Surveyor 16 Notifiable Infectious Diseases 221 Scabies 27 Smallpox Contacts 126 Public Health (Aircraft) regulations, 1938 45 Shops Acts Inspections 80 Shops Acts Re-inspections 4 Sunday Trading Inspections 297 Butchers' Shops 5 Milkshops 6 Grocers' Shops 3 Bakehouses 12 Fish Shops 1 Restaurant Kitchens 10 Greengrocers' Shops 3 Ice Cream Premises 71 Other food shops Food Inspections - 296 Factories 166 Outworkers 4 Offices 34 Cinemas 1 Music end Dancing Licences 15 Stables 4 Passages 4 Petroleum Stores 112 Registration of Hawkers 5 Building Licences 8,696 Certificate of Essential Repairs 636 Landlord & Tenant (War D mage) Amendment Act, 1941 9 Rets & Mice (Destruction) Act, 1919 343 Rats Treatment of Sewers 11 Fuel Enforcement 18 Rent Restrictions Acts 6 20,855 —4 NOTICES The Notices served during the year are as follows:- Verbal Preliminary Statutory Public Health and Housing Acts 289 1,491 139 Housing Byelaws - 32 1 Shops Acts 1 2 - Factory Act 1 8 - 291 1,533 140 SUMMARY OF SANITARY IMPROVEMENTS CARRIED OUT DRAINAGE Number of houses and premises redrained 4 Repairs or amendments to existing drains 64 Drains or gullies unstopped or cleansed 125 Manholes provided 29 Manholes repaired 38 Intercepting traps fixed 4 New gulley traps fixed 38 New soil pipes and ventilating, shafts fixed 16 Soil pipes and ventilating shafts repaired 33 WATER-CLOSETS AND SANITARY FITTINGS New water-closet buildings 7 New water-closet basins fixed 49 Water-closets unstopped, cleansed or repaired 67 Few sinks provided 16 Few lavatory basins provided 15 Waste-pipes trapped, repaired or unstopped 75 Waste-pipes diverted into proper drain 3 Baths provided or made usable 6 MISCELLANEOUS Roofs repaired 355 Eaves guttering renewed, cleansed or repaired 194 Rain-water pipes provied, repaired 101 Damp walls remedied 148 Damp-proof courses inserted 20 Paving of yards repaired 37 Rooms cleansed, distempered or papered 159 Premises disinfested of vermin 23 Drinking-water cisterns repaired, cleansed and covered 54 Water supply pipes repaired 35 Water supply (additional) provided 1 Windows and skylights provided or made usable 74 Sub-floor ventilation 54 Flours repaired 147 Walls and ceilings repaired 316 Windowsills repaired 62 Sashcords and fittings repaired 67 Sanitary dustbins provided 34 Accumulations of manure and refuse removed 8 Stoves, ranges and coppers repaired or renewed 125 Food Stores provided 1 Sundry items 111 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 Eleven houses have been des1t with under these Byelaws during the year and the following work carried out Byelaws 4 (a) Closet accommodation 1 4 (b) Water supply 3 4 (d) Food stores 3 5 (a) Repairs to drains 2 5 (b) Means of carrying off waste water 3 5 (g) Staircase repairs 2 5 (h) Handrails provided 2 8 Stairs lighted 1 Complied Notices with Sanitary accommodation 1 1 HOUSING STATISTICS 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) 2,640 (b) Number of inspections made for the purpose 4,780 (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 preceding sub-head) found not to be in all respects reasonably fit for human habitation 1,539 13 2. Remedy of Defects during the Year withovt service of farmal Notices Number of defective dwelling-houses rendered fit in consequence of informal action "by the Local Authority or their Officers 503 3 Action under Statutory Powers during the Year:- A - Proceedings under Sections 17, 18 and 23 of the Housing Act , 1930:- (1) Number of dwelling-houses in respect of which notices were served requiring repairs 3 (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:- (l) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 13 5 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:- (a) by owners 98 (b) by Loca1 Authority in default of owners --- C - Proceedings under Sections 19 and 21 of the Housing Act, 1930 (1) Number of dwelling-houses in respect of which Demolition Orders were made --- (2) Number of dwelling-houses demolished in pursuance of Demolition Orders --- D - Proceedin as under Section 20 of the Housing Act, 1930:- (1) Number of separate tenements or underground rooms in repsect of which Closing Orders were 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 --- 14 4. Overcrowding Twenty-two now cases of evercrowding have been reported during the year, involving thirty-four families and 127 persons. In three cases inspections were made at the request of other Local Authorities in connection with re-housing. INSPECTION AND SUPERVISION OF FOOD lbs ozs. lbs. OZS . Tinned Milk 640 6 Fish 2,874 10 Tinned Fish 250 13 Meat 557 0 Tinned Vegetables 465 3 Bacon 16 8 Tinned Meat 779 4 Cheese 1 8 Tinned Soup 80 14 Suet 7 0 Tinned Jam 62 8 Sausages 24 Tinned Marma1ade 31 8 Offal 91 8 Tinned Margarine 9 0 Smoked Fish 312 0 Tinned Fruit 165 7 Rabbits 60 0 Tinned Puddings 4 12 Jam 15 0 Tinned Cheese 74 0 Marmalade 9 0 Bread 736 0 Golden Syrup 2 0 Tea 11 0 Sweet 49 4 Sugar 156 0 Pickles 1 10 Cereals 43 4 Oranges 525 0 Biscuits 11 5 Dehydrated Meat Cubes 25 0 Dried Milk 137 6 Bottled Fruit 1 8 Dried Fruit 28 0 Eggs 297 Total Food Condemned - 8,309 lbs. 2 ozs. RODENT CONTRCL During the twelve months ending 31st December, 1246, the following work was carried cut under the Rats and Mice (Destruction) Act, 1919:- Visits by the Sanitary Inspectors Visits by the Rodent Operator Premises disinfected for Rats Premises disinfested for Mice No evidence of infestation Disinfestation in hand - Rats Disinfestation in hand - Mice 343 3,341 166 44 11 147 56 Rat CANPATIGN - SPECIAL ACHEME 1946/47 The Health Committee at their meeting in June considered the Ministry of Food Circular N.S.No.12. and recommended that a scheme on the terms and conditions laid down in the circular be prepared and submitted to the Ministry for approval. 15 A comprehensive scheme covaring the Borough and providing for visits to every dwelling-house and to all business premises was prepared and approval was received from the Ministry on the 21st July. Operations were commenced on the 9th September in the Finsbury Park and Stroud Green wards. Regular sewer maintenance treatments were carried out during the year to comply with the requirements of the Ministry of Food Circular N.S.No.ll. CIEaNSING STATIONS PHRSONS TRBATED HORITSEY OTHER DISTRICTS Other verminous Scabies conditions Woman & Children Pear Tree Cottage rëar of the Town Hall 296 114 162 6 578 Men & Youths Contral Depot, High Street.N.8. 49 2 30 1 82 INFECTIOUS DISEASES DIPHTERIA IMMUNISATION Regular sessions for this purpose are held at the Welfare Centres and the parents of children attending the Day Nurseries are also encoureged to allow their children to he immunised. l) Immunisetion during 1946 - Other verminous Scebies conditions Total Number of Children who completed & full course of Immunisation Age at 31.12.46. i.e . born in year Under 1 1946 1 1945 2 1944 3 1943 4 1942 5-9 1937 - 1941 10-14 1932 - 1936 Total under 15 Number immunised 22 727 217 66 40 85 32 1,189 16 2) Diphtheria Notifications and Deaths in relation to Immunisation NOTIFICATIONS DEATHS Age at date of notification No. of cases notified No. of cases in preceding column in which children had completed full course of immunisation Under 1 0 0 1 2 2 2 1 0 3 0 0 NIL 4 1 0 5-9 1 1 10-14 4 2 TOTALS 9 5 INFECTIOUS DISEASES NOTIFIED Scarlet Fever 138 Diphtheria 18 Pneumonia. 56 Erysipelas 22 Puerperal pyrexia 23 Ophthalmia Neonatorum 3 Cerebro-spinal Meningitis 10 Dysentery 21 Measles 497 Whoopinr Cough 167 Malaria (centreted abroad) 3 Folio-myelitis 2 965 Admitted to Joint Isolation Hospital 200 Admitted to other hospitals 35 Nursed at home 730 965 17 VACCINAION The Public Vaccinators inform me that they performed vaccination of persons in the Borough during 1946 as follows:- Doctor E. Buckler 304 Doctor R. Mackay and Doctor A. Dickie 686 OPHTHALMIA NEOMATORUM Domiciliary Institutional confinements confinements Cases notified 4 4 Cases removed to hospita1 1 Cases in which vision was unimpaired 8 TUBERCULOSIS The total number of cases on the Tuberculosis Register at the end of 1946 was 1,234, viz., pulmonary 979, non-pulmonary 255, an increase of 69 on the total for last year. • Accoimocdation for Tuberculosis cases in the County of Middlesex as at 31rt December as follows- Institution Adults Children Type of Case M F Harefield County 184 184 66 Pulmonary-Sanatorium Hospital 4 4 10 ,, Observation Clara Hall County 242 230 34 ,, -Sanatorium Hospita1 26 28 -- ,, -Hospital Danesbury Manor, Welwyn --- 55 -- ,, -Convalescent Grim's Dyke, Harrow Weald 50 --- -- -Re- ,, habilitation Ashford County Hospital 28 28 -- ,, -Hospital Central Middlesex County Hospital 34 25 -- -Hospital Chase Farm Hospital North Middlesex 18 18 -- ,, Hospital County Hospital Redhill County 13 12 -- ,, -Hospital Hospital West Middlesex 40 40 — — ,, -Hospital County Hospital 45 43 -- ,, -Hospital 18 Of the beds shown above, the following were not available for use owing to shortage of nursing and domestic staff Harefield County Hospital - 53 male 53 female 26 children Clare Hall County Hospital - 95 male 36 female 18 children Redhilld County Hospital - 16 male 14 female West Middlesex County Hospital - 24 male DEATHS STATISTICS Cerebro-spinal Fever 1 Tuberculosis of respiratory system 38 Other forms of tuberculosis 4 Syphilitic disease 8 Influenza 12 Measles 1 Cancer 209 Diabetes 8 Intra-cranial vascular lesions 119 Heart disease 282 Other diseases of circulatory system 70 Bronchitis 62 Pneumonia 63 Other respiratory diseases 10 Ulcer of stomach or duodenum 10 Diarrhoea under 2 years 6 Appendicitis 4 Other digestive diseases 29 Nephritis 22 Puerperal and post abortive sepsis 1 Other maternal causes 1 Premature birth 18 Congenital malformations, birth injuries, etc. 24 Suicide Road traffic accidents 7 Other violent causes 21 All other causes 77 1,112 MORTUARY Ninety one bodies were received at the mortuary, DISEASES OF ANIMALS ACTS Mr. F. 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 1946 as follows:- Total number of Licences issued under the Contagious Diseases of Animals Acts 0 Inspections made under the Contagious Diseases of Animals Acts 6 (Pigs 96) No action was necessary under the Tuberculosis Order, 1925. 19 INFANTILE DEATHS 1946 Sex Under 1 day 1 day & under 1 week 1 wks 2 wks. 3 wks. Total under & wks 1-2 mns. 3-5 mns. 6-8 mns. 9-11 mns. Total under 1 year Bronchitis M . . . . . . 1 . . . 1 F . . . Pneumonia. M . . . 1 1 2 1 1 1 . 5 F . . . . . . 1 1 . . 2 Diarrhoea & Enteratis M . . . . 1 1 3 . . . 4 F . . . . 1 1 1 . . . 2 Congenital Malformations M . 6 . 1 1 8 . . . . 8 F . 1 1 . . 4 . . . . 4 Premature Birth M 1 7 1 . . . . . . . 9 F 4 3 . . 1 8 1 . . . 9 Injury at Birth M 1 2 . . . 3 . . . . 3 F . 1 . . . 1 . . . . 1 Other diseases peouliar to the fiest year of life M . 3 . . . 2 . . . . 2 F 1 1 1 . 3 . . . . 3 11 other causes M . . . . . . . 1 . . 1 F . . . . . . . . . . . M 2 17 1 2 3 25 5 2 1 . 33 f 7 6 2 • 2 17 3 1 . . 21 20 ANNUAL REPORT ON MATERNITY AND CHILD WELFARE SERVICES 19 4 6 MATERNITY & CHILD WELFARE COMMITTEE (as at 31st December, 1946 Aldermen Mrs. C. M. Cave (Chairman) The Mayor, Alderman L.J. Valette, J.P Alderman S. G. Goulding ,, Miss E. C. McCullough ,, J. W. Rowlands, J.P. ,, J. W. Shipp ,, W. V. Wall, J.P. Councillor Miss O. Anderson ,, M. W, Burns ,, Mrs . N.C. Clegg ,, W. J. M. Crosland ,, Mrs. K. M. Crump ,, N. Muldoon ,, G. F. N. Nor man ,, G. W. F. Pallett ,, Mrs. G M. Reid ,, Mrs. R. A. Smythe ,, J. L. R. Webb ,, A. J. Young Co -opted Members Mrs. G. Bradfield Mrs. M. King Mrs. E. Jones Miss B. I. Smith Mrs. M. A. Vautier Mrs. G. Webb 21 MATERNITY AND CHILD WELFARE SECTION +Obstetric Surgeon J.R.Harris, O.B.E., M.A., M.B., B.Ch., M.R.C.S., L.R.C.P. +Assistant Obstetric Surgeon G.D.S.Briggs, M.R.C.S., L.R.C.P. D.R.C.O.G. +Dental Surgeon H. A. Crecke, L.D.S. Health Visitors 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 Visitor and School Nurse) Mis E. Whimster, H.V.Cert. , S.R.N., S.C.M. Miss W. Melhuish, H.V.Cert., S.R.N., S.C.M. Miss E. N. Gibbon, H.V.Cert., S.R.N., S.C.M. Miss H. M. Hird, H.V.Cert., S.C.M. Mrs. A. Jimack, H.V.Cert., S.R.N., S.C.M. (temp.) Clerks Miss H. Croak Miss P. Hill Midwives Miss M. Andrews, S.C.M. Miss A.C.Matthews, S.C.M. Miss R. Jones, S.R.N., S.C.M. Miss A. Spear, S.R.N., S.C.M. Miss A. Smith, S.R.N., S.C.M. +Mrs. M. Jamison, S.C.M. Alexandra Maternity Home Matron Miss E. Howell, S.R.N., S.C.M. Sister Miss E. Ball, S.R.N., S.C.M. Home Helps Service Organiser Mrs. H. M. Inward Assistant Organiser Mrs. J. Brooklyn 22 Day Nurseries Matrons - Ladywell Red Gables Clemence House Vincent House Stonecroft Kiss I. Stewart Mrs. M. Ryder, S.R.N. Mrs. A. Bawcomb, S.R.N. Miss M. Baker Miss W. Brindle, S.R.N. + Part-time Officers 23 To the Chairman and Members of the Maternity and Child Welfare Committee. Madam Chairman, Ladies and Gentlemen, The following pages give figures relating to the work of the Welfare Centres, Health Visitors, Domiciliary Midwives, Alexandra Maternity Home, Day Nurseries and the Home Helps Service. These institutions and services together provide an ever expanding system of social medicine, the value of which is being more and more appreciated by the public, about 80 to 90 per cent of whom make use of one or other of them. In 1946 the attendances of expectant mothers at Ante-nata1 Clinics were 10,415 as compared with 2,283 in 1938. Infants and children under 5 years of age made 32,934 attendances in 1946 in comparison with 18,911 in 1938. The other services have expanded in the same proportion. The increased work is partly explained by the exceptionally high birth rate now prevailing (2,008 births in 1946 as compared with 1,200 in pre-war years) and. partly by a greater proportion of the population making use of the services; but it must also be borne in mind that additional duties now fall on the Clinic staffs on account of rationing of food, clothes, etc. There is the distribution of . National Dried Milk, Orange Juice and Cod Liver Oil for the Ministry of Food. There arc certificates to furnish to expectant mothers for extra rations, shots and furniture; Family Allowance certificates and forms to fill up in connection with lost Ration Books are other items which add to the clerical duties of the staff. The telephone has become a much more popular means of communication with the Centres. For various reasons, therefore, there has been steadily increasing pressure of work at the Centres and this is likely to go on increasing as the facilities improve in quality and expand in scope. For example, the Fortis Green Welfare Centre, opened less than two years ago, is doing double the work which could be done at the smaller and less conveniently situated Coldfall Welfare Centre which it replaced. New Welfare Centres are about to be opened at The Campsbourne and at Stroud Green Road which it is hoped will relieve pressure at the Town Hall Centre and at Burgoyne Hall Centre. Consideration is being given to the appointment of part-time clerica1 assistance at the Centres to relieve the Health Visitors for their proper function of giving health advice. I desire to acknowledge the great value of the contribution which 24 the Voluntary Workers at the Welfare Centres are making, some of them faithful and regular attenders for many years without their help it would be quite impossible for the Centre,. to cope with the volume of work now being carried out. I have the honour to be, Madam Chairman, Ladies and Gentlemen, Your obedient servant, R. P. GARROW , Medical Officer of Health. THE MIDWIFERY SERVICE OF THE BOROUGH Alexandra Maternity Home Domiciliary Midwifery Service Ante-nata1 Post-natal Clinic Service The Alexandr Maternity Home, Muswell Hill.N.10. was acquired and opened in 1943. The first extension of the Home, to provide twelve additional maternity beds, together with labour rooms, nursery, etc., was completed by the Borough Engineer & Surveyor en the 31st December, 1946 and opened for the reception of patients on the 1st Jonuary, 1947. The new wing is at present a one storey brick building with flat roof on the Alexandra Park Read frontage. In foundations and structure, it is capable of taking first and second floors as may be demanded by the needs of the future. The accommodation new available at the Maternity Home comprsrs 25 lying-in beds, divided into small wards of 3, 4, 5 and 7 beds, and 6 single-bed rooms, together with three labour wares, two infant nurseries and all the necessary ancillary services (bathrooms, sluice rooms, store rooms, sterilising rooms, milk room, etc.)forming a compact and easily worked unit all on the ground floor. On the first floor in the original house, 11, Alexandra Park Road, are rooms capable of taking six ante-natal patients, on extremely important provision in view of the number of expectant mothers who may need a period of rest and treatment during pregnancy. Well away from these rooms, on the same floor, at the back of the building, is an isolation room complete with its own sterilising room, bathroom and water-closet. The former lift-shaft of a hand-operated lift Which was never used, has been converted into four very useful compartments, namely, a drug and dressing store on the ground floor, a duty room on the second floor and an extra staff bathroom on the third floor. It should be open to every expectant woman, primipara or multipara, normal or abnormal, rich or poor, well housed or badly housed to choose whether she should have her baby at home, as some refer, or away from home as an increasing number desire, and whether at home or away, she should have at her disposa1 everything that modern science, obstetric skill and the art of midwifery can provide to make the birth of her baby a safe and pleasant and happy experience. I am glad to be able to report that this ideal has now been achieved in Hornsey. There is now no "maternity bed problem" in this Borough. It has been solved by the acquisition and extension of the Alexandr 26 Maternity Home which is working smoothly at the rate of over 600 births per annum. This number represents about one half the total pre-war births in Hornsey and about one third of the exceptionally high number of births in the post-war years. The births in 1946 numbered 2,008 and this number is likely to be exceeded in 1947. This tota1 is catered for in a variety of ways in accordance with the wishes of the mothers, namely:- (a) Five whole-time Domiciliary Midwives, four of whom are assisted by Pupil Midwives completing their training for the certificate "State Certified Midwife" (S.C.M.). These latter are already fully qualified State Registered Nurses (S.R.N.) and have taken the examination for the first part of the S.C.M. It will therefore be appreciated that with this Midwife and Pupil team, the Council's Domiciliary Midwifery Service is in highly-trained competent hands. This staff is capable of dealing with 400 to 500 normal births cach year in the mother's own homes. (b) The Alexandra Maternity Home new deals with upwards of 600 norma1 births annually. (c) The North Middlesex County Hospital's Maternity Department has been the chief provision for Institutional Midwifery in the past. This hospital is equipped and staffed to deal with any obstetric emergency, foreseen and unforeseen, and, in addition, has a flyingsquad which comes out to the aid of Doctors, Midwives or Maternity Homes in grave emergencies. (d) Special Maternity Hospitals in London, like Queen Charlotte's, the City of London Lying-in Hospital, Queen Mary's Maternity Hospital and the Maternity Departments of the General Hospitals, large and small, take in a certain number of Hornsey mothers who make their own arrangements with these institutions. (e) Private Docters, Specialists and Private Nursing Homes deal with mothers who prefer to make their own arrangements independently of any public provision. The number in this group is small and tends to diminish. Working in the closest co-operation with this Domiciliary and Institutional Midwifery Service are the Ante-natal and Post-natal Clinic Services at the Council's four Maternity and Child Welfare Centres (which will number six before the end of 1947). These are staffed by Health Visitors, the Domiciliary Midwives, the Pupils in training and the Doctors who attend the Alexandra Maternity Home and. who are also "on call" to the Domiciliary Midwives in case of difficulty. As the maternity bed requirements of the Borough are now fully provided for, even at a period of exceptionally high birth rate, the 27 question may be asked "Why make provision for future extension of the Alexandra Maternity Home on the first and second floors?". A good reason is that nine of the 25 lying-in beds are in a building which was "temporary" in the 1914-18 war but still provides comfortable accommodation. However, it cannot be expectcd to last for ever. Then a portion of the staff is now housed at 2, Alexandra Park Road and it would be more convenient to have them in the main building. The first floor of the new wing would replace the temporary annexe and the second floor would provide ample accemmodation for all the staff required. Space has been provided on the ground floor for a stairway and lift to these upper floors when built. Another reason, not so good, is that in July 1948 Under the National Health Services Act the Alexandra Maternity Home will be transferred to the North Western Metropolitan Regional Hospital Board and and will no doubt serve an area larger than Hornsey At the same time, the Maternity and Child Welfare Centres, where the Ante-natal and Post-natal Clinics are held, and the Domiciliary Midwives. will be transferred to the Local Health Authority (Middlesex County Council). The Midwifery Service of the Borough, which the Council has striven for many years to develop and unify, is, at a time when the greatest measure of success has been achieved, threatened with dual and distant control. -28- MATERNITY & CHILD WELFARE DENTAL SCHEME Children under five Report by Miss Winifred M. Hunt, Senior Dental Officer There is a growing need for the treatment of pro-school children, but at present it is necessary to limit the service to those who attend the: Welfare Centres and Day Nurseries in the Borough. This year 267 children made 723 visits for inspection and treatment, compared with 171 children and 443 visits in 1945. The work done has increased proportionately. Every effort is made to preserve the temporary dentition either by fillings or silver nitrate dressings and extractions are reduced to - minimum. Parents vary - some are enlightened and anxious for conservative treatment, while others have a great deal to learn about dental health. Much advice is given, special emphasis being laid on development, diet, ora1 hygiene and harmful habits. The equivalent of 96 sessions were devoted to the work. These children are treated at the same time as the school children, where possible appointments being arranged for members of a family to attend together. -29- NOTIFICATION OF BIHTS Male Female Tota1 Live-births 1,232 1,103 2,335 Still-births 23 22 45 1,255 1,125 2,380 Of this number there were - Live-births Still-births_ Occurring in the Borough and transferred to other districts 369 6 Belonging to Hornsey and occurring outside the district 851 25 The 2,005 nett number of notified births belonging to Hornsey were divided among the districts of the Welfare Centres as follows:- Town Hall Centre 821 Burgoyne Road Centre 518 Church Road Centre 364 Fortis Green Centre 302 2,005 WELFARE CENTERS Attendances of mothers and babies at the Welfare Centres have shown a steady increase, and it has been necessary to arrange for extra sessions. Two additional Health Visitors were appointed during the year. The Centre in Coldfall Avenue, Muswell Hill, was closed for maternity and child welfare purposes on the 29th April and a new Centre opened in more commodious premises situated in the old Electricity Showrooms in Fortis Green, Muswell Hill. In order to meet the demards for more accommodation, work was started on a new Welfare Centre in Stroud Green Road to serve Stroud Green and Finsbury Park. It is expected that this Centre will open during 1947. Plans are also in hand for a new Welfare Centre to serve Central Hornsey end North Harringey to be situated in the region of High Street, Hornsey . -30- The following is a summary of the work carried out at the Welfare Centres. CENTRES Totals Town Hall Burgoyne Hall Church. Road Coldfall and Fortis Green Number of Children's sessions held 262 151 166 110 689 No. of sessions held 203 97 6l 51 412 No. of indiv. mths. seen by Doctor:- Ante-natal New cases 757 372 268 201 1,598 " " Old cases 3,041 1,645 845 601 6,132 Post-natal New cases 224 145 90 19 478 " " Old cases 22 23 1 60 106 4,044 2,185 1,104 881 8,301 Tot. att. of mths. 5,449 2,401 1,366 1,199 10,415 No. of babies att. Cens. 1st times:- Under 1 year 799 463 338 268 1,868 1-3 years 111 50 90 80 331 3-5 years 62 46 43 25 176 No. of babies on Cen. reg. at end of 1946 1,989 1,002 699 547 4,237 Indiv. babies seen by Doctor 4,890 2,482 984 745 9,101 Total no. of babies seen by Doctor 5,961 4,421 1,218 893 12,493 Tot. atts. of babies at Centres:- Under 1 year 10,902 6,889 2,944 3,270 24,005 1-3 years 4,059 1,948 960 439 7,406 3-5 years 793 381 199 150 1,523 1st vst Tot vst 1st vst Tot . vst 1st vst Tot vst 1st vst Tot vst Grand 1st vst Total Tot vst Vsts. paid by H.V's. to exp. mothers 183 267 199 238 49 73 31 41 462 619 To infs.und.1 year 616 1,808 435 1,111 274 660 231 412 1,556 3,991 To chil.agd.l-5 yrs. 140 2,435 66 901 192 502 35 583 433 4,421 Total visits 939 4,510 700 2,250 515 1,235 297 1,036 2,451 9,031 31 CHILD LIFE PROTECTION The Health Visitors are appointed as Child Life Protection Visitors for the purposes of enforcement of the provisions relating to Child Life Protection contained in the Public Healh Act, 1936. WORK CARRIED OUT BY CHILD LIFE PROTECTION VISITORS Number of foster mothers on register - At beginning of 1946 - 20 At end of 1946 - 20 Number of foster children on register- At beginning of 1946 - 36 Received during year - 65 At end of year - 37 Who died during year - On whom inquests were held - No proceedings were taken during the year. MATERNITY & CHILD WELFARE DETAL SCHEME 1946 CHILDREN UNDER FIVE Inspections 267 Old cases 89 New cases 178 Attendances 723 Finished cases 198 Teeth extracted 170 Teeth filled Temporary - 533 Permanent - 1 534 General anaesthetics 85 Local anaesthetics 11 Other treatments (silver nitrate dressings, scalings, etc.) 658 MATERNITY & CHILD WELFARE DENTAL SCHEME 1946 EXPECTANT AND NURSING MOTHERS The following work was carried out in connection with the Dental Scheme for expectant mothers by the Denta1 Surgeon, Mr. Creeke. Attendances 1,08l New cases 212 Examinations 236 Exttractions (210 under local anaesthetic, 836 under gas) 1,046 General anaesthetics 8 Fillings 350 Dressings 150 -32- Scelings 49 Attendances for dentures 356 Dentures provided Upper and lower 67 Single dentures 17 Dentures repaired 2 Finished cases 118 X-ray - CARE OF ILLEGITIMATE CHILDREN AND UNMARRIED MOTHERS Special attention is devoted to unmarried mothers and their children by the Medical Officers, Health Visitors and Midwives. Institutional care is available through the Scheme provided by the Middlesex County Council for the admission of mothers to a pre-natal hostel, confinement in a County Council Hospital and subsequent admission to a post-natal hostel. Mothers are also admitted to homes maintained by the London Diocesan Council for Moral Welfare Work, there being one such Home in Hornsey, namely, Beacon Lodge. The advice and help of the outdoor workers attached to Beacon Lodge is available to mothers. Many of these illegitimate, children are placed in the care of foster mothers and several are in attendance at the Day Nurseries. CARE OF PREMATURE BABIES 1) Number of premature babies notified during 1946 who were born - (a) at home 15 (b) in hospitals or nursing homes 13 2) Of those born at home - (a) nursed entirely at home 12 (b) died during first 24 hours 2 (c) survived at end of one month 11 3) Of those born in hospitals or nursing homes - (a) died during first 24 hours 3 (b) survived at end of one month 9 The following recommendations contained in Circular 20/44 on the "Care of Premature Babies" have been implemented. Paragraph 2. (b) Provision of adequate and suitable equipment in the home. (d) The services of a paediatrician. (e) The giving of particular attention to the babies by Midwives, Health Visitors. (f) The services of a Home Help. -33- Paragraph 3. In connection with the Maternity Home - (a) Provision of small wards with controlled temperature. (c) Provision of skilled nursing staff. (d) The cervices of a paediatrician. DOMICILIARY MIDWIVES The Council employs five Domiciliary Midwives and one relief Midwife (who does not attend confinements). The following is a summary of their work - Miss Miss Miss Miss Miss Miss Mrs. TOTAL Andrews Matthews Jones Hughes Spear Smith Jamison from to from from (relief 1.8. 30.6. 1.3. 1.9. ) Cons.att. 174 129 63 55 75 34 - 530 A.N.C.att. 58 46 37 51 38 27 - 257 A.N.vst. 589 337 294 126 178 59 - 1,583 P.N.vst. 2,207 1,899 880 925 1,205 659 807 8,582 Note - Miss Hughes retired 30.6.46. Miss Spear was appointed 1.3.46. Miss Smith was appointed 1.9.46. Miss Jones was absent due to ill-health until 1.8.46. 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 258 Number of Domestic cases 457 Total number of cases served 715 Full Part Free fee fee cases Number of Maternity & Child Welfrre cases paying 83 116 11 Number of Domestic cases paying 205 53 27 Total persons paying 288 169 38 Number of Helps employed at let January, 1946 15 Number of Helps resigned during the year 37 Number of Helps engaged during the year 55 Number of Helps employed at 31st December, 1946 37 Total number of visits made by Helps - Maternity and Child Welfare 2,500 Domestic 5,001 7,501 -34- DAY NURSERIES Since the 1st April, 1946, the Council has maintained five Day Nurseries - Ladywell, 27, Church Lane.N.8. Red Gables, 113, Crouch Hill.N.8. Clemence Kouso, 2 4, Queen's Avenue.N. 10. Vincent House, 68/70, Hampden Road.N.8. Stonecroft, 100, Priary Rord.N.8. One Dry Nursery , Queen's Lodge, 40/42, Groat North Road.N.6. was closed on the 31st March, 1946. The following statistics relate to the Day Nurseries - Appr. acc. Average daily att. Average number of children on Register Average number of mothers whose children were on Register Mothers in full time employ. Mothers in part time employ. Comp. cases In full time employ. In part time employ. Comp.cases 0-2 2-5 0-2 2-5 0-2 2-5 0-2 2-5 0-2 2-5 96 190 70 152 76 176 4 9 3 8 239 12 11 286 222 276 262 The total number of attendances made by children were - Ladywell - 16,998 Red Gables - 10,636 Clemence House - 11,695 Vincent House - 10,730 Stonecroft - 11,356 -35- BOROUGH OF HORNSEY ANNUAL REPORT OF THE SCHOOL MEDICAL OFFICER FOR 1946 R. P. GARROW, M.D., D.P.H. HORNSEY EDUCATION COMMITTEE List of Members, 3lst December, 1946 Councillor M. W. Burns (Chairman) „ Mrs. K. M. Crump (Vice-Chairman) The Mayor, Alderman L. J. Valuette Members of the Town Council:Alderman Mrs. C. M. Cave „ Wm. J. Grimshaw, J.P. „ Miss E. C. McCullough „ J. W. Rowlands, J.P. Councillor Miss O. Anderson „ E. C. Castle „ Mrs. D. A. E. Cox „ H. A, Goodwin „ W. H. Logsdon „ C. MacPhee „ N. Muldoon „ H. F. Nichols „ G.W.F. Pallett „ Mrs. G. M. Reid „ E. F. A. Travers „ A. J. Young -36- Co—opted Members Rev. W. F. P. Chadwick, M.A. Rev. E. S. Duval, M. A. Mr. C. Gibson Mr. H. Msrshall Mrs. D. A. MacPhee Mr. J. W. Palmer Miss A. M. Vaughan, B.A., B.Ed. Rev. E. Wilson, B.A. Appointed Members County-Alderman F. Messer, M.P. County-Councillor W. H. Evans Borough Education Officer R. E. Brettle, M.A., D. Phil. -37- STAFF OF SCHOOL MEDICAL SERVICES (December, 1946) School Medical Officer R.P.Garrow, M.D.,D.P.H. Deputy School Medical Officer Marian Lones, B.Sc . ,M.B.,, B.s., M.R.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. J. A. Montgomery, M.D. (Part-time) Dentists Winifred M. Hunt, L.D.S. Dorothy Young, L.D.S. Oculist Doctor Marian Lones Aurist F.P,M.Clarlce, B.A., B.Sc.L.R.C.P.,L.R.F.P.S. (Glas). D. Trevor, M.S.,M.B.,B.S., F. R. C o S. , M. R. C. S. (by arrangement with the Royal National 0rthopaedic Hospita1) Masseuse (Part-time) Mrs. M. Dean Miss M. Weston 'thootist (Part-time) . Miss Giles SPeach Therapist Miss Doroy Eucational Psychologist Miss M. Kent Nurses Kids L.N Othver Mrs . L Natton Mrs.C. -Nartin Dental Attendan.ts Miss L. Bird Miss J. Hughes Clerk Mrs. H. M. Cavalier Assistant Clerks Miss J. Porter Mise J. Adkins -38- To the Chairman and Members of the Hernsey (Divisional Executive) Education Committee. Mr, Chairman, Larlies and Gentlemen, I have the honour to submit my Annual Report on the work of the Schocl Medica1 Service for the year ending 31-st December, 1946. Periodical Medical Inspeotion, Dental Inspection and Cleanliness Inspections have been carried cut s in former years and the scheme of treatment as set cut in previous reports, is available to all the children in attendance at the Schools under the Authority. In the report for 1945 I mentioned two items required to enable the work to be carried out in more complete form, namely:- 1) An Orthopaedic Department in a separate pro-fabricated building adjacent to the School Clinic at the rear of the Town Hall 2) A Dental Clinic in an outlying part of the Borough to enable a third whole-time Dentist to be employed. Apart from these items, which have not yet been provided, the School Medical-Service is, in premises, personnel and equipment adequate to the work it has to perform. I have the honour to be, Mr. Chairman, Ladies and Gentlemen, Your obedient servent R. P. GARROW, school Medical Officer. -39- SCHOOL MEDICAL SERVICE .ANNUAL ,REPORT, AURAL CLINIC, 1946 by Doctor ,F. P.M. Clarko • Throughout the year 1946 the usua11 weekly session of the- E r, Nose and '.Throat Clinic was hold on Setureey mornings. The numbers attending and the regularily.of the attendences for treatment have increased as more normal, poace-time conditions were being restored. The ovecuated children have returned and the schools, suffering from certain .amount of disorgainieation- and depletion of numbers during the ware years, steadily resumed their pre-war norma1 routinc. All these factors make for a bettor end .more regular attendance of school children patients'the Clinics. The main principle, of the working of the Clinic conjuctiones as in previous years and the incidence of the Various condision at the Clinic, such as car diseases, defects of the nose end thront, deafness - and other conditions, continued in much.the same. relative proportions as in previous- years. The greater majority of patients seen were those referred for diseaes of the nose and throat. The number of 'oar' casos rolatively is much less than those of nose and throat. The number of chronic discharging oars is very small. To a great extent this is duo to the speccial -attention which is prid to the carly detection and treatment of the acutear running ear. The all important point to beer in mind is to trye and prevent the lacute' ear becoming chronic . We have for some time new followed a strict routine of insisting on a11 coses of acutc discherging ears being treated at the Clinic daily where required end we regularily employ err-suetion' with 10% Albucid, penieiliin or Carbolized Glycerin Solutions after caeful cleansing of the ear. Any co-existing nasal affection, which is very frequently present, is a1weys trearted as well. with this procedure we have rceived excellent results - the majority of acute cars'are 'dry' in week. For the 'chronic' disch rging cars we use Zinc Ionisetoon. For cases of Sinus Infection we empley Preetz was 1 'displecement', using for infected cases 10% solution of Scherings Albucid. For certain other types of nasal infections we use a 10% solution for argyrol or Celiosol Argentum. The results generally are very satisfactory. One point which we wish to stress is the very noticeable effect that successful nasol treatment has on diseased or hypertrophied tonsils. The tonsils end tonsil symptoms, such as recurrent sore throrts, subside very rermarkably in many instances ofter a course of nosrl treatment. Diastolisation or intra-nrssl massage,as described in previous reports, has been used in a number of cases for such conditions as nasal catarrh, rhinitis, deafness, mouth-brtnthing etc. It is a valuable method in suitable cases. -40— We have treated a number of children for unhealthy or hypcrtrophiod tonsils by "tonsil suction" - Fishing out the septic crypts with 10% Albucid or diluted Hydrogen Peroxide solutions. Mcny cases respond very grtisfactorily to this line of treatment. We adopt a conservative line towards the removal of tonsils. The. failure of tonsillectomy in so many instances to effect a euro of the condition for which it was done, only goes to show that the tonsils are not the dieses so but only a sign of a discso which is usually located in the basal sinuses and consequently their removal cannot effect a cure. There are, of course. certa in instances where tonsillectomy is the advisable procedure but this number is very limited. when such cases are ment with, argongements ' are made for their operative treatment at the local hospital. The gonera1 health and nutrition of the children, pro-school and school, seen at the Clinic during the year wero srtisf ctory. There wore no indie tiens of malnutritioa or obvious debility • The provision of school meals, milk, cod liver oil and malt and various tonics for all the ege groups, has had - material effect in sustaining' the all round, good genera1 health of the children. -41- DENTAL INEPECTION AND TREATNEBT OF SCHOOL CHILDREN 1946 Report by Miss Winifred M. Hunt. Senior Dental Officer The school population is 8,430 and the staff consists of two fulltime Dental Officers, Miss w. M. Hunt as. Senior and Miss D. A. Young, and two Dental Attendants Pro-school children are also treated. Inspections. 4,805 (routine 3,421, special 1,384). These consisted of children attending Primary and Secondary Schools in the Borough. The interval between routine inspections is now almost two years, having increased steadily throughout the year. It is responsible for the large number of specials (1,384) which are over 400 more than in 1945, and 600 more tir n in 1944. Many of these are not ordinary casual or emergency cases, but children who imagine that they must have missed a school inspection because of the lapse of time. It is unfortunate that much of the good of previous treatment may'be lost through bel ted re-inspection, A high proportion of parents show their interest by attending at the school inspections and this naturally does not nwke for speed. In 42 sessions 3,421 children (less than half those on the registers) were inspected, which was an average of 8l per session. Ala souths were charted, in full and consent caras given for pa rent1 s .signature. Of these, 2,787 or 80% were found to be defective, while of the total inspections the number was 4,271'Or 89%. ' Treatment. 3,427 children received treatment in 794 sessions. The acceptance rate is 80% which 'could be improved with adequate staff. •' Fillings - 65636 (permanent teeth 6,170) . (temporary teeth 460) Our aim is for quality in conservative work, as it is- felt that this is one of.the best-ways of encouraging acceptance of treatment on future occasions. . Extractions - 394-93 (permanent teeth 418) 'temporary teeth 3,075) There were 876 adninistr tions of nitrous oxide under which about 60% of the extractions were performed. In the remaining 40% a local anaesthetic was employed. It will be seen from the filling and extraction tot-Is th t there were nearly 2 fillings to 1 extraction, whereas in permanent teeth there were 15' fillings to 1 extraction. taking into account the fact that 240 permanent teeth were extracted for regulation purposes, 35 permanent fillings were inserted for every permanent tooth lost by disease. Other operations - 4,021 (permanent teeth 339) (temporary teeth 3,132) -42- • Scalings, gum and root treatments and sedative dressings were carled cut, while in connection with the temporary dentition, a large number of silver nitrate dres- ings wore also done. Sessions - Inspection 42 Treatment 794 Thirty-two sessions were required for rdministr ative .and other purposes and the equivalent of 96 sessions devoted to the inspection and treatment of pro-school children under the Maternity and Child V/elf re Scheme. Orthodontic cases have to be referred to a Dental Hospita1 as facilities are not available with in the Borough. It is hoped that suitable premises will soon be found in the Muswell Hill area and a surgery equipped so that a third Dental Officer may be appointed. As there is work for four, this would only partly relieve the congestion and should be followed by another surgery in the Harring^y district. The need for extension has beer, urgent for some time and the delay is adversly affecting the Service. It would indeed be a. retrograde stop if it should be found necessary to change our policy of ccnserv tion of teeth, for it has been suggested that, where understaffing exists, only selected children should receive complete treatment. Many years of education and hard work have been required to bring about the present satisfactory ttitudo of patients, parents and teachers. / -43- SPEACH THERAPY REPORT FOR THE YEAR 1946 From the 1st January to 31st September Speech Therapy operated on a part-time basis in the Borough of Hornsoy. Sessions were held as follows:- Monday mornings - Coldfall Clinic Monday afternoons - rear of Town Hall Thursday mornings - rear of Town Hall Thursday afternoons - rear of Town Hall All day e ch alternate Wednesday was spent visiting homes and schools. At the close of 1945 a long writing list had accumulated and a full-time Speech Therapy Progran e was recommended. It was not possible to commence this until the 1st October, 1946. On the lot October new Clinics were opened t the we lf are Centre, Church Road, Highgate, and" at the Welfare Centre, Burgoyne Ha11, Burgoyno Road, Harringay, and an additional Session a week was held at the Town Ha11 Clinic. One Session a week was found to be sufficient for visiting homes and schoels. The following figures are taken from the records for 1946 - Total number of attendances 1,083 Total number of Sessions 210 Total number of Sessions visiting homes and schools 41 Total number of children receiving treatment during the year 99 Number of children under observation 18 Number of children discharged cured 10 Number of children unsuit ble for further treatment 8 Number of children seen not requiring treatment 11 Number of children ceased treatment on leaving school 5 Number of children ceased treatment on leaving district 4 Number of children on waiting list 11 There has been a marked improvement in a number of the children and alh have made some progress. Apart from the ten children discharged as above, four others are also about to be discharged as soon as reports are received, from the schools. Of the eleven children on the waiting list, five wil be seen at the beginning of January 1947 rnd the other six have only slight speech refects 'and will be seen soon after. The adopting of a. full-time Speech Therapy Service now enables all children to receive -lequ te treatment. In order that no children should bo overlooked, doctors, dentists and teachers are requested to report the slightest speech defect. Treatment may ot always be recommended ultimately but all doubtful cases should be examined by the Speech Therapist. -44- Co-operation ' ith. the Psycho logri et during the year, has been much appreciated, especially with reference to- (a) intelligence testing - with a-view to separating out those mentally unsuitable for therapy? and (b) emotional problems - connected vith children suffering from speech defects. It is hoped that in future the Psychological and Speech Therapy services will be able to work closely together. The new Centres at Highgate and "Harningay have made it easier for children to attenc in thee districts and have enabled them to mis a less school. The Speech Therapist is very grateful to- the Nurses, in charge at these We If are Centres who have mads it possible for these Clinics to be held. ELEANOR N, DOREY, L.C.S.T. -45- ✓ . ANNUAL REPORT OF THE ORGANISERS OF PHYSICAL EDUCATION FOR THE YEAR ENDED 31st DECEMBER 1946 During the year ended 31st December, 1946, the Organisers- of Physical Education are able to report progress in certain directions. Swimming. It is felt that the appointment of a Swimming teacher, and the provision of limited transport facilities to end from certain schools, have already been justified, but the aim of the Organisers to er- are that every child should be given the opportunity-of learning to swim during school life,is. not yet realised. This realisation is- dependent primarily upon - (a) the provision of. additional instruction baths, in the Borough, (b) the appointment of at least one other qualified Swimaing teacher, and (c) an extended scheme of transport. From: the 25th May Onwards the average weekly attendance at Katiison Road Bath was 562. The peak attendance of 766 was reached in October, indie tin, that there was likely to .be a good- response to. the introduction of winter swim ing. Unfortunately, however, the attendance declined to 393 during the last week of the year. Swimming Tests. In 1946 the County of Mid "lesex .Schools, Swinging Awards'were introduced. These were devised by the Organisers of Physical Education with in the County and approved by the Education Committee. The tests aim to set a high standard of performance in the recognised.swimming.strokes and in general watermanship. It is not to be expected that large numbers will qualify for the wards until the scheme of swinning instruction covering the work required for the tests has been in operation for several years. The following.. County Awards were gained' in 1946 by Hornsey school children- Elementary - 99 Intermediate - 13 Advanced - 2 In considering future development, it- is suggested that'plans be included for coverting' Tol ington Open Air Pool into a covered bath so that the fullest benefit could be derived by the children'concerned independently of climatic conditions. This bath would be'in addition to the Instruction Baths to which reference'has already been made. 46 Swimrming Gala. The Inter-Schools Annual Swimming Gala was resumed in 1946 and the teachers are-to be congratulated on the results after an interval of seven years. The Gala is organised by the Schools Sports Association and is a voluntary activity. Playing Fields. The Organisers are pleased to report that progress is being made with Organised Games in spite of the fact that many lessons and matches have had to be cancelled during the season due to inclement weather. It will not be possible to put into operation a.full scheme of organised games training for all children until additional playing fields are secured. It is hoped that sufficient playing field acreage will be purchased outside the Borough at an early date. The acquisition of the Alexandra Park Racecourse for use as a central playing field would assist in solving the problems of acreage for use by schools in the Borough and would minimise the difficulties of transport. Sports. Meetings. The weather adversely affected a number of the Schools' Athletic Sports Meetings during the Summer term, although some were carried through successfully. The limited acreage of the existing fields prohibits the development of the Athletics Scheme to include Field Events. Doubtless this will be remedied when the new sites are available. Shoes and Clothing: for Physical Training. It is regretted that little progress has been made regarding the supply of shoes and clothing to the Schools. It is one of the major essentials that children should be properly equipped for physical training activities. It is hoped that the supply position generally will improve to enable this essential provision to be made on a 100% basis to the Schools in the near future. Teachers' Course. A short refresher course in Physical Training was held during the Summer term5 primarily for men teachers who had returned from the Services. Six members from Hornsey attended the Course. Dancing courses were held for teachers during the Summer and Autumn terms. Thirteen members attended from Hornsey. Ling Physical Education Association Conference Course. A class of boys from the North Harringay Secondary Modern School gave a physical training demonstration at the Ling Physical Education Association Annual Course at Easter. This demonstration was appreciated by a large audience. -47- •> 0 Recreative Classcs. There is a total of 23 Re event ivc Classes in operation. Of this number, five are conducted in connection with the Evening Institute, ton are Club Classes for which paid instructors rre engaged and eight are Voluntary Club Classes. The Older women's Class continues successfully at V'illoughby Road Church Hallo F. E. BIRKBY J. B. MARR Organisers of Physical Education. -48- NITHISTRY OF EDUCATION Medical Inspection And Treatment Pveturns- Year ended .1st December, 1946 BOROUGH OF JpKTSEY TABLE I Medical Inspections of Pupils attending Mointerned Primary and Second Try Schools A Routine Medic. 1 Inspections. l Nusibeof Inspections Entrants 2nd age Group 3rd age Group Total Primary end Secondary 1,166 1335 646 3,647 2 Number of Other Routine Inspections Primary and Secondary Grand Total 236 3,883 B. Other Inspections. Number of Special Inspections and Re-inspections 2,013 TABLE III Group 1. Treatment f Minor Ailments (exclodinsr unnl esnl Total number treated 7,682 Group 2. Treatment of Defective Vision end Souint. Errors of Refraction 862 Other defects 20 882 -49- TABLE II Clasification of the Nutrition of Pupils Inspected during the year in the Rontrec on(primery School only) Number of Pupils Inspected A B C D (Excellent) (Normal) (Slightly subnormal) (Bad) 3,883 1,805 2,043 35 (46.5%) (52.6%) (.9 %o) Nil No. of Pupils for whom spectacles were - (a) Prescribed 452 (b) Obtained - 437 Group 3 Treatment of Defects of Nose and Tirroat Received operative treatment 3 Received other forms of treatment 267 Total number treated 290 TABLE IV Dental Inspection and Treatment 1. Number of pupils inspected by the Dentist - (a) Routine age groups , 3,421 (b) Specials 1,384 (c) TOTAL (Routine and Specials) 4! sol 2. Number found to require'treatment 4,271 3- Number actually treated 3,427 4. Attendances made by pupils for treatment 6,287 5 Half-days devoted to - Inspections 42 Treatment 794 TOTAL 836 6. Fillings - Permanent teeth 6,176 Temdorary teeth 460 TOTAL 6,636 7. Extractions - Permanent teeth 418 Temporary teeth 3,075 TOTAL 3,493 8. Administrations of general anaesthetics for extractions 876 9. Other operations - Permanent teeth 839 Temporary teeth 3,182 TOTAL 4,021 TABLE V Verminous Conditions 1) Tota.1 number of examinations of pupils in the Schools by School Nurses or other authorised persons 20,114 2) Number of individual pupils found unclean 183 -50- TBLE VI School Medical and Dental Staff Proportion of Tims School Health Service Putilie Health School Medical Officer - R. P. Garrow 15/40 25/40 Assistant School Medic Officers - Marian Lones 50% 50% Margaret Robinson 2/11 9/11 James Montgomery (part-time) £50 per annum paid in £50 per annum respect of services paid in rcspcct of services Senior Dental Officer - Miss Winifred Hunt Both whole-time Assistant Dental Officer - Miss Dorothy Young School Nursing Staff School Nurses (whole-time) 2 Dental Attendants 2 -51-