AC 4411(1) ILFORD Borough of llford Health Report FOR THE YEAR 1950 I. GORDON M.D., Ch B., M.R.C.P., D.P H. Medical Officer of Health, etc. W. H. Houldershaw, ltd., (Printers) Southend-on-Sea. 1 ILFORD BOROUGH COUNCIL Municipal Year 1950/51 Alderman J. Barker, J.P., Mayor. Alderman S. C. V. Woods, Deputy Mayor. Aldermen: Barker, John, J.P., Mayor. Griggs, Albert Philip, J.P. Bryan, William Allen Vernon, J.P. Holness, Richard Thomas. Colvin. Gilbert, F.C.l.S. Woods, Sidney Charles Victor, J.P., Deputy Mayor. Cooper. Albert Edward, M.B.E., M.P. Wootton, Mrs. Florence Emily, O.B.E. Daniels, Russell Stearn. Young, Major Alexander, T.D., J.P. Eke, William Benjamin. (E.C.C.). Fallaize, Mrs. Lilian, J.P. Councillors: Bartlett, Edward Albert. Littlejohn, Mrs. Ruth Constance, M.A. Bennett, Mrs. Florence Edith. Manders, Ralph James David. Bone. George Robert. Masters, Frank Robert. Caunt, George Louis. Milburn, Mrs. Elizabeth Florence (E.C.C.) Chapman, Mrs. Ceinwen. „ Pavitt, Laurence Anstice. Cowan, Harold Douglas, F.C.P.A., F.C.C.S. Pearson, Frederick Thomas. Drew, Leslie Victor. Root, Harold Goldstone. East, John. Sherrell, Albert R. (E.C.C.). Faninc., Percy Victor (E.C.C.). Slater, Frank. Gibson, Cyril Irving. Smith, Mrs. Lily Maude, S.R.N. Gleed, Sydney George. ' Tamplin, Lewis Henry. Gooch, Lionel Archer Scott. Taylor, Sidney William. Groom, Victor William. Terry, Miss Anne Sylvia. Headley, Cecil Aubrey. Tullett, Mrs. Ethel Ross. Hewitt, Reginald. Tyler, Bertie Charles Newcombe. Hughes, Thomas Bernard. Waters, Owen Francis. Lawrence, Samuel George. Watts, Mrs. Mabel Lucy. Lee, Leonard Gordon Victor. Westley, Ronald Francis. 2 PUBLIC HEALTH COMMITTEE Municipal Year 1950/51 Councillor C. 1. Gibson, Chairman. Councillor Mrs. M. L. Watts, Vice-Chairman. Alderman J. Barker, J.P., Mayor. Alderman S. C. V. Woods (Deputj Alderman W. B. Eke. Mayor). Alderman A. P. Griggs. J.P. Alderman Mrs. F. E. Wootton, o.B.E Councillor Mrs. C. Chapman. Councillor A. R. Sherrell (E.C.C.). Councillor J. East. Councillor Mrs. L. M. Smith, S.R.N. Councillor Mrs. R. C. Littlejohn, Councillor Mrs. E. R. Tullet . M A' Councillor O. F. Waters. Councillor F. R. Masters. Councillor R. F. Westley. ILFORD HEALTH AREA SUB-COMMITTEE OF THE HEALTH COMMITTEE OF THE ESSEX COUNTY COUNCIL Municipal Year 1950/51 ilford Borough Council Representatives: Aldermen Barker (Mayor) Colvin. Eke, Mrs. Fallaize, Woods (Deputy Mayor), and Mrs. Wootton; "Councilors Mrs. Chapman, Gibson, Groom. Mrs. Lhtlejohn. Mrs. Milburn. Mrs. Smith. Miss Terry (.Vice-Chairman), Mrs. Tullett and Mrs. Watts (Chairman). Essex County Council Representatives: Alderman Green; Councillors Mrs. Ball, Berry, Glenny, Herridge, Porter and Mrs. Warr. The Executive Council for Essex Representative: Dr. H. N. Rose. Local Medical Committee Representative: Dr. J. A. Moody. Hospital Management Committee Representative: Mr. B. F. J. Nichols. Voluntary Organisations' Representatives: Mrs. A. Armitage, Mrs. B. Butcher, Miss N. L. Odell and Mrs. A. M. Pearce. 3 ILFORD COMMITTEE FOR EDUCATION Municipal Year 1950/51 Aldfrman G. Colvin, F.C.I.S., Chairman. Councillor R. J. D. Manders, Vice-Chairman. Alderman J. Barker, J.P., Mayor. Alderman S. C. V. Woods (Deputy Mayor). Alderman W. A. V. Bryan, J.P. Alderman A. E. Cooper, M.B.E., M.P. Alderman Majou A. Young, T.D., J.P. Alderman Mrs. L. Fallaize, J.P. (E.C.C.). Councillor L. A. Pavitt. Councillor Mrs. F. E. Bennett. Councillor F. T. Pearson. Councillor Mrs. C. Chapman. Councillor Mrs. L. M. Smith, S.R.N. Councilor P. V. Faning (E.C.C.). * Councillor S. W. Taylor. Councillor L. G. V. Lee. „ , Councillor Miss A. S. Terry. Councillor Mrs. R. C. Littlejohn, M.A. Councillor Mrs. E. R. Tullett. Councillor F. R. Masters. Councillor Mrs. M. L. Watts. Co-opted Members: Mr. M. W. Ferris. Rev. W. C. Johnson. Mr .H. S. Kenward, M.A. Mr. S. P. Lonergan. Mr. E. R. Lower, B.A. Mr. L. R. Maddieson. Miss H. S. Rich. County Nominated Members: County Alderman A. W. Green, M.B.E., J.P. Mr. W. R. Spencer 4 OFFICERS OF THE PUBLIC HEALTH SERVICES Ilford Borough Council. Medical Officer of Health, Acting Borough School Medical Officer, Acting Area Medical Officer, Ilford Health Area Sub-Committee: I. Gordon, M.D., Ch.B., M.R.C.P. (Lond.), D.P.H. (Edin.). Chief Sanitary Inspector: S. R. Daly, B.Sc., LL.B.. D.P.A. (Lond)., F.A.L.P.A., Barrister-at-Law. Essex County Council. Assistant County Medical Officers: D. M. B. Gross, M.D.. Ch.B. (Leeds), M.M.S.A., D.P.H. (Lond.) F. E. O'Connor, B.A., M.B., B.Ch., B.A.O.. D.P.H. (T.C. Dub.). L.M. (Rot.). A. Collins, M.B., B.Ch., B.A.O. (Cork). H. B. Grange, M.B., B.S. (Lond.). J. M. Pooley, M.B., B.S. (Lond.), D.C.H. Senior Dental Officer: E. V. Haigh. L.D.S.. R.C.S. (Eng.). Educational Psychologist: K. Pickett, B.Litt. (Oxon.), Dip. Psych. Superintendent of Midwives: Miss C. Blockley. Superintendent Health Visitor: Miss M. Preston. Health Visitors and School Nurses: Deputy Chief Sanitary Inspector: P. W. English. Sanitary Inspectors: S. G. Rackham. J. Cook. A. C. R. Neale. F. Nau. G. W. Newman. D. F. Scott. R. E. Smalley. D. J. Hewett. T. F. Johnson. Chief Administrative Assistant: F. J. Hocking. Miss A. L. Drinkwater. Miss G. E. Lewis. Miss I. L. Mobbs (part time). Miss C. Oldham. Miss M. G. Bennett. Miss L. Hockey. Mrs. V. M. Whiting. Mrs. D. Pawsey. 5 Officers of the Public Health Services—continued. Tuberculosis Visitors: Mrs. T. E. Bowman. Mrs. A. T. Jones. Mrs. P. B. Lascelles. Matrons of Day Nurseries: Sunshine House Miss I. E. Sandall. Green' Lane Mrs. E. Drower. Ley Street Miss G. M. Gross Stevens Road Miss M. Vose. Domestic Help Organiser: Mrs. L. G. Lawrence. Part Time: — Regional Hospital Board. Consulting Obstetrician (Puerperal Pyrexia Regulations): R. C. Percival, F.R.C.S. (Eng.), M.R.C.S.' (Eng.), L.R.C.P. (Lond.), M.R.C.O.G. Surgeon in charge of Orthopaedic Clinic: H. G. Korvin, D.M., F.R.C.S. Ophthalmologist: J. J. Kennedy, M.R.C.S., L.R.C.P., DO.M.S. Surgeon in charge of A ural Clinic: W. Ibbotson, F.R.C.S. Physician in charge of Rheumatism and Cardiac Clinics: K. Playfair, M.A., M.B., M.R.C.P. Physician in charge of Paediatric Clinic: C. B. M. Warren, B.A., M.R.C.P. Psychiatrist in charge of Child Guidance Clinic: A. H. a Burton, M.D., M.R.C.P., D.P.M., D.P.H. Essex County Council. Assistant Dental Officers (-Part-time): A. G. Clark, L.D.S., R.C.S. (Eng.). M. Snipper, L.D.S., R.C.S. (Eng.). Physiotherapist: Mrs. M. E. King, M.C.S.P. Speech Therapists: Miss P. M. Lough, L.C.S.T. Miss P. J. Kent, L.C.S.T. Ilford Borough Council. Public Analysts: George Taylor, F.l.C. J. Hubert Hamence, M.Sc., Ph D 6 PREFACE Public Health Offices, Ilford. September, 1951. To the Mayor, Aldermen and Councillors of the Borough of Ilford. Mr. Mayor, Ladies and Gentlemen, I submit herewith the Annual Report on the Health Services for the year 1950. During the year the standard of health of the borough was well maintained, and the various indices compare favourably with those for the rest of the country. The Infant Mortality Rate was once more the lowest we have recorded, being 18 7 deaths per 1,000 live births, as compared with 29 8 for England and Wales, and 26 3 for the Administrative County of London. A sobering thought, however, is the fact that the rate for illegitimate children is about three times that for those born legitimately. The still-birth rate, which is not so easy to control, shows a further welcome drop from 22 6 to 15 5. The death-rate has again shown a slight rise, from 9.5 to 9.7 per 1,000 of the population, this being due to the greater proportion of aged persons amongst us, and more deaths accordingly from diseases of the heart and blood-vessels, and cancer. Preventive medicine has had great success in the past in controlling scourges such as smallpox, cholera and typhoid; is there any possibility of the control of cancer and atherosclerosis (the main cause of degenerative disease of the heart and blood-vessels)? Research on both these topics is proceeding apace. There are suggestions which are receiving much attention. One is that one form of cancer, that of the lungs, may be due to excessive smoking, and another is that atherosclerosis may possibly be made worse by excessive consumption of foods, such as eggs, that contain considerable proportions of a fatty substance known as cholesterol. Neither suggestion can vet be accepted as proven, but if they do, are we, as specialists in preventive medicine, attempt to persuade people to reduce smoking and the overeating of certain foods which hitherto have been considered beneficial? No doubt man;, people will prefer to take the risk of not living so long. Between the ages of 5 and 15, eight children died. Five of these deaths were due to accidents, on the roads and in the home. Two were the result of tuberculosis. Thus seven out of the eight deaths might possibly have been prevented. The birth-rate continues to fall and is now 13.2, as compared with 14.5 the previous year and 15 8 the year before that. This fall in the birth-rate, combined with the prolongation of life caused by the introduction of life-saving antibiotics such as penicillin, Chloromycetin and aureomycin, will in the decades to come still further increase the pre portion of old people among us and intensify what is already one of our most difficult problems, the care of the aged. During the year there was one case of faucical diphtheria, which mad: a good recovery. The numbers of children immunised at our clinics is showing a considerable fall, from 2,811 in 1949 to 2,096; those done by general practitioners of which we have records were 1,010 as compared with 1,548 the previous year. 7 A rather better picture is shown by the rise in the number of vaccinations, against smallpox; there were 1,198 primary vaccinations, as compared with 831 the previous year, and 373 re-vaccinations as compared with 264. Again there were no cases of smallpox in the town. Measles and whooping cough, following the national trend, showed an increase in notifications over the previous year. The numbers were: measles—notifications 1.468, deaths nil; Whooping cough—notifications 1,121, deaths nil. The numbers notified in the winter of 1950/51 were the greatest since notification was made compulsory in 1940; the deaths, however, thanks to modern treatment, did not rise in a corresponding fashion. The problem of food hygiene is receiving attention. Experience has shown that it is difficult to stimulate interest in this topic, except amongst the public who patronise establishments that purvey food. It has been decided not to proceed with the formation of Clean Food Guilds until the Report of the Catering Trade Working Party has been considered by all concerned, as it is possible that further legislation may be introduced which will simplify the problem. Meanwhile two of the more senior sanitary inspectors are now devoting their entire time to inspection of food establishments and factories. Education is of paramount importance in this regard; a film strip projector has been purchased, and many lectures given to the public by the Chief and Deputy Chief Sanitary Inspectors and myself. Included in this effort was a series of talks to the Children's Cinema Clubs on Saturday mornings by the Senior Sanitary Inspector. School Health Service. This Service now deals with a population of 21,497. The Service is, in general being conducted efficiently and comprehensively. The main black spots of the previous year are, however, still with us—(a) the great deficiency in dentists; (b) the absence of an Orthoptic Clinic; (c) lack of residential accommodation for mentally and physically handicapped children; and (d) the long waiting lists for operations for tonsils and adenoids. Apart from (b), where the delay has been due to negotiations between the County and the Regional Hospital Board, these problems are national in extent. The Child Guidance Clinic has seen many changes this year. Dr. Burton, who has been consultant psychiatrist since the inception in January 1949, left on reaching the retirement age in June 1951, and his absence will be a source of regret to all the staff. However, the appointment of ancillary personnel has been rather more successful than of late and there is every chance that in the autumn of this year the clinic will for the first time be fully staffed. Should this prove to be the case, some inroads might be made into the large waiting list of 62, which is in itself much smaller than it might be, as it has been strictly pruned. Attention is drawn to the interesting experiment described in the School Health Service section, to ascertain if B.C.G. vaccination of school leavers will influence the incidence of tuberculosis. Part III Services, the successor to the old Maternity and Child Welfare Service, continues to expand. The number of cases sent for convalescence under Section 28 has increased from 37 to 58; the number of articles of sick room equipment on loan at the end of the year was 27, as compared with 5 the previous year. Home Nursing is at present conducted from the Training School in Leytonstone, but it is hoped that in future the service may be more fully integrated with other services provided locally. Home Nursing has shown a remarkable expansion since it was conducted on a voluntary basis prior to the coming into force of the National Health Service Act in 1948; 1,752 cases were served in 1950, as compared with 1,563 the previous year. 8 The Health Services Clinic at Manford Way on the Grange Hill Estate is now functioning and will be formally opened later in the year; meanwhile it caters for the clinics that were conducted in temporary premises in Elmbridge Road. An innovation started this year has been ante-natal clinics at Mayesbrook, Valentines Mansion, and Manford Way, for domiciliary confinements. The Midwives conduct these clinics, where mothers attend instead of being visited in their own homes, where conditions are not always as convenient as in clinics. In some cases it is still found more useful for the midwife to carry out the work at the mother's home. The Domestic Help Service has had to meet increased calls. 1,211 cases were helped, as compared with 808 the previous year. Welcome clerical assistance is now available for the Organiser, but it is still difficult for her to visit cases as frequently as desirable. Much of the departmental burden of the care of old people in Ilford falls on the Organiser and her staff. The Infant Welfare Centres and Day Nurseries continue to serve the town as efficiently as before. The Nursery in Green Lane should move to new premises in Goodmayes Lane in the autumn. It is hoped to introduce into this preface each year a brief special survey of some particular problem. Last year a reference was made to the social differences in the incidence of vaccination; this year some comment is made on the pressing problem of tuberculosis, as pictured over the last 30 years in Ilford through the medium of notifications of the disease, notification of deaths, and six-monthly visits carried out by the Sanitary Inspectors to keep the Tuberculosis Notification Register up to date. At the moment there is some discussion as to whether this register should continue to be kept by Sanitary Authorities, and not transferred to the local health authority. Perhaps this survey will demonstrate that the data have not been wasted. Owing to shortness of space, much has to be left out; details have been disposed in a graphic arrangement for easy understanding: for those wishing full details the relevant statistics are shown at the foot of the graphs, which are printed at the end of the preface. The most startling fact appearing is the enormous growth of the numbers on the register from 551 in 1920 to 1401 in 1950 (Fig. 2). Of course the town has also grown considerably in that period, so that a true picture can only be obtained by a calculation of the number on the register per 100,000 of the population. Figure 1 shows this. It is apparent that the number was steadily declining until an abrupt rise began in 1940, a peak reached in 1945, from which there has been little or no decline. It must be remembered that the Medical Officer of Health cannot remove cases from the register; this can only be done by the Chest Physician or the practitioner notifying the disease, if at all practicable. Accordingly it may be that many cured cases, who refuse to visit the clinic for "writing off" as cured, are cluttering up our register and giving unnecessarily large gross totals. A comparison of the annual totals (Fig. 2) of the register and those on the books of the Chest Clinic shows that except for the years 1927-1929, there always have been more on our register, and in fact the difference is less now than it was 25-30 years ago, so it cannot be the cause of the dramatic increase in the register since 1940. The increase can, of course, be due to more cases being notified. In this connection only pulmonary tuberculosis is of importance, for nonpulmonary tuberculosis is showing a progressive decline. The attack rate 9 of pulmonary tuberculosis (i.e. notifications per 100,000) is plotted on Figure 3. It will be noted that between 1920 and 1938 there was little real improvement, in 1940 and 1941 there were spectacular rises in notifications, and since then a gradual fall but the attack rate is still above that in 1939. Accordingly more notifications are partly the cause of the rise in numbers on the register. There is another important factor, the death rate of the disease is declining. In this connection it is more important to consider the case mortality rate, i.e., the number of deaths per 100 cases on the register, rather than the mortality rate per 100,000 of the general population, for the latter figure takes no cognisance of the number of cases of the disease among whom the deaths are occurring. Figure 4 shows how dramatically the death rate from tuberculosis is declining. This graph includes both pulmonary and nonpulnionary cases, but as the latter are over the years a steadily decreasing proportion, and include a large group of mild non-fatal types, it is apparent that the mortality rate from pulmonary tuberculosis is also decreasing. A conclusion from these figures is difficult to come by. Is tuberculosis becoming milder, is the resistance of the public to severe disease becoming stronger, are cases being notified earlier and in a state more amenable to treatment, and is modern treatment, both surgical and by means of drugs, keeping people alive longer? Another, and most disturbing conclusion, must be excluded. Are we keeping tuberculosis patients alive who would previously have died, keeping them alive, at home, and mixing with the general public, and in an infectious state so that we have more foci of infection abroad than before? Is this the cause of the obstinate tendency of the attack rate to remain higher than before the war? Unfortunately these questions cannot be answered by notifications and visits of sanitary inspectors. It is also of interest to review the provision of sanatorium accommodation over the last 30 years. The lower graph in Fig. 5 shows a steady increase in the number of cases in sanatoria, but the upper graph shows that since 1928 no improvement has occurred when related to the increase in pulmonary cases in the town. In Fig. 5 the pulmonary cases found to be in sanatoria are shown as a percentage of pulmonary cases visited by the Sanitary Inspectors. Finally, is the notification of tuberculosis becoming more exact? Ideally each fatal case of tuberculosis should be recognised and notified before death. Anything less than this means a human error or neglect on the part of some person. The upper graph in figure 6 is the annual record of deaths of tuberculosis in Ilford, the lower graph those of them that were notified as suffering from the disease before death. Both graphs should ideally coincide, but the gap is still too large, although narrowing very slightly. In this regard 1948 was the best year, 63 of the 69 deaths being notified. If there is this gap in those cases which are so ill that they die of the disease, what is the gap in mild and early cases, which may recover without treatment? No one can answer this, but it will inevitably be considerable. As before, I would like to thank all the members of my staff who have co-operated so effectively in the past year, and have helped in the collation of this report; also to my fellow officers for their kind aid during the past year. I would like to make special mention of the help I have received from the Chairmen, Vice-Chairmen and members of the Committees and Sub-Committees of the Ilford Borough Council and Essex 10 County Council, with whom I work. Finally, no Ilford report can be concluded without a word of thanks to the members of the Ilford Federation of Voluntary Welfare Workers for a further year of support. I have the honour to be, Your obedient Servant, 1. GORDON, Medical Officer of Health. 11 12 13 14 15 10 17 SECTION A. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in Acres) Land 8,402 8,435 Inland Water 26 Tidal Water 7 Population (Census 1921) 85,194 „ (Census 1931) 131,061 Registrar-General's Estimate of resident Population: — June 30th, 1947 179,820 „ 1948 183,400 „ 1949 185,000 „ 1950 186,200 Number of inhabitated houses (end of 1950) according to Rate Books (approx.) 47,421 Rateable Value—April 1st, 1950 (Houses and Land) £1,634,710 Sum represented by a penny rate, April 1st, 1950 (approx.) £6,650 Education Rate— 1949-50 1950-51 (E.C.C.) 6s. 10.47d. in the £ 7s.0.58d. in the £ Combined Rate (all services) 19s. 2d. in the £ 19s. 2d. in the £ The following figures as to unemployment were supplied by the Ministry of Labour:— Males Females As at January, 1950 463 163 As at January, 1951 513 168 Live Births Total M. F. 1950 1949 Legitimate 2,332 1,210 1,122 Birth Rate per 1,000 of the estimated net resident population 13.2 14.5 Illegitimate 74 43 31 Still Births 48 26 22 Rate per 1,000 total (live and still) births 15.5 22.6 Deaths 1.763 920 843 Death Rate per 1,000 of the estimated net resident population 9.7 9.5 Percentage of total deaths occurring in public institutions 36.9 33.7 18 Maternal mortality (heading 30 of the Registrar-General's Short List): — Rate per 1,000 No. of Deaths. total (live and still) births. 1950 1949 1950 1949 Pregnancy, childbirth and abortion 4 2 1.63 0.74 Death-rate of Infants under one year of age: — 1950 1949 All infants per 1,000 live births 18.7 20.1 Legitimate infants per 1,000 legitimate live births 17.6 19.9 Illegitimate infants per 1,000 illegitimate live births 54.0 31.7 Deaths from Cancer (all ages) 33.0 319 „ „ Measles (all ages) — 1 „ „ Whooping Cough (all ages) — 1 „ „ Diarrhoea (under 2 years of age) — 1 1. Rainfall. Total rainfall registered in the district during the year was 23 01 inches: the greatest fall in 24 hours was registered on 9th July, 139 inches. November was the wettest month. 2. Population. The number of patients and resident staff on the 30th June, 1950. at the following public institutions, was: — Claybury Hospital 2.529 Goodmayes Hospital 1.354 Australasian Hospital (Dr. Barnado's Homes) 1ll Total 3,994 3. Births. The number of births registered during the year was 2,406. Males Females Legitimate 1,210 1,122 Illegitimate 43 31 i.e., 3.1 per cent. of the births registered were illegitimate. The percentage of illegitimate births registered in the previous 10 years was 2.4 (1949) 3.2; 3.3; 3.1; 5.5; 4.2; 3.4; 3.5; 3.3; 2.5. The birth-rate, calculated on the net estimate of the population is 13 2 per 1,000 4. Deaths. The total number of deaths of Ilford residents was 1,763. This is obtained by taking the total deaths registered in the district (1,707). subtracting the deaths of non-residents occurring in the district (455), and adding the deaths of Ilford residents registered as having died in other districts (511). The number of deaths of non-residents registered in the district (principally in large institutions) was as follows: — Claybury Hospital 201 Goodmayes Hospital 83 King George Hospital 115 Ilford Isolation Hospital and Sanatorium 28 Other Non-residents 28 Total 455 10 The number of deaths of Ilford residents registered as having died in other districts during the year was as follows, and includes deaths at the following Institutions:— Oldchurch Hospital, Romford 83 Brentwood Mental Hospital 4 Wanstead Hospital 17. Queen Mary's Hospital, West Ham 3 Hospital for Sick Children, Great Ormond Street I London Hospital 60 St. Bartholomew's Hospital 10 . Charing Cross Hospital 3 Westminster Hospital 2 St. Joseph's Hospice, Hackney 17 Severalls Mental Hospital, Colchester 6 East Ham Memorial Hospital 4 University College Hospital 2 Whipps Cross Hospital 28 St. Luke's Hospital 3 London Chest Hospital 2 In other Hospitals, Institutions and residences outside the Ilford district 266 Total 511 The death rate, calculated on the net estimate of the population of 182,317, is 9.7 per 1.000. Inquests.— During the year, 61 inquests were held, 40 on Ilford residents, and 21 on non-residents. The ages at death were as follows: — Under 1-2 2-5 5-15 15-25 25-45 45-65 65 years and 1 vear years years years years years years upwards 1 — 3 4 4 14 21 14 Death-Rates from Tuberculosis and Cancer, 1950. The following Table shows the death-rates for 1950 tor Ilford. compared with the provisional death-rates for England and Wales for the same period, per 1,000 population; the figures having been supplied by the Registrar-General:— Ilford England and Wales Respiratory Tuberculosis .230 .321 Other Tuberculosis .022 .043 Cancer 1.810 1.889 5. Marriages.—1,602 marriages took place in the Ilford district during 1950, both parties or one of the contracting parties being Ilford residents. 7. Tables of Vital Statistics.— Table I gives a comparative statement of the birth-rate and death rate for the past five years. Table Ia gives a comparison of the vital statistics of Ilford with England and Wales, London and other towns. Table II gives a classified statement of the causes of death in 1950. arranged according to the age groups at which deaths occurred. 20 TABLE I.—Vital Statistics of Whole District During 1950 and Previous Years Year Gross population, estimated to middle of each Year Net Population estimated to middle of each Year Births Total Deaths Registered in the District Transferable Deaths Net Deaths Belonging to the District Uncorrected Number Net (6) of Non.Residents registered in the District of Residents not registered in the District Under 1 year of Age At all Ages Number Rate (c) Number Rate (d) Number Rate per 1,000 Net Births Number Rate (e) 1 2 2a 3 4 5 6 7 8 9 10 11 12 13 1940 173,900 170,331 2,690 3,443 20.2 1,546 8.9 321 428 102 29.6 1,653 9.7 1947 179,820 176,149 2,764 3,368 19.1 1,547 8.6 285 477 82 24.3 1,739 9.8 1948 183.400 179,637 2,239 2,848 15.8 1,351 7.3 260 427 62 21.7 1,518 8.4 1949 185,000 181,108 2,027 2,630 14.5 1,646 8.9 402 484 53 20.1 1,728 9.5 1950 186,200 182,317 1,933 2,406 13.2 1,707 9.2 455 511 45 18.7 1,763 9.7 (а) The net estimated population is found by deducting the population of Claybury and Goodmayes Hospitals from the gross estimated population. The population of Dr. Barnardo's Girls' Village Homes is included in the net estimated population of the district. (b) The net number of births is obtained by taking the uncorrected number of births supplied by the local Registrar and adding to or subtracting from it such a number as is supplied for this purpose by the Registrar.General. (c) and (e) Calculated on the estimated net population. (d) Calculated on the estimated gross population. 21 TABLE IA Table showing comparison between the Birth.rate, Death.rate, etc., of Ilford, other Towns, and of England and Wales for the Year 1950 (Provisional figures) Rate per 1,000 Total Population Annual Death.rate per 1,000 Population Rate per 1,000 Live Births Live Births bitths All Causes Typhoid and Paratyphoid Fevers Smallpox Tuberculosis (all forms) Pneumonia Whooping Cough Diphtheria Influenza Acute Poliomyelitis and Polioencphalitis Diarrhoea and Enteritis (under 2 Yrs.) Total Deaths under 1 Year England and Wales 15.8 0.37 11.0 0.00 — 0.36 0.46 0.01 0.00 0.10 0.02 1.9 30 126 County Boroughs and Great Towns, including London 17.6 0.45 12.3 0.00 — 0.42 0.49 0.01 0.00 0.09 0.02 2.2 34 148 Smaller Towns (Estimated Resident Populations 25,000 to 50,000 at Census 1931) 16.7 0.38 11.6 0.00 - 0.33 0.45 0.01 0.00 0.10 0.02 1.6 29 London Administrative County 17.8 0.36 11.8 0.00 — 0.39 0.48 0.01 0.00 0.07 0.01 1.0 26 ILFORD (Estimated Gross Population, mid 1950 180,200 12.9 0.26 9.5 — — 0.25 0.21 — — 0.06 0.01 — 18 (a) Rates per 1,000 total population; otherwise rates are based on civilian population A dash (— ) signifies that there were no deaths. 22 Registrar.General's Short List of Deaths and Causes : TABLE II Causes of, and Ages at, Death during the year 1950 CAUSES OF DEATH Net Deaths at the subjoined ages of "Residents" whether occurring within or without the district All Ages Under 1 year 1 and under 2 years 2 and under 5 years 5 and under 15 years 15 and under 25 years 25 and under 35 years 35 and under 45 years 45 and under 55 years 55 and under 65 years j65 and under 75 years 75 years and upwards ALL CAUSES 1763 45 10 4 8 27 35 76 142 284 450 682 1 Tuberculosis, respiratory 42 — — — — 5 8 10 10 5 3 1 2. Tuberculosis, other 4 — — — 2 1 — — — — 1 — 3 Syphilitic disease 5 — — — — — — — 1 1 2 1 4 Diphtheria — — — — — — — — — — — — 5 Whooping cough — — — — — — — — — — — — 6 Meningococcal infections 1 — 1 — — — — — — — — — 7 Acute poliomyelitis 2 — — — — 2 — — — — — — 8 Measles — — — — — — — — — — — — 9 Other infective and parasitic diseases 4 — 1 — — 2 — — 1 — — — 10 Malignant neoplasm, stomach 53 — — — — — 1 2 3 20 11 16 11 Malignant neoplasm, lung, bronchus 54 — — — — — — 2 11 18 16 7 12 Malignant neoplasm, breast 25 — — — — — — 3 6 5 9 2 13 Malignant neoplasm, uterus 10 — — — — — — 1 — 6 3 1 14 Other malignant and lymphatic neoplasms 188 1 — — — — 5 18 16 35 56 57 15 Leukaemia, aleukaemia 8 — — — — — — — 3 2 2 1 16 Diabetes 8 — — — — — — — — —— 3 5 17 Vascular lesions of nervous system 182 — — — — 1 — 5 9 36 51 80 18 Coronary disease, angina 233 — — — — — — 5 21 67 76 74 19 Hypertension with heart disease 112 — — — — — — 3 5 9 45 50 20 Other heart disease 319 — — — — 2 1 2 12 26 71 206 21 Other circulatory disease 58 — — — — — — 3 6 6 12 33 22 Influenza 11 — — — — 1 1 — 2 1 1 — 23 Pneumonia 39 4 1 — — — — 1 3 5 3 20 24 Bronchitis 99 — 1 1 — — — 1 5 14 32 45 25 Other diseases of respiratory system 12 — 1 — — — — 1 — 5 2 3 26 Ulcer of stomach and duodenum 11 — — — — — — — 2 1 5 3 27 Gastritis, enteritis and diarrhoea 4 — — — — 1 — — — 1 — 2 28 Nephritis and nephrosis 17 — — — — — 1 1 2 3 5 5 29 Hyperplasia of prostate 8 — — — — — — — — — 3 5 30 Pregnancy, childbirth, abortion 4 — — — — — 3 1 — — — — 31 Congenital malformations ... 17 11 2 1 — — — 1 1 1 — — 32 Other defined and ill.defined diseases 160 28 3 — 1 3 5 8 10 22 29 51 33 Motor vehicle accidents 25 — — 2 3 3 4 3 2 — 3 3 34 All other accidents 24 1 — — 2 2 4 1 2 4 3 5 35 Suicide 23 — — — — 2 2 4 10 3 1 1 36 Homicide and operations of war 1 — — — — — — — — — — — Special Causes (included above) Smallpox — — — — — — — — — — — — 23 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. 1. (i) Public Health Officers of the Authority.—Vide list at the beginning of this report. (ii) Home Nursing.—This service is administered by the Essex County Council. A report of the work performed during 1950 will be found in Part III Services section. (iii) Laboratory Facilities.—Pathological specimens are now sent to the Bacteriological Laboratory, Oldchurch Hospital, Romford, for examination. (iv) Legislation in Force.—Byelaws exist for: — (1) Prevention of Nuisances. (2) Cleansing of footways and pavements, and cleansing of earth closets, privies, ashpits and cesspools. (3) Dealing with common lodging houses and houses let in lodgings. (4) Houses let in lodging or occupied by members of more than one family. (Sec. 84. Ilford Act. 1937.) (5) Slaughterhouses and humane slaughtering of animals. (6) Pleasure Fairs. (Sec. 128, Ilford Act, 1937.) (7) Tipping of Dust, Spoil and Refuse. (Sec. 85, Ilford Act, 1937.) (8) For securing the cleanliness and freedom from pollution of tanks, cisterns and other receptacles used for storing water used or likely to be used by man for drinking or domestic purposes, or for manufacturing drink for the use of man. (9) Nuisances in connection with the removal of offensive or noxious matter. (10) Depositing of Rubbish, etc. (Sec. 249, Local Government Act, 1933.) (11) For securing the observance of sanitary and cleanly conditions and practices in connection with the handling, wrapping and delivery of food sold or intended for sale for human consumption, and in connection with the sale or exposure for sale in the open air of food intended for human consumption. (Section 15, Food & Drugs Act, 1938.) (12) Byelaws made under the Essex County Council Act, 1933. Parts IV, VI and IX.) Part IV—Establishments for Massage and Special Treatment. Inspections of licensed establishments are carried out quarterly. During 1950 nineteen applications for renewal of licences were received. The Council renewed the licences in respect of these establishments. Three new applications were received, which were granted. The licences expire on 31st March of each year. Part VI.—Hairdressers' and Barbers' Premises. During 1950, 62 visits of inspection were made by the Sanitary Inspectors to these premises. Part IX.—Camping Grounds and Moveable Dwellings. Part XI.—Manufacture of Ice Cream. Section 158 of this Act, which requires the registration of manufacturers ana vendors of ice cream and the premises used by them, came into operation in the Borough on the 1st February, 1934. 62 applications for registration in respect of 59 premises were 24 considered during the year. The registrations were granted as follows: — Purveyors retailing multiple firms' productions 61 Purveyors manufacturing and retailing their own productions (made apart from domestic premises) 1 Purveyors manufacturing and retailing their own productions (made on domestic premises) Nil In 1948. the Council delegated to the Public Health Committee, its powers and duties under Section 158 of the Essex County Council Act, 1933, and Section 77 and 80 of the Ilford Corporation Act, 1937, with regard to the granting, refusal or revocation of registrations, including the duty of interviewing applicants who are required to show cause why applications for registration should not be refused or existing registration should not be revoked. (13) Ilford Corporation Act, 1937. Section 77 of this Act provides for the registration of hawkers of meat, fish, fruit and vegetables, and their storage premises. Registration was granted to 16 persons (concerning 9 premises), but refused in 1 case on account of the unsuitability of the proposed storage premises. A warning letter was sent to a person who was found to be selling goods without being registered. Section 80 of the Act requires registration of premises used for the preparation or manufacture of sausages, or potted, pressed, pickled or preserved meat, fish or other food intended for sale. Three applications for registration were received during 1950 all of which were granted. (14) Shops Act, 1912.1934 (Sections 10 and 13). Since this Act came into operation the Sanitary Inspectors have made inspections in accordance with Sections 10 and 13 (3). During the year, 5,711 inspections were made, 16 Preliminary Notices were served, 10 of which were complied with. 5 Preliminary Notices served in 1949 were also complied with. 3 Certificates of Exemption from the provisions of sub. Section 2 of Section 10 were granted in 1950. There are three local Acts in operation—(1) The Ilford Improvement Act, 1898, which has important sanitary provisions; (2) The Ilford Urban District Council Act, 1904, the Section which deals with the control of tuberculosis is repealed, the powers of the Corporation now being contained in the Food and Drugs Act, 1938; and (3) The Ilford Corporation Act, 1937. The Ilford Corporation Act, 1937, repealed Section 62 of the Ilford Improvement Act, 1898, dealing with the holding of a wake over a body of any person who died while suffering from a notifiable disease. This offence is now dealt with in Section 165 of the Public Health Act, 1936. (15) Nurses Act, 1943 (Part 2). Nurses' Agencies. The Essex County Council, on application by the Ilford Council, delegated to them, in pursuance of Section 11 (11 the powers conferred upon the County Council by Part II of the Act, subject to certain conditions. During 1950 a licence was granted to one Nurses' Agency in Ilford; such licence expires on the 31st December, 1951. Agencies are inspected before the issue of a licence, and thereafter at intervals of not more than once a quarter. The Medical Officer of Health is authorised under Part 2, Section 9 (2) to enter and inspect any such licensed premises in the Borough. 25 (16) National Assistance Act, 1948.—(a) Section 47 provides for the removal of persons to hospital who are unable to devote to themselves proper care and attention. If difficulty is experienced in persuading a stubborn and recalcitrant patient to go into hospital it is possible, after the Medical Officer of Health certifies in writing and the local authority agrees, to take the case before the Court; and the Magistrate if persuaded of the necessity of the application, may issue an order for the person to be removed to a suitable hospital. It is essential for this Section to be invoked that (a) the person must be suffering from grave chronic disease or, being aged, infirm or physically incapacitated, is living in insanitary conditions, and (b) is unable to devote to himself, and is not receiving from other persons, proper care and attention. No persons were dealt with under this Act during the year, (b) Section 50 requires a Local Authority to arrange for the burial or cremation of a person who has died or been found dead, and where it appears to the Local Authority no suitable arrangements are being made for the disposal of the body. Provision is made in the Act for recovery from the estate of the deceased person, or any person who for the purposes of this Act was liable to maintain the deceased immediately before his death, of the whole or part of the expenses incurred. On the 1st March, 1949, the Ministry of Health issued a circular (No. 13/49), dealing more particularly with persons dying in hospital. The circular asks Hospital Committees and Boards to exercise their power to arrange burial where— (a) deceased patients' relatives cannot be traced; (b) those whose relatives are traceable but were not. immediately before the patient's death, liable for his maintenance under Section 42 (1) of the National Assistance Act and are not willing to arrange for the burial; and (c) those whose relatives are unable to obtain a death grant under the National Insurance Act, 1946, and cannot otherwise afford to arrange for burial. Where a "liable" relative fails to carry out his responsibility. Hospital Committees and Boards are advised to refer the matter to the Local Authority upon whom the duty rests under Section 50 of the Act, in view of the powers of recovery from the liable relative. Similarly, in the area of a County Council, the duty of burial or cremation rests with the County Council where the deceased person had been provided with accommodation under Part III of the Act. The burial of three persons were dealt with during the year. They were: — (1) The body of a stillborn male child found in a ditch at Chadwell Heath Lane. (2) A female, 82 years, lived in lodgings. (3) A female, 62 years, lived in furnished accommodation. (17) Hospitals, Etc. Isolation Hospital.—189 beds are provided. Maternity Hospital.—51 beds for the reception of maternity cases are maintained at the Ilford Maternity Hospital. Wilnett Lodge Post.Natal Home has accommodation for 9 patients. 26 King George Hospital.—The following is a return in respect of bed accommodation: — Total number of Beds at 31st December 1950 Pay Beds 14 Amenity Beds 7 Other Patients Children Medical Surgical Male Female Male Female 215 21 26 18 55 59 36 The above three hospitals are included in the Ilford and Barking Group. (Group 12 N.E. Metropolitan Regional Hospital Board.) Mental Hospitals.—There are two large Mental Hospitals in the district, the Goodmayes Hospital, with 1,275 patients (males 575, females 700), and Claybury Hospital, with 2,353 patients (males 1,023, females 1,330) in residence on 30th June, 1950. These Hospitals are included in Groups 21 and 20 respectively of the North East Metropolitan Regional Hospital Board. Other Institutions.—Girls' Village Homes, one of the late Dr. Barnado's Institutions, with 80 beds in the Hospital on 30th June, 1950. Maternity and Nursing Homes.—On the 1st January there were 3 private registered Nursing Homes in the district. 1 for medical and senile cases, 1 for medical and surgical cases and 1 for maternity cases. The Nursing Home for maternity cases closed down in September. 1950. The other two homes were still functioning on 31st December, 1950. All Nursing Homes in the district are visited by the Medical Officer of Health and the Chief Sanitary Inspector (or his deputy) quarterly and at other times when necessary. A letter was sent calling attention to saritary defects at one of the homes. (18) Ambulance Facilities. The Ambulance Service maintained and controlled by the Essex County Council has an Ambulance Station situated at Clarks Road, High Road, Ilford, which serves this area. The station is manned continuously. (1) The general procedure for obtaining an ambulance in emergency, is as follows: — Where there is a dialling system in operation in the Ilford Area, dial "999" or use the "emergency" buttons where provided. Where there is no dialling system, lift receiver and ask for an ambulance, or alternatively arrangements can be made to get in touch with the Ambulance Station. (2) In the case of "special" non.emergency requests for ambulance transport, application must be made to the County Medical Officer, County Hall, Chelmsford. Requests are only accepted from the staff of a hospital, doctors, midwives, home nurses or other competent persons (e.g., health visitors or an authorised officer on the Medical Health Service). In these cases it is necessary to indicate whether— (a) a trained nurses is required, or (b) a sitting case car is required, or (c) if the case is one of infectious disease, the nature of the disease as pronounced by the medical attendant. If any difficulty should arise in obtaining an ambulance a call may be made direct to the County Medical Officer, County Hall, Chelmsford; telephone numbers: 4388 and 2543. 27 19) Clinics and Treatment Centres: Maternity and Child Welfare.—Infant Welfare Centres are held at the following premises: — Holy Trinity Church Hall, Mossford Green, Barkingside (for residents of Barkingside area) Monday, 2 p.m. Chadwell Christian Mission Hall, Essex Road, Chadwell Heath (for residents of Chadwell Heath area) Monday, 2 p.m. Mayesbrook Clinic, Goodmayes Lane, mayes (for residents of Becontree area) Tuesday, 2 p.m. St. John's Church Hall, Devonshire Road, Seven Kings (for residents of Downshall area) Tuesday, 2 p.m. Manford Way Clinic, Hainault (for residents of Hainault area) Tuesday. 2 p.m. Congregational Church Hall, Woodford Avenue, Ilford (for residents of Woodford Avenue area) Wednesday, 2 p.m. Cecil Hall, Granville Road, Ilford (for residents of the north side of Cranbrook Road) Wednesday, 2 p.m. Cecil Hall, Granville Road, Ilford (for residents of the south side of Cranbrook Road) Thursday, 2 p.m. Seven Kings Methodist Church Hall, Seven Kings Road (for residents of Seven Kings area) . Wednesday, 2 p.m. Newbury Hall, Perryman's Farm Road, Newbury Park (for residents of the Newbury Park area) Thursday, 2 p.m. Vine Memorial Church Hall, Grosvenor Road, Ilford (for residents of Grosvenor Road area) Thursday, 2 p.m. Mayesbrook Clinic (for residents of Goodmayes area) Thursday, 2 p.m. Vine Memorial Church Hall, Grosvenor Road, Ilford (for residents of Ilford Lane area) Friday, 2 p.m. Valentines Mansion, Emerson Road, Ilford (for residents of Valentines area) Friday, 2 p.m. Fairlop School, Fencepiece Road, Barkingside (for residents of Hainault area) Saturday, 9.30a.m. Ante.Natal Clinics.—An Ante.Natal Clinic is held at the Maternity Hospital, Eastern Avenue, Ilford, on Tuesday morning, Tuesday afternoon (Obstetric Specialist), Wednesday morning, Thursday morning, Friday morning, Friday afternoon (Obstetric Specialist), Saturday morning; at Mayesbrook Clinic, Goodmayes Lane, on Monday and Thursday mornings, and alternate Saturday mornings; at Manford Way Clinic, Hainault, on Wednesday mornings and the first Thursday morning of each month. Midwives Ante.Natal Clinics are held at the Public Health Offices, each Monday afternoon; at Mayesbrook Clinic each Wednesday afternoon (first Wednesday in each month excepted): at Manford Way Clinic on the first and third Thursday afternoons in each month. Posl.Natal Clinics.—These Clinics are held at the Maternity Hospital on each Monday afternoon; at the Mayesbrook Clinic, Goodmayes Lane, on alternate Saturday mornings; and at the Manford Way Clinic, Hainault, on the first Thursday morning of each month. School and other Clinics.—Clinics are held at the following premises: — (i) Public Health Offices, Valentines Mansion for— Diphtheiia Immunization. Aural. Ophthalmic treatment. Paediatric. Infant Welfare. Midwives Ante.Natal. 28 (ii) Newbury Hall, Perryman's Farm Road, for— Minor Ailments. Orthopaedic and Remedial Exercises treatment. Rheumatism. Artificial Sunlight' treatment. Infant Welfare. Cardiac Clinic. (iii) Mayesbrook Clinic, Goodmayes Lane, for— Minor Ailments. Dental (Children and Expectant Mothers). Ophthalmic treatment. Artificial Sunlight treatment. Ante.Natal and Post.Natal. Diphtheria Immunization. Orthopaedic and Remedial Exercises treatment. Infant Welfare. Speech Therapy. Midwives Ante.Natal. (iv) Valentines School. Beehive Lane, for— Dental (Children). Speech Therapy. (v) Loxford Hall, Loxford Lane, for— Child Guidance Clinic. (vi) Manford Way Clinic. Hainault, for— Ante.Natal and Post.Natal. Infant Welfare. Diphtheria Immunization. Midwives Ante.Natal. (vii) Chest Clinic.—A clinic for the diagnosis of tuberculosis is provided by the North East Metropolitan Regional Hospital Board at 130.132, Cranbrook Road, Ilford. The following sessions are held each week: — For Adults—Monday, 2 to 4 p.m.; Tuesday, 10 to 12 noon; Wednesday evening, for workers only, by appointment; Friday, 10 to 12 noon and 2 to 5 p.m. For Children—Wednesday, 10 to 12 noon. A Pneumothorax Refill Clinic is held on Monday morning and on Thursday afternoon. (20) National Assistance Act. 1948."—The County Welfare Officer has kindly supplied me with the following information regarding Ilford residents: — Persons admitted to residential and /or temporary accommodation provided by or on behalf of Essex County Council: — Aged and other classes—Adults 44 Children 21 Blind persons 3 68 Blind persons: — Registered as blind 221 Partially sighted 30 Defective sighted 31 282 all of whom were under the supervision of Home Teachers and 11 were participating in the Home Workers Scheme operating through the agency of the National Institute for the Blind. One blind person was placed in employment (open industry), the total number in Ilford being twenty.five. The principal functions of the Welfare Committee are in relation to the providing of residential accommodation for aged persons requiring care and attention; temporary accommodation for persons who become homeless and where the circumstances are unforeseen; and the welfare of blind persons, 29 SECTION C. SANITARY CIRCUMSTANCES OF THE AREA. (i) Water Supply.—The district is served by the Metropolitan Water Board and the South Essex Waterworks Co., both maintaining a constant supply. The subject of the water supply of the Borough was dealt with at length in the Report for 1945. . The part of Ilford within the area of the Metropolitan Water Board is supplied with water derived from the River Lee, which after passing through storage reservoirs is filtered and chlorinated at Lee Bridge and Ferry Lane, and pumped from those works. Contact tanks are now in operation at these works in which the dose of chlorine is able to exert its full effect before the water passes into the distribution system. An additional amount of water is supplied to the area from Wanstead well and Rammey Marsh well. Samples of the water in all stages of purification are analysed daily at the laboratories of the Board. Lieutenant.Colonel E. F. W. Mackenzie, Director of Water Examination of the Board has kindly supplied me with the information that 1,998 samples of filtered water were submitted to chemical and bacteriological examination and found to be pure and wholesome. All new and repaired mains are chlorinated before being restored to use and samples of water from them are tested bacteriologically. The water is not plumbo.solvent. The length of mains laid by the Metropolitan Water Board in Ilford during 1950 was two yards of 3.inch and 743 yards of 4.inch. The water to the other part of the area is supplied by the South Essex Waterworks Co. The supply is obtained from the River Stour and from deep wells at Mill Road, Grove Road and Roding Lane. Mr. Hugh G. Ramsay, Engineer to the South Essex Waterworks Co., has kindly supplied me with the information that just under 4,000 chemical, bacteriological and biological examinations were made at the Langham laboratory, and all were reported as wholesome. The samples taken were from wells and houses in various parts of the area. A supplemental supply of water was obtained from the Metropolitan Water Board for the period 18th February to 3rd June. The length of mains laid by the South Essex Waterworks Co. in Ilford during 1950 was 46 yards of 3.inch, 247 yards of 4.inch, and 7 yards of 6.inch. There are now no public wells in existence. There are a few private wells for domestic and commercial purposes. 5 samples of piped water supply (3 South Essex Waterworks Co. and 2 Metropolitan Water Board) were taken for chemical and bacteriological examination, and all gave satisfactory analyses. (ii) Drainage and Sewerage.—The Borough Engineer has kindly supplied me with the following statement: — Ilford Corporation (Drainage) Bill. This bill has been passed by both Houses of Parliament and has received the Royal Assent. It is now known as the Ilford Corporation (Drainage) Act, 1950. It is hoped to commence the work which the act authorises during 1951. Flooding of Streams. No serious flooding of streams occurred during the year. Pollution of Streams. There was no serious instance of pollution of watercourses during the year. 30 (iii) Collection and Disposal of Refuse.—The Borough Engineer also kindly supplied the following information: — Tons The total amount of refuse collected 47,326 „ „ disposed of by barge 25,637 „ „ „ at Destructor 3,041 „ „ „ at tip 18,648 Collection of Salvage:— Tons Income Wastepaper 833 £5,943 Kitchen Waste 1,893 £5,113 2,726 £11,056 The Refuse Destructor Works. Suffolk Road, closed on 31st October, 1950. From 1st November all refuse was tipped on the shoot of the Barking Corporation. (iv) Sanitary Inspection of the Area.—The following is a summary of the work of the Sanitary Inspectors during the year: — Houses and premises inspected 20,759 Houses and premises reinspected (work in progress) 20,524 Visits during disinfection 978 Houses in which nuisances were detected 1,364 Houses in which nuisances were abated 1,564* Premises disinfected 497 Premises from which articles only disinfected 90 Articles disinfected 2,114 Premises disinfested for verminous conditions 31 * Includes 489 nuisances detected before 1st January, 1950. In addition to the above, 575 notices (102 statutory and 473 informal) served previous to 1st January, 1950, were also complied with. Notices served: — Statutory:- Served Complied with Public Health Act, 1936 146 103 Housing Act, 1936 28 16 Factories Act, 1937 1 1 Shops Act, 1934 — — Provide Water Supply (Ilford Improvement Act, 1898) 1 1 Provide Dustbin (Ilford Urban. District Council Act, 1904) 24 21 Food and Drugs Act, 1938 — — Cleanse Water Storage Cistern (Byelaws) 5 5 Cover Water Storage Cistern (Byelaws) 3 3 Informal 1,414 1,103 1,622 1,253 31 Complaints.—During the year. 2.091 complaints of nuisances were received and investigated. The following is a summary: — Accumulation of manure and refuse 44 Animals improperly kept 17 Bad smells 84 Dampness of premises 96 Defective drains, w.c.'s and fittings 305 Defective roofs, gutters, downpipes, etc. 123 Defective water fittings 70 Dirty and verminous houses 42 Dirty condition of rearway — Flooding of premises 11 Overcrowding 184 Smoke nuisances 28 Miscellaneous 1,087 Total 2,091 (v) Swimming Baths and Pools.—Samples of water for examination were taken from the open.air swimming bath from April to October (7). The samples were satisfactory, but in 2 samples, chlorine was absent, and in 4 samples the chlorine content was below the prescribed standard. Samples were also taken from the two indoor baths during January, March, April, May, June, July, August, September. October and December (17); all of the samples were satisfactory, but in 10 samples (4 from the 1st and 6 from the 2nd class) the chlorine content was above the prescribed standard. (vi) Eradication of Bed Bugs: — Houses found to be infested ... .. ... ... 34 „ Disinfested ... ... ... ... ... 34 (vii) Slaughter of Animals Act, 1933.—No licence to act as slaughterman was granted during the year. (viii) Increase of Rent and Mortgage Interest (Restrictions) Acts, 1920 and 1933.—The Chief Sanitary Inspector is authorised by the Council to make visits and certify under the provisions of the Acts. No certificates were issued in respect of premises during 1950. (ix) Rag Flock Acts, 1911 and 1928.—The Medical Officer of Healtl) and the Sanitary Inspectors are the appointed Officers for the purposes of enforcing the provisions of these Acts. There are no premises on which rag flock is manufactured, but one firm is using rag flock and is periodically inspected. (x) Smoke, etc., Abatement.—Complaints were received of alleged smoke nuisance from 8 factories in the Barkingside, Newbury Park, Grove Road and Ilford Lane areas. In all cases the firms concerned made efforts to remedy the unsatisfactory conditions by installing new plant or by making repairs and adjustments to existing plant. Two firms alleged that the complaints were due to the supply of unsatisfactory fuel. Two informal notices were served, both of which were complied with. Regular observations were maintained and investigations carried out with a view to abatement of the nuisances. 32 SECTION D—HOUSING. (i) Overcrowding.—No notices were served during 1950. (ii) Unhealthy Areas.—No representations or complaints have been made regarding unhealthy areas during the year. (iii) HOUSING STATISTICS. 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) 1,411 (b) Number of inspections made for the purpose . 9,529 (2) (a) Number of dwelling.houses (included under head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 21 (b) Number of inspections made for the purpose 928 (3) Number of dwelling.houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (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 1,364 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 1,500* 3. Action under Statutory Powers during the year: — A. Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936: — (1) Number of dwelling.houses in respect of which notices were served requiring repairs ... ... 28 (2) Number of dwelling.houses which were rendered fit after service or formal notices: — (a) By owners 50* (b) By local authority in default of owners 4* B. Proceedings under Public Health Acts: — (1) Number of dwelling.houses in respect of which notices were served requiring defects to be remedied 179 (2) Number of dwelling.houses in which defects were remedied after service of formal notices: — (a) By owners 195* (b) By local authority in default of owners C. No proceedings were taken under Sections 11, 12 and 13 of the Housing Act, 1936. 33 4. Housing Act, 1936, Part IV—Overcrowding: — (a) (i) Number of dwellings overcrowded at the end of the year 548 (ii) Number of families dwelling therein 627 (iii) Number of persons dwelling therein 2,086 (b) Number of new cases of overcrowding reported during the year 138 (c) (i) Number of cases of overcrowding relieved during the year 76 (ii) Number of units concerned in such cases 2331 (d) Particulars of any cases in which dwelling.houses have again become overcrowded after the local authority have taken steps for the abatement of overcrowding — (e) Any other particulars with respect to overcrowding conditions upon which the Medical Officer of Health may consider it desirable to report — * Includes compliances during 1950 of Notices served prior to 1st January, 1950. HOUSING ACT, 1936. During the year 1950 the work of receiving applications, calling for, calculations for the "permitted number," was continued with a view to the issue of housing certificates. 85 certificates, in respect of 242 houses, were issued during the year, making a total of 18,262 certificates, in respect of 25,042 houses, issued to the end of 1950. As new premises were constructed and placed upon the rating lists, permitted number" certificates were issued as required. 34 SECTION E. INSPECTION AND SUPERVISION OF FOOD. Milk Supply. (i) Milk and Dairies Regulations, 1949.—The Council is required to keep a register of all persons carrying on the trade of milk distributor, and of all dairy premises (other than dairy farms) in their district, and to remove from such register the name of any person who ceases so to trade and the address of any premises which ceases to be so used. Persons and premises registered as at 31st December, 1950: — Persons registered as distributors of milk 68 Premises registered as dairy premises (other than dairy farms) 15 147 inspections of dairy premises were carried out during the year. (ii) Milk (Special Designation) (Raw Milk) Regulations, 1949.— The following licences were granted, during 1950: — Accredited Nil do. (Supplementary) Nil Tuberculin Tested 30 do. (Supplementary) 7 (iii) Milk (Special Designation) (Pasteurized and Sterilized Milk) Regulations, 1949. The following licences were granted during 1950: — Pastuerized (Dealer's) 48 do. do. (Supplementary) 8 do. (Pasteurizer's) 2 Sterilized (Dealer's) 44 do. do. (Supplementary) 10 The Council delegated to the Public Health Committee all its powers and duties under the Food and Drugs (Milk and Dairies) Act, 1944, the Milk and Dairies Regulations, 1949, the Milk (Special Designation) (Raw Milk) Regulations, 1949. the Milk (Special Designation) (Pasteurized and Sterilized Milk) Regulations. 1949, the Food and Drugs (Milk, Dairies and Artificial Cream) Act, 1950, and any Regulations which might hereafter be made under the last named Act. The Essex County Council granted one producer's licence in respect of graded milk produced on a farm in the Borough during the year 1949. The Essex County Agricultural Executive Committee also granted one producer's licence in respect of graded milk. Both licences are still in operation. (iv) Sampling.—The following is the routine practice adopted: — Designated Milks, Raw and Ungraded (Heat treated) Milks.— These are sampled bi.monthly and after unsatisfactory reports. Biological Tests.—Samples of all milks, designated or otherwise, are submitted for biological test for T.B. in Spring. Repeat samples if positive after clearance by the Divisional Inspector of the Ministry of Agriculture and Fisheries. Milk Supplies to Elementary Schools.—These are sampled monthly and after unsatisfactory results. Ice Cream.—Samples are taken monthly from April to Septembe: and at regular intervals during the winter months as supplied by all manufacturers to tricycle salesmen and local retailers. Samples are repeated after unsatisfactory results, 35 The following results were obtained: — Grade of Milk or Ice Cream Total Satisfactory Unsatisfactory Remarks on unsatisfactory results Tuberculin Tested (Pasteurized) Milk 22 22 - - Tuberculin Tested Milk (Farm bottled) 16 15 1 The sample failed to satisfy the Methylene Blue Reduction test. The Area Milk Officer of the Ministry of Food was communicated with. Further samples proved satisfactory. Accredited 5 5 — — Pasteurized Milk 108 103 5 All 5 samples failed to satisfy the Methylene Blue Reduction test. The retailers were communicated with and re.sampling ordered at a later date. Further samples proved satisfactory. Sterilized 29 29 — — Heat.Treated Milk 7 7 — — Ungraded Milk 10 10 — — Ice Cream 140 130 10 In all cases the retailers were communicated with and the Sanitary Inspectors visited the premises to check the arrangements for storage, etc. Further available samples proved satisfactory. (v) Biological Tests.—34 samples of milk were submitted to a biological test for tuberculosis, none of which was found positive. (vi) Milk and Dairies Orders, 1926 and 1938: Inspection of Dairy Herds.—Four inspections were made by the Veterinary Officers of the Ministry of Agriculture and Fisheries. The Ministry's Divisional Inspector states that no cows were found to be suffering from tuberculosis. (vii) Legal Proceedings.—17 complaints of the presence of foreign bodies in milk were received and investigated during 1950. Legal proceedings were taken in one instance but the case was dismissed. (viii) Registration.. No application for registration was refused during 1950 36 Articles of Food Surrendered. During the year the following articles were surrendered and condemned as being unfit for the food of man: — Biscuits—110 tins, 8¾ lbs.; Butter, Margarine and Fats— ½ lb.; Butter (peanut)—2 tins; Cake—20 lbs.; Cereals—1861 lbs.. 4 packets. 1 box, 9 tins; Cheese—81¼ lbs., 1 box; Chocolate Spread—17 tins; Coconut (dessicated)—158 lbs.; Coffee—½ lb.; Confectionery—19½ lbs., 376 bars, 45 packets; Cordial—29 bottles; Eggs (shell)—1,337; Eggs (dried)—5 ozs.; Fish (wet and dry)—207 stones; Fish tinned—786 tins: Fish (shell)—6 bags, 2 boxes; Fish (paste)—561 tins, 10 jars; Flour328 lbs.; Foods (medicinal)—162 tins. 2 packets; Fruit (tinned)—873 tins; Fruit (bottled)—24 bottles; Fruit (dried)—226 lbs., 1 box; Fruit (fresh)—631¾ lbs., 2 boxes; Gravy Mixtures—96 ozs., 26 tins, 2 bottles; Jam. Preserves, etc.—230 tins and jars; Meat (fresh) 4 cwt. 26 lbs.; Meat (pies)—4 cwt. 95 lbs.; Meat (tinned)—549 tins; Milk (tinned)—1,708 tins; Pastry and Pudding Mixtures—49 packets, 5 tins; Pickles—42 jars; Poultry—3 geese, 12 chickens; Pudding (Black)—4 lbs.; Puddings—4 tins; Rabbits—120 lbs.; Rice—217 lbs.: Sandwich Spread—229 jars and tins; Sauces and Salad Cream, 239 bottles; Sausages—199 lbs.; Spices—278 packets, 1 drum; Soups. 365 tins; Sugar—56 lbs.; Vegetables (fresh)—2 lbs.; Vegetables (tinned) —1,368 tins; Vinegar—1 bottle. Foreign Bodies in Food. 25 complaints were received during 1950 of the presence of foreign bodies in foodstuffs. All were investigated and legal proceedings were taken in one case and a fine of £5 5s. 0d. plus £2 2s. 0d. costs, was imposed on the food manufacturers. Letters of warning were served in 6 cases. Food and Drugs Act.—During 1950, 314 samples (306 formal and 8 informal) of Food and Drugs were obtained; 1 formal sample and 2 informal samples were not satisfactory as follows: — (a) Milk (formal).—This sample was deficient in fat to the extent of 36%. Legal proceedings were taken against the dairyman but the case was dismissed under the Probation of Offenders Act on payment of £2 2s. Od. costs. (b) Iced cake (informal).—This sample contained two black specks which were identified as mice excreta. Legal proceedings were taken and the bakery firm was fined £5. (c) Bread (informal).—This sample contained foreign bodies which were identified as masses of oil charred bread. A letter of warning was sent to the bakery firm concerned. Food Poisoning. By virtue of Section 82 of the Ilford Corporation Act. 1937, food poisoning became compulsorily notifiable in Ilford as from 1st October, 1937. It is also notifiable under Section 17, Food and Drugs Act. 1938. Forty.eight notifications were received. The following is a summary for the year:— Agents Identified. No. of outbreaks No. of cases No. of deaths Organisms or other Agents responsible with No. of outbreaks of each. Suspected foods involved with No. of outbreaks of each. 2 3* 1 Salmonella Typhi.murium 1 Hashed beef 1 Staphy loeoccus pyogenes 1 Unknown 1 * (Although only one child in one outbreak was found to give a positive result on bacteriological investigation, a further 46 children were unwell, but were not notified.) 37 There were four other outbreaks involving 21 cases, but in no instance was the cause discovered. There were also 24 single cases; the agent was identified in only 16 instances of these, viz., Salmonella typhi.murium 11; Salmonella Newport 2; Salmonella Thompson 1; Salmonella Enteritides 1; B. Aertrycke 1. This last case proved fatal, the cause of death being certified as Gastro.enteritis (B. Aertrycke) following a post.mortem conducted by the Coroner. Twelve other instances of suspected food poisoning were investigated, but were not notified, and no specific cause was discovered. Bakehouses.—There are 31 bakehouses in the district, 25 of which are motive power. 250 inspections of bakehouses were carried out during the year. It was necessary to call upon the occupiers of bakehouses to carry out cleansing and other work in 6 instances, and the requests were complied with in all cases. Meat and Other Foods.—During 1950, 5,934 inspections were made of foodshops and food preparing premises, 47 Informal Notices were served under the Food and Drugs Act. 1938. and 1 Formal and 41 Informal Notices were complied with, including 1 Formal and 14 Informal Notices served in 1949. Diseases of Animals Acts, 1894.1937. (i) Regulation of Movement of Swine Order, 1950.—The Minister f Agriculture and Fisheries made this Order, which became operative on 6th August, 1950, and prescribed an area, which included Ilford, in which no sale of swine should be held in any market, fairground or saleyard unless authorised by the Local Authority. Restrictions were also placed on the movement of swine. Notice was received in respect of the movement of 1 white sow and 10 white store pigs to an address in the Borough. The animals were effectively isolated for the requisite period. (ii) Parasitic Mange Order. 1938.—Notification was received of suspected parasitic mange at stables at Newbury Park. Form A Detention Notice was served on the occupier and copies sent to the Local Authority, Police and Ministry of Agriculture and Fisheries. The suspicion was not verified by a Veterinary Officer of the Ministry and the Form A Notice was withdrawn. (iii) Anthrax Order, 1938.—Notification was received that a pig (sow) had died at the farm of a local hospital and that anthrax was suspected. Form A Notice was served on the Hospital Authorities and the Ministry of Agriculture and Fisheries was notified. The disease was subsequently diagnosed as swine erysipelas and not anthrax. (iv) Live Poultry (Regulation of Sales, Exhibitions and Movements) Order, 1950. Poultry Carcases (Importation) Order. 1950. Live Poultry (East Anglia) (Restrictions) and (England & Wales) (RESTRICTIONS) Orders, 1950.—These Orders deal with the requirements necessary to prevent the spread of Fowl Pest by controlling the movement nd sale of live poultry and poultry carcases. No cases of Fowl Pest were notified during 1950. 38 Prevention of Damage by Pests Act, 1949.—This Act, which repealed the Rats and Mice (Destruction) Act, 1919, came into operation on 31st March, 1950. All Local Authorities are required to take all necessary steps to keep their districts free from rats and mice. To this end inspections must be made and, where rats or mice are found on premises to serve notice on the occupier to carry out specified treatment and works to exterminate them and to enforce the duties imposed by the Act on owners and occupiers of land. Where an owner or occupier fails to comply with a notice served by the Local Authority under the Act, the Local Authority may carry out the work and recover the costs incurred. Failure to comply with the notice renders the owner or occupier liable to a penalty. It is the duty of all occupiers of land to notify infestations of rats and mice in order that the Local Authority may carry out their duties under the Act. During 1950, 185 complaints were received of the existence of rats affecting 196 premises. In 25 of these cases poison gas was used and in the remaining cases other means of eradication were employed. 1,533 visits were made by the Sanitary Inspectors. The Council decided to appoint a whole.time Rodent Operative, who commenced his duties on 1st January, 1951. Petroleum (Consolidation) Act, 1928.—The Sanitary Inspectors made 585 visits to premises where petroleum is stored, or in conjunction with the installation of such storage, and tested 6 petroleum appliances or fittings. The number of Licences issued was 135, and the fees paid to the Council for such Licences was £96 5s. Od. One Licence was issued for the storage of calcium.carbide, the fee payable being 5s. 39 SECTION F. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASES. The following diseases are notifiable to the Medical Officer of Health: — 1. Under Section 144 and 343, Public Health Act, 1936. Smallpox. Typhoid Fever. Cholera. Enteric Fever or Relapsing Fever. Diphtheria. Anthrax (made notifiable by the Local Membranous Croup. Authority as from 1/4/22). Erysipelas. Pemphigus Neonatorum (made Scarlatina or Scarlet Fever. fiable by Local Authority as from Typhus Fever. 29/6/29). 2. Under Regulations of the Ministry of Health. Plague L.G.B. Order, 19/9/1900. Puerperal Pyrexia The Puerperal Pyrexia Regulations, 1939. Ophthalmia Neonatorum P.H. (Ophthalmia Neonatorum) Regulations, 1926. Acute Primary and Acute} Influenzal Pneumonia } P.H. (Pneumonia, Malaria, Dysentery, Dysentery} etc.) Regulations, 1927. Malaria} Tuberculosis P.H. (Tuberculosis) Regulations. 1930. Acute Rheumatism (up to 16 The Acute Rheumatism Regulations, 1950. years) Measles and Whooping Cough The Measles and Whooping Cough Regulations, 1940. Acute Poliomyelitis} P.H. (Acute Poliomyelitis, Acute Acute Encephalitis} cephalitis and Meningococcal Infection) Meningococcal Infection} Regulations, 1949. The Public Health (Acute Poliomyelitis, Acute Encephalitis, and Meningococcal Infection) Regulations, 1949. (These regulations came into operation on 1st January, 1950. They were designed to replace, with slight modifications, the Public Health (Cerebro.spinal Fever and Acute Poliomyelitis) Regulations, 1912, and the Public Health (Acute Encephalitis Lethargica and Acute Polio.Encephalitis) Regulations, 1918. They introduced nomenclature consistent with the international tandard classification of diseases which was brought into general use on 1st January, 1950, slightly extend the scope of clinical conditions notifiable under the head of acute encephalitis, and distinguish between paralytic and non.paralytic forms of acute poliomyelitis.) The Acute Rheumatism Regulations, 1950, came into operation on the 1st October, 1950, for a period of three years, and revoked the Ilford (Acute Rheumatism) Regulations which ad been in operation since 1st April, 1935. The new regulations became operative in other areas beside Ilford, hence the special order. The t?rm "acute rheumatism" means: (i) rheumatic pains or arthritis accompanied by a rise of temperature; (ii) rheumatic chorea; (iii) rheumatic carditis ; (iv) valvular disease of the heart of rheumatic origin. 3. By Local Act. Food Poisoning Ilford Corporation Act, 1937, and Food and Drugs Act, 1938. In addition to the above diseases notifiable to the Medical Officer of Health, certain industrial diseases are notifiable to the Chief Inspector of Factories, Home Office, under Section 66 of the Factories Act. 1937. These are cases of Lead. Phosphorus, Arsenical or Mercurial Poisoning or Anthrax contracted in any factory. The Secretary of State can add other diseases to those mentioned by Regulation. 40 TABLE III.—Cases of Infectious Diseases Notified during the Year 1950 NOTIFIABLE DISEASE At all Ages Number of Cases Notified At Ages—years Total Cases Notified in each Ward Total Cases Admitted to Hospital Under 1 1 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upwards Cranbrook Park Loxford Clementswood Mayfield Goodmayes Fairlop Clayhall Barkingside N. Hainualt Seven Kings S. Hainault Smallpox - - - - - - - - - - - - - - - - - - - - - Scarlet Fever 397 2 112 266 12 3 2 - 14 18 50 53 32 19 46 58 41 17 19 30 210 Diphtheria, including branous Group 1 — — 1 — — — - — — — — — — 1 — — — — — 1 Enteric Fever (Typhoid and Para-Typhoid 2 — 1 — — 1 — - — — — — 1 1 — — — — — — 2 Pneumonia 194 11 11 25 10 36 56 45 14 30 7 8 17 8 7 14 17 21 25 26 100 Puerperal Pyrexia 20 - — — 12 17 — — - — — — — — 1 — — 26 — 2 29 Acute Poliomyelitis 26 — 3 11 8 3 1 — 3 — — 3 1 4 5 2 1 2 2 3 25 Acute-Encephalitis 1 — 1 - - - - - - - - - - - - - - - - - 1 Meningoccocal Infection 3 1 2 — — — — — — — — — 1 — — — 2 — — 3 Dysentery 81 9 38 10 12 6 5 1 3 2 — — 2 2 — 1 66 2 2 1 65 Ophthalmia Neonatorum 2 2 — — — — — — — — — 1 — 1 — — — — — — — Erysipelas 42 — — — 2 12 18 10 2 2 1 5 4 4 5 0 3 4 2 4 11 Pemphigus Neonatorum — — — — — — — — — — — — — — — — — — — — — Tuberculosis Pulmonary 230 — 5 11 76 88 42 8 21 14 23 12 14 19 32 7 16 15 22 35 — Other Forms 23 — 4 — 5 13 1 — 2 3 — 2 1 3 2 1 3 1 2 3 Anthrax — — — — — — — — — — — — — — — — — — — — — Malaria—Believed contracted in this country — — — — — — — — — — — — — — — — — — — — Believed contractecd abroad 1 — — — — 1 — — — — — — — — — — — — — 1 1 Acute Rheumatism 6 — — 6 — — — — — — 1 — 1 I — — 2 — — 1 5 Measles 1,468 35 652 772 7 1 1 — 54 1ll 88 68 125 139 41 233 91 73 225 220 40 Whooping Cough 1,121 66 554 486 1 7 7 — 41 75 26 51 102 151 75 126 116 138 66 154 18 Food Poisoning 48 1 4 5 16 10 12 1 1 2 — — 4 1 1 17 2 8 11 25 Totals 3,675 127 1,387 1,593 | 161 198 145 04 156 256 198 203 300 857 216 449 373 303 373 401 536 Of the cases notified, the following table shows the percentage treated in institutions, including those who were treated in the institutions from which they were notified: — Scarlet Fever 53.4 Diphtheria and Membranous Croup 100.0 Puerperal Pyrexia 100.0 Pneumonia 51.6 Acute Poliomyelitis 96.1 The year 1950, on the whole, showed a higher incidence of infectious disease than 1949. The number of cases of measles notified was 1,468 as compared with 1,663 the previous year, but whooping cough cases numbered 1,121 as compared with 566 in the year 1949. (a) Smallpox.—No cases were notified during 1950. Notifications regarding 21 persons who had been in contact with cases of Smallpox on board ship were received. These were visited by the Sanitary Inspectors, 66 visits being paid. The following gives particulars as to Vaccination during 1950: — Primary vaccination 1,198 Re.Vaccination 373 Under the National Health Service Act. 1946, compulsory vaccination was abolished, and from 5th July, 1948. this service became the responsibility of the Essex County Council vide Section 26 of the National Health Service Act, 1948. (b) Scarlet Fever.—397 cases were notified in 1950. There were no deaths from this disease. Thirty.five cases were admitted to Isolation Hospitals outside the district during 1950. 41 The total number of deaths of Ilford residents from the following infectious diseases during 1949 and 1950 were as follows: — 1949 1950 Scarlet Fever — — Enteric Fever — — Diphtheria — — Acute Poliomyelitis 4 2 Measles 1 — Whooping Cough 1 — Influenza 18 11 Tuberculosis—Pulmonary 48 42 Other forms 5 4 Pneumonia 70 39 Diarrhoea (under 2 years) 1 — Meningococcal Infections 1 1 Total 149 99 42 (c) Diphtheria.—One case only was notified in 1950. The patient (a boy of 6 years) was admitted to the Ilford Isolation Hospital and made a satisfactory recovery. (d) Ophthalmia Neonatorum.—Two cases were notified during 1950. Cases Vision Unimpaired Vision Impaired Total Blindness Deaths Notified Treated At Home In Hospital 2 2 — 2 . — — (e) Enteric Fever.—Two cases only were notified during the year, a female of 28 years and a male of 1½ years. The cases proved to be paratyphoid fever "B." The female patient was admitted to the Ilford Isolation Hospital and the male patient to Rush Green Hospital, Romford. Both patients made a good recovery. (f) Acute Anterior Poliomyelitis and Acute Polio.Encephalitis.— Twenty.six cases of the former disease were notified during 1950. Twenty.four patients were admitted to Hospital as follows: — Ilford Isolation Hospital, 13; Eastern Hospital, Homerton, 1; Rush Green Hospital, 5; Chingford Isolation Hospital, 1; Plaistow Fever Hospital, 2; London Hospital 1; Royal Herbert Hospital, Woolwich. 1. One case was nursed at home, and one attended the Outpatient Department at King George Hospital. Under I year 1—5 years 5—15 years 15—25 years 25 years and over Totals Males — 3 8 6 2 19 Females — — 3 2 2 7 Residual paralysis .— 2 3 7 1 13 Transferred to special Orthopaedic Units — — — — — — Referred to Orthopaedic Clinics for Physiotherapy — 2 1 8 2 13 Treated in "Iron Lung" — — — 1 1 2 Fatal — — — 2 2 Ten cases recovered with no residual paralysis. The first case was admitted to Hospital, on 28th June. Precautions were taken in Day Nurseries, Schools, Infant Welfare Centres and Treatment Clinics. The epidemic of 1950 was locally not as severe as that of 1949 but considerably exceeded those of pre.war years. From a national standpoint the incidence was more severe than that of 1949. but less severe than that of 1947. 43 Table showing Incidence of Infectious Disease, 1950, in age groups ; and total Deaths. Disease Total cases notified Under 1 year 1—2 2—3 3—4 4—5 5—10 10—15 15—20 20—35 35—45 45—65 Over 65 * Cases admitted to Hospital Total Deaths Smallpox — — — — — — — — — — — — — — — Scarlet Fever 397 2 3 22 45 42 230 36 11 3 1 2 — 207 — Diphtheria 1 — — — — — 1 — — — — — — 1 — Enteric Fever (including Para-typhoid) 2 — 1 — — — — — — 1 — — — 2 — Pneumonia 194 11 1 5 5 — 20 5 6 17 23 56 45 94 39 Puerperal Pyrexia 29 — — — — — — — 2 23 4 — — 29 — Acute Poliomyelitis 20 — 1 1 1 — 6 5 7 4 — 1 — 25 2 Acute Encephalitis — — — — — — — — — — — — — — — Meningococcal Infection 3 1 1 1 — — — —— — — — — — 3 1 Dysentery 81 9 11 2 10 14 12 — 10 6 1 6 — 2 — Ophthalmia Neonatorum 2 2 — — — — — — — — — — — — — Erysipelas 42 — — — — — — — 1 6 7 18 10 11 — Anthrax — — — —— — — — — — — — — —— — — Malaria believed to be contracted in this country — — — — — — — — — — — — — — — Malaria believed to be contracted abroad 1 — — — — — — — — 1 — — — 1 — Pemphigus Neonatorum — — — — — — — — — — — — — — — Acute Rheumatism 6 — — — — — 2 4 — — — — — 4 — Food Poisoning 48 1 1 — 2 — 4 2 14 8 5 11 — 11 1 Measles 1468 35 120 162 202 168 701 11 5 2 1 1 — 23 — Whooping Cough 1121 66 96 119 183 156 475 11 1 5 2 7 — 18 — * Excludes cases occurring at Barnardo's Homes, Claybury Hospital and Goodmayes Hospital 44 Influenza and Pneumonia.—These diseases showed a lower incidence in 1950 as compared with 1949. The incidence of influential and primary pneumonia throughout the year is shown by the following table. Month. 1950 Acute Primary Pneumonia Acute Influenzal Pneumonia Hospital Admissions Nursed at Home Hospital Admissions Nursed at Home Cases Deaths Cases Deaths Cases Deaths Cases Deaths January 10 . 13 — 11 3 9 . February 6 3 5 1 5 — 2 1 March 5 — 5 — 5 1 5 1 April 4 — 7 — 1 3 . May 4 — 2 — 5 1 4 . June 3 1 6 — 1 — 1 — July 6 1 2 — 1 — 3 1 August 8 — 2 1 2 — — — September 1 — 4 — 1 — 1 — October 3 — 4 1 1 — 1 — November 6 — 3 — 2 1 2 — December 10 1 0 1 5 — 3 — Totals 61 6 59 4 40 6 34 3 It will be seen from the above figures that of 120 persons notified .is suffering from acute primary pneumonia there were 10 deaths, equal to 8'3 percent.; and in the case of acute influenzal pneumonia 74 notifications with 9 deaths, equal to 121 per cent. 3. Tuberculosis.—During the year 1950 there was 230 new notifications of Pulmonary Tuberculosis and 23 of other forms of Tuberculous. 12 cases of Pulmonary and 3 cases of Non.Pulmonary Tuberculosis were transferred to Ilford. Notifications and Deaths from Tuberculosis of llford residents during 1950: — Age Periods New Cases Deaths Respiratory NonRespiratory Respiratory NonRespiratory M F M F M F M F Under 1 year . . . . . . . . 1.5 years 2 3 3 1 — — — — 5.15 2 9 — — — — 1 1 15.25 33 43 4 1 3 2 1 — 25.35 35 31 4 6 4 4 — — 35.45 11 11 2 1 4 0 — — 45—55 18 7 1 — 9 1 — — 55.65 13 4 — — 4 1 — — Over 65 6 2 — — 4 — — 1 Totals 120 110 14 9 28 14 2 2 Of the foregoing new cases, the following were notified from Institutions in the district: — Respiratory Tuberculosis NonRespiratory Tuberculosis King George Hospital 6 1 Claybury Hospital 9 1 Goodmayes Hospital 9 — Ilford Isolation Hospital and Sanatorium 7 — Dr. Barnado's Village Homes 2 1 Of the 46 deaths which occurred of Ilford residents, notification had previously been made of 41 of the cases. In the remaining five cases the presence of Tuberculosis was only discovered as a result of post mortem examination. During the year 1950 the following deaths occurred from Tuberculosis:— Pulmonary Non-Pulmonary Ilford Residents 42 4 Son-Residents— Claybury Hospital 7 1 Goodmayes Hospital 5 — Ilford Isolation Hospital 14 — King George Hospital 2 — Pulmonary NonPulmonary Total Number of cases on register, 1st January, 1950 1,153 204 1,357 Number of cases entered on register during the year 242 26 268 Number of cases removed from the register during the year: — Pul. NonPul. Recovered 44 30 Deceased 47 3 Left District 74 14 Lost sight of 3 2 Diagnosis not established 6 1 174 50 224 Number of cases remaining on register on 31st December, 1950 1,221 180 1,401 45 Cases of Tuberculosis, on notification, are visited by the Tuberculosis Nurses. Cases of longer standing were visited by the Sanitary Inspectors during the year, a visit being made to each patient every six months; 1,12l persons were visited during the year. The following reports were obtained: — Pulmonary Cases Other Cases Condition good 557 102 „ poorly 250 25 In sanatoria 99 12 No information as to present condition 24 4 Removed from district, etc. 40 8 970 151 46 The treatment of Tuberculosis is now under the control of the Regional Hospital Board. On the 31st December, 1950, there were 1,113 patients on the register of the Ilford Clinic. The Dentist held 18 sessions and treated 21 tuberculosis patients from the Ilford Sanatorium. They paid 59 visits to the Clinic. Seven were provided with dentures. The number of patients from Ilford sent to Institutions under the Tuberculosis Scheme during 1950 was as follows: — Pulmonary Non.Pulmonary Total Males Females Males Females Adults 75 89 4 5 173 Children 1 6 2 1 10 Tuberculosis Care Association.—This Association has assisted 98 cases with extra nourishment, clothing, and in other ways. Public Health Act, 1936 (Section 163).—No certificate in respect of the death of a patient was issued, stating that the body should not be removed from hospital for the purpose of being buried forthwith. 4. Venereal Diseases.—In the following table are classified the deaths notified as due to (1) Syphilis; (2) Locomotor Ataxy and General Paralysis of the Insane, which are certainly due to Syphilis; and (3) Aortic Aneurysm, which is very frequently caused by this disease: — Ilford Residents Ages Non.Residents in Institutions Total 0—1 1—5 5—15 15—25 25—35 35—45 45—55 55—05 65—75 75—85 85 up Syphilis . . . . . . . 1 1 . . 2 4 Locomotor Ataxia . . . . . . . . . . . . . General Paralysis of the Insane . . . . . . . . . . . 1 1 Aortic Aneurysm . . . . . . . . . . . 1 1 The deaths in Institutions of Ilford non.residents occurred chiefly at Claybury and Goodmayes Hospitals; 1 3 percent. of the registered causes of death in these Institutions fell under the above headings. Many other patients died from incidental causes; the reason, however, for their admission to these Mental Hospitals was some venereal infection. 47 The following figures show the number of cases of Ophthalmia Neonatorum notified during the past five years: 1946, 5; 1947, 11; 1948, 4; 1949, 1; 1950, 2. It is to be remembered that many cases of ophthalmia neonatorum are not due to gonorrheal infection, and neither case in 1950 were venereal. The treatment of patients is now the responsibility of the Regional Hospital Board. The following are the V.D. Treatment Centres situate nearest to Ilford:— Romford.—The Annexe, Oldchurch Hospital, Waterloo Road, Romford:— Sessions Monday, 4 to 6.30 p.m. Tuesday, 4 to 6.30 p.m. Thursday, 12 to 3 p.m. Whitechapel.—Whitechapel Clinic, Turner Street, Mile End, London, E1:- Sessions Monday to Friday, 10 a.m. to 7 p.m. Saturday. 10 a.m .to 3 p.m. Consultation Times Treatments are given from 9 a.m. onward. West Ham.—Queen Mary's Hospital, West Ham Lane, Stratford, London, E.15:— Sessions (Males) Monday, 3 to 6 p.m. Thursday, 11 a.m. to 1 p.m.; 6 to 8 p.m. Saturday, 2.30 to 4.30 p.m. (Females) Monday, 6 to 8 p.m. Thursday, 11 a.m. to 1 p.m.; 3 to 6 p.m. Saturday, 2.30 to 4.30 p.m. Publicity and Propaganda, Etc. Copies of the magazine "Better Health" are distributed monthly to the reading rooms of Public Libraries, the Infant Welfare Centres, and at the Public Health Offices. Public lectures to Ratepayers' Associations, Evening Institutes and Church organisations, etc., on health topics were given during the year. The Chairman of the Public Health Committee also made reference at a number of Council meetings to health subjects. Poster displays regarding Diphtheria immunisation and health topics were also given prominence. Arrangements were made for the films, entitled "Local Government" and "One Man's Story," to be shown to the members of the Public Health Committee and others on 9th January, 1950. Health Investigation: "Survey of Sickness." A "Survey of Sickness" was made by the Government Social Survey Organisation at the request of the Ministry of Health in Ilford during the period October. 1949. to March, 1950. The object of the Survey, carried out at regular monthly intervals, and based on samples of the population seeks to obtain information about the amount of ill-health occurring in the country under present conditions. Examination of Officers, Teachers and Servants. The following medical examinations were carried out during 1950:— ] Officers Teachers Servants New Appointments 119 3 99 Under Sickness Regulations 9 1 50 Totals 128 4 149 48 SECTION G.—FACTORIES. The Factory and Workshop Act, 1901, was superseded by the Factories Act, 1937, which came into operation on 1st July, 1938. There are 361 factories with mechanical power on the register. There are 221 factories without mechanical power on the register. There are 249 outworkers on the register. 1.—INSPECTION OF FACTORIES AND OTHER PREMISES. Including Inspections made by Sanitary Inspectors. Premises (1) Number of Inspections (2) Written Notices (3) Occupiers prosecuted (4) Factories with Mechanical Power 1,203 19 - Factories without Mechanical Power 644 4 - Other premises (not including Outworkers' premises) 15 - - Total 1,862 23 - 2—DEFECTS FOUND IN FACTORIES. Particulars Number of Defects No. of defects in respect of which Prosecutions were instituted Found Remedied Referred to H.M. Inspector Want of Cleanliness (S.l) 6 3 - - Overcrowding (S.2) - - - - Unreasonable Temperature (S.3) - 1* - - Inadequate Ventilation (S.4) - - - - Ineffective Drainage of Floors (S.6) - - - - Sanitary Conveniences (S.7):— Insufficient 1 3* - - Unsuitable or Defective 14 12 - - Not Separate for Sexes 2 1 - - Other Offences - - - - Total 23 20* - - *Includes compliances of defects found in 1949. 49 PART III.—SERVICES. National Health Service Act, 1946. Births.—In accordance with the provisions of the Public Health Act. . 1936, all live births and all stillbirths of twenty-eight weeks gestation and over must be notified within 36 hours to the Medical Officer of Health of the area in which the birth took place. The number of live births notified in Ilford under this Act during 1950 was 1,933 (988 males and 945 females), of which there were 90 (52 males and 38 females) where the ordinary place of residence of the parents was outside Ilford. In addition, 581 notifications of live births (316 males and 265 females) which took place outside the district, although the ordinary residence of the parents was in Ilford, were transferred to this district. During the year, 4 cases in which there was default in complying with the requirements of the Public Health Act relating to the Notification of Births were referred to the Area Clerk. The percentage of live births occurring in Ilford, notified by the various responsible persons, was as follows:— By Medical Practitioners 16 By Certified Midwives 99.64 By Parents and others 2 There were also 40 stillbirths (18 males and 22 females) notified in Ilford including 2 (females) where the home address of the parents was outside the district, and notifications of 10 stillbirths (5 males and 5 females) which took place outside the district, although the ordinary residence of the parents was in Ilford, were transferred to this district. Care of Premature Infants.—Of the 1,933 live births occurring in ilford during 1950, 90 weighed 51 lbs. or less at birth; 30 of these babies were born at home and 60 in Hospital (including 2 in Private Nursing Homes). The number of those born at home— (i) who were nursed entirely at home 17 (ii) who died during the first 24 hours 4 (iii) who survived at the end of one month 23 The number of those born in Hospital— (i) who died during the first 24 hours 1 (ii) who survived at the end of one month 57 Infant Mortality.—The number of infants dying within the first year of life was 45, the total number born being 2,406. The latter figure is supplied by the Registrar-General for calculating infant and maternal mortality rates. The infant mortality, or rate of deaths per 1,000 live births, was, therefore 18 7, the lowest figure ever recorded in Ilford. Neonatal Mortality.—The death-rate of infants under four weeks of age is known as the Neonatal Mortality. There were 32 deaths of infants under four weeks of age during 1950 and the rate for the year was 13 3 per 1,000 live births. 50 The figures for the past 45 years were as follows:— Year Number Rate Year Number Rate 1950 32 13.3 1927 32 19.3 1949 33 12.5 1926 32 21.2 1948 37 12.9 1925 37 24.9 1947 51 15.1 1924 28 19.5 1946 74 21.5 1923 34 21.2 1945 49 19.8 1922 40 27.1 1944 64 23.1 1921 38 25.5 1943 54 20.6 1920 45 27.0 1942 49 20.3 1919 36 30.8 1941 36 22.0 1918 32 30.4 1940 43 22.3 1917 29 24.7 1939 57 25.8 1916 43 28.8 1938 50 21.8 1915 54 35.1 1937 52 23.0 1914 43 28.7 1936 59 26.7 1913 37 24.6 1935 51 24.8 1912 45 30.2 1934 37 18.8 1911 34 21.4 1933 48 25.9 1910 54 32.2 1932 41 20.6 1909 56 34.0 1931 64 32.3 1908 55 33.2 1930 31 16.8 1,907 54 31.5 1929 48 27.4 1906 57 33.5 1928 41 23.6 51 The following table gives the deaths of infants under one year of age, classified according to age: — Infant Deaths—1950. Cause of death Under 1 week 1—2 weeks 2—3 weeks 3—4 weeks Total under 4 weeks 1—3 months 3—6 months 6—9 months 9—12 months Total Asphyxia i 1 _ 1 Asphyxia due to suffocation—found beneath blanket 1 1 Atelectasis ... ... .... 2 1 — — 3 — — — — 3 Atelectasis—Erythroblastosis 2 — — 2 —. — — — 2 Cardiac failure 1 — — — 1 — — — — 1 Cerebral Haemorrhage 1 — — — 1 — — — — 1 Cerebral Thrombosis 1 1 Congenital heart disease ... 1 — — 1 2 — — 2 — 4 Congenital Hydrocephalus Erythroblastosis Foetalis 1 1 1 1 1 Haemolytic disease 1 1 — — — — 1 Imperforate Anus ... 1 — — — 1 — — — — 1 Initial respiratory failure 1 1 — — — — 1 Multiple congenital abnormalities of the heart... ... ••• ••• 2 2 2 Prematurity 6 1 — 7 — — — — 7 Pneumonia—all forms (i 2 —* — 8 3 1 3 — 15 Toxaemia ... 1 — 1 ^Viliris tumour.—left kidney 1 — — — 1 — — — — 1 Totals 27 4 1 32 5 1 7 45 The comparative figures for the past 10 years are as follows: — Year No. of Deaths under 1 year Rate per 1,000 Registered Live Births 1950 45 18'7 1949 53 20-1 1948 62 21-7 1947 82 24-3 1946 102 296 1945 81 32'7 1944 102 36-8 1943 92 351 1942 74 30'6 1941 67 409 The mean average Infant Mortality rate for the past 10 years is therefore 29' 1 per 1.000 live births. 52 The following table shows the comparison for Ilford, England and Wales, London, and Towns having a population exceeding 50,000 for the past 10 years:— Year. Ilford England and Wales London Towns with population over 50,000 1950 18.7 30 26 34 1949 20.1 32 29 37 1948 21.7 34 39 32 1947 24.3 41 47 36 1946 29.6 43 41 46 1945 32.7 46 53 54 1944 36.8 46 61 52 1943 35.1 49 58 58 1942 30.6 49 60 59 1941 40.9 59 68 71 Illegitimate Births and Deaths.—74 of the live births registered (43 males and 31 females) were illegitimate, that is 31 per cent of the births registered. Four illegitimate children died under one year of age from the • following causes: — Atelectasis, aged 12 hours. Broncho Pneumonia, aged 11 days. Broncho Pneumonia, aged 14 days. Congenital Heart disease, aged 7 weeks. The infant mortality rate of illegitimate children was 54 per 1,000 compared with the infant mortality rate of 17 6 for legitimate children. The following table shows the birth and death rates of legitimate and illegitimate infants for the past ten years:— Legitimate Infants Illegitimate Infants Year Live Births Percentage of Registered Births Deaths Rate per 1,000 Legitimate Live Births Live Births Percentage of Registered Births Deaths Rate per 1,000 Illegitimate Live Births 1950 2,332 96.9 41 17.6 74 3.1 4 54.0 1949 2,567 97.6 51 19.9 63 2.4 2 31.7 1948 2,757 96.8 58 21.0 91 3.2 4 43.9 1947 3,258 96.7 78 23.9 110 3.3 4 36.4 1946 3,336 96.9 97 29.1 107 3.1 5 46.7 1945 2,343 94.5 73 31.2 136 5.5 8 58.8 1944 2,655 95.8 95 35.7 116 4.2 7 60.3 1943 2,532 96.6 89 35.2 89 3.4 3 33.7 1942 2,330 96.5 71 30.4 85 3.5 3 35.3 1941 1,756 96.7 61 34.7 60 3.3 6 100.0 In the latter part of 1950 the Ardmore Hostel at Buckhurst Hill, to which girls had been admitted with their babies where necessary, was closed down for such cases and the Chelmsford Diocesan Moral Welfare Association agreed to undertake the care of the unmarried mother and her child on behalf of the County Council. 53 There is also co-operation with a Voluntary Moral Welfare Worker in the district and all cases are followed up by the Health Visitors. Health Visitors and School Nurses.—The establishment of 18 in addition to the Superintendent Health Visitor was agreed by the Ilford Council on the recommendation of the Ministry of Health in 1947. Unfortunately, owing to the extreme difficulty in obtaining staff, it has still been quite impossible even to approach this number in spite of repeated advertisements and applications to various organisations. Clinic Nurses have, however, continued to be employed to relieve the Health Visitors by undertaking certain duties at the Infant Welfare Centres, Immunisation and other Clinics, school medical inspections and by visiting the homes of children under 5 years of age to see how they are progressing and to invite attendance at the Infant Welfare Centres, where advice can be given by the Health Visitor or Doctor. The Training Scheme for Health Visitors inaugurated by the Essex County Council in conjunction with the S.E. Essex Technical College has continued and certain trainees have been allocated to Ilford for practical instruction. One trainee, on completing the Course in 1950 and passing the examination for the Health Visitors' Certificate of the Royal Sanitary Institute, was appointed as a Health Visitor and School Nurse here. At the end of the year there were only 7 full-time and one part-time qualified Health Visitors and School Nurses in addition to the Superintendent Health Visitor, and 2 Clinic Nurses. The following is a summary of the home visits made by the Health Visitors and Clinic Nurses during 1950 as far as the Maternity and Child Welfare work is concerned. First visits to newly-born infants 2,421 Subsequent visits to children under 1 year of age 4,073 Subsequent visits to children over 1 year of age and under 5 9,867 Visits to expectant mothers . 60 Home visits for other reasons 4,242 Total visits paid 20,663 Day Nurseries. (a) Stevens Road Day Nursery.—The new Nursery in Stevens Road was opened on the 16th March, 1950, replacing the premises in Becontree, Avenue which were vacated on the 13th March, 1950. (b) Seven Kings Day Nursery.—Work commenced on the erection of the new Nursery in Goodmayes Lane in October, 1950, and it is anticipated that this will be completed by the autumn. In the meantime the Nursery has continued to occupy the premises in Green Lane. (c) As from the 1st April, 1950, the charge made to parents for meals for children attending the Nurseries was increased from 1/- to l/6d. per day for each child. (d) The Sunshine House Day Nursery was closed on Saturday mornings as from the 18th March. 1950. and as from that date the hours of opening at all the Nurseries have therefore been from 7.30 a.m. to 6 p.m., Monday to Friday only. (e) The training of Students at the Nurseries for the certificate of the National Nursery Examination Board continued. Six Students (three from the Stevens Road Nursery, one from the Ley Street Nursery, one from the Sunshine House Nursery and one from the Green Lane Nursery) entered for the examination during the year, all of whom obtained the certificate, 54 (f) The following is a table showing the attendances, etc., at the four Day Nurseries during 1950:— Situation Date of Opening Accommodation (Children) Average Daily during Including Saturday Attendance 1950 Excluding Saturday No. of Days in Quarantine Reasons for Quarantine No. on Waiting List at 31st Dec., 1950 Sunshine House, Girls' Village Homes, Barkingside 17.8.42 45 25 (To 11.3.50.) 34 85 3 Cases of C. Pox 52 13 „ „ W. Cough 1 „ „ S. Fever 7 v „ Measles 359-381, Green Lane, Seven Kings 5.5.43 50 — 46 99 7 Cases of W. Cough 26 28 „ „ Measles 6 „ „ S. Fever 226-236, Ley Street, Ilford 6.8.43 50 — 36 81 2 Cases of Mumps 56 7 „ „ Measles 1 „ „ C. Pox 3 „ „ S. Fever 12 „ „ W. Cough Beeontree Avenue, corner Winding Way, Dagenham (closed on 13.3.50) 17.1.44 40 — 33 15 1 Case of S. Fever - 1 „ „ Mumps 2 „ „ Measles Stevens Road, Dagenham (replacing Beeontree Avenue). 16.3.50 50 — 38 87 1 Case of C. Pox 8 29 „ „ W. Cough 55 Nurseries and Child-minders Regulations Act, 1948.—This Act which came into operation in August. 1948, requires, inter alia, that every local health authority shall keep registers— (a) of premises in their area, other than premises wholly or mainly used as private dwellings, where children are received to be looked after for the day or a substantial part thereof or for any longer period not exceeding six days; (b) of persons in their area who for reward receive into their homes children under the age of five to be looked after as aforesaid. The following shows the position regarding registrations under the Act:— (a) Premises (b) Child-minders Number on register at 31/12/49 Nil 5 Number registered during 1950 2 2 Number on register at 31/12/50 2 5 Number of children provided for at 31/12/50 65 36 Clinic. Premises.—Work commenced in June. 1950, on the erection of the new Health Services Clinic in Manford Way, Hainault, to serve the Ilford. Dagenham and Forest Health Areas, and I am pleased to be able to report that the building was completed by July of this year. Pending the erection of these premises, a temporary Clinic was opened in two houses rented from the London County Council, Nos. 30/32. Elmbridge Road, Hainault, at the end of February, 1950. and continued in operation until the transfer to the new Manford Way Clinic on the 18th July, 1951. Infant Welfare Centres.—95 voluntary lady helpers were engaged in the work at the Infant Welfare Centres at the end of December, 1950. During the year the following attendances were recorded:— Total number of attendances of infants 43,402 First attendances 2,490 Attendances of children from 1 to 5 years 13,062 Total number of children on roll, December 31st, after omission of all those who had not attended for six months 3,894 The following is a comparison of the attendances at the Infant Welfare Centres for the past five years:— Total No. of attendances of Infants First attendances Total No. of children on roll on 31st December 1950 43,402 2,490 3,894 1949 43,668 2,621 3,697 1948 49,444 2,641 3,712 1947 49,690 3,133 4,146 1946 46,620 2,886 4,049 From the above table it will be seen that the total attendances in 1950 decreased by 266 compared with 1949, but as there were 131 less first attendances than in 1949, due to a smaller number of infants born, it can be said that there has been an overall slight improvement in attend- dances. 710 sessions were held during the year; the average attendance at each session being 57 mothers with their infants. 56 The following are the figures for each Centre:— Sessions Average Attendance Barkingside 48 77 Chadwell 48 61 Beeontree 48 58 Downshall 48 71 Elmbridge (from 7/3/50) 39 36 Woodford Avenue 48 75 Seven Kings 48 65 Cecil Hall (Wednesday) 48 58 Cecil Hall (Thursday) 47 51 Newbury Hall 48 50 Goodmayes 48 59 Grosvenor Road 48 71 Ilford Lane 48 68 Valentines 48 59 Fairlop 48 44 Paediatric Clinic.—Dr. Warren, the Consultant Paediatrician, continued to attend the Clinic at Valentines Mansion during the year. 23 sessions were held and 58 new cases were referred from the Infant Welfare Centres and Maternity Hospital for the reasons set out in the following table; a total of 116 attendances were made. Diagnosis Discharged Improving Discharged with advice and for other reasons Discharged no Treatment Discharged Cured Referred to Dr., Hospital or Clinic Still attending Total Amentia — — — — — 1 1 Angioma — — 2 — — — 2 Asthma — 1 1 — 1 — 3 Behaviour problem — 5 — — 1 — 6 Bilateral Hydrocele — — — — — 1 1 Chronic diaorhoea — — — — 1 — 1 Congenital haemolytic disease — — — — — 1 1 Congenital heart disease — — 1 — — 1 2 Congenital laryngeal stridor — 1 — — — — 1 Conjunctivitis — — — — — 1 1 Constipation 1 2 — — — — 3 Eczema — 2 — — — — 2 Feeding problem 2 — — 1 — 3 6 Hemiplegia — — — — 1 1 2 Intertrigo of labia majora — — 1 — — — 1 Lipoma — — — — — 1 1 Mentally retarded — 1 — — — — 1 Microphthalmia — — 1 — — — 1 Mongol — — — — — 1 1 Multiple congenital defects — — — — — 1 1 N'ervous frequency — — — — — 1 1 Normal child—nil abnormal discovered 1 1 3 — — 2 7 Obesity — — 1 — — — 1 Pink disease — — — — 1 — 1 Prolapse of rectum — 1 — — — — 1 Right facial palsy — — — 1 — — 1 Rudimentary left femur — — — — 1 — 1 Rumination 1 2 1 — — 1 5 Slovenly posture — — — — — 1 1 Umbilical hernia — — 1 — — — 1 Totals 5 16 12 2 6 17 58 57 Ophthalmic Clinic.—140 children under 5 years of age were treated hy the Oculist during 1950. 66 pairs of spectacles were supplied. Orthopaedic Clinic. (i) Newbury Hall Clinic.—52 sessions were held during 1950, 428 children under 5 years of age being examined, making 1,051 attendances. (ii) Mayesbrook Clinic.—26 sessions were held during 1950, 172 children under 5 years of age being examined, making 425 attendances. The 600 children were found by the Orthopaedic Surgeon to be suffering from the following defects:— Diagnosis New Cases Old Cases A B A B Paralysis:— A.P.M. i 2 2 — Hemiplegia 1 — — — Deformity of hips — — 1 — Genu valgum 80 50 79 15 O.C.T. 25 8 35 20 Genu varum — — 3 4 Pes valgo planus 45 15 40 30 Valgus ankles 25 5 20 10 Talipes cale. valgus 5 — 8 — Congenital talipes E.V. 3 — 2 — Congenital defect — 1 2 1 In toeing 9 2 5 2 Deformity of toes 7 3 6 2 Torticollis 2 — 1 — N.A.D. 1 1 3 — Spastic Diplegia 1 — 3 — Orthopaedic defect connected with birth injury — 1 1 — Traumatic condition — — 6 — Other conditions 1 — 5 — Totals 206 88 222 84 A—Newburv Hall. B—Mavesbrook 53 pairs of Valgus Insoles, 2 pairs surgical shoes, 2 calipers, 1 inverting iron and 19 G.V. night splints were supplied during 1950. At the Newbury Hall Clinic, 29 children under five years of age were treated by the Physiotherapist during the year, and 194 attendances were made by these children. Treatment was also given to 41 children who made 377 attendances at the Mayesbrook Clinic. Aural Clinic.—The Aural Surgeon attended at 63 sessions during 1950 and 149 attendances were made by 106 children of pre-school age. 5 children were operated upon for removal of tonsils and adenoids at King George Hospital, Ilford. 58 Rheumatism Clinic.—32 sessions were held during the year at Newbury Hall, at which 23 children under 5 years of age. 13 being new cases, made 31 attendances. The following is a summary of the cases treated: — Condition New Old Total Congenital heart disease 3 4 7 No active rheumatic disease 4 4 8 Functional heart murmur 6 1 1 Pains-other than rheumatic — 1 1 Totals 13 10 23 Number of cases referred to Orthopaedic Surgeon 1 „ „ „ „ for X-ray and Electrocardiograph 11 Artificial Sunlight Clinic.—47 sessions were held at the Newbury Hall Clinic and 50 at Mayesbrook Clinic. 139 children in all were treated, making 841 attendances. The conditions treated were as follows:- Conditions Cases A B Anaemia, Debility and Malnutrition 28 13 Genu valgum 15 — Old Rickets 8 4 O.C.T. (Bow legs) 8 8 Bronchitis — 7 Other conditions 32 16 Totals 91 48 A—Newbury Hall. B—Mayesbrook. 88 cases were still attending at the end of the year; of the remainder _ 1 had removed from the district, 7 were discharged, having shown improvement. 16 were discharged having made a satisfactory recovery, 20 were discharged due to absence and 7 were discharged having made no progress. Speech Clinic.—6 children of pre-school age attended, making 58 attendances. The following is the classification of the defects found by the speech therapist:— Stammering 3. Dyslalia 3. 1 child was discharged with normal speech and in 4 cases the parents refused treatment. 59 Diphtheria Immunisation.— Tabular Statement as to Number of Children Schick Tested and Immunised at the Diphtheria Clinics from 1st January, 1950, to 31st December, 1950. Valentines Clinic Mayesbrook Clinic Elmbridge Clinic Grand Totals All Clinics School Children (Various Schools) Children under 5 years of age Total School Children (Various Schools) Children under 5 years of age Total School Children (Various Schools) Children under 5 years of age Total Numbers Schick Tested: Positive 16 — 16 7 — 7 — — — 23 Negative 11 — 11 7 — 7 — — — 18 Numbers inoculated (full course) 57* 410 467 27* 270 297 1 13 14 778 Positive after full course of inoculations and re-inoculated — 3 3 1 1 2 — — — 5 Negative after full course of inoculations 40 307 347 19 193 212 — — — 559 Re-inoculations (one only) 789 52 841 391 41 432 45 — 45 1,318 Awaiting re-test 4 71 75 5 38 43 2 10 12 130 Not re-tested after inoculation (on account of leaving District, etc.) 11 27 38 2 35 37 — — — 75 Positive after re-test but not inoculated for same reason 2 2 4 — 3 3 — — — 7 Final Schick Test in 1950 (1949 Cases):- Positive after full course of inoculations, and re-inoculated — — — — — — — — — — Negative 1 102 103 — 90 90 — — — 193 *Schick + 1949 = 15; Not Tested = 14. *Schick + 1949 = 5; Not Tested = 18. During 1950, a total number of 2,335 children attended at the Diphtheria Prevention Clinics, (1,441 at Valentines Clinic, 835 at Mayesbrook and 59 at Elmbridge), making a total number of attendances of 9,265 (6,088, 3,044 and 133), with an average per session of 59, 58 and 13 respectively. 60 During 1950, 60 private doctors were supplied with prophylactic for the immunisation of 1,010 children and record cards were received from general practitioners as follows:— Under 5 Over 5 Inoculations (full course) 841 25 Re-inoculations (one only) — 144 Vaccination.—During 1950 record cards were received from general practitioners and various hospitals as follows:— Ages up to 14— No. of children primarily vaccinated 1,095 No. of children revaccinated 60 Ages 15 and over— No. of adults primarily vaccinated 103 No. of adults revaccinated 313 Treatment of Minor Ailments.—Children suffering from simple dietetic ailments are treated at the Infant Welfare Centres. 2 belts were supplied to infants suffering from hernia during 1950. A certain number of infants were brought to the Clinics at Newbury Hall and Mayesbrook Clinic to receive treatment for minor ailments. Cardiac Clinic.—During 1950 eleven sessions were held. 27 expectant and nursing mothers were referred from either the ante-natal or post-nata clinics making a total of 67 attendances. The following is a summary of the cases examined by Dr. K. Playfair: Condition PostNatal AnteNatal Congenital Cardiac lesion 1 1 Extrasystoles — 3 Functional Cardiac disorder 1 3 Myocardial lesion — 2 No lesion 1 8 Still being investigated — 1 Valvular disease of the heart — 6 Totals 3 24 21 of these patients were referred to Queen Mary's Hospital for X-Ray and electrocardiograph. Midwives.—There were 16 State certified midwives (including the Superintendent. Deputy Superintendent. 10 domiciliary midwives and 2 parttime midwives). resident and practising in the district at the end of the year. In addition there were 21 State certified midwives at the Ilford Maternity Hospital and one at Wilnett Lodge post-natal home. At the beginning of the year there was one private nursing home in the area which dealt with maternity patients, but this closed down in October. 1950. Supervision of the midwives practising on the district, including regular inspections by the Medical Supervisor of Midwives, was carried out as in previous years, and general supervision, in accordance with the Rules of the Central Midwives Board, was exercised over the midwive practising at the Ilford Maternity Hospital and the Wilnett Lodge Hostel. Suspension from Practice.—No midwives were suspended from practice during the year. Medical Aid.—Medical aid was sought in 4 instances where the infant was found to have inflamed or discharging eyes. In all cases the condition of the eyes cleared satisfactorily. Domiciliary Midwifery Service.—At the end of the year there were 10 Domiciliary Midwives employed wholetime and 2 part-time midwives in addition to the Superintendent and Deputy Superintendent. 61 During the year 621 cases were attended. In 531 cases the midwives were engaged to attend as midwives and in 90 as maternity nurses. The patients resided in the following wards:- Barkingside 44; North Hainault 51; Cranbrook 38; Park 55; Seven Kings 57; South Hainault 50; Loxford 67; Clementswood 51; Goodmayes 14; Fairlop 80; Clayhall 66; Mayfield 48. 4,523 ante-natal visits were made during the year. A Doctor was called in to 129 of the 531 cases in which a midwife had been engaged. Of the infants born there were 9 stillbirths ascribed to the following causes:— Mother had fall 1 Prolapse of cord 1 Umbilical cord round neck 1 Unknown 6 In one of these cases the midwife was engaged as a maternity nurse only. There were 13 deaths of infants during the first year of life from the following causes:— Acute suppurative broncho-pneumonia 1 Asphyxia 1 Atelectasis 1 Broncho-pneumonia 1 Broncho-pneumonia associated with atelectasis 1 Broncho-pneumonia associated with icterus gravis neonatorum 1 Congenital heart disease 3 Congenital hydrocephalus 1 Imperforate anus 1 Prematurity 1 Toxaemia 1 In 2 of these cases the midwife was engaged as a maternity nurse only. Notices were received from the Domiciliary Midwives stating that artificial feeding had been substituted in respect of 29 infants attended by them during 1950. Salvation Army Midwifery Service.—75 cases were attended by the Salvation Army Midwives during the year, 68 as a midwife and 7 as a maternity nurse. A Doctor was called in to 17 of the 68 cases in which a midwife had been engaged. There were no deaths of infants during the first year of life. Notifications were received from the Salvation Army Midwives that it was proposed to substitute artificial feeding in respect of 3 infants. 62 Gas and Air Analgesia.—During 1950 gas and air analgesics were administered in 384 cases, of which 327 were attended by the Domiciliary Midwives (290 when acting as midwives and 37 when acting as maternity nurses) and 57 were attended by the Salvation Army midwives (50 when acting as midwives and 7 when acting as maternity nurses). All the domiciliary midwives employed at the end of the year were qualified to administer gas and air analgesics and the two Salvation Army midwives were also so qualified. Four sets of apparatus for the purpose of the administration of gas and air analgesics are stored in the Ambulance Depot and the apparatus is transported to the house of the patient on the request of the midwife. The Salvation Army midwives also have two machines which are kept at their Branch Home and taken or sent to the home of the patient when required. The service is freely available to all having home confinements, provided there are no medical contra-indications. and each expectant mother on booking the midwife is supplied with a leaflet explaining the nature and the availability of the service. Ante-Natal Clinics.—The following is a summary of the attendances at the Ante-Natal Clinics during the year:— Maternity Hospital Mayesbrook Clinic Elmbridge Clinic (from 10.5.50) First attendances 1,201 294 89 Subsequent attendances 9.509 2,628 522 Totals 10.710 2,922 611 Number of sessions 363 122 34 Average attendance at each session 29 24 18 All patients booked tor admission to the Maternity Hospital are medically examined at the Ante-Natal Clinics, the first appointment normally being made at the 16th week of pregnancy. The Consulting Obstetrician or his Deputy continued to visit the Ante-Natal Clinic twice weekly. During the year 103 sessions were held and a total of 1,249 examinations were made. Post-Natal Clinics.—All patients confined in the Ilford Maternitv Hospital and other patients on request are invited to attend the Post-Natal Clinics for the first time approximately six weeks after confinement. During 1950 clinics were held at the Maternity Hospital weekly, at Mayesbrook Clinic once monthly until July and then fortnightly, and at Elmbridge Clinic monthly from June. The following attendances were recorded:— Maternity Hospital Mayesbrook Clinic Elmbridge Clinic First attendances 849 206 38 Subsequent attendances 454 119 9 Totals 1,303 325 47 Number of sessions 52 23 7 Average attendances each session 25 14 7 63 Maternal Mortality.—During 1950 4 deaths of Ilford mothers were recorded by the Registrar-General as due to or in consequence of pregnancy or childbirth. Domestic Help Service.—During 1950 there was a still further increase in the demand for this service. Early in the year certain of the part-time Domestic Helps were appointed to full-time posts and at the end of 1950 there were 22 full-time and 127 part-time Helps employed. A full-time Organiser controls the service under the general direction of the Area Medical Officer. The following is a summary of the cases dealt with in 1950:— Number of applications received for assistance 1,442 Number of cases where Domestic Helps were provided (including 316 who were having service at the commencement of the year) 1,211 Number of cases which on investigation were either not eligible for assistance or did not require the service . 254 Number of cases referred to other sources, e.g.. W.V.S., I.S.S.C. "Help-air" 56 Cases booked but subsequently cancelled 123 Number of cases where, at the end of the year, a domestic help was booked to attend in future months (maternity cases) 80 Other cases awaiting help at end of year 27 Enquiries incomplete at end of year Convalescent Facilities.—The following tables show the number of persons sent away for convalescence during 1950, and the number of cases in which the Invalid Children's Aid Association arranged the placing of children in suitable convalescent homes. (a) Under Section 22 of the National Health Service Act, i.e. nursing mothers and young children. Name of Home No. of weeks' stay Remarks 1 2 3 4 5 6 7 8 9 10 Harts Leap, Sandhurst, Surrev - - - - - - - 1 - 1 Unaccompanied children (arranged by I.C.A.A ) Towers House, Eastbourne - - - - - 1 - - - - Unaccompanied child (arranged by I.C.A.A.) Whitechapel Mission Holiday Home, Southend-on-Sea 1 - - - - - - - - - Mother and infant (took own discharge) Mrs. Bryce, Eldon Lodge, Broadstairs - 1 - - - - - - - - Mother and infant Grange Maternity Home ana Nursery, Hindhead - - - - 1 - - - - - Unaccompanied child (arranged by Great Ormond Street Hospital) Bunce Court, Ottenden, Kent - - - - - 1 - - - - Unaccompanied child (arranged by I.C.A.A.) Totals 1 1 - - 1 2 - 1 - 1 2 mothers with infants 5 unaccompanied children (b) Under Section 28 of the Act, i.e., other persons requiring a change of air and surroundings to aid recovery and rehabilitation. 64 Name of Home No. of weeks Total Cases 1 2 3 4 5 Rustington Convalescent Home, Littlehampton - 2 - 1 - 3 Essex Conv alescent Home 1 3 6 - - 10 St. Joseph's Convalescent Home, Bournemouth - - 1 - - 1 Hunstanton Convalescent Home 1 3 9 - - 13 Bell Memorial Convalescent Home, Lancing - 1 2 1 1 5 Armitage House, Worthing - 1 - - - 1 Samuel Lewis Recuperative Holiday Home,Walton-on-Naze - 1 2 1 - 4 Limpsfield Convalescent Home 1 2 6 - - 9 Harriet Guy and Cowes War Memorial Convalescent Home, Isle of Wight 1 - 5 - - 6 "Orton Rigg", Canford Cliffs, Bournemouth - - - 1 - 1 Victorian Convalescent Home, Bognor Regis - 1 - - - 1 Merchant Taylors' Convalescent Home, Bognor Regis - - 1 - - 1 "Templecombe" St. Leonards-onSea - 1 - - - 1 Hermitage Convalescent Home, Hastings - 1 - - - 1 St. Michael's Convalescent Home, Clacton-on-Sea - - 1 - - 1 Totals 4 16 33 4 1 58 Loan of Sickroom Equipment.—It has been found in 1950 that this loan scheme has become more widely known and applications for articiss have increased considerably. The issues from the Public Health Offices are shown below:— Articles Loaned Number of Articles Articles in store at 31.12.50 on loan at 31.12,49 loaned or reloaned in 1950 on loan at 31.12.50 Mattress (Dunlopillo) 1 6 6 — Mattress (Hair) — 1 1 — Invalid Chair — 6 5 1 Air Pillow — 1 — 1 Air Ring 1 3 1 2 Back Rest 1 3 4 1 Hospital Bed — 1 1 — Iron Bed — 1 1 — Commode Chair — 1 1 — Crutches (Pair) 1 — 1 — Fracture Boards (Set) 1 — 1 — Pillow (Feather) - 1 1 — Pillow (Flock) - 1 1 — Rubber Sheeting - 4 2 — Medical Sandbags — 1 1 — Spinal Carriage — — — 2 Totals 5 30 27 7 65 Tuberculosis Visitors.—Three Tuberculosis Visitors were employed in the Area during 1950, making a total of 3,128 visits to homes in the Borough. Rehabilitation of Tuberculosis Cases.—Assistance in the maintenance charges of cases at the Papworth Hall Settlement was given as follows:— Number of cases being assisted at 31.12.1949 2 „ „ „ newly assisted in 1950 Nil „ „ „ for whom responsibility ceased Nil „ „ „ being assisted at 31.12.50 who at that date had been assisted for:— (a) Between 1 and 2 years Nil (b) Over 2 years 2 Open-Air Shelters for Tuberculosis Cases.—There were no openair shelters supplied for tuberculosis patients during 1950 but at the end of the year one such shelter, previously supplied by the County Council, was in use in Ilford. Boarding-out of Children (Tuberculosis Contacts).—Two applications were received in 1950 for assistance in the boarding-out of child contacts of tuberculosis patients under the scheme commenced in the County in December, 1949. It was found that one case did not come within the purview of the scheme and in the other the application was cancelled before the arrangements for placing the child were completed. Ilford Tuberculosis Care Association.—As reported last year. Mr. H. R. Stanbridge. a member of the Ilford Health Area Office Staff, took over the secretarial work of this Association as from the 1st January, 1950. The following shows the assistance given by the Association during 1950:— No. of Persons Assisted Total No. of Grants made Extra nourishment (grants made usually for periods of one month and renewed as required) 90 501 (including renewals) Fares of relatives visiting patients in Sanatoria 5 12 Furniture 1 1 Clothing 2 2 Travelling Expenses of Relatives Visiting Hospital Patients.— During the year 1950 the County Medical Officer of Health gave financial assistance from a small fund he had at his disposal to 8 Ilford persons to enable them to visit relatives who were patients in hospital. Home Nursing.—The Home Nursing Service in Ilford is undertaken by Nurses under the supervision of the Superintendent of the Beachcroft raining Home at Leytonstone. As soon as suitable premises are acquired, however, it is proposed that a Branch Home will be set up in Ilford. The work undertaken by Home Nurses operating in the Ilford area in 1950 was as follows:— Cases attended 1,752 Visits paid 50,449 66 Health Education.—Throughout the year Exhibition Display Stands in regard to the following subjects were on view for one week each at the Public Health Office, Mayesbrook Clinic and Newbury Hall:— Diphtheria Immunisation. Work of the Health Visitor. Care of the Feet. Breastfeeding. Care of the Teeth. Accidents in the Home. Cafe and Canteen Hygiene. Dental Treatment.—Mr. E. V. Haigh, the Senior Dental Officer, has submitted the following report:— "Full dental treatment has been given to all expectant and nursing mothers and to children under the age of five years who wished to take advantage of this service, on recommendation from the Ante-Natal and Post-Natal Clinics and Infant Welfare Centres. Owing to the shortage of dental surgeons, all the patients were treated by myself at Mayesbrook Clinic—no service being available at the Dental Clinic at Valentines School. An average of three sessions were devoted weekly to the treatment of expectant and nursing mothers and children under five. Unless there is a contra-indication, expectant and nursing mothers are given the option of gas or local anaesthesia for extractions—gas anaesthesia being given for nearly all extractions on children under five. Conservative treatment, such as fillings, scaling and gum treatment, is carried out on all patients where such treatment is required, and where the patient is willing to co-operate. Dental X-ray facilities are available at Mayesbrook Clinic when required, and in consequence the patient can be X-rayed immediately and thereby be saved time and pain. Dentures are provided for expectant and nursing mothers as and when required, being made by a local dental mechanic, whose work has been very satisfactory." The number of patients treated at the Clinic during 1950 is as follows:— Examined Needing Treatment Treated Made Dentally Kit Expectant and nursing mothers 145 144 214 142 Children under 5 197 197 212 188 The forms of dental treatment provided were: — Extractions Anaesthetics Fillings Scaling or Scaling and Gum treatment Silver Nitrate treatment Dressings Radiographs Denture^ Provided Local General Complete Partial Expectant and nursing mothers 771 66 140 345 144 - 105 2 54 47 Children under 5 015 1 180 84 - - 140 - - - Total number of sessions held—136. 67 SCHOOL HEALTH SERVICE. (a) Nutrition. The summary of heights and weights over 10 years which is printed at the end of this Report in Table VII A. and B. shows no appreciable change. (b) Incidence of Pediculosis and Scabies. (i) Pediculosis.—This shows a decrease on last year. 5 children being found to be infected with living hair vermin as against 33 in 1949, 56 in 1948, 49 in 1947 and 46 in 1946. (ii) Scabies.—There were no cases reported during the year, as compared with 5 in 1949, 19 in 1948, 43 in 1947 and 76 in 1946. School Premises.—There are 32 schools, with 61 departments, 21,497 children were actually on the rolls on 21st December, 1950, as compared with 21,123 in December, 1949. The figure 21,497 includes Barking Abbey (374) and Ursuline County Placed pupils (240). The number of children in average attendance at school for the year ended 19th December, 1950 = 18,967. The Sanitary Inspectors have paid the usual monthly visits to the elementary schools (1) to enquire as to the milk supplies, (2) to inspect the sanitary arrangements. 439 visits were made during the year. Medical Inspection.—In accordance with the Handicapped Pupils and Medical Services Regulations, 1945 (para. 49), this is carried out as follows:— (a) Every pupil who is admitted for the first time to a maintained school shall be inspected as soon as possible after the date of his admission. (b) Every pupil attending a maintained primary school shall be inspected during the last year of his attendance at such a school. (c) Every pupil attending a maintained secondary school shall be inspected during the last year of his attendance at such a school. During 1950 4,609 parents, or 75 per cent., attended the full routine medical inspections. Infectious Disease.—The following table shows the incidence of infectious diseases in the Ilford schools since 1946:— Scarlet Fever Diphtheria Measles and man Measle Chicken Pox Mumps Whooping Cough 1946 156 13 576 259 312 95 1947 120 7 1,056 122 27 332 1948 179 7 1,330 116 87 376 1949 262 — 641 75 224 210 1950 252 1 *766 80 25 466 *Of this number 753 were notified as measles. Disinfection of all the cloakrooms at the maintained primary and secondary schools was carried out during the Summer and Winter vacations. No schools were closed during the year on account of infectious disease. Table VI shows the incidence of infectious disease in the Ilford schools during 1950. 33 home visits were paid by the School Nurses to cases of minor infectious disease. In addition the Sanitary Inspectors paid 753 visits to measles cases, and 466 visits to whooping-cough cases. 68 RINGWORM:—  No. of cases at beginning of 1950 No. of cases reported during 1950 Total Remedied during 1950 No. of cases under observation at end of 1950 Scalp — — — — — Body — 1 1 1 — — 1 1 1 — Following Up.— During 1950. 1,688 home visits by the School Nurses were paid for the purpose, and 2,776 re-examinations of children (some on several occasions) were carried out by the doctors at school: 90 visits to schools were made for this purpose alone, and other children were seen at the visits for routine medical inspection. Medical Treatment. (a) Minor Ailments Clinics.—The attendances during 1950 were as follows:— Newbury Hall Mayesbrook Number of individual children seen 1,403 1,556 Number of attendances of children 2,773 2.844 Number of exclusion certificates granted 112 169 Number of certificates of fitness to attend school granted 132 217 The following table shows the conditions dealt with at both the Clinics during the year:— Subnormal Nutrition 482 Debility 12 Uncleanliness:— Head 129 Body 1 Skin:— Ringworm:— Head — Body 1 Scabies — Impetigo 19 Dermatitis 6 Urticaria 13 Furunculosis 36 Eczema 8 Other Skin Diseases (Non-Tuberculous) 330 Eye:— Blepharitis 41 Conjunctivitis 37 Defective Vision (excluding Squint) 148 Squint 29 Other conditions 74 Ear:— Defective Hearing 27 Otitis Media 20 Other Ear Diseases 69 69 Nose and Throat:— Chronic Tonsilitis only 68 Adenoids only 6 Chronic Tonsillitis and Adenoids 29 Nasal Catarrh 41 Nasal Obstruction 9 Other conditions 67 Enlarged Cervical Glands (Non-Tuberculous) 34 Defective Speech 31 Teeth—Dental Diseases 649 Heart and Circulation:— Functional 7 Organic 2 Anaemia 35 Infectious Diseases:— German Measles 1 Measles 1 Whooping Cough 1 Chicken Pox 2 Mumps 2 Colds and Coughs 228 Influenza 3 Lungs:— 18 Asthma Bronchitis 33 Pulmonary Catarrh 20 Other Non-Tubercular Diseases 2 Tuberculosis:— Pulmonary—Definite — —Suspected (Referred to T.B. Officer) 13 Developmental:— Hernia 1 Other 2 Psychological:— Development 7 Stability 20 Nervous System:— Nervous Debility 28 Habit Spasm 10 Chorea 1 Petit Mal 2 Enuresis 32 Other Conditions 3 Deformities:— Genu Valgum 5 Posture 15 Pigeon Chest 7 Flat Feet 53 Valgus Ankles 41 Other forms 30 Minor Injuries 78 Rheumatism 49 Other Defects and Diseases 147 Total number of ailments 3,315 70 SPECIAL CLINICS. Ophthalmic Clinic. During the year 1950. the School Oculist held 220 sessoins for the refraction of children suffering from defective vision (131 at Valentines and 89 at Mayesbrook). Full details of the work are given in Table IV. Group II. 4,006 attendances (2,278 at Valentines Clinic, 1,728 at Mayesbrook Clinic) were made by 1,504 schoolchildren (906 at Valentines Clinic, 598 at Mayesbrook Clinic), as compared with 1,265 schoolchildren in 1949. The 1,504 children were not all suffering from grave defects of vision. The following table shows the vision in the worst eye, as tested by Snellen's Type:— 6/6 6/9 6/12 6/18 6/24 6/36 6/60 less than 6/60 301 261 282 243 170 138 78 31 The children who saw 6/6 (practically normal vision) were suffering from symptoms such as headaches, inflamed eyelids, etc., which rendered further examination necessary. The 1,504 children were found to be suffering from the following defects:— Diagnosis New Cases Old Cases A B A B Myopia 72 46 177 95 Myopic Astigmatism 15 1 17 15 Hypermetropia 60 33 160 101 Hypermetropic Astigmatism 2 2 22 24 Anisometropia — — 5 7 Hypermetropia with Squint 7 - 16 13 Squint 45 41 192 121 Blepharitis 3 5 17 10 Chalazion — — - 2 Congenital Coloboma — 1 3 1 Corneal nebulae — — 1 1 Conjunctivitis 5 4 8 10 Nystagmus — — 6 6 Other conditions 7 — 6 9 N.A.D. 30 9 30 41 Totals 246 142 660 456 A—Valentines. B—Mayesbrook. 1.234 complete pairs of spectacles were provided, some of these being renewals after breakages. In addition, in 303 cases the lenses of spectacles were replaced or repairs of frames were carried out. The Hospital Management Committee, Ilford and Barking Group (N.E. Metropolitan Hospital Region), assumed responsibility for the supply of spectacles as from 25th September, 1950. Orthoptic Clinic.—The position is very disappointing. Of 435 cases of squint. 220 have been recommended for orthoptic treatment since 1st June, 1950. No such treatment is available for these cases in Ilford. A few urgent cases have been referred to the Orthopic Clinics at the London Hospitals, but they are unable to take any more at present. 71 Negotiations for an Orthoptic Clinic at Mayesbrook have made no progress and the situation is acute. Many children will need treatment as soon as the Orthoptic Clinic is opened. Orthopaedic Clinic. Mr. H. G. Korvin. F.R.C.S., the Orthopaedic Surgeon, makes the following report:— "The outstanding feature of Mayesbrook and Newbury Hall Orthopaedic Clinics is the overwhelming number of attendances. Only the highly efficient and co-operative work of the clerical, nursing, and physiotherapy staff make it possible to cope with such numbers at all. Even so there remains the difficulty of being able to give not more than three minutes, on an average, to each patient, while some cases, such as poliomyelitis, cerebral palsy, early tuberculosis, etc., require repeated examinations of up to 15 or 20 minutes. In order to ease the position the intervals between attendances have been extended where it could safely be done, and the checking of certain splints and of alterations to footwear has been delegated to the physiotherapist. The position could be further improved if it were possible to delegate supervision of certain cases after the first attendance to one or more of the School Medical Officers, acting as clinical assistants. "An improvement has been introduced at Mayesbrook in that the physiotherapist, Mrs. King, is attending there at the clinic in order that the treatment required can be discussed in each case, as was already being done at Newbury Hall. As in previous years operative cases have been referred to various hospitals, new amongst which were the East Ham Memorial Hospital and the Plastic Unit at Basingstoke. In the interest of the children's schooling and development stays in hospital were kept to the necessary minimum. "In the fitting of appliances certain changes had recently been made and smooth running has not yet been achieved, the chief difficulties being long delays, non-individual fittings, and the necessity for mothers and children to attend elsewhere for the purpose. Particularly difficult fittings have been arranged at East Ham Memorial Hospital where an experienced instrument-maker attends weekly. A trial is now being made in handing out, in certain cases, reconditioned splints, a stock of which is kept at the clinic. This saves time and expenses. Permission is at present being sought from the Regional Board to deal in a similar way with new splints and stock insoles. "The arrangement by which specified alterations to footwear are carried out by local shoemakers and stores is working, on the whole, very satisfactorily." (i) Newbury Hall Clinic.—52 sessions were held during 1950, 195 children of school age were examined for the first time during the year and 480 children were seen who had previously attended the clinic. These 675 children made 1,442 attendances. (ii) Mayesbrook Clinic.—26 sessions were held during 1950, 95 children of school age were examined for the first time during the year and 225 children were seen who had previously attended the clinic. These 320 children made 771 attendances. 72 The 995 children were found by the Orthopaedic Surgeon to b suffering from the following defects:— Diagnosis New Cases Old Cases A B A B Paralyses:— A.P.M. 4 4 5 6 Hemiplegia — — 2 1 Paraplegia — — — — Monoplegia — — 1 1 Spastic deplegia — — 5 — Scoliosis 2 3 8 3 Kyphosis 13 — 5 — Slack posture 20 6 15 4 Deformity of hips — 1 2 — Depressed sternum — — — — Deformity of chest — — 1 — Genu valgum 55 20 170 67 O.C.T. 15 5 25 5 Genu varum 7 2 2 4 Pes valgus-planus 25 13 75 87 Valgus ankles 30 25 78 26 Talipes calcano-valgus 1 — 3 3 Congenital talipes E.V. — — 6 1 Congenital defect 2 1 5 8 Intoeing — — 2 1 Pes cavus 2 2 — 3 Hallux valgus 2 — 11 1 Deformity of toes 13 5 20 6 Traumatic condition 2 3 8 1 Rickets — — — - Torticollis 1 1 2 1 N.A.D. 3 1 10 — Other conditions 6 3 18 5 Ortho: defect connected birth injury 1 - 1 1 Exostosis 1 T.B. Knee 1 — — - Totals 195 95 480 235 A—Newbury Hall. B.—Mayesbrook. 73 16 children of school age were admitted to Hospitals. Particulars as follows:— No. of cases Hospital Defects 5 Black Notley (2) Tenotomy. Tendo Achilles Bilateral Pes. Cavus Scolioses ? T.B. Spine 5 Harold Wood Tumour removed, Lower Ulna Pes. Cavus Osteoma of arm Deformity of toe Exostosis Right femur 4 East Ham Memorial Correction of toe Torticollis Cong. Dislocation of Hip Old Cong. T.E.V. 1 Rooksdown House, Basingstoke Correction of Deformities of Right hand and both feet 1 Victoria Hospital for Children, Tite Street Congenital Deformity of Hip During the year 89 pairs of valgus insoles, 19 pairs of surgical boots or shoes, 20 pairs Genu Valgum splints, 5 toe springs for drop foot, 6 calipers and inverting irons were supplied to school-children. 238 cases were discharged from the Orthopaedic Clinic, 85 as cured. 92 discontinued attendance and were kept under observation at school, 13 were showing improvement and were kept under observation at school, and 48 cases left school or left the district. The Physiotherapist attends the Newbury Hall Clinic for orthopaedic treatment on Thursday morning and Friday afternoon, and the Mayesbrook Clinic on Monday and Thursday afternoons. A total number of 193 sessions were held by the Physiotherapist for treatment during 1950 (99 at Newbury Hall Clinic and 94 at Mayesbrook Clinic). At Newbury Hall Clinic 265 individual children of school age were treated by the Physiotherapist during the year and 1,570 attendances were made by these children. Treatment was also given to 154 children, who made 1,086 attendances at the Mayesbrook Clinic. Artificial Sunlight Clinic.—The Physiotherapist attends the Newbury Hall Clinic on Monday morning and the Mayesbrook Clinic on Tuesday morning for artificial sunlight treatment, 47 sessions were held at Newbury Hall Clinic and 50 at Mayesbrook Clinic. At the Newbury Hall Clinic 191 children of school age were treated, making 691 attendances for treatment. At the Mayesbrook Clinic 101 children of school age were treated, making 496 attendances for treatment. 74 The lamp used at each Clinic is a Centrosol Unit. The conditions treated were as follows: — Defects Treated Cases A B Anaemia, Debility and Malnutrition 50 33 Pulmonary Fibrosis 5 1 Bronchitis 33 21 Bowlegs 8 1 Alopecia 5 — Asthma 5 — Knock Knees — — Old Rickets 10 1 Chilblains 5 — Flat Feet — — Psoriasis 4 2 Posture — 3 Acne 3 — Adenitis 5 3 Other Conditions ... 58 36 191 101 A—Newbury Hall Clinic. B—Mayesbrook Clinic. Of the 191 cases treated at the Newbury Hall Clinic, 2 were Open Air school-children. At Newbury Hall Clinic, 126 children of school age were discharged from the Artificial Sunlight Clinic, 60 were cured, 23 were showing considerable improvement, and 43 were discharged due to absence. 65 children were still receiving treatment at the end of the year. At Mayesbrook Clinic, 70 children of school age were discharged from the Artificial Sunlight Clinic, 12 were showing considerable improvement, 39 were cured and 19 were discharged due to absence. 31 children were still receiving treatment at the end of the year. Aural Clinic. The Aural Clinic is held at Valentines Mansion, the Surgeon attending two sessions weekly for 13 weeks and one session weekly for 37 weeks. 63 sessions were held during 1950 and 1,063 attendances were made by 539 children of school age, of, whom 353 were new cases. The Consulting Ear, Nose & Throat Specialist (Mr. Wm. Ibbotson, F.R.C.S.), submits the following report: — " 1 have been greatly encouraged by the results of Conservative Mastoid Drainage, in two stages, on several of the children. Where there have been Tonsillar disease and Nasopharyngeal Adenoid excess these have both been removed during the lattter part of the second stage, the former portion being devoted to the Closure of the Mastoid wound. Also, if the nasal Septum has been pathologically deflected, and especially if to the same side as the diseased ear, this has been 75 partially straightened by Simple Fracture, during the Second stage. The two encouraging results mentioned above are: — " (a) Marked improvement in the General Health. " (b) Definite increase in Hearing-power, so that the child is able to attend school with far greater advantage. " Frequently I have found that the diseased Tonsil on the same side as the infected Ear appears to be more purulent that the other. " Many children have suffered with Deafness due to Chronic Eustacian Catarrh, sometimes associated with Pathological deflection of the nasal septum to the affected side, and frequently with diseased Tonsils and Adenoid excess. If, after Tonsillectomy and Adenoidectomy the tympanic membrane remains retracted, with no improvement in hearing, then Eustachian Catheterisation. with the help of Ethyl Chloride general anaesthesia, and injection into the catheter of a mixture of the essential oils, has generally completed the cure. " I have thought it wise to advise the mothers of children suffering with diseased Tonsils and Nasopharyngeal Adenoid excess to keep them entirely away from all Cinemas, and all Swimming and Bathing, until the above lesions have been cleared away; else there is much risk of Acute Tonsillitis, so frequently leading to Mastoiditis. " A few of the children have shown convincing evidence that their deafness was due to Aprosexia, rather than to any intrinsic aural lesion, and improvement has followed the provision of free nasal airways, and healthy pharynx, followed by a course in the Speech Clinic. "The Diagnosis of active Tonsillar disease has not always been easy, seeing that the surface appearances have proved very deceptive, but pus has often been detected emerging from the crypts on slight pressure, whilst Haemolytic Streptococci have been reported in several cases. This latter class of case has been admitted to the llford Isolation Hospital at a very early date, and operated on, there being no doubt that there is much danger of this infection gravely affecting the general health of the patient, and spreading to his associates. 1 think that, in the great majority of cases, the absence of Toxaemia and Cervical Adenitis is strongly suggestive of there being no very active Tonsillar disease. " Where there has been recurrence of Adenoid excess in the nasopharynx after Adenoidectomy, as is very common, and which is certainly due to lymphoid reaction to fresh invasion of harmful bacteria, and which often subsides when that invasion has been overcome, these cases have demonstrated that further operation is unjustifiable in the vast majority. " Finally, I should like to add a note on the tragic position of so large a number of children waiting for Tonsillectomy and Adenoidectomy, some of whom were entered for operation 3 years ago, and show positive evidence of deterioration in health, and at the very period of their lives when the reverse should be the case." The following table shows the work of the Clinic:— 76 AURAL CLINIC Nature of Disease Still under treatment Recommended Hospital treatment Discharged as cured Discharged as improved Discharged as no treatment required Discharged as left district Discharged as left school Discharged Children whose parents refused to continue attendance or treated elsewhere Totals New Old New Old New Old New Old New Old New Old New Old New Old New Old (i) Acute Suppurative Otitis Media — — 1 — — 1 — — — — — — — — — — 1 1 (ii) Acute Catarrhal Otitis Media — — 1 — — — — — — — — — — — — — 1 — (III) Chronic Suppurative Otitis Media due to :— 1. Tympanic Sepsis 5 5 7 — — 2 — — — 1 — — — — 1 1 13 9 2. „ and Granulations 2 3 — — — — — — — — — 1 — 1 — — 2 5 3. Other Causes — 2 2 — — 1 — — — — — — — — — — 2 3 (iv) Mastoid Disease (previous operation) — 1 — — — 3 — — — — — 1 — — — — — 5 (v) Partial Deafness due to:— 1. Nerve Deafness 1 — — — — — — — — — — — — — — — 1 — 2. Tonsils and Adenoids — 1 1 — — — — — — — — — — — — — 1 1 3. Retraction of Membrana Tympani 6 5 5 2 1 2 — — — — — — — — — 2 12 11 4. Scarring of Membrana Tympani — 1 — — — — — — — — — — — — — — — 1 5. Other causes 1 3 3 — 1 1 — — — — — — — 1 — — 5 5 (vi) Opinion on Tonsils 12 3 219 13 6 30 — — — — — — 1 1 4 9 242 56 (vii) Rhinitis 6 7 4 2 — 2 — — — — — — — — 1 — 11 11 (viii) Other diseases or defects 22 39 38 5 1 20 — — — 1 1 1 — 3 — 9 62 78 Totals 55 70 281 22 9 62 — — — 2 1 3 1 6 6 21 353 186 77 Rheumatism Clinic. The Physician attended 32 morning sessions during the year, and 210 children (85 of these being new cases) made 395 attendances. The 210 children were found to be suffering from the following conditions: — Defects Found New Cases Old Cases Totals History of Rheumatism (observation) 2 7 9 ,, Chorea — — — Rheumatic Carditis — 5 5 Other Forms of Carditis 3 2 5 Tachycardia of Nervous origin 4 2 6 Congenital Heart Disease — 22 22 Rheumatism 1 5 6 Chorea — 1 1 Habit Spasm 1 — 1 Anaemia, Subnormal-nutrition and Debility — 1 1 No active Rheumatic disease 21 27 48 Heart Murmur functional 25 30 55 Acidosis, metabolic disturbance of Alimentary origin 2 2 Pains due to Orthopaedic condition 13 9 22 Allergic Type — 1 1 Arrhythmia 1 —- 1 Fibrositis 3 1 4 Other Conditions 11 10 21 Totals 85 125 210 Number of cases referred to Convalescent Home — „ „ „ General Hospital (In-patients) 4 „ „ „ Isolation Hospital 2 „ „ „ Ear, Nose and Throat Surgeon 14 „ Orthopaedic Surgeon 11 for X-ray and Electro-Cardiogram 55 „ „ Blood Sedimentation Rate 15 „ „ „ Psychiatrist 1 „ „ „ Open Air School — Speech Clinic.—Mrs. C. H. Mclntyre resigned her appointment as part-time Speech Therapist on 5th July, 1950. Miss P. M. Lough increased her number of sessions from five to seven with effect from 5th September, 1950. By the end of the year, 128 individual children of school age had received speech therapy at this Clinic, making a total of 1,812 attendances. The defects treated were as follows:— Stammering 57 Dyslalia 61 Cleft Palate 1 Post Operative- (Tonsillectomy) Dysarthria 1 Dysphonia 1 84 children of school age were discharged from the Clinic during the year. In 58 cases the speech was normal. Of the remaining 26 cases, 21 ceased to attend for treatment, 5 left school or left the district. Continuity of after treatment is secured with the co-operation of teachers who have been supplied with an explanatory memorandum on the subject prepared by the Speech Therapist. 78 School Dental Service.—Mr. E. V. Haigh, Senior Dental Officer, reports as follows: — " It has not been possible to bring the establishment of Dental Officers up to strength (10 officers = one for each 2,000 of the school population) although advertisements have been issued inviting Surgeons to make application for the vacant positions. " In December we had one full-time Dental Officer and two parttime officers, each attending one session (2½ hours) weekly. " Owing to the shortage of Dental Officers, it has only been possible to visit the Benton Open Air School for the purpose of inspection. " Children seen by the doctors at routine medical inspections and at the School Clinics, who are found to require dental treatment are referred to the Dental Clinics. " Urgent cases of toothache reported by the teachers or parents are given priority and conservative including orthodontic treatment, is carried out when possible, but in the existing condtiions it is impossible to provide an adequate and satisfactory service." Of 2,125 inspections by the Dentists (including special cases) 2,106 (or 99 per cent.) were found to require treatment, compared with 3,310 (or 88 per cent. in 1949), 7,887 (or 68.7 percent.) in 1948, 7,440 (or 64 per cent.) in 1947, 5,079 (or 69 per cent.) in 1946, 5,159 (or 64 per cent.) in 1945. In addition to the ordinary dental work of fillings and extractions, 157 regulation plates, 3 crowns, and 18 dentures were supplied. 2,216 visits were made by children to the Dental Clinic for regulation purposes. The amount of dental disease present in children at various ages is shown by the following table relating to school-children inspected by the school Dentists: — Age-groups (in years) No. of inspections of-children No. referred for treatment Percentage 5 391 386 98 6 368 363 98 7 285 281 98 8 238 235 98 9 193 191 99 10 205 205 100 11 137 137 100 12 105 105 100 13 83 83 100 14 80 80 100 15 38 38 100 16 2 2 100 Total 2,125 2,106 99 Full details of the dental work are shown in Table V. Open-air School.—During 1950 the number on roll varied from 81 on 31.12.49 to 76 on 31.12.50. The number of admissions was 29 and the number of discharges was 34. Debility without any other defect accounted for a total of only 17 children, of whom 8 were discharged to ordinary schools during the course of the year and 1 left the district. When the Open Air School was opened in 1929 it was designed to serve almost exclusively children who were suffering from debility and malnutrition, i.e., children with no specific physical defects but who needed more supervision, rest and nutriments than were provided in the ordinary schools. In the last few years the character of the school has gradually 79 changed following the greatly improved nutrition of school-children in general, and there are now no cases of " malnutrition " as such in the school, only the 17 debilitated children referred to above. As this change in nutrition has gone on, it has become increasingly possible to fill the vacancies available at the Open Air School with physically handicapped children for whom no provision had been made in the past. This tendency to become more specifically a school for children often very severely handicapped physically, culminated in 1948 in the formation of a small " Spastic Class " for the treatment of suitable cases of cerebral palsy. This class while termed " spastic " owing to its primary object, also takes in several children who, by reason of their handicaps, are unsuitable for inclusion in an ordinary class even in the Open Air School. During 1950 the composition of the class was as follows: — Spastic diplegia 7 Muscular dystrophy 3 Astrocytoma and paraplegia *1 * Discharged for home tuition during year. One spastic child was discharged on removal from the area. Special apparatus is available and every effort is made by practice and exercises to encourage the children to overcome their handicap. Owing to lack of space and limited accommodation, there are at present 4 cases of cerebral palsy awaiting admission to the class, which at present meets in a converted air raid shelter. All children attending the Open Air School are given full medical examination on admission, and thereafter at six-monthly intervals. A medical officer attends weekly for the purpose and also sees such children as are referred for special examination at the request of either Head Teacher or parent. Recommendations are made to attend the special clinics and also as to the amount of exercises individual children should undergo; recommendations for shower baths and natural sunshine are also made. All children receive cod liver oil and have a rest period during the lunch hour, and an effort is' made to follow special diets in exceptional cases. A course of asthma injections has been given to 10 children during the year and children suffering from lung diseases are given daily deepbreathing exercises. The rest hall destroyed by a bomb in 1944 is now being rebuilt and when the increased accommodation becomes available, it is hoped further to extend the activities of the school, so as to accommodate the original number of 115 children. Those admitted were recommended for examination from the following sources:— School Medical Officer 24 Tuberculosis Officer 1 Others 4 School Medical Officer:— Asthma 2 Asthma and Bronchitis 4 Pulmonary Catarrhal Bronchitis 1 Bronchitis 1 Debility and Catarrhal Colds 2 Maladjusted 1 Left Spastic Hemiplegia 1 Old Rheumatic Carditis 1 Pseudo-hypertrophic Muscular Dystrophy 1 Arrested T.B., left hip 1 Old Poliomyelitis 2 T.B., left hip 1 Malnutrition 3 Congenital Morbus Cordis 2 Rheumatism and Debility 1 80 Tuberculosis Officer:— T.B., left hip 1 Others:— Haemophilia 1 Asthma 1 Muscular Dystrophy 1 Bronchial Asthma 1 The 34 children not now on the roll ceased attendance for the following reasons:— Fit for ordinary school 24 Left school—over age 4 Left district 1 Removed from school at parents' request 1 Unfit for school owing to epilepsy 1 Admission to Partially Sighted School 1 Admission to Kennylands Camp School 1 Admission to Heatherwood Hospital 1 The Senior Dental Officer carried out one complete inspection of the children's teeth at the Open Air School. The following table shows the dental work carried out: — No. of children examined 66 No. of children referred for treatment 55 No. of children treated by Dental Officer 50 As a result of the Medical Officer's periodic examinations, a number of the children have been recommended certain treatment as follows:— Administration of Milk in school 27 Administration of Cod-liver Oil Emulsion 27 Administration of Malt and Oil, Parrish's Food, etc. 3 Referred to Orthopaedic Surgeon 1 „ Dental Surgeon 1 „ Aural Surgeon 1 „ Rheumatic Specialist 1 Recommended Asthma exercises 1 Recommended Convalescent Home treatment 4 Recommended Child Guidance Clinic 6 2 children received Artificial Sunlight treatment during the year. Treatment for Uncleanliness.—The School Nurses paid 188 visits to the schools (an average of 6 visits to each school during the year), for the purpose of inspecting the heads and clothing of the children with the following results: — Number of Examinations of Children Number Infested Per cent. 52,845 *299 0.5 *5 of this number were found to be infected with living vermin; the reminder with nits only. A child with any nits in the hair at all is included in these figures. The percentages for the past 5 years were as follows: — 1946 2.6 1947 1.7 1948 1.3 1949 0.9 1950 0.5 81 Other Ailments.—During 1950, 213 children were operated on for the removal of enlarged tonsils and adenoids as follows: — King George Hospital 62 St. Mary's, Plaistow 48 Ilford Isolation Hospital 12 Rush Green Hospital 18 Oldchurch Hospital 12 Queen Mary's Hospital 12 Wanstead Hospital 10 London Hospital 6 Privately 33 Provision of Meals and Milk for School-children.—The provision of meals in the schools commenced on 7th October, 1940. The total number of mid-day meals served during 1950 was 2,292,287 approximately. There are 21 kitchens in the Borough, established at the following schools: — Barking Abbey, Beal, Becontree, Benton, County High Boys, County High Girls. Cleveland, Dane, Fairlop, Gearies, Goodmayes, Gordon, Loxford, Mayfield, Newbury Park, Parkhill, Redbridge, South Park, The Glade, Uphall and Wm. Torbitt. As from 6th August, 1946, milk in school has been supplied free of charge in accordance with the Provision of Free Milk Regulations, 1946. In October, 1950, 17,984 children were receiving milk in school. Work done by the N.S.P.C.C.—The following 23 cases were investigated: — (1) Neglect 16 (2) Ill-treatment cases 2 (3) Other cases 5 (1 case was reported from the Public Health Department for neglecting medical advice; 2 were reported from other sources for general neglect.) 48 children (31 boys and 17 girls) were involved, 31 being of school age. In addition to this work, 126 supervision visits were paid to different cases, some of which were made to those reported during the previous year. The Invalid Children's Aid Association.— 1. Number of Ilford School-children sent to Convalescent Homes = 51. 2. Number of Ilford School-children sent to Residential Schools for convalescence and paid for by Education Committee = 6. 3. Holidays arranged for a T.B. Contact and 2 Chronic Sick Children. 4. Other work on behalf of Ilford School-children. (a) Loan of three invalid chairs. (b) Escorting children to Clinics, Hospitals and Convalescent Homes. (c) Supply of Clothing in 12 cases. (d) Number of home visits paid, 200. (e) Supervision of 2 foster mothers of T.B. Contacts. 82 Handicapped Children. Section 33 of the Education Act, 1944, and the regulations made thereunder have placed on the Local Education Authorities new responsibilities for the provision of suitable education for children suffering from disability of mind or body. A record of all such children is revised annually from returns submitted by all Head Teachers, and any new cases attending local maintained schools are reported to me with a view to medical examination and ascertainment of their suitability or otherwise of attendance at an ordinary school. The several categories of pupils requiring special educational treatment are defined as follows: — (a) Blind Pupils, that is to say, pupils who have no sight or whose sight is or is likely to become so defective that they require education by methods not involving the use of sight. (b) Partially Sighted Pupils, that is to say, pupils who by reason of defective vision cannot follow the ordinary curriculum without detriment to their sight or to their educational development, but can be educated by special methods involving the use of sight. (c) Deaf Pupils, that is to say pupils who have no hearing or whose hearing is so defective that they require education by methods used for deaf pupils without naturally acquired speech or language. (d) Partially Deaf Pupils, that is to say, pupils whose hearing is so defective that they require for their education special arrange ments or facilities but not all the educational methods used for deaf pupils. (e) Delicate Pupils, that is to say, pupils who by reason of impaired physical condition cannot, without risk to their health, be educated under the normal regime of an ordinary school. (f) Diabetic Pupils, this is to say, pupils suffering from diabetes who cannot obtain the treatment they need while living at home and require residential care. (g) Educationally Subnormal Pupils, that is to say, pupils who, by reason of limited ability or other conditions resulting in educational retardation, require some specialised form of education wholly or partly in substitution for the education normally given in ordinary schools. (h) Epileptic Pupils, that is to say, pupils who by reason of epilepsy cannot be educated in an ordinary school without detriment to the interests of themselves or other pupils and require education in a Special School. (i) Maladjusted Pupils, that is to say, pupils who show evidence of emotional instability or psychological disturbance and requir., special educational treatment in order to effect their personal social, or educational readjustment. (J) Physically Handicapped Pupils, that is to say, pupils, not being pupils suffering solely from a defect of sight or hearing, who by reason of disease or crippling defect cannot be satisfactorily educated in an ordinary school or cannot be educated in such a school without detriment to their health or educational development. (k) Pupils suffering from Speech Defect, that is to say, pupils who on account of stammering, aphasia, or defect of voice or articulation not due to deafness, require special educational treatment. The number of children coming within these categories and their disposition as on the 31st December. 1950, are tabulated hereunder:— 83 Return of Handicapped Pupils in the Area on 31st December. 1950 (Aged 2-16 years) HANDICAPPED PUPILS. Blind, Partially Blind, Deaf Partially Deaf. Delicate. Physically Handicapped. Educationally Subnormal. Maladjusted. Epileptic. Total 1 2 3 4 5 6 7 8 9 A. Newly placed in 1950 — 2 1 — 26 4 7 11 1 52 B. Newly ascertained in 1950 1 2 1 4 19 6 17 2 1 53 C. (i) Attending Special Schools— Day — 4 9 3 56 24 41 1 1 142 Boarding 1 3 4 1 9 1 14 3 1 37 (ii) Boarded in homes — — — — — — — 2 — 2 (iii) Attending assisted Schools — — — — — — 3 14 — 17 D. Unplaced— (i) At no school 1 1 2 2 — 5 4 2 1 18 (ii) At ordinary school — — — 2 — 2 17 1 1 23 E. Receiving home tuition (including those in D). — — — — — 1 — — — 1 Attending Special Schools Speech = Nil Diabetes = 1 Boarded in Homes Speech = Nil Diabetes = Nil Child Guidance Clinic.—The Child Guidance Clinic was opened on 3rd January, 1949, at Loxford Hall, Loxford Lane, llford. Dr. A. H. G. Burton, the Psychiatrist, reports as follows: — "Of the cases seen by me during 1950, 24% were delinquents, 18% being boys and 6% girls. 19% of the cases of delinquency were cases of stealing. The main cause of delinquency was an anxiety state usually produced by environmental conditions. This accounts for 13% of the cases of delinquency. "17% of the cases were of enuresis sometimes combined with encopresis. I feel doubtful whether there is any value in referring cases of enuresis (which has been continuous from infancy) to a Child Guidance Clinic. They rarely benefit, and 1 feel that it most cases they are not due to psychological causes but may be either due to an organic cause or bad handling in infancy which has resulted in a chronic inflammation of the urethra. Cases of enuresis which, however, occur later on are frequently due to psychological cause, often of an anxiety nature and can be remedied at the Clinic. 84 " Nearly 40% of the cases, with half as many girls as boys, were referred for such behaviour difficulties as sleeping difficulties including sleepwalking and nightmares—7 times as many boys as girls. Three cases were seen of adolescent difficulites in girls. Aggressiveness at school or at home—3 times as many boys as girls. Truanting—5 times as many boys as girls. "15% of the children seen by me were so maladjusted as defined by the Handicapped Pupils and School Health Service Regulation, 1945, that a residential special school was recommended. " The chief difficulty in the working of the Clinic has been in finding a Psychiatric Social Worker. A Child Guidance Clinic is not adequate in its service if there is not team work between a Psychiatrist, Psychologist and Psychiatric Social Worker. I do not feel that enough attempt has been made to secure a sufficient supply of these workers in this Country and probably the salaries offered are not attracting women to this important profession. " On the whole, parents have been very co-operative, regular in their attendance and appreciative of what is being done for their children. A Clinic like this which has ready access to the Health School Medical and Education Departments of both the County and the local areas, has a great advantage over those Clinics which are attached to Hospitals far away from the child's environment." The Psychiatrist undertakes 3 sessions weekly, whilst the Educational Psychologist is whole-time and the Psychiatric Social Worker undertakes 6 sessions weekly. Mrs. I. M. Seglow, Psychiatric Social Worker, terminated her appointment for domestic reasons on 14th April, 1950. Mrs. Henschel was appointed, in the capacity of Acting Psychiatric Social Worker, on 1st May, 1950. Miss J. Woods was appointed as an additional Clerk/Typist and commenced duties on 20th September, 1950. Mrs. Henschel being a qualified Play Therapist, the Clinic was able to undertake treatment interviews. During th,e year 165 new cases were referred to the Clinic. 15 cases were examined at request of courts. The following is a table of work undertaken at the Clinic: — Psychiatrist: — Cases diagnosed 100 Treatment interviews 258 Other interviews 90 Psychologist: — Cases tested 107 Treatment interviews 215 Other interviews 55 School visits on Clinic cases 18 Psychiatric Social Worker: — Cases interviewed at Clinic 495 Other interviews 17 Play Therapist: — Play Therapy interviews 109 Number of cases recovered or sufficiently improved to warrant discharge 25 Diagnosis and advice only 25 Discharged—non-co-operative 15 85 Employment of School-children and Young Persons.—From special inquiries made at the various schools during 1950 it was found that 72 children were employed out of school hours. 72 children were submitted for medical examination in accordance with the Byelaws made under Part II of the Children and Young Persons Act, 1933, with the following result:— Medically fit 70 Employment of Children in Entertainments Provisional Amending Rules, 1945.—40 Certificates were granted during the year. Examination of Officers, etc.—The undermentioned teachers and other officers were medically examined and reported upon during the year:— Newly-appointed Teachers 7 Newly-appointed Staff 3 Newly-appointed School Clerical Assistants 16 Total 26 Camp Schools. The Elmbridge Camp School at Cranleigh, Surrey, and Kennylands Camp School at Kidmore End. near Reading, were taken over entirely by the Essex Education Committee on the 1st April, 1948. Admissions and re-admissions of Ilford School-children to these two Camp Schools and the Hydon Heath Camp are medically examined by the Assistant Medical Officers prior to entry. Table Showing the Principal Causes of Death among Children of School Age (i.e., from 5–15 Years) in Ilford for 1948 and 1949. The Table also gives a Comparative Percentage of Deaths Registered at all Ages, and from 5—15 Years. Disease Percentage of total deaths (all ages) Percentage of total deaths at ages 5—15 1949 1948 1949 1948 1. Measles .06 – – – 2. Scarlet Fever – – – – 3. Whooping Cough... .06 – – – 4. Diphtheria – – – – 5. Acute Poliomyelitis and Polioencephalitis .23 12.5 – 6.—Influenza 104 0.6 12.5 — 7. Tuberculosis 307 4.5 25.0 20.0 8. Rheumatic Fever — — — — 9. Bronchitis, Pneumonia and other respiratory diseases 10.5 10.2 – – 10. *Meningitis and Nervous system 13.0 15.5 — 6.6 11. Heart Diseases 31.9 32.6 — 6.0 12. Acute and Chronic Nephritis 2.2 1.4 12.5 — 13. Violence 1.5 4.1 12.5 13.5 14. Other causes 36.44 31.1 25.0 53.5 100.0 100.0 100.0 100.0 * Excludes Meningococcal infections. 86 Deaths of School-children. llford.—The deaths of children of School Age during 1949 represent 0.46 per cent. of the Total Deaths registered (all ages), and during 1948 represent 0.98 per cent. B.C.G. Vaccination against Tuberculosis. In pursuance of the campaign started by the Ministry of Health for the study of B.C.G. vaccination against tuberculosis, the Medical Research Council requested permission to try out this method of mass immunisation amongst secondary modern school leavers in llford. The campaign, carried out in certain selected areas, is a pilot scheme which has the full approval of the Ministry of Health. The trial involves at the outset children of the age of 15. Participants are all volunteers. The scheme was circulated to all parents of school-leavers inviting their full co-operatiion. Meetings of Head Teachers were arranged to explain the scheme, and obtain their co-operation. All children participating in the scheme are tuberculin-tested. Of those found tuberculin-negative, half receive B.C.G. vaccine and the other half hot. These two groups, together with the tuberculin-positive group, are re-examined and followed up by a Medical Research Council team, especially assigned to this work. All groups are X-rayed and tuberculin tested at regular intervals for at least three years after leaving school. In addition they will receive regular visits from a health visitor. The object of these visits is to obtain follow-up information regarding the children's health, both at the time of the visit and during the previous interval, and to reduce the risk of loss through change of address. Information received from this followup will be amplified by the automatic notification to the unit of all persons of the age groups concerned visiting the chest clinics in the area. In this way it is hoped to obtain detailed information on the tuberculous morbidity arising in all groups in the years following their initial examination, and thereby to arrive at conclusions concerning the value of antituberculosis vaccines. The llford Committee for Education approved the scheme and it came into operation in October, 1950. 87 Ministry of Education MEDICAL INSPECTION RETURNS. Year Ended 31st December, 1950. TABLE I Medical Inspection of pupils attending maintained Primary and Secondary Schools (including Special Schools). A.—Periodic Medical Inspections. Number of Inspections in the prescribed Groups: — Entrants 2,377 Second Age Group 2,311 Third Age Group 1,394 Total 6,082 Number of other Periodic Inspections — Grand Total 6.082 B.—Other Inspections. Number of Special Inspections 3,588 Number of Re-Inspections 8,663 Total 12,251 C.—Pupils Found to Require Treatment. Number of Individual Pupils found at Periodic Medical Inspection to Require Treatment (excluding Dental Diseases and Infestation with Vermin). (No individual pupil should be recorded more than once in any column of this Table, and therefore the total in column (4) will not necessarily be the same as the sum of columns (2) and (3).) Group For defective vision (excluding squint) For any of the other conditions recorded in Table IIA Total individual pupils (1) (2) (3) (4) Entrants 35 633 655 Second Age Group 166 535 657 Third Age Group 112 219 307 Total (prescribed groups) 313 1387 1619 Other Periodic Inspections — — Grand Total 313 1387 1619 88 TABLE II. A.—Return of Defects Found by Medical Inspection in the Year Ended 31st December, 1950. Note.—All defects noted at medical inspection as requiring treatment are included in this return, whether or not this treatment was begun before the date of the inspection. Defect Code No. Defect or Disease Periodic Inspections Special Inspections Number of defects Number of Defects Requiring treatment Requiring to be kept under observation but not requiring treatment Requiring treatment Requiring to be kept under observation but not requiring treatment (1) (2) (8) (4) (5) 4 Skin 94 427 77 74 5 Eyes— a.Vision 313 151 214 27 b. Squint 53 29 32 2 c. Other 48 188 56 90 6 Ears— a. Hearing 27 27 80 18 b. Otitis Media 21 20 44 2 c. Other 16 70 34 37 7 Nose or Throat 389 214 696 378 8 Speech 83 30 84 52 9 Cervical Glands 8 46 261 87 10 Heart and Circulation 59 45 219 88 11 Lungs 63 75 302 164 12 Development— a. Hernia 22 1 48 — b. Other 24 1 110 — 13 Orthopaedic— a. Posture 243 21 201 8 b. Flat foot 421 64 276 19 c. Other 252 87 284 41 14 Nervous system— a. Epilepsy 3 1 6 — 6. Other 8 44 56 31 15 Psychological— a. Devel ment 2 7 13 7 b. Stability 21 19 129 32 16 Other 82 164 312 111 89 B.—Classification of the General Condition of Pupils Inspected During the Year in the Age Groups (See Note (ii) on Table 1). Age Groups Number of Pupils Inspected A—(Good) B—(Fair) C—(Poor) No. % of Col.2 No. % of col.2 No. % of col.2 (1) (2) (3) (4) (5) (6) (7) (8) Entrants 2377 1150 48.3 1145 48.1 82 3.6 Second Age Group 2311 697 30.2 1547 66.9 67 2.9 Third Age Group 1394 507 36.4 865 620 22 1.6 Other Periodic Inspections Total 6082 2354 38 7 3557 58.5 171 2.8 TABLE III. Infestation with Vermin. All cases of infestation, however slight, are recorded. This return relates to individual pupils and not to instances of infestation. (i) Total number of examinations in the schools by school nurses or other authorized persons 52.845 (ii) Total number of individual pupils found to be infested 284 (iii) Number of individual pupils in respect of whom cleansing notices were issued (Section 54 (2), Education Act, 1944) 5 (iv) Number of individual pupils in respect of whom cleansing orders were issued (Section 54 (3), Education Act, 1944) — TABLE IV. Treatment of Pupils Attending Maintained Primary and Secondary Schools (Including Special Schools). Notes:—(a) Treatment provided by the Authority includes all defects treated or under treatment during the year by the Authority's own staff, however brought to the Authority's notice, i.e., whether by periodic inspection, special inspection, or otherwise, during the year in question or previously. (b) Treatment provided otherwise than by the Authority includes all treatment known by the Authority to have been so provided, including treatment undertaken in school clinics by the Regional Hospital Board. [N.B.—The information asked for in this table falls into these two Divisions (a) and (b), except in Group 5 (Child Guidance Treatment).] Group 1.—Diseases of the Skin (Excluding Uncleanliness, for which see Table III). Number of cases treated or under treatment during the year By the Authority Otherwise Ringworm—(1) Scalp — — (ii) Body 1 — Scabies — — Impetigo 21 — Other skin diseases 406 30 Total 428 30 90 Group 2.—Eye Diseases, Defective Vision and Squint. Number of cases dealt with By the Authority Otherwise External and other, excluding errors of refraction and squint 11 29 Errors of Refraction (including squint) 121 * 247 Total 132 276 Number of pupils for whom spectacles were (a) Prescribed 742* 283 (b) Obtained 946 * 288 Total 1,688 571 * Including cases dealt with under arrangements with the Supplementary Ophthalmic Services. Group 3.—Diseases and Defects of Ear, Nose and Throat. Number of cases treated By the Authority Otherwise Received operative treatment (a) for diseases of the ear — 16 (b) for adenoids and chronic tonsilitis — 203 (c) for other nose and throat conditions 21 Received other forms of treatment 262 14 Total 262 254 Group 4.—Orthopaedic and Postural Defects. (a) Number treated as in-patients in hospitals 16 By the Authority Otherwise (b) Number treated otherwise, e.g., in clinics or out-patient departments 711 47 Group 5.—Child Guidance Treatment. Number of cases treated in the Authority's Child Guidance Clinics elsewhere Number of pupils treated at child Guidance Clinics 450 12 Group 6.—Speech Therapy. Number of cases treated By the Authority Otherwise Number of pupils treated by Speech Therapists 130 3 91. Group 7.—Other Treatment Given. Number of cases treated By the Authority Otherwise (a) Miscellaneous minor ailments 1,991 106 (b) Other: — (1) Heart and Rheumatism 210 — (2) Sunlight Treatment 292 — (3) Massage and Remedial Exercises 419 — Total 2,912 106 TABLE V. Denial Inspection and Treatment Carried Out by the Authority. (1) Number of pupils inspected by the Authority's Dental Officers: — (a) Periodic age groups 66 (b) Specials 2,059 Total (1) 2,125 (2) Number found to require treatment 2,106 (3) Number referred for treatment 2,106 (4) Number actually treated 4,411 (5) Attendances made by pupils for treatment 5,903 (6) Half-days devoted to: Inspection 1 Treatment 456 Total (6) 451 (7) Fillings: Permanent Teeth 1.419 Temporary Teeth 272 Total (7) 1,691 (8) Number of teeth filled: Permanent Teeth 995 Temporary Teeth 230 Total (8) 1,225 (9) Extractions: Permanent Teeth 768 Temporary Teeth 4,335 Total (9) 5,103 10 Administration of general anaesthetics for extraction 1,838 (11) Other operations: Permanent Teeth 4,817 Temporary Teeth 923 Total (11) 5,740 92 SCHOOL HEALTH SERVICE STAFF AND SCHOOL CLINICS AS AT 31st DECEMBER, 1950. I.—Staff of the School Health Service. Borough School Medical Officer: I. Gordon, M.D., Ch.B., M.R.C.P. (Lond)., D.P.H. Senior Dental Officer: E. V. Haigh, L.D.S. .R.C.S. Number Aggregate staff in the service of the L.E.A. in terms of the equivalent number of whole time officers (a) Medical Officers : (i) Whole time School Health Service *7 3.35 (ii) Whole time School Health and Local Health Services 7 6.67 (iii) General Practioners working part-time in the School Health Service – – (b) Dental Officers 2 Each attending 1 session of 2½ hours weekly (c) Physiotherapists, Speech Therapists, etc. Physiotherapist 1 Attends 8 sessions weekly Speech Therapist 1 Attends 7 sessions weekly (d) School Nurses 0 (1 part-time) (Combined posts, H.V. and S.N.) 4.25 (e) Nursing Assistants 2 (Clinic Nurses) 1 (f) Dental Attendants 2 1.75 * Includes Senior Dental Officer, but does not include officers employed part-time for specialist examinations and treatment. II.–Number of School Clinics (i.e., premises at which Clinics are held for school-children) provided by the L.E.A. for the medical and/or dental examination and treatment of pupils attending maintained primary and secondary schools. Number of School Clinics 4 III.—Type of Examination and/or Treatment provided at the School Clinics returned in Section II. either directly by the Authority or under arrangements made with the Regional Hospital Board for examination and/or treatment to be carried out at the Clinic. 93 Examination and/or Treatment (1) Number of School Clinics (i.e. premises) where such treatment is provided Directly by* the Authority (2) Under arrangements made with R.H.H.&c. (3) A. Minor ailment and other non-specialist examination or treatment 2 — B. Dental 2 — C. Ophthalmic 2 — D. Ear, Nose and Throat 1 — E. Orthopaedic 2 — F. Speech Therapy 1 — G. Others :— Rheumatism and Heart 1 — Artificial Sunlight 2 — Remedial Exercises 2 — IV.—Child Guidance Centres. (i) Number of Child Guidance Centres provided by the Authority = 1 Staff Number Aggregate in terms of the equivalent number of whole - time officers Psychiatrists 1 3/11 Educational Psychologists 1 1 Psychiatric Social Workers 1 6/11 Others :— Clerk/Typist 2 2 The Psychiatrist is employed by arrangement with the Regional Hospital Board. 94 Table VI.–Summary of Cases of Infectious Diseases among School Children, and of Contacts of such Cases, excluded from School Attendance during the Year ended the 31st December, 1950. SCHOOLS No. on Roll DISEASES AND CONTACTS Scarlet Fever Diphtheria Measles and German ' Measles Whooping Cough Chickenpox Polioencephalitis or Poliomyelitis Mumps Pneumonia Rheumatism Totals Cases Contacts Cases Contacts Cases Contacts Cases Contacts Cases Cases Contacts Cases Cases Cases Cases Contacts Beal Modern 686 – 4 – – 1 – 3 – – – – – – – 4 4 Becontree 1283 1 4 – – 36 – 33 6 1 2 1 – 1 – 74 11 Benton (Open Air) 85 — 1 — — 2 – 2 1 1 – – – – – 5 2 Chadwell 767 9 9 – – 45 – 51 6 28 1 1 9 – – 143 16 Christchurch 732 8 9 – – 76 12 28 1 – – – – – – 112 22 Cleveland 873 25 12 – – 46 6 6 1 – – – – 1 1 79 19 County High 1218 4 3 – – 1 — — – – – 1 – 1 1 7 4 Dane 729 — 3 — — – 1 – – – – – 1 1 – 2 4 Downshall 1301 10 6 — – 125 6 14 – 14 – – – 2 – 165 12 Fairlop 1776 30 26 — – 3 2 21 1 5 – 1 – 1 – 60 30 Gearies 1248 9 4 — — 18 — 37 2 2 1 – 1 1 – 69 6 Goodmayes 663 4 3 — — 78 1 38 9 – 1 – – – – 121 13 Gordon 261 10 7 – – 1 – 5 – 7 – – 1 – – 24 7 Highlands 858 9 4 – – 19 3 10 1 – 1 – 2 1 – 42 8 Loxford 372 1 4 — – – – – – – – – – – – 1 4 Mayfield 938 — 7 — — 2 – – – 1 – 2 1 – 1 5 9 Mossford (Fairlop) 316 4 2 — — 4 1 15 – 1 – – – – – 24 3 Mossford (G.V.H.) 159 4 3 — — 1 – 5 – – – – – – 1 11 3 Newbury Park 295 7 2 — – 7 1 18 3 – – – – – – 32 6 Parkhill 710 30 10 — — 76 23 29 1 2 – – 1 – – 138 34 St. Augustine's 256 2 9 — – 1 1 5 – 1 1 1 – – – 10 11 SS. Peter and Paul's 628 9 13 – – 22 1 11 1 – – – – 1 – 43 15 St. Vincent's 358 1 — – – – – 1 – – – – – – – 2 – South Park 923 20 12 – – 39 1 33 1 – – – – 2 1 95 14 The Glade 575 6 4 – – 71 5 19 4 3 – – – 1 – 100 13 The John Bramston 418 1 3 1 — 1 – 4 2 – – 2 – – – 7 7 The Mount 329 2 4 – — – – – – – – – – – – 2 4 The Redbridge 526 10 4 — — – 1 5 4 5 – – 1 2 – 23 9 The William Torbitt 927 5 4 — — 53 6 45 4 7 2 1 6 – – 118 15 Uphall 347 12 9 — — — — 2 – – – – – – – 16 9 Ursuline 240 2 9 — — 1 – 1 – – – – – – – 4 2 Woodlands 326 13 6 — – 5 2 4 1 2 – – – 1 – 25 9 Private — 14 3 – – 32 1 21 1 – 1 — — 1 – 59 5 Totals 21123 252 196 1 – 766 74 466 50 80 10 10 25 17 5 1622 330 95 96 Table VIIA.—Table Showing the Average Heights and Weights of the BOYS Examined. Age Groups School 5—6 Years 6—7 Years 7—8 Years 8—9 Years 9—10 Years 10—11 Years 11—12 Years 12—13 Years 13—14 Years 14—15 Years 15—16 Years 16—17 Years 17—18 Years Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children I Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children i Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number ot Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Beal Modern — — — — — — — — — — — — — — — — — — 2 152 38.1 2 158 53.8 1 162 53.5 — — — 30 169 58.0 11 172 59.8 — — — Becontree 35 111 19.0 12 114 20.6 1 121 26.4 1 124 28.4 5 130 26.7 9 141 84.1 67 141 33.5 6 144 41.0 8 149 42.7 52 158 49.8 5 163 54.7 — — — — — — Benton (Open Air) 5 113 20.8 12 115 20.3 20 120 21.9 12 125 25.2 8 125 24.2 10 134 31.3 4 145 33.4 5 149 35.0 4 149 36.1 3 152 41.1 2 134 27.1 — — — — — — Chadwell 6 111 20.6 2 108 19.3 3 127 23.1 1 125 27.8 — — — 16 142 35.0 29 147 37.4 — — — — — — — — — — — — — — — — — — Christchurch 63 113 21.1 49 117 21.7 2 122 23.8 1 130 26.9 2 129 29.0 10 138 33.8 50 144 35.1 1 141 33.5 — — — — — — — — — — — — — — — Cleveland 26 112 20.9 23 116 22.3 8 124 26.3 4 127 26.3 4 134 29.3 13 138 31.9 84 141 35.8 — — — — — — — — — — — — — — — — — — County High — — — — — — — — — — — — — — — 1 152 40.3 10 147 36.4 1 137 33.5 1 154 40.3 9 172 56.5 107 169 57.2 2 168 64.3 1 174 73.4 Dane — — — — — — — — — — — — — — — — — — 2 146 35.2 9 150 42.1 2 160 49.7 24 166 54.0 20 166 53.5 1 165 59.0 — — — Downshall 36 114 21.0 35 117 22.2 8 120 24.4 4 133 28.5 1 130 26.6 12 142 34.2 54 142 34.2 3 151 50.6 1 147 40.0 30 159 50.9 6 162 54.7 — — — — — — Kairlop 85 110 20.4 82 115 21.6 9 124 25.4 3 133 28.4 — — — 3 144 34.1 76 145 35.6 5 155 42.6 1 159 47.0 62 160 48.7 17 167 55.9 — — — — — — Gearies 3 108 20.0 1 119 29.0 1 119 22.0 — — — 2 131 28.8 2 129 29.2 65 145 35.9 10 149 39.5 1 143 35.5 40 162 50.8 7 161 51.2 — — — — — — Goodmayes 45 113 19.9 24 116 21.1 2 124 24.1 3 131 29.1 2 134 29.4 18 141 34.8 24 140 34.2 — — — — — — — — — — — — — — — — — — Gordon 20 113 21.2 19 116 22.8 1 120 21.5 — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Highlands 4 111 18.8 4 116 21.6 1 128 31.7 2 127 26.9 2 126 23.0 10 142 33.3 41 145 36.1 — — — — — — — — — — — — — — — — — — Loxford — — — — — — — — — — — — — — — —. — — 3 138 29.3 2 150 41.2 2 154 41.2 82 162 52.0 19 163 53.0 — — — — — Mayfield — — — — — — — — — — — — — — — — — — 11 145 37.8 12 149 39.5 10 152 44.1 56 160 49.0 15 166 54.5 — — — — — — Mossford 48 112 19.7 22 116 22.1 3 127 28.6 — — — 1 134 27.5 5 135 30.1 17 143 36.1 — — — — — — — — — — — — — — — — — — Mossford G.V.H. 7 107 18.7 5 109 19.5 1 116 21.8 1 125 24.8 2 131 27.6 1 130 29.8 — — — — — — — — — — — — — — — — — — — — — Newbury Park 7 112 20.4 19 116 22.2 5 124 26.2 1 130 26.2 4 132 32.7 6 143 34.1 27 147 37.2 — — — — — — 2 153 44.6 — — — — — — — — — Parkhill 18 115 21.1 41 117 22.2 5 122 26.2 2 139 36.0 3 135 30.5 7 145 40.1 65 144 34.7 — — — — — — — — — — — — — — — — — — St. Augustine's 2 110 19.3 14 115 23.0 5 121 24.2 2 131 29.1 — — — 2 134 29.4 13 143 33.1 — — — — — — — — — — — — — — — — — — SS. Peter and Paul 21 115 21.5 17 117 22.7 3 124 26.1 3 129 26.1 1 145 38.2 21 141 34.4 19 144 35.6 — — — 1 151 41.2 15 158 52.0 3 164 50.1 — — — — — — South Park 4 113 20.8 2 120 23.8 — — — — — — — — — 9 141 32.7 69 145 36.7 — — — — — — — — — — — — — — — — — — St. Vincent's 15 112 20.3 4 119 22.8 1 120 23.5 1 115 23.2 2 130 38.2 8 140 32.2 9 143 36.1 2 138 34.6 2 149 42.0 15 158 48.7 — — — — — — — — — The Glade 2 112 19.3 36 118 21.6 8 121 23.7 — — — 1 135 31.0 8 141 32.9 24 142 34.9 — — — — — — — — — — — — — — — — — — The John Bramston 43 107 19.3 21 113 21.8 3 115 21.0 4 121 24.2 4 126 27.4 3 145 35.5 16 143 33.8 — — — — — — — — — — — — — — — — — — The Redbridge 16 112 20.8 20 117 22.1 4 120 23.2 1 122 24.5 2 122 24.6 14 143 31.4 25 143 34.2 — — — — — — — — — — — — — — — — — — The Wm. Torbitt 30 114 20.8 43 116 21.7 3 121 22.4 2 126 25.5 1 145 30.8 2 151 37.0 51 144 34.7 — — — — — — — — — — — — — — — — — — Uphall 12 111 19.4 2 116 23.0 1 121 21.6 1 128 26.7 1 146 56.0 13 140 33.8 18 141 35.4 — — — — — — — — — — — — — — — — — — Woodlands 21 113 20.1 29 117 22.2 2 125 21.1 — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Ilford Boys—Averages for 10 years :— 1950 574 112 20.4 538 116 21.9 100 122 24.1 49 128 26.8 48 130 29.2 203 141 33.9 875 144 35.3 58 149 40.7 34 151 42.7 390 161 50.7 231 167 55.7 14 171 60.4 1 174 73.4 1949 891 118 20.6 433 117 21.9 99 122 24.1 52 127 25.8 55 133 29.2 177 139 32.9 822 143 34.5 54 147 38.9 40 152 41.9 392 160 50.7 247 165 55.3 27 171 61.7 3 173 61.6 1943 764 112 20.2 214 116 21.5 68 122 23.5 52 127 26.6 45 133 28.7 430 137 32.4 602 142 34.2 39 114 37.0 40 153 43.6 298 159 48.6 48 168 55.3 — — — — — — 1947 871 110 19.6 209 115 21.3 91 121 23.4 62 127 26.5 64 131 28.4 369 139 33.1 381 141 33.8 43 145 35.7 139 156 44.7 98 157 46.0 2 157 56.6 — — — — — — 1946 771 112 20.2 387 117 21.9 170 124 24.5 101 128 26.0 94 132 28.6 487 139 31.9 468 142 36.1 140 146 37.2 241 155 41.9 146 158 46.9 40 166 54.0 — — — — — — 1945 542 112 20.2 238 117 21.7 92 122 24.0 58 127 26.5 31 131 28.5 74 138 31.8 122 145 35.5 410 146 37.2 41 148 39.3 6 155 42.5 — — — — — — — — — 1944 783 112 19.9 168 116 21.7 83 122 22.4 76 127 26.3 61 132 29.5 59 139 32.6 128 141 34.4 548 146 37.3 73 150 41.0 — — — — — — — — — — — — 1943 723 111 19.6 348 116 22.1 192 121 23.6 184 126 26.6 130 132 28.1 125 137 32.0 152 143 34.8 546 145 36.4 171 151 42.0 — — — — — — — — — — — — 1942 735 111 19.8 420 115 20.9 259 121 23.7 600 127 26.4 220 131 29.2 217 137 32.0 214 142 34.6 513 146 37.8 162 151 41.5 — — — — — — — — — — — — 1941 377 111 19.6 257 116 21.2 158 122 23.5 519 127 25.9 265 128 28.7 227 137 31.7 201 143 35.9 427 145 37.2 119 151 41.1 — — — — — — — — — — — — 98 Table VIIB.—Table Showing the Average Heights and Weights of the GIRLS Examined. Age Groups School 5—6 Years 6—7 Years 7—8 Years 8—9 Years 9—10 Years 10—11 Years 11—12 Years 12—13 Years 13—14 Years 14—15 Years 15—16 Years 16—17 Years 17—18 Years Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number or Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children | Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Beal Modern — — — — — — — — — — — — — — — — — — 5 146 31.8 6 152 47.8 — 155 44.3 — 161 55.3 24 161 52.2 15 164 54.9 2 157 — Becontree 37 110 18.7 16 113 19.7 6 119 22.2 1 109 18.2 2 130 25.2 9 140 33.9 48 144 36.4 — 148 39.5 4 150 39.4 84 157 48.7 10 — 512 — — — — — — Benton (Open Air) 2 106 16.6 3 107 16.8 9 119 21.1 12 124 23.4 11 128 24.9 12 136 29.7 8 143 31.8 8 144 30.6 3 144 28.5 6 151 43.0 4 147 43.2 — — — — — — Chadwell — — — 4 108 25.0 1 131 29.2 1 128 25.0 — — — 9 142 34.8 44 145 37.1 — — — — — — — — — — — — — — — — — — Christchurch 64 113 20.2 43 116 21.5 2 131 28.4 — — — — — — 7 139 29.7 41 145 35.1 — — — — — — — — — — — — — — — — — — Cleveland 34 111 20.4 18 113 20.7 2 112 20.1 5 126 27.1 7 120 29.7 21 139 33.9 79 142 35.4 — — — — — — — — — — — — — — — — — — Countv High — — — — — — — — — — — — — — — — — — 2 144 37.6 7 145 35.7 2 161 50.7 6 159 44.6 1 166 56.2 2 161 — 2 — — Dane Central — — — — — — — — — — — — — — — — — — 4 141 34.9 3 144 37.6 2 152 46.7 45 160 54.3 13 155 524 — — — — — — Downshall 48 112 19.8 52 116 21.8 3 120 21.7 3 130 27.7 3 131 27.6 22 140 34.5 — 142 35.0 2 153 36.2 1 164 48.0 23 160 52.0 10 — 54.3 — — — — — — Fairlop 97 112 20.5 91 114 20.9 4 120 24.5 4 123 25.3 2 137 30.6 — — — 74 146 36.2 — 140 40.2 9 154 50.1 51 155 52.9 0 — — — — — — — — Gearies 3 109 21.0 — — — — — — 1 128 80.9 3 135 37.3 2 142 30.0 61 147 36.9 4 150 48.5 3 148 43 1 32 158 — — 159 51.2 — — — — — — Goodmayes 41 113 20.7 21 118 21.0 7 123 23.3 1 125 23.1 — — — 12 144 36.1 26 144 36.7 — — — — — — — — — — — — — — — — — — Gordon 18 112 20.3 15 117 22.5 3 123 24.5 — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Highlands 3 119 23.7 1 120 22.3 — — — 3 132 28.7 7 134 32.2 8 137 29.9 37 146 35.5 — — — — — — — — — — — — — — — — — — Mavfield — — — — — — — — — — — — — — — — — — 7 141 36.7 3 — 55.4 2 144 37.7 52 157 49.9 8 158 50.3 2 163 — — — — Mossford 21 110 18.8 10 116 20.6 2 120 28.1 2 127 23.1 — — — 5 138 32.4 17 143 35.4 — — — — — — — — — — — — — — — — — — Mossford G.V.H. 2 106 19.3 3 115 21.5 1 115 23.8 1 127 25.4 — — — 3 130 27.6 2 i n 31.5 — — — — — — — — — — — — — — — — — — Newbury Park 10 116 20.9 30 117 21.8 2 122 24.5 1 130 27.0 1 135 335 3 141 32.7 22 148 39.0 — — — — — — — — — — — — — — — — — — Parkhill 24 113 20.4 43 118 23.0 4 126 27.4 5 126 28.7 5 134 28.5 7 142 33.3 63 145 37.4 — — — — — — — — — — — — — — — — — — St Augustine's 3 114 20.6 10 115 21.3 1 122 22.0 — — 1 141 43.8 4 135 27.3 9 144 38.4 — — — — — — — — — — — — — — — — — — S.S. Peter and Paul 13 113 19.4 22 116 22.9 — — — 1 142 31.9 1 133 30.6 10 139 33.9 23 143 34.7 — 148 39.6 2 150 39.9 10 158 51.5 3 157 62.0 — — — — — — South Park 1 111 20.0 5 116 22.7 — — — 1 123 22.5 2 129 29.9 11 142 34.5 61 144 36.2 — — — — — — — — — — — — — — — — — Si Vincent's 7 113 20.6 10 113 19.5 1 122 23.4 2 126 25.2 3 127 26.6 10 138 32.9 8 143 35.9 — — — 3 154 42.2 13 158 48.2 — — — — — — — — The Glade 2 111 17.1 37 116 20.6 3 119 20.6 2 128 25.8 — — — 3 144 31.1 21 144 37.8 — — — — — — — — — — — — — — — — — The John Bramston 39 107 18.9 17 112 19.8 2 116 23.3 — — — — — — 4 134 28.9 12 141 39.2 — — — — — — — — — — — — — — — — — The Mount — — — — — — — — — — — — — — — — — — 1 143 37.8 3 159 50.4 1 151 40.7 70 158 49.9 7 159 54.2 — — — — — — The Redbridge 16 113 19.7 23 116 22.2 11 123 23.6 4 136 31.2 1 128 38.8 19 143 34.4 27 143 35.5 — — — — — — — — — — — — — — — — — — The William Torbitt 37 114 20.5 34 115 20.4 8 122 23.7 1 125 23.4 4 134 27.5 — — — 48 143 34.6 — — — — — — — — — — — — — — — — — — Uphall 14 108 18.6 1 125 27.5 — — — — — — 1 127 26.3 13 142 37.2 17 145 37.1 — — — — — — — — — — — — — — — — — — Ursuline — — — — — — — — — — — — — — — — — — 24 147 40.8 15 150 42.7 5 154 49.8 2 156 52.5 44 — — — — — — — — Woodlands 17 112 20.7 27 115 20.8 4 121 22.8 — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Ilford Girls—Averages for 10 years :— 1950 553 112 20.0 536 115 21.3 76 121 23.3 51 127 26.1 54 132 29.2 194 140 33.2 837 144 37.0 64 148 41.2 35 152 43.1 401 157 50.8 140 159 53.0 22 163 54.2 4 163 55.6 1949 823 111 19.9 418 115 21.2 82 121 23.5 46 126 26.0 56 130 28.3 21 6 139 33.4 815 143 35.8 57 147 40.7 49 152 44.0 421 158 50.0 257 161 53.8 47 161 55.7 3 163 55.2 1948 699 111 19.4 188 115 20.5 82 120 23.1 56 127 25.8 53 130 27.8 391 138 32.4 569 142 35.0 38 149 39.9 35 154 45.9 303 157 49.1 27 160 51.3 2 160 60.4 — — — 1947 777 111 19.0 224 115 20.7 84 119 23.2 80 126 25.9 — 129 27.4 384 138 32.2 316 141 34.1 29 145 35.9 116 155 45.6 92 157 47.4 1 154 38.7 — — — — — — 1946 708 111 19.3 396 116 21.2 167 121 23.2 116 127 25.2 71 132 28.6 445 138 31.5 415 142 34.4 76 148 39.8 265 156 45.8 121 157 48.5 25 162 56.1 18 160 56.9 — — — 1945 488 110 19.6 249 116 21.2 77 121 23.3 47 127 26.8 28 130 28.1 35 137 30.7 87 143 34.9 499 149 39.4 66 153 44.3 10 160 53.3 — — — — — — — — — 1944 710 110 19.7 167 116 21.3 55 122 23.7 45 127 26.1 51 133 29.2 49 138 31.4 69 143 35.8 492 149 39.2 59 153 42.9 — — — — — — — — — — — — 1948 636 110 19.2 375 115 20.8 175 120 22.5 172 125 25.5 125 130 27.6 111 136 30.8 107 143 34.7 597 148 38.4 143 153 42.2 — — — — — — — — — — — — 1942 617 110 19.1 448 115 20.7 240 122 23.2 588 126 24.4 228 131 27.9 213 136 30.8 150 143 34.5 451 148 38.5 171 154 43.8 — — — — — — — — — — — — 1941 330 110 19.2 268 115 20.6 161 121 23.0 523 127 26.0 255 132 28.1 208 137 31.5 139 142 33.9 423 148 38.5 163 153 43.1 — — — — — — — — — — — —