ILF 26 Library Ac 441(1) ILFPRD Borough of Ilford Health Report FOR THE YEAR 1951 I. GORDON M.D., Ch.B., M.R.C.P., D.P.H. Medical Officer of Health, etc. Waterlow & Sons Ltd., London and Dunstable. ILFORD BOROUGH COUNCIL Municipal Year 1951/52 Alderman P. V. Faning, J.P. (E.C.C.), Mayor. Alderman J. Barker, Deputy Mayor. Aldermen: Barker, John (Deputy Mayor). Faning, Percy Victor, J.P. (E.C.C.), Bryan, William Allen Vernon, J.P. (from 21.4.52), (Mayor). Griggs, Albert Philip, J.P. Colvin, Gilbert, F.C.I.S. (resigned 29.2.52) Cooper, Albert Edward, M.B.E., M.P. holness, Richard Thomas, O.B.E. (resigned 13.3.52). _ TT _ Woods, Sidney Charles Victor. Cowan, Harold Douglas, F.C.P.A., F.C.C.S. (from 25.3.52). Wootton, Mrs. Florence Emily, O.B.E. Daniels, Russell Stearn. Young, Major Alexander, T.D., J.P., C.A., (E.C.C.). Eke, William Benjamin. Fallaize, Mrs. Lilian, J.P. Councillors: Bartlett, Edward Albert. Bennett, Mrs. Florence Edith. Bone, George Robert. Caunt, George Louis. Chapman, Mrs. Ceinwen. Drew, Leslie Victor. East, John. Gibson, Cyril Irving. Gleed, Sydney George. Gooch, Lionel Archer Scott. Groom, Victor William. Headley, Cecil Aubrey. Hewitt, Reginald. Hughes, Thomas Bernard. Lee, Leonard Gordon Victor. Littlejohn, Mrs. Ruth Constance, M.A. Manders, Ralph James David. Masters, Frank Robert. Milburn, Mrs. Elizabeth Florence (E.C.C.). Pavitt, Laurence Anstice. Pearson, Frederick Thomas. Root, Harold Goldstone. Sherrell, Albert R. (E.C.C.). Slater, Frank. Smith, Mrs. Lily Maude, S.R.N. Tamplin, Lewis Henry. Taylor, Sidney William. Terry, Miss Anne Sylvia. Tullett, Mrs. Ethel Ross. Tyler, Bertie Charles Newcombe. Waters, Owen Francis. Watts, Mrs. Mabel Lucy. Westley, Ronald Francis. Woodham, Leonard Victor. A 2 PUBLIC HEALTH COMMITTEE Municipal Year 1951/52 Councillor Mrs. E. R. Tullett, Chairman. Councillor Mrs. M. L. Watts, Vice-Chairman. Alderman J. Barker, Deputy Mayor. Alderman W. B. Eke. Alderman P. V. Faning, J.P. (E.C.C.), Mayor. Alderman A. P. Griggs, J.P. Alderman Mrs. F. E. Wootton, O.B.E. Councillor Mrs. C. Chapman. Councillor J. East. Councillor C. I. Gibson. Councillor Mrs. R. C. Littlejohn, M.A. Councillor F. R. Masters. Councillor A. R. Sherrell (E.C.C.). Councillor Mrs. L. M. Smith, S.R.N. Councillor O. F. Waters. Councillor R. F. Westley. ILFORD HEALTH AREA SUB-COMMITTEE OF THE HEALTH COMMITTEE OF THE ESSEX COUNTY COUNCIL Municipal Year 1951/52 Ilford. Borough Council Representatives: Aldermen Barker (Deputy Mayor), Colvin, Eke, Mrs. Fallaize, J.P. (Vice-Chairman), Woods, and Mrs. Wootton; Councillors Mrs. Chapman, Gibson, Groom, Mrs. Littlejohn, Mrs. Milburn, Mrs. Smith, Miss Terry, Mrs. Tullett and Mrs. Watts (Chairman). Essex County Council Representatives: 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: Mrs. D. L. Belchamber. 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 1951/52 Councillor R. J. D. Manders, Chairman. Alderman G. Colvin, F.C.I.S., Vice-Chairman. Alderman J. Barker, Deputy Mayor. Alderman P. V. Faning, J.P. (E.C.C.) (Mayor). Alderman W. A. V. Bryan, J.P. Alderman S. C. V. Woods. Alderman Mrs. L. Fallaize, J.P. Alderman Major A. Young, T.D., J.P., Councillor Mrs. F. E. Bennett. C.A. (E.C.C.). Councillor Mrs. C. Chapman. Councillor F. T. Pearson. Councillor Mrs. L. M. Smith, S.R.N. Councillor L. A. S. Gooch. Councillor S. W. Taylor. Councillor Mrs. R. C. Littlejohn, M.a. Councillor Miss A. S. Terry. Councillor F. R. Masters. Councillor Mrs. E. R. Tullett. _ Councillor O. F. Waters. Councillor L. A. Pavitt. 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. Miss H. S. Rich. Mr. G. W. Stroud. County Nominated Members : Mr. W. R. Spencer. (One Vacancy). A* 4 OFFICERS OF THE PUBLIC HEALTH SERVICES Ilford Borough Council. Medical Officer of Health, Divisional School Medical Officer, Area Medical Officer, Ilford Health A rea Sub-Committee: I. Gordon, M.D., Ch.B., M.R.C.P. (Lond.), D.P.H. (Edin.). Deputy Medical Officer of Health : (Part Time) D. M. B. Gross, M.D., Ch.B. (Leeds), D.P.H. (Lond.), M.M.S.A. Chief Sanitary Inspector : S. R. Daly, B.Sc., LL.B., D.P.A. (Lond.), Barrister-at-Law. 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 (to 4-5-52). T. F. Johnson. J. A. Harris (from 7-7-52). Chief Administrative Assistant: F. J. Hocking. Welfare Officer for Old Folk: Miss E. A. Workman, B.A. (from 15-4-52). A dministrative A ssistant : J. J. Holland. Essex County Council. Assistant County Medical Officers: D. M. B. Gross, M.D., Ch.B. (Leeds), D.P.H. (Lond.), M.M.S.A. (Part Time). 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. J. W. McConachie, M.R.C.S., L.R.C.P. (Lond.), D.P.H. (from 1-5-52). Senior Dental Officer: E. V. Haigh, L.D.S., R C.S. (Eng.). Dental Officer: Miss M. M. O'Connell, L.D.S., R.C.S.I. (from 25-2-52). Educational Psychologists: K. Pickett, B.Litt. (Oxon.), Dip. Psych. Miss J. Reed, B.A. (Hons. Psych.). Psychiatric Social Workers: Mrs. V. Guttsman (from 24-9-51). Miss I. Zaphiriou (from 1-9-51). Play Therapist: Mrs. M. Henschel, B.A. (Dip. Psych.). 5 Officers of the Public Health Services— continued Superintendent of Midwives: Miss C. Blockley. Superintendent Health Visitor: Miss M. Preston. Health Visitors and School Nurses: Miss A. L. Drinkwater. Miss D. Lowenberg Miss I. L. Mobbs (part time). (from 14-8-51) Miss M. G. Bennett. Miss C. Oldham. Miss E. J. Whiting (from 14-8-51). Miss L. Hockey Miss G. E. Lewis. Mrs. R. Robertson (from 19-5-52) 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. Administrative Assistants: Miss H. Nonn (Part III Services). A. G. Hubbard (School Health Services). 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., D.O.M.S. (to 18-8-51). T. J. Regal, M.D. (Berlin), D.O.M.S. (Lond.) (from 21-8-51). Surgeon in charge of Aural Clinic: W. Ibbotson, F.R.C.S. (died 20-5-52). 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. (to 31-1-51). T. R. Savage, M.A., B.M., M.R.C.P. (from 7-2-51). 6 Officers of the Public Health Services— continued. Child Guidance Clinic: Consultant Psychiatrists: W. M. Burbury, M.A., B.S., M.B., D.P.M. (from 1-10-51). A. H. G. Burton, M.D., M.R.C.P., D.P.M., D.P.H. (to 4-7-51). Psychiatrist: J. Vincenzi, M.R.C.S., L.R.C.P., D.P.M. (from 23-5-51). 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.). E. M. Sycamore, 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. (to 27-5-52). Miss P. J. Kent, L.C.S.T. (to 13-3-52). Mrs. M. Walker, L.C.S.T. (from 1-8-52). Ilford Borough Council. Public Analysts: George Taylor, F.R.I.C. J. Hubert Hamence, M.Sc., Ph.D. 7 PREFACE Public Health Offices, Ilford. September, 1952. 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 1951. During the year a high standard of health was maintained and our indices bear comparison with those of any town in England. The Infant Mortality Rate, however, although better than in most places, records a slight set back, and this matter is discussed more fully later on in the preface with the topic of prematurity. The death rate has also risen slightly, from 9-66 to 10-32 per 1,000 of the population. As mentioned last year, this is largely due to the greater proportion of old people amongst us; cancer, vascular diseases of the nervous system and deaths of old people from bronchitis and pneumonia, largely a result of the 1950-1951 influenza, in themselves being responsible for a total increase of 132 deaths. The fall in the birth rate appears to have halted, for there was a slight rise, from 13-19 to 13-36. There was a welcome absence of any serious epidemic; again there was only one case of diphtheria, a boy of 5, who recovered. There were two cases of poliomyelitis, one of whom died. Measles, with 2,985 cases, an increase over last year, was also responsible for one death, and whooping cough, with 1,026 notifications, less than last year, was responsible for two deaths. There were six cases of enteric fever, with no deaths. An explanation is required of the vagaries of the figures of the population of Ilford. In June, 1950, it was stated to be 186,200, the census figure of April 8th, 1951, was 184,707, and in June, 1951, we were told it was 181,600. We are informed by the General Register Office that these figures do not mean that the population is decreasing, but that the June, 1950, numbers are less accurate than the Census totals, and the June, 1951, figures are less than those of the Census as many enumerated in April were not normally resident in the town, and other slight adjustments had to be made. Notification of Puerperal Pyrexia. At one time death after childbirth due to infection of the birth passages was a great scourge, especially in hospitals; with a more complete understanding of the nature of the transmission from mother to mother, via the attendant, with the introduction of antiseptics, insistence on asepsis, and finally with the introduction of antibiotics such as Penicillin, the disease has dropped to negligible proportions, and last year there were no deaths in Ilford of mothers attributable to childbirth. When the disease was prevalent notification was introduced in order to facilitate its control, and, as the nature of the disease changed in response to newer methods of treatment, the Puerperal Pyrexia Regulations were also modified, the latest form of the Regulations coming into effect on August 1st, 1951. These declare that any fever in a woman in whom a temperature of 100-4° Fahrenheit occurs within 14 days of childbirth must be notified. It must be remembered that the object of these Regulations is to control infections 8 of the birth passages, and the complications that arise therefrom. What exactly is being notified, and who is doing the notification ? It must be borne in mind that the cause of the fever is not required to be stated under the regulations, even if it is not in any way relevant to the intentions of the principles of notification of infectious disease. For some time, however, we have written to the doctor notifying the pyrexia and asking him for the cause. The results have been illuminating. Of the 65 notified since 1st August, 1951, we have had replies with respect to the causation of the fever in 62. Of these 62, in 50 cases (81 per cent.) the fever was quite unconnected with any infection of the birth passages. Of these 50, in 34 (55 per cent, of the total) the fever was due to some disturbance of lactation, often not proceeding as far as mastitis. Who are notifying the cases? In Ilford 63 per cent, of births occur in hospital, but 89 per cent, of notifications came from hospitals. Although complicated cases tend to be admitted to institutions, the causes of this fever are so trivial that they might well occur in domiciliary practice. The conclusion we have to come to is that the busy family doctor, appreciating the triviality of this notification, neglects to fill in yet another form, whereas the hospital doctor, more bound by rules, and with the help of the temperature chart, does so. We may thus assume that, at any rate in Ilford, notification of Puerperal Pyrexia has little relationship to infections of the birth passages, as intended, but tends to be merely an indication of minor breast troubles in maternity wards. This is a form to be filled in that can accordingly be easily dispensed with. Prematurity. It will be noted that for the first time for some years the infant mortality rate has risen, and is approximately at the level it was at in 1948. It is now 21.04 deaths per 1,000 live births, as compared with 18-7 in 1950 (but still well below the rates for England and Wales, Great Towns, Smaller Towns of England and the Administrative County of London). This rise is a disturbing factor in our vital statistics and merits further investigation. In 1950 forty-five children under one year of age died, and in 1951 there were fifty. Study of the death certificates brings forth the fact that on 9 certificates in 1950 prematurity was mentioned as a factor, and on 23 certificates in 1951, a considerable jump. Although the stillbirth rate, the causes of which have much in common with prematurity, rose (from 19-56 to 24-63 per 1,000 total births), there has been no rise in the proportion of premature children born to Ilford mothers (53.6 per 1,000 in 1950 and 52-6 in 1951). What is possible in the way of prevention ? This resolves itself into (a) the prevention of the deaths of premature infants, and (b) the prevention of prematurity itself. With respect to any possible activity of the local authority to prevent these deaths, it is of interest to note that of the 23 who died, 20 were born and died in hospital, and 3 were born at home and died in hospital (two of these were in a hospital within an hour). It is apparent therefore that it is mainly for the hospitals, and not the local authority, to prevent deaths of premature infants. The prevention of prematurity itself is a local authority duty and requires a knowledge of its causes. Important among these are a poor social environment, and certain obstetric conditions such as toxaemia, multiple pregnancy and haemorrhage. Ante-natal care can help, and last year ante-natal clinics to be run by midwives were introduced for the first time in Ilford for domiciliary cases, to supplement the work of the private doctor. Ante-natal clinics for cases to be confined in hospital have of course been conducted for many years. Domestic help in the home in the last few weeks of pregnancy may also help, and this service is of course in being, and consideration should be given to its expansion. 9 Ilford, Barking and Coronary Disease. Deaths due to disease of the coronary arteries (the arteries supplying blood to the heart muscle) are rapidly becoming numerically the most formidable cause of mortality in Western Countries; although not higher than the death rate from cancer, it is higher than the rate for cancer of any individual organ. This disease is unusual in that it is more prevalent amongst the more prosperous. For instance, the rate in the U.S.A. is 201 deaths per 100,000, in Ilford it is 125, and in Barking 91. That Ilford should have a rate so much higher than in Barking is a matter of some interest, and cannot be due to different standards of diagnosis, for our respective patients go to more or less the same hospitals, and finally, in cases of sudden death (which is often the end result of coronary disease) come to the notice of the same Coroner's Pathologist. As coronary disease is mainly a disease of the aged, perhaps it is because we have a higher proportion of old people than Barking. This is so, for in Ilford the percentage over 65 in 1947 was 9-5, and in Barking 6-5. In actual numbers we had 17,158, and Barking but 5,030. Over the age of 85 the difference is still greater, Barking having less than a quarter of those in Ilford, a point of great importance when we are informed that problems of the aged are not so urgent in Barking as here (maybe coupled with the suggestion that relatives in Ilford are less considerate towards their elders). However, the greater proportion* of old people in Ilford is not the complete answer, for further study of the figures show that amongst the aged, coronary disease is more prevalent in Ilford than in Barking. For those over 75, in Ilford 137 and in Barking 115 per 10,000 die of the disease, thus confirming the relationship with prosperity. There is much research and discussion in progress as to what factor of prosperity is responsible for a high coronary death rate. General practitioners suffer more than other doctors and doctors as a whole have a high rate. As it is usually doctors who theorise about the causes, many naturally choose those most commendable to themselves, and the theory has got around (with little or no proof) that stress and strain of the modern world is the cause, especially stress suffered by the independent man, who does not depend on the State for help. This is very self-satisfying, but means that modern Americans suffer more from stress than those in Ilford, and those in Ilford more than those in Barking. A less complimentary theory, but based on far more evidence, is that the more fats one consumes the more one is liable to coronary disease, and the more money one has in one's pocket, the more one eats fats (such as are present in eggs, milk, cheese, bacon, butter and margarine). Which General Hospitals Serve Us? I greatly doubt if any authority is aware of the answers to the following two questions: (a) to what extent does King George Hospital cater for the needs of Ilford residents, and (b) to what extent do Ilford residents patronise other hospitals of a comparable standard to King George Hospital ? These questions are of great importance when hospital planning is considered, for in Ilford much help is obtained from hospitals outside the area, especially the London Hospital and the facilities afforded by the great teaching hospitals must always be considered when local expansion is planned. As a "second best" method of approach, information obtained from death certificates is of help, as thereby we can tell in which hospitals Ilford residents have died. This method has some disadvantages in that it gives little information about patients with trivial complaints, minor surgical conditions, skin diseases, etc., but only about those with severe disorders from which death may occur. Of the deaths in 1951, in King George Hospital 65 per cent, were of Ilford residents. Only 8-4 per cent, came from Barking, and the rest, some 26.6 per cent., from elsewhere. These figures show that the King George Hospital is truly an Ilford Hospital, and although the only general hospital in the Ilford and Barking Group, caters very little indeed for Barking. One wonders if Ilford interests are similarly represented in its management. 10 With regard to (b), where do Ilford residents go when severely ill, the figures must be considered with some circumspection, for of the 714 who died in hospitals of all descriptions, many died in those, such as St. George's at Hornchurch, and Langthorne, which cater for the chronic sick, and others in specialist institutions such as isolation and mental hospitals. It would be well to confine our attention to general hospitals of teaching standard, and those equivalent to the old voluntary hospital and of similar standing to King George Hospital, in the Greater London Area. 422 Ilford residents died in such hospitals, of whom 192 were in King George Hospital (45-5 per cent.), 86 in Oldchurch (20.4 per cent.), and 65 (15-4 per cent.) in the London Hospital. The importance of the London Hospital to Ilford residents is further stressed by the fact that of the 75 that died in general teaching hospitals, 65 (86.7 per cent.) were in the London. The position with respect to provision of services for the aged and chronic sick is little changed. A welfare officer has been appointed to deal with these problems, and whilst she herself can provide no facilities, in the few months she has been with us she has done invaluable work in the co-ordination of other services and by bringing pressure to bear on some of the many different individuals involved in this work, a few of whom may not realise the urgency of the need. For many years there has been some dissatisfaction with the public mortuary at Buckingham Road Cemetery. This year the building has been reconstructed and now conforms with modern standards. The Pathologist, who has a difficult and unpleasant job to do, can work in lighter and more hygienic surroundings, there is refrigerating accommodation, and also, most important, a suitable but simple waiting room and chapel, for relatives who have to view bodies under what may be the most distressing circumstances. It is anticipated that Dagenham, and perhaps Barking, will also wish to make use of the facilities of this mortuary. It will be noted that the number of sanitary inspections has increased by a quarter. There was also a large increase in the number of complaints received, but this was entirely due to two factors; firstly, the implementation of the Prevention of Damage by Pests Act, and secondly, because of a more effective method of notification of the absence or damage of dust-bins. School Health Service. The most important matter to note in the past year has been the complete transfer of our specialist services (excepting the Child Guidance Clinic) to the Regional Hospital Board, who hitherto have only been responsible for the supply of the specialist in person. We naturally view this transfer with some measure of regret, and the Excepted Districts were not in any way consulted over the matter. It is anticipated that clinics will be continued on local authority premises and that we should still supply nursing and clerical assistance, for which the Board will compensate the County Council. Hitherto the transfer has been completed with most friendly co-operation at local level, and is working smoothly. However, neither the Hospital Management Committees nor the Health Area Administrations are their own masters in this matter, and it must be confessed that I view the future with some foreboding. This transfer also affects our physiotherapist, Mrs. King, and will affect the as yet unappointed and urgently required orthoptist, whose services we have been requesting for years, and whose appointment will now probably be even further postponed. The dental position at one time seemed to be on the point of improving but I regret to state that because of resignations we may soon find ourselves in as bad a position as ever. 11 The Child Guidance Clinic has been, for the first time, fully up to establishment in its ancillary staff, although psychiatric sessions have not been fully implemented because of lack of space. The waiting list is still growing apace, and this venture appears to be a permanent and expanding part of our services. The consultant psychiatrist, Dr. Burbury, is leaving to take up the position of Senior Lecturer in Child Psychiatry at the University of Leeds. She has brought to the Clinic much experience and academic distinction. Two recent innovations are worthy of note. The Enuresis Clinic has been successfully launched under the enthusiastic supervision of Dr. Pooley, and referrals of bed-wetters by doctors, and even specialists, are already necessitating extra sessions. To help maintain the interest of the Assistant County Medical Officers they all attend, about once a month, a ward round in the children's wards at Oldchurch Hospital for which facility we are grateful to Dr. Savage, our Consultant Paediatrician. Another matter of note is the increase in attendances at the Minor Ailments Clinics, mainly due to attendances of children suffering from dental trouble (which might have been prevented had we an adequate priority dental service). Diseases for which these clinics were originally started, such as impetigo and scabies, still continue to show a steady and welcome decline. Finally, I must express oar regret at the death of Mr. Ibbotson, who has been our Consultant Ear, Nose and Throat Surgeon since August, 1944. A highly skilled operator, he did his best to improve the unfortunate situation with respect to our long waiting list for tonsils and adenoids operations. In addition, he was a most cultured man and enthusiastic musician and poet. Part III Services. Although probably the most extensive of the three services administered from the Public Health Department, there is often less to comment upon from this Service than with the others. Perhaps this is because the service is steadily expanding and not undergoing much other change, apart from the services mentioned. A new venture that has been agreed is the completion of arrangements for the appointment of an occupational therapist for the tuberculous, particularly for those confined to their homes and either awaiting admission to a sanatorium or discharged from one and not yet ambulant. The Manford Way Health Services Clinic was formally opened by Mr. J. W. Bowen, Chairman of the London County Council, on 3rd November, 1951, and the services therein have been progressively extended, with the provision of orthopaedic and ophthalmic specialist services and some dental sessions for the Forest Health Area. The new Nursery in Goodmayes Lane was opened for the reception of children on 14th November, 1951. replacing the premises in Green Lane, Seven Kings, which were vacated on the 9th of that month. The Nursery was formally opened by the Worshipful the Mayor of Ilford on 24th November, 1951. Free milk for tuberculosis patients is now supplied through this department, instead of the Ilford Tuberculosis Care Association. The numbers of cases assisted have increased from 2 in 1951 to 49 at 28th July, 1952. Dr. E. R. Bransby, of the Ministry of Health, conducted a pilot survey of the diet of children under 5 and expectant and nursing mothers. He states:— "In all, we got information in Ilford relating to 12 expectant mothers and 42 young children, giving a total of 54 subjects. The mothers co-operated exceedingly well in the study and we were very gratified at the reception given to our investigators by the mothers. 12 As you will no doubt realise, the survey was made in a number of areas and the results are now just coming through. There is always considerable delay between the completion of the field work and the getting of the results because of the large amount of computing required." To illustrate the steady progress of the work done the following figures are apt:—- Convalescence (Section 28)—No. of cases sent :— 1949—37, 1950—58, and 1951—69. Loan of Sickroom Equipment (on loan at end of year) :— 1949—5, 1950—27, and 1951—86. Primary Vaccinations (by general practitioners under the County Scheme) :— 1949—831, 1950—1,198, and 1951—1,583. Revaccinations:— 1949—264, 1950—373, and 1951—771. Once again, there was no smallpox in the town. The record of diphtheria immunisations shows some recovery from the previous year's slump. In our own clinics :— 1949—2,811, 1950—2,096, and 1951—2,267. By general practitioners :— 1949—1,548, 1950—1,010, and 1951—1,548. (That precisely the same number were immunised in 1951 as in 1949 is confirmed.) As previously, I wish to thank all the members of my staff who have co-operated so effectively during the past year and have assisted in the preparation of this report; also to my fellow officers for their kind assistance 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 County Council, with whom I work. Finally, no Ilford report can be concluded without expressing appreciation of the work of the members of the Ilford Federation of Voluntary Welfare Workers. I have the honour to be. Your obedient Servant, I. GORDON, Medical Officer of Health. 13 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 „ (Census 1951) (provisional figure) 184,707 Registrar-General's Estimate of resident Population:— June 30th 1948 183,400 „ „ 1949 185,000 „ „ 1950 186,200 „ „ 1951 181,600 Number of inhabited houses (end of 1951) according to Rate Books (approx.) 50,750 Fateable Value—April 1st, 1951 (Houses and Land) £1,651,847 Sum represented by a penny rate, April 1st, 1951 (approx.) £6,700 Education Rate— 1950-51 1951-52 (E.C.C.) 7s. 0.58d. 8s. 0.19d. in the £ in the £ Combined Rate (all services) 19s. 2d. 20s. Od. in the £ in the £ The following figures as to unemployment were supplied by the Ministry of Labour:— Males Females As at January, 1951 513 Birth Rate per 1,000 of the estimated net resident population 168 As at January, 1952 607 246 Total M. F. 1951 1950 Live Births Legitimate 2,306 1,176 1 ,130 13.36 13.19 Illegitimate 70 38 32 Still Births 60 34 Rate per 1,000 total (live and still) births. 24.63 19.56 Deaths 1,835 942 893 Death Rate per 1,000 of the estimated net resident population. 10.32 9.66 Percentage of total deaths occurring in public institutions 40.58 36.92 14 Maternal mortality (heading 30 of the Registrar-General's Short list) :— No. of Deaths. Rate per 1,000 total (live and still) births. 1951 1950 1951 1950 Pregnancy, childbirth and abortion 0 4 0.0 1.63 Death-rate of Infants under one year of age:— 1951 1950 All infants per 1,000 live births 21.04 18.70 Legitimate infants per 1,000 legitimate live biiths 21.24 17.58 Illegitimate infants per 1,000 illegitimate live births 14.28 54.05 Deaths from Cancer (all ages) 357 330 „ ,, Measles (all ages) 1 — „ Whooping Cough (all ages) 2 — ,, Diarrhoea (under 2 years of age) — — 1. Rainfall. Total rainfall registered in the district during the year was 29-95 inches ; the greatest fall in 24 hours was registered on 6th August, 1-57 inches. February was the wettest month. 2. Population. The number of patients and resident staff on the 30th June, 1951, at the following public institutions, was :— Claybury Hospital 2,452 Goodmayes Hospital 1,337 Australasian Hospital (Dr. Bamardo's Homes) 98 Total 3,887 3. Births. The number of births registered during the year was 2,376. Males Females Legitimate 1,176 1,130 Illegitimate 38 32 i.e., 2-9 per cent, of the births registered were illegitimate. The percentage of illegitimate births registered in the previous 10 years was 3-1 (1950) 2.4; 3.2; 3.3; 3.1; 5.5; 4.2; 3.4; 3.5; 3.3. The birth-rate, calculated on the net estimate of the population is 13-36 per 1,000. 4. Deaths. The total number of deaths of Ilford residents was 1,835. This is obtained by taking the total deaths registered in the district (1,789), subtracting the deaths of non-residents occurring in the district (483), and adding the deaths of Ilford residents registered as having died in other districts (529). The number of deaths of non-residents registered in the district (principally in large institutions) was as follows:— Claybury Hospital 235 Goodmayes Hospital 69 King George Hospital 105 Ilford Isolation Hospital and Sanatorium 48 Other Non-residents 26 Total 483 15 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 86 Warley Hospital, Brentwood 5 Wanstead Hospital 22 Queen Mary's Hospital, West Ham 4 Hospital for Sick Children, Great Ormond Street 2 London Hospital 65 St. Bartholomew's Hospital 4 Rush Green Hospital 24 Westm inster Hospital 2 St. Joseph's Hospice, Hackney 8 Severalls Mental Hospital, Colchester 3 East Ham Memorial Hospital 4 Langthorne Hospital 19 Whipps Cross Hospital 29 St. Luke's Hospital 1 London Chest Hospital 5 In other Hospitals, Institutions and residences outside the Ilford district 246 Total 529 The death rate, calculated on the net estimate of the population of 177,811 is 1032 per 1,000. Inquests.—During the year, 43 inquests were held, 29 on Ilford residents, and 14 on non-residents. The ages at death were as follows :— Under 1 year 1-2 years 2-5 years 5-15 years 15-25 years 25-45 years 45-65 years 65 years and upwards — — 1 — 2 12 16 12 Death-Rates from Tuberculosis and Cancer, 1951. The following Table shows the death-rates for 1951 for 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 RegistrarGeneral:— Ilford England and Wales Respiratory Tuberculosis .213 .275 Other Tuberc ulosis .016 .041 Cancer (all forms) 2.007 1.962 5. Marriages.— 1,611 marriages took place in the Ilford district during 1951, both parties or one of the contracting parties being Ilford residents. 6. 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 1951, arranged according to the age groups at which deaths occurred. 16 TABLE I.— Vital Statistics of Whole District During 1951 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 Net (b) of Non-Residents registered in the District of Residents not registered in the District Under 1 year of Age At all Ages Uncorrected Number Number Rate (c) Number Rate (d) Number Rate per 1,000 Net Births Number Rate (e) 1 2 2 a 3 4 5 6 7 8 9 10 11 12 13 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 11.5 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 1951 181,600 177,811 1,677 2,376 133 1,789 10.1 483 529 50 21.0 1,835 10.3 (a) 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. 17 TABLE IA Table showing comparison between the Birth-rate, Death-rate, etc., of Ilford, other Towns, and of England and Wales for the Year 1951 (Provisional figures). Rate per 1,000 Home Population Death-rate per 1,000 Home Population Rate per 1,000 Live Births All Causes Typhoid and Paratyphoid Fevers Smallpox Tuberculosis (all forms) Pneumonia Whooping Cough Diphtheria Influenza Acute Poliomyelitis and Polioencephalitis Diarrhoea and Enteritis (under 2 Yrs.) Total Deaths under 1 Year Live Births Stillbirths England and Wales 15.5 0.36 12.5 0.00 0.00 0.31 0.61 0.01 0.00 0.38 0.00 1.4 29.6 (a) 126 County Boroughs and Great Towns, including London 17.3 0.45 13.4 0.00 0.00 0.37 0.65 0.01 0.00 0.36 0.01 1.6 33.9 148 Smaller Towns (Estimated Resident Populations 25,000 to 50,000 at Census 1931) 16.7 0.38 12.5 0.00 0.00 0.31 0.63 0.01 0.00 0.38 0.01 1.0 27.6 London Administrative County 17.8 0.37 13.1 — — 0.38 0.61 0.01 0.00 0.23 0.00 0.7 26.4 ILFORD (Estimated Gross Population, mid 1951 = 181,600) 13.0 0.33 10.1 - - 0.22 0.40 0.01 - 0.13 0.00 - 21.04 (a) Per 1,000 related Live Births. A dash (—) signifies that there were no deaths. B 18 Registrar-General's Short List of Deaths and Causes : TABLE II. Causes of, and Ages at, Death during the Year 1951. 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 65 and under 75 years 75 years and upwards ALL CAUSES 1,835 50 5 5 8 22 24 74 167 308 479 693 1 Tuberculosis, respiratory 38 - - - - - 2 6 4 14 12 — 2 Tuberculosis, other 3 - - - - 3 - - - - - - 3 Syphilitic disease 12 - - - - - - - 2 2 4 4 4 Diphtheria - - - - - - - - - - - - 5 Whooping cough 2 1 1 - - - - - - - - - 6 Meningococcal infections 2 1 - - - 1 - - - - - - 7 Acute poliomyelitis 1 - - 1 - - - - - - - - 8 Measles 1 - - 1 - - - - - - - - 9 Other infective and parasitic diseases 2 - - - - 1 1 - - - - - 10 Malignant neoplasm, stomach 62 — — — — 1 2 4 6 18 14 17 11 Malignant neoplasm, lung, bronchus 62 - - - - - - 3 12 23 21 3 12 Malignant neoplasm, breast 32 - - - - - 1 5 8 6 6 6 13 Malignant neoplasm, uterus 12 - - - - - - 2 2 5 3 — 14 Other malignant and lymphatic neoplasms 189 - - - 2 3 1 8 21 46 51 57 15 Leukaemia, aleukaemia 10 — 1 — — — — 1 1 — 5 2 16 Diabetes 10 — — — — 1 1 — — 2 4 2 17 Vascular lesions of nervous system 214 - - - - - 1 4 13 31 65 100 18 Coronary disease, angina 219 - - - - - 1 6 28 51 73 60 19 Hypertension with heart disease 65 - - - - - - 3 3 10 18 31 20 Other heart disease 322 — — — — 3 1 4 18 26 70 200 21 Other circulatory disease 60 - - - - - 1 3 6 6 14 30 22 Influenza 24 — — — 1 — - 1 1 2 8 11 23 Pneumonia 74 5 — 1 1 — - 1 - 11 18 37 24 Bronchitis 137 — — 1 — — 1 4 6 22 41 62 25 Other diseases of respiratory system 8 - - - - - - - 2 1 4 1 26 Ulcer of stomach and duodenum 22 - - - - - - - 3 6 2 11 27 Gastritis, enteritis and diarrhoea 9 - - - - 2 - 1 1 2 1 2 28 Nephritis and nephrosis 17 — — 1 — 1 — 4 3 2 6 — 29 Hyperplasia of prostate 16 - - - - - - - 1 1 4 10 30 Pregnancy, childbirth, abortion - - - - - - - - - - - - 31 Congenital malformations 14 5 1 — 1 1 1 — 4 — 1 — 32 Other defined and ill-defined diseases 152 38 2 - 2 2 5 6 13 14 29 41 33 Motor vehicle accidents 11 — — - - 2 - 2 2 2 — 3 34 All other accidents 13 — — - 1 1 - - 3 1 4 3 35 Suicide 20 - - - - - 5 6 4 4 1 — 36 Homicide and operations of war — — — — — — — — — — — - Special Causes (included above) Smallpox - — — - — — — - — - - - 19 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. 1. (i) Pubi.ic 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 1951 will be found in Part III Services section. (iii) Laboratory Facilities.— Pathological specimens are now sent to the Bacteriological Laboratory, OJdchurch Hospital, Romford, for examination. (iv) Byelaws exist for:— Prevention of Nuisances. Cleansing of footways and pavements, and cleansing of earth closets, privies, ashpits and cesspools. Dealing with common lodging houses and houses let in lodgings. Houses let in lodging or occupied by members of more than one family. (Sec. 84, Ilford Act, 1937.) Slaughteihouses and humane slaughtering of animals. Pleasure Fairs. (Sec. 128, Ilford Act, 1937.) Tipping of Dust, Spoil and Refuse. (Sec. 85, Ilford Act, 1937.) 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, oi for manufacturing drink for the use of man. Nuisances in connection with the removal of offensive or noxious matter. Depositing of Rubbish, etc. (Sec. 249, Local Government Act, 1933.) Essex County Council Act, 1933. Part IV—Establishments for Massage and Special Treatment. Inspections of licensed establishments are carried out quarterly. During 1951 twenty-three applications for renewal of licences were received. The Council renewed the licences in respect of these establishments. Five new applications were received, which were granted. The licences expire on 31st March of each year. Part VI.— Hairdressers' and Barbers' Premises. During 1951, 43 visits of inspection were made by the Sanitary Inspectors to these premises. Part IX.— Camping Grounds and Moveable Dwellings. Shops Act 1950 (Section 38). Since this Act came into operation the Sanitary Inspectors have made inspections in accordance with Section 38. During the year, 388 inspections were made, 2 Preliminary Notices were served, both of which were complied with. Three Preliminary Notices served in 1950 were also complied with. No Certificates of Exemption from the provisions of Section 38 were granted in 1951. 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 tubeiculosis is repealed, the powers of the Corporation now being contained in the Food and Drugs Act, 1938; and (3) The Ilford Corporation Act, 1937. B* 20 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 (1) the powers conferied upon the County Council by Part II of the Act, subject to certain conditions. 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. No application for a licence was received during 1951. (v) National Assistance Act, 1948.— The County Welfare Officer has kindly supplied me with the following information. The County Welfare Committee is responsible to the County Council for the duties imposed by Part III of the National Assistance Act, 1948, the main aspects being:— (a) the provision of residential and temporary accommodation, and (b) welfare arrangements for blind and other handicapped persons. Statistics are appended shewing the extent to which the present welfare services have been applied to residents within the Borough of Ilford during the year 1951 :— Residential and Temporary Accommodation. (a) Aged persons (including blind persons) admitted to hostels and other residential establishments:— 32. (b) Other classes (admitted to temporary accommodation) :— Adults 4, Children 4.—8. Blind Persons. Number of blind persons in the Borough :— Registered as blind 225 Partially sighted 37 Defective sighted 16 all of whom are under the supervision of Home Teachers and 7 participate in the Home Workers' Scheme operated through the agency of the Royal London Society for Teaching and Training the Blind. In addition, 2 blind peisons were placed in employment (open industry) during the year making the total number of Ilford residents so employed 25 (5 partially sighted). Three blind persons entered training centres during the year. 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. In April 1951 the Council delegated its power to the Public Health Committee regarding this section. It is essential for this Section to be invoked that the peison must be suffering from grave chronic disease or, being aged, infirm or physically incapacitated, is living in insanitary conditions, and is unable to devote to himself, and is not receiving from other persons proper care and attention. National Assistance (Amendment) Act, 1951.— This Act, which came into force on 1st September, 1951, gave local authorities further powers to enable them to deal expeditiously with certain urgent cases of persons in need of care and attention 21 which they were unable to provide for themselves and were not receiving from other people. Where the Medical Officer of Health and another registered Medical Practitionei certifies that, in the case of a person to whom Section 47 (1) of the National Assistance Act, 1948 applies, and it is necessary, in their opinion, that he should be removed without delay fiom the premises in which he is residing, an application for a removal order may be made to the appropriate court of summary jurisdiction or to a single justice without giving the person whose removal it is desired to secure or the person in charge of him seven clear days' notice which was previously necessary under Section 47 (7) of the 1948 Act. The application may be made either by the local authority or by the Medical Officer of Health where the authority authorises him to make such application and it will not be necessary to give notice to the person in charge of the hospital or other place providing the applicant shows that such person is willing to ieceive into the establishment the person in need of care and attention. The maximum period foi which an order may be made under the new Act is three weeks and any application for an order extending this period by not more than three months from time to time will be subject to the normal procedure under Section 47 of the Act of 1948. The Council at its meeting on the 25th September confirmed the recommendation of the Public Health Committee authorising the Medical Officer of Health to make applications to a court of summary jurisdiction or to a single justice, as the case may be, for orders for the removal to any hospital or suitable place of any person to whom the Act applies. Local Medical Practitioners were communicated with, setting out the powers of Local Authorities under this Act. 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 of 1948 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. 22 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 six persons were dealt with during the year. They were :— (1) A male, 60 years, lived alone in one room. (2) A male, 78 years, lived in lodgings. (3) A male, 28 years, hanged himself. (4) A female, 84 years, lived alone in one room. (5) A female, 64 years, who died in a local nursing home. (6) A female, 71 years, lived in lodgings. (vi) Hospitals, Etc. Isolation Hospital.— 188 beds are provided. Maternity Hospital.— 51 beds for the reception of maternity cases are maintained at the Ilford Maternity Hospital. King George Hospital.— The following is a return in respect of bed accommodation:— Total number of Beds at 31st December, 1951. 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 1,276 patients (males 584, females 692), and Claybury Hospital, with 2,234 patients (males 990, females 1,282) in residence on 30th June, 1951. (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. Barnardo's Institutions, with 80 beds in the Hospital on 30th June, 1951. Maternity and Nursing Homes.— On the 1st January there were 2 private registered Nursing Homes in the district, 1 for medical and senile cases and 1 for medical and surgical cases. These two homes were still functioning on 31st December, 1951. 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 sanitary defects at one of the homes. (vii) Ambulance Facilities : County Ambulance Service. A Central Ambulance Control has now been established by the Essex County Council at Ilford to deal with all requests for Ambulance transport arising in the whole of the Metropolitan area of Essex. The Control is manned continuously, is in direct contact with all Ambulance Stations in the Metropolitan area and is able to contact all other Ambulance Stations in the County. In cases of emergency it is only necessary to dial 999. All other requests for ambulance transport should be made, preferably in writing, to the Controller, Ilford Ambulance Control, High Road, Ilford, or in cases of urgency by telephone (Ilford 3311). Requests for Ambulance transport, other than emergency requests, are only accepted from Doctors, Midwives, Duly Authorised Officers and the medical staff of hospitals. 23 If any difficulty should arise in obtaining an Ambulance a call may be made direct to the Controller, Ilford Ambulance Control, Ilford 3311, or to the County Medical Officer of Health, County Hall, Chelmsford, Chelmsford 3231. (viii) 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. Chad well Christian Mission Hall, Essex Road, Chadwell Heath (for residents of Chadwell Heath area) Monday, 2 p.m. Holy Trinity Church Hall, Mossford Green, Barkingside (for residents of Fairlop area) Tuesday, 9.30a.m. Mayesbrook Clinic, Goodmayes Lane, Goodmayes (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,2p.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,2p.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. 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 and afternoon, 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 Friday 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. Post-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 Friday morning of each month. 24 School and other Clinics.— Clinic sessions are held at Health Services Clinics as under:— (i) Public Health Offices, Valentines Mansion for— Diphtheria Immunization. Aural. Ophthalmic treatment. Paediatric. Infant Welfare. Mid wives Ante-Natal. Enuresis. (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. Ophthalmic treatment. Orthopaedic treatment. (ix) 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. 25 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. 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 495 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 1951 was two yards of 3-inch, 504 yards of 4-inch and 289 yards of 6-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 over 3,500 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. No mains extensions were carried out by the Company during the year. There are now no public wells in existence. There are a few private wells for domestic and commercial purposes. 4 samples of piped water supply (2 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:— (a) Ilford Corporation (Drainage) Act, 1950: Applications for Main Drainage works affecting the soil and surface water sewerage of the western area of the Borough and amounting in value to some £360,000 to be spread over 3 years were submitted to the Ministry of Housing and Local Government. The Minister stated that the commencement of these works would have to be delayed as a measure of economy and the Council were considering making further representations regarding the soil sewerage part of the proposals. (b) Ilford and Barking Joint Sewerage Committee : Application to the Ministry for sanction to renew the screening plant and to provide a building round the new screening plant was similarly deferred. Flooding of Streams. No serious flooding of streams occurred during the year. 26 Pollution of Streams. There was no serious instance of pollution of watercourses during the year. (iii) Collection and Disposal of Refuse.—The Borough Engineer also kindly supplied the following information:— Tons Total amount of refuse collected and disposed of 46,713 Collection of Salvage:— Tons Income Wastepaper 1,145 £19,129 Kitchen Waste 1,794 £5,168 Scrap Metal, etc. 53 £1,446 2,992 £25,743 (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 25,089 Houses and premises reinspected (work in progress) 25,899 Visits during disinfection 745 Houses in which nuisances were detected 1,414 Houses in which nuisances were abated 1,377* Premises disinfected 370 Premises from which articles only disinfected 156 Articles disinfected 1,930 Premises disinfested for verminous conditions 22 * Includes 295 nuisances detected before 1st January, 1951. Notices served:— Statutory:— Complied Served with Public Health Act, 1936 142 91 Housing Act, 1936 8 4 Factories Act, 1937 1 1 Shops Act, 1934 — — Provide Water Supply (Ilford Improvement Act. 1898) 3 3 Provide Dustbin (Ilford Urban District Council Act, 1904) 34 25 Food and Drugs Act, 1938 17 9 Cleanse Water Storage Cistern (Byelaws) 5 5 Cover Water Storage Cistern (Byelaws) 3 3 Informal 1,921 1,478 2,134 1,619 In addition to the above, 366 notices (56 statutory and 310 informal) served previous to 1st January, 1951, were also complied with. 27 Complaints.—During the year, 3,185 complaints of nuisances were received and investigated. The following is a summary:— Accumulation of manure and refuse 68 Animals improperly kept 19 Bad smells 52 Dampness of premises 126 Defective drains, w.c.'s and fittings 314 Defective roofs, gutters, downpipes, etc. 114 Defective water fittings 62 Dirty and verminous houses 29 Dirty condition of rearway 4 Flooding of premises 22 Overcrowding 116 Smoke nuisances 28 Defective or no provision of dustbin 1,212 Rats and mice 355 Miscellaneous 664 Total 3,185 (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 1 sample the chlorine content was above, and in 3 samples the chlorine content was below, the prescribed standard. Samples were also taken from the two indoor baths during February, April, May, June, July, August, September, October and December (16); all of the samples were satisfactory, but in 13 samples (6 from the 1st and 7 from the 2nd class) the chlorine content was above the prescribed standard. (vi) Eradication of Bed Bugs:— Houses found to be infested 24 „ Disinfested 24 (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. One certificate was issued during 1951. (ix) Rag, Flock and other Filling Materials Act, 1951.—This Act, which came into operation on 1st November, 1951, and repealed the Rag Flocks Acts, 1911 and 1928, is designed to secure the use of clean filling materials in upholstered articles and other articles which are stuffed or lined, and for purposes connected therewith. The Council is a Local Authority for the purpose of the Act, and delegated its powers under the Act to the Public Health Committee. The Medical Officer of Health and Sanitary Inspectors are authorised officers for all the purposes of the Act by virtue of their appointments. It is unlawful, except on premises registered by the Local Authority, to use filling materials, specified in the Act, for any form of upholstery activities, subject to certain exceptions such as the re-making or reconditioning of any article, etc. Registration was granted in respect of 14 premises during 28 The occupier of registered premises may only obtain "rag flock" from premises licensed under the Act, either for the manufacture of rag flock or as a rag flock store. No licences were granted in 1951. The Act requires records to be kept on all registered and licensed premises and prohibits the selling or offering or exposing for sale of any articles containing unclean materials. An authorised officer of the Local Authority has right of entry for the purpose of inspection and is empowered to take samples from all registered and licensed premises. The Rag Flock and Other Filling Materials Regulations, 1951, prescribe standards of cleanliness, analysts who may undertake analyses and the fees to be paid to them, the form of certificate of test to be given by the prescribed Analyst, the records to be kept and the procedure, etc., for taking and treatment of samples. (x) Smoke, etc., Abatement.—Complaints were received of alleged smoke nuisance from 5 factories in the Newbury Park, Grove Road and Ilford Lane areas. In all cases the firms concerned made efforts to remedy conditions by installing new plant or by making repairs and adjustments to existing plant. Regular observations were maintained and investigations carried out but no emission was noted which would have enabled action to be taken under the Public Health Act, 1936. (xi) Public Health Act, 1936—Section 154.—Four instances were reported in 1951, of persons exchanging articles for rags received from children under the age of 14 years, in contravention of the Public Health Act, 1936. Legal proceedings were taken in one case and fines totalling £2 were imposed. Letters of warning were sent in two other cases. 29 SECTION D.—HOUSING. (i) Overcrowding.—No notices were served during 1951. (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) 2,051 (b) Number of inspections made for the purpose 11,716 (2) (a) Number of dwelling-houses (included under head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 6 (b) Number of inspections made for the purpose 410 (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 1,411 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 1,348* 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 8 (2) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) By owners 16* (b) By local authority in default of owners 2* b. Proceedings under Public Health Acts (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 187 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners 167* (b) By local authority in default of owners 1* c. No proceedings were taken under Sections 11, 12 and 13 of the Housing Act, 1936. 30 4. Housing Act, 1936, Part IV—Overcrowding :— (а) (i) Number of dwellings overcrowded at the end of the year 307 (ii) Number of families dwelling therein 389 (iii) Number of persons dwelling therein 1,086 (b) Number of new cases of overcrowding reported during the year 97 (c) (i) Number of cases of overcrowding relieved during the year 338 (ii) Number of units concerned in such cases 1,342 (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 1951 of Notices served prior to 1st January, 1951. HOUSING ACT, 1936. During the year 1951 the work of receiving applications, calling for calculations for the "permitted number" was continued with a view to the issue of housing certificates. 8 certificates, in respect of 9 houses, were issued during the year, making a total of 18,270 certificates, in respect of 25,051 houses, issued to the end of 1951. As new premises were constructed and placed upon the rating lists, " permitted number " certificates were issued as required. 31 SECTION E. INSPECTION AND SUPERVISION OF FOOD. Milk Supply. 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 Milk (Special Designations) (Specified Areas) Order, 1951, which came into operation on 1st October, 1951, specified an area, including Ilford, in which the compulsory use of special designations for retail sales of milk shall operate. (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, 1951:— Persons registered as distributors of milk 79 Premises registered as dairy premises (other than dairy farms) 12 187 inspections of dairy premises were carried out during the year. (ii) Milk (Special Designation) (Raw Milk) Regulations, 1949.— The following licences were granted during 1951:— Accredited Nil do. (Supplementary) Nil Tuberculin Tested 30 do. (Supplementary) 9 (iii) Milk (Special Designation) (Pasteurized and Sterilised Milk) Regulations, 1949. The following licences were granted during 1951:— Pasteurized (Dealer's) 51 do. do. (Supplementary) 10 do. (Pasteurizer's) 2 Sterilized (Dealer's) 48 do. do. (Supplementary) 11 do. (Sterilizer's) 1 The Essex County Council granted one producer's licence in respect of graded milk produced on a farm in the Borough. 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 Heat treated).— 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 Maintained Schools.—These are sampled monthly and after unsatisfactory results. 32 The following results were obtained:- Grade of Milk. Total Satisfactory. Unsatisfactory. Remarks on unsatisfactory results. Tuberculin Tested milk. 10 10 — — Tuberculin Tested (Pasteurized) Milk 28 27 1 The sample failed to satisfy the Methylene Blue Reduction Test. The retailers were communicated with and further samples proved satisfactory. Tuberculin Tested Milk (Farm bottled) 20 17 3 One sample failed to satisfy the Methylene Blue Reduction test. The Divisional Inspector of the Ministry of Agriculture & Fisheries was communicated with. Further samples proved satisfactory. The other 2 samples gave positive results when submitted to the biological test for tuberculosis. (See below). Accredited 6 6 — — Pasteurized Milk 121 113 8 All 8 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 34 34 - - (v) Biological Tests.—34 samples of milk were submitted to a biological test for tuberculosis, two of which were found positive. These samples were from milk produced at a farm in the Borough. The Divisional Inspector of the Ministry of Agriculture & Fisheries carried out an investigation and reported as follows. No clinical evidence of tuberculosis on inspection of the herd. Two cows, one of which was stated to have had an indurated udder, had recently been sold. Four group samples of milk were taken. One sample, involving ten cows was found to be positive. None of these animals showed clinical evidence of tuberculosis; four were sampled, the remaining six cows being dry. These samples were returned negative to the biological test. (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.—6 complaints of the presence of foreign bodies in milk were received and investigated. No legal proceedings were taken, but representations were made to the retailers in all cases. (viii) Registration.—No application for registration was refused during the year. 33 Ice Cream. (i) Registration. Section 158 of the Essex County Council Act, 1933, which requires the registration of manufacturers and vendors of ice cream and the premises used by them, came into operation in the Borough on the 1st February, 1934. In 1948, the Council delegated to the Public Health Committee its powers and duties 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. 29 applications for registration in respect of 29 premises were considered during the year 1951. The registrations were granted as follows:— Purveyors retailing multiple firms' productions 27 Purveyors manufacturing and retailing their own productions 2 Legal proceedings were taken against a person for selling ice cream in the Borough without registration and a fine of 10s. Od. was imposed. (ii) Ice Cream (Heat Treatment Regulations) 1947 to 1951. The Ice Cream (Heat Treatment, Etc.) Amendment Regulations, 1951 appointed the 1st March, 1951 as the date from which local authorities may require the use of thermometers to indicate and record temperatures to which ice cream mixture is subjected in the manufacture of ice cream. The Council decided, in accordance with the recommendations of the Minister of Health, that 4 thermometers should be provided of the following types:— A recording thermometer at the heat treatment stage; An indicating thermometer at the heat treatment stage; An indicating thermometer at the cooling stage; An indicating thermometer at storage stage. (iii) Sampling. Samples for bacteriological examination are taken monthly from April to September 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. In 1951, 110 samples were submitted for examination with the following results:— Ministry of No. of Samples Health % of Total. Unsatis- Provisional factory grade. Samples. 54 I 49.1 — 26 II 23.6 3 21 III 19.1 9 9 IV 8.2 5 110 100.0 17 Of the 17 unsatisfactory samples, 5 contained excessive bacteria and the remainder contained coliform organisms including some of faecal origin. The ice cream was manufactured in Ilford in 4 cases only. The local Medical Officers of Health were communicated with in cases where supplies were received from outside the Borough and in all cases the Sanitary Inspectors visited the premises to check the arrangements for manufacture and/or storage. Further available samples proved satisfactory. The Food Standards (Ice Cream) Order 1951 which came into operation on the 1st March, 1951 prescribed standards for ice cream. During 1951, 13 samples were submitted for chemical analyses, all of which complied with the Order. C 34 Food and Drugs Act, 1938. Meat and Other Foods. (i) Inspection and Supervision. The Council has made bye-laws under Section 15, Food and Drugs Act, 1938 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. The whole-time services of two Sanitary Inspectors are utilised to deal with food preparing premises, factory canteen premises and food and drugs sampling. During 1951, they made 9,336 inspections of food shops and food preparing premises and copies of the bye-laws were supplied and explained. Interviews were held with directors and representatives of most of the multiple firms having shops in the district and agreement arrived at as to matters of policy affected by the bye-laws. 489 informal and 17 formal notices were served under the Food & Drugs Act, and 10 formal and 406 informal notices were complied with, including one formal and 20 informal notices served in 1950. (ii) Food Hygiene. Twenty-two Lectures and demonstrations with film strips were organised for food handlers. For this purpose, canteens, restaurants and staff rooms have been kindly made available and food handlers in the vicinity invited to attend. Questions were raised followed by interesting discussions. These lectures were held in duplicate in order to allow the entire staffs of premises to attend without disorganising their business. Staffs of 147 canteens, cafes and food shops were invited, resulting in an attendance of 382. Further lectures are being organised and it is intended to cover the whole of the Borough in this manner. It is pleasing to note that the catering industry, as a whole, is co-operating admirably. (iii) Sampling. The Council has delegated to the Public Health Committee power to institute legal proceedings under the Act. 285 samples (279 formal and 6 informal) of food and drugs were obtained during the year 1951; 9 formal and 4 informal samples were not satisfactory as follows:— (a) Salt beef (formal).—Serological tests confirmed that this meat was horseflesh. Legal proceedings were taken against the butcher's manager who was fined £3, plus £5. 5s. 0d. costs. (b) and (c) Milk (formal).—These samples were deficient in fat to the extent of 13 per cent. and 6 per cent. respectively. Further samples, taken on the recommendations of the Public Analyst, proved satisfactory, and no further action was taken. (d) Vinegar (formal).—Consisted not of vinegar, but of coloured acetic acid. Legal proceedings were taken against the retailer who was fined £1. (e) Vinegar (formal).—Consisted not of vinegar, but of coloured acetic acid. Fines totalling £\ plus £1 costs, were inposed. (/) Whisky (formal).—Found to have a strength of only 40.1° underproof, whereas the Food & Drugs Act requires that the strength of whisky should not be lower than 35.0° underproof. Legal proceedings were taken and the licensee was discharged on payment of 4s. costs, the co-licensee was fined £20, plus £3 3s. 0d. costs and the barmaid was fined £5. On appeal, at the Court of Quarter Sessions, the co-licensee's fine was reduced to £10 and the barmaid was discharged, and no order was made as to costs. 35 (g) Whisky (formal) and (h) Gin (formal). These two samples had a strength of only 39.1° and 56.4° underproof respectively, as compared with the required standard of not lower than 35° underproof. Legal proceedings were taken and the managing licensee was fined £10 and £5 5s. 0d. costs on each summons in relation to whisky and gin. The non-resident licensee was discharged on payment of £2 2s. 0d. costs on each summons. (i) Lemon Pudding Mix (formal).—This sample contained two small yellow grubs and part of an insect pupae. It had a brownish colour and was devoid of any lemon flavour. Microscopical examination showed that it consisted essentially of a wheaten preparation containing cocoa and it appeared that the preparation was originally a cocoa pudding mixture and not a lemon mixture. A letter of warning was sent to the retailer. (j) Bread (informal). This sample contained a foreign object which was identified as rodent excreta. Legal proceedings were taken against the bakery firm and a fine of £2 was imposed. (k) Chocolate Sponge Sandwich (informal). This sample contained dirty dough, oil or fat, quartz sand and a piece of flint. Legal proceedings were taken against the bakery firm and a fine of £5, plus £1 1s. 0d. was imposed. (l) Milk (informal). This sample contained foreign matter consisting of general miscellaneous dirt, including finely ground particles of coal and sand, iron oxide or rust and a few cotton fibres. A letter of warning was sent to the retailer. (m) Red cherries—tinned (informal). This sample was submitted by a retailer following complaint of sulphur-like smell on tin being opened. The analyst found that Sulphur Dioxide was present to the amount of approximately 40 parts per million, and was of opinion that the Sulphur Dioxide was decomposing and giving rise to sulphur compounds which were probably harmless, but objectionable and that on this account the cherries were unsuitable for human consumption. The wholesalers withdrew the cherries from sale, and notified the Belgian packing firm. (iv) Hawkers of Food. Section 77 of the Ilford Corporation Act, 1937 provides for the registration of hawkers of meat, fish, fruit and vegetables and their storge premises. Registration was granted to 14 persons (concerning 7 premises). Legal proceedings were taken against a hawker in respect of his failure to display his name and address legibly on a barrow, from which fruit was being sold, contrary to the provisions of Section 78 of the Act. Fines totalling £1 were imposed. (v) 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. Section 80 of the Ilford Corporation Act, 1937, requires registration of such premises. No application for registration was received during 1951. (vi) Articles of Food Surrendered. During the year the following articles were surrendered and condemned as being unfit for the food of man:— Biscuits—42J lb.; Butter (Peanut)—2 tins; Cake—11 lb.; Cereals—63 lb., 4 pkts.; Cheese 36¾ lb., 32 pkts.; Cocoa—1 tin; Coconut (Desiccated), 3 pkts.; Coffee—3 bottles, 7 tins; Chocolate Wafers—2,160 pkts.; Chocolate Coconut Squares—240 buttons; Chocolate Spread—2 tins; Confectionery—101¼ lb.; Custard—2 tins; C* 36 Egg (Dried) 12 lb.; Fish (Wet and Dry)—165½ stones; Fish (tinned)— 541 tins; Fish Cakes—59; Fish Paste—19 jars; Flour—164 lb., 86 pkts.; Fruit (tinned)—1,656 tins; Fruit (bottled)—1,920 bottles; Fruit (Dried)— 341 lb.; Fruit Juice—32 tins; Food, Baby—227 tins, 1 bottle; Gelatine— 1 tin; Ginger—53 lb.; Gravy Mixtures—12 tins; Jam, Preserves, etc.— 200 tins; Jellies—119 pkts.; Lemon Barley Powder—42 drums, 6 tins; Meat (Fresh)—1.959JJ lb.; Meat (tinned)—3 tons 0 cwts. 1 qr. 10½ lb.; Milk (tinned)—957 tins; Milk (Dried)—11 lb.; Pastry and Pudding Mixtures—3£ lb., 4 pkts.; Pickle—15 jars; Potato Powder—160 lb.; Poultry—51 tins, 218½ lb.; Puddings—32; Rabbits—3 tins, 60 lb.; Sago—70 lb.; Salt—1 drum; Sauces and Salad Cream—350 bottles, 1 drum; Sausages—19 tins, 8 lb.; Spaghetti—132 tins; Spices—2 lb.; Soups—293 tins; Vegetables (Fresh) 36 cwt., 48 lb.; Vegetables (Tinned)—1,391 tins. In view of the large quantity of imported canned ham (2 tons, 3 cwt, 3 qr. and 3 lb.) surrendered for condemnation, the Public Health Committee decided that the matter should be referred to the Ministry of Food. The Ministry stated that similar complaints had been received from other authorities and that as the cause of the trouble appeared to be inefficient curing and canning, the matter was being taken up with the Governments of the countries concerned. (vii) Foreign Bodies in Food. 15 complaints were received during 1951 of the presence of foreign bodies in foodstuffs. All were investigated and legal proceedings were taken in two cases. A fine of £2 was imposed on the food manufacturers in one case and the other case was dismissed on payment of £3 3s. 0d. costs. Letters of warning were served in 5 cases. (viii) 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. Nineteen notifications were received. The following is a summary of the cases 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 4 Nil Salmonella Typhimurium 2 Unknown There was one other outbreak involving 2 cases but the cause was not discovered. There were also 13 single cases; Salmonella typhi-murium was traced in four cases. Seven other instances of suspected food poisoning were investigated, but were not notified, and no specific cause was discovered. (ix) Bakehouses.—There are 33 bakehouses in the district, 27 of which use motive power. 372 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 9 instances, and the requests were complied with in all but two cases, where work was in progress. Diseases of Animals Acts, 1894-1937 and 1950. (i) Diseases of Animals Act, 1950.—This Act, which came into operation on 1st January, 1951, in Part I consolidates the law relating to Diseases of Animals Acts. Its main purposes are to empower the Minister to make regulations for the eradication of disease, separation and treatment of diseased 37 animals, and to require notices to be given where diseases occur, to secure that infected premises are properly protected and disinfected ; for securing the slaughter of animals suffering from certain diseases, and for compensation for loss resulting therefrom. It regulates the movement of animals in cases where infection has occurred, and deals with the importation, quarantine and exportation of horses. It goes on to take measures for the prevention of sheep scab, control of dogs, and dealing with poultry diseases. Part II deals with the manufacture of veterinary therapeutic substances, and Part III is general, and relates to powers and finances of Local Authorities, duties of the Police, general administrative provisions, and offences and legal proceedings. (ii) Foot and Mouth Disease (Controlled Areas) Special Order No. 3, 1951.—This Order specified an area including Ilford in which the movement of animals was prohibited except under licence. (iii) Foot and Mouth Disease (Infected Areas) Special Order No. 28, 1951.—The Minister of Agriculture and Fisheries extended the Special Order declaring specified areas to be controlled areas to comprise the Administrative Counties of London and Middlesex as infected areas. Licences were issued permitting the entry into the Borough of 8 cows, 3 heifers in calf, 15 bullocks, 20 sheep and 35 pigs, and licences were countersigned permitting the removal from the Borough of 3 cows, 20 calves, 15 bullocks, 20 sheep and 41 pigs. (iv) Regulation of Movement of Swine (Amendment) Order, 1950.— This Order came into operation on 8th January, 1951, and extended to the whole of Great Britain the provisions of the Regulation of Movement of Swine Order, 1950, which prohibited the sale of swine in any market fairground or saleyard, unless authorised by the Local Authority and placed restrictions on the movement of swine. 15 licences were issued for removal from the Borough of 40 swine and 4 licences were countersigned in respect of 34 swine which were moved into the Borough. (v) The Transit of Horses Order, 1951.—This Order regulates the carriage of horses in rail and road vehicles. It requires (a) the vehicles to be suitably constructed and fitted and to be cleansed and disinfected at intervals; and (b) the horses carried in the vehicles to be fed and watered at intervals and to be protected against inclement weather and injury from overcrowding. (vi) Animals (Landing from Ireland, Channel Islands and Isle of Man) Order, 1933.—A licence was received for the removal of a white male goat from Birkenhead to Ilford. (vii) Agriculture Act, 1937.—The following Orders came into operation on 1st January, 1951 :— (a) The Tuberculosis (Area Eradication) Order, 1950, the provisions of which apply when the Minister declares an area to be an "Eradication Area" or an "Attested Area," (under section 23 of the Agriculture Act, 1937), for purposes connected with the control of tuberculosis. The provisions include the control of movement of cattle in such an area and ancillary provisions designed to prevent the introduction or spreading of tuberculosis. (b) The Tuberculosis (Slaughter of Reactors) Order, 1950, which empowers a veterinary inspector of the Ministry to require the owner or person in charge of a bovine animal in an "Eradication Area" or "Attested Area," to detain and isolate the animal where it is proposed to cause it to be slaughtered as a reactor to the tuberculin test or because it has been exposed to the infection of tuberculosis by contact with a reactor. It provides for the method of ascertaining the compensation value of any animal so slaughtered but the provisions of the Tuberculosis Order, 1938, regarding bovine animals found to be infected with tuberculosis otherwise than by a tuberculin test are not affected. (e) The Tuberculosis (Compensation) Order, 1950, which sets out the scale of compensation payable for bovine animals slaughtered under the powers of the Agriculture Act, 1937, which have proved to be reactors to the tuberculin test, or exposed to infection by tuberculosis. 38 (viii) The Live Poultry (England and Wales) (Restrictions) (Amendment) Order, 1951; The Live Poultry (Restrictions) Order, 1951; The Poultry Carcases (Importation) (Amendment) Order, and (Amendment No. 2) Order, 1951; The Isles of Scilly (Prohibition of Importation of Live Poultry and Hatching Eggs) Order, 1951.—These Orders deal with the requirements necessary to prevent the spread of fowl pest by controlling the movement and sale of live poultry and poultry carcases. Three cases of fowl pest were notified during 1951. 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. The Council has appointed a whole-time Rodent Operative, who commenced his duties on 1st January, 1951. The following is a statement of the work carried out during 1951:— Local Authority Type of Property Total Dwelling Houses Agricultural All other (including Business and Industrial) I. Total No. of properties in District 118 50,553 40 5,202 55,913 II. No. of properties inspected as result:— (a) of notification 35 356 1 73 465 (b) otherwise 16 38 — 9 63 III. No. of properties found to be infested by rats:— Major — — — 1 1 Minor 24 254 1 40 319 IV. No. of properties found to be seriously infested by mice 14 66 1 24 105 V. No. of infested properties (under III and IV) treated by the Local Authority 36 305 2 57 400 VI. No. of notices served under Section 4:— (1) Treatment — — 1 — 1 (2) Structural works (i.e., Proofing) - - - - - VII. No. of cases in which default action was taken by Local Authority following issue of notice under Section 4 - - - - - VIII. Legal proceedings - - - - - IX. No. of "block" control schemes carried out 1 39 Petroleum (Consolidation) Act, 1928.—The Sanitary Inspectors made 548 visits to premises where petroleum is stored, or in conjunction with the installation of such storage, and the testing of petroleum appliances or fittings. The number of Licences issued was 139, and the fees paid to the Council for such Licences was £100. One Licence was issued for the storage of calcium-carbide, the fee payable being 5s. 40 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 notifiable Scarlatina or Scarlet Fever. by Local Authority as from 29/6/29). Typhus Fever. 2. Under Regulations of the Ministry of Health. Plague L.G.B. Order, 19/9/1900. Puerperal Pyrexia The Puerperal Pyrexia Regulations, 1951. Ophthalmia Neonatorum P.H. (Ophthalmia Neonatorum) Regulations, 1926. Acute Primary and Acute Influenzal Pneumonia P.H. (Pneumonia, Malaria, Dysentery, etc.) Dysentery Regulations, 1927. Malaria Tuberculosis P.H. (Tuberculosis) Regulations, 1952. 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 En- Acute Encephalitis cephalitis and Meningococcal Infection) Meningococcal Infection Regulations, 1949. 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. The total number of deaths of Ilford residents from the following infectious diseases during 1950 and 1951 were as follows:— 1950 1951 Scarlet Fever — — Enteric Fever — — Diphtheria — — Acute Poliomyelitis 2 1 Measles — 1 Whooping Cough — 2 Influenza 11 24 Tuberculosis—Pulmonary 42 38 Other forms 4 3 Pneumonia (all forms) 39 74 Diarrhoea (under 2 years) — — Meningococcal Infections 1 1 Total 99 144 41 TABLE III.—Corrected Notifications of Infectious Diseases for the Year 1951. NOTIFIABLE DISEASE At all Ages Number of Cases Notified At Ages—years Total Cases Notified in each Ward *Total Cases Admitted to Hospital *Total Deaths 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. Hainault Seven Kings S. Hainault Smallpox - - - - - - - - - - - - - - - - - - - - - Scarlet Fever 278 2 57 207 10 2 - - 16 10 7 11 24 24 27 28 17 13 31 70 116 - Diphtheria, including Membranous Croup 1 - - 1 - - - - - - - - - - 1 - - - - - 1 - Enteric Fever (Typhoid and Para-Typhoid 6 - - 2 1 2 1 - - - - - - - 1 1 1 2 - 1 5 - Pneumonia 225 7 21 17 10 38 59 73 15 30 7 18 18 22 35 11 7 18 15 29 89 74 Puerperal Pyrexia 64 - - - 20 44 - - - - - 3 2 2 1 1 2 51 - 2 63 - Acute Poliomyelitis 1 - - - 1 - - - 1 - - - - - - - - - - - 1 1 Acute-Encephalitis 1 - 1 - - - - - - - - - - - - - - - - 1 1 1 Meningococcal Infection 2 - - 1 1 - - — 1 - - - - 1 - - - - - - 2 1 Dysentery 126 4 34 24 9 22 24 9 8 3 4 8 1 7 28 14 27 7 18 1 6 - Ophthalmia Neonatorum 3 3 - - - - - - - - 1 - - - 1 1 - - - - - - Erysipelas 31 - 1 - - 6 19 5 3 1 2 2 3 2 6 4 2 3 1 2 4 - Pemphigus Neonatorum - - - - - - - - - - - - - - - - - - - - - - Tuberculosis Pulmonary 211 1 4 10 54 97 39 6 11 13 19 15 8 24 19 17 14 20 19 32 149 38 Other Forms 28 — 2 4 11 6 5 — 2 3 1 — 2 1 2 2 2 6 3 4 14 3 Anthrax — — — — — — — — — — — — — — — — — — - - - - Malaria—Believed contracted in this country - - - - - - - - - - - - - - - - - - - - - - Believed contracted abroad - - - - - - - - - - - - - - - - - - - - - - Acute Rheumatism 10 - - 9 1 - - - - 2 2 - - 2 - - 2 - 1 1 9 - Measles 2,985 60 1,519 1,382 15 9 — — 302 138 256 220 274 157 512 292 220 242 141 231 22 1 Whooping Cough 1,026 77 528 405 5 11 — — 55 35 63 81 97 66 138 137 69 95 86 104 6 2 Food Poisoning 19 — 4 2 2 5 5 1 1 1 2 1 — 4 — 4 — — 5 1 6 — Totals 5,017 154 2,171 2,064 140 242 152 94 415 236 364 359 429 312 771 512 363 457 320 479 494 121 *Included in the figures in these columns are cases notified in previous years as well as 1951. 42 The year 1951, on the whole, showed a higher incidence of infectious disease than 1950. The number of cases of measles was 2,985 as compared with 1,468 the previous year. Whooping cough cases numbered 1,026 as compared with 1,121 in the year 1950. (a) Smallpox.—No cases were notified during 1951. Notifications regarding 19 persons who had been in contact with cases of smallpox in other areas or on board ship were received. These were visited by the Sanitary Inspectors, 116 visits being paid. The following gives particulars as to Vaccination during 1951:— Primary vaccination 1,583 Re-Vaccination 771 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.—278 cases occurred in 1951. There were no deaths from this disease. Thirteen cases were admitted to Isolation Hospitals outside the district. (c) Diphtheria.—One case only was notified in 1951. The patient (a boy of 5 years) was admitted to the Ilford Isolation Hospital and made a satisfactory recovery. (d) Ophthalmia Neonatorum.—Three cases occurred during 1951. The following figures show the number of cases of Ophthalmia Neonatorum notified during the oast five years: 1947. 11: 1948. 4: 1949. 1: 1950, 2 ; 1951, 3. It is to be remembered that many cases of ophthalmia neonatorum are not due to gonorrheal infection, and none of the cases in 1951 was venereal. Cases Vision Unimpaired Vision Impaired Total Blindness Deaths Notified Treated At Home In Hospital 3 3 — 3 — — — (e) Enteric Fever.—Six cases only occurred during the year, 3 males (7, 33 and 41 years) and 3 females (6, 17 and 53 years). Four cases were para-typhoid fever "B". All the cases were treated in Hospital and recovered. (/) (i) Acute Poliomyelitis.—One case only was notified during the year—a boy of 15 years. He was admitted to the Ilford Isolation Hospital and made a good recovery without any residual paralysis. One other case (which was not notified) occurred in a male child of two years. The child was admitted to King George Hospital, but died the day following. A post-mortem was performed by order of the Coroner, who certified the cause of death as acute anterior poliomyelitis. (ii) A cute Encephalitis.—One case occurred during the year—a boy of 3 years—following an attack of measles. The child was admitted to the Ilford Isolation Hospital, but died five hours after admission. A postmortem was performed by the Coroner who confirmed the cause of death. (iii) Meningococcal infection.—Two cases occurred during the year— males of 7 and 20 years. One case was admitted to the Ilford Isolation Hospital, but the patient died four days after admission. The other case was admitted to King George Hospital and was discharged after three weeks, having made a satisfactory recovery. (g) Pneumonia—Influenzal and Primary.—This disease was more prevalent during 1951 than in the previous year,- especially of the influenzal type, in the first two months of the year. Persons above the age of 65 years were mostly subject to attack. 43 The incidence of influenzal and primary pneumonia throughout the year is shown by the following table. Month, 1951 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 11 1 19 — 16 5 47 6 February 10 — 11 — 7 1 12 2 March 7 1 12 3 2 — — — April 3 — 3 — — — 2 — May 3 1 5 1 — — — — June 4 — 4 — 1 — — — July 7 — 5 1 1 — 1 — August - - - - - - - - September 1 — 2 - - - - - October 2 1 2 — — — 1 — November 2 — 4 1 1 — 1 — December 7 — 3 — 4 — 2 — Totals 57 4 70 6 32 6 66 8 It will be seen from the above figures that of 127 persons who suffered from acute primary pneumonia there were 10 deaths, equal to 7.8 per cent.; and in the case of acute influenzal pneumonia 98 persons with 14 deaths, equal to 14.2 per cent. (h) Tuberculosis.—During the year 1951 there was 211 new notifications of Pulmonary Tuberculosis and 28 of other forms of Tuberculosis. 16 cases of Pulmonary and 5 cases of Non-Pulmonary Tuberculosis were transferred to Ilford. Notifications and Deaths from Tuberculosis of Ilford residents during 1951:— Age Periods New Cases Deaths Respiratory NonRespiratory Respiratory NonRespiratory M F M F M F M F Under 1 year — 1 - - - - - - 1-5 years 3 1 2 - - - - - 5-15 4 6 1 3 - - - — 15-25 23 31 7 4 - - 1 2 25-35 33 31 3 2 - 2 - - 35—45 27 6 - 1 4 2 - - 45-55 15 9 2 - 4 - - - 55-65 15 - 2 1 11 3 - - Over 65 6 — — — 11 1 — — Totals 126 85 17 11 30 8 1 2 44 Of the foregoing new cases, the following were notified from Institutions in the district:— Respiratory Tuberculosis NonRespiratory Tuberculosis King George Hospital 5 3 Claybury Hospital 2 — Goodmayes Hospital 5 1 Ilford Isolation Hospital 7 — Dr. Barnardo's Village Homes 1 1 Of the 41 deaths which occurred of Ilford residents, notification had previously been made of 40 of the cases. In the remaining case the presence of Tuberculosis was only discovered as a result of post mortem examination. During the year 1951 the following deaths occurred from Tuberculosis:— Pulmonary Non-Pulmonary Ilford Residents 38 3 Non-Residents— Claybury Hospital 10 - Goodmayes Hospital 2 — Ilford Isolation Hospital 19 — King George Hospital 1 1 Non- Pulmonary Pulmonary Total Number of cases on register, 1st January, 1951 1,221 180 1,401 Number of cases entered on register during the year 227 33 260 Number of cases removed from the register during the year:— NonPul. Pul. Recovered 60 20 Deceased 52 3 Left District 73 11 Lost sight of 7 3 Diagnosis not established 5 1 — 197 38 235 Number of cases remaining on register on 31st December, 1951 1,251 175 1,426 Cases of Tuberculosis, on notification, are visited by the Tuberculosis Nurses. Cases of longer standing are visited by the Sanitary Inspectors during the year, a visit being made to each patient every six months; 1,226 persons were visited during the year. The following reports were obtained:— Pulmonary Other Cases Cases Condition good 663 98 Condition fairly good 174 32 Condition poorly 77 3 In sanatoria 97 4 No information as to present condition 35 3 Removed from district, etc. 33 7 1,079 147 45 The treatment of Tuberculosis is now under the control of the Regional Hospital Board. On the 31st December, 1951, there were 1,116 patients on the register of the Ilford Clinic. The number of patients from Ilford sent to Institutions under the Regional Hospital Board Tuberculosis Scheme during 1951 was as follows:— Pulmonary Non-Pulmonary Total Males Females Males Females Adults 72 63 8 6 149 Children 3 9 1 1 14 Tuberculosis Care Association.—This Association has assisted 53 cases with extra nourishment, clothing, and in other ways. (i) Venereal Diseases.—Treatment of these diseases 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, 12.15 to 3.15 p.m. Whitechapel. Whitechapel Clinic, Turner Street, Mile End, London, E.l.:— Sessions Monday to Friday, 10 a.m.Consultation to 7 p.m. Times Saturday, 10 a.m. to 3 p.m. 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. Examination of Officers and Servants. The following medical examinations were carried out during 1951:— Officers Servants New Appointments 109 91 Under Sickness Regulations 8 71 Totals 117 162 46 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 426 factories with mechanical power on the register. There are 226 factories without mechanical power on the register. There are 240 outworkers on the register. 1.—INSPECTION OF FACTORIES AND OTHER PREMISES. Including Inspections made by Sanitary Inspectors. Premises Number of Inspections Written Notices Occupiers prosecuted (1) (2) (3) (4) Factories with Mechanical Power 1,356 17 - Factories without Mechanical Power 270 2 - Other premises (not including Outworkers' premises) 42 — — Total 1,668 19 — 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.1) 11 9* — — Overcrowding (S.2) — — — — Unreasonable Temperature (S.3) - - - — Inadequate Ventilation (S.4) - — — — Ineffective Drainage of Floors (S.6) - - - — Sanitary Conveniences (S.7):— Insufficient 4 3 — — Unsuitable or Defective 7 9* — — Not Separate for Sexes 1 2* — — Other Offences — — — — Total 23 23* — — *Includes compliances of defects found in 1950. 47 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 1951 was 1,677 (864 males and 813 females), of which there were 74 (32 males and 42 females) where the ordinary place of residence of the parents was outside Ilford. In addition, 723 notifications of live births (361 males and 362 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, 2 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 .12 By Certified Midwives 99.64 By Parents and others .24 There were also 41 stillbirths (24 males and 17 females) notified in Ilford including 1 (male) where the home address of the parents was outside the district, and notifications of 22 stillbirths (15 males and 7 females) which took place outside the district, although the ordinary residence of the parents was in Ilford, were transferred to this district. The following table shows the causes of the 62 stillbirths notified where the usual residence of the parents was in Ilford:— Stillbirths, 1951. Cause of stillbirth Delivery by County Council Midwife at home Delivery in Hospital Total Anencephaly 1 3 4 Ante-partum hæmorrhage — 2 2 Atelectasis — 1 1 Congenital heart disease - 2 2 Difficult labour - 5 5 Eclampsia — 1 1 Exomphalos — 1 1 Multiple deformities - 3 3 Premature separation of placenta .. — 2 2 Retroplacental haemorrhage — 1 1 Spina bifida 1 1 Toxaemia 9 9 Uncertain 8 22 30 Totals 10 52 62 48 Care of Premature Infants.—Of the 1,677 live births occurring in Ilford during 1951, 83 weighed 5½ lbs. or less at birth; 22 of these babies were born at home and 61 in Hospital (including 2 where the home address of the parents was outside Ilford). Of the 22 babies born at home there were:— 15 who were nursed entirely at home; 7 who were transferred to hospital; Nil who died during the first 24 hours; 3 who died between the ages of one day and one month (all of whom had been transferred to hospital); 19 who survived at the end of one month. Of the 61 babies born in hospital there were:— 4 who died during the first 24 hours; 4 who died between the ages of one day and one month; 53 who survived at the end of one month (including the 2 where the home address was outside Ilford). In addition 44 notifications were received of births outside the district where the ordinary residence of the parents was in Ilford and the weight of the infant at birth was 5½ lb. or less. Of these there were:— 6 who died within the first 24 hours (all in hospital); 6 who died between the ages of one day and one month (all in hospital); 32 who survived at the end of one month. Infant Mortality.—The number of infants dying within the first year of life was 50, the total number born being 2,376. 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 21-04. The following table gives the deaths of infants under one year of age, classified according to age:— Infant Deaths—1951. 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 Acute Meningococcal Septicaemia - - - - - 1 - - — 1 Asphyxia, Breech delivery 1 - - - 1 - - - — 1 Asphyxia, Occlusion cord, spontaneous delivery 1 - - - 1 - - - - 1 Asphyxia, Placenta Praevia 1 - - - 1 - - - — 1 Atelectasis 5 - - - 5 - - - — 5 Congenital Heart Disease 1 - - - 1 - - - — 1 Hæmolytic Disease 2 - - - 2 - - - — 2 Intracranial Hæmorrhage 8 - - - 8 - - - — 8 Other Congenital Disease 1 1 1 1 4 2 - 1 — 7 Pneumonia 1 - - - 1 3 1 - 2 7 Prematurity 14 - - 1 15 — - - — 15 Suprarenal Hæmorrhage 1 - - - 1 — - - — 1 Totals 36 1 1 2 40 6 1 1 2 50 49 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 1951 50 21.0 1950 45 18.7 1949 53 20.1 1948 62 21.7 1947 82 24.3 1946 102 29.6 1945 81 32.7 1944 102 36.8 1943 92 35.1 1942 74 30.6 The mean average Infant Mortality rate for the past 10 years is therefore 27-0 per 1,000 live births. 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 1951 21.0 30 26 34 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 Neonatal Mortality.—The death-rate of infants under four weeks of age is known as the Neonatal Mortality. There were 40 deaths of infants under four weeks of age during 1951 and the rate for the year was 16-8 per 1,000 live births. The figures for the past 46 years were as follows:— Year Number Rate Year Number Rate 1951 40 16.8 1928 41 23.6 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 1907 54 31.5 1929 48 27.4 1906 57 33.5 D 50 Illegitimate Births and Deaths.—70 of the live births registered (38 males and 32 females) were illegitimate, that is 2.9 per cent. of the births registered. One illegitimate child died under one year of age, from the following cause:— Atelectasis, aged one day. The infant mortality rate of illegitimate children was 14.3 per 1,000 compared with the infant mortality rate of 21.2 for legitimate children. The following table shows the birth and death rates of legitimate and illegitimate infants for the past ten years:— Year. Legitimate Infants Illegitimate Infants 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 1951 2,306 97.1 49 21.2 70 2.9 1 14.3 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 31 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 The Chelmsford Diocesan Moral Welfare Association continued in 1951 to undertake the care of the unmarried mother and her child on behalf of the County Council and there has been direct co-operation through their Moral Welfare Worker for this district. In addition, all cases are followed up by the Health Visitors. Health Visitoes and School Nurses.—The shortage of health visiting staff continued and Clinic Nurses continued to be employed to relieve the Health Visitors of certain duties. The Essex County Council's Training Scheme for Health Visitors, in conjunction with the S.E. Essex Technical College, has continued and certain trainees have again been allocated to Ilford for practical instruction. Two trainees, on completing the Course in 1951 and passing the examination for the Health Visitors' Certificate of the Royal Sanitary Institute, were appointed as Health Visitors and School Nurses here. At the end of the year there were only 8 full-time and 1 part-time qualified Health Visitors and School Nurses in addition to the Superintendent Health Visitor, and 5 Clinic Nurses. The following is a summary of the home visits made by the Health Visitors and Clinic Nurses during 1951 as far as the Maternity and Child Welfare work is concerned. First visits to newly-born infants 2,393 Subsequent visits to children under 1 year of age 2,586 Subsequent visits to children over 1 year of age and under 5 9,842 Visits to expectant mothers 75 Home visits for other reasons 4,728 Total visits paid 19,624 51 Day Nurseries. (a) Goodmayes Lane Day Nursery.—As mentioned in the Preface, the Nursery in Green Lane, Seven Kings, was closed on Friday, the 9th November, 1951, being replaced by the new Nursery in Goodmayes Lane, which was opened to receive children on Wednesday, the 14th of that month. (b) During the year 1951 the charge made to parents for meals for children attending the Nurseries remained at 1s. 6d. per day for each child, but this was increased on the 1st January, 1952, to 2s. per day. (c) The hours of opening at all the Nurseries during 1951 continued to be from 7.30 a.m. to 6 p.m., Monday to Friday only. (d) The training of Students at the Nurseries for the certificate of the National Nursery Examination Board continued. Six Students (two from the Ley Street Nursery, two from the Sunshine House Nursery and two from the Green Lane Nursery) entered for the examination during the year, four of whom obtained the Certificate. D* 52 (e) The following is a table showing the attendances, etc., at the Day Nurseries during 1951. Situation Date of Opening Accommodation (Children) Average Daily Attendance during 1951 No. of Days in Quarantine Reasons for Quarantine with Number of Cases No. on Waiting List at 31st Dec. Chicken Pox Scarlet Fever Whooping Cough Mumps Measles Sunshine House, Girls' Village Homes, Barkingside 17.8.42 45 37 107 5 1 5 1 19 39 359-381, Green Lane, Seven Kings (Closed on 9.11.51) 5.5.43 50 40 122 1 2 20 3 15 - Goodmayes Lane, Goodmayes (Replacing Green Lane) 14.11.51 50 39 42 - - 2 2 - 21 226-236, Ley Street, Ilford 16.8.43 50 38 118 - 2 2 1 14 31 Stevens Road, Dagenham 16.3.50 50 34 94 5 1 - 1 25 1 53 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 31/12/50 2 5 Number registered during 1951 1 2 Number of registrations cancelled during 1951 (Removals from district, etc.) - 4 Number on register at 31/12/51 3 3 Number of children provided for at 31/12/51 83 17 Clinic Premises. (a) Manford Way Clinic.— The temporary Clinic at Nos. 30/32, Elmbridge Road, Hainault, two houses rented from the London County Council, was closed on the 18th July, 1951, the services carried on there being transferred to the new Health Services Clinic in Manford Way, where the first session was held on the 20th of that month. The Clinic serves the Uford, Forest and Dagenham Health Areas and in addition to the maternity and child welfare services (infant welfare, ante-natal and post-natal) provided for at the temporary Clinic there are facilities there for dental, ophthalmic, orthopaedic, diphtheria immunisation and minor ailment work. (b) Fairlop Clinic.— In late November, 1951, the Ilford Committee for Education requested that an endeavour be made to find alternative premises for the Infant Welfare Centre held at Fairlop School on Saturday mornings, as the accommodation used was required for school purposes. It has not been possible to find suitable alternative premises in the Fairlop Area but at the time of writing this Report arrangements have been made to hold an additional session at the Holy Trinity Church Hall, Mossford Green, where our Barkingside Clinic is held, to replace that held at Fairlop School. Mothers from the Fairlop Area who find it more convenient to attend the Manford Way Clinic, however, are being invited to attend there. Infant Welfare Centres.— 100 voluntary lady helpers were engaged in the work at the Infant Welfare Centres at the end of December, 1951. During the year the following attendances were recorded:— Total number of attendances of infants 44,419 First attendances 1,998 Attendances of children from 1 to 5 years 14,812 Total number of children on roll, December 31st, after omission of all those who had not attended for six months 4,887 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 1951 44,419 1,998 4,887 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 4,146 721 sessions were held during the year; the average attendance at each session being 61 mothers with their infants. 54 The following are the figures for each Centre:— Sessions Average Attendance Barkingside 49 69 Chadwell 49 61 Becontree 48 52 Downshall 48 69 Elmbridge (to 18/7/51) 27 36 Manford Way (from 20/7/51) 21 43 Woodford Avenue 48 69 Seven Kings 48 73 Cecil Hall (Wednesday) 48 73 Cecil Hall (Thursday) 47 64 Newbury Hall 48 44 Goodmayes 48 50 Grosvenor Road 48 72 Ilford Lane 48 71 Valentines 48 70 Fairlop 48 42 Orthopaedic Clinic. (i) Newbury Hall Clinic.— 48 sessions were held during 1951, 324 children under 5 years of age being examined, making 683 attendances. (ii) Mayesbrook Clinic.— 26 sessions were held during 1951, 174 children under 5 years of age being examined, making 376 attendances. The 498 children were found by the Orthopaedic Surgeon to be suffering from the following defects:— Diagnosis New Cases Old Cases A B A B Foot Strain - 1 - - Paralysis:— A.P.M. - 1 1 2 Hemiplegia - - 1 - Deformity of hips 1 1 - 2 Genu valgum 70 49 72 37 O.C.T. 17 3 31 13 Genu varum 1 - 5 2 Pes valgo planus 8 3 44 16 Valgus ankles 9 5 18 7 Talipes calc. valgus 2 - - - Congenital talipes E.V. 2 - 1 - Congenital defect - - 1 1 Intoeing 2 4 6 - Deformity of toes 6 2 2 2 Torticollis - - 1 - N.A.D 9 5 3 5 Spastic Diplegia - - 1 - Orthopaedic defect connected with birth injury - 1 1 - Traumatic condition paraplegia - - 1 - Other conditions 3 4 1 8 Scoliosis 1 - 1 - T.B. Arthritis of right knee 1 - - - Pes. calc. valg. 1 - - - Totals 133 79 191 95 A—Newbury Hall. B—Mayesbrook. 15 pairs of Valgus Insoles, 2 pairs surgical shoes, 5 Metatarsal bars and toe springs and 15 G.V. night splints were supplied during 1951. At the Newbury Hall Clinic, 23 children under five years of age were treated by the Physiotherapist during the year, and 229 attendances were made by these children. Treatment was also given to 24 "children who made 198 attendances at the Mayesbrook Clinic. 55 Paediatric Clinic.—The Consultant Paediatrician continued to attend the Clinic at Valentines Mansion during the year. 23 sessions were held and 77 new cases were examined, having been referred from the Infant Welfare Centres and Maternity Hospital for the reasons set out in the following table; a total of 146 attendances were made. Diagnosis Discharged Improved Discharged with Advice or for other reasons. Discharged no Treatment Discharged Cured Referred to Hospital, Dr. or Clinic Still attending Total Advanced skull ossification - 1 — - - 1 Air swallowing 1 1 — - — - 2 Angioma - - - - - 1 1 Behaviour problem — 4 — - 1 - 5 Brachycephaly — — — - 1 - 1 Congenital defects — — — - 1 - 1 Congenital facial palsy — 1 — - — - 1 Congenital haemolytic disease* - 1 - - 1 - 2 Congenital heart disease — — — - 2 2 4 Congenital laryngeal stridor* - - 1 - - - 1 Constipation 1 - - - - 1 Convulsions — — — 1 — - 1 Defects of Micturition — 4 — - 1 - 5 Depressed sternum — — — - — 1 1 Feeding problem 1 2 — - — 1 4 Fissure in ano — — — - — 1 1 Hernia — 2 — - 2 - 4 Hydrocele. — — — - 1 - 1 Malrotation and neonatal intestinal obstruction - - - - - 1 1 Mentally retarded — 1 — - — - 1 Microcephaly — — 1 - 1 - 2 Mongol - - - - - 3 3 Normal child—N.A.D. — 3 11 - — — 14 Otitis Media — - — - 1 — 1 Petit Mal — — — - 1 — 1 Physiological jaundice — — 1 - — — 1 Post pertussis cough — — 1 - — — 1 Scoliosis — — — - 1 — 1 Sensitivity to cows' milk — 1 — - — — 1 Speech defect — — — - 2 — 2 Talipes — — — - 1 — 1 Thrush — 1 — - — — 1 Tooth grinder — 1 — - — — 1 Tubercular cervical abscess and adenitis - - - - 1 - 1 Tuberculosis contact - 1 - - 1 — 2 Undernourished — 2 — - — — 2 Upper respiratory infection — 4 — - — — 4 3 30 15 1 19 10 78 * One case referred for two reasons. Ophthalmic Clinic.—166 children under 5 years of age were treated by the Oculist during 1951. 68 pairs of spectacles were supplied. Aural Clinic.—The Aural Surgeon attended at 81 sessions during 1951 and 123 attendances were made by 86 children of pre-school age. 8 children were operated upon for removal of tonsils and adenoids, 3 at Ilford Isolation Hospital, 3 at St. Marys Hospital, Plaistow and 2 at Rush Green Hospital. 56 Rheumatism Clinic.—26 sessions were held during the year at Newbury Hall, at which 28 children under 5 years of age, 15 being new cases, made 45 attendances. The following is a summary of the cases treated:— Condition New Old Total Tachycardia — 3 3 Congenital heart disease 2 4 6 No active rheumatic disease 3 1 4 Functional heart murmur 4 4 8 Pains—other than rheumatic 3 — 3 Other forms 3 1 4 Totals 15 13 28 Number of cases referred to Ear, Nose and Throat Surgeon 3 „ „ „ „ for Blood Sedimentation Rate 1 „ „ ,, „ ,, X-ray and Electrocardiograph 34 Artificial Sunlight Clinic.—49 sessions were held at the Newbury Hall Clinic and 48 at Mayesbrook Clinic. 97 children in all were treated, making 1,672 attendances. The conditions treated were as follows:— Conditions Cases A B Anaemia, Debility and Malnutrition 27 13 Genu valgum 1 2 Old Rickets 2 2 O.C.T. (Bow legs) 6 1 Bronchitis 2 7 Chilblains - 1 Other conditions 18 15 Totals 56 41 A—Newbury Hall. B—Mayesbrook. 38 cases were still attending at the end of the year ; of the remainder 1 had removed from the district, 9 were discharged having made a satisfactory recovery and 8 were discharged due to absence. Speech Clinic.—3 children of pre-school age attended, making 41 attendances. The following is the classification of the defects found by the speech therapist:— Dyslalia 2. Cleft Palate 1. Two of the children were discharged with normal speech. is Diphtheria Immunisation.— Tabular Statement as to Number of Children Schick Tested and Immunised at the Diphtheria Clinics from 1st January, 1951, to 31st December, 1951. Valentines Clinic Mayesbrook Clinic (a) Elmbridge Clinic (b) Manford Way 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 5 — 5 10 — 10 - — — 15 Negative 4 — 4 7 — 7 — — — 11 Numbers inoculated (full course) 48 335 383 27 299 326 2 83 85 794 Positive after full course of inoculations and re-inoculated 6 4 10 7 5 12 1 1 23 Negative after full course of inoculations... 33 295 328 15 285 300 2 81 83 711 Re-inoculations (one only) 821 74 895 473 66 539 35 4 39 1,473 Awaiting re-test 2 30 32 3 2 5 — 1 1 38 Not re-tested after inoculation (on account of leaving District, etc.) 6 3 9 2 5 7 - - - 16 Positive after re-test but not inoculated for same reason 1 3 4 2 2 - - - 6 Final Schick Test in 1951 (1950 Cases) :— Positive after full course of inoculations, and re-inoculated - - - - - - - - - - Negative — 84 84 — 67 67 - - - 151 During 1951, a total number of 2,429 children attended at the Diphtheria Prevention Clinics, (1,366 at Valentines Clinic, 939 at Mayesbrook and 124 at Elmbridge and Manford Way), making a total number of attendances of 8,309 (4,671, 3,041 and 597), with an average per session of 60, 59 and 12 respectively. (a) To 18th July, 1951. (b) From 20th July, 1951. During 1951, 62 private doctors were supplied with prophylactic for the immunisation of 1,548 children and record cards were received from general practitioners as follows:— Under 5 Over 5 Inoculations (full course) 969 38 Re-inoculations (one only) — 541 58 Vaccination.— During 1951 record cards were received from general practitioners and various hospitals as follows:— Ages up to 14— No. of children primarily vaccinated 1,324 No. of children revaccinated 116 Ages 15 and over— No. of adults primarily vaccinated 259 No. of adults revaccinated 655 Treatment of Minor Ailments.—Children suffering from simple dietetic ailments are treated at the Infant Welfare Centres. A certain number of infants were, however, brought to the Clinics at Newbury Hall and Mayesbrook Clinic to receive treatment for minor ailments. Cardiac Clinic.—During 1951, 11 sessions were held. 42 expectant and nursing mothers were referred from either the ante-natal or post-natal clinics, making a total of 79 attendances. The following is a summary of the cases examined by Dr. K. Playfair Condition PostNatal AnteNatal Anythuria of respiratory type — 1 Congenital Cardiac lesion — 3 Extrasystoles — 1 Extrasystoles and dyspepsia 1 — Functional Cardiac disorder 2 14 No lesion — 9 Rheumatoid Arthritis 1 — Still being investigated — 2 Valvular disease of the heart — 8 Totals 4 38 23 of these patients were referred to Queen Mary's Hospital for X-Ray and electrocardiograph. Midwives.—There were 14 State certified midwives (including the Superintendent, Deputy Superintendent, 9 domiciliary midwives and 2 parttime midwives), resident and practising in the district at the end of the year. In addition there were 19 State certified midwives at the Ilford Maternity Hospital. The Wilnett Lodge Post-Natal Home had closed on the 31st October, 1951. 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 midwives practising at the Ilford Maternity Hospital and at the Wilnett Lodge Hostel until its closure. 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 9 Domiciliary Midwives employed by the County Council whole-time and 2 part-time, in addition to the Superintendent and Deputy Superintendent. During the year 593 cases were attended. In 541 cases the midwives were engaged to attend as midwives and in 52 as maternity nurses. The patients resided in the following wards:— Barkingside 33; North Hainault 59; Cranbrook 45; Park 51; Seven Kings 58; South Hainault 55; Loxford 38; Clementswood 50; Goodmayes 14; Fairlop 76; Clayhall 63; Mayfield 51. 59 A Doctor was called in to 120 of the 541 cases in which a midwife had been engaged. Of the infants born there were 10 stillbirths. In one of these cases the midwife was engaged as a maternity nurse only. There were 5 deaths of infants during the first year of life where the birth had been attended by a Domiciliary Midwife, 3 of these occurring during the first two weeks of life. Notices were received from the Domiciliary Midwives stating that artificial feeding had been substituted in respect of 31 infants attended by them during 1951. During 1951 Ante-Natal Clinics conducted by the Domiciliary Midwives were set up, sessions being held weekly or fortnightly, as required, commencing in May at the Valentines and Mayesbrook Clinics and in August at the Manford Wav Clinic. The following is a summary of the attendances at these Clinics during the year:— Valentines Clinic Mayesbrook Clinic Manford Way Clinic First attendances 226 94 32 Subsequent attendances 594 196 98 Totals 820 290 130 Number of sessions 31 19 10 Average attendance at each session 26 15 13 In addition, 2,942 home ante-natal visits were made during the year. Salvation Army Midwifery Service.—52 cases were attended by the Salvation Army Midwife during the year, 49 as a midwife and 3 as a maternity nurse. A Doctor was called in to 22 of the 52 cases in which a midwife had been engaged. Of the infants born there were no stillbirths. One infant, where the birth had been attended by a Salvation Army Midwife, died at the age of 7 weeks. Notifications were received from the Salvation Army Midwives that it was proposed to substitute artificial feeding in respect of 7 infants. Gas and Air Analgesia.—During 1951 gas and air analgesia was administered in 428 cases, of which 391 were attended by the Domiciliary Midwives (370 when acting as midwives and 21 when acting as maternity nurses) and 37 were attended by the Salvation Army midwives (36 whilst acting as midwives and 1 when acting as a maternity nurse). All the domiciliary midwives employed at the end of the year were qualified to administer gas and air analgesia and the 1 Salvation Army midwife was also so qualified. Four sets of apparatus for the purpose of the administration of gas and air analgesia 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. 60 Ante-Natal Clinics.— After consultation with the Consulting Obstretrician, arrangements were made as from 13th August, 1951, for certain of the routine re-examinations of patients at the Ante-Natal Clinic held at the Ilford Maternity Hospital to be conducted by the Clinic midwives. Three Midwives' Clinics are held each week, running concurrently with a Doctor's Clinic, this arrangement ensuring that a Doctor is available for consultation by the Midwives if required. The following is a summary of the attendances at the Ante-Natal Clinics during 1951:— Maternity Hospital Mayesbrook Clinic (a) Elmbridge Clinic (b) Manford Way Clinic Doctors Midwives First attendances 1,101 — 314 159 Subsequent attendances 8,642 862 2,515 1,027 Totals 9,743 862 2,829 1,186 Number of sessions 340 72 130 53 Average attendance at each session 28 12 21 22 (a) To 18th July, 1951. (b) From 20th July, 1951. All patients booked for 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. Post-Natal Clinics.—All patients confined in the Ilford Maternity Hospital and other patients on request are invited to attend the Post-Natal Clinics for the first time approximately six weeks after confinement. During 1951 clinics were held at the Maternity Hospital weekly, at Mayesbrook Clinic fortnightly, and at Elmbridge Clinic, and after closure, at Manford Way Clinic, monthly. The following attendances were recorded:- Maternity Hospital Mayesbrook Clinic Elmbridge Clinic Manford Way Clinic First attendances 860 200 86 Subsequent attendances 654 138 17 Totals 1,514 338 103 Number of sessions 53 25 12 Average attendance at each session 28 13 8 Consultant Clinic.—The Consulting Obstetrician, or his Deputy, continued to hold a Clinic twice weekly for ante-natal and post-natal cases During the year 102 sessions were held and a total of 731 examinations were made. Maternal Mortality.—During 1951 there were no deaths of Ilford mothers recorded by the Registrar-General as due to or in consequence of pregnancy or childbirth. Domestic Help Service.—During 1951 there was a still further increase in the demand for this service, and at the end of the year there were 29 fulltime and 108 part-time Helps employed. 61 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 1951:— Number of applications received for assistance 1,387 Number of cases where Domestic Helps were provided (including 336 who were having service at the commencement of the year) 1,291 Number of cases which on investigation were either not eligible for assistance or did not require the service 173 Number of cases referred to other sources, e.g., W.V.S., I.S.S.C. 16 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) 77 Other cases awaiting help at end of year 20 Enquiries incomplete at end of year 13 Cases being served at 31st December, 1951 337 Convalescent Facilities.—The following tables show the number of persons sent away for convalescence during 1951, 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 2 3 4 5 6 7 8 Children's Convalescent Home, Beaconsfield. 1 - - - - - Arranged by Westminster Hospital. Mrs. Eades Home, Bognor Regis. — — 1 — — — — Arranged by I.C.A.A. Fairby Grange, Dartford. 1 - - - - - - Mother with infant. Harts Leap, Sandhurst, Surrey. - - - 2 - - 2 3 arranged by Great Ormond Street Hospital, 1 arranged by Wanstead Hospital. Manor House, Burgh Castle, Gt. Yarmouth. - - - - - 1 — Arranged by I.C.A.A. Zachary Merton Home, Grayshott. 1 - - - - - - Arranged through Jewish Board of Guardians. Milton Lodge, Bognor Regis. - - 2 - - - - Arranged by I.C.A.A. and one by Gt. Ormond St. Hospital. St. Gabriels, Bournemouth. - - - - 1 1 Arranged by I.C.A.A. St. Mary's, Broadstairs - - 1 - - - - Arranged by I.C.A.A. Westcott House, Bexhill. - - - — 1 — - Arranged by Gt. Ormond Street Hospital. Totals 3 — 4 2 2 2 2 One mother with infant, 14 unaccompanied children. 62 (b) Under Section 28 of the Act, i.e. other persons requiring a change of air and surroundings to aid recovery and rehabilitation. Name of Home No. of weeks' stay Total Cases 1 2 3 4 Armitage House, Worthing 1 1 — — 2 "Bannow," St. Leonard's-on-Sea — 1 — 1 2 Bell Memorial Home, Lancing — 4 12 — 16 Eastwood Lodge, Eastwood — 2 — — 2 Essex Convalescent Home, Clacton 1 3 10 1 15 Mrs. Hardy's Home, Four Marks — — 2 — 2 Hearts of Oak Home, Broadstairs — 1 — — 1 Hunstanton Convalescent Home — 2 1 — 3 Samuel Lewis Home, Walton-on-Naze — — 12 — 12 Limpsfield Convalescent Home 1 - - - 1 Rustington Convalescent Home, Littlehampton — — 8 — 8 St. Michael's Convalescent Home, Clacton — — — 1 1 "Templecombe," St. Leonards-on-Sea — — 3 — 3 Victoria Convalescent Home, Bognor — — 1 — 1 Totals 3 14 49 3 69 Loan of Sickroom Equipment.—It has been found in 1951 that this loan scheme has become more widely known and applications for articles have increased considerably. The issues from the Public Health Offices are shown below:— Articles Loaned Number of Articles Articles in store at 31.12.51 on loan at 31.12.50 loaned or reloaned in 1951 on loan at 31.12.51. Mattresses (Dunlopillo) 6 - 6 - Mattress (Hair) 1 — 1 — Invalid Chairs 5 25 16 2 Air Pillows — 4 1 1 Air Rings 1 23 8 5 Back Rests 4 12 7 2 Hospital Bed 1 — 1 — Iron Bed 1 — 1 — Commode Chairs 1 6 3 1 Crutches (Pair) 1 — 1 — Fracture Boards (Set) 1 — 1 — Pillow (Feather) 1 — 1 — Pillow (Flock) 1 — 1 — Rubber Sheeting 2 44 17 6 Medical Sandbags 1 — 1 — Spinal Carriages — 2 1 -* Air Beds — 4 1 1 Pillow (Down) — 1 1 — Bed Cradles — 2 2 — Bed Pans — 26 8 1 Diabetic Scales — 2 2 — Feeding Cups — 2 2 — Urinals — 9 3 5 Sputum Mugs — — — 4 Douche Cans — — — 2 Totals 27 162 86 30 * Returned to Central Store at Chelmsford. 63 Tuberculosis Visitors.—Three Tuberculosis Visitors were employed in the Area during 1951 making a total of 3,346 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 31.12.50 2 „ ,, „ newly assisted in 1951 1 „ ,, „ for whom responsibility ceased 3 ,, ,, ,, being assisted at 31.12.51 Nil Open-Air Shelters for Tuberculosis Cases.—One open-air shelter was supplied for a tuberculosis patient during 1951 and at the end of the year two such shelters were in use in Ilford. Provision of Free Milk to Tuberculosis Patients.—In December, 1951, arrangements were put in hand for supplying one pint of milk daily, free of charge, to tuberculosis patients, on the recommendation of the Chest Physician. Hitherto the service had been rendered only by the Ilford Tuberculosis Care Association. At the end of the year two patients were receiving free milk under the County Council's Scheme. Boarding-out of Children (Tuberculosis Contacts).—No applications were received in 1951 for assistance in the boarding-out of child contacts of tuberculosis patients under the County Council's scheme. Ilford Tuberculosis Care Association.—Mr. H. R. Stanbridge, a member of the Ilford Health Area Office Staff, continued to undertake the secretarial work of this Association during 1951. The following shows the assistance given by the Association during the year :— No. of Persons Total No. of Assisted Grants made Extra nourishment (grants made usually for periods of one month and renewed as required) 53 359 (including renewals) Travelling Expenses of Relatives Visiting Hospital Patients.— The County Medical Officer was able to give financial assistance in 1951 only in very special cases to enable them to visit relatives who were in hospital and no Ilford persons were assisted under this scheme. Home Nursing.—The Home Nursing Service in Ilford is undertaken by Nurses under the supervision of the Superintendent of the Beachcroft Training Home at Leytonstone. The work undertaken by Home Nurses operating in the Ilford area in 1951 was as follows :— Cases attended 2,036 Visits paid 57,836 Health Education.—At the Public Health Office and the Mayesbrook and Newbury Hall Clinics, posters covering various aspects of Health were displayed throughout the year. In December, 1951, a lecture, with film show, on Food Poisoning was given at the Barkingside Infant Welfare Clinic during one of the normal Child Welfare sessions. 64 Dental Treatment.—Mr. E. V. Haigh, the Senior Dental Officer, has submitted the following report:— "Owing to the continued shortage of Dental Surgeons in the Ilford Health Area, maternity cases and children under the age of five have received dental treatment only at Mayesbrook Clinic. On the average, two sessions were devoted weekly, when full dental treatment was given to expectant and nursing mothers and to children under the age of five. These patients were referred from the ante-natal, post-natal and child welfare clinics. Most extractions were performed under general anaesthesia, using nitrous oxide and oxygen, and always given by a doctor. Conservative treatment, such as fillings, scaling and gum treatment, was carried out on all patients who required such treatment. Dental X-ray facilities are available at Mayesbrook Clinic, and were used when required, often saving the patient pain and inconvenience by a much quicker diagnosis. Dentures were provided for expectant and nursing mothers when required. These have been made at a local dental laboratory under an arrangement that has been in operation many years. The work has been very satisfactory." The number of cases treated at the clinic during 1951 is as follows:— Examined Needing Treatment Treated Made Dentally Fit Expectant and nursing mothers 221 221 223 125 Children under 5 222 221 233 234 The forms of dental treatment provided were:— Extractions Anæsthetics Fillings Scaling or Scaling and Gum treatment Silver Nitrate treatment Dressings Radiographs Dentures provided Local General Complete Partial Expectant and nursing mothers 727 57 150 304 105 2 186 5 48 39 Children under 5 609 2 185 100 3 — 149 2 — — Total number of sessions held—132. 65 SCHOOL HEALTH SERVICE Nutrition. The summary of heights and weights over 10 years which is printed at the end of this Report in Tables VII A. and B. shows no appreciable change. Incidence of Pediculosis and Scabies. (i) Pediculosis.—7 children were found to be infected with living hair vermin as against 5 in 1950, 33 in 1949, 56 in 1948 and 49 in 1947. (ii) Scabies.—There was one case reported during the year, as compared with none in 1950, 5 in 1949, 19 in 1948, and 43 in 1947. School Premises.—There are 32 schools, with 61 departments, 22,543 children were actually on the rolls on 21st December, 1951, as compared with 21,497 in December, 1950. The figure 22,543 includes Barking Abbey (379) and Ursuline County Placed pupils (240). The number of children in average attendance at school for the year ended 18th December, 1951 = 17,677. 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. 749 visits have been 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 :— (а) 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 1951 4,533 parents, or 77 per cent., attended the full routine medical inspections. Infectious Disease.—The following table shows the incidence of infectious diseases in the Ilford schools since 1947:— Scarlet Fever. Diphtheria. Measles and German Measles Chicken Pox. Mumps. Whooping Cough. 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 1951 202 1 *1,316 320 28 389 Of this number 1,305 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 1951. 319 home visits were paid by the School Nurses to cases of minor infectious disease. In addition the Sanitary Inspectors paid 1,267 visits to measles cases, and 321 visits to whooping-cough cases. E 66 RINGWORM:- No. of cases at beginning of 1951. No. of cases reported during 1951. Total. Remedied "during 1951. No. of cases under observation at end of 1951. Scalp - 1 1 1 — Body — 6 6 6 — - 7 7 7 Following Up.—During 1951, 2,908 home visits by the School Nurses were paid for the purpose, and 3,369 re-examinations of children (some on several occasions) were carried out by the doctors at school ; 169 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 1951, were as follows:— Newbury Hall. Mayesbrook. Number of individual children seen 1,539 1,778 Number of attendances of children 3,286 3,017 Number of exclusion certificates granted 59 114 Number of certificates of fitness to attend school granted 56 122 The following table shows the conditions dealt with at both the Clinics during the year:— Subnormal Nutrition 822 Debility 57 Uncleanliness:— Head 97 Body 1 Skin:— Ringworm:— Head — Body 6 Scabies 1 Impetigo 13 Dermatitis 9 Urticaria 13 Furunculosis 33 Eczema 11 Other Skin Diseases (Non-Tuberculous) 256 Eye:— Blepharitis 36 Conjunctivitis 29 Defective Vision (excluding Squint) 148 Squint 20 Other conditions 76 Ear:— Defective Hearing 29 Otitis Media 25 Other Ear Diseases 32 67 Nose and Throat:— Chronic Tonsillitis only 97 Adenoids only 12 Chronic Tonsillitis and Adenoids 20 Nasal Catarrh 23 Nasal Obstruction 8 Other conditions 22 Enlarged Cervical Glands (Non-Tuberculous) 46 Defective Speech 16 Teeth—Dental Diseases 1,080 Heart and Circulation:— Functional 11 Organic 1 Anaemia 25 Infectious Diseases:— German Measles 1 Measles 1 Whooping Cough 1 Chicken Pox 7 Mumps 1 Colds and Coughs 249 Influenza 4 Lungs:— Asthma 21 Bronchitis 42 Pulmonary Catarrh 13 Other Non-Tubercular Diseases 7 Tuberculosis:— Pulmonary—Definite ... — —Suspected (Referred to Chest Physician) 21 Developmental:— Hernia 3 Other 2 Psychological:— Development 1 Stability 13 Nervous System:— Nervous Debility 12 Habit Spasm 3 Chorea — Petit Mal 3 Enuresis 26 Other Conditions 20 Deformities:— Genu Valgum 14 Posture 12 Pigeon Chest 1 Flat Feet 46 Valgus Ankles 31 Other forms 59 Minor Injuries 98 Rheumatism 27 Other Defects and Diseases 157 Total number of ailments 3,971 E* 68 SPECIAL CLINICS. Ophthalmic Clinic. During the year 1951, the School Oculist held 193 sessions for the refraction of children suffering from defective vision (99 at Valentines and 94 at Mayesbrook). Full details of the work are given in Table IV, Group II. 3,375 attendances (1,725 at Valentines Clinic, 1,650 at Mayesbrook Clinic) were made by 1,455 schoolchildren (720 at Valentines Clinic, 735 at Mayesbrook Clinic), as compared with 1,504 schoolchildren in 1950. The 1,455 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 6/60 281 226 271 218 156 179 74 50 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 1,455 children were found to be suffering from the following defects Diagnosis. New Cases. Old Cases. A B A B Myopia 66 76 148 127 Myopic Astigmatism — 10 3 10 Hypermetropia 59 53 134 151 Hypermetropic 1 3 9 7 Astigmatism 2 — 6 17 Anisometropia — — 3 — Hypermetropia with Squint - 2 2 2 Squint 29 35 142 139 Blepharitis 7 5 8 13 Chalazion — — — — Congenital Coloboma — — — 3 Corneal nebulae — — 1 — Conjunctivitis 3 7 6 4 Nystagmus 2 — 5 6 Other conditions 4 2 5 3 N.A.D. 46 29 29 31 Totals 219 222 501 513 A—Valentines. B—Mayesbrook. 865 complete pairs of spectacles were provided, some of these being renewals after breakages. In addition, in 333 cases the lenses of spectacles were replaced or repairs of frames were carried out. T. J. Regal (Mrs.), M.D., D.O.M.S., the Ophthalmic Surgeon, makes the following report:— "The majority of children had defective sight due to refractive errors and of these a fair proportion had also a squint. All these cases are seen at regular intervals and are kept under observation all during their school life. In addition to these the following conditions came under observation and received treatment at the clinics or were referred to hospitals:— Congenital abnormalities of the eyes and adnexae. Acute inflammatory, infective, allergic and traumatic affections of the eyes. 69 Orthoptic treatment. The conditions for orthoptic treatment are unfortunately most distressing. So far negotiations for the establishment of an orthoptic department going on for a long time have not led to the desired result and the position is desperate. In the most urgent cases London Hospitals and Oldchurch Hospital in Romford came to our rescue, but these hospitals are overworked and cannot take on any more cases. There are now more than 275 children awaiting treatment and cannot get it for lack of facilities. Constant enquiries of indignant parents add to our sense of frustration and we can only hope that the long overdue establishment of an orthoptic department will soon materialise." Orthopaedic Clinic. Mr. H. G. Korvin, F.R.C.S., the Orthopaedic Surgeon, makes the following report:— "During the year 1951 further measures were taken to reduce the excessively high number of attendances at the Orthopaedic Clinics at Newbury Hall and Mayesbrook. In uncomplicated cases of knock-knees, valgus ankles, posturai defect, etc., of only moderate severity, treatment was prescribed at the clinic and the child referred back to the School Clinic or Child Welfare Centre for further supervision by the Assistant School Medical Officer. At a preliminary meeting between the Orthopaedic Surgeon and the Assistant School Medical Officers the general lines of treatment in such cases had been discussed. The effect of this measure is only just beginning to make itself felt. Efforts have been made to reduce the time parents have to wait with their children at the clinics before being seen. In making the appointments patients expected to require more extensive examination were allotted ten or fifteen minutes instead of the usual two-and-a-half. In spite of this measure it was not always possible to eliminate delays. Operative cases were generally dealt with at the East Ham Memorial Hospital, but were kept there as in-patients for the shortest possible time. Parents co-operated willingly in achieving this. Post-operative physiotherapy was carried out at the Ilford clinics, but all plaster work in these cases, as in those requiring plaster splints only, had to be done at the hospital owing to lack of facilities at the clinics. Provision of simple equipment for this purpose would save time and often also provision of transport. As in previous years X-ray examinations for the clinics were carried out at King George Hospital. It was greatly appreciated that in spite of the well-known shortages, all requests were satisfied without undue delay. The provision of a simple X-ray viewing-box at each clinic facilitated the examination and reading of the films and so helped to eliminate possible sources of error. The use of a small stock of reconditioned splints has been found useful in that it allowed such splints to be supplied immediately when required. The fitting of appliances is still not uniformly satisfactory. It is thought that better results might be obtained if each appliance could be ordered from makers especially competent in the manufacture of the particular type. This report would be incomplete without mentioning the helpful co-operation and quiet efficiency of all concerned in the running of these clinics." (i) Newbury Hall Clinic.—48 sessions were held during 1951, 230 children of school age were examined for the first time during the year and 479 children were seen who had previously attended the clinic. These 709 children made 1,268 attendances. (ii) Mayesbrook Clinic.—26 sessions were held during 1951, 98 children of school age were examined for the first time during the year and 257 children were seen who had previously attended the clinic. These 355 children made 645 attendances. 70 The 1,064 children were found by the Orthopaedic Surgeon to be suffering from the following defects:— Diagnosis. New Cases. Old Cases. A B A B Paralyses:— A.P.M. 2 1 9 10 Hemiplegia — 2 4 3 Paraplegia — — 2 1 Monoplegia — — 1 — Spastic diplegia — — 4 — Scoliosis 1 1 5 2 Kyphosis 1 2 4 — Slack posture 8 4 31 11 Deformity of hips 3 — 3 1 Depressed sternum 1 1 — — Genu valgum 49 31 157 90 O.C.T. 4 1 15 12 Genu varum 10 2 7 3 Pes valgus-planus 33 10 115 58 Valgus ankles 21 5 61 37 Talipes calcaneo-valgus — — 6 2 Congenital talipes E.V. — — 4 2 Congenital defect 2 — 7 1 Intoeing 4 1 1 5 Pes cavus — — 3 3 Hallux valgus 11 3 5 4 Deformity of toes 22 7 19 7 Traumatic condition 1 — — — Rickets - — 1 — Torticollis 2 — 2 2 N.A.D 15 9 4 3 Other conditions 39 18 8 — Ortho: defect connected birth injury - - 1 - Exostosis 1 — — — Totals 230 98 479 257 A—Newbury Hall. B—Mayesbrook. 24 children of school age were admitted to Hospitals. Particulars as follows:— No. of cases Hospital Defects 1 London Hospital 1 Scoliosis. 23 East Ham Memorial 1 Supernumerary toes. 2 Claw toes. 1 Discoid cartilage right knee 2 Subluxation of hip. 2 Club foot. 1 Genu valgum. 1 Genu varum. 3 Exostosis. 1 Tight tendon Achilles. 7 Contracture of toes. 1 Osteomyelitis elbow. 1 Deformity of foot. 71 During the year 51 pairs of valgus insoles, 13 pairs of surgical boots or shoes, 14 pairs Genu Valgum splints, 5 toe springs for drop foot, 3 metatassal bars, 2 calipers and inverting irons were supplied to school-children. 565 cases were discharged from the Orthopaedic Clinic, 204 as cured, 267 discontinued attendance and were kept under observation at school, 56 were showing improvement and were kept under observation at school, 37 cases left school or left the district and 1 died. The Physiotherapist attends the Newbury Hall Clinic for orthopaedic treatment on Monday and Thursday mornings, and the Mayesbrook Clinic on Tuesday and Friday mornings. A total number of 191 sessions were held by the Physiotherapist for treatment during 1951 (95 at Newbury Hall Clinic and 96 at Mayesbrook Clinic). At Newbury Hall Clinic 221 individual children of school age were treated by the Physiotherapist during the year and 1,748 attendances were made by these children. Treatment was also given to 115 children, who made 1,040 attendances at the Mayesbrook Clinic. Artificial Sunlight Clinic.—The Physiotherapist attends the Newbury Hall Clinic on Tuesday afternoon and the Mayesbrook Clinic on Thursday afternoon for artificial sunlight treatment, 48 sessions were held at Newbury Hall Clinic and 49 at Mayesbrook Clinic. At the Newbury Hall Clinic 82 children of school age were treated, making 1,031 attendances for treatment. At the Mayesbrook Clinic 75 children of school age were treated, making 893 attendances for treatment. 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 23 27 Pulmonary Fibrosis 1 — Bronchitis 16 16 Bowlegs — — Alopecia 2 1 Asthma 1 2 Knock Knees - - Old Rickets - - Chilblains - 1 Flat feet - - Psoriasis 2 - Posture - - Acne 3 1 Adenitis 3 - Other Conditions 31 27 82 75 A—Newbury Hall Clinic. B—Mayesbrook Clinic. Of the 82 cases treated at the Newbury Hall Clinic, 5 were Open Air school-children. At Newbury Hall Clinic, 43 children of school age were discharged from the Artificial Sunlight Clinic, 21 as cured, 4 showing considerable improvement, 16 due to absence and 2 removed district. 39 children were still receiving treatment at the end of the year. 72 At Mayesbrook Clinic, 50 children of school age were discharged from the Artificial Sunlight Clinic, 30 as cured, 18 discharged due to absence and 2 removed district. 25 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 31 weeks and one session weekly for 19 weeks. 81 sessions were held during 1951 and 1,310 attendances were made by 667 children of school age, of whom 324 were new cases. The Consulting Ear, Nose & Throat Specialist (Mr. Wm. Ibbotson, F.R.C.S.), submits the following report:— "During 1951 I have made many swab examinations of children's tonsils to discover whether there be any haemolytic streptococcal infection, and a fair percentage has proved positive. I should like to add that so far I have been unable to decide by macroscopical examination whether tonsils are infected or not by this coccus. "All the cases proving positive have been operated on by me in Ilford Isolation Hospital within a few days of receiving the Bacteriologist's Report. "There still remains much difference of opinion as to what constitutes an infected tonsil, and I would suggest that wherever this difference exists, recourse should be had to a swab examination. "Once again I have received much encouragement by the great improvement in hearing and general health of the children who have undergone Conservative Mastoid Drainage for the cure of Chronic Tympanico-Mastoid Disease." The following table shows the work of the Clinic:— 73 AURAL CLINIC Nature of Disease. Still under treatment. 1 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 - - - - - - - - - - - - - - - - - - (ii) Acute Catarrhal Otitis Media — — 1 — 1 — — — — — — — — — - — 2 — (iii) Chronic Suppurative Otitis Media due to:— 1. Tympanic Sepsis 3 5 5 3 1 4 — — — — 1 — — — 1 3 11 15 2. „ ,, and Granulations - 2 - - - - - - - - - - - - - - - 2 3. Other Causes — 1 - - - - - - - - - - - - - - - 1 (iv) Mastoid Disease 1 2 - 1 - 3 - - - - - - - - - - 1 6 (v) Partial Deafness due to:— 1. Nerve Deafness 1 - - - - 1 - - - - - - - - - - 1 1 2. Tonsils and Adenoids 1 — 2 - - 1 - - - - - - - - - - 3 1 3. Retraction of Membrana Tympani 1 1 - - 1 3 — 1 - - — - — - 1 — 3 5 4. Scarring of Membrana Tympani - - - - - - - - - - - - - - - - - - 5. Other causes — 2 - - 1 3 - - — — — — — — 1 1 2 6 (vi) Opinion on Tonsils 24 46 191 56 27 93 - 1 1 3 4 1 - 1 7 11 254 212 (vii) Rhinitis 3 9 1 - - 4 - - - - 1 - - - 6 3 11 16 (viii) Other diseases or defects. 10 14 17 15 5 31 - 1 - 2 - - 1 4 3 11 36 78 Totals 44 82 217 75 36 143 — 3 1 5 6 1 1 5 19 29 324 343 74 Rheumatism Clinic. The Physician attended 26 morning sessions during the year, and 157 children (76 of these being new cases) made 290 attendances. The 157 children were found to be suffering from the following conditions:— Defects Found New Cases Old Cases Totals History of Rheumatism (observation) - 1 1 Rheumatic Carditis 1 4 5 Other Forms of Carditis 5 5 10 Tachycardia of Nervous origin 2 1 3 Congenital Heart Disease 3 13 16 Rheumatism 3 6 9 Habit Spasm - 1 1 No active Rheumatic disease 19 19 38 Heart Murmur functional 20 21 41 Pains due to Orthopaedic condition 8 3 11 Allergic Type — 1 1 Other Conditions 15 6 21 Totals 76 81 157 Number of cases referred to Convalescent Home 1 ,, ,, ,, General Hospital (In-patients) 4 ,, Isolation Hospital 1 ,, ,, „ Ear, Nose and Throat Surgeon 21 „ ,, „ Orthopaedic Surgeon 11 ,, for X-ray and Electro-Cardiogram 42 ,, „ „ Blood Sedimentation Rate 21 „ „ ,, Psychiatrist 1 „ „ ,, Open Air School 1 Speech Clinic.—Miss P. J. Kent commenced her appointment as part-time Speech Therapist for two sessions weekly on 8th March. Miss P. M. Lough continued to attend seven sessions weekly. By the end of the year, 119 individual children of school age had received speech therapy at this Clinic, making a total of 1,434 attendances. The defects treated were as follows:— Stammering 44 Dyslalia 64 Post Operative (Tonsillectomy) 4 Dysarthria 2 Dysphonia 2 Others 3 48 children of school age were discharged from the Clinic during the year. In 30 cases the speech was normal. Of the remaining 18 cases, 14 ceased to attend for treatment and 4 left school of 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. School Dental Service.—The position at the end of 1951 was acute as regards the staff of Dental Officers. At the end of the year there was only one full-time Dental Officer and two part-time officers, each attending one session (2£ hours) weekly. Due to the depleted staff it was not possible to visit any of the schools for the purpose of dental 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. 75 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 conditions it is impossible to provide an adequate and satisfactory service. During the year 2,098 children were specially referred to the Dejitists, all of whom were found to require treatment, the children being in the following age groups :— Age-groups (years) 5 6 7 8 9 10 11 12 13 14 15 No. of inspections of children 309 373 307 218 183 210 165 124 81 90 38 In addition to the ordinary dental work of fillings and extractions, 7 dentures and 108 regulation plates were supplied. Further, 38 X-ray examinations of the teeth of children of school age were carried out at the Mayesbrook Dental Clinic. Full details of the dental work are shown in Table V. Open Air School.—During 1951, the number on the roll varied from 76 on 31.12.50 to 81 on 31.12.51. The number of admissions was 36 and the number of discharges was 31. Debility without any other defect accounted for a total of 13 children in 1951, as against 17 in 1950. Three of the 13 were discharged to ordinary schools during the course of the year, and one left on reaching school leaving age. The tendency noted in 1950 towards becoming more specifically a school for physically handicapped children was again emphasised and is reflected in the following list of recommendations for admission. School Medical Officer:— Asthma 6 Asthma and bronchitis 6 Bronchitis 3 Bronchiectasis 1 Debility 3 Debility and malnutrition 1 Pulmonary catarrh 1 Colitis 1 Otitis media 1 Suspected T.B. left tibia 1 Congenital deformities 1 Spastic diplegia 1 Paresis of arms, hands and legs 1 Diplegia of athetoid type 1 Muscular dystrophy 1 Amyotonia congenita 1 Subnormal nutrition 1 Chest Physician:— T.B. right hip 1 Arrested T.B. left hip 1 Abnormal nutrition 1 Others:— Debility and nervousness 1 Spastic Paraplegia 1 76 The 31 children not now on the roll ceased attendance for the following reasons:— Fit for ordinary school 19 Left school—over age 3 Admission to convalescent homes 2 Unfit for school attendance 1 Admitted to hospital 1 Admitted to Gregg's School 1 Admitted to St. Patrick's Open Air School 1 Admitted to Royal Wanstead School 2 Gone to Switzerland 1 The so-called spastic class continued to develop along the previous lines, special therapy such as weaving and model making being introduced. The use of walking machines and tricycles was extended. In 1951 the composition of the class was as follows :— Cerebral Palsy 6 General muscular dystrophy 1 General muscular dystrophy and spina bifida occulta 1 Talipes and wasting of calf muscles and poor speech 1 Total 9 In addition to the above, 2 milder cases of spasticity attended the ordinary classes of the school. One child of 3 years of age is down for admission to the spastic class when he reaches school age. 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 30 Administration of cod liver oil emulsion 30 Administration of malt and oil, etc. 1 Referred to Orthopaedic Surgeon 1 „ Ophthalmic Surgeon 2 „ Aural Surgeon 1 ,, Rheumatism Specialist 1 ,, Dental Surgeon 8 Recommended asthma exercises 2 convalescent home treatment 1 ,, Child Guidance Clinic 3 „ Speech Clinic 1 A course of asthma injections was given to 10 children during the year. Four children received artificial sunlight treatment during the year. Owing to the depleted dental staff it was not possible for the Dental Surgeon to visit the school for the purpose of inspection. 21 children attended the Dental Surgery for treatment. The provision of extra rest and cod liver oil and milk continued as before and children with lung diseases were given daily deep breathing exercises. The rebuilding of the rest hall is nearing completion and it is hoped to extend the activities of the school after Easter 1952 as a result. Treatment for Uncleanliness.—The School Nurses paid 191 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 53,017 Number Infested *236 Per cent. 0-4 *Seven of this number were found to be infected with living vermin; the remainder with nits only. A child with any nits in the hair at all is included in these figures. 77 The percentages for the past 5 years were as follows:— 1947 1.7 1948 1.3 1949 0.9 1950 0.5 195 1 0.4 Other Ailments.—During 1951, 332 children were operated on for the removal of enlarged tonsils and adenoids as follows:— King George Hospital 70 St. Mary's, Plaistow 63 Ilford Isolation Hospital 50 Rush Green Hospital 3 Privately 146 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 1951 was 2,256,839 approximately. There are 19 kitchens in the Borough, established at the following schools:— Barking Abbey, Beal, Benton, County High Boys, County High Girls, Cleveland, Dane, Fairlop, Gearies, Goodmayes, Gordon, Loxford, Mayfield, Newbury Park, Parkhill, Redbridge, 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, 1951, 18,310 children were receiving milk in school. Work done by the N.S.P.C.C.—The following 41 cases were investigated:— (1) Neglect 28 (2) Ill-treatment cases 3 (3) Other cases 10 (One case was reported from the Public Health Department for neglecting medical advice ; 4 were reported from other sources for general neglect.) 131 children (72 boys and 59 girls) were involved, 65 being of school age. In addition to this work, 246 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.— Number of Ilford School Children sent to (a) Recuperation Holiday Homes 47 (b) Regional Hospital Board Homes 3 of these, three Recuperative Holiday Home cases had extensions of stay and fees were paid from Voluntary funds. Six children sent for ordinary holidays; 6 were loaned invalid chairs, and clothing and shoes supplied in 7 cases. 40 cases were referred for visiting and/or for advice only. Eight escorts to London provided and all escorts from London to Convalescent Home provided by Voluntary Workers (50 children). Home visits during the year—social care and after.care reasons—100 (approx.). 78 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 arrangements 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, that 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 require 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, 1951, are tabulated hereunder:— 79 Return of Handicapped Pupils in the Area on 31st December, 1951 (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 1951 1 1 2 5 30 14 20 4 1 78 B. Newly ascertained in 1951 - - - 1 41 20 19 4 1 86 C. (i) Attending Special Schools— Day - 2 10 5 58 23 56 1 - 155 Boarding 1 4 6 2 6 2 9 3 2 35 (ii) Boarded in homes - - - - - - - - - (iii) Attending assisted Schools — — — — 1 1 3 21 — 26 D. Unplaced— (i) At no school I 1 — 1 — 11 2 3 — 19 (ii) At ordinary school — - — 2 12 1 12 3 30 E. Receiving home tuition (including those in D). - - - - - 6 1 1 - 8 Attending Special Schools Boarded in Homes Speech = Nil. Speech = Nil. Diabetes = 1 Diabetes = 1 Child Guidance Clinic.—The Child Guidance Clinic was opened on 3rd January, 1949, at Loxford Hall, Loxford Lane, Ilford. Dr. W. M. Burbury, the Psychiatrist, reports as follows:— "During the past 12 months this Clinic has seen considerable changes of staff. Dr. Burton retired in July and I succeeded him in October. We have also now got the services of the fully qualified Psychiatric Social Workers, Miss Zaphiriou, who comes to us with experience gained at St. Bartholomew's Hospital and in Cambridge, and Mrs. Guttsman, who has just completed the Mental Health Course in London. These two workers replace Miss Cawley who has now returned to Canada, and to whom we send our grateful thanks. The Psychological service has been reinforced by Miss Reed, who has also recently finished her training in London. This alteration in the balance of the staff does of course mean that now the shortage of Psychiatric time and of that of the Non-Medical Psycho-therapist is very serious ; but in the present premises, it is really impossible to cope with more sessions and at present we quite often are reduced to one or other of the staff working in the caretaker's kitchen— a proceeding which is grossly unsatisfactory. The premises are, in fact, entirely unsuitable for the purpose of such a clinic as this, and it is to be hoped that soon effect will be given to the provision of something more fitting. 80 The following gives a picture of the types of case attending, and in the short space of time that I have known the Clinic, I feel it is impossible to make comment on this since most of them are children of whom I have no direct knowledge." Total number of cases—136 referred Boys 102 73 per cent. Girls 34 27 per cent. 136 Primary Reason for Referral. Enuresis. Aggressive behaviour. Withdrawn behaviour. Sleep disturbances . Stealing. Boys 8 22 14 5 12 Girls — 10 7 2 3 Total 8 32 21 7 15 Failure to attend school. Fears and Anxiety. Sexual Offence. Speech difficulties. Habit spasms. Boys 7 22 1 2 4 Girls 2 4 — — 3 Total 9 26 1 2 7 Asthma. No progress at school. Hysteria. Boys 1 3 1 Girls — 2 1 Total 1 5 2 Disposal of 1951 Referrals. Therapy. Advice to Parents Diagnosed and Advised. Residential Schools. Refer to Hospitals, etc. Boys 32 4 7 2 Girls 6 1 3 1 Total 38 5 10 3 Supervision at school. Remedial teaching. Withdrawn before exam. Awaiting. Discharge improved. Boys 4 3 17 29 2 Girls 1 — 7 16 1 Total 5 3 24 45 3 Carry Over from 1950. Discharge improved. Unco-operative. To Residential ; schools. Diagnosed and Advised. 30 9 6 5 Treatment continuing. 23 Number of cases diagnosed by psychiatrist in 1951 : 92. 81 Dr. A. H. G. Burton relinquished his appointment as Consultant Psychiatrist on attaining retiring age on 4th July, 1951, and was succeeded in this post by Dr. W. M. Burbury who commenced on 1st October, 1951. Dr. J. E. G. Vincenzi was appointed as Assistant Psychiatrist and commenced duties on 23rd May, 1951. Miss J. Reed was appointed an additional Educational Psychologist, commencing on 1st August, 1951. Mrs. V. Guttsman and Miss J. Zaphiriou were appointed as whole-time Psychiatric Social Workers and commenced in September, 1951. Miss J. Cawley, a Canadian Psychiatric Social Worker, assisted at the Clinic from 29th January to 30th August, 1951. Mrs. Henschel took over the duties of Play Therapist on 29th January, 1951. The Psychiatrists undertake 5 sessions weekly, whilst the Educational Psychologists and the Psychiatric Social Workers are whole-time. During the year 136 new cases were referred to the Clinic. Six cases were examined at request of courts. The following is a table of work undertaken at the Clinic:— Psychiatrist:— Cases diagnosed 92 Treatment interviews 376 Other inteiviews 214 Psychologist:— Cases tested 82 Treatment interviews 102 Other interviews 141 School visits on Clinic cases 59 Psychiatric Social Worker:— Cases interviewed at Clinic 633 Other interviews 63 Play Therapist:— Play Therapy interviews 134 Number of cases recovered or sufficiently improved to warrant discharge 33 Diagnosis and advice only 10 Discharged—non-co-operative 9 Employment of School-children and Young Persons.—From special inquiries made at the various schools during 1951 it was found that 153 children were employed out of school hours. 150 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 150 Employment of Children in Entertainments Provisional Amending Rules, 1945.—73 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 Head Teachers 4 „ „ Clerical Stafi 1 „ „ School Clerical Assistants 15 „ „ Store Keeper 1 „ „ Welfare Assistants 3 „ „ School Attendant 1 „ „ Cook Supervisor 1 26 82 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 1950 and 1951. The Table also gives a Comparative Percentage of Deaths Registered at all Ages. Disease Percentage of total deaths (all ages) Number of deaths at ages 5—15 1951 1950 1951 1950 1. Measles 0.05 - - - 2. Scarlet Fever - - - - 3. Whooping Cough 0.11 - - - 4. Diphtheria - - - - 5. Acute Poliomyelitis and Polioencephalitis - .11 - - 6. Influenza 1.31 .62 1 - 7. Tuberculosis 2.23 2.61 - 2 8. Rheumatic Fever 011 .06 - — 9. Bronchitis, Pneumonia and other respiratory diseases 11.93 8.51 1 - 10. *Meningitis and Nervous system 16.62 13.05 - - 11. Heart Diseases 30.41 27.73 - — 12. Acute and Chronic Nephritis 0.93 .97 - - 13. Violence 2.39 4.14 1 5 14. Other causes 33.91 42.20 5 1 100 100 8 8 *Excludes Meningococcal infections. Deaths of School.children. Ilford.—The deaths of children of School Age during 1950 represent 0.45 per cent. of the Total Deaths registered (all ages), and during 1951 represent 0.43 per cent. ILFORD ENURESIS CLINIC Dr. J. Pooley, Assistant County Medical Officer, makes the following Interim Report from December 19th, 1951 (date of commencement), to March 5th, 1952. "The Clinic is held at the Public Health Offices, Emerson Road, on alternate Wednesday mornings, and attendance thereat has been excellent. 1. Appointment List. At 21st February, 1952, there were 86 cases on the list:— Recommended by: Infants School Age Total Parents 1 1 2 Doctors in private practice 2 14 16 Infant Welfare Officers 5 - 5 Assistant School Medical Officers - 63 63 8 78 86 83 2. Procedure. At each Clinic, the procedure has been as follows:— (a) Examination of urine by Health Visitor (sugar, albumen, reaction). (b) History of enuresis is taken. (c) Physical examination (as far as concerns the enuresis is made). (d) The approachability of the child and parent is noted particularly. (e) General advice, and advice re charting all dry nights is given in each case. (f) Medicinal treatment is issued or prescribed (vide 3). 3. Treatment. Of the 86 cases on the list at 21st February, 1952, 42 cases (28 boys and 14 girls) had been seen up to 5th March, 1952. The treatment issued or prescribed for them was as follows:— (a) Benzedrine (either 5 mgms. or 2.5 mgms.) at night at a time decided upon for each individual child—32 cases. (b) Benzedrine (either 5 mgms. or 2.5 mgms.) + Mist. Potassium Citrate e hyoscyamus at night at a time decided upon for each individual child—4 cases. (c) Phenobarbitone grs. ½ at night—4 cases. (d) Advice only, without medicinal treatment—2 cases. N.B.—The phenobarbitone and the Mist. Pot. Cit. with hyoscyam. were not issued by the Area Health Office. In addition, it was necessary to send a small number of cases for investigation of physical defects (e.g. a case of right inguinal hernia). 4. Analysis of Results in respect of these 42 cases: Cases Not yet re-attended 10 Completely dry 10 Marked improvement (i.e. more than 14 dry nights in 28 since treatment) 12 Improvement (i.e. 5—14 dry nights in 28 since treatment 4 No improvement (i.e. less than 5 dry nights in 28 since treatment) 5 Self-discharged 1 42 5. Conclusions. Although the clinic has only been in existence for three months, and therefore cannot show as yet any scientific conclusions, the attitudes of both parents and children have been of interest and cooperative." G 84 Ministry of Education. MEDICAL INSPECTION RETURNS. Year Ended 31st December, 1951. 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 2,381 Second Age Group 2,039 Third Age Group 1,430 Total 5,850 Number of other Periodic Inspections — Grand Total 5,850 B.—Other Inspections. Number of Special Inspections 4,136 Number of Re-inspections 9,596 Total 13,732 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 is recorded more than once in any column of this Table, and therefore the total on column (4) will not necessarily be the same as the sum of columns (2) and (3).) Group. (1) For defective vision (excluding squint). (2) For any of the other conditions recorded in Table IIa. (3) Total individual pupils. (4) Entrants 61 894 925 Second Age Group 200 539 670 Third Age Group 208 380 525 Total (prescribed groups) 469 1,813 2,120 Other Periodic Inspections — — — Grand Total 469 1,813 2,120 85 TABLE II. A.—Return of Defects Found by Medical Inspection in the Year Ended 31st December, 1951. 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. Number of Defects Requiring Treatment. Number of Defects Requiring Observation but not Treatment. Periodic Inspection Special Inspection Periodic Inspection Special Inspection (1) (2) (3) (4) (5) 4 Skin 106 272 77 8 5 Eyes—a. Vision 469 174 104 11 b. Squint 68 22 20 2 c. Other 74 157 47 12 6 Ears—a. Hearing 30 37 66 6 b. Otitis Media 18 38 18 - c. Other 26 55 32 9 7 Nose or Throat 473 178 593 26 8 Speech 37 37 71 10 9 Cervical Glands 10 59 213 5 10 Heart and Circulation 55 50 115 5 11 Lungs 124 99 301 6 12 Developmental— a. Hernia 29 4 54 — b. Other 14 6 94 2 13 Orthopaedic— a. Posture 272 22 75 1 b. Flat foot 425 71 84 3 c. Other 419 136 270 15 14 Nervous System— a. Epilepsy 3 2 6 3 b. Other 11 65 37 4 15 Psychological— a. Development 3 — 13 — b. Stability 48 66 88 12 16 Other 173 260 198 58 86 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 2,381 937 39.3 1,386 58.3 58 2.4 Second Age Groups 2,039 476 23.4 1,541 75.5 22 1.1 Third Age Groups 1,430 478 33.4 943 65.9 9 0.7 Other Periodic Inspections - - - - - - - Total 5,850 1,891 32.3 3,870 66.2 89 1.5 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 53,017 (ii) Total number of individual pupils found to be infested 236 (iii) Number of individual pupils in respect of whom cleansing notices were issued (Section 54 (2), Education Act, 1944) 7 (iv) Number of individual pupils in respect of whom cleansing orders were issued (Section 54 (3), Education Act, 1944) [N.B.—The information asked for in this table falls into these two Divisions (a) and (6), 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—(i) Scalp — 1 Ringworm—(ii) Body 6 — Scabies 1 — Impetigo 13 — Other skin diseases 312 110 Total 332 112 Number of examinations made by Skin Specialist—61. 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. 87 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 141 36 Errors of Refraction (including squint) — 450 Total 141 486 Number of pupils for whom spectacles were (a) Prescribed — 882 (b) Obtained Total — 865 — 1,747 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 — 21 (b) for adenoids and chronic tonsillitis - 332 (c) for other nose and throat conditions - 29 Received other forms of treatment 110 119 Total 110 501 Group 4.—Orthopaedic and Postural Defects. (a) Number treated as in-patients in hospitals 24 By the Authority Otherwise (ft) Number treated otherwise, e.g., in clinics or out-patients departments 1,064 32 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 490 7 Group 6.—Speech Therapy. Number of cases treated By the Authority Otherwise Number of pupils treated by Speech Therapists 119 1 88 Group 7.—Other Treatment Given. Number of cases treated By the Authority Otherwise (a) Miscellaneous minor ailments 3,634 148 (b) Other (1) Heart and Rheumatism 157 7 (2) Sunlight Treatment 157 5 (3) Massage and Remedial Exercises 336 2 Total 4,284 162 TABLE V. Dental Inspection and Treatment Carried Out by the Authority (1) Number of pupils inspected by the Authority's Dental Officers:— (a) Periodic age groups — (b) Specials 2,098 Total (1) 2,098 (2) Number found to require treatment 2,098 (3) Number referred for treatment 2,098 (4) Number actually treated 2,495 (5) Attendances made by pupils for treatment 6,199 (6) Half-days devoted to : Inspection — Treatment 440 Total (6) 440 (7) Fillings: Permanent Teeth 1,468 Temporary Teeth 131 Total (7) 1,599 (8) Number of teeth filled: Permanent Teeth 1,153 Temporary Teeth 129 Total (8) 1,282 (9) Extractions: (i) Permanent Teeth:— (a) On account of Caries 767 (b) For other purposes 184 (ii) Temporary Teeth:— (a) On account of Caries 4,399 (b) For other purposes 222 (10) Administration of general anaesthetics for extraction 2,083 (11) Other operations Permanent Teeth 3,992 Temporary Teeth 604 Total (11) 4,596 89 SCHOOL HEALTH SERVICE STAFF AND SCHOOL CLINICS AS AT 31st DECEMBER, 1951. 1.—Staff of the School Health Service. Divisional 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 terms of the equivalent number of whole time officers (a) Medical Officers: (i) Whole time School Health Service - - (ii) Whole time School Health and Local Health Services 6 2 2/3 (iii) General Practioners working part-time in the School Health Service - - (b) Dental Officers 3 1 (c) Physiotherapists, Speech Therapists, etc. Physiotherapist 1 8/11 Speech Therapist 2 9/11 (d) School Nurses *10 (Combined posts, H.V. and S.N.) 4¾ (e) Nursing Assistants. 5 (Clinic Nurses) 2½ (f) Dental Attendants 2 1¾ *All hold Health Visitor s Certificate. 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 90 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. 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.B. &c. (3) A. Minor ailment and other non-specialist examination or treatment 2 - B. Dental 2 — C. Ophthalmic 3 — D. Ear, Nose and Throat 1 — E. Orthopaedic 3 — F. Speech Therapy 2 - 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 N umber Aggregate in terms of the equivalent number of whole-time officers Psychiatrists 2 5/11 Educational Psychologists 2 2 Psychiatric Social Workers 2 2 Others:— Play Therapist 1 6/11 Clerk/Typist 2 2 The Psychiatrists are employed by arrangement with the Regional Hospital Board. 91 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, 1951. SCHOOLS No. on Roll DISEASES AND CONTACTS Scarlet Fever Diphtheria Measles and German Measles Whooping Cough Chickenpox SonneDysen tery Mumps Pneumonia Rheumatism Totals Cases Contacts Cases Contacts Cases Contacts Cases Contacts Cases Cases Cases Cases Cases Cases Contacts Beal Modern 662 2 3 — — 2 3 1 - - - 1 - - 6 6 Becontree 1 245 9 11 — — 43 13 2 — 5 1 1 2 - 63 24 Benton (Open Air) 85 — — — — 3 1 1 — — - - - - 4 1 Chadwell 834 41 15 — — 49 10 20 2 5 — — 2 - 117 27 Christchurch 819 6 9 — — 17 4 3 4 1 — — 1 1 29 17 Cleveland 975 5 6 — — 15 2 24 4 2 4 — — - 50 12 County High 1,199 — 5 — — 5 — — — 1 — — — 1 7 5 Dane 721 1 4 — — — — — — — — — — - 1 4 Downshall 1,398 44 19 — — 27 7 36 7 55 — 5 — 1 168 33 Fairlop 1,855 10 4 — — 144 25 36 6 2 — 1 1 - 194 35 Gearies 1,256 4 2 — — 11 2 4 1 6 4 - - - 29 5 Goodmayes 687 7 6 — — 40 7 23 2 3 - 1 — - 74 15 Gordon 264 3 4 — — 62 6 4 — 14 2 — 1 - 86 10 Highlands 975 7 7 — — 127 21 18 — 4 1 — 1 - 158 28 Loxford 374 — — — — — — — — — — — — - - - Mayfield 947 — 3 — — 1 — — — 4 — 2 — - 7 3 Mossford (Fairlop) 340 1 1 — — 31 3 7 — 7 — - - - 46 4 Mossford (G.V.H.) 174 — - — — 30 2 7 — 6 - 1 - - 44 2 Newbury Park 359 3 1 — — 64 7 21 4 — 3 - - - 91 12 Parkhill 826 11 10 — — 36 3 45 6 34 - - 1 - 127 19 St. Augustine's 319 1 1 — — 23 2 2 — 1 — — - - 27 3 SS. Peter and Paul's 650 — 1 — — 25 5 7 — 1 1 10 - - 44 6 St. Vincent's 363 1 1 — — 3 2 3 - - - - - 1 8 3 South Park 941 11 6 — — 102 13 24 3 2 - 3 - - 142 22 The Glade 634 3 1 — — 2 — 9 1 35 - - 1 - 50 2 The John Bramston 473 5 5 1 — 79 9 16 2 3 — — 1 — 105 16 The Mount 318 — — — — 1 — 1 — — — — - - 2 - The Redbridge 554 6 4 — — 84 8 14 2 3 3 - - - 110 14 The William Torbitt 966 9 6 — — 68 12 24 6 113 3 2 1 - 220 24 Uphall 376 1 — — — 47 4 8 1 4 - 1 1 - 62 5 Ursuline 240 — 2 — — 19 2 1 - - - -- - 20 4 Woodlands 335 1 — — — 83 10 9 1 9 - - - - 102 11 Private 10 2 — — 73 5 19 2 — — — — — 102 9 Totals 2,2164 202 139 1 — 1,316 188 389 54 320 22 28 13 4 2,295 381 1 Piliomyelito case at Wanstead County High School. 1 Para-typhoid case at John Bramston School and 1 at Glenarm College (Private School). 93 94 Table VIIA.—Table Showing the Average Heights and Weights of the BOYS Examined (1951). Age Groups. 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 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) Beal Modern - - - - - - - - - - - - - - - - - - 2 146 38.2 8 152 39.5 2 160 55.2 6 161 49.8 19 170 60.4 18 170 62.4 - - - Becontree 5 111 20.3 2 113 20.2 1 121 23.8 1 120 21.6 3 124 25.4 25 137 31.8 44 140 35.2 2 138 39.3 1 142 40.0 52 160 48.3 14 160 511 - - - - - - Benton (Open Air) 8 109 18.4 9 118 21.3 6 121 23.0 14 125 24.7 11 131 27.8 3 129 27.3 7 142 34.5 1 129 24.0 7 153 38.9 - - - 3 149 37.0 - - - - - - Chadwell 64 114 21.5 76 117 22.1 6 123 25.7 1 133 28.4 - - - 5 144 36.0 50 144 36.4 - - - - - - - - - - - - - - - - - - Christchurch 41 114 21.2 25 117 22.3 5 125 251 - - - 3 136 28.6 5 139 31.4 43 144 36.3 - - - - - - - - - - - - - - - - - - Cleveland 40 112 20.2 24 114 21.3 1 121 24.0 4 131 27.9 6 132 30.9 11 140 33.4 64 141 35.8 - - - - - - - - - - - - - - - - - - County High - - - - - - - - - - - - - - - - - - 2 139 35.0 5 146 36.2 1 151 45.4 1 148 46.5 99 170 53.1 1 166 47.7 1 177 68.4 Dane - - - - - - - - - - - - - - - - - - 2 145 38.3 4 144 41.9 - - - 29 166 54.1 15 167 56.6 1 176 56.4 - - - Downshall 1 111 19.2 11 115 22.6 1 114 20.8 2 125 24.3 2 136 35.3 9 136 29.5 43 143 35.6 2 147 34.6 2 156 44.3 24 161 49.7 7 162 50.2 - - - - - - Fairlop 3 114 20.3 3 112 17.5 1 128 25.6 2 129 27.4 1 124 22.3 2 145 35.0 67 144 35.4 5 145 37.4 1 138 38.5 65 161 54.0 11 161 51.5 - - - - - - Gearies 38 115 21.5 58 118 22.8 9 124 26.4 4 126 25.5 1 131 26.5 26 144 37.4 22 144 37.4 5 143 35.9 1 148 41.1 34 163 52.2 16 164 54.9 - - - - - - Goodmayes 43 114 21.3 27 117 22.7 1 120 24.0 - - - 2 131 27.8 - - - 31 144 37.4 - - - 1 156 48.5 - - - - - - - - - - - - Gordon 24 114 21.4 14 116 20.9 - - - 1 135 29.2 - - - - - - - - - - - - - - - - - - - - - - - - - - - Highlands 8 116 23.4 65 116 22.3 5 124 25.4 6 127 27.1 6 139 27.2 5 141 32.5 43 144 34.8 - - - - - - - - - - - - - - - - - - Loxford - - - - - - - - - - - - - - - - - - 1 134 27.2 1 144 36.5 2 158 51.5 43 163 51.4 3 163 50.1 1 158 48.7 - - - Mayfield - - - - - - - - - - - - - - - - - - 1 138 30.6 6 143 35.7 1 148 51.2 90 160 50.8 28 163 53.6 - - - - - - Mossford 27 112 20.1 3 114 22.1 3 125 24.8 - - - - - - 9 140 35.6 12 145 41.8 - - - - - - - - - - - - - - - - - - Mossford G.V.H. 6 111 19.9 8 117 21.4 2 119 22.4 2 131 29.2 1 136 28.8 - - - 2 139 31.8 - - - - - - - - - - - - - - - - - - Newbury Park 26 115 21.8 8 118 22.7 1 124 20.4 1 138 33.0 - - - 5 139 33.9 7 146 35.5 2 154 36.1 - - - - - - - - - - - - - - - Parkhill 54 117 20.7 23 118 20.7 1 130 22.0 2 131 26.8 - - - 1 147 43.2 35 144 34.7 - - - - - - - - - - - - - - - - - - St. Augustine's 24 113 20.0 10 114 20.2 4 123 28.1 2 123 22.5 1 120 28.7 7 136 29.7 21 145 36.2 - - - - - - - - - - - - - - - - - - SS. Peter & Paul 16 115 20.3 22 118 22.7 6 129 28.6 - - - 2 133 25.3 6 142 34.5 26 143 34.0 1 144 46 0 2 153 42.3 7 163 50.1 3 176 57.2 - - - - - - South Park 22 115 20.2 45 118 22.1 5 124 24.5 3 131 28.6 2 130 29.5 2 141 36.5 49 144 35.4 - - - - - - - - - - - - - - - - - - St. Vincent's 5 112 21.3 3 111 20.8 1 115 21 .0 - - - - - - 4 135 31.6 9 142 33.7 - - - 1 156 50.0 22 156 49.4 - - - - - - - - - The Glade 20 115 21.3 44 118 22.8 6 123 26.6 1 122 24.9 - - - 3 141 30.9 24 148 37.6 - - - - - - - - - - - - - - - - - - The John Bramston 1 100 15.1 2 122 25.2 - - - - - - 1 134 25.4 5 141 34.5 18 148 37.1 - - - - - - - - - - - - - - - - - - The Redbridge 40 113 21.0 26 115 20.1 4 120 22.2 3 127 29.5 - - - 7 141 34.3 23 144 38.5 - - - - - - - - - - - - - - - - - The Wm. Torbitt 35 111 19.9 30 115 21.4 2 122 27.3 - - - - - - 10 142 33.5 48 144 36.1 - - - - - - - - - - - - - - - - - - Uphall 29 112 20.0 9 115 21.4 1 118 22.3 1 133 390 1 132 27.5 4 137 32.6 19 144 36.4 - - - - - - - - - - - - - - - - - - Woodlands 31 111 20.9 21 112 22.9 2 123 26.1 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Ilford Boys—Averages for 10 years 1951 611 113 20.8 568 115 21.7 74 123 23.9 50 128 26 6 43 131 28.2 165 140 33.5 715 143 35.9 42 146 37.4 22 153 44.2 373 161 51.2 218 165 53.3 21 170 60.7 1 177 63.4 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 891 113 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 51 147 38.9 40 152 41.9 392 160 50.7 247 165 55.3 27 171 61.7 3 173 61 .6 1948 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 39 144 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 31.8 122 143 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 - - - - - - - - - - - - 95 96 Table VIIB.—Table Showing the Average Heights and Weights of the GIRLS Examined (1951). School Age Groups Age Groups 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 (iD 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 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 — — — — — — — — — — — — — — — — — — 2 150 45.8 4 152 43.4 9 154 45.4 21 161 53.8 30 162 54.2 8 162 55.7 — — — Becontree 1 109 21.3 2 111 18.4 — — — 2 131 27.3 2 129 25.8 11 136 32.0 56 142 35.0 — — — — — — 46 156 49.0 9 160 57.3 — — — — — — Benton (Open Air) 3 109 15.4 3 111 16.7 9 105 18.4 6 125 24.9 5 134 28.9 11 136 27.0 5 135 28.8 8 149 36.3 5 154 40.1 1 149 31.3 1 184 30.6 — — — — — — Chadwell 54 113 20.4 75 115 21.2 7 119 23.1 2 127 25.5 — — — 8 141 34.5 56 146 35.9 — — — — — — — — — — — — — — — — — — Christchurch 29 114 20.1 36 115 20.8 1 121 23.6 4 128 30.7 5 131 28.2 8 143 34.4 43 144 36.1 — — — — — — — — — — — — — — — — — — Cleveland 37 113 20.0 19 117 22.0 2 129 32.1 4 128 26.1 4 132 29.0 16 135 30.8 61 145 37.5 — — — — — — — — — — — — — — — — — — County High — — — — — — — — — — — — — — — — — — 19 148 40.3 1 149 42.5 — — — — — — 139 162 — 18 162 56.4 — — — Dane Central — — — — — — — — — —. — — — — — — — — — — — 1 151 40.0 1 142 35.6 53 159 51.7 12 160 50.3 — — — — — — Downshall 3 109 17.2 14 115 21.2 1 122 19.5 1 125 25.2 1 125 25.3 10 141 33.4 38 140 37.8 6 144 35.7 1 158 46.2 37 160 50.5 1 156 52.4 — — — — — — Fairlop 2 109 23.0 — — — — — — 2 129 26.0 2 130 27.3 4 134 29.2 65 145 35.7 6 148 41.6 1 160 49.1 65 157 50.9 13 159 51.4 — — — — — — Gearies 41 114 19.9 56 117 21.3 6 123 25.1 4 132 28.4 2 133 30.2 3 142 35.2 46 149 38.6 9 152 43.7 3 151 48.7 35 158 51.0 1 169 67.0 — — — — — — Goodmayes 36 111 20.0 22 116 21.3 3 122 23.4 3 125 25.8 — — — 13 142 35.2 33 140 — — — — — — — — — — — — — — — — — — — Gordon 31 112 20.4 11 116 21.8 1 124 25.8 — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Highlands 10 112 20.8 66 117 22.3 5 124 23.4 5 128 27.3 — — — 7 141 33.8 42 147 — — — — — — — — — — — — — — — — — — — Mayfield — — — — — — — — — — — — — — — — — — 5 150 39.5 7 153 43.0 7 156 46.5 57 157 51.5 21 157 53.3 — — — — — — Mossford 17 109 19.0 4 115 19.9 1 119 25.0 — — — 1 146 26.0 6 135 31 .0 10 142 38.6 — — — — — — — — — — — — — — — — — — Mossford G.V.H. 4 111 20.4 7 116 21.8 2 125 24.8 4 124 27.0 1 132 29.2 6 137 33.3 9 142 36.3 — — — — — — — — — — — — — — — — — — Newbury Park 20 112 20.2 10 116 22.1 2 120 20.6 1 130 24.0 1 141 30.6 6 139 35.8 11 146 37.2 1 151 46.0 — — — — — — — — — — — — — — — Parkhill 28 114 19.6 35 117 22.2 2 126 23.6 — — — — — — 5 140 30.2 45 144 38.0 — — — — — — — — — — — — — — — — — — St. Augustine's 20 111 19.3 3 116 22.3 6 121 22.3 2 123 22.1 1 130 29.0 5 134 29.4 8 141 34.6 — — — — — — — — — — — — — — — — — — SS. Peter & Paul 21 113 20.1 18 116 22.3 2 115 20.1 — — — 1 132 25.0 8 140 32.4 26 144 35.8 3 147 35.3 1 161 44.2 2 163 52.0 6 153 43.0 — — — — — — South Park 23 114 21.2 50 117 21.5 3 124 26.5 4 132 28.9 6 131 28.0 3 140 40.1 80 144 35.6 — — — — — — — — — — — — — — — — — — St. Vincent's 8 110 20.2 1 116 20.8 2 112 21.1 1 135 31.9 — — — 5 134 31.8 14 141 34.3 — — — 2 126 26.4 22 159 51.1 — — — — — — — — — The Glade 22 114 19.0 46 118 20.6 1 119 23.1 3 129 26.3 — — — 4 138 31.6 22 146 38.3 — — — — —— — — — — — — — — — — — — — The John Bramston 1 120 26.7 — — — — — — 1 128 24.0 — — — 3 139 31.4 13 141 34.2 — — — — — — — — — — — — — — — — — — The Mount — — — — — — — — — — — — — — — — — — 1 145 37.0 2 145 30.5 3 157 46.0 58 158 50.0 11 161 55.6 — — — — — — The Redbridge 35 113 20.7 13 116 21.3 — — — 1 125 27.9 1 134 30.4 14 138 35.2 29 144 37.3 — — — — — — — — — — — — — — — — — — The William Torbitt 29 113 19.0 30 115 30.6 2 124 24.8 2 127 26.9 2 136 31.3 9 140 32.6 56 143 34.9 — — — — — — — — — — — — — — — — — — Uphall 20 112 19.6 8 114 20.2 1 112 17.3 1 130 29.8 1 141 28.6 1 136 31.0 16 143 35.3 — — — — — — — — — — — — — — — — — — Ursuline — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — 4 165 55.8 1 166 56.4 — — — Woodlands 31 110 19.9 13 113 20.7 1 120 21.6 — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Ilford Girls—Averages for 10 years:— 1951 526 112 20.0 542 116 21.3 60 119 22.8 53 128 26.9 36 132 28.4 166 138 32.7 811 144 36.5 48 149 40.1 33 153 43.8 397 158 50.8 248 161 55 0 27 162 56 1 — — — 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 52.4 4 163 55.6 1949 823 111 19.9 418 115 21.2 82 121 23.5 46 126 26.0 56 130 28.3 216 139 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 65 129 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 31.5 445 142 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 — — — — — — — — — — — — 1943 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 — — — — — — — — — — — —