AR 15/12/83 ??? one Ac 4411 (1) ??? ILF 27 Borough of llford Health Report FOR THE YEAR 1952 I. GORDON M.D., Ch.B., M.R.C P., D P H. Medical Officer of Health, etc. Page 8-10 67963 1 ILFORD BOROUGH COUNCIL Municipal Year 1952/53 Alderman H. D. Cowan, J.P., F.C.P.A., F.C.C.S., Mayor. Alderman P. V. Faning (E.C.C.), Deputy Mayor. Aldermen: Barker, John, J.P. Bryan, William Allen Vernon, J.P. Colvin, Gilbert, F.C.I.S. Cowan, Harold Douglas, J.P., F.C.P.A., F.C.C.S. Daniels, Russell Stearn. Fallaize, Mrs. Lilian, J.P. (E.C.C.) Faning, Percy Victor (E.C.C.). Gibson, Cyril Irving. Headley, Cecil Aubrey. Pearson, Frederick Thomas. Woods, Sidney Charles Victor. Young, Major Alexander, T.D., J.P., C.A., (E.C.C.). Councillors: Bartlett, Edward Albert. Bennett, Mrs. Florence Edith. Bysouth, Henry Albert. Caunt, George Louis. Chapman, Mrs. Ceinwen. Cunningham-Snell, Robert Davies, Stephen Robert. Drew, Leslie Victor. East, John. Gleed, Sydney George. Gooch, Lionel Archer Scott. Harris, Edgar Frank. Hewitt, Reginald. Hughes, Thomas Bernard. James, Francis Herbert Lee, Leonard Gordon Victor. Littlejohn, Mrs. Ruth Constance, M.A. Manders, Ralph James David. Masters, Frank Robert. Meynell, Mrs. Caroline Milburn, Mrs. Elizabeth Florence Pavitt, Laurence Anstice. Parfitt, William Arnold Root, Harold Goldstone. Shaw, Arnold John, B.A. Sherrell, Albert Reginald (E.C.C.). Smith, Mrs. Lily Maude, S.R.N. Tamplin, Lewis Henry. Taylor, Sidney William. Terry, Miss Anne Sylvia. Tulle-it, Mrs. Ethel Ross. Tyler, Bertie Charles Newcombe. Waters, Owen Francis. Watts, Mrs. Mabel Lucy. Westley, Ronald Francis. Woodham, Leonard Victor. 2 PUBLIC HEALTH COMMITTEE Municipal Year 1952/53 Councillor Mrs. E. R. Tullett, Chairman. Councillor Mrs. M. L. Watts, Vice-Chairman. Alderman G. Colvin, F.C.I.S. Alderman H. D. Cowan, J.P., F.C.P.A., F.C.C.S., Mayor. Alderman P. V. Faning (E.C.C.), Deputy Mayor. Alderman C. I. Gibson. Councillor Mrs. C. Chapman. Councillor J. East. Councillor Mrs. R. C. Littlejohn, M.A. Councillor W. A. Parfitt. Councillor A. J. Shaw, B.A. Councillor A. R. Sherrell (E.C.C.). Councillor Mrs. L. M. Smith, S.R.N. Councillor Miss A. S. Terry. Councillor O. F. Waters. Councillor R. F. Westley. ILFORD HEALTH AREA SUB-COMMITTEE OF THE HEALTH COMMITTEE OF THE ESSEX COUNTY COUNCIL Municipal Year 1952/53 IIford Borough Council Representatives: Aldermen Barker, Colvin, Woods; Councillors East, Harris, James, Lee, Mrs. Littlejohn, Masters, Mrs. Milburn, Sherrell, Mrs. Smith (Vice-Chairman), Miss Terry, Waters and Mrs. Watts (Chairman). Essex County Council Representatives: Alderman Mrs. Ball; Councillors Mrs. Banthorpe, Mrs. Fallaize, Faning, Green, Mrs. Paige, Dr. Skinner. The Executive Council for Essex Representative: Dr. H. N. Rose. Local Medical Committee Representative: Dr. S. J. Allen. Hospital Management Committee Representative: Mrs. F. E. Wootton, O.B.E. Voluntary Organisations' Representatives: Mrs. M. Armitage, Mrs. B. Butcher, Miss N. L. Odell and Mrs. A. M. Pearce. 3 ILFORD COMMITTEE FOR EDUCATION Municipal Year 1952/53 Councillor R. J. D. Manders, Chairman. Alderman G. Colvin, F.C.I.S., Vice-Chairman. Alderman J. Barker, J.P. Alderman W. A. V. Bryan, J.P. Alderman F. T. Pearson. Councillor Mrs. F. E. Bennett. Councillor Mrs. C. Chapman. Councillor R. Cunningham-Snell. Councillor L. A. S. Gooch. Councillor Mrs. R. C. Littlejohn, M.A. Councillor F. R. Masters. Councillor L. A. Pavitt. Alderman P. V. Faning (E.C.C.) (Deputy Mayor) Alderman S. C. V. Woods Alderman Major A. Young, T.D., J.P., C.A. (E.C.C.). Councillor A. J. Shaw, B.A. Councillor Mrs. L. M. Smith, S.R.N. Councillor Miss A. S. Terry. Councillor O. F. Waters. Councillor Mrs. M. L. Watts. Councillor L. V. Woodham. Co-opted Members-. Rev. D. Harnett. Rev. W. C. Johnson. Mr .H. S. Kenward, M.A. Mr. S. F. Loveless. Mr. E. R. Lower, B.A. Miss H. S. Rich. Mr. G. W. Stroud. County Nominated Members: Mr. W. R. Spencer. County Councillor A. F. J. Chorley. 4 OFFICERS OF THE PUBLIC HEALTH SERVICES Ilford Borough Council. Medical Officer of Health, Divisional School Medical Officer, Area Medical Officer, Ilford Health Area Sub-Committee: 1. 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), M.M.S.A., D.P.H. (Lond.). 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. A. C. R. Neale. G. W. Newman. R. E. Smalley. T. F. Johnson. J. Cook. F. Nau. D. F. Scott. J. A. Harris. Chief Administrative Assistant: F. J. Hocking. Welfare Officer for Old Folk : Miss E. A. Workman, B.A. Administrative Assistant J. J. Holland. Essex County Council. Assistant County Medical Officers: D. M. B. Gross, M.D., Ch.B. (Leeds), M.M.S.A., D.P.H. (Lond.) (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. (Eng.). Senior Dental Officer: E. V. Haigh, L.D.S., R.C.S. (Eng.). Dental Officers: Mrs. M. M. Alford, L.D.S., R.C.S.I. Miss E. NicGrianna, B.D.S. (Ireland) (from 1-10-52). Educational Psychologists: K. Pickett. B.Litt. (Oxon), Dip. Psych. Miss J. Reed, B.A. (Hons. Psych.). Psychiatric Social Workers: Mrs. V. Guttsman. Miss I. Zaphiriou. 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 M. G. Bennett. Miss E. J. Whiting. Miss G. E. Lewis (to 8-10-52). Miss A. I. McCarthy (from 28-7-52) Miss E. M. P. Collins (from 5-8-52) Miss L. M. Roberts (from 28-7-52 to 6-6-53) Miss M. G. Duguid (from 1-10-52) Miss H. Arnold (from 13-10-52) Mrs. E. M. Gajewska (from 2-2-53) Miss D. Lowenberg. Miss C. Oldham. Miss L. Hockey (to 1-2-53). Mrs. R. Robertson. Tuberculosis Visitors: Mrs. T. E. Bowman (to 24-8-52). Mrs. A. T. Jones. Mrs. P. B. Lascelles. Miss W. Kerr (from 5-8-52). 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. Nunn (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: H. J. R. Thorne, M.B., B.S., D.O., D.O.M.S. (from 10-2-53). T. J. Regal, M.D. (Berlin), D.O.M.S. (Lond.). E. M. L. Evans, M.B., B.Ch., D.O. (from 30-10-52 to 1-3-53). 6 Officers of the Public Health Services—continued. Surgeon in charge of Aural Clinic: M. Marks, M.R.C.S., L.R.C.P., D.L.O. Physician in charge of Rheumatism and Cardiac Clinics: K. Playfair, M.A., M.B., M.R.C.P. Physician in charge of Paediatric Clinic: T. R. Savage, M.A., B.M., M.R.C.P. Child Guidance Clinic: Consultant Psychiatrists: W. M. Burbury, M.A., B.S., M.B., D.P.M. (to 30-9-52). H. M. S. Davidson, M.B., B.S., M.R.C.S., D.P.M. (from 5-12-52). Psychiatrist: J. Vincenzi, M.R.C.S., L.R.C.P., D.P.M. Orthoptist: Mrs. M. J. Mindell, D.B.O. (from 9-2-53). Physiotherapist: Mrs. M. E. King, M.C.S.P. (to 2-4-53). P. J. Hunt, M.C.S.P. (from 30-3-53) Essex County Council. Assistant Dental Officers (Part-time): A. G. Clark, L.D.S., R.C.S. (Eng.) to 29-9-52). M. Snipper, L.D.S., R.C.S. (Eng.) (to 18-6-52). E. M. Sycamore. L.D.S., R.C.S. (Eng.). W. Ahluwalia, B.Sc., L.D.S., R.C.S. (from 13-10-52 to 31-12-52). R. J. Newman, L.D.S., R.C.S. (from 19-2-53). S. Samuel, L.D.S.. R.C.S. (from 14-1-53 to 18-3-53). J. T. Hutchins (from 11-3-53). 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, 1953. 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 1952. The health indices of the borough have maintained their satisfactory level. The rise in the Infant Mortality Rate reported last year (21.04 deaths per 1,000 live births) has not persisted, but the rate has fallen to 18.94, the second best so far recorded. The death rate for 1952 was 10 13 per 1,000 of the population, an improvement from 10.32 the previous year, this in spite of the larger proportion of old people amongst us and the severe fog last December. There was no serious epidemic. Poliomyelitis notifications were 15, with one death, and measles reached a very high figure with 3,166 notifications with, however, only two deaths (there were 6 fatal road accidents and 13 other accidents that led to death). The birth rate, however, did not maintain last year's improvement and fell from 13.36 to 13.02. Attention is drawn to the special reports in this issue by the Social Worker for the Aged (page 19), Senior Dental Surgeon (page 66), Ophthalmologists (page 70) the Orthoptist is now at work. Orthopaedic Surgeon (page 71), Ear Nose and Throat Surgeon (page 74) a commencement was made with tonsillectomy operations at the Isolation Hospital; Psychiatrist (page 82) the full sessions are now implemented the medical officer in charge of the Enuresis Clinic (page 85), and a report on Home Safety (page 45). My own report on Local Government follows, and is the reason for this short preface. In conclusion. I wish again to express my thanks for the continued efficiency and loyalty of the staff in all sections of the Public Health Department. I would also mention the kind co-operation and assistance received from the officers and members of other Departments of the Corporation, llford is probably unique in the extent of the help given by the Ilford Federation of Voluntary Welfare Workers and to them, and to the Women's Voluntary Services, and the Ilford Social Service Association, I wish to express my appreciation of their help during the past year. Finally, may 1 express my gratitude to the members of the Council, especially to 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. I have the honour to be Your obedient servant, I. GORDON, Medical Officer of Health. 8 CONURBATION CHAOS Greater London is divided up into local authorities, but one may not realise this when one considers the local administrative areas that are chosen to run their services by many bodies including, one may remark, some of the larger local authorities. There is a tendancy for an authority or its officer to declare with much pride that they or he do not take cognizance of local authority boundaries when arranging to administer their functions. They soon find, however, that if they do not delimit their areas, these will stretch from the North Sea to the Bristol Channel; so, in a great hurry, limits are drawn. However, by not believing in local authority boundaries, these limits may be made to cut across communities, communities may be left out of the reckoning, and many other inconsistencies arise. Lest it should be thought that I am exaggerating, I will draw attention to the struggle that was required to persuade medical superintendents of hospitals dealing with the chronic sick that Ilford, which previously used beds in Essex County Council institutions, required any accommodation for the aged sick whatsoever, when these superintendents set about arranging their catchment areas. Let us begin with the Post Office. Granted Ilford Parish was once a small attachment to Barking, but I am not sure that the postal authorities yet realise that this arrangement has come to an end, for the greater part of Ilford is in the Ilford and Barking Postal District. Outside this area in Ilford the most amazing inconsistencies exist. For instance, Chadwell Heath, Romford may be either in the Ilford or Dagenham Boroughs but the postal address would be Romford and part of llford has the postal address of Dagenham (in the Romford Postal District). Lest there be any jealousy, part of the borough of Dagenham is in the Ilford and Barking Postal District. A part of North Ilford also comes under the Woodford Green office. Most people will assume, with some justification, that Ilford, Dagenham and Romford are separate boroughs That letters and packages correctly addressed are efficiently sorted and delivered I have no doubt; the difficulty lies in the mind of the public, who obstinately consider that somebody living in Ilford has an address there, and not a Dagenham one, so letters are incorrectly addressed and therefore delayed. Letters and notifications from hospitals and doctors dealing with disease, which may require urgent action, are repeatedly sent to the Medical Officer of Health of the borough according to the postal address; this means of course that the Medical Officer of Health of Ilford gets correspondence meant for the Medical Officer of Health of Dagenham, and vice versa. The Metropolitan Police, in more ways than one, are a law unto themselves. South Ilford is in K Division, with headquarters in East Ham; North Ilford is in J. Division and its headquarters are in Hackney; both of these divisions contain fragments of other local authorities. J Division specialises in this. An old map shows that it once included parts of 5 metropolitan boroughs, part of one county borough, parts of 5 municipal boroughs, part of one urban district, and not one whole authority. It has now been reorganised to include parts of 3 metropolitan boroughs, parts of 2 county boroughs, parts of 2 municipal boroughs, 4 whole municipal boroughs and 2 whole urban districts, a definite indication of progress. The Coroner and his pathologist are so accustomed to dissections that they have dissected Ilford. Inquests on deaths north of Eastern Avenue except King George Hospital are held at Walthamstow; those south of Eastern Avenue, including King George Hospital, at East Ham. The mortuary in Ilford, with which we have taken so much trouble, takes bodies at the moment from South Ilford. East Ham. Barking and Dagenham, but those from North Ilford go to Walthamstow. The medical officer of health is vitally interested in investigations carried out in these premises and should not be subject to these directions from the coroner. The National Assistance Board with whom we should closely work as we are both interested in the welfare of old people, combine South Ilford with Barking and Goodmayes Ward with Dagenham. However, 9 they cannot compete with H.M. Inspectors of Taxes who combine North Ilford with Barking and South Ilford with Dagenham. One would hope that Essex County Council as a local authority would respect local authority boundaries. This hope is vain. The Children's Officer has divided Ilford up into three parts and each of the three officers dealing with each part is also concerned with adjacent authorities, South Ilford with Barking, Central and East llford with Walthamstow, and the rest with Chigwell and Waltham Holy Cross. This does not make for easy collaboration. The borough is of course divided up between the Metropolitan Water Board which serves the western part, and the South Essex Water Works Company who deal with the east. We have in the past had a map of supply areas from the one which did not agree with that provided by the other. So far 1 have considered authorities that have cut up the borough. The other way of introducing confusion is the random association of the borough with other authorities as may suit the wisdom or whim of the administration concerned. For instance, Beacontree Petty Sessions covers Ilford, Dagenham, Walthamstow. Leyton, Woodford and Barking. Ilford County Court, however, covers Ilford, Romford, Dagenham, Barking, Hornchurch, part of Rainham. Chigwell and Stapleford Abbots. The Factory Inspectors cover Southend, Barking. Dagenham, Ilford. Chelmsford, Maldon, Romford, Brentwood, Hornchurch, Thurrock. Billericay, Rayleigh, Purfleet, Canvey Island. Burnham and the rural districts of Maldon, Rochford and Chelmsford. The Rent Tribunal, however, prefers Barking, East Ham, Ilford and West Ham. Again. Essex County Council are not very helpful; the Welfare Department merely puts Ilford in the southern area of the county, and the local work is carried out from an office in Romford and no one individual's duties are confined to any particular district. (Like the children's officer, the welfare officer is a visitor whom we would like to know and co-operate with.) The County Council are to be congratulated in that, unlike as appertains in some other parts of the country, the Health Areas coincide with the Education Divisions, thus making possible continuity of supervision of handicapped children; as plans are now being made for supervision of adult handicapped, one would wish that the welfare areas also corresponded and allowed for utilization of the experience of the staff of the Divisional Executive. District Nursing is managed from headquarters in Leyton with a sub-office in Barking which covers Ilford south of the High Road. For the mental deficiency aspect of mental health, Ilford and Barking are jointly managed from an office in Romford, and for some aspects of mental health from the same office in Romford the boroughs of Romford and Dagenham are included. For the Care and After-Care of patients from mental hospitals and psychiatric clinics that part of Essex in the area of the Metropolitan Police District (excepting of course East and West Ham) is in the province of an officer in Walthamstow. It is a pleasure to have to record that changes can sometimes be made in these areas if sufficient representations are made. The plan for Child Guidance (under the Essex Education Committee) was to join Ilford and Romford, although these boroughs are separated by another and the Child Guidance Clinic is almost on the Ilford/Barking boundary, and Ilford and Barking are joined for the purpose of mental health (under the Essex Health Committee). This has now been satisfactorily altered. The London Electricity Board from its service centre in Ilford and branches, covers the borough of Ilford; so does the Valuation (Rating) office of the Inland Revenue; this breath of logic is understandable as once Ilford itself ran these offices. Small wonder that the great voluntary societies have difficulties in adapting themselves. The British Red Cross Society and the St. John Ambulance Brigade each have their Ilford Divisions, but the Ilford Division of the British Red Cross Society is under the County Director for the 10 administrative county of Essex whereas the Ilford Division of the St. John Ambulance Brigade is in the London District which covers the Metropolitan Police area. Perhaps this arrangement may reflect their differing outlooks. Another voluntary body, the British Medical Association, covers in its local division East Ham, West Ham, Barking and Ilford, except for Claybury Hospital. The statutory body that represents the interests of the local doctors is the Local Medical Committee which, in spite of the adjective local, covers the administrative county of Essex, i.e., excludes East Ham and West Ham (and Southend); no arrangement seems officially to take cognizance of the fact that co-operation should take place locally in Ilford between the medical officer of health and the doctors. The Ilford and Barking Hospital Management Committee, although it has no official catchment area, has an administrative area which includes, besides Ilford and Barking, part of Dagenham but excludes part of North Ilford. Catchment areas and administration for mental deficiency hospitals are quite different from those of general hospitals and mental hospitals; none are related to local authority health areas, or local authority mental health areas or general medical service areas (i.e., general practitioners). People state you can prove anything by statistics, and so you can, if you manipulate your statistics wrongly, or your source is incorrect; but not otherwise. The Ministry of National Insurance by means of new claims for sickness benefit can give useful information as to the course of a widespread epidemic, such as influenza. For some time past they have been helpful to many authorities in this matter and send us weekly returns (7 to 14 days late, as the information must first go to Chelmsford in the case of Essex). On the weekly return figures are listed for North and South Ilford, and we have faithfully plotted these figures on a graph for some time, imagining that they did refer to North and South Ilford. Since this present investigation started, I have found out that although there are three offices of the Ministry in Ilford. the figures for North Ilford include part of Chigwell, South Ilford includes part of East Ham and Dagenham, and part of South Ilford. i.e.. Goodmayes and Mayfield Wards, are not in the Ilford statistics at all, but appear, with parts of Dagenham and Barking, as Becontree. The Ministry of Health are doubtless impressed with the statistics given to them by the local health authority, i.e.. Essex, with respect to diphtheria immunisation, but do they consider to what community, if any. the statistics refer? Barking and Billericay are all there, in one big pudding, although socially and economically they are oceans apart. Comparisons of, say, the causes of death in different communities, by age and sex, can be very helpful to medical officers of health and others. However, as in Table 20 (and others) of the Registrar General's Statistical Review of England and Wales (1951) we have these figures for metropolitan boroughs and county boroughs and they are not given for other communities, but only as urban and rural aggregates made for each county. That is, we can compare East Ham with Finsbury, but not Ilford with Harrow (each of the latter is much larger than each of the former and quite as important). There are many other functions that I have not mentioned, such as Telephones, Gas, Transport (if local authorities had more say in London Transport the allegations made in the House of Commons with respect to lack of co-ordination in planning the Central London Line could not have been made), Ministry of Pensions, that would make confusion worse confounded in this administrative jungle. I would like to congratulate my staff who have carried out the investigations from which these details are derived. They have met co-operation, some indifference and a little hostility, and a large amount of ignorance from officials who sometimes seemed to think that it was an impertinence for Ilford to find out how Ilford was managed. These details are the result of what can only be termed a battle of wits, largely successful, but with some gaps that even our utmost persistence has been unable to fill. 11 SECTION A. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in Acres) Land 8,402 Inland Water 26 Tidal Water 7 8,435 Population (Census 1921) 85,194 (Census 1931) 131,061 „ (Census 1951) (provisional figure) 184,707 Registrar-General's Estimate of resident Population: — June 30th, 1949 185,000 „ „ 1950 186,200 „ „ 1951 181,600 „ „ 1952 182,200 Number of inhabited houses (end of 1952) according to Rate Books (approx.) 51,148 Rateable Value—April 1st, 1952 (Houses and Land) £1,665,208 Sum represented by a penny rate, April 1st, 1952 (approx.) £6,780 Education Rate— 1951-52 1952-53 (E.C.C.) 8s. 0.19d. 8s. 4.52d. in the £ in the £ Combined Rate (all services) 20s. 0d. 20s. 6d. in the £ in the £ The following figures as to unemployment were supplied by the Ministry of Labour:— Males Females As at January, 1952 607 246 As at January, 1953 711 232 Total M. F. 1952 1951 Live Births Legitimate 2,232 1,180 1,052 Birth Rate per 1,000 of the estimated net resident population. 13,02 13.36 Illegitimate 91 41 50 Still Births 51 24 27 Rate per 1,000 total (live and still) births. 21.48 24.63 Deaths 1,809 943 866 Death Rate per 1,000 of the estimated net resident population. 10.13 10.32 Percentage of total deaths occurring in public institutions 38.71 40.58 12 Maternal mortality (heading 30 of the Registrar-General's Short List): — No. of Deaths. Rate per 1,000 total (live and still) births. 1952 1951 1952 1951 Pregnancy, childbirth and abortion 1 0 0.42 0.0 Death-rate of Infants under one year of age:— 1952 1951 All infants per 1,000 live births 18.94 21.04 Legitimate infants per 1,000 legitimate live births 19.71 21.24 Illegitimate infants per 1,000 illegitimate live births 0.00 14.28 Deaths from, Cancer (all ages) 365 357 „ „ Measles (all ages) 2 1 „ „ Whooping Cough (all ages) — 2 „ „ Diarrhœa (under 2 years of age) 1 — 1. Rainfall Total rainfall registered in the district during the year was 23.31 inches; the greatest fall in 24 hours was registered on 4th May, 1.05 inches. November was the wettest month. 2. Population. The number of patients and resident staff on the 30th June, 1952, at the following public institutions, was:— Claybury Hospital 2,403 Goodmayes Hospital 1,365 Australasian Hospital (Dr. Barnardo's Homes) 85 Total 3,853 3. Births. The number of births registered during the year was 2,323, Males Females Legitimate 1,180 1,052 Illegitimate 41 50 i.e., 3.9 per cent. of the births registered were illegitimate. The percentage of illegitimate births registered in the previous 10 years was 2.9 (1951); 3.1; 2. 4; 3.2; 3.3; 3.1; 5.5; 4.2; 3.4; 3.5. The birth-rate, calculated on the net estimate of the population is 13.02 per 1,000. 4. Deaths. The total number of deaths of Ilford residents was 1,809. This is obtained by taking the total number of deaths registered in the district (1,728), subtracting the deaths of non-residents occurring in the district (431), and adding the deaths of Ilford residents registered as having died in other districts (512). The number of deaths of non-residents registered in the district (principally in large institutions) was as follows: — Claybury Hospital 191 Goodmayes Hospital 64 King George Hospital 100 Ilford Isolation Hospital and Sanatorium 33 Other Non-residents 43 Total 431 18 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 74 Warley Hospital, Brentwood 7 Wanstead Hospital 23 Queen Mary's Hospital, West Ham 3 Hospital for Sick Children, Great Ormond Street 1 London Hospital 53 St. Bartholomew's Hospital 10 Rush Green Hospital 13 Westminster Hospital 7 St. Joseph's Hospice, Hackney 17 Severalls Mental Hospital, Colchester 3 East Ham Memorial Hospital 2 Langthorne Hospital 21 Whipps Cross Hospital 34 St. Luke's Hospital 3 London Chest Hospital 1 In other Hospitals, Institutions and residences outside the Ilford district 240 Total 512 The death rate, calculated on the net estimate of the population of 178,432 is 10.13 per 1,000. Inquests.—During the year, 49 inquests were held on deaths occurring in Ilford, 24 on Ilford residents, and 25 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 1 1 1 13 9 23 Death-Rates from Tuberculosis and Cancer, 1952. The following Table shows the death-rates for 1952 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 Registrar-General: — Ilford England and Wales Respiratory Tuberculosis .106 .212 Other Tuberculosis 0.11 .028 Cancer 2.045 1.993 5. Marriages.—1,619 marriages took place in the Ilford district during 1952, 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 1a 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 1952, arranged according to the age groups at which deaths occurred. TABLE I.—Vital Statistics of Whole District During 1952 and Previous Years Year Gross population, estimated to middle of each Year Net Population estimated to middle of each Year Births Total Deaths Registered in the District Transferable Deaths Net Deaths Belonging to the District Uncorrected Number Net (6) of Non-Residents registered in the District of Residents not registered in the District Under 1 year of Age At all Ages Number Rate (c) Number Rate (d) Number Rate per 1,000 Net Births Number Rate (e) 1 2 2 a 3 4 5 6 7 8 9 10 11 12 13 1948 183,400 179,637 2,239 2,848 15.8 1,351 7.3 260 427 62 21.7 1,518 8.4 1949 185,000 181,108 2,027 2,630 14.5 1,646 8.9 402 484 53 20.1 1,728 9.5 1950 186,200 182,317 1,933 2,406 13.2 1,707 9.2 455 511 45 18.7 1,763 9.7 1951 181,600 177,811 1,677 2,376 13.3 1,789 9.9 483 529 50 21.0 1,835 10.3 1952 182,200 178,432 1,830 2,323 13.0 1,728 9.4 431 512 44 18.9 1,809 10.1 (а) The net estimated population is found by deducting the population of Claybury and Goodmayes Hospitals from the gross estimated population. The population of Dr. Barnardo's Girls' Village Homes is included in the net estimated population of the district. (b) The net number of births is obtained by taking the uncorrected number of births supplied by the local Registrar and adding to or subtracting from it such a number as is supplied for this purpose by the Registrar-General. (c) and (e) Calculated on the estimated net population. (d) Calculated on the estimated gross population. 14 TABLE Ia Table showing comparison between the Birth-rate, Death-rate, etc., of Ilford, other Towns, and of England and Wales for the Year 1952 (Provisional figures) Rate per 1,000 Total Home Population Death-rate per 1,000 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 Polioenceph- alitis Diarrhoea and Enteritis (under 2 Yrs.) Total Deaths under 1 Year Live Births Stillbirths England and Wales 15.3 0.35 22.6(a) 11.3 0.00 0.00 0.24 0.47 0.00 0.00 0.04 0.01 1.1 27.6(b) 160 County Boroughs and Great Towns, including London 16.9 0.43 24.6(a) 12.1 0.00 - 0.28 0.52 0.00 0.00 0.04 0.01 1.3 31.2 160 Smaller Towns (Estimated Resident Populations 25,000 to 50,000 at Census 1951) 15.5 0.36 23.0(a) 11.2 0.00 - 0.22 0.43 0.00 0.00 0.04 0.00 0.5 25.8 London Administrative County 17.6 0.34 19.2(a) 12.6 — — 0.31 0.58 0.00 0.00 0.05 0.01 0.7 23.8 ILFORD (Estimated Gross Population, mid 1952=182,200) 12.7 0.28 21.4(a) 9.9 - - 0.11 0.29 - - 0.02 0.00 0.4 18.94 (a) Per 1,000 total (Live and Still Births). A dash (—) signifies that there were no deaths. (b) Per 1,000 related Live Births. 16 Registrar-General's Short List of Deaths and Causes: TABLE II Causes of, and Ages at, Death during the year 1952 Net Deaths at the subjoined ages of "Residents" whether occurring within or without the district CAUSES OF DEATH 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 1809 44 3 6 10 15 32 47 174 296 461 721 1 Tuberculosis, respiratory 19 - - - — 1 5 2 2 4 4 1 2 Tuberculosis, other 2 - - - - - - 1 — — — 1 3 Syphilitic disease 9 - - - - - - - — 4 4 1 4 Diphtheria — — — — — — — — — — — — 5 Whooping cough — — — — — — — — — — — — 6 Meningococcal infections 1 — — 1 — — — — — — — — 7 Acute poliomyelitis 1 - - - - 1 - - - - - 8 Measles 2 — — 1 — 1 — — — — — — 9 Other infective and parasitic diseases 4 - - - - - - - 2 1 1 - 10 Malignant neoplasm, stomach 59 - - - - - - 3 11 10 22 13 11 Malignant neoplasm, lung, bronchus 64 - - - - - 1 3 13 24 17 6 12 Malignant neoplasm, breast 40 - - - - - 1 6 9 13 7 4 13 Malignant neoplasm, uterus 14 - - - - - - 1 3 4 4 2 14 Other malignant and lymphatic neoplasms 188 - - 1 1 2 6 4 28 38 47 61 15 Leukaemia, aleukaemia 9 — — 1 1 — — — 2 1 3 1 16 Diabetes 18 - - - - - 1 - 2 4 5 6 17 Vascular lesions of nervous system 230 - - - - 1 1 5 10 30 65 118 18 Coronary disease, angina 280 - - - - - 1 4 37 60 101 77 19 Hypertension with heart disease 37 - - - - - 1 - 1 4 11 20 20 Other heart disease 292 — — — 1 1 3 4 12 20 46 206 21 Other circulatory disease 89 — — — — — — 1 5 11 28 44 22 Influenza 5 — — 1 — — — 1 — 1 — 2 23 Pneumonia 53 6 — — 1 — 1 - 1 8 11 25 24 Bronchitis 131 - - - - - - - 8 23 41 59 25 Other diseases of respiratory system 9 - - - - - 1 1 - 3 1 3 26 Ulcer of stomach and duodenum 28 - - - - - - 2 3 6 8 9 27 Gastritis, enteritis and diarrhoea 6 1 - - - - 1 1 1 1 1 - 28 Nephritis and nephrosis 14 — — — — — 1 1 7 2 1 2 29 Hyperplasia of prostate 23 — — — — — — — — 2 9 12 30 Pregnancy, childbirth, abortion 1 - - - - - 1 - - - - - 31 Congenital malformations 17 8 1 1 2 2 — 1 2 — — — 32 Other defined and ill-defined diseases 132 29 1 - 3 3 3 2 11 17 21 42 33 Motor vehicle accidents 6 — — — 1 1 — — 1 — 2 1 34 All other accidents 13 - 1 - - 1 - 2 2 3 1 3 35 Suicide 12 - — — — 1 3 2 1 2 1 2 36 Homicide and operations of war 1 - - - - - 1 — - — — - Special Causes (included above) Smallpox - - - - - - - - - - - - 17 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. 1. (i) Public Health Officers of the Authority.—Vide list at the beginning of this report. (ii) Home Nursing.—This service is administered by the Essex County Council. A report of the work performed during 1952 will be found in Part III Services section. (iii) Laboratory Facilities.—Pathological specimens are now sent to the Bacteriological Laboratory, Oldchurch Hospital, Romford, for examination. (iv) 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 lodgings or occupied by members of more than one family. (Sec. 84, Ilford Act, 1937.) Slaughterhouses 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, or 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 1952 twenty-five applications for renewal of licences were received The Council renewed the licences in respect of these establishments. Two new applications were received, which were granted. The licences expire on 31st March of each year. Part VI.—Hairdressers' and Barbers' Premises. During 1952, 33 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 168 inspections were made, 5 Preliminary Notices were served, 3 of which were complied with. No Certificates of Exemption from the provisions of Section 38 were granted in 1952. There are three local Acts in operation—(1) The Ilford Improvement Act. 1898. which has important sanitary provisions: (2) The Ilford Urban District Council Act, 1904. the Section which deals with the control of tuberculosis is repealed, the powers of the Corporation now being contained in the Food and Drugs Act, 1938; and (3) The Ilford Corporation Act, 1937. 18 Nurses Act, 1943 (Part 2). Nurses' Agencies. The Essex County Council on application by the llford Council, delegated to them, in pursuance of Section 11 (1) the powers conferred 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 1952. (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. The following statistics show the extent to which the main services provided by the County Welfare Committee under the National Assistance Act, 1948, have been afforded to persons residing within the Borough of Ilford during the year 1952:— (1) Residential and Temporary Accommodation. (a) Aged persons (including blind persons) admitted to hostels and other residential establishments:—39. (b) Other classes (admitted to temporary accommodation):— Adults 9, Children 1f.—20. (2) Blind Persons. The numbers of registered blind, partially sighted and defective sighted persons resident in the Borough during the twelve months ended 31st December, 1952, were as follows:— (i) Registered as blind 240 (ii) Partially sighted 42 (iii) Defective sighted 11 all of whom were under the supervision of Home Teachers and 7 participated in the Home Workers' Scheme operated through the agency of the London Society for the Blind. In addition, 1 blind person was employed in the Workshops for the Blind and during the year 3 were placed in employment (open industry), the total number of Ilford residents so employed being 32 (9 partially sighted). National Assistance Act, 1948. (a) Section 47. One person was dealt with under this section during the year. This related to a woman of 86 years, living in one room. She was found to be in a dirty condition in her person and the room was insanitary. (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. The burial of three persons was dealt with during the year. They were:— (1) A male, 69 years, patient in a nursing home. (2) A male, 69 years, lived in lodgings. (3) A male, 73 years, knocked down by car in highway. 10 Miss E. A. Workman, the Welfare Officer for Old People, commenced her employment on April 15th, 1952. She reports as follows:— "The duties include not only the welfare of aged individuals who require assistance, but also co-operation with all other institutions and workers, both statutory and voluntary, who are concerned with the problem of old age. The former include hospitals, welfare departments, mental health workers, home teachers for the blind, sanitary inspectors, home nurses and domestic-help service; the latter, old age pensioners' clubs, Women's Voluntary Service, Old People's Welfare Committee, Ilford Social Service Association, and Patients' League. "The main aim of all work with the aged must be to preserve an active normal life at home as long as possible. This can be attempted by communal provision for their needs as is the case with the domestic-help service, which is particularly valuable, or by attempts to promote more satisfactory personal relationships. In the latter case the emphasis is on the individual and the Welfare Officer has to make contact with relatives, friends, neighbours, doctors, etc. "During this period of 8½ months, 465 persons aged 65 and over were dealt with. Of these 53 persons entered hospital, 30 were admitted to Homes (eleven to those administered by the Essex County Council, and 19 to private Homes), and 382 remained in their own homes. "Of these 465 persons, 64 died during the year, 48 at home, 14 in hospital and 2 in nursing homes. "A total of 569 visits was made by the Welfare Officer to these 465 cases. In addition to the 569 visits, 417 visits were paid to and interviews given at the Public Health Offices and elsewhere with relatives, friends and officers of the various voluntary and statutory bodies. "The problem of the nursing of chronic sick cases remains most difficult, and to ease this burden a special laundry service was inaugurated to deal with soiled articles. The admission to hospital of such cases is still a matter of some concern. "It is also becoming increasingly difficult to secure the admission to Homes of fairly active aged persons. There are also borderline cases, and cases of senile dementia, who are not clearly the responsibility of an;, authority. "An attempt is being made to ascertain some facts concerning the problem of old age in Ilford. For this reason a pilot survey was undertaken of the Clayhall Ward as a preliminary to a general survey of the whole Borough. A total of 498 visits was made resulting in 36 interviews of people aged 65 and over. This work was carried out with the assistance of the Women's Voluntary Service. "In addition visits were made by the Welfare Officer to a number of hospitals, to Old People's Flats and Clubs, to Finsbury Settlement and Iselden House. Laundry for the Aged Chronic Sick. "With the co-operation of the Ilford and Barking Group Hospital Management Committee, a free laundry service was introduced by the Council for the cleansing of bed linen and personal clothing of chronic sick aged persons who are incontinent. "Articles which are certified by the Sanitary Inspector under Section 84 of the Public Health Act. 1936, as requiring cleansing are laundered at Barking Hospital, transport being provided and laundry costs paid by the Ilford Borough Council. 20 "The service commenced on 8th December for a trial period of three months and by the end of December 8 persons had been assisted and 167 articles laundered." (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 1952. 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 1,269 patients (males 581, females 688), and Claybury Hospital, with 2,204 patients (males 928, females 1,276) in residence on 30th June, T952. (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 90 beds in the Hospital on 30th June, 1952. Maternity and Nursing Homes.—There are 4 private registered Nursing Homes in the distrirt for medical and senile cases. All Nursing Homes in the district are visited by the Medical Officer of Health and the Chief Sanitary Inspector (or their deputies) quarterly and at other times when necessary. (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. 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. 21 (viii) Clinics and Treatment Centres: Maternity and Child Welfare.—Infant Welfare Centres are held at the following premises: — Chadwell Christian Mission Hall, Essex Road, Chadwell Heath (for residents of Chadwell Heath area) Monday, 2 p.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 the Ilford portion of L.C.C. estate) 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 east side of Cranbrook Road) Wednesday, 2 p.m. Cecil Hall, Granville Road, Ilford (for residents of the west side of Cranbrook Road) Thursday, 2 p.m. Seven Kings Methodist Church Hall, Seven Kings Road (for residents of Seven Kings area) Wednesday, 2 p.m. Newbury Hall, Perryman's Farm Road, Newbury Park (for residents of the Newbury Park area) Thursday, 2 p.m. Vine Memorial Church Hall, Grosvenor Road, Ilford (for residents of Grosvenor Road area) Thursday, 2 p.m. Mayesbrook Clinic (for residents of Goodmayes area) Thursday, 2 p.m. Methodist Church Hall, Fremantle Road, Barkingside (for residents of Barkingside and Fairlop areas) 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 on alternate Wednesday afternoons; at Manford Way Clinic on alternate Thursday afternoons. 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. SchooJ and other Clinics.—Clinic sessions are held at Health Services Clinics as under:— 22 (i) Public Health Offices, Valentines Mansion for— Diphtheria and Whooping Cough Immunization. Aural. Ophthalmic treatment. Paediatric. Infant Welfare. Midwives 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 and Whooping Cough Immunization. Orthopaedic and Remedial Exercises treatment. Infant Welfare. Speech Therapy. Midwives Ante-Natal. Orthoptic. (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 Weffare. Diphtheria and Whooping Cough Immunization. Midwives Ante-Natal. Dental (Children only). Ophthalmic treatment. Orthopaedic treatment. (ix) Chest Clinic.—A clinic for the diagnosis and treatment 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 Refill Clinic is held on Monday morning and on Thursday afternoon. 23 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 1,393 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 Jested bacteriologically. The water is not plumbo-solvent. The length of mains laid by the Metropolitan Water Board in Ilford during 1952 was 515 yards of 4-inch and 229 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. Mains were extended by 453 yards, 4-inch size, 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. 7 samples of piped water supply (5 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: Further representations were made to the Ministry of Housing and Local Government, as a result of which an Inspector of that Ministry held a Private Inquiry, and a meeting took place at the Ministry's Offices. In a letter dated 10th December, 1952, the Council were advised that tenders could be obtained immediately for the construction of a storm relief sewer in Henley Road from Sunnyside Road to the River Roding and for an experimental length of soil sewer at the northern end of Horns Road; also that details could be prepared and submitted of the scheme to culvert the Mayes Brook from a point just north of Eastern Avenue to just south of the Ilford/Barking Borough Boundary, this scheme having been raised in priority consequent upon the impending development of the Marks Gate Estate in Dagenham and Ilford, the provisional starting date being the end of 1953. The details 24 of the new soil sewage pumping station in Roden Street and of the enlarged soil and surface water sewers in Sunnyside Road could also be prepared, a starting date in 1954-55 being envisaged. (b) Ilford and Barking Joint Sewerage Committee: Loan sanction has been granted and a contract let for the provision of new detritus handling plant at the Joint Pumping Station. Designs for a building to give protection to the plant are in hand. Flooding of Streams. No serious flooding of streams occurred during the year. Pollution of Streams. There was no serious instance of pollution of watercourses during the year. As from 1st October, 1952, the functions relating to the prevention of river pollution were transferred, under the provisions of the River Boards Act, 1948, to the newly formed Essex River Board. The Board made a request that, pending the creation of its own technical organisation, the Ilford Council would continue to act on behalf of the Board in connection with matters relating to pollution of rivers and streams, on an agency basis. The Council acceded to the request and, in 1952, investigation was made in one instance of alleged pollution of the River Roding. A sample of the River water was submitted to the Analyst and the report forwarded to the Board. (iii) Collection and Disposal of Refuse.—The Borough Engineer also kindly supplied the following information:— Tons Total amount of refuse collected and disposed of 46,298 Collection of Salvage:— Tons Income Wastepaper 1,247 £13,704 Kitchen Waste 1,708 £5,493 Scrap Metal, etc. 30 £861 2,985 £20,058 (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 30,741 Houses and premises reinspected (work in progress) 23,520 Visits during disinfection 599 Houses in which nuisances were detected 1,359 Houses in which nuisances were abated 1,418* Premises disinfected 487 Premises from which articles only disinfected 161 Articles disinfected 785 Premises disinfested for verminous conditions 24 * Includes 349 nuisances detected before 1st January, 1952. 25 Notices served:— Statutory: — Served Complied with Public Health Act, 1936 111 65 Housing Act, 1936 5 4 Factories Act, 1937 3 1 Shops Act. 1934 — — Provide Dustbin (Ilford Urban District Council Act, 1904) 62 49 Food and Drugs Act, 1938 14 11 Cleanse Water Storage Cistern (Byelaws) 2 1 Cover Water Storage Cistern (Byelaws) 3 3 Informal 1,558 1,234 1,758 1,368 "In addition to the above, 517 notices (77 statutory and 440 informal) served previous to 1st January, 1952, were also complied with. Complaints.—During the year, 3,034 complaints of nuisances were received and investigated. The following is a summary:— Accumulation of manure and refuse 58 Animals improperly kept 14 Bad smells 60 Dampness of premises 90 Defective drains, w.c.'s and fittings 347 Defective roofs, gutters, downpipes, etc. 96 Defective water fittings 72 Dirty and verminous houses 33 Dirty condition of rearway — Flooding of premises 14 Overcrowding 133 Smoke nuisances 28 Defective or no provision of dustbin 1,090 Rats and mice 371 Miscellaneous 628 Total 3,034 (v) Swimming Baths and Pools.—Samples of water for examination were taken from the open-air swimming bath from April to October (7). The samples were satisfactory, but in 2 samples the chlorine content was above, and in 2 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 November (16); all of the samples were satisfactory, but in 14 samples (6 from the 1st and 8 from the 2nd class) the chlorine content was above the prescribed standard. (vi) Eradication of Bed Bugs:— Houses found to be infested 25 „ Disinfested 25* (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. 26 No certificates were issued during 1952. (ix) Rag, Flock and other Filling Materials Act, 1951.—This Act, which came into operation on 1st November, 1951, and repealed the Rag Flock 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 has been granted in respect of 14 premises. 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. One licence was granted in 1952. 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 6 factories in the Ilford Lane, Green Lane, Grove Road and Newbury Park areas. Regular observations were maintained and investigations carried out. In 3 instances no emission was noted which would have enabled action to be taken under the Public Health Act, 1936, but informaf notices were served in the other 3 instances. (xi) Public Health Act, 1936.—Section 154.—One instance was reported in 1952, of a person exchanging articles for rags received from children under the age of 14 years, in contravention of the Public Health Act, 1936. (xii) Land Charges Act, 1925.—During the year 3,392 enquiries were dealt with under this act. (xiii) Under Section 25 of the Burial Act, 1857, one exhumation licence was issued by H.M. Home Office. An officer of the Public Health Department was present to ensure that the conditions of the licence with regard to due care, attention to decenly, liming, etc., were satisfactorily complied with. (xiv) Squatters.—A sanitary nuisance arose following the occupation of a hutted camp site at Woodford Bridge Road by squatters. Preliminary notices under the Public Health Act, 1936, were served upon the respective families requiring them to vacate the huts in order to abate the sanitary nuisance. 27 With a view to the protection of public health and pending the eviction of the squatters from the site, the Council decided to provide refuse and sanitary receptacles and for the collection of refuse, faecal matter and waste materials and for the cleansing of receptacles. Negotiations were entered into with the Essex County Council, the owners of the land, for steps to be taken to secure the eviction of the squatters and the huts were finally vacated early in 1953. Forcible eviction was not necessary. SECTION D.—HOUSING. (i) Overcrowding.—Two notices were served during 1952 and both were complied with. (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) 2,434 (b) Number of inspections made for the purpose 14,229 (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 353 (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 1,359 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 Loca.l Authority or their officers 1,227* 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 5 (2) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) By owners 7* (b) By local authority in default of owners 1* b. Proceedings under Public Health Acts:— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 178 28 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: — (a) By owners 181* (b) By local authority in default of owners 2* C. No proceedings were taken under Sections 11, 12 and 13 of the Housing Act, 1936. 4. Housing Act, 1936, Part IV—Overcrowding: — (a) (i) Number of dwellings overcrowded at the end of the year 278 (ii) Number of families dwelling therein 373 (iii) Number of persons dwelling therein l,002½ (b) Number of new cases of overcrowding reported during the year 90 (c) (i) Number of cases of overcrowding relieved during the year 119 (ii) Number of units concerned in such cases 443½ (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 1952 of Notices served prior to 1st January, 1952. HOUSING ACT, 1936. During the year 1952 the work of receiving applications, calling for calculations for the "permitted number" was continued with a view to the issue of housing certificates. 21 certificates, in respect of 21 houses, were issued during the year, making a total of 18,291 certificates, in respect of 25,072 houses, issued to the end of 1952. As new premises were constructed and placed upon the rating lists. " permitted number " certificates were issued as required. 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. 29 (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, 1952:— Persons registered as distributors of milk 105 Premises registered as dairy premises (other than dairy farms) 13 251 inspections of dairy premises were carried out during the year. (ii) Milk (Special Designation) (Raw Milk) Regulations, 1949:— The following licences were granted during 1952:— Accredited Nil do. (Supplementary) Nil Tuberculin Tested 36 do. (Supplementary) 8 (iii) Milk (Special Designation) (Pasteurised and Sterilized Milk) Regulations, 1949. The following licences were granted during 1952:— Pasteurized (Dealer's) 63 do. do. (Supplementary) 9 do. (Pasteurizer's) 2 Sterilized (Dealer's) 73 do. do. (Supplementary) 12 do. (Sterilizer's) 1 Two licences, granted by the Essex County Agricultural Executive Committee, in respect of the production of Tuberculin Tested and Accredited milk at farms in the Borough, are also 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. 80 The following results were obtained:— Grade of Milk Total Satisfactory Unsatisfactory Remarks on unsatisfactory results Tuberculin Tested Milk 6 6 - - Tuberculin Tested (Pasteurized) Milk 24 24 — — Tuberculin Tested Milk (Farm bottled) 17 17 - - Accredited 6 6 — — Pasteurized Milk 103 101 2 Both samples failed to satisfy the Methylene Blue Reduction test. The retailer was communicated with and re-sampling ordered at a later date. Further samples proved satisfactory. Sterilized 33 33 — — (v) Biological Tests.—23 samples of milk were submitted to a biological test for tuberculosis, all of which were found negative. (vi) Milk and Dairies Orders, 1926 and 1938: Inspection of Dairy Herds.—Four inspections were made by the Veterinary Officers of the Ministry of Agriculture and Fisheries. The Ministry's Divisional Inspector states that no cows were found to be suffering from tuberculosis. (vii) Legal Proceedings.—17 complaints of the presence of foreign bodies in milk were received and investigated. No legal proceedings were taken, but a warning was sent in one case and representations were made to the retailers in all other cases. (viii) Registration.—No application for registration was refused during the year. 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. 35 applications for registration in respect of 35 premises were considered during the year 1952. The registrations were granted as follows:— 31 Purveyors retailing multiple firms' productions 34 Purveyors manufacturing and retailing their own productions 1 (ii) Ice Cream (Heat Treatment Regulations) 1947 to 1952 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 1952, 94 samples were submitted for examination with the following results:— No. of Samples Ministry of Health Provisional grade. % of Total Unsatisfactory Samples. . 63 I 67.0 — 16 II 17.0 2 12 III 12.8 2 3 IV 3.2 — 94 100.0 4 The 4 unsatisfactory samples contained coliform organisms including some of faecal origin. 6 samples of ice lollies were also taken, two of which were unsatisfory—one contained excessive bacteria and the other contained coliform organisms including some of faecal origin. The ice cream was not manufactured in Ilford but the ice lollies were. 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 1952 prescribed new standards for ice cream. During 1952, 6 samples were submitted for chemical analysis, all of which complied with the Order. 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. 32 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 1952, they made 13.836 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. 190 informal and 14 formal notices were served under the Food & Drugs Act, and 19 formal and 248 informal notices were complied with, including 8 formal and 95 informal notices served in 1951. (ii) Food Hygiene. A "Clean Food" Exhibition was held for 3 weeks from the end of February, 1952, under the auspices of one of the large stores. There was a constant flow of visitors during the busy shop hours and at week-ends, and it is estimated that over 500 people stayed to see the hygiene films demonstrated in the small cinema. The Sanitary Inspectors were in attendance throughout the whole period of the exhibition and explained the principles of hygiene and the exhibits, and answered any necessary questions. Considerable interest was demonstrated and it was felt the principles of the hygiene of food handling were inculcated in the 5,000 visitors to the Exhibition. Twelve 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 12 canteens, cafes and food shops were invited, resulting in an attendance of 118. 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 cooperating admirably, as in the previous year. (iii) Sampling. The Council has delegated to the Public Health Committee power to institute legal proceedings under the Act. 210 samples (207 formal and 3 informal) of food and drugs were obtained during the year 1952; 11 formal and 2 informal samples were not satisfactory as follows:— (a), (b) and (c) Vinegar (formal).—These samples consisted of coloured acetic acid. Legal proceedings were taken in all cases. In two instances the retailers were fined £1 each, the other case was dismissed. (d) and (e) Butter Mints (formal) and Butter Scotch (formal).— The butter fat. if any, in these samples did not exceed 0.5% each and was insufficient to justify the descriptions. A letter of warning was sent to the manufacturer-retailer. (f) Pork sausages (formal).—Deficient in meat to the extent of 23%. Legal proceedings were taken and fines totalling £10 plus £3 3s. costs were imposed on the firm concerned. The manager was dismissed from the case on payment of £1 costs. (g) and (h) Whisky (formal).—Contained 68.7% and 67.8% proof spirit respectively. Both samples were in accord with the Act but were deficient to the extent of 13% and 2.2% respectively below the labelled 70%. No action was taken. 33 (i) Gin (formal).—Contained 66.3% proof spirit and although in accord with the Food and Drugs Act was deficient to the extent of 3'7% below the labelled 70%. No action was taken. (j) and (k) Mustard (formal).—Deficient in allyl isothiocyanate to the extent of 20% and 34% respectively. A letter of warning was sent to the firm concerned. (l) Sausage, unclassified (informal).—Contained a foreign body found to be a papilla from the side or rear of tongue of ox or pig. No action was taken. (m) Loaf of bread and small piece of bread (informal).—The small piece of bread contained a greyish black foreign body found to consist of fatty discoloured dough. No action was taken. (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 storage premises. Registration was granted to 20 persons (concerning 13 premises). (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. One application for registration was received, and granted, during 1952. (vi) Articles of Food Surrendered. During the year the following articles were surrendered and condemned as being unfit for the food of man:— Beverage—2 tins; Biscuits—80 lbs.; Butter—48 tins, 1½bs.; Cake 22½lbs., 276 Swiss Rolls; Cereals—37 pkts., 12 tins, 142 lbs.; Cheese— 102 lbs., 96 cartons, 7 portions; Coconut—60 lbs. 6 ozs.; Chocolate— 115 bars, 21 pkts.; Confectionery—459 lbs., 6 ozs,; Drugs and Medicines 20 bottles, 7 pkts., 2,900 tablets; Egg (Dried)—28 lbs.: Fats—986½ lbs.; Fish (Wet and Dry)—121 st. 4½ lbs., 6 boxes; Fish (Tinned)—239 tins; Fish (Shell)—5 galls., 9 lbs.; Fish Paste—9 jars; Flavouring, Colouring, etc.—43 pkts., 4 jars, 72½ lbs.; Flour—6,539 lbs. 10 ozs.; Foods, Medical and Baby—108 tins, 26 cartons, 47 bottles, 21 jars; Fruit (Tinned)—2,760 tins; Fruit (Bottled)—23 bottles; Fruit (Dried)— 699 lbs.; Fruit Juice—50 tins, 81 bottles; Jam, Preserves, etc.—466 lbs., 243 tins; Meat (Fresh)—5,124½ lbs.; Meat (Tinned)—4,462 lbs. 5½ ozs.; Meat Pies—18; Milk (Tinned)—709 tins; Milk (Dried)—21 tins; Nuts —290 lbs.; Pastry and Pudding Mixtures—5 pkts.; Pickles—16 jars, 8 tins; Poultry—32 lbs. 10 ozs., 9 tins; Puddings—18; Rabbits—75 lbs.; Salt—1 tin; Sauces and Salad Cream—16 bottles; Sausages—38 tins, 265¼ lbs.; Spirits—3 bottles; Soups—169 tins; Sugar—287½ lbs.: Soft Oil—112 lbs. 6 galls.; Vegetables (Fresh)—12 lbs.; Vegetables (Dried) —53½ lbs.; Vegetables (Tinned)—1,193 tins; Yeast—2 lbs. (vii) Articles of Food Seized. Arising out of a complaint, visits were made to two shops of a firm in the Borough when it was found that a quantity of shelled walnuts on sale were infested with larvae, maggots and mice excrement. The nuts were seized and submitted to a Justice of the Peace who ordered their condemnation. Legal proceedings were subsequently taken and the firm was fined a total of £40, plus £5 5s. 0d. costs. 34 (vii) Foreign Bodies in Food. 17 complaints were received during 1952 of the presence of foreign bodies in foodstuffs. All were investigated and legal proceedings were taken in one case. A fine of £20, plus £2 2s. 0d. costs was imposed on the food manufacturers. (viii) Food Poisoning. By virtue of Section 82 of the Ilford Corporation Act, 1927, food poisoning became compulsorily notifiable in Ilford as from 1st October, 1937. It is also notifiable under Section 17, Food and Drugs Act, 1938. Thirty-eight 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. 1 2 Nil Salmonella Typhimurium 1 Unknown There were four other outbreaks involving 11 cases but the cause was not discovered. There were also 25 single cases; Salmonella typhi-murium was traced in fourteen cases. Of the 25 single cases one was fatal, the cause of death being certified as Cerebral haemorrhage and Enteritis (Salmonella Typhi-murium). Four 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, 29 of which use motive power. 337 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 17 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) Foot and Mouth Disease.—Insofar as Ilford is concerned the following Orders were made in 1952:— Foot and Mouth Disease (Controlled Areas) Special Order No. 1, 1952, made 4.1.52. Foot and Mouth Disease (Controlled Areas) Special Order No. 2, 1952, excluded Ilford from 17.1.52. Foot and Mouth Disease (Controlled Areas) Special Order No. 4, 1952, operated 28.3.52. Foot and Mouth Disease (Controlled Area) Special Order No. 5, 1952, revoked Order No. 4 from 22.4.52. Foot and Mouth Disease (Infected Area) Special Order No. 52, 1952, included Ilford from 9.4.52. Foot and Mouth Disease (Infected Area) Special Order No. 54, 1952, revoked Order No. 52 from 28.4.52. Foot and Mouth Disease (Controlled Area) Special Order No. 9, 1952, included Ilford from 7.5.52. Foot and Mouth Disease (Controlled Area) Special Order No. 10, 1952, excluded Ilford from 17.5.52. 35 Foot and Mouth Disease (Infected Areas) Special Order No. 102, 1952, included Ilford from 13.6.52. Foot and Mouth Disease (Infected Areas) Special Order No. 111, 1952, excluded Ilford from 28.6.52. Licences were issued for entry into the Borough of 4 cows, 1 calving heifer and 16 pigs and countersigned for the removal from the Borough of 3 cows, 12 calves, and 137 pigs. (ii) Regulation of Movement of Swine Order, 1950.—This Order continued in operation during the year 1952. Licences were issued for removal from the Borough of 11 pigs and licences were received for entry into the Borough of 62 pigs. (iii) Fowl Pest Order, 1936. The Poultry Pens, Fittings and Receptacles (Disinfection) Order, 1952. Poultry and Hatching Eggs (Importation) (Amendment) Order, 1952. Live Poultry (Restrictions) Order, and (Amendment) Order, 1952. These orders deal with the requirements necessary to prevent the spread of fowl pest by controlling the movement of live poultry and prescribing conditions relating to cleanliness, disinfection, lighting and ventilation at exhibitions and shows. One case of fowl pest occurred in 1952. One poultry show was held during the year. The birds were in good condition and all requirements were complied with satisfactorily. One licence was received in respect of the movement of poultry from Yorkshire into the Borough. (iv) Prohibition of Landing of Animals and Hay and Straw from the Channel Islands Order, 1952, and Order (No. 2) 1952—The firstnamed Order came into force on 6.5.52 and was revoked on 1.9.52. Order (No. 2) came into operation on 12.12.52, and prohibits the landing in Great Britain of animals, hay and straw brought from the Channel Islands. (v) The Tuberculosis (Area Eradication) Amendment Order, 1952. The Tuberculosis (South-West Wales Eradication Area) Order, 1952. The Tuberculosis (South-West Scotland Eradication Area) Order, 1952. The Chief purport of these Orders is to declare an area in which a substantial majority of the cattle therein are free from a particular disease and to control or prohibit the movement of cattle into, or out of, or within such area. The main purpose is, of course, to eradicate tuberculosis on a regional basis. (vi) The Horses (Sea Transport) Order, 1952.—This Order amends and re-enacts the provisions of previous Orders relating to the carriage of horses by sea from ports in Great Britain and extends them to horses shipped to Great Britain from overseas. (vii) The Diseases of Animals (Extension of Definitions) Order, 1952.—This Order extends the definition of animals contained in the Glanders or Farcy Order, 1938, so as to comprise horses, asses, mules and jennets, and the term " disease " shall comprise glanders and the form of glanders commonly known as farcy. (viii) Anthrax Order, 1938.—Notification was received that a pig had died in suspicious circumstances at a farm at a hospital in the Borough. 36 A veterinary inspector of the Ministry of Agriculture and Fisheries examined the animal and certified it had not died of Anthrax. 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 1952:— Local Authority Type of Property Total Dwelling Houses Agricultural All other (including Business and Industrial) I. Total No. of properties in District 151 50,930 40 5,122 56,249 II. No. of properties inspected as result:— (a) of notification 62 371 — 77 510 (b) otherwise 17 40 2 8 67 III. No. of properties found to be infested by rats:— Major 1 3 — 1 5 Minor 39 223 — 29 291 IV. No. of properties found to be seriously infested by mice 18 82 36 136 V. No. of infested properties (under III and IV) treated by the Local Authority 67 332 1 85 485 VI. No. of notices served under Section 4:— (1) Treatment - - - - - (2) Structural works (i.e., Proofing) — — — 1 1 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 Nil 37 Petroleum (Consolidation) Act, 1928.—The Sanitary Inspectors made 809 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 142. and the fees paid to the Council for such Licences was £102. One Licence was issued for the storage of calcium-carbide, the fee payable being 5s. Pet Animals Act, 1951.—This Act came into force on 1st April, 1952, and the Council is the Local Authority for the Borough. The Act provides that no person may keep a pet shop, or carry on a business of selling animals as pets in premises of any nature (including private dwellings), or keep animals with a view to their being sold in the course of such a business, with certain exemptions, unless he obtains a licence from the Local Authority on payment of a fee not exceeding 10s. Od. In deciding whether to grant a licence the Local Authority is required to have regard to the need for securing that the accommodation shall be suitable as to size, temperature, lighting, ventilation, cleanliness, that there will be an adequate supply of suitable food and drink, that the animals will not be sold at too early an age, that all reasonable precautions will be taken to prevent the spread of infectious diseases and that appropriate steps will be taken in cases of fire or other emergency. It is an offence to sell animals as pets in any part of a street or public place, except at a stall or barrow in a market or to sell pets to children under 12 years of age. In accordance with the requirements of the Act the Council adopted a set of conditions for application to licences granted under the Act and decided that the licence fee payable should be 10s. Od. The Chief Sanitary Inspector was designated as the officer responsible for the administration of the Act and he and his Deputy were authorised to inspect any premises in the Borough where licences are In force. Licences were granted in respect of 10 premises during 1952. 38 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. Enteric fever (Typhoid and Paratyphoid). Cholera. Diphtheria. Relapsing Fever. Membranous Croup. Anthrax (made notifiable by the Local Authority as from 1/4/22). Erysipelas. Scarlatina or Scarlet Fever. Pemphigus Neonatorum (made notifiable 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 Dysentery Malaria P.H. (Infectious Diseases) Regulations, 1953. Tuberculosis P.H. (Tuberculosis) Regulations, 1952. Acute Rheumatism (up to 16 years) The Acute Rheumatism Regulations, 1950. Measles and Whooping Cough The Measles and Whooping Cough Regulations, 1940. Acute Poliomyelitis Acute Encephalitis Meningococcal Infection P.H. (Acute Poliomyelitis, Acute Encephalitis and 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 1951 and 1952 were as follows: — 1951 1952 Scarlet Fever — — Enteric Fever — — Diphtheria — — Acute Poliomyelitis 1 1 Measles 1 2 Whooping Cough 2 — Influenza 24 5 Tuberculosis—Pulmonary 38 19 Other forms 3 2 Pneumonia (all forms) 74 53 Diarrhoea (under 2 years) — 1 Meningococcal Infections 1 1 Totals 144 84 39 TABLE III..—Corrected Notifications of Infectious Diseases for the Year 1952 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 409 1 99 306 2 1 - — 34 15 9 14 40 26 87 32 15 30 36 71 148 - Diphtheria, including Membranous Croup - - - - - - - - - - - - - - - - - - - - - - Enteric Fever (Typhoid and Para-Typhoid) 2 - - - 1 1 - - - 1 - - - - - 1 - - - - 1 - Pneumonia 181 7 10 24 8 33 52 47 31 15 19 17 9 17 16 10 17 8 5 17 80 53 Puerperal Pyrexia 64 — — — 25 38 1 — 1 — 2 — — — 2 — 1 57 — 1 61 — Acute Poliomyelitis 15 — 5 5 2 3 — — 1 1 3 1 1 — 2 — 1 — 2 3 14 1 Acute-Encephalitis 1 — — 1 — — — — — — — — — — — — — — — 1 1 — Meningoccocal Infection 2 — — 1 — — 1 — 1 — — — — — 1 — — — — — 2 1 Dysentery 99 8 33 11 12 9 13 13 22 1 — — 2 3 10 10 44 1 — — 57 — Ophthalmia Neonatorum — — — — — — — — — — — — — — — — — — — - - — Erysipelas 34 — — — 1 9 17 7 3 2 3 7 1 3 1 6 2 2 3 1 6 — Pemphigus Neonatorum — — — — — — — — — — — — — — — — — — — - - — Tuberculosis Pulmonary 158 — 3 6 35 73 36 5 7 13 15 7 15 14 19 13 12 10 7 20 137 19 Other Forms 20 — 1 3 7 6 2 1 2 2 — 3 2 1 1 — 2 3 1 3 9 2 Anthrax - - - - - - - - - - - - - - - - - - - - - - Malaria—Believed contracted in this countrv - - - - - - - - - - - - - - - - - - - - - - Believed contracted abroad - - - - - - - - - - - - - - - - - - - - - - Acute Rheumatism 12 — — 12 — — — — — — 1 3 - 2 - 2 1 1 1 1 10 - Measles 3,166 48 1,149 1,940 18 11 — — 231 220 264 312 233 203 114 414 357 291 259 268 69 2 Whooping Cough 756 70 359 319 1 7 — — 82 59 56 54 47 55 142 52 59 41 63 46 20 - Food Poisoning 38 3 8 4 3 10 8 2 9 — 2 2 1 4 1 6 1 4 3 5 11 1 Typhus Fever 1 — — — 1 — — — — — — — — — — — — 1 — — 1 — Totals 4.958 137 1,667 2,632 116 201 130 75 424 329 374 420 351 328 402 546 512 455 380 437 027 79 * Included in the figures in these columns are cases notified in previous years as well as 1952. 40 The year 1952, on the whole, showed a slightly lower incidence of infectious disease than 1951. The number of cases of measles was 3,166 as compared with 2,985 the previous year. Whooping cough cases numbered 756 as compared with 1,026 in the year 1951. (a) Smallpox.—No cases were notified during 1952. Notifications regarding 3 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, five visits being paid. One suspected case of Smallpox occurred during the year. The patient was admitted to hospital, but the case was not confirmed. The following gives particulars as to vaccination during 1952:— Primary vaccination 1,428 Re-Vaccination 435 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.—409 cases occurred in 1952. There were no deaths from this disease. Seven cases were admitted to Isolation Hospitals outside the district. (c) Diphtheria.—No cases occurred in 1952. This is the first year in which it has been possible to record a clean "bill of health" for this disease in Ilford. (d) Ophthalmia Neonatorum.—No cases occurred in 1952. The following figures show the number of cases of Ophthalmia Neonatorum notified during the past five years: 1948. 4; 1949. 1; 1950, 2; 1951, 3; 1952, nil. It is to be remembered that many cases of ophthalmia neonatorum are not due to gonorrheal infection. (e) Enteric Fever.—Two cases only occurred during the year, both females, ages 19 and 42 years. Both cases were para-typhoid fever "B". One was admitted to the Ilford Isolation Hospital, the other attended the Out-patients' Department, London Hospital. The patients recovered satisfactorily. (f) Typhus fever.—A case of this disease occurred in March, 1952. The patient, a female of 21 years, left New Zealand on 26th January by steamship. The vessel passed through the Panama Canal and the patient went ashore at Colon and Curacao Island. The vessel arrived at Southampton on 26th February and the patient reached Ilford the next day. being admitted to the Ilford Isolation Hospital on 29th February. The patient recovered after a stay of 33 days in Hospital. This type of typhus fever is transmitted by the bite of a tick and is not louse-borne, as is the usual type of typhus fever. (g) (i) Acute Poliomyelitis.—Fifteen cases occurred during the year. They were males of 5, 6, 8, 8, 10, 13 and 18 years and females of 3, 3, 3, 4, 24, 25, 29 and 31 years. Twelve cases were admitted to the Ilford Isolation Hospital, two to Rush Green Hospital, Romford, and one case was nursed at home. Eleven cases were paralytic and four non-paralytic. One paralytic case was fatal, that of a male patient, aged 18 years, who died within a few minutes of admission to hospital. (ii) Acute Encephalitis.—One case only of this disease occurred. It was in a male child of five years who was admitted to the Ilford Isolation Hospital. The child was discharged after 5 weeks in hospital, having made a satisfactory recovery. 41 (iii) Meningococcal Infection.—Two cases of this disease occurred —a male of 57 years, an inmate of Claybury Hospital, and a female of 5 years who was admitted to Rush Green Hospital, Romford. Both patients recovered. One other case (which was not notified) occurred in a male child of two years. The child was admitted to the Ilford Isolation Hospital but died the same day. A post-mortem was performed by the Coroner who certified the cause of death as acute meningococcal septicaemia. (h) Pneumonia—Influenzal and Primary.—This disease was less prevalent during 1952 than in the previous year, especially of the influenzal type. The incidence of influenzal and primary pneumonia throughout the year is shown by the following table. Month, 1952 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 17 2 7 - - - 6 - February 6 1 7 — 3 1 5 — March 3 — 5 1 - — 3 April 6 1 8 — — — 2 1 May 6 — 7 1 — — — — June 2 - 3 - 2 1 - - July 2 — — - 1 — 2 — August 2 — 3 — 1 — 1 — September — — 4 2 — — — — October 6 1 7 1 - - - - November 3 1 5 1 4 1 1 - December 10 — 25 1 2 — 4 — Totals 63 6 81 7 13 3 24 1 It will be seen from the above figures that of 144 persons who suffered from acute primary pneumonia there were 13 deaths, equal to 9 0 per cent.; and in the case of acute influenzal pneumonia 37 persons with 4 deaths, equal to 10 8 per cent. It will be noted that there was a sharp rise in December, doubtless due to the very severe weather, particularly fog, which occurred in that month. (i) Tuberculosis.—During the year 1952 there were 158 new notifications of Pulmonary Tuberculosis and 20 of other forms of Tuberculosis. 10 cases of Pulmonary Tuberculosis were transferred to Ilford. It is interesting to compare the figures of the number of persons added to the list during the past 10 years, and these show that 1952 was the lowest during that period. Year Pulmonary Cases Non-Pulmonary Cases 1943 255 43 1944 222 33 1945 236 38 1946 247 34 1947 252 30 1948 266 26 1949 178 34 42 Year Pulmonary Cases Non-Pulmonary Cases 1950 242 26 1951 227 33 1952 168 20 Notifications and Deaths from Tuberculosis of Ilford residents during 1952:— Age Periods New Cases Deaths Respiratory NonRespiratory Respiratory NonRespiratory M F M F M F M F Under 1 year - - - - - - - - 1-5 years 2 1 1 - - - - - 5-15 4 2 1 2 — — — — 15-25 20 15 3 54 — 1 — — 25-35 19 17 1 3 1 4 — — 35-45 28 9 — 2 — 2 1 — 45-55 12 4 — — 2 — — — 55-65 17 3 1 1 2 2 - — Over 65 3 2 1 — 3 2 1 — Totals 105 53 8 12 8 11 2 - Of the foregoing new cases, the following were notified from Institutions in the district:— Respiratory T uberculosis NonRespiratory T uberculosis King George Hospital 6 — Claybury Hospital 1 — Goodmayes Hospital 6 - Ilford Isolation Hospital 2 — Dr. Barnardo's Village Homes 1 1 Of the 21 deaths which occurred of Ilford residents, notification had previously been made of 18 of the cases. In the remaining 3 cases the presence of tuberculosis was discovered as a result of (a) post-mortem examination; (b) from changes revealed by X-rays; and (c) the patient (aged 81 years) was said to have contracted tuberculosis of the spine at the age of three, but it was not established whether he had been notified. During the year 1952 the following deaths occurred from Tuberculosis: Pulmonary Non-Pulmonary Ilford Residents 19 2 Non-Residents— Claybury Hospital 5 — Goodmayes Hospital 2 — Ilford Isolation Hospital 9 — King George Hospital 2 1 43 Non- Pulmonary Pulmonary Total Number of cases on register, 1st January, 1952 1,251 175 1,426 Number of cases entered on the register during the year 168 20 188 Number of cases removed from the register during the year Pul. Non- Pul. Recovered 30 18 Deceased 25 3 Left District 73 9 Lost sight of 3 — Diagnosis not established 9 2 140 32 172 Number of cases remaining on register on 31st December, 1952 1,279 163 1,442 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; 1,072 persons were visited during the year. The following reports were obtained: Pulmonary Cases Other Cases Condition good 563 68 Condition fairly good 178 15 Condition poorly 38 2 In sanatoria 126 5 No information as to present condition 25 1 Removed from district, etc. 45 6 975 97 The treatment of Tuberculosis is now under the control of the Regional Hospital Board. On the 31st December. 1952, there were 1,133 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 1952 was as follows: Pulmonary Non-Pulmonary Total Males Females Males Females Adults 73 59 2 3 137 Children 4 1 3 1 9 Mass Radiography. The Mass Radiography Unit of the North East Metropolitan Regional Hospital Board attended in the Ilford district from 5th November, 1951, to the 21st January, 1952. Dr. Hugh Ramsay, the Medical Director, supplied me with particulars of the Survey as follows:— 44 Number of films taken at the Survey: — Miniature Large Male Female Male Female (a) General Public 1,784 2,987 106 119 (b) School children 792 843 20 12 (c) School teachers 141 140 4 1 (d) Local Firms and Organised 2,792 2,511 130 77 Groups 5,509 6,481 260 209 Totals 11,990 469 The classification of the most important groups was: — Males Females Totals M. F. Active Post Primary Lesions (a) 7 8 (b) — — (c) — — (d) 4 2 11 10 Inactive Post Primary Lesions (a) 42 42 (b) — 1 (c) 1 1 (d) 61 18 104 62 Inactive Primary Lesions (a) 11 23 (b) 1 4 (c) 1 1 (d) 15 21 28 49 Totals: 143 121 Tuberculosis Care Association.—This Association has assisted 71 cases with extra nourishment, clothing, and in other ways. (0 Venereal Diseases.—Treatment of thtse 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. Consultation Times Treatments are given from 9 a.m. to 8 p.m. Monday to Friday. Whitechapel.—Whitechapel Clinic, Turner Street. Mile End, London, E.1:— Sessions Monday to Friday. 10 a.m. to 7 p.m. Saturday, 10 a.m. to 3 p.m. Consultation Times Treatments are given from 9 a.m. onward. West Ham.—Queen Mary's Hospital, West Ham Lane, Stratford, London, E.15: — Sessions (Males) Monday, 3 to 6 p.m. Thursday, 11 a.m. to 1 p.m., 6 to 8 p.m. Saturday, 2.30 to 4.30 p.m. (Females) Monday, 6 to 8 p.m. Thursday, 11 a.m. to 1 p.m.; 3 to 6 p.m. Saturday, 2.30 to 4.30 p.m. 45 Publicity and Propaganda, Etc. 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. On 24th October a film show featuring Vaccination and Diphtheria Immunisation was held at the Town Hall. Accident Prevention in the Home. The Council agreed to membership of the Home Safety Department of the Royal Society for the Prevention of Accidents and the first step in their programme was the inviting of delegates from numerous local organisations to attend an inaugural meeting on 18th November, 1952, at which Mrs. Duncan. Manager of the Home Safety Department of RoSPA, addressed the meeting on the cause and effect of home accidents, means of combating them, and the suggestion of the formation of a local Home Safety Committee under the general guidance of the Public Health Committee. The Council agreed to the formation of such a Committee, to be designated the Home Safety Advisory Committee, and invitations were sent to the 12 delegates present at the inaugural meeting, and also to other voluntary bodies inviting the sending of a representative to the future meetings of the Committee to discuss the inauguration of a scheme in Ilford. The constitution of the Committee consisted of the Chairman and Vice-Chairman of the Public Health Committee, who were elected to the same offices in this Committee, and the Chairman and Vice-Chairman of the Road Safety Advisory Committee, together with one representative of each of the organisations who were participating in the scheme, and the function would be to advise the Public Health Committee and make the necessary recommendations in regard to the training of people in matters relating to safety in the home, the training of representatives to undertake propaganda work within the borough, and the dissemination of propaganda by means of pamphlets, posters, film shows and other suitable means. The Council authorised expenditure not exceeding £25 during the remainder of the current financial year. It was also agreed that a copy of the "Home Safety Bulletin," published by RoSPA quarterly, should be sent to all members of the Committee. At the end of the year the Home Safety Advisory Committee, in addition to the Council members mentioned above, included members from 18 voluntary organisations, including the local press, and arrangements were in hand to give, early in 1953, film shows and talks to various organisations. (Owing to legal difficulties the Council, early in 1953, handed over the administrative control to a voluntary committee.) Examination of Officers and Servants. The following medical examinations were carried out during 1952:— Officers Servants New Appointments 35 29 Under Sickness Regulations 7 15 Totals 42 44 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 400 factories with mechanical power on the register. There are 196 factories without mechanical power on the register. There are 220 outworkers on the register. 1— INSPECTION OF FACTORIES AND OTHER PREMISES. Including Inspections made by Sanitary Inspectors. Premises (1) Inspections (2) Number of Written Notices (3) Occupiers prosecuted (4) Factories with Mechanical Power 1,214 2 - Factories without Mechanical Power 170 37 - Other premises (not including Outworkers' premises) 66 2 - Total 1,450 41 - 2.—DEFECTS FOUND IN FACTORIES. Particulars Number of Defects No. of defects in respect of which Prosecutions were instituted Found Remedied Referred to H.M. Inspector Want of Cleanliness (S.l) 18 23* - - Overcrowding (S.2) — — — — Unreasonable Temperature (S3) - - - - Inadequate Ventilation (S.4) - - - — Ineffective Drainage of Floors(S.6) - - - - Sanitary Conveniences (S.7):— Insufficient 9 5 — Unsuitable or Defective 13 11 — Not Separate for Sexes 1 1 — Other Offences — — — Total 41 40* — * Includes compliances of defects found in 1951. 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 1952 was 1,734 (929 males and 805 females), of which there were 112 (55 males and 57 females) where the ordinary place of residence of the parents was outside Ilford. In addition 695 notifications of live births (359 males and 336 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 there were 4 cases in which there was default in complying with the requirements of the Public Health Act relating to the Notification of Births and warning letters were sent to the persons concerned. The percentage of live births occurring in Ilford, notified by the various responsible persons, was as follows:— By Medical Practitioners .23 By Certified Midwives 99.54 By Parents and others .23 There were also 44 stillbirths (20 males and 24 females) notified in Ilford including 2 (1 male and 1 female) where the home address of the parents was outside the district, and notifications of 13 stillbirths (6 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. This represents a total of 55 where the home address was in Ilford, whereas the Registrar-General has allocated only 51 stillbirths to Ilford. The following table shows the causes of the 55 stillbirths notified where the usual residence of the parents was in Ilford:— Stillbirths, 1952. Cause of Stillbirth Delivery by County Council Midwife at home Delivery in Hospital Total Abnormal foetus — 5 5 Abnormal kidneys — 1 1 Ante Partum haemorrhage — 2 2 Asphyxia — 8 8 Atelectasis — 5 5 Cord round neck 1 1 2 Hydrocephalus — 1 1 Intra uterine death — 2 2 Paparaceous foetus — 1 1 Placental insufficiency — 3 3 Pre-eclamptic toxaemia — 1 1 Prematurity and Congenital Atelectasis — 2 2 Prolapsed cord — 2 2 Rhesus negative — 1 1 Tentorium haemorrhage — 2 2 Toxaemia — 4 4 True knot in cord 1 — 1 Unknown 7 4 11 Very short cord 1 — 1 Totals 10 45 55 48 Care of Premature Infants.—Of the 1,734 live births occurring in Ilford during 1952, 85 weighed 5½lbs. or less at birth; 17 of these babies were born at home and 68 in Hospital (including 6 where the home address of the parents was outside Ilford). Of the 17 babies born at home:— 11 were nursed entirely at home; 6 were transferred to hospital; All survived at the end of one month. Of the 68 babies born in hospital:— 8 died during the first 24 hours (including one where the home address was outside Ilford); 5 died between the ages of one day and one month (including one where the home address was outside Ilford); 55 survived at the end of one month (including 4 where the home address was outside Ilford). In addition 40 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:— 3 who died within the first 24 hours (all in hospital); 3 who died between the ages of one day and one month (all in hospital); 34 who survived at the end of one month. Infant Mortality.—The number of infants dying within the first year of life was 44. the total number born being 2,323. The latter figure is supplied by the Registrar—General for calculating infant and maternal mortality rates. The infant mortality, or rate of deaths per 1,000 live births, was therefore 18 94. The following table gives the deaths of infants under one year of age, classified according to age:— Infant Deaths—1952. 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 Abnormalities of the Heart 1 — — — 1 1 — — — 2 Acute Purulent Bronchitis — — — — — — 1 — — 1 Atelectasis 12 1 — — 13 — — — — 13 Broncho Pneumonia 8 1 — — 4 2 — — — 9 Convulsions — — — — — — 1 — — 1 Hepatic Necrosis 1 — — — 1 — — — — 1 Hydrocephalus — — — — — — 1 — — 1 Intracranial injuries 3 — — — 3 1 — — — 4 Myelomeningocele — — — — — — 1 1 — 2 Porencephaly — 1 — — 1 — — — — 1 Prematurity 8 — — — 8 — — — — 8 Tentorial tear 1 — — — 1 — — — — 1 Totals 29 3 — — 32 4 4 4 — 44 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 1952 44 18.9 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 The mean average Infant Mortality rate for the past 10 years is therefore 259 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 1952 18.9 28 24 31 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 Neonatal Mortality.—The death-rate of infants under four weeks of age is known as the Neonatal Mortality. There were 32 deaths of infants under four weeks of age during 1952 and the rate for the year was 13 8 per 1,000 live births. The figures for the past 47 years were as follows:— Year Number Rate Year Number Rate 1952 32 13.8 1928 41 23.6 1951 40 16.8 1927 32 19.3 1950 32 13.3 1926 32 21.2 1949 33 12.5 1925 37 24.9 1948 37 12.9 1924 28 19.5 1947 51 15.1 1923 34 21.2 1946 74 21.5 1922 40 27.1 1945 49 19.8 1921 38 25.5 1944 64 23.1 1920 45 27.0 1943 54 20.6 1919 36 30.8 1942 49 20.3 1918 32 30.4 1941 36 22.0 1917 29 24.7 1940 43 22.3 1916 43 28.8 1939 57 25.8 1915 54 35.1 1938 50 21.8 1914 43 28.7 1937 52 23.0 1913 37 24.6 1936 59 26.7 1912 45 30.2 1935 51 24.8 1911 34 21.4 1934 37 18.8 1910 54 32.2 1933 48 25.9 1909 56 34.0 1932 41 20.6 1908 55 33.2 1931 64 32.3 1907 54 31.5 1930 31 16.8 1906 57 33.5 1929 48 27.4 50 Illegitimate Births and Deaths.—91 of the live births registered (41 males and 50 females were illegitimate, that is 3.9 per cent. of the births registered. No illegitimate child died under one year of age. The following table shows the birth and death rates of legitimate and illegitimate infants for the past ten years:— Legitimate Infants Illegitimate Infants Year Live Births Percentage of Registered Births Deaths Rate per 1,000 Legitimate Live Births Live Births Percentage of Registered Births Deaths Rate per 1,000 Illegitimate Live Births 1952 2,232 96.1 44 19.7 91 3.9 - - 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 3.1 5 46.7 1945 2,343 94.5 73 31.2 136 5.5 8 58.8 1944 2,655 95.8 95 35.7 116 4.2 7 60.3 1943 2,532 96.6 89 35.2 89 3.4 3 33.7 The Chelmsford Diocesan Moral Welfare Association continued in 1952 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 Visitors 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. Three trainees, on completing the Course in 1952 and passing the examination for the Health Visitors' Certificate of the Royal Sanitary Institute, were appointed as Health Visitors and School Nurses here and one further trainee was appointed as a Tuberculosis Health Visitor. At the end of the year there were 12 full-time qualified Health Visitors and School Nurses in addition to the Superintendent Health Visitor, and 5 Clinic Nurses. Although this shows an increase over previous years, the health visiting staff is still below the approved establishment of 18. The following is a summary of the home visits made by the Health Visitors and Clinic Nurses during 1952 as far as the Maternity and Child Welfare work is concerned. First visits to newly-born infants 2,389 Subsequent visits to children under 1 year of age 3,995 Subsequent visits to children over 1 year of age and under 5 11,895 Visits to expectant mothers 87 Home visits for other reasons 4,316 Total visits paid 22,682 51 Day Nurseries. (a) The hours of opening at all the Nurseries during 1952 continued to be from 7.30 a.m. to 6 p.m., Monday to Friday only. (b) As from the 1st January, 1952, the charge made to parents for meals for children attending the Nurseries was increased from 1s. 6d. to 2s. 0d. per day for each child and this continued in operation throughout the year. On the 18th January, 1953, however having regard to the provision in the National Health Service Act, 1952. that fees charged for the attendance of children at day nurseries should be in relation to the upkeep and running costs, the standard charge was increased to 7s. 6d. per child per day, with provision for this standard charge to be reduced, according to scale, when the means of the parents do not justify the full charge. Following this increase in January, 1953, there has been a marked decrease in the daily attendances at the Nurseries. It should, however, be mentioned that for some months previously the number of applications for day nursery accommodation had somewhat diminished, largely due to the decline in the birth rate over the past four or five years and possibly in part due to the fact that there have been less opportunities for married women to find employment than there were two or three years ago. (c) The training of Students at the Nurseries for the Certificate of the National Nursery Examination Board continued. Ten Students (two from the Ley Street Nursery, one from the Sunshine House Nursery, three from the Goodmayes Lane Nursery and four from Stevens Road Nursery) entered for the examination during the year, five of whom obtained the Certificate. In January, 1953, approval was given to arrangements being made for young students to attend part-time courses (on one day a week) at day continuation classes whilst awaiting enrolment for the Nursery Nurses' Course at a Technical College in the September following their sixteenth birthday; this enables them to pursue their studies in general subjects and so improve their general educational standard during this pre-nursery course period. (d) Stevens Road Nursery.—In view of the decrease in demand for accommodation at this Nursery, the Health Area Sub-Committee at their meeting in May, 1952, decided to offer to the Dagenham Health Area a block of 20 places. This offer was accepted and the first batch of children was admitted on the 30th June. The number of Dagenham children in the Nursery, however, has never exceeded 9 and at the 31st December was 6. As the demand for places at this Nursery continued to decline in the latter months of 1952, notwithstanding the arrangements referred to in the foregoing paragraph, and the number of children on the register has steadily decreased since, approval was given by the County Council to close the Nursery on the 28th July, 1953, the remaining children being transferred to the Goodmayes Lane Nursery. 52 (e) The following is a table showing the attendances, etc., at the Day Nurseries during 1952:— Situation Date of Opening Accommodation (Children) Average Daily Attendance during 1952 No. of Days in Quarantine Reasons for Quarantine with Number of Cases No. on Waiting List at 31st Dec. Chicken Pox Scarlet Fever hooping Cough Mumps Measles German Measles Meningitis Diarrhoea and Vomiting Sunshine House, Girls' Village Homes, Barkingside 17.8.42 45 37 120 2 7 - 20 6 1 - - 3 Goodmayes Lane, Goodmayes (Replaced Green Lane Nursery, open from 5.5.43 to 9.11.51) 14.11.51 50 41 170 — 1 2 13 39 5 1 10 2 226-236, Ley Street, Ilford 16.8.43 50 41 131 20 5 0 2 3 — — — 5 Stevens Road, Dagenham (Replaced Becontree Avenue Nursery, open from 17.1.44 to 13.3.50) 16.3.50 50 34 172 1 1 5 15 2 3 - - 1 53 Nurseries and Child-minders Regulation 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 31/12/51 3 3 Number registered during 1952 2 1 Number of registrations cancelled during 1952 (Removals from district, etc.) 2 1 Number on register at 31/12/52 3 3 Number of children provided for at 31/12/52 88 29 Clinic Premises. (a) Fairlop Centre.—Last year 1 reported that arrangements had been made for the Fairlop Infant Welfare Centre to be transferred from Fairlop School to the Holy Trinity Church Hall, Mossford Green, Barkingside, as the Education Committee required their accommodation for school purposes. The last session held at Fairlop School was on Saturday, the 16th August, 1952, and the Centre was transferred to the Holy Trinity Church Hall on Tuesday mornings, commencing on the 19th August. (b) Holy Trinity Church Hall, Barkingside.—Early on the morning of Monday, the 24th November, 1952, a fire occurred at this Church Hall, where the Barkingside and Fairlop Infant Welfare Centres were held on Monday afternoons and Tuesday mornings respectively . As the Hall was no longer usable, owing to the considerable damage caused to the buildings and the contents, emergency arrangements were made for the mothers to attend with their children at other Centres, and for Welfare Foods to be sold from the Barkingside Sub-Food Office. It was later possible to arrange for the hire of the Methodist Church Hall, Fremantle Road, Barkingside, on Thursday afternoons, to hold a combined session for both Centres, and the first session was held there on the 11th December, 1952. (c) Following complaints of nuisances created by photographers outside the Infant Welfare Clinic premises the matter was referred to the Ilford Borough Council, who made a Byelaw, operative from the 1st May, 1953, prohibiting the importuning of any person, for the purpose of taking or selling any photograph, in any of the streets in which the Clinics are situate. (d) Mayesbrook Dental Clinic.—When the Manford Way Clinic was completed in 1951, the equipment held at the Mayesbrook Clinic for the No. 2 Surgery was transferred to the Manford Way Clinic, to obviate purchasing new equipment at a time when there was a great shortage of Dental Officers. As towards the end of 1952 our staff of whole-time Dental Officers had increased to 3 (including the Senior Dental Officer) and in addition we had been successful in obtaining the services of parttime Dental Officers for sessional work, steps were taken to re-furnish the No. 2 Surgery at Mayesbrook Clinic and this was in use from the 19th January, 1953. 54 Infant Welfare Centres.—102 voluntary lady helpers were engaged in the work at the Infant Welfare Centres at the end of December, 1952. During the year the following attendances were recorded:— Total number of attendances of infants 42,033 First attendances 1,947 Attendances of Children from 1 to 5 years 13,360 Total number of children on roll, December 31st, after omission of all those who had not attended for six months 3,701 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 1952 42,033 1,947 3,701 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 3,712 718 sessions were held during the year, the average attendance at each session being 59 mothers with their infants. The following are the figures for each Centre:— Sessions Average Attendance Chadwell 48 47 Becontree 49 54 Downshall 49 63 Manford Way 49 41 Woodford Avenue 49 81 Seven Kings 49 61 Cecil Hall (Wednesdays) 49 62 Cecil Hall (Thursdays) 47 60 Newbury Hall 48 42 Goodmayes 48 47 Grosvenor Road 48 75 Ilford Lane 48 66 Valentines 48 68 1 Barkingside (to 17/11/52) 43 76 2 Fairlop (to 16/8/52) 30 34 1Fairlop (19/8/52 to 18/11/52) 14 21 3 Barkingside and Fairlop (from 11/12/52) 2 41 1 At Holy Trinity Church Hall. 2 At Fairlop School. 3 Combined session at Methodist Church Hall, Fremantle Road. 55 Orthopaedic Clinic. (i) Newbury Hall Clinic.—41 sessions were held during 1952, 227 children under 5 years of age being examined, making 372 attendances. (ii) Mayesbrook Clinic.—22 sessions were held during 1952, 111 children under 5 years of age being examined, making 177 attendances. (iii) Manford Way Clinic.—7 sessions (the first on the 12th March) were held during 1952, 25 Ilford children under 5 years of age being examined, making 34 attendances. The 363 children were found by the Orthopaedic Surgeon to be suffering from the following defects:— Diagnosis New Cases Old Cases A B C A B C Paralysis:— A.P.M. — 1 — — 1 — Hemiplegia 1 — — — — — Deformity of hips 1 2 — 1 2 — Genu valgum 60 28 5 44 24 2 O.C.T 5 4 — 14 6 2 Genu varum 4 4 1 — — — Pes valgo planus 13 4 5 25 9 4 Valgus ankles 3 3 — 8 4 1 Talipes calc. valgus 2 — — 2 — — Congenital talipes E.V. — — — 1 — 1 Congenital defect 1 1 — 2 3 — Intoeing 2 1 1 7 — — Deformity of toes 6 3 1 2 — — Slack Posture 1 - - - - - N.A.D. 2 1 — 4 3 2 Spastic Diplegia — — — 2 — — Other conditions 13 6 — _ 1 — Scoliosis 1 Totals 115 58 13 112 53 12 A—Newbury Hall. B—Mayesbrook. C—Manford Way. 15 pairs of Valgus Insoles, 3 pairs surgical shoes, 1 Metatarsal bar and toe spring, 10 G.V. night splints and 2 calipers and leg instruments were supplied during 1952. At the Newbury Hall Clinic. 42 children under five years of age were treated by the Physiotherapist during the year, and 200 attendances were made by these children. Treatment was also given to 16 children who made 65 attendances at the Mayesbrook Clinic. 56 Paediatric Clinic.—The Consultant Paediatrician continued to attend the Clinic at Valentines Mansion during the year. 23 sessions were held and 82 new cases were examined, having been referred from the Infant Welfare Centres, Schools and Maternity Hospital for the reasons set out in the following table; a total of 151 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 Ascariasis — — — — 1 — 1 Asthma 1 — — — 1 2 4 Asthmatic bronchitis — — — — 2 — 2 Behaviour difficulties — — — — 1 — 1 Cphalhaemaloma — — 1 — — — 1 Cervical adenitis — — — — 1 — 1 Chronic antritis — — — — 1 — 1 Colic 1 — — — — — 1 Congenital heart disease — — — — 2 2 4 Constipation — 2 — — 2 — 4 Diarrhoea — — — — 1 — 1 Enuresis — 1 — — 1 — 2 Facial palsy 1 — — — — 1 2 Feeding problem — 1 — — — — 1 Fibrocystic disease of pancreas — — — — 1 — 1 Haemorrhagic disease of the newborn — — — — 1 — 1 Hemihypertrophy — — — — 1 — 1 Hernia — — — — — — 2 Hypospadias — — — — 1 — 1 Intracranial haemorrhage — — — — — 1 1 Meningomyelocele — — — — 1 — 1 Mentally retarded — 1 — — 1 — 2 Mongol — — — — 1 — 1 Mongolian blue spot — — 1 — — — 1 Naevus — — — — 1 1 2 Normal child—N.A.D. — 4 5 — 1 3 13 Obesity — — — — — 4 4 Persistent inctopic suture — — — — 1 — 1 Pes cavus — 1 — — — — 1 Pilonidal sinus 1 — — — — — 1 Posseting — — — — 1 — 1 Recurrent parotitis — — — — — 1 1 Rickets — — — — — 1 1 Rumination 1 — — — — — 1 Spastic diplegia — 1 — — — 1 2 Sterno-mastoid tumour — — 1 — — — 1 Teething — 1 — — — — I Tonsils and Adenoids — — — — 1 — 1 Torticollis — — 2 — — 1 3 Uncertain — — — — — 2 2 Undernourishment — — — — 1 — 1 Undescended testes — — — — — 1 1 Unresolved pneumonia — — — — 1 — 1 Upper respiratory infection — 3 — — 1 — 4 Vomiting — — 1 — — — 1 5 15 11 — 30 21 82 57 Ophthalmic Clinics.—Attendances of children under school age for treatment by the Oculist during 1952 were as follows:— Valentines Mansion Mayesbrook Clinic Manford Way Clinic Total Number of children who attended 93 48 7 148 Number of pairs of spectacles prescribed 45 27 5 77 Total number of attendances made 204 109 10 323 (* First session held 17th March, 1952) Aural Clinic.—The Aural Surgeon attended at 92 sessions during 1952 and 90 attendances were made by 65 children of pre-school age. 9 children were operated upon for removal of tonsils and adenoids, 2 at Ilford Isolation Hospital, 4 at King George Hospital, Ilford and 3 at East Ham Memorial Hospital. Rheumatism Clinic.—31 sessions were held during the year at Newbury Hall, at which 33 children under 5 years of age, 14 being new cases, made 49 attendances. The following is a summary of the cases treated:— Condition New Old Total Rheumatism — 1 1 Congenital heart disease 2 6 8 No active rheumatic disease 1 1 2 Functional heart murmur 3 5 8 Pains—other than rheumatic 2 — 2 Other forms 5 2 7 N.A.D. 1 4 5 Totals 14 19 33 Number of cases referred to Ear, Nose and Throat Surgeon 1 „ „ „ „ „ Paediatrician 1 „ „ „ „ for Blood Sedimentation Rate 2 „ „ „ „ „ X-ray and Electrocardiograph 24 58 Artificial Sunlight Clinic.—51 sessions were held at the Newbury Hall Clinic and 49 at Mayesbrook. In all, 82 children under 5 years of age were treated, making 1,215 attendances. The conditions treated were as follows:— Conditions Cases A B Anaemia, Debilitv and Malnutrition 33 11 Wide Fontanelle 9 — Old Rickets 3 — O.C.T. (Bow legs) 4 3 Bronchitis 5 — Alopecia 1 2 Other conditions 8 3 Totals 63 10 A.—Newbury Hall. B.—Mayesbrook. 26 cases were still attending at the end of the year; of the remainder 2 had removed from the district, 37 were discharged having made a satisfactory recovery and 17 were discharged due to absence. Speech Clinic.—6 children of pre-school age attended, making 68 attendances. The following is the classification of the defects found by the speech therapist:— Dyslalia 5. Stammering 1. 59 Diphtheria Immunisation.— Tabular Statement as to Number of Children Schick Tested and Immunised at the Diphtheria Clinics from 1st January, 1952, to 31st December, 1952. Valentines Clinic Mayesbrook Clinic 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 1 — 1 5 — 5 — — — 6 Negative 6 10 16 4 1 5 1 — 1 22 Numbers inoculated (full course) 25 400 425 26 254 280 6 82 88 793 * Positive after full course of inoculations and re-inoculated 5 18 23 1 7 8 — 1 1 32 * Negative after full course of inoculations 22 718 740 15 331 346 4 102 106 1,192 Re-inoculations (one only) 6 28 95 723 347 53 400 72 3 75 1,198 *Awaiting re-test 4 207 211 1 101 102 3 36 39 352 *Not re-tested after inoculation (on account of leaving District, etc.) 12 344 356 13 147 160 7 41 48 564 *Positive after re-test but not re-inoculated for same reason as above — 4 4 — 1 1 — — — 5 Final Schick Test in 1952 (1951 Cases):— * Positive after full course of inoculations, and re-inoculated 1 — 1 — — — — 1 1 2 *Negative 30 288 318 13 109 122 — 42 42 482 During 1952, a total number of 2,534 children attended at the Diphtheria Prevention Clinics, (1,484 at Valentines Clinic, 812 at Mayesbrook and 238 at Manford Way), making a total number of attendances of 8,689 (5,102, 2,814 and 773), with an average per session of 50, 58 and 16 respectively. During 1952, 67 private doctors were supplied with prophylactic for the immunisation of 2,288 children and record cards were received from general practitoners as follows:— Under 5 Over 5 Inoculations (full course) 1,190 73 Re-inoculations (one only) 155 870 (* These figures include cases inoculated by general practitioners who made subsequent attendances at the Diphtheria Clinics). 60 Vaccination.—During 1952 record cards were received from general practitioners and various hospitals as follows:— Ages up to 14— No. of children primarily vaccinated 1,249 No. of children revaccinated 50 Ages 15 and over— No. of adults primarily vaccinated 179 No. of adults revaccinated 385 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 1952, 11 sessions were held. 53 expectant and nursing mothers were referred from either the ante-natal or post-natal clinics, and with 18 old cases made a total of 96 attendances. The following is a summary of the new cases examined by Dr. K. Playfair:— Condition PostNatal AnteNatal Congenital Cardiac lesion — 2 Functional Cardiac disorder 1 23 No lesion 1 8 Old healed infective endocarditis — 1 Rheumatoid Arthritis — 1 Still being investigated — 6 Valvular disease of the heart 2 8 4 49 11 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 18 State certified midwives at the Ilford Maternity Hospital. 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. 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 594 cases were attended. In 517 cases the midwives were engaged to attend as midwives and in 77 cases as maternity nurses. The patients resided in the following wards:— Barkingside 41; North Hainault 43; Cranbrook 65; Park 50; Seven Kings 56; South Hainault 48: Loxford 40; Clementswood 60; Goodmayes 17; Fairlop 73; Clayhall 62; Mayfield 39, 61 A Doctor was called in to 139 of the 517 cases in which a midwife had been engaged. Of the infants born there were 9 stillbirths. In 4 of these cases the midwife was engaged as a maternity nurse only. There were 9 deaths of infants during the first year of life where the birth had been attended by a Domiciliary Midwife, 7 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 27 infants attended by them during 1952. During 1952 Ante-Natal Clinics conducted by the Domiciliary Midwives were held weekly at Valentines Mansion and fortnightly at Mayesbrook Clinic and Manford Way Clinic. The following is a summary of the attendances at these Clinics during the year:— Valentines Clinic Mayesbrook Clinic Manford Way Clinic First attendances 297 137 106 Subsequent attendances 1,073 386 366 Totals 1,370 523 472 Number of sessions 49 24 24 Average attendance at each session 28 22 19 In addition 2,284 home ante-natal visits were made during the year. Salvation Army Midwifery Service.—44 cases were attended by the Salvation Army Midwife during the year, 43 as a midwife and 1 as a maternity nurse. A Doctor was called in to 19 of the 43 cases in which a midwife had been engaged. Of the infants born there was one stillbirth. Notifications were received from the Salvation Army Midwife that it was proposed to substitute artificial feeding in respect of 6 infants. Gas and Air Analgesia.—During 1952 gas and air analgesia was administered in 394 cases, of which 351 were attended by the Domiciliary Midwives (326 when acting as midwives and 25 when acting as maternity nurses) and 43 were attended by the Salvation Army midwives (42 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. 62 Ante-Natal Clinics.—The following is a summary of the attendances at the Ante-Natal Clinics during 1952:— Maternity Hospital Mayesbrook Clinic Manford Way Clinic Doctors Midwives First attendances 1,118 — 266 146 Subsequent attendances 6,975 2.955 2,456 1,019 Totals 8,093 2,955 2 722 1,165 Number of sessions 310 *192 130 62 Average attendance at each session 26 15 21 19 * Running concurrently with Doctors' Clinics. 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 1952 clinics were held at the Maternity Hospital weekly, at Mayesbrook Clinic fortnightly, and at Manford Way Clinic monthly. The following attendances were recorded:— Maternity Hospital Mayesbrook Clinic Manford Way Clinic[ First attendances 856 181 96 Subsequent attendances 512 98 3 Totals 1,368 279 99 Number of sessions 53 24 12 Average attendance at each session 26 11 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 103 sessions were held and a total of 702 examinations were made. Maternal Mortality.—During 1952 there was one death of an Ilford mother recorded by the Registrar-General as due to or in consequence of pregnancy or childbirth. Domestic Help Service.—During 1952 the heavy demand for this service continued. A full-time Organiser controls the service, under the general direction of the Area Medical Officer, and at the end of the year there were 16 full-time and 119 part-time Helps employed. 63 The following is a summary of the cases dealt with in 1952:— Number of applications received for assistance 1,341 Number of cases where Domestic Helps were provided (including 337 who were having service at the commencement of the year) 1,299 Number of cases which on investigation were either not eligible for assistance or did not require the service 208 Number of cases referred to other sources, e.g., W.V.S., I.S.S.A 12 Cases booked but subsequently cancelled 80 Number of cases where, at the end of the year, a domestic help was booked to attend in future months (maternity cases) 58 Other cases awaiting help at end of year 18 Enquiries incomplete at end of year 3 Cases being served at 31st December, 1952 390 In November, 1952, 5 of the Domestic Helps took the examination for the Diploma of the National Institute of Houseworkers, four of whom were successful, one obtaining a Class 1 pass and the other three Class 2 passes. Convalescent Facilities.—The following tables show the number of persons sent away for convalescence during 1952 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 Harts Leap, Sandhurst, Surrey - - - - - - 2 Both cases arranged by I.C.A.A. Beach Court, Lancing - - 1 - - - - Arranged by I.C.A.A. Whitechapel Mission Home, Southend-on-Sea 1 - - - - - - Mother with infant Brooklyn Babies Home, Christchurch - - 1 - - - - Arranged by Gt. Ormond Street Hospital Dedisham Mother and Baby Unit, Slinfold - - 1 — - - - Mother and infant (mother had 2 weeks only) Totals 1 - 3 - - - 2 2 mothers with infants 4 unaccompanied children 64 (b) Under Section 28 of the Act, i.e., other persons requiring a change of air and surroundings to aid recovery and rehabilitation. No. of weeks' stay Total Cases Name of Home 1 2 3 4 Armitage House, Worthing - 3 - - 3 Bell Memorial Convalescent Home, Lancing — 1 4 — 5 Channel View Rest Home, Deal — — 1 - 1 Church Army Home, Bexhill — — 2 — 2 Essex Convalescent Home, Clacton 4 10 14 2 30 "Heatherpine", Curridge, nr. Newbury — — 1 — 1 Mrs. Hollamby's Home, Swalecliffe, Whitstable — 1 — — 1 Kelsale Court, Saxmundham 1 — — — 1 Leconfield, Bonchurch, Isle of Wight — — 1 — 1 Samuel Lewis Home, Walton-on-Naze — 5 5 — 10 Rustington Convalescent Home, Littlehampton — 1 3 — 4 "Templecombe", St. Leonards-on-Sea 1 — — — 1 Totals 6 21 31 2 60 Loan of Sickroom Equipment.—A further considerable increase above that noted in 1951 has been evident in the applications for this equipment in 1952, articles loaned during this year having doubled the 1951 figure, and a corresponding increase in the purchase of new items of equipment has been necessary. The issues from the Public Health Offices were as follows:— Articles Loaned Number of Articles Articles in store at 31.12.52 on loan at 31.12.51 loaned or reloaned in 1952 on loan at 31.12.52 Mattresses (Dunlopillo) 6 6 10 — Mattress (Hair) 1 — — 1 Invalid Chairs 16 27 19 6 Air Pillows 1 5 1 1 Air Rings 8 64 23 16 Back Rests 7 33 11 7 Hospital Bed 1 — — 1 Iron Bed 1 — — 1 Commode Chairs 3 8 7 — Crutches (Pair) 1 — 1 — Fracture Boards (Set) 1 3 2 1 Pillow (Feather) 1 — — 1 Pillow (Flock) 1 — — 1 Rubber Sheeting 17 79 40 4 Medical Sandbags 1 — 1 — Spinal Carriages 1 1 1 — Air Beds 1 8 1 1 Pillow (Down) 1 1 2 — Bed Cradles 2 7 4 2 Bed Pans 8 42 20 6 Diabetic Scales 2 — 2 — Feeding Cups 2 4 1 1 Urinals 3 30 11 11 Sputum Mugs — 1 1 3 1 Douche Cans — 2 1 Water Beds — 2 — 1 Water Pillows — 2 1 — Bed Blocks — 1 1 — Totals 86 326 161 66 65 Tuberculosis Visitors.—Three Tuberculosis Visitors were employed in the Area during 1952 making a total of 4,204 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 31.12.51 Nil „ „ „ newly assisted in 1952 1 „ „ „ for whom responsibility ceased Nil „ „ „ being assisted at 31.12.52 1 Open-Air Shelters for Tuberculosis Cases.—No open-air shelters were supplied for tuberculosis patients during 1952 and at the end of the year only one such shelter was in use in Ilford. Provision of Free Milk for Tuberculosis Cases.—The County Council's scheme, commenced in Ilford late in 1951, for supplying to tuberculosis patients one pint of milk free of charge, on the recommendation of the Chest Physician, showed considerable progress during 1952 and the increase in the number of beneficiaries under the scheme still continues. Particulars of the grants made in 1952 are given below:— No. of cases in receipt of free milk at 31.12.51 2 „ „ new grants made during 1952 84 „ „ grants discontinued during 1952 27 „ „ cases in receipt of free milk at 31.12.52 59 Boarding-out of Children (Tuberculosis Contacts).—No applications were received in 1952 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 1952. 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) 69 444 (including renewals) Bedding and Furniture 1 1 Part Cost of Spectacles 1 1 Travelling Expenses of Relatives Visiting Hospital Patients.— The County Medical Officer was able to give financial assistance in 1952 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 undertaker by Nurses under the supervision of the Superintendent of the Lady Rayleigh Training Home at Leytonstone. The work undertaken by Home Nurses operating in the Ilford area in 1952 was as follows:— Cases attended 2,586 Visits paid 71,188 66 Health Education.—Posters covering various aspects of Health were displayed at the Public Health Offices and the Mayesbrook, Manford Way and Newbury Hall Clinics throughout the year and a supply of bookmarks publicising Diphtheria Immunisation was made available at the Public Libraries. In April and May, 1952, at the request of a Youth Club in the district, arrangements were made for lectures on Sex Education to be given by members of the medical staff of the Department to the male and female members of the Club separately, and in October, 1952, a public film show featuring Vaccination and Diphtheria Immunisation was given at the Ilford Town Hall. Dental Treatment.—Mr. E. V. Haigh, the Senior Dental Officer, has submitted the following report:— "Maternity cases and children under the age of five continued to receive dental treatment at Mayesbrook Clinic only. 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 1952 is as follows:— Examined Needing Treatment Treated Made Dentally Fit Expectant and nursing mothers 205 205 243 146 Children under 5 164 161 160 153 The forms of dental treatment provided were:— Extractions Anaesthetics Fillings Scaling or Scaling and Gum treatment Silver Nitrate treatment Dressings Radiographs Dentures Provided, repaired and remade Local General Complete Partial Expectant and nursing mothers 730 75 146 401 106 — 163 5 46 53 Children under 5 407 — 132 128 — — 124 — — — In addition there were 607 prophylactic treatments and other operations carried out in the case of expectant and nursing mothers. The total number of sessions held was 126. 67 SCHOOL HEALTH SERVICE. Nutrition. The summary of heights and weights over 10 years which is printed at the end of this Report in Table VIIA. and B. shows no appreciable change. Incidence of Pediculosis and Scabies. (i) Pediculosis.—13 children were found to be infected with living hair vermin as against 7 in 1951, 5 in 1950 33 in 1949 and 56 in 1948. (iii) Scabies.—There were no cases reported during the year, as compared with 1 in 1951, none in 1950, 5 in 1949 and 19 in 1948. School Premises.—There are 34 schools, with 63 departments, 23,403 children were actually on the roils on 18th December, 1952, as compared with 22,543 in December, 1951. The figure 23.403 includes Barking Abbey (383) and Ursuline County Placed pupils (240). The number of children in average attendance at school for the year ended 18th December, 1952 = 20,433. 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. 817 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:— (a) Every pupil who is admitted for the first time to a maintained school shall be inspected as soon as possible after the date of his admission. (b) Every pupil attending a maintained primary school shall be inspected during the last year of his attendance at such a school. (c) Every pupil attending a maintained secondary school shall be inspected during the last year of his attendance at such a school. During 1952 5,290 parents, or 78 per cent., attended the full routine medical inspections. Infectious Disease.—The following table shows the incidence of infectious diseases in the Ilford schools since 1948:— Scarlet Fever Diphtheria Measles and German Measles Chicken Pox Mumps Whooping Cough 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 1952 294 — *2,242 624 612 316 * Of this number 1,960 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 1952. 68 3 home visits were paid by the School Nurses to cases of minor infectious disease. In addition the Sanitary Inspectors paid 1,921 visits to measles cases, and 301 visits to whooping-cough cases. RINGWORM:— No. of cases at beginning of 1952 No. of cases reported during 1952 Total Remedied during 1952 No. of cases under observation at end of 1952 Scalp — 1 1 1 — Body — — — — — — 1 1 1 — Following Up.—During 1952, 4,736 home visits by the School Nurses were paid for the purpose, and 3,540 re-examinations of children (some on several occasions) were carried out by the doctors at school; 144 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 1952 were as follows:— Newbury Hall Mayesbrook Number of individual children seen 1,357 1,664 Number of attendances of children 2,516 2,887 Number of exclusion certificates granted 39 133 Number of certificates of fitness to attend school granted 39 101 The following table shows the conditions dealt with at both the Clinics during the year:— Subnormal Nutrition 878 Debility 28 Uncleanliness: — Head 103 Body 1 Skin:— Ringworm:— Head — Body — Scabies — Impetigo 15 Dermatitis 4 Urticaria 12 Furunculosis 44 Eczema 11 Other Skin Diseases (Non-Tuberculous) 257 Eye:— Blepharitis 45 Conjunctivitis 48 Defective Vision (excluding Squint) 118 Squint 14 Other conditions 78 69 Ear:— Defective Hearing 34 Otitis Media 22 Other Ear Diseases 19 Nose and Throat:— Chronic Tonsillitis only 80 Adenoids only 6 Chronic Tonsillitis and Adenoids 28 Nasal Catarrh 37 Nasal Obstruction 10 Other conditions 17 Enlarged Cervical Glands (Non-Tuberculous) 54 Defective Speech 20 Teeth—Dental Diseases 1,068 Heart and Circulation:— Functional 6 Organic — Anaemia 11 Infectious Diseases:— Scarlet Fever 1 German Measles 2 Measles 1 Whooping Cough 1 Chicken Pox 2 Mumps 8 Colds and Coughs 185 Influenza 1 Lungs:— Asthma 23 Bronchitis 29 Pulmonary Catarrh 18 Other Non-Tubercular Diseases 2 Tuberculosis:— Puliponary—Definite — —Suspected (Referred to Chest Physician) 14 Developmental:— Hernia — Other 2 Psychological:— Development 1 Stability 15 Nervous System:— Nervous Debility 1 Habit Spasm 1 Chorea — Petit Mal — Enuresis 24 Other Conditions 33 Deformities:— Genu Valgum 11 Posture 11 Pigeon Chest 1 Flat Feet 32 Valgus Ankles 25 Other forms 61 Minor Injuries 70 Rheumatism 16 Other Defects and Diseases 115 Total number of ailments 3,773 70 SPECIAL CLINICS. Ophthalmic Clinic. During the year 1952, the School Oculist held 210 sessions for the refraction of children suffering from defective vision (103 at Valentines, 99 at Mayesbrook and 8 at Manford Way). Full details of the work are given in Table IV, Group II. 3,540 attendances (1,709 at Valentines Clinic. 1699 at Mayesbrook Clinic and 132 at Manford Way Clinic) were made by 1,711 schoolchildren (831 at Valentines Clinic, 805 at Mayesbrook Clinic and 75 at Manford Way), as compared with 1,455 schoolchildren in 1951. The 1,711 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 6/8 6/24 6/60 6/60 less than 357 278 339 286 154 167 81 49 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 1,711 children were found to be suffering from the following defects: — Diagnosis New Cases Old Cases A B C A B Myopia 83 62 27 176 160 Myopic Astigmatism 4 4 - 3 5 Hypermetropia 95 72 36 183 218 Hypermetropic 2 2 - 14 11 Astigmatism Mixed Astigmatism 1 5 - 7 17 Squint 33 31 8 141 118 Blepharitis 7 3 - 14 8 Congenital Coloboma - - - - 2 Congenital Cataract - 2 - 1 - Conjunctivitis 4 3 - 12 13 Nystagmus - - - 6 5 Other conditions 1 1 - 5 10 NAD 15 17 4 24 36 Totals 245 202 75 586 603 A—Valentines. B--Mayesbrook. *C—Manford Way. (*The Ophthaimic Clinic opened on 17th March, 1952) 1,156 complete pairs of spectacles were provided, some of these being renewals after breakages. In addition, in 325 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 at Valentines Clinic 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 Clinic or were referred to hospitals: 71 Congenital abnormalities of the eyes and adnexae; acute inflammatory, infective, allergic and traumatic affections of the eyes. Blind or partially blind children are seen at regular intervals and advised as regards special schooling and contact is maintained with the school authorities about their progress. Orthoptic treatment, so far our greatest headache, will in future be carried out at the Orthoptic Clinic at Mayesbrook. A trained Orthoptist is about to be appointed and the Clinic will probably be opened about Easter, 1953." Dr. E. M. L. Evans, M.B.. B.Ch., D.O., the Ophthalmic Surgeon at Mayesbrook Clinic, makes the following report:— "Most of the children attending the Clinic had refractive errors. About 30% suffered from squint and other errors of muscle balance. The position with regard to orthoptic treatment has remained unsatisfactory, but I understand that it is hoped to open an Orthoptic Clinic in Mayesbrook in the near future, and this will be a great help. A small number of children with congenital abnormalities of the eyes and adnexae, and others with infective, allergic and traumatic affections were seen and received treatment." Orthopaedic Clinic. Mr. H. G. Korvin, F.R.C.S., the Orthopaedic Surgeon, makes the following report:— "1952 was an uneventful year at Mayesbrook and Newbury Hall Orthopaedic Clinics. We have succeeded in reducing the numbers of attendances by more than one-third. The opening of the Clinic at Manford Way played some part in this development, but in the main it was due to the Assistant School Medical Officers' taking over the supervision of many children after these had been examined at the Orthopaedic Clinic. 1 wish to express my thanks to these colleagues for the great help they are giving. It has made it possible to devote more time to difficult cases. It allowed also, by keeping the sessions within reasonable time-limits, to make the appointments system really efficient. X-ray examinations were again carried out at King George Hospital, Ilford. while operative treatment was, as in the past, undertaken at East Ham Memorial Hospital Thanks to the parents' co-operation, it was usually possible to send a child home a few days after operation. This economy in hospital beds made it possible to arrange admission in all cases without undue delay. The provision of surgical appliances was still not wholly satisfactory and further attempts at improving it are being made. To the equipment of the Physiotherapy Department at Newbury Hall a wallmirror was added for the teaching of postural exercises. Both clinics were running very smoothly in the past year, owing to the efficiency and helpfulness of all concerned." (i) Newbury Hall Clinic.—41 sessions were held during 1952, 174 children of school age were examined for the first time during the year and 420 children were seen who had previously attended the clinic. These 594 children made 869 attendances. (ii) Mayesbrook Clinic.—23 sessions were held during 1952, 73 children of school age were examined for the first time during the year and 208 children were seen who had previously attended the clinic. These 281 children made 396 attendances. (iii) Manford Way Clinic.—The first session was held on the 12th March, 1952. 72 7 sessions were held during 1952. 12 children of school age were examined for the first time during the year and 36 were seen who had previously attended a clinic. These 48 children made 82 attendances. The 923 children were found by the Orthopaedic Surgeon to be suffering from the following defects:— Diagnosis New Cases Old Cases A B C A B C Paralyses A.P.M. - - - 10 12 1 Hemiplegia - - - 6 2 - Paraplegia 1 - - 2 - - Monoplegia - - - 1 - - Spastic diplegia - - - 5 - - Spastic Quadriplegia 1 - - - 1 - Scoliosis 3 - 1 4 2 2 Kyphosis 2 1 1 1 - - Slack posture 6 2 - 20 8 2 Deformity of hips - - - 8 1 - Depressed sternum 1 - - - 2 - Genu valgum 30 19 1 130 70 13 O.C.T - - - 10 10 3 Genu varum 12 6 - 12 3 2 Pes valgus-planus 17 5 5 80 47 8 Valgus ankles 11 5 1 40 13 1 Talipes calcaneo-valgus - - - 3 2 - Congenital talipes E.V. - 1 - 6 - - Congenital defect 3 2 - 12 1 - Intoeing 2 - - 6 2 - Pes cavus 1 1 - 2 2 - Hallux valgus 19 8 1 9 5 2 Deformity of toes 10 6 - 23 2 1 Traumatic condition 5 2 - 8 - - Torticollis - - - 2 1 - N.A.D 10 1 1 7 3 - Other conditions 35 12 1 18 11 1 Foot strain 4 2 - 4 8 - Exostosis 1 - - - - - Lumbar Lordosis - - - 1 - - Totals 174 73 12 420 208 36 A—Newbury Hall. B—Mayesbrook. C—Manford Way. 15 children of school age were admitted to the East Ham Memorial Hospital. Particulars as follows:— No. of Cases Defects 2 Bunionectomy 4 Stapling of Knees 3 Skin Tendon Lengthening 1 Removal Exostosis Femur 1 Removal Exostosis Right Heel 1 Osteotomy Great Toe 1 Arthrodesis 1st Tarso Metatarsal Joint 1 Removal Swelling Med. Malleolus 1 Brodies Abscess—Femur Drained 73 During the year 29 pairs of valgus insoles, 10 pairs of surgical boots or shoes. 19 pairs Genu Valgum splints, 16 metatarsal bars, 4 calipers and inverting irons were supplied to school-children. 582 cases were discharged from the Orthopaedic Clinic, 193, as cured, 182 discontinued attendance and were kept under observation at school. 177 were showing improvement and were kept under observation at school, 30 cases left school or left the district. 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 195 sessions were held by the Physiotherapist for treatment during 1952 (96 at Newbury Hall Clinic and 99 at Mayesbrook Clinic). At Newbury Hall Clinic 215 individual children of school age were treated by the Physiotherapist during the year and 1,402 attendances were made by these children. Treatment was also given to 92 children, who made 851 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, 51 sessions were held at Newbury Hall Clinic and 49 at Mayesbrook. At the Newbury Hall Clinic 59 children of school age were treated, making 933 attendances for treatment. At the Mayesbrook Clinic 44 children of school age were treated, making 541 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 27 17 Bronchitis 12 7 Bowlegs 2 Alopecia 2 - Asthma 2 1 Knock Knees 1 - Old Rickets - 8 Chilblains 4 1 Other Conditions 11 13 59 44 A—Newbury Hall Clinic. B—Mayesbrook Clinic. Of the 103 cases treated 5 were Open Air school-children. At Newbury Hall Clinic, 41 children of school age were discharged from the Artificial Sunlight Clinic, 29 as cured, 1 showing considerable improvement, 10 due to absence and 1 removed district. 19 children were still receiving treatment at the end of the year. 74 At Mayesbrook Clinic, 31 children of school age were discharged from the Artificial Sunlight Clinic, 23 as cured, and 8 discharged due to absence. 4 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 40 weeks and one session weekly for 12 weeks. 92 sessions were held during 1952 and 1,411 attendances were made by 873 children of school age, of whom 292 were new cases. The Consulting Oto-Rhino-Laryngologist (Mr. Morton Marks) submits the following report:— "During 1952 the main problem has been the reduction of the enormous waiting list of tonsil and adenoid operations for this area. Some children are still awaiting operation who were placed on the list in 1946. It was felt that many of these no longer required operation and with this in view 1 undertook to see all these cases and review the whole waiting list. It was found that approximately 50% of the cases had either been operated on elsewhere or were no longer in need of operation and this in itself has considerably reduced the numbers. Furthermore, I have been farming out many of these operation cases to other of my hospitals particularly East Ham Memorial and St. Mary's Plaistow. Thirdly, we are now in the process of commencing a double operating session on Wednesday afternoons and evenings at Ilford Isolation Hospital wherein we hope to deal with 12 children a week. At the moment, however, owing to the need of utilizing these beds for infectious cases, we have had to delay the commencement of this service. By these measures it should be possible in the coming year eventually to reduce our numbers to manageable proportions." The Surgeons attending the Clinic during 1952 were:— Mr. Wm. Ibbotson, F.R.C.S., 2 sessions weekly to 30th April. Mr. J. G. Stonham, F.R.C.S., 1 session weekly 1st May to 3rd December. Mr. Morton Marks, M.R.C.S., 1 session weekly 1st May to 31st December. The following table shows the work of the Clinic:— 75 AURAL CLINIC Nature of Disease Still under treatment Recommended Hospital treatment Discharged as cured Discharged as improved Discharged as no treatment required Discharged as left district Discharged as left school Discharged Children whose parents refused to continue attendance or treated elsewhere Totals New Old New Old New Old New Old New Old New Old New Old New Old New Old (i) Acute Suppurative Otitis Media - - - - - - - - - - - - - - - - - - (ii) Acute Catarrhal Otitis Media - - - - - 1 - - - - - - - - - - - 1 (iii) Chronic Suppurative Otitis Media due to:— 1. Tympanic Sepsis 2 3 - 1 1 3 - - 1 1 - - - - - - 4 8 2. ,, Sepsis and Granulations - - - - - - - - - - - - - - - - - - 3. Other Causes - - - - - - - - - - - - - - - - - - (iv) Mastoid Disease (previous operation) - - - - - - - - - - - - - - - - - 5 (v) Partial Deafness due to:— 1. Nerve Deafness - - - - - - - - - - 1 - - - - - 2 1 2. Tonsils and Adenoids 2 3 2 2 3 1 - - - 1 - - - - - - 7 7 3. Retraction of Membrana Tympani 1 2 1 - - - - - - - - - - - - 2 2 4. Scarring of Membrana Tympani - - - - - - - - - - - - - - - - - - 5. Other causes - 1 1 - - 4 - - - - - 1 - - 2 - 3 6 (vi) Opinion on Tonsils 25 30 122 150 60 171 - 1 9 105 4 3 - 1 4 16 224 477 (vii) Rhinitis 1 4 2 - 1 3 - - 1 - - - - - 3 - 8 7 (viii) Other diseases or defects 11 15 5 13 14 30 1 - 8 8 - - - - 3 1 42 67 Totals 42 58 133 166 79 217 1 1 20 115 5 5 - 2 12 17 292 581 76 Rheumatism Clinic. The Physician attended 31 morning sessions during the year, and 164 children (75 of these being new cases) made 296 attendances. The 164 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 - 1 Other forms of Carditis 7 7 14 Tachycardia of Nervous origin 1 2 3 Congenital Heart Disease 2 11 13 Rheumatism 3 5 8 Habit Spasm - - - No Active Rheumatic Disease 4 16 20 Heart Murmur Functional 28 20 48 Pains Due to Orthopaedic condition 8 6 14 Allergic type - 3 3 Exocardial Bruit - 1 1 Fibrositis 1 - 1 Arrhythmia 1 - 1 Nothing abnormal detected 3 5 8 Other conditions 16 12 28 Totals 75 89 164 Number of cases referred to Convalescent Home 1 „ „ „ General Hospital (In-patients) - „ „ „ Isolation Hospital - „ „ „ Ear, Nose and Throat Surgeon 6 „ „ „ Orthopaedic Surgeon 13 „ „ „ For Xray and Electro-Cardiogram 60 „ „ „ Blood Sedimentation Rate 23 „ „ „ Psychiatrist 1 „ „ „ Open Air School 1 „ „ „ Paediatrician 1 Speech Clinic.—Miss P. J. Kent resigned her appointment as parttime Speech Therapist, for two sessions weekly, on 13th March, 1952. Miss P. M. Lough resigned her appointment as full-time Speech Therapist on 27th May, 1952. Mrs. M. Walker was appointed full-time Speech Therapist and commenced duties on 1st August, 1952. By the end of the year, 138 individual children of school age had received speech therapy at this Clinic, making a total of 1.481 attendances. The defects treated were as follows:— Stammering 48 Dyslalia 78 Cleft Palate 1 Dysarthria 4 Dysphonia 1 Hyperrhinophonia 1 Hyporhinophonia 4 Others 1 51 children of school age were discharged from the Clinic during the year. In 34 cases the speech was normal. Of the remaining 17 cases, 9 ceased to attend for treatment and 8 left school or left the district, 77 School Dental Service.—At the end of the year there were three full-time Dental Officers and one part-time officer attending six sessions weekly. Owing to the increased Dental Staff it was possible for the Dentists to visit some of the schools for the purposes of inspection. 3,409 children were inspected at schools of which 2,483 required treatment. 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. In addition to the 2,483 children referred for treatment by the Dental Surgeons at School Inspections there were 2,111 children specially referred by parents, teachers and School Doctors. The amount of dental disease present in children at various ages is shown by the following table relating to school children inspected by the School Dental Officers:— Age Groups (in years) No. of Children inspected at School No. of Children referred for treatment No. of Children specially inspected at the Clinic Total number of Children referred for treatment 5 270 168 315 483 6 351 221 373 594 7 359 231 240 471 8 452 390 259 649 9 420 370 168 538 10 359 249 216 465 11 270 203 169 372 12 260 182 158 340 18 279 191 101 292 14 296 191 83 ' 274 15 93 87 27 114 16 - - 1 1 17 - - 1 1 3409 2483 2111 4594 In addition to the ordinary dental work of fillings and extractions, 19 dentures and 167 regulation plates were supplied. Further, 52 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 1952 the number on the roll varied from 81 on 31.12.51 to 97 on 31.12.52. The number of admissions was 44 and the number of discharges was 28. Debility without any other defect accounted for a total of 6 children in 1952, as against 13 in 1951 and 17 in 1950, 1 of the 6 was discharged to ordinary school during the course of the year. Those admitted were recommended for examination from the following sources:— 78 School Medical Officer:— Asthma 11 Bronchitis 6 Debility 8 Chronic bronchitis and pulmonary collapse Pulmonary catarrh, nasal obstruction and antrum infection 1 1 Debility and emotional difficulties 2 Subnormal nutrition 4 Maladjusted 1 T.B. Adenitis 1 Injury to knee 1 Perthes' disease 1 Cerebral palsy 2 Paralysis 1 Still's disease 1 Old collapse of lungs 1 42 Tuberculosis Officer:— Old T.B. Lungs 1 Others:— Fallot's tetralogy and ? pulmonary stenosis 1 The 28 children not now on the roll ceased attendance for the following reasons:— Fit for ordinary school 15 Left school—over age 4 Admission to Convalescent Homes 1 Admitted to Harold Wood Hall Children's Home 1 Admitted to County High School 1 Admitted to Residential Open-air School Admitted to Residential School 1 Admitted to a Hospital School 1 Admitted to St. Anthony's Roman Catholic Centre. Manford Way 1 Died 1 The so-called spastic class continued to develop along the previous lines, with special therapy such as weaving and model making. The use of walking machines and tricycles was extended. In 1952 there were 10 in the class and the composition was as follows:— Spastic paraplegia 2 Spastic paraplegia and dislocation of hips 1 Spastic diplegia 2 Left spastic hemiplegia 1 Diplegia of atheloid type 1 Cerebral palsy 1 Talipes and wasting of calf muscles 1 Spina bifida occulta and paresis of lower limbs 1 In addition to the above 3 cases of milder spasticity attended the ordinary classes of the school. By arrangement with Romford Authority, one case from their area was admitted during the year. 79 One child of 4 years of age is down for admission to this spastic class when he reaches school age, should there be a vacancy. Another child aged 5 years is awaiting consideration for admission when her present treatment is finished. As a result or the Medical Officers periodic examinations a number of the children have been recommended certain treatment as follows:— Administration of Milk in school 39 Administration of Cod Liver Oil Emulsion 38 Administration of Malt and Oil, etc. 1 Referred to Orthopaedic Surgeon 1 „ „ Ophthalmic Surgeon 2 „ „ Aural Surgeon 1 „ „ Dental Surgeon 2 Recommended Asthma exercises 1 Recommended Convalescent Home treatment 3 Recommended Child Guidance Clinic 1 Recommended Paediatric Clinic 4 Recommended Artificial Sunlight treatment 1 A coure of asthma injections was given to 5 children during the year. 5 children received Artificial Sunlight treatment during the year. The Dental Surgeon has carried out one complete inspection of the children's teeth at the Open-air School. The following table shows the dental work carried out:— Number of children examined by the School Dentist 79 Number of children referred for treatment 59 Number of children treated by Dental Surgeon 42 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 re-building of the rest-hall was completed after the Easter Vacation. The School can now take 115 children as against 85 previously. Treatment for Uncleanliness.—The School Nurses paid 192 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 Individual Number of Children Examinations Number Per Examined of Children Infested cent. 19,811 57,274 *262 0 45 *Thirteen 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. percentages for the past 5 years were as follows:— 1948 1.3 1949 0.9 1950 0.5 1951 0.4 1952 0.4 80 Other Ailments.—During 1952, 473 children were operated on for the removal of enlarged tonsils and adenoids as follows:— King George Hospital 125 St. Mary's, Plaistow 48 Ilford Isolation Hospital 32 Rush Green Hospital 2 Queen Mary's Hospital 1 St. Leonard's Hospital 16 East Ham Memorial Hospital 26 Wanstead Hospital 1 Privately 222 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 1952 was 2,213,645 approximately. There are 20 kitchens in the Borough, established at the following schools:— Barking Abbey, Barley Lane, Beal, Benton, County High Boys, County High Girls, Cleveland. Dane, Fairlop, Gearies, Good- mayes, 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, 1952, 18,964 children were receiving milk in school. Work done by the N.S.P.C.C.—The following 44 cases were investigated:— (1) Neglect 26 (2) Ill-treatment cases 10 (3) Other cases 8 (Four cases were reported from the Public Health Department for neglecting medical advice; 40 were reported from other sources for general neglect.) 87 children (41 boys and 46 girls) were involved, 34 being of school age. In addition to this work, 193 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 35 (b) Regional Hospital Board Homes 1 1 Physically Handicapped boy provided with one week's holiday, from voluntary funds. 1 Problem Child provided with 2 weeks' holiday from voluntary funds. 1 Tricycle supplied to "Spastic" boy on advice from Orthopaedic Specialist. Numerous escorts provided to London or all the way to Convalescent Homes by Voluntary Workers. 70 homes were visited during the year. 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. 81 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, 1952, are tabulated in the following table:— 82 Return of Handicapped Pupils in the Area on 31st December, 1952 (Aged 2-16 Years) Handicapped pupils. Blind, Partially Blind, Deaf Partially Deaf. Delicate. Physically Handicapped. Educationally Subnormal. Maladjusted. Epileptic. Total 1 2 8 4 5 6 7 8 9 A. Newly placed in 1052 1 - - 3 45 11 12 14 1 87 B. Newly ascertained in 1952 3 1 - 1 44 14 21 11 - 95 C. (i) Attending Special School- Day - 1 9 4 68 27 54 2 - 165 Boarding 3 3 5 2 3 2 12 7 2 39 (ii) Boarded in homes - - - - - - - - - - (iii) Attending assisted Schools - - - 2 - 1 2 26 - 31 D. Unplaced— (i) At no school 2 2 - 1 2 10 - 1 1 19 (ii) At ordinary school - - - - 5 - 21 2 - 28 E. Receiving home tuition (including those in D). - - - - - 5 1 - 1 7 Attending Special Schools Speech = Nil Diabetes = Nil Boarded in Homes Spcech = Nil Diabetes = 2 Child Guidance Clinic.—The Child Guidance Clinic was opened on 3rd January, 1949, at Loxford Hall, Loxford Lane, Ilford. Dr. J. E. G. Vincenzi, the Psychiatrist, reports as follows:— "The position at 1st January. 1952, was that there was a waiting list of 69, and as at 1st January, 1953. 123. This is partly accounted for by the fact that the Dagenham area do not now keep a waiting list of their own, but it does to some extent show that the Clinic has not coped with its requirements, let alone made up leeway. This is largely due to the inadequacy of phychiatric and lay-therapeutic time available. Dr. Burbury left in August and Dr. Davidson was not appointed until December, so that for four months two psychiatric sessions a week were unfilled. With Dr. Davidson's appointment the prospects for 1953 are more favourable and it is hoped that extra lay-therapeutic time can be given, with the possibility of additional psychiatric sessions. During these four months the only psychiatrist working was obliged to take on cases of Dr. Burbury's, leaving even less time for diagnostic interviews. The position as regards the Clinic has not been entirely satisfactory owing to the inadequate number of rooms suitable for interviews and the fact that the premises were still being used for other 83 purposes making structural alterations impracticable. It is hoped that this difficulty will be overcome early in 1953. It is a fact that 84% of the children seen were taken on for treatment. This is much higher than usual but is explained by the fact that only urgent cases were seen." The statistical analysis of cases seen is given below:— Total number of cases: 180 referred Boys 114 63.3% Girls 66 36.7% 180 Primary Reason for Referral:— Boys Enuresis Aggresive behaviour Withdrawn behaviour Sleep disturbance 12 32 17 6 Girls 7 19 8 2 19 51 25 8 Stealing Failure to attend school Fears and anxiety Sexual Offence Boys 10 2 18 1 Girls 6 1 11 1 16 3 29 2 Speech Difficulties Habit Spasms Asthma No progress at school Boys 2 3 1 5 Girls 3 3 - 4 5 6 1 9 Hysteria Feeding difficulties Continued attedance at residential school Boys 2 1 2 Girls - - 1 2 1 3 Dr. W. M. Burbury resigned her appointment as part-time Consultant Psychiatrist with effect from 30th September, 1952. Dr. H. M. S. Davidson was appointed part-time Consultant Psychiatrist and commenced duties on 5th December. 1952, undertaking 2 sessions weekly. Dr. J. E. Vincenzi continued as Assistant Psychiatrist with 3 sessions weekly. It is hoped very shortly to increase the number of Consultant sessions to 4 and eventually the total number of sessions to 9. The Psychiatrists undertake 5 sessions weekly, whilst the Educational Psychologists and the Psychiatric Social Workers are whole-time. During the year 180 new cases were referred to the Clinic. Five cases were examined at request of Courts. 84 Employment of School-children and Young Persons.—From special inquiries made at the various schools during 1952, it was found that 177 children were employed out of school hours. 174 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 174 Employment of Children in Entertainments Provisional Amending Rules, 1945.—15 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 „ „ School Clerical Assistants 7 „ „ School Keepers 2 „ School Attendant 1 „ „ Laboratory Steward 1 „ „ Speech Therapist 1 „ „ Assistant Architect 1 „ Typist 1 „ „ Teachers 7 Intending Teachers 29 54 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 Health Camp are medically examined by the Assistant Medical Officers prior to entry. The following is a table of work undertaken at the Clinic:— Psychiatrist:— Cases diagnosed 107 Treatment interviews 525 Other interviews 170 Psychologist:— Cases tested 82 Treatment interviews 137 Other interviews 93 School visits on Clinic cases 99 Psychiatric Social Worker:— Cases interviewed at Clinic 996 Other interviews 149 Play Therapist:— Play Therapy interviews 648 Number of cases recovered or sufficiently improved to warrant discharge 35 Diagnosis and advice only 19 Discharged—non-co-operatiye 22 85 The Causes of Death among Children of School Age (i.e., from 5—15 Years) in Ilford, during 1952, were:— Asthma 2 Congenital heart and Mongolian idiocy 1 Epileptic Fits 1 Accident Cirrhosis of Liver 1 Rheumatic heart disease and operation 1 Malignant Cerebellar Tumour 1 Acute Leukaemia 1 Herschsprungs disease 1 10 ILFORD ENURESIS CLINIC Dr. J. Pooley, Assistant County Medical Officer makes the following Report from December 19th, 1951 (date of commencement), to 31st December, 1952. " The Clinic continues to be held on Wednesday mornings at the Public Health Offices, Emerson Road, and the attendance (apart from absences through illness) has been good. 1. Appointment List.—At 31st December, 1952, 153 cases had been seen, made up as follows:— Recommended by Children under 5 years of age Children of school age Total Boys Girls Boys Girls Parents 3 1 4 1 9 Doctors in private practice 3 2 9 1 15 Infant Welfare Officers 6 3 - - 9 Assistant School Medical Officers - - 62 47 109 Health Visitors - - 4 2 6 Consultant Clinics - 1 2 2 5 12 7 81 53 153 2. Procedure.—At each clinic the original procedure has been continued as follows:— (a) Examination of urine by Health Visitor (for sugar, albumin, reaction and specific gravity). (b) History of enuresis is taken (including that of any relevant illnesses). (c) Physical examination. (d) The approachability of the child and parent is noted. (e) General advice to child and parent is given, and in particular, discussion is directed towards individual problems. (/) Charting of all dry nights is explained. (g) Medicinal treatment is issued or prescribed (vide No. 3). 3. Treatment.—It will be seen that of the 153 cases examined at 31st December, 1952, 93 are boys and 60 are girls. The treatment issued or prescribed therefore was as follows:— 86 Cases (a) Benzedrine (either 2 5 mgm., 5 mgm. or 7 5 mgm.) at night at a time decided upon for each individual child 122 (b) Benzedrine and Mist, potassium citrate c hyoscyamus at night again at a time or times, decided upon for each child 9 (c) Phenobarbitone gr. ½ at night . 8 + cases failed on Benzedrine 8 (d) Sodium Amytal gr. i at night 1 + case failed on Benzedrine 1 (e) Ephedrine gr. ½, all of which cases had been ously treated with Benzedrine and included above 13 (f) Advice and charting only 13 (g) Cases referred (because of persistent failure to improve under one of the above measures) to hospital or Child Guidance Clinics 5 (h) Ephynal (previously treated by other methods and failed) 2 N.B.—The_phenobarbitone, sodium amytal, ephedrine, Mist. pot. cit c hyoscyamus and ephynal were not issued by the Health Area Office. It is interesting to note that of those completely dry (i) 21 (62%) were boys and 13 (38.2%) were girls; and (ii) the average number of visits for each of these children before discharge was: 4 visits for boys and 3.5 visits for girls; (iii) the average age was: 7 years for boys and 9 years for girls. 5. Conclusions.—Those cases which have been slow to improve have fallen into four main groups: — (i) Those with some home or school problem, often that of frustration. (ii) Overcrowding in the home. (iii) Those with any physical defect, e.g., asthma, worms, etc. (iv) Mismanagement by one or both parents. 4. Analysis of Results in respect of treated cases:— Cases (i) Completely dry 34 (ii) Very marked improvement (i.e., less than 5 nights wet in 28 nights) 34 (iii) Marked improvement (i.e., less than 14 nights wet in 28 nights) 31 (iv) Some improvement (i.e., more than 14 nights wet in 28 nights) 11 (v) No improvement 23 (iv) Not yet re-attended 20 Total 153 87 In almost every case, the time spent in talking to the child and thus securing his or her interest, has proved as valuable, or more so, than the medicinal treatment gfven. There have been a few cases who have relapsed as soon as the tablets have been discontinued—and in these, the substitution of a sweet or saccharin after a week or so, has often been sufficient to meet the case; in others, a gradual decrease of the dosage has been more satisfactory. The home background is invariably important—a harassed, tired mother in an overcrowded house, naturally cannot give the calm reassurance so necessary to the child. This was strikingly illustrated by a 6 year old boy who became completely dry as soon as a council flat was found for the family. The sleeping conditions in this family had been particularly bad. Of recent months a system of waking certain children one hour before their normal waking time has proved very effective. This appears to rule out a large number of "pre-waking enuretics" who have described dreams of "being in the toilet" and who have woken too late to control the act of micturition. Finally, it has been interesting to note that the 6—8 year old child is much more responsive to treatment than the younger child, and the child over 10 years of age is' usually a much more difficult problem. In general, the attitudes of both parents and children have been of interest and co-operation." 88 Ministry of Education. MEDICAL INSPECTION RETURNS. Year Ended 31st December, 1952. 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 3,196 Second Age Group 1,976 Third Age Group 1,573 Total 6,745 Number of other Periodic Inspections - Grand Total 6,745 B.—Other Inspections. Number of Special Inspections 3,540 Number of Re-inspections 9,169 Total 12,709 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 For defective vision (excluding squint) For any of the other conditions recorded in Table IIA Total individual pupils (1) (2) (3) (4) Entrants 92 929 989 Second Age Group 193 551 066 Third Age Group 227 373 539 Total (prescribed groups) 512 1853 2194 Other Periodic Inspections - - - Grand Total 512 1853 2194 89 TABLE II. A.—Return of Defects Found by Medical Inspection in the Year Ended 31st December, 1952. 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 156 353 75 1 5 Eyes— a. Vision 512 196 199 5 b. Squint 86 15 21 - c. Other 53 183 38 — 6 Ears— a. Hearing 30 37 70 8 b. Otitis Media 10 22 19 1 c. Other 16 24 25 2 7 Nose or Throat 390 187 619 22 8 Speech 44 41 58 2 9 Cervical Glands 13 54 194 3 10 Heart and Circulation 56 16 177 1 11 Lungs 85 76 335 8 12 Developmental— a. Hernia 38 - 111 - b. Other 16 2 112 1 13 Orthopaedic— a. Posture 281 11 74 1 b. Flat foot 474 52 81 2 c. Other 362 111 258 12 14 Nervous system— a. Epilepsy 1 - - - b. Other 10 62 13 1 15 Psychological— a. Development 3 4 16 - 16 6. Stability 75 30 130 1 Other 69 191 83 28 no B.—Classification of the General Condition of Pupils Inspected During the Year in the Age Groups (See Note (ii) on Table 1). Age Group Number of Pupils Inspected A—(Good) B.—(Fair) C—(Poor) No. % of Col. 2 No. 0/ /o of Col. 2 No. % of Col. 2 (1) (2) (3) (4) (5) (6) (7) (8) Entrants 3196 1302 41.0 1790 560 104 3.0 Second Age Groups 1970 620 31.4 1300 65.8 56 2.8 Third Age Groups. 1573 519 33.0 1033 65.7 21 1.3 Other Periodic Inspections - - - - - - - Totals 6745 2441 36.2 4123 61.0 181 2.8 TABLE III. Infestation with Vermin. All cases of infestation, however slight, are recorded. This return relates to individual pupils and not to instances of infestation. (i) Total number of pupils examined in the schools by school nurses or other authorized persons 19,811 (ii) Total number of individual pupils found to be infested 262 (iii) Number of individual pupils in respect of whom cleansing notices were issued (Section 54 (2), Education Act, 1944) 13 (iv) Number of individual pupils in respect of whom cleansing orders were issued (Section 54 (3), Education Act, 1944) - (v) Number of individual pupils disinfested:— By Local Authority 111 By parents 151 TABLE IV. Treatment of Pupils Attending Maintained Primary and Secondary Schools (Including Special Schools). Notes:—(d Treatment provided by the Authority includes all defects treated or under treatment during the year by the Authority's own staff, however brought to the Authority's notice, i.e., whether by periodic inspection, special inspection, or otherwise, during the year in question or previously. (b) Treatment provided otherwise than by the Authority includes all treatment known by the Authority to have been so provided, including treatment undertaken in school clinics by the Regional Hospital Board. [N.B.—The information asked for in this table falls into these two Divisions (a) and (b). except in Group 5 (Child Guidance Treatment).] Group 1.—Diseases of the Skin (Excluding Uncleanliness, for which see Table III). Number of cases treated or under treatment during year— By the Authority Otherwise Ringworm—(i) Scalp - 1 (ii) Body - - Scabies - - Impetigo 15 - Other skin diseases 327 91 Total 342 95 Number of examinations made by Skin Specialist—67. 91 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 182 21 Errors of Refraction (including squint) - 1,689 Total 182 1,710 Number of pupils for whom spectacles were - (a) Prescribed - 1,145 (b) Obtained - 1,127 Total - 2,272 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 - 14 (b) for adenoids and chronic tonsillitis - 473 (c) for other nose and throat conditions - 23 Received other forms of treatment Total 86 116 86 626 Group 4.—Orthopaedic and Postural Defects. (a) Number treated as in-patients in hospitals 15 By the Authority Otherwise (6) New cases treated otherwise, e.g., in clinics or out-patients departments 276 10 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 783 1 Group 6.—Speech Therapy. By the Authority Otherwise Number of pupils treated by Speech Therapists for the first time. 138 2 92 Group 7.—Other Treatment Given. New cases treated By the Authority Otherwise (a) Miscellaneous minor ailments 3,021 581 (b) Other (1) Heart and Rheumatism 75 4 (2) Sunlight Treatment 52 4 (3) Massage and Remedial Exercises 215 (4) Enuresis 132 — Total 3,495 589 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 3,409 (b) Specials 2,111 Total (1) 5,520 (2) Number found to require treatment 4,594 (3) Number referred for treatment 4,594 (4) Number actually treated 4,314 (5) Attendance made by pupils for treatment 9,553 (6) Half-days devoted to: Inspection 25 Treatment 988 Total (6) 1,013 (7) Fillings: Permanent Teeth 4,149 Temporary Teeth 823 Total (7) 4,972 (8) Number of teeth filled: Permanent Teeth 3,529 Temporary Teeth 787 Total (8) 4,316 (9) Extractions: (i) Permanent Teeth:— (a) On account of Caries 659 (b) For other purposes 144 (ii) Temporary Teeth:— (a) On account of Caries 3,701 (b) For other purposes 210 (10) Administration of general anaesthetics for extraction 1,792 (11) Other operations Permanent Teeth 4,361 Temporary Teeth 901 Total (11) 5,262 98 SCHOOL HEALTH SERVICE STAFF AND SCHOOL CLINICS AS AT 31st DECEMBER, 1952. 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 7 2.92 (iii) General Practitioners working part-time in the School Health Service - - (b) Dental Officers 4 3.36 (c) Speech Therapist 1 1 (d) School Nurses *13 (Combined posts. H.V. and S.N.) 5.85 (e) Nursing Assistants 5 (Clinic Nurses) 2.75 (f) Dental Attendants 4 3.46 * 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 5 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. 94 Examination and or Treatment Number of School Clinics (i.e. premises) where such treatment is provided Directly by the Authority Under arrangements made with R.H.B. &c. (1) (2) (3) A. Minor ailment and other non-specialist examination or treatment 2 - B. Dental 3 - C. Ophthalmic - 3 D. Ear, Nose and Throat - 1 E. Orthopaedic - 3 F. Paediatric - 1 G. Speech Therapy 2 - H. Rheumatism and Heart - 1 I. Artificial Sunlight 2 - J. Remedial Exercises 2 - IV.—Child Guidance Centres. (i) Number of Child Guidance Centres provided by the Authority = 1 Staff Number Aggregate in terms of the equivalent number of whole-time officers Psychiatrists 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. T.able VI.-Summary of Casss of Infectious Diseases among School Children, and of Contacts of such Casks, excluded from School Attendance during the Year ended the 31st December, 1952. SCHOOLS No. on Roll DISEASES AND CONTACTS Scarlet Fever Diphtheria Measles and German Measles Whooping Cough Chickenpox Poliomyelitis Mumps Pneumonia Rheumatism SonneDysen tery Totals Cases Contacts Cases Contacts Cases Contacts Cases Contacts Cases Cases Cases Cases Cases Cases Cases cts Barley lane 477 - - - - 7 - - - - - - - - - 7 - Beal Modern 686 - 3 - - - - - - - - - 1 1 - 2 3 Becontree 1238 5 16 - - 85 13 9 1 2 - 54 - - - 155 30 Benton (Open Air) 97 1 1 - - 1 - 2 - - - - - - - 5 1 Chadwell 646 30 7 - - 88 22 5 - 3 1 10 - - - 137 29 Christchurch 816 12 11 - - 117 - 22 1 187 - 57 2 1 - 398 12 Cleveland 1050 5 5 - - 168 17 10 2 112 1 51 - 1 - 348 24 Comity High 1224 1 8 - - 10 - - - 4 1 4 - 2 - 22 8 Dane 656 1 3 - - 1 - - - 1 - - - - - 3 3 Downshall 1408 21 12 - - 126 11 26 5 21 - 14 2 - - 210 28 Fairlop 1826 24 22 - - 51 2 35 1 70 - 90 1 - - 271 25 Gearies 1251 5 5 - - 175 21 2 - 92 1 65 3 - - 342 26 Goodmayes 646 27 10 - - 110 21 18 3 6 - 5 1 - 1 168 34 Gordon 258 6 2 - - 78 12 15 2 6 - 29 1 1 - 136 16 Highlands 1020 24 10 - - 121 - 45 - 4 - - 2 - 2 198 11 loxford 393 - - - - 1 - - - 1 - - - 1 - 3 - Mayfield 851 3 7 - - 5 - - - 1 - 1 - - - 10 7 Mossford (Fairlop) 352 1 1 - - 49 1 5 2 3 - 2 - - - 60 4 Mossford (G.V.H.) 172 2 - - - 30 - 4 - - - - - - - 36 - Newbury Park 405 4 1 - - 91 11 7 1 4 - 75 - - 1 182 13 Parkhill 902 12 3 - - 107 21 3 - 9 - 5 1 2 - 139 24 St. Augustine's 271 3 2 - - 9 - 8 - 30 - 18 - - - 68 2 SS. Peter and Paul's 663 2 1 - - 55 4 11 - 21 - 4 1 - - 94 5 St. Vincent's 383 - - - - 2 - - - 4 - - - - - 6 - South Park 1018 20 13 - - 164 - 5 2 24 - 3 1 - - 217 15 The Gilbert Colvin 512 3 - - - 72 2 2 - 1 - - - - - 78 2 The Glade 476 8 5 - - 86 12 3 - 4 - 2 - - - 103 17 The John Bramston 597 27 21 - - 23 - 29 3 1 1 33 - - - 114 24 The Mount 301 1 - - - 6 - - - 3 - - - - - 10 - The Redbridge 576 3 - - - 74 - 11 3 3 - 1 - - 1 93 3 The William Torbitt 1013 32 19 - - 139 13 18 3 3 - 64 - 1 - 257 35 Uphall 392 2 - - - 22 1 13 1 - - - 1 - - 39 2 Ursuline 240 3 3 - - 5 - 2 - - - - - - - 10 3 Woodlands 301 - - - - 111 21 3 - 3 - 25 - - - 142 21 Private - 6 1 - - 53 2 3 - - - - - 1 - 63 3 Totals 23117 294 192 - - 2242 207 316 31 624 5 612 17 11 5 4126 430 Encephalitis case at South Park School. 95 96 97 Table VIIA.-Table Showing the Average Heights and Weights of the BOYS Examined (1952). 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 j (in Kilogrammes) Beal Modem - - - - - - - - - - - - - - - - - - 5 148 37.4 8 150 37.4 1 160 54.0 1 159 42.4 5 169 58.9 22 174 58.6 - - - Becontree 58 111 20.4 53 115 20.9 8 125 26.1 2 121 27.2 1 128 24.0 55 138 32.3 39 141 33.7 3 145 39.2 4 151 40.3 57 159 51.5 3 166 57.2 - - - - - - Benton (Open Air) 10 108 17.6 10 104 183 9 120 23.1 13 124 23.7 13 129 25.4 7 132 29.1 8 137 29.3 6 146 35.9 5 151 36.5 5 163 46.1 1 173 56.0 - - - - - - Chadwell 31 113 20.8 31 117 22.3 1 129 25.1 - - - 1 147 43.4 4 137 31.2 30 143 34.0 8 142 34.2 1 152 37.6 - - - - - - - - - - - - Christchurch 5 113 19.8 5 115 21.2 - - - 2 125 25.1 3 133 27.9 1 133 29.0 31 144 36.5 - - - - - - - - - - - - - - - - - Cleveland 31 112 19.5 30 117 21.4 4 125 26.5 - - - 3 133 29.0 15 141 32.9 81 142 34.9 - - - - - - - - - - - - - - - - - - County High - - - - - - - - - - - - - - - - - - 10 144 36.7 1 153 35.8 14 158 45.3 4 159 51.8 87 170 57.8 24 172 62.3 1 174 56.2 Dane - - - - - - - - - - - - - - - - - - 20 142 34.6 2 148 35.5 3 153 42.4 21 165 52.5 15 170 58.1 - - - - - - Downshall 13 112 194 52 117 22.2 - - - 1 138 308 1 132 27.0 6 142 33.4 45 145 35.0 3 142 32.4 5 160 50.7 52 161 50.1 27 167 54.7 - - - - - - Fairlop 39 113 20.4 61 116 21.7 1 121 23.6 1 130 26.8 3 141 32.8 3 134 27.8 65 144 36.2 7 146 38.5 6 147 38.9 64 161 49.7 14 166 56.1 - - - - - - Gearies 37 114 20.1 20 118 22.0 4 122 23.8 3 126 31.7 - - - 10 144 37.0 51 144 35.1 1 159 47.0 3 154 46.7 21 163 53.3 31 166 55.3 - - - - - - Goodmayes 33 114 20.5 19 119 23.1 4 124 261 2 121 22.4 1 140 32.0 6 137 31.4 25 142 33.2 - - - - - - - - - - - - - - - - - - Gordon 33 113 20.2 10 113 20.8 2 126 25.6 - - - - - - - - - - - - - - - - _ - - - _ - - - - - - - - - Highlands 38 114 20.5 98 116 22.1 6 115 21.0 5 129 29.3 3 132 29.2 1 155 40.6 36 146 37.8 1 145 40.4 - - - - - - - - - - - - - - - Loxford - - - - - - - - - - - - - - - - - - 5 142 38.5 1 135 36.6 3 152 50.1 57 160 47.7 16 167 53.0 1 165 49.8 - - - Mayfield - - - - - - - - - - - - - - - - - - 8 143 35.8 - - - 4 150 42.5 63 162 49.6 21 163 50.5 - - - - - - Mossford 15 109 19.3 12 115 20.2 - - - 1 137 31.0 - - - 3 138 32.9 17 140 34.8 1 135 27.8 - - - - - - - - - _ - - - - - Mossford G.V.H. 3 118 22.0 7 115 21.0 2 124 22.2 2 128 22.9 1 129 26 1 140 35.0 3 143 34.5 - - - - - - - - - - - - - - - - - - Newbury Park 29 112 19.6 17 118 21.0 2 123 23.3 - - - - - - 3 148 42.5 19 141 34.1 1 146 32.7 - - - - - - - - - - - - - - - Parkhill 55 114 20.1 50 116 21.4 5 128 26.9 2 138 28.5 3 133 29.7 1 143 310 45 145 32.3 - - - - - - - - - - - - - - - - - - St. Augustine's 21 112 211 1 117 185 3 120 24.3 1 132 26.2 2 128 24.9 1 137 320 7 147 35.7 - - - - - _ - - _ - - - - - - - - - SS. Peter and Paul 28 112 20.3 29 118 22.5 3 130 25.4 1 123 24.6 2 138 31.5 11 140 30.9 22 143 33.2 1 142 34.0 1 151 35.0 3 165 54.5 5 168 57.0 - - - - - - South Park 60 116 20.8 81 117 21.2 2 126 279 4 129 27.2 3 133 31.7 6 145 35.8 44 144 35.0 1 153 37.3 - - - - - - - - - - - - - - - St. Vincent's 14 113 19.1 6 115 20.1 - - - 1 130 27.7 1 136 300 5 139 30.2 13 142 34.2 1 145 31.7 2 158 47.0 24 158 46.2 1 165 55.2 - - - - - - The Gilbert Colvin 24 113 20.5 35 117 22.3 2 124 280 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - The Glade 39 115 19.6 40 118 21.4 1 128 24.8 1 130 22.6 - - - 4 140 30.2 24 145 368 - - - - - - - - - - - - - - - - - - The John Bramston 46 109 19.9 23 113 20.3 - - - - - - - - - - - - 17 144 35.3 - - - - - - - - - - - - - - - - - - The Redbridge 39 113 21.0 18 117 21.7 2 129 27.4 4 129 27.2 - - 29.2 11 142 34.4 26 143 35.2 - - - - - - - - - - - - - - - - - - The Wm. Torbitt 54 112 197 61 115 21.7 3 117 23.7 5 126 24.0 1 133 33.0 3 143 35.5 49 145 35.4 - - - - - - - - - - - - - - - - - - Uphall 11 111 20.3 21 115 21.5 1 132 28.0 - - - 2 131 - 3 143 35.3 21 - - - - - - - - - - - - - - - - - - - - Woodlands 4 116 21.5 4 117 23.9 - - - 1 124 24.4 - - - - - - - - - - - - - - - - - - - - - - - - - - - Ilford Boys-Averages for 10 years:- 1952 820 113 20.2 799 116 21.2 65 123 24.8 52 127 26.2 44 132 28.6 110 140 32.8 766 143 35.3 46 146 36.2 52 154 41.3 372 161 49.8 226 167 55.9 47 172 60.3 1 176 56.2 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 1949 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 31 151 41.1 390 161 50.7 231 167 55.7 14 171 60.4 1 174 73.4 1948 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 1947 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 43.0 298 159 48.6 48 168 55.3 - - - - - - 1946 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 2 157 566 - - - - - - 1945 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 40 166 540 - - - - - - 1944 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 - - - - - - - - - 1943 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 - - - - - - - - - - - - 1942 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 - - - - - - - - - - - - 98 99 Table VIIB.-Table Showing the Average Heights and Weights of the GIRLS Examined. 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 - - - - - - - - - - - - - - - 2 141 35.5 9 147 39.4 4 151 43.0 - - - 1 154 47.8 19 160 54.2 19 161 57.8 3 159 49.5 Becontree 72 111 19.4 47 113 20.1 13 119 22.1 2 125 29.7 1 134 26.0 18 137 31.6 29 141 32.9 4 149 37.9 1 153 48.0 61 157 51.3 6 159 47.5 - - - - - - Benton (Open Air) 9 111 18.4 8 113 19.1 7 116 20.7 12 123 21.9 7 131 29.4 6 136 30.4 10 139 31.7 5 140 31.3 4 153 42.1 6 159 41.5 1 155 35.5 - - - - - - Chadwell 25 113 20.6 19 115 21.3 2 120 24.5 2 122 21.7 1 137 43.7 5 140 33.5 26 143 34.6 10 147 40.4 - - - - - - - - - - - - - - - Christchurch 4 112 20.3 4 117 21.4 1 115 20.0 - - - - - - 5 142 35.9 12 146 39.8 - - - - - - - - - - - - - - - - - - Cleveland 31 109 19.2 43 115 20.8 - - - - - - 4 134 29.5 10 141 36.8 68 143 35.9 - - - - - - - - - - - - - - County High - - - - - - - - - - - - - - - - - - 78 147 38.3 20 147 39.2 6 145 40.2 3 157 40.8 55 162 56.5 17 161 53.9 1 162 51.7 Dane Central - - - - - - - - - - - - - - - - - - 29 145 37.2 5 158 35.9 1 163 60.5 65 160 51.5 10 162 54.8 - - - - - - Downshall 27 115 20.8 41 115 21.2 2 126 25.1 7 125 25.9 7 130 28.0 10 140 31.0 48 143 33.2 2 153 43.0 - - - 44 159 50.4 20 162 55.0 - - - - - - Fairlop 33 112 19.7 43 115 20.4 3 125 25.6 3 123 25.2 2 134 32.7 1 139 28.8 71 146 32.9 3 148 37.2 4 164 59.8 66 159 49.6 6 161 52.8 - - - - - - Gearies 35 111 18.1 27 116 20.7 2 120 21.6 1 118 20.1 1 139 35.1 8 142 35.3 40 145 36.2 3 154 46.3 3 164 55.1 39 158 49.2 12 159 51.6 - - - - - - Goodmayes 43 113 20.0 23 117 15.4 1 132 27.4 2 126 230 2 126 24.5 6 137 31.6 29 147 37.5 - - - - - - - - - - - - - - - - - - Gordon 22 113 20.7 14 113 20.8 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Highlands 80 113 20.1 96 114 20.8 5 125 25.8 4 128 25.1 2 130 27.7 2 145 44.4 28 147 35.9 - - - - - - - - - - - - - - - - - - Mayfield - - - - - - - - - - - - - - - - - - 12 145 37.8 4 152 44.0 2 153 45.3 36 160 52.1 31 161 54.7 - - - - - - Mossford 26 110 18.6 18 112 19.6 1 117 20.2 - - - - - - - - - 7 141 31.3 - - - - - - - - - - - - - - - - - - Mossford G.V.H. 1 106 19.6 3 114 21.3 3 120 22.3 1 118 23.0 1 125 22.0 2 136 29.2 2 145 42.5 - - - - - - - - - - - - - - - - - - Newbury Park 30 112 19.2 18 116 20.9 3 125 23.3 2 125 24.4 1 135 26.5 4 145 40.6 10 146 36.7 - - - - - - - - - - - - - - - - - - Parkhill 64 113 20.0 38 116 21.4 2 124 29.1 2 131 27.5 3 136 30.5 3 146 38.9 35 144 35.3 - - - - - - - - - - - - - - - - - - St. Augustine's 8 110 20.2 8 121 22.6 3 123 24.2 - - - 1 137 37.8 1 143 33.0 9 140 31.7 - - - - - - - - - - - - - - - - - - S.S. Peter and Paul 21 112 19.9 13 113 19.6 2 124 23.1 1 130 24.7 1 133 28.0 9 141 33.3 20 146 36.7 - - - 1 159 60.0 6 155 47.9 1 162 45.0 - - - - - - South Park 56 114 20.5 66 117 21.9 3 120 23.0 10 127 26.2 - - - 3 140 34.6 41 144 35.7 - - - - - - - - - - - - - - - - - - St. Vincent's 6 111 18.9 8 115 20.7 1 117 18.8 - - - - - - 6 136 31.3 11 143 34.9 2 151 38.1 1 154 51.8 16 157 47.2 1 159 45.0 - - - - - - The Gilbert Colvin. 18 113 20.1 18 115 22.5 3 120 24.8 2 124 26.7 - - - 1 132 34.0 - - - - - - - - - - - - - - - - - - - - - The Glade 13 117 21.3 36 117 21.4 1 127 23.1 - - - 1 135 30.8 6 142 35.0 21 142 32.0 - - - - - - - - - - - - - - - - - - The John Bramston 39 109 20.2 17 113 21.4 - - - 2 114 21.7 - - - - - - 15 146 37.7 - - - - - - - - - - - - - - - - - - The Mount - - - - - - - - - - - - - - - - - - 2 145 34.4 1 157 41.5 4 154 46.9 64 159 52.0 5 159 47.1 - - - - - - The Redbridge 45 112 20.1 17 115 20.4 2 126 23.9 - - - 1 129 25.8 7 141 32.2 18 146 37.7 - - - .- - - - - - - - - - - - - - - The William Torbitt 34 113 20.1 47 116 21.7 8 122 23.8 4 129 25.5 3 134 30.4 3 136 30.6 40 144 37.5 - - - - - - - - - - - - - - - - - - Uphall 4 112 22.9 22 116 22.1 2 118 21.5 - - - - - - 6 139 32.6 25 146 37.7 - - - - - - - - - - - - - - - - - - Ursuline - - - 27 - - - - - - - - - - - - - - 39 143 370 16 147 422 2 154 52.8 3 160 53.0 72 145 55.6 31 160 53.8 1 154 45.0 Woodlands - - - 1 106 17.4 Ilford Girls-Averages for 10 years 1952 746 112 19.9 695 115 210 70 121 23.3 57 125 24.6 39 132 29.1 124 139 33.5 784 143 35.7 79 148 40.5 29 155 49.8 410 158 50.5 239 156 54.9 67 160 55.0 5 159 49.0 1951 526 112 20.0 542 116 210 60 119 22.8 58 128 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 50.8 140 159 530 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 19.0 224 115 207 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 21-8 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 30.8 107 118 34.7 597 148 38.4 143 153 42.2 - - - - - - - - - - - -