KF 28 P.C. ACK 4.10.54 4 C441WILFORD B Borough of ilford Health Report FOR THE YEAR 1953 GORDON M.D., Ch.B., M.R.C.P., D.P.H. Medical Officer of Health, etc. 1 ILFORD BOROUGH COUNCIL Municipal Year 1953/54 Alderman C. I. Gibson, J.P., Mayor. Alderman H. D. Cowan, F.C.P.A., F.C.C.S., Deputy Mayor. Barker, John, J.P. Bryan, William Allen Vernon, J.P. Colvin, Gilbert, C.B.E., F.C.I.S. Cowan, Harold Douglas, F.C.P.A., F.C.C.S. (Deputy Mayor) Daniels, Russell Stearn. Fallaize, Mrs. Lilian, J.P. (E.C.C.) Aldermen: Faning, Percy Victor (E.C.C.). Gibson, Cyril Irving, J.P. (Mayor). Headley, Cecil Aubrey. Pearson, Frederick Thomas. Woods, Sidney Charles Victor. Young, Major Alexander, T.D., J.P., C.A., (E.C.C.). Councillors: Aly, Harry Reginald Bertram. 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, A.M.Inst.Mech. Gleed, Sydney George. Gooch, Lionel Archer Scott. Grose, John Stanley. Harris, Edgar Frank. Hewitt, Reginald. Hughes, Thomas Bernard. James, Francis Herbert Littlejohn, Mrs. Ruth Constance, M.A. Loveless, Sydney Frank. Manders, Ralph James David. Masters, Frank Robert. Milburn, Mrs. Elizabeth Florence Parfitt, William Arnold Root, Harold Goldstone. Shaw, Arnold John, B.A. Sherrell. Albert Reginald (E.C.C.). Slater, Frank. Smith, Mrs. Lily Maude, S.R.N. Taylor. Sidney William (resigned 3.10.53) Terry, Miss Anne Sylvia. Tullett, Mrs. Ethel Ross. Tyler, Bertie Charles Newcombe. Waters, Owen Francis. Watts, Mrs. Mabel Lucy. Westley, Ronald Francis. Woodham, Leonard Victor. 2 PUBLIC HEALTH COMMITTEE Municipal Year 1953/54 Councillor Mrs. E. R. Tullett, Chairman. Councillor Mrs. L. M. Smith, S.R.N., Vice-Chairman. Alderman G. Colvin, C.B.E.. F.C.I.S. Councillor T. B. Hughes. Alderman H. D. Cowan, F.C.P.A., F.C.C.S. (Deputy Mayor) Alderman R. S. Daniels. Alderman C. I. Gibson (Mayor). Councillor H. R. B. Aly. Councillor Mrs. C. Chapman. Councillor Mrs. R. C. Littlejohn, M.A. Councillor W. A. Parfitt. Councillor A. R. Sherrell (E.C.C.). Councillor F. Slater. Councillor Miss A. S. Terry. Councillor J. East. A.M.Inst.Mech. Councillor Mrs. M. L. Watts. ILFORD HEALTH AREA SUB-COMMITTEE OF THE HEALTH COMMITTEE OF THE ESSEX COUNTY COUNCIL Municipal Year 1953/54 Ilford Borough Council Representatives: Aldermen Barker, Colvin, Headley. Woods; Councillors East, Grose, Harris, James, Mrs. Littlejohn, Masters. Mrs. Milburn, Sherrell. Mrs. Smith (Vice-Chairman), Miss Terry, Mrs. Watts (Chairman). Essex County Council Representatives: Aldermen Mrs. Ball and Young; Councillors Mrs. Banthorpe, Mrs. Fallaize, 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. D. L. Belchamber. Voluntary Organisations' Representatives: Mrs. M. Armitage, Mrs. B. Butcher, Miss N. L. Odell and Mrs. A. M. Pearce. 8 ILFORD COMMITTEE FOR EDUCATION Municipal Year 1953/54 Councillor R. J. D. Manders. Chairman. Alderman G. Colvin, C.B.E., F.C.I.S., Vice-Chairman. Alderman J. Barker, J.P. Alderman Mrs. L. Fallaize, J.P. (E.C.C.). Alderman F. T. Pearson. Councillor Mrs. F. E. Bennett. Councillor Mrs. C. Chapman. Councillor L. a. S. Gooch. Councillor Mrs. R. C. Littlejohn, M.A. Councillor S. F. Loveless. Councillor F. R. Masters. Councillor w. a. Parfitt. Alderman P. V. Faning (E.C.C.). 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: Mr. S. Baker. Rev, K. A. Bear, B.A. Rev. D. Harnett. Mr. H. S. Kenward, M.A. Mr. E. R. Lower, B.A. Miss H. S. Rich. Mr. C. G. Rolfe. County Nominated Member: 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: I. Gordon, M.D., Ch.B,, M.R.C.P. (Lond.), D.P.H. (Edin.). Deputy Medical Officer of Health : (Part Time) D. M. B. Gross, M.D., Ch.B., (Leeds), 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 (to 9.6.54) J. Cook. A. C. R. Neale. F. Nau. G. W. Newman. D. F. Scott. R. E. Smalley. J. A. Harris. T. F. Johnson. C. Broomfield (from 19.7.54) Chief Administrative Assistant (I.B.C. and E.C.C.): F. J. Hocking. Welfare Officer for Old Folk: Miss E. A. Workman, B.A. (to 28.8.54) 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. (to 30.11.53). Miss E. NicGrianna, B.D.S. (Ireland) (to 28.12.53) Educational Psychologists: K. Pickett, B.Litt. (Oxon), Dip. Psych, (to 27.2.53). Miss J. Reed, B.A. (Hons. Psych.). Miss E. A Wicks, B.A. (Hons.), (from 4.8.53). Psychiatric Social Workers: Mrs. V. Guttsman (to 31.1.54). Miss I. Zaphiriou. Miss C. Moffatt (from 1.4.54) Speech Therapist: Mrs. M. Walker (L.C.S.T.). 5 Officers of the Public Health Services—continued. Superintendent of Midwives: Miss C. Blocklley. Superintendent Health Visitor: Miss M. Preston. Health Visitors and School Nurses: Miss A. L. Drinkwater. Miss M. G. Bennett (to 11.10.53) Miss E. J. Whiting (to 26.11.53) Miss E. M. P. Collins Miss A. N. Bowmer (from 9.11.53) Miss M. G. Duguid Miss H. Arnold Mrs. E. M. Gajewska (to 6.10.53) Miss D. Lowenberg. Miss C. Oldham. Mrs. R. Robertson (to 14.2.54) Miss P.M. Leavett (from 10.8.54) Miss J. M. Smith (from 25.8.54) Miss I. L. Mobbs (from 12.10.53) (Part-time) Tuberculosis Visitors: Mrs. A. T. Jones (to 10.2.54) Miss J. E. Dent (from 21.9.53) Mrs. P. B. Lascelles (to 10.7.53) Miss W. Kerr (to 5.8.54) Miss C. McDonald (from 3.5.54) Mrs. T. Ivanauskas (from 19.7.54) Matrons of Day Nurseries: Sunshine House Green Lane Ley Street Stevens Road (Closed 28.7.53) Miss 1. E. Sandall. Mrs. E. Drower. Miss G. M. Gross 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. T. J. Regal, M.D. (Berlin), D.O.M.S. (Lond.) (to 24.11.53). A. B. MacClancy, L.R.C.P.(1.), L.R.C.S.(L), L.M., D.O. (from 30.11.53). 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. (to 28.4.54). Margaret M. Mason, M.A., F.R.C.S. (from 5.5.54). 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: H. M. S. Davidson, M.B.. B.S.. M.R.C.S.. D.P.M. Psychiatrist: J. Vincenzi, M.R.C.S., L.R.C.P., D.P.M. H. J. Altschulova, M.D (from 21.9.53). Orthoptist: Mrs. M. J. Mindell, D.B.O. Physiotherapist: P. J. Hunt, M.C.S.P. (to 25.5.54). Essex County Council. Assistant Dental Officers (Part-time): E. M. Sycamore, M.R.C.S., L.R.C.P., L.D.S., R.C.S. (Eng.). R. J. Newman, M.B.E., L.D.S., R.C.S., J.P. J. T. Hutchins. D. O'Connell, B.D.S., R.C.S. (I) (from 14.12.53). Mrs. I. N. Bravo, L.D.S., R.C.S. (from 17.2.54). L. P. Henry, L.D.S., R.F.P.S. (from 17.2.54). J. Tighe, B.D.S. (from 8.2.54). T. P. Taylor (from 15.3.54). V. H. Foy, L.D.S.. R.C.S. (from 6.7.54) Child Psycho-Therapist (Non Medical): Miss M. L. Harries, M.A. (from 1.2.54). Play Therapist (Part-time): Mrs. M. Henschel, B.A. (Dip. Psych.). Specch Therapist (Part-time): Mrs. F. M. Hatfield. L.C.S.T. (from 15.10.53). Ilford Borough Council. Public Analysts: George Taylor, F.R.I.C. J. Hubert Hamence,. M.Sc., Ph.D. 7 PREFACE Public Health Offices. Ilford. July, 1954. 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 1953. Those indices that reflect on the general health of the population remain a source of satisfaction. The infant mortality rate of 20.17 deaths per 1,000 live births is considerably lower than that for England and Wales, the Great Towns and Smaller Towns, and the London Administrative County. The death rate rose somewhat from 10.74 to 11.03, probably due to the fog and influenza of the 1952-1953 winter, but is still lower than in all the aforementioned groups. There were no deaths from child-bearing, diphtheria, poliomyelitis, smallpox or typhoid. However, 41 citizens died from accidents, and 26 of these were not motor vehicle accidents, an indication of the need for further work in Home Safety Propaganda. There were 16 suicides. Whilst we have every reason to be proud of the low infant mortality rate, low death rate and low figures for deaths from infectious diseases, this is but one side of the picture. Our work of prevention is far from ended when we still have something to prevent. Of the 1,942 deaths in Ilford in 1953, nearly a quarter come under the three headings of Bronchitis (160), Cancer of the Lung (61) and Coronary Disease (248) The English Disease. In the bad old days rickets was so prevalent in England that this complaint was known abroad as the "English Disease." Due to better child care and nutrition, this disease has been practically wiped out in this country, but, in a recent issue of the British Medical Journal it was suggested that the term "English Disease" be now given to chronic bronchitis. The figures for deaths from this disease in England and Wales, as compared with other countries, are most depressing. In 1950 England and Wales, with 65 deaths per 100,000, headed the table. This rate was over twice that of Japan and Belgium, over 30 times that of the U.S.A. and over 60 times that of Denmark. Many people are wondering why we should suffer so in this country. The climate is surely not so much different from that of Scandinavia, Belgium, or that misty country Japan, and anyway, even in England, the incidence is less in the country than in the towns. Smoking has been considered, but we certainly do not smoke more than the Americans. Many are coming to think that it is due to the pollution of the atmosphere by factory, power station and the domestic grate, especially the last one, almost an English institution. In the great London fog of the 1952-53 winter about 4,000 people are said to have died, and 8 this dramatic event shocked many. But what of the annual toll from chronic bronchitis, in Ilford in 1950—99 deaths, 1951—137 deaths, 1952— 131 deaths, 1953—160 deaths? This is not so dramatic, but is quite as disturbing. The American Disease. Coronary disease, an affection of the blood vessels supplying the heart, is now second from the top, with, in 1953 in Ilford, 248 deaths. A few years ago in my preface, I mentioned this complaint, and gave a commonly accepted view that it probably had some relationship to the consumption of fats. Research on a vast scale is going on all over the world on this matter, and people are gradually coming to the conclusion that an excess consumption of fats, especially in men over middle age, predisposes to coronary disease. Rationing is at an end, fats such as in butter, margarine, cream, eggs and pork are most palatable, and among the most expensive of foods. One would then conclude that the more prosperous nations would suffer more from this disease, and this is true. Figures have shown that the American male over middle age has a shorter prospect of life than similar males in any country whose statistics are reliable, and these American rates are entirely due to coronary disease. In fact we may now call it the American Disease. Even on our doorsteps we can note this social difference, for Ilford people, who are on the whole more prosperous than those living in Barking have, as I showed in an earlier preface, a higher death rate from this condition. Cancer of the Lung. Last year 61 Ilford people died from lung cancer. At the risk of being considered tedious, 1 would like to reiterate what 1 have said before, and assure readers that informed medical opinion is more than ever convinced of the relationship between cancer of the lung and smoking, especially heavy cigarette smoking. If you cannot stop smoking yourself, at least encourage the youngsters not to commence the habit. Civilization. In many of the less developed parts of the world the inhabitants suffer from undernutrition, malaria, a great variety of parasite diseases, their lives are short, and great numbers of their children die before the age of one year. Enormous efforts are being made to better their lot, to bring industry (and smoke) to them, better food (and more fats), higher wages (and more cigarettes). Will they then die of chronic bronchitis, coronary disease, and cancer of the lung, as one of the benefits of their newly found civilization, and perhaps suffer from psychoneurosis (which does not appear on death certificates)? Without doubt industrialization will bring enormous benefits, but it will also bring disadvantages that may be prevented. THOSE BOTH AGED AND HANDICAPPED It is not always realised that there are two groups of old people, the old age pensioner (some 23,000 of them in Ilford), and also a very much smaller group, those who are both aged and severely handicapped (probably not more than a few hundred). The former class are of no more concern to the Public Health Department than the rest of the population. The more independent, the better housed, the happier, the more liberally pensioned the old age pensioner, the better pleased the Public Health Department; not only because we are glad to see contented and healthy old people, but if they are well and happy there are fewer of them in the handicapped group; and our resources are sufficiently stretched already. A satisfactory solution to the problem of those bath aged and severely handicapped is not likely to be provided by increasing their pensions, 9 National Assistance Board grants, or giving them more independence. The services required, such as family doctor, hospital bed, welfare hostel, home nurse, domestic help, health visitor night attendant, sick room equipment, convalescence, and voluntary help, are either free to all anyway, or in case of necessity can be made free. Why then is there a problem of the chronic sick? It is because the services are not adequate and no increase of monetary benefits to the recipient will make them adequate. Although further expenditure on the health services cannot fail to improve them, even that cannot solve the problem. The root of all our difficulties is shortage of man-power, or more correctly, womanpower. Ilford, with proportionate regard to its population, spends more on the domestic help service than any other division in Essex, and with respect to help for the chronic sick the difference is even greater. The Night Attendant Service managed by the Ilford Social Service Association is a model for the rest of the country. So let no one suggest that we are behindhand in these matters. Yet we cannot do all we want because of lack of suitable women for these jobs. This is not a local problem, it is a national one; there are not enough suitable women now, and the position is going to get worse, to be nurses, school teachers, physiotherapists, dieticians, social workers, physical training instructors, radiographers, and so on. Raising of the salary of any section will not increase the pool. This factor, and not money, will eventually set a limit to expansion of the health services. Is it then so unreasonable that we seek other means of helping the aged and chronic sick? Voluntary help, for instance, and their own families. In the old days of the Means Test unpleasant visits had to be made to their families to find out what they could pay. It is quite wrong to think that today similar unpleasant visits are not made; they are, cap in hand, and also with this difference, that if the family do not wish to help, the law is on their side, and we are politely, or not so politely, shown the door. Meanwhile the aged sick parents, may be living in squalor and alone, and with mental faculties so disturbed by their ageing that they refuse any help, continue to suffer. Some Medical Officers of Health have suggested that there should be a scheme for routine examination of old people and arranging for notification of those that are specially handicapped, as is done with school children. This raises many more problems than it solves, the main one being—what are we going to do with notified handicapped old people that we cannot do now? If the notification gave the Medical Officer of Health further powers to ensure help for the aged there might be some advantage in it. In many fields there are changes since I wrote my last preface; many of these are dealt with in more detail elsewhere. Ilford has had its first slum clearance area approved; a local committee to consider the child neglected in its own home and the problem family has had its first meeting; the local health authority has taken over the distribution of welfare foods, with so far, little disturbance; B.C.G. vaccination against tuberculosis of school children has commenced, and also immunisation against whooping cough; plans have been made for two new clinics, at Couchmore Avenue and Kenwood Gardens, the latter to replace those held at Valentines Mansion and Newbury Hall; the first meeting to increase co-operation between general practitioners and health visitors was a great success; and plans for converting what was Stevens Road Day Nursery into a school for spastic children are awaiting Ministry approval. The Ilford Social Service Association has successfully launched a scheme for a chiropody service for old people. Although the Home Safety Committee has now become a voluntary enterprise under the supervision of the W.V.S., we are still closely associated with it. The Mass Miniature Radiography Unit of the North East Metropolitan Regional Hospital Board visited the Thompson Rooms in March, 1954, and the attendance was so unexpectedly high that the public suffered some inconvenience in waiting. Consideration is being given to more frequent visits of this valuable unit. 10 Almost the only sphere where we can report a diminution of our activities is in the School Minor Ailment Clinics. This is undoubtedly due to the fact that diseases such as scabies, impetigo, pediculosis, and running ears, have greatly diminished and, of course, any child can now attend his own doctor. Reports of specialists and other officers will be found in the body of the report. Again I cannot conclude without thanking those whose invaluable help has made my work easier. The Ilford Federation of Women's Voluntary Welfare Workers, who work in our Infant Welfare Centres; the Ilford Social Service Association, who arrange chiropody for pensioners, sickroom equipment, night attendants, holidays for old people, services that this Department is much interested in, and I deem it a privilege to be associated with the I.S.S.A. in this work. Over the past year or two the W.V.S. have been increasingly helpful, and look to us and we to them, for mutual assistance. The staff have given their usual loyal and efficient service, which is all the more appreciated when new ventures, such as the distribution of welfare foods, have to be undertaken. I must also mention the full co-operation of the Chief Officers and their staffs in other Departments, for which I am very grateful. Finally, I would like to express my thanks 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. 11 SECTION A. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in Acres) Land and Inland Water 8,425 8,432 Tidal Water 7 Population (Census 1921 85,194 „ (Census 1931) 131,061 „ (Census 1951) 184,706 Registrar-General's Estimate of resident Population:- June 30th 1950 186,200 „ „ 1951 181.600 „ „ 1952 182,200 „ „ 1953 181,200 Number of inhabited houses (end of 1953) according to Rate Books (approx). 51,466 Rateable Value—April 1st. 1953 (Houses and Land) £1,677,074 Sum represented by a penny rate, April 1st, 1953 (approx.) £6,850 Education Rate— 1952-53 1953-54 (E.C.C.) 8s. 4.52d. in the £ 9s. 0.60d. in the £ Combined Rale (all services) 20s. 6d. in the £ 23s. 4d. in the £ The following figures as to unemployment were supplied by the Ministry of Labour:— Males Females As at January, 1953 711 232 As at January. 1954 606 205 Live Births— 1953 1952 Total M. F. Birth rate per 1,000 population. Legitimate 2,164 1. .120 1,044) Crude Rate 12.31 13.02 Illegitimate 67 34 33) Adjusted Rate 11.94 11.90 Rate per 1,000 total (live and still) births Stillbirths 61 32 29 26.61 21.48 Death rate per 1,000 population. Deaths 1,942 995 947 Crude rate 10.71 10.13 Adjusted rate 11.03 10.74 Percentage of total deaths occurring in public institutions 41.05 37.71 Maternal mortality (heading 30 of the Registrar-General's Short List):— No. of Deaths. Rate per 1,000 total (live and still) births. 1953 1952 1953 1952 Pregnancy, childbirth and abortion 0 1 0 0.42 Leath-rate of Infants under one year of age:— All infants per 1,000 live births 20.17 18.94 Legitimate infants per 1.000 legitimate live births 19.87 1971 Illegitimate infants per 1,000 illegitimate live births 29.85 0.00 Deaths from Cancer (all ages) 354 365 „ „ Measles (all ages) — 2 „ „ Whooping Cough (all ages) 1 — „ „ Diarrhœa (under 2 years of age) 1 1 12 1. Rainfall Total rainfall registered in the district during the year was 20.24 inches; the greatest fall in 24 hours was registered on 31st October, 1.00 inches. July was the wettest month. 2. Population. The number of patients and resident staff on the 30th June, 1953, at the following public institutions, was:— Claybury Hospital 2,392 Goodmayes Hospital 1,385 Australasian Hospital (Dr. Barnardo's Homes) 75 Total 3,852 Registrar General's Memorandum on Transfer of Births, Deaths and Stillbirths. On the 17th October, 1952, the Registrar General issued a circular and memorandum to all Medical Officers of Health setting out revised arrangements which would operate as from 1st January 1953, dealing with the transfer of Births, Deaths and Stillbirths. The memorandum provides that births, deaths and stillbirths would be generally allocated (with certain exceptions) to the area in which they occurred, irrespective of whether they were ordinary residents or belonging to another area. The effect of these arrangements is that deaths, etc.. occurring at Claybury and Goodmayes Hospitals are now allocated to Ilford whether ordinary residents or not, and the rates following are based accordingly. In addition the Registrar General supplies each town with figures known as the "comparability factor" in connection with the birth and death rates. To make an approximate allowance for the way in which the sex and age distribution of the local population differs from that for England and Wales as a whole, the crude birth and death rates for the area are multiplied by the appropriate area comparability factor. The figures for Ilford are .97 for the birth rate and 1.03 for the death rate, and these are used in calculating these rates in Table 1a. When local crude birth and death rates have been so adjusted, they are comparable with the crude rate for England and Wales or with the corresponding adjusted rate for any other area. 3. Births. The number of births registered during the year was 2,231. Males Females Legitimate 1,120 1,044 Illegitimate 34 33 i.e., 3.0 per cent of the births registered were illegitimate. The percentage of illegitimate births registered in the previous 10 years was 3.9 (1952); 2.9. 3.1, 2.4, 3.2, 3.3, 3.1, 5.5, 4.2, 3.4. The adjusted birth-rate, calculated on the estimated population of 181.200 is 11.94 per 1.000. 4. Deaths. The total number of deaths of Ilford residents was 1,942. This is obtained by taking the total number of deaths registered in the district (1,688), subtracting the deaths of non-residents occurring in the district (172), and adding the deaths of Ilford residents registered as having died in other districts (426). The number of deaths of non-residents registered in the district was as follows:— King George Hospital 97 Ilford Isolation Hospital and Sanatorium 36 Other Non-residents 39 Total 172 13 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 69 St. Margaret's Hospital, Epping 4 Wanstead Hospital 21 Mile End Hospital 4 London Hospital 70 St. Bartholomew's Hospital 3 Rush Green Hospital 15 Westminster Hospital for Children 4 St. Joseph's Hospice, Hackney 20 Royal Free Hospital 4 East Ham Memorial Hospital 5 Harold Wood Hospital 12 Whipps Cross Hospital 27 St. Thomas Hospital 4 London Chest Hospital 3 In other Hospitals, Institutions and residences outside the Ilford district 161 Total 426 The adjusted death rate, calculated on the estimated population of 181,200 is 1.03 per 1,000. Inquests.—During the year, 65 inquests were held on deaths occurring in Ilford. 48 on Ilford residents, and 17 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 3 4 8 5 25 19 Death-Rates from Tuberculosis and Cancer. 1953. The following Table shows the death-rates for 1953 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 .149 .179 Other Tuberculosis .005 .022 Cancer (all forms) 1.954 1.994 5. Marriages.—1,652 marriages took place in the Ilford district during 1953, both parties or one of the contracting parties being Ilford residents. 6. Tables of Vital Statistics.—Table 1 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 1953, arranged according to the age groups at which deaths occurred. 14 TABLE 1. Vital Statistics of Whole District During 1953 and Previous Years Year Resident 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 (a) of Non-Residents registered in the District of Residents not registered in the District Under 1 year of Age At all Ages Number Rate Number Rate (b) Number Rate per 1,000 Net Births Number Rate 1 2 3 4 5 6 7 8 9 10 11 12 13 1949 185,000 2,027 2,630 14.5 1,640 8.9 402 484 53 20.1 1,728 9.5 1950 180,200 1,933 2,400 13.2 1,707 .2 455 511 45 18.7 1,703 9.7 1951 181,600 1,677 2,370 13.3 1,789 9.9 483 529 50 21.0 1,835 10.3 1952 182,200 1,830 2,323 13.0 1,728 9.4 431 512 44 18.9 1,809 10.1 1953 181,200 1,689 2,231 12.3(c) 1,688 9.3 172 426 45 20.1 1,942 10.7(c) (a) 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. (b) Calculated on the estimated resident population. (c) Crude rate. 15 TABLE 1A Table showing comparison between the Birth-rate, Death-rate, etc., of Ilford, other Towns, and of England and Wales for the Year 1953 (Provisional figures) Rate per 1,000 Total Home Population All Causes Typhoid and Paratyphoid Fevers Death-rate per 1,000 Home Population Rate per 1,000 Live Births Smallpox Tuberculosis (all forms) Pneumonia Whooping Cough Diphtheria Influenza Acute Poliomyelitis and Polioencephalitis Diarrhoea and Enteritis (under 2 Yrs.) Total Deaths under 1 Year Live Births Stillbirths England and Wales 15.5(c) 0.35 11.4(c) 0.00 0.00 0.20 0.55 0.01 0.00 0.16 0.01 1.1 26.8(6) 22.4(a) 160 County Boroughs and Great Towns, including London 17.0(c) 0.43 12.2(c) 0.00 o-oo 0.24 0.59 0.01 0.00 0.15 0.01 1.3 30.8 24.8(a) 160 Smaller Towns (Estimated Resident Populations 25,000 to 50,000 at Census 1951) 15.7(c) 0.34 11.3(c) 0 00 0.19 0.52 0.00 0.00 0.17 0.01 0.9 24.3 21.4(a) London Administrative County 17.5(c) 0.38 12.5(c) — — 0.24 0.64 0.00 — 0.15 0.01 1.1 24.8 21.0(a) ILFORD (Estimated Population, mid 1953 = 181,200) 11.9(c) 0.34 11.0(c) 0 .15 0.52 0.00 - 0.12 - 0.4 20.1 26.6(a) (a) Per 1,000 total (Live and Still Births). A dash (—) signifies that there were no deaths (b) Per 1,000 related Live Births. (c) Adjusted by comparability factor. 16 Registrar-General's Short List of Deaths and Causes: TABLE II Causes of, and Ages at, Death during the year 1953 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 1942 45 5 8 9 14 19 56 139 332 518 797 1 Tuberculosis, respiratory 27 — — — — 1 5 1 3 10 5 2 2 Tuberculosis, other 1 — — — — — — — 1 — — — 3 Syphilitic disease 6 — — — — — — — — 2 3 1 4 Diphtheria — — — — — — — — — — — — 5 Whooping cough 1 — 1 — — — — — — — — — 6 Meningococcal infections 1 — — — — — — — — — — — 7 Acute poliomyelitis — — — — — — — — — — — — 8 Measles — — — — — — — — — — — — 9 Other infective and parasitic diseases 5 — — — — — — — 1 1 2 1 10 Malignant neoplasm, stomach 69 — — — — — — 1 6 23 19 20 11 Malignant neoplasm, lung, bronchus 61 — — — — — — 3 11 22 19 6 12 Malignant neoplasm, breast 37 — — — — — — 1 9 7 11 9 13 Malignant neoplasm, uterus 10 — — — — — 1 — — 4 3 2 14 Other malignant and lymphatic neoplasms 177 — — — 1 2 3 9 18 38 46 60 15 Leukaemia, aleukaemia 7 — — — — — — 1 2 3 — 1 16 Diabetes 12 — — — — — — — — 2 3 7 17 Vascular lesions of nervous system 218 — — — — 1 — 3 9 27 69 109 18 Coronary disease, angina 248 — — — — — 1 9 21 50 86 81 19 Hypertension with heart disease 59 — — — — — — — 2 5 18 34 20 Other heart disease 301 — — — — 2 2 2 9 29 74 183 21 Other circulatorv disease 109 — — — — — — — 5 16 34 64 22 Influenza 22 — — — 1 — — — 3 2 7 9 23 Pneumonia 95 8 — 2 — — — 3 4 14 20 44 24 Bronchitis 160 — — — 1 — — 3 8 27 40 81 25 Other diseases of respiratory system 20 — — — — — — 1 7 5 4 3 26 Ulcer of stomach and duodenum 27 — — — — — — — 5 6 9 9 27 Gastritis, enteritis and diarrhoea 7 1 — — — — — 1 — 1 2 2 28 Nephritis and nephrosis 12 — — — — — 1 2 — 1 5 3 29 Hyperplasia of prostate 15 — — — — — — — — — 3 12 30 Pregnancy, childbirth, abortion — — — — — — — — — — — — 31 Congenital malformations 18 10 1 1 — — — 2 2 1 1 — 32 Other defined and ill-defined diseases 159 26 2 3 — 1 2 10 8 25 31 51 33 Motor vehicle accidents 15 — — — 3 4 1 2 2 1 — 2 34 All other accidents 26 — 1 1 3 1 9 1 — 3 3 11 35 Suicide 16 — — — — 2 1 — 5 7 1 — 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 1953 will be found in Part III Services section. (iii) Laboraiory 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, Iltord Act, 1937.) Slaughterhouses and humane slaughtering of animals. Pleasure Fairs. (Sec. 59, Essex C.C. Act, 1952). 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. (Sec. 53, Iltord Improvement Act, 1898.) Nuisances in connection with the removal of offensive or noxious matter. Depositing of Rubbish, etc. (Sec. 249, Local Government Act., 1933.) Establishments for Massage and Special Treatment. (Essex C.C. Act, 1933, Part IV.) Inspections of licensed establishments are carried out quarterly. During 1953 twenty-eight applications for renewal of licences were received. The Council renewed the licences in respect of these establishments. Four new applications were received which were granted. The licences expire on 31st March of each year. Hairdressers' and Barbers' Premises. (Essex C.C. Act 1933, Part VI). During 1953, 41 visits of inspection were made by the Sanitary Inspectors to these premises. Camping Grounds and Moveable Dwellings. (Essex C.C. Act 1933, Part IX.) (v) 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. (vi) Essex County Council Act, 1952. This Act came into operation in 1953. Reference is made in this Report in appropriate sections as to action taken under the Act. 18 (vii) Nurses Act, 1943 (Part 2.) Nurses Agencies. The Essex County Council on application by the Ilford Council. delegated to them, in pursuance of Section 11 (1) the powers 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 1953. (viii) 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 functions under 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 1953:— (1) Residential and Temporary Accommodation. (a) Aged persons admitted to hostels and other residential establistments:—34. (b) Other classes (admitted to temporary accommodation):— Adults 12, Children 27.—39. (2) Blind Persons. The numbers of registered blind, partially sighted and defective sighted persons resident in the Borough as at 31st December, 1953. were as follows:— (i) Registered as blind 258 (ii) Partially sighted 45 (iii) Defective sighted 12 all of whom were under the supervision of the County Council's Home Teachers. During the year five blind persons participated in the Home Workers' Scheme operated through the agency of the Royal London Society for the Blind, and one was employed in the Workshops for the Blind. In addition, 28 blind and 8 partially sighted persons were employed in open industry. The Council's Schemes for welfare services for other handicapped persons, including the deaf and dumb and hard of hearing have, since the last report, been approved by the Minister of Health, andthe implementation of these Schemes is now being dealt with in co-operation with the appropriate voluntary bodies." In Ilford the scheme for other handicapped persons has been delegated to a Sub-Committee of the Ilford Social Service Association, of which the Medical Officer of Health is a member. 19 National Assistance Act, 1948. (a) Section 47. One person was dealt with under this section during the year. This related to a man of 84 years, living in one room. He was found to be in a dirty condition in his person and living in insanitary conditions. (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. No burials were dealt with during 1953. Miss E. A. Workman, the Welfare Officer for Old People, reports as follows:— "During the year 1953 there was still considerable difficulty in coping with the number of old people who wished to enter Homes or Hospitals. Altogether 581 people were dealt with. Of these— 68 died in their own homes, 62 were admitted to hospital (30 of these later died in hospital), 26 entered Homes (15 of these being admitted to Homes administered by the Essex County Council), 11 entered private homes, 9 entered nursing homes, 5 were admitted to Mental Hospitals, and 8 moved from the district. The number of visits paid to these cases amounted to 817, and, in addition, 507 visits were paid and interviews given at the Public Health Offices to friends and relatives and officers of the various bodies interested in the welfare of the aged. A serious position is still caused by those old people who have suffered severe mental deterioration but are not certifiable. They are often unwilling to receive any assistance and even when this difficulty has been surmounted it is often impossible to provide sufficient supervision to enable them to be satisfactorily cared for in their own homes. The Council has been considering the question of employment for old people and has obtained information of the schemes in operation in the Metropolitan Boroughs of Shoreditch and Finsbury and early in 1954 a Sub-Committee visited the premises used by the Finsbury Council for providing employment for aged persons. The Ilford Council have appointed a special Sub-Committee to consider in detail the possibility of establishing in Ilford an employment scheme for elderly people similar to that in operation in the Metropolitan Borough of Finsbury. The laundry service for the cleansing of soiled bed linen and personal clothing continued to operate throughout the year, proving of invaluable assistance in the care of some very dffiicuit cases. During the year 30 persons were assisted and 2,889 articles were laundered." 20 (ix) 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 1953 Pay Beds 14 Amenity Beds 7 Other Patients Medical Surgical Children 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 1,287 patients (males 579, females 708). and Claybury Hospital, with 2,200 patients (males 901, females 1,299) in residence on 30th June, 1953. (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, 1953. 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. (x) 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 other Ambulance Stations in the Metropolitan area of the County and with the Divisional Control at Chelmsford. 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 (xi) Clinics and Treatment Centres: Maternity and Child Welfare.—Infant Welfare Centres are held at the following premises:— Parish Hall. Mossford Green, Barkingside (for residents of Barkingside area) Chadwell Christian Mission Hall, Essex Road, Chadwell Heath (for residents of Chadwell Heath area) Mayesbrook Clinic, Goodmayes Lane, Goodmayes (for residents of Becontree area) St. John's Church Hall, Devonshire Road, Seven Kings (for residents of Downshall area) Manford Way Clinic, Hainault (for residents of the Ilford portion of L.C.C. estate) Congregational Church Hall, Woodford Avenue, Ilford (for residents of Woodford Avenue area) Cecil Hall, Granville Road, Ilford (for residents of the east side of Cranbrook Road) Cecil Hall, Granville Road, Ilford (for residents of the west side of Cranbrook Road) Seven Kings Methodist Church Hall, Seven Kings Road (for residents of Seven Kings area) Newbury Hall, Perryman's Farm Road, Newbury Park (for residents of the Newbury Park area) Vine Memorial Church Hall, Grosvenor Road, Ilford (for residents of Grosvenor Road area) Mayesbrook Clinic (for residents of Goodmayes area) Vine Memorial Church Hall, Grosvenor Road. Ilford (for residents of Ilford Lane area) Valentines Mansion, Emerson Road. Ilford (for residents of Valentines area) Parish Hall, Mossford Green. Barkingside (for residents of Fairlop area) Monday, 2 p.m. Monday, 2 p.m. Tuesday, 2 p.m. Tuesday, 2 p.m. Tuesday, 2 p.m. Wednesday, 2 p.m. Wednesday, 2 p.m. Thursday, 2 p.m. Wednesday, 2 p.m. Thursday, 2 p.m Thursday, 2 p.m. Thursday, 2 p.m. Friday, 2 p.m. Friday, 2 p.m. 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 and afternoon, 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, every Wednesday morning and on Friday mornings as and when requirtd. 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. 22 School and other Clinics.—Clinic sessions are held at Health Services Clinics as under:— (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. B.C.G. Vaccination. (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. B.C.G. Vaccination. (iv) Valentines School, Beehive Lane, for— Dental (Children). Speech Therapy. (v) Loxford Hall, Loxford Lane, for— Child Guidance Clinic. (vi) Manford Way Clinic, Hainault. for— Ante-Natal and Post-Natal. Infant Welfare. Diphtheria and Whooping Cough Immunization. Midwives Ante-Natal. Dental (Children only). Ophthalmic treatment. Orthopaedic treatment. (xii) Chest Clinic.—A clinic for the diagnosis and treatment of tuberculosis is provided by the North East Metropolitan Regional Hospita 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. The Chief Sanitary Inspector reports as follows:— "The Minister of Housing and Local Government strictly enjoined all local authorities to carefully consider the housing conditions in their districts with special reference to the promulgation of slum clearance schemes in respect of property not capable of being made fit for human habitation and at reasonable cost and to secure improvement of those dwellings which could be rendered usable as home for a considerable period compatible with economy. In fulfilment of this exhortation the Ilford Borough Council authorised a preliminary survey of those properties which could be considered under these headings; the survey resulted in a detailed inspection and report on what is now known as the Ilford Lane Clearance Area, consisting of 32 houses, the occupants of which total 66 persons, the back land and some additional land to make the site suitable for the re-housing of the displaced families in the area leaving some units capable of rehousing persons displaced from other areas to be subjected to like treatment in the not too distant future. The Council resolved to deal with the matter by way of a compulsory purchase order and its submission for approval by the Minister followed. In the same period H.M. Government decided to implement this housing policy by submitting to Parliament a Housing Repairs and Rents Bill, which contains far-reaching proposals in respect of clearance areas, the retention of properties in clearance areas temporarily; to permit purchase by local authorities of such properties, and to prevent demolition of houses where a need for their retention exists. Furthermore the Bill proposes amendments of the standards of fitness for human habitation and varies in small details Section 9 of the Housing Act 1936. Perhaps the most extensive of the new proposals is that contained in Part II of the Bill—allowing an increase in rents of dwellinghouses occupied by statutory tenants which are (a) in a good state of repair; (b) fit for habitation according to the standards laid down in Clause 7 of the Bill; (c) the landlord proves that works of repair to the property have been carried out over a specified period. There is a right given to the tenant to apply to the local authority for a certificate that these conditions have not been complied with by the landlord. It is expected that this new piece of social legislation will augment the statute book early in 1954 thus further increasing the local authorities' housing duties. The Report Year engendered a grave problem in atmospheric pollution whereby a serious grit nuisance was created by a factory in the district. After joint consultation between representatives of the Council, its officers, representatives of the Company concerned and its advisors and the beneficial guidance of the London Regional Fuel Advisory Officer, a proposal to instal new plant to mitigate the nuisance was agreed upon and the necessary order for this was placed by the company. It is hoped that this longstanding cause for complaint by the residents affected will now cease. In the field of Food Hygiene, the Bye-laws made under the Food and Drugs Act, 1938, Section 15, have produced a marked benefit. All concerned in the food handling trade, whether employer or employee, owner or occupier, cook or waitress, are now fully conversant with the requirements as to standards of sanitation and the hygienic handling, wrapping and delivery of food in both closed and exposed premises. The two Sanitary Officers concerned primarily with the work of educating the trade and public have pursued their task with fidelity and the recipients of their advice and assistance have declared their thanks by improving the standard of hygiene in their own premises. Lectures and film strip exhibitions have been given to all willing to have them and proprietors have not been loth to afford facilities to their staffs to attend them. This teaching of hygiene was extended to the Ilford schools and it is hoped that there will be increased co-operation with this group, perhaps 24 the most important section of the community. Surveys of the catering establishments of the hospitals in Ilford were undertaken at the request of the management. Recommendations were made and these have been well received and it is hoped that they will be implemented in the near future. The unfortunate accident which occurred in Bristol in 1951 when 12 people were killed and another 12 injured by an explosion of petrol vapours in a garage was the subject of a public enquiry. The Report of Sir L. R. Dunne. Q.C., issued in 1952 was carefully considered by the Town Clerk and myself and a joint report submitted to the Council which accepted the proposals submitted to amend the existing conditions under which licences to store petroleum spirits and mixtures are to be issued. These have not been implemented as yet; the opinion of the Home Office is awaited. The Rodent Control work has been proceeded with according to approved methods and although there has not been a major infestation in the district, an experimental scheme was instituted of offering live rats to the Wellcome Laboratories. Euston Road, for examination by Dr. Broom to ascertain the prevalence or otherwise of leptospirosis. Some 77 rats have been submitted under the scheme. Results indicate some measure of infection among the rodents but to a similar extent as in the rest of Greater London. Administrative action under the Diseases of Animals Act, 1950, and the various Orders made thereunder included the issue of licences for the movement of pigs. There were no cases of swine fever or foot and mouth disease in the district and only one confirmed case of Fowl Pest which was not serious. A system of routine visits to all premises wherein animals are kept was instituted during the year under review and conditions were found to be good. The widespread flooding of February, 1953, which caused serious pollution problems in the flooded areas resulted in an appeal to unaffected areas for assistance in preventing any serious ill health resulting from the disaster. The Ilford Borough Council readily acceded to this request and assistance was given by 5 Sanitary Inspectors for varying periods, amounting in all to 34 days. Much useful work was carried out by these officers a fact which was borne out by a letter sent to the Borough Council by the Canvey Island Urban District Council expressing appreciation of the services rendered. It is gratifying to know that no serious calamity arose from this flooding from a public health point of view." (i) Water Supply.—The district is served by the Metropolitan Water Board and 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 the storage reservoirs at Walthamstow, is filtered and chlorinated at Lee Bridge works and Ferry Lane works and then pumped into supply 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 this area from Wanstead Well. Samples of the water in all stages of purification are analysed daily at the laboratories of the Water Board. Dr. E. Windle Taylor, Director of Water Examination of the Board has kindly supplied me with the information that 1,462 samples of filtered water were submitted to chemical and bacteriological examination and found to be pure and wholesome. All new and repaired mains are chlorinated before being restored to use and samples of water from them are tested to confirm that the quality of the water is up to that normally supplied. The water is not plumbo-solvent. 25 The length of mains laid by the Metropolitan Water Board in Ilford during 1953 was 1 yard of 3-inch. 538 yards of 4-inch and 226 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 3,800 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 679 yards, 206 yards of 6-inch and 473 yards of 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. 4 samples of piped water supply (2 South Essex Waterworks Co. and 2 Metropolitan Water Board) were taken for Chemical and Bacteriological examination, and all gave satisfactory analyses. (ii) Drainage and Sewerage.—The Borough Engineer has kindly supplied me with the following statement: — Main Drainage & Ilford Corporation (Drainage) Act, 1950. During 1953 two contracts were placed for the construction of sewers, viz., Henley Road Relief Sewer and a short experimental length in Horns Road. Both of these contracts were proceeding at the end of 1953. A detailed scheme was in preparation for the improvement of the Mayes Brook for submission to the Ministry. Of the other schemes quotations for the plant for the new Roden Street Pumping Station were invited and the scheme for Albert Road and Sunnyside Road Sewer reconstruction prepared. In addition, further representations were made to the Ministry of Housing and Local Government and an accelerated programme of works was provisionally approved on 7th September, 1953. The new programme entaile expenditure of £300,000 per annum for the next three years and includes the culverting of the Cran Brook from the River Roding to Valentines Park and from the Park to the Railway (East of Horns Road), the construction of the soil sewers in Gordon Road, Grange Road, Melbourne Road and Valentines Park. 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 (iii) Collection and Disposal of Refuse.—The Borough Engineer also kindly supplied the following information:— Tons Total amount of refuse collected and disposed of 50,632 26 Collection of Salvage: — Tons Income Wastepaper 987 £8,007 Kitchen Waste* 1,179 £4,333 Rags 7 £252 2,173 £12,592 (* The collection of kitchen waste ceased at end of September, 1953). (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 34,898 Houses and premises reinspected (work in progress) 23,328 Visits during disinfection 772 Houses in which nuisances were detected 1,833 Houses in which nuisances were abated 1,487* Premises disinfected 501 Premises from which articles only disinfected 188 Articles disinfected 869 Premises disinfested for verminous conditions 36 * Includes 292 nuisances detected before 1st January, 1953. Notices served:— Served Complied with Statutory:— Public Health Act, 1936 121 82 Housing Act, 1936 1 1 Factories Act, 1937 3 — Shops Act, 1950 2 2 Provide Dustbin (Ilford Urban District Council Act, 1904) 46 43 Food and Drugs Act, 1938 14 8 Cleanse Water Storage Cistern (Byelaws) 1 1 Cover Water Storage Cistern (Byelaws) 3 3 Informal 1,945 1,270 2,136 1.410 In addition to the above, 370 notices (61 statutory and 309 informal) served previous to 1st January, 1953, were also complied with. Complaints.— During the year 3,410 complaints of nuisances were received and investigated. The following is a summary:— Accumulation of manure and refuse 42 Animals improperly kept 15 Bad smells 73 Dampness of premises 129 Defective drains, w.c.'s and fittings 370 Defective roofs, guters, downpipes, etc. 102 Defective water fittings 70 Dirty and verminous houses 32 Dirty condition of rearway 2 Flooding of premises 25 Overcrowding 123 Smoke nuisances 54 Defective or no provision of dustbin 1,410 Rats and mice 404 Miscellaneous 559 Total 3,410 27 (v) 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 86 inspections were made. 2 Statutory Notices were served, both of which were complied with; and 3 Preliminary Notices were served and remained outstanding at the end of the year. In addition, 4 Preliminary Notices served prior to 1953 were complied with. 2 Certificates of Exemption from the provisions of Section 38 were granted in 1953. (vi) 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 4 samples the chlorine content was above, and in 3 samples the chlorine content was below, the prescribed standard. Samples were also taken from the two indoor baths during January. March, April, May, June, July, August, September, October and December (17); all of the samples were satisfactory, but in 12 samples (6 from the 1st and 6 from the 2nd class) the chlorine content was above the prescribed standard. (vii) Eradication of Bed Bugs:— Houses found to be infested 38 „ Disinfested 38 (viii) Slaughter of Animals Act, 1933.—No licence to act as slaughterman was granted during the year. (ix) Increase of Rent and Mortgage Interest (Restrictions) Acts, 1920 and 1933.—The Chief Sanitary Inspector is authorised by the Council to make visits and certify under the provisions of the Acts. No certificates were issued during 1953. (x) 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 15 premises. Ihe 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 1953. 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. 28 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. (xi) Smoke, etc., Abatement.— Complaints were received of alleged smoke nuisance from 9 factories in the Ilford Lane. Green Lane, Roding Lane. Grove Road and Newbury Park areas. Regular observations were maintained and investigations carried out. In 5 instances no emission was noted which would have enabled action to be taken under the Public Health Act, 1936, but one statutory and two informal notices were served in the other instances. (xii) Public Health Act, 1936.— Section 154.—Three instances were reported in 1953, of one person exchanging articles for rags received from children under the age of 14 years. Legal proceedings were taken in two instances. In the first, where toys were being exchanged, the defendant was fined £2 and ordered to pay £1 1s. 0d. costs. In the other, where goldfish were being exchanged, the magistrates refused to convict the defendant. An appeal was lodged in the High Court but the decision of the magistrates, that a goldfish was not an " article " within the meaning of the Act, was upheld. No order was made as to costs. (xiii) Land Charges Act, 1925.—During the year 3,653 enquiries were dealt with under this act, SECTION D.—HOUSING. (i) Overcrowding.—No notices were served during 1953. (ii) Clearance Areas.—As a result of a housing survey the Council declared an area to be a Clearance Area, the land to be acquired under a Compulsory Purchase Order with a view to redevelopment of the site for re-housing purposes. (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) 2,452 (b) Number of inspections made for the purpose 15,257 (2) (o) Number of dwelling-houses (included under head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 3 (b) Number of inspections made for the purpose 250 (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 1,833 29 2. Remedy of defects during the year without service of formal Notices:— Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 1,234* 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 1 (2) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) By owners 3* (b) By local authority in default of owners b. Proceedings under Public Health Acts:— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 171 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners 173* (b) By local authority in default of owners 11* 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 259 (ii) Number of families dwelling therein 358 (iii) Number of persons dwelling therein 931 (b) Number of new cases of overcrowding reported during the year 80 (c) (i) Number of cases of overcrowding relieved during the year 99 (ii) Number of units concerned in such cases 371½ (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 1953 of Notices served prior to 1st January. 1953. HOUSING ACT. 1936. During the year 1953 the work of receiving applications, calling for calculations for the "permitted number" was continued with a view to the issue of housing certificates. 14 certificates, in respect of 25 houses, were issued during the year, making a total of 18,305 certificates, in respect of 25,097 houses, issued to the end of 1953. As new premises were constructed and placed upon the rating lists, "permitted number" certificates were issued as required. 30 SECTION E. INSPECTION AND SUPERVISION OF FOOD. Milk Supply. The Council delegated to the Public Health Committee all its powers and duties under the Food and Drugs (Milk and Dairies) Act, 1944, the Milk and Dairies Regulations, 1949, the Milk (Special Designation) (Raw Milk) Regulations, 1949, the Milk (Special Designation) (Pasteurized and Sterilized Milk) Regulations, 1949. the Food and Drugs (Milk, Dairies and Artificial Cream) Act, 1950, and any Regulations which might hereafter be made under the last named Act. The Milk (Special Designations) (Specified Areas) Order, 1951, which came into operation on 1st October, 1951, specified an area, including Ilford, in which the compulsory use of special designations for retail sales of milk shall operate. (i) Milk and Dairies Regulations, 1949.—The Council is required to keep a register of ail 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. 1953: — Persons registered as distributors of milk 108 Premises registered as dairy premises (other than dairy farms) 13 218 inspections of dairy premises were carried out during the year. (ii) Milk (Special Designation) (Raw Milk) Regulations, 1949 and 1950:— The following licences were granted during 1953:— Accredited 2 do. (Supplementary) Nil Tuberculin Tested 33 do. (Supplementary) 9 (iii) Milk (Special Designation) (Pasteurised and Sterilized Milk) Regulations, 1949 to 1953:— The following licences were granted during 1953:— Pasteurized (Dealer's) 62 do. do. (Supplementary) 10 do. (Pasteurizer's) Sterilized (Dealer's) 77 do. do. (Supplementary) 13 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 raw milks, are submitted for biological test for T.B. quarterly. 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. 31 The following results were obtained:— Grade of Milk Total Satisfactory Unsatisfactory Remarks on unsatisfactory results Tuberculin Tested Milk 3 3 - - Tuberculin Tested (Pasteurized) Milk 24 24 — — Tuberculin Tested Milk (Farm bottled) 17 16 1 The sample failed to satisfy the Methylene Blue Reduction test. The County Agricultural Executive Committee was communicated with and further samples proved satisfactory Accredited 5 5 - — Pasteurized Milk 105 102 3 All samples failed to satisfy the Methylene Blue Reduction test. The retailers were communicated with and re-sampling ordered at a later date. Further samples proved satisfactory. Sterilized 36 33 - — (v) Biological Tests.— 34 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.— One examination was 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.—13 complaints of the presence of foreign bodies in milk were received and investigated. No legal proceedings were taken, but warnings were sent in two cases 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. 32 32 applications for registration in respect of 32 premises were considered during the year 1953. The registrations were granted as follows:— Purveyors retailing multiple firms' productions 32 Purveyors manufacturing and retailing their own productions Nil (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 1953, 69 samples were submitted for examination with the following results:— No. of Samples Ministry of Health Provisional grade. % of Total Unsatisfactory Samples. 52 I 75.4 — 14 II 20.3 2 1 III 1.4 1 2 IV 2.9 — 69 100.0 3 The 3 unsatisfactory samples contained organisms of faecal origin. The ice cream was not manufactured in Ilford in these instances and the local Medical Officers of Health or suppliers were communicated with and in all cases the Sanitary Inspectors visited the retailer's premises to check the arrangements for storage and sale. Further available samples proved satisfactory. The Food Standards (Ice Cream) Order 1952 prescribed new standards for ice cream. During 1953, 3 samples were submitted for chemical analysis, all of which complied with the Order. The increased consumption of lollies by children has raised the question of the possibility of harmful metallic contamination. This arises from the fact that it is common practice to shape the lollies in metal moulds. During the cooling and setting it is possible that a trace of the metal constitution of the mould may be absorbed into the lolly. The particular danger is the presence of traces of lead. 7 samples were submitted to the analyst and the lead contamination ranged from 0.5 to 2 parts per million, which was considered to be well below that harmful to man. 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 38 sold or intended for sale for human consumption, and in connection with the sale or exposure for sale in the open air of food intended for human consumption. The Essex County Council Act, 1952. Section 105, requires that as from 2nd April. 1953. any person intending to use premises which were not used immediately before that date for the sale, storage, or preparation for sale of any food (other than milk) intended for human consumption shall give not less than 14 days' notice to the Council of his intention so to do. 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 1953, they made 14,297 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. 152 informal and 14 formal notices were served under the Food & Drugs Act, and 14 formal and 149 informal notices were complied with, including 3 formal and 33 informal notices served in 1952. (ii) Food Hygiene. The following gives the numbers of food premises in the area by the type of business:— Cafes and Restaurants 146 Factory canteens 26 Butchers' shops 122 Grocers' shops 273 Fruiterers' and Greengrocers' shops 125 Fishmongers' and Fishfryers' shops 56 Bakehouses 28 Bakers' shops 52 Confectioners' shops 185 1,013 Fifteen 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 15 canteens, cafes and food shops were invited, resulting in an attendance of 275. 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. 297 samples (292 formal and 5 informal) were obtained during the year 1953; 10 formal and 5 informal samples were not satisfactory as follows: — (a) Bread (informal).— Contained rodent excreta. Legal proceedings were taken and the retailer was fined £2 and £1 1s. costs. (b) Bulterminl drops (formal).— Contained only 0.23% of fat and therefore misdescribed as "butter." A letter of warning was sent to the retailer. 34 (c) Suet (formal)— 2.3% deficient in fat. Resampling was ordered and further samples proved satisfactory. (d) Chopped Suet (formal).—Consisted not of chopped suet but of shredded suet with flour No action was taken. (e) Vinegar (formal).—Consisted of dilute and coloured acetic acid of full strength but misdescribed as vinegar. A letter of warning was sent to the retailer. (f) Milk bottle (informal).—Contained a greyish foreign body which had the general composition of a plastic clay. A letter of warning was sent to the dairy firm. (g) Slice of bread (informal).—Contained brownish grey foreign matter, found to consist of dirty dough containing quartz sand, coal dust and fragments of shredded tobacco. A letter of warning was sent to the retailer. (h) Portion of loaf (informal).—Contained a cigarette end. A letter of warning was sent to the retailer. (i) Pineapple slices (formal).—Almost devoid of the usual pineapple smell and taste, but no evidence that it was not genuine pineapple. No action was taken. (j) Milk bottle (informal).—In a dirty condition, having a deposit of dry milk containing moulds and wild yeasts. A letter of warning was sent to the dairy firm. (k) Butter brazils (formal).—Contained insufficient butter fat to justify the description "Butter Brazils." A letter of warning was sent to the retailer. (l) Vinegar (formal).—Consisted of a coloured solution of acetic acid and therefore misdescribed as vinegar. A letter of warning was sent to the retailer. (m) Vinegar (formal).—Consisted of a coloured solution of acetic acid and therefore misdescribed as vinegar. 5% deficient in acetic acid. Legal proceedings were taken and the retailer was fined £6 plus £2 16s. costs. (n) Gin (formal).—Contained only 68% of proof spirit instead of the 70% as stated on the label. A letter of warning was sent to the retailer. (o) Whisky (formal).—Contained only 68% of proof spirit instead of the 70% as stated on the label. A letter of warning was sent to the retailer. (iv) Hawkers of Food. Section 103 of the Essex County Council Act, 1952, came into operation on 2nd April, 1953, and provides that hawkers of any food, and premises used for the storage of such food, shall be registered by the local authority. Registration was granted to 12 persoans (concerning 7 premises), during 1953. This Act repealed Section 77 of the Ilford Corporation Act, 1937, which provided for the registration of Hawkers of meat, fish, fruit and vegetables only and their storage premises. Registration was granted to 3 persons (concerning 1 premise) under this Act, up to 1st April, 1953. (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. 35 Section 80 of the Ilford Corporation Act, 1937, requires registration of such premises. No application for registration was received during 1953. (vi) Articles of Food Surrendered. During the year the following articles were surrendered and condemned as being unfit for the food of man: — Bacon—8¼ lbs; Beverage—4 tins, 1 pkt., 3 lbs.; Butter—2½ lbs.; Cake—448 lbs., 2 Swiss rolls; Cereals—74 pkts., 60½ lbs., 9 tins; Cheese—376 pkts., 99 lbs. 2 ozs.; Coconut—20 lbs.; Chocolate 4¼ lbs.; Confectionery—36½ lbs.; 19 Munchmellows; Cream—4 galls., 6 cartons, 11 tins; Drugs and Medicines—1 bottle; Eggs—251; Eggs (Frozen)—28 lbs.; Fats—2 jars; Fish (Wet and Dry)—110 st. 5 lbs.; Fish (Tinned)—180 tins; Fish (Shell)—5 tins; Fish paste—9 jars; Flavouring, Colouring, etc.—1 jar, 6½ lbs., 10 pkts., 4 tins; Flour— 523 lbs.; Foods (Medical and Baby)—21 tins, 4 pkts.; Fruit (Tinned)— 3,724 tins; Fruit (Fresh)—242 lbs.; Fruit (Bottled)— 21 bottles; Fruit (Dried)—180 lbs.; Fruit Juice—15 tins; Jam. Preserves, etc.—263 tins; Meat (Fresh)—8,583½ lbs.; Meat (Tinned)—1,708 lbs. 13 ozs.; Meat Pies—59; Milk (Tinned) 981 tins; Nuts—14 lbs.; Pastry and Pudding Mixtures—91 pkts.; Pickles—54 jars; Poultry—25 lbs., 3 tins; Puddings—21: Rabbits—240 lbs. 9 tins; Salt—6 lbs.; Sauces, Salad Creams, etc.—12 bottles, 26 jars; Sausages—131 tins, 7841 lbs.; Soups—70 tins, 28 pkts.; Tomatoes (Tinned)—194 tins; Vegetables (dried)—24 lbs.; Vegetables (Tinned)—1,263 tins In all cases, the food is inspected by the Sanitary Inspectors at the premises and after condemnation is collected by the Department and conveyed to the Refuse Collection Depot where it is disposed of under supervision. The necessary certificates of condemnation are then issued. (vii) Foreign Bodies in Food. 15 complaints were received during 1953 of the presence of foreign bodies in foodstuffs. All were investigated and legal proceedings were taken in two cases. In one case a fine of £2, plus £1 Is. Od. costs was imposed and the other case was dismissed owing to insufficient evidence. A letter of warning was also sent in one case. (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-four notifications were received during the year. There were no serious outbreaks of food poisoning. Five outbreaks occurred involving eleven persons, but in no case was the cause discovered. There were also twenty-three single cases reported, the agent being identified in six instances as Salmonella Typhi-murium. Six suspected instances were investigated but were not notified, no specific cause being discovered. (ix) Bakehouses.—There are 28 bakehouses in the district, all of which use motive power. 450 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 16 instances, and the requests were complied with in all but one case, where work was in progress. Diseases of Animals Act, 1950. (i) Foot and Mouth Disease.—No outbreaks, affecting the Borough, occurred during 1953. 36 (ii) Regulation of Movement of Swine Order. 1950.—This Order continued in operation during the year 1953. Licences were issued for removal from the Borough of 1 pig and licences were received for entry into the Borough of 23 pigs. (iii) Swine Fever (Infected Areas) Order, 1953.—This Order restricted the movement of pigs into and out of the infected areas (which included the County of Essex) except under licence issued by the Local Authority. Licences were issued for removal from the Borough of 341 pigs, and licences were received for entry into the Borough of 169 pigs. The Order was revoked on 20th November, 1953. (iv) Fowl Pest Order, 1936.—One case of fowl pest was notified and confirmed. A second case was also notified but was subsequently diagnosed as not being fowl pest. (v) The Diseases of Animals (Extension of Definition of PoultryI Order, 1953.—This Order extends the definition of "poultry" in the Diseases of Animals Act, 1950, so as to include parrots and certain other birds likely to spread psittacosis, ornithosis and fowl pest. (vi) The Psittacosis or Ornithosis Order, 1953.—This Order extends the definition of "disease" in the Diseases of Animals Act. 1950. to include the disease known as "psittacosis" or "ornithosis." The Order also provides for the detention and isolation of birds affected or suspected of being affected, with the disease, and for the cleansing and disinfection of premises and utensils used for such birds. (vii) Parrots and Miscellaneous Birds (Prohibition of Importation) Order, 1953.—This Order prohibits the importation of parrots and similar birds into Great Britain. A subsequent Amendment Order allowed importation from Jersey, the Isle of Man and Northern Ireland. (viii) The Tuberculosis (Central Scotland Eradication Area) Order, 1953. The Tuberculosis (Pembrokeshire Eradication Area) Order. 1953. The Tuberculosis (West Glamorgan Eradication Area) Order. 1953. The main purport of these three 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. 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, 37 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 1953:— Type of Property Total Local Authority Dwelling Houses Agricultural All other (including Business and Industrial) I. Total No. of properties in District 163 51,705 40 5,024 56,932 II. No. of properties inspected as result:— (a) of notification 64 354 3 93 514 (b) survey under the Prevention of Damage by Pests Act, 1949 41 47 1 5 94 (c) otherwise — — — 770 770 III. No. of properties found to be infested by rats:— Major 2 2 Minor 75 181 3 45 304 IV. No. of properties found to be seriously infested by mice 11 82 - 27 120 V. No. of infested properties (under III and IV) treated by the Local Authority 92 217 3 70 382 VI. No. of notices served under Section 4:— (1) Treatment — — 2 — 2 (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 Leptospirosis Survey. An investigation into the presence of leptospirosis in rats obtained from the Ilford district was carried out by the Wellcome Laboratories of Tropical Medicine, Euston Road, London' Dr. Broom has furnished me with the results of his investigations in this field; these are as follows:— Total Number of Rats examined 77 Number Positive by one or more techniques 27 (35%) 38 Table 1. Incidence of Infection by Age and Sex. Adult Young Male Female Male Female No. examined 31 22 13 11 No. infected 13 7 3 4 Table 2. Number of Positive Findings Using Different Techniques. (1) Agglutination 24 (2) Dark-ground 12 (3) Kidney Culture 16 (4) Kidney Section 3 Table 3. Analysis of Positive Findings. Number Positive by all 4 methods 1 „ „ „ 1, 2, 3, Negative by 4 6 „ „ „ 1, 2, 4, „ „ 3 2 „ „ „ 1, 2, „ „ 3, 4 2 „ „ „ 1, 3, „ „ 2, 4 6 „ „ „ 2, 3, „ „ 1, 4 1 „ „ „ 1, „ „ 2, 3, 4 7 „ „ „ 3, „ „ 1, 2, 4 2 Total Positive 27 The results show an incidence of leptospirosis in Ilford very similar to that appertaining elsewhere. Dr. Broom's work in this field has been very satisfactory and I much appreciate his efforts. Petroleum (Consolidation) Act, 1928.—The Sanitary Inspectors made 1,013 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 137, and the fees paid to the Council for such Licences was £103. 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. 0d. 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. 0d. 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 11 premises during 1953. 39 SECTION F. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASES. The following diseases are notifiable to the Medical Officer of Health: 1. Under Section 144 and 343, Public Health Act, 1936. Smallpox. Enteric fever (Typhoid and Para- Cholera. typhoid). Diphtheria. Relapsing Fever. Membranous Croup. Anthrax (made notifiable by the Local Erysipelas. Authority as from 1/4/22). Scarlatina or Scarlet Fever. Pemphigus Neonatorum (made notifiable Typhus Fever. by Local Authority as from 29/6/29). 2. Under Regulations of the Ministry of Health. Plague L.G.B. Order, 19/9/1900. Puerperal Pyrexia The Puerperal Pyrexia Regulations, 1951 Ophthalmia Neonatorum P.H. (Ophthalmia Neonatorum) Regulations, 1926. Acute Primary and Acute Influenzal Pneumonia }P.H. (Infectious Diseases) Regulations, Dysentery 1953. Malaria Tuberculosis P.H. (Tuberculosis) Regulations, 1952. Acute Rheumatism (up to 16 The Acute Rheumatism Regulations, 1953. years) Measles and Whooping Cough The Measles and Whooping Cough Regulations, 1940. Acute Poliomyelitis P.H. (Acute Poliomyelitis, Acute En- Acute Encephalitis cephalitis and Meningococcal Infection) Meningococcal Infection Regulations, 1949. 3. By Local Act. Food Poisoning Ilford Corporation Act, 1937, and Food and Drugs Act, 1938. In addition to the above diseases notifiable to the Medical Officer of Health, certain industrial diseases are notifiable to the Chief Inspector of Factories, Home Office, under Section 66 of the Factories Act, 1937. These are cases of Lead, Phosphorus, Arsenical or Mercurial Poisoning or Anthrax contracted in any factory. The Secretary of State can add other diseases to those mentioned by Regulation. The total number of deaths of Ilford residents from the following infectious diseases during 1952 and 1953 were as follows:— 1952 1953 Scarlet Fever — — Enteric Fever — — Diphtheria — — Acute Poliomyelitis 1 — Measles 2 — Whooping Cough — 1 Influenza 5 22 Tuberculosis—Pulmonary 19 27 Other forms 2 1 Pneumonia (all forms) 53 95 Diarrhoea (under 2 years) 1 1 Meningococcal Infections 1 1 Totals 84 148 40 TABLE III.— Corrected Notifications of Infectious Diseases fob the Year 1953 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 366 - 68 284 10 4 - - 21 46 8 22 23 35 63 45 19 17 43 24 90 - Diphtheria, including Membranous Croup - - - - - - - - - - - - - - - - - - - - - Enteric Fever (Typhoid and Para-Typhoid) - - - - - - - - - - - - - - - - - - - - - - Pneumonia 219 5 18 29 7 34 56 70 26 22 15 10 9 15 27 25 15 17 22 16 90 95 Puerperal Pyrexia 57 — — — 19 38 — — — — — — — — 1 — — 55 — 1 55 — Acute Poliomyelitis 17 — 3 5 4 4 1 — 1 — 2 — — 2 2 3 2 2 1 2 17 — Acute-Encephalitis 2 — — — — 2 — — — — — — — — — — — 1 — 1 2 — Meningoccocal Infection 3 1 1 - - - 1 - - - - - - 2 - - 1 - - - 3 1 Dysentery 52 2 10 17 6 13 2 2 16 1 — 1 — 5 2 8 10 — 3 6 14 — Ophthalmia Neonatorum — — — — — — — — — — — — — — — — — — — — - — Erysipelas 33 — — — 4 11 13 5 3 2 1 — — 3 4 8 6 4 2 — 5 — Pemphigus Neonatorum - — — — - — - — — — — — — — — — - — — — — — Tuberculosis Pulmonary 156 — 1 10 38 66 35 6 12 9 17 9 14 18 10 15 9 15 14 14 97 27 Other Forms 18 — 1 7 2 3 5 - 1 1 — 1 1 1 2 1 4 3 1 2 4 1 Anthrax - — — - - - - - - - — - - - - - - - - - - - Malaria- Believed contracted in this country - - - - - - - - - - - - - - - - - - - - - - Believed contracted abroad 3 - - - 3 - - - - 1 - - 1 - - - - - 1 - 3 - Acute Rheumatism 6 — 1 4 l — — - — 1 1 — — 1 1 - — - — 2 5 - Measles 1,231 51 661 482 16 18 3 — 143 84 82 61 67 70 262 103 173 61 59 66 75 - Whooping Cough 820 53 361 393 2 5 5 l 43 65 98 92 66 49 61 93 46 59 64 84 20 1 Food Poisoning 34 1 5 2 4 11 10 1 13 2 1 - 3 2 1 3 5 - 1 3 5 - Typhus Fever — — — — — - — - — — — — — — — - - - — - - — Totals 3,017 113 1,130 11,238 110 209 l31 85 279 234 225 195 184 203 436 304 290 234 211 221 485 125 * Included in the figures in these columns are eases notified in previous years as well as 1953. 41 The year 1953, on the whole, showed a lower incidence of infectious disease than 1952. The number of cases of measles was 1,231 as compared with 3,166 the previous year. Whooping cough cases numbered 820 as compared with 756 in the year 1952. (a) Smallpox.—No cases were notified during 1953. Notifications regarding 7 persons who had been in contact with cases of smallpox in other areas or on board ship were received. Seven visits were paid by the Sanitary Inspectors. The following gives particulars as to vaccination during 1953:— Primary vaccination 1,439 Re-Vaccination 469 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.—366 cases occurred in 1953. There were no deaths from this disease. Eleven cases were admitted to Isolation Hospitals outside the district. (c) Diphtheria.—No cases occurred in 1953. This is the second successive 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 1953. The following figures show the number of cases of Ophthalmia Neonatorum notified during the past five years: 1949, 1; 1950, 2; 1951, 3; 1952, nil; 1953, nil. It is to be remembered that many cases of ophthalmia neonatorum are not due to gonorrheal infection. (e) Enteric Fever.—No cases were reported during 1953. (f) (i) Acute Poliomyelitis.—Seventeen cases occurred during the year. They were males of 11, 3, 4, 5, 5, 19, 28. 31, 33 and 45 years and fernales of 6, 7, 8, 18, 19, 19 and 31 years. Sixteen cases were admitted, to the Ilford Isolation Hospital and one to Plaistow Hospital. Twelve cases were paralytic and five non-paralytic. There were no fatal cases. (ii) Acute Encephalitis.—Two cases only of this deasease occurred, males of 33 and 41 years. Both were admitted to hospital and recovered. (iii) Meningoccocal Infection.—Three cases of this disease occurred. They were males of 4 months and two years and a female of 57 years. All were admitted to hospital and made a satisfactory recovery. (g) Pneumonia—Influenzal and Primary.—This disease was more prevalent in 1953 than in 1952. The greatest number of notifications mostly of the influenzal type, were received in February. (h) Tuberculosis.—During the year 1953 there were 156 new notifications of Pulmonary Tuberculosis and 18 of other forms of Tuberculosis. 16 cases of Pulmonary Tuberculosis were transferred to Ilford. 42 It is interesting to compare the figures of the number of persons added to the list during the past 10 years:— Year Pulmonary Cases Non-Pulmonary Cases 1944 222 33 1945 236 38 1946 247 34 1947 252 30 1948 266 26 1949 178 34 1950 242 26 1951 227 33 1952 168 20 1953 172 18 Notifications and Deaths from Tuberculosis of Ilford residents during 1953:— Age Periods New Cases Deaths Respiratory NonRespiratory Respiratory NonRespiratory M F M F M F M F Under 1 year - - - - - - - - 1-5 years — 1 1 - - - - - 5-15 6 4 3 4 — — — — 15-25 14 24 1 1 — 1 — — 25-35 26 11 — 2 2 3 — — 35-45 19 10 1 — 1 — — — 45-55 18 4 1 1 2 1 — 1 55-65 13 — 1 2 10 — — — Over 65 4 2 — — 6 1 — — Totals 100 56 8 10 21 6 - 1 Of the foregoing new cases, the following were notified from Institutions in the district:— Respiratory Tuberculosis NonRespiratory Tuberculosis King George Hospital 5 1 Claybury Hospital 5 1 Goodmayes Hospital 5 — Ilford Isolation Hospital 3 1 Dr. Barnado's Village Homes 3 3 Of the 28 deaths which occurred of Ilford residents, notification had previously been made of 23 of the cases. In the remaining 5 cases the presence of tuberculosis was discoverd as a result of post mortem examination, one of these cases being notified after death. 48  Pulmonary NonPulmonary Total Number of cases on register, 1st January, 1953 1,279 163 1,442 Number of cases entered on the register during the year 172 18 190 Number of cases removed from the register during the year Pul. NonPul. Recovered 51 14 Deceased 30 2 Left District 90 11 Lost sight of 1 1 Diagnosis not established 3 1 175 29 204 Number of cases remaining on register on 31st December, 1953 1,276 152 1,428 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; 1,283 persons were visited during the year. The following reports were obtained: Pulmonary Cases Other Cases Condition good 742 97 Condition fairly good 207 18 Condition poorly 41 1 In sanatoria 98 7 No information as to present condition 24 4 Removed from district, etc. 37 7 1,149 134 The treatment of Tuberculosis is now under the control of the Regional Hospital Board. On the 31st December, 1953, there were 1.118 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 1953 was as follows: Pulmonary Non-Pulmonary Total Males Females Males Females Adults 58 31 4 4 97 Children 1 - 2 1 4 Tuberculosis Care Association.— This Association has assisted 69 cases with extra nourishment, clothing, and in other ways. 44 (i) Venereal Diseases.— Treatment of these diseases is now the responsibility of the Regional Hospital Board. The following are the V.D. Treatment Centres situate nearest to Ilford:— Romford.— The Annexe, Oldchurch Hospital, Waterloo Road, Romford:— Males Females Consultations: Monday and Tuesday 4 to 6.30 p.m. Monday and Tuesday 4 to 6.30 p.m. Thursday 12 noon to 3 p.m. Thursday 12 noon to 3 p.m. Treatments: Monday to Friday 9 a.m. to 7 p.m. Monday to Friday 9 a.m. to 7 p.m. Saturday 9 a.m. to 6 p.m. Saturday 9 a.m. to 6 p.m. Whitechapel.— Whitechapel Clinic, Turner Street, Mile End, London E.1:- Males Females Consultations: Monday to Friday 10 a.m. to 7 p.m. Monday to Friday 10 a.m. to 7 p.m. Saturday 10 a.m. to 3 p.m. Saturday 10 a.m. to 3 p.m. Treatments: Monday to Friday 7 a.m. to 7 p.m. Monday to Friday 10 a.m. to 7 p.m. Saturday 7 a.m. to 3 p.m. Saturday 10 a.m. to 3 p.m. West Ham.— Queen Mary's Hospital, West Ham Lane. Stratford. London, E.15: — Males Females Consultations: Monday 3 to 6 p.m. Monday 6 to 8 p.m. Thursday 11 a.m. to 1 p.m. and 6 to 8 p.m. Thursday 11 a.m. to 1 p.m. and 3 to 6 p.m. Saturday 2.30 to 4.30 p.m. Saturday 2.30 to 4.30 p.m. Treatments: Monday 9 a.m. to 6 p.m. Monday 9 a.m. to 8 p.m. Tuesday 9 a.m. to 5 p.m. Tuesday 9 a.m. to 5 p.m. Wednesday 9 a.m. to 1 p.m. Wednesday 9 a.m. to 1 p.m. Thursday 9 a.m. to 8 p.m. Thursday 9 a.m. to 6 p.m. Friday 9 a.m. to 5 p.m. Friday 9 a.m. to 5 p.m. Saturday 9 a.m. to 4.30 p.m. Saturday 9 a.m. to 4.30 p.m. 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. Examination of Officers and Servants. The following medical examinations were carried out during 1953:— Officers Servants New Appointments 57 52 Under Sickness Regulations 8 77 Superannuation Allocation 2 1 Totals 67 130 45 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 418 factories with mechanical power on the register. There are 204 factories without mechanical power on the register. There are 238 outworkers on the register. 1.—INSPECTION OF FACTORIES AND OTHER PREMISES. Including Inspections made by Sanitary Inspectors. Premises Number of Inspections Written Notices Occupiers prosecuted (1) (2) (3) (4) Factories with Mechanical Power 1,772 19 - Factories without Mechanical Power 203 2 - Other premises (not including Outworkers' premises) 80 1 — Total 2,061 22 — 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) 13 14* - - Overcrowding (S.2) — — — — Unreasonable Temperature (S.3) 9 2 - - Inadequate Ventilation (S.4) - — — — Ineffective Drainage of Floors (S.6) - - - - Sanitary Conveniences (S.7):— Insufficient 5 4 - — Unsuitable or Defective 3 4* — — Not Separate for Sexes — — — — Other Offences — — — — Total 23 24* — — * Includes compliances of defects found in 1952. 46 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 1953 was 1,705 (891 males and 814 females), of which there were 127 (77 males and 50 females) where the ordinary place of residence of the parents was outside Ilford. In addition 656 notifications of live births (340 males and 316 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 no cases in which there was default in complying with the requirements of the Public Health Act relating to the Notification of Births. The percentage of live births occurring in Ilford. notified by the various responsible persons, was as follows:— By Medical Practitioners .18 By Certified Midwives 99.76 By Parents and others .06 There were also 45 stillbirths (28 males and 17 females) notified in Ilford including 3 (all males) where the home address of the parents was outside the district, and notifications of 16 stillbirths (6 males and 10 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 58 where the home address was in Ilford, whereas the Registrar-General has allocated 61 stillbirths to Ilford. The following table shows the causes of the 58 stillbirths notified where the usual residence of the parents was in Ilford:— Stillbirths, 1953. Cause of Stillbirth Delivery in Nursing Home Delivery by County Council Midwife at Home Delivery in Hospital Total Abortion - - 1 1 Anoxia — - 2 2 Ante-partum haemorrhage — - 6 6 Atelectasis — - 11 11 Degenerative changes in all organs — - 1 1 Diabetes mellitus—intra uterine death at 38 weeks - - 1 1 Hydrops foetalis — - 1 1 Hydrocephalus — - 2 2 Hypertension due to early pre-eclampsia toxaemia - - 6 6 Intra uterine death—obstructed labour — - 1 1 Intra uterine death—cause unknown — - 2 2 Loop cord prolapsed round neck — - 2 2 Multiple abnormalities — - 3 3 Partial separation of placenta—intracranial haemorrhage - - 1 1 Placental insufficiency — - 1 1 Rh. factor incompatibility — - 1 1 Thrombosis of main vessels in the placenta — - 1 1 Umbilical cord round neck — 1 1 2 Unknown 1 7 5 13 Totals 1 8 49 58 47 Care of Premature Infants.— Of the 1,705 live births occurring in Ilford during 1953, 77 weighed 5½lbs. or less at birth; 18 of these babies were born on the district (including 2 where the home address of the parents was outside Ilford) and 59 in Hospital (including 3 where the home address of the parents was outside Ilford). Of the 18 babies born at home:— 17 were nursed entirely at home (including 2 where the home address was outside Ilford); 1 was transferred to hospital. All survived at the end of one month. Of the 59 babies born in hospital:— 3 died during the first 24 hours; 2 died between the ages of one day and one month; 54 survived at the end of one month (including 3 where the home address was outside Ilford). In addition 43 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 51 lb. or less. Of these there were:— 3 who died within the first 24 hours (all in hospital); 6 who died between the ages of one day and one month (all in hospital); 34 who survived at the end of one month. Infant Mortality.—The number of infants dying within the first year of life was 45, the total number born being 2,231. 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 20.17. The following table gives the deaths of infants under one year of age. classified according to age:— Infant Deaths—1953. 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 Atelectasis 8 1 - - 9 - - - - 9 Broncho-Pneumonia 3 1 - - 4 1 1 2 1 9 Cerebral haemorrhage 5 - - - 5 - - — - 5 Congenital abnormalities 4 2 - - 6 1 - 1 1 9 Erythroblastosis foetalis - 1 - - 1 - - — - 1 Gastro-Enteritis - - - - - 1 - - - 1 General spasticity - - - - - 1 - - - 1 Meningitis - - - - - 1 - - - 1 Microcephaly, Meningocele, Prematurity - 1 - - l - - - - 1 Misadventure 1 - - - l - - — - 1 Prematurity 6 — - - 6 - - — - 6 Pulmonary Embolism due to venous infarction of both kidneys - - 1 - 1 - - — - 1 Totals 27 6 1 — 34 5 1 3 2 45 48 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 1953 45 20.2 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 The mean average Infant Mortality rate for the past 10 years is therefore 24.4 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 1953 20.2 27 25 31 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 4.6 53 54 1944 36.8 46 61 52 Neonatal Mortality.— The death-rate of infants under four weeks of age is known as the Neonatal Mortality. There were 34 deaths of infants under four weeks of age during 1953 and the rate for the year was 15.2 per 1,000 live births. The figures for the past 48 years were as follows:— Year Number Rate Year Number Rate 1953 34 15.2 1929 48 27.4 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 49 Illegitimate Births and Deaths.—67 of the live births registered (34 males and 33 females) were illegitimate, that is 3 per cent of the births registered. Two illegitimate children (1 male and 1 female) 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:— Year Legitimate Infants Illegitimate Infants Live Births Percentage of Registered Births Deaths Rate per 1,000 Legitimate Live Births Live Births Percentage of Registered Births Deaths Rate per 1,000 Illegitimate Live Births 1953 2,164 97.0 43 19.9 57 3.0 2 29.9 1952 2,232 90.1 44 19.7 91 3.9 — — 1951 2,300 97.1 49 21.2 70 2.9 1 14.3 1950 2,332 90.9 41 17.0 74 3.1 4 54.0 1949 2,567 97.0 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 1940 3,336 90.9 97 29.1 107 3.1 5 46.7 1945 2,343 94.5 73 31.2 136 5.5 8 58.8 1944 2,055 95.8 95 35.7 116 4.2 7 60.3 The Chelmsford Diocesan Moral Welfare Association continued in 1953 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 one trainee was allocated to Ilford for practical instruction during 1953. At the end of the year there were 7 full-time and 2 part-time qualified Health Visitors, and School Nurses in addition to the Superintendent Health Visitor, and 5 Clinic Nurses. This shows a decrease from the beginning of the year and the health visiting staff is well below the approved establishment of 18. The following is a summary of the home visits made by the Health Visitors and Clinic Nurses during 1953 as far as the Maternity and Child Welfare work is concerned: — First visits to newly-born infants ... ... 2,215 Subsequent visits to children under I year of age . . 7,189 Subsequent visits to children over I year of age and under 5 16,377 Visits to expectant mothers ... ... 352 Home visits for other reasons ... 4,532 Total visits paid 30,665 50 East Coast Flood Disaster, February, 1953, One Health Visitor and two Clinic Nurses were loaned, one for 2 days, one for 14 days and one for 13 nights to assist in relief duties (at ;i reception centre and in specialised home visiting) in the South Essex Health Area, following the flooding at Tilbury, Purfleet, Grays and Corringham. Day Nurseries. (a) The hours of opening at all the Nurseries during 1953 continued to be 7.30 a.m. to 6 p.m., Monday to Friday only. (b) The charge made to parents for meals for children attending the Nurseries had been 2/- per child per day from the 1st January, 1952. On the 18th January, 1953, however, as mentioned in the Annual Report for last year, the standard charge was increased to 7/6 per child per day with provision for this charge to be reduced according to scale when the means of the parents do not justify the full fee. This amendment was arising from 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 marked decrease in the daily attendances at the Nurseries noted last year has continued to be evident. Accommodation has, however, been made available to neighbouring Areas for children who can more conveniently attend an Ilford Nursery than one in their own Area, particular^ those residing on the Hainault (L.C.C.) Estate. (c) Stevens Road Day Nursery.—As was mentioned last year, this Nursery was closed on the 28th July. 1953. in view of the decline in the demand for places at the Nursery. At the date of closure only 4 children remained on the register and these were transfrred to the Goodmayes Lane Day Nursery. The few remaining staff were transferred to other Nurseries to fill vacancies there. Pending a decision as to the future use of the premises the Child Guidance Clinic was transferred there in the middle of November, 1953, for a period of one month whilst alterations were being carried out to Loxford Hall (d) The training of Students at the Nurseries for the Certificate of the National Nursery Examination Board continued. Five Students (two from the Ley Street Nursery, two from the Sunshine House Nursery and one from the Goodmayes Lane Nursery) entered for the examination during the year, four of whom obtained the Certificate. The fifth entered again in January, 1954, after having left the Sunshine House Nursery in December. 1953, and obtained the Certificate at this second attempt. 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. Four students (3 from Goodmayes Lane Nursery and one from Ley Street Nursery) attended such a course at the St. George's Day Release Centre. Dagenham, in 1953. 5l (e) The following is a table showing the attendances, etc., at the Day Nurseries during 195:- Situation Date of Opening Accommodation (Children) Average Daily Attendance during 1953 No. of Days in Quarantine Reasons for Quarantine with Number of Cases No. on Waiting List at 31st Dec. Chicken Pox Scarlet Fever Whooping Cough Influenza Measles German Measles Diarrhoea and Vomiting Sunshine House, Girls' Village Homes, Barkingside 17.8.42 45 30 101 - - 6 - 4 4 - - Goodmayes Lane, Goodmayes (Replaced Green Lane Nursery, open from 5.5.43 to 9.11.51) 14.11.51 50 31 77 17 1 1 - 1 2 - - 226-236, Ley Street, Ilford 16.8.43 50 34 S3 9 1 1 - 4 3 10 - Stevens Road, Dagenham (Replaced Becontree Avenue Nursery, open from 17.1.44 to 13.3.50) 16.3.50 Closed on 28.7.53 50 13 (To date of closure) 19 - - - 26 1 - - - 52 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) (b) Premises Child-minders Number on register at 31/12/52 3 3 Number registered during 1953 — 2 Number of registrations cancelled during 1953 (Removals from district, etc.) — - Number on Register at 31/12/53 3 5 Number of children provided for at 31/12/53 88 45 Clinic Premises. Barkingside and Fairlop Infant Welfare Centres.—The arrangements for these Centres to be held at the Methodist Church Hall, Fremantle Road, Barkingside, made in December, 1952, following the fire at the Holy Trinity Parish Hall where the Centres had previously been held, continued to operate throughout the whole of 1953. 1 am, however, pleased to report that the Barkingside Parish Hall has now been rebuilt and our Centres were transferred back to those premises as from the 1st March, 1954 Health Services Clinic, Couchmore Avenue.—In the Programme of Capital Buildings Proposals for the year 1953/54 the County Council agreed to include the erection of a Health Services Clinic on part of the site reserved in Heathcote Avenue (Couchmore Avenue area) for a health centre. Plans have been prepared and the necessary consents are awaited. It is proposed that the building should provide accommodation for the Local Health Authority's services (infant welfare, ante-natal, postnatal and immunisation clinics and facilities for Health Education) and School Health Services (school clinics and special medical inspection of school children) and should be so designed as to form an integral part of the future Health Centre when this is ultimately built. The Clinic will meet a real need in the north-west area of Ilford which is a considerable distance from the existing Clinics. Health Services Clinic, Kenwood Gardens.—Mention should also be made that the County Council have approved for inclusion in the Capital Buildings Proposals for 1954/55 the erection of a Health Services Clinic on part of the site reserved for a Health Centre in Kenwood Gardens. It is intended that this Clinic will replace that at present housed at the Public Health Offices. Valentines Mansion, and certain of the services at present carried on at Newbury Hall will also be transferred there. As in the case of the Couchmore Avenue area Clinic, this building also will be so designed as to form an integral part of the future Health Centre. This project is being given first priority in the County Council's programme for 1954-55 and plans have been drawn up. 53 Infant Welfare Centres.—104 voluntary lady helpers were engaged in the work at the Infant Welfare Centres at the end of December. 1953. During the year the following attendances were recorded:— Total number of attendances of infants 39,294 First attendances 1,924 Attendances of Children from 1 to 5 years 12,670 Total number of children on roll, December 31st, after omission of all those who had not attended for six months 3,629 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 1953 39,294 1.924 3,629 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 3,697 677 sessions were held during the year, the average attendance at each session being 58 mothers with their infants. The following are the figures for each Centre:— Sessions Average Attendance Chadwell 48 53 Becontree 48 59 Downshall 48 57 Manford Way 48 43 Woodford Avenue 48 89 Seven Kings 48 57 Cecil Hall (Wednesdays) 48 59 Cecil Hall (Thursdays) 49 65 Newbury Hall 49 34 Goodmayes 49 48 Grosvenor Road 49 61 Ilford Lane 48 56 Valentines 48 52 Barkingside and Fairlop 49 73 Orthopaedic Clinic. (i) Newbury Hall Clinic.—42 sessions were held during 1953, 171 children under 5 years of age being examined, making 275 attendances. 54 (ii) Mayesbrook Clinic.—24 sessions were held during 1953, 96 children under 5 years of age being examined, making 155 attendances. (iii) Manford Way Clinic.—7 sessions were held dnring 1953. 19 Ilford children under 5 years of age being examined, making 23 attendances. The 286 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:— Cerebral Palsy — 1 — — — — A.P.M. 1 — — — 1 — Hemiplegia 1 - - - - - Deformity of hips — — — 2 — — Genu valgum 61 26 9 22 17 1 O.C.T. 1 3 1 11 3 — Genu varum 2 2 — 5 3 1 Pes valgo planus 9 8 2 7 4 3 Valgus ankles 5 5 — 2 1 — Talipes calc. valgus — — — 1 — — Congenital talipes E .V. — 1 — 1 — — Congenital defect 1 1 — 1 1 — Intoeing 3 2 — — — — Deformity of toes 1 1 — 3 1 — Slack posture — — — 1 — — N.A.D. 1 1 — 1 2 2 Other conditions 11 3 — 8 8 — Scoliosis — — — 1 — — Hallux valgus 1 1 — — — — Deformity of chest 1 - - - - - Traumatic condition — — — 1 — — Metatarsal varus 3 — — 2 — — Totals 102 55 12 69 41 7 A—Newbury Hall. B—Mayesbrook. C— Manford Way. 32 pairs of Valgus Insoles, 1 pair surgical shoes, 3 Metatarsal bars and toe springs, 10 G.V. night splints and 181 wedges to shoes were supplied during 1953. At the Newbury Hall Clinic, 21 children under five years of age were treated by the Physiotherapist during the year, and 97 attendances were made by these children. Treatment was also given to 19 children who made 95 attendances at the Mayesbrook Clinic, and to 2 children who made 8 attendances at the Manford Way Clinic. Paediatric Clinic.—The Consultant Paediatrician continued to attend the Clinic at Valentines Mansion during the year. 25 sessions were held and 126 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 244 attendances were made. 55 Diagnosis Discharged Improved Discharged with Advice or for Other Reasons Discharged no Treatment Discharged Cured Referred to Hospital, Dr. or Clinic Still attending Total Abdominal pain - - - - 1 - 1 Adenopathy - - - - 1 - 1 Anaemia - 1 - - 1 - 2 Anal fissure - - - - 1 - 1 Asthma - - - - 1 2 - Behaviour difficulties - - - - 1 — 1 Birth trauma - 1 1 - 1 — 3 Boils - 1 - - - - 1 Breath holding 1 — - - - — 1 Congenital amputation of arm - 1 - - - - 1 Congenital heart disease - - - - 1 2 3 Congenital laryngeal stridor 1 - - - - - 1 Constipation - — - - 2 1 3 Enuresis - - - - - 1 1 Feeding problem - 2 1 - - — 3 Headaches 1 - - - - — 1 Heart murmur - - 1 - - 2 3 Hernia - 2 3 - - 1 8 Hydrocele - - - - 1 - 1 Hydrocephalus - - - - - 1 1 Hypospadias - — 1 - 1 — 2 Immaturity - - 1 - - — 1 Meningomyelocele - - 1 - — — 1 Minor skin sepsis 1 — - - — - 1 Mongol - 1 2 - 1 1 5 Naevus - - - - - 1 1 Normal child—N.A.D. - 3 12 - 5 - 20 Obesity - - - - 3 3 6 Oesophageal atresia — — — - — 1 1 Old fracture of humerus 1 - - - - - 1 Old poliomyelitis — — — - 1 — 1 Pain in neck - - - - 1 - 1 Pertussis - - 1 - - - 1 Pes cavus - - - - 1 - 1 Petit mal - - - - 1 - 1 Phimosis - - - - 1 - 1 Prematurity - 7 - - - 1 8 Primary amentia - - - - 1 - 1 Pyloric stenosis - - - - 1 - 1 Rectal prolapse - - 1 - - - 1 Rumination - 1 - - - - 1 Sinusitis - - - - 1 - 1 Spastic diplegia - - - - 1 - 1 Speech retardation - 1 - - - - 1 Spina Bifida - - - - 1 - 1 Sterno-mastoid haematoma - - 2 1 - - 3 Talipes varus - 1 - - - - 1 Tonsillitis - - - - 1 - 1 Ulcerative stomatitis - - - - 1 - 1 Uncertain 1 1 - - 5 2 9 Undernourishment - - - - - 1 1 Undescended testes - - - - 2 - 2 Upper respiratory infection 1 - - - - - 1 Upper respiratory infection with partial eventration of diaphragm - - - - 1 - 1 Urinary infection - - - - 2 - 2 Vomiting — 1 - — 2 — 3 7 24 27 1 47 20 126 56 Ophthalmic Clinics.—Attendances of children under school age for treatment by the Oculist during 1953 were as follows:— Valentines Mansion Mayesbrook Clinic Manford Way Clinic Total Number of children who attended 91 43 13 147 Number of pairs of spectacles prescribed 17 15 5 37 Total number of attendances made 155 90 28 273 Aural Clinic.—The Aural Surgeon attended at 50 sessions during 1953 and 107 attendances were made by 69 children of pre-school age. 23 children were operated upon for removal of tonsils and adenoids, 16 at llford Isolation Hospital, 5 at King George Hospital, Ilford and 2 at East Ham Memorial Hospital. Rheumatism Clinic.—32 sessions were held during the year at Newbury Hall, at which 18 children under 5 years of age, 8 being new cases, made 30 attendances. The following is a summary of the cases treated:— Condition New Old Total Rheumatism - 1 1 Congenital heart disease 1 2 3 No active rheumatic disease — 4 4 Functional heart murmur 6 3 9 Other forms 1 — 1 Totals 8 10 18 Number of cases referred to General Hospital 2 „ „ „ „ „ „ Paediatrician 1 „ „ „ „ „ for Blood Sedimentation Rate 3 „ „ „ „ „ „ X-ray and Electrocardiograph 7 57 Artificial Sunlight Clinic.—44 sessions were held at the Newbury Hall Clinic and 45 at Mayesbrook. In all. 64 children under 5 years of age were treated, making 777 attendances. The conditions treated were as follows:— Conditions Cases A B Anaemia, Debility, Malnutrition and Catarrh 28 7 Wide Fontanelle 3 1 Old Rickets 2 - O.C.T. (Bow legs) 2 2 Bronchitis 4 1 Alopecia 1 — Other conditions 10 3 Totals 50 14 A.—Newbury Hall. B.—Mayesbrook. 43 cases were still attending at the end of the year; of the remainder 16 were discharged having made a satisfactory recovery and 5 were discharged due to absence. Speech Clinic.—9 children of pre-school age attended, making 204 attendances. The following is the classification of the defects found by the speech therapist:— Dyslalia 4 Stammering 3 Dyslalia and Hyperrhinophonia 1 Cleft Palate 1 Diphtheria Immunisation.— Tabular Statement as to Number of Children Schick Tested and Immunised at the Diphtheria Clinics from 1st January, 1953, to 31st December, 1953. 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 - — - — — - 1 Negative 1 — 1 — - - - — — 1 Numbers inoculated (full course) 23 281 304 20 198 218 1 71 72 594 * Positive after full course of inoculations and further inoculated - 2 2 1 - 1 - - - 3 * Negative after full course of inoculations 21 405 426 12 226 238 - 47 47 711 Re-inoculations (one only) 408 142 550 257 57 314 53 1 54 918 * Awaiting re-test 5 107 112 15 159 174 — 31 31 317 *Not re-tested after inoculation (on account of leaving District, etc.) 47 417 464 32 213 245 11 105 116 825 *Positive after re-test but not further inoculated for same reason as above 1 - 1 - - - - - - 1 Re-tested& Schick Tested in 1953 (1952 cases): * Positive after full course of inoculations, and further inoculated - 3 3 - 2 2 - - - 5 * Negative 7 215 222 4 120 124 3 29 32 378 During 1953, a total number of 2,454 children attended at the Diphtheria Prevention Clinics, (1,426 at Valentines Clinic, 847 at Mayesbrook and 181 at Manford Way), making a total number of attendances of 6,405 (3,639, 2,251 and 515), with an average per session of 59, 43 and 11 respectively. During 1953, 69 private doctors were supplied with prophylactic for the immunisation of 2,123 children and record cards were received from general practitioners as follows:— Under 5 Over 5 Inoculations (full course) 1,138 92 Re-inoculations (one only) 127 766 (* These figures include cases inoculated by general practitioners who made subsequent attendances at the Diphtheria Clinics). 58 59 Diphtheria Immunisation (Continued). The following table is submitted to show the figures over the past five years:— 1949 1950 1951 1952 1953 No. of primary inoculations:— At Clinics 1,196 778 794 793 594 By General Practitioners 1,283 866 1,007 1,263 1,425* Totals 2,479 1,644 1,801 2,056 2,019 No. of re-inoculations:— At Clinics 1,615 1,318 1,473 1,198 918 By General Practitioners 265 144 541 1,025 918† Totals 1,880 1,462 2,014 2,223 1,836 No. of live births in Ilford 2,630 2,406 2,376 2,323 2,231 * Includes 195 combined Diphtheria and Whooping Cough inoculations. † Includes 25 combined Diphtheria and Whooping Cough inoculations. Whooping Cough Immunisation. From 1st April, 1953, whooping cough immunisation was introduced in the local health authority clinics and facilities were provided for the free provision of pertussis vaccine to general practitioners. It is not at this time the policy of the County Council to use a combined diphtheria/pertussis vaccine and in order to avoid increasing the number of immunisation sessions diphtheria and whooping cough prevention clinics were combined. Owing to the prevalence of polio-myelitis whooping cough immunisation was suspended after 1st July and not recommenced until 20th October. 1953. The following are the details of the number of children immunised against whooping cough at the three Ilford clinics held for this purpose together with records of such courses completed by general practitioners. Valentines Clinic Mayesbrook Clinic Manford Way Clinic *General Practitioners Inoculations (full course) Reinoeulations (one only) Attendances Inoculations (full course) Reinoeulations (one only) Attendances Inoculations (full course) Reinoeulations (one only) Attendances Inoculations (full course) Reinoeulations (one only) Children under 5 years of age 100 - 507 99 - 403 62 - 249 310 3 Children 5 years of age and over 11 - 32 1 - 5 - - 1 42 9 Totals 111 - 539 100 - 408 62 - 250 352 12 * For comparison, only plain pertussis injections carried out by general practitioners are entered in the above table. The figures for records received of combined diphtheria/pertussis courses of injections are as follows:— Inoculations 195 Re-inoculations 25 60 Vaccination.—During 1953 record cards were received from general practitioners and various hospitals as follows:— Ages up to 14— No. of children primarily vaccinated 1,253 No. of children revaccinated 73 Ages 15 and over— No. of adults primarily vaccinated 186 No. of adults revaccinated 396 The following table shows the figures over the past five years:— 1949 1950 1951 1952 1953 No. of primary vaccinations 831 1,198 1,583 1,428 1,439 No. of revaccinations 264 373 771 435 469 Totals 1,095 1,571 2,354 1,863 1.908 No. of live births in Ilford 2,630 2,406 2,376 2,323 2,231 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 1953, 12 sessions were held. 47 expectant and nursing mothers were referred from either the ante-natal or post-natal clinics, and with 23 old cases made a total of 109 attendances. The following is a summary of the new cases examined by Dr. K. Playfair:— Condition PostNatal AnteNatal Congenital Cardiac lesion — 3 Functional Cardiac disorder 3 26 No lesion — 5 Thyrotoxicosis — 1 Valvular disease of the heart — 9 3 44 24 of these patients were referred to Queen Mary's Hospital for X-Ray and/or electrocardiograph. Midwives.—There were 14 State certified midwives (including the Superintendent, Deputy Superintendent. 9 domiciliary midwives and 2 parttime midwives), resident and practising in the district at the end of the year. In addition there were 19 State certified midwives at the Ilford Maternity Hospital. 61 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 1 instance where the infant was found to have inflamed or discharging eyes. The condition of the eyes cleared satisfactorily. Domiciliary Midwifery Servicc.—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 562 cases were attended. In 520 cases the midwives were engaged to attend as midwives and in 42 cases as maternity nurses. The patients resided in the following wards:— Barkingside 46; North Hainault 47; Cranbrook 62; Park 53; Seven Kings 34; South Hainault 62; Loxford 33; Clementswood 31; Goodmayes 18; Fairlop 73; Clayhali 60; Mayfield 43. A Doctor was called in to 113 of the 520 cases in which a midwife had been engaged. Of the infants born there were 8 stillbirths. In 2 of these cases the midwife was engaged as a maternity nurse only. There were 3 deaths of infants during the first year of life where the birth had been attended by a Domiciliary Midwife. 2 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 32 infants attended by them during 1953. During 1953 Ante-Natal Clinics conducted by the Domiciliary Midwives were held weekly at Valentines Mansion and fortnightly at Mayes-brook cliic 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 287 105 97 Subsequent attendances 894 357 358 Totals 1,181 462 455 Number of sessions 48 24 27 Average attendance at each session 25 19 17 In addition 2,582 home ante-natal visits were made during the year. In order to make possible a more active collaboration between the general practitioners in the area and the midwives a scheme was devised, commencing on the 1st March. 1953. to provide for the doctor and the 62 midwife to have a consultation about their patient on three occasions (at specified intervals) during the pregnancy, the examinations taking place at the patient's home, the doctor's surgery or at the Local Health Authority's Clinic, as mutually agreed. In practice the joint consultation takes place in the majority of cases in the doctor's surgery, but in a few cases it is held in the patient's home. Salvation Army Midwifery Service.—One Salvation Army Midwife served in Ilford during the year. 73 cases were attended by her, all as a midwife. A Doctor was called in to 20 of the 73 cases in which the midwife had been engaged. Of the infants born there were no stillbirths. 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 1953 gas and air analgesia was administered in 473 cases, of which 403 were attended by the Domiciliary Midwives (370 when acting as midwives and 33 when acting as maternity nurses) and 70 were attended by the Salvation Army midwife. All the domiciliary midwives employed at the end of the year were qualified to administer gas and air analgesia and the one Salvation Army midwife was also so qualified. Four sets of apparatus for the purpose ot 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. Ante-Natal Clinics.—The following is a summary of the attendances at the Ante-Natal Clinics during 1953:— Maternity Hospital Mayesbrook Clinic Manford Way Clinic Doctors Midwives First attendances 1,116 — 290 121 Subsequent attendances 7,197 2,797 2,373 1,046 Totals 8,313 2,797 2,663 1,167 Number of sessions 262 *203 131 63 Average attendance at each session 31 13 20 18 * Includes 150 running concurrently with Doctors' Clinics. All patients booked for admission to the Maternity Hospital are medically examined at the Ante-Natal Clinics. During 1953 the first appointment, in accordance with previous practice, was normally made at the 16th week of pregnancy, but following consultations with the Consultant Obstetrician arrangements have been made, as from January, 1954, for the 63 first examination to be brought forward to the 10th week of pregnancy, or as soon as possible after that time if the booking for hospital admission is not made until after the 10th week. Further, arrangements were made, commencing in December, 1953, for all hospital booked patients to see the Obstetric Registrar at either the Ilford Maternity Hospital or the Mayesbrook Ante-Natal Clinic at about the 35th 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 1953 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 815 201 73 Subsequent attendances 316 86 6 Totals 1,131 287 79 Number of sessions 52 25 12 Average attendance at each session 21 11 6 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 101 sessions were held and a total of 836 examinations were made. Maternal Mortality.—During 1953 there were no deaths of Ilford mothers recorded by the Registrar-General as due to or in consequence of pregnancy or childbirth. Domestic Help Service.—During 1953 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 13 full-time, 105 regularly-employed part-time and 17 casual Helps employed. The following is a summary of the cases dealt with in 1953:— Number of applications received for assistance 1,353 Number of cases where Domestic Helps were provided (including 390 who were having service at the commencement of the year) 1,367 Number of cases which on investigation were either not eligible for assistance or did not require the service 207 Cases booked but subsequently cancelled 101 Number of cases where, at the end of the year, a domestic help was booked to attend in future months (maternity cases) 53 Other cases awaiting help at end of year 5 Enquiries incomplete at end of year 10 Cases being served at 31st. December, 1953 421 64 In September, 1953. a two-weeks training course for domestic helps was held by the County Council at the Mid-Essex Technical College, Chelmsford. One domestic help from Ilford attended and was found to be entirely satisfactory. Convalescent Facilities.—The following tables show the number of persons sent away for convalescence during 1953. (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 Temple House, Theobalds Park, Waltham Cross - - 1 Arranged by Invalid Children's Aid Association Violet Melchett Mothercraft Home, Chelsea, S.W.3 1 - - Mother with infant Dedisham Convalescent Nursery School, Slinfold. Sussex 1 - - Mother with infant (arranged by Gt. Ormond St. Hospital) Totals 2 - 1 2 mothers with infants 1 unaccompanied child (b) Under Section 28 of the Act, i.e., other persons requiring a change of air and surroundings to aid recovery and rehabilitation. Name of Home No. of weeks' stay Total Cases 1 2 3 Armitage House, Worthing — 1 — 1 Barton House Hotel, Barton-on-Sea — 1 — 1 Berkeley Home, Broadstairs — 1 — 1 Bell Memorial Convalescent Home, Lancing 1 4 6 11 Church Army Home, St. Leonards-on-Sea 1 2 — 3 Devonia Hall, Cliftonville — 2 — 2 Essex Convalescent Home, Clacton — 20 13 39 Mrs. Gowan's Home, Hove — — 1 1 Mrs. Hardy's Home, Four Marks, Alton, Hants. — — 1 1 Mrs. Hollamby's Home, Swalecliffe, Whitstable — 2 — 2 Hunstanton Convalescent Home — 3 6 9 Kenrith Lodge, 92 St. Helen's Road, Hastings 1 — — 1 LeconField, Bonchurch, Isle of Wight 1 — 9 3 Samuel Lewis Home, Walton-on-Naze — 1 5 6 St. Michael's Convalescent Home, Clacton — 1 — 1 St. Michael's Convalescent Home, Westgate-on-Sea — 1 — 1 South Court, Broadstairs — 1 — 1 Rustington Convalescent Home, Littlehampton — 6 5 11 Wind Whistle, Poundsgate, Newton Abbot — — 1 1 Totals 4 52 40 96 65 Loan of Sick Room Equipment.—The increasing demand for equipment continues and again applications throughout the year have more than doubled those for the previous year which showed a considerable Increase. The issues from the Public Health Offices were as follows:— Articles Loaned Number of Articles Articles in store at 31.12.53 on loan at 31.12.52 loaned or reloaned in 1953 on loan at 31.12.53 Mattresses (Dunlopillo) 10 9 10 2 Mattresses (Hair) —- 2 1 1 Invalid Chairs 19 20 23 6 Air Pillows 1 2 2 — Air Rings 23 165 48 2 Cushions (Dunlopillo) — 2 — 1 Back Rests 11 72 32 1 Beds — 3 2 — Commode Chairs 7 28 13 1 Crutches (Pair) 1 — 1 — Fracture Boards (Sets) 2 1 2 2 Pillows 2 4 6 2 Pillow Slips — 8 8 — Sheets (Pairs) — *2 *2 - Rubber Sheeting 10 177 78 3 Medical Sandbags 1 1 — 1 Spinal Carriages 1 - 1 — Bed Cradles 4 11 12 — Air Beds 1 14 — 5 Bed Pans 20 99 42 11 Diabetic Scales 2 3 5 — Feeding Cups 1 1 — 3 Urinals 11 68 27 8 Sputum Mugs 1 2 1 1 Douche Cans 1 — — 2 Water Beds - 1 1 — Water Pillows 1 — 1 — Bed Blocks (Sets) 1 — 1 — Pails — 1 — 1 Bowls — 1 - 1 Bedstead Sides — 1 1 — Totals 101 098 320 54 1952 Details 86 326 161 66 1951 Details 27 102 85 30 * Provided through special funds. Tuberculosis Visitors.—Three Tuberculosis Visitors were employed in the Area during 1953 making a total of 4,074 visits to homes in the Borough. Domiciliary Occupational Therapist.—Throughout 1953 efforts made to appoint an Occupational Therapist to commence a domiciliary service for patients suffering from tuberculosis were unsuccessful. I am, however, pleased to record that a joint appointment was made in May, 1954, to serve both the Ilford and Romford Health Areas. Rehabilitation of Tuberculosis Cases.—Assistance in the maintenance charges of cases at the Papworth Hall Settlement was given as follows:— 66 Number of cases being assisted at 31.12.52 1 „ „ newly assisted in 1953 Nil „ „ for whom responsibility ceased Nil „ „ being assisted at 31.12.53 1 Open-Air Shelters for Tuberculosis Cases.—No open-air shelters were supplied for tuberculosis patients during 1953 and at the end of the year no such shelters were in use in Ilford. Provision of Free Milk for Tuberculosis Cases.—The County Council's scheme, commenced in llford late in 1951, for supplying to tuberculosis patients one pint of milk free of charge, on the recommendation of the Chest Physician, again showed considerable progress during 1953 and the increase in the number of beneficiaries under the scheme still continues. Particulars of the grants made in 1953 are given below No. of cases in receipt of free milk at 31.12.52 59 „ „ new grants made during 1953 115 „ „ grants discontinued during 1953 42 „ „ cases in receipt of free milk at 31.12.53 132 Boarding-out of Children (Tuberculosis Contacts).—No applications were received in 1953 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 1953. The following shows the assistance given by the Association during the year:— No. of persons Assisted Total No. of Grants made Extra nourishment (grants made usually for periods of one month and renewed as required) 67 545 (including renewals) Clothing 1 1 Travelling Expenses of Relatives Visiting Hospital PatientsThe County Medical Officer was able to give financial assistance in 1953 only in very special cases to enable them to visit relatives who were in hospital and no Ilford persons were assisted under this scheme. Examination of Officers and Servants.—The following medical examinations of Essex County Council staff were carried out during 1953:— Officers Servants New Appointments 43 20 Other purposes 7 8 Invalid Night Attendant Service.—For some time now the Ilford Social Service Association have been operating a scheme for the provision of night attendants to provide some relief for those people who are called upon to sit up constantly all night with sick relatives or friends or to help those who are sick and have no-one to whom they can turn for such assistance. As from April, 1953, however, as it had been agreed 67 that night attendants could be provided in approved cases under a scheme introduced by the County Council, arrangements were made in Ilford to work this in conjunction with the Association's scheme. The Association have therefore continued to make all the arrangements but the County Council have made agreed payments to the Association in respect of approved cases where need in meeting the cost of the service has been proved. Up to the 31st December, 1953, assistance was given in this way in respect of 12 cases, involving a total of 123 nights' attendance. Home Nursing.—The Home Nursing Service in Ilford is undertaken by Nurses under the supervision of the Superintendent of the Lady Rayleigh Training Home at Leytonstone. Efforts to find suitable premises to establish a Branch Home in Ilford have at last been successful and "Abury House" in Aldborough Road, Ilford, was opened in the autumn of 1953. The following information I have received regarding the work undertaken by Home Nurses operating in the Ilford Area will be of interest:— Home Nursing in the Ilford Health Area Statistics, 1953 TABLE 1.—Number of cases attended and visits paid to them analysed in 25 disease groups. Disease Group Cases attended Visits paid 1. Tuberculosis 81 4,119 2. Other infective and parasitic diseases 94 503 3. Malignant and lymphatic neoplasms 159 4,816 4. Diabetes 97 10,517 5. Anaemia 87 2,404 6. Diseases of the Central Nervous system 189 8,772 7. Senility 149 4,998 8. Diseases of the eye and ear 129 912 9. Heart disease 342 7,588 10. Other diseases of the circulatory system * 109 3,802 11. Upper respiratory diseases 128 883 12. Pneumonia, Bronchitis and other diseases of the lung (except Cancer and Tuberculosis) 404 4,101 13. Constipation 89 192 14. Other diseases of the digestive tract 77 775 15. Circumcision 10 70 16. Gynaecological conditions 55 644 17. Other diseases of the genito-urinary system 39 1,305 18. Complications of pregnancy and the puerperium† 30 320 19. Infections of the skin and subcutaneous tissue 153 1,274 20. Other diseases of the skin and subcutaneous tissue 21 193 21. Diseases of the bones and joints 82 4,383 22. Post operative cases (not classifiable elsewhere)† 21 297 23. Preparation for X-ray 83 91 24. Injuries 54 1,062 25. Other defined, ill defined and unknown causes 75 1,715 Total 2,763 65,736 * Including ulcerated legs, whether stated to be varicose or not. † Including breast abscesses in women between 15 and 45 years. ‡ Treatment following colostomy or mastectomy has been classified to "Malignant and lymphatic neoplasms" and following other specified operations to the site of the operation. 68 TABLE 2.—Types of treatment provided. Type of Treatment Cases who received the specified treatment* Observation, advice, instruction etc. 18 Injections 1,265 Dressings 215 Enemata 278 Change of Pessary (with or without douche) 26 Wash outs and douches 42 Blanket Baths 121 Other specified treatment 29 General Care 761 Attendance at operation 7 Last Offices (with no other treatment) - Treatment unspecified 1 Total 2,763 * Cases who received more than one type of treatment have only been included once. The method of selection of the type of treatment to be counted tends to understate the importance of the treatment at the top of the table and overstate the importance of those further down since for example a case who received "injections and general care" has only been counted in the latter category. TABLE 3.—Age distribution of cases attended and visits paid to them. Age Group Cases attended Visits paid Males Females Males Females 0—4 43 44 213 205 5 — 14 93 92 580 491 15—24 17 50 296 316 25—44 123 257 2,193 4,051 45 — 64 313 418 5,730 10,928 65—74 259 374 5,680 13,089 75 and over 235 435 7,141 14,747 Age not stated 5 5 26 50 All ages 1,088 1,675 21,859 43,877 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 an exhibition stand which has become a permanent feature in the entrance hall of the Public Health Offices was used for the display of illustrative material covering four different subjects, viz., Accidents in the Home, Foot Health, Smallpox and The Sanitary Inspector. As part of the national publicity campaign on the subject of diphtheria immunisation, advertisements were inserted in the local press in May, 1953. This was followed by the showing of slides in three local cinemas, through the helpful co-operation of the managements, over a period of two weeks in J June, at the same time leaflets being made available for the public in the cinema vestibules. 69 During the year a total of 21 lectures on various Health subjects were given by members of the medical staff of the Department, 12 to mothers attending Infant Welfare and Ante-Natal Clinics and 9 to various organisations in the town. 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, three sessions were devoted weekly, when full dental treatment was given to expectant and nursing mothers and to children under the age of five. These patiens were referred from the ante-natal, post-natal and child welfare clinics. Generally 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, available at Mayesbrook Clinic, 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 1953 is as follows:— Examined Needing Treatment Treated Made Dentally Fit Expectant and nursing mothers 189 189 241 148 Children under 5 155 152 160 153 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 945 70 164 398 92 - 185 9 56 62 Children under 5 377 — 135 169 — — 112 — — — In addition there were 646 prophylactic treatments and other operations carried out in the case of expectant and nursing mothers. The total number of sessions held for expectant and nursing mothers and children under five years of age was 136½. 70 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.—5 children were found to be infected with living hair vermin as against 13 in 1952, 7 in 1951, 5 in 1950 and 33 in 1949. (ii) Scabies.—There were no cases reported during the year, as compared with none in 1952, 1 in 1951 none in 1950 and 5 in 1949. School Premises.—There are 34 schools, with 63 departments, 24,267 children were actually on the rolls on 23rd December. 1953, as compared with 23,403 in December, 1952. The figure 24,267 includes Barking Abbey (364) and Ursuline County Placed pupils (335). The number of children in average attendance at school for the year ended 23rd December, 1953 = 21,244. 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. 978 visits have been made during the year. Medical Inspection.—(1) In accordance with the Handicapped Pupils and Medical Services Regulations, 1945 (para. 49), this was carried out as follows until July, 1953:— (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. (2) As from the 4th August, 1953, the medical inspection has been in accordance with the School Health Service and Handicapped Pupils Regulations, 1953, as follows:— Paragraph 10.—(1) The arrangements made by the Authority for the medical (including dental) inspection of pupils attending schools maintained by the Authority shall ensure— (a) a general medical inspection of every pupil on not less than three occasions at appropriate intervals during the period of his compulsory school age and other medical inspections of any pupil on such occasions as may be necessary or desirable: Provided that there may be fewer than three general medical inspections for any pupil who attends schools maintained by the Authority for less than the period of his compulsory school age or, if the Minister approves, for all pupils: 71 (b) a dental inspection of every pupil who is admitted for the first time to a maintained school as soon as possible after admission and on such later occasions as may be practicable and necessary; and (c) that the attention paid to the general health and welfare of any pupil who is suffering from a disability of mind or body shall include particular attention to his disability. (2) So far as practicable, the parent of every day pupil shall be given the opportunity of being present at any general medical inspection and first dental inspection of his child. (3) Medical and dental records in approved form shall be kept for every pupil attending a maintained school. During 1953 5,558 parents, or 79 per cent., attended the full routine medical inspections. Infectious Disease.—The following table shows the incidence of infectious diseases in the Ilford schools since 1949:— Scarlet Fever Diphtheria Measles and German Measles Chicken Pox Mumps Whooping Cough 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 1953 276 — *664 44 10 368 * Of this number 401 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 1953. 77 home visits were paid by the School Nurses to cases of minor infectious disease. In addition the Sanitary Inspectors paid 391 visits to measles cases, and 349 visits to whooping-cough cases. Ringworm.—There were no cases of ringworm of the scalp; 1 of ringworm of the body was reported and treated successfully during the year. Following Up.—During 1953, 3,906 home visits by the School Nurses were paid for the purpose, and 3,529 re-examinations of children (some on several occasions) were carried out by the doctors at school; 139 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 1953 were as follows:— Newbury Hall Mayesbrook Number of individual children seen 1,128 1,220 Number of attendances of children 1,933 1,871 Number of exclusion certificates granted 43 130 Number of certificates of fitness to attend school granted 43 101 72 The following table shows the conditions dealt with at both the Clinics during the year:— Subnormal Nutrition 519 Debility 20 Uncleanliness:— Head 65 Body 1 Skin:— Ringworm:— Head — Body — Scabies — Impetigo 16 Dermatitis 2 Urticaria 9 Furunculosis 29 Eczema 13 Other Skin Diseases (Non-Tuberculous) 214 Eye:— Blepharitis 28 Conjunctivitis 17 Defective Vision (excluding Squint) 164 Squint 24 Other conditions 78 Ear:— Defective Hearing 31 Otitis Media 29 Other Ear Diseases 27 Nose and Throat:— Chronic Tonsillitis only 43 Adenoids only 6 Chronic Tonsillitis and Adenoids 54 Nasal Catarrh 14 Nasal Obstruction 5 Other conditions 32 Enlarged Cervical Glands (Non-Tuberculous) 37 Defective Speech 38 Teeth—Dental Diseases 696 Heart and Circulation:— Functional 6 Organic 2 Anaemia 1 Infectious Diseases:— Scarlet Fever — German Measles 1 Measles 1 Whooping Cough 1 Chicken Pox 1 Mumps 1 Colds and Coughs 131 Influenza 1 Lungs:— Asthma 11 Bronchitis 10 73 Pulmonary Catarrh 14 Other Non-Tubercular Diseases 4 Tuberculosis:— Pulmonary—Definite — —Suspected (Referred to Chest Physician) 23 Developmental:— Hernia 3 Other 4 Psychological:— Development 1 Stability 8 Nervous System:— Nervous Debility 3 Habit Spasm 1 Chorea — Petit Mal — Enuresis 25 Other Conditions 24 Deformities:— Genu Valgum 11 Posture 16 Pigeon Chest 1 Flat Feet 32 Valgus Ankles 28 Other forms 37 Minor Injuries 37 Rheumatism 8 Other Defects and Diseases 106 Total number of ailments 2,764 SPECIAL CLINICS. Ophthalmic Clinic. During the year 1953. the School Oculist held 204 sessions for the refraction of children suffering from defective vision (99 at Valentines, 94 at Mayesbrook and 11 at Manford Way). Full details of the work are given in Table IV, Group II. 3,273 attendances (1,472 at Valentines Clinic, 1,626 at Mayesbrook Clinic and 175 at Manford Way Clinic) were made by 1,730 schoolchildren (824 at Valentines Clinic, 807 at Mayesbrook Clinic and 99 at Manford Way), as compared with 1.711 schoolchildren in 1952. The 1,730 children were not all suffering from grave defects of vision. The following table shows the vision in the worst eye, as tested by Snellen's Type:— 6/6 6/9 6/12 6/18 6/24 6/36 6/60 less than 6/0 352 309 339 262 156 177 88 47 The children who saw 6/6 (practically normal vision) were suffering from symptoms such as headaches, inflamed eyelids, etc., which rendered further examination necessary. 74 The 1,730 children were found to be suffering from the following defects:— Diagnosis New Cases Old Cases A B c A B c Myopia 87 65 13 166 166 15 Myopic Astigmatism 5 5 — 6 4 — Hypermetropia 111 82 16 170 235 32 Hypermetropic 3 2 — 10 14 — Astigmatism Mixed Astigmatism 9 3 - 10 17 3 Squint 48 32 7 155 115 9 Blepharitis 2 2 — 4 5 — Congenital Coloboma — 1 — — 1 — Congenital Cataract — — — 1 — — Conjunctivitis 3 1 — 4 11 — Nystagmus — — -— 2 4 — Other conditions 2 — — 2 6 — N.A.D. 18 13 4 6 23 — Totals 288 206 40 536 601 59 A—Valentines. B.—Mayesbrook. C—Manford Way. 926 complete pairs of spectacles were provided, some of these being renewals after breakages. In addition, in 290 cases the lenses of spectacles were replaced or repairs of frames were carried out. Mr. H. J. R. Thorne, M.B., B.S., D.O., D.O.M.S,, the Ophthalmic Surgeon at Valentines Ophthalmic Clinic, makes the following report:— "The majority of children were seen because of defective vision in one or both eyes, usually detected during routine school medical examinations, and due to refractive errors. Of these cases, a not inconsiderable number also had a squint. In addition many cases of true or apparent squint were referred for examination, advice and treatment. All these cases are seen at regular intervals and kept under observation as necessary throughout their school life. A much smaller number of cases was seen because of:— (i) Congenital abnormalities of the eyes and adnexae. (ii) Acute inflammatory, infective, allergic and traumatic affections of the eyes. Partially sighted (or blind) children—fortunately few in number— were seen at regular intervals, reported on (on Form B.D.8) and advice given as to schooling and treatment. Good liaison is maintained with various London Eye Hospitals to which cases were referred as necessary for operation (e.g., for squint) or further detailed (hospital) examination and investigation. The provision of an Orthoptist now established and working at the Orthoptic Clinic at Mayesbrook on three days a week has been a great asset. This enables the necessary full treatment and observation ot squint cases to be satisfactorily carried out and is working quite smoothly. Arrangements for the fitting and supply of spectacles have been satisfactory." 75 Miss A. B. MacClancy, L.R.C.P.(I)., L.R.C.S.(I)., L.M., D.O., the Ophthalmic Surgeon at Mayesbrook Clinic, makes the following report:— "The majority of the children attending the Clinic have refractive errors—about 30% of these children suffer from squint. As a result of Routine Medical Inspection at the recently opened llford Junior Occupation Centre, cases requiring ophthalmic treatment are referred to this Clinic. There is now an Orthoptic Clinic at Mayesbrook—this is a great advantage in treating these squint cases, and the clinics are very well attended. A number of children with superficial eye conditions are also seen and treated. Cases of muscular unbalance are treated in the Orthoptic Department." Mayesbrook Orthoptic Clinic. Mrs. M. J. Mindell, D.B.O., the Orthoptist, makes the following report . "Mayesbrook Orthoptic Clinic was opened on 11th February, 1953. Between then and 31st December, 1953. two hundred and fifty new cases have been investigated. No. of Sessions New Cases Other Attendances Total Attendances February 30 62 25 87 March 42 65 114 179 April 36 45 135 180 May 30 9 129 138 June 27 11 97 108 July 27 14 120 134 August 23 2 111 113 September 25 10 105 115 October 22 8 86 94 November 24 18 92 110 December 22 6 79 85 Total 308 250 1,093 1,343 New Cases. Of the 250 new cases seen. 84 were seen only once; 25 of these had pseudo-strabismus or apparent squint, generally caused by excessive epicanthus, extra wide or extra narrow inter-pupillary distances, oblique palpebral fissures, etc., but were orthoptically satisfactory. The remaining 59 were either (a) too old to benefit from orthoptic treatment; (b) had already completed orthoptic treatment at another clinic; (c) were still attending some other orthoptic clinic and did not wish to transfer, or (d) although not orthoptically satisfactory, had had varying amounts of orthoptic treatment already and seemed unlikely to benefit from further treatment due to such factors as age. poor bfnocular vision, early onset, lack of stereopsis, etc. The remaining 166 were occluded where necessary before being given a course of orthoptic treatment of varying duration. In certain cases this treatment had to be postponed either because of the young age of the patient and/or lack of co-operation. For example, one type of orthoptic treatment necessitates the patient being able to read fluently and. unfortunately, many of the patients seen could not read at all. There were also 12 patients who, in the writer's opinion, would benefit from operative treatment. These 12 patients have been referred to their respective ophthalmic clinics and there, where the opthalmic consultant has advised surgery, patients have been temporarily 76 ferred to a hospital such as Moorfields, Oldchurch, etc. It must be pointed out that of these 12, only 3 have so far been operated upon, although a further 4 are awaiting their operation. The remaining 5 were not recommended by the ophthalmic consultant concerned for operation for various reasons. The writer referred these 5, as well as the other 7, for surgery because (a) patients were cosmetically satisfactory, but not orthoptically satisfactory; (b) patients were cosmetically poor and not orthoptically satisfactory, and/or (c) patients' deviation was symptom producing. In all cases the patients were unlikely to benefit from further orthoptic treatment without prior surgical aid. Discharges. During the year, 14 patients were discharged as "orthoptically satisfactory." Although this does not appear to be a big proportion of the total cases in review, it must be remembered that time plays a great part in curing any defect and although various other patients are up to standard, the writer does not think that they should be discharged until they have been satisfactory for at least three to six months. 9 patients have been discharged as "Improved." These include those patients who, though not orthoptically satisfactory, are unlikely to benefit further from additional orthoptic treatment. 3 patients were transferred to other clinics, as they moved from the Ilford area. 7 patients were discharged with intractable amblyopia, when prolonged occlusion failed to improve the visual acuity of the amblyopic eye. 12 patients were discharged after failing to keep any of four or more consecutive appointments. (An excessive amount of absenteeism was noticed throughout the year, though most of the absentees live in the extreme north of llford, i.e., that part for which the clinic is most inaccessible. Absenteeism was more marked during school holidays than during term time.) Total number of patients seen = 250 25 apparent squint 59 reports only seen only once 3 Transferred 14 orthoptically satisfactory 9 improved 7 intractable amblyopia 12 discontinued attendance discharged from orthoptic clinic 121 Under orthoptic supervision—occlusion treatment observation 250 Considering that the clinic is still in the first year of its existence and that, as stated above, patients are not generally discharged until about six months after attaining the required orthoptic standard, the figures shown above would seem to forecast promising results for the coming twelve months." Orthopaedic Clinic. Mr. H. G. Korvin, F.R.C.S., the Orthopaedic Surgeon, makes the following report:— "During the year 1953 it was possible to reduce further the number of attendances at the Orthopaedic Clinics at Mayesbrook 77 and Newbury Hall through delegating much of the routine work to the Assistant School Medical Officers. The Appointments System is now working reasonably well. It was regretted that in the Spring of 1953 our Physiotherapist, Mrs. King, who had served the Clinics so well for several years, had to resign her post owing to her moving away from the district. We were fortunate in securing the services of Mr. Hunt, M.C.S.P., for the required number of sessions so that all treatment could be continued without hitch or interruption. The provision of surgical appliances has been placed on a new footing. A fitter of Messrs. Pryor and Howard is attending Newbury Hall Clinic every Monday to take measurements or plaster casts of children nee_ding appliances. At Mayesbrook certain measurements are taken by" Mr. Hunt but for provision of more elaborate appliances they have to attend Newbury Hall. Some cases from Manford Way are measured there, too. These arrangements have led to speedier and more satisfactory results. Alterations to footwear are now done by Messrs. Remploy Ltd.. whose fitter attends both Clinics. X-ray investigations were again carried out at King George Hospital and operations were performed mostly at East Ham Memorial Hospital and occasionally at St. Margaret's Hospital, Epping. Infantile paralysis is taking an increasing share of the cases requiring regular treatment at the Clinics. I am glad to say that the Newbury Hall and Mayesbrook Clinics are able to provide the two or three sessions per week which most of these children require after the acute stage of their illness. It is thus possible to avoid prolonged separation from the parents which is so harmful to young children. I wish to thank all those taking part in the running of these Clinics for their most valuable help and co-operation." Minor Orthopaedic Defects. One of the School Medical Officers has under supervision and attends weekly one of the following Clinics conducted by the Physiotherapist: — Exercises Massage Sunlight The doctor supervising these Clinics attended the Seminar on Foot Health in London, arranged by the Central Council for Health Education from 23rd to 27th February. 1954. (f) Newbury Hall Clinic.—42 sessions were held during 1953, 167 children of school age were examined for the first time during the year and 266 children were seen who had previously attended the clinic. These 433 children made 640 attendances. (ii) Mayesbrook Clinic.—24 sessions were held during 1953. 65 children of school age were examined for the first time during the year and 125 children were seen who had previously attended the clinic. These 190 children made 276 attendances. (iii) Manford Way Clinic.—7 sessions were held during 1953. 6 children of school age were examined for the first time during the year and 41 were seen who had previously attended a clinic. These 47 children made 61 attendances. The 670 children were found by the Orthopaedic Surgeon to be suffering from the following defects:— 78 Diagnosis New Cases Old Cases A B C A B C Paralyses:— A.P.M. 2 — — 8 9 — Hemiplegia — 1 — 4 2 — Monoplegia — — — 1 — — Spastic diplegia — — — 2 — — Spastic Quadriplegia — — — 1 1 — Scoliosis 1 — — 4 1 2 Kyphosis — — — 3 2 1 Slack posture 4 4 — 11 6 3 Deformity of hips — — — 5 3 — Deformity of Chest 3 — — 1 — — Genu valgum 47 19 2 92 30 15 O.C.T. — — — 3 7 3 Genu varum 2 1 — 7 5 1 Pes valgus-planus 9 3 1 41 12 8 Valgus ankles 14 3 1 19 6 2 Talipes calcaneo-valgus — — — 1 2 — Congenital talipes E.V. — — — 1 2 1 Congenital defect 4 — — 2 1 — Intoeing — 1 — 6 — — Pes cavus 3 — — 3 — — Hallux valgus 8 7 — 11 7 1 Deformity of toes 18 5 1 5 4 9 Traumatic condition 2 2 — 2 1 1 Torticollis 4 — — 3 1 — NAD. 3 3 — 4 — 1 Other conditions 30 6 1 18 14 — Foot strain 9 9 — 4 1 — Metatarsal varus 4 — — 1 — — Spastic foot — 1 — — 2 — Cerebral Palsy — — — 1 — — Erbs Palsy — — — 2 — — Totals 107 65 6 200 125 41 A—Newbury Hall. B—Mayesbrook. C—Manford Way. 14 Children of school age were admitted to hospitals. Particulars as follows:— No. of Cases Operation Hospital 2 Arthrodesis, 2nd toes, both feet. East Ham, Memorial 1 Spike Arthrodesis, both feet. do. 1 Arthrodesis, right and left toes. St. Margarets, Epping. 2 Osteotomy of great toes. East Ham, Memorial. 3 Stapling of both knees. do. 1 Skin Plastic, 5th toes. do. 1 Manipulation of hips. do. 2 Open Division Sterno Mastoid. do. 1 Open Reduction, Shelf Operation, hips. do. During the year 55 pairs of valgus insoles, 14 pairs of surgical boots or shoes, 7 pairs Genu Valgum splints, 4 metatarsal bars, 3 calipers and inverting irons, 5 toe springs for drop foot, 3 repairs to Calipers and shoes, and 102 pairs wedges to shoes were supplied to school-children. 79 441 cases were discharged from the Orthopaedic Clinic, 112, as cured. 90 due to absence and were kept under observation at school. 204 were showing improvement and were kept under observation at school, 34 cases left school or left the district and 1 died. The Physiotherapist attends the Newbury Hall Clinic for orthopaedic treatment on Monday and Thursday mornings, and the Mayesbrook. Clinic on Tuesday and Friday mornings. A total number of 174 sessions were held by the Physiotherapist for treatment during 1953 (87 at Newbury Hall Clinic and 87 at Mayesbrook Clinic). At Newbury Hall Clinic 190 individual children of school age were treated by the Physiotherapist during the year and 1,248 attendances were made by these children. Treatment was also given to 97 children, who made 774 attendances at the Mayesbrook Clinic, and at the Manford Way Clinic to 12 Tlford children who made 99 attendances. Artificial Sunlight Clinic.—The physiotherapist attends the Newbury Hall Clinic on Tuesday afternoon and the Mayesbrook Clinic on Thursday afternoon for artificial sunlight treatment. 44 sessions were held at Newbury Hall Clinic and 45 at Mayesbrook. At the Newbury Hall Clinic 37 children of school age were treated, making 423 attendances for treatment. At the Mayesbrook Clinic 24 childern of school age were treated, making 316 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 11 9 Bronchitis 5 1 Bowlegs 1 Alopecia 4 Asthma 1 2 Psoriasis 2 2 Posture 1 Acne 1 Catarrh 5 3 Other Conditions 7 G 37 24 A—Newbury Hall Clinic. B—Mayesbrook Clinic. Of the 61 cases treated 6 were Open Air school-children. At Newbury Hall Clinic, 26 children of school age were discharged from the Artificial Sunlight Clinic, 18 as cured. 4 showing considerable improvement and 4 due to absence. 11 children were still receiving treatment at the end of the year. At Mayesbrook Clinic. 13 children of school age were discharged from the Artificial Sunlight Clinic, 8 as cured, 3 discharged due to absence and - showing considerable improvement. 11 children were still receiving treatment at the end of the year. 80 Aural Clinic. The Aural Clinic is held at Valentines Mansion, the Surgeon attending one session weekly. 50 sessions were held during 1953 and 1,205 attendances were made by 630 children of school age, of whom 321 were new cases. The Consulting Oto-Rhino-Laryngologist (Mr. Morton Marks) submits the following report: — "The year 1953 has shown a marked improvement in the position of children awaiting Tonsil and Adenoid operations in this area, although we can by no means as yet regard the situation with complacency. We have so managed to reduce the number on our waiting list that the average delay in admission now amounts to little over a year, as opposed to the position this time last year when the period was anything up to six years. This improvement has chiefly been effected by the opening of a very efficient little operating unit at the Isolation Hospital; this consists of 6 beds, arranged in pairs in 3 cubicles, an anaesthetic room and a small theatre. By utilising these 6 beds twice weekly I have been able to operate on 12 children every week. This unit in conjunction with the Consultative Clinic is a great advance—in that 1 now no longer have to rely on the good offices of other hospitals to deal with our cases but can now treat them all myself. There is, however, one difficulty in this arrangement. These beds are not officially allotted to me but are still on the establishment of the Consultant in Infectious Diseases, by whose grace I am allowed to use them. Consequently when these beds are required by him, it has been necessary to suspend operations. This was the case for a little over three months during the year—quite apart from a further three months suspension due to the epidemic of Infantile Paralysis. Nevertheless, in the six months remaining I operated on 274 cases. Waiting List on 1.1.53 354 Waiting List on 31.12.53 260 The major surgery I still take in to one of my other Hospitals but I have found that the incidence of chronic aural disease necessitating mastoid surgery appears to be diminishing and I believe this to be very largely due, among other things, to the fact that the pre-disposing factors such as infected tonsils and adenoids can now be more urgently dealt with. With regard to my Clinic we had a total of 1312 attendances of children of school age and under throughout the year of whom 367 were new cases. Of these, 180 children were put down for operation. From these figures it will be seen that if only we could further reduce our waiting list by a regular and uninterrupted service at the Isolation Hospital the so-called tonsil and adenoid problem in this area, at least in relation to the School Health Service, would cease to exist." (It is to be regretted that similar arrangements for operations at the Ilford Isolation Hospital have not so far in 1954 been provided.) The following table shows the work of the Clinic:— 81 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 - 2 - - 6 4 - - - - - - - - - 1 6 7 (ii) Acute Catarrhal Otitis Media 1 - 1 - 2 - - - - - - - - - - - - - (iii) Chronic Suppurative Otitis Media due to:— - - - - - - - - - - - - - - - - - 1. Tympanic Sepsis 3 2 1 — 2 1 - - - - - - - 1 1 1 7 5 2. ,, Sepsis and Granulations - - - - - - - - - - - -- - - - - - - 3. Other Causes 1 1 - - - 1 - - - - - - - - - - 1 2 (iv) Mastoid Disease(previous operation) 1 - - 1 - 1 - - - - - - - - - - 1 2 (v) Partial Deafness due to:— 1. Nerve Deafness 1 — — — — — — — — — — — — — — 1 1 1 2. Tonsils and Adenoids 1 2 1 — 3 1 - - - - - - - - - - 5 3 3. Retraction of Membrana Tympani 1 2 1 - 2 1 — - 1 - - - - — 1 — 6 3 4. Scarring of Membrana Tympani 1 — — — — 1 - — 1 - — - — - - — 2 1 5. Other causes 1 2 — — 1 — - — 1 - - - - - - - 3 2 (vi) Opinion on Tonsils 27 6 74 35 74 165 — 1 11 27 1 - - - 6 5 193 239 (vii) Rhinitis 8 1 1 — 8 5 — — 3 — — — — — 3 — 23 6 (viii) Other diseases or defects Totals 18 64 8 26 5 84 37 21 119 17 197 1 1 2 16 33 3 30 1 - - 1 8 *9 8 16 69 321 38 309 82 Rheumatism Clinic. The Physician attended 32 morning sessions during the year, and 169 children (91 of these being new cases) made 287 attendances. The 169 children were found to be suffering from the following conditions:— Defects Found New Cases Old Cases Totals Rheumatic Carditis — 1 1 Other forms of Carditis 4 5 9 Tachycardia of Nervous origin 1 — 1 Congenital Heart Disease — 12 12 Rheumatism 1 — 1 Arrhythmia 1 — 1 No Active Rheumatic Disease 8 10 18 Heart Murmur Functional 53 34 87 Pains Due to Orthopaedic condition 6 4 10 Allergic type 3 3 6 Nothing abnormal detected 4 2 6 Other conditions 10 7 17 Totals 91 78 169 Number of cases referred tc Convalescent Home 1 ,, ,, ,, General Hospital (In-patients) 6 ,, ,, ,, Ear, Nose and Throat Surgeon 19 ,, ,, ,, Orthopaedic Surgeon 15 ,, ,, ,, For X-ray and Electro-Cardiogram 59 „ „ „ Blood Sedimentation Rate 17 ,, ,, ,, Psychiatrist 1 ,, „ „ Open Air School 1 „ „ „ Paediatrician 1 „ „ „ Ultra Violet Ray 1 Speech Clinic.—Mrs. F. M. Hatfield was appointed part-time Speech Therapist (3 sessions weekly) at the Mayesbrook Clinic. for a period of one year, and commenced duties on 15th October. 1953. Mrs. M. Walker, L.C.S.T., the Speech Therapist, makes the following report:— "At the commencement of the year there was one full time Therapist holding 7 treatment sessions at Valentines Clinic and 4 at Mayesbrook, per week. It is generally satisfactory to treat 6 or 7 children individually per session. Some children are treated in groups but since the amount of clerical and administrative work is the same there is little immediate saving of time. Many children would benefit greatly from bi-weekly attendances but due to the large numbers requiring treatment it is possible to provide this for only a very few. These include, in particular, some cerebral palsied children and children with retarded speech and language development. At Valentines Clinic there is usually the 83 assistance of a working student who can herself treat another 4 carefully chosen children per session. In spite of this there was an almost constant waiting list of about 40 for this clinic and about 30 for Maysebrook. A part-time Therapist was therefore employed at Mayesbrook Clinic in October for a probationary period of one year. The position at present is:— Full time Therapist—8 sessions per week at Valentines 3 „ „ „ „ Mayesbrook Part time Therapist—3 „ „ „ „ „ The hoped for result has obtained only at Mayesbrook: at Valentines Clinic the apparent increase in speech difficulties has kept the waiting list at its high level. This increase may be real, or may be due to the fact that (1) parents are more readly accepting the offer of help for their children, and (2) that both the Ilford Speech Therapists accept pre-school children. It is important that these children be referred to the Speech Clinic as soon as the parent shows any anxiety, for this in itself may produce a severe difficulty in a child with originally only a mild defect. Reassurance and advice to parents at this early stage may preclude the child's attendance at the Speech Clinic. Moreover, defects are often easier to correct at an early age while the speech mechanisms are still plastic. It is interesting to note that in the majority of cases of dyslalia (substitutions of speech sounds, or baby speech, with no organic cause), unfavourable home conditions and emotional disorders similar to those affecting stammerers obtain. Group treatment was found to be particularly useful with the under fives. These are often only children, or children who for some other reason have little or no other opportunity to mix with their own age group. In these cases Speech Therapy is completely indirect and the latter part of each session is usually spent in group or individual play while Therapist and parents discuss home treatment and associated problems. Parents are co-operative on the whole. Attendance during term time is generally good (75%—80%) but is extremely poor during school holidays (30%—50% maximum), even by many children who are spending holidays at home. Head teachers and class teachers have been most helpful both in their information about the children, and in their co-operation, where possible, with treatment. In cases of mild dyslalia help could be given by teachers during reading lessons, and this could be undertaken in co-operation with the Speech Therapist. The Speech Clinic was given the use of a Grundig Tape Recorder for a short period. It was found to be invaluable in the treatment of stammerers. With dyslalics the recorder was an excellent aid to eartraining. The full time use of a Tape Recorder would probably shorten, to a great extent, the period of treatment required. During the year the innovation of regular visits to this and other Clinics by Dr. Gross, to discuss problems and to ensure a better linkup between various departments dealing with the same children, has proved a great asset. The following is a statistical analysis of work undertaken during the year." By the end of the year, 147 individual children of school age had received speech therapy at the Clinics making a total of 2,542 attendances. 84 The defects treated were as follows: — Stammering 50 Dyslalia 80 Cleft Palate 4 Dysarthria 6 Others 7 44 children of school age were discharged from the Clinics during the year. In 30 cases the speech was normal. Of the remaining 14 cases. 7 ceased to attend for treatment, 1 left school or left the district, 2 refused treatment, 3 were referred elsewhere and in one case treatment was not needed. School Dental Service.—Mr. E. V. Haigh, Senior Dental Officer, reports as follows: — "During 1953 the two new surgeries at Valentines Clinic were opened. They are a great improvement on the old surgeries, which were housed in a temporary building. The second surgery at Mayesbrook Clinic which was finished at the end of 1952 has been used by part time Dental Surgeons. In the past year with a staff equivalent to 3-7/1 lths full time dental officers, dental treatment was given to school children, nursing and expectant mothers and children under five years of age. With the above staff, a balance was possible of conservative treatment in ail branches, extractions, orthodontics and the supplying of dentures. During 1953 the number of new orthodontic cases increased slightly; this being due to the fact that it was possible with the extra staff to do more routine school dental inspection and so refer such cases for treatment. At the end of 1953 the number of Dental Officers dropped from the equivalent of 3-7/1 lths to 2-1/11th, this being due to the resignation of two full time Officers and so far only being replaced by one part-time Dental Surgeon. This shortage will mean that less conservative treatment will be possible because emergency treatment in the form of gas extraction for children suffering from toothache must take priority. Routine dental inspections at school will become more infrequent until further Officers are appointed. X.-ray facilities are still available at Mayesbrook Clinic for patients attending either Valentines Dental Clinic or Mayesbrook Dental Clinic: Manford Way Clinic have their own X-ray Unit." It was possible for the Dentists to visit some of the schools for the purposes of inspection. 3,702 children were inspected at schools of which 2,247 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 2,247 children referred for treatment by the Dental Surgeons at School Inspections there were 2,157 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:— 85 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 5 120 79 211 290 6 151 104 313 417 7 288 196 284 480 8 566 384 271 655 9 587 322 214 536 10 588 360 189 549 11 458 284 212 496 12 194 109 144 253 13 321 205 119 324 14 244 131 114 245 15 115 37 65 102 16 49 25 18 43 17 21 11 3 14 3702 2247 2157 4404 In addition to the ordinary dental work of fillings and extractions, 38 dentures and 160 regulation plates were supplied. Further, 86 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 1953 the number on the roll varied from 97 on 31.12.52 to 110 on 31.12.53. The number of admissions was 43 and discharges 30. During 1953 only one child was admitted for debility with no other defect. This again emphasises the change in character of the school from Open Air School to physically handicapped, which has been so apparent in the last few years. The general work of the school has continued steadily along previous lines with the closest co-operation between teaching and medical staff. Those admitted were recommended for examination from the following sources:— School Medical Officers 30 Borough Education Officer 8 Tuberculosis Officer 2 Others 3 School Medical Officers:— Asthma and eczema 2 Asthma 4 Bronchitis 1 Bronchitis and asthma 2 Debility and asthma 2 Bronchitis and hilar congestion 1 Bronchitis and emphysema 1 Asthma and interventricular septum 1 Obesity and psychological disturbance 1 Left pleural effusion 1 Old erythema nodosum and enlarged hilar glands 1 Recurrent respiratory infection 1 Osteochondritis 2 86 Upper motor neurone lesion following cerebral cyst 1 Congenital spastic paraplegia 1 Poor general physique 2 Old poliomyelitis 1 Valgus ankies and pes planus 1 Old rickets and recent osteoclasis 1 Ataxia 1 Emphysema, recurrent respiratory infection and sinusitis 1 Subnormal nutrition 1 Borough Education Officer: — Debility 1 Debility and subnormal nutrition 2 Old poliomyelitis 1 Haemophilia 1 Leg amputated 1 Catarrh of lungs 1 Old T.B. meningitis and primary complex 1 Tuberculosis Officer: — Pulmonary catarrh 1 Pulmonary T.B. (non-infectious) 1 Others: — Congenital athetosis 1 Paresis 1 Chronic bronchitis, asthma, eczema 1 The 30 children not now on the roll ceased attendance for the following reasons:— Fit for ordinary school 18 Left school—over age 4 Admitted to a Children's Home 1 Admitted to Residential Open Air School 1 Admitted to Ogilvie School of Recovery 2 Left the district 2 Died 1 Discharged at parents' request 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. Much new educational equipment has been obtained and the teacher in charge attended a special summer course on spastics and their management. In 1953 there were 10 in the class and the composition was as follows: Spastic paraplegia 3 Spastic diplegia 3 Spastic hemiplegia 1 Cerebral palsy 1 Talipes and wasting of calf muscles 1 Congenital athetosis 1 In addition to the above 3 cases of milder spasticity attended the ordinary classes of the school. Two children of 5 years of age are down for admission to this spastic class when there is a vacancy. As a result of the Medical Officer's periodic examinations, a number of the children have been recommended certain treatment as follows: — Administration of Milk in school 36 Administration of Cod Liver Oil Emulsion 34 Referred to Orthopaedic Surgeon 1 Referred to Ophthalmic Surgeon 4 Referred to Aural Surgeon 1 87 Referred to Dental Surgeon 4 Recommended Convalescent Home treatment 3 Recommended Child Guidance Clinic 1 Recommended Artificial Sunlight treatment 1 6 children received Artificial Sunlight treatment during the year. Owing to the shortage of dentists no complete inspection of the children's teeth was carried out at the Open Air School. There were, however, a number of children treated by the Dental Surgeon at the Dental Clinic. 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. Treatment for Uncleanliness.—The School Nurses paid 198 visits to the schools (an average of 6 visits to cach school during the year), for the purpose of inspecting the heads and clothing of the children with the following results:— Number of Individual Children Examined Number of Examinations of Children Number Infested Percent. 21,065 59,965 *187 0.31 * Five 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. The percentages for the past 5 years were as follows: — 1949 0.9 1950 0.5 1951 0.4 1952 0.4 1953 0.3 Other Ailments.— During 1953, 966 children were operated on for the removal of enlarged tonsils and adenoids as follows: — King George Hospital 317 St. Mary's, Plaistow 6 Ilford Isolation Hospital 218 Mile End Hospital 3 East Ham Memorial Hospital 29 Privately 393 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 1953 was 2.087,454 approximately. There are 21 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. Goodmayes. Gordon, Loxford, Mayfield Boys. Mayfield Girls. 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 1953. 19,513 children were receiving milk in school. Work done b\ the N.S.P.C.C.—The following 43 cases were investigated:— 88 (1) Neglect 22 (2) Ill-treatment cases 6 (3) Other cases 15 (Five cases were reported from the Public Health Department for neglecting medical advice; 38 were reported from other sources for general neglect.) 94 children (46 boys and 48 girls) were involved, 63 being of school age. In addition to this work, 228 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: — Recuperation Holiday Homes 36 Children sent for Holidays (not recuperative) from voluntary funds 9 Children loaned invalid chairs 4 Child loaned tricycle 1 Children supplied with clothing 3 Children supplied with bedding 2 Numerous escorts provided to London or to Convalescent Homes by Voluntary Workers 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 of children suffering from disability of mind or body. A record of all such children is revised annually from returns submitted by all Head Teachers, and any new cases attending local maintained schools are reported to me with a view to medical examination and ascertainment of their suitability or otherwise of attendance at an ordinary school. The several categories of pupils requiring special educational treatment as defined in the Handicapped Pupils (Certificate) Regulations, 1953. which came into operation on 16th December, 1953, are 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 normal regime of ordinary schools 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 who have some naturally acquired speech and language but whose hearing is so defective that they require for their education special arrangements or facilities though not necessarily all the educational methods used for deaf pupils. (e) Educationally Sub-Normal 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 jn ordinary schools. 89 (/) Epileptic Pupils, that is to say, pupils who by reason of epilepsy cannot be educated under the normal regime of ordinary schools without detriment to themselves or other pupils. (g) 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. (h) Physically Handicapped Pupils, that is to say. pupils not suffering solely from a defect of sight or hearing who by reason of disease or crippling defect cannot, without detriment to their healh or educational development, be satisfactorily educated under the normal regime of ordinary schools. (i) Pupils suffering from Speech Defect, that is to say, pupils who on account of defect or lack of speech not due to deafness require special educational treatment. (j) Delicate Pupils, that is to say pupils not falling under any other category in this Regulation, who by reason of impaired physical condition need a change of environment or cannot, without risk to their health or educational development, be educated under the normal regime of ordinary schools. The number of children coming within these categories and their disposition as on the 31st December, 1953, are tabulated in the following table in accordance with the Handicapped Pupils Regulations, 1945. Return of Handicapped Pupils in the Area on 31st December, 1953 (Aged 2-16 Years) Handicapped pupils. Blind, Partially Blind, Deaf Partially Deaf. Delicate. Physically Handicapped. Educationally Subnormal. Maladjusted. Epileptic. Total 1 2 3 4 5 6 7 8 9 A Newly placed in 1953 1 3 1 2 33 16 16 4 — 76 B Newly ascertained in 1953 1 5 1 1 32 13 29 10 — 92 C. (i) Attending Special Schools— Day 3 9 5 73 36 52 2 180 Boarding 6 2 5 4 10 2 15 6 1 51 (ii) Boarded in homes — — — — — — — — — — (iii) Attending assisted Schools — — — — — 3 2 24 — 29 D Unplaced- (i) At no school 3 4 — — — 4 3 1 — 15 (ii) At ordinary school — 2 — — 2 1 25 8 — 38 E Receiving home tuition (including those in D) 1 1 — — — 2 1 — — 5 Attending Special Schools Speech=Nil Diabetes=Nil Boarded in Homes Speech = Nil Diabetes = 2 90 Mental Health Service. The Occupation Centre for Mentally Defective Children and Adult Female Patients, was opened on 8th September, 1953, at the Methodist Church Hall, Bennett's Castle Lane, Becontree. It is known as the Ilford Junior Occupation Centre. There are 57 children on the register. Full medical inspection is carried out once a year, by one of the School Medical Officers, also a survey visit is made quarterly. Child Guidance Clinic.—The Child Guidance Clinic was opened on 3rd January, 1949, at Loxford Hall, Loxford Lane. Ilford. Dr. H. M. S. Davidson, the Consultant Psychiatrist, reports as follows: — "This year has just seen the fulfilment of the long promised alterations to the Clinic, giving us three additional rooms which is just sufficient for our present needs if sessional workers adjust their time carefully so as not to overlap each other, but we still need another larger room for group treatment to allow the mothers to attend a group at the same time as the children. During this last year group therapy has been given to a number of different groups of children and mothers which has incidentally enabled us to take on a larger number of children at one time and thereby to reduce the length of time on the waiting list. Many children have become adjusted with group therapy alone and for others it has served as an introduction to later individual treatment where this was indicated. Though most of the mothers have had individual interviews as well many of them acquired new insight more readily through discussion of common problems with other mothers in the group. The greatest difficulty in group work lies in the selection of cases so that the impact of each child has a therapeutic effect on his fellow members, but very little is known about the factors which determine this. We hope to study this aspect more fully in the future. Owing to shortage of staff and our long waiting list in the past we tended to have referred to us only the more serious cases of long duration. Many of these children were shortly due to leave school and others had reached a stage of chronicity which made it impossible to treat them adequately in the time available. I would like to stress the value of early referral since the younger the child and the more recent the symptoms the greater the hope of adequate adjustment. The belief that a child will "grow out of it" if left alone or that parents should be able to deal with behaviour problems on their own too often leads to unnecessary delay. Referral of earlier cases might lead to a temporary increase in our waiting list, but this would eventually be offset by the reduction in time needed for treatment. We feel it important to keep in touch with other workers in the the same field and welcomed Dr. Cullington's suggestion that some of the Barking Health Visitors should attend the Clinic once a month for case conferences. When a Barking case is being considered the School Medical Officer and Health Visitor concerned are invited to attend as well as the regular Health Visitors. One of our Psychiatric Social Workers takes part in a monthly conference on Problem Families with other social agencies in Barking. A meeting was arranged with the Medical Officer of the Dagenham area when the general working of the Clinic and the types of cases most suitable for referral were discussed. This year has seen many changes of staff. Mr. Pickett left at the beginning of the year and Miss Wicks has taken his place as Educational Psychologist; Miss Woods left to take up other work and Mrs. Leegood took her place on the secretarial staff, and Dr. Altschulova 91 joined us in September when additional psychiatric sessions were granted. Additional child therapy sessions have been authorised and we hope shortly to appoint another therapist. Our waiting list has been reduced from 123 last year to 49 at the end of 1953 and our increased staff has enabled us to reduce the length of time between referral and diagnostic interview very considerably. It is essential in our work that adequate and detailed records should be kept, but we have been seriously understaffed on the secretarial side so that much skilled time has been lost in writing notes and reports in longhand We have been granted an additional clerk on a temporary basis and hope this will be made a permanent appointment in order to maintain the efficient running of the Clinic." No. of cases referred to Clinic 192 No. of cases diagnosed at Clinic 172 Psychiatrists. Diagnostic interviews 172 Cases taken on for treatment 82 Treatment interviews 533 Other interviews 152 No. of Psychiatric Sessions per week 9 Psychologists. Clinic cases tested 135 Cases given remedial education 17 Treatment interviews (remedial education) 289 School visits on behalf of Clinic cases 57 Other interviews 7 School Psychological Service. Individual cases seen 163 No. referred to Clinic 28 Child Psychotherapists. Cases treated 35 Treatment interviews 467 Psychiatric Social Workers. Interviews at Clinic (Treatment and Social Histories) 1.165 Interviews elsewhere (Home Visits) 93 Waiting List. Last year 115 This year 52 Cases for diagnosis 49 Awaiting treatment 44 Employment of School-children and Young Persons.—From special inquiries made at the various schools during 1953, it was found that 157 children were employed out of school hours. 154 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 154 Employment of Children in Entertainments Provisional Amending Rules, 1945.—2 Certificates were granted during the year. 82 Medical Examination of Teachers, Officers and Servants.—The following examinations were carried out during 1953:— Officers Servants Teachers Intending Teachers Total New Appointments 23 10 28 65 126 Under Sickness Regulations 3 1 1 — 5 Camp Schools. The Elmbridge Camp School at Cranleigh, Surrey, and Kennylands Camp School at Kidmore End, near Reading, were taken over entirely by the Essex Education Committee on the 1st April, 1948. Admissions and re-admissions of Ilford School-children to these two Camp Schools and the Hydon Heath Camp are medically examined by the Assistant Medical Officers prior to entry. The Causes of Death among Children of School Age (i.e., from 5—15 Years) in Ilford. during 1953, were: — Influenza 1 Bronchitis and Scoliosis 1 Lymphatic Neoplasms 1 Accidents 6 9 Ilford Enuresis Clinic. Dr. J. Pooley. School Medical Officer, makes the following report for the 12 months ended 31st December. 1953. "The Clinic continues to be held on Wednesday mornings at the Public Health Offices, Emerson Road, and the attendances (apart from absence through illness) have continued to be fairly good. 1. Appointment List.—During the 12 months ended December 31st. 1953. there have been 97 new cases, made up as follows:— Recommended by Under 5 5 and over T otal Boys Girls Boys Girls Parents 1 1 5 1 8 Private Practitioners 2 — 7 1 10 Infant Welfare Officers 5 3 — — 8 School Medical Officers — — 44 13 57 Health Visitors 3 3 6 I 13 Head Teacher — — — 1 1 11 7 62 17 97 Total attendances Old and New cases 580 Number of sessions during 1953 37 98 2. Procedure.—At each clinic the original procedure has been continued and is 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 the child and parent is given, and in particular, discussion is directed towards individual problems. (f) Charting of all dry nights is explained. (g) Medicinal treatment is issued or prescribed (vide No. 3). 3. Treatment.—The treatment issued or prescribed was as follows: — Cases {a) Amphetamine Sulphate (either 2.5 mgms.. 5 mgms. or 7 mgms.) at night at a time decided upon for each individual child 78 (b) Amphetamine Sulphate + Mist. potassium citrate chyoscyamus 2 (c) Phenobarbitone gr.½ at night 3 (+ phenobarbitone for cases failed under (a) above 7 (d) Ephedrine gr. ½ at night 5 (all of which had been treated by amphetamine sulphate and included under (a) (e) Advice and charting only 13 (f) Cases referred to Hospital or Child Guidance Clinic (4 of which are included under (a) above 5 N.B.—Only the amphetamine sulphate was issued by the Area Health Office. 4. Analysis of Results:— Cases (i) Completely dry 29 (30%) (ii) Very marked improvement (less than 5 wet in 28 nights) 11 (iii) Marked improvement (less than 14 wet in 28 nights) 13 (iv) Some improvement (more than 14 wet in 28 nights) 22 (v) No improvement 11 (vi) Not yet reattended 11 97 (vii) Of the cases referred to the Clinic during 1952 and who were still receiving treatment during 1953, a further 41 cases were discharged completely dry. 94 further analysis and comparison of cases: — 1953 (97 new cases) 1952 (153 new cases) Number of boys dry 23 (24% of total girls and boys) 21 (14% of total girls and boys) Number of girls dry 6 (6% of total girls and boys) 13 (8% of total girls and boys} Total % dry 30% 22% % boys attending 75% 61% % girls attending 25% 39% Average age of boys 8.6 years 7 years Average age of girls 7 years 9 years Average No. of visits (girls and boys dry) 4 visits 4 visits 5. Conclusions.—The cases which have been slow to improve have again fallen in the four main groups mentioned in my previous report, namely: — (a) Those with some frustration, either at home or at school. (b) Overcrowding in the home. (c) Mismanagement by one or both parents. (d) Those with physical defect. Again this year, it has been proved that time spent in talking to the child and parenl is as valuable, or more so. than the medicinal treatment given. The home background is invariably important in the etiology of intractible cases, and where it has been possible to alter environment or circumstances, there has usually been a corresponding improvement in the child's enuretic condition. There have been a few cases in which the etiology has remained obscure and treatment has not helped, and it would seem that in these cases there may be some disharmony between the parasympathetic and sympathetic innervation— (ref. Marshall, C. J.. Brit. Med. Journal, Feb. 6th, 1954), or the bladder may be of the infantile type. Two 15 year old boys have illustrated this point quite well, and have gradually become dry after two years' training and advice in routine. The early waking routine for the "Pre-waking" enuretic has been continued. In the giving of the enuretic case history, and in the carrying out of treatment and advice, the attitudes of both parents and children have continued to be of interest and co-operation." 95 Ministry of Education. MEDICAL INSPECTION RETURNS. Year Ended 31st December, 1953. TABLE 1. 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 3,221 Second Age Group 2,152 Third Age Group 1,638 Total 7,011 Number of other Periodic Inspections 40 Grand Total 7,051 B.—Other Inspections. Number of Special Inspections 2,960 Number of Re-inspections 6,628 Total 9,588 C.—Pupils Found to Require Treatment. Number of Individual Pupils found at Periodic Medical Inspection to Require Treatment (Excluding Dental Diseases and Infestation with Vermin). (No individual pupil is recorded more than once in any column of this Table, and therefore the total on column (4) will not necessarily be the same as the sum of columns (2) and (3).) Group (1) For defective vision (excluding squint) (2) For any of the other conditions recorded in Table IIA (3) Total individual pupils (4) Entrants 118 821 896 Second Age Group 257 534 705 Third Age Group 223 291 467 Total (prescribed groups) 598 1646 2068 Other Periodic Inspections 2 4 6 Grand Total 600 1650 2074 96 TABLE II. A.—Return of Defects Found by Medical Inspection in the Year Ended 31st December, 1953. Note.—All defects noted at medical inspection as requiring treatment are included in this return, whether or not this treatment was begin 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 124 287 65 2 5 Eyes— a. Vision 600 174 226 2 b. Squint 128 28 33 — c. Other 52 125 41 3 6 Ears— a. Hearing 35 34 80 3 b. Otitis Media 13 29 11 — c. Other 20 35 32 6 7 Nose or Throat 316 167 413 12 8 Speech 41 41 51 — 9 Cervical Glands 8 37 130 1 10 Heart and Circulation 73 9 180 11 Lungs 51 30 326 1 12 Developmental— a. Hernia 14 3 47 — b. Other 19 4 135 — 13 Orthopaedic— a. Posture 224 21 67 — b. Flat foot 414 49 47 2 c. Other 327 86 224 5 14 Nervous system— a. Epilepsy 2 — 3 — b. Other 5 54 21 — 15 Psychological— a. ment 3 2 17 — b. Stability 50 10 147 — 16 Other 78 140 105 22 97 B.—Classification of the General Condition of Pupils Inspected During the Year in the Age Groups (See Note (ii) on Table 1). roup Number of Pupils Inspected A—(Good) B.—(Fair) C—(Poor) No. % of Col. 2 No. % of Col. 2 No. % of cor. 2 (1) (2) (3) (4) (5) (6) (7) (8) Entrants 3221 1203 37.3 1909 59.3 109 3.4 Second Age Groups 2152 710 33.0 1349 62.7 93 4.3 Third Age Groups 1038 350 21.4 1212 74.0 76 4.6 Other Periodic Inspections 40 20 50.0 20 50.0 — — Totals 7051 2283 32.4 4490 63.7 278 39 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 21,065 (ii) Total number of individual pupils found to be infested 187 (iii) Number of individual pupils in respect of whom cleansing notices were issued (Section 54 (2), Education Act, 1944) 5 (iv) Number of individual pupils in respect of whom cleansing orders were issued (Section 54 (3), Education Act, 1944) (v) Number of individual pupils disinfested:— By Local Authority 65 By parents 122 TABLE IV. Treatment of Pupils Attending Maintained Primary and Secondary Schools (Including Special Schools). Notes: —(a) Treatment provided by the Authority includes all defects treated or under treatment during the year by the Authority's own staff, however brought to the Authority's notice, i.e.. whether by periodic inspection, special inspection, or otherwise, during the year in question or previously. (b) Treatment provided otherwise than by the Authority includes all treatment known by the Authority to have been so provided, including treatment undertaken in school clinics by the Regional Hospital Board. 98 Group 1.—Diseases of the Skin (Excluding Uncleanliness, for which see Table III). Number of New Cases Treated during the year By the Authority Otherwise Ringworm (i) Scalp — — (ii) Body — 1 Scabies — 1 Impetigo 16 — Other Skin Diseases 266 29 Number of Examinations made by Skin Specialists 118 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 123 26 Errors of Refraction (including squint) — 1,743 Total 123 1,769 Number of pupils for whom spectacles were (a) Prescribed —. (b) Obtained — 988 955 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 — 28 (b) for adenoids and chronic tonsillitis — 966 (c) for other nose and throat conditions — 13 Received other forms of treatment 211 370 Total 211 1,377 Group 4.—Orthopaedic and Postural Defects. (a) Number treated as in-patients in hospitals 19 By the Authority Otherwise (b) New cases treated otherwise, e.g., in clinics or out-patients departments — 245 99 Group 5.—Child Guidance Treatment. Number of cases treated In the Authority's Child Guidance Clinics Elsewhere Number of individual pupils treated at child Guidance Clinics 163 4 Group 6.—Speech Therapy. By the Authority Otherwise Number of pupils treated by Speech Therapists for the first time. 72 3 Group 7.—Other Treatment Given. New cases treated By the Authority Otherwise (a) Miscellaneous minor ailments 497 786 (b) Other (1) Heart and Rheumatism — 173 (2) Sunlight Treatment — 72 (3) Massage and Remedial Exercises — 244 (4) Enuresis 97 4 (5) Hernias — 14 (6) Major Respiratory Diseases — 10 (7) Major Digestive Diseases — 12 (8) Major Injuries — 31 (9) Other Major Diseases — 29 Total 594 1,375 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 3,702 (b) Specials 2,157 Total (1) 5,859 (2) Number found to require treatment 4,404 (3) Number referred for treatment 4,404 (4) Number actually treated 4,349 100 (5) Attendances made by pupils for treatment 14,810 (6) Half-days devoted to: Inspection 21 Treatment 1,485 Total (6) 1,506 (7) Fillings: Permanent Teeth 6,075 Temporary Teeth 1,362 Total (7) 7,437 (8) Number of teeth filled: Permanent Teeth 5,582 Temporary Teeth 1,321 Total (8) 6.903 (9) Extractions: (i) Permanent Teeth:— (a) On account of Caries 766 (b) For other purposes 167 (ii) Temporary Teeth:— (a) On account of Caries 3.989 (b) For other purposes 264 (10) Administration of general anaesthetics for extraction 2,135 (11) Other operations: Permanent Teeth 5,838 Temporary Teeth 2,105 Total (11) 7,943 101 SCHOOL HEALTH SERVICE STAFF AND SCHOOL CLINICS AS AT 31st DECEMBER. 1953 1.—Staff of the School Health Service. Divisional School Medical Officer: 1. 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 5 1.91 (c) Speech Therapist 2 1.27 (d) School Nurses *10 (Combined posts, H.V. and S.N.) 4.5 (e) Nursing Assistants 5 (Clinic Nurses) 2.75 (f) Dental Attendants 4 3.82 * 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 5 102 III.—Type of Examination and/or Treatment provided at the School Clinics returned in Section II. either directly by the Authority or under arrangements made with the Regional Hospital Board for examination and/or treatment to be carried out at the Clinic. Examination and/or Treatment 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 — K. Enuresis 1 — L. Orthoptic - 1 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 3 9/11 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. 103 Tables VI.—Summary of Cases of Infectious Diseases among School Children, and of Contacts of such Cases, excluded from School Attendance during the Year ended the 31st December, 1953. 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 Contacts Barley Lane 564 10 7 - - 21 1 15 2 1 - - - - 3 50 10 Beal Modern 782 2 2 - - 1 - 1 - - - - - 1 - 5 2 Becontree 1202 12 13 - - 8 - 17 4 1 - - 3 2 2 45 17 Benton (Open Air) 110 1 4 - - 2 - 1 - - - - - - 1 5 4 Chadweli 672 3 4 - - 3 1 16 - - - - - - - 22 5 Christchurch 809 37 15 - - 17 1 30 5 - - 1 - - - 85 21 Cleveland 1108 4 7 - - 17 - 42 4 - 1 - 1 1 - 66 11 County High 1269 1 3 - - 9 - - - 1 - - - - - 11 3 Dane 622 - 4 - - 4 - - - - - - - - - 4 4 Downshall 1434 24 13 - - 23 2 30 3 - 1 - 2 - - 80 18 Fairlop 1865 37 33 - - 87 10 14 2 1 - 2 1 - - 142 45 Gearies 1293 6 4 - - 135 21 2 1 10 - - 1 - 1 155 26 Goodmayes 752 14 6 - - 29 - 3 2 - 1 - - - - 47 8 Gordon 245 5 2 - - 4 - 19 1 6 - - - - - 34 3 Highlands 1077 6 6 - - 40 1 9 3 3 - 1 6 - 2 67 10 Loxford 375 - - - - - - - - - - - - - - Mayfield 846 2 1 - - 1 - - - - - - - - - 3 1 Mossford (Fairlop) 354 10 4 - - - - 3 - - - - - - - 13 4 Mossford (G.V.H.) 210 8 3 - - 2 - 16 - - 1 - - - - 27 3 Newbury Park 433 2 - - - 12 1 19 1 6 - - - - - 39 2 Parkhill 914 5 2 - - 25 3 17 3 8 - - 3 1 - 59 8 St. Augustine's 297 7 2 - - 21 1 - - 3 - - - - - 31 3 SS. Peter and Paul's 690 12 10 - - 12 1 2 1 - 1 - 1 - 1 29 12 St. Vincent's 360 1 - - - - - - - - - - - - - 1 - South Park 1021 4 1 - - 8 2 33 2 - - - - - - 45 5 The Gilbert Colvin 521 15 3 - - 5 1 10 2 - - - - - - 30 6 The Glade 502 13 10 - - 1 - 21 3 - - - 1 - - 36 13 The John Bramston 613 6 5 - - 103 14 3 1 3 - 6 3 - - 124 20 The Mount 314 - 1 - - 1 - - - - - - - - - 1 1 The Redbridge 622 10 3 - - 23 2 4 1 1 - - 3 - 4 45 6 The William Torbitt 1059 3 2 - - 9 - 4 - - - - 1 - - 17 2 Uphall 378 1 2 - - 9 - 10 - - - - - - - 20 2 Ursuline 335 3 2 - - 5 - - - - - - - - - 8 2 Valentines *- - - - - - - - - - - - - - - - - Woodlands 255 - - - - 6 - 16 1 - - - - - 1 23 1 Private - 12 13 - - 21 3 11 2 - - - - - - 44 18 Totals 23903 276 187 - - 664 65 368 44 44 5 10 26 5 15 1413 296 * Valentines—included in Fairlop. 104 105 Table VIIA.—Table Showing the Average Heights and Weights of the BOYS Examined (1953). 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) Barley Lane 9 113 21.8 60 117 22.4 17 119 23.2 1 127 28.5 2 135 25.3 2 139 34.0 2 141 33.8 - - - - - - - - - - - - - - - - - - Beal Grammar - - - - - - - - - - - - - - - - - - 1 144 30.1 2 147 36.7 1 165 46.0 1 164 46.5 14 171 57.5 62 172 61.6 - - - Becontree 44 112 21.1 26 114 20.7 - - - - - - - - - 15 135 35.1 47 140 33.6 2 138 31.8 4 153 40.6 56 161 49.9 5 163 55.3 - - - - - - Benton (Open Air) 10 111 18.4 16 118 20.5 15 120 22.1 14 125 25.3 7 129 26.7 14 135 29.3 8 141 33.5 8 140 30.7 4 152 39.9 3 153 38.6 1 177 57.7 - - - - - - Chadwell 52 111 19.7 36 117 21.8 2 120 22.9 1 122 23.2 1 130 30.0 15 143 35.3 40 144 35.2 - - - - - - - - - - - - - - - - - - Christchurch 26 114 20.5 74 117 21.9 2 119 21.8 1 130 25.0 2 132 30.9 13 141 32.3 37 143 35.3 - - - - - - - - - - - - - - - - - - Cleveland 46 112 19.6 48 115 21.2 7 123 23.9 2 127 26.0 1 126 22.4 10 139 30.4 76 142 34.6 - - - - - - - - - - - - - - - - - - County High - - - - - - - - - - - - - - - - - - 14 146 39.1 1 151 31.7 - - - - - - 98 170 58.4 20 173 60.2 35 172 59.6 Dane - - - - - - - - - - - - - - - - - - 12 143 34.1 8 145 38.9 1 146 38.5 72 164 51.9 34 168 54.9 2 163 60.6 - - - Downshall 43 113 19.8 101 117 22.4 8 125 24.7 3 134 33.6 2 135 28.8 6 146 36.6 38 145 35.7 2 145 37.0 1 162 54.2 51 164 51.8 15 168 55.1 - - - - - - Fairlop 81 113 20.9 115 116 19.7 6 121 25.0 1 124 24.8 1 138 30.0 1 146 32.6 61 145 34.2 4 149 37.7 2 152 42.3 61 162 51.6 18 164 52.4 - - - - - - Gearies 43 111 19.7 29 116 22.0 4 118 23.1 1 119 23.9 1 120 25.5 3 139 37.5 46 146 37.4 5 146 38.2 2 158 54.0 46 162 51.4 13 164 53.9 - - - - - - Goodmayes - - - 1 120 21.5 1 118 19.4 3 129 24.7 - - - 12 144 37.5 37 113 34.5 - - - - - - - - - - - - - - - - - - Gordon 24 114 21.0 21 113 20.7 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Highlands 72 113 20.7 60 117 21.8 4 123 25.4 1 129 24.6 2 139 33.2 3 144 32.2 43 144 34.5 - - - - - - - - - - - - - - - - - - Loxford - - - - - - - - - - - - - - - - - - 5 144 33.4 6 150 38.6 1 152 46.0 66 160 49.4 18 165 53.2 - - - - - - Mayfield - - - - - - - - - - - - - - - - - - 2 141 36.7 7 140 37.9 2 156 57.7 54 163 52.1 33 166 52.2 - - - - - - Mossford 6 116 22.1 16 116 21.4 3 126 25.1 - - - - - - 1 145 30.2 16 141 35.1 - - - - - - - - - - - - - - - - - - Mossford G.V.H. 1 108 20.0 9 115 22.6 3 114 21.6 - - - 1 132 32.2 1 127 27.0 2 141 33.8 - - - - - - - - - - - - - - - - - - Newbury Park 2 112 20.0 27 112 20.8 - - - - - - 2 128 28.9 5 139 30.9 16 141 35.3 - - - - - - - - - - - - - - - - - - Parkhill 32 114 20.4 27 116 21.1 1 122 24.6 - - - 2 137 32.5 10 144 32.5 39 144 36.8 - - - - - - - - - - - - - - - - - - St. Augustine's - - - 2 119 21.5 - - - - - - - - - 4 146 37.4 12 144 40.0 - - - - - - - - - - - - - - - - - - SS. Peter and Paul 35 111 20.8 14 118 22.9 1 122 24.0 - - - - - - 17 140 33.0 18 114 36.9 3 148 31.5 2 156 40.3 11 158 48.7 10 167 53.9 - - - - - - South Park 31 114 20.3 67 118 22.7 2 120 24.2 1 130 26.6 - - - 3 136 33.4 51 145 36.0 - - - - - - - - - - - - - - - - - - St. Vincent's 11 112 19.7 4 113 19.7 - - - 1 121 23.6 1 134 27.0 8 139 32.6 13 141 34.8 1 152 47.0 2 144 32.8 20 162 52.7 - - - - - - - - - The Gilbert Colvin 7 114 20.7 23 116 23.5 - - - 2 130 29.3 - - - 4 142 33.6 30 145 35.1 - - - - - - - - - - - - - - - - - - The Glade 9 115 18.9 12 118 19.7 2 126 25.3 - - - 3 127 25.7 6 144 35.3 19 141 32.0 - - - - - - - - - - - - - - - - - - The John Bramston 38 111 20.9 75 115 21.5 1 127 26.0 1 129 26.5 2 137 29.1 5 144 34.8 24 144 34.7 - - - - - - - - - - - - - - - - - - The Redbridge 1 117 22.2 - - - - - - - - - 2 139 33.0 9 141 33.6 22 142 34.9 - - - - - - - - - - - - - - - - - - The Wm. Torbitt 2 111 19.5 10 114 22.0 - - - - - - 3 135 27.6 20 140 31.9 49 144 35.9 - - - - - - - - - - - - - - - - - - Uphall 14 111 19.4 20 115 20.3 3 133 27.4 - - - 1 149 43.0 7 136 31.5 19 147 37.5 - - - - - - - - - - - - - - - - - - Woodlands 10 108 19.8 32 114 21.5 - - - 1 121 27.0 - - - - - - - - - - - - - - - - - - - - - - - - - - - Ilford Boys—Averages for 10 years:— 1953 649 112 20.2 925 116 20.4 82 121 23.6 34 126 26.3 36 133 28.9 194 140 33.3 799 144 34.7 49 145 36.3 22 153 44.0 441 162 51.0 259 168 55.7 84 172 61.2 35 172 59.6 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 41.8 372 161 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 1950 574 112 20.4 538 116 21.9 100 122 24.1 49 128 26.8 48 130 29.2 203 141 33.9 875 144 35.3 58 149 40.7 34 151 41.1 390 161 50.7 231 167 55.7 14 171 60.4 1 174 73.4 1949 891 113 20.6 433 117 21.9 99 122 24.1 52 127 25.8 55 133 29.2 177 139 32.9 822 1 43 34.5 51 147 38.9 40 152 41.9 392 160 50.7 247 165 55.3 27 171 61.7 3 173 61.6 1948 764 112 20.2 214 116 21.5 68 122 23.5 52 127 26.6 45 133 28.7 430 137 32.4 602 142 34.2 39 144 37.0 40 153 43.6 298 159 48.6 48 168 55.3 - - - - - - 1947 871 110 19.6 209 115 21.3 91 121 23.4 62 127 26.5 64 131 28.4 369 139 33.1 381 141 33.8 43 145 35.7 139 156 41.7 98 157 46.0 2 157 56.6 - - - - - - 1946 771 112 20.2 387 117 21.9 170 124 24.5 101 128 26.0 94 132 28.6 487 139 31.9 468 142 36.1 140 146 37.2 241 155 41.9 146 158 46.9 40 166 54.0 - - - - - - 1945 542 112 20.2 238 117 21.7 92 122 24.0 58 127 26.5 31 131 28.5 74 138 31.8 122 143 35.5 410 146 37.2 41 148 39.3 6 155 42.5 - - - - - - - - - 1944 783 112 19.9 168 116 21.7 83 122 22.4 76 127 26.3 61 132 29.5 59 139 32.6 128 141 34.4 548 146 37.3 73 150 41.0 - - - - - - - - - - - - 106 107 Table VIIB.—Table Showing the Average Heights and Weights of the GIRLS Examined (1953). 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 i (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) Barley Lane 12 110 19.4 32 116 21.8 12 121 24.1 1 140 32.0 - - - - - - 4 144 33.9 - - - - - - - - - - - - - - - - - - Beal Grammar - - - - - - - - - - - - - — — — — — 9 150 42.5 1 157 42.6 — — — 2 157 50.7 13 161 57.0 32 162 55.1 5 164 55.6 Becontree 39 110 19.1 23 113 21.0 — — — — — — — — — 12 135 32.1 44 142 34.7 6 15.7 39.0 2 163 50.5 53 158 49.7 11 158 53.5 - - - - - - Benton (Open Air) 5 109 19.1 8 115 19.9 7 119 21.0 10 123 23.0 7 128 24.5 8 135 29.8 7 141 33.7 2 146 29.4 7 149 42.2 1 162 62.4 - - - - - - - - - Chadwell 27 113 19.5 24 116 21.0 1 120 22.2 - — — 3 130 26.9 13 140 33.0 31 143 31.4 — — — - - - - - - - - - - - - - - - Christchurch 17 115 21.2 44 117 21.2 — —- —- 2 121 21.5 1 131 39.0 8 140 34.1 56 145 36.7 - - - - - - - - - - - - - - - - - - Cleveland 39 112 19.7 22 117 21.1 2 125 24.2 — — — 4 137 30.0 32 140 32.1 53 144 34.4 — — - — - - - - - - - - - - - - - - County High — — — — — — — — — — — — — — — — — — 81 148 38.6 17 150 40.3 23 158 49.9 1 165 54.6 68 162 56.6 15 162 54.5 - - - Dane Central — — — — — — — — — — — — —- — — — — — 11 147 37.6 6 151 48.3 2 160 52.3 41 158 49.8 10 156 52.3 - - - - - - Downshall 71 112 19.3 94 116 21.3 6 123 23.2 5 129 27.1 — — — 9 144 32.7 40 143 34.1 3 151 45.0 5 158 49.4 64 161 52.3 14 161 495 - - - - - - Fairlop 74 112 19.3 87 116 21.3 7 118 21.7 — — — 2 130 26.7 2 131 27.0 70 145 34.4 7 146 38.4 2 151 40.8 61 159 50.3 17 160 50 9 Gearies 85 112 20.5 30 117 22.0 4 125 25.1 2 130 24.6 2 133 29.1 2 139 37.8 50 145 34.8 2 152 48.0 2 149 39.4 20 159 51.1 5 164 545 - - - - - - Goodmayes 1 112 21.7 3 119 22.6 2 121 21.8 4 131 26.4 4 131 26.3 10 141 31.2 42 147 36.3 2 154 39.8 - - - - - - - - - - - - - - - Gordon 20 110 19.6 17 114 20.2 3 122 23.9 - - - — — — — — — — — — — — - - - - - - - - - - - - - - - - Highlands 73 112 20.3 57 118 22.1 4 125 23.5 — — — 1 133 28.4 5 142 30.9 35 147 37.7 — — — — — - — - - - - - - - - - - - Mayfield - - - - - - - - - - - - - - - - - - - - - - 144 34.5 3 158 42.8 50 159 52.3 44 159 520 - - - - - - Mossford 2 115 20.9 23 114 21.6 2 123 25.3 - - - 2 133 30.1 2 137 27.2 8 153 42.6 - - - - - - - - - - - - - - - - - - Mossford G.V.H. - - - 4 117 23.5 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Newbury Park 14 111 20.0 33 117 21.7 1 119 21.4 1 127 26.6 1 134 28.1 2 142 32.1 15 142 - - - - - - - - - - - - - - - - - - - Parkhill 36 113 21.5 27 116 20.7 7 123 21.6 3 132 30.6 2 134 27.5 5 145 39.7 37 143 36.6 - - - - - - - - - - - - - - - - - - St. Augustine's 6 110 19.1 4 114 21.0 — — — — — — — — — 2 148 37.5 12 144 34.4 - - - - - - - - - - - - - - - - - - S.S. Peter and Paul 22 110 19.8 13 113 20.5 4 120 22.9 1 123 21.0 1 134 31.6 6 144 34.0 20 144 36.3 1 148 36.8 2 151 40.4 9 155 45.3 - - - 1 159 46.8 - - - South Park 32 116 21.6 71 117 21.9 3 124 24.0 3 127 25.8 — — — 1 142 33.0 58 145 36.4 — — - - - - - - - - - - - - - - - - St. Vincent's 15 109 18.2 5 113 19.7 3 115 20.5 2 131 25.0 2 130 23.1 8 140 34.7 14 142 34.6 4 147 37.2 — - - 13 155 48.5 1 162 530 - - - - - - The Gilbert Colvin 19 111 19.6 35 116 22.2 3 116 21.0 1 126 25.9 1 137 30.1 3 139 30.0 18 144 85.2 - - - - - - - - - - - - - - - - - - The Glade 14 116 21.2 28 115 19.8 - - - - - - - - - 4 138 31.6 17 145 33.4 - - - - - - - - - - - - - - - - - - The John Bramston 43 111 21.5 72 115 21.6 - - - 3 120 30.2 1 140 33.9 1 141 34.5 5 144 35.6 - - - - - - - - - - - - - - - - - - The Mount - - - - - - - - - - - - - - - - - - 12 147 37.2 - - - - - - 56 157 52.0 23 158 52.2 - - - - - - The Redbridge 1 118 20.2 - - - - - - - - - - - - 19 142 32.0 28 142 35.7 - - - - - - - - - - - - - - - - - - The William Torbitt 10 111 19.2 7 119 21.7 - - - - - - 2 144 39.8 10 142 31.8 41 144 33.5 - - - - - - - - - - - - - - - - - - Uphall 13 114 20.0 22 116 20.8 4 119 22.7 — — — 1 143 35.0 9 137 33.7 19 143 35.6 - - - - - - - - - - - - - - - - - - Ursuline — — — — — — — — — — — — — — — — — — 4 151 42.2 6 153 41.8 1 159 44.5 - - - 1 145 49.0 1 168 63.0 - - - Woodlands 17 111 19.4 42 114 29.6 5 119 23 .0 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Ilford Girls—Averages for 10 years:— 1953 657 112 20.0 827 117 21.3 81 119 22.8 38 127 25.8 37 133 28.9 173 140 32.5 841 143 35.5 59 150 39.9 49 156 47.1 374 156 50.9 212 160 53.6 49 162 54.9 5 164 55.6 1952 746 112 19.9 695 115 21.0 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 50.5 239 153 54.9 67 160 55.0 5 159 49.0 1951 526 112 20.0 542 116 21.0 60 119 22.8 53 128 26.9 36 132 28.4 166 138 32.7 811 144 36.5 48 149 40.1 33 153 43.8 397 158 50.8 248 161 55.0 27 162 56.1 - - - 1950 553 112 20.0 536 115 21.3 76 121 23.3 51 127 26.1 54 132 29.2 194 140 33.2 837 144 37.0 61 148 41.2 35 152 43.1 401 157 50.8 140 159 53.0 22 163 52.4 4 163 55.6 1949 823 111 19.9 418 115 21.2 82 121 23.5 46 126 26.0 56 130 28.3 216 139 33.4 815 143 35.8 57 147 40.7 49 152 44.0 421 158 50.0 257 161 53.8 47 161 55.7 3 163 55.2 1948 699 111 19.4 188 115 20.5 82 120 23.1 56 127 25.8 53 130 27.8 391 138 32.4 569 142 35.0 38 149 39.9 35 154 45.9 303 157 49.1 27 160 51.3 2 160 60.4 - - - 1947 777 111 19.0 224 115 20.7 84 119 23.2 80 126 25.9 65 129 27.4 384 138 32.2 316 141 34.1 29 145 35.9 116 155 45.6 92 157 47.4 1 151 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 - - - - - - - - - - - -