1 ??? 2 Library Borough of llford Health Report FOR THE YEAR 1955 I. GORDON M.D., Ch B., M.R.C.P., D.P H. Medical Officer of Health, etc. Table of Contents Page Ilford Borough Council—Members—Municipal Year 1955-56 1 Public Health Committee—Members—Municipal Year 1955-56 2 Ilford Health Area Sub-Cttee—Representatives—Municipal Year 1955-56 2 Ilford Committee for Education—Members 3 Officers of the Public Health Services 4-6 Preface 7-11 Reports by:— Consultants— Dr. Davidson—Psychiatrist 86 Mr. Korvin—Orthopaedic Surgeon 74 Miss Mason—Ear, Nose and Throat Surgeon 78 Dr. Thorne—Ophthalmologist 72 Dr. Woolf—Cerebral Palsy Unit 83 Assistant Medical Officers— Dr. Gross—Open Air School 81 Dr. O'Connor Wilson—Foot Survey 76 Dr. Pooley—Enuresis Clinic 88 Mr. Daly—Chief Public Health Inspector 24 Mr. Haigh—Senior Dental Officer 80 Miss Copping—Welfare Officer for Old Folk 20 Miss Hazel—Orthoptist 73 Mrs. Walker—Speech Therapist 79 Statistics & Social Conditions (Section A.)— Physical Features 12 Population 12 Births and Deaths 12-14 Rainfall 13 Vital Statistics (Tables) 15-17 General Provision of Health Services (Section B.)— Home Nursing 18 Laboratory Facilities 18 Legislation in Force National Assistance Acts 19 Hospitals 21 Ambulance Facilities 21 Clinic and Treatment Centres 22 Page Sanitary Circumstances of the Area (Section C.)— Water Supply 25 Swimming Baths 26 Drainage and Sewerage 26 Rivers and Streams Refuse Collection and Disposal Sanitary Inspections during year Shops Act 28 Slaughter of Animals Act 28 Rag Flock and Other Filling Materials Act 28 Atmospheric Pollution 28 Land Charges Housing (Section D.)— Overcrowding 29 Clearance Areas 29 Statistics 29 Housing Act (Permitted number) 30 Housing Repairs & Rents Act 1954 (Certificates of Disrepair) 30 Inspection and Supervision of Food (Section E.)— Milk 31 Ice Cream 33 Meat and Other Foods 33 Hawkers 35 Food Surrendered 35 Food Poisoning 36 Bakehouses 36 Miscellaneous— Diseases of Animals (Movement Orders, etc.) 36 Prevention of Damage by Pests Act (Rodent Control) 37 Pet Animals Act 39 Petroleum (Consolidation) Act 39 Infectious Diseases (Prevalence and Control) (Section F.)— Notifiable Diseases 40 Table showing total notifications received, 1955 41 Tuberculosis—Notifications, Deaths, etc 42 V.D. Treatment Centres 44 Propaganda, etc. 45 Factories (Section G.)— Registration and Inspection 46 PART III SERVICES. NATIONAL HEALTH SERVICE ACT 1946 Page Births 47 Infant Mortality 48 Neonatal Mortality 49 Illegitimate Births & Deaths 50 Visits by Health Visitors 50 Day Nurseries 51 Child Minders 53 Infant Welfare Centres—attendances 54 Smallpox Vaccination 59 Midwives 59 Gas and Air Analgesia 61 Maternal Mortality 62 Domestic Help Service 62 Convalescent Facilities 63 Loan Sick Room Equipment 64 Visits by T.B. Visitors 64 Occupational Therapy 64 T.B. Care and After Care 65 Medical Exams Staff 65 Invalid Night Attendant Service 65 Home Nursing 66 Health Education 66 Dental Treatment 67 Welfare Food Distribution 67 Clinics— Ante-Natal 61 Artificial Sunlight 57 Cardiac 59 Diphtheria Immunisation 58 Ear, Nose & Throat 57 Midwives 60 Obstetric Consultant 62 Ophthalmic 57 Orthopaedic 55 Paediatric 55 Post-Natal 62 Rheumatism 57 Speech 58 Whooping Cough Immunisation 58 SCHOOL HEALTH SERVICE— Page School Premises 69 Routine Medical Inspections 69 Follow up examinations 69 School Dental Service 80 Oral Hygiene 81 Open Air School 81 Cerebral Palsy Unit 83 Treatment for uncleanliness 84 Provision of Meals and Milk 84 N.S.P.C.C 84 Invalid Children's Aid Association 85 Handicapped Children 85 Mental Health Service 86 Employment of School Children 87 Medical Examinations of Staff and Teachers 87 Camp Schools 87 Causes of Death (Schoolchildren) 88 B.C.G. Vaccination 91 Ministry of Educational Statistical Tables 91-98 Infectious Diseases Table Heights and Weights Table 100 Clinics— Artificial Sunlight Child Guidance 86 Ear, Nose and Throat 78 Enuresis 88 Minor Ailments Ophthalmic 71 Orthopaedic 74 Orthoptic 73 Physiotherapy 77 Rheumatism 79 Speech 79 1 ILFORD BOROUGH COUNCIL Municipal Year 1955/56 Alderman F. T. Pearson, J.P., Mayor. Alderman C. A. Headley, J.P., Deputy Mayor. Aldermen: Barker, John, J.P. Bryan, William Allen Vernon, J.P. Colvin, Gilbert, C.B.E., F.C.I.S. Cowan, Harold Douglas, F.A.C.C.A., F.C.C.S. Daniels, Russell Stearn. Fallaize, Mrs. Lilian, J.P. (E.C.C.) Gibson, Cyril Irving. Gooch, Lionel Archer Scott. Headley, Cecil Aubrey, J.P. (Deputy Mayor). Pearson, Frederick Thomas, J.P. (Mayor). Woods, Sidney Charles Victor. Young, Major Alexander, T.D., J.P., C.A., (E.C.C.). Aiken, Kenneth Leslie. Aly, Harry Reginald Bertram. Bennett, Mrs. Florence Edith. Bysouth, Henry Albert, A.I.A.C. Chapman, Mrs. Ceinwen, M.B.E. Clack, Arthur Henry Davies, David Samuel. Drew, Leslie Victor. Earey, Eric Raymond, F.N.AA., F.V.I. East, John, A.M.Inst.Mech. Gleed, Sydney George. Green, Cecil Frederick Herbert, F.A.I.B. Grose, John Stanley. Harris, Edgar Frank. Hewitt, Reginald. Hitchcock. Leonard, A.I.B. Hodson, Harold. Hughes, Thomas Bernard. James, Francis Herbert (E.C.C.). Littlejohn, Mrs. Ruth Constance, M.A. Loveless, Sydney Frank. Martin, Robert. Masters, Frank Robert. Murphy, John Loughlin, A.I.N.A., A.I.Mar.E. Natzler, Isaac Bernard. Parfitt, John Howard, B.Sc. (Econ.). Root, Harold Goldstone, M.S.M. Shaw, Arnold John, B.A. Sherrell, Albert Reginald Prentice (E.C.C.). Smith, Mrs. Lily Maude, S.R.N. Terry, Miss Anne Sylvia. Tullett, Mrs. Ethel Ross. Waters, Owen Francis, J.P. Watts, Mrs. Mabel Lucy. Westley, Ronald Francis. Woodham, Leonard Victor. Councillors: 2 PUBLIC HEALTH COMMITTEE Municipal Year 1955/56 Alderman R. S. Daniels. Alderman C. I. Gibson. Alderman C. A. Headley, J.P. (Deputy Mayor). Alderman F. T. Pearson, J.P. (Mayor). Councillor Mrs. C. Chapman, M.B.E. Councillor J. East. A.M.Inst.Mech. Councillor S. G. Gleed. Councillor R. Hewitt. Councillor T. B. Hughes. Councillor Mrs. R. C. Littlejohn, M.A. Councillor A. J. Shaw, B.A. Councillor A. R. P. Sherrell (E.C.C.). Councillor Mrs. E. R. Tullett. Councillor Mrs. M. L. Watts. ILFORD HEALTH AREA SUB-COMMITTEE OF THE HEALTH COMMITTEE OF THE ESSEX COUNTY COUNCIL Municipal Year 1955/56 iiford Borough Council Representatives: Aldermen Barker. Bryan, Colvin, Gibson. Headley (Deputy Mayor), Woods; Councillors Clack, James, Mrs. Littlejohn, Masters, Murphy, Sherrell, Mrs. Smith (vice-Chairman), Miss Terry, Mrs. Watts (Chairman). Essex County Council Representatives: Aldermen Mrs. Ball, Glenny and Young; Councillors A. C. Berry, Mrs. S. M. Bovill, Mrs. G. M. chamberlin, F. A. Wortley. The Executive Council for Essex Representative: Dr. W. S. Macgowan. Local Medical Committee Representative: Dr. S. M. Pruss. Hospital Management Committee Representative: Alderman Mrs. L. fallaize. Voluntary Organisations' Representatives: Mrs. V. M. Ayling, Mrs. M. M. Bayer, Miss N. L. Odell and Mrs. A. M. Pearce. Councillor Mrs. L. M. Smith, S.R.N., Chairman. Councillor Miss A. S. Terry, Vice-Chairman. 3 ILFORD COMMITTEE FOR EDUCATION Municipal Year 1955/56 Alderman J. Barker, J.P. Alderman Mrs. L. Fallaize, J.P. (E.C.C.). Alderman F. T. Pearson, J.P., (Mayor). Alderman Major A. Young, T.D., J.P., C.A. (E.C.C.). Councillor Mrs. F. E. Bennett. Councillor Mrs. C. Chapman, M.B.E. Councillor E. R. Earey, F.N.A.A., F.V.I. Councillor T. B. Hughes. Councillor Mrs. R. C. Littlejohn, M.A. Alderman G. Colvin, C.B.E., F.C.I.S., Chairman. Alderman C. I. Gibson, Vice-Chairman. Councillor S. F. Loveless. Councillor F. R. Masters. Councillor J. L. Murphy, A.I.N.A., A.I.Mar.E. Councillor J. H. Parfitt. Councillor A. J. Shaw, B.A. Councillor Mrs. L. M. Smith, S.R.N. Councillor Miss A. S. Terry. Councillor O. F. Waters, J.P. Councillor Mrs. M. L. Watts. Councillor L. V. Woodham. Co-opted Members: Rev. K. A. Bear, B.A. Rev. M. hancock. Mr. H. S. Kenward, M.A. Mr. C. E. Loveless. Mr. E. R. Lower, B.A. Mr. C. G. Rolfe. Miss F. Stevens. County Nominated Members: County Councillor A. F. J. Chorley, M.B.E. County Councillor Mrs. A. R. Thomas. 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 Public Health Inspector: S. R. Daly, LL.M., B.Sc., D.P.A. (Lond.), Barrister-at-Law. Deputy Chief Public Health Inspector: P. W. English. Public Health Inspectors : A. C. R. Neale. J Cook. G. W. Newman. f. Nau. R. E. Smalley. d. f. scott. T. F. Johnson. C. Broomfield. Chief Administrative Assistant (I.B.C. and E.C.C.): F. J. Hocking. Welfare Officer for Old Folk : Miss M. J. Copping. 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 Wilson, 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. R. M. Noordin, M.R.C.S.. L.R.C.P. Senior Dental Officer : e. v. Haigh, L.D.s., r.C.S. (Eng.). Educational Psychologists: K. Pickett, B.Litt. (Oxon). Dip. Psych, (from 1.2.56). Miss E. A. Wicks, B.A. (Hons.) (to 30.12.55). Miss B. S. Gascoyne, B.A. (Hons. Psych.). Psychiatric Social Workers: Miss C. Moffatt (to 25.2.56). Miss J. M. Barton (from 26.9.55). Speech Therapists: Mrs. M. Walker, L.C.S.T. Miss P. A. Seagrave, L.C.S.T. (from 23.1.56). Cerebral Palsy Unit: Physiotherapists : Miss W. S. Ashbridgf.. M.C.S.P. (to 12.3.56). Miss P. Osburn, M.C.S.P. (from 1.5.56). Miss I. M. Goodacre, M.C.S.P. (Part-time). Occupational Therapist. Mrs. S. K. Pledger (to 30.6.56). 5 Officers of the Public Health Services— continued. Superintendent of Midwives: Miss c Blockley. Superintendent Health Visitor: Miss J. M. Oliver. Health Visitors and School Nurses: Miss E. M. P. Collins Miss A. N. Bowmer Miss M. G. Duguid Miss H. Arnold Miss E. Goodchild (from 24.8.55) Miss C. Oldham Miss P. M. Leavett Miss E. M. Brown Mrs. J. M. Weston Miss I. L. Mobbs Mrs. M. C. Nagel (from 16.8.55) Miss A. E. Ridpath (from 16.8.55) Tuberculosis Visitors: Miss C. McDonald Miss M. Forde Mrs. T. Ivanauskas Occupational Therapist (T.B. Cases): Miss J. M. Van der Lande (to 31.5.56). Matrons of Day Nurseries: Sunshine House (closed 18.5.56) Miss I. E. Sandall. Green Lane Mrs. E. Drower. Ley Street Miss G. M. Gross Administrative Assistants: Miss H. Nunn (Part III Services). E. S. Jenkins (School Health Services). Domestic Help Organisers : Mrs. L. G. Lawrence. Mrs. K. M. Bedwell. 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, DM., F.R.C.S. Ophthalmologists: H. J. R. Thorne, M B., B.S., D O., D.O.M.S. A. B. MacClancy, L.R.C.P.(L), L.R.C.S.(L), L.M., D.O. 6 Officers of the Public Health Services—continued. Surgeon in charge of Ear, Nose and Throat Clinic: Margaret M. Mason, M.A., F.R.C.S. Physician in charge of Rheumatism and Cardiac Clinics : K. Playfair, M.A., M.B., M.R.C.P. Physician in charge of Paediatric Clinic : A. Russell, O.B.E., M.D., M.R.C.P. Child Guidance Clinic : Consultant Psychiatrists : H. M. S. Davidson, M.B., B.S., M.R.C.S., D.P.M. J. Vincenzi, M.R.C.S., L.R.C.P., D.P.M. Psychiatrist: H. J. Altschulova, M.D. Cerebral Patsy Unit: Consultant Physician : D. L. Woolf, D.Phys.Med., M.R.C.S., L.R.C.P. (from 2.5.55). Orthoptist: Miss C. Hazell, D.B.O. Physiotherapist: A. Brand, M.C.S.P. Essex County Couocil. 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. (Eng.), J.P. J. T. Hutchins. D. O'Connell, B.D.S., R.C.S. (1) (to 17.2.56). Mrs. I. N. Bravo, L.D.S., R.C.S. L. P. Henry, L.D.S., R.F.P.S. (to 17.5.55). T. P. Taylor. V. H Foy, L.D.S., R.C.S. M. F. Marshall, B.D.S. (Sydney) (to 17.2.56). F. Summers. L.D.S., R.C.S. (Eng.) (to 31.12.55). A. J. Cassam, L.D.S., R.C.S. (from 14.5.56). Child Psycho-Therapists (Non Medical) : Miss M. E. Bergen, M.A., B.Sc. Mrs. H. Benjamin, M.A. (to 16.12.55). Miss P. Oppenheimer, B.A. (from 27.4.56). Speech Therapist (Part-time): Mrs. F. M. Hatfield, L.C.S.T. Ilford Borough Council. Public Analysts : Gboroe Taylor, F.R.I.C. J. Hubert Hamence,, M.Sc., ph.d Preface Public Health Offices, Ilford. August, 1956. To the Mayor, Aldermen and Councillors of the Borough of Ilford. Madam Mayor, Ladies and Gentlemen, 1 submit herewith the Annual Report on the Health Services for the year 1955. Births and Deaths. The birth rate in Ilford is steadily falling and at 11.21 births per 1,000 (as compared with the year before of 11.64) is far below the national rate of 15. In fact, there were 2,100 births, as compared with 2,081 deaths; the latter figure is steadily overtaking the former, and in a year or two. if the present trends continue, will do so. The number of deaths in 1955, 2,081. is 217 more than in the previous year. Of these extra deaths the vast majority (182) are attributable to either diseases of the aged (such as arteriosclerosis in its various form and cancer) or another group (of pneumonia and bronchitis), the penalty of living in an air-polluted conurbation in England. Our death rate (adjusted) of 11.79 is now slightly worse than the national rate of 11.7, but the figures since 1952 are quite unreliable as an index of the health of Ilford as. due to an instruction of the Registrar General, deaths in mental hospitals are assigned to the local authority where the hospitals are situated, and not to the areas whence the patient came. As we have two large mental hospitals in the Borough we must include in our figures the mental hospital deaths of patients originally from a large section of the Home Counties, probably an additional 250—300. although it is quite impossible to state the number for certain. A more certain indication of the health of the borough is the Infant Mortality Rate, which at 20 is considerably lower than the figures for England and Wales and the Great Towns (see Table 1.A.). The Family Doctor and Ourselves. For the first time for over 20 years a copy of this annual report is to be sent to every general practitioner in Ilford. There is no individual whose co-operation is more essential to the Medical Officer of Health than the General Practitioner, in the spheres of prevention of disease, care and after-care and much else. I feel progress is steadily being maintained in this matter of liaison, and it is to be hoped that Ilford doctors will make even more use of the help we can give. To this end a map has been prepared of the area served by each health visitor, and attached directions as to how to contact her, and these details have been sent to every practitioner. I hope the health visitor, as the general purpose medical and social visitor in the home, will soon be as well-known to the family doctor as the midwife and welfare worker for the aged now are. As this annual report is intended for readers such as our family doctors, councillors, officials in the various Ministries, as well as the general public, I have avoided issuing it as a chatty magazine, as some Medical Officers of Health like to do. Granted, the figures and statistics make dull reading, but they are not meant to be read, only to be referred to. The preface, and the statements of individual officers scattered throughout the report make, I hope, more readable fare. 8 The smallpox vaccination rate in llford, although one of the highest in Essex, is still too low and it was decided to institute such vaccination in one of our infant welfare centres. Hitherto this work has been done entirely by general practitioners, and in order not to offend them the llford Medical Society and the 15 doctors practising in the vicinity of the clinic were approached to find out if there was any objection. This example of public relations proved successful; only one of the fifteen doctors objected, and the Medical Society did not oppose. Had this been done without consultation, I am sure the reaction would have been far different An indication of our changed relationships with local doctors is given by two figures—the drop in attendances at minor ailment clinics from 1,597 to 1,292 (they now attend their own doctors) and the rise in number of articles laundered for the incontinent chronic sick from 3,570 to 6,734 (here we help the family doctor treat cases at home). Hazards of Radioactivity. This is one of the most important problems facing us today, and the Medical Officer of Health has to keep watch in his own sphere as over any other danger that may influence the health of the community he serves. Many industries use radioactive substances and dispose of radioactive matter, and although not strictly within my province, a survey was made of the main llford factories to find out if such a hazard exists. We found only one factory using radioactive substances, and of this case we have been aware for some years, and knew that conditions of safety there were excellent and that the relevant Home Office Inspector maintained a careful supervision of the personnel and processes involved. A chiropodist, who is licensed to practise by the llford Borough Council, asked if he could use a certain ointment, stated to have beneficial radioactive properties, in his practice. After consultation with national authorities on this matter, it was decided to recommend that the substance should not be used, for if it contained any substantial radioactivity it was dangerous, and if it did not it was useless and fraudulent. Following the publication by the Medical Research Council of "The Hazards to Man of Nuclear and Allied Radiations" it has been decided to inform all llford boot and shoe retailers of the dubious value and possible hazards of routine examination of the feet by X-rays in retail establishments. It is only possible at the moment to advise, as no legislation for supervising the practice exists. Danger—Contaminated Food. An interesting, and at times exciting, part of our work is the investigation of outbreaks of food poisoning: the solving of the problem of source of infection would tax at times the most capable detective from Scotland Yard. There was "The Case of the Mustard and Cress Sandwiches," where teachers and pupils in a local school fell ill, and all had partaken of mustard and cress grown in the class-room. We proved that the mustard and cress was the source of infection, but will never know how it became infected. In a local hospital certain patients became ill in "The Case of the Missing Peas " and the only possible source of infection was tinned peas. They remembered eating them, the ward staff remembered giving it to them, but the kitchen and catering staff were adamant that peas had never been issued on that day. We had more success with a small outbreak of a mild form of enteric due to an organism called paratyphoid B. It started, to our great anxiety, in a young man who was a pastry cook in a local bakery. When further cases occurred it became evident that all had partaken of artificial cream in cakes prepared on Friday the Thirteenth in another bakery, not in llford. "Serve him right." said the boy's llford employer. The Medical Officer of Health of the area where the bakery was situated managed to collect 43 cases in this part of Greater London who had been similarly 9 affected. It is assumed, but unfortunately cannot be proved for certain, that the imitation cream was infected indirectly by imported Chinese egg products. So ended " The Case of the Chinese Eggs." Some years ago a party of English tourists became infected on a boattrip up the Rhine; this year a party became ill with food-poisoning at the end of a trip to Norway. Most of the tourists in both cases did not live in llford, but we got to know of the outbreak first and much work is involved in informing local medical officers of health all over the country in an attempt to obtain a coherent picture of the outbreak. Although these alimentary disorders are notifiable as food-poisoning, dysentery and enteric fever, many of the minor cases do not come to the attention of the general practitioner or the medical officer of health. In order to get some indication of the possible extent of this trouble a survey was conducted by the sanitary inspectorate. A random sample of 535 adults and children, covering the whole borough, were visited, and note taken of any individuals who had had diarrhoea and vomiting in the four weeks prior to July 7th. There were 28 such, and if we assume that a similar proportion applies to the whole borough, about 9,000 had some sickness in that period, during which we only had 14 notifications from local doctors. In periods of heavy rain in llford the sewers cannot cope with the excess of water. There is flooding of gardens and houses with crude sewage which cannot be considered a position that any medical officer of health can view with equanimity. The borough has plans and has already started to remedy this matter, and although expensive, the project is essential. It is to be firmly hoped that the Ministry of Housing and Local Government will continue to allow this project to proceed, credit-squeeze or no credit-squeeze. Health Visitors. The Health Visiting staff is. for the first time for many years, nearly attaining the number on establishment. The scope of their work is widening and in the last year we have initiated a toddlers' clinic and infant welfare centre staffed by health visitors and not doctors. At Manford Way there is held a Social and Discussion Group with mothers and films and film strips have been shown. We find that the Health Visitor is the main co-ordinating worker in dealing with the few problem families in the town, and that her contacts with the various workers in this field enable us to reduce to a minimum formal case committees, although such committees, failing County Council leadership, are held on local initiative. Boys and girls who are tuberculin positive when tested after volunteering for B.C.G. vaccination have been infected previously some time in their lives with tuberculosis, and the onerous task of searching for a possible source of infection among their contacts is now being regularly undertaken by the health visitors. After years of striving it seems that King George Hospital will at last allow the health visitor to have some effective liaison with their paediatric department, as has existed for some time with the Maternity Hospital. As stated earlier in this preface, we hope the family doctor will avail himself of the services of the health visitor, and the latter's contact with local hospital staffs and their patients should make this G.P.-H.V. co-operation more useful. Health Education and Public Relations. To deal with these related matters an interdepartmental committee now functions. Among the projects in hand is an offer we have made to a number of voluntary societies in the town to come and talk to them. An approach has been made to 95 such societies (even that number is far from the borough total), and the response so far has been satisfactory (we would not care for it to be overwhelming!). We would like to have even more help from the schools in regard to health education than we have at present . It has been found that secondary school girls are extremely interested in child welfare. Boys (and girls too) 10 should be fully informed of the health hazards of cigarette smoking, before they take up the habit. Vaccination against tuberculosis is now recognised as a successful innovation, and it has been offered to boys and girls between their thirteenth and fourteenth birthdays. Such topics are included in the variety of health matters in which school children should take an interest. Research—the Latest. One of the advantages of this preface is that the local public can be made aware of recent trends of thought in medical research, in the early stages, and without sensational press ballyhoo. In accordance with this policy some years ago mention was made here of the association between heavy cigarette smoking and cancer of the lung. I would like to draw attention to another field in which much may be heard in the next few years as the present research becomes better known. Coronary disease of the heart is one of the greatest modern killers, as reference to the table of causes of death on page 17 will show. It has long been known (and 1 have also referred to this before) that amongst other factors excessive consumption of fats has something to do with the cause. Now it is being realised that certain fats are responsible, and others not. The fats blamed are those of animal origin, and " hardened " fats that make up much of our factory produced margarine. The safe fats and oils are of vegetable and marine origin, which contain much so-called " unsaturated fatty acids"; safe, that is, until they have been "saturated," or hardened, in the margarine factories. Some medical men are now proposing a radical change in our eating habits taking regard of this research, if we wish to live longer. New Ventures. (a) Poliomyelitis vaccination was started in the early summer of 1956. There was not as much vaccine made available as was originally hoped, but over 600 children were immunised, with no untoward incident. (b) The Cerebral Palsy Unit is now successfully functioning, over two-thirds of the children coming from surrounding areas. (c) Stoneleigh Court, flats erected by the Borough Council for aged persons who are in addition physically handicapped, has been opened and is now a successful feature of our community life. (d) Evening Dental Sessions, at first only for expectant mothers, but now for children, have been introduced for the convenience of the public. Voluntary Help. Once again I cannot conclude without a word of thanks to all the voluntary help that is available, and without which the borough would be far less satisfactorily served. This service is of two kinds, that of voluntary help in personal services such as given by the Ilford Federation of Women Voluntary Welfare Workers, the Women's Voluntary Services, and the Invalid Children's Aid Association. The other way in which help is received is by co-ordinating voluntary committees that deal with aspects of health matters that, for one reason or another, do not come within my statutory supervision. I refer to the Old People's Welfare and Handicapped Persons Welfare Committees of the Ilford Social Service Association, and the Home Safety Committee of the W.V.S. By my membership of these committees, theoretically voluntary, but in fact essential, I am enabled to give the people of Ilford a more satisfying and integrated service. Incidentally, I would like to draw attention to the urgent need for money for the Old People's Committee's Day and Night Attendant Service, and the Handicapped Persons Committee's Ambulance Fund. May I mention also the successful film produced by the Home Safety Committee which has been hired as far away as Edinburgh and sold as far away as Belgium. 11 It is sad to record the death of Mrs. Paddon, who was one of the two founder members of the llford Federation of Voluntary Welfare Workers in 1914, and retired in 1951, when she was chairman of the Cecil Hall Centre. I must draw attention to the various reports of specialists and other officers that are included herein. Such are the Foot Survey by Dr. O'Connor Wilson, and the discussion of problems of the aged by Miss Copping; this latter report shows how superficial is the diagnosis that all the troubles of the old people are caused by their children's neglect. I acknowledge the continued efficiency of my staff and the full cooperation of the chief officers and their departments throughout the year and in the provision of some of the statistics in this report. 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 SubCommittees of the llford 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. 12 SECTION A. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in Acres) Land and Inland Water Tidal Water 8,425 8,432 7 Population (Census 1921) 85,194 „ (Census 1931) 131,061 „ (Census 1951) 184,706 Registrar-General's Estimate of resident Population:— June 30th 1952 182,200 „ „ 1953 181,200 „ „ 1954 182,700 „ „ 1955 181.700 Number of inhabited houses (April 1st, 1955) according to Rate Books (approx.) 51,999 Rateable Value—April 1st, 1955 (Houses and Land) £1 705,033 Sum represented by a penny rate, April 1st, 1955 (approx.) £,6960 Education Rate— 1955-56 1954-55 (E.C.C.) 10s. 0.69d. in the £ 9s.7.3d. in the £ Combined Rate (all services) 23s. 4d. in the £ 23s. 4d. in the £ The following figures as to unemployment were supplied by the Ministry of Labour:— Males Females As at January, 1955 401 113 As at January, 1956 410 111 Live Births— 1955 1954 Total M. F. Birth rate per 1,000 population. Legitimate 2,045 1,041 1.0041 Crude rate 11.56 12.00 Illegitimate 55 35 20 Adjusted rate 11.21 11.64 Rate per 1,000 total (live and still) births Stillbirths 49 22 27 22.80 24.89 Death rale per 1,000 population. Deaths 2,081 1.032 1,0491 | Crude rate 11.45 10.20 Adjusted rate 11.79 10.50 Percentage of total deaths occuring in public institutions 39.28 41.88 No. of Deaths. Rate per 1,000 total (live and still) births. Maternal mortality (heading 30 of the Registrar-General's Short List) (Pregnancy, childbirth and abortion) 1955 1954 1955 1954 1 1 0.46 0.44 Death-rate of Infants under 1 year of age:— All infants per 1,000 live births 20.00 18.69 Legitimate infants per 1,000 legitimate live births 19.56 18.64 Illegitimate infants per 1,000 illegitimate live births 36.36 20.83 Deaths from Cancer (all ages) 391 354 „ „ Measles (all ages) 1 — „ „ Whooping Cough (all ages) - — „ ,, Diarrhœa (under 2 years of age) - 1 13 1. Rainfall. Total rainfall registered in the district during the year was 20 82 inches; the greatest fall in 24 hours was registered on 22nd September, 1.34 of an inch. May was the wettest month. 2. Registrar General's Memorandum on Transfer of Births, Deaths and Stillbirths, dated 17th October, 1952. 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 llford are .97 for the birth rate and 1.03 for the death rate, and these are used in calculating these rates in Table la. 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 2,100. Males Females Legitimate 1,041 1,004 Illegitimate 35 20 i.e., 26 per cent. of the births registered were illegitimate. The percentage of illegitimate births registered in the previous 10 years was 2.2 (1954), 3 0, 3 9, 2 9, 3.1, 2.4, 3.2, 3.3, 3.1, 5.5. The adjusted birth-rate, calculated on the estimated population of 181,700 is 11.21 per 1,000. 4. Deaths. The total number of deaths of llford residents was 2,081. This is obtained by taking the total number of deaths registered in the district (1,670), subtracting the deaths of non-residents occurring in the district (152), and adding the deaths of llford residents registered as having died in other districts (563). The number of deaths of non-residents registered in the district was as follows:— King George Hospital 99 llford Isolation Hospital and Sanatorium 24 Other Non-residents 29 Total 152 14 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 82 St. Margaret's Hospital, Epping 6 Wanstead Hospital 48 Langthorne Hospital 59 London Hospital and Brentwood Annexe 79 St. Bartholomew's Hospital 6 Rush Green Hospital 35 Plaistow Hospital 13 St. Joseph's Hospice, Hackney 15 Queen Mary's Hospital, Stratford 4 East Ham Memorial Hospital 8 Harold Wood Hospital 6 Whipps Cross Hospital 40 Middlesex Hospital 6 London Chest Hospital 3 St. Luke's Hospital 5 In other Hospitals, Institutions and residences outside the Ilford district 148 Total 563 The adjusted death rate, calculated on the estimated population of 181,700 is 11.79 per 1,000. Inquests.—During the year. 60 inquests were held on deaths occurring in Ilford, 48 on Ilford residents, and 12 on non-residents. The ages at death were as follows: — Under 1-2 2-5 5-15 15-25 25-45 45-65 65 years and 1 year years years years years years years upwards 2 — 3 1 5 4 15 30 Death Rates from Tuberculosis and Cancer, 1955 The following Table shows the death-rates for 1955 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 .104 .131 Other Tuberculosis .005 .015 Cancer of lung and bronchus .407 .389 Cancer, other forms 1.744 1.667 5. Tables of Vital Statistics.—Table I gives a comparative statement of the birth-rate and death-rate for the past five years. Table Ia gives a comparison of the vital statistics of Ilford with England and Wales, and other towns. Table II gives a classified statement of the causes of death in 1955, arranged according to the age groups at which deaths occurred. TABLE I.—Vital Statistics of Whole District During 1955 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 Numberj Rate (b) Number Rate per 1,000 Net Births Number Rate 1 2 3 4 5 6 7 8 9 10 11 12 13 1951 181,600 1,677 2,376 13.3 1,780 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) 1954 182,700 1,580 2,198 120(c) 1,552 8.5 164 476 41 18.7 1,864 10.2(c) 1955 181,700 1,632 2,100 11.56(c) 1,670 9.2 152 563 42 20.0 2,081 ll.45(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 Ia Table showing comparison between the Birth-rate, Death-rate, etc., of Ilford, other Towns, and of England and Wales for the Year 1955 (Provisional figures) Rate per 1,000 Population Rate per 1,000 Total (Live and Still) Births Rate per 1,000 Population Rate per 1,000 Related Live Births Death rate per million Population Whooping Cough Diphtheria Influenza Acute Poliomyelitis Pneumonia Live Births Stillbirths Deaths (all ages) Deaths under 1 year England and Wales 15.0 23.1 11.7 24.9 2.0 0.3 67 5.4 490 Great Towns 14.9 23.2 11.6 25.1 2.0 0.4 57 5.9 535 Smaller Towns 14.9 23.3 11.6 25.2 2.2 0.3 66 4.1 446 ILFORD (Estimated Population mid-1955 = 181,700) 11.2 22.8 11.8 20.0 — — 601 5.52 4573 A dash (—) signifies that there were no deaths. 1 11 deaths. 2 1 death. 3 83 deaths. 16 17 Registrar-General's Short List of Deaths and Causes TABLE II Causes of, and Ages at, Death during the year 1955 CAUSES OF DEATH Net Deaths at the subjoined ages of "Residents" whether occurring within or without the district All Ages Under 1 year 1 and under 2 years 2 and under 5 years 5 and under 15 years 15 and under 25 years 25 and under 35 years 35 and under 45 years 45 and under 55 years 55 and under 65 years 65 and under 75 years 75 years and upwards ALL CAUSES 2081 42 5 9 11 14 22 67 157 356 544 854 1 Tuberculosis, respiratory 19 - - - - 1 - 4 3 4 6 1 2 Tuberculosis, other 1 - - - - - - - - - - - 3 Syphilitic disease 5 - - - - - - 1 - 1 2 1 4 Diphtheria - - - - - - - - - - - - 5 Whooping cough - - - - - - - - - - - - 6 Meningococcal infections - - - - - - - - - - - - 7 Acute poliomyelitis 1 - - - - - - - - - - - 8 Measles 1 - 1 - - - - - - - - - 9 Other infective and parasitic diseases 7 - - 1 - - - 2 - 2 1 1 10 Malignant neoplasm, stomach 60 - - - - - - 3 4 14 18 21 11 Malignant neoplasm, lung, bronchus 74 - - - - - - 2 11 32 22 7 12 Malignant neoplasm, breast 35 - - - - - - 4 4 10 8 9 13 Malignant neoplasm, uterus 18 - - - - - - 2 2 8 2 4 14 Other malignant and lymphatic neoplasms 204 - 1 - 2 2 1 14 26 40 64 54 15 Leukaemia, aleukaemia 12 1 - - 1 - 1 1 2 3 2 1 16 Diabetes 13 - - - - - - - 1 2 3 7 17 Vascular lesions of nervous system 241 - - - - 1 3 3 9 42 73 110 18 Coronary disease, angina 348 - - - - - 1 4 30 81 115 117 19 Hypertension with heart disease 76 - - - - - - - 1 6 21 48 20 Other heart disease 300 - - - - - 2 7 13 23 38 197 21 Other circulatory disease 104 - - - 1 - - 1 8 12 31 51 22 Influenza 11 - - - - - 1 - 1 - 4 5 23 Pneumonia 83 2 1 2 1 - 1 - 6 9 16 46 24 Bronchitis 126 3 - - - - - 2 6 21 36 59 25 Other diseases of respiratory system 25 - - - - 1 - 1 5 4 4 10 26 Ulcer of stomach and duodenum 24 - - - - - - - 3 4 8 9 27 Gastritis, enteritis and diarrhoea 8 - - - - - - 1 - 2 2 3 28 Nephritis and nephrosis 18 - - - - - 1 3 1 3 3 7 29 Hyperplasia of prostate 12 - - - - - - - - 1 1 10 30 Pregnancy, childbirth, abortion 1 - - - - - 1 - - 1 1 10 31 Congenital malformations 12 7 2 2 - - - - 1 - - - 32 Other defined and ill-defined diseases 170 29 - 1 5 2 5 6 13 18 32 59 33 Motor vehicle accidents 18 - - 1 1 3 2 2 3 2 3 1 34 All other accidents 31 - - 1 - 4 1 1 2 4 4 14 35 Suicide 22 - - - - - 2 3 3 8 4 2 36 Homicide and operations of war 1 - - - - - - - - - 1 - Specia Causes (included above) Smallpox - - - - - - - - - - - - 18 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 1955 will be found in Part III Services section. (iii) Laboratory Facilities.—Pathological specimens are now sent to the Bacteriological Laboratory, Oldchurch Hospital, Romford, for examination. (iv) Byelaws exist for:— Prevention of Nuisances. Cleansing of footways and pavements, and cleansing of earth closets, privies, ashpits and cesspools. Dealing with common lodging houses and houses let in lodgings. Houses let in lodgings or occupied by members of more than one family. (Sec. 84, Ilford Act, 1937.) Slaughterhouses and humane slaughtering of animals. Pleasure Fairs. (Sec. 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, Ilford 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 1955 twenty-seven applications for renewal of licences were received. The Council renewed the licences in respect of these establishments. One new application was received, which was granted. The licences expire on 31st March of each year. It was necessary to call the attention of one licensee to default in complying with the byelaws. He subsequently discontinued the practice. Hairdressers' and Barbers' Premises. (Essex C.C. Act 1933, Part VI). During 1955, 43 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, 1955, 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. 19 (vii) Nurses Act, 1943 (Part 2.) Nurses Agencies. The Essex County Council on application by the llford Council, delegated to them, in pursuance of Section 11 (1) the powers conferred upon the County Council by Part II of the Act, subject to certain conditions Agencies are inspected before the issue of a licence, and thereafter at intervals of not more than once a quarter. The Medical Officer of Health and Deputy are 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 1955. (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 llford during the year 1955:— (1) Residential and Temporary Accommodation. (a) Aged persons admitted to hostels and other residential establishments:—49 (b) Other classes (admitted to temporary accommodation):— Adults, 9; Children, 13:—22. (2) Blind Persons. The numbers of registered blind, partially sighted and defective sighted persons resident in the Borough as at 31st December, 1955, were as follows:— (i) Registered as blind 266 (ii) Partially sighted 51 (iii) Defective sighted 13 all of whom were under the supervision of the County Council's Home Teachers. During the year 5 blind persons participated in the Home Workers' Scheme operated through the agency of the Royal London Society for the Blind, and 1 was employed in the Workshops for the Blind. In addition, 28 blind and 6 partially sighted persons were employed in open industry. During 1955, 2 blind persons from the Borough were admitted to homes for the blind. Schemes for welfare services for handicapped persons (general classes) and the deaf and dumb and hard of hearing, as approved by the County Council, have been implemented with the co-operation of voluntary organisations specialising in this field of work." In llford the scheme for other handicapped persons has been delegated to a Sub-Committee of the llford Social Service Association, of which the Medical Officer of Health is a member. 20 National Assistance Act, 1948. (а) Section 47 provides for the removal of persons to hospital who are unable to devote to themselves proper care and attention. No persons were dealt with during the year. (b) Section 50 requires a Local Authority to arrange for the burial or cremation of a person who has died or been found dead, and where it appears to the Local Authority no suitable arrangements are being made for the disposal of the body. The burial of seven persons was dealt with during the year as follows:— (1) A female, 80 years, occupied a flat. (2) A male, 75 years, patient in a nursing home. (3) A male, 29 years, found hanged. (4) A male, 59 years, died at own home. (5) A male, 84 years, patient in a nursing home. (6) A male, 44 years, patient in a nursing home. (7) A female, 71 years, patient at Claybury Hospital. Miss M. J. Copping, Welfare Officer for Old People, reports as follows:— "During 1955, 478 cases were dealt with, of which 367 were new cases, and 876 home visits paid. Visits were also made to various Almoners, Psychiatric Social Workers, Old People's Homes, Voluntary Organisations, etc. About 250 interviews with old folk, or their relatives, were conducted at the Public Health Offices. A large proportion were referred by relatives who were experiencing some difficulty in caring for a sick or senile old person residing with them. Other cases were referred by Private Doctors, Hospital Almoners, National Assistance Board Officers, llford Social Services Association and other similar bodies. Of the cases dealt with 56 were admitted to Hospitals, chiefly Langthorne, and 39 died in Hospital. Deaths at home numbered 48, Four applications for admission to Hospital supported by the Medical Officer of Health were unsuccessful and there were many more chronic sick persons who needed Hospital care, but whose Doctors felt it would be hopeless to apply because of the shortage of beds. The relatives nursing these persons often make great sacrifices on their behalf. Some are never able to go out for a few hours' pleasure and have not had a holiday for many years. Langthorne Hospital helped by accommodating several of these cases for 2 or 3 weeks while their families went away for a much needed rest. There is a great need for Convalescent or Holiday Homes which will accept the over 70's. These often apply for a change of air and scenery, either free or at a very low cost. They cannot usually undertake a long journey, often need ground floor bedrooms because they can no longer climb stairs, and require a little assistance during the night. It is almost impossible to find anywhere to accommodate them. Of 32 persons recommended to apply to Essex County Council for Hostel accommodation, 20 were admitted. Some applicants were deemed to be unsuitable and others died or became chronic sick during the waiting period. The period of waiting averages about one year, although priority is sometimes given to urgent cases. The most problematic cases are those physically fit but mentally confused. Whole families are frequently disorganised by someone not certifiable, but with a mind too disturbed to permit their acceptance by any Old Folks' Home or Hostel, or unwilling to consent to entering such a place. When still active they sometimes become a public nuisance and their families find it impossible to restrain them. In addition to the work associated with the Public Health Department about 200 home visits were paid to persons seeking consideration for one of the Stoneleigh Court flats. Many others were interviewed, and while some were obviously unsuitable or not eligible, the majority would have benefited by the special facilities offered. Applications are still being received. A large amount of correspondence was dealt with during the year, and hundreds of telephone enquiries handled. 21 The laundry service for cleansing of soiled bed linen and personal clothing continued to operate throughout the year, proving of invaluable assistance in the care of very difficult cases. During the year 40 persons were assisted and 6,734 articles were laundered." (ix) Hospitals, Etc. Isolation Hospital.—172 beds are provided; of these 69 are for the treatment of tuberculosis patients. 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 1955. Pay Beds 14 Amenity Beds 7 Other Patients Children Medical Surgical Male Female Male Female 211 21 26 18 55 55 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 98 Resident Staff and 1,341 patients (males 601, females 740), and Claybury Hospital, with 195 Resident Staff and 2,169 patients (males 879, females 1,290) in residence on 30th June, 1955. (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 and on 30th June, 1955, there were 45 Resident Staff and 49 patients. Nursing Homes.—There are 2 private registered Nursing Homes in the district 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 at Ilford deals with all requests for Ambulance transport arising in the whole of the Metropolitan area of Essex. The Control is manned continuously, is in direct contact with all Ambulance Stations in the Metropolitan area 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. 22 (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) Monday, 2 p.m. Chadwell Christian Mission Hall, Essex Road, Chadwell Heath (for residents of Chadwell Heath area) Monday, 2 p.m. Mayesbrook Clinic, Goodmayes Lane, Goodmayes (for residents of Becontree area) Tuesday, 2 p.m. St. John's Church Hall, Devonshire Road, Seven Kings (for residents of Downshall area) Tuesday, 2 p.m. Manford Way Clinic, Hainault (for residents of the llford portion of L.C.C. estate) Tuesday, 2 p.m. Congregational Church Hall, Woodford Avenue, llford (for residents of Woodford Avenue area) Wednesday, 2 p.m. Cecil Hall, Granville Road, llford (for residents of the east side of Cranbrook Road) Wednesday, 2 p.m. Cecil Hall, Granville Road, llford (for residents of the west side of Cranbrook Road) Thursday, 2 p.m. Seven Kings Methodist Church Hall. Seven Kings Road (for residents of Seven Kings area) Wednesday, 2 p.m. Newbury Hall, Perryman's Farm Road, Newbury Park (for residents of the Newbury Park area) Thursday, 2 p.m. Vine Memorial Church Hall, Grosvenor Road, llford (for residents of Grosvenor Road area) Thursday, 2 p.m. Mayesbrook Clinic (for residents of Goodmayes area) Thursday, 2 p.m. Vine Memorial Church Hall, Grosvenor Road, llford (for residents of llford Lane area) Friday, 2 p.m. Valentines Mansion, Emerson Road, llford (for residents of Valentines area) Friday, 2 p.m. Parish Hall, Mossford Green, Barkingside (for residents of Fairlop area) Friday, 2 p.m. Ante-Natal Clinics.—An Ante-Natal Clinic is held at the Maternity Hospital, Eastern Avenue, llford, 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 required. 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. 23 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. Ear, Nose and Throat. Ophthalmic treatment. Paediatric. Infant Welfare. Midwives Ante-Natal. Enuresis. B.C.G. Vaccination. Poliomyelitis Vaccination. (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. Poliomyelitis Vaccination. (iii) Mayesbrook Clinic, Goodmayes Lane, for— Minor Ailments. Dental (Children and Expectant Mothers). Ophthalmic treatment. Artificial Sunlight treatment. Ante-Natal and Post-Natal. Ante-Natal Relaxation Exercises. Diphtheria and Whooping Cough Immunization. Orthopaedic and Remedial Exercises treatment. Infant Welfare. Speech Therapy. Midwives Ante-Natal. Orthoptic. B.C.G. Vaccination. Poliomyelitis 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. Ante-Natal Relaxation Exercises Infant Welfare. Diphtheria and Whooping Cough Immunization. Midwives Ante-Natal. Dental (Children only). Ophthalmic treatment. Orthopaedic treatment. Poliomyelitis Vaccination. (xii) Chest Clinic.—A clinic for the diagnosis and treatment of tuberculosis is provided by the North East Metropolitan Regional Hospital Board at 130-132, Cranbrook Road, llford. 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 4 p.m. For Children—Wednesday, 10 to 12 noon. A Refill Clinic is held on Tuesday evening and Thursday afternoon. 24 SECTION C. SANITARY CIRCUMSTANCES OF THE AREA. The Chief Public Health Inspector reports as follows: — "Food and Drugs and Food Hygiene. Perhaps the most important piece of legislation dealing with public health is the Food and Drugs Act, 1955, which, as the preamble indicates, is 'An Act to Consolidate the Food and Drugs Act, 1938, the Food and Drugs (Milk Dairies and Artificial Cream) Act, 1950 and the Food and Drugs Amendment Act, 1954, together with certain other enactments amending and supplementing Part V of the Act of 1938 in relation to Slaughterhouses.' Whilst we in llford are not gravely concerned with slaughterhouse administration, we are nevertheless interested in the Hygienic handling of meat for human consumption, hence the policy of requiring that slaughterhouses be so situated and constructed as to afford speedy and healthy conditions in the supply of the nation's meat foods. Of greater direct interest to llford are the Food Hygiene Regulations, 1955, made on 16th December, 1955 and operative on 1st January, 1956, though some clauses relating to provision of equipment and structures will not become effective until 1st July, 1956. Opinions among public health officials on the Regulations have varied; some considered they are attenuated in form and difficult of administration, whilst others deem them far-reaching and 'of vast potentiality' for securing marked improvement of hygiene in the catering industry. The Sanitary Inspectorate of the Council feel that so important an industry should not be unduly hampered by unreasonable restrictions but should be controlled in those aspects of the trade which bear on human health. They therefore consider that the Regulations afford a means of securing public benefit without the imposition of strict police supervisory powers. It is felt that by co-operation between the Public Health Department and the trade, by an expansion of the already extensive education of food handlers in sound hygienic handling of food principles, by the maintenance of the existing system of inspection of food premises, together with the furnishing of advice to all engaged in food handling in all its forms, whether 'master or servant,' all of which are calculated to obviate the enforcement of the legal sanctions contained in this importance piece of delegated legislation, the danger to the public health from contaminated food will be negligible. Time and expense will determine the Act's efficacy. Housing Repairs and Rents Act, 1954—(Certificates of Disrepair). After great political controversy, Parliament placed on the Statute Book this Act, contemplating that it would (a) afford house owners an opportunity of increasing rents by prescribed amounts after serving written notices on the tenant that they had carried out works of repair to the statutory amount and thereby (b) enable owners to maintain the properties in a reasonable state of fitness for habitation by utilising the increase of rent thus secured for this mirDose. That the Act failed to secure its desired object can be illustrated by the figures for llford. Year Population No. of Houses in the Borough. No. assumed to be let at a rent No. of Applications for certificates. Revocation certificates applied for and granted Granted Refused 1954 182,700 51,975 10,395 47 6 8 1955 181,700 52,318 10,463 60 10 64 From these returns it can be assumed that the notices required to be served under the Housing Act and the Public Health Act have not been reduced very markedly. The figures would also indicate that either (a) the tenants of rented houses in llford are satisfied that the standard of fitness for habitation is reasonable—a proposition I adhere to. or (b) that the landlord is unable to increase the rent because he has not incurred the qualifying repairs expenditure or that the existing rent does not permit of a very great increase. 25 Slum Clearance. The Government empowered all local authorities to consider the housing condition in their respective districts and to furnish to the Ministry of Housing and Local Government approximate figures of those houses which they considered should be dealt with under the Housing Ac', 1936, as amended by the Housing Repairs and Rents Act, 1954. Ilford's slum clearance problem—never so great perhaps as that of many contiguous authorities —due no doubt to its reasoned supervision of housing conditions of its area, was nevertheless earnestly dealt with at once and figures submitted— after a rapid survey of the Borough—indicated that 291 houses would be dealt with by either Clearance Orders or Compulsory Purchase Orders during the ensuing five years. The Borough Council rested not on its laurels but implemented these proposals with public spirit by dealing with seven separate areas under the Housing Acts to such effect that it is anticipated that the five-year programme will be fully completed within schedule. Smoke Abatement. The Beaver Report on Air Pollution focused public attention on the problem of reducing this grave source of danger to public health. Many conferences have indicated the extent to the public concern in the matter with the result that the Government have laid before Parliament proposed legislation to control the pollution of the atmosphere, designated the "Clean Air Bill" and based on some of the proposals set out in the 1954 Report. Naturally, the Bill has been subjected to much opposition resulting in amendments and although the Bill has not yet been promulgated as a Statute it is felt that it will go some long way towards mitigating the more serious of the ' smoke nuisances.' One proposal in the Bill envisages the expansion of the powers of the Alkali Works Inspectorate at the expense of the Local Authorities as indicated in Clause 11. This quite naturally brought forth vehement protests from local authorities—who were already stripped of many of their functions to the advantage of central authorities—and from officers and their associations. One great feature of the publicity afforded this public health problem has been the willingness of the local authorities to deal with it from a scientific viewpoint; many of them—including llford—have set up atmospheric pollution measuring apparatus to determine the extent of the problem in both its content and its ultimate spread. It is proposed to set up three complete units in the Borough—one in the centre of the town, one at Gantshill and another in the New North Road district—all designed to ascertain the general extent of drift and effect of the greater London 'smog.' The results thus obtained when correlated with those of contiguous districts will provide a means of assessing more fully the best methods of dealing with the danger not only locally, but also generally. The legal power to deal with individual smoke nuisances may be increased by the Act if brought to fruition, that however remains as yet in the hands of our legislators." (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 llford 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. An additional amount of water is supplied to this area from Wanstead Well. 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. 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 3,030 samples of filtered water were submitted to chemical and bacteriological examination and 20 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. The length of mains laid by the Metropolitan Water Board in llford during 1955 was 94 yards of 4-inch. The water to the other part of the area is supplied by the South Essex Waterworks Co. The supply is obtained from the River Stour and from deep wells at Mill Road, Grove Road and Roding Lane. Mr. Hugh G. Ramsay, Engineer to the South Essex Waterworks Co., has kindly supplied me with the information that over 3,900 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, and were invariably satisfactory. Mains were extended by the Company as follows:— 14 yards of 12-inch. 203 yards of 6-inch, 312 yards of 4-inch and 230 yards of 3-inch. Owing to the hot weather of July and August it was necessary to obtain a supplementary supply from the Metropolitan Water Board. There are now no public wells in existence. There are a few private wells for domestic and commercial purposes. 8 samples of piped water supply (6 South Essex Waterworks Co. and 2 Metropolitan Water Board) were taken for Chemical and Bacteriological examination, and all gave satisfactory analyses. (ii) Swimming Baths and Pools.—Samples of water for examination were taken from the open air swimming bath from May to September (4). The samples were satisfactory, but in 2 cases the chlorine content was below the prescribed standard. Samples were also taken from the two indoor baths during January, March, April. May, June, August, September and December (13): all the samples were satisfactory. (iii) Drainage and Sewerage.—The Borough Engineer has kindly supplied me with the following: — " Main Drainage: llford Corporation Drainage Bill. Contracts to the value of approximately £439.000 were let during 1955, for the improvement of Soil and Surface Water Sewers and the culverting of watercourses. Drainage Act Works. Construction work on the Mayes Brook culverting and on the Goodmayes Park Balancing Lake were completed by December and authorisation was received from the Ministry for a short extension of the scheme along Eastern Avenue. Stage I of the Cran Brook Improvement (River Roding to Valentines Park Lake) was commenced in August, 1955 and should be completed during 1956. Works under Public Health Act, 1936. A contract for the new Roden Street Pumping Station was awarded on 28th November; demolition of the old baths and cottages and other site preparation works were completed. Good progress was made in the reconstruction of the Albert Road—Sunnyside Road sewers, the soil sewers of which receive the discharge from the Roden Street Pumping Station. The starting date for the Gordon Road soil sewer, one of the principal sewers to relieve flooding in Vicarage Lane, was agreed as 5th January, 1956. llford and Barking Joint Sewerage Scheme: Housing over Sumps. This project was proposed for the following major reasons:— (a) To provide adequate lifting facilities in order to avoid delay and inconvenience during breakdown on normal maintenance. (b) To ensure reasonable temperature level and reduce risk of freezing up of the screening plant and detritus grab machinery during cold weather. 27 (c) To reduce the risk of operatives being exposed to sewage spray via prevailing winds. (d) To reduce as far as possible sewage odours and insect nuisance at ground level and in the immediate neighbourhood of the Pumping Station. The estimated total cost of the work amounted to approximately £17,000. Improved Workshop and Messroom Accommodation. Designs for improvement and extension of Workshop and Messroom facilities were prepared, at an estimated cost of £21,193, subject to approval by the Ministry of Housing and Local Government. Electricity Supply to Pumping Station. All the main pumping units and equipment, approximately 2,000 b.h.p., are electrically driven, and sewage flow arriving at the Station has to be lifted 30ft. before it can be disposed of to the London County Council storm tanks and the river, there being no alternative method of dealing with this flow. In order to prevent breakdowns and obviate extensive flooding, and with a view to safeguarding the security of the Pumping Station, provision was made for a supply of 1,000 K.V.A. from the London Electricity Board, together with the attendant high tension and low tension switchgear and a 600 K.V.A. transformer. Flooding of Streams.— No serious flooding of streams occurred during the year. Pollution of Streams. Appreciable pollution of the Mayes Brook occurred. The pollution was principally caused from the works of two large firms in the Chadwell district, one through an accident in the works which permitted a large amount of oil to enter the surface water system. Investigations were instituted in an attempt to prevent further pollution." (iv) Collection and Disposal of Refuse.—The Borough Engineer also kindly supplied the following information:— Tons Total amount of refuse collected and disposed of Collection of Salvage: — 51,277 Tons Income Wastepaper 1,267½ £11,587 Rags and Scrap Metal 106 £1,063 (v) Sanitary Inspection of the Area.—The following is a summary of the work of the Sanitary Inspectors during the year:— Houses and premises inspected 32,532 Houses and premises reinspected (work in progress) 24,000 Visits during disinfection 510 Houses in which nuisances were detected 1,085 Houses in which nuisances were abated 1,134* Premises disinfected 265 Premises from which articles only disinfected 169 Articles disinfected 855 Premises disinfested for verminous conditions 31 * Includes 232 nuisances detected before 1st January, 1955. Notices served:— Served Complied with Statutory:— Public Health Act, 1936 146 90 Housing Act, 1936 — — Factories Act, 1937 2 — Shops Act, 1950 — — Provide Dustbin (llford Urban District Council Act, 1904) 39 22 Food and Drugs Act, 1938 7 5 Cleanse Water Storage Cistern (Byelaws) — — Cover Water Storage Cistern (Byelaws) — — Informal 1,185 982 1,379 1,099 28 In addition to the above, 303 notices (58 statutory and 245 informal) served previous to 1st January, 1955, were also complied with. Complaints.—During the year 3,200 complaints of nuisances were received and investigated. The following is a summary:— Accumulation of manure and refuse 25 Animals improperly kept 2 Bad smells 33 Dampness of premises 81 Defective drains, w.c.'s and fittings 413 Defective roofs, gutters, downpipes, etc. 136 Defective water fittings 39 Dirty and verminous houses 10 Dirty condition of rearway 7 Flooding of premises 28 Overcrowding 55 Smoke nuisances 110 Defective or no provision of dustbin 1,010 Rats and mice 652 Miscellaneous 599 Total 3,200 (vi) 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 126 inspections were made, 6 Preliminary Notices were served, 3 of which were complied with. One Certificate of Exemption from the provisions of Section 38 was granted in 1955. (vii) Eradication of Bed Bugs:— Houses found to be infested 31 „ Disinfested 31 (viii) Slaughter of Animals Acts, 1933 to 1954.—One licence to act as slaughterman was granted during the year. (ix) Rag, Flock and Other Filling Materials Act, 1951.—Registration has been granted in respect of 15 premises, where filling materials, as specified in the Act, are used. The occupier of registered premises may only obtain "rag flock" from premises licensed under the Act, either for the manufacture of rag flock or as a rag flock store. One licence was renewed in 1955 in respect of premises used as a rag flock store. (x) Atmospheric Pollution.—Complaints were received of alleged smoke nuisance from 12 factories in the llford Lane, Green Lane. Roding Lane, Grove Road and Newbury Park areas. Regular observations were maintained and investigations carried out. In 4 instances no emission was noted which would have enabled action to be taken under the Public Health Act, 1936, but 2 Statutory Notices and four informal notices were served in the other instances. The Government Committee on Air Pollution in its report recommended, amongst other matters, that steps should be taken to secure fuller and more frequent measurements of pollution and stated that local authorities could give most valuable service in this respect. The Council decided to provide three sets of apparatus each comprising a deposit gauge, a lead peroxide gauge and a combined volumetric for sulphur dioxide and smoke filter. Negotiations, in co-operation with the Department of Scientific and Industrial Research, as to suitable sites for installation of the apparatus, are in hand and it is hoped that the instruments will shortly be in operation. 29 The Essex County Council has decided to provide a laboratory service to carry out chemical examinations of samples from lead peroxide instruments and from deposit gauges, at a reasonable charge. (xi) Land charges Act, 1925.—During the year 3,780 enquiries were dealt with under this Act. (xii) Licence to Remove Human Remains.—A Home Office licence under Section 25 of the Burial Act, 1857, was issued for the removal of human remains of one person, from one grave to another in Barkingside Cemetery. All the necessary conditions were complied with. SECTION D.— HOUSING. (i) Overcrowding.— No notices were served during 1955. (ii) Clearance Areas.— Three areas were declared by the Council to be Clearance Areas, in 1955. (iii) HOUSING STATISTICS. 1. Inspection of dwelling-houses during the year: — (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1,970 (b) Number of inspections made for the purpose 16,831 (2) (a) Number of dwelling-houses (included under head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 — (b) Number of inspections made for the purpose — (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 14 (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 1,085 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 934* 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 — (2) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) By owners 1* (b) By local authority in default of owners — 30 B. Proceedings under Public Health Acts:— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 185 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: — (a) By owners 159* (b) By local authority in default of owners 6* c. Proceedings under Sections 11 and 13 of the Housing Act, 1936: — (1) Number of dwelling-houses demolished as a result of formal or informal procedure under Section 11 14 (2) Number of dwelling-houses closed in pursuance of an undertaking given by the owners under Section 11 and still in force — d. Proceedings under Section 12 of the Housing Act, 1936:— Number of separate tenements in respect of which Closing Orders were made — 4. Housing Act, 1936, Part IV—Overcrowding:— (a) (i) Number of dwellings overcrowded at the end of the year 194 (ii) Number of families dwelling therein 293 (iii) Number of persons dwelling therein 707½ (b) Number of new cases of overcrowding reported during the year 40 (c) (i) Number of cases of overcrowding relieved during the year 62 (ii) Number of units concerned in such cases 234 (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 1955 of Notices served prior to 1st January, 1955. HOUSING ACT. 1936. During the year 1955 the work of receiving applications, calling for calculations for the "permitted number" was continued with a view to the issue of housing certificates. 5 certificates, in respect of 12 houses, were issued during the year, making a total of 18,319 certificates, in respect of 25,129 houses, issued to the end of 1955. As new premises were constructed and placed upon the rating lists, "permitted number" certificates were issued as required. INCREASE OF RENT AND MORTGAGE INTEREST (RESTRICTIONS) ACTS, 1920 and 1933 AND HOUSING REPAIRS AND RENTS ACT, 1954. During 1955, 71 applications for Certificates of Disrepair were received. Of these, 60 were granted, 10 were refused and 1 was withdrawn. Applications for revocation of Certificates were received and granted in 64 cases. 81 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 Sterilized Milk) Regulations. 1949, the Food and Drugs Act, 1955, 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 llford, in which the compulsory use of special designations for retail sales of milk shall operate. (i) Milk and Dairies Regulations, 1949 to 1954.—Persons and premises registered as at 31st December, 1955:— Persons registered as distributors of milk 112 Premises registered as dairy premises (other than dairy farms) 13 207 inspections of dairy premises were carried out during the year. (ii) Milk (Special Designation) (Raw Milk) Regulations, 1949 to 1954:— The following licences were granted during 1955:— Tuberculin Tested 36 do. (Supplementary) 9 (iii) Milk (Special Designation) (Pasteurised and Sterilized Milk) Regulations, 1949 to 1953:— The following licences were granted during 1955:— Pasteurized (Dealer's) 64 do. do. (Supplementary) 10 do. (Pasteurizer's) 1 Sterilized (Dealer's) 85 do. do. (Supplementary) 13 do. (Sterilizer's) 1 One licence, granted by the Essex County Agricultural Executive Committee, in respect of the production of Tuberculin Tested milk at a farm in the Borough is 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. 32 The following results were obtained:— Grade of Milk Total Satisfactory Unsatisfactory Remarks on unsatisfactory results Tuberculin Tested (Pasteurized) Milk 27 27 — Tuberculin Tested Milk (Farm bottled) 18 17 1 The sample of milk produced at a farm outside the Borough failed to satisfy the Methylene Blue Reduction test. The County Agricultural Executive Committee was communicated with and further samples were taken. Pasteurized Milk 83 83 — — Sterilized 26 26 - - (v) Biological Tests.—18 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.—14 complaints of the presence of foreign bodies in milk were received and investigated. No legal proceedings were taken, but representations were made to the retailers in all cases. (viii) Registration.— No application for registration was refused during the year. 38 Ice Cream. (i) Registration. Section 158. Essex County Council Act, 1933. 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. 30 applications for registration in respect of 29 premises were considered during the year 1955. Registration was granted to 30 applicants in respect of the sale only of ice cream. (ii) Ice Cream (Heat Treatment Regulations) 1947 to 1952. 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 1955. 43 samples were submitted for examination with the following results:— No. of Samples Ministry of Health Provisional grade. % of Total Unsatisfactory Samples. 33 I 76.7 — 4 II 9.3 1 4 III 9.3 1 2 IV 4.7 2 43 1000 4 The unsatisfactory samples contained organisms of faecal origin. The Sanitary Inspector visited the manufacturer's premises to check the arrangements for manufacture, storage and sale. Further available samples proved satisfactory. The Food Standards (Ice Cream) Order 1953 prescribed standards for ice-cream. During 1955, 3 samples were submitted for chemical analysis, all of which complied with the Order. Meat and Other Foods. (i) Inspection and Supervision. The Council has made bye-laws under Section 15, Food and Drugs Act, 1938 for securing the observance of sanitary and cleanly conditions and practices in connection with the handling, wrapping and delivery of food sold or intended for sale for human consumption, and in connection with the sale or exposure for sale in the open air of food intended for humar consumption, 34 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 1955, they made 14,371 inspections of food shops and food preparing premises and copies of the bye-laws were supplied where necessary and the implications of them were made known to all persons concerned. 127 informal and 7 formal notices were served under the Food & Drugs Act, and 8 formal and 119 informal notices were complied with including 3 formal and 23 informal notices served prior to 1955. (ii) Food Hygiene. The following gives the numbers of food premises in the area by the type of business;— Cafes and Restaurants 129 Factory canteens 29 Butchers' shops 123 Grocers' shops 276 Fruiterers' and Greengrocers' shops 124 Fishmongers' and Fishfryers' shops 53 Bakehouses 25 Bakers' shops 53 Confectioners' shops 178 990 The practice of inculcating interest in the proprietors, directors and staffs of food handling organisations was continued in 1955, and it is satisfactory to note that the catering industry, as a whole, continues to cooperate admirably. Lectures and demonstrations with film strips and films were given to food handlers. Education in food hygiene has now been extended to the senior schools and to study groups of various local organisations. (iii) Sampling. The Council has delegated to the Public Health Committee power to institute legal proceedings under the Act. 257 samples (251 formal and 6 informal) were obtained during the year 1955; 5 formal and 2 informal samples were not satisfactory as follows: — (a) Gin (formal).—Contained only 64-6% proof spirit instead of 70% as stated on the label, and was also slightly below the standard of 65% proof spirit laid down under the Act. Letters of warning were sent to the licencee and to the brewers. (b) Portions of bread roll (informal).—One portion contained a small brownish-black foreign body and another portion showed a small circular area stained a brownish black colour. Both were due to caramelised glutinous starch matter. No action was taken in this case. (c) Orange Squash (formal).—Contained only 22% fruit juice instead of a minimum of 25% as required by the Food Standard (Soft Drinks) Order. A letter of warning was sent to the retailer, 85 (d) Rum and Butter Toffees (formal).—Contained a total fat content of 17.4% but the proportion of butter fat did not exceed 2%. The Analyst considered that not less than 4% butter fat should be present when the word "butter" is used without qualification as part of a description of sugar confectionery. In this case, however, the paper wrappings bore the inscription " Rum and Butter Flavour"— this description being in accord with the Ministry of Food's code of practice for butter-flavoured sweets containing less than 4% of butterfat. No action was taken in this case. (e) Gin (formal).—Contained only 67 8 proof spirit instead of 70% as stated on the label. A letter of warning was sent to the distillers. (J) Milk (informal).—Contained a small piece of greyish cardboard. No action was taken. (g) Gin (formal).—Contained only 68 7% proof spirit instead of 70% as stated on the label. Letters were sent to licensee and distillers. (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 6 persons (concerning 3 premises), during 1955. Registration was refused in two cases on account of unsatisfactory storage accommodation. (v) Registration of Premises used for the Preparation or Manufacture of Sausages, or Potted, Pressed, Pickled or Preserved Meat, Fish or other Food Intended for Sale. Section 80 of the llford Corporation Act, 1937, requires registration of such premises. 3 applications for registration were received, and granted, during 1955. (vi) Articles of Food Surrendered. During the year the following articles were surrendered and condemned as being unfit for the food of man:— Bacon, 219 lbs; Beverages, 2 tins, 3 bottles, 1½ lbs.; Biscuits, 61 pkts.; Bread, 6 loaves; Butter, 21 lbs.; Cake, 4 lbs.; Cereals, 218½ lbs., 45 pkts., 23 tins; Cheese, 200 lbs., 323 pkts.; Chocolate Spread, 51 lbs., 36 pkts.; Chicklettes, 6 dozen; Custard Powder, 2 drums; Cream, 36 tins; Confectionery, 60 lbs.; Eggs (Preserved) 44 lbs.; Egg Albumen, 2 lbs.; Fats, 2 pkts.; Fish (Wet and Dry), 115 stones; Fish (Tinned), 179 tins; Fish (Cakes), 25; Fish (Paste), 51 jars: Flour, 18 lbs.; Foods (Medical), 1 tin; Fruit (Tinned), 1.097 tins: Fruit (Bananas), 300 stems; Fruit (Bottled), 6 lbs.; Fruit (Dried), 562¾ lbs.; Fruit Juice, 44 tins; Jam, Preserves, etc., 102 tins. 21 lbs.; Jellies, 10; Meat (Fresh), 5,561¾ lbs.; Meat (Tinned), 2,797 lbs.: Meat (Pies), 270; Milk (Tinned), 544 tins; Nuts, 281 lbs.; Pastry & Pudding Mixtures, 34 lbs., 6 pkts.; Pickles. 12 jars; Poultry, 11 lbs.; Poultry (Tinned), 1 tin; Salt, 41 lbs.; Salad Cream. Sauces, etc., 13 bottles: Sausages, 3531 lbs.. 2 tins; Soups, 107 tins; Sugar, 3 lbs.; Tomatoes, 323 tins; Vegetables (Fresh). 11 lbs.; Vegetables (Dried), 25 lbs.; Vegetables (Tinned), 652 tins. (vii) Foreign Bodies in Food. 18 complaints were received during 1955 of the presence of foreign bodies in foodstuffs. All were investigated and legal proceedings were taken in one case. A fine of £10. plus £4 4s. costs, was imposed. Letters of warning were also sent in six other cases. 86 (viii) Food Poisoning. By virtue of Section 82 of the Ilford Corporation Act, 1937, food poisoning became compulsorily notifiable in Ilford as from 1st October, 1938. It is also notifiable under Section 17, Food and Drugs Act, 1938. Fifty notifications were received during the year. An outbreak occurred at Barley Lane School commencing early in July. The outbreak affected 40 persons, 36 children and 4 adults (the Head Teacher and her daughter, the welfare worker and the school secretary). The symptoms were common to all those affected, viz., abdominal pains, sickness and diarrhoea. All recovered quickly but many continued to return positive Salmonella typhi-murium organisms in faecal swabs, a few until late August. The investigation showed that the affected persons had partaken of sandwiches prepared by a class teacher made from bread and butter and mustard and cress, the latter grown in the classroom. The lint pads on which the cress had been grown were recovered and forwarded to the Public Health Laboratories at Colindale where Salmonella Typhi-murium was isolated from the lint pad and growing mustard and cress. It proved impossible to ascertain how the mustard and cress became infected, and it was not possible to procure further samples of seed from the original batch. Entirely unconnected with the above, four outbreaks occurred involving 27 persons, three being due to Salmonella typhi-murium and one to Staphylococci organisms. A further four outbreaks involving eight persons occurred but the cause was not discovered. There were also fifteen single cases the agent being identified in 6 instances as Salmonella typhi-murium. Sixteen other investigations of suspected outbreaks were also dealt with but no notifications were received. (ix) Bakehouses.—There are 25 bakehouses in the district, all of which use motive power, 506 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 11 instances, and the requests were complied with in all but two cases, where work was in progress. Diseases of Animals Act, 1950. (i) The Foot and Mouth Disease (Infected Areas) Special Orders Nos. 5, 7, 8 and 9, 1955.—These Orders restricted the movement of animals within the areas specified, which did not include llford. (ii) Swine Fever—Regulation of Movement of Swine Order, 1954. Regulation of Movement of Swine (Amendment) Order, 1955.—One licence was received for entry into the Borough of 6 pigs. They were satisfactorily isolated, as required by the Order. (iii) Swine Fever (Infected Districts) Order and (Amendment) Order, 1955.—These Orders were introduced as a result of the increase of Swine Fever in certain areas, the County of Essex being District No. 2. The Order prescribed rules regularising the sale, exhibition or gathering of swine in any market, fairground or saleyard, and controlled the movement of swine into, out of. and within, the districts under licence. During the period the restrictions were in operation licences were issued for the movement of 184 pigs out of the Borough and for entry into the Borough of 28 pigs. (iv) Swine Fever (Infected Districts) (Amendment) No. 2 Order, 1955.—This Order removed the County of Essex from the prescribed area. (v) Swine Fever (Infected Districts) Revocation) Order, 1955.— This Order ended the restrictions imposed. 37 (vi) Prohibition of Landing Swine from the Isle of Man Order, 1955.—This Order prohibits the landing in Great Britain of swine from Ihe Isle of Man, unless intended for slaughter. (vii) Prohibition of Landing Swine from Channel Islands (Revocation) Order, 1955.—This Order revoked the 1954 Order. (viii) Fowl Pest Order, 1936. The Live Poultry (Mid-Norfolk) Order, 1955, (Amendment) Order. 1955, and No. 2 Order, 1955. The Live Poultry (Mid-Norfolk) (Revocation) Order, 1955. The Live Poultry (Mid-Lancashire) Order, 1955, and (Amendment) Order, 1955. The Live Poultry (South Wales and South West England) Order, 1955. The Live Poultry (Essex) Order, 1955. Poultry Carcases (Landing) Order, 1955. These Orders deal with the requirements necessary to prevent the spread of fowl pest. During 1955, the Veterinary Inspector of the Ministry of Agriculture and Fisheries served notices declaring two premises in the Borough to be infected places. The necessary isolation precautions and disinfection were carried out. (ix) Importation of Hay and Straw Order, 1955.—This consolidation Order prohibits the landing in Great Britain of any hay or straw brought from countries other than those detailed in the Order. (x) The Tuberculosis (Argyll and Hebrides Eradication Area) Order. 1955. The Tuberculosis (North West England Eradication Area) Order, 1955. The Tuberculosis (Forth Eradication Area) Order, 1955. The Tuberculosis (Mid-Wales Eradication Area) Order, 1955. These Orders made by the Minister of Agriculture and Fisheries relate to the areas specified in the Schedules thereto declaring those areas, as respects which he is satisfied that a substantial majority of the cattle therein are free from any particular disease, to be an eradication area for purposes connected with the control of that disease and prohibiting or regulating the movement of cattle into, out of or within any such area. (xi) Animals (Landing from Channel Islands, Isle of Man. Northern Ireland and Republic of Ireland) Order, 1955.—This Order modified the conditions imposed by the 1933 Orders. (xii) Anthrax Order, 1938.—Notification was received of a suspected case of Anthrax. All necessary precautions were taken but the case was not confirmed. Prevention of Damage by Pests Act, 1949.—The Council has appointed a whole-time Rodent Operative, who commenced his duties on 1st January, 1951. Where infestation has been ascertained on inspection the services of the Rodent Operative are made available to secure effective disinfestation. 38 In the case of business premises these services are offered on a contractural basis, a practice which is greatly appreciated by most business firms. The following is a statement of the work carried out during 1955:— Type of Property Total Local Authority Dwelling Houses Agricultural All other (including Business and Industrial) I. Total No. of properties in District 215 52,318 29 5,021 5 7,53 1 II. No. of properties inspected as result:— (a) of notification 79 617 — 112 808 (b) survey under the Prevention of Damage by Pests Act, 1949 20 48 2 4 80 (c) otherwise — — — 833 833 III. Total No. of inspections and re-inspections carried out... 245 1,454 4 14,628 16,331 IV. No. of properties found to be infested by rats:— Major - - - - - Minor 44 235 2 23 334 V. No. of properties found to be infested by mice:— Major — — — — — Minor 28 137 — 63 228 VI. No. of infested properties (under III and IV) treated by the Local Authority 39 317 - 88 444 VII. No. of notices served under Section 4:— (1) Treatment - - - - - (2) Structural works (i.e., Proofing) — — — — - VIII. No. of cases in which default action was taken by Local Authority following issue of notice under Section 4 - - - - - IX. Legal proceedings — — — — X. No. of "block" control schemes carried out Nil 39 Petroleum (Consolidation) Act, 1928.—The Sanitary Inspectors made 1,473 visits to premises where petroleum is stored, or in conjunction with the installation of such storage, and the testing of petroleum appliances or fittings. The number of Licences issued was 139, and the fees paid to the Council for such Licences was £ 102 2s. 6d. 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 Chief Sanitary Inspector is designated as the officer responsible for the administration of the Act and he and his Deputy are authorised to inspect any premises in the Borough where licences are in force. Licences were granted in respect of 14 premises during 1955. 40 SECTION F. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASES. The following diseases are notifiable to the Medical Officer of Health: 1. Under Section 144 and 343, Public Health Act, 1936. Smallpox. Enteric fever (Typhoid and Paratyphoid). Cholera. Diphtheria. Relapsing Fever. Membranous Croup. Anthrax (made notifiable by the Local Authority as from 1/4/22). Erysipelas. Scarlatina or Scarlet Fever. Pemphigus Neonatorum (made notifiable by Local Authority as from 29/6/29) Typhus Fever. 2. Under Regulations of the Ministry of Health. Plague L.G.B. Order, 19/9/1900. Puerperal Pyrexia The Puerperal Pyrexia (Amendment) Regulations, 1954. Ophthalmia Neonatorum P.H. (Ophthalmia Neonatorum) Regulations, 1926. Acute Primary and Acute P.H. (Infectious Diseases) Regulations, 1953. Influenzal Pneumonia Dysentery Malaria Tuberculosis P.H. (Tuberculosis) Regulations, 1952. Acute Rheumatism (up to 16 years) The Acute Rheumatism Regulations, 1953. Measles and Whooping Cough The Measles and Whooping Cough Regulations, 1940. Acute Poliomyelitis P.H. (Acute Poliomyelitis, Acute Encephalitis and Meningococcal Infection) Regulations, 1949. Acute Encephalitis Meningococcal Infection 3. By Local Act. Food Poisoning llford 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 llford residents from the following infectious diseases during 1954 and 1955 were as follows: — 1954 1955 Scarlet Fever — — Enteric Fever — — Diphtheria — — Acute Poliomyelitis 1 1 Measles — 1 Whooping Cough — — Influenza 8 11 Tuberculosis—Pulmonary 26 19 Other forms 1 1 Pneumonia (all forms) 77 83 Diarrhoea (under 2 years) 1 — Meningococcal Infections — — Totals 114 116 41 TABLE III.— Corrected Notifications of Infectious Diseases for the Year 1955 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 136 - 24 108 3 1 - - 10 3 2 6 7 6 25 19 9 10 32 26 - Diphtheria, including Membranous Croup - - - - - - - - - - - - - - - - - - - - - - Enteric Fever (Typhoid and Para-Typhoid) 1 - - - - - 1 - - - - - 1 - - - - - - - 1 - Pneumonia 139 7 6 9 10 27 48 32 10 11 6 11 1 10 23 10 14 11 13 9 47 83 Puerperal Pyrexia 64 — — — 24 40 — — - 1 - - - - - - - 63 - - 63 - Acute Poliomyelitis 25 2 2 12 4 5 — — 1 2 2 1 3 5 3 9! 2 2 - 2, 25 1 Acute-Encephalitis 3 — 2 1 — — — — - - - 1 1 - - - - - - 1 3 1 Meningoccocal Infection — — — — — — — — — - - - - - - - - - - - - - Dysentery 36 1 11 3 3 6 6 6 7 4 - 1 - - 9 5 9 1 - - 20 1 Ophthalmia Neonatorum — — — — — — — — - - - - - - - - - - - - - - Erysipelas 18 — — — — 1 12 5 2 1 1 1 - 1 - 9, 5 - - 3 2 - Pemphigus Neonatorum — — — — — — — — — - - - - - - - - - - - - - Tuberculosis Pulmonary 123 1 1 8 27 44 34 8 7 8 8 11 12 11 10 13 11 7 10 15 91 19 Other Forms 15 — — 1 2 8 4 — 3 2 - - - - 4 1 3 - 2 2 1 Anthrax — — - - - - - - - - - - - - - - - - - - - - Malaria—Believed contracted in this country - - - - - - - - - - - - - - - - - - - - - - Believed contracted abroad - - - - - - - - - - - - - - - - - - - - - - Acute Rheumatism 12 — 1 10 1 — — — 1 — 1 2 - - 1 2 4 - - 1 11 - Measles 2,961 63 1,295 1,589 8 6 — — 283 84 135 185 204 261 257 448 396 281 96 331 127 1 Whooping Cough 518 44 200 266 1 7 — — 82 23 9 22 14 69 64 79 61 64 20 11 22, - Food Poisoning 50 1 5 25 4 9 6 — 3 1 1 - 3 3 2 3 8 2 4 20 4 - Typhus Fever - - - - - - - - - - - - - - - - - - - - - - Totals 4,101 119 1,547 2.032 87 154 111 51 409 140 165 241 256 366 398 583 518 443 155 427 444 107 * Included in the figures in these columns are cases notified in previous years as well as 1955. 42 The year 1955 showed a greater incidence of infectious disease, especially in the number of cases of measles. No fewer than 2,961 case^ were notified as compared with 963 in the previous year. The number of cases of whooping cough also increased over the previous year—518 as against 271. (a) Smallpox.—No cases were notified during 1955. The following gives particulars as to vaccination during 1955:— Primary vaccination 1,376 Re-vaccination 398 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.—136 cases occurred in 1955. There were no deaths from this disease. Only 26 cases were admitted to hospital, the remainder being nursed at home. (c) Diphtheria.—No cases occurred in 1955. This is the fourth successive year in which it has been possible to record a clean " bill of health " for this disease in llford. (d) Ophthalmia Neonatorum.—No cases occurred in 1955. The following figures show the number of cases of Ophthalmia Neonatorum notified during the past five years: 1951, 3; 1952, nil; 1953, nil: 1954, nil; 1955, nil. It is to be remembered that many cases of ophthalmia neonatorum are not due to gonococcal infection. (e) Enteric Fever.—One case was reported during 1955. This occurred in a male of 48 years who had visited a seaside town with a firm's outing. The organism discovered in the case was one of Para-typhoid "B." (f) Acute Poliomyelitis. Twenty-five cases of this disease were notified during the year. They were males of 4, 5, 5. 8, 8, 10, 11, 12, 18. 22, 24, 32, and 36 years, and females of 6 months, 8 months, 2¾, 5, 5, 7, 7, 12, 20, 27, 34. and 34 years. All the patients were removed to hospital. In addition to the foregoing cases a male child, aged 3 years, died in King George Hospital two days after admission. In the first place the death was certified, following a post mortem, as being due to Encephalitis, but further investigations proved that the cause of death was poliomyelitis. It was necessary to exclude two persons from their usual occupation who had been in direct contact with cases of poliomyelitis. Compensation was paid for loss of wages to the two persons concerned. (g) Acute Encephalitis. Three cases of this disease occurred. They were a male child 6 years, and two females of 3¾ and 4 years. All were removed to hospital. The female child of four years died three months after admission from meningo encephalitis. (h) Meningococcal Infection. No cases of this disease occurred during 1955. (i) Pneumonia—Influenzal and Primary. The number of cases which occurred during 1955 was 139 as compared with 148 during 1954. (j) Tuberculosis. During 1955 there were 123 new notifications of Pulmonary Tuberculosis and 15 of other forms of Tuberculosis. In addition 28 pulmonary and 4 non-pulmonary cases were transferred to the district. There has been little variation in the population of llford during the past five years yet there has been a dccline in the number of notifications as shown by the following figures:— Year Population No. of Persons added to list (all forms) Deaths (all forms) 1951 181,600 260 41 1952 182,200 188 21 1953 181,200 190 28 1954 182,700 207 27 1955 181,700 170 20 48 Notifications and Deaths from Tuberculosis of llford residents during 1955:— Age Periods New Cases Deaths Respiratory Non- Respiratory Respiratory NonRespiratory M F M F M F M F Under 1 year — 1 - - - - - - 1-5 years 1 — — — — — — — 5-15 4 4 — 1 - - - - 15-25 7 20 — 2 - 1 - - 25-35 13 14 - 2 - - - - 35-45 11 6 3 3 2 2 - - 45—55 13 3 - 1 3 - 1 - 55-65 18 - 1 2 4 - - - Over 65 3 5 — — 5 2 — — Totals 70 53 4 11 14 5 1 — Of the foregoing new cases, the following were notified from Institutions in the district:— Respiratory Tuberculosis NonRespiratory Tuberculosis King George Hospital 1 1 Claybury Hospital 7 1 Goodmayes Hospital 2 — llford Isolation Hospital 7 1 Dr. Barnardo's Village Homes 1 1 Of the 20 deaths which occurred of llford residents, notification had previously been made of 16 of the cases. In, the remaining four cases the cause of death was only discovered as a result of post-mortem. Pulmonary Non- Pulmonary Total Number of cases on register, 1st January. 1955 1,295 158 1,453 Number of cases entered on the register during the year 151 19 170 Number of cases removed from the register during the year Pul. NonPul. Recovered 24 6 Deceased 26 — Left District 95 12 " Lost sight of 1 — Diagnosis not established 5 3 151 21 172 Number of cases remaining on register on 31st December. 1955 1.295 156 1.451 The treatment of Tuberculosis is now under the control of the Regional Hospital Board. On the 31st December. 1955. there were 1,152 patients on the register of the llford Clinic. The number of patients from llford sent to Institutions under the Regional Hospital Board Tuberculosis Scheme during 1955 was as follows: Pulmonary Non-Pulmonary Total Males Females Males Females Adults 54 35 — 2 01 Children 2 — — — 2 44 Tuberculosis Care Association.— This Association has assisted 77 cases with extra nourishment, clothing, and in other ways. (k) 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 llford:— Romford.— The Annexe, Oldchurch Hospital, Waterloo Road, Romford:— Males Females Consultations: Monday and Tuesday 4 p.m. to 6.30 p.m. Monday and Tuesday 4 p.m. 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.l:— 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 9 a.m. to 7 p.m. Saturday 7 a.m. to 3 p.m. Saturday 9 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. Albert Dock Seamen's Hospital, Alnwick Road, London, E.16. Males Females Consultations: Monday, Wednesday and Friday 2 to 4.30 p.m. No female clinic. Treatments: Monday to Friday 9.30 a.m. to 5 p.m. Saturday 9.30 a.m. to 12 noon. 45 Publicity and Propaganda, Etc. Public lectures to Ratepayers' Associations, Evening Institutes and Church organisations, etc., on health topics were given during the year. The Chairman of the Public Health Committee also made reference at a number of Council meetings to health subjects. Poster displays regarding Diphtheria immunisation and health topics were also given prominence. Examination of Officers and Servants. The following medical examinations were carried out during 1955:— Officers Servants New Appointments 69 86 Under Sickness Regulations 3 19 On behalf of other Authorities 2 — Totals 74 105 In addition numerous enquiries were made of General Practitioners and Hospitals in respect of 23 cases, referred under Sickness Regulations, which were not subsequently medically examined at the Public Health Offices. 46 SECTION G— FACTORIES. The Factory and Workshop Act, 1901, was superseded by the Factories Act, 1937, which came into operation on 1st July, 1938. There are 412 factories with mechanical power on the register. There are 162 factories without mechanical power on the register. There are 278 outworkers on the register. 1.—INSPECTION OF FACTORIES AND OTHER PREMISES. Including Inspections made by Sanitary Inspectors. Premises (1) Number of Inspections (2) Written Notices (3) Occupiers prosecuted (4) Factories with Mechanical Power 1,941 11 - Factories without Mechanical Power 202 1 - Other premises (not including Outworkers' premises) 51 — — Total 2,194 12 — 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) 10 8 — — Overcrowding (S.2) — — — — Unreasonable Temperature (S3) - - - — Inadequate Ventilation (S.4) - — — — Ineffective Drainage of Floors (S.6) - - - -. Sanitary Conveniences (S.7):— Insufficient 4 4 - — Unsuitable or Defective 5 6 — — Not Separate for Sexes — — — — Other Offences — — — — Total 19 18 — — 4t 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 llford under this Act during 1955 was 1,635 (820 males and 815 females), of which there were 123 (60 males and 63 females) where the ordinary place of residence of the parents was outside llford. In addition 608 notifications of live births (325 males and 283 females) which took place outside the district, although the ordinary residence of the parents was in llford, 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. There were also 42 stillbirths (19 males and 23 females) notified in llford including 5 (2 males and 3 females) where the home address of the parents was outside the district, and notifications of 15 stillbirths (8 males and 7 females) which took place outside the district, although the ordinary residence of the parents was in llford, were transferred to this district. This represents a total of 52 where the home address was in llford, whereas the Registrar-General has allocated 49 stillbirths to llford. The following table shows the causes of the 52 stillbirths notified where the usual residence of the parents was in llford: — Stillbirths, 1955 Cause of Stillbirth Delivery in Nursing Home Delivery by County Council Midwife at Home Delivery in Hospital Total Anencephalic - 2 2 Ante-Partum Haemorrhage - 2 4 6 Atelectasis and Asphyxia - — 8 9 Hydrocephalus - — 2 2 Hypertension - — 5 5 Intrauterine death—Toxaemia - — 2 2 Loop cord round neck - — 2 2 Macerated Foetus - 1 - 1 Multiple Abnormalities - — 1 1 Placental insufficiency - — 0 6 Post Maturity - — 1 1 Prematurity - — 4 4 Unknown - 5 6 11 Totals - 8 41 52 48 Care of Premature Infants.— Of the 1,635 live births occurring in Ilford during 1955, 81 weighed 5½lbs. or less at birth; 18 of these babies were born on the district and 63 in Hospital (including 5 where the home address of the parents was outside Ilford). Of the 18 babies born at home: — 14 were nursed entirely at home; 4 were transferred to hospital; 15 survived at the end of one month; 3 died between the ages of one day and one month. Of the 63 babies born in hospital:— 5 died during the first 24 hours; 6 died between the ages of one day and one month; 52 survived at the end of one month (including 5 where the home address was outside Ilford). In addition 31 notifications were received of births outside the district where the ordinary residence of the parents was in Ilford and the weight of the infant at birth was 5½ lb. or less. Of these there were:— 2 who died within the first 24 hours (in hospital); 2 who died between the ages of one day and one month (both in hospital); 27 who survived at the end of one month. Infant Mortality.—The number of infants dying within the first year of life was 42, the total number born being 2,100. 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 0. The following table gives the deaths of infants under one year of age. classified according to age: — Infant Deaths—1955. Cause of Death Under 1 week 1 2 weeks 2 3 weeks 3—4 weeks Total under 4 weeks 1—3 months 3—6 months 6—9 months 9 12 months Total Acute Tracheo-Bronchitis - - - - - - 1 - - 1 Asphyxia 2 - - — 2 - - — 1 Atelectasis 7 - - — 7 - - — - 7 Broncho Pneumonia 2 - - — 2 1 - 3 - Cardiac Failure 1 - - - 1 - - - 1 Cerebral Haemorrhage 1 - - — 1 - - — - 1 Cerebral Compression 1 - - — 1 - - — - 1 Chronic Pancreatitis - - - - - - - - 1 1 Congenital Atresia of Oesophagus 1 - - - 1 - - - - 1 Congenital Heart Disease — - - — — 1 - — - 1 Convulsions — - - — — - 1 — - 1 Erythroblastosis Foetalis 1 - - — 1 - - — - 1 Haemolytic disease of newborn 3 - - - 3 - - - - 3 Hydrocephalus - - - - - 1 - - - 1 Intracranial Haemorrhag 1 - - - 1 - - - - 1 Leukaemia - - - - - - - 1 - 1 Multiple Abnormalities 2 - - — 2 - - — 1 3 Non Viable Foetus 3 - - - 3 - - - - 3 Prematurity 5 — — — 5 — — — — 5 Totals 30 — — — 80 3 2 4 3 42 49 The comparative figures for the past 10 years are as follows:— Year No. of Deaths under 1 year Rate per 1,000 Registered Live Births 1955 42 200 1954 41 18.7 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 The mean average Infant Mortality rate for the past 10 years is therefore 21.3 per 1,000 live births. The following table shows the comparison for Ilford, England and Wales and London for the past 10 years:— Year Ilford England and Wales London 1955 20.0 25 23 1954 18.7 25 21 1953 20.2 27 25 1952 18.9 28 24 1951 21.0 30 26 1950 18.7 30 26 1949 20.1 32 29 1948 21.7 34 39 1947 24.3 41 47 1946 29.6 43 41 Neonatal Mortality.—The death-rate of infants under four weeks of age is known as the Neonatal Mortality. There were 30 deaths of infants under four weeks of age during 1955 and the rate for the year was 14 3 per 1,000 live births. The figures for the past 10 years are as follows:— Year Number Rate 1955 30 14.3 1954 29 13.2 1953 34 15.2 1952 32 13.8 1951 40 16.8 1950 32 13.3 1949 33 12.5 1948 37 12.9 1947 51 15. 1946 74 21.5 50 Illegitimate Births and Deaths.—55 of the live births registered (35 males and 20 females) were illegitimate, that is 2 6% of the births registered. Two illegitimate children (both males) 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 1955 2,015 97.4 40 19.6 55 2.6 2 36.4 1954 2,145 97.8 40 18.6 48 2.2 1 28.8 1958 2,164 97.0 43 19.9 67 3.0 2 29.9 1952 2,232 96.1 44 19.7 91 3.9 — - 1951 2,306 97.1 49 21.2 70 2.9 1 14.3 1950 2,332 96.9 41 17.6 74 3.1 4 54.0 1949 2,567 97.6 51 19.9 63 2.4 2 31.7 1948 2,757 96.8 58 21.0 91 3.2 4 43.9 1947 3,258 96.7 78 23.9 110 3.3 4 36.4 1946 3,336 96.9 97 29.1 107 3.1 5 46.7 The Chelmsford Diocesan Moral Welfare Association continued in 1955 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 two trainees were allocated to Ilford for practical instruction during 1955. Four trainees, on completing the course in 1955 and passing the examination for the Health Visitors' Certificate of the Royal Institute of Public Health, were appointed as Health Visitors and School Nurses here. At the end of the year there were 13 full-time qualified Health Visitors and School Nurses in addition to the Superintendent Health Visitor, and 5 Clinic Nurses. Although this shows an increase from the beginning of the year, the health visiting saff is still 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 1955 as far as the Maternity and Child Welfare work is concerned: — First visits to newly-born infants 2,203 Subsequent visits to children under 1 year of age 4.120 Subsequent visits to children over 1 year of age and under 5 10.189 Visits to expectant mothers 534 Home visits for other reasons 824 Tatol visit paid 17,870 51 In addition there were 4,070 visits paid where no reply was received. On an afternoon in May, 1955, as in the previous year, arrangements were made for the Health Visitors to meet the local General Practitioners at the Town Hall, Ilford. with a view to increasing the degree of cooperation between the Department and the Doctors. Day Nurseries. (a) The hours of opening at the three Nurseries during 1955 continued to be 7.30 a.m. to 6 p.m., Monday to Friday only. (b) The standard charge for accommodation at the Day Nurseries continued during 1955 to be 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. The charge was. however, increased to 8/6 per child per day as from the 2nd January, 1956. The marked decrease in the daily attendances at the Nurseries noted in the last two years has continued to be evident and accommodation has continued to be made available to neighbouring Areas for children who can more conveniently attend an Ilford Nursery than one in their own Area, particularly those residing on the Hainault (L.C.C.) Estate. (c) Sunshine House Nursery.—In view of the continuing low attendances at the Nurseries, approval was given by the County Council to close this Nursery on the 18th May, 1956, the children being transferred to the remaining two Nurseries. (d) Stevens Road Day Nursery.—As reported last year, the premises occupied by this Day Nursery, until July, 1953, were transferred to the Ilford Committee for Education, as from the 1st March, 1955, for use as a Cerebral Palsy Unit which opened on the 2nd May, 1955. (e) The training of Students at the Nurseries for the Certificate of the National Nursery Examination Board continued. Seven Students (three from the Ley Street Nursery, two from the Sunshine House Nursery and two from the Goodmayes Lane Nursery) entered for the examination during the year, six of whom obtained the Certificate. The arrangements 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 also continued; this enables them to pursue their studies in general subjects and so improve their general educational standard during this pre-nursery course period. Two students (one from the Ley Street Nursery and one from the Goodmayes Lane Nursery) attended such a course at the St. George's Day Release Centre, Dagenham. in 1955, 52 (f) The following is a table showing the attendances, etc., at the Day Nurseries during 1955:— Situation Date of Opening Accommodation (Children) Average Daily Attendance during 1955 No. of Days in Quarantine Reasons for Quarantine with Number of Cases No. on Waiting List at 31st Dec. Chicken Pox Whooping Cough Measles Sunshine House, Girls' Village Homes, Barkingside 17.8.42 45 27 76 1 2 24 - Goodmayes Lane, Goodmayes (Replaced Green Lane Nursery, open from 5.5.43 to 9.11.51) 14.11.51 50 29 44 — — 23 2 226-236, Ley Street, Ilford 16.8.43 50 27 60 13 1 14 2 53 Nurseries and Child-minders Regulation Act, 1948.—This Act, which came into operation in August, 1948, requires, inter alia, that every local health authority shall keep registers— (a) of premises in their area, other than premises wholly or mainly used as private dwellings, where children are received to be looked after for the day or a substantial part thereof or for any longer period not exceeding six days; (b) of persons in their area who for reward receive into their homes children under the age of five to be looked after as aforesaid. The following shows the position regarding registrations under the Act:— (a) (b) Premises Child-minders Number on register at 31/12/54 4 3 Number registered during 1955 1 1 Number removed from register during 1955 — 1 Number on register at 31/12/55 5 3 Number of children provided for at 31/12/55 121 27 The child-minder whose name was removed from the register during the year cancelled her registration on leaving the district. Clinic Premises. Health Services Clinics, Kenwood Gardens and Heathcote Avenue (Couchmore Avenue area).—Although the Minister of Health has given his formal approval to the erection of these two Clinics on parts of the sites reserved for health centres, he is not at present prepared to give loan sanction, in view of the restriction of Local Government expenditure. In the meantime, the County Architect has been asked to ensure that, so far as is possible, plans and other detailed work are completed to enable the projects to proceed upon the lifting of the embargo. 64 Infant Welfare Centres.—98 voluntary lady helpers were engaged in the work at the Infant Welfare Centres at the end of December, 1955. During the year the following attendances were recorded:— Total number of attendances of infants 36,196 First attendances 1,855 Attendances of Children from 1 to 5 years 11,401 Total number of children on roll, December 31st, after omission of all those who had not attended for six months 3,687 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 1955 36,196 1,855 3,687 1954 38,392 1,858 3,565 1958 39,294 1,924 3,629 1962 42,033 1,947 8,701 1961 44,419 1,998 4.887 718 sessions were held during the year, the average attendance at each session being 50 mothers with their infants. The following are the figures for each Centre:— Sessions Average Attendance Barkingside 48 53 Chadwell 48 51 Becontree 48 56 Downshall 48 57 Manford Way 48 40 Woodford Avenue 48 74 Seven Kings 48 61 Cecil Hall (Wednesdays) 48 40 Cecil Hall (Thursdays) 47 44 Newbury Hall 48 37 Goodmayes 48 39 Grosvenor Road 48 59 Ilford Lane 48 46 Valentines 48 51 Fairlop 47 47 55 Orthopaedic Clinic. The following table summarises the attendances of children under 5 years:— Clinic Sessions New Cases Old Cases Attendances Newbury Hall 40 62 81 232 Mayesbrook 22 36 44 133 Manford Way 9 15 18 51 Totals 71 113 143 416 The 256 children were found by the Orthopaedic Surgeon to have the following defects:— Diagnosis New Cases Old Cases A B C A B C Paralysis:— Cerebral Palsy - - - - - - A.P.M. - — — 2 — — Deformity of hips 4 — — 1 2 — Genu valgum 30 19 6 29 22 8 Pes valgo-planus 5 1 1 15 4 3 Valgus ankles 3 4 — 1 8 1 Talipes calc. valgus — — — 1 — — Congenital talipes E.V. — 1 — — 1 1 Intoeing 4 2 2 2 1 1 Deformity of toes 1 4 1 4 2 1 Slack posture — — — — 1 — N.A.D 1 — 1 2 1 1 Other conditions 7 3 2 10 3 1 Torticollis - - 1 1 — - Metatarsal varus 5 1 — 5 1 Out. Curvature Tibiae 2 __ 8 2 Genu varum — 1 1 5 1 1 Totals 62 36 15 81 44 18 A—Newbury Hall. B—Mayesbrook. C.—Manford Way. 21 pairs of Valgus Insoles, 2 pairs surgical shoes, 1 Metatarsal bar and toe spring, 17 G.V. night splints, 68 wedges to shoes and 1 caliper and leg instrument were supplied during 1955. 1 repair to caliper and surgical shoes was also carried out. The Physiotherapist treated 58 children under 5 at Newbury Hall, 54 at Mayesbrook Clinic, 16 at Manford Way with attendances of 142, 140, 362, respectively. Paediatric Clinic.— Dr. A. Russell, the Consultant Paediatrician, continued to attend the Clinic at Valentines Mansion. 29 sessions were held and 128 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 309 attendances were made, 56 Diagnosis Discharged Improved Discharged with Advice or for Other Reasons Discharged no Treatment Discharged Cured Referred to Hospital, Dr. or Clinic Still attending Total Abnormal Suture Patency - 1 1 - - - 2 Acrocyanosis - 1 - - - - 1 Albino - - - - - 1 1 Anaemia - 4 - - - 2 6 Anxiety - 1 - - - — 1 Bronchial Catarrh - - - - - 1 1 Bruising - 1 - - - — 1 Cardio-Oesophageal Reflux - — - - - 1 1 Cardiac Murmur - — - - - 1 1 Cephalhaematoma - — 2 - - — 2 Congenital Abnormality of Skull - - - - - 1 1 Congenital Dislocation of Hips - - - - - 1 1 Congenital Heart Disease - 1 — - 1 — 2 Encopresis - — — - 1 — 1 Enuresis - 1 — - - — 1 Facial Asymmetry - — — - 1 1 2 Feeding Difficulty - 2 2 - 1 1 6 Fractured Clavicle 1 — — - - — 1 Fractured Skull, Cephalhaematoma - - - - - 1 1 Gastro-Duodenitis - — 1 - - — 1 Glycosuria - — — - 1 — 1 Haemalytic Anaemia of Newborn - - - - - 1 1 Hydrocele - 1 — - - — 1 Hyperostosis Corticalis Infantis - - - - 1 - 1 Hypospadias - — 2 - 2 1 5 Idiopathic Epilepsy - — — - — 2 2 Inguinal Hernia - — — - 1 — 1 Meningocele - — — - 1 — 1 Naevus - — 1 - — 1 2 Neonatal Breast Abscess - 1 — - — — 1 Nil Abnormal Detected 2 3 6 2 1 4 18 Obesity — 1 — — 3 4 8 Phimosis — — — — 1 — 1 Pigmentation — — — — — 1 1 Pilonidal Sinus — — — — — 1 1 Poor Circulation — — 1 — — 1 2 Prematurity 2 4 10 1 — 5 22 Prolapsed Rectum - - - - - 1 1 Ranula — — — — — 1 1 Recurrent Upper Respiratory Infection - - - - - 1 1 Rheumatoid Spondylitis — — — — 1 — 1 Sacrococcygeal Dimple - - - - - 1 1 Subcutaneous Fat Necrosis — — 1 — — — 1 Talipes — 1 — — 3 — 4 Umbilical Fibrolipoma — — 1 — — — 1 Umbilical Hernia — 1 — — 3 1 5 Unknown — 1 — — 3 — 4 Unresolved Pneumonia 1 1 — — 1 — 3 Vaginal Bleeding — — 1 — — — 1 Wart of Scalp - - - - - 1 1 6 20 29 3 20 38 128 57 Ophthalmic Clinics.— Attendances of children under school age for treatment by the Oculist during 1955 were as follows: — Valentines Mansion Mayesbrook Clinic Manford Way Clinic Total Number of children who attended 86 47 13 146 Number of pairs of spectacles prescribed 20 15 5 40 Total number of attendances made 140 90 19 249 Ear, Nose and Throat Clinic—The E.N.T. Surgeon attended at 47 sessions during 1955 and 45 attendances were made by 27 children of preschool age. 1 child was operated upon for removal of tonsils and adenoids at King George Hospital, Ilford. Rheumatism Clinic.—31 sessions were held during the year at Newbury Hall, at which 23 children under 5 years of age, 16 being new cases, made 23 attendances. The following is a summary of the cases treated:— Condition New Old Total Congenital heart disease - 1 1 No active rheumatic disease 1 — 1 Functional heart murmur 3 2 5 Other forms 12 4 10 Totals 16 7 23 Number of cases referred for X-ray and Electrocardiograph 5 Artificial Sunlight Clinic.— The following table summarises the attendances of children under 5 years:— Clinic Sessions New Cases Old Cases Attendances Discharged Cured Much Improved Left District etc. Newbury Hall 47 32 8 449 13 1 5 Mayesbrook 46 9 7 198 12 - 2 Totals 93 41 15 647 25 1 7 The conditions treated were as follows:— Conditions Cases A B Anaemia, Debilitv, Malnutrition and Catarrh 17 10 Wide Fontanelle 4 Bronchitis 7 1 Other conditions 12 5 Totals 40 16 A.—Newbury Hall. B.—Mayesbrook. 58 Speech Clinic.—27 children of pre-school age attended, making 399 attendances. The following is the classification of the defects found by the speech therapist:— Dyslalia 16 Stammering 3 Dyslalia and Stammer 1 Cleft Palate 1 Retarded Speech and Dysarthria 2 Language 2 Alalia 1 Aphasia 1 Diphtheria Immunisation.— During 1955 a total number of 1,514 children attended at the Diphtheria Prevention Clinics (932 at Valentines Clinic, 460 at Mayesbrook and 122 at Manford Way) making a total number of attendances of 4,706 (2,695, 1,570 and 441) with an average per session of 53. 30 and 9 respectively. The following table shows the figures over the past five years. No. of primary inoculations:— 1951 1952 1953 1954 1955 At Clinics 794 793 594 515 398 By General Practitioners 1,007 1,263 1,425 1,341 1,324* Totals 1,801 2,056 2,019 1,856 1,722 No. of re-inoculations:— At Clinics 1,473 1,198 918 772 437 By General Practitioners 541 1,025 918 1,112 808t Totals 2,014 2,223 1,836 1,884 1,245 No. of live births in Ilford 2,376 2,323 2,231 2,193 2,100 * Includes 543 combined Diphtheria and Whooping Cough inoculations, † Includes 127 combined Diphtheria and Whooping Cough inoculations. Whooping Cough Immunisation. 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) Reinoculations (one only) Attendances Inoculations (full course) Reinoculations (one only) Attendances Inoculations (full course) Reinoculations (one only) Attendances Inoculations (full course) Reinoculations (one only) Children under 5 years of age 130 - 417 80 - 283 34 - 108 452 11 Children 5 years of age and over 7 - 11 1 - 3 - - - 45 27 Totals 137 - 428 81 - 286 31 - 108 497 38 * For comparison, as it is not the policy of the County Council to use a combined diphtheria/pertussis vaccine, 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 543 Re-inoculations 127 58 Owing to the prevalence of poliomyelitis, whooping cough immunisation was suspended from the 4th August until the beginning of December, 1955. Vaccination.—During 1955 record cards were received from general practitioners and various hospitals as follows:— Ages up to 14— No. of children primarily vaccinated 1,209 No. of children revaccinated 49 Ages 15 and over— No. of adults primarily vaccinated 174 No. of adults revaccinated 349 The following table shows the figures over the past five years:— 1951 1952 1953 1954 1955 No. of primary vaccinations 1,583 1,428 1,439 1,359 1,383 No. of revaccinations 771 435 469 465 398 Totals 2,354 1,863 1,908 1,824 1,781 No. of live births in Ilford 2,376 2,323 2,231 2,193 2,100 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 1955, 12 sessions were held. 42 expectant and nursing mothers were referred from either the ante-natal or post-natal clinics, and with 21 old cases made a total of 89 attendances. The following is a summary of the new cases examined by Dr. K. Playfair:— Condition PostNatal AnteNatal Anaemia 1 — Congenital Cardiac lesion - 2 Functional Cardiac disorder 1 - No lesion 2 27 Still being investigated - 5 Valvular disease of the heart - 4 4 38 12 of these patients were referred to Queen Mary's Hospital for X-ray and/or electrocardiograph. Midmives.— There were 13 State certified midwives (including the Superintendent, Deputy Superintendent, 8 domiciliary midwives and 2 parttime midwives employed by the County Council), resident and practising in the district at the end of the year. In addition there were 23 State certified midwives at the Ilford Maternity Hospital. 60 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 2 instances where the infant was found to have inflamed or discharging eyes. The condition of the eyes cleared satisfactorily. Domiciliary Midwifery Service.—At the end of the year there were 8 Domiciliary Midwives employed by the County Council whole-time and 2 part-time, in addition to the Superintendent and Deputy Superintendent. During the year 492 cases were attended. In 437 cases the midwives were engaged to attend as midwives and in 55 cases as maternity nurses. A Doctor was called in to 73 of the 437 cases in which a midwife had been engaged. Of the infants born there were 7 stillbirths. In all of these cases the midwife was engaged as a midwife. There were 6 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 40 infants attended by them during 1955. During 1955 Ante-Natal Clinics conducted by the Domiciliary Midwives were held weekly at Valentines Mansion and fortnightly at Mayesbrook Clinic and Manford Way Clinic. The following is a summary of the attendances at these Clinics during the year:— Valentines Clinic Mayesbrook Clinic Manford Way Clinic First attendances 304 100 89 Subsequent attendances 750 289 256 Totals 1,054 389 345 Number of sessions 48 22 26 Average attendance at each session 22 18 13 In addition 2,245 home ante-natal visits were made during the year. The scheme continues whereby the doctor and the midwife have a consultation about their patient on three occasions (at specified intervals) during the pregnancy. The examinations take place at the patient's home, the doctor's surgery or at the Local Health Authority's Clinic, as mutually agreed, but in practice the joint consultation is held in the majority of cases in the doctor's surgery. 61 Salvation Army Midwifery Service.— One Salvation Army Midwife served in Ilford during the year. 56 cases were attended by her, all as a midwife, and a Doctor was called in to 17 of these cases. Of the infants born there was 1 stillbirth. Notifications were received from the Salvation Army Midwife that it was proposed to substitute artificial feeding in respect of 5 infants. Gas and Air Analgesia.—During 1955 gas and air analgesia was administered in 419 cases, of which 368 were attended by the Domiciliary Midwives (331 when acting as midwives and 37 when acting as maternity nurses) and 51 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. As reported last year, with a view to effecting an economy in the use of ambulance vehicles, from the 6th May, 1955, arrangements have been in operation for the midwives using cars in the course of their duties each to hold a machine at their respective homes to take with them to their own cases and there are three machines stored at the Ambulance Station for the use of the remaining midwives. With regard to the latter, the relatives of the patient are requested to collect a machine, where possible, but when they cannot do this, arrangements are made for a machine to be transported from the Ambulance Station to the house by a hired car. 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 exp'aining 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 1955 for patients booked for confinement in hospital:— Maternity Hospital Mayesbrook Clinic Manford Way Clinic Doctors Midwives First attendances 983 - 278 121 Subsequent attendances 5,488 4,056 2,435 1,038 Totals 6,471 4,056 2,713 1,159 Number of sessions 310 251* 128 65 Average attendance at each session 20 16 21 17 * Includes 200 running concurrently with Doctors' Clinics. All patients booked for admission to the Maternity Hospital are medically examined at the Ante-Natal Clinics. The first examination takes place at 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 are made 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. 62 In conjunction with the Ante-Natal Clinics at the Manford Way and Mayesbrook Clinics the Health Visitors hold classes for relaxation exercises. During 1955 there were 46 sessions at the Mayesbrook Clinic, with 570 attendances, and 51 sessions at the Manford Way Clinic, with 576 attendances. Relaxation exercises classes are also run by the staff of the Ilford Maternity Hospital for patients attending the Ante-Natal Clinic there. 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 1955 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 726 203 99 Subsequent attendances 169 92 10 Totals 895 295 109 Number of sessions 52 27 12 Average attendance at each session 17 11 9 Consultant Clinic.— The Consulting Obstretrician, or his Deputy, continued to hold a Clinic twice weekly for ante-natal and post-natal cases. During the year 100 sessions were held and a total of 1,269 examinations were made. Maternal Mortality.— During 1955 there was one death of an Ilford mother recorded by the Registrar-General as due to or in consequence of pregnancy or childbirth. Domestic Help Service.— During 1955 the heavy demand for this service continued. The service was controlled by a full-time Organiser, under the general direction of the Area Medical Officer, and at the end of the year there were 9 full-time, 107 regularly-employed part-time and 21 casual Helps employed. The following is a summary of the cases dealt with in 1955:— Number of applications received for assistance 1,452 Number of cases where Domestic Helps were provided (including 480 who were having service at the commencement of the year) 1,542 Number of cases which on investigation were either not eligible for assistance or did not require the service 244 Cases booked but subsequently cancelled 129 Number of cases where, at the end of the year, a domestic help was booked to attend in future months (maternity cases) 57 Other cases awaiting help at end of year 21 Enquiries incomplete at end of year 8 Cases being served at 31st December, 1955 564 Owing to the large number of Domestic Helps to be controlled and the very considerable amount of visiting involved to the many applicants for and recipients of this service, a second full-time Organiser was appointed from the 2nd January, 1956. and Ilford has now been divided into two areas for the purposes of administering this scheme. 63 in July and October, 1955, 2 two-weeks training courses for domestic helps were held by the County Council at the Mid-Essex Technical College, Chelmsford. Two domestic helps from Ilford attended and were found to be entirely satisfactory. Convalescent Facilities.—The following tables show the number of persons sent away for convalescence during 1955. (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 3 4 Beach Hill House, Convalescent Home, Mortimer, Reading - 1 Arranged by Invalid Children's Aid Association Zachary Merton Home, Tudor House, Grayshott 1 - Arranged by Jewish Board of Guardians Totals 1 1 2 Unaccompanied children (b) Under Section 28 of the Act, i.e.. other persons requiring a change of air and surroundings to aid recovery and rehabilitation. Name of Home No of weeks' stay Total Cases 1 2 3 4 Beach House Nursing Home, Kingsdown, Deal. — 1 — — 1 Bell Memorial Home, Lancing. 1 13 0 2 22 Mrs. Clarke's Home, 49a Stone Road Broadstairs. — — 1 — 1 Cumberland Convalescent Home, Herne Bay. — 1 — 1 2 Essex Convalescent Home, Clacton. — 7 4 1 12 Mrs. Haywards Home, 7 Arthur Rd., Cliftonville. — — 2 — 2 Hunstanton Convalescent Home. 1 1 10 — 11 Kenrith Convalescent Home, Hastings. — 1 — — 1 Leconfield, Bonchureh, Isle of Wight. — — 1 — 1 Lennox House, Southsea. — 3 1 — 4 Samuel Lewis Home, Walton-on-Naze. — 6 2 — 8 Maitland House, Frinton-on-Sea. — — 1 — 1 Rustington Convalescent Home, Littlehanipton. — 3 3 — 6 St. Michaels Convalescent Home, Clacton. 1 1 — — 2 Shoreditch Holiday Home, Copthorne, Sussex. 1 — — — 1 Totals 4 37 31 4 76 64 Loan of Sick Room Equipment.— The increasing demand for equipment continues and the following table shows the issues from the Public Health Offices during 1955: — Articles Loaned Number of Articles Articles in store at 31.12.55 on loan at 31.12.54 loaned or reloaned in 1955 on loan at 31.12.55 Mattress (Dunlopillo) 11 6 6 6 Mattress (Hair) 2 1 2 — Invalid Chairs 29 47 39 5 Air Pillows 4 2 2 2 Air Rings 91 249 88 24 Cushions (Dunlopillo) 9 6 10 5 Back Rests 60 150 67 3 Beds 3 1 3 2 Commode Chairs 21 32 25 1 Crutches 2 2 3 1 Fracture Boards (Sets) 3 2 3 1 Pillows 11 — 4 4 Pillow Slips *11 — *3 — Sheets (Pairs) *2 — — — Rubber Sheeting 132 287 120 37 Medical Sandbags (Sets) — 1 1 — Spinal Carriages 1 — 1 — Bed Cradles 14 21 11 4 Air Beds 1 11 1 4 Bed Pans 74 199 82 13 Diabetic Scales 5 — 3 2 Feeding Cups 2 17 4 7 Urinals 41 73 33 28 Sputum Mugs 3 5 2 3 Douche Cans — 1 1 1 Water Beds 1 — — 1 Water Pillows 1 1 — 1 Bed Blocks (Sets) 1 1 2 — Pails — — — 2 Bowls — — 2 Bedsteads Sides (Pair) 1 — 1 — Lifting Pole and Chain 1 — — 1 Commode Sorbo Cushion 1 — 1 — Kidney Dishes — 2 1 1 Totals 538 1,117 519 161 1954 Details 320 975 538 99 1953 Details 161 698 320 54 1952 Details 86 326 161 66 1951 Details 27 162 86 30 * Provided through special funds. Tuberculosis Visitors.— The three Tuberculosis Visitors made a total of 4,531 visits to homes in the Borough. Domiciliary Occupational Therapist.— The following shows the visits undertaken by the Domiciliary Occupational Therapist in 1955: — Number of visits to new patients 11 „ „ revisits to patients 288 „ „ other visits (to Chest Clinics, etc.) 3 65 Rehabilitation of Tuberculosis Cases.— Assistance in the maintenance charges of cases at the Papworth Hall Settlement was given as follows:— Number of cases being assisted at 31.12.54 2 newly assisted in 1955 Nil „ „ „ for whom responsibility ceased 2 „ „ „ being assisted at 31.12.55 Nil Open-Air Shelters for Tuberculosis Cases.— One open-air shelter supplied for a tuberculosis patient during 1954 was still in use at the end of 1955. Provision of Free Milk for Tuberculosis Cases.— The County Council's scheme for supplying to tuberculosis patients one pint of milk free of charge, on the recommendation of the Chest Physician, again showed progress during 1955 and the increase in the number of beneficiaries under the scheme still continues. Particulars of the grants made in 1955 are given below: — No. of cases in receipt of free milk at 31.12.54 159 „ „ new grants made during 1955 136 „ „ grants discontinued during 1955 86 „ „ cases in receipt of free milk at 31.12.55 209 Boarding-out of Children (Tuberculosis Contacts).—No applications were received in 1955 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 1955. 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) 75 563 (including renewals) Other grants (clothing, etc.) 2 2 Travelling Expenses of Relatives Visiting Hospital Patients— As in previous years, the County Medical Officer was able to give financial assistance in 1955 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 1955:— Officers Servants New Appointments 8 15 Other purposes 4 5 Invalid Night Attendant Service.—The scheme operating in conjunction with the Ilford Social Service Association for the provision of 66 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, has continued, the County Council making agreed payments to the Association in respect of approved cases where need in meeting the cost of the service provided by the Association's night attendants has been proved. The following are the details of the cases dealt with under the County Council's scheme during 1955:— No. of cases being attended at 31.12.54 3 „ „ new cases attended during 1955 22 „ „ cases discontinued during 1955 22 „ „ „ being attended at 31.12.55 3 Total nights' attendance given 450 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 but operating from the Branch Home "Abury House" in Aldborough Road, Ilford. The work undertaken by Home Nurses in the Ilford area in 1955 was as follows:— Cases attended 2,773 Visits paid 82,473 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 in the entrance hall of the Public Health Offices was used for the display of illustrative material on Care of the Teeth. As mentioned last year, a Health and Home Safety Week was held from the 18th to 23rd April, 1955, run by the Ilford Borough Council, the Essex County Council and the Women's Voluntary Services, an Exhibition being held at Messrs. Harrison Gibson's Store and a series of lectures being given at the Little Theatre. Various clinic services were demonstrated and the opportunity was taken at the same time to participate in the national publicity campaign on the subject of diphtheria immunisation, advertisements being inserted in the local press for two consecutive weeks. During the year a total of 41 lectures on various Health subjects were given by members of the medical staff of the Department, 30 to mothers attending Infant Welfare and Ante-Natal Clinics, and 11 to various organisations. Dental Treatment.—Mr. E. V. Haigh, the Senior Dental Officer, has submitted the following report:— " The treatment of expectant and nursing mothers has been carried out only at Mayesbrook Clinic during 1955. This has been due to the shortage of permanent dental staff. The patients were referred from antenatal and post-natal clinics; also children under five have been referred from welfare clinics and have received treatment. Three sessions per week were devoted to this work. Usually extractions were performed under general anaesthesia using nitrous oxide and oxygen and always given by a doctor. Other treatment, such as fillings, scalings and gum treatment, was given when necessary. Dental X-ray facilities available at the clinic were used where required, often saving the patient pain and inconvenience by a much quicker diagnosis. Dentures were provided for mothers when necessary, these being made by a local dental laboratory, by arrangements which have been in operation for many years," 67 The number of cases treated at the clinic during 1955 was as follows: — Examined Needing Treatment Treated Made Dentally Fit Expectant and nursing mothers 151 151 187 138 Children under 5 136 136 147 134 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 578 70 110 477 79 - 145 4 52 39 Children under 5 322 - 115 195 - - 67 - - - In addition There were 596 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 121. Distribution of National Welfare Foods. Owing to the closure of the local Food Offices, the distribution of national welfare foods (National Dried Milk, orange juice, cod liver oil and vitamin tablets) to beneficiaries has been the responsibility of the local health authorities under the National Health Service since the 28th June, 1954. The following shows the distribution centres in Ilford, with the days and times they are open:— (a) Main and Branch Centres. Main Distribution Centre, Monday to Friday 9.15 a.m.—4.45 p.m. 279 Cranbrook Road, Ilford. Saturday 9.15 a.m.—12.30 p.m. Methodist Church Hall, Tuesday and Friday 9.15 a.m.—1 p.m. High Road (entrance in Cleveland Road), Ilford. Saturday 2 p.m.—3.15 p.m. 9.15 a.m.—12 noon Methodist Church Hall, Tuesday 9.15 a.m.—1 p.m. Fremantle Road, Barkingside. 2 p.m.—3.30 p.m. Goodmayes Methodist Church Friday 9.15 a.m.—1 p.m. Hall, Blythswood Road (next to Seven Kings Library), Goodmayes, 2 p.m.—3.30 p.m. 68 (b) Infant Welfare Centres. Barkingside Monday 2—4 p.m. Fairlop Friday 2—4 p.m. Chadwell Monday 2—4 p.m. Manford Way Monday 2—4 p.m. „ „ Tuesday 2—4 p.m. „ „ Friday 2—4 p.m. Becontree Tuesday 2—4 p.m. Goodmayes Thursday 2—4 p.m. Downshall Tuesday 2—4 p.m. Woodford Avenue Wednesday 2—4 p.m. Cecil Hall Wednesday 2—4 p.m. „ „ Thursday 2—4 p.m. Seven Kings Wednesday 2—4 p.m. Newbury Hall Thursday 2—4 p.m. Grosvenor Road Thursday 2—4 p.m. Ilford Lane Friday 2—4 p.m. Valentines Friday 2—4 p.m. (c) Private Houses (W.V.S.). Mrs. Taylor, 31, Lime Grove, Hainault. Monday to Friday 9 a.m.—5 p.m. Mrs. Peacock, 15, Culpepper Close, Hainault. Evenings and Weekends only. (d) Mobile Depot (W.V.S.). Operating on Padnall Estate. Alternate Thursdays 2 p.m.—3.30 p.m. With a view to effecting economy and cohesion in the service, the work with regard to the national welfare foods has been fully integrated with that of the distribution of nutrients and medicaments which has been in operation in the maternity and child welfare service for many years. 69 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.—7 children were found to be infected with living hair vermin as against 4 in 1954, 5 in 1953, 13 in 1952, 7 in 1951 and 5 in 1950. (ii) Scabies.— There was one case reported during the year, as compared with none in 1954, 1953 and 1952, and 1 in 1951.— School Premises.— There are 34 schools, with 64 departments, 24.173 children were actually on the rolls on 20th December, 1955, as compared with 24,256 in December, 1954. The figure 24,173 includes Barking Abbey (390) and Ursuline County Placed pupils (332). The number of children in average attendance at school for the year ended 20th December, 1955 = 21,751. The Sanitary Inspectors have paid the usual monthly visits to the maintained schools (1) to enquire as to the milk supplies, (2) to inspect the sanitary arrangements. 988 visits have been made during the year. Medical Inspection.— As from the 4th August, 1953, the medical inspection has been in accordance with the School Health Service and Handicapped Pupils Regulations, 1953. During 1955 5,551 parents, or 76 per cent., attended the full routine medical inspections. 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 1955. 17 home visits were paid by the School Nurses to cases of minor infectious disease. In addition the Sanitary Inspectors paid 1,589 visits to measles cases, and 266 visits to whooping-cough cases. Followjng Up.—During 1955, 3,241 home visits by the School Nurses were paid for the purpose, and 3,550 re-examinations of children (some on several occasions) were carried out by the doctors at school; 177 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 1955 were as follows:— Newbury Hall Mayesbrook Number of individual children seen 739 553 Number of attendances of children 1,306 1,235 Number of exclusion certificates granted 15 20 Number of certificates of fitness to attend school granted 23 28 70 The following table shows the conditions dealt with at both the Clinics during the year:— Subnormal Nutrition 379 Debility 36 Uncleanliness:- Head 25 Body — Skin:— Ringworm:- Head 1 Body — Scabies 1 Impetigo 12 Dermatitis 2 Urticaria 1 Furunculosis 6 Eczema 3 Athletes Foot 5 Warts 122 Other Skin Diseases (Non-Tuberculous) 91 Eye:— Blepharitis 12 Conjunctivitis 16 Defective Vision (excluding Squint) 110 Squint 6 Other conditions 78 Ear:— Defective Hearing 20 Otitis Media 9 Other Ear Diseases 8 Nose and Throat:— Chronic Tonsilitis only 3 Adenoids only 3 Chronic Tonsilitis and Adenoids 35 Nasal Catarrh 15 Nasal Obstruction 5 Other conditions 5 Enlarged Cervical Glands (Non-Tuberculous) 17 Defective Speech 8 Teeth—Dental Diseases 125 Heart and Circulation:— Functional 2 Organic — Anaemia 4 Infectious Diseases:— German Measles 1 Chicken Pox 1 Mumps 1 Colds and Coughs 83 Influenza 3 Lungs:— Asthma 11 Bronchitis 5 71 Pulmonary Catarrh 4 Other Non-Tubercular Diseases 8 Psychological:— Development — Stability 14 Nervous System:— Nervous Debility — Habit Spasm 5 Chorea — Petit Mal — Enuresis 7 Other Conditions 23 Deformities:— Genu Valgum 4 Posture 7 Pigeon Chest 1 Flat Feet 18 Valgus Ankles 11 Other Forms 38 Minor Injuries 19 Rheumatism 5 Other Defects and Diseases 67 Total number of ailments 1,501 SPECIAL CLINICS. Ophthalmic Clinic. The following table summarises the attendances of school children:— Clinic Sessions New Cases Old Cases Attendances Valentines Mansion 97 309 740 1,482 Mayesbrook 90 175 564 1,500 Manford Way 11 46 72 204 Totals 198 530 1,376 3,186 72 The 1,906 children were found to be suffering from the following defects:— Diagnosis New Cases Old Cases A B C A B C Myopia 101 53 15 216 140 22 Hypermetropia 96 42 10 269 196 32 Mixed Astigmatism 34 19 — 50 50 3 Squint 26 32 8 145 119 12 Blepharitis 1 3 — 2 4 — Congenital Coloboma — — — 2 2 — Conjunctivitis 2 2 — 1 2 — Nystagmus — — — 3 2 — Other conditions 3 — — 2 6 — N.A.D. 46 24 7 50 43 3 Totals 309 175 46 740 564 72 A—Valentines. B.—Mayesbrook. C—Manford Way. 882 complete pairs of spectacles were provided, some of these being renewals after breakages. In addition, in 386 cases the lenses of spectacles were replaced or repairs of frames were carried out. Mr. H. J. R. Thome, M.B., B.S., D.O., D.O.M.S., the Ophthalmic Surgeon at Valentines Ophthalmic Clinic, makes the following report:— " Work at Valentines Ophthalmic Clinic has continued smoothly and satisfactorily throughout the year and the cases dealt with were of much the same types as in previous years. The majority of children were, as in the past, 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) Ocular pathology including congenital cataract (partial or complete), retinal dystrophy, retinal detachment and inflammatory affections. Partially sighted (or blind) children—fortunately few in number— were seen as required, reported on (on Form B.D.8) and advice given as to schooling and treatment. Good co-operation has been obtained from 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 Orthoptist has continued to work at the Orthoptic Clinic at Mayesbrook on three days a week. This is an indispensable part of a School Eye Clinic to enable the necessary full treatment and observation of squint cases (pre- and post-operative) to be satisfactorily carried out. The Orthoptic Clinic has functioned efficiently. The arrangements for the fitting and supply of spectacles have, in the hands of the attending Optician, been satisfactory." 73 Mayesbrook Orthoptic Clinic. Miss C. M. Hazel, D.B.O., the Orthoptist, makes the following report: Month Number of Sessions New Cases Old Cases Total Attendances Under Over 5 years Under Over 5 years Under Over 5 years January 26 1 7 - 11 4 101 February 24 — 1 — 5 6 79 March 27 2 7 1 — 9 101 April 22 4 5 1 3 10 83 May 24 6 7 1 3 17 81 June 25 2 4 — — 17 80 July 13 1 2 1 1 15 40 August 26 8 4 — 1 22 77 September 24 1 6 — 1 19 55 October 24 3 10 — 3 19 6S November 26 1 10 1 4 17 69 December 24 4 6 — 3 16 65 Totals 285 33 69 5 35 171 899 Discharges. In 1955 65 cases were discharged as follows:— (a) Orthoptically satisfactory 28 (b) Cosmetic 1 (c) Improved 9 (d) Failure to improve (including intractable amblyopia) 11 (e) Failure to attend 9 (f) Transferred 7 Total discharged 65 Statistics are lower than in the two previous years which can be attributed to the fact that the intake of new cases has been Lower, and most cases attending in 1953 and 1954 are either now discharged or attending at longer intervals. Total number of patients attending the Orthoptic Clinic on 31st December, 1955: 142. 74 Orthopaedic Clinic. Mr. H. G. Korvin, F.R.C.S., the Orthopaedic Surgeon, makes the following report:— " No new developments have taken place during the past year at the Orthopaedic Clinics at Mayesbrook and Newbury Hall. The number of attendances was at a satisfactory level, and the appointments system worked well. During the hot summer weeks working conditions in the old building in Perrymans Farm Road were very trying and the need for better ventilation was strongly felt. Where operative treatment was required this was carried out at East Ham Memorial Hospital, as in the past, and again, children under 12 could find admission with little delay, while those over 12 had to join a long waiting list. X-ray examinations were kindly carried out at King George Hospital, and latterly at Ilford Isolation Hospital. All surgical appliances and alterations to footwear were done by Messrs. Pryor and Howard, except where parents found it more convenient to get small alterations done at their own expense by a local cobbler. Mr. Brand. M.C.S.P.. Physiotherapist to the Clinics, spent a week of his annual leave in Birmingham studying the use of glass-fibre for temporary splints. The Hospital Management Committee very generously defrayed the expenses of this venture. I wish to thank all those taking part in the runing of these Clinics for their valuable help." The following table summarises the attendances of school children: — Clinic Sessions New Cases Old Cases Attendances Newbury Hall 40 89 240 471 Mayesbrook 22 80 95 241 Manford Way 9 3 23 33 Totals 71 172 358 745 75 Diagnosis New Cases Old Cases A B C A B C Paralyses:— A.P.M. 1 1 — 8 8 — Hemiplegia — — — 5 1 — Monoplegia - - - - - - Spastic diplegia — — — 1 — — Spastic Quadriplegia — — — 1 1 — Scoliosis 2 6 — 6 3 — Kyphosis — 1 — 3 1 — Slack posture 8 1 — 11 4 1 Deformity of hips 2 — — 5 2 — Deformity of Chest — — — — — — Genu valgum 16 10 — 74 28 12 O.C.T. — — 1 4 6 1 Genu varum 2 — — 2 5 1 Pes valgus-planus 7 4 — 37 10 4 Valgus ankles 7 11 1 15 3 1 Talipes calcaneo-valgus — — — 1 1 — Congenital talipes E.V. — — — 1 — — Congenital defect — 1 — — — — Intoeing — 1 — 4 — — Pes cavus — — — 1 — — Hallux valgus 12 10 — 15 4 — Deformity of toes 6 6 — 11 3 1 NAD 1 8 — 2 1 1 Other conditions 17 18 — 19 10 1 Foot strain — 1 — 4 1 — Metatarsal varus — — — 2 1 — Spastic foot — 1 — — — — Cerebral Palsy — 1 — 1 — — Spina Bifida — — — 1 — — Torticollis — 2 - 8 2 - Totals 81 78 2 242 95 23 A—Newbury Hall. B—Mayesbrook. C—Manford Way. 12 Children of school age were admitted to East Ham Memorial Hospital. Particulars as follows:— No. of Cases Operation 1 Bunionectomy Lt. and Rt. 1 Destapling 1 Arthrodesis 4th toe and Tenotomy and Capsulotomy 5th toe. 1 Subcutaneous Tenotomy 5th toe left. 1 Subcutaneous Tenotomy and Capsulotomy right 5th toe. 2 Division of Sterno-Mastoid Muscle for correction of Torticollis. 1 Arthrodesis—Hammer left toe. 2 Stapling 1 Bunionectomy and Osteotomy left toe. 1 Arthrodesis left foot. During the year 43 pairs of valgus insoles, 17 pairs of surgical boots or shoes, 5 pairs Genu Valgum splints, 3 metatarsal bars. 12 calipers and inverting irons, 3 toe springs for drop foot, 18 repairs to calipers and shoes, and 49 pairs wedges to shoes were supplied to school-children. 76 267 cases were discharged from the Orthopaedic Clinic, 102 as cured 44 due to absence and were kept under observation at school, 62 were showing improvement and were kept under observation at school, 59 cases left school or left the district. Minor Orthopaedic Defects. Dr. F. E. O'Connor Wilson, one of the school medical oHicers, has under supervision and attends weekly one of the following Clinics conducted by the Physiotherapist:— Exercises Massage Sunlight and she reports as follows:— Foot Survey, 1955. "During 1955 a foot survey was carried out by me in Ilford schools. 1,400 children between the ages of 9 and 10 years were examined; this age group was chosen as a fair average between the infant and senior groups. Very few children had badly worn or unsatisfactory footwear (0 2%) and few had dirty feet and dirty socks (1-9%). The children were examined in their ordinary outdoor footwear first, then in their bare feet. Not one child complained of pain in the feet or legs. The thirteen schools visited in the course of the examination covered a wide area of the district so that children from all social levels were surveyed. Of the total of 1,400 children, 468 or about 33% were found to have foot defects. This is a high percentage and might well be remedied by the development of toddlers' clinics. A greater number of girls had defects such as deflection of terminal phalanx of great toe—about 14% of all defects; whereas boys were only about 9% of this condition. Hallux valgus was more noticeable among girls—34% of all defects compared with about 12% of boys. More girls were suffering from curled toes, probably due to tight shoes worn previously. The incidence of flat feet was equal in both sexes though the number of boys with valgus ankles was double that found in the girls. There were very few defects of the soft tissues considering the large number of children surveyed. Before closing I would like to draw attention to the fact that plimsoles in school which are a free issue and are chosen by the children themselves may be badly fitting and crush the feet. Children usually choose shoes too small rather than too large. An adult to supervise these shoes and to check sizes periodically—at least once a term—might help to prevent foot troubles or aggravation of existing ones. The same applies to boys' football boots which are put aside when the season is over and worn again the next year and the next—so long as the foot can be squeezed into the boots. Occasionally the boots are passed on to someone else and used though not fitting well. This is the case where the parents cannot afford to buy the boy new boots and his enthusiasm for the game counteracts any pain from tight boots. Regarding the remedial exercises carried out by the Physiotherapist, where the parents and children co-operate there is rapid and permanent cure of the defect. This is specially so in the treatment of flat feet and valgus ankles. The Artificial Sunlight Clinic has a number of children receiving treatment for various ailments and all the children were markedly improved. Cases of underweight and the few cases of malnutrition, and those suffering from chronic catarrhal colds benefited most." 11 Physiotherapy Clinics. These are held at Newbury Hall on Monday and Thursday mornings and at Mayesbrook Clinic on Tuesday and Friday mornings. Cases are also seen at the Manford Way Clinic as required. Details of attendances:— Clinic Sessions New Cases Old Cases Attendances Newbury Hall 91 98 64 1,041 Mayesbrook 91 63 96 594 Manford Way 90 5 4 174 Totals 272 166 164 1,809 Artificial Sunlight Clinics. These are held at Newbury Hall on Tuesday afternoon and at Mayesbrook Clinic on Thursday afternoon. Details of attendances:— Clinic Sessions New Cases Old Cases Attendances Discharged Cured Much Improv'd Left District etc. Newbury Hall 47 22 12 335 12 2 5 Mayesbrook 46 13 12 319 12 2 — Total 93 35 24 654 24 4 5 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 15 11 Bronchitis 4 2 Alopecia 2 2 Asthma 8 1 Psoriasis 1 1 Posture - - Acne - - Chilblains 1 8 Eczema 2 1 Other Conditions 6 4 *84 25 A—Newbury Hall Clinic. B—Mayesbrook Clinic. *Of the 34 cases treated 6 were Open Air school-children. 78 Ear, Nose and Throat Clinic. The E.N.T. Clinic is held at Valenties Mansion, the Surgeon attending one session weekly. 47 sessions were held during 1955, and 716 attendances were made by 386 children of school age, of whom 260 were new cases. The Consulting Ear, Nose and Throat Surgeon (Miss Margaret Mason) submits the following report:— "The clinic in 1955 showed a small decline in numbers, compared with 1954; 260 new patients and 126 old patients made a total of 716 attendances. 132 cases were added to the waiting list for operations, as compared with 176 the previous year. Unfortunately, the Theatre block at the Ilford Isolation Hospital was only available for two operating sessions during the year, and the waiting list climbed to 188 by the end of the year, from 92 at the end of 1954. although 1 did manage to get a few of the more urgent cases treated at King George Hospital and elsewhere. This problem is still difficult of solution, on account of the likelihood of summer outbreaks of poliomyelitis, which in the present state of our knowledge makes tonsil and adenoid operations inadvisable. A number of cases of nasal allergy and chronic rhinitis have been treated this year by preliminary skin testing, followed by desensitising injections given over a period of 3—4 months. Parents have, on the whole, been most co-operative in attending regularly, even though they may live at a distance from the clinic. A number of cases of suspected deafness seen during the year have been further investigated and recommended for hearing aids and sometimes special schooling. In this we have been able to make use of the new clinic for deaf children recently opened in West Ham, for the under-fives; it would be of great assistance if similar facilities were available for children of school age, as we have to refer them to the Audiology Clinic in Gray's Inn Road, which is already rather overburdened, and does involve rather long journeys for our patients." The following table shows the work of the Clinic:— No. seen Tonsils and Adenoids Infection 239 Deafness 36 Otitis Media 11 Mastoid disease 2 Rhinitis 39 Other defects or diseases 59 386 ly Rheumatism Clinic. The Physician attended 31 morning sessions during the year, and 156 children (77 of these being new cases) made 248 attendances. The 156 children were found to be suffering from the following conditions:— Defects Found New Cases Old Cases Totals Pulmonary Stenosis 8 10 13 Rheumatic Carditis — 2 2 Other forms of Carditis 1 9 10 Tachycardia of Nervous origin 2 — 2 Congenital Heart Disease — 0 6 Rheumatism 3 1 4 No Active Rheumatic Disease 1 - 1 Heart Murmur Functional 35 25 60 Pains Due to Orthopaedic condition 0 2 8 Allergic type 1 1 2 Other conditions 15 21 36 N.A.D 10 2 12 Totals 77 79 156 Number of cases referred to General Hospital (In-patients) 18 „ „ ,, Ear. Nose and Throat Surgeon 14 Orthopaedic Surgeon 9 „ „ For X-ray and Electro-Cardiogram 53 „ „ „ Blood Sedimentation Rate 23 Speech Clinics. Mrs. M. Walker, L.C.S.T. and Mrs. M. Hatfield. L.C.S.T., make the following report: — "In the 1953/54 report we indicated that an increase in the number of Speech Therapists working in Ilford would be more than justified. Towards the end of 1955 a Therapist was appointed for 6 sessions per week at the newly opened Cerebral Palsy Unit and for 5 sessions at Manford Way—also a new appointment; the services of a full-time Therapist at Valentines Clinic and a part-time Therapist at Mayesbrook still being retained. The children at the Cerebral Palsy Unit have been seen to benefit from treatment on the premises, in that they no longer suffer the fatigue of travel before each session, there is no time waste, and they can be seen a little more frequently than was previously possible. The Unit, however, is in its infancy and accommodation for speech therapy is at best inadequate. It has not been possible to provide a room specially for speech therapy so that both therapist and child work under difficulties. It is hoped that in the future a room will be supplied, giving the quiet and familiar atmosphere that is so essential to the cerebral palsied. Waiting lists have fluctuated more this year due to the increase in the number of Therapists, and there have been no outstanding waits as in previous years. Therapists in Ilford, as elsewhere, have been interested by the excellent results of the six-year-old experiment in Leicester City where there is a special class for stammerers, set in an ordinary school, with an ordinary school syllabus, except for daily speech therapy. The children join the rest of the school for art, crafts, music, games and social activities. 80 Although most teachers are sympathetic and do their best not to put any undue stress on these children from the educational point of view, the competition and natural strains inherent in schooling at all appear to have a particularly bad effect on the majority of stammerers. Isolated treatments once a week can do nothing to alter these conditions, but with speech therapy a part of daily school life much could be done. It is interesting and important to note that shortly after entering such a class, where the child is no longer at a gross disadvantage through his speech, there is always a marked improvement in his ability to concentrate and in the school work. To open such a class in Ilford would certainly not be a simple matter. There would be administrative and transport difficulties, but these could be overcome and we feel sure that results would more than compensate. We arc still hoping for the long term loan or use of a tape recorder. This is not merely an amusing gadget, but is quite indispensable in the treatment of certain types of cases." The defects treated were as follows:— Stammering 62 Dyslalia 132 Rhinophonias 4 Cleft Palate 7 Dysphonia 1 Dysarthria 10 Others 10 81 children of school age were discharged from the Clinics during the year. In 49 cases the speech was normal. Of the remaining 32 cases, 2 ceased to attend for treatment, 15 left school or left the district. 5 refused treatment, 10 were referred elsewhere and in one case the child died before treatment commenced. School Dental Servcie.—Mr. E. V. Haigh, Senior Dental Officer, reports as follows: — "The Dental facilities for school children were almost the same in 1955 as in the previous year. There were 12 part-time dental officers and myself full time. The part-time dental officers and myself made the equivalent of 4 full-time surgeons: the number of sessions carried out by these part-time officers varied from one to five sessions per week. In addition Maternity and Child Welfare dental work was carried out by myself at Mayesbrook Dental Clniic. This occupied 3/llths of my time. Full dental treatment was given to school children, expectant and nursing mothers and children under 5 years of age. This treatment consisted of conservative dentistry, extractions, which were mainly carried out under general anaesthesia, orthodontics, and the supplying of dentures when necessary. With the continued increase in the number of dental surgeons it was possible to see 9,278 children at school dental inspections, a slight rise on the 1954 figure. Emergency treatment on two mornings a week which was started in 1954 was continued and has proved very satisfactory. Any school child can attend from any school in Ilford without an appointment and receive emergency treatment to relieve toothache or to make an appointment for fillings. The attendances on these mornings have steadily grown and are now between 20 and 30 per session. X-ray facilities are available at Mayesbrook Clinic for patients attending either Valentines or Mayesbrook Dental Clinic. Manford Way Clinic has a separate X-ray Unit for patients attending there." 81 It was possible for the Denists to visit some of the schools for the purposes of inspection, 9,278 children were inspected at schools of which 4,510 required treatment. Children seen by the doctors at routine medcial inspections and at the School Clinics, who are found to require dental treatment are referred to the Dental Clinics. In addition to the 4,510 children referred for treatment by the Dental Surgeons at School Inspections there were 2,328 children specially referred by parents, teachers and School Doctors. The amount of dental disease present in children at various ages is shown by the following table relating to school children inspected by the School Dental Officers:— Age Groups (in years) No. of Children inspected at School No. of Children referred for treatment No. of Children specially inspected at the Clinic Total number of Children referred for treatment 5 060 283 211 494 6 983 373 304 677 7 1053 481 305 786 8 1381 697 298 995 0 1164 571 250 821 10 1077 550 234 784 11 892 442 183 635 12 671 351 185 536 13 540 274 143 417 14 450 263 135 398 IS 257 141 65 206 16 72 46 4 50 17 55 29 1 30 18 21 9 — 9 9278 4280 2328 6838 In addition to the ordinary dental work of fillings and extractions, 26 dentures and 356 regulation plates were supplied. Further, 183 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. Oral Hygiene. During 1955 Miss Watts, the Oral Hygienist, visited secondary schools in llfbrd to speak to the senior pupils on the health and care of the teeth and mouth. Each lecture was of about an hour's duration and in that time the cause and prevention of dental disease were explained and personal hygiene stressed. Numerous questions were answered and interest was heightened by the showing of a 20-minute sound colour film " Let's Keep Our Teeth." The Dental Board of the United Kingdom supplied leaflets for distribution to the children. Both teachers and pupils received the talks with considerable enthusiasm and there is little doubt that such talks are a worthwhile feature of Health Education. Open Air School. During 1955 the number of children on roll varied, and was 108 both on 31.12.54 and on 31.12.55, the number of admissions being 38 and of discharges also 38. Only one child was admitted for debility as the sole defect. 82 The general work of the school has continued along previous lines and there has been the closest co-operation between teaching and medical staff. Hospitals also have been most helpful in supplying relevant information when asked. Recommendations of admission were received from the following sources:— School Medical Officers 33 Borough Education Officer 2 Others 3 38 The diagnoses were:— School Medical Officers:— Asthma 7 Asthma and debility 1 Asthma and bronchitis 2 Asthma and eczema 1 T.B. lungs 1 Old poliomyelitis 2 Hemiplegia 3 Congenital heart disease 1 Bronchitis Hydrocephalus and paraplegia 1 Collapse of lung 1 Rheumatic carditis 1 Subnormal nutrition 1 Delicate—old T.B. lungs 1 Deafness 1 Spastic diplegia 1 Instability 1 Debility after encephalitis 1 Cerebral Palsy 2 Chronic sinusitis 1 Hydrocephalus 2 33 Borough Education Officer:— Old poliomyelitis 1 Recurrent respiratory infection 1 2 Others:— T.B. knees and lung Delicate—old spina bifida 1 Old hemiparesis 1 3 The 38 children discharged left for the following reasons: — Fit for ordinary school 15 Left school o,ver age 4 Admission to residential O.A.S. 2 . Admission to special school 1 Left district 5 Parents' request 1 Transfer to Cerebral Palsy Unit 9 Disability so severe that child was found unsuitable for school 1 38 88 As a result of periodic examinations by the medical officer, children were recommended for treatment as follows:— Extra milk in school 28 Cod liver emulsion in school 28 Referred to orthopaedic surgeon 1 „ „ Speech Clinic 1 „ „ Ophthalmic Clinic 1 „ Dental Clinic 2 „ „ Paediatric Clinic 1 In addition, 6 children received artificial sunlight treatment during the year. Children with lung diseases were given daily deep breathing exercises. Cerebral Palsy Unit. Dr. D. L. Woolf, Consultant in Physical Medicine to the Cerebral Palsy Unit, reports as follows: — "A notable event during 1955 was the opening on May 2nd of the Cerebral Palsy Unit, with 9 cases transferred from Benton Open Air School. The Unit, which has 24 places, is housed in an old Day Nursery and is an annexe of Benton School under the same Head Teacher, but is otherwise self-contained. In addition to the necessary medical, teaching and domestic staffs, there are a Consultant in Physical Medicine who visits weekly, a School Medical Officer who visits weekly and is on call, and ancillary medical staff of physiotherapists, speech and occupational therapists, together with a state registered nurse and welfare workers. The aim of the Unit is to provide suitable cases with all necessary education and medical attention on the spot. Close liaison is maintained with the parent school and the possibility of transfer from the Unit to the Open Air School or vice versa is always borne in mind. The closest contact is maintained with the children's private doctors and any hospitals they may attend and co-operation has been full and very helpful. The Unit opened with 9 cases in May, and from September onwards there were 15 more admissions. Discharges, with their reasons, are given below:— Admissions:— May 9 September onwards 15 24 Discharges: — Unsuitable ... .. ... ... ... 3 Returned to Open Air School 2 Transfer to residential school 1 Over age 1 7 There are 17 children on roll at the time of this report. Of these, 5 live in Ilford and 12 come from outside the Borough, it being the intention that the Unit should serve not only Ilford itself but also adjoining districts. Children are admitted for a trial period of from 3 to 6 months after passing the School Medical Officer and the Consultant Physician, who reject obviously unsuitable ones. After the trial period they are reviewed in the light of progress and the reports of all staff concerned and a final decision made as to their placement, 84 Of the total number of children examined for suitability, 30 were rejected, but of these 3 are to be reviewed again later. At present there are three others being considered for admission. The difficulties so far encountered are mainly connected with lack of space, and the transport of children to and from the Unit. The heating during the winter months has also given much cause for anxiety and its inadequacy has materially interfered with therapy." Treatment for Uncleanliness.—The School Nurses paid 229 visits to the schools (an average of 6 visits to each school during the year), for the purpose of inspecting the heads and clothing of the children with the following results:— Number of Individual Children Examined 20,745 Number of Examinations of Children 61,558 Number Infested *105 Per cent. 017 *Seven of this number were found to be infected with living vermin; the remainder with nits only. A child with any nits in the hair at all is included in these figures. The percentages for the past 5 years were as follows:— 1951 04 1952 0.4 1953 0.3 1954 0.2 1955 0.2 Other Ailments.—During 1955, 396 children were operated on for the removal of enlarged tonsils and adenoids as follows:— King George Hospital 217 Ilford Isolation Hospital 2 Others 177 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 1955 was 2,166.435 approximately. There are 22 kitchens in the Borough, established at the following schools: — Barking Abbey, Barley Lane, Beal, Benton, County High Boys. County High Girls, Cleveland, Dane Fairlop, Goodmayes. Gordon. Loxford. Mayfield Boys, Mayfield Girls, Newbury Park, Parkhill, Redbridge, The Gilbert Colvin, The Glade, The John Bramston, 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 1955, 19,574 children were receiving milk in school. Work done by the N.S.P.C.C.—The following 35 cases were investigated:— (1) Neglect 25 (2) Ill-treatment cases 4 (3) Other cases 6 (Two cases were reported from the Public Health Department for neglecting medical advice; 33 were reported from other sources for general neglect.) 90 children (49 boys and 41 girls) were involved, 53 being of school age. In addition to this work, 210 supervision visits were paid to different cases, some of which were made to those reported during the previous year. 85 The Invalid Children's Aid Association.— Number of Ilford school children:— sent to Recuperation Holiday Homes 28 Loaned television set 2 Loaned push chair 1 Loaned invalid chair 2 Loaned tricycle 2 Supplied with clothing 3 Groceries given 1 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, came into operation on 16th December, 1953. The number of children coming within these categories and their disposition as on the 31st December, 1955, are tabulated in the following table in accordance with the Handicapped Pupils Regulations, 1953. Return of Handicapped Pupils in the Area on 31st December, 1955 (Aged 2-16 Years) handicapped pupils. Blind, Partially Sighted Deaf Partially Deaf. Delicate. Physically Handicapped. Educationally Subnormal. Maladjusted. Epileptic. Total 1 2 3 4 5 6 7 8 9 A. Newly placed in 1955 — — — — 21 18 14 10 1 64 B. Newly ascertained in 1955 — — — — 22 16 22 11 1 72 C. (i) Attending Special Schools— Day — 2 10 5 61 51 60 2 — 191 Boarding 7 1 5 1 5 2 13 15 1 50 (ii) Boarded in homes - — — — 1 — — 1 — 2 (iii) Attending assisted Schools - - - - - 2 4 13 — 19 D. Unplaced— (i) At no school 1 — — — 2 2 — — — 5 (ii) At ordinary school — — — — 4 — 20 6 - 30 E. Receiving home tuition (including those in D). 1 - - - - 3 - - 1 5 86 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. 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:— "The work of the Clinic has continued with little change throughout 1955. Our most pressing problem is the length of our Waiting List, which is increasing, with a corresponding delay in seeing children after referral. We are still having a greater number referred to us than we can see during each year, and it does not seem that one Clinic alone can supply the needs of the large area which we serve. Of the 189 cases referred last year 50 were considered urgent, and in addition we were asked to see and report on 23 cases for the Juvenile Courts. These latter have to be seen without delay and usually involve a greater number of interviews and expenditure of time than other cases, but we welcome this use of our facilities as an important part of community work though it does contribute to the delay in our routine casework. It has been our policy to give such treatment to every child that we can obtain a sufficiently good adjustment to maintain mental health in face of the ordinary difficulties of life with which they will have to deal. In practice this means that most children who are taken on for "treatment" receive weekly psycho-therapy, while their Mothers have weekly interviews to help them in their understanding and handling of the child. In some children the problems are such that less frequent attendances are needed, and we are always looking for methods whereby we can shorten the time of treatment without endangering the success of our work. When the child's problem is mainly one of social adjustment we can sometimes treat them in groups of 5—7 children, and we hope to begin some new groups in the coming year, and as we now have our annexe converted for use as a treatment room we have a suitable room where groups can meet. We are also planning discussion groups for Mothers at the same time. Much of the work of our Psychologists is carried out in the schools where problems are discussed and the progress of the children concerned is watched. The co-operation of Head Teachers has been most valuable and many difficulties have been resolved without having to refer the child to the Clinic. We have welcomed every opportunity to meet and discuss mutual problems with other workers in allied fields, but pressure of work has prevented us from doing as much as we would have liked. The monthly conferences with the Barking School Medical Officers and Health Visitors have continued, and Health Visitors from other areas and Probation Officers have attended conferences on cases in which they were interested. A Psychiatric Social Worker Student came to us for two months in the Summer, and Health Visitor Students spent a day in the Clinic during their training course. Members of our staff have given talks on remedial teaching to teachers, and on child guidance work to the Townswomen's Guild. Changes of staff have again curtailed our work to some extent during this last year. The sudden death of Miss Harries last Spring was a great loss to the Clinic, but happily Mrs. Benjamin came to our rescue temporarily, but was unable to remain with us permanently for family reasons, and we are again one Therapist short. Miss 87 Zaphiriou left us during the year when she returned to Greece, but Miss Barton came to us as P.S.W. in September, and Mrs. Pagram joined our staff of secretaries when the appointment was made permanent. Miss Wicks left us at the end of the year to take up an appointment in a Residential School for E.S.N. Children, in which we wish her every success. We are very glad to welcome Mr. Pickett who is returning to this Clinic as Psychologist in her place at the beginning of February. We would like to express our appreciation of the great understanding and full co-operation of the Ilford Health and Education Departments, which make an enormous contribution to the increase of our effectiveness in the community." No. of cases referred to Clinic 189 No. of cases diagnosed at Clinic 131 Psychiatrists. Diagnostic interviews 131 Treatment interviews 471 Other interviews 102 No. of Psychiatric Sessions per week 9 Psychologists. Clinic cases tested 95 Treatment interviews (remedial education) 230 School visits on behalf of Clinic cases 37 Other interviews 31 Child Psychotherapists. Treatment interviews 906 Psychiatric Social Workers. Interviews at Clinic (Treatment and Social Histories) 661 Interviews elsewhere (Home Visits) 39 Waiting List. Last year 96 This year 121 Cases for diagnosis 15 Awaiting treatment +45 Employment of School-children and Young Persons.—From special inquiries made at the various schools during 1955, it was found that 199 children were employed out of school hours. 196 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 196 Employment of Children in Entertainments Provisional Amending Rules.—8 Certificates were granted during the year. Medical Examination of Teachers, Officers and Servants.—The following examinations were carried out during 1954:— Intending Officers Servants Teachers Teachers Total New Appointments 28 11 25 59 123 Under Sickness Regulations 3 3 — — 6 Camp Schools. The Elmbridge Camp School at Cranleigh, Surrey, and Kennylands Park School at Kidmore End. near Reading, were taken over entirely by the Essex Education Committee on the 1st April, 1948. 88 Admissions and re-admissions of Ilford School-childro to these two Camp Schools and the Hydon Heath Camp are medically examined by the Assistant Medical Officers prior to entry. Medical, Supervision—Kennylands Park School. At the request of the Principal School Medical Officer, the Ilford Divisional School Medical Officer assumed responsibility for the medical supervision of Kennylands Park School during the year. Dr. Gross, School Medical Officer, is undertaking the routine medical inspection of new admissions and leavers to the school and carried out her first inspection during the Autumn Term 1955. It is anticipated that this work will entail two visits to the school, occupying four sessions. The Resident Nurse has been instructed to carry out the necessary pre-visit work, including weighing and measuring and preparing equipment. In addition the Nurse has been instructed to carry out a monthly survey of all children and to submit a return thereon to Dr. Gordon. The survey is intended to cover any problems of welfare that pupils might like to bring to the notice of the Nurse, and for this purpose pupils are seen individually. Arrangements are also in hand for Dr. Hemphill, visiting practitioner, to carry out full courses of immunisation, with booster doses where necessary, against diphtheria. Dr. N. Wood, Director of the Public Health Laboratory. Battle Hospital, Reading, has kindly consented to undertake Schick tests of all children who have no records of previous immunisation. The Causes of Death among Children of School Age (i.e.. from 5—15 Years) in Ilford, during 1955, were:— Rheumatic Carditis 1 Cerebral Astrocytoma 3 Leukaemia 1 Broncho Pneumonia 1 Multiple Injuries—Road Death 1 Disseminated Lupus Erythematosis 1 Peritonitis 1 Lymphosarcoma 1 Cirrhosis of Liver 1 11 Ilford Enuresis Clinic. Dr. J. Pooley, School Medical Officer, makes the following report for the 12 months ended 31st December, 1955. "The Clinic continues to be held at the Public Health Offices, Ilford. on Wednesday mornings and although the total number of new cases seen has been slightly less than during last year, the attendances have continued to be good. 1. Appointment List.—During the 12 months ended December 31st. 1955, there have been 67 new cases, made up as follows:— Age- Under 5 years Over 5 years Recommended by Boys Girls Boys Girls Parents — — 4 3 General Practitioners — 1 1 2 Infant Welfare Officers 4 4 — — School Medical Officers — — 30 16 Health Visitors — — — 1 Head Teachers — — 1 - 4 5 36 22 Total= 67 80 Total attendances (old and new cases) 337 Number of sessions 25 % attending—boys 59.7 girls 40.3 2. Procedure.—At each Clinic the original procedure has been adhered to and is as follows: — (a) Examination of urine is carried out by a Health Visitor (for sugar, albumin, reaction and specific gravity). (b) History of Enuresis is taken (including that of any relevant illnesses). Particular attention is given to the child's routine prior to and at bedtime. (c) Physical Examination. This has sometimes been deferred until the second interview if the child has been particularly nervoiii or ill at ease. (d) The approachability of the child and parent is noted. A child who is interested and keen is, of course, more responsive than the overmothered, shy or defiant little patient. (e) General advice to the child and parent is given, and one would stress again the value found in discussion directed towards individual problems, particularly discussion at the child's level. As has always been the practice at this clinic, more time is spent talking to the child, thus gaining his or her confidence, than in talking to the parent. Results have proved that suggestions made to the child have often been acted upon more faithfully by the mother, than when more general advice has been given. The mother has invariably caught the atmosphere intended quite quickly, and has been able to uphold the feeling of reassurance and confidence in the child, at home. (/) Charting of all dry nights is explained by use of pencil and paper for older children, and by the use of gummed coloured paper shapes for younger ones. (g) Medicinal treatment is issued or prescribed (vide No. 3). 3. Treatment.—The treatment issued or prescribed is as follows:— No. of Cases (a) Amphetamine sulphate (2 5 mgni.—10 mgm.) at night, at a time decided upon for each individual child 56 (fc) Phenoharbitone gr. | at night or during the day (including usage for certain cases failed under (a) above) 3 (c) Charting and advice only 8 67 Also (d) Hospital investigation (failed under (a) or (b) above) 1 (e) Child Guidance Clinic (do. do.) 1 (/) Other treatment (ephedrine gr. ½ + or — Mist, potassium citrate, etc.) (failed under (a) or (b) above) 3 (N.B.—As before, only the amphetamine sulphate was issued by the Area Health Office.) 60 4. Analysis and Comparison of Results. No. of cases: 1955 1954 1953 1952 (i) Completely dry 25 = 38'5% 41-6% 30% 22% (ii) Very marked improvement 6 (i.e., less than 5 wet in 28 nights) (iii) Marked improvement 9 (i.e., less than 14 wet in 28 nights) (iv) Some improvement 9 (v) No improvement 7 (vi) Not yet re-attended 11 67 cases (vii) Of the cases referred to the Clinic during 1954 and who were still receiving treatment in 1955, a further 28 were discharged dry. Further analysis and comparison of cases:— 1955 1954 1953 1952 No. % of total No % of total No. % of total % of total Number of boys dry 16 24.6% 21 27.3% 23 24% 14% Number of girls dry 9 14% 11 14.3% 6 6% 8% Average age of boys 8 yrs. 10 yrs. 8.6 yrs. 7 yrs. Average age of girls 7 yrs. 7 yrs. 7 yrs. 9 yrs. A verage No. of visits: (by boys and girls until discharged dry) 3 visits 3.5 visits 4 visits 4 visits 5. Conclusions.—It is interesting to note that in each year the number of boys referred to the Clinic is approximately twice the number of girls. As in previous years, five factors have been common in those cases which have been slow to improve, namely:— (i) Frustration either at home or at school. (ii) Overcrowding at home. (iii) Mismanagement (by one or both parents). (iv) Physical defect (this is uncommon amongst enuretics seen at Ilford). (v) Mental retardation. The home background is invariably important in the etiology of intractable cases, and where it has been possible to alter environment or circumstance, there has often been a corresponding improvement in the child's condition. There still remain the few cases which, in spite of a good home and co-operative parents, have been slow to respond. One of these cases was treated (in co-operation with the General Practitioner concerned) with "Disipidin" (posterior pituitary snuff) but no improvement occurred in this isolated case. In those cases which have responded, the "early-waking routin" has revealed a considerable number of pre-waking enuretics. Treatment with Amphetamine Sulphate.—During the last three years, results have shown that if a dramatic response is going to occur, it usually shows itself by a half to three-quarters of the number of nights becoming dry by the second month of treatment. 91 The altitudes of both parents and children have continued to be of interest and co-operation. I should like to express appreciation to many General Practitioners who have co-operated by prescribing where it has not been possible to issue medicaments from this office." B.C.G. Vaccination of School Children. No. of pupils to whom B.C.G. was offered 872 No. of pupils whose parents consented to treatment 437 No. of pupils undergoing tuberculin test 405 Positive: 55 No of pupils who received B.C.G. 327 No. of pupils post-tested 324 Converted to Positive 299 Negative 19 Absentees from readings 6 Ministry of Education. MEDICAL INSPECTION RETURNS. Year Ended 31st December, 1955. TABLE I. Medical Inspection of pupils attending maintained Primary and Seeondary Schools including (Special Schools). A.—Periodic Medical Inspections. Number of Inspections in the prescribed Groups:— Entrants 2,688 Second Age Group 2,777 Third Age Group 1,126 Total 6,591 Number of other Periodic Inspections 661 Grand Total 7,252 B.—Other Inspections. Number of Special Inspections 2,715 Number of Re-inspections 5,631 Total 8,346 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).) 62 Group For defective vision (excluding squint) For any of the other conditions recorded in Table IIA Total individual pupils (1) (2) (3) (4) Entrants 103 713 782 Second Age Group 286 629 845 Third Age Group 145 191 305 Total (prescribed groups) 534 1533 1932 Other Periodic Inspections 66 151 200 Grand Total 600 1684 2132 TABLE 11. A.—Return of Defects Found by Medical Inspection in the Year Ended 31st December, 1955. Note.—All defects noted at medical inspection as requiring treatment are included in this return, whether or not this treatment was begun before the date of the inspection. Defect Code No. Defect or Disease Number of Defects Requiring Treatment Number of Defects Requiring Observation but not Treatment Periodic Inspection Special Inspection Periodic Inspection Special Inspection (1) (2) (3) (4) (5) 4 Skin 127 87 25 - 5 Eyes- a. Vision 600 42 265 6 b. Squint 79 4 15 — c. Other 46 85 23 2 6 Ears— a. Hearing 38 17 55 2 b. Otitis Media 12 3 10 - c. Other 9 12 15 7 7 Nose or Throat 260 29 591 7 8 Speech 44 20 39 16 9 Cervical Glands 3 8 110 2 10 Heart and Circulation 75 5 149 8 11 Lungs 197 17 242 5 12 Developmental— a. Hernia 18 1 43 5 b. Other 13 1 61 4 13 Orthopaedic— a. Posture 254 33 30 85 b. Flat foot 296 64 61 158 c. Other 313 49 195 71 14 Nervous system— a. Epilepsy 1 — 6 4 b. Other 1 17 20 1 15 Psychological— a. Development 6 5 4 b. Stability 38 34 52 8 16 Other 152 72 136 46 93 B.—Classification of the General Condition of Pupils Inspected During the Year in the Age Groups (See Note (ii) on Table 1). Age Group Number of Pupils Inspected A—(Good) B.—(Fair) C—(Poor) No. 0/ /o of Col. 2 No. 0/ /o of Col. 2 No. °/ /o of Col. 2 (1) (2) (3) (4) (5) (6) (7) (8) Entrants 2688 1450 53.9 1197 44.5 41 1.5 Second Age Groups 2777 1623 58.4 1128 40.6 26 0.9 Third Age Groups 1126 749 66.5 363 32.1 14 2.1 Other Periodic Inspections 661 361 54.6 293 44.3 7 1.0 Totals 7252 4183 57.6 2981 41.1 88 1.2 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 20,745 (ii) Total number of individual pupils found to be infested 105 (iii) Number of individual pupils in respect of whom cleansing notices were issued (Section 54 (2), Education Act, 1944) 1 (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 32 By parents 53 TABLF 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. 94 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 9 Scabies — 1 Impetigo 12 2 Other Skin Diseases 230 21 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 168 20 Errors of Refraction (including squint) — 1,896 Total 168 1,016 Number of pupils for whom spectacles were (a) Prescribed — 943 (b) Obtained - 965 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 — 4 (b) for adenoids and chronic tonsillitis - 396 (c) for other nose and throat conditions - 12 Received other forms of treatment 103 160 Total 103 572 Group 4.—Orthopaedic and Postural Defects. By the Authority Otherwise (a) Number treated as in-patients in hospitals - 12 (b) Number treated otherwise, e.g., in clinics or out-patients departments - 530 95 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 67 7 Group 6.—Speech Therapy. By the Authority Otherwise Number of pupils treated by Speech Therapists for the first time 144 2 Group 7.—Other Treatment Given. New cases treated By the Authority Otherwise (a) Miscellaneous minor ailments 357 62 (b) Other (1) Heart and Rheumatism - 160 (2) Sunlight Treatment — 79 (8) Massage and Remedial Exercises 287 (4) Enuresis 67 - (5) Hernias - 16 (6) Major Respiratory Diseases — 14 (7) Major Digestive Diseases — 51 (8) Major Injuries — 5 (9) Other Major Diseases — 19 Total 424 643 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 9,278 (fc) Specials 2,328 Total (1) 11,606 (2) Number found to require treatment 6.838 (3) Number referred for treatment 6,838 (4) Number actually treated 4,518 96 (5) Attendances made by pupils for treatment 15,996 (6) Half-days devoted to: Inspection 58 Treatment 1,708 Total (6) 1,766 (7) Fillings Permanent Teeth 6,299 Temporary Teeth 2,296 Total (7) 8,595 (8) Number of teeth filled Permanent Teeth 5,337 Temporary Teeth 2,093 Total (8) 7,430 (9) Extractions: (i) Permanent Teeth:— (a) On account of Caries 744 (b) For other purposes 216 (ii) Temporary Teeth:— (a) On account of Caries 3,333 (b) For other purposes 302 (10) Administration of general anaesthetics for extraction 1,902 (11) Other operations: Permanent Teeth 8,112 Temporary Teeth 1,456 Total (11) 9,568 97 SCHOOL HEALTH SERVICE STAFF AND SCHOOL CLINICS AS AT 31st DECEMBER, 1955. 1.—Staff of the School Health Service. Divisional School Medical Officer: I. Gordon, M.D., Ch.B., M.R.C.P. (Lond), D.P.H. Senior Dental Officer: E. V. Haigh, L.D.S., R.C.S. Number Aggregate staff in terms of full-time officers employed in the School Health Service (a) Medical Officers: (i) Whole time School Health Service - - (ii) Whole time School Health and Local Health Services 7 2.97 (iii) General Practitioners working part-time in the School Health Service • (b) Speech Therapists 3 2 (c) School Nurses including Superintendent *14 (Combined posts, H.V. and S.N.) 6.3 (d) Nursing Assistants 5 (Clinic Nurses) 2.75 (e) (i) Senior Dental Officer 1 0.75 (ii) Dental Officers (PartTime) 10 2.72 (iii) Orthodontists — — (iv) Dental Attendants 5 8.89 *All hold Health Visitor's Certificate. II.—Number of School Clinics (i.e., premises at which Clinics are held for school-children) provided by the L.E.A. for the medical and/or dental examination and treatment of pupils attending maintained primary and secondary schools. Number of School Clinics 5 III.—Type of Examination and/or Treatment provided at the School Clinics returned in Section II, either directly by the Authority or under arrangements made with the Regional Hospital Board for examination ind/or treatment to be carried out at the Clinic, 98 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 3 —- H. Rheumatism and Heart - 1 I. Artificial Sunlight 2 — J. Remedial Exercises 2 — K. Enuresis 1 — L Orthoptic - 1 IV.—Child Guidance Centrf.s. (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 0.82 Educational Psychologists 2 2 Psychiatric Social Workers 2 2 Others:— Play Therapist 2 1 Clerk/Typist 3 8 The Psychiatrists are employed by arrangement with the RegionaJ Hospital Board. 99 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, 1955. SCHOOLS No. on Roll DISEASES AND CONTACTS Scarlet Fever Diphtheria Measles and German Measles Whooping Cough Chickenpox Poliomyelitis Mumps Pneumonia Rheumatism SonneDysen tery Food Poisoning Totals Cases Cum Contacts Cases Contacts Cases ! Contacts Cases Cases Cases Cases Cases Ca.es Cases Cases Contacts Barley Lane 610 21 - - 70 - - - - - - 1 - - 1 93 - Beal Modern 871 - - - - - - - - - - - - - - - - Becontree 1136 2 - 70 5 19 - - 2 1 - - - — 94 5 Benton (Open Air) 126 — 7 1 2 — — — — — 1 — 10 1 Chadwell 761 3 - 88 - - - - - — - - - — 91 - Christchurch 794 1 - 20 - 4 - 1 - — 1 1 - — 28 - Cleveland 1078 1 - 15 1 15 3 5 - - - - - — 38 4 County High 1241 - - — - - - - - - 1 - - — 1 - Dane 707 - - - - - 1 - 1 - - - - - - 2 - Downshall 1269 1 - 1 - - - 2 - - - - - 1 5 - Fairlop 1981 12 — 89 1 14 — 21 1 3 — 2 - 1 143 1 Gearies 1429 5 — 126 - 29 1 5 1 1 — — - 1 168 4 Goodmayes 787 3 — 66 1 7 1 1 — — — — 1 78 2 Gordon 205 3 — 74 - — — 1 — - — — - — 78 2 Highlands 1029 2 — 129 1 31 1 1 — - — — 2 — 165 2 I,oxford 390 - - - - - - - - - - - - - - - - Mayfield 1084 2 - — — - - - - - - 1 - — 3 - Mossford (Fairlop) 302 2 — 21 — 11 — 2 — - — — - — 36 — Mossford (G.V.H.) 191 — — 44 1 7 — — — - 1 1 - — 53 1 Newbury Park 448 — — 23 — 13 — — — 1 — — — — 37 — Parkhill 881 3 — 100 1 — 1 1 1 1 — — — — 106 2 St. Augustine's 294 5 — 26 — 4 — — — 7 — — - — 42 — SS. Peter and Paul's 709 1 — 3 — 9 1 1 1 - — 2 - — 17 1 St. Vincent's 199 — - 12 — 6 — 1 1 - — — - — 20 — South Park 1005 3 — 93 — 8 — 6 1 - — — - 1 112 — The Gilbert Colvin 528 10 - 78 2 26 6 — — 1 - - - — 115 8 The Glade 493 4 — 42 — 14 — — — 1 — — — — 61 — The John Bramston 624 3 — 23 — 5 2 34 1 19 — — 1 — 86 2 The Mount 315 1 — — — — — — — — — — — — 1 — The Redbridge 640 2 — 81 — 13 1 — — — — — — — 96 1 The William Torbitt 905 6 — 88 3 12 — 3 — — — — - — 109 3 Uphall 343 — — 35 — — — — 2 — — 1 - — 38 — Ursuline 332 1 — 1 — 2 — — — — — — - 1 5 — Woodlands 201 1 — 23 1 — — 2 — — — — - — 26 1 Private — 6 — - 37 — 9 — — — — — — — — 52 — Totals 23908 104 - - 1485 23 261 17 88 11 37 4 9 3 7 2009 40 101 102 Table Showing the Average Heights and Weights of Ilford Boys and Girls Examined. Age Groups Age Groups 5—6 Years 6—7 Years 7—8 Years 8—9 Years 9—10 Years 10—11 Years 11—12 Years 12—-13 Years 13—-14 Years 14—15 Years 15—16 Years 16—17 Years 17—18 Years Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children Examined Average Height (in Centimetres) Average Weight j (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) Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) j Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) BOYS 1955 605 113 20.6 842 116 21.9 125 123 24.3 68 124 25.5 38 135 29.9 320 142 34.4 994 144 35.7 46 146 37 3 13 155 470 381 162 50 7 206 168 57'8 62 171 61.4 45 175 63.5 1954 561 118 20.4 718 117 21.8 124 123 23.8 73 128 26.6 52 132 29.2 325 141 34.5 863 144 34 9 63 147 385 33 153 42.5 485 162 48.3 203 167 57.2 75 171 60'2 43 176 641 1958 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 44.0 441 162 510 259 168 55.7 84 172 61.2 35 172 56.6 1952 820 113 20.2 799 116 21.2 65 123 24.8 52 127 26.2 44 132 28.6 1 10 140 32.8 766 143 35 3 46 146 362 52 154 41.3 372 161 49.8 226 167 55.9 47 172 60.3 1 176 56.2 1951 611 113 20.8 568 115 21.7 74 123 23.9 50 128 26.6 43 131 28.6 165 140 33'5 715 143 35.9 42 146 374 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 29.2 208 141 33.9 875 144 35.3 58 149 407 34 151 411 390 161 50.7 231 167 55.7 14 171 60.4 1 174 734 1949 891 118 20.6 433 117 21.9 99 122 24.1 52 127 25.8 55 133 29.2 177 139 329 822 143 34.5 51 147 38.9 40 152 41.9 392 160 50.7 247 165 553 27 171 61.7 3 173 616 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 39 144 370 40 153 436 298 159 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 28.7 369 139 33.1 381 141 338 43 145 .35.7 139 156 44.7 98 157 46.0 2 157 56"6 — — — — — — 1946 771 112 20.2 387 117 21.9 170 124 24.5 101 128 26.0 94 132 28.6 487 139 31.9 468 142 36.1 140 146 37.2 241 155 41.9 146 158 469 40 166 540 — — — — — — GIRLS 1955 604 113 20.1 637 116 21.5 113 121 24.4 74 126 25.9 54 133 29.9 292 141 34.6 1052 144 36 6 73 149 40 5 34 156 48.8 359 159 507 180 159 52.5 68 161 54.8 19 161 54.7 1954 522 111 19.6 605 116 21.3 93 121 22.8 44 125 24.9 52 134 29.2 288 140 33 9 968 144 365 71 148 398 36 155 46.4 481 158 48.4 216 160 550 85 161 56.8 9 164 571 1953 657 112 20.0 827 117 21.3 81 119 22.8 38 127 25.8 37 133 28.9 173 140 325 841 143 355 59 150 399 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 79 148 405 29 155 49.8 410 158 50 5 239 156 54 9 67 160 55 0 5 159 49 0 1951 526 112 20.0 542 116 21.0 60 119 22.8 53 128 26.9 36 132 28.4 166 138 327 811 144 365 48 149 40.1 33 153 43.8 397 158 50.8 248 161 550 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 33.2 837 144 370 64 148 41.2 35 152 43.1 401 157 50.8 140 159 53.0 22 163 52.4 4 163 55.6 1949 823 111 19.9 418 115 21.2 82 121 23.5 46 126 26.0 56 130 28.3 216 139 334 815 143 35.8 57 147 40.7 49 152 44.0 421 158 500 257 161 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 32.4 569 142 350 38 149 399 35 154 45.9 303 157 49" 1 27 160 513 2 160 60.4 — — — 1947 777 111 19.0 224 115 20.7 84 119 23.2 80 126 25.9 65 129 27.4 384 138 322 316 141 34.1 29 145 359 116 155 45.6 92 157 474 1 154 38.7 — — — — — — 1946 708 111 19.3 396 116 21.2 167 121 23.2 116 127 25.2 71 132 28.6 445 138 315 445 142 34.4 76 148 398 265 156 45.8 121 157 48.5 25 162 56.1 18 160 56 9 ~