JournalRebind Co. Ltd. Unit 4, Pier Wharf, Grays, Essex. AC 1l(1) Azhmozdat 801 KF 34 Borough of llford Health Report FOR THE YEAR 1959 I. GORDON M.D., Ch.B., M.R.C.P., D.P.H. Medical Officer of Health, etc. PUBLIC HEALTH OFFICES„ Valentines Mansion, Emerson Road, ILFORD, Essex. WITH THE COMPLIMENTS of THE MEDICAL OFFICER OF HEALTH AREA MEDICAL OFFICER and DIVISIONAL SCHOOL MEDICAL OFFICER TABLE OF CONTENTS Page Ilford Borough Council - Members - Municipal Year 1959-60 1 Public Health Committee - Members - Municipal Year 1959-60 2 Ilford Health Area Sub-Committee - Representatives 2 Ilford Committee for Education - Members Municipal Year 1959-60 3 Officers of the Public Health Services 4-6 Preface 7-11 Reports by:- CONSULTANTS- Dr. Gurassa - Psychiatrist 132 Mr. Korvin - Orthopaedic Surgeon 120 Miss Mason - Ear, Nose and Throat Surgeon 125 Dr. Thorne - Ophthalmologist 119 Dr. Woolf - Cerebral Palsy Unit 130 ASSISTANT MEDICAL OFFICERS- Dr. Gross - Benton School and Cerebral Palsy Unit 128 & 130 Dr. O'Connor Wilson - Remedial Exercises 122 Dr. Pooley - Enuresis Clinic 136 Dr. Taylor - Health Education 104 Mr. Daly - Chief Public Health Inspector 36 Mr. Haigh - Senior Dental Officer 127 Miss Gascoyne - Education Psychologist 135 Miss Oliver - Superintendent Health Visitor 78, 143 Miss Copping - Welfare Officer for Old Folk 23 Miss Hazel - Orthoptist 119 Mrs. Walker - Speech Therapist 126 STATISTICS 8 SOCIAL CONDITIONS (SECTION A.)- Physical Features 12 Population 12 Births and Deaths 12,13,14, 15 & 18 Rainfall 13 Vital Statistics (Tables) 16-17  Page GENERAL PROVISION OF HEALTH SERVICES (SECTION B.)- Home Nursing 19 Laboratory Facilities 19 Legislation in Force 19-20 National Assistance Act 21-23 Hospitals 29 Ambulance Facilities 30 Clinics and Treatment Centres 31-35 SANITARY CIRCUMSTANCES OF THE AREA (SECTION C.)- 38 Swimming Baths 40 Drainage and Sewerage 40 Rivers and Streams 41 Refuse Collection and Disposal 41 Sanitary Inspection of the Area 42 Shops Act 43 Slaughter of Animals Act 43 Rag Flock and Other Filling Materials Act 43 Atmospheric Pollution 43 Land Charges 43 HOUSING (SECTION D.)- Overcrowding 45 Clearance Areas 45 Statistics 45-47 Housing Acts (Permitted number) 47 Housing Repairs & Rents Acts 48 INSPECTION AND SUPERVISION OF FOOD (SECTION E.)- Milk 49 Ice Cream 51 Meat and Other Foods - Inspection and Sampling 53 Hawkers 55 Food Surrendered 55 Food Poisoning 56 Bakehouses 57 Merchandise Marks Act 57 MISCELLANEOUS- Diseases of Animals (Movement Orders, etc.) 57 Prevention of Damage by Pests Act (Rodent 58 Pet Animals Act 60 Petroleum (Consolidation) Act 60 Litter Act 60 Noise Nuisances 60  Page INFECTIOUS DISEASES (PREVALENCE AND CONTROL) (SECTION F.)- Notifiable Diseases 61-62 Table showing total notifications received, 1959 63 Tuberculosis - Notifications, Deaths, etc. 64-66 V.D. Treatment Centres 66-68 Health Education 68 Mass Radiography 69 FACTORIES (SECTION G.)- Inspections, defects and Outwork 71 PART III SERVICES. NATIONAL HEALTH SERVICE ACTS, 1946-57. Births 73 Infant Mortality 75-76 Neonatal Mortality 77 Illegitimate Births & Deaths 77 Visits by Health Visitors 80 Day Nurseries 81-82 Nurseries and Child Minders Regulation Act 82 Health Services Clinics 83-84 Infant Welfare Centres-attendances 84-85 Smallpox Vaccination 92 Midwives 93 Gas and Air Analgesia 95 Maternal Mortality 97 Domestic Help Service 97 Prevention of Break-Up of Families 98 Convalescent Facilities 98 Loan of Sick Room Equipment 100 Chiropody Service 101 Visits by T. B. Visitors 101 Occupational Therapy 101 T.B. Care and After Care 102 Medical Exams-Staff 103 Invalid Night and Day Attendant Service 103-104 Home Nursing 104 Health Education 104 Dental Treatment 108 Welfare Food Distribution 110 Page CLINICS - Ante-Natal 96 Artificial Sunlight 88 Diphtheria Immunisation 89 Ear, Nose & Throat 88 Midwives 94 Obstetric Consultant 97 Ophthalmic 88 Orthopaedic 86 Paediatric 87 Poliomyelitis Vaccination 90 Post-Natal 97 Smallpox Vaccination 92 Speech 89 Whooping Cough Immunisation 90 SCHOOL HEALTH SERVICE- School Roll and Premises 113 Medical Inspection and following up 113 Staff 113,158 Visits 114 Specialist Services 115 Benton School (Physically Handicapped) 128 Cerebral Palsy Unit 130 Handicapped Children 140 Mental Health Service 141 General Welfare 142 B.C.G. Vaccination 147 Medical Examination of Staff and Teachers 147 Causes of Deaths (Schoolchildren) 147 Ministry of Education - Statistical Tables 148-160 Heights and Weights Table 161 CLINICS- Artificial Sunlight 124 Child Guidance 132 Dental 127 Ear, Nose and Throat 125 Enuresis 136 Minor Ailments 116 Ophthalmic 119 Orthopaedic 120 Orthoptic 119 Physiotherapy 124 Speech 126 1 ILFORD BOROUGH COUNCIL Municipal Year 1959-60 COUNCILLOR H.G. ROOT, M.S.M. J.P., Mayor. COUNCILLOR F.R. MASTERS, Deputy Mayor. Aldermen: BARKER, JOHN, J.P. BENNETT, MRS. FLORENCE EDITH. COLVIN, GILBERT, C.B.E., F.C.I.S. COWAN, HAROLD DOUGLAS, F.A.C.C.A., F.C.C.S. FALLAIZE, MRS. LILIAN, J.P. (E.C.C.) GIBSON, CYRIL IRVING. COOCH, LIONEL ARCHER SCOTT. HEADLEY, CECIL AUBREY, J.P. PEARSON, FREDERICK THOMAS. TERRY, MISS ANNE SYLVIA, J.P. WOODS, SIDNEY CHARLES VICTOR. YOUNG, MAJOR ALEXANDER M, O.B.E., T.D., J.P., C.A. (E.C.C.) Councillors: ALY, HARRY REGINALD BERTRAM. BANTHORPE, MRS. RUBY FLORENCE, J.P. BYSOUTH,HENRY ALBERT, F.I.A.C. CHAMBERLIN, MRS. GRACE MARY (E.C.C.). CLACK, ARTHUR HENRY. COPSEY, HUGH EDMUND (from 10.9.59) DAVIES, DAVID SAMUEL. DAVIES, GEORGE EVELEIGH, J.P., B.Sc. DREW, LESLIE VICTOR. EAREY, ERIC RAYMOND, J.P. F.N.A.A., F.V.I. GLEED, SYDNEY GEORGE. GREEN, CECIL FREDERICK HERBERT, F.A.I.B., (E.C.C.). GROSE, JOHN STANLEY. HARRIS, EDGAR FRANK. HERRIDGE, WILLIAM HENRY, J.P., (E.C.C.). HITCHCOCK, LEONARD, A.I.B. JAMES, FRANCIS HERBERT. LITTLEJOHN, MRS. RUTH CONSTANCE, M.A. LIVERMORE, JOHN. LOVELESS, CHARLES EDGAR, F.A.I.A. LOVELESS, SYDNEY FRANK. MARTIN, ROBERT. MASTERS, FRANK ROBERT, (Deputy Mayor). MURPHY, JOHN LOUGHLIN, J.P., A.I.N.A., A.I.Mar.E. NATZLER, ISAAC BERNARD. NORWOOD, JOHN HENRY. OSBORNE, ALAN FRANK. PARFITT, JOHN HOWARD, B.Sc. (Econ.) (to 29.7.59). ROLFE, CYRIL GEORGE, A.I.S.T. ROOT, HAROLD GOLDSTONE, M.S.M. J.P., (Mayor) RYDER, JOHN LOUIS. SEAMAN, ERIC WILLIAM, A.A.C.C.A. SHAW, ARNOLD JOHN, B.A. SHERRELL, ALBERT REGINALD PRENTICE, (E.C.C.) WATERS, OWEN FRANCIS, J.P. WATSON, GEORGE HENRY. WOODS. DOUGLAS EDWARD. 2 PUBLIC HEALTH COMMITTEE Municipal Year 1959/60 ALDERMAN MISS A.S. TERRY, J.P., CHAIRMAN. COUNCILLOR A.R.P. SHERRELL (E.C.C.), Vice-Chairman. ALDERMAN J. BARKER, J.P. ALDERMAN G. COLVIN, C.B.E., F.C.I.S. COUNCILLOR MRS. G.M. CHAMBERLIN (E.C.C.). COUNCILLOR S.G. GLEED. COUNCILLOR L. HITCHCOCK, A.I.B. COUNCILLOR F.R. MASTERS, (Deputy Mayor). COUNCILLOR J.H. NORWOOD. COUNCILLOR A.F. OSBORNE. COUNCILLORC.G.ROLFE, A.I.S.T. COUNCILLOR H.G. ROOT, M.S.M., J.P., (Mayor). COUNCILLOR J.L. RYDER. COUNCILLOR E.W. SEAMAN, A.A.C.C.A. COUNCILLOR G.H. WATSON. COUNCILLOR D.E. WOODS. ILFORD HEALTH AREA SUB-COMMITTEE OF THE HEALTH COMMITTEE OF THE ESSEX COUNTY COUNCIL Municipal Year 1959/60 Ilford Borough Council Representatives: ALDERMEN BARKER, COLVIN, MISS TERRY (Chairman); COUNCILLORS MRS. CHAMBERLIN (Vice-Chairman), CLACK, HARRIS, HITCHCOCK, MRS. LITTLEJOHN, C.E. LOVELESS, MASTERS (Deputy Mayor), MURPHY, OSBORNE, ROLFE, ROOT (Mayor), SHERRELL Essex County Council Representatives: ALDERMEN MRS. BALL, YOUNG, COUNCILLORS BERRY, MRS. FALLAIZE, MRS. GODFREY, MRS. WELSH, WORTLEY. The Executive Council for Essex Representative: MR. W.G. CATCHPOLE. Local Medical Committee Representative: Dr. S.M. PRUSS. Hospital Management Committee Representative: MR. W.A. PARISH. Voluntary Organisations' Representatives: MRS. G.M. BUTLER, MRS. D M. HOLLOWAY, MISS N.L. ODELL, MR. C.L. TUTT. 3 ILFORD COMMITTEE FOR EDUCATION Municipal Year 1959/60 ALDERMAN C.I. GIBSON, Chairman. ALDERMAN G. COLVIN, C.B.E., F.C.I.S., Vice-Chairman. ALDERMAN, J. BARKER, J.P. ALDERMAN MRS. F.E. BENNETT. ALDERMANMRS. L. FALLAIZE, J.P. (E.C.C.). ALDERMAN F.T. PEARSON ALDERMAN MISS A.S. TERRY, J.P. ALDERMAN MAJOR A.M. YOUNG, O.B.E., T.D., J.P., C.A. (E.C.C.). COUNCILLOR H.R.B. ALY. COUNCILLOR MRS. G.M. CHAMBERLIN (E.C.C.). COUNCILLOR H.E. COPSEY (from 22.9.59). COUNCILLOR G.E. DA VIES. COUNCILLOR MRS. R.C. LITTLEJOHN, M.A. COUNCILLOR J. LIVERMORE. COUNCILLOR S.F. LOVELESS. COUNCILLOR F.R. MASTERS. (Deputy Mayor). COUNCILLOR J.L. MURPHY, J.P. A.I.N.A., A.I.Mar.E. COUNCILLOR J.H. PARFITT, B.Sc. (Econ.). (to 29.7.59). COUNCILLOR C.G. ROLFE, A.I.S.T. COUNCILLOR E.W. SEAMAN, A.A.C.C.A. COUNCILLOR A.J. SHAW, B.A. COUNCILLOR O.F. WATERS, J.P. Co-opted Members: MR. S.R. BAKER. MRS. D.E. CARTER. THE VERY REV. CANON M. HANCOCK, B.A. MR. U.S. KENWARD, M.A. MR. E.R. LOWER, B.A. THE REV. H.R. NEALE. MISS F. STEVENS. County Nominated Members: COUNTY COUNCILLOR A.F.J. CHORLEY, M.B.E. COUNTY COUNCILLOR A.R.P. SHERRELL. 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: G.W. NEWMAN. J. COOK. R.E. SMALLEY. F. NAU. A.C.R. NEALE. D.F. SCOTT. T.F. JOHNSON. J.A. HARRIS C. BROOMFIELD. Chief Administrative Assistant (l.B.C. and E.C.C.): F.J. HOCKING. Administrative Assistant A.E. TOURLE. Welfare Officer for Old Folk: MISS M.J. COPPING, Dip. Social Sc. (Lond.). 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.) (Part Time). J.M. POOLEY, M B., B.S. (Lond ), D.C.H. (Part Time). R.M. NOORDIN, M.R.C.S., L.R.C.P. G.B. TAYLOR, M.B., B.S. (Lond ), D.C.H., D. Obst. R.C.O.G. Senior Dental Officer: E.V. HAIGH, L.D.S., R.C.S. (Eng.). Educational Psychologists: MISS B.S. GASCOYNE, B.A. (Hons. Psych.). MISSC.H.F. WATT, B.A. (Hon) (from 1.9.59.). Psychiatric Social Workers: MISS P, RADFORD. MISS J.M. BARTON. Speech Therapists: MRS. M.WALKER, L.C.S.T. MRS. P A. PRETIOUS, L.C.S.T. Cerebral Palsy Unit: Physiotherapists: MRS. B. LENNOX, M.C.S.P. (to 4.7.59.) MRS. F.G.COCKER, M.C.S.P. (to 31.8.59.) MISS G.L. BOWERS, M.C.S.P. (from 9.5.60.) MISS G. LE SAGE (from 16.5.60.) Occupational Therapist: MRS. M.I. RAVEN. 5 Officers of the Public Health Services—continued. Non-Medical Supervisor of Midwives: MISS R.K. JESSON. 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 C. OLDHAM MISS P.M. LEAVETT MRS. J.M. WESTON MRS. J.H. GADD (from 22.6.59.) MRS. L.K. LAWRENCE (part-time) MISS I. HARRIS (part-time) (from 19.10.59) MISS I.L. MOBBS MISS A.E. RIDPATH MRS. R.M.E. NELSON (to 29.2.60.) MRS. L.M. ELDRIDGE MRS. C.D. CONSTABLE MISS M.M. STOWER MISS L.A. MARTIN (to 21.10.59.) MISS R.A. BARTON MRS. M.R. VAN ALTAAN MRS. G. ODLING MRS. M.K. PRESSEY MRS. M. WELLER (part-time) (from 7.12.59.) Tuberculosis Visitors: MISS M. FORDE (to 1.10.59.) MRS. B.P. MAKEPEACE (to 7.5.60.) MRS. K.M. PARKES. MRS. M.J. MOORE (from 13.6.60.) MRS. C. EARWAKER (from 11.7.60.) Occupational Therapist (T. R. Cases): MISS Z.E. MERCER. Matrons of Day Nurseries: Goodmayes Lane Ley Street Mrs. E. DROWER. Miss G.M. GROSS Administrative Assistants: MISS H. NUNN (Part 111 Services). E.S. JENKINS (School Health Services). Domestic Help Organisers: MRS. L.G. LAWRENCE. MRS. K.M. BEDWELL. Chiropodists: MR. F.W. GIBSON (from 28.3.60.) MISS M.I. MERCER (from 20.4.60.) PART TIME:— Regional Hospital Board. Surgeon in charge of Orthopaedic Clinic: H.G. KORVIN, D M., K.H.C.S. Ophthalmologists: H.J.R.THORNE, M.B., B.S., D.O., D.O.M.S. C.W. BROWN, M.R.C.S., L.R.C.P. (to 31.1.60.) P. LANCER, M B., B.S. (from 2.2.60.) 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 Paediatric Clinic: A. RUSSELL, O.B.E., M.D., M.R.C.P. Child Guidance Clinic: Consultant Psychiatrist: W.P. GURASSA, M.D., M.R.C.P. Psychiatrist: H.J. ALTSCHULOVA, M.D. Cerebral Palsy Unit: Consultant: D.L. WOOLF, D.Phys.MedM.R.C.S., L.R.C.P. (to 30.6.60.) H.B. LEE. F.R.C.S. (from 1.7.60.) Orthoptist: MISS C. HAZEL, D.B.O. Pysiotherapist: A. BRAND, M.C.S.P. Essex County Council. Assistant Dental Officers (Part-time): E.M. SYCAMORE, M.R.C.S., L.R.C.P., L.D.S., R.C.S. (Eng.). (to 26,9,59.). R.J. NEWMAN, M.B.E., L.D.S., R.C.S. (Eng.), J.P. J.T. HUTCHINS. R.A. SOAR, B.D.S. R.C. BIGMORE. Y.G. TOOLSY, B.D.S. B. ABRAHAMS, L.D.S., R.C.S. (Eng.). (from 16.3.59.) W.V. VICTORS, L.D.S., B.D.S. (from 12.10.59.) Child Psycho-Therapists (Non Medical): MISS P. OPPENHEIMER, B.A. MISS L. FOLKART, B.A. Speech Therapist (Part-time): MRS. B.J. TINGEY, L.C.S.T. (from 19.4.60.) MRS. E.A. McGILL, L.C.S.T. (to 11.2.60.) Ilford Borough Council. Public Analyist: J. HUBERT HAMENCE, M.Sc., Ph.D. 7 Preface Phone PUBLIC HEALTH OFFICES, VALentine 3401 ILFORD. July, 1960. To the Mayor, Aldermen and Councillors of the Borough of Ilford. MR. MAYOR, LADIES AND GENTLEMEN, I submit herewith the Annual Report of the Health Services for the year 1959. In this report I intend to make my preface brief, dealing mainly with the difficulties of the water supply in the eastern part of the borough. A feature that has led to this brevity is my policy of trying to make individual officers express their own opinions as to various developments. The Chief Public Health Inspector has some interesting ideas on the relationship of the Public Health Inspectorate to the Police; Miss Copping, Welfare Worker for the Aged, has as usual some most decided and personal views. A newcomer is Dr. Taylor, Assistant County Medical Officer, appointed to devote an appreciable portion of his time to health education. His views on the success and failure of different forms of such education are interesting and provocative. Officers are appointed to do their jobs properly, not to write entertainingly about them, so it cannot be expected that all have equal facility with the pen, therefore I hope that it will not be taken as a slur that I do not mention each one individually. In particular one group have not been asked to write at all, the administrative staff. This is because although the maintenance of the public health depends to an enormous extent on their efficiency the general public cannot be said to be much interested in the internal workings of the department. A FEW STATISTICS In 1958 the infant mortality rate of 16. 6 deaths per 1,000 births caused me to comment that it would be 8 cult to conceive that that extraordinarily low rate could be reduced much further. Well, it has been, to a new record of 14.9. Thirty three infants under one year of age died in 1959, 27 of them in the first month, leaving six deaths only that could not be described as neo-natal. Only ten years ago in 1949 for example, of the 53 infant deaths 33 were in the first month and 20 later. This comparison of 6 with 20 shows the success we are having in preventing and curing infectious disease, and the comparison of 27 and 33 neo-natal deaths the relative lack of success in dealing with that group where congenital defects and prematurity are so prominent a feature. Otherwise there is not much change in the statistics from the previous year. This unexciting statement conceals the fact that no mother died in childbirth, and there were no deaths from diphtheria, whooping cough, meningococcal infection, scarlet fever, enteric, infantile diarrhoea and measles. There was however, one death from poliomyelitis. However, problems of our modern times that are not so easily controlled are shown by 104 deaths from lung cancer (1958 - 88), coronary disease 326 (1958 - 310), suicide 28 (1958 - 20). These three groups of figures show the direction in which the future activities of the Medical Officer of Health must lie and that there is still much for him to do. MATTERS OF INTEREST I will briefly indicate here a few new features of the past year. A chiropody service has been introduced, B.C.G. vaccination (for tuberculosis) and poliomyelitis vaccination extended. Demand for day nursery accommodation is increasing and so is the domestic help service, which in addition has taken over the invalid night attendance service from the Ilford Social Service Association. One new clinic (Kenwood Gardens) has been opened and another (Heathcote) will probably be functioning by the time this report is read. Our midwives are now assisting in the training of pupils. Health education is being actively pursued with the appointment of an Assistant County Medical Officer who spends an appreciable portion of his time in such activities. Further details on all these matters will be found in the body of the report. Early in the year when the clinics in Valentines Mansion moved to Kenwood Gardens the opportunity was 9 taken to expand the accommodation available to the overcrowded health office staff. Some adaptations were also carried out and working conditions have greatly improved. WATER, WATER, EVERWHERE- But not a drop from your garden hose until 1965 at the earliest, if you live in that part of Ilford served by the South Essex Waterworks Company. (S.E.W.C. ) It is difficult to believe in this very wet first half of July 1960 that last summer was phenomenally dry. School kitchens on occasions were without adequate supplies for the provision of meals, toilets in schools and a cinema were without flushing facilities and the local hospital found itself in great difficulties. The S.E.W.C. attributed much of the trouble to excessive use of hosepipes for watering private gardens and on the 8th July "temporarily" prohibited their use. The western part of the borough is served by the Metropolitan Water Board (M.W.B. ) who can supply all the water required in their section, although even the Board noted a drop in water pressure in the evenings in the Clayhall area during that period due to abnormal garden watering. They anticipate no future difficulties. The future outlook in the S.E.W.C. section is however very different. Although the Hanningfield Reservoir has been recently completed, a new boosting station about to come into operation and a new main to be constructed from the Heaton Grange Reservoir (Romford) commencing this November, in order to meet the demand for domestic and industrial purposes up to 1965 garden watering must be suspended. To meet the demand in 1965 the S.E.W.C. are negotiating for a supply from the only river now available to them in the County (the name of the river is not disclosed to me). If, however, the Order from the Ministry for the abstraction of this water is not granted the situation will become serious until 1968, involving the strictest economy in the use of water for domestic and trade purposes. Why 1968? The M.W.B. now endeavour but cannot guarantee to let the S.E.W.C. have 3½ million gallons daily from their Lee Bridge Works and some deep wells. There is no hope of improvement from this source for the River 10 Lee is used to capacity. It is one of the miracles of modern water engineering that the M.W.B. water from the River Lee is pure and wholesome, although a quarter of its daily flow is treated sewage and industrial effluent from places like Luton, Harpenden, Wheathampstead, Hatfield and others. The real change will come when the M.W.B. can make Thames water available when present works are completed. A main of 102" diameter in a tunnel will lead ample supplies of this water from Hampton to Walthamstow. This work should soon be completed but enormous engineering development will still be required to ensure this water is adequately stored, filtered, sterilized and delivered. When this is completed in 1968 at the earliest, and if satisfactory arrangements are made between the M.W.B. and S.E.W.C. (no doubt the Ministry will ensure they will be made) our troubles will be over. At least, say the S.E.W.C. , until 1981. Who is to blame for all this? Obviously we cannot blame the S.E.W.C. for the shortage of water sources in Essex, but could they have foreseen this shortage and persuaded the M.W. B. to provide adequate quantities of Thames water years earlier. The S.E.W.C. seem very satisfied that 25 gallons of water per head per day is provided, locally for domestic purposes. This amount has been satisfactory in the past for the average Englishman* but in the sixties when we have never before had it so good with better houses and more baths, and vastly increased numbers of motor cars that have to be washed, and industry expanding, could it not have been foreseen that the individual demand would rocket towards quantities that may seem excessive to the S.E.W.C. but not to American water engineers? The present negotiations of the S.E.W.C. and M.W.B. began in 1956, should they not have started in 1950? Perhaps also the S.E.W.C. feel that they were not sufficiently consulted about the export of population from London to Essex, if so, did they make their difficulties sufficiently well known? We can hardly blame the M.W.B. for not planning sufficiently well aheadfor other supplying authorities. They obviously manage their own area of supply efficiently. Can we blame the local authorities? They are represented on the M.W.B. with which organisation we have no quarrel. The S.E.W.C. is a statutory water company and thus has no local authority representation on its board, it 11 provides us with no annual report and there is no method of liaison except by correspondence in times of trouble. Surely public relations, actively pursued, should be even more a policy of a water company than it is of some of our leading industrial concerns, who have made of public relations a foremost feature (even though such a company tries to increase the demand for its product, whereas the S.E.W.C. would only be too happy if the demand were less. ) Is there not food for thought in the fact that at the end of this decade the west portion of the town will be supplied by M.W.B. water directly and the east portion by M.W.B. water that has been sold to the S.E.W.C. ? ACKNOWLEDGEMENTS In conclusion I must again thank the staff in the Public Health Department, both borough and county, for their unstinted co-operation. The voluntary societies who help us in our daily tasks and blaze the trail with new ventures that statutory bodies cannot at first undertake, but are apt to take over when they prove successful; once more I thank them. I would also like to record my appreciation of the friendly assistance of fellow Chief Officers. I would like to express my thanks to the members of the Council, especially to the Chairman, Vice-Chairman and Members of the Committees of the Ilford Borough Council and Essex County Council with whom I work. I have the honour to be Your obedient Servant, I. GORDON, Medical Officer of Health. *The Chief Public Health Inspector draws my attention to the second report of J.Simon, M.D., M.O.H. ,City of London, 1850, wherein he states that the Water Companies claimed then that they were supplying 21 gallons per head per day for domestic use. In addition Roman citizens were receiving 300 gallons per head per day in the fourth century A.D. 12 The following figures as to unemployment were supplied by the Ministry of Labour:- Males Females As at December, 1958 605 128 As at December, 1959 476 72 1959 1958 Live Births 2,216 2,228 Live Birth rate per 1,000 population — Crude rate 12.41 12.45 Adjusted rate 12.41 12.45 Illegitimate Live Births per cent of total live births 3.70 3.28 Stillbirths 49 43 Stillbirth rate per 1,000 total live and stillbirths 21.63 18.93 Total Live and stillbirths 2,265 2,271 Infant deaths (under 1 year) 33 37 Infant mortality rate per 1,000 live births — Total 14.89 16.61 „ „ „ „ „ „ „ _legitimate 14.99 16.70 „ „ „ „ „ „ „ - illegitimate 12.20 13.70 Neo-natal mortality rate per 1,000 live births (first for weeks) 12.18 13.02 Early Neo-natal mortality rate per 1,000 total live births (under one week) 10.38 - Perinatal mortality rate (stillbirths and deaths under one week combined per 1,000 total live and stillbirths) 31.78 - Maternal deaths (including abortion) Nil Nil Maternal mortality rate per 1,000 live and stillbirths 0.00 0.00 Deaths (all causes) 2,037 1,985 Death rate per 1,000 population — Crude rale 11.41 11.09 Adjusted rate 11.29 10.76 Percentage of total deaths occurring in public institutions 52.91 48.61 Deaths from Cancer (all ages) 387 369 „ „ Measles (all ages) Nil Nil „ „ Whooping Cough (all ages) Nil Nil „ „ Diarrhoea (under 2 years of age) Nil Nil SECTION A. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in Acres) Land and Inland 8,411 Water 8,404 Tidal Water 7 Population (Census 1921) 85,194 (Census 1931) 131,061 (Census 1951) 184,706 Registrar—General's Estimate of resident Population:- June 30th 1956 180.600 „ „1957 179,600 „ „ 1958 179,000 „ „1959 178,600 Number of inhabited houses (April 1st, 1959) according to Rate Books (approx) 52,239 Rateable Value — April 1st, 1959 (Houses and Land) £3,045,548 Sum represented by a penny rate, April 1st, 1959 (approx.) £12,320 1958-59 1959-60 Combined Rate (all services) 19s.l0d. in the £ 20s.6d. in the £ 13 1. RAINFALL Total rainfall registered in the district during the year was 16. 62 inches; the greatest fall in 24 hours was registered on 21st May, 1. 30 of an inch. December was the wettest month. 2. COMPARABILITY FACTOR - BIRTHS AND DEATHS. The Registrar-General supplies each town with figures known as the "area comparability factor" in connection with the birth and death rates. These factors make 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 death rate area comparability factors are also adjusted specifically to take account of the presence of any residential institutions in each area, and the birth rate area comparability factors are adjusted specifically to take account of the presence of sterile population in institutions for the mentally ill or mentally deficient in each area. The figures for Ilford are 1.00 for the birth rate and .99 for the death rate, and these are used in calculating these rates in Table 1A. When local crude birth and death rates have been adjusted (by multiplication by the appropriate area comparability factors) 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 ofbirths registered (adjusted for inward and outward transfers) during the year was 2,216. Males Females Legitimate 1,087 1,047 Illegitimate 40 42 i.e., 3.7 per cent. of the births registered were illegitimate. The percentage of illegitimate births registered in the previous 10 years was 3. 3 (1958), 2.7, 2.8, 2.6, 2.2, 3. 0, 3. 9, 2. 9, 3. 1, 2.4. 14 The adjusted birth rate, calculated on the estimated population of 178,600 is 12.41 per 1,000. 4. DEATHS. The total number of deaths of Ilford residents was 2,037. This is obtained by taking the total number of deaths registered in the district (1,682), subtracting the deaths of non-residents, occurring in the district (257), and adding the deaths of Ilford residents registered as having died in other districts (612). The number of deaths of non-residents registered in the district was as follows:- King George Hospital 86 Chadwell Heath Hospital 44 Claybury Hospital 67 Goodmayes Hospital 22 Other Non-residents 38 Total 257 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 Wanstead Hospital 38 Langthorne Hospital 69 London Hospital and Brentwood Annexe 74 St. Bartholomew's Hospital- 8 Rush Green Hospital 19 St. Joseph's Hospice, Hackney 15 London Chest Hospital 10 St. George's, Hornchurch 49 East Ham Memorial Hospital 8 Harold Wood Hospital 8 Whipps Cross Hospital 57 In other Hospitals, ions and residences outside the Ilford district 175 Total 612 15 The adjusted death rate, calculated on the estimated population of 178,600 is 11.29 per 1,000. Inquests.- During the year, 94 inquests were held on deaths occurring in Ilford, 65 on Ilford residents, and 29 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 1 2 3 10 30 48 DEATH RATES FROM CANCER, 1959. The following Table shows the death-rates for 1959 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 Cancer of lung and bronchus .582 .464 Cancer, other forms 1.585 1.676 5. TABLES OF VITAL STATISTICS.- Table I gives a comparative statement of the birth-rate and death-rate for the past five years. Table 1A gives a comparison of the vital statistics of Ilford with England and Wales, and the London Administrative County. Table II gives a classified statement of the causes of death in 1959, arranged according to the age groups at which deaths occurred. 16 TABLE I. - VITAL STATISTICS OF WHOLE DISTRICT DURING 1959 AND PREVIOUS YEARS Year Resident population, estimated to middle of each Year Births Total Deaths Registered in the District Transferable Deaths Net Deaths belonging to the District Uncorrected Number Net (a) of Non-Residents registered in the District of Residents not registered in the District Under 1 year of Age At all Ages Number Rate Number Rate (b) Number Rate per 1,000 Net Births Number Rate 1 2 3 4 5 6 7 8 9 10 11 12 13 1955 181,700 1,632 2,100 11.56 (c) 1,670 9.2 152 563 42 20.0 2,081 11.45 (c) 1956 180,600 1,738 2,115 11.71 (c) 1,676 9.3 162 572 33 15.6 2,086 11.55 (e) 1957 179,600 1,788 2,219 12.35 (c) 1,713 9.5 150 601 38 17.1 2,164 12.05 (c) 1958 179,000 1,785 2,228 12.45 (c) 1,622 9.1 241 604 37 16.6 1,985 11.09 (c) 1959 178,600 1,802 2.216 12.41 (c) 1,682 9.4 257 612 33 14.9 2,037 11.41 (c) (a) The net number of births is obtained by taking the uncorrected number of births supplied by the local Registrar and adjusting for inward and outward transfers. (b) Calculated on the estimated resident population. (c) Crude rate. 17 TABLE IA Table showing comparison between the Birth-rate, Death-rate, etc., of Ilford, London (Admin. County), and of England and Wales for the Year 1959. 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 16.5 20.9 11.6 22.2 0.5 - 173 1.4 602 London Admin. County 17.3 10.3 11.0 22.3 0.9 - 181 5.0 817 ILFORD (Estimated Population mid-1959=178,600) 12.41 21.6 11.29 14.9 - - 1401 5.62 8063 A dash ( —) signifies that there were no deaths. 125 deaths 21 death. 3144 deaths. 18 Registrar-General's Short List of Deaths and Causes TABLE II Causes of, and Ages at, Death during the year 1959 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 5 years 5 and under 15 years 15 and under 25 years 25 and under 45 years 45 and under 65 years 65 and nnder 75 years 75 years and upwards ALL CAUSES 2,037 33 4 8 12 68 491 542 879 1 Tuberculosis, respiratory 12 - - - - 2 7 - 3 2 Tuberculosis, other 1 - - - - - 1 - — 3 Syphilitic disease 2 - - - - - - - 2 4 Diphtheria - - - - - - - - - 5 Whooping cough - - - - - - - - - 6 Meningococcal infections - - - - - - - - - 7 Acute poliomyelitis 1 - - 1 - - - - - 8 Measles - - - - - - - - - 9 Other infective and parasitic diseases 6 1 1 1 - - 2 - 1 10 Malignant neoplasm, stomach 46 - - - - - 19 17 10 1 1 Malignant neoplasm, lung, bronchus 104 - - - - - 49 42 13 12 Malignant neoplasm, breast 34 - - - - 4 16 5 9 13 Malignant neoplasm, uterus 25 - - - - 2 7 6 10 14 Other malignant and lymphatic neoplasms 178 - - 1 2 9 58 55 53 15 Leukaemia, aleukaemia 8 - 1 1 - 1 2 2 1 16 Diabetes 12 - - - - 1 4 4 3 17 Vascular lesions of nervous system 242 - 1 - 2 2 35 70 132 18 Coronary disease, angina 326 - - - - 9 88 106 123 19 Hypertension with heart disease 73 - - - - - 16 19 38 20 Other heart disease 238 - - - - 4 33 46 155 21 Other circulatory disease 94 - - - - 4 22 20 48 22 Influenza 25 - - - - 1 4 8 12 23 Pneumonia 144 4 - - - 3 16 34 87 24 Bronchitis 137 1 - - - - 41 42 53 25 Other diseases of respiratory system 25 1 - - - 1 5 7 11 26 Ulcer of stomach and duodenum 21 - - - - - 5 10 6 27 Gastritis, enteritis and diarrhoea 9 - - - - 2 2 3 2 28 Nephritis and nephrosis 8 - - - - 1 3 1 3 29 Hyperplasia of prostate 15 - - - - - 1 2 12 30 Pregnancy, childbirth, abortion - - - - - - - - - 31 Congenital malformations 15 9 - 2 - 1 1 2 - 32 Other defined and ill-defined diseases 146 17 - - 1 13 25 29 61 33 Motor vehicle accidents 20 - 1 — 5 3 6 - 5 34 All other accidents 40 - - - 1 1 7 7 24 35 Suicide 28 - - - 1 4 16 5 2 36 Homocide and operations of war 2 - - 2 - - - - - Special Causes (included above) Smallpox - - - - - - - - - 19 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 Es sex County Council. A report of the work performed during 1959 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, EssexC.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. ) 20 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 1959, 26 applications for renewal of licences were received. The Council renewed the licences in respect of these establishments. The licences expire on 31st March of each year. Hairdressers' and Barbers' Premises. (Essex C.C. Act 1933, Part VI). During 1959, 55 visits of inspection were made by the Public Health 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. (vii) NURSES AGENCIES ACT 1957. The Essex County Council on application by the Ilford Council, delegated to them, the powers conferred upon the County Council by 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 Section 3(2) to enter and inspect any such licensed premises in the Borough. 21 No application for a licence was received during 1959. (viii) NATIONAL ASSISTANCE ACT, 1948.- The County Welfare Officer has kindly supplied me with the following information. "The County Welfare Committee is responsible to the County Council for functions under Part III of the National Assistance Act, 1948, the main aspects being:- (a) the provision of residential and temporary accommodation, and (b) welfare arrangements for blind and other handicapped persons. The following statistics show the extent to which the main services provided by the County Welfare Committee under the National Assistance Act, 1948, have been afforded to persons residing within the Borough of Ilford during the year 1959:- (1) Residential and Temporary Accommodation. (a) Aged persons admitted to hostels and other residential establishments:- 65 (b) Other persons admitted to residential accommodation:- 1 (c) Persons admitted to temporary accommodation:- Adults, 2; Children, 6;- 8. The County Council now have two Old Peoples' Homes in Ilford-Pegram House, Longhayes Avenue, Marks Gate, accommodating 47 residents and Heath Gate, Chadwell Heath Lane, Chadwell Heath which accommodates 60 residents. Additionally, financial grant is made by the County Council towards the cost of Welfare Services and amenities provided by the Borough in their special accommodation for old people at Stoneleigh Court. (2) Blind Persons The numbers of registered blind, partially sighted and defective sighted persons resident in the Borough as at 31st December, 1959, were as follows:- 22 (i) Registered as blind 323 (ii) Partially sighted 63 (iii) Defective sighted 14 all of whom were under the supervision of the County Council's Home Teachers. During the year 3 blind residents participated in the Home Workers' Scheme operated through the agency of the Royal London Society for the Blind, and I was employed in aWorkshopfor the Blind. In addition, 30 blind and 7 partially sighted residents were employed in open industry. During 1959, 2 blind residents from the Borough were admitted to homes for the blind. (3) Deaf or Dumb and other Handicapped Classes. The Welfare Committee of the County Council has continued to develop its activities in respect of welfare services for permanently and substantially handicapped persons (other than blind, as mentioned above) as provided for under Section 29 of the National Assistance Act, 1948, and in addition to direct provision such as special equipment on loan, grants towards the cost, of structural adaptations to meet special needs, etc. the fullest co-operation has been maintained with specialised organisations in this field of welfare services, many of these bodies actting as the Council's agents in this connection. An Occupational Centre for the physically handicapped has been opened at Barking and this is used, amongst others, by suitable handicapped persons from the Borough of Ilford. In addition, Visiting Officers have been appointed to assist in the work amongst handicapped persons and they will be instrumental in the ascertainment of individual needs, giving advice and also instruction in handicrafts, especially to the home-bound." In Ilford the scheme for other handicapped persons, sofar as voluntary action is concerned, has been delegated to a Sub-Committee of the Ilford Social Service Association of which the Medical Officer of Health is Chairman. 23 NATIONAL ASSISTANCE ACT, 1948. (a) Section 47 provides for the removal of persons to hospital who are unable to devote to themselves proper care and attention. Two persons were dealt with during the year. They were a male aged 76 years and a female aged 86 years. Both were admitted to hospital. (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 one person was dealt with during the year, a male, aged 83 years, who died at home. Miss M.J. Copping, Welfare Officer for Old Folk, reports as follows:- "During the year 1959, 679 visits were paid to elderly people, and 300 interviews conducted at the Public Health Offices, and elsewhere with relatives of the old people, other case workers, Almoners, Clergy and various persons with an interest in the cases. Many of the visits and interviews must, to meet the convenience of relatives, take place in the evenings or occasionally on Saturday afternoon or even on Sundays. The above visits exclude 699 visits to the elderly made by the Essex County Council Health Visitors and friendly visits made by voluntary persons which, I believe, have increased since last year. Certainly the number of visitors has increased, and I would like to record my thanks and appreciation of the efforts of those who so generously spare a little time from what are without exception very busy lives, to brighten the lives of the elderly and physically handicapped and incidentally assist me too by so doing. I am doubly grateful to those who have come to my aid immediately in some emergency and those who have provided transport to and from stations for old persons proceeding on convalescent holidays. Many 24 find walking to the public transport or mounting bus steps very difficult. The visits paid by me were almost identical in character to those paid last year. Approximately half were to persons awaiting admission to, or recently discharged from, the Geriatric Unit. This Unit is a tremendous blessing. No longer do we have cases referred to us by worried general practitione rs who cannot obtain beds. There are times when there is a waiting period of a week or two, but I think it is correct to say that no urgent case had to wait during 1959- My once weekly visits to the Unit continued throughout the year and I always look forward to them with pleasure. As for the old persons themselves, the majority of those admitted to the Unit thoroughly enjoyed their stay, and I find them full of praise for the medical and nursing staffs, and that sometimes forgotten, but exceptionally cheerful and compassionate section, the ambulance personnel. We do occasionally have a few grousers but these are invariably persons who by reason of their disabilities or their temperaments would not be happy and comfortable in any place. There are also those who, as the result of senile changes, are mentally incapable of settling down in Hospital or of understanding and appreciating what is done for them. My experience is that such persons become more confused when removed from their own familiar surroundings and unless there is some physical condition which necessitates Hospital care, they are better in their own homes with the help of domiciliary services. On the other hand, relatives and friends very understandably seek, and indeed require, a breakfrom them, but admission toHospital could sometimes be avoided if all the members of a family would pull their weight, and pool their resources. I do not agree with a current idea that families grow more inclined year by year to depend upon the Welfare State and to leave their old people to the care of the authorities, but I do find that there is a tendency to take it for granted that one particular member should take the entire responsibility, sometimes the eldest is thought to be the one whose duty is the greater; some men insist that they are exempt because "nursing is a woman's job". It does not seem to occur to them that the actual nursing is not 25 the only factor to be considered and that they could help by sitting with the patient occasionally or by arranging an outing by car, by pushing the invalid chair, or giving a little financial help which would lighten the task in some way. I am glad to say that this attitude more frequently arises out of sheer thoughtlessness than from deliberate unkindness or callousness, and when it is pointed out to a large family that one member has been carrying more than the fair share of a burden, the remainder generally respond. The most difficult type of visiting is that which results from complaints from members of the same household or neighbours about the old persons antisocial behaviour or dirty habits. These too usually arise from senility but the average citizen knows little about it unless they experience it within their own family circle. Many sons and daughters come to me in great distress labouring under an impression that their parentis suffe ring some very rare changes and is mental. They begin to fear mental instability in the family and to look for it within themselves. When I explain that these changes are common among persons of advanced years, they are much relieved. Of the 300 persons interviewed, about one third were relatives who came to discuss difficulties arising out of senility. In many cases the old persons themselves came to have a chat about their seriously failing memory or their inability to rise to the standards of cleanliness which were formerly their habit. The remaining interviews were mainly concerned with housing problems. There were persons whose landlords wish to gain possession of the property to sell it, persons living with younger generations of their family who find the noise of teenagers, or the lack of privacy, unbearable; others living alone who find the extreme silence insupportable, or who worry about the expenses, the uncultivated garden, etc. They all think that they want a little old age pensioners flat. For many it would be the ideal thing but as the demand is so much greater than the supply, in most instances I advise and encourage them to make the best of their present accommodation. 26 There have been many publications of late entitled "Preparing for Old Age" etc. , and a definite effort is being made in the field of social case work to encourage those in middle life to look ahead and plan for their retirement. This I think is a good thing. I would like to see the utmost effort made to encourage persons to take a long and thoughtful look at their accommodation in early middle life and to ask themselves "will I be able to climb those stairs, descend that rear doorstep, get into that particular bath, afford the repairs and maintenance, and either till or find someone else to till that particular garden when I am elderly?". Then while still earning and able to afford it, an extra handrail can be added to the staircase, perhaps two shallow door steps take the place of one steep one, a shallower bath be installed, the money be put aside to thoroughly repair and redecorate the premises a year or so before retirement, or perhaps an annuity purchased to help with rates. Or even better, it might be possible to make a move to a bungalow or to a smaller property, or a move nearer to transport, shops, and other amenities. The percentage of aged among our population increases year by year. We cannot allow people to take it for granted that they can go blithely on without giving a thought to such things until the day after retirement and then expect the local authority to be able to arrange rehousing. Some of those to whom we were obliged to explain that there is little hope of Ilford Borough Council ever being in a position to offer them housing accommodation decided to apply to Essex County Council for Part 3 accommodation. Sixty-six persons were referred by either Dr. Dunn or myself to the Welfare Department of the County. A few have been admitted but the average waiting period for any but extremely urgent cases seems to be about 18 months. A few persons with a little capital to spend, or with relatives able to give them financial assistance for a limited period, go to Private Homes pending an offer of accommodation. A very considerable proportion of my time is spent in seeking this accommodation, and in replying to letters and telephone enquiries relating to persons on the Part 3 waiting 27 list. These are from people who expect the Medical Officer of Health or myself to be in a position to expedite admission. I also interview a large number of callers making enquiries about the accommodation or complaining that they or their relatives have waited so long that they have given up hope. Unfortunately for me, but conveniently for himself, the Essex County Council's Area Welfare Officer is sufficiently remote inhis office at Romford to escape much of the work involved in dealing with these callers. Old people either cannot travel so far because of a disability or because they cannot afford the fare and their relatives find it inconvenient because of their hours of employment or domestic ties. The finding of holiday accommodation for the elderly is now becoming a regular part of my day to day duties. It is not difficult to find accommodation for the physically and mentally sound but unfortunately I am frequently expected to be able to arrange it free of charge. There is in fact a growing tendency throughout the country to expect the State to provide free holidays, free outings and free travel in public transport to every old age pensioner. It is necessary to maintain a sense of proportion about such appeals. With the ever increasing percentage of elderly among the population, we must take a long term view, and consider not only whether we can afford these concessions now but whether there may be twice as many persons requiring them in ten years time, and half as many persons in the wage earning age group of the population to pay the rates, taxes and contributions which pay for the concessions, bearing in mind that once such concessions are made withdrawal is almost impossible. People are inclined to overlook the fact that many a person in receipt of a state retirement pension, commonly called "an Old Age Pensioner" has another income, such as superannuation or an annuity, and is not a needy person. He may even have considerable capital in addition to his incomes. We are, I believe, in danger throughout the whole of this country of having a multiplicity of theoretical schemes or services for the elderly to create an impression, rather than a few well run reliable 28 services to satisfy proven demands. I would like to seethe existing services, especially the domiciliary ones, brought to perfection before we embark upon new schemes. The domiciliary services are understaffed and therefore inadequate. This seems to be due to poor remuneration or reliance upon unpaid volunteers. Each year I become more convinced that the best place for an old person to live in is his or her own home, and in order to make this possible we need to increase the scope and quality of the existing domiciliary services which are in themselves good practical services. Other activities in which I took part during the year were discussions and informative visits with overseas students on Health Education Courses, attendance at a Home Safety Session at CentralHall, Westminster, a visit to a Day Centre at Romford, and attendance at various local committee meetings as in former years. Some of my off duty time is spent serving on Committees at Canning Town Settlement, where I am the present Chairman of the Citizens Advice Bureau Committee. These contacts are useful in many ways. Among other things the Settlement has a Home for the Elderly where several people from Ilford are at present in residence. Before terminating my report I would like to make mention of the various organisations who invited me to talk to their members during the year. Evening addresses were given to The League of Jewish Women, the Toc H Womens Association (ilford and Barkingside Branches) and afternoon addresses to the Cradle Roll Fellowship of the Presbyterian Church. The questions asked and the knowledge revealed by these appreciative audiences left me in no doubt that there is a very considerable amount of sympathy and interest among the people of Ilford for the very large number of elderly persons residing in the town and for those who are engaged in trying to make their remaining years a time of contentment and happiness." The laundry service for cleansing of soiled bed linen and personal clothing continued to operate throughout the year, proving of invaluable assistance in very difficult cases. 29 During the year 80 persons were assisted and 13,307 articles were laundered. (ix) HOSPITALS, ETC. Chadwell Heath Hospital.- 163 beds are provided; 85 for general infectious diseases, 70 for geriatric cases, and 8 beds are used for ear, nose and throat cases. Maternity Hospital.- 51 beds for 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 1959. Pay Reds 14 Other Patients Children Medical Surgical Beds 7 Male Female Male Female 211 21 26 18 55 55 36 At 31.12.59 one bed was occupied by "chronic sick". The above three hospitals are included in the Ilford and Barking Group. (Group 12 N.E. Metropolitan Regional Hospital Board). Mr. H.F. Harris, the Hospital Group Secretary, informs me that the proposed extensions to the King George Hospital and the Barking Hospital, contained within the Group1 s Major Development Scheme , still awaits the approval of the Ministry of Health. "The anticipated total expenditure will be in the region of one and a half million pounds. "At King George Hospital we have proposed 100 additional general beds, a Major Casualty and Admission Department, Theatre Suite, X-ray Department, Pathological Laboratory, Kitchen and Dining Rooms, Medical and Nursing Staff Accommodation, Stores, Offices, etc. "At Barking Hospital we have proposed 125 general beds, a comprehensive Maternity Unit, X-ray Department, Theatre Suite, Out-Patient Department, Physiotherapy Department, Casualty and Admission 30 Department, Pathological Laboratory, Dispensary, Kitchen and Dining Rooms, Nurse Training Unit, Stores, Offices, etc." Mental Hospitals.- There are two large Mental Hospitals in the district, the Goodmayes Hospital, with 73 Resident Staff and 1,332 patients (males 600, females 732), and Claybury Hospital, with 166 Resident Staff and 2, 168 patients (males 865, females 1,303) in residence on 30th June, 1959. (These Hospitals are included in Groups 21 and 20 respectively of the North East Metropolitan Regional Hospital Board. ) Other Institutions.- Australasian Hospital (Dr. Barnardo's Homes), Barkingside, has 60 beds in the Hospital and on 30th June, 1959, there were 36 Resident Staff and 42 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 Public Health Inspector (or their deputies) quarterly and at other times when necessary. (x) AMBULANCE FACILITIES: COUNTY AMBULANCE SERVICE. The County Ambulance Service is provided and administered centrally by the Essex County Council. An 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. The Control which is equipped with two-way radio, is also in direct communication with ambulance vehicles operating in the area. 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, Aldborough Road, Ilford, or in cases of urgency by telephone (Valentine 8822). 31 Requests for ambulance transport, other than emergency requests, are only accepted from Doctors, Midwives, Duly Authorised Officers and the medical staff of hospitals. General medical practitioners, when arranging a patient's admission or first appointment at a hospital, inform the hospital concerned that ambulance transport is necessary and the hospital is then responsible for ordering the ambulance transport. If any difficulty should arise in obtaining an ambulance, a call may be made direct to the Controller, Ilford Ambulance Control, Valentine 8822, or to the County Medical Officer of Health, County Hall, Chelmsford, Chelmsford 3231. (xi) CLINICS AND TREATMENT CENTRES: MATERNITY AND CHILD WELFARE. - Infant Welfare Centres are held at the following premises Chadwell Christian Mission Hall, EssexRoad, Chadwell Heath (far residents of Chadwell Heath area) Monday, 2 p.m. Mayesbrook Clinic, Goodmayes Lane, Goodmayes (for residents of Becontree area) Tuesday, 2 p.m. St. John's Church Hall, Devonshire Road, Seven Kings (for residents of Downshall area) Tuesday, 2 p.m. Manford Way Clinic, Hainault(for residents of the Ilford portion of L.C.C. estate) Tuesday, 2 p.m. Marks Gate Clinic, Lawn Farm Grove, Chadwell Heath (for residents on Padnall Estate) Tuesday, 2 p.m. Kenwood Gardens Clinic (for residents of Woodford Avenue area) Wednesday, 2 p.m. Heathcote Avenue Clinic, (for residents of Barkingside and Clayhall area) Wednesday, 2 p.m. CecilHall, Granville Road, Ilford (for residents of the east side of Cranbrook Road) Wednesday, 2 p.m. 32 Seven Kings Methodist Church Hall, Seven Kings Road (for residents of Seven Kings area) Wednesday, 2 p.m. St. Albans Church Hall, Albert Road, Ilford (for residents of Grosvenor Road area) Wednesday, 2 p.m. CecilHall, Granville Road, Ilford (far residents of the west side of Cranbrook Road) Thursday, 2 p.m. Newbury Hall, Ferryman's Farm Road, Newbury Park (for residents of the Newbury Park area) Thursday, 2 p.m. MayesbrookClinic (for residents of Goodmayes area) Thursday, 2 p.m. St. Albans Church Hall, Albert Road, Ilford (for residents of Ilford Lane area) Friday, 2 p.m. Parish Hall, Mossford Green, Barkingside (for residents of Fairlop area) Friday, 2 p.m. Methodist Church Hall, The Drive (for residents of Valentines and Cranbrook area) Friday, 2 p.m. Ante-Natal Clinics.- An Ante-Natal Clinic is held at the Maternity Hospital, Eastern Avenue, Ilford, on Tuesday morning and afternoon, Wednesday morning and afternoon (Obstetric Specialist), Thursday morning and afternoon, Friday morning, and 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 the first Friday morning in each month when required. Midwives Ante-Natal Clinics are held at the Kenwood Gardens Clinic each Friday afternoon; at Mayesbrook Clinic on second and fourth Monday afternoons of each month; at Manford Way Clinic on alternate Thursday afternoons; at Heathcote Avenue Clinic on alternate Tuesday afternoons and at Marks Gate Clinic on fir st and third Wednesday afternoons of each month. Post-Natal Clinics.- These Clinics are held at the Maternity Hospital on each Monday afternoon; at the Mayesbrook Clinic, Goodmayes Lane, on alternate Saturday mornings; 33 and at the Manford Way Clinic, Hainault, on the first Friday morning of each month. School and other Clinics.- Clinic sessions are held at Health Services Clinics as under:- (i) KENWOOD GARDENS CLINIC, for — Minor Ailments Dental (Children and Expectant Mothers) Orthopaedic and Remedial Exercises treatment Artificial Sunlight treatment Diphtheria and Whooping Cough Immunization Ear, Nose and Throat Ophthalmic treatment Paediatric Infant Welfare Midwives Ante-Natal Mothercraft Enuresis B.C.G. Vaccination Poliomyelitis Vaccination Chiropody. (ii) MAYESBROOK CLINIC, Goodmayes Lane, for — Minor Ailments Dental (Children and Expectant Mothers) Ophthalmic treatment Artificial Sunlight treatment Ante-Natal and Post-Natal Mothercraft Diphtheria and Whooping Cough Immunization Orthopaedic and Remedial Exercises treatment Infant Welfare Speech Therapy Midwives Ante-Natal Orthoptic B.C.G. Vaccination Poliomyelitis Vaccination Chiropody 34 (iii) NEWBURY HALL,, Per ryman1 s Farm Road, far- Infant Welfare Chiropody. (iv) VALENTINES SCHOOL, Beehive Lane, for— Dental (Children) Speech Therapy. (v) LOXFORD HALL, Loxford Lane, for — Child Guidance. (vi) MANFORD WAY CLINIC, Hainault, forAnte-Natal and Post-Natal Mothercraft Infant Welfare Diphtheria and Whooping Cough zati on Midwives Ante-Natal Dental (Children only) Ophthalmic treatment Orthopaedic treatment Poliomyelitis Vaccination Chiropody. (vii) HEATHCOTE AVENUE CLINIC, forInfant Welfare Midwives Ante-Natal Mothercraft Diphtheria and Whooping Cough Immunization Poliomyelitis Vaccination Chiropody. (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, Ilford. The following sessions (by appointment only) are held each week. For Adults - Monday 2 to 4 p.m. (new cases) Friday 10 to 12 noon (" ") Tuesday 10 to 11.45 a.m. (old cases) Wednesday 2.30 to 4.15 p.m. (" ") Friday 2 to 4.30 p.m. (" ") Wednesday 6.30 to 8 p.m. (new & old cases) 35 For Children - Wednesday 10 to 12 noon Contacts Clinic - Tuesday 2.30 p.m. B.C.G. Clinic - Thursday 10.30 a.m. 36 SECTION C. SANITARY CIRCUMSTANCES OF THE AREA. The Chief Public Health Inspector reports as follows:"HOUSING ACT 1957 The Council's five year programme has been in large measure implemented. The deterrent to full fruition lies in the lack of available rehousing sites. Though Ilford has not got a major slum clearance problem, there yet remain areas of poor property which will have to be dealt with under housing legislation. An ameliorative procedure might be secured if private speculative developers were to construct dwellings vertically rather than horizontally. It is appreciated that most families prefer a garden site with a separate dwelling, but if they wish to reside within close proximity to the Metropolis, open space must be sacrificed for living space. The department will investigate the possibilities of the making of a Re-development Area in order to provide some space for re-housing purposes, yet retaining those properties which are not sub-standard. CLEAN AIR ACT 1956 The Council have decided to formulate a proposed Smokeless Zone and to this end a detailed inspection has been made of the Padnall Road, Billet Road and Marks Gate area. Should this proposal fructify, earnest consideration will be given to its extension across Eastern Avenue to the area south thereof. The complaints regarding general emissions of smoke were not so numerous as in previous years. Industry is obviously viewing its responsibility under the Act with some care. 37 THE LITTER ACT 1958 This new piece of legislation is to provide not only an amenity by keeping the country litter-free and tidy, but also to afford a reduction in the high cost of refuse collecttion and road sweeping. It enables any person, not merely the local authority, to institute proceedings against persons depositing litter in any street, road or other place to which the public have access. I have not yet heard of a private individual taking proceedings for an offence though the Council have successfully summoned offenders against the Statute. It would seem that the best means of securing the object of the Act is to take legal proceedings for breachesa step not generally acceptable, but efficacious when the public refuse to accept their responsibilities. The purpose of the Public Health Inspectors will be to educate if possible, and recommend prosecutions on non-acceptance of this proposal. PUBLIC HEALTH INSPECTORS (DUTIES) The modern conception of the work of these officers is markedly different from that in the nineteenth century. He is not now a strict sanitarian dealing only with the "filth nuisances" which produced the primary public health statutes; he is a person who executes legislation under the direction of the local authority, to secure normal comfort in the environment of the public. The task is now rather more protective than preventive. For some years there has been a shortage of qualified inspectors with the result that there has been an infiltration of partially trained personnel into the service. Happily this trend is disappearing, due no doubt to the splendid response by local authorities to the Government's studentship campaign. It has also been noted with some concern that there is a grave shortage of policemen to afford proper public protection against crime. Some mitigation of this defect might be secured if these officers were to be relieved of such local government administration functions relating to- 38 (a) Weights and measures; (b) Diseases of Animals Acts; (c) Petroleum inspection and licensing; (d) Sampling officers' duties under the Food and Drugs Act; (e) Licensing and inspection of hackney carriages; (f) The Welfare and Health work under the Shops Act; all of which could be expeditiously performed by the officers of a local authority, particularly the Public Health Inspector. This anomaly of utilising police officers for local authorities is the direct result of the transfer of the truly local authority functions from the Justices of the Peace who had previously dealt with local affairs both judicial and local. Many Royal Commissions and Parliamentary Committees have stated that the police should not be used for health purposes- neither for that matter ought they to be used in the modern systems of health and social welfare, especially as they are in such short supply. It may be suggested that the police form a local authority service, but strictly speaking it is a national service which ought to be paid for by the nation to safeguard the general public against breaches of the criminal law. All other duties ought to be transferred from the "Watch Committees" to the "Sanitary Authorities", with of course a grant increase equal to that formerly paid for the police officer, e.g. fifty per cent of the cost. " (i) WATER SUPPLY.- The district is served by the Metropolitan Water Board and South Essex Waterworks Co. The subject of the water supply of the Borough was dealt with at length in the Report for 1945. Dr. E. Windle Taylor, Director of Water Examination of the Metropolitan Water Board, has kindly supplied me with the following information. "Samples of the water at all stages of purification are submitted to chemical and bacteriological examination daily in the Laboratories. The part of Ilford in the area of the Board is supplied with water derived from the River Lee, filtered and 39 chlorinated at the Lee Bridge works and Ferry Lane works and then pumped into supply. An additional amount of water is supplied to the Ilford area from Ferry Lane and Wanstead wells. Contact tajiks are 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. During 1959 a total of 1,528 samples were examined. All new and repaired mains are chlorinated before being restored to supply water to consumers and samples of water from them are tested to confirm that the quality of the water is up to that normally supplied. The length of main laid by the Metropolitan Water Board in Ilford during 1959 was 1,209 yards of 4 inch and 1 yard of 3 inch. " The water provided to the remainder of the Ilford district by the South Essex Waterworks Co. is obtained from the River Stour and from deep wells at Mill Road, Grove Road and Roding Lane. Mr. Hugh G. Ramsey, Engineer to South Essex Waterworks Co. , has kindly supplied me with the following information. "During 1959 over 4,130 chemical, bacteriological and biological examinations were made at the Langham Laboratory, and all water going into supply was reported as wholesome. In addition samples were examined for radioactivity. Samples taken from the wells situated in the Company's statutory area were analysed weekly and all were likewise reported on as above; in addition samples were taken weekly from houses in various parts of the supply area for bacteriological examination and they were invariably perfectly satisfactory. A supplementary supply of water was obtained from the Metropolitan Water Board during the months of June, July, August, October, November and December, the total quantity supplied being 165 million gallons. 40 The water supply of the area and of its several parts has been satisfactory as to quality and quantity, but, owing to the exceptionally high demand during the extreme drought period, the pressures were at times less than normal. The following mains were laid inllford during 1959:- 3" 4" 6" 9" 12" 15" 18" 21" Yards 86 84 28 72 5 12 32 1459" There are now no public wells in existence. There are a few private wells for domestic and commercial purposes. Four samples of piped water supply (l South Essex Waterworks Co., and 3 Metropolitan Water Board) were taken by the Department and submitted for Chemical and Bacteriological examination, and all gave satisfactory analyses. (ii) PUBLIC SWIMMING BATHS.- There are three public swimming baths in the Borough. Two indoor, 120,000 gallons and 66,000 gallons respectively and one open-air, of 250,000 gallons approximately. Mains water supply is used in all cases and the method of treatment is by breakpoint chlorination. The water is normally changed once annually in the case of the larger indoor bath and the openair bath, which are closed during the winter months. The smaller indoor bath is, however, in ope ration throughout the whole of the year, and as is the case with all the baths, is "topped up" as necessary. Five samples of water for examination were taken from the open-air swimming bath from April to September. The samples were satisfactory. Twelve samples were also taken from the two indoor baths during January, March, April, May, June, July, August, September and November: all the samples were satisfactory and of a high standard of bacterial purity. (iii) DRAINAGE AND SEWERAGE.- The Borough Engineer has kindly supplied me with the following:- 41 Main Drainage Progress continued on the relief of flooding in the Borough. The following schemes were completed during the year, viz: (a) Vicarage Lane Soil and Surface Water Sewer £300,000 (b) Roding Lane South Surface Water Sewer £3 , 963 (c) Grove Road, Roxy Avenue and rose Avenue Surface Water Sewer £26,655 with resulting relief of flooding in these areas. Considerable progress has been effected on the following schemes which commenced during the year, viz:- (a) Roding Valley Mid-Level Soil Sewer - Stage 1 £99,787 (b) Ley Street/Horns Road Soil and face Water Sewers £161,524 In addition to the above, works on the following schemes have recently commenced:- (a) High Road, Chadwe 11 Heath £48,779 (b) Hainauit - Trelawney Road Surface Water Sewer - Stage 1 £200,500 RIVERS AND STREAMS Flooding.- A number of cases of flooding due to surcharge of sewers and watercourses in times of heavy rain were reported. Pollution of Streams.- There was no pollution of consequence reported during the year. (iv) COLLECTION AND DISPOSAL OF REFUSE.The Borough Engineer also kindly supplied the following information:- 42 Tons Total amount of refuse collected and disposed of 51,134 Collection of Salvage:— Tons Income Wastepaper 1,069 £7,904 Raps and Scrap Metal 119 £1,149 (v) SANITARY INSPECTION OF THE AREA.- The following is a summary of the work of the Public Health Inspectors during the year:- Ilouses and premises inspected 30,512 Houses and premises reinspectcd (work in progress) 24,560 Visits during disinfection 405 Houses in which nuisances were detected 769 Mouses in which nuisances were abated 785* Premises disinfected 24 Premises from which articles only disinfected 26 Articles disinfected 334 Premises disinfested for verminous conditions 28 ^Includes 135 nuisances detected before 1st January, 1959. Notices served:— Statutory:— Served Complied with Public Health Act, 1936 65 43 Housing Acts, 1936 and 1957 — — Factories Acts, 1937 and 1948 2 — Shops Act, 1950 2 1 Provide Dustbin (11 ford Urban District Council Act, 1904) 11 10 P ood and Drugs Act, 1955 2 1 Cleanse Water Storage Cistern (Byelaws) — — Cover Water Storage Cistern (Byelaws) — — Informal 908 746 990 801 In addition to the above, 192 notices (31 statutory and 161 informal) served previous to 1st January, 1959, were also complied with. Complaints. - During the year 3,008 complaints of nuisances were received and investigated. The following is a summary:- Accumulation of manure and refuse 57 Animals improperly kept 30 Bad smells 76 Dampness of premises 83 Defective drains, w.c.s and fittings 604 Defective roofs, gutters, downpipes, etc. 53 Defective water fittings 53 Dirty and verminous houses 29 Dirty condition of rearway 14 Flooding of premises 15 Overcrowding 24 Smoke nuisances 96 Defective or no provision of dustbin 593 Hats and mice 565 Miscellaneous 716 Total 3,008 43 (vi) SHOPS ACT, 1950 (Section 38).- Since this Act came into operation the Public Health Inspectors have made inspections in accordance with Section 38. During the year 90 inspections were made, 2 Statutory Notices and 3 Preliminary Notices were served. 1 Statutory and 3 Preliminary Notices (l served prior to 1959) were complied with. No Certificates of Exemption from the provisions of Section 38 were granted in 1959. (vii) SLAUGHTER OF ANIMALS ACT, 1933 to 1954.No licence to act as slaughterman was granted during the year. (viii) 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. No licence was issued in 1959 in respect of premises used as a rag flock store. (ix) LAND CHARGES ACT, 1925,- During the year 4,467 enquiries were dealt with under this Act. (x) ATMOSPHERIC POLLUTION.- Complaints were received of alleged smoke nuisance from 14 factories in the Grove Road, Redbridge Lane, Newbury Park, Green Lane and Ilford Lane areas. In 10 instances no emission was noted which would have enabled action to be taken under the Public Health Act, 1936, or Clean Air Act, 1956. Four informal notices were served in other instances. Three stations for measurement of atmospheric pollution have been installed in the Borough as follows:- No. 1 - Gantshill Library No. 2 - John Bramston School No. 3 - Ilford Town Hall. Each stationhas a deposit gauge a lead-peroxide instrument and a volumetric apparatus. Details of monthly records for the year 1959 are shown in the following table. 44 ATMOSPHERIC POLLUTION RECORDS JANUARY 1959 - DECEMBER 1959 Average Daily Concentrations MG. of SO3/day collection by 100 sq.cm. of Hatch A Pb02 (Lonvered cover) Monthly Deposits TONS per Sq. MILE Smoke in MG. per cubic metre Sulphur Dioxide in parts per 100 millions WATER (litres) P.H value WATER Insoluble matter ASH Other Combustible matter WATER soluble matter S.O4 STATION NO. 1 GANTSHILL LIBRARY 1959 January 0.53 5.9 3.1 3.10 4.1 6.75 5.00 1.75 8.63 2.11 February 0.36 7.4 3.0 0.10 — 7.52 5.07 2.45 5.97 1.88 March 0.12 6.2 1.6 2.0 5.7 8.19 5.74 2.45 7.89 2.48 April 0.47 5.9 1.3 3.25 4.9 5.20 3.46 1.74 6.07 1.58 May 0.03 2.5 0.61 2.75 6.1 4.13 2.85 1.28 2.95 0.97 June 0.03 1.9 0.55 0.6 6.2 3.79 2.75 1.04 2.89 0.67 July 0.18 1.6 0.62 1.85 6.7 4.87 3.36 1.51 4.80 1.44 August 0.03 2.3 0.49 1.85 4.4. 3.02 2.01 1.01 3.09 1.17 September 0.02 1.01 0.45 — — 5.54 3.83 1.71 2.01 0.37 October 0.11 4.4 0.85 3.20 5.2 6.48 4.73 1.75 7.18 2.08 November 0.24 9.0 2.1 4.15 4.4 4.63 3.39 1.24 8.09 2.25 December 0.17 8.3 1.8 5.75 4.4 5.77 3.15 2.62 10.34 2.08 STATION NO.2 JOHN BRAMSTON SCHOOL 1959 January 0.27 6.1 3.4 2.60 4.1 3.05 2.28 0.77 5.91 1.64 February 0.09 6.2 3.3 0.10 — 4.73 2.95 1.78 3.22 0.84 March 0.8 2.8 1.9 2.1 4.7 4.90 3.32 1.58 6.08 1.81 April 0.02 3.46 1.5 3.25 4.5 3.79 2.79 1.00 5.50 1.31 May 0.27 1.7 0.62 1.55 5.6 3.06 2.15 0.91 2.55 0.81 June 0.02 1.5 0.69 0.4 5.9 3.29 2.65 0.64 1.51 0.44 July 0.01 1.4 0.82 1.8 6.6 3.15 1.98 1.17 3.83 1.31 August 0.03 2.6 0.66 1.15 4.3 1.61 0.97 0.64 3.25 1.04 September 0.02 1.04 0.58 — — 6.14 4.43 1.71 2.05 0.44 October 0.09 3.3 1.3 2.90 4.8 4.43 3.39 1.04 5.81 1.88 November 0.16 5.3 2.3 4.70 4.3 6.58 4.30 2.28 8.90 2.08 December 0.13 4.6 2.4 5.35 4.4 4.87 3.09 1.78 10.20 2.15 STATION NO.3 ILFORD TOWN HALL 1959 January 0.56 22.7 4.5 1.90 4.1 7.94 5.07 2.87 9.91 2.80 February 0.41 20.38 4.7 0.05 — 6.64 4.00 2.64 5.30 1.57 March 0.18 8.7 2.8 1.05 7.8 8.34 5.34 3.00 12.74 2.63 April 0.30 9.3 2.5 1.9 4.7 5.67 3.44 2.23 8.40 2.17 May 0.05 4.0 0.86 1.95 5.9 4.39 2.88 1.51 3.78 1.30 June 0.06 3.2 1.1 0.12 6.2 4.34 2.90 1.44 2.40 0.80 Jnly 0.03 2.8 1.0 0.95 6.7 5.27 3.57 1.70 4.14 1.27 August 0.04 3.8 0.77 1.15 4.6 3.20 2.00 1.20 3.30 1.37 September 0.04 3.09 0.78 — _ 4.14 3.04 1.10 2.43 0.70 October 0.14 7.7 1.8 2.0 4.6 8.04 5.37 2.67 9.00 2.97 November 0.22 15.2 3.2 3.65 4.1 8.67 5.44 3.23 13.14 2.90 December 0.21 12.9 3.2 3.50 4.1 6.67 3.83 2.84 11.91 3.34 45 SECTION D.- HOUSING. (i) OVERCROWDING.- No notices were served during 1959. (ii) CLEARANCE AREAS.- Two areas we re declared by the Council to be Clearance Areas, in 1959. The Council makes a grant of £5 towards the removal expenses of any family required to move from a house to which a demolition or closing order applies. (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) 1,993 (b) Number of inspections made for the purpose 18,598 (2) (a) Number of dwelling-houses cluded under sub-head (l)above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 6 (b) Number of inspections made for the purpose 12 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 46 (4) Number of dwelling-houses sive of those referred to under the preceding sub-head)found not to be in all respects reasonably fit for human habitation 335 46 2. Remedy of defects during the year out service of formal Notices:- Number of defective dwellinghouses rendered fit in consequence of informal action by the Local Authority or their officers 241* 3. Action under Statutory Powers during the year:- A. Proceedings under Sections 9, 10, and 16 of the Housing Act, 1957. (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 — (b) By local authority in fault of owners — B. Proceedings under Public Health Acts:- (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 76 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:- (a) By owners 59* (b) By local authority in fault of owners 2 C. Proceedings under Section 17(1) of the Housing Act, 1957. (1) Number of dwelling-houses molished as a result of formal or informal procedure 46 (2) Number of dwelling-houses closed in pursuance of an undertaking given by the owners and still in force — 47 D. Proceedings under Section 18 of the Housing Act, 1957. Number of separate tenements in respect of which Closing Orders were made — 4. Housing Act, 1957, Part IV Overcrowding:- (a) (i) Number of dwellings crowded at the end of the year 42 (ii) Number of families dwelling therein 58 (iii) Number of persons (units) dwelling therein 201½ (b) Number of new cases of ing reported during the year 12 (c) (i) Number of cases of ing relieved during the year 18 (ii) Number of units concerned in such cases 82 (d) Particulars of any cases in which dwelling-houses have again become overcrowded after the local authority have taken steps for the abatement of ing - (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 1959 of Notices served prior to 1st January, 1959. HOUSING ACTS, 1936 and 1957. During the year 1959 the work of receiving applications, calling for calculations for the "permitted number" was continued with a view to the issue of housing certificates. 10 certificates in respect of 10 houses were issued during the year, making a total of 18,363 certificates, in respect of 25, 173 houses, issued to the end of 1959. 48 As new premises were constructed and placed upon the rating lists, "permitted number" certificates were issued as required. MEDICAL PRIORITIES FOR REHOUSING. In 1959 25 recommendations were made to the Housing Committee. In addition to the visits and reports of the Public Health Inspectors on the home circumstances, the Medical Officer of Health has consultations with the private doctors and/or Hospitals. INCREASE OF RENT AND MORTGAGE INTEREST (RESTRICTIONS) ACT, 1920 and 1933, AND HOUSING REPAIRS AND RENTS ACTS, 1954 and 1957. Particulars relating to 1959 are as follows Application for Certificates of Disrepair received 60 Certificates of Disrepair granted 59 Certificates of Disrepair refused 1 Certificates of Disrepair issued 27 Undertakings received from landlords 36 Unexpired Notices of Proposal to issue Certificates of Disrepair 5 Certificates cancelled 20 Applications for cancellations of Certificates applied for but not granted 1 Certificates as to remedying of defects specified in Landlord's Undertaking to remedy Defects: Issued to Landlords 14 Issued to Tenants 9 49 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 thereafter be made under the last named Act. The Milk (Special Designations) (Specified Areas) Order, 1951, which came into operation on 1st October, 1951, specified an area, including Ilford, in which the compulsory use of special designations for retail sales of milk shall operate. (i) MILK AND DAIRIES (GENERAL) REGULATIONS, 1959.- Persons and premises registered as at 31st December, 1959:- Persons registered as distributors of milk 109 Premises registered as dairy premises (other than dairy farms) 13 175 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 1959:- Tuberculin Tested 34 do. (Supplementary) 11 50 (iii) MILK (SPECIAL DESIGNATION) (PASTEURISED AND STERILIZED MILK) REGULATIONS, 1949 to 1953:- The following licences were granted during 1959:— Pasteurized (Dealer's) 70 do. do. (Supplementary) 11 do. (Pasteurizer's) 1 Sterilized (Dealer's) 100 do. do. (Supplementary) 14 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 milk (if any) are submitted for biological test for T. B. quarterly. Repeat samples if positive after clearance by the Divisional Inspector of the Ministry of Agriculture, Fisheries and Food. Milk Supplies to Maintained Schools.- These are sampled monthly and after unsatisfactory results. 51 The following results were obtained:- Grade of Milk Total Satisfactory Unsatisfactory Remarks on unsatisfactory results Tuberculin Tested (Pasteurized) Milk 36 35 1 Was decolourized at end of 30 minutes. Did not satisfy Meth. Blue test. Letter sent to Producer. Tuberculin Tested Milk (Farm bottled) - - - - Pasteurized Milk 77 77 - - Sterilized 21 21 - - (v) BIOLOGICAL TESTS.- No samples of milk were submitted to a biological test for tuberculosis. (vi) MILK AND DAIRIES ORDERS, 1926 AND 1938: INSPECTION OF DAIRY HERDS.- Two examinations were made by the Veterinary Officers of the Ministry of Agriculture, Fisheries and Food. The Ministry's Divisional Officer states that no cows were found to be suffering from tuberculosis. No samples of milk were sent for bacteriological examination. (vii) LEGAL PROCEEDINGS.- 3 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. ICE CREAM. (i) REGISTRATION. Section 158, Essex County Council Act, 1933. In 1948, the Council delegated to the Public Health Committee 52 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. 37 applications for registration in respect of 36 premises were considered during the year 1959 all were granted in respect of the sale only of ice-cream. (ii) ICE-CREAM (HEAT TREATMENT, ETC.)REGULATIONS, 1959. The Council has 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 the rmomete r 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 mobile salesman and local retailers. Samples are repeated after unsatisfactory results. In 1959, 24 samples were submitted for examination with the following results:- No. of Samples Ministry of Health Provisional grade. % of Total Unsatisfactory Samples. 18 I 75 - 1 II 4 - 2 III 8 - 3 IV 13 1 24 100 1 53 The Food Standards (ice-Cream) Regulations, 1959, described standards for ice-cream. During 1959, no samples were submitted for chemical analysis. MEAT AND OTHER FOODS. (i) INSPECTION AND SUPERVISION. The Council made bye-laws under Section 15, Food andDrugs Act, 1938 for securing the observance of sanitary and cleanly conditions and practices in connection with the handling, wrapping and delivery of food sold or intended for sale for human consumption, and in connection with the sale or exposure for sale in the open air of food intended for human consumption. The Public Health Inspectors reported three instances of individuals using tobacco whilst engaged in the handling of "open" food contrary to the Food Hygiene Regulations, 1955. Legal proceedings were taken and fines of £5 plus £2. 2s. costs; £5 plus 10/6d. costs and £2 plus £1 1s. costs respectively, were imposed by the Court. The Essex County Council Act, 1952, Section 105, requires that as from 2nd April, 1953, any person intending touse 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 Public Health Inspectors are utilised to deal with food preparing premises, factory canteen premises and food and drugs sampling. During 1959, they made 12,910 inspections of food shops and food preparing premises. 118 informal and 2 formal notices were served under the Food and Drugs Act, and 1 formal and 109 informal notices were complied with including 25 informal notices served prior to 1959. (ii) FOOD HYGIENE. The following gives the numbers of food premises in the area by the type of business:- 54 Cafes and Restaurants 140 Factory canteens 38 Butchers' shops 117 Grocers' shops 26l Fruiterers' and Greengrocers' shops 136 Fishmongers' and Fishfryers' shops 56 Bakehouses 22 Bakers' shops 45 Confectioners' shops 215 1,030 The practice of inculcating interest in the proprietors, directors and staffs of food handling organisations was continued in 1959, and the catering industry, as a whole, continues to co-operate. The lectures and demonstrations with film strips and films to food handlers were continued in 1959. Education in food hygiene has 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 Food and Drugs Act, 1955. 174 samples (170 formal and 4 informal) were obtained during the year 1959; 3 formal and 2 informal samples were not satisfactory as follows:- (a) Slice of Bread (informal).- Contained foreign matter including fragments of dried fruit, a dried fruit stalk, hemp fibres, some mould growth and traces of quartz sand. Legal proceedings were taken and the defendants were granted a conditional discharge on payment of £5. 5s. costs. (b) Rum Truffles (formal).- Contained no significant amount of rum. A letter of warning was sent to the retailer. 55 (c) Loaf of Bread (formal).- Advertised as containing less starch and would aid slimming. Was found to contain only approximately 5 per cent less carbohydrates than normal bread. No action was taken. (d) Rusks (informal).- Contained insect fragments. A letter of warning was sent to the manufacturers. (e) Pork Luncheon Meat (formal).- 12% deficient in meat. No action was taken. (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 3 persons and 3 premises were also registered during 1959. (v) REGISTRATION OF PREMISES USED FOR THE PREPARATION OR MANUFACTURE OF SAUSAGES, OR POTTED, PRESSED, PICKLED OR PRESERVED MEAT, FISH OR OTHER FOOD INTENDED FOR SALE. Section 80 of the Ilford Corporation Act, 1937, requires registration of such premises. 1 application for registration was received and granted during 1959. (vi) ARTICLES OF FOOD SURRENDERED. During the year the following articles were surrendered and condemned as being unfit for the food of man:- Bacon, 31 lb.; Beverages, 2 tins 1 bottle; Biscuits, 17 packets; Butter, 3¼ lb.; Cake, 9 lb.; Cereals, 13 tins, 141 lb.; Cheese, 95 lb.; Chocolate Spread, 2 lb.; Custard Powder, 1 drum; Cream, 25 tins; Confectionery, 35 lb.; Eggs preserved, 27 lb.; Egg Albumen, 158 lb.; Fats, 3 packets; Fish (Wet and Dry), 91 stones; Fish (Tinned), 229 tins, Fish Cakes, 7; Fish Paste, 13 jars; Flour 10 lb.; Fruit (Tinned), 1,333 tins; Fruit (Bottled), 2 lb.; Fruit (Dried), 56 4151b.; Fruitjuice, 24 tins; Jam Preserves, 72 tins; Jellies, 5 packets; Meat (Fresh), 4,206 lb.; Meat (Tinned), 2,025 lb.; Meat Pies, 111; Milk (Tinned), 301 tins; Nuts, 58 lb.; Pastry and Pudding Mixtures, 5 packets; Pickles, 29 jars; Poultry, 233 lb.; SaladCreams, 6 bottles; Sausages 198 lb.; Soups, 53 tins; Sugar, 1 lb.; Tomatoes, 188 tins; Vegetables (Dried), 7 lb.; Vegetables (Tinned), 367 tins. (vii) FOREIGN BODIES IN FOOD. 9 complaints (including 2 in paragraph (iii) Sampling) were received during 1959 of the presence of foreign bodies in foodstuffs; letters of warning were sent in 5 cases and legal proceedings in 1 case. (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, 1955. 71 notifications were received. There were 21 family outbreaks, 3 other outbreaks and 29 single cases. In 6 outbreaks (involving 19 persons) the causual organism was identified as Salmonella Typhi-murium; in 1 outbreak (involving 2 persons) as Salmonella Saint Paul; in 1 outbreak (involving 4 persons) as Staphylococci and in 2 outbreaks (involving 97 persons) as Cl. Welchii. In the remaining 14 outbreaks (involving 34 persons) no agent was identified. Regarding the single cases, the agents identified were Salmonella Typhi-murium 11, Salmonella St. Paul 3, Staphylococci 1. In the remaining 14 cases no organism was identified. With a view to preventing spread of infection a parttime assistant in a baker's shop, who was notifiedas a case of food poisoning was excluded from her employment for a period of 6 weeks and compensation for loss of earnings was paid in respect of this period. 57 (ix) BAKEHOUSES.- There are 22 bakehouses in the district, all of which use motive power, 375 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 8 instances and the requests were complied with in all but 2 cases where the work was in progress. (x) MERCHANDISE MARKS ACT, 1926.- No contravention of this Act was reported during 1959. DISEASES OF ANIMALS ACT, 1950. (i) SWINE FEVER (AMENDMENT) ORDER 1959. This Order became operative on 29th June, 1959 and amended the Swine Fever Order of 1938, to omit the obligation on the part of the Police to notify the Head Office of the Ministry of suspected swine fever. The Order further altered the definition of a "pig dealer". (ii) THE TUBERCULOSIS (WEST AND SOUTH MIDLAND AND EASTERN COUNTIES ERADICATION AREA) ORDER 1959. This Order which became operative on 1st March, 1959 declared the area therein detailed, which included the County of Essex, to be an eradication area for the control of tuberculosis in specified animals for which purposes the movement of cattle into such an area, except under licence or on specified transit journeys, was prohibited. (iii) THE DISEASES OF ANIMALS (ASCERTAINMENT OF COMPENSATION) ORDER 1959. This Order which became operative on 1st September, 1959 re-enacted and amended the Animals (Miscellaneous Provisions) Order of 1927 to ascertain the value of animals slaughtered under the principal Act and if disagreement arose, provide for the value to be determined by arbitration. 58 (iv) FOWL PEST (INFECTED AREAS RESTRICTIONS) ORDER 1956, AS AMENDED BY THE FOWL, PEST (INFECTED AREAS RESTRICTIONS) AMENDMENT ORDER, 1958. On 22nd January, 1959, the Ministry of Agriculture, Fisheries and Food, made an order known as the Fowl Pest (Essex Infected Area) Order 1959, effective from 26th January 1959, which declared an area in the County of Essex including Ilford to be a fowl pest infected area, prohibiting the movement of poultry out of, within, or into, such an area, except under licence. Permission was granted to one butcher in the area to slaughter 40 hens which he was unable to move fromhis premises. A licence was issued to the same butcher by the Ministry of Agriculture, Fisheries and Food for the transfer of 100 hens from Billericay to the Ilford area for slaughtering in accordance with the requirements of the Order. (v) THE FOWL PEST (ESSEX INFECTED AREA) (REVOCATION) ORDER, 1959. This Order which came into operation on 14th March 1959, revoked the previous Order restricting the movement of poultry within a specified area in Essex including Ilford. (vi) THE LIVE POU LTRY (RESTRICTIONS) AMENDMENT ORDER 1959. This Order, which became operative on 27th April 1959, amended the Live Poultry (Restrictions) Order 1957 by amending the definition of poultry dealer and included a power to licence the movement of poultry for the purposes of Jewish or Moslem methods of slaughter and imposed a duty to remove the carcases of poultry slaughtered under these methods. (vii) THE IMPORTATION OF HAY AND STRAW (AMENDMENT) ORDER 1959. This Order which prohibited the landing of hay and straw except from certain specified countries, adds to that list the countries of the Netherlands and Denmark. PREVENTION OF DAMAGE BY PESTS ACT, 1949.The Council has appointed a whole-time Rodent Operative. Where infestation has been ascertained on inspection the services of the Rodent Operative are made available to secure effective disinfestation. In the case of business premises these services are offered on a contractural basis, a practice which is greatly appreciated by most business firms. 59 The following is a statement of the work carried out during 1959. Type of Property Total Local Authority Dwelling Houses Agricultural All other (including Business and Industrial) I. Total No. of properties in District 223 52,514 25 6,491 59,253 II. No. of properties inspected as result:— (a) of notification 49 501 2 84 636 (b) survey under the Prevention of Damage by Pests Act, 1949 15 16 - 5 36 (c) otherwise - - - 1,030 1,030 III. Total No. of inspections and re-inspections carried out 172 1,238 3 13,180 14,593 IV. No. of properties found to be infested by rats:— Major - - - - - Minor 28 167 1 23 219 v. No. of properties found to be infested by mice:— Major - - - - - Minor 15 155 - 48 218 VI. No. of infested properties (under III and IV) treated by the Local Authority 41 286 1 56 384 VII. No. of notices served under Section 4:— (1) Treatment - - - - - (2) Structural works (i. e., Proofing) - 2 1 6 9 vm. No. of cases in which default action was taken by Local Authority following issue of noticc under Section 4 - - - - - IX Legal proceedings - - - - - X No. of "block" control schemes carried out Nil 60 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 Public Health 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 1959. PETROLEUM (CONSOLIDATION) ACT, 1928.- The Public Health Inspectors made 1,907 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 147, and the fees paid to the Council for such Licences was £124 15s. One Licence was issued for the storage of calcium-carbide, the fee payable being 5s. LITTER ACT, 1958.- The Public Health Inspectors are authorised by the Council to investigate and report offences under the Act. During 1959, 2 offences were reported. Legal proceedings were taken in both cases and fines of £5 and £2 respectively were imposed. NOISE NUISANCES-ILFORD CORPORATION ACT. 1937 AND PUBLIC HEALTH ACT, 1936.- Many complaints were received of noise nuisance in connection with the demolition and rebuilding of two large stores in High Road which were destroyed by fire on 16th March, 1959. Regular observations were maintained during day and night and as a result a statutory notice was served upon the building contractors to abate the nuisance. Following plant modifications and altered working arrangements, the notice was satisfactorily complied with. 14 other complaints regarding noise nuisances were received during the year. In 11 instances no nuisance was found to exist in respect of which action could be taken, but in 3 instances representations by the Public Health Inspectors resulted in abatement of the nuisances. 61 SECTION F. PREVALENCE OF, AND CONTROL OYER, INFECTIOUS DISEASES. The following diseases are notifiable to the Medical Officer of Health: 1. Under Section 144 and 343, Public Health Act, 1936. Smallpox Relapsing Fever. Cholera Anthrax (made notifiable by Diphtheria the Local Authority as Membranous Croup from 1/4/22). Erysipelas Pemphigus Neonatorum Scarlatina or Scarlet Fever (made notifiable by the Typhus Fever Local Authority as from Enteric fever (Typhoid and 29/6/29). Para-typhoid) 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 Influenzal Pneumonia Dysentery Malaria P.H. (infectious Diseases) Regulations, 1953. Tuberculosis P.H. (Tuberculosis) Regulations, 1952. Acute Rheumatism (up to 16 The Acute Rheumatism years) (Amendment) Regulations, 1958. Measles and Whooping Cough The Measles and Whooping Cough Regulations, 1940. Acute Poliomyelitis Acute Encephalitis Meningococcal Infection P.H. (Acute Poliomyelitis, Acute Encephalitis and Meningococcal Infection) Regulations, 1949. 62 3. By Local Act. Food Poisoning Ilford Corporation Act, 1937, and Food and Drugs Act, 1955. 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 numbers of deaths of Ilford residents from the following infectious diseases during 1958 and 1959 were as follows:- 1958 1959 Scarlet Fever - - Enteric Fever - - Diphtheria - - Acute Poliomyelitis - 1 Measles - - Whooping Cough - - Influenza 15 25 Tuberculosis - Pulmonary 9 12 Other forms 2 1 'Pneumonia (all forms) 99 144 Diarrhoea(under 2 years) - - Meningococcal Infections - - Totals 125 183 The year 1959 showed a higher incidence of infectious disease, especially in the number of cases of measles. 3,322 cases occurred as compared with 241 in the previous year. 48 cases of whooping cough occurred as compared with 56 in the previous year. (a) Smallpox.- No cases were notified during 1959. Under the National Health Service Act, 1946, compulsory vaccination was abolished, and from 5th July, 1948, 63 TABLE III.- CORRECTED NOTIFICATIONS OF INFECTIOUS DISEASES FOR THE YEAR 1959. 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 year 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 Cleraentswood Mayfield Goodmayes Fairlop Clayhall Barkingside N. Hainault Seven Kings S. Hainault Smallpox - - - - - - - - - - - - - - - - - - - - - - Scarlet Fever 327 1 61 255 10 - — - 42 16 7 15 24 31 31 25 35 26 23 52 23 — Diphtheria, including Membranous Croup - - - - - - - - - - - - - - - - - - - - - - Enteric Fever (Typhoid and Para-Typhoid) 1 — 1 - - - - - - - - - - - - - - - - - 1 — Pneumonia 184 - 7 10 7 29 65 66 19 19 8 12 / 20 22 23 22 10 18 4 31 144 Puerperal Pyrexia 55 - - - 23 32 - - - - 1 - - - 1 - 1 51 1 - 53 - Acute Poliomyelitis 6 - 2 2 2 - - - - - - - 2 - 2 - 1 - 1 — 6 1 Acute-Encephalitis - - - - - - - - - - - - - - - - - - - - - - Meningoccocal Infection 2 1 1 - - - - - 2 — — — — — — - — — — — 2 — Dysentery 142 5 30 37 8 33 26 3 8 10 9 3 6 4 22 1/ 28 18 13 4 12 - Ophthalmia Neonatorum — — — — — — — — — — — — — - - - — - — — — — Erysipelas 16 - - - - 3 11 2 3 - - 1 3 2 3 - 2 1 - 1 1 - Pemphigus Neonatorum 2 2 — — — — — — — — 1 — - — — 1 — — — - — — Tuberculosis Pulmonary 58 - - 3 8 23 17 7 1 5 11 3 9 3 5 1 5 4 3 8 21 12 Other Forms 5 - - 1 2 1 1 — 2 - 2 — 1 - - - - - - - - 1 Anthrax — - - - - - - - - - - - - - - - - - - - - - Malaria — Believed contracted in this country - - - - - - - - - - - - - - - - - - - - - - Believed contracted abroad — - — — - - - — - — - — - - - — - — - - - - Acute Rheumatism 4 - - 4 _ - - - — - - - - - - — 2 — 1 1 - — Measles 3,322 70 1,383 1,849 11 8 1 - 227 278 268 308 272 210 280 297 358 318 296 210 21 — Whooping Cough 48 2 22 23 - 1 - - 4 5 2 4 3 7 3 8 7 2 2 1 1 - Food Poisoning 71 - 7 12 10 17 20 5 5 12 12 — 7 1 2 9 10 4 4 5 6 — Typhus Fever - - - - - - - - - - - - - - - - - - - - - - Totals 4,243 81 1,514 2,196 81 147 141 83 313 345 321 346 334 278 371 381 471 435 362 286 178 158 *Included in the figures in these columns are cases notified in previous years as well as 1959. 64 this service became the responsibility of the Essex CountyCouncil vide Section 26 of the National Health Service Act, 1948. (b) Scarlet Fever.- 327 cases occurred in 1959. There were no deaths from this disease. Only 23 cases were admitted to hospital, the remainder being nursed at home. (c) Diphtheria.- No cases occurred in 1959. This is the eighth successive year in which it has been possible to record a clean "bill of health" for this disease in Ilford. (d) Ophthalmia Neonatorum.- No cases occurred in 1959. The following figures show the number of cases of Ophthalmia Neonatorum notified during the past five years: 1955, nil; 1956, 7; 1957, 6; 1958, 1; 1959, nil. No cases of Ophthalmia Neonatorum were due to gonococcal infection. (e) Enteric Fever (Typhoid and Para-Typhoid).- One case occurred in 1959. The patient, an infant, aged 1 year 4 months, was admitted to Hospital and made an uneventful recovery. (f) Acute Poliomyelitis.- Six cases occurred during 1959. They were males of 18, 3 and 2¾ years and females of 15½, 14 and 11 years of age respectively. All were admitted to Hospital (5 to Chadwell Heath Hospital- 3 were subsequently transferred to the Special Unit at Rush Green Hospital- and 1 to the Australasian Hospital). One patient, a female of 14 years, died, three others suffered some paralysis and were receiving physiotherapy treatment and the remaining two cases recovered without complications. (g) Acute Encephalitis. - No cases occurred in 1959. (h) Meningococcal Infection.- Two cases were reported-males of 4½ years and 11 months respectively. Both were admitted to hospital and made satisfactory recovery. (i) Pneumonia-Influenzal and Primary.- The number of cases which occurred during 1959 was 184 compared with 141 in 1958. (j) Tuberculosis.- During 1959 there were 58 new notifications of Pulmonary Tuberculosis and 5 of other forms 65 of Tuberculosis. In addition 113 pulmonary and 8 non-pulmonary cases were transferred to the district. The population of Ilford has not varied greatly during the past five years and the number of cases added to the register has also shown little change as the following figures show:- Year Population No. of Persons added to list (all forms) Deaths (all forms) No. of Persons on register 31st December 1955 181,700 170 20 1,451 1956 180,600 197 21 1.480 1957 179,600 178 13 1,510 1958 179,000 177 11 1,525 1959 178,600 184 13 1.562 Notifications and Deaths from Tuberculosis of Ilford residents during 1959:- Age Periods New Cases Deaths Respiratory NonRespiratory Respiratory NonRespiratory M F M F M F M F Under 1 year — — — — — — - - 1-5 years - — - - — - - - 5-15 2 1 — 1 — — — — 15-25 4 4 2 - — - - - 25-45 15 8 1 - — 2 — — 45-65 15 2 — 1 5 2 — 1 65-75 4 1 - - - - - - Over 75 - 2 - - 2 1 - - Totals 40 18 3 2 7 5 - 1 Of the foregoing new cases, the following were notified from Institutions in the district:- Respiratory Tuberculosis NonRespiratory Tuberculosis King George Hospital 1 2 Goodmayes Hospital 4 - Chadwell Heath Hospital 4 - Claybury Hospital - - Dr. Barnardo’s Village Homes - - Of the 13 deaths which occurred of Ilford residents, notification had previously been made of 11 of the cases. In the other cases the presence of tuberculosis was discovered as a result of post-mortem, and operation, respectively. 66  Pulmonary NonPulmonary Total Number of cases on register, 1st January, 1959 1,371 154 1,525 Number of cases entered on the register during the year 171 13 184 Number of cases removed from the register during the year Pul. NonPul. Recovered 6 5 Deceased 24 2 Left District 101 4 Lost sight of 3 1 Diagnosis not established 1 — 135 12 147 Number of cases remaining on register on 31st December, 1959 1,407 155 1,562 The treatment of Tuberculosis is now under the control of the Regional Hospital Board. On the 31st December, 1959, there were 1,338 patients on the register of the Ilford Chest Clinic. The number of patients from Ilford sent to Institutions under the Regional Hospital Board Tuberculosis Scheme during 1959 was as follows:- Pulmonary Non-Pulmonary Total Males Females Males Females Adults 22 12 1 - 35 Children 2 - - - 2 Tuberculosis Care Association.-Assistance was granted to 23 persons who received 181 extra nourishment grants. 82 other grants (cash, etc. ) were also made to 56 patients. (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 Ilford:- 67 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 F riday 9 a.m. to 7 p.m. Saturday 9 a.m. to 1 p.m. Saturday 9 a.m. to 1 p.m. Whitechapel.- Whitechapel Clinic, Turner Street, Mile End, London, E. 1.:- Males Females Consultations: Monday to Friday 10 a.m. to 7 p.m. Monday to F riday 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 8 a.m. to 7 p.m. Monday to F riday 9 a.m. to 7 p.m. Saturday 8 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 F emales Consultations: Monday 3 to 6 p.m. Thursday 11 a.m. to 1 p.m. and 6 to 8 p.m. Monday 6 to 8 p.m. Thursday 11 a.m. to 1p.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. 68 Albert Dock Seamen’s Hospital, AlnwickRoad, 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. HEALTH EDUCATION. Public lectures to Voluntary Guilds and 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, Poliomyelitis vaccination and health topics were also given prominence. EXAMINATION OF OFFICERS AND SERVANTS. The following medical examinations were carried out during 1959:- Officers Servants New Appointments 30 44 Under Sickness Regulations - 17 On behalf of othe r Authorities 5 - Total 35 61 In addition enquiries were made of General Practitioners and Hospitals in respect of numerous cases, referred under Sickness Regulations, which were not subsequently medically examined at the Public Health Offices. 69 MASS RADIOGRAPHY. A mass radiography survey was conducted in Ilford from October 19th to December 15th 1959 (8 weeks and 2 days). The Unit was located at the Thompson Rooms, Fullwell Cross, at hotel car parks in Eastern Avenue, High Road, Seven Kings, Ilford Lane, Redbridge Lane and Gantshill, and at two factories. Dr. H. Ramsay, the Medical Director, has kindly supplied me with the following details. 1. Number X-rayed (Miniature Film): Male Female Total Referred by General Practitioners 561 632 1, 193 General Public 2,714 3,453 6,167 Organised Groups 1,118 914 2,032 4,393 4,999 9,392 Recalled for further investigation: 114 60 174 2. Results: (a) Tuberculosis Cases requiring immediate treatment:- General Practitioner Referrals 5 2 7 General Public 2 1 3 Organised Groups. - 1 1 Cases requiring close Clinic supervision:- Organised Groups 1 1 2 (b) Carcinoma of Lung- All General Practitioner Referrals 6 1 7 70 (c) The following conditions were also found:- Congenital and acquired abnormalities of heart and vessels. Sarcoidosis, Bronchiectasis, Pneumonitis, Hiatus Hernia, High Right Hemi-Diaphragm, Pneumoconiosis, Spontaneous Pneumothorax, Thyroid Abnormalities, Emphysema, Pulmonary Fibrosis-Non Tuberculosis, Pleural Thickening, Abnormalities of the Bony Thorax and soft tissues, congenital and acquired. 71 SECTION G. - FACTORIES. Prescribed Particulars on the Administration of the Factories Act, 1937. PART I OF THE ACT. 1. INSPECTIONS for purposes of provisions as to health (including inspections made by Public Health Inspector s). Premises Number on Register Number of Inspections Written notices Occupiers prosecuted (1) (2) (3) (4) (5) (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 155 118 - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authorities 455 904 3 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 51 98 - - Total 661 1,120 3 - 2. Cases in which DEFECTS were found. (If defects are discovered at the premises on two, three or more separate occasions they should be reckoned as two, three or more "cases"). Particulars Number of cases in which defects were found Number of Cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector (1) (2) (3) (4) (5) (6) Want of cleanliness (S.l) - - - - - Overcrowding (S.2) - - - - - Unreasonable temperature (S.3) 1 1 - 1 - Inadequate ventilation (S.4) - - - - - Ineffective drainage of floors (S.6) - - - - - Sanitary Conveniences (S.7) (a) Insufficient 2 1 - 2 - (b) Unsuitable or defective 4 2 - 4 - (c) Not separate for sexes - - - - - Other offences against the Act (not including offences relating to Out-work) - - - - - Total 7 4 - 7 - 72 PART VIII OF THE ACT OUTWORK (Sections 110 and 111) Nature of work Section 110 Section 111 No. of out-workers in August list required by Section 110(1) (c) No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwholesome premises Notices served Prosecutions (1) (2) (3) (4) (5) (6) (7) Wearing ) Making apparel ) etc. 80 - - - - - Furniture and upholstery 27 - - - - - Cosaques, Christmas stockings, etc. 38 - - - - - Total 145 - - - - - 73 PART III - SERVICES NATIONAL HEALTH SERVICE ACTS, 1946 - 1957. BIRTHS. - In accordance with the provisions of the Public Health Act, 1936, all live births and all stillbirths of twenty-eight weeks gestation and over must be notified within 36 hours to the Medical Officer of Health of the area in which the birth took place. The number of live births notified in Ilford under this Act during 1959 was 1,802 (911 males and 891 females), of which there were 108 (57 males and 51 females) where the ordinary place of residence of the parents was outside Ilford. In addition 529 notifications of live births (275 males and 254 females) which took place outside the district, although the ordinary residence of the parents was in Ilford, were transferred to this district. There were also 41 stillbirths (26 males and 15 females) .notified in Ilford including 4 (3 males and 1 female) where the home address of the parents was outside the district, and notifications of 11 stillbirths (5 males and 6 females) which took place outside the district, although the ordinary residence of the parents was in Ilford, were transferred to this district. This represents a total of 48 where the home address was in Ilford, whereas the RegistrarGeneral has allocated 49 stillbirths to Ilford. The following table shows the causes of the 48 stillbirths notified where the usual residence of the parents was in Ilford:- 74 STILLBIRTHS 1959 Cause of Stillbirth Delivery in Nursing Home Delivery at Home Delivery in Hospital TOTAL Anencephaly - - 6 6 Asphyxia - 1 6 7 Atelectasis - - 1 1 Calcified Placenta - - 1 1 Cerebral Haemorrhage - - 1 1 Displacement of Heart - 1 - 1 Foetal Abnormalities - - 3 3 Hydrocephalus: Spina Bifida - - 1 1 Intra- and Ante-Partum Haemorrhage - - 3 3 Intra-Uterine Death - - 1 1 Maceration - 1 2 3 Placental Insufficiency - - 4 4 Post-Maturity - - 1 1 Prolapsed Cord - - 1 1 Prolonged Labour - - 2 2 Rhesus Incompatibility - - 2 2 Ruptured Uterus - - 1 1 Toxaemia - - 6 6 Unknown - 2 1 3 Totals - 5 43 48 CARE OF PREMATURE INFANTS.- Of the 1,802 live births occurring in Ilford during 1959, 77 weighed 5½ lb. or less at birth; 11 of these babies were born on the district and 66 in Hospital (including 11 where the home address of the parents was outside Ilford). 75 Of the 11 babies born at home:- 7 were nursed entirely at home; 4 were transferred to hospital; All survived at the end of one month. Of the 66 babies born in hospital:- 1 died during the first 24 hours; 3 died between the ages of one day and one month (including 1 where the home address was outside Ilford); 62 survived at the end of one month (including 10 where the home address was outside Ilford). In addition, 40 notifications were received of births outside the district where the ordinary residence of the parents was in Ilford and the weight of the infant at birth was 5j lb. or less. Of these there were:- 7 who died within the first 24 hours (in hospital); 1 who died between the age of one day and one month (in hospital); 32 who survived at the end of one month. INFANT MORTALITY.-The number of infants dying within the first year of life was 33, the total number born being 2,216. 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 14. 9, the lowest on record for Ilford. The following table gives the deaths of infants under one year of age, classified according to age:- 76 INFANT DEATHS 1959. 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 Bronchitis - - - - - - 2 - - 2 Anencephaly 1 - - - 1 - - - - 1 Atelectasis 5 _ - - 5 - - - - 5 Broncho-Pneumonia 1 _ - - 1 2 - - - 3 Cerebral Haemorrhage 1 - - - 1 - - - - 1 Cerebral Oedema 1 - - - 1 - - - - 1 Congenital Morbus Cordis 2 - - - 2 1 - - - 3 Haemorrhagic Disease of Newborn - 1 - - 1 - - - - 1 Hyaline Membrane 1 - - - 1 - - - - 1 Hydrocephalus and Spina Bifida 1 2 - - 3 - - - - 3 Intracranial Haemorrhage 1 - - - 1 - - - - 1 Multiple Abnormalities 1 - - - 1 - - - - 1 Pneumothorax 2 - - - 2 - - - - 2 Prematurity 4 1 - - 5 - - - - 5 Pyelonephritis - - - - - 1 - - - 1 Tentorial Tear 2 - - - 2 - - - - 2 TOTALS 23 4 - - 27 4 2 - - 33 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 1959 33 14.9 1958 37 16.6 1957 38 17.1 1956 33 15.6 1955 42 20.0 1954 41 18.7 1953 45 20.2 1952 44 18.9 1951 50 21.0 1950 45 18.7 77 The mean average Infant Mortality rate for the past 10 years is therefore 18. 2 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 1959 14.9 22 22 1958 16.6 23 23 1957 17.1 23 22 1956 15.6 24 21 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 NEONATAL MORTALITY.- The death-rate of infants under four weeks of age is known as the Neonatal Mortality. There were 27 deaths of infants under four weeks of age during 1959 and the rate for the year was 12.2 per 1,000 live births. The figures for the past 10 years are as follows:- Year Number Rate 1959 27 12.2 1958 29 13.0 1957 30 13.5 1956 25 11.8 1955 30 14.3 1954 29 13.2 1953 34 15.2 1952 32 13.8 1951 40 16.8 1950 32 13.3 ILLEGITIMATE BIRTHS AND DEATHS. - 82 of the live births registered (40 males and 42 females) were illegitimate, that is 3. 7% of the births registered. 78 One illegitimate child died under one year of age. The following table shows the birth and death rates of legitimate and illegitimate infants for the past ten years:- 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 1959 2.. 134 96.3 32 15.0 82 3.7 1 12.2 1958 2, 155 96.7 36 16.7 73 3.3 1 13.7 1957 2, 158 97.3 38 17.6 61 2.7 - - 1956 2,056 97.2 30 14.6 59 2.8 3 50.8 1955 2,045 97.4 40 19.6 55 2.6 2 36.4 1954 2, 145 97.8 40 18.6 48 2.2 1 20.8 1953 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 The Chelmsford Diocesan Moral Welfare Association continued 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 Workers for this district. In addition, all cases are followed up by the Health Visitors. HEALTH VISITORS AND SCHOOL NURSES.- Miss J.M. Oliver, Superintendent Health Visitor, reports:- "Having made my debut last year it would be a pleasant taskto be able to announce something spectacular about the Health Visitors' work for 1959. Happily the service continues, although we are still not fully staffed. 79 I should like to pay tribute to the Health Visitors who are carrying on prepared to tackle any problem, visiting the homes in all weathers, either by cycling or on foot. To the Clinic Nurses who attend the routine clinics relieving the Health Visitors for more important jobs. Also to the Tuberculosis Visitors who by tact and persuasion bring the people to the Chest Clinic. What we achieve can never be evaluated in print, our main aim being to assist everyone, where possible, to attain complete mental and physical fitness. Our Mothercraft and Relaxation Classes continue to run successfully. The Mothers' Club at Manford Way continues to be very popular, and added to this is an additional one at Cecil Hall. Many requests for the Health Visitors to talk were received from Boy Scouts, St. John's Cadets, Young Wives' and Mothers' Unions, and the talks were on many varied subjects. Sixty-seven homes were visited this year to enquire how patients were after hospitalisation due to home accidents. It is unfortunate that people should be so badly incapacitated, needing hospital care, very often as the result of some simple misfortune or folly in the home. It is here too that we meet many elderly folk needing considerable assistance. Our work has increased amongst the physically handicapped people, and aids, though sometimes small, assist towards greater independence. The link with Voluntary Agencies continues and much helpful assistance on both sides comes from my being invited to be a member of the Multiple Sclerosis Society and the Physically Handicapped Committee held locally. Various students continue to visit us, usually to broaden their knowledge of Public Health Services. Two Student Health Visitors came for their practical training in October 1959. As new clinics are built it is hoped to extend our teaching activities." 80 At the end of the year there were 18 full-time and 3 part-time qualified Health Visitors and School Nurses in addition to the Superintendent Health Visitor, and 5 Clinic Nurses. The following is a summary of the home visits made by the Health Visitors and Clinic Nurses during 1959 as far as Part III Services are concerned:- First visits to newly-born infants 2,309 Subsequent visits to children under 1 year of age 6, 106 Subsequent visits to children over 1 year of age and under 5 15, 521 Visits to expectant mothers 1, 131 Home visits for other reasons (inc. 699 visits to old folk) 3,613 Total visits paid 28,680 In addition there were 6,581 visits paid where no reply was received. The arrangements made in 1957 for the Health Visitor serving in the area in which his practice is situated to assist at the baby clinic held by one of the general practitioners once a month, have continued and have proved most satisfactory. As was reported last year, with a view to increasing the degree of co-operation between the Department, Hospitals and the Doctors, a meeting at which medical and nursing staff from the Hospitals and the Health Areas and also general practitioners from both Ilford and Barking attended was held at the Chadwell Heath Hospital on the 27th January, 1959. To continue our policy of decentralising the health visitors so far as is practicable, a room on the first floor at Newbury Hall has been rented from the Borough Council from the 1st April, 1959 as an office for the two health visitors working in that area. 81 The following is a table showing the attendances, etc., at the Day Nurseries during 1959:- Situation Date of Opening Accommodation (Children) Average Daily Attendance during 1959 No. of Days "in Quarantine" Reasons far Quarantine with Number of Cases No. on Waiting List at 31 st Dec. Chicken Pox Mumps Measles German Measles Goodmayes Lane, Good- mayes (Replaced Green Lane Nursery, open from 5.5.43 to 9.11.51). 14.11.51 50 33 58 1 - 9 2 2 226-236, Ley Street, Ilford 16.8.43 50 42 85 16 - 19 1 4 82 DAY NURSERIES. (a) The hours of opening at the two Nurseries during 1959 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 remains at 10/6 per child per day. Provision is made for this charge to be reduced according to scale when the means of the parents do not justify the full fee. 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. (c) The training of Students at the Nurseries for the Certificate of the National Nursery Examination Board continued. Six Students (3 from the Ley Street Nursery and 3 from the Goodmayes Lane Nursery) entered for the examination during the year, 3 of whom obtained the Certificate. (d) The table on the previous page shows the attendances, etc., at the Day Nurseries during 1959. NURSERIES AND CHILD-MINDERS REGULATION ACT, 1948. - This Act 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. 83 The following shows the position regarding registrations under the Act: (a) Premises (b) Child-minders Number on register at 31/12/58 7 5 Number registered during 1959 3 _ Number removed from register during 1959 3 1 Number on register at 31/12/59 7 4 Number of children provided for at 31/12/59 158 24 Of the premises referred to in (a) above as removed from the register, one was closed on the removal of the nursery to other premises (included in the number registered during 1958), another because the person holding the registration could not continue to rent the building and the third as the occupier no longer wished to receive children therein to be looked after during the day. The child-minder whose name was removed from the register (see (b) above) no longer wished to act in that capacity. CLINIC PREMISES. Manford Way Health Services Clinic. - The Family Planning Association continued to use these clinic premises for their sessions on the first and third Monday evenings in each month and on every Monday evening from August, 1959, a charge being made to them to cover the cost of heating, lighting, cleaning and caretaking. Kenwood Gardens Health Services Clinic. - The building of this new clinic was completed in December 1959. The premises were equipped and ready for full occupation from 1st February I960 when the clinic services previously carried on at Valentines Mansion and Newbury Hall, with the exception of the infant welfare centres, were transferred over, the health visitors for the area having taken up occupation early in January. 84 On Saturday afternoon, 5th March 1960, the clinic was officially opened by the Worshipful the Mayor of Ilford who was accompanied by the Mayoress. The Chairman of the Health Area Sub-Committee presided and amongst the guests were the Chairman of the Health Committee, members of the County Council, the Ilford Borough Council and the Ilford Health Area Sub-Committee and the County Medical Officer of Health. The services provided at the new clinic, with its modern facilities, include an infant welfare centre (replacing the Woodford Avenue Centre which had been held at the Woodford Avenue Congregational Church Hall), mothercraft classes, midwives' ante-natal clinics, immunisation and vaccination, routine and special examinations of school children, minor ailments, dental and chiropody clinics, and certain specialist clinics (orthopaedic, ear, nose and throat, paediatric and ophthalmic). There are also greatly improved facilities for health education. The two rooms which had been used for clinic purposes at Valentines Mansion have now been taken over for additional office accommodation which was so urgently needed. Heathcote Avenue Health Services Clinic.- At the time this report is going to press this building is not yet quite ready for occupation, but it is anticipated that it will be opening shortly. As was mentioned last year, the premises are much smaller than the Kenwood Gardens Clinic and the services provided will be more limited. These will, however, include an infant welfare centre (which replaces the Barkingside Centre held at the Parish Hall, Barkingside), mothercraft classes, midwives'ante-natal clinic, chiropody, immunisation and vaccination, routine and special examinations of school children and health education. In addition the health visitors for the area will have their office in the Clinic. INFANT WELFARE CENTRES.- 99 voluntary lady helpers were engaged in the work at the Infant Welfare Centres at the end of December 1959. During the year the following attendances were recorded:- 85 Total number of attendances of infants 35,961 First attendances 2,043 Attendances of children from 1 to 5 years 9,796 Total number of children on roll on 31/12/59 after omission of all those who had not attended for six months 3,859 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 1959 35,961 2,043 3,859 1958 35,756 1,946 3,802 1957 37,948 1,916 3,976 1956 36,902 1,895 3,916 1955 36,196 1,855 3,687 762 sessions were held during the year, the average attendance at each session being 47 mothers with their infants. The following are the figures for each Centre:- Sessions Average Attendance Barkingside 48 41 Chadwell 48 61 Becontree 48 49 Down shall 48 47 Manford Way 48 31 Woodford Avenue 48 67 Seven Kings 48 53 Grosvenor Road 47 44 Cecil Hall (Wednesdays) 42 41 Cecil Hall (Thursdays) 47 35 Newbury Hall 49 55 86  Sessions Average Attendance Marks Gate 50 25 Goodmayes 49 47 Ilford Lane 47 41 Valentines 48 48 Fairlop 47 63 In April, 1959, the Marks Gate Infant Welfare Centre was transferred from St. Mark's Church Hall to the newlyopened Marks Gate Health Services Clinic in the Dagenham Health Area and in February I960, when the Clinic at Valentines Mansion was closed down, on the opening of the Kenwood Gardens Health Services Clinic, the Valentines Centre was moved to the Methodist Church Hall, The Drive, and was re-named "The Drive Infant Welfare Centre." ORTHOPAEDIC CLINIC. The following table summarises the attendances of children under 5 years:- Clinic Sessions New Cases Old Cases Attendances Newbury Hall 43 70 101 285 Mayesbrook 22 27 35 87 Manford Way 8 8 18 33 Totals 73 105 154 405 The 259 children were found by the Orthopaedic Surgeon to have the following defects:- Diagnosis New Cases Old Cases A B C A B C Deformity of hips - - - 1 - 1 Genu valgum 34 15 2 59 19 4 Pes valgo-planus 2 - - 1 - - Valgus ankles 8 3 4 6 6 3 Congenital talipes E.V. 1 - - 2 - - Intoeing 7 - - 16 - 1 Deformity of toes 7 3 - 5 2 - Scoliosis - 1 - - - - Metatarsal varus - - - 2 1 - Out. curvature tibiae - 2 1 1 3 3 Genu varum 2 - - 2 2 - Deformity of Foot 1 - - - - "" Other conditions 8 3 1 6 2 6 Totals 70 27 8 101 35 18 A —Newbury Hall. B — Mayesbrook. C —Manford Way. 87 4 pairs of Valgus Insoles, 6 G.V. night and C.D.H. splints, 155 wedges to shoes, one surgical shoe and one caliper were supplied during 1959. The Physiotherapist treated 266 children under 5 at Newbury Hall, 70 at Mayesbrook Clinic, 45 at Manford Way, with attendances of 491, 213, 222 respectively. PAEDIATRIC CLINIC.- Dr. A. Russell, the Consultant Paediatrician, continued to attend the Clinic at Valentines Mansion, 23 sessions were held and 101 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 224 attendances were made. Diagnosis Discharged Improved Discharged with advice or for other reasons Discharged No treatment Cured Referred Hospital, Doctor or Clinic Still attending Total Anaemia 1 3 - 1 1 - 6 Accessory auricle R. ear - - - - 1 - 1 Achondroplasia - - - - 1 - 1 Anal spasm - - - - 1 - 1 Cardiac murmur - 1 1 - - 3 5 Cephalhaematoma - - 1 - - - 1 Cheirodactyly - - - - - 1 1 Chronic sepsis - 1 - - - - 1 Congenital mcgacephaly - - - - - 1 1 Congenital tremor - - 1 - - - 1 Constipation - - - - - 1 1 Craniostenosis - - - - 1 1 2 Cryptorchidism - - 1 - - - 1 Diurnal enuresis - - - - 1 - 1 Epilepsy - - - - - 1 1 Epistaxis - - - - - 1 1 Facial palsy - - - - - 1 1 Feeding problems - 1 - - - 2 3 For observation - - - - - 1 1 Fractured clavicle - - 1 - - - 1 Haemorrhagic disease of the newborn - - - - - 2 2 Hæmangioma - - - - - 1 1 Hernia 1 2 - - 1 - 4 Hydrocele - - - - 1 1 2 Hypospadias - 1 1 - - 1 - Impetigo - 1 - - - - 1 Mongolism - - 1 - - 2 - Naevus - - - - 1 - 1 Napkin rash - 1 - - - - 1 Necrosis of back - - 1 - - - 1 Nil abnormal discovered - 7 8 - - 5 20 Obesity - - - - 4 5 9 Ophthalmia - 1 - - - - 1 Patency of cranial suture - - - - 1 - 1 Pilonidal sinus 1 - 2 - - - 3 Post nasal snorting - - - - - 1 1 Prematurity - - 1 - - l 2 Premature menarche - - 1 - 1 1 1 Rhinitis - - - - - 1 1 Rumination - - - - 1 1 Septicaemia - - - - - 1 1 Speech retardation - - - - - 1 1 Sterno mastoid tumour - 1 - - - 1 2 Thoraco-lumbar kyphosis - - 1 - - - 1 Tongue-tie - - 1 - - 1 2 Torticollis 1 - - - - 1 Underweight - - 2 - - - 2 Totals 3 21 23 1 16 37 101 88 OPHTHALMIC CLINICS.- Attendances of children under school age for treatment by the Ophthalmologists during 1959 were as follows:- Valentines Clinic Mayesbrook Clinic Manford Way Clinic Total Number of children who attended 48 43 13 104 Number of pairs of spectacles prescribed 18 20 4 42 Total number of attendances made 83 79 25 187 EAR, NOSE AND THROAT CLINIC.- The E.N.T. Surgeon attended at 45 sessions during 1959. 42 attendances were made by 28 children of pre-school age. 4 children were operated upon for removal of tonsils and adenoids at King George Hospital, Ilford, and 3 at the Chadwell Heath Hospital. 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 45 1 11 35 3 2 1 Mayesbrook 47 - 8 22 3 2 2 Totals 92 1 19 57 6 4 3 The conditions treated were as follows:- Conditions Cases A B Anaemia, Debility, Malnutrition and Catarrh 5 5 Bronchitis 4 1 Chilblains - 2 Other conditions 3 - Totals 12 8 A.- Newbury Hall. B.- Mayesbrook. 89 SPEECH CLINIC.- 33 children of pre-school age attended, making 553 attendances. The following is the classification of the defects found by the speech therapist:- Dyslalia 24 Stammering 1 Retarded speech and language 8 DIPHTHERIA IMMUNISATION.- During 1959 a total number of 710 children attended at Clinics for diphtheria immunisation (316 at Valentines Clinic, 290 at Mayesbrook, 80 at Manford Way, 21 at Newbury Hall, and 3 at Marks Gate) making a total number of attendances of 1, 613 (673, 692, 185, 54 and 9 respectively). Diphtheria and whooping cough immunisation is undertaken at the same session and, as the numbers attending have declined, at the Valentines and Mayesbrook Clinics this work is combined with the school clinics held for the treatment of minor ailments and at the Manford Way, Newbury Hall and Marks Gate Clinics immunisation is undertaken at the infant welfare clinic sessions. *Includes 514 combined Diphtheria and Whooping Cough inoculations. +Includes 200 combined Diphtheria and Whooping Cough inoculations. The following table shows the figures over the past five years. No. of primary inoculations:- 1955 1956 1957 1958 1959 At Clinics 398 338 282 401 373 By General Practitioners 1,324 1,745 1,492 1,681 1,669* Totals 1,722 2,083 1,774 2,082 2,042 No. of re-inoculations At Clinics 437 478 252 330 304 By General Practitioners 808 1,579 888 1,366 888+ Totals 1,245 2,057 1, 140 1,696 1,192 No. of live births in Ilford 2, 100 2, 115 2,219 2,228 2,216 90 WHOOPING COUGH IMMUNISATION.- The following are the details of the number of children immunised against whooping cough at the Valentines and Mayesbrook Clinics where sessions were held for this purpose and at the Newbury Hall and Manford Way Infant Welfare Centres, together with records of such courses completed by general practitioners. Valentines Clinic Mayesbrook Clinic Newbury Hall and Manford Way Clinics *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 121 - 372 167 - 514 81 - 245 796 14 Children 5 years of age and over 1 - 3 - - - - - 2 12 76 Totals 122 - 375 167 - 514 81 - 247 808 90 *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 514 Re-inoculations 200 VACCINATION AGAINST POLIOMYELITIS.- The programme of vaccination of the eligible groups, i.e. children and young persons from the age of six months to 25 years, expectant mothers, doctors, nurses, ambulance staff and their families proceeded during 1959, sufficient vaccine being made available to cover all those who registered. Since early in I960 this vaccination has been made available to all persons up to the age of 40 years at the time 91 of their application, and other special groups of the population, including practising dentists and also certain public health staff, together with their families. Registration of the older age group, although not high, has been steady and has been comparable with the "young adult" group. The general practitioners have continued to play an important part in the scheme and most of those practising in the Area are participating. During 1959 in addition to holding sessions at the various clinics, many of which were combined with school clinic or infant welfare centre sessions, our medical and nursing staff visited the Village Homes, Barkingside to vaccinate children resident there. We were also fortunate in gaining excellent co-operation from many of the larger firms in the Area in the registration of their "young adult" personnel who were prepared to accept the offer of vaccination and several of these firms made accommodation available to enable our staff to hold sessions at the factories during working hours. The statistics given below show the vaccinations carried out by our medical staff:- Premises No. of Sessions Injections given First Second Third Public Health Offices 81 2,009 2,138 4,056 Mayesbrook Clinic 49 1,393 1,441 2,156 Manford Way Clinic 30 480 490 913 Newbury Hall 15 244 247 551 Marks Gate Clinic 8 23 24 29 Village Homes 2 51 57 151 Factories 24 964 894 316 Totals 209 5, 164 5,291 8, 172 The medical staff at the Village Homes, Barkingside also held five sessions there, carrying out a total of 306 second and 74 third injections, and the Honorary Medical Officer of the Ilford Football Club vaccinated 12 members of the Club (primary course of two injections). 92 Record cards received in 1959 from general practitioners were as under:- Completed primary courses (two injections) 12,685 Third injections ("boosters") given 14,671 At the 3 1 st December, 1959a total of 40, 380 primarycourses had been completed in Ilford (30, 861 children under 16 years, 7,281 persons aged 16 to 25 years, 1,920 expectant mothers and 318 general practitioners, ambulance staff, etc. ). SMALLPOX VACCINATION.- During 1959 record cards were received from general practitioners and various hospitals as follows:- Ages up to 14 - No. of children primarily. vaccinated 1,289 No. of children revaccinated 84 Age 15 and over - No. of adults primarily vaccinated 193 No. of adults revaccinated 478 In addition 47 children were primarily vaccinated at the Manford Way Clinic. The following table shows the figures over the past five years:- 1955 1956 1957 1958 1959 No. of primary vaccinations 1,383 1,545 2,169 1,714 1,529 No. of revaccinations 398 445 975 537 562 Totals 1,781 1,990 3,144 2,251 2,091 No. of live births in Ilford 2,100 2,115 2,219 2,228 2,216 TREATMENT OF MINOR AILMENTS.- Children suffering from simple dietetic ailments are treated at the Infant Welfare Centres. Facilities are, however, available at the sessions held for school children at Kenwood Gardens 93 and Mayesbrook Clinics for children under school age to receive treatment for minor ailments, although in practice very few so attend. MIDWIVES.- There were 12 State certified midwives (including the Non-Medical Supervisor of Midwives, 9 domiciliary midwives and 1 part-time midwife employed by the County Council), resident and practising in the district at the end of the year. In addition there were 25 State certified midwives at the Ilford Maternity Hospital. Supervision of the midwives practising on the district, including regular inspections by the Medical Supervisor of Midwives, was carried out as in previous years, and general supervision, in accordance with the Rules of the Central Midwives Board, was exercised over the midwives practising at the Ilford Maternity Hospital. Suspension from Practice.- No Midwives were suspended from practice during the year. Medical Aid.- Medical aid was sought in one instance where the infant was found to have a discharging eye. The condition of the eye cleared satisfactorily. Domiciliary Midwifery Service.- At the end of the year there were 9 Domiciliary Midwives employed by the County Council whole-time and 1 part-time, in addition to the Non-Medical Supervisor. During the year 431 cases were attended. In 397 cases the midwives were engaged to attend as midwives and in 34 cases as maternity nurses. A Doctor was called in to 56 of the 397 cases in which a midwife had been engaged. Of the infants born there were 3 stillbirths. In 2 of these cases the midwife was engaged as a midwife and in the other as a maternity nurse. One death occurred of an infant during the first year of life where the birth had been attended by a Domiciliary Midwife. Notices we re received from the Domiciliary Midwives stating that artificial feeding had been substituted in respect of 28 infants attended by them during 1959. 94 During 1959 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 408 131 95 Subsequent attendances 945 346 335 Totals 1,353 477 430 Number of sessions 49 25 32 Average attendance at each session 27 19 13 In addition 1,789 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. The Ilford Borough Council continued to provide housing accommodation, where necessary, for midwives employed in the service of the Ilford Health Area Sub-Committee. At the 3 1st December, 1959, one maisonette and two flats were being rented by the County Council from the Borough Council under this arrangement. Arrangements were made in 1959 for the Domiciliary Midwives to assist, as from the 1st January, I960, in the training of pupil midwives from the Thorpe Coombe Maternity Hospital, Walthamstow. Five of the whole-time midwives were approved by the Central Midwives Board as teaching district midwives and the arrangements provide for four pupil midwives, who are accommodated at the Chadwell Heath Hospital and remain for a period of three months, to be received at a time. 95 Salvation Army Midwifery Service.- One Salvation Army midwife, with a further midwife assisting her as required, served in Ilford during the year and in view of the shortage of County Council midwives the governing body, the Mothers' Hospital, Clapton, agreed to their undertaking certain cases outside their normal area to relieve the position to a degree. 164 cases were attended by them, 160 as a midwife and 4 as a maternity nurse. A Doctor was called in to 43 of these cases. Of the infants born there was one stillbirth. Notifications were received from the Salvation Army Midwives that it was proposed to substitute artificial feeding in respect of 26 infants. Gas and Air Analgesia.- During 1959 gas and air analgesia was administered in 515 cases, of which 376 were attended by the Domiciliary Midwives (348 when acting as midwives and 28 when acting as maternity nurses) and 139 were attended by the Salvation Army midwives (135 when acting as midwives and 4 as maternity nurses). All the domiciliary midwives employed at the end of the year were qualified to administer gas and air analgesia and the Salvation Army midwives were also so qualified. Arrangements continued in operation for each of the midwives using cars in the course of their duties to hold a machine at their respective homes to take with them to their own cases and there are also 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 al! living home confinements, provided there are no medicalcontra-indications, and each expectant mother on booking the midwife is supplied with a leaflet explaining the nature and the availability of the service. 96 ANTE-NATAL CLINICS.- The following is a summary of the attendances at the Ante-Natal Clinics during 1959 for patients booked for confinement in hospital:- Maternity Hospital Mayesbrook Clinic Manford Way Clinic Doctors Midwives First attendances 947 - 278 131 Subsequent attendances 4,608 3,510 2,629 875 Totals 5,555 3,510 2,907 1,006 Number of sessions 307 239* 130 65 Average attendance at each session 18 14 22 15 *Includes 188 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. In conjunction with the Ante-Natal Clinics at the Manford Way and Mayesbrook Clinics the Health Visitors hold classes for relaxation exercises. During 1959 there were 100 sessions at the Mayesbrook Clinic, with 975 attendances, and 102 sessions at Manford Way Clinic, with 1,039 attendances. A weekly session was also run byHealth Visitors at Valentines Mansion, 46 sessions being held in the year, with 248 attendances. Relaxation exercises classes are in addition held by the staff of the Ilford Maternity Hospital for patients attending the Ante-Natal Clinic there. 97 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 1959 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 722 203 68 Subsequent attendances 139 76 7 Totals 861 279 75 Number of sessions 52 27 12 Average attendance at each session 16 10 6 CONSULTANT CLINIC.- There were two Consulting Obstetricians in 1959 who each held a weekly Clinic for ante-natal and post-natal cases. During the year 102 sessions were held and a total of 1,541 examinations were made. MATERNAL MORTALITY.- During 1959 there were no deaths of Ilford mothers recorded by the RegistrarGeneral as due to or in consequence of pregnancy or childbirth. DOMESTIC HELP SERVICE.- During 1959 the heavy demand for this service continued. The service was controlled by two full-time Organisers, under the general direction of the Area Medical Officer, and at the end of the year there were 6 full-time, 116 regularly-employed parttime and 24 casual Helps employed. The following is a summary of the cases dealt with in 1959:- 98 Number of applications received for assistance 1,548 Number of cases where Domestic Helps were provided (including 674 who were having service at the commencement of the year) 1,772 Number of cases which on investigation were either not eligible for assistance or did not require the service 147 Cases booked but subsequently cancelled 206 Number of cases where, at the end of the year, a domestic help was booked to attend in future months (maternity cases) 71 Other cases awaiting help at end of year 17 Enquiries incomplete at end of year 9 Cases being served at 31st December, 1959 727 Two training courses, each of two weeks' duration, were held by the County Council at Chelmsford in 1959. Three domestic helps from Ilford attended and all were found to be entirely satisfactory. PREVENTION OF BREAK-UP OF FAMILIES— HEALTH OF CHILDREN.- Supervision of the few problem families in the Area continues, the Health Visitors taking the leading role and discussing the problems with interested persons, e.g., General Practitioners, Teachers, Housing Manager and Psychiatric Social Workers. Local case conferences are called as necessary. CONVALESCENT FACILITIES.- The following tables show the number of persons sent away for convalescence during 1959. 99 (a) Under Section 22 of the National Health Service Act, i.e., nursing mothers and young children. Name of Home No. of cases No. of weeks' stay Remarks The Church Army Home Bexhill-on-Sea 1 2 Mother and child Shoredith Holiday Home Copthorne 1 2 Mother and two children Totals 2 4 (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 2 3 4 5 Armitage Home Worthing 1 - - - 1 Bell Memorial Convnlescent Home, Lancing 11 8 2 1 22 Brook Lane Rest Home, Brighton 2 1 - - 3 Mrs. Clark's Home, Brighton 2 - - - 2 Cumberland Convalescent Home, Heme Ray 3 - - - 3 Mrs. Foster's Home, Leconfield, Isle-of-Wight - - 1 - 1 Mrs. Hayward’s Home, Cliftonville 1 - - - 1 Mr. Henderson's Home, Bournemouth - 1 - - 1 Holiday Home, Braemar Royal, Bournemouth - - 1 - 1 Kenmure Guest House, Brighton 2 - - - 2 Lennox House, Southsea - 1 - - 1 Mildmay Convalescent Home, Ramsgate 4 - - - 4 Mrs. Pollitt's Home, Broadstairs 1 - - - 1 Rustington Convalescent Home, Littlehampton 5 4 - - 9 Samuel Lewis Convalescent Home, Walton-on-Naze 5 - - - 5 St. Michael's Convalescent Home, Clacton-on-Sea 17 2 - - 19 St. Michael's Convalescent Home, Westgate-on-Sea 1 - - - 1 Victorian Convalescent Home, Bognor Regis 2 - - - 2 Totals 57 17 4 1 79 100 LOAN OF SICK ROOM EQUIPMENT.- The considerable demand for equipment continues and the following table shows the issues from the Public Health Offices during 1959. Articles Loaned Number of Articles Articles in store at 31.12.59 on loan at 31.12.58 loaned or reloaned in 1959 on loan at 31.12.59 Mattress (Dunlopillo) 12 19 14 - Mattress (Hair) - 2 1 2 Invalid Chairs 49 70 49 8 Air Pillows - 1 - 2 Air Pings 54 201 50 54 Cushions (Dunlopillo) 11 26 11 1 Back Rests 72 191 69 20 Beds 8 9 7 1 Commodes 34 47 48 3 Crutches 7 13 12 4 Fracture Boards (Sets) 4 - 4 - Pillows 2 2 3 5 Pillow Slips - - - 1* Rubber Sheeting 124 301 128 50 Medical Sandbags (Sets) - - - 1 Bed Cradles 16 34 25 - Air Beds 2 4 1 4 Bed Pans 73 250 77 36 Diabetic Scales 2 - 2 2 Feeding Cups - 15 2 9 Urinals 32 82 43 24 Sputum Mugs 3 - 2 2 Douche Cans 1 2 1 1 Water Beds - 1 - 1 Water Pillows - - - 1 Bed Blocks 1 1 2 - Pails - - - 2 Bowls - - - 2 Bedstead Sides (Pair) 1 - 1 - Lifting Pole and Chain 6 7 7 - Commode Sorbo Cushion - 1 - 1 Kidney Dishes 1 - - - Rubber Toilet Seat (inflatable) 2 - 2 - Totals 517 1,279 561 237 1958 Details 619 1,083 517 238 1957 Details 555 1,062 619 125 1956 Details 519 1,158 555 180 1955 Details 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. 101 CHIROPODY SERVICE.- During 1959 the Minister of Health indicated that he was prepared to receive proposals from Local Health Authorities wishing to establish or extend a chiropody service as part of their arrangements for the prevention of illness, care and after-care under Section 28(l) of the National Health Service Act 1946. Such proposals were submitted by the County Council and approved by the Minister, including the setting up of a service in those Areas, of which Ilford was one, where none was already operating. It was decided that treatment would be given so far as practicable only in premises owned or hired by the County Council and by salaried officers, and that initially priority would be given to the provision of comprehensive facilities for the elderly, the physically handicapped and expectant mothers, although these would be extended to other categories when circumstances permitted. Authority was given to appoint two full-time chiropodists for Ilford in the first instance. The posts were advertised in December 1959 and two appointments were made, the successful candidates taking up duty in March and April I960 respectively. A third post is now in process of being filled. With the removal of most of the clinic services from Newbury Hall to the new Kenwood Gardens Health Services Clinic it was possible to rent part of the ground floor accommodation at that Hall as our main chiropody clinic, with two chairs. In addition sessions are held at the health services clinics. Arrangements have now been made for the chiropodists to visit regularly the two Welfare Committee residential establishments in the Area and to undertake domiciliary chiropody in the case of patients who are unable to travel even by ambulance vehicle to the chiropody clinics. TUBERCULOSIS VISITORS.- The three Tuberculosis Visitors made a total of 2, 592 visits to homes in the Borough. DOMICILIARY OCCUPATIONAL THERAPIST.- The Domiciliary Occupational Therapist, who also serves in Romford, Dagenham, Barking and part of the Forest Health Areas, undertook the following visits in Ilford during 1959:- 102 Number of visits to new patients 11 Number of revisits to patients 214 Number of other visits (to Chest Clinics , etc. ) 31 REHABILITATION OF TUBERCULOSIS CASES.- No cases required assistance in the maintenance charges at a rehabilitation settlement during 1959. OPEN-AIR SHELTERS FOR TUBERCULOSIS CASES. One open-air shelter supplied for a tuberculosis patient during 1958, continued in use throughout 1959. PROVISION OF FREE MILK FOR TUBERCULOSIS CASES. - The County Council's scheme for supplying to tuberculosis patients one pint of milk per day free of charge, on the recommendation of the Chest Physician, showed a further decline during 1959. Particulars of the grants made in 1959 are given below:- No. of cases in receipt of free milk at 31.12.58 150 " " new grants made during 1959 58 " " grants discontinued during 1959 116 " " cases in receipt of free milk at 31.12.59 92 BOARDING-OUT OF CHILDREN (TUBERCULOSIS CONTACTS).- No applications were received in 1959 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 1959. 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) 23 181 (including renewals) Other grants (Christmas cash gifts, clothing, etc.) 56 82 103 TRAVELLING EXPENSES OF RELATIVES VISITING HOSPITAL PATIENTS.- As in previous years, the County Medical Officer was able to give financial assistance in 1959 only in very special cases to enable them to visit relatives who were in hospital; no Ilford persons, however, applied for assistance under this scheme. EXAMINATION OF OFFICERS AND SERVANTS.The following medical examinations by Essex County Council staff were carried out during 1959:- Entrants to County Council Service 30 Other purposes 9 For other Authorities 6 INVALID NIGHT ATTENDANCE SERVICE.- The experimental scheme operating in conjunction with the Ilford Social Service Association for the provision of night attendants to provide some relief for those people called upon to sit up constantly all night with sick relatives or friends, or to help sick persons with no one to whom to turn for such assistance, continued until the 30th November 1959, 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 was proved. The following are the details of the cases dealt with under this scheme during 1959:- No. of cases being attended at 31.12.58 Nil No. of new cases attended during 1959 12 No. of cases discontinued during 1959 10 Total number of attendances given 201 The County Council decided that as from 1st December 1959 a directly-provided night attendant service should be operated throughout the whole of the Administrative County as part of the Health Area Services. As it was not practicable to take over from that date from the Ilford Social Service Association who had been running this service for many years, the Association agreed to continue to provide on behalf of the County Council the necessary attendance during the month of December 1959; in that month attendance was continued for a total of 26 nights at the two cases who were already having a night attendant at the 30th November, no new cases arising; service was discontinued in these two cases before the end of December 1959. 104 Since 1st January 1960 a directly-provided service has been operating, this being integrated with the Domestic Help Service and controlled by the two full-time Organisers under the general direction of the Area Medical Officer. The six night attendants employed by the Ilford Social Service Association were offered appointments, three of whom accepted. INVALID DAY ATTENDANCE SERVICE.- The arrangement with the Ilford Social Service Association for providing day attendants in approved cases to sit with sick and infirm persons who cannot afford to meet the charge made by the Ilford Social Service Association, the County Council making agreed payments to the Association, has continued. Details of the cases dealt with under this arrangement are as follows:- No. of cases being attended at 31.12.58 1 No. of new cases attended during 1959 11 No. of cases discontinued during 1959 12 No. of cases being attended at 31.12.59 Nil Total number of attendances given:- (a) whole days 149 (b) half days 76 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 1959 was as follows:- Cases attended 2,089 Visits paid 59,815 HEALTH EDUCATION.- Dr. G.B. Taylor, Assistant County Medical Officer, reports:- "Health Education is constantly going on in the ante-natal clinics, post-natal clinics, infant welfare centres. In these clinics individual advice is given and it is this personal advice which is the most effective means of conveying medical information. These centres therefore are of primary importance 105 in the teaching of health education. However, there are certain aspects of health education which cannot be carried out through these clinics because they affect the public in general. During the last three months of 1959 a "Check that Fall" campaign was carried out. The reason for this campaign was that the fatality figures from falls in the home in England and Wales were roughly 6,000 a year, and on analysing them, over 90% of these fatalities occurred in people over 65 years of age. I felt that it would be of little use directing the campaign to the public in general, and I therefore convened a meeting at the Town Hall, inviting 20 people who were leaders of Old People's Organisations. After the illustrated lecture I was surprised at the enthusiasm shown. The leaders suggested that I should visit each of their clubs and give a lecture on the prevention of falls. Fifteen lectures were given and the attendance at each lecture was between 80 and 100. This was most gratifying, because these people belonged to the particular age group in which fatalities from falls occurred. They were a very stimulating audience and asked many practical questions after each lecture. Posters were displayed in different parts of the Town and the Clergy helped us in bringing to the notice of their congregations the fatalities from falls in the home. Although the campaign itself was directed to the over 65's, children under the age of five also suffer fatal accidents from falls in the home. Talks were given in the infant welfare centres about falls and posters were also displayed, drawing attention to the dangers to children of falls in the home. The poliomyelitis immunisation figures in Ilford for the ages 15 - 25 are very poor. They amount to roughly 33% of the population. In an effort to improve these figures I decided to have a short intensive campaign with heavy publicity. Before the campaign began I personally saw all the managers of the shops in the High Road and most of them in the Cranbrook Road. I explained to them the position about the poor response to poliomyelitis immunisation and the majority of the managers were willing to co-operate. At a pre-determined time all these shopkeepers were 106 sent the same poliomyelitis posters which were displayed at the beginning of a week's campaign. In addition posters were sent to youth clubs, post offices, council notice boards, council vans, schools and evening institutes. The three main cinemas in Ilford displayed poliomyelitis posters and also showed screen flashes. A recorded appeal by the well-known radio personality, Eamonn Andrews, was sent to jazz clubs, dance band leaders, and to the local football ground. Small leaflets were sent to factories to enclose in pay packets. We also hired a broadcasting van which toured the streets of Ilford and advertised the campaign in the press. Since I did not know what the response would be to this campaign I asked all the chemists in Ilford if they would act as registration centres, sending them at the same time request forms. The idea in this was that people would merely have to go into the chemists to ask for a request form. They were told by broadcast that the chemists were acting as registration centres. After this campaign there was no increase in requests for poliomyelitis immunisation and there can be only three possible reasons for this:- 1. That the campaign was inefficiently run. 2. That the figures we have are incorrect. 3. That the people are apathetic. To comment on the first, that the campaign was inefficiently run. We made use of all the modern means of publicising and I do not think we could have improved upon our efforts. The second point, that the figures we have are incorrect, is not without moment because some of the Ilford residents have been immunised by the London County Council. However, we have now made allowance for this and there are still 60% of people between the ages 15 and 25 who are not immunised. The third point, that the public are apathetic, seems to be the correct one. Apathy of the general public is not novel, and health educators can only 107 continue their efforts, hoping that over the years, there will be a gradual reorientation of custom and habit. Although the immunisation figures for the under 15's are quite good I gave an illustrated lecture to youth leaders at the Town Hall and gave them information and advice on poliomyelitis immunisation which they conveyed to their boys and girls. Most of the youth leaders wrote to me saying that the majority of their youths had been immunised but the few who had not they were able to influence. Sex Education is fraught with danger because it has such a high emotional content. It seems that the best way of teaching sex education is to include it in a general course and I was asked to participate in such a course. This particular course included talks to youths on the many aspects of marriage, such as getting a mortgage, buying the right type of furniture, investment of money and the spiritual and physical side of marriage. I gave an illustrated talk on the physical side of marriage to an audience of about 50. I was helped in this by one of our health visitors. The arrangements were that she spoke to the girls separately and then I spoke to the boys, after which they were grouped together and shown a film. Some of the boys asked personal questions about intimate matters arising from the lecture. The leaders of this group seemed to think that the lecture was very worth while. Many fathers want factual information about pregnancy and labour and a film entitled "The Birth of a Baby" was shown at the Manford Way Clinic. This was well attended and several of the audience asked whether they could have some more films on subjects such as Child Development. Many Health Workers from abroadnOw visit this country to learn about health education. I was asked to write a paper to be read before an international seminar of health workers convened by the Central Council for Health Education. The paper was entitled "The Demands for Health Education". I based the lecture upon my experience in Ilford over the 108 past 12 months, illustrating the lecture with slides and a recorded interview I had with two headmasters. The lecture, which lasted about two hours, is shortly being published in the Health Education Journal. It is interesting to note that of the four lecturers at this seminar, 50%, that is Mrs. Gordon and myself, were from Ilford. Finally, a course of lectures was given to the British Red Cross Society in preparation for an examination. These lectures covered a wide aspect of health varying from dietetics to the structure of the National Health Scheme. Most of the students reaped the reward of their and our labours in passing the examination." Posters covering various aspects of Health were displayed at the Public Health Offices and the Mayesbrook, Manford Way and Newbury Hall Clinics throughout the year and a display unit, loaned by the Royal Society for the Prevention of Accidents, on the subject of burns and scalds, was installed in the entrance hall at Valentines Mansion for three weeks from the 21st August, 1959. During the year a total of 85 lectures on varied Health subjects were given by members of the medical staff, health visitors and domestic help organisers to various organisations and children. In addition 252 lectures on Mothercraft were given by the Health Visitors at their ante-natal relaxation classes at the Mayesbrook and Manford Way Clinics, a series of 12 lectures constituting each course. DENTAL TREATMENT.- Mr. E.V. Haigh, the Senior Dental Officer, has submitted the following report:- "During 1959 Dental facilities continued to be provided at Mayesbrook Clinic for expectant and nursing mothers and for children under five years of age. The total number of sessions devoted to these patients was 95; this giving an average of two sessions per week-one during the day and one evening session. The evening session is continuing to be very popular with many of the expectant and nursing 109 mothers. This is due to the fact that many find it difficult to attend during the day because either they are working or they are unable to find anyone to look after their children. It has been most noticeable that the evening patients are much more at ease and therefore less troublesome to treat. The total number of patients treated under this service during 1959 was 288, an increase of 78 over the previous year. The reason that more patients were treated in the same number of sessions was due in my opinion to the fact that mothers are becoming more dentally conscious and are receiving dental treatment from the time of leaving school. Many came for an examination, not because they had pain. These mothers usually require only a small amount of treatment to make them dentally fit. It is not so common to see mothers with grossly neglected mouths as a few years ago. The choice of local or general anaesthesia was available to the patient when extractions were required. Most were performed under a general anaesthetic, this being given always to children under five. All anaesthetics were administered by a Medical Officer. The dentures supplied were made by a local dental laboratory, an arrangement which has been in operation for many years and is satisfactory. Dental X-Ray facilities which are important in the diagnosis of many dental abnormalities continue to be available at Mayesbrook Clinic. " The number of cases treated at the Clinic during 1959 was as follows:- Examined Needing Treatment Treated Made Dentally Fit Expectant and nursing mothers (a) Day Sessions 62 61 65 53 (b) Evening Sessions 112 112 119 96 Children under 5 105 104 104 91 110 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 (a) Day Sessions 179 26 47 144 62 - 68 2 12 6 (b) Evening Sessions 78 56 - 226 180 5 137 2 6 8 Children under 5 130 - 58 218 - - 47 - - - In addition there were 116 prophylactic treatments and other operations carried out in the case of expectant and nursing mothers at day sessions and 276 at evening sessions. The total number of sessions held for expectant and nursing mothers and children under five years of age was 95, 46 during the day and 49 in the evenings. DISTRIBUTION OF NATIONAL WELFARE FOODS. The distribution of national welfare foods (National Dried Milk, orange juice, cod liver oil and vitamin tablets) to beneficiaries has continued to be the responsibility of the local health authorities under the National Health Service. On the 28th December, 1959, the food store and office were moved from the former ambulance station at ClarksRoad to the accommodation provided for this service at the new Kenwood Gardens Health Services Clinic and the main distribution centre which had been operating at the Public Health Offices, Valentines Mansion, was transferred there as from the 11th January, I960. The distribution centre which had been held on one day a week at the Methodist Church Hall, Fremantle Road, was closed on the 5th January, I960, as the main distribution centre is now in the catchment area it was formerly serving. The following shows the present distribution centres, with the days and times they are open:- Ill (a) Main Centre Kenwood Gardens Clinic, Monday to 9.30 a.m. - 5 p.m. Kenwood Gardens, Friday Ilford. Saturday 9.30a.m. - 12noon (b) Branch Centres Methodist Church Hall, Tuesday and (9.15 a.m. - 1 p.m. High Road (entrance Friday (2 p.m. - 3.15 p.m. in Cleveland Road), Ilford. Saturday 9.15a.m. - 12noon Goodmayes Methodist Friday 9.15 a.m. - 1 p.m. Church Hall, Blythswood Road, (next to Seven Kings Library), Goodmaye s. 2 p.m. - 3.30 p.m. (c) Infant Welfare Centres Chadwell Monday 2-4p.m. Marks Gate Tuesday 2-4p.m. Manford Way Tuesday 2-4p.m. „ „ Friday 2-4p.m. Becontree Tuesday 2-4p.m. Goodmayes Thursday 2 - 4 p.m. Downshall Tuesday 2-4p.m. Kenwood Gardens Wednesday 2-4p.m. Heathcote Avenue Wednesday 2-4p.m. Cecil Hall Wednesday 2-4p.m. „ „ Thursday 2-4p.m. Seven Kings Wednesday 2-4p.m. Newbury Hall Thursday 2 - 4 p.m. Grosvenor Road Wednesday 2-4p.m. Ilford Lane Friday 2-4p.m. The Drive Friday 2-4p.m. Fairlop Friday 2-4p.m. (d) Private Houses Mrs. Taylor, Monday to 9 a.m. - 5 p.m. 31, Lime Grove, Hainault. Friday Mrs. Peacock, 15, Culpeper Close, Hainault. Evenings and Weekends only 112 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. 113 SCHOOL HEALTH SERVICE SCHOOL ROLL AND PREMISES.- There are 39 schools with 65 departments. The number of children on the school roll of Primary and Secondary Schools in Ilford on 18th December, 1959, was 23,481 which figure includes Barking Abbey (450). In addition there were 112 children attending the special schools. MEDICAL INSPECTION AND FOLLOWING UP.During the year 8,335 periodic medical inspections were carried out and in addition, 817 special inspections and2,403 re-inspections were undertaken. 5,550 parents or 66. 5 per cent, attended the full medical inspections. As in previous years the Elmbridge and Kennylands Boarding Schools remained under this authority for the purpose of medical supervision and Dr. Gross visited each school once a term to undertake routine medical inspections and follow-up cases. During the early part of the year there were rather extensive outbreaks of influenza at both schools and owing to the number of children affected at Kennylands School the Ilford Division had to provide additional nursing help which was rendered by the Superintendent Health Visitor and two Health Visitors, the Resident School Nurse having herself gone sick with the complaint. At Elmbridge School the position was a little more difficult as following the influenza epidemic there was a considerable outbreak of Haemolytic Streptococcal sore throat. Consequent upon this all the children were swabbed and some 120 were found to be positive, several of them developing scarlet fever. The infection did not completely abate until after the Easter recess. We acknowledge the considerable assistance and co-operation rendered by the Hambledon Rural District Council in supervising the swabbing and the advice given during this period. The existing arrangements, however, whereby Surrey County Council undertook dental inspection and treatment of pupils at Elmbridge School were continued. STAFF.- Dr. G. B. Taylor was appointed to the staff as an Assistant County Medical Officer and School Medical Officer and commenced duties in a full-time capacity on 13th july. 1959. 114 Owing to the continued shortage of part-time Dental Officers it was only possible to carry out a limited number of inspections of pupils at school. VISITS.- (a) The Public Health Inspectors made 1, 190 visits to maintained schools, (l) to enquire as to the milk supplies and (Z) to inspect the sanitary arrangements. (b) School nurses made (i) 137 visits to schools (118 for general hygiene and 19 for head inspections) when 15,766 individual children were examined and 18, 138 actual examinations were made, (ii) 3,313 home visits in regard to treatment recommended, and (iii) 994 home visits to cases of minor infectious diseases. (c) Dr. O'Connor Wilson visited all primary schools during the latter part of the year with a view to testing the views of Head Teachers on carrying out a Posture and Foot Survey in all schools with an age group of 9 to 11 years. This suggestion was well received and we are to commence this survey early in the year I960. I have continued my own regular visit to schools in an endeavour to become more fully acquainted with schools and Head Teachers and have set myself the target of conducting one routine medical inspection in each school. I am now just over half-way through this programme which must depend on the time I have available. A further innovation during 1959 was the regular attendance of Health Visitors at Case Conferences held at the Child Guidance Clinic and there is now a good liaison with that service and the Health Visitors. In some instances the General Practitioner is also able to attend the Child Guidance Case Conferences. (d) A separate report is furnished by the Chief Public Health Inspector on the general subject of hygiene conditions in schools. DEFECTIVE HEARING.- An Amplivox audiometer was purchased in January 1959 and Dr. Gross attended a three-day course on the use of this machine and the testing of hearing. As a result, the majority of children found to have defective hearing were tested-the more complex cases being referred to the Ear Nose and Throat Surgeon. This has saved much unnecessary referral to London hospitals for this purpose. 115 INFECTIOUS DISEASES.- In the Ilford schools there was also rather an extensive outbreak of measles and influenza lasting from January to March 1959 and at one time the absence in most schools was as much as 50%. At one of the Ilford schools there was a mild outbreak of food poisoning due to C. Welchii which was traced to meat pies supplied for school meals - the apparent cause being the slow cooling of large pies. Some 60 children and 5 members of the staff were affected. As a result of investigation the Public Health Laboratory suggested smaller pies which should not be cooked overnight. This recommendation was passed to the Education Department for action. MINOR AILMENT CLINICS.- The Minor Ailment clinics functioned as amended on 1st December 1958, a full session weekly being operated at both the Mayesbrook and Newbury Hall Clinics. In addition facilities were afforded forany urgent cases to consult the doctor at the immunisation clinics held weekly at Mayesbrook Clinic and the Public Health Offices. NEW OR ORIGINAL WORK.- Upon his appointment to the staff Dr. G. B. Taylor took over Health Education with particular reference to lectures and films in schools. He has commenced interviewing individual Headmasters with a view to introducing talks in schools about the association of lung cancer and cigarette smoking. The majority view so far is that most Headmasters will welcome a lecture on cancer and smoking, giving the facts as they are known to date. It is appreciated, however, that schools do differ in their needs for general health education, but it is hoped to overcome any problems by good liaison between the medical authorities and the teaching profession. SPECIALIST SERVICES.- The various specialist clinics functioned as in previous years and these are the subject of separate reports by the Consultants included under the particular Clinic details. STATISTICS.- The Ministry of Education Annual Returns and the summary of heights and weights over a period of 10 years are printed at the end of this Report. 116 MEDICAL TREATMENT. (a) Minor Ailments Clinics.- The attendances during 1959 were as follows:- Newbury Hall Mayesbrook Number of individual children seen 275 434 Number of attendances of children 464 689 Number of exclusion certificates granted 8 19 Number of certificates of fitness to attend school granted 4 18 The following table shows the conditions dealt with at both the Clinics during the year:- Subnormal Nutrition 188 Debility 55 Uncleanliness:- Head 21 Body Skin: - Ringworm: - Head Body 1 Scabies Impetigo 7 Dermatitis 3 Urticaria - Furunculosis 6 Eczema 3 Athletes Foot 21 Warts 88 Other Skin Diseases (Non-Tuberculosis) 34 Eye:- Blepharitis 5 Conjunctivitis 5 Defective Vision (excluding Squint) 64 Squint 6 Other conditions 39 117 Ear:- Defective Hearing 5 Otitis Media 1 Other Ear Diseases 12 Nose and Throat: - Chronic Tonsilitis only 17 Adenoids only 2 Chronic Tonsilitis and Adenoids 8 Nasal Catarrh 10 Nasal Obstruction 4 Other conditions 7 Enlarged Cervical Glands (Non-Tuberculous) 5 Defective Speech 16 Teeth - Dental Diseases 35 Heart and Circulation:- Functional - Organic Anaemia 2 Infectious Diseases:- Chicken Pox 1 German Measles - Whooping Cough Colds and Coughs 15 Influenza 2 Lungs:- Asthma 6 Bronchitis 2 Pulmonary Catarrh 8 Other Non-Tubercular Diseases 9 Psychological: - Development 1 Stability 9 Nervous System: - Nervous Debility 1 Habit Spasm 1 Chorea - Petit Mal Enuresis 6 Other Conditions 14 118 Deformities: - Genu Valgum 2 Posture 2 Pigeon Chest - Flat Feet 17 Valgus Ankles 3 Other Forms 19 Minor Injuries 10 Rheumatism 5 Other Defects and Diseases 34 Total number of ailments 837 RECUPERATIVE HOLIDAYS. During 1959, 20 children were recommended for recuperative holidays and were placed by the Borough Education Officer. 119 SPECIAL CLINICS OPHTHALMIC CLINIC. The following table summarises the attendances of school children:- Clinic Sessions New Cases Old Cases Attendances Valentines Mansion 103 289 854 1,642 Mayesbrook 92 196 454 1,012 Manford Way 12 36 69 203 Totals . . . 207 521 1,377 2,857 984 complete pairs of spectacles were provided, some of these being renewals after breakages. In addition, in 269 ' cases the lenses of spectacles were replaced or repairs of frames were carried out. Dr. H.J.R. Thorne, M.B. , B.S. , D.O., D.O.M.S., the Ophthalmologist, reports as follows: - "The School Eye Clinic at Valentines Mansion, Ilford, has continued to function smoothly and satisfactorily and the clinic has been well attended. The cases seen callfor no special comment - the usual school eye clinic "mixture" with refractive errors and squints predominating. Good co-ope ration has been obtained from London Eye Hospitals to which cases requiring further investigation and/or operation have been referred as necessary. The Orthoptic Department (at Mayesbrook) and the arrangements for fitting and supply of spectacles (by attending Optician) have been quite satisfactory. " ORTHOPTIC CLINIC. Miss C.M. Hazel, D. B.O. , makes the following report on the Orthoptic Clinic held at Mayesbrook Health Services Clinic for the year ended 31st December, 1959. 120 "273 sessions were held throughout the year and 91 new cases were referred for treatment. In addition 87 old cases were under treatment. Total attendances amounted to 604 and 47 patients were discharged. The Orthoptic Clinic functioned efficiently as an indispensable adjunct to the School Eye Clinic in the treatment and observation ofgquint cases - both true and latent and pre- and post-operative." Miss Hazel attends at the Clinic for three days a week. ORTHOPAEDIC CLINIC. Mr. H.G. Korvin, F.R.C.S., the Orthopaedic Surgeon, makes the following report:- "No major changes took place at the orthopaedic school clinics during 1959, but there are some minor improvements to report. A telephone was installed at Newbury Hall Clinic which obviated the necessity for incoming calls to be taken at the neighbouring school, and made the surgeon more get-at-able for his hospitals. The electric fan in the Newbury Hall consulting room was a great blessing in the exceptionally hot summer months. Attendances were at a reasonable level. Arrangements for X-ray and laboratory examinations, hospital admissions, and provision of appliances were the same as in the past. Plans were made, during the year, for the equipment of the new clinic at Kenwood Gardens and it is hoped that the transfer there of the Newbury Hall Clinic will take place early in I960. I wish to thank all those taking part in the work at the clinics for their valuable help and co-operation. " The following table summarises the attendances of school children:- Clinic Sessions New Cases Old Cases Attendances Newbury Hall 43 90 246 467 Mayesbrook 22 42 99 178 Manford Way 8 3 13 27 Totals 73 135 358 672 121 SUMMARY OF CASES SEEN Diagnosis New Cases Old Cases A B C A B C Cerebral Palsy - - - - 1 - A.P.M - - - 5 10 - Hemiplegia - - - 4 - - Scoliosis 2 - - 5 3 - Kyphosis - - - 4 1 - Slack posture 9 5 1 10 3 1 Deformity of Hips 1 - - 3 - - Genu valgum 22 8 2 101 34 3 O.C. T. 1 1 - 3 1 1 Genu varum - - - 5 - 1 Pes valgus-planus 1 1 - 16 6 1 Valgus ankles 13 6 - 20 11 1 Talipes calcaneo-valgus - 1 - 1 2 - Intoeing 2 1 - 5 1 - Hallux valgus 5 2 - 8 4 - Deformity of Foot 1 - - 1 - - Deformity of Toes 12 5 - 15 12 - Torticollis 1 - - 3 - - N.A.D 14 - - - - - Other conditions - 11 - 30 8 4 Foot strain 4 - - 5 1 1 Metatarsal varus 1 - - 1 1 - Osteomyelitis - - - 1 - - Spina Bifida 1 - - - - Totals 90 42 3 246 99 13 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 Operation Cases 1 Bunionectomy and phalangeal Osteotomy Rt. 2 Phalangeal Osteotomy Gt. Toes R. & L. 1 Inter-phalangeal Arthrodesis Toes. 122 1 Subastragaloid Arthrodesis Lit. Foot 1 Subcutaneous Sternomastoid tenotomy 1 Arthrodesis 3rd Toe 1 Inter-phalangeal (open division of Sternomastoid) 1 Holdsworth Operation R. & L. 1 Destapling both knees 1 Removal of loose bodies from Lt. elbow 1 Elongated tendon Lit. position Rt. foot During the year 12 pairs of valgus insoles, 7 pairs of surgical boots or shoes, 3 pairs Genu Valgum splints, 1 metatarsal bar, 5 calipers and inverting irons, 13 repairs to calipers and shoes, and 63 pairs wedges to shoes were supplied to school children. 130 cases were discharged from the Orthopaedic Clinic, 52 as cured, 19 due to absence and were kept under observation at school, 48 were showing improvement and were kept under observation at school 11 cases left school or left the district. MINOR ORTHOPAEDIC DEFECTS. Dr. F.E. O'Connor Wilson, one of the school medical officers, has under supervision and attends periodically one of the following Clinics conducted by the Physiotherapist:- Exercises Massage Sunlight and she reports as follows "REMEDIAL EXERCISES The clinics for remedial exercises were large and well attended during 1959, as will be seen from the following numbers:- Newbury Hall No. of new cases = 303 " " attendances = 1,533 Mayesbrook No. of new cases = 251 11 " attendances = 1,202 Total No. of new cases = 554 11 " " attendances = 2,735 123 360 cases were referred from school medical Inspections and these made 544 attendances. These clinics show a marked increase in numbers and attendances over those of 1958. Classes were held to demonstrate the exercises for the particular defect. Mothers were present at these classes and were encouraged to assist their children to do the exercises daily at home. Where children could not attend the classes regularly, the mothers were given lists of exercises to do at home and the children were seen at intervals by the physiotherapist to supervise progress. Children from the Open Air School who attend for treatment of deformities are taken direct to the clinic from the school by motor coach and in the care of a lady assistant. They return to the school in the coach following treatment. A number of children have regular swimming therapy of one hour sessions each week at the Public Baths and this treatment is found to be of great benefit in certain cases. The visiting doctor examines the children periodically and discharges them from treatment when the deformity is corrected. Strapping and plaster splints for correction of some deformities are carried out at two sessions each week. Massage and electrical treatment are given at one session each week. Printed forms are issued to mothers of growing girls and boys advising them about the correct type of footwear to be purchased. Printed forms are also issued to teenage girls whoare referredfor chest deformities, advising them about the correct type of brassiere to be worn. Children are referred to the clinic by the Orthopaedic Specialist, by private practitioners, and by the Assistant County Medical Officers of Health." 124 PHYSIOTHERAPY CLINICS. These were 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 91 104 68 1,238 Mayesbrook 93 65 31 953 Manford Way 91 - 10 63 Totals 275 169 109 2,254 ARTIFICIAL SUNLIGHT CLINICS These were 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 Improved Left District etc. Newbury Hall 46 9 14 267 7 3 1 Mayesbrook 47 21 19 385 9 - 9 Total 93 30 33 652 16 3 10 The lamp used at each Clinic is a Centrosol Unit. The conditions treated were as follows:- Defects Treated Cases A B Chilblains 2 4 Anaemia, Debility and Malnutrition 8 20 Bronchitis 1 1 Other Conditions 5 3 16 28 A - Newbury Hall Clinic. B - Mayesbrook Clinic. 125 EAR, NOSE AND THROAT CLINIC. Miss M.M. Mason, F.R.C.S. , Ear,Nose and Throat Consultant, reports as follows:- "The Clinic maintains a steady flow of work - 182 new patients, 16 of them under 5, were seen this year, as against 177 in 1958. Attendances totalled 502 altogether. 101 tonsil and adenoid ope rations were performed at King George Hospital and Chadwell Heath Hospital, 7 of them on under-5 children, and 24 of these also had sinus disease which was treated at the same time. 14 cases of suspected deafness were investigated at the Clinic by pure-tone audiometry, and a further 7 referred to Special Deafness Units. Of these, 2 school children and 1 toddler have since been issued with hearing aids and are receiving auditory training. There was a decline in the incidence of rhinitis and ear disease during the year, and it seems likely that this was related to the exceptionally hot and dry summer. " The following table shows the work of the Clinic:- No. Diagnosed Tonsils and Adenoids Infection 97 Deafness 4 Otitis Media 11 Mastoid disease - Rhinitis 6 Other defects or diseases 28 146 During 1959 94 children were operated on for the removal of enlarged tonsils and adenoids as follows:- King George Hospital 62 Chadwell Heath Hospital 32 126 SPEECH CLINICS. Mrs. M. Walker, the Senior Speech Therapist, reports on the work of the Speech Clinics during 1959 as follows "The Speech Therapists working in the Ilford area during 1959 were as follows:- Mrs. Walker - full-time Valentines Clinic and schools Mrs. McGill - 6 sessions Mayesbrook Clinic per week and schools Mrs. Pretious - full-time Manford Way and Valentines Clinics, Cerebral Palsy Unit and schools. This has been a 'bumper year' for attendances at the Speech Therapy clinics exceptforthe recurrent fall-off during school holidays. In spite of this, however, discharge numbers are lower than usual. This is partly due to the late referral of so many stammerers, who, unless they are seen early while the stammer is still in the primary 'easy' phase tend to need years of treatment, and thus to occupy at least one treatment period per week, more or less permanently. On the brighter side retarded language cases are being referred earlier resulting on the whole in better prognoses, from the general educational as well as from the speech point of view. More clinics are being held in schools, where there are sufficient speech-defective children to carry a complete session, and although contact with parents cannot be so good, this is offset by the fact that very few treatments are mis sed by these children. We are sorry to be losing the services of Mrs. McGill, who has done such invaluable work in the Mayesbrook area and I trust we shall be receiving a replacement of an equally high standard." 127 The defects treated were as follows:- Stammer 62 Dyslalia 120 Retarded speech and language 8 Hearing losses 5 Cleft Palate 7 Dysarthria 4 Neurological 1 Treatment not needed 1 Others 4 104 children of school age were discharged from the Clinics during the year. In 70 cases the speech was normal. Of the remaining 34 cases, 5 left the district, 9 improved, 4 ceased to attend, 5 left school, 5 were referred elsewhere, 6 did not require treatment. SCHOOL DENTAL SERVICE. Mr. E.V. Haigh, Senior Dental Officer, reports as follows: - "Dental Clinics continued with little change during 1959 to give dental treatment to school children in Mayesbrook Clinic and Valentines Clinic with two surgeries each and one at Manford Way. As in the past years it has been impossible to obtain full-time Dental Officers to staff the Clinics and we can only continue by using part-time Officers, each one doing a few sessions per week. During 1959 several part-time Dental Officers had to reduce the number of sessions they worked for us owing to their private practice demanding more of their time. This shortage of staff is due to the difference in remuneration between private practice and school clinic work. The number of half days devoted to treatment dropped by 334 but even so the number of children actually treated was 3,339, only slightly less than in 1958. The number of attendances made by these children was 12,894. It has become impossible to inspect regularly the children at school; sufficient numbers apply for treatment to keep the Dental Surgeons fully occupied. 128 Emergency treatment and inspections on two mornings a week continued during 1959 at Mayesbrook Clinic when any child from any Ilford School without an appointment could attend and be seen by myself for the relief of pain if possible; appointments being made for extractions, conservative or orthodontic treatment. The number of patients attending on these mornings varies from 15 to over 30 per session. I continued with one evening session per week for school children, the time of these sessions being 5.15— 8.15 p.m. They have been most satisfactory for older children studying for examinations, who do not wish to attend during school time. I have a waiting list for these evening sessions and only patients who cannot possibly attend during the day may be given an after school appointment. At the beginning of 1959 an X-ray machine was installed at Valentines Clinic and a dark room for developing the films was fitted up and equipped. This means that X-ray facilities are now available at all dental clinics and patients do not have to travel from one Clinic to another should they require an X-ray. This can save time and pain, a quicker diagnosis being possible. Most extractions were performed under general Anaesthesia which was always given by a Medical Officer, the average number of children attending per session being between 20 and 25. Children usually prefer general Anaesthesia. Because there were less dental inspections^ at schools many children requiring extractions have not been seen. This accounts for the slight drop in Anaesthetics given during 1959. " Full details of the dental work are shown in Table V. BENTON SCHOOL. Dr. D.M.B. Gross, Medical Officer in charge, reports as follows:- 129 "During 1959 the number of children on roll varied, being 81 on the 31.12.58 and 76 on 31.12.59. There were 23 admissions and 28 discharges. Recommendations for admissions were received from the following sources:- School Medical Officer 6 Borough Education Officer 1 Head Teacher 6 Parent's request 3 Hospital 4 Re-admission 1 Others 2 23 The diagnoses were as follows:- Collapse right lung 1 Nephritis 1 Asthma 3 Slipped Epiphysis 1 Achondroplasia 2 Dislocated left hip 1 Congenital Heart 2 Haemophilia 1 Coeliac disease 1 Old Poliomyelitis 1 Spina bifida 1 Bronchitis 2 Multiple fractures 1 Osteomyelitis 1 Muscular Dystrophy 1 Paraplegia 1 Diabetes 1 Epilepsy 1 23 The 28 children discharged left for the following reasons:- Fit for ordinary school 14 Left school (over age) 4 Admission to Special School 4 Left district 6 28 130 Throughout the year periodic medical examinations took place at this school with the usual referral of suitable cases to the various specialist clinics when necessary. The close association with the C.P.U. has again proved most valuable and two cases were transferred after preliminary trial at the Unit. The work continues along the same lines as previously and the association with the Youth Employment Officer has been helpful in several cases. I should like to thank all the staff concerned for their continued help and co-operation. " CEREBRAL PALSY UNIT. (i) Dr. D. L. Woolf, Consultant in Physical Medicine to the Cerebral Palsy Unit, reports as follows:- "There have- been eight new admissions to the Unit during 1959 and six discharges. Three new admissions were not classified as Cerebral Palsy, but the Unit was considered the best placing for these children. 24 children are at present on roll. No waiting list exists except for children under five years of age. The Medical Auxiliaries and teaching staff continue to work in close liaison. Unfortunately, the Unit, during the latter part of 1959, experienced a shortage of physiotherapists. No improvement in the treatment rooms has taken place this year, but we look forward to the day when the Unit will be sited in a more accessible place and decorated for staff and children consistent with the requirements of modern rehabilitation. I would like to express my thanks to the medical auxiliaries and teaching staff for their co-operation and contribution to a cheerful atmosphere. 11 (ii) Dr. D.M.B. Gross, Medical Officer in charge, makes the following report: - "The Unit has been open since May 1955 and during the year 1959 the number of children on roll 131 varied, being 22 on 31st December 1958, and 24 on 31st December 1959. During the year under review 15 children were examined with a view to admission of these, 10 were accepted and came from the following areas:- 4 Ilford 3 Romford 2 Forest 1 South Essex (on waiting list) The five children rejected, with the reason for rejection and the responsible authority concerned, were:- South Essex: (a) Partially sighted pupil (b) Limited expectancy of life. mission to residential school for the physically handicapped more suitable (c) Suitable for admission to C.P.U. , but earlier placement requested at Elizabeth Fry School. (d) Mild Cerebral Palsy South East Considered suitable but distance Essex: too far to travel. During the year 6 children were discharged, as follows: - Ilford: (a) School leaving age: Section 57(5)Education Act 1944 (b) Removed from Area (c) Transferred to Benton School (d) Transferred to Benton School Forest: (a) To residential Special School (b) School leaving age Registered Disabled Person. Remedial work has been much hampered by the lack of physiotherapy. Both physiotherapists resigned in July and by the end of the year it had still been impossible to replace them. This has caused much 132 anxiety but is part of a nation-wide shortage. It is, however, hoped to remedy the position in the near future. In all other respects the work of theUnithas proceeded smoothly. The heating is now very much improved and a very close liaison has been maintained with the various hospitals. There is one child on the waiting list, aged 5 years." CHILD GUIDANCE CLINIC Dr. W. P. Gurassa, Consultant Psychiatrist, reports as follows:- "There have been a number of cnanges in staff during the past year principally in the appointment of myself as Medical Director in place of Dr. Davidson, and Miss Watt as Psychologist in place of Mr. Pickett, the latter appointment after a gap of several months. We have been fortunate in obtaining permission to appoint an additional Psychiatric Social Worker, who is very much needed to relieve the pressure on our two present Social Workers. These changes have necessitated the renewal of contact with various agencies concerned with children in the area, in particular the schools where the lack of a Psychologist was acutely felt. We have endeavoured to continue and extend Dr. Davidson's policy of integrating the Clinic1 s activities with those of other agencies concerned with the education and welfare of children, and the current year has seen a considerable increase of contact with such people as Head Teachers, Probation Officers, School Enquiry Officer s, etc., so that we are increasingly learning to understand each other's points of view, and to co-ordinate the help given to children and parents. Meetings were also arranged with School Medical Officers and Health Visitors, and it is pleasing to note that Health Visitors are regularly attending our Conferences and working closely with us. The diagnostic waiting list has been reduced considerably, and it is possible to see new referrals 133 much sooner than before; there is still a delay with regard to the provision of more intensive treatment, and it is intended to reduce this by providing group treatment. We have been considering ways in which we can extend our activities during the next year. It is hoped to provide at least one evening session for diagnosis and treatment. This will be of particular benefit to children who have left school and need to continue treatment here, and also to allow selected children to attend out of school time. Most of our cases are still referred from School Medical Officers, but we do have an increasing number from General Practitioners who, in some instances, are able to attend our Conferences. One disturbing note is the continued lack of facilities in the area for the admission of disturbed children and adolescents to suitable Units for observation and treatment. Many other areas have provided such Units, but they are only available to us in exceptional circumstances. Some interim measures are urgently required pending more permanent provisions in the remote future. In summing up I would say that while we are mainly occupied with the treatment and supervision of children referred to us we are increasingly concerned with improving our contact and communication with all people who are interested in the welfare of children with the particular aim of helping to prevent the development of established nervous disorders. " The following is a table showing the work undertaken at the Child Guidance Clinic during 1959: — 31st December Previous Year Present Year I- 1. (a) Cases awaiting first appointment 6 11 (b) Cases referred to Clinic during the year (including special diagnostic cases) 127 134  31st December Previous Year Present Year 2. (a) Cases still under investigation 31 (b) Cases diagnosed during the year and found not to require specific treatment (i) Cases closed 10 (ii) Cases kept under supervision 82 (c) Cases diagnosed and which received specific treatment during the year either (i) At the Clinic 35 (ii) By placement in residential school 4 (d) Cases diagnosed and awaiting specific treatment on 31st December of present year either (i) At the Clinic 22 (ii) By placement in residential school 4 (e) Cases withdrawn before diagnosis 6 II. 1. (a) Cases carried forward from previous year and which received treatment during the year (i) Supervision 45 (ii) Specific treatment:- At the Clinic 55 (iii) By placement in residential school 6 (b) Or cases closed during the year (i) Specific treatment and/or supervision completed 55 (ii) Not taken up further owing to non-co-operation or for other reasons 73 (iii) Improved whilst awaiting specific treatment 12 135 31st December Previous Year Present Year III. 1. Distribution of treatment or supervision: - (i) Psychiatrists: Children under treatment 41 Children awaiting treatment 1 Number of cases supervised 90 (ii) Psychotherapist: Number of children treated 37 Number of children awaiting treatment 17 (iii) Psychiatric Social Workers: Number of cases advised 324 Number of cases awaiting advice 22 (iv) Educational Psychologists: Children given remedial education 8 Children awaiting remedial education 9 SCHOOL PSYCHOLOGICAL SERVICE. Miss B.S. Gascoyne, Educational Psychologist, reports as follows:- "During the year the work of the psychologist in the Ilford schools was necessarily rather restricted because Mr. Pickett's place was not filled until September, but since Miss Watt started to work in the area then, much of the leewayhas been made up. It was felt by the Clinic staff as a whole, and perhaps by the psychologists in particular, that the need for day classes for maladjusted children was becoming more and more essential. It is hoped that two maybe set up next September which will accommodate those children who are unable to fit into the normal school routine thus causing considerable difficulties not only to their teachers but also them* selves. It is envisaged that the classes will be very 136 small so that it will be possible for the children to have much individual attention and that they should be treated as a separate entity from any existing school in the same way as the Special Remedial Classes form Valentines School. Few day maladjusted classes exist so this type of work can still be considered to be in the pioneer stage but fortunately the L.C.C. have such a school near Hammersmith and one was started at Leyton last September, so we are hoping to profit by the experiences of our neighbours and have already been given very valuable information on the type of setting and personnel required. " ILFORD ENURESIS CLINIC. Dr. J. M. Pooley reports as follows "During the 12 months ended December 3 1st 1959, the clinic continued to be held at the Public Health Offices, Ilford, on Wednesday mornings. Attendances have, on the whole, been good and there has been a 50% increase in the number of new cases referred, as compared with last year. There are now 9 "Bed Buzzers" in use through the clinic and the results from their use have been very interesting and encouraging, as will be seen from the figures given below. I. Appointment List During the 12 months ended December 31 st 1959, there have been 68 new cases (as compared with 46 last year) made up as follows:- Recommended by Under 5 years Over 5 years Boys Girls Boys Girls Parents - 1 2 - General practitioners 2 1 - - Infant Welfare Officers 4 2 - - School Medical Officers - 33 17 Health Visitors - - 2 3 Hospital Specialist - - 1 - 6 4 38 20 137 Total = 68 cases Total attendances = 346 Number of sessions = 39 II. The Procedure adopted in previous years has been largely adhered to at each clinic. This includes Urinalysis, History of the Enuresis, physical examination; considerable time is devoted to talking to and gaining the confidence of the child, and finally advice is given to the parent, usually through the child by clear direction as to routine and charting and finally the taking of medicaments if indicated. As has been proved in previous years, suggestions made to the child, but in the presence of the mother, have always been acted upon more faithfully by the parents. III. Treatment. The treatment issued or prescribed has been made up as follows:- No. of Cases 1. Long acting (bonded) Dexampheta- mine (5mgm. taken at bedtime) 36 2. Plain Dexamphetamine ( 5 mgm. at bedtime 3 3. Amphetamine sulphate (2.5 - 5 mgm. ) 11 4. Phenobarbitone (either at night or in divided doses through the day) 13 5. Disipidin (posterior pituitary snuff) 6 6. Routine and Charting only 7 7. The Sentinel or Down's "Bedbuzzer" 13 8. A few cases vfrere referred to hospital or to the Child Guidance Clinic for further investigation or treatment. Some of the cases treated with Disipidin or the buzzer had previously been treated with the amphetamine series and had failed. 138 IV. Analysis and comparison of results 1959 1957 1956 1955 1. Completely dry = 38% 23% 46% 38% 2. Very marked im- 26 provement, (i.e. le s s than 10 wet in 28 nights) 3. Improved (more 10 than 10 wet in 28 nights) 4. No improvement 3 5. Self discharged 12 77 (this figure includes 9 cases who were referred backfrom 1956 for recommencement of treatment) Further Analysis of Results Of the 68 cases who were referred during 1959 it is interesting to note the numbers of boys compared with girls in the following analysis: Boys Girls New Cases 57% 43% Of the cases discharged dry 42% 58% Average age 8 yrs. 7yrs. Of the cases who were discharged dry the treatment used was as follows:- Treatment Number of Cases 1. Long acting dexamphetamine salt 7 ) 2. Short acting dexamphetamine ) 50% salt 6) 139 Treatment Number of Cases 3. Bed buzzer 6 ) ) 4. Phenobarbitone 3 ) ) 50% 5. Charting 3 ) ) 6. Disipidin Snuff 1 ) Although this is necessarily a limited survey, both the treatment indicated and the results obtained show an interesting preponderance ofenuretic children with deep sleeping habits , over enuretic children where other etiological factors are concerned. The Use of "Dexten" (Dexamphetamine-resinate) A number of these tablets was issued for use at the IlfordEnuresis Clinic as it was felt that it would be interesting to compare a series of cases treated with this long acting substance, with a comparable series treated with the short-acting, non-bonded amphetamine salt. This work is still continuing, but the number of cases treated is not yet sufficient to enable a true comparison to be made. During previous years, amphetamine sulphate (Benzedrine) has often been given in divided doses, e.g. at 7p.m. and 11 p.m. with encouraging results, so that the use of Dexten in avoiding the necessity of waking a child for the second dose is already obvious. It has been shown that the rate of release of dexamphetamine from Dexten (determined by in-vitro experiments) is as follows:- Time after ingestion % liberated (hr s.) 2 hours 26 4 41 6 51 8 62 10 75 12 85 14 85 (Sir Adolphe Abrahams, The Lancet, December 28th 1957). 140 Thus it can be seen that a probable optimal plasma concentration will occur between the hours of 2 a.m. and 5 a.m., from a dose given at 7 p.m. and this may in some cases answer the problem of having to lift an enuretic child at frequent intervals during the night. The bed-buzzer is again proving an extremely useful addition to the clinic resources. Some cases who have previously been very resistant to treatment have become dry in from 4 to 6 weeks, and have remained so after the buzzer has been removed, as long as the machine is not removed prematurely. I stillhope that more new cases may be referred from within the public health services, and that general practitioners will feel free to refer cases to the Enuresis Clinic should they wish to do so. " HANDICAPPED CHILDREN. Section 33 of the Education Act, 1944, and the regulations made thereunder have placed on the Local Education Authorities 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 l6th December, 1953 (amended by 1959 Regulations). The number of children coming within these categories and their disposition as on the 31st December, 1959, are tabulated in the following table in accordance with the Handicapped Pupils Regulations, 1953, and amended by the Handicapped Pupils and Special Schools Regulations, 1959, operative with effect from 1st April, 1959. 141 CATEGORY Number of children of school age on 31st December 1959, formerly ascertained as handicapped pupils and requiring special educational treatment (s.e.t.) Attending day special school Awaiting placement in day special school Attending residential special school Awaiting placement in residential special school Attending boarding homes Awaiting placement in boarding homes Attending independent schools Awaiting placement in independent schools Attending hospital schools Awaiting placement in hospital schools Receiving Education in hospital under Section 56 Receiving home tuition under Section 56 Awaiting home tuition under Section 56 Total No. of children of school age requiring s.e.t. Blind - - 4 - - - - - - - - - - 4 Partially Sighted 2 — 3 - - - - - - - - - - 5 Deaf 7 - 3 - - - - - - - - - - 10 Partially deaf 14 - - - - - — - — — — — — 14 Delicate 30 — 7 3 - - 1 - - - - - - 41 Physically handicapped 49 3 8 3 - - - - - - - 4 - 67 E.S.N. 61 17 24 2 - - 4 - - - 2 - 110 Maladjusted - - 14 5 2 — 21 - - - - - - 42 Epileptic 1 - 1 1 - - - - - - - - - 3 Speech defect - - - - - - - - - - - - - - Total 164 20 64 14 2 - 26 - - - - 6 - 296 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, Becontreer. 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. 142 GENERAL WELFARE 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 1959 was 2,136,426 approximately. There are 26 kitchens in the Borough, established at the following schools:- Barking Abbey, Barley Lane, Beal Boys, Beal Girls, Becontree C.P. Unit, Benton, Caterham, County High Boys, County High Girls, Cleveland, Dane, Fairlop Boys, Fairlop Girls, Goodmayes, Gordon, Loxford, Mayfield Boys, Mayfield Girls, Mossford Green, 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, 1959, 19,882 children, were receiving milk in school. Provision of Baths. - Shower baths are installed at Beal, County High Boys, Barking Abbey Grammar, Caterham, Dane, Fairlop Boys and Loxford Secondary Schools. Work done by the N.S. P. C.C. - The following 41 cases were investigated:- (1) Neglect 21 (2) Ill-treatment cases 8 (3) Other cases 12 (Three cases were reported from the Public Health Department 56 were reported from other sources for general neglect). 108 children(60 boys and 48 girls)were involved, 71 being of school age. In addition to this work, 135 supervision visits were paid to different cases, some of which were made to those reported during the previous year. 143 The Invalid Children's Aid Association. - 1 child was placed in a convalescent home and her fees paid by voluntary finds. Others assisted were 1 loaned tricycle, 1 loaned T.V. set, 1 supplied with clothes wringer and 1 supplied with latex foam mattress. 4 new cases were referred during the year for casework and visiting and 23 old cases were given continued casework and after care visiting. THE HEALTH VISITOR AND THE SCHOOL NURSE. Cleanliness Inspections in Schools. - The Superintendent Health Visitor submits the following report:- "The present arrangements for liaison between health visitor and school follow the trend which commenced in the Summer term 1958. At the beginning of each term the health visitor visits the school and discusses any cases which the headmistress brings forward. The health visitor also brings forward any problems which she knows may arise especially if a child is just beginning school and has a difficult family background. In the summer term every child is seen by the health visitor and a complete hygiene inspection is carried out. In some schools the Head Teacher requested that the routine hygiene inspection took place as before, at the beginning of each term. The health visitor does this on request at the convenience of the school. Other schools ask for a few classes to be seen; one child may be causing some concern and rather than embarrass this child, classes round his or her age group are seen. Telephone calls to the department asking for the health visitor to visit a school to diagnose head infestation are received fairly frequently and the teacher's suspicions usually correct. After much discussion and recommendation from the health visitors it was decided to test the eyes of 144 all children at about the age of 8 years. We find a considerable number of eye defects in this age group and the results achieved make the extra work well worth while. All children with a defect found are followed up at home; the situation is explained to the mother and, if wished, referral form to the specialist is signed at this visit. " The above scheme has also been found to be of benefit in the follow-up of those cases found at routine medical inspection to be "unsatisfactory", for the Health Visitor has the opportunity of discussing the condition with Head Teachers and in many cases school meals are recommended. All "unsatisfactory" cases are re-examined by the school medical officer. In many cases nutriments are supplied or recommended and the case seen again at varying periods of one, three or six months or less frequently on the decision of the doctor. It will be appreciated that in quite a number of such cases, because of environmental factors, no treatment or action is likely to bring forth a completely "satisfactory" condition and only the assistance most suited to the needs can be offered. Chiropody. - In 1960 chiropody clinics will be established under Local Authority control in Ilford and when fully developed the necessity of referring cases privately or unnecessarily to hospitals should be deviated. Dental Health. - Once again Mrs. J.Thurston, Essex County Dental Hygienist, was seconded to the Ilford area and she reports on her visit as follows:- "During the months of March, April, May and June of this year I gave sixteen lectures on dental health in seven Ilford schools. They were well received on the whole, the response from staff and pupils being noticeably better in certain schools. The film 'Gateway to Health' an American production, was well received at all schools with one exception, where it was the considered opinion of the staff present, that the film shown on previous occasions 'Let's Keep our Teeth' was a more interesting and informative aid and had greater appeal since it was an English production and more easily understood 145 than the American accent and idiom. I am inclined to agree with this point of view but also feel that new presentation of health information is desirable for both children and staff, for obvious reasons. Pamphlets were in short supply which was a pity, since they are a means of reaching the parents and arousing their interest, however slight. In my opinion, to be really successful the subject of dental health should be presented, not in the form of isolated lectures with a film, which have little lasting effect, but should consist of a fairly lengthy programme in each school. This would include considerable class preparation beforehand, followed by a week with a demonstrable exhibition giving opportunities for active participation by the children themselves. Finally a further period of classroom work would help to assess the amount of knowledge assimilated and the interest shown. The above programme has been followed by the County Health Education Organiser in Health Weeks in which I have participated, with considerable success in arousing and maintaining interest in the subject. More might have been achieved in this series of talks if they had been incorporated in such a programme. " Hygienic Conditions in Schools in the Division. - The Chief Public Health Inspector reports on this matter as follows:- "Routine monthly visits are made by the Public Health Inspectors to the Schools in the Borough of Ilford, particular attention, of course, being paid to the provision of school milk and its condition and the standards of sanitation. The defects ascertained on these visits are reported to the Borough Education Officer and the County Medical Officer of Health in so far as sanitary defects arise from the School Meals Service. In the newer schools the sanitary accommodation is generally satisfactory but in the older schools the sanitary conveniences are situated at a point distant from the school entailing the crossing of the 146 ground for access. The conveniences themselves are generally old, difficult to keep clean and subject to freezing in cold weather. The only solution, of course, is to install sanitary conveniences at a point within the building of a modern standard and sufficient for the use of the number of students attending the schools. Another difficulty in the system appears to be the delay in carrying out work of renovation after notification from the Public Health Department. This is due to financial limitations over which we have no local control. The washing facilities available for the schools are in some cases situated remote from the sanitary conveniences, a factor which is not conducive to sound hygienic practice for school children, and in some cases there is no hot water available for hand washing. Insofar as the staff facilities are concerned, in many instances there is insufficient accommodation or it has to be shared with other people. Finally the system of providing drinking water in open fountains at the schools is somewhat antiquated; they are placed in open school playgrounds and thereby subject to freezing and contamination. It would be far better if a system of drinking water supply were installed with the washing facilities and other sanitary conveniences at a point within a building, thereby permitting strict supervision as to cleanliness, hygiene, maintenance and making them less prone to the effects of inclement weather. Generally speaking in the modern schools, the sanitary accommodation and conditions are satisfactory but the older schools should be considered for complete re-organisation and the system of maintenance and repair ought to be speeded up to prevent in some cases serious nuisance and even, so far as school canteens etc. are concerned, contraventions of the Food Hygiene Regulations. " 147 Employment of School-children and Young Persons. During 1959, 135 children were submitted for medical examination in accordance with the Bye-laws made under Part II of the Children and Young Persons Act, 1933 and all were found to be medically fit. Employment of Children in Entertainments Provisional Amending Rules. - 11 Certificates were granted during the year. B.G.G. VACCINATION OF SCHOOL CHILDREN. No. of pupils to whom B.C.G. was offered 2,268 No. of pupils whose parents consented to treatment 1,107 No. of pupils undergoing tuberculin test *1,150 Positive: 59 No. of pupils who received B.C.G. 994 * 43 carried forward from previous year. MEDICAL EXAMINATION OF TEACHERS, OFFICERS AND SERVANTS. - The following examinations were carried out during 1959:- Officers Servants Teachers intending Total Teachers New Appointments 14 26 18 52 110 Under Sickness Regulations — 4 — — 4 THE CAUSES OF DEATH AMONG CHILDREN OF SCHOOL AGE (i.e., FROM 5-15 YEARS) IN ILFORD, DURING 1959 WERE:- Chronic renal failure 1 Multiple Metastases 1 Sub-dural Haemorrhage 1 Leukaemia 2 Hepatic Failure 1 Respiratory Failure 1 Rupture of Congenital Intracranial Aneurysm 1 8 148 MINISTRY OF EDUCATION MEDICAL INSPECTION RETURNS YEAR ENDED 31st DECEMBER, 1959. TABLE I. Medical Inspection of pupils attending maintained Primary and Secondary Schools including (Special Schools). A. - PERIODIC MEDICAL INSPECTIONS. Number of Inspections 5-14 year age group 7,986 Number of other Periodic Inspections 349 Total 8,335 / B. - OTHER INSPECTIONS. Number of Special Inspections 817 Number of Re-inspections 2,403 Total 3,220 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 sums of columns (2) and (3). ) 149 Age Groups inspected (by year of birth) For defective vision(excluding squint) For any of the other conditions recorded in Table IIA Total individual pupils (1) (2) (3) (4) 1954 41 194 230 1953 30 178 193 1952 23 74 93 1951 12 25 34 1950 7 21 26 1949 10 10 20 1948 252 378 562 1947 146 206 297 1946 25 30 50 1945 78 109 169 1944 and earlier 327 270 539 TOTAL 951 1,495 2,213 TABLE II. A. - RETURN OF DEFECTS FOUND BY MEDICAL INSPECTION IN THE YEAR ENDED 31st DECEMBER, 1959. 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. 150 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 136 - 49 - 5 Eyes — a. Vision 951 2 283 1 b. Squint 50 - 17 — c. Other 41 2 25 - 6 Ears — a. Hearing 36 1 32 — b. Otitis Media 15 - 11 - c. Other 8 - 3 - 7 Nose or Throat 119 — 425 - 8 Speech 50 7 45 2 9 Lymphatic Glands 1 - 42 - 10 Heart and Circulation 34 - 80 1 11 Lungs 94 - 144 2 12 Developmental — a. Hernia 13 — 11 — b. Other 11 - 71 - 13 Orthopaedic — a. Posture 356 — 34 1 4. Flat foot 259 — 53 — c. Other 314 - 164 - 14 Nervous system — a. Epilepsy 4 - 11 - b. Other 11 - 16 - 15 Psychological — a. Development - 4 15 - b. Stability 69 1 99 1 16 Abdomen 11 - 19 - 17 Other 101 8 135 3 151 B. - CLASSIFICATION OF THE GENERAL CONDITION OF PUPILS INSPECTED DURING THE YEAR IN THE AGE GROUPS. Age Groups inspected (by year of birth) Number of Pupils Inspected No. whose condition was classified Satisfactory Unsatisfactory 1954 1,280 1,260 20 1953 841 820 21 1952 352 339 13 1951 92 90 2 1950 87 84 3 1949 58 57 1 1948 1,815 1,795 20 1947 1,020 1,009 11 1946 154 146 8 1945 732 724 8 1944 and earlier 1,904 1,892 12 TOTAL 8,335 8,216 119 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 authorised persons 18,138 (ii) Total number of individual pupils found to be infested 46 (iii) Number of individual pupils in respect of whom cleansing notices were issued (Section 54 (2), Education Act, 1944) - 152 (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 15 By parents 31 TABLE IV. TREATMENT OF PUPILS ATTENDING MAINTAINED PRIMARY AND SECONDARY SCHOOLS (INCLUDING SPECIAL SCHOOLS). Notes:- (a) Treatment provided by the Authority includes all defects treated or under treatment during the year by the Authority's own staff, however brought to the Authority's notice, i.e., whether by periodic inspection, special inspection, or otherwise, during the year in question or previously. (b) Treatment provided otherwise than by the Authority includes all treatment known by the Authority to have been so provided, including treatment undertaken in school clinics by the Regional Hospital Board. GROUP 1. - DISEASES OF THE SKIN (EXCLUDING UNCLEANLINESS, FOR WHICH SEE TABLE III). Number of New Cases Treated during the year By the Authority Otherwise Ringworm (i) Scalp - - (ii) Body 1 - Scabies - - Impetigo 7 - Other Skin Diseases 155 16 153 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 119 12 Errors of Refraction (including squint) - 1,886 Total 119 1,898 Number of pupils for whom spectacles were (a) Prescribed - 1,014 (b) Obtained — 984 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 - 2 (b) for adenoids and chronic tonsillitis - 379 (c) for other nose and throat conditions - 7 Received other forms of treatment 66 52 Total 66 440 154 GROUP 4. - ORTHOPAEDIC AND POSTURAL DEFECTS. By the Authority Otherwise (a) Number treated in clinics or out-patients departments 194 493 (b) Pupils treated at school for postural defects 34 - 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 145 3 GROUP 6. - SPEECH THERAPY By the Authority Otherwise Number of pupils treated by Speech Therapists for the first time 82 2 155 GROUP 7. - OTHER TREATMENT GIVEN. New cases treated By the Authority Otherwise (a) Miscellaneous minor ailments 244 40 (b) Other (l) Sunlight Treatment 30 - (2) Massage and Remedial Exercises 360 169 (3) Enuresis 68 1 (4) Hernias - 8 (5) Major Respiratory Diseases - 12 (6) Major Digestive Diseases - 13 (7) Major Injuries - 1 (8) Other Major Diseases - 7 Total 702 251 TABLE V. DENTAL INSPECTION AND TREATMENT CARRIED OUT BY THE AUTHORITY (l) Number of pupils inspected by Dental Officers:- (a) Periodic age groups 3,700 (b) Specials 2,264 Total (1) 5,964 (2) Number found to require treatment 4,170 (3) Number referred for treatment 4,170 (4) Number actually treated 3,339 (5) Attendances made by pupils for treatment 12,894 156 (6) Half-days devoted to: Inspection 26 Treatment 1,331 Total (6) 1,357 (7) Fillings: Permanent Teeth 6,042 Temporary Teeth 1,373 Total (7) 7,415 (8) Number of teeth filled: Permanent Teeth 5,272 Temporary Teeth 1,315 Total (8) 6,587 (9) Extractions: (i) Permanent Teeth:- (a) On account of Caries 727 (b) For other purposes 100 (ii) Temporary Teeth: (a) On account of Caries 1,045 (b) For other purposes 82 (10) Administration of general anaesthetics for extraction 969 (11) Other operations: Permanent Teeth 3,465 Temporary Teeth 1,144 Total (11) 4,609 (12) Orthodontics (i) Cases commenced during year 182 (ii) Cases carried forward from previous year 1,355 (iii) Cases completed during year 157 (iv) Cases discontinued during year 66 (v) Pupils treated with appliances 155 157 (vi) Removable appliances fitted 206 (vii) Fixed appliances fitted - (viii) Total attendances 3,461 (ix) Number of sessions devoted to treatment 250 Number of pupils supplied with artificial dentures 25 Number of dentures fitted 26 158 SCHOOL HEALTH SERVICE STAFF AND SCHOOL C LINICS AS AT 31st DECEMBER, 1959. 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 8 2.68 (iii) General Practitioners working part-time in the School Health Service - - (b) Speech Therapists 3 2.54 (c) Physiotherapist C.P. Unit 1 1.00 (d) Occupational Therapist C.P. Unit 1 1.00 (e) School Nurses including Superintendent 22* (Combined posts, H.V. and S.N.) 9.15 (f) Nursing Assistants 6 (Clinic Nurses) 3.75 (g) (i) Senior Dental Officer 1 .8 (ii) Dental Officers (Part-time) 6 1.65 (iii) Orthodontists - - (iv) Dental Attendants 4 3.8 * All hold Health Visitor's Certificate. 159 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 6 III. - TYPE OF EXAMINATION AND/OR TREATMENT provided at the School Clinics returned in Section II. either directly by the Authority or under arrangements made with the Regional Hospital Board for examination and/or treatment to be carried out at the Clinic. Examination and/or Treatment Number of School Clinics (i.e. premises) where such treatment is provided Directly by the Authority Under arrangements made with R.H.B. &c. (1) (2) (3) A. Minor ailment and other non-specialist examination or treatment 4 - B. Dental 3 - C. Ophthalmic - 3 D. Ear, Nose and Throat - 1 E. Orthopaedic - 3 F. Paediatric - 1 G. Speech Therapy 4 - H. Cerebral Palsy Unit - 1 I. Artificial Sunlight - 2 J. Remedial Exercises & Physiotherapy 3 2 K. Enuresis 1 - L. Orthoptic - 1 160 IV. — CHILD GUIDANCE CENTRES. (i) Number of Child Guidance Centres provided by the Authority = 1. Staff Number Aggregate in terms of the equivalent number of whole-time officers Psychiatrists 2 0.82 Educational Psychologists 2 2 Psychiatric Social Workers 2 2 Others:- Child Psychotherapist 2 1 Clerk/Typist 3 3 The Psychiatrists are employed by arrangement with the Regional Hospital Board. 161 162 Table Showing the Average Heights and Weights of Ilford Boys and Girls Examined. Owing to a change in the Presentation of Ministry of Education Returns whereby Periodic Medical Inspections are recorded in Years of Birth, from and Including 1958, the Figures recorded below cannot be compared with the Groups in previous years. 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 BOYS 1958 - - - 573 111 19.7 533 115 21.2 123 120 23.6 71 125 25.9 39 130 28.8 55 136 31.8 1097 143 36.4 630 146 37.7 48 150 41.5 30 155 46.1 635 162 52.3 89 170 60.3 1959 589 1ll 20.1 403 114 21.1 152 120 23.0 50 126 26.2 49 132 28.8 34 137 32.5 835 144 36.6 516 146 38.3 95 150 42.0 358 163 53.0 764 163 53.5 106 170 60.4 97 174 64.3 GIRLS 1958 - - - 552 111 19.5 461 115 20.8 118 120 23.1 32 126 25.5 31 129 28.6 41 137 30.0 1005 145 37.6 527 147 39.4 31 149 41.7 23 156 46.3 708 159 51.6 95 162 56.5 1959 691 110 19.6 438 114 20.6 200 119 22.9 42 125 25.8 38 129 30.3 24 136 32.0 980 144 37.1 504 148 39.2 59 152 43.5 374 160 52.2 791 159 51.9 95 161 56.1 51 162 54.8 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 (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) 1 Number of Children Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) Number of Children 1 Examined Average Height (in Centimetres) Average Weight (in Kilogrammes) | Number of Children j 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 i Average Height (in Centimetres) Average Weight I (in Kilogrammes) J 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) BOYS 1957 498 113 20.5 470 116 21.7 62 123 24.7 35 127 26.8 29 132 29.8 603 142 34.9 781 144 36.5 18 145 38.5 8 148 45.2 437 160 50.7 48 167 57.4 59 170 62.4 10 168 63.8 1956 818 112 20.0 409 117 21.7 89 122 23.9 70 128 27.9 47 135 30.8 555 140 34.6 688 142 36.1 50 145 38.7 37 152 43.8 575 162 51.1 160 168 57.4 104 172 61.2 60 174 64.3 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 47.0 381 162 50.7 206 168 57.8 62 171 61.4 45 175 63.5 1954 561 113 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 38.5 33 153 42.5 485 162 48.3 203 167 57.2 75 171 60.2 43 176 64.1 1953 649 112 20.2 925 116 20.4 82 121 23.6 34 126 26.3 36 133 28.9 194 140 33.3 799 144 34.7 49 145 36.3 22 153 44.0 441 162 51.0 259 168 55.7 84 172 61.2 35 172 56.6 1952 820 113 20.2 799 116 21.2 65 123 24.8 52 127 26.2 44 132 28.6 110 140 32.8 766 143 35.3 46 146 36.2 52 154 41.3 372 161 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 37.4 22 153 44.2 373 161 51.2 218 165 53.3 21 170 60.7 1 177 63.4 1950 574 112 20.4 538 116 21.9 100 122 24.1 49 128 26.8 48 130 29.2 203 141 33.9 875 144 35.3 58 149 40.7 34 151 41.1 390 161 50.7 231 167 55.7 14 171 60.4 1 174 73.4 GIRLS 1957 452 113 20.0 441 116 21.1 66 122 24.4 55 128 28.5 41 132 29.7 456 141 34.8 826 144 37.4 24 150 41.5 13 151 46.6 305 158 50.1 119 160 53.1 44 161 55.0 16 161 55.3 1956 782 112 19.7 373 117 21.6 91 121 23.1 44 126 26.4 46 134 29.8 438 141 34.9 821 142 37.1 100 150 41.4 57 156 48.1 525 157 50.2 149 160 53.0 128 164 54.1 23 158 54.5 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 50.7 180 159 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 36.5 71 148 39.8 36 155 46.4 481 158 48.4 216 160 55.0 85 161 56.8 9 164 57.1 1953 657 112 20.0 827 117 21.3 81 119 22.8 38 127 25.8 37 133 28.9 173 140 32.5 841 143 35.5 59 150 39.9 49 156 47.1 374 156 50.9 212 160 53.6 49 162 54.9 5 164 55.6 1952 746 112 19.9 695 115 21.0 70 121 23.3 57 125 24.6 39 132 29.1 124 139 33.5 784 143 35.7 79 148 40.5 29 155 49.8 410 158 50.5 239 156 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 32.7 811 144 36.5 48 149 40.1 32 153 43.8 397 158 50.8 248 161 55.0 27 162 56.1 - - - 1950 553 112 20.0 536 115 21.3 76 121 23.3 51 127 26.1 54 132 29.2 194 140 23.2 837 144 37.0 64 148 41.2 35 152 43.1 401 157 50.8 140 159 53.0 22 163 52.4 4 163 55.6