Journal Rebind Co. Ltd. Unit 4, Pier Wharf, Grays, Essex. AC 4411 (1) BOROUGH OF LEYTON HEALTH REPORT FOR THE YEAR 1957 * MELVILLE WATKINS M.R.C.S., L.R.C.P., D.P.H. Medical Officer of Health, Borough of Leyton Area Medical Officer, County of Essex Divisional School Medical Officer 67966 INDEX Page( s) Acreage 6 Ambulance Service 57 Ante-natal Clinics 47 Atmospheric Pollution 31 & 44 Bacteriological Examinations 43 Birth Notifications 47 Birth Rate 6 Birth Registrations 47 Births Illegitimate 6 Burial of the Dead 2 Business Premises 40 Care of the Aged 15 Chemical Analysis 43 Child Welfare Clinics 48 Clinic Sessions 52 Convalescent Home Treatment 50 & 58 Day Nurseries 50 Death, Causes of 8 Death Rate 6 Dental Treatment 48 Diphtheria Immunisation 55 Diseases of Animals, Acts and Orders 30 Disinfestations 38 Domestic Help Service 58 Domiciliary Midwives 53 Extra Nourishment 57 Factories Acts. 1937/48 37 Food, Clean 29 Food, Condemned 29 & 43 Food Premises 36 Food and Drugs Act 1955 29 & 36 Foot Clinic 57 Fog 13 Gas and Air Analgesia 53 Health Centres 47 Health Education 32 Health Visiting 54 Health Week Exhibition 16 Home Nursing 54 Homes for the Elderly 14 Hospitals 9 Housing 23 Housing Repairs & Rents Act, 1954 34 Ice-Cream 43 Immunisation 54 Infant Mortality Infectious Diseases 9 Page(s) Laboratory Facilities 9 Laundry for Incontinent 3 Legal Proceedings 41 Leyton Corporation Act, 1950 34 Maternal Mortality 6 Maternity Nursing 53 Maternity Outfits 53 Medical Aid 53 Medical Examination of Staff 59 Meteorological Conditions 5 Midwifery 53 Mortuary 2 Mothers Club 45 National Assistance Act, 1948 - (Sections 47 and 50) 2 National Health Service Act, 1946 - (Part III) 45 Neo-Natal Mortality 51 Notices, Sanitary 34 Nursing Homes 9 Open-Air Shelters 57 Pet Animals Act, 1951 41 Poliomyelitis 10 Poliomyelitis Vaccination 56 Post-Natal Clinic 47 Premature Infants 50 Rag, Flock Act, 1951 41 Redevelopment Areas 24 Rodent Control 28 Sanitary Circumstances 23 & 33 Scabies Clinic 3 Shops Act, 1950 34 Sick Room Equipment 57 Slum Clearance 24 Smoke Abatement 44 Statistics, Vital 6 Tuberculosis 12 Vaccination 54 Vital Statistics 6 Welfare Foods Distribution of 45 & 50 Whooping Cough Immunisation 56 public health committee 1957-1958 The Worshipful the Mayor: Councillor Mrs. A. M. M. Burrell, J.P. (ex-officio) Chairman: Councillor F.W.Marshall Vice-Chairman: Councillor W.A.Cross Aldermen Councillors G.S.Flack B. G. Rayner E. A.Rigg Mrs.E.M.Dare H. E. Martin E. L. Sanders W. H. Sanders F. W.Wigg STAFF Medical Officer of Health: Melville Watkins, M.R.C.S., L.R.C.P., D.P.H. Deputy Medical Officer of Health: Mary Lyle Gilchrist. M.D., M. B.. Ch.B. , D.P.H. Chief Public Health Inspector; B. J. Ashcroft, II A P.H.I M. Inst.B. E. Deputy Chief Public Health Inspector: R. A. Reeves, M. A. P.H.I. Chief Administrative Assistant: W. D.Softley TO THE MAYOR ALDERMEN AND COUNCILLORS OF THE BOROUGH OF LEYTON Mr. Mayor, Ladies and Gentlemen, I have the honour to submit this my third Annual Report as required by the Ministry of Health. As will be noted this includes a statistical section on the Health Services (National Health Service Act - Part III) but does not include a Report on the School Health Services inasmuch as this year this has been published as a separate document. The Registrar General's estimate of population in the Borough for 1957 is 99,670. The decline in the population thus continues and compared with 1956 shows a decrease of 1230. The previous year showed a decrease of 1100. This is partly due to a natural decrease by excess of deaths over births of 68. The birth rate of 11.64 shows a reduction as compared with the 1956 figure of 11.74 per 1000 births. This figure is a long way below the provisional National rate of 16.1. The Death Rate of 12.32 per thousand of population is slightly lower than that of 1956 (12.84) but is higher than the provisional national figure of 11.5. Conditions causing the highest mortality were Diseases of the Circulatory System, Cancer and Diseases of the Lungs, in that order. There were five fewer deaths from Cancer of the Lung than in 1956. The age distribution of Deaths shows an interesting comparison between 1957 and figures for 1907, i.e. fifty years ago. 1907 1957 1907 1957 0 - 1 yrs 242 17 25 - 45 yrs 152 35 1 - 5 " 110 8 45-65 " 226 292 5 - 15 " 53 5 65 75 " 185 318 15-25 " 47 9 75 and over 170 544 Of the fourteen deaths classified as due to "all other accidents', eleven of them occurred in persons of 70 to 92, nine as a result of falls in the home and two in respect of accidental coal gas poisoning. During the year a voluntary committee was set up to disseminate propaganda on home safety. It is pleasing to note that the infantile death rate of 14.65 (compared to 22.78 in 1956, and a provisional national rate of 23.0) is, with the exception of 1954, the lowest ever recorded in Leyton. In general, the incidence of notifications of disease was very low measles and whooping cough accounted for almost 1200 of the 1600 notifications received during the year. The notifications of pneumonia totalled 223 which was largely due to the outbreak of Asian 'flu in the autumn of the year. Nineteen cases of poliomyelitis were notified and these are dealt with more fully in the body of the report. No applications were made to a Court of Summary jurisdiction for orders under Section 47 of the National Assistance Act 1948 during the year. Visits were made to a number of cases where it was considered such action might be necessary. However, with the co-operation of the personal health services it was possible to keep the patients at home. Twentyone burials were carried out under Section 50 of the National Assistance Act 1948. The arrangements entered into between the Borough Council and the local Hospital Management Committee for the provision of mortuary facilities at Whipps Cross Hospital Mortuary have continued during the year. 56 bodies were admitted and a further number ol' (2) bodies were admitted to Queens Road Mortuary. Walthamstow on instructions of H. M. Coroner. With the co-operation of Hackney Borough Council facilities are made available at the Cleansing Centre. Millfields Road, Hackney for the treatment of Leyton patients suffering with scabies or verminous conditions. During the year three residents availed themselves for treatment and made four attendances. The arrangements entered into with Walthamstow Borough Council for the disinfection of bedding at the Walthamstow Disinfecting Station have continued and are eminently satisfactory. In January 1957 the premises at the rear of 280 High Road, Leyton were converted and adapted for use as a laundry for the incontinent. The service is operated by handymen attached to the Department, and there is no doubt of the value of the service to the relatives or friends of patients who had difficulty in the laundering of foul linen and personal clothing. During the year the service has been made available to the County Borough of West Ham Public Health Department on a financial arrangement. In 1957 a total of 115 individual launderings involving 1417 articles took place. In February 1957 I submitted a report to the Public Health Committee and in fact to all members of the Council on the housing for the elderly. This is dealt with in the body of the report, and I am pleased to record that at the time of writing one house at 81 Bushwood has been adapted and houses several elderly people plus a Housemother and two other houses are in process of being adapted for a similar purpose. The diagnosis of cases of smallpox in Tottenham and Walthamstow resulted in an increase in the number of people wishing to be vaccinated. Local medical practitioners and the clinics were inundated with such requests, and it appears that a high vaccinal state of the population can only be achieved by sporadic outbreaks of the disease. Many contacts of the cases notified in neighbouring areas were kept under surveillance by the staff of the department. Vaccination against poliomyelitis continued throughout the year and although many administrative difficulties were encountered due to the change in policy with respect to types of vaccine available approximately 50 per cent, of those children eligible for registration were in fact registered and had been vaccinated by mid summer of 1958. The acceptance rate is still not satisfactory. I am indebted to the Chief Public Health Inspector for his report on the sanitary circumstances in the area. By the mid summer of 1958 staff shortages had been resolved and we had a full estab lishment for the first time for many years. As will be seen from the comprehensive report contained herein a great deal of work has taken place in respect of slum clearance and redevelopment areas and early in the year the long formal procedure was satisfactorily concluded with the Minister's decision on the Crescent Road area scheme. This is the first of several slum clearance ventures with which the department is confronted. In connection with the Council's interest in the Clean Air Act and atmospheric pollution in general impetus to the declaration of smoke control areas must be accelerated by the report on the London fog of 2 5 December 1957. The high mortality due to air pollution as existed in the weather conditions of those few days can be alleviated. The (3) high rate of atmospheric pollution existing in winter (as compared with summer) must surely be due to the domestic fire. Contained in the report is a comprehensive survey of the Health Week Exhibition and all who attended were enthusiastic regarding this example of positive health education. In a modern health department such efforts should be made from time to time, however the establishment of administrative and clerical officers in the Health Department does not allow for time to be spent on designing exhibits or the making, painting and erection of same, together with special lighting effects, and it was only by unstinted loyalty of the staff in "do it yourself" work that made the Exhibition possible at such infinitesimal cost. Health education goes on the whole year round and the talks given by the medical and nursing staff and the Chief Public Health Inspector to groups of mothers and local organisations total several hundreds. The informal chats given to small groups, where questions are encouraged, is in my opinion the most valuable form of health education. In the education of the public 'en masse' lies the value of a Health Exhibition. Although the duties of public health inspectors are statutorily laid down, I consider that work in health education is more important than legal enforcements. Indeed the informal chat on personal hygiene to the food handler can do more to encourage food hygiene than the enforcement of physical improvements to the premises. As Medical Officer of Health I am required to report on the persona] health services, (of which I am Area Medical Officer).This section of the Annual Report is mostly statistical as there is a limit to the time which may with advantage be spent on the compilation of reports. A Health Exhibition, vaccination against poliomyelitis, and the compilation of a separate Jubilee School Health Report during the year have been events of sufficient magnitude in total to disrupt to a degree the normal work of the Health Department. The carrying out of the environmental and personal health services under one roof is to my mind one of the most valuable integrations of Local Government. I take the opportunity of recording my appreciation of the support of the Council and in particular Councillor P.W.Marshall Chairman of the Public Health Committee, and Alderman Mrs. J. Hammond, Chairman of the Leyton Health Area Sub-Committee, the co operation of Officers of other departments, and the loyalty and industry of the staff of the Health Department. I have the honour to be Mr.Mayor. Ladies and Gentlemen. Your obedient servant, MELVILLE WATKINS Medical Officer of Health. (4) meteorological conditions 1957 I am indebted to the Director of the Meteorological Office of the Air Ministry for the following summary of the main features of the weather during 1957. January Mild. Mild by day and night. Less rainfall than average. Sunshine exceeded the normal quota by about 30%. February Wet and mild. Mildest February since 1946. More than twice normal quota of rainfall. Sunshine, however, was above average. March Exceptionally mild, dry. Not quite as sunny as normal, but mildest March on record. Rainfall about 40% less than normal. April Very dry. April was very dry, and only 9 millimetres of rain was recorded. This is 24% of the normal rainfall for April Temperatures were a little above average. Sunshine was 20% more than usual. May Rather dry. Sunshine a little above average. Rainfall deficient by about 40%. June Warm and very sunny. Sunniest June at Kew for more than 75 years. A total of 291 hours of sunshine. There was half the normal quota of rainfall July Wet. Cloudy and wet with 90% of normal sunshine and 50% more rain than normal. Thunder on seven days. August Rather cool cloudy and wet. Marked lack of warm days. The first few days were sunny and warm the rest of the month was cool cloudy and wet. Rainfall exceeded normal by 76% 10% less sunshine than normal. September Again cool, cloudy and wet. Rainfall above average by 28%. Sunshine deficient by a quarter of normal monthly quota. October Fairly dry and mild. Only 68% of normal rainfall. Dry first half of month. November Stormy at first then mostly dry. Most of rain fell in first 5 days and monthly rainfall total was about average for November.A little more sunshine than average. No fog. December Dry mild and sunny. In spite of some hard frosts (with persistent fogs) in the first week of the month and some heavy rainfalls (nearly an inch at Kew the second week) London had approximately 25% less than normal December rain and 25% more than normal sunshine. Christmas was bright dry and rather mild. (5) VITAL STATISTICS Area in Acres 2,594 Population (Census 1951) 105,978 Population (Registrar-General*s Estimate, 1957) 99,670 Assessable Value for General Rate purposes £1,270,116 General Rate in the £ (1957/58) 19s. 2d The Registrar-General's mid-year 1957 estimate of population (viz., 99,670) has been used for the calculation of the following statistics:- Live Births = Legitimate - Males 600 - Females 508 Illegitimate - Males 29 - Females 23 Total 1,160 Birth rate per 1,000 of population 11.64 Stillbirths Males 18 Females 8 Rate per 1,000 total (live and still) births 21.92 Deaths - Males 609 Females 619 Total 1,228 Death rate per 1,000 12.32 Number of women dying from diseases and accidents of pregnancy and childbirth:- From sepsis 0 From other causes 0 Rate per 1,000 total (live and still) birth 0.00 Death rate of infants under one year of age:- All infants per 1,000 live births 14.65 Legitimate infants per 1,000 legitimate live births 12.63 Illegitimate infants per 1,000 illegitimate live births 57.69 The natural decrease of population (i.e., excess of deaths over births) was 68. Comparability Factor To make approximate allowance for the way in which the sex and age distribution of the Borough population differs from that for England and Wales as a whole, the Registrar Genera] has issued the following comparability factors for Leyton. Area comparability factor for births 0.98 Area comparability factor for deaths 0.92 These factors, when applied to the crude rates, produce the following adjusted rates - Live births 11.40 Deaths 11.33 (6) COMPARATIVE STATISTICS OF BIRTHS MORTALITY ETC LEYTON, 1901 1957. Year Population Births Birth Rate Deaths Death Rate Deaths under 1 year Infantile Death Rate 1901 100 000 2 963 29 63 1 243 12 4 404 136 1902 100 000 3 152 31 52 1 183 11 8 336 106 1903 102 000 3.273 32 08 1 112 10 9 322 99 1904 104 000 3 198 30 07 1 370 13 1 444 138 1905 105 000 3 209 30 05 1 177 11 2 303 94 1906 108 000 3 344 30.9 1 327 12 2 382 114 5 1907 120 000 3 190 26 6 1 269 10 6 182 86 6 1908 121 200 3 071 25 3 1 185 9 8 242 78 8 1909 121 200 2 979 24 6 1 208 9 9 244 81 9 1910 123.300 3 Oil 24 4 1 112 9 0 191 63 4 1911 124 736 2 931 23 5 1 473 11 8 327 116 6 1912 126 700 2 797 22 1 1 343 10 6 223 79 7 1913 129 366 2 904 22 4 1 336 10 3 242 83 3 1914 130 847 2 800 21 4 1 363 10 4 219 78 2 1915 124 497 2 655 21 3 1 510 12 1 225 84 7 1916 B 132. 107 * D 121 420 * 2 560 19 4 1471 12 1 197 76 9 1917 B 125 352 * D 112 452 * 2 005 16 0 1 414 12 6 172 85 8 1918 B 125 352 * D 112 452 * 1 791 14 3 1,723 15 3 161 89 9 1919 B 129 062 * D 123 896 * 2, 195 17 0 1 397 11 3 154 70 16 1920 128 832 3 168 24 6 1.330 10 3 207 63 54 1921 128 432 2 679 20 86 1 290 10 04 182 67 94 1922 131 600 2 416 18 36 1 420 10 79 155 64 16 1923 132 800 2 328 17 53 1 228 9 25 106 45 53 1924 133 500 2 101 15 74 1 325 9 92 110 52 36 1925 132 700 2 091 15 76 1 349 10 16 114 54 51 1926 130 000 2 022 15 55 1 261 9 7 131 64 79 1927 128 920 1 826 14 16 1 322 10 25 80 43 81 1928 130 300 1 853 14 22 1 290 9 90 91 49 10 1929 128 300 1 731 13 49 1 510 11 76 100 57 77 1930 128 300 1 757 13 69 1 222 9 52 81 46 09 1931 128 600 1 812 14 09 1 365 10 61 71 39 18 1932 127 140 1 666 13 10 1 341 10 54 89 53 43 1933 125 700 1 499 11 91 1. 468 11 67 76 50 70 1934 123 430 1 454 11 78 1 317 10 67 64 44 02 1935 121 690 1 493 12 26 1 225 10 06 60 40. 18 1936 11S 900 1 421 11 85 1 272 10 61 74 52 07 1937 118 100 1 420 12 02 1 349 11 42 75 52 81 1938 117 200 1 509 12 87 1 148 9 79 70 46 38 1939 B 116 100 * D 110 800 * 1.499 12 90 1 242 11 21 46 31 65 1940 96 500 1 353 14 02 1 563 16 2 50 39 03 1941 84 790 1 129 13 31 1 142 13 46 37 38 30 1942 86 960 1 452 16 69 1 123 12 91 73 50 27 1943 87 880 1 595 18 14 1 248 14 20 57 35 73 1944 85 440 1 613 18 87 1 285 15 04 68 42 15 1945 87 330 1 474 16 87 1 147 13 13 52 35 27 1946 101 910 2 223 21 81 1 181 11 58 64 28 78 1947 105 550 2 359 22 35 1 278 12 10 78 33 06 1948 106.100 1 810 17 06 1 118 10 53 38 20,99 1949 106 700 1 630 15 27 1 232 11 54 43 26 38 1950 106 600 1 447 13 57 1 134 10 64 29 20 04 1951 104 700 1 311 12 52 1 362 13 00 27 20 59 1952 104 2 00 1 355 13 00 1 220 11 70 37 27 30 1953 103 200 1 279 12 39 2 029 19 66 30 23 45 1954 103 100 1 232 11 95 1 133 10 99 18 14 61 1955 102 000 1 136 11 13 1 258 12 33 28 24 64 1956 100 900 1 185 11 74 1 296 12.84 27 22 78 1957 99 670 1 160 11 64 1 228 12 32 17 14 65 * Population as estimated for purposes of B Birth Rate D Death Rate. (7) (8) Deaths The Registrar-General*s classification of causes of death by sex totals are shown in Table I on this page. The total number of deaths in 1957 (1228) compares with 1296 in 1956 the respective death rates per 1 000 population being 12 32 and 12 84. CAUSES OF DEATH AT DIFFERENT PERIODS OF LIPE 1957 AGE GROUPS MALES AGE GROUPS FEMALES Causes of Death Total 0- 1 1-5 5-1 E 1525 25 45 45 65 65 75 75+ TOTAL MALES 0- 1 1-5 5-15 15 - 25 2545 45- 65 6 575 75 + Total females 1. Tuberculosis respiratory 17 . - - - - 9 3 2 14 _ _ _ _ 2 _ _ 1 3 2. Tuberculosis other 1 - - - - - - 1 - 1 - - - - - - 3. Syphilitic disease 4 - - - - - - 1 2 3 - - - - - 1 - - 1 4. Diphtheria - - - - - - - - - - - - - - - - . 5. Whooping Cough - - - - - - - - - - - - - - - - - . . 6. Meningococcal Infections 1 - - - - - - - - - - - - 1 - - - - 1 7. Acute Poliomyelitis - - - - - - - - - - - - - - - - - - - 8. Measles - - - - - - - - - - - - - - - . . _ _ 9. Other infective and parasitic diseases 1 _ _ _ _ 1 . 1 _ . . - - - - - 10. Malignant neoplasm stomach 32 - - - - 1 5 6 5 17 - - - - - 4 6 5 15 11. Malignant neoplasm lung bronchus 50 _ _ _ _ 1 19 17 5 42 . . . . - 3 3 2 8 12. Malignant neoplasm breast 20 - - - - - - - - - - - - - 3 8 6 3 20 13. Malignant neoplasm uterus 5 - - - - - - - - - - - - - - 3 1 1 5 14. Other malignant and lymphatic neoplasms 108 . 1 1 19 17 12 50 . . . i 2 23 14 18 58 15. Leukaemia aleukaemia 4 - - - 1 - - - 1 2 - - - - - 2 - - 2 16. Diabetes 5 - - - - 1 - - 2 3 - - - - - 1 1 2 17. Vascular lesions of nervous system 147 _ _ _ 1 9 17 22 49 _ _ _ . . 23 18 57 98 18. Coronary disease angina 181 - - - - 5 43 36 33 117 - - - - i 4 25 34 64 19 Hypertension with heart disease 21 _ _ _ 2 1 2 5 _ „ _ . . 3 6 7 16 20- Other heart disease 205 - - - - 2 10 10 61 83 - - 1 - 2 12 17 90 122 21 Other circulatory disease 53 - - - - - 8 7 9 24 1 5 10 13 29 22. Influenza 9 - - - - - 2 2 - 4 - - - 2 - 1 - 2 5 23. Pneumonia 87 - 1 - - 1 7 10 24 43 1 4 - - 1 3 5 30 44 24; Bronchitis 85 - - - - - 18 21 22 61 - - - 1 - 2 11 10 24 25. Other diseases of respiratory system 13 _ _ _ _ _ 3 4 1 8 . . . . 1 3 1 5 26. Ulcer of stomach and duodenum 20 - - - - - 2 4 3 9 - - - - 1 1 5 4 11 27. Gastritis enteritis and diarrhoea 9 _ _ _ _ _ _ 2 _ 2 1 . . _ . 1 3 2 7 28. Nephritis and nephrosis 8 - - - - - 2 - 2 4 - - - 1 1 - 1 1 4 29. Hyperplasia of prostate 10 - - - - - 1 2 7 10 - - - - - 30. Pregnancy childbirth abortion 31. Congenital malformations 6 - 1 - - - - - - 1 3 1 1 - . - - - 5 32- Other defined and ill defined diseases 87 8 1 1 _ 13 10 4 37 3 _ _ 1 4 9 5 28 50 33. Motor vehicle accidents 8 - - 1 - 1 2 1 1 6 - - - - - 1 - I 2 34- All other accidents 14 - - - - 1 1 4 6 - - - - - - - 8 8 35. Suicide 14 - - - - - 4 3 - 7 - - - 2 2 2 1 7 36 Homicide and operations of war 3 - - - - - - - - 1 1 - - 1 - - - 3 TOTALS 1 228 8 2 3 2 14 180 176 224 609 9 6 2 7 21 112 142 320 619 LABORATORY FACILITIES (a) Pathological Department, Whipps Cross Hospital, E.11. For pathological specimens. (b) Central Public Health Laboratory Colindale. For special bacteriological investigations, supply of lymph for vaccination; supply of diphtheria toxin (FT,) (c) Counties Public Health Laboratories, Queen Victoria Street, London. For bacterial and chemical examination of water, milk and other foods. (d) Public Analysts, Analytical Laboratory 20 Eastcheap, E.C.3. For analysis under provisions of Food and Drugs Act 1938. AMBULANCE FACILITIES In July. 1948 the County Council became responsible for the provision of ambulance facilities in the area. The service is now administered centrally from Chelmsford., the vehicles and staff being accommodated at the Ambulance Depot in Auckland Road. (Telephone: LEY. 6077/8). HOSPITALS The following hospitals, administered by the Leytonstone (No.10) Group Hospital Management Committee on behalf of London N.E. Regional Hospital Board, are situated within the Borough of Leyton. (a) Whipps Cross Hospital. (b) Langthorne Hospital. NURSING HOMES There are two nursing homes in the Borough registered under the provisions of the Public Health Act, 1936 1 Queens Road Leytonstone. with accommodation for 69 patients "Brooklands" 22 Fairlop Road, Leytonstone, with accommodation for 25 patients. HEALTH SERVICES CLINICS (See page 47) PREVALENCE AND CONTROL OF INFECTIOUS AND CONTAGIOUS DISEASES The following cases of infectious and contagious disease were notified during the year. - Disease Notifications Received Smallpox Diphtheria Erysipelas 17 Scarlet Fever 60 Pemphigus Neonatorum Tuberculosis Pulmonary 51 Tuberculosis, Other forms 9 (9) Disease Notifications Recived Pneumonia 223 Ophthalmia Neonatorum 3 Typhoid Fever 1 Paratyphoid Fever 1 Puerperal Pyrexia 13 Meningococcal Infection 1 Poliomyelitis Paralytic 11 Poliomyelitis, Non-paralytic 8 Acute Encephalitis Infective 1 Acute Encephalitis, Post infectious Measles 1,033 Whooping Cough 159 Dysentery 6 Food Poisoning 29 TOTAL 1,626 diphtheria No case of diphtheria has been notified since 1951. Information regarding immunisation against diphtheria is to be found on page 55. dysentery Only six cases were notified in 1957 compared to 49 cases in 1956. Five of the cases were removed to hospital. None of the persons notified had the disease in a serious form. food poisoning Twenty nine persons were notified as suffering from food poisoning, compared with forty-six in 1956. In only two cases was hospitalisation necessary. There were three "outbreaks" involving nine cases and twenty "single" cases the agent (salmonella organisms) being identified in five of them. poliomyelitis During the year nineteen notifications were received in respect of poliomyelitis. Eleven cases were "paralytic" and eight "non-paralytic." Of these, five paralytic cases were diagnosed in Whipps Cross Hospital in respect of patients residing outside the Borough of Leyton. Although these five cases are recorded in the Leyton return of notifications received, no action is taken other than to notify the Medical Officer of Health of the Area in which the patient is normally resident. ANNUAL INCIDENCE SINCE 1947. The following list shows the annual number of cases of poliomyelitis notified in the Borough from 1947 1957 inclusive - YEAR CASES YEAR CASES YEAR CASES YEAR CASES 1947 14 1950 14 1953 8 1956 3 1948 2 1951 - 1954 1 1957 19 1949 20 1952 12 1955 21 (10) CASES NOTIFIED DURING 1957. At the foot of this page is a table showing in summary form the relevant information regarding the cases notified during the year. It will be seen that of the fourteen Leyton cases thirteen of them occurred during the months of July and August, and seven had some paralysis. The notes recorded in the summary under 'Progress' set out the results of a recent follow-up of the cases and reveals that eight cases have continuing paralysis some eight months after the disease was diagnosed. GENERAL Nine of the fourteen cases notified were under 12 years of age. With the extension of the scheme for vaccination against poliomyelitis to include all children under 15 years of age, it is hoped that by the early summer of 1958 a good proportion of this age group will have had at least an initial immunising dose of vaccine against the disease. In order to place poliomyelitis in its true perspective it should be noted that no deaths occurred from this disease in Leyton during 1957, whereas nine deaths occurred from 412 road accidents and eleven deaths from an unknown total number of accidents in the home. NO. Date of Notification Sex Age Site of Paralysis or Paresis at time of Notification Progress 1 9.7.57 F 1½ Right arm and shoulder Right arm and shoulder still paralysed Attending for physiotherapy. 2 9.7.57 M 7 Nil Complete recovery 3 15.7.57 M 9 Left arm Arm still paralysed. Making no progress. 4 14.7.57 M 4ft Left arm and legs Left arm and legs still affected. Having physiotherapy at hospital. 5 17.7.57 F 8 Nil Complete recovery 6 18.7.57 M 28 Neck Still in hospital. Has generalised paralysis. 7 30.7.57 F 6 Nil Complete recovery 8 31.7.57 M 30 Right arm Right arm still affected. Attends hospital as out patient. 9 7.8.57 P 3 Nil Complete recovery 10 7.8.57 F 4 Nil Paralysis left leg and lower back. Attends for physiotherapy three times a week. 11 12.8.57 P 1% Nil Complete recovery 12 21.8.57 M 11 Nil Complete recovery 13 21.8.57 F 41 Lower limbs Still some paralysis 14 5.11 57 F 12 Lower limbs Both arms still paralysed. Attending hospital for physiotherapy. (11) measles 1,033 notifications of persons suffering from measles were received in 1957 compared with 831 in 1956. Fifteen of the patients were removed to hospital. No deaths were recorded as due to measles. whooping cough The number of cases notified was 159 compared to 163 in the previous year. Eighteen of the cases occurred in infants under one year of age. No deaths were attributable to the disease. Information regarding protection against whooping cough will be found on page 56. scarlet fever The number of cases notified 60 is two more than the cases notified in 1956. The disease continues to appear in a mild form. In only six cases was it necessary for the patient to be admitted to hospital. pneumonia 223 cases of pneumonia were notified during 1957 an increase of 82 on the 1956 noti fications. This is due, in part to the 'Asian' "flu epidemic which was prevalent in the latter part of the year. 150 of the notifications were received from one general medical practitioner. It is likely therefore that the true incidence was many times greater than the number of cases notified. tuberculosis The following is a statement of particulars appearing in the Register of Notifications of Cases of Tuberculosis for the year ended 31st December. 1957 PULMONARY NON PULMONARY TOTAL M F Total M F Total Number on register at commencement of year 530 424 954 37 55 92 1046 Number first notified during year 35 16 51 1 8 9 60 Number entered in register otherwise than by notification 16 11 27 4 1 5 32 Number removed during year 46 33 79 4 2 6 85 Number remaining at end of year 535 418 953 38 62 100 1053 Died 21 5 26 2 - 2 28 Removed from district 16 17 33 1 - 1 34 De-notified 1 - 1 1 - 1 2 Cured 8 11 19 2 2 21 (12) NEW CASES The following table gives particulars regarding the new cases which have occurred during the year - Age Periods NEW CASES Pulmonary Non-Pulmonary M F M F 0-1 - - - - 2-4 1 - - - 5-9 - - - - 10-14 - - - 1 15-19 1 2 - 1 20-24 3 2 - 1 25-34 5 5 - 1 35-44 3 3 - 2 45-54 8 3 - - 55-64 4 1 1 - 65 and over 10 - - 2 TOTALS 35 16 1 8 the london fog of december 2 5, 1957 Much has been written regarding the London fog of December 1952 which it is estimated caused the death of 4,000 persons, and recently,investigations have been completed and reported in the Monthly Bulletin of the Ministry of Health which show that the fog of December 2 5, 1957 was associated with a considerable increase in mortality in the Greater London area. From this investigation it is apparent that the atmospheric conditions which prevailed a few days before and subsequently gave rise to the fog were in themselves a cause of increased mortality. It is estimated that there were between 700 and 1,000 deaths and that the heavier concentrations of the East of London were accompanied by a proportion ate increase in the number of deaths in that area. The figures of weekly deaths registered in East London showed an increased ratio of 1.5 for the week of the fog compared to that of the previous week whereas the County of London's increased ratio was 1,15- and for the whole of Greater London 1 2. An interesting result of the investigation shows that the rise of deaths is noted at a period when the atmospheric pollution was in the early stages climbing towards its maximum. Meteorologically the fog of 5th December 1957 was neither consistently dense nor were the levels of atmospheric pollution in most areas as high as previous fog episodes known to be associated with a similar high mortality, however in Leyton the atmospheric pollution was the highest recorded since observations began in 1950 and the highest daily average of smoke expressed as millegramms per 100 cubic metres during the fog was 234.3 as against a daily average for that time of year of 88,1. The sulphur dioxide readings expressed as parts per 100 million parts of air were 75.4 being three times the daily average for that time of the year. The week preceding the fog the statement of new claims to sickness benefit received by the Ministry of Pensions and National Insurance shows that there were 565 such claims received in Leyton and Leytonstone. In the week including the period of the fog the claims (13) increased to 820 and in the week ended 31st December. 1957 reached 1,171 new claims. In the Borough of Leyton there was an approximate increase of 60% in the deaths due to respiratory diseases in the four week period including and following the fog. HOMES FOR THE ELDERLY In February 1957 I submitted to the Public Health Committee, a Report regarding homes for the elderly, and I set out hereunder relevant extracts from the Report. Since I assumed office at Leyton I have had referred to me a number of cases by the health visiting staff, Public Health Inspectors and Domestic Help Organiser in which I have had to determine whether action should be taken under Section 47,. National Assistance Act, 1948. On visiting these cases it is pathetic to see the breakdown that has occurred in the person's health and the contributory cause of these breakdowns is invariably inadequate housing accommodation. The Public Health Committee, as a preventive service, cannot ignore this growing problem. The problem patients are invariably to be found in a first-floor back addition room to which he or she has been banished by the owner-occupier, who. because he needs accommodation for his growing family, does all he can to make life awkward for the sub tenants, in the hope that they will find alternative accommodation, and we find these frail, ambulant old people so scared of being a nuisance that they hesitate to come out of their room to attend to the most elementary of human needs or to obtain water or coal. The sub tenant in many cases had previously had two or three rooms, but is gradually coerced to move into one. With them they wish to take all their treasures in the way of furniture clothing and the usual accumulation of sentimental mementos that mean so much to the individual. We therefore find that the room is so overcrowded that it is impractic able for it to be properly cleansed. All washing preparation of meals and sleeping are done in the one room but that in itself is not so bad. What is more distressing is that the occupant is lonely and feels unwanted. The Health Visitor calls but infrequently, and the Domestic Help may be in attendance but with so small a place her services cannot often be used. These housing conditions make it particularly difficult for old and young to maintain happy relationships, and it is even more complicated when there are three generations living under one roof. There are those elderly people who, whilst capable of maintaining an independent existence, require help because they have continued to live in a house or flat now too large for them to look after and being also alone in a home once shared with others become lonely and depressed. THE DEMAND How many cases are there in the Borough at the present time who would benefit from alternative accommodation of the types enumerated hereunder? We have on our register of old people almost one thousand cases. Of these 387 live alone 151 are house bound and 329 have a limited mobility. These are cases which have been brought to our notice how ever there are many more of whom we have no knowledge but probably only a minority would move into such accommodation as is described later. Re housing them in small labour saving flatlets in close contact with others would save them from deteriorating into the problem with which we so often have to deal in services for the elderly. In Leyton this type of alternative accommodation has been lacking and it is in an endeavour to meet this need that the following proposals have been formulated. (14) WHAT IS NEEDED There are four types of accommodation for elderly people needed. (a) A house in which each tenant has a bed sitting room with a communal dining room and kitchen. Each house has a "house mother" who is resident and responsible for the persons living in the house. This type of "home" would cater for the frail ambulant who needs a little oversight and the companionship of others. (b) A house with rooms converted into small self-contained flatlets with a small kitchen unit incorporated in the room. Each person is self-supporting and brings his or her own furniture. They share lavatory and bathroom and also have a resident "house mother" with genera] supervising duties over the house as a whole. (c) An increased proportion of small flatlet accommodation incorporated in new housing schemes. (Nationally one person in every 9,2 persons is over 65 years of age, whilst locally one person in every 7,5 exceeds this age. This proportion is bound to increase with a lower birth rate and the removal from the Borough of young couples). (d) Ad hoc flatlet units for old people but not in large isolated communities. Schemes (a) and (b) would offer immediate alleviation of the problem whereas schemes (c) and (d) should be constantly borne in mind when planning on a long term policy. Of schemes (a) and (b) the latter offers that degree of independence which most old people cherish. HOW IT MAY BE PROVIDED The ultimate responsibility for providing for the general housing needs in the Borough,, including those of old people rests with the Local Authority. Small flats and bungalows for old people are now provided but there is no provision for "homes" in which elderly people may live in independent existence and yet have some supervising care and companionship. Subsequently the Council approved that houses should be purchased and adapted for the use of old people and at the time of writing three houses two in Bushwood and one in Forest Drive West have been purchased: two of the properties are in the process of adap tion. and one other has been completed and is occupied by seven elderly people together with a house mother. The accommodation provides a separate bed sitting room for each tenant and includes a communal toilet and bathroom and a communal kitchen on each floor where two persons share a gas cooker and stainless steel sink but have individual cupboards supplied for them. Doubts have been expressed of the wisdom of providing communal kitchens but in the short time I have had to observe the tenants in their new home in Bushwood, it is apparent that they have settled down well, are perfectly happy in this type of accommodation and are enjoying the companionship of their fellow tenants. CARE OF THE AGED In June 1957 the Leytonstone (No. 10) Hospital Group Management Committee invited the Council to appoint representatives to attend a joint meeting of health and welfare authori ties, together with other local interested bodies and persons in the district from which patients are admitted to hospital for the purpose of (15) (a) describing and discussing the full range of the hospitals' activities, and (b) considering the desirability of establishing a local co-ordinating body to deal with the problems of the aged as a whole. In the first instance the officers of the Local Health and Local Sanitary authorities, together with those of the local medical committees, National Assistance Board and represent atives of various voluntary organisations, met the members of the Hospital Management Committee and after frank discussions the following Resolution was carried unanimously - (a) That this Joint Meeting of representatives of the Health and Welfare Authorities Local Medical Committees, National Assistance Board Officers, Voluntary Organisations and the Leytonstone Hospital Group recognising the need for a definite policy of co ordination between the various Bodies responsible for the Care of the Aged are unanimously of opinion that a Co ordination Committee should be set up comprising representatives of the various official and voluntary bodies present at this meeting for the purpose of considering from time to time how the existing services for the elderly can best be co ordinated and improved and to make recommendations thereon; and (b) That as a preliminary step the nominated officers of the respective Authorities and Organisations be authorised to explore the whole problem and to report thereon for consideration by the Co ordination Committee. In October 1957 the Minister of Health issued a Circular 14/57 which reported on the Survey the Minister had conducted through his officers of the facilities available to the chronic sick particularly the aged chronic sick and infirm. In the report on Homes for the Elderly which precedes this item I have written of the demand for housing accommodation for the elderly as is known to us but we are aware that there are many more in need of care and attention, and it is right that the responsible authorities, e.g. hospitals, welfare, local health public health housing should meet together and seek a measure of co-operation. However, without an adequate provision of beds for chronic sick, welfare hostel accommodation and local authority housing, it is obvious that the problem cannot be solved and that there will be a greater demand for hospital beds than can be adequately provided and I commend the action of the Leytonstone (No.10) Hospital Group Management Committee in taking the initiative in an endeavour to co relate the hospital, welfare and local authority services. HEALTH WEEK EXHIBITION In November 1956 at the request of the Chairman. I reported to the Public Health Committee upon a proposal that a Health Week and Exhibition be held in the Borough during 1957, and the Committee resolved (a) that a sum of £250 be provided for this purpose in the draft Revenue Estimates for the year 1957/58 and (b) that the Leyton Health Area Sub Committee be asked to co operate in the arrangements for this venture. In the following month the Public Health Committee instructed me to proceed with the arrangements and an unofficial Sub Committee of the Chairman and Vice Chairman of the two Committees, together with the Medical Officer of Health, Chief Public Health Inspector and the Chief Administrative Assistant was set up and they held several meetings regarding the publicity and general ideas of presentation. Only a small percentage of environmental Health (16) Service exhibits were borrowed and the remainder of them, together with the whole of the persona] Health Service exhibits, were designed and built by members of the staff of the Department. General arrangements for the Exhibition, the publicity., etc.. entailed a considerable amount of administrative time and inasmuch as the day to day work had to continue it was only by the public spirited action of the staff in giving up their free time that the project was carried to such a successful conclusion and at so small a cost. At the wish of the Sub Committee a brochure was produced and handed to each visitor to the Exhibition. According to my own observations it was noted that few visitors used the brochure. However it was a permanent record of the Exhibition for them to take away and subsequently study. There was an Official Opening by The Worshipful the Mayor of Leyton (Councillor Mrs. A.M.M.Burrell) supported by the Chairman of the Committees concerned in the presentation of the Exhibition, together with the Chairman of the County Health Committee (Alderman K E B Glenny), and the County Medical Officer of Health. On subsequent evenings there were displays and demonstrations by the Women's League of Health and Beauty, Leyton Civil Defence, and the Leyton Branch of the St.John Ambulance Brigade. The official attendance was 5141. LOCAL HEALTH AUTHORITY EXHIBITS ESSEX COUNTY HEALTH SERVICES In presenting the Health Exhibition it was considered that there should be some method of linking together the individual exhibits to give a certain amount of continuity and for this purpose it was resolved to create a typical family and show how in their normal lives use both the environmental and personal Health Services. The family were called THE DAWSON FAMILY and included Mr. & Mrs. Dawson their three children together with Grandma and Grandpa. On ascending the staircase to the Exhibition the visitors saw a large photograph of the family group and on every stall there were photographs showing the family using the Services. This was an original theme in Health Education and raised a great deal of comment from pro fessional people by its eye-catching qualities. STAND No.1 HEALTH VISITING This exhibit showed all the activities of the health visitor both in clinics and the visiting of expectant mothers babies, toddlers and school children together with the agedFilm strips were available on every aspect of their work including home safety and these were projected on request to the health visitor in attendance. STAND No. 2 - NUTRITION This exhibit which by an adroit use of horticultural subjects showed that first-class plants and flowers can only be obtained by giving them nutrition in the form of fertilisers and other chemical agents, and drew an analogy that is the same way (with welfare foods nutrients and medicaments) growing children require the right food and is properly cooked and different types of food for building up and maintaining the health of various parts of the body. STAND No. 3 HOME NURSING & MIDWIFERY This exhibit showed the excellent work carried out by the home nurses and home nurse midwives attached to the Lady Rayleigh Training Home, together with the County midwives. The general equipment used by these members of the Local Health Authority staff in their work was on show together with all types of sick - room equipment which is available free on loan. (17) STAND No.4 FOOT HEALTH The use of the correct foot wear to obviate foot defects was the main message of this display which together with charts and plaster casts of feet abnormalities taken by the staff at the local foot clinics made a worthwhile exhibit. An interesting item kindly loaned by the Principal of the Cordwainer's College was the display of footwear which was on show at the Great Exhibition in Hyde Park in 1851. STAND No. 5 DAY NURSERIES This exhibit which was backed with an original painting 8' x 4' by a pupil of the Leyton County High School for Boys displayed in photographs a child's day in the nursery in which the child was seen in surroundings where his time was fully occupied with sense training, playing and emotional development. Also displayed were types of play equipment in use in the nurseries, together with a list of categories on which admission is made. STAND No.6 SCHOOL HEALTH SERVICE, DENTAL This exhibit showed the modern dental equipment with which the three clinics in Leyton have been supplied, and most interesting exhibits showing the development of teeth and jaws together with sections of teeth in process of dental decay. STAND No. 7 - SCHOOL HEALTH SERVICE, GENERAL This exhibit in the form of paper sculpture, showed the many services available to all school children. STAND No.8. DOMESTIC HELP SERVICE This is not an easy subject to portray in an exhibition. However, the difficulty was surmounted by portraying an average room with a patient in bed and a domestic help in the room commencing her duties. By ribbons leading from the domestic help's hand to notices pointing out duties like cooking, cleaning, shopping, etc., were emphasised. STAND No. 9 VACCINATION & IMMUNISATION This exhibit, which attracted a great deal of interest owing to its colour and lighting showed rainclouds marked with the various diseases, with an umbrella - the panels of which were marked with vaccination and immunisation giving protection to the child underneath. Charts were also displayed showing the incidence of disease in the Borough over the past years and how these diseases had been reduced by preventive measures. STAND No.10 LIBRARY SERVICE The Leyton Public Libraries were invited to exhibit and they provided a very colourful stand with the accent on books which were available to readers on health, physical fitness etc. BOROUGH OF LEYTON (LOCAL SANITARY AUTHORITY) ENVIRONMENTAL HEALTH SERVICES The Dawson family theme proved an excellent medium for illustrating the impact of the County Council's personal health services on the individual. At each stand visitors to the Exhibition, old and youngs were able to identify themselves with members of the Dawson family taking advantage of these services. The problem confronting the Chief Public Health Inspector was how to continue this personal theme in the much broader communal field covered by the environmental health services provided by the Leyton Borough Council. It was necessary to introduce the Dawson family to, and associate them with, the statutory duties and respon sibilities of their Local Council in relation to such broad issues as housing, slum clearance, (18) clean air, clean food, nuisance abatement, rodent and pest control, etc. Reference to plate No.1 illustrates how this was achieved by means of photographs, cutouts and captions. At this point visitors (having been conducted round the County stands) were introduced to a member of the public health inspectorate, who explained the message the display panel meant to convey. It was pointed out that environmental sanitation could be defined broadly as the control of all those factors in man's physical environment which exercise a deleterious effect on his physical development, health and survival, and that this definition summed up the responsibilities of the local sanitary authority. The conditions in which people live, work and play, the purity of their food and drink and of the air they breathe have considerable influence on their health and well-being, and the aim of the environmental health services is to control or eliminate those factors which are, or may be, harmful. The exhibits which followed this general introduction to the environmental health services are described hereunder. STAND No.11 HOME SAFETY With the co-operation of the County Medical Officer of Health this exhibit took the form of a castle, the analogy being that an Englishman's home is his castle but has he a fifth column within, the fifth column being does he take all precautions against accidents in the home. STAND No.12 FIFTY YEARS OF LEYTON HEALTH This exhibit showed 50 years" progress in Leyton's health, and the vital statistics of 1906, together with photographs of Leyton in that period side by side with similar statistics for 50 years later, viz. 1956- made quite an interesting comparison of the progress that has taken place during the lives of many visitors to the Exhibition. STANDS Nos.13 and 14 DIARY OF A PUBLIC HEALTH INSPECTOR PLATES Nos.2 & 3 The lead in to this exhibit took the form of a bigger-than life silhouette (Plate No.2) flanked on each side by display panels setting out in broad outline the conditions of appointment statutory qualifications, duties and responsibilities of a Public Health Inspector. This enigmatic figure aroused a great deal of comment. It was not long before it was dubbed "the man in black", "the third man", etc., which,, of course was just what was anticipated, for this silhouette was intended to be a gimmick designed to catch the public eye it certainly had the desired effect of attracting attention and thereby stimulating interest in the exhibit which followed Diary of a Public Health Inspector (Plate No.3) which was devoted to unveiling the mystery and introducing the Inspector to the public he serves. The Public Health Inspector performs a wide variety of duties in the field of environmental hygiene and is mainly concerned with the repair, closure and demolition of unfit houses, slum clearance, drainage, nuisance abatement, rodent and insect pest control, diseases of animals, air pollution and smoke abatement, shops, factories places of public entertainment, water supply, food administration (including inspection condemnation and sampling of meat and other foods, inspection of food premises, and food hygiene) registration and licensing of certain types of premises and/or persons ice cream milk, hairdressers, pet animals, rag flock, food hawkers, shell-fish vendors and slaughtermen. Much thought was given to the problem of featuring this wide range of activity in a manner comprehensible to the lay-man as well as to the student of public health. It was finally decided to take advantage of the fact that a Public Health Inspector is required by law to keep a daily record of his inspections and of the action taken in the execution of his duties. In furtherance of this, a greatly enlarged reproduction of an Inspector's diary (open at a page) 5'8' high and 5.0" wide, was constructed. By relating the entries in the diary to photographs, captions, models, equipment and other material exhibits , it was possible to record in handwriting legible from a distance of 6'0' some 35 different facets of an Inspector's work. The photographs showed the Leyton Inspectorate performing each function (19) referred to on the open page local men carrying out public health duties in recognisable local surroundings. This exhibit attracted a great deal of attention and from the questions asked of the staff in attendance and the comments made in the local press it was apparent that we had succeeded in capturing the interest of a large section of the population in the wide scope and importance of the services provided by their Local Council. It also paved the way to a better understanding of the more specialised treatment given to slum clearance, housing improvements and conversions, clean air. rodent control, and clean food in the re maining stands. STAND NO.15 - HOUSING SLUM CLEARANCE PLATES Nos. 4 & 5 Broadly speaking, the work of the Public Health Department in relation to housing is concerned with the repair, demolition and closure of unfit houses and slum clearance. Dwelling houses are inspected as a general routine or on complaint and statutory action taken as appropriate to secure the remedying of defects such as dampness,, general disrepair leaking roofs etc. Consequent upon the Government's direction to Local Authorities to take active steps to review housing conditions in their areas and resume full exercise of their powers and statutory responsibilities under the Housing Acts in relation to slum clearance (curtailed during the war and post-war period), the Council instructed its officers to complete the necessary preparatory work in respect of two areas in the Borough selected for redevelopment. This stand portrayed briefly Leyton's first-ever slum clearance and redevelopment scheme the Crescent Road Area. Between May 1955 and January 1956, every house in the Area was surveyed in detail by Public Health Inspectors to determine the extent to which the houses were defective in relation to disrepair, stability, dampness, natural lighting, ventilation, water supply, drainage saintary facilities, and bad arrangement in relation to other build ings. In February 1956 the Medical Officer of Health submitted to the Council's Public Health Committee an official representation in respect of four clearance areas, and a report prepared jointly with the Chief Public Health Inspector on the main and material conditions existing in the Areas which in their opinion rendered demolition of all houses and other buildings necessary either by reason of their bad arrangement or the narrowness or bad arrangement of the streets; or because they were dangerous or injurious to the health of the inhabitants of the Areas. The mural diagram at the head of the stand, captions, photo graphs maps and other documents., indicated clearly the various administrative stages of the scheme before a public local inquiry ordered by the Ministry of Housing and Local Government was held in the Council Chamber on 8th January 1957. At the time of staging the exhibition the decision of the Minister of Housing and Local Government had not been received, but it is now known that the Leyton Housing (Crescent Road Area) Compulsory Purchase Order 1956 was confirmed without any material modification. A model prepared by the Borough Engineer and Surveyor, was included, showing the proposed new layout of the area. STAND NO.16 HOUSING IMPROVEMENTS AND CONVERSIONS PLATE No.6 Display material in this stand showed how older houses can be made into comfortable modern homes with the help of Government grants and was therefore of special interest to anyone owning or renting a soundly buil,£ house which lacked modern amenities such as bath room, hot water system, internal W.C., etc. Of the 27,000 odd houses in Leyton many hundreds are more than 65 years old. Some of these older houses are known to be past saving fit only for demolition but the great bulk of them are structurally sound and if brought up to modern standards will provide good homes for many years to come. The Housing Acts 1949/54 provide for money grants to help owners to modernize such houses by improvement or conversion. (20) This stand explained about the grants what they are for. and how they can be obtained. A model was included showing typical old houses before and after improvement. STANDS Nos.17 and 18 CLEAN AIR PLATE No.7 We breathe about 3,000 gallons or 38 lb. of air every day. In towns, this air is heavily polluted by smoke (including soot, ash, grit and tar) and sulphur acids, caused by the burning of coal, over 200 million tons of which is burned annually in Great Britain. The burning of this coal produces nearly 3 million tons of smoke and grit, besides over 4 million tons of sulphur acids, which is all discharged into the air. About half of all the smoke present in the air comes from household chimneys and for each ton of coal burnt the domestic fire produces twice as much smoke as industry and discharges it at a lower level. Smoke is mostly unburned coal and is just wasted heat - paid for but not used! In effect the entire output of 10,000 miners is lost. Smoke cuts off health-giving sunlight and daylight (in winter by as much as 60%) causing a higher Death Rate in towns than in the country it blackens and damages the lungs and irritates the throat and breathing passages, encouraging bronchitis coughs and catarrh and making recovery from pneumonia and tuberculosis more difficult. The ill effects of smoke are greatly intensified during periods of smog (the smog of December 1952 caused 4,000 deaths in Greater London). Smoke damages buildings, metals and fabrics it harms vegetation, it makes laundry bills higher and causes unnecessary expenditure on cleaning glass and paintwork. At a conservative estimate, smoke costs the nation £250 millions a year or £25 for every family. In view of the recent passing of the Clean Air Act which aims at the reduction and eventual abolition of air pollution the themes portrayed on this stand were of great importance and of topical interest. The causes, effects and remedies of air pollution were described and illustrated by models, photographs and other exhibits. Apparatus for the measurement of pollution was also displayed this apparatus was similar to that installed at the Public Health Offices Sidmouth Road where daily measurements of the amount of pollution by smoke and sulphur dioxide have been made for the past seven years in co op eration with the Department of Scientific and Industrial Research. A working model of a town demonstrated the formation of smog and several film strips dealing with various aspects of the subject of Clean Air were shown at intervals. STANDS Nos.19 and 20 RODENT AND PEST CONTROL PLATE No.8 The Council is represented on an Area Committee set up by the Infestation Control Division of the Ministry of Agriculture. Fisheries and Pood the central authority for rodent and pest control to deal generally with the problem of rodent control in liaison with adjoining Boroughs. The Committee comprises representatives of 11 neighbouring local authorities. There is a statutory obligation on the part of occupiers of property to report to their local authorities the presence of rats and mice and unless there is full co operation by the public in this matter effective control measures are extremely difficult to carry out. Staff is available in the Public Health Department to deal with infestations of rats and mice in business premises and dwelling houses. This service is free to tenants of domestic premises, but a charge is made to commercial and industrial undertakings. The Ministry's exhibit featured the common rat and illustrated the main points of rodent infestation in town and country. Rats and mice devour and contaminate vast quantities of foodstuffs. They do great damage to property by gnawing woodwork water pipes electric (21) Plate No. 1. BOROUGH OF LEYTON PUBLIC HEALTH EXHIBITION Display panel introducing the statutory duties and responsibilities of the Local Sanitary Authority in relation to the control of the environmental health services. Plates 2 and 3. BOROUGH OF LEYTON PUBLIC HEALTH EXHIBITION Stands Nos. 13 and 14. Diary of a Public Health Inspector. Plates 4 and 5. BOROUGH OF LEYTON PUBLIC HEALTH EXHIBITION Stand No. 15. Housing—Slum Clearance Procedure. Plate No. 6. BOROUGH OF LEYTON PUBLIC HEALTH EXHIBITION Stand No. 16. Housing—Improvements and Conversions. Plate No. 7. BOROUGH OF LEYTON PUBLIC HEALTH EXHIBITION Stands Nos. 17 and 18. Clean Air. Plate No. 8. BOROUGH OF LEYTON PUBLIC HEALTH EXHIBITION Stands Nos. 19 and 20. Rodent and Pest Control. (This exhibit was provided by the Ministry of Agriculture, Fisheries and Food, Rodent Control Division.) Plate No. 9. BOROUGH OF LEYTON PUBLIC HEALTH EXHIBITION Stand No. 21. Clean Food. cables, and by burrowing beneath buildings undermine foundations. They also carry many serious diseases which can be transmitted to man and domestic animals. STAND No. 21 CLEAN FOOD PLATE No.9 In the Borough of Leyton there are some 2,373-odd business premises, made up of factories, industrial undertakings, food premises - catering establishments, shops, etc. involving some 3,087-odd activities including registration and licensing. All these premises are subject to routine inspection by the Public Health Inspectors to ensure compliance with the provisions of the Acts, Orders and Regulations controlling them, and for the welfare of those who work in them. The work of the department in relation to Food and Drugs administration embraces many activities and is concerned broadly with the soundness and purity of food and the conditionsin which food is prepared, transported, stored, handled and sold. Food is inspected to determine its fitness for human consumption and samples are submitted to the Public Analyst, who reports on its constituents and freedom or otherwise from adulteration. However, clean food is not wholly concerned with the structural condition of premises, a most important and unpredictable factor in the campaign for cleaner food is the worker. Carefully designed and elaborately equipped food premises are not proof against the care less food handler who fails to observe the elementary principles of personal hygiene. It is often said that "one man's meat is another man's poison". In relation to food handling it could be said that ONE MAN"S POISON MAY BE ANOTHER MAN'S MEAT. This is the crux of the problem. One employee in a food establishment may by ignorance, apathy or mere carelessness jeopardise the health of hundreds of people. The education of the food handler is therefore the greatest single step that can be taken in producing cleaner food, and it is for this reason that of the many aspects of food and drugs administration the hygiene of food hand ling was selected as the main theme for this stand. HEALTH EDUCATION FILMS The exhibition display stands were supplemented by films on air pollution food hygiene, rodent and pest control, and housing defects these were shown in the Council Chamber each evening and were very well attended, ESSAY COMPETITION School children who visited the exhibition were invited by their teachers to write an essay on "The exhibit which interested me most". Of the 12 essays which were awarded a prize by His Worshipful the Mayor of Leyton Councillor Mrs.A.M.M.Burrell.J.P., 8 dealt with the environmental health services. The results of this competition were most gratifying for young persons of school age to write about technical subjects and such broad issues as atmos pheric pollution slum clearance, housing improvements, and rodent and insect pest control reflects credit not only on the manner in which the work of the department was portrayed but also on the way the exhibits were presented by the staff in attendance. It is also desired to acknowledge once again the co operation received from various organisations and Government departments, full details of which were given in the Exhibition Guide. I reported to the July meeting of the Public Health Committee that *the Exhibition has been the best example of teamwork with which it has been my pleasure to be associated* which opinion was endorsed by the public Health Committee and the Council, vide Minute 304 "RESOLVED (a) That the Committee place on record their sincere appreciation of the valuable work and unstinted efforts of all members of the staff of the Public Health Department, and others, during the period of the Exhibition and in connection with its preparation and (b) That suitable letters of thanks be sent to all persons and organisations whose co operation and assistance helped to ensure the success of the venture". A similar recommendation was passed by the Leyton Health Area Sub Committee at their meeting in June. 1957. (22) SANITARY CIRCUMSTANCES OF THE AREA PART 1 COMMENT The employment of an adequate number of well qualified and experienced Public Health Inspectors is essential to the operation of a comprehensive sanitary service. The authorised establishment of Public Health Inspectors in Leyton allows for one Inspector for every 11 thousand inhabitants the officially recorded average for England and Wales is one Inspector for every 9 thousand inhabitants. There are however many factors other than population which have to be considered when assessing the number of Inspectors required to perform satis factorily the work of a local sanitary authority. A district containing much obsolescent property requires more intensive attention than one of the same size of more modern develop ment. As a result of the Government's direction to local sanitary authorities to resume the campaign of slum clearance and because of the additional responsibilities imposed on them by new legislation for example. Pood Hygiene Regulations. Clean Air Act, Rent Act, introduced over the past 2 years, many local authorities have been compelled to increase their estab lishments thus aggravating the national shortage of Public Health Inspectors. Urban areas such as Leyton are at a disadvantage in their bid for available technical staff owing to the fact that they are unable to offer the attraction of working conditions such as can be expected in rural or semi rural, or urban areas of more recent development. This means in effect that districts which have the highest proportion of obsolescent property domestic commercial and industrial and consequently the most acute problems in slum clearance, housing maintenance and air pollution, are having the greatest difficulty in recruitment of new staff and the retention of existing staff. At no time during the past year was Leyton able to fill 4 vacancies on the Council's establishment. The depleted staff of 4 District Inspectors (half of what is officially recorded as adequate) are fully employed dealing with complaints, applications for certificates of disrepair the training of Student Public Health Inspectors and other matters requiring urgent day to day attention, leaving little, if any time for less urgent work and special duties such as slum clearance surveys and air pollution surveys. The adverse effect of the serious staff shortage would have been considerably greater but for the fact that the Chief Public Health Inspector has undertaken a complete and systematic re organisation of this Section of the Department. It may be generally understood that the Public Health Inspector is a designated statutory officer, whose primary function is to deal with matters which require investigation and inspection outside the office, but it should be realised that to perform efficiently his statutory duties on the district, the Inspector must also carry out certain essential clerical work and office duties records correspondence, drafting of notices specifications schedules of evidence, preparation of reports etc. as well as devoting sufficient time to the study of technical literature and of the ever increasing flow of new Acts, Statutory Orders and Regulations affecting his work. He is also required by law to keep a daily record of his inspections and of the action taken by him in the execution of his duties and must be available at the office during certain times of the day for interviews with complainants and other members of the public recipients of notices etc. The administrative and procedural changes which have taken place as a result of this comprehensive re organisation have proved successful in enabling the inspectorate to expedite the legislative and clerical aspects of their work thus increasing the time available for technical duties, district inspections and field work generally. HOUSING AND NUISANCE ABATEMENT The work of the Sanitary Department in relation to housing is concerned generally with the repair demolition and closure of unfit houses, slum clearance and the issue of certifi cates of disrepair. Dwelling houses are inspected as a general routine or on complaint and statutory action taken as appropriate to secure the remedying of defects and abatement of (23) nuisances. Of these statutory duties confronting the Local Sanitary Authority none is more onerous than that of maintaining in a habitable condition existing housing accommodation, the extent of this responsibility insofar as it concerns the Public Health Inspectorate may be gathered from the fact that over the past 12 months some 15,017 inspections and re inspections were made under Public Health Acts,. Housing and Rent Acts and other legislation, 1,780 complaints regarding unsatisfactory conditions were investigated and 583 notices specifying works to remedy defects such as dampness, general disrepair, defective drainage leak ing roofs, etc., were served. In addition, pursuant to the requirements of Section 3 of the Housing Act 1957 and the Housing Consolidated Regulations, 1925/32 some 599 houses were surveyed to ascertain their fitness for human habitation having regard to the standard prescribed by the Act and the possibility or otherwise of their being included in a slum clearance scheme or dealt with by demolition or closing order procedure. Legal proceedings arising from the failure of owners to comply with the requirements of notices served under the nuisance abatement procedure of the Public Health Acts were instituted in 13 cases. Such proceedings are not, however always successful in enforcing essential repairs in one instance the Public Health Committee were obliged to operate the deferred demolition procedure as provided by Section 17 of the Housing Act, 1957 which enables the Council to purchase such houses at site value with a view to maintaining them in a tolerably habitable condition until such time as alternative accommodation is found for the occupants. The Housing Repairs and Rents Act. 1954, and other enactments relating to the control of rents and the right to retain possession of houses were amended and to some extent con solidated by the Rent Act, 1957 and the Rent Restrictions Regulations. 1957 introduced by Parliament in July of this year. The somewhat complicated procedure under the new legislation relating to the issue of certificates of disrepair and with regard to the rights and duties of the tenant and responsibility of the local sanitary authority made it necessary for the Council to set up a special enquiry bureau to assist members of the public. 194 applications for certificates of disrepair were received and dealt with by the Public Health Inspectorate during the first six months of the new Act coming into operation 177 notices (form J) of the Council's proposal to issue such certificates were served on landlords arising out of which 85 undertakings (form K) to remedy defects specified thereon within a period of 6 months were submitted by the owners and accepted by the Council. 41 new certi ficates of disrepair were issued and 48 were brought forward from the previous Act (Hous ing Repairs and Rent Act 1954). Administration of the new Rent Act has added considerably to the work of the Public Health Inspectors Section of the Department the steady flow of applications from tenants for certificates continues and at the time of preparing this report over 300 had been received and dealt with. SLUM CLEARANCE AND REDEVELOPMENT AREAS The Council's first venture in slum clearance was brought to a satisfactory conclusion when a Public Local Inquiry in respect of the Leyton Housing (Crescent Road Area) Compulsory Purchase Order, 1956 which comprised 4 clearance areas was held in the Town Hall on Tuesday 7th January 1958. The Inquiry was ordered by the Minister of Housing and Local Government to enable persons who objected to their properties being included in the Compul sory Purchase Order either on the grounds that they were not unfit for human habitation or because of other personal or business reasons, to be heard. It is now known that the Compulsory Purchase Order was confirmed by the Minister without any material modification. In this connection it was gratifying to note that the Officers' interpretation of the complex and controversial standard as to what may be considered to be a house unfit for habitation within the terms of the Housing Acts was in every case upheld by the Minister thus providing a reliable basis on which to classify houses in future slum clearance schemes. The Inquiry marked the last stage of a lengthy procedure which started in May 1955 with a detailed inspection of all houses in the areas by the Public Health Inspectorate. (24) At its meeting on 10th April, 1956, the Public Health Committee recommended the Council to declare the afore mentioned areas to be clearance areas in accordance with the provisions of section 25 of the Housing Act, 1936. (now section 42 of the 1957 Act), and referred to the Housing and Town Planning Committee the question of the steps to be taken to secure the clearance and re-development of the areas and the re-housing of persons to be displaced. At its meeting on 12th April. 1956, the Housing and Town Planning Committee supported the recommendation of the Public Health Committee and recommended the Council to make a Compulsory Purchase Order to purchase lands in the Clearance Areas and additional lands considered necessary to secure a site of convenient shape and dimensions for satis factory development. The above-mentioned recommendations were confirmed by the Council at its meeting on 26th April, 1956. Along with my official representation to the Public Health Committee in February. 1956. I submitted a report prepared jointly with the Chief Public Health Inspector on the main and material conditions existing in the Areas which led us to the conclusion that all the houses were unfit for habitation or were by reason of their bad arrangement, or the narrowness or bad arrangement of the streets, dangerous or injurious to the health of the inhabitants of the areas and that the most satisfactory method of dealing with conditions in the areas was by demolition of all the buildings. It may be of interest to recall some of the features included in that joint report and to illustrate certain of these features with photographs (please refer to photographs between pages 27 28 when reading the outline report which follows): Boundaries of the Clearance Areas and Number of Buildings The four clearance areas are bounded on the south side by Church Road the south-east side by Junction Road the north-east side by Grange and Goldsmith Roads and the north-west side by Carlisle Road. Altogether there are 136 dwelling houses (including 17 dwelling houses and shops) and 3 industrial premises. The total population of the 136 unfit houses included in the clearance areas consists of 158 families comprising 466 Persons. The average number of persons per house is 3 1. Statutory overcrowding exists at only 2 houses. Type and Description of Buildings (a) DWELLING HOUSES With the exception of 3 houses in Goldmsith Road which have basement floors in addition to ground and first floors and 3 single-storied cottages in Junction Road all the houses in the areas are two-storied with either single or two-storied back additions. All houses have through ventilation and yard space at rear. Frontages vary from 9ft. to 35ft. Pour of the houses in the area are detached and 2 are semidetached and the remainder built in terraces. The construction generally is traditional - brick walls slated or tiled pitched or central valley gutter roofs timber floors and joinery work plaster walls and ceilings. Six of the properties have no forecourts. W. C's are situated externally. Accommodation varies from 4 to 9 rooms, including sculleries. 4 houses have bathrooms. Mains water supply is provided over scullery sinks. About 50% of the houses have no halls or internal passages which means that living rooms are entered direct from the street or forecourt; staircases rise from living rooms and rooms are intercommunicating. Twenty-four houses are occupied by the owners. (25) (b) INDUSTRIAL BUILDINGS The three industrial buildings are included in the clearance areas on the grounds that they are considered dangerous or injurious to the health of the inhabitants of the area by reason of their bad arrangement in relation to adjoining dwellings. The Glass Works in Grange Road is surrounded by dwelling houses in close proximity part of the works is built into the yards at the rear of houses in Grange Road and in one instance the Factory boundary fence is as close as 3' 6". The factory also encroaches on the yard at the rear of a house in Carlisle Road. The noise and fumes from working machinery and glass furnace at this factory is a source of nuisance and annoyance to neighbouring residents. The Shoe Factory in Carlisle Road (see Plate No. 18 - page27-28) is built into and over-shadows the yard of adjoining houses; the north wall which is 30ft. high is within 13ft. of the back additions of houses in Crescent Road. This factory obstructs free admission of light and air to neighbouring dwelling houses and is a source of nuisance and annoyance to neighbouring occupants. PRINCIPAL GROUNDS OF UNFITNESS FOR HABITATION Following is a summary of the principal grounds for being satisfied that the houses coloured pink on the map are unfit for habitation. The majority of the under-mentioned defects exist in varying degrees at all houses. STABILITY .See Plate No.21 , Evidence of uneven settlement - brickwork of front and rear elevations bulged and/or fractured out of plumb and alignment brickwork courses out of level window and door openings out of square sills fractured roofs sagging floors out of level excessive vibration in floors. REPAIR - EXTERNAL Brickwork sills and copings - Perished brickwork and pointing and broken loose rendering to walls and chimney stacks. Badly weathered and defective sills and copings Paving - Sunken and fractured paving of yards and passages. Roofs Gutters - Main and back addition roofs sagging, slates and/or tiles missing displaced or defective eaves gutters and rainwater pipes perished and defective valley gutters badly constructed and leaking. Woodwork - Sagging roof timbers window and door frames decayed and/or badly worn or ill-fitting. REPAIR INTERNAL Woodwork generally - Badly worn and weak stair treads badly fitting and defective doors and window frames sashes decayed badly worn and ill fitting. Floors - Ground floor timbers decayed and/or sunken out of level and unstable, floor-boards badly worn and/or worm-infested. (26) Walls and Ceilings - Plaster loose and/or perished, scullery walls rough and unrendered. Generally - Broken and uneven solid floors defective sink waste pipes, defective and/or obsolete fire grates, defective chimney flues jambs and hearths. Freedom from damp - Dampness rising in walls due to absence of effective damp proof courses dampness penetrating walls and ceilings due to porous brickwork defective sills and window connections leaking roofs eaves gutters and rainwater pipes and valley gutters. Excessive dampness below ground floors due to absence of site concrete. Natural Lighting - Insufficient natural light in ground floor back rooms due to obstruction or overshadowing caused by close proximity of adjoining buildings badly positioned small and/or low windows and in some rooms absence of direct natural lighting altogether. Staircases passages and W. Cs. dark due to absence of windows to the external air Ventilation - Rooms without permanent means of ventilation and/or ventilation impeded by reason of decayed or defective window woodwork making sashes difficult, if not impossible to open. Inadequate ventilation to staircases and W.Cs. Water Supply - With a few exceptions the only water supply available for domestic and personal purposes is by cold water tap over scullery sinks There is general absence of fixed baths or wash- basins. In a limited number of houses the tenants have provided their own water heaters and/or washing coppers otherwise there are no facilities for domestic washing or hot water supply systems. In 18 houses the only sink and water supply is shared by more than one family. Drainage and Sanitary Conveniences - Surface drainage impeded by broken and sunken paving of yards and passages roof drainage inadequate due to insufficient rainwater pipes and/or eaves gutters At a number of houses main drainage system is defective. W.Cs. are inconveniently situated in yards and often badly sited with little, if any, privacy. In 23 houses the only available W.C. is shared by more than one family. Facilities for Storage Preparation and Cooking of Food and for the Disposal of Waste Water (See Plates Nos. 16 and 17) All houses are without food storage accommodation with ventilation to the external air. Facilities for the preparation of food are generally inadequate. Food is often prepared in cramped and unsatisfactory conditions in small congested sculleries and in the majority of houses the only water supply available for culinary purposes is over the scullery sink which, because of restricted accommodation and absence of bathrooms must also be used for other domestic requirements and for bodily cleansing. Bad Arrangement (See Plates Nos 12 13 16 17, 18 19 20 22. 23) Generally speaking the houses and other buildings in the area are badiy arranged on the site, obstructing free admission of natural light and impeding the circulation of air. The majority of the houses are badly arranged internally staircases often constitute a danger to the occupants by reason of their position construction and inadequate lighting i.e. they rise from living rooms or from dark narrow passages, entrances are obstructed by door openings stairs are steep, narrow and winding handrails are missing headroom is insufficient and rooms at head of stairs are entered from small dark landings (27) Plates Nos. 12 and 13. CRESCENT ROAD SLUM CLEARANCE AREAS Front and rear view of houses in Church Road showing general bad site arrangement and congestion. Plates Nos. 14 and 15. CRESCENT ROAD SLUM CLEARANCE AREAS Front and rear elevations of houses in Crescent Road. Plates Nos. 16 and 17. CRESCENT ROAD SLUM CLEARANCE AREAS View of houses in Crescent Road showing internal bad arrangement—note colliding doors at foot of staircase and cramped and unsatisfactory scullery with inadequate sanitary facilities. Plate No. 18. CRESCENT ROAD SLUM CLEARANCE AREAS View taken from the rear of houses in Crescent Road showing general bad site arrangement and close proximity of factory in Carlisle Road. Plate No. 19. CRESCENT ROAD SLUM CLEARANCE AREAS View taken from rear of houses in Grange Road and single storied bungalows in Junction Road—showing general bad site arrangement. Plate No. 20. CRESCENT ROAD SLUM CLEARANCE AREAS View taken from rear of houses in Crescent Road showing close proximity of back additions and general bad site arrangement. Plate No. 21. CRESCENT ROAD SLUM CLEARANCE AREAS View taken from rear of houses in Church Road—note close proximity of back additions and marked evidence of structural settlement and over-hanging brickwork. Plates Nos. 22 and 23. CRESCENT ROAD SLUM CLEARANCE AREAS Two pictures showing typical examples of internal bad arrangement of houses—note steep, narrow, winding and dangerous staircases rising from threshold of sculleries. Other typical forms of bad arrangement are living rooms entered direct from the street or forecourt rooms intercommunicating absence of passages ground floor rooms at different levels and/or below ground level low ceilings fuel storage cupboards beneath stairs and entered from living rooms doors of adjacent door openings collide when opened and room accommodation cramped and congested - in many houses floor space of living rooms does not exceed 90 sq.ft. GENERAL OBSERVATIONS All houses are between 70 and 100 years old and are out-worn to such a degree as to be beyond any material improvement short of demolition and rebuilding. They are obsolete in design badly arranged internally and/or externally deficient in amenities now regarded as essential and fall seriously short of the general standard of housing in the district. The Crescent Road Area marks the beginning of a long term programme of slum clearance and re-development in the Borough and as many years must elapse before its fulfilment it is inevitable owing to the shortage of alternative housing accommodation and the scarcity of land on which to build new houses - that a substantial proportion of the 1,500 or more houses reported to the Minister pursuant to section 1 of the Housing Repairs and Rents Act, 1954. as being unfit for habitation and liable to be dealt with under section 17 (demolition) and/or section 42 (clearance areas) of the Housing Act will have to be retained and main tained for housing purposes for many years to come. The Public Health Committee will there fore be faced for an indefinite period with the problem of enforcing essential repairs to insanitary properties. The section of this report entitled "Sanitary circumstances of the area. Part 2 Statistics" contains full details of inspections and notices served under the Housing and Public Health Acts and relevant legislation the number of houses classified as a result of inspections under the Housing Consolidated Regulations 1925/32, details of improvements affectedto dwelling houses as a result of informal and statutory action, and further information regarding the institution of legal proceedings and the administration of the Rent Act, 1957. RODENT AND INSECT PEST CONTROL Under the prevention of Damage by Pests Act, 1949 the Statutory duty of the Council in regard to rodent control is threefold to inspect the district in order to ascertain the degree of infestation by rats and mice, to destroy rodents on land of which they are the occupiers and to ensure if necessary by legal proceedings that owners and occupiers of land are taking all practicable steps for the destruction of rats and mice. It should be noted that land for this purpose includes buildings or parts of buildings. In order to meet its obligations under the Act the Local Authority must maintain an organisation ade quate to requirements for effective rodent control according to the condition of infesta tion of its area and in particular pay special attention to efficient rodent control in its sewers, refuse dumps, refuse destructors and its other public service properties. In this connection the Council's sewers were disinfested in April and October, each treatment being of four to five weeks duration and involving some 1,000 odd manholes. As a result of investigation of surface infestations by the Public Health Inspectorate it was necessary to liaise with the Borough Engineer and Surveyor in regard to the repair of drainage systems at 115 houses which had proved a souce of infestation. Some 518 complaints were received during the year concerning rodent infestation involving treatment by rodent operatives of 419 private houses and 100 business premises. The total number of visits in connection with these investigations and subsequent disinfestation amounted to 5,188. The Chairman of the Public Health Committee. Councillor P.W.Marshall, and the Chief (28) Public Health Inspector continued to be the Council's representatives on the No.8 Workable Area Committee set up by the Ministry of Agriculture, Fisheries and Food, for rodent control. The Committee, comprising some 11 neighbouring authorities meets about three times per year and apart from discussing general methods of rodent control and forms of treatment, investi gate the results of the simultaneous treatment of interconnected sewers carried out biannually by adjacent authorities. BUSINESS PREMISES In the Borough there are some 2,373 business premises, made up of factories, industrial undertakings, food premises-catering establishments, shops, etc., -involving some 3,087 activities including registration and licensing. All these premises are subject to routine inspection by the Public Health Inspectors to ensure compliance with the provisions of the Acts, Orders and Regulations controlling them, and for the welfare of those who work in them. Because of staff shortages it was not possible to maintain throughout the year a regular and systematic inspection of all business premises. Nevertheless. 2,243 inspections were carried out, 160 notices were served and 261 new registrations and/or licences were dealt with. Attention is drawn to the statistical section (Part II) which gives detailed information as to the Acts, Orders and Regulations involved and the action taken in relation there to. FOOD AND DRUGS AND SHOPS ACTS ADMINISTRATION The Council is the Food and Drugs authority for the district and the Public Health Inspectors are authorised under the Food and Drugs Act, 195-to procure samples of food and drugs for chemical analysis or for bacteriological or other examinations. 138 samples of a variety of food and drugs was submitted to the Public Analyst for chemical analysis. 14 adverse reports were received and reported to the Public Health Committee, these related to 6 informal samples and 8 formal samples. Of the 6 unsatisfactory reports received in respect of informal samples, 3 were followed by formal samples which proved to be satis factory, in 2 cases no further action was required and in the remaining case a further formal sample proved to be unsatisfactory and representations were made to the manufacturers concerned. In respect of the reports received concerning the 8 formal samples, in 2 cases the Committee considered no further action was justified, and in the remaining cases, 2 of which concerned oranges contaminated with thiourea and 2 samples of hot milk obtained from a common supplier, representations were made to the Ministry of Agriculture. Fisheries and Food and the proprietors concerned respectively. MEAT AND FOOD CONDEMNED The statistics table in Part II (Page 33 ) gives information as to foodstuffs in respect of which condemnation certificates were issued as a result of routine inspection of food premises. In addition 16 complaints regarding unsound and/or adulterated food were investigated by the Public Health Inspectors and reported to the Public Health Committee. In four cases the Committee authorised legal proceedings (details of which are also given in the Statistical Section) in 7 instances the Committee resolved to send warning letters to the retailers and/or manufacturers concerned the remaining 5 cases were noted with a resolve for no further action. FOOD HYGIENE The campaign for cleaner food continues to receive special attention. The new provis ions contained in the Food Hygiene Regulations for securing observance of sanitary and hygienic practices in the food trades, which came into force in January and July last year (29) made it necessary, in order to ensure uniformity in applying the new standards for the Public Health Inspectorate to undertake a detailed survey of 1500 odd premises in the Borough, comprising shops, factories, catering establishments, clubs, schools, staff and factory canteens, stalls, etc., where food is prepared, stored, handled, transported or sold. In spite of staff difficulties, every effort has been made to continue with this survey. Of the 2,250 visits to food premises made by Public Health Inspectorate during the year, 298 were detailed inspections recorded on inspection cards specially designed and introduced for the purpose and 160 notices in relation to contraventions of the Regulations regarding provision of separate facilities for hand washing and for washing of food and equipment, provision of hot and cold water. first aid kit. locker accommodation construction and maintenance, etc., were served. Although substantial progress has been made, the Chief Public Health Inspector was obliged to report to the Public Health Committee in November of this year that because the depleted staff of Public Health Inspectors were almost fully employed on dealing with com plaints applications for certificates of disrepair and other matters which brook no delay, the detailed survey of food premises had been seriously curtailed. The Committee were informed that, in order to appreciate fully the implications of this situation insofar as the administration of the Food Hygiene Regulations is concerned, it is necessary to take into account the fact that the survey had so far resulted in the detailed inspection of some 642 premises, and since its success in the terms of improvements effected as a result of full compliance with notices served must depend largely on the ability of the staff to carry out re inspections on a systematic basis, it means in effect that our requirements are to some extent being nullified by lack of appropriate enforcement action. The practical application of the new standards to the wide variety of food premises has presented some difficulty, especially where business and domestic activities are com bined. The occupier of a small shop may apply to the local authority for a certificate exempting his premises from certain requirements because of restricted accommodation or other special circumstances. No such applications have so far been received. Taken by and large, food traders in the Borough have responded well in complying with the statutory requirements, but it should be realised that the Pood Hygiene Regulations are not wholly concerned with premises, apparatus and equipment., they also lay down requirements in respect of the cleanliness of persons engaged in the handling of food and of their clothing and habits. Routine visits to the Council"s Pleasure Ground Lea Bridge Road, were made by Public Health Inspectors during Easter. Whitsun and August Fairs. Food hawkers" stalls mobile canteens, etc. were inspected and registrations checked. It is pleasing to report general improvement in the standard of hygiene practised by food vendors. It appears that inspec tions of the Pleasure Ground during Bank Holiday Fairs over the past years have had the desired effect, both in regard to ensuring that all food vendors are registered with the Council, and that trading is conducted in a hygienic manner. Attention is drawn to the statistical section of the report which gives details in tabular form of premises and businesses registered and/or licensed under the Food and Drugs Act. 1955, and associated legislation. Full details are also given of inspections, notices, legal proceedings and improvements effected to business premises as a result of action taken by the Department. DISEASES OF ANIMALS ACTS AND ORDERS The administration of the law relating to diseases of animals is carried out partly (30) by officers of the Ministry of Agriculture, Fisheries and Pood and partly by officers of County Councils and local sanitary authorities. In Leyton, Public Health Inspectors are the authorised officers under the various Acts and Orders. The Diseases of Animals Acts and Orders deal generally with the prevention and control of outbreaks of scheduled diseases and protection of animals against unnecessary suffering and in this connection 141 inspections were carried out during the year. ATMOSPHERIC POLLUTION The functions and responsibilities of the Public Health Committee in relation to air pollution and smoke abatement are extended by the Clean Air Act; the provisions now in force deal inter alia with the establishment of smoke control areas. Whereas the Clean Air Act places the responsibility of enforcing its main provisions on Local Authorities in their areas, smoke has no boundaries and the nature of the problem prompted the Public Health Committee to advise the Council to convene a joint conference of Local Authorities for the purpose of discussing matters of common interest in regard to air pollution and to give preliminary consideration to the possibility of joint action in regard to any proposals for the creation of smoke controlled areas which might involve more than one Authority. The Committee also had in mind a suggestion made by the Minister of Housing and Local Govern ment in a memorandum on Smoke Control Areas in which he stated that it was highly desir able that Local Authorities should keep one another informed about their smoke control programmes and co-ordinate as much as possible. The Council confirmed the Committees proposals and a joint conference of Local Author ities was duly held in the Council Chamber at Leyton Town Hall on Thursday. 24th October, under the Chairmanship of the Mayor (Councillor Mrs.A.M.M. Burrell, J P.), It was attended by representatives of the Ministry of Housing and Local Government, the London and Home Counties Smoke Abatement Advisory Council and the following Local Authorities- Barking. Dagenham. East Ham, Hackney, Ilford, Leyton, Poplar, Walthamstow. Wanstead & Woodford West Ham, and Woolwich. Councillor F.W.Marshall (Chairman of Leyton's Public Health Committee), in an opening statement, said that the nature of the problems connected with the campaign for clean air made it imperative that local authorities should get together to exchange information and discuss the common problems arising from the administration of the Clean Air Act. The present Conference was to be informal and purely exploratory, he said, and it was not expected or intended that any fixed decisions would be made at this juncture. Councillor Marshall outlined the action so far taken by his Council in regard to air pollution, men tioning the various forms of publicity which had been adopted including the recent Leyton Borough Public Health Exhibition; the measurement of atmospheric pollution in co operation with the Department of Scientific and Industrial Research; representations to local indus trial and utility undertakings in regard to complaints about air pollution from these sources, and the provision of lectures and film shows. He also referred to a proposal that the Council's "all-electric" Crescent Road Redevelopment Area should form the nucleus of Leyton's first smoke control area. From this small beginning it was hoped to expand the area over which smoke would be controlled. The remainder of the proceedings mainly took the form of statements from represent atives about their Council's proposals for implementing the provision of the Act. and the action they had already taken in the campaign for clean air. Doubts were expressed about availability of solid smokeless fuels in sufficient quantity; but the representatives were informed that both the Government and the manufacturers had this aspect well in mind and had made good progress with their plans for meeting the anticipated increased demand. It was agreed that all possible publicity should be given, and that the public must be encouraged to accept that the major cause of atmospheric pollution was the domestic fire. (31) Many householders had already installed smokeless fuel appliances in their homes; but the high cost of smokeless fuels, as compared with coal, resulted in complaints and prejudice. It was still not realised by many people that the heating value of coke and other smoke less fuel was greatly superior to that of ordinary coal . so that less was used for a given amount of heat. Their use also brought certain other advantages. Some representatives advocated the greater use of electricity. They said this was the real key to the problem. In connection with smoke control areas, reference was made to the high cost of the conversion and adaptation of existing fireplaces, but the representatives were reminded that Government grants were available which would substantially reduce the burden on house holders. Two of the representatives advised caution in local authorities' approach to the problem, but Councillor Marshall (Leyton), in summing up the discussion, advocated persistence in this matter in view of the high cost of air pollution in terms of money and human lives and suffering. He said that Leyton would go ahead and play their full part in the campaign for clean air. It was decided to convene another session of the Conference in October, 1958 when it was proposed that the representatives should report progress and that the various prob lems involved be given more detailed consideration in the light of further experience of the working of the Act. A vote of thanks to the Leyton Corporation for convening and arranging the conference was proposed by Councillor S.J.Relph (Wanstead & Woodford), seconded by Mr.H.G.Clinch (London and Home Counties Smoke Abatement Advisory Council) and passed unanimously. The Chairman of the Public Health Committee, Councillor F.W.Marshall, and the Chief Public Health Inspector are the Council's representatives on the London and Home Counties Smoke Abatement Advisory Council and the Standing Conference of Co operative Bodies set up by the Department of Scientific and Industrial Research with which Leyton is co-operating in the investigation of atmospheric pollution. Daily observations continued throughout the year. The recording apparatus operated by the Public Health Inspectors is situated in the offices in Sidmouth Road, a summary of these observations is reported to the Public Health Committee quarterly. The tables which follow show the results recorded during the 12 months ended March, 1958, divided into summer and winter periods. The average results for the 7year period ended March, 1957, are also shown for comparison. Concentration of smoke is expressed in milligrams per 100 cubic metres and sulphur dioxide in parts per 100 million. The average concentration of smoke for the year ended 31st March. 1958. was 22.2 milligrams per 100 cubic metres, compared with 21.3 milligrams for the previous seven years an increase of 4.2% whilst the concentration of sulphur dioxide for the same period was 7.6 parts per 100 million, compared with 6.8 parts for the previous seven years - an increase of 11.8%. The practical measures taken by Public Health Inspectors to mitigate pollution of the atmosphere by smoke and grit include the taking of smoke observations of factory chimneys; inspection of boiler installations advice to boiler operatives on proper use of fuel and methods of stoking, and discussions with managerial staff 99 such investigations were carried out during the year. HEALTH EDUCATION The year under review was an important one in the field of health education, for it marked the opening of the first comprehensive Public Health Exhibition dealing with all aspects of health services to be held in Leyton for 25 years it was held in the Town Hall for one week, commencing May 27th. A full report on the "Borough of Leyton Public Health (32) Exhibition" with supplementary photographs appearing on other pages. It was of course imposs ible within the confines of an exhibition hall to have on display all aspects of the manifold duties and responsibilities of the Local Sanitary Authority in relation to the control of the Environmental Health Services but it is hoped that the subjects which were featured, namely- Clean Air, Clean Food, Rodent and Insect Pest Control, Housing Improvements and Conversions, Slum Clearance, Diary of a Public Health Inspector. Home Safety, etc., were portrayed in such a manner and in such detail as to stimulate the civic interest of the rate-payers and others in the work of the Public Health Department, and to give some indi cation of the problems confronting the Council; how such problems affect the community at large and to what extent the individual can play his part towards better environmental conditions and communal relationship. Just how far we were successful in achieving our objective is of course difficult to say but judging from the large number of people who visited the Exhibition, the measure of support received from members of the Council and from various organisations in the Borough, and the favourable comments made in the local and national press there is good reason to believe that we were at least successful in capturing the interest of a large section of the community. We would very much like to think that the following comment made by a school girl in a prize winning essay about the Exhibition is typical of what most people who visited the Exhibition would have said had they been asked: "From this fine and well organised exhibition I learnt more about how Leyton*s public health service is run. I did not realise how much energy and expense is put in to this service for the benefit of Leyton residents. I can now say that Leyton is doing an excellent and worthwhile job for the welfare of her residents. That afternoon proved not only practical, but very enjoyable." Many verbal and written tributes to the undoubted success of the Exhibition were in fact received from various quarters. During the year the Medical Officer of Health and the Chief Public Health Inspector gave several health education talks to various organisations. Health education is not however concerned solely with public exhibitions, lectures to organised groups of people, etc. Health education forms a valuable and important part of a Public Health Inspector's routine day to day work on the district, he performs his statutory duties as a designated officer under the various Acts Statutory Orders and Regulations introduced by Parliament to protect the health and welfare of the community and to promote satisfactory environmental conditions, by constant investigations, by per suasion and by educational methods. In the cause of clean air. clean and safe food and the betterment of environmental conditions in houses, shops, factories work shops, places of public entertainment, etc., and in the promotion of congenial communal relationship he is continually practising health education in a personal and practical way by giving advice and instruction on the spot-it is only as a last resort that he uses his statutory powers by way of legal enforcement. SANITARY CIRCUMSTANCES OF THE AREA- PART II-STATISTICS Reference has been made in the preceding paragraphs to the following tables and charts giving details in tabular form of the action taken and visits made by the Public Health Inspectorate pursuaht to their statutory duties and responsibilities. (33) 1. INSPECTIONS, RE-INSPECTIONS, ACTION (a) GENERAL STATUTORY PROVISIONS COMPLAINTS RECEIVED INSPECTIONS AND RE-INSPECTIONS INFORMAL NOTICES SERVED FORMAL NOTICES SERVED NOTICES COMPLIED WITH BY OWNER NOTICES COMPLIED WITH BY LOCAL AUTHORITY HOUSES CLASSIFIED No. OF SEPARATE LETTINGS AFFECTED No. OF FAMILIES IN OCCUPATION FAMILIES WITHOUT SEPARATE W C SEPARATE WATER SUPPLY Housing Acts 1936/57 121 825 - 15 7 - 599 - - - - Housing Repairs and Rents Act, 1954 5 28 - - - - - - - - - Public Health Acts, 1936 986 9460 580 235 642 115 - 540 665 181 22 Prevention of Damage by Pests Act 1949 518 1282 3 - 4 - - - - - - Pood and Drugs Act, 1955 28 2243 160 25 192 - - - - - - Shops Act 1950 15 319 1 - - - - - - - - Essex County Council Act, 1952 2 129 - - - - - - - - - Leyton Corporation Act, 1950 - 71 2 - - - - - - - - Factories Act, 1937/48 30 242 - 6 2 - - - - - - Pet Animals Act, 1951 1 30 - - - - - - - - - Rag Flock and Other Filling Materials Act 1951 - 6 - - - - - - - - - Rent Act 1957 150 241 - - - - - - - - - Diseases of Animals Acts - 141 - - 1 - - - - - - (34) (b) DETAILED (i) Housing Act, 1957 (Sections 17/18) Housing Repairs and Rents Act. 1954 (Section 3) 1 house was dealt with under the deferred demolition procedure of the Housing Act, 1957. (ii) Housing Repairs and Rents Act, 1954, Rent Act, 1957. The under-mentioned returns required by the Ministry of Housing and Local Government give details of action taken as a result of applications received under: (a) Section 26(i) of Part II, Housing Repairs and Rents Act. 1954. Number of Applications for Certificates of Disrepair Number Granted Number Refused Number of Applications for Revocation of Certificates of Disrepair Number Granted Number Refused Dwelling-houses which have been the subject of a notice of repairs increase of rent under Part II of the 1954 Act. 5 3 2 - - - (iii) RENT ACT, 1957. (b) Paragraph 4 of the First Schedule, Rent Act, 1957. Applications for certificates received 194° Decisions not to issue certificates Nil Decisions to issue certificates 177 Undertakings given by landlords under paragraph 5 of the First Schedule 85 Undertakings refused by local authority under proviso to paragraph 5 of the First Schedule Nil Certificates issued 41 Applications by landlords for cancellation 4 Objections by tenants to cancellation 1 Decisions by local authority to cancel in spite of objection Nil Certificates cancelled by local authority 1 *17 of these applications were not dealt with owing to their being withdrawn or invalid. (35) (iv) FOOD AND DRUGS ACT. 1955 (INSPECTION AND SUPERVISION OF FOOD PREMISES). The following inspections were carried out at the undermentioned food premises in accordance with the requirements of the Public Health Act, 1936, Food and Drugs Act, 1955 and Food Hygiene Regulations, 1955, Ice Cream (Heat Treatment Reg.), 1947/52, Shops Act, 1950, Factories Act, 1937, Leyton Corporation Act, 1950, Essex County Council Act, 1952, and relevant legislation. Type of Premises Insp. Det. Surv. Insp. Routine Total Number of Inspections Bakehouses 13 43 56 Bakers 22 29 51 Butchers 8 230 238 Catering Establishments 19 265 284 Confectioners 67 136 203 Corn Chandler 1 - 1 Dairies and Distributors of Milk 2 16 18 Factories - 35 35 Factory Canteens 7 19 26 Fish Friers 8 29 37 Fishmongers 11 45 56 Game Dealers 4 6 10 Greengrocers 19 123 142 Horse-flesh Dealers - - - Ice-Cream places 4 57 61 Itinerant Food Dealers Stalls and Vehicles 15 114 129 Food Storage Accommodation Local Authority Canteen 3 5 8 Meat Depots - 8 8 Miscellaneous 2 222 224 Multiple Stores 1 9 10 Off Licences 20 32 52 Provision Shops 67 366 433 Public Houses 2 30 32 School Canteens 3 19 22 Shell-fish Vendors - 7 7 Slaughterhouses (Poultry) - 103 103 Street Markets - 4 4 TOTAL INSPECTIONS 298 1952 2250 (v) INSPECTION OF BUSINESS PREMISES OTHER THAN FOOD PREMISES. Inspections were carried out at the undermentioned business premises having regard to the requirements of the Public Health Act, 1936, the Shops Act. 1950; the Factories Act, 1937; the Pet Animals Act, 1951; the Rag, Flock and Other Filling Materials Act, 1951 the Diseases of Animals Acts and Orders, the Leyton Corporation Act. 1950 and the relevant legislation. (36) Type of Premises Insp. Det. Surv. Insp. Routine Total Inspection Clubs Factories with Mechanical Power Factories without Mechanical Power Fairgrounds Hairdressers and Barbers Local Authority Properties Miscellaneous Shops, etc. Nursing Homes Outworkers Pet Animals Shops Public Conveniences Rag Flock Retail Shops Schools Stables Workplaces - - - - 3 1 - - 2 4 1 - 1 222 20 7 61 30 50 3 114 29 38 6 51 7 1 1 1 222 20 7 64 30 50 3 114 30 38 6 53 11 2 1 TOTAL INSPECTIONS 11 641 652 (vi) FACTORIES ACTS, 1937/48 The following is an extract from a Statutory Return made annually to the Ministry of Health under the provisions of Part I of the above Acts. Premises Number on Register NUMBER OF Inspections Written Notices Occupiers Prosecuted (i) Factories in which Sections 1 2, 3, 4 and 6 are to be enforced by Local Authorities 59 20 - - (ii), Factories not included in (i) in which Section 7 is enforced by the Local Authority 392 222 6 1 (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers premises) - - - - TOTAL 451 242 6 1 (37) vii) PREVENTION OP DAMAGE BY PESTS ACT, 1949 - RODENT CONTROL DISINFECTION Rats Mice Total Complaints received 370 148 518 Enquiries and visits made:- By Rodent Operatives 2827 1079 3906 By Public Health Inspectors 1211 71 1282 Premises treated individually:- Dwelling Houses 316 103 419 Business/industrial Premises 53 47 100 Premises re-treated:- Dwelling Houses 8 - 8 Business/industrial Premises 7 1 8 Number of rooms treated - - 244 Number of sites/tips treated - - 32 2. NUISANCES ABATED, DEFECTS REMEDIED, IMPROVEMENTS EFFECTED (i) PUBLIC HEALTH ACTS Nature of work carried out to dwelling houses and other premises:- Cement Work to sink waste gullies repaired 21 Choked drains cleared 32 Dampness remedied 333 *Drains relaid or partly relaid 164 Floors repaired 84 Guttering repaired or renewed 100 Miscellaneous defects remedied 287 New W.C. pans and traps provided 28 Plaster repaired 308 Rainwater pipes repaired or renewed 38 Roofs repaired or renewed 212 Rooms redecorated 39 Sashcords renewed 116 Sinks provided 8 Sink waste pipes repaired or renewed 20 Stoves repaired or renewed 23 Vent pipes repaired or renewed 13 W.C. Cisterns repaired or renewed 37 Window sills, etc. repaired 103 Yards paved 17 *In 115 cases the public sewer was involved, the work carried out on behalf of the owners by the Council under the supervision of the Borough Engineer and Surveyor, the expenses incurred thereby being recovered from the owners. (ii) FOOD AND DRUGS ACTS/FOOD HYGIENE REGULATIONS/SHOPS ACT Nature of contraventions remedied and improvements effected to food establishments, business/industrial premises as a result of statutory and informal action„ Walls/Doors/Windows not kept clean or repaired 168 Ceiling not kept clean or repaired 117 Floor not kept clean or repaired 62 Inadequate ventilation 16 Inadequate lighting 5 Inadequate receptacles for refuse 17 Accumulation of refuse in room 10 Personal cleanliness 4 Cleanliness of apparatus and fittings 28 Facilities for personal cleansing and/or washing food and equipment inadequate, i. e: Wash-basins 38 Hot water 70 Soap/towels/nail-brush 31 Sinks 11 Food not protected from contamination 38 First-aid equipment 30 Wash-hand notice 47 Artificial light in W. C. 27 Inadequate W. C. accommodation 4 Inadequate locker (clothing) accommodation 17 Yard paving defective 5 Name and address not displayed 6 Roof defective 2 General defects 5 (iii) FACTORIES ACTS The under-mentioned details were submitted to the Ministry of Health in accordance with the provisions of Part I of the above Act- Nature of Contravention Number of factories in which defects were found Found Remedied Want of cleanliness 3 1 Sanitary Conveniences (S. ) (a) Insufficient 1 - (b) Unsuitable or defective 1 1 Other offences against the Act (not including offences relating to Outwork) 7 5 TOTAL 12 7 (39) 3. REGISTRATION AND/OR LICENSING OF BUSINESS PREMISES (i) APPROXIMATE NUMBERS OF BUSINESS PREMISES IN THE BOROUGH AND FUNCTIONS INVOLVED. NATURE OP TRADE/BUSINESS CARRIED ON No. of Premises ADDITIONAL LICENCES, REGISTRATIONS AND OTHER FUNCTIONS INVOLVED 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Ice-Cream Milk Preserved Food Shell Fish Power Factory Non-Power Factory Catering Off-Licence Bakehouse Confectionery Fish Frier Grocer Barber With Storage Poultry Slaughterhouse Hairdressing A. Baker 42 - - - - 28 - 1 - 28 2 - - - - - - B. Butcher 76 - - 46 - 5 - - - - - - 4 - - 1 - C. Catering 103 54 1 - - - - - - - - - - - - - - D. Confectionery 147 55 - - - - - - - - - - - - - - - E. Pish 47 - - - 16 - - 10 - - - 29 - - - - - P. Greengrocer 80 1 - - - - - - - - - - 3 - - - - G. Grocer 205 51 89 1 - 2 - - - - - - - - - - - H. Multiple Store 5 3 - - - - - 2 - - - - 3 - - - 1 I. Milk 12 1 - - - - - - - - - - 2 - - - - J. Ice-Cream 113 - - - - - - - - - - - - - - - - K. Rag Plock 9 - - - - 7 2 - - - - - - - - - - L. Pet Animals 14 - - - - - - - - - - - 1 - - - - M. Hairdresser 95 - - - - - - - - - - - - 44 - - - N. Hawker 113 - - - - - - - - - - - - - 54 - - O. Public House 35 - - - - - - 10 32 - - - - - - - - P. Off Licence 45 4 3 - - - - - - - - - 2 - - - - Q. Factory 454 - - - - - 58 36 - - - - - - - - - R. School 18 1 - - - - - 17 - - - - - - - - - S. Council Property 4 2 - - - - - 2 - - - - - - - - - T. Hospital 2 - - - - - - 2 - - - - - - - - - U. Miscellaneous Shops 754 - - - - - - - - - - - - - - - - TOTAL PREMISES: 2,373 TOTALS: ADDITIONAL FUNCTIONS 714 172 93 47 16 40 60 80 32 28 2 29 15 44 54 1 1 (40) (ii) DETAILS OF REGISTRATIONS/LICENCES ACT OR REGULATION On Register 31 12,1956 Removed during 1957 Registered during 1957 On Register 31 12 1957 Pood and Drugs Act, 1955 S. 16 Ice-Cream Premises 286 12 11 285 S. 16 Butcher's Premises 47 - - 47 Milk and Dairies Regs., 1949 Distributors 96 1 10 105 Milk (Special Designations) Regs. (Annual Licences) Sterilised 105 - 104 104 Sterilised - supplementary 7 - 8 8 Pasteurised 62 - 51 51 Pasteurised - supplementary 5 - 6 6 Tuberculin tested 17 - 22 22 Tuberculin tested - supplementary 6 - 6 6 Essex County Council Act, 1952 Hawkers of Pood 104 - 9 113 Hawkers Premises 54 - - 54 Leyton Corporation Act, 1950 - S. 63 Vendors of Shell Pish 13 - 3 16 S. 48 Hairdressers and Barbers 80 - 15 95 Pet Animals Act, 1951 (Annual Licences) Pet Shops 14 1 16 16 Rag Flock and Other Filling Materials Act, 1951 Registration of Premises 9 - - 9 TOTAL 905 14 261 937 4. LEGAL PROCEEDINGS (i) PUBLIC HEALTH ACT Resulting from the 235 statutory notices served on owners under the nuisance ment procedure of the Public Health Act, 1936, in thirteen instances it was necessary to (41) institute legal proceedings to secure compliance therewith. The results of such action are given hereunder. Date of Hearing Nature of offence and address of premises concerned Result of Court Proceedings 2. 1.1957 Statutory nuisance - 45 Poppleton Road, E. 11. Abatement Order, 28 days. £2.2s. costs 10. 4.1957 Statutory nuisance - 21 (lower) Stanley Road, E. 10. Abatement Order, 28 days. £2 2s. costs 10. 4.1957 Offence under Byelaw 36 of Leyton Good Rule and Government Byelaws. Defendant fined 20/= 12 6.1957 Exchange of articles for Old Clothes and Rags. Defendant fined 20/- 12. 6 1957 Statutory nuisance - 19 Stanley Road, E. 10. Daily penalty of 10/Total £87. 13 2.1957 Statutory nuisance - 20 Ivy Roadr E. 17. Abatement Order, 28 days. £2 2s. costs 12 6 1957 Statutory nuisance - 20 Ivy Road, E. 17. Failure to comply with Order, £5. 18. 9 1957 Statutory nuisance - 11 Avenue Road, E. 11. Abatement Order, 28 days. £1 Is. costs 18. 9. 1957 Statutory nuisance - 17 Avenue Road, E. 11. Abatement Order, 28 days. £1 Is. costs 26. 9. 1957 Statutory nuisance - 19 Stanley Road, E. 10. Appeal dismissed. £10 10s. costs. 1 10. 1957 Statutory nuisance - 21 (lower) Stanley Road E.10. Defendant fined £3. 2.10 1957 Statutory nuisance - 3 Avenue Road. E.11. Abatement Order. 28 days. £1 Is. costs 2 10 1957 Statutory nuisance - 5 Avenue Road, E.11. Abatement Order 28 days. £1 is. costs 13.10 1957 Statutory nuisance - 11 Lynton Road, E.11. Defendant fined £2. 27 11 1957 Statutory nuisance - 143 Crownfield Road, E.15. Abatement Order 28 days. £2.2s. costs (ii) FOOD AND DRUGS ACT AND RELATIVE LEGISLATION Legal proceedings were instituted in seven instances (involving 22 summonses) under the provisions of the Food and Drugs Act and relative legislation. The following are the results of such action. Date of Hearing Nature of Contravention Result of Court Proceedings * 13.3.1957 Cockroach in bread Proprietor fined £5 5s. 27.3.1957 Smoking in food premises Defendant fined £5. 11.9.1957 Dirty milk bottle Company fined £5. £2 2s. costs 2.10.1957 Food Hygiene Regs. Butchers premises Dismissed 22.5.1957 Glass in sweets Wholesalers fined £10. 14.8.1957 Glass in bread Fined £5 and £2 2s. costs. Plus 10/- witness expenses 12.2.1958 Razor blade in mince tart Defendant fined £20. * This case brought forward from 1956. (42) 5. HEAT AND FOOD CONDEMNED Condemnation certificates were issued in respect of the under-mentioned unsound foodstuffs surrendered by various traders in the Borough as result of routine inspection of food premises. The food condemned was destroyed by fire at the Council's Destructor Works. Commodity Cwts Qrs. Lbs. Commodity Units Meat 6 3 20 Chickens 228 Pish 3 1 13 Turkeys 8 Sausages 1 8 Heart 1 Offal 1 0 18 Lamb 1 Ham - - 22 Milk 185 tins Bacon - 3 4 Luncheon meat 299 " Cooked meat - - 20 Soup 35 " Cheese - 2 3 Vegetables 168 " Raisins - 3 16 Fruit 374 " Prunes - - 12 Pish 55 " Ham 24 " Cauliflower 1 cask Orange drink 20 pkts. Mussels 1 bag 6. SAMPLING (a) FOOD AND DRUGS ACT, 1955 (i) CHEMICAL ANALYSIS Commodity Taken Satisfactory Unsatisfactory Milk 18 15 3 Ice Cream 6 5 1 Ice Lollies 3 3 - Miscellaneous 111 101 10 TOTAL 138 124 14 (ii) BACTERIOLOGICAL EXAMINATION Commodity Taken Grade I II III IV Ice Cream 10 7 3 - - Ice Lollies 3 - - - - Water 21 - - - - Miscellaneous 6 - - - - TOTAL 40 7 3 - - (43) 7. ATMOSPHERIC POLLUTION (i) SMOKE ABATEMENT 99 observations were made as to quantities of smoke emitted from chimneys of industrial and commercial premises. Written intimations were sent to the managements of a number of business undertakings regarding excessive smoke and grit emission. (ii) DAILY RECORDS The following tables show the results recorded during the twelve months ended March. 1958 divided into "Summer" and "Winter" periods. The average results for the 7-year period ended March, 1957 are also shown for comparison. CONCENTRATION OF SMOKE EXPRESSED IN MILLIGRAMS PER 100 CUBIC METRES MONTH MONTHLY AVERAGE HIGHEST DAILY AVERAGE LOWEST DAILY AVERAGE 1950/57 1957/58 1950/57 1957/58 1950/57 1957/58 April 17.4 20.4 40.2 54.1 7.2 9.3 May 8.0 9.2 21.9 15.8 2.5 2.9 June 4.6 5.8 9.3 13.2 1.2 1.0 July 3.8 5.5 8.3 11.2 1.1 2.1 August 5.2 6.6 9.3 15.6 2.6 1.1 September 7.7 8.9 17.9 19.5 2.8 4.1 SUMMER AVERAGE 7.8 9.4 17.8 21.6 2.9 3.4 October 24.9 24.7 78.9 52.6 6.5 9.5 November 37.8 35.5 100.8 83.0 12.1 13.4 December 43.0 56.8 120.8 234.3 12.4 9.9 January 38.9 38.3 110.0 94.3 14.0 12.1 February 36.0 26.0 78.2 47.5 16.1 10.3 March 28.8 29.2 83.3 61.5 11.3 14.9 WINTER AVERAGE 34.9 35.1 95.3 95.5 12.1 11.7 CONCENTRATION OF SULPHUR DIOXIDE EXPRESSED AS PARTS 100 PER MILLION MONTH MONTHLY AVERAGE HIGHEST DAILY AVERAGE LOWEST DAILY AVERAGE 1950/57 1957/58 1950/57 1957/58 1950/57 1957/58 April 5.7 5.7 13.6 18.3 2.0 2.4 May 3.0 4.2 6.4 8.3 1.2 1.0 June 2.5 3.2 4.8 6.2 1.0 0.8 July 2.2 3.0 4.5 5.0 0.7 1.7 August 2.8 3.4 4.8 7.0 1.2 0.4 September 3.7 4.2 7.5 8.1 1.6 2.4 SUMMER AVERAGE 3.3 4.0 6.9 8.8 1.3 1.5 October 7.7 9.0 17.9 15.7 3.1 4.4 November 11.3 10.1 25.9 20.0 4.9 4.8 December 12.9 17.2 32.4 75.4 4.4 3.8 January 11.4 12.9 31.9 30.6 5.1 5.3 February 10.3 9.3 23.7 16.1 5.0 5.8 March 8.2 9.3 17.9 20.9 3.3 4.9 WINTER AVERAGE 10.3 11.3 25.0 29.8 4.3 4.8 (44) NATIONAL HEALTH SERVICE ACT, (PART III) SERVICES The Local Health Authority have delegated most of the Part III Services to the Leyton Health Area Sub-Committee. The Chairman, Alderman Mrs. J. Hammond, O.B.E.. J.P., is also Chairman of the Borough of Leyton Welfare Services Committee and, in consequence, there is a close liaison between the two Committees, especially with regard to the welfare of the aged. The three Health Services Clinics are fully used and the disposition of the foot clinics there has proved beneficial both to the persons who avail themselves of the service and the chiropody staff. A scheme for the extension of Granleigh Road Clinic awaits the decision of the Minister. There was an increase, compared to the previous year, of first-attenders at the Antenatal Clinics, and a 10% increase in the overall attendances at the Child Welfare Clinics; the greatest increase being at Granleigh Road Clinic. At Leyton Green Clinic there was a slight decrease in the attendances. Ante-natal relaxation classes were held at all clinics. The Mothers' Club at Leyton Green Clinic continues and in fact, goes from strength to strength. Some good lecturers were obtained and at both educational and social evenings attendances were good. Dental treatment for expectant and nursing mothers, and children under five years of age. continued during the year. Even if little treatment is necessary the service grants the opportunity to meet and induce confidence in the pre-school child. It is found that the earlier the age at which a child meets the dental staff the more he will tend to regard them as friends. The "take up" of welfare foods shows a steady decline which does not "tie up" with the increase in clinic attendances. However, the decline is not confined to Leyton clinics but appertains all over the country. The two day nurseries have been fully occupied during the year, in fact, there is (45) generally a waiting list for admissions. More medico-social cases have been admitted ana the day nurseries are taking a part in preventive medicine. Fewer recommendations for convalescence for mothers and children have been received during the year. It is pleasing to be able to record the drop in the infant and neo-natal mortality rates. The number of home confinements varies by only one from the figure for last year. Approximately 80% of the births take place in adjacent maternity hospitals. The home nurse midwives still have difficulty in arranging the practical domiciliary training that is necessary for the pupil midwives. There have been staffing difficulties in the Health Visiting Service during the year and at no time had we a full establishment. A number of advertisements in the Nursing Press brought no applications and it would appear that it is difficult to recruit staff in an area such as this without the extra inducements of housing and provision of cars which appertain in some areas. The visiting of the elderly (and there are almost a thousand in this category who are on the Register and receiving regular visits) takes up a considerable amount of time of the health visitors. Visits of this nature are more time consuming than visits to mothers and their children as old people like to talk and indulge in reminiscences and, in fact they are loathe to let the visitor depart as many of them are "victims of loneliness". The Home Nurses continue to carry out their excellent work and the co-operation that exists between them and the medical and nursing staff of the Department is exemplary. Compared to last year there is a 100% increase in the number of primary vaccinations against smallpox and 500% increase in the number of re vaccinations. This was due to the outbreaks of smallpox in neighbouring boroughs in the middle of the year. The decrease in the numbers immunised against diphtheria is regrettable as only by a high rate of immunisation can the disease be really controlled. The figures for 1957 show that half as many children were immunised by general practitioners and 20% fewer by the County Council staff than in the previous year. Both medical and nursing staff are unremitting in their propaganda for immunisation however, as so many of the present day mothers have not seen a case of diphtheria or have never heard of deaths from the disease they are indifferent to this valuable preventive measure. "Booster" doses were also fewer five times in respect of immunisation by general medical practitioners and 20% in respect of the County Council's medical staff. Vaccination against poliomyelitis during 1957 was carried out as far as supplies of vaccine allowed. I am indebted to the County Medical Officer of Health for the statistics relating to the Ambulance Service, and I record my appreciation of the co operation that exists with the staff attached to the local Ambulance Station. The figures of attendances at the three foot clinics show a small increase on the previous year. The 'waiting' time for treatment varies from clinic to clinic, however, overall it is between 11 - 13 weeks. I can see no chance of improvement in this period of time between treatments owing to the staff difficulties and accommodation together with the problem of an increase in foot conditions with an ageing population. (46) The loan of sickroom equipment continues to meet the needs of those patients being nursed at home. There is always a waiting list for invalid chairs; however, every attempt is made to assist people in the occasional visit to friends and shops. The Leyton, Wanstead and Woodford Tuberculosis Care Association have continued to make good progress during the year and many tuberculous patients have testified regarding the help they have received from the Association during times of financial hardship. Last year I submitted a comprehensive report on the Domestic Help Service. During the year there has been a negligible increase in the number of hours worked by the helps and only by constant surveillance of the amount of time allocated has the average yearly increase been reduced. This is an extremely valuable service and the many letters of appreciation received confirm this assessment. COUNTY HEALTH SERVICES - STATISTICS SECTION 21 HEALTH CLINICS Leyton Green Road. Leyton, E.10. (Opened in 1933) Granleigh Road, Leytonstone, E.11. ( " " 1935) Dawlish Road. Leyton, E. 10. (" " 1951) SECTION 22 CARE OF MOTHERS AND YOUNG CHILDREN Births Registered During Year Male Female Legitimate 600 508 Illegitimate 29 23 Births notified - 1200 CLINICS Ante Natal - First attendances 588 Subsequent attendances 3151 Post-Natal - Leyton Green Lady Rayieigh Training Home New Cases 79 90 Total attendances 160 100 (47) Child Welfare Leyton Green Park House Dawlish Road Emmanuel Hall UNDER 1 YEAR First attendances 606 853 441 79 Subsequent attendances 4748 6167 3586 1032 Total attendances 5354 7020 4027 1111 1-5 YEARS - First attendances 332 410 190 50 Subsequent attendances 2346 2208 1528 428 Total attendances 2678 2618 1718 478 Total attendances (both age groups) 8032 9638 5745 1556 Number examined by Clinic Doctor 2211 3042 1752 - Number weighed 7499 9164 5417 1535 DENTAL CLINICS Patients inspected and treated during the year Expectant Mothers Nursing Mothers Children under school age (1) Patients examined 108 69 365 (2) Patients found to require treatment 95 65 323 (3) Patients who have commenced treatment 95 65 323 (4) Patients who have completed treatment 66 51 266 (5) Patients awaiting treatment - - - (6) Attendance for treatment 278 220 715 (48) Types of treatment given Expectant Mothers Nursing Mothers Children under school age Extractions - (a) Permanent teeth 52 134 - (b) Temporary teeth - - 217 Fillings - (a) Permanent teeth 132 70 - (b) Temporary teeth - - 466 Inlays provided - - - Crowns provided - - - Anaesthetics administered - (a) Local 28 39 11 (b) General (i) by Medical Offrs. on County Staff - - - (ii) by others 25 28 115 (a) Scaling 44 23 12 (b) Prolonged scaling and gum treatment 32 10 - Silver nitrate treatment 10 4 219 Dressings 83 105 209 X-ray examinations 12 7 - Dentures provided - (a) Full - 15 - (b) Partial 8 10 - Dentures repaired 1 1 - Dentures re-made — (a) Full - - - (b) Partial ~ ~ ~ Orthodontic appliances - (a) Fixed - - - (b) Movable - - - Prophylactic treatment and other operations Gum treatment 27 9 9 Number of treatments (scaling and prophylactic carried out by Oral Hygienists) 81 56 12 Orthopaedic Clinic New cases 71 Re-inspections 88 Minor alterations to footwear 151 Surgical appliances supplied 2 (49) Ophthalmic Clinic Children referred 5 Attendances 12 WELFARE FOOD Issues - The total issues during 1957 were:- National Dried Milk (Tins) 27,816 Cod Liver Oil (Bottles) 6,782 Vitamin A & D Tablets (Pkts) 3,767 Orange Juice (Bottles) 66,094 CARE OF PREMATURE INFANTS (weighing 51bs. 8ozs. or under):- Born at Home 16 Born in Hospital or Nursing Home 67 DAY NURSERIES There are two Day Nurseries in the area, each having accommodation for 60 children. (1) Ellingham Road Day Nursery. Ellingham Road, Leyton, E.15. (Tel.Maryland 3683) (2) Knotts Green Day Nursery, Leyton Green Road, E.10. (Tel. Leytonstone 4100) KNOTTS GREEN ELLINGHAM ROAD TOTAL 0-2 yrs. 2-5 yrs. 0-2 yrs. 2-5 yrs. 0-2 yrs 2-5 yrs. Number of approved places at end of year 15 35 15 35 30 70 Number of children on register at end of year 16 44 15 45 31 89 Total attendances during year 3003 8504 2524 8321 5527 16 825 Number of days open 254 255 CONVALESCENT HOME TREATMENT Numbers sent to Convalescent Home Children 3 Mother and children 4 mothers with 7 children (50) INFANT, NEO NATAL AND FOETAL MORTALITY Live Births 1160 Deaths under 1 year 17 Deaths under 4 weeks 15 (Rate per 1,000 live births) MORTALITY RATES Infantile 14.65 Neo natal 12.93 (Rate per 1,000 live births) STILLBIRTHS Number 26 Rate per 1,000 21.92 (51) (52) HEALTH CLINICS - CLINIC SESSIONS HEALTH CLINIC MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY Leyton Green. Leyton Green Rd. E.10. (LEYtonstone 3650. Ext.267) A.M. Dental Minor Ailment Foot Clinic Dental Orthoptic Minor Ailment Foot Clinic Dental Minor Ailment Orthoptic Ophthalmic Foot Clinic Dental Minor Ailment Ante-natal Foot Clinic Dental Minor Ailment Ophthalmic Orthoptic Foot Clinic Minor Ailment Dental (Alt.) Foot Clinic (Alt.) P.M Infant Welfare Foot Clinic Dental Infant Welfare Foot Clinic Dental Orthoptic Infant Welfare Foot Clinic Dental P.N. (2nd) A.N. Exercises Orthopaedic Foot Clinic Dental Orthoptic Special Medicals Foot Clinic A.N. Exercises (Alt. Fridays) Immunisation Evening Foot Clinic Foot Clinic Park House Granleigh Road. E. 11. (LEYtonstone 3650 Ext. 268) A.M Dental (1) Minor Ailment Ante-natal (2nd and 4th) Foot Clinic Dental (1) Oral Hygiene Minor Ailment Foot Clinic Dental (1) Minor Ailment 0 Aural Clinic Foot Clinic Dental (1) Minor Ailment Foot Clinic Dental (1) Minor Ailment Foot Clinic Dental (1) (Alt.) Minor Ailment Foot Clinic (Alt.) P.M Dental (1) Ante-natal Exercises Foot Clinic Dental (1) Oral Hygiene Infant Welfare Foot Clinic Dental (1)& (2) Infant Welfare Foot Clinic Dental (1) Infant Welfare Foot Clinic Dental (1) Immunisation Ante-natal Exercises Foot Clinic Evening Foot Clinic Foot Clinic Dawlish Road Dawlish Road E. 10. (LEYtonstone 3650 Ext. 287) A.M Minor Ailment Dental (1) Foot Clinic Oral Hygiene Speech Clinic Dental (1) Minor Ailment Foot Clinic Speech Clinic Dental (1) Minor Ailment Ante natal Toddlers Foot Clinic Speech Clinic Dental (1) &(2) Minor Ailment Speech Clinic Dental (1) Minor Ailment Foot Clinic Speech Clinic Minor Ailment Dental (l)(Alt) Foot Clinic (Alt.) P.M Dental (1) Infant Welfare Foot Clinic Speech Clinic Dental (1) Immunisation Foot Clinic Ante natal Exercises Speech Clinic Dental (1) Foot Clinic Speech Clinic Infant Welfare Foot Clinic Dental (1) & (2) Speech Clinic Dental (1) Foot Clinic Speech Clinic Emmanuel Hall Hitcham Road E.10. Evening Foot Clinic Foot Clinic P.M Weighing Session * By arrangement SECTION 23 MIDWIFERY Cases attended by Council Midwives Midwives Total Essex County Council Attached to the Lady Rayleigh Training Home Beechcroft Road Cases attended: (a) As Midwives 85 120 205 (b) As Maternity Nurses 3 23 26 Ante-natal Visits 393 1400 1793 Ante-natal Examinations 774 1844 2658 Post-natal Visits 1495 5618 7113 Administrations of Gas and Air Analgesia 80 64 144 Administrations of Pethidine 36 59 95 Gas and Air Analgesia Percentage of administrations 62.33 Medical Aid Where the Medical Practitioner had arranged to attend the patient 16 Others 81 Fees paid to Doctors Number of accounts received 47 Total amount paid to Medical Practitioners £129.15.0. Maternity Outfits Number of outfits issued to Expectant Mothers 223 (53) SECTION 24 HEALTH VISITING Health Visitors During the year the Health Visitors made 18,532 visits to homes. (a) To expectant mothers:- First visits 227 Subsequent visits 175 (b) To children under 1 year of age - First visits 1197 Subsequent visits 4623 (c) To children between the ages of 1 and 5 years - First visits 320 Subsequent visits 5575 (d) Other visits - Whooping cough — Measles — Ophthalmia neonatorum — Discharging eyes 2 Diarrhoea 8 Puerperal Pyrexia 3 Children's Act 10 After deaths 51 After stillbirths 15 Miscellaneous 1209 Ineffective 2704 Old people 2390 Hospital follow-up 23 Pemphigus neonatorum — SECTION 25 HOME NURSING Number of new cases 1444 Number of visits paid to above 57616 SECTION 26 VACCINATION AND IMMUNISATION Vaccination against Smallpox NUMBER OP PERSONS VACCINATED (OR RE-VACCINATED):- Age at date of Vaccination Under 6 months 6-12 months 1 Year 2-4 years 5-14 years 15 years and over Total Number Vaccinated 513 155 76 158 353 332 1587 Number re-vaccinated - 1 3 19 180 546 749 (54) Diphtheria Immunisation Age (in years) at final injection Children* who completed a full course of primary immunisation during the year Children* who were given a reinforcing injection during the year By General Practitioners By County Staff By General Practitioners By County Staff Under 1 283 258 - - 1 93 154 - - 2 14 18 1 1 3 12 6 - 2 4 8 9 27 44 5-9 35 68 134 553 10-14 10 12 37 38 Total 455 525 199 638 * Including temporary residents Percentage of School Children Immunised (1956) 5-year age group - Number examined 944 Number immunised 777 Percentage immunised 82.3 10-12 + age group - Number examined 1398 Number immunised 1125 Percentage immunised 80.4 14 year age group Number examined 1285 Number immunised 993 Percentage immunised 77.2 (55) Protection against Whooping Cough Age at time of final injection Children who completed a full course under the County Scheme Records of combined diphtheria-pertussis immunisations received By General Practitioners By County Staff Under 6 months 20 11 27 6-12 months 93 337 128 1 year 35 88 37 2- 4 years 14 29 7 5 years and over 11 12 9 Total (primary courses) 173 477 208 Reinforcing injections 31 — 37 Poliomyelitis Vaccination 1957 The following children in the various age groups received a complete immunising course in 1957. Year of Birth Boys Girls 1947 249 241 1948 198 201 1949 198 177 1950 165 157 1951 115 106 1952 135 134 1953 139 110 1954 104 122 1955 14 15 1956 23 16 1340 1279 2619 Hospital Staff 8 12 Total immunised during year 1957 2639 Total immunised during year 1956 370 Total to 31st December, 1957 3009 Total Registrations to end of 1957 4720 (56) SECTION 27 AMBULANCE SERVICE Patients conveyed - Stretcher cases 4.761 Emergency cases 3681 Other cases 33,655 Total mileage 145,175 miles SECTION 28 PREVENTION OF ILLNESS, CARE AND AFTER CARE Foot Clinic Male Female Children New cases 259 871 361 Total attendances 3725 17514 2066 Tuberculosis (a) Open Air Shelters - Number in use at end of year 2 Total number of visits to shelters by health visitors or tuberculosis visitors 8 (b) Extra Nourishment - Number of new cases supplied with free milk 32 Total number being supplied with free milk at end of year 26 Loan of Sick Room Equipment Air Beds 4 Air Rings 73 Bed Back Rests 61 Bed Blocks 2 Bed Cradles 15 Bed Pans 105 Crutches 1 Invalid Chairs 32 Rubber Sheets 102 Urinal Bottles 36 Feeding Cups 7 Steam Kettles 1 Commodes 17 Mobile Lifting Pole & Chain 1 Total 457 (57) Convalescence for Adults Number of applications during year 85 Length of stay - One week 2 Two weeks 47 Three weeks 29 Four weeks 7 SECTION 29 DOMESTIC HELP Number of helps and hours worked - Number of domestic helps enrolled at end of year - Whole time helps 7 Regular part-time helps 112 Number of domestic helps actually employed at end of year 107 Number of hours worked during year 147,519 Work of Domestic Help Organiser (1) First Visits 500 (2) Re visits to beneficiaries (a) Domestic help present 69 (b) Domestic help not present 241 (3) Other visits 156 Help Provided Maternity Acute Sick Tuberculosis Chronic Sick Aged Not Sick Others Total Aged Others Requests for help from new cases during the year 46 30 5 385 62 21 5 554 New cases help during the year 38 27 5 345 50 17 4 486 Total cases completed during the year (a) 39 28 13 303 52 14 4 453 Cases being helped at end of year who have received help for - Under 3 months - 4 - 78 5 4 - 91 3-6 months 1 - - 46 5 2 - 54 6- 12 months - - - 83 8 3 - 94 Over 12 months - - 10 294 31 12 - 347 Total (b) 1 4 10 501 49 21 - 586 Total cases helped during the year ((a) plus (b)) 40 32 23 804 101 35 4 1,039 Hours of help provided during the year 3,011 1,207 3,356 118,378 15,846 5,390 331 147,519 (58) MEDICAL EXAMINATION OF STAFF County Council employees - Number of medical examinations for - (a) Entrants to County Council's service 95 (b) Retirement on Superannuation 1 No. of medical examinations Leyton Borough Council 87 Others 2 Entrants to teaching profession and training colleges 48 (59)