AC 4411(1) Library LEY 53 BOROUGH OF LEYTON THE HEALTH OF LEYTON 1959 G. T. CROOK 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 Health Offices Sidmouth Road, Leyton, E.10 LEYtonstone 3650 PUBLIC HEALTH COMMITTEE 1959-1960 The Worshipful the Mayor: Councillor J.J.Walsh, J.P. (ex-officio) Chairman: Councillor F.W.Marshall Vice-Chairman: Councillor Mrs. A.M.M. Burrell Aldermen: G.S. Flack B.G. Rayner Councillors: Mrs. E. Bartram R.W, Burlton W.A. Cross Mrs. E.M. Dare 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, M.A.P.H.I,, M. Inst. B.E. Deputy Chief Public Health Inspector: R.A. Reeves, M.A.P.H.I. to 28.2.59. G.F. Downing, A.M. I.P.H.E., M.A.P.H.I, from 28.2.59. 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 the Annual Report of the Department. As required by the Ministry of Health, and for the convenience of Members, this also includes sections on the County Health Services (National Health Service Act-Part III Services) and the School Health Service. My predecessor, Dr.M. Watkins, resigned on 31st October, 1959, to take up a similar post in the Borough of Walthamstow after a period of four years* service with this Authority. From that date until I took up my appointment on 1st March, 1960, Dr. Mary L. Gilchrist acted as Medicai Officer of Health. Since assuming my duties, I have been most impressed with the standard of the health services in Leyton, and I feel that I am fortunate in being appointed to such a well established service. Public health, however, is never static and there is always the challenge of changing patterns of community health, of new legislation, and of modern thought and re-orientation of views, and I look forward to the prospects of playing my part in developing the service to meet the new problems which will face the various Committees dealing with the work of the Department in the future. As this report constitutes a review of a year during which different officers have been responsible for the work of the Health Department it cannot be otherwise than fragmentary. In the section of the report dealing with the sanitary circumstances of the area (for which I am indebted to Mr B.J. Ashcroft, Chief Public Health Inspector) attention is drawn to the progress being made in slum clearance and the action so far taken in respect of smoke control areas. Both slum clearance and the implementation of the Clean Air Act, 1956, will impose considerable duties upon the public health inspectorate for many years. It is pleasing, however, to contemplate the foundations which are being laid so that future generations in Leyton will enjoy better planned housing and cleaner air. The personal health services (i.e. Part III National Health Service Act, 1946) continue to serve the public, and I consider Leyton very fortunate in having three excellent clinic centres each covering an area constituting a population of approximately 30,000 persons. The disposition of the medical officers, health visitors and chiropody staff to the clinics is a tribute to the foresight of my predecessors, and it is extremely pleasing to observe mothers of small children calling at the clinics for advice outside child welfare service sessions. Extremely valuable work has been carried out by Miss Roger, senior health visitor at Leyton Green Clinic, in her formation of the Mothers* Club. This is health education at its best, allied with the promotion of social intercourse between young mothers. The poliomyelitis programme during the year has been extremely heavy, due to the (2) introduction of the third, or 'booster' dose, and whilst the number vaccinated in the eligible age-groups is not entirely satisfactory, much has been done to reduce the notification rate of poliomyelitis. The section on the School Health Service is mainly statistical, as this service quietly and efficiently carries out its statutory obligations to ensure that the scholars in the Leyton Division are fit to assimilate the education made available to them. A major problem to the service is that of the child who is mentally retarded or emotionally disturbed. In the early days of the school Health Service the poor physical state of the children overshadowed the less obvious mental maladjustments. Now, with the improvement of the physical state of the child, more time is required to be devoted to the problems of detecting and helping the child who is suffering from mental disorder. I hope that it will be possible in the near future to increase the Child Guidance facilities in the Division. It would be remiss of me to close these notes without reference to the excellent work carried out by my immediate predecessor, Dr. Melville Watkins, and my Deputy Dr. Mary L.Gilchrist. I also place on record my appreciation of the co-operation I have received from the Members of the Council, the other Chief Officers, and the staff of the Health Department since taking up my appointment. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, G.T. CROOK, Medical Officer of Health. Health Offices, Sidmouth Road. Leyton, E.10. Tele LEYtonstone 3650 (3) VITAL STATISTICS Area in acres 2,594 Population (Census 1951) 105,978 Population (Registrar-General's Estimate, 1958) 97,830 Assessable Value for General Rate Purposes £1,365,558 Genera] Rate in the £ (1959/60) 20s. 10d The Registrar-General*s mid-year 1959 estimate of population (viz., 97,830) has been used for the calculation of the following statistics:- Live Births 1,204 Live Birth Rate per 1,000 population 12.30 Stillbirths 24 Stillbirth rate per 1,000 total (live and stillbirths) 19.54 Total Live and Stillbirths 1,228 Infant Deaths 13 Infant Mortality rate per 1,000 live births 10.79 ,, ,, ,, ,, 1,000 legitimate births 11.32 ,, ,, ,, ,, 1,000 illegitimate births Neo-Natal Mortality Rate (first four week) per 1,000 related live births 6.64 Early Neo-natal Mortality Rate (first week) per 1,000 related live births 4.15 Peri-natal Mortality Rate (stillbirths and deaths during the first week) per 1,000 total still and live births 23.61 Percentage of illegitimate live births 4.65 Maternal Deaths (including abortion) Maternal Mortality Rate (including abortion) per 1,000 total live births Total Deaths 1,388 Death Rate 14.18 Natural Decrease of Population 184 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 RegistrarGeneral has issued the following comparability factors for Leyton. Area comparability factor for births 0.99 Area comparability factor for deaths 0.80 These factors, when applied to the crude rates, produce the following adjusted rates:- Live Births 12.18 Deaths 11.34 (4) COMPARATIVE STATISTICS OF BIRTHS, MORTALITY, ETC. LEYTON 1901-1959. 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 3,011 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 E 132,107* 2, 560 19.4 1,471 12.1 197 76.9 D 121,420* 1917 B 125,352* 2,005 16.0 1,414 12.6 172 85.8 D 112,452* 1918 B 125,352* 1,791 14.3 1,723 15.3 161 89,9 D 112,452* 1919 B 129 062* 2, 195 17.0 1, 397 11.3 154 70.16 D 123 896* 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 119,900 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 104,200 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 1958 98,760 1, 252 12.67 1,338 13.54 31 25.87 1959 97,830 1,204 12. 30 1,388 14.18 13 10.79 * Population as estimated for purposes of B-Birth Rate; D-Death Rate. (5) Deaths The Registrar-Generals classification of causes of death by sex totals are shown in Table I on this page. The total number of deaths in 1959 (1,388) compares with (1,338) 1958 the respective death rates per 1,000 population being 14.18 and 13.54. CAUSES OF DEATH AT DIFFERENT PERIODS OF LIFE-1959 AGE GROUPS-MALES AGE GROUPS-FEMALES Causes of Death TOTAL 0-1 1-5 5-15 15- 25 2545 45- 65 65- 75 75+ TOTAL MALES 0-1 1-5 5-15 15- 25 2545 45- 65 65- 75 75+ TOTAL FEMALES 1. Tuberculosis, respiratory 10 1 - - - 2 - 1 1 5 - - - - 1 3 1 - 5 2. Tuberculosis, other - - - - - - - - - - - - - - - - - - 3. Syphilitic disease 1 - - - - - - - - - - - - - - - - 1 1 4 Diphtheria - - - - - - - - - - - - - - - - - - - 5. Whooping Cough - - - - - - - - - - - - - - - - - - - 6. Meningococcal Infections - - - - - - - - - - - - - - - - - - - 7. Acute Poliomyelitis - - - - - - - - - - - - - - - - - - - 8. Measles - - - - - - - - - - - - - - - - - - - 9. Other infective and parasitic diseases - - - - - - - - - - - - - - - - - - - 10. Malignant neoplasm stomach 32 - - - - - 6 5 2 13 - - - - - 8 6 5 19 11. Malignant neoplasm lung, bronchus 51 - - - - 1 22 15 6 44 - - - - - 3 3 1 7 12. Malignant neoplasm breast 22 - - - - - - - - - - - - - - 16 2 4 22 13. Malignant neoplasm uterus 7 - - - - - - - - - - - - - 2 1 - 4 7 14. Other malignant and lymphatic neoplasms 123 - - 1 _ 1 20 23 16 61 - - - - 6 13 22 21 62 15. Leukaemia, aleukæmia 7 - - 1 - - 1 1 - 3 - - - - - 1 2 1 4 16. Diabetes 4 - - - - - - 1 1 2 - - - - - - 2 - 2 17. Vascular lesions of nervous system 192 - - - - 1 13 18 35 67 - - - - 1 15 34 75 125 18. Coronary disease, angina 190 - - - - 3 50 33 34 120 - - - - - 11 27 32 70 19. Hypertension with heart disease 28 - - - - - - 3 4 7 - - - - - 3 4 14 21 20. Other heart disease 295 - - - - 2 5 17 80 104 - - - - 1 4 26 160 191 21. Other circulatory disease 50 - - - - - 6 7 11 24 - - - - - 7 8 11 26 22. Influenza 14 - - - - - 2 2 4 8 - - - - - - 1 5 6 23. Pneumonia 99 2 1 - - 1 9 12 23 48 1 - - - 1 3 8 38 51 24. Bronchitis 76 - - - - - 19 18 16 53 - - - - - 2 9 12 23 25. Other diseases of respiratory system 12 - - - - 1 1 5 2 9 - - - - - - 1 2 3 26. Ulcer of stomach and duodenum 20 - - - - - 3 6 3 12 - - - - - 1 3 4 8 27. Gastritis, enteritis and diarrhœa 8 - - - - - 1 1 _ 2 - - - - - 1 1 4 6 28. Nephritis and nephrosis 4 - - - 1 1 - - - 2 - - - - 1 - - 1 2 29. Hyperplasia of prostate 8 - - - - - - 4 4 8 - - - - - - - - - 30. Pregnancy, childbirth, abortion - - - - - - - - - - - - - - - - - - - 31. Congenital malformations 5 1 - - - - 1 - - 2 1 - - - - 1 1 - 3 32. Other defined and ill-defined diseases 88 6 _ 2 1 1 8 10 10 38 1 1 - 1 3 8 12 24 50 33. Motor vehicle accidents 15 - - 1 2 3 - 2 3 11 - - - - - 1 1 2 4 31. All other accidents 19 - - - 1 - 1 1 5 8 - 1 - - 1 - 1 8 11 36. Suicide 7 - - - - - 1 - - 1 - - - - 2 1 2 1 6 36. Homicide and operations of war 1 - - - - - - - - - - - - - 1 - - - 1 TOTALS 1.388 10 1 5 5 17 169 185 260 652 3 2 1 20 103 177 430 736 (6) SURIAL OF THE DEAD In accordance with Section 50 of the National Assistance Act, 1948, the Council is responsible for the burial or cremation of the body of any person who had died or been found dead within the Borough, and where no private arrangements are being made for the disposal of the body. Authority is given to recover from the estate of the deceased person, or from any person who, under the Act, was liable to maintain the deceased immediately prior to his/her death, the expenses incurred in carrying out the duty, in so far as these expenses are not covered by any grant under the National Insurance Act, 1946. During the year 20 burials were arranged by the Department. INTERNATIONAL CERTIFICATES OF VACCINATION AND INOCULATION Arrangements continued during the year for the authentication of Certificates of Vaccination and Inoculation, These certificates are required by persons proceeding abroad from this country and the purpose of the authentication is to provide information to health authorities abroad that the signature of the person issuing the certificate is that of a registered medical practitioner. PUBLIC SWIMMING BATHS I am indebted to Mr.W.B.Dinn, Baths Superintendent, for the following report on the Public Swimming Baths in the Borough. "There are two indoor public swimming baths establishments in the Borough, (a) High Road Baths, and (b) Cathall Road Baths, Leytonstone. Further, there is an open air Bathing Pool at Whipps Cross, Leytonstone, administered by the Baths Superintendent for and on behalf of the Joint Committee elected from members of the Leyton and Walthamstow Borough Councils. Set out hereunder are the principal details of the establishments:- Baths Capacities in gallons Source of Water Supply Water Treatment Rate of Filtration in G.P.H. (approx.) Theoretical hours of "turnover" Baths: Large 198,000 Small 37,000 Principally deep well Coagulation, Filtration and Chlorination and Aeration Large 69,000 Small 13,000 Large 2.87 Small 2.69 Baths: Large 90,000 Small 70,000 Principally deep well Coagulation, Fil tration and Chlorination and Aeration Large 22,000 Small 18,000 Large 4.09 Small 3.33 Pool: 1;300,000 M.W.B. Mains Coagulation, Filtration and Chlorination and Aeration 80,000 or 160,000 or 240,000 according to number of pumps in use 16.25 or 8,125 or 4.06 Regular bacteriological examinations are taken of the water and examined by the Council's analysts, who record a high standard of purity." (7) LABORATORY FACILITIES (a) Pathological Department, Whipps Cross Hospital, E.11. For pathological specimens. (b) Centra] Public Health Laboratory, Colindale. For special bacteriological investigations; supply of lymph for vaccination; supply of diphtheria toxin (F.T.) (c) Counties Public Health Laboratories, Queen Victoria Street, London. For bacteria] 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 LEYtonstone 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 35) LAUNDRY FOR THE INCONTINENT 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. There is no doubt of the value of the service to the relatives or friends of patients who have difficulty in the laundering of foullinen and personal clothing. During the first year of the operation of the service (1957) a total of 115 individual launderings took place involving 1,417 articles. Also in 1957 an agreement was entered into with the County Borough of West Ham whereby launderings were carried out in respect of West Ham patients. (8) INFECTIOUS DISEASE-NOTIFICATIONS DISEASE Number notified during Year 1957 1958 1959 Scarlet Fever 60 106 156 Whooping Cough 159 104 29 Measles 1033 433 894 Acute Poliomyelitis, Paralytic 11 - 2 Acute Poliomyelitis, Non-paralytic 8 - - Tuberculosis, Respiratory 51 41 46 Tuberculosis, Meninges and C.N.S. 1 - - Diphtheria - - - Smallpox - - - Tuberculosis, Other 8 3 5 Meningococcal Infection 1 - - Acute Encephalitis, Inf. - 1 2 Acute Encephalitis, Post-infectious 1 - - Dysentery 6 38 88 Ophthalmia Neonatorum 3 2 - Puerperal Pyrexia 13 1 - Pneumonia 223 132 167 Paratyphoid 1 - 1 Enteric or typhoid 1 - 1 Food poisoning 29 23 38 Erysipelas 17 13 10 Malaria - - - Pemphigus Neonatorum - - - Chickenpox - - - 1626 897 1439 A comparison of the total numbers of notifications received during each of the years 1957-1959 prompts the following observations. Poliomyelitis. Originally 3 cases of paralytic poliomyelitis were notified. One of these was subsequently withdrawn as "not poliomyelitis," and one other was a Walthamstow case which was notified on admission to a local Hospital. The third case relates to a resident who had an acute paralysis, however in a few days made a complete recovery. This patient had had two injections of vaccine against poliomyelitis. Tuberculosis. The new notifications in respect of tuberculosis were slightly up during 1959 compared to the previous" year. Seventeen of them were in respect of patients aged 45 years and over. Scarlet Fever. Cases of scarlet fever show a considerable increase, which would be a matter of concern but for the fact that the majority of cases were an infection of a mild type which quickly responded to treatment. (9) TUBERCULOSIS The following is a statement of particulars appearing in the Register of Notifications of cases of Tuberculosis for the year ended 31st December, 1959, PULMONARY NON-PULMONARY TOTAL M P Total M P Total Number on register at commencement of year 541 414 955 36 63 99 1054 Number first notified during year 26 21 47 3 1 4 51 Number entered in register otherwise than by notification 21 12 33 - - - 33 Number removed during year 57 35 92 5 14 19 111 Number remaining at end of year 531 412 943 34 50 84 1027 Died 16 7 23 - 1 1 24 Removed from district 33 22 55 - 7 7 62 De-notified - - - - - - - Cured 8 6 14 5 6 11 25 Of the cases first notified during the year the age group distribution was as follows:- Age Periods PULMONARY NON-PULMONARY M F M F Under 5 years - - - - 5-14 years - 1 1 - 15-24 ,, 3 8 - 1 25-44 ,, 10 8 2 - 45-64 ,, 9 3 - - 65 and over 4 1 - - TOTAL 26 21 3 1 (10) SANITARY CIRCUMSTANCES OF THE AREA PART 1-COMMENT ESTABLISHMENT OF PUBLIC HEALTH INSPECTORS The establishment of Public Health Inspectors comprises the Chief Public Health Inspector, Mr. B. J. Ashcroft, Deputy Chief Public Health Inspector, Mr. R.A.Reeves, 7 District Public Health Inspectors, and 3 Student Public Health Inspectors. I am pleased to report that for the first time for many years a full complement of District Public Health Inspectors was maintained during 1959. Mr. Reeves, Deputy Chief Public Health Inspector, retired from the service of the Council in February. Mr. Reeves was held in high esteem by his colleagues and at the presentation which preceded his retirement many tributes were paid to the loyal and conscientious service he had rendered the Council and the public for some 32 years. The post of Deputy Chief Public Health Inspector was filled in June on the appointment of Mr. G.F. Downing who was previously with Slough Corporation. The student scheme for the training of Public Health Inspectors introduced by the Council in 1954 is still in operation and has shown good results. Two of the Students obtained the necessary statutory qualifications during the year and one has since been absorbed into the permanent establishment of Public Health Inspectors; the other obtained a post with a neighbouring authority. HEALTH EDUCATION The local sanitary authority is armed with a large and ever increasing number of complicated Acts, Statutory Orders and Regulations to eliminate or control those factors in man's physical environment which are or may be harmful, but it should be realised that pure and safe food and water clean air, and the maintenance or the betterment of environmental conditions in houses, factories, workshops, shops, and places of public entertainment cannot be secured by legislation alone, and more and more emphasis must be placed on the importance of health education both in the field during the course of routine day to day visits of inspection as well as in the form of health exhibitions film shows, window displays and talks to selected groups of people. The promotion of health education in all its aspects forms an important part of the duties of the Public Health Inspectorate, but none is more important or indeed more effective than that carried out on the district, it is an accepted fact that people learn more rapidly and thoroughly by demonstration and participation than by theoretical instruction. Public Health Inspectors meet people at their places of work, for instance, food handlers and operators of industrial plant capable of causing air pollution, visit people in their homes and indeed are in contact with everyone in the community whose activities have a public health significance. The Inspector has, therefore, extensive unrivalled scope for effective health education by demonstrating on the spot how the principles and practices of environmental sanitation should be observed (11) and pointing out faulty habits and practices as they occur. Pull advantage is also being taken of the Health Education facilities provided by the shop windows at 280 High Road, Leyton, E.10. Photographs of displays produced and contributed by the Public Health Inspectors on various aspects of the environmental health services under the control of the local Sanitary authority in relation to air pollution, smoke control, clean food and food hygiene generally, rodent control and insect pest control, house improvements, etc., appear between pages 33-34. Judging from the number of enquiries received and requests for technical literature and health propaganda leaflets, it would appear that this novel way of presenting a small health exhibition is proving quite successful in stimulating civic interest in the work of the Department. Further use is proposed to be made of the shop premises by using not only the windows but the shop itself for a full scale clean air and smoke control exhibition as part of the Council's publicity campaign in relation to the establishment of smoke control areas. HOUSING AND NUISANCE ABATEMENT The section of the report entitled "Sanitary circumstances of the area, Part IIStatistics" 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 affected to dwelling houses as a result of informal and statutory action, and information regarding the institution of legal proceedings and the administration of the Rent Act, 1957. 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 certificates 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 nuisances. Of the statutory duties confronting the Local Sanitary Authority none is more important or indeed 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 some 13,327 inspections and re-inspections were made during the year under the Public Health Act, Housing and Rent Acts, Prevention of Damage by Pests Act and other legislation; 2,217 complaints regarding unsatisfactory conditions were investigated and 816 notices specifying works to remedy defects such as dampness, general disrepair, defective drainage, leaking 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 604 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 Act (12) were instituted in 8 cases. Such proceedings are not, however, always successful in enforcing essential repairs; in two instances the Public Health Committee were obliged to operate Closing/Demolition Order procedure as provided by Section 17/18 of the Housing Act. During the year under review 74 applications under the Rent Act, 1957 for certificates of disrepair and 48 applications for certificates as to the remedying of defects etc., were received and dealt with by the Public Health Inspectorate; 87 notices (Form J) of the Council's proposal to issue such certificates were served on landlords arising out of which 59 undertakings (Form K) to remedy defects specified thereon within a period of 6 months were submitted by the owners and accepted by the Council and 39 certificates of disrepair were issued. SLUM CLEARANCE AND REDEVELOPMENT AREAS The Council's programme in relation to slum clearance and re-development continues to make satisfactory progress; it is gratifying to note that most of the houses contained in the first scheme - the Crescent Road area-have now been demolished and redevelopment of new houses is now well in hand. Every house in the first stage of the Beaumont Road area has been surveyed in detail by the Public Health Inspectorate to determine the extent to which the houses were defective in relation to disrepair, stability, dampness, natural lighting, ventilation, water supply, drainage and sanitary facilities and bad arrangement in relation to other buildings. In October 1959 the Medical Officer of Health submitted to the Public Health Committee an official representation in respect of 5 Clearance Areas, and a report prepared jointly with the Chief Public Health Inspector on the main and materia] conditions existing in the Areas which in their opinion rendered demolition of all houses and other buildings necessary, either by reason of their unfitness for human habitation, or because they 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. At its meeting on 10th November, 1959, the Public Health Committee recommended the Council to declare the afore-mentioned areas to be clearance areas in accordance with provisions of Section 42 of the Housing 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. The Housing 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 satisfactory development. This was subsequently confirmed by the Council at its meeting on 26th November, 1959. Official representation was also made to the Public Health Committee during the year in respect of a small Clearance Area adjoining the Crescent Road scheme - the Carlisle Road Area, At the time of preparing this report confirmation of the Compulsory Purchase Order had been received from the Ministry of Housing and Local Government. The Crescent Road, and Beaumont Road areas form part of (13) a long term programme of slum clearance and redevelopment 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 as required by Section 1 of the Housing Repairs and Rents Act, 1954. as being unfit for habitation and liable to be dealt with by slum clearance or individual demolition will have to be retained and maintained for housing purposes, for many years to come. The Public Health Committee will therefore be faced for an indefinite period with the problem of enforcing essential repairs to insanitary properties, 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 the 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 adequate to requirements for effective rodent control according to the condition of infestation 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 1,100 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 14 houses which had proved a source of infestation. Some 504 complaints were received during the year concerning rodent infestation involving treatment by rodent operatives of 369 private houses and 53 business premises. The total number of visits in connection with these investigations and subsequent disinfestation amounted to 4,237. The Chairman of the Public Health Committee, Councillor F.W.Marshall and the Chief Public Health Inspector continued to be the Councils representatives on the Workable Area Committee set up by the Ministry of Agriculture, Fisheries and Food for rodent control. The Committee, comprising some 16 neighbouring authorities, meets about three times per year and apart from discussing general methods of rodent control and forms of treatment, investigate the results of the simultaneous treatment of interconnected sewers carried out bi-annually by adjacent authorities, BUSINESS PREMISES-GENERAL The main statutory provisions affecting commercial and industrial premises are contained in the Factories Act, 1937, Shops Act, 1950, Food and Drugs Act, 1955, Food Hygiene Regulations, 1955/57, Merchandise Marks Act, 1926/53, Clean Air Act, 1956, and Public Health Act, 1936; in addition there are numerous Orders and Regulations. (14) In the Borough there are some 2,392 business premises, made up of factories, industrial undertakings, food premises-catering establishments, shops, etc. - involving some 3,171 activities including registration and licensing. 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. During the year 4,452 inspections were carried out, 55 notices were served and 237 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 which has been taken. FOOD PREMISES-INSPECTION There are 1,500 premises-comprising shops, factories, catering establishments, schools, clubs, staff and factory canteens, stalls, etc., -where food is sold, prepared, stored, handled or transported. The number of visits of inspection in relation to these premises carried out during the year amounts to some 2,213 and 49 formal notices in relation to such contraventions of the Pood Hygiene Regulations as 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, faulty construction and maintenance etc., were served. Routine visits to the Council's Pleasure Ground, Lea Bridge Road, were made by Public Health Inspectors during Easter, Whitsun and August Pairs, Pood hawkers' stalls, mobile canteens, etc., were inspected and registrations checked. Inspections were also carried out during the Cricket Festival held at the Sports Ground, High Road, Leyton, in August. It is pleasing to report continued general improvement in the standard of hygiene practised by food vendors. It appears that inspections of the Pleasure Ground during Bank Holiday Pairs 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,, FOOD - INSPECTION AND SAMPLING The taking of samples of food for bacteriological and chemical examination forms an important part of the work of the Public Health Inspectors in the campaign for clean and safe food. Ice-cream premises were given special attention during the summer months. In the case of one particular ice-cream manufacturer, bacteriological results were found to be consistently poor and a thorough investigation was made into the method of manufacture, storage and sale, accompanied by bacteriological checks at each stage. Swabs were taken, in co-operation with the Public Health Laboratory, of all the implements used, including scoops, weighing machines, freezers and ladles, while bacteriological samples were obtained of all the ingredients, before and after mixing, including ice-cream powder, water supplies, milk and the finished product. The results obtained proved that the fault lay with the person concerned in the preparation of the ice-cream, and not in the implements or equipment, and subsequent batches of ice-cream, made under the guidance and supervision of the Public Health (15) inspector proved to be of excellent bacterial purity. 200 samples of various kinds of food were submitted to the Public Analyst for examination. With the ever-increasing variety of food and drugs appearing on the counter for sale to the public, it is important that samples should include the new and littleknown products as well as the traditional and well-tried variety, and by careful and selective sampling, this end is achieved. To avoid unnecessary duplication in the sampling of branded goods, close liaison is maintained between neighbouring Pood and Drugs Authorities, and in this way a general picture of the samples purchased over a fairly wide area is always available. It is interesting to note that the first general pure food law to be made in this or any country, which was "An Act for preventing the adulteration of Articles of Food and Drink" celebrates its centenary next year. The whole process of food manufacture, preservation and presentation for sale has naturally undergone radical change during these years and the relevant legislation has been amended and strengthened accordingly. The nature of food offences, intentional or otherwise, has also altered with the passage of time, and, whereas prosecutions for the addition of water to milk, for instance, were once commonplace, the problems which face the sampling officers today may vary from the food label which misleads as to vitamin content, to a sample of starch-reduced slices of slimming bread, which is not all that its manufacturer would have the customer believe. With regard to the samples taken during the year, 6 adverse reports were received and reported to the Public Health Committee. Upon instructions from the Committee, the attention of the manufacturers were drawn to 2 samples, the Ministry of Agriculture, Fisheries and Food was notified of the results of one sample, the Committee asked for no further action on the results of 2 samples, and legal proceedings were instituted in one case, the result of which is included in the statistical section of the report which also contains further information as to foodstuffs in respect of which condemnation certificates were issued as a result of routine inspections of food premises. Included in the list of condemned foodstuffs is 130 lbs. of desiccated coconut which was the subject of information received from the Port and City of London, that samples of this consignment taken on importation had revealed the presence of food poisoning organisms and that part of the consignment had been delivered to a Leyton baker. Fortunately the coconut had not been used, and samples were submitted for examination. These were also found to be infected and the coconut was voluntarily surrendered by the baker and destroyed under the supervision of a Public Health Inspector. During the year, 10 complaints regarding unsound and/or adulterated food were investigated and reported to the Public Health Committee. The hot summer weather seems to have had an influence on the type of complaint, as all 10 incidents occurred between the months of May and September while the foods implicated were those which are normally prone to complaints of this type i.e. Bread (5). (16) Milk (3), Cornish Pasty (2). Five successful prosecutions were instituted, warning letters were sent in 3 instances, and the remaining 2 cases were noted with a resolve for no further action. 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 Pood and Drugs Act, 1955, and associated legislation. Pull details are also given of inspections, notices, legal proceedings, and improvements effected to business premises as a result of action taken by the Department. AIR POLLUTION AND SMOKE CONTROL In a circular addressed to Local Authorities, the Ministry of Housing and Local Government referred to a review made in consultation with the Clean Air Council, of progress by Local Authorities in establishing smoke control areas since the powers of Section 11, Clean Air Act, 1956, became operative. While the first response was encouraging, the Minister hoped that in future it would be possible to make faster progress, especially in removing the smoke pall from the "black areas" where air pollution is worst, and said that in his view the task of bringing under smoke control the large number of areas involved needs to be systematically planned and executed by local authorities. The Minister had asked that Councils in "black areas" should now consider their smoke problem as a whole; decide on the smoke control areas that are needed, in what order of priority they should be made, and how many years it is likely to take to finish the job, and that they should then prepare a phased programme for establishing smoke control areas over the next five years. He had suggested that informal consultation between neighbouring authorities on programming may be desirable, and invited local authorities to inform him of their conclusions by 30th June, 1959. As a result of the decision of the Committee in relation to this circular, a preliminary survey of the Borough was carried out by the Public Health inspectorate and a phased programme of Smoke Control areas which would ultimately bring the whole Borough under smoke control was considered and accepted by the Council. Approval of the Council's first proposed smoke control area was received from the Ministry of Housing and Local Government in June. Since that time every house, factory and other building in the area has been surveyed by the Public Health Inspector to ascertain the extent, if any, to which existing fire places and furnaces require replacement or adaptation and the estimated cost of the works involved. The area comprises approximately 295 acres, the nucleus of which is the Crescent Road Redevelopment area, and the new housing development at Ive Farm and Villiers Close, and is contained within the following boundaries:- Windsor Road and Ruckholt Road to the South; Brewster Road, Vicarage Road, Park Road and Marsh Lane to the North; High Road Leyton to the East; and the Borough Boundary to the West; 1,776 families and 98 industrial and other premises will be affected if the Council's proposed Smoke Control Order is confirmed by the Ministry of Housing and Local Government. The Order is scheduled to come into operation on 1st October, 1961. The total estimated cost of the works involved in replacing or adapting the 1,665 domestic fireplaces in regular use in the area is £18,505., of which expenditure 4/10ths will be borne by the (17) National Exchequer, 3/10ths by the Local Authority and the remaining 3/10ths by the owner or occupier according to who undertakes to carry out the work. In this connection the Council will in accordance with the provisions of Section 12 of the Clean Air Act, 1956. repay to the owner or occupier a grant of 7/l0ths of the expenditure necessarily incurred by such adaptation or replacement. Owners or occupiers of private dwellings are advised not to do anything until they receive from the Council a letter which will give them all the information they require. Conditions precedent to the payment of grant are:- (a) The work proposed to be carried out must first be approved by the Council. (b) The work, which must be carried out between the date of tion of the Smoke Control Order and the date on which it comes into operation, must be completed to the satisfaction of the Council and solid fuel burning appliances must have been correctly installed in accordance with the appropriate British Standard Codes of Practice. (c) Any appliances proposed to be installed must be selected from the official lists of either:- "Recommended Domestic Solid Fuel Appliances" of the Coal Utilisation Council, 3 Upper Belgrave Street, London, S.W.1., and Solid Smokeless Fuels Federation, 74 Grosvenor Street, London, W. l.; or "Tested and Approved Domestic Gas Appliances" of the Gas Council, 1 Grosvenor Place, London, S. W. 1.; or "Recommended Domestic Electrical Appliances" of the British Electrical Development Association, 2 Savoy Hill, London, W.C.2. Copies of these lists can be seen during normal office hours at:- Town Hal 1, High Road, Leyton, E.10. Public Health Department, Sidmouth Road, Leyton, E.10. Leyton Public Libraries. Gas and Electricity Showrooms and solid fuel appliance dealers* premises. (d) Appliances must be of the fixed type Grant is not payable for portable gas, electric and oil fires or for portable gas pokers. (e) Where work consisting of, or including, the provision of any cooking or heating appliance which can readily be removed without injury to itself or the fabric of the dwelling, is (18) carried out by a tenant with the aid of a grant, seven twentieths of such grant is payable on completion and the balance at the end of two years from the coming into operation of the Order, payment of such balance being made to the actual occupier of the dwelling at the end of such two years and provided that the appliance has not in the meantime been removed. The landlord's consent to the proposed work must be signified in the space provided on the application form. (f) Owners or occupiers are entirely free to install appliances of superior quality or finish if they so desire, but grants will be based on the minimum expenditure necessarily incurred in complying with the Smoke Control Order. The cost of provision of points for gas ignition to solid fuel burning appliances and of points for electrical appliances is also eligible for grant. All owners and occupiers will also be sent a form of application to enable them to apply for approval of works of adaptation or replacement with a view to obtaining the grant. Arrangements have been made for the shop premises, 280 High Road, Leyton, E. 10, (adjoining the Public Health Offices, Sidmouth Road, Leyton. E. 10) to be used as a clean air exhibition centre and advice bureau to assist persons affected by the proposed smoke control order; approved appliances including gas and electric will be on display and a Public Health Inspector will be available to answer enquiries. It is anticipated that there will also be mobile exhibitions touring the smoke control area at which practical demonstrations of solid fuel appliances "under fire" will be given for the benefit of house-holders. The joint conference of neighbouring Local Authorities, first convened by Leyton Council in 1956 for the purpose of discussing matters of common interest in regard to air pollution and for exchange of ideas, has developed into a standard forum for discussion of progress and difficulties, and is proving very successful. Further meetings have been held in Wanstead. Woodford East Ham and West Ham. The Chairman of the Public Health Committee, Councillor P.W.Marshall, and the Chief Public Health Inspector are the Council's representatives on the London and Home Counties Clean Air Advisory Council and the Standing Conference of Co-operating 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 of smoke and sulphur dioxide have been made for the past ten years. The recording apparatus operated by the Public Health Inspectors is situated in the offices in Sidmouth Road, The tables which follow show, in Table 1, the results recorded during each of the ten years since observations began whilst Tables 2 and 3 show the concentrations respectively of smoke and sulphur dioxide recorded during each of the 12 months ended March, I960, divided into summer and winter periods, the average results for the nine-year period ended March 1959, are also shown for comparison. (19) The average concentration of smoke for the year ended 31st March, I960, was 17 milligrams per 100 cubic metres, compared with 22 milligrams for the previous nine years - a decrease of 22.7%.whilst the concentration of sulphur dioxide for the same period was 6.4 parts per 100 million, compared with 7.1 parts for the previous nine years - a decrease of 9.9%. The average smoke concentrations for the year ended 3lst March, 1960 (17 milligrams per 100 cubic metres) and for the winter of 1959/60 (28 milligrams per 100 cubic metres) were the lowest in Leyton since records began, and were considerably lower than the figures for 1958/59. 1,660 visits of inspection were made under the Clean Air Act in connection with the establishment of smoke control areas, 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. It was necessary to institute legal proceedings in respect of a contravention of the Dark Smoke (Permitted Periods) Regulations, 1958. The prosecution was successful and a fine of 10 guineas plus 10 guineas costs was imposed. Special surveys are in progress for the scientific measurement of grit and dust deposited in specified parts of the Borough; for this purpose nine standard deposit gauges are being used, the results from which are published monthly in the bulletin of of the Department of Scientific and Industrial Research. (20) ENVIRONMENTAL HEALTH SERVICES. HEALTH EDUCATION Shop Window Displays FOOD HYGIENE MARCH/APRIL 1959 PEST INFESTATION AUGUST/SEPTEMBER 1959 HOUSING - IMPROVEMENT GRANTS AUGUST/SEPTEMBER 1959 ATMOSPHERIC POLLUTION DECEMBER 1959 /JANUARY 1960 ATMOSPHERIC POLLUTION DECEMBER 1959 / JANUARY 1960 SANITARY CIRCUMSTANCES OF THE AREA PART II - STATISTICS Reference has been made in the preceding paragraphs to the following tables and charts giving details of the action taken and visits made by Public Health Inspectors pursuant to their statutory duties and responsibilities. INSPECTIONS, BE 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 Clean Air Act, 1956 39 1600 4 4 - - - Housing Acts. 1936/57 7 1094 - 6 4 - 604 Public Health Acts 1936 1667 7394 506 246 549 14 - Prevention of Damage by Pests Act 1949 504 1104 7 1 7 - - Pood and Drugs Act 1955 45 1072 - 49 42 - - Shops Act 1950 - 913 - - - - - Essex County Council Act, 1952 - 104 - - - - - Leyton Corporation Act, 1950 •• 17 - - - - - Factories Act 1937/48 9 212 - 5 7 - - Pet Animals Act 1951 1 25 - - 1 - - Rag Flock and Other Filling Materials Act 1951 - 2 - - - Rent Act 1957 259 259 - - - - Merchandise Marks Act, 1926/53 2 107 - - - . (21) (b) DETAILED (i) Housing Act, 1957 (Sections 17/18) Housing Repairs and Rents Act, 1954 (Section 3) 1 Demolition Order and 1 Closing Order were made under the Housing Act,1957. (ii) Rent Act, 1957 (a) Paragraph 4 of the First Schedule, Rent Act, 1957 Applications for certificates received 74 * Decisions not to issue certificates 12 Decisions to issue certificates 87 Undertakings given by landlords under paragraph 5 of the First Schedule 59 Undertakings refused by local authority under proviso to paragraph 5 of the First Schedule Nil Certificates issued 39 Applications by landlords for cancellation.... 39 Objections by tenants to cancellation 10 Decisions by local authority to cancel in spite of objection 6 Certificates cancelled by local authority 46 Applications for certificates (Form P) 48 Discrepancies in the above figures are caused by procedures in some cases extending over December - January. * 2 applications not dealt with owing to completion of repairs before visit by Public Health Inspector. (iii) 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 Number of Inspec tions Bakehouses 11 Bakers 16 Butchers 140 Catering Establishments 59 Carried Forward 226 (22) Type of Premises Number of Inspect ions Brought Forward 226 Clubs 31 Confectioners 79 Dairies and Distributors of Milk 11 Factories 20 Factory Canteens 3 Fish Friers 24 Fishmongers 17 Greengrocers 138 Ice-Cream Places 10 Itinerant ) Stalls and Vehicles Food Dealers ) Food Storage Accommodation 74 Local Authority Canteen 6 Meat Depots 11 Miscellaneous 35 Multiple Stores 5 Off-Licences 28 Provision Shops 316 Public Houses 21 School Canteens 11 Shell-fish Vendors 2 Street Markets 4 TOTAL INSPECTIONS 1072 (iv) Inspection of Business Premises other than Pood 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. Type of Premises Number of Inspections Clubs 1 Factories with Mechanical Power 131 Factories without Mechanical Power 18 Fairgrounds 3 Hairdressers and Barbers 13 Local Authority Properties 2 Miscellaneous Shops, etc. 13 Outworkers 63 Pet Animals Shops 25 Rag Flock . 2 Retail Shops 17 Schools 11 Stables 2 Workplaces 11 TOTAL INSPECTIONS 312 (23) (v) Prevention of Damage by Pests Act, 1949 - Rodent Control/Disinfection Rats Mice Total Complaints received 389 106 495 Enquiries and visits made:By Rodent Operatives 2468 575 3043 By Public Health Inspectors 1083 111 1194 Premises treated individually:Dwelling Houses 235 74 309 Business/Industrial Premises 57 30 87 Premises re-treated:Dwelling Houses 19 1 20 Business/Industrial Premises 6 - 6 Number of rooms treated (sprayed) - - 252 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 ... 2 Choked drains cleared ... ... ... ... 7 Dampness remedied ... ... ... ... 241 * Drains relaid or partly relaid ... ... ... 25 Floors repaired ... ... • ... ... 68 Guttering repaired or renewed ... ... ... 67 Miscellaneous defects remedied ... ... ... 207 New W.C. pans and traps provided ... ... 26 Plaster repaired ... ... ... ... 164 Rainwater pipes repaired or renewed ... ... 27 (24) Roofs repaired or renewed 201 Rooms redecorated 11 Sashcords renewed 102 Sinks provided 2 Sink waste pipes repaired or renewed 13 Stoves repaired or renewed 17 Vent pipes repaired or renewed 25 W.C. cisterns repaired or renewed 43 Window sills, etc., repaired 26 Yards paved 2 * In 14 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 20 Ceiling not kept clean or repaired 8 Floor not kept clean or repaired 3 Inadequate ventilation ... 2 Inadequate receptacles for refuse 2 Accumulation of refuse in room 3 Cleanliness of apparatus and fittings 2 Facilities for personal cleansing and/or washing food and equipment inadequate, i.e. Wash-basins 10 Hot water 18 Soap/towels/nail-brush 4 Sinks 1 Food not protected from contamination 8 First-aid equipment 12 Wash-hand notice 13 Artificial light in W.C. 13 Inadequate locker (clothing) accommodation 4 Name and address not displayed 1 Miscellaneous 7 (25) 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 Ice-Cream Milk Preserved Food Shell Pish Power Factory Non-Power Factory Catering Off-Licence Bakehouse Confectionery Fish Frier Grocer Hairdresser With Storage Baker 42 _ - - _ 18 - 1 - 18 2 - 4 - - Butcher 75 - - 48 - 5 - - - - - " - - Catering 87 54 1 - - - - - - - - - - - - Confectionery 142 55 - - - - - - - - - - - - - Dairies 6 - 6 - - - - - - - - - - - - Fish 40 - - - 13 - - 10 - - - 29 - - - Greengrocer 93 1 - - - - - - - - - - 3 - - Grocer 234 51 89 1 - 2 - - - - - - - - Multiple Store 5 3 - - - - - 2 - - - - 3 1 Milk - - - - - - - - - - - - - - - Rag Flock 11 - - - - 7 4 - - - - - - - - Pet Animals 10 - - - - - - - - - - - 1 - - Hairdresser 82 - - - - - - - - - - - - - - Hawker 126 - - - - - - - - - - - - - 58 Public House 36 - - - - - - 10 32 - - - - - - Off Licence 46 4 3 - - - - - - - - - 2 - - Factory 448 - - - - - 54 36 - - - - - - - School 18 1 - - - - - 17 - - - - - - - Council Property 4 2 - - - - - 2 - - - - - - - Hospital 2 - - - - - - 2 - - - - - - - Miscellaneous Shops 885 131 - - - - - - - - - - - - - TOTAL PREMISES 2392 TOTALS: ADDITIONAL FUNCTIONS: 779 302 99 49 13 32 58 80 32 18 2 29 13 1 58 (26) (ii) Details of Registrations/Licences ACT OR REGULATION On Register 31.12.1958 Removed during 1959 Registered during 1959 On Register 31.12.1959 Pood and Drugs Act, 1955:- S. 16 Ice-Cream Premises 303 8 10 305 S. 16 Butcher's Premises 48 - 1 49 S. 16 Fishmonger's Premises - - 2 2 S.16 Outworker's (Onion Peeling) - 1 1 " Milk and Dairies Regs., 1949:- - - - - Distributors 113 24 15 104 Milk (Special Designations) Regs. (Annual Licences):- Sterilised 112 - 99 99 Sterilised - 8 - 7 7 Pasteurised - supplementary 63 - 51 51 Pasteurised - supplementary 6 - 6 6 Tuberculin tested 24 - 21 21 Tuberculin tested - supplementary 6 ~ 5 5 Essex County Council Act, 1952: - Hawkers of Pood 122 2 3 123 Hawkers Premises 58 ~ 2 60 Leyton Corporation Act, 1950:- S. 63 Vendors of Shell Pish 16 3 - 13 S. 48 Hairdressers and Barbers 97 21 4 80 Pet Animals Act, 1951 (Annual Licences):- Pet Shops. 14 - 10 10 Rag, Flock and Other Pilling Materials Act, 1951:- Registration of Premises 9 - - 9 TOTAL 999 59 237 944 (27) 4. LEGAL PROCEEDINGS (i) Public Health Act of Hearing Nature of offence and address of premises concerned Result of Court Proceedings 7. 1.1959 Statutory nuisance - 169 Dawlish Road, E. 10. Abatement Order. 28 days. £2. 2.0. Costs. 28. 1.1959 Statutory nuisance - 4 (upper) Crownfield Road. Abatement Order. 28 days. £2.2.0. Costs. 28. 1.1959 Statutory nuisance - 41 Avenue Road, E. 11. Abatement Order. 28 days. £2. 0. 0. Costs. 28. 1. 1959 Statutory nuisance - 80 Crownfield Road. Abatement Order. 28 days. No Costs. 4. 2.1959 Statutory nuisance - 59 Cathall Road, E. 11. Abatement Order. 14 days. £1.1.0. Oosts. 4. 2. 1959 Statutory nuisance - 187 Dawlish Road, E. 10. Abatement Order. 14. days. £1.1.0. Costs. 25. 3.1959 Statutory nuisance - 44 Avenue Road, E. 11. Abatement Order. 21 days. £1.1.0. Cbsts. 23. 9.1959 Non-compliance with Abatement Order 169 Dawlish Road, E. 10. Fined £2.0.0. (ii) Food and Drugs Act, 1955. Food Hygiene Regulations, 1955 Date of Hearing Nature of offence and address of premises concerned Result of Court Proceedings 18. 2.1959 6. 4. 1959 Contravention of Food Hygiene Regulations, 1955 B. Cain, 7 Cathall Road, E. 11. Fine: 7 x £l. No Costs. 18. 2.1959 6. 4.1959 Contravention of Food Hygiene Regulations, 1955 M. C. Mugele, 269 High Road, Leyton, E. 10. Dismissed. No Oosts. 6. 5. 1959 Contravention of Food Hygiene Regulations, 1955 T. Dragone, 481 High Road, Leytonstone, 2.11. Fine: £3. £1.1.0. Costs. 23. 9.1959 Unsound Cornish Pasty - W. E. Porter, 52 Church Road, Leyton, E. 10. Fine: £1. £1. 3. 4 witness's expenses. 18. 9.1959 Cockroach in loaf - Edward May & Son (Leyton) Ltd., 198 Capworth Street, Leyton, E. 10. Fine: £1. £2. 2. 0. Costs. 26.10.1959 Dirty Milk Bottle - L. C. S. , Stratford, E. 15. Fine: £3. No Costs. 4.11.1959 Foreign matter in bread - W.J.Barton, Ltd., 611b Lea Bridge Road, Leyton, E. 10. Absolute discharge. £2.2.0. Costs. 16.12.1959 Unfit Cornish Pasty - Direct Egg Supply Co., (Suffolk) Ltd., 678 Lea Bridge Road, Leyton, E. 10. Fine: £5. £3.6.0. Costs and witness's expenses. (28) 5. MEAT AND FOOD CONDEMNED Condemnation certificates were issued in respect of the undermentioned unsound food-stuffs surrendered by various traders in the Borough as a result of routine inspection of food premises., The food condemned was destroyed by fire at the Council's Destructor Works. Commodity Cwt. Qrs. Lbs. Commodity Units Lamb - 2 14 Luncheon Meat 181 Tins Pish 3 - 4 Vegetables 77 " Dog-Pish - 1 14 Pish 30 "" Pork 4 1 4 Ham 11 " Bacon 1 1 12½ " Cheese - 1 22½ Fruit 194 " Ham - 1 18¼ Jam 1 " Pore Ham - 1 5 Milk 24 " Sausages - 1 9½ Liver 62 " Liver - - 10¼ Gherkins 116 Jars Beef 2 - 22 Jam 25 " Sleeps Plucks - 1 17 Chickens 5 " Suet - - 13 Leg of Mutton 1 " Meat 4 3 7½ Salmon 1 " Currants - 1 22 Eggs 1 Case Pigs Melts - 1 - Corned Beef - - 2 Skate 2 - 10 Gammon - - 7¼ Dessicated Coconut 1 - 18 6. SAMPLING - FOOD AND DRUGS ACT, 1955. (i) Chemical Analysis Commodity Taken Satisfactory Unsatisfactory Milk 17 14 3 Ice-Cream 4 4 - Ice Lollies 1 1 - Miscellaneous 178 169 9 TOTAL 200 188 12 (ii) Bacteriological Examination Commodi ty Taken Satisfactory Unsatisfactory Ice-Cream 7 6 1 Ice Lollies 1 1 - Ice-Cream Powder 1 1 - Coconut 2 - 2 Water 16 16 - Miscellaneous 15 8 7 TOTAL 42 32 10 (29) 7. FACTORIES ACTS, 1937 to 1959. The following are the prescribed particulars required by Section 128 (3) of the Factories Act, 1937, to be included in annua] reports. 1. Inspections. Premises Number on Register NUMBER OF Inspections Written notices Occupiers prosecuted (1) (2) (3) (4) (5) (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 58 18 1 _ (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 390 131 4 - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers premises) - - - - TOTAL 448 149 5 - 2. Cases in which defects were found Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred To H. M. Inspector By H. M. Inspector (1) (2) (3) (4) (5) (6) Want of cleanliness (S. 1) - 2 - - - Overcrowding (S. 2) 1 - - - - Unreasonable temperature (S. 3) - - - - - Inadequate ventilation (S. 4) - - - - - Ineffective drainage of floors (S. 6) _ _ - _ _ Sanitary Conveniences (S.7) (a) Insufficient 4 3 - 1 - (b) Unsuitable or defective - 3 - - - (c) Not separate for sexes 1 - - 1 - (d) Other - 13 - - Other offences against the Act (not including offences relating to Out-work 1 _ _ _ _ TOTAL 7 21 - 2 - (30) 3. Outwork. Nature of Work SECTION 110 SECTION 111 No. of out-workers in August list required by Section 110(1) (C) No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No.of instances of work in unwho1esome premises Notices served Prosecutions ( 0 (2) (3) (4) (5) (6) (7) Wearing ) Making apparel ) etc. ) Cleaning ) and ) Washing 153 Household Linen Furniture and Upholstery 1 1 Umbrellas, etc. 9 The making of boxes or other receptacles or parts thereof made wholly or partially of paper. 12 Feather sorting 1 Cosaques, Christmas stockings, etc. 4 Lampshades 8 TOTAL 189 (31) TABLE 1 AIR POLLUTION RECORDS FOR TEN YEARS ENDED 31st MARCH, I960. ending 3lst March. SMOKE (Milligrams per 100 cubic metres) SULPHUR DIOXIDE (parts per 100 million) Summer Winter Year Summer Winter Year 1951 11 37 24 2.9 9.4 6.2 1952 9 37 23 2.6 9.3 5.9 1953 8 40 24 3.1 10.4 6.7 1954 6 29 18 2.9 10.1 6.5 1955 7 30 18 4.4 11.3 7.8 1956 7 35 21 3.7 10.9 7.3 1957 8 38 23 3.9 10.6 7.3 1958 9 35 22 4.0 11.3 7.6 1959 8 39 24 4.3 13.1 8.7 1960 7 28 17 3.8 9.1 6.4 10 year's average 8 35 21 3.6 10.6 7.0 TABLE 2 CONCENTRATION OF SMOKE EXPRESSED IN MILLIGRAMS PER 100 CUBIC METRES MONTH MONTHLY AVERAGE HIGHEST DAILY AVERAGE LOWEST DAILY AVERAGE 1950/59 1959/60 1950/59 1959/60 1950/59 1959/60 April 18 16 41 35 8 6 May 8 6 21 15 3 1 June 5 5 10 12 1 2 July 4 4 9 9 1 1 August 6 5 10 11 2 1 September 8 5 18 12 3 1 SUMMER AVERAGE 8 7 - - - - October 24 16 76 46 7 6 November 39 42 101 119 13 14 December 45 28 131 70 13 10 January 40 30 109 114 13 10 February 36 31 81 101 16 12 March 29 21 76 40 12 8 WINTER AVERAGE 35 28 - - - - YEARLY AVERAGE 22 17 - - - - (32) TABLE 3 CONCENTRATION OF SULPHUR DIOXIDE EXPRESSED AS PARTS PER 100 MILLION MONTH MONTHLY AVERAGE HIGHEST DAILY AVERAGE LOWEST DAILY AVERAGE 1950/59 1959/60 1950/59 1959/60 1950/59 1959/60 April 5.8 6.8 13.8 14.4 2.1 2.6 May 3.3 3.0 6.7 9.3 1.2 0.7 June 2.8 3.2 5.4 6.8 1.0 1.7 July 2.5 3.2 4.7 6.9 09 1.1 August 3. 1 3.3 5.3 5. 5 1.3 1.4 September 3.8 3.1 7. 5 7.4 1.6 0.6 SUMMER AVERAGE 3. 6 3.8 - - - - October 7.9 5.9 19.2 14.2 3.4 2.7 November 11.3 12.2 25.1 27.2 4.9 6.8 December 13.7 9. 9 37.1 25.7 4.7 4.1 January 12.1 10.1 33.2 32.9 5.0 4.7 February 10.9 9. 5 27.8 24.7 5.1 5.1 March 8. 5 6.7 18.1 12.3 3.7 2.7 WINTER AVERAGE 10.7 9.1 - - - - YEARLY AVERAGE 7.1 6.4 - - - - (33) LEYTON HEALTH AREA SUB-COMMITTEE Representing:- Essex County Council: Alderman Mrs„ M„ Ball Councillors Mrs.LoFallasie, J.P. Miss D.D.„Forster G. W. Mason Mrs. W. M. Pal ethorpe Mrs. V.L.Wil son (1 vacancy) Leyton Borough Council: Aldermen Mrs. J.Hammond, O.B.E., J.P. (Chairman) Mrs. R. King B. G. Rayner Councillors P.W.J.Ayerst R. W. Bur] ton Mrs E. M Dare K. F. Drew G.W.Hales F .W. Marshal 1 T .C.Messenger (Vice-Chairman) P .A .Parry Mrs E V Pearson J .A. Punshon W. H .Sanders E. J.Whiteley Leyton, Wanstead and Wood ford Care Association: Mrs. A. M. CIewer Mr. G. A.Dicker Voluntary Organisations: 1 Vacancy (34) PERSONAL HEALTH SERVICES (LEYTON HEALTH AREA SUB-COMMITTEE) SECTION 21 - HEALTH CLINICS The Sub-Committee have no health centres as such, however, there are three excellent combined treatment centres at Dawlish Road (1951), Granleigh Road (1935) and LeytonGreen Road (1933) During the year a new reception centre has been erected in the waiting hall at Leyton Green Clinic thus releasing a room for an extension of the chiropody service. The new reception opened in January i960, and many tributes have been paid to the greatly improved direction and control of the public using the clinic. Late in the year work was started in the new extension to Granleigh Road Clinic. At the time of writing this is almost completed and ready for occupation™ This will undoubtedly constitute improved facilities both for the public and the staff. This clinic, in accordance with the new policy was completely redecorated during the year. Contemporary decorative schemes were used and in general they have been well received. SECTION 22 - CARE OF MOTHERS AND YOUNG CHILDREN BIRTHS During the year the following births were registered:- Male Female Legitimate 603 545 Illegitimate 34 22 Total 637 567 Stil1-Births Legitimate 16 8 Illegitimate - - In the same period 1,248 notifications were received under Section 203 Public Health Act, 1936. CHILD WELFARE CLINICS A slight reduction in attendance occurred at Leyton Green and Granleigh Road Clinics and in the same period the attendances at Dawlish Road Clinic increased. Nine child welfare sessions are held each week. Three at Leyton Green, three at Granleigh Road, two at Dawlish Road and one at Bnmanuel Hall, Hitcham Road. It is interesting to record that 91.9% of babies born in 1959 attended child welfare clinics in the area. (35) CO a> HEALTH CLINICS - CLINIC SESSIONS HEALTH CLINIC MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY Ley ton Green, Leyton Green Road, E. 10. (LEYtonstone 3650 Extn.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 Orthoptic Foot Clinic Dental Orthoptic Special Meds. Foot Clinic A. N. Exercises (alt. Fridays) Immunisation Evening Foot Clinic Dental Clinic Foot Clinic Park House, Granleigh Road, E. 11. (LEYtonstone 3650 Extn. 268) A. M. Dental (1) Minor Ailment Ante-natal (2nd and 4th) Foot Clinic Den tal (1) Oral Hygiene Minor Ailment Foot Clinic Dental (1) Minor Ailment * Aural Clinic Foot Clinic Dental (l) Minor Ailment Foot Clinic Dental (l) Minor Ailment Foot Clinic Dental (l) (Alt.) Minor Ailment Foot Clinic (Alt.) P. M. Dental (1) Ante-natal Exercises Foot Clinic Dental (l) Oral Hygiene Infant Welfare Fbot Clinic Dental (1)&(2) Infant Welfare Foot Clinic Dental (1) Infant Welfare Foot Clinic Dental (l) Immunisation Ante-natal Exercises Foot Clinic Evening Foot Clinic Dental Clinic Foot Clinic Dawlish Road, Dawlish Road, E. 10. (LEYtonstone 3650 Extn. 287) A. M. Minor Ailment Dental (1) Foot Clinic Oral Hygiene Speech Clinic Dental (1) Minor Ailment Foot Clinic Speech Clinic Dental (l) Minor Ailment Ante-natal Toddlers Foot Clinic Speech Clinic Dental (l) & (2) Minor Ailment Speech Clinic Dental (l) Minor Ailment Foot Clinic Speech Clinic Minor Ailment Dental (l)(Alt) Foot Clinic (Alt. ) P. M. Dental m Infant Welfare Foot Clinic Speech Clinic Dental (l) Immunisation Foot Clinic Ante-natal Exercises (Alt.) Speech Clinic Dental (l) Foot Clinic Speech Clinic Infant Welfare Foot Clinic Dental (1)&(2) Speech Clinic Dental (1) Foot Clinic Speech Clinic Evening Foot & Dental Foot & Dental Foot & Dental Emmanuel Hall, Hitcham Road, E. 10. P.M. Weighing Session * By arrangement Child Welfare - Clinic Attendances Leyton Green Park House Dawlish Road Bnmanuel Hall UNDER 1 YEAR - First attendances 488 879 478 89 Subsequent attendances 4177 59 52 4239 1091 Total attendances 4665 6831 4717 1180 1-5 YEARS - First attendances 216 381 225 58 Subsequent attendances 1903 1762 1090 300 Total attendances 2119 2143 1315 358 Total attendances (both age groups) 6784 8974 6032 1538 Number examined by Clinic Doctor 2111 2866 2034 - Number weighed 6643 8682 6006 1466 CARE OF PREMATURE INFANTS (weighing 5lbs. 8ozs. or under):- Born at Home 10 Born in Hospital or Nursing Home 53 CONVALESCENT HOME TREATMENT Numbers sent to Convalescent Home Children 7 Mother and Children 4 mothers with 7 children WELFARE FOODS There was no change during the year in the genera] arrangements for the distribution of welfare foods to mothers and young children. The figures of issues show a further decrease whichis national as well as local. During the year the Minister called attention for the need to encourage expectant mothers to take up their welfare foods tokens early in pregnancy. In accordance with the Ministers suggestions copies of the Ministry's leaflet "Maternity Care" were made more generally available at clinics and midwives premises. Issues - The total issues during 1959 were:- National Dried Milk (Tins) 18,887 Cod Liver Oil (Bottles) 4,030 Vitamin A & D Tablets (Pkts.) 3,814 Orange Juice (Bottles) 37,584 (37) TESTS FOR PHENYLKETONURIA Since 1958 tests have been taking place in the area in connection with the diagnosis of phenylketonuria in young babies The tests are instituted to ascertain if there is any evidence of delay in mental development which may be shown by the presence of phenylketonuria shown in the urine Every baby attending the Child Welfare Clinic has its urine tested either at the Welfare Clinic or at home„ Should a test prove positive then the child's general medical practitioner and the medical department at the Hospital for Sick children are immediately notified. ANTE-NATAL CLINIC Ante-Natal Clinic sessions are held at each.of the health services clinics and at the Lady Rayleigh Training Home, 554 first attendances were recorded and these patients made a total of 3,423 attendances during the year. POST-NATAL CLINIC This Clinic is held at Leyton Green Road monthly and referrals are made by the clinic medical officers, midwives, etc. Dr.Anne Clark, the medical officer in charge examined 145 mothers who made 202 attendances. BIRTH CONTROL CLINIC This clinic is also under the control of Dr.Clark to whom the patients are referred by general medical practitioners. Twelve mothers were so referred and made a total of 37 attendances. DENTAL TREATMENT Although the national shortage of dental staff is still acute in all areas all expectant and nursing mothers and children referred by the clinic medical officers were seen and received treatment while some of the older mothers are not willing to undergo a full course of treatment to render them dentally fit, most of the younger mothers are, and it is among this latter group that the most good can be done by way of approach to the very young children. When it is appreciated that children entering school have on the average five decayed teeth and on multiplying this figure by the number of births per annum some idea of the amount of work necessary among school entrants can be envisaged. (38) DENTAL CLINICS Patients inspected and treated during the year Expectant Mothers Nursing Mothers Children under school age (1) Patients examined 85 81 447 (2) Patients found to require treatment 62 64 327 (3) Patients who have commenced treatment 62 64 327 (4) Patients who have completed treatment 44 46 248 (5) Patients awaiting treatment - - - (6) Attendance for treatment 181 186 925 Types of Treatment Given Expectant Mothers Nursing Mothers Children under school age Extractions - (a) Permanent teeth 40 106 - (b) Temporary teeth - - 334 Fillings - (a) Permanent teeth 59 105 - (b) Temporary teeth - 491 Inlays provided - - - Crowns provided - - - Anaesthetics administered - (a) Local 38 46 5 (b) General - (i) by Medical Officers on County Staff - - - (ii) by Others 16 22 162 (a) Scaling 23 11 8 (b) Prolonged scaling and gum treatment 35 15 4 Silver nitrate treatment - - 427 Dressings 63 119 370 X-ray examinations 13 3 - Dentures provided - (a) Pull 3 14 - (b) Partial 4 9 - Dentures repaired - - - Dentures remade - (a) Pul 1 - 1 - (b) Partial - - - Orthodontic appliances - (a) Fixed - - - (b) Movable - - - Prophylactic treatment and other operations Gum Treatment - - 1 Number of treatments (scaling and prophylactic carried out by Oral Hygienists) 54 21 11 (39) The services of the oral hygienist are invaluable as an introduction to dental bare for the very young patients and it has been found that these children approach operative dentistry in a much calmer frame of mind,, SPECIALIST CLINICS Specialists allocated by Leytonstone Group No.10 Hospital Management Committee attend at the health services clinics in the area and deal with pre-school children as well as scholars. Dr.A.Logan Adam ophthalmic consultant attends at Leyton Green Clinic on Wednesdays and Fridays. During the year seven pre-school children were referred to her and they made nine attendances. Mr.H.A.Oatley, Orthopaedic Consultant attends Leyton Green Clinic on Thursdays and the clinic medical officers referred 68 new cases to him. Set out hereunder is a summary of the work. Re-inspections 101 Minor alterations to footwear 87 Surgical appliances supplied 5 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. (Telephone: MARyland 3683) (2) Knotts Green Day Nursery, Leyton Green Road, E.10. (Telephone: 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 18 41 19 41 37 82 Total attendances during year 3807 7471 3357 8607 7164 16,078 Number of days open 254 254 – (40) 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 76 140 216 (b) As Maternity Nurses 9 22 31 Ante-natal Visits 315 1134 1449 Ante-natal Examinations 596 2247 2843 Post-natal Visits 1360 5867 7227 Administrations of Gas and Air Analgesia 81 112 193 Administration of Pethidine 71 80 151 Administration of Trilene - 34 34 Gas and Air Analgesia Percentage of administrations 78.1 Medical Aid Where the Medical Practitioner had arranged to attend the patient 37 Others 62 Fees paid to Doctors Number of Accounts received 47 Total amount paid to Medical practitioners £120.1.6d. Maternity Outfits Number of outfits issued to Expectant Mothers 238 (41) SECTION 24 - HEALTH VISITING Health Visitors During the year the Health Visitors made 17,756 visits to homes. (a) To expectant mothers:- First visits 234 Subsequent visits 144 (b) To children under 1 year of age:- First visits 1224 Subsequent visits 3810 (c) To children between the ages of 1 and 5 years:- First visits 112 Subsequent visits 5142 (d) Other visits:- Whooping cough - Measles - Ophthalmia neonatorum 4 Discharging eyes - Diarrhoea 13 Puerperal Pyrexia 3 Childrens Act 19 After deaths 99 After stillbirths 17 Miscellaneous 1664 Ineffective 2472 Old people 2720 Hospital follow-up 78 Pemphigus neonatorum 1 SECTION 25 - HOME NURSING Number of new cases 1207 Number of visits paid to above 51,709 SECTION 26 - VACCINATION AND IMMUNISATION Vaccination against Smallpox NUMBER OF 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 689 85 25 22 29 54 904 Number re-vaccinated - - - 2 5 87 94 (42) 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 Genera] Practitioners By County Staff By General Practitioners By County Staff Under 1 291 363 - - 1 77 137 - - 2 14 17 - - 3 19 12 4 2 4 5 8 47 54 5-9 24 67 111 355 10- 14 3 5 15 16 Total 424 609 177 427 * Including temporary residents 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 25 20 43 6-12 months 103 490 124 1 year 28 76 30 2-4 years 6 20 10 5 years and over 3 3 2 Total (primary courses) 165 609 209 Reinforcing Injections 15 - 55 (43) Poliomyelitis Vaccination 1959. The following persons in the various age groups received a complete immunising course in 1959. CATEGORIES PRIMARY BOOSTER Male Female Male Female Born 1943 to 1959 2868 2766 4377 4178 Born 1933 to 1942 1650 2015 362 565 Born 1920 to 1932 67 50 5 4 Over 40 years - - - - Hospital Staff 133 547 39 123 Total Vaccinated during year 1959 4718 5378 4783 4870 " " " " 1958 3244 3116 520 517 " " " " 1957 1359 1303 - - " " " " 1956 179 168 - - " "to end of 1959 9500 9965 5303 5387 Total Registrations to end of 1959 - 20,601 Expectant Mothers Vaccinated - ( 540 Primary 413 Booster SECTION 27 - AMBULANCE SERVICE This Section of the National Health Service Act is administered centrally and the responsibility of the County Council. I am indebted to the County Medical Officer of Health for supplying the following statistics of the work carried out during 1959. Stretcher cases conveyed 4,811 Other cases conveyed 34,443 Total patients conveyed 39,254 Total mileage 142,701 Accidents 1,056 Other emergency 3,362 Total emergency cases conveyed 4,418 (44) SECTION 28 * PREVENTION OF ILLNESS. CARE AND AFTER CARE Foot Clinic The increasing number of geriatrics requiring treatment and the necessity of keeping them ambulant has for some time been given serious consideration by Chiropodists. The undesirability of continual padding on skins devitalized by circulatory disorders to disturbances has long been recognised,, Some form of permanent protective padding was sought. Replaceable pads held in position by an elastic band would not be suitable in many cases:- (a) danger of restricting an already feeble blood supply; (b) a large number of old people would be unable to put them on, due to inability to stoop, or if they did manage to put them on they might not be in the correct position and would increase pressure where it should be relieved. Various methods have been used, some complicated, involving taking plaster casts and making elaborate appliances of varying types. Other and more simple ways required only the taking of an impression of the foot on weight, bearing in such a way that pressure points were clearly shown Arrangements were made for visits to be made to the London Foot Hospital and later to a L.C.C. Clinic at Greenwich to compare the different techniques. As a result we began the making of semi-permanent pads in July So far we have fitted 100 patients with insoles, each one cut and shaped to the requirements of each foot. The cost has worked out at 3s, l¼d per patient, of which 2s,6d. is recovered when the insole is issued. Successful results have been obtained in approximately 85% of the cases selected, so much so, that padding has been discontinued with a consequent saving in material. I have discussed the results with various people, all of whom agree that 85% success is a very high and satisfactory figure. The making of appliances is now a standard part on the ciriculum of the hospitals and schools training chiropodists. Male Female Children New cases 209 757 382 Total attendances 3841 18138 2508 (45) 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 14 (b) Extra Nourishment - Number of new cases supplied with free milk 10 Total number being supplied with free milk at end of year 10 Loan of Sick Room Equipment Air Rings 65 Bed Back Rests 66 Bed Cradles 15 Bed Pans 132 Crutches 1 Diabetic Scales 2 Invalid Chairs 39 Rubber Sheets 145 Urinal Bottles 37 Feeding Cups 2 Commodes 46 Fracture Splints 9 Sputum Mugs 1 Total 560 Convalescence for Adults Number of applications during year 76 Length of stay:- Two weeks 38 Three weeks 22 Four weeks 3 SECTION 29 - DOMESTIC HELP Number of helps and hours worked:- Number of domestic helps enrolled at end of year Whole-time helps 3 Regular part-time helps 141 Number of domestic helps actually employed at end of year 144 Number of hours worked during the year 179,37414 Work of Domestic Help Organisers:- (l) (2) Total (1) First Visits 449 45 494 (2) Re-visits to beneficiaries - (a) Domestic help present 151 34 185 (b) Domestic help not present 599 154 753 (3) Other visits 383 89 472 (46) Help Provided Maternity Acute Sick Tuberculosis Chronic Sick Aged not Sick Others Total Aged Others Requests for help from new cases during the year 53 33 4 397 58 15 7 567 New cases helped during the year 47 32 3 346 49 9 8 494 Total cases completed during the year (a) 44 29 5 313 55 12 6 464 Cases being helped at end of year who have received help for - Under 3 months 3 5 - 55 5 1 1 70 3-6 months - 2 2 50 4 - 1 59 6-12 months - - 103 12 3 - 118 Over 12 months - - 2 378 47 11 - 438 Total (b) 3 7 4 586 68 15 2 685 Total cases helped during the year (a) plus (b) 47 36 9 899 123 27 8 1,149 Hours of help provided during the year 2,972¼ 877¼ 2,4275½ 146,884 19,308½ 5,270 1.635 179,374½ MEDICAL EXAMINATION OF STAFF County Council employees:- Number of medical examinations:- (a) Entrants to County Council's service 150 (b) Retirement on Superannuation 2 No. of medical examinations Leyton Borough Council 50 Others 4 Entrants to teaching profession and training colleges 76 (47) SCHOOL HEALTH SERVICE LEYTON COMMITTEE FOR EDUCATION 1959-1960 Chairman: Councillor A.L.Chamberlain Vice-Chairman: Councillor Mrs.E.V.Pearson Aldermen: Mrs. J.Hammond, 0.B.E., J. P. Mrs. R.King C.J.Mills, J.P. Councillors: G. S. Bentley Mrs. E. M. Dare R. J.V.Gill Miss V.D.Gostling F.D. Ives W. J. Low F. W. Marshal 1 J. A. Powell J. A. Punshon G. W. A. Robinson J.J.Walsh, J.P. County Councillors: E.C.Hardy G. W. Mason Co-optative Members: Mrs.A.D.Baxter I.A.Brown Mrs. F. E. Cochrane Mrs.E.Edwards F. W. H. May Mrs.M. Mosley STAFF All the staff employed on school health service duties (with the exception of the Speech Therapist) also carry out duties in respect of Part III Services. The following table shows the whole-time equivalent of staff employed in the school health service as at 31st December, 1959:- Medical Officers 2.95 Dental Officers 3.03 Dental Attendants 2.07 Nursing Staff 7.50 Oral Hygienist 0. 55 Speech Therapist 1.00 Administrative and Clerical 3. 00 Clinic Clerks 1.00 21.10 (48) SCHOOL CLINICS Aural Clinic Sessions as required Park House Clinic Child Guidance Monday to Friday 10 a. m - 1 p. m 2 p. m - 5 p. m Child Guidance Clinic, 263 High Street, E. 17. Dental Clinics Monday to Friday 9 a. m - 5 p. m Park House Clinic, Dawlish Road Clinic, and Leyton Green Clinic Saturday (alternate) 9 a. m - 12 noon Park House Clinic, Dawlish Road Clinic, and Leyton Green Clinic Foot Clinics - Mondays to Fridays and alternate Saturdays Treatment of school children at all Clinics by appointment. ft Minor Ailment Clinics - Monday to Friday 9 a. m - 11 a. m Dawlish Road Clinic, Leyton Green Saturday 9 a. m - 11 a. m Clinic and Park House Clinic # Doctors' Consultation Clinics - Monday, alt. Friday and Saturday 9 a. m - 12 noon Leyton Green Clinic Tuesday, Friday and alt. Saturday 9 a. m - 12 noon Dawlish Road Clinic Tuesday, Thursday and alt. Saturday 9 a. m - 12 noon Park House Clinic Ophthalmic Clinic - Wednesday 9.30 a.m - 12 noon ) Leyton Green Clinic Friday 9.30 a. m - 12 noon ) Orthopaedic Clinic Thursday 2 p. m - 5 p. m Leyton Green Clinic Orthoptic Clinic Tuesday (alternate) 9 a.m - 12 noon ) 2 P. m - 5 P. m ) ) Wednesday 9 a.m - 12 noon ) Leyton Green Clinic 2 p. m - 5 P. m ) ) Friday ) 9 a.m - 12 noon ) 2 p.m - 5p.i ) Remedial Exercises - Park House Clinic Monday 4.45 P.m - 5.30 P.m ) Wednesday 4.45 P.m - 5. 30 P.m ) Speech Clinic - Monday to Friday 9 a.m - 12 noon ) Dawlish Road Clinic 2 p.m - 5 P.m ) Vaccination and Immunisation Vaccinations and Immunisations of school children at all Clinics by appointment. # Attendances at all Clinics, except Minor Ailment Clinics and Doctors Consultation Clinics are by appointment. (49) SCHOOL MEDICAL INSPECTION SCHOOL POPULATION Designation of School Number of Schools Number of Pupils Primary 20 6,072 Secondary 10 6,445 Special 1 215 Total 31 12,732 ROUTINE MEDICAL INSPECTIONS Group Number of Pupils Examined Percentage of Parents Present 5 year 924 86.04 10-12 + year 1,207 79.45 14 year 1,162 17.73 Other 172 5.23 3,465 REINSPECTIONS - ALL GROUPS - 3,837 PHYSICAL CONDITION OF PUPILS AT ROUTINE MEDICAL INSPECTIONS Age Group (by year of birth) Number Inspected Condition Classified Satisfactory Unsatisfactory 1955 and later _ _ - 1954 306 293 13 1953 575 566 9 1952 18 18 - 1951 7 7 - 1950 545 540 5 1949 493 483 10 1948 119 116 3 1947 37 36 1 1946 8 8 - 1945 238 235 3 1944 and earlier 1119 1113 6 TOTAL 3465 3415 50 PHYSICAL CONDITION The number of children reported as unsatisfactory is small, though it is 18 more than last year, 1.4% of those examined as against 1% in 1958 Half of the cases were seen at entrance examination. Some reported were in the type of family who never attends the Infant Welfare Clinic and who are a cause of anxiety to the Health Visitor. These cases often improve when school dinners and school milk can be given and the fact that the child is out of a rather poor home, ill-ventilated and lacking in ordered (50) meals etc., seems to help the child. The figure can be affected also by ail inspection taking place in school just after an outbreak of a debilitating illness such as influenza. Therefore in such small numbers as reported here it is unlikely that this year's increase is of any significance. FINDINGS OF MEDICAL INSPECTION (a) Individual children found to require treatment Age Group (by year of birth) Pupils Inspected Defective Vision Any other Condition Total Pupils with Defects 1955 and later _ _ - - 1954 306 18 41 51 1953 575 35 79 103 1952 18 4 1 4 1951 7 1 2 2 1950 545 60 72 128 1949 493 62 71 125 1948 119 19 18 32 1947 37 7 7 13 1946 8 2 - 2 1945 238 50 32 76 1944 and earlier 1119 206 150 342 TOTAL 3465 464 473 878 (b) Pupils found to have undergone tonsillectomy Age Group Number Inspected Number found to have undergone tonsillectomy Boys Girls Boys Girls 5-year 481 443 21 11 10-12 + year 598 609 106 134 14-year 570 592 114 148 Other periodic 52 120 12 21 TOTAL 1701 1764 253 314 (c) Hygiene Inspection in Schools The Nursing Staff carried out 20,828 inspections during the year and 56 cases were found to be infested, i.e. 0.27 per cent. Consideration had been given to reducing the number of hygiene inspections in Infant and Junior Schools to once a year as is done in Secondary Schools because the incidence and severity of infection was so low. Early in 1960, however, several cases of very severe infestation were discovered in three schools and we cannot as yet reduce this measure of control. Actually these inspections should be called a general review inspection. The cleanliness of the hair is only a minor point in the health visitor's survey, for she discusses with the head teacher, and class teacher too, if necessary, any children who appear to be in any way unsatisfactory and refers them to the School Medical Officer for further investigation. She visits the home, and takes whatever action is considered right in the circumstances. (51) (52) Defect or Disease Entrants Periodic Inspections Total Special Inspections DEFECTS FOUND BY PERIODIC AND SPECIAL INSPECTIONS DURING THE YEAR Leavers Others * Treatment Observation Treatment Observation Treatment Observation Treatment Observation Treatment Observation Skin 10 9 43 3 25 (14) 13 (6) 78 25 119 64 Eyes - (a) Vision 53 37 256 20 155 (117) 48 (23) 464 105 285 7 (b) Squint 21 1 5 1 12 (9) 4 (3) 38 6 14 1 (c) Other 3 5 1 - 4 (1) 4 (2) 8 9 57 12 Ears - (a) Hearing 10 41 3 15 4 (3) 39 (27) 17 95 235 7 (b) Otitis Media 13 20 5 6 5 (3) 25 (17) 23 51 20 17 (c) Other 5 6 16 1 18 (1) 3 (2) 39 10 49 8 Nose and Throat 29 70 11 2 16 (9) 30 (14) 56 102 48 7 Speech 10 20 6 3 9 (5) 5 (4) 25 28 59 3 lymphatic Glands - 39 2 2 - (-) 7 (1) 2 48 11 1 Heart 2 21 1 11 2 (1) 8 (5) 5 40 20 1 Lungs 16 33 9 18 5 (3) 27 (21) 30 78 48 22 Developmental - (a) Hernia 6 2 - 1 1 (1) 1 (-) 7 4 4 1 (b) Other 4 16 4 3 11 (5) 24 (11) 19 43 45 2 Orthopaedic - (a) Posture 5 11 16 20 17 (6) 23 (7) 38 54 8 2 (b) Feet 19 27 16 5 20 (10) 15 (7) 55 47 87 6 (c) Other 7 31 30 8 23 (10) 28 (11) 60 67 37 6 Nervous System - (a) Epilepsy 1 5 2 - 2 (2) - (-) 5 5 3 - (b) Other - 2 2 1 1 (-) 10 (4) 3 13 25 6 Psychological - (a) Developmental - 7 1 2 2 (-) 17 (5) 3 26 50 7 (b) Stability 7 57 4 14 22 (15) 38 (18) 33 109 110 32 Abdomen 4 2 1 1 4 (4) 3 (2) 9 6 24 3 Other - 9 9 4 8 (4) 6 (2) 17 19 612 152 * Numbers in brackets are those children who are already known, i.e. Total in column minus number in brackets equals new cases found. MEDICAL TREATMENT MINOR AILMENT CLINIC A doctor attends each Clinic for two morning sessions and alternate Saturday mornings for consultations A school nurse is on duty every morning for dressings and minor injuries, etc. During 1959, 1,932 children attended 2,283 times to see the doctor and 1,373 children attended 3,091 times for advice and treatment from the nurse SPECIAL CLINICS SUMMARY FOR 1959 Or thopaedic Aural Ophthalmic Or thoptic Sessional Programme 1 a week 1 a month 2 a week 4 a week Total Sessions 41 9 85 237 New Cases 152 32 252 122 Attendances 538 80 1509 1915 ORTHOPAEDIC CLINIC Mr. H. A Oatley, the Orthopaedic Consultant, is also on the medical staff of Whipps Cross Hospital and all cases requiring hospital investigation or treatment were referred to his clinic at that hospital. This co-operation is invaluable as it ensures continuity of treatment under the same specialist During the year the under-mentioned number of children were referred to the various departments at the Hospital,, 32 Radiological investigation 2 Physiotherapy 14 Operative treatment 52 Fitting of surgical appliances AURAL CLINIC Mr.C.J.Scott, our Ear, Nose and Throat Consultant, died suddenly in 1959. He had always been co-operative and helpful and we much regret his passing. Owing to his death there was some difficulty in arranging for consultations and there were no clinic sessions on three occasions in 1959 Although the number of cases seen is small, it is found to be a useful adjunct to the doctor's consultations clinic. (53) Many of the cases referred there belong to families who would not trouble to go to hospital but will come to the clinic that is near their homes and where the waiting time is very much less than with hospital appointments Twenty-one of the thirty-two new cases required hospital referral as noted below. Removal of Tonsils and Adenoids 7 Removal of Adenoids 3 Removal of Polypi 1 Antral Lavage 2 Mastoidectomy 1 X-ray sinuses 3 Further investigation 4 OPHTHALMIC CLINIC AND ORTHOPTIC CLINIC The Ophthalmic Clinic under the Ophthalmic Consultant, Dr. A.Logan Adam, continues to work to capacity and the Orthoptist, Mrs. S, Box, is investigating many more children under five years,, As Mrs.Box is also Orthoptist at Whipps Cross Hospital under Mr.Klein, the Consultant Ophthalmologist, co-operation exists for referral for operative treatment under Mr. Klein. REMEDIAL EXERCISE CLASSES Sixty-seven children made 553 attendances. The classes are for children who require foot and posture exercises, exercises to improve general condition and some cases of chest disease with poor chest expansion. The children appear to benefit and enjoy the classes. DENTAL INSPECTION AND TREATMENT The Senior Dental Officer's report for the year ended 31st December, 1959, is set out below:- "The happiest event to be recorded on the staffing side during the year under review was the application by one of our part-time Dental Officers (Mr Arnold) for full time employment. Even so, with the reduction in sessions worked by part-time officers the staffing position has remained at little more than fifty per cent of establishment (54) over the year, being the equivalent of three to three and a half dental officers out of an establishment of six- The seriousness of the situation can be realised when it is remembered that these dental officers are responsible for over 13,000 school children, some 2,500 pre-school children in the two and a half to five year age group, and some one thousand or so expectant mothers per annum. The recommended number of school children alone per dental officer for a complete service is 3,000 (vide 'Health of School Child* 1954-55). To bridge this gap, to a certain extent, judicious discrimination on offer of conservative treatment has been carried out for some time to ensure that the best possible service is offered to those who most appreciate it, which is shown by regular attendance and the carrying out on the part of the patient of those recommendations laid down for dental health. Hie work of the hygienist (Mrs Thurston) has been found to be of great value in educating patients in the proper care of their mouths Having once been referred to her for scaling, cleaning, or tooth brushing instruction, it is quite remarkable what a large proportion of these patients ask for regular inspection by the dentist and regular cleaning by the hygienist. Apart from regular inspection and treatment and genera] educational measures on dental care, the fluoridation of the water supply may yet be found to be one of our greatest helps in controlling dental decay Much controversy concerning these measures is going on at the present time, and the Ministry of Health tests in the experimental areas of Watford, Anglesey and Kilmarnock are continuing,, Those in Andover have been discontinued for other than scientific reasons. Orthodontic treatment continued to be very popular, but here again all children in need of such treatment cannot be given it due to the number of such cases, and the shortage of dental officers. The cases are limited as far as possible, therefore, to those children whose health is suffering as a result of the dental irregularity, or where the parent has accepted regular dental treatment throughout the child's school life. Fixed and removable appliances are used, but where possible, the latter, as they are not so time-consuming in the surgery. A limited number of evening sessions are worked throughout the area and are proving popular with the older children, The tables show the general scope and amount of work carried out.," DENTAL INSPECTION AND TREATMENT Periodic Specials (a) Number of pupils inspected 5,459 670 (b) Number found to require treatment 3,495 670 (c) Number offered treatment 3,401 670 (d) Number actually treated 2,776 670 (55) Periodic Specials (e) Number awaiting treatment 107 – (f) Attendances made by pupils for treatment 9,806 982 (g) Half-days devoted by:- (a) Dental Officers to- (i) Periodic (school) inspection 45 (ii) Treatment 1,398 (b) Oral Hygienist to(i) Treatment 135 (ii) Other Purposes 83 (h) Fillings- (i) Permanent teeth 4,729 (ii) Temporary teeth 2,011 (i) Number of teejh filled(i) Permanent teeth 4,337 (ii) Temporary teeth 1,919 (j) Extractions- (i) Permanent teeth- (a) On account of caries 816 (b) For other purposes 152 (ii) Temporary teeth- (a) On account of caries 2,464 (b) For other purposes 372 (k) Anaesthetics administered(i) Local 1,276 (ii) General(a) By Medical Officers on County Staff Nil (b) By others 1,520 Average number of general anaesthetic cases per general anaesthetic session 17.69 (1) Orthodontics- (i) Cases commenced during the year 102 (ii) Cases carried forward from the previous year 177 (iii) Cases completed during the year 60 (iv) Cases discontinued during the year 21 (v) Pupils treated with appliances 142 (vi) Removable appliances fitted 107 (vii) Fixed appliances fitted 35 (viii) Total attendances 1,251 (ix) Number of sessions devoted to treatment 128 (m) Number of- (i) Pupils supplied with artificial dentures 40 (ii) Dentures fitted 36 (n) Other operations- (i) Permanent teeth 3,720 (ii) Temporary teeth 1,582 (56) (o) Number of other operations in (n) carried out by the oral hygienist:- (i) Permanent teeth 875 (ii) Temporary teeth Nil (p) Analysis of other operations.(i)Silver Nitrate treatment 608 (ii)Scaling, polishing and cleaning 874 (iii)Gum treatment 82 (iv)Dressings 2,281 (v) X- rays 260 (vi)Crowns fitted 22 (vii)Inlays fitted 2 (viii) Miscellaneous 1,173 DENTAL INSPECTIONS IN SCHOOLS School No. of children inspected No. requiring treatment No. referred for treatment No. accepting treatment Percentage of acceptances Leyton County High, Boys 704 387 360 155 43.1 Connaught Secondary Modern 506 327 327 171 52.3 Leyton Manor " " 80 63 63 16 25.4 George Mitchell Sec. " 494 414 414 199 48.1 Barclay Primary Junior 549 279 279 136 48.4 Davies " " 323 205 201 125 62.1 Downsell " " 399 313 313 180 57.6 Mayville " " 383 214 210 156 74.4 Sybourn " „ 431 268 245 146 59.6 St. Josephs " " 204 134 134 91 67.9 Barclay Primary Infants 304 197 197 102 51.8 Church Mead" " 177 111 111 66 59.5 Davies " " 135 79 78 52 66.7 Lea Bridge " " 51 40 40 31 77.5 Mayville " " 158 97 97 60 61.9 Harrow Green 97 68 65 41 63. 1 (57) CHILD GUIDANCE CLINIC TABLE I ANALYSIS OF FIGURES FOR 1959 Number of cases referred to the Clinic 77 Number of cases diagnosed at the Clinic 40 (a) Psychiatrists Diagnostic interviews 41 Cases taken on for observation and treatment 25 Treatment interviews 225 Other interviews 12 # Total number of phychiatric sessions 212 (b) Psychologists Clinic cases tested 42 Cases given remedial education 7 Treatment interviews (remedial education) 148 School visits on behalf of clinic cases 48 Other interviews at clinic 5 Other interviews outside 44 (c) School Psychological Service Individual cases seen 121 Number referred to clinic 27 (d) Play Therapists Cases treated 11 Treatment interviews 284 (e) Psychiatric Social Workers Interviews at clinic 623 Interview elsewhere 40 (f) Waiting List Cases for diagnosis (by doctors) 37 Waiting for treatment (g) Total cases treated during year 93 Leyton and Forest Division joint sessions (58) TABLE II ANALYSIS OP CASES REFERRED 1. Nervous disorders, e.g. fears; depressions; apathy; excitability 17 2. Habit disorders and physical symptoms; e.g. enuresis; speech disorders; sleep disturbances; tics; fits, etc. 16 3. Behaviour disorders; e.g. unmanageable; tempers; stealing; lying; sex problems, etc. 34 4. Educational; e.g. backwardness; failure to concentrate 10 TABLE III ANALYSIS OF CASES DIAGNOSED 1. Nervous disorders, e.g. fears; depressions; apathy; excitability 19 2. Habit disorders and physical symptoms; e.g. enuresis; speech disorders; sleep disturbances; tics; fits, etc. 3 3. Behaviour disorders; e.g., unmanageable; tempers; stealing, lying, sex problems, etc. 11 4, Educational, e.g. backwardness; failure to concentrate 5 5. No basic disturbance of child, e.g. mainly parental over-anxiety ... 2 TABLE IV ANALYSIS OF CASES CLOSED DURING 1959 1. Improved and recovered after treatment 19 2. Improved after partial service, i.e. before diagnosis – 3. Diagnosis and advice only 1 4. Interrupted, e.g. on parents* initiative 10 5. Closed for miscellaneous causes, removed from area, placement at E.S.N. School, etc. 8 6. Spontaneous Improvement 44 (59) The increasing number of cases referred to the Child Guidance Clinic, and the long waiting time before these cases are seen, underlines the urgent need for an extension of the service so that more diagnostic and treatment sessions can be given by the phychiatrist. This also means an increase in the educational psychologist and phychiatric social worker staffing. It is hoped that before very long extensions to the service in this area will be approved. REMEDIAL TEACHING OF READING IN LEYTON SCHOOLS SESSION 1958-9 The following report was submitted to the Leyton Committee for Education by the Educational Psychologist. This report deals with the work done in the Junior Schools of Leyton to improve the reading ability of children who have fallen behind although of normal or above normal intelligence. This is the seventh year in which the scheme has operated and the need for it does not show any signs of diminishing although one's impression is that reading ability, in general, has improved. It has become increasingly clear to the teachers that failure to learn to read in children of good intellectual capacity is very often linked with some degree of emotional disturbance. The advantage of keeping these small remedial groups in being in the schools is therefore self evident since they provide a very simple and readily available means of helping some disturbed children to reach adjustment. Further and more intensive help for disturbed children is, of course, available at the Child Guidance Clinic but if the remedial groups in the school can help some children to adjust then the heavy waiting list at the Child Guidance Clinic is thereby relieved. It is essential, however, that Head Teachers and class teachers, as well as the remedial teachers themselves, should be on the watch for those children who cannot adjust even with the individual help of the remedial group, but skill and experience are needed in judging the time for asking for more help for the child. One boy, for instance, made only six months gain in reading ability in his first eight months in the remedial group, but in his second year in the group he has gained 39 months. There has to be a balance between acting too soon and waiting too long. It seems that one has waited too long if a child is allowed to pass on to the Secondary School still having made little or no progress in the remedial group. During the first term in the 4th Year in the Primary school such children should be brought to the notice of the Educational Psychologist. The remedial scheme operated in nine primary schools. The teachers have continued to work with their customary enthusiasm. The number of children in the groups this year was 203 - Number of boys 132 ) Number of girls 71 ) 203 The following table shows the length of tuition and gains in reading age in months (60) during the period of remedial teaching:- Nos. of Children Length of Remedial Teaching Numbers of Children with their Gains in Reading Age in months 0-6 7-12 13-18 19-24 25-30 31*36 37-42 MONTHS 129 3 terms 13 36 42 15 16 7 3 38 2 terms 3 12 16 7 1 1 1 36 1 term 9 13 6 1 1 203 The average age of the children at the beginning of the year was 9 years l month, and their average reading age was 7.5 years. At the end of the period the average reading age was 8.5 years. Fifty-seven of the children passed out of the primary school at the end of the summer term. Their average reading age was 9.3 years but it should be noted that this average has been lowered by two or three boys who have apparently made no progress in reading in their last year in the group. These are the ones who should have been reported earlier. Of the fifty-seven moving on, twenty-one had achieved reading ages of over 10 years, and many of the others were not far behind. The way in which the re-adjustment of these children shows itself most strikingly is, however, in a more attentive attitude to work and school and in an increase in cheerful self-confidence. When this change takes place the teachers may justifiably be satisfied with the remedial aspect of their work. B.C.G. VACCINATION Number of school children to whom B.C.G. Vaccination has been offered - 1271. Result of Heaf Tests Result of Mantoux Tests Tuberculin Positive Tuberculin Negative Vaccinated with B. C. G Tuberculin Positive Tuberculin Negative Vaccinated with B. C. G (1) (2) (3) (4) (5) (6) 31 415 412 7 112 112 TOTAL TUBERCULIN POSITIVE TOTAL TUBERCULIN NEGATIVE TOTAL VACCINATED WITH B. C. G Columns (1) & (4) Columns (2) & (5) Columns (3) & (6) 38 527 524 The acceptance rate of 41% is very low compared with other areas in Essex and in (61) the country as a whole. The reason is hard to find. Acceptance rates vary from school to school and year to year which seems to cut out the effect of propaganda or Head Teacher enthusiasms or disapproval since one would imagine that a pattern would have emerged by now, but it has not, and we are in the dark over this. TUBERCULOSIS VACCINES CLINICAL TRIAL This scheme was reported on fully in 1958- The Medical Research Council continued 'follow up' examinations in 1959 assisted by members of the Health Visiting and Nursing Staff. Of the 218 young people invited for their sixth annual X-ray, 126 attended, i.e. 58%, and of these 50% completed the skin tests. In addition, of the 93 who defaulted on the previous occasion 32 attended this time. It is expected that i960 will see the completion of this trial. SPEECH CLINIC CHILDREN HAVING RECEIVED TREATMENT DURING 1939 Under 5 years Primary School ' Secondary School Special School TOTAL Cases commenced before 1959 and continuing after December, 3ist 1958. Articulation Defect – 14 2 15 31 Stammer – 3 9 1 13 Articulation Defect and Stammer -– 3 – 1 4 Total – 20 11 17 48 Articulation Defect 3 41 2 4 50 Cases commencing treatment during 1959 Stammer 1 10 2 – 13 Articulation Defect and Stammer – 1 – – 1 Total 4 52 4 4 64 Therefore total cases receiving treatment during 1959 - 108 Total new cases - 64- 2 failed to attend for treatment. (62)  Boys Girls Total Children at present undergoing treatment 74 23 97 Children discharged 40 23 63 On Waiting List Nil Average number of cases treated daily 17 Homes visited 40 School departments visited 44 Parents interviewed 127 Children referred to other clinics 5 Number of children leaving before cure or discharge 19 Total number of attendances 2097 Number of children not at present attending but names on list 62 Number of children referred found not to require treatment Nil CHIROPODY CLINICS There are two chiropodists working in each of the Health Services Clinics and children are accepted for treatment on referral from the Minor Ailment Clinic or from their private practitioners. There is no waiting list, and children are seen by appointment within a few days of the doctor's request. A copy of a report is set out below on an outbreak of plantar warts at a Leyton secondary modern school which was submitted by the chiropodist who investigated the outbreak and treated the children. "During 1959 sixty-six pupils received treatment at the Foot Clinic, Dawlish Road, for plantar warts. Of that number, 48 have been discharged and 18 are still attending the Clinic. Because of the large number of pupils reporting for treatment in the early months of the year a foot inspection was held on the 15th May, 1959. Twenty-six new cases were found as a result, and of that number 6 were attending their own doctor, 3 were (63) attending private chiropodists and one was attending hospital. The remaining 13 were treated at this foot clinic. Since the inspection, new cases have continued to report - the incubation period for plantar warts is a very long one - but these cases have lessened considerably. One can, therefore, assume that the outbreak is on the decline. GENERAL OBSERVATIONS 1. Most of the cases responded well to routine treatment. Some, however, proved more resistant, and consequently the child's attendance at the Clinic was longer. 2. Every effort is made to eradicate the infection expeditiously, but the ultimate success of treatment largely depends on the individual reaction. 3. Endeavour is also made to interfere as little as possible with the normal activities of the patient. 4. At the inspection the general standard of foot hygiene was good. A limited number of fungoid infections was found, but all were already under treatment. 5. I am indebted to the headmistress and her staff for their co-operation during the past year." Set out hereunder is a table shewing the conditions treated in the various age groups during the year:- Condition Under 5 yrs. 5 - 7 7-9 9 - 11 11 - 13 13 + TOTAL M P M F M F M P M P M F Corns 1 1 3 3 4 4 3 2 5 4 10 7 47 Callous – – – 1 – – – – – 1 – 1 3 Ingrowing Nail 2 – – 1 – – – – – 2 3 – 8 Erythema Pernio – – – – – – – – – 1 – – 1 Tinea Pedis – – – – 1 – – – – 1 2 5 9 Verrucae Pedis 1 2 6 3 17 14 17 41 46 102 14 51 314 Total in Age Groups 4 3 9 8 22 18 20 43 51 111 29 64 382 7 17 40 63 162 93 (64) (65) HANDICAPPED PUPILS CATEGORY Number of children of school age on 31st December, 1959, formally ascertained as handicapped pupils and requiring special educational treatment (s. e. t.) Children of school age on register of handicapped pupils but not requiring s. e. t. and attending ordinary schools Children age 2-5 years ascertained as handicapped pupils Children aged 2-5 years on register but not formally ascertained. Attending day special school Awaiting placement in day special school Attending residential special school Awaiting placement in residential special school Attending boarding homes 1 Awaiting placement in boarding homes Attending independent schools Awaiting placement in independent schools Attending hospital schools Awaiting placement in hospital schools Receiving Education in hospital under Section 5fi Receiving home tuition under Section 56 Awaiting home tuition under Section 56 Special Maladjusted Classes in Day School Total No. of children of school age requiring s. e. t. Receiving Special Education Awaiting Special Education Blind -– – – – – – 2 – – – – – – – 2 – – – 2 Partially sighted 2 – – – – – – – – – – – – – 2 6 – – 1 Dsftfo 3 – – – – – – – – – – – – – 3 – 1 – – Partially deaf 3 – – – – – 1 – – – – – – – 4 10 1 2 2 Delicate – – 5 – – – 1 – – – – – – – 6 – – – – Physically Handicapped 14 3 – – – – – – – – 13 2 – – 32 34 2 – 21 E.S.N 81 – 5 – – – 6 – – – – – – – 92 – – – 14 Maladjusted – – 6 1 1 – 8 – – – – – – 14 30 – 1 – – Epileptic – – – – – – 2 – – – – – – – 2 13 – – 1 Speech defect – – – – – – – – – – – – – – – – – – 1 Dual defects – – – – – – 1 – – – – – – – 1 – – – 1 TOTAL 103 3 16 1 1 – 21 – – – 13 2 – 14 174 63 5 2 43 LEYTON SPECIAL E.S.N. SCHOOLS A full report was made on Harrow Green and Leyton Green Schools in 1958, and I do not propose to make any fresh observations this year. I submit the statistics of the work done at the school by the Assistant Medical Officer who visits regularly. Number on Roll in 1959 Total - 199 Leyton 82 Forest 117 Leyton Harrow Green 80 Green 119 Number admitted 1959 35 Number left 1959 31 Reasons for leaving:- 1. Attained age of 16 - (a) Notified under Section 57 (5) 9 (b) Not notified 3 2. No longer in need of special education 2 3. Notified as Ineducable under Section 57 (3) 6 4o Removal to other areas 4 5. To Residential School (E.S.N.) 2 6. To Residential School (Open Air) 1 7. Returned to Normal School 3 8. To Day Maladjusted Class 1 TABLE A LEYTON GREEN PRIMARY (E.S.N.) SCHOOL Routine Specials Boys Girls Boys Girls No. Inspected 27 10 18 12 Parents present 13 5 - – Unsatisfactory 3 1 1 1 Code No.4 Skin 2 – – – (66)  Routine Specials Boys Girls Boys Girls 5 (a) Vision 2 2 – 3 (b) Squint 3 1 – 2 (c) Others – – – – 6 (a) Hearing 2 2 8 4 (b) 0. Media 1 1 – – (c) Others – – – – 7 Nose and Throat 2 1 8 1 8 Speech 3 3 – 6 9 Lymphatic glands – – – – 10 Heart – – – – 11 Lungs – – – – 12 Developmental(a) Hernia 1 – – – (b) Others – – 2 1 13 Orthopaedic(a) Posture – 1 – 1 (b) Peet 3 – – – (c) Others – – 1 – 14 Nervous System(a) Epilepsy 1 – 1 2 (b) Others - - - - 15 Psychological(a) Development – – – – (b) Stability 7 3 2 1 18 Abdomen – – – – HARROW GREEN SECONDARY (E.S.N.) SCHOOL Routine Specials Boys Girls Boys Girls No. Inspected 18 8 29 30 Parents present 10 4 – – Unsatisfactory - 2 2 2 Code No. 4 Skin 1 1 – – 5 (a) Vision 1 3 – 1 (b) Squint – – 1 – (c) Others – – 1 1 6 (a) Hearing 1 – 2 1 (b) 0. Media – – 2 -– (c) Others – – – 1 (67) Routine Specials Boys Girls Boys Girls 7 Nose and Throat 1 – – – 8 Speech – – 1 – 9 Lymphatic glands – – – – 10 Heart – – – – 11 Lungs 2 1 2 – 12 Developmental(a) Hernia – – – – (b) Others – – 1 – 13 Orthopaedic(a) Posture – – – 1 (b) Feet – 1 – – (c) Others – – – – 14 Nervous System(a) Epilepsy – – – 2 (b) Others – – – 1 15 Psychological(a) Development – – 9 6 (b) Stability 5 1 8 6 18 Abdomen – – 3 3 DAY MALADJUSTED CLASSES At their meeting on 12th February Leyton Committee for Education resolved to establish Day Classes for Maladjusted Children at the Lea Bridge Infants School. The School Medical Officer co-operated closely with the Borough Education Officer and the Staff of the Walthamstow Child Guidance Clinic, particularly the Educational Psychologist, in the setting up of the class. A good deal of work had to go into the choosing of suitable children, and the knowledge gained in assessing the first group of children admitted to the school should prove very helpful when considering further expansions. The classes commenced in September, 1959. At the end of the Autumn term there were 14 children attending. There were two classes, with two teachers. The staffing ratio looks very extravagant but the problem; presented by these children is a difficult one, and the teachers had a very heavy task in the first weeks of the term. By the end of the term, however, all concerned in the setting up of the classes felt that they had justified themselves and, most important, so did the parents of the children. It is not an easy task to decide which children are suitable and valuable experience is being gained by the education and medical staff concerned in the care of these disturbed children. (68) At the end of the first term three children were transferred - two back to their old school as they had made quite marked improvement in school work and behaviour and one to a Day Physically Handicapped School as her physical handicap was more severe than her behaviour difficulty and it was decided she was not in the right environment. By the end of the first term the experiment seemed to give such promise for the future that plans were being laid for the school's expansion in I960. HEARING AIDS A survey taken in January 1959, showed seven children were wearing hearing aids in Leyton Schools, OUTBREAKS OF INFECTIOUS DISEASE IN 1959 There were no notable outbreaks of infectious disease in the Borough of Leyton during 1959, but Sonne dysentery could give cause for anxiety, it having become practice ly endemic everywnere in the country. One can never be sure, when a few cases have been reported in an area, that a major outbreak is not going to appear. It is difficult to control. The infection is very rarely found to be food borne and one has to concentrate on measures entailing strict personal hygiene, cleanliness of school and exclusion of all children or school staff with diarrhoea. TUBERCULOSIS IN SCHOOL CHILDREN One girl, aged 9, was admitted to hospital with tuberculous pleural effusion in March, 1959 She was discharged home in July, 1959, and discharged cured in i960, One boy, aged 12, was admitted to hospital with a tuberculous kidney. In January, 1959, a boy from a neighbouring area who attended a Leyton Secondary School was confirmed as a case of pulmonary tuberculosis All contacts of the boy at school were skin tested and the Chest Physician carried out "follow-up" examinations. No further cases of infection were found and the source of the original infection was never discovered I should like here to record my gratitude for the cooperation of the pupils* parents, the school staff and the chest physician. DEATHS OF CHILDREN OF SCHOOL AGE During the year seven children of school age died. The deaths were due to the following:- Cerebral Tumour Male - 10 years Myelblastic Leukemia Male - 8 " Cirrhosis of Liver Male - 14 " Intestinal Obstruction due to Megacolon Male - 12 " Bronchopheumonia (spastic microcephalic) Male - 5 " Fractured skull following a road accident Male - 6 " Asphyxia - Accidental death Male - 15 „ In 1958 there were three deaths of children of school age, all boys. This year sev«n children died, again all boys. (69) HEALTH EDUCATION During the year 236 talks were given by Health Visitors in Schools to pupils who totalled 4,492 attendances. Courses were commenced in Ruckholt Secondary Modern School in 1959. This is an increase on the work in previous years, ENEURESIS ALARMS In 1959 one eneuresis alarm was purchased for each Clinic. Reports in the Medical Journals and the local Paediatric Unit indicated that this method of treatment was having some success, and it was considered desirable that such facilities should properly be given from the School Clinic. It is proposed to increase the number of alarms available at each Clinic to three, as the waiting time between each case is never less than four weeks, and may be as long as eight weeks. It is considered that if three are available at the Clinics we will be able to cope more efficiently. If we consider this number is still insufficient more alarms will be ordered. Dr.Hinden, the Paediatrician at Whipps Cross Hospital, has recently asked for our co-operation in the matter of treating the children with eneuresis. It would appear that, because of the success of this new treatment, more parents are bringing the children to the Clinics and asking for help„ So far the number of cases treated is too small to be of any value statistically but there have been several quite dramatic improvements in children of the 13-14 age group who had not reacted to any other type of medical care both by the general practitioner and by hospitals, and the psychological effect of achieving a dry bed has been very gratifying. (70) SANITARY INSPECTION OF SCHOOL PREMISES SANITARY FACILITIES AND CATERING ARRANGEMENTS, 1959. The following report has been submitted by the Chief Public Health Inspector, Borough of Leyton, to whom I am indebted, "Periodic inspection of the sanitary facilities and catering arrangements at school premises have been carried out throughout the year by the Public Health inspectorate of the Local Sanitary Authority. Such inspections have shown that the provisions contained in the Pood Hygiene Regulations, 1955, for securing the observance of sanitary and hygienic conditions and practices in connection with the preparation, transport, storage and handling of food are being complied with at school central kitchens and dining centres throughout the Borough. Although it was not found necessary to initiate any formal action under the Public Health Acts and Food Hygiene Regulations, the close liaison and co-operation which exists between the Local Authority's Public Health Inspectors, the Borough Education Officer and the School Meals Organiser have made it possible for informal recommendations to be made and implemented from time to time to secure the active co-operation of catering staff in observing and practising strict personal cleanliness in all matters connected with the handling and preparation of food and to ensure, in the interest of food hygiene generally, that the best possible use is being made of existing premises and available equipment. In conjunction with the Supplies Department of the Essex County Council the inspection of food supplies, especially meat, as delivered to the schools by the contractors, has now been established. At the present time there are two separate contracts for the supply of meat to schools and day nurseries; the premises of each contractor are not situated in the Borough and are therefore outside the immediate supervision of the Local Sanitary Authority. However, in order to check on the standard of food supplied and the condition of the vehicles used for transportation, inspections are made from time to time at approximately 7.30 a„m.. while meat is in course of delivery to the kitchens. So far, no contraventions of the Pood and Drugs Act in respect of the nature, substance or quality of the food supplied, or in regard to the requirements of the Pood Hygiene Regulations governing the transportation of meat have been observed. The results of such inspections are reported to the Supplies Department, and it is intended that these early morning visitations shall be continued." (71) IMPROVEMENTS TO SCHOOL PREMISES CARRIED OUT DURING YEAR ENDED 3IST DECEMBER, I 959. I am grateful to the Engineer and Surveyor, Borough of Leyton, for the following summary:- LAKE HOUSE COUNTY SECONDARY New annexe at Dames Road comprising 2 Science Rooms, 2 Housecraft Rooms and Needlework Room, with sanitary and staff accommodation. Heating and domestic hot water by oil fired boilers. GEORGE MITCHELL COUNTY SECONDARY Improvements to layout of equipment in Scullery, including new sinks and wall til ing„ MAYVILLE COUNTY PRIMARY Existing Classroom/Dining building extended and converted into Kitchen and Dining Room with new equipment., ST.JOSEPH'S R.C. New classroom block including sanitary, washing and cloakroom accommodation erected on adjoining site. Classroom in main school extended and converted as Kitchen. New Staff rooms with sanitary and washing facilities provided on first floor. BARCLAY COUNTY PRIMARY New gas radiators provided in Dining Room to replace obsolete overhead typei DOWNSELL COUNTY PRIMARY New wood floors laid in five classrooms to replace worn out flooring. LEA BRIDGE COUNTY INFANTS Sinks with hot and cold water fitted in two classrooms. Alterations to existing Cloaks and sanitary accommodation for use of maladjusted children. THE UNDER MENTIONED SCHOOLS WERE REDECORATED INTERNALLY:- Lake House County Secondary Cann Hall County Primary Junior (72) INDEX Page(s) Acreage 4 Air Pollution 17, 32 Ambulance Service 8, 44 Ante-natal Clinics 38 . Aural 53 Bacteriological Examinations 29 Birth Control Clinic 38 B. C. G. Vaccinations 61 Birth Notifications 35 Birth Rate 4 Birth Registrations 35 Births, Illegitimate 4 Burial of the Dead 7 Business Premises 14, 23, 26 Child Guidance Clinic 58 Child Welfare Clinics 35, 37 Clinic Sessions 36 Convalescent Home Treatment 37, 46 Comparability Factor 4 Day Maladjusted Classes 68 Day Nurseries 40 Death, Causes of 6 Death Rate 4 Dental Treatment 38, 54, 57 Diphtheria Immunisation 43 Disinfestations 24 Domestic Help Service 46 Domiciliary Midwives 41 Eneuresis Alarms 70 E.S.N. Schools 66 Factories Acts, 1937/48 30 Food, Condemned 29 Pood, Hygiene 25 Foot Clinic 45, 63 Gas and Air Analgesia 41 Handicapped Pupils 65 Health Clinics 35 Health Education 11, 70 Health Visiting 42 Hearing Aids 69 Home Nursing 42 Hospitals 8 Housing and Nuisance Abatement 12 Housing Repairs & Rents Act, 1954 13 Ice-Cream 29 Immunisation 43 Improvement to School Premises 72 Infant Mortality 43 Infectious Diseases 9 International Certificates 7 Page(s) Laboratory Facilities 8 Laundry for the Incontinent 8 Legal Proceedings 28 Maternal Mortality 4 Maternity Outfits 41 Medical Aid 41 Medical Examination of Staff 47 Midwife 41 Minor Ailment Clinics 53 National Health Service Act, 1946 (Part III) 35 Notices, Sanitary 24 Nuisances, Abated 24 Nursing Homes 8 Ophthalmic Clinic 40 Orthopaedic Clinic 40 Ortheptic 54 Pet Animals Act, 1951 27 Phenylketonuria 38 Poliomyelitis Vaccination 44 Population 4 Post-Natal Clinic 38 Premature Infants 37 Redevelopment Areas 13 Remedial Exercises 54 Remedial Teaching of Reading 60 Rent Act, 1957 22 Rodent & Insect Control 14, 24 Routine Medical Inspections 50 Sampling (Pood & Drugs Act, 1955) 15, 25, 29 Sanitary Inspection of Schools 71 Sanitary Circumstances 11-33 School Clinics 49 School Health Service 48 Sick Room Equipment 46 Slum Clearance 13 Smoke Abatement 17, 32 Speech Clinic 62 Statistics, Comparative- (Births, Deaths, etc.) 5 Statistics, Sanitary 21 Statistics, .Vital 4 Swimming Baths 7 Tuberculosis 10, 70 Tuberculosis, Open Air Shelters 46 Vaccination 42 Vital Statistics 4 Welfare Foods, Distribution of 37 Whooping Cough, Immunisation 43 Printed by LEYTON BOROUGH COUNCIL