AC- 4 411(1)| BOROUGH OF LEYTON THE HEALTH OF LEYTON 1960 G.T.CROOK M.R.C.S., L.R.C.P., D.P.H. Medical Officer of Health, Borough of Ley ton Area Medical Officer, County of Essex Divisional School Medical Officer Health Offices Sidmouth Road, Leyton, E.10 LEYtonstone 3650 Public Health Committee 1960 -1961 The Worshipful the Mayor: Councillor P. W. Wigg, J.P. (ex-officio) Chairman: Councillor F.W.Marshall Vi ce-Chai rman: Councillor Mrs. A. M. M. Burrell Aldermen: G. S. Plack B. G. Rayner Councillors: Mrs. E. Bartram R. W. Burl ton Mrs. D. E. Collins W. H. Sanders E. J. Whiteley L. E. G. Wonnacott STAFF Medical Officer of Health: G.T.Crook, 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: G. F. Downing, A. M. I. P. H. E. , M. A. P. H.I. Chief Administrative Assistant: W. D. Softley TO THE MAYOR, ALDERMEN AND COUNCILLORS OF THE BOROUGH OF LEYTON. Mr.Mayor, Ladies and Gentlemen, I have the honour to submit my report on the health of the people of Leyton during the year 1960 as required by the Minister of Health. This also includes sections on the County Health Services (National Health Service Act, 1946 Part III Services) and the School Health Service. This is the second introduction to an annual report for Leyton which I have written although I took up my appointment on the 1st March, 1960. Again, therefore, as in the previous year, this report deals with a review of a year during which different officers have been responsible for the work of the Health Department, and I would like to repeat my appreciation of the excellent work undertaken by my predecessor Dr. Watkins and my Deputy Dr. Mary Gilchrist. Environmental Health Services. The general incidence of notifiable infectious diseases in the year under review is the lowest ever recorded in the borough, and indicates that one of the early problems of Public Health, is now very largely under control. One of the most recent prophylactic measures concerning infectious diseases relates to the control of poliomyelitis and it is encouraging to report that only one case of poliomyelitis was notified in respect of any Leyton resident during 1960. The Council's slum clearance re-development programme is progressing satisfactorily and most of the houses contained in the first scheme, the Crescent Road Area, have now been demolished and the new housing development is well advanced. A local public enquiry in respect of the first stage of the second area, Beaumont Road Area, was held in October, 1960 and a report on these proceedings is included in the section of the report dealing with sanitary circumstances (for which I am indebted to Mr.B.J.Ashcroft, Chief Public Health inspector). The first smoke control area was confirmed by the Minister of Housing and Local Government during 1960 and it comes into force on the 1st October, 1961. This will be the first step in bringing one more environmental health hazard under control and I feel that it's long term effects on the health of the community will be considerable and result in a much lowered incidence of respiratory disorders and diseases. Personal and School Health Services These sections are mainly statistical and record the large volume of work undertaken in maintaining the community health of mothers, young children, school children and other sections of the community with particular emphasis on problem families, the elderly and the handicapped. In the early days of Public Health in the middle of the last century the major community health hazards were those of the environment. Infectious diseases were rife and the community supplies of water and food were uncontrolled and liable to heavy contamination with disease organisms. Much of the housing was built without ordered overall planning and was unfit for human habitation. These were the major community (1) health problems and Public Health In its early days was almost entirely an environmental health service. At the beginning of this century it became apparent that there was an enormous amount of sickness and death amongst mothers, infants and young children and Public Health has since been concerned with developing the personal and school health services, which have played their part in bringing about a great improvement in physical health of mothers and children in this country. The main problems of community health which are with us today concern, in the main, mental ill-health. Something like half the hospital beds in the country are occupied by patients suffering from a mental disorder and it is estimated that a third of all general practitioner's prescriptions are for sedative-hypnotic and tranquiliser types of drugs prescribed in the management of mental disorders. Public Health is now faced with the problems of how to play its part in treatment and support by its after-care services of mental disorder in the community and also to take the lead in developing a preventive service for mental health. Prevention of mental ill-health will largely be undertaken by assisting the emotional growth of children in families in which there are emotional tensions. Health Visitors are learning to detect and help these families and during 1960 case conferences were begun at the Child Guidance Clinic in Walthamstow; and Claybury Hospital have greatly assisted by courses designed to increase the Health Visitors understanding of the causation and manifestations of psycho-neurosis. It is hoped in future reports to describe more fully the trends and developments in the service in a preamble, and for the main body of the report to contain mainly statistical and detailed information concerning the services. I am grateful to all members of the staff for their loyal co-operation and to officers of other departments for their help in all matters in which they have come into contact with the Health Department. I would also like to express my appreciation of the helpful and constructive understanding which I have received from the members of the Council. I am, Mr.Mayor, Ladies and Gentlemen, Your obedient Servant, G.T.CROOK, Medical Officer of Health. Health Offices, Sidmouth Road, Leyton, E. 10. Telephone: LEYtonstone 3650. (2) VITAL STATISTICS Area in acres 2, 594 Population (Census 1951) 105,978 Population (Registrar-General's Estimate, 1960) 96,870 Assessable Value for General Rate Purposes £1,366,766 General Rate in the-£ (1960/61) 22s.8d The Registrar-General's mid-year 1960 estimate of population (viz., 96,870)has been used for the calculation of the following statistics:- Live Births 1, 260 Live Birth Rate per 1,000 population 13.00 Stillbirths 21 Stillbirth rate per 1,000 total (live and stillbirths) 16. 39 Total Live and Stillbirths 1, 281 Infant Deaths 28 Infant Mortality rate per 1,000 live births 22. 22 " " " " 1,000 legitimate births 22. 78 " " " " 1,000 illegitimate births 13.33 Neo-Natal Mortality Rate (first four weeks) Per 1,000 related live births 15.87 Early Neo-natal Mortality Rate (first week) per 1,000 related live births 15.08 Peri-natal Mortality Rate (stillbirths and deaths during the first week) per 1,000 total still and live births 31.22 Percentage of illegitimate live births 5.95 Maternal Deaths (including abortion) - Maternal Mortality Rate (including abortion) per 1,000 total live births) - Total Deaths 1,395 Death Rate 14. 40 Natural Decrease of Population 135 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 0.81 These factors, when applied to the crude rates, produce the following adjusted rates:- Live Births 12.87 Deaths 11.66 (3) COMPARATIVE STATISTICS OF BIRTHS, MORTALITY, ETC. LEYTON 1901-1960. 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 B 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 1,420 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 * 1,499 12.90 1,242 11.21 46 31.65 D 110,800 * 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 l,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 1960 96,870 1,260 13.00 1,395 14.40 28 22.22 * Population as estimated for purposes of B - Birth Rate; D - Death Rate. (4) (5) Deaths The Registrar-General's classification of causes of death by sex totals are shown in Table I on this page. The total number of deaths in 1960 (1,395) compares with (1,388) 1959 the respective death rates per 1,000 population being l4.40 and 14.18. CAUSES OF DEATH AT DIFFERENT PERIODS OF LIFE - 1960 CAUSES OF DEATH AGE GROUPS - MALES AGE GROUPS - FEMALES TOTAL 0-1 1-5 5-15 1 525 2545 4565 6575 75 + TOTAL MALES 0- 1 1 - 5 5- 1 5 1 5- 25 2545 4565 6 5- 75 7 5+ TOTAL FEMALES 1. Tuberculosis, respiratory 6 - . - - - 1 4 - 5 - - - - - - 1 - 1 2. Tuberculosis, other - - - - - - - - - - - - - - - - - - 3. Syphilitic disease 4 - - - - - 2 1 1 4 - - - - - - - - - 4. Diphtheria - - - - - - - - - - - - - - - - - - - 5. Whooping Cough - - - - - - - - - - - - - - - - - . - 6. Meningococcal Infections - - - - - - - - - - - - - - - - - - - 7. Acute Poliomyelitis - - - - - - - - - - - - - - - - - - - 8. Measles - - - - - - - - - - - - . - - - - - - 9. Other infective and parasitic diseases 2 - . - 1 - - - - 1 - - - - - - - 1 1 10. Malignant neoplasm stomach 46 - - - - - 10 9 8 27 - - - - 2 1 8 8 19 11. Malignant neoplasm lung, bronchus 70 - - - - 1 32 22 7 62 - - - - - 3 2 3 8 12. Malignant neoplasm breast 31 - - - - - - - - - - - - - 2 17 6 6 31 13. Malignant neoplasm uterus 7 - - - - - - - - - - - - - - 1 2 4 7 14. Other malignant and lymphatic neoplasms 100 - - - - 2 12 18 13 45 - 1 - - 3 16 15 20 55 15. Leukaemia, aleuksemia 9 1 1 - - - - - 1 3 - - 1 - - 2 2 1 6 16. Diabetes 6 - - - - - - - - - - - - - - 1 - 5 6 17. Vascular lesions of nervous system 200 - - - - - 19 15 35 69 - - - - - 12 27 92 131 18. Coronary disease, angina 190 - - - - 2 37 39 31 109 - - - - - 9 26 46 81 19. Hypertension with heart disease 30 - - - - - 4 5 3 12 - - - - - 2 7 9 18 20. Other heart disease 275 - - - - 3 6 18 64 91 - - - 1 1 12 14 156 184 21. Other circulatory disease 75 - - - - - 7 13 13 33 - - - - 1 2 11 28 42 22. Influenza 4 - - - - - 1 - - 1 - 1 - - - 1 - 1 3 23. Pneumonia 76 1 - - - 2 2 8 27 40 2 - - . - 1 8 25 36 24. Bronchitis 73 - - - - - 13 15 18 46 - - - - - 2 7 18 27 25. Other diseases of respiratory system 8 - - - - - 3 2 2 7 - - - - - 1 - 1 26. Ulcer of stomach and duodenum 15 - - - - 1 4 3 3 11 - - - - 1 1 2 - 4 27. Gastritis, enteritis and diarrhoea 10 - - - - - - 1 1 2 - - - - - 2 2 4 8 28. Nephritis and nephrosis 5 - - - - - 1 - 2 3 - - - - - - 2 - 2 29. Hyperplasia of prostate 8 - - - - - 1 3 4 8 - - - - - - - - - 30. Pregnancy, childbirth, abortion - - - - - - - - - - - - - - - - - - 31. Congenital malformations 9 2 1 1 - - - - - 4 3 - - - 2 - - - 5 32. Other defined and ill-defined diseases 100 11 - - - - 12 9 11 43 6 - - 2 4 7 12 26 57 33. Motor vehicle accidents 9 - - - - - 2 - 4 6 - - 1 - - - - 2 3 34. All other accidents 14 1 - - - 2 1 - 1 5 1 - - - - 1 1 6 9 35. Suicide 13 - - - - 4 3 1 - 8 - - - - 1 3 1 - 5 36. Homicide and operations of war - - - - - - - - - - - - - - - - - - - TOTALS 1,395 16 2 1 1 17 173 186 249 645 12 2 2 3 17 96 157 461 750 BURIAL OP 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 12 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 establishment:- Baths Capacities in gallons Source of Water Supply Water Treatment Rate of Filtration in G. P. H. (approx. ) Theoretical hours of "turnover" High Roaci Baths: Large 198.000 Principally deep well Coagulation, Filtration and Chlorin- Large 69,000 Large 2.87 Small 27, 000 ation and Aeration Small 13,000 Small 2.69 Oathall Rc Baths: ad Large 90,000 Principally deep well Coagulation, Filtration and Chlorinr ation and Aeration Large 22,000 Large 4.09 Small 70,000 Small 18,000 Small 3.33 Whipps Cro Pool: ss 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 (6) Regular bacteriological examinations are taken of the water and examined by Council's analysts, who record a high standard of purity. During the year under review the major swimming bath at Cathall Road has been closed for reconstruction and modernisation. Frequent tests are made (at least daily) for the ascertainment of available chlorine content in the open-air pool attheLeyton County High School for Girls. In all cases the water samples were found to be of a high degree of bacterial purity and chemically satisfactory. " SEWERAGE I am indebted to Mr.J.T.Lewis, M.I.C.E., M.I.Mun. E., Borough Engineer and Surveyor for the following notes on the present situation regarding sewerage and sewage disposal in the Borough: - "(1) The present dry weather flow of sewage from the Borough is approximately 3% million gallons in the 24 hours. (2) Disposal of sewage from the Borough is governed by appropriate sections of the London County Council (General Powers) Act, 1925, under which Leyton Borough Council are authorised to discharge sewage to the London County Council's Outfall sewer in Hackney. Such discharge is restricted in amount and to a maximum rate and greater flows or flows arriving when the London County Council's outfall is itself full are stored in tanks in the Council's Auckland Road Depot until such time as the discharge is able to be recommenced. (3) A larger part of the present sewerage system in the Borough is some 70-90 years old, and is generally of an inadequate capacity and of poor structural condition. The Council have, however, embarked on a comprehensive programme involving the reconstruction of all main trunk foul and surface water sewers in the Borough over a period of approximately 15 years. For the purpose of this programme, the Borough has been divided into five sections or drainage areas, and the sewers in each section are to be reconstructed in turn. A contract for the first section, that is West Leyton, Section 1, is now in hand, and includes the Council's Crescent Road Redevelopment Area. This will be followed shortly by a contract for the reconstruction of the control and pumping arrangements for sewage from the whole of the Borough at the Council's Auckland Road Depot." LABORATORY FACILITIES (a) Pathological Department, Whipps Cross Hospital, E.11. For pathological specimens. (b) Central Public Health Laboratory, Colindale. For special bacteriological investigations; supply of lymph for vaccination; supply of diphtheria toxin (F. T.) (c) Counties Public Health Laboratories, Queen Victoria Street, London. For bacterial and chemical examination of water, milk and other foods. (d) Public Analysts, Analytical Laboratory, 20 Eastcheap, E. C.3. For analysis under provisions of Food and Drugs Act, 1938. (7) 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 (No. of beds available 978) (b) Langthorne Hospital (No. of beds available 632) 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 Pairlop Road, Leytonstone, with accommodation for 25 patients. HEALTH SERVICES CLINICS (See page 45 ) 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 foul linen 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. For Leyton patients there were 1,061 launderings involving 9,078 articles comprising bed linen, pyjamas, nightdresses, etc. 534 launderings comprising 8,094 draw sheets were undertaken on behalf of West Ham patients. (8) INFECTIOUS DISEASE - NOTIFICATIONS Number notified during Year DISEASE 1957 1958 1959 1960 Scarlet Fever 60 106 156 50 Whooping Cough 159 104 29 42 Measles 1033 433 894 215 Acute Poliomyelitis, Paralytic 11 - 2 1 Acute Poliomyelitis, Non-paralytic 8 - - - Tuberculosis, Respiratory 51 41 46 40 Tuberculosis, Meninges and C.N.S. 1 - - 1 Diphtheria - - - Smallpox - - - - Tuberculosis, other 8 3 5 6 Meningococcal Infection 1 - - 1 Acute Encephalitis, Inf. - 1 2 - Acute Encephalitis,Post-infectious 1 - - - Dysentery 6 38 88 31 Ophthalmia Neonatorum 3 2 - 3 Puerperal Pyrexia 13 1 - 2 Pneumonia 223 132 167 47 Paratyphoid 1 - 1 - Enteric or typhoid 1 - 1 1 Pood Poisoning 29 23 38 11 Erysipelas 17 13 10 6 Malaria - - - - Pemphigus Neonatorum - - - - 1626 897 1439 451 The number of notification of infectious diseases received during 1960 were the lowest ever recorded in the Borough. (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, 1960. PULMONARY NON-PULMONARY TOTAL M F Total M F Total Number on register at commencement of year 531 412 943 34 50 84 1027 Number first notified during year 29 11 40 5 2 7 47 Number entered in register otherwise than by notification 22 9 31 1 4 5 36 Number removed during year 47 20 67 2 4 6 73 Number remaining at end of year 535 412 947 38 52 90 1037 Died 8 2 10 - 2 2 12 Removed from district 31 10 41 1 - 1 42 De-notified - - - - - - - Cured 8 8 16 1 2 3 19 Of the cases first notified during the year the age group distribution was as follows: - Age Periods PULMONARY NON-PULMONARY M P M F Under 5 years - - - - 5-14 years - - 1 1 15-25 " 10 7 1 2 26-45 " 8 2 2 - 46-65 " 7 1 - - 65 and over 4 1 - - TOTAL 29 11 4 3 (10) Public Health Inspection of the Area PART 1 - COMMENT HOUSING AND NUISANCE ABATEMENT Of the statutory duties and responsibilities confronting the Local Sanitary Authority none is more important, or indeed more onerous, than that which concerns obsolete housing. The duties of the Public Health Inspectorate in relation to existing housing accommodation is concerned generally with the repair, demolition or closure of unfit houses, slum clearance, and other matters arising from the issue of certificates of disrepair under the Rent Act. 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. Over the past twelve months some 10,632 inspections and re-inspections were made under Public Health Acts, Housing and Rent Acts, Prevention of Damage by Pests Act and other legislation; 1,640 complaints regarding unsatisfactory conditions were investigated, and 775 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 500 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 were initiated in 34 cases, and in all but one case the work was completed either before the date of the hearing or after adjournment of the summonses. Such proceedings are not, however, always successful in enforcing essential repairs; in one instance 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 42 applications under the Rent Act, 1957, for certificates of disrepair, and 18 applications for certificates as to the remedying of defects etc., were received and dealt with by the Public Health Inspectorate; 42 notices (Form J) of the Council's proposal to issue such certificates were served on landlords, arising out of which 26 undertakings (Form K) to remedy defects specified thereon within a period of six months were submitted by the owners and accepted by the Council and 16 certificates of disrepair were issued. The statistical section of the report contains details of inspections and notices served under the Housing and Public Health Acts and other relevant legislation; the number of houses classified as a result of inspections under the Housing Consolidated Regulations, 1925/32; details of improvements effected 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. SLUM CLEARANCE AND RE-DEVELOPMENT AREAS The Council's programme in relation to slum clearance and re-development continues to make satisfactory progress; most of the houses contained in the first scheme - the Crescent Road area - have now been demolished and the new housing development is well in hand. (11) A Public Local Inquiry in respect of the first stage of the second area - the Leyton Housing (Beaumont Road Area) Compulsory Purchase Order, 1959, was held in the Town Hall on Wednesday 5th October, 1960. The order embraced five clearance areas together with adjoining lands, the whole comprising a net area of approximately 6.34 acres. The inquiry was ordered by the Minister of Housing and Local Government to enable persons who objected to their properties being included in the Compulsory Purchase Order, either on the grounds that the properties were not unfit for human habitation, or because of other personal or business reasons, to be heard. It is now known that the Compulsory Purchase Order was confirmed by the Minister without any material modification. The officers' interpretation of the complex and controversial standard as to what might be considered to be a house unfit for habitation within the terms of the Housing Acts was in every case upheld by the Minister, this provides a reliable established basis on which to classify houses in future clearance schemes. The Inquiry marked the last stage of a lengthy procedure which began in September, 1958, with a detailed inspection of all houses in the areas by the Public Health Inspectorate. At its meeting on 10th November, 1959, the Public Health Committee recommended the Council to declare the aforementioned areas to be clearance areas in accordance with the provisions of section 42 of the Housing Act, 1957, and referred to the Housing and Town Planning Committee the question of the steps to be taken to secure the clearance and re-development of the areas and the re-housing of persons to be displaced. At its meeting on 17th November, 1959, the Housing and Town Planning Committee supported the recommendation of the Public Health Committee, and recommended the Council to make a Compulsory Purchase Order to purchase lands in the clearance areas, and also additional lands surrounded by, and adjacent to, the clearance areas, considered necessary to secure a site of convenient shape and dimensions for satisfactory development. The above recommendations were confirmed by the Council at its meeting on 26th November, 1959. In addition to the Beaumont Road Scheme, a small area adjoining the Crescent Road area was made the subject of a further order, this being the Leyton Housing (Carlisle Road Area) Compulsory Purchase Order, 1959. The Order comprised a clearance area of 10 houses, together with other land. A public inquiry was ordered to be held on 2nd February, 1960, but prior agreement was reached with an objector and the inquiry was cancelled. The Ministry of Housing and Local Government confirmed the Order without modification on 22nd April, 1960. Along with the official representations to the Public Health Committee in respect of the Carlisle Road and Beaumont Road Clearance Areas in March, 1959, and October, 1959, respectively, the Medical Officer of Health submitted reports prepared jointly with the Chief Public Health Inspector on the main and material conditions existing in the areas which led to the conclusion that all the houses were unfit for habitation or were, by reason of their bad arrangement, dangerous or injurious to the health of the inhabitants of the areas and that the most satisfactory method of dealing with conditions in the areas was by demolition of all the buildings. It may be of interest to recall some of the features included in the joint reports and to illustrate certain of these features with photographs. (Please refer to photographs between pages 14 and 15 when reading the outline report which follows). Boundaries of the Clearance Areas and Number of Buildings - BEAUMONT ROAD AREAS The five clearance areas are bounded on the north-west by Capworth Street, on (12) the south-west side partly by branch line of British Railways (London Midland Region) and partly by industrial premises not included in the Compulsory Purchase Order, on the south-east side by the rear boundaries of properties in Beaumont Road (even numbers), and on the north-east side mainly by the rear boundaries of properties in High Road. Altogether there are 115 dwelling houses (including nine dwellinghouses which are used partly for business purposes). The total population of the 115 unfit houses included in the clearance areas consists of 136 families, comprising 374-persons. The average number of persons per house is 3.3. Statutory overcrowding exists at only two houses. CARLISLE ROAD AREA The area is situated on the north-westerly side of Carlisle Road, and contains ten dwelling houses, nine being in Carlisle Road and one in Shaftesbury Road. Three properties are used partly for business purposes. The population consistsof 11 families, comprising 23 persons.The average number of persons per house is 2.3. Type and Description of Dwelling Houses The majority of the houses in the areas are situated in terraces and are of the two-storey type with single or two-storey back additions. All houses have through ventilation and yard space at rear. Frontages vary from lift, to 28ft. 9ins. Ten houses have no forecourts. The construction is traditional - brick walls, slated or tiled pitched or central valley gutter roofs, timber floors (with the exception of some scullery floors which are of concrete) and joinery work, plaster walls and ceilings. W.C.*s are situated externally, except at six houses where the W.C.'s are entered from the sculleries. Internal accommodation varies from five rooms, including scullery, to nine rooms. Eight houses have bathrooms, two of which are converted sculleries and three temporary outbuildings. Mains water supply is provided over scullery sinks. Twenty-seven houses have no internal halls or passages, so that living-rooms are intercommunicating, and entered direct from the street or forecourt. At 35 houses staircases rise from living-rooms or sculleries. Principal Grounus of Unfitness for Habitation Following is a summary of the principal grounds for being satisfied that the houses coloured pink on the map are unfit for habitation. The majority of the under-mentioned defects exist in varying degrees at all houses. Stability. (See Plates Nos.3 and 8) Evidence or uneven settlement - brickwork of rear and front elevations bulged and/or fractured out of plumb and alignment, brickwork courses out of level, window and door openings out of square, sills fractured, roofs sagging, floors out of level, excessive vibration in floors. (13) Repair - External Brickwork, Sills and Copings - Perished brickwork and pointing, and broken, loose rendering to walls and chimney stacks. Badly weathered and defective sills and copings. Paving - Sunken and fractured paving of yards and passages. Roofs and Gutters. (See Plates Nos.l, 2. 4 and 7) - Main and back addition roofs sagging, slates and/or tiles missing, displaced or defective, eaves gutters and rainwater pipes perished and defective, valley gutters badly constructed and leaking. Woodwork - Sagging roof timbers, window and door frames decayed and/or badly worn or ill-fitting. Repair - Internal Woodwork Generally - Badly worn and weak stair treads, badly fitting and defective doors and window frames, sashes decayed, badly worn and ill-fitting- Floors - Ground floor timbers decayed and/or sunken out of level and unstable, floorboards badly worn and/or worm-infested. Walls and Ceilings - Plaster loose and/or perished, scullery mils rough and unrendered. Generally - Broken and uneven solid floors, defective sink waste pipes, defective and/or obsolete fire grates, defective chimney flues, jambs and hearths. Freedom from Damp. (See Plates Nos.l, 2, 6, 10, 11 and 13) Dampness rising in walls due to absence of effective damp proof courses, dampness penetrating walls and ceilings due to porous brickwork, defective sills and window connections, leaking roofs, eaves gutters and rainwater pipes and valley gutters. Excessive dampness below ground floors due to absence of site concrete. Natural Lighting - Insufficient natural light in ground floor back rooms due to obstruction or overshadowing caused by close proximity of adjoining buildings, badly positioned small and/or low windows, and in some rooms absence of direct natural lighting altogether. Staircases, passages and W.C.'s dark due to absence of windows to the external air. Ventilation - Rooms without permanent means of ventilation and/or ventilation impeded by reason of decayed or defective window woodwork making sashes difficult, if not impossible, to open. Inadequate ventilation to staircases and W.C.'s. Water Supply - Except in a few instances, the only water supply available for domestic and personal purposes is cold tap water over scullery sinks. There is a general absence of fixed baths and washbasins. A small number of tenants have provided their own washing coppers and/or water heaters, otherwise there are no facilities for domestic washing or hot water supply systems. In 11 houses the only sink and cold water supply is shared by more than one family. (14) Plates Nos. 1 and 2. BEAUMONT ROAD SLUM CLEARANCE AREAS. Front elevations of houses in Beaumont Road showing sagging roofs and rising dampness. Plate No. 3. BEAUMONT ROAD SLUM CLEARANCE AREAS. Front elevation of properties in Capworth Street, showing evidence of structural settlement. Plate No. 4. BEAUMONT ROAD SLUM CLEARANCE AREAS. View of rear of houses in Beaumont Road showing sagging roofs and bad site arrangement. Plate No. 6. BEAUMONT ROAD SLUM CLEARANCE AREAS. Front elevations of houses in Beaumont Road. Note houses entered direct from the street and evidence of rising dampness. Plate No. 5. BEAUMONT ROAD SLUM CLEARANCE AREAS. View of Beaumont Cottages showing bad site arrangement and narrow access to path. Plate No. 7. BEAUMONT ROAD SLUM CLEARANCE AREAS. View of rear of houses in Beaumont Road showing sagging roofs and bad site arrangement. Plate No. 8. CARLISLE ROAD SLUM CLEARANCE AREAS. Houses entered direct from street, with steep stairs rising from narrow passage. Note also settlement fractures in brickwork and window sill. Plates Nos. 9 and 10. BEAUMONT ROAD AND CARLISLE ROAD SLUM CLEARANCE AREAS. Rear elevations of houses showing bad site arrangement; note close proximity of back additions and railway viaduct (lower picture). Plates Nos. 11 and 12. BEAUMONT ROAD AND CARLISLE ROAD SLUM CLEARANCE AREAS. Typical examples of cramped unsatisfactory sculleries with inadequate sanitary facilities; note also extensive rising dampness in walls. Plates Nos. 13 and 14. BEAUMONT ROAD AND CARLISLE ROAD SLUM CLEARANCE AREAS. Typical examples of internal bad arrangement of houses. Note steep staircases rising from a narrow passage (upper picture) and from a living room (lower picture); note also extensive dampness in wall (lower picture). Drainage and Sanitary Conveniences - Surface drainage impeded by broken and sunken paving of yards, and roof drainage inadequate. At a number of houses the main drainage system is defective. With a few exceptions already referred to, W. C. s are inconveniently situated in yards and often badly sited, with little, if any, privacy. In 22 houses the only available W. C. is shared by more than one family. Facilities for Storage, Preparation and Cooking of Food and Disposal of Waste Water. (See Plates Nos.10 and 11) - Most houses are without food storage accommodation with ventilation to the external air. Facilities for the preparation of food are generally inadequate. Because of restricted accommodation and absence of bathrooms, the scullery sinks and water supply must be used for general domestic requirements, including bodily cleansing, as well as for the preparation of food. Bad Arrangement (See Plates Nos.4-13) - Many of the houses are badly arranged on the site, obstructing free admission of natural light and impeding the circulation of air. The majority of the houses are badly arranged internally, staircases often constitute a danger to the occupants by reason of their position, construction, and inadequate lighting. Other typical forms of bad arrangement are houses entered direct from street or forecourt, rooms inter-communicating, ground floor rooms at different levels, fuel storage cupboards beneath stairs and entered from living rooms, and room accommodation cramped and congested. General Observations - The houses are between seventy and one hundred years old and are outworn to such a degree as to be beyond any material improvement short of demolition and re-building. They are obsolete in design, badly arranged internally and/or externally, deficient in amenities now regarded as essential, and fall seriously short of the general standard of housing in the district. The Crescent Road and Beaumont Road areas mark the beginning of a long-term programme of slum clearance and re-development in the Borough and, as many years must elapse before its fulfilment, it is inevitable - owing to the shortage of alternative housing accommodation, and the scarcity of land on which to build new houses - that a substantial proportion of the 1,500 or more houses reported to the Minister pursuant to Section 1 of the Housing Repairs and Rents Act, 1954, as being unfit for habitation and liable to be dealt with under Section 17 (demolition) and/or Section 42 (clearance areas) of the Housing Acts, 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 In order to meet its obligations under the Prevention of Damage by Pests Act, 1949, a Local Authority must maintain an organisation adequate to requirements for effective (15) rodent control according to the degree of infestation of its area, and in particular pay special attention to effective rodent control in its sewers, refuse tips, refuse destructor works, and its other public service properties, and areas of land which provide a reservoir of infestation. The methods used for disinfestation should, broadly speaking, comply with the recommendations prescribed by the Ministry of Agriculture, Fisheries and Pood. A Regional Committee (Workable Area Committee) has been set up by the Ministry to discuss problems connected with rodent control and the need for co-operation between contiguous Authorities ir carrying out simultaneous disinfestation of inter-connected sewers, land, etc. The Committee comprises some thirteen neighbouring authorities in Metropolitan Essex. The Chairman of the Public Health Committee and the Chief Public Health Inspector are the Councils representatives on this Committee, which meets about three times a year. The Departments permanent establishment of rodent operatives/handymen comprises three employees. The Laundry Service for the Incontinent, set up during the latter part of 1957 was later found to require the services of one rodent operative/handyman working approximately full time. The duties carried out by the rodent operatives, apart from time required on emergency measures, during 1960, were apportioned as follows:- Two operatives were employed on - (i) General duties in connection with rodent control, including block treatments of the Dagenham Brook, Marsh Lane Tip, etc., and bi-annual sewer baiting; (ii) Operation of smoke machine, and assisting Public Health Inspectors in carrying out smoke tests of drainage systems suspected of being a source of rodent infestation; (iii) General handyman duties in and around the Health Offices and Stores including maintenance and cleaning of equipment, smoke machine, pressure sprayers, poison bait containers, etc.; (iv) Operation of smoke machine, and assisting Public Health Inspector (Housing) in carrying out smoke tests on drainage systems of properties included in Slum Clearance areas. The drainage system of every house is tested as part of the detailed survey; (v) Supervision of the destruction at the Council's Destructor Works of foodstuffs condemned by the Public Health Inspectorate. One rodent operative was employed on - (i) The Laundry Service for the Incontinent for approximately ninety per cent, of the time comprised in a full working week (44 hours); (ii) Disinfection following infectious disease and the disinfestation of premises of vermin. The delivery by public transport of samples of food and drugs to the Public Analyst, and other Laboratories, and duties in connection with sampling - cleaning of equipment, utensils, jars, bottles, etc. approximately ten per cent. It is found from experience that the source of surface infestation in domestic (16) and other property is in the majority of cases traced to defects in drainage systems and sewers. When such evidence is found appropriate action is taken by the Public Health Inspectorate under the Public Health Act to effect necessary repairs; meanwhile the rodent operatives carry out disinfestation treatment. By reason of its age, much of the drainage in Leyton does not conform to accepted standards of design and construction. In those areas which contain aggregations of obsolescent properties, drainage defects are invariably due to open clay joints or subsidence and failure of pipes owing to inadequate concrete support; this accounts for many surface infestations. If it were possible to confine rats to sewers and drains the problem of surface infestation would not be so acute. As it is, defective drains and sewers provide a ready means of communication for rats migrating in search of nesting places and change of diet; rats travel along working sewers when scavenging food, but they need dry, undisturbed places for nesting. The only practicable method available to the Local Authority for reducing the rat population in sewers is by poisoning, and two such treatments are carried out each year. Poison baiting of sewers is not expected to eliminate sewer rats completely, for the impossibility of bringing all rats to feed at available baiting points, which are necessarily limited to manholes suitable for the purpose, is evident; and the rat population soon builds up again following disinfestation. Technical officers of the Rodent Division of the Ministry of Agriculture, Fisheries and Pood are confident, however, that poisoning campaigns carried out by adjoining Local Authorities in the London area over the years have resulted in a reduction of rats in the sewers and a proportionate decrease in surface infestation, but, as already indicated, measures taken to destroy rats, however successful, have only a limited and temporary effect. The area of land comprising Auckland Road Depot and Destructor Works, Temple Mills Railway Sidings, the Allotments, Marsh Lane Tip, and the open surface water sewer which is referred to as the 'Dagenham Brook, provides a natural habitat for rodents, preventing their complete eradication; all that we can hope to do with such reservoirs of infestation is to keep the number of rodents down to reasonable proportions; this is achieved by regular and systematic block treatment of the whole area. Hydrogen cyanide gas is used wherever practicable as an alternative to solid poison baiting treatment, especially in the region of the Dagenham Brook, but owing to the highly lethal and dangerous character of this method of destruction its use is limited to open land where there can be no possible danger to human life. Conditions at the Auckland Road Depot are conducive to the propagation and sustenance of rats; there is shelter and food and, by reason of the nature of the buildings, favourable harbourage for nesting and breeding purposes. It is natural, therefore, that during certain times of the year, especially in the winter, rats tend to leave the open land and migrate to the depot. Such migration was evident during October and November, when the level of the water in the Dagenham Brook and Lea Valley generally was exceptionally high due to abnormal rainfall during that period. To fully appreciate the extent of the problem, it should be realised that rats are prolific breeders. Technical research has shown that a pair of rats and their progeny may, in the course of twelve months, increase in number to well over one thousand, and, whenever there is a marked reduction in the numbers of a rat colony, which occurs as a result of disinfestation, there is a tendency for the colony to breed quickly in order to restore its numbers. This emphasises the need for effective disinfestation at regular intervals. Four block treatments are carried out at the Depot each year and (17) additional poison baiting is introduced whenever it is found that the infestation is rising during the migratory periods. The staff required for sewer baiting consists of two employees of the Borough Engineer's Department working as one gang, with a rodent operative in charge. Each treatment covers a period of eight weeks, and as this occurs twice a year it means that for at least four months of every year there is only one rodent operative available for routine control work throughout the Borough and for carrying out other essential duties in the Public Health Department. A similar situation arises when one rodent operative/handyman is engaged almost full-time for a period of two to three weeks in carrying out extensive block treatments. This leaves little, if any, margin to cover emergencies, and infestations requiring special attention must necessarily be carried out at the expense of routine rodent control work, investigation of complaints, etc. However, at the time of preparing this report this Council had agreed (vide minute 2369, 1960/61), to the appointment of an additional rodent/laundry operative to work on a flexible fifty-fifty basis between the two community health services relating to Rodent Control and the Laundry for the Incontinent. During 1960, 716 complaints were received concerning rodent infestation, involving treatment by the rodent operatives of 457 private houses and 108 business premises. The total number of visits in connection with these investigations and subsequent disinfestation amounted to 4,429. BUSINESS PREMISES - GENERAL The statutory provisions affecting the 2,391 business premises in the Borough are many and varied, including legislation designed to cover specific buildings such as the Factories Acts, 1937/60, and the Shops Act, 1950; and more general enactments which affect properties of all kinds, i.e. the Public Health Act, 1936. A large number of business premises are concerned with matters which require registration and/or licensing. Due to the close proximity of dwelling houses and industry in parts of this Borough, it is not surprising that the two cannot exist side by side without occasionally giving rise to annoyance. The cause of such annoyance can be any one of a number of conditions ranging from air pollution by smoke and dust to excessive noise, particularly the latter, which with the increasing mechanisation in factories is the subject of a large proportion of complaints made to the Public Health Department, necessitating many inspections and observations outside of the normal office hours. The legal provisions dealing with complaints of noise are contained within the statutory nuisance sections of the Public Health Act, 1936, as extended by section 52 of the Leyton Corporation Act, 1950, with the recent addition of the Noise Abatement Act of 1960. With these provisions it is possible to deal with the more serious type (18) of noise nuisance, particularly where the Local Authority is convinced that a statutory nuisance is being created or that the noise is, in fact, prejudicial to health. There are, however, many instances where although action would not be warranted under the above provisions the complainants (frequently petitioners) nevertheless suffer considerable inconvenience, and it is in these cases that every effort is made to secure by persuasion and suggestion the amelioration of conditions. This has been achieved in a number of cases in the past year, and conditions greatly improved by various measures such as the erection of baffle walls, cancellation of a night shift, attention to electric fans, re-location of machinery, and by general good-will and co-operation of industrial management. An example of new legislation affecting business premises is the Fabrics (Misdescription) Regulations, 1959, which prescribe new standards of non-flammability to which textile fabrics must conform if they are described in any way which implies that they are non-flammable or give a measure of safety from fire. The Regulations are made under the Fabrics (Misdescription) Act, 1913, and it is an offence under the regulations to describe as non-flammable or as giving a degree of protection from fire, any textile fabric which does not conform to the requisite prescribed standards. Shoppers buying fabrics which meet the standards will be assured not only that they give a high level of protection but that the processing will not be destroyed by normal laundering. The Act lays the duty of enforcement on Local Authorities. In Leyton the officer authorised under the Act is the Public Health Inspector. There are two standards now in force, one to which fabrics must conform if they are described in terms which suggest they are non-flammable, and a lower, but nevertheless stringent, standard to which all textile fabrics for which some degree of the quality of non-flammability is claimed must conform. Standard washing treatments are prescribed to which the fabrics must be submitted before the final burning tests. These treatments are designed to ensure as far as possible that the material will retain its fire-resistant properties throughout its useful life, always provided that it is washed in ways suitable for coloured fabrics and is not bleached; bleach tends to destroy the effect of flame-resistant processing. The relevant standards are as follows:- (a) Performance requirements of materials for Flameproof Clothing. (B. S.3120, 1959). This standard also covers material used for flameproof industrial clothing. (b) Performance requirements of fabrics described as of low Flammability. (B. S. 3121, 1959). In addition, the following British Standards have also been made in connection with this matter:- (c) Tests for the Flammability of Fabrics. (B.S.2963, 1958) (d) Flame Proof Industrial Clothing. (Materials and Design). (B.S.1547, 1959). (e) Method of Test for Flameproof Materials. (B.S.3119, 1959). The performance requirements of the British Standards, (a) and (b) for textile fabrics, are reproduced below:- (19) SPECIFICATION (a) British Standard No.3120 1. Scope This British Standard specifies the performance requirements for materials for flameproof clothing when tested by the specified method, and the marking of flameproof materials. (NOTE: The term "flameproof" shall not be attributed to a textile fabric for any purpose of trade unless the fabric complies with the standard prescribed in regulations in force under the Fabrics (Misdescription) Act, 1913. 2. Definitions For the purpose of this British Standard, the following definitions shall apply:- Flameproof material. Material which complies with the requirements of this standard. Inherently flameproof material. Material which, although not submitted to a flameproofing process, is flameproof. Durably flameproofed material. Flameproofed material which after being submitted to a washing treatment remains flameproof. 3. Flameproofness Requirements. The material shall be tested in accordance with the requirements of B.S.3119, and shall comply with the following:- (a) Duration of flaming. No test specimen shall continue to flame for more than 8 seconds after the igniting flame has been removed. (b) Extent of after-glow. After-glow shall not spread beyond the area of material damaged by flaming. (c) Length of material which chars or melts. The average length of material which chars or melts on the six specimens shall not exceed 314 in. (85 mm.) and the maximum length of charred or melted material in any one specimen shall not exceed 4½ in. (114 mm.). (b) British Standard No.3121 1. Scope This British Standard specifies the performance requirements for textile fabrics described as of low flammmability. 2. Definitions Flame resistance rating is a figure derived from the flammability testing of fabrics and is of the same order as the time in seconds necessary for the propagation of flame over a distance of 100 in. in a vertical strip of fabric. 3. Flame-resistance Rating Requirement. Any fabric purporting to be of low flammability within the terms of this British Standard shall have a flameresistance rating of 150 or more, or shall be reported "self-extinguishing" or "Flame not propagated" when tested, both in the original state and after treatment in accordance with Clause 4, by method A (the vertical strip test) specified in B.S. 2963. (B.S. 2963 is "Tests for the flammability of fabrics") (20) SPECIFICATION (a) British Standard No.3120 4. Durability Requirement The material shall comply with the requirements of Clause 3 both before and after the washing treatment prescribed in Appendix 'A' 5. Marking The material shall be indelibly marked - FLAMEPROOF - at least once in every yard (0.9m) of its length. (b) British Standard No.3121 4. Durability Requirement In order to indicate that their flame-resistance rating will continue during their useful lives, fabrics to be described as of low flammability shall fulfil the requirements of Clause 3, after having been subjected to the washing treatment described in Appendix 'A'. 5. Identification All fabrics or garments presented as complying with this British Standard shall be identified by a statement on the following lines: "Low flammability fabric (B.S.3121). " If the low flammability properties of the fabric are deleteriously affected by bleaching the description shall add: "Do not bleach." NOTE: Appendix 'A' referred to in paragraph 4 above sets out the method and temperatures to be used when washing the fabric. In the case of Industrial Clothing, subject to the test for non-inf1ammability, the washing test is not prescribed for fabrics made up into such clothing which is indelibly marked with instructions to re-process after each cleaning. In order to ascertain the quantity of non-flammable textiles being made and sold in the Leyton area a special survey was made of shops, stores and factories dealing in textiles; of the 94 premises visited, only 3 retail shops were foundto have a limited quantity of the material for sale. Arrangements were made with the laboratories of the Retail Trading Standards Association at Hartfield House, Henley-on-Thames, for the testing of samples purchased under the Regulations, and of the four submitted during 1960, three were satisfactory and one failed the test. These results are set out in the statistical section of the report. In the case of the unsatisfactory sample, the facts were submitted to the London County Council, who administer the regulations in London and within whose area the factory which made the defective garment is situated. FOOD PREMISES - INSPECTION It is an established fact that the best form of Health Education in respect of food hygiene is obtained by personal contact between the officer and food handler, and the routine visits of inspection made by the Public Health Inspector present an ideal opportunity for this type of work. The Food Hygiene Regulations, 1955/57, have now been amended and consolidated by the Pood Hygiene (General) Regulations, 1960, which increase their scope and effect. An instance of this is contained in Regulation 9, which now makes it an offence to use herbal smoking mixture in a food room containing open food in addition to the normal tobacco previously prohibited under the old regulations. In (21) addition to these Regulations the Minister of Health and the Minister of Agriculture, Fisheries and Food, with the approval of the Food Hygiene Advisory Council under Section 13(8) of the Food and Drugs Act, 1955, have published four Codes of Practice dealing with specific food trades. These are as follows:- (i) Food Hygiene Codes of Practice - Hygiene in the Retail Meat Trade; (ii) Food Hygiene Codes of Practice - The Hygienic Transport and Handling of Meat; (iii) Food Hygiene Codes of Practice - Hygiene in the Retail Fish Trade; (iv) Food Hygiene Codes of Practice - The Hygienic Transport and Handling of Fish. Although these Codes have no statutory force, they provide positive suggestions for improving conditions in the meat and fish trades and all meat and fish premises in the Borough have been visited and the Codes of Practice made known to employers and employees. There are some 1,121 premises in the Borough which are concerned with some aspect of the food trades and catering industry. All such premises are subject to regular inspection; 52 notices were served during the year in relation to contraventions of the Food Hygiene Regulations and other matters. The total inspections of business premises numbered some 3,000 odd, and 262 new registrations and/or licences were dealt with. Routine inspections were carried out at the Council's Pleasure Ground, Lea Bridge Road, during the Easter, Whitsun and August Fairs, and the Cricket Festival held at the Sports Ground, High Road, E.10., also received regular visits. A steadily improving standard of hygiene in connection with the mobile fair ground food stalls, is the result, I am convinced, of this requirement for registration in accordance with the provisions of Section 103 of the Essex County Council Act, 1952, and their regular inspection whilst stationed in Leyton. FOOD INSPECTION AND SAMPLING The investigation of complaints regarding foodstuffs purchased in the Borough has continued, and it is apparent that members of the public are becoming more aware of the need for bringing such cases to the attention of the Public Health Department. During the year 15 such complaints regarding unsound and/or adulterated food were investigated and reported to the Public Health Committee. The foods implicated were:Bread and confectionery (10); milk (2); meat (1); butter (1); and sweets (1); while the reason for complaint was either the appearance of mould growth or the discovery of foreign matter contained in the article of food. The nature of the extraneous items was varied and included small quantities of vegetable lubricating oil as used in the larger baking machines. This type of complaint has increased over the years and is associated with the increase of machinery in the baking industry. Having regard to the large (22) number of loaves baked in this manner, and the need for constant lubrication of moving parts, it is perhaps not surprising that an occasional loaf becomes contaminated. However, to the unfortunate housewife to whom the loaf is delivered, the appearance of black particles in the substance of a loaf of bread which may resemble grease, tar, or even rodent excreta, is disturbing, and is usually sufficient cause for complaint to be made to the Public Health Department. It is only by the active co-operation of members of the public that cases such as these can be investigated. Foreign matter of a more serious nature, including cigarette ends, an insect, mouse excreta and pieces of metal were discovered in the remainder of the food items submitted for examination, and 4 successful prosecutions were instituted, warning letters sent in 8 instances and two cases were noted by the Public Health Committee. At the request of the Public Health Committee, its Chairman, the Town Clerk, the Medical Officer of Health and the Chief Public Health Inspector interviewed the chief officers of a large bakery company in connection with problems of food delivered and storage in the Borough. A total of 133 samples of food and drugs of all kinds was taken for submission to the Public Analyst for chemical examination, and 93 bacteriological samples were examined by the Public Health Laboratories. Of the bacteriological samples, 55 were in connection with imported desiccated coconut, some of which upon examination were found to be infected with salmonella food poisoning organisms, which necessitated the destruction of supplies at bakers premises within the Borough. Only two unsatisfactory chemical reports were received from the Public Analyst during the year. These concerned samples of luncheon meat loaf which, in the opinion of the Analyst, had a low meat content, and instant coffee, which contained a small amount of preservative, contrary to the Public Health (Preservative etc. in Pood) Regulations. In view of the fact that the standard for luncheon meat loaf was being considered by a Joint Committee of the Association of Public Analysts and the Pood Manufacturers Federation, the Committee decided on no further action in this case, while in regard to the instant coffee, representations to the company concerned resulted in the method of manufacture being so altered as to eliminate any further trace of preservative. Attention is drawn to the statistical section of the report, which gives details in tabular form of premises and businesses registered and/or licensed under the Food and Drugs Act, Orders and Regulations. Full details are also given of inspections, notices, sampling, legal proceedings, and improvements effected to business premises as a result of action taken by the Department. DISEASES OF ANIMALS ACTS AND ORDERS The administration of the law relating to diseases of animals is carried out partly by officers of the Ministry of Agriculture, Fisheries and Food, and partly by officers of County Councils and Local Sanitary Authorities. In Leyton, Public Health Inspectors are the authorised officers under the various Acts and Orders. The Diseases of Animals Acts and Orders deal generally with the prevention and control of outbreaks of scheduled diseases, and protection of animals against unnecessary suffering. (23) CLEAN AIR ACT, 1956. LEYTON'S FIRST SMOKE CONTROL AREAS No. 1 - Date of operation 1st October, 1961. No. 2 - Date of operation 1st October, 1962. (24) AIR POLLUTION AND SMOKE CONTROL Leyton Borough Council have now had their first Smoke Control Order confirmed by the Minister of Housing and Local Government. The Order, which comes into operation on the 1st October, 1961, relates to an area of some 295 acres in the south-western part of the Borough, bounded by Windsor Road and Ruckholt Road to the south, Brewster Road, Vicarage Road, Park Road and Marsh Lane to the north, Leyton High Road to the east, and the Borough boundary to the west. (Please refer to map on page 24 )• It includes the Crescent Road Re-development Area and the Council's new housing development at Ive Farm, and affects some 1,776 householders, 28 industrial undertakings and 49 commercial concerns. The Order itself specifies certain exemptions, and other exemptions are allowed by Government orders already in force. After the operative date it will be an offence, punishable by a fine, for the occupier of any building of any kind in the Smoke Control Area to allow smoke to be emitted. All owners and tenants of affected premises have been given full information in writing as to the conditions under which grants towards the cost of replacing or adapting existing fireplaces will be made, together with a schedule of works required at the particular premises. Owners and occupiers of premises were advised to liaise with each other, for the grant can be paid to whoever does the work. Applications for the Council's approval of the work the owner or occupier wishes to carry out to enable that person to comply with the requirements of the Order are now being received at the Public Health Department, and works of adaptation are being carried out under the supervision of the Public Health Inspectorate. Mobile exhibitions have been stationed within the Smoke Control Area for the purpose of displaying approved appliances, and these will be repeated later in the year. These exhibitions are supplemented by similar displays at the shop premises at 280 High Road, E.10., adjoining the Council's Public Health Department. It is hoped that as a result of this publicity all the persons whose dwellings require adaptation within the Smoke Control Area will have undertaken the work by the time the Order becomes operative on the 1st October, 1961. 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 continued throughout the year. The recording apparatus operated by the Public Health inspectors is situated in the offices in Sidmouth Road; a summary of these observations is reported to the Public Health Committee bi-annually. The tables which follow in the statistical section show the results recorded during the twelve months ended March, 1961, divided into summer and winter periods. The average results for the five year period ended March, 1960, are also shown for comparison. Concentration of smoke is expressed in milligrams per 100 cubic metres and sulphur dioxide in parts per 100 million. The average concentration of smoke for the year ended 31st March, 1961, was 15 milligrams per 100 cubic metres, compared with 21 milligrams for the previous five years, a decrease of 28.6%, whilst the concentration of sulphur dioxide for the same period was 6.7 parts per 100 million, compared with 7.5 parts for the previous 5 years, a decrease of 10. 7%. (25) The practical measures taken by Public Health Inspectors to mitigate pollution of the atmosphere by smoke and grit include the taking of smoke observations of factory chimneys, inspection of boiler installations, advice to boiler operatives on proper use of fuel and methods of stoking, and discussions with managerial staff. 298 such investigations were carried out during the year, and a further 2,033 inspections were made in connection with the establishment of Smoke Control Areas. 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 the Department of Scientific and Industrial Research. The special survey conducted to measure the amount of dust and grit deposited in the vicinity of the Lea Bridge Road Gas Works has continued during the year. The results obtained from the standard deposit gauges during 1959 are given below, and it is proposed to submit a further report to the Public Health Committee when the figures for 1960 are available. The problem of atmospheric pollution in the vicinity of the Lea Bridge Road Gas Works was brought to the attention of the Council in the form of a petition signed by 558 residents, and submitted to the Town Hall during September of 1958, alleging nuisances from the manufacture of "clean-glow" smokeless fuel. Prom the observations made in this area and from numerous individual complaints it became apparent that in spite of extensive improvements in the processing, stocking and handling of coke and other fuels carried out by the North Thames Gas Board as a result of representations made by the Council and Public Health Department, there had been no appreciable reduction in the emission of dust and grit deposited in the vicinity of the Works, probably due to the fact that such modifications as had taken place were being offset by an increase in the emission of coal carbonised, and also because the type of coal used for the manufacture of "clean-glow" produced more dust than other grades of fuel. It was found that the nuisance from the Gas Works was not solely concerned with the emission of smoke, dust and grit from chimney furnaces and fixed plant, but that part of the dust nuisance could be attributed to certain open air processes, such as stock-piling and man-handling of coke and other fuels in close proximity to surrounding dwelling houses. As a result of these investigations the Council decided (vide Council Minute 1145(3), 1958/59) that the Ministry of Housing and Local Government, the Alkalies Inspectorate Division of the Ministry, and the North Thames Gas Board be invited to appoint representatives to attend a joint meeting with members of the Public Health Committee and the appropriate officers of the Council to discuss the problem. This meeting took place at the Town Hall on the 29th October, 1958, under the Chairmanship of Councillor P.W.Marshall, chairman of the Public Health Committee. Accompanying him were the Vice-chairman and two members of the Public Health Committee, the Town Clerk, the Medical Officer of Health and the Chief Public Health Inspector. There were also present Mr.R.W.Sorensen, M.P., and the representatives of the Ministry of Housing and Local Government and of the Alkalies inspectorate. The representatives of the North Thames Gas Board were informed of the Council's grave concern at the continuance of the serious nuisances emanating from their Works at Lea Bridge Road, and of the Council's determination that these nuisances should cease. It was emphasized that although the Council recognised that the North Thames Gas Board had a statutory duty to provide an adequate gas supply, the Corporation's duty (26) as a Public Health Authority was paramount. The officers of the Board acknowledged that consequent upon the introduction of a new form of coke manufacture at the Lea Bridge works in October, 1956, there had been cause for complaint, they were aware that these complaints continued, and conceded that to a degree they had been justified. They claimed, however, that remedial steps had been, and were being taken, steps which had resulted in a considerable arrestment of the emission of dust and grit, and expressed a confident opinion that within the next twelve months the problems with which they were faced would be overcome. It was also agreed that a survey for the measurement of grit and dust should be carried out by the Council in co-operation with the North Thames Gas Board in the vicinity of the Lea Bridge Gas Works. The Board's extensive programme of improvements in processing, stocking and handling of coke has continued. The works carried out have been mainly concerned with reconstructing, enlarging and enclosing the coke-grading plant, and special attention has been given to dust suppression during loading operations. Stock-piling of "Clean-Glow" fuel has been reduced to a minimum and is now confined to the land recently exchanged with the Council. The land adjoining Clementina Road is no longer used for this purpose, or for the storage of "bog ore" oxides; stock-piles of this material are being kept at the Board's works at Becton. In the main coke is loaded direct from storage hoppers into bags or by bulk into lorries and railway wagons. A new chemical jet system has been installed which enables dust-suppressing liquid to be sprayed wherever dust is likely to be created on the coke conveyor and at bag and bulk loading points. This system uses a special surface active chemical agent which, when diluted in water, results in a solution that has greatly increased wetting, penetrating and spreading powers, and so is extremely effective in contacting, confining and agglomerating dust. This system originated in America, and is comparatively new to this country. Air ducts fitted with fans for dust extraction have also been installed on the main processing plant where coke is discharged from the base of retorts and at other points on the conveyor belt and night storage hopper, chemical dust-suppressing liquid is not practicable for use on this part of the plant because of the high temperature of the coke. The measures taken have undoubtedly resulted in considerable improvement in the works generally and in the amenities locally. The arrangements made in conjunction with officers of the Gas Board and the Central Electricity Generating Board to carry out a survey for the scientific measurement of grit and dust deposited in the vicinity of the works comprised the setting up of six standard deposit gauges at the following sites:- Gauge Site Authority No. 2 London Co-operative society, C.E.Generating Board Markhouse Corner, E.10. No. 3 Metropolitan Water Board Works, " " " Lea Bridge Road, E.10. No. 4 107 Clementina Road, E.10. North Thames Gas Board No. 5 Lea Bridge Gas Works. E.10. Leyton Borough council No. 6 107 Clementina Road, E.10. " " " No. 7 Transformer chamber adjoining " " " "Hare & Hounds" Lea Bridge Rd., E. 10. (27) The monthly deposits of grit and dust from the gauges Nos.5, 6 and 7 under the control of the Council's Inspectors are analysed by the Public Analyst. Gauge No. 4 is analysed by the North Thames Gas Board, and gauges Nos.2 and 3 by the Central Electricity Generating Board. The results from the gauges are expressed in tons per square mile per month and are published in the Atmospheric Pollution Bulletin of the Department of Scientific and Industrial Research. The special survey is still in progress, and this report covers the twelve month period 1st January to 31st December, 1959. The results from the gauges are summarised hereunder. RESULTS OBTAINED PROM STANDARD DEPOSIT GAUGES IN LEYTON (a) Period six months from January to June, 1959. Sites of Standard Deposit Gauges Deposited matter from standard deposit gauges in tons per square mile per month Average Deposit for six months; tons per square mile per month January February March April May June Leyton Gauge No.2 - 7.27 20.07 14.37 4.74 7.11 10.71 3 - 11.96 20.43 19.46 7. 12 13.57 14.51 4 11.9 8.26 15.71 19.50 7.97 15.64 13.16 " 5 - 17.92 39.68 33.75 13.61 40.51 29.09 6 18.01 13. 17 28.98 16.98 10.20 18.64 17.66 " 7 - - 14.63 18.62 10.27 14.67 14.55 (b) Period six months from July to December, 1959. Sites of Standard Deposit Gauges Deposited matter from standard deposit gauges in tons per square mile per month Average Deposit for six months; tons per square mile per month July August Sept. October November December Leyton Gauge No.2 17.61 20.64 19. 01 23.51 21.69 17.09 " 3 17.47 15.74 22. 47 23.82 16.34 15. 97 " 4 14.51 16.67 12.70 18.50 28.71 23.07 19.03 n 5 33.19 20. 03 10. 90 21. 40 26 40 - 22 38 " 6 14.84 15.01 13.57 18.91 26.21 23.36 18.65 " 7 14.56 16.04 13.45 17.32 20.10 21.71 17.19 (c) Average results for six and twelve-monthly periods. Sites Of Standard Deposit Gauges Deposited matter from gauges in tons per sq. mile Average deposit for six months, January to July, 1959 Average deposit for six months, July to December, 1959 Average deposit for twelve months January to December, 1959 (1) (2) (3) (4) Leyton Gauge No. 2 10.71 17.09 13.90 " 3 14.51 15.97 15.24 " 4 13.16 19.03 16.09 " 5 29.09 22.38 25.73 " 6 17.66 18.60 18.15 " 7 14.55 17.19 15.87 Average of above 6 Gauges 16.61 18.38 17.49 (28) It is recognised that when a standard deposit gauge is exposed for a number of successive months at the same site a variation in the successive results can be expected. The standard "deviation" is at most places about 40% of the reading; this means that about one reading in three is different from the average by more than 40%. This variation is not, however, due entirely to changes in the rate of emissions from chimneys, industrial plant and other sources of pollution; fluctuations in meteorological factors such as rainfall, speed and direction of wind and turbulence of the atmosphere, have to be taken into account also. For this reason the average readings taken over the twelve-month period of investigation are likely to be most reliable. Reference to the third table, column (4), shows that the average monthly deposit for Leyton's six gauges - which includes the gauges situated within the curtilage of the Gas Works - is 17.49 tons per square mile, which is less than the officially recorded deposits over the same period for gauges in several of the neighbouring authorities. Although comparison with the remaining neighbouring areas is not so favourable, it will be noted that gauge No. 5 - the one situated in the Gas Works - showed a marked decrease in the' average of deposited material during the latter half of 1959 (22.38) as against 29.09 for the period January to June. In making this comparison, due regard must be had to the fact that the six gauges in Leyton are situated in close proximity to known sources of pollution (Gauge No.5 being actually in the Gas Works) whereas gauges in the neighbouring areas are for the most part set up to check the general level of atmospheric pollution in the district as a whole, and not, as in Leyton's case, to monitor any specific plant or installation. In order to provide some comparison with average national figures, the following data have been extracted from the report by vhe Department of Scientific and Industrial Research on the Investigation of Atmospheric Pollution:- Deposited Matter - National Average Annual figures for the Deposited matter - tons per whole country - square mile per month - High 106.97 ( Average for ( Leyton's 6 Average 17.28 ( Gauges 17.49 High Values - are arithmetic means for the six sites at which the six greatest deposits for the whole year were observed. Average Values - refer to all sites (1,090) at which deposit gauges were in operation. Interpretation of the results obtained over the twelve-month period of investigation indicates that the rate of deposition of dust and grit in the vicinity of the works has fallen to a reasonable level having regard to the concentration of industry in the district, but a longer period of observation is necessary before definite conclusions can be drawn and for this reason the standard deposit gauges have remained in position for a further twelve months. The present situation is undoubtedly much more satisfactory than it was when members of the Council met representatives of the Board in October, 1958. It is significant that complaints are rarely received by the Department. This does not, of course, necessarily mean that there is no cause for complaint, or that the problem is (29) solved, but nevertheless I am satisfied that substantial progress has been made towards reducing the rate of deposition of dust and grit in the Lea Bridge/Clementina Road Area to a level which approximates closely with the national average level of atmospheric pollution in comparable urban areas in London and elsewhere. The Joint Conference of neighbouring Local Authorities first convened by Leyton Borough Council in 1956 for the purpose of discussing matters of common interest in regard to air pollution and exchange of ideas met twice during the year at West Ham and Ilford. Matters discussed and forwarded to the Minister of Housing and Local Government for consideration included availability of supplies of smokeless fuel, simplification of procedure and standard grants for converting or adapting fireplaces, and the extension of grant provisions to dwellings situated outside the smoke control area. The conference also decided that a committee of technical officers of the authorities represented should be convened by the Leyton Borough Council with a view to the introduction of a standard form of grant procedure and to discuss other matters of a technical nature. HEALTH EDUCATION During the year technical officers of the Health Department gave a number of Health Education talks to various groups of people and organisations. Pull advantage is also being taken of the Health Education facilities provided by the shop windows at 280 High Road, Leyton, E.10. 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 included air pollution, smoke control, clean food and food hygiene generally, rodent control and insect pest control, nuisance abatement and housing. Further use is now being made of the shop premises by using not only the shop 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. Health education is not, however, concerned solely with public exhibitions, and lectures to groups of people. Health education forms a valuable and important part of a Public Health Inspector's routine day-to-day work on the district; he performs his statutory duties as a designated officer under the various Acts, Statutory Orders and Regulations introduced by Parliament to protect the health and welfare of the community and to promote satisfactory environmental conditions by constant investigations, by persuasion and by educational methods. In the cause of clean air, clean and safe food, and the betterment of environmental conditions in houses, shops, factories, workshops, places of entertainment, etc., and in the promotion of congenial communal relationship he is continually practising health education in a personal and practical way by giving advice and instruction on the spot - it is only as a last resort that he uses the statutory powers by way of legal enforcement. (30) Public Health Inspection of the Area PART 2 - 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. 1. INSPECTIONS, RE-INSPECTIONS, ACTION (a) GENERAL STATUTORY PROVISIONS COMPLAINTS RECEIVED INSPECTIONS AND RE-INSPECTIONS INFORMAL NOTICES SERVED FORMAL NOTICES SERVED NOTICES COMPLIED WITH BY OWNER NOTICES COMPLIED WITH BY LOCAL AUTHORITY HOUSES CLASSIFIED Clean Air Act, 1956 53 2331 - 2000 - - - Housing Acts, 1936/57 3 1212 - 1 - - 500 Public Health Acts, 1936 1570 10632 527 247 458 4 - Prevention of Damage by Pests Act, 1949 716 1059 5 - 2 - - Food and Drugs Act, 1955 39 1394 - 38 44 - - Shops Act, 1950 - 1068 2 - - - - Essex County Council Act, 1952 - 41 - - - - - Leyton Corporation Act, 1950 - 98 1 - - - -- Factories Acts, 1937/48 4 222 - 5 6 - - Pet Animals Act, 1951 - 20 1 - 1 - - Rag Flock and Other Filling Materials Act, 1951. - 1 - - - - - Rent Act, 1957 67 71 - - - - - Merchandise Marks Acts, 1926/53 - 49 - - - - - (31) (b) DETAILED (i) Housing Act, 1957 (Sections 17/18) Housing Repairs and Rents Act, 1954 (Section 3) 1 Closing Order was made under the Housing Act, 1957 (ii) Rent Act, 1957 Paragraph 4 of the First Schedule, Rent Act, 1957 Applications for certificates received 42 Decisions not to issue certificates Nil Decisions to issue certificates 49 Undertakings given by landlords under paragraph 5 of the First Schedule 23 Undertakings refused by local authority under proviso to paragraph 5 of the First Schedule. Nil Certificates issued 14 Applications by landlords for cancellation 7 Objections by tenants to cancellation 4 Decisions by local authority to cancel in spite of objection 1 Certificates cancelled by local authority 6 Applications for certificates (Form P) 18 Discrepancies in the above figures are caused by procedure in some cases extending over December - January. (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, and Food Hygiene Regulations, 1955, Ice-Cream (Heat Treatment Regs.) 1947/52, Shops Act, 1950, Factories Act, 1937, Leyton Corporation Act, 1950 Essex County Council Act, 1952, and relevant legislation. Number of Type of Premises Inspections Bakehouses 44 Bakers 18 Butchers 221 Catering Establishments 139 Clubs 4 Confectioners 45 Dairies and Distributors of Milk 6 Carried Forward477 (32) Number of Type of Premises Inspections Brought Forward 477 Factories 180 Factory Canteens 17 Fish Friers 32 Fishmongers 70 Greengrocers 55 Ice-Cream Places 9 Itinerant Stalls, Vehicles and Food Dealers Food Storage Accommodation 34 Local Authority Canteens 6 Meat Depots 9 Miscellaneous 14 Multiple Stores 22 Off-Licences 13 Provision Shops 83 Public Houses 10 School Canteens 33 Street Markets 13 TOTAL INSPECTIONS 1077 (iv) Inspection of Business Premises other than Food Premises Inspections were carried out at the undermentioned business premises having regard to the requirements of the Public Health Act, 1936; the Shops Act, 1950; the Factories Act, 1937; the Pet Animals Act, 1951; the Rag, Flock and Other Filling Materials Act, 1951; the Diseases of Animals Acts and Orders; the Leyton Corporation Act, 1950; and the relevant legislation. _ Number of Type of Premises Inspections Clubs 4 Factories with Mechanical Power 172 Factories without Mechanical Power 8 Fairgrounds 6 Hairdressers and Barbers 98 Local Authority Properties 3 Miscellaneous Shops, etc. 14 Outworkers 11 Pet Animals Shops 20 Rag Flock 1 Retail Shops 109 Schools 15 Workplaces 1 TOTAL INSPECTIONS 462 (33) (v) Prevention of Damage by Pests Act, 1949 - Rodent Control/Disinfestation Rats Mice Total Complaints received 545 171 716 Enquiries and visits made:- By Rodent Operatives 2869 724 3593 By Public Health Inspectors 980 79 1059 Premises treated individually:- Dwelling Houses 312 64 376 Business/Industrial Premises 58 36 94 Premises re-treated:- Dwelling Houses 56 5 61 Business/Industrial Premises 14 3 17 Number of rooms treated (sprayed) - - 209 Seven "block treatments" of premises for rat infestation were carried out. 34 2. NUISANCES ABATED. DEFECTS REMEDIED, IMPROVEMENTS EFFECTED (i) PUBLIC HEALTH ACTS Nature of work carried out to dwelling houses and other premises:- Choked drains cleared ... ... ... 9 Dampness remedied ... ... ... ... 371 Drains relaid or partly relaid ... ... 6 Floors repaired ... ... ,.. ... 59 Guttering repaired or renewed ... ... 82 Miscellaneous defects remedied ... ... 123 New W.C. pans and traps provided ... ... 19 Plaster repaired ... ... ... ... 186 Rainwater pipes repaired or renewed ... ... 36 (34) Roofs repaired or renewed 230 Rooms redecorated 2 Sashcords renewed 110 Sinks provided 3 Sink waste pipes repaired or renewed 21 Stoves repaired or renewed 32 Vent pipes repaired or renewed 19 W. C. cisterns repaired or renewed 45 Window sills, etc., repaired 95 Yards paved 6 (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 22 Ceiling not kept clean or repaired 17 Floor not kept clean or repaired 6 Inadequate ventilation 1 Inadequate receptacles for refuse 3 Accumulation of refuse in room 2 Cleanliness of apparatus and fittings 11 Facilities for personal cleansing and/or washing food and equipment inadequate, i.e:- Wash-basins 5 Hot water 6 Soap/towels/nail-brush 4 Food not protected from contamination 8 Wash-hand notice 7 Artificial light in W. C. 1 Inadequate locker (clothing) accommodation 2 Name and address not displayed 1 Miscellaneous 2 (35) 3. REGISTRATION AND/OR LICENSING OF BUSINESS PREMISES (i) Approximate numbers of Business Premises in the Borough and Functions involved. ADDITIONAL LICENSES. REGISTRATIONS AND OTHER FUNCTIONS INVOLVED 1 2 3 4 5 6 7 8 9 10 H( 12 13 14 NATURE OP TRADE/BUSINESS CARRIED ON No. of Premises Ice-Cream Milk Preserved Pood Shell Pish Power Factory Non-Power Factory Catering Off-Licence Bakehouse Confectionery Fish Frier Grocer Hairdresser With Storage Baker 42 - - - - 24 - 1 - 18 2 - 4 - - Butcher 75 - - 48 - 4 - - - - - - - - - Catering 90 54 1 - - - - - - - - - - - - Confectionery 143 55 - - - - - - - - - - - - - Dairies 4 - 4 - - - - - - - - - - - - Pish 41 - - 2 12 - - 10 - - - 29 - - - Greengrocer 94 1 - - - - - - - - - - - - - Grocer 233 51 89 2 - 1 - - - - - - - - - Multiple Store 5 3 - - - - - 2 -- - - - 3 1 - Rag Flock 9 - - - - 3 2 - - - - - - - - Pet Animals 11 - - - - - - - - - - - - - - Hairdresser 92 - - - - - - - - - - - - - - Hawker 132 - - - - - - - - - - - - - 57 puhlie House 36 - - - - - - 10 32 - - - - - - Off Licence 46 6 3 - - - - - - - - - - - - Factory 451 - - - - - 57 30 - - - - - - - School 18 1 - - - - - 17 - - - - - - - Council Property 4 2 - - - - - 2 - - - - - - - Hospital 2 - - - - - - 2 - - - - - - - Miscellaneous Shops 863 129 - - - - - - - - - - - - - TOTAL PREMISES 2391 TOTALS: ADDITIONAL FUNCTIONS 780 302 97 52 12 33 59 74 32 18 2 29 12 1 57 (36) (ii) Details of Registrations/Licences ACT OR REGULATION On Register 31.12.1959 Removed during 1960 Registered during 1960 On Register 31.12.1960 Pood and Drugs Act, 1955, Sec. 16 Ice-Cream Premises 305 25 22 302 Butcher's Premises 49 2 2 49 Fishmonger's Premises 2 - - 2 Milk and Dairies (General) Regulations, 1959 Distributors 104 19 12 97 Dairies 5 1 - 4 Milk (special Designation) Regs. (Annual Licences) Sterilised 99 - - 97 Sterilised (Supplementary) 7 - - 7 Pasteurised 51 - - 55 Pasteurised (Supplementary) 6 - - 6 Tuberculin Tested 21 - -- 23 Tuberculin Tested (Supplementary) 5 - - 5 Essex County Council Act, 1952 Hawkers of Pood 123 - 9 132 Hawkers' Premises 60 3 - 57 Leyton Corporation Act, 1950 Section 63 - Vendors of Shellfish 13 1 - 12 " 48 - Hairdressers and Barbers 80 - 13 93 Pet Animals Act, 1951 (Annual Licences) Pet Shops 10 - - 11 Rag Flock and Other Filling Materials Act,1951 Registration of Premises 9 - - 9 TOTAL 949 51 58 961 (37) 4. LEGAL PROCEEDINGS (i) Public Health Act, 1936 Date of Hearing Nature of offence and address of premises concerned Result of Court Proceedings 20.4.1960 Statutory nuisance - 143 Crownfield Road, E.15. Abatement Order. 28 days. £2.2.0 costs. Pined £2.0.0. In 34 cases legal proceedings were instituted, and work was completed either before the Court hearing, or after adjournment of the hearing. (ii) Pood and Drugs Act, 1955. Food Hygiene Regulations, 1955. Date of Hearing Nature of offence and address of premises concerned Result of court Proceedings 26.10.1960 Cigarette ends in Cheese/Spam/Corned Beef Rolls - W.Hooker & Son, Ltd. L. S & J. Sussman Ltd., 12 Albany Road, E. 10. Fine: £10.0.0. Costs: £3.3.0. 7.12.1960 Unfit Butter - Harry's Stores (Leyton) Ltd., 668 Lea Bridge Road, E. 10. Absolute discharge. Costs £3.3.0. Court costs 4s.Od. Two applications for legal proceedings were pending at the end of the year. 5. MEAT AND FOOD CONDEMNED Condemnation certificates were issued in respect of the under-mentioned unsound foodstuffs 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 Cwts, Qt ra. Lbs. Commodity Units Skate 5 1 21 Luncheon Meat 97 tins Pish 2 2 7 Vegetables 56 " Roe 1 0 Fish 67 " Meat 5 0 11 Ham 11 " Liver 3 0 6 Fruit 169 " Pigs' Spleens 1 17 Milk 27 " (38) Commodity Cvts, Qtrs, Lbs. Commodity Units Kidney 1 12 Gherkins 30 jars Chickens 3 25 Salmon 1 " Offal 8 Sauerkraut 16 " Sausages 1 2S4 Suet 22 pkts. Rabbits 4 8 Flour 11 " Gammon 1 8 Margarine 9 " Bacon 1 26 ½ Pigs Kidney 16 boxes Ham 1 2½ Pork Luncheon Meat 4 Cheese 2 23 Pork Brawn 6½ Rice 1 22 Grapes 5 Desiccated Coconut 4 2'/4 Cooking Pat 2 14 Pickling Onions 5 0 0 6. SAMPLING - FOOD AND DRUGS ACT, 1955 (i) Chemical Analysis Commodity Taken Satisfactory Unsatisfactory Milk 7 7 _ Ice-Cream 13 13 - Miscellaneous 113 111 2 TOTALS 133 131 2 (ii) Bacteriological Examination Commodity Taken Satisfactory Unsatisfactory Milk 7 7 _ Ice-Cream 13 12 1 Ice-Lollies 4 4 - Coconut 55 52 3 Water 21 21 - TOTALS 100 96 4 (39) 7. SAMPLING - FABRICS (MISDESCRIPTION) ACT, 1913 - FABRICS (MISDESCRIPTION) REGULATIONS. 1959. Four samples were obtained and sent to the Retail Trading Standards Association at Henley for testing for non-flammability in accordance with these Regulations. They were: Nylon net material labelled "Flame Proof" Fibreglass curtain material, of which the makers claim "It will not burn. " Nylon net material labelled "Flare Free" Nylon waist slip sold as "Flare Free" The last mentioned was found to be unsatisfactory. I give below an extract from the R.T. S. A. report on the garment: "This garment was composed of three different fabrics, viz: White lace outer layer, pink net inner layer and white locknit waist fabric. These have been tested separately, in accordance with B.S. 3120: 1959, with the following results:- White locknit waist fabric: There was insufficient fabric to carry out the full series of tests as specified in British Standard 3120: 1959. Such tests as were possible, however, indicate that the fabric complies with the requirements of this standard. Pink Net: This fabric complies with the requirements of B. S. 1320: 1959, performance requirements of materials for flameproof clothing. White Lace: When tested in accordance with B.S.3120: 1959 this fabric burnt out completely, and therefore fails to comply with the requirements of this standard. The fabric has also been tested against B.S.3121: 1959, performance requirements of fabrics described as of low flammability. The fabric has a flame resistance rating of about 60 and therefore fails to comply with this standard. This fabric, therefore, should not be described in any manner which would imply a degree of the quality of non-inflammability or safety from fire. Since the white lace forms a large and important part of the garment, we consider that these conclusions must also refer to the garment as a whole." Information was passed totheL.C. C., in whose area the manufacturer of the garment was situated, but, as the retailer had closed the business and left the Borough shortly after the sample was taken, no further action was possible. (40) 8. 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 annual reports. 1. Inspections. Number on Register (2) NUMBER OF Premises (1) Inspections (3) Written notices (4) Occupiers prosecuted (5) (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 59 9 . - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 392 206 5 - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) - - - - TOTAL 451 215 5 - (41) 2. Cases in which defects were found. Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted Pound 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) - - - - - Unreasonable temperature (S. 3) - - - _ _ Inadequate ventilation (S.4) - - - - - Ineffective drainage of floors (S.6) - . - - - Sanitary Conveniences (S. 7) (a) Insufficient - 2 - - - (b) Unsuitable or defective 1 - - - - (c) Not separate for sexes - 2 - - - (d) Other 4 3 - 1 - Other offences against the Act (not including offences relating to Out-work - - - - - TOTAL 5 9 - 1 - 3. Outwork Nature of Work SECTION 130 SECTION 111 No. of outworkers in August list required by Section 110 (l)(c) No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwholesome premises Notices served Prosecutions (1) (2) (3) (4) (5) (6) (7) Wearing apparel Making 162 Brushes 4 Bags 3 Artificial Flowers 4 Umbrellas, etc. 10 Shoes 11 Boxes, etc., wholly or partly of paper, Making 39 Trimmings 13 Feather sorting 2 Cosaques, Christmas Stockings. etc. 9 Lampshades 10 TOTAL 267 - - - - - (42) CONCENTRATION OF SMOKE EXPRESSED IN MILLIGRAMS PER 100 CUBIC METRES MONTH MONTHLY AVERAGE HIGHEST DAILY AVERAGE LOWEST DAILY AVERAGE 1955/60 1960/61 1955/60 1960/61 1955/60 1960/61 April 18 15 45 37 8 6 May 7 7 15 17 3 1 June 5 4 12 10 1 1 July 4 4 9 7 1 2 August 6 5 12 10 2 2 September 7 5 15 11 2 2 SUMMER AVERAGE 8 7 - - - - October 23 19 69 51 7 8 November 43 23 102 72 16 5 December 43 35 119 80 13 8 January 40 26 115 69 13 10 February 36 19 94 41 15 5 March 27 21 56 43 11 6 WINTER AVERAGE 35 24 . - - - YEARLY AVERAGE 21 15 _ .. _ _ CONCENTRATION OF SULPHUR DIOXIDE EXPRESSED AS PARTS PER 100 MILLION MONTH MONTHLY AVERAGE HIGHEST DAILY AVERAGE LOWEST DAILY AVERAGEH 1955/60 1960/61 1955/60 1960/61 1955/60 1960/61 April 6.5 6.3 15.4 12.9 2.9 3.0 May 3.8 5.0 7.8 12.7 1.3 1.1 June 3.3 2.9 6.6 8.9 1.3 0.6 July 2.9 2.7 5.5 3.9 1.2 1.7 August 3.4 3.5 6.2 7.1 1.4 1.5 September 3.7 3.6 7.6 5.4 1.5 2.0 SUMMER AVERAGE 3.9 4.0 - - . - October 8.2 7.0 19.8 11.9 3.7 3.0 November 11.8 9.7 24.7 22.4 5.6 4.5 December 13.3 11.8 37.0 20.7 5.0 4.6 January 12.4 9.4 34.7 22.0 5.2 4.8 February 11.6 8.8 32.2 24.5 5.3 4.7 March 8.6 9.8 16.8 26.9 4.0 4.3 WINTER AVERAGE 11.0 9.4 - - - - YEARLY AVERAGE 7.5 6.7 - - - - (43) Leyton Health Area Sub - Committee Representing:- Essex County Council: Alderman Mrs. M. Ball Councillors Mrs.L. Fallasie, J-P. Miss D.D. Forster G. W. Mason Mrs. W. M. Palethorpe Mrs. V. L. Wilson (1 vacancy) Leyton Borough Council: Aldermen Mrs.J.Hammond, 0. B.E., J.P. (Chairman) Mrs.R.King B.G.Rayner Councillors Mrs.E. Bartram R. W. Burlton Mrs. D. E. Collins G. W. Hales C. H. Hicks F. W.Marshall Mrs. E. V. Pearson Mrs. N. M. Plunkett J. A. Punshon W. H. Sanders J.J. Walsh E. J. Whit el ey Voluntary Organisations: Mrs. A. M. Clewer Mr. G. A. Dicker Miss H.Harford Hospital Management Committee: Alderman Miss D.Wrigley, B. A. Executive Council for Essex: County Councillor Mrs.A.M.M.Burrell Local Medical Committee for Essex: Dr. J. F.B.Hill. (44) Personal Health Services (Leyton Health Area Sub - Committee) SECTION 21 - HEALTH CLINICS During the year Leyton Green Clinic has been completely redecorated both externally and internally, and the former Clerk/Receptionists Office has been converted to a one cubicle chiropody surgery for the Chief Chiropodist. The new extension to Granleigh Road Clinic, which was commenced in 1959, has now been completed and comprises Clerk/Reception Office, Welfare Poods Distribution Centre and Health Visitors Office accommodation. SECTION 22 - CARE OF MOTHERS AND YOUNG CHILDREN BIRTHS During the year the following births were registered:- Male Female Legitimate ... 619 566 Illegitimate ... 40 35 Total 659 601 Still-Births: Legitimate ... 14 7 Illegitimate ... ... - In the same period 1,303 notifications were received under Section 203 Public Health Act, 1936. CHILD WELFARE CLINICS Attendances at clinics have remained fairly constant over the last year.. Nine child welfare sessions are held each week. Three at Leyton Green, three at Granleigh Road, two at Dawlish Road and one at Emmanuel Hall, Hitcham Road. Emmanuel Hall closed in August for reconstruction of the building and was not re-opened until April, 1961. It is interesting to record that 93.6% of babies born in 1960 attended child welfare clinics in the area. (45) HEALTH CLINICS - CLINIC SESSIONS HEALTH CLINIC MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY Leyton 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 Dental (Alt.) Foot Clinic (Alt.) Minor Ailment P.M. Dental Infant Welfare Foot Clinic Dental Infant Welfare Foot Clinic Dental Orthoptic Infant Welfare Foot Clinic Dental P.N. (2nd) A.N.Exercises Orthopaedic Foot Clinic Dental Orthoptic Special Meds. Foot Clinic Immunisation Evening Foot & Dental Dental Clinic Dental Clinic Foot Clinic Park House, Granleigh Road, E. 11. (LEYtonstone 3650 Extn.268) A.M. Dental Minor Ailment Ante-natal Foot Clinic Dental Oral Hygiene Minor Ailment Foot Clinic Dental Minor Ailment Play Session Foot Clinic Dental Minor Ailment Foot Clinic Dental Minor Ailment Foot Clinic Dental (Alt.) Minor Ailment Foot Clinic (Alt.) P.M. Dental A.N.Exercises Foot Clinic Remedial Exercises Dental Oral Hygiene Infant Welfare Foot Clinic Dental Infant Welfare Foot Clinic Remedial Exercises Dental Infant Welfare Foot Clinic Dental A.N. Exercises Aural Clinic Foot Clinic Evening Foot Clinic Dental Clinic Foot Clinic Dawlish Road, Dawlish Road, E. 10. (LEYtonstone 3650 Extn.287) A.M. Dental Minor Ailment Foot Clinic Oral Hygiene Speech Clinic Dental Minor Ailment Foot Clinic Speech Clinic Dental Minor Ailment Ante-natal Toddlers Foot Clinic Speech Clinic Dental Minor Ailment Speech Clinic Dental Minor Ailment Foot Clinic Speech Clinic Dental (Alt.) Minor Ailment Foot Clinic (Alt.) P.M. Dental Infant Welfare Foot Clinic Speech Clinic Dental Immunisation Foot Clinic Ante-natal Exercises (Alt.) Speech Clinic Dental Foot Clinic Speech Clinic Dental Infant Welfare Foot Clinic Speech Clinic Dental Foot Clinic Speech Clinic Evening Foot & Dental Foot & Dental Foot & Dental Emmanuel Hall, Hitcham Road,E.10. P.M. Weighing Session In addition there are evening sessions for Poliomyelitis Vaccination. Child Welfare - Clinic Attendances Leyton Green Park House Dawlish Road Emmanuel Hall UNDER 1 YEAR - First attendances 732 681 471 91 Subsequent attendances 4615 5385 4383 733 Total attendances 5347 6066 4854 824 1-5 YEARS - First attendances 336 350 233 38 Subsequent attendances 1592 1352 1604 172 Total attendances 1928 2702 1837 210 Total attendances (both age groups) 7275 8768 6691 1034 Number examined by Clinic Doctor 1862 2221 1924 Number weighed 6716 7336 6673 961 CARE OF PREMATURE INFANTS (weighing 51bs. 8ozs. or under) Born at Home 11 Born in Hospital or Nursing Home 74 CONVALESCENT HOME TREATMENT Numbers sent to Convalescent Home Children 1 Mother and Children 3 mothers with 4 children WELFARE FOODS There was no change during the year in the general arrangements for the distribution of welfare foods. Issues - The total issues during 1960 were:National Dried Milk (Tins) 15,948 Cod Liver Oil (Bottles) 3,932 Vitamin A & D Tablets (Pkts.) 4,125 Orange Juice (Bottles) 36,733 (47) TESTS FOR PHENYLKETONURIA In I960, 588 children were tested at the clinics and another 225 were tested in their homes ANTE-NATAL CLINIC Since the recommendations of the Cranbrooke Report have been published practically every domiciliary midwifery case now books her own doctor or a doctor on the obstetric list for the confinement. This means all ante-natal and post-natal examinations are carried out by the doctor booked and consequently has greatly reduced the number of cases seen at the clinics. From the 1st October. 1960 the weekly ante-natal clinic at the Lady Rayleigh Training Home was discontinued and arrangements were made for all cases to be seen at the other clinics. The clinic at the Lady Rayleigh Home can be re-established at a future date if the need should arise. In addition midwives and health visitors are now assisting at practitioners antenatal clinics. Attendances at clinics including those with only midwives in attendance were 3,423 and 313 patients attended for the first time. POST-NATAL CLINIC Dr.Anne Clark has been the medical officer in charge of this clinic since July, 1939 and it is with regret that I record Dr. Clarke's resignation in October, 1960. The clinic isnowunder Dr.Jaikaran's supervision. In 1960 112 mothers made 166 attendances. DENTAL TREATMENT The Area Dental Officer reports as follows: - "All cases referred by the Council's Medical Officers during the year were seen and, where necessary, treated. A pleasing feature to record is the fact that an ever increasing proportion of mothers are bringing children from about 2-3 years for examination even when they are sure no treatment is necessary. This has a beneficial effect in introducing the child to the surroundings of a dental surgery at a time when little or nothing requires to be done. They are then much more amenable to treatment at a later date. There are still too many mothers who refuse to submit to full dental treatment but the proportion of those seen who will not have the necessary conservative work gets less from year to year. (48) It is gratifying to find mothers bringing their children for treatment who were themselves treated at the Council's clinics in years past. Figures published by the Minister of Education in "The Health of the School Child" for 1958 and 1959 and quoted later in this report under the School section show that the average number of decayed, missing or filled teeth per school entrant at 5 years of age is 5.7 that is, over a quarter of its total temporary dentition has been affected by dental disease in three years (2.5). This emphasises, as nothing else could, the need for very early and very frequent (not longer than three monthly) examinations if the temporary teeth are to function as they should do until the eruption of the permanent teeth. DENTAL CLINICS Types of Treatment Given Expectant Mothers Nursing Mothers Children under school age Extractions (a) Permanent teeth 96 27 - (b) Temporary teeth - - 267 Fillings (a) Permanent teeth 68 119 - (b) Temporary teeth - - 514 Inlays provided - - - Crowns provided - - - Anaesthetics administered (a) Local 27 69 3 (b) General (i) by Medical Officers on County Staff - - (ii) by Others 20 21 125 (a) Scaling 24 40 7 (b) Prolonged scaling and gum treatment 22 15 1 Silver nitrate treatment - - 275 Dressings 46 124 189 X-ray examinations 4 12 2 Dentures provided (a) Full - 15 - (b) Partial 2 15 - Dentures repaired - - - Dentures remade (a) Full - - _ (b) Partial - - - Orthodontic appliances (a) Fixed (b) Movable - - - Prophylactic treatment and other operations Polishing 2 - 5 Number of treatments (scaling and prophylactic carried out by Oral Hygienists) 47 50 13 (49) Patients Inspected and treated during the year Expectant Mothers Nursing Mothers Children under school age (1) Patients examined 71 98 495 (2) Patients found to require treatment 46 69 385 (3) Patients who have commenced treatment 46 69 385 (4) Patients who have completed treatment 35 44 297 (5) Patients awaiting treatment - - - (6) Attendance for treatment 146 316 343 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 17 pre-school children were referred to her, 11 for whom she prescribed spectacles. Mrs.Box, Orthoptist accepted 63 new cases for treatment, who made 82 attendances. Mr.H.A. Oatley, Orthopaedic Consultant attends Leyton Green Clinic on Thursdays and the clinic medical officers referred 74 new cases to him. Set out hereunder is a summary of the work:- Re-inspection 148 Minor alterations to footwear 116 Surgical appliances supplied 9 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 childre on register at end of year 17 42 15 43 32 85 Total attendances during year 2990 8852 3085 9822 6075 18674 Number of days open 255 255 - (50) SECTION 23 - MIDWIFERY Cases attended by Council Midwives MIDWIVES TOTAL Domiciliary Midwife Training Home Cases attended - (a) as Midwives 73 147 220 (b) as Maternity Nurses 5 41 46 Ante-natal Visits 263 590 853 Ante-natal Examinations 714 2265 2979 Post-natal Visits 1287 5245 6532 Administrations of Gas and Air Analgesia 78 120 198 Administration of Pethidine 42 76 118 Administration of Trilene - 30 30 Gas and Air Analgesia Percentage of administrations 74.4 Medical Aid Where the Medical Practitioner had arranged to attend the patient 36 Others 49 Fees paid to Doctors Number of Accounts received 30 Total amount paid to Medical Practitioners - £78.12. 6d. Maternity Outfits Number of outfits issued to Expectant Mothers 283 (51) SECTION 24 - HEALTH VISITING Health Visitors During the year the Health Visitors made 18,170 visits to homes. (a) To expectant mothers:- First visits 353 Subsequent visits 240 (b) To children under 1 year of age: - First visits 1282 Subsequent visits 3839 (c) To children between the ages of 1 and 5 years:- First visits 197 Subsequent visits 5163 (d) Other visits:- Children's Act 12 After deaths 88 After stillbirths 25 Miscellaneous 1741 Ineffective 3071 Old People 2857 Hospital follow-up 107 SECTION 25 - HOME NURSING Number of new cases 956 Number of visits to patients 50,771 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 619 98 31 27 29 65 869 Number re-vaccinated - - - 6 5 135 146 (52) Diphtheria Immunisation Age (in years) at final injection Children* who completed a full course of primary immunisation during the year Children* who were given a reinforcing injection during the year By General Practitioners By County Staff By General Practitioners By county Staff Under 1 340 350 - - 1 69 165 - - 2 21 16 1 - 3 15 17 1 1 4 11 9 52 89 5-9 9 50 126 314 10-14 6 11 29 34 Total 471 618 209 438 * 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 78 15 60 6-12 months 104 435 91 1 year 30 64 24 2-4 years 15 18 10 5 years and over 2 6 5 Total (primary courses) 229 538 190 Reinforcing injections 24 _ 36 (53) Poliomyelitis Vaccination 1960. The following persons in the various age groups received a complete immunising rourse. CATEGORIES PRIMARY BOOSTER Male Female Male Female Born 1943 to 1960 670 602 1959 1964 Born 1933 to 1942 218 373 1276 1717 Born 1920 to 1932 620 839 175 432 Over 40 years 25 58 44 132 Hospital Staff 9 140 57 429 Total Vaccinated during year 1960 1533 1922 3464 4387 „ „ „ „ 1959 4718 5378 4783 4870 „ „ „ „ 1958 3244 3116 520 517 „ „ „ „ 1957 1359 1303 - - „ „ „ „ 1956 179 168 - - „ „ to end of 1960 11,033 11,887 8767 9774 Expectant Mothers Vaccinated during 1960 - 238 Primary 528 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 1960. Stretcher cases conveyed 4,738 Other cases conveyed 31,067 Emergency cases conveyed 4,529 Total 40,334 Total mileage 142,464 (54) SECTION 28 - PREVENTION OF ILLNESS, CARE AND AFTER CARE Foot Clinic With the extension of the proposals of the County Council to commence foot clinics in areas which had not previously had them the demand for chiropodeal staff exceeded the supply, and movement of staff was both expected and experienced where staff of basic grades sort promotion in newly opened centres. This resulted in a temporary shortage of locum tenens for a period of the year. However, with the increase of the establishment from six full-time chiropodists to eight we were more fortunate than most other areas and, in fact, the total attendances during the year were 23,513 compared to 26,387 in 1959. In 1952 arrangements were made for non-ambulant patients to be transported to and from the clinic by ambulance. A medical certificate stating the patient's inability to attend by Public Transport is necessary before they are placed on the "ambulance list". In 1960 32 non-ambulant patients were transported to the clinic by ambulance and made 103 attendances. During the year a total of 6,031 patients (of whom 1,277 were new patients) attended for a total of 23,513 treatments. It wos found possible to discharge 247 adults and 369 children. The defects treated were as 1 out hereunder:- Bursitis 63 Callosity 229 Hard Corns 326 Soft Corns 25 Corn under nail 32 Claw Toes 4 Hallux Rigidus 22 Hallux Valgus 58 Hammer Toe 5 Hyperidrosis 12 Hyperkeratosis 2 Metatarsalgia 11 Nail Club 40 Nail Ingrowing 48 Nail Involuted 6 Pes Planus 24 Septic Condition 18 Tinea Pedis 10 Trigger Toe 6 Verruca Pedis 336 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 15 Total number being supplied with free milk at and of year 14 (55) Loan of Sick Room Equipment Air Bed 1 Air Rings 66 Bed Back Rests 68 Bed Blocks 1 Bed Cradles 19 Bed Pans 150 Bed Trays 3 Crutches 4 Diabetic Scales 1 Invalid Chairs 61 Rubber Sheets 176 Urinal Bottles 54 Feeding Cups 2 Commodes 62 Sputum Mugs 3 Total 671 Convalescence for Adults Number of applications during year 51 Length of stay:- Two weeks 32 Three weeks 19 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 149 Number of domestic helps actually employed at end of year 143 Number of hours worked during the year 175,540 Work of Domestic Help Organisers:- (1) (2) Total (1) First Visits 273 383 656 (2) Re-visits to beneficiaries- (a) Domestic help present 196 115 311 (b) Domestic help not present 851 973 1824 (3) Other visits 402 438 840 (56) Help Provided Maternity Acute Sick Tuberculosis Chronic Sick Aged not Sick Others Total Aged Others Requests for help from new cases during the year 59 48 1 480 59 9 8 664 New cases helped during the year 42 34 1 406 40 6 7 536 Total cases completed during the year (a) 39 38 2 297 42 7 6 431 Cases being helped at end of year who have received help for Under 3 months 5 2 - 76 10 - 1 94 3-6 months . 1 . 59 7 1 . 68 6-12 months - 3 - 106 9 3 1 122 Over 12 months - - 3 436 40 11 1 491 Total (b) 5 6 3 677 66 15 3 775 Total cases helped during the year (a) plus (b) 44 44 5 974 108 22 9 1206 Hours of help provided during the year 2.088¾ 2,072½ 1,355 146,550¼ 16,540¼ 4,045)¼ 2,888 175,540 MEDICAL EXAMINATION OF STAFF County Council employees:- Number of medical examinations - (a) Entrants to County Council's service 123 (b) Retirement on Superannuation 3 (c) Other purposes (including entrants to Teaching Profession and Training Colleges 87 No. of medical examinations Leyton Borough Council 98 Others 2 (57) School Health Service LEYTON COMMITTEE FOR EDUCATION 1960-61 Chairman: Councillor A.L.Chamberlain Vice-chairman: Councillor Mrs. E. V. PearBon Aldermen: Mrs. A. M. M. Burrell G. S. Flack Mrs. J. Hammond, O.B.E., J. P. Mrs. R. King C.J.Mills, J.P. Councillors: G.S.Bentley I. A. Brown R. J. V. Gill W.J. Low F. W. Marshall Mrs. N. M. Plunkett J. A. Punshon G. W. A. Robinson J.J. Walsh County Councillors: E.C.Hardy G. W. Mason Co-optative Members: Mrs. A.D.Baxter Mrs.E.Edwards Miss R.Hodges F. W. H. May Mrs.M. Mosley J. D. Watson 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, 1960:- Medical Officers 2.55 Dental Officers 2.70 Dental Attendants 3.19 Nursing Staff 6.96 Oral Hygicnist 0.49 Speech Therapist 1.00 Administrative and Clerical 3. 00 Clinic Clerks 1.00 20.89 (58) (59) School Clinics Aural Clinic Sessions as required Park House Clinic Child Guidance - Monday to Friday 10 a. m - 1 p.m Child Guidance Clinic, 2 p.m - 5 p.m Monoux Building, High Street, E.17. Dental Clinics - Monday to Friday 9 a.m. - 5 p.m Park House Clinic, Dawlish Road " Leyton Green " Saturday (alternate) 9 a.m - 12 noon Park House Clinic Dawlish Road " Leyton Green " Foot Clinics - Park House Clinic ft Mondays to Fridays and alternate Saturdays 9 a. m. - 12 noon Dawlish Road " 2 p.m. - 5 p.m. Leyton Green " # Minor Ailment Clinics - Monday to Friday 9 a. m - 11 a. m Dawlish Road Clinic, Saturday 9 a. m - 11 a. m Leyton Green " Park House " tt 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 " Tuesday, Thursday and alt.Saturday r 9 a. m - 12 noon Park House " Ophthalmic Clinic - Wednesday 9.30 a. m - 12 noon Leyton Green Clinic Friday 9.30 a. m - 12 noon Orthopaedic Clinic - Leyton Green Clinic Thursday 2 p.m - 5 p.m Orthoptic Clinic - Tuesday (alternate) 9 a. m - 12 noon Leyton Green Clinic 2 p.m - 5 p.m Wednesday 9 a. m - 12 noon 2 p.m. - 5 p.m Friday 9 a. m - 12 noon 2 p.m - 5 p.m 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. REINSPECTIONS - ALL GROUPS - 2.874 PHYSICAL CONDITION OF PUPILS AT ROUTINE MEDICAL INSPECTIONS Age Group (by year of birth) Number Inspected Condition Classified Satisfactory Unsatisfactory 1956 and later - - 1955 314 303 11 1954 618 606 12 1953 19 19 - 1952 10 9 1 1951 638 630 8 1950 350 346 4 1949 63 63 - 1948 21 21 - 1947 14 14 - 1946 415 415 - 1945 and earlier 1,045 1,040 5 TOTAL 3,507 3,466 41 (60) School Medical Inspection SCHOOL POPULATION Desi gnat ion of School Number of Schools Number of Pupi1s Primary 19 6, 152 Secondary 10 5,751 Special 2 211 Total 31 12,114 ROUTINE MEDICAL INSPECTIONS Group Number of Pupils Examined Percentage of Parents Present 5 year 932 91.62 10-12 + year 1,052 82. 11 14 year 1,460 23. 19 Other 63 3,507 68.88 FINDINGS OF MEDICAL INSPECTION (a) Individual children found to require treatment Age Group (by year of birth) Pupils Inspected Defective Vision (excluding squint) Any other Condition Total Pupils with Defects 1956 and later - - - - 1955 314 13 34 47 1954 618 19 78 91 1953 19 1 3 4 1952 10 - 1 1 1951 638 70 89 151 1950 350 40 49 75 1949 63 8 12 20 1948 21 3 7 9 1947 14 2 1 3 \ 1946 415 88 38 122 1945 and earlier 1,045 218 90 272 TOTAL 3,507 462 402 795 (b) Pupils found to have undergone tonsillectomy Age Group Number Inspected Number found to have undergone tonsillectomy Boys Girls Boys Girls 5-year 485 447 36 21 10-12 + year 486 566 96 78 786 674 180 139 Other periodic 31 32 8 11 TOTAL 1,788 1,719 320 249 (c) Hygiene Inspection in Schools The Nursing Staff carried out 18,702 inspections during the year. The arrangements for carrying out cleanliness inspections were previously reported in 1959. In 1960 only 28 cases of infestation were found giving an incidence of 0.15% of all examinations. This was a further decrease as compared with previous years. The incidence over the last five years is as follows: 195 6 0. 31% 195 7 0. 32% 195 8 0. 29% 195 9 0. 27% 196 0 0.15% (61) DEFECTS FOUND BY PERIODIC AND SPECIAL INSPECTIONS DURING THE YEAR Defect or Disease Periodic Inspections Special Inspections Entrants Leavers Others * Total Treatment Observation Treatment Observation Treatment Observation Treatment Observation Treatment Observation Skin 6 13 31 16 24 (8) 10 (5) 61 39 125 49 Eyes (a) Vision 32 43 306 18 124 (80) 64 (22) 462 125 232 21 (b) Squint 13 7 2 2 13 (8) 2 (2) 28 11 9 1 (c) Other 2 4 7 - 3 (1) 2 (1) 12 6 54 13 Ears - (a) Hearing 2 44 3 18 4 (1) 36 (23) 9 98 29 9 (b) Otitis Media 3 23 5 3 4 (4) 13 (10) 12 39 7 4 (c) Other 2 5 3 4 3 (-) 3 (21 8 12 119 20 Nose and Throat 16 49 10 8 11 (4) 15 (4) 37 72 48 16 Speech 12 20 - 2 3 (3) 9 (3) 15 31 19 3 Lymphatic Glands 1 18 - 3 -(-) 6 (-) 1 27 17 2 Heart 2 7 - 8 - (-) 10 (5) 2 25 4 3 Lungs 5 25 11 14 9 (5) 17 (10) 25 56 24 10 Developmental - (a) Hernia 2 2 - _ 1 (1) -(-) 3 2 2 2 (b) Other 1 15 2 10 8 (4) 14 (7) 11 39 47 6 Orthopaedic - (a) Posture 6 12 11 13 10 (4) 17 (5) 27 42 5 4 (b) Feet 28 30 30 14 16 (5) 17 (6) 74 61 73 13 (c) Other 21 29 28 21 31 (15) 40 (8) 80 90 38 2 Nervous System - (a) Epilepsy - 2 - 4 1 (1) 4 (4) 1 10 3 - (b) Other - 5 2 1 4 (3) 2 (1) 6 8 24 - Psychological - (a) Developmental 1 12 2 - 4 (2) 25 (17) 7 37 46 7 (b) Stability 3 56 4 16 24 (15) 47 (22) 31 119 82 30 Abdomen 2 - 1 2 -(-) 4 (-) 3 6 16 2 Other 1 3 7 9 4 (2) 3 (-) 12 15 493 141 * 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 1960, 1,516 children attended 1,976 times to see the doctor and 1,268 children attended 2,469 times for advice and treatment from the nurse. ORTHOPAEDIC CLINIC This clinic has had a very active year under the supervision of Mr. H. A. Oatley. P. R. C. S. Orthopaedic Consultant. During 1960 the following numbers of children were referred to Whipps Cross Hospital by Mr.Oatley. 35 Radiological investigation 5 Physiotherapy 25 Operative treatment 80 Fitting of surgical appliances AURAL CLINIC After the death in 1959 of Mr.C.J.Scott, this clinic went through an uncertain period, but sessions have now become regular under Mr. A. W.Morrison, F. R. C. S., and towards the end of the year the number of cases had increased. The following children were referred to hospital during 1960 for treatment or further investigation: (63) SPECIAL CLINICS SUMMARY FOR 1960 Orthopaedic Aural Ophthalmic Orthoptic Sessional Programme 1 a week 1 a month 2 a week 6 a week Total Sessions 39 11 91 246 New Cases 153 57 219 107 Attendances 730 123 1, 496 1,888 Removal of tonsils and adenoids.14 Removal of tonsils only 1 Removal of adenoids only 7 Antral lavage 2 Laryngoscopy 1 Myningosplasty 1 Paracentesis 1 Antro choanal polyp 1 S.M.R 2 X-ray 4 Further investigation 1 OPHTHALMIC CLINIC AND ORTHOPTIC CLINIC Dr. A. Logan Adam, Ophthalmologist and Mrs. S. Box, Orthoptist continued to investigate and treat all those children referred by Assistant County Medical Officers. In August, 1960, Mr.J.L.Boscoe was appointed Senior Opthalmic Optician by the Leytonstone No.10 Group Hospital Management Committee, and he is now in attendance at Leyton Green on every Wednesday and Friday morning. This enables close liaison between ophthalmologist and optician which is important for accurate ophthalmic dispensing. Every parent is given the option of having spectacles dispensed at the clinic or any other optician of their own choice. Mr.Boscoe is also able to make many minor repairs to spectacle frames at the clinic. REMEDIAL EXERCISE CLASSES Mrs. W.Davies has taken this class throughout the year. Each class attends twice weekly for six weeks. A course of foot exercises is alternated with a course for posture and breathing exercises, and children between seven years and fifteen years are accepted. 78 children attended 438 times. Dental Inspection and Treatment The year opened with three full time dental officers and three part time dental officers making between them the equivalent of 4/llths of a full time officer. In addition the three full time officers worked a total of six evening sessions per week. At the year's end two of the part-time officers had resigned and there remained the three full time officers who continued to work a total of six evening sessions per week and one dental officer who gave one session per month to orthodontic work. The staffing position remains, therefore, as it has done for some time at approximately 3¼ dental officers out of an authorised establishment of 6. This is very serious in view of the demand for treatment and also the amount of dental disease in children which is shown to be increasing. (64) A survey of the incidence of dental decay carried out on behalf of the Ministry of Education by seven local education authorities showed that the percentage of five year old children showing no decayed, missing or filled teeth decreased between 1953 and 1958 from 14.8% to 12.8% that is, a reduction of rather more than one eighth, while the decrease in the 12 year olds was from 12% to 5% - a reduction of well over a half. In the five year age group during the same period the average number of decayed, missing or filled teeth per child has risen from 5. 1 to 5.6 an increase of nearly 12% but the 12 year group figure has risen from 3.8 to 5.5 or over 44% (vide "Health of the School Child" 1958 - 1959 p.39). It is very satisfactory to report that during the year the now high speed compressed air turbine drills were installed in two of our five dental surgeries. The reports of the dentists using this apparatus, and of very many patients who have been on the receiving end are most satisfactory. What vibration there is with these drills is mostly beyond the range of human perception, the work is accomplished in less time, and the general over all experience is of a vast improvement over the earlier methods of cavity preparation. ORTHODONTICS During the year a part-time orthodontic specialist was appointed by the N. E. Metropolitan Regional Hospital Board to Whipps Cross Hospital where he will be available to our dental officers who may need a second opinion on the treatment of an orthodontic case in this area. DENTAL HYGIENE The work of the dental hygienist (Mrs.Thurston) particularly on the educational side is of great value in helping our patients to take greater care of their teeth when once the mouth has been rendered dentally fit and between courses of treatment. She instructs them in approved methods of tooth brushing and also in good dietary principles. This appears to be particularly necessary at the present time when the children are subjected to mass advertising on the television screen, and elsewhere, by skilled salesmen and appealed to during school hours by the school tuck shop. The following table extracted from "The Health of the School Child 1958-1959" gives some idea of the size of the problem one has to face in the realm of sugar consumption in the country. SUGAR CONSUMPTION PER CAPITA IN THE U.K. (Group figure including sugar, glucose & honey) YEAR Lbs. YEAR Lbs. YEAR Lbs. Pre-War 108.7 1946 82.4 1953 103. 1 1940 80.3 1947 87.2 1954 111.2 1941 72.3 1948 88.3 1955 114.2 1942 72.3 1949 97.3 1956 116.3 1943 71.9 1950 89.2 1957 119.0 1944 76.9 1951 98.2 1958* 120.7 1945 73.8 1952 93.3 (65) * provisional Emphasis therefore must be on all and every method which can be used to prevent tooth decay rather than upon trying to cope with it when it has arisen. To encourage good methods of tooth brushing and oral hygiene to cut down the amount of sugar, biscuits, cakes, sticky sweet puddings and ice lollies, and to substitute nuts, raisins, raw carrot, and perhaps the most useful of all, the finishing of a meal with raw fruit such as an apple, followed by mouth rinsing. Also the elimination of all eating between meals. The Ministry of Health tests into the artificial fluoridation of domestic water supply continue and the five year test period ends in 1961. One awaits the results of these tests in the hope that some general scheme will be recommended in areas where the natural proportions of fluoriside is less than 1 part in a million of water. EXPERIMENTAL TRAINING SCHEME FOR DENTAL AUXILIARIES The year 1960 saw the opening of the training school for auxiliary dental workers who will be allowed to fill teeth and extract temporary teeth under the supervision of a dental officer. The first of these auxiliary workers should be available for employment from about August 1962 but as the School intake is only 60 per annum the number available to the School Dental Services will not be large. It is by a combination of these means that we hope to achieve the aim of a satisfactory school dental service viz: that children leave school dentally sound, trained in the care of the teeth, and without the loss of permanent teeth. (66) The tables recording the work carried out during the year are largely self explanatory. DENTAL INSPECTION AND TREATMENT Periodic Specials (a) Number of pupils inspected 7,233 612 (b) Number found to require treatment 4,313 612 (c) Number offered treatment 3,960 612 (d) Number actually treated 3,400 612 (e) Number awaiting treatment 324 - (f) Attendances made by pupils for treatment 10,199 912 (g) Half-days devoted by: - No. (a) Dental Officers to - (i) Periodic (school) inspection 58 (ii) Treatment 1, 360 (b) Dental Hygienist to (i) Treatment 184 (ii) Other purposes 50¼ (h) Number of X-ray examinations 239 (i) Fillings - (i) Permanent teeth 4,520 (ii) Temporary teeth 2,161 No. (j) Number of teeth filled - (1) Permanent teeth 4,102 (11) Temporary teeth 2,042 (k) Extractions - (i) Permanent teeth - (a) on account of caries 666 (b) for other purposes 200 (ii) Temporary teeth - (a) on account of caries 2,813 (b) for other purposes 423 (1) Anaesthetics administered - (i) Local 1,074 (ii) General - (a) by Medical Officers on County Staff Nil (b) by others 1,598 (iii) Average number of general anaesthetic cases per general anaesthetic session 16.5 (m) Orthodontics - (i) Cases commenced during year 136 (ii) Cases carried forward from previous year 816 (iii) Cases completed during year 108 (iv) Cases discontinued during year 20 (v) Pupils treated with appliances 182 (vi) Removable appliances fitted 159 (vii) Fixed appliances fitted 23 (viii) Total attendances 1,572 (ix) Number of sessions devoted to treatment 177 (n) Number of - (i) Pupils supplied with artifical dentures 22 (ii) Dentures fitted 22 (o) Other operations - (i) Permanent teeth 3,235 (ii) Temporary teeth 1,509 (p) Number of other operations in (o) carried out by Dental Hygienist - (i) Permanent teeth 779 (ii) Temporary teeth Nil (q) Analysis of figures in (o) - (i) Silver Nitrate Treatment 618 (ii) Scaling 846 (iii) Gum Treatment 53 (iv) Dressings 1,822 (v) Crowns fitted 10 (vi) Other operations 1,395 (67) 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, Girls 590 240 203 60 29.6 Goodall Secondary Modern 503 352 352 120 34.1 Leyton Manor " " 496 317 274 78 28.5 Norlington " " 513 341 326 152 46.6 Ruckholt " " 518 308 308 100 32.6 Barclay Primary Junior 556 327 257 153 59.5 Cann Hall " " 399 210 205 142 69.3 Church Mead" " 420 273 238 136 57.1 George Tomlinson Primary Junior 243 111 109 70 64.2 Newport Primary Junior 476 300 300 182 60.6 Rvbourn " " 374 196 177 100 56.4 Barclay Primary Infants 328 218 197 107 54.3 Two Visits 182 127 101 55 54.5 Cann Hall Primary Infants 150 81 81 54 66.6 Church Mead " " 212 138 108 52 48.1 Downsell " " 195 133 133 102 76.7 George Tomlinson " " 198 80 78 50 64.1 Newport " " 200 121 121 64 52.8 Sybourn Primary Infants 167 125 110 72 65.5 Two Visits 196 141 115 67 58.0 Leyton Green E.S.N. 67 45 43 22 50.0 (68) Child Guidance Clinic TABLE I ANALYSIS OF FIGURES FOR 1960 Number of cases referred to the Clinic 89 Number of cases diagnosed at the Clinic 65 (a) Psychiatrists Diagnostic interviews — 67 Cases taken on for observation and treatment 26 Treatment interviews 325 # Other interviews 11 # Total number of psychiatric sessions 284 (b) Psychologists Clinic cases tested 74 Cases given remedial education 8 Treatment interviews (remedial education) 143 School visits on behalf of clinic cases 55 Other interviews at clinic 9 Other interviews outside — 56 (c) School Psychological Scrvicc Individual cases seen 177 Number referred to clinic 35 (d) Play Therapists Cases treated 10 Treatment interviews 193 (e) Psychiatric Social Workers Interviews at clinic 982 Interviews elsewhere 43 (f) Waiting List Cases for diagnosis (by doctors) 40 Waiting for treatment (g) Total cases treated during year 128 # Leyton and Forest Division joint sessions (69) TABLE II ANALYSIS OP CASES REFERRED 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. 14 3. Behaviour disorders; e.g. unmanageable; tempers, stealing, lying; sex problems, etc. 40 4. Educational; e.g. backwardness; failure to concentrate 16 TABLE III ANALYSIS OF CASES DIAGNOSED 1. Nervous disorders, e.g. fears; depressions; apathy; excitability 37 2. Habit disorders and physical symptoms; e.g. enuresis; speech disorders; sleep disturbances; tics; fits, etc. 5 3. Behaviour disorders; e.g. unmanageable; tempers; stealing, lying; sex problems, etc. 14 4. Educational, e.g. backwardness; failure to concentrate 7 5. No basic disturbance of child, e.g. mainly parental overanxiety 2 TABLE IV ANALYSIS OF CASES CLOSED DURING 1960 1. Improved and recovered after treatment 20 2. Improved after partial service, i.e. before diagnosis 4 3. Diagnosis and advice only 1 4. Interrupted, e.g. on parents* initiative 18 5. Closed for miscellaneous causes, removed from area, placement at E. S. N. School, etc. 15 6. Spontaneous Improvement 2 (70) PREMISES The clinic removed to its new premises at Monoux Building on 20th April. These are much more convenient and spacious than the old ones, and the staff all appreciate the improved amenities. NEW DEVELOPMENT IN THE WORK OF THE CLINIC In July, 1960 the clinic was approached by the Tutor and Organiser of the Mental Health Course held at the London School of Economics, with a view to placing two students for six months practical training in Child Guidance work. Miss Laquer was asked to undertake supervision of their case work and to select suitable patients for this. This entails a weekly supervision period for each of these students. As the students in question are already workers experienced in the field of social work, we find their services helpful to the clinic team. The first two students will be followed by two others for the second half of the academic year. This is the first time that Mental Health Course students have been attached to a Local Authority Clinic. Conferences at Lea Bridge School for Maladjusted children were attended regularly by the Educational Psychologists and the Psychiatric Social Workers in the Leyton area, to discuss the children placed there from the clinic. Such contact is extremely valuable to us at the clinic and is also no doubt of value to the staff of the school, in the absence of regular psychiatric advice in the school itself. ACTIVITIES OF STAFF OUTSIDE THE CLINIC Discussion groups for Health Visitors in Leyton started in October, 1959 are continuing with mutual benefit of the participants. Remedial Teaching of Reading in Leyton Schools Session 1959 - 60 The scheme to give remedial teaching in reading to small groups of children in the Junior Schools of Leyton has now completed its eighth year. This year the number of children who have been in a remedial reading group for one or more terms has risen slightly, but the large preponderance of boys continues. Boys 145 Girls 68 Totai 213 (71) This table gives their progress:- Numbers of Children Length of Remedial Teaching Numbers of Children with their Gains in Reading Age in Months MONTHS 0-6 7-12 13-18 19-24 25-30 31-36 37-42 43-48 101 3 terms 8 38 24 15 10 3 1 2 58 2 terms 15 22 9 5 5 0 2 0 39 1 term 19 14 4 2 0 0 0 0 198 42 74 37 22 15 3 3 2 213 15 children unscored for various reasons There were 23 children or 11% of those whose progress was fully recorded who made only half a yearns gain in reading age although they had between 6-12 months extra help. Of these there were five who hardly made any progress at all and the psychologist is following them up in school during the present session. Against this must be set the 82 or 41% who made more than a year's gain in reading age although some of them had less than a year's extra help. Of these 23 or 11% mademorethan 2-years gain. Both the Head Teachers and the remedial teachers feel that these results well justified the scheme as a whole and for some of the children the extra individual help made a turning point in their lives. Unfortunately, there are still some children we have been unable to help, either because of their intellectual limitations or their emotional disturbances. The remedial reading scheme in the Junior School cannot eradicate the problem of the poor reader in the Secondary School, although we believe that it has made a considerable contribution. All the remedial teachers have worked with their customary persistence and enthusiasm. One teacher who takes the groups in three schools was ill during the year and there was a gap of several weeks before a substitute could be found. This certainly interfered with the progress of some children. In the majority of cases progress is good, but not spectacular and it is no use beginning remedial teaching and then giving it up before the child is able to go on alone. This means that the turnover in some groups is rather slow and hence other children cannot be included. Children now know about the scheme and come and ask if they can go to the "reading teacher" for extra help. When one boy of nine was brought from his class and told he could go to the special room for extra reading lessons, he jumped up and down and said "Oh, goody - I've been hoping for this." A great deal of research into causes of reading failure is being done both here and in other countries and there is a good body of knowledge about special weaknesses and other methods to overcome them. The crux of the problem with children of eight and over is, however, one of motivation - how to get them to go on trying when the task is so complex and when they cannot achieve a quick result. It is in this situation that the individual relationship with a teacher is the only way to carry the child through to success and this relationship cannot be formed in a day nor broken off without due preparation. The teachers find that the child's need for them gradually eases off as success is achieved. (72) B.C.G. Vaccination Number of school children in the age groups for B.C.G Vaccination - 4,371. AGE GROUP Result of Heaf Tests Result of Mantoux Tests Tuberculin Positive (1) Tuberculin Negative (2) Vaccinated with B.C.G (3) Tuberculin Positive (4) Tuberculin Negative (5) Vaccinated with B.C.G (6) Children under 14 yrs. 42 485 485 20 248 248 over 14 4 20 20 2 30 30 TOTAL TUBERCULIN POSITIVE Columns (1) & (4) TOTAL TUBERCULIN NEGATIVE Columns (2) & (5) TOTAL VACCINATED WITH B.C.G Columns (3) & (6) Children under 14 yrs. 62 733 733 " over 14 " 6 50 50 " The acceptance rate for children under 14 years of age was 45%. In April, 1959 the Minister of Health approved the extension of B. C. G. Vaccination to children of 14 years and upwards. This was implemented in the next programme which began in January, 1960. Each child can be offered B. C.G in two consecutive years and this may lead to an increase in the number of acceptances. Tuberculosis Vaccines Clinical Trial The active phase of this scheme was completed in August, 1960. Long term observation of the age groups will still be kept by the department and periodic returns of infection found will be made to the Medical Research Council. (73) Speech Clinic CHILDREN HAVING RECEIVED TREATMENT DURING 1960 Under 5 years Primary School Secondary School Special School TOTAL Articulation Defect - 18 1 17 36 Cases commenced before 1960 and continuing Stammer 1 4 7 1 13 after December, 31st 1959 Articulation Defect and Stammer - 4 1 1 6 Total 1 26 9 19 55 Articulation Defect 14 31 1 6 52 Cases commencing treatment during 1960 Stammer Articulation Defect and Stammer - 4 1 - 5 - 1 1 - 2 Total 14 36 3 6 59 Therefore total cases receiving treatment during 1960 - 114 Total new cases - 59. Boys Girls Total Children at present undergoing treatment 75 27 102 Children discharged 15 5 20 On Waiting List Nil Average number of cases treated daily 20 Homes visited 15 School departments visited 25 Parents interviewed 117 Children referred to other clinics 9 Number of children leaving before cure or discharge 17 Total number of attendances 2,228 Number of children not at present attending but names on list 92 Number of children referred found not to require treatment 1 (74) Chiropody Clinics Chiropody treatment for school children is provided at each of the Health Clinics in the area at the request of the staff of the Minor Ailment Clinic or the private practitioner. 392 children were accepted for treatment and 369 were discharged and a total of 2,600 attendances were made by children at the clinics. The new cases were treated for the following conditions:- Condition Under 5 yrs. 5-7 7-9 9-11 11-13 13 + TOTAL M F M F M F M P M F M F Verrucae 1 - 4 5 16 17 22 58 39 73 22 79 336 Bursitis 1 - - - - - - - - - - 1 2 Callous - 1 - - - - - - - - 4 - 5 Claw Toes - 1 - - - - - - - - - - 1 Corns 1 2 2 1 - 1 - 2 8 7 2 10 36 Hallux Valgus - - - - - - - 1 - - 1 2 4 Hyperidrosis - - - - - - 1 - - - - - 1 Ingrowing Nail - - - 1 - - - - - - - 3 4 Club Nail - - - - - - - - - - - 1 1 Tinea - - - - - - - - - - 1 - 1 Underlying 5th Toe. - 1 - - - - - - - - - - 1 TOTAL IN AGE GROUPS 3 5 6 7 16 18 23 61 47 80 30 96 392 (75) HANDICAPPED PUPILS CATEGORY Number of children of school age on 31st December, 1960, 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 aged 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 Awaiting placement in boarding homes Attending independent schools Awaiting placement in independent schools Attending hospital schools Awaiting placement in hospital schools Receiving Education in hospital under Section 56 Receiving home tuition under Section 56 Awaiting home tuition under section 56 Special Maladjusted Classes in Day School Total number of children of school age requiring s.e.t. Receiving Special Education Awaiting Special Education Blind - - - • - - 2 - - - - . _ _ 2 _ - - 1 Partially sighted 2 - - - - - - - - - - - - - 2 7 - - 2 Deaf 3 - - - - - - - - - - - - - 3 - 1 - - Partially deaf 4 - - - - - 2 - - - - - - - 6 10 4 - - Delicate 1 - 3 - - - 2 1 - - - - - - 7 - - - - Physically Handicapped 19 - - - - - 1 - - - - - 2 - 22 36 _ _ 10 E.S.N 83 - 2 - - - 4 1 - - - - - - 90 - - - 12 Maladjusted 21 - 5 1 3 - 7 4 - - - - 1 - 42 1 - - - Epileptic - - - - - - 2 - - - - - - - 2 3 - - 3 Speech defect - - - - ' - - - - - - - - - - - - - - - Dual defects 1 - - - - - - - - - - - - - 1 - - - - TOTAL 134 - 10 1 3 - 20 6 - - - - 3 - 177 57 5 - 28 (76) Leyton Special E.S.N. Schools The Special Schools in Leyton are regularly visited by one Assistant Medical Officer, which ensures continuity of medical supervision within the schools. Number on Roll in 1960 Varied from 194 to 200 Leyton 80 - 86 Forest 110 - 120 Number admitted 1960 41 Number left 1960 48 Reasons for leaving:- 1. Attained age of 16 - (a) Notified under Section 57 (5) 7 (b) Not notified 12 2. No longer in need of special education 6 3. Notified as Ineducable under Section 57 (3) 5 4. Removal to other areas 10 5. To Residential School (E.S.N.) 3 6. Returned to Normal School 4 7. To special Class in Secondary Modern School 1 LEYTON GREEN PRIMARY (E.S.N.) SCHOOL Specials Boys Girls No. inspected 11 20 Parents present - 9 Unsatisfactory 2 3 Code No.4 Skin - 1 (77) Specials Boys Gi ri s 5 (a) Vision 2 4 (b) Squint - 2 (c) Others - - 6 (a) Hearing 3 4 (b) 0.Media 2 1 (c) Others - - 7 Nose and Throat 1 1 8 Speech - 2 9 Lymphatic glands - - 10 Heart 1 1 11 Lungs - - 12 Developmental - (a) Hernia - - (b) Others 2 1 13 Orthopaedic - (a) Posture - 1 (b) Feet 2 2 (c) Others 1 - 14 Nervous System - (a) Epilepsy 1 1 (b) Others - - 15 Psychological - (a) Development - - (b) Stability 2 1 18 Abdomen - - HARROW GREEN SECONDARY (E. S. N.) SCHOOL 1944 Routine 1945 Routine 1945 Specials Boys Gi rl s Boys Girls Boys Gi rls No. inspected 7 1 5 8 17 5 Parents present 6 1 4 4 5 1 Unsatisfactory - - 1 1 2 2 Code No.4 Skin - - 1 1 - - 5 (a) Vision 3 - 3 3 1 1 (b) Squint - - - - - - (c) Others - - - - 1 1 6 (a) Hearing - - 1 - 2 1 (b) 0.Media - - - - 2 - (c) Others - - - - - 1 (78)  1944 Routine 1945 Routine 1945 Specials Boys Gi ri s Boys Gi rl s Boys Gi ri s 7 Nose and Throat - 1 1 1 1 - 8 Speech - - - - 1 - 9 Lymphatic glands - - - - - - 10 Heart - - - - - - 11 Lungs - - 1 2 3 1 12 Developmental - (a) Hernia - - - - 1 - (b) Others - - - - 1 - 13 Orthopaedic - (a) Posture - - - - 1 1 (b) Feet - 1 1 2 1 1 (c) Others - 1 - - 1 - 14 Nervous system - (a) Epilepsy - - - - - - (b) Others - - - - - - 15 Psychological - (a) Development - - - - 1 1 (b) Stability - - 5 1 5 1 18 Abdomen - - - - 1 1 LEYTON GREEN SCHOOL (AGE RANGE 5-12 YEARS) It has been the custom up to 1959 to try to carry out a routine inspection of each child in the school year, though of course 100% cover was never attained; but a good percentage of the children with or without parents would be seen. In 1960 routine inspections were not arranged and only those cases who gave the school staff, the School Health Visitor, the parents or the School Medical Officer cause for concern were seen. Parents were not always able to come but were written to or in some cases telephoned regarding the child's difficulties. It remains to be seen whether this procedure is as satisfactory as the old way. In a Special School drawing children from a wide area outside the Leyton Borough it is doubtful if it is desirable. Local children are well-known to the medical and nursing staff but the background is not so well-known where children come from a distance and the School Medical Officer concerned is not completely happy about it. It is probable that a routine inspection will be carried out in 1961. The majority of the children seen at these special inspections were having emotional or learning difficulties and the physical defects tended to take second place. One epiliptic child and her mother attended on two occasions and required a great deal of time and consideration. Similarly a mongolian defective child and his parents attended on three occasions in the year, taking up three afternoon sessions of the School Medical Officer's time. (79) Parents whose children were proving to be on the borderline of educability were always seen before official application to examine the child was made. The type of letter which is required by law to be sent to the parents of such children is such an intimidating document that it was considered by the School Medical Officer that parents should have some explanation of the elaborate procedure beforehand. In spite of this precaution most parents were distressed on the receipt of the letter asking them to attend with the child for the examination. The procedure under the new Mental Health Act may be simplified but the documents concerned are still quite considerable. Mr. Head, the peripatetic teacher of the deaf, has visited the school on several occasions. He did not find any children whose learning difficulties could be attributed to hearing defects. Two children have been admitted from day partially deaf schools as after trial at these schools it was realised that their main handicap was mental retardation and not deafness. One child still wears a hearing aid but it is doubtful if she really needs it. There appears little difference in her responses whether she has the aid or not. She is really on the borderline of educability. HARROW GREEN SCHOOL (AGE RANGE 11-17 YEARS) Pour boys were considered educationally good enough to return to secondary modern schools. Their standard of attainments were so above tiie level of the children in the top class of the school and with their I.Q. score around 80-84 it was considered worthwhile to let them return. Two of the boys are emotionally maladjusted - once their learning difficulties had cleared up it was seen that their underlying emotional problems were serious and needed attention. They have been referred to the Child Guidance Clinic for treatment for these emotional difficulties. Three of the boys returned to their new schools in January, 1961 and it is too early to say how they are getting on. The boy with the most serious maladjustment who has been nine months in his new school is making quite good progress. One boy returned to a special class in his previous school. It was considered that he was correctly placed by the School Medical Officer and by the school staff but the emotional pressure on the boy by his parents who were deeply ashamed of his school failure was such that he became very disturbed and unable to settle down and work. When a class for retarded children was re-opened at his old school he was transferred there, still notified of course as requiring special educational treatment. One boy stayed on at school until he was 17. He was very small in stature and his physical maturity was delayed. He did benefit from his extra year and has now taken up employment. Before children are deascertained the School Medical Officer and the school staff consult together and the agreement of Head Teacher, Class Teacher and School Medical Officer has to be complete before a child is allowed to leave school before the age of 16. Also no child is ascertained as requiring further consideration by the Mental Health Authority without discussing it with the parents. The only cases where this is not done are the very few who have never attended any medical examination with the child or answered any invitation to see the Headmaster or the School Medical Officer. These cases are very few fortunately. (80) The Juvenile Employment Officer, Mr. Rees Owen attends at the school and consults with the parents and head teacher and the child about future employment. He has a report from the School Medical Officer also and sometimes in difficult cases a discussion is held with the School Medical Officer and also with the Mental Health Officer if it is a child who has been reported as in need of community care. The great majority of the children do well in the work found for them. Mr. Rees Owen takes a great deal of trouble to find the right work for these school leavers. It is important to start them off in work suited to their capacity otherwise if it is too difficult they can be greatly discouraged. A few parents have to be helped to understand this. They have ambitious ideas much too exacting for the poorer equipped child. This area is fortunate in having a Juvenile Employment Officer who has an excellent liaison with employers who will give these children a good start with sympathetic understanding of their problems. THE DAY SCHOOL FOR MALADJUSTED CHILDREN, LEA BRIDGE ROAD E.10. This school opened in September, 1959 with two teachers and 13 children; four girls and nine boys, ranging in age from 7-12 years. By the end of 1960 there were 23 children and three full-time teachers and one part-time teacher who specialised in teaching children with special reading difficulties. Mr.Giles, who had been teacher in charge, was appointed in November as Head Teacher, an appointment which gave great satisfaction to all those in any way concerned in the school's well-being as there is no doubt that his work in establishing this school has been of the highest order. Initially the school was only two classes and the school premises were shared with a small infant school of two classes, and the playing space for outdoor activities was very much limited as the open ground at the rear of the premises was used by a nearby secondary school. It was obvious after the first six months that the school would only fulfil its object fully if it could expand to such a size that numbers justified the appointment of a Head Teacher with sufficient teaching staff that he or she could be more or less free of routine teaching and the school be self contained in its own premises and with plenty of space for outdoor activities of a constructive and imaginative kind. These objectives were fortunately achieved. The infant school moved out, the large piece of open ground was freed for the use of the school, and in September, 1960, the school started to function as a quite independent unit. The number of children in the school remained the same until the end of the Summer term. In June all the children except one attepded, with their two teachers in charge, a weekend camp in the grounds of Hassobury School. It was a great success and the teachers found it a valuable experience in giving them even more insight than just school contact gave of the problems of the children in their care. So many of the children come from homes with limited interests and resources it could not but be helpful to them to extend their experiences and widen their horizon in this way. It is hoped to repeat the experiment in 1961. At the end of the first school year one boy returned to a secondary modern school. He was a less severely disturbed child than the majority of the others and it was felt (81) that since he was keen to try to cope with the ordinary school that the request should be granted. The Child Guidance Clinic staff and teaching staff were hopeful that he would be alright. By the end of his first term, however, he had broken down again and he has been re-admitted and has settled in happily. One boy admitted in January proved such an impossible pupil that Home Tuition was recommended and this, coupled with continued treatment at the Child Guidance Clinic, is proving helpful to him. This boy had had to be excluded from his ordinary school for impossible behaviour. He is a child who might be called "brain damaged" and this type of child poses a very special problem and one to which we do not yet know the answer. A similar type of boy was admitted in the Autumn term for a trial period but he also had to be excluded and admitted to a hospital for further investigation. He is to attend a Residential School eventually. These very aggressive non co-operative children appear to be over stimulated by the higher emotional tensions and the freer atmosphere which exists in a school like this and our experience after 15 months suggest that such a school is not for them. The staff of the Child Guidance Clinic are actively concerned in the treatment and supervision of the children in the school and are constantly in touch with the teachers. It is essential that the staffing of the Child Guidance Clinic should be generous having to allow for frequent attendances of children to have therapy from the psychiatrist, help from the educational psychologist and frequent contact with the parents from the psychiatric social workers. The School Medical Officer also should be able to visit every 2-3 weeks in each school term or be able to attend the school at short notice when the inevitable crisis blows up. The School teachers do a most valuable piece of work out of school, taking children out after school hours or at the weekend to various places of interest or entertainment theatre, zoo museums, etc. Every home has been visited by the child's teacher and helpful contacts made with parents often themselves hostile or emotionally disturbed and difficult. The teachers find that in this way they are helped to see the child's problems in a clearer light and know better how to deal with the child's difficulties. These schools cannot be anything but costly in the use of highly trained personnels time. A generous staffing ratio of highly trained and dedicated teachers are an essential, indeed fundamental, necessity if the children are to benefit from attendances at such a school. Experience of this school has also shown that of great importance too is the quality and temperament of the ancillary staff. The school caretaker must have infinite patience, resource, initiative and compassion and not be one bound by his book of rules. In this respect Lea Bridge Road School has been very fortunate and found such a man. Equally the school secretary, the mid-day assistant and the coach attendant have to be exceptional people to cope with these immature, disturbed and often very unhappy children. The work is very exacting and demanding- for all the staff in the school, but already good results can be seen. The great majority of the parents are deeply grateful for the help given. One father reported his boy 100% improved. This boy has completely lost a nervous tic that irritated beyond endurance his parents and the staff of his previous school. Those concerned with the school feel that it has justified its foundation and are watching with interest its progress. (82) HEARING AIDS There are seventeen children wearing hearing aids who are resident in Leyton, many of whom are attending Special Schools. AUDITORY TRAINING I wish to thank Mr.B. R. Head, Peripatetic Teacher of the Deaf, for the following report:- "There are at present seven partially deaf children with hearing aids in Leyton schools placed as follows: - Primary School 2 Secondary School 3 Maladjusted 1 E.S.N 1 There is one pre-school child aged three years. The children in school are being visited as frequently as possible for auditory training, usually every two to three weeks but the pre-school child is being seen weekly. All of the children being visited are making reasonable educational progress and the question of placement in a school for the deaf or partially deaf does not arise at present. In the case of the one pre-school child being visited, such a placement may have to be considered in the future as she seems to be too severely deaf to enter a normal school. One pre-school child who was being visited at home was admitted to the William Morris School for the Deaf in October, 1960. This child was slow to settle down but by the end of his first term had begun to make progress. Unfortunately, on his return after a long absence this term he appears to be less settled than he was. Another child who had been attending a Secondary school moved to Canvey Island. His new school has been visited and his headmaster has been acquanited with his difficulties. With one exception all the children being visited have Medresco 0.L. 56 hearing aids. The exception is a severely deaf girl who is using a Multitone aid. One boy, suffering from a severe high frequency loss, could possibly make better progress with a more suitable hearing aid than the 0.L.56 and experiments are being carried out to discover which aid would be most suitable for him. When these are concluded a recommendation will be made." OUTBREAKS OF INFECTIOUS DISEASE IN 1960 There was nothing other than the seasonal outbreaks of infectious disease during 1960, and there is nothing of significance to report. (83) TUBERCULOSIS IN SCHOOL CHILDREN One girl aged 12 years was admitted to hospital with cervical adenitis, and one boy aged 12 years was admitted for tubercular meningitis. Both children were in hospital and under successful treatment at the end of the year. One girl aged 15 years, who, removed into Leyton with a notified lung infection, was discharged, cured, after investigation by the Chest Physician. DEATHS OF CHILDREN OF SCHOOL AGE During the year four children of school age died. The deaths were due to the following:- Acute Lymphatic Leukaemia Female aged 6 years Acute Myelblastic " Male "13 " Cerebral damage & Pulmonary Stenosis Male " 10 " Cerebral Laceration due to Road Accident Female aged 11 " HEALTH EDUCATION The Health Visitors work in close co-operation with the teaching staff in all types of schools. Primary Schools Health Education is carried out informally and mostly individually. In the main it consists of encouraging good habits. Some attempts are being made on group teaching but so far they have mostly been concerned with the care of teeth. Secondary Schools The Health Visitors are teaching in all the secondary modern schools in this area and also at the school for educationally subnormal children. This year, the Health Education Syllabus in the secondary schools has been revised to meet the present needs of the pupils, and it is set out below, its attention to the physical and emotional changes of adolescence will be self-evident. Talks are included on the problems of adolescence, leisure pursuits, budgeting and choosing clothes. Group discussion is encouraged and the atmosphere is most informal so that questions on any subject can be answered or discussed. The syllabus is flexible to meet the particular needs of the groups. In the E.S.N. School teaching is carried out mainly by demonstration, as the girls more easily absorb practical experience. Here the syllabus is more concerned with mothercraft. The pupils learn how to handle a model baby and the technique of bathing, how to choose a layette and where to obtain help. During the year pupils made 4,340 attendances at 232 talks given by the Health Visitors. (84) Health Education Syllabus FOR SECONDARY SCHOOLS 1. Growing Up Needs of the baby - toddler - school child - adolescent - adult. 2. The Family & The Community Citizenship. Clubs and other Organisations. 3. How the Body Functions Elementary Anatomy and Physiology. 4. Nutrition Food values - Importance of a balanced diet. 5. Posture in Health Fresh air - sleep - training for fitness and good habits. 6. How to be well groomed Care of the skin - hair - eyes - teeth - feet. 7. Problems of Adolescence Leisure - human relationships. 8. Choosing clothes Budgeting - choice of materials - suitability and attractiveness. 9. Home Safety Prevention of accident - First Aid. 10. Community Health Prevention of spread of disease - immunisation - vaccination. 11. Public Health Services Health Clinics - the work of the Public Health Department. 12. Visit to Welfare Centre a.m. Visit to Welfare Centre. Baby bathing demonstration and filmshow. p.m. Visit to Day Nursery. (85) Sanitary Inspection of School Premises Sanitary Facilities and Catering Arrangements 1960 I am indebted to the Chief Public Health Inspector, Borough of Leyton, for the following report:- "In addition to routine inspection of school premises, a comprehensive detailed survey of the sanitary facilities and catering arrangements at school premises, central kitchens and dining centres was carried out by the Public Health Inspectors during the year. The standard of sanitary accommodation prescribed by regulations made under the Education Acts refers especially to new school buildings and cannot, therefore, be regarded as strictly applicable to existing schools, some of which were built a generation or two ago. Whereas, with few exceptions, it is found that older schools are not supplied with water closets, urinals, wash-hand basins etc. on such a generous scale as is recommended in the regulations for new school buildings, they approximate to those standards so closely that no official recommendation was considered necessary. Sanitary conveniences and fittings were found to be in a reasonable state of repair, good working order, and free from nuisance. The standard of premises, equipment and general facilities provided for school catering was judged in the light of current legislation. The Food Hygiene Regulations 1955/57 have now been amended and consolidated by the Food Hygiene (General) Regulations, 1960, the effect of which is to increase their scope. An instance of this is contained in Regulation 9, which makes it an offence to use herbal smoking mixture in a room containing open food - under the old regulations tobacco only was prohibited. The Minister of Health, and the Minister of Agriculture, Fisheries and Food, in conjunction with the Food Hygiene Advisory Council, have published this year codes of practice in relation to certain food trades. In general the standard of hygiene in the preparation, cooking, distribution and serving of school meals was found reasonably satisfactory, and compares favourably with the general standard found in commercial establishments and industrial canteens. It was, however, necessary on completion of the detailed survey to make recommendations regarding comparatively minor infringements of the regulations at a number of schools; these were concerned mainly with works of maintenance and decoration. Close liaison was maintained between the Public Health Inspectorate and the School Meals Organiser during the detailed survey. The most effective form of Health Education in regard to food hygiene is obtained by personal contact between the officer and food handler. With this objective in view, many routine visits to school kitchens and dining centres are made by the Public Health Inspectorate; we have always found catering staff at such centres to be co-operative in their readiness to accept recommendations and advice in connection with the observance of hygienic practices, and the necessity for strict personal cleanliness in ensuring that the best possible use is made of existing premises and available equipment and facilities. (86) The inspection of food supplies delivered to schools was continued during the year. These inspections are carried out while meat is in course of delivery to kitchens, usually at about 7.30 a.m. so far it has not been necessary to report to the Supplies Department of the Essex County Council regarding any infringement of the Pood and Drugs Act in respect of the nature, substance or quality of the food supplied, or any contravention of the requirements of the Pood Hygiene Regulations governing transport of meat and other food. A number of samples of water and of milk were obtained from schools for chemical and bacteriological examination. The reports of the public analyst and bacteriologist were satisfactory in every case. " (87) Improvements to School Premises carried out during year ended 31st December, 1960 LEYTON COUNTY HIGH SCHOOL FOR GIRLS New extensions to provide nine additional water closets for pupils. GOODALL COUNTY SECONDARY New building in playground comprising two Science rooms, Woodwork and Metalwork rooms, with sanitary and washing accommodation for pupils and staff. Heating and Domestic Hot water by Oil Fired Boiler. Domestic Science block reconstructed to provide two modern rooms for Domestic Science with sanitary and washing accommodation for pupils. Conversions within the main building to provide up-to-date rooms for Needlework, Art and Craft, Library, and new Changing Rooms and Showers. BARCLAY COUNTY PRIMARY New quarry tile floor and stainless steel sinks and draining boards provided in kitchen. New floor covering in Dining room and Cloaks. DOWNSELL COUNTY PRIMARY New hardwood floors to two Classrooms and part of corridor in Junior School to replace worn out flooring. GEORGE TOMLINSON COUNTY PRIMARY New large window with eight opening sashes to improve ventilation of kitchen. MAYVILLE COUNTY PRIMARY Vacant site in Southwell Grove Road levelled and tar paved to form extension of Junior Playground. New hardwood floors laid in three Classrooms to replace worn out flooring. DRAPERS SPORTS GROUND New Pavilion containing small Hall, Changing rooms, showers, Sanitary accommodation for pupils and staff, with living quarters for Groundsman on first floor. The undermentioned schools were redecorated internally: Barclay County Junior (including Kitchen) Goodall " Secondary Newport " Infant The Leyton Green Annexe of Harrow Green Special School (88) INDEX Page(a) Acreage 3 Air Pollution 25, 43 Ambulance Service 8, 54 Ante-Natal Clinics 48 Auditory Training 83 Aural 63 Bacteriological Examinations 39 B.C.G. Vaccinations 73 Birth Notifications 45 Birth Rate 3 Birth Registrations 45 Births, Illegitimate 3 Burial of the Dead 6 Business Premises 18, 32, 33, 36, 37 Child Guidance Clinic 69 Child Welfare Clinics 45, 47 Clean Air Act, 1956 24-25 Clinic Sessions 46 Convalescent Home Treatment 47, 56 Comparability Factor 3 Day Maladjusted Classes 81 Day Nurseries 50 Death, Causes of 5 Death Rate 3 Dental Treatment 48, 64 Diphtheria Immunisation 53 Diseases of Animals Acts & Orders 23 Disinfestations 15, 34 Domestic Help Service 56 Domiciliary Midwives 51 Essex County Council Act, 1952 37 E.S.N. Schools 77 Fabrics (Misdescription) Regs., 1959 19, 40 Factories Acts, 1937/48 41 Food and Drugs Act, 1955 32, 35, 37 Food, Condemned 38 Food Hygiene 22, 35 Food Sampling 22, 39 Foot Clinic 55, 75 Gas and Air Analgesia 51 Handicapped Pupils 76 Health Clinics 45 Health Education 30, 84 Health Visiting 52 Hearing Aids 83 Home Nursing 52 Hospitals 8 Housing and Nuisance Abatement 11 Housing Repairs & Rents Act, 1954 32 Ice-Cream 39 Immunisation 53 Improvement to School Premises 88 Infant Mortality 3 Infectious Diseases 9. 83 International Certificates 76 Laboratory Facilities 7 Laundry for the Incontinent 8 Legal Proceedings 38 Leyton Corporation Act, i950 37 Page(a) Maladjusted Children, Day School, Lea Bridge Road 81 Maternal Mortality 3 Maternity Outfits 51 Medical Aid 51 Medical Examination of Staff 57 Medical Treatment 63 Midwifery 51 Milk & Dairies (General) Regs. 1959 37 Milk (Special Designation) Regs. 37 Minor Ailment Clinics 63 National Health Service Act, 1946 (Part III) 45 Noise Abatement Act, 1960 18 Notices, Sanitary 34 Nuisances, Abated 34 Nursing Homes 8 Ophthalmic Clinic 64 Orthopaedic Clinic 63 Orthoptic 64 Outworkers 42 Pet Animals Act, 1951 37 Phenylketonuria 48 Poliomyelitis Vaccination 54 Population 3 Post-Natal Clinic 48 Premature Infants 47 Public Health Inspection 12-43 Public Health Inspection Statistics 31 Rag, Flock and Other Filling Materials Act, 1951 37 Redevelopment Areas 11 Remedial Exercises 64 Remedial Teaching of Reading 71 Rent Act, 1957 32 Rodent Control & Insect Control 16, 34 Routine Medical Inspections 60 Sampling (Food & Drugs Act, 1955) 23, 39 Sanitary Inspection of Schools 86 School Children, deaths of 84 School Clinics 59 School Health Service 58 Sewerage 7 Sick Room Equipment 56 Slum Clearance 11 Smoke Abatement 25, 43 Specialist Clinics 50, 63 Speech Clinic 74 Statistics, Sanitary 31 Statistics, Comparative - Births, Deaths, etc. 4 Statistics, Vital 3 Swimming Baths 6 Tuberculosis 10, 84 Tuberculosis, Extra Nourishment 55 Tuberculosis, Open Air Shelters 55 Vaccination 52 Vital Statistics 3 Welfare Foods, Distribution of 47 Whooping Cough, Immunisation 53 Printed by LEYTON BOROUGH COUNCIL