4411 (1) Library Rom 39 II ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR ROMFORD FOR THE YEAR 1964 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR ROMFORD FOR THE YEAR 1964 CONTENTS Pages Committee Members 6 Health Department Staff 8 Vital Statistics 11 Infectious Diseases 16 Maternity Services 18 Clinics 19 Welfare Foods 19 Day Nurseries 19 Staff Medical Examinations 21 Health Visiting 21 Vaccination and Immunisation 21 Prevention of Illness, Care and After Care 22 Home Nursing 24 Children at Risk 24 School Health Service 25 Vaccination against Tuberculosis 27 Handicapped Pupils 28 Child Guidance Service 29 Sanitary Circumstances of the Area 32 Inspections 34 Factories Acts 36 Housing 37 Caravans 38 Disinfestation of Insects and Pests 40 Inspection and Supervision of Food 42 Clean Air 55 Public Baths 56 Housing 57 Shops and Offices 60 TOWN HALL, ROMFORD To The Mayor, Alderman and Councillors of Borough of Romford. February, 1964. Mr. Mayor, Ladies and Gentlemen, Due to the London Government Act 1963, the Borough of Romford will, with effect from 1st April, 1965, become part of the London Borough of Havering. This, therefore, is the last in the series of Annual Reports relating to Romford. It has been prepared at an early date, before the receipt of the usual vital statistics from the Registrar General so that it may be presented to you before the forthcoming re-organisation in Local Government. Figures compiled locally have therefore been included, but as these will show some variations from those received from the Registrar General, amendments will be available at a later date, on application. To illustrate the changes which have occurred in the vital statistics from the early days of the century, and also with the first year of the Borough, some comparisons have been made with 1901 and 1937, the year when Romford became a Municipal Borough. Of the staff employed in 1937 only three still remain with the Department, one of whom will retire before the Health and Welfare Department of the Borough of Havering takes over. Also mentioned in the report are some facts in the history of the development page 4 of the Health Services in Romford throughout the years. It is interesting to note that up to the end of the 1920's there were only two full-time officers in the Health Department, viz.: one Sanitary Inspector and one Health Visitor, and the growth of the services only commenced in earnest with the appointment of the first fulltime Medical Officer of Health in 1934. In presenting this report, I should like to thank my colleagues and members of the Council for the help they have given me during this year, and also express appreciation to everyone who contributed to the development of the Health Services in Romford over the years. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, Medical Officer of Health. Tel.: Romford 46040. page 5 PUBLIC HEALTH COMMITTEE as at December, 1964 His Worship the Mayor—Councillor P. J. SMYTH, J.P. Chairman—Councillor F. G. CARRICK Vice-Chairman—Councillor Mrs. M. P. HURLEY, CC. Alderman Mrs. M. CLARK-LEWIS. Alderman Mrs. L. A. IRONS, O.B.E., J .P ., c.c. Alderman J. M. WHALE Councillor C. B. BARNETT. Councillor G. R. G. JOHNSON, LL.M. Councillor W. C. MILLS ROMFORD COMMITTEE FOR EDUCATION as at December, 1964 His Worship the Mayor—Councillor P. J. SMYTH, J.P. Deputy Mayor—Councillor A. HAWKESWORTH, B.E.M., J.P. Chairman—Alderman P. D. RIDLEY, M.A. (Cantab.) Vice-Chairman—Councillor W. G. RUSSELL Representative Members:— Alderman Mrs. M. CLARK-LEWIS. Alderman Mrs. L. A. IRONS, Councillor Mrs. I. M. BARBER O.B.E., J.P., C.C. Councillor F. G. CARRICK Councillor F. E. BROOKS Councillor G. R. G. JOHNSON, Councillor Mrs. L. S. HUTTON LL.M. Councillor R. S. KILBEY Councillor L. C. MILLS Councillor S. E. SHUTE, C.C. Co-opted Members:— Mr. F. FISHER Mrs. R. M. LATHAM Mr. J. G. PITTAWAY Mrs. S. LIBMAN Nominated Members:— Alderman Mrs. O. M. J. ROBERTS, J.P., C.C. Councillor W. FALK page 6 ROMFORD HEALTH AREA SUB-COMMITTEE of the Essex County Health Committee as at December, 1964 Chairman—Alderman Mrs. L. A. IRONS, O.B.E., J.P., C.C. Vice-Chairman—Councillor Mrs. M. P. HURLEY, C.C. Romford Borough Council Representatives: Alderman Mrs. M. CLARK-LEWIS. Alderman A. McGONAGLE Alderman P. D. RIDLEY, M.A. Councillor C. B. BARNETT (Cantab.) Councillor F. G. CARRICK Councillor P. C. ALLAM Councillor A. DAY Councillor Mrs. R. C. COFFIN Councillor R. J. G. McGLASHAM Councillor R. S. KILBEY Councillor W. G. RUSSELL Councillor H. PACKHAM Councillor M. J. WARD, B.A. Lssex County Council Representatives:— County Alderman K. E B. GLENNY, O.B.E., J.P. County Alderman Mrs. E. C. SAYWOOD County Councillor Mrs. S. M. BOVILL County Councillor S. A. LEGG The Local Medical Committee for Essex Representative— Dr. R. M. S. MATTHEWS The Romford Group Hospital Management Committee Representative:— Mr. C. NUNN, J.P. Voluntary Organisations' Representatives:— Mrs. L. N. GOMER Mrs. E. McCORD, O.B.E. Mrs. C. E. SIMS Miss C. TABENER page 7 HEALTH DEPARTMENT STAFF as at December, 1964 Medical Officer of Health, Area Medical Officer, and Divisional School Medical Officer:— F. L. GROARKE, M B., L.M., D.C.H., D.P.H. Assistant Medical Officers of Health and School Medical Officers :— Mrs. J. M. E. CORBETT, M B., Ch.B. J. J. DUFFY, M B., B.C.H., B.A.O., D.P.H. Mrs. E. M. HAGA, M B., B.S., M.R.C.S., L.R.C.P., D.P.H, Mrs. J. M. WARE, M B., B.S. Dental Officers:— Miss M. L. ELL, L.D.S., R.C.S.(Eng.) (Area Dental Officer) Mrs. C. LEEMING, B.D.S. J. LUKE, L.D.S, R.C.S.(Eng.) (Part-time) N. YELLON, L.D.S., R.C.S.(Eng.) (Part-time) Chief Public Health Inspector:— H. C. BOSWELL Senior Public Health Inspector:— W. HODSON Public Health Inspectors:— E. B. BECKETT G. F. HOBSON J. C. BUCKINGHAM E. LONG P. EDWARDS D. PAGE O. WHITWORTH T. GIBBS (Student) C. PORTER (Student) Shops Inspector:— S. F. TITTERTON Assistant Shops Inspector:— M. LEE Rodent Officer:— R. DENT Superintendent Health Visitor:— Miss F. K. WELLS Health Visitors, School Nurses, etc.:— Mrs. P. ALGHAL1 Mrs S. A. KIRBY Mrs. J. ARTHUR (ParMimo) Mrs A. M. LeCOUNT Miss S. AZZONE Mrs C. C. LEDDEN Mrs. J. BERRY (Tuberculosis Mrs. F. C. MARSHALL Visitor) (Tuberculosis Visitor) Mrs. J. A. CHILD Mrs. B. M. MATTHEWS Miss O. CLEMENTS Mrs. G. PHILLIPS Miss E. COOGAN (Clinic Nurse) Miss P. F. CULLIS Miss M. POOLE Mrs. J. GORDON (Clinic Nurse) Mrs. M. RIGBY Miss D I. HALL Mrs. P. P. RUTHVEN Mrs. S. HOLLAND Miss A. P. M. THOMAS (Tuberculosis Visitor) Miss A. M. TIDD Miss K. ISZATT Mrs. M. WILLIAMS page 8 staff Superintendent of Home Nurses and Area Non-Medical Supervisor of Midwives:— Miss N. MARSH District Midwives:— Mrs. V. CASSON Miss C. M. KERR Mrs. G. V. CHANDLER Miss D. D. K. MARTIN Miss E. B. GRAHAM Mrs. G. MERRY Mrs. C. GRAY Miss R. A. MERRY Miss M. C. HAMER Mrs. C. MITCHELL Mrs. D. JACKSON Mrs. M. PARSONS Miss E. E. JEENES Mrs. G. E. SEXTON Mrs. F. A. SMITH District Nurses:— Mrs. E. M. ANDREWS Mrs. J. CORNISH Miss G. V. BOOTES Mr. I. FISHER Mrs. E. BROOME Mrs. J. D. JENNINGS Mrs. E. D. CARRINGTON Mr. V. J. ROSS Mrs. B. CASEY Mrs. A. C. SILCOCK Mrs. C. COOK Mrs. M. E. SIMMONS Mrs. S. A. WOTHERSPOON Day Nurseries—Matrons:— "St. Moritz"—Mrs. D. GIBSON. Collier Row—Mrs. D. STINSON Rush Green—Mrs. R. M. O'HALLORAN Domestic Help Organiser:— Miss T. HARROD Dental Surgery Assistants:— Mrs. K. GOULDING Miss M. HUGHES Mrs. J. D. SKINGSLEY Mrs. C. THOMAS Speech Therapists:— Miss A. JONES Mrs. K. HILTON (Part-time) Chiropodists:— L. BOLLAND N. A. CUMMING (Sessional) E. DRANSFIELD G. H. EVANS (Part-time) Mr. A. PARKER D. D. WATERS Occupational Therapist:— Miss Z. MERCER (Part-time) Organiser, Workshop for the Elderly:— Mrs. L. LYON page 9 administrative and clerical staff Chief Administrative Assistant:— E. W. GOWERS Senior Administrative Assistant:— E. LAMB Administrative and Senior Assistants:— A. G. MELOY —Supplies and Maintenance Mrs. B. MATHER —Secretarial and Records G. PALMER —Smoke Control Mrs. M. BARNARD —School Health Miss R. HARVEY —School Health Miss P. MANN —Domestic Help Section Clerical Assistants:— Miss D. M. BARTLEY-BERRY Miss M. O. LITTLE (Clinic Clerk) Miss J. CARDY Miss D. NEAL (Clinic Clerk) Mis. B CAREY (Clinic Clerk) Miss J. NEWBERRY Miss E. COOPER Mrs. J. PETERSEN (Clinic Clerk) Mrs V. COOPER (Clinic Clerk) Miss J. SAGGERS (Part-time) Mrs. E. CHAPMAN (Clinic Clerk) Miss G G. SMITH (Clinic Clerk) Mrs. J. COMPTON Miss J. SMITH (Clinic Clerk) Mrs. L. CRUSE (Part-time) Miss V. C. WARREN Miss P. GOODREM Mrs. A. J. WHITE Public Analyst:— HUBERT HAMENCE, Ph.D., M.Sc., F.R.I.C. REGIONAL HOSPITAL BOARD STAFF Orthopaedic Surgeons:— G. BARCLAY, F.R.C.S. j. a. Mclaughlin, f.r.cs. Child Psychiatrist:— J. E. VINCENZI, M.R.C.S., L.R.C.P., D.P.M. Chest Physicians:— S. STEEL, M.D., M.R.C.P. E. WOOLF, M.R.C.S., L.R.C.P. (Harold Hill Area) Ophthalmologists:— P. DAS GUPTA, M.B., B.S. P. LANCER, M B., B.S., M.R.C.S., L.R.C.P., D.C.H. Physiotherapists:— Mrs. M. LAMBERT Mrs. A. SLIP page 10 MATTERS OF LIFE AND DEATH Population of Romford The Registrar General's estimate of the mid-year population for 1964 is 115,610, a decrease of 350 compared with the figure of 1963 of 115,960. As the natural increase of births less deaths would be 920, it follows that 1,270 more persons removed from the district than came to live here. In 1937 the population of the new Borough of Romford was 51,830, while in 1901 the population of the Romford Urban District was 13,656. Births 1,775 live births and 31 still births were notified in 1964. These figures, however, vary from figures relating to registered births supplied by the Registrar General due for the most part to the fact that notifications relate to births occurring in the year, whereas the official figures refer to those registered during the year. Another factor is that the place of residence at the time of booking for hospital is generally given on the notification of a birth from a hospital, whereas the place of residence at the time of the birth is that which is taken into account for registered births. The numbers above, whilst only approximate, give the following rates:— Rate per 1,000 of Estimated population 15.4 Still Birth Rates per 1,000 live and still births 17.2 In 1937 there were 847 Births and 36 Still births, giving a birth rate of 16.3 and a still birth rate of 40.8, whilst for 395 births in 1901 the birth rate was 28.9. Loss of Infant Life During the year 12 children died during the first year of life and there were 31 Still births. page 11 Statistically these are divided as follows:— 1. Perinatal Mortality. (Still births and deaths during the first week of life.) The following table sets out details for the pas five years and comparison with the rate for England and Wales. Year Stillbirths Deaths in first week of life Perinatal Death Rate At Home In Hospital Born at Home Born in Hospital Romford England & Wales 1964 6 25 2 15 27.1 * 1963 7 38 2 21 34.0 29.3 1962 6 24 4 20 27.9 30.8 1961 6 34 3 21 31.9 32.2 1960 6 24 6 32 27.2 32.9 * Not yet available. 2. Infants Deaths. (Deaths of Infants under one year of age.) The infant death rate per 1,000 live births in 1964 was 16.9. This is lower than the figure of 17.0 for 1963. The comparative figures for 1937 and 1901, 51.9 and 139.2, illustrate the tremendous improvements achieved in increasing the expectancy of life of a new born child since the turn of the century. INFANT MORTALITY—1964 Cause of Death 0-1 Month 1-3 Months 3-6 Months 6-12 Months Total under 1 year Asphyxia Neonatorum 1 — - - 1 Atelectasis 2 - — — 2 Coarctation of Aorta — 1 — — 1 Congenital Cystic Kidney 1 - — — 1 Congenital Heart Disease 3 - — 1 4 Exomphalus 1 - — — 1 Hirschsprungs Disease — - 1 — 1 Hypoparathyroidism 1 - — — 1 Intussusception — - 1 — 1 Neuroblastoma of Adrenal Gland - - — 1 1 Prematurity 9 - — — 9 Renal Anomaly 1 - — — 1 Rhesus Incompatibility 1 - — — 1 Tracheo-Bronchitis — 2 2 — 4 Volvulus of Gut 1 — — — 1 Totals 21 3 4 2 30 page 12 3. Neo Natal Deaths. (Deaths occurring in the first month of life.) NEO-NATAL MORTALITY—1964 Cause of Death Under 1 wk. 1-2 weeks 2-3 weeks 3-4 weeks Total Asphyxia Neonatorum 1 - - - 1 Atelectasis 2 — — - 2 Congenital Cystic Kidney — 1 — — 1 Congenital Heart Disease 1 2 — — 3 Eamphalos 1 — — — 1 Hypoparathyroidism — 1 — — 1 Prematurity 9 — — — 9 Renal Anomaly — — 1 — 1 Rhesus Incompatibility 1 — — — 1 Volvulus of Gut 1 - — — 1 Totals 16 4 1 — 21 page 13 DEATHS 1964 Sex Total all ages Under 4 weeks 4 weeks & under 1 year 1— 5— 15— 25— 35— 45— 55— 65— 75 & over Syphilitic Disease M 1 - - - - - - - - - 1 - F 2 - - - - - - - 1 1 - - Malignant Neoplasm, Stomach M 13 - - - - - - 1 1 3 5 3 F 8 - - - - - - 1 2 1 1 3 Malignant Neoplasm, Lung, Bronchus M 50 - - - - - - 1 2 27 13 7 F 12 - - - - - - - 3 3 6 - Malignant Neoplasm, Breast M — - — — — — — — — - — - F 24 - — — — — 1 2 4 3 10 4 Malignant Neoplasm, Uterus F 5 - - - - - - - 3 — 1 1 Other Malignant and Lymphatic Neoplasms M 44 - 1 1 1 — 1 2 5 9 11 13 F 51 - — 1 2 1 — 2 4 6 22 13 Leukaemia, Aleukaemia M 1 - - - - - - - - 1 - - F 1 - — — — — — — — - 1 - Diabetes M 1 - — — — — — — — — 1 - F 4 - - - 1 — - - - 1 1 1 Vascular Lesions of Nervous System M 44 - - - - - - - 4 8 14 18 F 48 - - - - - — 1 3 7 12 25 Coronary Disease, Angina M 103 - — — — — 1 2 21 24 31 24 F 65 - - - - - - — 3 12 25 25 Hypertension with Heart Disease M 3 - - - - - - - 1 - - 2 F 17 - - - - - - - - - 4 13 Other Heart Disease M 41 - - - - - 1 2 6 7 6 19 F 53 - - - - - 1 1 2 3 9 37 Other Circulatory Disease M 11 - - - - - - 2 1 1 2 5 F 22 - - - - - - 1 5 1 4 11 page 14  Sex Total all ages Under 4 weeks 4 weeks & under 1 year 1— 5— 15— 25— 35— 45— 55— 65— 75 & over Influenza M 1 - - - - - - - 1 - - - F - - - - - - - - - - - - Pneumonia M 20 — - - - - - - - 3 6 11 F 18 - - - - - - 1 2 4 2 9 Bronchitis M 43 — 2 - - - - - 2 8 19 12 F 12 — 2 - - - - - - - 4 6 Other Diseases of Respiratory System M 4 — - - - - - 1 - - 2 1 F 2 — - - - - - - - - 1 1 Ulcer of Stomach and Duodenum M 4 - - - - - - - - 2 2 — F 1 - - - - - - - 1 - - - Gastritis, Enteritis and Diarrhoea M 1 — - - - - - - - - - 1 F 2 — - - - - - - - - - 2 Nephritis and Nephrosis M 1 — - - - - - 1 - - - - F 4 - - — — — 1 — - 1 2 - Congenital Malformations M 4 2 2 - - - - - - - - - F 7 3 1 1 1 - - - - - 1 — Other Defined and Ill-Defined Diseases M 26 10 — — — 1 — 2 3 2 3 5 F 38 6 1 — — 1 — 3 5 2 6 15 Motor Vehicle Accidents M 16 — — — — 6 2 2 1 3 1 1 F 6 - — — — 3 — — — — 1 2 All Other Accidents M 6 — — 2 — — — 1 2 1 — — F 8 - — — 1 — — — 1 — 1 5 Suicide M 3 — — — — — 1 — 1 — 1 — F 4 — — - - — - 1 - 2 - 1 TOTAL ALL CAUSES M 441 12 5 3 1 7 6 16 52 99 118 122 F 415 9 4 2 5 5 3 13 39 47 114 174 page 15 The Crude Death rate per 1,000 Estimated Population is 7.4. The equivalent rates in 1901 and 1937 were 16.9 and 9.8 respectively. 62 deaths of residents of Romford were due to Lung Cancer. 50 of these were male and 12 were female. The deaths of 61 persons were ascribed to Bronchitis and other allied respiratory diseases. Accidents accounted for 36 deaths during the year, 22 males and 14 females. This total includes the deaths of 16 male and 6 females resulting from motor vehicle accidents. 3 males and 4 females committed suicide compared with a total of 12 in 1964. INFECTIOUS DISEASES The following notifications were received during the ye Figures for 1937 and 1901 are appended for comparison. 1964 1937 1901 Pneumonia 3 95 — Tuberculosis: Respiratory 36 63 Not Non-Respiratory 4 9 notifiable Scarlet Fever 51 233 9 Dysentery 12 1 — Puerperal Pyrexia — 10 2 Measles 767 Not Not Whooping Cough 79 notifiable notifiable Food Poisoning 447 Erysipelas 4 12 10 Cerebrospinal Fever — 1 — Poliomyelitis— Non-Paralytic — 5 — Encephalitis Lethargica — 1 - Diphtheria — 87 30 Ophthalmia Neonatorum 2 2 — Typhoid and Paratyphoid 3 10 12 Small Pox - - 8 page 16 Measles. An average of four or five notifications of Measles per week were received throughout the first three quarters of the year. In the December quarter however the number of cases notified rose considerably, this being the commencement of an epidemic. These epidemics occur usually at intervals of 18 months to two years. It is hoped that the measles vaccine now under trial will prevent these epidemics in future years. Tuberculosis. Notification of Tuberculosis in 1964 totalled 40. This year, however, is the first in which no deaths from this disease have been recorded in the district. Some patients on the register died during the year, but tuberculosis has not been given as the underlying cause. B.C.G. Vaccination of Mantoux negative contacts, and of secondary school children and students at colleges has been continued. Dr. S. Steel, Chest Physician at the Romford Chest Clinic, has kindly supplied the following information on the work of the Chest Clinic:— During the year 1964 the Romford Chest Clinic has continued to serve the needs of the combined areas of Romford Borough and Hornchurch Urban District. As forecast in the report on the services of the Romford Chest Clinic for 1964, there has been a steady decline in the number of notified cases of tuberculosis on the Clinic register from approximately 1,500 to the present figure of approximately 1,000. This has been due to the fact that many patients have now reached the stage where they can be regarded as having recovered from their tuberculous disease. In consequence, there has also been a reduction in the number of contacts of cases of tuberculosis who have been followed up on the Clinic's miniature x-ray unit. In contrast there has been an increase in the number of patients referred to the Clinic by their General Practitioners with non-tuberculous chest conditions, so that the work of the Clinic has, in fact, increased. This has also been added to by the number of patients referred by the Mass Radiography Service which has been operating in the area. As a consequence, there has been a widening of the scope of the services of the Romford Chest Clinic to include the more general aspects of chest medicine and associated cardiac conditions, and an electrocardiograph and apparatus for respiratory function tests have been installed in the Clinic. page 17 Food Poisoning A total of 447 notifications of suspected cases of food poisoning were received. None, however, were confirmed bacteriologically. MATERNITY SERVICES Reference was made in my report for last year concerning the difficulties in finding local maternity beds for some expectant mothers. The following are the places of confinement of Romford Mothers during 1964. At home 693—38.4% Oldchurch Hospital 852—47.2% Hospitals in other areas 259—14.4% The maternity services as detailed in my annual report for 1963 have been maintained, and we had our full establishment of midwives throughout the year. Five Midwives are now allocated to Group Medical Practitioners, the remaining ten being allocated to districts. It is interesting to note that the Romford Urban District Council commenced a Midwifery Service in 1933 employing one Midwife. With the coming into operation of the Midwives Act 1936, the number of midwives employed was increased to four on the 1st September, 1937. Analgesia. 77.2 per cent. of the women who were confined at home received inhalation analgesia during labour and 52.2 per cent. received injections of pethidine. Some, of course, received both analgesia and injections. Turning back the pages of our history, the routine use of inhalation analgesia commenced in Romford in 1949 followed by Pethidine in 1951. Clinic Premises. Work on the extensions to Marks Road Clinic was completed in May 1964, enabling the Service at the temporary annexe in Mawney Lane to be transferred to the main building. These extensions, coupled with the provision of oilfired central heating, modern lighting and other improvements, have brought this clinic up-to-date. The building itself was the first purpose built clinic in the Town, having been completed in 1935. page 18 The clinic services commenced in Romford in 1917 with one Child Welfare Session per week held at the Public Baths. This remained the only centre until 1932, when additional sessions were commenced at Church Halls at Collier Row, and Princes Road. At the present time, apart from other clinic services, 13 Child Welfare Sessions are held weekly and one monthly at nine clinics. Attendances at the Child Welfare Clinics in 1964 were as follows:— Number of children born in 1964 who attended 1,518 Total number of children who attended 3,899 Total attendances 24,183 The 1,518 children born in 1964 who attended the clinics during the year represent approximately 88 per cent. of the total number of children born, after allowing for the fact that mothers of babies born in the last two weeks of the year could scarcely have had an opportunity of taking their babies to a clinic before the end of the year. Distribution of Welfare Foods. Distribution of Welfare Foods was continued from all Child Welfare Clinics and from the 7 shops undertaking distribution on a voluntary basis. The following are details of the number of items distributed during the year with those of 1963 for comparison. 1964 1963 National Dried Milk 28,316 32,747 Cod Liver Oil 2,719 3,000 Vitamin Tablets (A and D) 2,800 3,296 Orange Juice 36,358 35,396 Day Nurseries. The three Day Nurseries in the Borough were opened during the war years to enable mothers of young children to help the war effort by going to work. The Western Road Nursery was opened in 1942, followed by Collier Row and Rush Green Nurseries in 1943. The latter two are of war-time construction and are now nearing the end of their useful life. A replacement for the Collier Row Nursery is now being built and should be completed in mid-1965. A new Day Nursery at Rush Green to replace the existing one is included in the ten year development plan for 1965-66. page 19 In peace time, the role of the Day Nursery has changed, its prime object being to provide accommodation for children requiring admission either on medical or social grounds. Attendances at the two 40-place and one 50-place Nurseries during the year were as follows:— No. on Register Av. Daily Attendance January 139 96.2 February 138 103.9 March 137 103.9 April 145 94.8 May 145 101.4 June 143 100.6 July 137 92.8 August 138 72.0 September 147 114.0 October 144 88.1 November 143 55.2 December 153 94.7 An outbreak of E Coli Type 0111 infection occurred among the children and staff during October at Western Road and Hulse Avenue Day Nurseries. Admissions and re-admissions were restricted, and complete disinfection of both premises was carried out. These measures were effective in clearing up the infection. Nurseries and Child Minders Regulations Act. Registration under this Act at the end of the year was as follows:— Registered Children Permitted Premises 5 199 Persons 3 11 page 20 Staff Medical Examinations. 533 Medical examinations were carried out by Local Authority Medical Staff in 1964. Health Visiting. In his Annual Report for 1915, Dr. Alfred Wright, The Medical Officer of Health reported:— "The Romford Urban and Rural Councils have conjointly appointed a Lady Health Visitor for the two districts combined. This official will commence her duties on January 1st. I am sanguine that her work will be highly beneficial." Some two years later the Maternity & Child Welfare Act 1918 made it obligatory for local authorities to provide a Health Visiting Service and a full-time Health Visitor was appointed by the Romford Urban District Council in 1919. Thirteen years later, in 1932, the establishment was increased to two. In 1964 the Staff of Health Visitors in Romford numbered 21 and their visits totalled over 21,500 as follows:— Visits to Children under 5 years of age 15,912 Tuberculosis households 3,567 The aged 1,094 School children 367 Other cases 586 In addition to the above visits the Health Visitors attended Clinic Sessions, and the majority also carried out School Nursing duties. Vaccination and Immunisation Smallpox Vaccination. The following gives details of vaccinations recorded. 1964 1963 Number of Primary Vaccinations at Clinics 442 92 Number of Primary Vaccinations by General Practitioners 670 417 1,112 509 Number of Re-Vaccinations at Clinics 77 11 Number of Re-Vaccinations by General Practitioners 571 504 648 515 Total Vaccinations and Re-Vaccinations 1,760 1,024 page 21 Diphtheria Tetanus and Whooping Cough. The number of children immunised against Diphtheria, Whooping Cough and Tetanus during the year was as follows:— Family Doctor Clinics Total Diphtheria 15 29 44 Diphtheria and Tetanus 143 45 188 Diphtheria, Whooping Cough and Tetanus 737 614 1,351 Whooping Cough 173 — 173 Tetanus 221 57 278 Poliomyelitis. The following sets out the number of children vaccinated during the year:— Primary Courses Family Doctors Clinics Salk Vaccine 96 - Sabin Vaccine 893 878 Total 989 878 Re-inforcing Doses Salk Vaccine 45 - Sabin Vaccine 847 506 Total 892 506 Prevention of Illness, Care and After Care Chiropody Service. This service commenced as recently as 1960. After a difficult start due to a shortage of chiropodists. the establishment has been full for some time and the four fulltime and two part-time chiropodists carried out the following treatments during 1964:— 1964 1963 At Clinics Domiciliary At Clinics Domiciliary 9,402 1,541 6,233 462 In addition 233 treatments were given to residents at Old People's Homes administered by the Welfare Department. page 22 Sick Room Equipment. The number of articles on loan at the end of the year was 1,023 compared with 905 at the end of 1963. During 1964, 828 articles were loaned for the first time. Disposable Hospital underpads for incontinent persons being nursed at home were issued free of charge during the year. Recuperative Holidays. 46 persons recommended by their medical practitioners were sent to Convalescent Homes for recuperative holidays. Domestic Help Service. 915 patients were provided with a Domestic Help during the year. The Domestic Helps worked for 126,526 hours at the homes of these patients. Details of the classes of patients assisted are as follows:- No. of Cases Hours provided Aged 634 98,698 Maternity 120 4,926 Chronic Sick 104 19,198 Others 57 3,704 Night Attendance Service Nine patients were provided with a night attendant during the year, as follows:— Patients Hours Involved 1. Patients residing alone 2 60 2. Patients seriously ill in their own homes where an aged husband or wife could not provide the necessary assistance 2 50 3. The relief of relatives who had to give routine night attendance to sick people 5 500 page 23 Home Nursing 27,869 visits were paid to the homes of 1,027 sick persons during the year by the 13 full-time Home Nurses employed in the area. 132 of these visits were to patients under 5 years of age, 9,583 to patients over 5 and under 65, and 18,154 to patients over 65 years. The Home Nursing Service became part of the local health authority service in 1948, having previously been undertaken by voluntary District Nursing Associations. At that time seven nurses were employed on these duties. Early in 1964, authority was given for the appointment of a male home nurse—the first in Romford. Such was the demand on his services, however, that when a vacancy occurred the opportunity was taken of appointing a second male nurse. Their services have been well received and they have relieved the female nurses of nursing many of the heavy patients. Children at Risk Mention was made in my Annual Report for 1963 of the "At Risk" Register commenced during that year to enable any adverse factors connected with the newly-born infant, whether related to the medical history of the mother, the pregnancy, or the birth to be recorded, and for the child to be followed-up with a view to the detection of any defects at an early age. so that treatment can be started as soon as possible. Of the 1,775 live births notified during 1964, the following numbers have been added to the Register:— Born at Home 31 Born in Oldchurch Hospital 409 Born in other Hospitals 62 It is expected that the majority of "At Risk" babies will be found amongst those born in hospital, as the majority of mothers confined in hospital are admitted for medical or obstetric reasons. page 24 THE SCHOOL HEALTH SERVICE The development of the school health service began towards the end of the nineteenth century and the earliest mention of the services provided in Romford is found in the Medical Officer of Health's report for 1911, when it was stated that "a Special Medical Inspector, appointed by the County Council, visits schools at times stated and in cases of impaired health of children (eyes, adenoids etc.) the parents are instructed to seek medical advice." In his report for the following year the Medical Officer of Health also states "a nurse has now been appointed to look after children suffering from whooping cough, ringworm, vermin, etc." Following the coming into force of the Education Act 1944 the Borough of Romford became an "Excepted District" for the purpose of the Act and on 1st October, 1946, the Medical Officer of Health for Romford was appointed Acting Borough School Medical Officer, and took over the administration of the School Health Services which had previously been the responsibility of the Essex County Council. At that time there were 15 County, Voluntary or Assisted Schools in the Borough comprising 23 departments and the school population was approximately 8,500. In the 18 years which have followed the population of the Borough has increased enormously and in 1964 there were over 20,000 schoolchildren attending 56 schools in Romford. The School Health Service has expanded to meet the demands of the increased school population and the services provided have widened in scope to keep abreast of the changing medical and social needs of the school child. Not least important has been the work carried out in connection with the assessment of pupils handicapped by mental or physical disability and the educational facilities provided for them. In addition to Havering Grange School which provides special education for 100 educationally sub-normal children, two Nursery classes for maladjusted children are successfully operating and a special unit for disturbed children has recently been inaugurated. SCHOOL HEALTH SERVICE 1964 School Population 20,235 Primary Schools 40 Secondary and Grammar Schools 15 Special School for Handicapped Pupils 1 page 25 MINOR AILMENT CLINICS Number of Cases treated during the year Eye Diseases 2 Ear, Nose and Throat Defects 15 Skin Defects 72 Miscellaneous Minor Ailments 54 Total 143 MEDICAL CONSULTATIONS:- Special Inspections 510 Re-examinations 279 Examination of Children for Employment In entertainment — Other employment 89 Total attendances at Minor Ailment Clinics 2527 Speech Therapy 148 new cases were referred for Speech Therapy during the year and 3,787 attendances were made for treatment. 156 children were under treatment at the end of the year. Dental Services The Dental Clinic at Parklands Junior School was refitted with modern equipment early in 1964 and the services of a full time Dental Officer were obtained for this clinic in February. Unfortunately the Dental Officer resigned in August and it was not possible to make use of the clinic for the remainder of the year. During the year 9,018 children were inspected by the Dental Officers at school and treatment was offered to each child who was found to be dentally unfit. 7,325 attendances were made for dental treatment. Specialist Services Orthopaedic and Ophthalmic Clinic Sessions continued at Marks Road Clinic and the Harold Hill Health Centre throughout the year in co-operation with the Regional Hospital Board. The Physiotherapy Clinic at Harold Hill was closed in August owing to the resignation of the Physiotherapist but re-commenced in October, when a new appointment was made. page 26 Cases dealt with at the Specialist Clinics were as follows:— Ophthalmic Clinics Conditions treated:— External and other eye diseases 5 Errors of refraction (including squint) 1,418 Number of children for whom spectacles were prescribed: 542 Orthopaedic Clinics Number receiving treatment 923 Total attendances at Orthopaedic Specialists Clinics 380 Total attendances at Physiotherapy sessions 3,434 Vaccination against Tuberculosis B.C.G. Vaccination was again offered to all 13 year old school children and the statistics relating to this service are as follows:— Number tuberculin tested after parents' consent received 1,230 Positive results 73 Negative results 1,048 Number who reecived B.C.G. Vaccination 1,048 Routine Audiometric Testing of Schoolchildren Additional portable audiometers have been purchased to facilitate the carrying out of routine hearing tests in schools and more members of the medical and nursing staff have had special training in the techniques involved. Most children now have a routine hearing test shortly after admission to school and further tests are carried out at the times of their periodical routine medical inspections. The results of these tests are most valuable in the early recognition of hearing defects and treatment at a specialist audiology unit, including the provision of a hearing aid where necessary, can often enable a child who might otherwise be classified as "dull" to obtain full benefit from the educational services provided. During the year 2,426 routine audiometric tests of schoolchildren were carried out and 33 children were referred for specialist examination and treatment. page 27 Handicapped Pupils During the year 41 children were newly ascertained as handicapped pupils and 41 children were admitted to schools providing education suitable to their individual handicaps. By the end of the year Havering Grange School was able to accept almost its full quota of 100 pupils but there were still 18 on the waiting list. The school was visited regularly by a School Medical Officer and Health Visitor and the Speech Therapist paid weekly visits. The following is a summary of the ascertained and placement of handicapped pupils during the year:— No. of pupils ascertained during the year No. of pupils admitted to Special Schools during the year Total No. of pupils in Special Schools at the end of year Day Residential Day Residential Deaf 1 1 - 4 — Partially hearing. 2 — — 7 2 Blind — — — — 1 Partially sighted. — 1 — 3 — Epileptic 1 — — — 2 Delicate 8 — 5 3 9 Physically handicapped 1 1 - 13 7 Educationally Sub-normal 25 28 1 97 10 Maladjusted 3 1 3 — 12 Speech — — — — — Dual Defects* — — — 4 4 Totals 41 32 9 131 47 *Dual defects (children ascertained in respect of more than one defect):— (a) Attending Day Special Schools 1 Partially Hearing/Partially Sighted 1 Partially Hearing/E.S.N. 2 Physically Handicapped/E.S.N. (b) Attending Residential Special Schools 1 Maladjusted/E.S.N. 1 Deaf/E.S.N. 1 Deaf/Physically Handicapped 1 E.S.N./Physically Handicapped page 28 Convalescence Short stay convalescent holidays were arranged for 43 pupils during the year. Nursery Classes for Maladjusted Children The nursery classes at Parklands and Mead Infants Schools have continued with considerable success and there were 17 children attending the classes at the end of the year. Special Unit for Disturbed Children In November 1964 an experimental unit for disturbed children was established at Manor Primary School staffed by a teacher in charge and a full time welfare assistant who work in close cooperation with the staff of the Child Guidance Clinic. Dr. J. Vicenzi, Medical Director of the Romford Child Guidance Clinic, states:— "This Unit, housed in an ordinary school, is able to cater for children diagnosed as autistic and who have reached a certain point of development with regard to toilet training and ability to eat in association with other children. The diagnosis of autism is a very difficult one since there is still a great deal of discussion about which symptoms are significant and also about the future outlook for these children. It is therefore important that each case is considered in great detail before admission and children should be studied carefully while they are in the Unit in the hope that the clinic staff may eventually he able to produce observations which will be helpful in this field." A list of local children diagnosed by various consultants and doctors was compiled to select suitable candidates for admission, although several of these were found unsuitable for this type of unit and some lived so far away that it seemed best to await further developments before admitting them. In view of the experimental nature of the project it was felt advisable to restrict the number of children to two initially, but in fact only one child, a boy of 10 years, was admitted in November. This boy has already derived considerable benefit from attendance at the unit and another boy of a similar type is to be admitted in January 1965. page 29 Child Guidance Clinic The work of the Child Guidance Clinic continued throughout the year and 148 Romford children were referred to the clinic for treatment in addition to 192 children from neighbouring districts. A total of 2,571 psychiatric interviews were carried out and 3,743 interviews with other members of the clinic staff. At the end of the year 303 cases were under treatment at the clinic and 39 cases were awaiting their first appointment. page 30 School Health Service Statistics for the Year 1964 Total (All Schools) 1. Medical Inspection of Pupils (a) Periodic No. of Pupils examined at school (i) Entrants 1923 (ii) Second age group 1852 (iii) Third age group 1990 (iv) Other periodic examinations 79 Total 5844 Number of defects found requiring treatment 1324 Number of defects found requiring observation 2109 Number of individual pupils found to require treatment 1190 Nutritional classification of pupils examined Satisfactory 5841 Unsatisfactory 3 (b) SPECIAL Number of pupils specially examined 511 Number of defects found requiring tretment 320 Number of defects found requiring observation 80 (c) Re-inspections Number of pupils re-inspected 664 2. Treatment (a) Total attendances at Specialist Clinics:- (i) Ophthalmic 1821 (ii) Orthopaedic 380 (b) Total attendances at treatment clinics:- (i) Minor Ailment 2527 (ii) Physiotherapy 3434 (iii) Speech Therapy 3787 3. Hygiene Inspections (i) Number of examinations of pupils in schools 12817 (ii) Number of pupils found unclean 70 4. Dental Treatment (i) Number of pupils inspected 9018 (ii) Number found to require treatment 4819 (iii) Attendances for treatment 7325 (iv) Number of fillings: Permanent teeth 3462 Permanent teeth 2803 (v) Number of teeth filled: Permanent teeth 2798 Temporary teeth 2551 (vi) Number of teeth extracted: Permanent teeth 322 Temporary teeth 1218 (vii) Number of general anaethetics administered 586 (viii) Other operations 3674 page 31 SANITARY CIRCUMSTANCES OF THE AREA The Public Health Inspector, or Inspector of Nuisances as he was then called, was the first full-time health officer of the Council. Before the end of the nineteenth century he had been redesignated Sanitary Inspector, and it was not until 1956, that the present name of Public Health Inspector was adopted. This latter designation was long overdue, as the Public Health Inspector's duties had widened considerably over the years, to cover many aspects of the physical environmental health service. Mr. H. C. Boswell, Chief Public Health Inspector, reports as follows:— THE PHYSICAL ENVIRONMENT The following report is essentially a review of the work performed by the Public Health Inspectorate during the past year in their endeavours to secure satisfactory hygienic conditions for the well being of the inhabitants of the Borough, and also gives one an opportunity of assessing a programme for further improvements in the environment. As stated in previous reports, the work of the Public Health Inspectors is varied and covers a very wide field in their endeavours to secure good conditions of living, working and recreation. Although some of the services mentioned in the following report are not the direct responsibility of the Public Health Inspector, he must keep himself acquainted with all the kindred branches of environmental health and sanitation. It is, therefore, pleasing to state that there is a happy relationship and co-operation with all sections of the Health Services, including the Public Analysts and the Pathological Laboratories. Much of the work carried out is collated under the heading "Nature and Number of Inspections." This unfortunately relies on the number of inspections made for specific purposes, and does not present a true picture of the amount of work involved. For example, one visit may only occupy a few minutes of an Inspector's time, but there are others which require his attention for many hours. page 32 1. (i) Water Supply Mr. P. Gordon Spencer, The Chief Engineer of the South Essex Waterworks Company, has kindly provided the following information relating to the Public Water Supply within the District:— (a) Particulars of any new extension of Public Water Supply during the Year 1964 "Construction is proceeding for a 20 million gallon service reservoir at Heaton Grange in connection with the supply of the whole of the area, including that of the Borough of Romford, also completion of a one million gallon service reservoir at Bedford's Park, almost entirely for the benefit of the supply in the Borough of Romford." (b) Length of mains laid in yards: 3" 4" 6" 9" 12" 15" 140 902 1,002 443 6 152 (Bedford's Park) Total 2,645 yards (c) The water supply of the area and of its several parts has been satisfactory both as to quality and quantity. (d) Bacteriological and chemical examinations are made of the raw water, of the water in its various stages of treatment, of the water supplied from the Company's wells and of the water going into supply. Analyses are also made of samples obtained from consumers' taps in the various parts of the Companys district and all proved to be satisfactory. A total of over 4,055 chemical, bacteriological and biological examinations have been made. In addition samples were examined for radioactivity. (e) Fluorine Content We do not make frequent fluorine determinations but, on the basis of past results, I put the fluorine content of the supplies to Romford at 0.2—0.25 P.P.M.: under occasional conditions, when Langham boreholes are in use, the figure will rise somewhat and could then be up to approximately 0.3 P.P.M. page 33 (f) The waters are not liable to plumbo-solvent action. (g) No contamination has risen, therefore no action has been necessary. (h) The following are the average dwelling houses supplied during 1964—34,981. In connection with the population, we can only give you the official figure up to 30th June, 1964, which is 115,610. (ii) Sanitary inspection of the Area (a) Complaints During the year 2,189 complaints were received and recorded. 7,661 visits were made to investigate these complaints, and, where necessary, notices were served to abate nuisances or remedy defects. (b) TABLE 10 NATURE AND NUMBER OF INSPECTIONS DURING THE YEAR Accumulations and Refuse Deposits 189 Bakehouses 23 Butchers' Shops and Stalls, etc. 164 Canteens (School and Factories) 61 Cesspools 16 Clean Air Act General 161 Clean Air Act Smoke Control Areas 2,097 Clean Air Act Smoke Observations 52 Clean Air Act Atmospheric Pollution 1,024 Common Lodging Houses 4 Dairies and Milkshops 10 Drains, relaid and altered 409 Drainage—obstructed or defective 667 Drains—tested and inspected 428 Disinfections and Disinfestations 8 Diseases of Animals Act 2 Dustbins 17 page 34 TABLE 10—Continued. Establishments for Massage and Special Treatment 20 Factories Act (Mechanical Power) 27 Factories Act (Non-mechanical) 10 Factories Act (Outworkers Premises) 8 Food Preparing Premises 301 Food Hawkers 26 Food Hygiene Observations 248 Food Inspections 821 Food Sampling—Formal 8 Food Sampling—Informal 135 Food Shops 351 Food Vehicles 13 Housing Acts—General 259 Housing—Rent Act, 1957 72 Heating Appliances (Fireguards) Act. 1952 25 Ice Cream Vendors 51 Ice Cream Samples 94 Infectious Diseases Including Food Poisoning 2,285 Insects and Pests 17 Keeping of Animals 90 Licensed Caravan Sites 91 Licensed Premises 22 Milk Sampling 167 Miscellaneous 659 Markets 45 Merchandise Marks Act 5 Noise Abatement Act 106 Nuisances, Public Health Act 1,407 Pet Animals Act, 1951 11 Prevention of Damage by Pests Act, 1949 4,007 Public Baths 17 Public Conveniences 30 page 35 TABLE 10—Continued. Rag Flock Act 2 Schools 10 Shops Act—All Sections 1,648 Slaughterhouse and Meat Inspection 1,579 Streams, Ponds and Watercourses 106 Tents, Vans and Sheds 244 Verminous Premises 73 Water Closets 18 Water Supplies and Samples 59 (c) Informal Notices (Number served) 194 Statutory Notices (Number served) 74 (d) As a result of the service of Notices, the necessary works were completed by the owners or occupliers in all cases except 31, the works for which were still in hand at the end of the year. (e) Notices served under the Shops Act 7 (f) Notices served under the Food Hygiene Regulations 25 (iii) Factories Acts, 1937 and 1948 A summary of the statistics, as required by the Ministry of Labour and National Service, is given below:— TABLE II 1. INSPECTIONS Premises No. on Register Inspections Written Notices Occupiers Prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 29 1 - - (ii) Factories not included in (i) in which Sec. 7 is enforced by the Local Authority 359 27 - - (iii) Other Premises in which Sec. 7 is enforced by the Local Authority (excluding outworkers premises) 40 9 - - Total 428 37 — — page 36 2 CASES IN WHICH DEFECTS WERE FOUND PARTICULARS NO. OF CASES IN WHICH DEFECTS WERE FOUND Found Remedied Referred to H.M. Inspector Referred by H.M. Inspector Want of Cleanliness - - - - Overcrowding - — — — Unreasonable Temperature - — — — Inadequate Ventilation - — — — Ineffect. drain. of floors - — — — Sanitary Conveniences (a) Insufficient - - - - (b) Unsuitable or defective - — — — (c) Not separate for sexes - — — — Other offences - — — — Total — — — — 3 OUTWORK Nature of Work No. of Outworkers No. of Cases of Default No. of Prosecutions Wearing Apparel — making etc. 14 - - Box Making 4 - — Total 18 - - During the year 8 inspections were made of Outworkers' premises. (iv) Housing The number of Council Houses in Romford is as follows:— Owned by Romford Council 4,628 Owned by London County Council 8,300 Included in those owned by the Romford Council are 71 Dwellings for Old People housing 74 persons, with a resident warden on call, and 64 Old People's bungalows, housing 71 persons with an itinerant warden (not on immediate call, but available for emergencies and living on the spot). The number of London County Council Houses also include 127 Old People's bungalows, housing 146 persons, with a warden also available for emergencies. page 37 (v) Caravans There are five residential Caravan Sites in Romford one being owned by the Council, and four privately owned. During the year one privately owned site was closed. The total number of caravans on the Sites mentioned above is 305. 66 are on the Site owned by the Council, and the privately owned Sites contain 135, 81, 14 and 9 caravans. The numbers on two of the privately owned Sites are being decreased, as the Site licences are for a limited period. (vi) Gipsies The present position is little changed, except perhaps that, because of extended building, the number of available open sites for the itinerant gipsy are being restricted. When, therefore, these people are moved, they travel to the next site and on again in ever lessening circles so that an area is now hardly free of gipsies. The general public in direct contact with one of these areas are becoming more vocal in their discontent at the inability of the Council to permanently free their area of this nuisance. The Public Health Inspectors have a thankless task being cursed by the gipsies for not letting them settle, for a few days, to enable them to earn a living, and also receiving continuous telephone calls from irate rate-payers for permitting the build-up of gipsy caravans in the area. It is very difficult to reconcile the needs of both parties. There are times when the gipsies are unwell, or the mother arrives in the area for a confinement, or a member of the family needs hospital treatment and it is to the Health Inspector that these people have to turn for sympathetic consideration of their problem. The time must soon be approaching when serious consideration should be given to the possibility of setting up a caravan site to enable these persons on the fringe of our present society to be settled and drawn into active membership of the Borough, if only for the benefit of the future generation. (vii) Prevention of Damage by Pests Act, 1949 It is the duty of every local authority, under the above Act, to take such steps as may be necessary to secure as far as practicable that their district is kept free from rats and mice. page 38 The Local Authority also have a specific liability to ensure, as far as practicable, that all land and buildings occupied by them are kept free from rats and mice. This includes Parks, Recreation Grounds, Schools and Public Buildings and all sewers vested in the Local Authority. It is not widely known, but it is the duty of the occupier or owner of any premises to notify the Local Authority of the presence of rats or mice on land that they occupy, and it is, in fact, the responsibility of the occupier to take steps to rid their premises of these pests. This Council have, however, provided a service for this purpose over a number of years, and one Rodent Officer is employed in the Health Department. This Officer is provided with a van and the necessary equipment to trace and deal with all forms of infestation. This service is provided free to all ratepayers in the District. During the past year, 478 notifications were received of infestations and the Public Health Inspectors and Rodent Officer carried out 4,007 inspections and reinspections of premises and all necessary measures were taken to eradicate the rats and mice. Regular routine inspections are made of all Parks, Recreation Grounds and Schools and disinfestation is carried out when necessary. Considerable thought has to be given to the right type of poison to be used, and after much experience it is considered that the most satisfactory and economical poison to use is that commonly known as "Warfarin." This poison has the approval of the Ministry of Agriculture, Fisheries and Food and has the following advantages:— It is reasonably safe as far as humans and domestic animals are concerned, and it is not necessary to use pre-baits. Therefore, the first baits contain poison and much time is saved. There are two specific ways that members of the public encourage rats and mice, to which specific attention should be drawn. The first of these is the frequent practice of the public in throwing large quantities of bread out to feed birds. Instances have been found where large slices of bread have been thrown page 39 onto lawns. These are far too large for birds to consume or carry away and supply plenty of food for rats and mice. If people desire to feed birds, the bread should be broken up fine, and placed on a bird table. The second point is the placing of sheds and chicken houses too close to the ground. All buildings of this type should be kept at least nine inches above the ground so as to enable a dog or cat to get under. Sheds very close to the ground afford comfortable nesting places for rats and mice. Treatment of Sewers The inspection and baiting of sewers is under the supervision of the Highways Superintendent. This work is usually carried out at regular intervals on a block basis, specified areas of the Borough being treated at one time. Where, however, it is proved that certain house drains are infested, treatment of the sewers in that area are carried out on request from this Department. During last year, 327 manholes were inspected and treated. (viii) Disinfestation of Insects and Pests Numerous complaints were dealt with during the year concerning insects and pests that invade homes, shops and stores. Insects can have a variety of effects on the human race or its environment. They can destroy or harm food, ruin furniture, materials and works of art, cause damage to timbers, endanger health or just cause annoyance. The present modes of travel, whereby any destination can be reached in a relatively short time is a great asset to the public, but at the same time it has brought its problems, as during recent years new species of insects have been introduced to this country from abroad, either in cargoes or luggage. The variety of species of insect pests is always increasing, and identification becomes more difficult. However, we are fortunate in being able to send species either to the Natural History Museum or to one of the firms that manufacture " pesticides," for page 40 identification. From these sources, in addition to the identification, we can learn the life history, country of origin, whether the insect is harmful or not and the best control measures to use. It is evident that the public are becoming more insect conscious, by the number of requests that are made for assistance to eradicate various insects. Apart from the housefly which is the most common of household pests, those that we are mainly called upon to deal with are:—timber beetle, furniture beetles, carpet moths, store beetles, gooseberry mite and, most frequently, wasps and ants. One of the outstanding effects of the better standard of housing and hygiene enjoyed by most people today is the notable decrease in the infestations of bed-bugs and house fleas. Prior to the war, these were common to the majority of working class houses, and created full time work for disinfestation teams, but today they are relatively rare. Assistance and advice is given in all cases of infestation. Some treatments are carried out by the Rodent Operative, but in severe cases the persons concerned are advised to obtain the services of specialist firms. Where necessary, the destruction of clothing and bedding is undertaken by the Council upon the receipt of a written request from the owner. (ix) Pet Animals Act, 1951 Under this Act, a person who desires to sell pets, of any description, by retail, must be licensed by the Local Authority. These licences are renewable annually and conditions are attached to the licence, in order to regulate the manner in which the animals are kept and exposed for sale. At present there are 12 persons licensed in the borough to keep Pet Shops, 4 of these are in respect of stalls in the Market Place. Pets on these stalls are restricted to puppies, goldfish and tortoises. Inspections are made to ensure that the conditions of the licences are complied with. page 41 2. Inspection and Supervision of Food The inspection, sampling and supervision of foods in all its phases, from the producer to the consumer, forms a very important part of the duties of the health inspectorate in the protection of the health of the public. Various infectious diseases can be transmitted by foodstuffs. Food poisoning and other intestinal illnesses can be caused by the ingestion of foods that are either contaminated, are out of condition, or badly processed. It is, therefore, essential that all premises where foods are processed, manufactured, prepared and sold are kept under constant supervision in order to ensure that the food is handled and stored in a proper manner and also that the premises and personnel comply with the requirements of the Food Hygiene Regulations. The various Acts, Regulations and Orders that are in existence for controlling the processing, manufacture, composition, labelling, storage and sale of food are far too numerous to list in detail in this report, suffice it to say that they have been made by the Government with a view to protecting the public in one form or other. It is the inspectorate's duty to be conversant with all this legislation and ensure that it is complied with. (i) Registration of Milk Distributors All dairies and distributors of milk must be registered with the local authority under the Milk (General) Regulations, 1959. Premises must comply with the conditions laid down in the regulations, and the local authority have power to revoke or cancel a registration for certain non-compliance of the Regulations. At the end of the year 72 firms were on the Council's register as Retailers or Distributors. Licensing of Milk Dealers As Romford is a specified area, where only designated milk may be sold, all retailers must be licensed under the Milk (Special Designation) Regulations, 1963. The Licensing authority under these Regulations is the Food and Drugs Authority. Therefore, as Romford is a Food and Drugs Authority, the Council is responsible for the enforcement page 42 of these Regulations. Under these Regulations, the only designations that licensed dealers may use, in relation to milk sold by them, are:— "UNTREATED" — "PASTEURISED" — and "STERILISED" The form of licence, known as the Dealers (Pre-Packed) Licence permits the sale of the three types of designated milk. These are issued to the dealer who receives his milk in the bottle or container ready for sale to the consumer. The 72 dairies and distributors who are registered with this Council have all been granted Dealers (Pre-Packed) Licences. Sampling During the year 165 samples of milk were taken for bacteriological examination. Of these, 10 failed the Methylene Blue Test for keeping quality. Eleven samples were declared void when they reached the laboratory due to an excessive rise in the atmospheric shade temperature and were not included in the tests. Of the unsatisfactory samples, 8 were from automatic vending machines, the fault being traced to the cooling element, and two were from small distributors, stock rotation being the cause of the poor samples. The matters were taken up with the persons responsible and improvement effected. Anti-Biotics in Milk During the year, a distributor commenced selling "untreated" milk from an automatic vending machine. Six samples of this milk were submitted for examination for the presence of anti-biotics, one of which gave a positive reaction. This was traced to a cow that was suffering from a general infection and which the farmer was treating himself. He was not aware that the anti-biotics would pass into the milk. This information was passed on to the Divisional Milk Officer of the Ministry of Agriculture, Fisheries and Food, who are responsible for the production of milk and "dairy farms." Brucellosis Two samples of "untreated" milk were submitted for the examination of " brucella Abortus," and both gave negative results. page 43 Chemical Examination Fifteen samples of milk were submitted for chemical examinnation, one informal and one formal being found to contain added water to the extent of 5 per cent. and 1 per cent. respectively. A visit was made to the farm concerned, when it was found that the milk pipe-lines were not properly fixed and rinsing water was retained in the sagging parts of the pipes after cleansing operations. Further samples taken from the same producer were satisfactory. This matter was also referred to the Divisional Milk Officer, of the Ministry of Agriculture, Fisheries and Food. (ii) Ice Cream The Manufacture and sale of ice cream is governed by the Food and Drugs Act and various Orders and Regulations made thereunder. Provision is also made under the various Acts for the registration of manufacturers and vendors of ice cream. In this Borough registration is made under the Romford Urban District Council Act, 1931, as this Act provides for the registration of the person as well as the premises, whereas the Food and Drugs Act, 1955, only provides for the registration of premises. By using the Local Act, the Local Authority have control over the itinerant vendor which is not provided for under the National Act. The ice cream trade has passed through many phases, and during the last few years it had reached the stage where practically 90 per cent. of the ice cream is manufactured by large wholesale distributors. A recent development has been the sale of "soft" ice cream. This is an ice cream that has been made in the factory, put into hermetically sealed containers, and stored in a cold place. When required, this mix is fed into a freezer and served direct as a loose ice cream. The public seem to prefer this softer ice cream to the factory made pre-packed type that has undergone a hardening process. The sale of this new type of ice cream was at first confined to shops, but vans are now equipped with motor driven freezers page 44 for this type of trade. Vans adapted for this purpose therefore can no longer be classified as vending vehicles, but are in fact, a mobile manufacturing plant. Vans that have been specially built for this purpose, comply in all respects with the Food Hygiene Regulations, as all surfaces are covered with impervious material and in addition to cold storage cabinets and freezers, they are equipped with hand basins and means of providing hot water for washing. Providing the operator obtains his initial mix from a reputable firm and observes the highest standards of hygiene in regard to the equipment and methods of handling, this new form of vending should not create any hazards or problems, but great care must be observed in cleaning and sterilising the equipment. At the end of the year, 272 persons were registered with the Council as vendors of ice cream. Of these 39 were registered as itinerant vendors, the remainder being shop premises. Regular checks are made on all premises and vehicles. During the year 102 samples of ice cream were taken for bacteriological examination. These samples were classified as follows:— Ministry of Health (Provisional) Grade 1—49 „ „ „ „ „ 2—14 „ „ „ „ „ 3—23 „ „ „ „ „ 4—16 Three lollies were also submitted for bacteriological examination and two were found to be unsatisfactory. Six samples of ice cream and six ice lollies were also submitted to the Public Analyst for chemical examination and all proved to be genuine and complied with the Food (Standard) Regulations. (iii) Meat Inspection There are now three licensed slaughterhouses in the Borough. One of the slaughterhouses is licensed for the slaughter of horses as well as cattle. The two large slaughterhouses are operated by Wholesale Butchers who supply meat to retail butchers over a large area and also provide meat for the London markets. page 45 Ritual slaughter is performed at one slaughterhouse in accordance with the Mohammedan religion for the supply of mutton for shipping crews and to meet the demands of the increasing Mohammedan population in the East-End of London. The Meat Inspection Regulations, 1963, came into operation on the 1st October, 1963. These Regulations now make it compulsory for every Local Authority to ensure that 100% inspection of the carcases and organs of every animal slaughtered for sale for human consumption within their district is carried out by competent officers. The Regulations permit the Local Authorities to make a charge for this service, and this Council resolved to make the maximum charges allowed which are as follows:— Cattle and Horses 2/6d. Calves and Pigs 9d. Sheep 6d. When these charges were first introduced, it was not surprising that the local meat traders objected to making payment on principle, especially as they had had this service free for a number of years. In fact, two of the meat traders exercised their right under the Regulations, and appealed to the Minister against what they considered to be excessive charges. The Minister asked to be provided with a statement of cost showing how the charges had been established. After studying these, the Minister affirmed that the charges were in order and dismissed the appeals. These Regulations contain certain requirements that the meat trade must comply with in order to facilitate the inspections. They also contain detailed instruction regarding the method of inspections and procedure to be adopted, and reqiure the inspectors to mark all carcases, that have been passed as fit for human consumption with an official stamp. This naturally places a great responsibility on the inspector. In the Schedule annexed to the Regulations, there are no less than 37 diseases and pathological conditions which can render a carcase unfit and the Inspector must be conversant with all these. Slaughtering takes place in the Borough on seven days a week and the Public Health Inspectors attend the slaughterhouses late in the evenings and on Saturdays and Sundays to ensure that 100% inspection of all meat produced in the Borough is maintained. page 46 CARCASES INSPECTED AND CONDEMNED 1964 Cattle Calves Sheep and Lambs Pigs Horses TOTAL Number killed (if known) 3875 1010 46886 20987 167 72925 Number inspected 3875 1010 46886 20987 167 72925 All diseases except Tuberculosis Whole carcases condemned 29 7 577 42 1 656 Carcases of which some part or organ was condemned 632 - 2986 642 8 4268 Percentage of the number inspected affected with diseases other than Tuberculosis 17.06% 0.69% 7.6% 3.26% 5.39% 6.75% Tuberculosis only whole carcase condemned — — 2 3 — 5 Carcases of which some part of organ was condemned 10 - 41 244 - 295 Percentage of the number inspected affected with Tuberculosis 0.26% — 0.09% 1.15% — 0.41 % page 47 During the year under review 1,579 such visits were made. In this period, a total of 72,925 carcases were inspected, and a total of 17 tons. 14 cwts. 59 lbs. of meat was found to be unfit for human consumption. A table setting out the particulars of animals slaughtered and inspected, together with details of condemnation, is included. Cysticercus Bovis During the year, 10 beasts were found to be infested with C. Bovis, these are subdivided as follows:— 3 Cattle (ex Cows) lesions in the heart muscle. 4 Cattle (ex Cows) lesions in the cheek muscles. 3 Cows lesions in the cheek muscles. No generalised cases were found and after condemnation of the affected parts, the carcases were subjected to cold storage treatment for the required period. Export of horse-flesh In addition to meat inspected for home consumption, horse carcases are inspected for export to Belgium. This inspection has to satisfy the requirements of the Belgian Government, and each consignment of horse-flesh has to be accompanied by an official certificate signed by the Inspector, who has examined and passed the meat. These certificates as well as official labels are provided by the Ministry of Agriculture, Fisheries and Food and have been approved by the Belgian Government. In addition to the slaughterhouses, there are four wholesale butchers and 72 butchers shops in the district. These are all inspected frequently throughout the year. (iv) Food Products in General In addition to the premises used for Milk, Ice Cream and Meat referred to above, the following food premises are registered under the Romford Urban District Council Act, 1931, and are subject to the Food Hygiene Regulations, 1960. Bakers 10 Cafes 69 Confectioners 122 Fishmongers 31 Greengrocers 73 Grocers 148 Miscellaneous 6 Hawkers 70 Licensed Premises 56 page 48 There are also 48 food stalls situated in the Market Place on three days of the week. All these premises are subject to regular inspections to ensure that the requirements of the Food Hygiene Regulations are complied with. During the past year, 2,085 such inspections were made, and 25 informal notices were served where contraventions were noted. Many improvements were obtained through personal approach and the majority of the food shops in the Borough comply with the requirements of the Food Hygiene Regulations. (v) Unsound Food During the year, 821 visits were made to food premises mainly on request, for the purpose of dealing with unsound food, and a total quantity of 11 tons. 17 cwt. 61 lbs. of food was surrendered as unfit for human consumption. Where possible, all unsound food is disposed of for animal feeding. Any which is not suitable for this purpose is disposed of by the Cleansing Department. (vi) FOOD AND DRUGS ACT, 1955 (a) Food and Drugs Authority The Council are a Food and Drugs Authority as defined by Section 85 of the Food and Drugs Act, 1955, and are responsible for the enforcement of the provisions of the Act relating to sampling of foods and drugs, and the Public Health Inspectors are accordingly "Authorised Officers" under the Act. (b) Public Analyst It is the duty of every Food & Drugs Authority to appoint Public Analysts. Those appointed under the Act for Romford are:— Dr. J. H. Hamence, F.R.I.C., and Mr. P. S. Hall, F.R.I.C., both of 20 Eastcheap, E.C.3. The Analysts have been most helpful in advising on the types and quantities of samples taken and any complicated points relating to samples. page 49 (c) Samples submitted for Analysis During the year 240 informal samples and 14 formal samples were submitted to the analyst, of which only 19 were found to be not genuine. A few of these samples were submitted as a result of complaint, but in the majority of cases, the complaints were not confirmed. Informal samples are purchased by the sampling officers in the same manner that the articles would be purchased by an ordinary customer, no indication being given to the vendor that the article is to be subjected to analysis. Should the informal sample, however, prove to be not genuine, a formal sample is taken and the vendor is notified to this effect, and is given one part of the sample for future reference. The original purpose for sampling under the Food & Drugs Act, was in order to trace adulteration of foods and drugs. Fortunately, this practice is not so common as it used to be in the early part of the century. Sampling nowadays is carried out to ensure that foods and drugs comply with the various legal standards and codes of practice regarding composition, and do not contain any harmful preservatives or colouring matter contrary to the Regulations on these matters. Also to ensure that the public are not being deceived by mis-descriptions or exaggerated claims on labels or advertisements. Duplication of sampling by Local Authorities is difficult to control, but fortunately as far as this area is concerned, consultations are held at regular intervals with the adjoining authorities, where information on sampling is exchanged. As will be seen from the following table, a wide variety of foods were sampled during the year. page 50 SUMMARY OF SAMPLES TAKEN FOR ANALYSIS DURING THE YEAR 1964 Article Number examined Result of Analysis Formal Informal TOTAL Genuine Not Genuine Almonds, Ground - 1 1 1 - Apples — 1 1 1 - Apple Pie Filling — 1 1 1 - Apricot Chutney — 1 1 1 - Baconburger — 1 1 1 - Beef Steak with onions — 1 1 1 - Beef suet — 1 1 1 - Best of the milk — 1 1 1 - Birchermuesli, Swiss — 1 1 1 - Blackberries — 1 1 1 - Blackcurrant health drink — 2 2 2 - Bread — 3 3 - 3 Bread crumbs - 1 1 1 - Butter — 6 6 6 - Butter sponge pudding — 1 1 1 - Butter and pancake mix — 1 1 1 - Boned chicken in chicken jelly - 1 1 1 - Carmine — 1 1 1 - Carrots, Diced — 1 1 1 - Cheese spread — 2 2 2 - Cheese sauce — 1 1 1 - Cherry fruit filling — 1 1 1 - Cherry Pie filling — 1 1 1 - Chicken croquettes — 1 1 1 - Chicken fillets — 1 1 1 - Chewing Gum — 1 1 1 - Chest & cough herbs — 1 1 1 - Chop Sauce — 1 1 1 - Chutney — 1 1 — 1 Cocktail Onions — 1 1 1 - Cocktail sticks — 1 1 1 - Coffee, instant — 4 4 4 - Cooking fat — 1 1 1 - Canned Beef — 5 5 3 2 Canned beef — 1 1 1 - Cornflour — 1 1 1 — Cream, Imitation — 1 1 1 — Cream — 5 5 5 1 Cream Slice — 1 1 — — Cream rice milk pudding — 2 2 2 — Custard powder — 2 2 2 — Dessicated Coconut — 1 1 1 1 Dressed Crab — 4 4 3 1 Dressed Crab — 2 2 1 - Drinking Chocolate - 1 1 1 — Evaporated Milk — 2 2 2 — Fish Cakes — 2 2 2 — page 51 Article Number examined Result of Analysis Formal Informal TOTAL Genuine Not Genuine Flour Self-raising - 2 2 2 - French Ice — 1 1 1 — Fritter Mix — 1 1 1 — Full Cream Mix Instant — 1 1 1 — Fruit Cocktail — 1 1 1 — Fruit Salad — 4 4 4 — Fruit Filling — 1 1 1 — Gin 1 — 1 — 1 Glace Cherries — 2 2 2 — Golden Cake — 1 1 — 1 Green Beans — 1 1 1 — Green Beans Cut — 1 1 1 — Ham & Chicken Roll — 1 1 1 — Horseradish, creamed — 1 1 1 — Ice Cream 3 — 3 3 — Ice Cream — 6 6 6 — Ice Lolly — 7 7 7 — Instant Chiffon — 1 1 1 - Instant Cafden — 1 1 1 - Instant Piping — 2 2 2 - Jam — 2 2 2 - Jelly — 1 1 1 - Jelly, instant — 1 1 1 - Kako, cake mixture — 1 1 1 - Kidney Herbs — 1 1 1 - Lamb Tongues — 1 1 1 - Lard — 2 2 2 - Lemon Curd — 1 1 1 - Lemon Pie Filling — 1 1 1 - Liver and Bacon — 1 1 1 - Loaf of Bread — 1 1 — 1 Loganberries in syrup — 1 1 1 - Lolly syrup — 1 1 1 - London grill — 1 1 1 - Macaroni Cheese — 1 1 1 - Margarine — 3 3 3 - Marmalade — 1 1 1 - Meringues, Baby — 1 1 1 - Milk 2 9 11 9 2 Milk, Condensed — 1 1 1 — Milk, Channel Isles — 4 4 4 — Milk, Evaporated — 1 1 1 — Milk, Chocolate — 3 3 3 — Milkset Vanilla Flavour — 1 1 1 - Minced chicken in jelly — 1 1 1 - Mincemeat — 2 2 2 — Mint Sauce — 1 1 1 - Mixed Fruit — 2 2 2 - Mixed herbs — 1 1 1 - Mixed pickle — 1 1 1 - Monosodium glutinate — 1 1 1 - Mustard — 1 1 1 - Mixed peel — 1 1 1 - Noodles with egg — 1 1 1 - Nuttolene — 1 1 1 - page 52 Article Number examined Result of Analysis Formal Informal TOTAL Genuine Not Genuine Onions, Instant - 1 - 1 - Onions, Sauce — 1 1 1 — Orange Squash — 1 1 1 — Parsley, Thyme and lemon — 1 1 1 — Pastes — 2 2 2 — Pastes, meat and fish — 3 3 3 — Peas — 3 3 3 — Peanut butter — 2 2 2 - Peas processed - 1 1 1 - Peas, dried - 1 1 1 - Pie filling - 2 2 2 - Pickled onions - 1 1 1 - Pizza with cheese - 1 1 1 - Pork luncheon meat - 4 4 4 - Portugese soup with prawns - 1 1 1 - Pork Pie - 1 1 — 1 Quick Flan - 1 1 1 - Raspberry pie filling - 1 1 1 - Rhubarb in syrup - 1 1 1 - Rice - 1 1 1 - Roast Pork - 1 1 1 - Rum 2 — 2 2 - Sage - 1 1 1 - Salmon Mayonnaise — 1 1 1 - Savaroni Chicken flavoured — 1 1 1 - Sausages, beef - 2 2 1 1 Sausages, pork - 11 11 9 2 Sausages, pork tinned - 1 1 1 - Sild in oil - 1 1 1 - Smoked herring fillet - 1 1 1 - Smoked pork sausage - 1 1 1 - Soup - 2 2 2 - Soup Almonds - 1 1 - 1 Spaghetti — 1 1 1 - Sponge pudding - 1 1 1 - Stock tablets, chicken - 1 1 1 - Steak and Kidney pudding - 1 1 1 - Stewed steak - 2 2 2 - Strawberries in syrup - 4 4 4 - Strawberry flavour essence - 1 1 1 - Strawberries - 2 2 2 - Sweets - 2 2 2 - Sunny spread — 1 1 1 - Pastilles indigestion - 1 1 1 - Tea - 1 1 1 - Trimmets - 1 1 1 - Vegetable and chicken baby food - 1 1 1 - Vinegar malt 1 - 1 1 - Welsh rarebit, instant - 1 1 1 - Whisky 5 - 5 5 - Yorkshire pudding - 1 1 1 — Total 14 240 254 235 19 page 53 (vii) FOOD HYGIENE REGULATIONS, 1955 The Public Health Inspectors continue to devote a considerable amount of time to the inspection of food premises of all types to ensure that the requirements of the above Regulations are complied with. Provision is not made in these Regulations for the service of Statutory Notices in the case of contraventions and legally every contravention found by the Inspectors could result in prosecution. However, in practice it is rare that the contraventions observed are sufficiently serious as to warrant immediate legal action. When contraventions are noted they are immediately drawn to the attention of the occupier and the need for improvement explained. This verbal intimation is always followed by a letter indicating the nature of the offence and allowing the offender a period of grace in which to comply with the Regulations. This procedure has been adopted with a view to educating food traders rather than to prosecute, and it appears to be paying dividends as the general standard of food shops in the district has greatly improved. In addition, to the inspection of food shops and restaurants frequent visits are made to factory and school canteens and other food preparing premises. The two main difficulties experienced with the enforcement of the Regulations are (a) the protection of open foodstuffs exposed for sale on stalls in the open market and (b) smoking by food handlers. It is extremely difficult to impress on stallholders in the Market the need for protecting foodstuffs from contamination in the open air, but there has been a marked improvement especially with regard to the stalls used for the sale of meat and fish. Some concern is still felt, however, regarding the stalls used for the retail trade of biscuits, cakes and sugar confectionery. It is considered that the only way to ensure that the Food Hygiene Regulations are complied with is to request these stallholders to provide their own mobile stalls constructed on a caravan basis, so that they are properly enclosed and service is only made from behind a screened counter. It it pleasing to report that during the past year, several of the stalls selling open food have been modernised to comply with the Regulations. As regards smoking, the main difficulty is that this habit is so widespread and ingrained that some food handlers, especially page 54 the stallholders, do not appreciate that they should be subjected to this prohibition whilst the customer is not. Few people would appear to appreciate that the reason for prohibiting the use of tobacco, including snuff, whilst handling open food is that the habit brings the fingers into close contact with the nose and mouth, both possible reservoirs of food poisoning germs. The hands may thus become contaminated and the contamination transferred to the foodstuffs. (viii) EDUCATIONAL ACTIVITIES In addition to the routine duties of inspections and observations, the Public Health Inspectors continue to give talks and lectures to local organisations and wherever possible great stress is laid on food hygiene. At least once during the year a lecture is given to staffs employed in school canteens. Frequent lectures are also given on the general work of the Health Department. These lectures are enhanced by the use of coloured slides depicting the various aspects of the work. (ix) LEGAL PROCEEDINGS The following cases were taken under the Food and Drugs Act, 1955. (a) Bandage found in a joint of rolled beef Fined £5. (b) Mould growths in cake Fined £5. (4) CLEAN AIR ACT, 1956 (a) Smoke Control Areas (i) The work of conversions and adaptations in the Romford No. 1 and No. 2 areas was completed during the year. These areas covered some 899 acres and included 2,005 dwellings. (ii) The survey for No. 3 area has been completed. When put into operation it will cover an area of 723 acres and include 3,469 dwellings. (b) Atmospheric Pollution Romford is one of 120 towns that have agreed to co-operate with the Department of Scientific and Industrial Research in a National Survey. Five volumetric meter stations have been set up within the Borough and daily recordings are assessed and the page 55 results forwarded to the Ministry Department. A monthly bulletin is published showing a comparison between the towns participating. The sites were chosen under direct Ministry guidance and designed to standardise throughout the country the positioning of the meters so that National figures when obtained were from basically similar stations. These stations are set in the following position:— 1. Residential district with high population density. 2. Residential district with low population density. 3. Industrial District. 4. Business and commercial district. 5. Proposed Smoke Control Area. Daily weather records are also required for the purpose of compiling accurate returns and the Royal Liberty School Meteorological Society are kindly co-operating and supplying these. 5. RAINFALL During the year, the amount of rainfall recorded at Raphael Park was 19.21 inches, this being 2.65 inches lower than the previous year. 6. PUBLIC BATHS There is one Public Bath situated in Romford, which was opened in 1900. The swimming bath is 70 feet long by 30 feet wide. The water for the swimming bath is obtained from a well situated in the curtilage of the baths. This water is filtered and heated with Breakpoint Chlorination, and has a turnover every 2½ hours. The temperature of the water is maintained at 76°F. The maximum load for the swimming bath is 100 persons. The bath is very well patronised and during the high season admissions has to be restricted. Both chemical and bacteriological samples are taken from the well and at frequent intervals and the results of the examination have always been satisfactory. In addition to the swimming bath, hip baths are also available for the use of the public. Although the baths are old they are maintained in a very satisfactory manner. During the year work was commenced on the new swimming bath at Central Park, Harold Hill. page 56 SCHOOL BATHS A number of schools within the Borough are now provided with outdoor swimming baths. These are inspected at regular intervals and samples of the bath water taken for examination. The standard of purity of the water is satisfactorily maintained. 7. HOUSING ADMINISTRATION (a) General Surveys continue to be made in order to deal with sub-standard and unfit houses. During the year, 1 unfit house was demolished, and a further 2 had been represented and Demolition Orders were made in respect of these. (b) Council Housing The Public Health Inspectors continue to co-operate with the Housing Department by carrying out inspection of houses, at present occupied by applicants on the Housing List, in order to assess the properties in connection with " points " scheme for substandard housing. HOUSING STATISTICS FOR THE YEAR 1964 Number of houses erected during the year:— (1) By Local Authority NIL (2) By Private Enterprise 121 (3) By London County Council NIL 1. Inspection of Dwelling Houses During the Year (1) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 2,493 (b) Number of inspections made for the purpose 3,964 (2) (a) Number of dwelling houses (included under head (1) (above) which were inspected and recorded under the Housing Consolidated Regulations 1925 and 1932 NIL (b) Number of inspections made for the purpose NIL (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 2 page 57 (4) Number of dwelling houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects fit for human habitation 861 2. Remedy of Defects during the Year without service of Formal Notices Number of dwelling houses rendered fit in consequence of Informal action by the Local Authority or their officers 674 3. Action under Statutory Powers during the Year (a) Proceedings under Section 9, 10 and 12 of the Housing Act, 1957— (1) Number of dwelling houses in respect of which Notices were served requiring repairs NIL (2) Number of dwelling houses which were rendered fit after service of Formal Notices NIL (a) By Owners NIL (b) By Local Authority in default of owners NIL (b) Proceedings under the Public Health Acts. (1) Number of dwelling houses in respect of which Notices were served requiring defects to be remedied 74 (2) Number of dwelling houses in which defects were remedied after service of Formal Notices (a) By Owners 48 (b) By Local Authority in default of owners 21 (c) Proceedings under Section 16 and 17 of the Housing Act, 1957 (1) Number of dwelling houses in respect of which demolition orders were made 2 (2) Number of dwelling houses demolished in pursuance of Demolition Orders 1 (3) Number of demolition orders revoked NIL (4) Number of Closing Orders made NIL (5) Number of Closing Orders revoked NIL page 58 (d) Proceedings under Section 18 of the Housing Act, 1957 (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made NIL (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined the tenement or room having been made fit NIL 4. Housing Act, 1957, Part IV—Overcrowding (a) (1) Number of dwellings overcrowded at end of year 12 (2) Number of families dwelling therein 17 (3) Number of persons dwelling therein 88 (b) Number of new cases of overcrowding reported during the year NIL (c) (1) Number of cases of overcrowding abated during the year NIL (2) Number of new cases of overcrowding relieved during the year NIL (3) Number of persons concerned in such cases NIL (d) Particulars of any cases in which dwelling houses have again become overcrowded after the local Authority have taken steps for the abatement of overcrowding NIL 5. Rent Act, 1957 During the year the Public Health Inspectors made 75 inspections in connection with the requirement of this Act. These inspections dealt with applications for Certificates of Disrepair, checking undertakings made by owners, and inspecting the works carried out to remedy the defects and disrepair. page 59 The following is a summary of the matters dealt with during the year:— Number of applications for Certificates 15 Number of Certificates issued 2 Number of Certificates cancelled NIL Number of Undertakings accepted 13 Number of applications for Certificates as to remedying of defects, "Form O." 7 Number of Certificates as to remedying of defects:— Granted "Form P" 7 Refused NIL SHOPS & OFFICES Mr. S. F. Titterton, D.S.A.A., the Council's Senior Shops Inspector, who works under the supervision of the Chief Public Health Inspector has submitted the following report on the various duties for which he is responsible. The shops inspectorate has been increased by the appointment of Mr. M. Lee as an Assistant Shops Inspector from the staff of the department. Shops Act 1950 This Act consolidated a series of measures from 1912-1938 and made no change in the law. It provides for the statutory closing hours of shops, early closing days, restrictions on the opening of shops on Sunday, and maximum working hours of young persons. The health and welfare provisions contained in sections 37-39 have been repealed by the Offices, Shops and Railway Premises Act 1963. Shops authorities have a definite responsibility to enforce the law. Closing hours and Sunday trading continue to be controversial, particularly with the trades there is a division of opinion whether to restrict the opening of shops to five days or extend the present arrangements of 5 ½ days to six days a week, excluding Sunday. In February of this year, the Home Secretary's enquiry into the Shops Act 1950 (excluding Sunday) brought forward many suggestions in what form a new Bill should take. It is understood that Part 1 of the Act which deals with early closing days and page 60 evening closing hours is under active consideration by the Home Secretary and that there is some question of introducing a Bill under the Ten Minute Rule to deal with half days. The long awaited Report of the Departmental Committee on the Law on Sunday Observance (Crathorne Report) Cmd. 2228 was published in December. The report deals with Sunday activities generally, but most of the report deals with Sunday trading. The Committee stand by the principle of restriction on Sunday trading but make certain recommendations to tidy up the anomalies found to exist in Part IV of the Shops Act 1950. The Young Persons (Employment) Act 1938 This Act regulates the hours of young persons similarly to the Shops Act 1950 and deals with occupations in transport and undertakings, residential hotels and clubs, places of entertainment. In the last session of Parliament an important new measure received the Royal Assent known as the Young Persons (Employment) Act 1964 and its purpose is to extend the kinds of employments mentioned in the Act of 1938 and to increase the penalties under this Act. It now regulates the hours of young persons for example in night clubs, where hitherto there has been no restriction in law as to their maximum hours or at times when they ought not to be employed (after 10 p.m. or before 6 a.m.). It may be said, there is no night life in Romford. Certainly the place is relatively quiet when all the shops are closed but here is a new Act which will discourage the employment of young persons in this kind of establishment should this activity spread from the larger cities. Offices, Shops & Railway Premises Act, 1963 This Act provides for the safety and working conditions of those employed in shop or office and follows closely the provisions of the Factories Acts. It makes provision for the registration of premises where persons are employed to work and this was brought into effect by the Notification of Employment of Persons Order 1964 which require employers to notify during the period 1st May-31st July 1964 the numbers employed and other relevant matters. Up to the end of the year 969 premises had been registered with this authority. This figure, in relation to the number of premises existing within the Borough, is above the average for the country. This was brought about by the department page 61 ing Form OSR.l to known employers though the onus of making a return was obligatory on the employer. It should be noted that employers who did not register within the period or who have not notified of their intention to employ persons in shop or office are liable to a fine of £20. A most important feature of the Act is that employers must notify the authority of any accident on the premises of employees or visiting employees of other employers, which result either in the death of that person or absence from work for more than three days from doing his usual work. During the period 1st August (when the main provisions of the Act came into force) and the 31st December 1964, 17 accidents were notified to the department. Fortunately, there were none to warrant legal action though possibly in breach of a statutory duty. All these accidents are reported to the Ministry for statistical purposes and causation. The 'accident rate' in industry is grave and, in November, Mr. Richard Marsh, M.P., Parliamentary Secretary to the Minister of Labour, announced, when launching the quarterly publication of "Accidents" in its new format published by H.M.S.O., that during 1963, 1¾ million man hours were lost through industrial action whereas 19 million man hours were lost due to accidents in industry. The number and types of accidents occurring in the non-industrial field which now come under the jurisdiction of local authorities is, as yet, an unknown quantity but the required notification of accidents will enable this to be assessed. This information will be published in "Accidents." It cannot be over-emphasised in this report that employers and their employees must do everything possible to decrease this ever mounting toll of accidents. A fall, as was reported in one case to this department impaired the employee for more than three months. Failure to notify an accident is a punishable offence. The Minister has made Orders and Regulations relating to dangerous machines, first aid, sanitary accommodation and washing facilities. Lighting regulations are under active consideration. To denote the importance of this Act, the Ministry of Labour has sent out no less than 24 Circulars to local authorities on the page 62 administration interpretation and enforcement of the various provisions and this has meant that staff engaged in the enforcement of the Act have been "put into the picture" as to what is expected of them to secure a degree of uniformity on the enforcement of this important piece of legislation. The first annual report as required to be submitted to the Ministry, appended hereto, is obtainable from this authority at a reasonable charge. Consumer Protection Act 1961 This Act gives the Secretary of State power to make Regulations on safety requirements and construction of Certain Goods likely to cause death or personal injury. With the ever increasing number of deaths and injuries caused to children by burning and, in particular, the use of flammable children's nightwear, the Government have now made a regulation under this Act, known as The Children's Nightdresses Regulations 1964 which came into force on the 1st October 1964. Thus there are now three sets of regulations covering goods likely to cause death or personal injury. The Heating Appliances (Fireguards) Regulations 1953, The Oil Heaters Regulations, 1962 and the 1964 Regulations. It was announced by a spokesman for the Home Office, at the National Home Safety Conference, held in London, on the 27/28 October 1964, that the Oil Heaters Regulations did not apply to oil heaters manufactured before the 1st June 1962 but that amending Regulations were now in course of preparation. This will now satisfy the severe criticisms of Home Safety Advisory Committees and indeed many other bodies concerned with safety in the home, particularly with regard to the selling of second hand oil heaters. Routine visits have been made to shops and stalls where these goods are sold. Retailers had shown a remarkable interest in the Childrn's Nightwear Regulations and were greatly concerned that no children's nightdresses were kept that did not conform. This was found to be so on the many inspections carried out. However, there were 20 heating appliances where the guards page 63 did not conform with the Regulations and it was apparent in these cases that the manufacturers had failed to detect the faults during manufacture. All were returned for amendment. The following conferences were attended:— The Institute of Shops Acts Administration National Home Safety In conclusion, I would thank the Committee for the privilege of attending these conferences and for the facilities given in my capacity as Hon. Editor of 'The Inspector' the official journal of the Institute of Shops Acts Administration. The various Acts with their limitations have been enforced as can be seen in the schedules of this report. SHOPS ACT, 1950 (a) Inspections 1,810 inspections and observations were carried out for various purposes under the Act, during the year. The following contraventions were noted:— (i) Early Closing Day Failing to exhibit notice 4 Failing to close shop for serving customers 1 Failing to observe the regulations 1 (ii) Evening Closing Hours Failing to close shop for serving of customers 2 (iii) Sunday Trading Failing to close shop for serving of customers 2 Failing to observe the Regulations 4 page 64 (iv) Conditions of Employment Failing to exhibit Notice as to Assistants' Weekly Halfholidays 16 Failing to allow proper intervals for meals and rest 1 Failing to exhibit Abstract of Act, and keep records of young persons 13 Failing to keep records of Sunday employment 1 OFFICES, SHOPS AND RAILWAY PREMISES ACT, 1963 Annual Report from the 1st May, 1964 to 31st December, 1964 as required by the Ministry of Labour. TABLE A Registrations and General Inspections (1) Class of premises (2) Number of premises registered during the year (3) Total number of registered premises at the end of year (4) Number of registered premises receiving a general inspection during the year Offices 231 221 2 Retail shops 685 659 3 Wholesale shops, warehouses 26 21 Catering establishments open to public, canteens 70 65 Fuel storage depots 3 3 page 65 TABLE B Number of visits of all kinds by Inspectors to Registered Premises 183 TABLE C Analysis of Persons Employed in Registered Premises by Workplace Class of workplace (1) Number of persons employed (2) Offices 2,712 Retail Shops 3,887 Wholesale Departments, warehouses 393 Catering establishments open to the public 698 Canteens 71 Fuel storage depots 25 Total 7,786 Total Males 3,355 Total Females 4,431 TABLE D Exemptions NIL page 66 TABLE E Prosecutions NIL TABLE F Inspectors Number of Inspectors appointed under Section 52 (1) or (5) of the Act 11 Number of other staff employed for most of their time on work in connection with the Act NIL Mawney Pass Ltd., 149 North Street, Romford, Essex.