Acknowledge 14/1/66 C 4411 (1) Public Health WAL 59 BOROUGH OF WALTHAMSTOW REPORT OF THE MEDICAL OFFICER OF HEALTH for the Year 1964 MELVILLE WATKINS, M.R.C.S., L.R.C.P., D.P.H. MEDICAL OFFICER OF HEALTH BOROUGH OF WALTHAMSTOW REPORT OF THE MEDICAL OFFICER OF HEALTH for the Year 1964 MELVILLE WATKINS, M.R.C.S., L.R.C.P., D.P.H. MEDICAL OFFICER OF HEALTH INDEX Page SECTION A-Statistics and Social Conditions of the Area 6 SECTION B-General Provision of Health Services in the Borough 9 SECTION C-Infectious Diseases 13 SECTION D-Sanitary Circumstances of the Area 19 SECTION E - Sanitary Circumstances of the Area-Statistics 25 SECTION F - National Health Service Act, 1946-Part III Services 35 Page Acreage 6 Adulteration of Pood 31 Ambulance Facilities 10 Ante-Natal Clinics 47 Assessments 6 B. C. G. Vaccination 58 Birth Notifications 47 Births 6 'Brookscroft' Welfare Centre 50,51,53 Care of Mothers and Young Children 42,47 Chest Clinic 42 Chest Care Association 43 Chiropody 41,58 Clearance Areas 22 Clinics 53 Committees 4,35 Comparability Factor 8 Confinements 55 Convalescence 52, 59 Cremation 12 Condemned Food 30 Daily Guardian Scheme 52 Day Nurseries 37,52 Deaths from Accidents in the Home 8 Deaths, Infants 6 Deaths, Causes of 7 Dental Laboratory 46 Dental Treatment 38,49 Diphtheria Immunisation 57 Diseases of Animals Acts 24 Disinfections 12, 25 Disinfestation 20 Page Domestic Help Service 41,60 Domiciliary Chiropody 41,58 Employment 8 Factories Act 1961 31 Food and Drugs Act 1955 23 Food Hygiene Regulations 1960 23,31 Flooding 12 Food Inspection 28 Food Poisoning 14 Funeral Arrangements 11 Gas and Air Analgesia 54 General Dental Service 37,46 Hairdressers 21 Health Education 39,60 Health Centres 37 Health Services Clinics 46 Health Visiting 39,55 Home Nursing 40,56 Hospital Accommodation 10 Housing Act 1957 22 Housing. General 17 Housing, Inspection 28 Housing, Statistics 16 Ice Cream 22,29 Immunisation 41,57 Improvement Grants 16 Infant Mortality 6 Infectious Diseases 10,13,25 Inquests 12 Laboratory Facilities Land Charges Laundry Service for the Incontinent 11 Page Legal Proceedings 23 Liaison (Hospitals and G.Ps.) 39 Massage and Special Treatment 11 Maternal Mortality 6 Meals on Wheels Service 11 Meat and other Poods 23, 29 Medical Examinations 11,62 Medicaments 51 Midwifery 38,54 Milk Supplies 22,29 Moral Welfare 42 Night Attendance 62 Notices, Sanitary 25 Nursing Homes 10 Nutrients 5l Old People's Welfare 11 Orthopaedic Treatment 48 Outworkers 32 Offices, Shops etc. Act, 1963 25 Paediatric Clinic 48 Pet Animals Act, 1951 24 Poliomyelitis 14 Poliomyelitis Vaccination 58 Population 6 Post Mortems 12 Post Natal Clinics 47 Premature Infants 47 Prevention of Damage by Pests Act, 1949 24,33 Page Prevention of Illness 41,58 Public Health Inspection 19,25 Rainfall 12 Rateable Value 6 Rehousing 18 Rent Act, 1957 21,27 Rodent Control 33 Sampling of Pood 23,30 Scabies Treatment 10 Sickroom Equipment 59 Smallpox Vaccination 57 Smoke Abatement 19,27 Social Conditions 6 Special Premises 26 Staff 4,9,36 Statistics 6,25,46 Stillbirths 6 Swimming Baths 20 Tetanus Immunisation 57 Toddlers Clinics 53 Tuberculosis 14,15,59 Vaccination 41,57 Verminous Premises 20 Vital Statistics 6 Water 20 Welfare Centres 50 Welfare Foods 51 Welfare Services 45 Whooping Cough Immunisation 57 4 HEALTH COMMITTEE 1964-65 Chairman: COUNCILLOR MRS. E.L. BALDWIN Vice-Chairman: COUNCILLOR F. FURBER Bx-officio THE WORSHIPFUL THE MAYOR-COUNCILLOR T.H. CHILD, J.P. THE DEPUTY MAYOR-ALDERMAN MRS. W.M. PALETHORPE CHAIRMAN OF FINANCE COMMITTEE-COUNCILLOR H.J.E. PALETHORPE ALDERMAN E.C. REDHEAD ALDERMAN C.B. REYNOLDS ALDERMAN T. W. SMITH COUNCILLORS: C.G. ABLEY R.J.L. CAVE MRS. R. COLIN L.V. GRAHAM MRS. L.D. GURR J.H. HAMMOND COUNCILLORS: J.E. NICHOLLS A.M. O'REILLY F.A.J. 0'SHEA MRS. B.M. REYNOLDS F.S. WATTS D. WEINSTEIN Medical Officer of Health: M. WATKINS, M.R.C.S., L.R.C.P., D.P.H. Deputy Medical Officer of Health: G.H.G. POOLE, M.B., B.S., D(Obst.) R.C.O.G., D.P.H. Chief Public Health Inspector: W. RICHARDS, D.P.A., M.A.P.H.I. Deputy Chief Public Health Inspector: N. SMITH, M.A.P.H.I. Chief Clerk: R. ROSE 5 TO THE MAYOR, ALDERMEN AND COUNCILLORS OF THE BOROUGH OF WALTHAMSTOW MR. MAYOR, LADIES AND GENTLEMEN. I beg to submit my report upon the Health of the Borough for the year 1964. Owing to the reorganisation due to the London Government Act, 1963, the Borough of Walthamstow, will, as from 1st April 1965, become part of the new London Borough of Waltham Forest. This then will be my last report as Medical Officer of Health for the Borough of Walthamstow. The pressure of work due to the amalgamation, together with the limited time factor, prevents one from making a comprehensive and critical assay of the progress made in the field of Health during the year. The report must therefore, be mainly statistical and is presented in the same form as last year's. I wish to acknowledge the support and encouragement received from past and present members of the Council and to offer thanks for their services to all members of the Health Department Staff who have been associated with me during my term of office. Acknowledgement is particularly due to Mr.R. Rose who has retired after fifty years loyal and devoted service in the Health Department, having been for the last thirty-five years the Chief Clerk. I am, Your obedient servant, MELVILLE WATKINS Medical Officer of Health. 6 A.-STATISTICS & SOCIAL CONDITIONS OF THE AREA Area (in acres) 4,343 Population (Registrar General's Estimate, mid-year 1964) 106,100 Number of Assessments (31st December 1964) 41,386 Rateable Value (31st December 1964) £5,623,163 Estimated Product of a penny rate (1964/65) £22,550 Population.-The Registrar General's Estimate of the home population at mid-year, 1964 is 106,100, a decrease of 1160 on the previous year. The steady decline continues. This figure has been used for the calculation of the following statistics:- Live Births: Number 1,779 Rate per 1,000 population 16.7 Illegitimate Live Births per cent of total live births 7.0 Stillbirths: Number 17 Rate per 1,000 total live and stillbirths 9.4 Total Live and Stillbirths 1,796 Infants Deaths (deaths under 1 year) 27 Infant Mortality Rates: Total infant deaths per 1,000 total live births 15.1 Legitimate infant deaths per 1,000 legitimate live- births 15.1 Illegitimate infants deaths per 1,000 illegitimate live births 16.1 Neo-natal Mortality Rate (deaths under 4 weeks per 1,000 total live births) 10.1 Early Neo-natal Mortality Rate (deaths under 1 week per 1,000 total live births) 8.3 Perinatal Mortality Rate (stillbirths and deaths under 1 week combined per 1,000 total live and stillbirths) 12.2 Maternal Mortality (including abortion): Number of deaths 1 Rate per 1,000 total live and stillbirths 0.55 Deaths.-The Registrar General's classification of causes of death by sex totals is given on page 7. 7 Causes of Death as given by the Registrar General for the Year 1964 Causes of Death Males Females Total 1963 1. Tuberculosis, Respiratory 4 3 7 6 2. Tuberculosis, other 1 - 1 - 3. Syphilitic Disease 2 2 4 1 4. Diphtheria - - - - 5. Whooping Cough _ - - - 6. Meningococcal Infections - - - - 7. Acute Poliomyelitis - - - - 8. Measles - - - - 9. Other Infective and Parasitic Diseases - - - 1 10. Malignant neoplasm, stomach 20 13 33 36 11. Malignant neoplasm, lung, bronchus 57 14 71 83 12. Malignant neoplasm, breast - 25 25 19 13. Malignant neoplasm, uterus - 8 8 8 14. Other malignant and lymphatic neoplasms 71 70 141 114 15. Leukaemia, aleukaemia 5 2 7 8 16. Diabetes 4 11 15 16 17. Vascular lesions of nervous system 55 86 141 161 18. Coronary disease, angina 158 98 256 253 19. Hypertension with heart disease 8 8 16 14 20. Other heart disease 22 52 74 140 21. Other circulatory disease 19 31 50 74 22. Influenza - - - 7 23. Pneumonia 42 55 97 110 24. Bronchitis 54 18 72 87 25. Other diseases of respiratory system 6 4 10 11 26. Ulcer of stomach and duodenum 4 4 8 16 27. Gastritis, enteritis and diarrhoea 3 4 7 8 28. Nephritis and nephrosis 6 3 9 6 29. Hyperplasia of prostate 7 - 7 3 30. Pregnancy, childbirth, abortion - 1 1 - 31. Congenital malformations 2 3 5 10 32. Other defined and ill defined diseases 41 52 93 87 33. Motor Vehicle Accidents 11 - 11 9 34. All other accidents 7 11 18 17 35. Suicide 5 3 8 7 36. Homicide and operations of war - - - - Totals 1964 614 581 1,195 - Totals 1963 684 628 - 1,312 The age distribution of Cancer deaths was as follows: Deaths from Lung Cancer are shown separately but are also included in the total age groups. Under 1 yr. 1-4 yrs. 5-14 yrs. 15-24 yrs. 25-44 yrs. 45-64 yrs. 65-74 yrs. 75 yrs. A over Total deaths - - 1 3 13 112 76 80 Lung Males - - - - - 26 19 12 Females - - - - - 7 4 3 8 The total number of deaths in 1964 (1195) compares with 1312 in 1963, the respective death rates being 11.2 and 12.2 per 1,000 population. The comparability factors for Walthamstow are given by the Registrar General as follows:- Comparability factor for births 1.06 Comparability factor for deaths 1.01 The above factors, when applied to the crude rates, produce the following adjusted rates:- Live births 17.7 Deaths 11.3 Deaths from Accidents in the home Thirteen deaths occured in 1964 from this cause. Six died at home. Ages and sexes were:- Pemale: 83, 79, 70, 67, 67, 66, 38, 1. Male: 89, 85, 84, 67, 36. In order to put these and other deaths in proper perspective, the following comparison is made:- Cause of Death 1964 1963 (a) Suicide 8 7 (b) Motor Vehicle accidents 11 9 (c) All other accidents 18 17 (d) Accidents in the home (included in line (c)) 13 10 (e) Tuberculosis 8 6 (f) Poliomyelitis Nil Nil Employment Contributed by Miss G. Cordell, Manager of the Local Employment Exchange. 1. Insured population of the Boroughs of Walthamstow, Leyton, Chingford and Wanstead & Woodford:- Approximately 48,927 men and 38,073 women 2. Insured population of the Borough of Walthamstow:- Approximately 21,002 men and 15,472 women 3. The number of persons placed in employment in the whole area during 1964:- 4,661 men and 1,386 women These figures include approximately:- 320 disabled men and 99 disabled women 9 4. The weekly average of persons unemployed in the whole area during 1964:- 711 men and 132 women These figures include approximately:- 110 disabled men and 17 disabled women. NOTE: The figures for insured persons are based partly on the number of N.I. books exchanged during the June to September quarter, and partly on returns rendered by certain employers showing the number of N.I. cards they hold. Caution should be exercised in comparing the number of persons unemployed with the insured persons, as an unemployed person need not necessarily register in the area where his N. I. card is exchanged. Normally, an employed person's N. I. card would be counted in the area in which he works, while, if he became unemployed he would be likely to register at the Employment Exchange in the area in which he lives. B.-GENERAL PROVISION OF HEALTH SERVICES IN THE BOROUGH Public Health Officers of the Authority The following changes in the Officers employed in the Health Department took place during the year:- Appointments From Miss H. Attree Junior Clerk 28.9.1964 Mrs. L. McLellan Clerical Assistant 28. 9. 1964 Mr. T. Watson Inspecting Assistant 2.11.1964 Mr. R. Meadows Pupil Public Health Inspector 27.7.1964 Mr. C. Rampling Public Health Inspector Resignations Miss S. Horsnell Clerical Assistant 26.7.1964 Miss K. Smith Junior Clerk 2.10.1964 Laboratory Facilites Arrangements continued with the Public Health Laboratory Servic at Colindale until 20th July 1964 from which date the service was transferred to the Laboratory at Edmonton. The number of specimens examined at each Laboratory during the year was as follows:- Specimens Colindale 1/1/64-19/7/64 Edmont on 20/7/64-31/12/64 Total Faeces and rectal swabs 653 199 852 Nose and Throat swabs 17 13 30 Pood 6 9 15 Miscellaneous 5 2 7 Totals 681 223 904 10 In addition 5 Throat and Ear swabs were examined at the Laboratory at Connaught Hospital. Ambulance Facilities These are available from a depot situated at Whipps Cross which is administered centrally from Chelmsford, via the Control Centre at Ilford. Treatment of Scabies and Verminous Conditions The arrangement with Hackney Borough Council, detailed in the report for 1953, continued. Five treatments were given at the cost of £4.2.6d. Hospital Accommodation (a) Acute Casea.-There were no major changes in 1964 in regard to the hospital accommodation available for the inhabitants of the Borough. (b) Chronic Cases.-Regional Hospital Boards have asked that Medical Officers of Health shall support when necessary on 'social' grounds the recommendations of medical practitioners for the admission of the chronic sick to hospital. All possible help was given when requested. The following table shows the position in regard to hospital and hostel admissions considered and/or supported on 'Social' grounds. Total number of cases 30 New Cases 29 Brought forward from 1963 1 M.O.H. requests to Langthorne Hospital or Area Welfare Officer 5 Admitted to Hospitals 5 Admitted to Hostels 5 Died before admission 3 Refused Hospital or Hostel accommodation 4 Cancelled or deferred 4 Waiting for Hostel accommodation 8 Section 47 operated 1 It is a pleasure again to record the unfailing help and consideration experienced from Dr. DeLargy at Langthorne Hospital from Mr.F.J. Meacock, Area Welfare Officer and my staff. (c) Infectious Diseases.-St. Ann's Hospital, Tottenham, is the main hospital to which any infectious disease cases are admitted from this area. Public Health Act, 1936-Nursing Homes There is no Nursing Home registered in the Borough. 11 Essex County Council Act, 1933 (Establishments for Massage and Special Treatment) No new licence was granted under the Act during 1964. During the year the medical staff paid fifteen visits to the establishments registered for massage and special treatment. Old People's Welfare Association The Town Clerk, as Honorary Secretary of the Walthamstow Old people's Welfare Committee, informs me that the Committee's 'Meals on Wheels' Service provided 34,601 meals (including 104 free Christmas dinners) during 1964. The following table is a summary of the Meals-on-Wheels provided during the year. Number of Meals served weekly (approximate) 707 Number of people receiving meals (approximate) 721 Number of new cases, for the year 196 Number of vehicles involved 7 Number of voluntary helpers 62 Number of visits annually 260 Laundry Service for the Incontinent This service continues for the assistance of those elderly persons whose relatives are unable to cope with soiled linen. In December 1961, the Borough Council agreed to undertake the service for two neighbouring authorities on a financial cost basis. The following table shows the number of cases dealt with during 1964:- Total number of persons-Walthamstow 24 Total number of persons-Woodford 10 Total number of persons-Chingford 2 Average number of cases per week 23 Total number of articles laundered 17,386 Average number of articles per week 328 Total number of journeys 1,996 Funeral Arrangements Arrangements continued with regard to burials within the terms of the National Assistance Act, 1948. Medical Examinations During the year the medical staff carried out 354 examinations of Borough Council employees in respect of the Superannuation and Sick Pay Schemes. 12 Disinfection The Council continued to provide facilities for steam disinfection for the Chingford and Leyton Corporations. General Contributed by Mr.D.M.P.Sullivan, Borough Engineer and Surveyor. Cremation Facilities for cremation are available at the City of London Crematorium at Manor Park and also the Manor Park Crematorium, Manor Park. Inquests and Poat Mortema Walthamstow Others Total Post Mortem Examinations only 100 149 249 Post Mortem Examinations and Inquests 17 25 42 Inquests only 4 85 89 121 259 380 Rainfal1 The annual rainfall at the Ferry Lane station was 21.73 inches. In 1963 it was 23.38 inches. F1ooding Limited flooding occurred on three occasions during the year, and extensive flooding on one occasion. 13 C. - INFECTIOUS DISEASES The following table shows the ward incidence of the various infectious diseases which were notified during the year:- Disease St. James Street High Street Hoe Street Wood Street Hale End Higham Hill Total Scarlet Fever 9 7 17 12 23 26 94 Whooping Cough 23 5 11 13 12 17 81 Measles 13 1 12 11 22 11 70 Diphtheria - - - - - - - Pneumonia 1 - - - - - 1 Meningococcal Infection - - - 1 - - 1 Acute Poliomyelitis Paralytic - - - - - - - Non-Paralytic - - - - - - - Acute Infective Encephalitis - - - - - - - Post Infectious Encephalitis - - - - - - - Dysentery 63 16 16 8 4 9 114 Ophthalmia Neonatorum 2 - - - - - 2 Puerperal Pyrexia 6 2 4 13 4 4 33 Smallpox - - - - - - - Paratyphoid Fever - 1 - - - - 1 Typhoid Fever - - - - 1 - 1 Food Poisoning - 3 6 10 - 5 24 Erysipelas 1 - - - 3 1 5 Malaria - - - - - - - Tuberculosis Respiratory 7 4 11 9 7 10 48 Meninges and Central Nervous System 2 _ _ - _ - 2 Other Forms 2 2 2 1 - 3 10 Totals, 1964 129 41 77 78 76 86 487 Totals, 1963 425 226 382 344 511 443 2,331 14 Food Poisoning Twenty-four cases were notified during 1964 and none was fatal. There were two familial 'outbreaks', in which the infecting agent was Salmonella Typhi-murium and Enteriditis respectively. Poliomyelitis No case of Poliomyelitis was notified during the year. Tuberculosis The following table shows particulars of new cases of tuberculosis and of all deaths from the disease in the Borough during 1964 Age Periods NEW CASES DEATHS Pulmonary NonPulmonary Pulmonary NonPulmonary M F U F M F M F Under 1 year - - - - - - - - 1-4 years - - - - - - - - 5-9 years 1 - - 2 - - - - 10-14 years - 1 1 - - - - - 15-19 years - - - - - - 1 - 20-24 years 4 - 1 - - - - - 25-34 years 14 1 4 1 - - - - 35-44 years 6 2 2 - - - - - 45-54 years 5 2 1 - - - - - 55-64 years 4 1 - - 1 2 - - 65 and over 6 - - - 3 1 - - 40 8 9 3 4 3 1 - Totals 48 12 7 1 60 8 15 TUBERCULOSIS NOTIFICATION AND DEATH RATES The following graph shows the trend of notification of tuberculosis since 1935, and of deaths from tuberculosis. The fall in the latter results in the survival (and increased longevity due to new. methods of treatment) of many infective patients, i.e. an increase in the infecting pool. Notifications of tuberculosis (all forms) in persons of all ages are shown in black, and deaths from tuberculosis (all forms) in persons of all ages are shown in red. 16 HOUSING Contributed by Mr.F.G.Southgate, A.R.I.B.A., Borough Architect. Statistics Houses completed by the Local Authority 1964 F1ats Houses Hoe Street Ward 14 - St. James Street Ward - - Higham Hill Ward 14 10 High Street Ward - - Hale End Ward 52 - Wood Street Ward 22 - Totals 132 10 Houses completed by Private Enterprise Flats Houses Hoe Street Ward 8 1 St. James Street Ward - 2 Higham Hill Ward - - High Street Ward - - Hale End Ward 17 10 Wood Street Ward - 1 Totals 25 14 Note: All were permanent houses and flats In addition to the main building programme, improvements and conversions were carried out at a number of Council owned properties. Improvement Grants Applications received from owner/occupiers:- Discretionary 128 Standard 113 Total number of grants and amounts approved by Council to owner/occupiers:- Discretionary Standard 78 86 £26,133 £10,720 Applications received from Warner Estate Ltd. Discretionary 6 Total number of grants and amounts approved by Council to Warner Estate Ltd. Discretionary 6 £1,359 17 Summary Total number of applications Discretionary 134 Standard 113 Total number of grants Discretionary 84 Standard 86 Total amount of grants Discretionary £27,491 Standard £10,720 General Mr.R. Park, the Council's Acting Housing Manager has kindly contributed the following details of rehousing carried out by the Housing Department in 1964:- No. of new properties made available for letting 153. Acquired 121 Normal vacancies 139 Nominations to private landlords 3 New properties at Canvey New properties at Billericay Total 416 Families rehoused:- 1-bedroom group 122 2-bedroom group 144 3-bedroom group 135 4-bedroom group 15 Total 416 Property under management at December 1964:- Pre-1939 houses and flats 1,614 New houses and flats 3,482 Properties at Canvey Islan 206 Properties at Billericay 441 Prefabricated bungalows 3 Properties converted into flats 312 Properties acquired for housing purposes 1,160 Properties for Clearance and Demolition 653 Halfway houses 2 General Properties 46 Commercial Properties 6 Garages 1,958 Total 9,883 The number of families rehoused in New Towns during 1964 was 103. 18 The following extracts are taken from the Annual Report of the Housing Management Committee:- Rehousing During 1964 the Letting Sub-Committee considered reports dealing with individual cases submitted in accordance with the Conditions of the Points Scheme:- Conditiona o f Points Scheme 'C' Families living with relatives 44 'D' Families living apart 4 'E' Irregular overcrowding 165 'G' Two refusals of alternative accommodation 2 'K' Three or more families (relatives) in House 'H' Transfer of priority housing 'J' Special cases 66 'J' Rehousing subject to nomination 2 M.O.H. Medical recommendations (T.B.) 2 M.O.H. Cases for consideration 8 Special requests for emergency accommodation 62 Total 355 Arising from the review of the housing register carried out in 1963, the Housing Management Committee decided to give special consideration to some 300 families who have been registered for more than ten years where some degree of hardship has occurred over a long period. This is continuing but a number of decisions to offer accommodation have already been made. The Committee has also adopted a basis of assessment for elderly applicants which is supplementary to the main points scheme and takes greater account of the period after age 65 during which certain important amenities have been lacking or hardship has occurred, in order that the most necessitous cases among the elderly shall receive consideration in order of need as and when suitable flats become available. MEDICAL CASES During 1964, five cases claiming rehousing priority for tuberculosis were investigated and reported upon. They were all added to the list. 19 The position at the end of 1964 was as follows:- Class 1 Class 2 Class 3 Class 4 Total On list at end of 1963 3 4 10 10 27 Added to list during 1964 - - 1 4 5 3 4 11 14 32 Rehoused or removed from list during 1964 1 1 _ 4 6 On list at end of 1964 2 3 11 10 26 In addition to the tuberculosis cases, sixteen other cases were recorded as needing special consideration on medical grounds and seventy-eight on general grounds. D. SANITARY CIRCUMSTANCES OF THE AREA Contributed by Mr.W. Richards, Chief Public Health Inspector. Public Health Inspection of the Area During the year 302 Intimation Notices were served; 11 were in respect of business premises and 291 related to defects in private houses. 395 were complied with without resort to statutory procedure. These notices required the carrying out of various repair works and resulted in better housing conditions and improved conditions in factories. It was found necessary to institute legal proceedings against owners of property for non-compliance with notices in seven cases. The hearing was adjourned 14 days in one case; in others, costs of £2.2.0. were awarded and Orders of twenty-eight days were made; costs of £3.3.0. were given in three other cases; and in the remaining case £1.1.0. costs was awarded. Large numbers of food premises and various other types of premises were inspected and various works were carried out to these premises. These works resulted in improved hygienic conditions. Smoke Abatement Observations in respect of smoke nuisances from premises amounted to 425. Investigations were carried out in all cases and steps taken to abate the nuisance. New boiler plant was installed in some factories and improvements effected in others. Atmospheric pollution instruments are in operation, for measurement of sulphur in the atmosphere, at the Sir George Monoux Grammar School, in Willow Walk, in Blackhorse Lane and at the Woodford County High School. The recordings of the above instruments are similar to those obtained by adjacent authorities and are lower than those given 20 for Central London. An instrument for measuring smoke pollution is in operation at the Town Hall. Daily readings are taken and the figures obtained are in milligrams of solid matter per 100 cubic metres of air. Smoke Control Areas Smoke Control Areas Nos.6,7 and 8 came into operation during the year. The Council decided not to make any more smoke control orders as the incorporation into the London Borough of Waltham Forest will take place early next year, therefore no surveys were carried out during the year. Water Supply The whole of the area is supplied by the Metropolitan Water Board and the standard has been satisfactory both in quality and quantity. Bacteriological and chemical examinations of supplies are carried out by the Metropolitan Water Board. The Water supplied is not plumbo solvent in action; no cases of lead contamination or other forms of contamination have been found. All the dwelling houses and the population in the area are supplied direct from the water mains, by means of piped supplies to the houses. Verminous Premises The number of dwelling houses reported to be infested with vermin remains comparatively small. Sixty-six rooms were disinfested and insecticides were issued, free of charge, to twenty-four tenants. Swimming Baths and Pools There are two public swimming baths and three school swimming baths within the Borough. The water used in these baths is obtained from the Metropolitan Water Board mains and is recirculated and treated by filtration plants consisting of pressure filters, chlorination plants and, in some cases, aeration plants. The water in the baths is changed as often as necessary, depending on the amount of use. Samples of water from all these baths are taken at frequent intervals for both chemical and bacteriological examination. All samples taken during the year indicated that the water was suitable for bathing purposes. 21 Contributed by Mr.B.M.F.Dixon, Manager of Walthamstow Baths. Swimmers 166,923 Slipper Baths 79,341 O.A.P. (Free) " " 9,082 Steam Baths 1,564 O.A.P. " " 88 256,998 In 1964 the Baths received over a quarter of a million visits from people using the Baths' facilities. The pool water was sampled by the Medical Officer of Health with the routine high standard results in clarity and bacteriological purity. 1449 lessons were taken in the 'Learn to Swim' courses which have the proud record of 769 swimmers taught by qualified teachers since their inception in 1962. Six more of these courses will be held in 1965. Sewerage Arrangements for sewerage and sewage disposal in the district are adequate. Hairdressers Ninety-eight premises are registered under the Walthamstow Corporation Act 1956. Inspections of these premises were carried out under the Bye-Law requirements and most were found to be in a reasonable condition. Rent Act, 1957 This Act empowers the landlords of dwelling houses to increase rent provided the property is in good repair. On receipt of a notice of increased rent from the landlord, the tenant, if he considers that the property is not in good repair, must serve a notice on the landlord specifying the works he considers should be carried out. If the landlord does not carry out the works specified or does not give an undertaking to carry out the work within six weeks, the tenant may apply to the Council for a Certificate of Disrepair. This Certificate, if issued, will enable the tenant to deduct any increase already paid from the date of the application to the Council and he need not pay the increased rent demanded. If the landlord has not carried out the undertaking given by him to the tenant in six months following the date of the undertaking, the tenant is again entitled to make a deduction in his rent. If he desires a certificate stating that the undertaking has not been remedied, he may apply to the Council for same. This Certificate is also used when the landlord makes application to the Council stating that he has carried out the undertaking. There are twenty-one forms specified by the Act for use between landlord and tenant; the Council may be involved in thirteen of these. 22 Housing Act, 1957, Section 81 Applications for "permitted number" were received from landlords and certificates issued during the year respecting 10 lettings. Local Land Charges Enquiries relating to outstanding sanitary notices were dealt with in 2,314 cases. Clearance Areas The Council are purchasing large numbers of dwelling houses which are included in the 1960-65 slum clearance programme. When all the dwellings in a proposed clearance area have been purchased by the Council, the tenants will be rehoused, the dwellings demolished and the site redeveloped. Milk Supplies During the year 72 samples of milk were taken and submitted to the Counties Laboratories for bacteriological examination, including Phosphatase, Methylene Blue and Turbidity Tests. These samples of milk were mainly taken from roundsmen during the course of delivery, or on arrival at schools. They include monthly sampling from one dairy. During the year the Milk (Special Designations) Regulations, 1963 came into force which revoked the Regulations of 1960. As all milk now provided in the country is tuberculin tested, raw milk will in future be designated "untreated", the designation tuberculin tested no longer in use. All milk sold in the Borough must be either untreated, pasteurised or sterilised. Ice Cream During the year one manufacturer ceased business and at the end of the year there were four left on the register. Samples of ice cream are taken for both chemical and bacteriological examination. Those taken for chemical examination complied with the legal requirements for fat content etc. and samples taken for bacteriological examination were mostly of a high standard. Seven samples of ice lollies were taken for bacteriological examination and were satisfactory. Where reports showed that any of these samples were unsatisfactory, the manufacturer was informed and further check samples were taken as soon as possible. If the manufacturer was outside the district, copies of the reports were sent to the local authority of the district where the article was manufactured. 23 Meat and Other Foods There is no slaughterhouse in operation in the Borough. A considerable amount of various types of food was inspected, a certain quantity of which was condemned as unfit for human consumption. Sampling of Food for Bacteriological Examination Various types of food were sampled including cooked meats, cream, corned beef and meat pies. Most of these samples were found to be in a satisfactory condition although some improvement could be effected in the case of cooked meats. Food and Drugs Act, 1955 During the year, 97 samples were submitted to the Public Analysts for chemical examination. Chemical and Bacteriological Examination of Foods Chemical examinations of food samples are carried out by the Public Analysts, Dr. J.H.Hamence, F.R.I.C. and Mr. P. S.Hall, A.R.I. C., of 20, Eastcheap, London, E.C.3. and bacteriological examinations by the Counties Public Health Laboratories, Thresh House, Verulam Street, Gray's Inn Road, London, W.C.1. Food Hygiene (General) Regulations, 1960 A reasonably high standard continues to be maintained in the food premises within the Borough. It was found necessary to serve notices under the Regulations in a few cases, most of which had been complied with by the end of the year. The conditions laid down in the Regulations are being maintained throughout the district. One dairy in the area is registered under the Milk and Dairies Regulations. Condemned food is destroyed at the Council's Depot. The only exception to this is where sufficient meat is condemned and is worth salvaging, and it is then disposed of through reliable sources, being used mainly for soap manufacture. Legal Proceedings The following action was taken during 1964:Food and Drugs Act. 1955 Selling milk not of quality demanded. Absolute Discharge. Costs £5.5.0. Selling food contrary to Act. (Mould on crumpets) Case dismissed. 24 ouldy sausages Fine £5.0.0. Costs £2. 2.0. Cigarette in loaf of bread Fine £20.0.0. Costs £2. 2.0. Mouldy apple turnover Fine £2.0.0. Costs £1.1.0. Maggots in bacon pieces Fine £2.0.0. Costs £3. 0. 0. Mould on steak and kidney Conditional discharge for 12 months. Costs £3.3.0. Part of cigarette in loaf Fine £2.0.0. Costs £1.1.0. Part of insect in loaf of bread Fine £2.0.0. Costs £3.3.0. Food Hygiene (General) Regulations, 1960 Smoking where there was open food Case dismissed Failing to keep overalls clean Pine £1.0.0. Costs 10.6. Common Lodging Houses There is no common lodging house in the area. Rag Flock and Other Filling Materials Act, 1951 No applications for approval were received during the year and all premises registered or licensed under the Act were inspected. Diseases of Animals Acts Swine Fever (Infected Areas) Order, 1953 No licences were issued during the year. Fowl Pest Order, 1936 No Orders were issued during the year. Foot and Mouth Disease Orders No Orders were issued during the year. Pet Animals Act, 1951 Sixteen premises are licensed in the Borough for the sale of pet animals. All licenses are renewed annually and all premises were inspected during the year. Prevention of Damage by Pests Act, 1949 The agreed scheme of work has continued and the two trained Operatives have been fully engaged under the general supervision of the Public Health Inspectors. 25 Offices, Shops and Railway Premises Act, 1963 This Act became operative during the year and 647 premises were registered during the year. Due to shortage of staff it was only possible to inspect one of these premises. Many more inspections will be carried out next year. E. STATISTICS Public Health Inspection of the Area No.of inspections made No.of nuisances remedied No.of complaints received No.of Intimation Notices No. of Statutory Notices Total Visits Served Compiied with Served Complied with 18,710 1,066 2,575 302 305* 79 105* 23,712 * Includes notices outstanding from previous year. The following table shows the nature of work executed and improve ments effected during the year- Drains tested, 32; drains reconstructed or repaired, 156; drain obstructions removed, 67; drains, means of access provided, 29; drains, ventilation provided or improved, 8; soil pipes renewed or repaired, 46; rainwater pipes repaired or renewed, 44; roofs repaired or renewed, 175; gutterings repaired or renewed, 142; W.C.pans and traps provided, 70; W.C.s repaired or cleansed, 65; gully traps provided, 38; waste pipes repaired or renewed, 53; stoves and firegrates repaired or renewed, 7; water supply reinstated, 21; yard and forecourt pavings repaired, 62; dirty houses cleansed, 9; dirty rooms cleans, 50; floors repaired, 75; ventilation under floors provided or improved, 15; dampness remedied, 220; offensive accumulations removed, 19; manholes repaired or resealed, 64; miscellaneous repairs, 702; animals improperly kept, 47. Infectious Diseases Visits to premises, 6. Disinfections Rooms disinfected, 14; articles disinfected, 4,851, articles destroyed, 22. 26 Special Premises Number Visits paid Factories (a) Non-power 56 11 (b) Power 485 98 (c) Other premises 20 15 Outworkers 337 131 Butchers 80 89 Bakers and Shops 45 47 Fishmongers, Fryers and Curers 46 35 Cafes and Caterers 89 69 Grocers 219 205 Greengrocers 77 57 Ice Cream Manufacturers 4 24 Ice Cream Vendors 419 48 Dairies 1 9 Milksellers 143 5 Ladies' Hairdressers 68 13 Gentlemen's Hairdressers 51 12 School kitchens 26 31 Schools 59 16 Street stalls 121 69 Public Houses 38 27 Rag Dealers – – Caravans 4 6 As a result of the-regular periodical visiting of the above premises, the following works were carried out:- Butchers Cleansings, 3; floors repaired and ventilated, 1; accumulations removed, 2; light and ventilation improved, 1; other improvements, 2. Bakers Cleansings, 2. F i shmon/je rs Cleansings, 2; other improvements, 2. Cafes and Cat ere rs Cleansings, 4; floors repaired, 1; other improvements, 2. Grocers Store rooms cleansed, 3; other improvements, 6. Greengroce rs Store rooms cleansed, 2; washing accommodation improved, 1; other improvements, 3. Hairdressers Special cleansing, 1. 27 Public Houses Cleansings, 2. Street Traders Stalls improved, 1; store rooms improved, 1. Smoke Abatement Readings from atmospheric pollution instruments for the year are as follows: (the figures given are in milligrams of sulphur per day) Jan. Feb. Mar. April May June Sir George Monoux Grammar School 3.6 2.6 2.2 1.8 1.0 0.94 Willow Walk site 2.6 2.3 2. 1 1.7 0.85 0.75 Woodford County High School 2.0 1.7 1.5 1.0 0.53 0.53 Blackhorse Lane Site 3.3 2.4 2.1 2.0 1.3 0.94 July Aug. Sept. Oct. Nov. Dec. Sir George Monoux Grammar School 0.86 0.85 0.92 1.9 2.3 2.6 Willow Walk site 0.72 0.52 0.79 1.5 1.7 2.2 Woodford County High School 0.57 0.50 0.63 1.1 2.1 1.6 Blackhorse Lane site 0.74 0.77 0.90 1.9 2.2 2.1 Rent Act, 1957 The following action was taken under the Act during 1984:Part I - Applications for Certificates of Disrepair (1) Number of applications for certificates 14 (2) Number of decisions not to issue certificates 6 (3) Number of decisions to issue certificates (a) in respect of some but not all defects 1 (b) in respect of all defects 7 (4) Number of undertakings given by landlords under paragraph 5 of the First Schedule 4 (5) Number of undertakings refused by local authority under proviso to paragraph 5 of the First Schedule – (6) Number of certificates issued 7 Part II - Applications for Cancellation of Certificates (7) Number of applications by landlords to Local Authority for cancellation of certificates 15 (8) Number of objections by tenants to cancellation of certificates 5 (9) Number of decisions by Local Authority to cancel in spite of tenant's objection 3 (10) Number of certificates cancelled by Local Authority 13 In addition to the above, 6 applications were received from landlords and tenants for certificates as to remedying, or failing to remedy, the defects set out on the undertaking given by the landlord, and all applications were granted. 28 Housing Inspections I. Inspection of dwelling houses during the year:– (1) (a) Total number of dwelling houses inspected for housing defects (under the Public Health or Housing Acts) 1,236 (b) Number of inspections made for the purpose 3,781 (2) (a) Number of dwelling houses (included under sub-head (1) above) which are inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 19 (b) Number of inspections made for the purpose 16 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation (N.B. These comprise individual unfit houses) 1 (4) Number of dwelling houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 291 II. Unfit houses closed:- (1) Under Sections 16(4), 17(1) and 35(1), Housing Act, 1957 4 (2) Under Sections 17(3) and 26, Housing Act, 1957 (3) Parts of buildings closed under Section 18, Housing Act, 1957 1 III. Unfit houses made fit and houses in which defects were remedied:– (1) After informal action by Local Authority 395* (2) After formal notice under (a) Public Health Acts 105 (b) Sections 9 and 16, Housing Act, 1957 – (3) Under Section 24, Housing Act, 1957 – * including those notices outstanding from previous years. Inspection and Supervision of Food Details of Milk Samples taken: Grade No. of Samples Results. Satisafty. Unaatiafty. Pasteurised 71 71 – Sterilised 1 1 – Totals 72 72 – 29 Milk (Special Pesijnations) Regulations, 1960 As from the 1st January, 1961 these Regulations brought into force new forms of licences and period of duration. The following licences are in operation to 31st December, 1965. Pasteurisers' Licences 1 Dealers' Licences: Tuberculin Tested 1 Dealers' Pre-packed Milk Licences: Sterilised 128 Pasteurised 88 Tuberculin Tested 29 There are no cow-keepers in the district. The number of Retail Milk Distributors is 143. Fourteen visits were paid to registered premises and a satisfactory standard of cleanliness was maintained. Ice Cream Seven applications for registration were received and dealt with as follows:- Vendors, New 4 Vendors, Transfers 7 Number on Register at end of year 423 Number of premises used for manufacturing 4 Food St andards (Ice Cream) Regulations 1959 Six samples of ice cream were taken and submitted to the Public Analysts. Five of these samples were satisfactory, the sixth was unsatisfactory and a warning letter was sent to the manufacturer. Bacteriological Examination of Ice Cream Forty-four samples were submitted for examination and for grading in accordance with the provisional test of the Ministry of Health, with the following results:- Grade 1-20 Grade II-13 Grade III-5 Grade IV-4 Lollies (various) Seven samples were examined for bacterial purity and were satisfactory. Meat and Other Foods There is no slaughterhouse in the Borough. 30 The following is a summary of food surrendered and condemned as being unfit for human consumption. Where possible, the food was salvaged. 267 tins Milk 47 tins Cream 549 tins Soup 279 tins Strained foods 64 tins Steak 2 tins Pork Luncheon Meat 1 tin Minced Beef 2 tins Tongue 3 tins Irish Stew 15 tins Meat Pudding 6 tins Steak and Kidney Pie 23 tins Sausage and Beans 87 tins Rice Pudding 19 tins Macaroni 11 tins Ravioli 1 tin Cheese Flaps 50 tins Spaghetti 3 tins Egg Custard 804 tins Vegetables (various) 352 tins Fish 882 tins Fruit (various) 14 tins Fruit Juice 9 tins Sponge Puddings 8 tins Syrup 5 pkts.Rice 45 pkts.Meat Pies 20 pkts.Beef 82 pkts.Beefburgers 51 pkts.Sausages 17 pkts. Chops 3 pkts.Offal 4 pkts.Chicken 539 pkts.Vegetables (various) 3 pkts. Strawberries 257 pkts. Fish (various) 5 pkts. Pastry 14 pkts. Biscuits 10 pkts. Cereals 15 pkts. Mousse 3 pkts. Jellies 7 pkts. Eclairs 163 lbs. Pork 277 lbs. Beef 62 lbs. Lamb 14 lbs. Rabbit 138 lbs. Chicken 260 lbs. Ham 549 lbs. Luncheon Meat 380 lbs. Corned Beef 96 lbs. Jellied Veal 483 lbs. Fish 5 lbs. Sausages 224 lbs. Butter Beans 26 cwts. Potatoes 13 lbs. Fruit Pie Filling 5 lbs. Chocolate 26 lbs. Cornflour 4 jars Salad Cream 5 jars Sandwich Spread 3 jars Pickles 1 jar Jam 24 bots. Sauce 2 bots. Fruit cordial 56 Ice Lollies 58 Ice Creams 3 Cream Sponges Cooked Meats Sampling of these products continued during 1964, fifty-nine samples being taken. Twenty-eight were classified as unsatisfactory because of bacteriological contamination which occurred during storage and exposure for sale. Miscellaneous Samples Sixteen samples of various foods were taken for bacteriological examination, fourteen of which were satisfactory. Appropriate action was taken in respect of the unsatisfactory samples, one being a jellied eel and the other a sample of mousse. 31 Adulteration, etc.-Food and Drugs Act. 1955 During the year, ninety seven samples of food and drugs were submitted to the Public Analysts. Seven samples were reported as being unsatisfactory, details respecting same are given below:- Description of Articles Result of Analysis Action taken Kosher Milk Ice Deficient milk solids by 2.2% Warning letter Bread and butter Mixture of butter and margarine Legal proceedings Pork Sausages ) Beef " ) Contained preservatives (sulphur dioxide) within prescribed limit but no declaration of same Warning letter Rhubarb (tinned) Foreign matter - mould growth Warning letter Cream doughnut with buttercream Artificial cream used Warning letter Bread Contained blackish pellet - charred dough Warning letter Food Hygiene (General) Regulations, 1960 The following food premises are established in the Borough:- Butchers, 80; Bakers, 45; Fishmongers, 46; Cafes and Caterers, 89; Grocers, 219; Greengrocers, 77; Dairies, 1; Milksellers, 143; Ice Cream Manufacturers, 4; Ice Cream Vendors, 419. The following inspections were carried out in respect of food premises:- Butchers, 89; Bakers, 47; Fishmongers, 35; Cafes and Caterers, 69; Grocers, 205; Greengrocers, 57; Dairies, 9; Milksellers, 5; Ice Cream Manufacturers, 24; Ice Cream Vendors, 48. Factories Act, 1961 The following tables show the work carried out under the above Act. 1 - INSPECTIONS Premises Number on Register Number of Inspections Written notices Occupiers prosecuted (1) (2) (3) (4) (5) (i) Factories in which Sections 1, 2,3,4 and 6 are to be enforced by Local Authorities 56 11 1 – (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 485 98 1 – (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) 20 15 1 – Totals 561 124 3 – 32 2 - Cases in which DEFECTS were found Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted Pound Remedied Referred To H.M. Inspector By H.M. Inspector (1) (2) (3) (4) (5) (6) Want of cleanliness (S. 1) 6 5 – – – Overcrowding (S.2) – – – – – Unreasonable temperature (S.3) – – – – – Inadequate ventilation (S.4) – – – – – Ineffective drainage of floors (S.6) – – – – – Sanitary Conveniences (S.7) (a) Insufficient – – – – – (b) Unsuitable or defective 8 5 – – 1 (c) Not separate for sexes 1 2 – – 1 Other offences against the Act (not including offences relating to Outwork) 7 7 – – – Totals 22 19 – – 3 NUMBER AND TRADES OF OUTWORKERS NOTIFIED Wearing Apparel (making of) 238 Household linen 2 Curtains and furniture hangings 1 Furniture and upholstery 1 File making 2 Umbrellas, etc 3 Artificial flowers 7 The making of boxes or other receptacles or parts thereof made wholly or partially of paper 17 Brush making 10 Stuffed toys 17 Cosaques, Christmas stockings 37 Lampshades 2 Total 337 33 Prevention of Damage by Pests Act, 1949 Type of Property Non-Agricultural (5) Agricultural (1) Local Authority (2) Dwel1ing Houses(inc. Council Houses) (3) All other ( including Business Premises) (4) Total of Cola.(l) (2) & (3) I. Number of properties in Local Authority's District 13 34,625 6,574 41,212 3 II. Total number of properties inspected as a result of notification 3 294 59 356 – Number of such properties found to be infested by:– Common rat Major – – – – – Minor 3 232 53 288 – Ship rat Major – – – – – Minor – – – – – House mouse Major – – – – – Minor – 31 4 35 – III. Total number of properties inspected in the course of survey under the Act 3 180 85 267 – Number of such properties found to be infested by: - Common rat Major - – – – – Minor 2 142 48 192 – Ship rat Major - – – – – Minor - – – – – House mouse Major - – – – – Minor - 22 8 30 – IV. Total number of properties otherwise inspected (e.g. when visited primarily for some other purpose) – 77 34 111 –– Number of such properties found to be infested by:- Common rat Major – – – – – Minor – 42 22 64 – Ship rat Major – – – – – Minor – – – – – House mouse Major – – – – – Minor – 8 6 14 – V. Total inspections carried out including reinspections 78 2,964 326 3,368 – 34  Type of Property Non-Agricultural (5) Agriculture. (1) Local Authority (2) Dwel1ing Houses(inc. Counci1 Houses) (3) All other (including Business Premises) (4) Total of Cols.(l) (2) A (3) VI. Number of infested properties (in Sections II,III & IV) treated by the L. A. 5 477 141 623 VII. Total treatments carried out including retreatments 42 2,440 440 2,922 VIII. Number of notices served under Section 4 of the Act: (a) Treatment – – – – – (b) Structural Work (i.e. Proofing) – – – – – IX. Number of cases in which default action was taken following the issue of a notice under Section 4 of the Act – – – – – X. Legal Proceedings– – – – – – XI. Number of "Block* control schemes carried out – – – – – 35 SECTION F NATIONAL HEALTH SERVICE ACT, 1946 PART III SERVICES WALTHAMSTOW HEALTH AREA SUB-COMMITTEE 1964/1965 Chairman: Councillor Mrs. E.L. BALDWIN (Waltharastow Borough Council). Vice-Chairman: Councillor P. FURBER, J.P. (Walthamstow Borough Council). MEMBERS: Representing:- Essex County Council: Alderman K.E.B. GLENNY, O.B.E., J.P., (Chairman,County Health Committee) Alderman H.J.E. PALETHORPE Councillor Mrs. M.J. HARVEY Councillor Mrs. J.L. LOCK Alderman Mrs. S.M. BOVILL, (Vice-Chairman,County Health Committee) Councillor W.J. BOWSTEAD, J.P. Councillor Mrs. A.E. WELSH Walthamstow Borough Council: Alderman Mrs. W.M. PALETHORPE, J.P. Councillor R.J.L. CAVE Councillor L.V. GRAHAM Councillor J.H. HAMMOND Councillor A.M. O'REILLY Councillor Mrs.B.M. REYNOLDS Councillor C.G. ABLEY Councillor Mrs. R. COLIN Councillor Mrs. L.D. GURR, J.P. Councillor J.E. NICHOLIV5 Councillor P.A.J. O'SHEA Councillor P.S. WATTS Councillor D. WEINSTEIN Executive Council for Essex: Mr. J.W.R. NATION Forest Group Hospital Management Committee: Mrs. B.E. BOTTOMLEY, J.P. Local Medical Committee for Essex: Dr. W.R. JOHN Voluntary Organisations: Mrs. M. BROWN Miss A. WOOLGAR Mr. E.P. MARR Mrs. W.E. POWELL 36 WALTHAMSTOW HEALTH AREA STAFF Area Medical Officer: M. WATKINS, M.R.C.S. , L.R.C.P. , D.P.H. Assistant County Medical Officers: G.H.G. POOLE, M.B., B. S., D. (Obst.) R.C.O.G. , D.P.H. MISS C. DOOLEY, L.R.C.P. & S.I. MRS. M. EDWARDS, M. B., Ch. B., D.C.H. (Part-time) MISS J. NEWMAN, M. B., Ch.B. , D. R.C.O.G., D.C.H. (Part-time) MISS J. WERREN, M. B. , B.S. . D. (Obst. ) R.C.O.G., D.C.H. Chief Administrative Assistant: F.J. AYLWARD Superintendent Health Visitor: MISS C. OLDHAM, S.R.N. , S. C. M. , H. V. Cert. Super in t endent of Home Nurses and Non-Medical Supervisor of Midvives: MISS N. CHADWICK, S.R.N., S.C.M., H.V.Cert.. Q.N. Senior Dent a I Officer: G.P.L. TAYLOR, L. D. S.. R.C.S. Chief Chiropodist: R.J. KING, M.Ch.S. 37 NATIONAL HEALTH SERVICE ACT (PART III) SERVICES The Local Health Authority functions under the National Health Service Act are administered by the Walthamstow Health Area Subcommittee on behalf of the County Health Committee (Essex County Council). Details are given in statistical form on pages 46 - 62. Section 21 HEALTH CENTRES In my Report for 1963 I referred to the construction of new premises in Hurst Road, Walthamstow and outlined the services and clinics which would be accommodated therein. Work on the site commenced during September 1964 and it is anticipated that the building operations will be completed during November 1965. Plans have also been formulated during 1964 for the provision of a Health Services Clinic in Handsworth Avenue, Highams Park, which will replace the existing Clinic accommodation provided nearby in a converted building constructed during the last war for the use of A.R.P. personnel. This new Clinic, as designed at present, will be integrated with a housing development scheme prepared by the Walthamstow Borough Council which is intended to provide a number of flats and maisonettes on a site secured by the clearance of some large, old houses and a small disused factory. The Clinic is scheduled for erection during 1965. Redecoratlon and Improvements to Premises Pursuing the policy of phased programmes of annual improvements, internal or external redecorations were carried out during 1964 to various premises under the control of the Health Area Sub-Committee. In addition the following special works were completed: Day Nurseries At both Nurseries an extension of the existing buildings was constructed by means of thermal blocks to provide a small room suitable for the preparation of milk meals for young children. The Handsworth Avenue Nursery was also equipped with a gas-fired boiler to replace the worn out coke boiler and part of the verandah at this Nursery was enclosed to provide storage space. General Dental Service There is little change to report from the previous year. The statistical summary on page 46 of this report shows a slight reduction in the number of sessions for the year but the amount of work per session remains the same. 38 In April 1965 the dental staff employed on General Dental Service work will be leaving the Essex Executive Council and coming under the authority of the new North East London Executive Council. The staff look forward to establishing the same happy relationship that has always been enjoyed with the Essex Executive Council. Section 22 CARE OF MOTHERS AND YOUNG CHILDREN Priority Dental Service The statistical details of patients inspected and treated during the year are given on page 49 of this Report. The figures indicate an increase in the number of fillings for pre-school children, but more could be done if only mothers would take full advantage of the facilities offered for their children. It is to be hoped that increased dental health education will bring more requests for treatment. Section 23 MIDWIFERY During the year one full-time midwife retired, and another resigned her appointment to take up district nursing elsewhere. It was possible to recruit a replacement midwife immediately with the result that the total staff now employed is 6 whole-time midwives and 3 district nurse/midwives. A further whole-time midwife will shortly take up her appointment to complete the establishment. In view of the continuing National shortage of practising midwives the local situation is very satisfactory. The number of home deliveries was 538 and there were 293 48-hour hospital discharges, representing increases of 30 and 17 respectively compared with 1963. Twenty pupil midwives from Thorpe Coombe Maternity Hospital undertook their district midwifery training at the Nurses Home and all passed the examination. The district midwives attended lectures given at Thorpe Coombe on the use of the new drug Syntometrine and it has now been made available for use. Disposable gloves and mucous extractors have been supplied and this has contributed to an all round improvement in the standard of equipment provided. It is gratifying to be able to report that there exists an excellent relationship and close liaison between the doctors and district midwives in Walthamstow. 39 Section 24 HEALTH VISITING Current emphasis to improve still further the health services and the contribution which can be made by the Local Health Authority, has been based on closer liaison with general practitioners and hospitals, and expansion of the Health Education programme. The functions of the Health Visiting Service in Walthamstow are carried out by seventeen health visitors, three of whom are part-time, and over the years it has been necessary to make good the shortage of qualified health visitors by employing five State Registered Nurses on certain clinic duties. In this situation it has not been easy to meet the modern challenge, but despite the difficulties mentioned a considerable degree of success has been achieved. Some aspects of the work carried out in 1964 are mentioned below: - Liaison with General Practitioners Seven weekly morning or afternoon sessions are held at which doctors and health visitors work together in a combined effort to deal both medically and socially with cases where help is needed. In many instances this arrangement proves how important it is to have this close link at local level. Liai son with Hospitals For many years weekly contact with local geriatric and paediatric hospital units has been established, resulting in requests by various departments for approximately 300 home visits during 1964. This service has now been extended to Claybury Psychiatric Hospital by agreement with Dr. Pippard, Consultant Psychiatrist. Already much benefit has been derived from this contact. The health visitor is able to play a very important part in the prevention of mental ill-health in her unique role as a family visitor. Expansion of the Health Education Programme Apart from the considerable amount of individual health education, which incidentally is one of the most effective forms, we have managed to extend the number of sessions devoted to talks and discussions in schools. These cover senior girls in seven Secondary Modern departments and two Grammar schools. Added to this, talks have been given by request to youth organisations and clubs, young wives groups and professional bodies on a wide variety of subjects. Time spent on preparation of education material is often lengthy and much of this work is done out of duty hours. This extra-mural work carried out by the health visiting staff in addition to work in the clinics and homes of the local population is greatly appreciated. 40 As with other towns, problems arise as a result of the constantly fluctuating immigrant population. Although numbers are not large in Walthamstow, inadequate housing and the language barrier together with financial difficulties causes concern from time to time. This report would not be complete without reference to the many local voluntary organisations whose assistance and augmentation of the health services in Walthamstow is greatly valued and appreciated. Section 25 HOME NURSING The services of the district nurses are in great demand as a result of the rapid turnover of patients discharged from hospital and continued requests for services to the elderly. As a result of another Joint Study Day and Conference at East Ham in April on similar lines to the 1963 arrangements, the knowledge gained enabled the district nurses to give more teaching in rehabilitation to patients under their care, and this in turn encouraged more family co-operation. It now appears easier, where the need is great to admit urgent cases to Langthorne Hospital for treatment. The six weeks'in-and-out' scheme is proving very successful. There has also been a closer liaison and co-operation between the hospitals, doctors and Public Health workers, and more detailed information has been given about treatment for patients being discharged from hospital through direct contact with the ward sister, to the benefit of the district nurse and patient concerned. Social Act ivi ties A summer outing to Jaywick was arranged last June for 37 ambulant patients, the money being raised by a Jumble Sale. Although the weather proved inclement the outing was successful, and many requests were received for a similar trip in 1965. This activity provided a focal point for the personal side of the service, and was a stimulating subject of conversation between nurses, patients and relatives for months before and after the outing. A further Jumble Sale was held in October last, a special feature including a stall held by teenagers. As a result 50 Christmas parcels were distributed by the nurses to all needy patients at Christmas. The nurses, midwives and pupil midwives regularly assist on National Flag Days. 41 Section 26 VACCINATION AND IMMUNISATION Arrangements for protection of children against Diphtheria, Whooping Cough, Tetanus, Smallpox and Poliomyelitis continued on the lines referred to in previous Reports. Section 28 PREVENTION OF ILLNESS CARE AND AFTER CARE Chiropody This report for the year 1964 will be the last dealing with the Chiropody service as administered by the Essex County Council through the Walthamstow Health Area Sub-Committee. The Chiropody service was commenced by the Walthamstow Borough Council in September, 1931, and was transferred to the County Council in July 1948. From the 1st April, 1965, the provision of the service will be a function of the London Borough of Waltham Forest. The Chiropody service in Walthamstow was one of the very early services in the country, and the many recipients of the service undoubtedly have been pleased to see the provision of Chiropody in the Borough continuing throughout the various phases of Local Government reorganisation. The service will continue to be provided, of course, after the 1st April next. During 1964, the number of treatments to Clinic patients increased from 19,820 to 22,044. This was despite a drop in the number of domiciliary visits which occurred as a result of the resignation of one part-time Chiropodist, and the prolonged absence of another following an accident on the way to work. Treatments to children amounted to 2,070, and this figure is included in the total referred to above. Section 29 DOMESTIC HELP SERVICE Throughout 1964 the pattern of the Service has remained consistent with other years with a heavier demand during the first quarter, probably owing to the amount of sickness amongst the aged. The number of maternity cases helped has not varied significantly in comparison with the previous year, but the hours of service given to this category indicates a slight decrease in demand. Requests for the night attendance service in 1964 were similar in number to 1963. Help was usually for one or two nights' duration only, owing to termination either by removal to hospital or death. The number of domestic helps has decreased during the year, several left after quite short periods and there have been fewer applicants. There also remains the difficulty of providing week-end Service because of lack of volunteers. Nevertheless we have continued to cover every urgent need. 42 CHELMSFORD DIOCESAN MORAL WELFARE ASSOCIATION The 'Carville' Home at 43 West Avenue Road, Walthamstow, is a Home for unmarried mothers and their babies and is administered by the Walthamstow Deanery Branch of the above Association. The Home provides accommodation for a total of 16 mothers and their babies. Miss M.H. Ward, Superintendent of the Home, contributes the following details:- "The age of the residents continued to rise. We had no fourteen or fifteen year olds and only three aged sixteen during 1964. The ages of 70% of the residents ranged between seventeen and twenty one years. "The length of stay is more flexible, but we still prefer the " expectants" to be admitted six weeks before the expected date of confinement. "Out of fifty five babies admitted during the year only nineteen were placed for adoption, the rest being fostered at the grandparent* s home or in a job with the mother. Two were admitted to the Dr. Barnardo's Homes. "We still have a quota of "Old Girls" keeping in touch. One in particular, now living in Italy, never forgets us at Easter and Christmas. "The relaxation classes continue to be appreciated by the expectant mothers and we are indebted to the area health visitor for her unfailing kindness. "The table below summarises the Indoor Work for 1964:- Admitted Adults Babies Total From Walthamstow 8 5 13 From rest of County 56 45 101 From Outside County 3 5 8 Totals 67 55 122 WALTHAMSTOW CHEST CLINIC Dr. H. Ramsay, Consultant Chest Physician, has contributed the following:- New Notifications Respiratory 47 Non-Respiratory 15 This is a reduction of three compared with 1963. The main reduction has been in the group of respiratory cases which is down by eight, while the non-respiratory cases have been increased by five. 43 Last year a statement was included on the Pakistani group in the area, and again they have provided a substantial number of the total i.e. Respiratory 12 Non-Respiratory 6 Other groups of immigrants together have produced three respiratory cases, and two non-respiratory cases. Thus immigrant groups taken as a whole have produced 23 cases out of the total of 62. It is encouraging to note that the total number of cases has diminished but the number of cases among immigrants is again seen to be very substantial. There is an increased interest in this problem, and the Government are beginning to make efforts to try and control the situation. I did not mention the carcinoma figures in my report last year. This is, of course, one of the major problems in chest diseases at the present time. The total for the Walthamstow area was:- 1963 1964 Males 27 47 Females 7 6 Children – – WALTHAMSTOW, CHINGFORD AND LEYTON CHEST CARE ASSOCIATION Miss A. Woolgar, Honorary Case Secretary of the Walthamstow, Chingford and Leyton Chest Care Association reports as follows:- " As indicated in the Report for 1963, the former Walthamstow and Chingford Association of Tuberculosis Care Helpers joined forces with the Leyton Tuberculosis Care Association and as from April 1st, 1964 the two organisations cajne together under their new title. "The work has, in general, followed the usual pattern, patients being assisted on the recommendation of the Chest Clinic staff in any way which would contribute to their well-being and where possible, their return to employment. "The following gives some indication of the means by which such assistance has been given:- Tuberculous Patient s Non-Tuberculous Patilent.s Grocery 21 5 Fares to visit 4 5 Rent, rates, debts 14 10 Bedding, clothing 25 12 Holiday expenses 4 3 Fuel 37 15 Christmas grants 98 32 44 "Many other minor grants were made to cover such items as shoe repairs, health service charges, radio licences etc. and as always, we have had the close co-operation of other local voluntary and statutory agencies. "For many years we have enjoyed a very happy and helpful relationship with the staff of the local Health Department and are pleased to take this opportunity of expressing our appreciation of their help, and with it the hope that within the new London Borough of Waltham Forest the present friendly liaison may continue." 45 COUNTY COUNCIL OF ESSEX - WELFARE COMMITTEE RESIDENTIAL AND WELFARE SERVICES Mr. W.E. Boyce, County Welfare Officer has kindly prepared the following table and expanatory notes:- Extent to which services provided in 1964. Number of Walthamstow residents in accommodation provided under Section 21 (1) (b) National Assistance Act, 1948. Number admitted to residential accommodation during 1964. (including Voluntary Homes) Number admitted to temporary accommodation under Section 21 (1) (b) National Assistance Act, 1948. Blind Persons, etc. Other Classes of Handicapped Persons Registered Registered Number employed in- Blind Partially sighted Defective sighted Workshops Home Workers' Scheme Open Industry Male Female Total Male Female Women Children 61 119 180 10 19 7 23 196 52 25 3 5 25 326 The above table indicates the extent to which the various services provided by the County Council under the provisions of the National Assistance Act, 1948, have been afforded in 1964 to persons having residence in the Borough of Walthamstow. The provision or residential accommodation for aged persons continues to be developed; at the present time the County Council has three aged persons' homes in Walthamstow, which accommodate a total of 165 residents. Welfare services are available for blind and handicapped persons in a variety of ways, these include home visitation by specialised field workers, tuition in handicrafts, recreational and holiday facilities and, especially for the handicapped person, the supply of home aids, gadgets and hoists and, in addition, the Committee give financial aid towards the cost of structural alterations designed to assist the handicapped person in overcoming his disability. There is also a local occupational centre for physically handicapped persons and, on average, 60 persons attend daily. 46 STATISTICAL SUMMARY Section 21 Health Service Clinics Low Hall Lane, E.17 (Opened in 1929) Higham Hill Priory Court, E.17 (Opened in 1959) Silverdale Road, Highams Park, E.4. (Adapted for Clinic purposes 1948) West Avenue, E.17 (Opened as Health Services Clinic in 1949) General Dental Service No. of sessions 393 Appointments made 2,334 kept 2,029 Plastic fillings 174) Amalgam fillings 805) Inlays 1 Crowns 2 Scalings and gum treatments 259 Dressings 211 Extractions 189 General anaesthetics 13 Local anaesthetics 274 X-rays 422 Impressions 403 Bites 85 Try-ins 171 Pull upper dentures 71) ^ Full lower dentures 59) Partial upper dentures 22) dentures Partial lower dentures 10) Repairs 39 Orthodontic Appliances 4 Dental Laboratory Dentures Repairs Relinea Remakes Appliances Crowna s General Dental Service 129 102 11 12 . 2 2 Walthamstow Committee for Education 29 15 – 2 89 16 1 Leyton Committee for Education 43 8 – – 45 7 – Forest Divisional Executive Committee for Education 9 2 – – 35 – – Maternity and Child Welfare Patients 3 - – – – 1 – 47 Section 22 CARE OF MOTHERS AND YOUNG CHILDREN Notification of Births Domici1iary Institutional Live Still Live Still Notified births which occurred in the Area 544 2 2,016 25 Birth notifications transferred out to places outside the Area 1 – 1,088 17 Birth notifications transferred in from places outside the Area 2 – 364 9 Care of premature infants (Weighing 5½lb. or under) Born at Home 20 Born in Hospital or Nursing Home 69 Ante Natal and Post Natal attendances (Local Authority Clinics) Ante Natal Post Natal New Patients - Low Hall Lane Clinic 28 5 Silverdale Road Clinic – – West Avenue Clinic – – District Nurses Training Home and Midwives' sessions held at Ante-Natal Clinics 648 – Totals 676 5 Total Attendances - Low Hall Lane Clinic 45 5 Silverdale Road Clinic – – West Avenue Clinic – – District Nurses Training Home and Midwives' sessions held at Ante-Natal Clinics 2,070 – Totals 2,115 5 48 Orthopaedic and Physiotherapy Clinic (Children under School Age) New cases seen by Orthopaedic Surgeon 35 Re-attendances 68 Children treated 9 Children attending for aftercare 13 Children attending for U. V.L 1 Paediatrlc Clinic (Children under School Age) New cases - Heart Disease 7 Genite Urinary 11 Nervous System 2 Developmental 8 Speech 1 Gastro — Intestinal 2 Total 31 Total attendances 48 49 Dental Clinics Patients inspected and treated during the year. Expectant and Nursing Mothers Children under school age Patients examined 25 74 Patients found to require treatment 23 65 Patients who have commenced treatment 21 70 Patients who have completed treatment 8 30 Attendance for treatment 110 116 Types of Treatment Given Extractions- (a) Permanent teeth 19 — (b) Temporary teeth - 70 Fillings- (a) Permanent teeth 73 — (b) Temporary teeth - 32 Crowns and Inlays provided 3 - Anaesthetics administered- (a) Local - - (b) General (i) by Medical Offrs. - - (ii) by Dental Offrs. 3 42 Scalings and gum treatment 13 - Silver nitrate treatment - 82 Dressings 16 5 Radiographs 30 - Dentures provided- (a) Full 1 - (b) Partial 3 - Dentures repaired — - Dentures remade- (a) Full — - (b) Partial — — Orthodontic appliances- (a) Fixed — - (b) Movable — — Prophylactic treatment and other operations 46 13 50 MATERNITY AND CHILD WELFARE CLINIC ATTENDANCES Higham Hi11 and Priory Court Low Hall Lane Silverdale Road West Avenue Winchester Road 'Brookscroft' (Voluntary Scheme) TOTALS CHILD WELFARE CENTRES- No. of sessions held by (a) Medical Officers 99 150 53 104 52 81 539 (b) Health Visitors 2 3 52 — — 24 81 Children attending for the first time 1964 271 205 66 235 103 279 1,159 in the year who were born in 1963 271 74 44 245 70 67 771 1962 83 57 17 39 36 102 334 1961 55 29 14 33 17 68 216 1960 16 18 10 5 11 25 85 1959 23 6 5 2 7 10 53 1958 — — 1 — — 1 2 TOTALS: 719 389 157 559 244 552 2,620 Total Attendances 6,712 6,173 2,215 5,335 3,378 6,390 30,203 No. of children seen by Medical Officer 1,423 2,232 532 1,736 755 673 7,351 ANTE-NATAL AND POST-NATAL CLINICS- No. of sessions held — 13 — — — — 13 Patients attending for the first time in the year (a) Ante-Natal — 28 — — — — 28 (b) Post-Natal — 5 — — — — 5 Total Attendances(a) For ante-natal examination — 45 — — — — 45 (b) For post-natal examination — 5 — — — — 5 ANTE-NATAL MOTHERCRAFT AND RELAXATION CLASSESNo. of classes held 14 44 49 32 5 — 144 Patients attending for the first time in the year 8 64 59 15 — — 146 Total Attendances 22 247 342 62 29 — 702 51 WELFARE FOODS DISTRIBUTION CENTRE National Dried Milk (Tins) Cod Liver Oil (Bottles) Vitamin Tablets (Packets) Orange Juice (Bottles) Brookscroft Welfare Centre 1,792 387 378 3,524 Low Hall Lane Health Services Clinic 1,997 311 304 2,526 Northcott House Distribution Centre 7,374 369 714 7,755 Higham Hill and Priory Court Health Services Clinic 2,627 331 341 3,695 Silverdale Road Health Services Clinic 1,064 235 211 4,218 West Avenue Health Services Clinic 2,532 317 268 4,044 Winchester Road Infant Welfare Centre 1,065 188 183 2,592 General Practitioner's Surgery 369 43 34 713 TOTAL issues at Distribution Centres 18,820 2. 181 2,433 29,067 In addition the following were issued to:- Hospitals (National Health Service) 1,323 — 6 Day Nurseries — 108 — 540 GRAND TOTAL OF ISSUES 20,143 2,289 2,433 29,613 Nutrients and Medicaments Sales Free Issue lbs. ozs. lbs. ozs. Adexolin — — 14 4 Bemax 77 — — — Cow and Gate 8,548 — — — Farex 991 4 — — Glucodin 57 12 — — Lactagol 12 8 — — Maltoline with Iron — — 2 8 Marmite 227 — — — Milk of Magnesia — — 4 8 Mist Ferri et Ammon.Cit.Pro. Infantibus — — 5 12 Ostermilk 6,439 — — — Robinson's Ready Cook Groats 464 — — — Scott's Twin Pack' 515 8 — — Virol 491 3 — — Trufood 260 — — — S.M.A 1,502 — — — Rose Hip Syrup 21,595 Bottles — — Iron Tablets — — 5,040 Tablets Multivite Tablets — — 3,000 Tablets Value of Cash Sales £4,764. 4s. 5d. 52 Convalescence No applications were received during the year in respect of mothers and young children. Day Nurseries There are two day nurseries in the Borough approved for training purposes each having accommodation for 60 children aged 0-5 years. HIGHAM HILL HANDSWORTH AVE TOTAL 0-2 yrs 2-5 yrs 0-2 yrs 2-5 yrs 0-2 yrs 2-5 yrs Number of approved places at end of year 20 40 20 40 40 80 Number of children on register at end of year 14 48 15 49 29 97 Total attendances during year 3,248 9,475 3,844 9,824 7,092 19,299 Average attendances 12.7 37.0 15.0 38.4 27.7 75.4 49.7 53.4 103.1 Number of days open 256 256 — Training Number of Students who gained certificate of National Nursery Examination Board 9 Daily Guardian Scheme No. of Guardians on Register at end of year 18 No. of applications for services of Daily Guardian 59 Referred to Day Nurseries 37 Referred to Daily Guardian but nothing further heard 15 Placed with Daily Guardian 7 Continued in care of Daily Guardian from previous years 1 53 PROGRAMME OF CLINICS HELD AT DATE OF PUBLICATION MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY Town Hall A.M. Dental Chiropody Orthoptic Minor Ailment Ophthalmic (2nd & 4th) Dental Chiropody (Schoolchildren) Optician Dental Chiropody Ophthalmic (1st,3rd & 5th) Orthoptic Minor Ailment Dental Chiropody Paediatric (1st & 3rd) Dental Chiropody Orthodontic Minor Ailment Dental Ophthalmic (2nd & 4th) Optician (2nd & 4th) Minor Ailment P.M. Dental Chiropody Ear, Nose & Throat Ophthalmic (1st,3rd & 5th) Orthoptic Dental Chiropody Ophthalmic Optician Orthoptic Dental Chiropody Immunisation & Vaccination Orthoptic Dental Chiropody Ophthalmic Optician Dental Chiropody Ophthalmic Orthodontic Optician Evening Chiropody General Dental Service Chiropody Chiropody General Dental Service Chiropody Orthodontic Silverdale Road A. M. Chiropody Minor Ailment Chiropody (Schoolchildren) Dental Chiropody Toddlers Clinic Chiropody Chiropody Dental P.M. Infant Welfare Chiropody Dental Midwives Ante Natal Clinic Chiropody Dental Infant Welfare Dental Relaxation & Mothercraft Class Chiropody Dental Evening Chiropody Chiropody Higham Hill and Priory Court A.M. Chiropody Dental Dental Chiropody (Schoolchildren) Dental Chiropody Chiropody Dental Chiropody Dental Dental P.M. Dental Chiropody Infant Welfare Dental Chiropody Toddlers Clinic Dental Midwives Ante Natal Clinic Chiropody Infant Welfare Chiropody Dental Relaxation & Mothercraft Class Dental Evening Chiropody Chiropody Low Hall Lane A.M. Chiropody Chiropody (Schoolchildren) Chiropody Minor Ailment Chiropody Chiropody P.M. Infant Welfare Chiropody Relaxation & Mothercraft class Infant Welfare Chiropody Ante Natal/ Post Natal Chiropody Infant Welfare Chiropody Evening Chiropody Chiropody Chiropody Chiropody West Avenue A.M. Chiropody Dental Dental Chiropody (Schoolchildren) Dental Chiropody Dental Chiropody Dental Chiropody P.M. Chiropody Dental Infant Welfare Dental Relaxation & Mothercraft Class Chiropody Dental Infant Welfare Dental Toddlers Clinic Dental Evening Chiropody Chiropody Winchester Road P.M. Infant Welfare District Nurses Training Home, Carisbrooke Road P.M. Midwives Ante Natal Clinic Midwives Ante Natal Clinic Midwives Ante Natal Clinic Old Monoux School, High Street Speech Therapy and Child Guidance Consultations daily (morning and afternoon) From Monday to Friday Orthopaedic Clinic, Wingfield House School, Hale End Road Speech Therapy and Massage and Treatment-sessions daily (morning and afternoon) From Monday to Friday Walthamstow Child Welfare Society, (Voluntary Society) Brookscroft Forest Road P.M. Massage Remedial Exercises and Sunlight Treatment Weighing Clinic & Immunisation Infant Welfare Massage Remedial Exercises and Sunlight Treatment 54 Section 23 MIDWIFERY Cases attended by Council Midwives MIDWIFERY Domiciliary confinements attended under N.H.S. arrangements where (a) a doctor was not booked 10 (b) a doctor was booked 533 Cases delivered in hospital and other institutions but discharged and attended before tenth day 278 Miscarriages attended 4 New cases booked 648 Cases on the books at the end of the period 235 Medical aid notices issued 8 Visits paid (as midwife) (a) Ante-natal 2,709 (b) Nursing 5,758 (c) Other post-natal 198 Total visits 8,665 ADMINISTRATION OF ANALGESICS Cases in which Gas and Air was administered 446 Cases in which Trilene was administered 21 Cases in which Pethidine or a related compound was administered 337 CLINIC SESSIONS Number of sessions attended (a) Medical Officer's clinics 8 (b) General practitioner's clinics 426 (c) Midwife's clinics 289 Number of ante-natal examinations by the midwife (a) Medical Officer's clinics 17 (b) General practitioner's clinics 2,534 (c) Midwife's clinics 2,070 Number of women attending midwife's clinics who had not previously attended any ante-natal clinic in the current year 741 55 Place of Confinement During the year, Walthamstow Mothers were confined as follows:- Forest Gate Hospital 21 Mother's (Salvation Army) Hospital, Clapton 162 North Middlesex Hospital, Edmonton 12 Paistow Maternity Hospital 36 Thorpe Coombe Maternity Hospital 920 Wanstead Hospital 43 Other Hospitals or Nursing Homes 98 Total 1,292 At Home: Essex County Council Midwife present 541 Domiciliary confinements out of Essex 2 Total Confined 1,838 Section 24 HEALTH VISITING During the year the Health Visitors made 21,792 visits to homes:- HEALTH VISITING Cases visited for the first time in the current year (a) children born in 1958 60 " " " 1959 924 " " " 1960 1,639 " " " 1961 1,317 " " " 1962 1,537 " " " 1963 1,541 " " " 1964 1,876 (b) persons aged 65 or over 1,619 (c) others (excluding school nursing cases) 1,008 Number included in item (2) (a) mentally disordered persons 80 (b) persons discharged from hospital (other than mental hospitals) 86 (c) tuberculosis households 15 (d) households visited on account of other infectious diseases 25 Number included in item (2) and where appropriate item (3) who were visited at the special request of a G.P. or hospital (a) persons aged 65 or over 192 (b) mentally disordered persons 31 (c) persons discharged from hospital (other than mental hospitals) 44 56 Total number of effective visits to (a) children under 5 years of age 13,233 (b) persons aged 65 or over 2,467 (c) others (excluding school nursing cases) 2,316 Total effective visits 18,016 Total number of ineffective visits to (a) children under 5 years of age 2,799 (b) persons aged 65 or over 645 (c) others (excluding school nursing cases) 332 Total ineffective visits 3,776 Sessions attended at G.P.'s surgeries (included above) 232½ Visits of inspection to tuberculosis shelters — SESSIONS WORKED Number of sessions (half days) devoted to (a) Health visiting 3,283¼ (b) Child welfare centres 1,361 (c) Ante-natal, post-natal, relaxation 284½ (d) School clinics 113 (e) Other school nursing 310½ (f) Health education (including mothercraft) 253¼ (g) Other work (including clerical) 1,594¾ Total sessions 7,200¼ Section 25 HOME NURSING Cases visited for the first time in the year (a) Aged under 5 at 1st visit in year 84 (b) Aged 5 and under 65 at 1st visit in year 385 (c) Aged 65 or over at 1st visit in year 1,186 Total cases 1,655 Visits made to cases (a) Aged under 5 at 1st visit in year 302 (b) Aged 5 and under 65 at 1st visit in year 10,234 (c) Aged 65 or over at 1st visit in year 47,541 Total visits 58,077 Cases on the books at the end of the year 253 57 Section 26 VACCINATION AND IMMUNISATION The following tables give details of prophylactic treatment carried out during the year by General Practitioners and Local Health Authority Staff. Disease Protective Course Age at date of Immunisation or Vaccination Under 1 yr 1-4 yrs 5-9 yrs 10-15 yrs 15 yrs & over Diphtheria Primary 1,455 387 157 7 — Reinforcing 23 1,063 781 32 — Whooping Cough Primary 1,439 341 24 5 — Reinforcing 20 814 146 18 — Tetanus Primary 1,451 472 1,011 71 — Reinforcing 23 960 309 27 — Smallpox Primary 54 622 18 97 Reinforcing — 14 22 304 Type of Vaccine used Immunisations or Vaccinations completed by General Practitioners Immunisations or Vaccinations completed by County Staff Primary Course Re in forcing doses Primary Course Reinforcing doses Diphtheria, Whooping Cough and Tetanus combined 1,080 644 723 354 Diphtheria and Tetanus combined 18 135 163 140 Diphtheria only 13 138 27 470 Whooping Cough only 6 — — — Tetanus only 168 38 853 8 Poliomyelitis: (a) Salk 214 326 9 19 (b) Sabin 846 321 872 1,413 Smallpox 544 313 245 29 58 Poliomyelitis Vaccination Category Number of persona vaccinated Salk Vaccine (2 doses) Sabin Vaccine (3 doses) Children born in 1964 69 251 " " " 1963 96 886 " " " 1962 13 137 " " " 1961 3 66 " " " years 1943/60 18 305 Persons born in years 1933/42 18 44 Persons born before 1933 who were under 40 year and 'special' groups 6 29 Totals 223 1,718 Reinforcing doses 2,079 B.C.G. Vaccination Category Number skin tested Result of Heaf Test Vaccinated with B.C.G. Tuberculin Positive Tuberculin Negative School children 1,255 149 1,106 1,106 Students attending further education establishments — — — — Totals 1,255 149 1,106 1,106 Section 28 PREVENTION OF ILLNESS, CARE AND AFTER CARE Chiropody New cases during year Cases being treated at end of year Clinic attendances during year Domici1iary treatments during year Pre-school children 4 1 8 — School children 432 235 2,070 — Expectant Mothers — — — — Physically handicapped 4 4 21 — Aged (over 65 years of age) 373 1,647 8,083 891* Others 597 2,898 10,971 — Total 1,410 4,785 21,153 891 *Including 219 at Welfare Committee's Establishments 59 Tuberculosis Home Visits and Clinics attended Tuberculosis Visitors Health Visitors Total of 'Tuberculous' households at end of year 1,026 — Visits to 'Tuberculous' households during the year (excluding non-access visits) 1,438 15 Attendance at Chest Clinic sessions during the year 466 — Extra Nourishment Number of cases during year supplied with free milk 26 Total number being supplied free milk at end of year 82 Rehabi1itation Number of cases receiving rehabilitation treatment for whom financial responsibility accepted Nil Loan of Sick Room Equipment Number of articles on loan at end of year which had been on loan for:- (a) under 1 year 81 (b) 1 and under 2 years 65 (c) 2 and under 3 years 72 (d) 5 years and over 11 Total 229 Convalescence for Adults Number of applications during year 67 Length of stay: Twelve days 1 Thirteen days 1 Two weeks 39 Three weeks 2 Four weeks 1 Of the 67 applications received, recuperative holidays were arranged and accepted by 44 of the patients. 60 The reasons for the cancellations are given in the following summary:- Patient made private arrangements 3 Patient not fit at date of admission 3 Assessment forms not returned 14 Patient refused arrangements made 3 Health Education Teaching to groups by Departmental Staff No. of Sessions Total Attendances (a) Clinic, Welfare Centres, Relaxation Classes 144 702 (b) School 165 3,290 (c) Professional Organisations 28½ Unknown (d) Parent/Youth/General Adult Group 6 162 (e) Others 41 696 Total 384½ 4,850 Number of film shows given at sessions referred to above 84 Exhibits Staged 52 Section 29 DOMESTIC HELP Visits by Domestic Help Organisers Domestic Help Service Night Attendance Service First visits to homes: 651 15 Re-Visits to homes: (a) Help/Attendant present 348 — (b) Help/Attendant not present 3,141 13 Miscellaneous visits: (a) Help/Attendant seen 212 — (b) Others 54 — 61 Help provided Category TOTAL 'A' 'B 'C' 'D' Aged 65 and over Maternity Chronic Sick under 65 Others under 65 Requests for help from new cases during the year 413 91 66 62 632 Cases not eligible, or not requiring Assistance 70 12 6 21 109 New cases helped during the year 343 79 60 41 523 Total cases completed during the year 485 81 72 47 685 Cases being helped at end of the year 919 — 88 4 1,011 Total cases helped during the year 4, 131 88 419 64 4,702 Hours of help provided during the year 156,338 2,199 13,557¾ 842¼ 272,937 Notes (1) All cases 65 years of age or over are included in category A. (2) Expectant mothers and those debilitated or incapacitated as a direct result of confinement are included in category B. (3) Tuberculosis cases under 65 years- are included in category C. Analysis of cases of mental disorder, and other cases Included under Category 'D' in previous table New cases helped Cases completed Cases being helped at end of year Mental disorder 65 years and over (see note) — — — Mental disorder under 65 years (see note) — — — Help for harassed mothers 1 1 — Problem family (see note) — — — Absence of mother 7 9 3 Acute Illness 32 36 13 Others 1 1 1 Notes (1) Mental disorder includes all cases where help is given as a direct result of mental illness or mental subnormality in a family. Cases 65 years of age or over are included in category A and those under 65 years in category D. Hours of help (included above) provided for cases of mental disorder (i) 65 years or over Nil (ii) under 65 years Nil 62 Night Attendance Service Seriously ill patients residing alone Inability of aged husband or wife to care for seriously ill patients at night Relief of relatives who have to give routine night attention to sick people TOTAL Requests for help from new cases during year 2 1 10 13 New cases helped during year 2 1 10 13 Cases helped earlier in present year reopened during year — — — — Total cases completed during year (a) 2 1 9 12 Cases being helped at end of year (b) — — 1 1 Total cases helped during year i.e. total of (a) and (b) 2 1 13 16 Hours of attendance provided during year 30 50 715½ 795½ MEDICAL EXAMINATION OF STAFF Category No. of medical examinations County Council employees: (a) Entrants to County Council's service 246 (b) Retirement on Superannuation 1 Walthamstow Borough Council employees 349 Entrants to teaching profession and training colleges 94 Others 9 Total 699 ???